#584 Diabetes Variables: Walmart

November 26, 2021Scott Benner

Diabetes Variables: Walmart

Scott and Jenny Smith, CDE share insights on type 1 diabetes care

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Scott Benner 0:00
Hello friends, and welcome to episode 584 of the Juicebox Podcast.

Today, I have a brief diabetes variables episode for you with me and Jenny Smith. I'll be getting to it in just a few moments. Before I start, please let me remind you that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan are becoming bold with insulin. if I'm remembering correctly, there's three more variables episodes left, and then they're done. Took all year but I thought it was a really good idea. And I hope you enjoyed it. For today, I have one for you that is very real, and yet may be misunderstood by some people. My friend Jenny Smith has had type one diabetes since she was a child 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 and most make some models of insulin pumps and continuous glucose monitors. I don't usually put so much effort into timing the episodes, but this one's for Black Friday.

This episode of The Juicebox Podcast is sponsored by trial net. And trial net offers type one diabetes risk screening at no cost to relatives of people with type one diabetes, you can sign up right now at trial net.org. Forward slash juicebox. I don't know if this is just a thing from online. But how many times have you heard someone with type one diabetes say that Walmart makes their blood sugar? Go low? Yeah.

Jennifer Smith, CDE 2:03
Or any really I mean, it doesn't have to be that brand name place. But yes, but absolutely. But

Scott Benner 2:10
online. It's it's a moniker right? I went to Walmart, my blood sugar, I'm on my way to Walmart, I know my blood sugar is going to get low. Okay, so is it as simple as people are maybe sedentary in their day to day life. And now all of a sudden they're up, they're moving around, they're driving, they're getting out of their car, they're walking through the parking lot. They're walking through Walmart, they've added activity, probably with an insulin on board that's meant for sitting around.

Jennifer Smith, CDE 2:37
That's the simplest explanation of anything. Yes. I mean, that's it's not rocket science, quite honestly. And it's, it's longer term lingering. It's not that you for the most part, people aren't running in and getting batteries at Target. And then they end up back in the car. And then they're low. That's this is like, Okay, I'm planning you know, the trip to Walmart or wherever it is. And it's a trip, it's you're doing your errands, you're getting things done, it may not just be there, you may also be going to the grocery store, you may love be lugging bags and think of I mean most big places like a target or a Walmart these days, or not just go in for like underwear, right? They are like the super targets. They are the stores, you can buy your water jugs there. You can buy gigantic things of totally lit paper, or whatever it is. So you might be doing a little bit more activity than just walking around popping things into your car

Scott Benner 3:39
doing a bit of an excursion. You're lifting things. You're right. Yeah, maybe you're doing the like, Oh, let me look at the shower curtains before I go buy milk because it's all in place. And you're humping around. And then you get low at Walmart. All right, correct.

Jennifer Smith, CDE 3:55
Yes. And, you know, quite honestly, if you're a parent of a child, and you're the person with diabetes, and your children are young enough that they won't sit in the cart anymore. And then they're running around and they're in between all the aisles. You're not only putting things in your cart, you're now chasing around a lot more in terms of, you know, activity.

Scott Benner 4:17
It's it's interesting that anecdotally, I mean, I understand that it's joking for the most part, but then you do see a couple of people say very earnestly, like Walmart makes me low. Like they like they don't see it as well WalMart where I shop, it's not Walmart, it's this is where I'm going shopping, and they don't make the connection between the exercise. And the thing like it's such a weird A B that the people's minds have some time

Jennifer Smith, CDE 4:44
right it's just it's the store right? It's the stores fault that I went low. I mean, it's it's funny because quite honestly, I mean everybody in terms of like, nobody's perfect with diabetes. And myself. I have had to like grab a bag Have like gummy bears the middle of target shopping because I was like, I started out fine. I planned that, you know, like all the things that you would plan knowing what was coming. And it still didn't work out the way that you did. And now with, you know, like wearing masks everywhere. Now it's like popping them under the mascot. It looks like you're chewing on something. But she doing like, you know, the fun stuff.

