Diabetics Doing Diabetes Strong with Christel Oerum

[00:00:07] Rob Howe: Welcome to the Diabetics Doing Things podcast. We've been telling the amazing stories of type 1 diabetics all across the world since 2015, and we have over a thousand years of living with T1D on the podcast. The interviews range from incredible feats to everyday victories, and we celebrate them all just the same. Thanks for listening, and if you want to get involved even further, just send me an email at rob at diabeticsdoingthings.com. Hello and welcome back to another episode of Diabetics Doing Things. We are telling the amazing stories of type 1 diabetics from all across the world. And my very special guest today, I'm super excited to finally have her on the podcast. We've been very sort of ships in the night over the years on the Diabetes Online Community. Wow, I'm having trouble speaking this evening. Christel Oerum, welcome to the show, Christel. Thank you. Thank you so much for having me.

[00:01:16] Christel Oerum: I've been looking forward to this.

[00:01:18] Rob Howe: Yeah, I have as well. I'm super excited that we were able to find the time so quickly. Christel, you are obviously the power behind the Diabetes Strong Community. and diabetesstrong.com. I'm really excited to hear about all of that. But more importantly for me, and I think where we can all just sort of find ourselves on equal playing ground and equal footing, diagnosis and kind of where those things, we all sort of find those relatable stories. And I'm really excited for yours because not only do we get to hear about you, but also the story of being diagnosed overseas as well always, I think, resonates with different people. So with that, I'll turn it over to you. Let's get

[00:02:04] Christel Oerum: started. All righty. Yeah, it's interesting. It's actually a sort of side note. I feel like a lot of times when you meet other people living with diabetes, the first thing is like, so how long have you been living with diabetes? How was it diagnosed? So I think that's definitely the introduction thing to talk about. So I was diagnosed in 97. So that's just over 20 years ago. and I was 19 years old at that time. It was, it's, whenever I talk about it, it's always, well, it's kind of dual because I was diagnosed by my primary care physician. So my family doctor, and it was kind of, it was one of those situations where I did not think anything was wrong. Right. I, despite showing all the traditional symptoms of type 1 diabetes, I mean, I slept a lot. I would, it was in December, and I was kind of falling asleep at family events. And my family started to notice and I, I have big family of a lot of nurses and doctors. And they're like, this is weird. You know, this is not normal. I wasn't stick thin. But I was, you know, definitely lean, despite eating a box of ice cream every night. That was awesome. Yeah, I really like sweets. But of course, that's not normal either. But I didn't really think about it you know I drank a ton of water but being deadly tired all the time definitely bothered me I would fall asleep at work which was of course not optimal I worked in a preschool at that point so yeah not optimal anyway I went to my family doctor and he kind of just talked you know about general nutrition again I was 19 I was partying quite a bit so that could be it right so he's like okay you need to take care of yourself but let's just take a blood sugar Messure blood sugar. So he did that in the office and he was like, okay, so you have diabetes. The way I remember it, he basically said that and send me home. I had never heard about diabetes before. Well, I probably heard about it. I didn't know what it was. I didn't know anybody. So that part of it was, I always want to call traumatic. I mean, I was in this, for those who don't know me, I was born and raised in Denmark, Denmark, everybody's on their bicycles all the time. So I got on my bicycle to go home, to drive home. and I just remember that drive home, it's not more than like 10 minutes. I remember thinking, oh my God, I'm going to die. I just been handed a death sentence. Not knowing, just being completely confused. And this is sort of the time before cell phones. So I didn't just, you know, call home or call a friend. I had that 10 minutes driving home thinking, oh my God, I'm going to die. or just not knowing. And I get home. So my mom is a nurse, and she knew a little bit more about diabetes than I do. And first of all, she was kicking herself for not seeing the symptoms. But she also sort of calmed me down. I'm like, you know, this is not death and blah, blah, blah. Anyway, so that was kind of the first part of my diagnosis. The second one was then when I went to something called Steno Diabetes Center. So Steno Diabetes Center is one of the premier diabetes centers in Denmark. um and my mom and i went there and the way i remember it we actually didn't go for a few days which still blows my mind that you'd send home somebody would type 1 and not anyway long story uh they must have felt that i was safe and my mom and i came to the to steno and i was 19 so i was actually you know assigned a pediatric nurse and i remember this because this is this is so important this her name was Lotte. I remember her name i remember what she looks like and she sat me down she's like you know what this is a major i mean it sucks you've been diagnosed with diabetes however this should never don't let this ever stand in your way from doing all the things that you want and that was so powerful and something I've taken with me um back then I had I had I had a in 98 I had a trip planned where I was going to go backpacking around India because that's what I wanted to do and she's like you're going so within a year of my diagnosis I went again time before uh cell phones and all that good stuff so all my of course everything went wrong um and my insulin got ruined and spoiled and everything was well a little chaotic um so she and i were communicating per fax those who don't know what fax is and basically you put a piece of paper in a machine it'll sort of send that you know across the world wow it all worked out it all worked out and that's kind of that's really one of the things that i've taken with me that I had a lot by my side for another year, I think, until I turned 20 and they moved me to the adult, the adult section of the hospital, I guess. But she was always like, you go do, you know,

