DIABETES AND PHYSICAL ACTIVITY: PREVALENCE, BARRIERS AND CLINICAL OUTCOMES OF PHYSICAL ACTIVITY AMONG TYPE-2-DIABETIC PATIENTS IN FIJI ISLANDS

S. Begum¹, D.G. Waqa², A. Akinremi³

¹College of Medicine, Nursing and Health Sciences, Fiji National University, Physiotherapy and Physiology, Suva, Fiji, ²College of Medicine, Nursing and Health Sciences, Fiji National University, School of Public Health and Primary Care, Suva, Fiji, ³Hampton University, Physical Therapy, Hampton, United States

Background: Despite evidence supporting the positive effects of physical activity on diabetes, participation in physical activity among diabetic patients remains relatively low. With the high burden of diabetes and diabetic complications in Fiji, having recommended levels of physical activity among this patient population could potentially improve clinical outcomes, prevent complications, and reduce healthcare costs. In addition, low physical activity could contribute to the pathogenesis of other non-communicable diseases in this patient population.

Purpose: To describe the levels of physical activity and barriers to physical activity faced by diabetic patients in the Fiji Islands.

Methods: A cross-sectional design involving 340 T2DM was conducted using purposive sampling across three health centers in Suva (Raiwaqa, Nuffield & Samabula). Data on sociodemographic, clinical parameters, and physical activity levels were obtained using a structured questionnaire and the short form IPAQ questionnaire. Data were summarized as mean and percentages. Inferential statistics of chi-square and Kruskal Wallis for categorical variables were used to test for significant differences in physical activity levels between groups; with the alpha level set at 0.05. Ethical approval was obtained from the Institutional; review Board and the Ministry of Health.

Results: Of the 340 participants (males: 136, average age of 59 yrs. and females: 204, average age of 61yrs), 70% were aged >55 years. Fifty-six percent of participants self-report being physically active(p=0.021); 67% were overweight or obese; 70% had HbA1c >7%; 59% had RBS >10mmol/L and 67% had BP > 130/80mmHg. Participants who reported as physically active had better clinical parameters: total cholesterol <5mmol/L (61%, p=0.04), HbA1c ≤7% (70%, p=0.001), RBS ≤10mmol/L (66%, p=0.002) and blood pressure <130/80mmHg (66%, p=0.011). Females with post-secondary school education and good family support had better clinical outcomes compared with others. Identified barriers include poor knowledge about physical activity intensity, lack of motivation, distance for exercising, support from spouse, busy schedule, family discouragement, lack of time, physical restriction, social issues, lack of resources, and inclement weather conditions.

Conclusions: Physical inactivity among patients with T2DM is high in Fiji (54%). Participants with good physical activity levels had better clinical outcomes. Patients with T2DNM in Fiji faced a variety of barriers to physical activity. Multi-sectoral approaches to addressing these barriers are needed.

Implications: Type-2 diabetic patients in Fiji face diverse barriers to physical activity. However, those who are able to participate overcome these barriers and participated regularly in physical activity had beneficial effects. Barriers to physical activity need to be addressed so that more patients can benefit from it.

Funding acknowledgements: None

Keywords:
Type 2 Diabetes
Physical Activity
Fiji Islands

Topics:
Non-communicable diseases (NCDs) & risk factors
Health promotion & wellbeing/healthy ageing/physical activity
Community based rehabilitation

Did this work require ethics approval? Yes

Institution: College of Medicine, Human Health Research and Ethics Committee

Committee: CHHREC and Ministry of Health

Ethics number: CHHREC/042.21