CARDIAC REHABILITATION IN PATIENTS WITH DIABETES MELLITUS

AbstractINTRODUCTION: Prevalence of cardiovascular diseases (CVD) is ۱۹.۴% in Iran anddiabetes mellitus is an important CVD risk factor in this country. Non-insulin-dependentdiabetes mellitus (type II DM) is associated with increased morbidity and mortality due toatherosclerosis. With cardiac rehabilitation (CR) we can modify CVD risk factors such astype II DM and play an important role in decreasing its mortality and morbidity. Weinvestigated 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 ۴۹۶ cardiacpatients (۴۱۹ with type II DM and ۷۷ without type II DM). All of the subjects completeddemographic data questionnaires and underwent weight and height measurement, exercisetest to assess exercise capacity (EC), echocardiography, and blood test to assess lipidprofile and fasting blood glucose. The subjects then participated in a ۲۴-session CRprogram. Each session consisted of ۱۰ minutes warm-up, ۴۰ minutes aerobic exercise, ۱۰minutes cool-down and ۲۰ minutes relaxation. They also took part in ۸ educational sessionson life style modification, diet therapy and stress management supervised by CR team (acardiologist, a physician, a physiotherapist, a nurse, a nutritionist and a psychiatrist). At theend of the program, all measurements, exams and tests were repeated. Data were analyzedwith SPSS۱۱.۵ using independent t-test at level of P<۰.۰۵.RESULTS: We studied ۴۱۹ non-diabetics (mean age: ۵۵.۶۱±۹.۴۱ years) and ۷۷ diabetics(mean age: ۵۸.۵۹±۷.۷۶ years). Mean EC increased significantly after CR in both groups. Inthe diabetic group, EC increased significantly compared to the non-diabetic group(۶۲.۲۱±۱۳۳.۴۰ vs. ۳۳.۶۸±۳۱/۴۲, P=۰.۰۲). Mean levels of triglyceride, cholesterol, LDLcholesterol,as well as body mass index and heart rate decreased significantly after CR inboth groups. However, no significant difference was seen between the two groups in respectof these variables.DISCUSSION: CR is an effective intervention in diabetics as well as non-diabeticsespecially given its remarkable effects in improving EC as a critical indicator of mortality andmorbidity of diabetic patients. Hence we suggest these patients undergo CR programs.Keywords • Cardiac rehabilitation • Exercise capacity • Diabetes mellitus •Cardiovascularrisk factors