#1950 Name a Rule You Break
Name a Rule You Break
A Facebook post asked people to name a diabetes rule they break. Hundreds answered. Scott and Jenny Smith go through the list and plan a series around every one of them.
Jump to a moment
- The series came from one line in the Facebook group. A member named Andy posted: name a diabetes rule that you break. Hundreds of people answered, and Scott sorted the replies by how often each came up — eleven main rules. Each will become its own short episode with Jenny.
- What people mean by “bad diabetic.” Scott's read after going through the responses is that it isn't about numbers at all — it's about the sense of breaking an expectation someone was handed. Jenny's counterpoint is instructive: she has never felt like a bad person for not doing it by the book, because she knows the clinical rules and she knows the Jenny rules, and she does the ones that work.
- The top of the list is lancets. Twenty-two people named not changing the lancet. Jenny guessed it first, along with reusing needle caps and syringes, which Scott had folded into the same category. Skipping alcohol swabs was her second guess and also on the list.
- Some “rules” are worth breaking and some are not. Jenny draws a clear line: swagging carbs, skipping calibration, and stretching a site are one kind of thing, but rotating injection sites, priming a pen, and clearing air from a line have real consequences if you skip them. She is also pro-calibration when a CGM is being wonky, rather than never.
- The rest of the list. Doctor's authority, stretching supplies past their dates, finger sticks and hand-washing, logging and writing down data, running out of supplies, and going through TSA scanners wearing devices — which both of them do, and which Jenny notes is technically against manufacturer guidance. Scott adds one the list missed: how badly people pack supplies when they travel.
- Juicebox Podcast Facebook group — Where the original post came from — the private community, free to join.
- Diabetes Pro Tip series — Episodes 1000-1025 with Jenny Smith — the management foundation.
- Jenny Smith — Integrated Diabetes — Jenny is a dietitian and diabetes educator who has lived with type 1 for over 35 years.
Every word of the conversation
Cold open & sponsors0:06
Friends, we're all back together for another episode of the juice box podcast. Hey. Nothing you hear on the juice box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan. T1dexchange.org/juicebox.
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There is one blood glucose meter in this house, the Kontoor Next Gen blood glucose meter. That meter is on my daughter's person right now and at all times. It is incredibly accurate and waiting for you at kontoornext.com/juicebox. Jenny, this is the first time we are recording with my new setup. You don't know about this, but I have a new, can I tell you something embarrassing real quickly, then we'll jump into this?
A new setup, and a consultant1:49
Sure. I've been making this podcast for fifteen years, I think. Mhmm. And I hired a consultant to come look at my setup, and he looked at it and said, I can't believe this works.
Oh, no. Well, you put it all together, and clearly it works because what you got is a good product.
I I made it so long ago. He's like, what is this cable for? I was like, well, that's how the audio gets from here to there. And he goes, that's not how that's supposed to happen. And I went, really?
And he goes, nope. And he, like, he's like, pull that out, do this, do that. And we did a bunch of stuff, and I was he's like, do you hear how much clearer it is already? And I was like, I do. And I was like, oh my god.
And then I felt silly. And he was trying to tell me, no. You figured this out. Like, he's like, you MacGyver this whole thing together. And and he's like, it's it's I can't believe how good your podcast sounded, he told me.
So, anyway
Well, good job for doing what you had done. There's getting it.
There's boxes here that I don't need anymore. He's like, I don't know what that is. You don't need that. And I was like, oh, okay. So I'm just I've decided to just be happy and move forward.
But Awesome. But, anyway, this is the new setup. Hopefully, going forward, I would think probably somebody might hear this sooner. But in, I guess, mid to late August this year, you should notice the podcast sound different consistently after that. Oh.
So anyway
I will have to pay attention then.
Jenny's like, maybe I'll listen to this dumb podcast once. Oh, I listen. I listen with
I listen to grab on on topics, honestly, that I can draw something from. And there are a number of them, so thank you.
The Facebook post behind the series3:29
Thank you. Oh, no, please. So I wanna do something based on a Facebook post. I actually wanna make a series based on a Facebook post. And the post was it was super simple, and I I wanna give Andy credit for it, one of the group members.
