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Scott Benner 0:00
Hello friends, and welcome to episode 993 of the Juicebox Podcast.

Jenny Smith is back with me today for another diabetes myth. Today we're going to tackle the myth that if you're using insulin as a type two, it's a failure. While you're listening, please remember 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 healthcare plan or becoming bold with insulin. If you'd like to hire Jenny, she works at Integrated diabetes that gums that diabetes for over 35 years she's a dietitian, a CDE she's wonderful, you'll hear integrated diabetes.com Speaking of good deals, use my link drink ag one.com forward slash juice box. And when you do, your first order will come with a free year supply of vitamin D and five free travel packs of 81 you can use the offer code juice box at checkout at cozy earth.com to save 40% off of your entire order. And if you go to us med.com forward slash juicebox you'll be getting a special link just for Juicebox Podcast listeners. And you can get started with us med Alright, let's get to the show shall we?

Today's episode of The Juicebox Podcast is sponsored by Dexcom. Now Dexcom makes the sensor that my daughter's wearing right now the Dexcom G seven. They also make the G six which many of you are using dexcom.com forward slash juicebox. If there's an easier way to manage type one diabetes, I don't know it. The Dexcom G seven is a simple CGM system that delivers real time glucose numbers to your smartphone or your smartwatch. No finger sticks are required. Effortlessly see your glucose levels and where they've headed. So you can make smarter decisions about food activity, and the other variables that are impacting your blood sugar. Go to my link dexcom.com forward slash juicebox to see the device. Watch great videos. Find out more about how it works. We're just get started. You have type two diabetes, type one gestational Dexcom may be for you Dexcom G seven can help you to spend more time in range, which is proven to lower a onesie. The more time you spend in range, the better and healthier you'll feel. Use the Dexcom clarity app which is built right into the Dexcom G seven app to track your glucose trends. It will even provide you with a projected a one C in as little as two weeks. dexcom.com forward slash juicebox Dexcom G seven features lightning fast 30 minute warmup time. Oh, that's twice as fast as other CGM systems. Wait, do you see how terrific it is to go from one device to the next. The way we do it here is you're wearing a G seven, and you put on the next one, but don't disconnect the first one. So the next one sits on for a half an hour. And now it's ready to go. And then you make the switch. You never lose a reading. It's absolutely fantastic. There's actually a ton that's great about the g7. You gotta go to the link to check it out. dexcom.com forward slash juice box, set your alerts and alarms wherever you want. So you're notified of lows, highs falling or rising blood sugars. And of course that 30 minute warm up is just magical. Dex comm.com forward slash juice box head over now get started. What else can you do with this link? Let me show you. Oh, let me see. New Dex calm, explore the G six explore the g7 Oh, you can put in your information to get Dexcom to contact you and get started. That's pretty cool. There's a bunch of frequently asked questions at the bottom to answer all of your questions. When you use my links, you're supporting the production of the podcast and helping to keep it free. I appreciate you listening to this ad right now. And because you were nice enough to do that. It will be no more ads for the rest of the show.

Jennifer Smith, CDE 4:19
I have 10 minutes. Alright, so whatever we can do short 10 minutes. Okay, that's

Scott Benner 4:24
awesome. I have it right here. I know you do. Don't worry, Jay. There's a list for everything you're with.

Jennifer Smith, CDE 4:32
Outstanding. You're like I got this. We're gonna

Scott Benner 4:35
let's go right to this one. All right. Let's discuss the myth that insulin is bad for someone with type two diabetes. Oh, my big one which I mentioned with oh, this person must have been on the podcast I mentioned this in my episode was that for decades? I believe that going on insulin was the last resort for someone with type two So how do we make sense of this idea? When, as soon as you're told you have pre diabetes or type two diabetes, someone says to diet and exercise, we can turn this around? Now, I guess first of all, is that always true? Like, is there a world where you couldn't if you couldn't stop if your knees didn't hurt? If you didn't have a job? Can you diet and exercise your way? Out of type two? Every time?

Jennifer Smith, CDE 5:29
Every time? No? Okay, I think, again, that's it is it's kind of a blanket statement. And unfortunately, no, as we know, every person is individual, right? Every person has a way that something will or will not necessarily work, or we'd have even insulin itself, we'd have one kind of insulin, and everybody would just be able to use the one kind of insulin right? Does lifestyle, especially for type two, in a grand majority of studies in research, you can actually find that lifestyle from the get go, especially if type two is discovered earlier, rather than later, when many, many times complications may have already set in, unfortunately. And that might be what send somebody to the doctor because of something that they're experiencing to kind of get it checked out. And then they discover, oh, well, you have diabetes as well. Right. But I think the earlier the better, which just calls for more early on health screenings from primary care, and just lab work, you should get that done yearly to check up on things and see how things are going. Because the sooner that you can catch it, the sooner you can make really awesome lifestyle changes. And you could halt the progression. Absolutely.

