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Patients with diabetes in cardiac rehabilitation: attendance and exercise capacity

Marni J Armstrong1, Billie-Jean Martin, Ross Arena

  • 11Faculty of Medicine, University of Calgary, Calgary AB, CANADA; 2Cardiac Wellness Institute of Calgary, Calgary AB, CANADA; 3Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL; and 4Faculty of Kinesiology, University of Calgary, Calgary AB, CANADA.

Medicine and Science in Sports and Exercise
|October 16, 2013
PubMed

Insights

Diabetic patients, particularly women, had lower cardiac rehabilitation (CR) completion and follow-up rates. Cardiorespiratory fitness gains were less sustained in diabetics, highlighting the need for targeted CR interventions.

Area of Science:

  • Cardiology
  • Metabolic Diseases
  • Exercise Physiology

Background:

  • Diabetes mellitus is associated with increased mortality following myocardial infarction.
  • Cardiac rehabilitation (CR) participation is known to mitigate this elevated risk.
  • Understanding disparities in CR engagement and outcomes for diabetic patients is crucial.

Purpose of the Study:

  • To investigate differences in CR attendance and cardiorespiratory fitness changes between diabetic and nondiabetic patients.
  • To examine how these differences vary by sex.
  • To assess the long-term maintenance of cardiorespiratory fitness post-CR.

Main Methods:

  • Retrospective cohort study analyzing data from 1996-2010 in Calgary.
  • Inclusion of 7036 nondiabetic and 1546 diabetic patients referred for CR.
  • Cardiorespiratory fitness assessed using maximal exercise testing (METs) at baseline, 12 weeks, and 1 year post-CR.

Main Results:

  • Diabetic patients (79.5%) were less likely to complete CR than nondiabetic patients (84.9%), with a more pronounced difference in women.
  • Diabetic patients were less likely to attend the 1-year follow-up (42.7%) compared to nondiabetic patients (53.7%), especially women.
  • While both groups improved cardiorespiratory fitness, gains were less maintained at 1 year in diabetic patients compared to nondiabetic patients.

Conclusions:

  • Diabetic patients, especially women, demonstrate lower adherence to CR completion and follow-up.
  • Cardiorespiratory fitness improvements achieved during CR are not as well-maintained in diabetic individuals.
  • Targeted interventions addressing barriers to CR adherence in diabetic patients are recommended to improve long-term outcomes.
Abstract

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