#260 Defining Diabetes: Trust Will Happen
Defining Diabetes: Trust Will Happen
Scott and Jenny Smith, CDE define the terms that are at the center of your type 1 diabetes care.
Bonus content from listeners.
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Pandora - Spotify - Amazon Alexa - Google Play/Android - iHeart Radio - Radio Public or their favorite podcast app.
+ Click for EPISODE TRANSCRIPT
DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Defining diabetes is made possible by Dexcom on the pod and dancing for diabetes, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, the Always consult a physician before becoming bold with insulin, or making any changes to your medical plan. Very much enjoying these defining diabetes episodes. So much so that I'm adding a little flavor to our Fridays. So far, you've been getting defining diabetes every Friday, I'm going to start mixing in something else that I call ask Jenny and Scott, these will be questions sent in by you through the Facebook page that Jenny and I will read and then do our best to answer. So I don't exactly know what I'm gonna do yet. It might be like every other Friday, like a defining than an ask, I don't know, maybe I'll add a third day to the week on the show. I don't know if that would be too much for you guys. You're not getting three episodes a week. Anyway, I'm figuring it out. And I hope you enjoy it today, though, it's still defining diabetes. Today, we're talking about an adage from the podcast that I believe is just a staple of how I manage Arden trust that what you know is going to happen will happen.
I'm going to ask you today is a very common saying from the podcast. And I don't even know if you've ever heard me say it. But if I said to you that I think this is a diabetes management tool. And that phrase is trust that what you know is going to happen will happen. Now, do you want? Do you want me to tell you how I use it? Or do you want to take a guess? I'll take Yeah, okay, this will be fun.
Jennifer Smith, CDE 1:37
So trusting that you know what's going to happen will happen comes from it comes from the intuitive experience of doing what you've done before and drawing on that experience. And I would say for somebody who is for somebody who's newer to diagnosis, like say a month in there may not be as much to draw on. But knowing what you know about the basic medicine, you take insulin, you can also make some pretty good assumptions about what's going to happen. My drawing on experience, for adjustments that I make for exercise, the things that I put into place, I know that if I do too much or too little, I can probably guess a million dollars that I don't have, and what the outcome is going to be. I know that if I do too much of this, and I don't adjust this way, I'm, I'm probably gonna end up higher than I want to be or I'm probably gonna end up lower than I want to be, or I'm going to have to eat something along the way to prevent being lower than. So, I mean, that's what I take it as it's, it's kind of the draw on experience. Yep. Know what's probably gonna happen.
Scott Benner 3:05
It's a phrase that I came up with. And I know there are a couple things in the podcast that I say that are just not like they're not poetry, they don't they don't read well, but they're easy to remember, right? There's probably 1000 better ways to say trust that what you know is going to happen will happen. But what it means to me is when it's when somebody says how do i Pre-Bolus when I'm at well, foods going to make you hire your Pre-Bolus takes a certain amount of time to go into effect. I'm sure you've Pre-Bolus I'm sure you've Bolus before it at and started dropping right away and thought, Oh my gosh, like, look how quick that wasn't that Bolus, the insulin doesn't work that quickly. You know, you've messed something up before that made you low there. It's a confluence of events that make it look like that Bolus is what did it, you have to trust that what you know is going to happen is going to happen, that eating food will make your blood sugar go up, that Pre-Bolus takes a certain amount of time, those things if you don't trust them, then you can get your insulin out of balance so quickly, that you just start bouncing around and then nothing that you're seeing makes sense. And then you start doing the opposite, which is you start thinking you're seeing something happen, you're wrong about it. And then you start gaining see it happened a couple of times and you cling to it like it's a rule. You know, you people all the time, say I get low all the time. And I'm like, yeah, your baseline is not high enough. Now, like that doesn't make any sense. And I'm like, Sure it does. Because your bazel is too low, your blood