RESUMO
OBJECTIVES: Current exercise recommendations for people with type 1 diabetes (PWT1D) are based on research involving primarily young, fit male participants. Recent studies have shown possible differences between male and female blood glucose response to exercise, but little is known about whether these differences are sex-related (due to physiological differences between male and female participants), or gender-related (behavioural differences between men and women). METHODS: To better understand gender-based behavioural differences surrounding physical activity (PA), we asked men and women (n=10 each) with T1D to participate in semistructured interviews. Topics discussed included motivation and barriers to exercise, diabetes management strategies, and PA preferences (type, frequency, duration of exercise, etc). Interview transcripts were coded by 2 analysts before being grouped into themes. RESULTS: Six themes were identified impacting participants' PA experience: motivation, fear of hypoglycemia, time lost to T1D management, medical support for PA, the role of technology in PA accessibility, and desire for more community. Gender differences were found in motivations, medical support, and desire for more community. Women were more motivated by directional weight dissatisfaction, and men were more motivated to stay in shape. Men felt less supported by their health-care providers than women. Women more often preferred to exercise in groups, and sought more community surrounding T1D and PA. CONCLUSION: Although men and women with T1D experience similar barriers around PA, there are differences in motivation, desire for community, and perceived support from medical providers.
RESUMO
Due to improvements in diabetes care, people with type 1 diabetes (T1D) are living longer. Studies show that post-menopausal T1D women have a substantially elevated cardiovascular risk compared to those without T1D. As T1D may also accelerate age-related bone and muscle loss, the risk of frailty may be considerable for T1D women. Exercise and physical activity may be optimal preventative therapies to maintain health and prevent complications in this population: They are associated with improvements in, or maintenance of, cardiovascular health, bone mineral density, and muscle mass in older adults. Resistance exercise, in particular, may provide important protection against age-related frailty, due to its specific effects on bone and muscle. Fear of hypoglycemia can be a barrier to exercise in those with T1D, and resistance exercise may cause less hypoglycemia than aerobic exercise. There are currently no exercise studies involving older, post-menopausal women with T1D. As such, it is unknown whether current guidelines for insulin adjustment/carbohydrate intake for activity are appropriate for this population. This review focuses on existing knowledge about exercise in older adults and considers potential future directions around resistance exercise as a therapeutic intervention for post-menopausal T1D women.