#299 Ask Scott and Jenny: Chapter Ten
Scott Benner
Answers to Your Diabetes Questions…
Ask Scott and Jenny, Answers to Your Diabetes Questions
Can a fast drop in blood sugar values affect your health?
How do you help your body recover from a high?
How do you know when to adjust basal rates, correction factors and insulin sensitivity?
Let’s talk about basal to bolus insulin ratio.
How do you figure out what type of insulin to use?
What are the impacts of diabetes on your dental health?
What is the best insulin pump for you and how do you choose?
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Pandora - Spotify - Amazon Alexa - Google Play/Android - iHeart Radio - Radio Public or their favorite podcast app.
+ Click for EPISODE TRANSCRIPT
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
Hello, everyone, welcome to Episode 299 of the Juicebox Podcast. Today's show friends is sponsored by the Contour Next One blood glucose meter, this is the meter my daughter uses, it is incredibly accurate, easy to carry around. And if you go to the link right now that's in your show notes are the one that's at Juicebox podcast.com. And click on it, it will take you to Contour Next one.com. When you get there, top right corner, there's a yellow button says about getting a free meter, click on it, scroll down a little bit, fill out a little bit of information. And you're on your way. There are some limitations and restrictions that apply. But it'll only take you a second to find out if you're eligible. If you're not go to your doctor and be like, Yo, I want to try the Contour. Next One write me a prescription for that. Think about it. How long have you had that meter that you're using? Is it old? Is it out of date? Is there technology that exists? It's better than the one you're carrying around right now? I bet you there is. And I bet you it's the Contour. Next One.
Welcome back to another episode of Ask Scott and Jenny. This is sort of a super sized episode. What are we going to talk about today? Among other things, how to help yourself coming back from high blood sugar. When should you adjust your basal and bolus rates, different types of insulin the impact diabetes can have on your dental health, which sounds boring, but isn't. And Jenny talks about insulin pumps, she kind of rates them it's fun. 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 health care plan. We're becoming bold with insulin. And if you'd like to get Jenny Smith, working for you go to integrated diabetes comm and click on Jenny's email address. Actually, the email addresses in the show notes. It's the Juicebox podcast.com On this episode, and all the episodes Jenny's involved in so you just want to email Jenny and say something like hey, Jenny, I'd like to hire you. And then you'll start that conversation with her. Now you guys ready? Here comes don't? Don't it's gonna jump up now. Done ready?
I haven't asked Jenny question. My wife met somebody recently, who said that their adult child lived for a fairly long time with higher elevated blood sugars higher a one C, they kind of pulled themselves together, all at once out of nowhere, got it come to come down quickly, but then had like neuropathy problems that the doctor told them was from a fast drop. I'd love you to explain that to me, because I only heard that one other time, but not even put that way.
Jennifer Smith, CDE 2:59
And from the physiology standpoint, I mean, I'm certainly not a neurologist or anything to explain it from the physiology component. But it's the same as I think not that long ago, we had talked about changes in AI as well, with really fast changes in blood sugar. So it's the same thing it's your body has adapted to the high values. And as such, the neuropathy if it was probably there, as well as probably getting worse along the time of the blood sugars being too high. Now with the quick change in blood sugar. The change to how the sensation of those nerves are, I guess, feeling things because of the change in the glucose level, which has been impacting the health of the nerve cells. That's what brings on a more significant and more profound pain than they may have been living with when their blood sugar's were just high.
Scott Benner 3:59
So is that a bit of a false narrative then then the queen? Yeah, it was coming anyway, it might have just come a little quicker because you took this thing that your body was accustomed to, and so greatly changed it
Jennifer Smith, CDE 4:11
and greatly changed. Exactly if
Scott Benner 4:13
I'm diagnosed today with an 11. And I somehow end up with a five, two months from now, I'm not going to give myself neuropathy.