sugar goes up, you correct it, you forget that you corrected it four hours later, you get low, and then I say make your Basal higher and you go that doesn't make any sense which I get it it doesn't. But But you know, then once you look at it and you trust that you need the right amount of bazel and then it could be more that happens now all of a sudden a variable pops up in your life. Your period comes and now instead of saying I don't have enough basal insulin, Your Honor, I got I don't know what's wrong. It's just diabetes. I guess I have to live like this like but no. Your body is making a call to you, it's saying, hey, I need more insulin now than I did last week. So trust that and give it more insulin. I just think that it's the, I think it's a statement that says to your point, you're not going to know right away. But once you start seeing things over and over again, trust them, once you count carbs for a bowl of cereal. And, you know, empirically, you're sure you know, because I counted them 100%, right, and there's 75 carbs in this bowl of cereal and includes the milk. And my insulin to carb ratio tells me that that's seven units of insulin, you put the seven units of insulin in, you do a great Pre-Bolus. And 30 minutes later, your blood sugar jumps up to 250. And then it levels off and sits there and you correct that 250 with, I don't know, say two units of insulin, then your blood sugar comes back down that Cruz's right in at 90. The next time you pour that bowl of cereal, trust that you need all of that insulin, who who cares what the carb ratio
Jennifer Smith, CDE 5:55
per unit units work to bring you down, you didn't get low, you need that upfront, get it
Scott Benner 5:59
up front, stop the spike, trust it. Like you know, there's, there's leaps that you have to make in managing insulin. Because if you don't, you'll keep doing the math, it'll keep going wrong, you keep banging your head against the desk. And then there's that burning that I I've spoken to so many people that have that burning in their gut, they know they're right. And they can't make the leap to doing just what common sense tells them to do. And I'm saying trust your gut trust that what you know is going to happen will happen and go for it. You know, and then what's the worst that could happen that you used two units too much of insulin for the cereal. So drink a juice,
Jennifer Smith, CDE 6:38
right? You know how much too much was there? So cover it with food,
Scott Benner 6:42
cover it with food, right? Think about it differently. Speaking of thinking differently, there'll be some bonus content right after these words with other perspectives on this topic. Before you go, I've added a private Facebook community, to my Facebook page to the bold with insulin Facebook page. It already has like 350 people in it, which is astonishing. I put it up like two days ago. And everyone's already asking questions, supporting each other and answering questions. And finding it absolutely heartwarming to see people take something that they've learned on the podcast, run it through their own lives, and then be able to kind of stand up and say to someone else, oh, I hear what you're saying. That's a good question. Here's what I would do. Anyway, if you're looking for support or think maybe you can support someone, check out the Baldwin on Facebook page, go to the community group and join. I'm seeing adults, parents of children with type one, there's a grandmother in there, and plenty of new listeners, lots of people trying to be bold with insulin for trying to support someone who is I hope you check it out. It's absolutely free. And maybe you can add something or take something you know one of those give a penny take a penny things is the convenience store. That could be you but with like diabetes stuff. Jenny Smith is not just the delightful voice you hear on the Juicebox Podcast. She's also a real live person with a job and she works at integrated diabetes. If you'd like Jenny to help you in your personal journey with Type One Diabetes, go to integrated diabetes.com find Jenny's profile and send her an email. There's also links right here in the show notes about you know how you can do that. I think there's actually even a link there to her email. And there's a brief description of her you know, Bona Fie days, why it is you might want to give Jenny a ring. Thanks so much to the sponsors Dexcom on the pod and dancing for diabetes, there are links in your show notes at Juicebox podcast.com, where you can find out more about the Dexcom g six continuous glucose monitor, figure out what's going on at dancing for diabetes calm and order a free no obligation pod experience get That's right, a free no obligation demo of the Omni pod.
