Background: With diabetes rates escalating globally, there is the need for a better integration
of all aspects of diabetes care for improved population outcomes. An understanding, not only
of regional but global literature on physical activity barriers and its facilitators is important if
healthcare providers and policy makers are to create programs tailored to their populations.
Objectives: Herein, we report the results of a narrative review of the global barriers and facilitators
of physical activity for patients with diabetes mellitus.
Methodology: An in-depth literature search was conducted to identify English-language studies that
examined physical activity barriers and associated facilitators among patients with diabetes mellitus.
Major electronic literature databases that were searched included Google Scholar, PubMed, Hub-Med, and Highwire.
Results: Studies were available from Africa, Asia, Australia, Europe, and, predominantly North
America. A total of 34 predominantly internal barriers emerged globally. The most commonly reported
were time constrains, fear of provoking additional disorders, exercise venue and weather related
barriers. Facilitators of physical activity were reported for most of the internal barriers (e.g.
time constraints, lack of knowledge etc) while the external barriers (e.g. weather, environmental pollution
etc) received only a minimal attention.
Conclusions: Globally, patients with diabetes are confronted with an enormous number of physical
activity barriers. Unlike the robust solutions proffered for the internal barriers, the literature is largely
silent about solutions to the external barriers, which though fewer, may be highly influential. Additional
data is needed to better understand physical activity behaviors in populations outside of North