EXTOD Exercise for Type 1 Diabetes

Education Education

EXTOD education programme - face to face

EXTOD education programme - face to face

Thursday 1 July, 2021 12pm
Face to face

Face to face group education

Funded by the NIHR and in collaboration with colleagues from the Leicester diabetes centre we have developed a group structured education programme to support safe exercise in Adults with T1DM: the EXTOD education programme. This is delivered in three separate sessions with each session separated by at least a week to allow patient to have a go at the techniques learned in each session before the next session. See table 1 below for more details of the programme.

Table 1 – details of the Adult EXTOD education programme

As part of this programme there is a training programme for health care professionals (HCPs) to learn how to deliver the programme, a curriculum with teach aids for the programme, a patient workbook, online videos which summaries the topics learnt and a website. Like DAFNE the programme is delivered by a Doctor, Nurse and Dietitian. To learn more about the programme please click here to see our paper.

This programme has been tested in a pilot study of 96 patients with T1DM and shows benefits in wellbeing, treatment satisfaction, reduction in barriers to exercise and improvement in glucose control around exercise. This programme is due to be rolled out in third quarter of 2021 in Somerset and Birmingham in 2021. NHS Wales have also commissioned this programme and rollout across Wales will being in 2022.

How does a team become trained to deliver the EXTOD education programme?

We recommend that 4 members of a team are trained in delivering the programme. To be trained the members of the team must be specialist in Type 1 diabetes, have a good understanding of carbohydrate counting and ideally regular deliver other education programme such as DESMOND or DAFNE or similar courses.

Training is done in three stages.

Stage 1 - increasing knowledge on exercise and type 1 diabetes.

HCPs wanting to deliver the EXTOD education programme will need be trained on how to advice patients with T1DM on controlling their glucose around exercise. In addition, they will need to learn what changes patients with T1DM need to make to their training regimes, insulin dosages and nutritional intake to ensure that they get the most out of the exercise they do and perform at the best level they can do. This training can be provided in four ways:

  1. Attending an Annual EXTOD HCP conference + a one day face to face course.
  2. Attending an Annual EXTOD HCP conference + two half day virtual courses.
  3. Attend a two day face to face course.
  4. Attend a four half day virtual course.

To learn more about our Annual EXTOD HCP conference click here.

To learn more about our face to face and online courses click here.

Stage 2 - Curriculum training.

To learn how to deliver the EXTOD education programme HCPs will have to attend a training program. This can be delivered in two ways:

  1. A two day face to face training course
  2. A four half-day virtual training course.

Stage 3 - Delivery and assessment

The final stage will ensure that the HCPs are delivering the programme in the right way. For this the HCPS will have to:

  1. Observe one face to face EXTOD Education programme being delivered.
  2. Be observed delivering one face to face EXTOD Education programme.

How does revalidation take place once trained?

To ensure fidelity of the programme, HCPs delivering the programme will need to be observed delivering the programme at least once a year. Audit data will also have to be collected to access the effectiveness of the programme. When the programme is updated additional training will be required.

How often will the course be updated?

The programme will be updated every 3 years as the field is advancing very quickly. Additional training will be laid on when changes are made to the programme.

What are the costs of the programme?

The costs of the programme are divided into four parts

  1. Stage 1 knowledge training- this is the training to increase knowledge around exercise and Type 1 diabetes.
  2. Stage 2 curriculum training - this is the training to deliver the programme
  3. Stage 3 delivery and assessment - this is to ensure that the HCPs deliver the programme in the correct way.
  4. Year on year costs - this covers revalidation, audit, programme books and updating of the programme.

If you would like us to cost out how much it will cost for your hospital / region please email R.C.Andrews@exeter.ac.uk

Can the course be translated to other languages or used in countries outside the UK?

We can work with HCPs from other countries to adapt the programme. As well as translation some content may need to be changed to make sure the course is culturally correct and acceptable. There will be an additional cost for this adaption.

If you want further information about this please email R.C.Andrews@exeter.ac.uk.

Is there an online EXTOD education programme?

We are currently working with the Open University to covert this programme to an online group education programme. This online programme will be launched in January 2022. To learn more about this programme click here.