#1801 Super Diabetic - Part 2

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Katarina shares pregnancy with type 1, a 54-hour labor, shoulder dystocia, and a terrifying NICU moment—plus pumps, pre-bolusing struggles, and raising three boys along the way.

Key Takeaways

  • Start with the Basics: For those newly diagnosed with Type 1 Diabetes, the Bold Beginnings series serves as a straightforward and practical foundational guide.
  • Mental Health Matters: The ACEs (Adverse Childhood Experiences) list is a crucial psychological tool indicating that early trauma can correlate with future physical issues, including autoimmune diseases.
  • Finding the Right Tech: Managing diabetes is highly personal; finding the right device, such as switching from multiple daily injections to a tubeless pump, can drastically improve your day-to-day comfort and control.
  • Pregnancy and Insulin Resistance: Insulin needs and insulin resistance change dynamically during pregnancy, often requiring adjustments to pre-bolus timing, basal rates, and correction factors.
  • Leveraging Pump Modes: Utilizing both automated and manual modes on an insulin pump can be beneficial, especially during pregnancy when an algorithm may not be aggressive enough for specific meals or periods of insulin resistance.

Resources Mentioned

FULL EPISODE TRANSCRIPT

Welcome & The Bold Beginnings Series

Scott Benner (0:0) Welcome back, friends, to another episode of the Juice Box podcast.

Katarina (0:14) Hey. My name is Kataria, and I am a type one diabetic.

Scott Benner (0:22) This is part two of a two part episode. Go look at the title. If you don't recognize it, you haven't heard part one yet. It's probably the episode right before this in your podcast player. If you're new to type one diabetes, begin with the bold beginnings series from the podcast.

Scott Benner (0:38) Don't take my word for it. Listen to what reviewers have said. Full beginnings is the best first step. I learned more in those episodes than anywhere else. This is when everything finally clicked.

Scott Benner (0:49) People say it takes the stress out of the early days and replaces it with clarity. They tell me this should come with the diagnosis packet that I got at the hospital. And after they listen, they recommend it to everyone who's struggling. It's straightforward, practical, and easy to listen to. Bold Beginnings gives you the basics in a way that actually makes sense.

Scott Benner (1:10) While you're listening, please remember that nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan or becoming bold with insulin. This episode of the Juice Box podcast is sponsored by the Dexcom g seven, the same CGM that my daughter wears. Check it out now at dexcom.com/juicebox. Today's episode is also sponsored by Omnipod.

Scott Benner (1:44) Did you know that the majority of Omnipod five users pay less than $30 per month at the pharmacy? That's less than $1 a day for tube free automated insulin delivery. And a third of Omnipod five users pay $0 per month. You heard that right. 0.

Scott Benner (2:01) That's less than your daily coffee for all of the benefits of tubeless, waterproof, automated insulin delivery. My daughter has been wearing an Omnipod every day since she was four years old, and she's about to be 21. My family relies on Omnipod, and I think you'll love it. And you can try it for free right now by requesting your free starter kit today at my link, omnipod.com/juicebox. Omnipod has been an advertiser for a decade.

Scott Benner (2:27) But even if they weren't, I would tell you proudly, my daughter wears an Omnipod. Omnipod.com/juicebox. Terms and conditions apply. Eligibility may vary. Why don't you get yourself that free starter kit?

Scott Benner (2:39) Full terms and conditions can be found at omnipod.com/juicebox. The podcast is also sponsored today by Cozy Earth. You can use my offer code juice box at checkout to save 20% off of your entire order at cozyearth.com. Everything from the joggers that I'm actually wearing right now to the sheets I sleep on, the towels I use to dry myself with, and whatever else is available at cozy earth dot com. Just use the offer code juice box at checkout.

Trauma, Mental Health, and the ACEs List

Scott Benner (3:10) You're not sure if you've got trauma?

Katarina (3:13) Well, I sometimes I get in my head and, like, that's the crazy part of me where I'm like, maybe there's something that I have pushed down so far that I have completely erased from my history, and there was, like, something super traumatic that happened to me.

Scott Benner (3:34) I think that's called Caucasian lady TikTok is what you're talking about right now. Okay. I think you're I think you're fine. So, Ross.

Katarina (3:42) Ouch. Ouch. So true, Scott. So true.

Scott Benner (3:47) I don't know. I'm trying to decide between this mauve and this brown for my wall. 'm gonna start a TikTok account that will eventually have 300,000 followers while I try to decide what color of tan to paint my house. No. Listen. I mean

Katarina (4:02) Life is hard. You don't understand that the walls need to be a certain color. It needs to give a certain aesthetic.

Scott Benner (4:09) Why did BMW move the buttons from there to there? I can't reach them now. And, like, it's so but no. Sir seriously, like, I would imagine that if you had something that traumatic, you'd be at least have an inkling about it.

Katarina (4:20) Yeah. I think I'm pretty good. So

Scott Benner (4:24) Do you know the Yeah. Do you listen to anything that I do with Erica, by any chance? Like, that mental health stuff, or are you just so healthy you don't need that? Okay.

Katarina (4:33) Good. I would I would like to say it's because I'm so mentally healthy. But, no, I I have not listened to anything with Erica.

Scott Benner (4:43) Okay. So that's fine. So she and I are getting ready to do we just finished up a series of about body grief, which is gonna be very interesting if you find it. I I think you should try to give it a whirl. But we're gonna start something up that we're calling let me see if I can find the word because I'm I made it up.

Scott Benner (5:03) So people are like, awesome. Mental health that you made up. I said to her, you know, there's that that ACEs list that we do you know the ACEs list? It's a group of indicators about past trauma that indicate future problems.

Katarina (5:19) Okay.

Scott Benner (5:20) Okay. And so it is a very, very well established tool in psychology, right, in therapy. So there the 10 aces are this, abuse. So if you as a child experienced emotional abuse, a parent or an adult regularly swore at you, insulted you, humiliated you, or made you feel afraid that you'd be physically hurt. If you there was actual physical abuse, a parent or an adult in the home hit, kicked, beat, or physically harmed you, sexual abuse.

Scott Benner (5:55) If you had if you experienced emotional neglect, physical neglect, if your mother was treated violently, if there's substance abuse in the house, mental illness in the house, if your parents are separated or divorced, or if you have a family member who's incarcerated. These 10 things are an indicator of future issues that you'll have. Right? Okay. And it's a fairly a fairly reasonable measuring stick.

Scott Benner (6:23) Works pretty good is what I'm saying. And I started thinking, what's the opposite of that? What happens to people that lead them to having happy unencumbered lives? And I said to Eric, I'm like, I wanna go over that. Like, I'm like, let's try to figure out what it is that happens to healthy people that leads them to not have problems in the future.

Scott Benner (6:45) Because by the way, the Yeah.

Katarina (6:46) Like, how how to be set up for success.

Scott Benner (6:49) Yeah. And as a parent, that might be interesting to list too. Also,

Katarina (6:53) like Absolutely.

Scott Benner (6:54) So you score that ACEs list and a higher score correlates with ready? Heart heart disease, autoimmune disease, depression and anxiety, addiction, and early mortality.

Katarina (7:07) Oh, jeez.

Scott Benner (7:08) Isn't that crazy?

Katarina (7:09) Wow. Yeah. That's so sad.

Scott Benner (7:11) Yeah. Of well, actuary tables, also can figure out exactly when you wanna die. So you could figure that out now, by the way. If you went to an actuary, they could probably tell you within, like, two years how long you're gonna live. Isn't that crazy?

Scott Benner (7:26) Jerry is like, please do not I don't wanna I don't wanna know that at all. Like, they don't know if you're gonna get hit by a meteor three weeks from now or something like that, but, like, know, that kind of thing. Anyway, I feel like this is going off the rails. So let's get back.

Life After a Type 1 Diagnosis

Scott Benner (7:40) You've got diabetes now, type one. It's been diagnosed. You get a pump. Do you get a pen? Do you get what how do you start?

Katarina (7:47) I was doing, like, multiple daily injections, and I think they gave me a trial with the Dexcom. Oh, yeah. They gave me both, the Dexcom g six and the Libre Freestyle.

Scott Benner (8:03) Okay.

Katarina (8:04) I think the Freestyle had, like, just come out when I was diagnosed as type one. And so that, like, just getting on insulin I was pretty heartbroken again, like, see just, okay. This is this is the rest of my life. Like, it it gay it how would I say this? Like, in some ways, it was, like, reassuring.

Katarina (8:34) Like, yes. This makes a lot of sense. And then in other ways, it was, like, just as heartbreaking. Okay. I am dependent on this medication for the rest of my life.

Scott Benner (8:45) So you got your answer, but it was not the answer you were looking for.

Katarina (8:49) Yeah.

Scott Benner (8:50) Yeah. Yeah. And it's not comforting. Oh, you have you know what I mean? Like, oh, we know what's wrong with you. You have type one diabetes. Awesome. You know, like, I have an answer, and functionally, know how to make myself feel better, but this is not something I wanted for myself. That kind of feeling? Okay.

Katarina (9:07) Yeah. I and in that moment, it felt so large. Oh, excuse me. It felt so large. Just like, wow.

Katarina (9:18) This this is, like, who I am now, and this just like it just like

Scott Benner (9:29) Take your time. I'm interested in what you get to. Seriously, don't feel don't feel pressure. I'm not kidding.

Katarina (9:34) I I had a lot just like, how did this even happen? And it was very much like, okay. This is the rest of my life. Mhmm. Like, I'm gonna be on these medications for the rest of my life.

Katarina (9:53) And I I still kinda, like, struggle with that, especially since every time you switch jobs that you switch insurance, and then coverage is different with medications. But I will say out of so many of the autoimmune diseases, like, I am very like, type one has been so thoroughly researched, and there is so much medication and devices out there, which is amazing.

Scott Benner (10:32) Mhmm.

Katarina (10:32) And so it is like, okay. There is so much support medically for type one as an autoimmune disease because they're I I've met some people who have an autoimmune disease, and they're just like, yeah. I can only eat I can eat red meat and a little bit of lettuce, and that's it for the rest of my life.

Scott Benner (10:57) And How does that make you feel when you talk to people who have that situation?

Katarina (11:00) I'm like, wow. It makes me so grateful. Like, oh, I can still have ice cream. I shouldn't all the time, but I can still have ice cream and be just fine. Like, if I bowl this correctly, if I go on a little walk afterwards, like, totally fine.

Scott Benner (11:19) Yeah.

Katarina (11:21) But, yeah, some people who have to just, like, give up all dietary things, change their lifestyle dramatically just to try and stay alive.

Scott Benner (11:33) Makes you feel grateful when that's not your situation?

Katarina (11:36) Yes. Yes.

Scott Benner (11:38) Okay. And, well, I mean so you're gaining perspective as this goes on?

Katarina (11:42) Yes. Yeah. Very much.

Scott Benner (11:43) Are you still MDI now?

Katarina (11:45) No. I am now on a pump. When I during my first pregnancy, my doctors and I have a wonderful, wonderful care team. I like being pregnant because they are so attentive Mhmm. To my diabetes.

Scott Benner (12:02) Mhmm.

Katarina (12:03) And they asked and kind like, they heavily suggested I go on a pump.

Scott Benner (12:10) Heavily suggested?

Katarina (12:13) They're like, it's easier to control your diabetes, and it's a lot more important when you have a, like, a living being you're trying to keep alive inside of you.

Scott Benner (12:23) Okay. So they heavily suggested you went with it. Yes. You said okay. Alright.

Scott Benner (12:27) And what you're finding? How how has that changed things for you?

Katarina (12:30) So I have some thoughts. I had a very negative experience with the first pump I used. It was so miserable, but it did keep my sugar levels in a very good balance.

Scott Benner (12:44) Okay.

Katarina (12:45) I just hated like, it was corded. Is that the right term?

Scott Benner (12:50) Tubed?

Katarina (12:51) Tubed. Yes. Tubed. That was like, oh my goodness. Like, I like wearing dresses.

Katarina (13:00) Where am I gonna put this? And I'm, like, so pregnant. There is no good wear good way to, like

Scott Benner (13:05) You didn't you did not enjoy the idea of tubing?

Katarina (13:08) No. No. No. And it I would wake up all the time just, like, cotton tubes. Like, how how is this even happening?

Katarina (13:16) And then so I went back to daily injections pretty much instantly after giving birth

Scott Benner (13:24) Mhmm.

Katarina (13:24) With my first pregnancy. And then my second pregnancy, I went to a tubeless pod and amazing. And I've been on it ever since. So that was back in 2024, I guess, 2023.

Scott Benner (13:43) You had done pod at that point?

Katarina (13:45) Uh-huh.

Scott Benner (13:46) Okay. And Yeah. And you've been doing well since. What's your a one c today?

Katarina (13:50) I haven't gotten a recent one since October. In October, it was 6.8. So

Scott Benner (13:57) Awesome. Good for you. It's not what?

Katarina (14:01) It's okay.

Scott Benner (14:02) It's okay.

Katarina (14:03) Like, trying to get better. But I I think it's gone down since then because oh, I'm also pregnant again.

Growing the Family and Minivan Life

Scott Benner (14:10) Wait. You're you're pregnant right now?

Katarina (14:13) Yeah.

Scott Benner (14:13) And you have two kids? Yeah. Oh my god. This is a this is a I mean, you did you get a minivan? Are you all set with that?

Katarina (14:20) Yeah. Oh, Scott, please.

Scott Benner (14:23) Why'd you do that?

Katarina (14:24) Salt in the wound.

Scott Benner (14:25) Why'd you give up? Why'd you give up?

Katarina (14:28) No. Okay. Remember how we were talking about my beautiful husband who is so responsible and forward thinking?

Scott Benner (14:36) Yeah. Except for getting your pregnant three times in the last five years. Okay.

Katarina (14:42) No. That's the that was me. That's the crazy part. But I had this beautiful RAV four 2004 RAV four that I loved with all my heart.

Scott Benner (14:54) Right.

Katarina (14:54) And it was it was fun for, like, a single person and had to be in the shop, like, twice a year. You know? And my husband was like, yeah. We're getting a van.

Scott Benner (15:09) It's too small. Oh, so you're driving a man a van around. Did you get maroon? What horrible color is it?

Katarina (15:14) Oh, it's it's gray. I I would have loved a maroon van. I was like, we're gonna wrap it. Do some, like, floral pattern.

Scott Benner (15:26) We're no. You're not. You're gonna put that money in a bank to send one of those kids to college with. Don't you worry?

Katarina (15:31) Literally. Yeah. After look I looked into it too, and I got some quotes, and it was just like

Scott Benner (15:39) You are awesome. Yeah. You you really are. You're I swear to god. I thought I I can't tell when the most Caucasian thing you're gonna say is gonna stop.

Scott Benner (15:50) Oh, no. But I looked into getting my minivan wrapped. It's pretty high on my list right now. Fantastic. Oh my gosh.

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Scott Benner (17:25) The g seven is a simple CGM system that delivers real time glucose numbers to your smartphone or smartwatch. The g seven is made for all types of diabetes, type one and type two, but also people experiencing gestational diabetes. The Dexcom g seven can help you spend more time in range, which is proven to lower a one c. The more time you spend in range, the better and healthier you feel. And with the Dexcom Clarity app, you can track your glucose trends, and the app will also provide you with a projected a one c in as little as two weeks.

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Scott Benner (18:13) You must have him working twenty four hours a day. What what kind of job does he have? What is what kind of work does he do?

Katarina (18:19) He so we were both working in biotech when we got married, and now he's still working for a biotech company. He works for BD.

Scott Benner (18:32) Yeah.

Katarina (18:32) I don't know if you're familiar with that, but it's, like, basically on every, syringe.

Scott Benner (18:38) Yeah. They make the syringes.

Katarina (18:39) Yeah. Yep. He's on, like, tech support now.

Scott Benner (18:45) Okay.

Katarina (18:46) So, yeah, he he recently made a career shift, but he's he's doing great. So yeah.

Scott Benner (18:53) You got him out there hustling. He's hustling for the family?

Katarina (18:55) He is hustling. He is hustling for the family. I am thankful.

Scott Benner (18:59) How many of these, babies do you think you're gonna end up with?

Katarina (19:04) I think three is a good number.

Scott Benner (19:07) Mhmm. Yeah. And

Katarina (19:09) and But I also think four or five is a great number too. No. Oh my god. Five is too many. Five is too many for me, but there is, like, a crazy part of me that's like, but four.

Katarina (19:20) Why?

Scott Benner (19:21) Is like a two year period?

Katarina (19:22) I'm like, I I'm not even done having this one. Stop thinking.

Scott Benner (19:25) I'm still cooking this one. What are the first two? Are they, boys, girls? What do you got?

Katarina (19:29) Boys. And I'm pregnant with my third boy.

Scott Benner (19:32) Oh, my goodness. Yeah. Alright.

Katarina (19:34) I'm so excited. Are you? So excited.

Scott Benner (19:36) You're not worried about, like, oh my god. I'm gonna try for a girl one day?

Katarina (19:41) Yeah. I

Scott Benner (19:42) mean, don't do it. Let me just say that right now. Four is too many. I don't know how you're you better hope AI takes over the world. Nobody needs a job because you're not sending four kids to college.

Scott Benner (19:51) That's terrible. What did you go

Katarina (19:53) need college by the time they're that age.

