Scott Benner 2/17/25 Scott Benner 2/17/25

#1436 Life Coach: Doesn't Remember to Bolus

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12 year old Kyler tries to figure out why he doesn't remember to bolus.

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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
Welcome back, friends. You are listening to the Juicebox Podcast.

Kyler is 12 years old. He has type one diabetes. His mom brought him on the podcast because he has trouble remembering to Bolus for his food sometimes. And so Kyler and I have a conversation, and we come up with a plan, and this is 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. I know this is gonna sound crazy, but blue circle health is a non profit that's offering a totally free virtual type one diabetes clinical care, education and support program for adults 18 and up. You heard me right, free. No strings attached, just free. Currently, if you live in Florida, Maine, Vermont, Ohio, Delaware, Alabama or Missouri, you're eligible for blue circle health right now, but they are adding states quickly in 2025 so make sure to follow them at Blue circle health on social media and make yourself familiar with blue circle health.org. Blue circle health is free. It is without cost. There are no strings attached. I am not hiding anything from you. Blue circle health.org, you know why they had to buy an ad no one believes it's free. The episode you're about to enjoy was brought to you by Dexcom, the Dexcom g7 the same CGM that my daughter wears. You can learn more and get started today at my link, dexcom.com/juice, box. Today's podcast is sponsored by the insulin pump that my daughter has been wearing since she was four years old. Omnipod. Omnipod.com/juice box. You too can have the same insulin pump that my daughter has been wearing every day for 16 years. Hey,

Kyler 2:00
my name is Kyler Davis. I'm 12 years old, playing baseball.

Scott Benner 2:05
Kyler, how old were you when you got type one, five years old, five. So seven years ago? 910, yeah. Okay, so you were five. Do you have any brothers or sisters? Yeah, I have a eight year old brother. Does he have diabetes? He does not. No, does anybody else in your family?

Speaker 1 2:23
No, I'm the first one in the family to get the type one. Gotcha,

Scott Benner 2:27
that's not exciting, huh? No, no. How to make you feel like, when do you remember that time? Or do you not remember it really?

Speaker 1 2:36
I mean, I like vacantly remember it. What are your recollections it was kind of scary. Mean, I didn't really know what was happening to five years old.

Scott Benner 2:50
What about now? How is it different now?

Speaker 1 2:53
Oh, I'm just really used to it now, because I've had it for seven years.

Scott Benner 2:57
So you don't think about it the same way. You're not scared by it. No, no no. Does it make you feel different at all, or not in a way that bothers you? It doesn't really bother me. Okay, you have any problems with kids, anybody? Give you crap about it.

Speaker 1 3:11
I mean, my friends like we joke about it, but I don't really care.

Scott Benner 3:15
Is it joking in a way that you feel like you're in on, or do you feel like they're making in on? Yeah, not like they're making fun of you and you have to have to go along with it, or something like that. Okay, yeah, awesome. You have a good group of friends. Yeah, I have a great group of friends. Awesome. Awesome. How long you've been playing baseball since I was probably four or five? No kidding. What position do you play? Second base and outfield. Second base in outfield? Are you lefty? Righty, righty, right handed. Do you love it? Oh, yeah, I love baseball. Yeah, you gotta love baseball. It's a lot of work, yeah, a lot of hours out in the sun and the heat and batting cages in the winter time and all that stuff. Tell me about it. Yeah, my son played all through college. Wow, yeah, it's cool. It's over now. He's like, 24 but gosh, my son started playing baseball. He hadn't quite turned four years old yet, and he was in this little T ball League, and he played that for a year, and then he played little league well now. Then he played at the YMCA for another year, and then he went to, like, our town's little league when he was six, yeah. And he played there from 678-910-1112, then Little League ended at 12, and then they played a ton of travel ball, and played for his middle school, and has played for his high school. And then he went on and played in college, and I've spent a lot of time on a baseball field, so yeah, you definitely have to love it. Do you think you think you love it enough to keep playing? Oh, yeah, yeah. I don't know how to ask this. Are you a big kid? Not really. No, no, you're pretty average size. Do you think Asia, Yeah, mom or dad, tall? Do you have any hope of being tall?

Unknown Speaker 4:51
No, my parents are really short.

Scott Benner 4:55
It's their fault, then Kyler, not yours. So yeah, you're gonna try to keep playing for your school. Yeah,

Speaker 1 5:00
yeah, my middle school doesn't have a team right now. Oh, we have fields, but they're for the high school. So

Scott Benner 5:06
what are you going to do for

Speaker 1 5:08
baseball? I'm playing on a travel ball team right now. That's awesome.

Scott Benner 5:12
You guys like play in the spring and the fall? Yeah, that's great. That's good. That's good baseball, all right. Well, that's that's awesome. How do you find your blood sugars during games? I

Speaker 1 5:23
usually just check it when I'm like, the dugout, batting or on bench.

Scott Benner 5:28
Yeah. Do you have problems with lows while you're playing or highs? Or do you usually do you have, like, a system where you stay pretty level

Speaker 1 5:35
when I go low, my mom usually just brings me a snack in the dugout.

Scott Benner 5:40
Yeah. Have you ever felt low, like, while you're out on the field?

Unknown Speaker 5:43
No, not really,

Scott Benner 5:44
actually. Okay, that's good. What's the gear you use for your diabetes? You have a CGM or a pump or anything like that, yeah,

Speaker 1 5:50
pump and a CGM. What do you use? Omnipod five and the Dexcom six?

Scott Benner 5:57
So it's algorithm. It's taking care of, like, some of your decisions for you, yeah, yeah. What did you have before that? Before Omnipod five? I think I started with it, yeah, I started with it. Omnipod five was your first pump. So what have you had, like, two years, maybe, yeah, okay, all right. How did you like that over injections? Oh,

Speaker 1 6:16
it's so much better. Okay, how come guys, you don't have to stab yourself every day. Pretty much, staying

Scott Benner 6:23
away from the stabby part is the good part. I hear you so your mom reached out. Why? Like? Why? Because she she sent me a note pretty quickly. I think I said I was looking for people to be on episodes about, like, I don't understand, like, something they don't understand. And I think she said, Did she tell you what she told me? No, I have no idea what she said. Is she right there? Yeah, ask her. What did what did she say to me? What'd you say?

