Slow Heart Rate with long intervals between beats

[Mary__0__0]

  My husband has a slow heart rate (45-60)with long intervals between beats.  He had a monitor on for 24 hours and this showed the above data.  He is a diabetic and he also smokes.  We were told by family Dr. that this could be a malfunction in the sinus node of heart due to the diabetes.  He is going to try to get him in a Cardiologist within the next few days.  My questions is how much is this due to the diabetes and does smoking affect this?  

[CCF CARDIO MD APS]

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Dear Mary,
Firstly, there are a number of physicians answering the questions on varying days, and as it states in the opening of this forum, the questions will be answered as soon as possible and more than likely with in 4 or 5 business days.
As for your question, the exact mechanism by which the diabetes leads to a malfunctioning sinus node is not known, but surely the cause is related.  Smoking if anything speeds up the heart like caffeine.  
Smoking is deadly as it is, BUT in a diabetic, it is even more deadly.  Tell your husband that he is at greater risk for heart disease (heart attacks and heart failure), loss of a limb from poor circulation, and loss of the ability to have an erection, kidney failure-JUST from the diabetes AND HE IS MAKING HIS RISK MUCH WORSE BY SMOKING.
I hope this information is useful. Information provided in the heart forum is for
general purposes only.  Only your physician can provided specific diagnoses and therapies.
Feel free to write back with further questions. Good luck!
If you would like to make an appointment at the Cleveland Clinic Heart Center, please
call 1-800-CCF-CARE or inquire online by using the Heart Center website at
www.ccf.org/heartcenter. The Heart Center website contains a directory of the
cardiology staff that can be used to select the physician best suited to address your
cardiac problem.