#1717 Knowing All Your Tools - Part 1
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 wherever they get audio.
Sarah shares her LADA journey—misdiagnosed as type 2, overwhelmed postpartum, then empowered by a new endocrinologist and GLP-1 therapy—showing how persistence and better care can change diabetes management.
+ Click for EPISODE TRANSCRIPT
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. (0:01) Welcome to the Juice Box podcast. (0:03) From my family to yours, I want to wish you a happy holiday.
Sarah (0:17) Hi there. (0:18) My name is Sarah, and I officially have latent autoimmune diabetes of adulthood or LADA.
Scott Benner (0:25) If this is your first time listening to the Juice Box podcast and you'd like to hear more, download Apple Podcasts or Spotify, really any audio app at all. (0:34) Look for the Juice Box podcast and follow or subscribe. (0:38) We put out new content every day that you'll enjoy. (0:42) Wanna learn more about your diabetes management? (0:44) Go to juiceboxpodcast.com up in the menu and look for bold beginnings, the diabetes pro tip series, and much more.
Scott Benner (0:51) This podcast is full of collections and series of information that will help you to live better with insulin. (0:58) If you're looking for community around type one diabetes, check out the Juice Box Podcast private Facebook group. (1:05) Juice Box Podcast, type one diabetes. (1:08) But everybody is welcome. (1:09) Type one, type two, gestational, loved ones, it doesn't matter to me.
Scott Benner (1:14) If you're impacted by diabetes and you're looking for support, comfort, or community, check out Juice Box podcast, type one diabetes on Facebook. (1:23) Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. (1:28) Always consult a physician before making any changes to your health care plan. (1:33) US Med is sponsoring this episode of the JuiceBox podcast, and we've been getting our diabetes supplies from US Med for years. (1:41) You can as well.
Scott Benner (1:43) Usmed.com/juicebox or call (888) 721-1514. (1:50) Use the link or the number, get your free benefits check, and get started today with US Med. (1:56) The podcast is also sponsored today by the Omnipod five. (2:00) And at my link, omnipod.com/juicebox, you can get yourself a free what'd I just say? (2:07) A free Omnipod five starter kit.
Scott Benner (2:10) Free? (2:12) Get out of here. (2:12) Go click on that link. (2:13) Omnipod.com/juicebox. (2:16) Check it out.
Scott Benner (2:17) Terms and conditions apply. (2:18) Eligibility may vary. (2:20) Full terms and conditions can be found at omnipod.com/juicebox. (2:25) Links in the show notes. (2:26) Links at juiceboxpodcast.com.
Scott Benner (2:28) Today's episode is also sponsored by Skin Grip. (2:32) Your devices, they can fall off. (2:34) But with Skin Grip, they stay secure for the full life of the device. (2:38) Juice Box podcast listeners will save 20% on their first order at my link, skingrip.com/juicebox. (2:46) If you want a durable skin safe adhesive that lasts, you want Skin Grip.
Sarah (2:50) Hi there. (2:51) My name is Sarah, and I officially have latent autoimmune diabetes of adulthood or LADA for seven years. (2:59) And I have recently went through a really life changing, really informative endocrinology appointment, which felt like it gave me some power back with my disease process and really giving me options, which is what motivated me to reach out to you to be able to share because I anticipate there's other folks who are in the in a similar situation, and maybe maybe this could benefit them.
Scott Benner (3:25) I'm not a 100% sure what you're gonna say, but if it goes any way the way I expect, I think you're a 100% correct. (3:31) Awesome. (3:32) Hey. (3:32) What do you do for a living? (3:34) Most people you guys don't know this if you're listening, but most people, I'm like, go ahead and introduce yourself when you're ready.
Scott Benner (3:40) And it'll be like, hey. (3:42) I'm you just launched right into it. (3:44) Did you practice that in front of a mirror? (3:46) Or
Sarah (3:46) No. (3:48) But thank you for that.
Scott Benner (3:49) You don't have a job that requires you to speak to people?
Sarah (3:53) Well, I do. (3:53) Yeah. (3:54) No. (3:54) For sure I do.
Scott Benner (3:55) Okay. (3:55) You don't wanna tell me what it is?
Sarah (3:57) No. (3:57) I'm happy to tell you what it is. (3:58) I a nurse, and I spent the bulk of my career working in a peds ICU in the beginning, and now I switch to safety and quality. (4:08) And I work for a big hospital system and I am in a ton of meetings. (4:14) I connect with people a lot.
Sarah (4:15) I hope I come across as calm and informed and able to communicate, but we'll see. (4:21) I mean, this is just the first minute. (4:22) You never know how it will go.
Scott Benner (4:24) Well, I would love to be in a meeting with you.
Sarah (4:27) Well, thank you.
Scott Benner (4:28) Yeah. (4:28) You have a, a nice mix of able to communicate. (4:31) You seem assured of what you're saying, and you were, you know, timeline wise. (4:36) I like I like the the I don't know. (4:38) The order in which you you laid out what you said.
Scott Benner (4:40) So that was really great.
Sarah (4:41) Thank you.
Scott Benner (4:41) You listen to podcast?
Sarah (4:43) I do.
Speaker 3 (4:44) Do I seem calm when I'm speaking?
Sarah (4:46) Yeah.
Scott Benner (4:47) How do I seem? (4:48) Because I I think I seem scattered.
Sarah (4:51) I I think you seem scattered too, but that doesn't mean you're not calm. (4:55) Like, I think you're all over the place, but that's you still have a calm, confident presence.
Scott Benner (5:00) Okay. (5:01) It's interesting. (5:02) I I always wonder, could I speak linearly? (5:04) I don't know that I could. (5:06) Like, you know, start at a and end at z.
Scott Benner (5:08) I don't know if I could do that or not.
Sarah (5:10) What if your brain doesn't work that way, I just it just doesn't.
Scott Benner (5:15) It doesn't, but yours does.
Sarah (5:17) Well, I don't think so. (5:18) I mean, I could be scattered. (5:19) It's still early.
Scott Benner (5:20) Thirty minutes from now, you're just gonna be like, I went to the circus. (5:23) I'm like, wait, what? (5:25) You know, a little behind the scenes picture of this. (5:29) Yeah. (5:29) I believe that, you know, an hour is a long time to talk.
Scott Benner (5:33) Not for me. (5:34) Like, I'd go listen to a two or three hour podcast if I was interested. (5:37) I'd have no trouble with
Sarah (5:37) it.
Scott Benner (5:38) Mhmm. (5:38) But I think that for most people, it's easier if this conversation you and I have really ends up being eight or nine short conversations that are somehow tied together than telling, a tome. (5:52) And and I think it's more entertaining that way too.
Sarah (5:54) That feels that feels reassuring because I feel like there's certain buckets of my story that breaks down into several little stories, so that that's great. (6:03) And then I don't have to talk for an hour, but we can have this great dialogue about it.
Scott Benner (6:08) Perfect. (6:09) Let's start. (6:09) Seven years ago, you said? (6:11) Yep. (6:12) How old were you then?
Sarah (6:13) I was 37.
Scott Benner (6:14) Okay. (6:15) And now you are seven years later, but you don't have full blown here it comes type one diabetes?
Sarah (6:21) I think that I do. (6:23) I mean, this has been such an interesting ride. (6:26) I've, like, fully am insulin dependent. (6:29) I, have a lot of type one history in my family. (6:34) I have the anti the antibodies.
Sarah (6:39) Thank you. (6:39) Yep. (6:39) For type one. (6:41) And it just happened when I was later, but it had a slower progression. (6:47) So I I've been referred to as type one a lot of my seven years and then also recently just said, nope, you're LADA, and you can be treated as type one or type two.
Scott Benner (6:58) Okay. (6:58) How many other people in your family line have type one or other autoimmune issues?
Sarah (7:03) Yeah. (7:03) Have a sibling who has type one who was diagnosed at, like, nine, a great grandfather who died from type one diabetes at, like, age 29 before insulin was available. (7:14) I have my dad who was diagnosed in his fifties with type two initially and then one point five or LADA. (7:25) Mhmm. (7:25) And, there's some MS diagnoses in my family, Hashimoto's for me, Hashimoto's for my mom.
Sarah (7:33) So it's it's a smattering.
Scott Benner (7:37) It's unless there's 50 kids in that family, it seems like a lot.
Sarah (7:40) Yeah. (7:41) It's a lot.
Scott Benner (7:41) Was diagnosed your sister was diagnosed at nine. (7:44) So you've you grew up around type one. (7:47) I wanna understand if does hindsight let you think, oh, I could see it coming now even before your initial seven years ago? (7:56) Like or was there no way to know this was gonna happen to you until it happened?
Sarah (8:01) I appreciate that question. (8:03) So it was it was my brother just so I don't in case you I'm sorry. (8:07) Correct that. (8:07) No problem. (8:08) My mom was such a great advocate for us.
Sarah (8:11) So after my brother got diagnosed, she enrolled us in trial net. (8:15) So I was immediately tested for antibodies and I was GAD positive. (8:20) So that was at 11.
Scott Benner (8:22) Okay.
Sarah (8:23) So my mom knew, like, she told me kind of what that meant. (8:28) Like, there's a higher chance of you developing type one diabetes, and we just don't know what, when, or what. (8:36) What really triggered my diagnosis was having my third kid. (8:41) Like, it it felt like that was totally that event that pushed me over, that pushed my body into into this.
Scott Benner (8:48) Yeah. (8:49) Like your kid grabbed a ripcord on the way out or something.
Sarah (8:51) Totally. (8:51) Yes. (8:52) And that's totally his personality too. (8:54) Like, how can I just blow things up? (8:56) And yeah.
Scott Benner (8:57) What's this switch, Mark? (8:58) Don't touch. (8:59) Yes. (9:01) Boom. (9:02) Mom has diabetes.
Scott Benner (9:04) Okay.
Speaker 3 (9:05) So did your mom tell you when she did try on it?
Scott Benner (9:10) Like, did you grow up knowing that this might happen? (9:12) Yep. (9:13) Oh, you did?
Sarah (9:13) But I you know, as a an 11 year old, so just growing up, like, I was like, okay. (9:18) That that's something that could happen. (9:20) But, of course, you're like, that will never happen to me. (9:23) So even though I knew that, I didn't actually think it it would.
Scott Benner (9:27) Did it leave your mind as time passed on, or did you always have the same level of, like, background concern about it?
Sarah (9:33) I would say it left my mind. (9:38) I also am pretty health aware, and maybe hypochondriac is a better word for that. (9:45) Like, just always worried something is wrong. (9:48) And so I also have a tinge of that and I think probably helps me, you know, catch it early.
Scott Benner (9:57) Gotcha. (9:58) I wonder if it's because someone tells you you might get type one diabetes. (10:01) Totally. (10:02) We'll never know. (10:03) I'd love to rerun your life again, not tell you, and see if you're a hypochondriac.
Sarah (10:06) I know. (10:06) You never know.
Scott Benner (10:07) Yeah. (10:08) Taking away the fact that you had the trial net experience, is there anything about your life prior to your diagnosis that pointed to it? (10:19) Like, forget that you knew it was coming. (10:21) Were there it's it's kinda great because you're if you're hypercontract, you were really paying attention to what was happening to you. (10:25) Like, could you look back now and write out the road map?
Scott Benner (10:28) Oh, yeah. (10:28) When I was 14, I lost a bunch of weight and gained a bunch of weight. (10:32) And how about that? (10:33) Like, two years later, I got Hashimoto's or, like, is there anything like that that sits in your memory?
Sarah (10:38) I don't think so. (10:40) I was an adult when I was diagnosed with Hashimoto's. (10:43) I had gestational diabetes with all three of my kids. (10:46) Excuse me. (10:47) Insulin dependent.
Sarah (10:49) But I don't think there was anything that said, yes. (10:52) This is gonna be my future.
Scott Benner (10:54) Okay. (10:55) I appreciate you answering because I'm trying to figure out you know, I'm just trying to look backwards to see if there's signs or things that people could be paying attention to.
Sarah (11:03) For sure.
Scott Benner (11:04) Yeah. (11:04) Right. (11:05) Right. (11:06) Happened that led to you thinking like, uh-oh. (11:10) Here it comes.
Sarah (11:11) Yeah. (11:12) I so gestational diabetes with all three. (11:15) My first two kids, it was like, delivered, the placenta is out, my blood sugars returned to normal. (11:21) There was no issues. (11:23) My third kid, it was, like, a couple hours after delivery.
Sarah (11:27) They checked my glucose, and it was high. (11:30) Like, it was, like, one eighty or something, and I just immediately felt like this is not this is not good. (11:38) Like, I have delivered this kid. (11:40) The placenta is out. (11:41) These these glucose levels should be back to normal.
Sarah (11:44) And so that was my first something's going on. (11:49) About a year later, I had a checkup to just check an a one c post gestational diabetes, and it was elevated. (11:57) Question. (11:58) Yeah.
Scott Benner (11:59) First two pregnancies, baby comes out, you deliver the placenta, your blood sugar goes right back.
Sarah (12:03) Right? (12:03) Immediately. (12:04) Yes.
Scott Benner (12:04) Yeah. (12:04) Okay. (12:05) That's been my understanding talking to other people. (12:07) So then having had two experiences that way, a brother with type one, a dad with type one Mhmm. (12:14) A grandfather who wasn't lucky enough to be born before, I guess, 1921 or something like that.
Scott Benner (12:20) Why when you had the elevated after the third, didn't you raise your hand and go, hey. (12:25) I I don't wanna wait a year to find out about like, what happened in that that moment there?
Sarah (12:30) I think probably life and having three kids and just being overwhelmed was enough to distract me like, okay. (12:40) Crap. (12:41) But also by the time I discharged, my glucose level is back to normal. (12:45) So it it was like this tiny red flag that I was able to suppress.
Scott Benner (12:50) Got it. (12:50) Okay. (12:50) Thank you. (12:51) Okay. (12:51) Please keep going.
Sarah (12:52) Yeah. (12:52) So I had a elevated a one c like in the nines, and my endocrinologist said, hey. (13:01) I think this is type two. (13:03) Let's get you started on metformin. (13:05) And so started that.
Sarah (13:06) I got kicked out of trial net because I got started on metformin, really walking down that type two diabetes diagnosis. (13:13) Like, what does this mean? (13:15) Is metformin all there is? (13:17) And also still having three young kids, it was enough of a distraction for me not to really go down the rabbit hole of where I, you know, frequently go today.
Scott Benner (13:28) Did that doctor know about the type one in your family?
Sarah (13:32) Yes.
Scott Benner (13:33) Fascinating. (13:34) Okay. (13:34) Yeah. (13:34) Sorry. (13:35) So what is that rabbit hole of, hey.
Scott Benner (13:37) You have type two diabetes. (13:38) Here's metformin.
Sarah (13:40) I mean, I think it would be, wait a second. (13:43) I have all this type one in my family. (13:46) Let's do some digging. (13:47) What the actual heck? (13:48) You know?
Sarah (13:49) Like, it doesn't make sense for me to have type two, but I I just I don't think mentally I was I was there.
Scott Benner (13:55) Okay. (13:55) Because you had antibodies. (13:57) The doctor knew that?
Sarah (13:58) Oh, good question. (13:59) I don't know if they did. (14:00) I they may have not because, you know, when you enroll in trial, that that's kept in trial, that and it's not like it gets to your health record.
Scott Benner (14:10) Right. (14:11) But and you didn't mention it? (14:12) No. (14:13) And you would describe yourself at that point as overwhelmed?
Sarah (14:16) I would say yes. (14:17) Like, I had kids. (14:19) Like, anxiety really ramped up for me. (14:22) I had some postpartum depression. (14:24) So, like, my when my kids were young, it was it was rough for me.
Sarah (14:28) So I think that's just one more thing on top of a complex family life that I either just couldn't quite deal with or couldn't quite dig into.
Scott Benner (14:37) If I was a therapist, I would say I'd like to acknowledge that I appreciate that. (14:41) But instead, I'm gonna tell you that I I really appreciate you digging into that with me because what I think it does for other listeners I mean, like, look at Sarah. (14:51) Like, she knew she had type one diabetes. (14:53) Like, right? (14:53) Like, she knew she had autoantibody.
Scott Benner (14:55) She knew she had type one in the family. (14:56) She, like, she you should be listening to her speak, she bright lady. (15:00) You're in health care.
Sarah (15:01) Mhmm.
Scott Benner (15:01) Right? (15:02) Like and still the wash of life Mhmm. (15:06) Was a somebody said type two, and your feet came out of the sand, and you just went out to sea with it. (15:10) And just were like, okay. (15:11) I have type two.
Scott Benner (15:12) Just like that. (15:13) Yeah. (15:14) So I hope everybody hears that and realizes that when you're beating yourself up, when you have no context for this whatsoever and, you know, you or your kid end up in the hospital and you're like, oh, like, how do I not see this? (15:25) Like, it's really easy not to say it. (15:27) Mhmm.
Scott Benner (15:27) So yeah. (15:28) That's all. (15:29) I so thank you. (15:30) Unless you think the postpartum and stuff like that has impact on the story, I feel like you should just move forward. (15:35) But if you think it has impact, you can tell me about it.
Scott Benner (15:40) Today's episode is brought to you by Omnipod. (15:42) Did you know that the majority of Omnipod five users pay less than $30 per month at the pharmacy? (15:49) That's less than $1 a day for tube free automated insulin delivery. (15:53) And a third of Omnipod five users pay $0 per month. (15:57) You heard that right.