He just said, name a diabetes rule, and I think rule is in quotes, that you break. And then a lot of people responded. A lot of people responded.
Oh, I can think of lots of things.
So I wanna so it's funny because it gave me some reflective time as a person who does not have type one
Sure.
To really think about the idea that, gosh, are people walking around feeling like they're breaking rules? And I could tell from a lot of the responses that they did that I think that's where the you know when some people call themselves bad diabetics? Sure. I think they're referring to, I know there's a thing I'm supposed to be doing and I don't do it. I'm a bad diabetic.
I think after having those conversations, that's what I'm hearing them say.
“Bad diabetic” means broken expectations4:34
So that it's not you you have a sense that it's not all tied to the numbers, that it's actually some of the habits and the things that they've been taught or we've been taught that they're not doing the way that, you know, the book says to do it.
Expectations. I feel like they think they're breaking expectations. So, anyway, so we're gonna make a series, called I don't know what.
Can I tell you something funny
I guess so? Please.
I never really feel like I'm break like, I'm never like, I'm a bad person because I'm not doing it the way I just I'm like, screw that. I just wanna do it the way I do it because it works. And, you know, I know the rules clearly. I know the clinical rules. Mhmm.
And then I know the Jenny rules.
Clinical rules, and Jenny rules5:18
You know, the ones that work. Well, listen. There's some rules on here. There's no way you're not following. But so I have it broken down into a list by how many times somebody mentioned it that they break Okay.
They break I every time I say break the rule, please just assume my quotes around it. Okay. We have one, two, three, four, five, six, seven, eight, nine, ten, 11 main rules that that people brought up. And so I first wanna hear what you think the rules are. Like, what comes to mind when you think of diabetes rules?
Then I'm gonna tell you what this list is, and then we're gonna make little episodes around each one.
Guess the list: lancets first6:01
I would hope that one of them is to change your lancet.
That is one of
The little pokey thing that you poke your finger with. Right? The lancet. Change the lancet every time you poke your finger. It's gotta be one of them.
Right?
22 people mentioned not changing their lens sets. Okay.
Oh, yes.
And that so that's one of them. Alright. You got that. Oh, this is fun. Let's see if you can get the rest of them off the list.
I'll make a list of when you get right. Go ahead.
Another one has to be similar changing the needle cap or even the syringe that you use for an injection.
All of those are blended into the
They're all together.
Lancet category. I bet you're I bet there's gonna you're not gonna get some of these.
I'm sure I'm not.
Yeah. Yeah.
And I typically tell people not to use this, and I think you have as well, but using alcohol to clean a slight a site.
Very good, Jenny. That's one too. I skip alcohol swabs is Mhmm. One of them. I don't skip them.
I just don't use them, but that's Just don't use them. Right. I have a rule too around alcohol.
Yes. I think one applies to something I do even though you're not supposed to technically do it because I'm still using g six. Oh. I've not switched. So I restart my g six.
Restart your CGM.
Because you know what? Then I get, like, three weeks out of one sensor most of the time.
This is just gonna make people sad and upset because I the g six is done already. Right?
It is. I as of July 1, you technically, they're not supporting or sending supplies from what I understood it to be. Now I have
A stack?
A good a good back stack of them.
Can you imagine all the people listening right now that are like, wait. I could have restarted the g six. Oh, yes.
And there are so many YouTube videos about how to restart it. Each of them a little bit different. I found the way that it works for me. So anyway, that but that I think is a breaking the rule.
Alcohol swabs8:09
Well, that wasn't on here, but I like that one. That was good. So we'll use that as, like, we'll call it again, assume the the air quotes, misusing tech. Maybe we'll make that our own
Or miss yeah. That would be a good one. Right. I think another one and this it kind of only applies to those who may be using a steel needle cannula for an insulin pump, and it might go along with the lancet idea. But because the steel needle, it's kind of like a thumbtack, and you can pop it right back under if you needed to and you're really short on supplies.
Now this is not medical advice. Please do not do this. I'm just saying that I know that some people do reuse that set and pop it in and just apply an extra little tacky around it to put it back in.
Jenny, you have found one of the things that people suggested. They stretch sites, use use things longer than they should, put stuff where that it's not supposed to be put. They don't rotate. Yep. That's all under one too.
