#1012 Fat and Protein (REMASTERED Diabetes Pro Tip)

September 23, 2023Scott Benner

In this episode of the Juicebox Podcast, Scott interviews Jenny Smith about how to bolus for fat and protein. They discuss the misconception that these macronutrients don't require insulin and provide valuable insights into the timing of bolusing for them. Additionally, Scott introduces a special bonus episode with Vicky, who shares her experience with bolusing for a keto diet. Whether you're eating keto or not, these episodes offer valuable information on managing insulin for fat and protein.

You can listen online to the entire series at DiabetesProTip.com or in your fav audio app.

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - Radio Public, Amazon Alexa or wherever they get audio.

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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 0:04
Hello friends, and welcome to the diabetes Pro Tip series from the Juicebox Podcast. These episodes have been remastered for better sound quality by Rob at wrong way recording. When you need it done right, you choose wrong way, wrong way recording.com initially imagined by me as a 10 part series, the diabetes Pro Tip series has grown to 26 episodes. These episodes now exist in your audio player between Episode 1000 and episode 1025. They are also available online at diabetes pro tip.com, and juicebox podcast.com. This series features myself and Jennifer Smith. Jenny is a CD and a type one for over 35 years. This series was my attempt to bring together the management ideas found within the podcast in a way that would make it digestible and revisit double. It has been so incredibly popular that these 26 episodes are responsible for well over a half of a million downloads within the Juicebox Podcast. While you're listening 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 healthcare plan or becoming bold with insulin. This episode of The Juicebox Podcast is sponsored by assenza diabetes makers of the contour next gen blood glucose meter and they have an amazing offer for you. Right now at my link only contour next one.com forward slash juice box free meter you can get an absolutely free contour next gen starter kit that's contour next.com forward slash juice box free meter. while supplies last US residents only. The remastered diabetes Pro Tip series from the Juicebox Podcast is sponsored by touched by type one. See all of the good work they're doing for people living with type one diabetes at touched by type one.org and on their Instagram and Facebook pages. This show is sponsored today by the glucagon that my daughter carries G voc hypo pen, find out more at G voc glucagon.com forward slash juicebox a half an hour before you and I started recording this someone sent me a message on Instagram and said how do I deal with fat and protein overnight because I was bawling all night with my kid. So I texted them back and I said hey, great timing. Can you see my recording calendar from where you're at? And hold tight? Because the answers coming? This is another one that Jenny proposed that I'm really interested in. And I don't know how much help I'm gonna make. Why don't we start with what I know? Because it's so little. So forever seriously. So for everyone who listens to the podcast and knows that I'm just sort of fluid with insulin Right? Like more. More need equals more insulin. And so because of that, I don't usually stop and think about whether that means it's protein or fat or what it is just if Arden's blood sugar seems to require insulin, I give it more. I'm assuming I'm been handling fat and protein rises for ever.

Jennifer Smith, CDE 3:17
You're not dissecting her meals, you're just saying I see the need. I'm giving more insulin. That's kind of what you do. Yeah,

Scott Benner 3:24
I see diabetes as a forest fire and I fly over it with a giant plane full of water and just drop all the water on top of it. Then I go oh, look, we got most of it. And and

Jennifer Smith, CDE 3:35
look at that's where the fire started. There it is right that comes in and looks at and Scott's like, I didn't really care where it started. I just want to take care of

