#269 Defining Diabetes: Low Before High
Defining Diabetes: Low Before High
Scott and Jenny Smith, CDE define the terms that are at the center of your type 1 diabetes care.
Bonus content from Pro Paddle Boarder and Windsurfer, Fiona Wylde.
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About Jenny Smith
Jennifer holds a Bachelor’s Degree in Human Nutrition and Biology from the University of Wisconsin. She is a Registered (and Licensed) Dietitian, Certified Diabetes Educator, and Certified Trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. You can reach Jenny at jennifer@integrateddiabetes.com
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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Defining diabetes is made possible by in pen from companion medical. Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. And Always consult a physician before making any changes to your healthcare plan or becoming bold with insulin. You're about to hear a snippet of an interview that I've just completed with Fiona Wylde Fiona is a 22 year old professional wind surfer who uses the in pen. So you're gonna hear that little snippet right now. And then Jenny and I are going to come on and define a diabetes term. When Jenny's finished spreading her diabetes wisdom, Fiona will be back to tell you something about the pen that I bet you don't know. To be honest with me, I'm 48 years old, how far would I paddle before I had a stroke? Or an aneurysm? Couple of feet? A couple minutes? How far do you think I'd make it
Jennifer Smith, CDE 0:49
go as far as you want to go? That's the cool thing is that, you know, it doesn't really matter. You Don't you know me, okay, if you were to, you know, jump off the start line and try and go sprinting, you'd probably be out of breath kind of soon. But you can jump on a board, you can go with your friends, your family, if you have a dog and put your dog on the board go cruising around, like, there's all sorts of different things you can do. It's like, it's like a bicycle, you know, you have your people who go out and ride 100 miles, you know, in the weekend, and that's what they do for fun. And then you have some people who have cruiser bikes, or even a bikes that you know, put a picnic basket on the front and go, you know, cruising around paddling is the same in that sense. Like you can, you know, have top line race equipment, go, you know, for speed, or distance, or whatever. Or you can just grab more of a Cruisee board and go have fun, go exploring, maybe you know, paddle into a different place that you've never seen before. Or it's cool to paddle out and look back at what you're looking at every day, and just get a different perspective.
Scott Benner 1:51
I see you're saying this is where people like you who are super athletic, don't understand that other people don't have brains. Like here's your saying I would paddle out to get a different perspective, which does sound neat, except I would paddle out and then have a panic attack that there's no way I can make it back again. Then I would start imagining what giant Canadian fissure in the river that will keep my body when I sink to the bottom. Like that's, that's how it would occur to me.
Jennifer Smith, CDE 2:15
Well, yeah, that just crossed my mind.
Scott Benner 2:19
Wouldn't it be great if if Fiona's entire career was killed today? She can't get over the anxiety of thinking about whether or not salmon could eater? And she's like, I never thought of it before. I can't go back and
Jennifer Smith, CDE 2:33
yeah, okay. Yeah, I'll be alright with that.
Scott Benner 2:37
So first of all, it's amazing. And you said something a while ago already that I jotted down and I don't make a lot of notes and I do this. But did you say that there was a paddleboard race? That was 13 miles? Yeah. Okay, so when when they say go, first of all, I have questions. Does everyone finish you starts?
Jennifer Smith, CDE 2:59
I'm pretty much in the Elite Field. Yeah. Okay. In the open field, there might be a couple that pull out. But it's just, it'd be more like a marathon in that sense. You know, it takes a while. Some people, some people, you know, don't, maybe some people just get tired or fatigued. And then yeah, you have to pull out from but for the most part, and especially within the Elite Field, pretty much everybody finishes,
Scott Benner 3:25
how long does it take to go? Like, like the person who wins? How long does it take them to go 13 miles.
Jennifer Smith, CDE 3:33
With that particular race, too. That's the other thing with water, it all depends on the conditions. If you have 13 miles with wind at your back, and you're going where we call downwind, which you can kind of surf little bumps that the wind is generating the whole time, you're gonna go a lot faster than if you have a headwind or completely flat water. So it depends, but in that specific race that was in North Carolina, around Wrightsville Beach, and that was about a two and a half hour race.
Scott Benner 4:03
So I'm gonna tell you that I'm not 100% certain I could stand on the board for two and a half hours. Like, take all the rest of it.
Jennifer Smith, CDE 4:09
Oh, there's a lot of training. I'm not kidding. Like,
Scott Benner 4:13
your legs like super tired.
Jennifer Smith, CDE 4:14
Your legs are exhausted. Yeah, most people think that all paddling comes down to you know, your arms and your shoulders and all that but there's so much balancing involved, and your legs are bigger muscles, you might as well use them more. So by the end of it, my legs are shot.
Scott Benner 4:33
Jenny and I are going to define a term from the podcast right now. And after that Fiona is going to tell you something else about the impact. I am now going to ask Jenny to define something that's not a real term, right. It's something that was made up on the podcast. So you hear me say a lot that I have these kind of like tenants these ideas that I use day to day while I'm helping Martin with their blood sugar. And there's a bunch of them but I'm now just going to blurt one of them out. And then let Jenny define it from her perspective. So what does that mean to her when she hears it? Because maybe she can add more clarity to it than my oversimplification. So where do we want to start? Because there's a lot of them, I'm going to start with, you'd rather stop a low or falling blood sugar than fight with the high ones. What does that mean to you?
