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The Role of Lifestyle in Secondary Prevention of Coronary Heart Disease in Patients With Type 2 Diabetes

      ABSTRACT

      It is unclear whether standard cardiac rehabilitation programs (i.e. moderate changes in diet and exercise) are of benefit to coronary heart disease (CHD) patients with diabetes. These patients not only tend to have more comorbidities, but are also less likely to be referred to such programs than CHD patients without diabetes. This report reviews the role and practicalities of lifestyle interventions in the secondary prevention of CHD in patients with diabetes, with a special focus on results from our 2 multisite comprehensive lifestyle change interventions.These interventions emphasize a very-low-fat, high-complex-carbohydrate diet, moderate exercise, stress management and group support. We conclude that participation in a multicomponent secondary prevention program employing the above interventions may be of benefit not only to CHD patients in general, but in particular to those with CHD and diabetes.

      RÉSUMÉ

      On ne sait pas très bien si les programmes de réadaptation cardiologique standard (c.-à-d. modifications modérées de l'alimentation et exercice) profitent aux patients atteints de maladie coronarienne et de diabète. Non seulement ces patients ont-ils tendance à avoir plus de maladies concomitantes, mais ils sont moins susceptibles d'être adressés à de tels programmes que ceux qui sont atteints de maladie coronarienne mais pas de diabète. Ce compte rendu passe en revue le rôle et la valeur concrète des interventions touchant le mode de vie pour la prévention secondaire de la maladie coronarienne chez les patients atteints de diabète et met l'accent sur les résultats de nos deux interventions multicentriques et exhaustives sur le mode de vie. Ces interventions comportaient une alimentation très faible en gras et riche en glucides complexes, de l'exercice d'intensité modérée, la gestion du stress et un groupe de soutien. Nous avons conclu que la participation à un programme de prévention secondaire comportant les diverses interventions ci-dessus pourrait profiter non seulement aux patients atteints de maladie coronarienne en général, mais en particulier à ceux atteints de maladie coronarienne et de diabète.

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