Adherence to physical activity recommendations and barriers to physical activity participation among adults with type 1 diabetes

Abstract

Background Physical activity (PA) is important for those with type 1 diabetes (T1DM); however, accurate information on PA in people with T1DM is limited. Aims This study assessed adherence to PA guidelines using both objective and subjective PA measures and evaluated the relationship between accelerometer-measured PA and cardiovascular disease (CVD) risk factors. Barriers to PA were also assessed. Methods Using an observational cross-sectional design, PA was measured objectively over 7 days in 72 participants (34 males) using an accelerometer (ActiGraph) and subjectively using the International Physical Activity Questionnaire (IPAQ). Perceived barriers to PA were assessed using the Barriers to Physical Activity in Diabetes (type 1) scale. Multiple linear regression models assessed the influence of PA on HbA1c and CVD risk factors. Results Mean age ± SD was 40.9 ± 12.9 years, diabetes duration was 18 ± 11.6 years, and HbA1c was 65 ± 14 mmol/mol /8.0 ± 1.3%. Twenty-three (32%) participants exercised according to PA recommendations as measured by an accelerometer. Sixty-nine (97%) participants reported meeting the recommendations as per the IPAQ. Those meeting recommendations (accelerometry) had a lower HbA1c (p = 0.001), BMI (p = 0.032), waist circumference (p = 0.006), and fat mass (p = 0.032) and a greater number of hypoglycaemic events (p = 0.004). Fear of hypoglycaemia was the strongest barrier to PA (mean 3.4 ± 2.0). Conclusion The majority of participants failed to meet PA recommendations. Meeting the recommendations was associated with healthier CVD risk factor profiles. Individuals with T1DM possibly overestimate their PA using self-reported measures and require support and education to safely improve activity levels.

Relationship between Objectively and Subjectively Measured Physical Activity in Adolescents during and after COVID-19 Restrictions

“…As expected, participants tended to significantly overestimate their actual PA at the MVPA intensity. This is in line with the body of literature on the topic, independently of the type of participants and the personal/environmental conditions during the study [ 18 , 38 , 39 , 40 ].…”

Barriers to Physical Activity in Children and Adults Living With Type 1 Diabetes: A Complex Link With Real-life Glycemic Excursions

“…To our knowledge, this work is the first of its kind to explore the link between barriers to PA with actual everyday life glycemic excursions, especially during PA. In all the target groups (adults, children, parents), the fear of hypoglycemia was the top barrier to PA in line with the literature [10][11][12][33][34][35]. We show that the more time children/adolescents spent in hypoglycemia on the nights subsequent to everyday life PA sessions ≥1.5 MET-hours, the more they reported fear of exercise-induced hypoglycemia as a barrier.…”

“…Moreover, more than half (55,3%) of the adults in the current study met the international PA recommendations, unlike participants in other studies (e.g. 33% [39] ; 32% [33]). It is thus possible that the number of participants with low PA levels in our study was too small to highlight the link between low levels of PA and high scores of barriers to PA as detected by Keshawarz et al [10].…”

From Zero to Hero: Type 2 Diabetes Mellitus Patients Hike on the Way of St. James—A Feasibility Study with Analyses of Patients’ Quality of Life, Diabetes Distress and Glucose Profile

“…The relatively low overall PAID scores can be rated as positive because physical activity can be stressful, especially for insulin-treated patients with diabetes, given their risk of hypoglycemia and the higher demands set on diabetes self-management to prevent exercise-induced hypoglycemia [ 25 ]. According to Finn et al [ 26 ], this may in fact be a reason for non-adherence to physical activity programs or for not following physical activity recommendations. Their concerns about hypoglycemia may have been lower due to the presence of professional medical personnel during the hike.…”