[00:07:12] Rob Howe: go do what you want. We have the tools. So. Yeah. And I think, I think that's super important. I mean, go and do it. Even if you have to send a fax or even if your insulin gets ruined. I mean, I think all of those things are important because if you don't, you'll never know. And I think I cannot recommend traveling enough to people, not just people who are type 1, but people who aren't. Because I think you get exposed to things that otherwise you just read about or maybe never read about. And I think when you're exposed to them, you get to learn things about yourself that you otherwise wouldn't know. And you can't quantify how important that is or how valuable that is to a person. So I'm really glad to hear you say that. I'm also really glad because right now, I think especially in the diabetes online community, the conversations around DKA and sort of the, you know, unawareness of, yeah, you know, I was tired or I was urinating a lot or I was losing weight. Like those seem like normal things on their own, but when they're all together, you know, they can be catastrophic relatively quickly. So I'm really glad to hear you sort of highlight that that was your experience as well. You know, for you in those moments, what do you remember about those diagnosis? and I think we talked about this before we jumped on the, uh, jumped on the air, the quote unquote air, you know, this is really just like a DVR to radio show. Right. But, um, you know, before we jumped on, we talked about, you know, the importance of the rhetoric and the conversations from, from doctors when you got that relationship and you had that conversation, like, I'm going to go do these things. How important was that to the first few years of you living with type 1?

[00:09:06] Christel Oerum: i think it sets the tone right if you're told up front ah you know what this is gonna this is gonna pull you down this is gonna be this is gonna be a burden this is gonna stand in your way from doing many things you might believe that right um and if you're a person who tend to believe that anyway is this going to be amplified by an authority sitting there in front of you telling it right Right. So, I mean, I lucked out that I was that Lotte was the one who put in front of me. I think, quite honestly, I'm not really the person to to just sit and weep either. So, I mean, that that definitely plays into that story as well. But I think having the support and having somebody who believes that this should not stand in your way is instrumental, really, especially if you're diagnosed pretty young, because it sets the tone for everything, right? Actually, it doesn't matter when you're diagnosed, young or old. I think it still sets the tone.

[00:10:16] Rob Howe: 100%. And I think, you know, in that sort of young or old context, you know, you mentioned you, you know, now in 2018, you know, over 20 years living with type 1. What's going through your mind and what are you thinking when you think back on the last 20 years and you think forward towards the next 20? You know, what do you think about your life with type 1, you know, as it relates to time? and checking those things off the list, young and old, as you kind of go forward? What crosses your mind?

[00:10:51] Christel Oerum: Well, I think a lot of the tools that we have now, I mean, I wear a CGM. The amount of data that I'm getting and just how much I've learned about myself throughout the years makes the way I approach managing my diabetes today is completely different from what I did just five or two years ago for that matter, because my opinion is kind of like, well, I keep learning and I keep adding to my tool, my diabetes toolbox. Um, and the tools are just getting better and better. Um, so it's definitely, it's good and bad actually, because I started with a CGM, I think five years ago and I worked religiously for a year and it became so, it's so it took over my life and it became so time consuming and I would look at it I would overreact I would overcorrect it was a mess and I ended up taking off our whole year because I think all this technology is excellent but it can also be so overwhelming that we end up you know being quote-unquote diabetic 24 7 and yes we are but I don't my personal belief is that we don't, we shouldn't have to think about it every second or analyze or whatever. Something should be able to just like go in the background. Um, so that's when I say good or bad, but I think mainly it is all the information I have now. I have that has, especially when it comes to exercise, because that's what I do, right. Um, just knowing so much about, well, what's going on in the body, knowing my own formula for how my body reacts to different things has made given me a confidence and has made my life easier living with diabetes and that's been that's something that's developed over years and it's hopefully going to continue to develop right um i would also say going back to that india trip back then when i said all my insulin was ruined is i had this long-angle insulin that you had to mix. So it was like there was a little ball in the mixture and you sort of had to mix the insulin crystals, I guess. And apparently that type of insulin doesn't really do well with fluctuations in temperature as well as being shaken. And I went on like a camel trek through Rajasthan or something because I was 19 and that's what I was doing. So all that insulin got ruined, right? So the newer insulin such as more robust and it, in general, I do think it's become easier. But I also think that as we get older, as we live longer and longer with diabetes, it never becomes easy, but it becomes easier. Agreed. And I think, you know, we're going to

[00:13:45] Rob Howe: talk about fitness at length because that's, you know, who you are and kind of where you position yourself now and in this journey in your life. But I do want to focus a little bit on, I think, technology as a double-edged sword, because I agree with you. It's been, you know, awesome recently to get on CGM and to be able to track your life with diabetes a little bit more modern, right? A little bit more rigorously, but also that can have negative consequences, right with too many people looking in or too much control or really living and dying by you know your your everyday number um how do you how do you address those things with yourself and then also with the people you communicate with and in the community and and the conversations that you have how do you address the the need to you know be gentle with yourself but also you know rely on some of that technology and take those different things into account yeah well first of all i don't

