Physical activity (PA) is an important element in type 2 diabetes mellitus (T2DM) management. The aims of this study were to assess the percentage of adults with T2DM who perform PA, according to the intensity level and to describe barriers to exercise and the association between metabolic control and other clinical variables.
Multicenter, observational, cross-sectional study. Data were collected through the International PA Questionnaire (IPAQ) and the PA Barrier Questionnaire. Adults (18–65 years old) with T2DM from 17 Argentine diabetes centers were included, from May to July 2018.
A total of 270 men (54.9 ± 9.8 years) and 225 women (55.3 ± 9.6 years) were included. Duration of diabetes: 8.2 ± 6.3 years. The BMI in men was 32 ± 10.6 kg/m2, whereas that in women was 32.5 ± 7.2 kg/m2. The last two HbA1c values were 7.6 ± 1.7% and 7.5 ± 1.6. Results also showed that 12.7% had clinical heart disease, 13.7% had nephropathy, 20.8% had neuropathy, 6.1% had diabetic foot and 14.1% had retinopathy. The level of PA was low in 52.3% of the patients studied and moderate in 30.5%. The most frequent barriers were: “lack of will” (59.6%) and “lack of energy” (37.2%). The low level of PA was associated with age (OR: 1.05 per year of age; p < 0.001), HbA1c (OR: 1.16 per 1%; p < 0.05), BMI (OR: 1.06 per kg/m2; p < 0.001) and sex (OR: 1.69 for women; p < 0.01).
PA in a cornerstone in management T2DM. Nevertheless, in this study, 52.3% of T2DM adults showed low level of PA. The main barriers reported were related to low personal motivation. These factors should be taken into account to implement programs to promote physical activity.
Citation: Carolina Gómez Martin, Maria Laura Pomares, Carolina Maria Muratore, Pablo Javier Avila, Susana Beatriz Apoloni, Martín Rodríguez, Claudio Daniel Gonzalez. Level of physical activity and barriers to exercise in adults with type 2 diabetes[J]. AIMS Public Health, 2021, 8(2): 229-239. doi: 10.3934/publichealth.2021018
Physical activity (PA) is an important element in type 2 diabetes mellitus (T2DM) management. The aims of this study were to assess the percentage of adults with T2DM who perform PA, according to the intensity level and to describe barriers to exercise and the association between metabolic control and other clinical variables.
Multicenter, observational, cross-sectional study. Data were collected through the International PA Questionnaire (IPAQ) and the PA Barrier Questionnaire. Adults (18–65 years old) with T2DM from 17 Argentine diabetes centers were included, from May to July 2018.
A total of 270 men (54.9 ± 9.8 years) and 225 women (55.3 ± 9.6 years) were included. Duration of diabetes: 8.2 ± 6.3 years. The BMI in men was 32 ± 10.6 kg/m2, whereas that in women was 32.5 ± 7.2 kg/m2. The last two HbA1c values were 7.6 ± 1.7% and 7.5 ± 1.6. Results also showed that 12.7% had clinical heart disease, 13.7% had nephropathy, 20.8% had neuropathy, 6.1% had diabetic foot and 14.1% had retinopathy. The level of PA was low in 52.3% of the patients studied and moderate in 30.5%. The most frequent barriers were: “lack of will” (59.6%) and “lack of energy” (37.2%). The low level of PA was associated with age (OR: 1.05 per year of age; p < 0.001), HbA1c (OR: 1.16 per 1%; p < 0.05), BMI (OR: 1.06 per kg/m2; p < 0.001) and sex (OR: 1.69 for women; p < 0.01).
PA in a cornerstone in management T2DM. Nevertheless, in this study, 52.3% of T2DM adults showed low level of PA. The main barriers reported were related to low personal motivation. These factors should be taken into account to implement programs to promote physical activity.
American Diabetes Association
Body mass index
Glycated Hemoglobin A1c
High-performance liquid chromatography
International Physical Activity Questionnaire
Metabolic Equivalent of task
Physical activity
Type 2 diabetes mellitus
World Health Organization
[1] | American Diabetes Association (2018) 5. Lifestyle management: Standards of Medical Care in Diabetes. Diabetes Care 41: S38-S50. |
[2] | Martínez-Gómez D, Guallar-Castillon P, Mota J, et al. (2015) Physical activity, sitting time and mortality in older adults with diabetes. Int J Sports Med 36: 1206-1211. doi: 10.1055/s-0035-1555860 |
[3] | Colberg SR, Sigal RJ, Yardley JE, et al. (2016) Physical activity/exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care 39: 2065-2079. doi: 10.2337/dc16-1728 |
[4] | Mendes R, Sousa N, Almeida A, et al. (2016) Exercise prescription for patients with type 2 diabetes—A synthesis of international recommendations: Narrative review. Br J Sports Med 50: 1379-1381. doi: 10.1136/bjsports-2015-094895 |
[5] | International Diabetes Federation. IDF Diabetes Atlas (2019) .Available from: https://www.diabetesatlas.org/en/. |
[6] | Ministry of Health, Argentina. 4th National Risk Factors Survey (2019) .Available from: https://www.indec.gob.ar/ftp/cuadros/publicaciones/enfr_2018_resultados_definitivos.pdf. |