Scott Benner 6:50
Yeah, I'm not saying like, I'm not saying keep, you know, taking poor care of your health, if that's what's happening, I'm saying that telling someone, hey, just eat a salad, do a sit up, and this is gonna go away is not always gonna happen, right? No, and there are new medications. Now we've talked about them in the type two Pro Tip series. I'm watching two people I know, using ozempic right now with their type two with like, great success, not just awesome, not just weight loss, like lower, like they're almost no spikes at meals, like more normal blood sugar is really fantastic stuff. And I wonder if after more weight loss, if you won't see that get better and better as time goes on. But my point is, this is if you're in a position where you need the insulin, and you're not taking it, you are doing more harm than good in that in that time. And, and this is the next part of this. And you know, I started off by saying type two, but I mean, maybe this really, because I hear this from so many people. And this is the last thing I'm going to ask you in this episode is a very short episode. But I think this is a big deal. I was told not to inject insulin, because it kills the rest of your pancreas. Now, you know, that's the thing people think, Oh, that's so wrong, right? But why do they think that I can never figure this one out. Shoes and type ones.

Jennifer Smith, CDE 8:14
That it kills your pancreas. If I mean, if anything, actually injecting insulin. It can actually, it can take the stress off of the betas that from a standpoint of type two, maybe initial diagnosis, you have to use insulin for a short time because levels have been so high, you're almost at this glucose toxic level, that you have to get something to overcome that in a faster manner than many of the oral kind of therapies, or even some of the newer injectables may not hit that the way that it needs to be done. And so taking insulin helps to decrease the stress that's being put on the betas, you're asking them to work without a break. It's almost like asking them to do 24 hour 24 hour at this really high production rate that they're never going to be able to overcome. And so adding some injectable insulin can actually decrease the stress and could actually do the opposite of what you just said.

Scott Benner 9:17
I listen. Um, I don't think it I've just heard people say it over and over and over again. Listen, this whole series is about basically you and I go and why would someone think that and trying to come up with where that would come from? I don't, I don't get this one. Like you don't either use insulin, you make it worse, you use insulin, you stop your pancreas from working the rest of the way or by the way, you can use too much insulin, which I think those two thoughts live on the same plane of existence in someone's head, but I don't understand where that comes from either. Like is it? Is it that type ones. Maybe it's that when people start using insulin, they'll sometimes gain weight as type ones and then they say insulin made me gain weight. They don't. What's your answer to that? I say I tell them the same thing. Every time. Insulin doesn't make you gain weight, calories make you gain weight, you're just

Jennifer Smith, CDE 10:10
which is true. But from an from a type one perspective on a little deeper level, if they have had such high blood sugars for such a long time, then they've actually been able to maintain or most often you see weight loss prior to diagnosis, because they've been peeing out an excessive amount of calories, because the body doesn't have the insulin to actually put it into the body in storage, like it's supposed to. Yes, so you lose weight by pulling out the excess, that you're, you know, that should be actually kept, you're the ones you start taking insulin, your body's like, Yay, I've got something here that I can package this stuff away the way that it's supposed to. And so, yes, you may get back to a healthy weight, I've actually also seen, especially in kids and teens, where they may not have actually been keeping up with growth curves prior to diagnosis even. And once they start on insulin, and their body actually has the right amount there, then weight gain can actually increase. And if you're not careful, as you said initially, then caloric intake needs to be the next step in management. Just because you're taking insulin, doesn't mean that you can go hog wild with caloric intake might be a need to balance

Scott Benner 11:32
also the cause and effect is off sometimes. So like you said, the way I think about this, what you just said was like that you're in like a low level of DKA all the time, right? Yeah. So your your, your body's trying to die because it doesn't have enough insulin, but you're giving it just enough to keep it from actually happening. And so you're on this unhealthy weight to begin with. And then suddenly you add the right amount of insulin. God knows what do you hear people say all the time at their diagnosis, I swear to you, I hear it 50 times a year, I thought, Oh my God, my diet is finally working. They see it all the time. They're so thrilled before they're diagnosed because they're like, I'm finally losing the weight that I've been trying to lose,

Jennifer Smith, CDE 12:10
especially for adults who are diagnosed Oh, my God. Yeah, absolutely.

Scott Benner 12:14
So So you're basically in that situation where your body can't properly perform. And so you're underweight for the reasons, Jenny said, and then you bring the insulin in, and your body's like, Oh, good, I can do the right things now, not realizing you've been eating crazy amounts of food, because who cares, right? Because I wasn't getting people say it all the time. Well, I got I was eating ice cream. I was doing this. I never gained any weight. I thought I finally figured it out. Bla bla bla. So I think that's, I think that's that space right there. But, I mean, again, I don't I mean, that's, that's as close as I can come to digging through it. But with the certainty that people will say it online, I'm stunned and scared by it all the time, because I don't use insulin is. I mean, especially for a type one. It's just such a dangerous statement to make. And absolutely, it happens a lot. Oh, don't use it, the more you use, the worse it's gonna get, you're gonna kill your pancreas, you're gonna die. I'm like, oh, god, shut up. No, no, no, like, stop saying that's where you? I don't know. Yeah, absolutely.

