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Scott Benner 0:00
This episode of defining diabetes is brought to you by Dexcom Omni pod. The Contour Next One blood glucose meter and touched by type one. Please visit touched by type one.org dexcom.com forward slash juicebox. My omnipod.com forward slash juice box or Contour Next one.com. To find out more about the sponsors. In this episode of defining diabetes, Jenny Smith and I will be defining feeding insulin. Now, you know Jenny, she's in all the pro tip episodes and defining diabetes and ask Scott and Jenny. She's also a person who's been living with Type One Diabetes for over 30 years. Jenny holds a bachelor's degree in human nutrition and biology from the University of Wisconsin. She is a registered and licensed dietitian, a certified diabetes educator and a certified trainer on most makes and models of insulin pumps, and continuous glucose monitoring system. Jenny services are for hire, check her out at integrated diabetes.com.

We're gonna get started in just a moment. But before we do, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical more. Otherwise, please always consult a physician before making any changes to your health care plan. or becoming bold with insulin.

There are people and I am not bothered by it. I'm just telling you there are people who come into the podcast as new listeners who if they hit the right episodes, once they get through an episode where you're not on it. They're like, Where's the woman go? No, no, I'm like, No, I understand. And like she's on these and these knees. And they're like, Okay, I get it. Like I got a note one time, please. Like, I don't understand where did Jenny go?

Jennifer Smith, CDE 2:01
Still here, I was like, Jenny,

Scott Benner 2:02
Jenny records podcasts like, like, she's tanning. Like, she's canning vegetables, he just makes a bunch of them, and then brings them out when she needs them.

Jennifer Smith, CDE 2:11
I feel like people think that I like live in your closet.

Scott Benner 2:15
Let me get Jenny Hold on a second.

Jennifer Smith, CDE 2:18
There she is right over here.

Scott Benner 2:19
There you go. Ask me your question.

I use this phrase. And in my mind, it paints a tapestry of idea. And I hear back from people and they'll say like, I don't understand what you mean. So. So I use this a lot. I say feeding insulin. So you know, I'm like, oh, you're feeding the insulin. And that apparently doesn't make sense to some people. So when I use that phrase with you, what does it make you think of?

Jennifer Smith, CDE 2:56
Yeah, feeding insulin means that you're having to actually, I guess on a negative side of feeding insulin, it means that you're putting in food to compensate for there being an excessive insulin that shouldn't be there. Right. So whenever you're feeding insulin, especially, and that's something it's a term I use when I'm talking to people about weight management. Because if you're constantly adding extra food, because insulin is driving your blood sugar down, then there's a problem. there's a there's a balance that's off, you're getting too much insulin from somewhere, whether it's bazel, or too much bolus or whatever, and you're constantly having to put food in to avoid drops. I'm now on the positive of feeding insulin. I mean, that's what we do. We we feed insulin with the carbs that we put in, but hopefully there's a balance there when we're feeding insulin that way. So and if you find yourself feeding insulin too much, you can you'll have weight issues. Yeah, that wrap around that too. And we talked about that a lot. The idea that because you have type one diabetes, and you're using manmade insulin, food seems like medicine. And so you stop thinking about it as calories where you know, sometimes, I mean, don't get me wrong, you know, in the moment, when you're falling, don't don't hold up Skittles and go, No, you know,

Scott Benner 4:12
a moment on the lips, a lifetime on the hips, don't think that think oh, I want to stay alive and eat the Skittles. But right, the idea is to not have to feed that insulin. So if you want to get a look into my mind for a second, there's gonna be an old reference, I guess. But if Pac Man is insulin, and the dots are glucose, you don't want Pac Man to have energy when the dots are gone, because he's gonna turn on you and bite your face. Right? Exactly. And he needs to have more dots until until he's done. And so, but there's ways to reverse engineer that idea as well. And I don't think that people would think about it this way. But I think I just created that situation with Arden just now. So by way of an example, she gets up in the morning, she still goes Going into school at home. And it's the end of the school year, she has to return her books to school. So she she leaves the house, Kelly takes her. And I don't know if she was excited or not, I don't know. But her blood sugar was sitting around 110. I was recording a podcast earlier today. And I told her, I'll make you breakfast when I'm done. So she left the house and the 110 went diagonal up and it went 115 120. You know, it kept going her auto bolus started bolusing at it from the loop and it leveled off at 140. Then she gets home and she's hungry. And so we bolused for the 40 points plus her meal. And we're going to create a fall that happens. And we're going to in essence, feed the insulin to stop the fall at a level number. And so there's, that's there's a positive way to think about it. I think when I use the term in public, or in my mind, I don't think of what I just did is feeding the instant I think of it as Pre-Bolus saying and timing the food instead of timing the insulin. Does that make sense? Okay, yeah,

