About blood sugar and exercise with Christel from Diabetes Strong

Exercise is one of the best things you can do for your long-term health, but when you have diabetes, exercise becomes much more complicated. On this week’s "Live, with Scott!", we’re talking with Christel Oerum from Diabetes Strong. She has devoted her career to training people with diabetes. As you will learn in the video, Christel was diagnosed with type 1 diabetes in her late teens. When she discovered weight lifting, there wasn’t a lot of material out there for training people with diabetes. So she created her own methods and now offers them through her site Diabetes Strong. Later in the podcast, she’ll tell you where you can download a book that details her methods.

Summary

• Christel’s diabetes story
• Her transition from business to weight lifting and her struggles with finding good training material
• Why she created Diabetes Strong
• The mental game of exercise with diabetes
• The importance of finding an exercise formula that works for you and your diabetes
• Why it helps to find an exercise (or movement) that you like
• Where you can find her ebook on being fit with diabetes

Transcript

Scott Johnson: All right. Welcome to another episode of Live with Scott. Thanks so much for tuning in. My name is Scott Johnson. I've been living with diabetes since I was five years old and the diabetes social media space, that's you by the way, has been a big part of my wellbeing for a long, long time. Thanks for helping me along. As your host today, I am thrilled to connect you with Christel from Diabetes Strong. Christel is an absolute treat and I can't wait for you to meet her. But first, last week's winners. Congratulations to Kate Loveman who just won some fun mySugr swag and a total body training kit courtesy of our guest last week, Kelly from GenerationFit.

Scott Johnson: We'll send you a message on Facebook after the show to coordinate details. Stick with us to learn how you can win some free fun mySugr swag too. Now, while we get going, please share a quick hello in the comments and let me know where you're watching from. I'd love to say hello. If we cover anything that resonates with you, please show some love. I would appreciate that as well. Finally, if you know anyone that might find this helpful, please share this with them. That would be amazing. Now, today's episode is sponsored by the mySugr Bundle. Get unlimited strips, automatic supply refills, personalized support and more all for just $49 every month. Learn more at mysugr.com/facebooklive.

Scott Johnson: Now, more on this week's guest. Christel is the owner and force behind Diabetes Strong. She's a Los Angeles based speaker, a writer, diabetes coach, and diabetes advocate. She's been living with Type 1 diabetes since 1997 and as I mentioned she is the force behind the amazing website Diabetes Strong. Today she talks with us about getting started with an exercise we like, sticking with it and learning how to manage blood sugars around it. This took me forever with my basketball sessions back in Minneapolis. If I only knew about Christel and Diabetes Strong back then, right? All right. Let's dive in.

Scott Johnson: Hey Christel. Great to connect with you again.

Christel Oerum: Hi, Scott, how are you?

Scott Johnson: Doing great. Thanks for coming on the show.

Christel Oerum: Thank you for having me. I appreciate it.

Scott Johnson: Of course. Of course. So, to start things off for those that may not know you and your story, I'd love to dive into that a little bit. Can you share a little bit about your story and how you got involved in what you're doing now?

Christel Oerum: Yeah. Well, it's a long story given I've been living with diabetes for 21 years now. So, I was diagnosed back in 97 at 19. It was not dramatic in the sense that I had the common symptoms of I had to go to the restroom a whole lot, I was not gaining weight despite eating a lot. I had a good appetite. I was thirsty all the time. I was tired. I was falling asleep at work. My family started to get concerned so they asked me to see my doctor. I just went to my primary care. He gave me a long spiel. He's like, "You're 19. You shouldn't be partying as hard." Which I was. You should take care of yourself which I was not, but basically, after this long spiel, he ended up just measuring my blood sugar and bam, it was very high.

Christel Oerum: I don't remember how high but he basically right there in his office told me I had diabetes. I had no clue what that meant. I did not know anybody with diabetes. I thought I'd been handed a death sentence and I rode home on my bicycle because I grew up in Denmark and everybody bikes on their bicycles. So, I biked home thinking I was going to die like now. So, that part of it was a little bit traumatic I would say. I got home. My mom is a nurse so she knew enough to be able to explain to me it's not a death sentence. I ended up getting stellar care in the diabetes center and I had an amazing diabetes nurse who pretty much sat me down and she's like, "This sucks but there's nothing you can't do."

