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Lookup NU author(s): Dr Rachel StockerORCiD, Dr Siân RussellORCiD, Dr Guy TaylorORCiD, Professor Miles WithamORCiD, Professor James ShawORCiD, Dr Daniel WestORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2026 The Author(s). Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK. Aims: Maintaining physical function, and thus independence, is essential for people ageing with diabetes. For older adults with long-term insulin-treated diabetes, managing frailty, preserving body mass index (BMI) and muscle strength and mitigating hypoglycaemia risk are key challenges. Resistance training (RT) offers benefits, including reduced hypoglycaemia risk, increased bone density and improved muscle strength, yet its uptake remains low. This study explores behavioural influences and barriers to RT participation among older adults living with insulin-treated diabetes and prefrailty. Methods: A qualitative approach was employed, involving semi-structured interviews with individuals living with prefrailty aged 60 years or older with insulin-treated diabetes (type 1 diabetes (n = 12); type 2 diabetes with BMI < =30 kg/m2 (n = 4)). Frailty was assessed using the Rockwood Clinical Frailty Scale (3–4). Data were analysed using framework analysis and aligned to the COM-B model of behaviour change to deductively identify barriers and facilitators. Results: Barriers to RT were identified across psychological capability, physical capability and social opportunity COM-B domains. Key barriers included fears of fatigue, hypoglycaemia and injury, diabetes-related complications and difficulties using RT equipment. Outdated advice about exercise safety and lack of awareness of RT's benefits further hindered participation. Facilitators included tailored education on diabetes-specific RT benefits, a supportive, flexible training environment and the presence of an exercise-competent partner. Conclusions: This study highlights perceptual and practical barriers that discourage older adults with diabetes and prefrailty from engaging in resistance exercise. Addressing these barriers through educational initiatives and creating adaptable exercise programmes could enhance exercise participation rates in this population.
Author(s): Stocker R, Russell S, Taylor GS, Witham MD, Shaw JAM, West DJ
Publication type: Article
Publication status: Published
Journal: Diabetic Medicine
Year: 2026
Volume: 43
Issue: 7
Print publication date: 01/07/2026
Online publication date: 16/05/2026
Acceptance date: 07/05/2026
Date deposited: 01/06/2026
ISSN (print): 0742-3071
ISSN (electronic): 1464-5491
Publisher: John Wiley and Sons Inc.
URL: https://doi.org/10.1111/dme.70367
DOI: 10.1111/dme.70367
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