Listen, if you have type 1 diabetes or your kid has type 1 diabetes or someone you love has diabetes or perhaps you have type 2 diabetes and are taking insulin, I can confidently say you need to own a copy of this book and actually read it. I call it my diabetes bible and refer back to it often! It will teach you how to manage your insulin better and empower you to make all those hundreds of daily diabetes decisions faster and with more confidence. I sure do hope you will follow along with us. See links below to get your copy from Amazon or get your signed copy from the author, Gary Scheiner, on his company's website, integrateddiabetes.com. Enjoy!
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taming, the highs and lows.
My amazing guest today has notonly been living with type one
diabetes for several years, butshe is also the.
(00:20):
Of a little girl living withtype one.
In other words, she has a lot ofinsight and wisdom to share with
us.
I love this chapter, anothergreat chapter.
That's going to talk all abouthow to prevent lows and highs
before they become a majorproblem as always, you can check
out the show notes to find alink to where you can buy your
very own copy of think like apancreas and follow along with
(00:43):
us.
All right.
Without further ado, let's getstarted.
You're listening to the sugarmamas podcast, a show designed
for moms and caregivers of typeone diabetics here.
You'll find a community oflike-minded people who are
striving daily to keep theirkids safe, happy, and healthy in
(01:05):
the ever-changing world of typeone.
I'm your host and fellow T one Dmom, Katie Roseboro.
Before we get started.
I need you to know that nothingyou hear on the sugar mamas
podcast should be consideredmedical advice.
Please be safe, be smart, andalways consult your physician
before making changes to the wayyou manage type one diabetes.
(01:29):
Thanks.
All right, everybody.
I am here with Samantha todayand Samantha and I are gonna be
going over chapter nine of thinklike a pancreas and chapter nine
is called taming, the highs andlows.
So this chapter is all about, ithas a really big focus on
preventing low blood sugar, cuzthose are just not good and are
(01:54):
the most dangerous.
But then also the second half ofthe chapter talks about
preventing uh, high blood sugarsand after meal spikes.
So this is another great reallypractical chapter in my opinion.
But before we get started,Samantha, I would love it.
If you would introduce yourselfand just tell the listeners how
you are connected to the worldof type one diabetes.
Samantha (02:13):
hi everybody.
My name's Sam.
I am located all the way acrossthe country here in
Pennsylvania.
I have been a type one diabeticsince I was 11 discovered by my
mom.
We have a whole mess ofdiabetics in the family.
And my grandmother was sittingat the table and noticed me like
chug a glass of water, which I'mtold was abnormal.
(02:34):
I was like a soda girl, I guess.
And I have no, I don't rememberit whatsoever, but they checked
my blood sugar, like on thespot.
And I was, my mom tells mecorrectly, four 60, something
like that.
So I was actually diagnosed withdiabetes the day after the.
Nine 11 attack.
Oh.
So I was in a hospital bed withthe news being just awful.
(02:57):
It was just mm-hmm so September12th was my day, but it was just
awful, but yeah, so I've beendiabetic now for about 21 years.
And then I also had a nine yearold daughter who has been type
one for the past two years.
Katie (03:09):
I just have to know,
like, as you've obviously been
living with diabetes for a whilenow, which it's, first of all,
it's crazy to think that nine 11happened that long ago.
But anyway, I know, I knowmadness.
I know.
But so how is it like livingwith type one and then having a,
now a daughter that is diagnosedwith diabetes?
(03:30):
Like, is there any part of youthat's like, okay, we got this
or just as a parent, are youstill just freaking out?
Like what?
Just take me through theemotions of that whole scenario.
Samantha (03:39):
So for me, diabetes
is.
Eventually, I, I always like tosay, to tell people that either
just got diagnosed or other kidsgot diagnosed, like eventually
it's just such a part of youthat it's, it's just something
you have to do every day.
It's not something that youdread or you're annoyed with or
it's whatever, it's justsomething you do.
So I get a little, like, I wannause the word, like frustrated
(04:02):
when I see some posts, like fromdifferent diabetic communities
that are like, they really comedown hard on themselves because,
and they're newly diagnosed andit's like, man, you just wanna
be like, it gets easier.
You know what I mean?
Like you just want to be like atfirst it's so frustrating it for
you to have it.
And then.
eventually, it's just, you justdo it.
Like you just have to carry on,like, there's, there's no one at
(04:25):
the end of the day, if you havea breakdown and you're like, you
know what?
I can't do this.
No one else is gonna save you,but yourself with diabetes, like
mm-hmm you gotta just keep onkeeping on scenario.
So it's like, Ugh, gosh, we havethat moment of frustration.
Like, let yourself be annoyedthat you were super low or super
high, but like, it has to besomething that you think about
every day, but doesn't consumeyou every day.
(04:45):
Does that make sense?
Katie (04:46):
Yeah.
Yeah.
Like.
Yeah.
And I mean, OB I don't have typeone, but I just, as the
caregiver of one, I just feellike the longer time goes on
too.
You do, you really do have toadopt a little bit of an
attitude of like, whatever, man.
I mean, that's not to say thatwe're like being reckless and
just, I mean, obviously we wannamanage my daughter's diabetes as
well as we possibly can, butit's just as, you know, diabetes
(05:10):
just doesn't always play by therules and never just forget
things.
Like sometimes you just forgetto pre bolus or you did you
screwed up the carb count orwhatever it is.
Yeah.
And now you're at 300 and it'sjust like, you just have to
learn to be like, whatever, likewe're gonna get through it.
Yeah.
We're gonna get the number downand tomorrow's another day.
Like you really that's exactlyhow
Samantha (05:30):
I feel with Amelia.
Like yeah.
You know what, like it's, it wasa crappy day.
I totally get it.
But at the same time, likeyou're gonna be fine.
Like, yeah, you were SU you weresuper low.
Oh man, take a nap.
We gotta we'll come back for theday after that you're super
high.
Let's get your blood sugar downand let's like, go for a jog
together.
Like it's just something youhave to do while it's
frustrating for everyoneinvolved at the same time.
(05:52):
You like, can't let it ruin yourlife.
So it's like gotta learn how tojust figure it out day by day.
Katie (05:57):
And, and just move on,
move on.
Yeah.
Yeah.
Yep.
Well thank you for, for thatinsight.
And okay, so I'm sorry.
Your daughter was diagnosed whenshe was two.
How old is she now?
Samantha (06:06):
She, that was when she
was seven.
That was like August of 20, 20.
Katie (06:11):
Okay.
I'm sorry.
You said two years ago, Ithought.
Oh yeah, yeah, yeah.
I thought you said when she wastwo.
Okay.
Okay.
Got it.
Okay.
So yeah.
Oh, all right.
Well, my daughter was diagnosedright around the same time as
your daughter.
Cause my daughter was diagnosedin August of 2020, so yeah, man,
you had like the two worldtragedies, like you were
diagnosed the day after nine 11and then your daughter is
diagnosed in the middle of apandemic.
(06:32):
Exactly.
No, no, no more a mess, a mess.
A mess for sure.
Oh, that was not fun.
Still not fun.
No, but okay.
So real quick, before we jumpinto the chapter, I'm just
curious, would you share withlisteners, like what you guys
use in terms of like, are youdoing MDI?
Are you doing pumps?
What are y'all on?
Samantha (06:51):
Yeah, so I was on the
tandem T slim for the longest
time.
That kept me the best in controlwhile we were attempting IBF
with my now son who's here.
Oh.
But he I'm MDI now because afterhe was born long story short, I
didn't need insulin for like amonth so I was like, oh my gosh,
I just took everything off.
I'm like, do you know what?
(07:12):
We're just gonna like, holdinsulin until I can figure out
what I need.
Mm-hmm so I'm MDI Lanis and noblog for now.
And Amelia is a Potter.
She just got the.
Katie (07:21):
Okay.
Oh, that's very exciting.
We are also potters.
We are actually on the old, theclassic, the arrow system at the
moment.
Oh my gosh.
And now we just got approval forboth the dash and the Omnipod
five, like officially letters inthe mail.
Which is great.
But I don't know.
I'm like hesitant to switch tofive just cuz we're doing DIY
loop now, which you know, isanother automated system and I
(07:44):
don't know.
I just, I don't, I can't decideif I wanna, I actually emailed
the endocrin just this morningand I was like, can I, I just.
This is just like a generalquestion.
Like, can we flip flop cuz likeright now?
Yeah.
You know, like, can you write usa prescription for the five, but
like two, three months from now,if we don't like it, can we try
the dash?
And I don't know.
I just wanted to feel her outfor it.
Like I don't, if you're approvedfor everything, like if you can
(08:06):
get coverage, is that reallythat big of a deal to just
Samantha (08:08):
so for the five, this
is probably good for info for
you to have.
Okay.
We have the dash, but the fiveyou can do automated or manual.
