#1885 Bolus 4 - Coffee
Wait, bolus 4 coffee - maybe!
Bolus 4 - Coffee
Cold Open & Sponsors 0:00
Welcome back, friends. You are listening to the Juice Box podcast. Jenny and I have been chitchatting for so long. We're almost out of time, but we're gonna do a bolus four for you. To begin with, let's just let's do coffee.
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Jenny, say testing for me real fast.
Testing.
Okay. Jenny and I have been chitchatting for so long. We're almost out of time, but we're gonna do a bolus four for you to begin with. Let's just let's do coffee. Oh.
Oh.
No Carbs, But Your Blood Sugar Rises 2:30
Because I don't know what the first thing about it, and I I was with somebody this weekend who said, oh, my blood sugar's been high. I've been drinking a lot more caffeine than I should have. And I was like, oh, okay. So, I'm just gonna ask you to talk my me through it. Why is coffee a thing that I assume if I look up doesn't carbs in it?
Is that right?
Why does that help people,
or does it?
So it does. Caffeine is I equate it similar to, like, an adrenaline hit.
Mhmm.
Right? So caffeine, why do most people drink caffeine?
I well, I've come to learn the whole world is medicated on caffeine or cigarettes
Of some kind.
Or a vape pen or something. I didn't know until I talked to everybody. But everyone's jacked up on something. Yes. So I'm
gonna get that. I mean, caffeine in coffee, black coffee, we're talking about to begin with. It can raise blood sugar levels essentially because it can reduce some insulin sensitivity based on the fact that caffeine kicks your energy into gear. Right? And so a typical cup of coffee, somewhere between, like, two hundred and two hundred and fifty milligrams of caffeine depending on your size and kind of coffee you drink, blah blah blah.
Right? So if you are a person who just likes black coffee and you're seeing a rise despite thinking, well, gosh. There aren't any carbs. You're right. There aren't any carbs.
But you're bolusing for something that requires you to cover a a rise in the blood sugar because of its effect. Right?
Is it measurable, or is it a thing you have
to figure out? Yeah. If you pay attention a 100%. If years ago when I started enjoying coffee, I don't like coffee black myself. I like to have a little bit of cream in it, But I would I tested it first without the cream to get an idea of what just happens with the coffee.
Right? And I eventually found that my typical cup of coffee takes about a unit of insulin. A cup
of okay. Is that is that eight ounces? Six
three? Eight ounces. Okay. Mhmm. An eight ounce cup of coffee or a one cup cup of coffee, not your Jethro cups from the, you know
The big gulp.
The gigantic gulp mugs that you get at the fancy
them Jethro cups. What is that? Is that, like, what is that
something to your They're gigantic. Jethro is, like, gigantic. Right?
So can no. No. I just thought maybe it was, like, something local to you.
Yeah. No.
Is there I mean, can is it reasonable to say that everyone is a unit for eight ounces, or is that not a reasonable thing to say? No.
Test Your Own Caffeine Rise 5:15
No. Mine, what I did to test, and this is what I recommend to most people who wanna get an idea is drink your cup of coffee with stable, nice looking blood sugar. Drink it. Don't bolus for it. Check the rise.
Mhmm. Check the rise. How much did your blood sugar go up, and where did it finally plateau from the effect of the coffee? Because that will happen. It'll happen even if you eat carbs without any bolus.
You will get to a point where the carbs finally have kind of hit enough, and now basil is just holding you flat there because you didn't bolus. Right? So if you can establish the rise amount on average that you get from a cup of coffee, then you can use your math based on your correction factor or your ISF Mhmm. To figure out how much insulin you need to prevent that rise.
Okay.
So I saw a rise in blood sugar over a couple of days of doing it. I averaged it, and I was like, oh, that's on in general, it's like a unit of insulin I need for a cup of coffee. So that's how I recommend figuring it out. A unit may not be necessary for everybody. It might be point three.
It might be two units. Depending on what your sensitivity to insulin looks like, that's what you're gonna base that on. And, you know, for today's pumps that really are driven by allowing you to take a bolus that it's not gonna subtract any insulin behind it, we often have to add carbohydrate. Right? So then if you know about what one unit does to cover the rise, you can equate that one.
You should also then cover that same number of grams of carb that is your insulin to carb ratio at that time of day. Okay. And then you can enter it, get the bolus rolling, and move forward.
Jenny’s Numbers: Cream, Sugar & a Unit Per Cup 7:01
Now you said you don't like black coffee. Do you sweeten it with something?
I do. I well, I put in a little bit of it's like a coconut milk creamer that I use. It's like a tablespoon. It's two grams of carb. Okay.
