Abstract
BACKGROUND: Managing glycemia around exercise is challenging for individuals with type 1 diabetes (T1D) and their healthcare professionals (HCP). We investigated HCP knowledge and confidence around exercise counseling for youth with T1D worldwide. OBJECTIVE: To assess HCP familiarity with ISPAD Clinical Practice Consensus Guidelines and confidence to deliver recommendations about T1D and exercise. METHODS: A new online survey was developed on strategies and competencies about exercise for youth with T1D, comprising of 64 questions, divided into eight different categories, assessing HCPs perceived exercise knowledge, confidence, training, and barriers to exercise counseling. RESULTS: A total of 125 HCPs mean ± SD age 42 ± 8.2 years (74% female, 73% physicians) completed the survey. The ISPAD exercise guidelines were considered familiar to 68/125 (54%) of responders. Overall, 91/125 (73%) felt confident with giving recommendations about exercise with 47/125 (38%) recommending 45-60 mins/day of physical activity, while 16/125 (13%) recommended >60 mins/day. Several topics related to self-management around exercise were covered by most, but not all responders, and differences were observed in exercise content "confidence" and/or "competence" based on geographic location (p = 0.048). No differences in exercise recommendation dose, confidence, or familiarity with ISPAD guidelines were observed for age, sex, type of HCP, years in practice, or healthcare type. CONCLUSIONS: Exercise counseling for youth with T1D remains a challenge in most healthcare settings, globally. In general, the number of physically active minutes per week is under-prescribed for youth with T1D and many HCPs in various settings around the world feel that more professional education is needed to boost confidence around the education of several exercise-related topics.