Scott Benner (15:58) 0. (15:59) That's less than your daily coffee for all of the benefits of tubeless, waterproof, automated insulin delivery. (16:05) My daughter has been wearing an Omnipod every day since she was four years old, and she's about to be 21. (16:11) My family relies on Omnipod, and I think you'll love it. (16:14) And you can try it for free right now by requesting your free starter kit today at my link, omnipod.com/juicebox.
Scott Benner (16:22) Omnipod has been an advertiser for a decade. (16:25) But even if they weren't, I would tell you proudly, my daughter wears an omnipod. (16:29) Omnipod.com/juicebox. (16:32) Terms and conditions apply. (16:33) Eligibility may vary.
Scott Benner (16:35) Why don't you get yourself that free starter kit? (16:37) Full terms and conditions can be found at omnipod.com/juicebox. (16:42) I used to hate ordering my daughter's diabetes supplies. (16:46) I never had a good experience, and it was frustrating. (16:50) But it hasn't been that way for a while, actually, for about three years now because that's how long we've been using US Med.
Scott Benner (16:57) Usmed.com/juicebox or call (888) 721-1514. (17:06) US Med is the number one distributor for Freestyle Libre systems nationwide. (17:11) They are the number one specialty distributor for Omnipod Dash, the number one fastest growing tandem distributor nationwide, the number one rated distributor in Dexcom customer satisfaction surveys. (17:23) They have served over 1,000,000 people with diabetes since 1996, and they always provide ninety days worth of supplies and fast and free shipping. (17:33) US Med carries everything from insulin pumps and diabetes testing supplies to the latest CGMs, like the Libre three and Dexcom g seven.
Scott Benner (17:43) They accept Medicare nationwide and over 800 private insurers. (17:49) Find out why US Med has an a plus rating with the Better Business Bureau at usmed.com/juicebox, or just call them at (888) 721-1514. (18:00) Get started right now, and you'll be getting your supplies the same way we do.
Sarah (18:05) Yeah. (18:06) I don't think it does have impact on the story. (18:07) It just provides context about where my mental state was when all this was happening.
Scott Benner (18:12) Okay. (18:13) Okay. (18:13) So please.
Sarah (18:14) Yeah. (18:15) About a year later, still on metformin, I suddenly started dropping, you know, 15 pounds, which I was super pumped about because I was like, man, I'm, like, eating all this crap, and I'm still losing weight. (18:27) This is amazing. (18:28) And not no red flags going off for me, just, like, really loving life. (18:33) And then I remember working and being like, dang.
Sarah (18:36) My fingers are, like, so tingly. (18:39) And this has been happening, like, every single day in the afternoon. (18:43) Like, what the heck is going on? (18:45) And it was those two things that I probably sat with for a month. (18:52) Like, I'm losing weight.
Sarah (18:54) My fingers are tingly and not quite ready to acknowledge it. (18:58) And then I just finally, one morning, I woke up and checked my blood sugar fasting, and I I knew it was gonna be terrible, and it was, like, three eighty.
Scott Benner (19:08) Oh, yeah. (19:10) And there you go. (19:11) You said, I don't have type two diabetes?
Sarah (19:12) Like, damn it. (19:13) Yes. (19:14) Here it is. (19:15) And that was that was it.
Scott Benner (19:16) I thought the tingling was just an alarm to remind me of how awesome and skinny I was.
Sarah (19:20) Totally. (19:21) I know.
Scott Benner (19:23) I've bought so many great clothes in the last month.
Sarah (19:26) I know. (19:27) And now, dang.
Scott Benner (19:29) No. (19:29) I hear it. (19:30) Okay. (19:30) So what do you do? (19:31) Do you go back to that doctor and you hit him with a rolled up newspaper, or how do you handle it?
Sarah (19:36) It was interesting. (19:37) So I called my endocrinologist and said, crap. (19:40) My fasting was three eighty. (19:42) What do I do? (19:43) And, like, it was so interesting because I don't think this would happen with, like, regular people who maybe aren't in health care who didn't have the gestational diabetes diagnosis, but literally it was over the phone.
Sarah (19:58) Like, you're starting Humalog. (19:59) You're starting, long acting. (20:02) Go pick it up. (20:03) This is starting today. (20:05) Start checking your blood sugars, we'll get you in an appointment when we can, and it's not for like four weeks.
Sarah (20:11) And so I just don't think of any scenario where someone with this new diagnosis is managing that on their own without actually going in. (20:20) Does that make sense?
Scott Benner (20:21) Yeah. (20:22) Oh, it feels positive and negative to me. (20:24) It feels positive that the doctor was like, didn't fight you and say, no. (20:28) We'll give you more metformin. (20:29) What have you been eating?
Scott Benner (20:30) Like, that kind of thing. (20:31) But you didn't get that. (20:32) You got you got, oh, gosh, you know, capitulation. (20:35) Same doctor that gave you the type two diagnosis? (20:37) Yes.
Scott Benner (20:38) Okay. (20:39) And but on the other side of it, is it because you're in medicine? (20:41) Do you think that they were like, oh, she'll know what to do. (20:44) Here. (20:44) Take your insulin?
Sarah (20:44) Yes. (20:45) I totally think so because they knew I was a nurse. (20:47) They knew my mom was a diabetes educator. (20:50) Like, we of course, I had the resources, and so I'm not faulting them for that. (20:55) It really just was like, I can't believe that happened like that.
Scott Benner (20:58) No direction, education, anything at all. (21:00) Just we'll send some scripts over and you you rock and roll, you get going.
Sarah (21:04) Get started. (21:04) Yep.
Scott Benner (21:05) How did you figure out I mean, you go to your brother, or how do you figure out how to get your even, like, choose a the amount for basil, for example?
Sarah (21:12) Yeah. (21:12) I think I leaned in on my mom. (21:15) Just her she had the knowledge. (21:18) It was, okay. (21:19) Try to do this many, units of insulin for this many grams of carbs, and then it was just off and running.
Sarah (21:26) It was trial and error.
Scott Benner (21:27) Well, your mom worked for, like, Medtronic or something like that?
Sarah (21:30) She worked for Medtronic, she also worked for Tandem.
Scott Benner (21:33) So you go to your mom, who raised a kid with type one Yep. (21:37) Has has the background, you know, professionally to some level or another. (21:40) Yep. (21:40) And you go MDI?
Sarah (21:42) I go MDI.
Scott Benner (21:44) Okay. (21:45) And you're how much did you need in the beginning?
Sarah (21:48) Oh gosh. (21:49) Like, you will be really testing my memory. (21:51) I remember it was, like, keep under 20 units a day. (21:55) That was the first the first prescription.
Scott Benner (21:58) I was gonna guess, like, a lot less than now Yes. (22:00) Or not really?
Sarah (22:01) Yes. (22:02) Yeah. (22:02) Now it's a little bit different. (22:03) But, yes, like, at the peak, a lot less than where I started or than where I got to.
Scott Benner (22:09) Excellent. (22:10) So okay. (22:10) So you go to your mom, but then you're not I mean, where are you, postpartum? (22:17) How long how old is your youngest at that point?
Sarah (22:19) At least a year. (22:20) Not quite two.
Scott Benner (22:22) Would you still consider yourself in that malaise, that haze there?
Sarah (22:25) No. (22:25) I think I was out of that. (22:27) Yep.
Scott Benner (22:28) Okay. (22:28) So you're a little more clear minded at that point. (22:31) So explain to me your mindset about the diagnosis being thrown into it. (22:36) Like, I'm really interested in those first four weeks before you get to the doctor.
Sarah (22:39) Mhmm. (22:39) It was a ton of denial, and that actually lasted a really long time. (22:44) Like, this is something I'm doing today. (22:47) This is something I'm doing during this hour, but it's not my the rest of my life. (22:53) I I just, like, could not could not get there because of how almost, like, devastating it feels to, you know, to get that that sinking and feeling to be like, oh my gosh.
Sarah (23:07) This is the rest of my life, and I just could not. (23:09) And so I handled it almost like I handled work sometimes. (23:15) Like, there's a critical situation, you know what to do, you have the training to do it, just do it and get it done and make sure your glucose levels are in normal range.
Scott Benner (23:27) Okay. (23:27) And I'm sorry to ask, but you you didn't go to your brother. (23:31) You're not close or you are close, but you didn't occur to you to go to him?
Sarah (23:34) Oh, for sure. (23:35) Like, I my brother knew, my dad knew, my mom knew. (23:39) I mean, my whole family knew. (23:40) We talked about it, like, processed it, and it sucked. (23:44) But his journey was so much different, like, been diagnosed at nine or at seven or whatever it was.
Sarah (23:52) And then this kind of slower onset, it just was different. (23:57) The nice thing was is it opened up this channel of communication between all three of us, my dad, my brother, me. (24:02) Like, we're in this little tribe together.
Scott Benner (24:05) Yeah.
Sarah (24:05) And then this is a little bit of a tangent, but I quickly advocated to get on a pump. (24:10) I quickly advocated to get on dexcom, and at that point, neither my dad or my brother were on a continuous glucose monitor. (24:17) So literally within thirty days of this diagnosis, I was on one and, you know, they've been on this for years.
Scott Benner (24:24) Yeah. (24:24) I was going to ask, I guess, was your dad's, like the entirety of his advice, like, don't eat that toast. (24:30) I don't know. (24:30) I give myself the thing, and I try not to eat bread. (24:33) Is that, like, you know, is that how he's managing?
Scott Benner (24:35) It was how he was managing Okay. (24:38) Did your brother follow suit with that management style more so? (24:42) I I know it's hard to, like, call because it feels like you're calling him out now because now you know how to live with diabetes. (24:47) You know what it really means to say this out loud. (24:49) But do you think he was doing as well as he could have been?
Sarah (24:52) No. (24:52) I would say no. (24:53) And I I could say that to his face for sure. (24:56) And I also think he was doing what he could with what he what what was going on in his life. (25:04) And not like not like he had a ton of stuff going on, but it's it's a lot.
Sarah (25:07) And he was and he's had it since he was young. (25:10) And it just He's
Scott Benner (25:12) older than you?
Sarah (25:12) He's younger than me.
Scott Benner (25:14) Younger than you. (25:14) So how so he grew up with it through the eighties?
Sarah (25:20) Through the eighties. (25:21) Yep. (25:21) Because he was born in, like, '82.
Scott Benner (25:25) Okay. (25:25) So he probably got Lantus and Humalog at the very beginning of Lantus and Humalog. (25:29) Yep. (25:30) Yeah. (25:30) Okay.
Scott Benner (25:33) But and so I know what the tools were like back then as far as how they were, communicated to people, and it really was about, like, testing periodically, and Mhmm. (25:42) It's not I don't think it nearly is what it was. (25:44) So your mom's understanding of management is back there as well. (25:48) Oh, speaking of your mom and your dad, you sound like you guys have a pretty close relationship. (25:53) So this question is really just for me.
Scott Benner (25:56) Were they devastated when you were diagnosed even though you were 37?
Sarah (26:00) No. (26:01) I would Yeah. (26:01) Say I and maybe that's just also their, like, Scandinavian roots. (26:08) Like, it is what it is. (26:09) Like, you move forward.
Sarah (26:11) And it also is like this probably was writing on the wall.
Scott Benner (26:15) Yeah. (26:15) That you think they've been waiting for it forever. (26:17) Maybe it was a relief.
Sarah (26:18) I think they, yeah, knew that it was probably coming, especially my mom knowing what the antibodies meant and knowing that I was GAD positive at 11.
Scott Benner (26:28) You know, as soon as I don't know. (26:30) As soon as Arden was diagnosed, a couple years later, we sent Cole to trial that he did not have any autoantibodies. (26:35) K. (26:36) But he but he did develop Hashimoto's a handful years ago.
Sarah (26:39) Okay.
Scott Benner (26:40) And I will admit that it took some effort not to look at him and think, oh, god. (26:45) Is he gonna get diabetes? (26:46) Every time I looked at him. (26:47) Yeah. (26:48) And I still can't tell if it feels more possible because of my job.
Scott Benner (26:55) And I hear everyone's stories and no one comes on to tell the story of how they were this, you know, the I don't know, the brother or daughter or sister of a type one and nothing ever happened to them. (27:05) Like, nobody comes on to tell that story. (27:06) So every story I hear sounds like that Or so I don't know if I I feel that way because I hear the stories or because if it's a real anxiety, you know, and a genuine, like, back back brain concern. (27:19) Mhmm. (27:19) But somehow knowing that your parents because I know some people think of parenting differently than I do.
Scott Benner (27:26) Right? (27:26) I'm I'm sure we all think of it in a ton of different ways, but I I feel like it's a lifelong endeavor. (27:32) I just I don't know if I could handle fifteen years from now, like, like, being 70 year will I be 70 in fifteen? (27:40) Hold on a second. (27:40) Jesus Christ, I will be.
Scott Benner (27:42) Okay. (27:42) So I don't know if I oh, it was terrible. (27:45) Now I'm upset. (27:46) I I don't know if fifteen years from now, I'm 70 years old and my, you know, I don't know, 40 year old son calls me up and says, hey. (27:56) I have type one.
Scott Benner (27:57) I I don't know if I could handle it. (27:59) Like and I'm and your actually, your parents' reaction is making me feel a little more like maybe I can.
Sarah (28:04) Yeah. (28:04) And almost like a relief. (28:05) Like, oh my gosh. (28:06) We made it to 40, and I'm, of course, not projecting that that's gonna happen.
Scott Benner (28:10) Yeah.
Sarah (28:11) I have that same feeling for my three kiddos, like, just waiting for that diagnosis, which is terrible. (28:17) And they all did trial meds and they don't have the autoantibodies, and I will always be waiting for that for the rest of their life. (28:25) So, yes, I hear you.
Scott Benner (28:26) Yeah. (28:27) Any autoimmune on your husband's side? (28:29) I don't know if you're married still, but
Sarah (28:30) I am still married and no, there's no autoimmune on his side.
Scott Benner (28:34) Okay. (28:35) Just is he just annoyingly healthy?
Sarah (28:37) Yes. (28:37) Which is awesome for him. (28:39) Yep.
Scott Benner (28:40) Awesome for him.
Sarah (28:41) Yeah.
Scott Benner (28:44) You said you have Hashimoto's as well?
Sarah (28:45) I do. (28:45) Yep.
Scott Benner (28:46) Alright. (28:47) So before we get into you jumping onto a pump really quickly, how old were you when you were diagnosed with that?
Sarah (28:51) I was probably about 25.
Scott Benner (28:54) Oh, okay. (28:55) Managed with Synthroid?
Sarah (28:56) Yep.
Scott Benner (28:57) Do you have any symptoms even when you were medicated?
Sarah (29:01) No. (29:02) Not really.
Scott Benner (29:03) Okay. (29:03) You've been good with that. (29:04) You haven't needed a t three to help or anything like that? (29:06) Nope. (29:07) Nope.
Scott Benner (29:07) Awesome. (29:07) Oh, that's great. (29:09) Any of your kids have Hashimoto's? (29:10) No. (29:11) No.
Scott Benner (29:12) How old are they?
Sarah (29:14) They are 14, 12, and eight.
Scott Benner (29:17) Oh, wow. (29:17) And you're wait. (29:19) And you're 44?
Sarah (29:19) Yep.
Scott Benner (29:20) You start a little late?
Sarah (29:22) Start a little late for what? (29:23) Kids?
Scott Benner (29:23) Yeah. (29:24) 30. (29:24) How old were you when you
Sarah (29:25) 30 was my first kiddo. (29:27) My parents were totally young. (29:29) So, yes, they were totally done having three kids by, like, the time they were 27. (29:33) So, yes, starting at 30 is later than what they did for sure.
Scott Benner (29:38) Oh, your mom and dad are still younger then?
Sarah (29:40) Yeah. (29:40) My mom is 69, my dad is 70.
Scott Benner (29:43) How do you like that? (29:44) Can you still talk to them? (29:46) You know what I mean?
Sarah (29:46) Yeah. (29:47) I I have always loved that they're younger and always envisioned myself, like, being a super young parent, which I am what I am. (29:56) You know, it is what it is. (29:57) But I yeah. (29:58) I always I've always loved that.
Scott Benner (30:00) Okay. (30:00) You meet a guy late. (30:01) You build a career first?
Sarah (30:03) Like, I started building my career. (30:06) I loved I loved nursing and jumping into that. (30:10) We I didn't meet my husband till I was 26, I think.
Scott Benner (30:17) Oh, and he's older than you or younger?
Sarah (30:20) He's just a year older, so not
Scott Benner (30:21) Okay.
Sarah (30:22) Not that much older.
Scott Benner (30:23) So you waited till you found a decent one?
Sarah (30:26) Yeah. (30:27) And he's a decent guy. (30:28) And we got married when we were 29 and then, like, surprise, then had a baby at 30.
Scott Benner (30:34) Was three kids your goal?
Sarah (30:37) It was we didn't have a goal. (30:39) We for sure, wanted to try to have a boy and a girl or a son and a daughter. (30:44) And our we had boy, girl, and then we we sat on that, like, hey. (30:49) Maybe we're done. (30:50) Maybe we're not.
Sarah (30:51) And then it was just decided for us that we weren't done, and then we had a third.
Scott Benner (30:55) Did you go to a wedding? (30:56) What happened?
Sarah (30:59) I don't know.
Scott Benner (30:59) It was k. (31:00) Yeah. (31:00) I don't know. (31:02) Caught me in a weak moment.