Scott Benner (19:56) You better you better hope not. I would assume you're voting for universal basic income right now is the way you're the way you're hoping. But seriously, like, it's did you go to a private college?

Katarina (20:09) Yeah. I did.

Scott Benner (20:10) Mhmm. Do you remember what it cost?

Katarina (20:13) Oh, I'm so I'm a stay at home mom. Mhmm. And I am still paying off my student loans.

Scott Benner (20:19) Yeah. Without a job.

Katarina (20:21) Without a job.

Scott Benner (20:22) Yeah. So you're not paying off your student loans. That schmuck that you you you snook her in to get you're pregnant is paying them off. Right? With your with your cute laugh and, like and he was like, alright.

Scott Benner (20:33) I'll pay for your student loans. That's what happened. Am I wrong? I'm I'm not wrong. Please.

Scott Benner (20:38) And

Katarina (20:39) he has no student loans, no debt to his name. He's yeah. He's totally job without all that,

Scott Benner (20:46) or did the did his parents cover it for him?

Katarina (20:49) He his parents definitely helped him out.

Scott Benner (20:51) Oh my gosh. This is awesome. Yeah. Seriously, you guys are blessed. It's going really well.

Scott Benner (20:58) But but, seriously, please don't have more children. Like, there's so many children. Like, how are you like, do you have enough space for them? Where are gonna put them?

Katarina (21:06) I you know, you don't need space. You could just, like, stack them on top of each other. Right?

Scott Benner (21:11) Well, when they get older, they're gonna want their own space.

Katarina (21:15) We'll deal with it when it comes.

Scott Benner (21:16) No. You won't. They're gonna beat the hell out of each other trying to get away from each other. It's not how it works. This is trust me.

Scott Benner (21:22) It's not how it works. They're gonna they're gonna want a place to to retreat to. They're gonna want their own space. That's fair. That's fair.

Scott Benner (21:29) They're gonna ask you for things. Every one of those oh my god. You're athletic. Right? Are those kids gonna be athletic?

Katarina (21:37) They are already showing some signs. It's pretty cute. But they are, yeah, very tough. Like, oldest just likes fighting other kids. Like

Scott Benner (21:49) So he's gonna do UFC?

Katarina (21:50) We we as parents call it wrestling, and he's like, I don't know what wrestling is, but I really like fighting that boy.

Scott Benner (21:58) Like so so you're gonna that kid's gonna be in some UFC training camp that you're gonna have to pay for. And oh my god. You're and that minivan is gonna smell like holy wait. Do you wait. Do you see what that minivan smells like when those three sweaty boys get in that car?

Scott Benner (22:14) Oh, it's gonna smell like, you know what it's gonna smell like, don't you?

Katarina (22:18) I, played roller hockey throughout high school.

Scott Benner (22:23) Okay.

Katarina (22:23) And because Southern California, playing ice hockey is way too expensive.

Scott Benner (22:28) I thought you were gonna say because I was wrestling with my sexuality, but go ahead.

Katarina (22:36) Everyone in high school would also agree with you.

Scott Benner (22:38) Okay.

Katarina (22:42) And, oh my goodness, the odors were awful.

Scott Benner (22:46) It's horrible.

Katarina (22:47) So so bad. And that was even me smelling my own self.

Scott Benner (22:51) Like Your van's gonna smell like testicles. That's what it's gonna smell like. Yeah. Sweaty, hot, dirty testicles. That's what your van's gonna smell like.

Katarina (22:59) Can't wait.

Scott Benner (22:59) God bless you. You're gonna have a great time. And and each one of those little sports is gonna cost a a small fortune.

Katarina (23:06) Yeah. Yeah? We already are kinda running into that. Like, what the heck?

Scott Benner (23:12) Yeah. No. It's insane. Don't fall for it. Seriously.

Scott Benner (23:16) Just tell send them out in the backyard, tell them to beat up the dog, and that's it. You know what mean? But because he likes to fight. By the way, please don't hurt your animals. Okay.

Scott Benner (23:24) Alright. Please. So how did you find the process of making the babies with the diabetes? Because it was kinda new to you still, and you're Right.

Katarina (23:31) Right. Yeah. And that has definitely been a journey in itself. I feel like with this third pregnancy, I am chasing after two boys, and I don't really even recognize that I'm pregnant half the time. So my first baby was eleven pounds.

Scott Benner (23:53) Oh, was your blood sugar high during the pregnancy?

Katarina (23:55) No. I was like, I think my a one c was 5.8. I I I was, like, kept it in pretty good check. Very yeah. I was I was trying to be, like, pretty controlled, but just a very large baby.

Katarina (24:12) And that was like, the pregnancy was great. I felt amazing while being pregnant. And then, like, in the third trimester, I had pretty much everyone that saw me in public came up to me and was like, is it twins? And I I was like, oh gosh. Am I gonna get this comment every other five seconds?

Scott Benner (24:37) We're so far away from when I had those abs. This is crazy. Yeah. Did you keep that, like, athletic build? Like, you know, some ladies are, like, athletic and pregnant still, or did it today's episode is brought to you by Omnipod.

Scott Benner (24:52) Did you know that the majority of Omnipod five users pay less than $30 per month at the pharmacy? That's less than $1 a day for tube free automated insulin delivery. And a third of Omnipod five users pay $0 per month. You heard that right. 0.

Scott Benner (25:09) That's less than your daily coffee for all of the benefits of tubeless, waterproof, automated insulin delivery. My daughter has been wearing an Omnipod every day since she was four years old, and she's about to be 21. My family relies on Omnipod, and I think you'll love it. And you can try it for free right now by requesting your free starter kit today at my link, omnipod.com/juicebox. Omnipod has been an advertiser for a decade.

Scott Benner (25:35) But even if they weren't, I would tell you proudly, my daughter wears an Omnipod. Omnipod.com/juicebox. Terms and conditions apply. Eligibility may vary. Why don't you get yourself that free starter kit?

Scott Benner (25:47) Full terms and conditions can be found at omnipod dot com slash juice box.

Katarina (25:52) I was trying to, but it was like I I don't know. I and I could, like, hyperanalyze myself. I think the average person who saw me would say I was still athletic while pregnant.

Scott Benner (26:07) Mhmm. You

Katarina (26:09) didn't You

Scott Benner (26:09) know? Didn't feel that way.

Katarina (26:11) I I saw changes in my body that were like, oh, wow. Where like, why am I squishy right here?

Scott Benner (26:20) Mhmm.

Katarina (26:20) And so that was, like, you know, dealing with that, but it's fine.

Scott Benner (26:25) Did you have trouble getting back into the shape you wanted to be when you were, finished with the pregnancy?

Katarina (26:30) Yeah. There there were these, like, pesky, like, five to 10 pounds that are just still hanging on.

Scott Benner (26:38) Mhmm.

Katarina (26:38) And so that's but then again, like, I pretty much got pregnant with my second a year postpartum.

A Traumatic Birth Story

Scott Benner (26:47) On purpose? So

Katarina (26:48) that one was, very much surprised.

Scott Benner (26:52) No is fine if you just wanna say no. So

Katarina (26:57) my first was, like, a very traumatic birth. The pregnancy was amazing. The birth itself was horrendous. How? So I had to be induced.

Katarina (27:08) And, like, I am kind of crunchy. Like, you you were like, what's the whitest thing this girl is gonna say? I'm I'm bad. Did you

Scott Benner (27:16) have doula?

Katarina (27:18) No. I didn't.

Scott Benner (27:20) Okay. Alright. It's okay.

Katarina (27:22) And

Scott Benner (27:22) Maybe next time.

Katarina (27:26) Yeah. That's I I didn't wanna pay the money. That that was just me.

Scott Benner (27:30) So you won a doula. You just didn't wanna pay for it.

Katarina (27:33) Yeah. Now insurances cover doulas. How cool is that?

Scott Benner (27:37) You try to have one of these babies in your living room in a baby pool?

Katarina (27:41) So you it cannot do that, as a diabetic.

Scott Benner (27:47) It's Yeah. They won't like you. I know.

Katarina (27:50) But, yes, I would have loved to be one of those moms for sure.

Scott Benner (27:55) I would've

Katarina (27:55) okay. I got induced. I was in labor. Like, so they did all the things. I'm not gonna get into too much detail, but I was in labor for fifty four hours.

Katarina (28:12) So went in on a Monday afternoon, and my baby was born Thursday morning.

Scott Benner (28:21) What in the hell? Are you serious?

Katarina (28:23) Yeah. Oh,

Scott Benner (28:25) jeez. I would have given up in the middle. I would have been like, that's enough. We're good.

Katarina (28:30) And, oh my goodness, I was, like, trying to do it natural, like, no epidural. And if if there's anyone who is listening who's pregnant, if you get induced, just don't

Scott Benner (28:44) Don't fight.

Katarina (28:45) Don't put your body through that because, yeah, it's it's almost impossible to do it, like, without an epidural.

Scott Benner (28:54) Wow. Yeah. So you try so okay. Alright. So you're it was long and painful.

Katarina (28:59) Yeah. And so, like, about thirty two hours in that I finally was like, okay. I'm not progressing. Let's get the epidural. And they gave me the epidural things, and it only worked in half my body too, which is so fun.

Scott Benner (29:14) So

Katarina (29:16) I'm like, they're just giving me twice the amount of epidurals and, like, turning me on my side so that it'll, like, seep down into the other half of my body.

Scott Benner (29:29) There's no reason to use so much technical terms. Okay? It's Oh, I seeped out into your body. Is that what they said to you?

Katarina (29:38) What the they put me on my side, and they because it was just, like, only working for half of my body. So half my body was numb. The other half was still feel feeling pain.

Scott Benner (29:48) Oh my gosh. I I love you. I think you're awesome.

Katarina (29:52) A little crazy.

Scott Benner (29:53) Don't think you know what the hell you're talking about, but I think you're awesome. I love you. I think Just Hey, Bruce. You're starting

Katarina (30:01) to realize the laughter is now out of delirium Yeah. Than anything else.

Scott Benner (30:05) You're like, they turned me on my side to get the medication to go the other way. I am a 100% sure that is not how it works.

Katarina (30:11) That is literally what they said.

Scott Benner (30:13) Well, they gotta get out of the hospital if that's what they said. You gotta get out of there. That's the wrong place to be. Oh my god. Were you with doctor Jekyll?

Scott Benner (30:22) Is what was happening exactly? Doctor Frankenstein, did any of this happen come up when you were talking? We're just gonna spin you over so it moves to the other side of you. There's oh my god. Are you gonna make me look this up?

Katarina (30:36) Do it. Do it. Are you That is literally what happened, though. They were like, oh, okay. Yeah.

Katarina (30:41) We'll put you on your side. And so that the this is now I'm, like, questioning it because that does sound a little funky, but that's literally what was happening. Because they you put the epidural into the spine, and then if it's, like, a little bit on the side, it'll only get I now I'm like now I'm questioning how it how that works.

Scott Benner (31:07) Oh my god. Hold on a sec. Wait. Wait a sec. Wait. Wait. Wait. Wait. Okay. I think I've got a question set up here that asks the that gets to the point.

Scott Benner (31:20) Oh my god. Hold on a second. Oh, I so I said, can a pregnant woman's epidural be made to impact other parts of the body by turning the body? That seems like what you said to me. Right?

Scott Benner (31:33) Says it says, the short answer is yes to a degree, but within limits.

Katarina (31:39) Yeah.

Scott Benner (31:40) Okay. An epidural delivers anesthetic into the epidural space around the spinal nerves. The medication doesn't stay perfectly fixed. It can spread up and down the spine and slightly side to side, so gravity can matter. Larger doses, continuous infusions, or partial or uneven blocks.

Scott Benner (31:58) Does turning the body change where it works? Positive position can influence spread, especially early on. I take it back. I'm so sorry. Side lying can make one side feel more numb than the other.

Scott Benner (32:10) Lying flat versus slightly upright can change how high numbers how high the numbness can creep up, and tilting is sometimes used to reduce one size blocks preventing okay. God bless you. I was wrong. We've all learned something. I'm sorry I laughed at you.

Scott Benner (32:25) I wasn't just laughing at you. I was snickering, and I apologize. Okay? I jumped to conclusions.

Katarina (32:31) No offense taken.

Scott Benner (32:32) I don't know everything. I should've looked.

Katarina (32:34) Saying it. I'm like, that does sound a little weird.

Scott Benner (32:36) Sounds stupid is why. Okay. Alright. Okay. Fair enough.

Katarina (32:42) Yeah. And so I'm, like, on my side. And then finally, I they're like, oh, you're dilated enough to start pushing. So I go into active labor. And, normally, like, your average active labor is, like, one hour.

Katarina (33:02) And in hospital settings, they don't want you to go beyond four hours. Mhmm. So it's, like, probably gonna get a C section if the baby hasn't come out after four hours. And I was, like, very, very against the C section for my first baby, and I'm pushing, pushing, pushing. And they're like, you're doing a great job.

Katarina (33:20) Like, we could see his head. And, like, the four hour mark goes by, and then, like, four and a half hours. And, finally, like, I push this baby out. Well, his shoulder had gotten stuck, which is called shoulder dysplasia. So there was, like, a nurse that hopped onto my bed and was shoving my stomach to try and get this baby out of me.

Scott Benner (33:48) Jesus. And you got pregnant again? I would've been like, listen. That ain't happening twice. Wait.

Scott Benner (33:55) You from I can see the head till the baby was out was over four hours?

Katarina (34:00) It it will once I started pushing, so you couldn't quite see the head then, But it was, like, around the four hour mark pushing that you could see the head.

Scott Benner (34:11) The crowning, and then it happened after that. Okay. Alright. I was like, my god. The kid was just, like, down there hanging out all

Katarina (34:17) the Like, in that those moments, his heart rate dropped and all of a sudden I stopped having contractions. So he was just stuck.

Scott Benner (34:26) Oh my gosh.

Katarina (34:27) Like, squeezed, couldn't couldn't get out, and there was, like, no contraction to push him out.

Scott Benner (34:33) Yeah. I'm being big baby, but are you a petite person or no?

Katarina (34:38) I am five foot seven, a hundred and forty pounds.

Scott Benner (34:42) Yeah. You're not petite. Okay. Alright. So that kid should have come out of there is what you're saying.

Scott Benner (34:46) Yeah. Yeah.

Katarina (34:47) And he, like so, yeah, he gets stuck. His heart rate has dropped in, like, super low, and they finally push him out. And just like this blue lifeless baby is born.

Scott Benner (35:03) Oh my god.

Katarina (35:04) And both my husband and I, like, ugh, even thinking about it, like, now, I get so emotional because it was like, to me, those first moments, like, I gave birth to a dead baby.

Scott Benner (35:18) That's how it felt.

Katarina (35:19) Like, he wasn't breathing. He was like, I can't tell you when I say lifeless, like, he just flopped. Like, there was no muscle movement at all, and he was totally blue. It was it was so awful seeing that, and they, like, whisked him straight over. There was, like, a NICU doctor there who immediately intubated him and was, like, trying to get him to cough or cry for and it felt like an eternity.

Katarina (35:47) I think it was it wouldn't wasn't more than five minutes, but we were just like, oh

Scott Benner (35:52) Oh gosh.

Katarina (35:52) My goodness.

Scott Benner (35:53) Like Wow. That's something.

Katarina (35:54) Yeah. It was it was awful, and there was a lot of components to that as well, like super long birth. His blood sugars were, like, 30 when he was born. Mhmm. So really, really low.

Katarina (36:10) His heart rate had dropped. He had swallowed his he had swallowed his own poop, which sometimes babies do if they're I

Scott Benner (36:18) do that sometimes.

Katarina (36:20) Yeah. You know, just a little snack. My gosh. Mom's not feeding me enough. I'm hungry.

Katarina (36:26) Yeah. And so, like, he basically, there was just, like, a bunch of gunk in his lungs. And, yeah, I didn't even get to see, like, my living child before he was whisked to the NICU. So I'm just, like, sitting there. Like, I have no idea, like, how much my baby weighs, like, anything.

Katarina (36:52) They're sewing me up, and I'm just like, is he alive? Like, what happened?

Scott Benner (37:00) Really? How long did that go on for you? You weren't sure about his how how he was?

Katarina (37:06) So they took him down to the NICU, and I it's like, those first moments of being, like, freshly postpartum, like, those first few minutes, I it could have been hours, and it could have just been five minutes. I cannot give you a solid answer.

Scott Benner (37:27) Okay.

Katarina (37:27) It just felt, like, so so long. It just felt like a whole lifetime had passed by.

Scott Benner (37:35) Yeah. I can't imagine. But he was okay.

Katarina (37:38) He and yeah. So likes to hit things? Yes.

Scott Benner (37:42) Did you name him Elvis because he was blue and blue Hawaii?

Katarina (37:46) Oh, that's so mean.

Scott Benner (37:47) Because you should have.

Katarina (37:49) And So so we he he's in the NICU, and it's kind of funny because the, like, doctor and all the nursing staff is just like, he is so big. Nothing fits him. Like, his neighbor, his little NICU neighbor was one and a half pounds. And then our gigantic son of eleven pounds Yeah. Like

Scott Benner (38:13) So hungry. He's really

Katarina (38:15) 10 times the size of baby next door.

Scott Benner (38:18) Like, I'm so hungry. I'd eat my own poop. Oh my god. Chattering, this is awesome. Yeah.

