BACKGROUND Physical activity (PA) is a cornerstone of type 2 diabetes mellitus (T2DM) treat-ment. Sex differences in PA behavior or barriers/facilitators to PA among individuals with T2DM are unclear. PURPOSE To summarize the evidence related to sex differences in participation in PA and barriers/facilitators to PA among individuals with T2DM across the life span. DATA SOURCES Systematic searches (CRD42021254246) were conducted with Ovid MEDLINE, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine Database (AMED), APA PsychInfo, and SPORTDiscus. STUDY SELECTION We included studies with assessment of PA, sedentary behaviors (SB), or bar-riers/facilitators to PA among individuals with T2DM by sex or gender. DATA EXTRACTION Participant characteristics, meeting PA guidelines, participation in PA and SB, and barriers/facilitators to PA were extracted by two independent reviewers. DATA SYNTHESIS A total of 53 articles (65,344 participants) were included in the systematic review and 21 articles in the meta-analysis. Sex differences were not observed in meeting of PA guidelines among adolescents (odds ratio 0.70 [95% CI 0.31, 1.59]), but males were more likely than females to meet PA guidelines among adults (1.65 [1.36, 2.01]) and older adults (1.63 [1.27, 2.09]). Males performed more moder-ate-to-vigorous PA (MVPA) than females across all age-groups. Common barriers to PA were lack of time (men) and lack of social support and motivation (women). LIMITATIONS Limitations include heterogeneity of measures used to assess PA and lack of strat-ification of data by sex. CONCLUSIONS Sex differences in meeting PA guidelines were not observed among adolescents but were apparent among adults and older adults with T2DM. Females consistently en-gagedinlessMVPAthanmalesacrossthelifespan.
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Acknowledgments. The authors acknowledge Christi Piper, Strauss Health Sciences Library, for her valuable help in optimizing the search strategy. Funding. This study was supported by the National Institutes of Health (T32AG000279 to M.O.W., L30NR019425 to M.O.W., R01DK123334 to A.B., P50CA244688 to A.G.H., P30DK048520 to K.S.M., P30DK116073 to J.E.B.R., UL1TR001082 to J.E.B.R., R01AG066562 to J.E.B.R., R01DK124344 to J.E.B.R. and J.G.R., and K12HD057022 to J.G.R.), the Ludeman Family Center for Women’s Health Research (M.O.W., A.J.P., A.G.H., K.J.N., R.L.S., J.E.B.R., and J.G.R.), the American Diabetes Association (1-21-CMF-003 to L.A.A.), and the Department of Veterans Affairs (BX004533 to R.L.S., BX002046 to J.E.B.R., and CX001532 to J.E.B.R.). Duality of Interest. No potential conflicts of interest relevant to this article were reported. Author Contributions. M.O.W. and J.G.R. conceived of the idea. M.O.W., A.J.P., L.A.A., A.B., A.G.H., K.S.M., J.E.B.R., and J.G.R. refined the topic to be studied. M.O.W. performed the literature searches. M.O.W., A.J.P., L.A.A., and K.C. screened articles for eligibility. M.O.W., A.J.P., and L.A.A. extracted relevant data. A.J.P. performed the analysis. M.O.W., A.J.P., and L.A.A. drafted the manuscript. All authors discussed the results, critically revised the manuscript, and approved the final version to be published.
© 2022 by the American Diabetes Association.