#1793 Bolus 4 - Real Food
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Scott and Jenny talk about bolusing 4 real food.
Key Takeaways
- Settings Evaluation: If bolusing for "clean" or "healthy" foods (whole ingredients like salmon, broccoli, or blueberries) is difficult, it is a primary indicator that your basal rates, carb ratios, or correction factors may need reevaluation.
- The Impact of Processing: Highly processed "Rube Goldberg" meals (like Cinnabon or McDonald's) have hidden variables like high fat and complex additives that require layered boluses; simpler foods should ideally follow a straightforward "count and pre-bolus" logic.
- Dynamic Life Changes: Significant changes in activity levels (sedentary vs. active) or body composition (weight loss/gain) necessitate proactive adjustments to insulin settings, as old settings may be masking or creating management issues.
- The Value of Visual Tools: Utilizing tools like the Juicebox Podcast Settings Calculator or Bolus Simulators can provide visual motivation and a starting point for discussions with medical providers, especially when navigating weight loss or lifestyle shifts.
- Automated System Awareness: For users of automated insulin delivery (AID) systems like Omnipod 5, it's crucial to periodically check manual settings. As the algorithm adapts to growth or lifestyle changes, manual settings often become outdated and "left behind."
Resources Mentioned
- Omnipod 5 Starter Kit: omnipod.com/juicebox
- Dexcom G7 CGM: dexcom.com/juicebox
- Juicebox Podcast Settings Calculator: juiceboxpodcast.com/settings
- Meal Bolt Roadmap: juiceboxpodcast.com/meal-bolt
- Bolus Simulators: juiceboxpodcast.com/bolusfour
- Juice Cruise 2026: juiceboxpodcast.com/juicecruise
- Juicebox Podcast Facebook Group: Search "Juicebox Podcast, Type 1 Diabetes" on Facebook
Introduction and Meal Bolt Overview
Scott BennerWelcome back, friends, to another episode of the Juice Box podcast. In every episode of bolus four, Jenny Smith and I are gonna take a few minutes to talk through how to bolus for a single item of food. Jenny and I are gonna follow a little bit of a road map called meal bolt. Measure the meal, evaluate yourself, add the base units, layer a correction, build the bolus shape, offset the timing, look at the CGM, tweak for next time. Having said that, these episodes are gonna be very conversational and not incredibly technical.
Scott BennerWe want you to hear how we think about it, but we also would like you to know that this is kind of the pathway we're considering while we're talking about it. So while you might not hear us say every letter of Miel Bolt in every episode, we will be thinking about it while we're talking. If you wanna learn more, go to juiceboxpodcast.com/meal-bolt. But for now, we'll find out how to bowl us for today's subject.
Scott BennerIf you're looking for community around type one diabetes, check out the Juice Box podcast private Facebook group. Juice Box 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 Juice Box podcast, type one diabetes on Facebook. Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise.
Scott BennerAlways consult a physician before making any changes to your health care plan. This episode of the Juice Box podcast is sponsored by the Omnipod five. And at my link, omnipod.com/juicebox, you can get yourself a free what'd I just say? A free Omnipod five starter kit. Free? Get out of here. Go click on that link. Omnipod.com/juicebox. Check it out. Terms and conditions apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox. Links in the show notes. Links at juiceboxpodcast.com. Today's episode is also sponsored by Dexcom.
Scott BennerThe Dexcom g seven, the same CGM that my daughter wears. You can learn more and get started today at my link, dexcom.com/juicebox. Jenny, I I got a note from somebody the other day that said, are you and Jenny? Well, don't all yet. Are you and Jenny?
Jenny SmithAlways get lovely note. I mean, you know, some of the the notes are very inquiring. Mhmm. I think that that's great.
Defining "Healthy" and "Real" Food
Scott BennerWell, this lady said, can you do some bolus for us for healthy food? And I said, we're just doing the ones people asked about. I don't know. Like, it's funny as I started to think about it is I don't know what she meant by healthy food, but when I—
Jenny SmithOh, she didn't give any examples. It was just—
Scott BennerNo. Healthy food. Can you please well, the McDonald's one had come out. And the best I got so many, like, really interesting little notes from people about the McDonald's one. But the best one was, I don't eat at McDonald's. I just tuned in to hear Jenny try to hold her gasp inside.
Jenny SmithThat's kind of funny.