Navigating Diabetes During Pregnancy

Scott Benner (38:26) You you, you, you and I, we've had a good time today. Is this pregnancy going differently? Is your I mean, what where do you want your a one c during this one? What are you shooting for?

Katarina (38:38) I I am aiming for it to be a little bit lower. So I I think my most recent, like, from my Dexcom, you know, how they give you,

Scott Benner (38:50) like Clarity.

Katarina (38:51) Every yes. Yes. Every fourteen days. I think it's about six point four, and I I would like to get down into, like, the five

Scott Benner (39:01) What's stopping you from pushing it down more?

Katarina (39:04) I'm no. I'm working on it. But, like, literally myself is stopping me.

Scott Benner (39:09) Yeah. I don't mean, like, what's, like, physically I I imagine you're trying. But, like, I'm saying, like, functionally, are you not prebolising enough? Are you not using enough insulin? Do you not have your settings up high enough? Like, that kind of thing.

Katarina (39:22) I am prebolising is probably the biggest thing that I'm doing wrong.

Scott Benner (39:30) Okay.

Katarina (39:31) And it's just it is hard, like, to gauge when to do that.

Scott Benner (39:40) Well, start with sooner.

Katarina (39:42) Yeah.

Scott Benner (39:43) Yeah. And then keep working until it works out the way you want it to. Because, I mean, is the doctor telling you they'd like to have your a one c at a five. Right?

Katarina (39:52) No. That's just me. My my doctor is, like, pretty pretty pleased with how my levels are. I'm just like, I wanna get as, like, a much healthier a one c personally.

Scott Benner (40:06) How far along in the, in the this knocked up are you?

Katarina (40:09) I have just entered my third trimester.

Scott Benner (40:12) Oh, you're almost done. Yeah. Oh, okay. So you're past the you're gonna this is the cruising trimester a little bit. Right?

Scott Benner (40:19) As far as blood sugars go, it gets a little easier here. Has that been your experience in

Katarina (40:23) the past? It actually gets

Scott Benner (40:24) harder for you.

Katarina (40:25) Harder. Okay. Like, just thinking about eating a piece of toast and my blood sugars will spike.

Scott Benner (40:32) Mhmm. So why don't you like, I mean, listen. It's all about the insulin. So you just have to reevaluate your basal, your carb ratio, and your correction factor and just make them stronger so that they they combat the situation. Is that I mean, are you trying to, like you know what I mean?

Scott Benner (40:50) Like, your insulin needs are greater, so more insulin.

Katarina (40:54) Yeah.

Scott Benner (40:54) Yeah. And what are you not doing that?

Katarina (40:58) I am Are

Scott Benner (41:01) you afraid to get low?

Katarina (41:03) I think, like, in terms of pre bolusing for specifically for that, it's just like sometimes I will pre bolus, and then I'm like, oh, okay. Actually, like, can't eat right now, and I won't be able to eat for another, like, forty five minutes because of those other kids. Middle of something. Yeah.

Scott Benner (41:31) Yeah. Have you thought of putting them in a closet? And then you can just do whatever you need to do.

Katarina (41:35) I know.

Scott Benner (41:36) Yeah. No. I I mean, I hear what you're saying. I'm not you you

Katarina (41:39) The weird thing with the pump being in automated mode, it's like you I want it to be aggressive, but then it'll auto correct. Like, it'll it'll be like, oh, you're going too low. And so

Scott Benner (41:55) Have you tried putting it in manual to see if it's better for you like that?

Katarina (41:58) It yeah. It actually does. It is nice going into manual. It's, like, weird. There's, like, pros and cons to both, and I I do like switching to manual every now and then because it's, like, in some ways, I like controlling it more because if I'm I know I'm gonna be, like, out and about not able to eat for a while

Scott Benner (42:21) You prefer to be in

Katarina (42:22) a in manual mode. I'll I'll just, like, dial it back a little bit, like, my my settings. Like, you can

Scott Benner (42:28) Right.

Katarina (42:28) Take it down a few like, by a percentage.

Scott Benner (42:31) Yeah. I mean, listen. It's you know, the that algorithm is not gonna be probably aggressive enough for the pregnancy, like, to to be where you want it to be. But I understand I understand wanting to have, you know, wanting to have the the comfort that it's looking out for you on the other side too. I don't know.

Scott Benner (42:48) I might get up in the morning and put it in manual and then, you know, and then put it back into auto later in the evening before I go to bed, give it time to get things straight for overnight. Who knows?

Katarina (42:58) I like that.

Scott Benner (42:59) Yeah. I mean, just because you just need more insulin and doing what it's doing and targeting, etcetera. I'm assuming you have the lowest target set. It's targeted at one

Katarina (43:08) ten. Yes.

Scott Benner (43:09) Right. So, I mean, yeah, I would try that. Just remember this. When you flip it into manual, that's your old settings. That has nothing to do with your current needs.

Katarina (43:19) Mhmm.

Scott Benner (43:20) So you might have to look at those settings and and dial them in. And at the same time, be aware that when the pregnancy is over, that manual is gonna be way too aggressive for you.

Katarina (43:29) Yes.

Scott Benner (43:29) You know? Oh my gosh. It's a lot to think about, especially with little how how old are your kids right now?

Katarina (43:35) Three and a half and one and a half.

Scott Benner (43:37) Oh my god. That's enough. I would take care of them without diabetes would be too much, especially the ones out there beating everything to death or whatever he's doing. We're not worried he's gonna, like

Katarina (43:47) I like fighting, mom.

Scott Benner (43:48) He's not gonna start snapping the heads off of small animals or anything like that. Right?

Katarina (43:51) No. No. No. Okay. Oh, he he is my gentle soul, but it's just when he sees another boy who's about his size, which is usually, like, a five or a six year old, like, somebody twice his age. He's yeah.

Katarina (44:05) He's just, like, down to clown, and I'm like, okay.

Scott Benner (44:08) I can kick this kid. Let's try it.

Katarina (44:10) Yeah. My my goal my ask of my family is that I'm the first person this year to go to the hospital to give birth. Like, no one else should be going hospital for any reason, please.

Scott Benner (44:25) For bruises and bumps. I have you seen those I'm gonna leave you with this. Have you seen those TikToks where the mom comes into the room or the dad comes to the room with cameras on and they go, hey. I got into a fight with a dad down the street and he wants to he wants he said he's gonna beat me up, but he's got a kid your age, and and I need you to come fight the kid. And then No.

Scott Benner (44:44) Oh, they're great because some kids so first of all, you're all terrible parents. I just wanna say that upfront. But but some of the kids are like, I'm not looking to be in a fight. Thank you. Right.

Scott Benner (44:56) Right. But some kids are like, yo. Well, let me get my shoes. I'm just like, oh my god. Yeah.

Scott Benner (45:03) Like, seriously, like, little kids are like, let me get my shoes and let's get at this. And I'm like, what what kind of lives are you people living? And I must be so boring to most of you. I swear to you. Most of you must listen and be like, that guy is so freaking boring.

Scott Benner (45:16) I I prefer to think of it as solid and predictable. Yeah.

Katarina (45:20) But You know?

Scott Benner (45:21) Yeah.

Katarina (45:21) Yeah. Think that's good.

Scott Benner (45:22) Kinda awesome. Alright. Listen. You were terrific. I don't you know, when you're pregnant the sixth time, call me back.

Episode Wrap-Up & Sponsor Details

Scott Benner (45:29) We'll do it again.

Katarina (45:31) Thanks.

Scott Benner (45:32) Yeah. I mean, once you've gotten rid of this guy and brought in a a guy making more money to to float this whole this whole endeavor you got going here. What do you got? What do you got? Like, money coming?

Scott Benner (45:41) Your parents leave you something? What is it you're counting on exactly? Something's going on back there. You don't have to tell me. I got it all worked out.

Scott Benner (45:48) I got it all worked out. I wouldn't marry you on a bet, by the way. I know we'd be broke and there'd be 17 kids, and I'd be like, what the hell happened? Like, Jesus Christ. Alright.

Scott Benner (46:03) Alright. Let's just keep doing what you're doing. You're doing a good job.

Katarina (46:07) Thank you.

Scott Benner (46:07) You're very welcome. Hold on a second for me. This episode of the Juice Box podcast is sponsored by the Omnipod five. And at my link, omnipod.com/juicebox, you can get yourself a free, what I just say, a free Omnipod five starter kit. Free?

Scott Benner (46:32) Get out of here. Go click on that link. Omnipod.com/juicebox. Check it out. Terms and conditions apply.

Scott Benner (46:38) Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox. Links in the show notes. Links at juiceboxpodcast.com. A huge thank you to Cozy Earth, a longtime sponsor.

Scott Benner (46:53) Cozyearth.com. Use the offer code juice box at checkout. You will save 20% off of your entire order when you use that code. Don't let me down kids. Head over there now.

Scott Benner (47:05) Get yourself some joggers, some towels, some sheets. Save yourself some money. Support the podcast. Make your life beautiful and comfortable all at the same time. Cozyearth.com.

Scott Benner (47:14) Use the offer code juice box at checkout. Dexcom sponsored this episode of the juice box podcast. Learn more about the Dexcom g seven at my link, dexcom.com/juicebox. Thank you so much for listening. I'll be back very soon with another episode of the Juice Box podcast.

Scott Benner (47:33) If you're not already subscribed or following the podcast in your favorite audio app, like Spotify or Apple podcasts, please do that now. Seriously, just to hit follow or subscribe will really help the show. If you go a little further in Apple Podcasts and set it up so that it downloads all new episodes, I'll be your best friend. And if you leave a five star review, oh, I'll probably send you a Christmas card. Hey, kids.

Scott Benner (47:58) Listen up. You've made it to the end of the podcast. You must have enjoyed it. You know what else you might enjoy? The private Facebook group for the Juice Box podcast.

Scott Benner (48:06) I know you're thinking, Facebook, Scott, please. But no. Beautiful group, wonderful people, a fantastic community. Juice Box podcast, type one diabetes on Facebook. Of course, if you have type two, are you touched by diabetes in any way?

Scott Benner (48:21) You're absolutely welcome. It's a private group, so you'll have to answer a couple of questions before you come in. We'll make sure you're not a bot or an evil doer, then you're on your way. You'll be part of the family. How would you like to share a type one diabetes getaway like no other?

Scott Benner (48:36) Join me on Juice Cruise 2026. You may be asking, what is Juice Cruise? It's a week long cruise designed specifically for people and families living with type one diabetes. It's not just a vacation. It's a chance to relax, connect, and feel understood in a way that is hard to find elsewhere.

Scott Benner (48:53) We're gonna sail out of Miami, and the cruise includes stops in CocoCay, San Juan, Saint Kitts, and Nevis aboard the stunning Celebrity Beyond. This ship is chosen for its comfort, accessibility, and exceptional amenities. You're gonna enjoy a welcoming environment surrounded by others who get life with type one diabetes. I'm gonna host diabetes focused conversations and meetups on the days at sea. There's thoughtfully designed spaces, incredible dining, and modern amenities all throughout the celebrity beyond.

Scott Benner (49:25) Your kids can be supervised, there's teen programs so everyone gets time to recharge. Not just the the kids going on vacation, but maybe you get the kickback a little bit too. There's gonna be zero judgment, real connections, and a whole lot of sun and fun on Juice Cruise twenty twenty six. Please come with me. You're going to have a terrific time.

Scott Benner (49:44) You can learn more or set up your deposit at juiceboxpodcast.com/juicecruise. Get ahold of Suzanne at cruise planners. She will take care of everything. Links in the show notes. Links at juiceboxpodcast.com.

Scott Benner (49:57) Have a podcast? Want it to sound fantastic? wrong way recording.com.

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#1800 Super Diabetic - Part 1

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon MusicGoogle Play/Android - iHeart Radio -  Radio PublicAmazon Alexa or wherever they get audio.

Katarina was shredded, misdiagnosed as type 2, and quietly falling apart. From parking lot naps to finally demanding antibody testing, this is her late-onset type 1 wake-up call.

Key Takeaways

  • Adult Misdiagnosis is Common: Adults, even those in peak physical condition, are frequently misdiagnosed with Type 2 diabetes based solely on age. Antibody testing is essential for an accurate Type 1 diagnosis.
  • Hyperglycemia Causes Physical Strain: Chronic high blood sugar leads to severe dehydration and electrolyte imbalances, which can manifest as deep, internal "organ pain" often mistaken for general aging or back issues.
  • The Psychological Impact of Diagnosis: A sudden diagnosis at age 28 can trigger significant mortality fears and grief over a perceived loss of lifespan, despite modern management erasing many of these risks.
  • Advocacy and Second Opinions: When medical providers dismiss symptoms or suggest "lifestyle" fixes for an athletic individual, patients should insist on specific diagnostic tests like antibody and C-peptide levels.
  • The "Invisible" Onset: During the honeymoon phase, oral medications like Metformin may appear to work temporarily, but viral illnesses like COVID-19 can accelerate the total loss of insulin production.

Resources Mentioned

FULL EPISODE TRANSCRIPT

Opening and Juice Cruise 2026

Scott Benner (0:00)

Welcome back, friends. You are listening to the Juice Box podcast.

Katarina (0:10)

Hey. My name is Katarina, and I am a type one diabetic.

Scott Benner (0:17)

How would you like to share a type one diabetes getaway like no other? Join me on Juice Cruise twenty twenty six. You may be asking, what is Juice Cruise? It's a week long cruise designed specifically for people and families living with type one diabetes. It's not just a vacation. It's a chance to relax, connect, and feel understood in a way that is hard to find elsewhere. We're gonna sail out of Miami, and the cruise includes stops in CocoCay, San Juan, Saint Kitts, Nevis aboard the stunning Celebrity Beyond. This ship is chosen for its comfort, accessibility, and exceptional amenities. You're gonna enjoy a welcoming environment surrounded by others who get life with type one diabetes. I'm gonna host diabetes focused conversations and meetups on the days at sea. There's thoughtfully designed spaces, incredible dining, and modern amenities all throughout the celebrity beyond. Your kids can be supervised and there's teen programs so everyone gets time to recharge. Not just the the kids going on vacation, but maybe you get the kickback a little bit too. There's gonna be zero judgment, real connections, and a whole lot of sun and fun on Juice Cruise twenty twenty six. Please come with me. You're going to have a terrific time. You can learn more or set up your deposit at juiceboxpodcast.com/juicecruise. Get ahold of Suzanne at cruise planners. She will take care of everything. Link's in the show notes. Link's at juiceboxpodcast.com.

Sponsors and Name Nuances

Scott Benner (1:43)

Nothing you hear on the juice box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan. The episode you're about to listen to was sponsored by Touched by Type one. Go check them out right now on Facebook, Instagram, and, of course, at touchedbytype1.org. Check out that programs tab when you get to the website to see all the great things that they're doing for people living with type one diabetes. Touched bytype1.org. Today's episode is also sponsored by the Tandem Mobi system, which is powered by Tandem's newest algorithm, Control IQ Plus technology. Tandem Mobi has a predictive algorithm that helps prevent highs and lows and is now available for ages two and up. Learn more and get started today at tandemdiabetes.com/juicebox. The podcast is also sponsored today by the Eversense three sixty five. The Eversense three sixty five has exceptional accuracy over one year and is the most accurate CGM in the low range that you can get. Ever since cgm.com/juicebox.

Katarina (2:51)

Hey. My name is Katarina, and I am a type one diabetic.

Scott Benner (2:57)

Katarina, I am happy to meet you, and I am even happier that all those years ago, I started setting up the beginning of the podcast the way I did because for lover money, I would not have pronounced your name correctly.

Katarina (3:11)

I guess I should have started with that. Yeah.

Scott Benner (3:14)

It popped up in front of me. Right? It's just—and and we're not sharing your last name, but your last name just does not let into your first name. I don't know if that and makes—and it popped up, and I'm like, chat or chat. I guess I just wanted to say the h really badly, you know. So anyway, there's a little secret for people who haven't been listening that long. The reason that the podcast starts with somebody going, hi, my name is—is because I was tired of saying people's names wrong, so I just figured I'd make them say it first. And that way, I would—I'd be able to—I do it all the time, by the way.

Katarina (3:49)

That's brilliant.

Scott Benner (3:50)

So, anyway—alright. So, Katarina, you have type one. Yes?

Katarina (3:53)

Yes. I do.

Scott Benner (3:55)

How old are you?

Katarina (3:56)

I am 33 years old.

Scott Benner (3:59)

It's a good age. It is. It is—like I'd killed two strangers to be 33 ago, just so you know.

Katarina (4:06)

I'm not mad about it.

Scott Benner (4:09)

How long have you had type one?

Katarina (4:10)

I was diagnosed when I was 28 years old.

Scott Benner (4:16)

Oh, I like this. Not for you. I like it for the story. So do you have brothers, sisters?

Katarina (4:24)

I have two brothers and a sister, and no one in my family, no one like, none of my grandparents, aunts, uncles. I think I have, like, a great great aunt who had type one. But no one even has, type two diabetes.

Scott Benner (4:45)

You just—you're like, you were incredibly healthy people except for cat over here. And—yeah. Yeah. So—and do—do people call you cat?

Katarina (4:53)

I—No. Prefer them not to.

Scott Benner (4:56)

Tell me what to say. It's just Katarina every time.

Katarina (4:59)

Yeah. Yeah.

Scott Benner (5:00)

It doesn't shorten to anything? To gym or anything? Nothing?

