Effects of an adapted cardiac rehabilitation programme on arterial stiffness in patients with type 2 diabetes without cardiac disease diagnosis

Purpose: To determine the effects of a 12-week cardiac rehabilitation programme of aerobic and resistance exercise training on arterial stiffness, peak calf vasodilatory reserve, and haemostatic markers in patients with type 2 diabetes. Methods: Observational cohort study examining effects of 12 weeks of exercise training in 23 subjects (13 men, 10 women; mean age of 56.110.1years) with type 2 diabetes mellitus. Subjects performed exercise training for 12 weeks [aerobic training 5days/week, 70%-75% peak cardiovascular fitness (VO2peak) and resistance training 2-3days/week, 60% of one repetition maximum]. Vascular stiffness (pulse-wave velocity), augmentation index, peak calf vasodilatory reserve, and VO2peak were measured pre- and post-exercise training. Secondary outcomes included heart rate variability and haemostatic measures. Results: VO2peak increased by 16% (20.1 +/- 5.5 vs 23.2 +/- 8.8mL/kg/min, p=0.002) and abdominal circumference was reduced (101.9 +/- 13.3 vs 97.9 +/- 12.7cm, p<0.03). Vascular function was improved including central arterial stiffness (central pulse-wave velocity: 8.44 +/- 1.75 vs 8.02 +/- 1.60m/s, p=0.026) and the aortic augmentation index (21.7 +/- 10.6% vs 18.3 +/- 12.6%, p=0.005); peak calf vasodilatory reserve increased from 30.3 +/- 10.6mL/100mL/min to 38.0 +/- 15.3mL/100mL/min (p=0.04). No changes were seen in heart rate variability, blood lipids, glycated haemoglobin and C-reactive protein. Conclusion: A 12-week cardiac rehabilitation programme of aerobic and resistance training significantly reduces arterial stiffness and improves aerobic fitness in individuals with type 2 diabetes mellitus.