Family Support is Associated with Moderate to Vigorous Physical Activity Adherence in Adolescents with Diabetes

Abstract

Adolescents with type 1 or type 2 diabetes have known risks for future cardiovascular (CV) disease, the leading cause of morbidity and mortality in adults with diabetes. Limited research is available on efficacious approaches to promoting regular, physical activity as a salient component of diabetes management to control glucose levels and minimize future CV risks and complications in this population. PURPOSE: The purpose of this study was to examine the associations of adolescents' perceptions of diabetes-specific family support with their adherence to a 16-week personalized exercise program to achieve 60 minutes/day of moderate to vigorous physical activity (MVPA). We also explored the associations of the frequencies of adherence to daily MVPA (i.e. 10, 30, or 60 minutes/day MVPA) with glucose control. METHODS: Baseline measures of adolescents' perceptions of family support were obtained using the Diabetes Social Support Questionnaire-Family Version (LaGreca & Bearman, 2002). Adherence to their personalized exercise program was measured using accelerometers. Adolescents were instructed to wear the accelerometers daily except when sleeping, bathing or swimming. Glucose control was measured at baseline and at the completion of the intervention with A1C% using a DCA 2000®. RESULTS: A sample of 29 adolescents with diabetes (20 type 1; 9 type 2) participated. There were 12 males; 17 females (15 Hispanic white; 1 Hispanic black; 13 Non-Hispanic white). Average baseline A1C% was 9.2 ± 1.8% vs. 8.4 ± 1.7% for those with type 1 vs. type 2 diabetes, respectively. Significant positive associations between family support of blood testing, exercise and meal planning with all levels of adherence to MVPA were found, with some stronger associations noted with higher frequencies of adherence to 60 minutes/day of MVPA (r =.38 to.50, p <.05). Family support for insulin administration was also significantly related to greater adherence to 60 minutes/day of MVPA (r =.41, p <.05). The frequency of 30 minutes/day of MVPA was negatively associated with percent change in A1C% (r =.-.49, p <.001). CONCLUSIONS: Adolescents' views of a supportive family environment for overall diabetes management provide a foundation for successful adherence to participation in routine daily MVPA and improvements in glucose control.