Sarah (31:03) Got me in a weak moment.
Scott Benner (31:05) So you jumped onto a pump pretty quickly. (31:08) Did you go what what pump did you get?
Sarah (31:10) I went to the t slim.
Scott Benner (31:12) Okay. (31:12) And back then back then, but seven years ago, was there even bolus IQ at that point?
Sarah (31:18) No. (31:18) There was not.
Scott Benner (31:19) Okay. (31:20) I I guess take me a little bit through your education process because it was probably a self education. (31:25) Right? (31:25) Or did the endo finally jump in and add value?
Sarah (31:28) It really felt like a self education and partnering with my mom. (31:32) Like, even when I got started on a pump, it was my mom that came over and, like, walked me through it while I was on the phone with someone trying to tell me, but really it was my mom working through it and showing me how to use it. (31:45) And I remember calling my mom and being like, oh, my blood sugars are here. (31:51) Like, something's going on or this happened and this happened. (31:53) And she would help troubleshoot with me, which I thought was super valuable because, of course, your mom is just so much more available than any provider could ever be.
Sarah (32:02) And so that was invaluable for me. (32:04) And it was trial and error managed by me, less by endocrine.
Scott Benner (32:10) And how slowly was your ramp up in needs? (32:13) How many months or years did it take for you to get to your insulin need that you have now?
Sarah (32:18) I would say it was gradual but continuous. (32:23) It was, like, every year, I felt like I was taking more insulin. (32:28) That was the most stressful thing for me is, like, what the actual heck? (32:34) Like, this is just gonna keep going for the rest of my life. (32:37) Like, every year, I'm gonna be taking more insulin every single day.
Sarah (32:40) Like, that's terrible. (32:42) And it just it felt like that was the journey that I was on.
Scott Benner (32:46) So then tell me, would you prefer it all just happened in a moment, or do you I mean, I guess the question comes from a more, like, psychological side because I think health wise, you'd prefer that it to take forever if it could. (33:01) Right?
Sarah (33:01) For
Scott Benner (33:01) sure. (33:01) So what's your look back on that?
Sarah (33:03) My look back is, yes. (33:05) I probably have the preferred way of having it ramp up gradually, you know, every year getting more and more, and it was very distressing. (33:14) Like, the diabetes distress, which my diabetes educator quite shared that term with me and I really have globbed onto it, it just increased the distress every time I had to go up.
Scott Benner (33:28) Do you have any of those feelings of your body letting you down? (33:31) I guess this is probably a a forward looking thing, but, like, Erica and I are are starting to do a, a series around body grief. (33:38) Yeah. (33:38) And that idea of, like, how hard it is to live every day, like, feeling like your body's not doing what it's supposed to do and all that comes with that.
Sarah (33:48) I don't I totally see that, and I don't think that was my experience.
Scott Benner (33:52) Okay. (33:52) Or just this it was probably omnipresent, I guess. (33:56) Like, it's getting work. (33:57) It felt and it felt like it was getting worse. (33:59) Right?
Scott Benner (33:59) Yeah. (33:59) Making quotes. (34:00) Yeah. (34:01) So okay. (34:02) What made you wanna come on the podcast?
Scott Benner (34:04) Tell me again. (34:04) You you went over it at the beginning, but I'd like you to outline it again because I think I probably jerked you away from it a little bit.
Sarah (34:09) Yeah. (34:09) Sure thing. (34:10) My diabetes journey, when it kicked off, just stayed the same. (34:16) It's like this is type one, you're, you know, latter type one, but usually referred to as type one. (34:22) Your C peptide is really low.
Sarah (34:24) It was checked one time and this is what your life is gonna be. (34:29) And probably a year ago, the distress for me was really picking up, like, doing a ton of research. (34:38) Like, what else is there for type one? (34:40) What else is there? (34:41) This can't be it.
Sarah (34:43) It can't be just try harder, and you're doing so much better than, like, ninety percent of my patients. (34:50) But, like, that's not the goal I was looking for. (34:53) It's like, I want I want to have an a one c of someone without diabetes, and I want to be really tightly controlled. (35:02) And I want every single tool to be available to me, not just what the endocrinology team thinks is best for me. (35:10) I want all the research.
Sarah (35:12) I want all the potentials. (35:14) And so that's that's where I was sitting over the last year. (35:18) I got a recommendation to try a new endocrinologist in the spring, and that was life changing for me. (35:27) He really started at the beginning and said, I'm not gonna write a diagnosis on your chart. (35:34) We're gonna see what the labs tell us and we'll go from there.
Sarah (35:38) And so it was this really full history. (35:40) It was drawing every hormone under the sun, all the autoantibodies again, c peptide, literally everything. (35:47) And coming back to that appointment and walking through what my labs were telling was so insightful. (35:57) I was surprised that my c peptide was actually in the normal range. (36:02) It was like 1.5.
Sarah (36:04) And when I first was checked at diagnosis, I was like point four.
Scott Benner (36:09) I guess describe the difference between what I'll call, like, your first diagnosis with that endocrinologist and your, you know, what should we call it?
Sarah (36:19) Like, your the rebirth. (36:21) I don't know.
Scott Benner (36:21) Yeah. (36:22) Was gonna call it rebirth. (36:23) Like, you you know when you get married again? (36:24) Like, you're like, oh, let's do another wedding.
Sarah (36:26) Yes.
Scott Benner (36:26) You were like, let's start this over again.
Sarah (36:28) Exactly that.
Scott Benner (36:30) How did that really support you though?
Sarah (36:33) It was so validating to me. (36:35) And I remember, like, wanting to connect with my husband after this appointment to just talk through it. (36:41) And we were on a walk, and I was sobbing. (36:43) Like, I knew I knew there was more. (36:46) I knew that there was more to this than just what was available to me and that the story is so much deeper than just on paper.
Sarah (36:55) It felt like this endocrinologist was looking at me truly inside of who I was and what was going on with my body and wanting to respond to that versus your a one c looks great. (37:09) Keep up the good work. (37:10) And it Yeah. (37:11) It just was it was so validating.
Scott Benner (37:14) So you have this probably enduring feeling that there's more to this than I understand.
Sarah (37:19) Yes.
Scott Benner (37:19) And you can't just let it go. (37:21) Yeah. (37:22) Yes. (37:22) So that is infuriating, anxiety ridden, all the I would imagine a little bit of all that. (37:30) Yes.
Scott Benner (37:30) Yeah. (37:31) What made you like, what tipped you over? (37:35) What made you say, no. (37:35) You know what I really need to do? (37:37) I need to go find a different doctor who's gonna be more involved with me.
Scott Benner (37:40) Like, was there a a moment that pushed you or desperation?
Sarah (37:44) I think it was desperation. (37:46) It was a combination of a couple things. (37:48) I remember bringing an idea to my endocrinologist about amylin or reading about that and wondering, like, is that a place for me? (37:59) Is that something that's really helpful? (38:00) And I think I understand now that that's not prescribed anymore.
Sarah (38:04) Is that correct? (38:05) I think you probably know that.
Scott Benner (38:07) It does seem like I have an email from somebody who, you know, it's funny. (38:12) There's a guy that was on the podcast in the first year. (38:14) I haven't emailed him back yet. (38:16) This is great that you brought this up, actually. (38:18) He wants to come on about that.
Scott Benner (38:20) Oh, interesting. (38:21) Yeah. (38:22) I've been using it forever, and suddenly, I cannot find it. (38:27) It's, it's such a shame. (38:28) But, no, there's somebody very recently.
Scott Benner (38:30) So I don't know. (38:31) Is Amlan no longer available? (38:35) I don't know if that's the case.
Sarah (38:38) I feel like I read something, like, it's not as effective as maybe it was thought to be.
Scott Benner (38:45) Contextually, you were looking for anything. (38:48) I like this, by the way. (38:49) You and I would dork out together talking about stuff. (38:51) Like, so you, like, you were just like, maybe this will work.
Sarah (38:55) I was looking at everything and anything trying to find articles or research showing, like, what's the latest technology? (39:02) What have people tried? (39:04) Really just anything. (39:06) And what I think I was talking about, like what tips you over the edge, I reached out to my endocrinologist and asked like, what about Amylin? (39:14) And his response really punched me in the gut.
Sarah (39:19) And I don't blame him for it. (39:20) This is just where they were was I don't prescribe that, and I don't even know who I would recommend you to to prescribe that. (39:29) It, like, crushed me because it felt like, oh my gosh. (39:33) Like, there's all this chatter and all this research happening, and I'm not being offered that or I'm not even given the opportunity to discuss it. (39:42) Like, where where does that what's the place for that?
Sarah (39:45) Where do I have this conversation with a provider about all the things that I read? (39:50) And they tell me, yes. (39:52) It's a good idea. (39:53) No. (39:53) This is why this is not a good idea, but have that collaborative relationship.
Sarah (39:58) And that that pushed me over the edge.
Scott Benner (40:00) I also think that it's telling that anything that they don't do, many of them aren't gonna wanna be involved in. (40:07) You don't go into an office and say, hey, you know, would you sit here and philosophize with me for a few minutes about what would happen if this and maybe you and I will try it together and wouldn't that be interesting? (40:16) He's like, I don't know what to do and I don't know where to send you. (40:19) That sentence is, please stop asking me about this. (40:22) Mhmm.
Scott Benner (40:23) Yeah. (40:23) Because we're not talking about this anymore. (40:24) Yep. (40:25) And then then you were like, right on. (40:27) I'm gonna go find a different doctor.
Sarah (40:28) Yes. (40:28) Exactly that.
Scott Benner (40:30) I tell people all the time that when they wanna switch doctors, I would call around. (40:35) Like, I think and and have real conversations on the phone. (40:38) Lay out your expectations and say, is this the kind of office where this is permissible and encouraged? (40:44) Because if not, you're gonna make an appointment. (40:46) You're gonna wait weeks and months.
Scott Benner (40:48) You're gonna go in, say your thing, and run the risk of the person looking up at you and going, I don't do that. (40:52) I don't know where to send you for that. (40:54) Like, it could take you two years to find a good doctor that way. (40:56) How did you find one on the first try?
Sarah (40:58) It was divine intervention. (41:01) The diabetes educator that I was connecting with and really walking through all this, like I was able to be very real with her about what I was thinking, where my distress was, what that conversation with my provider was. (41:13) And she said, I have a recommendation for an endocrinologist. (41:16) She also gave me a couple other recommendations too. (41:19) She saw him at one point and she said he saved my life.
Sarah (41:22) He was able to diagnose me as Latta. (41:25) That's what she had said. (41:27) And she said he's different and it might be just what you're looking for. (41:31) So I, like, I did some research online. (41:34) There were some terrible reviews, but I just something felt like I had to try it, and I was able to get into them quickly, and it just worked it worked out.
Scott Benner (41:45) Yeah. (41:45) I I think that your vibe then when you got there was this is the right person.
Sarah (41:50) Yep. (41:51) Good. (41:51) Definitely.
Scott Benner (41:52) That's awesome. (41:52) Awesome. (41:53) So what else did you in that time of picking through and saying, how about Amlan? (41:57) Like, was there other things that popped up for you or ideas about management that you what did you think was in that toolbox that you hadn't opened yet?
Sarah (42:06) I read a lot about GLP ones because that was really coming out to, like, so much publicity. (42:12) Like, it was coming out on Bravo and Real Housewives and all this other stuff. (42:16) I'm like, what the heck is this, and how does it benefit? (42:19) And being available to just those with a type two diagnosis didn't necessarily make sense to me. (42:26) The more I read about it, the more I felt like this actually seems like there could be an offering beyond type two.
Sarah (42:34) So it was like knowing that that was all drumming up and getting excited and people were looking at it, seeing that there were some research started by using that on type one or people with type one. (42:45) And I think that was that was it. (42:48) Like, there's there's something else out there for me because these discussions are happening in research and articles and in the diabetes community.
Scott Benner (42:56) Are you using a GLP one now?
Sarah (42:58) I am.
Scott Benner (42:59) Which one?
Sarah (43:01) I never say this right. (43:03) Mounjaro. (43:04) Thank you. (43:04) I always wanna say, like, bonjour or something. (43:07) Mounjaro.
Sarah (43:07) Yes. (43:08) So
Scott Benner (43:09) how long and what dose?
Sarah (43:11) I have been on it since April and I am at seven point five.
Scott Benner (43:16) Did you have weight to lose?
Sarah (43:17) For sure. (43:18) Yep. (43:18) I Yeah. (43:19) Had like 15 pounds to lose.
Scott Benner (43:21) Is it gone?
Sarah (43:22) It's gone. (43:23) Yeah.
Scott Benner (43:24) And you so you're at seven point five because it's a good maintenance dose for you?
Sarah (43:28) Yes. (43:29) And because my my the weight loss happened pretty quickly in a short amount of time, and now my hair is falling out. (43:36) You know, I'm just going through some of that hair loss that happens, and so I'm not willing to go up. (43:41) I'm still seeing the great impact of it. (43:43) I just wanna hold until I know I'm not gonna lose all my hair.
Scott Benner (43:47) That does happen to some people. (43:49) Right? (43:49) Their hair thins a little bit. (43:50) Yeah. (43:52) Have you tried going backwards to see if you can hold position with with even less?
Sarah (43:57) I haven't. (43:58) No. (43:58) But that would be a good idea.
Scott Benner (44:00) If you don't wanna do it as a script, you could go on Amazon, buy vials, inject it into a vial, then draw it all out with an insulin needle to give yourself a measurement and then mess around with how much of it to give yourself.
Sarah (44:12) Oh, that's genius.
Scott Benner (44:13) Yeah. (44:13) Yeah. (44:14) Okay. (44:14) That's for you. (44:15) Arden right now is using 17 equivalent insulin units of Mounjaro, and I think it's a little too much.
Scott Benner (44:24) I think the next time she does it, I'm gonna try try tell her to try 15.
Sarah (44:27) Okay.
Scott Benner (44:28) It really keeps her blood sugars super stable.
Sarah (44:32) That's amazing.
Scott Benner (44:34) Yeah. (44:34) Do you have insulin resistance? (44:35) Is that where it's helping you?
Sarah (44:38) Well, can I can I go into a little bit more? (44:40) And if I'm telling you too much, please feel free to No.
Scott Benner (44:43) Go crazy. (44:44) Yeah. (44:44) Please. (44:45) Please.
Sarah (44:45) Within this endocrinology appointment, getting my c peptide level back, antibodies, which was GAD, and that I was positive for the insulin antibodies. (44:56) So knowing that, like, actual insulin was being attacked, and I did not have the islet antibody, which breaks down that protein in your pancreas. (45:08) So two out of those three. (45:10) So just learning all this, and he described it by having a c peptide in the normal range. (45:15) He said your beta cells or whatever is producing insulin are like raisins.
Sarah (45:21) We need to help those be grapes so that you can utilize the insulin or they can produce insulin and you can utilize it. (45:29) And so that that was a good visual for me to understand what we were gonna do with, GLP one. (45:38) So getting that c peptide level back and my autoantibodies allowed him to say, this is LADA for sure. (45:48) This is your diagnosis. (45:49) It's LADA, and you can be managed like type one or you can be managed like type two.
Sarah (45:56) And he said, if you're gonna be managed like type two, the repertoire of available medications just just explodes. (46:04) Like, there's so many other opportunities. (46:07) And he said, I think that you should go on a GLP one because it will protect those beta cells. (46:13) You'll have protection of those so they're not destroyed and that they'll work properly. (46:17) You'll have the cardiovascular benefit, the inflammation, and protection against dementia or all those things.
Sarah (46:26) And he said that's that's the way to go. (46:28) And that felt amazing. (46:30) Like, there's something else I can try, and it's not just insulin, and it's not just me trying harder. (46:36) It was, like, the gift no one would ever be able to give me. (46:39) It was amazing.
Scott Benner (46:42) That's awesome. (46:43) Yes. (46:43) How did and it's the same doctor. (46:45) You Same doctor. (46:46) Progressive doctor ended up helping you in a number of different ways.
Scott Benner (46:48) Yes. (46:49) Yeah.
Sarah (46:50) It just felt like this is someone who is understanding this journey and where people with distress are at. (46:57) And it felt like people should know this. (47:00) Like, you shouldn't just get your C peptide checked once. (47:02) It's fluid. (47:03) It changes depending on your blood glucose level.
Sarah (47:05) Like, you should be checking that regularly to ensure you have the right diagnosis because I'm sure there's folks out there with LADA who are managed like type one or diagnosed as type one only and then don't have access to additional medications where if they had these additional labs, they'd be able to have that access.
Scott Benner (47:26) Doctor Hamdi was on the show earlier this year, and he talked about that he believes there will be a lot of dual diagnosis in the future. (47:36) I believe that. (47:37) Yeah. (47:38) And how valuable that'll be. (47:39) I mean, that's ardent.
Scott Benner (47:40) That's how ardent is diagnosed is that, you know, if she didn't have type one, she'd be insulin resistant. (47:46) Like, she still would be. (47:47) And these two things are not mutually exclusive. (47:50) Like, she has yes. (47:52) She has type one diabetes, and she's more insulin resistant than you would expect her to be.
Scott Benner (47:58) And so, you know, it makes her eligible for that medication. (48:02) And what a big deal it it is for. (48:05) You know, for people who would say, oh, well, you just lost weight. (48:09) That's why you're using less insulin. (48:11) Do you have more context for them than that?
