Dysrhythmia and electrocardiographic changes in diabetes mellitus: pathophysiology and impact on the incidence of sudden cardiac death

Background The incidence of sudden cardiac death (SCD) is increasing in diabetes mellitus. Susceptibility to dysrhythmias and the reliability of an electrocardiogram in diabetic hearts are debatable issues. Objectives To highlight the underlying mechanism of dysrhythmia and electrocardiographic changes in diabetic patients and the impact on the incidence of SCD. Methods Most the pertinent articles (English and non-English) published in Medline, Scopus and EBSCO Host research databases have been reviewed. Results and conclusion In the absence of systematic reviews, susceptibility to dysrhythmias and electrical instability in diabetic patients are underestimated. This susceptibility has been found to be enhanced, unchanged or reduced in different studies. To find a link between SCD and diabetes, the published studies provide controversial results; however, the majority of studies with a long-term follow-up support this link. The role of hyperglycemia, autonomic neuropathy and anti-diabetic agents as predisposing factors deserve more attention to fortify the clinical judgment and decrease the incidence of SCD.