[00:14:48] Christel Oerum: share my data with anybody i shared it with my husband for half a day and it managed to stress him out so badly that he was like can we please take it off mainly because he's like well i want to give you the example of saying why why we decided to take it off again i just wanted to share it with him because i wanted to see what it looked like on his phone i actually didn't want him to have the data. I just wanted to see. I was curious. So I shared and then I went for a walk and I didn't reduce my insulin enough for that walk. So I went low. So I texted him in from the park saying, Hey, you know what? I'm going to lower. I'm just going to sit here on the bench and pop a few glucose taps. And then I'm going to go home. He's like, okay, no problem. And you know, the CTM lacks a little bit, right? So it kept alarming him because it takes a little bit of time for blood sugars come up so i kept alarming he's low she's low no she's urgent low and you know the way that the cgm can almost i i call it scream at you so he was sitting at home getting all these aggressive warnings and he in his mind of course knows that i'm okay because i just texted him and he could he ended up calling me he's like are you okay he's like yeah yeah you know I tested and my blood sugar saw on the way up so I'm fine but that was that was a little intense for him poor guy so we kind of took it off again so so that was that was not as good of an experience as it could be the way that I manage is is that I had that one year where I I would almost say didn't use it right and again overreacting chasing highs and lows at any time so what I've learned is that technology is great but technology doesn't necessarily know me there is a 10 minutes delay as well or five or 10 minutes delay on the on the CGM so what I do is I don't if I have an arrow down for example on my on my CGM but I'm still within the range that I'm comfortable being in I don't react because I need to see what happens I need to be in the sense that let's say I'm at 100 I have an arrow down it's like that's fine I could be at 90 with a straight arrow in 10 minutes right right so I I work with a lot of people are attacked with a lot of people who see the arrow down and they start popping glucose taps off I'm like well okay you probably don't need them so that's what I mean about overreacting to the data is that the the data doesn't let's say that you go for a walk and you start dropping your during your walk when you're done with your walk you sit down and hang out on the couch your sugars might level out by themselves right so you don't necessarily need to treat because there's nothing to treat. I don't know if that makes sense. Yeah, I think it does. I think the,

[00:17:54] Rob Howe: you know, it all comes down to whether it's technology or, or just sort of, or exercise, it all comes down to knowing yourself and listening to your, to your body and having that experience. I think experience is kind of what I wanted to focus on because whether it's diabetes or it's exercise or it's CGM or it's, you know, testing your blood sugar or it's, you know, worrying about, you know, whether you feel like you're going low or whether you've overdosed for carbs or whatever the case is, it all comes down to experience. And with that, you know, how do you, you know, especially in the fitness world where there There are so many people who are, you know, snake oil salespeople or, you know, there's the 2018 quick fix culture where everybody wants to look at the destination without taking the journey into account. How do you think I want to talk about base level? So, like, how do you think the base people with with diabetes base level of fitness knowledge compares to a person without diabetes base level of fitness knowledge? Are those both the same? Are we all the same? Do we all have about the relative same level of knowledge? Or do you think people with diabetes have more knowledge than people without?

[00:19:15] Christel Oerum: so yeah i've been thinking about that i actually i think it's about the same to be honest i think there's so much information out there there's so much information available if you google how to lose weight for example or how to get stronger you'll get a tracillion hits and it'll all say hey i have the solution if you just only eat pineapples every day you'll reach your goals or if you only do this, you'll reach your goals. Or if you do a handstand every day, I mean, it's, I think, based on a little bit what you said as well, there's so many quick fixes. And it's, I think it is very tempting for anybody living with diabetes or not to believe in quick fixes. Because we all wrote results yesterday. So I actually think that sort of the general population it's it's probably the same everybody's confused um also because we see we see some authorities once in a while like dr os for that matter going out and saying this is the this is the holy grail this is the way to do things right um and people want to believe and i get it so it's really hard i think you know the way to weed out the snake oils and the supplements, salespeople and all that is to, well, simply realize and accept that there's no quick fix. There are lifestyle changes and there's effort. And just as, you know, if you want to gain strength, well, that's going to take time. It's going to require you to actually put in some, some energy if you want to lean out well same thing it's going to require some some energy to

[00:21:09] Rob Howe: do that and well i think too sucky but that's the way it is yeah and i think people's you know accepting that everybody comes to that realization at different points in their life and i think that's why it's i think i'm such a big advocate of of people playing sports and people putting their children into sports early because you learn so quickly how to fail and what it's like to lose. And, you know, that is just a very big lesson and a very important lesson that if you don't learn early, I think it can form you into a lifestyle of fear-based decisions because you're afraid of, you know, what happens if I don't get this the first time? Or what happens if this doesn't work out for me right away. Yeah. And especially I think with, um, you know, fitness or, um, you know, health or, or exercise based decisions, like that is a lifelong journey. Nobody gets to their, you know, goal figure or goal weight or goal vertical leap overnight. It takes day in and day out and day in and day out effort. Yep. Um, but it's also, it also

[00:22:25] Christel Oerum: So it comes down to, excuse me, what makes people want to make those changes, right? What is the event that makes people want to change or make changes to their lifestyle? And often it is, sometimes it's driven by fear, which is not something I really believe in. It's if you don't do something about your health right now, you're going to have a heart attack. Or the doctor looks at you, if you don't do anything right now about your diabetes management, you'll have like a lot of complications later in life. And it doesn't work. um but some of the other ones are well there's a wedding in two months and all the other bride maids bridesmaids look like runway models or there's something else coming up right um so i think often the things that come up are in very short time so again back to the wedding or the holiday or something else coming up and all of a sudden people are oh my god i need to be in in you know model shape for two months like that's probably not gonna happen but um you know let's set you on the path down health instead but it's it's it's a hard pill to swallow i think i think it is and it can't be for me as well i mean sometimes i wake up because i really want bigger biceps like now why you know oh yeah and i i mean i feel the same way like if i

[00:23:50] Rob Howe: if somebody snaps a picture of me and I'm maybe slouching or don't have the best posture, or I'm just like, ah, is that really what I look like? I better, you know, attack this next time I go in the gym. And I think, you know, with the explosion of fitness in the last, you know, 20 years, and especially on social media in the last five to 10 years, you know, we're beat over the head with this idea of perfection and these, you know, amazing, you know, people with amazing physiques, you know, I think yourself included. I mean, how do you, how do you, how would you tell someone who, you know, with or without type 1, but you know, because this podcast is focused on people with diabetes, how can someone tell if the information that they're getting, you know, curated as it is on social media, how can they tell that if it's good, a good, and based on science, and B, is it safe for them to do with type 1?

