Experiences and Patterns of Physical Activity among Urban Adults with Prediabetes

Abstract

Diabetes poses a pressing public health concern, with prevalence rising globally and in Thailand. Individuals with prediabetes are at elevated risk of progressing to type 2 diabetes within 5–10 years if preventive measures are not undertaken. Insufficient physical activity is a critical modifiable risk factor, particularly in urban contexts where sedentary occupations, constrained environments, and time-limited lifestyles restrict opportunities for movement. This study explored patterns of physical activity among adults with prediabetes living in an urban district of Bangkok. A qualitative case study design was employed, and data were collected between May and September 2024 through semi-structured in-depth interviews and participant observation with 15 participants diagnosed with prediabetes. Data were analyzed using thematic analysis. Four central themes emerged: (1) work demands and the rhythms of urban life as determinants of physical activity; (2) urban infrastructure and commuting challenges as constraints, with participants compensating through small bouts of activity; (3) limited leisure time, diverse meanings attached to physical activity, and social capital as factors influencing adherence; and (4) perceptions of prediabetes and external cues, including clinical results and family history, as triggers for incremental lifestyle changes. The results of this study therefore emphasize that interventions aimed at promoting physical activity among at-risk urban populations should transcend individual-level counseling. They should encompass policy reforms at the urban level to facilitate and ensure the safety of walking and cycling, in conjunction with the development of community-based support mechanisms designed to mitigate time constraints and environmental barriers commonly encountered by this population.