{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:11:28Z","timestamp":1789186288065,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Engaging in exercise presents unique challenges for those with type 2 diabetes (T2D) and diabetes\u2010related foot ulcer disease (DFUD). This brief report describes the development of practical considerations aiming to support exercise in people with T2D and DFUD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research Design and Methods<\/jats:title>\n                    <jats:p>An expert group of multidisciplinary healthcare professionals (HCPs), researchers and individuals with DFUD reviewed available evidence and developed practical considerations for the assessment, prescription and monitoring of exercise within an ongoing randomised controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Key considerations include screening for contraindications, individualising exercise prescription, determining weight\u2010bearing status and initial supervision by HCPs. Self monitoring of exercise and appropriate foot protection advice and care are also encouraged.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We have developed practical considerations to use when delivering an exercise intervention within a study aiming to improve cardiovascular health for people with T2D and DFUD. For this specific population, these recommendations include prescribing non\u2010weight bearing physical activity (such as arm ergometry or chair\u2010based upper limb exercises) for those with active foot ulcers, educating and encouraging footcare self\u2010management (including how to check feet and when to seek advice), monitoring glucose levels in participants at high risk of hypoglycaemia or hyperglycaemia and reducing the barriers to exercise. Pragmatic measures aimed at maintaining safety include determining the level of pre\u2010assessment and individualised monitoring based on clinical presentation and\/or risk as well as equipment and staff resource. This approach may also be helpful when supporting exercise in a wider population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.70338","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T19:18:48Z","timestamp":1777576728000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Expert considerations to guide the development and delivery of an exercise intervention in people with type 2 diabetes\u2010related foot ulcer disease"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6709-7634","authenticated-orcid":false,"given":"Vicki L.","family":"Johnson","sequence":"first","affiliation":[{"name":"Leicester Diabetes Centre University Hospitals of Leicester NHS Trust  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicky","family":"Hall","sequence":"additional","affiliation":[{"name":"Leicester Diabetes Centre University Hospitals of Leicester NHS Trust  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Berrington","sequence":"additional","affiliation":[{"name":"Leicester Diabetes Centre University Hospitals of Leicester NHS Trust  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Burdon","sequence":"additional","affiliation":[{"name":"Leicester Diabetes Centre University Hospitals of Leicester NHS Trust  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Schreder","sequence":"additional","affiliation":[{"name":"Leicester Diabetes Centre University Hospitals of Leicester NHS Trust  Leicester UK"},{"name":"Diabetes Research Centre, College of Life Sciences University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Diabetes Research Centre, College of Life Sciences University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Brough","sequence":"additional","affiliation":[{"name":"Leicester Diabetes Centre University Hospitals of Leicester NHS Trust  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J.","family":"Highton","sequence":"additional","affiliation":[{"name":"Diabetes Research Centre, College of Life Sciences University of Leicester  Leicester UK"},{"name":"National Institute for Health and Care Research Applied Research Collaboration East Midlands  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Hadjiconstantinou","sequence":"additional","affiliation":[{"name":"Leicester Diabetes Centre University Hospitals of Leicester NHS Trust  Leicester UK"},{"name":"Diabetes Research Centre, College of Life Sciences University of Leicester  Leicester UK"},{"name":"NIHR Biomedical Research Centre University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances L.","family":"Game","sequence":"additional","affiliation":[{"name":"Department of R&amp;D University Hospitals Derby and Burton NHS Foundation Trust  Derby UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa J.","family":"Keogh","sequence":"additional","affiliation":[{"name":"Sheffield Teaching Hospitals NHS Foundation Trust  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solomon","family":"Tesfaye","sequence":"additional","affiliation":[{"name":"Sheffield Teaching Hospitals NHS Foundation Trust  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Valabhji","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction, Faculty of Medicine Chelsea and Westminster Hospital Campus, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4894-9819","authenticated-orcid":false,"given":"John R.","family":"Petrie","sequence":"additional","affiliation":[{"name":"Robertson