Physical activity and glycaemic control among adults with type 2 diabetes in Suva, Fiji: a cross sectional pilot...

Type 2 diabetes mellitus is a major health burden in Fiji (19.3% prevalence). Evidence suggests increased physical activity improves glycaemic control and health outcomes; however, this remains unstudied in Fiji's population.

This study aimed to assess physical activity levels and explore its relationship with glycaemic control among diabetic patients.

A quantitative, cross-sectional pilot study was conducted at Samabula Health Center, Fiji, from September to November 2022 using convenience sampling for 174 adults with diabetes. The International Physical Activity Questionnaire, short form, assessed physical activity, whereas capillary fasting and random blood sugar assessed glycaemic control targets. Logistic regression analysed associations.

The study found 64% of participants were physically inactive, with females significantly less active than males (odds ratio (OR) = 0.49, 95% confidence interval (CI) = 0.25-0.98). Poor glycaemic control was common (75%), although adherence to lifestyle and pharmacological management plans were significantly associated with good control (OR = 2.37, 95% CI: 1.05-5.37). Increased physical activity levels were not significantly associated with meeting glycaemic control targets.

Despite clinic attendance, patients with diabetes remained inactive, had poor glycaemic control and were non-adherent to lifestyle and drug treatment. Contradicting previous evidence, physical activity was not associated with meeting glycaemic control targets, possibly reflecting point-of-care glucose variability compared to the gold-standard glycated hemoglobin measure (HbA1c), and cross-sectional study design limiting causal interpretation. Future research should investigate glycaemic control and physical activity barriers, especially among women, physician practices and test culturally adapted interventions. Fiji's National Wellness Policy and Non-Communicable Disease (NCD) Strategic Plan must consider strengthening diabetes management guidelines, clinician training and patient support to address systemic gaps.