“I Tried Forcing Myself to do It, but Then It Becomes a Boring Chore”: Understanding (dis)engagement in Physical Activity Among Individuals With Type 2 Diabetes Using a Practice Theory Approach

Lack of physical activity (PA) is common among individuals with type 2 diabetes (T2D). We apply a practice theory approach to investigate PA engagement in the context of T2D. Data were collected through semi-structured individual interviews ( n = 23) and focus groups ( n = 3x6) and analyzed by deductive-inductive reflexive thematic analysis using a practice theory framework. Forty-one purposefully selected individuals with T2D (29 men) between the ages of 54 and 77 years were included. The analysis resulted in three main themes informed by five subthemes, reflecting the key elements of practice theory (i.e., meanings, materialities, and competencies). One overarching theme identified PA engagement as an unsustainable and insurmountable project in constant and unequal competition with the practice of physical inactivity. To increase PA among individuals with T2D, future PA interventions and strategies should aim to establish a stronger link between PA and everyday life practices.

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Vascular dysfunction and insulin stimulated blood flow : impact of physical inactivity and type 2 diabetes

10.32469/10355/48201 ◽

2014 ◽

Author(s):

◽

Leryn J. Boyle

Keyword(s):

Physical Activity ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Blood Flow ◽

Insulin Sensitivity ◽

Endothelial Function ◽

Physical Inactivity ◽

Vascular Dysfunction ◽

Insulin Stimulation

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] Individuals with type 2 diabetes (T2D) have blunted femoral artery insulin mediated blood flow which is critical for the delivery and uptake of glucose into skeletal muscle. However, it is unclear in humans the precise mechanisms by which insulin resistance impairs insulin stimulated blood flow. Further, chronic physical inactivity is a powerful stimulus for reduced insulin sensitivity and vascular dysfunction; however, the effects of short term, modest reductions in physical activity are limited. Thus, we examined 1) if inactivity for 5 days would impair endothelial function in healthy individuals (study one) 2) if reducing whole body insulin sensitivity, via 5 days of inactivity, would impair the blood flow response to insulin stimulation in parallel with glycemic control (study two) and 3) phosphorylation of endothelial nitric oxide (eNOS) and endothelin-1 (ET-1) production to insulin stimulation would be decreased and increased, respectively, in insulin resistant individuals (study three). We demonstrated significant reductions in endothelial function with only 5 days of reduced daily steps while blood flow to glucose ingestion was unaltered. Further, in obese humans with type 2 diabetes it does not appear that that the reduction in blood flow to 1 hr of insulin stimulation is due to altered peNOS or ET-1. Collectively, these data suggest that reduced daily physical activity and chronic insulin resistance mediate negative impacts on vascular function and insulin stimulated blood flow and signaling.

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Abstract 16: Economic Cost of Type 2 Diabetes Attributable to Physical Inactivity in the United States in 2012

Circulation ◽

10.1161/circ.133.suppl_1.16 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

