Barriers to regular exercise among adults at high risk or diagnosed with type 2 diabetes: a systematic review
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The aim of this systematic review was to identify the reported barriers to regular exercise among adults either at high risk or already diagnosed with type 2 diabetes (T2D), because of the importance of exercise in the prevention of T2D. We searched the MEDLINE, Cinahl and PsycINFO databases. All potentially relevant articles were reviewed by two researchers, and 67 titles were found, of which 13 papers met inclusion criteria. Internal and external barriers to exercise were identified among adults either at high risk of T2D or already diagnosed. Internal barriers were factors which were influenced by the individual's own decision-making, and external barriers included factors which were outside of the individual's own control. It is important for counselling to identify the internal and external barriers to regular exercise. In this way, the content of counselling can be developed, and solutions to the barriers can be discussed and identified. Further research on the barriers to regular exercise is needed.
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Exercise adherence is notoriously low among free-living individuals with obesity or type 2 diabetes, particularly when interventions are unsupervised or not integrated into clinical support systems.
“Exercise adherence is notoriously low among free-living individuals with obesity or type 2 diabetes, particularly when interventions are unsupervised or not integrated into clinical support systems [213–215].”
From Effects of Skeletal Muscle Hypertrophy on Fat Mass and Glucose Homeostasis in Humans and Animals: A Narrative Review with Systematic Literature Search (2025) · cites this paper as [213]
The Introduction describes sedentary adults as a concern, and the Discussion identifies barriers to regular exercise among adults at high risk of or diagnosed with type 2 diabetes, including feeling too overweight to exercise. The Discussion also recommends individualized exercise counselling. However, the review does not establish that adherence is particularly low in free-living people when interventions are unsupervised or outside clinical support systems. (LLM, conf=0.85)
Experimental — accuracy not yet measuredIndividuals with type 2 diabetes and comorbid obesity often cite discomfort as a barrier to exercise.
“However, individuals with T2D with comorbid obesity often cite discomfort as a barrier to exercise (Korkiakangas 2009), and similar findings have been reported in regard to diet modulation (Tomiyama 2010).”
From Mindfulness-based interventions for adults with type 2 diabetes mellitus (2021) · cites this paper as Korkiakangas 2009
The review’s Table 3 (Discussion, p. 423) lists feeling uncomfortable, physical discomfort, and feeling too overweight to exercise as barriers among adults at high risk for or diagnosed with type 2 diabetes. It does not establish how often discomfort is cited specifically by people who have both diagnosed diabetes and obesity. (LLM, conf=0.84)
Experimental — accuracy not yet measuredLack of time is often cited as a barrier to being physically active.
“'Lack of time' is often cited as a barrier to being physically active (Korkiakangas et al. 2009;Reichert et al. 2007)”
From Towards the minimal amount of exercise for improving metabolic health: beneficial effects of reduced-exertion high-intensity interval training (2012) · cites this paper as Korkiakangas et al. 2009
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- Authors
- Korkiakangas, E. E., Alahuhta, M. A., & Laitinen, J. H.
- Affiliations
- Finnish Institute of Occupational Health (FI)
- Corresponding author
- Korkiakangas, E. E.
- Venue
- Health Promotion International
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-09-30
- Volume
- 24
- Issue
- 4
- Pages
- 416-427
- ISSN
- 0957-4824 (ISSN-L)
- 1460-2245
- OpenAlex
- W2113043745
- Cited by
- 276
- References
- 65
- Citations by year
- 2026: 6 · 2025: 17 · 2024: 21 · 2023: 23 · 2022: 21 · 2021: 25 · 2020: 23 · 2019: 18 · 2018: 28 · 2017: 20 · 2016: 10 · 2015: 20 · 2014: 15 · 2013: 13 · 2012: 6
- FWCI
- 0.59
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Health Promotion International (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Academy of Finland (118176)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- barriers to exercise, type 2 diabetes, diabetes prevention, physical activity, internal barriers, external barriers, physical activity counseling
- MeSH terms
- Culture, Decision Making, Diabetes Mellitus, Type 2, Humans, Motivation, Time Factors, Exercise
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