#450 After Dark: Psychedelics

ADULT TOPIC WARNING. Psychedelic Drug use and Type 1 Diabetes

Psychedelic Drug use and Type 1 Diabetes

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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 friends and welcome to Episode 450 of the Juicebox Podcast. Today's episode is yet another in the after dark series. After Dark series you say, I don't know what you're talking about Scott Well, let me tell you all the way back in 2019 at Episode 274 we did our first afterdark when we talked about having type one diabetes, and drinking alcohol that led to 283 we'd edition 305 trauma and addiction 319 sex from a female perspective 336 depression and self harm 365 sex from a male perspective 372 divorce and co parenting 380 for bipolar disorder 393 bulimia and depression 399 heroin addiction Episode 422 is with Amy. And it was so varied and multifaceted. I think those things mean the same thing. But it was so much that that I just called it after dark Amy. The point is that these episodes are about topics that exist in everyone's day to day life. But there are topics that we don't talk about. And I thought that there should be a place for people with type one diabetes to talk about the stuff that goes on in everyone's life. That you know, for one reason or another isn't the kind of conversation you have and mix company or whoever proper people say stuff like that. Anyway, today's show is with Ashlyn Ashton is 23 years old, she has type one diabetes, and she used to psychedelics. So we're going to talk about it.

I want to start here by saying that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, please always consult a physician before you make any changes to your medical plan, or become bold with insulin. I'll also throw in that I can't. For the life of me imagine using psychedelic drugs. I'm actually not a drug user at all. I don't even drink but I also don't have any judgment about other people's business. All that said, it's gonna be some pretty clear talk about how to use psychedelic drugs in this. So if you're a kid, stop now do not listen to this without your parents. Please forget, please, I commend you if you're under $18 this Alright, that's it. You've been told. Towards the end of the episode Ashlyn is going to bring up something called dance safe.org I'm just putting it here, so it's in your head. It's an interesting organization that helps people test their drugs to make sure they're pure. There's a whole world around drugs that I did not know existed. But this seems like a kindness dance safe.org Alright, let's get going.

This episode of The Juicebox Podcast is brought to you by the Omni pod tubeless insulin pump, go to my Omni pod.com forward slash juice box to see if you're eligible for a free 30 day trial of the Omni pod dash or to get a free no obligation demo pod sent right to your house you can do all of that at my Omni pod comm forward slash juice box. The episode is also sponsored by the Dexcom g six continuous glucose monitor. Find out more about ardens cgm@dexcom.com forward slash juicebox Omnipod and Dexcom are absolutely indispensable tools for everyone using insulin. You know what else is pretty great. Touched by type one.org check them out at touched by type one.org or on Facebook or Instagram.

Ashlyn 3:53
My name is Ashlyn I'm 22 years old and I've had type one for the last 13 years I think 2008

Scott Benner 4:03
it wasn't seven you were nine

Unknown Speaker 4:05
Yeah,

Scott Benner 4:06
you were diagnosed Okay, that seems like a long time doesn't seem like a long time to you

Ashlyn 4:13
not yes and no. Yes When I think about it, but diabetes wasn't really something that the forefront of my life until kind of recently

Scott Benner 4:25
interesting. Okay, so you're saying when we do the math you recognize that's been a long time, but you didn't think about it till more recently. Is this going to be a story where you didn't really pay much attention to diabetes at first or your

Unknown Speaker 4:37
opinion? Oh no, I

Ashlyn 4:38
medium cared for a lot of like my teenage years. I never went like full burnout stop taking insulin or anything like that. But I just kind of, you know, I never the endo to me was just like the prescription lady.

Scott Benner 4:54
Medium care your first person has ever said that. I found that. I like that a lot. I took Medium care of the situation so

Ashlyn 5:02
well my my Awan C's were never like over, you know, seven, like, eight. I remember, you know, I don't think I really got it under seven and a half until I was like 17. Okay.

Scott Benner 5:16
Was that trying to think here? So you if you were diagnosed like 13 years, you know what year it was? Did you say and I didn't hear

Ashlyn 5:26
2008 I think.

Scott Benner 5:28
Okay, so what kind of technology Do you have at that time?

Ashlyn 5:35
You're gonna laugh but I've been on MDI the whole time.

Scott Benner 5:39
I'm not gonna laugh. So you were just MDI with a meter you didn't have a glucose monitor, nor do you have one right now.

Ashlyn 5:47
I'm wearing a CGM. Right now I have the G six on I think the first time I use Dexcom was maybe back when the g4 was a thing, the big bulky one. I didn't really like it. I grew up in Florida, like we we always were swimming and stuff. And it was just people gave me like, weird looks at the beach and stuff like that. And I felt a lot of like, pressure.

Scott Benner 6:12
Okay. I, you're not the first person that said they don't want something stuck to their body, that's for sure. I'm sort of like musing in my head that you call it the bulky one, because I do remember that it was taller by a bit. By I guess it has a different feeling when you're wearing it versus when you're looking at it on somebody to? Because like I

Unknown Speaker 6:32
also Oh, go ahead. I'm sorry.

Ashlyn 6:35
Oh, no, I also think I got bigger. You know, and I was like, 11 it was it took up a wave bigger patch of real estate on my body. I

Scott Benner 6:44
gotcha. I understand. Okay, so MDI for it sounds like a long time just to meet or do you remember, like, how frequently did you actually test? Was it just a meals? Or how did you handle day to day stuff?

Unknown Speaker 6:57
Um,

Ashlyn 6:57
I was younger, it was mostly at meals, if I fell off, you know, like, I'd say average three times a day. Not anything crazy. As I as I got older, I did go through some periods of burnout. But I always just kind of did it off a feeling for maybe a year, which is not the best.

Scott Benner 7:20
Before we keep going, is your cell phone near the microphone?

Ashlyn 7:23
Yeah, I can move it. Is that any better?

Scott Benner 7:28
Well, we'll know in a second. Sometimes you're, you're starting a word. And there's this electronic thing that happens. Because your phone's always like pinging sites and it's always getting information that kind of interferes with the mic if it's too close, but Okay, so three times a day to somebody who was diagnosed today, even to you now that you're using a CGM. Like think of that in hindsight for a second. If I if I told you today, you were only allowed to know what your your blood sugar was three times today. Does that sound insane to you now?

Ashlyn 7:58
No, I, I go not. I'm one of those people that freaks out in the two hour window. Now.

Scott Benner 8:05
No kidding. Say you're warming up new sets, and you're just like, the world's coming?

Ashlyn 8:12
Well, it wasn't always like that. I ran into some issues. I recently moved to Colorado. And the altitude has kind of,

Scott Benner 8:22
yeah, make sure

Ashlyn 8:24
changed everything to an extreme sense. I had to cut my basil in half. and troubleshoot doing that all on my own. Because, you know, I didn't have an endo up here. And because of COVID, they were all booked out. And I tried doing telehealth with my doctor in Fort Lauderdale. And he just didn't understand the altitude and just kept telling me to raise my basil.

Unknown Speaker 8:50
And

Scott Benner 8:51
I just, I just made me think of something. If we could build a colony for type ones, 6000 10,000 feet in the air. Do you think nobody would have diabetes? Because you're right, you're like the you're the countless person in a row who's told me that at higher elevations, specifically in Colorado, not for nothing, that they need significantly less insulin than they do at a lower elevation. Do you think it'll level off at some point you've been able to talk to anybody who's gone through it?

Ashlyn 9:21
So no, the answer's no. I've talked to a lot of people here in Colorado, and they say that you adjust and all of that. And I think that right now I'm making the switch over to tandem. I have my pump training on Tuesday. I'm very excited.

Scott Benner 9:38
Got the control like you're out.

Ashlyn 9:41
Yeah, just because I'm noticing that during the mornings, the basil seems to be pretty good for the 15 units, but overnight and like after 3pm it's just I'm going down. You know, and I can't keep waking up three times a night.

Scott Benner 9:59
It's super easy. First thing I'm enjoying talking to somebody who had an eight a one C as a matter of course, who's thinking like you are now it's so we're gonna have to get back to this at some point. But firstly, I want to know about about the growing up time with diabetes. I want to understand a little bit if it was you and your mom or you and your Dad, are you on both of them, or how did they management work?

Ashlyn 10:22
I got the diagnosis that night and I have a younger sister, they instantly put her in the trial net over at University of Miami. And I remember it vividly. We were on vacation at the Bahamas and she had got my mom had gotten the call that my sister had the antibodies and it was just like a vacation ruining

Unknown Speaker 10:41
moment.

Scott Benner 10:43
I think if I get that call while I'm in the Bahamas, I say hey, you know what you call back in a couple of days. I getting that now, while I'm paying all this money to be. That sucks.

Ashlyn 10:54
So yeah, so then my sister got diagnosed when she was five, and we're five years apart. So maybe a year after I got diagnosed. Okay.

Unknown Speaker 11:02
Wow. And yeah.

Scott Benner 11:06
Sounds like a lot. It really does especially so did your sister just do MDI as well, which she managed basically the same as you.

Ashlyn 11:13
So my sister has like a, she has a funny relationship with insulin and food and she's all over the place. Her a onesies have been in the 10s and just really weird, binge eating habits. She tried the Omni pod for a while, but she has. She has like severe eczema and the cranial I kept like rejecting for her

Scott Benner 11:40
severe eczema that can be auto immune to skin issues.

Ashlyn 11:47
There's runs in my dad's family pretty hard,

Scott Benner 11:50
does it? Can I say something that I found out about recently? Hold on one second. I don't know if this is for. We'll keep talking. But I'm gonna see if I can find something. Find out if it's for eczema as well.

Ashlyn 12:05
She also has issues with the Dexcom. And she's one of those people that has to put like the

Scott Benner 12:09
bunch of barriers and everything on

Ashlyn 12:11
Yeah, or else it'll come off like in a day.

Scott Benner 12:14
No kidding. Well, there are some newer drugs over the last couple of years, that are are for things like hives. allergic reactions, like the asthma, you know, stuff like that, that in the past people have thought of as not being you can't really impact it. But these, these newer drugs seem to have a real impact on something like that. And I'm wondering if there's something like that for eczema as well, though, I don't know. But I do think of it as a an autoimmune issue. When your skin and when your skin has odd reactions like that two different things. Which I guess we don't find crazy. But okay, so your sister sounds like she had or has an eating disorder? Would you call it dyeable? emia?

Ashlyn 13:07
No, she, she's like right at the cusp, where she's just eating and doing a lot of insulin at once. And she hasn't really figured out the whole not taking the insulin part of it. And that's why I try not to address it, because I'm like, I don't want to make that click in her mind. Oh,

Scott Benner 13:25
you think she's close to diet, believe me, but she hasn't actually figured out how to make it happen yet.

Ashlyn 13:31
Well, she just hasn't. She hasn't. She hasn't stopped like stop taking the insulin for what she eats. And it's at the point now where she's also on Metformin. And I just, she's a very, she's struggling. Yeah, very strong willed person, then you cannot make her do anything she doesn't want to do. And this is her life. And this is what she's choosing. And I have to step back. Gotcha.

Scott Benner 13:56
No, I understand. And she's entertained still. Is that right?

Unknown Speaker 13:58
She's 17. Yeah. Wow,

Scott Benner 14:00
good luck. I tried to talk Arden into taking a vitamin the other day, and it turned into two hours of my life. So I was just like, just swap this one little tiny bite, okay. I feel like I have a tiny bit of understanding about what you're talking about. And yet the rest of it is, is a little foreign to me, but we're not here to talk about her. I just tried to understand the vibe. And what makes you personally say, because it sounds like you were in your late teens when you decided you don't want your a one C to be in the eights. How does that it was

Ashlyn 14:36
it was really diabetes related. I just started taking more of an interest in like overall health. You know, I noticed that I felt better and I think honestly, it was just, you know, I was using the same dosing practices and everything. I just was eating lower glycemic foods.

Scott Benner 14:52
Okay, so just just an overall like decision on your part, like, Hey, I'm going to do a little better with my diet and then that impacted your diabetes.

Ashlyn 15:00
Well, I started working at like a health food store. And you know, the options there, everything was kind of lower gi and I started, you know, buying food at work. And then I was like, Hey, I kind of feel better. Wow.

Scott Benner 15:11
Yeah. It's amazing how feeling better will will impact your decisions. So I guess them with that in mind. You, you reached out to me and asked about coming on and you were specifically like, I think I could be in an after dark episode. And I'm always interested in those emails when people are just like, I'm definitely going to be an after dark episode. If I come on the podcast like, oh, okay, how come? Yours was just super specific. And I guess I want to ask you about it and find out more about it. So can you describe what made you reach out?

Ashlyn 15:47
So I started with all of these altitude issues in Colorado, whatever. It got to the point where I ended up going to the ER, they turn me away, and I called my primary care physician just out of, you know, sheer, like, if the hospital doesn't help me, who's gonna help me, you know? And one of the, the nurses, she was like, Look, I was really thinking about you and your situation. I don't really know how to help you. But I did start listening to this podcast, and I think it would be really helpful for you. And I, at the time, I was working in the cannabis industry, and I was, you know, trimming with my hands. So I needed something to listen to. And I was like, why not?

Scott Benner 16:27
Oh, that's so a nurse. So you have low blood sugar issues because of the altitude that sends you to a hospital. The nurse tells you about the podcast, you've got time to kill, cuz you're trimming? What do we call it? Is there a way to say, Are you trimming buds? What do you do?

Unknown Speaker 16:42
Yeah,

Unknown Speaker 16:43
there you go. Sorry. No,

Scott Benner 16:44
we're good enough. Wait, do you see how little about what you and I are about to talk about that? I understand. It's gonna be fascinating for you.

Unknown Speaker 16:51
That's why I was so nervous about this. I'm like, I'm going to talk to a dad about now.

Scott Benner 16:55
Don't think that just think of me as a guy who doesn't know anything about this. And is 30 years older than you. Okay, so. So do you do you smoke on the regular? Is that part of your life?

Ashlyn 17:08
Oh, yeah, it's been it's been a part of my life since about 1615. I wouldn't say constant until you know, I moved out 18. I really like marijuana because when my blood sugar is high, it kind of helps relieve the symptoms until you know, the insulin has time to work.

Scott Benner 17:30
Okay, so there was a time when you couldn't keep your blood sugar down. It comes with symptoms like like, how did it make you feel when your blood sugar was high just for people to understand.

Unknown Speaker 17:42
So

Ashlyn 17:44
I'm going to make like an allegory to like glaucoma where people have like the bulgy eye feeling. When my blood sugar's high, I get very sleepy and it feels like my eyes are going to bulge out of my head. And the marijuana kind of helps, you know, decrease that pressure behind my eyes.

Scott Benner 18:04
Now, I will sound like a dad for a second. Okay. When that happened, you didn't think I wonder if I gave myself more insulin if my blood sugar would go down?

Ashlyn 18:13
Oh, no, it's already insulin on board. It's not using lower blood sugar.

Scott Benner 18:17
No, no, no, no, I don't mean that. I just meant okay. So you weren't, you weren't higher all the times you were jumping up staying up? Kind of smoking not to feel bad while you were higher than let the insulin bring you back down. Now you do a better job of balancing the insulin against your meals, I guess.

Ashlyn 18:33
Well, yeah, I just I was smoking regardless. And it was just kind of like, Oh, my blood sugar's over 200. And I don't feel as bad and, you know, I mean, just kind of relax and wait for the stuff to kick in.

Scott Benner 18:46
Gotcha. happy accident that though, that the weed helps with high blood sugar kind of sickness that you felt.

Ashlyn 18:52
Yeah, it's just something that you know, over time, I was smoking regardless, and it was just like, cool side effect.

Scott Benner 19:00
Finally, a side effect that I love. Right, you're used to putting on those commercials, and all the side effects are like, you'll poop in your pants, or you might off and your kidneys will explode. But now you're just like, you're gonna feel good. So it just takes away that feeling. And that was a happy accident. Did you move to Colorado? To be closer to weed? Becca?

Unknown Speaker 19:23
No, no,

Ashlyn 19:24
I have family over here. And at the beginning of COVID, I had I just was at a job I didn't love and I just wanted to change and you know, my cousin lives out here and she's always just like, whenever you're done with Florida, come out.

Scott Benner 19:38
Okay, nice. Do something for me. If you were putting on the spot here for a second. Be a salesperson for a second talk. talk me into smoking weed tonight.

Ashlyn 19:51
Oh, talk you into it. Yeah, probably not a peer pressure. No, no.

Scott Benner 19:56
Don't think of it all like 2020. Thank you very much. You know, we're just sitting around like, you're a commercial. You're, and you want me to, you're trying to you're trying to get me to buy a Honda, except you're trying to bring me over to your side here. I'm just interested, like, what would you say to somebody if I said, I have tons of interest in doing this, but I just, I grew up in the wrong time. I don't think of it the way you do. Make me feel comfortable with it.

Ashlyn 20:24
So this is like when I got my grandma to smoke with me.

Scott Benner 20:27
Okay, you know what? I would have known to ask like that, I would have just said, How did you get your grandma to try?

Ashlyn 20:34
She has glaucoma. That's pretty much all I had to say I was really I don't know, it just, you know, it's something that helps pass the time. And honestly, during quarantine, it's been needed. I just, I have a highly anxious person. And it's just something like I can't drink. Really, alcohol is not something that sits in my stomach very well. Plus the diabetes aspect. So smoking weed naturally was just kind of like, well, if I can't drink, I'll do that.

Scott Benner 21:12
Well see now I feel like we're getting to it. So you do have a low level of anxiety kind of all the time.

Unknown Speaker 21:19
Oh, yeah. All the time. Right.

Scott Benner 21:21
And this helps with that.

Ashlyn 21:25
Yeah, it does, as long as you're in the right, like set mindset and setting, which is something we'll get into about the other stuff.

Scott Benner 21:33
Yeah, I love that. This is even why you came on. You're doing such a good job of teasing the story out. I don't know if you're doing it on purpose, and you're a genius or if it's just happening naturally. But I'm very much enjoying this. So. So you have a natural kind of level of anxiety. Has that. Is that a lifetime thing? Have you felt Oh, yeah. As a child?

Ashlyn 21:51
Oh, yeah. When I was like three or four, I was the kid that was hiding behind their parents legs would let my mom go out to the mailbox without me. It was not anything to do with the diabetes. I was born this way. No, no, I

Scott Benner 22:03
understand. So since you were little, what about? Can we help for a second? Like, let's use the lockdown for a second? Do you have any pile up feelings of like, like dread about the lockup? Like I'm never getting out of here. Life's never gonna be the same again. Do you? Has that become worse over the last year?

Ashlyn 22:23
It's not really much ado about the lockdown as much as far as like the diabetes not being the same, honestly. Because when all of this started, I drastically cut carbs down. I, I had a grazer when I eat, you know, and I had to stop doing that. And just like how many I broke out the food scale even which for me is unheard of.

Scott Benner 22:45
So you were said the lockdown for you. It's been more about like, not just being on a 24 seven, like popping a little something in your mouth, like snacking for out of boredom.

Ashlyn 22:56
Right. And I just you know, everybody says the diabetes is the job that like you can't take days off from and that's kind of the feeling that I have sometimes.

