Diabetes as a risk factor for cardiac conduction defects: a review

Area of Science:

• Cardiology
• Endocrinology
• Public Health

Background:

• Diabetes mellitus (DM) is a growing global health concern, particularly in aging populations.
• DM is a significant risk factor for cardiovascular disease (CVD) and mortality.
• Coronary artery disease, cardiomyopathy, and left ventricular hypertrophy are established cardiovascular complications of DM.

Purpose of the Study:

• To review the current literature on the association between diabetes mellitus and cardiac conduction abnormalities.
• To raise awareness among clinicians about the increased prevalence of specific conduction blocks in diabetic patients.
• To explore potential underlying mechanisms, such as autonomic neuropathy or DM-associated CVD.

Main Methods:

• A comprehensive literature search was conducted using Medline, Google, and published books.
• References were reviewed for associations between cardiac conduction abnormalities (AV-block, bundle branch block [BBB], RBBB, LBBB, bifascicular block), autonomic neuropathy, and DM.
• Focus on non-randomized studies reporting prevalence data.

Main Results:

• Non-randomized studies suggest an increased prevalence of right bundle branch block (RBBB), bifascicular block, and high-degree atrioventricular (AV)-block in patients with DM.
• Left bundle branch block (LBBB) prevalence was not consistently reported as increased in DM patients.
• The association between DM and cardiac conduction abnormalities is often overlooked in clinical practice and reviews.

Conclusions:

• Diabetes mellitus is linked to a higher risk of specific cardiac conduction abnormalities, particularly RBBB and AV-block.
• The underlying causes of these conduction abnormalities in DM require further investigation.
• Increased clinical awareness and research are needed to address this underrecognized cardiovascular risk in diabetic patients.