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Scott Benner 0:00
Hello friends and welcome to episode 677. It's a short one, but it's good

Hello, everybody on this episode of The Juicebox Podcast, Jenny Smith and I will be defining hyper and hypo as it relates to all things, not just diabetes. Please remember, while you're listening that nothing you'll 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, or becoming bold with insulin. I'm going to just ask you the briefest of favors. If you are a US citizen who has type one diabetes, or is the caregiver of someone with type one diabetes, please go to T one D exchange.org. Forward slash juicebox. When you get there, join the registry take the survey takes fewer than 10 minutes, I would consider it a personal favor T one D exchange.org. Forward slash juicebox. If you're enjoying the Juicebox Podcast, please share it with someone who you think might also enjoy it. If you're loving the defining diabetes series. There are so many of them to choose from right there in your podcast player, where diabetes pro tip.com. This episode of The Juicebox Podcast is sponsored by us med. US med is a place where you get diabetes supplies, and they do it. Well they do it better. They offer you better service and better care than you're accustomed to getting. All you need to do to get a free benefits check is to go to us med.com forward slash juice box or call 888-721-1514 Hi, Jenny. Hi, Scott. How are you?

Jennifer Smith, CDE 2:05
I'm fine. How are you today?

Scott Benner 2:07
Good. Have you seen the little animations of you and I talking on Instagram and and Tiktok yet?

Jennifer Smith, CDE 2:14
I have I saw when you originally showed me what was going to be there but I have not seen recently. Because I have to admit I'm not a tic tac, or Instagrammer.

Scott Benner 2:26
So the person making the videos Maggie, who is a great young artist whose sister has type one diabetes. She has now added what I'm gonna call googly eyes to us. So while we're talking now the eyeballs move around inside of the eyes. Oh no, I'm absolutely like enamored by it. So

Jennifer Smith, CDE 2:43
I'm sure that if I showed it to my boys, they would probably think it was the coolest thing in the world to see

Scott Benner 2:47
your voice coming out of a cartoon. Yeah. Oh, yeah. All right. Well, you should check it out. I don't think you should get on Tik Tok because I have to tell you, it really is a time suck. Like it is it is the scrolling. Like I got it just to put this stuff, you know, for the for the podcast app. And then I'm like scrolling and I'm like, oh my god, I can see how people get lost in this. It's fascinating. So

Jennifer Smith, CDE 3:06
yes, I have stay away. I have more things that I need to do then.

Scott Benner 3:11
Yeah. If you're not on Tik Tok, you're doing okay. I think I was hoping today that we could define something that I mean, in all honesty, I had skipped over we I'd made a list and thought this isn't necessary. But it is. So we're going to do it. I want to define hypo and hyper just those words, and then we'll attach them to diabetes, and a couple of other things. So you know, everybody understands, again, Isabel helping me with the Facebook page, she said, I know this seems basic, but you really could use an episode on what hyper and hypothyroidism is people ask especially new newly diagnosed people, we don't have anywhere to send them. So here we are. Great. Awesome. Okay, so let's start like super simple, right? We're just going to use the dictionary. Hypo is a noun, and it means

Jennifer Smith, CDE 4:11
under or beneath a level of where you want to be. Right? And, yes, I mean, hypo hypoglycemia, hypo thyroid, hypo, many other medical terms that come along with hypo, it is like, it's low, right? It's under where a level of comfort would be.

Scott Benner 4:35
I also should have said and this is going to be a good indication to all of you that I stopped paying attention to my English teacher in about seventh grade, but it actually can be used as a verb as well, but we mostly think of it as a prefix, under beneath down less than normal, in a lower state of oxidation, for example, in a low and usually the lowest position in a series of compounds. So glycemia You know, I didn't think of this but darn it. Let's define. Let's define glycemia for a minute. Why not? I don't even think glycemia is a word, right? It is the presence of glucose in the blood. Now I'm learning. Yes. All right, like this podcast, okay? Jenny, then you

Jennifer Smith, CDE 5:21
can then you can put them together low presence of glucose in the blood. Yeah. Jenny, I hypoglycemia.

