Determinants of physical activity among 6856 individuals with diabetes: a nationwide cross-sectional study

Abstract

IntroductionThe aims of this cross-sectional study were to (1) describe habitual physical activity and adherence to WHO recommendations, and (2) investigate the association of comorbidity, obesity, stress, and health-related quality of life (HRQoL) with moderate to vigorous physical activity (MVPA) among individuals with diabetes.Research design and methodsThis study included 6856 participants with diabetes from the Danish National Health Survey from 2017. The primary outcome measure was weekly MVPA. Exposures included self-reported number of conditions, body mass index (BMI), perceived stress, and HRQoL. Mean difference in MVPA across exposures was estimated by multiple linear regression analyses.ResultsForty per cent of individuals with diabetes were not adherent to WHO recommendations for physical activity. Individuals with diabetes had higher BMI, more comorbidities, higher perceived stress, and lower HRQoL. Individuals with three or more comorbidities were significantly associated with lower weekly MVPA (−0.48 hours/week, 95% CI −0.88 to −0.07) compared with individuals with no comorbidity. Furthermore, overweight or obese (class I–III) individuals engaged in significantly less weekly MVPA (obese class III vs normal weight: −1.98 hours/week, 95% CI −2.49 to −1.47). Higher perceived stress was significantly associated with lower weekly MVPA (−1.76 hours/week, 95% CI −2.18 to −1.34) versus low perceived stress. Finally, having low physical and mental HRQoL was associated with lower weekly MVPA (−0.93 hours/week, 95% CI −1.19 to −0.66 and −0.39 hours/week, 95% CI −0.71 to −0.08 respectively vs moderate or high HRQoL).ConclusionsWe found that 40% of individuals with diabetes do not engage regularly in adequate physical activity. Comorbidities, higher BMI, higher perceived stress, and lower HRQoL were associated with less engagement in physical activity. This study suggests that subgroups of individuals with diabetes are at higher risk of physical inactivity.

Accelerometer-derived physical activity and sedentary behaviors in individuals with newly diagnosed type 2 diabetes: A cross-sectional study from the Danish nationwide DD2 cohort

“…Risk factors associated with a high-risk physical activity profile presented in prevalence rate ratios mutually adjusted for all other risk factors. associated with physical activity levels (37). Our results showed that especially the presence of more than two comorbid conditions was associated with an almost 2-fold higher prevalence of a high-risk physical activity profile.…”

“…We found older age, higher BMI, unemployment, retirement, comorbidities and current smoking to be associated with a high-risk physical activity profile consisting of high sedentary time and low moderate-to-vigorous physical activity. Another study on correlates of physical activity in individuals with type 2 diabetes has reported similar associations in addition to higher perceived stress and lower health-related quality of life being negatively associated with physical activity levels ( 37 ). Our results showed that especially the presence of more than two comorbid conditions was associated with an almost 2-fold higher prevalence of a high-risk physical activity profile.…”

Detailed descriptions of physical activity patterns among individuals with diabetes and prediabetes: the Lolland-Falster Health Study

“…In addition, since total volume of physical activity has been reported being equally strongly associated with cardiometabolic health as MVPA,35 52 a whole-day approach should be considered when increasing physical activity in individuals with diabetes. Focusing on increasing LPA in a whole-day perspective rather than exercise-based MVPA in a short timeframe among inactive individuals with diabetes could offer a seemingly equally effective approach, particularly if they suffer from other determinants such as obesity and comorbidities that prevent them from engaging in exercise-type activities with higher intensities 6 7. Considering the low levels of physical activity among participants with diabetes in the present study, replacing a significant part of the day spent being sedentary with LPA may be more feasible for some to overcome possible barriers of engagement in higher intensity activities.…”

“…Most prior studies used self-reported instruments and only estimated adherence to the recommendations of physical activity in individuals with diabetes 7 8 28 29. We identified few studies that used device-based measurements among individuals with diabetes or prediabetes to report physical activity intensities and adherence to WHO recommendations.…”

“…Although regular physical activity among individuals with diabetes is important, the whole-day physical activity pattern is largely unknown. Most population-based studies used self-reported instruments to assess physical activity and reported that a large proportion of individuals with diabetes did not adhere to physical activity recommendations 7 8. However, numbers in these reports may be inaccurate, for example, due to social desirability and recall bias.…”