Diabetes mellitus and atrial fibrillation-Untying the Gordian Knot

Diabetes mellitus (DM) as the most common metabolic disease is considered to be the epidemic of the 21st century. Despite the ubiquitous “healthy lifestyle” trend in the society, the level of physical activity leaves much to be desired, not to mention a rational, balanced diet. Hence, it is currently estimated that by 2045 the number of patients with DM will increase to approx. 693 million, that is, by almost 30% compared to the current population of people suffering from this disease. In cardiology, an analogous example of a disease entity that is becoming an epidemic is atrial fibrillation (AF). It is the most common arrhythmia in clinical practice and is one of the main causes of disability and deterioration of the quality of life due to cardiovascular reasons. While the likelihood of AF increases with age as the global population ages, it is estimated that this arrhythmia will occur in as many as 6-12 million Americans by 2050 and 17.9 million Europeans by 2060. Numerous clinical trials and registries indicate a higher incidence of AF among patients with DM. The coexistence of both conditions is important from a clinical point of view, as it worsens the treatment outcomes for both diseases and is associated with either an increase in mortality or a rise in the number of strokes and hospitalization for both cardiological and internal reasons.