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People With Diabetes Less Likely to Spot Signs of Atrial Fibrillation

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People With Diabetes Less Likely to Spot Signs of Atrial Fibrillation

People with diabetes are less likely to notice signs and symptoms of atrial fibrillation — a dangerous type of heart arrhythmia (irregular heartbeat) — and more likely to experience serious complications of the condition, according to a new study published in the Journal of the American Heart Association.

At least 2.7 million people in the United States have atrial fibrillation, also known as Afib, according to a press release on the study. This type of arrhythmia increases the risk for blood clots, stroke, heart failure, and other cardiovascular problems. Diabetes (type 1 or type 2) — along with other common conditions like asthma and hyperthyroidism — are known to increase the risk for atrial fibrillation.

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A total of 2,411 participants, with an average age of about 74, were enrolled in the study at 14 different health care locations in Switzerland between 2014 and 2017. Each underwent a clinical exam at the time of enrollment, which included various blood tests, a cognitive assessment, and an electrocardiogram (ECG or EKG). An ECG is often used to help identify atrial fibrillation, along with other arrhythmias. About 17% of participants had diabetes (type 1 or type 2) at the time of enrollment. The researchers were interested in comparing traits of people with or without diabetes who were also found to have atrial fibrillation.

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Diabetes linked to inability to recognize symptoms of Afib

Perhaps surprisingly, the researchers found that having diabetes wasn’t linked to a meaningfully higher risk for persistent atrial fibrillation — people with diabetes were only 1% more likely to have the condition. But having diabetes was linked to an inability to recognize symptoms of atrial fibrillation — among participants with Afib, those with diabetes were 26% less likely to report noticing symptoms like a rapid heartbeat. People with diabetes were also found to be at greater risk for several other cardiovascular conditions, including high blood pressure (204% more likely), heart attack (55% more likely), heart failure (99% more likely), and stroke (39% more likely). Having diabetes was also found to raise the risk for cognitive impairment by 75%.

“It is remarkable to find that patients with diabetes had a reduced recognition of atrial fibrillation symptoms,” said study author Tobias Reichlin, MD, a professor of cardiology at Bern University Hospital in Switzerland, in the press release. “This research can provide insights on improving the management of atrial fibrillation and prevention of its complications.” For example, Reichlin noted, it’s possible that people with diabetes should be systematically screened for atrial fibrillation, since they appear less likely to notice symptoms that could lead to testing for Afib. And a delayed diagnosis of atrial fibrillation may account for at least some of the increased risk for stroke that people with diabetes experience overall.

The researchers mentioned some limitations to their study — first, that diabetes status was based on medical records rather than clinical measurements, which means that some participants could have had diabetes that wasn’t identified. There was also no data available on diabetes duration or blood glucose control, which could have had an effect on both the risk for atrial fibrillation and whether participants noticed its symptoms. Finally, it’s unclear whether the study’s findings would apply to populations outside Switzerland, which is far less diverse than countries like the United States, Canada, and Britain.

Want to learn more about protecting your heart? Read “Be Heart Smart: Know Your Numbers,” “Does Diabetes Hurt Your Heart?” “Fight Off Heart Disease With These Five Heart-Healthy Foods” and “Lower Your Risk of Heart Disease.”

Quinn Phillips

Quinn Phillips

Quinn Phillips on social media

A freelance health writer and editor based in Wisconsin, Phillips has a degree from Harvard University. He is a former Editorial Assistant for Diabetes Self-Management and has years of experience covering diabetes and related health conditions. Phillips writes on a variety of topics, but is especially interested in the intersection of health and public policy.

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