The Benefit of a Cardiac Rehabilitation Programme on Cardiovascular and Exercise Parameters in Patients with Type 2 Diabetes Mellitus: The First Study Among the Iranian Population

Background: An appropriate physical regimen in diabetic patients positively modified both motor and sensory neuromuscular parameters, improved functional capacity and slowed the progression of diabetes and its cardiovascular sequelae.Objective: We examined the effects of a cardiac rehabilitation (CR) programme on cardiovascular and exercise parameters in diabetic patients undergoing coronary artery bypass surgery (CABG) and compared them to non-diabetics.Methods: Data were collected prospectively on 1,316 consecutive patients who underwent pure CABG enrolled in an exercise-based cardiac rehabilitation programme (phase II) at Tehran Heart Center and categorised into two groups; the diabetes group (n=361) and non-diabetics (n=955). The main outcome measures were cardiovascular parameters, exercise training energy expenditure (ETEE) and treadmill velocity of first and last session of CR in the two groups.Results: Regarding the change in heart rate, peak and post-exercise heart rates were improved more in non-diabetics than the other group after attending cardiac rehabilitation programme. An increase in heart rate recovery was also detected in non-diabetics compared to diabetic patients. However,changes in post-exercise systolic blood pressure and also in resting and post-exercise diastolic blood pressures were not different between the two groups. Multivariate analysis showed more improvement in ETEE in non-diabetics than diabetics (β: 2.035, 95% CI for β: 0.687-3.382, p=0.003) in the presence of main confounders.Conclusion: Significant improvements can be occurred in heart rate recovery, post-training exercise heart rate, and also ETEE after attending cardiac rehabilitation programme in both diabetic and non-diabetic patients undergoing CABG, but the diabetic group took less advantage of this programme than non-diabetics.