#393 After Dark: Bulimia and Depression

ADULT TOPIC WARNING

My anonymous 19 year old guest has bulimia, and depression. She also has type 1 diabetes.

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:10
Hello friends, and welcome to Episode 393 of the Juicebox Podcast. Today's episode is another in the after dark series which by the way turns one year old this month. First afterdark episode came out in October of 2019 was about drinking with Type One Diabetes. It was followed by smoking weed, trauma and addiction, sex from a female perspective, depression and self harm sex from a male perspective, being a parent in a divorce situation and co parenting, and we talked about bipolar disorder. And in this episode, we're going to tackle billiat and depression with a 19 year old type one who was really kind and open about coming on the show. We do take her name out. So there's gonna be little lapses and audio, where a name was said just out of an abundance of caution for her privacy. Please remember while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. Please always consult a physician before making any changes to your health care plan, or becoming Bold With Insulin.

This episode of The Juicebox Podcast is sponsored by the Contour Next One blood glucose meter. Check it out at Contour Next one.com Ford slash juice box. We're also sponsored today by touched by type one touched by type one.org. Or find them on Facebook or Instagram. Before we get started, I want to remind you that this episode of the podcast is a frank discussion about bulimia, which includes purging. There's also some talk about depression and other sensitive topics.

Anonymous Speaker 1:59
My name is I live in an area and I was diagnosed with diabetes in January of 2018. And I am currently 19 years old.

Scott Benner 2:09
So type one in January of 2019 2018 2018 2019 2020. Like two and a half years.

Anonymous Speaker 2:18
Yeah, just about were you

Scott Benner 2:21
17 yet Are you still 16 when you're diagnosed?

Anonymous Speaker 2:24
I was 17 as

Scott Benner 2:28
a senior in high school.

Anonymous Speaker 2:31
I was a junior in high school

Scott Benner 2:33
the junior. Gotcha. Alright. junior in high school diagnosed in area. Any other diabetes in your family? Or was it a complete surprise?

Anonymous Speaker 2:45
No, it was a complete surprise.

Scott Benner 2:47
Nobody at all. Nothing. How about any weird like? hypothyroidism, celiac? any of that stuff rolling around in the family? Yeah, number nine. I know. You don't go around asking everybody.

Anonymous Speaker 3:00
No, it's not a popular topic during family dinner.

Scott Benner 3:03
Yeah, Jane, I see you in the bathroom a lot after dinner. What could that be? Yeah. What is that celiac 90 chance. Okay, so Okay, so pretty, pretty much an anomaly in your family. What are the first steps your How are you diagnosed?

Anonymous Speaker 3:18
I had a blood test for for my other treatment, which I guess we'll get into soon. And, um, and it showed that my glucose was elevated. So we just did another one. And they told me during finals week that I had to go into the hospital to get checked out. So, um, so there I was diagnosed. Um, and

yeah, so it wasn't,

Scott Benner 3:50
it wasn't. You know, I was getting a blood test for something else that I'm gonna tell you about in a second Scott. And they found that my glucose was elevated.

Anonymous Speaker 3:59
Yeah, I just it was very convenient. You know, it was it wasn't very high. I think it was maybe 8.1. But, yeah, I just, I didn't want to stay overnight. I just had to, you know, come back to the hospital for a few days just to get training. And that was pretty much it.

Scott Benner 4:16
I understand. So if this was like a bad cheesy 80s morning radio show, there'd be like a snoring sound effect right now, while you were telling your story, just.

Anonymous Speaker 4:25
Yeah, it wasn't exciting. I'm sorry. No, no, I

Scott Benner 4:27
mean, I'm happy didn't make something up. I was skiing Scott, Mount Kilimanjaro. I didn't know if you knew you could actually skip that high. But you can and yeah, nothing like that. Okay, so listen, that's great. You didn't go through a lot of the medical issues that you could have gone into you didn't end up in DK. None of that happened, right?

Anonymous Speaker 4:46
No, no. Right.

Scott Benner 4:47
Excellent. Okay, so where are you going to get a blood test for?

Anonymous Speaker 4:52
Okay, so, I was currently in treatment for my eating disorder. I was diagnosed with leukemia, about Few months prior, um, so I was currently in outpatient, and I had to be getting routine blood tests and, and it was my doctor there who discovered it. Okay,

Unknown Speaker 5:16
the babies.

Scott Benner 5:17
So believe me now we're going to talk about something that I don't know anything about. And I want to learn more about At what age do you think it's began? And is that even the right way to talk about it began? Like, how do you see Believe me at first Do you see it as a? Is it a disease? Is it a? Is it a psychological disorder? Is it like how do you talk about it in your life?

Anonymous Speaker 5:42
Okay, so the bulimia, the actual diagnosis didn't actually happen until really a few months before my diabetes diagnosis without getting too soon. But, um, the whole eating disorder began when I was much younger, probably around 14. And, you know, it began as just a thought process and then became something more, you know, first started off with, with restricting, and then later on, it escalated to a full blown eating disorder, and it ended up being glia. So the way I look at it is, yeah, I guess, sorter

Scott Benner 6:22
No, no, it's, so what happens when you're 14 is they're, like, suddenly in a pressure for how you look? Or what yeah, I think starts it.

Anonymous Speaker 6:35
So everyone has a different

way to develop it. Um, lots of times, there's a certain trauma, and this is a coping mechanism. Um, and you know, everyone's trauma is different. So, um, so for me, personally, it was just different life events that was happening at the time, and it felt just, you know, a classic way just to take control, and make myself feel better. So,

you know, I felt that if I was thin, then all

my problems would go away.

Scott Benner 7:06
Let me ask you a question there. A trauma. So I'm not asking for your specifically if you of course, don't want to share it. But could it be anything from like, like a parent getting divorced, or an A, like, like, an assault, like up to like an assault or anything like that last something that takes you out of control? And then the blumea is a way to find control? Is that the idea?

Anonymous Speaker 7:32
Yeah, that's a perfect way to put it. It's any sort of event that no matter how objectively big or small that makes you feel, that you're not in control? And this is something that you could take control of. Gotcha. Okay.

Scott Benner 7:44
Well, I guess that's it. This is gonna sound strange, maybe? Or maybe it won't, but does it work? Does it give you a feeling of control? And does it alleviate the pain coming from the trauma?

Anonymous Speaker 7:56
So at first, um, and at first it does, and, but it quickly spirals, you know, because then soon, the disorder takes over? what you thought you had control, and it becomes controlling you. So. So it might be at first there is this first sense of relief, but it doesn't last?

Scott Benner 8:23
How does it end up taking control of you?

Anonymous Speaker 8:28
Um, it becomes

it takes over every aspect of your life, um, that.

Scott Benner 8:41
Take your time. It's okay. There's no pressure here.

Anonymous Speaker 8:44
Yeah, I just want to find a good way to phrase it.

Well, for me, personally, since I was struggling with a disorder and a type one diabetes diagnosis, it was almost like a cruel joke. How, on one hand, I was in sort of recovery, where I was told not to consciously think about what I ate, and that's constantly thinking about it. Because up until that point, for years, at that point, it was the one thing on my mind, you know, whenever, whenever an event happened, I would my mind would Amelie go to Oh, it's because you're not thin enough. Whenever, you know, I feel like I need control. It was okay, you got to do this habit, you know. But on the other hand, I was a newly diagnosed diabetic and I had to figure out how to you know, at the time I was in carb ratios and figuring out the best time to eat and like how to eat properly with insulin and having eat when I didn't want to because of a low blood sugar or not being a wrinkled, I couldn't eat because of a high blood sugar. So is this really cruel duality of you know, trying to recover from an eating disorder and trying to

Unknown Speaker 9:48
become a good diabetic?

Scott Benner 9:50
Let's make sure I understand. So part of the recovery from the eating disorder is not scheduling and being really specific Think about your food intake and your apps. And so you're going through that process for a number of years. And so you were, you feel like it started around 14. So that means you lived with it for a number of years before it was recognized, and then you start doing work on it. But let me ask you real quickly, how was it recognized? How did you end up in treatment for it?

Anonymous Speaker 10:23
So, okay, so eating disorders are bright hidden, and, and it was doing a good job of hiding it. And it was the summer when I was about 15 or 16. Where I was a lifeguard. And this is where the thinking story is. So don't worry, there is some excitement. But as I was guarding, I think did and the doctor of the camp, I guess, pulled me aside that one Look, I mean, he and he told me you're not eating enough. And that was the first time someone you know, said something face on. And so obviously, I was caught off guard. And

Scott Benner 11:12
so he you fainted, and an adult came up to you and please, I don't know which microphone I'm using to talk right into it. Because sometimes your face is moving away from the microphone, but don't get just be a little cognizant of it. So. So you fainted while you were lifeguarding and adult came up to you and said you need to eat more. Do you feel like that that was based on your physical appearance that he said that he or she said that?

Anonymous Speaker 11:36
Yeah, I believe so. I don't think I look particularly bad. emaciated. I never got to that point. But um, he must have been in the field, you know?

And maybe saw some other signs on Oh, yeah.

Scott Benner 11:57
Well, let's, maybe this is, by the way, so interesting. Because now I'm talking to somebody from my part of the country, and you talk faster than I do. So.

Anonymous Speaker 12:09
I'll try so don't worry. I also

Unknown Speaker 12:10
um, it's, by the way, I'm sorry.

Scott Benner 12:14
And and so why do I have this? Oh, because the thing Nevermind. Um, so, okay, you're talking very quickly, I'm keeping up I'm gonna slow you down a little bit because other people might not be or your pot, your episodes only going to be 45 minutes long, by the way. won't be any the actual like air pauses that everybody got. It's, it's, um, it's nice to talk to somebody from around here. So I can, yeah, I can. We can like hammer through all this. But I want to make sure that we stop and dissect it enough so that it's making sense to people who don't understand. So I think First things first, let's let's define bulimia for a second. So what's the What is it? And how like, how what is it moment to moment, if I have bulimia, what am I doing?

Anonymous Speaker 13:02
So the clinical diagnosis would be

purging I think more than more than three times a week for three months at a time. I'm not sure exactly. But that's the clinical diagnosis. But what that actually is, the life is a horror story. It's every moment um, food and body image is on your mind. And every time you eat, at least for me personally, it was it was like a need to get rid of it. And and a guilt you know, the guilt for being alive because you have to eat to be alive and and every moment just feeling like a weight and having to get nice and neat to get rid of that weight.

Scott Benner 13:43
Okay, so you can you can imagine in your mind that this food is going to go into you and make you fat. And you have to get it out. And on top of that you feel badly for needing to eat to begin with. Hmm, wow. So I looked it up here it says a serious eating disorder marked by bingeing followed by methods to avoid weight gain, believe me is potentially life threatening eating disorder. People with this condition bingi then they take steps to avoid weight gain. Most commonly This means vomiting or purging. But it can also mean excessive exercising or fasting treatments, including counseling medications and nutritional education. So were you just purging Is that how you were handling it?

Anonymous Speaker 14:25
Yeah, so I didn't. Um, I didn't have a textbook pinches. I definitely have overheating issues. But um, but that generally would be the cycle of eating to a point of like, uncomfortableness and then need to purge it. But also, it was just food in general, you know, but definitely overeating is a huge part of it.

Scott Benner 14:48
What's the onus for the overeating is it so that you don't feel well so that it feels like it should come out? Or is it because you know it's coming out so you could just eat whatever you want?

Anonymous Speaker 15:00
more towards the second, it's, um, because every time I would allow myself to eat something that quote unquote, was a bad food, I would think this is the last time you could do this. So I would just eat as much as I can and then yeah, get rid of it.

Scott Benner 15:16
It's that that thing people know, when they, when they're thinking to start a diet, they have that same idea, like, I'm going to start a diet on Monday, so this weekend, or do your food like that, that so that's sort of an idea. Gotcha. Do you during that, did you enjoy eating the food? Um,

Anonymous Speaker 15:47
no, because it's

it doesn't feel like your main, you know, you're you're eating as a compulsion, not for enjoyment.

Scott Benner 16:00
Okay, and, and there's not even a feeling of like, oh, gummy bears. I love gummy bears. It's not even that you don't get that out of anything, either. Not at all. No, it's interesting, because then there's then the connection between the overeating and the eating things that are quote unquote bad for you. Is all psychological. It's nothing to do with the food at all. Really? It's that idea? Wow. Cheese. Okay, that's pretty up. So let's see. Give me a second. I gotta wrap my head. This podcast is taking me in places I didn't expect just so you all know. And I guess because I curse this just became an after dark episode. So congratulations. I made it. Okay. All right. So there's a compulsion to eat. Eating happens, the purging happens? Because I'm interested, how long do we let the food stay in? Before we send it back out? Again?

Anonymous Speaker 16:57
20 minutes is prime. And a guess a depends on at which point recovery I was because, um, you know, it would my mindset would be just make another 10 minute just make it another 10 minutes to not do it. Um, but yeah,

Scott Benner 17:16
20 is about as far as you can make it are there. You know, we always talk about support online for things, thinking about it helping people but is there something like how do you learn how to be bulimic? Do you? Can you go online and find out how to do something that's not good for you, too? I mean, I guess you can, right?

Anonymous Speaker 17:33
Yeah, I didn't, actually, so

Scott Benner 17:37
are you? Are you showing off? Yeah.

Anonymous Speaker 17:43
I'm good, talented. It was, um, it was fine. After I really developed it did I go into all the forums and just like, kind of compare myself to see how, you know how each of us do it ourselves. But, um, I mean, I knew from from media, you know, from all the movies to watch all the books you read, like, what it is and how to do it, but I didn't need to look up tips or step by step manual, you know,

Scott Benner 18:10
but but that exists. So what what I'm wondering is, is when where there are those places online? It's not self loving self loathing completely right. Is there a little bit of like, like, peacocking? Like, I'm really good at this, or is there any of that that goes on?

Anonymous Speaker 18:25
For sure. There is, um, pro Ana, like pro anorexia, there's just pages and pages of, of

people who are hurting possibly supporting each other

of how to be a good anorexic or a good bulimic. And so it's very sick because you because people could find support through that supporting their disorder versus finding a support group or a therapist

Scott Benner 18:57
that keeps you in it and keeps you feeling like, this is great. Like he's doing it too. She's doing it too. There's there's health are they actually talking about like, there are healthy ways to accomplish this?

Anonymous Speaker 19:08
What do you buy healthy? Well, like

Scott Benner 19:09
better way? I don't know. Like, are they really talking about like, Hey, here's the great way to handle this this isn't that do they know it's bad for them and they don't care or they are just some people try to say it's not really detrimental to you like what's the, I guess? What's the scope of the conversation?

Anonymous Speaker 19:26
So it's more just about success. Whether that success is good for you or not, it doesn't matter it just you know, this is how you lose weight. This is how you successfully successfully purge. Um, this is how you exercise suddenly and

Scott Benner 19:42
I understand I just wanted to make sure I was clear, but okay. Is what are the physical problems that come from purging

Unknown Speaker 19:56
In my case, it was diabetes.

Anonymous Speaker 19:59
By It really throws your body out of whack. Um,

Unknown Speaker 20:05
a,

Anonymous Speaker 20:07
you know, there's long term effects you could have tearing in your esophagus from the acid bruising on your knuckles and purging teeth issues, you know, they always say a dentist could tell who's to blame. Um, so the acid

Scott Benner 20:23
hits the teeth, and then your teeth aren't prepared for stomach acid. Not in that. Not in that frequency.

