CARDIAC REHABILITATION IN PATIENTS WITH DIABETES MELLITUS

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, LDL-cholesterol, 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.