Scott Benner 10/1/21 Scott Benner 10/1/21

#552 Diabetes Variables: Bad Sites

Diabetes Variables: Bad Sites

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 0:00
Hello friends, and welcome to Episode 452 of the Juicebox Podcast.

Hey everybody, this is the next episode in the diabetes variable series. So it's going to be me and Jenny Smith. Jenny, of course, is a 30 plus year type one, a CDE, a nutritionist, she says a whole bunch of stuff. And she's here today to talk about a new topic, something that might come up in your life that very well may impact blood sugars. Today, the variable that Jenny and I will be talking about is bad sites. Please remember, while you're listening, 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 are becoming bold with insulin. On the front page of Juicebox Podcast comm a lot of the series that are within the podcast have their own space, like on the website so you can see them because I know there's a lot of episodes. Today I've added the variable series. So that's there now as well. So if you're looking for a certain episode, you're not sure what episode number it is head there and do a little scrolling, you'll find it. I'll get started right after this brief message from our sponsor.

This show is sponsored today by the glucagon that my daughter carries g vo cuyp open, Find out more at G Vogue glucagon.com forward slash juice box. Alright, Jenny, so I have four of them set aside to try for today. One of them. I can't wait to see how you respond. But the other ones are our I want to start with a couple that are shorter I think and and then see see what we're going to get to so Okay, this one I think is going to be a really short variable. But I want to talk about bad sites. So just you're using an insulin pump. And the site stops being as effective as you expect, or as you've I guess, experienced already with the site. But people have the hardest time baling changing, it's like, yeah, it's that they the hope that sticks with them is sometimes fascinating. I can't tell if it's the if it's this thing supposed to last this long, dammit. Like I'm not given up or I mean, I even get if it's money. But right. You know, like if you're saying, I don't want to take this thing off. But if you have insurance. So I guess the first thing to say to people is if you have insurance, and you experience bad sites, your provider can write you a prescription for more stuff, if that becomes necessary

Jennifer Smith, CDE 3:00
to change more frequently, not at all. No. In fact, with all the pumps, I think there are people who definitely find I get today to I can maybe make it today, two and a half. If it looks like it's really, really still working well. But I don't push it anymore to day three. So yes, I mean, if you're one of those people then just don't push it. Know what you know, and ask your doctor to write for changes every 48 hours instead of every 72.

Scott Benner 3:26
Yeah, it's so an example is you know what the funniest thing about diabetes is whenever I go to talk about I always have a fresh example because that's never stops. But Arne and I are going to go shopping this afternoon together, we're going to find little baskets to put on her shelves that she put up. She put up shelves and she wants to put baskets on the shelves. I've been a stay at home dad for a long time. So that seems like a reasonable way for me to spend my afternoon to me,

Jennifer Smith, CDE 3:50
but for bunny eggs or something or what is she putting?

Scott Benner 3:54
I don't know what she's putting out there. Hopefully she's not hiding, you know, paraphernalia which I don't believe she is. But not the point. The point is that I woke up this morning to find that Arden's blood sugar had been fairly sticky at like 140 overnight. And I thought, Oh, we must have missed on the last thing that she ate and you know, the basil is holding her nice and steady. I'll Bolus this I Bolus it and it doesn't move. And as soon as that happened, I thought this site is shot. Like it just it hits me like immediately. Now do I yank the pump off or right away? No, I turned to all of our settings up a little bit and made all of her insulin stronger. And it worked. And then when the settings reverted back, it drifted back up again. So in my mind, she's not getting insulin correctly anymore, because I'm not getting what I expect. Right? And so I told her just before you and I did this, I said Listen, do one more Bolus because that's going to bridge this time. I'm going to be talking to Jenny and then I said and then we're going to pull your pump before we go before we go. Cuz, I mean to get eight more hours out of this thing. I mean, I guess we could just jack it up, it's probably leaking, right or something get or what? So what are all the things that could go wrong with a site?

Jennifer Smith, CDE 5:12
Yeah, it's like a rabbit hole of information about site, right? It really is. So what could it be, it could be that the site is in a place that just got bumped or nudged or something. And so now, it's not really working as well under the site, maybe you develop like a little tiny, like, I don't know, like a clap, let's say it, but it's not absorbing quite as well. Thus, when you bump everything up, and now you're jacking in a little bit more insulin, it's kind of pushing out enough to overcome whatever the reason for the resistance is at the site, it just could be that this area, especially if you've documented enough to know the, you know, the right hip and the left hip don't absorb as well after day two, so let's just change it when it's in those locations sooner than later. So it could be the site, right? You know, variables of site, it could be infection at the site, especially in infections, I usually, usually you know that you have something starting, even if it's a mild infection, I'm not talking something major, but usually the site hurts. It's sore. You might even notice a little bit of bruising, like outside the canula kind of area, but definitely it's sore in sites should not be sore. I mean, they should be with the little flexible canula under the skin, and or even the ones who use the steel infusion sets. It shouldn't hurt.