I haven't seen You don't put sugar in
it, though, I would imagine.
I don't put sugar in it.
No. But somebody's going to.
Of course. So Absolutely. If you look at any of the restaurant types of coffees or the, I guess, the coffee shop types of coffee, whether it's Dunkin' Donuts or Starbucks or whatever, most people don't go there for a cup of black coffee.
There's no one there. But but in your house, you you you know, you're one of those people who has a coffee maker that comes on in the morning, and the best part of waking up is Folgers in your cup or whatever. And you and you run downstairs and you have a cup.
Mine's the mine's the pour over. It's a drip cup. I don't we don't use a coffee maker. But yeah.
I'm a look at you. You're fancy. And so
Tastes better, honestly. And I don't like things running through plastic. So
Yeah. I don't know. I'm with you. It's just me. And but but somebody's gonna come down in the morning, have a cup.
Yes. But they're gonna put in the sugar, but they don't, like I mean, people I've watched people make coffee. They grab sugar and toss it. Toss it. It's a it's a it's an about thing.
So how does I mean, explain let's just pick a number. Like, how would two is two I don't I don't drink here's the thing you don't say out loud a lot. There's a couple things you shouldn't say out loud in pub in in mixed company because it really confuses people and causes them to look at you oddly. But I've never had coffee before.
Okay.
So I'm gonna say that now just so I can let you know. I don't know what I'm talking about. But is, like, is two tablespoons of sugar
That's a lot of that's a lot of sugar.
Teaspoons?
Two teaspoons would be about right. And if you compare it to what you might get at, again, a sort of a coffee shop if you're doing the packets Right. Each packet of sugar is a teaspoon, and it's four grams.
Okay. Well, that's a great way to so each packet's four grams of carbs. Yep. So for you specifically, if you had a eight ounce cup of coffee, you need a unit for your coffee, and then let's just say you're a person who then put in two packets of sugar. Yeah.
Now that's eight carbs. Let's just use your numbers. What would that be for you? Let's stick with you for a minute.
Yeah. So in the morning time, specifically, I have an insulin to carb ratio that's one to 11. I mean, if we just do it one to 10 to make it easy in terms of counting, right, that's an extra point eight units of insulin because I'm eating eight grams of carb as sugar on top of the one unit for the coffee.
Yeah. So now you have the coffee. We're adding the sugar for you and the creamer. So now you're up to, like, what, 15 carbs. So what would you do?
Would you do would you actually dial in the carbs? You would. But if you were if you were to spit on it, would you do two units maybe? You already love Omnipod five, the tubeless, waterproof, automated insulin delivery system. Now it's even stronger.
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Links in the show notes. Links at juiceboxpodcast.com to Dexcom and all of the sponsors. When you use my links, you're supporting the production of the podcast and helping to keep it free and plentiful. You think you go heavier?
I guess if I'm estimating, sure, I might go heavier, but I I use I mean, I use my pump. Right?
Yeah.
No. I I put the carbs in for the one unit that I require for the coffee. Right? The grams of carbs, that'd be, like, 11. Mhmm.
Right? And then, essentially, I'm gonna add the four extra, or the eight extra that comes to 19 grams of carb. Mhmm. And so, yes, about units, I guess. And then I look at my blood sugar.
Right? What's my blood sugar doing? Blah blah blah.
Tell the Pump It’s Carbs 12:11
Do I need to would you I'm just gonna use the word. Would you lie to the pump and tell it that you were having since you're one to 11, would you tell it 11 carbs for the coffee, or do you put in one and then bolus for the creamer, for example?
No. I put in the grams of carbs so that again, from based on the kind of algorithm you use Yeah. The acknowledgment of what you put in is how the system kinda follows it out and or helps you after. And so I definitely put it in as if it's a carbohydrate.
Okay. Let me hit everybody real quick. Heavy cream, point four grams per tablespoon. Half and half is point six or point seven. Regular flavored liquid creamer, five grams per tablespoon.
Powdered flavored creamer, two grams per half a teaspoon, zero sugar liquid creamer, of course, does not have any in it. That's just a breakdown of creamers just in case you're wondering.
And I want I love to bring up the creamer because, again, as you said, you know, heavy cream, half and half, whatever, it's pretty negligible. Mhmm. Right? I mean, unless you're really low insulin to carb ratio, you could have couple tablespoons of that without really much damage in terms of miscount of carbohydrates.
Yeah.
Creamers, Syrups & Shop Drinks 13:24
When you start getting into the flavored coffee meats and whatever other brand people are using with all the flavors and the sugars and everything, do you really sit in the kitchen and take a table tablespoon measure and pour into that and then pour it into oh, no. You're guessing. Dump it out of the jar. And on average, your dump is going to be about an eighth to a quarter cup depending on how heavy handed you are. Mhmm.
