The techniques described herein relate to computerized methods and apparatus for insulin dosing guidance and decision support for diabetic patients. The techniques can recommend one or more exercises to a diabetic patient. The techniques can recommend adjustments to a diabetes treatment plan based on a diabetic patients planned exercise. The techniques can provide recommendations to a diabetic patient while exercising. The techniques can customize a computerized exercise planning tool that is used to develop an exercise plan for a diabetic patient based on user preference data of the diabetic patient, data indicative of a treatment aspect of the diabetic patient, data indicative of a physiological aspect of the patient, or some combination thereof.