Cardiovascular disease is a leading cause of morbidity and mortality in diabetes [1]. Both type 1 diabetes (T1D) and type 2 diabetes (T2D) increase risks of atheromatous cardiovascular events, heart failure and arrhythmias compared with non-diabetic populations [[2], [3], [4], [5], [6], [7]]. However, studies evaluating the association between diabetes and conduction disorders are limited, particularly regarding distinct subtypes of conduction blocks and their relationship with different types of diabetes [[7], [8], [9], [10], [11], [12]]. Many studies lack detail on putative confounders, limiting their ability to assess the independent impact of diabetes on conduction abnormalities. Additionally, data on T1D are limited.

Overall, uncertainties remain about diabetes and the incidences of conduction disturbances regarding: 1) their different types and locations: sinus node disease (SND), atrio-ventricular (AV) block located above the His bundle or of infra-Hissian location, left bundle branch block (left BBB) or right bundle branch block (right BBB) and 2) the relationship to the etiology of diabetes. We aimed to determine whether diabetes is independently associated with a higher risk of conduction disturbances and whether this risk differs between T1D who were rarely evaluated in previous analyses and T2D [13]. To address these knowledge gaps, we analyzed data from two large independent databases, the French Programme de Médicalisation des Systèmes d’Information (PMSI) and the international TriNetX network.