The Secondary Prevention of Cardiometabolic Disease in Diabetes Patients: Novel Advancements and the Way Forward

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PHYSICAL ACTIVITY (D WARBURTON, SECTION EDITOR)

The Secondary Prevention of Cardiometabolic Disease in Diabetes Patients: Novel Advancements and the Way Forward Leanna Lee & Paul Oh

Published online: 12 July 2014 # Springer Science+Business Media New York 2014

Abstract The prevalence of type 2 diabetes mellitus (T2DM) in developed countries around the world has never before reached greater proportions. Given the chronic nature of the disease and its frequent, concomitant presence of cardiometabolic risk factors, patients with T2DM are most likely to experience fatalities associated with cardiovascular disease (CVD). Chronic cardiometabolic disease and T2DM are preventable, reversible, and can be delayed with the appropriate lifestyle choices or modifications. Recent findings examining intensive lifestyle interventions targeting weight loss, and the potential feasibility of incorporating high intensity interval training (HIIT) into the exercise regimens of patients with T2DM, encourage optimism as we, as a society, move into the future and seek a novel approach to extricate ourselves from this trend of premature death associated with chronic cardiometabolic disease. The way forward in the secondary prevention of cardiometabolic disease involves eliciting change in our perception of physical activity at the earliest stage in life possible: childhood.

Keywords Type 2 diabetes . Cardiometabolic disease . Primary prevention . Secondary prevention . Exercise . High intensity interval training (HIIT) . Continuous moderate intensity training (CMIT) . Vigorous physical activity (VPA) . Moderate-vigorous physical activity (MVPA) . Physical activity . Overweight . Obese . Bariatric surgery . This article is part of the Topical Collection on Physical Activity L. Lee (*) : P. Oh University Health Network Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute (UHN-TRI), 347 Rumsey Road, Toronto, ON, Canada M4G 1R7 e-mail: [email protected] P. Oh e-mail: [email protected]

Cardiorespiratory fitness (CRF) . Children . Adolescence . Cardioprotective

Introduction It is undeniable that we have entered into an era in which we are faced with an alarming epidemic of type 2 diabetes mellitus (T2DM) [1, 2]. With nearly a sixfold global increase in the number of individuals afflicted with diabetes from the year 1985 to 2000 [1], and predictions from the World Health Organization that there will be an additional 39 % increase in diabetes cases around the world from the year 2000 to 2030 [1], it behooves us to no longer turn a blind eye to this global epidemic and to take decisive action moving forward into the future. This is of utmost importance in light of statistical data suggesting that T2DM now ranks as the sixth-leading cause of mortality in developed countries [3], with almost 70 % of those deaths being linked to cardiovascular disease (CVD) [4]. Unfortunately, it is commonplace that the majority of individuals with T2DM also present with accompanying cardiometabolic risk factors which include being