Scott Benner 23:05
Yeah, that idea that you can never get away from it.

Ashlyn 23:08
Right. And it's like the first thing that I do in the morning. And the last thing I do before I go to bed is probably looked at the Dexcom app.

Scott Benner 23:15
So just being high make you ignore your, your blood sugars, or does it just not make it feel as on the present?

Ashlyn 23:24
And I know that's a problem that a lot of people have. I know and you guys did like the after dark weed episode he he said something like that, like he ignores his diabetes. But for me, I've been smoking so long that like, No, not at all. You know, if anything, like I'll just be watching TV and like have my phone open. And I just glanced at every once in a while and just act accordingly. Yeah, you know, I just make sure to get some like, keto munchies. You know, pepperoni sticks are like my favorite.

Unknown Speaker 23:59
Because you do get munchie when you're high.

Unknown Speaker 24:01
Oh, yeah.

Scott Benner 24:02
Okay. Is there a level of trying to make this clear for people who don't know anything about it? Is there you know how you see a person take a shot, like a shot of whiskey, and they don't have anything else. You know, I go there that sometimes that relaxes a person, but that same person could have 20 shots, and then they would just fall on the floor into a puddle. So can you take like, how does weed work? Like is one hit the same as, like, could you take enough hits in five minutes to just obliterate yourself? Or is that not possible?

Ashlyn 24:36
It is very possible. I think what you're talking about would be similar to like a gravity bomb or ice I smoke concentrates, which is basically how it sounds concentrated weed through like a like a device that heats it up. And you know, I have a higher tolerance. It doesn't destroy me, but for you who's never released. moped, if you were to go and take a small hit of concentrate, you would probably be high for like five hours

Scott Benner 25:05
just shut my eye. And that would be like sitting down and kind of incapacitated. Hi.

Unknown Speaker 25:12
Oh, yeah,

Scott Benner 25:14
you've got me googling gravity bomb, by the way, in case you're wondering. I'm doing right now. Good luck. No, I found it. I'm good. I see. Okay, all right. That's something that can't be described on a budget. Okay, so that so that is, so that's a possibility. And I asked because then that means that you are thoughtfully smoking throughout the times that you are to keep yourself in a space where you can look at your blood sugar and say, I see that my blood sugar 68 and I should eat some carbs. Like not not Oh,

Ashlyn 25:49
yeah, I don't even let it get to 68.

Scott Benner 25:51
Okay, because you could smoke yourself to a place where you looked and were like, hey, my blood sugar 68 I'm gonna die, whatever. That could happen.

Ashlyn 25:59
Oh, no, that's not me. Other people's mileage may vary, but that's not me. I could never do that. Because it's just, that's not my personality.

Scott Benner 26:07
Okay, so Okay, that's interesting. That's interesting to know. So no matter how, what level of

Ashlyn 26:14
what's the word, we'll get into it. I feel when we start talking about everything else, you'll be like, Oh, okay.

Scott Benner 26:19
I'm trying to understand, because I'm trying to see like, no matter how, what level of high you are, it's funny. I don't even have a word like I would if you were drinking, I'd say drunk, right, no matter how drunk you are. But I guess it is no matter how high you are. Right. That would be

Unknown Speaker 26:33
there's other terms that would

Scott Benner 26:35
use some of the national order. Yeah. Which Oh, gosh, should I be saying?

Ashlyn 26:41
Do you want to be hip and cool? Like the kids? I guess I would say, and I get really high. Sometimes I'll be like, I'm Stoney. baloney.

Scott Benner 26:50
Okay. So what you think in this situation is what I should have said when I was asking the question, no matter how Stoney baloney You see, that doesn't work. I feel like these are not good adjectives.

Unknown Speaker 27:04
No, they're not

Scott Benner 27:07
great, where there's a whole section of society where enough words has been made up that you can't speak English with them anymore. Alright, so we have to stick with Hi, just don't think Oh, yeah. Okay. Okay, okay. Thank you. I appreciate that. I'm just trying to like, illuminate like, is it possible because he tried to understand the other side of this conversation right now You and I are talking. But somebody's mother's listening. And they're looking across the room right now at their seven year old who hides behind their legs all the time. And they're thinking, Oh, Jesus, Johnny's gonna smoke weed when he gets older. And so, it's so how, you know, so what's their level of concern? Like, look at yourself, from my perspective for a second, should I be worried about you?

Unknown Speaker 27:54
No, not at all. Okay,

Ashlyn 27:56
I, you know, I pay my bills, like, I'm going full time working full time going to school on top of, you know, the diabetes, the weed all of it. But if for a moment, my responsibilities were slipping, I'd cut all of it out. But I have that level of self control with myself and that level of accountability. And that's where things start to get shaky. If you have an addictive personality, if you you know, can't hold yourself accountable, then you can't play this game.

Scott Benner 28:23
So there are people who use and aren't addicted. And there are people who are addicted. You've seen both kinds of people.

Ashlyn 28:30
Oh, yeah, for sure. And it's, it's honestly, people with an addictive personality. It's not It's not the weed. It's the person.

Scott Benner 28:38
Yeah, okay. So even if this was Oreos, they'd be eaten too many of them

Ashlyn 28:43
right? And it's just whatever your brain chemistry latches on to and you know, you have to make that choice for yourself and really sit down and say you know, do I have a level of self control to where I can balance

Scott Benner 28:56
Yeah, I feel like my I don't even know see it's funny. I don't think of it as self control I would think of it is things that I'm more or less were just left my head things that just sort of naturally happened to me like more or less Where the hell's the word Ash on I didn't smoke anything and I can't find it. They call this a pothole right if you're smoking

Ashlyn 29:23
I have never heard that I'll

Scott Benner 29:24
have to use it like I've hit a pothole meaning I can't think of a word. Holy Christ. Wait a second. proclivity. Wow, that's why I couldn't think of it because it's a word from 1978. But but like some, like, I don't believe I have a proclivity towards like addictive stuff that way. Like I feel like you could give me weed and I could use it and then three days later, never think about it again.

Ashlyn 29:53
That's me with with everything though. Everything in anything, you know, I'm just not who I am.

Scott Benner 30:00
Yeah, like I'm not a smoker, but I could smoke a carton of cigarettes this week and then never think to have a cigarette again. But right, but smoking the cigarettes would feel like work to me. I'd be like, Oh,

Ashlyn 30:11
I could never I

Scott Benner 30:11
can't believe I promised I was gonna smoke a carton of cigarettes is how it would feel if that odd situation came up. And I feel like Alright, so what's the difference between smoking and edibles? I feel like I feel like I hear Seth Rogen talking about a body high versus something else but I don't understand the difference.

Ashlyn 30:38
So the difference between smoking weed and edibles is definitely duration of highness. And a lot of people if you're not living in an illegal state, and you're, you know, going down the down the street and buying it from somebody how much is in there, you don't really know. And that's where you kind of hear all these horror stories of people. You know, buying edibles and then you know, laying facedown for two days.

Scott Benner 31:07
So if I get a chocolate chip cookie, and it's not a it's not a weak cookie, and it's got extra chips in it. I think lucky I got extra chocolate chips. But if I get a gummy that's a weed gummy and somebody put in way too much weed in my gummy. I don't get to think who I got extra t hc is a THC PS. Yeah, I get to think oh, I'm laying on the floor staring at the car. So it's not like getting bonus chocolate chips. It's like it's a it's it's like somebody taking a prescription medication, compounding it wrong, and you're getting way too much in one pill. Well,

Ashlyn 31:40
from what I understand, it's a different absorption as well. You're absorbing the when you smoke, you're absorbing the THC through your lungs. And when you take an edible you're absorbing it through your stomach lining and to my knowledge is may or may not be right. There are two different tolerances. To listen. We're

Scott Benner 31:59
taking your word for it, because I don't know if you've noticed, but you're much more comfortable talking about this than diabetes. So

Unknown Speaker 32:06
you already know

Scott Benner 32:07
you're way smoother when you come to this. I'm like how did you get your blood sugar down? You're like, yeah, it's just a different food. Tell me about weed well, so you don't you don't eat your weed.

Unknown Speaker 32:19
No,

Ashlyn 32:20
I'm not I'm not a huge fan of apples. They do have sugar free edibles here now, which is great. But I just duration of time. And it's just sometimes like I wake up in the morning and I feel groggy after and that's like, I that's a commitment.

Scott Benner 32:43
There's a great article, I think it was from California as a number of years ago, when because weed was legal in California before Colorado, excuse me before like anywhere else, right? Like Colorado was diverse. So this article is out of Colorado is in a major newspaper. It was this big company that was thinking about leaving Colorado, because somebody in New York asked for something to be shipped from Colorado to New York and you know, supposed to be overnighted in a day or two later, it wasn't there. And they called up. And the person they spoke to was like, hey, Relax, man, I'll get there. How do we hire people who aren't high? Because if we can't do that, I gotta get any work done here. But I think that's how people think about it in general. Do you know what I mean? And I'm not saying that's true. I'm saying I think that's the like, I have no judgment about you smoking at all. Like I don't feel in any way judgmental about it. I don't like I'm not sitting here thinking like, Oh, you shouldn't do it. I'm not telling you. I've never done it. And then I'm telling you right now, I don't know why. Like, there's nothing stopping me from doing it.

Ashlyn 33:50
That's that's your prerogative and your choice. And honestly, everybody needs to make that choice for themselves. I'm not somebody who, you know, when somebody has never smoked weed, I'm like, why don't you try it? You know? No, that's, that's honestly horrible behavior. And I hate when people do that, because that's somebody's life and somebody's choice and don't influence them.

Scott Benner 34:11
Well, it is interesting, isn't it that, you know, that culture in general, especially, I guess, here, it says that when you turn 21 you can drink until you fall over on your face? And that's not just okay. It's almost like a rite of passage. But there's a guarantee somebody listening right now saying, well, like what about the person she said might get addicted to it, it could ruin their life, but nobody ever talks about like beer could ruin your life or, you know, cigarettes could ruin your life or any other things that sugar could ruin your there's a lot of addictive things that could ruin your life. This is the only one that people have judgement about, for some reason that they'll voice out loud. Like I'm sure people look at you kind of like side eyed if you're a drunk, but they won't say anything to you about it. And if they do, then they'll say to you Hey, I think you have a medical condition. You know, alcoholism is a medical condition. But nobody thinks of weed that way at all and other drugs. So the reason you came on is because you sent me an email and you're like, hey, do you want to talk about being a type one and using psychedelics? And I was like, wow, there's two things, one of them I know a lot about, and one of them I know absolutely nothing about. That'd be great. Why don't you come on the podcast and talk about that. So in my mind, when you say psychedelics, I think mushrooms, like psilocybin, these are the words that are popping into my head that I don't know anything about.

Ashlyn 35:40
So so when I said psychedelics I'm pretty much open to talking about whatever, silicided LSD you know, anything like that? I

Unknown Speaker 35:53
have.

Ashlyn 35:54
I have a lot of experience with that kind of stuff and trying to manage diabetes while you're doing it.

Scott Benner 36:02
Well, that's what the rest of this hour is about. So where do you wins the art? What's the first You caught me with the LSD for some reason? Cuz that feels like a 60s word in that funny. I'm like, Oh,

Ashlyn 36:13
I'm trying to talk to the moms on the podcast, you know,

Scott Benner 36:17
try to make sure they understand what you're talking about. Or you think I like I was hipper than them when I went with psilocybin. And they were like, I don't know what that is.

Ashlyn 36:26
Yeah, I was surprised. I was like, what are we on Joe Rogan?

Scott Benner 36:30
I know some stuff about a couple of things. I love culture. Like I love knowing about things. I don't necessarily need to need to ever try some things, but I do like knowing about them. So okay, so what's the first I was gonna say psychotropic, but I don't know if that's different than psychedelic. Oh, Christ. Okay, you explain it to me? What's the first thing you ever did? How old were you?

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Ashlyn 40:59
I the first time I tried psychedelics it was I just graduated high school and I kind of reconnected with some family and they were really into like the electronic dance music scene. And for my graduation, they bought me a ticket to go to a festival. Maybe two weeks before the festival I had to go up there to do orientation for my school and we wanted to do like a trial run and how everything would go you know, do it at home, try it be safe. And I took maybe 1.5 grams of mushrooms, you know, followed up by a little bit of a little bit of fruit punch because vitamin C potentially eight silicided.

Scott Benner 41:52
So you take 1.5 grams, and then you drink vitamin C to make it more potent.

Ashlyn 41:58
Yep, it makes it a bit more potent and the duration of action is maybe like an hour less.

Scott Benner 42:04
And this was practice getting high. You were practicing to go to an EDM concert where you would do it there. Is that right?

Ashlyn 42:11
Huh? Yeah, I just wanted to do a trial run just to you know, you have a handle on thing.

Scott Benner 42:16
This is the most responsible approach to an irresponsible thing I've ever heard. You made me think of when bank robbers run out warehouses and tape it off like a bank to try first. Like we just want to make sure we know where it's gonna be. So okay, so your practice at home? What did you find out when you're cracked? And you were like, 18 ish?

Ashlyn 42:38
Yeah, I was 18. I just went on a walk, you know, watched a movie went to bed. It was really relaxing, mild. And I was like, I can do this. Is it fine?

Scott Benner 42:49
is is that amount considered micro dosing? Or is that not? No, no.

Ashlyn 42:56
Anything like under point five, I believe is micro dosing. The beginners dose is about a gram to a gram and a half. And then like standard usage is probably two to two and a half grams.

Scott Benner 43:11
Hmm. Interesting. I feel like I'm not gonna be able to have ads on this episode. No, no, I'm gonna have to get different advertisers for this one. Find out who makes it gravity Bong and forget them here. Okay, because I've heard of people using like, micro doses of mushrooms to medicate. Like, day to day medical issues.

Ashlyn 43:36
I cannot speak to any of that. I am very skeptical of the whole micro dosing day to day ideal.

Scott Benner 43:44
Ah, okay, so that's a whole like sub culture of mushrooms. Maybe like that's a different branch.

Ashlyn 43:51
Yeah, that that's the you gotta talk to like the Silicon Valley guys who do that in code and stuff.

Scott Benner 43:58
I see what you're saying. I hear what you're getting at.

Ashlyn 44:00
You think I'm doing it. I'm doing it. I'm not taking point to to go do some math homework.

Scott Benner 44:06
Ashlyn like, I'm not screwing around. If this is happening, it's happening. How long does it happen for like you when you do it? How long does it last?

Ashlyn 44:15
So with with mushrooms, it's about six to eight hours, depending on how much you take. And then with acid, it's about 12. Plus,

Scott Benner 44:24
could you just jump right off the tracks onto something else? I wasn't done with the mushroom thing yet. So how do you So talk to me about managing your diet? Well, it's just gonna be a weird segue. But you said you've made changes in your diabetes care over the last couple of years. And you talked about earlier having a one season the eights, what is your a one c now?

Unknown Speaker 44:45
So

Ashlyn 44:46
I haven't gotten it tested for a while, but if I look at clarity, right now, it's 6.4.

Scott Benner 44:51
Okay. So I mean, I believe in the data, I use data to track Arden's you know, in between her blood draws, and I I find a number of different apps to be really close. So I'm how I'm completely comfortable saying you have an A one C, and the six is now. And so obviously your management is different now than it used to be you have a Dexcom, you said, You're obviously you're starting to see trends and understand the data and everything. What is it like? So you talked about, when you're smoking weed, you can keep up with your blood sugars? Is it still possible with mushrooms?

Ashlyn 45:27
Yeah, it's definitely possible. But there's a threshold. I have never, you know, taken more than, oh, I've never taken more than six grams at a time.

Scott Benner 45:44
Did that number scare you when you thought of it in your head?

Ashlyn 45:47
Well, because I, the one time I took five was a complete accident. And I normally don't even go that far, I'll normally stay around to maybe less than that. Just because I if you start taking bigger doses of psychedelics you cannot see. And that's not something I'm interested in.

Scott Benner 46:07
Okay. So hold on, I got a couple thoughts here. So there's an amount that you can take where you can still manage yourself. Do you always have a wingman? When you take them? Sir? Oh, yeah,

Ashlyn 46:17
100% 100%, I would not be doing this if I did not. And that's something that I want to stress. This is not a solo venture kind of thing. You know, when I do this kind of stuff in public, it's the only time I bring out the Dexcom PDM. And I make sure to give that PDM to somebody else.

Scott Benner 46:36
Okay, so you have a straight person with you. Every time you do mushrooms, there's somebody you know, that cares about you. And if it's going to sit with you for six to eight hours while you're high and they're not.

Ashlyn 46:46
Well, they're not not always straight, but it's another pair of eyes.

Scott Benner 46:50
So, okay, so we have two high people looking at your Dexcom person, is that right?

Unknown Speaker 46:56
Yeah, it's family, you know, they have my best interests at heart.

Scott Benner 47:00
Okay. All right. So there. So there's an amount that you feel more comfortable at, like you're you feel more in control that, but let's, let's go for Yeah, let's go for a second, to try to understand the difference a little bit. You smoke weed, you're relaxed. You do mushrooms? What are you

Ashlyn 47:22
so in the beginning phases, when it starts to kick in, I normally I'm anxious beforehand to begin with. But some people that I've seen online, they think compare the come up on mushrooms to similar to low blood sugar, you kind of get that disoriented, feeling sweaty, you're just kind of like what's going on. But then you've kind of hit the peak at levels out and then you're able to like you feel not as confusing bodily signals.

Scott Benner 47:52
Okay, what point to garden gnomes talk to you and dragons made of penises fly around? When does that happen?

Ashlyn 47:59
I've never been there. And I don't want to be there.

Scott Benner 48:02
Okay, so. So there's so there's a there's, so just like we talked about with the weed, you could smoke enough weed to knock yourself out, you could drink enough to knock yourself out. You could take enough mushrooms to put yourself somewhere else where your brain is talking in pictures that are likely

Ashlyn 48:16
Well, you reach a point in it's called ego. And what really happens is once you start getting into those bigger doses, it kind of feels like people call it being in a loop. And you kind of like your memory gets very scrambling. And you'll like it's like moments of clarity. And I like to describe it as like peeling the layers of high off. If that makes sense. Okay, you like peak, and then it'll be like mental confusion a little bit, and then it'll be like, you kind of gets stuck. Almost some people describe it as where you're just kind of like stuck in one moment. And you're on a loop. And that's if you take a lot and that's not you know, I I don't like that feeling. And that's not something that's very like, it does not make your diabetes easy to manage when you don't know what time it is,

Scott Benner 49:21
is what you're saying that things slow down so much that you can take a macro view of ideas that is so far back you've never been able to pull that far back in your life because everything's going so slowly.

Ashlyn 49:35
Yeah, kind of time distortion is huge. And then dispersion is huge. And I've only seen the looping thing through other people. That's not really something that I've experienced myself. I have no interest.

Scott Benner 49:52
What's the there are people who have done this that just never come back from it right? They're just like, they lose their minds afterwards. That's It's not.

Ashlyn 50:01
Yeah, it's people who have like latent schizophrenic genes and stuff like that I have a, an ex boyfriend who that kind of happened to and he never really bounced back. But that it, that's a whole other story.