Unknown Speaker 6:51
Oh, she understands why I dose when I eat. She

Scott Benner 6:53
doesn't understand why you dose, why you eat. Okay, all right, okay, so, all right. So, Kylie, do you think that's a fair statement. Do you not give yourself insulin every time you eat? Yeah, okay, that's pretty honest. Do you have any idea why you don't? It's hard to keep track of every day you eat. Number times a day, what happens you like, you get hungry, and then, like, walk me through it a little

Speaker 1 7:19
bit. I get hungry, I'll grab the snack then, like, I just eat it without dosing. Yeah? Because

Scott Benner 7:27
you're not thinking about it. Or do you? Yeah? Do you ever ignore it on purpose? No, you've never once grabbed food and thought, I know I should be giving myself insulin, but screw it. I'm not doing that maybe once, but not that that's not a frequent thought that's in your head. No. So what do you think happens? Do you think it's just you're just busy living and it just doesn't occur to you? Yeah. What happens then, if you don't give yourself insulin? Like, who figures out that you didn't do it? How does that work itself out? My dad. But how like? How is he like? He doesn't just magically, I mean, is he does he look across the room at you and be like, Kyler is eating. I see he's eating. He's definitely not giving himself insulin. Kyler give yourself insulin. Or is it a thing where your blood sugar goes up and then people are aware of it?

Speaker 1 8:16
My blood sugar goes up, okay? And

Scott Benner 8:19
then how high does it go up before somebody notices? Do you know, probably 250 How do you feel when your blood sugar is that high? Today's episode of The Juicebox Podcast is sponsored by Omnipod. And before I tell you about Omnipod, the device, I'd like to tell you about Omnipod, the company. I approached Omnipod in 2015 and ask them to buy an ad on a podcast that I hadn't even begun to make yet because the podcast didn't have any listeners, all I could promise them was that I was going to try to help people living with type one diabetes, and that was enough for Omnipod. They bought their first ad, and I used that money to support myself while I was growing the Juicebox Podcast. You might even say that Omnipod is the firm foundation of the Juicebox Podcast, and it's actually the firm foundation of how my daughter manages her type one diabetes every day. Omnipod.com/juicebox whether you want the Omnipod five or the Omnipod dash. Using my link, let's Omnipod know what a good decision they made in 2015 and continue to make to this day. Omnipod is easy to use, easy to fill, easy to wear. And I know that because my daughter has been wearing one every day since she was four years old, and she will be 20 this year, there is not enough time in an ad for me to tell you everything that I know about Omnipod, but please take a look omnipod.com/juicebox I think Omnipod could be a good friend to you, just like it has been to my daughter and my family. You can manage diabetes, confident. With the powerfully simple Dexcom g7 dexcom.com/juicebox the Dexcom g7 is the CGM that my daughter is wearing. The g7 is a simple CGM system that delivers real time glucose numbers to your smartphone or smart watch. The g7 is made for all types of diabetes, type one and type two, but also people experiencing gestational diabetes, the Dexcom g7 can help you spend more time in range, which is proven to lower a 1c The more time you spend in range, the better and healthier you feel. And with the Dexcom clarity app, you can track your glucose trends. And the app will also provide you with a projected a 1c in as little as two weeks. If you're looking for clarity around your diabetes, you're looking for Dexcom. Dexcom.com/juice box. When you use my link, you're supporting the podcast. Dexcom.com/juice box. Head over there. Now I get hot. Hot, like, sweaty, yeah, okay. And then what happens? Like, your parents come up to you and they're like, Hey, you didn't like, do they give you crap about it? Or are they pretty cool? How do they handle it? Yeah, they give me crap. Has it ever occurred to you to be like, I should just probably give myself insulin, and then none of this would happen. Yeah, tell me why that doesn't happen?

Unknown Speaker 11:23
Probably because,

Scott Benner 11:25
take your time. I'm being serious. Take your time and think about it, because you very well might not know, but I'm looking for your opinion, like, how come you can't make that change? I'm like, tired of doing it. Ah, okay. It's been too much, too long. Yeah. Okay, so I know you're just, I don't mean to say you're only 12, but 12 is pretty young. And, you know, diabetes is a, certainly a big responsibility, and you've already been living with it for seven years, you've come to the conclusion, I imagine, this is going to be for the rest of your life. Do you feel like that? Yes. Okay. And are you aware of why it's important to not manage your meals the way you are right now? Like how much of the health part of diabetes Do you understand?

Unknown Speaker 12:14
Probably 75 80%

Scott Benner 12:17
if I said to you, Kyler, we don't want your blood sugars to be 250 every time you eat. Do you know why we don't want that?

Speaker 1 12:24
Yeah, because then it will jack up my immune system.

Scott Benner 12:29
Well, there's more to it. So your blood sugar bouncing around like that, going high and then coming back down. Does it get low after you you fix the high blood sugar? Sometimes, sometimes, yeah, yeah, right. Then you got to eat food. You don't want to bring it back up again, like that. Bouncing is just generally speaking, not good for your body. And higher blood sugars are, you know, like, I know you can go to a 250 blood sugar, and it's not, you know, it's not like something horrible. You don't have to run to the hospital, right? But that, over and over again is slowly doing, you know, damage to your health. And so while you're sitting there, probably thinking, like, I don't what the big deal is, the thing beeped, I gave myself insulin, like it's over now, like your parents are thinking about, like, long term. They're thinking about stuff you can't even, like, imagine yet. Like, do you know how old your parents are? They're probably really old. Do you know how old they are? Yeah, they're like, 50 and 60. Oh, my God, they're almost dead. It's crazy. What they do have? What do you like, the last of 17 kids? Or something? Kyler, what happened there would your parents start having kids later in life? I'm just joking. Oh, they're not that old. Oh, okay,

Unknown Speaker 13:43
my mom made me tell you that I'm joking.

Scott Benner 13:45
How old are they? You know, 43

Unknown Speaker 13:48
and my mom's 39 it's

Scott Benner 13:51
still pretty old they, I mean, they probably, like, get up off the couch and they're, like, creaky, right? And they don't move too fast, yeah, no, no, it's almost over. I barely ever seen my mom get off the couch, yo. She just lives there. Yeah, yeah. She's not out walking, going for a run, anything like that.

Speaker 1 14:07
I've never seen her do that. Once in my life. Does

Scott Benner 14:10
she sit at all your games? Oh, yeah, she sits down. Kyler, you're awesome. Okay, so your parents are thinking long term, right? They've been alive 40 years. They have perspective on life you don't have yet. You won't have it for a long time, right? Like it's hard for a young person to worry about the future, to consider the future, even, because in your world, life's only been 12 years old, 12 years long so far. So they are really thoughtfully trying to set you up to be healthy for a very long time. They also probably want you to have good habits so that when you're older, and maybe, you know, maybe you're on like a, I don't know, maybe your travel team goes away to Florida to play, or something like that for a week, or maybe you end up at college or something that you know how to take care of your health. Yeah. And like I would imagine, I've got a daughter who's 20 years old, who's had diabetes since she was two. And, I mean, that's still my goal is, is to help her understand the things that she's going to need to know to be healthy forever. Now, day to day, that's hard to keep in mind while people are, you know, it feels like they're bugging you about stuff. I think your bigger concern probably is trying to figure out how to not feel like you're sick of it like I think the goal you should have is try to is, how do you like fold diabetes into your day to day life, so that it doesn't feel like a chore while you're doing the things that are are important for you. You know what I mean? Yeah, you know what I mean? Like, good, yeah, good. What are you gonna say?