Unknown Speaker 20:31
No, is that and just

Scott Benner 20:34
you said knuckles? I don't I'm not following that one. I'm sorry.

Anonymous Speaker 20:38
I'm just from, like, if you use your hands to purge, then, um, then your teeth would dig into your knuckles and cause scarring.

Scott Benner 20:50
Oh, so I'm reaching down my throat so frequently that I'm hurting my knuckles with my teeth.

Anonymous Speaker 20:55
Yes. And that could also result in stores around the mouth, also from acid reflux.

just general stomach issues, digestion issues.

Scott Benner 21:06
But do you and your doctors believe that? So I'm assuming everyone understands that if you end up having type one diabetes in your life, you've have some sort of genetic markers that predispose you. And the way I find myself thinking about it is that sometimes some sort of a health trauma can kind of speed the process up. And so maybe you were going to get diabetes when you were 10. But instead, you know, I don't know you got the flu really badly when you were five and or a virus or baba or whatever? Do you really believe that? That the impact that believe me had on your system threw you into type one. Don't ignore what kind of meter you're using just a blood glucose meter, it seems really simple, right? Like, it doesn't matter. There's a ton of them, I'll just take the one that doctor gives me except there's differences in accuracy. There's differences in quality of testing. And you can achieve that quality with the Contour Next One blood glucose meter. Go to Contour Next one.com forward slash juice box to learn all about Arden's blood glucose meter. It's got amazing accuracy. At an amazing price. It may even be less expensive. If you bought it with Archer insurance, not crazy, it's something could be cheaper without using your insurance than it is using it could be may not be maybe not sure, check it out Contour Next one.com forward slash juicebox. That's how you'll find out. This meter is small, yet easy to handle has a super bright light, even for a guy like me whose vision is you know, not great at night anymore. It's easy to read, has a great app if you'd like it's Bluetooth connected, and it works well. So well. In fact, that if you touch blood with a test trip and don't get enough, you can actually go back get the rest without impacting the accuracy of the test. And that accuracy is right at the top of industry standards. I love the Contour Next One blood glucose meter, and the numbers it gives back to us because we need those numbers to be something we can trust. Go poke around at Contour Next one.com forward slash juice box, you may even be eligible for an absolutely free meter. And they have an awesome test strip savings program. It's all there at the website. Check it out. If you've gotten yourself a brand new shiny meter that works so much better than the meter you have now you should check out touched by type one.org. I love this type one diabetes organization. They do really incredible work for people living with type one and they do it in very interesting and fun ways. You can learn more at touched by type one.org and go find them on Facebook and Instagram. There's lots to see lots to do. Lots to be excited about. There are links to these sponsors, as well as all the sponsors of the Juicebox Podcast right there in the show notes of your podcast player and at Juicebox podcast.com. I appreciate when you use the links. Alright, we have not even begun to scratch the surface yet in this episode. So let's get back to it.

Do you really believe that the impact that blumea had on your system threw you into type one?

Anonymous Speaker 24:51
Yeah, so that's why I stressed that I started my Blimey I really developed a few months ago for my diagnosis because Cuz as I was going through that, you know, I had the classic type one symptoms, I was very thirsty, I was very lethargic. And I thought it was a direct correlation of the Lamia, you know, because you're getting rid of fluid, so of course, you're going to be thirsty. And, and there's, like you said, there's a genetic factor to diabetes, the marker, and then the environmental factor. And, um, and, you know, I started purging in about like, early December of 2017. And then late January of 2018, I was diagnosed. So it was very hard for me to come to terms with because everyone tells you, you know, it's an autoimmune disorder. It's okay. Like, it wasn't your fault. And at that time, it really did feel like my fault, because it felt like, I chose the eating disorder. And I did this to myself.

Scott Benner 25:54
I see. Well, I mean, obviously, people told you this already. But you, you know, you could have just gotten a virus six months later, and never had the eating disorder and had diabetes. So I hope you found a way not to, to, you know, pressure yourself about that

Anonymous Speaker 26:09
was a therapy. Yeah, yeah.

Scott Benner 26:11
I was gonna say that's how that happens. Right? Do you listen? Have you heard the recent after dark episode about self harm? Yes. Did you find a lot of? I don't know, like parallels between that new?

Anonymous Speaker 26:27
Yes. Can you

Scott Benner 26:29
tell me how?

Anonymous Speaker 26:31
Yeah, um, so

a very common theme that I hear in the episodes is that lots of diabetics find it hard to take care of themselves until they're in a position of taking care of someone else. And, um, and I find that unfortunate, you know, because,

Unknown Speaker 26:55
um,

Anonymous Speaker 26:57
you know, because your will to live, we're really only come from yourself. But that's such a complicated paradox, because you simply don't have a will to live at that point. So how are you supposed to break out that cycle? You know, and when you don't feel like you want to live? Why you take care of your diabetes, you know, it could almost feel like you're punishing yourself, which is, you know, we're like, self harm comes in, you know, feels it was it's another sentence of taking control, you know, it's the opposite of what you think control would be, because you, you're saying, I don't care what the diabetes is telling me to do, I'm going to do what I want. But by doing that, you're just destroying yourself. You're not taking control of your body?

Scott Benner 27:43
Do you have any anxiety issues or depression?

Anonymous Speaker 27:50
Yeah. Oh, so diagnosed around that time, that was huge in everything, because, you know, I'm Dexcom. Right. And, you know, I would spend hours just staring at that graph, you know, trying to figure out the correlations and trying to keep it 100% sense, stable, as much as you try. And you can't always do that. With the depression, um, you know, I would, I wouldn't eat or eat too much, which also goes into the eating disorder, which also throws your blood sugar off whack, and I'm just not feeling the need to take care of myself.

Scott Benner 28:29
Okay. All right. What signs should parents be looking for? in eating disorders that maybe like you said, it's a very hidden thing. But is there a way if you look back, is there a way that someone could have seen you?

Anonymous Speaker 28:48
Yeah, isolation is a huge piece. You know, I've been always afraid, bubbly, extroverted kid. And I want to come out in my room, which is really more signs of depression, but it's specifically with the eating disorder, it would be a classic, I'm not hungry or picking out their food. It's very tough, because with all as much as there's those obvious signs, you know, like, you see someone not eating, but I'm having eat disorder, you get very good at hiding it. So I would only eat in front of people. So to show them that I was okay. maximizing your time around people by always having food with you, making it make it impossible for them to wander, like to think oh, she's not eating ever, because she's always eating when she's around me. Yeah, so I wouldn't say that the signs necessarily really correlate around food, I think would be more around mood because that is where I thought it might have been a little more obvious for people to realize because I simply wasn't myself anymore. So that could be that could be a million things, but you know, to approach someone and say, you know, I see it. I see that something's going on talk to me about it. And you don't have to call them out and say I think I'm disorder, I think your depression or whatever issue you think. But um, but since we feel so isolated and embarrassed, it's so hard to reach out for help

Scott Benner 30:19
you do you have two parents? Are you in a? or? Yeah, they're there. They're

Anonymous Speaker 30:26
married, happily married?

Scott Benner 30:28
And are there any? Has there been any kind of backlash for them? Do they feel badly for not seeing it? Or what's that relationship like now?

Anonymous Speaker 30:41
Right. So my parents have become my number one supporter. In the beginning, it wasn't like that. So, back to when I was 15. And the with when I was lifeguarding, and the, the cam doctor encouraged me to talk to someone about it. And the first person I would reach out would be my parents, the first thing they told me was, you don't look fat enough have eating disorder. So a, and I didn't, and that I didn't get help. You know, it was months after that. I'm trying to get them to realize that something was wrong. And I was able to plan for myself at that point, I had my friend who knew about it, pushing me to go into therapy. So in the beginning,

they were in denial.

Scott Benner 31:32
Was it? Was it just a misunderstanding of what an eating disorder was? Or were they trying to be, you know, denying what was happening? And by the way, how did that feel? Well, hold on answer those questions first, and then I'll,

Anonymous Speaker 31:46
yeah, a huge piece of it was denial for sure. Because again, I was this bubbly, extroverted child, and they looked at me and they think my kids, where did I go wrong? How did How could I have done this to her? And, obviously, you know, there's so many contributing factors. It wasn't bad, you know, but, um, but hurts. I imagined to see your kid go through something like that. Yeah. So for sure. It was nine. Okay. And then another, another, no, just another piece. Also, just not understanding but you start at first, you know, it took it took a good year for them to realize that I was actually struggling with something.

Scott Benner 32:29
Were you and you are being supported during that year by friends.

Anonymous Speaker 32:34
I'm not really know because, um, I had a friend who was definitely a huge support at the time, but there's only so much a friend could do and only so much I could allow myself to to allow my friend to do for me, because this is a this is more than more than us, you know. And, you know, as much as I can feel accepted in my friendship, I'm still killing myself.

Scott Benner 33:05
Okay. Yeah. When you tell your parents and they respond, you don't look thin enough to have an eating disorder. I'm being serious about this, but it's gonna come off as flippant, but it's not. Where you inside thinking. This is amazing. I have been really working hard at being thin and they don't think I look thin. Like did that actually hit you that way?

Anonymous Speaker 33:27
It was horrible. Because I'm

a sick goal of some of the disorder is to look sick enough. And I didn't look sick enough. It seems like in disorder is a very external thing. Um, but it's not. It's not it's internal.

Scott Benner 33:45
For how you looked, it must have I'm putting myself in your shoes for a second and maybe I'm wrong. But it feels like to me like you'd be like, this is what I think this is part of my goal here is to look thin, and you're telling me I don't look thin? Like did that spiral you to hear that? You didn't look the way you expected? You did? Or did you? Could you tell that it was just them? Not wanting their daughter to have bulimia?

Anonymous Speaker 34:09
No, at the time it pushed me just try harder.

Scott Benner 34:13
So I can think that's what I was thinking you were probably like, oh, I'll show you. Yes. Wow, this is uh, yeah, this is messed up. It let's let's we're halfway through so let's give people a little bit of context for where you are now. So you mean you've been in treatment for a while. How What are your goals? Like you know, I I don't know how to think about it. Like I think about when alcoholics talk about you're always an alcoholic. You just haven't drank today, like what's the what's the goal for bulimia.

Unknown Speaker 34:48
So

Anonymous Speaker 34:51
there will always be a piece of it, but it will never be like a once was

Unknown Speaker 34:58
the

Anonymous Speaker 35:01
The goal is to,

as cliche and as it sounds, is to love yourself at any point of your life. Because, you know, our bodies always change. And, and you got to find love from internally. The goal, surprisingly, isn't to never purge again. Because as since this was my coping mechanism for the longest time, it does come up time and time again. But doesn't mean that I, in the DSM five still believe that, you know, because I understand my triggers, and I understand how to not fall into a spiral. So, the goal for it is to not be Hi, I'm Lena, you know, just to be another piece of my story.

Scott Benner 35:51
Do you have new coping mechanisms that you employ?

Anonymous Speaker 35:57
Yeah, so, um,

Unknown Speaker 36:01
um,

Scott Benner 36:03
well, give me this, what's it, what's an example of something that would need you to employ a coping mechanism what could happen in your day to day life that might, that would throw you off tilt.

Unknown Speaker 36:15
So

Anonymous Speaker 36:18
So has a lot to do with my perception of others.

In recovery, I have to learn about this certain partnership about on my end, I have to work on overcoming like, my sensitivities and my triggers, because people say things that they don't even realize that they're saying, and on their end, you know, the people around me should work on being more sensitive, you know, obviously, there's objective things that you shouldn't tell someone, um, like,

for example,

this is an example of something that you would never expect to trigger me, but it did when, when I was 17, I guess, newly diagnosed, I was told that I had to have more carbs in my diet. So I, every morning, I had a yogurt with a quarter cup of granola, which is a lot of granola for the amount of yogurt I was having. And, and I always have it in the morning in school. And one day, my friends, some eating it, and she was like, wow, is that granola, yogurt, or yogurt and granola? implying that that was a lot of granola. And over time, everyone kind of funny. But as he stood up, went out, I threw it out. Because it was, to me that was like, you're saying on eat too much. And objectively, that's that just a comment doesn't mean anything. But for someone with an eating disorder that was destructive. So, um, that scenario happened. Now. my thought process would be, she doesn't mean anything by it. You know, let me just enjoy my yogurt. So that's on my end.

Scott Benner 37:54
It's interesting, because I guess it is all how you react to things. I know. If someone said something like that, to me, my reaction would be, hey, you're a nasty, aren't you? Why don't you shut up? And and like, I would never think like that her opinion meant anything to me. But it it's, it's very meaningful to you. As I'm recording again, so I responded to you. We lost for a second and she's back. But I responded to her statement. And now I realize that she didn't hear it, which is interesting. Yeah.

Unknown Speaker 38:31
Why am I unable now? What was the

Scott Benner 38:34
response? I'm trying to I'm having a technical issue on my make sure I'm recording your voice now. Why is it doing this to me? Okay, I said that it's interesting that you cared what people think because I if somebody said to me, I'd be like, you're a horrible, like, why do you like leave me alone? I like a lot of granola with my yogurt. What's it to you? Why don't you come over here and let me see if I can get this yogurt up your ass. Like I didn't. I would feel like just go away. And die, but it really impacted you. Yeah, does does that always the case.

Unknown Speaker 39:17
So, um,

Anonymous Speaker 39:20
now, um, these situations happen all the time where where people say or do things that to my disordered brain feels like a direct attack while someone else will just go off. But, um, so to me now, um, one time if you feel insecure, instead of rushing to that unhealthy unhealthy coping mechanism or to that unhealthy reaction. I would, um, put in this piece of how am I going to react to this, where it's where I realize that it's not a therapy package. Just people beat people, you know, people talk. And so sometimes, most of the time now I'm successful sometimes I'm not. And I'm,

Scott Benner 40:13
no, I just it's maybe it's got to do with your age or, or your situation. I don't know. And but I and I don't remember myself when I was 16, I guess as well as I think I do. I just know that right now, I can't imagine something, somebody could think of me that I care about. That way, like, don't get me wrong. If people I respect or love have, like constructive criticisms, I'd like to hear them. But I'm just like somebody at school or someone walking down the street. I don't know, like, when I order soft serve ice cream. I'm like, Can you put sprinkles on that? To the point where you're not sure if I got ice cream with sprinkles or sprinkles with ice cream, please? Thank you very much. And I don't care what the person at the place things. I just like my ice cream crunchy. You don't mean? So. But, but but that's it

Anonymous Speaker 41:02
can't really have it. So that's, that's exactly what it is, you know, that I had to find, like self esteem, where the only a pain that mattered were the people that mattered. And now now I think I could say that the average person who would make a dumb comment really isn't does not affect me whatsoever. But, um, and now when someone posts me does make a comment. Um, it doesn't trigger me in the classic sense. You know, um, it just, it's something that I worked through myself,

Scott Benner 41:40
thinking about your diabetes. And believe me, if there were there, there was an overlap, right? So you were diabetic, while you were learning how to manage bulimia. So you were purging while you were using insulin? Is that correct?

Unknown Speaker 42:02
Yes. Okay.

Scott Benner 42:04
How do you do that?

Anonymous Speaker 42:09
It was fun. It was great. Because it a, you see the the physical effects after purging became so obvious because it drops your blood sugar very quickly, soon afterwards. And that I would have to catch it. So it would be, let's say with juice, but maybe didn't work. Or maybe when I go when my culture goes, Well, I become starving so that I will eat again. And then I would purge again. And it would just be there would be nights of just a cycle of binging and purging. I'm

Scott Benner 42:41
going to leave because of the butcher. Let's go step by step. Where you like Pre-Bolus sing meals for you bolusing when you ate like, how are you? Where was that?