Scott Benner 50:18
I'm not I don't, I don't need you to tell me about him. I just wanted to make sure I'm in an interesting situation here. I listen to everybody who, you know, you say I have type one diabetes. And if somebody were to send me an email and say, Hey, if type one diabetes and I, I pilot a train, you know of a locomotive, I'd be like, I would love to hear about that. You were like, I have type one diabetes. And I do like a dog. So I was like, I would love to hear about that. Then once you get on, we talk about it. It's not in, it's not every conversation where someone listening can go get a train and drive it. And so I want to make sure that while people are listening, that they they understand that, you know, that there's more to it than just like, Oh, I do a little bit of it. And you know, I see a pretty color. And six hours later, everything's cool. You also seem like you're not really well, you're not sure if you're able to manage your blood sugars? Or how do you do that? So how do you let's take any kind of judgment out of it for a second, you're a person who's decided they're going to do mushrooms and you have type one diabetes? How do you approach that, so that you get through it? Well.

Ashlyn 51:28
Like I said, before, mindset and setting, if you're somebody who's uncomfortable, and like kind of has like a little bit of trepidation about the whole thing, do it at home where you feel comfortable, where you have a whole gallon of juice in the fridge if you need it. You know, you want to make sure that you're comfortable. Because if you're not that's going to come out and you're not going to have a good time. And so for me, I have to make sure that I have a level of baseline comfortability, and I plan for a tizzy to happen.

Scott Benner 51:58
So the mindset impacts the high?

Ashlyn 52:01
Well, yeah, in a way, if you kind of it's easy to get, let your emotions get the best of you if that makes sense. And if you start, like fixating on a part of your life that you're not comfortable with, or there has been in the beginning, one or two trips, where I just bodily did not feel right. And I did. zeroed in on checking my blood sugar because I was like, this kind of feels like low blood sugar. And, you know, the trip was not as fun as it could have been just because, you know, I was paying attention to diabetes during that time.

Scott Benner 52:37
Are you saying that diabetes can mess up a trip the same way can mess up a soccer game, like it just doesn't act the way you want it to one day and I got my whole Saturday's ruined. Now. Let's get brand. So then you just you were able to then just like hyper focus on it, you just were like, I'm just gonna pay more attention to my blood sugar, because my body feels different. And that's an idea that I, I think a lot of people don't relate to, or at least I don't like the idea of how does my mind feel versus how does my body feel?

Ashlyn 53:06
Well, for me, I've really, I'm somebody who's very big on like, the brain body connection, like, if I don't feel right, I'm testing. Okay, you know, and I feel like that has been the thing that, you know, when things do get kind of crazy, or, you know, things go off the handle, that's been the thing that saved me

Scott Benner 53:24
that so like when you felt like really low, for example,

Ashlyn 53:28
well, I remember one of the first times that I had done like a bigger dose of mushrooms. In my dorm, I had my blood sugar went down to 40. And immediately it started causing like, visual distortion. And I was like, Whoa, this either just really kicked in or something is wrong. And so immediately, I just went to test and it was 40. And I, you know, drank a bunch of juice and then carried on. But the thing is that in my experience psychedelics do not affect my diabetes in any discernible way.

Scott Benner 54:04
Don't make your blood sugar go up or down or anything like that.

Ashlyn 54:07
No, it's just the stress that you have, or the you know, I make sure to eat a huge meal beforehand, just so that the fat and stuff tides me over. I want that straight line the whole way through.

Scott Benner 54:19
I would think to an anxious person in general, you've probably by now with a Dexcom realize that anxiety pushes your blood sugar up a little bit, right.

Ashlyn 54:29
And I don't really have that big of like stress, caffeine or adrenaline response versus what I've seen from other people.

Scott Benner 54:37
Gotcha. Oh, that's interesting, because I was wondering like this even weed when it releases your anxiety, do you see like just a gentle lessening of your blood sugar or not? I wasn't certain.

Ashlyn 54:48
Sometimes I can see like, if my blood sugar's already going down and I smoke weed, they can kind of exacerbate that a little bit but at this point, I'm so used to it or compensated It's not a big deal. Okay?

Scott Benner 55:03
Where do you get mushrooms from? Like, I don't mean the guy's name. I mean, is it? Like how is it regulated? Like if we can't if we can't regulate weed gummy bears, how are we like, meaning like for potency? How are we doing that with mushrooms?

Ashlyn 55:19
There's actually different strains of there's a lot of good information on the internet, if you look into it, the most common one, they're called a golden teachers. That's kind of the the bigger kept mushrooms. And then there's like the smaller ones, which have a name that I can't say. But it's just it comes with the territory. And honestly, I'm a big researcher, if I'm doing something, I'm going to find out everything about what I'm doing. So that you know just gives me that sense of ease.

Scott Benner 55:56
Have you ever tried to I Alaska?

Unknown Speaker 55:58
No.

Ashlyn 56:01
No, I have no interest that you kind of really lose yourself and you throw up and that that's like three days and I don't know how that could be managed with type one. I I've seen people do DMT and stuff like that. And I have really no interest that looks not very fun. What the hell

Scott Benner 56:21
is the empty? My Don't let me just cover your mouth when you're, you know, this generation. You don't you don't respect me at all. I'm just kidding. What is the Mt.

Ashlyn 56:33
DMT you may have to Google it.

Scott Benner 56:37
I can do that. Imagine if the FBI came in right now. And they were like, let's just look at your history real quickly. Wow. dimethyl tryptamine

Ashlyn 56:48
Yep. So it's, it's a psychedelic, and some people say, and this has been like debunked, that it's the chemical that your brain releases when you die. Okay, um, it's a five minute hallucinogenic trip. And you this is like, what when people imagine psychedelics, this is the drug that they're talking about? I believe, you know, you really. That's the one that kind of takes you to like another world for five minutes. And

Scott Benner 57:18
then we're tied I came from is what you're saying?

Ashlyn 57:20
Yeah, the Grateful Dead was not putting that in people's lemonades.

Scott Benner 57:24
So there's a chemical substance that occurs in many plants, animals, just like when you hear about people looking frogs and stuff like that in the

Ashlyn 57:31
Yeah, way more way more closer to something like that. Um, it's pretty much the the mack daddy of psychedelics.

Scott Benner 57:41
Hmm. There are there are some animals that do that with other animals too. Like there's there. I've seen like a video I think of a was a primate of some sort. getting high off of a another animal was interesting that it just sat there.

Ashlyn 57:57
Oh, yeah. Like the dolphins with like, the puffer fish,

Scott Benner 58:01
stuff like that. Like that's really is fascinating, isn't it? Okay, so that you don't do, but you've done it. Well, I like how you were like, no, but you've done LSD, or you just said LSD so that people would understand what you're talking about?

Ashlyn 58:14
I actually, yeah, that is, if I had a psychedelic of choice. It's definitely acid. Mushrooms kind of make my stomach hurt. Yeah, they kind of make my stomach hurt. And I've always just preferred acid. It's just a cleaner cut high, in my opinion, especially if I'm, you know, going to be doing 30 miles that day of walking and dancing and craziness.

Scott Benner 58:44
Tell me something. Have you ever gone to an EDM concert without being high? Yep. Does the music suck?

Ashlyn 58:50
No, I but I enjoy the music sober.

Scott Benner 58:54
That's what I was. Like. I'm wondering, is it like not i'm not making a judgment about EDM. I'm like, hold on a second almost died. Sorry about that. I am. I'm genuinely asking like, do you need the drugs to make the music palatable? But you like the music? No. So then it so for a person like me, if you said to me, Scott, I'm going to take you out of yourself for the next six hours. I would, I would genuinely not want that. So what what comes from it for you? Do you not I mean, like, what, what's the reasoning behind doing it? I'm not asking you to, to not ask you to talk me into why it's okay. I'm not saying it's not okay. I'm asking what you get from it, and why it's important.

Ashlyn 59:42
So for me, I'm among the group of people that see psychedelics as like a mental refresh button. It just kind of shakes up my perspective and gets me out of the same old rut that my brain is in sometimes and It's not something that I do all the time. I, you know, I, I haven't done it in maybe a year and a half now, since quarantine happened just because I'm not gonna sit at home and do that, you know, there's no point I'm not. I don't need it, you know, it's just when it's worth it, it's worth it. And if I'm going to go out to a club or go out and dance, then yeah, I'll probably take some but

Scott Benner 1:00:25
so I wouldn't see this any differently than a person who just says, Look, I've worked a long week, and I'm going to drink on Friday night and shut my brain off for a while and wake up Saturday morning and start over again.

Ashlyn 1:00:38
Yeah, but yeah, pretty much and I mean, I, the sad thing is, is that my body works better. You know, taking psychedelics or weed than having two beers, having two beers will mess me up for quite some time.

Scott Benner 1:00:53
Yeah, I don't get drinking. Just Personally, I don't

Unknown Speaker 1:00:58
know, I don't like that.

Scott Benner 1:01:01
But I, I also have never, I've never had the feeling that I wanted to reset. Like, I'm like, my life's become, you know, almost unmanageable at times, you know, there's outside influences people. And I grew up in a place where we didn't have any money. There's been things that as I look back, I think, well, if I was gonna forget something, that would have been a great thing to forget, where that would have been a perfect day not to remember, but I've never, I've never had anything that's wanted to push me over to doing something about it. And I've had plenty of opportunities to it's just never, ever occurred to me to actually follow through with it.

Ashlyn 1:01:41
Yeah, but that that's your choice. And, you know, honestly, psychedelics are not a one size fits all solution. Yeah, you know that that's something you have to decide for yourself. And I'm somebody who struggles with depression and feeling. You know, like, I need to change sometimes. It's just again, this is a really personal choice. And that's what I want to stress. I'm not glorifying this, I don't want people to feel like Oh, you got to do this. No, no, no, if this is something people are going to do this, whether you know the information on how to do it is there or not, and I mainly want to do this just for harm reduction purposes and to say you can do it, but make sure that you're being smart and taking care of yourself and that's your priority at the end of the day.

Scott Benner 1:02:24
At the end of this I want you to go over kind of all the things someone should do to be safe, but I have more questions. Do you think a Walton do you think are you using any pharmaceutical drugs for depression or anxiety?

Unknown Speaker 1:02:38
No,

Scott Benner 1:02:38
do you think you would be if you didn't smoke weed?

Ashlyn 1:02:41
No, I tried SSRIs when I was maybe 1516 I just really didn't like how they made me feel. And I don't think that it worked for me but at the same time my depression and anxiety isn't debilitating to the point where I can't manage my life right?

Scott Benner 1:03:01
So a sign of the the side effects of an SSRI that you experienced without the weed would you need them but be unwilling or unable to take them?

Ashlyn 1:03:12
No, no, I don't think so. At all. I you know, smoking weed is not like a must have for me. You know, I I don't think that anything would be different. If I wasn't smoking weed, I just would be a little bit more bored.

Scott Benner 1:03:28
I just wasn't sure if you were managing your health with it.

Ashlyn 1:03:33
No, I don't I don't see it like that. And I know a lot of people are pushing for medicinal marijuana and in the way that I see it. It's really good for physical stuff. Like if you have glaucoma or Parkinson's or whatever, but I really don't think that people should be using it for mental health disorders. I don't think that the studying and has been done and I don't think there's enough evidence for that. And I've seen it personally be negative for some people, and I don't think that people should be pushing it for mental health especially.

Scott Benner 1:04:05
Yeah. Hey, quick question. How did your grandmother like acid?

Ashlyn 1:04:10
Oh, she she hasn't done it.

Scott Benner 1:04:16
I'm sorry. I didn't think she did. I was teasing. You're, you're just you're just calm enough that that I can't tell if my sarcasm is coming through to you or if it's just coming through on a delay, like I'm not certain, but

Ashlyn 1:04:29
Oh, that that's me that I'm super monotone level. Jefferson. I can't tell

Scott Benner 1:04:35
if you're chill or if you're monotone like that was the but Are you high now?

Ashlyn 1:04:39
No, I I'm going to go to work after this.

Scott Benner 1:04:42
Um, what are you doing for can you say?

Ashlyn 1:04:44
Yeah, yeah, right now I'm doing a e commerce listing for goodwill. I like to call it budget antique roadshow.

Scott Benner 1:04:54
And you said at one point you were working at a weed farm.

Ashlyn 1:04:57
Yeah, I actually had to leave when all All of this stuff started happening with the diabetes. We were working out in like farms like 40 miles from the nearest hospital. And it just, I can't dig trenches and, you know, have basil issues,

Scott Benner 1:05:13
your blood sugar's work. Yeah, no kidding. Is that getting worked out? Or you're?

Ashlyn 1:05:19
Whoa, we'll see you on Tuesday. I really hope when I get the pump, it just makes things a little easier, because I just hate that I'm tied to this basil rate for 24 hours. You know, there's some times where like, last night, I, I, my blood sugar was just stuck at 90. And normally, my correction factor is really, or my insulin to carb ratio is really low right now. I thought I was at one to eight. And it seems to be like that during the morning. Like I just right now I had like some toast and stuff. And I i dose for and it went well. But last night, I was stuck at 80. And I ended up eating like, I want to say 40 grams of carbs. And I had like glucose shell I had a banana and the Dexcom never even gave me like one arrow up.

Scott Benner 1:06:08
That's super interesting. So you were clearly going to get lower. Because if you put that much food in and you weren't going up at that number, but are you comfortable at 80 or 90 when you're stable?

Ashlyn 1:06:19
Oh, yeah, I'm comfortable dosing it 80 or 90 for smaller meals. I just want all of this happened. You know, before this, my day, I had like a whole playbook. I was really comfortable. I was confident in using insulin. You know, I, I was really good. But now my confidence in the medication is kind of faltered. And I need to rebuild all of that. And that's kind of where I'm at right now. I've been trying to when all of this started, I was eating maybe 10 grams of carbs a day for months.

Unknown Speaker 1:06:50
No, I now I'm not. I'm sorry.

Unknown Speaker 1:06:54
Oh, no, you're good? No, I

Scott Benner 1:06:55
think you put that really well. That idea of like when the confidence is gone. It's impossible to make a decision all of a sudden, because you can trust it. Because it works a certain way I use this much insulin this happens. This much this happens if I get low I do this, I get high do this. You suddenly leave one place go to another place. And you can't feed a low enough. That's frightening like that.

Unknown Speaker 1:07:20
No, I

Ashlyn 1:07:22
want all of this started. I was I remember, I was working and I went to go take the garbage out. And you know, just to stay level. At that point. I was eating a glucose tab every five minutes. And at first I thought there was something wrong with the lantis I was taking. Because it happened and it happened overnight. Yeah. And I went to go take the garbage out if my blood sugar went from 130 to 55. After like lifting two bags of garbage.

Scott Benner 1:07:50
How much? How much have you reduced your Lantus since you've been there?

Ashlyn 1:07:57
The land I actually switched off of lantis, because I was noticing that during the day, it would just tank me like that. And then overnight, it would give up. And so during the day, I would be feeding, feeding the insulin feeding the insulin and then overnight, it would just stop working,

Scott Benner 1:08:12
you're gonna like having a pump.

Ashlyn 1:08:14
I ended up switching over to receba. I had done that. And it had better results in the past. And I just figured it would last a little bit longer and not just leave me with no coverage overnight. Now, and I switched from 20 units of lantis to 15 units of receba.

Scott Benner 1:08:31
Is that still too much? Are you still feeding insulin?

Ashlyn 1:08:35
I'm feeding insulin at night, it seems like during the morning. It's perfect. You know, I was this morning, I woke up at 140. And I ate some toast did like a unit and a half and it states like went down to 120 and then went up to 141. So it's hold. It's held there this whole time. So I can't say that. The basil is off right now. But it seems like as soon as I get home from work

Scott Benner 1:09:05
that it wants to just,

Ashlyn 1:09:08
it just falls and then I I try to catch it. But then it's just like I'm trying to nudge and then it gets down to like 90 and then I'm like okay, well now I'm going to have to start force feeding.

Scott Benner 1:09:20
Can I ask you something that's not in my business? Do you take birth control?

Ashlyn 1:09:24
Yeah, I do. And I kind of cut that out because I've noticed that on the days that I like do take it it's causes more insulin resistance. And during this time, I've just kind of cut it out because it's just a variable that I don't want to account for.

Scott Benner 1:09:40
Yeah, because I was thinking like there's part of me was thinking like maybe a birth control pill would cost them insulin resistance, which I you know, it's not really I shouldn't say that way. I don't think of it as causing insulin resistance. I think of it as causing a hormonal shift that makes your blood sugar want to go up and

Ashlyn 1:09:55
I know I've I've definitely noticed that But my thing is that right now, one unit of insulin is dropping me maybe 90 points.

Scott Benner 1:10:05
Wow, how much do you what can I ask you? i? Yeah, I

Ashlyn 1:10:08
feel like 124. Wow.

Unknown Speaker 1:10:11
Yeah, that's crazy.

Ashlyn 1:10:13
Yep. And so for small corrections in the morning, like, I laughed when you were talking about like pediatric dosing and you're not even pulling the syringe because that's that true.

Scott Benner 1:10:22
I am right now that that's cholera. Apparently, it's Colorado dosing. Isn't it funny that this conversation is partly about you getting high and partly about you not being able to stay high. This whole thing's about elevation. Yeah. Can I ask you, as we cop on an hour? Is there anything that we haven't talked about? Because I'm, you have the blind leading the sighted right now, because I really don't know what I should be asking you about? Is there something we haven't talked about?

Ashlyn 1:10:53
Um, no, I really wanted to do this, just because when I started, you know, dabbling in that kind of stuff, there really wasn't any kind of resource for people with diabetes, and people are gonna do this, whether the information is out there or not. And I just, you know, harm reduction.

Scott Benner 1:11:11
That's why I agree with that. 1,000,000%. I think, I think if you're raising, like, if you're a parent right now, and you've got like, a little like, eight year old, I go, you know, Jenny, I don't know, I said, Jenny. Oh, actually, I'm recording with Johnny tomorrow. That's why I think it's just in my head. You know, little Jenny, she's terrific. She's never gonna do anything wrong. And sometimes, you know, she won't, right? She'll just grow up and go on her way. And sometimes your kid's gonna grow up and drink or, you know, smoke or get high or do Do you know, LSD, I know, that doesn't seem like something you think's gonna happen. But here's Ashlyn telling you, she loves it. So, um, you know, could happen. And to pretend that it will never end do not speak of it out loud, is a mistake, because you feel like, well, if I don't talk about it, it won't happen, which is, you know, crazy, because you've never talked to your kids once about having sex, and guess what? You know, so you can't stop it by not talking about it. But you can be certain that if you don't have a situation where people feel like they can communicate that when they do do something like this, or like anything that they're not comfortable talking to you about, you're never gonna find out about it. And then you're not gonna have any ability to help them. And I think as a parent, you can't always think of helping as making them stop, you have to think of helping is giving them enough information that they can do it, whatever it is, without ending up with the you know, a terrible outcome or gonorrhea. So you see, got a, you got to talk about stuff like this. Okay, so let's take this last couple of minutes here. And you give me your playbook for how to do this safely.

