Purpose: This study explored community dwelling individuals with diabetes mellitus experiences and or challenges with regards to the inclusion of physical activity in their management of their disease.

Relevance: The prevalence of diabetes mellitus in South Africa has increased drastically over the last two decades and ranks third in terms of mortality and morbidity for the general population. Urbanization plays an important role in the emergence and high prevalence rates of type 2 diabetes mellitus and is associated with more availability of food, eating of unhealthy fast foods and a less physical active lifestyle. Physical activity has gained much attention for its role in preventing premature disease and disability and it became widely recognized as a key health behaviour, associated with reduced morbidity and mortality of chronic diseases of lifestyle such as hypertension and type 2 diabetes, diabetic complications, improved glucose tolerance and insulin sensitivity. Various studies have been done in sub-Saharan Africa to investigate participation in physical activity and have shown the urban-rural discrepancies but most of these made use of self-reported information with questionnaires that are not validated for the population of the present study. Although quantitative studies, in the absence of others, give some indication of physical activity participation and patterns among individuals it provide little information regarding the individual, social and cultural factors underlying physical activity participation or the lack thereof.

Participants and Methods: Permission and ethical clearance for the study was obtained from the University of the Western Cape, South Africa (11/4/2) and the Western Cape Department of Health (RP59/2011). Thirty six clients were conveniently approached to participate in the study. Focus group discussions were conducted with 26 consenting individuals with diabetes mellitus from 6 randomly selected community health care centers in the Cape Metropolitan Region, Western Cape.

Analysis: Data from the audiotape recordings was transcribed verbatim by an independent person with experience in transcription to produce a manuscript. A comparison was made between notes taken during the discussions to verify accuracy. Content analysis was done by extracting meaningful ideas of the participants’ opinions (coding into themes). Thereafter the transcripts were read through several times by the authors to look for emerging themes. Grouping of the themes into broader categories were done in order to fit small categories together. After the derivation of themes, an independent researcher read through the transcripts and generated themes that were then compared to the themes of the researcher.

Results: The discussions yielded five (5) main themes: safety/fear; lack of time/conflicting responsibilities; co-morbidities; lack of motivation/enjoyment and involvement of others. Conclusion and Implications: Individuals with diabetes mellitus in urban communities experience several environmental and social facilitators and/or barriers to incorporating physical activity in their daily routines. Therefore when designing or promoting physical activity interventions for individuals with diabetes mellitus in urban communities it is important to create safe and supportive environments to enhance participation.

Key words: physical activity; diabetes mellitus; environmental/social factors