Intensive cardiac rehabilitation improves glucometabolic state of non-diabetic patients with recent coronary artery bypass grafting

Background: The aim of this study is to examine the effect of an intensive CR program early after coronary artery bypass grafting on glucometabolic state of non-diabetic patients with CAD. Methods: 60 patients were included in the study. All patients underwent Oral Glucose Tolerance Test (OGTT), Homeostasis Model Assessment (HOMA) Index and Six Minutes Walking Test at baseline and at the end of CR. The patients were then included in a 3-month follow-up program. Results: At baseline 61% of the patients had normal fasting glucose, while after OGTT 28.3% had normal glucose tolerance, 41.6% had impaired glucose tolerance (IGT), and 30.1% had type 2 diabetes mellitus (T2DM). At the end of the CR program the number of patients with T2DM was significantly lower (- 22%, p < 0.05) while the number of normal glucose tolerance patients had significantly increased (+ 26%; p < 0.05). T2DM and IGT patients showed worse performances at Six Minutes Walking Test than normal glucose tolerance patients at baseline but had a similar improvement after 4. weeks of training. After 3. months follow-up fasting blood glucose, insulin levels and HOMA index were increased compared to 4. week values, but were lower than baseline. Conclusion: OGTT is important to evaluate glucometabolic state of CAD patients. Intensive CR improves glucometabolic state and insulin resistance in CAD patients with impaired glucose metabolism.