Sarah (48:13) I I do. (48:14) I it's that raisin grape, like, mentality that I feel like makes so much sense. (48:20) It you know, as soon as I started, it was like my insulin per carb ratio totally changed. (48:28) It was, like, from eight carbs for one unit to nine and then 10 and then 11, just like this marching change that I needed less insulin to to cover carbs. (48:39) And that was, like, immediate proof to me that this was working and that those beta cells were plumping up like grapes and they could function how they were supposed to.
Sarah (48:48) And it's for sure, like, you're you're gonna lose weight. (48:53) You're probably gonna eat less. (48:54) That is less insulin, but I'm not necessarily looking at how much insulin I'm using during the day. (49:01) I'm looking at how much insulin it takes to manage the carbs.
Scott Benner (49:06) Okay. (49:06) And do you see less significant spikes around food? (49:17) This episode was too good to cut anything out of, but too long to make just one episode. (49:22) So this is part one. (49:23) Make sure you go find part two right now.
Scott Benner (49:25) It's gonna be the next episode in your feed. (49:27) Today's episode was sponsored by Skin Grip. (49:31) And Skin Grip, they understand what life with diabetes is like, and they know how infuriating it can be when a device falls off prematurely. (49:39) And they don't want that to happen to you. (49:41) Juice Box podcast listeners save 20% off with their first order when you use the link skingrip.com/juicebox.
Scott Benner (49:48) Links are also available in the show notes of your podcast player and at juiceboxpodcast.com. (49:54) Today's episode is also sponsored by the Omnipod five. (49:58) And at my link, omnipod.com/juicebox, you can get yourself a free what I just say? (50:05) A free Omnipod five starter kit. (50:08) Free?
Scott Benner (50:10) Get out of here. (50:10) Go click on that link. (50:11) Omnipod.com/juicebox. (50:14) Check it out. (50:14) Terms and conditions apply.
Scott Benner (50:16) Eligibility may vary. (50:18) Full terms and conditions can be found at omnipod.com/juicebox. (50:22) Links in the show notes. (50:24) Links at juiceboxpodcast.com. (50:27) Arden has been getting her diabetes supplies from US Med for three years.
Scott Benner (50:31) You can as well. (50:32) Usmed.com/juicebox or call (888) 721-1514. (50:39) My thanks to US Med for sponsoring this episode and for being longtime sponsors of the Juice Box Podcast. (50:45) There are links in the show notes and links at juiceboxpodcast.com to US Med and all of the sponsors. (50:52) As the holidays approach, I wanna thank all of my good friends for coming back to the Juice Box podcast over and over again.
Scott Benner (50:58) It means the world to me. (50:59) It's the greatest gift you could give me. (51:01) Thank you so very much. (51:03) Unless, of course, you wanna share the show with someone else, then that would be an awesome gift too or a five star review. (51:08) I don't know.
Scott Benner (51:08) You don't really owe me a gift, but, I mean, if you're looking for something to do. (51:12) You know, subscribe and follow, tell a friend, etcetera. (51:14) Thank you. (51:15) Merry Christmas. (51:19) Hey.
Scott Benner (51:20) I'm dropping in to tell you about a small change being made to the Juice Cruise twenty twenty six schedule. (51:25) This adjustment was made by Celebrity Cruise Lines, not by me. (51:28) Anyway, we're still going out on the Celebrity Beyond cruise ship, which is awesome. (51:32) Check out the walkthrough video at juiceboxpodcast.com/juicecruise. (51:37) The ship is awesome.
Scott Benner (51:39) Still a seven night cruise. (51:41) It still leaves out of Miami on June 21. (51:44) Actually, most of this is the same. (51:45) We leave Miami June 21, head to Coco Cay in The Bahamas, but then we're going to San Juan, Puerto Rico instead Of Saint Thomas. (51:53) After that, Bastille, I think I'm saying that wrong, Saint Kitts And Nevis.
Scott Benner (51:57) This place is gorgeous. (51:59) Google it. (52:00) Mean, I you're probably gonna have to go to my link to get the correct spelling because my pronunciation is so bad. (52:04) But once you get the Saint Kitts and you Google it, you're gonna look and see a photo that says to you, oh, I wanna go there. (52:10) Come meet other people living with type one diabetes from caregivers to children to adults.
Scott Benner (52:17) Last year, we had a 100 people on our cruise, and it was fabulous. (52:22) You can see pictures to get at my link juiceboxpodcast.com/juicecruise. (52:27) Can see those pictures from last year there. (52:29) The link also gives you an opportunity to register for the cruise or to contact Suzanne from Cruise Planners. (52:35) She takes care of all the logistics.
Scott Benner (52:37) I'm just excited that I might see you there. (52:39) It's a beautiful event for families, for singles, a wonderful opportunity to meet people, swap stories, make friendships, and learn. (52:49) Have you tried the Small Sip series? (52:51) They're curated takeaways from the Juice Box podcast, voted on by listeners as the most helpful insights for managing their diabetes. (52:58) These bite sized pieces of wisdom cover essential topics like insulin timing, carb management, and balancing highs and lows, making it easier for you to incorporate real life strategies into your daily routine.
Scott Benner (53:09) Dive deep, take a sip, and discover what our community finds most valuable on the journey to better diabetes management. (53:16) For more information on small sips, go to juiceboxpodcast.com. (53:20) Click on the word series in the menu. (53:22) Hey. (53:23) What's up, everybody?
Scott Benner (53:23) If you've noticed that the podcast sounds better and you're thinking, like, how does that happen? (53:29) What you're hearing is Rob at Wrong Way Recording doing his magic to these files. (53:34) So if you want him to do his magic to you, wrongwayrecording.com. (53:39) You got a podcast? (53:40) You want somebody to edit it?
Scott Benner (53:41) You want Rob.
Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!
#1716 Bolus 4 - Christmas
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 wherever they get audio.
Jenny and Scott talk about how to bolus for Christmas snacks.
+ Click for EPISODE TRANSCRIPT
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. (0:01) Welcome to the Juice Box podcast. (0:03) Happy holidays to everyone juggling carbs, cookies, and the chaos of this season. (0:20) In every episode of bolus four, Jenny Smith and I are gonna take a few minutes to talk through how to bolus for a single item of food. (0:28) Jenny and I are gonna follow a little bit of a road map called meal bolt.
Scott Benner (0:33) Measure the meal, evaluate yourself, add the base units, layer a correction, build the bolus shape, offset the timing, look at the CGM, tweak for next time. (0:44) Having said that, these episodes are gonna be very conversational and not incredibly technical. (0:50) We want you to hear how we think about it, but we also would like you to know that this is kind of the pathway we're considering while we're talking about it. (0:57) So while you might not hear us say every letter of Miele Bolt in every episode, we will be thinking about it while we're talking. (1:04) If you wanna learn more, go to juiceboxpodcast.com/meal-bolt.
Scott Benner (1:10) But for now, we'll find out how to bowl us for today's subject. (1:16) While you're listening, please remember that nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. (1:24) Always consult a physician before making any changes to your health care plan or becoming bold with insulin. (1:36) This episode of the juice box podcast is sponsored by the Kontoor Next Gen blood glucose meter. (1:42) Learn more and get started today at kontoornext.com/juicebox.
Scott Benner (1:48) Today's episode is also sponsored by Medtronic Diabetes, who is making life with diabetes easier with the MiniMed seven eighty g system and their new sensor options, which include the instinct sensor made by Abbott. (2:03) Would you like to unleash the full potential of the MiniMed seven eighty g system? (2:07) You can do that at my link, medtronicdiabetes.com/juicebox. (2:12) Jennifer, Christmas is coming. (2:14) The goose is getting fat.
Scott Benner (2:15) Pleased to put a penny in the old man's hat. (2:17) We are gonna talk today on bolus four.
Jenny Smith (2:20) Where's he gonna get his penny from?
Scott Benner (2:21) I don't know.
Jenny Smith (2:22) They don't make pennies anymore.
Scott Benner (2:23) Oh, that's right. (2:24) They stopped making pennies. (2:25) I gotta change that whole thing then. (2:39) You remember that old news story about the guy who had his Bitcoin key on a computer and the computer got thrown away and he spent, like, he spent his entire life going through a dump piece by piece looking for the hard drive?
Jenny Smith (2:50) It's a
Scott Benner (2:50) true story.
Jenny Smith (2:50) I have never heard that.
Scott Benner (2:51) Look it up. (2:52) It'll make you, wanna jump out a window. (2:53) He was wealthy on the hard drive. (2:55) Couldn't remember Sure. (2:56) The He was.
Scott Benner (2:58) Can you imagine? (2:59) Anyway, I, went out and talked to people
Jenny Smith (3:02) You always do.
Scott Benner (3:03) And they eat some funky stuff at Christmas I didn't know about. (3:07) I'm starting strong here. (3:08) We're gonna do a little list like we did at Thanksgiving. (3:10) So first of all, basic stuff, turkey, stuffing, potatoes. (3:14) If you're doing that stuff on Christmas, just go find the bowls for Thanksgiving episode.
Scott Benner (3:19) It'll cover that. (3:20) Today, Jenny and I are gonna talk about the little things sitting around the house at Christmas. (3:24) Do you know what puppy chow is by any chance?
Jenny Smith (3:26) I do.
Scott Benner (3:27) Do you really?
Jenny Smith (3:28) It's all sugar.
Scott Benner (3:28) Somebody had to tell me what it was.
Jenny Smith (3:30) You've never heard of puppy chow?
Scott Benner (3:31) I had no idea. (3:32) Really? (3:33) Also, apparently, some people call it muddy buddies.
Jenny Smith (3:36) Yeah. (3:36) I was gonna ask if you knew it by another name compared to
Scott Benner (3:40) in my life. (3:41) Like, just looking at this, I was like, oh, what is I must sound like such a healthy eater, but now I just eat different junk when I eat junk.
Jenny Smith (3:47) No. (3:47) It's really just sugar on top of carbohydrates on top of it's essentially you start with, like usually, it's Crispix cereal.
Scott Benner (3:57) Okay.
Jenny Smith (3:59) And then there's peanut butter and chocolate, and then you roll it in powdered sugar, essentially.
Scott Benner (4:07) I'm looking at it right now. (4:09) Cup of semi sweet chocolate chips, a half a cup of peanut butter, nine cups of crispy rice cereal squares, and a cup and a half of confectioner's sugar.
Jenny Smith (4:17) See, I had all the ingredients.
Scott Benner (4:19) Jenny's like, I've heard this. (4:21) Well, you're from the Midwest. (4:22) There's no way this didn't exist in somebody's home that you know about.
Jenny Smith (4:25) A 100%. (4:26) It was on, I would say, most tables at Christmas time. (4:33) Just like Cheez Whiz and Ritz crackers.
Scott Benner (4:37) My Which I don't
Jenny Smith (4:37) know why Cheez Ritz. (4:39) Right? (4:40) I mean, we got all the good cheese here
Scott Benner (4:42) in Wisconsin. (4:43) Cheese?
Jenny Smith (4:44) And it was like although my mom always made her really good do you know what summer sausage is?
Scott Benner (4:50) I only know because my brother lives in Wisconsin.
Jenny Smith (4:52) That's right. (4:53) Yeah. (4:53) Yeah. (4:53) So summer sausage and sliced cheese and various types
Scott Benner (4:57) Mhmm.
Jenny Smith (4:58) Of crackers.
Scott Benner (4:59) My I I I hope not to throw her under the bus here. (5:01) My sister-in-law, the first time she visited here at Christmas time, she came from your part of the country. (5:06) She brought with her something that she was calling caramel corn, but it wasn't real popcorn with caramel over top of it. (5:13) It was that
Jenny Smith (5:14) The puffed.
Scott Benner (5:15) Yeah. (5:15) The puffed popcorn, and she brought so much of it. (5:19) And she was so by the way, I wanna say something here, I think this is kind of important here. (5:22) She was so proud of it. (5:23) It was a thing that she had done with her mom growing up.
Scott Benner (5:26) Mhmm. (5:27) And it was a real, like, Christmas tradition for her. (5:29) And she brought it in a bag and, like and I looked at it, I thought, we're all gonna die if we eat that. (5:34) And but it was just sugar melted through Styrofoam is what it looked like to me.
Jenny Smith (5:40) Pretty much.
Scott Benner (5:40) Yeah. (5:41) Yeah. (5:41) Okay. (5:42) Alright. (5:42) If you break down puppy chow, you're gonna get 21 grams of fiber, 302 grams doing fiber?
Scott Benner (5:49) For the whole concoction. (5:51) Cup of semi sweet chocolate, half a cup of peanut butter, nine cups of crispy rice, cup and a half of confectioner's sugar. (5:57) Right? (5:57) But in this whole thing, just in case you lost your mind and ate all the puppy gel by yourself, you'd get 21 grams of fiber, 302 grams of sugar, a 115 grams of fat, and 56 grams of protein. (6:09) If you cut it up into 16 bars, a bar would be 32 carbs, 1.3 fibers, 19 sugars, 30.9 net carbs, 7.2 grams of fat, and 3.5 grams of protein.
Scott Benner (6:25) That would be in 16 bars.
Jenny Smith (6:27) Now let me tell you Mhmm. (6:29) That would at least be measurable.
Scott Benner (6:33) But that's not because it's all, like, pickpicks. (6:35) Right?
Jenny Smith (6:35) Not a bar.
Scott Benner (6:36) Yeah. (6:36) Yeah. (6:36) Yeah.
Jenny Smith (6:37) It's kind of like popcorn in a bowl.
Scott Benner (6:41) But it's loose. (6:41) Right?
Jenny Smith (6:42) It's loose.
Scott Benner (6:43) Yeah. (6:43) I guess what people are asking because this popped up a number of times, like, am I bolusing for this?
Jenny Smith (6:48) My expectation would be that a bar how many you said 18 or 16?
Scott Benner (6:54) I said you could 16 bars? (6:55) You could cut this concoction into 16 or 24. (6:58) If you cut it into 24 bars, it would be 21 carbs total for a bar. (7:03) But how do you I wonder if it can
Jenny Smith (7:05) Well, that's what I'm looking at, like, portion 16 bars. (7:11) My expectation is that it would be, like, a third of a cup portion. (7:17) So if you're trying to envision a scoop or a handful out of a bowl, you could say probably whatever fits in the palm of a woman size adult hand would be approximate to what you'd get in one of these bars.
Scott Benner (7:36) I'm trying to see if the Internet can do this. (7:38) Oh. (7:38) I mean, they they
Jenny Smith (7:40) The other way to break it down would be if the Internet can take it
Scott Benner (7:44) Well, I wanna know one piece. (7:46) Portion. (7:47) I want piece. (7:48) I wanna know, like because we all know, like, a Skittle is this, this is that. (7:51) Like, if you had a puppy chow.
Scott Benner (7:54) Right?
Jenny Smith (7:55) Hi, Graham. (7:56) Is that that puppy chow is more than a Skittle?
Scott Benner (7:59) Because brands differ, the only way to do this is by estimating how many squares are in a cup. (8:04) Most crispy rice cereal, like Rice Chex, have 30 or 40 pieces per cup. (8:08) We're gonna get this. (8:09) Typical labeled for crispy rice squares, one cup, a 100 calories, 23 carbs, three sugar, two protein. (8:16) So one cereal square should be point six to point eight carbs.
Scott Benner (8:23) And okay. (8:24) Okay. (8:25) So then put the chocolate, sugar, and peanut butter on a piece and estimate carbs again. (8:42) Maybe we can get close here.
Jenny Smith (8:44) Or just don't eat it.
Scott Benner (8:48) So, Jenny, the other I got feedback the other day. (8:51) Somebody said, hey. (8:52) Can you, do a bolus for something healthy? (8:54) And and I said, hey. (8:56) I just asked people what they want to know how to bolus for.
Scott Benner (8:59) No one asked for a rib and a baked potato. (9:02) I gave it to ChatGPT this time. (9:05) Each coated cereal square is about 1.4 to 1.9 carbs.
Jenny Smith (9:09) So I would have guessed two or three.
Scott Benner (9:11) Okay. (9:11) So there you go. (9:12) Two or three carbs, but
Jenny Smith (9:14) Per piece.
Scott Benner (9:15) It's gonna hit like a truck, right, with that powdered sugar.
Jenny Smith (9:18) It is. (9:18) Yeah. (9:19) Yeah. (9:20) Even though there are fat and protein parts to it Mhmm. (9:27) Absolutely.
Jenny Smith (9:29) You need to be falling before you start to eat this.
Scott Benner (9:33) Jenny's like, you're 90. (9:34) You bolus. (9:35) You'll hear three beeps. (9:37) Your Dexcom is screaming in pain. (9:39) Have some puppy chow.
Scott Benner (9:40) Everything will be fine.
Jenny Smith (9:43) Well, the other back end of this is the fat and the protein or more the fat.
Scott Benner (9:48) It is gonna hit you again. (9:49) Right?
Jenny Smith (9:49) It'll hit you later.
Scott Benner (9:51) Yeah. (9:51) So it's gonna be boom, big pop up, and you're probably not gonna get ahead of it unless you're pre bolus the hell out of it. (9:58) And then you know what ends up happening. (10:01) And then you see a big number, put insulin on it, and then you end up riding two fifty for four hours afterwards. (10:06) That is what probably happens with this thing.
Scott Benner (10:08) Right?
Jenny Smith (10:08) Yeah.
