Atrial Fibrillation and Diabetes Mellitus

trial fibrillation (AF) is the most common sustained arrhythmia worldwide and represents a major health burden affecting an estimated 33 million individuals and climbing. The development of AF is multifactorial in etiology with age, sex, genetics, race, and comorbid conditions such as smoking, obesity, and diabetes mellitus playing a role. 2 Diabetes mellitus affects 285 million lives globally; this number is projected to increase to 439 million people by 2030. oreover, the insulin resistance of diabetes mellitus also conveys increased thromboembolic risk through various means including induced hypercoagulability, endothelial dysfunction, and impaired fibrinolysis. Diabetes mellitus and AF are believed to share related mechanistic pathways for thrombosis. Findings from the Emerging Risk Factors Collaboration demonstrated that the adjusted hazard ratios for risk of stroke in patients with diabetes mellitus were 2.27 (95% CI, 1.95-2.65) for ischemic strokes and 1.56 (95% CI, 1.19-2.05) for hemorrhagic strokes. The risk of stroke and systemic arterial embolism (SSE) in diabetes mellitus coupled with the risk of thromboembolism in AF is a unique risk profile, one that has rightfully been the focus of several recent studies.