Type 1 diabetes

Teaming up to increase activity in T1D

Wednesday, 5 Dec 2018

Can you describe the aim of your project in 10 words?

Exploring how group education addresses fear of hypoglycaemia – a barrier to physical activity.

What do we already know about the relationship between fear of hypoglycaemia and physical activity levels in people with type 1 diabetes?

We know that physical activity rates in the type 1 diabetes population are low. Some studies suggest these rates are lower than that observed in the general population. This, together with the potential health benefits of physical activity have driven numerous studies to examine what is preventing people with type 1 diabetes from becoming active. The results of several studies indicate fear of hypoglycaemia is the strongest barrier to physical activity in people living with type 1 diabetes.

What have you already discovered in this area so far?

Curtin researchers, together with Diabetes WA conducted a small pilot study of a self-management, group education program in 2017. Although the sample size was small, we did see a modest reduction in fear of hypoglycaemia being reported as a barrier to physical activity as well as increased confidence in managing blood glucose levels surrounding physical activity. This pilot work has led to a larger randomised control trial, which aims to determine the feasibility and preliminary efficacy of self-management, group education in reducing fear of hypoglycaemia as a barrier to physical activity.

What aspect of this research excites you the most?

Anyone who knows me will tell you I get a genuine kick out of watching people grow in confidence and performance when it comes to any physical activity venture. I can’t wait for more people to get excited about physical activity instead of being fearful of it. With the right support, people living with type 1 diabetes can tackle and succeed in anything they wish. A feasible and accessible program that allows people living with type 1 diabetes to confidently pursue whatever physical activity goal they have means we’re a step closer to having everyone on a level playing field.

A program to reduce fear of hypoglycaemia sounds like it might benefit from psychological input. What do you as an exercise physiologist bring to this project?

Thankfully we have a fantastic research team including a very talented health psychologist, Professor Nikos Ntoumanis, who is guiding the project from a behavioural psychology point of view. The literature does however suggest, in order to address the unique barriers experienced by people living with type 1 diabetes such as fear of hypoglycaemia, knowledge of how physical activity types, intensities and duration affect blood glucose levels is required, as well as self-efficacy in using carbohydrates and or insulin adjustment to manage blood glucose levels for physical activity. As an exercise physiologist and diabetes educator with experience in group, self-management education, I was uniquely placed to explore and address this gap.

How long before this project might impact patient care?

We are lucky to be collaborating with Diabetes WA who currently deliver a suite of diabetes self-management education programs under the National Diabetes Services Scheme. We are also working closely with a project steering group, including four consumer members and representatives from a number of community stakeholder groups who are informing aspects of our research methods, materials and knowledge translation. This integrated approach to our research, along with the support of the ADEA Diabetes Research Foundation is expect to result in timely and meaningful research translation, likely to occur within four years.

What’s your Holy Grail – the one thing you’d like to achieve in your research career?

As an early career researcher embarking on my PhD, my first goal is to get an answer to our current research question! Beyond this project, I hope to find out more as to how we can better use group education in the adult type 1 diabetes space. The Holy Grail would be to see more accessible, evidence based interventions available for adults living with type 1 diabetes.

What is your biggest research hurdle?

I think, like most research projects, having research funds available to undertake the work in reasonable timeframes is a challenge. Thankfully, I have been lucky enough to receive the ADEA Diabetes Research Foundation Research Fellowship for 2018. This is a new fellowship offered by the foundation with the aim to develop research capacity and evidence-based practice in diabetes education and care.

Who has inspired you in work or life?

My older sister by 12 years definitely had a huge influence on me in my formative years. As a medical scientist, she was always encouraging and nurturing my inquisitive mind and love of science, saying that one day I could be a scientist too! My late brother heavily influenced my decision to pursue exercise physiology as my career of choice. My interest was sparked when I began taking him to the cardiac rehabilitation gym at Royal Perth Hospital during my undergraduate years. Seeing the physical and psychological gains my brother experienced through physical activity after years being advised against exercise due to his congenital heart condition (Tetralogy of Fallot), sparked my interest and passion for exercise physiology.

What are three things you cannot live without?

  • My cat Bob who is my unofficial fourth project supervisor
  • My bike to clear my head
  • Chocolate because I am more pleasant when it’s in my life.

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