Socioeconomic Inequalities, Adolescence, Sex and Disease Duration as Associates of Physical Activity Avoidance Among Children with Type 1 Diabetes.

Abstract

To determine physical activity(PA) avoidance and its associates among children with type 1 diabetes at four situations: leisure time(LT) PA out of school, LT PA at school during breaks, attendance at physical education(PE) classes and active plays during PE classes. Cross-sectional study. Among 137(9-18 years-old) children with type 1 diabetes registered at Ege University Pediatric Endocrinology Unit(August 2019-February 2020), 92 who attended were interviewed face-to-face. Their responses were rated on a 5-point-Likert scale for PA in four situations. Never/rarely/occasionally responses were defined as avoidance. Chi-square and t/MWU tests and multivariate logistic regression analysis were used to detect variables associated with each avoidance situation. Among the children, 46.7% avoided PA during LT out of school and 52.2% during breaks, 15.2% avoided PE classes and 25.0% avoided active plays during PE classes. The older(14-18 year-olds) avoided PE classes(OR=6.49, 95%CI=1.10-38.13) and PA during breaks(OR=2.85, 95%CI=1.05-7.72) and girls avoided PA out of school(OR=3.18, 95%CI=1.18-8.06) and during breaks(OR=4.12, 95%CI=1.49-11.40). Those who had a sibling(OR=4.50, 95%CI=1.04-19.40) or had a low-educated mother(OR=3.63, 95% CI=1.15-11.46) avoided PA during breaks and those from low-income households avoided PE classes(OR=14.93, 95%CI=2.23-99.67). As the disease prolonged, avoiding PA during LT out of school increased(4-9 years;OR=4.21, 95%CI=1.14-15.52 and ≥10 years; OR=5.94, 95%CI=1.20-29.36). Adolescence, gender, and socioeconomic inequalities deserve special focus for better PA behavior among children with type 1 diabetes. As the disease prolongs, revising and strengthening the interventions for PA is needed.