1. Structured PA exercises
Correlates of physical activity and sitting time in adults with type 2 diabetes attending primary health care in Oman
Thamra S Alghafri1, Saud M Alharthi1, Yahya Al-Farsi2, Elaine Bannerman3, Angela M Craigie3, Annie S Anderson3
Directorate General of Health Services, Ministry of Health, Muscat, Oman
Sultan Qaboos University, College of Medicine & Health Sciences , Sultanate Of Oman
Centre for Public Health Nutrition Research, University of Dundee, Ninewells Hospital and Medical School
Background
Engaging in regular PA can have beneficial outcomes for adults with T2D, including improved self-management, weight loss, reductions in medication usage, and improvements in fitness, HbA1c and fasting glucose1. Hence, understanding factors associated with meeting PA recommendations2 is essential for planning effective PA promotional activities congruent to local and cultural norms.
Aim
In adults with type 2 diabetes attending primary health care in Muscat, Oman we aim to:
Identify prevalence of meeting physical activity recommendations (at least 150 minutes of moderate to vigorous physical activity or 75minutes of vigorous PA/week or achieving at least 600 MET-min/week ) and current sitting time 3
Identify correlates of meeting physical activity recommendations and current sitting time
Explore culturally acceptable physical activity delivery methods for possible integration within routine diabetes care in PHC
Table 1: Correlates of meeting WHO PA recommendations in adults with type 2 diabetes
Meeting PA recommendations
Numbers(%) OR
95%CI
P-value
Gender
Male
45 (34.6)
4.8
<0.001
Female
21 (12.0) .
Age
≤57
45 (29.0)
3.0
0.001
>57
21(14.0)
Stages of PA
Not active
32(15.5)
2.2
0.009
Active
34(34.7)
Reporting Barriers
No barriers
42(32.8)
2.6
0.002
Barriers
24(13.6)
Methods
A cross-sectional study using the Global Physical Activity Questionnaire4 was conducted in 17 randomly selected primary health centres in Muscat, Oman. Clinical data including co-morbidities were extracted from the health information system. Data was collected on perceptions and status of PA, preferred PA and suggested PA intervention within diabetes care. Patients with T2D were approached if they were ≥18 years, and had been registered in the diabetes clinic for >2years.
Table 2: Suggested physical activity service delivery components
PA consultations
117(38.4%)
Structured PA exercises
41(13.4%)
PA referrals
17(5.6%)
Mixed components
34(11%)
All of them
49(16%)
None of them
10(3.3%)
Don’t know
37(12%)
Key results
Figure  1: Meeting WHO physical activity recommendations in Omani adults with type 2 diabetes  
Three hundred and five completed the questionnaire (females 57% and males 43%), mean age of 57 (SD10.8) years and mean BMI was 31.0 (SD6.0) kg/m2. Hypertension (71%) and dyslipidaemia (62%) were the common comorbidities and 58.4% had HbA1c ≥7%.
A fifth (21.6%) of the study sample (n=305) met the physical activity recommendation (12%females, 35%males) (Figure 1).
Odds of meeting PA recommendations were significantly greater in males, individuals ≤57 years, individuals reporting active stages of PA and those with no barriers to leisure PA (Table 1).
Median sitting time was 705 (IQR 180) min/d and older individuals (>57) had significantly longer sitting time compared to younger ones (OR 2.8, 95%CI ).
PA consultation was the major intervention of interest to participants (38%) (Table 2).
Conclusions
Very low levels of physical activity and long sitting time was evident in population of type 2 diabetes in Oman.
Identifying gender specific barriers to physical activity could be useful to plan effective physical activity interventions.
Interventions to reduce sitting time in adults with type 2 diabetes are warranted.
Physical activity consultations linked to individuals’ stages of change and delivered by health care providers involved in diabetes care may be promising.
References
INTERNATIONAL DIABETES FEDERATION, IDF Diabetes Atlas, 6th Edition. Available at
Heath GW, Parra DC, Sarmiento OL, Andersen LB, Owen N, Goenka S, Montes F, Brownson RC: Evidence-based intervention in physical activity: lessons from around the world. Lancet 2012, 380(9838):
Martin SB, Morrow JR, Jr., Jackson AW, Dunn AL: Variables related to meeting the CDC/ACSM physical activity guidelines. Med Sci Sports Exerc 2000, 32(12):
Bull FC, Maslin TS, Armstrong T: Global physical activity questionnaire (GPAQ): nine country reliability and validity study. Journal Of Physical Activity & Health 2009, 6(6):
Competing interests
The authors declare that they have no competing interests
Acknowledgements
Ministry of Health and The Research Council, Oman.