So doing it manual is just likethe dash.
Okay.
Okay.
So, and that's honestly what wehave Amelia on, because I don't
know about you.
I'm a little bit of a controlfreak with Amelia's diabetes.
(08:28):
Like I wanna know that theinsulin she needed, I gave to
her, or if, gosh, forbid shewould go low.
Like I was the reason not likeher pump malfunctioning or, you
know, so mm-hmm, yeah.
I'm having a little bit of acontrol problem with the
automated system, but I'm, I'mworking on it.
I'm working on
Katie (08:45):
it.
Yeah, no, I am.
I'm the same exact way when weswitched to the DIY loop, our
control.
Yeah.
I think I was, I think wehonestly had better control when
we weren't on the automatedsystem.
It's getting better.
I mean, I think we're getting towhere it's like the same as it
was before, but man, it's takenus several months to get there.
Yeah.
Or a few months.
Um, But yeah, I'm, I'm alsocontrol freak, so, And the
(09:07):
author of this book says that inthe little section that he
writes about the automatedsystems, he's like, if you
already have really good controlof your diabetes, like these
systems might really frustrateyou.
So, yeah.
And I was like raising my hand.
Okay.
That's good to know that themanual mode is this basically
the same as dash.
Let me tell you what I'm let metell you one of my biggest
hesitant the thing I'm mosthesitant about is that you
(09:28):
can't, there's no view app.
So I can't see.
What she's done.
Like if I tell her to do thismany carbs, like I can't
actually yeah.
See that she's done that.
Because there's been times whereshe hasn't and then of course
that right.
Results in really high bloodsugars and stuff.
So, and I know they're workingon it, like the Omnipod FAQ
section says that they areworking on a view app for the
(09:50):
Omnipod five, but like right nowwith DIY loop, I use night scout
and I can see everything thatshe does.
Yeah.
And I.
Again, with the control freaksituation.
I'm like, I don't know if Iwanna lose that.
So yeah.
Samantha (10:03):
So with the five too
it's not compatible, I don't
know if you're a Samsung girl oran apple girl, but it's not
compatible with iOS yet.
And that had me wow.
Up.
I was like, oh my God, come on.
Like, I was so excited to getrid of the phone.
Like she, everyone, her kids inher class were like, why doesn't
they have two phones?
Why doesn't they have twophones?
And I was really hoping to justget rid of one and yep.
(10:26):
They were like, maybe somedaysoon.
I'm like, do you know what onthe pod come on, man.
Katie (10:31):
I mean, I, they have to
be working around the clock to
get that done because I wouldsay over half the population
uses iPhone.
Like they've got to get thatdone.
So, yeah.
And they, they have said severaltimes, like we're working on it,
we're work working on it, we'reworking on it.
And I know that Apple's kind ofa pain in the butt when it comes
to like jumping through theirhoops and getting across their
red tape.
So I think it's just a matter oftime, but yeah, I think Same.
(10:54):
I, I totally agree.
I'm like, can we just get rid ofone device?
That would be so great.
Yeah.
I
Samantha (10:58):
know she would be less
mortified when she got them out.
For
Katie (11:01):
sure.
Yes.
Yeah.
Okay.
Well, I guess we should talkabout this chapter yeah, yeah,
of course.
Alright, so we're gonna dive inagain, the, the name of the
chapter is taming, the highs andlows.
Again, I just wanna encouragepeople.
The author, Gary Scheiner isamazing.
He was so kind in giving me thegreen light to do the series,
and I just highly recommend thatyou buy a copy of the book.
(11:23):
I refer back to it all the timewhen I just need to be reminded
of something.
don't rely on me and Sam to giveyou every single detail of this
chapter.
Like there's just too much forus to talk about in an hour long
podcast.
And there's also lots of graphsand tables that you're gonna
wanna see with your eyes that Ireally just cannot possibly do a
good job of describing withwords.
(11:43):
So get a copy and follow alongwith us.
Okay.
So the first thing that I lovedabout this chapter is the author
reminds us that even people whomanage their diabetes to a T and
meticulously still spend around25% of their time out of range.
So everybody just take a deepbreath.
Perfection is rarely achievedwithout losing your mind, at
least.
So just keep that in the back ofyour mind.
(12:05):
But he really starts off strongin the chapter about encouraging
people to do whatever they canto prevent low blood sugars
because there's really just nobenefit to having.
Multiple low blood sugars.
I mean, as his wife, theauthor's wife.
So lovingly said, she said, anyidiot can have a decent A1C if
(12:26):
they're taking too much insulinand going low all the time.
So, and that's true, right?
Like you can be having thesemajor crashes, which will lower
your A1C, but it's just not safeand it's not healthy for
anybody.
So you know, I'm gonna, I'llgive some reasons soon other
reasons why you wanna avoid thelows.
The author kind of de definesmild lows as like in the, kind
(12:47):
of in the seventies gettingcloser to like upper sixties
moderate lows, he says are likein the fifties and forties and
then severe lows are more likein the twenties and thirties, or
if you just have a reallyprolonged, like moderate, low
but mild lows.
Okay.
So here's the reasons why youwanna prevent these things.
They cause poor physical andmental performance, which can be
(13:08):
embarrassing.
They can impair judgment, whichcan be dangerous.
And then they can cause moodchanges, which just can just be
frustrating for everybodyinvolved.
They also can cause weight gainand rebound high blood sugars,
which in other words is known asthe diabetes roller coaster.
And that's definitely not a ridethat you wanna, that you wanna
get on.
And then the severe lows youknow, are super dangerous.
(13:29):
They can cause.
Seizures loss of consciousness,coma, or even death.
So, and they, they actually, ifyou're having several severe
lows, they can increase yourrisk of developing dementia
later in your life.
God, I know, right?
That's happy.
that you like one be high allthe time.
I know, actually, after readingthis chapter, I've like made it
(13:50):
my goal this summer to avoid lowblood sugars at all costs.
I'm like, OK, let's, let's focuson this.
Cause I think I was more focusedon preventing the highs, which.
I still don't like, but now I'mlike, okay, let's try to prevent
those lows.
Okay.
Yeah.
This is interesting.
He also says that too many lowscan actually lead to like a dev.
He calls it a devolution ofsymptoms or just kind of a
breakdown of low symptoms overtime which is also known as
(14:11):
hypoglycemia and awareness.
So this is when you do not feelor experience signs of low blood
sugar just until it's too late.
And then at that point in time,you really can't think clearly
enough to treat your lowproperly.
And then research has also shownuh, good news that this can be
reversed if you spend severalweeks above 80 milligrams per
deciliter deciliter.
(14:33):
So you're trying to avoid lowsaltogether.
And of course that may causelike a small bump in your A1C
number, but to regain theability to self detect those
signs and symptoms of lows, it'slike absolutely worth it.
So I have some questions fromyou, Samantha.
Hit me.
I'm curious to know, like whatlow symptoms do you and your
daughter experience, and thenhave you ever experienced the
(14:54):
evolution of symptoms that hetalks about?
Samantha (14:56):
So for me, I'm like,
unfortunately hyper aware of
being low.
Like my, my DCOM might bereading.
Like, let's just for example,say like 2 0 1, but I stacked a
ton of insulin and I start tofeel low at 200.
So Amelia, like will sometimesdo that too.
She'll be like, I think I'm lowand I'll check her on.
Like, you're not low.
Like your dots are fine.
(15:17):
You're 180.
You're not low.
And she has three units on boardand then don't, you know, it,
she gets up, walks around forfive minutes and is crashing.
Like, so it's, we both just getlike a little, like, I think
like everyone else, just like alittle bit sweaty.
I can feel that my pulse isgoing up.
Like, I get a little, I can tellmy pulse is higher and I'm
shaky, but she, she more or lessis just, just shaky.
(15:38):
Like she starts to feel a littleoffbeat mm-hmm.
But that's
Katie (15:42):
really it for her.
Yeah.
Okay.
Does she, and she, you and say,mommy, I feel low or how does
she verbalize it?
Well,
Samantha (15:50):
I feel so bad because
I used to like, she'd say it and
I'd be like, you're not lowAmelia, go sit down.
Cause I thought she wanted asnack.
You know what I mean?
Like I would be like, you're noteating a snack.
We've just had lunch.
Like every other mom and thenlike 10 minutes later she'd be
low.
So yeah, she always comes to me.
She'll be like, and she justrecently started like checking
the Dexcom on her own.
Like, she'll be like, am I low?
(16:12):
And I'd be like, look at yourphone.
Like really trying to likeencourage a habit because again,
control freak mom.
I'm like, oh, I'll check it foryou.
I'm watching your blood sugarevery 10, you know?
Oh my gosh.
But yeah, she just recentlystarted like checking on her
own, like, you know what?
I felt weird and I'm 85 sidewaysdown.
Like, should I eat something?
