Exercise stress testing in patients with type 2 diabetes: when are asymptomatic patients screened?

Abstract

There are no evidence-based guidelines for screening asymptomatic diabetic patients for coronary artery disease (CAD). One well-studied screening tool is exercise treadmill testing. Many diabetic patients with no symptoms of CAD have abnormal stress tests. For asymptomatic patients, identification of cardiovascular risk factors and risk stratification may help physicians justify the performance of treadmill evaluation. Patients considering moderate or vigorous exercise and those at highest risk can undergo exercise stress testing with referral for further evaluation as indicated. For patients with decreased exercise capacity, inability to reach target heart rates, or absence of chest pain during exercise, stress nuclear imaging may be more valuable than exercise electrocardiograph testing.