So That's
all on because I was gonna say rotation of sites to locations that are not what are approved technical sites.
That's one of the things people say the rules they break are that. The Kontoor next gen blood glucose meter is sponsoring this episode of the juice box podcast, and it is entirely possible that it is less expensive in cash than you are paying right now for your meter through your insurance company. That's right. If you go to my link, contournext.com/juicebox, You're gonna find links to Walmart, Amazon, Walgreens, CVS, Rite Aid, Kroger, Meijer. You could be paying more right now through your insurance for your test strips and meter than you would pay through my link for the Contour Next Gen and Contour Next Test strips in cash.
What am I saying? My link may be cheaper out of your pocket than you are paying right now even with your insurance. And I don't know which meter you have on you right now. I can't say that. But what I can say for sure is that the Contour Next Gen meter is accurate.
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I don't know if some of the breaking rules is getting lab tests as frequently as their provider recommends. Is that in there?
Yeah. Let's see. Doctor authority. I skip endo appointments. I don't do what the doctor says just because they're a doctor.
I learned on my own. I yeah, I guess that's right there, like, not listening to medical advice.
Right. Okay. And, again, what I've experienced with that is you could be correct in not listening to that medical advice, especially if you are seeking assistance outside of your medical practice because they're not serving you well.
More from the list12:00
Mhmm.
Then remember that that's not necessarily breaking a rule. It's just that you've learned beyond what your clinician has told you, and it's working better the way that you are doing something. So that's not a it's not a breaking the rule, but you could see it as Yeah. That.
I wonder where you stand on this one. I'm gonna give you one. So Oh. I don't think if I'm being really thoughtful about it, I don't think I've checked Arden's ketones a half a dozen times in twenty years.
Could that be rule breaking? I guess.
Right? Well, when you're when you're guy is to have right? They tell you a high blood sugar for not long, you should be checking ketones.
Anything over two fifty. In fact, I think you most meters, if they don't still do it, used to when your blood sugar was at least two forty Mhmm. Would or, you know, like, 13 something if you're a millimole user, you got a reminder on your blood glucose meter to check ketones.
Really? Oh, that's interesting. Yes. Yeah.
But I I do think that if you are somebody who can skirt around illnesses, that you don't get sick very frequently or that you don't have high blood sugars like that
Mhmm.
You may not check ketones regularly. And so doing it I always think that doing it at least to get an idea of where do your ketones typically sit, especially in a fasting state, like you wake up in the morning, and do a ketone check.
Yeah.
See where you typically sit because then it gives you a ground, at least a baseline for here and now. Where are my fasting ketones typically? Because then if you do it in the future, you kind of have a base to go off of. Right? Especially if you're sick or you've taken your insulin doses down considerably because you're ill.
It at least gave you a guideline of, well, my ketones are usually point one or they're usually point two, and gosh, now they're two point something. Clearly, I have ketones I
have Okay. Do something Alright.
Right.
That's good.
But that is interesting that, I mean, I I infrequently test my ketones. I don't
Yeah. I mean, there's been times where I realized she hasn't had insulin by mistake. You know, like, we had a bad sight one time, got knocked off during swimming. We didn't realize it. Check them then.
I mean, in the beginning, if she got sick, I would check them, but I think it's after the third or fourth time that you check and there's no ketones, you think, okay. Well, it got higher, but I'll get it back down pretty quickly and, you know, that kind of thing. Not that I'm blase about it. Okay. What are the the big ones?
This is interesting because there's no way you wouldn't do this, and it's the number one mentioned thing.
So it's something that I wouldn't do?
There's no way you
That I would definitely follow the rules in doing this?
Yeah.
Not bolusing for food.
Prebolusing. Prebolusing. Prebolusing
is the one Same category.
Everybody was like, I see, isn't that interesting? You just think of prebolusing as bolusing for food. They I do. They think of it as an extra step they have to take, and it's overwhelmingly listed by people.
That's interesting.
Yeah. People it's I it's my takeaway from doing the podcast that it is one of the things that people with type one diabetes struggle with maybe more than anything else is prebolising.
