Writhing All Over The Table

In this episode, Carly gives us the lowdown on how different types of exercise affect blood glucose levels, and shares her tips for keeping them in check. We have a good rant about ketone strips expiring (just when you need them!) and Benjamin hilariously recounts his many misadventures with sharp objects.

Whether you're a fitness fanatic or just trying to stay on top of your numbers, we've got something for you. 

Join us for a fun, informative, and laugh-out-loud episode as we navigate the lived reality of type 1 diabetes. 

Episode Transcript

(00:00):
Music.

(00:10):
Today on Life in Beta, some new research that's diagnosing diabetes just from voice recordings.
Carly walks us through how blood glucose levels tend to react to different types
of exercise and how she handles it.
And Benjamin reveals just how many times he's stabbed himself with diabetes supplies.
I stabbed myself with an insulin pen. I have shot myself with a G6.

(00:33):
I have shot myself with a Mio. Generally uncoordinated.
No, this is a product flaw, nothing to do with me.
Music.
Welcome to Life in Beta, the show where we talk about the lived reality, real life with Type 1.
Do you want to phrase it a different way, Carly? Is that, you're giving me a

(00:54):
look already? No, the lived reality. The lived reality of Type 1. We are the BBC.
Welcome to BBC News. Should we, we'll get this back on track now,
shall we, that we've just put the whole thing in the toilet.
That is Benjamin Jardine, the dire boss. How's life, Benjamin?
I'm doing well. I'm doing well. We've got lots of things to talk about,

(01:14):
including exercise, which is the bane of my existence.
And I'm sitting next to the fittest person in the building and I don't like it.
Okay. Well, speak of the devil, Carly Green.
I love talking about exercise and Type 1. No. Shock. Horror.
If you're joining us for the first time, a little bit about us.
Combined about 50 years of Type 1 lived experience.

(01:36):
Half a century of lived experience at Type 1. Indeed. Did I tell you I did the maths?
On our adults' community, and we have about 10,000 years of lived experience in that community.
Well, that's a pretty cool number. It is. Very cool. It's an awesome number.
Take that, any health professional who thinks they know about type 1.
Speaking of, we are not health professionals.
Benjamin was a speech pathologist in a past life, but really has nothing to

(01:58):
do with type 1, so it doesn't count.
Although there is a story today where I will get to use my health professional experience.
Oh, true. True dat. True dat. All right, little teaser. Little teaser.
Yeah, so about 50 years of lived experience. We all work at the Type 1 Diabetes
Family Centre, so we kind of just live, eat and breathe Type 1 all day, every day.
Back in the day, we kind of were all on MDI at some point, multiple daily injections.

(02:21):
Now we're on various bits of tech.
And so that's how we use clubs, rub sticks together to make fire.
Yes. That's how old we are. Speak for yourself.
All right. Shall we dive straight into the news? Let's do it.
I'm loving these stories this week, actually.
So here we go. Right into Benjamin's previous professional health care experience.

(02:44):
We have a study released where they are able to predict whether people have
pre-diabetes or type 2 diabetes based on the pitch of their voice. What? Exactly.
So this was a study of 505 participants. They were all fitted with CGMs,
and then they recorded their voice several times a day for two weeks,

(03:06):
and they discovered a linear relationship between glucose levels and voice pitch.
So basically the higher your glucose level, the higher your voice pitch.
Oh, I would have thought it was the opposite. If your blood glucose is going
high, I would have thought lethargic.
Well, I actually notice it in choir sometimes. Again, those who are new, I conduct a choir.

(03:27):
And I find it difficult to demo for the basses if I'm running high during that
rehearsal. It just bottom range disappears.
So I support this study is what I'm saying. Right, right.
I was really hoping I'd get a really deep Barry White voice if I ran high.
No, you just have to drink for that. It's not quite Mickey Mouse.

(03:47):
An evening of intense singing and bursting your vocal
cords yeah that'll give you the high stuff but yeah if you
want so this is a legit finding yes legit finding
so they're actually they are there's a company called click labs and they had
a previous study that showed basically that type two could be diagnosed from
voice recordings and so they're actually working on developing an app basically
for gps to use to be able to like that it was some ridiculous like i want to say 90

(04:14):
% accuracy kind of thing that they could diagnose. Good morning, doctor.
How are you doing? You have type 2 diabetes. Good morning. Exactly.
So, yeah, I mean, I can't see this replacing CGMs for us. Like,
in theory, you know, you could talk to your phone. I was going to sing into my CGM. Yeah, nah.
No, so. Because it just wouldn't be that accurate for a loop to work,

(04:35):
for example. That wouldn't be a thing.
But kind of, I guess it's a little bit more type 2 news, if I'm honest.
But it was just so cool I couldn't not put it in the show notes. Why?
Why, Adam? Because they can, I think, is the answer. I mean,
why does pitch go up when your blood glucose is high?
That's a great question. I don't know. That's super weird.
I can't think of the anatomical reason.

(04:58):
This whole thing just boggles me, actually. This sounds like one of those troll
articles that someone puts up.
505 study participants. Like, it's not one of those, like, oh,
yeah, we did 11 people and more research is needed.
No, this is 500 people and, like, you know, 90-whatever percent accuracy of
diagnosis. Yeah, an opportunity for non-invasive glucose monitoring.

(05:22):
There's a question mark at the end of that sentence. Yeah, there is.
Because I don't think this replaces CGM. Yeah, it's just not going to be accurate enough. But, yeah.
Interesting, nonetheless. There's some dystopian future where everyone's voice
is recorded and they pick the type 1s and the type 2s out.
Yeah, you have to go stand in a corner and, yeah.
And sing falsetto in a choir. Maybe.

(05:44):
That was a very odd piece of news, thank you. Delightful. Great way to start
off the show. Delightful. Throw that in there.
Let's go back to something a little bit more serious. This is a public service announcement.
You might have received, if you are a Medtronic user, or maybe it was from an
NDSS email, I can't remember, Medtronic are phasing out their Mio infusion sets.