Jennifer Smith, CDE 4:23
No, no, no, the neuropathy was there to begin with the pain symptoms were something that were exacerbated essentially, because of the major shift in glucose that the body was not used to again it I mean, it does take some time to bring blood sugars down and you know more power to the person who was like gosh, I can't live with you know, 400 blood sugars anymore. I'm going to get them down to be like 150 Now instead, but still, that's a major shift for the body to handle. If you do it all at once great but you you may have some of those typical symptoms like again, you may have major shift in the way that you see things, you may think that you are seeing things great when your budget was at 300. And now one is down in normal, now you can't see anything, we have to give your time your body time to a climate to that new, what is healthy value, and then go see the doctor, if it doesn't. If it doesn't get better, you know, within like a month or so of being in target. Same thing with the neuropathy. While it may help to go and see, you know, your neurologist, or whoever's helping you to manage that, likely, they're not going to change too much other than potentially maybe prescribing some additional pain management strategy for you until the glucose levels are stable enough at that target value. And the symptoms kind of go away, or they come to a more normal stable, you know, range. And at that point, then of course, they're preventing further further damage from happening. So okay,
Scott Benner 6:01
well, I'm keeping stuff together here in a little bit of a blend. So elanco wants to know about helping her body recover from high blood sugar. So she's just talking about I think, a day, you know, where you have six hours and you're elevated, and you finally get back down? Is there something she could be doing to fortify yourself to feel better sooner to? Like, I don't know, like other than hydration, I wouldn't know what to say. Like, how do you make that blog go away?
Jennifer Smith, CDE 6:27
Yeah, if it does, it takes some time. I don't think there's necessarily any one cut and dry kind of strategy. Hydration certainly is a big one. Absolutely. Also, you know, if things like regular food intake, or snacks, or even activity, sometimes those can sort of help you clear. That mental fog, as things are changing to even just getting out in sometimes the fresh air and getting a walk and getting movement and whatnot can help as well. So
Scott Benner 7:05
is it a diabetes thing and more of just a human thing? Maybe because you've been put through this situation. And now you got to kind of bounce from it's like, almost like, I guess, like being sick. And then you wake up and you're like, Oh, you have that weird, like, lost feeling. I don't know what being obviously, I don't know what being high feels like. So my job, I just know people's descriptions of it. Okay, let's see, I feel like we've said this before. But correction factors, and insulin sensitivity, basal rates? When do you
Unknown Speaker 7:40
adjust? Like, like you said, when you know what? To a job?
Scott Benner 7:44
Yeah, yeah. Well, when do you When do you know when to adjust? Like, let's say, you know, it's your base, or, you know, it's your insulin to carb ratio or something like that? How long do you wait before you save yourself? This is my new normal, I need to make an adjustment in my pump to cover this is it? To me, this is another one of those like somebody wants you to tell them how much time? I don't know how to answer that. Like, I know doctors will tell you what three days is that sometimes
Jennifer Smith, CDE 8:09
even longer than that some doctors want like a week's worth of data to see that it's a definitive trend. I mean, I usually, I usually say, you know, if you know that, now, all of a sudden, whatever reason is happening, you're waking up at 150, when you used to wake up at 100. And it's been happening in the last three nights, and you have literally not changed anything, clearly something changed. So go ahead, make a change to the Basal or if you're kind of wary about changing your profile set at Temp Basal. In this instance, set a Temp Basal increase at bedtime of a certain percent and see if it hits the mark. If you wake up where you were great. Go in see how much the pump was delivering based on the temp you instituted and make that change into the Basal profile.
Scott Benner 8:54
Great. I would say that this is one of the things that led me to say things like more insulin, because I just kept looking at these scenarios like Jennifer's talking about here. And I just thought there's not enough of a rhyme or reason to this, that I can say to myself, okay, what I'll do is I'll wait X amount of days every time this happens. So just I just decided like, I'm gonna stay fluid. And if it's like this today and tomorrow, great, and if it changes, you know, the next day, right, what am I gonna do? I know, I'm, I'm gonna have to do what I have to do.
Jennifer Smith, CDE 9:31
Right? I mean, sometimes it takes I would say, for me personally, I always look at things after like a two day, you know, if it's tonight, for some reason, in the morning, I wake up in the morning higher than normal. And that's one night, I don't know. Let's see. I'm gonna go to bed at my normal rate where I would usually go to bed. If I see a rise again overnight tonight, in the middle of the night, if I wake up, I'm probably going to pop in some change of some kind, just that I don't wake up high again. And tonight, then I'm going to say, I'm going to go in and change my Basal profile, I'm not going to deal with this, right, I'm not going to wake up to alarms and alerts if I don't have to. And you know what, if I end up dipping down, then well, just two nights that I needed some extra insulin. And I'll go back to what I needed. But an overall change, usually, most people have had diabetes, a number of years, kind of get this intuitive sort of feeling about something has shifted, I know that something has shifted, I don't know why it shifted, I just need, quote, unquote, more insulin.
