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Diabetes mellitus (DM) is an independent risk factor for AF, and adds risks to increased mortality and hospitalizations when present along with AF. The pathophysiology of AF related to DM is complex with many inter\u2010related factors. Atrial cardiomyopathy (atriopathy) related to structural changes from subcellular abnormalities and fibrosis, coupled with cardiac mechanical dysfunction, abnormal ion expression, dysregulation of the renin\u2010angiotensin\u2010aldosterone system and the autonomic nervous system function, play crucial roles in genesis and progression of AF. 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