Assessing Exercise Barriers for Pakistani Men with Type 2 Diabetes

This report presents a study investigating the barriers to exercise participation among men of Pakistani ethnicity diagnosed with type 2 diabetes. The research begins with an introduction to diabetes, its types, and the significance of physical activity in managing the condition, particularly focusing on type 2 diabetes. The study's aim is to assess whether type 2 diabetes acts as a barrier to exercise within this specific ethnic group. The objectives include evaluating the medical requirements of exercise for type 2 diabetes patients, examining chronic conditions resulting from poor diabetes management, and understanding the attitudes of Pakistani men towards exercise. The literature review explores diabetes, the medical necessity of exercise, and related challenges. The methodology includes search strategies, inclusion and exclusion criteria, and quality appraisal. The findings are presented in the results chapter, followed by conclusions and recommendations. The report highlights limitations such as time and budget constraints, and the structure includes chapters on introduction, literature review, methodology, results, and conclusion. The report underscores the importance of exercise in controlling blood sugar levels and preventing complications associated with type 2 diabetes.

Is Type 2 Diabetes a barrier for
exercise participation in men of
Pakistani ethnicity

ACKNOWLEDGEMENT
I am so thankful to all those persons who have given me provision, guidance as well as much
needed motivation so as to complete the current research study. Firstly, I owe my thanks to guide
who gave me chance to undertake this dissertation. Furthermore, I am thankful to my team
members, family and friends who helped me in all possible accords. This led to successful
completion of dissertation and achievement of relevant results.

ABSTRACT
Diabetes is determined to be a type of chronic disease which can not be cured. There are
various type of medications provided so that the rate of negative impact faced by people can be
reduced. Main focus of the research is carried out on assessing whether type 2 diabetes a barrier
to exercise participation in men of Pakistani (South Asia) ethnic origin. People face difficulty to
exercise due to lack of understanding. The research recommends that health care professional
should make sure that they help patients to prepare proper balance diet and type of exercise that
can be done so that type 2 diabetes can be controlled.

Contents
CHAPTER 1: INTRODUCTION.........................................................................................................
1.1 Overview................................................................................................................................5
1.2 Aim of the research................................................................................................................5
1.3 Objectives of the research......................................................................................................6
1.4 Rational of the study..............................................................................................................6
1.5 Significance of the research...................................................................................................6
1.6 Limitations of the study.........................................................................................................6
1.8 Dissertation Structure............................................................................................................7
CHAPTER 2: LITERATURE REVIEW..............................................................................................
2.1 Introduction............................................................................................................................8
2.2 Overview to diabetes.............................................................................................................8
2.3 Medical requirements of exercise for the patients suffering from type 2 diabetes................9
CHAPTER 3: SEARCH STRATEGY...............................................................................................
3.1 Introduction..........................................................................................................................14
3.2 Search strategy.....................................................................................................................14
3.3 Inclusion criteria..................................................................................................................15
Exclusion criteria.......................................................................................................................15
Search results.............................................................................................................................15
Quality Appraisal of Studies..............................................................................................................
CHAPTER 4: RESULTS...................................................................................................................
CHAPTER 5: CONCLUSION AND RECOMMENDATION..........................................................
5.1 Conclusion...........................................................................................................................22
5.2 Recommendation.................................................................................................................22
REFERENCES...................................................................................................................................

