Učestalost atrijalne fibrilacije kod oboljelih od dijebetes melitusa tipa 2

Abstract

Goal: Diabetes mellitus type 2 is a metabolic syndrome with systemic disorders of carbohydrate metabolism, fat and protein due to the absolute or relative lack of biologically active insulin. Atrial fibrillation is characterized by high frequency excitation of atria, consequent asynchronous atrial contraction, and irregular ventricular excitation. Diabetes predisposes fibrillation through metabolic abnormalities, structural, electrical, electromechanical, and autonomic remodeling of atrias. The study had to examine the incidence of atrial fibrillation in type 2 diabetes mellitus patients and to investigate the effect of continuous anti-diabetic therapy on the frequency of atrial fibrillation. Materials and methods: The test was conducted from 01. 10. 2017 to 01.01.2019. 106 patients with type 2 diabetes mellitus were evaluated. The data were collected on the basis of history, available medical documentation, laboratory analyzes and electrocardiograms. Data processing is done using standard statistical methods. Results: The survey covered 10 (9%) men and 96 (91%) women. The age of the respondents was 30-44 years (5 subjects, 4.7%), 44-59 years (38 subjects, 35.8%), 60 years and more (63 respondents, 59.5%). The therapeutic modalities included metformin (24 subjects, 22.6%), metformin and insulin (35 subjects, 33%), insulin (8 subjects, 7.5%), metformin and sulfonylurea derivatives (39 subjects, 36.9%). Diabetes in subjects was up to 5 years (8 subjects, 7.5%), 5-10 years (26 subjects, 24.5%), 10-15 years (32 subjects, 30.2%), over 15 years (40 respondents, 37.8% ). A healthy electrocardiogram had 83 (78.3%) subjects, atrial fibrillation 21 (19.8%) subjects, other rhythm disorders 2 (1.9%) subjects. The frequency of fibrillation within the therapeutic modality was: metformin therapy, 1 (4.2%) subjects, metformin and insulin therapy, 9 (25.7%) subjects, insulin therapy, 3 (37.5%) subjects, metformin therapy and sulfonillureas 9 (20.5%) respondents. Conclusion: Type 2 diabetes mellitus patients have high incidence of atrial fibrillation (19.8%). Continuous metformin therapy results in statistically significantly lower incidence of atrial fibrillation compared to other therapeutic modalities (p <0.001). Early detection, metformin administration, and diet regimen can significantly reduce the incidence of atrial fibrillation in patients.