And that's so that's like a hugeturning point for us.
Katie (16:32):
That's awesome.
Yeah, Sarah, I feel like Sarahstill has the ability to
recognize her lows for the mostpart every now and then there
it'll go unnoticed, but like,she'll say I feel low and her
hand, she always holds her handsout and you can see her, me do
visibly shaking.
Yeah.
Yeah.
Yeah.
And I don't even, I don't evenat that point in time, if she's
having symptoms, like I don'tcare what the Dexcom says.
(16:53):
I'll just give her like fiveSkittles, just really just to
give her peace of mind.
And then I'll be like, okay,let's do a finger prick and
double check to see whereyou're, where you're really at.
Cause you know, sometimes otherthings can present like lows,
like anxiety or maybe you'vebeen out in the heat for a
really long time.
And you just, I don't know.
You're you feel like headed orhigh, you know, it's true.
Ugh.
Mm-hmm yeah.
Okay.
Have you ever experienced, likeI'm, I'm assuming no, just based
(17:16):
on what you tell me, but like,so you've always been able to
detect your lows.
You've never like, lost thatability?
Samantha (17:20):
No, never the only
time that I might miss it and
anytime a million might miss, itwould be more like in the middle
of the night, like when you'redead asleep and wake up trenched
and mm-hmm before the Dexcom, itused to be so bad.
Like the Dexcom is life changingbecause before that came out, it
would be, I would just be likeliving on a prayer.
just, oh my God, the way thingsI said to me all the time, like
(17:43):
the way that diabetes hadchanged for you, like it used to
be so bad and now it's like, ohmy God.
Yeah.
I have 25 minutes.
I.
It's so different.
It's so different.
Katie (17:55):
Oh yeah.
I, I don't even know that lifeand I don't know how y'all did
it, so my hat is off to you.
No, I don't wanna that's right.
No.
All right.
Well, the author then jumps intolike treatment of mild to
moderate lows which that justdepends on a variety of factors
because your diabetes may vary.
Everybody's different andresponds differently to, you
(18:18):
know, carbohydrates.
But it definitely, you know,usually depends on how big you
are.
So like the bigger your bodysize is usually you're gonna
need more carbs to kind of bringyour number up table nine.
One in the book kind of givesseveral examples of different
body sizes and like about howmany carbs you would need to
bring you up.
And then it also depends onlike, What is the blood sugar
level, like the lower, the bloodsugar is at the time.
(18:41):
You're obviously obviously goingto need more carbs to, to bring
that up.
It also depends on the rate ofchange, which is like the arrows
that you see on your CGM graph.
So, you know, if, if you'retreating a 90 you know, straight
arrow down, which I guess that'snot technically a low at that
point in time, but it's headingin that direction, you know,
(19:01):
versus a 50 double arrow down,you're gonna need more carbs to
correct that 50 double arrowdown than you would for the, for
the 90, with just one arrowdown.
And then you also need to payattention to the dots.
This is Katie's advice, not theauthor's advice.
But I, that has been such a hugehelp to us.
And I actually did a wholeepisode on it.
It's episode number 50.
But your Dexcom or I don't, I,I'm not super familiar with
(19:25):
Libra, but for us, like our Dexcom might say.
a hundred double arrow down,which at the beginning of all
this would've sent me into apanic, but I've learned like, if
you look at the dots, you know,sometimes the, the arrows have
not caught up with the dots, cuzsometimes you'll, you'll look at
the dots and you can see thatthat line is straightening out.
So it's not continuing to gostraight down.
(19:46):
And that just has helped me belike, okay, wait, we are
leveling out.
I think the arrows just need aminute to catch up.
Like I don't wanna over treatthe slow cause then we're gonna
be dealing with a high.
I would encourage everybody topay attention to the dots.
Do you guys, do you do that?
Samantha (19:58):
Yeah, so we, that my
husband was actually the one
with the clarity on that becauseI was a big arrow girl for the
longest time.
Mm-hmm and it kind of like wouldsend Amelia into like a panic
because she would see the doublearrows and just lose her mind.
We're huge on saying like toourselves, like.
Remember, it's like how we feel,not what the Dex comp says.
So if you ate and you feel likeyou're starting to feel better,
(20:21):
then if the Dex console saysdouble arrows, think about how
you're feeling.
Don't read the number we've evengone as far as.
Turning off the Bluetooth andnot hear the sound cause, oh my
gosh.
It's like the, it's the it'sthat external stuff that like
really shouldn't matter, butyour body's not like trained to
like your, your brain's readingthese dots and arrows like, oh
my God.
(20:41):
Oh my God, my God.
But in reality, like it's, ithas how you're feeling inside
has nothing to do with what thedots or thes are telling you.
Unfortunate.
Katie (20:50):
um, I know like Sarah,
you know, you, you said you guys
turned the Bluetooth off or, orturned the alarms off.
Yeah.
But we had to change, we our, Iguess it was our low alarm used
to be the crying baby, because Iwanted, I'm like, oh my husband
too.
yeah.
I'm like, what's gonna reallyget my attention.
And it was that whaling baby.
And and, but that would giveSarah so much anxiety when that
(21:12):
baby would start crying thatlike I had to change it because
she could just could not handleit.
She, she would like, it was sobad.
I'm like, okay, well, we can'tdo the crying baby anymore.
Let's pick a different alarm.
That was us.
Exactly us work forward.
I, I thought about doing theambulance one, but I'm like, I
don't want that to go off whenI'm in the car, cuz I'm gonna
think there's like a cop rightbehind me or, or fire truck or
whatever the siren is.
(21:33):
What
Samantha (21:33):
I, so did did yours,
like originally like sound like
her high chime and mine doobviously, but her high chime
and low chime sound different.
So like the high is like a, Heyme, but the low was like a
deeper mm-hmm you know what Imean?
Is her, was hers originally likethat?
Katie (21:47):
I don't remember what it
was originally.
Cuz I feel like we changed itpretty quickly from the oh, like
list of options that you canchoose.
Now we have it, her high alarmsounds like she just won a video
game.
It's like do do or whatever andmy, my husband always says new
high score.
Like funny.
(22:10):
Yeah.
And then her low is, is like a,it's like a, it's just like the
beeping, so yeah, All right.
The author does briefly talkabout what foods are best to
treat a low.
So obviously like high GI foods.
So glucose tabs are a goodexample.
Smarties candies.
Those are like straight updextrose sweet tarts, those gels
that you can inhale prettyquickly.
(22:31):
Spree, candies, Airheads, ruts,nerds, and bottle caps.
And then just like a juice box.
Those are all probably the bestthing to treat a low quickly.
I know when Sarah went to, wasgetting ready to go back to
school after her diagnosis, the,the nurse that was there,
training the staff on type one,diabetes was like, What are you
bringing to treat Lowe's?
And I was like, she likesSkittles and it makes it easy
(22:53):
math for me.
And the nurse was like, well, wereally need to think about a
healthier option.
Like what about strawberries?
And I was like, listen, lady,
Samantha (23:00):
you obviously don't
Katie (23:00):
get it.
I'm like, strawberries are ahealthy choice.
And she will have plenty ofthose in her actual lunch.
But if we need to get her bloodsugar up quickly, she's gonna be
eating candy or drinking a juicebox, cuz I'm not gonna play
around with that while she's atschool.
So I actually
Samantha (23:14):
got the tension in
high school for eating candy
when I was low and not havingsomething healthy.
She wrote me up for andetention.
The nurse did.
Katie (23:21):
Are you serious?
Did you
Samantha (23:22):
get out of it?
Swear to God.
Yeah, no.
I walked down to the office andthe principal who like knew my
mom was like, why are you here,Sam?
I had never gotten attention in.
And I was like I ate candyinstead of fruit.
When I was low, he ripped up thepaper and play of me and put it
in his trashcan.
He's like, go back to class.
I was like, okay.
Gosh,
Katie (23:38):
geez, Louise.
That's ridiculous.
I mean, I can see that I can seeit happening, but oh my gosh,
that's annoying.
Samantha (23:44):
God people don't
really get it.
It's like, it's such so, sofrustrating.
And it will be for like ourkids.
Like, it's so frustratingbecause unless you love someone
with IVs or have it yourself,you do not get it.
Yeah.
It's.
Stressful.
Katie (23:56):
I know.
I know.
And, and I, but it's alsoannoying to have to explain it
to everybody.
You know, I, I feel like I'vejust kind of adopted the mindset
of like, whatever they don'tunderstand.
They never will.
Like, why am I gonna try toexplain, you know what I mean?
Like why waste my breath?
Which yeah.
Maybe that maybe that's not, Imean, education is important,
but you know, I feel like yougotta learn.
You gotta learn when is theproper time to educate and when
(24:17):
you just need to be like smileand nod, just smile and nod.
Thank you.
Thanks so much.
Yeah.
so do you, yeah.