Scott Benner 10:37
Put that in there. I genuinely think that that's, that's one of those scenarios where you just have to, you just have to stay fluid and take care of it. You know, right? It comes. Because I would rather because I know what the fear is, right? Like, what if I turn it up, and then all of a sudden, five days now that causes a low? In my mind, that would be another time to adjust? And at least for the last five days? You haven't been high? Right? You know, I think it's all in the way you want to look at it. Right? Hey, welcome to the new age of smart diabetes management. Welcome to the Contour Next One blood glucose meter. By integrating your blood glucose meter with a smartphone app, you can simplify the management of your diabetes, blood sugar results captured through the day can be automatically synced and logged in over time, the results may create meaningful insights into how your activities affect your blood sugar levels, which can help improve your understanding of your diabetes. All of this while being on the same platform you use for so many other aspects of your life. Yes, smartphone. So check out Contour Next one.com. There's links in the show notes and a Juicebox podcast.com. That'll take you right there. When you get there, you're going to find out about the simple to use, and remarkably accurate Contour. Next One smart meter, and the contour diabetes app. It seamlessly connects via Bluetooth technology to capture all of your blood sugar readings, and help you to manage your diabetes smarter. When you combine the Contour Next One meter with the contour diabetes app, you're going to have a smart system that allows you to engage the level that is right for you to manage your diabetes. All right, so head into the show notes, hit the link, check it out, some people will be eligible to get the Contour. Next One meter for free. There's a little yellow box at the top of the page, check it out, you might be the one where if you'd like to talk to your doctor about the Contour Next One meter, just be like Yo, I want to use the same meter that the guy on the podcast kid uses. And then tell them it's the Contour. Next One, you will not be disappointed this meter or rocks. Please use my link. It's available at Juicebox podcast.com. We're in the show notes of your podcast player. Okay, very quickly. I'm not going to seem to make sense when I start talking in this next bit with Jenny. But what happened was while Jenny and I were talking Arden's pump ran out of insulin at school, and Jenny and I took a break, I ran across the street, and we changed the pump real quick. Right? So now that'll make sense for you. Ready in 5432 you have to be a little impressed.
Jennifer Smith, CDE 13:17
I'm actually really impressed. Like, your school literally must be like right across the street.
Scott Benner 13:23
It's um, that's pretty close. It really is across the street, right? it's it's a it's a four minute ride. You know, she met me in the office, we rolled down to the nurse and and bing bang, boom, I'm back. So eight. I think I think I was going for 18 minutes total. So
Jennifer Smith, CDE 13:42
yeah, it wasn't long. So awesome.