(06:05):
So this is as their seven-day extended infusion set is coming in,
they're phasing out the Mios, which is the exact same connector type and everything.
So as of the 1st of September, so already passed now, they're removing two colour options.
So if you want 60 centimetres, then you have to have blue. And if you want the

(06:27):
80 centimetre line, you have to have pink.
But that will soon be redundant because as of the 1st of November,
they're all going, all of them. It doesn't matter what line length,
what cannula length, what colour, they're all going.
It's extended infusion sets all the way. So you can still get quick set and.
The other one, the even older one. But if you wanted Mio, you're now on the
extended. This feels like the end of an era.

(06:49):
Oh, yeah. I remember using Mios when they first came out back in Medtronic days.
The Mio was this bulletproof little puck that you could throw anywhere.
Like the Nokia 3310. It was a Nokia. I loved this thing.
I distinctly remember ripping a side out
and digging around out in my car and finding one that had

(07:11):
got wedged under the seat and crushed by the seat mechanism
and it's still fired wow those things were bulletproof indestructible
they were also terrible in that you stretched them out and then they fired and
that was so tenuous yeah that i shot myself in the finger oh really hurt oh
don't recommend you have a bad habit of that because while we were filming for

(07:33):
typod essentials i stabbed myself with an insulin pen i have shot Shot myself with a G6.
I have shot myself with a Mio. It's generally uncoordinated.
Just, yeah. No, this is a product flaw. Nothing to do with me.
Whatever you need to sleep at night, Benjamin. I'm sticking with it.
But these Mios, they're, oh.
Yeah, end of the era. And the colours are gone. The colours used to be a cool
little thing for the kids. They could have a blue or a pink one if they wanted to.

(07:57):
Yeah, what are the, do the tandem ones come in colours? I don't think so.
No. I feel a bit left out because I remember seeing, before I went onto a pump,
just on through Instagram, social media, the cute little pink attachments.
And I was like, I want one of those. I thought they were just like you buy them and you add them on.
No, I think it depends on what. No, you could up until recently choose on Medtronic

(08:18):
anyway. You can pick one or a blue one. Yeah, what colour you want.
Yeah. No, can't for me. Yeah. So, I mean, this one November transition,
I feel a little bit sorry for anybody who has kind of rushed into this decision
of going, okay, well, I have to try, I have to kind of do the extended thing now.
I was in the lucky position of going, oh, do you want to try it? Sure.
And, you know, I could go back and forth. I mean, personally,

(08:39):
I've had an awesome experience with them.
So, if you're worried about it, I'd say, take a deep breath,
dive on in. I have found them to be really, really great.
Obviously, every seven days instead of every three is awesome.
And the actual insertion has been a lot cleaner.
I've had way better readings for longer as a result because less kinks and all this kind of stuff.
But I get that, obviously, it's just a little bit scary when you're trying a new infusion set.

(09:01):
Well, this has moved really quickly, right? The seven-day infusion set only
just came out and now they're saying that is superior, we're getting rid of Mio.
It is actually a big thing to change your pump site type.
I remember people will come and order their supplies And even if they see a
different box, I remember when they changed the box on something,

(09:22):
you think you're getting the wrong thing, right?
Because you're so used to getting it and then it suddenly arrives in a different thing.
And now they're saying you've got a couple of months to switch over completely.
How interesting. Yeah, so classic type one, right? It is a better solution.
Seven days is great, but you've got a couple of months to sort yourself out. Yep. Yikes. Yep.
So, yeah, I mean, have a look on various online communities.

(09:45):
If you're in Western Australia, you can jump onto ours.
And there's a heap of people that have posted about it, people saying what they
do and don't like about it. I've got a video in there that kind of gave all the pros and cons.
If you want to have a watch or a read.
Farewell to the Mio. Indeed. Good night, moon. All right, Dexcom G7.
So this isn't out yet in Australia. It's had TGA approval.

(10:07):
We're just waiting for, we think,
actually a September launch is what we heard. So any day now in theory.
But this is an issue that people overseas are seeing when they travel from their
home country to another country.
And then for whatever reason, they have to reinstall the Dexcom G7 app.
So that could be you lost your phone, your phone broke.

(10:27):
There is an error apparently that comes up where it says, you need to reinstall this app.
And people go, oh, okay, reinstall the app. And then they're in a different
country and it says, no, sorry, you can't use this app.
So the reason for this is a little bit geeky. Basically, different countries
have different things that they approve.

(10:48):
So the features that get approved in Australia might be slightly different to
the features that get approved in Europe or the USA or whatever.
So, they have to provide you different versions of the app to account for that.
G6, what they did was they put a different version of the app in each country's app store.
So, you just go to your version of the iOS store or the Google Play store or
whatever, and you just download the version you've always had.

(11:10):
With G7, they're doing it slightly differently, what's called geofencing,
where they put the same version of the app in all the stores,
which is easier for them, only one app to manage.
And then depending on what basically
when you log in with your dexcom login that determines
what country you are from and hence what set of features you get however
if you try and log in in europe for example but with an australian dexcom login

(11:36):
it's going to go these don't match up sorry and kick you back out again which
is obviously going to have big issues if you well for any like you just can't
get cgm readings right if you're
on a tandem pump you're all right because it'll still talk to your pump.
You won't be able to see it on your phone, but you can see your graph on the
pump and that just runs its own thing.
Omnipod 5, when it comes out, the loop will still run.

(11:59):
But, oh, no, you've got the controller, so you're probably all right there.
Oh, no, you don't get CGM readings on the controller, I don't think. Oh, no, do you?
I just, we haven't even got the G7 yet, but unfortunately there's a few negatives
that are stacking up here.
And I'm just trying to, like, brush it under the carpet because I've been waiting
for the G7 for so long. I'm like, I don't care. It's smaller.

(12:19):
It looks better. I've been waiting for this. Like, don't give me the negative stuff.
And then each week I'm just getting, like, another little negativity.
Speaking of which, we should do a little plug for, I did a little field trial
of the Dexcom G7 and wrote up my findings on the Type 1 Family Centre blog,
including the good, the bad and the ugly.