Scott BennerBut I said, that did happen. Many times Yeah, it did. But but at the same time, I think I made this person say, and, you know, what about healthy foods? As I started thinking about it, I was like, aren't healthy foods easy to bolus for? Like, aren't they carb counts for the most part and a little bit of pre bolus in the right place, and where am I misthinking it?
Jenny SmithThat would be my first, I guess, way to explain it as well. Yeah. In general, food that is and I wouldn't even say let's just say clean food. Right.
Scott BennerThat's how it makes me think. Something that's not processed or has a ton of stuff in it. Yeah.
Jenny SmithRight. I mean, the ingredients are all readable. They're real food ingredients. There might be, like, sodium or ascorbic acid or something. But, again, those are they're still real food.
Scott BennerYeah. Right? Why don't we do bolus for real food today? Alright. And—
Jenny SmithWhat kind of real food do you wanna eat?
Scott BennerWell, Jenny, now this is the problem. Right? Because she didn't give me any examples, and I am, I grew up a trash person. So I don't know how I'm supposed to think of what people eat.
Jenny SmithWell, when I think of real food, I think of the food on the plate didn't necessarily come from a box, let's say. And there are some packaged foods that are still quality foods that are somewhat processed. I think of bean. You can buy dry beans. There's a whole process, like, you have to soak them and then cook them and then drain them and rinse them. Like, it's it's a process, right, which most people in today's world, they just don't have the time for. So then you purchase canned bean. Okay. Great. They're processed, but they're not full of a bunch of junk.
Jenny SmithThings like dry let's do quinoa. Quinoa is dry. You buy it in a package. That doesn't mean it's not a quality nutrient dense food. It's just the way that we now have to buy it. Right? Even if you have a co op or something you go to and you buy it from their bulk, it's still technically dehydrated and you know what I'm saying?
When Simple Food Becomes Difficult
Scott BennerI know what I do. I wonder if when she said, you know, real food or or healthy food or however she put it. I just pulled up a list. I just I just went and I said, like, give me a list of real foods that humans eat most often worldwide. And I mean, and it's chicken, pork, fish, bananas, beans, you know, garlic, tomatoes Broccoli. Broccoli. Yeah. Cabbage, bananas, apples, oranges, grapes. And now I'm thinking, if she's having trouble bolusing for this stuff, is it more about settings and timing? Is it maybe back to the basics? Because this shouldn't be difficult. Right?
Jenny SmithIt shouldn't be difficult. And that is it's a good place to start. Is it that your settings aren't right? That's the first place of evaluation. If you're sitting down and you're eating let's give a meal of something like grilled vegetables, some baked salmon Mhmm and maybe blueberries. Okay? All real food. You might put a little oil on it to cook it. You might or butter. You might put some seasonings on or whatever. But in general, that's real food.
Jenny SmithYou can count on the nutrients that you look up, that you get from chat GPT, from a photo, from whatever. You can count on the carbs, proteins, and fat being real Mhmm and not impacted by a bunch of other additives Yeah or ingredients. And so a meal like this, you'd essentially say, well, what are my carbs? Right? I've got some broccoli, pretty low carb, very low glycemic, got a good amount of, you know, dietary fiber in it. Even has vegetables are by weight, actually a little higher in protein. Most people don't think they can get protein from veggies, but you can. And then you've got your blueberries, which are also a carbohydrate source. Again, pretty low glycemic. So a meal like this, once your settings are set, should be pretty easy to bolus for. There's not much on the back end that you're gonna have to worry about.
Scott BennerRight. It it just feels to me that a person who's eating that way like, I just know from talking to you really mostly. Like, you eat like this. And I've seen your graphs for years. They look like I expect them to look almost all the time. Right? And around food. And so her just as we're chatting about it now, I'm like, maybe this maybe I really maybe I really was onto something all those years ago when I was like, it's just timing and amount. Like, use the right amount of insulin at the right time. Like, I might have been onto something. You know?
Scott BennerAnd when you're talking about, you know, chicken nuggets and french fries and Cinnabon and all the other things that are on that that bolus four list, is growing because you and I have been making it for a while now, those are like like Rube Goldberg meals. Like, there's arms sticking out of places that you have to think about and you don't, like, really understand all the pieces that are there. It's so big and unwielding.
