Physical activity as clinical practice care for patients with type 2 diabetics and its implementation in routine clinical care: an expert opinion survey

Introduction: Physical activity (PA) is integral to type 2 diabetes (T2D) treatment, yet few national health services incorporate structured PA services as part of T2D treatment. Moreover, healthcare professionals acknowledge their role in integrating PA into the daily routines, but implementation faces notable barriers. Recognizing the pivotal role of healthcare systems and professionals in promoting physical activity–based interventions is crucial to closing the gap between guidelines and their implementation in real-world settings. Methods: The study involved 363 healthcare and physical activity professionals across diverse clinical settings. A questionnaire, developed through a focus group and literature review, assessed participants’ attitudes and knowledge on PA and national practices pertaining to PA for people with T2D. The questionnaire’s internal reliability was examined using Cronbach’s alpha. Chi-squared tests compared participants’ attitudes and knowledge prevalence in each healthcare and physical activity professionals’ sector. Results: Participants (mean age = 48.00 ± 12.55) overwhelmingly supported PA inclusion in healthcare (97.8%) and reimbursement (77%). Translating PA recommendations into clinical practice remains a significant challenge due to several interrelated barriers. These include time constraints that hinder physicians’ ability to provide in-depth counseling during routine visits, and patient-related factors, such as low responsiveness (43.8%) and limited awareness (33.3%). Around 70% of physicians endorsed regular PA recommendations. Exercise physiologists (30%) and physiotherapists (28%) were deemed most qualified to instruct T2D patients, followed by physicians (15.7%). A majority (57%) advocated for a multidisciplinary approach to PA prescription, incorporating aerobic, strength, and stretching training. Conclusion: The study underscores the need for the National healthcare system to prioritize infrastructure development, including multidisciplinary teams, for personalized PA programs vital to individuals with T2D.