Changes in physical activity among adults with diabetes: a longitudinal cohort study of inactive patients with Type 2 diabetes who become physically active

Abstract

AimsTo identify the predictors and clinical effects among inactive patients with diabetes who become physically active, in the setting of a large integrated health system.MethodsWe studied adults with Type 2 diabetes with at least two clinic visits between December 2011 and November 2012 who reported being inactive at their first visit. The mean (±sd) interval between their first and last visit was 6.2 (±2.3) months. We analysed self‐reported moderate‐to‐vigorous physical activity data collected using a structured intake form during routine clinical care.ResultsThe study cohort (N = 6853) had a mean age of 60.2 years; 51.4% were women and 53.6% were non‐white. Nearly two‐thirds (62.5%, n = 4280) reported remaining physically inactive, while 16.0% reported achieving the recommended moderate‐to‐vigorous physical activity levels (≥ 150 min/week) by the last visit of the study period. Female gender (odds ratio 0.77, 95% CI 0.67, 0.88), obesity (BMI 30–34.9 kg/m2: odds ratio 0.76, 95% CI 0.60, 0.97; BMI ≥ 35 kg/m2: odds ratio 0.55, 95% CI 0.42, 0.70), chronic kidney disease (odds ratio 0.78, 95% CI 0.65, 0.94) and depression (odds ratio 0.77, 95% CI 0.62, 0.96) were each independently associated with not achieving the recommended moderate‐to‐vigorous physical activity level, while physician referral to lifestyle education was a positive predictor (odds ratio 1.40, 95% CI 1.09, 1.85). Controlling for baseline differences, patients achieving the recommended moderate‐to‐vigorous physical activity target lost 1.0 kg more weight compared with patients remaining inactive (P < 0.001).ConclusionsPatients with diabetes in a real‐world clinical setting lost weight after becoming physically active; however, nearly two‐thirds of patients remained inactive. Novel interventions to address physical inactivity in primary care should address barriers faced by older patients with medically complex disease.

Self-regulation resources and physical activity participation among adults with type 2 diabetes

“…It is worth noting that only 13 percent of patients are achieving the composite goal of these three clinical indicators ( Leiter et al, 2013 ). Despite the benefits of PA for T2D, between 60 and 70 percent of adults with diabetes in the United States and in Canada are not practicing enough PA or are not considered physically active ( Health Canada, 2002 ; Morrato et al, 2007 ; Palakodeti et al, 2015 ), compared to between 40 and 50 percent of adults in the non-diabetic US and Canadian populations ( Health Canada, 2002 ; Morrato et al, 2007 ; Statistics Canada, 2014 ; Ward et al, 2016 )…”

Feasibility and behavioral effects of prolonged static and dynamic standing as compared to sitting in older adults with type 2 diabetes mellitus

“…For example, despite well-known physical exercise-related health benefits, in general, the older adult population remains sedentary for an average of 9.4-hours a day (up to 80% of their waking day) [23]. Diabetic patients engage even 10-20% less frequently in physical activities [24][25][26]. These observations indicate a clinically unmet need to promote physical activity in older adult patient populations who need it the most.…”

Implementation and evaluation of a primary diabetes prevention programme for young adult employees in Japan: A non‐randomized controlled trial

“…The amount of physical activity did not change with education. Even patients with a diagnosis of diabetes have trouble learning to exercise regularly despite specific rewards such as control of blood sugar and prevention of complications (Morrato, Hill, Wyatt, Ghushchyan, & Sullivan, ; Palakodeti, Uratsu, Schmittdiel, & Grant, ; Senba, Sato, Koga, & Fujita, ), so it is probably even harder for healthy young adults to prioritize exercise over jobs or time with family. Some factors that have been found to inhibit exercise are difficulty of securing free time and the desire to spend free time and money on more pleasurable activities (Tanbo & Inagaki, ).…”