I'm always trying to expand my knowledge about type one diabetes and using insulin so that I can speak to you about it better, and do better job for my daughter. Last night, I got a private message from someone who was thanking me for opening the private group that I was just talking about a second ago. So there's a Juicebox Podcast discussion group where listeners are talking and helping each other. Anyway, this person sent me a note. And in part of their note, they said, quote, it's a place where we can all speak and practice and embrace the language you taught us. And, you know, that was just really an amazing thing for me to read. Because it It took me a minute, it probably sounds a little you know, I don't know unseemly to say it here. But when I read those words, my first reaction was, Wow, that's amazing. Like, I never had that intention for the podcast. I didn't realize it was gonna be so impactful for somebody. But then I felt good about it. I was like I did do that didn't I like I made up a thing a saying and attach it to an idea and someone heard it and applied it their own life and had real success and I was proud myself, but then I saw these people helping each other in this private group. And what really interested me was seeing my thoughts distilled through another person's experiences. So I say something on the podcast and other person hears it on the podcast, they put it into practice in their own life. And, of course, may have a slightly different results or find a different way to use the tool. And I find that incredibly interesting. And I want to learn from that. So I posted, you know, an image today that says, trust that what you know is going to happen will happen. And I asked people, can you please tell me your definition for this idea? You know, I asked Jenny Smith about it, and it's gonna be on the podcast, and but I'd love to know what you guys think the answers were some I expected and some were really eye opening. So I'm going to go through them with you just kind of briefly. One person says this is central for us. To me, it means trusting your gut on the patterns you've seen over and over, even if there's no clear explanation like food or exercise. So to them, it means trust your gut. Another person says, This is so hard for me, I feel like this is where I am now I know where I think I know what I should do. And sometimes I do it. And it works out beautiful. But most of the time, I'm still cautious, I'm cautious because I feel like bazel changes so often. And if bazel is often who knows what the outcome is going to be. So that's a person who wants to trust if it's sort of just can't figure out how to yet couple other people come in and support her on that statement. You know, say I understand how hard it is to be cautious, but you can do it and be very nice. Now the next person says, For me, this translates to quote, we know that that's it, we know that we know that it translates to we know that. So what they're saying is while they're slowly working with their daughter, as she gets ready to head to college next year, they'll say to themselves out loud quote, we know that if your say 2022 units will get you to 140 with no food on board. Then she says we extrapolate each situation from their quote we know takes the place of trust what will happen in in their mind. So in their mind, it's not trust, what you know is going to happen will happen. It's we know that what I know is going to happen will happen it's it's a way for them to find confidence. Even another person says sometimes I get timid about reacting but then I realized that I can always nudge it back up with carbs or even my Temp Basal. So it gives me freedom to work with the insulin. It has kept this person from having high blood sugars from unexplained things like food, bad infusion sites, as their honeymoon period ends their period stress. That one phrase helps them with all that this one's great. This thing is one of our absolute favorites. She says she's secretly waiting for it to be on a T shirt which I promised to make happen. The statement is normally followed in their house by now be bold with insulin. So we know what's going to happen will happen now be bold.
For us, the statement means stay ahead of what you know was going to happen. So it doesn't take a ton of time and insulin to get a big back down again. This same means so much to me that I watched myself apply to all parts of my life. This one really touched me. In relation to diabetes, we're still pretty early in and just coming out of honeymoon. So I repeat this to myself when I feel unsure. So much for me is in the confidence in the technology to be able to catch something before a larger issue arises. So when I'm still feeling shaky, to be bold, I tell myself trust what you know is going to happen is going to happen. And if it doesn't, in the worst case scenario, I'll lean on my Dexcom That one's excellent. But the person says this is a mantra to me, you see how many people are in this private group you got to get there. This is a monster To me, it means many things if you eat and don't those who will eventually end up with high blood sugars. If there's two arrows going up, you can't just watch them go up, you have to react if nothing is working. Maybe the pump site needs to be changed. to them. It's all about not waiting to make a decision to be bold. Another person says this means Believe in yourself. trust your gut. Trust your common sense. stop doubting. They call it a powerful encouraging reminder of what they've been taught on the podcast. Another person says for us this means trust the trend, it's more about the trend than the number. Now there was one here Ah, this topic is one I've been struggling with my daughter has a protein fat rise every night about the same time. I'm getting better tackling it but I second guess myself and I end up regretting not to say more aggressively. This person uses it in a completely different way. I need to tell myself when I'm in a rush, like to see a low rise or high come down. They tell themselves be patient and let what you've already boldly done actually have time to work. I could keep going here because there's some I could keep going here because there are a lot but I just want to do this last one.