Anonymous Speaker 42:53
So it depends what the intention of the meal was. Because sometimes if if it was supposed to be a normal meal was supposed to be dinner, and then yeah, that would be a Pre-Bolus or a normal amount of Bolus. Um, and then it just and then as I ate, um, it depends also what state I was in, it was just a normal meal, then I would just add more insulin. But if it was, okay, this is becoming a purge, I would, um, at that point, I was on MDI, so. And if it wasn't what I was reading on the insulin pump, then I would start like camping the bazel, because I knew what was coming.

Scott Benner 43:31
So some meals, so some meals weren't gonna end up with the purge. No, okay. But it and if it happened, you wouldn't necessarily know before it happened, you don't look at the food and you wouldn't look at the food and say, I'm going to eat this, then I'm going to throw it up. Or it might be your intention was I'm going to, I'm going to keep it. And so at some point, the I'm going to call it a decision, but I guarantee that's not the right word for it, a decision is made that you're going to purge. Now you're cognizant that I'm going to do this, but I have all this insulin going. So I'll drink juice, you didn't think of juice the same way as you thought of food? Or was the idea of keeping yourself alive because of the insulin more powerful than the feeling that you needed to purge?

Anonymous Speaker 44:19
That's exactly what it was, um, where you know, because also, a low blood sugar is a very obvious in your face. Issue, you know, where I was able to face head on, but when doctors or people would tell me, you know, in years from now, you're going to tear your esophagus. You know, that doesn't matter to me in the moment, you know, all I see now is, is I have this Twitter, my body that I have to get out and I would have a whole bunch of girls on my treat that I'm not thinking about. Yeah, but if you just didn't purge, you wouldn't have the cycle.

Scott Benner 44:54
Gotcha. But like if I put you on some train tracks and tied you down and said hey, you have enough time to either Untie yourself or purge that cheeseburger you just ate, you would untie yourself and get off the train tracks. Now, yes. Now you're like, well, now I would. Wow. Okay, what else do I need? What else do I need to understand about bulimia that's untreated? And type one, like, what are people who are living through these two things now? What are they dealing with?

Anonymous Speaker 45:32
So I think it all starts from how the person is educated. Because when calling correctly teaching someone how to be a good diabetic is like teaching them how to have eating disorder. If you don't have a healthy mindset around food, it becomes a chore. I remember when I first started listening to the podcast and hearing how you talk about what's art in about how she could eat whatever she wants. And you know, we'll just Polish correctly, it was Mind blown to me, I never thought that that was possible. I separately correlated my worth to my blood sugar and to the food I was eating. And, and for someone struggling with it is to understand that obviously, your self esteem comes from doing action and taking action. But just to be able to give yourself acceptance that, um, that you're still a good person, even if your blood sugar's a little bit haywire.

Scott Benner 46:34
Do you recognize that? Oh, well, let me start by saying, I recognize that what you're saying is true. Do you recognize that for people who don't have an eating disorder, anxiety or depression that these thoughts are? very infrequently enter their mind? Like, do you know that that's not my life, for instance, that I don't derive self worth from? Like, you know, what you were just talking about? Or I'm like, do you know that you you think differently?

Anonymous Speaker 47:07
Yeah. So it's funny. Um, I would?

At one point, no, because I'm a felt like, this is the normal thought process. It doesn't like, it doesn't matter to me, if someone else's is thinking differently. I mean, I'm

Scott Benner 47:32
not that I, what I was wondering was that, like, like, there, let's maybe blow it up a little bit here, like their artistic minds, and there are maybe more mathematical minds, right. And that, you know, a person who's maybe a tiny bit OCD, who's really good at math goes for a ride on a country road with horses on the side of the road doesn't see the trees doesn't see the horses, just the road in front of them. while I'm driving along, thinking like, it's a lovely landscape. And, you know, like, like, isn't it interesting how the cows seem to cross the water right there and like, like, and the know, and other people don't see that. And it first struck me when, during the self harm episode, when she was talking about these things that were just so true to her. And I realized, like, I've never had that thought in my entire life. Like, I've never considered that once. It's never impacted me at all. And you're, I'm having the same thought talking to you like, there are things that impact you really significantly. And I'm not saying that, you know, you should not let them impact you. I'm not talking like that. I'm saying that there's some way you're wired, that I'm not wired. And you know, and vice versa, too. And let me give you an example of that. I am not a trim lean person, okay. And I've never really been my entire life. And I don't care. Like and so like, I want to be healthy, and I want to live forever. But I don't think of myself, visually, like I don't think oh, I shouldn't do this or wear that. Or people will think that I'm this or that. I don't know that. Like I'm aware that people probably look at me and think I wonder why Scott doesn't knock 20 pounds off. But I don't care. And I'm not. I'm not concerned with it. Like I don't tie him who I am at all to how I look. And trust me, I probably need about 5% of that from you. Like if you could lend it to me that would probably be good for me because it would be better for my health. Just to say five

Anonymous Speaker 49:42
or something.

Scott Benner 49:45
I could send some back to you. I think it would help too. And the one thing I haven't asked you yet that I keep wondering to myself while we're talking like do I get through this without asking this but I really want to add context to it. If you're okay with it. When you You're 14 and this starts. Were you overweight?

Anonymous Speaker 50:04
No. Okay. Can you I was I was

not underweight. But I'm towards

the lower end of a normal weight.

Scott Benner 50:16
Okay. And so even now, how tall are you now? I'm 5656. Would you tell me what you weigh right now?

Anonymous Speaker 50:25
I don't know. But it's part of it. I will weigh yourself, right? Yeah, yeah. No, I don't. But I would. It's a pretty large bracket, but I would say between 140 and 160, maybe.

Scott Benner 50:40
Okay. And are you happy with? Do you even think about how you look now? Like, how do you handle that? Like, are you like, I'm, I look great like this, or I'm comfortable like this? Do you think of it as health? Like, how do you think of your body now.

Anonymous Speaker 50:53
So, um, now I acknowledge that this is not my ideal body type. But I, I am in the process of not equating my work to that, where I'm able to, I'm able to still get dressed and feel good about myself with still knowing that, you know, I'm not, I'm not exactly where I want to be, but I still like myself. And that's okay, you know. So, it's not as debilitating as it once was, you know, there was a time where I really want to go out I wouldn't, I wasn't able to go to school, because I couldn't bear people see my body. And I'm so thankful It's not like that anymore. But, um, that's, that's exactly what I'm a person with eating disorders isn't. doesn't think like, you know, you that you're able to acknowledge, like, you were saying, like, Yeah, I would like to lose a couple pounds, but it's fine. You know, I'm still me. Right. But someone with eating disorder equates it. It's your personality, you know?

Scott Benner 51:56
Gotcha. Do you? Um, can I ask you? Are you in a relationship? No. Okay. Have you? Is that something you want?

Anonymous Speaker 52:06
Um, well, everyone listening me up, but not currently.

Scott Benner 52:12
Like, I don't know if I need a relationship. But you could still, you know, maybe we could hook up for a second I I not looking for you to be involved.

Anonymous Speaker 52:23
Sorry, mom and dad, when you listen to this, but

Scott Benner 52:26
like, I'm not looking for somebody to be involved in my day to day decisions or anything like that, but a little bit, that'd be okay. Is that what you're saying?

Anonymous Speaker 52:36
No, Mom and Dad listen.

Unknown Speaker 52:39
Um,

Anonymous Speaker 52:41
so, I

Okay, so this also really deeply ties into eating disorder. Because when I'm, when my friends were, you know, having relationships, um, I couldn't fear someone looking at me. So, um, and I couldn't, and I knew I was incapable of loving someone else until I love myself. And, um, and now, I'm, I'm really working towards that, you know, like I said earlier, it's a, it's a, it's a partnership, where I have to work on my own self esteem, and my partner will have to be sensitive to that. And I see myself on like, an upward trajectory where I could see myself, you know, being in a healthy relationship, because I have enough self esteem for it. But it's not one of my priorities currently.

Scott Benner 53:41
Cool. Well, I'm glad to hear that you can see it happening is believe me more male or female disorder? Is there not? Is it I'm looking right now? Because I'm interested.

Anonymous Speaker 53:53
That's a good question. I don't know. Let's see what what does it say? What does Google say

Scott Benner 53:57
Lamia affects one to one and a half percent of females nurse attend to one ratio of females to male suffering. Yeah. Because you know, it's funny, I know you're younger, but we're talking about this and us to be on so I'm gonna keep going with my line of thought here. It what I'm picturing is is that like to be intimate with somebody, if your clothes came off, you would back then for certain not be able to handle them looking at you, no matter what your body style was in that moment. Is that right? Correct. Okay, and what I was thinking when you said that was you should try being a boy because it really nobody, I don't really think about anything when that's going on. I'm like, oh, sex, and the rest of it sort of flies out the window. I wonder what it is that um, it just occurred to me that, that maybe there was a weird delineation between this being male to female. And I get that like, I mean, I mean, I don't get it from a female perspective, but I feel like I can understand at least you know, academically what that must be like.

Anonymous Speaker 54:59
Yeah. Just the same thing and the other half a dark episode about sex and diabetes, where I'm about feeling insecure about insulin pump or glucose monitor. And if and just like how some people might feel like that is a flaw, I feel like my body is the flaw. So, yeah. Okay,

Scott Benner 55:18
but at this point today, is it fair to say you don't feel like that? Or you don't feel like that sometimes? Or where are you at right now?

Anonymous Speaker 55:29
Um, I feel better about it. Um, and it's, I acknowledge that's not what it once was. And I acknowledged that I could feel good in the body type that I'm currently in now. But it's still hard. It's still not, you know, because like, currently the stage of recovery that I'm in, I'm medically okay, but I'm still working through the, the mindset of it. And that will take a little more time.

Scott Benner 56:01
You medicated it off for you. I started to ask about depression anxiety earlier, we didn't really go completely into it. Are you taking any medications?

Anonymous Speaker 56:09
Yeah, I'm currently on Prozac.

Scott Benner 56:12
Prozac? Is that helpful?

Anonymous Speaker 56:15
Yeah, so it's just

Unknown Speaker 56:21
a

Anonymous Speaker 56:25
medication doesn't work. Unless you have the motivation to work on yourself all it does, at least the type of medication and I'm on an SSRI just helps give me more energy to deal with my emotions, but it doesn't get rid of the emotions. So um, so it's not it's not. It's not supposed to be long term. I mean, I've been on it for four. I started the journey on medications around two years ago. And I see where I'm where I am right now. I'm budbreak comfortable being on medication. I don't mind it. I do see myself in the future, eventually weighing myself off of it.

Scott Benner 57:08
Have you gone through all of them? Have you tried like Lexapro? stalybridge.

Anonymous Speaker 57:11
Nah, I only I only I tried Zoloft.

Scott Benner 57:16
So your teacher just says I'm a Prozac kind of girl. Yeah. Listen, the idea is to find one that works. Right. So, um, and I really don't mean to push you, but was there a trauma back then that started all this off? Like, can you put your thumb on what happened? Or no? Where do you not want to tell me either any answers fine.

Unknown Speaker 57:41
So

Anonymous Speaker 57:42
this was also a really huge thing for me was that, um, most people have an major external trauma that affects their internal for me, it was really it was all internal it was, it was the way that I perceived the world, and how and how I reacted to it. Like, growing up, you know, I had fantastic family and fantastic parents, but, you know, no person is perfect. And, and, and, from certain actions that may have not been perceived by everyone else as as, as wrong to me, made me feel like, I didn't belong and I wasn't loved. So my mind definitely equated that to my weight. Gotcha. And it was the same with my social life where any kind of have a an issue. You know, I always again, I was always an extroverted kid, I had friends, but but when I lost a friend, it felt like it was directly correlated to my body. So the truth is, there wasn't a major trauma, which is I hope some people would find comfort in that because I have a hard time. It's almost, it's, it's a little bit ridiculous, but I'm almost embarrassed to admit that because thank God, I don't have trauma. But

it kind of feels like why did you have an eating disorder?

Scott Benner 59:16
Does the Um, excuse me for a second? Sorry, does the onset of the bulimia in the 14 did it all correlate with when you began to get your period?

Anonymous Speaker 59:30
No, I was. I don't care too much later. I was. Wait. 15

Scott Benner 59:37
Okay. Just there's there's some disorders that that happen. Sort of when all of the hormones come in? Yeah. Yeah. I wasn't sure if it was a if that was, you know, I wasn't gonna I wasn't looking for like, oh, on the day I got my period. I suddenly I wasn't I didn't mean like that. I just meant like, was it close, but it sounds like it wasn't Okay. This is more important than normal. Is there anything we didn't talk about then? That we should have? Because I really did not know how to ask questions while you were talking. I feel like I didn't okay. But I also feel like,

Anonymous Speaker 1:00:14
Yeah, you did a great job, and I hope I did, too. Um, what was your goal? Yes. Yeah, that's what I was gonna say like, why I wanted to come on. I always heard of Dibley, Mia, you know, like restricting insulin to lose weight. But I never heard of someone like me that struggle with eating disorder prior to the diagnosis that led to it feeling like, everything was my fault, both the eating disorder and both the diabetes, and and I wanted someone maybe out there who may feel the same way to realize that it's okay. And it's and that's not true. And and, you know, everyone has their own story. So, what's your mind?

Scott Benner 1:01:06
Well, I think that well, thank you. First of all, that's excellent. I think that there are obviously a number of things that can go on in a person's life, that sometimes are easier to ignore, then to address. It feels easier. The truth is that doing something's no harder than not doing it, it's actually probably easier to do it than it is to not do it. How convoluted I just made that sound. But you're shooting something constantly anyway, right? You're always doing something, do the thing that will help you. Right, you know, so if you're feeling the way we as described, the first step is what do you think? Is it general practitioner just Hey, I feel depressed, I feel anxious. I haven't either. I think I might have an eating disorder. Like, is it just telling somebody is that the first step?

Anonymous Speaker 1:01:59
I think the first step is to have some sort of support. Um, I know, there's so many horror stories of people who ask medical professionals for help, and they're told the same thing that I was told when my parents that I was, I wasn't sick enough. Um, but the reason why that, even though that did hugely impact my eating disorder, it didn't send me into a spiral. Because, you know, I had a good friend group, you know, um, and I had a friend I could talk to. So, the weather, if, if someone feels like they're, they're able to face that on their own, you know, reaching out to a medical professional. Um, that, of course, would be the first choice. But, and obviously, this is very hard for someone dealing with this because as isolating B, you're very insecure. So you might not feel like you have a support group. But the reality is, you probably do, and there are people who love you, whether it's your family or your friends, so to know that going into whatever treatment you're going into, I think, makes all the difference.

Scott Benner 1:03:03
Okay, thank you. Um, what do you think? The future like short term is for you? Are you in college?

Unknown Speaker 1:03:16
All right, yes.

Scott Benner 1:03:17
Well, nobody's in college right now. But are you in your bedroom getting an education and paying a lot of money for?

Anonymous Speaker 1:03:25
Exactly, um, yeah, I'm actually I want to go into nursing specifically endocrinology. Because it feels like a field that I can make a difference and a field that I relate to. Um Yeah, cuz I want to do the education properly, you know, because like I said earlier, you don't want to treat um, they want you don't want to tell a diabetic how to having disorder.