Jennifer Smith, CDE 5:29
Overall, it means that it is, it's easier to navigate carbs in to stop a drop, or to treat a low. For the most part, there are some sticky lows that are sticky and nasty to bring up. But for the most part, a stopping a low or treating a trend down can be easier because carbs work faster, then if you're already high, and at a deficit of insulin, a deficit of insulin is always it's like you're behind the track your way at the end of where you need to be. And so you have to play catch up. And playing catch up takes time, because our rapid acting insulin today is not quite the term rapid it takes time. So it's it's easier even though we've been schooled in this like, fear of insulin kind of thing, because oh, it can cause a low blood sugar lows are easier to treat. And to prevent further dropping, then trying to correct for a high that's rising really fast or stuck high. For some reason.
Scott Benner 6:56
This This to me, I started with this one because this is my getting up in the morning. Thought I'd rather stop a low or falling blood sugar than fight with a high when it has to be your mantra every day I it's there's times it's hard because it feels it can be feel exhausting in the beginning, you know, before you really put all the pieces together and it kind of gets easier. But I partly believe that that's where the idea of being bold with insulin came from me like I thought to myself one day like I just have to be bold and do this. And think bold with insulin. I wasn't thinking in T shirts back then I was just thinking about how to get
Jennifer Smith, CDE 7:30
through the day. Right? But or magnets or whatever,
Scott Benner 7:34
answer buttons, it depends on where you see me. But But no, seriously, like, I think that's at the core every day, like you have to just be in that mindset. Because when you do that, yeah, sure, you might have a couple lows. But I'd rather have a couple of lows a month and have 27 days of good blood sugar's then have you know, 27 days, you know, crap, blood sugars, and three lucky days where it actually works out for reasons I don't even understand. Okay, this is going to be really interesting. We're going to do more of this the next time we talk because I like Oh, I like hearing you can have fun. Tell me what I think you're in Penn app has information from your Dexcom on it. So you open up your M pen app, it knows what your blood sugar is because of your Dexcom do you then just tell it this is how many carbs I'm thinking of having and it tells you it's suggested amount of insulin?
Jennifer Smith, CDE 8:28
Yeah, so I've set prerequisites of okay, you know, this is my carb ratio, and this is what I'm planning on doing. And it'll Yeah, you pretty much put in, you know, how many carbs that you want to do and want to eat? And then you give yourself, okay, you know, it's suggesting this amount of insulin, you're like, Alright, I think that's about right. Or, you know, maybe I'm gonna have a little bit more food than that. So I'm gonna give myself a little bit more. But it's nice, because you can, you know, you can think of okay, what, what do I want to eat? You know, how many carbs are in it roughly. And then it's nice, because I would normally just be like, okay, that for me, that's this amount of units, whereas using that, it definitely gives you more precise. You know, just give me a more precise number of like, no, if you're not, you actually need more insulin than that you're gonna go high. And so that's been a that helps me kind of alleviate a lot more of the like, big swings of up and down.
Scott Benner 9:22
That's excellent. But yeah, that's one of the major things that's missing when you're injecting really, right. Yeah, that whole piece of it plus now. So now the pen app knows how much insulin is on board. So in the same situation, except say you've had a I don't know say you had a snack at 11 o'clock and you gave yourself some insulin now it's just an hour and a half later and you're going to have a meal. We you put in your you know, I'm going to eat 40 carbs. It takes into account the insulin still left from the snack and it gives it gives you a different dose. If that insulin still active, yeah, my gosh and how valuable do You find that information?
Jennifer Smith, CDE 10:02
Well, for me, it's huge. Because, you know, a lot of times I, you know, it's easy to just look at a meal and be like, Okay, that's, I know how many carbs are in here. And that's how much insulin I'm gonna eat. But it's harder when it's like, okay, I already gave myself some insulin for food a little while ago. And I don't necessarily know how much you know, insulin is left or how much has been absorbed. And so then you end up stacking insulin. And for me, well, for anybody really, I think stacking insulin is one of the things you want to try and avoid the most.
Scott Benner 10:34
Now, you do not want to have more insulin than you need in your body, that's for sure.
Over the next several weeks, you'll be hearing a lot more from Fiona. I'll be sharing with you small clips from her interview with me which will go live at the end of this little, this little thing we're doing here with companion medical. And she's going to be sharing tips about how she uses the N pen at the end of these episodes, so you can check them out at companion medical.com But there is of course links in your show notes of your podcast player. And at juicebox podcast.com. I'm not gonna lie if you go through those companion medical No, you're coming from the podcast, which would really help. Hey, you can check Fiona out on Instagram at Fiona underscore wild and wild is Wyl de there's also a link in your show notes for Fiona's Instagram account. She does some pretty amazing stuff for a human being, especially considering she's doing it on a piece of what appears to be Styrofoam over a giant body of water. Thanks so much for the recent reviews that you guys left on iTunes. They were completely sweet and wonderful. Hope you're enjoying the Juicebox Podcast. I hope you've checked out the private and public Facebook groups. And of course, follow me on Instagram at Juicebox Podcast. Thanks so much. Have a great weekend. I'll see you next week
Jennifer Smith, CDE 12:06
Hey, this is Chantel Wilde and the Juicebox Podcast is super crazy.
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