CARDIAC REHABILITATION IN PATIENTS WITH DIABETES MELLITUS

Abstract

Abstract
INTRODUCTION: Prevalence of cardiovascular diseases (CVD) is 19.4% in Iran and
diabetes mellitus is an important CVD risk factor in this country. Non-insulin-dependent
diabetes mellitus (type II DM) is associated with increased morbidity and mortality due to
atherosclerosis. With cardiac rehabilitation (CR) we can modify CVD risk factors such as
type II DM and play an important role in decreasing its mortality and morbidity. We
investigated the effects of CR on cardiac patients with and without type II DM.
METHODS: In this retrospective before-and-after study we analyzed data from 496 cardiac
patients (419 with type II DM and 77 without type II DM). All of the subjects completed
demographic data questionnaires and underwent weight and height measurement, exercise
test to assess exercise capacity (EC), echocardiography, and blood test to assess lipid
profile and fasting blood glucose. The subjects then participated in a 24-session CR
program. Each session consisted of 10 minutes warm-up, 40 minutes aerobic exercise, 10
minutes cool-down and 20 minutes relaxation. They also took part in 8 educational sessions
on life style modification, diet therapy and stress management supervised by CR team (a
cardiologist, a physician, a physiotherapist, a nurse, a nutritionist and a psychiatrist). At the
end of the program, all measurements, exams and tests were repeated. Data were analyzed
with SPSS11.5 using independent t-test at level of P<0.05.
RESULTS: We studied 419 non-diabetics (mean age: 55.61±9.41 years) and 77 diabetics
(mean age: 58.59±7.76 years). Mean EC increased significantly after CR in both groups. In
the diabetic group, EC increased significantly compared to the non-diabetic group
(62.21±133.40 vs. 33.68±31/42, P=0.02). Mean levels of triglyceride, cholesterol, LDLcholesterol,
as well as body mass index and heart rate decreased significantly after CR in
both groups. However, no significant difference was seen between the two groups in respect
of these variables.
DISCUSSION: CR is an effective intervention in diabetics as well as non-diabetics
especially given its remarkable effects in improving EC as a critical indicator of mortality and
morbidity of diabetic patients. Hence we suggest these patients undergo CR programs.

Keywords • Cardiac rehabilitation • Exercise capacity • Diabetes mellitus •Cardiovascular
risk factors