I am 23 years old, I have had type 1 diabetes for 10 months, and I take premixed insulin. Is it okay to exercise, such as joining a gym?

First of all, I want to commend you for wanting to go to the gym and make exercise a part of your daily routine. Preparing an individual with diabetes for a safe and enjoyable exercise program is as important as the exercise itself. The young individual with diabetes (such as yourself) in good metabolic control can safely engage in most activities. Exercise is beneficial to the health of people with diabetes and is also an excellent way to manage diabetes along with a healthy food plan and medication (in your case insulin).

Benefits of Exercise:

Exercise can take some glucose out of the blood to use for energy during and after exercise which lowers blood glucose levels.
Exercise can also help delay or stop large blood vessel and heart disease (cardiovascular disease).
People with diabetes should exercise to counteract that increased risk for cardiovascular disease, to reach and stay at a healthy weight and just to enjoy themselves.

Before beginning an exercise program, talk to your physician, inform him of your plans. Find a member of your diabetes team who can work with you with regard to the guidelines for safe and enjoyable exercise incorporating food, exercise and insulin into your treatment plan. Then, find a gym that has a trainer who is certified by a reputable organization such as ACSM, AFAA, ACE, IDEA who can be an informed educator and guide you through a proper, safe and fun exercise session. Your exercise program should include a proper warm-up, aerobic workout, strength training session and cool-down.

As I stated above, metabolic control is the key. Here are some general guidelines to help you get started.

Always check your blood glucose before engaging in any physical activity.

Avoid exercise if blood glucose levels are over 250 mg/dl [13.9 mmol/L] and ketones are present
Avoid exercise if blood glucose levels are over 300 mg/dl [16.7 mmol/L], irrespective of whether ketones are present.

Take added carbohydrate if blood glucose levels are less than 100 mg/dl.

If this is your fist time engaging in an activity, check your blood glucose 30 minutes in to the activity. This will help you gauge if extra carbohydrate will be needed and help prevent hypoglycemia.
Remember. different people respond differently to different types of activity.

Monitor blood glucose before and after exercise.

Know when changes in insulin and food intake are made.
Learn the glycemic response to different exercise conditions.

Food intake

Consume added carbohydrate as needed to avoid hypoglycemia.
Always have foods available that are carbohydrate based during and after exercise.

PL