Heart patients who also have diabetes can do their rehabilitation exercises more safely thanks to the world’s first guide on the subject, published by international experts including a Swansea University academic.
The guide will be an important resource for health professionals to help the growing number of cardiac rehabilitation patients also suffering from diabetes.
The guidelines, approved by international diabetes organizations, were created by a team including Dr. Richard Bracken of the School of Sports and Exercise Sciences, College of Engineering, and Diabetes Research Group at Swansea University Medical School.
Exercise and improving activity levels are central parts of cardiac rehabilitation, which aims to improve the health and fitness of people with heart problems.
Currently around 25% of cardiac rehabilitation participants in Europe, North America and Australia have diabetes. That number is rising, mainly because there are some common risk factors for cardiovascular disease and diabetes, particularly obesity and sedentary lifestyle.
While it is crucial for cardiac rehabilitation patients to be more active, one major obstacle is that many fear that the exercise itself will put them at risk.
However, there are additional concerns in patients with diabetes, particularly about falling blood sugar levels, which lead to hypoglycemia. The fear of “hypo”, which can lead to dizziness, disorientation, anxiety and many other symptoms, is one of the main obstacles that prevent people with diabetes from integrating exercise into daily life.
This explains why cardiac patients who also have diabetes are less likely to enter and continue a cardiac rehabilitation program than patients without diabetes.
This is where the new instructions can make a difference. It focuses on controlling blood sugar levels during rehabilitation to reduce the risk of acute glycemic problems during exercise. The aim is to give patients with diabetes more confidence so that they can do the rehabilitation exercises more often and stick with them and improve their overall health.
The new guidelines provide clear advice to health professionals in the following areas:
-The interactions that may occur between drugs that patients with cardiovascular disease and diabetes may use
-The best types of exercise for these patients, the ideal intensity, and the safest times of the day
-The different requirements for patients with type 1 and type 2 diabetes
The guidance, contained in a statement, has been approved by the UK and Canadian Cardiovascular Prevention and Rehabilitation Associations, the International Cardiovascular Prevention and Rehabilitation Council and the UK Association for Sports and Exercise Sciences.
Dr. Richard Bracken, one of the authors, and a diabetes expert on the A-STEM research team at Swansea University School of Exercise and Exercise Science and the Lifestyle Research Group at Diabetes Research Group, Medical School, said:
“Exercising safely is important to improve the health of patients with cardiovascular problems.
An increasing number of these patients also suffer from diabetes. Therefore, it is important that cardiac rehabilitation programs meet their needs.
This expert guidance means healthcare professionals can design cardiac rehabilitation to give patients with diabetes the security they need to start and follow the program, which will improve their overall health. “
Buckley, JP, et al. (2020) Pre, During, and Post-Exercise Acute Glycemic Management for Cardiovascular Rehabilitation Participants with Diabetes Mellitus: A Joint Statement by the British and Canadian Cardiovascular Prevention and Rehabilitation Associations, the International Council on Cardiovascular Prevention and Rehabilitation, and the British Association of Sport and Movement science. British Journal of Sports Medicine. doi.org/10.1136/bjsports-2020-102446.