Speaker 1 15:50
It's just like, you just gotta fit it in, yeah? Like you have all these things going on and then just gonna squeeze it in, like it's priority number one, but

Scott Benner 16:00
the trick is to not feel like it's extra like. So I think, you know, if I told you you were gonna go cross the street today, like you wouldn't think like looking left, right, left was like a burden, you'd say that's an obvious thing I need to do so that I can get across the street safely, like you wouldn't just I couldn't take you to the curb and just say, hey, Kyler, shut your eyes and run for it like you wouldn't do that. You'd be like, No, I don't want to get hit by a car. I'm not interested in that. But I think that the idea of not bolusing for your meals very consistently, it does to your parents, feel like you're shutting your eyes and running across the street, that makes sense? Yeah, yeah. So now, how do you like now it's not the answer. We don't want you to feel bad about it. We don't want you to feel overwhelmed about it. Like, that's not the goal, like nobody's trying to make you feel bad. How do you make the decision that Bolus thing for food is brushing your teeth is looking both ways, like, how do we turn it into a thing that just happens without you having to feel like it's a burden or an extra thing you're doing? Do you think that's possible? Yeah, how would you go about it? Do you think like if you had to set a plan up for you to feel better about that? I mean, what would that look like to you?

Speaker 1 17:22
Like, set and be certain times to eat and then no Bolus right before them. So

Scott Benner 17:30
if you had set meal times, you think it would help you to, like, make sure your your insulin was in. Well, I've seen people put notes on the refrigerator that just say Pre Bolus, like stuff like that, like little reminders. Because, Kyler, listen, you don't know me, you know what I mean. But I'm, like, childish in my mind still and like, I understand, I understand that you get busy. You're thinking about things you know you're not interested in, like this just sucks. Like I've I've interviewed adults from, you know, 20, 3040, 5060, years old. They all have type one diabetes, and that they almost all agree that Pre Bolus in their meals sucks, that having to remember to give yourself insulin before you eat is not fun, like but they'll also all tell you that it's a really important part of living healthy with diabetes. Now, if I was going to try to talk you into it, what I would say is this, the couple of minutes that it takes to give yourself insulin before you eat saves you so much trouble on the back end, right? It saves a 250 blood sugar. It saves that conversation with your dad. It saves you getting low later, from the from the mistimed insulin that caused the correction. It saves you from having to eat crap you don't want, drinking a juice box you don't want, like. It saves you from all of those things. It just to me, seems worth it to trade that couple of minutes of thought before the meal for all the crap that comes when you don't do it. Like, do you know what I mean? Like, maybe it's important to think about it like that. Like, it's, you're not giving something up. You're actually you're getting a lot back instead. Yeah, 100% Yeah, right. Like, your time and, like, you know? I mean, how many times have you been hanging out with friends or something and like your mom, like has to walk in the room with a juice box or candy? And like you don't, you probably feel like a baby when that happens, right? Yeah, yeah, you're not looking for that. So, like, by taking control of your meals and putting yourself in charge, you're not just avoiding those problems, those potential problems, but you're also giving yourself control, like you're in charge of this going well, instead of just acting like diabetes just happens to me, and you know it's not up to me, like you can make decisions, like you can take control your of your life and make decisions. Questions that give you the ability to write the story about how the rest of your day goes. Does that make sense? Yeah, yeah. What do you like to do for fun, besides baseball, play video games? Which ones Call of Duty? You got the new one with the new zombies? They put the zombies back the way they're supposed to be. I heard Yeah. You like the zombie ones, the the maps are. Now,

Speaker 1 20:24
I'm not a huge fan of the zombies. Do you like scary movies?

Scott Benner 20:28
Yeah? Do Yeah, I don't like scary movies at all. They scare me, I think is probably why. But so you like scary movies, but don't like the zombie maps? No, because the zombies aren't shooting back,

Speaker 1 20:42
no. It's just, I don't really like the, like the setting and the the way it's laid out. I got

Scott Benner 20:47
you, you prefer the more traditional maps, yeah, yeah. Do you get online with friends and talk to them while you're uh while you're playing? Yeah? Do you like use the headphones to gang up on people and, like, make plans and stuff like that? Uh huh, yeah. It's pretty great. Do you do the um, the achievement stuff to like, level up the weapons and the gear and stuff, or do you guys not do that?

Unknown Speaker 21:08
We do it sometimes.

Scott Benner 21:09
Yeah. Which gun do you prefer to use? Probably the Mk, don't tell me your game gamer handle, but do you like it? Yeah, yeah. All right. You don't want people hunting down Call of Duty. Do No, no, no. Okay, so it's not lost on me Kyler, that this is not a conversation that most 12 year olds have to have. You know what? I mean? No, probably not. Yeah. It sucks a little bit, but I will tell you this, I've talked to a lot of people who have type one diabetes who grew up with it, and they will tell you later in life that having type one although they don't want it, and they would obviously get rid of it if they could, but it does teach them to be more mature or thoughtful that oftentimes people with type One diabetes are not so easily shaken by life events, because they know what it is to like live through a tough thing. Do you know what I mean? Like, do you have any of those feelings like, do you see any of the value in diabetes?

Unknown Speaker 22:10
Yeah, it gets me out of class.

Scott Benner 22:14
How does it get you out of class? When

Speaker 1 22:16
my blood goes low, I get called down. I get to miss math class.

Scott Benner 22:20
Yeah. Get shot. Do you not like math? Oh no. What subjects do you like reading? Do you enjoy fiction? Non fiction? What kind of reading Do you like non fiction? So like sci fi, not really

Unknown Speaker 22:34
like history, history?

Scott Benner 22:36
Oh no kidding, like historical stories or actual like, just this is what happened in the past. Like, this is like both kind of, what are some of your favorite historical events World War Two? What about it? What do you like about about learning about it? I like learning about the Nazis and what they were doing.

Unknown Speaker 23:02
Yeah, I'm not a fan of the trust.

Scott Benner 23:05
I believe you. So what about that? Like, is it hard for you to believe that, that a group of people would were being that horrible? Yeah, weird, isn't it? So you're trying to get a feeling for like, what, like, how, how that could happen? Yeah. Do you find yourself to be a kind person in your regular life? Yeah? Yeah. Do you have trouble with people who aren't kind?

Speaker 1 23:33
Yeah, I deal with them how so kind of talk some sense into them. You

Scott Benner 23:40
find yourself kind of trying to be a voice of reason for people when they're they're being maybe unkind.