(12:39):
Literally. It's a good title.
So, yeah, what's the CliffsNotes from that?
Yeah, let me give you the really quick CliffsNotes on Dexcom G7.
It is as small as you think it is. It is tiny. It is unobtrusive.
It is cool. Its packaging is super small.
So, if you have been one of those people like me who has looked at how much

(12:59):
you throw away every time you put on a G6, G7 is super much better.
Super much better. Good language.
Good English. Yep. We're doing good English today.
On the slightly...
Side, connectivity was a bit iffy. Had the phone drop out quite a bit.
So, that's the thing we're hearing a lot about.

(13:19):
It settled down. It settled down definitely by day two or day three,
but my insulin pump needs that data now, not day two or day three.
So the dropouts settled down in day two or day three. Is that what you're saying?
The dropout settled down in day two or day three. So explain that one. That's super weird.
As did the readings getting a lot closer. So they were a bit out for the first

(13:39):
24 hours, as can happen on any sensor, came closer.
And then on the ugly, the adhesive dropped.
Yeah, talk about that. This is the worst adhesive ever. I don't know where they've
got it from or what they've done or how.
There is a picture on the blog post. This thing crinkles up and cracks and separates
and you get little bits of glue that you've got to pull off individually.

(14:01):
It's delightful. Wait, after you take the sensor off, so the actual between
the sensor and the skin? This is the overpatch that goes on top. Oh, the overpatch.
Exciting thing, overpatch is included in the package. You don't have to request
other overpatches. Yay. The overpatch sucks.
The overpatch is ugly. I did see a picture of it It sucks It sucks so bad It
took me forever To get rid of it It was disgusting Okay Ick out of ten Do not

(14:25):
recommend Right Did it keep it on your body For the intended time?
It did But I don't know Whether that had anything To do with the overpatch Because
it took me About five goes To get the overpatch To even stick So this is the
weirdest Thing ever It took forever to stick And then when it stuck It would
not come off So whatever black voodoo They are using Change it please.
Okay Okay, so no overpatch. It's small.

(14:47):
It's great. Question marks around connectivity.
I'm still on board.
Benjamin, your skin just doesn't like stuff generally.
So you might be- That is an accurate statement. You might be an edge case.
I would have said that, but then the first person who I know who also did a
field trial said exactly the same thing. Yeah.

(15:08):
Lauren in our community was like, yeah, same thing.
Super weird. Don't get it. Still small, still cool. Yeah.
So there are some, back to the geofencing issue, there are some issues.
Let's get back to another thing that sucks. Yeah.
There are some solutions. You can bring a G6 with you, but, like,
good lord. I knew you were going to say that.
The solution is don't use G6. Adam, why would you even?

(15:31):
I know. I know. Plus, I don't think you can even order them from the pharmacy,
like, because you'd have to change your NDSS. No, no, no. Let's just backspace.
You cannot bring a spare G6 with you. All right. Carly says no.
You can't access that if you're accessing a G7.
True, true. All right. Sorry, forget I said that.
You can use the G7 receiver.

(15:51):
You're funny. Do you get that for free? I don't think so. Yeah, that's another no.
You can set up a VPN back to your home country, which for the uninitiated is
a virtual private network, which basically allows you to trick the internet
into thinking that you're in a different location than you actually are.
Easier than it was once upon a time i think you can get like

(16:13):
i think express vpn for example they do you can
actually get a vpn on your phone so you don't have to do too much weird stuff
you just install an app but should have got sponsored by a vpn company that
would have been a brilliant well we can still still can still talk to them or
you can you'll love this one benjamin what's called a biota a build your own
dexcom build your own dexcom yep yep so this is android only so if If you're

(16:34):
on iPhone and go to a different country,
you can- Deserve everything you get. Yeah.
You can go buy some crappy Android phone from a service station and then build
your own Dexcom app from some weird site off the internet, and then you can
get reading. Yeah, they're not elegant solutions.
VPN, I mean, for me as a tech person, I'm like, sure, that would work. But even still.

(16:58):
Carly, are you all right? She's managed to attach her hair to the back of her
shirt, and she's writhing all over for the table i cannot get it off i'm sorry,
Do you need a hand? How did you do that? Oh, it keeps catching.
But this one's really cool. Can I get the scissors? Can we just chop it? Absolutely not.

(17:19):
Spoiler sport. So Carly has just demonstrated a point that I was going to make,
which is that things go wrong at strange and random times.
So back to Descom G7. So you travel. Yep.
Every time you travel, you risk Murphy's Law. We know this with insulin pumps.
Things do go wrong. When we see GMs, things go wrong.

(17:41):
They wait. They know there is a sixth sense. Are we living in a world where
they assume that you have to stay in your state if you have G7?
They're trying to control us.
I can see how some Dexcom software nerd was like, this is a super elegant solution.
We'll just tie it to whatever country they're from and we'll tie it to their
account and blah, blah, blah. But it's like people move and people get on planes

(18:04):
more than they ever have.
Sure do. So, yeah, not viable. And apparently, at the moment,
Dexcom support staff don't even really know what to do with it.
So, they're all giving different solutions. I know, because you just went through
the solutions, which were break the app, go find a VPN. Well,
and those are like the best solutions that the community has come up with.
That's not even, Dexcom won't recommend a VPN, right? Because then you're using.

(18:25):
What's Dexcom going to say? I don't. Go home.
Sorry, holiday's over. We'll send you a G6.
Yikes. Okay. Okay, well, it's not here yet. Pack the glucometer.
Yeah, I mean, your pump's not going to work, but yeah.
Anyway, moving on. So, Carly, this is your segment. If you've finished being

(18:50):
a drama queen with your hair.
Oh, that was a look.
Thank you, Adam. You're such a delight. We're going to move into one of our
fave sections, how I type one. And today we are talking about exercise.
And I'm very looking forward to talking about exercise. We don't talk about

(19:10):
it enough when it comes to type one.
And we know, like we know that exercise is so beneficial for our mental health
and physical wellbeing.
However, when it comes to type one, it feels like we need a double-sided whiteboard.
The planets need to be in a certain place in order for it to all work.
And we know exercise is possible. We see people with type one do amazing things.

