December 2020 Br J Cardiol 2020;27:129–31 doi:10.5837/bjc.2020.038
Tim P Grove, Neil E Hill
Introduction It has been estimated that around one in four people who attend a cardiovascular prevention and rehabilitation programme (CPRP) have diabetes mellitus (DM) and many more are at risk of this condition.1 CPRPs provide an ideal opportunity to help support people with DM through optimisation of their medical therapies, diet and exercise. However, medications such as insulin and insulin secretagogues (sulfonylureas) increase the risk of hypoglycaemia during aerobic exercise.2,3 Repeated bouts of hypoglycaemia increase the risk of cardiovascular mortality,4,5 hypoglycaemia unawareness,6 disability,7 and reduce physical activity adheren
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