Ashlyn 1:12:54
Okay, so the main things that I would stress is, you know, definitely go out and buy a test kit. Right now I have a test kit for anything that I have, you know, I have one for acid, and you can buy them off of Amazon for $15. I have these strips that like you can dip it in whatever you're going to take in, it'll tell you if there's fentanyl in them. You know, you want to protect yourself and somebody wants, I like to remember Somebody once told me that if you know, celebrities are dying from bad drugs, why? Why can't you? Why are you comfortable getting drugs from somebody and not testing them?

Scott Benner 1:13:35
So there are test kits that I can buy? That will tell me if what I'm taking is pure. Is that right?

Ashlyn 1:13:42
Yep. It's called a reagent. The one for acid is called like the Arabic reagent. And you just cut a small piece of whatever you're taking off, or, you know, you put it you drop them on. And then over the course of 15 seconds, it'll either turn purple if it's like, what you want, or it'll turn a different color based on what's actually in there. And I've, you know, I'm glad that I've had them because I've bought stuff and then brought it home tested it and I'm like, well, that's not good.

Scott Benner 1:14:15
And so people cut drugs with other stuff, I guess to make it

Ashlyn 1:14:19
it's it's called like a research chemical. A lot of people do it because it's a lot cheaper to produce and, you know, handout instead of having a $5 manufacturing cost, you have a $2 manufacturing cost and that's profit to these people. And you're just you're just a number.

Scott Benner 1:14:37
Yeah. Gotcha. And so they put stuff in it that cuts it so they have more to sell, and then you go home and makes you separate.

Ashlyn 1:14:44
It might be something completely different. And I've been in situations where you know, I I'm saying this for a reason. I've taken stuff to where, oh, this was supposed to last 12 hours. It's two days now.

Scott Benner 1:15:00
It's Thursday now and I'm still high. And what about? Do? Do narcotics ever end up in it? Or they're just people who are nefarious and just want to screw with people? So they put stuff in it that just doesn't belong there?

Ashlyn 1:15:15
Well, I really couldn't tell you why they do what they do. And I just all I'm saying is you got to protect yourself against it. I don't know. I don't know why anybody would do that. That's not something that you know, makes sense to me. So,

Scott Benner 1:15:30
so yeah, so basically, like your friendly neighborhood drug dealer might not be a great person. They might just have

Unknown Speaker 1:15:36
Yeah, newsflash.

Scott Benner 1:15:39
So I, because I'm imagining and i, you are so like, of this generation, like, You're not even willing to, like, Wonder out loud about what a drug dealer might do? That is nefarious. I really do like that about your generation. I'll do it for you then. So imagine that your drug dealer is a bad guy, and you're buying some mushrooms from him, but he really wishes you were buying heroin from him. Maybe he puts a little something in whatever he's selling you to get you going in a different direction. You come back to him, What are you looking for? And he goes,

Ashlyn 1:16:07
Oh, that that's extreme? Of course it is.

Scott Benner 1:16:10
But you understand that right now there is a 32 year old woman listening to this, who thinks that's exactly what's going to happen to Johnny when he tries mushrooms, right?

Ashlyn 1:16:21
That's a stretch, but you all you can do is really be one step ahead of them. And these tests to protect yourself. Yeah. And like I said, the website that I sent you a link to it's called dance safe. They, they show up at like any major Dance Festival in the US, and they have a little tent. And it's it's basically like no harm, no foul, you show up there with whatever you're taking. And they'll test it for you and give it back to you right on the spot. It just harm reduction. They usually have like a little tent or something. And I see people all the time go over there to get their stuff tested. Because they just they're trying to make sure that you the paramedics have less to deal with that day.

Scott Benner 1:17:06
Yeah, that's such a it really is a I've been through the website twice. And she sent it to me, dance safe.org and it's an organization that just does exactly what national just said. It's really lovely. Actually. Do people use it? Like when you're at the events? Do you see people lined up doing this?

Ashlyn 1:17:26
Oh, yeah. And they're, they're super friendly. I go over there just to talk sometimes. You know, they're, they're people with really good like knowledge base. They sometimes they'll have like the booklets where it's like if you buy like pressed pills or whatever, like look for the yellow school bus that you have, like on there, and it'll tell you if it's real or fake or whatever. And they're no judgement.

Scott Benner 1:17:50
Yeah, look at this cocaine test kits, LSD test kits, MDMA. I really do have something for everything.

Ashlyn 1:17:58
And you know, if it's $15 to save you from a hospital bill or a really bad experience, just do it. Why, especially if you're diabetic.

Scott Benner 1:18:11
You know, I'm gonna sound like a, like a rube for a second. But what is spent in on why do I not want it in my body?

Ashlyn 1:18:18
fentanyl is something that they that drug dealers, it's like, it's basically like super heroin. Oh, it's, yeah, it's they people cut like pressed pills or cocaine or anything like that with fentanyl. It's, it's been linked to like a bunch of people's deaths like Mac Miller, who's like a rapper?

Scott Benner 1:18:40
Yeah. died on that plane, right? No, who am I? Oh,

Unknown Speaker 1:18:44
I don't. Yeah,

Ashlyn 1:18:46
I don't think he died on a plane. He just I can't remember if it was Xanax or what? But he had gotten some kind of pill and they had mixed it with fentanyl. And if you look it up, the lethal dose for fentanyl is not. It's like not even like your fingernail. Okay, it's it's a crazy small amount. And so if anybody mixes that in you're, you're pretty much toast.

Scott Benner 1:19:11
You know, for some reason, I was thinking of juice world.

Unknown Speaker 1:19:13
Juice. Well, how

Scott Benner 1:19:15
did I do that? I don't know. I'm 50. You were like rap? And I was like, I know where I'm at I juice. Well.

Ashlyn 1:19:23
I forget that he died. Yeah. Or he? Yeah,

Scott Benner 1:19:26
he's the one I'm thinking of. May I have this right? He was on a plane with a bunch of drugs, and they got rated and his idea to get rid of them was to take them. I believe that's what happened. You'd have to Google that to make sure that I'm attributing the right person. But yeah, apparently. That's not a great idea. either case, you're looking for other bad ideas. Hey, can you put people at rest or maybe you won't? Do you do any drugs that people will think of is hard, like cocaine, or?

Ashlyn 1:19:56
Yeah, I have in the past. It's Something that, you know, I'm just out here doing. But I have done it. And honestly, the saddest part is once again, alcohol is worse on my system. Your I have an easier time doing harder drugs than alcohol.

Scott Benner 1:20:17
House. Can I ask you I know you're young. And and you are you probably don't realize that because you're as old as you've ever been right now. So it doesn't feel that way. But do you? Do you have any, like mentors that are much older than you? who have been through a lifestyle like the one you've kind of describe today? Because I'm wondering like, is this? How sustainable is this? over decades, not just a year or two? Do you know what I mean? Like,

Ashlyn 1:20:45
oh, I, at my level with not having an addictive personality and using it as like an anniversaries, birthdays, Christmas kind of thing. I really don't see myself having a problem as long as you take those precautions. I do know people who are older and I do have some family that have struggled with drug addiction, drug abuse. But they're still kicking.

Scott Benner 1:21:12
I genuinely from my perspective, and keeping in mind my perspective as a person that doesn't drink or get high. I don't see the difference between what you just said, and me making the point that I know some people who have a wine with dinner three times a week, and I know people who are alcoholics. Like I don't see the difference between that I think there are some people who do things in moderation. And there are some people who don't. And I imagine you can apply that aesthetic to just about anything in life, not just

Ashlyn 1:21:45
Oh, yeah, for sure. I mean, my sometimes when I, when I feel bad about being diabetic, it's gonna sound horrible, but I'll put on my 600 pound life.

Scott Benner 1:21:56
And you're just like, Oh look, because it's just other problems that aren't mine.

Ashlyn 1:22:00
Well, that's complete sugar addiction. And that looks so much worse than anything I experienced in my day to day life with type one. They can't even go take a shower, because they're so addicted to food and sugar. And like, that's not even technically a drug in the society. I mean, now people are starting to realize, okay, yeah, sugar may be as addictive as cocaine. But for some people, you know, I watch people at my job have three cans of coke in a six hour period. And I'm just like, Oh, God,

Scott Benner 1:22:35
I have no pain. Yeah, soda freaks me out. That is actually one of the funny like, that's one of those things. I would never drink soda. Like that has like, a massively crazy day for me would be if I had like a Diet Mountain Dew, and it would be like a 12 ounce can like like, Oh my God, I've done something insane today.

Ashlyn 1:22:57
I see people like I like last week, I saw one of my co workers go and get like one of those large ICS from like the 711. And just drink the whole thing. And I was like, wow, must be nice, huh?

Scott Benner 1:23:11
I listen, I have a hard time disagreeing with you. I think if I drank one of those, my brain would explode. And my heart would start racing. And I think I'm talking myself out of ever believing I should try drugs, because that might really might really, if he's gonna get me,

Ashlyn 1:23:27
honestly, at this point where I'm at mentally, and this is gonna probably sound insane. I judge people a little bit more for stuff like that versus like, Hey, I do psychedelics, maybe three times a year?

Scott Benner 1:23:40
Well, there you go. That is perspective. I mean, that's a perfect place to stop actually, that really is perspective. Because there's somebody right now, who listened to you and thought this was great. I'm glad she did this. I know what to look for. There's somebody who listened to us and just thought, oh, squirrels out of control. And they're literally standing there thinking that with their hand, like halfway down a potato chip bag drink. That's

Ashlyn 1:24:00
what I definitely didn't want to hear. I don't want to be that person who's, you know, drugs are cool. Okay. Hey, that's not what I'm trying to do. No,

Scott Benner 1:24:10
no, I think you've done a great thing. Like I really do. I think that the way you described it earlier, that people are going to do what people are going to do and information is power, and that they need to have it.

Ashlyn 1:24:21
Right. If this saves 117 year old kid from you know, going to the hospital because he took something that he shouldn't have. Yeah, then I'm happy.

Scott Benner 1:24:32
Yeah, I have to tell you that. To me, these episodes feel the same way as talking about diabetes aimia, which is there are people who tell you like don't talk about it, because you'll teach people how to use their insulin or not use their insulin to have to facilitate this eating disorder. Right. And I think, boy, that makes sense. Like, it really does like is there someone out there right now who doesn't know what it is and you explain it to them and then they go do it because now they have the explanation. I guess that's a, it's an argument that could be made. But I just think that the greater good is served by people having knowledge.

Ashlyn 1:25:10
No, I'm 100% there with you. I mean, I feel like if the, if the knowledge was more readily available, I would have saved myself so many weird, bad times, you know, and I just, I want to save people some time by saying, you know, this is possible. But let's make sure that we have everything in place. And that if something does happen, you can say, you know, I got this, even if I don't feel right, right now, I have the tools and I'm capable.

Scott Benner 1:25:41
Alright. Well, I appreciate you doing this. I really do. Because I know that I know that I probably to some people, they probably think that I'm full of crap, right that like, you know, why would Why would a person who's doesn't drink doesn't get high? doesn't smoke, have people talking about stuff like this on a podcast, I can see people who would just think that I'm saying I don't do those things. And I do. But I really don't like I just never have and, but I do really see the value in other people understanding and I have long believed that overarching Lee, in the diabetes community, what I've seen is people talking about very kind of surface things that in the end don't end up being super valuable to people. And I just always wanted to bring them information that I thought would be really valuable. So it was very cool that you reached out to do this. And and I just I can't thank you enough because it was it was it was brave of you to say that even though you're 100 you're 100% telling me like I do this once in a while, a couple times a year. But you know, you know, not everybody's gonna hear it that way. So I really appreciate this. Thank you.

Ashlyn 1:26:54
Yeah, no problem. I mean, if if people want to feel that way, and want to be judgmental that's on them, but I don't I don't live in that space. You know, I'm very active and open about what I have going on. And I feel no shame whatsoever. It's made me who I am today, and I can't think it enough. Honestly,

Scott Benner 1:27:12
it's beautiful. It really is. I want to wish you a ton of luck with your pump. I think you're gonna like it a lot. And I really hope that you would doesn't have to be a podcast. But if you could let me know if the pumps able to get ahead of the the altitude thing, or if the altitude thing seems to change. You live there longer, though. I can't imagine. I mean, that just seems strange to me. But I'd love to know how that resolves. Actually,

Ashlyn 1:27:37
yeah, me too. I mean, I really can't find any information about this online at all. I honestly thought I was going crazy at the beginning,

Scott Benner 1:27:46
the best I can tell you is that I've had more people than I can count, reach out and tell me they've gone to Colorado and required significantly less insulin. And the higher they go, the worse it gets. But I've never been able to come up with any real explanations for it. Oh, wow. So I'm sorry.

Ashlyn 1:28:04
Yo, no, it honestly this happened in September. And honestly, it's been six months of just re building confidence and trying to remake a playbook to something.

Scott Benner 1:28:16
Yeah, no, I I seriously want to wish you luck. Even if you just think to send me an email six months from now. I'd love to know how it worked out for you.

Ashlyn 1:28:24
Yep, I definitely will. I actually also scheduled an appointment with integrated diabetes. And that's tomorrow. Oh, so I'm gonna have like a pre pump. I guess consult with them and then go see my actual endo in person on Tuesday to do this

Scott Benner 1:28:41
very cool. Who you're doing it with it? integrated?

Ashlyn 1:28:44
It's not Jenny.

Unknown Speaker 1:28:45
It's some.

Ashlyn 1:28:46
It's another lady.

Scott Benner 1:28:48
I think I might have made Jenny a very popular person. So

Ashlyn 1:28:52
I figured as much I didn't request her specifically because I'm like, she's

Unknown Speaker 1:28:55
probably booked. She

Scott Benner 1:28:56
is I'm starting to have trouble getting her. So she's definitely doing well. I wish you luck. I think that's really smart. It's interesting. You're literally doing the same thing with your pumping that you did with your mushroom and you're like, let me just do a test run first before I get right into this. Your person? No, I'm

Ashlyn 1:29:14
a big preparer. That's why I logged on 10 minutes early. Cuz I gotta I gotta be ready.

Scott Benner 1:29:20
That's insane. That's exactly right. Like, I jumped on this. People wouldn't know that. Like I jumped on this really early, hoping that no one's ever early. But I was like, oh, it would help me today. If it was earlier. So in there you are. So I like your pre planning. It's, it's, it's exactly why you I think you thought to reach out about this topic. So very apropos.

Ashlyn 1:29:41
Mm hmm. All right, for sure. Thank you so much.

Scott Benner 1:29:43
Thank you. First, I want to genuinely thank Ashlyn for coming on and sharing her story. It takes a lot to tell people Hey, I do something that You might think is weird, or strange or questionable, but I think is completely normal. So judgments aside, because that's what I like, I like not judging people. You know, honestly, I don't see this any different than the how we eat episodes, right? Somebody wants to eat pescatarian What do I care, low carb, cool, whatever. I'm just interested in people's stories and what they do feel like that helps everyone who's listening. So anyway, thanks so much Ashlyn for coming on the show. Thank you on the pod Dexcom and dancing for diabetes for sponsoring this episode. You can check out that free no obligation demo of the Omni pod or look into the free 30 day trial the Omni pod dash at my Omni pod.com forward slash juice box, get yourself a Dexcom g six continuous glucose monitor@dexcom.com forward slash juice box both of these products are perfect for anyone using insulin. And of course, touched by type one is doing amazing things for people living with type one diabetes, and you should check them out on Facebook, Instagram, or at touched by type one.org. Can't remember those links. They're all at Juicebox Podcast comm or right there in the show notes of the podcast player that you're listening in right now. And if you'd like to find the rest of the afterdark series, go to Juicebox podcast.com. Scroll down scrolling and there it is afterdark audio diabetes topics that no one else talks about. They're all right there. And if you think you have a story that would work for the afterdark series, send me an email and let's find out. Lastly, I hope you enjoyed the episode. I really appreciate your listening and the support you guys give the show. When listeners share the show with others it is how it grows. And it's how we get these great stories. Thank you so much. Hope you have a great day. I'll talk to you soon.

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#449 Diabetes Pro Tip: Postpartum

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

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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 0:11
Hello friends and welcome to Episode 449 of the Juicebox Podcast. Today's episode is the 22nd installment in the diabetes pro tip series. The pro tip episodes began way back at Episode 210. And obviously have happened 21 times prior to this one. If you'd like to see all of those episodes in one place, you can actually go to diabetes pro tip comm they're all right there. Or at Juicebox Podcast comm you scroll down a little bit to where it says pro tip episodes, and you can scroll through them there. The episodes of course are also available in any podcast player that you listen to. Now, each one of these episodes has one thing in common. My friend, Jenny Smith, Jenny is a CDE, who has had Type One Diabetes for over 30 years. She holds a bachelor's degree in human nutrition and biology from the University of Wisconsin. Jenny 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 systems. She is also pretty much the only person I asked diabetes questions to and I love her in these episodes. At the end of this episode, which by the way, if you're a person who's like, Oh, I'm never gonna have a baby or I'm a boy, or whatever it is, you're thinking right now postpartum doesn't apply to me. These diabetes pro tip episodes are, I think terrific. And I think they all go together. There's a lot to learn from listening to this episode, because at its essence, it's dealing with huge variables, which is what you'll find after you've had a baby. So doesn't apply. But it does. You'll see at the end of this episode, I'll tell you where you can find Jenny, I'll tell you where the rest of the pro tip episodes are and what the topics are. And anyway, I think you should listen to this one whether you're going to have a baby or not. Please remember while you listen 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, or becoming bold with insulin. And last thing, this episode of The Juicebox Podcast is sponsored by the Omni pod tubeless insulin pump, go to my Omni pod.com Ford slash juice box to get yourself a free no obligation demo of the Omni pod or to see if you're eligible for a free 30 day trial of the Omni pod dash ui 30 days free. You heard me my Omni pod comm forward slash juice box go check it out. The podcast is also sponsored by the Contour Next One blood glucose meter. The most easy to use, easy to carry accurate meter that my daughter has ever held, owned or used. Contour Next One forward slash juicebox. Get yourself that Contour. Next One. All right, well, that took three minutes, which is probably two minutes longer than it took mostly to get pregnant. So here's Jenny bump. As time passes, I'm becoming more and more aware of a lot of pregnant women or women who want to get pregnant who have type one diabetes who are listening to the show. And who are enjoying that there's a series back in the show with Samantha where I interviewed her every three months like during her pregnancy.

Jennifer Smith, CDE 3:38
Yeah, I remember you mentioning her and

Scott Benner 3:40
that apparently is making the rounds on the on the internet and the way people listen to things. And I just get a number of emails and I'm sure you do as well that are either that start off with like, I can't, I'm never gonna be able to get pregnant because I can't get myself together. And then they go I can't believe I did it or I'm doing it you know, like that kind of a thing. But then there's that. The rest of it that I guess we stopped thinking about because the baby's out. And I don't know that's that's weird. So a person in my mind, being a person who's never been pregnant and doesn't have type one. That journey seems painfully taxing to me from going from not thinking you'll be ever, ever be able to have a baby to figuring it out to then doing it having these insanely great a onesies while you're pregnant. And I don't know it just feels like it would be super simple to just not abandon it but lose sight of it after you have the baby because of all the things that happened after that.

