Exercise in Diabetes and Factors That Prevent Exercise: A Traditional Review

Year 2026, Volume: 6 Issue: 1 , 43 - 51 , 20.04.2026

Ali Ceylan

https://doi.org/10.71255/maunsbd.1744095

https://izlik.org/JA56HK22CS

Abstract

This review was planned to determine and investigate the importance of exercise and barriers to exercise in diabetic individuals, and studies on exercise and barriers to exercise in diabetic individuals were analyzed. According to the results found, motivation, income and social status of the individual, education level, working conditions, access to health services, living environment (physical environment), green space, urban life, perceived degree of difficulty during exercise, fatigue, lack of time, television and similar distracting habits, availability of facilities to perform exercise, disease or other accompanying health problems, It was determined that boring exercise, insufficient motivation and energy, obesity, insufficient support in activity participation, fear of injury, embarrassment, cultural differences, climatic conditions, limited number of activities due to lack of safe places, incomplete information, hypoglycemia that may develop during exercise and lack of information on hypoglycemia management were important barriers to exercise participation and sustainability in diabetic individuals. Diabetes treatment requires a multidisciplinary approach. Emphasizing the importance of active life by all health disciplines in patients who are diagnosed and followed up is important in terms of gaining the habit of physical activity or exercise. For this reason, units under the name of diabetes physiotherapy, such as diabetes nurses, should be established in health facilities and individual-specific exercise recommendations should be given by physiotherapists who have a good command of the field and who have developed themselves in this field. We believe that by establishing physiotherapy units in primary health care facilities, the need for physiotherapy in secondary and tertiary health care facilities can be reduced.

Keywords

Diabetes mellitus , exercise , barriers.

Diyabette Egzersiz ve Egzersizi Engelleyen Faktörler: Geleneksel Derleme

https://izlik.org/JA56HK22CS

Abstract

Bu derleme diyabetik bireylerde egzersizin önemini ve egzersizin önündeki engelleri belirlemek ve incelemek amacıyla planlanmış ve diyabetik bireylerde egzersiz ve egzersiz önündeki engelleri ortaya koyan çalışmalar incelenmiştir. Elde edilen sonuçlara göre motivasyon, bireyin gelir ve sosyal durumu, eğitim düzeyi, çalışma şartları, sağlık hizmetlerine erişimi, yaşadığı çevre (fiziksel çevre), yeşil alan, kent yaşamı, egzersiz sırasında algılanan zorluk derecesi, yorgunluk, zaman eksikliği, televizyon ve benzeri dikkat dağıtıcı alışkanlıklar, egzersiz gerçekleştirebilecek tesis varlığı, hastalık veya eşlik eden diğer sağlık sorunları, egzersizin sıkıcı bulunması, irade ve enerji eksikliği, obezite, aktiviteye katılımda destek eksikliği, yaralanma korkusu, utanma, kültürel farklılıklar, iklim şartları, güvenli yerlerin eksikliği nedeniyle sınırlı faaliyet sayısı, eksik bilgi, egzersiz sırasında gelişebilecek hipoglisemi ile hipoglisemi yönetimindeki bilgi eksikliği diyabetik bireylerde egzersize katılımdaki ve sürdürülebilirliğindeki önemli engeller olduğu belirlendi. Diyabet tedavisi multidisipliner bir yaklaşım gerektirir. Tanı konup takibi yapılan hastalarda tüm sağlık disiplinleri tarafından aktif yaşamın öneminin vurgulanması, fiziksel aktivite veya egzersiz alışkanlığının kazandırılması açısından önem arz etmektedir. Bu nedenle sağlık tesislerinde diyabet hemşiresi gibi diyabet fizyoterapisi adı altında birimler oluşturularak, alana hâkim ve bu alanda kendini geliştiren fizyoterapistler tarafından bireye özgü egzersiz önerileri verilmelidir. Birinci basamak sağlık tesislerinde de fizyoterapi birimleri oluşturularak ikinci ve üçüncü basamak sağlık tesislerindeki fizyoterapiye gereksinimlerin azaltılabileceği kanısındayız.

Keywords

Diabetes mellitus , egzersiz , engeller.

Ethical Statement

Bu derleme etik beyan gerektirmemektedir.

