Clinical and epidemiological aspects of atrial fibrillation and/or atrial flutter in patients with diabetes mellitus: a cross-sectional retrospective population-based study

BACKGROUND: Diabetes mellitus (DM), atrial fibrillation (AF), and atrial flutter (AFL) are among the most prevalent cardiovascular disorders, with their incidence steadily increasing worldwide. The coexistence of DM with AF or AFL is associated with a more severe disease course and a less favorable prognosis compared with each condition occurring independently. AIM: To analyze current clinical and epidemiological aspects of atrial fibrillation (AF) and atrial flutter (AFL) in patients with diabetes mellitus, including sex- and age-related characteristics, distribution by subtype, and the relationship between diabetes mellitus and outcomes after radiofrequency catheter ablation. METHODS: A retrospective analysis of medical records was performed for patients hospitalized in the cardiology department of the National Medical Research Center for Endocrinology named after Academician I.I. Dedov (Moscow, Russia) between January 1, 2017, and October 30, 2025. RESULTS: Among the analyzed discharge summaries, 218 patients (24.9%) had type 2 diabetes mellitus. Of these patients, 30.7% had paroxysmal AF, 22.5% persistent AF, 15.1% persistent AF combined with AFL, 12.8% persistent AFL, 12.4% paroxysmal AF combined with AFL, and 6.5% paroxysmal AFL. Comparative analysis of patient groups with and without diabetes mellitus did not demonstrate convincing evidence of an effect of impaired carbohydrate metabolism on the outcomes of radiofrequency catheter ablation. CONCLUSION: This study clearly demonstrates the prevalence of diabetes mellitus among patients with AF and AFL and identifies criteria for further investigation of the impact of diabetes mellitus on the outcomes and progression of AF. Further study of this issue is required.