Jennifer Smith, CDE 4:45
And I don't think it's that. I don't think it's that the good majority of women really think that they're just going to just give it all like all the work that I've put in over the past, you know, nine to maybe 12 months if they really did a lot of really good preconception management to kind of get there and managed, it could have been a long haul of, you know, nine to 18 months, let's call it of trying to really strategically nail things down. But, and I don't think that if you've done that, or even if you've come into pregnancy, maybe not where you wanted, but you really did an awesome job of mastering things and getting things taken care of through the pregnancy. By the end of pregnancy, most women are like, Oh, I'm just gonna, like throw it all in the basket, everything I learned how to do. But there is a big piece postpartum that, especially as a first time mother, is completely 100%. New. Yeah, it's I mean, it is it's like being thrown into like, a new job. In a country where you don't speak the language, they're like, Here you go, it's all yours to like, figure

Scott Benner 5:52
it out. And by the way, the job will die if you drop it or remove it,

Jennifer Smith, CDE 5:57
or you're gonna kill a million people, if you don't do it exactly the right way. That's

Scott Benner 6:00
how it feels, isn't it?

Jennifer Smith, CDE 6:02
That's kind of what it is postpartum. I think a lot of the a lot of the Up, Down comes in, because you're trying to manage something 100% new, or the hormones that shift and change after you deliver can be a roller coaster of effect. And for me, I usually say, in a general sense, the first three months post delivery, is going to be kind of a roller coaster up and down. Mainly because especially if you're nursing or pumping to feed your child, the shift in hormones, and the shift in how much you're nursing how much you're pumping, can drive things, the opposite way that you would think that they might, which makes it very difficult to establish, I would have usually like over Bolus for this or I would have usually been really aggressive to nail down this now climbing blood sugar, but I'm going to nurse in the next 15 minutes. So I really can't do this strategy, because otherwise I'm going to take so there's a lot that changes postpartum.

Scott Benner 7:22
Okay, so not only. So there are some people who enter a pregnancy and already have that agency that they need. But But despite that, whether you're a person who had to get there, or you were there already, once you're pregnant, your insulin needs, they drastically change. I know it's not like trimester to trimester Exactly. Right. But there are times when you don't need as much as you think and times you need so much more that it's hard to imagine how much more you need. Right? Right. So now you have that in your head, you've been pregnant, you're having breakfast that prior to pregnancy, took three units during pregnancy took 12 units, and now you've you're holding the baby, you're thinking is this 12 units? Is it three units? Why does the weight of the world feel like it's on my shoulders? Like you know, am I nursing? All this stuff comes together? And how do you do that? It's so you started by saying the hormones, and I only want to spend a second on this. But you know, I'm older. And growing up, it doesn't happen much anymore, like society has really shifted, you know, in the way people are towards each other. And that might be harder for like somebody in their mid 20s to believe but when 30 years ago, you know, stuff that you think of as a joke now is actually how people would think about women sometimes like oh, you know, she gets upset, or you know what time of the month it is, or that kind of thing, not giving any, like, credence to the idea that when your hormones are jumping on, it's really difficult to deal with. And you're right and, and that women are in a particularly vulnerable situation because of that. So how you feel from a hormonal shift could be physically, it also could mean your your clarity. And I think what you said is just really important to remember, especially for first time mothers, when you have a baby and they give it to you, it does genuinely feel like someone just told you that the fate of the world rests in your hands. And you don't understand what to do. But if you mess it up for certain the universe won't exist anymore. It really feels like that.

Jennifer Smith, CDE 9:32
And some people have really awesome babies that are like the easiest. They just they sleep when you'd expect that they nurse beautifully. They sleep again, like they don't have any like, major poop problem. Like you know, you just have this like what you would call like, I have no trouble with my perfect baby, blah, blah, blah. And then there are women who just don't like some kids are just not type of an infant as a newborn, and I think when you have diabetes to then it brings in management again of something that's completely new. I don't know, should I do this? Should I try this is the doctor right? You know, am I gonna do this wrong to my child, blah, blah, blah. And then there's diabetes in the picture, and the timing of insulin, and the timing of adjusting and remembering to change your pump site or to actually take your basal insulin injection. I mean, there's a world of scheduling difference that comes into the picture postpartum.

Scott Benner 10:34
And I would imagine, too, and this is just me imagining but if you live for nine months within a one seat, and like the low fives, there's got to be a part of you as a type one is just like, wow, I want this for the rest of my life to wait. And now you feel like if it's going away, now, it's another failure on top of, I don't understand why this baby throws up all the time. Or, you know, like, I, I'm sure people are like, Oh, yeah, like I've everyone's heard the joke about like, the baby peed on me one time. Yeah, that's fine. My son couldn't hold down food for months, until we figured out what to give him. And, and the culmination of it was, quite honestly, Kelly holding him at her grandfather's funeral. When basically it felt like somebody took a half a gallon of spoiled milk and dumped it on Kelly, because it just came out of him like that at a funeral. And she had only been a mom for a little time. And it's hard. And it's so it's fun to talk about, like, oh, the baby peed on me. It throws up all the time. But sometimes it throws up at a funeral. And you're hormonal, and your grandfather's bed.

Jennifer Smith, CDE 11:40
Now your CGM is going off because your blood sugar is skyrocketing. Because you're stressed out about said incident.

Scott Benner 11:46
Yep. And I was gonna say my wife didn't have type one diabetes. So then all that other stuff that goes on top of it. So what do you so is it similar? Like, could you sit down and make a flowchart? Is it similar for people at at least at some core level? Or is it going to be different for every woman?

Jennifer Smith, CDE 12:05
There are similarities as you know, we talk about in our in my pregnancy book that I co wrote, it's, there's enough similarity, just like in pregnancy, I mean, everybody's going to have some shifts and changes that are a little bit different, very specific to you. Just like diabetes is very specific person to person, but postpartum Yes, I mean, the transition typically, as soon as you have delivered and the placenta has been delivered as well. It's, it's like the placenta, which is the major like functional hormonal unit. Once that's gone, and baby is out, the hormone shift. It's like a drop off a cliff. It's like, it's gone fast, which is the reason that we usually say, based on where you were, at this point in pregnancy, just before delivery in terms of insulin use, if you didn't know where you were pre pregnancy, so you could see how much things shifted up by the end of pregnancy, then we usually recommend adjusting basil rates down by about 50% Wow, okay, that's the that's expected, it could be a little less, it could be a little bit more person to person, again, may differ. But that's a baseline adjustment. So if you've never been told what to do, and nobody's directing very well expect that postpartum you should cut your bezels by 50%. Another really good idea is to most women know when their due date is. If you're using an insulin pump, especially set up a profile, that's called postpartum, okay, because as soon as you deliver, all you have to enable to do is enable that.

Scott Benner 13:39
Wow, that's that was gonna be my question. Like you're saying, like, placenta comes out, you take a deep breath, and go, I need my pump right now. And and that's it. 50% less

Jennifer Smith, CDE 13:48
50% less. Yeah.

Scott Benner 13:50
So that placenta is please forgive me if this is ham fisted, but it's the it's the equivalent of a giant sausage cheese pizza sitting in your stomach that somebody just reaches in and takes out all the sudden and now you don't have that impact anymore. Correct. Wow. Okay. Yeah, I don't know if anybody's ever seen a placenta but it is very close to a cheese pizza. When you look at it.

Jennifer Smith, CDE 14:12
They're very interesting. organs. I mean, they're, and the cool thing is that your body creates it for one purpose. And then it's gone. It's not like your heart which is like, you know, it's always there for your whole entire life. It's like your body makes this thing just like it makes the baby and then oh, it's all done it's only got this like nine month life

Scott Benner 14:35
that's it. I was just thinking this I it's funny. You said that because I was just thinking the same thing. Like why can't we just tell our body to make another heart? Yeah, like I mean, if we can do that, it could at least you know, vacuum or something, you know,

Jennifer Smith, CDE 14:47
at least also make another pancreas man.

Scott Benner 14:51
I mean, why not? I'm not a doctor, but somebody should get on that.

Unknown Speaker 14:56
I entirely agree.

Scott Benner 15:00
Imagine if you just had a panel on your back and you flip the switch and then nine months later your body just spit out an organ. There you go. Have a little slot on your side. I don't know why this isn't possible, probably because of science, but never. Okay, so baby comes out. We're all like, ooh, and and on taking those weird bloody pictures that people take in the beginning and everything and then I change my basil rate. What am I going to see next, my budget? Does the body begin making milk at birth? Or does it even start prior to that?

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Jennifer Smith, CDE 19:36
The way that it should happen again, everybody's a little different and what happens. But what should happen is a first milk is created. It's called colostrum. And essentially that's very short lived in production before milk comes in. It could be a short lived, you know, few days it could be 24 hours before your milk comes in. But that milk is a very like, it's very simple form of nutrition for the baby, it's kind of what the baby is in need of right here and now, and there's not much of it. So it's not like, if you were to pump it, you're gonna get like six ounces of it. That's just that what you would get, right? So but in that simple form, and with the loss of the pregnancy hormones, now you have this sensitized system that was resistant, leading up to this point. And so there and also lies some mental shift, the shift of, you know, nearing the end of pregnancy coming, you know, Pre-Bolus isn't 15 minutes, it's sometimes 45 minutes by the end of pregnancy, in order to have good flat after meal blood sugars, well, now you have to completely flip that switch, and it's back to maybe I need 10 minutes, maybe I need no Pre-Bolus in the early couple of weeks post delivery. So not only is it that your bezel shifts, but it's also that your ratios, shift your insulin to carb, your correction factor your Pre-Bolus time. So there's, there's a major transition,

Scott Benner 21:18
right? You just become a completely different person with Type One Diabetes, just like that. Right? And so is it similar to, but more drastic to getting your period like being that, like, there's that, you know, what I mean, I don't know if it works for everybody. But Arden's three sometime now that she's on birth control, she's more like two different people during the month. But and, and it can be, it's drastic for us, you know, she can go from a unit an hour to two units an hour, basil, depending on what time of the month it is. And it does, but it doesn't flip like a switch. It's not like, but I can see it happen, happens over hours and maybe a day, but it doesn't happen. It's not like at three o'clock. She's like, I just got my period and everything changes immediately. Why is it that just blown up? Much more? Because I mean, what are you really talking about? So for people who don't know, like, I go into pregnancy, I just said, I go into print, let's just say, Alright, I'm pregnant. I have type one diabetes, if

Jennifer Smith, CDE 22:22
you're a lady with long curly hair, I'm

Scott Benner 22:24
a lady. I have type one diabetes, I get pregnant, my basal rate is 1.5 an hour in the first trimester, is it? How much does it go up?

Jennifer Smith, CDE 22:35
A lot in the early weeks. Typically, we a good round estimate is if you know the percent of increase you've had in the days before your cycle starts. If you've taken enough notice, and you have arrived and you offset it by a percent of Temp Basal or an extra basil dose or whatnot, you can expect those early weeks of pregnancy, typically up to about 678 weeks, that you're going to have an increase in insulin need. That's pretty similar. It might be more dramatic than that. It may be less, but you're going to have a ramp as your body is increasing. Its production of now pregnancy hormones to sustain the pregnancy in furthering along.

Scott Benner 23:17
Okay, so I should have said, my my Bolus was ones that we can keep track, right? It say I'm one usually when I get my period, I'm too. So then we're gonna say in the first six to eight weeks of pregnancy, I'm probably going to be more like two more like I have my period, correct? Yes. And they're right. And then from there it goes, it goes up again.

Jennifer Smith, CDE 23:38
So end of first trimester, most women notice either a plateau, okay? Or they notice a bit of a dip off in their insulin needs. For just that end of the first trimester, usually, we say on average, it's about it starts at about eight weeks, goes through about 12, maybe even 1414 weeks, which is that vertel very early second trimester start time period of sensitivity, you may have needed to back off of your Pre-Bolus time again a little bit, you may have gone down slightly in your baseline basil needs just more sensitivity around meal boluses and kind of almost feeling like things have sort of stabilized like you have a little bit more wiggle room like I can eat three chips in between and not actually Bolus for it because it doesn't seem to do anything. Right, right or right. And then second trimester again, a little bit of a nudge up potentially in early second trimester. But a little bit more stability up until about 18 weeks 18 to 20 weeks. We kind of refer to it as the the slow roller coaster climb. So if you imagine you're at the bottom of the roller coaster to begin with, and now around 18 to 20 weeks you start that slow like click click click the roller coaster Hill and that kind of progresses you Increase in resistance along the way all the way up until about 3536 ish weeks just

Scott Benner 25:07
a steady climb.

Jennifer Smith, CDE 25:09
It's a steady climb. And initially in the second trimester, it's on average, expect to make some tweaks to things about every two weeks give or take in Basal as well as insulin to carb ratio as well as the Pre-Bolus, time continues to lengthen, your correction factor may need to get more aggressive. But usually by the beginning of the third trimester, that's the most resistant time, okay. And often through like 34 to 36 weeks, as you're

Scott Benner 25:38
talking, I'm literally have a piece of paper in front of me, and I'm just kind of moving a pen, as you're talking, like trying to make a graph of what to understand. And especially now it's going to grow up every two weeks. So I know this isn't mathematical. And I'm not telling anybody that if you started with one unit, the day before you got pregnant, but where can somebody end up who started at one unit an hour, where could they end up at 35 weeks.

Jennifer Smith, CDE 26:01
So insulin needs, on average, double or triple from pre pregnancy to the end of pregnancy, or what we would consider just pre delivery time, which is about by 36 weeks, by 36 weeks, we reach again, this sort of like plateau place where again, some sensitivity can start to come back, some women's Basal needs start to dip off just slightly shouldn't be aggressive or heavy. And in fact, it's a time period that if you are having aggressive changes in your insulin in terms of like drops in need, it's a time to check in with your provider. Some of it can be relevant to placental failure. And so it's a time again, if things changed drastically that you would check in. But otherwise, it's expected a little bit of a nudge down a little bit of increase in sensitivity kind of creep back in before you actually deliver. But on average, you know, how much to adjust. Like I said, most women either double or triple their needs from three to about that 36 weak point.

Scott Benner 27:04
And so I now you have the baby. And you could be going from this mindset on three units an hour. back to why Yeah, back to one all of a sudden, exactly. And on top of that all the sensitivity around meals has changed. And and you're telling me nursing is going to drop the blood sugar

Jennifer Smith, CDE 27:24
nursing for most women who have good milk supply, and are able to, you know, pump or nurse completely without you know, most women experience especially in the early weeks, usually about the first eight to 12 ish weeks post a delivery, notice some shifts down in glucose. After nursing, during or after, if your child nurses for a lengthy period of time, you could notice it during the nursing session itself. Some women notice it only at certain times of day versus the whole day, you know, having to consistently pay attention every nursing session they're eating, you know, like to glucose tablets, or having half a juice box or something like that. I mean, our recommendations are once you once you are a few weeks out from delivery, kind of baby by that point has some typical sleep wake poop kind of patterns, you're probably still nursing about every three ish hours, maybe a little lengthier overnight, as long as your baby's nursing well during the day, or feeding well during the day. But you know, most often if you're going to nurse in the aftermath of a meal, a good recommendation is to take the bolus dose down or count carbs, but under dose by you know 25%.

Scott Benner 28:47
So it's dramatic enough that if I eat, I keep saying I if the lady eats before nursing, that meal won't need as much insulin because you're going to need some of that meal. So that means if you're not planning on eating, and you're going to nurse, you need to eat something going into the nursing,

Jennifer Smith, CDE 29:03
typically going into nursing or during the nursing session to prevent a low. Yes, and it could be anywhere. It could be simple. It could be five grams of carb, it could be as much as 15 grams of carb. It just depends. And that's where you know, looking at things like insulin on board. Yeah, you might not be bolusing and nursing directly after but if it's still like within two or three hours after you Bolus, you still have some active insulin from that Bolus. And we tell people I at least I say and I know I feel like you agree with having active insulin while you're exercising is a pretty sure way to make yourself low. But and so I'd want to avoid active insulin during nursing as well or plan for it.

Scott Benner 29:48
And the other thing is there too. If you can go negative insulin and get through exercise without dropping you can't do that with nursing this nursing more taxing on your body then some forms of exercise. Is that fair? Like, is there a correlation to think about it in? There are no,

Jennifer Smith, CDE 30:07
I guess there's some relation to think about it. I think, like, I was thinking of overnight, right? Where for the most part, moms, dads, they're tired at night with a newborn, many people are. And if that's the case, you're likely going to bed at like nine o'clock like nursery child and you're like, Okay, go into sleep, because I'm going to be up again at like midnight, one o'clock to do this all over again. You may have eaten dinner at like, seven o'clock, you're going to bed Well, you're well into basil insulin by let's call it 11pm. Right. So any time you're going to nurse after that, and you're only on basil. And I experienced this myself for both my kids, Basil overnight, if I even if I had it at all, am I of basil. While I was nursing kids overnight, in those early months, it was like near nothing. My basil was like, point 2.25 overnight, it was already down to almost nothing. And if I nursed and didn't still have something minimal, like I actually made these, what are called like lactation cookies. They're made with like oats and flax and peanut butter and stuff that helps with lactation, blah, blah, blah, but I made them so they were each about five grams of carb. But they were nice, because I could eat it, it had some stability to it, it wasn't just pure glucose. So it had some stability. And so I've usually eat it as soon as I started nursing, or something like trail mix some nuts and seeds with a little bit of like dried fruit in it, something that was no more than about five or 10 grams of carb. And that helped with the stability component with rather than the bank I

Scott Benner 31:46
was dying. And so this is another time, you know, where the the food choices you make are going to make things easier for you to get you can and you know, so it's gonna, you're gonna have a different scenario going into nursing, if you're like, Hey, I know what to do. I'll have a handful of this and a little bit of that, and that's gonna work out perfectly. But on Thursday, when you're like, you know what I'm gonna do, I'm gonna have ice cream before I nurse there's gonna be all everything about ice cream still exist there and your diabetes. Okay,

Jennifer Smith, CDE 32:15
in fact, those kinds of things, you know, as we know, ice cream, typically should cause a bit of a rise possibly later fat, depending on how much have you ate, you know, two spoonfuls, probably Yeah. But like the whole point of it, probably.

Scott Benner 32:29
You're telling me that there's a way that I can get I can have ice cream far enough out in the future ahead of my nursing where I could balance that fat rise against the nursing. You know, there are some lunatics that listen to this podcast are gonna try that I saw somebody online this morning, who's trying to stay 100% in range till they get to their endos appointment and they're doing it. That's awesome. Oh, my God.

Jennifer Smith, CDE 32:51
That's a lot of

Scott Benner 32:54
meat. Yeah, I don't know. I don't do that. So I for Arden, I think they just get there. They got a little like, I just want to say

Unknown Speaker 33:04
to them, that's what I want

Scott Benner 33:06
to tell people too. I know it sounds difficult in the beginning to have a baby. But if you want to know how good you will get at it at some point. Here's a great example. About two minutes ago, there was a bang in Jenny's house that was so loud. I thought the world was coming to end. He didn't flinch. She didn't stop talking. It was that's what happens. You eventually you just become a steely eyed missile man. She just did not move. She's just

Jennifer Smith, CDE 33:33
because there are beings all day in my house. I mean, when you work, you know from your own home office, and you have children in your home. I'm sure there will be more bangs. I don't know what they're doing upstairs. But they are having fun. It was so

Scott Benner 33:45
it was just a great example of how you do become really great at parenting after you've had kids for I swear to you, you did Oh, yes. I don't need it. It's almost like you didn't hear it.