Scott Benner 6:45
Okay. So if I'm going to make an admission here are not an admission and admission. I'm going to admit something. omission is when you leave something out. Yeah, admit

Jennifer Smith, CDE 6:55
Okay, when you you have to admit something. What are you going to admit,

Scott Benner 6:59
I Arden's had diabetes since she was two. And I hear people say my pumps occluded all the time, I've never figured out what they mean when they say I mean, I understand the word. But mean physically, like the word makes me feel like somebody stuck bubblegum in your tubing, you know, like, but that's obviously not it. So, when people say, I got an occlusion, what are they talking about?

Jennifer Smith, CDE 7:30
Well, a true occlusion is different than a site, that's technically gone bad, okay. In a site that is occluded, occluded, means like, you know, like the tubing is straight underneath the skin. And typically, tubing will be bent visually, to some degree when you remove it. And most pumps I know, at least Omni pads. If you have an occlusion and your pad errors, it will tell you that it's either a pod error, or it will tell you that a pod occlusion is detected. And to change the pod at that point. So and all of the pumps will register an occlusion based on a certain amount of insulin that gets backed up into the pump. And it triggers the alarm to say this insulin hasn't gone in up to this certain amount. And each pump has kind of a designated amount that triggers that occlusion alarm. So an occlusion is definitely different than a sight problem. Now an occlusion could be it could be something that starts to make the site not feel good to because obviously, if you've got like a bent canula under the site, that might be more irritating than something that's just supposed to be sitting straight, right? Most often though, what I've found is that an occlusion will happen soon after a site change.

Scott Benner 8:58
Okay? But a bad not always

Jennifer Smith, CDE 9:01
but a bad site could be two, three days in, etc. But an occlusion usually is sooner than later in the life of a site, mainly because it usually happens on the sight being put under the skin. Okay? Something has triggered it to bend, etc. could it happen while you're wearing it? Yes, it could, if

Scott Benner 9:24
we're likely from the injury,

Jennifer Smith, CDE 9:26
more likely from the actual puncture under the skin,

Scott Benner 9:30
I should knock on some wood but in 13 years or more of using Omnipod arms had one bent candle ever. And I've never seen the occlusion thing. I actually think it's kind of cool that on the pod. If Omnipod thinks you're not getting insulin correctly, the thing just errors and shuts off. Yes. Like it's just like, Look, this is bad for you. I'm going to force you to put on a new insulin pump now. Yeah,

Jennifer Smith, CDE 9:51
I've always thought to it has more checks and balances to alerting sooner than later that something isn't right internally. Then the other pump So

Scott Benner 10:00
I also don't see them as much since they took the manufacturing in house. Oh, you know, interesting. Yes. Since they moved from China to I just did an interview with them not too long ago. But since they moved that they have a, if you've never seen it, it's astounding, like the man in mass in Boston. Yeah. So maybe that's it, too. Okay, so so here's the bigger question, I guess and how to wrap this up. You learn what a bad site and bad sites just a colloquial phrase, it's not a technical term, it's a phrase that stops working the way you want it to, excuse me a site that stops working the way you want it to work, you start to notice them, after experiences, like and then kind of like figure out when you can be like, This is bad. I'm jumping on this. So there's no real. I don't think there's any way in this conversation to say just look for this, this and this other than to say, if the site's not acting like you expect, if it's towards the end of the site, life, maybe switching now's a good idea. Do you have anything to add to that? Or is that kind of it?

Jennifer Smith, CDE 11:03
It's kind of true. I mean, if you have enough hindsight from your life with diabetes, right, from experiences, you can say, Well, my lunch usually does this my breakfast usually does this, my run in the afternoon usually does this kind of thing. And if it's not, and considering other variables that could be impacting towards a higher blood sugar. If none of those are really in the picture. I usually our recommendations, take take a correction. Like you kind of did you drove a correction in and you're like, Huh, I didn't do anything. Don't, don't play, just change it out. Just change it out, get some insulin going again, who knows what the reason was when you could play with thinking about what the reason is forever. Just change it out deal with the high blood sugar and move on.

Scott Benner 11:52
Okay. All right. So cool. Thank you.