[00:24:47] Christel Oerum: Yeah. It's pretty much impossible, to be honest. I mean, Instagram is a picture, and everybody, or most people at least, are using filters, et cetera. And it's not necessarily reality, right? I mean, we try, some of us, you and I, we try to be as real as possible, but still, you know, I can't tell my whole life story on Instagram either. It's hard. So I think, first of all, you need to, well, put your thinking cap on and say, okay, does this sound reasonable? Right. Right. And this is another promise of if you just again, go back to the pineapple, pineapples every day, then insulin sensitivity is going to be amazing. I mean, does that sound reasonable? I mean, to me, it doesn't. But it's what you can do, of course, is you can always go out and research and say, is this founded in science? Right. Most people don't do that. Right. Most people look at the glossy pictures and then they base their decisions on that. So I think for any young or old who looks at social media, you need to accept that social media often is not 100% reality. A lot of people, if they're trying to sell you something, look at what they're trying to sell you. What is their, probably also what is their background and why are they trying to sell you this? because I just, if I find that there are a lot of, like I was just quoting Healthline on, they asked me, okay, what about these raspberry ketones? Can they make, you know, can they make you drop weight and can they make us go into ketosis and blah, blah, blah. I'm like, no, it's a fancy marketing scheme for something. That's actually a flavor. I mean, it's, if it's too good to be true, it is, it usually is.

[00:26:59] Rob Howe: Yeah, I love that. I think that's something that I learned early on from my parents. If it sounds too good to be true, it probably is. If it sounds too easy, it's probably, if it walks like a duck and it quacks like a duck, it's probably a duck, right?

[00:27:16] Christel Oerum: Yeah. But I mean, again, I have people in my Facebook community who post about, well, they're really happy with doing something. Sure. you know, whether or not that is a supplement or whatever. And the way I usually comment on it is saying that's great. Great that it works for you. And if you like the taste of the supplement, fantastic. Just know, for the most part, these supplements do not have any scientific backing, meaning that nobody has been able to replicate the claims that these manufacturers have in a clinical setting. But with that information, as long as it's not something that's going to kill you, knock yourself out. So I think it's just, I think people like me and other people who are within the industry of fitness and who are some sort of authority within certain communities, it's our responsibility to also go out once in a while and say, hey, great if it works for you, but please know there's no significant, no scientific backing for this.

[00:28:28] Rob Howe: Right.

[00:28:29] Christel Oerum: I mean, you can eat all the salmon you want. It's not going to cure your diabetes. It really isn't. But if you like the taste, sure. Actually, don't eat too much because that's not healthy either.

[00:28:39] Rob Howe: Oh, you know, it's funny. So, yeah. I, when I was younger, I guess I was probably 22. My first job at this time, I was an intern there, was at USA Boxing. the national governing body for Olympic boxing in the U.S. And so it was sort of my dream job was to work in the Olympic sports world at the time. And, you know, it was a great experience for me. And at one point we had an event, the Olympic trials for the 2012 Olympic team, which is actually the summer before in 2011. So I believe it was August 2011 in Mobile, Alabama. and our special guest was a Olympic bronze medalist and uh world heavyweight world champion Evander Holyfield and he uh he was there at the at the event and he had to get picked up from the airport and needed someone to go around with him so I of course was like yes I want to volunteer I want to like be his like chauffeur and valet basically for the weekend and so I got to spend a lot of time with him and I asked him you know you know at what point you know what was he doing for some of his training. And one of the things he told me throughout the day was, you know, everything in moderation. He's like, if you drink too much water, you can drown, you know, so you kind of have to take everything with a grain of salt. He's like, so people throw, oh, well, you need to do this and this and this and this. And he's like, well, if you commit too much to one particular thing, you know, and for, you know, diabetes, like insulin is great for us. It controls our blood sugar, but if you take too much, you could die. So, you know, everything in moderation, You got to make sure that you're doing all of your research.

[00:30:18] Christel Oerum: Yep, for sure.

[00:30:20] Rob Howe: And with that, I think a lot of people, you know, in the fitness realm, especially, and I'm glad that you mentioned your Facebook group, because I think social media is a great resource for people to reach out for advice. And especially with diabetes, because typically you get advice from your doctor. And if you're a young person, typically your parents. and I think it's nice to have those middle ground of people who are functional experts, people living with diabetes, and you can ask those questions. And for me, with my background in basketball, I get a lot of questions that are fitness-related, and I'm sure with you, I mean, in Diabetes Strong, you get thousands of questions about type 1 and fitness. What are the most common questions that you get and answer around T1D and fitness?