References

• Alghafri, T., Alharthi, S.M., Al Farsi, Y.M., Bannerman, E., Craigie, A.M., & Anderson, A.S. (2017). Perceived barriers to leisure time physical activity in adults with type 2 diabetes attending primary healthcare in Oman: a cross-sectional survey. BMJ Open, 7(11):e016946.
• Aranceta-Bartrina, J., Pérez-Rodrigo, C., Alberdi-Aresti, G., Ramos-Carrera, N., Lázaro-Masedo, S. (2016). Prevalencia de obesidad general y obesidad abdominal en la población adulta española (25–64 años) 2014–2015: estudio ENPE. Rev Esp Cardiol, 69(6), 579-87.
• American Diabetes Association (ADA). (2003). Standards of medical care for patients with diabetes mellitus. Diabetes Care, 26(2), 33-50.
• Atlas, D. (2015). International diabetes federation. IDF Diabetes Atlas, 7th edn. Brussels, Belgium: International Diabetes Federation. p:33.
• Baker, J.D. (2016). The Purpose, Process, and Methods of Writing a Literature Review. AORN Journal, 103(3), 265 269.
• Baumeister, H., Hutter, N., Bengel, J., & Härter, M. (2011). Quality of life in medically ill persons with comorbid mental disorders: a systematic review and meta-analysis. Psychother Psychosom, 80(5), 275-86.
• Bell, D.S.H. (2013). Combine and conquer: advantages and disadvantages of fixed‐dose combination therapy. Diabetes Obes Metab, 15(4), 291-300.
• Boulé, N.G., Haddad, E., Kenny, G.P., Wells, G.A., & Sigal, R.J. (2001). Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta-analysis of controlled clinical trials. JAMA, 286(10), 1218-27.
• Brazeau, A.S., Rabasa-Lhoret, R., Strychar, I., & Mircescu, H. (2008) Barriers to physical activity among patients with type 1 diabetes. Diabetes Care, 31(11), 2108-09.
• Chang, C., Khurana, S., Strodel, R., Camp, A., Magenheimer, E., & Hawley, N. (2018). Perceived barriers to physical activity among low-income Latina women at risk for type 2 diabetes. Diabetes Educ, 44(5), 444-53.
• Chen, L., Magliano, D.J., & Zimmet, P.Z. (2012). The worldwide epidemiology of type 2 diabetes mellitus—present and future perspectives. Nat Rev Endocrinol, 8(4), 228-36.
• Clark, M.L., & Utz S.W. (2014). Social determinants of type 2 diabetes and health in the United States. World J Diabetes, 5(3), 296-304.
• Cockerham, W.C., Hamby, B.W., & Oates, G.R. (2017). The social determinants of chronic disease. Am J Prev Med, 52(1), 5-12.
• Colberg, S.R., Sigal, R.J., Fernhall, B., Regensteiner, J.G., Blissmer, B.J., Rubin, R.R., et al. (2010). Exercise and type 2 diabetes: the american college of sports medicine and the
• Colberg, S.R., Castorino, K., & Jovanovič, L. (2013). Prescribing physical activity to prevent and manage gestational diabetes. World J Diabetes, 4(6), 256-62.
• Colberg, S.R., Sigal, R.J., Yardley, J.E., Riddell, M.C., Dunstan, D.W., Dempsey, P.C., et al. (2016). Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care, 39(11), 2065 79.
• Cronin, P., Ryan, F., & Coughlan, M. (2008). Undertaking a literature review: a step-by-step approach. British Journal of Nursing, 2008, 17(1): 38-43
• Den Braver, N.R., Lakerveld, J., Rutters, F., Schoonmade, L.J., Brug, J., Beulens, J.W.J. (2018). Built environmental characteristics and diabetes: a systematic review and meta analysis. BMC Med, 16(1),1-26.
• Dendup, T., Feng, X., Clingan, S., Astell-Burt, T. (2018). Environmental risk factors for developing type 2 diabetes mellitus: a systematic review. Int J Environ Res Public Health, 5, 15(1), 78.
• Duarte, C.K., de Almeida, J.C., Merker, A.J.S., de Oliveira Brauer, F., da Costa Rodrigues, T. (2012). Physical activity level and exercise in patients with diabetes mellitus. Rev Assoc Med Bras, 58(2), 215-21.