(19:33):
We've got type one athletes, AFL players, netball players, Olympians.
And then sometimes it feels like impossible to grab the dog and go on a 20-minute
walk around the block without having to shove your face full of jelly beans.
So it's one that we don't learn enough about, but it's super important to talk about because.

(19:53):
It's super beneficial for you and for your glucose management as well.
We thought this was quite timely too, because we've got our interview with Duncan Reid next episode.
I know we told you last episode and the episode before that,
that Duncan was coming next, but it was a whole thing. Duncan is coming, we promise.
But as a preamble to that, we thought we'd kind of just share how mere mortals
deal with exercise before we get to Duncan Reid, the pro.

(20:16):
And I think also, as we were talking about, because the education around exercise
is often, to put it mildly, crap. Crap.
I mean, I was told it's really hard.
Thanks. Thanks. Good on you. All right. Bye. Yeah. I will say the same thing.
And just to give a bit of background to it, as some people know,
I've spoken about it before.

(20:36):
I was working as a personal trainer at the time. I've had many years in the
fitness and nutrition space, and I was diagnosed right in the middle of that.
So I felt like, okay, this is pretty crappy outcome, but I've got some good
information and education behind me.
And I was told, as far as exercise goes, make sure you have a snack of carbohydrate value.

(20:58):
So, I was like, okay, I must eat before I work out.
Predominantly, I was doing resistance workouts, so lifting weights.
So, I was like, okay, first time when I was feeling better, walked into the gym, had a banana.
I was like, that's carb-y, let's go do do this.
And then I was checking kind of every 15, 20 minutes to see what was going on

(21:20):
and went like totally through the roof and continue to go through the roof for like a solid six hours.
And I just remember sitting there very confused.
I felt shocking. Like I'd gone in to do this workout to feel better.
I started to feel worse. I came out of it feeling worse. And then I felt very
deflated for the next 24 hours.

(21:41):
And you would have had a high pitched voice apparently. apparently oh i'm so depressed,
that's a shit.
Uh, so yeah, it was very confusing for me and I thought, okay,
maybe that was an isolated incident.
I tried again, reduced the amount of carbs I was having each time I saw that

(22:01):
I was going up and I was like, okay, something's really not right here.
And that kind of started my rabbit hole into research about exercise and type
one and figured out that different exercises actually will have a different
effect on your glucose levels.
Yeah. Okay. So can you take us through the theory of that? Yeah.
Let's just put it super simple.

(22:21):
So let's talk about our two main parts of exercise. We've got our aerobic exercise,
which is like you're walking, you're swimming, you're running,
jogging, you're steady state cardio.
What we know about aerobic exercise is that generally you are going to trend down.
So you either need to manage that by pulling back your insulin requirements
for that exercise or managing with glucose.

(22:43):
Our other part of exercise is your anaerobic exercise and this is your weights
lifting or your resistance type of exercise, it does really depend on how hard
you are working, how heavy you might be lifting and for how long.
But generally, you're going to see an increase and this is because we have more
stress hormones running around in the bloodstream when we do this and the body's

(23:05):
like, oh, we cannot sustain this and it starts pushing up things like cortisol and that.
I don't think I'd ever have that problem. I just can't imagine myself putting
myself through that kind of hell. Yeah.
I don't know. It looked like you were having a pretty hard time in Pilates yesterday
morning. Bloody oath. Yeah.
Not doing that again in a hurry. So again,
yeah, it'll be more dramatic if you are lifting really heavy,

(23:28):
really challenging, or you've got a PT who's grinding on your tail and making
you push through those last few reps, you are absolutely going to see an increase.
Back, my little brother was actually training me. He's a PT in the early days
of type 1 because I just felt like I needed a little bit of motivation.
Let's get the sibling out. He can beat me. I'll be angry at him. That's fine.

(23:51):
And slowly through trial and error, I figured out I actually needed like a little
bit of insulin to help cover that rise, even for post-exercise.
So I'll just be super clear. It is a trial and error period.
What works for me is not going to work for everybody else, but it's often what
Now that I'm on a pump, that was MDI days, I actually don't have to take a bolus

(24:13):
for that type of exercise.
The algorithm will actually be enough to handle it.
And then you have to watch out after. So, often you're going to get this immediate
rise when you're lifting weights and doing resistance types of workouts.
You have to be quite careful coming off the back of that about an hour or so
later because you will start to see a little bit of a dip generally as well.

(24:33):
So being mindful about what your post-workout bolus is going to look like if
you're heading into a meal.
So the dip is, I'm assuming, that the muscles are then kind of rebuilding and
like pulling glucose out so that they can heal themselves.
And you're more sensitive to insulin after any workout. So that sensitivity
kicks in once the stress hormones have faded away.

(24:55):
And I might just add on that as well, just to give a bit of clarity around that.
When I was on MDI and I did a heavy session at the gym, I would actually have
to pull back my nightly basal insulin for the next two nights.
That's a 48 hour period that I had to reduce my night basal and not by a huge
amount, but around like two to three units, I would have to pull it back.

(25:17):
And that's what I found worked for me. Otherwise I would be going low around
those peak times of the basal insulin.
And then day three, I could revert back to normal. And then by that time I'm
ready to do another workout. So I might get one night in and then I have to to pull it back again.
So, it is a bit of a delicate dance. And for those of you listening going, nah,
too challenging, it can feel that way sometimes,

(25:38):
but it's so important to invest the time and invest the right advice and support
around you so that you can manage the exercise in your day-to-day that really
works for you and makes you feel good. I can't stress that enough. It's super important.
Yeah, I trained for the, well, Carly bullied me into doing the HPF run for a reason a few months ago.

(25:59):
Up until that point, I'd only ever done like 5Ks at a time. I was like,
look, I can run 5Ks now. That's about all the fitness goal I ever need to have in my life.
And then Carly was like, oh, well, if you've done five, you can do 12.
Well, it didn't exactly go like that.
The Family Centre team was running the HPF run for a reason.
And we were rallying the community around us and we had a young man doing the

(26:21):
12 kilometre all on his own and I was like, okay, who of us is one of the better runners in the group?
Oh, you flatter me, Carly. And which distance did you do, Fitness Queen?
Was it the 12K? It was all about community for me. Carly did the four.
So in your corner. Anyway. Okay.