Scott Benner 13:45
Next time I do an on the pot. And I tell you, you can swap it on the pod fast. you believe me? We've done Arden's on the bench of a softball field. Keep the dust away for a second, right. Anyway. All right, I think we can get through a couple here. Okay. I like this one. Tara wants to know, about bazel bolus ratio. So she says that her endo tells her you know 5050 but then Becky comes in and says we're 30% bazel 70% bolson. Are those fine with it? I feel like I'm gonna say if you are too heavy on the Bolus side, you're probably bumping in nudging too much. And you could probably get some back from Basal. But what is the like why do people say well, what do you say? Because I've heard 5050 to
Jennifer Smith, CDE 14:32
5050 is a starting place It really is. And that's why endo is kind of look at that as a place to start with potentially where adjustments might need to be made. But you also have to consider some other things from the standpoint of like, metabolic bazel insulin need, what I've seen in practice, and seems to you know, be kind of correct is that If you have a pretty active lifestyle, metabolically, you are probably more at an appropriate body weight, and you will respond to insulin better. So sensitivity will be higher. So from a standpoint of background bazel insulin, your basal insulin and an active life may actually be less, you may be kind of one of those people whose bazel bolus ratio is more like 4060 40%, coming from bazel. Because without food in the picture, your body just responds nicely to insulin, it could even be more than that. Maybe it's 35. Or you know, whatever. More commonly, though, for most active, it's about like 4060, give or take kind of thing. On the opposite of that, if you have a really busy life, but you're mostly sedentary and you really are only able to get to the gym once or twice a week, you're probably on the other end of that you probably have a higher metabolic need, because your body's just not responding as well to insulin. So your basal needs may be a lot higher. And it may seem like your boluses aren't really that heavy, then, as far as like an analysis, another good place to look is at the breakdown of your bolus insulin, like how much of your bolus is truly derived from just covering the food that you're putting in. And how much of it is actually corrective. Because if you're constantly like you just said, if you're constantly nudging, by correcting with little bits, because it's just not getting down to target, it may very well be that your background is also not high enough, it could be that you're covering with more Bolus, because in the back, there's just not enough there to keep you you could be using more Basal,
Scott Benner 17:00
right. And so there's a lot of different scenarios. This is interesting. So you know, your activity, if you were a person who didn't need very much bazel to keep you stable, but you had big meals, you might even see a swing like that. Right? Right. Right. So then there is no right ratio, there's no correct ratio, there's a correct ratio for you. But there is a way to check to make sure, hey, let's make sure that we couldn't be doing some of this with Basal and take away some of that bumping in. And I think that's specific to people who listen to the podcast, like the bumping and nudging is great. But if you're bumping and nudging, and your kid puts on 10 pounds, because they're growing, you're going to just keep pumping and nudging when you should be thinking more based
Jennifer Smith, CDE 17:43
on a problem or bazel. Exactly. Yeah, yeah. And you're right. I mean, from the standpoint of somebody who, like I think I commented, I don't know when we talked a couple times before about mango man. He's a type one who is an expert in like nutrition. He's got like a PhD. I don't, I don't remember too much more about him. But he, I mean, he eats like hundreds of grams of carbs in a day, but he's also really, really, really active. And so I would, I would estimate that his Basal needs are probably pretty low. But his boluses are probably fairly big, given that he eats so much carbon at a time. And then it covers it, and it drops him back down to his target. And his bazel holds him there until the next time he eats you know, 200 grams of carbs.
Scott Benner 18:36
I think that that makes 100% sense. And I think that is the clarity for this question. So I think we did good there. Okay, so here's one that I don't know that there's any truth to this one. Katherine's asking about figuring out what type of insulin they should be using. And I know that technically, there's not a big difference between the insolence right, the fast acting insulins, but some people do see differences differences when they use them. But is there anything that we could like literally say, like humalog novolog, a Piedra? Are there fiasco? I mean,
Jennifer Smith, CDE 19:16
are there discernible differences between them? I mean, the fiasco obviously, there, there should be a discernible difference with fiasco. If you get response by using it. Yes. For the most part, the two that are the most similar and action that I would say a good majority of people who've switched between novolog humalog novolog because now their insurance covers it up. Now you're covering human logs. So let's switch you back. They usually don't notice much of a difference in its action. There are people however, who do notice a difference. I personally don't notice the difference between novolog and human log at all. I tried to Piedra and it it didn't work the same for me at all, I especially noticed it when I was using extended boluses, it just didn't have the same emphasis or work the same in an extended fashion as my human log normally did. I've got a friend who she knows that if she's on human log, she uses more insulin on human log than if she goes back to novolog. She knows that. So I, you know, definitively again, majority of people don't notice much of a difference novolog to human log, I think the two outliers there, a Piedra may work a bit differently for you. Again, there are people who can use interchangeably all three of Piedra novolog, humalog and have no difference whatsoever. fiasco is kind of in its own category, really, I think there is there's a definite difference, mainly because it's action is faster. And then there are some people of course, with ABS, but it works great, like me, worked for five months, and it was done. It didn't want to work for me at all anymore. I'm done. That's it. Yeah.