Jenny SmithLike abstract art. You have to look at it for a long time to kind of pull the parts apart and say, I don't know. I think the artist was saying this.
Scott BennerYeah. And I think I need some insulin here for that part and a little more over here for that thing that's gonna come at me. And, oh, there's the boot down here that cooks the toaster. That's gonna need insulin forty five minutes from now. And, like, okay. Now, when you that's hard to understand. You put together a plate with fish and a broccoli and a half a potato or something like that. Like, I mean, it's count the carbs pre bolus and make sure your blood sugar is moving in the right direction when you start eating, and you should be okay.
Jenny SmithRight. And something fair to bring, which I love actually, I love this question. So whoever asked it, thank you. I think it's a wonderful way to highlight the fact that all the hard things that we've addressed, they are truly hard. They're things like you said, we have to pull them apart. We have to figure out what parts are gonna hit when, and then it still is the timing of when to put the insulin in the right way. Right? But simpler foods, real just basic. Essentially, you need the information, the carbs, and then you just need to know that your settings are starting in the right place.
Jenny SmithAnd then even bolus timing isn't that difficult. And with today's technology, we have our CGMs that are pointing our glucose trend in a direction or stable or in the other direction that then goes into the consideration too, but it's a little less cumbersome than what we get from more, I guess, full and complex meals.
The Variable Problem: A Real-Life Example
Scott BennerI'm probably chief among them at some point in my life that would look at a a Cinnabon at the mall and think, oh, that's very sugary, but not think about all the fat that's in it. Or you get a a so you people don't think about how something's cooked sometimes. Right? Like, you commented during the during the McDonald's bowls where you're like, is this all fried? And I was like, Jenny, they don't even have an oven in there. What are you talking about? I do remember that. I've never yeah.
Scott BennerSo I guess I I feel like this is maybe a good spot to bring up that there's a settings calculator on the website. And maybe if you're having that much trouble bolusing for simple clean meals, maybe your settings are off or, you know, you know what I'm saying? Like, maybe that's a good place to go.
Jenny SmithI do. I also think another consideration here is maybe maybe this person was also asking because they were considering doing a bit of turnaround in what was typical for them to eat. And maybe they've got down what they were doing. And now that they want to eat a little cleaner, let's call it, the food is simplified in a way that you're right. Maybe the settings actually were catered to the type of intake they had and they had it figured out. But now that they've started eating a little bit cleaner or home cooked meals and they know what goes into their food, they may actually be seeing things that are not responding like they'd expect with the settings they've got. Yeah. And therein lies a a good question of, well, what do you do with that? Right? You have it figured out for harder stuff, but now the simple stuff comes in and it all goes wonky and it should be easier.
Scott BennerYeah. So if you were eating differently and then changing to cleaner or I mean, honestly, if you were a sedentary person and then suddenly got more active and because maybe those two things go hand in hand. I'm gonna get some more exercise and eat better. You'd you wouldn't realize after time that the settings you have now, what your carb ratio is, your bolus, you know, correction factor, your basal insulin, those settings, what those settings are are set up for a sedentary person eating not cleanly. And now you suddenly get active and, oh gosh, I I seem to mess up all my mess.
Scott BennerListen, last night last night, I'd already told Jenny about this. I feel like I'm saying something twice to somebody. But last night, my family took me to a concert for it was my Christmas present. And Arden had a class late in the afternoon. She runs in the house. She's like, I haven't eaten yet today. And she looks around, looks around, looks around, and grabs a muffin. Then runs upstairs and gets ready to go to this thing like we are. We gotta go. You know what I mean? Right. And it's like a muffin from Costco. It's not—
Jenny Smithit's yeah. Those are gigantic.
Scott BennerAnd it wasn't the big big one. It was the smaller one. They figured out not to give you six giant ones. They now give you eight slightly less giant ones. But, like, she grabbed it off the counter, bolus while she was eating it, and now we're sitting in the car for an hour driving, and I'm watching her blood sugar just two thirty. It is just sitting there. It ain't moving. Alright? And the algorithm's pushing, and it isn't moving. So we bolus, and it's not moving. But eventually, we're like, fair enough. There's enough insulin in here. Like, we have to stop.