I know that the short episodes I'm gonna have a little more for you right after this. g vo hypo pen has no visible needle, and it's the first pre mixed autoinjector of glucagon for very low blood sugar and adults and kids with diabetes ages two and above. Not only is chivo hypo pen simple to administer, but it's simple to learn more about. All you have to do is go to G Volk glucagon.com forward slash juicebox. g voke shouldn't be used in patients with insulin, Noma or pheochromocytoma. Visit g Vogue glucagon.com slash risk.

So the diabetes variable series is coming along pretty well. So far. There's trampolines, temperature, travel, exercise, hydration, food quality, tunneling, video games, stress masturbation school and today's episode bad sites. I think it's working out well putting them out on Fridays. So expect that to keep happening. And that's pretty much it, I guess, on the variables front. Now, if you're new to the podcast, don't miss out on other series like the diabetes pro tip episodes, defining diabetes, after dark algorithm pumping how we eat, there are so many to choose from. I'd also like to let you know about the private Facebook group that's dedicated to this podcast. It's called Juicebox Podcast type one diabetes, it is a private group, as I just mentioned, meaning you're going to have to answer a couple of questions to prove you're a real person to get in. But once you're in there, you're going to be with at least I mean, at this point, it'll probably be 16,000 by the time you hear this, but at least 15,000 people just like you talking about type one diabetes, it really is a kind and valuable space. So don't go there expecting like, Oh, it's Facebook, I'm gonna fight with people. It's not like that. It's actually pretty great. There's a link in the show notes if you need it. Anyway, if you don't want to, I mean, you know, cool, but I just want to let you know it was there. I hope you're very much enjoying the podcast. I hope you're just enjoying the podcast actually very much seems excessive. If you are, please share it with someone else who you think might also enjoy it. And if you're a practitioner, and you're listening Hi. And if you're a practitioner and you're listening, and you're suggesting this podcast other people hi and thank you really appreciate it. Alright guys, I'll be back really soon. plenty more to come. We're going to finish the year up super strong with a ton of great episodes. By now, the podcast has crested easily 4 million downloads. There were more downloads in 2020 One by August. Then there were in all of 2020 and 2021 might reach a real milestone at the end. So keep your eyes out for that. We'll do a little celebration when it happens at the end of the year.

#548 Diabetes Variables: School

Diabetes Variables: School

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

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Scott Benner 0:00
Hello friends, and welcome to Episode 548 of the Juicebox Podcast.

Hey everybody, this is the next episode in the diabetes variable series. So it's going to be me and Jenny Smith. Jenny, of course, is a 30 plus year type one, a CDE, a nutritionist, she says a whole bunch of stuff. And she's here today to talk about a new topic, something that might come up in your life that very well may impact blood sugars. Today, the variable that we'll be talking about is school. Please remember, while you're listening, 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 are becoming bold with insulin. On the front page of Juicebox Podcast comm a lot of the series that are within the podcast have their own space, like on the website so you can see them because I know there's a lot of episodes, and today I've added the variable series. So that's there now as well. So if you're looking for a certain episode, you're not sure what episode number it is head there and do a little scrolling. You'll find it after this brief advertisement. We'll get started.

This show is sponsored today by the glucagon that my daughter carries g vo cuyp open, Find out more at G Vogue glucagon.com forward slash juicebox. Can we do school as a variable? Because not only is it that time of year right now. But a lot of children are going back to school for the first time after COVID right now. And the internet is full of new parents who are astonished that their children's blood sugar's don't look the same when they go to school as they do when they're at home. Yes. So I can start by saying that for Arden even though she's a fairly chill person, the first couple of days going back to school in person every year forget COVID are not Arden's insulin needs go up. There's some sort of either underlying adrenaline anxiety, maybe, I don't know, maybe she's, I don't know, I don't know what it is the hydrated, like maybe she's rushing, I couldn't even begin to tell you, I can just tell you that for the first few days. I find myself fighting to use more insulin, and then suddenly, it's just okay. And I don't know, when

Jennifer Smith, CDE 2:51
does it even out to her typical normal nun school needs then or do other things change?

Scott Benner 2:59
know, if you're coming back from the summer vacation, then? Well, it can go to it can go two different ways like so if she's sedentary during summer vacation, she might need a little more insulin to begin with. But if she's going back to this, like now she's walking more, right? Like there's so much to change is first of all, you're up earlier. So you run into more feet on the floor, like the life thing, which you may have been controlling with basil while they were sleeping in during the summer. Right? Like there's there's that. But I always just at at its face. To me, it seemed like anxiety, adrenalin, stress, excitement, and then it kind of goes away. But in fairness, Arden's bales are typically a little stronger during the school year than they are. Otherwise, yeah. So but I'm, I'm assuming that everybody's could be different, like, you know, you might be maybe somebody's suddenly going to be more active because schools there are suddenly getting exercise on days where they didn't have or, or I guess, if you're super active at home, maybe you end up getting less exercise because you're going to school.

