Goals

Review: Fit With Diabetes e-Book by Christel Oerum

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As much as I like to proclaim that I don’t exercise, the reality is simply not true. While I might not partake in dedicated workouts or fitness regimes, there is plenty of physical activity in my day. My job keeps me on my feet all day, and I do enjoy getting outdoors and going for walks through my neighbourhood in the afternoons. Not to mention all of the incidental exercise involved with tasks like housework!

As with every other aspect of my life, my diabetes needs due consideration when I’m active as well.

I’m a big fan of reading offerings that give me practical information I can take away and apply to my own diabetes management at home. It’s one of the reasons why I’m such a big fan of Christel Oerum, a longtime T1D and co-founder of the website Diabetes Strong (diabetesstrong.com). Christel created her website after struggling to find information about exercise and nutrition with diabetes. 

Christel has recently launched an e-book, Fit With Diabetes, and kindly sent me a copy which I had the pleasure of reviewing.

The book kicks off with a chapter on goal setting and finding your motivation, which will likely resonate with most readers. Who doesn’t have something at the back of their mind that they’re aspiring towards? Even if your direct goal isn’t fitness related, I’m willing to bet you would find something in this book that will help you reach that goal. Improved blood sugar levels, better nutrition and healthier lifestyle comes to mind.

I was nodding my head as I read through the chapter on Cardio, the main form of physical activity that I tend to make adjustments for. Given that getting up and going to work every day involves cardio, I’ve had no choice but to endure months and months of practice, patience and frustration to finally reach a place where I can work, eat and navigate my blood sugar levels without so much bumpiness.

Most cardio workouts increase insulin sensitivity during and after a workout, causing blood glucose levels to drop. The book provides practical suggestions for reducing basal rates and insulin doses for meals in advance of a workout, right through to avoiding lows in the hours afterward. Christel’s lived experience really shines through as she provides plenty of real life examples for undertaking cardio with both an insulin pump and Multiple Daily Injections.

Have you ever noticed your blood sugar levels starting to rise after exercise is over? One of the lightbulb moments that I had while reading this chapter was that a reduced pre-workout insulin bolus might need a follow up if food is still digesting once the workout is over. Ding!

The book moves into resistance training, and admittedly this chapter didn’t speak to me so much as I haven’t stepped inside a gym in years! Christel talks through navigating blood sugars during these higher intensity workouts, which can cause blood glucose levels to rise.

This chapter is definitely written in the spirit of motivating the reader to get into the gym and move past any personal reservations or fears. There are several pages of sample resistance workouts and illustrations in the book, with exercises that will suit both the gym go-er and someone with basic equipment at home.

For me, however, the most valuable part of this book was the chapter on nutrition. I say this because the nutrition advice in this book makes the most sense, but in my opinion isn’t reaching enough people with diabetes. I’ll have more to share on this soon…

Christel talks through calculating your daily kilojoule (or energy) needs in order to fuel your body and match the energy you expend each day. It was refreshing to hear her recommending carbohydrates rather than avoiding them altogether. Based on her own experience, she recommends a diet of 30% carbohydrate, 40% protein and 30% fat, however of course you could adjust these percentages to suit your own preferences. 

Another handy tool that Christel suggests to help track your nutrition is the smartphone app, My Fitness Pal. I’ve been using it myself since reading this book and it is amazing.

There are also chapters on meal planning and recipes, losing weight with diabetes and further advice to support a healthy lifestyle.

The Fit With Diabetes e-book very much runs in similar veins as Gary Scheiner’s Think Like a Pancreas. It wasn’t screaming at me to change everything about myself, nor was it holding back on providing practical suggestions because ‘everyone is different.’ The book is simply there to help you get more out of physical activity while managing diabetes.

Even if you’re not a fitness nut like me, I am very confident that you will find something to take away from this book. You can purchase your copy of the eBook here, and you can also follow Christel at diabetesstrong.com.

Disclosure: Christel sent me a copy of the Fit With Diabetes e-book. There was no expectation that I would write about or promote the book, and all opinions expressed here are my own!

Mid Year Blues

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I sit down in the evening, and I marvel at how quickly yet another day has gone by. I glance at the calendar, and I cannot believe that it will be August in a few days. I watch the mornings slowly beginning to get lighter, and I want to make the most of this beautiful time of the year before its gone once again. Another Friday rolls around, and I cannot believe how quickly the weeks are flying by.

In the grand scheme of things, there are a million things that I want to do.

