Introduction
It is well established that physical activity and exercise training is, as part of a multidisciplinary rehabilitation program, key to optimise health and prognosis in patients with cardiovascular disease (CVD).1 It will contribute to greater improvements in body composition, lipid profile, blood pressure, exercise capacity and muscle strength, inflammation, vascular function and even cardiac function.2 These effects may help to explain why exercise training and physical activity is independently related to enhanced survival rates and lowered risk for adverse cardiovascular events in patients with coronary artery disease, and lower hospitalisation rates in heart failure patients.3,4
However, type 2 diabetes mellitus (T2DM) is very often co-existent in CVD patients, which may clearly affect the clinical outcome (e.g. prognosis). For example, increased prevalence rates of diabetes have been reported in patients with coronary artery disease, such as in the Framingham Heart Study5 and the Multiple Risk Factor Intervention Trial6. From these studies, the prevalence of diabetes in patients with coronary artery disease varied from 14 to 26%. These prevalence rates can be even higher in heart failure patients.7 As a result, clinicians should be aware of the potential presence of T2DM in every patient with CVD at entry of a rehabilitation program, even when it is not diagnosed yet.
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A full article on this topic titled "How to adjust my exercise prescription when my cardiac patient also suffers from type 2 diabetes mellitus?" is available in the Recommended Reading section.
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