Scott Benner 3:43
meaningless to me, I'll go get another plane full of insulin and drop it back on again. So So I never really think about stuff like that I do a little more obviously, as you and I have been speaking as the years go past, but I find it to be it's another level. Like sometimes I joke about things being like like ninja level, like, I think that you don't really need to know about fat and protein if you're doing what I do. But you do need to know if you want to start understanding things in a bigger way. So I'm really excited to do this. Now. The only thing I know about protein is that I do indiscriminately Bolus for protein. I don't know why I do it. But I do it. So where some people might look at a plate and go, oh, there's potatoes. Well, that's, you know, this many carbs. But then there's a you know, a cheeseburger well that's meat. I don't do that. And here's a roll that rolls 25 carbs and you know, and we're gonna have broccoli and I don't know, broccoli probably has five or six carbs or like, so I look at it. I look at I look at a plate I go broccoli, and six, the roll. Let's call it 30 Then I look at the potatoes and add another 35 And then I look at the burger and I go. Let's call it 10 and we'll extend it for a little bit. it. And so that's me looking at a cheeseburger with mashed potatoes and broccoli, right? I don't know why I do that with the other than I know, people who eat incredibly low carb, who tell me that they Bolus for their protein but farther out from when they actually ingest it. Is any of that right? If visiting, dancing for diabetes is wrong, I don't want to be right about this, I want to be right about the fat and protein thing. But I would not want to be right about visiting dancing for diabetes being wrong. If it was wrong, which it's not, I think you should definitely do it. Dancing, the number four diabetes.com. You know, studies show that if ads are incredibly confusing, they work so much better. Check out dancing for diabetes on Instagram and Facebook, throw them all like it's a really great organization, dancing the number four diabetes.com Even if you're not interested, could you go like 30 pages because they paid for this. And now I'm listening back to it. And I didn't do a very good job. So let's at least give them their money's worth. Is any of that right? Because,

Jennifer Smith, CDE 6:09
yes. And again, I from the standpoint of looking, you're not doing this in a blind way, you have, you have the method that you've developed for analyzing looking at Arden's control and her management and what happens here and what happens there. And you remember it, you've got like this, like library of like, times of this has happened, you can like pick from them, Scott, and you're like, I know this happened last time. So let's time this time for the burger and broccoli, we're gonna give 10 for the the burger, because I know what happened last time and something was off. And the carb count for everything else was right, right. In context, though, for everybody who's listening, and why would you need to Bolus for protein. It's really typically two points that you'd need to Bolus for protein one, you brought up the low carb eaters, or those who are eating lower carb at times, if you've got a meal that's typically less than about 15 to 20 grams of carb and a normal amount of protein, not like this big 16 ounce steak, but a typical, you know, five ounce chicken four or five ounce chicken breasts, let's say you're usually going to need about 4050, sometimes even 60% of the amount of protein in the aftermath of that meal in order to accommodate for your body's own digestion of protein in a low carb environment, because remember, carb is the body's natural first fuel, right? Okay, if there's not enough of that first fuel there, your body looks to another source, like protein digests it down, and you get a usable amount of glucose out of protein. Even if it's not a huge amount of protein eaten in a lower carb environment. The opposite of that would be let's say, she has a high carb meal, or anybody has a high carb meal that's like the meat lovers pizza, okay, and which is not only a huge amount of carbs, as well as a huge amount of fat, but you've got this large amount of protein, let's say instead of your standard, like 25 gram portion of protein, which is like about the size of the palm of a woman's hand, that's about 20 to 25 grams of protein, that's pretty normal amount, okay, if you've got this huge amount of protein that you're taking in, even in a normal amount of carb or a high amount of carbs, you're still going to need Bolus for about, let's say, 50% of that protein, but it's going to be a drawn out type of insulin need. So both of those scenarios would require you to take, you're doing like a dual Bolus, you're extending some of it, assuming you're meeting that protein kind of need for a while. Protein Bolus typically is a good idea is at the end of the meal, to set an extended Bolus with 0% delivered upfront and 100% extended out over about a three hour time period. And that's just for aware proteins impact usually starts impacting about two two ish hours after a meal. And then by about three hours, you're too high and you might sit high and correct to try to get it back down. When in effect had you use what you use to correct to actually Bolus for the protein you wouldn't have had the rise to correct to begin with.

Scott Benner 9:36
Yeah, I got it. It's parallel to the idea of over Bolus and like when you can't Pre-Bolus And you throw in a ton of extra to handle the rise before the rise happens. Okay, so i i Bolus the meal normally. Then I finish eating and I put in this amount for the protein in an extended Bolus 0% up front the rest of it out over maybe three hours. Correct. So So Basically, I'm creating a heavier blanket of insulin over the timeframe where the food's going to have impact where the

Jennifer Smith, CDE 10:07
protein is going to have the impact or where you're assuming from previous experience with meals like that, that impact is going to kind of fall in and fat is even longer. But as we've kind of talked about before fat can have impact up to 10 to 12 hours after eating high fat.