Scott Benner 5:29
I was gonna say I would listen to this podcast. Okay, so glycaemia the presence of glucose in the blood. So hypo, beneath normal, less than normal, presence of glycine, of glucose in the blood, and then hyper, which, if you've anyone's ever had a hyper kid, you know, this won't sound crazy, highly excited, extremely active, excessively excessive. That is or exists in a space of more than three dimensions that one doesn't really like It's like hyperspace. Oh, yeah, I really should have paid attention in school. This is all very interesting. I feel like an idiot. Okay, so but excessive, is where we're going to ride on this. So hyperglycemia excessive presence of glucose in the blood. That's it. Now, why somebody couldn't just call it high blood sugar and low blood sugar. You know, smart people, doctors, they fancy.

Jennifer Smith, CDE 6:25
Right? Well, and they're just medical terms, right? I mean, hyper and hypo, even in the sense of other medical conditions that carry that same prefix, if you will. They're just a medical term, rather than saying high and low blood sugar or high and low blood glucose even I also think, just glucose and sugar, right? I mean, when you say, my blood sugar is this, some people say my blood glucose is this, it's just another word for the same thing.

Scott Benner 6:54
Do you have a preference? Personally, when you write it out? And you know, someone else is gonna say it? Do you think blood glucose or blood sugar? How do you write it out?

Jennifer Smith, CDE 7:02
I abbreviate the G, because that's my quick way to type up something.

Scott Benner 7:08
After writing blogs, for so long, I did the same thing. But in the beginning, I had this like this blood sugar sound. I don't know. Like, I like this is not sound, I don't know, appropriate or something like that. But I don't think of it now. It's however it comes off my fingers when I'm typing. Like when I'm talking to somebody, I don't think of it one way I don't care. I

Jennifer Smith, CDE 7:28
guess if you, if I think about when I write about it, when I'm writing more professionally, I use the term blood glucose. And when I'm writing more from just a general kind of public, I typically use blood sugar. Okay, not that people don't know what glucose is, especially within the diabetes realm. I just think that blood sugar is often more what we say. Yeah. And so it's more readable. I don't know if that makes sense.

Scott Benner 8:02
Yeah, I think it just makes it feel more affable, honestly, just sure available to people. As an example, and we're not going to turn this into a third grade English lesson, but hypothyroidism is a condition in which the thyroid gland doesn't produce enough thyroid hormone. So back to hypo, low last, etc. Hyperthyroidism, the overproduction of a hormone by the butterfly shaped gland and the neck called the thyroid. Excessive too much. I just pulled up a couple of other words to make the point that it's not always about. It's not always about medicine. Hyperbole, as an example, is an exaggerated statement. We're claimed not meant to be taken literally hyper hyper. Right? Is the prefix. My, my last thought is just to get away away and Jenny used to be a nurse. Right, Jenny? What is hypo perfusion?

Jennifer Smith, CDE 8:56
Good to correct you I wasn't a nurse, or I'm not a dietician.

Scott Benner 9:01
Sorry. It's the same thing.

Jennifer Smith, CDE 9:05
Oh, well, you know, if I had thought that when I was going to school, then I probably would have ended up being a nurse. But yeah, so that different,

Scott Benner 9:15
I make a suggestion. Sure. We'll have to add CDE to the defining diabetes series.

Jennifer Smith, CDE 9:23
That would be great because you can have many credentials that precede CDE, which is actually not CDE even anymore. It's now c d c e s certified diabetes care and education specialists to make it even more complicated than it ever was.

Scott Benner 9:40
Have you given over to that yet? Because you you said you were gonna fight it in the big guy

Jennifer Smith, CDE 9:44
in credentialing just in terms of my signature and the way that I you know, put, again, sort of publications and that kind of stuff out I do. But I still call myself a CDE because I that's just like, what I've been long term.

Scott Benner 9:59
I have to Say I like these. Oh my gosh, I've gotten too hot tea and it doesn't matter. Oh no. I'm just gonna start drinking scalding water. When I'm recording from Elon just, I'll drip a little lemon in it and pour down my throat. I was gonna say I like the free flowing pneus of our conversations, because my just miss speaking for a second, immediately made my brain go, Hey, why are we not defining this stuff for people? Because people all the time, say, who just see today? I don't know, I saw the lady. You don't I mean, like, the doctor is the doctor, an endocrinologist? I don't know, what's the woman I don't know. Like, like, you know, she writes the prescriptions. It seems like she's got a medical degree.

Jennifer Smith, CDE 10:37
That's I saw these people. And they told me to do this. And I don't necessarily know what they are, you know, in fact, in terms of like that defining of even clinicians, many endo offices now sort of transition often on between, you see the Endo, you see the nurse practitioner or you see the Endo, or you see the PA, a physician's assistant, right, and you go back and forth. So it's not every three or four months, you're seeing the same Endo, you may see them only twice a year and in between, you actually follow up with the nurse practitioner, the physician's assistant, because that's the time that they have.