[00:31:06] Christel Oerum: There's definitely two. There's two that always stand out. One is how do I not go low during cardio? Or how do I manage blood sugars in general during exercise? Because it's complex, especially if you don't know the basics. And the second one is how do I lose weight with diabetes? Those are the two most asked questions. And just, I mean, actually based on that, I have dedicated guides to that on diabetes strong so i have a guide section saying okay this is your guide to doing that because i get those questions all the time and it's it's actually it's two questions that i can answer so it's about and my my goal my goal here in life is to empower people to go out and be happy and healthy living with diabetes because again to quote Lotte, we can do whatever we want to do as long as we have the right information the right tools and we're willing to put in the work it's not you know this everybody who's listening to this probably know this this is not an easy disease to live with or to manage right because we have to be and we don't have full information you really do when people tell me oh diabetes is random like no it's not random we just don't have full information. Sometimes in the sense that we don't know everything that's going on in our bodies, right? We have parts of information. We might know our blood sugars, we might know what we ate, we might know, you know, do we feel okay, or we're stressed out, but generally, we don't have 100% information. But yeah, those two questions are the ones that are raised the most. And it's also especially the one to how to lose weight with diabetes, people don't don't necessarily believe me because my approach to that is the way they use weight with diabetes is the same way if you want to lose fat. It's the same way as if you do not have diabetes. You need to move and you need to eat in a way that allows your body to drop the body fat.

[00:33:17] Rob Howe: And I think, what is it about that question? I mean, I think people are so focused and there's so much, and I won't even go into like the media's perception of, you know, body image and things like that. But what is it about the hard thing about hard things, right? Like losing weight and changing your lifestyle is not an easy thing to do and often is not that much fun. And I think there's a lot of hard work. What is it about people looking for that quick fix and looking at that like, oh, no, I have to move and work out and wake up early and eat foods that I don't necessarily like to eat sometimes? Even though I think – me personally, I would love to eat salmon and lean meat and chicken and vegetables all the time. It's great for me, but for some people, they don't want to do that. What is it about those responses and how do you respond to those when you hear them?

[00:34:13] Christel Oerum: um well at first i want to point out that if i could just if my body allowed it and if it was healthy i would eat carrot cake for every meal and that would be the only thing i would eat yeah i just want to say that that doesn't doesn't really fit with my goals or sort of my my my goals for my overall health um but it's it depends you know if it's somebody actually there was a woman who asked that in one in my group um not that long ago she's like i don't enjoy this how do you guys

[00:34:45] Rob Howe: enjoy it you know exercising first of all man what an honest answer or what an honest question i think i think yeah a very like that's that that takes a lot of strength okay continue yeah i thought it

[00:34:59] Christel Oerum: was great and people are weighing in i mean people are very supportive um that's the power of peer support really um but my response to it is everything at first is not going to be fun not everything most things won't be fun up front it's the same thing um so like running i always use running because at least for me you know running the first few runs are awful and you can especially if you don't have music in your ears you can hear yourself you sound like you're dying and it's just for me generally unpleasant um but then it gets easier as your body starts becoming like oh this is what we're doing your body starts understanding the you know functionality so to say of running and you get in better shape and it becomes more enjoyable but you need to get over that hump and most people don't like to be uncomfortable right which i get but that means that they stop before they come over the hump. So back to okay how do we solve this? Well what I often tell people is find something you enjoy it doesn't have to be running. My example is always I really wanted to get into spinning. My mom loves it I have several girlfriends who spin and they love it and they keep telling me how fantastic it is. I was like okay I need to try this and I gave it an honest try I think I went to eight different spinning classes and I hated it every second of it I thought it was awful um so after the times I'm like okay I tried this this is not my cup of tea I'm not going to do that again what I do is I do all sort of other stuff right so what I tell people is you know figure out what it is for you it might be basketball you know well go play basketball right it doesn't have to be running or spinning or dancing and if you're uncomfortable you know exercising in front of others do it in your home it doesn't have to be in a gym it doesn't have to be in a class there are so many options it's just that um some people kind of get stuck in the well exercise means i have to put on gym clothes tight spandex and be in the gym no it can be whatever you think is fun and whatever you know makes you happy so if that's just moving to music at home do that and then all of a sudden you might want to go for a run that's fine but it's also about progression it's about starting somewhere so but it's the initial hump can be hard to get over

[00:37:39] Rob Howe: and I think people underestimate the value of incremental progress just getting a little bit better at doing those things every day. And it's boring and it's hard to look back, you know, at doing a little bit extra every day, whether that's dancing to music at your house or going to a spin class. And you look back six months from now after going just a little bit every day and seeing the progress you make, you know, you've got to celebrate those wins too. I think, you know, part of tracking and part of success is tracking where you've been. and you know, you got to make sure to do that for you. I know you mentioned the guides and I definitely want to link to those in the show notes, um, of this episode, you know, how do you approach the, those two questions, um, you know, in, in whether that's preparation for, you know, overcoming lows while doing cardio or exercise, um, you know, or, and I think we've already covered, you know, the weight loss question, but you know, how do you prepare for a cardio workout maybe versus a high intensity weight training workout?