(26:45):
Siblings separate. Back to going from 5Ks to 12Ks. Yes, I digress.
What Adam's trying to say, he took on a wonderful personal challenge,
12 kilometers, having never run that before. Take us through what that looked like for you.
Just recompose myself. So I think previously 5K runs, like I would kind of,

(27:07):
I'd smash a couple of jelly beans to begin with because I knew that I would
just, I would tank super hard and I would just crash.
So even if I started at like 11, I would be low after the end of a half hour 5K run.
So doing 12Ks, I kind of had to figure out what the formula was so that I could stay somewhat stable.
So for me, I think that was, again, just me personally, that was like three

(27:29):
jelly beans to begin with.
And then two every two kilometers seemed to be enough to kind of keep me fairly level.
Level obviously you're always fighting that like delay in cgm
so you know i would start i would kind of keep an
eye on it and then as i would drop below six then
i would kind of treat again and normally by the end of the run i would either

(27:50):
be low or high i never really seem to be able to kind of sustain it for too
long but it was it was it got me through like i never had any major hypos while
while i was running in the race the race was fine they were annoying as all
hell to chew while you're.
Running and dry mouth and all that kind of stuff. But that worked pretty well for me.
There's the whole basal adjustment thing, but I didn't put a heap of effort into it.

(28:14):
But I just seemed, yeah, that was like another factor that I was like,
I can't pull this lever, but it was just giving me wacko results.
And I was like, ah, I'll just smash the glucose.
I guess you were- Well, that's a super interesting place to go,
right? So Adam went with the strategy that I think most of us get taught,
which is if you are going low, bring more glucose and take your jelly beans and it's a quick fix.

(28:35):
But let's throw ourselves to the expert here.
Well, I guess you were training for something in the short term,
right? So it wasn't something that you were going to sustain in your week to week exercise.
You do a 12 case every day? No, no, I haven't really done it since.
So I think, look, it's important to know that when you're training for an event,
yes, you're going to have to supplement with glucose, particularly if you're

(28:57):
doing a long run like that. And that's completely normal.
I don't love running, but I recently wanted to,
diversify my fitness a little bit and had kind of avoided running since I was
diagnosed eight years ago because a guilty, another one of those people that
fell into the category of, it's just a little too challenging.

(29:18):
Like I have to really do some math around it.
And I am one that really dislikes having to feed my workouts with sugar.
I just like, it's something that should make you feel good. I want to go into a workout.
It might be tough at the time. I might want to get out of that workout at the
time, but once it finishes, you feel great.
And I don't want to be ending in a hyper where I'm having to feed with sugar and go, you know what?

(29:42):
I feel crap coming out of that workout and I should be feeling good and it should
make me look forward to the next one.
So that's kind of, mine's more about, I guess, how my headspace works with having
to go low or high during a workout.
I would just love to be as close to a normal person, go in, do a workout,
come out of it and not have to deal with a complicated rollercoaster.
So I do adjust my insulin and it's become particularly –.

(30:08):
Easy actually with the pump because you've got a little bit more flexibility
on when you can change it.
When I was on MDI, I'd have to plan and commit to that basal insulin for the next 24 hours, right?
So there was a little bit more involved, which is hence why I didn't do a whole lot of cardio back then.
I found it much easier just to stick with my gym workouts and that worked for

(30:29):
me. But I decided to get out of my comfort zone.
And recently I just wanted to get around Lake Munga.
Just simply like that's about 4Ks. I just wanted to run around there,
not go low during, not go low shortly after, not go high shortly after,
not be high before the run.
So you're like not asking for a lot. Not much.

(30:52):
And so I did a call out to the community and I was like, runners,
swimmers, cardio friends, tell me what works for you. I'm looking for a little bit of input.
So I did that first and it gave me a really good starting point.
I remember pulling my basal back an hour before the run by about 60%,
and then towards the end of the run, clicking onto exercise mode,

(31:16):
which would reduce my autobolus and just lift my target range.
That was way too aggressive.
I went super high, and then I went super low after that workout when I went
to go bolus for the next meal because I was correcting the high rollercoaster.
Whenever you're high, it's just, it's, yeah, delicate balancing game.

(31:37):
That didn't work. So, I went with something a little more conservative and I
pulled back 40% and I ended up going low. Mm-hmm.
Third time around, it only took me three weeks. And I'll just point out,
I picked one day a week to do this because I didn't have to play around with
any sensitivities and I could get a clear picture of what was going on.

(32:00):
So I was like, Wednesday is going to be my day.
I'm going to carve out the next month. I'm devoting it to just getting this one run in a week.
So although you have to take the time out, it was absolutely worth it.
And then third time, had a Goldilocks moment moment.
And I started at 6.8.
I ran and I finished at 6.7. Oh, stuck the landing. Yeah. I stood,

(32:21):
I just stared at it and I was like.
It was a unicorn moment. So I celebrated, but not hard. And I tried it again.
No, because I did my part.
And it worked. And can I just, while I'm thinking about it, I should have mentioned this at the start.

(32:42):
One of the big don'ts for exercise and type one is do not go off and exercise
when you have some rapid insulin on board.
So that is a steep learning curve as well.
And I didn't know this. Nobody told me this at the beginning,
but for me, I roughly knew that insulin stopped working around the two hour
mark, maybe existed for the third hour, but it really stopped doing anything around the two hours.

(33:05):
So I I thought, okay, I've got to wait two hours after a rapid dose of insulin
for a meal before I exercise.
So doing exercise fasted happens to be one of the most effective,
easiest things for those with type 1, for those, yeah, for those people with
type 1. That is another little tool to have in your pocket.
Unfortunately, I don't do that because I can't move without coffee in the morning.

(33:31):
So, for those out there who can't exercise fasted, I see you, I am you.
I needed at least a coffee and it can't be black, has to have a bit of almond
milk in it. So, I had my coffee in the morning.
I waited two hours and I worked out that I needed 50% less bolus on that coffee.
So, I'm just going to add that in there. I did actually have a little tiny bit of rapid in my system.

