Prescription of Physical Activity by General Practitioners in Type 2 Diabetes: Practice and Barriers in French Guiana

Abstract

BackgroundGeneral practitioners (GPs) are the major primary healthcare players in the management of type 2 diabetes. In addition to a well-balanced diet, physical activity (PA) appears as a necessary non-medicinal therapy in the management of diabetic patients. However, GPs emphasize several obstacles to its prescription. The aim of this study is to evaluate the practices, barriers, and factors favoring the prescription of PA in type 2 diabetic patients by GPs in French Guiana.MethodWe conducted a cross-sectional descriptive study using a questionnaire, designed to interview 152 French Guiana GPs and describe their practice in prescribing PA in type 2 diabetic patients.ResultsOur results revealed that the prescription of PA as a non-medicinal therapeutic choice in the management of type 2 diabetes was practiced by 74% of the French Guiana GPs. However, only 37% of GPs responded that they implemented the recommendations; indeed, only one-third knew about them. The majority of GPs were interested in PA training, but only 11% were actually trained in this practice. The lack of structure adapted to the practice of PA and the lack of awareness of the benefits of PA in metabolic pathology appeared as the main obstacles to PA prescription.ConclusionThis study highlights the importance of improving the training of GPs in the prescription of PA, the development of adapted PA structures, and collaboration between the different actors within the framework of the sport-health system in type 2 diabetes in French Guiana.

Exercise Is Medicine through Time: Prescription of Adapted Physical Activity in Treatment and Rehabilitation

“…Increased muscular strength may be a general predictor of functional lower limb strength and improved balance. The APA group demonstrated this by increasing the load lifted in the 1RM leg press and the number of repetitions completed during the 30" STS test [30,31]. Otherwise, there were no appreciable changes in APA as indicated by the upper limb strength testing.…”

“…Globally, type 2 diabetes is a significant public health issue. Even though physical activity (PA) has been shown to have positive benefits on type 2 diabetic patients, a 2009 World Health Organization (WHO) study states that 27% of the disease is caused by physical inactivity [30,31]. To assist reduce risk factors and avoid metabolic diseases, the French National Health Authority has promoted PA since 2011 by including it as a non-medicinal therapy and an essential component of the type 2 diabetes care route.…”

“…This is a challenging goal to accomplish in an area where a significant infrastructure gap is caused by rapid population growth and unplanned city expansion. Conclusively, in order to effectively treat type 2 diabetes in French Guiana, it is imperative that general practitioners have better training in prescribing PA, that appropriate PA structures be developed, and that stakeholders in the sport-health system cooperate together [30,31].…”

Knowledge and practice of the physical activity prescription by generalists and specialist physicians of the City of Kinshasa: A cross-sectional study

“…It is also possible that the existence or absence of a public health policy governing doctors' involvement of in PA promotion plays a signi cant role. It appears that the highest proportions are found in studies conducted in countries with public health policies, such as "prescription physical activity" (14,(18)(19)(20)(21)(22)(23)(24). Among other things, these guidelines give GPs the authority to prescribe PA.…”

Exercise Prescription Principles among Physicians and Physical Therapists for Patients with Impaired Glucose Control: A Cross-Sectional Study

“…Physical therapists were also more likely than physicians to recommend anaerobic exercise and to “always” refer patients with glucose control issues to another physical exercise specialist. Increasing referrals to exercise specialists may improve exercise recommendations by overcoming some of the barriers to exercise prescription [ 40 ].…”