Exercise to preserve β-cell function in recent-onset Type 1 diabetes mellitus (EXTOD) - a randomized controlled pilot...

Area of Science:

• Endocrinology
• Metabolic Diseases
• Exercise Physiology

Background:

• Residual beta-cell function at diagnosis of Type 1 diabetes (T1D) is crucial for reducing long-term complications.
• Preserving beta-cell function is a key therapeutic goal in managing T1D.

Purpose of the Study:

• To test the hypothesis that exercise preserves beta-cell function in individuals with newly diagnosed Type 1 diabetes.
• To gather data for designing a definitive clinical trial on exercise interventions in T1D.

Main Methods:

• A 12-month randomized controlled pilot trial involving adults (16-60 years) diagnosed with T1D within 3 months.
• Participants were randomized 1:1 to either usual care (control) or monthly exercise consultations (intervention).
• Primary outcomes included recruitment, adherence, and exercise uptake; secondary outcomes assessed insulin sensitivity and beta-cell function loss.

Main Results:

• 58 participants were recruited (28 control, 30 intervention), with 41 completing the study.
• The intervention group showed increased moderate to vigorous physical activity (MVPA) (243 to 273 min/week), with 61% meeting ≥150 min/week target.
• Exploratory data suggested improved insulin sensitivity and reduced insulin requirements in the intervention group, though beta-cell function loss rates were similar.

Conclusions:

• Recruitment and randomization of newly diagnosed T1D patients to an exercise intervention are feasible.
• The intervention successfully increased and maintained exercise levels for 12 months.
• Future trials require enhanced adherence measures and more precise beta-cell function assessments.