Abstract
Objectives
Individuals with type 2 diabetes should engage in ≥150 min of moderate- to vigorous-intensity
physical activity (MVPA) weekly, but most do not meet this guideline. Understanding
how social determinants correlate with physical activity in adults with type 2 diabetes
may improve development and delivery of physical activity interventions. This study
aimed to explore associations between objectively measured MVPA with sociodemographic
characteristics in adults with type 2 diabetes.
Methods
Cross-sectional data from cycles 1 through 5 of the Canadian Health Measures Survey
were analyzed. Participants (N=876) 20 to 79 years of age with type 2 diabetes and
≥4 days of valid activity monitor wear were included. Proportions with 95% confidence
intervals for objectively measured MVPA were compared according to sociodemographic
characteristics. Ordinal logistic regression was used. Secondary outcomes included
light-intensity physical activity, screen time and proportion of activity monitor
wear time spent sedentary.
Results
Only 15.5% of women and 26.2% of men met Diabetes Canada physical activity guidelines,
and approximately 75% of activity monitor wear time was spent in a sedentary state.
Higher odds of achieving low levels of physical activity were observed among women
who were former or current smokers (odds ratio [OR], 4.51; p<0.001), and among men
who were ≥65 years of age (OR, 2.92; p<0.001), of middle (OR, 2.20; p<0.05) and lowest
(OR, 3.06; p<0.05) income tertiles and current or former smokers (OR, 3.01; p<0.05).
Conclusions
Sociodemographic factors are strongly associated with levels of MVPA in adults with
type 2 diabetes. Sociodemographic information should be routinely collected by clinicians
and used to inform more tailored and effective interventions for this patient population.
Résumé
Objectifs
Les individus atteints du diabète de type 2 devraient faire ≥ 150 min d’activité physique
d’intensité modérée à vigoureuse (APMV) par semaine, mais la plupart ne se conforment
pas à cette recommandation. La compréhension de la façon dont les déterminants sociaux
sont en corrélation avec l’activité physique chez les adultes atteints du diabète
de type 2 peut améliorer l’élaboration et la prestation d’interventions en matière
d’activité physique. La présente étude visait à explorer les associations entre l’APMV
mesurée objectivement et les caractéristiques sociodémographiques chez les adultes
atteints du diabète de type 2.
Méthodes
Les données transversales recueillies des cycles 1 à 5 de l’Enquête canadienne sur
les mesures de la santé ont fait l’objet d’une analyse. Nous avons sélectionné les
participants (N = 876) atteints du diabète de type 2 qui avaient de 20 à 79 ans et
qui avaient porté ≥ 4 jours un moniteur d’activité valide. Nous avons comparé les
pourcentages (intervalles de confiance à 95 %) d’APMV mesurée objectivement selon
les caractéristiques sociodémographiques. Nous avons utilisé la régression logistique
ordinale. Les critères secondaires étaient l’activité physique d’intensité légère,
le temps passé devant un écran et le pourcentage de temps de port du moniteur d’activité
passé dans la sédentarité.
Résultats
Seulement 15,5 % des femmes et 26,2 % des hommes se conformaient aux recommandations
en matière d’activité physique de Diabète Canada, et approximativement 75 % du temps
de port du moniteur d’activité physique était passé dans la sédentarité. Nous avons
observé une plus grande probabilité d’avoir de faibles niveaux d’activité physique
chez les femmes qui étaient d’anciennes fumeuses ou des fumeuses actuelles (rapport
de cotes [RC], 4,51; p < 0,001), et chez les hommes qui avaient ≥ 65 ans (RC, 2,92;
p < 0,001), étaient dans le tertile de revenu intermédiaire (RC, 2,20; p < 0,05) et
le tertile de revenu plus faible (RC, 3,06; p < 0,05), et qui étaient des fumeurs
actuels ou d’anciens fumeurs (RC, 3,01; p < 0,05).
Conclusions
Les facteurs sociodémographiques sont fortement associés aux niveaux d’APMV chez les
adultes atteints du diabète de type 2. Les renseignements sociodémographiques devraient
être collectés de façon systématique par les cliniciens et utilisés pour élaborer
des interventions plus efficaces et mieux adaptées à cette population de patients.