Jennifer Smith, CDE 6:11
absolutely.

Scott Benner 6:13
Absolutely. But when I generally save, you know, you're feeding the insulin, my intent of that is to say, hey, it's possible, your bazel is too high. Because I you see, you find yourself feeding your insulin I when when people show me a graph, and it bounces. My first question is always, are you stopping highs with insulin on this graph a lot or stopping lows with food a lot? Right? And that moves me towards too much bazel or not enough? bazel? It's my first question. So anyway, when I say feeding insulin, or when you hear somebody saying that, I think that is a complete explanation of what I mean by that. Do you

Jennifer Smith, CDE 6:50
know, absolutely. And I think you know, when you talk about it in terms to have, like that weight management piece of it, I was just, I just worked with somebody who she said, You know, I feel like I'm eating more normally now. And I don't feel like I'm eating as much. And I'm actually feeling more. She called it real appetite. And I said, That's right, when we adjust your, your baseline levels of insulin the right way, technically, and she's not using loop. She's just normal conventional pumping, right? So um, you know, when she gets hungry for a meal now, she knows that she's really hungry. That it's not because her insulin is telling her, Hey, there's too much of me here, like your Pac Man example. Yeah, I need more food. Please put more in. So now she has more real understanding of what appetite feels like, rather than just insulin appetite.

Scott Benner 7:50
So I realize I'm just asking you, and it's your personal experience. But is hunger? Because you're low? Does it feel different than hunger? Because you're hungry? Where is it the same feeling?

Jennifer Smith, CDE 8:02
To me, there is a definite difference, like from my personal experience, and I think everybody might be different, but I can tell the difference. When I have hunger from being low. It's more, it's much more ravenous. It's, I need food now. And it's definitely like, I don't want to sit down and eat a nice salmon fillet and a salad hunger. It's, I would like to eat the whole entire, like container of glucose tablets, which we know it doesn't taste very nice. Yeah, right. So it's, I would say it's definitely more of you need something now. Whereas if I've, like skipped a meal, because I've been out in the yard gardening through like lunch hour or something. I can tell by the time I get to like the mid afternoon, even if my blood sugar has stayed normal, you know, hopefully has stayed normal through that time. I am. I'm hungry, right? Like I can tell the pit of the stomach kind of hunger difference from a low blood sugar. It's an it's a more now craving.

Scott Benner 9:06
I figured that out first. It was a time of day thing when Ottomans say she was hungry at like 930 at night. I'm like, she's not hungry. What is that? And then inevitably, in the next 20 minutes, her blood sugar would start to fall and I was like, Oh wow, she's feeling the drop before it's happening. And it registers this hunger for anyway, I think it's funny. It's the two small words but I think feeding insulin It teaches you a lot about how to use it you it is not your goal to be doing that. And and if you find yourself doing it too frequently, it is very possible that either your basal insulin is too strong or you're over bolusing it meals and creating Lowe's later you should not I know that seems obvious, but I don't think it is that people once they get caught in the in that little Have, I'm always low and I'm feeding, they get to that feeling of like, this is just what my diabetes is. But it doesn't have to be that way.

Jennifer Smith, CDE 10:06
Right? Especially with today's very smart, smart technology that we have to use, you know, years ago, when I was diagnosed, you did actually feed the insulin, because that's how the insulin works. And you know, your, your intermediate cloudy insulin, it peaked at a certain time. So you had to eat a meal and a snack at a certain time in order to coincide with when it's action kind of was there. Today's insulin, even though it's not as rapid as we want it to be.

Scott Benner 10:34
That's not as necessary.