CHAPTER 1: INTRODUCTION
1.1 Overview
Diabetes is a chronic disease where it cannot be cured. However, its impact on the body
can be reduced to minimum with proper management. It is a long-life disease which carries high
blood sugar, where less insulin is secreted by pancreas. Type 2 diabetes generally occurs due to
lack of physical activity and obesity. However, some of them are genetic risk to it. Common
symptoms that are related to it are, feeling tired, increased hunger, sores that do not heal easily
etc. Long term complications that are related to this disease include, diabetic retinopathy, heart
diseases and stroke. Some extreme intensity cases of diabetes type 2 leads to, kidney failure,
blindness and amputation of limbs due to poor blood flow (Chau and et.al., 2012).
The disease can not be cured. However, it is preventable when normal body weight is kept
with diet management and adequate amount of physical activity. Exercise plays an important role
in keeping appropriate blood circulation and continuous secretion of insulin through the
pancreas. Metformin is the typical recommendation of health professionals. However, in case of
high intensity of extreme blood glucose level, injections of insulin are also suggested to the
patient. Some of the common sign and symptoms involved in this process includes, polyureic
condition, that is frequent urination, increase in thirst, increase in hinger and appetite and weight
loss.
Diabetes leads to increase the risk of cardiovascular disease by 2 to four times in people
with 20-fold increase in limb amputations. Type 2 diabetes is considered as the main cause of
renal failure and non-traumatic blindness in the patients. Scientists have stated that different bits
of DNA have been found that affect one’s body and also have larger impact on how body tends
to form insulin. Another reason can be when wrong amount of insulin information is sent by
communication carrying cells leading to high throw of glucose to the blood (Fitzpatrick, Bulsar
and Zheng, 2017). It tends to damage the cells and the process and amount in which insulin is
actually be secreted by pancreas.
1.2 Aim of the research
It is important to have a specific aim in order to conduct a research. Hence, aim for the
present research 
“To assess whether type 2 diabetes a barrier to exercise participation in men of
Pakistani (South Asia) ethnic origin”
5

1.3 Objectives of the research
Based on the above aim, following objectives can be prepared for present study:
 To assess the medical requirements of exercise for the patients suffering from type 2
diabetes.
 To examine chronic condition that a patient may face due to poor management of type 2
diabetes
 To ascertain the attitude of Pakistani diabetes type 2 towards exercise.
1.4 Rational of the study
It is important that any research that has been conducted by the researcher hold certain
relevance. It helps in generating adequate amount of knowledge regarding the subject matter.
The present research will be conducted on assessing whether type 2 diabetes a barrier to exercise
participation in men of Pakistani (South Asia) ethnic origin. The researcher carries insufficient
amount of knowledge regarding the subject matter. Hence, it will help in addressing the issue
and gather the same for the investigator. Another important aspect for which the present research
has been conducted is due to understanding various aspect of type 2 diabetes and its direct
relation to exercise. Moreover, the research will also focus upon understanding the role of
physical activity in controlling blood sugar level (Haas and et.al., 2012).
1.5 Significance of the research
It is important that any research that has been conducted by the researcher holds certain
significance so that appropriate results from the same can be generated. The present research
focus upon relationship between physical exercise and type 2 diabetes. It will help reader to
gather adequate amount of knowledge where they will able to understand the important of
exercise for the patient suffering from type 2 diabetes (Murano and et.al., 2014). Another
important aspect related to it is to understand the topic in detail so that unidentified knowledge
can be gathered through proper conduction of research. In the end, it can be stated that, the
present research will also be helpful to the other scholars who are conducting research on same
or similar topic.
1.6 Limitations of the study
There are various limitations that are attached to the research which are required to be
considered by the researcher. One of the important aspect is related to time and budget
constraint. There is limited budget available to the researcher and the important aspect are
6