Katarina (5:05)

No. When I go to Starbucks or a coffee shop, I I say CC.

Scott Benner (5:12)

So—What do you say at—what's the chicken place?

Katarina (5:16)

Chick fil A?

Scott Benner (5:17)

Yeah. What do you do there?

Katarina (5:18)

CC. Yeah.

Scott Benner (5:20)

Can I—can I share something? As a test of my wits, I—and listen. To say that I'm at Chick fil a maybe five times a year is about accurate. It's usually to pick up for somebody else. But when I'm in that line, I never say my name. I always—but I don't preplan a name. And—and the—the quality of the name that I come up with goes a long way to how happy I am with myself afterwards. I'm like, the last time I was there, I said Corey. And I'm like, Corey? I was like, so disappointed in myself for, like, twenty minutes after. So much so that when I picked it up, she goes, Corey.

Scott Benner (5:56)

And I went, that's not actually my name. And she goes, this isn't your order? I'm like, no. It's my order, but it's not my name. And then I—I make up a name every time I come here. And she goes, right? And I said, I do it to see what, like, kind of fun name I can come up with. And she—she looks at me—I mean, we've known each other for eight seconds, me and this lady, and she goes, and you came up with Corey? And—and I was like, I know I've been disappointed the whole time I've been in the line. She goes—she just goes, you should be, and she hands me the bag and walks away.

Scott Benner (6:24)

It's awesome. Anyway, alright. Katarina, that's what we are. I'm not—yeah. I mean, I'm not gonna push you on the Cece thing. Although, it does make me think of new girl, and then I get very happy.

Katarina (6:33)

That's literally when I started using the nickname because I really liked Cece, and I had straight across bangs at the time. And I was like, she's so beautiful. I wanna be just like her. And people were asking me, oh, what's your nickname? And so I was like, just call me Cece, even though it has nothing to do with my name besides that it starts with a c.

Scott Benner (6:56)

So I took a lot of problems for my daughter when—when, one day, she said, which one of the new girl characters is your favorite? I really thought about it. And I was like, I think Cece. And she's like, what? She's so—so upset with me. It's like everybody else feels like more like a caricature as it goes on. I feel like she's the only person who grows as the show goes on.

Buying a House and Life Insurance News

Katarina (7:19)

Interesting.

Scott Benner (7:20)

Yeah. So, anyway, this isn't either here nor there. Are you—so you're—so you don't have a lot of family background with with medical issues.

Katarina (7:28)

Right.

Scott Benner (7:29)

Tell me how your type one presents. How do you first start noticing it? Because it must be an interesting story.

Katarina (7:35)

Yeah. So this was back in 2020. My husband and I, we had just got bought a house, and so we were applying for life insurance. And I was like, okay. No big deal. I'm super healthy. Like, we're both super healthy. Nothing to be concerned of. And they took the blood sample. And, like, you know, within the week, they're like, you are super diabetic. There is no way you're getting life insurance. And I was like, what? Like, taken totally aback. And the reason why I bring up that it was COVID was because normally in January, I get, you know, like, my physical, and I had—or, I guess, my birthday is in March. So, normally, in March, I get my physical, but that was right in the middle of COVID. And so I had skipped it for 2020, and then lo and behold, there was some pretty big underlying issues that were unfolding. Everyone asked me, like, oh, like, did you have any symptoms? And I'm like, all of them. I—I was chugging water, peeing all the time. I went to—and this is the crazy thing—I went to an ENT doctor because my throat felt like it was closing up. And they were like, oh, you're just very anxious because nothing's wrong with your throat. But it was just that my body was, like, shutting down.

Scott Benner (9:16)

You're either anxious or dying. We're not sure—we're gonna go with anxious. You are a bit of a—a conundrum, aren't you? Can I—may I make a snap judgment after seven minutes and six seconds?

Katarina (9:29)

Oh, go—go for it.

Scott Benner (9:30)

Okay. 28 years old married looking for life insurance. It is a very responsible thing to do. But yet your first name is Katarina, which makes me think that you grew up with a couple of hippie parents. Right?

Katarina (9:45)

Oh my gosh. No.

Scott Benner (9:48)

I mean, I'm onto you already. I know what's going on. Alright? So—and—and so, like, how did you—and I'm gonna—can I guess? Is the boy that you allowed to marry you, like, super straight lace?

Katarina (9:59)

Yes. Absolutely. Right. He's the one that keeps me in check for sure.

Scott Benner (10:03)

Right. Because you looked at your parents, you looked at yourself, and you're like, one of us is gonna have to pay the bills, and I'm gonna need to find a boy that thinks about that stuff. Is that about right?

Katarina (10:12)

Absolutely. I got—you took me—but we can go now. I understand you completely. So alright. So because—I mean, it doesn't make any sense. I really—can I just share with people? I'm making a judgment on your last name. But you got some old Jewish hippies parents. Right?

Katarina (10:30)

My dad is German, and my mom is first generation Greek—Actually.

Scott Benner (10:36)

Oh, look. Yeah. See, I was wrong. I can be wrong. It's fine. But I—so I—it's funny because I laid over a couple that I know over top of your life, and I was like, oh, this is what her parents are like for sure. Like, your parents smoking a bunch of weed and everything?

Katarina (10:51)

They—I feel like, no. They're not about that, but they—both of my parents are artists. But they—they're a little bit more straight edge, but I think that's because, like—they had kids. They—they had kids. So they went into survival mode.

Scott Benner (11:10)

They're not artists who don't smoke weed. Let's just say that. Okay? They're artists who hid their weed from their kids really well. Okay. Anyway, I'm sorry. So because I'm just dying—like, a 28 year old getting life insurance? Like, what the hell? You're like, we gotta get all of our ducks in a row.

Katarina (11:34)

That's—that's all my husband.

Scott Benner (11:36)

This is the most Caucasian thing that anyone said to me this month so far. I just wanna be completely clear. That was fantastic. Alright. Okay. So I'm so sorry. So okay. So you—you're super diabetic from the test that they get back, and you've got all the symptoms so much so that you're going to other doctors trying to figure out what the little things are going on with you. So you're chugging water. Your throat feels like it's closing. Did you end up with a thyroid issue?

Thyroid Issues and Family History

Katarina (12:03)

No. And that is actually in my family history. So I'm keeping an eye on that, and it's, like, kind of surprising that—I think that's, like, most shocking out of all of this.

Scott Benner (12:16)

I don't know. It's like—I'll be getting thyroid issue. Like, like, don't worry. It's coming. So you do have autoimmune in your family?

Katarina (12:22)

Yeah. And my—my—my cousins, there's, like, a couple of them who do have some autoimmune diseases. But none of my siblings do.

Scott Benner (12:38)

That's okay. Extended family makes sense to me. What—what are we talking about? Celiac? Are we talking about vitiligo? What do we got?

Katarina (12:45)

Ep—epilepsy and MS.

Scott Benner (12:48)

I don't like epilepsy. It's autoimmune. But—but usually no. Don't think so. I don't think so.

Katarina (12:56)

Then I'm just making that up.

Scott Benner (12:57)

You're too busy managing your four zero one k to look things like this up, I can see. Well, not you, but the boy. And so hold on a sec. I would be great at speed dating, I just realized. Let's see. Is there's no way. Sorry. I'm typing. Can't type and talk at the same time. Epilepsy is not autoimmune.

Katarina (13:24)

Okay. Alright. I really thought it was.

Scott Benner (13:27)

It's okay. Well—Listen. You're—you're busy. You—you—you have two kids, don't you?

Katarina (13:33)

Yes. I do.

Scott Benner (13:33)

Okay. What was the other thing you were talking about? MS. MS. That one is autoimmune for sure.

Scott Benner (13:44)

Would you like me to check just so you can feel terrible about yourself if it isn't? No. Wait. I'm just kidding. It is.

Katarina (13:52)

Can you imagine—worrying me. Gosh. This whole time I've been telling people, oh, yeah.

Scott Benner (13:57)

They walk away and they go, she's sweet. Don't worry about it. It's fine. At least she's pretty. Oh, so rough. Anyway, but the—okay. So but there's—there's, hypothyroidism. Is it Hashimoto's to people—are people diagnosed?

Katarina (14:20)

It's hyper—wait. Hold on. The one where that makes you sluggish. Is that hyperthyroidism? Right?

Scott Benner (14:27)

Hypo.

Katarina (14:29)

Hypo. Yeah. So hypothyroidism. Yep. Yeah. Like, my mom's side is all has thyroid issues.

Scott Benner (14:38)

Tired? Yeah. Yeah. Do they take medication for it?

Katarina (14:42)

Yeah. My when my mom started, it was just, like, night and day difference in her energy levels. Which is, like, really nice to see. You know? It's always a little bit sad, and that's kind of how I felt with my diabetes too, just getting diagnosed. Like, oh my gosh. I'm dying. And then being—actually addressing it, getting the right medication, and it's like, oh, you are doing so much better now that we've addressed the problem.

Scott Benner (15:12)

Yeah. I you know, I had a conversation with somebody last night who's in a situation where they can't afford a medication for someone in their family. Ugh. And three of them need it. They can afford to get it for two of them. And I was listening to the converse—this is a private conversation, but I was listening to the conversation and you could hear they were like, well, the youngest one has time. Like—and I thought, oh, this is so sad. Like—yeah. Because I know how valuable it is when you get your answer. And you can look back in hindsight and see what you'd been missing out on or had been limited by. Yeah. It's just—that's definitely not—not fair. And—and it sucks. Like, you know, your—your mom's running around. It's like, mom's always tired, she's exhausted and doesn't know why and feels bad about it on top of everything else. So, anyway, well, I hope you don't get hypothyroidism.

Katarina (16:03)

Yeah. Me too.

Scott Benner (16:04)

Yeah. Me too. Thank you. You're very welcome. Oh, you're—it should be a card, like a greeting card. I hope you don't get hypothyroidism. Happy birthday. I should just start sending those to people. That's hilarious. So you're—have kids or don't have kids at your diagnosis time?

Eversense and Tandem Mobi Break

Scott Benner (16:22)

This episode of the Juice Box podcast is sponsored by the Eversense three sixty five. Get three hundred and sixty five days of comfortable wear without having to change a sensor. When you think of a continuous glucose monitor, you think of a CGM that lasts ten or fourteen days. But the Eversense three sixty five, it lives up to its name, lasting three hundred and sixty five days. That's one year without having to change your CGM. With the Eversense three sixty five, you can count on comfort and consistency three hundred and sixty five days a year because the Eversense silicone based adhesive is designed for your skin to be gentle and to allow you to take the transmitter on and off to enjoy your shower, a trip to the pool, or an activity where you don't want your CGM on your body. If you're looking for comfort, accuracy, and a one year wear, you are looking for Eversense three sixty five. Go to eversensecgm.com/juicebox to learn more.

Scott Benner (17:27)

Let's talk about the Tandem Mobi insulin pump from today's sponsor, Tandem Diabetes Care. Their newest algorithm, Control IQ Plus technology and the new Tandem Mobi pump offer you unique opportunities to have better control. It's the only system with auto bolus that helps with missed meals and preventing hyperglycemia, the only system with a dedicated sleep setting, and the only system with off or on body wear options. Tandem Mobi gives you more discretion, freedom, and options for how to manage your diabetes. This is their best algorithm ever, and they'd like you to check it out at tandemdiabetes.com/juicebox. When you get to my link, you're going to see integrations with Dexcom sensors and a ton of other information that's gonna help you learn about Tandem's tiny pump that's big on control. Tandemdiabetes.com/juicebox. The Tandem Mobi system is available for people ages two and up who want an automated delivery system to help them sleep better, wake up in range, and address high blood sugars with auto bolus.

Starting a Family and High Sugars

Katarina (18:33)

I don't. Okay. So we had been married for a year, and we were kind of talking about it. Like, when do we wanna start? And then I get this news. And so that kind of tables everything, and we're just, like, very focused on getting me healthy. And that's, like, even on the doctor's suggestions too because we were like, oh, like, we kind of wanted kids, and the doctor was like, "well, I don't even know if a baby would survive in your body at this point. Like, your sugars are so high." Oh. And so, yeah, I I worked really hard to get my sugar levels in a good place.

Scott Benner (19:23)

Mhmm. How long did that take?

Katarina (19:26)

You know, it—it was only about, like, six months to a year where I I was, like, really buckled down. And it's funny. I I know you've had other people you've talked to who have also, like, been diagnosed later, and they get diagnosed as type two. But—can I paint a picture of what I looked like when I was diagnosed?

Scott Benner (19:54)

Okay.

Katarina (19:59)

So I have always been very athletic, and I was in peak shape. I was, like, very, very lean in an athletic body fat percentage, so very shredded. I call my doctor to get further testing done after this, and she's like, "oh, you're type two. You just need to lose weight."

Scott Benner (20:28)

You're like, "lose weight, lady. I got abs."

Katarina (20:31)

Yeah. I—yes. Literally. And I was like, "from where on my body? Do you want me to cut off my arm? Like—I'll lose weight. I don't have weight to lose."

Scott Benner (20:43)

I might call your episode "very shredded super diabetic." And so you—I—wait. Wait. So does—does this doctor physically know you? Have they met you?

Katarina (20:53)

No. Oh, okay. Had switched. And so I had switched my, like, primary care because I got a new job during COVID, and she never met me in person. It was all online. And so finally, I, like, requested, like, let me come in so you can physically see me. She—she looks at me, and she was like, "that's kinda surprising. Well, here, start taking metformin." And I'm like, even still? What? Like, just because I'm 28 years old, you're gonna write me off as type two diabetic?

Scott Benner (21:31)

Well, did she—did you have any confidence? Like, when she says take metformin, I mean, are you at the point where you're like, "you might not know what you're talking about"? Like, did it—

Katarina (21:39)

I was very skeptical—

Scott Benner (21:41)

Okay.

Katarina (21:41)

But I also was so taken aback by having diabetes that—Okay. It was—it was like, "okay. I guess I'll start this." Because the way she—she even presented it was like, "you need to get on medication right away." And metformin, you can—like, you'll probably be taking this for the rest of your life because she was under the impression I was type two, But it won't—it won't, like—you could get off it if you need to or, like, switch it up or something.

Scott Benner (22:16)

I—I don't—yeah. I don't—I—none of that makes sense to me. Everyone needs a healthy amount of, "no. I don't believe you." Like, you—yeah. Not not enough where you're like that person who's just, you know, saying, like, every time somebody says something, like, "you're wrong." Like, not like that. But just enough where you can stop and go, "I don't trust you enough. I don't know you well enough yet for me to make a big decision about my health just based on this thing that you've randomly said after you've been wrong about two things already." But I get your point. Like, you just—you're dizzy by the whole thing. Right?

Katarina (22:49)

Yes. Yeah. Absolutely. I was—I was so shocked. And it's funny in retrospect, looking, like, looking back, I could just feel what I was feeling. But my husband and I, we would, like, go on walks every evening, and there were so many times where I would just be sobbing to him because I was just in total shock. And I was like, "I'm gonna die before, like, we start a family." It just felt like all of a sudden, I was immortal up until this point, and then it—like, life really hit me. Like, "oh, wow. Out of nowhere, I just get this, like, disease, and now we have to change our whole lives around it."

Marriage and Cheesy Love

Scott Benner (23:37)

Yeah. And he's thinking, "oh, I picked the wrong girl. I dated a girl before this. She didn't seem to have anything wrong with her." And so, like, I mean, she was annoying, but not like this. The—but does that pop into your head too? Because you're not married that long. Do you think that he's got buyer's remorse? I I know that's not how I should say it, but, like, do you—does that worry you?

Katarina (23:58)

You know, he was so supportive and still is. I should never say was, but, like, especially during that time, it makes me—like, thinking back, I'm—I fall in love with him all over again just to be super cheesy.

Scott Benner (24:17)

That's nice.

Katarina (24:18)

He—he was immediately like, "okay. Like, there's been some studies done that say, like, keto can help with type two diabetes. Let's try a low carb slash keto diet"—and which we did, which is not the thing that you should be doing when you're actually type one. But he was, like, very supportive through the whole thing. We did make a ton of lifestyle and diet changes, and he was just, like, holding my hand through the whole thing.

Scott Benner (24:55)

He's willing to make adjustments with you and all that. Hey. Did you just say you shouldn't do keto if you're type one?

Katarina (25:02)

You know, it was—

Scott Benner (25:04)

I mean, those people are gonna come get you. I just want you to know. And I have nothing to do with this. I just wanna say—no. No. I just wanna say out loud. It's not gonna be hard to find her. There can't be that many Katarinas, and I'm not part of this. Okay? No. I'm just kidding. I—you—you can do keto and have type one.

Katarina (25:21)

Well, I think because I—I had an experience where I kind of was, like—when I was doing keto those first couple months, I—or, like, let's be real. It was, like, a week that I lasted.

Scott Benner (25:38)

I had four chicken breasts got, and when they were gone, I gave up. Okay? Yeah.

Katarina (25:45)

Give me my carbs.

Scott Benner (25:49)

Oh my god. But—But he was willing to, like, make adjustments with you and try things.

Katarina (25:53)

Yeah. Yeah.