Scott Benner 1:03:53
So you're so you're in college now your goal is to be a nurse and and hopefully help people with different endocrine issues probably specifically type one. That's lovely. What about your health? Like, how do you like like, I'll give you like, here's an example of my question. I started eating on a What do they call it intermittent fasting kind of schedule recently, which has been really helpful for me so during the pandemic, I lost 11 pounds on purpose right yeah, you're probably the it's weird probably that I'm telling you so but but

Unknown Speaker 1:04:29
by the way, well for you it's great.

Scott Benner 1:04:31
Is this not the most fun conversation about believe me it probably has ever been recorded? Seriously, but But anyway, just went through it intermittent fasting thing, I don't eat before noon, and they don't eat after eight. And in other than that, I'm just eating. I mean, I don't want to say like whatever I want, like I'm conscious to go, you know, not eating like a gallon of ice cream or something like that. But I'm eating pretty normally, in that in that other space. I feel first thought of doing it because of a type two I spoke to who told me how well they were managing their type two diabetes with intermittent fasting, which was really exciting. They were able to cut back on their medications and things like that. And the person told me they had lost weight. I thought, Oh, you know, I'd like to lose weight. Let me try that. And so what? The only thing I tell myself in the beginning, was I just made it very specific, not before noon, not after eat. And to the point where if I got hungry at like, 755, I was like, Well, you've got five minutes to eat something you don't mean like, like, I just, that's what I stayed. And it's, it's, it gave me like some rules that are worth helping me. And I'm wondering, what the rules are you have? Or is it not about that is like, what have you learned in therapy? Is it about just don't restrict yourself? Or is it about healthy rules? Or how do you manage going forward now from here, and where? Where is that you're going? Exactly?

Anonymous Speaker 1:06:07
Yeah, that's a great question. Um, Chad's my therapist, she's the best one we are without her literally. And what I learned with her was, that it's a two piece thing, because there is because even though this is an internal disorder, all the manifestations are external. So there is physical rules that I do have for myself, you know, like, I try to practice intuitive eating, and, and I do what makes me feel comfortable. And, and that also goes in hand with diabetes, because they're, you know, I have to be cognizant, cognizant of the amount of food I'm eating, you know, which is not, you know, you don't tell someone who is someone who's in in treatment and patient, you know, they're not allowed to weigh their food. And I was doing that for the longest time when I was carb counting. So. So now.

Unknown Speaker 1:07:09
Sorry, I lost my train of thought,

Scott Benner 1:07:10
you know, you see, see, you're not allowed to weigh your food because of your treatment. But that's how you were managing your carb counting.

Anonymous Speaker 1:07:16
Yes. So it was a fun duality. But so yes, there is a physical piece. But it's mostly it's mostly internal. Where,

where

Unknown Speaker 1:07:32
I

Anonymous Speaker 1:07:37
had like, hearing you talk about the way that that, you know, you started this intermittent fasting, it was really obvious that you didn't correlate your self worth to your body. And that is my goal. Now, I'm where, back to what I was saying before, how I'm able to look myself and and like, where I'm at, but still acknowledged, I still want to lose the weight. Does that answer your question?

Yeah, it does. I kind of lost my train of thought.

Scott Benner 1:08:08
No, it's it's a long process. And by not, so you're just taking small steps in the right direction, not looking for giant leaps, just continue to do what's best for you. And your physical self should come along as that goes, which is really what I found with this is that I just did what I was supposed to do when without being focused on the physical stuff, the you know, the outwardly physical stuff that just kind of came along for me. So, you know, you just do the right things in the right things happen. Yeah, yeah. No, I hear you that that I, you know, I have to be honest with you. I think that's how I live in general. I don't think that's a bad way to conduct yourself. You know, it's not always about mine mind mind, get more for me, as much as it is, you know, if I do the right thing, sometimes I'm going to benefit from that. Sometimes I won't, but at least I'm always putting the right thing out. And I think that ends up generally speaking, paying you back, so it's a great idea. Good for you. Hmm. Well, congratulations on you know, persevering through telling your parents and then being like, come on, you know, and and that couldn't have been easy. And to stick with it. And now you've got you know, everybody supporting you well, and you're and you're, you're doing the right things that it's, you know, it's really to be applauded, just just doing the right things is, is not always easy.

Anonymous Speaker 1:09:40
Thank you. And I just wanted to put just a final disclaimer out there for anyone listening that struggling with this or something similar, that it's so easy to start comparing yourself but to realize that every experience is different, like I know that I listed a lot of examples, but no one should feel that they're quote unquote, not doing your right or doing a wrong based on my own experience that with any sort of stutter or struggle, you know, everyone has their own experience. So I'm hope no one was triggered.

Scott Benner 1:10:11
So the treatment, the treatment itself is, is going to be wildly different depending on you, depending on the person. Right, huh, that's, it's interesting. You know, we're done. But I'm gonna keep talking for a second, the idea of being triggered is, in my mind, and it is a more to newer idea, like the idea that I might say something or see something or do something or hear something that puts me down a path that of just other people would have known not to say, you know, what, what's the, like, my question to you is, there's a question around that idea of being triggered. How do you hold people accountable for that? Or is that on you? Like, do you mean like, if I'm an idiot, and I look at a person, I'm like, Oh, well, you shouldn't be wearing that shirt. Obviously, I'm an ass. If I say that, but is it? Like, can you really give me that kind of power? like to do you don't mean? Like, it's a weird? Yeah, no, 100%?

Anonymous Speaker 1:11:15
No, no, um, it's, that's, that's exactly it. Where I'm, it doesn't matter what anyone tells me. It matters how I react to it. You know, obviously, it would be nice if people shoot each other well, and don't say dumb things. But if they do, it doesn't, it's irrelevant. what they said. It's really how I reacted like, like how I was saying earlier, people said the most non triggering things that shouldn't be triggered, but worth it didn't matter what they said it was up to me of how I reacted to it.

Scott Benner 1:11:53
So you were like, a live nerve to you were just anything could have made you feel?

Anonymous Speaker 1:11:57
Yeah, worse.

Yeah. Because no one should go go around the lie about their life walking on eggshells, you know, I don't want that was a huge thing with me and my relationships in my life, Where, where, you know, you want people to treat you normal, but they're not your normal if every time they say something, you burst out crying. So, um, so yeah, it's really up to you and how you respond.

Scott Benner 1:12:20
Okay. Yeah, I just I didn't understand cuz I'm old. And, like, you know, I grew up in a time where if somebody said something, and you let it impact you, that was your fault. And at the same time, it is not lost on me that people who you know, profess to, like, I speak the truth, my head, no one's looking for your truth. Just shut up. You don't mean? Like, it's that idea of, like, we all know somebody who runs around just being everybody, and then they like, I'm just telling you how it is. I'm like, no, it's, you know, you're just an angry old, you know, well, I guess I'm thinking of one person in particular. But, um, but you know, that person who believes themselves to be a truth teller really isn't they're just, they're hurting and they're trying to hurt other people. It's fairly obvious, right? You know, unless you're a comedian. By the way, if you're a professional comedian, you're making your money that way, then okay. Making fun is the way to go. But it's just you with four people at a family function. Maybe keep it to yourself, if you don't like my shoes. I guess this one, I'm

Anonymous Speaker 1:13:21
not getting paid to me enough.

Scott Benner 1:13:23
Yeah. Right. If you are then right on, and then I'm paying, like, then then it's then All's fair. You know? Yeah. Okay. This was good. Like, I feel dizzy from this, but it was good. Yeah, so no, it's not you. It's just that, you know, what started out is like a podcast where I'm just like, let me just tell people how we managed my daughter. And then suddenly, you know, one day somebody was like, Can you touch on this topic? And then I started thinking about, like, well, maybe I could expand here, maybe this isn't servicing this person. You know, I've had a lot of conversations and learned about a lot of things that I didn't expect to know about. And it's always been really helpful to me. And it's nice to hear, you know, how you see the world and how the world impacts you. And I think it's great for other people to hear it too. I just didn't expect that it was going to come from my, my diabetes podcast, of all things that I'm starting to feel like the podcast is, you know, has grown somehow in scope. And so I appreciate you. Yes.

Anonymous Speaker 1:14:25
Yeah. So yeah, and thank you for pointing it out. I mean,

Scott Benner 1:14:29
no, that's not what I was doing. But I appreciate that. So are you using the podcast? Like, like, like, have you like been through the pro tips? Like, does it help you day to day, diabetes?

Anonymous Speaker 1:14:40
Yeah, so um, when I began really managing my diabetes, you know, not just trying stay alive, but actually trying to, you know, deal with it. Um, I'm not sure how I stumbled upon the podcast, but um, I think the first episode that I listen to attract mix of the word title. So I wonder where my house is gonna be?

Scott Benner 1:15:05
What was the title? Tell me? Do you remember?

Anonymous Speaker 1:15:08
It was the wheat episode I think, Oh,

Scott Benner 1:15:09
I see are

Anonymous Speaker 1:15:10
you know, again mom and dad is listening.

Scott Benner 1:15:16
Okay, so hold on let's talk around this for half a second and then we'll get back to your thought maybe we're not done. You like the idea of weed? Or you smoking you don't want your parents to know, or I guess there's no way to answer that but like, but the title Got you. So

Anonymous Speaker 1:15:34
it just it would just sound interesting. I don't know, I think I mean, I remember distinctly that being the episode that made me come to listen to the podcast. I'm not sure if it was the first episode I listen to. Um, but um, it just sounded different. You know? Um, no one really spoke about that. So I'm Mom and Dad, I'm sober. Good, I'm fine. Your parents right

Scott Benner 1:15:56
now are listening this and thinking God, I hope she never finds our weed. Yeah.

Unknown Speaker 1:16:04
So

Scott Benner 1:16:06
I didn't mean to put that ahead. I'm sure your parents aren't always. Like, are my parents smoking? I'm not alone. I'm teasing. I'm sure they're not.

Anonymous Speaker 1:16:18
They do go on. They do go on a lot of walks together. So

Scott Benner 1:16:23
I got you probably just in the basement, just walk down stairs, going out, they probably do like a step by step thing at the back door and close the door and then just slide right downstairs. Um,

Anonymous Speaker 1:16:34
but I was just remembering what the original question was. How? Yeah, so once I start listening to the podcast, I just lose your ego. It completely changed my management, the first at first when I started listening, I was listening for like, I guess the other people hearing the stories and every time I would hear you say something radical, I would just think that's so stupid.

Like, like, That's ridiculous. He is

he you know, he's I live with this. But once you put, you know, your ego aside and actually listen to what you're saying. I completely changed my management. And.

Unknown Speaker 1:17:15
And,

Anonymous Speaker 1:17:17
you know, there was probably about a year ago that I started listening to the podcast, and I really feel like I'm a different person now both in recovery, both as a diabetic and just as a Christian as a whole. So,

Scott Benner 1:17:29
Leah, were you hate listening to me at first? You know, I know please, you'd be like the thousandth person to say yes to that. So I

Anonymous Speaker 1:17:43
there were things that I that I like, like I wasn't, I wasn't continuing to listen, just the heat on it. But there were lots of times that I would just get mad and but

Unknown Speaker 1:17:54
yeah, well no to be

Scott Benner 1:17:56
to be serious. And I've heard it now from enough people to put context around it. And I understand it's, it's first of all, you're listening to a person who doesn't have diabetes tell you how to manage insulin, which has got to be strange. Like I I've never really fully immersed myself in that thought, but it's just got to be weird. And, and it can be angering, and especially when I start talking about like, you don't understand, just do this, and it'll work. And you're just like, No, I've been doing this for years, and it doesn't work in your name. Please stop talking. And you know, but there's got to be a little part of you that's like, well, what if it does work? Like I really would like to have that experience, you know? Yeah, okay. Yeah.

Anonymous Speaker 1:18:34
maturity, I'm just putting that passed me, you know, just because you're not someone who has who understands it, and you're giving good advice. So

Scott Benner 1:18:46
Leah, nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, please always consult a physician before making any changes to your health care plan, or becoming bold with insulin because I don't give advice here. I'm just telling people what I do and they can do whatever they want. I hear what you say no, and I appreciate that. Don't get all serious on me. I was half kidding there. But, but no, I really, I'm glad for you because especially your age. You know, you are very it's interesting, you are very mature. I don't know if you like that about yourself or not. But you know, it's it's obvious like talking to you like your your thought process is of, of an age that's I would say greater than 19. And to be able at 19 to hear stuff that doesn't sound like what you're doing that makes you feel like a you know, he doesn't know like Shut up. Like that kind of feeling. And to to to be thoughtful enough to listen anyway. That's really great. Like you're doing a lot of good things for yourself. So good for you. Congratulations. You're welcome. Now I'm it's really, it's impressive. It really is. What do you think the rest of your day is gonna look like? Because I'm going to do laundry and Then I'm gonna put a podcast episode up

Anonymous Speaker 1:20:03
that sounds thrilling. Yeah,

Scott Benner 1:20:05
I'm I'm gonna cook dinner and then afterwards to your parents are off getting loaded somewhere so they're having a great time.

Anonymous Speaker 1:20:12
Yeah, their days definitely better than mine. So no, my days been pretty good so far. So

Scott Benner 1:20:17
now they're on your phone right now looking for dating apps trying to make sure you're not unlike, you know, Tinder or something like that. But But seriously, do you Is there anything you're trying to say to the people listening right now? Give a zip code or anything like that. Anyway, yeah, well out of respect your parents the I don't know what this episode is gonna be called. But it won't be knocking around late just for certain.

Anonymous Speaker 1:20:54
They'll appreciate that. Oh,

Scott Benner 1:20:55
of course. Let me say thank you again and goodbye.

Hey, a huge thanks to Leah for coming on the show and sharing so honestly, and, and being so brave. Thanks also to the Contour Next One blood glucose meter and touched by type one for sponsoring this episode. You can go to touch to buy type one.org or Contour Next one.com. forward slash juice box to learn more. There are also links in your show notes, and at Juicebox podcast.com. To these and all the sponsors. Hey, if you're listening online, could you consider getting that podcast out for me and subscribing? That would be helpful. I would like that. Plus, it's super simple to listen that way and absolutely free. Hope you enjoyed the podcast today. And if you did, and are looking for more of the after dark series, you're looking for Episode 274 about drinking 283 about weed 305 about trauma and addiction 319 sex with Type One Diabetes from a female perspective. Episode 336. about depression and self harm 365 is sex with Type One Diabetes from a male perspective on episode 372, divorce and co parenting Episode 384. Bipolar disorder. If you think you'd be a good person to be on a feature after dark episode, send me a note at Scott at Juicebox podcast.com. Thanks so much for listening. Hey, thanks for the great ratings and reviews that I've gotten recently on Apple podcasts. It's great to see you guys all coming into the private Facebook group. That's been really exciting. There's a link in the show notes to that. I think we're up to about 6500 people in there now. great conversations. And what else? I think that's it. I really appreciate you listening. I'll be back very soon with another episode.

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#392 Advice for T1 parents from T1 adults

Adults living with type 1 diabetes share their thoughts with type 1 parents.

From the Juicebox Podcast private Facebook group

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio -  Radio Public, Amazon Alexa or their favorite podcast app.

+ Click for EPISODE TRANSCRIPT

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends, welcome to Episode 392 of the Juicebox Podcast Today Show will be brief, but full of great information. Let me explain while we play some music.