So look at the overage that you may be adding to just coffee because of lack of measurement.
Yeah. It sounds like creamer is the ketchup of drinks. You know
what mean?
You're like, I don't know. Yeah. Yeah.
Yeah. Well and then when you start looking at some of the restaurant style or the, you know, coffee shop kinda style stuff, not only is there there's usually just real milk or real creamer in it when they're making some of the specialty drinks.
Mhmm.
But let's look up some of the pumped liquid flavorings. Right? They do come sugar free, which is an a better option in terms of saving you the carbohydrates and the kick to your blood sugar. But many people don't like them. So or they don't like the sweeteners that's involved in it, so they're gonna do the regular sugar.
And most coffee shop places are doing at least two to four pumps of those syrupy sugars that go in for your fancy peppermint mocha that you get at, you know, the holiday times. And
there's so in the end, this is just there's more carbs in it maybe if you're doing stuff like that than you than you think. And on top of that, you're getting a kick from the caffeine.
Yes.
Tea, Soda & the Caffeine Nobody Counts 15:07
Do people see a rise from tea?
So I again, n of one We're
just using you
to I I don't. I don't see any rise in my blood sugar from tea. I have a cup of tea before I go to yoga in the morning. I drink it on the way there. In a fasted state, I don't have anything else.
I don't see any rise from that whatsoever. I usually do, like, a green tea or a white tea. Sometimes it's herbal tea, which, again, you shouldn't technically see an impact. But tea caffeine is fairly low comparative, whether it's a black tea or a white tea, or a green tea, very, very low compared to your cup of coffee.
Okay.
So hit wise, maybe you might, but I don't.
How does how does soda punch in comparison to coffee? I think you know what I mean? Is it is it not one is coffee just really zooshed up for caffeine? Maybe we should break that down so people can understand.
That's a great you know, a good question. Again, if it's just regular coffee, I wouldn't necessarily say, gosh. Drink a cup of regular coffee to treat a low blood sugar because it's gonna raise your blood sugar like soda will.
Okay.
So does definitely I mean, it's it's sugar. So it is almost a streamline, right, into bloodstream to kind of help. So coffee's not gonna really kick you like that, but I do in terms of, like, bolus strategizing. I pre bolus for my cups of coffee.
Okay. How much do you do?
Usually, if it's it's just my typical morning cup Mhmm. I will usually do about twelve to fifteen minutes is my average.
Okay. Alright. So it takes it takes because it will hit hard enough to mess you up if not.
Yes. Okay.
Well, that's interesting. What about so but if there's tea and I put I mean, some people put cream in tea and sugar in tea. So just treat it the same way, but don't worry about the caffeine effect from it.
For the most part, correct. Like a matcha latte or something like that, which is like a green tea powder, essentially, that's fluffed up with milk of some type. Right? And they may, again, then add a vanilla or some type of flavoring syrup to it. So you can see just the tea in and of itself probably wouldn't eat a bolus.
But if you're adding to it, then what you're adding if there is carb in it, absolutely, you need to consider and count.
Would a person with type two diabetes get hit with black coffee? Yeah. Yeah. They'd get the same feeling from it? Mhmm.
Okay. It's interesting. I it's one of the things that throughout my time in this, people are always talking about. Like, my you know, they don't know what's going on in the morning. And when somebody eventually says, do you drink coffee?
And then, you know, oh, I do. How come? There's no carbs in coffee. And then it starts that whole conversation. Yeah.
It's really it's super interesting. I I I brought this up here. Hopefully, this is fairly accurate. Average caffeine content in a brewed coffee, eight ounces, 95 milligrams. Standard cola, like Coca Cola, 34.
Diet cola, like Diet Coke, 46. Citrusy soda, like Mountain Dew, 54. Espresso, 63. Instant coffee, 62. So just brewed coffee has it's a lot.
I mean, that's obviously a lot more than than what we're seeing with everything else. Is caffeine impacting people all over the place and they don't do you think they don't think about it when you talk to people?
I definitely encounter enough people that when we're looking at blood sugar records and trying to navigate out is, like, what's coming where.
Mhmm.
Right? It's the where were things happening here? We're trying to make an adjustment. Is it basal? Is it a ratio?
Is it something that's not being counted? So we do talk through in pretty heavy detail. And beverages are a big place that I bring up because it often gets missed
Yeah.
In other, you know, health care discussion. Nobody really remembers to ask, well, gosh, you wake up in the morning and, you said, your your pod has been dripping coffee for you already, and it's ready to go. And you pour your cup while you're brushing your teeth or shaving or getting in the shower or whatever you're doing, and it's it's not a thought.