Scott Benner (25:54)

That's awesome. I mean, I was just asking if you had, like, an underlying concern that, like—because you hadn't been married that long. And it is a big switch in—I know, bait and switch is the the wrong way to say it, but it—it could feel that way to the other person. Like, this isn't what I thought I was getting involved in. But he sounds like a good guy, and and you—you love each other, and you're all good. So that's not a problem. Also, you said it sounded cheesy to say I could fall in love with him all over again. I want you to know, this August, I will be married for thirty years. And it doesn't sound—no. No. That's awesome. We're just—we're trying to outlast each other. That's all. Nobody wants to give up first. My point is is that last year for my—for my birthday, my wife said to me, and I believe this is a quote, "I didn't have time to get you anything. Happy birthday." So—so my point is is, like, I don't think that sounds cheesy. I think it's nice. You know? And then two times a year, my wife says, "I love you." It's always very touching to me. Just hang in there for a little longer. Wait a year in your fifties. Oh my god. And you're still trying to pull off Katarina? That ain't gonna work either, by the way. You'll be CC by then. Oh my gosh. I'm so sorry. I don't know why. I think your laugh just makes me happy. I'm not sure what's going on exactly. Do people generally like being around you, do you think?

Katarina (27:20)

I—I hope so. I I feel like I—I have a plenty of friends and really good company that I hang out with.

Scott Benner (27:30)

Yeah. No. You're making me not like my friends. I'm like, ugh. These people aren't trying hard enough is what I'm thinking. So okay. So you're trying a bunch of things. You're kinda—you're still whacked out of your mind a little bit trying to, like, make sense of all of it. I mean, the—when you say you're out for walks crying, is it, gosh, what I've lost or what I don't understand? What do you think is making you sad right then and there?

Lifespan Anxiety

Katarina (27:54)

It just feels like my lifespan has been shortened in front of my eyes. And it does seem—it felt like the odds were against me. Like, we had all these dreams of getting old together. You know?

Scott Benner (28:12)

Oh, you didn't think you were gonna live as long?

Katarina (28:15)

I—like, I want to live till I'm 100 and be super healthy and then—

Scott Benner (28:25)

And rich. And I'm like—right. I want a spaceship and a giant penis. I got a lot of things I want. Yes. Yes.

Katarina (28:34)

Alright. And then when I find out I have diabetes, it's like, oh, this is, like, something that, like, it just—if I—I don't know. In—in the moment, it really felt like, "oh my goodness. Like, that just took twenty years off of my life, and it's gonna be something I'm dealing with for the rest of my life." Mhmm. And all of those things are still true, but I'm not as emotional about it. And it does seem like I am able to have more control than I was giving myself credit for.

Scott Benner (29:21)

Do you not have Google? I do. Oh, okay. By the way, that sound—whatever that was—I would marry you. That's delightful. I—I did—that—that's how you got the guy right there. You were like, I do. And he was like, alright. That's cute. Let's do it. So listen. Does type one shorten your lifespan? It's all you had to type into the thing, and it would have said, "no. Probably not." And—and—and, you know, and they would have told—like, listen. Biggest factors: chronic high blood sugars, severe hypoglycemia, DK, smoking inactivity, poor access to care.

Katarina (29:58)

I'm looking at, like, what is the average lifespan of a—and I was at this time, I still thought I had type two diabetes. And so "what is the average lifespan of a diabetic?" It doesn't matter type one or type two. Okay.

Katarina (30:17)

And then, you know, I get into the, like, dark part of the Internet where it's like, "you're probably gonna lose three limbs and go blind."

Scott Benner (30:26)

Would you make it to Reddit? Are you on Reddit? Is that what you kids do?

Katarina (30:30)

No. No. I not know how to use Reddit.

Scott Benner (30:33)

I mean, it's a—it's a message board. It's not that hard. So but then—oh, so you just got into people online talking about the worst things that had happened to them. Yeah. Yeah. And you thought that must be the rule, not someone—

Katarina (30:48)

And I was looking up averages too, like, "what's the average lifespan?" And it was, like, ten years shorter than someone who doesn't have anything. And so I guess you kinda think, like, okay. That kinda makes sense.

Scott Benner (31:07)

But Listen. Type one diabetes—this is my Googling—does not automatically shorten your life—or control over many years can, but good consistent management can largely erase any gap. Are plenty of people living right now in their sixties, seventies, and eighties who are complication free or minimally affected who have had type one diabetes for most of their life, and they're older now. Imagine, you know, the next thirty years of algorithms keeping your blood sugar in check and you know, all that stuff. Yeah. You'll probably live to a 100.

Katarina (31:38)

I hope so.

Scott Benner (31:39)

Yeah. I mean, I don't think I will, but I think you could. And then, you know—and by the way, I don't—do you know a lot of older people? If, great grandparents or great grandparents? Yeah. How's their life? Oh—

Katarina (31:56)

you know, it's actually really sad because both of my grandparents are widowed. So it's like my dad's dad is still alive, and my mom's mom is still alive. And I think they were doing great up until the point their spouse passed away. Yeah. And how old are they? Oh my—oh. They're eighties? I don't not know. Yeah. Late eighties. Yeah. I'm gonna say wrong, I'm gonna be totally embarrassed. So next question.

Scott Benner (32:26)

Do you think that lady is really looking for twenty more years of this—is what I'm asking you? Like, maybe you're—Right. Right. Maybe your goals will change then. Fair. Yeah. It's weird, isn't it, as a young person to recognize that there might be a time in your life that you've been here for so long that you're just like, "I could go now."

Katarina (32:45)

I'm—I'm a good life. Yeah. I'm done. This was good. I'm done. Thanks. Yeah. Yeah. It's hard. I can't fathom that right now. I mean, I realize that's how people feel at some point, but I can't wrap my head around that. When I was 28, like, I would not have been able to for sure. You know?

Katarina (33:03)

Yeah. It—it—it definitely came as a shock. But, no, that's a—that's a good point. I think, especially, like, when you're younger, it's like, there's so much out there, so much to learn, so much to do, so much to see. Mhmm.

Scott Benner (33:17)

Well, that's back when—that's when you're not peeing when you're sneezing and having trouble wake standing up. You know what I mean? Yes. Yeah. Exactly. That's when you've never called a friend to say, "hey. I'm stuck on the toilet." Once those things happen, you start looking for exit ramps. You're like, "okay. I—maybe this is enough."

Katarina (33:35)

Yeah. Yeah. Like, sitting on an airplane for over five hours is just like, "nope. Not gonna happen for me." So—Yeah. You know, like, when you're—I don't know. My—my grandma was such an avid traveler, and now she's just like—she lives in Northern California. And making the flight down to Southern California, she's like, "not for me."

Scott Benner (34:00)

Yeah. You can FaceTime with grandma if you wanna see her. She—she's not leaving. Yeah. No. I mean, that's just what age does. Like, I don't think he'd even mind me saying this. Like, I have a neighbor who's in his seventies, and, you know, we're just in New Jersey and he—he visits—he and his wife visit their son in, like, the Michigan area. And he said to me about a year ago, he said, "Scott, the—it's getting hard to make the drive." Like, just—just the drive is getting difficult for him. Like, he said, like, know, things are moving a little fast and, you know, I don't feel as comfortable on the highway anymore. Like, you know, all that stuff. And he's completely with it. Like, you know what I mean? Like, there's nothing wrong with him. And he's just a little older and, you know, his reflexes are a little slower, and it's, you know, it's nerve racking. And he said then because it's nerve racking, it's exhausting.

Katarina (34:46)

Yes. Absolutely.

Antibody Testing and COVID

Scott Benner (34:47)

I Anyway, I told him. Was like, get him one of those cars, drives itself. You'll be fine. Yeah. But not—not the point. The point is is that you're panicked, you're young, you see your life changing in completely different ways, and you're getting a misdiagnosis at the moment as a type two. How long does the misdiagnosis go on for?

Katarina (35:05)

So that was in October. And then finally, I'm—I had been asking my doctor pretty much, like, right away. "Hey. Can I get tested? Like, can you test my antibodies?"

Scott Benner (35:20)

You learned that online? The Internet told you that?

Katarina (35:22)

I had talked to a friend who was a doctor who was like, maybe you should, like, ask about this. And I—I asked and asked and asked. And finally, I got COVID in December 2020. And the metformin had kind of been like—I was waking up—my sugar levels between ninety nine and one thirty, and that was fine for, I guess, like—

Scott Benner (35:54)

Everybody said it was okay. Yeah. Yeah.

Katarina (35:57)

And so then in COVID, I was waking up regularly 02:50, and it never went back down. And that's when I started being like, "I think this is a problem. Like, this is late January, and I'm still, like, haven't gone below 200."

Scott Benner (36:21)

Yeah. The honeymoon was ending for your type one. Yeah. Yeah. And you're—you're counting on metformin. Is that what that—was happening?

Katarina (36:29)

Yeah.

Scott Benner (36:29)

Did you lose more weight on metformin?

Katarina (36:31)

I did.

Scott Benner (36:32)

Did you get an eight pack? A rail. I was gonna say, how much better could you get? Was it messing with your activity? Because you said you're athletic. You must be working out and stuff like that too.

Katarina (36:43)

You know, it was—so it did help a little bit because I was very sluggish. Like, some of the other symptoms—basically, after lunch, I would have to go to my car and take a nap because I physically was so exhausted. Like, my blood sugar levels were through the roof, must have been, that I couldn't—I couldn't get through the day if I didn't take a nap. Oh. And I thought, this isn't a problem. This is just what everybody deals with.

Scott Benner (37:15)

Oh, really? Yes. You're—you're in the parking lot at your job, like, snoozing, and you're like, "this is okay?"

Katarina (37:21)

I didn't think anything of it. I was just like, "well, I—it's—it's probably because I'm so active." I I don't even know, like—

Scott Benner (37:29)

What you were thinking about. Reasoning—was. And—

Scott Benner (37:32)

Did you feel foggy? Did your mind feel foggy?

Katarina (37:35)

Yes. All the time. Okay. And when I went—when I would go to sleep at night, my organs hurt. And 28 year old me was like, "it's just because I'm getting old."

Internal Pain and Dehydration

Scott Benner (37:50)

Your organs hurt. Please put that in context for me.

Katarina (37:53)

Like, it felt like my kidneys—I—because I imagine—it was, like, in my—it was in my back, and so I'm imagining my kidneys. Mhmm. And then, like, just it felt crampy and in pain. I—like this dull pain that was always there, and it kinda makes sense. Like, your kidneys would be impacted because they're, like, trying to filter out all this sugar, and they're getting bogged down. And so—

Scott Benner (38:29)

And you're just like, "well, you know, I'm 28. This is what happens."

Katarina (38:32)

Yes. Yeah. Yes. You're asleep in the parking lot with four addicts that you work with at lunchtime thinking this is all completely normal.

Katarina (38:46)

I think I was the only one. It really did—I feel—feel like—nobody sees me. You're like—in—in that movie Dune walking through the desert by yourself just waiting for, you know, the earth to swallow you up. So are you, at some point, gonna tell me you were in DKA, or did someone finally figure it out and give you insulin?

Katarina (39:07)

So I—I asked to get tested, asked to get tested. And finally, they were like, "okay. We'll test your antibodies." And, like, again, a week later, they were like, "oh, wow. You're actually type one." I'm like, "thank you."

Scott Benner (39:27)

Just so you don't think you're crazy, I did a little, ISR overlords about that—that organ thing. And it said if you've undiagnosed type one diabetes, you could be dehydrated, which puts your organs under strain. You know, you were—you were obviously—had lost more weight. So, like, electrolyte imbalances, reduced blood volume, fluid loss in general, that can feel like deep internal aching pressure or a dull widespread pain that doesn't feel muscular. That sound familiar?

Katarina (39:57)

Yes. Absolutely.

Scott Benner (39:59)

Also, ketones, ketoacidosis perhaps could be like a—what they're calling, like, a "chemical irritation." Irritates the tissue, triggers inflammation, affects nerve signaling. People describe it as quoting, "my insides feel raw." Everything hurts, but I can't point to one spot or, like, a heavy sick pain rather than a sharp pain. Yeah. Wow. That—is what's happening. Okay. Well, here's a little more for you just so you can feel better. Your liver could be dumping glucose, producing ketones, processing stress hormones like cortisol and adrenaline. It's overloaded—that could cause the liver to swell. Your right upper abdominal discomfort could come from that or a sense of internal pressure or soreness, not a stabbing pain. Also, your muscle and tissues are breaking down. So—Without insulin, your body starts to break down muscle, fat, protein, which will feel like deep aches, weakness, or a flu like "everything hurts" sensation. And then let's see. Nervous system distress. This can distort pain signals and body awareness making sensations feel bigger, more diffused, or hard to localize, which actually leads to people saying "my organs feel like they hurt." There you go. Yeah. You weren't crazy. You're just sitting in a parking lot by yourself. That's all. My gosh. But you—you know what? It—you know how many people—go—you—you listen to podcasts. Right?

Katarina (41:22)

Yeah.

Scott Benner (41:23)

Yeah. This happens to people all the time. Yeah. Really terrible. Yeah. Yeah. I feel very fortunate. I never had to be hospitalized, so we were able to, like, get me on medication. But yeah.

Scott Benner (41:37)

A relief to hear you had type one?

Katarina (41:40)

It was. It—it would—it made so much more sense because I just kept questioning, like, "type two, really." Like—and—and then I'd have friends who—it pisses me off, but also it's like, okay. That's kind of warranted. But they were like, "well, you do eat a lot of carbs, so it—you—you kinda deserve it."

Scott Benner (42:08)

So—really? You got that from people you know? Yes. My god. So you have a—you have a general misunderstanding of what it means to have type two. They have a bigger one. And—apparently aren't afraid to, like, share their misgivings with you.

Katarina (42:22)

Oh, yes.

Scott Benner (42:23)

Lovely. These people you knew a long time, I hope?

Katarina (42:26)

They were coworkers, like, year.

Scott Benner (42:29)

Oh, they're parking lot zombies. I see. Oh, that might be your title. Well, that's terrible, by the way. I—I—have you disconnected your friendship with them at this point, or how did you handle that?

Katarina (42:43)

Oh, you know, it's just something that—it's like—

Scott Benner (42:48)

You think it was like, well meaning, like, they were joking with you?

Katarina (42:51)

Yes. Yes. And as you kind of pointed out, I do laugh a lot, and so it's like, brush it off. That's fine.

Scott Benner (43:01)

Is that really who you are, or is that a—a psychological thing that you do to stop from crying?

Katarina (43:07)

Do you—do you wanna unpack this right now? Because—should I start crying on the podcast?

Scott Benner (43:12)

Which—which—which is it? Is that you—are you coping, or is it, like, just how you feel?

Katarina (43:17)

No. I think—I think I'm generally pretty—now I have no idea. Now I'm gonna second guess myself, and I'll be thinking about this for the next month. Yeah. It'll give you something to do when you're living to a 100. Go ahead. No. I think I'm generally a pretty, like, positive person. Yeah. For the most part. Do you have any trauma in your past? No big ones? No. Drinking, drug use in your house, parents hit each other, nobody's been to prison?

Katarina (43:51)

No.

Scott Benner (43:52)

Happy go lucky person?

Katarina (43:54)

I—I would say I am very blessed compared to so many other people I meet. Putting into perspective, like, there is nothing I—have that really is that bad. So—

Scott Benner (44:19)

The Joe Walsh song applies to you. Life's been good to you so far?

Katarina (44:22)

Yeah. Yeah. Yeah. Gotta say so.

Scott Benner (44:24)

Yeah. So this is what happens. So—so this is what happens when you raise a child reasonably. They can actually laugh about things—unlike when I—the way I was raised where I have to laugh to hide my feelings. Is that right? That's fine. I don't mind. I like wondering about stuff like that. I really do. Like, I think it's important to wonder, like, are you laughing to stop from crying or are you laughing because you're generally amused? Because I see both sides of it. Like, I—I feel like I have a pretty good sense of humor. And, like, if somebody were to come up to me and, like, in the middle of me struggling with, like, a diabetes diagnosis that I couldn't get together, they were like, "well, man, you do eat a lot of carbs." I'd be like, "fair enough." You know, like—like—and—and I don't think I'd hold a grudge about it. But in other situations, like, I do laugh sometimes because it's hard for me to be, like, honest about how I feel, you know. So, I mean, I'm sure we all do that at some point, but generally speaking. Okay. We're fine. So you've been to therapy already?

Katarina (45:23)

Yeah.

Scott Benner (45:24)

Yeah. No. I know. I can tell you have been. Because your parents sent you, like, pre—they—your parents are like, "why don't you go to therapy before you have a problem?" Just make sure you understand how to talk to people. Am I right?

Katarina (45:39)

Yeah. I—my parents have been very supportive my whole life.

Scott Benner (45:43)

No. I can tell. Yeah. This is what you get. You get decent parents. It is—it is funny. Like, there are times where I'm like, "do I have an—like, buried trauma that I just, like, haven't unpacked?" Gonna have trauma in a second because you sound far away from the microphone. What just happened?

Katarina (46:02)

Oh, sorry.

Scott Benner (46:03)

That's okay. Can you hear me?

Scott Benner (46:05)

Yeah. Get in there. Okay. So you're not—you're not sure if you've got trauma?

Outro and Part Two Teaser

Scott Benner (46:17)

This episode was too good to cut anything out of, but too long to make just one episode. So this is part one. Make sure you go find part two right now. It's gonna be the next episode in your feed. The conversation you just heard was sponsored by Touched by Type One. Check them out, please, at touchedbytype1.org on Instagram and Facebook. You're gonna love them. I love them. They're helping so many people at touchedbytype1.org. Head now to tandemdiabetes.com/juicebox and check out today's sponsor, Tandem Diabetes Care. I think you're gonna find exactly what you're looking for at that link, including a way to sign up and get started with the Tandem Mobi system.