What do you guys use to treatLowe's
Samantha (24:27):
so, so ridiculous.
We are huge on tropical punchKool-Aid.
It is so stink and sweet.
So I literally, if we're, ifwe're coming down, we, we have
these like little tiny, youknow, the glasses that come with
like your normal glasses, butlike the little short guys.
Yes.
Mm-hmm one of them is like,Solve the problem every time.
So Amelia always wants to likeadd a Snickers in there, but I'm
(24:48):
like, let's just try Kool-Aidfirst.
Like let's just try a drink.
Cause it's like too much.
Katie (24:52):
right.
We'll we'll add that Snickers toyour dinner later today.
yes.
Yeah.
She's a mess.
Coolaid forever.
I love that.
So do you, are you just like oldschool?
Mixing it up with the powder andthe water in a picture?
Oh, cool girl.
Samantha (25:04):
Two packets, two puffs
of sugar.
It's always in my fridge.
Katie (25:08):
I'm gonna buy some just
to try it.
I love it.
Samantha (25:10):
If you gotta, you
gotta
Katie (25:13):
man.
I could crush some grape Koolaidwhen I was a kid.
That was my favorite.
Samantha (25:17):
Yes, same.
So we have learned that I, I,this could just be us.
I don't know the it's the reddye.
I don't know what it is, but thetropical punch has like somehow
some better effect with treatinglows.
We got the orange and I likechugged one, one day and it like
did nothing for my blood sugar.
And I'm like, what is happening?
It could be in my brain.
I don't know what it is, buttropical punch hits it every
(25:39):
time.
Katie (25:39):
Okay.
All right.
Tropical.
But now that is a fun scienceexperiment for your daughter to
do.
I'm like, I know which flavor ofKoolaid will bring my blood
sugar back up.
The quickest, when I'm having alow, the blue raspberry
Samantha (25:51):
lemonade, like sends
like does too much, like she
could have like a shot glass, ablue raspberry lemonade,
Koolaid.
And she would just, it wouldjust knock her on her butt.
So we're like never changing theflavor.
My husband's always like, can wetry something else?
I'm like, no, it has to be this.
Katie (26:06):
Denied not happening.
Samantha (26:08):
Denied.
That's what we're doing.
No change.
Katie (26:09):
okay.
I'm gonna try it.
I'm gonna let you know how itgoes.
I can't wait.
I can't.
Okay.
okay.
The author does throw in a quickblurp about overtreating your
loaves, because we've all beenthere, right.
Either whether we're panickingand we're just shoving candy and
juice in our kids' faces or ourfaces.
Or you're just, cuz I, I don'tknow.
Cause I don't have type one, butI've heard that when you have a
low you're like extra hungry,which my daughter actually,
(26:32):
yeah.
My daughter actually verbalizedthat for the first time.
The other day she's like, mommy,I just feel so hungry when I'm
low.
And I'm like, oh, okay.
This is the first time I heardyou say that.
So it's easy to treat overtreatlows.
The author just suggests that ifyou do, like if you recognize
that you have overtreated yourlow, once your blood sugar comes
up to like a reasonable level,like it's re recovered, you go
(26:52):
ahead and dose for the You know,to cover the carbs that you
overtreated with which is a boldmove, you know, if you just
recovered from a low, but do youguys, you know, what, what's
your kind of experience beenwith overtreating low's.
So with
Samantha (27:06):
Amelia, it's kind of,
we're very careful with her
while she's at school, becauseto have that rebound, like where
you were already low and thenover did it.
And she's like trying to learnand stuff in school, that's just
like too much for her.
So we're super careful with hermm-hmm but before, before the
decks come before I could likereally see what was going on.
I did, I would like eat like awhole stinking bag of gummy
(27:27):
bears or something like when Iwas low, because it is so true.
It's like, you're super hungry,but you're you also feel like it
doesn't even feel like hunger tome, it used to feel.
Almost like you were medicatingsomething like, it almost felt
like you were taking more andmore and more and more until you
felt right.
Mm-hmm like, not like until youfelt full.
Cause you never feel full.
Like you could just eat forever.
Mm.
But it was almost like until youdidn't feel low anymore, but
(27:49):
then by that time you were farpast the amount of carbohydrates
you had eaten.
Mm-hmm and I had done that forliterally ever.
And if Amelia was, if it was upto Amelia, she would do, she
would do the same, but I'malways like, Hey, Hey, Hey, Hey,
Hey, Hey.
Cause the one time she crushed abag of gummy bears and I'm like
meals, what are you doing?
You're so to have five.
And she was like, oh, they werejust really good.
(28:09):
But I know what was reallyhappening was like, she just
like didn't realize how many shewas eating or she was just.
Feeling well and needing to eat.
And, but, so she was like, theytasted really good.
I got them for her like a weeklater.
And she was like, E these aregross.
Why'd you buy them?
I'm like, okay.
Yeah.
That solidifies what just
Katie (28:26):
happened.
Yep.
Yep.
Exactly.
Yeah.
I, I had to, I had to send Sarahto school with something that
she likes well enough to eat, totreat her lows, but not to where
she likes so much that she willjust like overeat.
Like I was for a while there, Iwas sending her with Gatorade
and I would like mark the bottlewith like, okay.
(28:48):
Oh my God.
Like, if you have a low, I wantyou to drink to this line and
then I'll let you know if youneed to drink some more.
Well, she would just like startdrinking the Gatorade and not
stop.
And I'm like, okay, we need tonot send you with Gatorade
anymore.
Samantha (29:00):
That's diabetes, like
turns off your self control.
I don't
Katie (29:02):
understand it.
Yeah.
Well, I mean, let's be honest,self control is hard enough as
it is without diabetes.
Yeah, I know.
Yes.
I can see where that would be.
Definitely even just with theanxiety of treating it low, like
you just kind of are, are maybea little panicked and you're
like, I need to drink the wholejug.
I just have to drink the wholething.
Samantha (29:18):
yeah.
That's meals a hundred percentme.
I'm like the other day I was 41when I woke up and my husband
saw my alarm and he was like,I'll go eat something to eat.
And I was like, Ugh, no, I'vegotta probably actually eat
something, not just theSnickers.
And he, I had to put down ourbaby and go and eat something.
And he was like, Sam 41.
How'd that happen?
And what's really happened is mybasal is like all messed up from
(29:39):
the baby yet.
And I would take, I took Lantand I had adjusted it like five
extra units.
Well, that was too many.
Like mm-hmm so I was low thatwhole.
No
Katie (29:47):
back.
Oh, no.
How old's your baby?
He is four months yesterday.
Oh my gosh.
You like just had a baby.
I'm sorry.
I
Samantha (29:53):
did just have a baby.
I literally just went back towork like a month ago.
Katie (29:57):
oh my gosh.
Well, congratulations.
When you said you had a baby andyour insulin was all outta
whack.
I was like, well, I, I justassumed it was like a couple
years ago, but you like a newone?
No, he's a new guy.
Samantha (30:08):
He's a new guy.
Katie (30:09):
Oh my gosh.
You're amazing.
You.
Oh, you, you have a type onedaughter.
You have type one yourself.
You just had a newborn and youjust went back to work.
Oh my gosh.
You're amazing.
Yes.
Samantha (30:19):
Yeah.
And he was an IVF baby on top ofall of that, so, oh yeah.
He was
Katie (30:23):
working baby.
Yes.
Yep.
You worked for that one.
Okay.
all right.
The author that's for sure.
yes.
Yeah.
The author transitions intotreatment of severe lows, which
hopefully, hopefully, no, youknow, hopefully we don't have to
experience those or at least notmany of those in our life, but
he just kind of gives some tipsfor, for that.
(30:43):
He says, definitely do not likeif somebody is having a seizure
or has like blacked out, do notput food or drink in their mouth
because they could choke on itor it could go into their lungs,
which is not good.
Definitely don't stick yourfingers in their mouth because
if they're having a seizure,they could chomp down on your
fingers and do some majordamage.
This should be number one on thelist, but call for emergency
help.
Right.
And then administer theglucagon.
(31:04):
And he actually on page 2 67 and2 68 of the book, he like.
Bullet points out the steps totreating a severe low using
those traditional red glucagonkits.
And because he's like theinstructions for those things
are not written in a languagethat anyone can understand.
It's so confusing.
(31:24):
And then of course, if you're ina pink mode trying to treat a
low, a severe low, like you'renot gonna take the time to read
those instructions.
So he, right.
Like writes them out in plainEnglish for you, which is very
nice to have.
And then he says, you know, theperson should come to in like 10
to 20 minutes.
You know, hopefully by thattime, if you've called 9 1, 1,
the paramedics have arrivedalso.
(31:46):
But he also makes a note thatlike, if you are sick or your
child is sick and they cannotkeep anything down, but they're
having a low blood sugar, youcan actually use those emergency
red glucagon kits to micro dose,the glucagon.
