Abstract
Objectives
Ever since the first research on barriers to physical activity (PA) highlighting fear
of hypoglycemia as a major barrier, many studies have attempted to understand their
demographic and behavioural determinants. However, no research has been conducted
on whether these perceived barriers toward PA are based on real-life–experienced adverse
glycemic effects of exercise.
Methods
Sixty-two adults and 53 children/adolescents living with type 1 diabetes, along with
their parents, completed the Barriers to Physical Activity in Type 1 Diabetes-1 (BAPAD-1)
questionnaire on barriers to PA. Continuous glucose-monitoring data were collected
during 1 week of everyday life for 26 adults and 33 children/adolescents. Multiple
linear regressions were used to explore links between BAPAD-1 scores and glycemic
excursions experienced during and after everyday-life self-reported PA sessions, controlling
for behavioural (accelerometry) and demographic confounders.
Results
In children/adolescents, the more time spent in hypoglycemia on nights after PA sessions,
the more they reported hypoglycemic risk as a barrier (ß=+0.365, p=0.034). Conversely,
in adults, the higher the proportion of PA sessions accompanied by a drop in blood
glucose, the less hypoglycemia was a barrier (ß=−0.046, p=0.004). In parents, BAPAD-1
scores were unrelated to children/adolescents’ everyday-life exercise-induced hypo/hyperglycemia.
Conclusions
In children/adolescents, fear of hypoglycemia was predominant in those exposed to
nocturnal hypoglycemia associated with PA sessions. In adults, fewer barriers may
mean they accept a bigger drop in their glycemia during PA. This shows the importance
of finding and promoting age-specific solutions to prevent exercise-induced hypoglycemia.
Résumé
Objectifs
Depuis les premières recherches sur les obstacles à l’activité physique (AP) qui ont
démontré que la peur de l’hypoglycémie était un obstacle majeur, plusieurs études
ont tenté de comprendre leurs déterminants démographiques et comportementaux. Toutefois,
aucune recherche visant à déterminer si ces obstacles perçus à l’AP sont fondés sur
les effets indésirables réels de l’exercice sur la glycémie n’a été réalisée.
Méthodes
Soixante-deux adultes et 53 enfants/adolescents diabétiques de type 1 et leurs parents
ont rempli le questionnaire Barriers to Physical Activity in Type 1 Diabetes-1 (BAPAD-1)
sur les obstacles à l’AP. Les données de surveillance de la glycémie en continu ont
été collectées durant 1 semaine de vie habituelle chez 26 adultes et 33 enfants/adolescents.
Des régressions linéaires multiples ont été utilisées pour explorer les liens entre
les scores BAPAD-1 et les excursions glycémiques vécues pendant et après les séances
quotidiennes d’AP auto-déclarées en tenant compte des facteurs de confusion comportementaux
(accélérométrie) et démographiques.
Résultats
Plus les enfants/adolescents passaient de longues périodes en hypoglycémie au cours
des nuits qui suivaient les séances d’AP, plus ils déclaraient que le risque d’hypoglycémie
était un obstacle (ß = +0,365, p = 0,034). À l’inverse, plus les adultes avaient une
proportion de séances d’AP accompagnées d’une baisse de la glycémie, moins l’hypoglycémie
était un obstacle (ß = −0,046, p = 0,004). Chez les parents, les scores BAPAD-1 n’étaient
pas reliés aux hypo/hyperglycémies des enfants/adolescents induites par l’exercice
quotidien.
Conclusions
Chez les enfants/adolescents, la peur de l’hypoglycémie était prédominante chez ceux
qui étaient exposés à l’hypoglycémie nocturne associée aux séances d’AP. Chez les
adultes, le fait d'avoir moins de barrières peut signifier qu’ils acceptent une baisse
plus importante de leur glycémie durant l’AP. Ceci démontre l’importance de trouver
et de promouvoir des solutions en fonction de l’âge pour prévenir l’hypoglycémie induite
par l’exercice.
Keywords
Mots clés
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Article info
Publication history
Published online: October 26, 2022
Accepted:
October 17,
2022
Received in revised form:
October 14,
2022
Received:
June 21,
2022
Identification
Copyright
© 2022 Canadian Diabetes Association.