Scott Benner (10:09) Yeah. (10:09) Alright, guys. (10:10) So look. (10:12) You can all of you. (10:13) By the way, you don't need me and Jenny.
Scott Benner (10:14) Chat GPT. (10:15) I just you know, Gemini, I don't care which one you use. (10:18) I've been messing with Gemini a little bit lately. (10:20) I think Chat GPT knows. (10:22) I think it knows I'm cheating on it.
Jenny Smith (10:24) I've never clicked on the Gemini. (10:26) I know it sits on my Chrome corner. (10:28) It looks at me.
Scott Benner (10:29) They just did a nice update. (10:31) It's coming along. (10:32) Alright. (10:33) Let's see what's next. (10:35) Homemade chocolate fudge.
Scott Benner (10:37) Yeah.
Jenny Smith (10:39) Oh.
Scott Benner (10:40) I got it here as, granulated sugar, cocoa powder, milk, butter, vanilla extract, salt, calories for a one inch square piece, 70 to a 100, fat for that same piece, two to four, carbs fourteen fourteen, sugar 13, protein one.
Jenny Smith (10:56) Is it like a one inch by one inch square?
Scott Benner (11:00) Yeah. (11:00) Mhmm. (11:01) Oh my god.
Jenny Smith (11:02) Yeah. (11:02) It's packed.
Scott Benner (11:04) Oh, I love fudge. (11:05) I do wanna be honest if it's refrigerated. (11:08) You know what I mean? (11:09) Like, just wanna
Jenny Smith (11:10) I prefer my mom always made fudge. (11:13) It was the thing that she and my dad made together Mhmm. (11:18) In the days before Christmas.
Scott Benner (11:21) Yep.
Jenny Smith (11:22) And I it's a great childhood memory. (11:25) My favorite was always her peanut butter fudge.
Scott Benner (11:28) My my mother-in-law makes it with fluff or something in it too, like, you know, the fluff and
Jenny Smith (11:34) butter The marshmallow.
Scott Benner (11:35) The marshmallow stuff. (11:36) Yeah. (11:36) Yeah. (11:36) And I gotta tell you, it's like crack. (11:39) And then she'll bring it.
Scott Benner (11:40) She'll be like, I made fudge. (11:41) And I'm like, don't leave that here.
Jenny Smith (11:43) I wonder does she make it chocolate?
Scott Benner (11:47) Yes.
Jenny Smith (11:49) Oh, okay. (11:50) Because I wonder if what she was trying to make was my mom makes something similar. (11:56) It's called divinity. (11:57) Divinity is a really difficult recipe to make because it takes temperature and timing to get it to fluff the right way. (12:06) But it's white just like a marshmallow.
Scott Benner (12:09) Oh, I don't
Jenny Smith (12:09) know And you mix in, like, chopped walnuts or chopped pecans.
Scott Benner (12:14) Oh, I do know that. (12:15) I know I've never had
Jenny Smith (12:16) it. (12:16) I say it is delicious.
Scott Benner (12:18) Mhmm. (12:19) But it's sugar.
Jenny Smith (12:19) But it's all sugar.
Scott Benner (12:21) Does this sound right? (12:22) Granulated sugar, light corn syrup. (12:24) We'll get back to the fudge. (12:25) Water, two large egg whites, vanilla, chopped pecans
Jenny Smith (12:28) Yep.
Scott Benner (12:29) A pinch of salt. (12:30) Yeah. (12:30) Cook the syrup, bring it to a hard boil, a hard ball stage. (12:34) Oh, this is like you're making candy.
Jenny Smith (12:36) It is. (12:37) Yeah. (12:37) Your mom And my mom had it down. (12:39) It was her grandmother's recipe.
Scott Benner (12:42) Okay.
Jenny Smith (12:43) And they always made it.
Scott Benner (12:44) Alright. (12:44) You wanna do it for the people and then we'll go back to the fudge? (12:47) Sure. (12:47) I have an old fashioned divinity recipe right here in front of me. (12:51) Let's see if you people are out there.
Jenny Smith (12:53) You wanna fix a low blood sugar.
Scott Benner (12:55) That'll take care of it.
Jenny Smith (12:56) Take care of the divinity.
Scott Benner (12:57) Alright. (12:58) Where is this at? (12:58) I these websites. (13:00) Okay. (13:01) There's not a lot in it, but it's all sugar.
Scott Benner (13:06) There's not much else in it, I guess, but sugar. (13:10) Okay. (13:11) So let me go back to my little thing here. (13:14) Break down. (13:16) Does the cooking of the sugar change it?
Jenny Smith (13:20) It does. (13:20) So it's not if you've done it right, it is no longer granular.
Scott Benner (13:25) Right. (13:26) It's it's like
Jenny Smith (13:26) It's like a marshmallow texture.
Scott Benner (13:28) Okay.
Jenny Smith (13:29) Mhmm. (13:29) It's not pulley No? (13:31) Like a marshmallow, but it's got that squish consistence consistency when you actually bite into it. (13:41) It's it's like fluff.
Scott Benner (13:43) Mhmm.
Jenny Smith (13:43) It's great.
Scott Benner (13:45) So I gave it I gave it that recipe that I just told you, two and a half cups granulated sugar, corn syrup. (13:52) Just in case you're wondering on the ingredients, two and a half cups of granulated sugar, wow, has 500 grams of carbs in it.
Jenny Smith (14:00) Mhmm. (14:00) Corn syrup.
Scott Benner (14:02) Corn syrup is a 100 this it's only a half a cup of corn syrup, a 120 grams of carbs. (14:08) Then the egg whites, the pecan, it is just corn syrup and sugar. (14:12) Wow. (14:12) That's good. (14:12) So it's about how it's cooked.
Scott Benner (14:14) Estimate per piece, if you make 24 pieces with this concoction, you're getting if you make wow. (14:21) If you make 24 pieces per piece, a 137 calories.
Jenny Smith (14:26) And most, it's all sugar.
Scott Benner (14:28) 26 and a half grams of carbs Mhmm. (14:31) Fat 3.3 protein under one. (14:34) You're bolusing like you're bolusing for the sugar bowl, really.
Jenny Smith (14:37) A 100%.
Scott Benner (14:38) Yeah.
Jenny Smith (14:38) Yes.
Scott Benner (14:39) All upfront, real like
Jenny Smith (14:41) Like, at Christmas time, I would wish for low blood sugars.
Scott Benner (14:46) Look at you. (14:47) Look at you being human on this on this thing. (14:51) I mean, if we look at the fudge recipe, are we just gonna see the same thing? (14:55) Is it just gonna be sugar, quick hit, and, you know, some fat on the end? (15:01) Contournext.com/juicebox.
Scott Benner (15:04) That's the link you'll use to find out more about the Kontoor next gen blood glucose meter. (15:09) When you get there, there's a little bit at the top. (15:11) You can click right on blood glucose monitoring. (15:13) I'll do it with you. (15:14) Go to meters.
Scott Benner (15:15) Click on any of the meters. (15:16) I'll click on the next gen, and you're gonna get more information. (15:19) It's easy to use and highly accurate. (15:21) SmartLight provides a simple understanding of your blood glucose levels. (15:25) And, of course, with second chance sampling technology, you can save money with fewer wasted test strips.
Scott Benner (15:31) As if all that wasn't enough, the Kontoor Nextgen also has a compatible app for an easy way to share and see your blood glucose results. (15:40) Contournext.com/juicebox. (15:44) And if you scroll down at that link, you're gonna see things like a buy now button. (15:49) You could register your meter after you purchase it. (15:51) Or what is this?
Scott Benner (15:51) Download a coupon. (15:53) Oh, receive a free Kontoor Next Gen blood glucose meter. (15:59) Do tell. (16:00) Kontoornext.com/juicebox. (16:03) Head over there now.
Scott Benner (16:04) Get the same accurate and reliable meter that we use. (16:09) Unlike other systems that will wait until your blood sugar is a 180 before delivering corrections, The MiniMed seven eighty g system is the only system with meal detection technology that automatically detects rising sugar levels and delivers more insulin as needed to help keep your sugar levels in range even if you're not a perfect carb counter. (16:30) Today's episode of the Juice Box podcast is sponsored by Medtronic Diabetes and their MiniMed seven eighty g system, which gives you real choices because the MiniMed seven eighty g system works with the Instinct sensor made by Avid, as well as the Simplera Sync and Guardian Force sensors, giving you options. (16:51) The Instinct sensor is the longest wear sensor yet, lasting fifteen days and designed exclusively for the MiniMed seven eighty g. (17:00) And don't forget, Medtronic Diabetes makes technology accessible for you with comprehensive insurance support, programs to help you with your out of pocket costs or switching from other pump and CGM systems.
Scott Benner (17:13) Learn more and get started today with my link, medtronicdiabetes.com/juicebox.
Jenny Smith (17:18) Fudge is mostly just sugar. (17:21) It does have a little bit more fat, but in general, yeah, it's a it's a quick hit.
Scott Benner (17:28) Yeah. (17:28) So everything on this list so far is pre bolus ahead of time, try to get your blood sugar moving in the right direction before you tax the insulin with this food.
Jenny Smith (17:39) Or like we talked about for Thanksgiving
Scott Benner (17:42) Mhmm.
Jenny Smith (17:43) It's the fact that you may also have a heavier meal or something else along with it like the cheese and crackers Mhmm. (17:53) Or a charcuterie board or something.
Scott Benner (17:56) I had a by the way, a French person yelled at me the other day for how we said that.
Jenny Smith (18:00) Well Don't worry.
Scott Benner (18:01) She's less
Jenny Smith (18:01) than I don't speak French.
Scott Benner (18:02) Yeah. (18:03) We're we're way off apparently.
Jenny Smith (18:04) How did she say the
Scott Benner (18:05) say it? (18:05) Remember she's French. (18:06) I can't I can't estimate
Jenny Smith (18:07) the question. (18:08) Ask Google Translate to say it for you.
Scott Benner (18:11) I'm just saying I don't think it's charcuterie is what I'm getting at. (18:13) Sure. (18:16) The fudge, I've got three quarters of a cup of butter, two and a half cups of granulated sugar, two thirds of a cup of evaporated milk, a little salt. (18:26) Estimated total for this. (18:28) Wow.
Scott Benner (18:28) It's a lot for the whole thing. (18:30) Cut it into servings. (18:33) You guys could be doing this at home though, and I think you should be to be perfectly honest. (18:37) Like Mhmm. (18:38) I mean, think about for all the years that Ardent's had diabetes, and I've been around people with type one, and they're out there with a scale and they're measuring and some scales are, like, giving them in for you just take the recipe, copy it, drop it into any, you know, any one of these things, like Gemini or Chachy Peter or whatever, and just say, this down for nutrition for me.
Scott Benner (18:58) And woo, comes right back. (19:00) Like, you know, and it really should help you. (19:03) I was having a conversation with a person in the medical field the other day who's not particularly diabetes related, but adjacent to it. (19:12) And they said, you know, from their perspective, the biggest problem they think people with diabetes end up having is they don't count their carbs correctly. (19:20) And I think what that person was saying was they don't use the right amount of insulin.
Scott Benner (19:25) That was the kind of the roundabout way of like it was interesting because from their perspective, it just looked like, oh, if they counted their carbs better, they'd be okay. (19:33) Obviously, that ignores a lot of things. (19:35) But it was a a slightly medical, still layman's view of the situation. (19:42) But all these foods point this out exactly. (19:44) Like, where people are probably going wrong is they're probably just misestimating what it is they're taking in if they're lucky enough
Jenny Smith (19:51) that they're setting. (19:52) To not enough insulin.
Scott Benner (19:54) Yeah. (19:54) And you're just there. (19:55) Fudge poured in eight by eight inch pan gives you sixty four one inch squares. (20:01) Eight wow. (20:02) Eight grams of carbs for the one inch square, 2.3 fat negative
Jenny Smith (20:08) bad compared to the divinity.
Scott Benner (20:10) No. (20:11) Not at all. (20:13) The calories 53. (20:14) 53 for a little one by one.
Jenny Smith (20:16) It's like an apple.
Scott Benner (20:17) Really? (20:18) Is that how many calories in an apple?
Jenny Smith (20:20) Most fruit is about 50 ish calories per portion.
Scott Benner (20:24) No kidding. (20:25) Let us learn and stuff. (20:27) What's next?
Jenny Smith (20:28) I like this list, by the way.
Scott Benner (20:30) This list is just like this list is meant to kill you. (20:33) Gingerbread cookies. (20:35) Oh. (20:36) Flour, molasses, brown sugar, butter, eggs, spices, baking soda. (20:42) Let's see what do we get out of this.
Scott Benner (20:44) It looks like one medium cookie, uniced, 160 calories, six grams of fat, 27 carbs, 15 sugar, two protein.
Jenny Smith (20:54) And what I will say while gingerbread cookies were the note here, a cookie is a cookie is a cookie.
Scott Benner (21:01) It all kinda hits the same.
Jenny Smith (21:03) In terms of portion, I'm not talking about the cookie that could serve six people.
Scott Benner (21:09) Yeah. (21:09) Yeah. (21:09) Yeah. (21:09) Sure.
Jenny Smith (21:10) Right? (21:10) Your typical gingerbread size cookie or for, again, a a quick eyeball, it's about the size of the just the palm of your hand.
Scott Benner (21:20) Okay.
Jenny Smith (21:21) Usually about 25 to 30 grams of carb.
Scott Benner (21:24) I'm looking at this, and y'all just don't make a chocolate chip cookie at Christmas and a and a and a butter cookie and you're done? (21:30) There's more than that? (21:31) That's all we do. (21:32) Little butter cookie. (21:32) And by the way, we throw them away by the end.
Scott Benner (21:34) We bake these cookies like there's more people living in here than there are. (21:39) And, like, two or three of us aren't on a GLP medication. (21:41) And then, like, there's, like, a big thing of cookies. (21:43) And then, you know, a week later, everybody's like, cookies and then we throw them out. (21:47) How much of eating do you think is that?
Scott Benner (21:50) Is about the well, this is what I do. (21:52) This is how I remember it. (21:54) You know what mean?
Jenny Smith (21:55) That's a good question.
Scott Benner (21:56) Yeah. (21:56) You eat the way you were taught to eat.
Jenny Smith (21:59) To some degree. (22:00) I mean, I have definitely adjusted things, especially with the education I have and the information I have at hand. (22:10) But I learned to eat a balanced plate to begin with.
Scott Benner (22:14) Yeah. (22:15) So I just there are just times where I realized that I'm doing things because that's what we do. (22:23) Mhmm. (22:23) And I hate that because as far back as when I wrote a book, I put the pot roast story in my book. (22:28) Right?
Scott Benner (22:29) Like, you know the pot roast story?
Jenny Smith (22:31) I don't. (22:31) I've never read your book.
Scott Benner (22:33) Jenny, did I not give you a copy of the book? (22:35) That's not No.
Jenny Smith (22:36) I've never I've never would read it if I had it.
Scott Benner (22:40) No. (22:40) You wouldn't. (22:40) Don't lie to me.
Jenny Smith (22:41) Listen. (22:41) I would. (22:41) Alright. (22:42) I like reading.
Scott Benner (22:43) A lady and her and her daughter, her young daughter, are making a pot roast. (22:47) The woman pulls the pot roast out of the refrigerator. (22:50) She cuts both ends off of it, puts it in the pan, and sticks it in the oven. (22:54) The girl goes, why'd you cut the ends off the pot roast? (22:57) And the mother, without hesitating, says to the little girl, well, that's how my mom makes it.
Scott Benner (23:02) Mhmm. (23:02) So you're gonna have to ask grandma. (23:04) So the little girl does. (23:05) The next time she sees her grandmother, she says, how come you cut the ends off the pot roast? (23:09) And the woman says, I don't know.
Scott Benner (23:11) That's how my mom made it. (23:13) Next time we're at the home, ask great grandma. (23:15) So they get through the home. (23:17) Great grandma's a thousand years old, Methuselah, you know, and the the little girl goes, you know, tells her the whole story about the pot roast and everything. (23:24) And the old lady just thinks and thinks and thinks.
Scott Benner (23:26) She goes, oh, I know. (23:27) I had a very short pan.
Jenny Smith (23:29) Mhmm.
Scott Benner (23:30) And I just think that a lot of things happen for those reasons.
Jenny Smith (23:33) 100%. (23:33) Yeah. (23:34) There's not a true cooking strategy or reason that the end pieces were bad and you didn't wanna eat them. (23:43) My thought was the pan wasn't big enough Yeah. (23:46) So they just cut it off.
Scott Benner (23:47) And generationally, you end up doing something over and over and over again for no good reason. (23:52) Like making divinity, for an example. (23:56) Eggnog, Jenny. (23:57) Egg yolks by the way, I've known Jenny so long now. (24:01) There's no way in hell you would drink eggnog.
Scott Benner (24:03) Right?
Jenny Smith (24:04) I don't I have had eggnog.
Scott Benner (24:06) Uh-huh. (24:07) Was it I do not prefer it. (24:08) No. (24:08) Okay. (24:09) Alright.
Scott Benner (24:09) I think there's something about the consistency of it you wouldn't like. (24:12) Granulated sugar, heavy cream, whole milk, heavy cream and whole milk, and nutmeg, vanilla extract, alcohol is optional. (24:19) Calories for a cup, 250. (24:21) 15 grams of fat, 20 carbs, 19 sugar, protein nine. (24:26) Is that the eggs?
Jenny Smith (24:27) It's the eggs.