Jennifer Smith, CDE 33:56
Don't pay attention. Sometimes. Oh, yep. Sometimes like that. Like I have a big sign that my husband made for me. And it's outside my office door. And one side says quiet zone mommy is working. And the other side is mommy is done. You may enter and be loud is what it says. Well, you know, when I'm working, it's still always in the quiet zone. Well, you know, with an EIGHT and a four year old. They know what the sign says. But that doesn't always still click into place.

Scott Benner 34:28
So yeah, does not overwhelm what they want in their hearts at that moment. That's for sure. I listen artists. It's funny. Arden's gonna be 17 in a couple of months. Wow. Isn't that crazy? And I saw her go into where my wife was working the other day. She looked at me like she was six like, Hey, watch this. slides into Kelly's chair sits on top of Legos. Mom, can you rub my head? Kelly's like, you know, reaching around for the keyboard and everything. So it will it will you won't always feel overwhelmed. How many people do you? I don't I'm not sure gonna say how many people but I mean, do you see women generally able to stick to their diabetes goals after pregnancy? Or should they expect it's going to get out of whack? And they're going to have to do some work to get it back? Like how does that usually go?

Jennifer Smith, CDE 35:18
I, I see that you should expect that there's going to be fluctuation that you will have to learn to adjust to, I myself, I had to learn to adjust. Because, you know, as much as I know, clinically, and professionally, the experience itself speaks volumes about what you need to transition through. And so I think every woman postpartum should expect that things are going to be a little bit wonky here for a bit of time. And I mean, some things that I think, helped me transition where I prepped some meals and froze them prior to baby coming, you know, and whether you have diabetes or not, that can be really, really helpful. You know, some of those kinds of things I also had snacks planned I had, meanwhile, you end up sometimes nursing your child wherever is comfortable, you know, planned places, you know, in the baby's room, in your bedroom, and a comfy chair in the living room, just some things that were like easily reachable, that I didn't have to like, call to somebody to bring me and I just had glucose tablets, and some juice boxes, like trail mix, and that kind of stuff sort of set multiple places around. So I mean, there's some planning that you can do ahead of time. But the diabetes management piece of it, it kind of learned as you go, I mean, I'd say that about the women that I work with through pregnancy, if I had to estimate, I'd say about 50% of them end up sort of sticking with me a little bit longer postpartum, just because especially then the new moms, you know, ones that already have one or two kids. They're like, Ah, yeah, I think I got this, you know?

Scott Benner 37:09
So does being pregnant with type one, give you an advanced. So what do I want to say here? There are so many times when I'm making this podcast, that it occurs to me that success with diabetes hinges, a good deal on your desire to be successful, and your ability to feed that desire with effort. Does that make sense? Yeah, absolutely. And so you, you get pregnant. And then it becomes like this thing we were talking about, in the beginning like this, I have this feeling that you are in charge of the universe all of a sudden, and I will tell you to, and I mentioned it sometimes when I talk to adults who didn't have particularly well managed, like, teen years or whatever, a lot of them have a through line, they started to care more about themselves, where they started caring more about another person, like they want and then they wanted to be healthy or because they wanted to be in this relationship or because they wanted to go to do something or, and the baby falls in that category to me like I want to, I'm going to do this so that the baby can be healthy, and that the number of women I've talked to who were living really unmanaged lives with type one diabetes, and then all of a sudden, 4.8 a one sees, you know, they mean an eating like, a lot because they're growing a baby. It happens. I just see it a lot. And so I always kind of think personally, as a person who's never going to have a baby and hopefully never have type one diabetes. There's something about that motivation in there. That I guess the fight in postpartum is to not, I don't know if it's something you can stop, but for all these things that are going to happen to you postpartum to try to still whittle out a little bit of your energy or effort to devote to your blood sugar.

Jennifer Smith, CDE 39:05
Absolutely. And I think a good reason there too, in terms of diabetes postpartum is glucose management still translates into that time period for the sake of the child even though they're no longer growing in you. And your blood sugars aren't as direct have an impact, postpartum if you are nursing and you are not managing your glucose, as optimally as you know would be helpful. Those higher glucose levels are going to impair your ability to make enough milk. Okay, if left high, your ability will be decreased. You will also be more dehydrated as you nurse it takes fluid out of you if you're not putting it back and glucose levels are also trending high. That in and of itself is a I'm going to make your glucose management more difficult.

Scott Benner 40:03
Does it change the milk itself?

Jennifer Smith, CDE 40:05
To a degree? I mean years ago, we don't we don't talk about this really much anymore. Although I have heard some women who've asked me Should I just, you know, pump when I'm really, really high and then dump it because I've been told that that I sugar, milk is really bad for my baby, I mean, overall, increment of right now my blood sugar is high, because I ate something and didn't really have the right carb count, and I'm knocking it down Should I not feed my hungry child right now, absolutely not, go ahead and feed your child nurse your child, pump, whatever, don't get rid of the milk, your body works really hard to make that milk don't get rid of. But the goal is to have more sustained levels that are still in target to so you're able to continue to make milk and that the amount of milk sugar that's in that that breast milk is stable, right? That it's stable, and at the level that it's supposed to be protein fact, carb content of milk changes as the milk as the baby's kind of needs change through the growth cycle. So you want that amount of natural carbon there to be appropriate. If you're sustaining blood sugars, you know, well above 180, you can guarantee that your milk is richer in carb, not by like loads and gallons. But overall, you're supplying your child with bits more carb, and in a tiny growing body. A little bit can be a lot.

Scott Benner 41:36
Okay, that's it just occurred to me like we talked about undiagnosed people can, their urine can smell sweet, or their breath can smell sweet. I was like, I wonder if it could happen to the milk through that makes sense. So much like most of this about diabetes, sustaining low variability is always just very important. No bouncing around, you know, that kind of thing. But if you just threw, like, say you were a person who had the Weber's like, boom, I'm going back to my nine a one see that milk would be tainted in some way? Not Yes. Yeah. It's not perfect as what we're saying.

Jennifer Smith, CDE 42:11
It's not perfect, right? I mean, it is enabled, perfect. I don't know. But I mean, if you're sustained if you're sustaining these really elevated glucose levels, that's not a benefit. And you're going to I mean, for the most part, you're going to have difficulty maintaining no production.

Scott Benner 42:29
You are, it made me wonder when you were talking about long term? What about people who I know sometimes you see people like nursing a two year old? So it for people who do that? Should they expect that? That hit like your body never gets used to that, right? Like, you're gonna get that thing? Yeah, that blood sugar hits gonna come forever? If you? No, not

Jennifer Smith, CDE 42:47
really? No, actually, no. In fact, after about three to four months postpartum, there's a stable enough nature to the milk supply into what your body or your baby is demanding. That for the most part, things stabilize, wow, a lot easier after about three to four months. In fact, I nursed my kids while after they were a year old. And in fact, I think they were both almost two. I mean, it wasn't all day, it was like, for bedtime, and for nap time by the end. So it wasn't really that they were probably even getting very much, but usually post a year, you're typically not going to see that hit. And the big reason, especially after about six months to a year is because now your baby is starting to eat. Okay, while milk supply is still considered the main nutrient up to a year of age, some kids start eating really, really well, after 678 months. And so you may see a decrease in the amount of nursing that goes on as the baby becomes more interested in food and takes in less, especially the overnight many women, you know, might have a really great child who just sleeps all night. And so they might only nurse once or twice maybe or on eat, you know, some women nurse on need during the day. But those, those sessions are not typically going to cause the drop in blood sugar that the early three months will cause

Scott Benner 44:15
I want to make sure I didn't misunderstand something. So there is a balance between you might not be using as much and your body's becoming very good at making it or is the like At first I thought you were saying like the same lady's body that can make an organ knows that can figure out how to make milk without it being like a tax on the system. Like is there some of that and some of the not being

Jennifer Smith, CDE 44:36
back? I think it's a mix. Yeah, honestly, because for the most part, like I said about at three to four month mark. I would say the women that I get to work with well past the immediate postpartum time period, they find a lot more stability in their glucose even though they continue to nurse beyond that point. Then the lactation or the nursing sessions, don't Have the hit that they do initially.

Scott Benner 45:02
Okay, thank you. It's a quick little parable. Why are I asked you to think of there's anything that we haven't talked about, let me tell you that I was interviewing somebody recently who said that they were listening that I interviewed this person I was I talking to them doesn't matter. I was conversing with a person who said that they're pregnant now. They're listening to episodes of the podcast about pregnancy with you in them, while reading the book that you wrote, and did not connect that you were the person from the podcast, they didn't realize the person that wrote in the book was the person talking in the pocket, and all of a sudden, it hit them one day. And she's like, Oh, my gosh, it's the same Jenny. That's awesome. That was really cute. I want to tell you about that. I almost just texted her. And I'm like, I'm gonna tell her that while we're recording the postpartum episode instead? That's awesome. Yeah, it was really cool. Anything we didn't say that we should have? Oh, I'm

Jennifer Smith, CDE 45:56
trying to think, Mmm hmm. You know, the only other thing that we didn't really touch on, while it should be considered is, depending on how you're feeling postpartum. I mean, most women have like this, I give you restrictions up until about six weeks post delivery, when you're going to have your check in with your ob and blah, blah, blah, and make sure everything's healing well, and you're okay. And then they kind of like, check you off. And you can drive again, or you know, if you've had a C section, or you can get out and start running again, or whatever. And I think that's a piece to consider in the mix with diabetes, because, you know, we know what exercise. Now you not only have exercise coming into the mix, but you've also got nursing coming into the mix, and all these insulin changes that you're trying to make. So one of the big things that sort of fits here is if you have maternity time, not all women do. But if you do have maternity time, use your maternity time to try to establish sort of a route, like a routine or a schedule. And some of that's going to be dictated by the baby, obviously. But even regular for you trying to get your nutrition in timely through the course of the day. You know, once nursing is a little bit more regular the baby's wake in nursing times or more you can fit it in or around the meals and exercise is a big one of that. If you're going to start exercising, try it at a similar time of the day to kind of get a feel for how does this work? You know, what can I get away with? What's too much? What's too little? Because I think that just brings in the whole, like, I feel good enough to go and you know, take a three mile run. But what's this gonna do? I don't know. Let's try.

Scott Benner 47:44
I hear you. So it's not dissimilar to it is interesting, as you're talking about it, it really feels like postpartum is a lot like just being diagnosed but having way more information about diabetes, right? Like Like, what if, what if somehow magically, I knew the things I knew, but never had to put it into practice. And then all of a sudden, there was a newly diagnosed person here, I'd be able to roll with the variables much better because I have better tools. And so you're going to go from having diabetes, maybe not doing it, as well, learning how to do it really well, or already knowing how to do it well, and then it's gonna feel like you're diagnosed again, and you're taking care of a baby at the same time. And all your variables changed again, I'll tell you, this is giving me a different feeling for first episode of season seven 2021 was with a woman named Jill, who was diagnosed as she got pregnant. So she was pregnant for the first time and had Type One Diabetes the first time and I am now talking to you thinking I had a lot of empathy for I might not have had enough like, like hearing about us.

Jennifer Smith, CDE 48:57
That's a whirlwind of change. Not only is she pregnant, but now she's pregnant with something she has no background to managing. And she's got to learn how to manage it through the variables of pregnancy as they shift and change. I would imagine that postpartum was probably a lot more difficult for her than pregnancy was

Scott Benner 49:17
I wonder she's she's active on the Facebook page. She looks like she's doing terrific. She actually also was Miss diagnosed type two diagnosed type one. It's a fascinating story. You have to go listen to it if you haven't heard it. Let me know

Unknown Speaker 49:32
which episode is it.

Scott Benner 49:33
I'm actually going to look right now because I don't know. I've I think I'm at the point now where this I've done so many of these.

Jennifer Smith, CDE 49:42
I know you're like

Scott Benner 49:45
hold on let me look real quick. It is called wait on i thought was January only 21. I'm looking. Why do I not see it. It would it would be helpful if I knew what year it was. Now that I know what year it is, I'm getting down. It's called wine beans, babies and cue. It's episode come up with these names. It's Episode 425. Well, she was misdiagnosed as type two. So you know, she still went on a wine vacation with our friends. Beans, I forget babies because she was pregnant. Because she was told she could go she could. She was told she could get pregnant by a person who told her she had type two diabetes. And then she got pregnant as she found out she had type one diabetes, and a doctor with the last initial of Q set her straight. That's where all that comes from. And that's you just made I can't remember what the beans were Damn it is a good episode. She's really lovely. Yeah, but I know her because she reached out right in that moment. Like she found the podcast and she's like, I don't know what to do. I just found out I'm pregnant. I have a baby coming in. I have type one. So I was like, Well, after you figured this all out and had that baby, you got to come on the podcast. Yeah, tell the story. Anyway, she's terrific. And, and so are you. We've covered this pretty well. I like this a lot. We did a little like personal chatting at the beginning. So we didn't get to do one of the things I wanted to do. But I'll just put that on my list for now.

Unknown Speaker 51:18
Okay.

Scott Benner 51:19
I thank you very much. I somehow find it delightful that your kids were much noisier than normal. While we were talking about having

Unknown Speaker 51:27
this was one child.

Unknown Speaker 51:29
Oh, really? That was just,

Jennifer Smith, CDE 51:30
this is just the four year old. The other ones that

Unknown Speaker 51:32
school? Oh, I can

Jennifer Smith, CDE 51:35
imagine he is. So my mom came my mom came this past weekend to visit for my birthday. And she brought them a ring toss game, which has like it's like a wooden base. And then it's got you know the things to like, throw the rings over. And I'm expecting that either the whole thing was lifted up and dropped on the floor. Or the ring toss was being thrown from a larger distance and maybe all the rings at one time were being thrown? How much

Scott Benner 52:03
of this do you think is the part of the country you live in? Is your mother prepping them for beer pong later is do you think that what this could be? I swear to you, it felt like two adults lifted up your dining room table and dropped it for about eight inches.

Jennifer Smith, CDE 52:19
And the funny thing is, it was like like you said I didn't flinch. Because it was like a background like I don't it's just a background noise.

Scott Benner 52:26
I thought I thought off the Bleep myself out because here was the thought in my head. I thought did she not hear that? Cuz you didn't blink. It was fascinating. Anyway, ladies, have a baby get through all this and one day you'll either be as good at this as Jenny or is numb as Jenny is I'm not sure how to put it.

Unknown Speaker 52:48
Yes, it's

Scott Benner 53:00
a huge thanks to the Contour Next One blood glucose meter and Omni pod for sponsoring this episode of the Juicebox Podcast. You can get your free no obligation demo of the Omni pod or find out if you're eligible for the free 30 day trial of the Omni pod dash at my Omni pod.com forward slash juice box. And of course get yourself a meter that just flat out works get the Contour Next One blood glucose meter at Contour Next One comm forward slash juice box. In just one second, I'm going to tell you how to reach Jenny, and where the rest of those diabetes pro tips are at.

Jenny Smith works at integrated diabetes.com that's all you have to do go to integrated diabetes.com Jenny does this for a living. She could actually help you in your personal life. All right now there's diabetes pro tip episodes. They're right here in your podcast player. Like I said at the beginning, they begin at Episode 210. But I've also made a list of them and put a player at diabetes pro tip.com. So at diabetes pro tip comm you scroll down a little bit, and there's tons of links there to different podcast players that you can click on and keep in mind you should never pay for a podcast player. There are plenty of good options that are free. Where you can listen right there on the website. There's a player embedded and has all the episodes in a row from 210 all the way to this one. Now 210 is called newly diagnosed or starting over I think these episodes are made to listen to an order and kind of together they coalesce very nicely. And there's Episode 211 to 12 to 17 to 18 about MDI insulin Pre-Bolus ng and Temp Basal and then there's to 19 to 24 to 25 to 26 to 31 insulin pumping, mastering your CGM bumping and nudging making the perfect Bolus and variables from there. We talked about setting basal insulin exercising with Type One Diabetes, the rise that your blood sugar may experience from fat and protein, how to handle illness injury and surgery, glucagon and low blood sugars, emergency room and hospital protocols. Talking about your long term health, revisiting the bumping and nudging episode. pregnancy is in Episode 364. We have one at 371 that explains Type One Diabetes to others. So if you've got a babysitter or a mother in law, who doesn't seem to get it, just send them Episode 371. Episode 379 is about the glycemic index and the glycemic load of food which is incredibly, incredibly important whether you know it or not. And then of course, this episode, diabetes, pro tip, postpartum, I think you're going to love this series. If this is your first one, go back and check out the rest. There's a little description at the top of the page. And there's even some reviews from listeners who've already listened to the pro tip series. Don't forget, it's 100% free. And you're not on anyone else's schedule. You don't have to be in a program with a guy you found on Instagram. You don't have to be at a certain place at Tuesday night at eight o'clock, you can listen to these at your leisure. And over and over again, if there's something that you didn't understand. They're there for you. And I hope they help. I don't think you should have to pay someone to understand how to be healthy. And that is just one of the reasons why I've put together this diabetes pro tip series. You can shut this off now. Or you can hang out for a second while I read you a couple of the reviews from the site. type one Tara said through an apple podcast review. This podcast has changed my life. I had a desire to lower my agency and manage my blood sugar's better, but was going at it blindly finding this podcast put everything into a tangible and practical management approach that has taken my agency from 8.3 to 6.3 in less than six months. And that's just right now it's going to keep coming down. It's been 1971 again, through Apple podcasts. My son was diagnosed type one about five months ago. I've learned so much from just the pro tip shows. And we'll be listening to all of the episodes. This podcast is amazing, both for the information and for the shared experiences from Scott and his guests that make you feel less like you just got hit in the face with a shovel. And more like you can find ways of keeping your loved ones happy and healthy. And finally, Marty said, I saw a mention of this podcast and one of the Dexcom groups I follow on Facebook. The pro tip series is filled with such great information. Thank you. For someone who has been living with diabetes for 30 plus years. I wish I had been more proactive in finding this information sooner. I'm going to recommend this to my end. Oh, I want to thank you so much for listening for sharing the show with others. And of course, for subscribing in a podcast app. Please please please hit subscribe in your podcast player. All right. I'll talk to you soon. Take care

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#391 Diabetes Pro Tip: Glycemic Index and Load

All carbs aren’t created equally

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

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Amazon Alexa - Google Play/Android - iHeart Radio -  Radio Public or their favorite podcast app.