Scott BennerParked the car at the NJ PAC Center. By the way, NJ PAC Center, thank you for building another, parking lot because it's a disaster there, but still the traffic is horrible. And you had to walk. And you get out of the car. We're late hustling through the parking garage, up a bunch get to the escalator. Escalator's out of order. Ran up the stairs. Run inside. Get our tickets. Everybody's gotta go to bathroom. Run-in the bathroom. Like, we're going to see Yo Yo Ma. Like, I'm not seeing it. Like, I wanna be on time. Like, we're hustling. Right?
Jenny SmithYou're not seeing, like, a dog jump through hoops or something.
Scott BennerThis is one of these things that listen. This doesn't belong here, but you should go sit quietly in a room. Be very still. Listen to Yo Yo Ma play once in your life. It'll change how you feel about being alive. You can manage diabetes confidently with the powerfully simple Dexcom g seven. Dexcom.com/juicebox. The Dexcom g seven is the CGM that my daughter is wearing. The g seven is a simple CGM system that delivers real time glucose numbers to your smartphone or smartwatch.
Scott BennerThe g seven is made for all types of diabetes, type one and type two, but also people experiencing gestational diabetes. The Dexcom g seven can help you spend more time in range, which is proven to lower a one c. 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 one c in as little as two weeks. If you're looking for clarity around your diabetes, you're looking for dexcom. Dexcom.com/juicebox.
Scott BennerWhen you use my link, you're supporting the podcast. Dexcom.com/juicebox. Head over there now. Today's episode is brought to you by Omnipod. Did you know that the majority of Omnipod five users pay less than $30 per month at the pharmacy? That's less than $1 a day for tube free automated insulin delivery. And a third of Omnipod five users pay $0 per month. You heard that right. 0. That's less than your daily coffee for all of the benefits of tubeless, waterproof, automated insulin delivery.
Scott BennerMy daughter has been wearing an Omnipod every day since she was four years old, and she's about to be 21. My family relies on Omnipod, and I think you'll love it. And you can try it for free right now by requesting your free starter kit today at my link, omnipod.com/juicebox. Omnipod has been an advertiser for a decade. But even if they weren't, I would tell you proudly, my daughter wears an Omnipod. Omnipod.com/juicebox. Terms and conditions apply. Eligibility may vary. Why don't you get yourself that free starter kit? Full terms and conditions can be found at omnipod.com/juicebox.
Managing the Crash: Community and Compassion
Scott BennerAnd so, like, I'm trying to get to this thing, and we sit down, and I'm not very involved in her care anymore. But I think just out of repetition, the last thing I did before we turned our phones off was look at her blood sugar. Because I know from years of experience, something's gonna go wrong. This is gonna be it right here. Right? And but I wasn't thinking about at that point, oh, we gave her a bunch of insulin. She was stuck high. We just weren't I didn't think about any of that till the next day, till today. But no kidding. I opened up my phone and I was like, hey. You're one forty five arrow straight down. Like, you're you're crashing. And I said, what do you have with you?
Scott BennerAnd she goes, I have two juice boxes and a pack of Gushers in my purse. And I said, well and I reached in my pocket and I pulled out a fistful of gummy bears. I said, I brought gummy bears. And she was like, okay. So and I don't know that I'm ever gonna be able to stop myself. Jenny, I think if you and I went somewhere, I would stick, like, snacks in my pocket for you. Like, I just think I don't, like I don't know how to not do that. You know what mean? So—
Jenny SmithYou just yeah. No. You're a good you're a good parent and a good friend. You're lovely.
Scott BennerSo she's she's having a couple of gummy bears, and I'm like, do a juice. Then And you could see on her face, goes, but I only have two juices. If I do one and we have a problem, what am I gonna do? I watched her work that out in her head, she goes, I'll just get up if it's a problem. I thought, I do not want you to have to get up and miss this. No kidding. If you have to get up, I'm gonna go with you. And I don't wanna miss this either. Yeah. And I said, drink a juice. Let's do a couple gummy bears. I think we're good. The single arrow down went to double arrows down. Arden does not see double arrows ever, ever, ever. So what was it? It was bad timing, bad amount, suddenly having more exercise.
The Juicebox Podcast Settings Tools
Scott BennerAnd so, like, in a in in that that moment, that could happen to you in your real life. And so listen, juiceboxpodcast.com/settings. You're gonna be met with a calculator. It just asks for your weight in pounds, and it's going to give you a starting point to think about your settings. I am not saying it is gonna be a it's gonna be right or anything like that, but maybe a great opportunity for you to go back to your doctor and say, hey. I looked at this calculator, and it says my basal should be more like this, but mine's way higher. Maybe that's when you're gonna find out that you're over baseling yourself to make up for the fact that you don't count carbs well or—
Jenny SmithRight. Who knows what, you know, collection of variables are being hidden by your settings. And now you take those variables away, and suddenly your settings are way off. That happens.
