1. Benefits of outdoor activities and sports

• Exercise is beneficial and important for everyone’s health and emotional wellbeing. When someone has Type 1 Diabetes (T1D) it is even more important as it helps to improve the control of their blood glucose. 
• Read more about exercise and the impact on T1D here. 
• Having Type 1 Diabetes does NOT limit their ability to exercise outside and join sports. It can help them to make new friends, find new interests and explore new places. 
• With good preparation and knowing what to be careful of. They can enjoy outdoor sports and activities like everyone else!

2. How to prepare for outdoor activities and sports with T1D 

• Tell their coach or friends that they have T1D and make sure they know what to do in case of a low blood glucose (Hypo)/high blood glucose (Hyper). 
• Encourage your child to share HelloType1 with their coach and friends so that they learn about T1D management.
• Remind your child to test their blood glucose before activity and more regularly throughout activity. 
• Take a snack if they need to. 
• Pack extra snacks and drinks including electrolytes (granola bar, sports drink or coconut)
• Make sure they bring their Hypo Kit and first aid kit. Wear cotton socks and athletic shoes that fit well and are comfortable.
• Long periods of exercise may require extra carbohydrates and/or a reduction in insulin dose. Discuss this with their doctor or nurse.
• Keep insulin at the right temperature. Read more here
• If hot; they should wear sunscreen/hat if needed, wear protective and breathable clothing.
• If cold; they should wear layers of clothing and keep warm.
• Make sure they are aware of Hypo and Hyper symptoms – especially during prolonged exercise.
• Read more here to manage hypoglycaemia and hyperglycaemia. 

3. What to do after outdoor activities and sports with T1D

• After their activity, check to see how it has affected them blood glucose level and adjust insulin if needed. 
• After being physically active, check their feet for sores, blisters, irritation, cuts, or other injuries. 
• Remind them to keep their feet clean after exercise (wash the feet, keep clean and dry, apply some lotion if needed to avoid injury) 
• If their feet are tender; elevate them or soak them in warm water. 
• Call their doctor if an injury doesn’t begin to heal after 2 days.
• Delayed onset hypoglycaemia can occur, dropping their blood glucose in the 6 to 15 hours after exercise.
• If their blood glucose levels continue to fall after exercise, they may need to decrease their insulin doses before and after exercise.  Ask their doctor or nurse for support. 

4. Different factors to consider when exercising

• Type, intensity and duration of exercise (see table below)
•  The amount of insulin left in them body (Time since last insulin injection)
•  Time and composition of last meal

• Pre-exercise blood glucose (in general aim 7 – 10 mmol/L or 126 –180 mg/dL)1 

• Their fitness levels

• Every person with T1D reacts differently to exercise and insulin, so together you can help them understand their body! 
• It is common to have fluctuation of blood glucose during and after exercise. 
• Practice, experiment and record. Help them learn how their body performs when and after doing sport and outdoor activities. 
• Have regular review and discussion with their doctors or nurses. 
• They will learn and be able to stabilise their blood glucose while enjoying the fun and benefits of exercise. 

HelloType1 content is based on published, internationally recognised guidelines and then reviewed by local experts to ensure it fits local context. The translation is based on simplified English language to ensure it conveys the safest and clearest possible message in regional languages. Basic insulin and blood glucose testing access is still an issue in the South-East Asia region and our chief aim is to address this. HelloType1 content is not intended to replace the advice of individual healthcare professionals but as a collaborative tool to help them improve the outcomes of disadvantaged people with Type 1 Diabetes in the region.