And just to like bump theirblood sugar up.
If they can't, you know, ifthey're, if they're vomiting and
they can't keep anything down.
(32:07):
Right.
And then he Al he, he says, andwe actually do not, we need to
get one.
Sarah does not wear one, but hesays you should always be
wearing a medical ID.
Bracelet or have something inyour wallet like a wallet card
or wear a necklace that has yourmedical ID.
Because first responders aretrained to look for those things
first.
So bracelet, necklace, orwallet.
(32:27):
And I think tattoos actually arepretty popular too.
Like have it tattooed on yourwrist?
Yeah.
Yeah.
So have you or your daughterever experienced an extreme low?
Uh,
Samantha (32:35):
Honestly there was
only one time where I was super
low and it was because again,during the whole IVF business,
we were, I had, I was stuck at400 for like hours and my doctor
had like really pushed hard on.
you know, we were doing thisanger retrieval and you know, my
blood sugars had to be perfect.
Perfect, perfect.
Blah, blah, blah.
And again, this was not anendocrinologist who doesn't
(32:56):
really get it, but still thatstuck in my brain.
Mm-hmm and I was stuck at like400 for like five hours.
So I was stacking on stack andon stacking didn't have a pump.
Didn't really remember how muchinsulin I took.
And when all came, crashingdown.
Oh my goodness.
It was so bad.
We like, I was like walking intoCVS and I, we were like picking
something up.
I think I remember like leaningon my husband's shoulder and he
(33:17):
was like, what's going on?
And I'm like, I thinksomething's wrong.
And he like, got my phone outtamy purse.
It was like low, double arrowsdown.
Cause I like, didn't see itcoming.
And he was like, oh my, well,thank God we knew the
pharmacist.
He like found one of myprescriptions with the glucagon
on it.
We just did it right there inCVS.
And I like, oh my gosh, the, seethey say 10 to 20 minutes, but
for me, like, I felt betterinstantly.
(33:38):
Like I put it in and I was likeinstantly better.
Really?
Okay.
Which is insane.
Right?
Yeah.
Cause it's like, and itobviously wasn't.
Passed out or like near death oranything, but I was like, not
doing well and I like took itand I was like standing straight
up, ready to party.
The husband was like, what justhappened that crazy?
I don't even know.
I know madness, but it like doeskind of calm your nerves with
(34:00):
the whole, like if got yourforbid, you know, I mean, it was
the, one of the girls were superlow, you know, that it, it's not
like you're not sitting therestanding over there then for 10
minutes being like, okay, like,yeah, start working
Katie (34:10):
now.
Or, you know, yeah.
I've, well, I've heard severalmoms who have had to do that to
their kids.
Like they, most of them havesaid that like, of course they
called, you know, for emergencyservices.
But like, by the time they gotthere, their kid was really fine
cuz they had administered theglucagon and like, and they,
some, a lot of times they don'tdidn't even end up having to go
to the hospital.
I'm just curious, like, do youremember what your blood sugar
(34:33):
went up to after you used theglucagon?
I've always just, I just, andI'm sure everybody's different,
but yeah.
I wanna know like how high is itgonna take you.
Samantha (34:40):
So I was
unrecognizable high on the
Dexcom and I was four 90, Ithink, on
Katie (34:46):
my meter.
Okay.
So it's gonna take you up and Ifelt like, Ooh, garbage.
Mm, yeah, after that low.
So it's high save your life, butyeah.
It's you pay for it?
Oh my gosh.
Yeah.
I mean like, who really careswhat you're gonna go up to?
Like, let's just get it in.
Exactly.
Exactly.
It's, I'm just, I've alwayswanted to know, like,
Samantha (35:04):
it's one of those
things, like if you're taking a
glucagon, like you almost wannatake insulin with it as you're
taking it, because it's like,you are gonna pay for this for
sure.
Katie (35:13):
Hmm.
Interesting.
I, I almost, when I had the de Iwore a Dexcom for 10 days, a
couple a month or two ago, and Iwas like, so tempted to, cause
my daughter has all these nasalspray Basim oh.
And and like, some of them arelike on the verge of being
expired and I'm like, I'm justso tempted to like, do try this
(35:33):
just cuz I wanna see what, how anormal pancreas would handle
this.
Like if it would, I of course Idid not.
I just feel like that's not,that's not the right thing to
do, but I was just thinkingabout like, I'm like I'm, I'm
just curious.
I wonder how this would affectlike a normal fire a little bit.
Yeah, exactly.
Okay.
Interesting.
All right.
I think that's all I wanted tosay from that section.
(35:56):
Oh, do you guys wear medical ID,bracelets or necklaces or
anything?
Samantha (35:59):
No, we don't.
We probably should, but she's sowe're still, we're newly in this
place.
We're like, we're very observantof like what people think of us.
Well, Amelia is mm-hmm so we're,we're working through that where
she's very, really worried aboutlike people knowing she's low or
seeing that she's eating andthey're not allowed to eat in
school.
So yeah.
Everyone knows she's diabetic.
(36:20):
I read to her class and, and anyother scenario, I'm always with
her so far.
So until she's a little bitolder and I'm not really around
as much, I'm kinda letting thatone fly.
Katie (36:30):
Yeah.
That's true.
Sarah doesn't wear one eitherand we're kind of in the same
boat.
Like Sarah does not as little ashumanly possible, like do not
call her out or make her feel,even if that means wearing like
a pretty silver bracelet.
She's like, Nope, Nope.
I don't wanna do that.
Like, cuz she nice too.
Yep.
Yeah,
Samantha (36:47):
yeah.
It's I feel so bad for them, but
Katie (36:49):
I do too.
I mean, I get it.
I'm not that doesn't bother.
I mean, it bothers me.
It makes me sad to think.
They're so self-conscious aboutit, but it, you know, I get it.
I, I can, yeah, I can sympathizewith that.
All right.
The author goes through, kind ofgives a, a good list of just
tips for preventing lows in thefirst place.
I'm just gonna kind of quicklyread through these.
And some Sam, you can let meknow kind of what has helped you
(37:12):
and like what you've just foundto be helpful off of this list.
Sure.
But using a CGM properly, whichsounds like a no brainer, but
you know, you need to turn onyour alerts and you need to make
sure they are set at a point.
A threshold above the point ofhypoglycemia.
Cuz if you have it said at like60 it might be a little bit too
(37:33):
late if you, you know, if yourkid is 60 double arrow down,
like you want it to alert youbefore that.
So you have a little bit moretime to recover gracefully from
the low.
So set your alerts at areasonable level.
I think Sarah as just said itlike I have it set differently
on a few different apps, but Iwanna say it's somewhere between
70 and and 80.
(37:53):
The apps that I have.
I like it to be set a littlehigher, cuz I, you know, at 80 I
feel like we can catch it beforeit gets to be a scary, a scary
low.
Yeah.
Samantha (38:01):
We're at a hard 80 on
Katie (38:03):
everything.
Okay.
Okay.
He said author suggests use ahybrid closed loop system, such
as tandem control IQ, Omnipodfive or DIY loop.
Those are the systems thatadjust your basal rates.
So if it predicts that you'regonna go too low, it will like
shut off your basal.
Which is pretty cool.
They are great especially if youwanna sleep through the night,
but they are so are frustratingcuz like Sam and I already
(38:25):
discussed.
If you're a control freak, theycan be they can be frustrating.
Like sometimes you don't want itto shut off the basal.
Okay.
Author also suggests matchingyour insulin to your needs,
which, you know, makes sense.
Don't have more insulin than youneed.
That obviously takes a lot oftrial and error to kind of
figure out how much you or yourkid needs.
And at different times of theday he suggests using a rapid
(38:46):
acting insulin rather than likeregular insulin, because rapid
acting clears the system in likethree to four hours.
So it offers less risk of bloodglucose levels declining, even
after food has digested regularinsulin takes a lot longer to
get cleared from the system.
You wanna dose properly andprecisely if possible.
So if you can get your hands onlike syringes or you know,
(39:10):
prefilled, insulin cartridge, orpins, insulin pins that have
like half unit measuremeasurements.
So you can be more precise inyour dosing.
You wanna give your insulin timeto work, which, so, in other
words, you don't wanna stackyour insulin.
Bolus of rapid acting insulincan take three to four hours and
sometimes more to stop working.
So don't stack it now.
I will say that we do not followthis rule all the time, because
(39:34):
I just feel like yes, the longertime goes on, I do feel like you
just kind of learn to know yourkid's body and you just kind of
know, okay.
I just need to give this sometime.
So let me be patient and wait itout.
Or, okay.
This is just not gonna bring herdown anytime soon and I need to
get more insulin.
So I, I don't know.
I just feel like you kind offigure that out as time goes on.
(39:55):
Okay.
You wanna time your bolus thisproperly?