(33:55):
So, maybe I had to pull back my basal a little bit more than if you were doing it fasted.
So, we've talked about this before. This is one of the real challenges of type
one, that once you put insulin in, you can't take it out, right?
So, exactly the same with rapid as with basal. Once it's in, you can't take it out.
Life happens, unplanned exercise. My kids are very good at this.
They wait for me to do my bolus and then they're like, we want to go to the park. Thanks.

(34:16):
At that point, glucose is your tool because you've got insulin on board already.
But Carly, our expert here has worked out ways to manipulate the insulin on the other side.
It is a good shout out to get a great diabetes educator if you need help with
the experimentation because diabetes educators are nerds and they love nothing more than a problem.
Hey, I want to do this 4K run around Lake Mungo. Which tool do I pull at what

(34:38):
level of basal, et cetera? They love that stuff.
If you need some more help with that, we also have a exercising with type one
module on t1learning.com, which includes a cool little experimentation spreadsheet,
which is a way to do what Carly just described and say, I'm going to do one
day a week, same thing, vary one thing, play around with my insulin,

(35:00):
see what happens, record the result.
It only took you, what, three times to get to a Goldilocks moment?
Yeah, it took three times.
So, I think, yeah, important to say that you do have to carve out the time and
it's well and truly worth investing the time into which exercise,
you know, makes you feel good.
I'm just going to keep pushing that. I feel passionate about the space, like go and do it.

(35:21):
And if it feels like too much of a complicated life experiment,
then you get the people in your corner that you need.
Being accountable for it was one thing, which is why I put it out in the community
and was like, hey guys, I'm going to try this this week. What's your tips?
And then once I told everybody, I was like, well, I actually have to go and do this now.
So, being accountable, I then had to report back and be like,

(35:41):
hey guys, this didn't work.
I opened myself up for having to try that again a third time.
And I was so happy that I did because I may have dropped it before that.
So, be accountable, but find someone who will come and do the exercise with
you or tell someone about it, whether that's a professional,
a personal trainer, your diabetes educator, whatever it is, have someone there
in the corner that you can come and report back to. It really does help. Yes.

(36:03):
And then jot it down. Once you've done one, once you nail it,
you do really feel like you're a super person. Absolutely.
So I'm going to chip in here with a fun little story as the least fit of the
three of us, but I also love exercise.
And as you may know, if you've listened to the podcast, I have been doing martial
arts for a little while now. I love my karate.

(36:24):
I just want to remind everyone that Type 1 likes to throw little challenges
out there. So here's a really good example.
Obviously, martial arts and insulin pumps and CGM is fun generally because people
are trying to kick me and punch me and my technology doesn't like that very much.
So a couple of, it must be a couple of weeks ago now, I inserted a new CGM just
before a karate class, probably a poor choice anyway, but nevermind,

(36:47):
and got a bleeder as you do.
Delightfully bloody one, but you know, bleeders are readers, so continue, off we go.
Went into class, where do you think I got hit?
On the CGM. Straight on the CGM. Sidekick straight into the CGM. It goes flying off.
You know, that's confronting enough. It's not like I start the class and go,
by the way, I'm a cyborg. Please don't kick me in my technology.

(37:10):
Rips it off. All the blood that's been pooling underneath it comes out in a bit of a spray.
Murder scene. So first off, my partner is horrified because they've just kicked
me and blood's gone flying everywhere.
Everywhere i'm wearing a white karate gi which suddenly
gets a freddy krueger style spray of blood along
it the sensei comes running across thinking that someone's

(37:31):
been killed and i then do the rest of the class with this beautiful blood spray
over my karate jacket you just have to laugh that's my advice on that sometimes
type one is just funny that was really funny yeah no one's gonna want to spar
with you after that they'll be like this guy is like off the wall's insane.
Started off some cool conversations about what type one is though.

(37:52):
Yeah, good education moment.
Absolutely. And now people are a little bit cautious about kicking me,
so I win more sparring competitions. So there you go. Use your type one as an advantage.
All right, we're going to wrap up this little segment of how I type one with
a couple of key takeaways.
I think the most important one is don't listen to people who say you can't exercise
with type one. 100%. Absolutely possible.

(38:13):
We have seen people go from finding it really hard to take the dog for the walk,
all the way up to ultramarathons and Olympic competition and everything in between. It is all doable.
It isn't easy, as we spoke about, and it is an experiment of one.
So no one can tell you the answer because everyone's body is different,
everyone's life is different, but it's kind of a fun experiment to go and work out what works for you.

(38:37):
The super exciting thing is that there are thousands of other people living
with type one who have gone on that same journey and are more than happy to
chip in their opinion, aren't they, Carly?
They are. Ah, don't be afraid to ask. I will pick up the phone any day and have
a chat about anything type one.
I mean, it's a big part of what we all do here, but definitely it's something that you want to do.
Reach out to the community, reach out to other people with type one, see how they did it.

(39:00):
It'll give you a little bit of a confidence boost and know what you're doing
and what you might expect from that type of exercise.
And if you're still concerned, go with something that's super low impact,
like Pilates or yoga, generally has a minimal response on your blood glucose
levels. That's true. I can vouch for that.
Start, experiment, have some fun, chat to other people who do it,

(39:23):
bring great people onto your team if you need them.
Good information is always good. Excellent.
It's time for an ad break, I think. I believe it is. Excellent.
Take it away. The Life in Beta podcast is brought to you by. Brought with an R.
Sorry. Something that happens at my family dinners. Like someone will say,
oh, yeah, I bought some blah tonight. And my sister goes, brought?

(39:45):
We can retake that segment. Adam may not be here for the next podcast.
Regardless, this podcast is
brought to you by us, the delightful people at the Type 1 Family Centre.
And we would love to remind you all that if you have been listening to our podcast
and hearing us talk about low-carb options and the option to vary diet as a

(40:06):
way of helping to manage type 1,
then we have curated a range of recipes into a brilliant cookbook,
the Carb Conscious Cookbook, which is battle-tested recipes,
the best of the best reduced-carb recipes for you to try out and see if they
help you with your blood glucose management.
Benjamin, that is available as an e-book and a physical book.
You can find out more information on the Type 1 Family Centre website.