Unknown Speaker 23:47
Yeah, I take charge.

Scott Benner 23:49
Does that work? Do you have you had luck talking people into, uh, into maybe acting better? Yeah, I have no kidding. Can you share one of those experiences with me? I mean,

Speaker 1 24:00
they're like, I'm in Boy Scouts, and they're these, ton of their kids, they're always yelling at each other, and one of the scout leaders told me I had to take charge, like, so I just stepped in. They all kind of like, shut down. Yeah.

Scott Benner 24:17
What did you offer to them? What advice did you give them in that moment?

Speaker 1 24:21
I was like, You're not going to get anywhere with just yelling at each other.

Scott Benner 24:25
Did they do it a different way, or did they just kind of shut off and stop? They kind of just shut off and stop. Yeah, you think they weren't maybe accustomed to being redirected like that? No, yeah. Are you what happens when somebody redirects you? Do you you respond usually, or do you shut off?

Speaker 1 24:43
I do it. I I'm a great listener. Yeah,

Scott Benner 24:48
always been since you were little. Yeah, you like following rules. Like, does it make you? Does it make you uncomfortable to break rules? No, I always follow the rules. You do, except. Are the Pre Bolus in your meals? Yeah, pretty much you change your pumps when you're supposed to. Or do you let them go to the last second and then you're like, Oh, I guess I'll do it. Now, I

Unknown Speaker 25:09
changed my pumps when I'm supposed to.

Scott Benner 25:12
What's your high alarm set out like, when does your CGM beep at you? 250 probably. 250 okay. Do you know what your a 1c is, 7.1 Okay, are you mostly managing it on your own, or your parents still helping? My

Speaker 1 25:26
dad usually helps a lot. Yeah, like I said, my mom just sits on the couch all day,

Scott Benner 25:31
the old couch, lady, like, 60s, five years old, yeah, yeah, yeah. I understand your dad is the one who's a little more involved with your blood sugar. Yeah. Do you know why that is like, Have you guys ever discussed why your dad's the one who helps more than your mom? No, not really. No. Do you like it that way? Or do you wish they were both more involved? I was they were both involved. Do you think your dad understands it better than your mom does? Or do you think, yeah, he does, yeah, how did he learn about it? Did he ever tell you? No,

Speaker 1 26:04
he never. He just, like, after like, a year, he was, like, an expert, yeah,

Scott Benner 26:09
he figured it out. Interesting. Okay, so if you were to go to your mom, like we were in Cub Scout or in Boy Scouts, and tell her that you wanted her to be more involved, like, what would you share with her? Like, why? Why that's important to you? I mean,

Speaker 1 26:24
she's, like, involved pretty much, but I feel like my dad is just, like, a little more involved. So I'd probably say just like, can you get involved, like, a little bit more? Yeah,

Scott Benner 26:35
is she in the room right now? Yeah. Is this uncomfortable?

Speaker 1 26:39
Yeah, yeah, she's yelling at me for saying these things. Is she

Scott Benner 26:43
eyeball on you right now? Yes, giving you the look, that's okay, we're tell her, we're getting to it. Do we gonna figure out? Like, we're gonna figure out how to make a trade off here? So if you'd like her to do something, and she'd like you to do something, right? Yeah, she wants you to, like, Well, I mean, you're here for. Why? Because the Bolus thing, right? She wants you to, like, be more cognizant about bolusing for your meals, and remember to do that stuff. And you'd like her to do something too. So maybe when you guys, like, maybe when you get off here, you guys could have that conversation and just talk about that, like, simple thing, like, look, I think I could be more aware of my Bolus thing for my meals. I wish you could be a little more involved. Like, so let's try to think Kyler, like, how could she be more involved that would help you Bolus at your meals to remind me better, yeah, that's a lot to remember, isn't it? Yeah, yeah. It's overwhelming. Sometimes I imagine, oh, yeah, yeah. So, see, we found this perfect balance. I think this is our answer, if I'm being honest. Like, I think that, like, this is our answer, which is, I think your mom wants you to Pre Bolus, because it would be healthier for you, but also because it would be less turmoil in your house, right? And she also wants to think that you're learning well enough to help yourself as you get older, like I understand all of her desires, I think, and I think that it's possible that after seven years in such a long time of having type one diabetes, that maybe it's easy to forget that you're just 12 and that, yes, you should be involved With your diabetes, and you should understand what's going on, because you need to know for the future, but at the same time, 12 years old, and you could use a hand, right? Yeah, that's pretty much what we're talking about here. So, and it's fun to tease your mom about being old, you know, or whatever. I had fun with that too, or, you know, like the sofa or whatever, you know, but I'm sure she's pretty involved in your life, and you're just looking for this very specific thing from her. So is it fair to say that if for the next month, it became your mom's job to remind you 15 minutes before meals? Yeah, that it was 15 minutes before meals that maybe you could build up a little bit of a memory for that yourself. You think that's reasonable?

Unknown Speaker 29:07
Oh, yeah, yeah, I think that'd be great. And then

Scott Benner 29:10
what about while you're at school? Maybe a text message, yeah, right. This is how I used to do it with my daughter, like I had an alarm set on my phone while she was at school for whenever she had meals, or even, like, gym class or anything that needed, like an adjustment with with insulin, and my alarm would go off, and I'd stop, and I'd send her a text and I'd say, hey, you know, like, it's time to Pre Bolus for lunch. And you know, we would talk about it back and forth, and text for a second, and she'd get her Bolus in for lunch, and that would stop her from getting high at lunch, which was awesome. Or sometimes it would go off, and I would get like, a note, like, hey, like, her gym class is in a half an hour. And I'd say, Arden, let's set like, a Temp Basal decrease so that you don't get low at gym, like that kind of stuff. I

Speaker 1 29:58
have a nurse at my school that I go to for. My lunch, you do? So, yeah,

Scott Benner 30:02
okay, and is that an actual pre bullish, or does she bullish? You and you just go right to the food.

Speaker 1 30:07
It's a Bolus, or it's a Pre Bolus. I go 10 minutes early. Okay,

Scott Benner 30:12
good, good, good. So you, what do you? So what do you really need your mom? You need your mom in the morning and at dinner time, right? Yeah, yeah. And then if you're gonna have a snack, like now, listen, if, if we put her in charge, and you stand up at seven o'clock at night to go to the snack drawer, right, get a pretzel or something like that, and she says, You don't forget to bullish. You can't be mad at her because you asked her to remind you. Yes. All right, so you got to be fair to her too while you're doing it, 100% all right. Does it sound like a plan? Yep. Awesome. You think it'll work? Yeah, good. I'm excited. So now, if you're excited and I'm excited and she's excited, then together, I think we got a plan we do. Do you think I could talk to her for a minute here at the end and go over the plan with her so she knows? Yep, all right. Kyler, will you send me an email in a month and tell me how it's going? Uh, yeah, 100% I'll send you that email. I really appreciate it, man. Good luck at baseball. Have fun. Keep keep having fun while you're playing. It's a great sport. Thank you. Yeah, absolutely. Hand the phone to your mama. Good to talk. All right, see you. Yep. Hello. Hey. How are you? Hi, good. How are you? I'm good. So we came up with a plan. Okay, all right, I know you didn't expect to be on but do you want to introduce yourself real quick, or now that you're the old couch lady, would you prefer not to?