I think because it's defined by a time in which let me back up. It's not really an extra step because in either case, whether you're bolusing ahead of time or you're bolusing at the meal, you're just you're bolus thing. It's a thought
it's a thought process.
Working through the middle16:00
But it's an ahead of time thought process to what is coming. And that means there's planning that you have to do for knowing what are you going to eat. Right?
I heard a kid tell me recently, I don't know I'm gonna be hungry twenty minutes before I'm hungry.
And I thought
I thought that's fair. You know? Mhmm. I've had other people explain to me, like, it feels like a loss of control or an an unfair step, like, that kind of thing. Like, why should I have to do that when other people don't have to?
So there's a a couple things around there. So prebolism My Yeah.
My counter to that thought is always if I pre bolus, I'm less likely to have to interact later, which means I don't have as many steps. Yep. I don't have as much frustration. I've taken a piece of anxiety, worry, more, you know, poking buttons and looking at things. Like, if I pre bolus then the aftermath.
Yeah. I wait if my alarms go off, and if they don't, then woo hoo.
I mean, listen. That's how I see it, but I also don't have to do it. So True. Yeah. This one has the word rule right in it, which it's funny because then it because this is also mentioned a lot.
This one threw me off because it's so not a rule, but, obviously, it's beaten in everybody's head, the fifteen fifteen rule.
Fifteen fifteen.
Yeah. I get low blood sugar. I take 15 carbs. I wait fifteen minutes. I retest.
I can't believe that persists. It's really interesting.
It persists because it's still taught.
Wow.
That is a 100% a rule that is still taught that needs to not be taught, but meaning don't take it out completely in what to do, but give context to how how you should treat it. What should you treat it with? What time frame should you look at? How can you use your technology? Like, there's a whole bunch more information than just a simplified rip off page that says fifteen fifteen.
This is what you need, and that gets ingrained in your head, especially at diagnosis where everything is brand new and you just want the set of five things that's gonna contain this.
The, the next thing is I find interesting because this was overwhelmingly brought up. It's kind of a a little conglomeration of ideas, but rage bolusing, waiting to correct, stacking insulin. But that's another one that I think of as poor education that leads to that feeling. Right? Because when people say stacking, I hear bolusing.
When people say rage bolusing, I hear correcting. And when people say I didn't wait long enough to correct, I hear they didn't do a good enough job counting their carbs the first time.
Or pre bolus ing.
Yeah. Or pre bolus ing. Right? It's it's and it's to me, it's all in the way you couch it when you explain it to somebody. Like, it's funny that, like, education has come down to three pejoratives around what could be three, I don't know, three statements that make you feel empowered.
Right.
It's it's interesting to me. It's all that's all bad communication is what that is. Yeah.
What bad communication, more really education that needs to be updated.
Yeah. No. Right. It's just a different way to talk about it. Yeah.
Alright. Listen. We're gonna we'll we'll run through all these, and then Jenny and I are gonna do little, like we'll do, like, vind like, small sip kind of episodes on each of the ideas. Yeah. Because the Internet, it needs the Internet wants us to do shorter content once in a while, Jenny.
We have to give the Internet what it wants.
Is is oh, I know. I'm sorry about that. Is one of the things on the list I'm curious if it is remembering to refill your prescriptions in time?
Running out of supplies20:09
I have expired supplies of this and and so using expired supplies, which I think if you understood how those dates work, you wouldn't think of them necessarily as expired.
I was Yeah. Tell people, like, your supplies are not cheese. Yeah. Really. Right?
They're not cheese. They're not salami. They're not something
that Will this work? And I go, there's one definite way to find out. Put it on and see if it works. Put it
on and use it, honestly.
Because you were gonna throw it out anyway, so give it a whirl. Yeah. And this one that I find to be overwhelmingly debated online, insulin storage. Oh. So my insulin has to be refrigerated.
It cannot get warm to the people who are like, I have not refrigerated my insulin in decades.
I will tell you that that's the rule that I adhere to. Again, having been diagnosed thirty eight plus years ago, I think it's fear, I think, is the wrong word, but I wanna know that it has been at a stable temperature. What is the most stable? It's in my refrigerator. Mhmm.