I chant this in my sleep, I swear, this is something I continually tell myself over and over. This means to me that you've learned from experience, you know, what will happen because it has happened time and again, over and over making the same mistake. So when you feed your kid like that dreaded Panda Express kids meal, and you see the rise Two hours later, it takes everything inside of you. But you have to hit it and hit it hard, even if he's 103. Because you know, what will happen? Trust yourself. So many people doubt themselves out of fear or failure be have, but you've been through this, you know it, so act on it, do what you know will work even though your husband is looking at you with big eyes. And a doctor if he knew would chastise you, you know, do it. Okay, that's what the people on the webpage were set. So that's what some of the people. So Jenny had her interpretation, which I just dropped on her. I didn't tell her ahead of time. She just heard it. I was like, trying to get her to like really put it into diabetes thoughts right away, which I think she did. And then you got to hear the perspective of people who have heard this over and over again, and are actually using it their lives. And that's how they're using that tool. So you decide if you want to use that tool. And if you are, how, maybe you'll make an amalgam of all these ideas. Or maybe you'll just run it through your own filter and decide what it does best for you. Thank you so much for listening to the Juicebox Podcast. really special show coming up on Tuesday return guest Nicole Nicole was back on episode 151 was called complications are complicated. If you haven't heard it, go listen, get ready for Tuesday. Because Nicole's coming back on the podcast to tell us how her transplant when Nicole has a brand new pancreas and kidneys. She actually said they're used but I can't wait for you to hear this. Episode. 151 complications are complicated. It's homework before Tuesday.
About Jenny Smith
Jennifer holds a Bachelor’s Degree in Human Nutrition and Biology from the University of Wisconsin. She is a Registered (and Licensed) Dietitian, Certified Diabetes Educator, and Certified Trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. You can reach Jenny at jennifer@integrateddiabetes.com
Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!
#258 Defining Diabetes: Pre Bolus
Defining Diabetes: Pre Bolus
Scott and Jenny Smith, CDE define the terms at the center of your type 1 diabetes care
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Pandora - Spotify - Amazon Alexa - Google Play/Android - iHeart Radio - Radio Public or their favorite podcast app.
+ Click for EPISODE TRANSCRIPT
DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Defining diabetes is made possible by Dexcom on the pod and dancing for diabetes, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before becoming bold with insulin, or making any changes to your medical plan. I wanted to find Pre-Bolus Jenny, because I believe that if you just Pre-Bolus, you can knock about a point off your a one say it's not the first step when I talk to people, the first step is always we need to get your basal insulin right. But Pre-Bolus is incredibly important. Mm hmm. People don't do it for what I think of is probably two basic reasons. One is no one ever explained to them what it was, which is fascinating. And the second one is, they'll say, I don't need on a schedule. I'm a free loving person. I'm all cool and hip, and everything about my life is free and easy. And it's hard for me to tie myself down man, like, like, right here, then they'll complain about their budget or being high for five hours in the fight they were and I was like, we just need five seconds worth of focus about 15 minutes before you eat. So let's define Pre-Bolus first.
Jennifer Smith, CDE 1:11
So Pre-Bolus thing essentially, is when you take insulin at a set time before keyword there before actually starting to take your first bite of food allows time for our poorly named rapid acting insulin to get more active in the system. Because food specifically carbs have very quick impact. The saliva in your mouth starts to break things down so that when it gets to your gut, it's gonna be easier even to break down. So taking insulin, before you start to eat, goal being about 15 minutes, give or take. But a 15 minute rule of thumb to start with if you've never been doing it, and you're hearing this and like, oh, let's give that a try. 15 minutes is a good rule of thumb to sell,
Scott Benner 2:05
and then you can find out. I tell people all the time, you can use your CGM to figure out your Pre-Bolus time, people will be like it's longer, it's shorter, whatever, I don't know what you're gonna be. But you can get your blood sugar stable at a lower number, right like 30, nice and stable 130 for a couple hours, get all the insulin out of you then hit yourself with a bolus that you think's going to take you to 90 and see how long it takes for that to start moving. Right? Once your blood sugar starts moving, that distance of time is about about what your Pre-Bolus is. I just saw something. So I googled it right while you were speaking. Uh huh. I was gonna do that thing where I'm like, Jenny, now I'm gonna read the definition from the internet. And the seriously satis thing happened and I'm not joking. The second return for the words Pre-Bolus definition are from Arden's day in the Juicebox Podcast, I can't believe how is that possible? Awesome. No, it's not awesome. It should be like coming from like nine hospitals and like, like,
Jennifer Smith, CDE 3:01
well, I'm saying that it's awesome that it's there at all.
