DC2439 - Exercise Barriers in Type 1 Diabetes: Fear of Hypoglycaemia Predictors

Blinded Abstract: Background
Regular physical activity (PA) benefits those with type 1 diabetes (T1D), yet many are below recommended activity levels. This study aimed to assess knowledge and barriers to PA in the T1D population using an online questionnaire.

Methods
Adults with T1D were recruited via [a Diabetes Research Network] and social media to complete a 61-item online questionnaire on PA barriers (BAPAD1 scale), diabetes management, exercise, and sport. Pearson's correlations identified factors associated with perceived PA barriers. Factors with r>0.30 were used in linear regression to determine independent predictors of BAPAD1 scores, with partial eta squared indicating effect sizes.

Results
Of 474 participants, 463 (52% female) with median age 45-54 years, disease duration 21-25 years, and HbA1c 50-55mmol/mol were analyzed. 78.8% reported CGM usage, 63.7% treated with MDI and 36.3% CSII. Overall BAPAD1 score was low (mean [SD] 2.72 [0.52]), and fear of hypoglycaemia (FOH) was the highest reported barrier to PA (3.60 [2.02]). Discussing exercise in-clinic negatively correlated with FOH (r = -0.141; P = 0.002), as did knowledge of insulin/carbohydrate adjustments before/after/around exercise [(r = -0.394; P < 0.001)(r = -0.402; P < 0.001)(r = -0.418; P < 0.001)]. Exercise confidence predicted the highest variance in BAPAD1 scores (ηp2 = 0.483).

Conclusion
Regardless of the prevalent use of CGM and CSII, FOH remained a major barrier to PA. Discussing exercise in-clinic was associated with reduced FOH. To overcome this barrier, improved exercise education and dialogue within clinical encounters is needed.