Published: 2021-03-23

Study of exercise treadmill test in type 2 diabetes mellitus patients

Sahil Nagrani, Prajakta Patil, Supriya S. Barsode, Nisarg Momale, Parth Mehta


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.


Diabetes Mellitus, Treadmill test, Coronary heart disease, Blood sugar, Bruce protocol

Full Text:



Joshi SR, Parikh RM. India-diabetes capital of the world: now heading towards hypertension. J Assoc Physicians India. 2007;55:323-4.

Kumar A, Goel MK, Jain RB, Khanna P, Chaudhary V. India towards diabetes control: Key issues. Australas Med J. 2013;6(10):524-31.

Bacci S, Villela M, Villela A, Langialonga T, Grilli M, Rauseo A et al. Screening for silent myocardial ischaemia in type 2 diabetic patients with additional atherogenic risk factors: applicability and accuracy of the exercise stress test. Eur J Endocrinol. 2002;147:649-54.

Bellet S, Roman L. The exercise test in diabetic patients as studied by radioelectrocardiography. Circulation. 1967;36(2):245-54.

Abenavoli T, Rubler S, Fisher VJ, Axelrod H, Zuckerman KP. Exercise testing with myocardial scintigraphy in asymptomatic diabetic males. Circulation. 1981;63(1):54-64.

Premalatha G, Anirudhan MK, Mohan V, Sastry NG. Treadmill (Cardiac Stress) Test in the Diagnosis of Ischaemic Heart Disease in NIDDM Patients: Usefulness and Safety. Int J Diab Dev Countries. 1995;15:3-6.

Sharda M, Soni AK, Meena S, Nigam H, Singh A. A prospective Study on Utility of Exercise Treadmill Test in Type 2 Diabetes Mellitus Patients. Int J Diabetes Develop Countries.1995;15:3-6.

Kim MK, Baek KH, Song KH, Kwon HS, Lee JM, Il Kang M et al. Treadmill Test in Detecting Asymptomatic Coronary Artery Disease in Type 2 Diabetes Mellitus. Diabetes Metab J. 2011;35:34-40.

Sarkar NC, Jain S, Sarkar P, Tilkar M, Modi N. Early detection of coronary artery disease in asymptomatic type 2 diabetes mellitus patients. Int J Adv Med. 2017;2(1):26-9.

Lavekar AS, Salkar HR. Treadmill Test to Detect Stress Induced Ischemic Heart Disease in Type 2 Diabetes Mellitus Patients Asymptomatic for CAD: A Hospital Based Cross-sectional Study in Rural Population of Central India. J Diabetes Metab. 2016;4(2):244.

Ambepityia G, Kopelman PG, Ingram D, Swash M, Mills PG, Timmis AD. Exertional myocardial ischemia in diabetes: A quantitative analysis of angina perceptual threshold and the influence of autonomic function. J Am College Cardiol. 1990;15(1):72-7.

Kannel WB, Agostino RBD, Wilson PW, Belanger AJ, Gagnon DR. Diabetes Mellitus, Fibrinogen and risk of cardiovascular disease. The Framingham experience Am Heart J. 1990;120:672-6.

Giri S, Shaw LJ, Murthy DR, Travin MI, Miller DD, Hachamovitch R et al. Impact of diabetes on the risk stratification using stress single-photon emission computed tomography myocardial perfusion imaging in patients with symptoms suggestive of coronary artery disease. Circulation, 2002;105(1):32-40.

Gupta SB, Pandit RB. Silent myocardial ischemia and cardiac autonomic neuropathy in diabetics. Ind Heart J. 1993;44:227-9.

Fuster V, Badimon L, Badimon JJ, Chesebro JH. The pathogenesis of coronary artery disease and the acute coronary syndromes. New England j Med. 1992;326(5):310-8.

Dave TH, Wasir HS, Prabhkaran D, Dev V, Das G, Rajani M et al. Profile of coronary artery disease in Indian women: correlation of clinical, non-invasive and coronary angiographic findings. Indian heart j. 1991;43(1):25-9.

Bouchard A, Sanz N, Botvinick EH, Phillips N, Heilbron D, Byrd IIIBF et al. Noninvasive assessment of cardiomyopathy in normotensive diabetic patients between 20 and 50 years old. Am J Med. 1989;87(2):160-6.