This is going to come to a surprise to an but an posted on the private Facebook group a simple question. She said to the T one DS in the group. What advice would you give to us parents? Like what things did your parents do? Well, and what do you wish they did differently? And I thought, this has got a chance to be a good post.

Unknown Speaker 0:48
And I'll be damned if it wasn't

Scott Benner 0:49
so good. In fact, I'm gonna read everyone's answers to you. I love that the podcast attracts as many adults living with type one as it does parents of children. It might really honestly be the only place with such a great blend. And I love how they help each other. The private Facebook group, by the way, if you're interested is called Juicebox Podcast type one diabetes, there's a couple of quick questions that you answer to, you know, prove that you're a human being. And then you're right in and talking with well over 6000 people, just like Anne, and the people who answered these questions.

Before we get started, I'd like to remind you about the T one D exchange. You can be heard and support the Type One Diabetes community while you help drive research that really matters for people living with type one. The T one D exchange registry is a research study designed to harness the power of individuals with Type One Diabetes. This is a nonprofit research organization that is dedicated to accelerating therapies improving care for people living with Type One Diabetes. they translate real world experiences into real world solutions that make your life easier. The registry is a research study designed to gather real world evidence firsthand, easily and quickly. The questionnaire that you'll fill out can be done on your mobile device from the comfort of your home. And since Type One Diabetes is a chronic condition that people live with their entire lives, participants can complete the questionnaire annually to help researchers understand surviving and living with type one, this is an amazing thing you can do it is 100% HIPAA compliant, absolutely anonymous. And when you join the registry besides doing all of those things I've just listed, you end up supporting the podcast. So if you've ever wanted to support this podcast without actually spending money, this is a great way to do it and feel good about what you've done. I joined the registry. As the parent of a child with type one by the way, you have to be a US resident either have type one diabetes, or be the parent or guardian of a child. I don't think it took me seven minutes to finish. It was really simple to do. T one d exchange.org. forward slash juicebox. In just a few months, over 400 listeners of this podcast have added their voice to the T one D registry. I believe that what the T one D exchange is doing is valuable and heartfelt. And I'm genuinely proud to be telling you about it. I hope you can add your voice to the others.

Let's get to this post, shall we? Please remember while you're listening that nothing you hear on the Juicebox Podcast should be considered advice medical or otherwise please always consult a physician before making changes to your health care plan. We're becoming bold with insulin. Now back to Ann and her question to the T one DS in this group. What advice would you give to us parents? Like what things did your parents do well, and what do you wish

Unknown Speaker 4:11
they did differently?

Scott Benner 4:15
Okay, the first should do these invoices but that would be terrible. Wouldn't it if I was like amber said that wouldn't be good at all. Can you imagine if I thought to do that. Amber made a list she said at times it will seem like you have it all figured out. But other times you will feel like a failure. Don't beat yourself up long battle. She also suggest to take your supplies out of the boxes that they come in and you know find some sort of a kit or a place to put them so you're not digging through you know cardboard all the time. She says to get a little cooler bag for travel. Amber also said that Adam and Eve juicy juice has 4.23 ounces of juice in a box. Amber that's Arden's juice box as well. She uses the ones with Sesame Street characters on them. Those are her she has two favorite flavors in there. And you're right. They are terrific for not causing a rebound. Hi. Rachel said, my parents gave me a lot of independence. It was very helpful for our relationship and my self management. I was diagnosed in the early 2000s when I was five, so texting wasn't a thing back then. And I had to be a bit more independent. Always speaking positively is so important. Like saying, quote, you did so well yesterday. How did you bolos for that? Is it productive and affirming statement, I wanted to please with my blood sugars. I always thought of them as grades. She says to try to find a way to take that pressure from your children. And just think of the blood sugars as numbers, and that they have nothing to do with your child's worth or value. Also let them know that they're total badasses. It wasn't until much later that Rachel realized the incredible stress that her parents were under. While they learn to take care of her and type one diabetes. Nancy said that she's the parent of a 20 year old that was diagnosed at 19. She's found that asking things like why are you low? or Why are you Hi, is something she tries not to do? Instead, she asks, If she's okay. Often then her daughter would tell her what caused what was happening. And then she'd help her to fix it. Her daughter manages very well now she says, but in the beginning, she didn't want to think about it. And so Nancy did most of it. Never tell them they can have something to eat. I completely agree with Nancy. However, she always tried to prepare foods that were easy on her daughter that didn't spike her blood sugar's too much. And she kind of did it without her daughter knowing. And she says don't fuss when things go crazy. Just offer to help. Now even though Nancy's not an adult who's living with Type One Diabetes. I thought her comment was wonderful. And so I put it here. Thank you very much, Nancy. Amy says let them be kids, let them make mistakes so they can learn from them don't make everything about diabetes. When they get home from school, your first question should be how was your day? Not how are your blood sugar's let them choose their level of independence, and what they're comfortable with, don't force them to do everything on their own, because they will have the rest of their life to do it without your help. Amy, again, I am in complete agreeance with what you said there. I used to see art and come in the door. And I was overwhelmed. Wondering what our blood sugar was, like, Is she okay, you know, this is before dexcom share and I couldn't see it. And I just realized one day that I was seeing my daughter as diabetes instead of herself. And I made a conscious effort to change that. Lisa was diagnosed at age 10. And now it's 33 years later, she's married. for 20 years. She has three wonderfully healthy babies. And anyone seen the high fives the low sixes and all Lisa wanted to tell you was to let them dream of the future about college and weddings and kids. Don't just think that diabetes means that none of those things are going to happen. They can absolutely have any of those dreams. Thank you. Lisa Meghna was diagnosed in March of 2000 when she was about 16 years old. Take the emotion out of treating diabetes and put your love and emotion into taking care of the kids. Because diabetes is a disease. blood sugars are data. She says when your car needs gas, the tank you just fill it up. We need new spark plugs. You just put them in, but we don't get angry about it. being mad at diabetes won't help. You have to accept that this is where you're at now as parents for your kids best life. The best thing her parents did. Never let her feel sorry for herself and never let anyone else feel sorry for her either.

She wasn't coddled, no one made excuses for she says to get involved in care from day one. Even her 10 year old son knows how to check her blood sugar she says you see what Megan saying? She She wants your children to know how to take care of themselves. Meghan goes on to say please don't settle for good enough. You're still the parent and you can still empower a team to take care of themselves while pulling back the reins when needed. No different than homework or anything else. Caitlin shares that she thinks her parents were actually scared. But it would come out as anger when her blood sugar was high. They didn't offer a lot of help, but would yell at her when her blood sugar's were high. And she remembers being afraid. She says that she actively hid her blood sugar's to keep these things from happening. So she wants you to remember that while highs are not good. You can help. And being angry is not the way that started a conversation between a lot of different people. My dad was classic for this to someone else says, I think this is very common fear coming across as anger to kids and teens, it definitely doesn't help. But I'm not sure how to prevent this as a parent. Caitlin jumps back in and says, I think by naming it and saying things like, this is scary for me because I care about you. Let's focus on getting it down. And then maybe we can talk about what happened and how to prevent it next time. She said she's not talking about parents just feeling a little anxious, she's referring to being yelled at sworn at and blamed. And then not giving any suggestions for what to do or how to prevent it. Someone says they paid their kids to stay in range. It's funny. Now people are just agreeing, I'm gonna pay my kids this is the guys are adorable in here. Hold on. Someone then says they see a problem with paying their kids to stay in range. Laura comes back and speaks directly to Caitlin saying you should never have had to endure that. With all the other weights you had to bear deserve to be held, maybe cried over protected, valued and affirmed. You did not ask for this disease. after all. I so hope that things are better between you and your parents now. We all blow at his parents sometimes. And they definitely did for this one hugs and prayers. This, by the way, is a great Facebook page. You really should get into it if you're not. Marta says they never made a big deal of diabetes, they were never afraid of insulin. And her endo was the same. She said that was the good part, the bad part. They gave her too much freedom when taking care of her diabetes. She said as a team, she needed a system of checks and balances. And I have to echo this as well. I've now interviewed well over 400 people and many if not all of the type ones that I know who did not have good support from their parents, his children regret it and are sometimes suffering because of it as adults. Jeff says that at some point, you're going to need to hand over responsibility to your kid. But he doesn't know what that age is. But he thinks it's before 18 they should know how to bowls for their meals and adapt bazel settings. Jeff has had type one for 22 years. And he feels that knowledge is invaluable. Steffi comes in and says that she wants to add that she thinks children give hints to when they're ready. She said when she was seven, she decided to take care of herself. She had already learned everything she needs to know from being involved right from the start at her diagnosis. In 1983. At four years old, her parents still stayed involved. And Jeff remarks that you don't just dump it on them, you build them up to it, which is my plan. I'm just slowly filling Arden with knowledge that I don't even think she knows she has. Caroline says I was diagnosed Caroline, you wrote a lot. I was diagnosed at 16 months. And I have an identical twin and three other siblings who are all non diabetic, Lucky kids. I was not treated differently than any of them, which I know had to be extremely hard to balance. My mom had a friend who was type one who gave her some tips. One was to never say no to letting me eat if I was hungry. And she would have said yes to any of my other siblings if they asked. So a lot of times if my blood sugar was a little high, and I wanted to say a cookie, my mom would ask me to run up and down the steps for a while

or go outside and jump on the trampoline so forth. A lot of times she sent the twins with her. So I actually never picked up on the fact that it was a diabetes thing until I was in high school. And then she like offhandedly mentioned it she laughs where if she didn't ask me to exercise she'd allow me to have like one bite if I wasn't really hungry, and I just wanted to eat something because someone else was. She says side note. It really helped me to develop self control because I can literally just have one bite and be fine. It was also a very gradual transition of her handing over my responsibilities. However, I always knew what was going on. So I knew my shot, schedule, my amounts, adjustments and so forth before I did my shots. Likewise, I was always taught how to count carbs, and knew how many I was allowed to eat before I chose what I had. I was super involved in decisions about pumps, versus shots, and things like that. I honestly don't know if I have any bad things to say about my parents. And what they did regarding my type one. There were probably mistakes, but I don't remember any. Samantha was eight years old when she was diagnosed and as soon as she was ready her parents let her take the reins. She says I think I was self managing by 12. Did they help and support me? Yes. But her situation made it so that she had to express to her medical team when she needed help. She says there are going to be failures. Some of them you can foresee others you can't. But how else does one learn? She says I'm not saying hit the brakes completely. I was really mature, but take a step back give them a choice because their life and their type one diabetes, but not a type one diabetes life. I can really see how a lot of you found this podcast This is excellent. Alaina says My mother was a dietician my father a doctor, they did a really good job teaching me because the science behind the disease, so it wasn't just high BGS or bad for you. It was a Scott, it was a discussion about the small vessel damage and the eyes and the kidneys, and the effects of different carbohydrates and glycemic indexes and how insulin actually works. What was going on at a cellular level, during hypoglycemic episodes, etc. She said it made her view her body like a science experiment rather than a piece of broken equipment. And she learned at an early age how to experiment to find what worked for her. And 39 years later, she's still experimenting, studying and learning. Thank you for sharing that. That was excellent. Holly says, Go at your child's pace. She was diagnosed at two years old. She's 25 now and she has a baby on the way. Congratulations Holly. Holly Megan, a baby. Holly got her first pump when she was six. And while it was relatively new, it was up to her if she wanted one. She was completely sure, but they supported her decision. She said she was also a late kind of quote taking charge kinda kid. Her endo kept pushing her to do her own site changes. Holly adds here that she did not like herpes, endo. But the doctor wanted her to try so many different infusion sites to find something that she was comfortable putting on. I still hate doing shots on the random occasion that I have to, and she has to hype herself up to do them. We got the Dexcom. But I didn't want to wear it all the time. So we weren't for a week for so she worked for one week out of the month. Now she sees the Dexcom is such an invaluable tool. And she hates being without it. She wants you to know that burnout is real. And that at times your children will be dealing with this over their entire life possibly. So don't shove all the responsibility onto them too early. Try not to treat your kids differently because of diabetes. Let them do what they want to do sports, food etc. She says yes, there can be limits and you know measuring but don't tell your kid No. When you would tell a non diabetic Yes. If you have other kids get them involved. She says during her childhood, all three of her siblings gave her shots, slight changes, etc. She has a very vivid memory of her brother laying on the floor with her while they were waiting for their parents to get home. Because she had large ketones. Having diabetic friends made a big difference for her. When it came to emotionally handling diabetes in her teen years. It was rough. And she had a lot of unanswered emotional questions. She says I hit it more because I didn't want people to know that she says that's okay. being diagnosed is a physical learning experience, especially at a young age. But she says that the emotional side didn't hit her for a long time. And that that was harder in her opinion than the physical learning.

She had fears about the future rejection, she wondered why it was her who had diabetes. But she can happily say now as a grown mature person, that they will become more confident and be open. Susan's here with a more low carb idea. She says now you have a diabetic in the family. So the whole family changes. You can all eat differently, but those differences don't have to be made to be huge. She's not saying we can't have cake now because Johnny is diabetic. It's just you make where you order a different cake. You don't say we have we can't have spaghetti because Susie can't have pasta. You say zoodles and Pum Meeny noodles with meatballs for dinner. Just exactly as you would do if your child had a nut allergy. You know she says nobody would have peanut butter them. So she's suggesting to just make the changes don't advertise them or make her production over it. She thinks your child will thank you when they are healthy and strong as teens and adjusted adults who know how to eat well. In any restaurant situation, low carb protein packed 37 years ago, Susan says she was taught from her from day one. No more grains, fruits, sugars or starches. She's talking about all kinds of different foods here that you can use. She says if I came and cooked for you for a week, I seriously doubt you would even realize your carbs have been cut and I think This is an excellent time to point out that this Facebook group is completely inclusive, there are people in there that eat every carb you can imagine. And there are Susan, who doesn't. and everywhere in between. There's no judgement in this page. It is unlike any Facebook group I've ever seen in my life, incredibly supportive, tons of different ideas, really worth your time. Rick has lived with diabetes for 57 years, there are more options with the current technology. He says. What his parents did for him back then, back in the day, was to instill in him that he had to take responsibility for his diabetes management, they did not hover over him. They taught him that it was just diabetes, and that he could live with it. Well, it was not something that would limit him. And he couldn't use it as an excuse for failing to reach his full potential in life. They taught Rick that he could do anything he wanted. As long as he put this condition under his control. That's excellent recommend you step back. She says Don't be afraid as a parent to use injections and finger pokes. Even with all the new technology, not to say that they aren't great. But having the ability and confidence to use any management strategy for diabetes is the best way forward. She says she tests often, she listens to people who have had diabetes longer than she has. She likes to see how they've adapted over the years. Go with your child to appointments so that everyone in the house can be on the same page. self advocacy and confidence can be built up instead of dashed, when things aren't going right. Even in spite of you doing your best. continue learning and adapting, breathe and have faith. I want to again echo this statement that you do not want to be the person who looks up one day and says oh gosh, is this not how anybody does that anymore? You want to keep learning. But using basic tools are still very important. I think Arden's Contour. Next One meter is one of the greatest tools we have. But she also has the Dexcom g sex, these things are not mutually exclusive. Thank you stuffy. Nicki says that she believes that there's a fine line between you can do anything. And this disease doesn't make you different. But you can also acknowledge that you are a little different. And you have different needs, and that it's hard. She says more on the emotional side for her. Nikki was diagnosed at four. And it didn't really hit her until she was like 23 or 24. What the emotional burden of the disease would be. I hope as you're listening that you see that different people experienced diabetes in different ways. And that all of these remembrances and advice from people isn't going to fit you. But some of it will, some of its going to fit you perfectly. I'm glad you're listening. And I want to keep going.

