Conduction disturbances in Type 1 and Type 2 Diabetes in two large independent nationwide and international databases

Type 1 (T1D) and type 2 diabetes (T2D) are associated with increased cardiovascular risk, but limited data exist on their independent association with conduction disturbances. We evaluated the association between diabetes and conduction disorders, comparing T1D and T2D populations with non-diabetic controls in two independent databases.

Observational study using two large databases with matched cohorts: the French PMSI and the international TriNetX network. PMSI captures nationwide hospital admissions in France, while TriNetX includes patients from over 120 healthcare organizations worldwide. We identified > 440,000 patients with T2D from PMSI and > 900,000 patients with T2D and > 20,000 patients with T1D from TriNetX. Using 1:1 propensity score matching, these patients were matched to non-diabetic controls based on demographics and comorbidities RESULTS: Compared to no DM, T2D was associated with a higher risk of conduction disturbances, including atrioventricular block (HR 1.22 [1.19-1.25], PMSI; HR 1.50 [1.45-1.55], TriNetX), left bundle branch block (BBB), (HR 1.12 [1.08-1.17], PMSI; HR 1.50 [1.47-1.54], TriNetX), and right BBB (HR 1.14 [1.09-1.18], PMSI; HR 1.38 [1.34-1.43], TriNetX). Patients with T2D also had a higher risk of myocardial infarction (HR 1.29 [1.25-1.32], PMSI; HR 2.14 [2.08-2.19], TriNetX). Conversely, T1D was not associated with an increased risk of conduction disorders in the TriNetX cohort.

T2D is independently associated with conduction disturbances and a higher incidence of coronary events compared to no DM, whereas T1D does not appear to confer the same risk. This suggests distinct pathophysiological mechanisms and the possible need for enhanced monitoring in T2D patients.