Endocrine Abstracts

^*These authors contributed equally to this work.

Background

Regular physical activity has a crucial role in the control of Type 1 Diabetes (T1D). Insecurity in the management of insulin therapy and fear for dysglycemia are barriers to the practice of exercise in T1D.

Aim

To identify barriers to regular physical activity in adult patients with T1D; to evaluate the impact of two educational sessions about exercise and strategies to achieve better glycemic control in this setting.

Materials and Methods

We conducted an online prospective study with adult patients with T1D, treated with functional insulin therapy (multiple daily injections regimen, exclusively). The patients had to perform physical activity regularly. Two 45 minutes Zoom webinars were carried out, with a two-day interval between them. In the first session, different types of exercises and strategies to adopt to minimize hipo- and hyperglycemias were explained. The second session was more practical with the debate of clinical cases brought by the speakers and the participants. The impact of the webinars in the knowledge of the attendees was evaluated through 15 questions applied before and after the sessions. For the assessment of perceived barriers to physical activity, the BAPAD-1 scale was used.

Results

We invited 67 patients to participate; 19 (28.4%) accepted and answered the BAPAD-1 scale. The majority were men (57.9%). Average age was 34 ± 8.8 years and median disease duration was 12.3 ± 10.4 years. In BAPAD-1, the average global score was 30.3 ± 12.3 points [maximum score: 77 (seven points per question)]; women had a higher global score (38.0 vs 24.7, P = 0.015). Fear of hypoglycemia was the main barrier to the practice of exercise (median score 5.0), in particular for women (P = 0.015). Weather conditions and the location of the gym were also frequent barriers in our population. Thirteen patients answered the pre-sessions’ test. The average classification was 71.8 ± 10.6%. Ten patients attended both sessions and answered the after-sessions’ test. The global score improved (92.7 ± 8.0%, P < 0.001). After the webinars, 80% of patients reported feeling confident/very confident in the management of their T1D in this particular setting. All the patients reported being satisfied with the sessions.

Conclusions

Patients with T1D face various barriers to the practice of exercise, mainly fear of hypoglycemia. Therefore, therapeutic education should pay special attention to hypoglycemia management. The webinars showed to be effective in increasing confidence and additional strategies to minimize exercise-induced dysglycemia. The low rate of participation was reported to be due to constraints associated with work and with the COVID-19 pandemic.