Scott Benner 11:13
So my brain like, I know, you have a firm background in nutrition. Like I understand all that. And I guess my brain just was like, well, she's the CDE she must have had to have been a nurse in the middle of it. And now so Okay, so we have more stuff anyway. Just

Jennifer Smith, CDE 11:27
remember things in nursing school that I was like, Yeah, I don't want to do that. I don't want to ever ever do that to a person. So no, I'm not going to be a nurse.

Scott Benner 11:37
Well, then just for fun.

Jennifer Smith, CDE 11:38
I I very much appreciate the nurses who do and can do those types of things. But I That's not me. I can do blood. You could bleed all over me. I could do wounds, weird looking gashes.

Scott Benner 11:51
Where's the line pee?

Jennifer Smith, CDE 11:53
Oh, the line is mucus. Oh,

Scott Benner 11:57
I wish you could have saw the face Jenny just made we should make it a poster. I just sideways or tongue came out or one of her eyes went one way she's like,

Jennifer Smith, CDE 12:05
yes. No, I was I was an ICU dietitian. So I did like tube feedings and IV nutrition and all that kind of stuff. And I would have to move away when they were doing like suctioning of patients and stuff. I like the noises and not for you. Not for me. Nope. My Oh, come back. Thank you. My wife

Scott Benner 12:27
is like three clinicals away from being an RN. And I mistakenly got her pregnant before she could finish off. So I do remember that she never got back to it. But she even said that. She thought by the time if she would have finished she's like, I don't think I could have like actually helped people. Like it just was Yeah, her vibe. And it wasn't about the people. It was more about the that stuff. Okay, but anyway, just for shits and giggles Do you know what hyper perfusion is? Now that I brought it up? Because if not, I gotta tell people.

Jennifer Smith, CDE 12:57
What and why? I'm curious actually. Why?

Scott Benner 13:00
Because it had the word hypo in it. And I thought I wonder if anyone just randomly know what this is? Oh,

Jennifer Smith, CDE 13:05
well, it has to do with like blood flow. It's hyper. Hyper is more and hypo is a reduction in the amount of blood flow.

Scott Benner 13:15
This is why you're listening to the podcast because Jenny knows stuff about stuff she doesn't know about. Hypo fusion has nothing to do with diabetes, but it describes a reduced amount of blood flow. There you go. You can't trust somebody who knows stuff. They're not supposed to know who you're supposed to trust.

Jennifer Smith, CDE 13:29
Correct. There you go. Well, thank

Scott Benner 13:31
you so much for doing this. I

Jennifer Smith, CDE 13:32
really You're welcome. Absolutely.

Scott Benner 13:36
That was good. That was hilarious. Actually. It's always fun. Good time. All right. hyperperfusion. I'm getting rid of tabs on my

Jennifer Smith, CDE 13:43
Yeah. Are we stalled for a second? I need to I think I forgot my orange link in my kitchen. And I need to go grab it because my loop is red right now. We'll be right back.

Scott Benner 13:54
No problem. While Jenny's off getting her orange link. I'm going to tell you about today's sponsor, US med

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on next week's defining diabetes, Jenny and I will be defining all of the different types of diabetes. And there are more than you think. To find a list of all of the defining diabetes episodes, go to Juicebox Podcast type one diabetes on Facebook, it's a private group for people who listen to this podcast. And right there at the top of the page. You click on a little tab called where the is it God, I can never remember the name of this. I'm going to curse. I'm going to curse. I don't want to curse just trying to finish this ad and I'm done for the week when I get this done. Like I actually get a day off tomorrow. I mean, I still have to record but I don't have to edit and I just want to tell you the name of this. Featured, you go to the Juicebox Podcast type one diabetes, it's a private Facebook group. Almost 25,000 people in it. They use insulin, they chat with each other, they help each other. And under the featured tab at the top. There's lists of episodes in different series, including the defining diabetes episodes. So if I didn't sound too crazy, just then maybe you'll go check them out. I just didn't want to curse. That's the end of my week and I had knee surgery. I'm feeling okay, but I'm not supposed to be sitting here right now. I'm supposed to have my flights. This is not your problem. Just go find that. Just go find it. It's Juicebox Podcast type one diabetes. It's a private group answer a couple questions you get right in. It really is a magical place. I'm not kidding

you. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.