Keywords
Mots clés
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References
- Physical activity and diabetes.Can J Diabetes. 2018; 42: 54-63
- Physical activity/exercise and diabetes: A position statement of the American Diabetes Association.Diabetes Care. 2016; 39: 2065-2079
- Accelerometer-derived sedentary and physical activity time in overweight/obese adults with type 2 diabetes: Cross-sectional associations with cardiometabolic biomarkers.PLoS One. 2015; 10e0119140
- Physical activity intensity and biological markers among adults with diabetes: Considerations by age and gender.J Diabetes Complications. 2013; 27: 134-140
- Objective measurements of activity patterns in people with newly diagnosed type 2 diabetes demonstrate a sedentary lifestyle.Diabet Med. 2013; 30: 1063-1066
- Accelerometer-determined moderate intensity lifestyle activity and cardiometabolic health.Prev Med. 2011; 52: 358-360
- Association of socioeconomic position with health behaviors and mortality.JAMA. 2010; 303: 1159-1166
- Why do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse.Soc Sci Med. 1997; 44: 809-819
- Diet and exercise among adults with type 2 diabetes: Findings from the Third National Health and Nutrition Examination Survey (NHANES III).Diabetes Care. 2002; 25: 1722-1728
- Factors associated with physical activity in Canadian adults with diabetes.Med Sci Sports Exerc. 2006; 38: 1526-1534
- Physical activity in the United States measured by accelerometer.Med Sci Sports Exerc. 2008; 40: 181-188
- Comparison of self-reported and accelerometer-measured physical activity in Canadian adults.Health Rep. 2018; 29: 3-15
- Canadian Health Measures Survey: Ethical, legal and social issues.Health Rep. 2007; 18: 37-51
- Canadian Health Measures Survey (CHMS) data user guide: Cycle 3.Statistics Canada, Ottawa, Ontario2015
- Role of metformin in the management of polycystic ovary syndrome.Ther Adv Endocrinol Metab. 2010; 1: 117-128
- Therapeutic use of metformin in prediabetes and diabetes prevention.Drugs. 2015; 75: 1071-1094
- Canadian Health Measures Survey: Brief overview.Can J Public Health. 2007; 98: 453-456
- Moderate and vigorous physical activity intensity cut-points for the Actical accelerometer.J Sports Sci. 2011; 29: 783-789
- Canadian Health Measures Survey (CHMS) data user guide: Cycle 5.Statistics Canada, Ottawa, Ontario2019
- Low income lines, 2008-2009. Ottawa: Statistics Canada, 2010 (2010.) (Accessed January, 2020)
- Mitigation of risk to respondents of Statistics Canada’s Surveys.Statistics Canada, Ottawa, ON2010 (2010.) (Accessed July, 2019)
- Assessing proportionality in the proportional odds model for ordinal logistic regression.Biometrics. 1990; 46: 1171-1178
- Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies.BMJ. 2007; 335: 806-808
- Canadian Health Measures Survey (CHMS) data user guide: Cycle 1.Statistics Canada, Ottawa, Ontario2010
- Canadian Health Measures Survey (CHMS) data user guide: Cycle 2.Statistics Canada, Ottawa, Ontario2013
- Canadian Health Measures Survey (CHMS) data user guide: Cycle 4.Statistics Canada, Ottawa, Ontario2017
- Population-based estimates of physical activity for adults with type 2 diabetes: A cautionary tale of potential confounding by weight status.J Obes. 2011; 2011
- Accelerometer-measured moderate-to-vigorous physical activity of Canadian adults, 2007 to 2017.Health Rep. 2019; 30: 3-10
- Individualized estimation of physical activity in older adults with type 2 diabetes.Med Sci Sports Exerc. 2017; 49: 2185-2190
- Calibration of two objective measures of physical activity for children.J Sports Sci. 2008; 26: 1557-1565
- Prediction of activity energy expenditure using accelerometers in children.Med Sci Sports Exerc. 2004; 36: 1625-1631
- Understanding the social factors that contribute to diabetes: A means to informing health care and social policies for the chronically ill.Perm J. 2013; 17: 67-72
- Social determinants of health and diabetes: A scientific review.Diabetes Care. 2021; 44: 258-279
- Addressing social determinants to improve patient care and promote health equity: An American College of Physicians Position Paper.Ann Intern Med. 2018; 168: 577-578
- Adoption of social determinants of health EHR tools by community health centers.Ann Fam Med. 2018; 16: 399-407
- Leveraging the social determinants of health: What works?.PLoS One. 2016; 11e0160217
- Alberta Healthy Living Program: A model for successful integration of chronic disease management services.Can J Diabetes. 2013; 37: 254-259
- The role of ethnicity in predicting diabetes risk at the population level.Ethn Health. 2012; 17: 419-437
- Type 2 diabetes and indigenous peoples.Can J Diabetes. 2018; 42: 296-306
- Understanding how discrimination can affect health.Health Serv Res. 2019; 54: 1374-1388
- Time to tackle the physical activity gender gap.Lancet Public Health. 2019; 4e360
- Psychosocial variables related to why women are less active than men and related health implications.Clin Med Insights Womens Health. 2016; 9: 47-56
- Standardizing and optimizing the use of accelerometer data for free-living physical activity monitoring.J Phys Act Health. 2005; 3: 366-383
- Diabetes in Canada: Facts and figures from a public health perspective. Public Health Agency of Canada, Ottawa2011
Article Info
Publication History
Published online: April 06, 2022
Accepted:
April 2,
2022
Received in revised form:
February 24,
2022
Received:
July 27,
2021
Identification
Copyright
© 2022 Published by Elsevier Inc. on behalf of Canadian Diabetes Association.
