Physical Activity and Self-Efficacy in Overweight/obese Adults with Type 2 Diabetes and Concurrent Kidney Disease

Abstract

Physical activity (PA) is an important component in the prevention and management of type 2 diabetes and chronic kidney disease (CKD). Determining current patterns and predictors of PA is essential to implement programs that encourage behavior change for patients with these diseases. PURPOSE: To describe self-reported PA and self-efficacy among adults with type 2 diabetes and CKD and determine predictors of overall PA patterns. METHODS: 76 overweight/obese participants (age: 66±8 y; body mass index [BMI]: 33.0±5.3 kg/m2; sex: 60% male; ethnicity: 91% non-Hispanic white; race: 80% white) with type 2 diabetes and CKD, participating in a technology-delivered lifestyle intervention, completed two well-validated surveys at baseline: International Physical Activity Questionnaire-Short Version and Self-Efficacy for Exercise (SEE) Scale. Biomarkers (hemoglobin A1c, glomerular filtration rate, C-reactive protein) were collected via blood draw. Multiple linear regression was performed to predict total metabolic equivalent (MET)-minutes/week of PA based on biomarkers, BMI, and SEE. Preliminary analyses were conducted to ensure no violation of the assumptions of the regression model. Statistical analyses were conducted using IBM SPSS Statistics (version 22.0). RESULTS: Participants self-reported completing (median [interquartile range, IQR]) 594(1435) MET-minutes/week walking intensity, 160(780) MET-minutes/week moderate intensity, 0(960) MET-minutes/week vigorous intensity, and 1431(2938) total MET-minutes/week. 40.8% of participants met the PA guidelines of 150 minutes/week (median [IQR]: 107[346] min/week). Average SEE scores were 55±22 (range 2 to 90). SEE was the only statistically significant predictor of total MET-minutes/week (β=0.364, p=0.004). CONCLUSION: Self-efficacy for exercise was a strong predictor of PA in patients with type 2 diabetes and CKD. Social cognitive theory-based programs that build self-efficacy and incorporate PA should be developed to promote risk reduction of these chronic diseases. Given the tendency to self-report higher levels of PA, future studies should include more objective measures of PA to explore these relationships. Supported by NIH Grant R01 DK100492 (PI MA Sevick)