So for this one, like if you'reeating a really heavy meal or a
meal with a lot of fat andprotein you probably don't wanna
give your insulin.
Ahead of time.
You might wanna wait until likeyou're eating the meal or maybe
right until you finish the meal.
Just because you don't want yourinsulin to like peak or be
working its strongest beforeyour food even has a chance to
(40:19):
digest, cuz all that fat slowsdown digestion and your carbs,
those carbs don't get into thesystem for quite some time.
You wanna set appropriatetargets.
So the lower, lower the targetthe greater, the chances of
hypoglycemia because liketarget.
Targets of 80 or 90, they don'tleave a whole lot of room for
error.
So he suggests aiming for atarget of a hundred or more,
(40:42):
which I think that's in our, allof our calculations in our pump
settings.
That's our target is a hundredat the moment.
If you are coming off a daywhere you had a low or your
numbers were just super erraticand crazy, or maybe you like
exercise really, really heavily,the author suggests consider
making your target higher forthe next 24 to 48 hours.
(41:03):
If you usually have it at like90 or a hundred, you know, the
next day or two, you might wannahave it at like one 20 or
something that's gonna keep youa little safer.
And then he says to time mealsand snacks appropriately, which.
We don't, we don't do this.
I'm just gonna say we just kindof eat.
I mean, I guess we kind of eatat the same time, lunch, lunch.
No, let me start over breakfast,lunch and dinner around the same
time.
(41:23):
But anyway, he just makes it abig, like, apparently if you're
using NPH, which I feel like notmany people are using that at
this time, but if you are, yeah,you like really have to be
scheduled about when you eat.
And even as little as a half anhour, being off schedule can
make a huge difference and causeyou to have low blood sugars.
But then even if you're on along acting insulin, like some
of the more commonly used ones,like he mentions glaring, BAS
(41:47):
Glar or Deir.
If you're off by like a fewhours with your meals and
snacks, it can cause significantdrops in blood sugar, which I
did not know.
We're almost done with the list.
He says you also wanna deductfiber.
So fiber is included in the carbcount, unlike all the
prepackaged labels nutrition,facts, and whatnot, but fiber
does not get converted intoglucose during digestion.
(42:08):
So he suggests that you subtractthe grams of fiber from the
total carbohydrate count.
He also says you need to adjustfor exercise in daily activity,
which we are we've discussed atlength in previous episodes.
That was.
A lot of what chapter seven andeight was about.
So you can go back and reviewthat.
But he says, if you are using ahybrid closed loop system and
(42:28):
you're like exercising or doinga lot of activity, you
definitely wanna raise thetarget blood glucose at least an
hour before exercising, which Iknow the Omnipod five that your
daughter's on has like theexercise mode or I forget what
the connectivity mode.
Yeah.
Yeah.
And isn't the target like one50.
Yeah.
Samantha (42:44):
Okay.
It's super cool.
I haven't used it yet.
I think it only works for whenyou're in automatic mode, which
we have not trusted yet, but I'mlooking forward to the day that
I do.
I love it.
Katie (42:54):
Oh my God.
You're like, we're not doing it.
We're not yeah.
Yeah.
Self okay.
Samantha (42:58):
Self control.
Katie (43:00):
Yeah, the DIY loop has
they call'em overrides, but it's
the same thing you can like tellit what you want.
The.
Target to be at.
And at first I was just turningthem on the overrides on like
right before Sarah would go todance class or right before
she'd get in the pool.
And then I realized like, oh, Ineed to like, turn this on an
hour or two before if I actuallywant it to be effective.
(43:20):
So yeah.
We're big 10
Samantha (43:21):
basal
Katie (43:22):
girls in that scenario.
I know I do miss 10 basals andextended BOS.
Those are nonexistent with theDIY loop system.
Yeah.
Oh no, I know.
All right.
He also last two things.
He says you wanna adjust foralcohol to prevent low blood
sugars, cuz alcohol, go back andlisten to episode 60.
That's the, the episode on howalcohol affects somebody with
(43:44):
type one diabetes, but longstory short, it can cause your
numbers to drop.
So after you've been drinkingyou wanna make sure you lower
your basal level or you need toconsume some extra carbohydrates
and then he ends with you justneed to check, check, check, and
evaluate, look for patterns oflows in your CGM data or your
logbooks.
If you've been keeping those andthen just really talk it through
(44:07):
with your healthcare team on howyou can kind of prevent those
lows in the future, if you'reseeing those patterns.
All right.
So Sam, what, on that long listof tips to prevent lows kind of
stuck out to you?
Like, you know, what have youstruggled with, or maybe what
have you been really successfulwith?
Any of the above
Samantha (44:24):
Half to half units was
huge like that.
I feel like with them trying tofigure like regulate everything
and all that.
I think half units were just, ifwe weren't able to do half units
during the night and stuff likethat, she'd be crashing left and
right.
And she'd be high.
It's just half units reallychanged the world.
But the, it really helped usboth having like the IOB, like,
so we were able to see how manyto prevent stacking, because I
(44:46):
feel like that was such a hugething before, if you were MDI
and you like, weren't have, youdidn't have a pump on you that
was showing you how many insulinunits you took or, you know, you
just kept taking it like that.
And it wasn't really somethingthat like your endocrinologist
talked about.
Like, they were never, like,they were like, oh, you took
insulin two hours ago.
And like, that's fine.
Like, you should keep in mind.
You don't take more insulinuntil two hours.
(45:08):
Well, in reality, it's like.
Four for us.
Do you know what I mean?
Like mm-hmm, it's four hoursuntil it's completely out of
Amelia system.
So it's like, mm-hmm Oh gosh.
So that really changedeverything.
Having the insulin on board tocheck, to see how much we took.
Yeah.
The half units and honestly likethe 10 basal function.
That is huge for us.
Mm-hmm cause she is so much likefor her, I'm not there when
(45:30):
she's at school.
If I know she's gonna be in gym.
If I know if she's going torecess, I can call her, I see
her kind of trending down andI'm like, Hey babe, turn your
BAS off.
And that almost always saves theday mm-hmm
Katie (45:40):
Yeah.
I know.
I agree.
I mean, usually if you can catchit quick enough, it can, you
know, prevent them, prevent youfrom having to treat the low
with food, which I think isgreat.
Yeah.
You know?
Yeah.
Huge.
Yeah, definitely.
Cuz you know, as fun as itsounds to eat candy all day
long, it really does get old.
I think according to my daughterit does it does.
Yeah.
Frustrating.
(46:00):
Yeah.
And I did wanna say and I'm sureyou, I'm sure you've heard of
this too, but like for.
For listeners that are on MDI.
Like if you want to have accessto those kind of like pump
features of being able to seeinsulin on board and keeping
track of all of that, theMedtronic in pin, which this is
not an ad and it's, this is notsponsored by Medtronic, but like
(46:22):
the Medtronic in pin hasBluetooth technology where you
actually connect it.
You connect your insulin pin toan app on your, on your, your
phone or your kid's phone.
Whoever's the type one.
And it keeps track of all thatdosing information for you.
So you can flip, open the appand see, oh, I have this much
insulin on board.
Maybe instead of giving moreinsulin, I just need to get up
and move around a little bit orwhatever the case may be.
(46:43):
So I did an interview with agirl.
This was like towards thebeginning of the podcast
episodes, but she uses the inpin and she said is it's like
really helped her with rage,boing and.
And not stacking her insulin.
Samantha (46:55):
I love that phrase.
I love that phrase.
I rage bulls so much.
It's not even funny.
Katie (47:00):
I know I do too.
And, and, but again, I feel likeI've learned when I need to
rage, bolus, and when I need tonot rage bolus.
So
Samantha (47:08):
it's so funny that you
mentioned the pen too, because I
actually I'm a nurse and workfor a, an insurance company and
mm-hmm I I'm, I work in apharmacy, so I review different
meds and all that stuff.
And I create I create thequestion set for like prior
authorizations.
So like all the people that areout there that are like, Oh, my
gosh, I submitted this for priorand I'm waiting on this
(47:29):
insurance company forever.
Like, hi, it's me.
yeah, it's me.
You're waiting on.
like, so I just got the I penpolicy up today and I was like,
oh my gosh, this sounds so cool.
Katie (47:40):
It is cool.
We actually own two I pens,which I don't even know how that
happened.
To be quite honest, they did notsend me one.
I purchased one through ourinsurance and for whatever
reason, Picked it up at thepharmacy.
And then like two weeks later,another one came in the mail.
So I don't know what happened,but wow.
We have two and we have not usedthem yet.
(48:00):
Cuz my daughter hasn't wanted totake a pump break recently, but
when she does or if she does wewill definitely try it out cuz I
think they're awesome.
I can't wait to hear about it.
Yeah.
All right.
Let's talk about dealing withthe post meal spikes.
So that was first part of thechapter was all about the lows.
