Cardiovascular Rehabilitation in Patients With Diabetes

Abstract

In Brief PURPOSE The cardiovascular disease risk profile and exercise capacity of coronary heart disease patients with type 2 diabetes mellitus (DM) were measured and compared with those of nondiabetic (NDM) patients before and after a 6-week multidisciplinary cardiac rehabilitation program. METHODS Subjects included 413 patients with DM (56.9 ± 7.9 years) and 614 patients with NDM (56.8 ± 10.3 years). RESULTS At program entry, DM patients had a higher prevalence of risk factors (hypertension, hypercholesterolemia, hypertriglyceridemia, obesity, excess abdominal fat, and depression), had a lower peak oxygen uptake (14.3 ± 4.4 vs 16.6 ± 5.4 mL · kg−1 · min−1; P < .001), and covered a shorter distance in the 6-minute walk test (404 ± 117 m vs 445 ± 116 m; P < .001) than NDM patients. At the end of the exercise program, all patients achieved significant improvements in physical capacity, which were similar in DM and NDM patients (+27.6 ± 28.2% vs +30.5 ± 27.7% for peak oxygen uptake and +21.0 ± 31.5% vs +21.3 ± 53.2% for the 6-minute distance test). CONCLUSION DM patients with coronary heart disease had a higher prevalence of cardiovascular disease risk factors as well as lower physical capacity than NDM patients at the beginning of rehabilitation. All patients demonstrated improvement in exercise capacity after rehabilitation. More importantly, the extent of the improvement was similar in DM and NDM patients. This study, which involved a large population, emphasizes the capacity of DM patients to fully benefit from a multidisciplinary risk factor management program, including exercise training and educational programs. Despite having a lower exercise capacity and a higher cardiovascular risk profile than those of nondiabetic patients, patients with type 2 diabetes improved exercise capacity at a similar level to nondiabetic patients. Results suggest that diabetic patients can fully benefit from a cardiovascu-lar rehabilitation program that is tailored to their needs.