Abstract 9094: Intensive Lifestyle Medicine for Primary & Secondary Prevention for Cardiovascular Risk Reduction in Patients With Diabetes

Abstract

Introduction: Cardiovascular disease (CVD) carries significant morbidity and mortality, especially for patients with diabetes. Intensive Cardiac rehabilitation (ICR) has proven benefits for patients with CVD through a high fiber low fat diet, peer support, exercise and stress reduction; which may help in diabetes management. However, outcomes of ICR in patients with diabetes with and without CVD are unknown. Hypothesis: ICR can improve outcomes in diabetic patients with or without CVD. Methods: We conducted a retrospective cohort study of 4793 diabetic patients who were offered ICR at 46 CR centers across USA from January 2016 to December 2020. Five ICR centers in Hawaii had patients enrolled with diabetes without any CVD as Hawaii is the only state in US which has approved ICR for diabetic patients without CVD for primary prevention. ICR sessions are 4-hours long, twice weekly for 9-weeks of lifestyle modification aiming at high fiber low fat diet, peer support, exercise and stress reduction. Diabetic patients were divided into two groups: CVD group (known CVD) - 3723 patients (78%) and Non-CVD group (without CVD) - 1070 patients (22%). Primary endpoints were change in HbA1C, LDL and BP. Secondary outcomes were change in BMI, triglycerides, cholesterol, HDL, dietary fat intake, dietary fiber intake, depression scores (CESD) and exercise minutes per week. We used t tests to compare variables pre and post ICR. Results: The mean age of patients was 66.5 ± 0.2 years, 43% were females and 44% were white. ICR completion rate & number of ICR sessions was higher in Non-CVD group (Non-CVD: 60.11 ± 27.16 vs. CVD: 55.67 ± 33.15, p<0.01). Primary (HBA1c, BP, LDL) and secondary outcomes improved in both groups Pre and Post ICR as shown in table. Conclusions: Significant improvement in diabetes & ICR outcomes were achieved for both groups after completing ICR. Although long term outcomes are unknown, diabetic patients should continue to participate in ICR for further risk reduction.