Now we're gonna move on totalking about those high blood
sugars a fancy word for a postmeal like after you've eaten is
(48:22):
post prandial.
So you might hear someendocrinologist say that.
And some researchers, I knowthat I did an interview with a
guy once that he said that word.
20 times and I had to Google itcause I had no idea what he was
talking about.
But post prandial, that meansafter me, I'm not gonna use it,
but I just want people to know.
Okay.
So I just look like real quick.
I just wanna give listeners areview of what happens in a,
(48:45):
like a normal functioningpancreas system, somebody
without type one diabetes.
This just helps me to rememberthat like it's real hard to be a
pancreas because our systems areso efficient and when they're
working, it's just amazing whatthey can do.
And to try to like mimic that asa human, with like outside
(49:05):
medications, it's just, it'snot, it's just not easy.
So when somebody without typeone, diabetes starts eating the
pancreas, like immediatelyreleases insulin and it starts
to produce amylin.
which is another hormone bothinsulin and amylin come from the
beta cells.
So those are the cells that getdestroyed in type one diabetes.
And the insulin that our bodymakes in our pancreas, it starts
(49:27):
working like literallyimmediately and it finishes it,
the whole job that it was setout to do in a matter of
minutes.
And then there's amylin, whichis also, it's a hormone that
keeps food from reaching theintestines too quickly.
So basically it slows downdigestion.
So the reason why blood sugarsspike so much after meals in
someone with type one diabetesis because number one, food
(49:50):
digests much faster because wedon't have that, you know, you
don't have that Amlin working.
And then the insulin that youget out of a cartridge or a vial
works much, much slower than.
What the insulin that thepancreas makes.
And so I just, I don't know.
I just think that's important toremember, to, to keep
everybody's mind and perspectiveof this is really a hard job and
(50:11):
we're doing the best that wecan.
But the author says thatsignificant post-meal spikes
have been shown to produceearlier onset of kidney disease
and accelerate the progressionof already existing eye
problems.
So just keep that in mind.
You know, they're gonna happen,but let's try to keep'em from
happening all the time.
Glucose variability, which islike the standard deviation
(50:31):
number that you see on your CGMdata that is associated like the
higher, that number is the morelikely you are to have long term
cognitive impairment andincreases your risk for
dementia, which Ooh, who wantsto think about that?
I think that's in pretty severecases, but.
Yeah, just wanted to throw thatout there.
But then in the short term youknow, your quality of life can
(50:51):
suffer with these giant spikesand blood sugar.
They make you have low energy,poor brain function, your moods
can be altered and your physicaland athletic ability becomes
diminished, which you, youmentioned that after you had to
treat that low and you had thatgiant spike and I'm sure you've
you've, you know, probablyexperienced it other times, but
you just feel crummy, right?
(51:11):
Yeah.
Awful.
Yeah.
Um, Interestingly enough, Inever really heard the time
behind it, but apparently mostpost meal spikes happen about an
hour and 15 minutes after thestart of a meal, which I was
thinking about us eatingbreakfast, which is usually when
we see our biggest spikes.
And that's pretty spot on likean hour and 15, maybe an hour
and a half after breakfast iswhen, if she's gonna spike.
(51:32):
That's when we that's, when wesee the spike and then table
nine, three in the book justgives a really sweet summary of.
After meal blood glucose targetskind of based on age.
So usually a little bit moreconservative for the younger,
for the younger kids.
And then the author jumps righton into how to better control.
Post meal spikes.
So I'll, again, Sam, I'll readdown the list and you can kind
(51:55):
of just tell me what stuck outto you and like, okay, what
you've used and what you've beensuccessful with with you or your
daughter.
But he says you wanna choose theright insulin.
So again, NPH uh, regular orregular insulin is not great,
cuz it takes forever to startworking.
you know, if possible you reallywanna choose like a Humalog or a
Novalog that works, you know, arapid acting insulin that works
faster.
(52:15):
And then there's FIAs, which isan ultra rapid acting insulin
that, that works about five or10 minutes faster than Novalog
or Humalog.
And it gets cleared outta thesystem faster, maybe like an
hour faster or so, and thenAfreza which is the inhalable
insulin.
I've I it's, Sarah's not oldenough to use it.
I think you have to be 18 to useAfreza but I've heard great
(52:35):
things.
So if your kid or you are overthe age of 18, may might wanna
look into that.
um, Author suggests using a prebolus for most meals.
A pre bolus is when you giveinsulin 15 to 20 minutes before
eating, since it can take thatlong for insulin to even start
working again, you would notwant to do this with like a
really heavy fatty meal.
(52:56):
Like a good example is pizza orfettuccini Alfredo or anything
that has like a really richcreamy sauce to it.
Lots of cheese, stuff like that.
Okay.
He also says You know, avoidingthe post meal spikes you might
wanna consider using, like hecalls it the super bowls
technique, which I think is aterm that was coined by the guy
that wrote the sugar surfingbook.
(53:16):
I think don't quote me on that,but this is a technique where if
you're on a pump, unfortunatelyonly pump users can use this
technique, but you would turnoff your basal rate for a few
hours, like maybe three hours.
So, but you're missing threehours worth of basal.
So instead you would actuallytake that insulin up front.
So if you have your basal rateset at like one unit an hour and
(53:37):
you turn it off for three hours,you would actually take those
three units of insulin that youwould be missing up front.
And this would be for like ahigher GI meal.
That's gonna hit your system,like really hard and really
fast.
So a good example would be likebreakfast cereal because you
might need all that insulin upfront to kinda combine combat
that after meal spike.
We've tried that a few timeswith breakfast cereal and I
(53:59):
would say like three quarters ofthe time it worked really great.
And then of course, there's justthose other times where diabetes
doesn't play by the roles in.
It did not cereal and breakfast
Samantha (54:09):
is a beast to handle
no matter what I feel.
Yes.
Katie (54:12):
Yep.
I agree.
It really is.
You know, we've gotten better,but there's still some days and
it's certain cereals, like I'venoticed that any cereal that
involves cinnamon, which isironic, right.
Because yeah.
Random people like people tellyou to eat it.
yeah.
People tell you that cinnamonwork, cure diabetes, but I have
found that any cereal that, youknow, even like a quote unquote,
healthy cereal with cinnamon, Idon't know what it is, but it's,
(54:35):
it's like always the worst.
So but yeah, breakfast cereal isfor sure a beast.
Okay.
I'm like quickly checking in onSarah and she's at camp and her
Dexcom says 92 straight arrowdown, but the dots suggest
otherwise.
So I'm gonna give it a minute.
And I also just told her to eatsome Smarties.
So I feel like she's gonna startcoming back up.
Sorry had to take a brief pausethere.
(54:55):
That's okay.
Yeah.
Samantha (54:56):
I thought I was low
before we started, so I was like
inhaling a plum and Arine justgoing hard in it.
And I'm two 30 now.
So I was wrong.
Not should I oh
Katie (55:04):
no.
Oh man.
No, I'm sorry.
So no
Samantha (55:07):
guessing people
Katie (55:11):
I, no, I couldn't tell
you how many carbs were in a
plum.
That's not usually a fruit.
I, I buy, but I'll have to lookit up when we're done.
Um, Okay.
This is interesting, but if youapparently, if you inject rapid
acting insulin into a muscle itcan bring your number down in
about like half the time.
I have not experimented on thiswith Sarah, cuz I just feel like
that's not my, I don't know.
(55:31):
I don't wanna, that feels likeI'm messing with fire.
So I'm just, I'll let her trythat when she's an adult, when
she makes up her own mind to dothat.
But but anyway, he said thatthis can also cause bruising and
you might need to use a littlebit longer.
Syringe or pin needle, becauseyou gotta go a little deeper to
get into the muscle.
He suggests you could warm thesite before you eat, which I
mean, who really has time to dothat, but you could kind of like
(55:54):
put a warm compress over thearea that you're gonna inject
the insulin into in that makesthe insulin go get absorbed
faster.
Um, He suggests that you getmoving so 10 to 15 minutes of
mild activity after you eat,like immediately after you eat,
typically does the job.
And he says the key is just toavoid sitting for long periods
of time after eating, which ifyou've ever gone to the movie
(56:16):
theater with your type onediabetic and they've eaten movie
theater snacks and have satthrough a movie, you will figure
that out really quickly.
yes.
A hundred percent.
It's like the worst.
Yes.
So get moving.
And then don't smoke or vapebecause that constricts your
blood vessels and your insulincannot move around properly and
get absorbed if you are If yourblood fus are shrunk, so don't
(56:37):
smoke or vape.
All right.
So Sam, what on that list oftips to prevent after meal blood
sugar spikes stuck out to youthe most?
So we are
Samantha (56:45):
huge, huge pre
bowlers.
