The NDSS is administered by Diabetes Australia

Physical activity

If you haven’t already, it’s time to get active as part of managing your diabetes (plus, it’s a cool way to enjoy your free time!).

Why get moving

Creating good habits is key to living your best life with diabetes.

Make room for regular physical activities, whether it’s hitting the gym, walking your dog, or showing off your skills on the field with friends.

Taking charge of your health

When you’re young, your parents are usually in charge of your healthcare, scheduling appointments for you and keeping your diabetes supplies up to date. But as you grow up, you become responsible for your own healthcare. This means you can choose the care you need and make your own decisions about how to manage your diabetes.

It’s important to stay connected to diabetes health professionals during this transition time. Even though getting used to a new system and the added responsibilities may feel hard in the beginning. The aim is to stay as well and healthy as possible, now and in the future.

Ready for adulthood

Becoming a young adult is an exciting time. There’s a lot to balance, including your study, job, social life, sport and any other hobbies or interests you might have.

It can be tough to juggle everything and it’s easy to let your diabetes management and health checks slip off the radar. But juggling the responsibilities of life and your diabetes is part of growing up. This is why it’s really important to stay connected to your diabetes health professionals during this time.

Why? Well, type 1 diabetes is a complex condition that can affect your body and your mind. Knowing how to look after yourself will decrease the risk of getting diabetes-related complications now and in the future. Plus, your diabetes health professionals can support you as you get used to managing your diabetes as a grown-up.

What are ketones ?

When the body doesn’t have enough insulin to use glucose for energy, it uses fat instead. When fat is used for energy, the body makes a chemical called ketones.

Small levels of ketones in your pee or less than 0.6 mmol/L in your blood aren’t harmful. But be careful because too many ketones can be bad for you. Too many ketones can make the blood acidic. This can be dangerous because it can lead to DKA.

Staying active helps you:

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Feel great and boost your confidence.

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Chase away stress.
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Make new friends.

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Sleep like a champ.

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Keep a healthy weight.



1. Frequency

Try to be active everyday. Remember, this might be something you build up to achieving.


2. Intensity

Use the talk test. This means you exercise hard enough that you can still talk but you can’t sing comfortably. This intensity level will help manage your blood glucose and keep you fit.

3. Time

Being active for 60 minutes every day.


4. Type

It comes down to what you enjoy doing. Anything is better than nothing. Think about bike riding, team sports, surfing, yoga, pilates, dancing, or strengthening exercises.

The ideal combination is exercise that increases your heart rate (cardio-based exercise) and works your muscles (strength-based exercise).

This will help your insulin work better and create more muscles which can store and take away the glucose from your bloodstream.

Where to inject

Different sites may cause the insulin to work faster or slower depending on the type of insulin you use. This is the same if you’re using a syringe, insulin pen and pen needles, or an insulin pump.

Insulin is injected into the fatty (subcutaneous) layer under the skin. The more common sites used are the tummy (abdomen) and upper buttocks.

If using arms or thighs, it’s important to avoid injecting into the muscle. The insulin will be absorbed much faster in a muscle, increasing the risk of a hypo.

Talk to your diabetes health professional about which injection sites you can use.



~15 minutes


Back of upper arm
Back of upper arm

Back of upper arm

~20 minutes




~30 minutes




~30 minutes


Rotate your injection site

It’s important to “rotate” injections within your chosen injection site. Lipohypertrophy is a firm, fatty lump that appears on the skin. It happens when injecting in roughly the same spot over a long period of time. This changes the appearance of the skin and can also affect how quickly insulin is absorbed.

If you find a fatty lump, avoid using the area until the lump is gone. Talk to your diabetes health professionals if you’re worried about your injection sites.

An easy way to rotate insulin injection sites is to imagine a flower shape on your stomach, like in this diagram. Use one petal of the flower each day of the week to inject insulin, with each injection being in a slightly different spot in that petal.

  • Always use a new spot for each injection or when inserting a cannula.
  • Use a pattern to space out the sites you use such as on this diagram.
  • Always inject at least 1cm away from your belly button and 1cm away from your ribs.
  • Avoid injecting two different insulins in the same spot.
  • Check your injection sites regular by running your finger over the site, feeling for any changes.
Sitting less is important too!

Sitting less is important too!

Try to limit your screen time to 2 hours per day outside of any educational screen time on most days. Are there times of the day you could switch some of your sitting time for standing or being active, especially in your spare time?

How can I be more active?

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Schedule your exercise like an appointment.
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Exercise with a friend, family member, or group.
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Set an exercise goal and track your progress. An app can help you set goals, and track and share your progress.
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Use an activity tracker to record your steps.
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Stand and move during screen breaks.
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Check out scavenger hunt apps for some fun new ideas.

Tech time out

It’s easy to love your screens. Did you know that managing your screen time and moving more can actually be a game-changer for your health, happiness, and success?