Scott Benner (24:28) Okay.
Jenny Smith (24:28) Well and it's made with milk.
Scott Benner (24:30) Okay.
Jenny Smith (24:30) So that has eggs.
Scott Benner (24:31) How do I bowls for eggnog?
Jenny Smith (24:34) It's a good question. (24:35) How much fat is in there?
Scott Benner (24:37) Fat, fifteen fifteen.
Jenny Smith (24:39) That's pretty high fat.
Scott Benner (24:40) In liquid.
Jenny Smith (24:41) Fairly high protein.
Scott Benner (24:43) Like drinking gravy. (24:45) That makes any wretch.
Jenny Smith (24:47) So gross. (24:48) It's like wet bread. (24:49) Do you know how many people
Scott Benner (24:51) Oh, wet bread to you after the Thanksgiving bowl of were store?
Jenny Smith (24:56) I hope you enjoyed your Thanksgiving even if you didn't have wet bread. (25:01) Like, thank you. (25:03) I did not make wet bread.
Scott Benner (25:04) I think we have struck an amazing balance where you sometimes say insulting things about food people like, and yet they don't or they aren't insulted. (25:12) And we have such a nice thing going on with the people listening. (25:14) So I don't know
Jenny Smith (25:15) how Because I say you like what you like. (25:18) And we just want you to know how to navigate it.
Scott Benner (25:21) That's all. (25:21) But Jenny's not gonna pretend she would have gravy in a in a lifetime.
Jenny Smith (25:24) No.
Scott Benner (25:25) I don't know how do we bowl this for it's a lot of carbs and a lot of sugar and a lot of fat all at the same time. (25:30) So
Jenny Smith (25:31) And it's liquid.
Scott Benner (25:32) Yes. (25:32) It's gonna hit pretty fast. (25:33) Right?
Jenny Smith (25:34) And liquids usually hit a little faster in terms of the carbs.
Scott Benner (25:38) Mhmm.
Jenny Smith (25:41) It's a good question. (25:43) I would say you still need a pre bolus for it. (25:48) Mhmm. (25:49) But then in the aftermath, you really need to pay attention for the fat and the protein hit.
Scott Benner (25:54) Yeah.
Jenny Smith (25:56) It's almost like the puppy chow. (25:58) Not quite as fast.
Scott Benner (26:00) You think it'll be longer tail?
Jenny Smith (26:02) I would expect it might be a longer tail.
Scott Benner (26:05) Also, you're not gonna just dab eggnog. (26:07) Right? (26:08) And does the boo if you put booze in it, would that change it?
Jenny Smith (26:11) A shot? (26:12) I mean, maybe a cup a capful.
Scott Benner (26:14) It's not gonna be a big change to that.
Jenny Smith (26:17) Okay. (26:17) Gonna be major. (26:19) But, yeah, I'd expect a pre bolus and then to pay attention to the aftermath.
Scott Benner (26:26) Okay. (26:27) Okay. (26:27) Fruit cake. (26:29) I'm I forget what's in it. (26:30) Butter, eggs, but it's cake with, fruit and rum and brandy, etcetera.
Scott Benner (26:35) 325 calories to slice 10 grams of fat, 56 carbs, 32 sugar, five protein. (26:42) That's gonna hit you like a truck. (26:43) You might wanna bowl us yesterday for that.
Jenny Smith (26:46) Well, and what's in it besides the carbs from the bready part? (26:52) But you've got candied fruit.
Scott Benner (26:54) Yeah. (26:54) And dark brown sugar or molasses.
Jenny Smith (26:57) Right.
Scott Benner (26:57) Yeah. (26:58) I put molasses on pumpkin pie.
Jenny Smith (27:01) Oh, really?
Scott Benner (27:02) Yeah. (27:03) It's like my my grandmother was Pennsylvania Dutch, and she would always put karo syrup or molasses over pumpkin pie. (27:08) And I can't Interesting. (27:09) I can't eat it without, like, a tablespoon of it over top of it.
Jenny Smith (27:13) Wow.
Scott Benner (27:13) Yeah. (27:14) I made my own pies at Thanksgiving. (27:15) They were awesome in case you're wondering. (27:18) It's really more about the
Jenny Smith (27:19) They were.
Scott Benner (27:19) It's more about the pie crust.
Jenny Smith (27:21) Oh, I like crust.
Scott Benner (27:22) Yeah. (27:23) Who doesn't love that? (27:24) Alright. (27:25) Anyway, you guys also asked about potato latkes.
Jenny Smith (27:29) Oh.
Scott Benner (27:30) This is interesting because there's matzo meal. (27:34) Matzo's hard to bolus for. (27:36) Like, real matzo, it's tough. (27:38) I have some experience with, like, real, like, traditional matzo.
Jenny Smith (27:42) Yeah.
Scott Benner (27:42) It's so good. (27:43) But it hits your stomach like a lead brick after it's in there. (27:47) Like, it's crazy. (27:48) But, man, is it good while you're eating it?
Jenny Smith (27:49) And are we talking about latkes that are fried?
Scott Benner (27:53) Russet potatoes, shredded onions, grated eggs, binders, matzo meal, flour or potato starch, salt, pepper, high heat oil for frying.
Jenny Smith (28:02) Okay.
Scott Benner (28:03) Yeah. (28:03) Fat, four to six, carbs, 12, sugar, one. (28:06) But this is the ingredients, not the frying. (28:08) It doesn't it doesn't include the frying. (28:11) How much oil does something pick up when you fry it?
Jenny Smith (28:14) That's a great question.
Scott Benner (28:15) Oh, yeah. (28:16) I wonder if we can figure that out, actually.
Jenny Smith (28:18) I would expect it picks up at least a tablespoon. (28:23) Let's say the portion is the size of the palm of your hand. (28:27) Mhmm. (28:28) And a tablespoon of oil is around 10 grams of fat.
Scott Benner (28:33) Yeah. (28:33) Are we doing that thing together this year? (28:35) Because if we are, you're gonna need to know this. (28:37) Or you're not sure if you're coming yet?
Jenny Smith (28:39) I'm not sure yet.
Scott Benner (28:40) Oh, okay.
Jenny Smith (28:40) I will know by the end of the day today.
Scott Benner (28:43) Really? (28:43) Oh. (28:45) Let's say this. (28:46) If you come, then you and I will do a bolus for for that. (28:51) And I don't think it's gonna get a ton of downloads, but I do think people would find it incredibly interesting because the foods are they are challenging.
Scott Benner (28:59) Let's see. (28:59) Frying is the primary contributor to fat content in latkes. (29:03) The raw potato, blah blah blah. (29:04) Therefore, frying typically adds three to eight grams of fat per medium. (29:09) Okay.
Scott Benner (29:10) So that means that the concoction as made has four to six grams of fat in it, but as cooked, more like eight. (29:22) So it does picks up a couple more grams of fat. (29:24) If you were to bake them, you'd have about two grams, fewer. (29:29) But oh, hot oil sears the outside immediately creating a crust to prevent the oil from soaking in the center at a temperature.
Jenny Smith (29:36) It doesn't
Scott Benner (29:36) so ak in. (29:37) This is interesting. (29:38) So if you're deep frying it at the correct temperature, the oil three fifty to three seventy five, because it sears, it stops some of the oil from coming in. (29:46) But if you use if your oil's too cool, then the potato will actually absorb more and you'll end up with much more fat in it. (29:54) So it's a lot about the you have to get the cooking process right too.
Scott Benner (29:57) That's interesting. (29:58) Okay.
Jenny Smith (29:59) It was wonder I think I've told you before in college, one of my favorite classes
Scott Benner (30:06) Mhmm.
Jenny Smith (30:06) Was food science, and it really was all food chemistry.
Scott Benner (30:10) Yeah.
Jenny Smith (30:10) It was the reasoning between temperatures and adding certain ingredients at certain times. (30:16) It was very interesting.
Scott Benner (30:17) There's a lot of little things. (30:18) I love a poached egg, Jenny. (30:20) And, you know, if you put a splash of white vinegar in the water, it helps the eggs stay together when you poach the eggs. (30:26) That's a thing somebody Yeah. (30:27) Yeah.
Scott Benner (30:28) Somebody told me that one time and I was like, oh, and it changes everything because they come out so nice and uniformed and it's there's a lot of stuff you would know. (30:34) Let's do a chocolate babka before we do the last thing. (30:38) Okay?
Jenny Smith (30:38) Oh, that so reminds me of Seinfeld.
Scott Benner (30:41) Oh, is that do you know the episode name?
Jenny Smith (30:44) Oh, it's I don't know the name of the episode, but both Elaine and Jerry, I think Jerry, they end up going to, like, a bakery
Scott Benner (30:53) Mhmm.
Jenny Smith (30:53) And they have to get the chocolate bobcat.
Scott Benner (30:56) They have to? (30:57) And this is the whole thing?
Jenny Smith (30:58) And it it ends up, like, being hilarious just like all the Seinfeld episodes do. (31:04) Yeah. (31:05) But it's that that reminded me.
Scott Benner (31:07) Do you watch Curb Your Enthusiasm?
Jenny Smith (31:09) Yes.
Scott Benner (31:09) Curb is awesome. (31:11) Seinfeld season five episode 13, The Dinner Party.
Jenny Smith (31:15) There you go.
Scott Benner (31:16) Features chocolate bobcat in the title. (31:18) There we go. (31:19) The conflict, Jerry and Elaine forget to take a number at the bakery counter. (31:22) As a result, a couple ahead of them buys the very last chocolate babka. (31:26) That's it?
Jenny Smith (31:28) And then she, like I think she chases her down the street and, like, it's, like, it's a whole it's so funny.
Scott Benner (31:34) What's that she made a show later in life called Veep. (31:38) And if you like biting harsh comedy, it's awesome. (31:41) It's I
Jenny Smith (31:42) don't know that I've ever seen that.
Scott Benner (31:43) Veep is awesome. (31:45) Chocolate babka has, 250, 280 calories per slice, 12 grams of fat, 35 grams of carbs, 15 sugar, five protein. (31:54) This stuff's all the same really, isn't it? (31:56) The way you're gonna bolus for it. (31:58) Plus, you brought it up earlier, and it probably should be said again.
Scott Benner (32:01) It's not like you're just gonna have babka, and that's it.
Jenny Smith (32:04) Correct.
Scott Benner (32:04) You're gonna have all this other stuff going on. (32:06) You just I I'm gonna say again, it's gonna sound overly simplified. (32:09) On days like this, get ahead, stay ahead. (32:13) Once you lose the high ground, you're in trouble. (32:16) So and then Yeah.
Scott Benner (32:17) Look for lows at the end of the day. (32:20) Right? (32:20) I mean, that's really what you gotta do.
Jenny Smith (32:22) It really is. (32:23) And with the ease of even what you're showing
Scott Benner (32:26) Mhmm.
Jenny Smith (32:26) The ability to look up information. (32:30) And I use this strategy, which in the past year has really improved in teaching people because the resources are right at your fingertips.
Scott Benner (32:42) Yeah.
Jenny Smith (32:42) These days, it's silly to say, well, I can't go over to uncle Bob's house.
Scott Benner (32:48) I can't figure it out.
Jenny Smith (32:48) You say, I can't figure it out. (32:50) No. (32:50) No. (32:51) You type it in to chat GPT.
Scott Benner (32:54) Yeah. (32:54) Or whatever. (32:55) Listen, I also, I do this like this live on purpose so that people listening could get the idea of, like, I probably don't need Scott and Jenny to talk about every food on the planet. (33:04) I could probably figure this out on my own. (33:06) Because, seriously, when we sat down, all I had was the list of things that people gave me.
Scott Benner (33:11) These, 10 you know, don't know if we got through all 10 of them or not.
Jenny Smith (33:14) You know, the one that is it on the list? (33:16) And I'd be surprised if it wasn't.
Scott Benner (33:19) Which?
Jenny Smith (33:20) Are candy canes on the list?
Scott Benner (33:22) Honey, I just brought candy canes up because they weren't on the list. (33:25) I'm gonna tell you a story that I'm embarrassed by.
Jenny Smith (33:28) Oh.
Scott Benner (33:29) I think a year or two ago, I saw a guy on Instagram making candy canes in his candy shop out in California, and they were huge. (33:35) They were, like, I don't know, a foot and a half long and, like, the diameter of, I don't know, maybe an inch and a half across. (33:42) And they were expensive. (33:44) And I was like, oh my god. (33:45) I'm buying these.
Scott Benner (33:45) And I bought them, and I had them shipped to me. (33:47) And it was very expensive, and they really weren't any better than any other kitty kit I ever had.
Jenny Smith (33:53) I'm sorry. (33:54) Disappointed.
Scott Benner (33:55) But they were huge and lovely, and they made nice ornaments. (33:58) Candy canes are sugar, corn syrup, peppermint oil, red 40. (34:02) Are we still allowed to have that? (34:03) Commercial additive titanium dioxide for bright white color and water.
Jenny Smith (34:09) A lot of foods
Scott Benner (34:10) Is it?
Jenny Smith (34:10) And thing.
Scott Benner (34:11) Yes. (34:11) That doesn't sound like food at all. (34:14) But calories 50 to 60 for a standard five to six inch candy cane, fat zero, carbs 14. (34:21) Holy Hannah. (34:21) Really?
Scott Benner (34:22) Sugar, 11 to 12. (34:24) It is just sugar. (34:25) It's spun sugar.
Jenny Smith (34:26) It's just sugar. (34:27) And like you, although I didn't order them from some person way across the country.
Scott Benner (34:33) By the way, they were lovely. (34:33) I ain't doing it again. (34:35) So I
Jenny Smith (34:37) would say that you would've noticed the difference in the candy canes at the candy shop. (34:45) Yes. (34:46) I worked at a candy shop.
Scott Benner (34:47) Wait. (34:47) Is that why I didn't like the candy cane as much? (34:50) Wait. (34:51) Go I'm sorry. (34:51) Keep going.
Scott Benner (34:52) You worked in a candy shop in high school?
Jenny Smith (34:54) I worked in a candy shop in high school. (34:56) I can't believe I've never told you this.
Scott Benner (34:57) I don't know this.
Jenny Smith (34:58) I did. (34:59) It was an old candy shop
Scott Benner (35:01) Mhmm.
Jenny Smith (35:01) From, like, the nineteen thirties.
Scott Benner (35:04) Okay.
Jenny Smith (35:05) And the third generation owner was my boss. (35:10) And all of the candy, the chocolates, everything were handmade. (35:17) And I got to help make Christmas candy.
Scott Benner (35:21) The stretching and the pulling and all that?
Jenny Smith (35:23) The stretching and the pulling and and the belt that it goes down and the heating elements that keep it just the right temperature to be able to mold. (35:32) Sure. (35:33) And there were like, to make the candy canes or the candy cane wreath. (35:38) Mhmm. (35:38) Or the have you ever seen ribbon candy?
Scott Benner (35:40) Yeah. (35:41) Yeah. (35:41) He makes that too. (35:42) Yeah. (35:42) It I wish I knew the guy's name.
Jenny Smith (35:44) It was a beautiful process.
Scott Benner (35:46) Yeah.
Jenny Smith (35:47) And those candy canes, again, please let me have a low blood sugar.
Scott Benner (35:52) Because that's what you're looking for.
Jenny Smith (35:53) They were good. (35:54) Like, really good. (35:57) In fact, they made what were called cherries.
Scott Benner (36:01) Okay.
Jenny Smith (36:02) And they sold them in bags, and they're about an inch in diameter. (36:07) And when we sold them, we gave the purchasing person a thing of green wire. (36:16) And so what you do when you take it home Mhmm. (36:18) Is you heat the end of the wire in a flame.
Scott Benner (36:22) Okay.
Jenny Smith (36:22) You put it into the cherry. (36:24) You put another cherry on the other end. (36:26) Mhmm. (36:27) And then you hang them on the tree. (36:29) Oh.
Jenny Smith (36:29) And they're beautiful.
Scott Benner (36:30) It's lovely.
Jenny Smith (36:31) They're also really tasty.
Scott Benner (36:33) Yeah. (36:33) I imagine they are. (36:34) I've done a little picking around while you've been talking.
Jenny Smith (36:37) Oh.
Scott Benner (36:37) First of all, titanium dioxide often listed as t I o two or food additive e one seven one is a naturally occurring mineral used primarily as vivid white pigment. (36:49) It is sourced from the earth, processed, and refined into a fine white powder. (36:54) It what does it do? (36:55) Its primary function is to whiten and add opacity commonly used in candy canes, powdered donuts, coffee creamers, cake frosting, and other colored candies like Skittles, creates a white base layer so the outer color shell looks vibrant rather than dull. (37:11) It is a physical UV blocker.
Scott Benner (37:13) It reflects UVs away from the skin. (37:16) In cosmetics, it's used in toothpaste, industrial uses, primary pigment, and almost all white paints, plastics, and papers. (37:24) It is a bit controversial because the concern revolves around nanoparticles, extremely small particles of titanium dioxide. (37:32) Some suggest, these nanoparticles can accumulate in the body and potentially damage DNA or genotoxicity if ingested over long periods. (37:39) It is the ban in the EU due to these concerns.
Scott Benner (37:42) The European Union banned titanium dioxide as a food out of in 2022. (37:47) In The US, the FDA is still considering it safe for consumption. (37:52) Interesting. (37:52) And I asked afterwards, would a handmade candy cane because I now realize the reason I didn't like the handmade candy cane as much as I like the store bought one is the store bought ones are chewier. (38:02) Does that make sense?