Scott Benner 21:04
I you know, I would say for Arden, she used novolog. And she she used a pager. With novolog, we saw a ton of like double arrows up double arrows down, you know, big spike after a meal, then a crazy crash later kind of a feeling. And for Arden, I've only ever been able to explain it that a PG appears to just work smoother for her. Like it's just more constant and it and predictable for me. And that's it. You know, I don't know that human log wouldn't be better. I never tried it. Right. And and you know, people all the time, like, you know, don't you want to try fiasco? And I'm like, Well, I don't I want to hear about fiasco is that it works for the people it works for and others don't. And here's the other thing about crowdsourcing this information, right? It's that we don't know everybody's other details that they don't share with you like, oh, you're all you see someone line who says, human doesn't work for me. They don't say, by the way, human doesn't work. For me. My blood sugars are mainly in the 250s. Most of the time, I eat an incredibly carb heavy diet. And I don't have a CGM, like you don't mean like, they don't give you all the details about their life. They just say something like, you know, I didn't like that television show. But you know, you don't I mean, like, you don't get enough of the details to know why crowd sourced information is tough sometimes, because it lacks the details that you you often need. The one thing I'll say is that it can't hurt to try, you know, a reasonable endocrinologist should let you try if you want to. Right, Arden did need more a pager than she needed. novolog. So her ratio went up a little bit when we switch,
Jennifer Smith, CDE 22:42
but it worked better, but it works way better, less spiking, dropping. So yeah. And I think that it takes evaluation, you know, if you if you have a sense that there are that there's something that just doesn't seem right. Ask your doctor for, you know, as many doctors have some sample bottles, ask them for a sample bottle of the opposite type of insulin and see if you don't get better response from it. I mean, if and if you don't notice anything different well, then maybe something in your settings needs to change or something in your strategy needs to change, you know, but at least you've tried and you've kind of addressed
Scott Benner 23:20
to see whether or not I will just tell you that for Arden with a Piedra I have. I don't I mean double arrow in either direction. I don't remember. Like it just, it just does not happen. So, um, okay. Uh, let's see. We're doing well, by Well, I mean, we have time left. That one seems like it's a little too much for now. Let me uh, that one's pretty obvious. I could get answered there. Oh, okay. Here's a pretty simple one. What are the impacts that type one diabetes, if any has on your dental health?
Unknown Speaker 24:03
Um, well.
Jennifer Smith, CDE 24:06
Overall, we know that diabetes can affect most places in the body. Here oral health included. People with diabetes more commonly have a potential for bleeding gums, more ginger vitus gum diseases, more potential for receding gums. And, you know, the interesting thing about it is it seems to be for the most part, the higher blood sugars again, can cause more oral health problems. So long story nutshell short, just keep your blood sugars contained to try to avoid dental problems. Does it mean that everybody with diabetes is going to end up with some type of gum disease because of, you know, mismanaged blood sugars. Not necessarily, you know, but it is certainly one of the potential, I guess complications of, of life with diabetes. Now, the interesting thing is, I mean, I have receding gums myself, I've had them for years. But the interesting thing is that, to me, I don't know how it could relate to my blood sugar control.
Scott Benner 25:30
Pills really good. Yeah, it's
Jennifer Smith, CDE 25:31
good. I haven't let my blood sugar's run at like 300 or 200. Even, you know, for years and years. The interesting thing is that it actually started after I had kids. In fact, I didn't have my first cavity. until after I had a child. And my I asked my dentist about it actually, at the time, I was like, are you sure there's a cavity there? Are you sure? Like, I've never had a cabinet in my whole entire life, you know? And he, he said, Well, interestingly, we do know that the oral health of women during pregnancy, because of all the hormone changes, there are some things that can impact like the natural bacteria in the mouth of a pregnant woman. And so he said, it can provide a better environment for bacteria to start causing
Scott Benner 26:19
problems. That's a technical way. Yeah, let me let me tell you what I've witnessed in my life, making a baby drains the life out of you. And for women worse, your feet get bigger. That's not a good thing. anybody whose feet get bigger while they're pregnant, it doesn't go back. So congratulations for that one. And I just think of it as like a demon in a movie that sucks. Like, you know, they go face to face, you can see the life pulling out of like the live person and bringing in the demon back to life. That's what happens. That's what your kids are their life suckers. So um, I will add this, and this isn't specifically about diabetes. But if you are bouncing around on that roller coaster and correcting a lot with sugar, especially overnight, that could impact your dental health.