I can't guarantee the temperature of the shelf in my house being up and down, whether I've got the air conditioning on the same as I did yesterday or it's a nice day and I don't turn it on or, you know, whatever. It's in the fridge. That's where I keep it. Whether you don't or not is entirely up to you because the manufacturing companies have obviously placed out there the rule that once in use, you have up to what? Twenty eight, thirty days to actually make use of it.
And then where the breaking comes in, this is where I break the rule. Like, my bottle of insulin is definitely like, I use it beyond a month. Come on. There's insulin left in the darn bottle, and I have plenty insulin. I'm not at a deficit, but there are some people who are.
I will
Please don't throw your bottle away just because it's twenty eight days.
When we talk about this, I'll share how I feel about it. So Cool. Because I have I'm fairly specific about it in a couple of places and then much more laxed about it. Other I'll I'll give my thing later. Cool.
But but your question about not filling scripts, not on here. I think that's Oh. Yeah. Like, so so not keeping up not keeping up with supply orders. Is that a thing you see happening to people a lot?
Somewhat. They run out
a lot?
They run out or they run out because not necessarily by their fault. Right? But they used up more or it's a time of year that they're going through things more. And then that reminder kind of comes through, and it might be a text message that gets delayed in them responding to and right now, in today's world, everything can be reordered by a click of a button. I mean, that's what I do.
Right? I get the text message, hey. Your refills are ready. And I click the button, and there it goes. It's sent off, and I get my supplies.
But you do have to pay attention, and we're busy people. And it might be forgotten. Mhmm. And then you might say, well, gosh. I used up three when I usually only use up one, and now I'm down to only one in my box.
So
Yeah. That's a good one. I think that I see online, again, a lot of people, like, I I ran out. I need help. Or Right.
I think the one that that isn't on here is that it it's fascinating how poorly some people pack when they travel with diabetes. Yes. I don't know. I brought one. You brought one.
What if that's the one
that goes for ten days.
Also, what if that's the one that goes bad? Like, I I wherever Arden goes, if she's more than thirty minutes from the house, she has two pumps, two CGMs. Like, because one might go bad, and then what do you do if the next one you put on goes bad? That Right. It ruins your day then.
Anyway, I'll get to that later. Nope. Let's roll through we'll roll through a couple of these. Carb counting and swagging, they people see that as breaking rules by swagging their carbs. It's how it's literally the whole way I do it.
Carb counting and swagging24:33
We got this one. We got that one. Okay. Sorry. Doctor's authority, stretching sites out, expired supplies.
Oh, finger sticks and calibrations. I don't do finger sticks as at all. I don't wash my hands before I do finger sticks. I desperately wish I was a person who would calibrate my CGM, but I'm not. Like, that was all that right there.
I'm a fan of calibrating CGMs, I just wanna say. Mhmm.
Using When needed, I think it has Not constantly.
But when if it's being wonky, you know Yeah. Give it a whirl. See what happens. Yep. Here's the rest.
Rotating injection sites and spots, priming your pen, or clearing air from a line. Oh.
Mhmm. Now those are those are a breaking. Let's say it's a breaking the rule, but it can have big consequences if you aren't doing those steps.
Right.
So just FYI.
Finger sticks and calibration25:41
This one I found interesting. Log, it's still being brought up logging or writing down my data. I mean, is any I have never done that once in my life. I'm sure you have. You probably have books.
Oh.
Yeah. Of numbers. My mom saves everything. She still has my books. She still has all of the logs, all the meals, and the units of insulin, and where my blood sugar was, and whether I went out and threw the ball in the yard with my dad, like, notebook after notebook.
She was trying to figure it out. Yeah.
She was. Yeah. Absolutely. I mean, making records to actually spot some trends that she could then go to the doctor and say, what do we do with this information? And to her credit, honestly, it's one of the reasons that she pretty quickly after diagnosis got my doctor to rewrite the prescription for test strips for finger sticks.
Because she was like, I don't I don't know what's going on here. Like, they told me to check my my blood sugar about four or five times a day at the most.
Yeah.
She's like, I don't I don't know what to do with this.
Awesome. Thanks. Here's one that I find. I I this is another big con online conversation all the time. I go through TSA with like, I go through the scanners with my my stuff on, but I I can't ever decide if I've Arden does that sometimes.