Jennifer Smith, CDE 4:09
Right? That's true and or more, you know, especially I see this as a difference. Kids have gone through high school, understanding kind of what their insulin needs do with school days and that kind of thing. And then they go off to college, in which they may have a huge campus that they're now walking across from class to class or back and forth, which brings in a very different structure than to their insulin needs, comparative to the last four years in a very, very structured day to day schedule, not walking all over the place, etc. I find that when kids go back to school, more often than not, I see issues with it's funny like the foot on the floor, I call it the foot in the school. I guess soon as they are either like On their way to school for some kids, or as soon as they put set foot on the school property, and they're heading in, up goes the blood sugar. Yeah. 900 less common for the drop. It's more common for a rise.

Scott Benner 5:13
I when the world was normal, I would drive Arden to school every day. And as we would pull out of the house, I'd make us I'd ever make a small Bolus. Yeah, it was for nothing other than I could see your blood sugar one day of 20 or 30 points as we were approaching the school and she was getting in there. But it's, it's um, it's just kind of fascinating to think about all the different implications that could happen, just changing. You know, your physical spot. This is my life here at home. This is my life at school. And it changes but I'm talking about like, for the moment, I'm talking about that first couple of days, like you can call it whatever you want, you know, I would assume, listen to me, I don't know about you. The day before school started every year, I cried. Like I would like I was like, I don't want to do this. I don't want to go there. I want to go back to school. Oh my god, no, I hated school. Like with a burning passion. I hated going to school. And a lot of your kids might feel that way and not be telling you, you don't mean like I just I could not have

Jennifer Smith, CDE 6:18
that's totally not my kids. My boys already have their backpacks already for the first day. And they're very, very excited.

Scott Benner 6:24
thing made me nauseous. Kids are buying stuff. They're excited. I got new pens, not me. I looked I was like, Oh, this now I gotta go over there. Listen to these people. Well, I hate this. Like I just I there was nothing about school that I found attractive, except for the social stuff. Sure, I just I mean, I'll talk to anybody. So like, I'm good with that, like super smart people, girls were cuter. You know, like Rick, you don't need like the nowadays like I'm I'm think you're allowed to look at each other anymore. But in the 80s, we were pretty touchy feely, like going both ways. Like everyone was exploring, you know what I mean? And so there were a lot of friendly boys and a lot of friendly girls. And nobody said anything about it. And it was that part of it was fun. But the rest of it was

Jennifer Smith, CDE 7:11
more anxiety inducing just the class component and all that kind of stuff.

Scott Benner 7:16
I wish I could put myself back in my own head to tell you if I was anxious or not, I just didn't like it. Like, I don't know that if I was I don't think I don't know, if I was anxious like this several times. Like I felt like, I don't do well with this. And maybe Sure, maybe we would call that anxiety today. But I just I think

Jennifer Smith, CDE 7:34
that brings in another one in terms of school is the impact of one class versus another. And how the child sort of feels about that class or that type. or that type of learning, right? You know, the people who really love their math or really love their science or really don't, they'd rather be in English class or writing or doing more, you know, self kind of guided stuff then. So those are pieces. I was when I talking when I'm talking to parents, I talked a lot about knowing what your child's schedule is going to look like right? Where is there going to be PE Where is there going to be recess? Where are the classes that you know as a parent know that they kind of struggle in again math, English, writing whatever it is. Because those may be the times that you have to do something to offset what you see is happening.

Scott Benner 8:30
Yeah, I'm excited you brought that up because during COVID I learned

de veau hypo pan has no visible needle, and it's the first pre mixed autoinjector of glucagon for very low blood sugar and adults and kids with diabetes ages two and above. Not only is chivo hypo pen simple to administer, but it's simple to learn more about. All you have to do is go to G Vogue glucagon.com forward slash juicebox g Vogue shouldn't be used in patients with insulin, Noma or pheochromocytoma. Visit g Vogue glucagon.com slash risk.