• Egan, A.M., Mahmood, W.A.W., Fenton, R., Redziniak, N., Kyaw Tun, T., Sreenan, S., et al. (2013). Barriers to exercise in obese patients with type 2 diabetes. QJM, 106(7), 635-38.
• Finn, M., Sherlock, M., Feehan, S., Guinan, E.M., & Moore, K.B. (2022). Adherence to physical activity recommendations and barriers to physical activity participation among adults with type 1 diabetes. Ir J Med Sci, 191(4),1639-46.
• Fowler, M.J. (2008). Microvascular and macrovascular complications of diabetes. Clin Diabetes, 26(2), 77-2.
• Garber, C.E., Blissmer, B., Deschenes, M.R., et al. (2011). American College of Sports Medicine. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc, 43: 1334–1359.
• Gonzalez, J.S., Peyrot, M., McCarl, L.A., Collins, E.M., Serpa, L., Mimiaga, M.J., & Safren S.A. (2008). Depression and diabetes treatment nonadherence: a meta-analysis. Diabetes Care, 31(12), 2398-03.
• Grace, A., Chan, E., Giallauria, F., Graham, P.L., & Smart, N.A. (2017). Clinical outcomes and glycaemic responses to different aerobic exercise training intensities in type II diabetes: a systematic review and meta-analysis. Cardiovasc Diabetol, 14, 16(1), 1-10.
• Graham, H., & White, P.C.L. (2016). Social determinants and lifestyles: integrating environmental and public health perspectives. Public Health, 141, 270-78.
• Herriott, M.T., Colberg, S.R., Parson, H.K., Nunnold, T., Vinik, A.I. (2004). Effects of 8 weeks of flexibility and resistance training in older adults with type 2 diabetes. Diabetes Care, 27(12), 2988-89.
• International Diabetes Federation. Facts & figures, 2025. [cited 2025, Dec 13]. Available from: https://idf.org/about diabetes/diabetes-facts-figures/
• Jones, M., & Nies, M.A. (1996). The relationship of perceived benefits of and barriers to reported exercise in older African American women. Public Health Nurs, 13(2), 151-58.
• Kennedy, A., Narendran, P., Andrews, R.C., Daley, A., & Greenfield, S.M. (2018). Attitudes and barriers to exercise in adults with a recent diagnosis of type 1 diabetes: a qualitative study of participants in the exercise for type 1 diabetes (EXTOD) study. BMJ Open, 8(1),e017813.
• Koponen, A.M., Simonsen, N., Laamanen, R., & Suominen, S. (2015). Health-care climate, perceived self-care competence, and glycemic control among patients with type 2 diabetes in primary care. Health Psychol Open, 2(1), 2055102915579778.
• Márquez, J.J., Ramón, G., & Márquez, J. (2011). Actualidad en ejercicio y diabetes tipo 2 (II). Arch. Med Deporte, 28(143),188-98.
• Marín-Peñalver, J.J., Martín-Timón, I., Sevillano-Collantes, C., & del Cañizo-Gómez, F.J. (2016). Update on the treatment of type 2 diabetes mellitus. World J Diabetes, 7(17), 354-95.
• Morrison, S., Colberg, S.R., Mariano, M., Parson, H.K., & Vinik, AI (2010). Balance training reduces falls risk in older individuals with type 2 diabetes. Diabetes Care, 33, 748–750.
• Naslafkih, A., & Sestier, F. (2003). Diabetes mellitus related morbidity, risk of hospitalization and disability. J Insur Med, 35(2), 102-13.
• Ogurtsova, K., da Rocha Fernandes, J.D., Huang, Y., Linnenkamp, U., Guariguata, L., Cho, N.H., et al. (2017). IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract, 128, 40 50.
• Oliveira, C., Simões, M., Carvalho, J., & Ribeiro, J. (2012). Combined exercise for people with type 2 diabetes mellitus: a systematic review. Diabetes Res Clin Pract, 98(2):187-98.