Jennifer Smith, CDE 27:07
Absolutely.
Scott Benner 27:08
Because you're taking this juice in your mouth. And then it sits in their mouth and gives them cavities when Arden had baby teeth. And we were not good at this. I'm almost horrified to tell you that I think she had they were on her baby teeth. But I think she had 10 cavities one time, like all at once. And you know, she had to, she actually had to go to the hospital to be put under because they were so worried about blood sugar, because we were so bad at her blood sugar back then. You know, like, like now when she goes to the dentist, I'm like, it'll be fine. I'll take care of it. You do your thing. I'll do my thing. Her blood sugar will be okay. But back then had to go to the hospital insurance didn't want to cover it. Yeah, my wife's company actually stepped up and forced the insurance company to do it, which was lovely at the time. It was like a $15,000 bill to put her in the hospital to fix it was crazy. But it was just from the juice. Now. We had it all worked out. And then one time she told me she was sick of the juice she was drinking. But I had found this kind of like impactful juice that wasn't it has fairly natural stuff in it. So I switched her to something else. And in that six months, she got a cavity. And nothing had changed about it. She wasn't using a lot of juice, but that so we switched away from that juice. And she hasn't had a cavity since then. Hmm. So interesting. Yeah, it's not from diabetes directly, but it is indirectly from it.
Jennifer Smith, CDE 28:31
Correct? Correct. And that it's also a hard thing, that overnight component and I'm glad that you brought that part up. Because who overnight really, even as an adult, a knowledgeable adult who wants to treat their low blood sugar and then oh, yep, got to go to the bathroom. I gotta brush my teeth, we got to floss and like chewed on gummy bears, right? Eat the juice or whatever. Nobody wants to do that two o'clock in the morning, right? I don't want to do that.
Scott Benner 29:00
You've already and I do know, some people keep water next to the bed just to swish at least to try to. And that's better than nothing, right? But yeah, to your point. I mean, you're gonna drink juice and then Go brush your teeth. And then imagine 15 minutes later you get low again, a drink some more juice, you're brushing your teeth again. And, and at the same time, you know, to avoid a cavity. Maybe it's not a bad idea. But I mean, I, you know, I'm supposed to take like, one over the counter and acid before I go to bed at night. And sometimes I'll brush my teeth and then I'll take it. I'll be like, oh, like do that for and now again. You know, it doesn't have to be constantly it happens every once in a while, you know? A great while. Okay, well, that's a big question. I'm skipping right over that. We get to that one later. But that's a huge question. That's not a that's not an ask Scott and Jenny. that's a that's a bigger one. Um,
Unknown Speaker 29:56
that's an episode one is
Scott Benner 29:57
a complete episode. I don't know that. I have an answer to any of It. So
Jennifer Smith, CDE 30:03
that's a you need an appointment to discuss this
Scott Benner 30:05
girl again, therapist and six friends. Oh, I see Chris here says that I should just say what are a couple of times so you can make fun of my accent. He doesn't care what we talked about there is satin Jenny as long as I say whatever. And by the way, I've noticed I've never brought it up but when Jenny accesses her brain so when I ask her a question, she accesses her brain to think of it. her left eye closes more than a right eye. And I wonder if she? Oh, yeah, I don't think she knows that. I don't know. It's almost like she's a supervillain. And she's got information somewhere. And she's like, Huh, and she pulls it right out. Because for you guys listening. I don't tell Jenny this stuff up. Like I'm just throwing questions at her. And she's like, okay, answer you like on the spot. Yeah, yeah, it's it's like a driver's test. But you're driving in a car. And you know, they're like, turn now turn now.
Jennifer Smith, CDE 30:53
That's really funny. I've never noticed that.
Scott Benner 30:56
Yeah, exactly. So Alright, so here's one that I think we could finish up our time with. Is there in your mind? Because you deal with everybody in the you know, who uses all kinds of different pumps? Mm hmm. And obviously, you use Omni pod? And that's to you, the best for you. But But is it the best for you? Or if I got you secretly off in the corner? Is it the one you think would if I made you the king of the world? But you put one on everybody or no? And what are the pros and cons of the other pumps at all of them? Actually?