Scott Benner (38:04) Oh. (38:05) Yeah. (38:05) See, you suck on a candy cane. (38:06) Right? (38:07) Like, that's how most people do it.
Jenny Smith (38:08) Like, I don't if it's chewy, it goes in the garbage.
Scott Benner (38:11) Oh, yeah. (38:11) Yeah. (38:12) Yeah. (38:12) Yeah. (38:13) So the texture is different.
Scott Benner (38:15) So it says here around the corn syrup. (38:18) Commercially, rely heavily on high fructose corn syrup and often preservatives or stabilizers to ensure the candy cane stays hard for months sitting on the shelf. (38:26) Handmade ones use regular corn syrup, not necessarily high fructose or glucose syrup to prevent crystallization. (38:33) However, you can find an all natural handmade recipe using cream of tartar or vinegar or lemon juice to stabilize. (38:39) I didn't dislike it.
Scott Benner (38:41) I guess it was just different. (38:42) And now I'm realizing it was different because it was probably oddly enough better for me than the one I would have bought in the store. (38:48) And now I gotta buy it again. (38:50) Damn it.
Jenny Smith (38:51) Is that your research? (38:53) All of a
Scott Benner (38:53) I mean, listen, I'm not doing it. (38:55) I just won't need another candy cane. (38:56) I'll be good. (38:57) Do you hang candy canes on your on your tree?
Jenny Smith (39:00) We don't hang candy canes No. (39:03) On the tree.
Scott Benner (39:03) I didn't grow up with that, but I got married and I was told that that had to be done. (39:08) Oh. (39:08) Yes. (39:09) Christmas Eve, Santa hangs candy canes on the tree when he comes.
Jenny Smith (39:13) Yeah. (39:13) We never did that.
Scott Benner (39:14) I didn't do that one either. (39:15) Anyway, Jenny, we've done it again, obviously. (39:18) Yay. (39:18) Yeah. (39:18) Yeah.
Scott Benner (39:19) People are are gonna be thrilled. (39:20) Juiceboxpodcast.com/meal-bolt if you wanna look at the way Jenny and I think about, you know, setting up a bolus. (39:29) But for the most part, these things that you guys asked about for Christmas, good luck. (39:34) And if you wanna know
Jenny Smith (39:36) of the holidays.
Scott Benner (39:36) Yeah. (39:37) And go find out go find the Thanksgiving bolus for do you want me to tell you I should tell them what episode it is before we go. (39:43) Thanksgiving bolus for for the meal. (39:45) We went over turkey, potatoes, stuffing, all the stuff, and had a bolus for that big meal. (39:52) It looks like that was episode hold on a second.
Scott Benner (39:56) Sixteen ninety two, bolus for Thanksgiving. (39:59) I was talking about log Logan's candies on Instagram. (40:06) They have nearly a million followers.
Jenny Smith (40:08) Wow.
Scott Benner (40:09) And they're in Ontario, California. (40:12) And now that we sit and had this conversation, I realized that their candy cane actually tasted probably like what a candy cane is supposed to taste like
Jenny Smith (40:19) supposed to taste like.
Scott Benner (40:20) And not what I get when I I'm in the store. (40:22) So I'm now gonna apologize and tell you you should go check them out. (40:25) Even if you just go to their Instagram to watch them make candy, it is just like Jenny was, explaining in her experience, absolutely fascinating to watch them make it.
Jenny Smith (40:34) It
Scott Benner (40:35) is. (40:35) So really cool. (40:36) Alright. (40:36) Sorry. (40:37) Logan's candy is on Instagram.
Scott Benner (40:39) Alright, guys. (40:39) Merry Christmas. (40:40) Happy New Year. (40:41) Happy Hanukkah. (40:43) And Jenny and I might be back with a well, we'll see.
Scott Benner (40:46) We'll see what we're back
Jenny Smith (40:46) With something.
Scott Benner (40:47) Yeah. (40:47) Something. (40:48) Alright. (40:48) See you guys. (40:49) Bye.
Scott Benner (40:57) I'd like to remind you again about the MiniMed seven eighty g automated insulin delivery system, which of course anticipates, adjusts, and corrects every five minutes twenty four seven. (41:08) It works around the clock so you can focus on what matters. (41:12) The juice box community knows the importance of using technology to simplify managing diabetes. (41:18) To learn more about how you can spend less time and effort managing your diabetes, visit my link, medtronicdiabetes.com/juicebox. (41:29) Having an easy to use and accurate blood glucose meter is just one click away.
Scott Benner (41:35) Contournext.com/juicebox. (41:39) That's right. (41:39) Today's episode is sponsored by the Contour NextGen blood glucose meter. (41:45) Okay. (41:45) Well, here we are at the end of the episode.
Scott Benner (41:47) You're still with me? (41:48) Thank you. (41:49) I really do appreciate that. (41:51) What else could you do for me? (41:53) Why don't you tell a friend about the show or leave a five star review?
Scott Benner (41:56) Maybe you could make sure you're following or subscribe in your podcast app, go to YouTube and follow me or Instagram, TikTok. (42:05) Oh, gosh. (42:06) Here's one. (42:07) Make sure you're following the podcast in the private Facebook group as well as the public Facebook page. (42:13) You don't wanna miss please, do you not know about the private group?
Scott Benner (42:17) You have to join the private group. (42:18) As of this recording, it has 74,000 members. (42:21) They're active talking about diabetes. (42:25) Whatever you need to know, there's a conversation happening in there right now. (42:28) And I'm there all the time.
Scott Benner (42:29) Tag me. (42:30) I'll say hi. (42:37) In each episode of the bolus four series, Jenny, Smith, and I are gonna pick one food and talk through the bolus thing for that food. (42:46) We hope you find it valuable. (42:48) Generally speaking, we're gonna follow a bit of a formula, the meal bolt formula, m e a l b o l t.
Scott Benner (42:56) You can learn more about it at juiceboxpodcast.com/meal-bolt. (43:02) But here's what it is. (43:03) Step one, m, measure the meal, e, evaluate yourself, a, add the base units, l, layer a correction, b, build the bolus shape, o, offset the timing, l, look at the CGM, and t, tweak for next time. (43:26) In a nutshell, we measure our meal, total carbohydrates, protein, fat, consider the glycemic index and the glycemic load. (43:35) And then we evaluate yourself.
Scott Benner (43:37) What's your current blood sugar? (43:38) How much insulin's on board? (43:39) And what kind of activity are you gonna be involved in or not involved in? (43:43) Do have any stress, hormones, illness? (43:46) What's going on with you?
Scott Benner (43:47) Then a, we add the base units. (43:50) Your carbs divided by insulin to carb ratio, just a simple bolus. (43:55) L, layer of correction. (43:56) Right? (43:57) Do you have to add or subtract insulin based on your current blood sugar?
Scott Benner (44:01) Build the bolus shape. (44:03) Are we gonna give it all upfront, a 100% for a fast digesting meal, or is there gonna be like a combo or a square wave bolus? (44:10) Does it have to be extended? (44:12) Offset the timing. (44:13) This is about pre bolusing.
Scott Benner (44:15) Does it take a couple of minutes this meal or maybe twenty minutes? (44:19) Are we gonna have to again consider combo square wave boluses and meals? (44:24) Figure out the timing of that meal. (44:26) And then l, look at the CGM. (44:29) An hour later, was there a fast spike?
Scott Benner (44:31) Three hours later, was there a delayed rise? (44:33) Five hours later, is there any lingering effect from fat and protein? (44:37) Tweak. (44:39) Tweak for next time, t. (44:41) What did you eat?
Scott Benner (44:42) How much insulin and when? (44:44) What did your blood sugar curve look like? (44:47) What would you do next time? (44:49) This is what we're gonna talk about in every episode of bolus four. (44:54) Measure the meal.
Scott Benner (44:55) Evaluate yourself. (44:56) Add the base units. (44:57) Layer a correction. (44:58) Build the bolus shape. (44:59) Offset the timing.
Scott Benner (45:00) Look at the CGM. (45:01) Tweak for next time. (45:03) But it's not gonna be that confusing, and we're not gonna ask you to remember all of that stuff. (45:08) But that's the pathway that Jenny and I are gonna use to speak about each bolus. (45:14) If you have a podcast and you need a fantastic editor, you want Rob from Wrong Way Recording.
Scott Benner (45:20) Listen. (45:20) Truth be told, I'm like 20% smarter when Rob edits me. (45:24) He takes out all the, like, gaps of time and when I go, and stuff like that. (45:29) And it just I don't know, man. (45:31) Like, I listen back and I'm like, why do I sound smarter?
Scott Benner (45:34) And then I remember because I did one smart thing. (45:37) I hired Rob at wrong way recording dot com.
Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!
#1715 Bolus 4 - Pasta
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 wherever they get audio.
Jenny and Scott talk about how to bolus for pasta.
+ Click for EPISODE TRANSCRIPT
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, and welcome back to another episode of the Juice Box podcast. (0:14) In every episode of bolus four, Jenny Smith and I are gonna take a few minutes to talk through how to bolus for a single item of food. (0:22) Jenny and I are gonna follow a little bit of a road map called meal bolt. (0:26) Measure the meal. (0:28) Evaluate yourself.
Scott Benner (0:29) Add the base units. (0:31) Layer a correction. (0:32) Build the bolus shape. (0:33) Offset the timing. (0:35) Look at the CGM.
Scott Benner (0:36) Tweak for next time. (0:38) Having said that, these episodes are gonna be very conversational and not incredibly technical. (0:44) We want you to hear how we think about it, but we also would like you to know that this is kind of the pathway we're considering while we're talking about it. (0:51) So while you might not hear us say every letter of Miele Bolt in every episode, we will be thinking about it while we're talking. (0:58) If you wanna learn more, go to juiceboxpodcast.com/meal-bolt.
Scott Benner (1:04) But for now, we'll find out how to bowl us for today's subject. (1:10) While you're listening, please remember that nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. (1:18) Always consult a physician before making any changes to your health care plan or becoming bold with insulin. (1:30) Pasta. (1:31) Jennifer, that's what we're gonna talk about.
Scott Benner (1:33) Okay. (1:33) So so. (1:34) I'm gonna pull up my favorite pasta. (1:37) And then you can bring up yours. (1:39) So I am gonna tell y'all that after having a kid with diabetes for a long time and fighting with pasta, I finally found that a company called Dream Fields
Jenny Smith (1:50) Oh, you're like, dad, that's been around for a long time.
Scott Benner (1:53) Has a pretty low impact on Arden compared to other pastas, not compared to a salad. (1:58) Right. (1:59) So
Jenny Smith (2:00) I'm curious about your Dream Fields. (2:02) This is a great one to do. (2:03) I'm curious about your Dream Fields experience and how you guys have figured out navigating it.
Scott Benner (2:10) It just doesn't Go ahead.
Jenny Smith (2:13) Mainly because year Dreamfields has been out a long time. (2:18) Okay. (2:18) I can't even remember. (2:19) I it's got to be at least fifteen years that Dream Fields has been out. (2:26) Really?
Jenny Smith (2:26) If not oh, yes. (2:28) Because the first time I experienced Dream Fields was actually at a dietetics nutrition conference, and they were in the exhibit hall talking about the low glycemic impact, the more sustained energy, you know, more sustained satiety in the aftermath of the meal, blah blah blah. (2:46) Very exciting. (2:47) At the end of the conference, they, like, they were willing to ship all dietitians a box of, like, 10 boxes or something fun like that. (2:54) I was like, great.
Jenny Smith (2:55) I'll give it a try. (2:57) So I go home doing, you know, my due diligence with figuring things out, and I bolus as it told me to with net carbs
Scott Benner (3:06) Okay.
Jenny Smith (3:07) On the package.
Scott Benner (3:08) Did it work?
Jenny Smith (3:09) Jenny was not a happy camper. (3:11) It did not work. (3:13) And I didn't really I didn't really expect it to. (3:17) Right? (3:17) In the back of my head, I was like, I don't expect this, but let's give it a try.
Jenny Smith (3:21) Let's give it a try based on everything that I've been told and learned about it, blah blah blah. (3:26) And that was one of those, like, turning point light bulb. (3:30) I knew that I knew better, and that carbs are not something to count. (3:34) But I did when I figured it out finally. (3:37) I found that 100% it was much slower
Scott Benner (3:39) Mhmm.
Jenny Smith (3:40) Than other pastas.
Scott Benner (3:41) Yeah. (3:42) I can't I can't figure it does it just doesn't hit as fast or hard No. (3:45) For for Arden. (3:46) Exactly. (3:47) I'm I'm gonna look at the, and for people who understand this better than I do, durum wheat, simole semolina.
Scott Benner (3:54) Semolina. (3:55) Yep. (3:55) Mhmm. (3:55) And then it has something in it called inulin, which I
Jenny Smith (3:59) guess what that is?
Scott Benner (3:59) No. (4:00) I hope you do.
Jenny Smith (4:01) Mhmm. (4:01) I do. (4:02) Inulin is actually a it's in a lot of products that have a high fiber content. (4:08) It's an easy to add inexpensive fiber source. (4:11) It comes from chicory root.
Jenny Smith (4:12) In fact, you might actually see chicory root sometimes on a label
Scott Benner (4:15) Okay.
Jenny Smith (4:16) Instead of inulin, but, essentially, it's just a fiber source.
Scott Benner (4:19) I wonder if we're gonna find out the fibers, what helps it. (4:23) Wheat gluten, xanthine gum, wheat protein isolate, pectin, potassium chloride, niacin iron, thiamine monod monotrate. (4:34) Is that right? (4:35) Riboflavin, and folic acid.
Jenny Smith (4:38) These are all vitamins.
Scott Benner (4:39) Okay. (4:39) And folic acid. (4:40) Well, I've been sliced and put vitamins in our in our pasta.
Jenny Smith (4:43) We've added them back.
Scott Benner (4:45) They put Jenny's like, yeah. (4:46) They strip it all out, and they dump it back in again. (4:48) You've heard me complain about this already.
Jenny Smith (4:50) So There's gotta be truthful.
Scott Benner (4:51) Here's the thing that I find most difficult about pasta. (4:56) It's two ounces of pasta, dry.
Jenny Smith (4:59) Do you know how many grams that is?
Scott Benner (5:01) Well, I'm looking at it, so it's unfair to me. (5:03) But 56 grams?
Jenny Smith (5:04) 56 grams? (5:05) Mhmm. (5:05) That's the weight. (5:06) And I think it's an important place because it's the most common one that I hear people say, well, it told me that it was 56 grams.
Scott Benner (5:14) Mhmm.
Jenny Smith (5:14) Said, no. (5:15) No. (5:15) That's the weight of the uncooked product. (5:18) So pastas and rices specifically or many grains, in fact, the serving size is listed as a dry weight.
Scott Benner (5:27) Mhmm.
Jenny Smith (5:27) Two ounces dry or 56 grams if you are weighing in grams like many much of Europe does and Canada and whatnot. (5:35) But that's not how many grams of carb are in the product.
Scott Benner (5:37) Also, by the way, I don't measure it dry when I'm putting it on their plate. (5:42) That's my point is it's not easy to, like No. (5:46) Figure out. (5:46) Like, do you cook it off on the side to make sure you have it maybe in another pot? (5:50) But this is an interesting thing here.
Scott Benner (5:51) It says a half inch circle because I I pick spaghetti noodles. (5:55) So a half inch circle is about 56 grams, about two ounces. (5:59) That's gonna contain 42 carbs.
Jenny Smith (6:03) Mhmm.
Scott Benner (6:03) Five dietary fiber, four soluble fiber, one insoluble fiber, two total sugars We
Jenny Smith (6:10) talked about fibers before. (6:12) Do you remember? (6:12) No. (6:13) Soluble versus insoluble?
Scott Benner (6:14) I mean, one sounds like it's gonna melt, one sounds like it's not going to, but I don't know what that means.
Jenny Smith (6:20) Yeah. (6:20) So many some packages like this will have the total fiber broken down as soluble and insoluble. (6:26) Mhmm. (6:26) Soluble fiber is the kind that actually eventually will hit your bloodstream, but it does slow down the carbohydrates so you have a much a much more stable effect of this food.
Scott Benner (6:39) Okay.
Jenny Smith (6:40) Insoluble fiber is the kind that's more guess, describe it like roughage. (6:44) Right? (6:45) It moves everything through and gets removed when you go to the bathroom, but it does not turn into glucose. (6:51) And so you don't have to count insoluble fiber. (6:54) Now not all labels tell you the total fiber breakdown.
Scott Benner (6:58) Mhmm.
Jenny Smith (6:59) And so when dietary fiber is more than about five grams, you can assume that about fifty fifty, 50% soluble, 50% insoluble, the insoluble 50% yours is what you're gonna deduct from the total carb to bolus for your insulin. (7:15) So in this case, Dreamfields broke it down nice. (7:18) They gave you the soluble and the insoluble. (7:20) Insoluble is only one. (7:21) Really, only one gram should come off of that forty two gram.
Scott Benner (7:24) Okay. (7:25) There's a little more fiber. (7:26) I just jumped to another one like a popular brand, Barilla Yeah. (7:29) Just to see if it would be it's I gotta tell you, like, visually, it looks exactly the same. (7:34) You know?
Scott Benner (7:34) I mean, there's more things in the dream field where as the Barilla is literally the semolina wheat flour, durum wheat flour. (7:43) That's it. (7:44) And then they added minerals and vitamins, but they're all very similar.