Scott Benner 3:05
But yeah, but the point is, is that what does Google Search just told me was is that nobody tells people about this. It's literally not.
Jennifer Smith, CDE 3:14
Are there any hospitals? Are there any hospitals that are even listed on your Google search? Are there any, like therapeutic
Scott Benner 3:22
to blockhouse? Mine. And then the next one that pops up is a definition for the word Bolus. And it says missing pre. So it's not even. Yeah, there's three things that say Pre-Bolus on it. And one of them is somebody saying I can't seem to do very well with my meal boluses. And it's somebody just complaining about Pre-Bolus. The word definition is excluded from the search. So I am the only search that has the word Pre-Bolus. And it's because on my blog posts, I have some of them tagged because they're about Pre-Bolus. Sure, but I just it's just really sad. Like, I listen, I did not set this up. I wish I did not be a genius. But I really got sad, like when I saw it, I mean, there's a Wikipedia entry. That's even not helpful. It says, a Pre-Bolus of insulin can combine a meal bolus and a correction bolus. When the blood sugar is above the target range before a meal. That's not accurately what a pre marlis is.
Jennifer Smith, CDE 4:21
And that's not at all the time.
Scott Benner 4:23
The timing of the bolus is a controllable variable to bring down the blood sugar level before eating again, causes it to increase.
Jennifer Smith, CDE 4:33
That's entirely wrong. That's right.
Scott Benner 4:36
Yeah, sad. Okay.
Jennifer Smith, CDE 4:38
I never look at Wikipedia for any Oh,
Scott Benner 4:40
yeah, that's not I'm just saying that's the only other thing that popped up like that. Yeah. That's so sad. Right? Okay, so we'll change that. I'm gonna get what Jenny? I'm going to take this audio and I'm going to build a web page. It's just about Pre-Bolus. And I'm gonna make sure I'm gonna get people write blog articles about it, and I'm gonna turn it to a thing because Listen, here's my definition of Pre-Bolus. And I'm sure Jenny just said the same thing. I'm about to say Pre-Bolus sing or pre injecting or pre, whatever you want to call it. It's not really pre nine, if you really think about it, insulin does not go into your system and start working right away. Right? Say it all the time. It's not a light switch, you don't just flip a switch and it happens. Insulin right. So while to work. Mm hmm. You need the impact that that insulin is having on your blood sugar to coincide with the, the food or your you know, anything else, it's trying to make your blood sugar rise, you want to get involved in a fair fight. And I guess this is this place of time is to say it is all you know, it says, Oh my gosh, I just, I don't even know what I was just trying to say that this is a good place to say this. It's a tug of war that you don't want either side to win. And if you just yell, go and let both sides start pulling both sides being insulin on one side and carbs or body function on the other. If you just yell go, carbs and body function are always going to win because it takes a while for your insulin to come online. You need insulin in your body sooner, so that it comes online when the carbs start pulling so that instead of the broke getting jerked all the way on one side. And now that you know your carbs are winning this tug of war greatly, then all the sudden your insulin comes online starts pulling the by then it's too weak. Because you know you only bolus for the carbs you counted, you did not bolus for the momentum that the carbs now have or the distance between your target blood sugar and where it is now. You were 90 when you put the insulin in. Now you're 150 your blood sugar shooting up you have this momentum you have to stop you have to bring the number back and you have to cover the food but you only put in insulin for the food. But if you put that insulin in for the food in time for it to begin working when the the carbs try to pull on that rope, then the carbs can't move the rope because the insolence add its power then and it's fighting. So when you see somebody with a straight line on their CGM online, that's what's going on behind the scenes, the insulin and the carbs are embroiled in a battle that neither of them can win. Right? And then they hired they dropped the rope in the center of the rope is right where it started. And that's how my weird brain thinks about bolusing.