Scott Johnson: Yeah. Nice.

Christel Oerum: It was fantastic. It was one of those things I had planned on going backpacking around India within a year of that diagnosis. She's like, "You're going." I went.

Scott Johnson: Yeah.

Christel Oerum: A lot of things went wrong, but I went. It was something I'll always remember. I think that's the one that mindset has set me on the journey I'm on right now or where I ended up, rather. I'm not going to take you through all the 21 years because that's going to be really boring, but I got an MBA. I did business for a long time. I worked for some of the big diabetes companies and then back in 2015, time flies, but back in 2015, I moved to Santa Monica, California, so Cali like you and started to see all these really fit people. I was like, "This is cool. I want this." I'm really fascinated with muscles and stuff like that.

Christel Oerum: So, I started to say I want to do this. I want to compete in a fitness competition. Bodybuilding. So, me being me, I was like, "Okay. How do I do this with diabetes?" Go online, I'm going to find the resources and they're all going to be there and it just came up empty.

Scott Johnson: Yeah.

Christel Oerum: There is nothing that I felt ... No, that's not true. There were guidelines saying if you exercise, you need at least 15 grams of carbs. Great. That for me is not useful. I think the other guides were you should measure your blood sugar. Thank you. I didn't know. Been living with Type 1 diabetes for a long time. So, basically I started to document my own journey and that's what led to what's now my full-time job is managing diabetesstrong.com which is my website that has everything diabetes and health including exercise and food and all those good things, but also mental health because-

Scott Johnson: It's a big part of the picture, isn't it?

Christel Oerum: It really is. I think it's so cool to see how more emphasis is being paid ... What's the right word? There's more emphasis on the mental side now. We have more resources. Still not enough resources. But there are more resources for people who are struggling.

Scott Johnson: Yeah. I agree. It's so important and we are I feel turning a corner and I like to think that the mechanical side of diabetes that the pokes and the measuring and dosing, that stuff is part of it, but for me it's so much harder to do those things if my head is not on straight.

Christel Oerum: Yeah. It's interesting because stuff like that you just burn out which is basically kind of what you're describing there. I think a lot of people go through that but they can't quite put their finger on what's going on. I find a lot of people who find that kind of information on Diabetes Strong. They write me. They go like, "Oh my gosh. There's a word for it and I'm not alone and this is how I can work through it." That's kind of one of the pillars of everything I do. It's all based on knowledge. Because there's a lot of challenging things with diabetes but the more we know it's never going to be easy, but the easier it gets.

Christel Oerum: So, of course, it could be data overload and all that, but basically what I tried to provide is a place where people can go and find well I need specific, usable information about hey I want to X cycle all the time. What can I do? Or whenever I go to the gym I do HIIT training. Heart rate up, heart rate down. All those things or resistance training, my blood sugar goes up. What comes? So, those things I don't want to just have a website where you can go and say, "This is going to happen. Full stop." Because great. I notice that. What do I do? So, it's a lot about what do I do to be successful.

Scott Johnson: A lot of why behind it. That's another thing that I've noticed around Diabetes Strong is there's kind of the what can I expect and here's why it happens. It's a full package of information. So, let's dive a little bit deeper into just exercising with diabetes. Because I know it's a really complex topic. Sometimes complex because it's complicated but sometimes, I'm the master of over complicating situations.

Christel Oerum: No.

Scott Johnson: I can get myself kind of wrapped around the axle and sort of intimidate myself into not taking action because I'm a little intimidated by it or I'll overthink a situation. Something like that. So, let's talk about thoughts that you might have for someone who's interested in exercise. They maybe tried it a few times. They're frustrated because they've had some bad experiences around their blood sugars with exercise. What do you tell them?