Rotating sites, priming, logging27:04
She doesn't always get wandered. But then I've heard people say I went through, and then my my, I don't know, my CGM, you know, stopped working. So I don't I don't I honestly will have to figure out when we talk about it what what the real
Yeah. That would be a good one to I usually say we should technically follow what's recommended by the, manufacturer. Right? I too follow I guess, I'm a little breaker. Like, I wear my products on my body.
I wear Omnipod and Dexcom. They stay on my body. I clearly can't take them off. I go through the big old scanner. I don't ask to be hand wandered or look at my supplies.
If they see stuff in my supplies they wanna take a peek at, have at it. You can swab my hands. I promise there's nothing funky there.
Yeah. Do you know the greatest thing that's happened since I've lost weight is now when I go in the scanner and I hold my hands up and I do the thing, I'm thin enough that it leaves a gap of of, under my arm, and they have to pat me down to make sure there's nothing there when I'm wearing a sweatshirt because my because my fat is not filling the space. It looks weird on the scanner. I'm every they're like, we're sorry. Have to pat you down.
TSA and the scanner28:12
I go, no. No. It's fine. It's the best part of my day.
It's all good.
Here we go. I'm happy to be patted down. I don't follow the rigid meal schedule I was given. So there's people that are, I guess, still being given, you know, eat at a certain time, eat a certain thing. This one breaks this is the last one.
I and this one, I don't know why. Like, I think this one breaks my heart for some reason. It's so simple, but I don't carry fast acting insulin and supplies with me when I leave the house. I don't understand traveling without your diabetes stuff.
I don't. Yeah.
Yeah. That's a hard one for me. And maybe it's because I'm a parent. I don't know.
Yeah. And I wonder if it's more that nobody's really given this person or the people who commented within it what should go in. I always talk to people about it, like, a t one d to go bag. Right?
Yeah.
It should be packed next to the door. It might not have insulin in because, obviously, however you keep it, store it, but it should go in as soon as you're going to leave the house. And I adhere to a similar rule as you. If I'm gonna be a minimum of thirty minutes away from home, usually, means I'm going to something I want to be at. Yeah.
And I don't want to have to interrupt that when my pod dies.
I I had to make it was a long time ago, but I had to make a decision in a movie theater. Am I gonna leave in the middle of this movie, or am I gonna let her blood sugar rocket up so she can stay and watch this movie? And both of those this both of those ideas made me equally upset, and so I bring stuff. And a movie is one of the things. Like, we don't bring it in even.
It stays in the car, but I am not gonna walk out of a movie and drive home because something goes wrong. I don't want a a vent to be ruined. I don't want that Right. It's not even the time. It's the feeling.
It's the Yeah. It's the psychological, like, oh my god. I have diabetes, and then this stupid thing doesn't work anymore. And now I have to leave here. And I and I don't I just don't.
I'm trying to avoid that feeling. Now Right. Addendum to that, most people are not carrying glucagon with them.
That's true. Yeah. And You're right.
I know it can be expensive if you don't have the right insurance, and it is hard to spend money on something that you will very likely throw away. But I don't know. That one that one gets me a little bit too. Anyway Yeah. Jenny, we are gonna come back, and then we're gonna do, like, little vignettes on all of these.
And, we'll pick through them one at a time and see see what we figure out. I appreciate it. That sounds like fun. It's been nice talking to you. Thank you so much.
You as well.
I'll see you soon.
Okay.
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Today's episode was sponsored by the Contour next gen blood glucose meter. It's the meter my daughter uses. She has it on her right now, and you're one click away from having it too. And don't forget using JuiceBox podcast links helps support the show. Friends, my 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 am joined by Jenny Smith, who is a diabetes educator with over thirty five years of personal experience, and we break down the 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 in the menu. If this is your first time listening to the juice box podcast and you'd like to hear more, download Apple podcasts or Spotify, really any audio app at all. Look for the juice box podcast and follow or subscribe.
We put out new content every day that you'll enjoy. Are you tired of scrolling past clips that last five seconds? Are you an adult? Would you like to have a long conversation? Juice box podcast is the place to be.
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