Jennifer Smith, CDE 7:16
So it's a very, it's a very good example of the tug of war I've used several times since you mentioned it because it's a very easy way to consider what your goal is in using Pre-Bolus it's very easy to comprehend even for kids. It's very easy to comprehend a game of tug of war 100%
Scott Benner 7:41
Sure, yes, for sports fans soccer fan. It's not Pre-Bolus things like playing without a goalie. Are you a baseball fan? It's like hitting off a little leaguer? Are you a football fan? It's like not having an offensive line expecting your quarterback not to get sack basketball, imagine they raised the hoop to 50 feet, right? Like these are the situations you're putting yourself in if you're not Pre-Bolus. And I'm telling you right now, this podcast is incredibly helpful. I mean that and I think you'll find it to be helpful. But if you just Pre-Bolus you're going to get an A one c reduction. That's it. I mean, the rest of it is hugely important. But this is this is this is 1 billion steps. It's understanding your basal insulin, which technically is Pre-Bolus saying right having the right bazel is nothing more or less than having your basal insulin be at the right power at the right time. Being you know, Pre-Bolus thing is having a meal insulin at the right power at the right time. Okay, I can't give away all the secrets or there won't be a podcast.
Jennifer Smith, CDE 8:40
Not true. There's always something to discuss with
Scott Benner 8:42
diabetes. Definitely not true. Jenny Smith is not just the delightful voice you hear on the Juicebox Podcast. She's also a real live person with a job and she works at integrated diabetes. If you'd like Jenny to help you in your personal journey with Type One Diabetes, go to integrated diabetes comm find Jenny's profile and send her an email. There's also links right here in the show notes about you know how you can do that. I think there's actually even a link there to her email. And there's a brief description of her you know, Bona Fie days Why it is you might want to give Jenny a ring. Thanks so much to the sponsors Dexcom on the pod and dancing for diabetes. There are links in your show notes at Juicebox podcast.com. Where you can find out more about the dexcom g six continuous glucose monitor. Figure out what's going on at dancing for diabetes.com and order a free no obligation pod experience get that's right a free no obligation demo of the Omni pod
About Jenny Smith
Jennifer holds a Bachelor’s Degree in Human Nutrition and Biology from the University of Wisconsin. She is a Registered (and Licensed) Dietitian, Certified Diabetes Educator, and Certified Trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. You can reach Jenny at jennifer@integrateddiabetes.com
Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!
#255 Defining Diabetes: Glycemic Index and Glycemic Load
Defining Diabetes: Glycemic Index and Glycemic Load
Scott and Jenny Smith, CDE define the terms at the center of your type 1 diabetes care
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Pandora - Spotify - Amazon Alexa - Google Play/Android - iHeart Radio - Radio Public or their favorite podcast app.
+ Click for EPISODE TRANSCRIPT
DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Defining diabetes is made possible by Dexcom on the pod and dancing for diabetes, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before becoming bold with insulin or making any changes to your medical plan.
Jenny, what is the glycemic index?
Jennifer Smith, CDE 0:24
How do we explain Oh, glycaemic index, that's a excellent one. So it's essentially a number from zero to 10. That's assigned to a food with pure glucose being represented as 100. Right. And it represents the relative rise in glucose level within two hours after eating or taking that food in. And the index being from zero to 100, or 100, being pure glucose, the higher the foods number, like watermelon, watermelon has a GI or glycemic index of 72. So it's close to 100, it's considered a high gi food, the higher the number, the faster and more more profound, the impact is going to be on blood sugar. The lower the glycemic index, you know, down in like, you know, less than 55 is considered low glycemic index. Those should have slower lower impact on blood sugar in the aftermath of eating.
Scott Benner 1:25
Other Are there any foods with carbs that have no impact? Where is that person to person? Because you just ironically said watermelon, which doesn't touch Arden at all?
Jennifer Smith, CDE 1:37
Well, that may be another definition. It might be glycemic load. That's the difference there.
Scott Benner 1:43
Right? Why don't we combine the two of them go ahead glycemic load, keep going?
Jennifer Smith, CDE 1:46
Okay. So glycemic load is essentially, it takes glycaemic index one step further, glycemic load talks about the amount of food eaten at a time. So let's say you had, you know, a half a cup of watermelon, despite it having a high glycemic index, the half a cup load amount that you're eating might be very low. And so the impact in the aftermath of eating is also going to be very low, it's the same thing. Like if you eat a bucket of white rice versus a half a cup of white rice, the glycemic index is the same. But your the impact it has on your blood sugar should be lower and less dramatic, because you're not eating this gigantic portion of it.
Scott Benner 2:32
So load is more about amount.