Let’s dive into a super fun plan to help you get the most out of your screen time, manage your diabetes and feel more energised and active!

Step 1 Understand your screen time

Step 1: Understand your screen time

It’s important to know how much time you’re actually spending on screens each day. Use a screen time tracker app or your device’s built-in screen time monitor to keep track of your daily usage. You might be surprised at how quickly it adds up!

Step 2 Set your screen time goals

Step 2: Set your screen time goals

Now that you have a better idea of your screen time habits, it’s time to set some goals. Decide on a realistic limit for your daily screen time and document it in your online journal. Remember, limit your screen time to 2 hours per day, outside of screen-based activities for educational needs. The goal is to find a balance between screen time and other activities, so don’t be too hard on yourself.
Step 3 Create a schedule

Step 3: Create a schedule

With your goals in mind, create a daily schedule that includes specific times for screen usage and physical activities. Break your screen time into smaller chunks throughout the day, and make sure to schedule regular breaks for movement and exercise.
Step 4 Find fun alternatives to screen time

Step 4: Find fun alternatives to screen time

Let’s make this fun by finding exciting activities to replace some of your screen time.

  • Play a sport.
  • Go for a walk or run.
  • Learn a new dance.
  • Try out yoga or meditation.
  • Join a club or group activity.

The possibilities are endless, so get creative and find what you love!

Step 5 Make It social

Step 5: Make it social

Instead of spending hours scrolling through social media or playing video games alone, invite friends and family to join you in your new activities. You can also join local clubs or teams to connect with others who share your interests.
Step 6 Track your progress and celebrate your wins

Step 6: Track your progress and celebrate your wins

Keep track of your screen time and physical activity each day. You can use an app, notebook or online journal to log your progress. Don’t forget to celebrate your achievements, no matter how small they may seem. Every step counts!
Remember, this is a journey, and it’s okay if you need to change your goals or plan along the way. Life happens, and it’s important to be flexible and adapt to new situations. Just keep trying to find that balance between screen time and activity. You’ll feel healthier and happier!

Make a game plan for competitive sports

Playing competitive sports with type 1 diabetes can be challenging, but with the right tips, you can have fun and achieve in your favourite activities. 

Keep in mind that everyone’s body responds differently to exercise, so you will need to work with your diabetes team to make a plan and adjust your activity, carbs, and insulin as needed.

Team up with your diabetes squad

When playing sports, you’re part of a team, and handling diabetes during sports means another important team: your diabetes health professionals. They’ll guide and help you manage diabetes for your health and sports performance. By working out how your body responds to different activities and using their advice, you’ll become a pro at tweaking activity, carbs, and insulin to match your activity levels.

Pack your essentials

When packing your sports bag, don’t forget your diabetes kit.

Your diabetes kit should have:

  • glucagon
  • insulin
  • a blood glucose and ketone meter, and lancet device (finger pricker)
  • blood glucose and ketone monitoring strips
  • fast-acting carbs (such as jelly beans, glucose tablets or gels)
  • longer-acting carbs (such as a muesli bar or sandwich)
  • water.

Talk to the coach

Make sure the coach knows about your diabetes, what to look out for, and how to deal with any problems.

Give your coach written instructions about signs of a hypo and how to treat it, where your diabetes kit is, and when and how to give glucagon if needed. Make sure they know when to call 000 and how to reach your parents or carer in an emergency.

Set blood glucose goals

Your blood glucose targets before and during exercise should be based on your needs. Your diabetes health professionals can help you set goals depending on the type and length of exercise and your situation.

Usually a blood glucose level of between 7-10 mmol/ is considered a sweet spot for exercise.

Check your blood glucose before, during, and after exercise. This helps you and your diabetes health professionals understand how your body reacts to different types of physical activity and sport. Your diabetes health professionals can help you fine-tune your insulin, activity and carb intake for top performance.

Check out the decision-making tree to help guide you on what to do.

Be prepared for low blood glucose

If your blood glucose level is under
4 mmol/L, this is a hypo. Treat it and stop exercising until your blood glucose is in the target range.

If your blood glucose level before exercise are between 4 and 7 mmol/L, you may need some extra carbs before, during or after exercise.

Delayed onset hypos can happen up to 24 hours after exercise. This is because your muscles keep taking up glucose while they recover. Check your blood glucose before bed and overnight, especially if you’ve exercised a lot in the afternoon. Everyone is different and reactions to exercise vary from person to person. Blood glucose level can change depending on the type of exercise, your fitness and how you manage your diabetes. Ask your diabetes health professionals for advice about how you can reduce your risk of hypos when you exercise.

Watch out for high blood glucose

Watch out for high blood glucose

Check for ketones if your blood glucose level is higher than 15 mmol/L before or during exercise.

If you have blood ketones between >0.6-1.5 mmol/L you may need to stop or delay exercise and have a correction dose of insulin to help clear the ketones. You will have to wait 15-60 minutes to reassess if your blood glucose and ketone levels have normalised before starting exercise.