I learned that during biology Arden's blood sugar went up she hated that teacher. She really dislike teacher, like on a visceral level did not like being with her. And because of that, I would I would see that the climb and it was it was that real steady, slow like 8595 103 110 120 and it was just go and go and go and go and like what is happening right now. It took me a while to figure out that she just did not enjoy that hour and a half. Like you know, yeah, she and she was I irritated the minute she thought about it, and then I think aggravated the entire time when she was there. Sure, she might have had like a low level of like, anger or I don't know, like, but some emotion that's pushing her up. You know, to me, that's what this variable is about. Like it's it's more about the impacts of school like I don't want to talk about, you know how things change when you have to go to the nurse's office and your Pre-Bolus your Pre-Bolus Singh is different, like I don't know, that fits here. That's not a variable. That's, that's just, you know, circumstance, I will drop in here for anybody listening, that episode number four of this podcast is called texting diabetes. And it is me telling you how I got our out of the nurse's office. So Arden is a senior this year, and has not been to the nurse for something diabetes related since her last day of second grade. And I accomplished all that with just texting. So I just managed her remotely, even when she was little. And you know, there

Jennifer Smith, CDE 11:03
and you have had a benefit of being a dad who has the time to follow as close as you do.

Scott Benner 11:10
Yeah, yeah. I mean, it's not like in the middle of a business meeting. I'm like, hold on everyone. My daughter's 120 diagnol. Up, we have to manage this right now. I, I had the I tell people all the time. Like, if you enjoy the podcast, part of the, you know, part of the thanks goes to Kelly, because I've been a stay at home dad, and I've been able to focus on this stuff for so long. But yeah, I mean, but there are a number of people who have the opportunity. And if you do, it's, I'll tell you to you don't have to go to the nurse's office, suddenly, you can Bolus on better schedules, you can fix Lowe's more quickly, with less, less of an impact and causing, you know, maybe avoid causing a high later, there's a lot about managing at school, that is difficult because of the time gaps. The I have to realize this is happening, then I have to ask somebody, if I can leave, then I gotta walk down to the nurse's office, then I have to wait in line till the nurse can get to me. And by the time all that happens, your your you know, wherever your alarm is, you're 30 points higher, or maybe 20 points lower, you know.

Jennifer Smith, CDE 12:17
And the thing you learned early on, though, given that it was you know, second third grade that she no longer had to go to the nurse was you learned early on to navigate that like school health treatment plan, right? To be able to say, this is what we will be doing. This is how we will be navigating her blood sugar management at school. And unfortunately, a lot of people don't, they don't have that type of very specific plan. Or sometimes the school systems just they don't support it

Scott Benner 12:51
really resistant, and they're tough to get past some of them can be really difficult to get past I'm a little more forceful. And Arden's 504 plan is like rock solid. We have good doctors who will write things in like I've had a sentence and I Arden's 504 plan forever that just says, parents make the last decision. Like I don't care what this this document says if the parent says do something differently, that's what you're doing. That was very helpful. Having ardan cell phone designated as a medical device was very helpful. There's there's a number of different things that you can do.

Jennifer Smith, CDE 13:28
Those are all really helpful little I just that sentence that you have in your 504 because there are a lot of parents who are frustrated in terms of management, because their 504 says things like only only able to treat and or adjust, you know, for blood sugar changes. If blood sugar is here, and or like the whole iob thing. If there's no iob then you can take care of this 300 level blood sugar. Well, you know, to get past that parents will make the final decision period like bold highlight and yellow.

Scott Benner 14:08
Yeah, then then what we're doing is we're satisfying the legal requirements of the document, but putting ourselves in a common sense, ability to make decisions, right? Because in the end, those those ranges are set up, so no one gets in trouble. And, and, you know, some school nurses are like, Look, I don't want to get in trouble. The paper says this, I'm doing this. And they might even know it's the wrong thing. But they're not going to go against the document. So suddenly you put yourself in control. And that's it. Yeah, schools different. Maybe one day I'll have to do a 504 episode. I bet that would go over very well. I don't know. I remember writing that thing. Initially. And it's morphed since then and grown and changed, but I don't know. I remember the day I did it the first time I was still like I don't want to tell like going to school is like I don't want to do yes and no and there was no help back then either. You would just go online and look for like the ADA had this forever document you're like this. This is too much, you know, so I read it and I highlighted things that I thought might be important. And then every year we'd given take a little in horse trade and get rid of some stuff, add some stuff and that was it, but Okay, well, I really appreciate you doing this. Thank you.

Jennifer Smith, CDE 15:23
Yeah, absolutely. Awesome. Hope you have a very nice weekend. You too. Thanks.

Scott Benner 15:38
This show is sponsored today by the glucagon that my daughter carries. g vo hypo Penn. Find out more at G Vogue glucagon.com forward slash juice box. My friend Jennifer Smith has been living with Type One Diabetes since she was a child she was diagnosed over 30 years ago. She holds a bachelor's degree in human nutrition and biology from the University of Wisconsin. She is a registered and licensed dietitian and certified diabetes educator and a certified trainer on most makes and models of insulin pumps and continuous glucose monitoring systems. She also works at integrated diabetes Comm.