Jennifer Smith, CDE 31:30
Yeah, this is actually a great question. Because I think it's also a big part of the reason that oftentimes people end up coming to work with us is because we, we don't push to one specific direction when somebody comes to us and says, Hey, you know, I'm considering a pump coming from MDI, or, hey, I've been on this pump for like, eons. And do you think that there's something that would be better for me? Should I be considering this one? Should I be considering this one? What's coming out? What's, you know, which company is heading development and kind of moving the fastest and blah, blah, blah, blah, blah? Um, I, I personally would, I've got reasons for staying on Omnipod right now, which, you know. And there, I mean, the reasons really are such that it provides me with a system that allows me to get the best management.
Scott Benner 32:30
So So Jenny is talking around something so I can put ads on my epic, correct? Yeah. So um,
Jennifer Smith, CDE 32:36
so I'm trying really hard. If, if that wasn't a potential, I would say, put on the spot about another pump that I would consider changing to I would consider changing to tandem? Why would I think they are being the newest pump company of the three that are currently on the market? I think tandem has stepped up, they've done a fantastic job of development of making a product that's user friendly, touchscreen, small, convenient to use. And they're continuing to quickly move ahead with their technology. They're they're trying to bring to the table management that can help people better they are. So I mean, if I had to choose, you know, within the next month, because my current setup was no longer going to be available to me, I would say, yeah, I'll, I'll choose tandem, I like it.
Scott Benner 33:45
And so what you think tandem brings overpowers the tubeless nature of Omni pod for you.
Jennifer Smith, CDE 33:52
That's the only drawback I can definitely say the tubeless nature of Omni pod is a huge step above the other two companies on the market. But from I feel like that tubeless piece is it's more aesthetic. It really is. It's something that I as an adult, I can get over it. I don't I don't love tubing by any means. But I can get over it. If a system provides me with something that helps my management, the to versus non tube. I don't really think it has anything to do with what I get from a control perspective. Right. It's more my lifestyle that the tubeless is huge benefit for but I can deal with the tubing. If it means the pump provides me with what I need for good management a
Scott Benner 34:52
gun to your head right now though. Pick a pump,
Unknown Speaker 34:56
Omni pot okay.
Scott Benner 35:00
Good second for you.
Jennifer Smith, CDE 35:01
tandem is a good second and I hate you know, saying I mean Medtronic has been on the market a long time. They're they're also, it's a really good pump it truly is. But for I think for a fair number of people with the current system they have on the market. I've got a lot of people I work with who they like their Medtronic pump, but they choose to use a different CGM, because they're CGM is just not meeting the mark. For many people, myself included I did the pump was okay. It was fine to use. It was a tube pump, it did what it was supposed to do, blah, blah, blah. But their sensor has never worked for me. So you know, from an all around, encompassing, that's why I said, you know, if I had to choose because I no longer could use my Omnipod. I would choose tandem, because at least it still connects and works with Dexcom.
Scott Benner 35:54
Okay, if so, Omni pod ads, say the FDA goes to phone control. And that's okay. That pretty much levels the playing field, and tilted towards on the pod for you away from tandem. Like if you get the same kind of like one screen touchy feeling from it,
Jennifer Smith, CDE 36:13
the ones green touchy feeling getting rid of a PDM that feels like
Scott Benner 36:18
you're carrying a thing? Yeah,
Jennifer Smith, CDE 36:19
I'm carrying like a thing around like, it's even bigger than most glucometers
Scott Benner 36:25
are the new ones. You're so you're, you're you're stuck with the PDM because of what you're doing. And so and, and Right, so the dash is smaller. Right. But still, it's you're carrying an extra thing? Right. And I think to this, this whole question becomes moot, probably within the next 1012 months. Right. Like when, when horizon, you know, if if horizon comes out and, and the other companies are going to, you know, they're going to make their changes again, and it's just a lot of stuff is going to change. The insulin pumps are gonna change a lot in the next year and year and a half, I think.
Jennifer Smith, CDE 37:03
We hope
Scott Benner 37:04
Yes. Yeah. Well, yeah, those are their timelines, right? Like, or what if it all comes out? You're just like, sort of the same?