Jenny SmithAnd in this case, the variable being had she had, like, some scrambled eggs and, I don't know, an apple, it would have been very different. The stock high wouldn't have happened. You wouldn't have been prompted to bolus bolus to kinda get it or allow the algorithm to do what it was again, all the things and it just brings into light the true amount of variables we do have to look and consider every single day.
Scott BennerYeah. 100%. The life portion of it that's hard to write down on a list and make sense of or that I wasn't even thinking was happening while it was happening. Right? But yeah. But if your if your settings are rock solid and all all Arden would have had to have done is pre bolus, and we would have been okay. But because of the rush, that didn't happen. It threw everything off, and then you see this cascading problem. Yeah. The same thing could happen to you, you know, if you're like, hey. I used to eat like this, but now I wanna have what did the lady call it? Hell, I wanna eat healthier. Healthier. Yeah. Right. So go get your settings right.
Scott BennerI mean, I'll just for people just I'm looking at it right now. I typed in one fifty as a weight. As soon as you type in that number, it asks you if you're highly sensitive, have standard sensitivity, if you're resistant or highly resistant. When you click on one of those things, it chooses your daily dose. Right? So, like, at the standard number for a hundred and fifty, it has thirty seven and a half units. But if you go to resistant, it goes to forty four point three. If you go to highly sensitive, it goes down to thirty point seven. There's also, like, a little slider you can fine tune it to maybe, you know, if you really feel like you know better or maybe you and your doctor could do it together, whatever. As soon as and then it gives you your basal, your carb ratio, and and it's not perfect. But it's it's a good way to look at your settings now and then look at this and go, why are these so far off? You know?
Jenny SmithIt's a good starting place. I think another way to use that tool could also be let's say you feel like you are highly resistant because you know your lifestyle. And let's say it's the turn of the year and you're like, I'm gonna make some changes. Right? I'm gonna start walking three or four days a week. I'm gonna do this class. I'm gonna also clean up my pantry. I'm gonna get rid of this. I'm gonna bring this in instead. You could potentially use that tool then. You're the same weight, but now, goodness, you've cleaned things up. You've gotten a lot of the resistant generating foods out of your intake and you're adding exercise.
Jenny SmithSo maybe now you're more normal sensitivity. You could use the tool at your same weight to see, goodness, how much should my dosing change taking your current let's say you're on a pump, taking your current profile and just scaling it back to see does this now hit better? Mean, even those on MDI could do the same thing. They could say, okay. Well, it told me or I'm using this basal dose. Now that I'm more sensitive and I've cleaned things up, gosh, look at how much less I can probably start to use. And again, it's not like a big jump. It's just a scale it back and see what ends up working.
Scott BennerBut you could use that tool as a starting place instead of trying to just figure it out in your brain and pick something from the air. I'll you tell another thing you can do with it very simply is if you're looking for motivation about, like, weight loss even, like, if you put in here a 170 pounds, it tells you your total daily insulin is 42. Well, guess what? If you lost 20 pounds and you went to one fifty, it goes down to 37. You know? And especially now with GLPs, I'm getting a lot of notes from people.
Scott BennerI just got a really great one yesterday. Person thanked me. But there are people who are losing 30 pounds quickly. Right? And then they're losing another 20. Imagine you weighed two hundred pounds and you're using, you know I don't know. You're using fifty units of insulin a day. And then all of a sudden, you're down 50 pounds and it's down to 37. Like, what a great motivator. Absolutely. Listen. We'll talk to people all the time. Like, I want you to use the amount of insulin you need. I think the way I've said it before, I'm pretty comfortable with. I can't tell you how to eat, but if you're gonna make a poor health decision with food, let's not also make a poor health decision with diabetes.
Scott BennerWith your blood sugar. Yeah. Right. Let's at least have the the the blood sugar parked together. But that might be a motivator for people. I don't know what motivates people anymore. That note I got yesterday was from a guy whose kid has diabetes. It's not even him. He listens to the podcast for the child. I did that weight loss diary, and he said that motivated me. I've lost, like, 30 pounds already. That's awesome. You know, like, you how so whatever motivates people, I don't I don't know. Right? But maybe or just go mess with the calculator just to give yourself a shot.