Centre for Biostatistics\/ Glasgow Clinical Trials Unit, School of Health &amp; Wellbeing, College of Medical, Veterinary and Life Sciences University of Glasgow  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3619-9579","authenticated-orcid":false,"given":"Ketan K.","family":"Dhatariya","sequence":"additional","affiliation":[{"name":"Elsie Bertram Diabetes Centre Norfolk and Norwich University Hospitals NHS Foundation Trust  Norwich UK"},{"name":"Norwich Medical School University of East Anglia  Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Yates","sequence":"additional","affiliation":[{"name":"Leicester Diabetes Centre University Hospitals of Leicester NHS Trust  Leicester UK"},{"name":"Diabetes Research Centre, College of Life Sciences University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie J.","family":"Davies","sequence":"additional","affiliation":[{"name":"Leicester Diabetes Centre University Hospitals of Leicester NHS Trust  Leicester UK"},{"name":"Diabetes Research Centre, College of Life Sciences University of Leicester  Leicester UK"},{"name":"NIHR Biomedical Research Centre University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2343-7099","authenticated-orcid":false,"given":"Kamlesh","family":"Khunti","sequence":"additional","affiliation":[{"name":"Leicester Diabetes Centre University Hospitals of Leicester NHS Trust  Leicester UK"},{"name":"Diabetes Research Centre, College of Life Sciences University of Leicester  Leicester UK"},{"name":"National Institute for Health and Care Research Applied Research Collaboration East Midlands  Leicester UK"},{"name":"NIHR Biomedical Research Centre University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-022-05787-2"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001168"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2008.01.004"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-012-2673-3"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-008-0940-0"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.70028"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-102955"},{"key":"e_1_2_11_9_1","unstructured":"Department for Health and Social Care.UK Chief Medical Officers' physical activity guidelines 2019\u201309\u201007."},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/dsi22-0016"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-2584"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2021.108733"},{"issue":"3","key":"e_1_2_11_13_1","first-page":"92","article-title":"Should patients with active foot ulcers be non\u2010weight bearing or take exercise to improve cardiovascular fitness?","volume":"17","author":"Dhatariya K","year":"2014","journal-title":"Diabetic Foot J"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.13010"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/s24154875"},{"key":"e_1_2_11_16_1","unstructured":"National Institute for Health and Care Excellence.Diabetic foot problems: Prevention and management.2019."},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000002800"},{"issue":"2","key":"e_1_2_11_18_1","first-page":"185","article-title":"Clinical utility of pre\u2010exercise stress testing in people with diabetes","volume":"35","author":"Armstrong MJ","year":"2019","journal-title":"Can J Cardiol"},{"key":"e_1_2_11_19_1","volume-title":"ACSM's Guidelines for Exercise Testing and Prescription","author":"American College of Sports Medicine","year":"2021"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v5.i1.17"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-024-06134-3"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcdd7020015"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.2337\/dsi22-0015"},{"key":"e_1_2_11_24_1","unstructured":"Association of Chartered Physiotherapists in Cardiovascular Rehabilitation.Association of Chartered Physiotherapists in Cardiovascular Rehabilitation standards for physical activity and exercise in the cardiovascular population 2023 4th edition.2023."},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.13016"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2005.07.005"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.4324\/9781003045267-21"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.4.986"},{"issue":"12","key":"e_1_2_11_29_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0003743","article-title":"Effect of exercise based on ACSM recommendations on blood pressure and heart rate in hypertensive patients: a systematic review and meta\u2010analysis of randomized controlled trials","volume":"4","author":"Chen J","year":"2024","journal-title":"PLoS Glob Public Health"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-102446"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.70338","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dme.70338","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.70338","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:00:31Z","timestamp":1789185631000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.70338"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":29,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/dme.70338"],"URL":"https:\/\/doi.org\/10.1111\/dme.70338","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]},"assertion":[{"value":"2026-02-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70338"}}