Scott Benner 10:21
How does that technically happen? So these are where my questions exist. And by the way, I just everyone listening, I just stared at Jenny while she said that and thought, Oh, I'm in a Master's class about diabetes. And so, so fat as an example, when How does fat does it slow down? Digestion? Like why does fat hold up blood sugar I don't understand, I guess. The remastered diabetes Pro Tip series is sponsored by assenza diabetes makers of the contour next gen blood glucose meter and they have a unique offer just for listeners of the Juicebox Podcast. If you're new to contour, you can get a free contour next gen starter kit by visiting this special link contour next one.com forward slash juice box free meter will you use my link you're going to get the same accurate meter that my daughter carries contour next one.com forward slash juice box free meter head there right now and get yourself the starter kit. This free kit includes the contour next gen meter 10 test strips, 10 lancets, a lancing device control solution and a carry case. But most importantly, it includes an incredibly accurate and easy to use blood glucose meter. This contour meter has a bright light for nighttime viewing and easy to read screen, it fits well in your hand, and features Second Chance sampling, which can help you to avoid wasting strips. Every one of you has a blood glucose meter, you deserve an accurate one contour next one.com forward slash juicebox free meter to get your absolutely free contour next gen starter kit sent right to your door. When it's time to get more strips, you can use my link and save time and money buying your contour next products from the convenience of your home, it's completely possible that you will pay less out of pocket in cash for your contour strips, then you're paying now through your insurance, contour next.com forward slash juice box for a meter go get yourself a free starter kit. while supplies last US residents only touched by type one has a wide array of resources and programs for people living with type one diabetes. When you visit touched by type one.org. Go up to the top of the page where it says programs there you're going to see all of the terrific things that touched by type one is doing and I mean, it's a lot type one, it's school, the D box program golfing for diabetes, dancing for diabetes, which is a terrific program, just click on that to check that out. Both are caused their awareness campaigns and the annual conference that I've spoken at a number of years in a row. It's just amazing, just like touched by type one touched by type one.org. Or find them on Facebook and Instagram links in the show notes links at juicebox podcast.com. To touch by type one, and the other great sponsors that are supporting the remastering of the diabetes Pro Tip series touched by type one.org.

Jennifer Smith, CDE 13:36
Yes, so one it's also usually the reason as you just said fat does slow digestion a bit. It's a it's a tough nutrient for your body to break down and make use of. So even if there's a ton of carb with it, it's often the the reason that somebody eats a pizza and they're like, Wow, I must have nailed that carb count because my blood sugar is like beautiful rock steady flat, no rise at all. And then all of a sudden later, they get this like creep and the creep happens and it happens and then you ride high and you're like throwing insulin at it and dumping the plane worth of insulin. The problem here you know, it's it's it's annoying, right especially for people who may not realize where it's coming from because they've never been told what it potentially could be. So it's not a miss missed amount of carbs but it is the reason that you had that nice flat look in the aftermath of eating that let's call it pizza. Otherwise if you just ate the pizza crust, I guarantee that pizza crust is going to give you a rise without the fat being there right even if you did, right right right right right bread or potatoes or whatever it is. Now fat The other reason it impacts blood sugar is because as it gets to the system A creates a rise in triglycerides in the bloodstream, which is a stress on the system. So we know what stress does to blood sugar, right but as stressor, if it impacts insulin use as if, as if it's reducing it by about 50%. So let's say your Basal overnight is running at 1.0 units an hour, and it works beautiful, you've tested it, you know that it does what it's supposed to do. But in the effect of pizza, or anything, high fat, nachos and cheese or whatever it, you know, the whole bucket of chocolate, whatever, you essentially have a Basal now that's functioning almost like point five instead of one. And so you are not getting the impact of all the Basal uniate, your blood sugar climbs because of the fat, and it stays high, because of the fat and it can be long duration. So I mean, you know, we typically recommend people accommodate for a high fat meal or something, you know, high fat in nature, like the whole hog, and does Sunday by her whatever, 50% increase in Basal at the end of the meal, okay, and you extend it out over eight hours,