The Bolus Simulator and Fat/Protein Impacts
Scott BennerNow once you have good numbers from it or a starting point, there is another calculator. So that one's gonna be juiceboxpodcast.com/bolusfour. By the way, these all have, like, a ton of, disclaimers. You're gonna have to click through to use them. You know, they're educational purposes only. Talk to your doctor, that kind of stuff. But once you have those numbers from the settings, then you can take those numbers and put them into the calculator. And once if I did it the way I meant to by the way, I wanna say these calculators were made by, like, vibe coding on AI just so you know, you know, how they came. So if you take that number, insulin to carb ratio for one fifty, which is I'm looking at the other one here. 13.3. Now let's just believe these insulin sensitivity, it has 48, and we're gonna make our target blood sugar on the calculator 90.
Scott BennerThere's a little thing here you can you can calculate. Like, you can put a cap on how much, you know— it can give you— kinda like yell at you if you if it goes over 25. Max bolus limit. Yeah. Very nice. Right? So then we take carbs all of sudden, and we say, hey. A 50 carb meal, no fat, no protein. I, you know, I have no insulin on board. My current blood sugar is, you know, 100. I'm trying to get the 90. I have a stable arrow. It says simulate the strategy, and it tells you 3.97 units for the 50. Yep. And and it gives you a little, like, wait ten minutes on a pre bolus thing, suggestion. But the minute— I'm sorry. No. No. Jump in.
Jenny SmithYeah. I was gonna say and to compare for, again, somebody who's considering moving to a healthier intake. Now take that carb content and add into it, especially if you're working on weight loss potentially or stabilizing your weight to keep yourself where you really want to be, Add into that 50 grams. Now the meal contains 30 grams of fat and 50 grams of protein. What is the dose difference? My goodness.
Scott BennerYeah. It doubles it, basically. It's still Right? Three point nine seven up front, but now it's asking for three point five three over the next eight hours. So the theoretical requirement is seven and a half units, and that's you know, now you're setting square wave boluses or, you know, extended boluses. A lot of you are on algorithms right now that don't accept fat as an input, so the algorithm's just gonna fight with the the rise, and it's not gonna use nearly enough. And not only that, but then now you can come back. It's it's such a great point. You come back again, and then cut the fat down to 15 and cut the protein down to 25 and then hit it again and see to yourself, oh, now it's five and a half units of insulin. And what happens if I lost 10 pounds and these settings change again? Like Yes. Whatever's gonna motivate somebody to do a bigger idea. I hope these things help you. I hope you play around with them and they they make sense for you and help you—
Jenny SmithThat's what I was gonna say. I think the beauty of technology is that tools like this can give you more insight when you're working really hard to navigate some changes that you know are going to eventually pay off. They are going to be better for you. Right? But it's hard when you I'm a very visual learner myself. And so when I can see it there, I say, oh, wow. Yeah. Look at that. It definitely makes a really big difference. Whereas, sometimes it's something that's said, but you don't really have anything to attach it to. doesn't really make sense.
Reevaluating the Big Picture
Scott BennerThis is a lot to understand, and it it's a lot easier if you don't really have to understand it. You can just see it, and it go and it makes your brain go, oh, okay. I see why that's important. And I I don't know. I've just had enough conversations with enough people to think that oddly enough around using insulin, people don't think about the food that much. Right? Like, it it it's it's the whole thing. Right? You're controlling the impact of the food with the insulin, but we don't talk about it that way. And I understand listen. I understand why bigger picture, you or your kid gets diagnosed. You don't wanna feel like your life is gonna change. And so what does the doctor say? Oh, nothing's gonna change. Just count your carbs and use insulin.
Scott BennerThey're not thinking beyond the bigger picture. They're okay if your blood sugar goes to two fifty and comes back down five hours later. That's and if you're not okay with that, then I gotta look at the rest of these variables around exercise and body composition. What am I eating? You know? And not not and I don't mean what am I eating, like, punitively. I mean, like, what's in there and what does it need so that it doesn't cause a problem for me, blood sugar wise. That's all.