Guys, I really appreciate you listening to the show. If you are a US resident who has type one diabetes or a US resident, who is the caregiver of a child with Type One Diabetes, please consider going to T one d exchange.org. forward slash juicebox and completing their survey. When you do, you'll be adding important information, important information to the lives of people with type one diabetes and you'll be supporting the podcast. It's literally easy to do. There are no big questions nothing will be asked that you don't know the answer to it's completely HIPAA compliant. 100% anonymous and takes less than 10 minutes you can do it right there on your phone. Your tablet, your computer really is easy. I hope you try it. T one d exchange.org forward slash juicebox. Thanks so much for listening. I'll be back soon with another episode of the Juicebox Podcast.

#544 Diabetes Variables: Masturbation

Diabetes Variables: Masturbation

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

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Scott Benner 0:00
Hello friends, and welcome to Episode 544 of the Juicebox Podcast.

Hey everybody, this is the next episode in the diabetes variable series. So it's going to be me and Jenny Smith. Jenny, of course, is a 30 plus year type one, a CDE, a nutritionist, she says a whole bunch of stuff. And she's here today to talk about a new topic, something that might come up in your life, that very well may impact blood sugars. The variable that we'll be talking about today is masturbation. I know you probably saw that in your podcast player, but I'll just give you a second to let it sink in. Right. So you know, that's what we're going to talk about. And it's gonna be serious and it's gonna be silly. So try to expect both serious and silly here. Please remember, while you're listening, that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your healthcare plan. or becoming bold with insulin. I looked up some euphemisms for masturbating, because I thought I would put a couple in here, but if I'm being honest, a number of them are disturbing, so we're just gonna skip it. Instead, I'd like you to say your favorite euphemism out loud right now, no matter where you are.

This show is sponsored today by the glucagon that my daughter carries. g vo cuyp. Open. Find out more at G Vogue. glucagon.com forward slash juicebox. Okay, all right. I'm just I'm just gonna ask you before we start, are you Oh, are you up for something here?

Jennifer Smith, CDE 1:53
Sure. It's not like technically research, like, Oh my gosh, I have to delve into like studies for this question

Scott Benner 2:00
the exact opposite of that. Okay, you're ready? I feel so weird. I'm not gonna look directly at you, Jenny. Okay, I want to talk about a variable today that I'm hoping I mean, honestly, if you can't help me with this is going to be such a sad conversation but orgasm. Oh, interesting. Good question. It's a honestly, do you want to know where I got it

Jennifer Smith, CDE 2:26
from? From your questions online besides

Scott Benner 2:29
the list? The The reason I moved it up on my list was, there was a massive conversation in the private Facebook group amongst parents. I just it's so weird to say, who all had an aha moment at the same time. And a lot of their statements sounded like this. Oh, I just thought that at a certain time of night, my kids blood sugar went up, or I thought a shower made my kid's blood sugar go up, or I thought and I was like, Oh my god, I never thought of this. So

Jennifer Smith, CDE 3:04
that's in the population in which that will occur. Yes, because I've got little kids who are like five and their bath makes their blood sugar go up, I guarantee it's

Scott Benner 3:16
gonna be a different thing. So the the, so the conversation started very boy centric, like people are very much like, Oh, this is why my son showers make his blood sugar up. This is why when my son's like, door is locked, his blood sugar goes up like this stuff, right? But then very lovely. adult women who have type one in the group jumped in and said, I gotta be honest with you. My blood sugar goes up to when I'm doing that. And I was like, Okay, now some people said it doesn't. And some people says it does. But I want to, I guess I'm separating orgasm, during intercourse from orgasm while you're by yourself, because I guess it's probably if you're doing it right. It's probably more vigorous when you're doing it with somebody else. Right. So then there's other things to think about, like I

Unknown Speaker 4:09
would guess so. Yeah, two children stop.