Speaker 2 31:31
Just to clarify, my name is Mary. I'm Tyler's mom, and I I'm actually a teacher, so I do not sit on the couch all day.

Scott Benner 31:41
You're not 65 and on the sofa constantly.

Speaker 3 31:43
No, no, I'm teaching. I

Scott Benner 31:47
think he was being sarcastic at points. He was very funny.

Speaker 2 31:49
Yes, he is a little sarcastic. I apologize for that. Don't apologize. It

Scott Benner 31:54
was awesome. So what we talked about was, and I know you were hearing one side of it, but it sounds like so just between you and I and everyone listening, and Kyler, if he ever listens to this too, what I'm hearing is, is that he needs help, yes, and he wishes it would come from you. Yeah, that's what I'm getting. So he doesn't think you're not involved, but he thinks his dad's more involved with diabetes. And what I heard was, and listen, I could be 100% wrong, but I've spoken to a lot of people, what I heard was, he's just 12 years old, and this is a lot, and yeah, he should remember to Bolus his meals, but he's not, and he needs somebody to help him. So I said, Well, your mom wants you to make this, you know, this change to make these and I explained to him why, like, all the health reasons why, and that you're worried about him later when he goes away to college or gets a job or something like that. You know that it's about health and his safety and happiness and all that stuff. Like, I stuck up for all the old couch ladies out there and but at the same time, like, he also has a deeper voice, and he's got a little bravado about him, and I could see how you could read him as older than he is, maybe, and then you give him the diabetes, and he's had it for so long, and it doesn't seem like that big of a deal to Pre Bolus, but Mary, I've talked to a lot of people with type one, and they all describe that remembering to Bolus for their meals is really difficult that you just get caught up living and you don't think about it. So what we said was, is that he could commit to doing it, if you could commit to reminding him, I think he's looking for you 15 minutes before a meal, to tell him, Hey, we're getting ready to have breakfast. We're getting ready to have dinner. It's time to Bolus to be a little involved in that for a month, like so like, for the next 30 days, if you guys do it together, to see if it builds a little more of a of a rhythm between the two of you and helps them. And then he said he'd send me an email in a month and tell me how it was going awesome. I love that, all right. I would say too that during school times like, you know, I it sounds like he goes to the school nurse, so you probably don't need it there. But I did tell him, I'm like, Look, if you stand up at seven o'clock at night and go, like, you know, to the pretzel drawer to get a pretzel or something like that, if your mom yells across the room at you from the sofa, like you got a Bolus for that, I was like, you can't be mad at her because you asked her to remind you. Yeah, that's the that's the key. No, I know. Don't worry. I got kids anyway. Listen, if this works, Mary, no, I'm gonna sell this. I'm gonna put it in a bottle and sell it. All right, all right. And if it doesn't work, I'm not gonna be super surprised. But if it does work, like, maybe he just needed someone who wasn't you to, like, propose an idea, because then he can accept it. Because I'm nobody to him, right? Like, I'm just a voice, and at the same time, like I tried to give him, he's a very, uh, like, thoughtful kid he talked about. Boy Scouts a little bit and being told to, like, step in and help people. And, you know, it sounds like he's, like, you know, got a real, like, emotional side to him, but comes off kind of like, you know, like, maybe he's got a big personality at the same time. Uh huh. I just think Mary's Not My Kid. But it sounds to me like you should just remember that he's 12. Yeah, you know, yep, that's pretty much this. Of course it is. No I understand, but that's what I got out of this.

Speaker 2 35:29
All right. Well, we appreciate it. We will definitely give it a try and let you know. Thank you.

Scott Benner 35:35
Do you think this was an I don't understand, or a Scott life coach? I think it was definitely a life coach. I do too. I'm gonna make sure I put it into this category. Yeah, I like it. I think I might have a thing going here with this. Yeah.

Speaker 2 35:48
I agree, yeah. All right, it was very helpful

Scott Benner 35:54
around Mary. Are you being serious? No, you should be a life coach as well. Well, I don't have time for that, but I this podcast thing ever goes, I was gonna say tits up. Is that a saying? Everyone knows? I think so. Yeah, if that ever happens, I'll pivot to this. There you go. There you go. I really appreciate you doing this. I appreciate you bringing them on. It was very, very nice of you to set up. I'd like to ask you, like, in a month, would you reach out and tell me how it went? Because I could add in your email to the end of the episode. Yeah, absolutely awesome. What do you teach? I teach fifth grade math. Oh my gosh, God bless you. Yeah. Is that why he told me he doesn't like math?

Speaker 2 36:37
He really doesn't like math, which is very hard for me, I was gonna

Scott Benner 36:40
say, is he just digging at you, or does he not like math? No, he

Speaker 2 36:44
really does not like math. He never has, so it's been that's hard on me. Hey,

Scott Benner 36:49
at least he reads. That's awesome. Yes, he does enjoy your reading. So there's that that's good, by the way, the reading thing might Evan flow a little bit and come back. But my son was a big reader when he was younger, and got back to it in his 20s. Yeah,

Speaker 2 37:02
he's not. He doesn't do it outside of school, but at school he does enjoy it. So I'll take

Scott Benner 37:07
it hopefully eventually it will do you think he'll keep playing baseball. Hopefully

Speaker 2 37:11
we'll see his team's going to Cooperstown this summer. So that's pretty exciting. Yeah,

Scott Benner 37:16
they'll have a great time. They have those little replica fields to play on. That's pretty awesome. Yeah, so yeah. Then next year, the fields get bigger. Oh, great. They go to the 5070, field. So now instead of 46 what is it? 4660 right? So it's 60 feet the first base, 46 feet to home plate, yeah. And then it goes to 5070, so 50 from the pitcher's mound to home, 70 feet to first. But the 5070 fields are usually on full size outfields, so 5070 is the first time you figure out if they can play baseball or not. Oh gosh. Well, we'll see if he's still rolling and doing well there, then you're stuck. He's gonna end up playing high school. So okay, yeah, we'll see. We'll see what happens. Get your sunscreen and your floppy hat ready. Mary, yeah. All right, thank you so much for that. All right, thank you. Have a great day.

