Type 1 Diabetes Raises the Risk of Atrial Fibrillation in Women

Women with type 1 diabetes (T1D) face a 50% greater risk for atrial fibrillation (AF) than the public at large, a study from Sweden has found.

Overall, the risk of AF, an irregular and often rapid heartbeat, increased in type 1 diabetic patients who had renal complications and poor glycemic control. Men had a slightly elevated AF risk when compared with the general population, according to findings published Aug. 21 in The Lancet Diabetes and Endocrinology. Atrial fibrillation increases the risk of stroke, heart failure and other heart-related complications.

Marcus Lind (pictured), PhD, and a team from NU Hospital Group in Uddevalla and the University of Gothenburg, set out to investigate possible associations between AF and T1D.

“Acute myocardial infarctions and heart failure are more common in persons with type 1 diabetes than in the general population,” Lind said. “It was of interest to evaluate whether atrial fibrillation is associated to type 1 diabetes, especially since it has not earlier been evaluated in population-based studies.”

Lind and his associates matched 36258 patients who had type 1 diabetes to 179980 nondiabetic individuals in a control group. During a follow-up period of about 10 years, 749 patients (2%) and 2882 controls (2%) were diagnosed with AF.

The researchers adjusted for comorbidities, diabetes duration, education level and birth place. They found that the risk for atrial fibrillation was 1.13 for men and 1.5 for women compared with the controls. The excess AF risk increased with worsening glycemic control and renal complications, the researchers said.

“Persons who had no renal complications had, in principle, no excess risk of AF,” Lind said. When comparing the sexes, the study showed that a man with type 1 diabetes actually has a higher risk for AF than a woman at the same age, Lind said.

“However, the excess risk of AF is higher for women if we compare with men/women in the general population,” he said. Why is that the case? More research is required to find the answer.

Lind stressed that the excess AF risk in persons with T1D was relatively low when compared to myocardial infarctions and heart failure. Like all cardiovascular conditions, these heart ailments are rare at young ages and mainly appear in older adults, he said.

“If good glucose control can be sustained, there are great chances to avoid renal complications and hence avoid an increased AF risk,” he said. “Moreover, AF is easy to screen for. The treatments are improving and AF can often be cured, meaning reverting the heart rhythm back to normal.”