Jennifer Smith, CDE 4:16
Oh, yeah. Yes, I would guess so. I mean, experience wise. And actually, because I get into those conversations with my female clients. I don't think it's honestly ever been something that I've worked with, that a gentleman has brought up to me, but the women that I work with, especially like in preconception time, and all of that kind of stuff. It's it's a topic that that's brought up. I've actually found I think, it seems to be about like a 5050. And in women, so to speak, not the teens but women who seem to have more of a drop in their blood sugar. After but, you know, I'd have To have data with markers so when and whatever to actually see was there actually arise before like the drop off almost like you drop in blood sugar after exercise, but not maybe during it. So that could be but I would expect in the teen population, I'd expect if I, if there's a little bit of maybe like, maybe there's like a behind the scenes like anxiety, especially for teens who live with their parents and are in their shower or lacking their bedroom door. And there are other people in the house, right? So they're kind of at a point of like,

Scott Benner 5:39
So are you saying that while in my

Jennifer Smith, CDE 5:41
mind, maybe a little anxious doing this because they might be discovered maybe I don't know. I thought

Scott Benner 5:48
I enjoy thinking mister with you. This is fun. So the plotting, you're saying could bring your like an anxiety or something? While I'm walking around the house, making sure I got door locks tissue. Whenever I need, I might be getting like, like, Hey, I'm about to do this thing. Maybe somewhat. Maybe it's exciting. Maybe I'm excited. I'm about to do it. Maybe I'm worried somebody is going to catch me. Right? Okay,

Jennifer Smith, CDE 6:15
I would I would put it kind of in the class of like, practice running, usually will keep your blood sugar steady or drop it right. You get to your a race and the adrenaline of the race day performance expectations and everything. Many of the athletes I work with on their race or their you know, team kind of competition, they their blood sugar's go up, I see what you're saying. Maybe it's I mean, again, studies would have to be done to the

Scott Benner 6:44
point. I guess we can just talk these are all thought yeah. So

Jennifer Smith, CDE 6:49
that's a great question. That's a great question. Really, it is,

Scott Benner 6:52
listen, it is something that I would guess impacts most people. I might be giving something away here. But I would say many days of the week. Yeah. frequently with enough frequency that it should be talked about. There's no way anyone's going to talk about you said earlier. This has never come up with any gentlemen, I'm going to tell you Jenny, a guy who brings up the Bleep this up. But a guy who gets on with you to talk about diabetes and starts talking about their health habits probably not going to come across like gentlemen. This is true. That's why they're not asking. They're probably just figuring out on their own. That's why the podcasts here so we can talk about stuff like this.

This show is sponsored today by the glucagon that my daughter carries. g vo hypo Penn. Find out more at G Vogue glucagon.com forward slash Juicebox.

Jennifer Smith, CDE 7:54
Podcast Funny thing is about it that from a parent's standpoint, it's not something I've heard in terms of a question from parents either. Yeah. And the topic of alcohol comes up very frequently for my teen population. I mean, I've had questions as young as kids who are like 13 and 14, parents questioning, you know, well, we don't encourage this. And we've been, you know, we've discouraged until this certain age or whatever. It is a point that I want you to bring up to reference the dangers of it. But this other topic,

Scott Benner 8:30
people don't want to think about it. I'm here, don't bring up by going through the the Facebook, the thread, it was forever long. And most people found it incredibly valuable. Because you realize that especially for a mom, I think, like I would imagine it dad's just like I get that happening. And I don't say anything, but moms are probably like they look at their sons. And they don't think of them that way when they're young. And then you hit that moment where you're going to figure this part out. That's not nearly the first thing that's going to pop into your head when you're like, I wonder why his blood sugar is going up. Because you're going to be thinking like, oh, maybe this is happening. Maybe it's a Grossberg maybe it's this, maybe it's that

Jennifer Smith, CDE 9:06
or maybe he's sitting and eating the bag of Pringles in his bedroom and forgot to Bolus or whatever you're thinking other things.

Scott Benner 9:13
But more more accurately what happened is somebody they found attractive, he probably scrolled by on Instagram. And now there you go, now we're gonna see what we can do. So is there a physical like suit? But to start over again, you're saying women, when they're by themselves as often as not finish? And then their blood sugar's drop? Or what do you see there?

Jennifer Smith, CDE 9:38
Yeah, I mean, I would say again, in the women that I'm working with, mostly that the topic comes up, it's like in the preconception stage, right? Where they're actually trying to have a child and have to do things in order to have the child we you know, into terms of that many are very willing and want to actually make notes about things that they can figure out what to do. And so most often, I would say, like I said before about 50, at least 50% of women find that it's more the after is a drop in blood sugar. Versus the during. Okay, so. And I would expect maybe it has to do with movement and length of time together and all of the other things that could propel more of a drop in blood sugar, or it could be, you know, like the end of a run. Many people have a lower blood sugar in the aftermath of a run for hours because of the lasting effect of those like, feel good hormones and the exercise, so

Scott Benner 10:47
Okay, but if we're, if we're talking about Have you had any experience with like, women talking about masturbating, or no smoking, mostly, yeah. So no, nobody's ever come to you and said, like me when I flick my been like stuff, nothing like that. By the way, what's your favorite? What's your favorite? Well, I'm gonna bleep this out. So no one ever tell me your favorite euphemism for masturbating that a woman can use?

