BACKGROUND: Peak oxygen uptake (VO2peak) and muscle function are more decreased in patients with a combination of chronic heart failure (CHF) and type 2 diabetes mellitus (2DM) compared to patients with only one of the conditions. Further, patients with 2DM have peripheral complications that hamper many types of conventional exercises. AIM: To evaluate the efficacy and applicability of eight-week aquatic exercise in patients with the combination of CHF and 2DM. METHODS: Twenty patients (four women) with both CHF and 2DM (age 67.4 +/- 7.1, NYHA II to III) were randomly assigned to either aquatic exercise or a control group. The patients exercised for 45 minutes 3 times/week in 33-34degreesC, swimming pool. RESULTS: The training programme was well tolerated. Work rate (+11.7 +/- 6.6 versus -6.4 +/- 8.1 Watt, p < 0.001) and VO2peak (+2.1 +/- 0.8 versus -0.9 +/- 1.4 mL/kg/min, p < 0.001) and walking capacity (p = 0.01) increased significantly in the training group. Muscle function was also significantly improved and Hba1c decreased significantly (p < 0.01) during training, while fasting glucose, insulin, c-peptide, and lipids were unchanged. Training also increased vitality measured by SF-36 significantly (p = 0.05). CONCLUSION: Aquatic exercise could be used to improve exercise capacity and muscle function in patients with the combination of CHF and 2DM.

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