SAT-614 Physical Activity Facilitators And Barriers In Adults With Type 1 Diabetes: A Survey-based Research Study

Abstract Disclosure: S. Mauro: None. K.C. Anderson: None. A.A. Panzer: None. K.S. Fitzgibbon: None. K.M. Love: None. Introduction and Objective: Physical activity (PA) is vital for people with type 1 diabetes (T1D) as it is associated with improved mortality, glycemic control, and quality of life. Despite this, people with T1D exercise less than their unaffected peers. This study aimed to identify barriers and facilitators to exercise in adults with T1D and determine if sociodemographic, T1D management self-efficacy, or quality of life factors were independently associated with meeting recommended PA. Methods: We conducted a cross-sectional online survey study of adults with T1D aged ≥18 years old recruited through the T1D Exchange and Reddit. Questions related to exercise quantity and intensity, diabetes quality of life (DQOL), self-efficacy, demographic characteristics, and exercise facilitators. Exercise barriers were rated using a 7-point Likert scale. SAS 9.4 was used to conduct descriptive, Mann-Whitney U, and logistic regression analyses. Logistic regression was performed to determine if the following predictors were independently associated with meeting PA recommendations: age, gender, income level, insurance payor, urban/rural location, automated insulin delivery (AID) use, and DQOL. Results: Of the 281 respondents who completed questions about exercise quantity, 162 (62%) were women, mean age 52.6 ± 16.6 years and 150 (53%) met PA guideline recommendations. Most commonly selected facilitators were insurance reimbursement of exercise program/gym (50.9%), attending an exercise group (39.9%), and one-on-one advising from a health advisor (37.4%). For those not meeting PA recommendations, most commonly reported barriers to PA were risk of hypoglycemia and weather conditions (median response 5, “likely” to prevent activity). Other common barriers for those not reaching PA recommendations and which showed discordance between the meeting and not meeting recommended PA groups included: fatigue before and during exercise, exercise cost, activity location, and loss of glycemic control (all p<0.01, meeting vs. not meeting PA recommendations). Upper (vs. middle) income status was independently associated with meeting PA recommendations (adjusted odds ratio 2.3, 95% CI: 1.2-4.4) but the other covariates including age, gender, insurance payor, location, AID use, and DQOL were not. Conclusion In this cohort with T1D not meeting recommended PA, most commonly reported modifiable barriers to PA were fear of hypoglycemia/loss of control, fatigue before and during exercise, exercise cost and location. Addressing fatigue and glucose self-management surrounding PA with counseling and future research interventions may promote PA uptake, and advocacy is needed to promote insurance reimbursement of exercise facilities/programs in this population. Presentation: Saturday, July 12, 2025