Endocrine Abstracts

Background: Effects of cardiac rehabilitation (CR) on glucose metabolism of coronary artery disease (CAD) patients (pts) without diabetes has not been assessed.

Aim: Evaluate effects of an intensive CR program on glucose metabolism of no-diabetic CAD pts with.

Methods: Sixty non-diabetic pts (M/F 53/7), age 71.2±9.2, were submitted to a 3 week CR program. Oral glucose tolerance test (OGTT), HOMA index, six minute walking test (6mwt) were performed at baseline (T0), three weeks (T1) and after three months (T2). At discharge a dietetic and exercise program was recommended.

Results: At T0 28.3% had normal glucose tolerance, 41.6% IGT, and 30.1% were diabetic (DM). At T1 there was a significant reduction of BMI (29.8±3.4 vs 29.0±3.8 P 0.001), waist circumference (81.0±34.1 vs 79.1±33.4 cm P 0.006), HOMA-R (2.6±1.4 vs 1.8±0.8, P 0.002). 64.7% of previous diagnosed IGT pts had normal glucose tolerance (P 0.04), and 77% of previous DM resulted IGT. At T2 BMI, fasting glicemia, HOMA-R increased to similar values than baseline.

Overall at T1 distance walked at 6MWT improved significantly (287±107.9 vs 482±117.8, P 0.001). IGT pts had a worst performance than pts with normal glucose tolerance at baseline and discharge 6MWT (291.1±83.4 vs 344.4±87.1; P<0.04; and 444.9±102.3 vs 510.7±84.7, P<0.02 respectively). No difference was found between IGT and DM pts at baseline (291.1±83.4 vs 264.7±86.3 m; P>0.05) and discharge 6MWT (444.9±102.3 vs 457.8±100 m, P>0.05).

Conclusion: OGTT is usefull to identify gluco-metabolic state in CAD pts. IGT pts have a worse functional capacity than normo-glicemic. CR program improves glucose metabolism and insulin resistance in cardiac pts with impaired OGTT. However results are lost when CR is stopped.