I want to sit down and write, every day. I want to put more effort into my meals, rather than the usual toasted sandwich I have for lunch every day. I want to save the money I spend on the odd treat at lunchtime. I want to work on my fitness. I want to improve my hba1c. I want to finish all the odd jobs at the house this weekend. I want to read. I want to get hooked on a new TV show, instead of falling asleep out of lack of interest. I want to make time for myself. I still dream of one day having a career that I’m really passionate about. I want to feel full of energy. I want to be excited. I want to be enthusiastic. I want to go to bed feeling fulfilled at the end of the day.

In this grand scheme of this thing that we call life, there are simply not enough hours in the day to get all of these things done.

Last week at the Telethon Type 1 Diabetes Centre in Perth, Canadian T1D athlete Sebastien Sasseville spoke about having a bank of good and bad blood sugar levels. He reminded us that there’s no point focussing on those bad readings that were deposited in the past. Like anything in the past, there’s nothing I can do to change it. I can only look forward, and at what I can do today to deposit more readings into the good blood sugar bank.


I’ve definitely been reflecting on my own diabetes management quite a lot at the moment, particularly now that things are starting to settle somewhat with my insulin pump. I think a lot about where I’m hoping to be with my diabetes in the long run, and what I hope to achieve.

One of my favourite quotes reads “no expectations, no disappointment.” I’m often reminded of the diabetes goal I set for myself at the beginning of the year. That goal of striving for stable overnight glucose levels was full of expectations, and led to a lot of disappointment.

While I’m unlikely to start training for a climb up Mount Everest or a triathlon across Canada anytime soon, I did take away a small piece of inspiration from Seb’s talk. Going into the second half of this year, I’m definitely going to try to focus more on my diabetes for today, and for the now.

https://www.instagram.com/p/BIPTtdeAMcA/?taken-by=franksita

Because in the grand scheme of things, the now is what is going to get me to where I want to be in the long run.

Diabetes Game Plan: 2016 Edition

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New year, new me.

Kidding! Don’t even get me started on those Facebook statuses…

Ever since I’ve had diabetes, my New Year’s resolution has obviously centred around (wait for it) diabetes. Eat well, get my blood sugar levels down, maintain a good hba1c result without too many hypos and exercise. Scrap that last one, who the hell am I kidding here!

If I’m being honest here, I feel that for the better part of the last five years, my diabetes management has sort of stayed the same. I’ve chalked up good hba1c results, but they’re extremely difficult to sustain inbetween endo visits. Making a dedicated effort that delivers those sustained results is also hard, especially when there are a million other things going on in life.

But I want to do better than okay with my diabetes. I’ve already been at it for five, going on six years. That fraction of my life with diabetes is slowly, but surely growing. I want to look after myself. I want to minimise my risk of future complications. I want to remain hypo aware. I want to remain independent, and in control of my diabetes. I want to live a long, and healthy life.

So instead of that overall improvement this year, I’m going to strive for stable overnight glucose levels.

Night times over the past few months have never been such hard work. I can’t remember the last night where I didn’t have to wake up at 1am, test and give a correction shot. My last full night’s sleep seems like a lifetime ago. And mornings where I have woken up in range without minimal effort overnight have been rare occurrences.

I also know that it’s been a long time since I’ve had a full, uninterrupted night’s sleep. It’s been a long time since I’ve woken up feeling refreshed. It’s been a long time since I’ve woken up feeling pleased with my morning number, and have that sentiment echo positively throughout my day.

So, perhaps this is an argument in favour of switching to the pump. However, until that decision is made next month, I still need to manage with Multiple Daily Injections.

So, in 2016, I’m making a resolution to focus on the back end of the day. Say, from 4pm to 10pm – the 6 hour window before I go to sleep for the night. In these 6 hours, I will focus on doing as much as I can to not spoil my overnight glucose levels. Staying away from high fat foods. Satisfying my desire to graze on junk food with something healthy. Being patient when testing and correcting after dinner.

I know that I can do this.

I hope that I will eventually return to a point where I have some confidence that my overnight glucose levels will remain stable.

I hope that I will be able to return to a point of getting a full, uninterrupted night’s sleep more often.

I hope that if I can get those overnight levels within range, I will have one third of a stellar a1c result up my sleeve and a lot more enthusiasm in my mornings.

September Goals, Of The Diabetes Kind

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I always tell myself that I’m going to do all of these new things. I’m going to eat healthier, exercise more, get my BGLs down, finish my book and take more time out for myself. It’s so easy to imagine the better person that I’m going to be for it, and I always get swept away at the thought of achievement and success.

If only reality were that simple. I have been absolutely terrible at sticking with goals in the past. And I always get laughed at for the things that I quickly give up or put away, such as the new book on my bedside table every week, or the bike and helmet sitting out in the shed. I doubt that I’ve kept with a single one of my goals in the past. Until now, that is.