Jennifer Smith, CDE 11:14
Oh, my God, I don't even know. I know. There was I guess I never think about that. I mean, in terms of like, what you would call it? I don't? Yeah,

Scott Benner 11:26
I don't know. Fine. All right. I just thought totally funny. Alright, so. Alright, so

Jennifer Smith, CDE 11:34
I think it's a great question, though. Especially considering all of the like, tuning commentary that was kind of being discussed online about it.

Scott Benner 11:45
Yeah, it was super interesting how interested people are I also listen, as I think through what I know about masturbation, and what I know about diabetes, I would say for an older person who doesn't feel a guy who doesn't feel like oh, someone's going to catch me doesn't have any of that build up stuff. I would say that, you know, you'd be surprised how it pops into men's heads, like, in the course of a day, you know, like the way you might the way you might think like, I'm gonna get a glass of water now, like a guy might be like, Oh, you know, I'm gonna do and so that might be very blunt, say leading into it. And then so I'm a guessing there's vigor and excitement. dooring.

Jennifer Smith, CDE 12:22
And then it could be like an adrenaline rush could

Scott Benner 12:24
be a bit of an adrenaline rush, although sometimes it's medical journey. You know what I'm saying? Sure. No, you don't even know you're such an awesome person. I such a white person, you're such a nice person. Like, here's my sometimes it just needs to be accomplished. Okay. It's like a chore and not not a fun thing. But I would think that to

Jennifer Smith, CDE 12:44
get it done, it's like mowing the lawn, check it off.

Scott Benner 12:47
See, there's your euphemism. It's, it's next time your husband like disappears for 15 minutes, and he comes back go, Hey, were you mowing the lawn? Never know what you were talking about. And, and so I would, I would guess, too, for a lot of women it might feel more intimate than then for guys who might see it more as utilitarian sometimes. I guess. Yeah. So there's a lot to be considered here. But if you're the parent of a adolescent child, and you can't figure out why every time the door's locked, there's a blood sugar change. I mean, I don't know where to go from there with that I never had to have that conversation with my kids so far. Although in the course of the conversation online, an adult woman talked about her mother could see her orgasms on this CGM and knew it over like, because her mother was like, inspect your clue. So so the girl would go out sometimes on a date she see this thing happen, the girl comes home. And then no mom started putting two and two together and then the girl grows up and becomes an adult and the moms and now though girl's mom knows when she's having sex by your CGM data.

Jennifer Smith, CDE 13:59
I feel like my you got to get rid of Yeah, that would be time to go then. You can't follow me anymore. I'm

Scott Benner 14:04
so sorry. But anyway, that's a variable. It's really interesting. I guarantee you no one else is going to bring up on their diabetes blogger podcast except for me.

Jennifer Smith, CDE 14:14
No. So that might be more of an after dark.

Scott Benner 14:18
I think I can do it. After Dark berry diabetes variable after dark, and then I'm just gonna call it I don't even know what I would call it. I'll use my I can't use my favorite euphemism. But anyway, I will share something personal with you or not about me about a euphemism that I think is funny. All right. We're done with this. Now it's over.

A huge thank you to one of today's sponsors, g Vogue glucagon, find out more about chivo hypo pen at G Vogue glucagon.com forward slash juice box. you spell that g VOKEGL Uc ag o n.com forward slash juicebox. And if you enjoy Jenny she actually does this for a living so you can find her at integrated diabetes comm Let me help you with your diabetes needs.

Before I go, I'll remind you that the diabetes pro tip series begins at Episode 210 and goes on for quite some time. Episode 211 is called all about MDI while 212 is all about insulin to 17 Pre-Bolus to 18 Temp Basal to 19 insulin pumping to 24 mastering a CGM to 25 bump and nudge to 26 the perfect Bolus 220 excuse me 231 variables, that's a pro tip that just talks about variables. And then this is a episode about a specific value anyway. Let's not get confused, you're probably writing 237 diabetes pro tip setting Basal insulin 256 exercise 263 fat and protein 287 illness injury and surgery 301 glucagon and low VGS 307 emergency room protocols 311 long term health 350 bump a nudge Part Two 364 pregnancy 371 explaining type one glycemic index and glycemic load 449 postpartum 470 weight loss they are available right here in your podcast player at Juicebox Podcast calm and at diabetes pro tip comm check them out. Please, please, please. Thank you so much for listening. I'll be back soon with another episode of the Juicebox Podcast.