Cardiac rehabilitation in patients with heart failure and diabetes mellitus

Over the past decades, cardiac rehabilitation has had a spectacular evolution, from the mere monitoring of the patients' return to physical activity to a multidisciplinary approach focused on patient education, individualized physical exercise, changes in cardiovascular risk factors and, not least, an improvement in patient quality of life. Heart failure represents an important public health problem, and the association of this disease with diabetes mellitus significantly reduces prognosis in these patients, the two disorders potentiating each other. Recent data demonstrate a significant benefit of cardiac rehabilitation in patients with diabetes mellitus and heart failure, with important effects in reducing mortality, increasing exercise capacity and improving symptoms. Unfortunately, cardiac rehabilitation is generally underused, most probably due to the lack of awareness and low adherence of patients, as well as due to insufficiently developed programs at national level.