Doctors Should Encourage Exercise in Patients With Diabetes, CV Disease

Physicians need to take an active role in prescribing specific exercise training in patients with both type 2 diabetes mellitus and cardiovascular disease, according to a position paper published online Jan. 14 in the European Journal of Preventive Cardiology.

Hareld Kemps, M.D., Ph.D., from the Maxima Medical Centre in Veldhoven, Netherlands, and colleagues provide recommendations for doctors on how to motivate patients with both type 2 diabetes mellitus and cardiovascular disease to incorporate physical activity into their daily routine, set achievable and measurable goals, and design individualized exercise training programs to meet those goals.

The authors recommend that increasing cardiorespiratory fitness; controlling glucose and blood pressure; reducing inflammation; and improving vascular function, dyslipidemia, and muscle strength are all important goals of an exercise training program. To ensure adherence, the type of activity needs to be adapted to the patient's preferences and comorbidities and adjusted to training progress over time. Remote guidance and monitoring are crucial for providing regular feedback to further encourage adherence. The optimal duration, volume, and intensity should be personalized. High-volume resistance training can be beneficial in combination with aerobic exercise training. Patients should be carefully checked and regularly monitored, especially for cardiac autonomic neuropathy and hypoglycemia.

"Diabetes doubles the risk of mortality but the fitter patients become, the more that risk declines," Kemps said in a statement. "Unfortunately, the majority of patients do not engage in exercise programs."

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