required to be covered in it. Adequate investment is required to be considered so that each and
every activity involved in the research are measured appropriately. Moreover, effective results
outputs are generated from the same that can benefit the readers and other scholars as well.
Another aspect is related to lack of time. A prolonged research can affect the viability and
reliability of data included in it. Hence, it is important that the investigation is complete in the
specific time frame.
Since, the dissertation deals with the medical issue of diabetes, lack of secondary
information available on various modes can affect the overall conclusion and recommendations
aspect of it. In such case, unavailability of adequate information can barricade the understanding
and data related to the topic. It also affects the overall conclusion of the research. Restricted
learning is not able to generate adequate results. Hence, it is recommended that the researcher
must be careful regarding these limitations while developing any dissertation.
1.8 Dissertation Structure
It is important that before opting for completion of dissertation, it is important to prepare a
blueprint that how the same will actually be prepared. Hence, the present dissertation will follow
the following structure:
Chapter 1: Introduction: It is first and foremost chapter of dissertation that helps in discussing
regarding the basic idea of subject matter. Hence, it has helped in gathering the main aim,
objective and rationale of the research for better understanding.
Chapter 2: Literature review: It is considered to be one of the most important chapter of the
research, where, data from various sources is collected so as to develop adequate understanding
regarding the subject matter. It is also plays essential role in critically reviewing the opinion of
various researchers and reach to the specific results based on it.
Chapter 3: Research methodology: It helps in describing the research methodology that can be
used by the researcher in completing the dissertation. Hence, all the inclusion and exclusion
criteria and search strategy will be described in this chapter.
Chapter 4: Discussion and Findings: It is an important chapter where themes has been
formulated to assess the main findings of research and their direct link to aims and objectives
being framed for the research.
7

Chapter 5: Conclusion: In the end, this chapter tends to conclude the over all srux of the
dissertation and data that has been collected based upon the opinions of various researchers on
the topic type 2 diabetes.
CHAPTER 2: LITERATURE REVIEW
2.1 Introduction
It is considered to be one of the most important chapter of the overall researcher where
opinions of various another researcher is critically analysed. It will help in evaluating the opinion
of other researcher with respect to type 2 diabetes, and the same will be critically assessed based
on the opinion of some other researchers as well. Thematic analysis process has been chosen to
perform this function. Hence, various themes related to aims and objectives have been prepared
so hat detailed analysis with respect to the subject matter can be gathered.
2.2 Overview to diabetes
According Powers and et.al., (2015) Diabetes is a chronic health condition where pancreas
tend to secrete less amount of insulin to the body which ultimate increases the glucose level in
blood. It is a metabolic disorder which once occurred, cannot be cured. The condition is
reversible and can be brought to control with the help of change in over lifestyle and dietary
factors. The condition is brought into consideration when the cells become insensitive to insulin
and tend to gradually produce high amount of glucose level and transferring the same to blood.
There are certain reasons due to which, diabetes is generally caused. These are, being
overweight, lack of activity, lack of exercise or other kind of physical activity, genetics, high
intake of artificial sweeteners, etc. Some common signs related to it includes, excess urination,
unintentional gain or loss of weight, fatigue, blurred vision, excess thirst etc. A blood sugar level
more than 125 when fasting and more than 200 is a simple and clear curt diagnosis of diabetes.
Diabetes have become epidemic in various countries that requires constant review to assess
that it does not affect the life of an individual. In such cases, it is generally advised to the patient
to go through blood sugar level at least once in a week so that it can be tracked and medications
can be changed and updated accordingly. The common drug that is advised by the doctor in this
scenario is Metformin. However, the dosage of drug is changed as per the intensity of diabetes
prevailing in the body. Other type of treatment that is generally recommended by the doctors
include, bringing adequate changes in the lifestyle, diet control, etc. (Sohal, Sohal and Khan,
2015). Meeting the doctor to create an effective treatment plan can help the patient to reduce its
8

