Provider Perspectives on Exercise in Children with Type 1 Diabetes

Abstract

Background: The benefits of exercise for adults with type 1 diabetes (T1D) are well known but literature in children is limited creating knowledge deficits for pediatric providers and patients. The objective of this study was to determine provider awareness of guidelines, current practices and barriers to counseling during visits. Methods: Members of the Pediatric Endocrine Society were asked to take an online survey including questions about provider demographics and perspectives on exercise counseling for children with T1D. Descriptive analyses were performed. Results: A total of 80 providers completed the survey. The majority practice in an urban setting (69%) at academic medical centers (82%). Of respondents, 54% reported they were unaware of exercise guidelines from the American Diabetes Association (ADA) that suggest 60 minutes of exercise daily. Of those who reported awareness, 16 of 37 identified them correctly but only 7 of the 16 reported recommending them clinically. Most providers (40%) reported recommending at least 30 minutes of exercise 5 days per week. The majority reported exercise counseling should be a priority at all visits (55% strongly agree, 30% agree) and cited barriers to counseling were: presence of more pressing issues (76%) and lack of time (61%). Respondents reported cardiovascular health (85%), improved insulin sensitivity (68%) and weight control (56%) as the most important exercise benefits. Conclusions: Pediatric endocrinologists report exercise counseling is important for patients with T1D but time barriers to counseling exist for the majority. Counseling tools that require less time during clinical visits may be beneficial to providers and patients. Also, even respondents who were aware of current guidelines reported recommending shorter periods of exercise. The reason for this discrepancy is unknown but it may reflect the desire to recommend more realistic goals. Further research about the benefits of shorter periods of exercise in this population is needed. Disclosure J. Ilkowitz: None. M. Gallagher: None.