Dealing with the management of either Type 1 or Type 2 diabetes will usually be associated with clear and obvious differences in the approach to sport and adventure.

In people with Type 1 diabetes and especially in the younger age group the dependence upon insulin represents a very real challenge in achieving excellence in competitive sport. There will also be major worries and safety considerations for those attempting expeditions or adventures into unknown and physically demanding areas of the world.

The very same demands may challenge people with Type 2 diabetes. However, in general this group of people tend to be older, often overweight and present with poorer levels of overall fitness. Although not in any way a pre-judgment of any individual with Type 2 diabetes the general focus is often weight loss and regular exercise so that the diabetes can be adequately controlled with these so called lifestyle changes.

It is a useful policy from the outset for physicians to carefully assess the exercise goals and expectations of their patients. Cardiovascular fitness and suitability for exercise can be defined using straightforward investigations. Fitness regimes and personal training schedules can be established for those that require this level of input. Although achieving sustained participation in regular exercise may represent the hardest challenge of all for any patient with diabetes, it is in the design of individualised nutrition/insulin regimes in people with Type 1 diabetes that requires the most detailed understanding.