Examining the barriers and benefits of exercise in type 1 diabetes mellitus: EXTOD

In people with type 1 diabetes (T1D), the insulin producing beta cells within the pancreas are destroyed by the bodies own immune system. This means that insulin levels fall, and these people need to take insulin treatment (as injections).

At the time the diagnosis of T1D is made, upto a quarter of the beta cells can remain. Even though this is not enough to avoid having to take insulin injections, protecting and preserving them protects the patient from the complications of diabetes in future years. These complications include heart disease, kidney failure and blindness. These are important reasons for preserving beta cell function in patients with new T1D.

There is now some evidence that regular and sustained exercise can protect beta cells in patients with other forms of diabetes. We do not yet know is this is the case in T1D. The aim of this study is to find out if exercise preserves beta cells in T1D.


This is a 2 stage study:

1) we will first examine barriers to exercise in adults newly diagnosed with T1D

2) we will then examine whether exercise preserves beta cell function in adults newly diagnosed with T1D. This will be a randomised study where people will be asked to undertake at least the nationally recommended levels of exercise for 1 year, and the amount of beta cells measured at the end. 

The barriers to exercise identified in the first part of this study will be used to facilitate the second part of the study.


This study is a multi-centre study run through 20 hospitals around England.

The following hospitals are involved in the EXTOD study:University Hospital Birmingham

  • Musgrove Park Hospital, Taunton
  • Bristol Royal Infirmary, Bristo
  • Southmead Hospital, Bristol
  • Gloucester Royal Hospital, Gloucester
  • Yeovil District Hospital, Yeovil
  • Queen Elizabeth Hospital, Welwyn Garden City
  • Pinderfields Hospital, Wakefield
  • Churchill Hospital, Oxford
  • Alexandra Hospital, Redditch
  • George Eliot Hospital, Nuneaton
  • Russell’s Hall Hospital, Dudley
  • Walsall Manor Hospital, Walsall
  • New Cross Hospital, Wolverhampton
  • Birmingham Heartlands Hospital, Birmingham
  • Good Hope Hospital, Birmingham
  • City Hospital, Birmingham
  • Cheltenham General Hospital, Cheltenham
  • Weston General Hospital, Weston super Mare
  • Frenchay Hospital, Bristol
  • Royal United Hospital, Bath
  • Royal Devon and Exeter Hospital, Exeter

Target population

Adults newly diagnosed with type 1 diabetes (within the past 3 months) who feel they can increase their current exercise levels.