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June 7, 2026Diabetes

Adults with type 2 diabetes and obesity face a ~8% rate of incident AF.

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Why the study?

T2D and obesity are independent AF risk factors with obesity accounting for up to one-fifth of cases, motivating quantification of AF incidence and cumulative burden in this population.

Population

8,166,278 adults with coexisting obesity and T2D without prior AF

Design

Retrospective RWE cohort study

Follow-up

Up to 84 months

Key result

Among 8,166,278 adults with type 2 diabetes and obesity, 7.8% developed incident atrial fibrillation, corresponding to an incidence rate of 1.886 per 100 patient-years.

Authors

PRPIERANTONIO RUSSORNRamaa NathanWJWEI JIE

Discussion

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Member takes

Overview

High AF incidence in T2D with obesity supports screening consideration; leaves open prospective validation of benefit.

Key Points

  • To quantify the incidence and cumulative burden of atrial fibrillation (AF) in adults with type 2 diabetes and obesity.
  • Conducted a retrospective real-world evidence cohort study using Symphony administrative claims data (2018-2025).
  • Identified adults with obesity and type 2 diabetes with ≥12 months of continuous enrollment and no prior AF.
  • Calculated AF rates and cumulative incidence using Kaplan-Meier methods and analyzed risk using multivariable Cox regression.
  • Among 8,166,278 adults, 635,233 (7.8%) developed AF, with an incidence rate of 1.886 per 100 patient-years (95% CI 1.881-1.891).
  • Cumulative AF incidence increased from 1.5% at 6 months to 12.9% by 84 months.
  • Post-AF mortality risks were significantly higher for individuals aged ≥75 years (HR 2.84) and those with heart failure (HR 2.20).

Study Design

Type

Cohort (n=8,166,278)

Structured PICO

P
Population
8,166,278 adults (mean age 67 years, 46% female) with coexisting type 2 diabetes and obesity and no prior atrial fibrillation, followed for up to 84 months.
O
Outcome
Incident AF rates (per 100 patient-years) and cumulative AF incidencehard clinical

In a large cohort of over 8 million adults with type 2 diabetes and obesity, the incidence of atrial fibrillation was high (1.886 per 100 patient-years), supporting the need for targeted AF screening.

Cite This Study

RUSSO et al. (2026) conducted a cohort in Type 2 diabetes and obesity (n=8,166,278). Type 2 diabetes and obesity was evaluated on incident AF (95% CI 1.881-1.891). Among 8,166,278 adults with type 2 diabetes and obesity, 7.8% developed incident atrial fibrillation, corresponding to an incidence rate of 1.886 per 100 patient-years.

synapsesocial.com/papers/6a250b707def13d035e1b63dhttps://doi.org/10.2337/db26-2960-lb
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