Why this matters
Exercise is one of the most powerful things a person with Type 1 diabetes can do for their health - and one of the least often discussed in clinic.
53%
of adults with Type 1 fear hypoglycaemia during exercise.
University of Exeter with Breakthrough T1D and EXTOD
150 min
weekly moderate activity is the target - most do not reach it.
UK Chief Medical Officers' guidelines
24 to 36 h
is how long post-exercise hypoglycaemia risk persists.
EXTOD Handbook, ch. 8
The barrier
Fear of hypoglycaemia, not lack of motivation
People with diabetes routinely tell us they want to be active but do not know what will happen to their glucose. Unpredictability, not apathy, is what keeps them sedentary. That makes this an education problem - which means it is solvable in a consultation.
“I always go low when I run.”
Insulin on board and start glucose, not the exercise itself. Addressable with a pre-session plan.
“I went high, so I stopped bothering.”
Catecholamine-driven rise misread as failure. Normalising this is often enough.
“I don't know where to start.”
No framework. ICE - insulin, carbohydrate, exercise - gives them three questions instead of a rulebook.
“My team never mentioned exercise.”
The most common one. A single conversation changes the trajectory.
Who we are
About EXTOD
EXTOD - EXercise for Type 1 Diabetes - is a research-led programme funded by the NIHR Research for Patient Benefit programme. It is a collaboration between Somerset NHS Foundation Trust, the Universities of Exeter, Birmingham and Leicester, and University Hospitals Birmingham and Leicester.
Everything on this site - the guides, the tools, the training - comes out of that work. Each tool cites the research it is built on.
Next
Take it into clinic
The Rule of ICE (insulin, carbohydrate, exercise), a troubleshooting framework and the tools the people you see are already using.