Scott Benner (47:02)

The podcast episode that you just enjoyed was sponsored by Eversense CGM. They make the Eversense three sixty five. That thing lasts a whole year. One insertion? Every year? Come on. You probably feel like I'm messing with you, but I'm not. Ever since cgm.com/juicebox. Thank you so much for listening. I'll be back very soon with another episode of the juice box podcast. If you're not already subscribed or following the podcast in your favorite audio app, like Spotify or Apple Podcasts, please do that now. Seriously, just to hit follow or subscribe will really help the show. If you go a little further in Apple Podcasts and set it up so that it downloads all new episodes, I'll be your best friend. And if you leave a five star review, oh, I'll probably send you a Christmas card. Would you like a Christmas card?

Scott Benner (47:56)

If you've ever heard a diabetes term and thought, "okay, but what does that actually mean?" You need the defining diabetes series from the Juice Box podcast. Defining diabetes takes all those phrases and terms that you don't understand and makes them clear. Quick and easy episodes. Find out what bolus means, basal, insulin sensitivity, and all of the rest. There has to be over 60 episodes of Defining Diabetes. Check it out now in your audio player or go to juiceboxpodcast.com and go up into the menu. If you're looking for community around type one diabetes, check out the Juice Box Podcast private Facebook group. Juice Box Podcast, type one diabetes. But everybody is welcome. Type one, type two, gestational, loved ones, it doesn't matter to me. If you're impacted by diabetes and you're looking for support, comfort, or community, check out Juice Box podcast, type one diabetes on Facebook. If you have a podcast and you need a fantastic editor, you want Rob from Wrong Way Recording. Listen. Truth be told, I'm, like, 20% smarter when Rob edits me. He takes out all the, like, gaps of time and when I go, and stuff like that. And it just—I don't know, man. Like, I listen back and I'm like, why do I sound smarter? And then I remember because I did one smart thing. I hired Rob at wrongwayrecording.com.

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#1799 Bolus 4 - Krispy Kreme

Scott and Jenny talk about bolusing 4 donuts.

Companies that Support Juicebox

Simplify Lifewith Omnipod
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DexcomG7 15 Day Sensor
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US MEDGet your Diabetes Supplies
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Tandem
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Touched By Type 1
EversenseOne Year One CGM
Eversense
Simplify Lifewith Omnipod
Omnipod
DexcomG7 15 Day Sensor
Dexcom
Save 20%Save 20% with offer code: JUICEBOX
Cozy Earth
US MEDGet your Diabetes Supplies
US MED
ContourEasy to Use and Highly Accurate
Contour Next
MiniMedMake everyday a better day
Minimed
TandemControl-IQ+ with AutoBolus
Tandem
CommunitySupport Touched By Type 1
Touched By Type 1
EversenseOne Year One CGM
Eversense

Key Takeaways

  • The Meal Bolt Roadmap: A strategic approach to bolusing includes measuring the meal, evaluating yourself, adding base units, layering a correction, building the bolus shape, offsetting timing, looking at the CGM, and tweaking for next time.
  • Total Sugars as Pre-Bolus Timing: While not a rigid medical rule, a helpful starting strategy for pre-bolusing high-sugar foods is to use the total grams of added sugar as the pre-bolus time in minutes.
  • Algorithm Dynamics: When using an automated pump algorithm, be mindful that the system might pull back basal insulin during a blood sugar climb, which might require a larger upfront bolus or an extended bolus to compensate.
  • Don't Underestimate Frosting: Add-ons like icing and fillings carry a massive carbohydrate load. A regular glazed donut has about 22 carbs, but adding icing can increase that by 15 carbs alone.
  • Wait for the Downward Tick: Before diving into a high-sugar, fast-hitting food like a donut or cookies, aim to see a diagonal down arrow or a slight drop on your CGM to ensure the insulin has actively started working.

Resources Mentioned

FULL EPISODE TRANSCRIPT

Introduction & The Meal Bolt Roadmap

Scott Benner (0:0) Hello, friends, and welcome back to another episode of the Juice Box podcast.

Scott Benner (0:15) 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.

Scott Benner (0:23) Jenny and I are gonna follow a little bit of a road map called meal bolt.

Scott Benner (0:27) Measure the meal. Evaluate yourself.

Scott Benner (0:30) Add the base units. Layer a correction.

Scott Benner (0:33) Build the bolus shape. Offset the timing. Look at the CGM.

Scott Benner (0:37) Tweak for next time.

Scott Benner (0:39) Having said that, these episodes are gonna be very conversational and not incredibly technical.

Scott Benner (0:45) 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.

Scott Benner (0:52) 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.

Scott Benner (0:59) If you wanna learn more, go to juiceboxpodcast.com/meal-bolt.

Scott Benner (1:05) But for now, we'll find out how to bowl us for today's subject.

Scott Benner (1:10) While you're listening, please remember that nothing you hear on the juice box podcast should be considered advice, medical or otherwise.

Scott Benner (1:18) Always consult a physician before making any changes to your health care plan or becoming bold with insulin.

Sponsor Messages

Scott Benner (1:30) US Med is sponsoring this episode of the Juice Box podcast, and we've been getting our diabetes supplies from US Med for years.

Scott Benner (1:37) You can as well.

Scott Benner (1:39) Usmed.com/juicebox or call (888) 721-1514.

Scott Benner (1:46) Use the link or the number, get your free benefits check, and get started today with US Med.

Scott Benner (1:52) A huge thanks to my longest sponsor, Omnipod. Check out the Omnipod five now with my link, omnipod.com/juicebox.

Scott Benner (2:02) You may be eligible for a free starter kit, a free Omnipod five starter kit at my link.

Scott Benner (2:09) Go check it out. Omnipod.com/juicebox. Terms and conditions apply.

Scott Benner (2:14) Full terms and conditions can be found @omnipod.comslashjuicebox. (2:19) Jenny, we are gonna do some bolus four stuff.

Bolusing for a Krispy Kreme Glazed Donut

Jenny Smith (2:22) Oh, fun. These are always fun.

Scott Benner (2:24) I have a list.

Scott Benner (2:25) These are,

Jenny Smith (2:26) Are we gonna do McDonald's again?

Scott Benner (2:27) No. No. We can't do that again.

Scott Benner (2:29) That was, that was good though. People were very That's

Jenny Smith (2:31) way fun.

Scott Benner (2:32) People had a good time with that one. So no.

Scott Benner (2:34) We're not gonna do that, but we are gonna look at the list, a pretty extensive list that people sent in. Do you wanna do a well, we did McDonald's, so that one's done.

Jenny Smith (2:44) Okay.

Scott Benner (2:44) Should we do another restaurant, or do you wanna just wanna do a donut?

Scott Benner (2:49) Why don't we do a short one here?

Jenny Smith (2:50) Do a doughnut. Sure.

Jenny Smith (2:51) We've not done that. Gosh. That's something I guess I would think that we would have already done.

Jenny Smith (2:56) It's a pretty common

Scott Benner (2:58) Let's just do a Krispy Kreme doughnut.

Jenny Smith (3:01) Oh my gosh.

Scott Benner (3:03) Have you ever had one?

Jenny Smith (3:04) I have actually had a Krispy Kreme doughnut. Yes.

Scott Benner (3:07) Alright.

Jenny Smith (3:08) When I was in college, I worked with Habitat for Humanity.

Scott Benner (3:12) Okay.

Jenny Smith (3:13) And our, spring break trips, I was never I never went and laid on a beach.

Jenny Smith (3:17) My spring break, we took what were called collegiate challenge trips. Mhmm.

Jenny Smith (3:21) And so we took, like, a big, huge or a couple of, like, 15 passenger vans, and we would pack it all up, all of our supplies.

Jenny Smith (3:28) We had to get donations, and we would go somewhere out of state And many of the places we went because we still wanted it to be warmer on spring break, we would go or we would pick a location that was somewhere in the South.

Jenny Smith (3:40) So I'd gone to New Orleans, and I've been to Mississippi and to Georgia and North Carolina and West Virginia.

Jenny Smith (3:48) Oh my gosh. They were all of my spring break trips were spent with Habitat.

Jenny Smith (3:51) It was an amazing thing. But my point being that that's where I had Krispy Long story, that's how I got Krispy Kreme.

Scott Benner (3:58) Travel the country to have a have a doughnut. Well, I'm on their website, krispykreme.com.

Scott Benner (4:05) Is that what it is called? Let me make sure. Yeah.

Scott Benner (4:07) Krispykreme.com.

Scott Benner (4:08) And I'm starting with I think we're gonna do a few of them.

Scott Benner (4:12) Original just the original glazed donut. When I think of a Krispy Kreme, I just think of, like, a glazed donut.

Scott Benner (4:18) Okay.

Scott Benner (4:18) You ready?

Jenny Smith (4:20) I'm ready.

Scott Benner (4:21) Alright.

Scott Benner (4:22) Well, I'll tell you the calories just for fun. It's got a 190 calories in it.

Scott Benner (4:25) Calories from fat, a 100. Total fat, 10.

Scott Benner (4:29) Saturated fat, five.

Scott Benner (4:31) No trans fat, no cholesterol, a 100 milligrams of sodium. Total carbs?

Jenny Smith (4:36) Maybe 15 or probably oh, a glazed one. Glazed. Sorry.

Jenny Smith (4:39) I was thinking of a cake doughnut. Probably about 40 to 50?

Scott Benner (4:45) They say 22. Really?

Scott Benner (4:47) They say total carbohydrates 22. Dietary fiber less than one, sugar's 10, protein free.

Jenny Smith (4:53) I wonder how big their glazed donuts are.

Jenny Smith (4:56) Because that's and it's also then not a terrible amount of glaze.

Scott Benner (5:00) Okay.

Scott Benner (5:01) Would you mind all the carbs are coming from,

Jenny Smith (5:03) you think? From the sugar?

Jenny Smith (5:04) Would think I mean, the donut itself obviously has the majority of the fat in it. And Mhmm.

Jenny Smith (5:11) For that many calories, half the calories are coming from fat.

Jenny Smith (5:15) And there's not really any protein. So that makes sense that it would be approximately 20 some grams of carb Mhmm.

Jenny Smith (5:24) Based on the calorie value at four calories per gram.

Jenny Smith (5:28) That's about right for the math of the calories.

Applying Ratios and Algorithm Nuances

Scott Benner (5:30) Let's do it for you.

Scott Benner (5:31) What's your insulin to carb ratio?

Jenny Smith (5:34) It depends what time of day it is.

Scott Benner (5:36) Alright. Well, let's say you're having a donut in the afternoon.

Jenny Smith (5:39) So in the afternoon, it's a one to 12.

Scott Benner (5:41) Twelve. And sensitivity?

Jenny Smith (5:44) My sensitivity is 85 in the afternoon.

Scott Benner (5:47) 85 in the afternoon.

Scott Benner (5:49) We're gonna make it what would you target if you were targeting a blood sugar?

Jenny Smith (5:53) My target is 85 in my system. 85.

Scott Benner (5:57) Okay.

Scott Benner (5:58) 22 carbs and fat 10. No protein in this. Right? No.

Scott Benner (6:09) Oh, three.

Jenny Smith (6:11) Oh, there is a little protein.

Scott Benner (6:12) Little bit of protein.

Scott Benner (6:13) What's Jenny's blood sugar in the afternoon before she eats this doughnut?

Jenny Smith (6:17) My blood sugar in the afternoon generally is somewhere between, like, ninety and one twenty.

Scott Benner (6:23) I was gonna put 96. How we do that? Okay.

Scott Benner (6:27) I'm gonna assume you have a nice stable arrow because I'm gonna use my strategy simulator online. Okay.

Scott Benner (6:32) But I wanna hear about you first. So how's Jenny bolusing for this doughnut?

Scott Benner (6:37) So it's just the doughnut.

Jenny Smith (6:38) Okay. I have a stable blood sugar.

Scott Benner (6:40) Stable blood sugar.

Jenny Smith (6:40) My blood sugar is 85. Yeah. Right? Mhmm.

Jenny Smith (6:43) Or no.

Jenny Smith (6:44) What did you say?

Scott Benner (6:44) I I made your blood sugar 96.

Jenny Smith (6:46) But the target was 85 96. Okay.

Scott Benner (6:49) How is Jenny Prebola saying? Ten grams of fat, 22 grams of carb.

Scott Benner (6:54) Does it tell how many grams of added carb or or added sugar?

Scott Benner (6:57) Added sugar.

Scott Benner (6:58) Sugar's 10 protein. It doesn't quantify anything as added sugar.

Jenny Smith (7:04) So total carbs are 22 and sugars are 10.

Scott Benner (7:07) Yes.

Jenny Smith (7:08) So my pre bolus is fifteen minutes in the afternoon.

Scott Benner (7:13) Okay.

Jenny Smith (7:14) Sometimes twenty depending on the time of the month.

Scott Benner (7:17) Mhmm.

Jenny Smith (7:18) But fifteen.

Jenny Smith (7:20) Let's say this is a sensitive normal time.

Scott Benner (7:22) Does this need an extended bolus for you?

Jenny Smith (7:25) With only 10 grams of fat, this type of thing doesn't need an extended bolus.

Jenny Smith (7:29) No.

Scott Benner (7:29) For you.

Jenny Smith (7:29) Not at all.

Scott Benner (7:30) You would

Jenny Smith (7:30) For take me, I would take all the carbs.

Jenny Smith (7:32) I wouldn't even I wouldn't cover fat or put it into my system, which I could if I wanted to.

Jenny Smith (7:39) I wouldn't put it in there. I would just put the carbs in.

Scott Benner (7:41) Okay.

Scott Benner (7:42) And that's a thing that you think you'd have success with.

Scott Benner (7:45) So what would your what do you think the bolus would be? Two units?

Scott Benner (7:49) Are you considering the fat or just not stretching it for the fat?

Jenny Smith (7:53) I'm just not stretching it for the fat.

Scott Benner (7:55) Okay.

Scott Benner (7:56) Well, then it's gonna be more like what? 2.8? Something like that?

Jenny Smith (8:01) Two point I mean, with my ratio, again, I Yes.

Jenny Smith (8:05) Can't do the math in my head anymore. Yeah. Is. Was my fault.

Jenny Smith (8:07) Does it for me?

Scott Benner (8:09) Well, then just just put me in the world.

Scott Benner (8:11) You grab the doughnut, How much do you throw in for it?

Scott Benner (8:14) Somebody goes, that's 22

Jenny Smith (8:15) cards. I would put I would put if I was just out in the world and I was bolusing on my own, I would take two units for it.

Jenny Smith (8:21) Okay. So I'd be a little bit heavier than my one to 12 calls for.

Jenny Smith (8:25) It would be less than two units if it was a one to 12.

Jenny Smith (8:29) Okay. Right?

Jenny Smith (8:30) But I would just say two.

Scott Benner (8:32) The, the the thing on the website says two units up front, point eight five over three hours.

Jenny Smith (8:37) Oh, okay. For the fat, I'm assuming Yeah. For the website.

Jenny Smith (8:41) Because it does always consider the fat free.

Scott Benner (8:43) Not gonna not you know but this is interesting.

Scott Benner (8:45) So but you know from your own life that that's not gonna need that for you.

Jenny Smith (8:50) I do. And I can also say that experience for many years on MDI

Scott Benner (8:57) Mhmm.

Jenny Smith (8:58) I would never have covered extra for something like this with the system I use now, which is Trio.

Jenny Smith (9:07) I also would not cover extra mainly because I know that the system is already got my back.

Scott Benner (9:15) Okay.

Jenny Smith (9:16) Especially with dialed in settings. Right?

Jenny Smith (9:18) I mean, all of this bolus thing for anything boils down to are your settings in a pretty good place to begin with.

Jenny Smith (9:25) Mhmm. And so on other systems, however, I wouldn't have even done it on a basic pump that doesn't have an algorithm in it because, again, nothing is being taken away.

Jenny Smith (9:36) Right? Mhmm. I might consider other algorithms and the potential response algorithms that are the adaptive algorithms that do more of a hard set, just pull back, suspend based on what the trend looks like, that maybe you need to consider what ends up happening because it's pulled back, and that then adds in to some potential

Scott Benner (10:01) Yeah.

Scott Benner (10:01) So you make

Jenny Smith (10:01) Lingering.

Scott Benner (10:02) You make this two unit bolus for these 22 carbs, which seems pretty small, but it's got a lot of sugar.

Scott Benner (10:08) It hits you fast. While you're climbing, the system has pulled back basil.

Scott Benner (10:12) It's not resisting anything there at all. So maybe you do need that point eight five

Jenny Smith (10:17) Correct.

Scott Benner (10:17) Pumped in over the hours afterwards.

Jenny Smith (10:18) And, again, it may not be just because of the fat.

Jenny Smith (10:21) It might be because of what your system has actually tried to help you with. Yeah.

Jenny Smith (10:25) I also think, you know, if pre bolus has been pretty well done, then on some of these systems, may actually see some pretty nice containment of your blood sugar.

Jenny Smith (10:36) You started my blood sugar at 96, and if I pre bolus right and I eat this, I'm I'm also not one to, like, shove it all down my

Scott Benner (10:44) might go slowly while you're eating.

