International Journal of Advances in Medicine | April 2021 | Vol 8 | Issue 4 Page 557
International Journal of Advances in Medicine
Nagrani S et al. Int J Adv Med. 2021 Apr;8(4):557-562
http://www.ijmedicine.com
pISSN 2349-3925 | eISSN 2349-3933
Original Research Article
Study of exercise treadmill test in type 2 diabetes mellitus patients
Sahil Nagrani, Prajakta Patil, Supriya S. Barsode*, Nisarg Momale, Parth Mehta
INTRODUCTION
Thirty million people suffer from diabetes in India
according to the study of diabetic society of India. Type 2
diabetes is the most prevalent form of diabetes. There has
been a global epidemic of type 2 diabetes mellitus more so
in the developing world.
1,2
Myocardial involvement in diabetes may occur relatively
earlier impairing early diastolic relaxation. The greatest
cause of mortality in type 2 diabetes is coronary artery
disease and its sequelae.
3
The Framingham study has
shown that cardiovascular mortality is twice in diabetic
men and four times in diabetic women as compared to non-
diabetic counterparts. Exercise is a common physiological
stress used to elicit cardiovascular abnormalities not
present at rest and to determine adequacy of cardiac
function. It has emerged as the most practical and non-
invasive means of discovering latent ischemic heart
disease. The diagnostic value of the stress test is maximum
when applied to a population in which the diagnosis is
most uncertain.
Even when there is no history of chest pain, there exists a
strong possibility of significant narrowing in the coronary
tree in patients with appropriate risk factors, especially
diabetes mellitus.
An attempt will be made through this study to detect early
disease and offer treatment modalities to asymptomatic
patients having diabetes mellitus.
ABSTRACT
Background: The aim of this study was to assess the prevalence and clinical predictors of silent myocardial ischemia
in patients with type 2 diabetes mellitus, and the early diagnosis of coronary artery disease.
Methods: A cross sectional prospective study was conducted including all confirmed diabetic patients in the age group
between 40-60 in Bharati medical college hospital Pune in western Maharashtra. A detailed clinical examination and
history was taken and relevant laboratory investigations, Electrocardiogram and Treadmill Stress test was done using
Bruce protocol. The quantitative data was represented as their mean ± SD. Categorical and nominal data was expressed
in percentage. All analysis was carried out by using SPSS software version 21.
Results: Male preponderance was seen in the study with 64% of the study subjects. The mean age of the study subjects
was 50.67±5.51 years. A p<0.001 was obtained showing positive correlation between BMI and TMT positivity. TMT
positivity steadily increased with the duration of diabetes mellitus. Obtained p<0.001. The correlation between
dyslipidemia and TMT positivity was significant, with a p=0.007. Correlation of Fasting as well as Post-prandial blood
glucose levels with TMT positivity proved to be statistically significant, with a p<0.001.
Conclusions: Exercise Treadmill test in diabetic patients has a significant role in screening diabetic individuals for
coronary ischemia. The results obtained clearly indicate that an exercise treadmill test may be proposed as the first test
for screening for coronary ischemia in diabetic population as it is safer, cheaper and non-invasive.
Keywords: Diabetes Mellitus, Treadmill test, Coronary heart disease, Blood sugar, Bruce protocol
Department of Medicine, BVDUMC, Pune, Maharashtra, India
Received: 11 February 2021
Accepted: 16 March 2021
*Correspondence:
Dr. Supriya S. Barsode,
E-mail: supriyabarsode@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: https://dx.doi.org/10.18203/2349-3933.ijam20211055