Scott Benner 16:02
wow. 50% Basal increase over eight hours for a ton of fat. See, that's ton of fat, that's where it's at Jenny. So there's a couple things in there. But the one thing she just said was how the the impact of the food sort of gives the the appearance that your Basal is only at half power. Because Because now your body needs so much more insulin. It's funny, because that stuff we say I've been saying for years, but I never thought of it that way. Right? I never considered it the way you just said it. I always say the buyer, like you know, in high carb situations, you need more basil, that just makes sense. If you know, if one unit keeps you stable, when you're not, you know, when you're not putting the body through through the paces, then when you're when you're attacking it with ice cream, or pizza or something like that, it stands to reason that you would need more in that situation. Right to meet the need. But it's interesting the way you put it. I hope that maybe that I'll find a strike other people maybe at the core of their thinking, because that's a neat idea. Like when when you're using that kind of food, it's as if you don't have enough basil by half correct. So they have they have something to like measure with even the idea of eight hours. I think the genius behind the extended, you know, the Temp Basal increase over that much time is that if you do start to trend down at some point, you can just make the decision, hey, the foods out of my system. Now I can shut it off. Maybe I'll have to reconnect this a tiny bit to you know, but that's it. Right. Right.

Jennifer Smith, CDE 17:27
And or maybe you got enough temping increase for quite a while. And now it's going to navigate down as you turn it off, and you may not necessarily get 100% back to target, but you're certainly going to navigate down to a much lower number than you would have been had you not done that at all.

Scott Benner 17:42
Yeah, yeah. I mean, you have to know by now, if you've been listening this long that you would rather stop a lower falling blood sugar than a fight with a high one. That's it. You know, it's simple. How much truth is in the way my brain thinks about, like, more dense Carvey stuff like a soft pretzel or pizza or something like that, in that it sits in my stomach, and it breaks down slower, so that it has more opportunity to so my blood sugar is being impacted by over a longer period of time, sometimes past when the impact of my Bolus is there. Do I think about that correctly? Or is that just the cartoon way that works?

Jennifer Smith, CDE 18:21
No, it's a it's a great way to kind of think about it and also plan to Bolus for it. And some of that also takes experience, right? It takes experience seeing, well, gosh, whenever I eat this soft pretzel, it's all carb. And unless you're like dipping it in the cheese sauce, or something high fat that kind of comes along with it, the vat of butter, if you're just eating the soft pretzel, it's all carb, but the dense nature of it may be what requires a little bit more drawn out. Because you don't necessarily need that quick impact all up front, you may need some but then you're going to need it for a little bit longer in the aftermath. The same is true for some of those, like more whole grain hearty types of starchy foods, things like wild rice or quinoa, or you know, those kinds of things. They've got better fiber complex to them, they've not been processed, they're going to break down slower, and they're going to have a lower glycemic impact. So you may need to draw out the Bolus a little bit in order to prevent having a low before it kind of impacts or hits you later.