Christel Oerum: Well, first of all, I had a lot of people reach out and say, "I know it's silly but I'm scared of lows." I'm like, "It's not silly. That's a real fear and it's based on you continuing to go low." So, I think it's a rational fear. If something keeps happening. But, it's rational. Right? But you can take that fear and you can have it limit you or some people are like, "I can't exercise." I'm like, "Yes you can, but you need the right information." So, what I would encourage people to do if you do want to be active and active, it doesn't have to be going to the gym. Maybe go for a walk with your dog or your family. That's exercise.

Christel Oerum: You want to be able to do that without having to chug a whole bottle of Gatorade or all your glucose tabs or whatever. So, I recommend the first figure out what are you doing? So, let's say you're going for a walk or you're going to the gym or you're going for a swim. So, that's what we call cardio exercise. That's going to impact blood sugars in one way versus if you do other activities such as we talked before like HIIT training where your heart rate goes up, down. The same thing with weight lifting. That will impact blood sugars in a different way.

Christel Oerum: So just knowing that means that you can start peeling away the layers and figure out what can we do about it then? So, if you, Scott you're like, "Hey Christel I really want to go for a walk every afternoon with my family but I keep dropping low," I tell you, "Well, you're doing a cardio exercise. That you're most likely letting your blood sugars come down. So, that's what you're seeing." [inaudible 00:11:13] that type of exercise. What can we do about it? Well, in my perspective there's two levers, right? We can eat those 15 grams of carbs that I've been told in the past or you can lower your insulin if you're on insulin. That's two levers and you decide which one you want to pull.

Scott Johnson: Yeah.

Christel Oerum: We can't always pull the insulin if we already have a ton of insulin on board. Again for us on insulin, but just knowing that and knowing that you have the power to go in and make some of these changes to-

Scott Johnson: That's great.

Christel Oerum: Yeah it's powerful because we can't eliminate lows.

Scott Johnson: Right.

Christel Oerum: We just can't but we can reduce the amount. The same if you notice that you go high after a workout, well first it might come down by itself. Do I stress out? That's just the body's response to that kind of exercise or you might need a little bit of a correction. Again we're talking insulin. So, I think it's one of the other things as well because I met people who say, "Well I can't do resistance training because my blood sugars go up." Well, that is a usual response to what we call anaerobic exercise, but most often it will come down again and doing that kind of training will improve your insulin sensitivity. Meaning how effective your body is at using your insulin, and that's regardless if you're injected or not.

Christel Oerum: So, then there's that benefit. So, you might need less insulin going forward. So, it's a lot of benefits. It's just understanding the mechanics and how it all works out. It all makes it easier [inaudible 00:12:50] makes you understand why should I be doing this.

Scott Johnson: Right. Kind of stepping back and looking at the bigger picture at times can help put those situations into perspective.

Christel Oerum: Yeah. I am simplifying things and saying you can just pull back your insulin or eat more carbs. It requires work. Quite honestly. It requires work to figure out how to pull those levers and then that's why I have all those resources on the website because that's not just a tried out once and then you got it. We all know it's not that easy. We all know that it takes a while but for example what I do on the website is I provide structure. So, you can go on the website, you can search for finding my formula. That's what I call it. Finding a formula for exercise. I have downloadable sheets and it's all free.

Christel Oerum: Everything on the site is pretty much. You can download those and use them. One thing that often surprises people is when I say, "Well, what I think is the most important again if you're on insulin is you keep an eye on your IOB. So, active insulin and that includes basal.

Scott Johnson: Right.

Christel Oerum: A lot of people have not been told that by their team.

Scott Johnson: Right. So for just a second, so we might have viewers who don't know what active insulin is. So, active insulin I'm going to talk about just the short-acting that you might have injected for correction or a meal. So, once you inject insulin or give yourself a dose with your insulin pump or really whatever you're using to give yourself insulin, once you squirt that insulin in your body, it's hanging around working to lower blood sugar or work on those carbohydrates for a number of hours.