Scott Benner 5:24
I mean, Arden was younger. And I didn't have quite a grasp on this. This would happen to us and I never get back then I didn't have to and to to even put the I didn't even know what to into was let alone right. I couldn't add them up, you know. But it would be interesting that if she got low in a public place where they sold food, and you grab something off the shelf, she was too low to be okay with. She felt like she was shoplifting the food. Right? I wonder too. If that happens if people's mind start going down weird paths, like I can't eat this. I haven't paid for it. I'll go pay for it first. Like you ain't got time to pay for it. Like explain it to the security guy. Yeah, you know, when he catches you down in the Gatorade, and I'll 16

Jennifer Smith, CDE 6:05
Yes, I mean, those are all my internal monologue. I could care less if you're gonna ask me why I'm eating gummy bears right now. Have at it. I got a whole load of stuff to talk to you about. So don't bug me.

Scott Benner 6:16
I'll pay for it. Calm down. Yeah. But But it happened to her more than a couple times where she's like, I can't eat this. I haven't paid for it. Oh, Arden. That's sweet, honey, you're just gonna eat it. And we're gonna pay for it afterwards. It's fine. You know, I think because if we wait, and now I'm explaining it like now and you have to remember to back then probably no CGM. I just got this little I'm looking at this number on this little freestyle meter, you know, and I'm like, Oh, honey, we'll pay for it later. Eat the food. Eat the food. Eat it, just eat it. Right, right. Because there's that other thing that happens to her too when she if she gets too low. She goes, I don't want juice. And I'm like, But juices the thing that works the best right now liquids, the thing that works the best right now. And then she starts turning into a food connoisseur. She's like I would prefer to have and I was like, yeah, no, not right. Now. If you eat that, you know, you're gonna pass out before you wake up. So can we get to it, please?

Jennifer Smith, CDE 7:11
Right. That's the point at which she's like, I'd rather have a boiled egg Daddy, you're like, No. Yeah. Oh, my gosh.

Scott Benner 7:17
She once said to me, can I get avocado toast? And I was like, as soon as we're done fixing this low blood sugar, you can now write avocado says great.

Jennifer Smith, CDE 7:27
But as a variable. I mean, you're right. And in terms of like, it just takes planning. Like if it's if it's commented on often enough, clearly people know that when they're going to go out whether it's grocery shopping, or Walmart or wherever. You're going for it. Yeah.

Scott Benner 7:44
Well, let me let me ask you a question as a person with type one your whole life basically. What is that mechanism there that makes the idea of Pre-Bolus thing so difficult or setting a Temp Basal to go grocery shopping? Or, you know, like, I mean, I mean, how many people stand up randomly at 1115 and go I'm going grocery shopping right now. Like you don't think you're you at least know you're going grocery shopping today. Right? Like, set a Temp Basal if you get low at the grocery store,

Jennifer Smith, CDE 8:13
right? Or if you don't, if you can't think that far ahead. Again, if it wasn't really a plan, you're driving and you pick up your kids, you're like, Oh, I really needed this at the store. So and then you stop off. Okay, fine, unplanned but at that point, then you know, what's going to happen? Yeah, so take a snack. Right?

Scott Benner 8:34
Like have some sort of like stabilizing snack before you leave or something. Right. Yeah, I actually it's funny you said like that, because what I was thinking was that somebody recently I asked what episodes of the podcast are really helpful and she's like, she said, trust the trust episode. It's called trust what you know is gonna happen it's gonna happen. And that's what I wrote about like, I mean, how many times you have to get low at Walmart before you go. I got to do something about this. I'm going to Walmart can't possibly be Walmart's fault.

Jennifer Smith, CDE 9:03
Hey, or maybe you plan your Walmart trips around the around the fact that when you're high, I have to go out the door. to Walmart,

Scott Benner 9:11
you see your blood sugar 180 Diagonal up. You know what, it's time to go grocery shopping. That's right. There you go. Hey, what's up everybody? I'm going to explain TrialNet to you in some detail. As I mentioned before, trial net does type one diabetes risk screening at no cost to relatives of people who have type one diabetes. Here's who's eligible, immediate family members under the age of 45. And second degree, family members under the age of 20. I'm going to break that down for you. If you're between two and a half and 45 years old, and you have a parent brothers Sister or child with type one, you are eligible for trial.

