Ege University Institute of Health Sciences, Chronic Diseases, Diabetes Support, İzmir, Turkey
Ege University Faculty of Medicine, Department of Public Health, İzmir, Turkey
J Clin Res Pediatr Endocrinol. 2023 Aug 23;15(3):238-247. doi: 10.4274/jcrpe.galenos.2023.2022-9-13. Epub 2023 Feb 20.
To determine physical activity (PA) avoidance and its associated factors among children with type 1 diabetes in four situations: leisure time (LT) PA out of school, LT PA at school during breaks, attendance at physical education (PE) classes and activity during PE classes.
Cross-sectional study. The cohort consisted of 137 children, aged 9-18 years, with type 1 diabetes registered at a tertiary center between August 2019 and February 2020, 92 of whom attended for face-to-face interview. Responses were rated on a 5-point-Likert scale for PA in the four situations. Never/rarely/occasionally responses were defined as avoidance. Chi-square, parametric/non-parametric comparison and multivariate logistic regression analysis were used to detect and confirm 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 play during PE classes. Older children (14-18 year-olds) avoided PE classes [odds ratio (OR)=6.49, 95% confidence interval (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 poorly-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 duration of 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 greater focus for better PA behavior among young people with type 1 diabetes. As the disease duration prolongs, revising and strengthening intervention to encourage PA may be needed.
在四种情况下确定 1 型糖尿病儿童的体力活动（PA）回避及其相关因素：校外闲暇时间（LT）PA、课间 LT PA、参加体育课和体育课活动。
横断面研究。该队列包括 2019 年 8 月至 2020 年 2 月在一家三级中心登记的 137 名 9-18 岁 1 型糖尿病儿童，其中 92 名接受了面对面访谈。对四种情况下的 PA 进行 5 点李克特量表评分。从不/很少/偶尔的回答被定义为回避。使用卡方检验、参数/非参数比较和多变量逻辑回归分析来检测和确认与每种回避情况相关的变量。
在儿童中，46.7%在 LT 校外回避 PA，52.2%在课间回避 PA，15.2%回避体育课，25.0%回避体育课中的活跃运动。年龄较大的儿童（14-18 岁）回避体育课[优势比（OR）=6.49，95%置信区间（CI）=1.10-38.13]和课间 PA[OR=2.85，95% CI=1.05-7.72]，女孩回避校外 PA[OR=3.18，95% CI=1.18-8.06]和课间 PA[OR=4.12，95% CI=1.49-11.40]。有兄弟姐妹的儿童（OR=4.50，95% CI=1.04-19.40）或母亲文化程度较低（OR=3.63，95% CI=1.15-11.46）回避课间 PA，低收入家庭的儿童回避体育课（OR=14.93，95% CI=2.23-99.67）。随着疾病持续时间的延长，校外 LT 期间的 PA 回避增加（4-9 年；OR=4.21，95% CI=1.14-15.52 年；≥10 年；OR=5.94，95% CI=1.20-29.36 年）。
青少年、性别和社会经济不平等现象值得更多关注，以改善青少年 1 型糖尿病患者的 PA 行为。随着疾病持续时间的延长，可能需要修改和加强干预措施以鼓励 PA。