Christel Oerum: It's something that many of your insulin pumps or an insulin calculator will keep track of how much insulin is in your body but if you don't have one of those tools, then it's kind of up to you and your brain to think about how much insulin you have on board and exercise or activity can often supercharge insulin that you're using which then can ... You have to be much more aware of going low with that activity. So, if we start throwing around some phrases or terms that are unfamiliar, that's a great opportunity for you to drop some comments in for us and we'll answer those questions for you. That's great.

Christel Oerum: Yeah. A note to that is for people on pumps, insulin pumps, if you look it will say insulin on board, IOB on the screen but that does not include your [inaudible 00:15:37].

Scott Johnson: Right. Yep.

Christel Oerum: Your basal is also fast acting so that would also be impacted by exercise. I would say even if your ... So let's say that you do not take insulin, so let's say that maybe you're not even taking any medications. So, let's say that you're not taking any medications or you're taking a tablet like a Metformin, something like that. Those will not, in the same way, be impacted by exercise. Because that means also you're less likely of having low blood sugars. However, exercise can still impact your blood sugar. So, that means that I would say if you tend to have a little bit of a high blood sugar in the afternoon, you can go for a walk. Because that will, for the most part, help blood sugars come down.

Christel Oerum: Again, if you measure your blood sugar right after a resistance training workout and you see it come up, in my perspective that's okay if it comes down again.

Scott Johnson: Sure yeah.

Christel Oerum: Because it's also basically your liver is kind of dropping out glucose into your bloodstream. It's helping you out. Basically, people get so frustrated. I get frustrated as well if my blood sugar goes up based on my workout. I try to remember it's actually my body trying to look out for me. It's a little annoying. It could stop that. It's like, "Hey you need energy. Let me give you some sugar from your liver." But yeah. It works for everybody.

Scott Johnson: Yeah. Our bodies are incredibly complicated and some parts of it are really stupid. You know how our pancreases aren't working the way they should and our livers can only do one thing at a time and we will do a whole nother episode on all different parts of this stuff. But one thing that you mentioned and talk about it a lot which I like so much is finding an activity that you enjoy. So, in my case, this was a big deal for me because I love playing basketball and the fact that I enjoy it so much was exactly the motivation that I needed to fight through all of the work that it took to learn how to manage my blood sugars around it. Can you talk a little bit about how important it is to find something you enjoy doing?

Christel Oerum: For sure. I think if you want to start out and you have this idea in your head that I want to move more, so let's use the word movement rather than exercise. Because exercise can be kind of like a no starter for a lot of people. It sounds uncomfortable. So if you're talking about movement, finding something that you enjoy is also going to be more likely for you to stick with it. I think a lot of times when we talk about again exercise people think I have to be in the gym, have to put on my Spanx, I have to do this and that. That's not the case.

Christel Oerum: Movement can be anything. So, you know when people tell me there's nothing I enjoy. Okay. Let's take a step back. What did you do as a kid? Most of us did something. Went to the basketball court and shoot hoops with the other kids or we got on our bicycles and biked around the neighborhood. I swam. I danced. Whatever it could be. I'll walk with the dog. So, it's always digging back, finding that joy and that joy can help people through because it's the same thing. Expecting to, wanting to go exercise. That's not going to happen to a lot of people unless it's become a routine. I actually like going to exercise because it's [inaudible 00:19:22] for me, I enjoy moving my body.

Christel Oerum: But you have to rely on something else to get you out of the house or you can work out in your house as well but get started and that can be with true joy of what you're doing. It doesn't have to be for an hour either. Just get started.

Scott Johnson: Yeah. That I imagine plays into how to stick with the exercise you're doing, right? Yeah.

Christel Oerum: That's the other thing. It's funny. It's one of the things. My thing was always spinning. So, I have girlfriends who love spinning. Get on a spinning bike and you spin for an hour. They love it, my mother loves it. Everybody around me seems to love it. I was like, "Okay, I'm going to give it a go." I tried it out. I tried five different instructors over a month. I bought a class pass which means you can attend different classes. I hated it every single time. It was awful. Everything was like, "Can this please be over?" So, after a month, I'm like, "Okay, this is not for me." And I'm gone.