If you're two and a half to 20 years old and have an aunt, uncle, cousin, grandparent, niece, nephew or half brother or sister with type one, you're eligible. If you've tested positive for auto antibodies outside of trial net, you are eligible for trauma. Okay, now that's who's eligible. Now I'm going to tell you how to sign up. You go to trial net.org forward slash juicebox, you'll answer a couple of quick questions, make sure that you're eligible for testing. And then you can join 1000s of t one D families on the pathway to prevention. Here's how you get screened three ways. They're all simple trial that can send you an in home test kit. And this kit will provide you with everything that you need to collect a finger stick blood sample from the safety of your own home, and return it using FedEx contactless pickup, the second way you could do it is to get a lab test kit, then you could take this free screening kit to any Quest Diagnostics lab, or lab core lab for a blood drop. And the third way is if you live near a trial net location, you can go there to have the blood trial done. After that, you just need your results. And they'll take between four to six weeks to get to you. If your results show that you are in the early stages of type one diabetes trial net, we'll schedule a follow up visit to see if you're eligible for a prevention study. You may be asking yourself, why would I want to know if I or a loved one have these antibodies? Well, type one family members are at a 15 times greater risk to develop T one D than the general population. T one D risk training will detect if you are in the early stages of type one diabetes. If you are identified as at risk trauma will be there to help you. They have prevention trials. If your screening results show that you're in the early stages and type one, you may be eligible to join Prevention Study. It's testing the ways to slow or stop the disease progression. There's also ongoing monitoring by top type one diabetes researchers in the world. And if you develop type one, being monitored in a clinical research study like trial that decreases your chances of DKA from 30% down to three. So there you go. All of that absolutely free to you. A future without type one starts with you. Research can only advance with participants, the more participants who are involved in clinical research, the faster we'll get our answers. So you're in a unique position to identify treatments that will slow or stop type one from happening for you or a loved one and helping clinical research that could help everybody. In the last 20 years trauma has been the leading network and type one diabetes prevention research. In addition to being able to accurately predict who is going to develop type one trial that has now found a way to delay it by leading it to Ms. apoB prevention trial to miss aplomb is the first drug to delay type one diabetes for a median of two years. Trial net.org forward slash juicebox when they ask you where you heard about them, say the Juicebox Podcast and when you get your kit, you have to complete it and send it back in order for the podcast to get credit for you. Trial net.org forward slash juicebox Alright guys, so like I said there's a couple of more variables episodes coming up. But they began back on episode 491 With trampolines after that there was temperature, travel, exercise hydration, food quality, leaky sites or tunneling video games stress masturbation school, bad sites, growth hormones, sleep pump site placement, a full moon weight change this one today, Walmart and there's a couple more coming before this series wraps up for 2021 I hope you've enjoyed it. Go back and check out the ones that you might have missed. They're all available at Juicebox Podcast comm we're right there in your podcast player. I'm putting this one out specifically on Black Friday in case you're out there in the thick of it trying to get yourself a cheap TV or something like that. Just wanted to have this one for that. There's also a diabetes pro tip episode of episode 231 all about variables. If you don't know what the diabetes pro tips are, you should check them out at juicebox podcast.com or diabetes pro tip.com A pro tip series begins at episode 210. Hey, thanks so much for everything. You guys are absolutely terrific the way you listen download, subscribe, share the show with other people. The support is amazing. To be very clear with you the week of Thanksgiving is normally one of the slowest downloaded weeks, all year and yet this year, I didn't even notice a slowdown. I was really touched Honestly, I know there are a lot of things you do with your time. You're busy. You could be doing anything and listening to anything. And the fact that there was no downturn this week. I mean, it really blew my mind. I really appreciate it. Seriously, this is the end of the seventh season of this podcast. And to think that it's on the uptick is, it's just mind bending to me. I really love you guys. I appreciate your support. I'll be back very soon with another episode of The Juicebox Podcast. Happy Thanksgiving. To those of you who celebrate. And to the rest of you. I hope you enjoy your Thursday. Oh, that reminds me, the private Facebook group Juicebox Podcast type one diabetes right now it's really late on Thanksgiving night. While I'm doing this. Don't ask why I didn't do this sooner. I messed up. It's just full of people celebrating and sharing their graphs about how they handled Thanksgiving. Some people had some tough times. If you want to see great examples of how people Bolus for a big day full of food. You should check it out. Juicebox Podcast type one diabetes. It's a private Facebook group with now I think over 17,000 members. It's absolutely an amazing place to either watch other people talk about type one management and living with type one, where to get involved yourself and have one of those conversations that you need to have