(40:29):
That is some information I have brought to you all. Thank you, Mr. Proclo.
Nicely wrapped around there, Benjamin. Like a pro. Like a pro.
It's time for, now this is really annoying. You know, we have our little like
pick of the week, but you might not have heard, we do little finger clicks just
then, but we have an AI that goes through and just makes little tweaks to the
final edit of the podcast.

(40:49):
And it removes helpful things like ums and ahs and stuff.
It'll be interesting to see whether that makes it through either.
But the finger clicks get removed as well.
So I don't know. I'm going to have to figure out a workaround for that.
Disappointing. You're not getting the full experience. He's going to have to
do the work himself instead of outsource it all to AI. Something like that.
Anyway, time for prick of the week. Prick of the week. Oh, all right.

(41:13):
What? You were saying Adam's the prick of the week? I can riff on that because,
you know, we just had a grammar lesson.
Moving on. I want to rant. No, no, shocker.
Today, it's about expiry dates on supplies. Oh, my goodness.
All right. So we were going through some of the kits here at the Family Centre.

(41:34):
And why can expiry dates not be the same so that I can say, okay,
every 12 months I need to renew this stuff? No.
Ketone strips have a different date. Insulin pump supplies have a different date.
CGMs have a different date. I look at the CGM box and I can't work out which
one's the manufacturing date and which one's the expiry date and who cares about
expiry dates anyway and then I use one that doesn't work.

(41:54):
They don't even write expiry date on it. They've got that weird hourglass symbol.
Yes. Yes. I know. In what universe is that expiry date? Yeah.
I feel like the medical industry with all the restrictions that are on them,
it would be kind of required that you very clearly write what this date actually is.
I have to press a button four times to confirm, yes, I know I'm giving myself

(42:16):
an insulin bolus, but they don't have to write expiry date. Maybe you should replace it anyway.
Breathe. I know. It can be super annoying because we don't, with technology
now, we don't use testing strips that often, but we do know from reports from
the community that they can be wildly inaccurate.
So even if you have expired strips, like I've done this before where I've been

(42:37):
like, Like, okay, I need to double check this new sensor. Something's not right.
And then I see that I'm like a year out from my expiry date on the strip.
And I'm like, is this even worth
it? Like, I can't even believe the result that it's giving me, can I?
For me, it's ketone strips. Because like you're meant to have ketone strips
that are in debt all the time, just in case for those times when,
you know, you're running super high or you're sick or whatever it is.

(42:59):
And they're like 10 bucks a pack or something for 12 of the buggers.
And then when you actually need them, they've expired. You blow the cobwebs off the thing.
Yeah, useless. Batteries in your backup blood glucose monitor. Yes. Again.
That's annoying. I only need it when my CGM doesn't work. We've spoken about Murphy's Law.
It will happen and I will have it there and be very excited.

(43:22):
Look, I bought my thing. I did my, oh.
No, I had to switch to the charging, the Leroy charging one because.
But then I've got to remember to charge it.
That's, at least that's doable. You have a dead battery and you're trying to
test your blood glucose.
No deal whereas you can just plug this one in and wait like two minutes and
it's going to bring something to charge my yeah i think it has the right connection

(43:45):
because it uses one from 40 years ago yeah it uses mini usb i think which nobody
something nobody uses mini usb anymore,
he's not going to take anything that i'm going to say it's all just a hassle
and it sucks and it's my prick of the week so yes expiry dates,
Awful, awful, awful, awful. Let's lift the mood and go to our pick of the week.

(44:08):
Yes. So this is an app I found on YouTube.
There's a, I can't remember his name, a YouTuber. He's awesome.
He's from Europe somewhere. Clearly he made an impression.
No, I watch all his stuff. It's great. And he did an intro video to an app called
Sweet Dreams. Which is only available on iOS and is therefore my prick of the week.
Well, too bad for the iPhone users at the table and in the community.

(44:31):
And they are, the developers are apparently open to, this is if I was a developer,
this is what I would say, open to creating an Android version.
So we'll see when they get around to that.
But yes, it's an iOS app, but basically it is a replacement for your standard CGM app.
So if you use Libre or Dexcom, or even if you use Night Scout,
and Medtronic is coming, this is an app that you can use that gives you all

(44:54):
kinds of different customization options. So different alarms,
you can change the graph, colour, height, time in range, sorry, range, height.
What's a high and what's a low. Yeah, all this kind of stuff.
It's got versions for the Apple Watch, for the iPhone.
You can put stuff in CarPlay even, so you can see when you're driving.
You can get an extra complication that goes on your Mac. Like all,

(45:15):
it's just everywhere, all kinds of different options.
I love that it's called a complication. It's exactly what it is.
That's an Apple nerd term that I shouldn't have bothered using for this,
people. He's set himself up. Now, Carly, you have been trial running this app.
Would you like to show everyone how many notifications this app has given?
Yes. Well, this is Adam's pick of the week.

(45:35):
It quite possibly might be my disappointment of the week.
I can't give a completely like accurate profile on my experience just yet.
I downloaded it yesterday afternoon, so not even 24 hours yet. it.
However, it's a little too bossy, if I'm honest.

(45:57):
So it is giving me, and I'm sure you can change this. I just haven't been able to go in yet.
Five minute updates with what my blood glucose is doing.
So yeah, I heard my phone vibrating like constantly yesterday afternoon noon.
And it was like right after lunch. And I probably should have pre-bowled for lunch.