Christel Oerum: There's so many things you can do so finding something that's not awful I think can, first of all, make you want to come back and it's going to make you stick with it. That's the other thing I was going to talk about positive motivation versus negative motivation. So, positive motivation is what's going to make you go and what's going to make you stick with it. So, positive motivation is doing this. For me, it's resistance training. That's my go-to workout. It makes me feel empowered. I love the ... I'm not a huge woman. I love the feeling of being able to lift heavy weights. I enjoy my body being able to do that. So, that's what I rely on in order to get to the gym is I know I'll really like it.

Christel Oerum: The negative motivation would have been, "Oh my God, my muscles are tiny. I look awful. I need to go to the gym." That's not going to necessarily keep you going because it's so negative. So, finding that positive drive and it can be hard. Because we have a tendency to be really negative about ourselves.

Scott Johnson: Our brains are our own worst enemy half the time.

Christel Oerum: Yeah. It's one of those things, that's also why scare tactics they don't work in the long run.

Scott Johnson: I think diabetes is also built or at least the messages around diabetes that we tell ourselves in kind of our own inner talk, it's ripe for that self-criticism. You get a blood sugar that is out of target and the first thing is, "Oh, what did I do wrong?"

Christel Oerum: Yep.

Scott Johnson: So, I agree. It's very, very easy to set yourself up for that negative message. It takes a lot of real intention to be positive with your messages.

Christel Oerum: It's hard. It really is. That's also something that if anybody wants to work on it, they can either go to the website or I actually also have an eBook which I think is fairly affordable that people can buy and simply get started because that takes you through how do you then set that positive motivation?

Scott Johnson: Great. So, talk about the eBook for a minute. How much is it and then let's dive in to take us through the eBook.

Christel Oerum: How much is it? So, the original price was $15 but we put a more or less of a permanent discount on it. So, you can find it between $10 and $15 online on the website.

Scott Johnson: Very affordable. I imagine tuning in to Diabetes Strong and all the different places that you guys are connected with is a great way to find out more about the book but let's talk about the book itself. Tell us where the book came from and what people would get out of reading the book.

Christel Oerum: Yes. So, the eBooks, the reason why I put it together was that I kept getting questions from people like, "Do you have any [inaudible 00:23:35] all this stuff put together?" In the sense that people go to the website and there's so many resources there that sometimes if you know that you're looking for I just want to get started, I want to learn. Now we kind of get into what's in the book, I want to learn how to set my goals. I want to learn how to limit those lows or reduce those highs associated with exercise. I want to learn how can I set up an exercise program that works for my goals and I even have specific examples with workouts. Same with food. If I want to gain muscle, if I want to lose fat. Well, what's the strategies and how should I do it?

Christel Oerum: So, all of that the book takes you through. So, I think it's 82 pages. It's not a small booklet. It's only in eBook format but people print it out. I love that. Seeing people print it out and showing it. So, that's kind of fun. So, it's resources. Every page is actionable.

Scott Johnson: Amazing.

Christel Oerum: Again, it gives you I think you said it really nicely before. You should be my PR person. It's what's going on, why is it going on, what can you do?

Scott Johnson: Yeah. I think that's the biggest thing is in today's world where there's so much information coming at us that having actionable information is the key to it. So, there's something that you mentioned earlier and just a moment ago that I want to poke on a little bit. So, I am not a woman. But I imagine that one of the questions you get a lot from women when talking about resistance training is if I lift weights, aren't I going to get big and bulk up and stuff like that. Can you address that a little bit for viewers that might have that question in their mind?

Christel Oerum: You bet. I wish it was like that. I've been trying to build muscle for so long. So, basically the women that you see who are huge, like have muscles the size of Scott's head, those ladies use steroids. Or they're ... I don't want to call them a freak of nature but they're unique. Most of us will never get to that point unless we put in a lot of effort and take steroids, to be honest. What's going to happen, so muscle building takes time. That's also even if you embark on a three-month program which a lot of us tend to do, we're going to do this 12-week program, everything is going to be perfect.

