Cognitive Determinants of Physical Activity and Their Inter-relationships with Mental Distress and Diabetes Self-care in Patients with Type 2 Diabetes Mellitus

Background: Diabetes is an increasing problem in Hong Kong. Physical activity is an integral part of diabetes care but received surprisingly few attention locally. This study is the first study with focus on physical activity in Type 2 diabetes in Hong Kong.;Methods: For this cross-sectional study, 576 patients were recruited from two specialized diabetes clinics in Hong Kong for telephone interview. The interview included measures of physical activity (by IPAQ), mental distress (by DASS21), diabetes self-care (by SDSCA), self-care self-efficacy (by DES), exercise efficacy, attitude and subjective norm towards exercise, time-spent on exercise, instrumental social support, and various indicators of diabetes control (HbA1c, blood pressure, LDL-cholesterol). Regression models were fitted to identify determinants of physical activity, mental distress, and diabetes self-care. Structural equation modeling was used to model the inter-relationships between the variables.;Results: About half of the patients did not meet international guidelines of physical activity for diabetes patients. Exercise efficacy and attitudes towards exercise are the two dominant factors that predict physical activity level and exhibit significant difference between key stages of change. Level of mental distress was very low and did not correlate with physical activity or diabetes self-care.;Conclusion: There is a need to implement physical activity programs for the diabetes patients in Hong Kong. Stage-matched intervention for increasing physical activity level should be introduced into the current diabetes management routine.