(46:19):
So I had quite a lot of things going on. So it was just like,
brr, rising at, you know, 0.3, brr, rising again at 0.2. By the way,
did you know you were rising?
You're rising, rising. Every five minutes it's like-
rising rising and then it got above eight and
it's like glucose high and i'm like

(46:40):
um excuse me settle down
so do much i know just like a bit of
awareness for those that tend to feel a little bit overwhelmed by the tech this
may not be the right thing well you're gonna go you're gonna customize it right
so all of this stuff is customizable we should we should have done it before
the show gone through and and sorted that out so you can we are field testing

(47:03):
what it's really like to install the app,
which is that it's a whiny, annoying thing until you.
Customize it and then you can make it what you want.
Positively, I will say it gives you a lot more insight, clearly,
every five minutes at what exactly it's doing. So it does give you good information.
But what I will say is that some of the cool features that you have listed here

(47:25):
on our run sheet today, you have to pay for.
So it's Not super expensive. It is $29.99 for the year.
So that is pretty reasonable if you see value in the app or it's $5 a month.
And for me, I just was kind of like, oh, like Netflix, like kids apps.
I was like, I don't really need another thing to pay for. But some of the features,

(47:46):
as you've said, are quite cool.
Like seeing it visible on your lock screen, seeing it visible on your screen in the car.
It could be quite cool. We need to report back on it. but it's something new
that, you know, Adam's gotten excited about.
I'm a bit like, ah, a little bit too much.
So there's this cool feature where it's got like a nightstand mode.
So you turn the phone horizontally and like put it in your little nightstand

(48:07):
and it does like a dark screen with, you know, your trend and your number and all that kind of thing.
So if you wake up in the middle of the night, you can just see the number.
Kind of like that sugar pixel clock thing. Yeah, 100%, 100%.
There's some cool accessibility features.
So you can, it will read your readings to you. And again, you can choose when
it reads them, what range, that kind of thing.
So handy either if you have a vision impairment, but also for things like if

(48:29):
you go for a run, it'll do it through your headphones.
So it will tell you your number and your trend.
But again, only if you're above or below certain points or whatever.
This is quite funny. If you're working on your MacBook, the alerts are going
to come up on your MacBook.
Well, yeah, if you want them there. Again, fully customizable.
It's just options, people. No escape from your blood glucose.

(48:50):
Android people would appreciate options. That's what you people are all about.
I think we should have a new segment, which is Carly's of the week,
because we had this with Smart Insulin as well, where we were really excited
by Smart Insulin. And Carly's like, no.
And then Carly's going, no, it's never going to happen. Not convinced. It sounds like rubbish.
Cynic of the week. I do have that part to me, and it's funny,

(49:12):
because I generally get excited by things, like new shiny things.
I'm like, ooh, exciting, exciting.
But there is a clear pathway for me that's like,
Yeah, no, I don't think so. Last feature, I'll tell you about this.
Helpful for parents, maybe partners,
depending on whether you share with your partner or not. I don't.
Where it's called ping. So if you're following your, let's say your child,

(49:36):
and you see them up or down or whatever, let's say they're having a hypo,
you can ping them through the app.
And then with touch of one button, they can say, yep, acknowledged.
As in, yes, I'm doing something about it. But so like easier than getting a
phone call or even a text message where you have to type and reply or whatever.
It's just like, have you got this? Acknowledge yes.
So at least you know they're conscious and they're able to do something.

(49:57):
The customization is very cool.
Yeah, I did see a funny little thing. There's some kind of like customization
here called Dynamic Island that you live in.
And so you can actually choose emojis to replace readings on your graph,
which is that is quite funny. I do quite like that.
Yes, it'll sit up in the up in the Dynamic Island. So once you hit like a certain

(50:18):
number, it'll show your emoji of your face.
That would soften the burden of getting so many notifications if you see yours of choice.
Yeah, like above 10, it's just eye roll. Yeah, or like the poo emoji. Yeah.
Customisation like that is cool, right? It brings a little bit of fun into it
when you're trying to collect data. So I do appreciate that.

(50:40):
But we need to look into it more.
But putting it out there. So it's called Sweet Dreams. You can get it on the iOS store.
Again, it works with Freestyle Libre, Dexcom, G6 and G7 when it launches, and also Night Scout.
So if you're into DIY looping and you've got your CGM stuff in the cloud already.
Probably already got Xtrip and Xtrip is cool. But anyway, moving on.

(51:00):
So I guess would it be similar as well to like Happy Bob? Is that what it was called?
Happy Bob was before my time, before I was paying attention to these things.
So, I did hear good things about it. Was it Happy? Okay. Yeah. Anyway. I don't know.
I didn't use it myself, but I remember it being a bit of a thing,
particularly, I think, for kids with type 1, just adding a little bit more,
I don't know, fun. Levity. A little bit of fun into it.

(51:22):
Although, it would give you some pretty interesting remarks when you hit certain glucose targets.
Like, kind of sarcastic. Oh.
Like, I'm pretty sure. I don't want to say it out loud. How's that rage ball
that's going for you? Yeah, I think there was like a Karen.
Like there was like a happy Bob. I think there was like a Karen.
Oh, wow, Karen mode. That's cool. Yeah, yeah, Karen mode.

(51:43):
Again, bit of fun. Take it. I don't need a Karen telling me what to do with my blood glucose.
Thank you. But key takeaway, there's lots of customization out there.
Sweet Dreams, Xtrip, there's a whole bunch of them.
So don't feel like if you've got the app for your particular CGM, you don't like it.
There are options out there. There's lots of tweaking you can do.
Make it work for you. do not have every five minutes, you are raising your blood glucose by 0.2.

(52:05):
Yeah, probably. Yikes. Not the way to go.
All right. Thanks for joining us. That's Life in Beta for another week. Next week.
Everything we said about exercise will be blown out of the water by the incredible Duncan Reid.
And he is actually coming this time. It's happening. Next episode,
Duncan Reid. That's all. Ta-ra.
Ta-ra. Ta-ta.

(52:26):
No, you can't mix it up now. No, Carly, I'm not buying it. No.
Music.
If you've been listening today thinking that is so relatable,
you should consider joining our online community where over 1,000 other people
with Type 1 are sharing their experiences, learning and supporting each other.

(52:48):
Head to type1familycentre.org.au forward slash connect.
No, no, I'm sorry. I'm not doing ta-ra. You did last week. You just said it
anyway. We can cut that, right? We went to Scatter 2, right?