+ Click for EPISODE TRANSCRIPT

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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 0:10
Hello, friends, welcome to Episode 391 of the Juicebox Podcast. This episode is a another in the pro tip series. That's right, Jenny Smith is here today, Jenny and I are going to be talking rather loosely, more colloquially, if you will, about the glycemic load and glycemic index. Now, please don't turn off your podcast player. I know that seems boring. But what we're really going to be talking about is understanding that different foods impact blood sugar differently, even if those two foods both have the same amount of carbs in them. This is incredibly important. This is something that many of you just undervalue. So while you're listening today, please keep in mind that I think this is incredibly important. And also keep in mind that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, please always consult a physician before making any changes to your health care plan. We're becoming bold with insulin.

Today, I've invited Jenny Smith to come back. Do you know Jenny, Jennifer has had Type One Diabetes for 32 years now. Jenny also holds a bachelor's degree in human nutrition and biology from the University of Wisconsin. She's a registered and licensed dietitian, a certified diabetes educator, and a certified trainer and most makes and models of continuous glucose monitors and insulin pumps. So you know, Jenny from the pro tip episodes, and from defining diabetes, and from ask Scott and Jenny, I know Jenny from my life. And there's no one I'd rather talk about stuff like this with that her. So today, Jenny and I are going to dig a little deeper into glycemic load and index. There are other episodes that deal with this topic. But it deserves to be in here in the pro tip series as well. Because so many people think a carb is a carb is a carb. And that's just not the case. Today, I'm gonna put the ads up front, so that we can talk straight through this episode of The Juicebox Podcast is sponsored by the Contour Next One blood glucose meter. This is the blood glucose meter that my daughter uses every time she checks her blood sugar. And there's a good reason why it's not because they're advertisers on the podcast, we had the meter before the podcast that Contour Next One is small, easy to handle has a beautiful bright light for nighttime viewing a test strip that allows a second chance blood drop, meaning you can go in, get some blood not enough and go back without ruining the accuracy of the test. And speaking of accuracy, this thing is gold standard. I trust it implicitly Contour Next one.com forward slash Juicebox Podcast get there, there's gonna be a lot more than just the next one meter. Here's some other information you'll find at the website. First of all, contour makes other meters. I use the next one, and I love it. But you may want a different one that's under the products tab. Under the resource tab, you can get the contour diabetes app, which works with the Contour Next One meter, it's really great helps you make a ton of sense of your data. Then we get to the meters and test strips tab. Free Contour Next One meter, it's possible Can you imagine that that you could be eligible for a free meter. So check it out. There's also a choice card that may help you save on test trips. And of course support if you need it. All this should be enough. But while you're there, there's one more thing to look into. And it's this is it possible that the cash price for the Contour Next One would be cheaper than what you pay through your insurance. Hmm. It is possible look into it. So whether you just want the Contour Next One meter, want to read more about how it works. You need to get that app you want to look at other meters. Find out if you're eligible for a free meter. Or look into that choice card to save on test trips. Everything you need to know about this is at Contour Next one.com Ford slash juicebox. Please don't forget to check out touched by type one.org if I'm not mistaken. Dancing for diabetes is coming up very soon. Check them out touched by type one.org also find them on Facebook and Instagram. Last thing before we get going t one D exchange dot org forward slash juicebox, it will take you less than 10 minutes to add yourself or your child's information to the T one D exchange registry, you need to be a US citizen. But once you put that information in there, and it's just there's the simplest things asking you questions about life with diabetes. And then they use this data to help make better decisions in the world for people with type one. One example, just one example is that the data from the T one D exchange, led to the ADA lowering target a one C for children. That's a big important step. Because of how it impacts the practitioners and how they talk to you about expectations. It seems like one of those things you just kind of wouldn't think about, but they need to happen. T one d exchange.org. forward slash juicebox. Support the sponsors support the show I thank you very much. All that's out of the way now. So let's get to my conversation with Jenny Smith, about understanding the difference between one carb and another. And the importance of that difference, and how it's going to impact your management. I know it sounds convoluted. I know it sounds boring. But it's it's everything. So please, lesson.

Okay, Jamie? So I know how people's minds work. And the problem with this episode is it's going to be incredibly important. And they're going to see the title and not listen to it. Right? Nobody. I'm just going to curse and I'll bleep it out later. For some reason. You are adoring glycemic load and glycemic index of foods. You're making me crazy. Okay. So here's the here's the problem. The core of this cod podcast, the concept behind it is, I don't think you should have to limit your diet. The unspoken part of that sentence is I also don't think you should have a bag of sugar every day. Right? So I want. Yeah, listen, if you get crazy one day, and you're like, having a pop tart, or I want to eat a bowl of cereal, I want you to understand how to Bolus for that that's really at the the reasoning for the podcast that it's at its beginning, like I said, but the amount of people who say, Hey, listen, I counted these carbs. And it didn't work. So I don't know what you want me to do about it? Well, what I want you to do about it is understand that there's a difference between 10 grams of potatoes and 10 grams of sugar and 10 grams of Pop Tarts and Cheerios. And are the I'm fascinated by how many unhealthy foods people think are healthy. Which one jumps into your mind when you say that? Because I think of wheat bread right away. Like somehow being wheat bread doesn't make it bread.

Jennifer Smith, CDE 8:19
I think of especially in the past five years, I would say maybe even more than that.

Scott Benner 8:27
I know what you're gonna say God,

Jennifer Smith, CDE 8:28
I think of

meal bars. Okay, I don't know

Scott Benner 8:35
what else to call them. That's not what makes a good.

Jennifer Smith, CDE 8:38
It's kind of like the bread idea. Just because Wonder Bread now says that it's wheat bread versus white bread. That's like if you want real bread, like go back to granny. Yeah, bake some bread how she made her bread, right? And even you know breads today being there's a plethora of them on the market. Right? But just because it says wheat bread doesn't mean that it's healthy bread. I mean, if you're talking about like healthy bread, if you're going to eat it, you're talking about the sprouted like low glycemic we'll talk about the glycemic since the purpose of this whole episode. But right I mean, those types of breads the unprocessed, you can actually physically see the grains in it or the seeds or whatnot. There's a big difference between wonder wheat bread and sprouted grain zekiel bread. Yeah, major difference.

Scott Benner 9:32
Even even when I make bread at the house, I'm only just making white bread, but it's at least sugar, flour, yeast, water, butter. That's it. That's what's in it. Like salt. Excuse me. That's that's what's in it. It's of course the flowers processed and the sugars processed. But you can buy a loaf of wheat bread and the first ingredient is high fructose corn syrup. And people are like, I don't know what

Unknown Speaker 9:59
happened. Right, right? I do.

Jennifer Smith, CDE 10:02
I do, too. Yeah, absolutely. It's kind of like I said to though, with the bars, people, lives are busy today. Very busy. And I actually did a whole, like, I think I did a blog post about this actually, or was in part of our newsletter or something all about, like, sort of the false advertising of nutrition bars, right? You're eating your nutrition bar, because it's like, it's low carb, or it's low glycemic, or it's follows your keto plan, you know, what they're, if you're gonna follow a plan, follow a plan and eat real food.

Most I say most of the time like these, like 9010 8020, kind of, most of the time you're doing real food, you know where it came from, your grandmother could identify it, I can guarantee that if I showed my grandmother who is no longer living something like, I'm not gonna name a brand, but a general like, a store bought processed meal bars to be like, what is this? What is this? What is this, go make yourself a peanut butter sandwich or

Scott Benner 11:12
something? No, those things are so dense, with calories and carbohydrates and all that stuff. My son uses them. So my son does not like to have a full stomach when he's playing baseball. But you can't go play college baseball in the heat without fuel. But he can take like a half of one of those bars and power them through a baseball game. There's so much jammed into it. So he likes them because they don't fill a stomach. But it goes to show how much fuel is in it and, you know, things that impact your blood sugar. I thought, you know, when you said, you know, a bar, I thought you might say vegan food. And I thought you vegan diet. And I thought you might say no gluten stuff. Because I had to remember one time, they were trying to figure out my iron issue. And a doctor said, Hey, don't eat gluten for a month. And in a month of eating not gluten. I gained like eight pounds. And I thought, but I'm eating healthier. And then I looked back and I went No I'm not. I'm just eating things that don't have gluten in them. Right, right. Okay, confused, no gluten with health. And my daughter's friend is a vegan. But she's basically a human garbage can. You know, it's fascinating.

Jennifer Smith, CDE 12:33
It is in terms of I mean, just those two, vegan or even being vegetarian is kind of the first right. Okay, you don't want to eat meat. Great. I mean, for the most part, the only animal that I eat is fish. Okay, I don't eat any of the other animals on the planet. I eat fish. It's occasional, not very often. So for the most part, we are mostly vegetarian. And but you could be a very unhealthy vegetarian, you could also be a very unhealthy vegan. Yeah, I mean, if you're doing a heck of a lot of the processed, oh, but it doesn't have any animal based product in it. Great, but like, How long has it been sitting in the bag or the box on the shelf just because it doesn't have animal product in it? Or? Right? I mean, there are healthy ways to be vegetarian or vegan. There are also healthy ways to be on a ketogenic diet. You know, a lot of the products that are on the market for that type of an eating fueling plan are very processed, you can be healthy and actually eat good real food on a ketogenic diet or on a vegetarian diet or on a paleo or a caveman diet. But much of the processed stuff that's out there like you found with the the gluten free stuff. Yeah. Unfortunately, a lot of the gluten free packaged processed stuff. It's made out of very this brings in glycemic index. It's made out of very high glycemic, quick impacting refined carbohydrate, right rice flour, tapioca starch, potato flour. I mean, the lower glycemic ones would be things like if it's made out of like an almond flour, or like the nut flowers or like a coconut flour or something like that. Those tend to be lower impact, lower glycemic still processed. Yeah, but um,

Scott Benner 14:24
well, the reason I bring it up and I'm sure this happens to you constantly been to me far less because I don't speak to nearly as many people one on one as you do. But I am just endlessly inundated with people who want to know like, I don't understand why this isn't working. I eat healthy. It's almost like when people say it's almost like when people say to me, oh, my blood sugar got really low. I've learned not to infer what I think of is low into what they say in the beginning. When someone say to me, oh, I get really low. I'd go right over it. Now. I stopped and I go What does that mean? What number is really low? Because sometimes the person will say 85. And I'll go, Oh, well, that's not really well. And so it frames my conversation. So when people say I eat healthy, I do. I'm like, what does that mean? Because I need to understand what you're eating to talk to you about the insulin you're using, because we did everything right here. Your blood sugar should not be 200 right now, why don't understand I had a really healthy meal. And then when you talk to them, you know, it's like, oh, I had avocado toast and you think oh, that does sound healthy. Except a they don't know. There's carbs and avocados for some reason. They're completely dis concerned with the fact it's in the avocado, and there's high fructose corn syrup and the toast they made and I'm like, Yeah. Okay. So, so, I don't care how anyone eats. I would think of myself as the only real diet I stick to is an intermittent schedule. I only eat in the certain hours. But other than that, in the past week, I've had Ben and Jerry's ice cream. I'm making ribs tonight for dinner, Texas style, in case anyone's wondering gonna smoke them. And you know, I think last night we had I had chicken parm that I made last night. But keeping with Jenny's point, I made the chicken parm I took a chicken breast, I hammered it flat. I put bread crumbs on it, and a little tomatoes and some mozzarella cheese, you at least you could see what was on it, and

Jennifer Smith, CDE 16:25
you knew what you put in it. Yeah, and I didn't have an idea.

Scott Benner 16:28
And I didn't fry it in any of the in, I don't use processed oil either. And the and the olive oil I use is the only cold pressed I don't I don't use the heat pressed. So those are pretty much the only things that I follow. And besides taking, you know, a reasonable amount of like, you know, vitamins. I don't really do anything differently. But I'm also not really interested. I'm not trying to impact my weight. I just want to be healthy and I want to eat something.

Jennifer Smith, CDE 16:56
And you're not concerned with your own blood sugar overall. I mean, you're concerned with your daughters.

Scott Benner 17:00
Yeah, I want a glucose monitor a couple of times my body handles my diet. So that that's and I'm not overtaxing it. I didn't eat like three pints of Ben and Jerry's ice cream. You know,

Jennifer Smith, CDE 17:11
but I think it's also I think that actually brings up kind of a good, a good visual of the difference between glycemic index and glycemic load when you were wearing that continuous monitor. I remember you either. I think you texted and you texted like how much you physically had to eat. In order to get the CGM to register like a bump up in your blood sugar's showing that your body was actually being taxed.

Scott Benner 17:41
It was fascinating. Yeah,

Jennifer Smith, CDE 17:43
by the amount that you ate. And that actually speaks to the load impact, right. So when we talk about glycemic index and glycemic load, glycemic index is really just it considers the amount of food that you've eaten carbohydrate that will turn into impacting sugar in the next two hours after you consume the food. But that's just the tip of the iceberg in understanding and that's been when I talk to people, you know, who are trying to consider glycemic index and like, you have to take it a step farther, there are depths or there is depth to glycemic index. And a step farther is glycemic load, in terms of glycemic load talks about the amount of the food that you're eating at a particular time. And my favorite example to give is watermelon. Watermelon has a very high glycemic index. If you're not familiar with glycemic index or not quite sure it's a scale of zero to 100, with 100 being pure glucose. So as foods are rated on that scale with a number, that higher the number or the closer to 100, the faster the impact should be on your glucose level. Okay? But again, this is in a simple lab generated testing, right where you're only eating my example watermelon, you're not eating watermelon on top of chicken parm on top of like a whole stick of butter. Right.

Scott Benner 19:13
I also wonder, are these things tested on people with diabetes when they come up with the index or people with a working pancreas when they come up with the index?

Jennifer Smith, CDE 19:22
That's okay, that's, I believe it was I believe it's people with a working pancreas. Yeah, to give a true definition of what the impact could be. When sort of outside insulin dosing isn't in the picture but that is a really good thing. It makes me think, maybe looking that up.

Scott Benner 19:40
Here's what it made me wonder about, you know, when somebody tries to catch a low by turning their bezel off for an hour, and then they create like, a void in front of them a black hole where there's no and then they have the tiniest bit of carbs, like my blood sugar shot way up. I don't understand it. Well, your pancreas doesn't work, and you took away all the insulin in your body and then added even the tiniest bit carbs. So the glycemic index of anything away from insulin is probably 100, right? Like everything probably hits like 100 away from insulin. And so when you've got the right amount of bazel, in, these foods are going to still hit on this chart. And before we go on, like I just want, I'm gonna roll through it real quick and just pull a couple out to give people an idea. whitebread is a 75. Right? White rice is a 73 cornflakes are 81. But an apples 36. Right, strawberry jam is 49, a potato boiled is 78. But a potato mashed is 87. So everything hits differently. And when I stand on stage, I try to simplify it down by saying foods punch at a different weight, some of them just hit harder than others. And that's and it's interesting to they have sugars listed out here. sucrose is 65. Glucose is 103. Honey is 61. And fructose, if I'm saying that right is 15. And

Jennifer Smith, CDE 21:11
so it's fructose is fruit sugar. And that kind of brings into the treatment for lows, then, the reason that glucose tablets technically work the best or anything in which dextrose is one of the first three ingredients in like a candy kind of thing. That's the reason it's going to work the best because glucose is the simplest form of sugar that there is there's no breakdown to it, it gets in and it gets distributed and use. Whereas something like fructose, or galactose, which is milk, sugar, sucrose, they're more come there are more combined chemical sugar structures. So your body has to break it apart, to get the glucose out, okay, to actually impact the blood sugar. So

Scott Benner 21:52
in a scenario where a person takes a glucose tab, and it takes forever for their blood sugar to go back up, but eventually it rockets up, that means they have a lot of active insulin at the tabs fighting with is that is that what you would infer from that,

Jennifer Smith, CDE 22:05
that would be the estimate, you know, if there's iob, and there's a load of it, and there's a low and you only take one glucose tablet, that's like a drop in like the ocean of impact the other. The other reason could possibly be whatever is in the stomach already might be hampering the true absorption of that if the glucose tablets kind of sitting on top of that digestion. And if that other food is really highly fibrous, or very high in fat or a lot of protein, it may take longer for that little bit of glucose to definitely impact and get absorbed. Yes. Okay.

Scott Benner 22:43
All right. So I'm sorry, we kind of got away from it for a second. But it all feels really important, you know, that, that you can't just I mean, all carbs aren't created equal. I guess that's how I've boiled it down for the podcast. But again, the the amount of you out there who I try to say to people, like when they're really learning about the podcast, they're going through the pro tip episodes, and they're getting the ideas down, but they're still spiking, and they're getting low later. I always say like, why don't you just simplify your food choices for a little while, while you're practicing? You know what I mean? Like, I think I think I said to somebody recently, if you got it in your head that you wanted to learn how to box and you went to the gym a couple of times, you took some sparring, and you were starting to get confident. Once you had a little bit of confidence under your feet. Your next thought wouldn't be, you know, I had to go find iron mike tyson and see if he wants to go a couple rounds with me because you're not ready for that yet, right? But people make a couple of good boluses in a row and they're like, I'm gonna try Cheerios like, no, don't try Cheerios, it's day three. You're not good at this yet. You're getting better at it. And so if you're having trouble putting tools into practice, I always say go for things that are you know, that don't punches hard while you're practicing it, cut yourself a break, you know,

Jennifer Smith, CDE 24:00
and also learn and I think I've said this before to some other episodes, but learn the foods are the that are most common for you. Take a look at what you love to eat, write them down. Most people have about 20 foods that are over and over what they eat almost every single day, right? mark them down, look up their glycemic index and see how does it work when you try to cover these foods, even if it's like a meal, let's say you eat chicken and broccoli and rice three nights a week because it's like one of your favorite things in the whole great, write it down. Figure out what you did. What happened if it's especially if it didn't work the way that you wanted it to work out and then eat it again, you know, two nights from now and try it again. Maybe it was more insulin that you needed. Maybe the timing was a little bit different. Maybe it takes into consideration though. Well gosh, tonight ate a whole cup of rice with the chicken and the broccoli. And maybe Wednesday night I decided to eat only a half a cup of the rice with this Same amount of chicken and broccoli. So there's the load impact, right? It's the portion of the rice, the rice itself in one cup versus half a cup versus four cups, still has the same glycemic index, that's not going to change. But the load takes into, I guess, what you have to pay attention to is your eating now like a whole cup versus a half a cup. And that load impact is going to then be the big driver of blood sugar after In fact, you might need to play with timing of the insulin a little bit differently based on portion,

Scott Benner 25:36
right. And so Jenny brought up earlier that I tried to drive my blood sugar up when I was wearing a glucose monitor. And I obviously don't have diabetes. And I took a I think it was a big piece of cake with a lot of icing on it. And I ate it and waited. And my blood sugar did not go up very much at all. And I was

Unknown Speaker 25:53
more right. So I

Scott Benner 25:53
forced myself for you people, I hope you're happy. I forced myself by the way, I did not enjoy it. I did not enjoy the last third of the first piece. And I really didn't enjoy the second piece. And I was just like, Oh my goodness. And and when I get to like 132 something like that my blood sugar like,

Jennifer Smith, CDE 26:14
stayed under the defined like 140 mark. Yeah, no, yeah,

Scott Benner 26:18
I couldn't eat myself over 140 if I tried, and, and, but still, I got to 130 in a life where I wasn't getting to 130 a lot. I was having to like, do what Jenny said to get the 130 was having to stack multiple different tough foods on top of each other, like layer them on top of each other's having to have bread with potatoes, and then something else and more and more. I was I spent one night I don't know if you know those little spearmint leaf candies that are just like they're just sugar with, like, they literally they take sugar, and then they dip it in sugar. You know, I sat with a glucose monitor in front of me just going like just popping one of those in like every three minutes. And my blood sugar would not move off of 89 like it just wouldn't move. And I was just like I'm not trying to

Jennifer Smith, CDE 27:12
paint curious. I was Thank you pancreas. Thank you. No, I

Scott Benner 27:16
hate I told you I had a deep feeling of guilt. eating food and watching my blood sugar not go up like a significant it makes me sad thinking about it. I had a real deep feeling of guilt the first number of days I work. And I was just you know, I'm trying to do these things so I can talk about them on the podcast. And at the same time I'm looking over at my daughter while we're like correcting a 130. So it doesn't turn into a 170 you know, and, and I'm just But anyway, like, let's get back to the fun part. I am throwing these candies into the point where I was like, I hate these things now. I couldn't get my blood sugar to go up. That was it. It was it was pretty fascinating. Having said all that, again, I think that the podcast exists because I think people are gonna have a candy once in a while. I think that when people look at the you know at Harvard's good you know what you can swap out for lower glycemic index things. And I think oh, I could have corn on the cob or a leafy green or peas. Hmm. You know, I think most people are like, I would like corn. Would you like corn flakes or bran flakes? No. I want corn flakes. You know. Even white rice to brown rice is you know, now there are ways like you'll learn how to like for us. We I've switched the house over just a boss MADI rice. It just hits Arden differently. Oh, it just does and who cares Why? Like, I tried four different races. And I finally got to one and I was like this is the one that doesn't hit her as hard. This is the one we eat now.