Unknown Speaker 38:06
Thanks. Bye.

Scott Benner 38:15
A huge thanks to Omnipod, not just my longest sponsor, but my first one, omnipod.com/juice box. If you love the podcast and you love tubulin pumps, this link is for you. Omnipod.com/juice box. Dexcom sponsored this episode of the juice box podcast. Learn more about the Dexcom g7 at my link. Dexcom.com/juicebox, earlier you heard me talking about blue circle health, the free virtual type one diabetes care, education and support program for adults. And I know it sounds too good to be true, but I swear it's real. Thanks to funding from a big T 1d philanthropy group, blue circle health doesn't bill your insurance or charge you a cent. In other words, it's free. They can help you with things like carb counting, insurance navigation, diabetes technology, insulin adjustments, peer support, Prescription Assistance and much more. So if you're tired of waiting nine months to get in with your endo or your educator, you can get an appointment with their team within one to two weeks. This program is showing what T 1d care can and should look like. Blue circle health is currently available in Florida, Maine, Vermont, Ohio, Delaware, Alabama and Missouri. If you live in one of those states, go to blue circle health.org to sign up today. The link is in the show notes, and please help me to spread the word blue circle health had to buy an ad because people don't believe that it's free, but it is. They're trying to give you free care if you live in Florida, Maine, Vermont, Ohio, Delaware, Alabama and Missouri. It's ready to go right now. And like I said, they're adding states so quickly in 2025 that you want to follow them on social media. Blue circle health and you can also keep two. Attacking blue circle health.org to see when your free care is available to you. I can't thank you enough for listening. Please make sure you're subscribed, you're following in your audio app. I'll be back tomorrow with another episode of The Juicebox Podcast. If you're looking for community around type one diabetes, check out the Juicebox Podcast. Private, Facebook group Juicebox Podcast, type one diabetes. But everybody is welcome. Type one type two gestational loved ones. It doesn't matter to me if you're impacted by diabetes and you're looking for support, comfort or community, check out Juicebox Podcast type one diabetes on Facebook. The episode you just heard was professionally edited by wrong way recording, wrongway recording.com, you.

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Scott Benner 2/16/25 Scott Benner 2/16/25

#1435: Small Sips: All Carbs Aren't Created Equal

Carb counting isn’t just about numbers—it’s about understanding how different carbs affect blood sugar differently.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, welcome to the sips series.

These foundational strategies were nominated by listeners. They told me, these are the ideas in the podcast that truly made a difference for them. So I distilled them down into short, actionable insights. There's not going to be any fluff or complex jargon, just practical, real world diabetes management that you can start applying today. And I know your time is valuable, so we're keeping these short. Another small sip will come out once a week for the foreseeable future. If you like what you hear, check out the Pro Tip series or the bold beginning series for more. Those series are available in the menu at Juicebox podcast.com and you can find complete lists of all of the series in the featured tab on the private Facebook group. Please remember that nothing you hear on the Juicebox Podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your health care plan or becoming bold with insulin. The questions you have, I guarantee you there's answers to them in the Juicebox Podcast, and it's all free. You Jen,

Jenny, broccoli, mashed potatoes, white bread, rice,

Jennifer Smith, CDE 1:35
lollipop. I like broccoli in there. They're

Scott Benner 1:37
all food, right? They're things people put in their mouth, they

Speaker 1 1:41
are all food. I like the fact that they are technically all food, yeah. Now,

Scott Benner 1:46
if we took 10 carbs of broccoli, 10 carbs of mashed potatoes, 10 carbs of brown rice, 10 carbs of basmati rice, 10 carbs of all giant lollip, how much? How big would a lollipop have to be to be 10 carbs? Probably not that big, right? Well, yeah, no, your

Jennifer Smith, CDE 2:02
typical lollipops, like the little round, circular ones that are like a quarter size, are usually five to eight grams a piece, depending so, you know,

Scott Benner 2:10
I'm old enough to think of that as a doctor's office lollipop. It is. Yeah, I don't think they give this away. Lollipops

Speaker 1 2:16
that had the curved bottom, they had the two sticks that were a curve. Do you remember

Scott Benner 2:21
those so excited? She's so excited. She's like, I love that lollipop. I have to tell you. I went into a place the other day to order something, some food, and it wasn't gonna be ready for a half an hour. And I said, I'm gonna go wait in my car. You know, it's that time of year. I'm like, hey, these people are sick. I know they are. I gotta get out of here. And they had a, like, a bowl of lollipops. And I was like, I'm just gonna take one of those. I just I rolled outside, sat in my car with my lollipop. But I bring these things up because if we took 10 carbs, 30 carbs, and made equal piles, carb wise, of all these different foods, it doesn't mean that those carbs are all going to impact your blood sugar the same way. It doesn't mean that they're going to require, and they think this is the part that throws people off the same amount of insulin. So 10, you know what I mean? I want to talk about that.

Jennifer Smith, CDE 3:08
Yeah, no, I think it's valuable to bring up, because I think in the world we live in now, with the technology we have, we can actually see more of what you're saying. We can see that 10 grams of broccoli versus 10 grams of mashed potatoes, let's say are all worth they're all worth the same amount of insulin. But because we have the quality of technology in delivering that insulin, we have a better way to push that insulin out, to cover the food. And we also know a lot of people, thankfully now know a lot more about Pre Bolus thing for certain things versus not other things. So that the understanding of how insulin works and then how food digests, they're really they're the two factors that are so very important, and a carb is a carb as a carb is not true when you're trying to deliver insulin to match the effect that that CARB is going to have once it hits your

Scott Benner 4:13
bloodstream, right? I have to tell you that we did a defining diabetes episode called carb absorption and digestion. It's 668, was a long time. It was a very long time ago, and I understood by then, through my experience with Arden, that all carbs weren't created equally. Like, that's how I thought about it, and it's how it comes out in the podcast. It wasn't until one day, I think, in one of the pro tip episodes, where you started talking about the digestion. And I have to admit, like, I don't know if I ever told you this at the time, but I was like, oh, that's why. Like, you know what I mean? Like, I was like, I knew it was happening. I saw it happening. I knew how to combat it, like, the whole thing, I didn't know why it was happening. And I found that's been such a almost set a delightful path, because I think it. Really opened up the podcast a lot, because it's led to so many other things, like, great, like, you know, initially, just the conversation of, like, Look, if you put those potatoes in there, the makeup of those is going to, you know, kind of dictate how it gets digested, how long it stays in your system, how long it's impacting but if you like, go flop a little sour cream, you know, or some butter on top of it. Butter is a great example, because no carbs and butter. So you know, if your mashed potatoes are really just a butter delivery system, and it slows down your digestion, well, then those potatoes, they sit in your stomach longer, they impact longer. And that's what I mean by it like, yes, it's 10 carbs of potatoes, but the impact over the timeline of digestion, the life of the insulin, all the things that are going on at the same time are not going to all be equal. You can't just push the button put in the insulin, wait however long you're going to wait, eat the mashed potatoes, have the experience, and then do that again with broccoli and have the experience. I think that's why people with diabetes so often say things like, I did the same thing today that I did yesterday, and it didn't work out the same, except you didn't do the same thing. You just aren't seeing the variables that make yesterday different from today