• Ostman, C., Jewiss, D., King, N., & Smart, N.A. (2018). Clinical outcomes to exercise training in type 1 diabetes: a systematic review and meta-analysis. Diabetes Res Clin Pract, 139, 380-91.
• Peters, K., Elands, B., & Buijs, A. (2010). Social interactions in urban parks: Stimulating social cohesion?. Urban For Urban Green, 9(2), 93-100.
• Physical Activity Guidelines Advisory Committee. (2008). Physical Activity Guidelines Advisory Committee Report. Washington, DC: Department of Health and Human Services, p:683.
• Riddell, M., & Perkins, B.A. (2009). Exercise and glucose metabolism in persons with diabetes mellitus: perspectives on the role for continuous glucose monitoring. J Diabetes Sci Technol, 3(4), 914-23.
• Riddell, M.C., Gallen, I.W., Smart, C.E., Taplin, C.E., Adolfsson, P., Lumb, A.N., et al. (2017). Exercise management in type 1 diabetes: a consensus statement. Lancet Diabetes Endocrinol, 5(5), 377–90.
• Ried‐Larsen, M., MacDonald, C.S., Johansen, M.Y., Hansen, K.B., Christensen, R., Almdal, T.P., et al. (2018). Why prescribe exercise as therapy in type 2 diabetes? We have a pill for that! Diabetes Metab Res Rev, 34(5), e2999.
• Rojas-Rueda, D., Nieuwenhuijsen, M.J., Gascon, M., Perez Leon, D., & Mudu, P. (2019). Green spaces and mortality: a systematic review and meta-analysis of cohort studies. The Lancet Planet Health, 3(11), e469-e477.
• Sallis, J.F., Hovell, M.F., & Hofstetter, C.R. (1992). Predictors of adoption and maintenance of vigorous physical activity in men and women. Preventive Med, 21(2), 237-51.
• Sigal, R.J., Armstrong, M.J., Bacon, S.L., Boule, N.G., Dasgupta, K., Kenny, G.P., Riddell, M.C. (2018). Physical activity and diabetes. Can J Diabetes, 42, 54-63.
• Shultz, J.A., Sprague, M.A., Branen, L.J., & Lambeth, S. (2001). A comparison of views of individuals with type 2 diabetes mellitus and diabetes educators about barriers to diet and exercise. J Health Commun, 6(2), 99-115.
• Swift, C.S., Armstrong, J.E., Beerman, K., Campbell, R.K., & Pond-Smith, D. (1995).Attitudes and beliefs about exercise among persons with non-insulin-dependent diabetes. Diabetes Educ, 21(6), 533-40.
• Sluik, D., Buijsse, B., Muckelbauer, R., et al. (2012). Physical activity and mortality in individuals with diabetes mellitus: a prospective study and meta-analysis. Arch Intern Med, 172, 1285–1295
• Thomas, N., Alder, E., & Leese, G.P. (2004). Barriers to physical activity in patients with diabetes. Postgra Med J, 80(943), 287-91.
• Tripathi, B.K., & Srivastava, A.K. (2020). Diabetes mellitus: complications and therapeutics. Med Sci Monit, 12(7), 130 47. 2024 World Health Organization (WHO). Physical Activity, 2023. [cited Aug 08]. Available https//https://www.who.int/health-topics/physical activity#tab=tab_1. from: Wysham, C.H., & Kirkman, M.S. (2011). Response to Comment on: American Diabetes Association. Standards of 50 Medical Care in Diabetes—2011. Diabetes Care, 34(5), e54 e54.
• Van Holle, V., Deforche, B., Van Cauwenberg, J., Goubert, L., Maes, L., Van de Weghe, N., De Bourdeaudhuij, I. (2012). Relationship between the physical environment and different domains of physical activity in European adults: a systematic review. BMC Public Health, 12(1), 1-17.
• Yang, P., & Oh, P. (2013). Predicting aerobic fitness improvements after participation in a hybrid supervised and home-based exercise program in people with type 2 diabetes. CJD, 37(6), 388-93.
• Zhang, P., Zhang, X., Brown, J., Vistisen, D., Sicree, R., Shaw, J., Nichols, G. (2010). Global healthcare expenditure on diabetes for 2010 and 2030. Diabetes Res Clin Pract, 87(3), 293-01.