Diabetes Type 2 and Physical Activity Program: Potential Application of Risk-Engine UKPDS Score in Out-Patient Context

Diabetes mellitus Type 2 (DMT2) carries a high risk of cardiovascular (CV) morbidity and mortality. Physical activity (PA) is widely prescribed for this population. However, detection of the eventual risk level and the potential additional increase through physical exercise are of paramount importance in these patients. A model for predicting absolute risk for coronary artery disease in diabetes has been provided in the investigation by the UKPDS (United Kingdom Prospective Diabetes Study). The present study aims to verify the potential feasibility of the UKPDS calculation in an out-patient context, where patients with DMT2 can be selected for an exercise prescription program. All patients investigated were consecutively enrolled in the study at the time of the first clinical check-up in the outpatient center of the University of Perugia-Internal Medicine Department. A group of 101 Caucasian patients (62 males; 39 females; aged 67 ± 2 years) were studied. In agreement with the UKPDS score, gender, age, ethnicity, Body Mass Index, systolic blood pressure and smoking habits were considered. The global mean cardiovascular risk calculated by the UKPDS risk-engine was 25.8% of a first cardiovascular event within 10 years after the initial observation. Despite an absence of symptoms, the risk was globally high and in agreement with current literature. Conclusion: The data are suggestive of a potential large clinical application of UKPDS risk-engine score in an outpatient context, especially in those asymptomatic DMT2 patients potentially enrolled in a physical activity program. This pilot investigation supports the importance for immediate estimation of cardiovascular risk in DMT2 subjects to implement basic therapeutic strategies such as physical activity