Carrie says allow your children to still be children. She says she was diagnosed at six years old, and that the diagnosis made her grow up much faster than her peers. She needed support, but also to take responsibility for her care. Completely restricting certain foods can be detrimental for many reasons. I completely agree carry. diabetics are not allergic to carbs, we just have to figure out how foods affect our blood sugars, and how to utilize insulin. Also, what works for someone might not work great for you. And that's okay. It doesn't mean one thing is right and one thing is wrong. You will figure out It feels like I just said this and then I'm reading and carry saying and I will feel silly for saying it myself. Anyway, if you will figure out what works best for you and your type one. And that all being said, What works one day might not work well the next. Allow yourself and your child some grace, you will figure out what works best for you. And remember, there's no such thing as perfection. Do not fear food or carbs. insulins not the enemy, neither of the carbs, do not compare dosages to others. certain amount of insulin isn't good or bad. Someone taking lessons and then your child or more insulin than your child means zero. Your child will need as much as they need. And that's the right amount. There are a lot of smart people listening to this podcast. I'm excited. Hey, Tara says that it may be hard now you know the sleepless nights you're having and you know being careless towards your own health, but that it's temporary. And these moments will be over before you know it. She's right by the way. Your support right now means everything. She says she can look back at her childhood and think wow, look how much my parents did for me. They sacrificed so much for me. I have a different bond with my mother than I think I ever would have if I didn't have diabetes. And it looks like Tara made Lisa cry, West cry. And Chelsea tell us that she has to say that her bond with her son has grown. He's five. And now we laugh a lot more. And I feel differently towards him. And I think it's the same for him. Cheese, you guys are all sweet. West jumps in to say thanks to the original poster. Yes, thank you very much for this question. And for the great responses. Sitting here on the beach, watching his little type one play as my wife and I try not to ugly cry reading these responses. So good and grateful for this community. I am to us. Tiffany says my mom was a type one. And I think a lot of her mismanagement stems from parenting. I could be wrong, she says, but I just don't want to cause any additional issues. So I try to pick my words carefully. Regarding food eating, I try to be forgiving, and have grace. Because most the time the numbers aren't in his control. She's speaking about her son now. Anyway, my son is eight and I don't want to cause any adverse to food or anything. And she's scared that she will. I am a I'm a big believer in that not restricting food for people with type one. Diabetes is important because of this very idea. I also want to say kind of harkening back to Susan's comment. Susan is eating low carb, but she's doing an amazing job of cooking for it. It's not a restriction. It's a exchange. I think there's a difference there. And it's important to feel that difference. You know, I'm kind of rewarding some of these with people's thoughts. Because, you know, people write differently than they speak. But I'm just gonna read Jacqueline's. My mom never restricted me from anything. And let me be a team. She gave me a lot of freedom. And then she says, I never abused my medical condition or pushed it to its limits. And I really thank her for that today. 13 years later, as an adult, she also never treated me like a baby at home or in public. I feel bad because I was diagnosed in high school. I'm sure I wasn't a peach, she says, between the hormones and the diagnosis and my new way of life. Ross's parents allowed her to independently manage her diabetes. From day one, she was diagnosed at 16 years old. And it's all I ever wanted, I took care of myself, and I never about 24 years strong. She says good job, Ross. Heather wants you to know that therapy and or support groups for the whole family are available. Don't force therapy, but encouraging normalize it by talking about it as a tool for well being in diabetes management. If you do this, find a therapist for your kid, when they are a preteen or earlier. Or a diagnosis if they've already if they're or diagnosis if they're already a teen. If you can't look for one specializes in diabetes, try really hard to get them one who has diabetes, she has the diff for any reason the child wants to switch therapist, you should support that.

Here's the last one. Melanie said that her parents just sort of ignored diabetes. It wasn't until she was 18 and moved out that she started taking care of herself and figuring out our health. It's been a long health journey, she says. But I say that to say the fact you care so much is a huge thing. There is no perfect way to manage type one diabetes. But as a parent, the fact that you care speaks volumes. What I wish my parents would have done is just reassure me that I could still live a normal life, and that food isn't the enemy. I just have to handle it differently. But I still can enjoy all the things that I love. She had major fear wrapped around food, because she was just left to figure it out for herself. She says just being a support is huge.

I genuinely want to thank and for posting her original question. I've been watching this thread grow over days. And I just thought this would be a great episode of the podcast. I hope you agree. The last post in the thread is from Anne and it says thank you all so much for responding to this thread. For all of your wonderful advice. I do want my daughter to have good numbers because it's my job as a mom to keep her healthy. But I think I've been overlooking the mental aspect. Because I don't have type one diabetes. I recognize that I won't truly know what it feels like to be her. So your words are invaluable to me. I hope she grows into a person who has a healthy relationship with food and a desire to take good care of her body. Seek out. Good advice. Just like you all you guys. Anybody else want to cry? I'm a little misty Hold on a second. God dammit. Oh, Jesus Christ. Facebook group is great. I love this podcast. I hope you enjoyed all this. I'm gonna rerun my words about the D one D exchange here in case you skipped over him at the beginning. While we're all in the mood to help each other. This is a way for you to help people you're never going to meet that may actually come back and help you. Geez, I really am crying. This is terrible.

Unknown Speaker 30:37
Guys.

Scott Benner 30:39
I really love all you guys. This is really like, I never expected this when I started this podcast. I'm so grateful. Okay, all right. Hey, don't forget if you're enjoying the show, please share it with others. If you like what you heard here today, you probably really will love the private Facebook group. There's a link in the show notes to that. If you need any of the links there at Juicebox Podcast com Please support the sponsors, the sponsors allow me to keep making the show. I have to be honest with you, it is a Wednesday afternoon. I am a grown person and that I can afford to read the internet to you is is because of the sponsors I'm not gonna lie. I definitely could not put this kind of effort or time into the show if it wasn't ad supported. So you know support the sponsors support the show.

Unknown Speaker 31:29
Speaking of which,

Scott Benner 31:35
before we get started, I'd like to remind you about the T one D exchange. You can be heard and support the Type One Diabetes community while you help drive research that really matters for people living with type one. The T one D exchange registry is a research study designed to harness the power of individuals with Type One Diabetes. This is a nonprofit research organization that is dedicated

to accelerating therapies improving care for people living with Type One Diabetes. they translate real world experiences into real world solutions that make your life easier. The registry is a research study designed to gather real world evidence firsthand, easily and quickly. The questionnaire that you'll fill out can be done on your mobile device from the comfort of your home. And since Type One Diabetes is a chronic condition that people live with their entire lives, participants can complete the questionnaire annually to help researchers understand surviving and living with type one. This is an amazing thing you can do it is 100% HIPAA compliant, absolutely anonymous. And when you join the registry besides doing all of those things I've just listed, you end up supporting the podcast. So if you've ever wanted to support this podcast without actually spending money, this is a great way to do it and feel good about what you've done. I joined the registry. As the parent of a child with type one by the way, you have to be a US residents either have type one diabetes or be the parent or guardian of a child. I don't think it took me seven minutes to finish. It was really simple to do. T one d exchange.org. forward slash juicebox. In just a few months over 400 listeners of this podcast have added their voice to the T one D registry. I believe that what the T one D exchange is doing is valuable and heartfelt. And I'm genuinely proud to be telling you about it. I hope you can add your voice to the others.

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#391 Diabetes Pro Tip: Glycemic Index and Load

All carbs aren’t created equally

Scott and Jenny Smith, CDE share insights on type 1 diabetes care

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Amazon Alexa - Google Play/Android - iHeart Radio -  Radio Public or their favorite podcast app.

+ Click for EPISODE TRANSCRIPT

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:10
Hello, friends, welcome to Episode 391 of the Juicebox Podcast. This episode is a another in the pro tip series. That's right, Jenny Smith is here today, Jenny and I are going to be talking rather loosely, more colloquially, if you will, about the glycemic load and glycemic index. Now, please don't turn off your podcast player. I know that seems boring. But what we're really going to be talking about is understanding that different foods impact blood sugar differently, even if those two foods both have the same amount of carbs in them. This is incredibly important. This is something that many of you just undervalue. So while you're listening today, please keep in mind that I think this is incredibly important. And also keep in mind that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, please always consult a physician before making any changes to your health care plan. We're becoming bold with insulin.

Today, I've invited Jenny Smith to come back. Do you know Jenny, Jennifer has had Type One Diabetes for 32 years now. Jenny also holds a bachelor's degree in human nutrition and biology from the University of Wisconsin. She's a registered and licensed dietitian, a certified diabetes educator, and a certified trainer and most makes and models of continuous glucose monitors and insulin pumps. So you know, Jenny from the pro tip episodes, and from defining diabetes, and from ask Scott and Jenny, I know Jenny from my life. And there's no one I'd rather talk about stuff like this with that her. So today, Jenny and I are going to dig a little deeper into glycemic load and index. There are other episodes that deal with this topic. But it deserves to be in here in the pro tip series as well. Because so many people think a carb is a carb is a carb. And that's just not the case. Today, I'm gonna put the ads up front, so that we can talk straight through this episode of The Juicebox Podcast is sponsored by the Contour Next One blood glucose meter. This is the blood glucose meter that my daughter uses every time she checks her blood sugar. And there's a good reason why it's not because they're advertisers on the podcast, we had the meter before the podcast that Contour Next One is small, easy to handle has a beautiful bright light for nighttime viewing a test strip that allows a second chance blood drop, meaning you can go in, get some blood not enough and go back without ruining the accuracy of the test. And speaking of accuracy, this thing is gold standard. I trust it implicitly Contour Next one.com forward slash Juicebox Podcast get there, there's gonna be a lot more than just the next one meter. Here's some other information you'll find at the website. First of all, contour makes other meters. I use the next one, and I love it. But you may want a different one that's under the products tab. Under the resource tab, you can get the contour diabetes app, which works with the Contour Next One meter, it's really great helps you make a ton of sense of your data. Then we get to the meters and test strips tab. Free Contour Next One meter, it's possible Can you imagine that that you could be eligible for a free meter. So check it out. There's also a choice card that may help you save on test trips. And of course support if you need it. All this should be enough. But while you're there, there's one more thing to look into. And it's this is it possible that the cash price for the Contour Next One would be cheaper than what you pay through your insurance. Hmm. It is possible look into it. So whether you just want the Contour Next One meter, want to read more about how it works. You need to get that app you want to look at other meters. Find out if you're eligible for a free meter. Or look into that choice card to save on test trips. Everything you need to know about this is at Contour Next one.com Ford slash juicebox. Please don't forget to check out touched by type one.org if I'm not mistaken. Dancing for diabetes is coming up very soon. Check them out touched by type one.org also find them on Facebook and Instagram. Last thing before we get going t one D exchange dot org forward slash juicebox, it will take you less than 10 minutes to add yourself or your child's information to the T one D exchange registry, you need to be a US citizen. But once you put that information in there, and it's just there's the simplest things asking you questions about life with diabetes. And then they use this data to help make better decisions in the world for people with type one. One example, just one example is that the data from the T one D exchange, led to the ADA lowering target a one C for children. That's a big important step. Because of how it impacts the practitioners and how they talk to you about expectations. It seems like one of those things you just kind of wouldn't think about, but they need to happen. T one d exchange.org. forward slash juicebox. Support the sponsors support the show I thank you very much. All that's out of the way now. So let's get to my conversation with Jenny Smith, about understanding the difference between one carb and another. And the importance of that difference, and how it's going to impact your management. I know it sounds convoluted. I know it sounds boring. But it's it's everything. So please, lesson.

Okay, Jamie? So I know how people's minds work. And the problem with this episode is it's going to be incredibly important. And they're going to see the title and not listen to it. Right? Nobody. I'm just going to curse and I'll bleep it out later. For some reason. You are adoring glycemic load and glycemic index of foods. You're making me crazy. Okay. So here's the here's the problem. The core of this cod podcast, the concept behind it is, I don't think you should have to limit your diet. The unspoken part of that sentence is I also don't think you should have a bag of sugar every day. Right? So I want. Yeah, listen, if you get crazy one day, and you're like, having a pop tart, or I want to eat a bowl of cereal, I want you to understand how to Bolus for that that's really at the the reasoning for the podcast that it's at its beginning, like I said, but the amount of people who say, Hey, listen, I counted these carbs. And it didn't work. So I don't know what you want me to do about it? Well, what I want you to do about it is understand that there's a difference between 10 grams of potatoes and 10 grams of sugar and 10 grams of Pop Tarts and Cheerios. And are the I'm fascinated by how many unhealthy foods people think are healthy. Which one jumps into your mind when you say that? Because I think of wheat bread right away. Like somehow being wheat bread doesn't make it bread.

Jennifer Smith, CDE 8:19
I think of especially in the past five years, I would say maybe even more than that.

Scott Benner 8:27
I know what you're gonna say God,

Jennifer Smith, CDE 8:28
I think of

meal bars. Okay, I don't know

Scott Benner 8:35
what else to call them. That's not what makes a good.

Jennifer Smith, CDE 8:38
It's kind of like the bread idea. Just because Wonder Bread now says that it's wheat bread versus white bread. That's like if you want real bread, like go back to granny. Yeah, bake some bread how she made her bread, right? And even you know breads today being there's a plethora of them on the market. Right? But just because it says wheat bread doesn't mean that it's healthy bread. I mean, if you're talking about like healthy bread, if you're going to eat it, you're talking about the sprouted like low glycemic we'll talk about the glycemic since the purpose of this whole episode. But right I mean, those types of breads the unprocessed, you can actually physically see the grains in it or the seeds or whatnot. There's a big difference between wonder wheat bread and sprouted grain zekiel bread. Yeah, major difference.

Scott Benner 9:32
Even even when I make bread at the house, I'm only just making white bread, but it's at least sugar, flour, yeast, water, butter. That's it. That's what's in it. Like salt. Excuse me. That's that's what's in it. It's of course the flowers processed and the sugars processed. But you can buy a loaf of wheat bread and the first ingredient is high fructose corn syrup. And people are like, I don't know what

Unknown Speaker 9:59
happened. Right, right? I do.

Jennifer Smith, CDE 10:02
I do, too. Yeah, absolutely. It's kind of like I said to though, with the bars, people, lives are busy today. Very busy. And I actually did a whole, like, I think I did a blog post about this actually, or was in part of our newsletter or something all about, like, sort of the false advertising of nutrition bars, right? You're eating your nutrition bar, because it's like, it's low carb, or it's low glycemic, or it's follows your keto plan, you know, what they're, if you're gonna follow a plan, follow a plan and eat real food.

Most I say most of the time like these, like 9010 8020, kind of, most of the time you're doing real food, you know where it came from, your grandmother could identify it, I can guarantee that if I showed my grandmother who is no longer living something like, I'm not gonna name a brand, but a general like, a store bought processed meal bars to be like, what is this? What is this? What is this, go make yourself a peanut butter sandwich or

Scott Benner 11:12
something? No, those things are so dense, with calories and carbohydrates and all that stuff. My son uses them. So my son does not like to have a full stomach when he's playing baseball. But you can't go play college baseball in the heat without fuel. But he can take like a half of one of those bars and power them through a baseball game. There's so much jammed into it. So he likes them because they don't fill a stomach. But it goes to show how much fuel is in it and, you know, things that impact your blood sugar. I thought, you know, when you said, you know, a bar, I thought you might say vegan food. And I thought you vegan diet. And I thought you might say no gluten stuff. Because I had to remember one time, they were trying to figure out my iron issue. And a doctor said, Hey, don't eat gluten for a month. And in a month of eating not gluten. I gained like eight pounds. And I thought, but I'm eating healthier. And then I looked back and I went No I'm not. I'm just eating things that don't have gluten in them. Right, right. Okay, confused, no gluten with health. And my daughter's friend is a vegan. But she's basically a human garbage can. You know, it's fascinating.