[00:38:47] Christel Oerum: Yeah, I think really important is to first understand that aerobic exercise, which would be a cardio session where your heart rate goes up and stays up, impacts blood sugar significantly different than anaerobic exercise. Anaerobic means that your heart rate comes up, comes down, up and down, up and down. So if you kind of imagine those two sort of heart rate profiles. So the first one might be, you know, cardio might be going for a run or bike ride or dance class or whatever. well the anaerobic might be you know strength training it might be your cross-site class or if you do if you like to do sprints so that might be it so there's basically two different kinds of exercise and understanding that aerobic exercise for the most part will make blood sugars drop while anaerobic can actually make your blood sugars increase during the exercise just having that knowledge i'm going over it very quickly but just having that base knowledge means that you can start thinking about well which kind of strategies do I need to implement in order to be not go high or low and not having my sugars go high or low during and after exercise so I always say you know I remember being taught I remember coming to my doctors and they didn't do a good job I guess but saying hey I'm going low when I go bike riding what's up with that and they're like here's a pamphlet and the pamphlet said eat 15 grams of carbs like great so i'm just going to stop my face so what i what i i always say there's two levers yes we can eat more carbohydrates but that's only one lever the other lever is we can lower our insulin if we tend to go low or we can you know increase our insulin if we tend to go high right and for some reason that link has not been made for a lot of people. They only think we have the carbohydrate liver. And I think that's a fundamental flaw in how diabetes management is taught by, I guess, our general sort of medical society. There's also, to that point, there's also only just been published a paper within the last year about how to manage type 1 diabetes during exercise so I'm giving the whole medical society a break here in sense that they haven't had anything to refer to but anyway so the way I prepare is let's say I want to go for you know bike ride in the afternoon I'll walk walk is cardio well I'll have to make sure that I don't have a lot of insulin on board from my fast acting. So I'm on MDI. So I'm an MDI-er, meaning I do pen therapy. I have my long acting and my fast acting. So in an afternoon, the only thing I can vary is my fast acting, my boluses, right? So I just need to make sure that I reduce whatever meal time or correction boluses I take the four hours before my walk. I know that's a lot of planning in order to not go low and if I all of a sudden want to go out and I know that I have more insulin on board than what will keep me level through my walk I'll have to eat some carbohydrates so that's kind of like very basic of it as for me and interval and anaerobic training so I do a lot of resistance training that's kind of my thing what I do is always eat before that because I believe in, you know, feeding the machine and I want enough energy to actually go into the gym and be effective. So I eat and then for that meal, I'll just reduce my bolus to not go low. As I, to the, the listener who paying attention, like, hey, didn't you just say that that can make your blood sugars increase? True. So what I do is I don't do as much of a reduction for my meal as I would if it was cardio, but I still do a little bit of reduction. So actually having a little bit of insulin on board from that meal can help me prevent my blood sugar from going insanely high during the workout. So this is a little complicated to sort of try and explain in a short time and like this, but if people want to see it visually, I'm visual. So I have some tables as well that kind of shows it stepwise saying, okay, if you are, if you've eaten, these are the general recommendations. I'm not a medical professional. I'm not allowed to give medical guidance. However, that paper I mentioned before, I can quote that. So that's what I'm doing. So that's what you will find on the site. So there's a lot of general information on the site saying, I don't want to call general. I want to call it, there's a lot of scientifically backed information on this site, but what I make sure to always do is make sure that you as a user can use it.

[00:43:52] Rob Howe: Right. Right. Breaking down into layman's terms.

[00:43:58] Christel Oerum: Yeah, and it's a step-by-step approach. Because, again, as I said up front, my goal with the website is to empower people. And I don't think you empower people just throwing a lot of information at them they can't use or anything. Right. And of course, you'll find, you know, my own experience sprinkled in there again, but we're all different. Right. And I always tell we all different. I'm like, yes, we're all different, but we also all move within the same patterns. so again most people go low during cardio session how much insulin you need on board in order to not go low will depend on you it'll depend on your fitness level it depends on the type of activity you're doing depends on your body fat it depends on all sort of good things so that's when it comes down to what i call finding your formula for exercise and diabetes management because you know that you're going to drop but you need to figure out how much and i have some people who come to me like that's a lot of work christelle i'm like yeah it is a lot of work but if you put in the upfront work and figure out your formula it's not that you're set for life because your formula is going to evolve over time as you change and we get older and our hormones change and our body fat changes and our muscle muscle changes and all that but it gives you a really good starting point it gives you such a good starting point i'm at what i'm now at a point where i've been doing this for so long and i've been tweaking my formula for so long that and i just realized that the other day i did i did a long training session again also because this is what i do i think i did an hour and a have. I did not check my CGM once. Not once during those 90 minutes because I knew I was good.

[00:45:53] Rob Howe: Right.

[00:45:55] Christel Oerum: I mean, I have that level of confidence now just because I put in the work.

[00:46:00] Rob Howe: And that preparation, I think like the confidence is the result of the preparation. It's the reward of the preparation.

[00:46:10] Christel Oerum: Oh, yeah. I mean, it didn't just come to me. Right. it's it's it's it does require work it requires a lot of tracking which works for me because that's in my personality but that's also where I that's what I try and teach I try to teach that method of okay how do you get to it how do you get to finding your formula how do you get to collecting the right type of data and the right type of information to figure things out a lot of people don't think about you know insulin on board meaning how much active insulin do they have in their body they don't they don't necessarily think about that and I'm like that's instrumental um to knowing how your body is whether how your blood sugar is going to react during exercise right because you know if you're not fasting you're going to have fast acting you know insulin in your body right and there's different strategies depending on if you're pen therapy or if you're on pump therapy and all that. And you mentioned this as well. I think for you,

[00:47:14] Rob Howe: you mentioned your insulin, um, your insulin on board rate or your active insulin time is four hours. That can be different for someone else as well. So like digging into those numbers and that type of whatever type of therapy you're on, whether MDI or pump, all are factors. And I think I talked to someone recently who works with the diabetes research field, and they mentioned diabetes as an experiment with too many inputs. There's so many factors down to age and what you ate for breakfast and how much sleep you got the night before to what type of insulin you use. Like all of those things take into account and very day to day that it's nearly impossible to formalize and standardize the experiment. So, you know, controlling those factors by, like you said, knowing your formula and keeping track and tweaking it over time is the best way to, you know, get that confidence.

