Key result
Metformin and SGLT2i may lower AF risk in diabetes while insulin is linked to higher risk.
Why the study?
Despite extensive epidemiological evidence linking diabetes mellitus and atrial fibrillation, the underlying mechanisms and the influence of glucose-lowering therapies on AF susceptibility remain incompletely defined.
How do different glucose-lowering drugs impact the risk of atrial fibrillation in patients with diabetes mellitus?
Design
Narrative review
Authors
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Should not yet change prescribing in diabetes; leaves open confirmation of AF risk reduction with metformin or SGLT2 inhibitors versus insulin in prospective trials.
How do different glucose-lowering drugs impact the risk of atrial fibrillation in patients with diabetes mellitus?
Glucose-lowering therapies have heterogeneous effects on atrial fibrillation risk in diabetic patients, with metformin and SGLT-2 inhibitors showing favorable or neutral profiles compared to the increased risk associated with insulin.
Grigore et al. (2025) studied this question. Metformin and SGLT-2 inhibitors may have favorable effects on atrial fibrillation risk in diabetes, while insulin therapy is associated with higher risk.
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