Jennifer Smith, CDE 6:19
correct, sometimes Absolutely. And when we talk about there are, you know, working with as many little kids as I have the opportunity to, there are a lot of little kids and even adults, but who have likes, and they stick with those likes for an amount of time before they decide, well, I just don't like that anymore. I'm not going to eat it. But that makes it a little bit easier to determine the impact, and then you have to take into consideration the variables around that. So you may have figured out your grilled chicken with steamed broccoli, and you have it every single day for dinner because that's your favorite thing to eat, but the variable surrounding entry into that meal time, or even after that meal time, can then make a shift in how the insulin gets in in a timely manner versus a more lengthy manner, versus, you know what I mean, like exercise you're doing volleyball for three hours ahead of that meal, versus the next day you've had three tests, and you come into dinner time and you've had no activity, because if you've just been sitting, there are those variables that are going to impact this meal needs two units in a given scenario, but the variables surrounding that are going to change day to day.

Scott Benner 7:39
I have probably 1000 times said to people, if you're really struggling to figure out how your insulin works, get boring for a few days and eat the same thing for breakfast, the same thing for lunch, the same thing for dinner. You'll get better at it, like, because right then, at least you can see like, oh, I tried a 10 minute Pre Bolus. This didn't work. You know, like, there's nothing worse than somebody being so bum fuzzle that they start saying things like, I saw someone lying the other day. Said, This is what's making me think of it. She said, I don't understand. I'm up to a one hour Pre Bolus. And I was like, Oh, well, that's not your problem. Then right? Like, your basal is wrong, or you're, you know, the meal before isn't being addressed correctly, or any number of problems. But like, if you're up to, like, trying to Pre Bolus your meal for an hour, you're looking at the wrong problem, you know. And I just think that if you simplify, you can see how like this food works, and then you can see, well, now I can figure out like this food mixed with this food on a plate might work differently again, and that's a little easier for me. I'm a very boring person. You and I are going to get done here. I'm going to go downstairs. I'm going to take two I'm going to take two eggs, I'm going to take a little bit of protein, I'm going to put it in a pan with like, half a tablespoon of butter, I'm going to fry it up on a throat and a wrap, and I'm going to eat it like I do every morning. I don't care. Doesn't bother me. But do that for a few days, you'll start seeing consistencies. Start realizing, hey, my Pre Bolus was a little short. It was a little long. This carb ratio doesn't work for this meal, but it does work for lunch for some reason, like, who cares? Why learn that you know, right? Expect that what's going to happen is going to happen, and do it again the next day. Have some success. And then, like you said, now you've got actionable tools that you know how to use. Start applying them to different scenarios, right? And

Jennifer Smith, CDE 9:22
then you can take that even further. Let's say you love your protein wrap that you're eating, and you decide, well, goodness, you know, I'd really like to get some good antioxidant quality into this meal as well. I'm going to start throwing some blueberries or some raspberries into this right? Well, that's an addition to what you had figured out. So now, if things go sideways and you didn't expect them, it's okay. I added this extra. How do I need to compensate for this? It's an do I add a secondary Bolus at a different time? Do I Bolus a little bit longer Pre Bolus? Do. So what do I do? Right? So you can take your again foundation of things that you do most of the time, and most people have about 80% of the same foods over and over and over again in a week's time. You can figure those out. You can start throwing in the oddities and figure it out in an easier way. Yeah,

Scott Benner 10:21
I mean, listen, I don't have diabetes, but that wrap can sometimes have I'll tell you what I'll do. Sometimes I smoke sausage and I put it in the refrigerator and I put it with my wrap. Sometimes I do chicken, sometimes I do shrimp, sometimes I do beef. Sometimes I'll get crazy and put bacon in there. I'm crazy. Just losing weight for the last two years has been a lot of fun, but the bacon, if I was using insulin, would slow down digestion differently than the chicken, or the chicken would digest 45 minutes later, an hour later, versus maybe the beef would do it a different time. Or the shrimp might not really impact me very much. It's all there. But like you said, you throw, not that you're putting a berry in with shrimp, but all of a sudden you like, throw some berries into it. You could, I guess. But now, all of a sudden, you might get hit with some fast acting carbs, because that wrap, prior to that is eggs. It's a protein in the wrap. I try to use a fairly low carb wrap. That's probably a slow, consistent impact. All of a sudden, I have a little bowl of blueberries on the side. Now I'm gonna get a zing of, you know, fast acting sugar, it changes Pre Bolus time. It changes the amount of insulin. You know, yeah, all of a sudden now, if I was getting a 50 point rise out of the wrap that I was getting rid of in two hours, that fast acting sugar could throw that 50 point rise another 50, 100 points higher if I don't hit it correctly, one way or the other. What I can tell you is that people report back that the phrase not all carbs are created equal really help them understand diabetes episode 668, 739, and 1068, are some places you can hear that discussed. Awesome. Thank you.

Unknown Speaker 11:54
Thank you.

Scott Benner 12:02
If you or a loved one was just diagnosed with type one diabetes, and you're looking for some fresh perspective. The bold beginning series from the Juicebox Podcast is a terrific place to start. That series is with myself and Jenny Smith. Jenny is a CD CES, a registered dietitian and a type one for over 35 years, and in the bowl beginnings series, Jenny and I are going to answer the questions that most people have after a type one diabetes diagnosis. The series begins at episode 698, in your podcast player, or you can go to Juicebox podcast.com and click on bold beginnings in the menu. Are you starting to see patterns, but you can't quite make sense of them. You're like, Oh, if I Bolus here, this happens, but I don't know what to do. Should I put in a little less, a little more? If you're starting to have those thoughts, if you're starting to think this isn't going the way the doctor said it would, I think I see something here, but I can't be sure. Once you're having those thoughts, you're ready for the diabetes Pro Tip series from the Juicebox Podcast. It begins at Episode 1000 you can also find it at Juicebox podcast.com up in the menu, and you can find a list in the private Facebook group. Just check right under the featured tab at the top, it'll show you lists of a ton of stuff, including the Pro Tip series, which runs from episode 1000 to 1025 Hey everybody. I know there's so many episodes you might be like, I don't know where anything is, but if you go to Juicebox podcast.com or go to the private Facebook group and look in the feature tab, you'll see a complete list of all the series that exists within the podcast. And I'm talking about after dark ask Scott and Jenny algorithm, pumping bold beginnings, defining diabetes, defining thyroid, diabetes, pro tip, diabetes, variables, mental wellness, type two diabetes, how we eat, and if we add something else, like, say, my weight loss diaries, which we did, you'll find them there as well. And as a matter of fact, we're about to add a new list right now about GLP medications, because we have a seriously nice grouping of episodes on that topic. This is a good way for you to keep up with what's going on on the Juicebox Podcast, and even a better way to find those series that are, you know, compendiums at this point, 1020, episodes that are all on the same topic. So.