Scott Benner (10:46) Yeah. Yeah. Yeah. Right.

Jenny Smith (10:47) If I'm gonna eat a donut, I'm gonna, like, enjoy the bites of the donut.

Scott Benner (10:50) I would imagine if you're bolusing for this, you would wanna see, like, a down like, a diagonal down arrow or a falling blood sugar before you started to eat.

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Pre-Bolus Strategy with Total Sugars

Jenny Smith (13:27) Yeah.

Jenny Smith (13:27) I usually say, you know, if you were stable, like, a trend of one or two dots kind of already headed down, each dot on Dexcom at least is a five minute incremental shift.

Scott Benner (13:37) Mhmm.

Jenny Smith (13:37) And so you've got some visual of momentum from the insulin already. Right?

Jenny Smith (13:42) Kind of that tug of war game that you talk about.

Scott Benner (13:44) Yeah.

Jenny Smith (13:44) It's the insulin's got a little more tug now. Great.

Jenny Smith (13:47) I can put the carbs in because the insulin is definitely showing impact, and I know that these carbs, especially with glaze, they're gonna start to hit.

Scott Benner (13:56) Yeah. The original glazed cake doughnut, Jenny, has 15 grams of fat in it and 40 carbs.

Jenny Smith (14:05) Oh, see, there's where I probably was think I guessed originally 40 to 50. Yeah.

Jenny Smith (14:10) So the doughnut you gave that was 22 isn't a isn't a cake doughnut.

Scott Benner (14:15) No. It's a regular old just glazed doughnut. Yeah.

Scott Benner (14:17) This is the the cake doughnut, which I prefer I prefer a cake doughnut over a regular doughnut if we

Jenny Smith (14:23) I was thinking more of a cake doughnut, honestly.

Scott Benner (14:25) Just to see what that does with Jenny's settings, that turns this into 3.46 up front, and then it wants 1.2 over three hours.

Scott Benner (14:34) It's like four and a it's over four and a half units even for you.

Scott Benner (14:38) K. And I say even for you because your your sensitivity is 85 and your your carb ratio is 12. So

Jenny Smith (14:43) And that's also a lot of insulin at one time Mhmm.

Jenny Smith (14:48) For me.

Scott Benner (14:48) For you. Yeah. Yeah. What would that do?

Scott Benner (14:50) Do you think you'd do you think you'd have success with this or do you think you'd struggle with this?

Scott Benner (14:54) Think you'd get low?

Jenny Smith (14:55) I think I'd have to have it as my first experiment.

Jenny Smith (14:59) And evaluate. Again, a true experiment is always without an algorithm.

Scott Benner (15:04) Yeah.

Jenny Smith (15:04) It just is because you get the true action of your decision and timing and the true action of insulin that's just solidly there.

Jenny Smith (15:13) There's nothing giving and taking. I've grown very much connected to my algorithm.

Jenny Smith (15:19) I like it a lot, as do most people.

Scott Benner (15:23) Yeah.

Scott Benner (15:23) Fills in a lot of holes and takes away a lot of your thoughts later.

Jenny Smith (15:27) Right.

Jenny Smith (15:27) So as you ask about, do you think I'd get low?

Jenny Smith (15:31) Do you you know, what do you think would happen?

Jenny Smith (15:33) I expect because my system does a a pretty darn good job of preventing lows.

Jenny Smith (15:39) I think it would try really hard given the load of insulin though being units.

Jenny Smith (15:46) Mhmm.

Jenny Smith (15:46) Right? And depending on what my assumed timing would be, I might actually dip a little bit initially that it maybe it couldn't pull back enough.

Jenny Smith (15:57) That one has 15 grams of fat. Right?

Scott Benner (16:01) Yes.

Jenny Smith (16:01) And so I might also expect I mean, I like fat.

Jenny Smith (16:05) I'm not like low fat by any means. So 15 grams is what I'm saying is 15 grams isn't really a concern to me either.

Jenny Smith (16:13) Mhmm. But if it did do any pulling back, then the end effect might also be a little bit of a curve up.

Jenny Smith (16:19) So I would view it as anything that's new. It's an experiment. Mhmm.

Jenny Smith (16:25) And I see how it works.

Filled Donuts and Fast Hitting Sugars

Scott Benner (16:27) You know, marketing is a thing because I, for some reason, in my head, thought Krispy Kreme doughnuts were, like, cleaner somehow.

Scott Benner (16:35) And I know now as I'm looking at the ingredients, I'm like, this is ridiculous.

Scott Benner (16:38) Why would I even why did I think of them as a better alternative than, like, say, Dunkin' Donuts?

Scott Benner (16:43) I think it's just the colors. I think it's because they use green around I think it I actually think the marketing works.

Jenny Smith (16:49) That could be or it looks the the, logo Yeah. Also looks really old school.

Scott Benner (16:56) Yes. I think Right? Yeah. Krispy Kreme says to me, hey.

Scott Benner (16:59) We're gonna have a doughnut like a gentleman.

Jenny Smith (17:00) Or your grandma baked it.

Scott Benner (17:02) Right.

Scott Benner (17:02) And Dunkin Donuts says to me, let's go. We're all gonna die together. Yeah.

Jenny Smith (17:05) Yeah. Actually, Dunkin Donuts is kind of like it's like plastic doughnuts compared to crispy crispy creams.

Jenny Smith (17:12) And because, you know, Dunkin Donuts, it's a very, like, bold. It's pink.

Jenny Smith (17:16) It's like it's almost like

Scott Benner (17:17) It's loud. Yeah.

Jenny Smith (17:18) Loud. Yeah. Kind of.

Scott Benner (17:19) It really I think that might be it.

Scott Benner (17:20) I think Dunkin' Donuts says to me, like, let's get in this pickup truck, set it on fire, and see how long we can drive it before it blows up.

Scott Benner (17:26) And Krispy Kreme does feel like, oh, my mom my grandma made it for me.

Jenny Smith (17:29) Right?

Jenny Smith (17:30) It's just the label and every I mean, I don't even know Krispy Kreme's clearly been around a lot longer, I think, than Dunkin' Donuts.

Jenny Smith (17:35) I don't

Scott Benner (17:35) even know. Alright. They have filled doughnuts.

Scott Benner (17:38) You wanna do chocolate iced custard, or

Jenny Smith (17:41) do

Scott Benner (17:41) you wanna do original glazed cream filled?

Scott Benner (17:43) Oh, there's also a New York cheesecake filled doughnut.

Jenny Smith (17:46) Oh my gosh.

Scott Benner (17:47) I can't even this stuff. Almost like

Jenny Smith (17:50) Imagine what

Scott Benner (17:51) Right.

Scott Benner (17:51) Let's do the chocolate iced custard because that's really just Boston cream. Right?

Scott Benner (17:56) Isn't that what that is, basically? Woo.

Scott Benner (17:59) Let's go.

Scott Benner (18:00) Not as much as I thought because you take the cake factor away. Oh, that's interesting.

Jenny Smith (18:06) He's filling it with something.

Scott Benner (18:08) Yeah. So it's 37 carbs, 17 sugar, 16 fat.

Scott Benner (18:14) There's more fat than I thought getting away from the cake aspect, but still that's, you know, okay.

Jenny Smith (18:20) So it's interesting and that's why I asked about the original doughnut that glazed kind of doughnut that you mentioned before in terms of total carbs versus sugars.

Scott Benner (18:29) Mhmm.

Jenny Smith (18:31) Most often, I've seen a lot of people doing it, and I think if you don't really know from a pre bowl strategy where to possibly start with a time is I've seen a lot of people having success

Scott Benner (18:44) Okay.

Jenny Smith (18:45) With taking the total sugars or the added sugars if it is on a label and using that as a default starting pre bolus.

Scott Benner (18:54) Say that again for me.

Jenny Smith (18:56) Yeah. I've seen so this one has what?

Jenny Smith (18:58) 30 some grams of total carb?

Scott Benner (19:00) Total carb, 37. Sugar, 17.

Jenny Smith (19:02) 17. Yeah.

Jenny Smith (19:04) So it's about half sugar.

Scott Benner (19:07) Okay.

Jenny Smith (19:07) Right?

Jenny Smith (19:08) But what what I've seen people doing, again, this is not medical recommendation or anything disclosure, blah blah blah.

Jenny Smith (19:14) I am just saying what I have seen people do and some people have real good success with a starting place.

Jenny Smith (19:20) They need to tweak it, but as a starting place taking the total sugars, which are the hit point.

Jenny Smith (19:26) Right?

Scott Benner (19:26) Okay.

Jenny Smith (19:27) And they're using that as a marker of how many minutes do I even need to pre bolus.

Jenny Smith (19:32) Let's start with the total sugars as a pre bolus time. So this seventeen minutes. Right?

Jenny Smith (19:38) I mean, you might just round it to fifteen to be easy, but

Scott Benner (19:41) Is there a scientific reasoning behind that?

Jenny Smith (19:43) I have looked and looked. I don't see a scientific reason.

Scott Benner (19:46) But you see people have luck with it.

Jenny Smith (19:47) I have seen people have luck with it, and I have seen commentary on people using that as a strategy.

Scott Benner (19:55) That's interesting. I'm making a note about that. Okay.

Jenny Smith (19:59) But I I wanted, you know, more about it just that when you do have a label and you can see, gosh, this is this many grams of carb, but, oh my gosh, 50% of it is added sugars or or the total sugar, you know, kind of added stuff in. I mean, donuts have flour, so that's carbohydrate from natural grain.

Jenny Smith (20:18) Right?

Scott Benner (20:19) It's

Jenny Smith (20:19) processed, but that's another but at least it's not added.

Jenny Smith (20:24) It's something that came with the flour that they use.

Scott Benner (20:26) I see.

Jenny Smith (20:26) Whereas the added is really what you're aiming to see the hit from Mhmm.

Jenny Smith (20:31) Because it's so fast. And so it's often, like I said, it's often a starting place that I see people using and saying, gosh, I'm just gonna use the added sugars here as a marker.

Jenny Smith (20:42) Now that also deeper level is where's your blood sugar? Where is it heading?

Jenny Smith (20:46) Where is it come from? What insulin on board?

Jenny Smith (20:48) I mean, there are many other factors to consider too, but it's a starting place.

Scott Benner (20:52) I'm gonna do this just for this one.

Jenny Smith (20:53) I can't believe you've never seen that, by the way.

Scott Benner (20:55) I mean, I feel like I have, but, you know, as a good podcast host, I had you repeat it so that people could hear it for yeah.

Scott Benner (21:01) Yeah. It's a trick of the trade, Jenny.

Jenny Smith (21:03) Hopefully, I explained it well enough because

Scott Benner (21:05) I think you did. Okay. Hey.

Scott Benner (21:06) Here's the ingredients for this chocolate iced custard filled doughnut.

Scott Benner (21:10) I'll only do this for this one doughnut, then we're gonna go do a couple more doughnuts from Krispy Kreme.

Scott Benner (21:14) Oh. Enriched flour, wheat flour, niacin, reduced iron, thiamine, mono nitrate, riboflavin, folic acid, water, palm oil, soybean oil, sugar, yeast, hydrogenated soybean oil, soy flour, leavening, you know, baking soda, salt, mono monoglycerides, weak gluten, soy lecithin, skim milk, cellulose gum, ascorbic acid, calcium propionate to maintain freshness, egg yolk enzyme it says egg yolks, comma, enzymes.

Scott Benner (21:51) In the filling, water, high fructose corn syrup, corn syrup. I like that there's two different corn syrups.

Scott Benner (21:57) Right?

Scott Benner (21:57) Hydrogenated coconut oil, modified food starch, sucrose fatty acid esters, salt, natural and artificial flavor, phosphoric acid, sodium benzenate, polysorbate 60, potassium sorbate to maintain freshness, colored with beta carotene.

Scott Benner (22:15) Icing is sugar, water, cornstarch, cocoa, corn syrup, solids, palm oil, soybean oil, chocolate liquor, soy lecithin, salt enzyme modified soy protein, mono and diglycerides, polysorbate 60, sodium, and something called hexametaphosphate.

Scott Benner (22:36) Enjoy your doughnut. Damn. That is a lot more in that than I thought there was gonna be.

Scott Benner (22:42) What the hell?

Jenny Smith (22:43) Wow. I yeah.

Jenny Smith (22:45) I I mean, in doughnuts like, you've ever looked up, but doughnuts aren't that difficult to honestly make.

Scott Benner (22:51) That's what I thought when I was looking at it. Yeah.

Scott Benner (22:53) Like, it's just a little cake. It's a little piece of cake. Right?

Scott Benner (22:56) With

Jenny Smith (22:56) And the funny thing as you're going through them, I'm thinking like and you brought it up.

Jenny Smith (23:01) Like, they've got not only high fructose corn syrup, which is really corn syrup that they've essentially added some enzymes to, and the fructose in it makes it a little sweeter than regular corn syrup, but they use both high fructose corn syrup and corn syrup.

Jenny Smith (23:20) Because clearly, there's something fancy in the recipe that makes it taste the right way.

Oreo Cookies Deep Dive

Scott Benner (23:25) Some of that in too. Alright. So I'm gonna do one more, one of their fancier donuts, and I almost did the I almost did the New York cheesecake one.

Jenny Smith (23:33) I was gonna ask if, you know, tomorrow is Valentine's Day whether you celebrate it or not.

Jenny Smith (23:39) Do they have anything special? I know a lot of times

Scott Benner (23:42) Yes.

Scott Benner (23:42) There are Valentine's donuts here. After we do this one, I'll look at one of the Valentine's sauce.

Scott Benner (23:47) I instead of going to the New York, cream cheese or whatever it was, I went to the Oreo cookies and cream filled donut.

Scott Benner (23:55) And those Oreos really throw on a little punch.

Scott Benner (23:58) This one has 49 carbs, 28 sugars, 20 fat. That's that's that's a big jump.

Jenny Smith (24:06) It's a loaded donut, man.

Scott Benner (24:08) It's a loaded donut.

Jenny Smith (24:10) I wish I could see what these things look like.

Jenny Smith (24:12) You have

Scott Benner (24:12) a you have the Internet know.

Jenny Smith (24:15) I don't I usually like to let you

Scott Benner (24:17) I know. I know.

Jenny Smith (24:17) There's a way we do this. Yeah. Yeah.

Scott Benner (24:19) The 49 carbs, 20 fat, four protein.

Jenny Smith (24:23) How much sugar?

Scott Benner (24:24) Sugar, 28. Now would you tell somebody to pre boast twenty eight minutes for this?

Scott Benner (24:29) You Jenny's like, I might.

Jenny Smith (24:32) Look at how much. So 49 grams of total carb?

Scott Benner (24:36) Yeah.

Jenny Smith (24:36) Is that what you said? And 28 of that is sugar.

Scott Benner (24:40) That's a lot of sugar.

Jenny Smith (24:40) That's added sugar.

Jenny Smith (24:42) That is more than half of this doughnut is sugar.

Scott Benner (24:46) Yeah. You know what?

Scott Benner (24:47) That makes me feel like Do you

Jenny Smith (24:48) know how many teaspoons of sugar that is?

Jenny Smith (24:50) I gave you the math for this before.

Scott Benner (24:51) Oh, you think I remember that? Stop it.

Scott Benner (24:53) Go ahead. You tell me. Mhmm.

Scott Benner (24:55) I don't know.

Jenny Smith (24:55) It's seven teaspoons of sugar. Seven? Seven.

Scott Benner (24:59) Measuring teaspoons of sugar. Goddamn.

Scott Benner (25:03) Yeah. Yep. In one of those donuts.

Jenny Smith (25:05) That's just added sugar. Right?

Jenny Smith (25:06) That's just the added sugars. So just as a reference, you said I mean, you were very surprised, like, twenty eight minute pre bolus.

Jenny Smith (25:13) I'm thinking, if there's nothing else in your stomach and you're eating this and

Scott Benner (25:19) You might need the insulin to be running away to grab this when it hits you.

Jenny Smith (25:23) Right? Absolutely.

Scott Benner (25:24) By the way, this pushed me.

Scott Benner (25:25) Know this was supposed to be about donuts, but this pushed me to oreo.com because those Oreos really shushed up those so chocolate.

Scott Benner (25:34) Let's see. Chocolate sandwich cookie. I'm trying to just find a regular Oreo.

Scott Benner (25:39) Wait.

Scott Benner (25:39) This website is fancy as hell. You ready?

Jenny Smith (25:43) Even know who makes is it who makes Oreos?

Scott Benner (25:46) I mean, Nabisco, I Nabisco.

Scott Benner (25:48) Think. Is that right? Isn't it all like some oil company now or a

Jenny Smith (25:52) Oh, absolutely.

Scott Benner (25:52) Or a missile manufacturer or something? A 100%.

Jenny Smith (25:55) They're all people that you're like, yeah. You should make my food.

Jenny Smith (25:58) That sounds like a great idea.

Scott Benner (25:59) Honestly, I think listen.

Scott Benner (26:01) I don't know a lot about a lot, but I think if you look into it, a lot of the big, like, agri companies are just owned by consortiums of finance of money that, you know, I think that Yes.

Scott Benner (26:13) The same group that used to own cigarettes or maybe still does.

Scott Benner (26:15) Like, it's possible RJ Reynolds is making your your bread or something like that. Oh.