Priyank P Shah ◽

Fayez Shamoon ◽

Mahesh Bikkina ◽

Harold Kohl

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Physical Inactivity ◽

Leisure Time ◽

Sensitivity Analyses ◽

Physical Activity Guidelines ◽

Average Annual Cost ◽

The Cost ◽

The U.S

Objective: Type 2 diabetes has grown to epidemic proportions in the U.S. and physical activity levels in the population continues to remain low, although it is a major primary preventive strategy for diabetes. The objectives of this study were to estimate the direct medical costs of type 2 diabetes attributable to not meeting physical activity Guidelines and to physical inactivity in the U.S. in 2012. Methods: This was a cross sectional study that used physical activity prevalence data from the 2012 Behavioral Risk Factor Surveillance System (BRFSS). Estimates of relative risk of type 2 diabetes for subjects not engaging in any leisure time physical activity and those not meeting physical activity guidelines were obtained for multiple studies published in the literature. Using the prevalence of not meeting physical activity guidelines, physical inactivity and the respective relative risks, the population attributable risk percentage (PAR%) for type 2 diabetes was estimated by Levin’s formula. These data were combined with the prevalence and cost data of type 2 diabetes (in 2012) to estimate the cost of type 2 diabetes attributable to not meeting physical activity Guidelines, and to physical inactivity in 2012. Sensitivity analyses were done for i) varying the prevalence of not meeting physical activity guidelines from 30-70%, and ii) varying the average annual cost of type 2 diabetes from $4394 (for person less than 45 years of age) to $11825 (for person greater than 65 years of age). Results: The prevalence of U.S. population meeting physical activity guidelines and engaging in no leisure time activity was 50% and 30% respectively in 2012. The average annual cost attributable to type 2 diabetes in the US, was $7888 per person. The cost of type 2 diabetes in the U.S. in 2012, attributable to not meeting physical activity guidelines was estimated to be $18.6 billion, and that attributable to physical inactivity was estimated to be $5.9 billion. Based on sensitivity analyses, these estimates ranged from $10.36 billion to $27.9 billion for not meeting physical activity guidelines and $3.3 billion to $8.87 billion for physical inactivity in the year 2012. Conclusions: This study shows that billions of dollars could be saved annually just in terms of type 2 diabetes cost in the U.S., if the entire adult population was active enough to meet physical activity guidelines. Physical activity promotion, particularly at the environmental and policy level should be a priority in the population.

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Preventing type 2 diabetes mellitus in Qatar by reducing obesity, smoking, and physical inactivity: mathematical modeling analyses

Population Health Metrics ◽

10.1186/s12963-019-0200-1 ◽

2019 ◽

Vol 17 (1) ◽

Cited By ~ 1

Author(s):

Susanne F. Awad ◽

Martin O’Flaherty ◽

Katie G. El-Nahas ◽

Abdulla O. Al-Hamaq ◽

Julia A. Critchley ◽

...

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Physical Inactivity ◽

Population Level ◽

Baseline Scenario ◽

Obesity Prevalence ◽

The Impact

Abstract Background The aim of this study was to estimate the impact of reducing the prevalence of obesity, smoking, and physical inactivity, and introducing physical activity as an explicit intervention, on the burden of type 2 diabetes mellitus (T2DM), using Qatar as an example. Methods A population-level mathematical model was adapted and expanded. The model was stratified by sex, age group, risk factor status, T2DM status, and intervention status, and parameterized by nationally representative data. Modeled interventions were introduced in 2016, reached targeted level by 2031, and then maintained up to 2050. Diverse intervention scenarios were assessed and compared with a counter-factual no intervention baseline scenario. Results T2DM prevalence increased from 16.7% in 2016 to 24.0% in 2050 in the baseline scenario. By 2050, through halting the rise or reducing obesity prevalence by 10–50%, T2DM prevalence was reduced by 7.8–33.7%, incidence by 8.4–38.9%, and related deaths by 2.1–13.2%. For smoking, through halting the rise or reducing smoking prevalence by 10–50%, T2DM prevalence was reduced by 0.5–2.8%, incidence by 0.5–3.2%, and related deaths by 0.1–0.7%. For physical inactivity, through halting the rise or reducing physical inactivity prevalence by 10–50%, T2DM prevalence was reduced by 0.5–6.9%, incidence by 0.5–7.9%, and related deaths by 0.2–2.8%. Introduction of physical activity with varying intensity at 25% coverage reduced T2DM prevalence by 3.3–9.2%, incidence by 4.2–11.5%, and related deaths by 1.9–5.2%. Conclusions Major reductions in T2DM incidence could be accomplished by reducing obesity, while modest reductions could be accomplished by reducing smoking and physical inactivity, or by introducing physical activity as an intervention.

