Physical activity behaviour in people with diabetes residing in India: A cross-sectional analysis

Summary

Aim

To describe and analyse physical activity behaviour and barriers and facilitators, in adults with diabetes residing in India.

Methods

The sample consisted of 190 (110 men and 80 women) adults with diabetes living in India. The mean age of the sample was 57 years (18 to 83 years), and the mean duration since diagnosis of diabetes was 10.38 years (SD 8.41 years). All participants completed a questionnaire about their physical activity behaviour, importance of, and barriers and facilitators.

Results

In all, 78.9% of participants thought that physical activity was important in the control of diabetes. In all, 54.7% of respondents did regular physical activity every week, and physical activity was more frequent in men (63.6%), and in those with an intermediate (60%) or advanced (65.2%) level of English. Barriers that discouraged participants from physical activity were lack of time (31.6%), lack of knowledge (23.2%) and health limitations (17.4%). Potential identified facilitators included more information about physical activity (39%) and group exercise with people of the same sex or speaking the same language.

Conclusions

Most of the sample thought that physical activity is important to control diabetes, although few participated in regular physical activity. Findings also suggest that physical activity had a higher importance for men, for those with an advanced level of English and those under 60 years of age. Men, those with intermediate or advance level of English, and people under 60 years were significantly more active.

Résumé

Objectif

Décrire et analyser les niveaux, les barrières et les facilitateurs de l’activité physique chez les adultes diabétiques résidant en Inde.

Méthodes

L’échantillon était constitué de 190 adultes (110 hommes et 80 femmes) atteints de diabète vivant en Inde. L’âge moyen de l’échantillon était de 57 ans (18 à 83 ans) et la durée moyenne du diagnostic de diabète était de 10,38 ans (écart-type de 8,41 ans). Tous les participants ont rempli un questionnaire sur leur niveau, leur importance, les obstacles et les facilitateurs pour l’activité physique.

Résultats

Au total, 78,9 % des participants pensaient que l’activité physique était importante dans le contrôle du diabète. Au total, 54,7 % des répondants faisaient de l’activité physique régulièrement chaque semaine, et l’activité physique était plus fréquente chez les hommes (63,6 %) et chez ceux ayant un niveau d’anglais intermédiaire (60 %) ou avancé (65,2 %). Les obstacles qui décourageaient les participants à l’activité physique étaient le manque de temps (31,6 %), le manque de connaissances (23,2 %) et les limitations en matière de santé (17,4 %). Les facilitateurs potentiels identifiés comprenaient plus d’informations sur l’activité physique (39 %) et des exercices de groupe avec des personnes du même sexe ou qui parlent la même langue.

Conclusions

La majorité de l’échantillon pensait que l’activité physique est importante pour contrôler le diabète, même si peu d’entre eux participaient à une activité physique régulière. Les résultats suggèrent également que l’activité physique a une plus grande importance pour les hommes, pour ceux qui ont un niveau d’anglais avancé et ceux de moins de 60 ans. Les hommes, ceux qui ont un niveau d’anglais intermédiaire ou avancé et les personnes de moins de 60 ans étaient significativement plus actifs.

Introduction

India has one of the highest prevalence of diabetes mellitus in the world (n ≥62 million) [1]. It is predicted that by 2030 79.4 million individuals residing in India will suffer from the condition [1]. The prevention and good management of diabetes to reduce complications is thus of paramount importance. Indeed, several studies have underlined the central role of physical activity in the management of type 1 or type 2 diabetes [2], [3]. In those with diabetes physical activity has been shown to improve glycemic control, insulin sensitivity, and restore diabetes associated complications (cardiovascular disease and retinopathy) [4]. However, despite such knowledge, diabetes-related vascular complications and other factors often discourage participation in physical activity [3].

Even though evidence points to the positive improvements associated with physical activity in diabetes management, studies have reported a low prevalence of physical activity in those with diabetes, with some studies reporting that only 10% of people participate [5]. One explanation may be that few physicians prescribe physical activity as a therapy for diabetes because there is a lack of information on how to implement such therapies [3]. In light of this knowledge, physical activity guidelines have been developed for people with diabetes [6]. These practice guidelines recommend that people with diabetes obtain at least 150 minutes of moderate to vigorous physical activity (MVPA) per week. It is also necessary to highlight that resistance training is important, that doing small amounts of physical activity can be better than doing none, and that it is important to reduce time spent being sedentary [6], [7], [8]. Furthermore, the position statement of the American Diabetes Association about physical activity and diabetes [9] should be taken into consideration. This statement offers detailed recommendations of physical activity for people with diabetes similar to those stated above. Interventions targeting physical activity promotion in populations with diabetes are therefore needed. However, before this is implemented, it is important to know the levels of physical activity for whom the intervention is to be designed, and if possible explore barriers that are associated with the current levels of activity. A recent review investigated barriers of physical activity in those with diabetes mellitus. The most commonly reported barriers were time constraints, fear of provoking additional disorders, exercise venue and weather-related barriers. The review concluded that additional data is needed to better understand physical activity behaviours [10]. One study not included in the aforementioned review interviewed 28 participants with type 2 diabetes on barriers and facilitators to physical activity participation; four main themes were identified:

• the body as a barrier to physical activity because of functional limitations;

• logistical challenges, including lack of time and awareness of where to exercise in the local area;

• being physically active with others, providing a sense of mutual commitment and enjoyment may facilitate physical activity;

• goal-setting and self-tracking may also facilitate physical activity [11].

At present, there is a paucity of studies exploring physical activity behaviour in those with diabetes residing in India, as well as barriers of, and facilitators to, physical activity in this population. Such information is necessary to aid in the development of a targeted physical activity promotion strategy for this sample. The aims of the present study are to:

• describe physical activity behaviour;

• as well as barriers of and facilitators to physical activity, in a sample of adults with diabetes residing in India.