Jennifer Smith, CDE 2:35
load is more about amount. So you know, in terms of like carb impact, carbs are not the enemy. Most of what the problem is timing of insulin, and then also the amount that people choose to eat. Right.
Scott Benner 2:54
In moderation, I guess. Right? Correct. are manageable. Okay, so I have to try to go through this in my head, because I want to make sure I understand because this is this is one that's beyond me a little bit. glycemic index is like literally a scoring system. And there are certain foods that fall into certain ranges of index high, I guess there, is there a medium and a low? Is that how it is
Unknown Speaker 3:16
moderate? and low?
Scott Benner 3:17
Yep. And so that is, first of all, I guess, where do they find that? Is that like, Is there like a magic Genie that's in charge of the glycemic index? Is that something the government does? Where's that?
Jennifer Smith, CDE 3:30
That's interesting. So and then one point of I guess, reference, we talk about glycemic index is the fact that glycemic index was established for foods in a digest alone setting, right, so when they took apples or watermelon, or grapes, or whatever they were, it was looked at as impact only be being digested as that one food, it wasn't like grapes on top of meat lovers cheese pizza, right? You know that that kind of takes it as a one point in time. This is what the impact and low and this is what the impact should be. This is what you should expect from this food fast, moderate or slow. So
Scott Benner 4:12
so when I tell you the people, some foods like hit, they punch above their weight, like that's what I'm talking about. I'm talking about work index, like it's okay. So I guess that you have, like, I guess there's a way that you would look at a food and maybe apply something to it that you think is true, that might not be true, but there's actually a scoring system somewhere called the glycemic index, maybe I'll try to find a link and put it in here for people, and they can see what these foods are supposed to, you know how they're supposed to hit. And then from there, glycemic load is the idea of how much of this food you eat, and how for how big of an impact for how long it's gonna have. Correct right. So like, in a very simplistic way, I used to say to my wife Never forget the first time like we gave Arden a lollipop and we like bolused for it, and then realize that she didn't really need the insulin for the lollipop because the sugar like hit her really fast, but then it sort of just went away again. I realized Now look, I realize now looking back, it didn't go away. She was MDI, and she was probably at too much basal insulin. So sure, so we were feeding the bazel with the lollipop because it felt like it went in and went away. But now I realized that in a perfectly balanced system, where ardens bazel is right, that lollipop does have an impact on her,
Jennifer Smith, CDE 5:32
and would need insulin to cover it and we need insulin to
Scott Benner 5:35
cover it. Jenny Smith is not just a delightful voice you hear on the Juicebox Podcast. She's also a real live person with a job and she works at integrated diabetes. If you'd like Jenny to help you in your personal journey with Type One Diabetes, go to integrated diabetes comm find Jenny's profile and send her an email. There's also links right here in the show notes about you know how you can do that. I think there's actually even a link there to her email. And there's a brief description of her you know, Bona Fie days, why it is you might want to give Jenny a ring. Thanks so much to the sponsors Dexcom. On the pod and dancing for diabetes, there are links in your show notes at Juicebox podcast.com, where you can find out more about the Dexcom g six continuous glucose monitor, figure out what's going on at dancing for diabetes.com. and order a free no obligation pod experience get That's right, a free no obligation demo of the Omni pod. Before I go, I just want to thank everyone who downloaded and shared the show because the other day it reached 1 million downloads. Absolutely amazing. took a couple years to get there. But one of the exciting part because of you guys and how you share the show. I'm pretty certain that 2 million downloads will be here this time next year. Is that amazing? Your good words and sharing or how the show grows. So thank you very much from the bottom of my heart. Go out spend the rest of your weekend being bold. Do it with your insulin, do it in your personal life do in your professional life. Just be bold. If you can't remember to be bold, go to Juicebox podcast.com. Scroll down the merchandise you can buy a shirt right there. That'll remind you just look in the mirror. You're like oh yeah, I'm supposed to be bold. Alright, well, that was weird, but please buy a shirt.
About Jenny Smith
Jennifer holds a Bachelor’s Degree in Human Nutrition and Biology from the University of Wisconsin. She is a Registered (and Licensed) Dietitian, Certified Diabetes Educator, and Certified Trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. You can reach Jenny at jennifer@integrateddiabetes.com
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