Yeah. I just looked at a Red
Go ahead.
Red Bull has eighty milligrams in it. So that's gotta be a thing. I see kids walking around with Red Bulls all the time. Mhmm. And they probably have sugar in it too.
And the Red Bull, I believe, does have sugar in it.
Okay.
I think there's a free version too. I've never had Red Bull. Like, I've never had any of those energy.
When I get tired, I go to sleep.
Right? I just I
guess I I guess the day is over. I'll go sleepy now. Let's see. A standard 8.4 ounce can of Red Bull contains 27 grams of sugar.
Okay. So There is a sugar free one, isn't there, if I remember correctly?
Sugar free alternatives, but they're still gonna have the car the the caffeine.
Mhmm. So That's a purpose for drinking it, really.
Well, I I would yeah.
The caffeine. Yeah. Right. I
I I think so. I I think in the eighties, people stopped doing this and they went to that caffeine and stuff. Mhmm. Yeah. There was a hand motion I did for Jenny that none of you are gonna know the answer to.
Wrap-Up & Good Coffee Stories 20:32
So around coffee, is there anything we missed here? Like, I know, like, you know, we didn't dig deep enough in just to see to see, but you guys really, I one of those Dunkin' Donuts or Starbucks coffees that are flavored and everything are gonna have way more carbs in it than you probably think, and then consider the caffeine as well. But I think the way Jenny laid it out, just, you know, kinda drink a a cup of black coffee or, you know, with minimal stuff in it to see what it does to you. That's great information to have. Like, how much can I expect this coffee to move my blood sugar without all the other impacts?
And then you maybe can have a better time in the morning and enjoy your coffee. I
Agreed.
I see people drinking it. You guys seem to love it. So Yeah. I just when I think of coffee, I think of I think of my parents smoking like, my dad smoking a cigarette and, like, the coffee and, like, all this. It's just not something I'm interested in because of that.
You know?
So That makes sense. It's a it's a negative association that you have along with it.
I did I I should say I I was in the Dominican Republic recently. I went out on a cruise to check out the cruise ship for the juice cruise.
Yeah.
We got off in the Dominican and we did a bunch of little, like like, stuff. And one of the things we went to, they brewed coffee, like, right from, like, beans that were, like, right
really good.
I don't know. I tried it. I felt like I was gonna die. So I tried it, but I I took a few sips, and I was like, oh, okay. And that was it.
They were rolling cigars too. I did buy cigars. They were really good.
Sure. They were.
I sent them to my brother. He already is complaining that they're gone.
So Good coffee too. I used to have a a friend who lived in Hawaii. When they would come back to visit, they would bring the Kona coffee.
Mhmm.
It is Just better. Really good coffee as well. Cool. Yeah.
It's awesome. Alright. Well, I appreciate you doing this with me. Thank you very much.
No. Thank you.
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- Black coffee has no carbs but can still raise blood sugar. Caffeine acts like an adrenaline hit and can reduce insulin sensitivity, so the rise is real even when you’re not eating anything.
- To find your own number, drink your usual cup on a stable blood sugar without bolusing and watch how far it rises and where it plateaus; then use your correction factor (ISF) to estimate the insulin that rise would need. Jenny’s is about a unit per 8-oz cup — but it could be 0.3 or 2. Work the math out with your care team.
- On many automated pumps a no-carb bolus won’t “stick,” so people enter the coffee’s effect as grams of carb (using their carb ratio) and announce add-ins like sugar and creamer as the carbs they are, so the algorithm accounts for it.
- The add-ins are where the carbs hide. Heavy cream and half-and-half are negligible; flavored liquid creamers (~5g a tablespoon) and shop drinks with several pumps of syrup add up fast — and free-pouring creamer from the jar means you’re guessing high.
- Tea usually has far less caffeine than coffee and may not move your blood sugar much on its own — but anything you add (milk, sugar, syrup, a matcha latte) still counts. Pre-bolusing coffee (Jenny does ~12–15 minutes) can blunt the spike. Confirm strategies with your care team.
- Omnipod 5 — Tubeless automated insulin delivery, now with a 100 mg/dL target option — an episode sponsor. Free starter kit at the link.
- Dexcom G7 — The CGM Arden wears — 30-minute warmup, up to 10 followers. An episode sponsor.
- Algorithm Pumping Series — Scott’s collection of episodes on automated insulin delivery.
- Bold Beginnings Series — The newly-diagnosed series with Scott and Jenny Smith.
- Juice Cruise — The community cruise Scott scouted in the Dominican Republic.