Jennifer Smith, CDE 13:20
And I think from a type two perspective, for the majority of time, people feel like insulin means that they have ultimately failed in everything that they have put into action, you know, their doctor or their educator was like, let's let's do these lifestyle things that start you on these medications. And potentially, at some point, many people will still need to use insulin. And there is a progressive nature to type two. Again, lifestyle still navigated and maintained really well, at some point, many people may or may need insulin added. That doesn't mean it's a failure, it means that now you're going to have something that also helps because in the background, your pancreas isn't doing as much as it was before doesn't mean that you failed in all of your management and adjustment to your life and everything. You have to keep doing those things. Insulin is just it's an additional tool in your toolbox. That's going to help keep you healthy.

Scott Benner 14:21
And I'm not saying either that you don't want to extend that time if you can, correct Yeah, I think that's fantastic. If you get by the way, even like a slow onset, like a lot of diagnosis, like like, keep it going as long as you can. Every day you don't have to futz with all this stuff is fantastic, you know, but, but once it comes, I don't know couching it as a failure is, is dangerous. And I don't think it's not true that doctors don't say like, well, we want to keep you off of insulin as long as possible. And then people's brains fill in the rest of that with however, these myths start to exist, right.

Jennifer Smith, CDE 14:54
They're kind of reading between the line of which there's not, there's not really something written there. They're just filling it in, like you said, like the doctor, we're gonna keep insulin out of the picture for as long as we can, which again, is kind of like saying, Well, gosh, once we get to that point, but that's it, we got to add insulin now.

Scott Benner 15:12
Jenny, I'm gonna end with this because I, I'll go on forever if I talk about this, but I think that if people could get a printed list every day of all the things they're wrong about that they think they're exactly right about me included, everybody included, we'd all spend a lot of time just sat in the corner going, Oh, my God, I thought that for sure was right. Because your brain fills in the gaps with whatever information you have, and it doesn't mean it's the right information. So anyway, I appreciate you doing this. Thank you. Absolutely, thank you.

I want to thank Dexcom for sponsoring this episode of The Juicebox Podcast and remind you that you can support the podcast and help yourself by going to dexcom.com forward slash juicebox. Go get started today with the g7 for the GS six. I also want to thank Jenny and remind you that she works at integrated diabetes.com You can actually hire Jenny to help you with your diabetes. Thanks, thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. This myth series I'm enjoying it there's a handful more episodes left than the series is done. But what a great idea this was whoever thought of this on the Facebook group. Thank you wonderful. If you are a loved one has been diagnosed with type one diabetes. The bold beginnings series from the Juicebox Podcast is a terrific place to begin listening. In this series, Jenny Smith and I will go over the questions most often asked at the beginning of type one. Jenny is a certified diabetes care and education specialist who is also a registered and licensed dietitian and Jenny has had type one diabetes for 35 years. My name is Scott Benner and I am the father of a child who has type one diabetes. Our daughter Arden was diagnosed in 2006 at the age of two. I believe that at the core of diabetes management, understanding how insulin works, and how food and other variables impact your system is of the utmost importance. The bold beginning series will lead you down the path of understanding. This series is made up of 24 episodes. And it begins that episode 698 In your podcast, or audio player. I'll list those episodes at the end of this to listen, you can go to juicebox podcast.com. Go up to the menu at the top and choose bold beginnings. Or go into any audio app like Apple podcasts, or Spotify. And then find the episodes that correspond with the series. Those lists again are at Juicebox Podcast up in the menu or if you're in the private Facebook group. In the featured tab. The private Facebook group has over 40,000 members. There are conversations happening right now and 24 hours a day that you'd be incredibly interested in. So don't wait. So don't wait. Check out the bowl beginning series today and get started on your journey. Episode 698 defines the bowl beginning series 702, honeymooning 706 adult diagnosis 711 and 712 go over diabetes terminologies in Episode 715 We talked about fear of insulin in 719 the 1515 rule episode 723 long acting insulin 727 target range 731 food choices 735 Pre-Bolus 739 carbs 743 stacking 747 flexibility in Episode 751 We discussed school in Episode 755 Exercise 759 guilt, fears hope and expectations. In episode 763 of the bowl beginning series. We talk about community 772 journaling 776 technology and medical supplies. Episode Seven at treating low blood glucose episode 784 dealing with insurance 788 talking to your family and episode 805 illness and ketone management. Check it out it will change your life