People with atrial fibrillation and diabetes less likely to notice symptoms of arrhythmia

People with diabetes are less likely than those without diabetes to recognise the common symptoms of atrial fibrillation (AF), according to a study published in the Journal of the American Heart Association.

The study, which used data from more than 2,400 AF patients in Switzerland, also found that adults with diabetes and AF were more likely to have a lower quality of life and experienced more coexisting health conditions than people with AF without diabetes.

Adults with diabetes and atrial fibrillation were more likely to have a lower quality of life

Of the 2,411 participants (who were predominantly male with an average age of 74) about 17% were diagnosed with diabetes. The participants were then categorised as having either insulin-dependent diabetes or non-insulin dependent diabetes, both of which included people with type 1 and type 2 diabetes.

The researchers then compared AF symptoms, quality of life outcomes, cardiac comorbidities and neurological comorbidities among participants with and without diabetes in order to determine how diabetes may affect AF patients.

They found that AF patients with diabetes were about 25% less likely than those without diabetes to recognise common symptoms of AF (such as a rapid heartbeat), and that people with diabetes were three times more likely than those without diabetes to have high blood pressure; 55% more likely to have had heart attacks; and about twice as likely to have heart failure.

People with diabetes also had a 39% increased stroke risk and were 75% more likely to have cognitive impairment. These factors were shown to negatively impact quality of life as they can affect mobility and the ability to perform self-care and other normal activities.

Older diabetes patients should be routinely screened for atrial fibrillation

Study author Tobias Reichlin, M.D., professor of cardiology at Bern University Hospital, Switzerland, said the team thought it was important to investigate the topic since diabetes is one of the major risk factors for AF.

“It is remarkable to find that patients with diabetes had a reduced recognition of atrial fibrillation symptoms. The reduced perception of atrial fibrillation symptoms may result in a delayed diagnosis of atrial fibrillation, and, consequently, more complications such as stroke,” he said.

Prakash Deedwania, M.D., a member of the scientific advisory board for Know Diabetes By Heart (KDBH), and a professor of medicine at the University of California, San Francisco School of Medicine said the findings indicate that patients with diabetes should be routinely screened for AF.

“With the serious consequences of failing to recognize AFib in time, it seems prudent to consider screening older patients with diabetes for AFib so that treatment may be initiated when appropriate,” she explains.

The authors acknowledge there are limitations to the research and say future studies among larger, more diverse populations of people are now needed to confirm these findings.