impact to minimum on lifestyle. The main causes of diabetes type 2 is related to unhealthy
lifestyle followed by the individual such as, major consumption of sugar and carbohydrates,
eating and drinking of food products containing artificial sweeteners, lack of physical activity,
chronic and high stress level, etc.
Long term complication of diabetes can lead the patient to strokes, cardio vascular disease,
diabetic retinopathy that can cause partial or total blindness, kidney failure, amputations of the
limbs due to lack of blood flow (Caperchione, Chau and Jennings, 2015). A sudden stroke of
hyperglycaemic state can also result in ketoacidosis in the patient and ultimately death as well.
Type 2 diabetes is quite preventable if healthy lifestyle is adopted by the individual. Staying at
normal weight as per the body mass index, eating properly and exercising regularly can help in
dealing with the issue to the core.
2.3 Medical requirements of exercise for the patients suffering from type 2 diabetes
As per the view of Haas and et.al., (2012) Medical requirement for the patents suffering
from type 2 diabetes physical activity is an important component for attention plan. It is one of
the most important factor to have a healthy plan and maintained blood glaucous level through
mediation. In this context, regular excise is most important plan for medical requirement form
type 2 diabetes person. According to Arora and et.al., (2012) to stay fit and active throughout in
life, is help to finer control on diabetes and liquid body substance glaucous level in correct way.
To control blood glaucous level for long term, abide by such as nerve pain and kidney disease.
On the other hand, exercise has so many benefits for such kind of disease. It makes easier to
control the level of types 2 diabetes. As per the view of Walton and et.al., (2012) In this way,
such kind of disease because body does not use insulin in properly. In addition, healthy diet can
help to remove such kind of problem and blood glaucous level. Exercising assistance keep heart
healthy and strong. Plus, exercise assistance keeps bang-up cholesterol and that activity avoid
arteriosclerosis.
According to Ryan and et.al., (2013) traditional benefit are better bodily function of
weight, increase the level of good HDL and stronger bones. In this context, exercise is help to
improve mood, better sleep and stress pull off. It is astute to check blood sugar with glucose
metre before and subsequently exercise to kind sure are in a safe scope. In addition, some aerobic
exercise is walking, tennis, basketball, swimming and biking remove and control the level of
types 2 diabetes. However, in contrast to this, as per the view of Arora and et.al., (2012) join
9

group classes at the gym and control the level of blood glaucous. Remember of stay fit and
drinking water always have a treatment for low blood. To be focus on someone else exerciser
does make it more fun and motivated.
In the opinion of Haas and et.al., (2012) exercise is considered to be an important activity
in the treatment plan of diabetes type 2. The goal of treatment plan of individual suffering from
type 2 diabetes is to ensure optimal level of Blood glucose, Lipid, blood pressure level. It helps
in preventing the body from chronic complications of diabetes. Various people tend to opt for
effective meal plan to control their blood glucose level and blood pressure. However, others opt
for daily exercising, indulging in physical activity, losing excessive weight of the body
implementation of self-care behaviour, taking oral medication for diabetes which can be in the
form of metformin and supplemental insulin as well. Diet and physical exercise is the common
treatment plan for managing blood glucose level. Weight loss management and maintain the
same control blood pressure abnormalities. However, in contrast to this, as per the views of
Healy and et.al., (2013) maintaining blood glucose level at rest and at the time of exercise have
high dependence on coordination and integration of sympathetic nervous and endocrine systems.
Contracting muscles tend to uptake of Blood glucose. It helps in mobilization of alternative fuels
present in the form of free fatty acids. The research has been able to conclude that exercise play a
major role in prevention and control of insulin resistance in the body. Both aerobics and other
type of physical exercise helps in improvement of insulin action. Diabetes related health
complications are also reduced through the same. It has been assessed that it is also able to
manage Blood glucose levels, Cardiovascular risk and mortality, lipids, etc. It is important that
exercise is conducted on regular basis for various benefits.
According to Lawton and et.al., (2005) the researcher suggested regarding type 2 diabetes
being 4 times more common in British South Asian regions due to low level of physical exercise.
The study was conducted among 23 Pakistani and 9 Indians patients and their perception
regarding undertaking physical activities as a part of their diabetes care. Although the
respondents are aware of the importance of conducting physical exercise as a diabetes patient.
However, some of them suggested the reason of lack of time that has led them to indulge quite
less in physical exercise. It has led them to indulge in more social activities rather than exercise.
They have not been understanding its impact on their future health. Hence, the researcher has
suggested that it requires adequate amount of campaigning that can used by them to make the
10

