The aim of the study was to clarify the pathogenetic mechanisms of arrhythmias in patients with diabetes mellitus type 2 (DM 2), and the role of diabetic factors in their onset. A comparative analysis of arrhythmias was performed in 212 cardiological patients, 114 of whom had DM 2, and 98 did not. The character of concomitant pathology was similar: the patients had primary arterial hypertension, coronary heart disease, and no myocardial infarction background. The study found that the frequency of more severe and prognostically unfavorable arrhythmias was higher in the DM 2 subgroup; these arrhythmias were associated with the compensation of carbohydrate metabolism according to the level of glycated hemoglobin (HbA(1c), immunoreactive insulin (IRI), and C-peptide. Severe metabolism decompensation (HbA(1c) > 8.5%) was more often associated with ventricular arrhythmias and low IRI and C-peptide levels, whereas relatively low (< 7.0%) HbA(1c) level was associated with supraventricular arrhythmias and elevation of IRI and C-peptide levels. Arrhythmias in DM 2 were also associated with left ventricular geometric anomalies, revealed by means of electrocardiography.
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