Scott Benner 19:29
Right. You have to stop thinking about the food goes in and my blood sugar tries to go up right away so I'll get it That's not That's why your timings messed up. Like you have to understand a little bit how the food makes its way through your system with high carb, low carb high fat, low fat, you know and in between there the the you know, I used to tell people like try to imagine an overlay machine like but then that got like an old idea. You know, like when you're in school when they do the you know, the somebody would write on a piece of plastic and it would they'd shine it up on the board, right? Yeah, yeah, they used to say take two pieces of plastic instead and make one, like a line of the impact where your insolence hitting and want a line of where the food's hitting the goal is you have to slide those, those pieces of plastic left and right, me till they match up. Yeah, you absolutely can't. You can't just throw in all the insulin now and just hope it hits because you hear people say all the time, like, oh, I Bolus and I got low. And then I got high later. None of this makes sense, diabetes. And I'm like, No, you're so close to you. It's interesting. Jenny earlier, you said that I look at a plate. And I just know from experience and everything. And I also think I just know, I don't know why I know. And that's important to understand. Like, I can't quantify it for you. Sometimes I can just look at a plate and go, that's this much insulin, I know it. And it is obviously from something but at the same time, I have privately for the one person who call me an egomaniac in a recent review. This is not me being egotistical. I'm just telling a story. But I, I fixed two kids Basal rates this week, remotely. And they sent me a graph. And as soon as I looked at the graph, I thought, I know what's wrong with this. But I couldn't explain it to you. Like, you know what I mean? Like I couldn't write a manual about why this graph right points to what it points to, but I knew as soon as I saw it, and I think everybody can get to that, because I know who I am. I know what I got in school is for grades. I can't possibly be that smart. Right? So you so seriously, like I think time just teaches but and Please, Dad, this is not an invitation for everyone to send me their thing. But I, but I am by the way, it did make me think, Jenny, I think there's gotta be a way to start a service where you take people's graphs and make basil recommendations back from the graphs, because once you get people moving in the right direction with their basil, they start to see it, and then they can die, then they can dial it in on there. And then they don't need you this this person, this lovely person has texted me. You have to let me send you something cuz I'm going to be bugging you for the rest of my life. And I laughed and I said, Hey, you can't send me anything. And I don't, please, I don't want anything. And but but be you're not going to need me for like, ever, like three days from now, this is going to just make all the kinds of sense in the world to you. It just starts to you start to see it. You know, when you have diabetes and use insulin, low blood sugar can happen when you don't expect it. G Bo Capo pen is a ready to use glucagon option that can treat very low blood sugar in adults and kids with diabetes ages two and above. Find out more go to G voc glucagon.com forward slash juicebox G voc shouldn't be used in patients with pheochromocytoma or insulinoma. Visit G voc glucagon.com/risk. Right, I wish the matrix wasn't a 20 year old movie because it's such a great reference. But things start to slow down, you know, they

Jennifer Smith, CDE 23:08
do and they start to they start to come together in a way like like Neo sort of all of a sudden, all of those images that are flooding the screen in the matrix, like you said, That's a great movie to bring up in context here. Because it just it comes together and his brain is like, I can see it all it's clear. And I mean, diabetes, life with diabetes changes, variables come up. And there are always going to be new avenues to explore and figure out but the intuition of the day to day management, the intuition gets easier. And I think that that's what you kind of you manage off of a lot of really good built in intuition of It's this. It's this feeling and you can't you can't often I think other people would agree, you can't often put that down in writing. You can't say, I know how I know how this is wrong. I can't tell you why. But I know this is how to fix it. I know this needs to be adjusted here. You need something else here or whatever. Now. Some of it can be you know, some of that intuition can be simplified. If you do do some, you know, we're talking all about like food and the impact carbs and fats and proteins and some of that if you know, I've gotten a little bit into the science of why there's impact there from these foods that we don't really ever talk about fats and proteins are kind of like swept under the table when diabetes education comes, you know, comes up. It's usually all carbs, right? We focus on carbs, we learn how to carb count. And I mean, the basics of carb counting are pretty easy with a label. You look at the label for the serving size, you look down the label for the total carb amount. Next down, you might look at fiber if there's enough of it, you might do you know, deduct a little bit of it, but that's what we're taught. And then you're given this little ratio of It's like, oh, for every 10 grams that you count from a label, you need this much insulin to take with it, right. So it's a very mathematical figure. But if we take it sort of one step farther than that very simple carb counting, as you mentioned before, not all carbs are created equal, you know, you could have 10 grams of counted, you know, celery versus 10 grams of counted watermelon, there's going to be a different impact blood sugar wise from those carbs, even though the carb count is exactly the same. And so that it kind of brings in, can you be precise in carb counting to a degree, you can look at labels, you can measure, you can use weighted scales and all of that kind of thing, you can get precise. But from the standpoint of then understanding why blood sugar did this versus did this, you know, up swings, stable flat dropped down, that actually it takes it a step further into glycemic index, and the nature of that food and glycemic index also, in it encompasses the components of a meal to not just the carb at the meal. But like I said, before, with the pizza, you could have just the flat old pizza crust and Bolus for that with just all the carb that's there, you're aftermath blood sugar is gonna look very different than when you eat it as like a meat lover, or an all over cheese pizza. There are different components, they're impacting how those carbs are going to change your blood sugar.