patients aware regarding importance of diabetes. A realistic and cultural sensitive approach that
can help in making them aware regarding its importance.
As per findings made by Emadian, England and Thompson, (2017) it is identified that
people from South Asia are most likely to develop 2 diabetes mellitus (T2DM) living at UK
when compared with the white British counterparts. Main reason this type of condition is
occurred due to the eating behaviour. To carry out the research, there are about 63 samples
selected and thee samples were South Asian men aged between 18 to 64 with body mass index of
over 23.0 kg/m2 and individuals who were not previously diagnosed with T2DM. The findings
show that about 54% were having healthy diet. However, the date of consumption made for oily
fish was low. Further, the body was positively associated with high added sugar with 69.8% of
men were having unhealthy intake of sugar sweetened beverages. The study shows that people
from other counties visit to other for work or any other reason, then the diet that is taken by them
is not proper. Due to such conditions, there are problems faced for health. further, it can also be
stated that there are many dietary improvement and factors that have negative affect on eating
behaviour are similar to observation that are made in general UK population. There are many
changes that have taken place in relation with the type of food that is being consumed. The rate
of as per the findings show that all the people from South Asia socially men are highly
influenced with the changes consumption that are made by them. Among the total samples that
were taken into consideration, there are many aspects in which the consumption of high sugar
related products are consumed highly.
From the findings there were made by Medagama and Galgomuwa, (2018), it can be
stated that South Asian people are highly prevalent of diabetes, low level of physical activity and
increased cardiovascular risk. There are many similar researches that are carried on similar topic
and it is identified that people who belong to this areas have low level of physical activity living
with endogenous environment. In this research about 40 of the respondents were chosen with
long standing type 2 diabetes. Majority of the respondents did not had any type of understanding
for the total time or duration for which the physical activities should be done. There are many
different type of factors that are identified through this research that limits the physical activities
and they are as follows:
11

Lifestyle: In accordance with the time of lifestyle that is carried out by individuals do not
have time to consume healthy diet. With this respect, there are individuals who fail to have their
food on time. There are negative impacts over health when time for consumption of food is not
fixed.
Time management: It is required to time so that requirement of body can be satisfied.
From the findings, it is identified that people do sleep at same time daily. It is important for the
body to get proper rest. Apart from this, there are requirement of vitamins, proteins, etc. that are
needed and when a person lacks these, then they are not able to find time for themselves.
Social factors like prioritizing household activities: When talking about the South Asian
women, there are many household activities that are required to be performed by them
(McDowell and Grant, 2016). When these are done, then they are not able to get time for
physical activities. When talking about, men, they are generally busy with their office work and
thus after their work, they do not get time for doing any type of physical activities.
From research carried out by Lawton, Ahmad and Hallowell, (2006), it is identified that
Type 2 diabetes is 4 times more common among British South Asians when it is compared with
general population. Apart from this, there are risks of diabetic complications. This is a type of
situation that is linked with lower level of physical activity amongst South Asians. The type of
perception that is carried out by patients with Type 2 diabetes towards experience towards
physical activity so that they are able to reduce the negative impact of disease they are facing.
Majority of participants are not able to find time for themselves so that physical activities can be
performed. However, people do understand the importance of exercise but fail to get benefited
with it due to lack of proper management of time. More specifically, people are busy with social
expectations and cultural norms. Other than this there are other health problems that were
reported by participants due to which they fail to perform physical activities. In order to
overcome such type of issues, it is important that promotion should be done so that people
develop interest and willingness towards the roles that are performed by them. From all the
researches that are carried out, main problem that are faced by people is related with
management of time. More than half of the people know about the benefits that they will get
through physical activity but due to lack of proper planning and other social factors, individuals
fail to manage their time.
12