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Shared pathophysiological drivers include chronic inflammation, oxidative stress, atrial remodeling, autonomic dysfunction, advanced glycation end-products, and epicardial adiposity. Although AF management in diabetic patients remains challenging, guideline-directed anticoagulation, individualized rate and rhythm control, and newer antidiabetic therapies—especially SGLT2 inhibitors and GLP-1 receptor agonists—may improve AF outcomes. A comprehensive individualized strategy is essential to reduce morbidity and mortality.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/complex-interrelationship-and-therapeutic-advances-in-diabetic-patients-with-atrial-fibrillation/406207/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/complex-interrelationship-and-therapeutic-advances-in-diabetic-patients-with-atrial-fibrillation/406207.png","ImageObject",300,407,{"name":92,"@type":93},"Sarah ","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why do diabetes mellitus and atrial fibrillation often coexist?","Question",{"text":113,"@type":114},"They share mechanisms that promote AF development and deterioration, including chronic inflammation, oxidative stress, atrial remodeling, autonomic dysfunction, advanced glycation end-products, and epicardial adiposity.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How does diabetes affect atrial fibrillation outcomes?",{"text":118,"@type":114},"Diabetes increases the risk of new-onset AF, contributes to suboptimal arrhythmia control, and is linked to poor prognosis in patients with AF.",{"name":120,"@type":111,"acceptedAnswer":121},"What therapeutic advances are highlighted for diabetic patients with AF?",{"text":122,"@type":114},"The review emphasizes guideline-directed anticoagulation, tailored rate and rhythm control, and novel antidiabetic therapies such as SGLT2 inhibitors and glucagon-like peptide-1 receptor agonists to potentially improve AF outcomes.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},406207,1790695560,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146,"preview_page_count":4},962085320529,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","| W | J | C | World Journal of\u003Cbr>Cardiology |\n| --- | --- | --- | --- |\n\nSubmit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Cardiol 2025 December 26; 17(12): 114575  \nDOI: 10.4330/wjc.v17.i12.114575 ISSN 1949-8462 (online)  \nREVIEW  \nComplex interrelationship and therapeutic advances in diabetic patients with atrial fibrillation  \nAikaterini-Eleftheria Karanikola, Dimitrios Tsiachris, Nikos Argyriou, Michail Botis, Konstantinos Pamporis, Panagiotis Xydis, Christos Fragoulis, Athanasios Kordalis, Konstantinos Tsioufis  \nSpecialty type: Cardiac and cardiovascular systems  \nProvenance and peer review:  \nInvited article; Externally peer reviewed.  \nPeer-review model: Single blind  \nPeer-review report’s classification Scientific Quality: Grade A, Grade A  \nNovelty: Grade B, Grade B  \nCreativity or Innovation: Grade B, Grade B  \nScientific Significance: Grade B, Grade B  \nP-Reviewer: Mohammed Ali U, Senior Scientist, Ethiopia  \nReceived: September 24, 2025  \nRevised: October 8, 2025  \nAccepted: November 10, 2025  \nPublished online: December 26, 2025  \nProcessing time: 91 Days and 15.7 Hours  \nAikaterini-Eleftheria Karanikola, Dimitrios Tsiachris, Nikos Argyriou, Michail Botis, Konstantinos Pamporis, Panagiotis Xydis, Christos Fragoulis, Athanasios Kordalis, Konstantinos Tsioufis, First Department of Cardiology, National and Kapodistrian University of Athens,“Hippokration”General Hospital, Athens 11527, Greece  \nCorresponding author: Dimitrios Tsiachris, Assistant Professor, First Department of Cardiology, National and Kapodistrian University of Athens,“Hippokration” General Hospital, Vas. Sofias 114, Athens 11527, [Greece.](Greece. dtsiachris@yahoo.com)[ dtsiachris@yahoo.com](Greece. dtsiachris@yahoo.com)  \nAbstract  \nDiabetes mellitus and atrial fibrillation (AF) are two global epidemics that frequently coexist, with diabetes mellitus contributing to both an increased risk of new-onset AF and a worse prognosis. Pathophysiological mechanisms underlying this relationship include chronic inflammation, oxidative stress, atrial remodeling, autonomic dysfunction, advanced glycation end-products and epicardial adiposity. Management remains challenging; however, recent advances offer promise, including guideline-directed anticoagulation, tailored rate and rhythm control, and particularly, novel antidiabetic therapies, such as sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists, may improve AF outcomes. A comprehensive, individualized approach is essential to mitigate morbidity and mortality in this high-risk population.  \nKey Words: Diabetes mellitus; Atrial fibrillation; Arrhythmia; Atrial remodeling; Pathophysiology; Management  \n©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.  \nCore Tip: Diabetes and atrial fibrillation are closely related conditions that increase cardiovascular risk through shared mechanisms of metabolic dysfunction, inflammation and atrial remodeling. Their coexistence complicates treatment decisions, yet novel strategies are reshaping care. Beyond optimized anticoagulation and rhythm control, emerging antidiabetic agents show promise in improving outcomes. This comprehensive review highlights current evidence, evolving therapies and the need for individualized management to reduce the burden of morbidity and mortality in this population.  \n WJC  [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 26, 2025  Volume 17  Issue 12   \nKaranikola AE et al. Mechanisms and treatment of diabetes and AF  \nCitation: Karanikola AE, Tsiachris D, Argyriou N, Botis M, Pamporis K, Xydis P, Fragoulis C, Kordalis A, Tsioufis K. Complex interrelationship and therapeutic advances in diabetic patients with atrial fibrillation. World J Cardiol 2025; 17(12): 114575  \nURL: [https://www.wjgnet.com/1949-8462/full/v17/i12/114575.htm](https://www.wjgnet.com/1949-8462/full/v17/i12/114575.htm)  \nDOI: [https://dx.doi.org/10.43","cbCaic5EupRgN1Mu","https://ap.wps.com/l/cbCaic5EupRgN1Mu","pdf",901803,17,"English","# Abstract\n# Core Tip\n# Introduction\n# Search Strategy","[{\"question\":\"Why do diabetes mellitus and atrial fibrillation often coexist?\",\"answer\":\"They share mechanisms that promote AF development and deterioration, including chronic inflammation, oxidative stress, atrial remodeling, autonomic dysfunction, advanced glycation end-products, and epicardial adiposity.\"},{\"question\":\"How does diabetes affect atrial fibrillation outcomes?\",\"answer\":\"Diabetes increases the risk of new-onset AF, contributes to suboptimal arrhythmia control, and is linked to poor prognosis in patients with AF.\"},{\"question\":\"What therapeutic advances are highlighted for diabetic patients with AF?\",\"answer\":\"The review emphasizes guideline-directed anticoagulation, tailored rate and rhythm control, and novel antidiabetic therapies such as SGLT2 inhibitors and glucagon-like peptide-1 receptor agonists to potentially improve AF outcomes.\"}]","Complex interrelationship and therapeutic advances in diabetic patients with atrial fibrillation | PDF",1790564160,43]