# Diabetologists’ Knowledge and Prescription of Physical Activity in Southeast Europe

## TL;DR

This study assesses diabetologists' knowledge and prescription of physical activity for diabetes management in Southeast Europe, finding gaps in guideline adherence and prescription practices.

## Contribution

A novel instrument was developed and validated to evaluate diabetologists' knowledge and practices regarding physical activity prescriptions in diabetes care.

## Key findings

- Median overall knowledge score was 15 out of 22, indicating at least satisfactory knowledge in 90% of participants.
- Only 26% of diabetologists knew the recommended physical activity levels for diabetes patients.
- Physical activity goals were discussed in 53% of check-ups, but only 25.5% of records documented clear instructions.

## Abstract

Background and Objectives: Physical activity represents a cornerstone in the management of diabetes mellitus; however, the majority of persons with diabetes remain insufficiently active. Current guidelines emphasise the need to educate individuals with diabetes on physical activity at each clinical visit. The aim of the study was to develop an adequate instrument and test diabetologists’ knowledge on physical activity and related guidelines in diabetes, as well as investigate their prescribing habits. Materials and Methods: The instrument was developed with four diabetologists using Delphi and RAND appropriateness methods, then distributed to diabetologist societies in 12 Southeast European countries for anonymous completion by their members. Data were analysed using Mann–Whitney U test and Pearson  x2 test. Results: Out of 302 analysed respondents, 123 (41%) worked at university hospitals, at average four days a week in outpatient departments, mean number of patients was 16 a day; 95 (32%) had a PhD, and 105 (35%) university teaching positions. Median overall knowledge was 15 (Q1–Q3, 13–17) out of 22 maximum points. 26% diabetologists knew recommended level of physical activity for people with diabetes. Physical activity goals were discussed during check-ups in 53.0% of cases; re-education and goal adjustments were provided in 33.4% when health status changed; and clear instructions were documented in 25.5% of medical records. Conclusions: Diabetologists’ overall knowledge of physical activity was found to be at least satisfactory in 90% of participants. Knowledge of the guidelines is insufficient in 75% of participants. The prescribing habits are inadequate in half of the participants.