One of my personal goals at the beginning of this year was to start a blog. And never in a million years did I imagine what would come from it. For one thing, I never thought that I’d be able to keep at it for so long. Or that I would enjoy writing it so much. Or that people would actually read it. I never thought that I would actually become interested, or dare I say passionate, about diabetes. I never would have guessed that there was a massive Diabetes Online Community out there, and that I would have friends all over the world because of it. And I never would have imagined writing an advocacy column for Insulin Nation that was noticed by Diabetes Australia and resulted in a small policy change.

Today, setting some new goals finally seems realistic. And I actually have some confidence in myself that I might achieve them, or at least give them a red hot crack.

Return to good overnight blood sugar levels

I enjoyed 2 weeks of waking up to perfect blood sugar levels, and it was honestly the best feeling in the world. I woke up with so much positive energy and enthusiasm to go about my day, and I would love to return to that.

Set some social media free time

I heart the DOC. It’s the best thing that’s come from having diabetes, ever. But I do feel that it has gotten to the point of being a little overwhelming and time consuming. I would love to get into a routine of switching off before bed. I feel a lot calmer and happier when I make time for myself, and sleep easier.

Finish my book

A year ago, I eagerly trekked into the city to grab a copy of Under the Dome by Stephen King, yet I’ve lacked all motivation to read it. I picked it up again a few weeks ago, and I’m now more than halfway through.

Be more positive

I would love to be a little more positive. I often curse, complain, sigh and let the frustrations that occur throughout the day get to me. I would love to be able to just shrug them off and see more positives.

Read more diabetes blogs and interact more in the #DOC

I kind of feel guilty that I write a diabetes blog, but don’t read as many others as I’d like. I also feel guilty for all the support I receive from the #DOC but don’t return back. I’ll often spend time crafting a response to a tweet or blog post, overthink my comment, and then end up deleting it. I need to just go with it!

Write another column for Insulin Nation

I wrote a fantastic piece for Insulin Nation in July about access to test strips in Australia. It triggered an overwhelming response and was one of my proudest advocacy moments. I’d love to come up with another story as well written as that one, and I know that they would love to have me back to write for them again.

It goes to show that you should dream big. If you believe in it, others will see it.

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Be Realistic, But Don’t Settle for Satisfactory

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How do you feel about a hba1c target of 6.5%? Chatter among the #DOC this week has been circling the new NICE (National Institute for Health and Care Excellence) guidelines for people with diabetes in the UK. I initially felt quite reactive to this like many others on social media, however some rational thinking has softened my view.

In Australia, I’ve always been told that I should strive for a hba1c of between 6 and 7%. That hasn’t changed in the 5 years that I’ve lived with diabetes. During that time, my hba1c has plummeted due to frequent hypoglycemia, it has gone up due to burnouts and it’s also fallen within the satisfactory range. And I can tell you from experience that a satisfactory hba1c level is extremely difficult to maintain while trying to live an active and ever changing life.

My main concern about this suggested target is that each and every person with diabetes is different. And we all have our own unique circumstances surrounding our diabetes. There are children, teenagers and adults living with diabetes. Some of us are newly diagnosed, while others have been living with it for several years. Some of us have a parent or carer to help us manage diabetes, while others do it on their own. Some of us are content with where we are at, while others are fine tuning and making room for improvement.

So, in that respect, a stock standard number for the masses is certainly not a one size fits all approach. That number will be easily achieveable for some, and completely unrealistic for others. That number is going to set some up for success after success, and others up for repeated failure. And while a number is a great means of motivation and goal setting, it isn’t always a true reflection of the hard work and effort we’ve put in to managing our diabetes.

On the other side of the argument, Mike at Everyday Ups and Downs points out that the lower target is a way of encouraging us not to settle for something satisfactory. I’ve been really excited at seeing borderline acceptable hba1c levels in the past, only to be told by doctor’s that it should be lower. My response at the time was more than dismissive, but looking back at it today, I finally get it. I should strive for a lower number if it’s a realistic goal for me, as it will further reduce my risk of complications in the future.

Mike also suggests the 6.5% target is a way of making doctors more comfortable with seeing lower hba1c numbers in patients. It’s news to me, but apparently some non-hypoglycemic patients are told that their hba1c levels are too low. Crazy!

So, what do I think of all of this? Don’t pay too much attention to what’s in the media or to others. Set your own goals that cater to you and your diabetes situation. Make them realistic. Have a team of people around to cheer you along. Take some time to relish an achievement, and then move the goalpost a little further back. And remember that nothing is impossible if you put your mind to it.

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