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Barriers to Exercise in Adults with Type 1 Diabetes and Insulin Resistance

Alobaid, A, Zulyniak, MA, Ajjan, RA, Brož, Jan, Hopkins, M and Campbell, Matthew (2023) Barriers to Exercise in Adults with Type 1 Diabetes and Insulin Resistance. Canadian Journal of Diabetes.

Item Type: Article


Objective: To explore attitudes to exercise and quality of life (QoL) in adults with type 1 diabetes (T1D) with and without insulin resistance (IR).
Design: We pooled baseline pre-treatment data from a subset of T1D individuals from two randomised controlled trials (RCT). Estimated glucose disposal rate (eGDR), a validated surrogate marker of IR, was calculated using an established formula to classify individuals according to IR status with a cut-point of <6mg/kg/min for the determination of IR. Self-reported barriers to exercise were obtained using a validated questionnaire, the Barriers to Physical Activity in T1D (BAPAD-1). In addition, QoL was determined using the 36-item short form (SF-36) questionnaire. Differences between dichotomised variables were assessed using independent t-tests, Mann-Whitney U tests or Fisher’s exact tests. Linear regression was employed to explore the association of eGDR with BAPAD-1 and QoL scores, with sequential adjustment for potential confounders.
Results: Of 85 individuals included, n=39 were classified as having IR. The mean BAPAD-1 total score was higher for individuals with IR (IR 3.87±0.61 vs. non-IR 2.83±0.55; P<0.001). The highest exercise barrier scores for individuals with IR were risk of hypoglycaemia (5.67±1.26) and risk of hyperglycaemia (5.23±1.20), whereas the highest scoring exercise barrier scores for non-IR individuals were non-diabetes related; low level of fitness (3.91±1.26) and physical health status excluding diabetes (3.67±1.48) were ranked highest. QoL scores were comparable between groups (P>0.05).
Conclusions: Risk of hypoglycaemia was the greatest barrier to exercise in T1D individuals with IR, whereas non-diabetes related barriers to exercise were more salient in T1D individuals without IR.

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Uncontrolled Keywords: Physical activity; attitudes to exercise; insulin resistance; quality of life; type 1 diabetes.
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Depositing User: Matthew Campbell


Item ID: 16054
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Official URL:

Users with ORCIDS

ORCID for Jan Brož: ORCID iD
ORCID for Matthew Campbell: ORCID iD

Catalogue record

Date Deposited: 31 May 2023 13:23
Last Modified: 31 May 2023 13:23


Author: Jan Brož ORCID iD
Author: Matthew Campbell ORCID iD
Author: A Alobaid
Author: MA Zulyniak
Author: RA Ajjan
Author: M Hopkins

University Divisions

Faculty of Health Sciences and Wellbeing > School of Nursing and Health Sciences


Sciences > Biomedical Sciences

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