Research has suggested that heart and kidney disease play greater roles as risk factors for sudden cardiac death in patients with diabetes. Originally, diabetic autonomic neuropathy was always believed the main risk factor. The study involved 462 patients with diabetes who were followed for 15 years. Of the patients, the researchers documented 21 cases of sudden cardiac death.

Reporting in the Journal of Neurology, Neurosurgery, and Psychiatry (February 2005), the researchers found that heart disease, including plaques in the blood vessels feeding the heart and heart attacks, was the biggest risk for sudden cardiac death. The researchers noted that all of the participants who died had some amount of plaque buildup. Kidney disease was also found as a key risk factor for the sudden cardiac death.