[00:48:15] Christel Oerum: Yeah. Well, I do. I do recommend that if people sort of want to dig in. And so I even have like a worksheet on the website that's free for download is that people try and reduce as many variables as possible. Exactly to your point is that let's try and sort of isolate a few things here. So what I usually say is if you can try and do the same kind of workouts for at the same time, try and eat fairly the same thing, just so we sort of get a feel for what's going on.

[00:48:47] Rob Howe: um but and i think that's essential really you know taking it outside of even fitness is process is essential and systems are essential for you know when when things get difficult and when other variables get introduced because if you can take the thinking away and you know okay i and and and know what your steps are you can at least control what you can control right you control those variables to an extent. And I am, I'm already making notes to myself to follow up with an email on some of the things that we've talked about, because the show notes for this episode are going to be relatively extensive. I can already tell. Kind of with that in mind, you recently released your ebook, Fit with Diabetes. Yes. Which first of all, congratulations. I know that, you know, just basically looking at it was a tremendous effort. How did you approach that book differently than some of the other extensive blog content and programs that you've put out in

[00:49:47] Christel Oerum: the past? Yeah. Well, first of all, thank you. Yeah, it's my first ebook. So that's kind of like my baby. So it's based on a lot of it is based on, you know, I've done these fit with diabetes challenges. So that started, I think I've done five now, which is sort of online challenges, where people follow a program for four weeks and they basically get articles emails in their inbox every day um so last one we had was in january so the ebook is kind of a a write-up of all the experience and all the key elements of all those five challenges so it's everything from you know goal setting to well how to lose weight with diabetes because that's one of the questions that gets asked a lot to exactly how do you find your formula and what are some of the base knowledge that you need to know about um aerobic anaerobic exercise or what i talked about before and what i then did is is also include meal plans include exercise plans you know including pictures of me exercising so that you know how to do it um but basically it's a comprehensive guide It's primarily for type ones because I do talk a lot about insulin. So I guess I can also be for type twos who are insulin dependent. But it's a lot of focus on, okay, how can you successfully exercise and eat so that it fits your goals within the sort of the thinking about type 1 in the same time? sounds a little weird um but it's it's basically 80 pages of hands-on advice and it's very much the same tone as i have on the website um in the sense that it is always what are the problems how do we solve them how do i empower you to go out be successful for it by yourself right um so right now that is again my first ebook the only one i really have i haven't really decided if I'm going to write another one. I've had some people in type 2 community who are not necessarily on insulin reach out and say, hey, could you do one for us as well? So I might do that. I don't know. It took a lot of time. Yeah. So it's one of those things I have to, yeah.

[00:52:10] Rob Howe: That's one of the things I struggle with as well is sort of the, I don't know if there's a law about it, but it's sort of like content begets more content. It's just you make something and then all of a sudden now you have to make more.

[00:52:25] Christel Oerum: Yeah, and I mean, I really love the empowering aspect of doing what I do. So it's fun. It's not like it's a drag to do it at all. It's just only have so many hours in a day.

[00:52:42] Rob Howe: Right. Not to kind of put you on the spot with that, but what do you think is next for Diabetes Strong?

[00:52:52] Christel Oerum: Well, I want to continue. we want to we in the sense that i don't think i've given him any credit at all of this this podcast actually my husband and i run diabetes strong together so i have to give just a little bit of credit uh so he's part of the the team um our our goal for diabetes strong is definitely to continue to grow to reach as many people as we can we want to be the go-to place for health and fitness and exercise for people living in diabetes and i'm not and that's that's been the goal for the site all the time it's not just for type ones for anybody there's a lot of focus on insulin dependent diabetes but if you notice I usually don't say type 1 type 2 I say insulin dependent or not right so the goal is to grow we have around a quarter of a million visits a month right now we want to grow to a million we could do that by end of year that That would be fantastic. I find that, you know, for every new person we reach, that's a win. Every incremental person that we reach that we can empower, that's definitely a win. And just continue to be an inspiration for others. To show people, you know, I have people who come to me and say, hey, I can't exercise because I have diabetes. It makes me so sad. It makes me so sad. So going from people saying, hey, I can't exercise to, I thought I couldn't exercise, but now I have the right knowledge to go and do and be successful and confident that I can. You can't see me right now. I have a huge smile on my face because that just really makes me happy, you know, giving people those tools. So I think we're still going to have that, the .com, the diabetesstrong.com platform. It's still going to be the main platform. I mean, you can also find us on Instagram and on Facebook, of course. But the goal is to focus on growing the website and just continue. Also, so that's another thing. If you go to Diabetes Strong now, you'll see it's not just me posting anymore. It's more of a health website now. We have other voices there as well. First of all, you get tired of listening to me. and I can only provide my perspective right and my way of seeing the world and I think kind of almost back to what you were talking about before about traveling it's good to have other perspectives it's good to have other voices so people from other walks of life or who have other experiences are also on our site and giving their given their like two cents of different things also we're going to be creating more guides so as I said we already have the how to lose weight with diabetes we have how to exercise or how to find your formula with diabetes I get a lot of questions about stuff like keto diets which is not something I do and I honestly would not be able to well I would but I didn't want to sit down and write a big guide about it so somebody else is doing that for us and we're including on the site because I basically my belief is that you do you in this sense that what works for me doesn't necessarily work for everybody else in the whole wide world right so I want to make sure that the site has a lot of different options for being healthy and happy and that also goes back to exercise not everybody's going to be into resistance training just because I am and I tell everybody's fantastic so I want to make sure that there are other other activities are represented as well. So we're going to go even broader and add more stuff. I love it. And I think,