[7] | Thomas N, Alder E, Leese GP (2004) Barriers to physical activity in patients with diabetes. Postgrad Med J 80: 287-291. doi: 10.1136/pgmj.2003.010553 |
[8] | Morrato EH, Hill JO, Wyatt HR, et al. (2007) Physical activity in U.S. adults with diabetes and at risk for developing diabetes, 2003. Diabetes Care 30: 203-209. doi: 10.2337/dc06-1128 |
[9] | Rodríguez M, Puchulu F (2015) Conocimiento y actitudes hacia la diabetes mellitus en la Argentina [Knowledge and attitude towards diabetes mellitus in Argentina]. Medicina 75: 353-366. |
[10] | Dillman CJ, Shields CA, Fowles JR, et al. (2010) Including physical activity and exercise in diabetes management: Diabetes educators' perceptions of their own abilities and the abilities of their patients. Can J Diabetes 34: 218-226. doi: 10.1016/S1499-2671(10)43010-5 |
[11] | Heath GW, Parra DC, Sarmiento OL, et al. (2012) Evidence-based intervention in physical activity: Lessons from around the world. Lancet 380: 272-281. doi: 10.1016/S0140-6736(12)60816-2 |
[12] | Heiss V, Petosa R (2014) Correlates of Physical Activity Among Adults with Type 2 Diabetes: A Systematic Literature Review. Am J Heal Educ 45: 278-287. doi: 10.1080/19325037.2014.933139 |
[13] | Egan AM, Mahmood WAW, Fenton R, et al. (2013) Barriers to exercise in obese patients with type 2 diabetes. QJM Int J Med 106: 635-638. doi: 10.1093/qjmed/hct075 |
[14] | Alghafri T, Alharthi SM, Al Farsi YM, et al. (2017) Perceived barriers to leisure time physical activity in adults with type 2 diabetes attending primary healthcare in Oman: A cross-sectional survey. BMJ Open 7: e016946. doi: 10.1136/bmjopen-2017-016946 |
[15] | Lidegaard LP, Schwennesen N, Willaing I, et al. (2016) Barriers to and motivators for physical activity among people with Type 2 diabetes: patients' perspectives. Diabet Med 33: 1677-1685. doi: 10.1111/dme.13167 |
[16] | Dutton GR, Johnson J, Whitehead D, et al. (2005) Barriers to physical activity among predominantly low-income African-American patients with type 2 diabetes. Diabetes Care 28: 1209-1210. doi: 10.2337/diacare.28.5.1209 |
[17] | Morales E, Torres W, Mejias J, et al. (2015) Estimación de los niveles de actividad física en pacientes con diabetes tipo 2 que asisten al centro de investigaciones endocrino—metabólicas “Dr. Félix Gómez” Maracaibo - estado Zulia. Síndrome Cardiometabólico 2: 79-85. |
[18] | Manzaneda AJ, Lazo-Porras M, Málaga G (2015) Actividad física en pacientes ambulatorios con diabetes mellitus 2 de un Hospital Nacional del Perú. Rev Perú Med Exp Salud Publica 32: 311-315. doi: 10.17843/rpmesp.2015.322.1626 |
[19] | Morales J, Carcausto W, Varillas Y, et al. (2018) Actividad física en pacientes con diabetes mellitus del primer nivel de atención de Lima Norte. Latinoam Hipertens 13: 49-54. |
[20] | Delgado Fernández M, Tercedor Sánchez P, Manuel Soto Hermoso V (2015) Traducción de La Guía Para El Procesamiento de Datos y Análisis Del Cuestionario Internacional de Actividad Física (IPAQ). Versiones Corta y Larga . |
[21] | Caravalí Meza N, Bacardi Gascón M, Armendáriz-Anguiano A, et al. (2016) Validación del Cuestionario de Actividad Física del IPAQ en Adultos Mexicanos con Diabetes Tipo 2. J Negat No Posit Results 1: 93-99. |
[22] | Centers for Disease Control and Prevention HHS, NIH, NIDDK, NDEP. Barriers to being active quiz Accessed July 1, 2020. Available from: http://www.cdc.gov/nccdphp/dnpa/physical/life/barriers_quiz.pdf. |
[23] | Rubio-Henao RF, Correa JE, Ramírez-Vélez R (2015) Propiedades psicométricas de la versión al Español del cuestionario “Barriers to being active quiz”, entre estudiantes universitarios de Colombia. Nutr Hosp 31: 1708-1716. |
[24] | Instituto Nacional de Estadística y Censos. Censo 2010. Available from: https://www.indec.gob.ar/indec/web/Nivel4-Tema-2-41-135. |
[25] | World Medical Association declaration of Helsinki (2013) Ethical principles for medical research involving human subjects. J Am Med Assoc 310: 2191-2194. |
[26] | Kennerly AM, Kirk A (2018) Physical activity and sedentary behaviour of adults with type 2 diabetes: a systematic review. Pract Diabetes 35: 86-89. doi: 10.1002/pdi.2169 |
[27] | Lipert A, Jegier A (2017) Comparison of Different Physical Activity Measurement Methods in Adults Aged 45 to 64 Years under Free-Living Conditions. Clin J Sport Med 27: 400-408. doi: 10.1097/JSM.0000000000000362 |
[28] | Palermo M, Sandoval MA (2016) Assessment of Physical Activity Level among Patients with Type 2 Diabetes Mellitus at the UP—Philippine General Hospital Diabetes Clinic. J ASEAN Fed Endocr Soc 31: 144. |
[29] | Chang C, Khurana S, Strodel R (2018) Perceived Barriers to Physical Activity Among Low-Income Latina Women at Risk for Type 2 Diabetes. Diabetes Educ 44: 444-453. doi: 10.1177/0145721718787782 |
publichealth-08-02-018-s001.pdf |