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Scott Benner 2/15/25 Scott Benner 2/15/25

#1434 Small Sip: Are You Stacking Insulin

Stacking insulin is often misunderstood. If insulin is still needed, it’s not stacking—it’s effective management.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, welcome to the sips series.

okay, Jenny, I'm at the office talking to the endocrinologist. Kids just been diagnosed. I've just been diagnosed, and I ask the question if I ate dinner at 7pm and at 7:45pm someone brought out ice cream. Should I Bolus for that too? And my doctor, for some reason, says to me, no, don't do that. You don't want to stack your insulin. Stack

Unknown Speaker 1:55
your insulin. Okay, so not right. So

Scott Benner 2:00
whether they get told incorrectly, where people develop the idea on their own, somebody is going to say to you after being newly diagnosed, don't stack insulin. What do you think of when you because there is a world where you can stack insulin. So what? What is 100% what is that? Stacking

Jennifer Smith, CDE 2:21
insulin is taking insulin that isn't meeting the need for another lovely, I guess, little saying, right? It is insulin that really is kind of being almost given willy nilly, right? You may not think that you're doing it that way, but it is a okay, I've given insulin my blood sugar is still high, or, goodness, the air was going up. Now I'm gonna give more insulin. I think of it as not really having a thoughtful delivery reason,

Scott Benner 2:51
purposeless, except for the fact that you have a high number and you're trying to squash it right, correct, exactly.

Jennifer Smith, CDE 2:57
I mean not stacking insulin or taking insulin for, what you need it for is not stacking, even if you're adding insulin within the defined time period of a three to four hour action window, which is what we call IO B, or insulin on board, is essentially the time frame that we're given to watch for This concept of stacking, right? And if you need the insulin, though, such as, somebody brings brownies over an hour after you finish your lunch and you really want to eat the brownie, do you need insulin for the brownie? 100% you need insulin for the brownie.

Scott Benner 3:33
And here's where the saying that helps people came out of the podcast. It's not stacking. If you need it, that's bolusing, right? That's it. That's the thing that apparently helps people more than anything. Is that phrase, yes. So I don't want you to stack your insulin. That would be bad and wrong, and you're gonna end up low, or like, panicky low later if you do that. But you have to cover the carbs that you take in. That's that you just

Jennifer Smith, CDE 4:00
do sometimes other pieces. This consideration comes up a lot when I start talking to people about why blood sugars might not seem to be responding to that initial amount of insulin, and then they bring in the idea, but if I add more, I'm stacking right? No, you're not. Let's look at the meal content. Is your meal high fat. Is it high protein? Because now you've Bolus for carbohydrates here, and in the end, hours later, you might have an impact from other pieces, other macro nutrients in that meal that are going to require more insulin. Are you adding insulin within the original Bolus? Is time frame of action 100% you are. But if you don't, your blood sugar is going to sit high.

Scott Benner 4:44
If you misunderstand the impact of a food item, like you said, it's got more fat and it's going to extend its time whatever, like you You misunderstand. You count the carbs, or you just count the carbs wrong. You count the carbs. You say, Oh, it's 10, but it was really 20. If you Bolus 7pm eat 10 carbs, you think, Bolus for 10 carbs, 20 minutes later, realize, oh, gosh, that was twice as many carbs as I thought it was. If you put in the rest of the insulin, you're just covering the carbs. You're not stacking insulin, right? It becomes one of those. It's like a boogey man, I think for diabetes, like, right? Like, somebody's going to tell you very early on after you're diagnosed, do not stack insulin. And then that phrase is going to override all your common sense in the future when you're like, I think I don't have enough insulin here, because what does it

Jennifer Smith, CDE 5:33
bring in? It brings in fear, yes, teaching somebody to be afraid of putting in extra of something that might cause, again, a place of fear is brought in with talking about low blood sugar or hypoglycemia, right so, oh my goodness, if I take more insulin right now, it's going to cause a low blood sugar, and I don't want to do that. And again, with today's technology, thankfully, you've got more information to actually be able to stop any detrimental outcome from taking more when you need more. You would

Scott Benner 6:07
think that the new technology would have squashed the better high than low theory, but it hasn't for every clinician, and I'm always interested by what we choose to say, like, better high than low means like, well, I'd rather you have a higher blood sugar than be, you know, like, fighting with a low or passing out, or something that, well, like, okay, I guess I can agree with that. But like, what if we would have just said, like, better stable and in range than low, right? Come that wasn't the thing, but probably because of no CGM. Like, it's easier for me to say that because glucose monitors exist now,

Jennifer Smith, CDE 6:40
I would expect absolutely and I I also think within that realm, there are some people who take it to another place of saying, Okay, I only have these time frames of available eat and Bolus. Within this time frame, I can't do that. I was told I can't take extra insulin. It could be dangerous to take extra so I'm going to eat a breakfast, I'm going to eat a lunch, which is well outside of that action time, and I'm going to eat a dinner, and that's it. Well, goodness, if you're hungry, if you're metabolically up or down, if you're a training athlete, that is not going to be a stretch.

Scott Benner 7:18
I don't know, like I just, I just want to say this one again, right? So just put it here at the end. You can stack insulin. I don't want you to do that, but it's not stacking if you need it, that's bolusing correct, okay? And that is one of those phrases that the feedback comes over and over again, like there's a lot of people's light bulb moments. Yeah. So awesome. I appreciate you talking about

Unknown Speaker 7:39
with me, of course,

Scott Benner 7:50
if you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode? Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast if you're ready to level up your diabetes care. The Diabetes Pro Tip series from the Juicebox Podcast focuses on simple strategies for living well with type one. The Pro Tip episodes contain easy to understand concepts that will increase your knowledge of how insulin works. And so much more, my daughter has had an A, 1c, between five, two and six, four, since 2014 with zero diet restrictions, and some of those years include her in college. This information works for children, adults and for the newly diagnosed, and for those who have been struggling for years, go to Juicebox podcast.com and click on diabetes pro tip in the menu, or head over to Episode 1000 of the Juicebox Podcast to get started today with the episode newly diagnosed. We're starting over and then continue right on to Episode 1025 that's the entire Pro Tip series. Episode, 1000 to 1025 i.

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