If your blood ketones are higher than 1.5 mmol/L, you must not exercise.

Exercising when your blood glucose levels are high and you have ketones can be dangerous. This is because your muscles don’t have enough insulin to use glucose for energy. You could be at risk of developing DKA (diabetic ketoacidosis). Ask your diabetes health professionals how you should best manage exercise if your blood glucose is outside your target range or you have ketones.

Remember, with the right planning, support, and determination, you can excel in any sports while managing your type 1 diabetes.
Stay active, stay healthy, and aim high!

Packing your sports bag

As well as your sports gear, don’t forget your diabetes kit, which should include:

These help raise your blood glucose level quickly. Pack 2 or 3 of these in your kit:

  • jellybeans (a small bag).
  • glucose tablets or gels (pre-packaged portions of 15g)
  • non-diet soft drinks or fruit juice (small bottle or box)
  • glucose tablets.

After treating a hypo, you might need a snack to keep your blood glucose steady. Here are some ideas:

  • a sandwich
  • 1 piece of fruit (like an apple or banana)
  • 1 muesli bar
  • 1 small tub of yogurt (100g) or 1 Cup of milk (200ml)
  • 5 water crackers.

"I listened to what people had to say, but ultimately, I had to make up my own mind about what I was capable of. I decided I was going to do everything I could to prove that I could still compete as an athlete, and that diabetes would not defeat me."

Gary Hall Jr.
American swimming star and 10-time Olympic medalist

Good habits for staying fit and healthy

Too much screen time is not healthy.

Try to do 2 hours or less per day of screen time. Break up long periods of sitting as often as possible.

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Sleep is super important!

Try to go to bed and wake up at the same time each day (even on weekends). If you are aged under 13 you’ll need 9-11 hours and If you’re aged 14-17 you need 8-10 hours per night.

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Moving more, sitting less and sleeping well will help you feel healthy and happy.
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Everyone feels stressed sometimes.

But did you know stress can impact diabetes? Stress releases hormones that increase blood glucose levels. Exercise is a two-for-one deal. It helps us feel less stressed, and reduces blood glucose levels at the same time!

Managing exercise and glucose levels

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2022 The Authors. Pediatric Diabetes published by John Wiley & Sons Ltd

During high intensity (anaerobic): short duration

Blood glucose levels can rise for a short time (approx. 1 to 2 hours). This type of activity releases glucose from the liver. At the same time your muscles stop taking up glucose and blood glucose levels rise.
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During moderate intensity (aerobic): long duration (more than 30 minutes)

Blood glucose levels usually decrease. Aerobic exercise uses large groups of muscles over a longer period of time. The working muscles use up stored glucose in the muscles. Then they start to take up more glucose in from the bloodstream.

Think of your muscles like a sponge, soaking up and using the glucose in your bloodstream every time you work your muscles.

Attention: You may need extra carbs depending on your blood glucose levels and the amount of insulin in your body (on board).

During mixed intensity exercise (more than 60 mins)

Blood glucose levels usually remain steady. Activities like team sports tend to stop and start, combining high and low intensity activity. These types of sports often result in stable blood glucose levels compared to continuous aerobic activity such as cycling, going for a run, swimming laps.

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A hypo can feel different for everyone. Over time, you’ll learn how your body reacts to a hypo. It’s good to know the early symptoms so you can treat it quickly. Let others know about your symptoms so they can help if needed.

Tips for managing exercise and blood glucose levels

Avoid exercising during the peak of insulin action. You could do this by planning exercise sessions to be:

  • approximately 3-4 hours after a meal.
  • before breakfast if blood glucose are in a safe range levels are in safe range.
  • just before your next meal, when there is smaller amounts of bolus insulin in the body.

This does require some advanced planning and may not work out if you are training for a sport or can’t change your exercise times. If that is the case you could look at:

  • adjusting your pre-exercise mealtime and after exercise mealtime insulin doses
  • matching your carb intake to the exercise to energy cost if insulin has not been adjusted.

There is no “one-size-fits-all” approach to managing diabetes and exercise. There are many things that can affect blood glucose levels when it comes to exercise, for example:

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Exercise type and intensity

moderate intensity, such as swimming or running

high intensity, such as sprinting or lifting weights

mixed intensity, such as team sports

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Exercise duration
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The time of day of exercise

Insulin use before exercise including:

insulin type and amount

timing of insulin

amount of insulin already in your body, or on board

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Timing and type of carbs for meals and snacks

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Fluid type and amount

An exercise plan

An exercise plan

It’s important to work with your diabetes health professionals to develop an exercise plan. An exercise plan should include guidance about how and when to adjust insulin and tips about carbs in meals and snacks. This is important for staying safe, but it will also help getting the most out of exercise.

Don’t forget to review the plan regularly to adjust for changing needs such as growth and a new insulin regimen.