[00:56:43] Rob Howe: you know, for me, you know, you mentioned, you know, needing more voices. I think that's something that I get spoiled with because that's my platform is entirely built on that, right? This entire podcast is built on other voices. And, you know, my success is built on standing on the shoulders of giants, you know, the giants in this type 1 community, even, you know, because every voice matters. And I think every voice resonates with someone different. And I think that's so important. So I'm glad that you are, have been able to broaden that and find, you know, the voice that works for someone so that you can continue to perpetuate the idea of you do you. And that all of those inputs that go into diabetes and are a challenge, but is also an opportunity to bring in other people to, to educate, to empower, to resonate with, to, to be relevant, to connect. And I think that's super important. Um, I want to ask a fun question because I think this is, uh, you know, this is my podcast. I get to do what I want, right? Um, if you could only do one exercise for the rest of your of your days what would it be and why if you could only do one

[00:58:01] Christel Oerum: what would it be how long would i have to do it for that's that's two um only one exercise it would probably be squatting or leg press which is kind of a form of squatting i'm not i'm actually not super good at squatting but i i'm one of those people i like to go to the gym again i love resistance training i think i've said that a trillion times now um and what i like is i like to feel like i'm getting bang for my buck and this is one of those major muscle groups working your whole lower body your core everything and your heart rate goes through the roof it's actually any kind of a sort of like like day is my favorite but yeah something like squat or leg press for sure. And it gives you nice legs, nice, strong legs, and your legs carry everything. Right.

[00:58:52] Rob Howe: Nobody's going to be upset about yourself included, right? Exactly. Exactly. I love it. I am a huge proponent of squats because my entire athletic career, I was never very good at them. And then I had a coach that was like, no, we're going to focus on this and we're going to get good at it. And it totally changed my athletic career. It totally changed my athletic ability. It totally changed my physicality. And I'm forever grateful to that person for, for making me do that. Also, you know, we talked earlier about nobody likes working on their weaknesses and that was a huge weakness of mine. And, um, and it, like I said, I'm super grateful. Kevin Cronin, shout out to you, wherever you are, my friend. Okay, now for the question that I always ask all of my guests, and I'm really excited. I think you've hinted at what this answer might be, but I'm excited to hear your answer. So the context is important. Imagine that you are in an airport at your gate, and they're about to close the door to your gate, but you run into someone who has either recently been diagnosed with insulin dependent diabetes. I'm going to make it, uh, I'm going to, I'm going to frame it around your, uh, your context. Cause I love that message and I want to make sure that you reach, uh, you know, your audience with it as well. Um, and they've either been recently diagnosed with insulin dependent diabetes or are struggling with it. What's the one thing that you tell them in that 30 seconds before your gate closes and

[01:00:26] Christel Oerum: you got to jump on that flight? So I would probably tell them, let's say that it's a newly diagnosed saying, and we talked about this earlier, it will get easier. It will never be easier, but it will get easier as you gain more information. And please know that living with diabetes does not mean that you can't do all the things that you dream of. It doesn't mean that you can't start a family. It doesn't mean that you can't travel the world. It doesn't mean that you You can't be happy. If you want to do it, just go do. Safely. I think that would be it.

[01:01:08] Rob Howe: Yeah, I love it. You do you, right? It doesn't have to stop you. I love it. That's great. And I think that's, you know, in some ways, you know, that's the message that I want to make sure however they get it, that everybody living with diabetes understands that they have in front of them, that it is their choice that with the right preparation that they can do whatever

[01:01:32] Christel Oerum: it is that they want. Yeah, it's a question about having the right preparation and the right tools. Obviously, we need our, you know, we need our insulin, and we need to be able to measure our blood sugars. But what I often, I kind of have three pillars, what I say is there's nothing we can't do as long as we have access to the right medications as I just said the right knowledge and the right mindset and what I work on on diabetes strong is you know the knowledge and the mindset part and I think I really truly believe that if you have those three pillars down you're good to go but mindset is also important oh 100%

[01:02:18] Rob Howe: you know Christel thank you so much for not only taking the time out to do this awesome interview but for also being so proactive in scheduling and I appreciate I know we've had a couple reschedules thank you so much for being flexible and to being the force that you are in this online diabetes world I appreciate you and your husband as well big shout out to him for all the work that you guys do

[01:02:43] Christel Oerum: thank you Really appreciate it. Thank you for letting me chat for a full hour. I appreciate it.

[01:02:48] Rob Howe: Yeah, I'm happy to have you. I think, like I said, my world is built on the stories and the experiences of my awesome guests. So thank you for being willing to chat.

[01:03:04] Christel Oerum: Got it. I'll do it anytime.

[01:03:06] Rob Howe: And like I said, I am going to send you a follow-up with a big list so I can get all of the links together for my show notes. I know you're on Instagram as Diabetes Strong IG. I know you also have Facebook groups, Facebook pages. You're all across the social media web and on DiabetesStrong.com. Your e-book is Fit With Diabetes. Definitely go check that out. And for anybody who else wants to get in touch with you in any other way, anything I missed, we will include that in the show notes. sounds good thank you yeah you are welcome and thanks so much again for the time and i look forward to seeing what's next for for christelle and you and your husband and fit with diabetes and diabetes strong