Scott Benner 26:36
And when those variables are invisible to you, it causes you to say, oh, that's just diabetes, I can't do anything about that. That's just diabetes. But there is like I've, I've been saying forever Jenny's just put it into specific words, which is beautiful. But I've been saying forever. If your blood sugar is getting really high or really low, you're not using the insulin correctly. I know that doesn't help you figure out how to use in somebody, it should help you to know that there's still an answer. And just because you don't see it in the moment doesn't mean it doesn't exist. It would be no different than if I sat down and looked at multivariable calculus. And then I said, and then I said you there's no answer to this. Well, a person who understands Multivariable Calculus would say, of course there is you just don't you just don't understand calculus. And so the trick is with diabetes, how do you find the ideas that help you get through this stuff without everything turning into a calculus problem? Right? Like, how does it just become day to day super simple and easy. And the reason you need to listen to Jenny is not only because she, you know, teaches this stuff and Integrated diabetes, not just because she's been living with type one diabetes for a very long time, not just because she's the CD, or nutritions, blah, blah, blah, all that stuff, but she lives in a part of the country where food literally tries to kill people. So I mean, that wow, like my brother and Jenny live reasonably near each other and the things my brother describes as food. When he got there, I was like, Brian, that's not food, don't eat that. Like,

Jennifer Smith, CDE 28:08
I would have to say Madison is sort of a little bit of an island in the state of Wisconsin. So Madison is a little bit a little we're a little beyond what the typical Wisconsinite but yes,

Scott Benner 28:20
well, I'm just saying if you're rolling into a moment with you know, bratwurst on a roll with a beer with some popcorn, so can caramel. Yeah. And cheese curds deep fried like you, boy, you you need to know what you're doing, you know?

Jennifer Smith, CDE 28:32
Right? Absolutely. And that's, you know, that's where understanding and learning things like, hey, fat, and protein and all of these factors, they can have an impact for you. It's not all cut and dry. Count the carbs, take the insulin and you've got it made it it's not and I I hate saying that because it sounds like, Well, gosh, I'm never gonna get a handle on this if I have to start being a mathematician and you know, figuring it, all

Scott Benner 28:58
right, but you will if you just if you think beyond what you were told. So somebody tells you like Jenny said, they'll flip the box over a half a cup of this is 10 carbs, you know, you get sick, you know, you get a unit for every 10 carbs. So that's a unit like that. But then once that doesn't work, you know, you guys have heard me say it a million times. It's insane to go back the next day recount the same 10 carbs and go okay, unit, because that's what the math The doctor told me. No, no, I used the unit, my blood sugar went up, it took me three quarters of the unit to correct it next time. Let's try a unit and a half for a unit. Like try more because more it took more. You know, you just have to like, you have to be able to walk past it. Yeah, you have to I'm telling you for the people that I speak to over and over and over again. There's a moment where you just have to trust your gut. Like you have to trust that what you're seeing is actually happening, which is why I made one of the tenants of the podcast, you know, trust that what you know is going to happen is going to happen. You know, and that's just that's simple. Like it's not I say all the time, like it's not stalking if you need it. And somebody I got a private message of the day it said that sentence unlocked my world just, you know, changed my life. And I thought, I'm glad I randomly said it because I didn't think of it ahead of time. i You guys have been listening for a long time you realize there's no notes in front of me. I've planned none of this. As a matter of fact, Jenny and I started recording, I go, Hey, we're gonna do like the fat and protein today. Okay, and she goes, okay. It's about unlocking your mind from what, you know, the confines that you are giving at diagnosis. And it's really it's, it's energizing to see it happen to people early in their diagnosis, because then you know, they're not going to live their whole life like this, but it's rewarding to see someone who's live with diabetes for a long time. Have like the light turned back on for them. Yeah, I mean, some of the messages you guys send her you guys want me tissues, you know what I mean? So it's really something Okay, so I did we do we did carb counting basics. I like flipped the box over, take a look go by weight

