Diabetes Mellitus

Diabetes mellitus (DM) is a chronic metabolic disease characterized by hyperglycaemia resulting from impaired insulin secretion, impaired insulin action, or both.

DM is present in 25% of patients with atrial fibrillation (AF).

Chronic hyperglycaemia causes myocardial and atrial fibrosis. Atrial dilatation and remodelling occur, thereby creating a substrate for AF.

Illustration depicting diabetes mellitus as a significant risk factor for atrial fibrillation with an ECG recording of the arrhythmia.

Diabetes Mellitus
Definition Diabetes mellitus is a chronic metabolic disease characterized by hyperglycaemia resulting from impaired insulin secretion, impaired insulin action, or both.
Symptoms Polyuria (frequent urination) Polydipsia (increased thirst) Fatigue Visual impairment Delayed wound healing Neuropathy (tingling and numbness of the lower limbs) Recurrent urinary tract infections Pruritus Weight loss (in type 1 DM)
Diagnosis Fasting plasma glucose (after 8 hours) >7 mmol/l HbA1c (glycated haemoglobin) >6.5 % Random plasma glucose >11 mmol/l

Diabetes Mellitus and Atrial Fibrillation	Class
Adequate glycaemic control in patients with diabetes mellitus reduces the incidence and improves the clinical course of AF and reduces the risk of cardiovascular disease.	I
Preferred pharmacological treatment of diabetes mellitus in patients with AF should include: SGLT2 inhibitors or metformin.	IIa