Christel Oerum: It's a start, but you will not build huge muscle in that amount of time. Also just as women, we don't have the same amount of testosterone and we're built differently. So, I wouldn't worry too much about that. Even if somebody is really prone to putting on muscle. Well, if you're for example in a calorie deficit, that's really really hard. So, let's say that you're trying to lean out meaning drop body fat without dropping muscle mass. You're going to be at a calorie deficit. It's going to be really hard to build more muscle, but you can maintain the muscle you have.

Christel Oerum: So, that is pretty much impossible to become She-Hulk but there are some girls out there have some amazing muscle. If you look at what they do to get there, most people don't put in that kind of work.

Scott Johnson: Yeah. Yeah.

Christel Oerum: Because a lot of the ... Well, you're looking at athletes for the most part. Most of us don't put in five hours a day and eat accordingly. So, I wouldn't worry too much. Again, if you find that you're building a little bit faster than you'd like, just pull it back a little bit.

Scott Johnson: Pull it back a little bit yeah. That's great. Well, thank you for that. So, women out there if you're interested in adding some resistance training and as you heard in last week's episode about how beneficial it can be and as you talk about today, Christel about what all the good things it can do for your insulin resistance, resistance training is an important tool in the diabetes toolbox. That's great. So, because I don't have the foresight that I would like to, we didn't get you scheduled in time to talk about the challenges that you guys do on Diabetes Strong. We'll have to get better about that for next time, but you guys do these twice a year or how often? I'd love for you to tell the viewers a little bit more about what's involved in these and look forward to it again coming up sometime soon, yeah? Or the next time.

Christel Oerum: So, well, one of my readers reminded me this morning I think it was. We've been doing these since 2016. It's online what we call challenges. Basically it is people signing up online and they get daily emails of what we call the daily challenge which would be read this article, gain more knowledge about exercising with diabetes. It can be meal plans, exercise, I have some exercise videos that's also available on the website. This one started January 6th. So, yeah. We're about halfway through.

Scott Johnson: Sorry folks. My fault. [inaudible 00:28:59]

Christel Oerum: Last year we only had the January one. This year so far we only planned this January one, but who knows? It is popular. 36,900 people sign up this time.

Scott Johnson: That's amazing. You guys are doing-

Christel Oerum: It's so cool.

Scott Johnson: Yeah. You're doing great work to help so many people and it's great. I will do a better job of getting-

Christel Oerum: I'll remind you.

Scott Johnson: Yeah. So, thank you. Thank you guys for all that you do with that. So, there's that but I also would love for you to talk a little bit more about all the cool resources available on Diabetes Strong. One of the greatest things that viewers that you could do after watching this video is head over to diabetesstrong.com and just dive in to all the great stuff that's there.

Christel Oerum: I think it's fairly intuitive, the site. But it's my site. But of course you can see up top, you can see all the different stuff and there are pull-down menus. There's also search-

Scott Johnson: Oh shit. Sorry folks. I pressed the wrong button and now I interrupted the interview and I'm live, back on camera. Super embarrassing. So, we cut off right when Christel was talking about her great diabetes website Diabetes Strong. It's a super, wonderful amazing resource and I hope you go check it out. We will upload a complete interview with Christel. There were only a couple of minutes left so I didn't mess up that bad (aside from the bad language). But anyway, as always and as a special thanks to everyone watching, I have a special mySugr tote bag with some goodies inside.

Scott Johnson: Always nice to give away some fun stuff. So, leave a comment in the description below and we will pick a lucky winner or two before next week's episode and announce the winners on the show. So, again head over to Christel's website. diabetesstrong.com. We will put that link in the comments and the notes and get you over there. Now, once again today's episode is sponsored by the mySugr bundle. Get unlimited strips, automatic supply refills, personalized support and more all for just $49 every month. Learn more at mysugr.com/facebooklive.

Scott Johnson: Be sure to tune in next week to connect with the amazing Jane Dickinson. AADE's 2019 educator of the year and program director of the Diabetes Education and Management Master's program at Teachers College, Columbia University and a long time champion for the language we use around diabetes. Thank you so much for joining today and please like this video, share it with your friends. Have another amazing day and we'll see you next week.