Prescribing exercise to patients with diabetes and cardiovascular disease

  • Mary Corcoran
  • Univadis Medical News
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The European Association of Preventive Cardiology has published a new position article on exercise training for patients with type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). 

The article provides practical recommendations on patient assessment prior to commencing an exercise programme and treatment targets, and guidance on designing individualised exercise training programmes, as well as risks specific to T2DM and cardiac comorbidity.  

It stresses the importance of individualising exercise training programmes and targets following a careful initial evaluation.

It recommends patients with T2DM and CVD should be 'carefully checked and regularly monitored', particularly for cardiac autonomic neuropathy and hypoglycaemia. “Patients at risk or severely detrained patients should start exercising at low intensity, with each increment to be supervised closely, aiming at integration of regular physical activity into daily routine,” the article states. 

It recommends that before taking up a structured moderate-to-high intensity exercise programme, patients should be assessed for silent myocardial ischaemia. 

High-volume, moderate-intensity training is recommended for improving body composition and cardiovascular risk factors. The article states that high-intensity interval training may provide an alternative in some cases. High-volume resistance training has beneficial effects in combination with aerobic exercise training, it adds.