Attitudes to Exercise and Diabetes in Young People with Type 1 Diabetes Mellitus: A Qualitative Analysis

Abstract

AimsTo investigate young people’s attitudes to, and understanding of, physical activity on glycaemic control in Type 1 Diabetes Mellitus.MethodsFour focus groups with 11–14 and 15–16 year olds were conducted with twelve young people with Type 1 Diabetes, from within a larger study investigating physical activity and fitness. Qualitative analysis of the focus group data was performed using Interpretative Phenomenological Analysis.ResultsFour superordinate themes were identified: Benefits of Exercise, Knowledge and Understanding, Information and Training and “You can do anything”. Young people felt that exercising helped them to manage their diabetes and had a beneficial psychological and physical impact on their bodies. They reported a lack of knowledge and understanding about diabetes among school staff and other young people. The overwhelming sense from young people was that although diabetes impacts upon their lives, with preparation, physical activity can take place as normal.ConclusionsWhilst young people had an awareness of the physical and psychological benefits of exercise in managing their diabetes, they experienced difficulties at school. Professional support and discussions with young people, giving tailored strategies for managing Type 1 Diabetes during exercise are needed. Healthcare teams should ensure that the support and educational needs of school staff are met. Providing more opportunities to empower young people to take on the responsibility for their Type 1 Diabetes care is merited. Young people felt diabetes did not stop them from participating in activities; it is simply a part of them that needs managing throughout life.

Feasibility and safety of a group physical activity program for youth with type 1 diabetes

“…Each session consisted of 35 minutes of MVPA followed by 45 minutes of discussion of relevant topics. The intervention targeted two identified barriers to MVPA for adolescents with type 1 diabetes . First, it augmented supervised MVPA exercises and games with diabetes self‐management education (DSME) and glucose self‐monitoring activities so that adolescents could develop skill controlling their own glucose around enjoyable MVPA activities.…”

“…First, it augmented supervised MVPA exercises and games with diabetes self‐management education (DSME) and glucose self‐monitoring activities so that adolescents could develop skill controlling their own glucose around enjoyable MVPA activities. Second, it created an environment to practice MVPA exclusive to peers with type 1 diabetes and to alleviate social concerns regarding disclosure of diabetes around MVPA (eg, testing glucose before school sports) . Our intention was that decision‐making and self‐monitoring skills learned and practiced in this safe environment would transfer to sustaining active living outside the sessions as well.…”

“…Among the challenges of engaging in regular MVPA for adolescents with type 1 diabetes are the need for monitoring blood glucose levels and adjusting diet and insulin before, during, and after MVPA. Adolescents, parents, and healthcare providers have reported that these responsibilities are carried out without adequate support resources . Adolescence is a period of transition in type 1 diabetes management, in which responsibility for diabetes management shifts from being family‐centered to being more autonomous .…”

“…Adolescence is a period of transition in type 1 diabetes management, in which responsibility for diabetes management shifts from being family‐centered to being more autonomous . Adolescents and healthcare providers have concerns that teachers and coaches supervising organized sports have limited knowledge and understanding of safe diabetes management to support them with engagement in MVPA . Lack of support for self‐management of type 1 diabetes for MVPA may account for the fact that fewer than half of adolescents with type 1 diabetes make appropriate adjustments to diet and insulin to accommodate MVPA .…”

ISPAD Clinical Practice Consensus Guidelines 2018: Management and support of children and adolescents with type 1 diabetes in school

“…The same information should be passed on to the trainer and the school. While the school is a very important environment for the introduction and encouragement of physical activity, it is also recognized that there will be a lack of knowledge and understanding about T1D and physical exercise …”