Jennifer Smith, CDE 12:33
It is in terms of I mean, just those two, vegan or even being vegetarian is kind of the first right. Okay, you don't want to eat meat. Great. I mean, for the most part, the only animal that I eat is fish. Okay, I don't eat any of the other animals on the planet. I eat fish. It's occasional, not very often. So for the most part, we are mostly vegetarian. And but you could be a very unhealthy vegetarian, you could also be a very unhealthy vegan. Yeah, I mean, if you're doing a heck of a lot of the processed, oh, but it doesn't have any animal based product in it. Great, but like, How long has it been sitting in the bag or the box on the shelf just because it doesn't have animal product in it? Or? Right? I mean, there are healthy ways to be vegetarian or vegan. There are also healthy ways to be on a ketogenic diet. You know, a lot of the products that are on the market for that type of an eating fueling plan are very processed, you can be healthy and actually eat good real food on a ketogenic diet or on a vegetarian diet or on a paleo or a caveman diet. But much of the processed stuff that's out there like you found with the the gluten free stuff. Yeah. Unfortunately, a lot of the gluten free packaged processed stuff. It's made out of very this brings in glycemic index. It's made out of very high glycemic, quick impacting refined carbohydrate, right rice flour, tapioca starch, potato flour. I mean, the lower glycemic ones would be things like if it's made out of like an almond flour, or like the nut flowers or like a coconut flour or something like that. Those tend to be lower impact, lower glycemic still processed. Yeah, but um,

Scott Benner 14:24
well, the reason I bring it up and I'm sure this happens to you constantly been to me far less because I don't speak to nearly as many people one on one as you do. But I am just endlessly inundated with people who want to know like, I don't understand why this isn't working. I eat healthy. It's almost like when people say it's almost like when people say to me, oh, my blood sugar got really low. I've learned not to infer what I think of is low into what they say in the beginning. When someone say to me, oh, I get really low. I'd go right over it. Now. I stopped and I go What does that mean? What number is really low? Because sometimes the person will say 85. And I'll go, Oh, well, that's not really well. And so it frames my conversation. So when people say I eat healthy, I do. I'm like, what does that mean? Because I need to understand what you're eating to talk to you about the insulin you're using, because we did everything right here. Your blood sugar should not be 200 right now, why don't understand I had a really healthy meal. And then when you talk to them, you know, it's like, oh, I had avocado toast and you think oh, that does sound healthy. Except a they don't know. There's carbs and avocados for some reason. They're completely dis concerned with the fact it's in the avocado, and there's high fructose corn syrup and the toast they made and I'm like, Yeah. Okay. So, so, I don't care how anyone eats. I would think of myself as the only real diet I stick to is an intermittent schedule. I only eat in the certain hours. But other than that, in the past week, I've had Ben and Jerry's ice cream. I'm making ribs tonight for dinner, Texas style, in case anyone's wondering gonna smoke them. And you know, I think last night we had I had chicken parm that I made last night. But keeping with Jenny's point, I made the chicken parm I took a chicken breast, I hammered it flat. I put bread crumbs on it, and a little tomatoes and some mozzarella cheese, you at least you could see what was on it, and

Jennifer Smith, CDE 16:25
you knew what you put in it. Yeah, and I didn't have an idea.

Scott Benner 16:28
And I didn't fry it in any of the in, I don't use processed oil either. And the and the olive oil I use is the only cold pressed I don't I don't use the heat pressed. So those are pretty much the only things that I follow. And besides taking, you know, a reasonable amount of like, you know, vitamins. I don't really do anything differently. But I'm also not really interested. I'm not trying to impact my weight. I just want to be healthy and I want to eat something.

Jennifer Smith, CDE 16:56
And you're not concerned with your own blood sugar overall. I mean, you're concerned with your daughters.

Scott Benner 17:00
Yeah, I want a glucose monitor a couple of times my body handles my diet. So that that's and I'm not overtaxing it. I didn't eat like three pints of Ben and Jerry's ice cream. You know,

Jennifer Smith, CDE 17:11
but I think it's also I think that actually brings up kind of a good, a good visual of the difference between glycemic index and glycemic load when you were wearing that continuous monitor. I remember you either. I think you texted and you texted like how much you physically had to eat. In order to get the CGM to register like a bump up in your blood sugar's showing that your body was actually being taxed.

Scott Benner 17:41
It was fascinating. Yeah,

Jennifer Smith, CDE 17:43
by the amount that you ate. And that actually speaks to the load impact, right. So when we talk about glycemic index and glycemic load, glycemic index is really just it considers the amount of food that you've eaten carbohydrate that will turn into impacting sugar in the next two hours after you consume the food. But that's just the tip of the iceberg in understanding and that's been when I talk to people, you know, who are trying to consider glycemic index and like, you have to take it a step farther, there are depths or there is depth to glycemic index. And a step farther is glycemic load, in terms of glycemic load talks about the amount of the food that you're eating at a particular time. And my favorite example to give is watermelon. Watermelon has a very high glycemic index. If you're not familiar with glycemic index or not quite sure it's a scale of zero to 100, with 100 being pure glucose. So as foods are rated on that scale with a number, that higher the number or the closer to 100, the faster the impact should be on your glucose level. Okay? But again, this is in a simple lab generated testing, right where you're only eating my example watermelon, you're not eating watermelon on top of chicken parm on top of like a whole stick of butter. Right.

Scott Benner 19:13
I also wonder, are these things tested on people with diabetes when they come up with the index or people with a working pancreas when they come up with the index?

Jennifer Smith, CDE 19:22
That's okay, that's, I believe it was I believe it's people with a working pancreas. Yeah, to give a true definition of what the impact could be. When sort of outside insulin dosing isn't in the picture but that is a really good thing. It makes me think, maybe looking that up.

Scott Benner 19:40
Here's what it made me wonder about, you know, when somebody tries to catch a low by turning their bezel off for an hour, and then they create like, a void in front of them a black hole where there's no and then they have the tiniest bit of carbs, like my blood sugar shot way up. I don't understand it. Well, your pancreas doesn't work, and you took away all the insulin in your body and then added even the tiniest bit carbs. So the glycemic index of anything away from insulin is probably 100, right? Like everything probably hits like 100 away from insulin. And so when you've got the right amount of bazel, in, these foods are going to still hit on this chart. And before we go on, like I just want, I'm gonna roll through it real quick and just pull a couple out to give people an idea. whitebread is a 75. Right? White rice is a 73 cornflakes are 81. But an apples 36. Right, strawberry jam is 49, a potato boiled is 78. But a potato mashed is 87. So everything hits differently. And when I stand on stage, I try to simplify it down by saying foods punch at a different weight, some of them just hit harder than others. And that's and it's interesting to they have sugars listed out here. sucrose is 65. Glucose is 103. Honey is 61. And fructose, if I'm saying that right is 15. And

Jennifer Smith, CDE 21:11
so it's fructose is fruit sugar. And that kind of brings into the treatment for lows, then, the reason that glucose tablets technically work the best or anything in which dextrose is one of the first three ingredients in like a candy kind of thing. That's the reason it's going to work the best because glucose is the simplest form of sugar that there is there's no breakdown to it, it gets in and it gets distributed and use. Whereas something like fructose, or galactose, which is milk, sugar, sucrose, they're more come there are more combined chemical sugar structures. So your body has to break it apart, to get the glucose out, okay, to actually impact the blood sugar. So

Scott Benner 21:52
in a scenario where a person takes a glucose tab, and it takes forever for their blood sugar to go back up, but eventually it rockets up, that means they have a lot of active insulin at the tabs fighting with is that is that what you would infer from that,

Jennifer Smith, CDE 22:05
that would be the estimate, you know, if there's iob, and there's a load of it, and there's a low and you only take one glucose tablet, that's like a drop in like the ocean of impact the other. The other reason could possibly be whatever is in the stomach already might be hampering the true absorption of that if the glucose tablets kind of sitting on top of that digestion. And if that other food is really highly fibrous, or very high in fat or a lot of protein, it may take longer for that little bit of glucose to definitely impact and get absorbed. Yes. Okay.

Scott Benner 22:43
All right. So I'm sorry, we kind of got away from it for a second. But it all feels really important, you know, that, that you can't just I mean, all carbs aren't created equal. I guess that's how I've boiled it down for the podcast. But again, the the amount of you out there who I try to say to people, like when they're really learning about the podcast, they're going through the pro tip episodes, and they're getting the ideas down, but they're still spiking, and they're getting low later. I always say like, why don't you just simplify your food choices for a little while, while you're practicing? You know what I mean? Like, I think I think I said to somebody recently, if you got it in your head that you wanted to learn how to box and you went to the gym a couple of times, you took some sparring, and you were starting to get confident. Once you had a little bit of confidence under your feet. Your next thought wouldn't be, you know, I had to go find iron mike tyson and see if he wants to go a couple rounds with me because you're not ready for that yet, right? But people make a couple of good boluses in a row and they're like, I'm gonna try Cheerios like, no, don't try Cheerios, it's day three. You're not good at this yet. You're getting better at it. And so if you're having trouble putting tools into practice, I always say go for things that are you know, that don't punches hard while you're practicing it, cut yourself a break, you know,

Jennifer Smith, CDE 24:00
and also learn and I think I've said this before to some other episodes, but learn the foods are the that are most common for you. Take a look at what you love to eat, write them down. Most people have about 20 foods that are over and over what they eat almost every single day, right? mark them down, look up their glycemic index and see how does it work when you try to cover these foods, even if it's like a meal, let's say you eat chicken and broccoli and rice three nights a week because it's like one of your favorite things in the whole great, write it down. Figure out what you did. What happened if it's especially if it didn't work the way that you wanted it to work out and then eat it again, you know, two nights from now and try it again. Maybe it was more insulin that you needed. Maybe the timing was a little bit different. Maybe it takes into consideration though. Well gosh, tonight ate a whole cup of rice with the chicken and the broccoli. And maybe Wednesday night I decided to eat only a half a cup of the rice with this Same amount of chicken and broccoli. So there's the load impact, right? It's the portion of the rice, the rice itself in one cup versus half a cup versus four cups, still has the same glycemic index, that's not going to change. But the load takes into, I guess, what you have to pay attention to is your eating now like a whole cup versus a half a cup. And that load impact is going to then be the big driver of blood sugar after In fact, you might need to play with timing of the insulin a little bit differently based on portion,

Scott Benner 25:36
right. And so Jenny brought up earlier that I tried to drive my blood sugar up when I was wearing a glucose monitor. And I obviously don't have diabetes. And I took a I think it was a big piece of cake with a lot of icing on it. And I ate it and waited. And my blood sugar did not go up very much at all. And I was

Unknown Speaker 25:53
more right. So I

Scott Benner 25:53
forced myself for you people, I hope you're happy. I forced myself by the way, I did not enjoy it. I did not enjoy the last third of the first piece. And I really didn't enjoy the second piece. And I was just like, Oh my goodness. And and when I get to like 132 something like that my blood sugar like,

Jennifer Smith, CDE 26:14
stayed under the defined like 140 mark. Yeah, no, yeah,

Scott Benner 26:18
I couldn't eat myself over 140 if I tried, and, and, but still, I got to 130 in a life where I wasn't getting to 130 a lot. I was having to like, do what Jenny said to get the 130 was having to stack multiple different tough foods on top of each other, like layer them on top of each other's having to have bread with potatoes, and then something else and more and more. I was I spent one night I don't know if you know those little spearmint leaf candies that are just like they're just sugar with, like, they literally they take sugar, and then they dip it in sugar. You know, I sat with a glucose monitor in front of me just going like just popping one of those in like every three minutes. And my blood sugar would not move off of 89 like it just wouldn't move. And I was just like I'm not trying to

Jennifer Smith, CDE 27:12
paint curious. I was Thank you pancreas. Thank you. No, I

Scott Benner 27:16
hate I told you I had a deep feeling of guilt. eating food and watching my blood sugar not go up like a significant it makes me sad thinking about it. I had a real deep feeling of guilt the first number of days I work. And I was just you know, I'm trying to do these things so I can talk about them on the podcast. And at the same time I'm looking over at my daughter while we're like correcting a 130. So it doesn't turn into a 170 you know, and, and I'm just But anyway, like, let's get back to the fun part. I am throwing these candies into the point where I was like, I hate these things now. I couldn't get my blood sugar to go up. That was it. It was it was pretty fascinating. Having said all that, again, I think that the podcast exists because I think people are gonna have a candy once in a while. I think that when people look at the you know at Harvard's good you know what you can swap out for lower glycemic index things. And I think oh, I could have corn on the cob or a leafy green or peas. Hmm. You know, I think most people are like, I would like corn. Would you like corn flakes or bran flakes? No. I want corn flakes. You know. Even white rice to brown rice is you know, now there are ways like you'll learn how to like for us. We I've switched the house over just a boss MADI rice. It just hits Arden differently. Oh, it just does and who cares Why? Like, I tried four different races. And I finally got to one and I was like this is the one that doesn't hit her as hard. This is the one we eat now.

Jennifer Smith, CDE 28:52
does it differ based on how you cook it or prepare it?

Scott Benner 28:56
I only prepare it one way Jenny. I have the zeros is it's a Roshi, people are making fun of me now a rice steamer I have the greatest rice steamer on the face of the planet. And let me tell you why I am able to afford this rice steamer. I was walking through a Macy's one day and they had this little rack of things that had clearly been returned to the store but bought online that they don't stock in the store. And so they just want to get rid of it because they have no place to put it. And my I luckily for me, is it zeros z OJIRUS hai they make bom bom rice cookers right? Wow. And my eye catches this rice cooker that I know in my heart costs like $500 right and obviously I'm not going to own a $500 rice cooker in my lifetime. No. And I looked over and that thing said 75 bucks. And I moved across that store, like Usain Bolt in his prime. I was like allaway people, I snatched this box up and I was holding it. I was like hugging it back. Everybody just moved, like I felt like everyone else knew as I looked around, I realized I was the only one aware that I was holding a very expensive rice cooker with a $75 price tag on it. And I actually it was so crazy. I went over to an employee, I was like, This is $75. And she goes, Yeah, and I went, I will buy this. Thank you. So I took it. It makes perfect rice. It is fascinating. You put the rice in, you fill the water up to the line that corresponds with the cups, the number of cups of rice use, you push a button, it plays Twinkle, twinkle, little star, and 55 minutes later, you're eating the best ratio ever had in your entire life. I don't know I place tinkle. Take a little star when you start up, but it does.

Jennifer Smith, CDE 30:49
My kids would probably love that. They would think that

Scott Benner 30:51
other than that I am the worst. I can't make rice. I screw rice up six ways from Sunday every time I try to make it so

Jennifer Smith, CDE 30:58
I barely have rice. I only have rice when we do sushi.

Scott Benner 31:01
When my son is trying to gain weight, he wants it in the house too. So I make it and I and it goes in the um, it goes in the refrigerator. He just adds it to everything he's eating. You know? Yeah,

Jennifer Smith, CDE 31:10
my choice is always My kids love quinoa, thankfully. And then wild rice, which isn't technically even rice, it's it's the seed of a long grass. So there's little education for you.

