By Anna Horner | News & Views
It is not unusual for cardiac rehabilitation professionals to be concerned when enrolling diabetes patients in a CR program, especially if their facility lacks an in-house diabetes educator. They may worry that someone taking any diabetes medication might have a low blood sugar reaction and may feel unsure how to respond under these circumstances. Thankfully, such scenarios will be happening less and less as more diabetes patients take non-secretagogues — medications that do not increase insulin production and, therefore, do not cause low blood sugar.
Diabetic patients do not require any special intervention when it comes to CR, according to Mary Finckenor, MA, RD, CDCES, BC-ADM, CCRP, a dietitian and diabetes educator at Atlantic Health System. “More and more people are coming in with well-managed diabetes. They have meters and their blood sugars are in pretty good control. As long as they meet the other parameters and their blood sugars aren’t out of range, they're usually fine,” Finckenor explains. “I can't remember the last time we couldn't start a patient in CR because of their diabetes. At times we’ve had to put a patient on hold until their diabetes is better managed, but that does not happen often. And it's happening less and less as the medications and treatments improve.”
Most diabetes patients typically aren’t restricted when it comes to the types of exercises they can perform as part of a CR program. Finckenor notes, “If they have neuropathy, and they're having issues with their gait, you might not put them on a treadmill. You would put them on a bike or a NuStep, for instance, but such an issue would be apparent to the CR professional.”
In her AACVPR live webinar on April 25, Finckenor will discuss diabetes basics to help CR professionals who don’t have access to a diabetes educator at their facility. The sheer volume of information can be overwhelming, she admits, and it can be difficult to keep up with all the available medications. “It can make non-diabetes-professionals feel like they’re in over their heads,” Finckenor says. “But the good news is that for the bulk of patients, you really don't need to worry as much as in the past.”
Her presentation will provide CR professionals with information about cardio-protective diabetes drug categories, explain the difference between secretagogue and non-secretagogue diabetes medications and detail exercise guidelines for all patients, whether they are low or high risk. “The tricky thing with diabetes and exercise is there’s no hard and fast guidelines in the literature,” Finckenor asserts. “But there are some general parameters, and from them, you can build a foundation for a safe and effective CR program that takes the guesswork out of managing diabetes patients.”
The livestream event has ended. Please enjoy the webinar recording, available at no cost to AACVPR members.