Most people with type 1 diabetes are failing to meet physical activity recommendations, a new study has shown.

Physical activity is known to reduce the risk of cardiovascular disease (CVD) in patients with type 1 diabetes. According to current guidelines, those with the condition should engage in at least 150 minutes of moderate-to-vigorous intensity physical activity every week, with no more than two consecutive days without activity.

Researchers from Trinity College Dublin (TCD) and Tallaght University Hospital set out to assess how well patients with type 1 diabetes in Ireland comply with these guidelines and what the barriers to compliance are.

Physical activity was measured objectively over seven days in 72 participants using an Actigraph accelerometer, and subjectively using the International Physical Activity Questionnaire (IPAQ).

Perceived barriers to activity were also assessed using the Barriers to Physical Activity in Diabetes scale.

The study found that the majority of participants with type 1 diabetes did not meet activity recommendations. Furthermore, overestimation of time spent being physically active was seen as a big concern because it most likely results in people not getting sufficient exercise and therefore not realising the associated improvements in CVD risk factors.

Overall, just one-third of people with type 1 diabetes were found to be meeting activity recommendations when activity levels were measured using an accelerometer.

Meanwhile, the study also found that diabetes-specific barriers do exist, which result in poor uptake of exercise among this group. Specifically, the fear of hypoglycaemia was seen as a major barrier.

According to the study’s senior author, Mary Finn of TCD’s School of Medicine and Tallaght Hospital’s Department of Nutrition and Dietetics and Department of Endocrinology, physical activity “is a crucial cornerstone of health for those with type 1 diabetes”.

“This study highlighted that most patients are not meeting the recommended exercise goals. Safely correcting this deficit will require a concerted effort.

“Healthcare professionals must offer more support and education to help these individuals increase their exercise levels without increasing the risk of exercise-induced hypoglycaemia,” she commented.

She said that the study highlights “practical gaps that need to be addressed through appropriate education on the impact of exercise on glucose variability and implementation of strategies to avoid exercise-induced hypoglycaemia”.

Ms Finn also noted that technology can help in this area. She suggested that those with type 1 diabetes should be encouraged to use wearable fitness tracking devices to accurately keep track of their activity levels. Medical devices, such as continuous glucose monitors and closed-loop systems should also be encouraged to increase ‘time in range’, i.e. the percentage of time that individuals are within the normal blood sugar range.

These devices are also valuable in preventing potentially dangerous exercise-induced hypoglycaemia and can therefore increase patient safety while providing reassurance when exercising, she added.

The study is published in the Irish Journal of Medical Science and can be viewed here.