Jenny Smith (7:47) And the slow factor from the Dream Fields is the inulin.
Scott Benner (7:51) That's
Jenny Smith (7:51) it. (7:51) I think you said that there's a wheat gluten. (7:53) Right? (7:54) And then there's a protein some you said protein something. (7:57) Isolate.
Jenny Smith (7:59) Protein isolate. (8:01) Those are the pieces that are slowing the Dreamfields down comparative to the Barilla pasta.
Scott Benner (8:07) That's interesting. (8:08) So that's it. (8:09) Those things are what makes the Dreamfields not hit hard. (8:12) I had to buy so many different pastas to fit. (8:14) It would have been really helpful if, like, just knew what inulin was.
Scott Benner (8:17) I think that probably
Jenny Smith (8:18) There you go.
Scott Benner (8:19) Would have been quicker. (8:20) Now you all know that you're listening, so that's awesome. (8:22) Okay. (8:22) Now we're gonna put sauce on it. (8:24) So if you use the Dream Fields versus the Barilla Mhmm.
Scott Benner (8:29) The Barilla even though the the ingredients are almost exactly the same aside from what we just meant, the the basic ingredients are the same. (8:37) The carb counts are the same. (8:38) It's still gonna hit faster and probably longer than the Dreamfields would, like, a higher blood sugar. (8:45) So Borrelia's gonna need more of a pre bolus, probably an extended bolus. (8:50) I've never had to use an extended bolus with the Dreamfields, though.
Jenny Smith (8:54) Very consistent. (8:55) A bolus, do you do less pre bolus for the Dreamfields?
Scott Benner (8:58) We don't measure our food well. (9:01) So I know that.
Jenny Smith (9:03) So I know that.
Scott Benner (9:04) Yeah. (9:05) Yeah. (9:05) Yeah. (9:05) So when like, I don't know how much. (9:07) Like, Arden puts an amount of pasta in a bowl or on a plate that, like, she's
Jenny Smith (9:11) hungry average, so you've figured it out.
Scott Benner (9:14) Yeah. (9:14) Then she rolls up with her her average bolus, hits it, and then you hit it again if it looks like you weren't heavy enough. (9:21) But it's hard to I mean, I don't know. (9:24) Unless you don't eat it, it's kinda hard to over bolus for pasta because it hits pretty hard.
Jenny Smith (9:28) And the lower I think some of the ingredients that you're mentioning, like the durum wheat or the durum semolina wheat tend to be lower glycemic index Mhmm. (9:36) Than other types of pastas made from, you know, other types of wheat. (9:41) Pasta in general is considered low glycemic, but that's also if you cook it the way that it says on the package to cook it al dente. (9:50) And, really, that means that it should have a bit of chewability to it. (9:54) It should not be soft and, like, you shouldn't be able to, like, squish it and it gets, like, flat and gross and bushy with your fork.
Scott Benner (10:01) Mhmm.
Jenny Smith (10:01) It should have some need to chew, and that also then slows down the glycemic impact that it's going to have. (10:10) So there are lots of things that go into these foods that having the degree that I do and having had to do, like, food science, I understand at a little bit deeper level.
Scott Benner (10:19) Yeah.
Jenny Smith (10:20) But I think the it's the big consideration when we have something as a medical condition that's so impacted by food. (10:29) We end up needing to become schooled in so many different things. (10:34) But in general, you know, your Barilla pasta compared to your Dreamfields, the Barilla is going to have a quicker hit because it doesn't have the ingredients of the Dreamfields. (10:43) There are other products like the Dreamfields, some of the chickpea pastas now or the lentil based pastas. (10:50) You know, there's another brand called Kaizen.
Jenny Smith (10:52) That's a zucchini bean based pasta, tastes, cooks nicely, but has a very low glycemic index comparative to regular wheat based pastas. (11:04) So even those, if you're playing with them, you really have to do experiments with each kind because they may impact a bit differently, and your strategy might need to be different.
Scott Benner (11:15) Okay. (11:16) Before we finish this
Jenny Smith (11:18) Yeah.
Scott Benner (11:19) Because I'm gonna jump to let me just jump to something very quickly. (11:22) Like and please don't no one be upset with me. (11:25) I just picked a very basic pre made jarred pasta sauce. (11:29) I gotta tell you, this isn't the one I would use, but it's okay. (11:33) Ragu with meat sauce.
Jenny Smith (11:35) There you go. (11:36) It's probably one that many, many, many, many people eat.
Scott Benner (11:39) I'm assuming around the country, it's available in a lot of places. (11:41) Right? (11:42) So a serving size for that is let's see. (11:45) There's five servings per container, but it's a 23 ounce container. (11:50) Each serving is a half a cup, 70 calories.
Scott Benner (11:55) Total fat, one and a half. (11:57) Saturated, non trans, non cholesterol, non sodium, 490. (12:01) Total carbs. (12:02) This doesn't make much sense to me, but 12 grams of carbs Mhmm. (12:06) Dietary fiber, two, total sugar, seven.
Scott Benner (12:08) No added sugar. (12:09) So I guess that's just the sugar from the tomatoes?
Jenny Smith (12:11) I don't know. (12:12) You'd have to look in the ingredient list to actually see.
Scott Benner (12:16) Tomato puree, water, tomato paste, beef salt. (12:20) Wait. (12:20) Beef, comma, salt. (12:21) Thank god. (12:22) Because I was like, I don't know what beef salt is.
Scott Benner (12:23) Beef, comma, salt, soybean oil, sugar, dried onions, dried garlic, spices, citric acid.
Jenny Smith (12:31) See, sugar.
Scott Benner (12:32) Sugar. (12:32) Yeah. (12:32) Yeah. (12:33) Sugar. (12:33) Yeah.
Scott Benner (12:33) It it literally just says sugar. (12:35) They didn't even dress it up at all. (12:36) They're just like, no. (12:37) We put sugar in it.
Jenny Smith (12:38) Sugar in acidic foods, like, again, it's from a preservative standpoint. (12:42) Sugar in acidic foods also helps to moderate flavor. (12:46) It helps with, like, a preservative component to it. (12:49) Pasta sauces like this marinara sauce eaten alone are likely gonna have a faster impact than you would expect. (12:58) In fact, pasta sauces tend to have a higher glycemic than the actual pasta you put it on.
Scott Benner (13:04) There's no way that most people look at a red sauce and are counting carbs for it.
Jenny Smith (13:09) Most correct. (13:10) I just don't so.
Scott Benner (13:11) I mean, maybe the creamy white sauce, Well, that's fatty, but that's what
Jenny Smith (13:18) It's fatty, but it could also be made like, gravy is made with flour, and most people don't count that.
Scott Benner (13:23) Ain't that something? (13:23) Yeah. (13:24) Okay. (13:24) So, anyway, keep in mind you're gonna put sauce on it. (13:28) The meat's gonna slow down your digestion.
Scott Benner (13:30) I mean, I oh, that's interesting, by the way.
Jenny Smith (13:32) Beef in it.
Scott Benner (13:33) It just says beef. (13:35) Well, I wonder what that means. (13:40) But that that's upsetting to me because I'm thinking that means cow toes or something like that. (13:46) Oh, no. (13:47) Oh my god.
Jenny Smith (13:48) I don't know. (13:49) I don't wanna know.
Scott Benner (13:50) I have no idea. (13:51) I just please please know and tell me.
Jenny Smith (13:53) No. (13:54) I don't know. (13:54) I if for people who are wondering, there are a couple of pretty popular brands of no sugar added or very low sugar marinara sauces. (14:04) The most common one I hear is Rao's or Rae's. (14:07) I don't know I think it's Rao's.
Jenny Smith (14:08) It's r a o, apostrophe s.
Scott Benner (14:11) Okay.
Jenny Smith (14:11) That one is low carb. (14:13) If people also had the time and were willing within cooking and you have a food processor or a hand blender or anything, marinara sauce is so easy to make. (14:24) Mhmm. (14:25) And it's a great way that you can hide vegetables in a sauce that kids tend to like anyway and blend it up.
Scott Benner (14:32) I do that to myself when I make red sauce. (14:35) Right. (14:35) Because I don't like onions, but I'll puree, like, a whole onion, put it in there for it you that's easy. (14:41) And I Right. (14:42) I sneak mushrooms in for people who
Jenny Smith (14:45) Garlic. (14:45) Yeah. (14:46) Yuck. (14:46) All the kinds of you can sneak carrots in. (14:48) I there are a whole bunch of things that you can sneak in that nobody knows once.
Jenny Smith (14:52) It's all pureed and saucy.
Scott Benner (14:54) And you don't have to put sugar in it afterwards. (14:56) Correct. (14:56) You're making me think back to when my mom used to make pizza. (14:58) I'm making finger quotes because it was terrible, but God bless her. (15:01) She was trying.
Scott Benner (15:02) But I I remember her putting sugar into the sauce when she made the sauce. (15:07) And then later when I tried it as an adult, I found myself thinking, well, that doesn't seem right. (15:12) And then I realized that no respectable pizza maker puts sugar in their sauce. (15:17) Like, there's no sugar in pizza sauce.
Jenny Smith (15:19) But it tasted good from mom. (15:21) Mom was trying.
Scott Benner (15:22) Sure it did. (15:23) Boy, they made me fat on purpose, it feels like. (15:25) Here's the thing I wanted to bring up before we're done with pasta. (15:28) I remember the first time I saw this argument online where somebody was like, you know, all you have to do is cook your pasta, refrigerate it, then reheat it, and it doesn't hit the same way. (15:38) Then I watched people go like, you're out of your mind.
Scott Benner (15:40) And then, blah blah, and they went back and forth. (15:42) Then I looked into it, and that's actually true.
Jenny Smith (15:45) It is true. (15:46) It actually creates resistant starch. (15:48) Does it with potatoes? (15:49) You can do it with rice. (15:50) Yep.
Jenny Smith (15:51) Mhmm.
Scott Benner (15:51) Yeah. (15:51) So reheated I'm gonna let Chachi PT tell us. (15:54) Okay? (15:54) The reason cooking and then refrigerating pasta lowers its glycemic impact has to do with resistant starch in formation. (16:02) Number one, starch structure and digestion.
Scott Benner (16:04) This is gonna break Jenny's heart because she probably had to go to college to learn this. (16:08) Pasta and other starchy foods is made up of two main starch molecules, amylose and amoleptin. (16:16) Mhmm. (16:16) Okay? (16:17) When pasta is freshly cooked, the starch molecules are in gelatinized, more open form, making them easy for digestive enzymes to break down into glucose.
Scott Benner (16:26) This leads to a higher glycemic response, is a faster rise in your blood sugar. (16:31) So the cooling effect, which is called retrogradation, when cooked pasta is cooled in the refrigerator, the starch molecules undergo a process called retrogradation. (16:43) During this, the gelatinized starch chains recrystallize into a more compact structure. (16:49) The transformation creates resistant starch, a form of starch that resists digestion in the small intestine. (16:56) Resistant starch and blood sugar.
Scott Benner (16:58) Because resistant starch isn't broken down into glucose in the small intestine, it behaves more like fiber. (17:03) It passes into the large intestine where it feeds beneficial gut bacteria instead of spiking blood sugar. (17:09) The result is a lower glycemic impact. (17:12) Blood glucose rises more slowly and steadily after eating cooled pasta compared to freshly cooked pasta. (17:17) Interestingly, if you reheat the refrigerated pasta, much of the resistant starch remains intact.
Scott Benner (17:23) Mhmm. (17:24) There you go. (17:24) Cook your pasta and your potatoes, put it in the refrigerator, pull it out the next day, heat it back up. (17:29) It's not gonna hit the same way.
Jenny Smith (17:31) Which is also a really good way to, again, if you're doing any type of food prep, you've got a busy week, it's a fairly easy thing to cook a bunch of things all at one time like this. (17:40) You can cook your rice. (17:41) You can cook your potatoes. (17:42) You can cook your pasta all at one time. (17:44) Put them away in the fridge, and you've got things ready for the coming week.
Jenny Smith (17:48) And they're also going to hit your blood sugar less.
Scott Benner (17:52) There you go. (17:53) And, now, guys, Jenny and I are gonna say goodbye, but she's gonna get to see the puppy. (17:58) Should we let you do that while we're recording still Friday? (18:00) Sure. (18:01) Friday.
Scott Benner (18:01) Come here, buddy. (18:01) Friday. (18:02) Friday. (18:03) Come here. (18:03) You haven't seen him in a while.
Jenny Smith (18:05) No. (18:05) I have not.
Scott Benner (18:06) You wanna come see Jenny? (18:09) Alright. (18:10) Hold on a second. (18:12) I'm gonna get very
Jenny Smith (18:13) Oh my goodness. (18:14) He's so cute. (18:16) Hi, Friday. (18:17) He probably can't hear me.
Scott Benner (18:18) Oh, I can make
Jenny Smith (18:18) He's like, hi.
Scott Benner (18:19) One second. (18:20) Now he can hear you. (18:21) He can hear you now.
Jenny Smith (18:22) How old is he? (18:23) Hi, Friday.
Scott Benner (18:24) He was born Hi. (18:25) He was he was born on election day. (18:28) What's your
Jenny Smith (18:29) job? (18:29) Oh my god.
Scott Benner (18:29) So in November, he'll be here.
Jenny Smith (18:31) How is he he's not fully grown yet, or is he?
Scott Benner (18:35) I don't know. (18:35) He feels pretty fat while I'm holding him here. (18:37) No. (18:37) He's actually really lean. (18:39) He's good.
Scott Benner (18:39) I don't think he's I don't know that he's fully grown, but he's gotta be close at this point. (18:44) His color is so he's so pretty. (18:46) Aren't you
Jenny Smith (18:46) He's pretty, like, chill for still being under a year old.
Scott Benner (18:50) Only because trapped him in this room, and he realized he can't get out. (18:54) The reason he's up here is, like I said, because there's a guy painting downstairs. (18:57) Yeah. (18:57) And he would just be up this guy's butt.
Jenny Smith (19:00) He would be
Scott Benner (19:01) so Yes.
Jenny Smith (19:01) He would say, can you pick me up? (19:03) I'm really cute. (19:04) Look at my ears.
Scott Benner (19:04) He would be aggressively cute the entire time he was down there. (19:08) Instead, he's been laying under my feet the whole time. (19:10) So Aw.
Jenny Smith (19:11) Yeah. (19:11) Anyway He's been quiet.
Scott Benner (19:12) Thank He was awesome. (19:13) Yes. (19:13) I will thank him for you. (19:15) Alright. (19:15) Hold on one second for me.
Scott Benner (19:16) Awesome. (19:16) I appreciate you doing this.
Jenny Smith (19:17) Yeah.
Scott Benner (19:27) In each episode of the bolus four series, Jenny, Smith, and I are gonna pick one food and talk through the bolus thing for that food. (19:35) We hope you find it valuable. (19:37) Generally speaking, we're gonna follow a bit of a formula, the meal bulk formula, m e a l b o l t. (19:46) You can learn more about it at juiceboxpodcast.com/meal-bolt. (19:51) But here's what it is.
Scott Benner (19:52) Step one, m, measure the meal, e, evaluate yourself, a, add the base units, l, layer a correction, b, build the bolus shape, o, offset the timing, l, look at the CGM, and t, tweak for next time. (20:15) In a nutshell, we measure our meal, total carbohydrates, protein, fat, consider the glycemic index and the glycemic load, and then we evaluate yourself. (20:26) What's your current blood sugar? (20:27) How much insulin's on board? (20:28) And what kind of activity are you gonna be involved in or not involved in?
Scott Benner (20:32) Do have any stress, hormones, illness? (20:35) What's going on with you? (20:37) Then a, we add the base units. (20:39) Your carbs divided by insulin to carb ratio, just a simple bolus. (20:44) L, layer of correction.
Scott Benner (20:46) Right? (20:47) Do you have to add or subtract insulin based on your current blood sugar? (20:50) Build the bolus shape. (20:52) Are we gonna give it all upfront, a 100% for a fast digesting meal, or is there gonna be like a combo or a square wave bolus? (20:59) Does it have to be extended?
Scott Benner (21:01) Offset the timing. (21:03) This is about pre bolusing. (21:04) Does it take a couple of minutes this meal or maybe twenty minutes? (21:08) Are we gonna have to again consider combo square wave boluses and meals? (21:13) Figure out the timing of that meal.
Scott Benner (21:15) And then l, look at the CGM. (21:18) An hour later, was there a fast spike? (21:20) Three hours later, was there a delayed rise? (21:22) Five hours later, is there any lingering effect from fat and protein? (21:27) Tweak.
Scott Benner (21:28) Tweak for next time, t. (21:30) What did you eat? (21:31) How much insulin and when? (21:33) What did your blood sugar curve look like? (21:36) What would you do next time?
Scott Benner (21:38) This is what we're gonna talk about in every episode of bolus four. (21:43) Measure the meal, evaluate yourself, add the base units, layer a correction, build the bolus shape, offset the timing, look at the CGM, tweak for next time. (21:52) But it's not gonna be that confusing, and we're not gonna ask you to remember all of that stuff. (21:57) But that's the pathway that Jenny and I are gonna use to speak about each bolus. (22:06) The Juice Box podcast is edited by Wrong Way Recording.
Scott Benner (22:10) Wrongwayrecording.com. (22:13) If you'd like your podcast to sound as good as mine, check out Rob at wrongwayrecording.com.
Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!