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EXercise to Prevent frailty and Loss Of independence in insulin treated older people with DiabetEs (EXPLODE): protocol for a feasibility randomised controlled trial (RCT)

Lookup NU author(s): Dr Rachel Stocker, Professor James Shaw, Dr Guy Taylor, Professor Miles WithamORCiD, Dr Daniel WestORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Introduction There are 3.9 million people in the UK with diabetes. Sarcopenia, increased frailty and loss of independence are often unappreciated complications of diabetes. Resistance exercise shows promise in reducing these complications in older adult diabetes patients. The aim of this feasibility randomised controlled trial is to (1) characterise the physical function, cardiovascular health and the health and well-being of older adults with mild frailty with/without diabetes treated with insulin, (2) to understand the feasibility and acceptability of a 4-week resistance exercise training programme in improving these parameters for those with diabetes and (3) to test the feasibility of recruiting and randomising the diabetic participant group to a trial of resistance training. Methods and analysis Thirty adults aged ≥60 years with insulin-treated diabetes mellitus (type 1 or 2), and 30 without, all with mild frailty (3–4 on the Rockwood Frailty Scale) will be recruited. All will complete blood, cardiovascular and physical function testing. Only the diabetic group will then proceed into the trial itself. They will be randomised 1:1 to a 4-week semisupervised resistance training programme, designed to increase muscle mass and strength, or to usual care, defined as their regular physical activity, for 4 weeks. This group will then repeat testing. Primary outcomes include recruitment rate, attrition rate, intervention fidelity and acceptability, and adherence to the training programme. A subset of participants will be interviewed before and after the training programme to understand experiences of resistance training, impact on health and living with diabetes (where relevant) as they have aged. Analyses will include descriptive statistics and qualitative thematic analysis. Ethics and dissemination The North East-Newcastle and North Tyneside 2 Research Ethics Committee (20/NE/0178) approved the study. Outputs will include feasibility data to support funding applications for a future definitive trial, conference and patient and public involvement presentations, and peer-reviewed publications. Trial registration number ISRCTN13193281.

Publication metadata

Author(s): Stocker R, Shaw JA, Taylor GS, Witham MD, West DJ

Publication type: Article

Publication status: Published

Journal: BMJ Open

Year: 2021

Volume: 11

Online publication date: 08/12/2021

Acceptance date: 24/10/2021

Date deposited: 27/01/2022

ISSN (electronic): 2044-6055

Publisher: BMJ Group


DOI: 10.1136/bmjopen-2021-048932


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Funder referenceFunder name
Wellcome Trust