Jennifer Smith, CDE 10:35
It's not as necessary. Yeah. So

Scott Benner 10:38
I, I hear that. Okay, thank you. Hey, here's some quick contact information for the sponsors. If you're interested, to get the dexcom g six continuous glucose monitor, you're gonna want to go to dexcom.com forward slash juice box, and hit the button that says get started with Dexcom JSX. It's just that simple. If you get there and you want to read a little bit, definitely check into it. Zero finger sticks, customizable alarms, and alerts, smart device compatibility with Android and iPhone, the ability to share data, or data, this depends on where you live in the country or the world. Although right now, some people are like it's data, or data, you're fighting with each other, but you're just fighting with the voice in your head. So don't do that. You can any anyway, no matter how you say you can share that data with up to 10. People, it's amazing, right? Your kid could be at school being tracked by their mother, father, grandmother, school nurse, or just a friendly guy, you met up the street, you're like, Hey, you want to watch my kids blood sugar. I mean, if you're, you know, if you're a hippie, you might do that, although do hippies have cell phones, I don't know, it's not for me to judge. Anyway, dexcom.com forward slash juice box, you're also going to want an omni pod tubeless insulin pump, that you're going to get my Omni pod.com forward slash juice box. And on the pod has quite a little deal where they'll send you a free, no obligation demo of the AMI pod to your home so that you can wear it and check it out. I've worn it on the pod demo before. It's astonishing how quickly you forget you're wearing something. And you'll really get a feeling for what it's gonna be like to have a tubeless insulin pump, right, just this little device that's with you, and nothing else to clip to your belt or stuff in your bra or do anything like that with and there's no obligation. So I mean, if it doesn't cost anything, and they're not holding you to it, you might as well give it a try my omnipod.com forward slash juice box. And of course, if you go to Contour Next one.com there's a button at the top of the page to see if you're eligible for an absolutely free blood glucose meter. And I have to tell you a little more context now because at the moment, I'm wearing a Dexcom Pro to get the feeling for it. You'll hear me talk about that later. But because I'm doing that I'm testing a lot. So not just with Arden, but I'm testing myself to get a feeling for you know where the CGM sitting with accuracy. And all that stuff that I've been telling you has been my experience about using the meter with my daughter goes double for me. Small, convenient, accurate. pocket size. It's great, the light works great at night. And trust me My eyes are you know what I mean? And I what they used to be Contour Next one.com and of course, touched by type one, please, please please go to touched by type one.org to check out the good work that these amazing people are doing. For children living with type one diabetes, and people with type one diabetes in general. They raise money to support a cure. They put on all these kinds of great programs to support the community. You can be part of it touched by type one.org. We're just gonna tell you one more thing before I go short episode today. So today we defined feeding insulin. But there are many other defining diabetes episodes. It starts way back in Episode 236. And some of you are going to say Look, I know what Bolus says Scott, I don't need that episode. But you'd be surprised about how many new people with type one diabetes don't. So Episode 236 is Bolus 241 honeymooning 245 time and range 247 standard deviation 249 extended Bolus 251 algorithm 253 non compliant 255 glycemic index and glycemic load 258 Pre-Bolus 260 Trust will happen to 69 low before high to 84 brittle diabetes 286 stop the arrows 288 ketones, 295 insulin resistance and overall singing Of course today Episode 344 Feeding insulin. And there are many more on the way that was all very confusing to you, you can go to Juicebox podcast.com and scroll down. All of the episodes are there. Actually the Ask Scott and Jenny episodes are there as well. And the diabetes pro tips and of course, all this is condensed way down at diabetes pro tip comm if you want to check out the pro tips, we're share them with somebody. That's diabetes pro tip.com.

The point is at the end of tip, see what i'm saying diabetes pro tip, there's no s. No s at the end of tip. It's just tip, and then the dot and then the calm. That's my tip for you today about how to spell diabetes. Perfect. Thank you very much to Jenny Smith for coming on the show as she always does to help us understand terms and ideas. bigger, more vexing Type One Diabetes issues. She really is the best Asus there is an S at the end of best assist, but not at the end of diabetes pro tip calm. I mean the English language is funny punctuation right