Rationale:
Identifying individuals with the metabolic syndrome provides opportunities to intervene in the management of shared disease pathways predisposing individuals to both cardiovascular disease [CVD] and diabetes.
Objective:
To determine the effect of multifactorial CR on the metabolic syndrome and related clinical variables in cardiac patients with comorbid type 2 diabetes mellitus.
Methods:
Twenty-eight [28] patients [22 men, 6 women) with a mean age of 66.2 +/- 8.5 years served as the basis for this study. They were enrolled in the Diabetes Exercise Center and participated in the multifactorial Cardiac Rehabilitation Program [CRP] of the Marshall University Medical Center. Interventions included exercise, smoke cessation, nutritional counseling, and weekly educational sessions with a variety of topics related to diabetes management and care. Guest speakers were physicians, nurses, exercise physiologists, podiatrists, registered dietitians, pharmacists, physical therapists, and other health professionals. Social events [e.g., picnics, holiday luncheons] as well as fun competition events [e.g., Wellness Challenge], were also scheduled to enhance group camaraderie. Patients were screened and risk stratified prior to program entry with a medical profile that included a history, physical, multi-stage exercise test, pulmonary function test, lipid profile, CBC, HbA1c, anthropometric measures, and risk factor analysis. Selected measures were repeated at 12 weeks and on a pattern of care basis.
Results:
Significant (P <.05) changes in the metabolic syndrome were observed for systolic blood pressure, serum triglyceride, and fasting blood glucose. Other variables exhibiting significant improvement were: HbA1c, total serum cholesterol [TSC], LDL-C, VLDL-C, TSC/HDL, LDL/HDL, NONHDL, exercise compliance, dietary compliance, and Beck Depression Inventory score.
Conclusion:
Participation in a multifactorial CRP improved outcomes for the metabolic syndrome profile and related clinical variables in cardiac patients with comorbid type 2 diabetes mellitus.