Current control of diabetes after cardiac rehabilitation program: the ReCardio registry

Abstract Objective The objective of this study is to evaluate the current control of diabetes in patients that have completed contemporary cardiac rehabilitation (CR) programs across Spain, using data from the prospective, multicentre ReCardio national registry. Methods We conducted a prospective, multicentre, cross-sectional registry including consecutive adult patients with ischaemic heart disease (acute coronary syndrome, chronic coronary syndrome, or prior coronary revascularization) who completed a CR program in seven Spanish centres between October 2024 and October 2025. Each centre enrolled the first five consecutive eligible patients attending their discharge visit every month. Data were pseudonymized and captured in a unified web-based platform, enabling structured data entry, semantic interoperability through SNOMED CT, and optional natural-language processing for automated variable extraction. This interim analysis included the first 244 patients. An external independent company performed the statistical analysis. Continuous variables were summarized as mean ± SD or median (IQR), and categorical variables as frequencies and percentages. Paired comparisons between baseline and discharge metrics were conducted using the Wilcoxon paired-samples test. Results Among patients with diabetes (n=53, 21.5%), mean fasting glucose showed no significant change from start of CR to end of CR (116.5 ± 27.1 vs. 117.0 ± 9.3 mg/dL). In the overall cohort, fasting glucose remained within the normal range (99.8 ± 20.1 vs. 99.1 ± 24.6 mg/dL, p = no significant difference). Blood pressure improved during CR, with reductions in both systolic (134.6 ± 17.4 to 123.5 ± 17.3 mmHg) and diastolic values (81.8 ± 9.5 to 74.4 ± 9.5 mmHg). Renal function remained stable, with no significant changes in creatinine (0.9 ± 0.2 at start of CR to 1.1 ± 1.9 mg/dL at end of CR) or in glomerular filtration rate CKD-EPI (93.3±18.0 at start of CR to 91.8±15.0 at end of CR). Among individuals with diabetes, antidiabetic therapy was widely prescribed (89.3%). SGLT2 inhibitors were the most frequently used agents (82.1%), predominantly empagliflozin (37.5%) and dapagliflozin (16.1%). Metformin was prescribed in more than half of diabetic patients (55.4%), followed by GLP-1 receptor agonists (30.4%), primarily semaglutide (21.4%). DPP-4 inhibitors were prescribed in 10.7% of diabetic patients, and insulin in 8.9% of the diabetic population. Conclusions Patients with diabetes completing contemporary CR programs in Spain show good overall glycaemic control, with stable fasting glucose and HbA1c levels throughout the CR program. These findings suggest that while current CR frameworks support maintenance of acceptable diabetes control, further strategies—such as targeted metabolic interventions or closer glucose-focused follow-up—may be required to achieve additional glycaemic optimization within CR pathways.For image description, please refer to the figure legend and surrounding text.