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June 7, 2026Diabetes

635,233 (7.8%) developed AF (incidence rate 1.886 per 100 patient-years, 95% CI 1.881-1.891), with cumulative incidence rising from 1.5% at 6 months to 12.9% at 84 months.

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Population

8,166,278 adults with coexisting type 2 diabetes and obesity, mean age 67 years, 46% female, with ≥12 months…

Design

Cohort

Follow-up

up to 84 months

Authors

PRPIERANTONIO RUSSORNRamaa NathanWJWEI JIE

Discussion

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Overview

In a large cohort of over 8 million adults with type 2 diabetes and obesity, the incidence of atrial fibrillation was high (1.886 per 100 patient-years), supporting the need for targeted AF screening.

Key Points

  • To quantify the incidence and cumulative burden of atrial fibrillation (AF) in adults with type 2 diabetes and obesity.
  • Conducted a retrospective real-world evidence cohort study using Symphony administrative claims data (2018-2025).
  • Identified adults with obesity and type 2 diabetes with ≥12 months of continuous enrollment and no prior AF.
  • Calculated AF rates and cumulative incidence using Kaplan-Meier methods and analyzed risk using multivariable Cox regression.
  • Among 8,166,278 adults, 635,233 (7.8%) developed AF, with an incidence rate of 1.886 per 100 patient-years (95% CI 1.881-1.891).
  • Cumulative AF incidence increased from 1.5% at 6 months to 12.9% by 84 months.
  • Post-AF mortality risks were significantly higher for individuals aged ≥75 years (HR 2.84) and those with heart failure (HR 2.20).

Structured PICO

P
Population
8,166,278 adults with coexisting type 2 diabetes (T2D) and obesity, mean age 67 years, 46% female, with ≥12 months of continuous enrollment and no prior AF
O
Outcome
Incident AF rates (per 100 patient-years) and cumulative AF incidencehard clinical

In a large cohort of over 8 million adults with type 2 diabetes and obesity, the incidence of atrial fibrillation was high (1.886 per 100 patient-years), supporting the need for targeted AF screening.

Cite This Study

RUSSO et al. (2026) studied this question.

synapsesocial.com/papers/6a250b707def13d035e1b63dhttps://doi.org/10.2337/db26-2960-lb
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 12959-LB: Temporal Sequencing of Heart Failure and Atrial Fibrillation in Patients with Obesity and Type 2 Diabetes: A Real-World Evidence Study2026
  2. 2Obesity and Atrial Fibrillation: From Mechanisms to Treatment2025 · 12 citations
  3. 3Abstract Fri149: The Growing Burden: Atrial Fibrillation Mortality Trends Among Obese Adults in the United States (1999–2023)2025
  4. 42652-P: Risk of Developing Cardiorenal Complications in People Living with Overweight or Obesity, with vs. without T2D2026
  5. 5Type 1 diabetes mellitus and atrial fibrillation – clinical relationships, mechanistic insights and therapeutic implications2025