Raccomandazioni per la riabilitazione cardiovascolare nel paziente con diabete mellito

Translated title of the contribution: Reccomandations for cardiovascular rehabilitation in diabetes mellitus

Alberto Camerini, Carmine Chieffo, Raffaele Griffo, Marco Comaschi, Marinella Gattone, Edoardo Mannucci, Ezio Faglia, Carlo Giorda, Maria Luisa Biorci, Francesco Fattirolli

Research output: Contribution to journalArticle

Abstract

Cardiac rehabilitation is accepted as an important component in the management of heart disease. Diabetes Mellitus is a chronic disease frequently associated to ischemic heart disease and both disease require continuing medical care, aggressive treatment of other risk factors, educational programs for self management of disease to prevent acute complication. The scientific community should offer standard of care for management of diabetic patients with coronary artery disease, and should designe new strategies to promote prevention in this high risk patients. The need to define characteristics and peculial problems of diabetics patients with ischemic heart disease encouraged the Board of the Italian Group of Cardiac Rehabilitation and Prevention (GICR) to set up a working group composed of cardiologists and diabetologists chosen on the basis of their proven specific experience. The document is subdivided in six parts. In the first section is described the cardiovascular risks in patients with diabetes and the importance of post-prandial hyperglycemia and glycemic variability. We analyse also the difference in prevalence of ischemic heart disease in Italian diabetic patients compared with other countries. In the second section we described clinical presentation of ischemic heart disease in diabetic patients such as acute myocardial infarction and unstable angina, and the revascularization procedures (balloon angioplasty and coronary bypass surgery). We analysed the differences between the procedures and the evidence-based results. In patients with myocardial infarction we analysed the evidence-based therapy and specific advantages of aspirin, beta-blockers and ace-inibitor in diabetic patients. In this section we also posed particular attention to the clinical course of patients who underwent bypass grafting and to the impact of diabetes on short and long-term results and on main intervention-related complications including deep infections, mediastinitis, neurological problems, renal failure. In the third section we evaluated the factors resposible of atherosclerosis progression and their treatment, and we underlined that cardiac rehabilitation is less effective for patients with diabetes mellitus. Suggestions proposed in this paper about risk factors are in line with the recommendations of standards guidelines of American Diabetics Association. In patients with concomitant diabetes and ischemic heart disease we suggest blood pressure

Translated title of the contributionReccomandations for cardiovascular rehabilitation in diabetes mellitus
Original languageItalian
Pages (from-to)263-282
Number of pages20
JournalMonaldi Archives for Chest Disease - Cardiac Series
Volume60
Issue number4
Publication statusPublished - Dec 2003

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Camerini, A., Chieffo, C., Griffo, R., Comaschi, M., Gattone, M., Mannucci, E., Faglia, E., Giorda, C., Biorci, M. L., & Fattirolli, F. (2003). Raccomandazioni per la riabilitazione cardiovascolare nel paziente con diabete mellito. Monaldi Archives for Chest Disease - Cardiac Series, 60(4), 263-282.