Scott Benner 31:23
I love I love a nice long rice because I like the the this sort of like, you know, spices that go on with it too.

Jennifer Smith, CDE 31:30
Yeah, but those some they work glycaemic Lee better. And I've just found long term that I mean, my family likes it. So it's not like I even have to cook it separate for me, and then something like brown rice. So

Scott Benner 31:42
yeah, I can't believe I spent so much time talking about my excitement about getting a cheap rice cooker in this podcast episode. I'm sorry for all that for everyone who's listening is like yeah, buddy. This is not helping me. I'm not buying a $500 rice cooker? Well,

Jennifer Smith, CDE 31:54
well, because of the way I asked him how you cooked it. And that does bring in as you were talking about the glycemic index before about like a baked potato versus a boiled potato versus you know, the glycemic index can change based on how something is prepared and or how ripe something is. So for example, like your Apple that you mentioned before, I think it's in like the 30s or 40s or something right? Most apples are considered low glycemic, anything under 50. On the glycemic index scale is considered low glycemic slow impact. Apples are there a kiwi fruit is there most of the berries are there. But then you get into the fruit that you really eat at its peak sweetness. You're talking about the summer melon, you're talking about pineapple, papaya, mango, bananas, grapes being cherries. They're all high glycemic, because their sugars are so developed to get that flavor that you want. I mean, I guarantee you're not going to eat it. Well, some people do. My husband doesn't care. He's one of the people can eat like a green banana, put it in a smoothie, he doesn't care. He's like the bananas there. Because I like the nutrition in it. I don't care how it tastes right. I cannot eat a green but

Scott Benner 33:10
he's dry on the outside when you're biting Do you notice that like the fob? Like, why is that doing that to my mouth?

Jennifer Smith, CDE 33:15
In the my mouth? Yeah, I wish people could see us that we make when we're talking. Oh, but I mean, I bring that in because glycemic index is higher for a ripe for fruit. And the impact is going to be faster. And I can tell you if I make a smoothie with a less than ripe banana because it's what we've got, and I want a smoothie. The impact is definitely different for me. And I strategize my bolus timing, different based on that. Based on that,

Scott Benner 33:47
well, you hit one with Arden loves cherries, and they like I have to like swing at those with both hands. You know, when your bolusing there, they're really tough. That is, see I I find all this fascinating. And I find it sad, because I don't think that many people think about it at all. They just count the carbs. And then they're like, well, this I counted the number and the number says 10. So it's 10. I do right? You know what I mean? Nobody thinks about the insulin, because I don't think about the carbs that much like I look at the food and I pick the insulin. I saw somebody the other day. They were you know, they had this meal. And they're like, we used two units or three units. And I was like, What is this like a? Like, I don't understand is this like a four year old kid and it wasn't it was a teen and I'm like, that's not gonna work. And you know, and then I asked them their ratio, and they're like, Oh, it's one to 10 and I was like, You think this is 25 carbs? I was like, This is 60 carbs. You know, if it's one it's 60 and I'd be scared to say 60 as I was looking at it, I was like I'd like to go 70 to be perfectly honest with you and and and they're very 2030 they're not sure. And then the kids blood sugar jump Up to 240. And they don't know what happened. And then they're correcting, correcting, correcting, then the food gets digested out the kids crashing down, and then they're correcting, and then they won't and it goes by and it's just, it's never ending,

Jennifer Smith, CDE 35:12
I think, you know, the topics of glycemic index and glycemic load are, they really are such, they're kind of the, like, further down the road when you're talking about like, just correct carb counting how to get that squared away, right? That is step number one, get, get some carb counting, get some labels read, even if you have to do portion estimation, that's your tool that you're get good at portion estimation, then for again, those foods that are on your, these are the typical things that I eat. Great, then we can move on further to things like glycemic index glycemic load a little bit better bolus timing, and then you kind of then maybe another step further is how is it cooked? Right? Am I boiling? My potatoes? Are my baking my potatoes? Am I you know eating a green banana? am I eating a completely black but

Scott Benner 36:06
what you're you're kidding on something that I know I want to talk about on the podcast more with you in the future, which is F after speaking to so many people, like I realized that there's a an order in which you should pay attention to things when you're starting. Right, right. And like in an overly simplistic way, like I always say, if I was if I was on the Titanic, and I was thinking you, you somehow recognize me as a person who could help people with diabetes. You know, like, Scott, I have a tape recorder, you're 30 seconds. What do you want to tell people about type one diabetes, I'd say get your basal insulin, right? Learn how long your Pre-Bolus is, and then understand the glycemic load index of food. And then I would go under and freeze to death and drown. But But those like if the if I could only say those things to you like three things to you, I'd say that. And then from there, I'd start talking about well, it's timing and amount, you know, and you can't forget about overnight, this happens. And you know, protein and fat cause rises. Like there's the variables, I just think of it as the seed of the idea. Like I always think of like management of diabetes is a tree, it's 100 year old tree with 1000 branches. And every point of that tree is important. But at its core at its seed, it's bazel. And then it's you have to Pre-Bolus and then it's you have to understand the impact of the food. Like that's the start of it, you never, but I see so many people who are out on the tip of the 700th branch going, I really want to understand this part. I was like there's a lot more to understand before you dig into that, you know, they're back at the trunk. And here's the problem, right? No one tells you to Pre-Bolus no one ever tells you basal insulin is important. And the words glycemic index and glycemic load are not sexy, and I don't like to pay attention to them. When I hear them. My brain goes in boring. That's for people who eat good. Like that's how it made me feel when somebody said to me in a doctor's office one day, I'm not trying to run a marathon. I don't care about glycemic load. They instead of saying, hey, you over here, these are the three most important things you need to understand. They told me the most important things and then moved on to stuff that doesn't matter as much. So not that none of it matters at all matters, but there's a core of it. And if you do the core, you're okay. I'm telling you bazel Pre-Bolus glycemic load glycemic index. Is anyone seen the sixes? That's my guess. You want it in the fives. start crawling out in the edges of the tree and figure out the rest of it. But this is an exercise. Yeah, get a pump and go for a walk. Like there's I could say stuff all day, but you know, stop eating Pop Tarts and telling me like it's not fair. I can't help it. Of course, it's not fair. But first your poison.

Jennifer Smith, CDE 38:58
I remember the last time I had an

early college because there was like nothing left in the cafeteria or something. And I was like, Oh my god, I have to eat something but

Scott Benner 39:08
my insulin Chinni assigned to that if you want to goddamn pop tart, eat it. I don't care. Just don't act like you don't understand what happened afterwards because that makes me sad. Like I just you're killing me online. Okay, you're putting things up online. You're making me sad because I want to come say all this stuff to you. I don't have time. And you're breaking my heart. So and and when I when I help people privately. Some people get it more quickly. And some people get it slowly. And then some people give it away like after they know it and I've seen him do it and then they stopped doing it. I'm just going to tell you like I don't follow many people's tax comms. And when I do I don't for long. But when I do, and I've seen you do it, and I've seen you understand it, and then you have a 300 blood sugar. I got to stop following you. It just it breaks my heart like I just can't like it eats me up. You know, I look at the graph and I'm like, Oh my god, like they didn't Pre-Bolus? Or why are they not correct?

Unknown Speaker 40:05
Could have

Scott Benner 40:06
been a bad pump site or could listen, it could have been anything. The problem is, it's just, it's ripping my guts out. I can't look at it anymore. Like with my daughter, I can do something about it.

Jennifer Smith, CDE 40:15
But it's it's hard to follow people. I agree. I mean, with the, with the many, many, many people. I see their data. Yeah, it is. It's hard. Because I think, you know, there's, there's no, there's no stop to, like, my job isn't like, I go to the office, I do my job, I put everything away, I close the door, and then I go home, right? Like, the people that I work with become like, they're almost like family to me, right? There are people that I care about the people that I get the privilege to work with, and help and I want the best. And I sometimes I feel like I could just like go home with everybody. I

Scott Benner 40:57
just texted a person this morning. And I said, if you could just come here for, I think 18 hours. I could just do this for you. And you could see, but they and they know what to do and they won't do it. And I'm just like, oh my god, it just really I listen, I'm not trying to turn this. It's hard on me. Like a really does. Like it just rips me up. Like I'm like you keep making the same mistake over and over again. But it's not out of ignorance. You you quite honestly know not to do it. And you just I don't know if it's fear habits

Jennifer Smith, CDE 41:29
are hard to break.

Scott Benner 41:30
Yeah, or habits are hard to break. But you're just you're doing the wrong thing. Like it's and I've told you it's the wrong thing. 10 different ways. And each time I say you say I understand I now you know what it is. I now know what my wife feels like when she's talking to me. It must be Kelly. I'm so sorry. It must be incredibly frustrating to say the same thing to me a million times, amigo. No, no, I understand. I hundred percent understand it three days later. I'm just doing it again. But But and so it's like, I don't mean to come down on it. I'm not trying to come down with evil. I'm just saying that. Jenny's not wrong, like following someone's blood sugar is it's a lot. And it's tough to win a guy. I don't think I know everything. And I but it's tough. When you look at a graph and you go, Hey, you know what, you need more? bazel? And they go No, you know what I think? And I always think to myself, I actually started saying it out loud. I started going like, why don't we stop worrying about what you think cuz what you think led to this graph I'm looking at, you know, so try what I think first I get and see what happens.

Jennifer Smith, CDE 42:32
That's even try it my way for a little bit. Yeah,

Scott Benner 42:35
here and listen, I'm gonna cost Jenny some money and save all of you and our paying or Freddie, stop explaining to Jenny what you think, let her tell you what's going on. Because you're just in therapy at that point. And that's not getting you to a better blood sugar thing. You know what I mean? Right? How many stories people tell you where you're just like, stop talking, this doesn't matter.

Jennifer Smith, CDE 42:59
And sometimes, you know, sometimes it's a marriage of what I see. And sometimes it's adding in then what they've seen, but they're addressing a certain way, because they think something's happening, that isn't really the reason for it. So it's kind of a marriage of what I see and how to tell them about what to do differently. It's not that what you're seeing is wrong, it's that the adjustments are not quite the right, adjust. You're

Scott Benner 43:24
100% right. And I was being too flippant, like you do need to hear it from them. But it's fascinating how infrequently their interpretation of what they're seeing is right. Right. You know, you need to you need to hear what's happening. You don't need their interpretation of what's happening. It's much it's interesting. Anyway, it's like it's like trying to do I don't know it's it's the weirdest customer service in the world like it people. This is like that except times like a million. So anyway, Jenny has to go. She's She's so I do drop bombs of knowledge and truth all over this episode. So I really appreciate that. I will talk to you soon. Awesome. Huge thanks to Jenny Smith. Hey, Jenny services are for hire. You can find out more about her at integrated diabetes. There's a link right there in the show notes. There's also a link for the Contour Next One meter touched by type one, the T one D exchange, and all of the other sponsors of the various podcast episodes that includes Omni pod Dexcom and G Vogue glucagon. All right, they're right there, right there right there. In your podcast player notes. Those links are also available at Juicebox podcast.com. But I'm gonna roll through them really quickly for you just in case and then I'm going to do a little freeform chatting about this topic. All right, ready, touched by type one.org. Contour Next one.com forward slash juicebox T one d exchange.org. forward slash juicebox. The other sponsors that aren't in that aren't on this episode, but are still incredibly important. Dexcom is available@dexcom.com forward slash juice box, you can get a free no obligation of the Omni pod at my Omni pod.com forward slash juice box and learn more about GMO glucagon at G Volk, glucagon comm forward slash juice box. Okay, now, almost everyone who uses insulin runs into this specific problem. And that problem is this. You count your carbs, you put in your insulin, and everything goes exactly the way you expect. Next day, you make a meal, you count your carbs, you put in your insulin, and nothing goes the way you expect your blood sugar gets low later, or it gets incredibly high. This is confusing, because yesterday, I counted my carbs, I put it in my insulin and everything worked. Today I did it again, some of you will question your carb counting skills. When this happens, some of you will run out and buy a very expensive scale. Very few people say to themselves, I bet the glycemic load of the food was greater or lesser than the glycemic load of the food from yesterday. Now you wouldn't think that because nobody tells you to think it or they say too soon after you've been diagnosed, and you feel like somebody just hit you in the head with a baseball bat. So you're not really listening, or the words glycemic load and glycemic index seem difficult, or maybe next level or whatever. But it's not. It's very simple. Some foods impact blood sugar differently, even if their carb count is the same. That's it, you just have to see it happen, except that it's true. Remember, and adjust your insulin for that food. That's what this entire episode told you. That very simple idea. You make yourself meatloaf mashed potatoes, you put some broccoli with it, you count the carbs. And somehow you've decided it's I don't know I'm making up a number. It's 40 carbs, which by the way, it's more. And you give yourself your insulin, your blood sugar shoots up later you correct with, I don't know, a couple more units, your blood sugar comes back down, it doesn't get low. The next time you have mashed potatoes and meatloaf and broccoli, and you count the carbs and you come up with 40. Again, you have to remember the two units you corrected with, you have to remember that those two units belong in the initial bolus. Maybe not every drop of two units, but pretty close. The reason I say that is because once you have a higher number, it takes more insulin to bring it down. But some of that insulin, if it was in the initial bolus, the spike would not have happened from these potatoes. And by the way later, the fat and protein and the meat that keeps your blood sugar higher layer, which you know, you need to go listen to the fat and protein pro tip episode to understand that.

So the next time you have this meal, I don't care what the carb counts that you have to trust that what you know is going to happen is going to happen. So all these little sayings and isms that you hear throughout the show, they're really just shortcuts to understanding that there is a different glycemic load from food to food to food. Because the next day, you could have a meal with 40 carbs in it that doesn't have those starchy potatoes in them. And I don't know wasn't mixed with the fat and the protein. And all that insulin could end up being too much. Now your meal ratio works. So what you're hearing is that your meal ratio isn't set in stone. It's all dependent on the foods you're eating, the glycemic load and the glycemic index of the foods. But you know, you can go check it out if you want. It's a matter of fact, I'll I'll find the chart that Jenny and I were talking about. from Harvard right now. I find it right now for you. And I'm typing. So I'm vamping a little trying to kill time. Because I don't feel like editing this part out. You're looking for a link called a good guide to carbs the glycemic index from Harvard health publishing and a link called glycemic indexed for 60 plus foods, which will give you an idea of what we're talking about that white bread punches different than corn tortillas. It's sweet corn punches different than porridge that on orange raw hits you differently than a potato boiled, which by the way hits you differently than a potato mashed which by the way hit you differently than a potato fried. These are the things you need to understand when you're watching your blood sugar's move all over the place, and sometimes it works. And sometimes it doesn't you love to hear people say, Oh, you know that about diabetes? One day, everything just works. And the next day it doesn't. It's not really true. If you had the right ratio of insulin, it would work every day. That is true. I promise you. All right, I'll put links in the show notes to those two blog posts from Harvard. I hope you're enjoying the pro tip episodes. If this was the first one you heard, you're probably like, you should definitely go back to Episode 210. And start at the beginning. Diabetes pro tip newly diagnosed, we're starting over and then listen through those pro tips. The pro tips are also available at diabetes protip.com. But you know, listen to your podcast app because that's how kids do things and they know way better about technology than us. Thanks for listening. I genuinely appreciate it. I'll talk to you soon.

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