Abstract
Objective: Despite the well-established benefits of physical activity (PA), many people with type 1 diabetes (T1D) still do not meet the recommended levels of PA. The aim of this study was to identify the current barriers, motivators, and facilitators to PA engagement in people with T1D.
Methods: A survey was developed to assess: i) PA habits; ii) barriers, motivators and facilitators to PA; and iii) diabetes self-management. The survey was promoted through targeted social media platforms and participants completed an online survey between September 2024 to May 2025. The survey included participant demographic questions, the International Physical Activity Questionnaire (IPAQ), the Diabetes Self-Management Questionnaire - Revised (DSMQ-R), and a series of questions relating to barriers, motivators and facilitators towards PA and exercise. Data were summarised using frequencies, means, and percentages for categorical data. Inferential analysis included χ2 tests for categorical data. Interpretation of inferential statistics was guided by a threshold of p ≤ 0.05.
Results: 120 adults with T1D (n = 99 females, n = 21 males; aged 41 ± 12 years), with a duration of diabetes of 20 ± 13 years and HbA1c of 50.2 ± 10.7 mmol·mol-1 completed the survey. Lack of time (53%) and excessive workloads or work commitments (53%) were the most reported barriers to PA, followed by a fear of hypoglycaemia (49%). The top three motivators for being physically active were improved physical and mental health (94%), disease prevention (88%), and improvements in body image (87%). When the cohort was stratified by PA levels, a fear of hypoglycaemia emerged as the number one barrier to PA in those who do not meet the minimum recommended PA guidelines (68%). Although not the most common barrier, a fear of hypoglycaemia was still reported (32%) by those meeting the recommended PA guidelines. The motivators for PA engagement did not change when stratified for PA level. 89% of participants reported that their continuous glucose monitor was the primary facilitator, with support from family and friends (51%) and reduced costs/ improved affordability to gyms (48%) the second and third-most-reported facilitators. When stratified by PA levels, continuous glucose monitors remained the primary facilitator for both groups.
Conclusion: Previous research identified fear of hypoglycaemia as the main barrier to exercise participation. Our findings indicate that fear of hypoglycaemia remains the primary barrier to exercise participation in those who do not meet PA guidelines yet not for those who meet PA guidelines. The findings indicate that continuous glucose monitoring plays an important role in supporting physical activity participation in people with T1D. The findings of this study suggest that future strategies to promote and support PA engagement in people with T1D may need to be individually tailored to account for differing barriers, facilitators and motivators.