Jennifer Smith, CDE 37:11
right? Exactly. I do know that there are there are definite nuances between the three, what are considered kind of those hybrid control hybrid, closed loop systems with the FDA approved pumps, right? I mean, 670 G is already out, control, like you, hopefully will be out sometime soon. Even that compared to Medtronic, it's different, the system will work a bit differently, the you know, what it does for you will be a bit different and horizon from everything I know about it, which isn't a heck of a lot. It will also have its specific pieces that are different compared to control IQ and six, seven Digi. So I think each system will do something better than a current conventional pump does. But you know, you'll have to figure out which one is best for you.
Scott Benner 38:04
Yeah, there's gonna be a lot of choosing and I think to a no, I can say that. What I thought was really cool with the pod said was, look, when, when our horizon system comes out, we're gonna have an algorithm. But if you want to use the tide pool algorithm, then use that one, like, they don't care which algorithm you use, which is a is is a huge step towards trying to give you choice. Now, having said that, I don't exactly know when tide pools gonna make it through the FDA either. So there's a lot happening and at the same time, it's unsure. It's uncertain until it actually happens. So all right, well, that was good. I have a bazillion more for next time.
Unknown Speaker 38:38
Okay.
Scott Benner 38:41
Okay is right Jenny. Thank you so much, Jenny Smith for coming on the Juicebox Podcast and sharing your wealth of knowledge with everyone. Don't forget, you can hire Jenny at integrated diabetes.com or right there in the show notes is her email address, you can just send her an email. Thank you so much to the sponsor, Contour. Next One meter, this is Arden's blood glucose meter, it is terrific and it can be yours. Click on the links in the show notes go to Juicebox podcast.com. If you don't have shown us that you can find by the way you do you just might not know how to get to them. Or you can go to Contour Next one.com to see if you're eligible for a free Contour Next One meter. mm meter scrape I swear to God, it's amazing. You're thinking like it's just the blood sugar meter but new stuff bomb diggity. Hey, friends, couple of things coming up on February 16. I will be speaking at the type one nation event in Dallas. He says questioning whether or not he knows where he'll be. Let me click on the link. You get to Juicebox Podcast com scroll to the bottom of the page, click on events and you'll see these there. Type One Nation summit North Texas they call it the greatest Dallas and Greater Fort Worth Arlington chapter. This event is on Sunday, February 16. I'm doing a one hour talk there about being bold with insulin. You can also see me coming up in Atlanta, Georgia, Saturday, September, Saturday, September, I said September. Let's try again. On Saturday, February 29. I am doing a ton of speaking there that day, I'll be speaking in a bunch of different sessions. And one of my sessions will actually be with Jenny, Jenny and I are gonna do a q&a together. That'll be fun. Come out and witness Jenny and I meet each other in person for the first time. You can still get tickets. There's links again here on my page. I'm going to be at the jdrf in Wisconsin on March 26. It's a Thursday night from think five to 8:30pm. It's just three solid hours of me chit chatting about the stuff on the podcast, show up at five leave at 830 a new person while we're rolling through the events, Saturday, May 30, had touched by type one in Orlando, Florida. And they will be at the type one nation event in Virginia. That's rich from Richmond, Virginia, August 22. That's a long time from now. I just had to turn one down the other day that broke my heart. I wanted to do it so badly. But it conflicted with a date. I had something set up on already, but we're trying to figure out something else to do. So I can come out. I can't tell you where because you'll all be bummed out and they really wanted me there and I wanted to come so you can't be like, you can't be like up their butts about or anything like that. They really tried. It was my fault. My schedule didn't link up but I so wanted to go. I love that part of the country. Okay, so yeah, Juicebox podcast.com, scroll to the bottom, click on events, get yourself tickets. Thanks so much for listening. I hope you have a terrific weekend. I hope I see you at one of the live events. I can't tell you how much it means to me that you are listening to the podcast and sharing it with other people. January is well on its way to being the most downloaded month of this podcast. So that's because of you guys. And I really very much appreciate all the effort you put into getting the word out about the Juicebox Podcast. I'll talk to you soon.
Please support the sponsors - Contour Next One
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
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!