Scott Benner (26:20) But let's say that Jenny gets out of her mind and is gonna eat six Oreo cookies.

Scott Benner (26:27) Jenny, it's all over. Life's gotten sideways. Alright.

Scott Benner (26:30) You're

Jenny Smith (26:31) I go to the store and I'm just gonna sit in my car and Yeah.

Scott Benner (26:33) You're you're gonna sit and you're gonna eat six Oreo cookies. Now Okay.

Scott Benner (26:37) Three Oreo cookies is sorry. This website, I think, is meant to is not to it doesn't want you to be able to read it.

Scott Benner (26:47) So three Oreo cookies has seven grams of fat, so I'm gonna put in 14 grams of fat.

Scott Benner (26:51) And I really have to pick through this trans wait. Wait.

Scott Benner (26:55) I'm not put the carbs anywhere near the top.

Scott Benner (26:58) Carbohydrate oh, it gives you total carbs 25. So six of them is gonna be 50.

Scott Benner (27:05) Protein?

Scott Benner (27:06) Is there a protein? Yeah. You're gonna get two grams of protein.

Jenny Smith (27:09) Woo hoo.

Jenny Smith (27:10) My muscles are saying, thank goodness.

Scott Benner (27:13) Things are coming together now.

Scott Benner (27:15) The my muscles are saying thank you. The added sugar for this is 14, but you're having six, so it's 28. The calculator, which by the way, I you know, the estimator is I don't think even able to take into account the idea of, like, how hard the sugar's gonna hit right away because Right.

Scott Benner (27:36) It's still like, look, for you, it'd be 4.3 upfront, 1.12 over three hours, like a five and a half unit bolus Mhmm.

Scott Benner (27:44) With a ten minute pre bolus. But I want you to talk more about it again from your perspective.

Scott Benner (27:49) You're gonna eat six Oreo cookies. Mhmm. How are you gonna bolus for six Oreo cookies?

Jenny Smith (27:54) Go for a run after I eat.

Scott Benner (27:56) And he's like, I'm gonna eat them while I'm running.

Jenny Smith (27:59) I'm sorry.

Scott Benner (28:00) Would that work? Can you just eat them while you're running with that, like

Jenny Smith (28:04) Oh my god.

Jenny Smith (28:05) I'd probably throw them. Like, there's nothing to drink along. Oh god.

Jenny Smith (28:09) I can't even imagine doing that.

Scott Benner (28:10) Have you had an Oreo in the last ten years?

Scott Benner (28:13) They're not as good as they used to be. I just wanna say that.

Jenny Smith (28:15) I probably the last time I honestly had an Oreo cookie was in college. Okay.

Jenny Smith (28:20) Probably.

Scott Benner (28:21) Yeah.

Jenny Smith (28:21) Yeah. I mean, I know what an Oreo tastes like.

Jenny Smith (28:23) Yes.

Scott Benner (28:23) So these you think about how you're gonna bowl this for the 50 carbs for the regular six Oreo cookies.

Jenny Smith (28:29) Which again

Scott Benner (28:30) Well, I look at the double stuff.

Jenny Smith (28:32) My estimate would be so it's 50 grams of carb because you said three has 25. Right?

Jenny Smith (28:37) Right. And my expectation is that half of that total carb is coming from sugar would be my guess.

Scott Benner (28:46) 28. Right. I

Jenny Smith (28:47) think it was. 28. Okay.

Jenny Smith (28:49) So I would absolutely let's say my blood sugar is in target, the unicorn number of 100, nice and level.

Jenny Smith (28:59) Mhmm.

Jenny Smith (28:59) Let's just say it is. It's not moving.

Jenny Smith (29:02) I'm going to give this a minimum of a twenty minute knowing my response to a minimum of a twenty minute pre bolus.

Scott Benner (29:10) Okay.

Jenny Smith (29:11) And if in twenty minutes, I'm I should be seeing already a downward tick just with my knowledge of how insulin works with me in this situation.

Scott Benner (29:21) Okay.

Jenny Smith (29:22) I should be seeing I would give this it's coming down.

Jenny Smith (29:26) I might even be hitting 80 before I take my first bite.

Jenny Smith (29:30) So again, here is that time frame is an estimated pre bolus time Mhmm.

Jenny Smith (29:36) But I'm really paying close attention to my CGM in a scenario like this where I've been eating Oreos since college where I didn't have a CGM and it was my best guess and I I don't have any clue what happened after I ate the Oreos in college.

Scott Benner (29:52) Do you think it's a mistake that on the mega stuff Oreos, it's harder to find the nutritional information on the website because I don't think it's a mistake.

Jenny Smith (30:03) Aren't they they're double stuffed. Right?

Scott Benner (30:05) They're calling this one mega stuff.

Jenny Smith (30:07) Oh, so they're more than double stuff.

Scott Benner (30:09) It feels by the way, it feels funny to type in Oreo mega stuff and then nutrition afterwards.

Scott Benner (30:16) It feels like those are two, two words that don't go together.

Jenny Smith (30:19) I'm also curious what the portion size would be because the regular Oreos are three is a single portion.

Scott Benner (30:26) Yeah. I'm finding a bag right now to look at the label

Jenny Smith (30:28) on I'm curious if because they're mega stuffed, maybe only one is a portion, or are they telling peep or are they suggesting to people that it's two?

Scott Benner (30:38) I see what you're saying.

Jenny Smith (30:39) Do you know what I mean?

Jenny Smith (30:41) Like, are they

Scott Benner (30:41) Serving size is two cookies

Jenny Smith (30:43) Okay.

Scott Benner (30:44) On the mega stuff.

Scott Benner (30:45) Total carbs for those two cookies are 25, and total sugars are 17. So because you're getting the same cookie amount.

Scott Benner (30:54) You're just getting more of the cream inside. I mean, I'm calling it cream.

Jenny Smith (30:58) Sugar actually goes up. You get one less cookie, but you get more stuffing.

Jenny Smith (31:03) So the carbs remain the same as three regular Oreo cookies. Yeah.

Jenny Smith (31:07) But the total carbs are actually the total amount of added sugars is slightly more.

Scott Benner (31:12) Yeah.

Scott Benner (31:12) And then if you had six of six of these, you'd have 75 carbs.

Scott Benner (31:18) You'd have seventeen, twenty, 36, 46, 49, 54 sugars. Is that right? Is that 17 times three?

Scott Benner (31:29) Fifty four? And I think I just let people in real time see my my poor math.

Scott Benner (31:36) I could have just multiplied, but for some reason, that's not how my brain does it.

Scott Benner (31:41) That in this three and a half. So three, six, nine, ten and a half.

Scott Benner (31:48) It'd be 10 and a half if you had six of them. Yeah.

Jenny Smith (31:51) So there's less fat in the double stuff? Yeah.

Jenny Smith (31:54) Must just be all sugar then the cookies must have the fat because the other ones have more fat in three cookies.

Scott Benner (32:01) Mhmm. That puts your balls up to about seven and a half, by the way, in case you're wondering.

Valentine's Day Donuts & Hidden Icing Carbs

Scott Benner (32:06) Anyway, let's go back to the Krispy Kreme real quick because Jenny asked about the Valentine's.

Jenny Smith (32:10) If they had anything fancy.

Scott Benner (32:12) Yeah.

Scott Benner (32:12) Well, I mean, though, I think the Oreo one, looks it's fancy.

Jenny Smith (32:16) It looks fancy.

Scott Benner (32:17) Yeah. They put extra stuff

Jenny Smith (32:18) on it.

Jenny Smith (32:18) You know, the funny thing is that when consider this is where my brain goes in consideration of, like, my intake, which you can take it as it is.

Jenny Smith (32:28) If I'm gonna eat 75 grams worth of carb,

Scott Benner (32:32) it's gonna be donut. Yeah.

Jenny Smith (32:33) Yeah. It's not gonna be a donut. It's not gonna be cookies.

Jenny Smith (32:36) But again, that's me. Yeah.

Jenny Smith (32:37) This is not a you should do this or whatever.

Jenny Smith (32:39) It's a if I want that, I'm going for really good sushi someplace.

Jenny Smith (32:44) And I like want this to be food that I can enjoy, that I'm

Scott Benner (32:48) sitting on next you.

Scott Benner (32:49) A year Jenny sends me a picture of her plate from a restaurant. She's like, I'm doing it.

Scott Benner (32:53) Like like, look at me look at me eating. You know what?

Scott Benner (32:56) I take your point about the Valentine. It'll be beyond Valentine's Day, obviously, when people get this.

Scott Benner (33:01) Also, you're reminding me that tomorrow is Valentine's Day.

Jenny Smith (33:03) There you go.

Jenny Smith (33:04) Lovely for your wife that you remember now.

Scott Benner (33:07) She was gonna get flowers.

Scott Benner (33:09) I love you, chocolat. Oh, I love you chocolat doughnut, teddy bear cookies and cream doughnut, your berry sweet doughnut, and sprinkled with love doughnuts.

Scott Benner (33:20) So they have four here's why I'm bringing this up because if someone ends up at Krispy Kreme tomorrow or this week, they're gonna go, oh my god.

Scott Benner (33:28) It's Valentine's Day.

Scott Benner (33:29) And there's gonna be one in there.

Scott Benner (33:30) And then it's gonna come home and it's gonna go on your counter. Right?

Scott Benner (33:33) And then your gonna walk by and there's gonna be a Red Heart donut with a bow on it.

Scott Benner (33:37) They'll be like, mom, I'm gonna have a donut, the thing.

Scott Benner (33:38) And you yeah. Yeah.

Scott Benner (33:39) And then the Red Heart donut has 44 carbs in it and 26 sugars and 18 fat. Okay.

Scott Benner (33:46) Yeah.

Scott Benner (33:46) It's not getting crazy beyond what they're No. What they're doing with most actually, will say they do seem to keep their donuts.

Scott Benner (33:53) They're all pretty similar. Like, the stuffed ones are

Jenny Smith (33:57) Okay.

Scott Benner (33:57) Hitting nutritionally about all the same. Like, one doesn't seem oddly different than the other.

Scott Benner (34:01) The teddy bear is 46 carbs, 28 sugar, nine fat. Yeah.

Scott Benner (34:07) These these are all sort of, like, you know

Jenny Smith (34:10) If I was to pick one, honestly, I don't even know I don't know what they look like.

Jenny Smith (34:14) You said there's like a red heart one. Right?

Scott Benner (34:16) Mhmm.

Jenny Smith (34:16) And then the I'd probably pick the teddy bear one, honestly.

Jenny Smith (34:20) Like, if I was gonna pick one just out of cuteness and but then I'd feel bad eating it if it had a face

Scott Benner (34:25) or something.

Scott Benner (34:25) I'm gonna send it to you so you can see it. Hold on a second.

Scott Benner (34:28) And then they have a a regular it looks like they're glazed donut, but with icing on top and just up with, like, red and sprinkles and stuff.

Scott Benner (34:35) That's 37

Jenny Smith (34:36) Okay.

Scott Benner (34:37) And 15. That's interesting.

Scott Benner (34:40) Like so so their glazed donut with icing on top is 37 carbs, and it really does look like that's all it is.

Jenny Smith (34:49) Okay.

Scott Benner (34:49) Right? And 50. So the glazed donut says 22. You put icing on top of it, it takes it up 15 more carbs just for the icing.

Scott Benner (35:05) Anyway, I think that's

Jenny Smith (35:06) partly heavy.

Scott Benner (35:07) Yeah.

Scott Benner (35:07) I partly, I feel like that's some of the value in these conversations actually is that yeah.

Scott Benner (35:12) I just don't know that our brains do the math real quick when we look at things.

Scott Benner (35:17) Like, oh, donut. It's Valentine's Day.

Scott Benner (35:19) Like, you know, that kind of stuff.

Jenny Smith (35:20) Or underscore I know I I think a lot of people unconsciously undercount for things like frosting.

Jenny Smith (35:28) Like, it I know that there's sugar there, but Mhmm.

Jenny Smith (35:31) Gosh, it can't have 25 extra grams worth of carb in it. Yeah.

Scott Benner (35:35) Right? Yeah.

Scott Benner (35:36) Especially you make a good point because if somebody's eating the the glazed doughnut as part of their life with 22 carbs, then you're like, oh, this glazed doughnut has icing.

Scott Benner (35:45) There's no way you're gonna add 15 carbs in your mind to

Jenny Smith (35:49) Right.

Scott Benner (35:49) To that.

Scott Benner (35:50) I sent you the the teddy bear so you can see it. Oh.

Scott Benner (35:53) I know it's a little I don't know if it's cute or odd. You like it?

Scott Benner (35:56) Jenny likes it.

Jenny Smith (35:57) It's kinda it is kinda cute. Honestly.

Scott Benner (36:01) Aw.

Scott Benner (36:02) Yeah. Well, you'll eat that cute teddy bear and it'll go inside you and try to kill you from the inside out.

Scott Benner (36:07) That's

Jenny Smith (36:07) right. There

Scott Benner (36:08) you go.

Jenny Smith (36:10) I was so cute.

Jenny Smith (36:11) You shouldn't have eaten me. Yeah. You

Scott Benner (36:13) you'll you'll experience your own bear attack.

Scott Benner (36:16) Not the way you see in the YouTube videos.

Jenny Smith (36:17) You're right.

Episode Wrap-Up & Closing Remarks

Scott Benner (36:18) Jenny, thank you for doing Krispy Kreme doughnuts.

Jenny Smith (36:20) Thank you.

Scott Benner (36:21) I appreciate it.

Scott Benner (36:21) I'll talk to you soon. And happy Valentine's Day.

Jenny Smith (36:23) You too.

Scott Benner (36:24) Is that why you're wearing red?

Jenny Smith (36:27) Kinda. Yeah? Yeah. Yeah.

Jenny Smith (36:29) I mean, we don't really do anything for Valentine's Day, honestly.

Jenny Smith (36:32) I mean, Nathan will usually bring me flowers or something, but honestly, it's truly is just like a money making.

Jenny Smith (36:39) No. I I It's like, you know, it's so

Scott Benner (36:42) I expect my wife to apologize to me tomorrow around 03:00.

Scott Benner (36:46) And she'll go, I did not get you anything from Like,

Jenny Smith (36:48) she says I didn't get you anything, and you're like, great.

Jenny Smith (36:50) Here are your flowers.

Scott Benner (36:50) I got flowers for you. And then she'll say thank you.

Scott Benner (36:53) Actually, Jenny, I think this is a good point to place.

Scott Benner (36:55) I don't think I've ever said this before. I'll just slide this in at the end of the episode.

Scott Benner (36:58) On all occasions, birthday, Valentine's Day, anniversary, those sorts of things.

Scott Benner (37:05) I go out on the morning of, I hand select flowers and come home and arrange them myself.

Scott Benner (37:11) Oh. I think it's a nice little addition. It's like, it's not just here I bought flowers.

Scott Benner (37:16) It's like I saw these I

Jenny Smith (37:17) took time.

Scott Benner (37:18) They look like they were nice together. I put some time into it.

Scott Benner (37:20) She's never once seemed impressed by that, but I think it's a big deal.

Jenny Smith (37:25) I think that's lovely. It really is.

Scott Benner (37:27) Don't don't marry an Irish Catholic girl.

Scott Benner (37:29) They their their hearts are buried under ice. That's all.

Jenny Smith (37:32) I'm just saying I married an Irish Catholic boy.

Scott Benner (37:34) Yeah.

Scott Benner (37:34) He knows what Jenny knows what I mean. Okay. Alright.

Scott Benner (37:37) No shade on the rest of you.

Scott Benner (37:38) I'm sure some of you are very warm and cuddly.

Scott Benner (37:40) Not as cuddly as that donut. Right. On it though. See you guys.

Scott Benner (37:51) A huge thanks to US Med for sponsoring this episode of the Juice Box podcast.

Scott Benner (37:56) Don't forget, usmed.com/juicebox. This is where we get our diabetes supplies from. You can as well.

Scott Benner (38:03) Use the link or call (888) 721-1514.

Scott Benner (38:08) Use the link or call the number, get your free benefits check so that you can start getting your diabetes supplies the way we do from US Med.

Scott Benner (38:16) Today's episode is also sponsored by Omnipod. Check out the Omnipod five now with my link, omnipod.com/juicebox.

Scott Benner (38:26) You may be eligible for a free starter kit, a free Omnipod five starter kit at my link.

Scott Benner (38:33) Go check it out.

Scott Benner (38:34) Omnipod.com/juicebox. Terms and conditions apply.

Scott Benner (38:38) Full terms and conditions can be found at omnipod.com/juicebox. (38:45) Okay.

Scott Benner (38:45) Well, here we are at the end of the episode.

Scott Benner (38:47) You're still with me? Thank you.

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Scott Benner (39:32) My diabetes pro tip series is about cutting through the clutter of diabetes management to give you the straightforward practical insights that truly make a difference.

Scott Benner (39:40) This series is all about mastering the fundamentals, whether it's the basics of insulin, dosing adjustments, or everyday management strategies that will empower you to take control.

Scott Benner (39:50) I'm joined by Jenny Smith, who is a diabetes educator with over thirty five years of personal experience, and we break down complex concepts into simple, actionable tips.

Scott Benner (40:00) The diabetes pro tip series runs between episode one thousand and one thousand twenty five in your podcast player, or you can listen to it at juiceboxpodcast.com by going up into the menu.

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