Jennifer Smith, CDE 31:04
box over? Yeah, I mean, if you wanted to go beyond the carb counting basics and get more into a little bit, I mean, taking it beyond would really be looking at the glycemic index, but then one beyond would be glycemic load. You know what that is?

Scott Benner 31:18
Those are going to be defining diabetes things we're going to do after we stop recording this journey. Okay, awesome. All right. We're gonna we did well with this, I think, yeah, I want to thank assenza diabetes for sponsoring the remastered diabetes Pro Tip series. Don't forget you can get a free contour next gen starter kit at contour next one.com forward slash juicebox free meter, while supplies last US residents only. If you're enjoying the remastered episodes of the diabetes Pro Tip series from the Juicebox Podcast you have touched by type one to thank touched by type one.org is a proud sponsor of the remastering of the diabetes Pro Tip series. Learn more about them at touched by type one.org. A huge thank you to one of today's sponsors G voc glucagon, find out more about Chivo Capo pen at G Vogue glucagon.com Ford slash juicebox you spell that GVOKEGLUC AG o n.com. Forward slash juicebox. I hope you enjoyed this episode. Now listen, there's 26 episodes in this series. You might not know what each of them are. I'm going to tell you now. Episode 1000 is called newly diagnosed are starting over episode 1001. All about MDI 1002 all about insulin 1003 is called Pre-Bolus Episode 1004 Temp Basal 1005 Insulin pumping 1006 mastering a CGM 1007 Bumping nudge 1008 The perfect Bolus 1009 variables 1010 setting Basal insulin 1011 Exercise 1012 fat and protein 1013 Insulin injury and surgery 1014 glucagon and lo Beegees. In episode 1015 Jenny and I talked about emergency room protocols in 1016 long term health 1017 Bumping nudge part two in Episode 1008 teen pregnancy 1019 explaining type one 1020 glycemic index and load 1021 postpartum 1022 weight loss 1023 Honeymoon 1024 female hormones and in Episode 1025 We talk about transitioning from MDI to pumping. Before I go I'd like to share two reviews with you of the diabetes Pro Tip series, one from an adult and one from a caregiver. I learned so much from the Pro Tip series when our son was diagnosed last summer. It really helped get me through those first few very tough weeks. It wasn't just your explanations of how it all works, which were way better than anything our diabetes educator told us. But something about the way you and Jenny presented everything, even the scary stuff. That reassured me that we could figure out how to deal with this and to teach our son how to deal with it too. Thank you for sharing your knowledge and experience with us. This podcast is a game changer 25 years as a type one diabetic, and only now am I learning some of the basics. Scott brings useful information and presents it in digestible ways. Learning that Pre-Bolus doesn't just mean Bolus before you eat but means timing your insulin so it is active as the carbs become active. Took me already From a decent 6.5 A one seat down to a 5.6. In the past eight months, I've never met Scott. But after listening to hundreds of episodes and joining him in his Facebook group, I consider him a friend. listening to this podcast and applying it has been the best thing I have done for my health since diagnosis. I genuinely hope that the diabetes Pro Tip series is valuable for you and your family. If it is find me in the private Facebook group and say hello. If you're enjoying the Juicebox Podcast, please share it with a friend, a neighbor, your physician or someone else who you know that might also benefit from the podcast. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. Jennie Smith holds a bachelor's degree in Human Nutrition and biology from the University of Wisconsin. She is a registered and licensed dietitian, a certified diabetes educator and a certified trainer on most makes and models of insulin pumps and continuous glucose monitoring systems. She's also had type one diabetes for over 35 years and she works at integrated diabetes.com. If you're interested in hiring Jenny, you can learn more about her at that link.