Jenny SmithAnd that's why I think these these conversations that I have the opportunity to have with you are valuable from my perspective in what I see out in the world of people with diabetes. Because these are the tidbits, the pieces that don't ever make it into the on the discussion table in the room with many clinicians. I'm not saying all, but with many clinicians, it is a starting place of count your carbs. Here's your insulin to carb ratio. This is how it works. This is easy math. But it it never goes farther than that. There aren't enough of these beyond the base discussions that people need in order to feel like they have some ability to succeed.
Scott BennerWhen I realized talking to you years ago that the settings that somebody gave my daughter at her diagnosis were from simple math equations. And I was like you were like, yeah. That's what we all do. We use them. I was like, wait. So I can know the math too? And she was like, yeah. And I'm like, oh, okay. When I realized that and then I realized that Arden was diagnosed at such a small age, at such a small weight, and she was gaining weight and no one ever reevaluated her settings. Yeah. It was the oddest thing, and it took me a a long time to figure out that that wasn't happening. And I think listen. The numbers are gonna—it's been a long time ago now, but I think I realized that when her insulin sensitivity was, like, one unit moves her 350 points, I was like, what? That's not right at all.
Scott BennerAnd I sat there thinking, like, where do we get that number from? And I'm like, oh, that's from three years ago. Yeah. And I'm like and then I sat in that office. It was one of the first times I thought, oh, these people are not gonna be helpful to me. I see. Okay. I got it. I'm gonna have to pay attention. Okay. But how does that happen? Like, because there's a little kid. She's diagnosed in the hospital, seventeen pounds on death's door. I swear to God. She a day and a half on insulin, she was nineteen and a half pounds. And then on the years that's followed, she's 20, 25, 30. Like, she's gaining weight appropriately. No one ever changed her settings again. And we're over there struggling, and I don't know why. And I and they're like, no. Are you counting the carbs right? I'm like, I mean, I think so. anyway, it could spin out of control really quickly.
Closing Thoughts and Future Planning
Scott BennerThen nothing wrong with going back once in a while and say to yourself, hey. And and I, by the way, I slow rolled this out. I put it out to the community on Facebook first. I got a lot of good feedback from it. Jenny is sharing it with people privately now, which makes me feel comfortable, talking about it more. But I got I got back from somebody who's like, I thought that calculator was gonna be a joke and I put it in. She's like, it matched all my settings. And I was like, right on. And I said, do you think you have good settings? She goes, my stuff works like right. And I was like, good. Good. Like, go Yeah. try to help yourself. I don't know. Absolutely.
Jenny SmithYeah. And No. And, you know, that's one of the things that I always take a look at, especially with my younger population. I ask all of my like, what's their weight? How are they on their growth curves, especially? Are they staying on it? Are they veering off of it in one way or another? And then we look at their their intake. And then with some of the algorithm pumps too that are adaptive algorithms, something really valuable to look at is for little kids, as the system adapts to giving them insulin, kids are also growing. So over time it has to adapt to that growth and it gives more and they need more insulin, but what gets left behind are their manual settings.
Jenny SmithAnd unfortunately, if you ever did have to use manual pumping mode then, things like the base basal for only manual mode, it might be three units behind what the system has adapted to giving in the automated basal profile. So it's really important to pay attention to all of these. Kids specifically through the growing years but even adults who might be making life changes. Again, kinda going back to this woman who may be what's healthy food look like for bolusing? Right? Maybe something changed, so you should pay attention to that.
Scott Benner100%. You and, you know, you said just now, but, like, real specifically, Omnipod five, like, you start off with a setting and that thing's adjusting your insulin now into the future, into the future, into the future. All the time. You suddenly go back to manual. Those settings have nothing to do with you anymore. Right. Maybe or maybe not. I don't know, but, like, you certainly don't know. That's for sure. And I I think it's worth just looking at once in a while. You could change your eating habits could change. Your body composition could change. Your activity level could change. There's a lot of different things that are changing. You can't just keep staring and going like, oh, well, that part is done now. It is not let's just not set it and forget it.
Scott BennerI know you want it to be, but it it just in a lot of cases isn't. Especially with growing kids or people whose lives are changing, and people's lives are changing a lot now. I mean, honestly, Jenny, look at me. I don't even look like the same person I look like two years ago. No. You don't. Yeah. It's insane. And then there's the guy or the thing, lost 25 pounds already. People I got a note from a woman the other day who said, never stop making that podcast. I believe she said she's lost a 130 pounds since she lost since listening to my weight loss diary. Right? And Wow. Then you know what the next problem becomes? One person says, I'm in the ER and DKA because of my GLP.
