Management of patients with type 2 diabetes in cardiovascular rehabilitation

Eur J Prev Cardiol. 2019 Dec;26(2_suppl):133-144. doi: 10.1177/2047487319882820. Epub 2019 Nov 13.

Abstract

The clinical benefits of rehabilitation in cardiovascular disease are well established. Among cardiovascular disease patients, however, patients with type 2 diabetes mellitus require a distinct approach. Specific challenges to clinicians and healthcare professionals in patients with type 2 diabetes include the prevalence of peripheral and autonomic neuropathy, retinopathy, nephropathy, but also the intake of glucose-lowering medication. In addition, the psychosocial wellbeing, driving ability and/or occupational status can be affected by type 2 diabetes. As a result, the target parameters of cardiovascular rehabilitation and the characteristics of the cardiovascular rehabilitation programme in patients with type 2 diabetes often require significant reconsideration and a multidisciplinary approach. This review explains how to deal with diabetes-associated comorbidities in the intake screening of patients with type 2 diabetes entering a cardiovascular rehabilitation programme. Furthermore, we discuss diabetes-specific target parameters and characteristics of cardiovascular rehabilitation programmes for patients with type 2 diabetes in a multidisciplinary context, including the implementation of guideline-directed medical therapy.

Keywords: Diabetes; cardiovascular rehabilitation; exercise; intake screening.

Publication types

  • Review

MeSH terms

  • Automobile Driving
  • Blood Glucose / analysis
  • Cardiac Rehabilitation*
  • Comorbidity
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / psychology
  • Diet
  • Exercise
  • Exercise Test
  • Exercise Tolerance
  • Health Behavior
  • Humans
  • Hypertension / complications
  • Hypertension / therapy
  • Lipids / blood
  • Mental Health Services
  • Overweight / complications
  • Overweight / therapy
  • Patient Education as Topic
  • Patient Participation
  • Physical Examination
  • Return to Work
  • Risk Factors
  • Sleep Apnea Syndromes / complications
  • Sleep Apnea Syndromes / diagnosis
  • Sleep Apnea Syndromes / therapy

Substances

  • Blood Glucose
  • Lipids