Motivation States for Physical Activity Among Middle-Aged Adults with Type 1 Diabetes Mellitus

Background: Individuals with diabetes face challenges with glucose fluctuations that complicate physical activity (PA) both biomedically and psychologically.One relevant psychological factor is the fear of hypoglycemia.Transient cravings to move or be sedentary might also be involved.The purpose of this study was to identify whether T1DM-related physical activity barriers (i.e., fear of hypoglycemia or hyperglycemia, glycemic variation) predict physical activity at a momentary level, and whether motivation states hold a mediating role.Methods: Adults (n=23, 4811yr of age, 2713yr with T1D, 78% female, 91% non-Hispanic white, HbA1c 7.11.0%)who completed an exercise intervention completed two weeks of ecological momentary assessment (EMA) surveys under conditions of daily living, wearing a continuous glucose monitor from routine care and an Actigraph GT9X activity and sleep monitor issued by the study. Results:We found predictors of transient motivation states included both psychological and biological variables.Although, circadian variation was the strongest determinant: an effect size of f 2 = 0.16-0.17.Transient motivation states were meaningful predictors of PA levels over the subsequent 3 hours (f 2 = 0.08-0.10),much more so than planned PA intention that morning (f 2 < 0.01).Conclusions: Psychological factors affecting exercise behavior varied according to the time of day and were further perturbed by glucose levels and aversions to hypo-and hyperglycemia.