Scott BennerAnd I'm like, no. You are not in the ER because of your GLP. You're in the ER because you're not taking enough insulin. That's a different thing. And so, like, then people see that and they get scared of it. And and, like, so there's more to nothing listen. Between this, your relationship with your mom, politics, the world, nothing's as simple as as a banner, you know, statement. The headline's never the answer, so you gotta dig into this stuff. That's what I'm gonna leave with everybody with. Like, dig into this a little bit. Try to figure it out. Awesome. Jenny, you were terrific. Jenny Helps. We should call this episode. Jenny Helps? Yeah. Oh, I like that. Yeah. It's nice, isn't yay. It'll be called bolus for healthy food or something But like you know what I mean. Alright. I'll talk to you.
Scott BennerThis episode of the Juice Box podcast is sponsored by the Omnipod five. And at my link, omnipod dot com slash juice box, you can get yourself a free what I just say? A free Omnipod five starter kit. Free? Get out of here. Go click on that link. Omnipod.com/juicebox. Check it out. Terms and conditions apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox. Links in the show notes. Links at juiceboxpodcast.com. Dexcom sponsored this episode of the juice box podcast. Learn more about the Dexcom g seven at my link, dexcom.com/juicebox.
Scott BennerIf you've listened to any number of podcasts or maybe watched a YouTube video, you're very accustomed to listening to the creator of that content ask you and sometimes just outright beg you without any feeling of self respect for you to follow, subscribe, share an episode. The reason that happens in podcasting specifically is because podcast players don't have a sophisticated recommendation engine like YouTube or TikTok does. They can't watch listener behavior and then give you content that you might like. Word-of-mouth skips that line completely. It's an instantly expanding reach engine and really the only thing I've ever found that helps to keep the Juice Box podcast growing.
Scott BennerSo subscribe and follow because that the algorithm understands. Set up automatic downloads, listen to the show, but share it with somebody else. Leave a five star review. Make it a thoughtful review that the algorithm can understand. I really appreciate the time it takes you to do those things, and I hate that I have to say this to you because I feel like an idiot. But subscribe and follow, tell a friend, please and thank you. How would you like to share a type one diabetes getaway like no other? Join me on Juice Cruise 2026. You may be asking, what is Juice Cruise? It's a week long cruise designed specifically for people and families living with type one diabetes.
Scott BennerIt's not just a vacation. It's a chance to relax, connect, and feel understood in a way that is hard to find elsewhere. We're gonna sail out of Miami, and the cruise includes stops in CocoCay, San Juan, Saint Kitts, and Nevis aboard the stunning Celebrity Beyond. This ship is chosen for its comfort, accessibility, and exceptional amenities. You're gonna enjoy a welcoming environment surrounded by others who get life with type one diabetes. I'm gonna host diabetes focused conversations and meetups on the days at sea. There's thoughtfully designed spaces, incredible dining, and modern amenities all throughout the celebrity beyond.
Scott BennerYour kids can be supervised, there's teen programs so everyone gets time to recharge. Not just the the kids going on vacation, but maybe you get the kickback a little bit too. There's gonna be zero judgment, real connections, and a whole lot of sun and fun on Juice Cruise twenty twenty six. Please come with me. You're going to have a terrific time. You can learn more or set up your deposit at juiceboxpodcast.com/juicecruise. Get ahold of Suzanne at cruise planners. She will take care of everything. Link's in the show notes. Link's at juiceboxpodcast.com.
Scott BennerMy diabetes pro tip series is about cutting through the clutter of diabetes management to give you the straightforward practical insights that truly make a difference. This series is all about mastering the fundamentals, whether it's the basics of insulin, dosing adjustments, or everyday management strategies that will empower you to take control. I'm joined by Jenny Smith, who is a diabetes educator with over thirty five years of personal experience, and we break down complex concepts into simple, actionable tips. The diabetes pro tip series runs between episode one thousand and one thousand twenty five in your podcast player, or you can listen to it at juiceboxpodcast.com by going up into the menu. The episode you just heard was professionally edited by Wrong Way Recording. Wrongwayrecording.com.
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