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Exploring the Experiences of West African Immigrants Living with Type 2 Diabetes in the UK

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16193516 ◽

2019 ◽

Vol 16 (19) ◽

pp. 3516

Author(s):

Alloh ◽

Hemingway ◽

Turner-Wilson

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

African Immigrants ◽

West African ◽

Health Concern ◽

Theory Approach ◽

The Uk ◽

West African Immigrants ◽

The Impact

The increasing prevalence and poorer management of Type 2 diabetes among West African immigrants in the UK is a public health concern. This research explored the experiences of West African immigrants in the management of Type 2 diabetes in the UK using a constructivist grounded theory approach. In-depth individual interviews were conducted with thirty-four West African immigrants living with Type 2 diabetes in the London area. Fifteen male and nineteen female adult West African immigrants with age range from 33–82 years participated in the study. Participants were recruited from five diabetes support groups and community settings. Initial, focused and theoretical coding, constant comparison and memos were used to analyse collected data. Three concepts emerged: Changing dietary habits composed of participants’ experiences in meeting dietary recommendations, improving physical activity concerned with the experience of reduced physical activity since moving to the UK and striving to adapt which focus on the impact of migration changes in living with Type 2 diabetes in the UK. These address challenges that West African immigrants experience in the management of Type 2 diabetes in the UK. The findings of this research provide a better understanding of the influencing factors and can be used to improve the support provided for West Africans living with Type 2 diabetes in the UK, presenting a deeper understanding of socio-cultural factors that contribute to supporting individuals from this population.

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Association between Levels of Physical Activity, Sarcopenia, Type 2 Diabetes and the Quality of Life of Elderly People in Community Dwellings in Lebanon

Geriatrics ◽

10.3390/geriatrics6010028 ◽

2021 ◽

Vol 6 (1) ◽

pp. 28

Author(s):

Dana Saadeddine ◽

Leila Itani ◽

Dima Kreidieh ◽

Dana El Masri ◽

Hana Tannir ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Type 2 Diabetes ◽

Elderly People ◽

Lower Risk ◽

Physical Inactivity ◽

Cross Sectional ◽

Related Quality

There is a lack of data from developing countries on the link between physical activity (PA) on health outcomes. This study examines the association between the level of PA and sarcopenia, cardiovascular risk factors (i.e., dyslipidemia, type 2 diabetes (T2D), and cardiovascular diseases), and the health-related quality of life (HRQoL) among elderly people, in community dwellings in Lebanon. In this cross-sectional, observational study, body composition, levels of PA, and the HRQoL of 243 elderly people living in community dwellings, are obtained. The participants are then categorized based on a PA cut-off point of 600 metabolic equivalent task minutes per week (MET-min/week). In our sample, the prevalence of physical inactivity, defined as performing less than 600 MET-min/week, is 51.44% (125/243 participants).They displayed a higher prevalence of sarcopenia (36.0% vs. 18.6%), T2D (39.6% vs. 21.1%), as well as a lower physical (65.67 ± 20.72 vs. 75.08 ± 17.29) and mental (67.58 ± 21.51 vs. 76.95 ± 17.16) HRQoL. On the other hand, regression analysis shows that an increased rate of PA to ≥600 MET-min/week is associated with a lower risk of T2D (OR = 0.43, 95% CI: 0.22–0.84, p = 0.013) and sarcopenia (OR= 0.40, 95% CI: 0.22–0.73, p = 0.003) by 60%, and higher scores of the physical (β = −7.65; −11.87, −3.43, p = 0.0004) and mental (β = −8.47; −13.08, −3.85, p = 0.0004) HRQoL by nearly eight points. Our results show a high prevalence of physical inactivity in Lebanese adults over the age of 60; however, an adequate level of PA among this population seemed to be associated with a lower risk of sarcopenia and T2D, as well as a better HRQoL. However, future longitudinal studies are still needed to clarify if intervention based on increasing levels of PA can determine improvement in these clinical outcomes. If this is shown to be the case, it emphasizes the importance of implementing strategies to increase physical activity within this population.

