Those who have type 1 diabetes mellitus should include regular sports or recreational activities in their overall healthcare programs. Essential responsibilities of physicians who treat these patients include preparticipation clearance, education about blood glucose self-monitoring, exercise prescription, aggressive dietary and insulin management plans, identification of risk factors and potential complications, and ongoing education. Exercise has risks and benefits that must be understood so that participation yields a safe, enjoyable outcome that meshes with the patient's culture, activity goals, and lifestyle.