Jennifer Smith, CDE 28:52
does it differ based on how you cook it or prepare it?

Scott Benner 28:56
I only prepare it one way Jenny. I have the zeros is it's a Roshi, people are making fun of me now a rice steamer I have the greatest rice steamer on the face of the planet. And let me tell you why I am able to afford this rice steamer. I was walking through a Macy's one day and they had this little rack of things that had clearly been returned to the store but bought online that they don't stock in the store. And so they just want to get rid of it because they have no place to put it. And my I luckily for me, is it zeros z OJIRUS hai they make bom bom rice cookers right? Wow. And my eye catches this rice cooker that I know in my heart costs like $500 right and obviously I'm not going to own a $500 rice cooker in my lifetime. No. And I looked over and that thing said 75 bucks. And I moved across that store, like Usain Bolt in his prime. I was like allaway people, I snatched this box up and I was holding it. I was like hugging it back. Everybody just moved, like I felt like everyone else knew as I looked around, I realized I was the only one aware that I was holding a very expensive rice cooker with a $75 price tag on it. And I actually it was so crazy. I went over to an employee, I was like, This is $75. And she goes, Yeah, and I went, I will buy this. Thank you. So I took it. It makes perfect rice. It is fascinating. You put the rice in, you fill the water up to the line that corresponds with the cups, the number of cups of rice use, you push a button, it plays Twinkle, twinkle, little star, and 55 minutes later, you're eating the best ratio ever had in your entire life. I don't know I place tinkle. Take a little star when you start up, but it does.

Jennifer Smith, CDE 30:49
My kids would probably love that. They would think that

Scott Benner 30:51
other than that I am the worst. I can't make rice. I screw rice up six ways from Sunday every time I try to make it so

Jennifer Smith, CDE 30:58
I barely have rice. I only have rice when we do sushi.

Scott Benner 31:01
When my son is trying to gain weight, he wants it in the house too. So I make it and I and it goes in the um, it goes in the refrigerator. He just adds it to everything he's eating. You know? Yeah,

Jennifer Smith, CDE 31:10
my choice is always My kids love quinoa, thankfully. And then wild rice, which isn't technically even rice, it's it's the seed of a long grass. So there's little education for you.

Scott Benner 31:23
I love I love a nice long rice because I like the the this sort of like, you know, spices that go on with it too.

Jennifer Smith, CDE 31:30
Yeah, but those some they work glycaemic Lee better. And I've just found long term that I mean, my family likes it. So it's not like I even have to cook it separate for me, and then something like brown rice. So

Scott Benner 31:42
yeah, I can't believe I spent so much time talking about my excitement about getting a cheap rice cooker in this podcast episode. I'm sorry for all that for everyone who's listening is like yeah, buddy. This is not helping me. I'm not buying a $500 rice cooker? Well,

Jennifer Smith, CDE 31:54
well, because of the way I asked him how you cooked it. And that does bring in as you were talking about the glycemic index before about like a baked potato versus a boiled potato versus you know, the glycemic index can change based on how something is prepared and or how ripe something is. So for example, like your Apple that you mentioned before, I think it's in like the 30s or 40s or something right? Most apples are considered low glycemic, anything under 50. On the glycemic index scale is considered low glycemic slow impact. Apples are there a kiwi fruit is there most of the berries are there. But then you get into the fruit that you really eat at its peak sweetness. You're talking about the summer melon, you're talking about pineapple, papaya, mango, bananas, grapes being cherries. They're all high glycemic, because their sugars are so developed to get that flavor that you want. I mean, I guarantee you're not going to eat it. Well, some people do. My husband doesn't care. He's one of the people can eat like a green banana, put it in a smoothie, he doesn't care. He's like the bananas there. Because I like the nutrition in it. I don't care how it tastes right. I cannot eat a green but

Scott Benner 33:10
he's dry on the outside when you're biting Do you notice that like the fob? Like, why is that doing that to my mouth?

Jennifer Smith, CDE 33:15
In the my mouth? Yeah, I wish people could see us that we make when we're talking. Oh, but I mean, I bring that in because glycemic index is higher for a ripe for fruit. And the impact is going to be faster. And I can tell you if I make a smoothie with a less than ripe banana because it's what we've got, and I want a smoothie. The impact is definitely different for me. And I strategize my bolus timing, different based on that. Based on that,

Scott Benner 33:47
well, you hit one with Arden loves cherries, and they like I have to like swing at those with both hands. You know, when your bolusing there, they're really tough. That is, see I I find all this fascinating. And I find it sad, because I don't think that many people think about it at all. They just count the carbs. And then they're like, well, this I counted the number and the number says 10. So it's 10. I do right? You know what I mean? Nobody thinks about the insulin, because I don't think about the carbs that much like I look at the food and I pick the insulin. I saw somebody the other day. They were you know, they had this meal. And they're like, we used two units or three units. And I was like, What is this like a? Like, I don't understand is this like a four year old kid and it wasn't it was a teen and I'm like, that's not gonna work. And you know, and then I asked them their ratio, and they're like, Oh, it's one to 10 and I was like, You think this is 25 carbs? I was like, This is 60 carbs. You know, if it's one it's 60 and I'd be scared to say 60 as I was looking at it, I was like I'd like to go 70 to be perfectly honest with you and and and they're very 2030 they're not sure. And then the kids blood sugar jump Up to 240. And they don't know what happened. And then they're correcting, correcting, correcting, then the food gets digested out the kids crashing down, and then they're correcting, and then they won't and it goes by and it's just, it's never ending,

Jennifer Smith, CDE 35:12
I think, you know, the topics of glycemic index and glycemic load are, they really are such, they're kind of the, like, further down the road when you're talking about like, just correct carb counting how to get that squared away, right? That is step number one, get, get some carb counting, get some labels read, even if you have to do portion estimation, that's your tool that you're get good at portion estimation, then for again, those foods that are on your, these are the typical things that I eat. Great, then we can move on further to things like glycemic index glycemic load a little bit better bolus timing, and then you kind of then maybe another step further is how is it cooked? Right? Am I boiling? My potatoes? Are my baking my potatoes? Am I you know eating a green banana? am I eating a completely black but

Scott Benner 36:06
what you're you're kidding on something that I know I want to talk about on the podcast more with you in the future, which is F after speaking to so many people, like I realized that there's a an order in which you should pay attention to things when you're starting. Right, right. And like in an overly simplistic way, like I always say, if I was if I was on the Titanic, and I was thinking you, you somehow recognize me as a person who could help people with diabetes. You know, like, Scott, I have a tape recorder, you're 30 seconds. What do you want to tell people about type one diabetes, I'd say get your basal insulin, right? Learn how long your Pre-Bolus is, and then understand the glycemic load index of food. And then I would go under and freeze to death and drown. But But those like if the if I could only say those things to you like three things to you, I'd say that. And then from there, I'd start talking about well, it's timing and amount, you know, and you can't forget about overnight, this happens. And you know, protein and fat cause rises. Like there's the variables, I just think of it as the seed of the idea. Like I always think of like management of diabetes is a tree, it's 100 year old tree with 1000 branches. And every point of that tree is important. But at its core at its seed, it's bazel. And then it's you have to Pre-Bolus and then it's you have to understand the impact of the food. Like that's the start of it, you never, but I see so many people who are out on the tip of the 700th branch going, I really want to understand this part. I was like there's a lot more to understand before you dig into that, you know, they're back at the trunk. And here's the problem, right? No one tells you to Pre-Bolus no one ever tells you basal insulin is important. And the words glycemic index and glycemic load are not sexy, and I don't like to pay attention to them. When I hear them. My brain goes in boring. That's for people who eat good. Like that's how it made me feel when somebody said to me in a doctor's office one day, I'm not trying to run a marathon. I don't care about glycemic load. They instead of saying, hey, you over here, these are the three most important things you need to understand. They told me the most important things and then moved on to stuff that doesn't matter as much. So not that none of it matters at all matters, but there's a core of it. And if you do the core, you're okay. I'm telling you bazel Pre-Bolus glycemic load glycemic index. Is anyone seen the sixes? That's my guess. You want it in the fives. start crawling out in the edges of the tree and figure out the rest of it. But this is an exercise. Yeah, get a pump and go for a walk. Like there's I could say stuff all day, but you know, stop eating Pop Tarts and telling me like it's not fair. I can't help it. Of course, it's not fair. But first your poison.

Jennifer Smith, CDE 38:58
I remember the last time I had an

early college because there was like nothing left in the cafeteria or something. And I was like, Oh my god, I have to eat something but

Scott Benner 39:08
my insulin Chinni assigned to that if you want to goddamn pop tart, eat it. I don't care. Just don't act like you don't understand what happened afterwards because that makes me sad. Like I just you're killing me online. Okay, you're putting things up online. You're making me sad because I want to come say all this stuff to you. I don't have time. And you're breaking my heart. So and and when I when I help people privately. Some people get it more quickly. And some people get it slowly. And then some people give it away like after they know it and I've seen him do it and then they stopped doing it. I'm just going to tell you like I don't follow many people's tax comms. And when I do I don't for long. But when I do, and I've seen you do it, and I've seen you understand it, and then you have a 300 blood sugar. I got to stop following you. It just it breaks my heart like I just can't like it eats me up. You know, I look at the graph and I'm like, Oh my god, like they didn't Pre-Bolus? Or why are they not correct?

Unknown Speaker 40:05
Could have

Scott Benner 40:06
been a bad pump site or could listen, it could have been anything. The problem is, it's just, it's ripping my guts out. I can't look at it anymore. Like with my daughter, I can do something about it.

Jennifer Smith, CDE 40:15
But it's it's hard to follow people. I agree. I mean, with the, with the many, many, many people. I see their data. Yeah, it is. It's hard. Because I think, you know, there's, there's no, there's no stop to, like, my job isn't like, I go to the office, I do my job, I put everything away, I close the door, and then I go home, right? Like, the people that I work with become like, they're almost like family to me, right? There are people that I care about the people that I get the privilege to work with, and help and I want the best. And I sometimes I feel like I could just like go home with everybody. I

Scott Benner 40:57
just texted a person this morning. And I said, if you could just come here for, I think 18 hours. I could just do this for you. And you could see, but they and they know what to do and they won't do it. And I'm just like, oh my god, it just really I listen, I'm not trying to turn this. It's hard on me. Like a really does. Like it just rips me up. Like I'm like you keep making the same mistake over and over again. But it's not out of ignorance. You you quite honestly know not to do it. And you just I don't know if it's fear habits

Jennifer Smith, CDE 41:29
are hard to break.

Scott Benner 41:30
Yeah, or habits are hard to break. But you're just you're doing the wrong thing. Like it's and I've told you it's the wrong thing. 10 different ways. And each time I say you say I understand I now you know what it is. I now know what my wife feels like when she's talking to me. It must be Kelly. I'm so sorry. It must be incredibly frustrating to say the same thing to me a million times, amigo. No, no, I understand. I hundred percent understand it three days later. I'm just doing it again. But But and so it's like, I don't mean to come down on it. I'm not trying to come down with evil. I'm just saying that. Jenny's not wrong, like following someone's blood sugar is it's a lot. And it's tough to win a guy. I don't think I know everything. And I but it's tough. When you look at a graph and you go, Hey, you know what, you need more? bazel? And they go No, you know what I think? And I always think to myself, I actually started saying it out loud. I started going like, why don't we stop worrying about what you think cuz what you think led to this graph I'm looking at, you know, so try what I think first I get and see what happens.

Jennifer Smith, CDE 42:32
That's even try it my way for a little bit. Yeah,

Scott Benner 42:35
here and listen, I'm gonna cost Jenny some money and save all of you and our paying or Freddie, stop explaining to Jenny what you think, let her tell you what's going on. Because you're just in therapy at that point. And that's not getting you to a better blood sugar thing. You know what I mean? Right? How many stories people tell you where you're just like, stop talking, this doesn't matter.

Jennifer Smith, CDE 42:59
And sometimes, you know, sometimes it's a marriage of what I see. And sometimes it's adding in then what they've seen, but they're addressing a certain way, because they think something's happening, that isn't really the reason for it. So it's kind of a marriage of what I see and how to tell them about what to do differently. It's not that what you're seeing is wrong, it's that the adjustments are not quite the right, adjust. You're

Scott Benner 43:24
100% right. And I was being too flippant, like you do need to hear it from them. But it's fascinating how infrequently their interpretation of what they're seeing is right. Right. You know, you need to you need to hear what's happening. You don't need their interpretation of what's happening. It's much it's interesting. Anyway, it's like it's like trying to do I don't know it's it's the weirdest customer service in the world like it people. This is like that except times like a million. So anyway, Jenny has to go. She's She's so I do drop bombs of knowledge and truth all over this episode. So I really appreciate that. I will talk to you soon. Awesome. Huge thanks to Jenny Smith. Hey, Jenny services are for hire. You can find out more about her at integrated diabetes. There's a link right there in the show notes. There's also a link for the Contour Next One meter touched by type one, the T one D exchange, and all of the other sponsors of the various podcast episodes that includes Omni pod Dexcom and G Vogue glucagon. All right, they're right there, right there right there. In your podcast player notes. Those links are also available at Juicebox podcast.com. But I'm gonna roll through them really quickly for you just in case and then I'm going to do a little freeform chatting about this topic. All right, ready, touched by type one.org. Contour Next one.com forward slash juicebox T one d exchange.org. forward slash juicebox. The other sponsors that aren't in that aren't on this episode, but are still incredibly important. Dexcom is available@dexcom.com forward slash juice box, you can get a free no obligation of the Omni pod at my Omni pod.com forward slash juice box and learn more about GMO glucagon at G Volk, glucagon comm forward slash juice box. Okay, now, almost everyone who uses insulin runs into this specific problem. And that problem is this. You count your carbs, you put in your insulin, and everything goes exactly the way you expect. Next day, you make a meal, you count your carbs, you put in your insulin, and nothing goes the way you expect your blood sugar gets low later, or it gets incredibly high. This is confusing, because yesterday, I counted my carbs, I put it in my insulin and everything worked. Today I did it again, some of you will question your carb counting skills. When this happens, some of you will run out and buy a very expensive scale. Very few people say to themselves, I bet the glycemic load of the food was greater or lesser than the glycemic load of the food from yesterday. Now you wouldn't think that because nobody tells you to think it or they say too soon after you've been diagnosed, and you feel like somebody just hit you in the head with a baseball bat. So you're not really listening, or the words glycemic load and glycemic index seem difficult, or maybe next level or whatever. But it's not. It's very simple. Some foods impact blood sugar differently, even if their carb count is the same. That's it, you just have to see it happen, except that it's true. Remember, and adjust your insulin for that food. That's what this entire episode told you. That very simple idea. You make yourself meatloaf mashed potatoes, you put some broccoli with it, you count the carbs. And somehow you've decided it's I don't know I'm making up a number. It's 40 carbs, which by the way, it's more. And you give yourself your insulin, your blood sugar shoots up later you correct with, I don't know, a couple more units, your blood sugar comes back down, it doesn't get low. The next time you have mashed potatoes and meatloaf and broccoli, and you count the carbs and you come up with 40. Again, you have to remember the two units you corrected with, you have to remember that those two units belong in the initial bolus. Maybe not every drop of two units, but pretty close. The reason I say that is because once you have a higher number, it takes more insulin to bring it down. But some of that insulin, if it was in the initial bolus, the spike would not have happened from these potatoes. And by the way later, the fat and protein and the meat that keeps your blood sugar higher layer, which you know, you need to go listen to the fat and protein pro tip episode to understand that.

So the next time you have this meal, I don't care what the carb counts that you have to trust that what you know is going to happen is going to happen. So all these little sayings and isms that you hear throughout the show, they're really just shortcuts to understanding that there is a different glycemic load from food to food to food. Because the next day, you could have a meal with 40 carbs in it that doesn't have those starchy potatoes in them. And I don't know wasn't mixed with the fat and the protein. And all that insulin could end up being too much. Now your meal ratio works. So what you're hearing is that your meal ratio isn't set in stone. It's all dependent on the foods you're eating, the glycemic load and the glycemic index of the foods. But you know, you can go check it out if you want. It's a matter of fact, I'll I'll find the chart that Jenny and I were talking about. from Harvard right now. I find it right now for you. And I'm typing. So I'm vamping a little trying to kill time. Because I don't feel like editing this part out. You're looking for a link called a good guide to carbs the glycemic index from Harvard health publishing and a link called glycemic indexed for 60 plus foods, which will give you an idea of what we're talking about that white bread punches different than corn tortillas. It's sweet corn punches different than porridge that on orange raw hits you differently than a potato boiled, which by the way hits you differently than a potato mashed which by the way hit you differently than a potato fried. These are the things you need to understand when you're watching your blood sugar's move all over the place, and sometimes it works. And sometimes it doesn't you love to hear people say, Oh, you know that about diabetes? One day, everything just works. And the next day it doesn't. It's not really true. If you had the right ratio of insulin, it would work every day. That is true. I promise you. All right, I'll put links in the show notes to those two blog posts from Harvard. I hope you're enjoying the pro tip episodes. If this was the first one you heard, you're probably like, you should definitely go back to Episode 210. And start at the beginning. Diabetes pro tip newly diagnosed, we're starting over and then listen through those pro tips. The pro tips are also available at diabetes protip.com. But you know, listen to your podcast app because that's how kids do things and they know way better about technology than us. Thanks for listening. I genuinely appreciate it. I'll talk to you soon.

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