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Perilaku gaya hidup dan obesitas sebagai faktor risiko kejadian diabetes melitus tipe 2 di RSUD. Aji Batara Agung Dewa Sakti Samboja Kabupaten Kutai Kartanegara

Berita Kedokteran Masyarakat ◽

10.22146/bkm.8337 ◽

2016 ◽

Vol 32 (12) ◽

pp. 461

Author(s):

Neni Sundari ◽

Fatwa Sari Tetra Dewi ◽

Muhammad Robikhul Ikhsan

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Physical Inactivity ◽

Central Obesity ◽

Multivariable Analysis ◽

Healthy Behavior

Lifestyle behavior and obesity as risk factors for the occurrence of type 2 diabetes mellitus at RSUD Aji Batara Agung Dewa Sakti Samboja, Kutai KartanegaraPurposeThe aim of this study was to determine the correlation between knowledge of healthy behavior and obesity on the occurrence of type 2 diabetes mellitus.MethodsThis research was an observational-analytical- quantitative study with a case-control design. The study subjects were selected by purposive sampling totaling 212 outpatients and inpatients in the RSUD Aji Batara Agung Desa Sakti in which 106 patients were suffering type 2 diabetes and 106 control patients that were not suffering diabetes mellitus. All subjects were between 25-64 years old.ResultsKnowledge of healthy behavior was not statistically significant in the occurrence of type 2 diabetes mellitus while in the univariable data analysis, central obesity was statistically significant. This finding was closely related to the behavior of low physical inactivity but central obesity increased with age and the prevalence was greater in women. Multivariable analysis showed that central obesity, physical inactivity (moderate physical activity and low activity) and very high incomes were the main risk factors for type 2 diabetes mellitus.ConclusionThe occurrence of type 2 diabetes mellitus in the community needs to be reduced by improving healthy lifestyles, physical activity and patterns of healthy diet, by eating fruits and vegetables, and not drinking alcohol nor smoking.

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Abstract #217: Combined Predictability of Physical Activity and Bodyweight on Healthrelated Quality of Life Among Nigerian Type 2 Diabetes Mellitus

Endocrine Practice ◽

10.1016/s1530-891x(20)42523-6 ◽

2015 ◽

Vol 21 ◽

pp. 31

Author(s):

Akolade Idowu ◽

Adeyinka Idowu ◽

Adesoji Tade

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Healthrelated Quality Of Life

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How to Maintain a Healthy Body Weight

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831.76.4.208 ◽

2006 ◽

Vol 76 (4) ◽

pp. 208-215 ◽

Cited By ~ 10

Author(s):

Astrup

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Weight Loss ◽

Body Weight ◽

Glycemic Index ◽

Dairy Products ◽

Weight Control ◽

Healthy Body Weight ◽

Healthy Body

The epidemic of both obesity and type 2 diabetes is due to environmental factors, but the individuals developing the conditions possess a strong genetic predisposition. Observational surveys and intervention studies have shown that excess body fatness is the major environmental cause of type 2 diabetes, and that even a minor weight loss can prevent its development in high-risk subjects. Maintenance of a healthy body weight in susceptible individuals requires 45–60 minutes physical activity daily, a fat-reduced diet with plenty of fruit, vegetables, whole grain, and lean meat and dairy products, and moderate consumption of calorie containing beverages. The use of table values to predict the glycemic index of meals is of little – if any – value, and the role of a low-glycemic index diet for body weight control is controversial. The replacement of starchy carbohydrates with protein from lean meat and lean dairy products enhances satiety, and facilitate weight control. It is possible that dairy calcium also promotes weight loss, although the mechanism of action remains unclear. A weight loss of 5–10% can be induced in almost all obese patients providing treatment is offered by a professional team consisting of a physician and dieticians or nurses trained to focus on weight loss and maintenance. Whereas increasing daily physical activity and regular exercise does not significantly effect the rate of weight loss in the induction phase, it plays an important role in the weight maintenance phase due to an impact on daily energy expenditure and also to a direct enhancement of insulin sensitivity.

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