I mean, mm-hmm if we don't, wesee like, almost instantly that
it was a mistake, especiallybecause Amelia is a big Duncan
donuts fan mm-hmm I dunno howhuge Duncan is in Florida, but
it is everywhere here and she isa glazed chocolate donut theme.
So typically it's like, oh, canwe stop?
(57:06):
And she takes like eight unitsfor 10 chocolate munchkins,
which would be fine if she wastaking it, you know, a half an
hour before she ate.
But oh my goodness.
Do we usually pay for that?
I'm like, oh man, like, come on,we made that mistake.
But yeah, so we actually triedalso, cuz we kept on having that
issue.
(57:26):
So we tried to get the.
How do you say it?
The Thias the, the FIAs.
Yeah.
Yeah.
Yeah.
But they told us that myendocrinologist said that they
it's a non-preferred drug inour, with our insurance plan and
that they didn't see like greatsuccess with it.
So we're still no blog girlsforever.
Katie (57:44):
Okay.
I know.
I have toed around with the ideaof trying FIAs too, because it's
covered by our insurance.
I don't know if my doctor wouldprescribe it, but it is covered.
Yeah.
But I'm like, I, I don't know.
I've heard mixed reviews.
Like it really doesn't work thatmuch faster and like not worth
the change.
Right.
I don't know.
Maybe one day we'll give it atry, but we haven't yet stay
tune.
(58:05):
Stay tuned.
Um, And I just wanted to confirmthat dunking donuts is a big
deal here in Florida.
and we actually, this was atradition that started before
diabetes, but I was like, we arenot giving that up.
I don't care about diabetes.
Right.
But we're not,
Samantha (58:19):
I think that how I
feel this morning.
Katie (58:22):
Yeah.
There you go.
But we, the last Friday of everymonth, so 12 times a year, we
swing through Duncan and get adonut, so
Samantha (58:30):
12 times a year.
So yeah, we definitely hit upDuncan much more than that.
Katie (58:34):
I mean, I'm not gonna say
those are the only times we hit
up Duncan, but I'm just sayingthose are the scheduled times.
Yes.
Those are the scheduled times.
yeah, but we have to give itSarah likes the strawberry
frosted donut with sprinkles andyeah, we ideally like.
A 20 or 30 minute pre bolus isbest for that, but yes, for us
at least.
But yeah, but we don't, youcan't always, you can't always
(58:56):
make that that's.
I mean, you know, cause a lot oftimes we're swinging through
dunking after I pick him up fromschool.
So she might only get like a 10or 15 minute pre bolus by the
time we yep.
Pull in the direct, our thing
Samantha (59:06):
is the way that the
route to school is set up.
I always say, she'll be like,why should I take my insulin?
I'm like, take eight units whenyou're by burger king, she'll
call me and be like, Hey, I'm atburger king.
Should I take that insulin?
but she's really 10 minutes awayfrom dunking Uhhuh.
Oh
Katie (59:22):
my gosh.
So things that we suggest Iknow.
Right, exactly.
I don't know.
It's nice that our kids are alittle older though.
Cause they can like, I know dothat on their own sort of.
Thank God.
I know.
Thank God.
all right.
I'm gonna quickly go throughthis next section.
It is on.
So that was.
You know a list of how toprevent the after meal spikes.
And then this is like a tips onhow to get food to digest more
(59:46):
slowly, which could also help toprevent the after meal spikes.
But he basically says you wannatry to eat lower GI foods.
Those are, you know, things thathave a lot of fiber um, and GI
stands for glycemic index.
If listeners don't know that,but table nine, four in the book
in this chapter provides ways tosubstitute high GI foods for low
(01:00:09):
GI foods.
So you might wanna take a lookat that.
We just don't really do that.
I mean, we try to eat healthymost of the time, but I'm not
like.
Spending all my days, trying tofigure out ways to substitute
high GI foods for low GI foods.
But that's just me.
Amen.
Yes.
Yeah.
I did not know this.
I think this is reallyinteresting if apparently if you
add some acidity to your food,like vinegar it slows down the
(01:00:32):
rate of digestion, like Hmm.
By a lot.
So the, apparently this is whysourdough bread is much lower on
the glycemic index than regular,like just regular white bread.
And research has shown thatadding acidity in the form of
vinegar.
So either just taking like ashot of vinegar straight or
using a salad dressing that hasvinegar can reduce one hour post
(01:00:53):
meal, blood sugar rise by asmuch as 50%.
Wow.
I'm like so tempted to haveSarah take a shot of apple cider
vinegar after she eats breakfastcereal and see what happens.
Samantha (01:01:03):
I know, I wish I could
get Amelia to do that.
Maybe
Katie (01:01:05):
if I offer some Robux.
Yeah.
Or pickles.
Sarah loves pickle or yeah.
Yeah.
Oh too.
Yeah.
Maybe like here have somepickles with your toast
breakfast
Samantha (01:01:16):
with your breakfast.
Can you imagine?
Katie (01:01:18):
Yeah, I know I could not.
So I don't know.
Fun fact did not know that hesuggests splitting your meal, so
eat some up front, save some forlater sequence properly.
So eat your meals in a sequence,like try to eat your protein
first proteins and veggiesfirst, and then save like the
carbs for later in the meal usean add-on medication Simin,
(01:01:38):
which is also called preAlatoid.
That's the like hormonereplacement for amylin that
hormone that I was talking abouta little while ago and then GLP
one receptor agonist also slowdown digestion.
I'm not gonna say anything elseabout those other than that,
cuz.
That's probably beyond the scopeof me.
Mm-hmm but he also says getmoving, which is, was in the
(01:01:59):
last section, but not only, youknow, muscle activity, you know,
it, it's kind of like freeinsulin cuz you don't when your
muscles are exercising, they cantake in glucose without insulin,
but also when your muscles areexercising, it diverts blood
flow away from your intestinesand from digestion.
So it slows down digestion.
So good to keep in mind andlet's see.
(01:02:20):
Oh, this was super interestingto me because I think we were
actually seeing this sometimesin the morning with Sarah.
But apparently when you have alow blood sugar, one of the many
responses that your body hasincludes accelerated gastric
emptying, which means that fooddigests and raises blood sugar
even more quickly than usualfollowing a low blood sugar.
(01:02:41):
So that would be great forsomebody that's having a low
blood sugar.
Right.
But when it occurs soon beforeeating a meal, it can contribute
to excessive post meal spikes.
So in the mornings.
especially with cereal, I wasdoing like a 30 minute pre bolus
for before Sarah would eat hercereal.
But sometimes that would causeher to go low before she
(01:03:02):
actually ate the cereal mm-hmmAnd then we would see these
really big spikes.
And I was kind of attributingthat to like a rebound high from
like the adrenaline that's beingdumped into our system.
And then mm-hmm, that's causingthe high blood sugar, but I feel
like it also might have been.
You know, partly attributed tothis, like the accelerated
(01:03:23):
gastric emptying, which meanslike, not only are we dealing
with a rebound high andbreakfast cereal, but now we're
dealing with this like superfast digestion that's causing
her blood sugar to go evenhigher.
So then I start, this has workedreally well for us, but I'll
give her, like, I call it anAppetiser.
I'm like, here's your Appetiserand I'll I'll give her like,
(01:03:43):
just a little tiny handful ofcereal or like a couple grapes
or just something that's gonnalike bump her up a tiny bit to
keep her from crashing beforeshe actually eats her breakfast.
Yeah.
So what, what on that list stuckout to you the most to when it
comes to getting carbs, todigest more.
Samantha (01:03:59):
We're a huge on taking
a walk.
Like if we just ate and took aton of insulin, taking it, if it
wasn't on the list, but we takewalks or I have her like hop
right in the shower.
Dinner can sometimes be hard forus, like right before bed and
too much insulin lingeringbefore she gets asleep.
So I'm like get in the shower.
So everything and love loudbefore you go to bed.
Katie (01:04:20):
Oh yeah.
We used to shower in the bathall the time.
That's like one of Sarah'sfavorite go-tos I'm just gonna
get in the bath too.
Perfect.
Yeah.
Samantha (01:04:29):
Yeah.
How can see you later?
We like prop up iPad.
Give her a movie.
We're like just sit in there fora little bit.
Katie (01:04:33):
Yeah, exactly.
I love it.
What if she dropped it?
Is it waterproof at the
Samantha (01:04:36):
iPad?
No.
Yeah, no, no.
So we have this little stoolit's designated for the iPad.
It's like this Amelia stool thatwe have in her room.
We grab it on like grab youriPad stool.
We put it by the tub.
Katie (01:04:45):
Okay.
She's not like holding it overthe tub.
You have it like God, no.
Samantha (01:04:51):
we saw her like 10th
iPads.
So definitely no
Katie (01:04:53):
yes.
Yeah.
Okay.
Okay.
Gotcha.
All right.
Well, let's see.
All right.
Troubleshooting routine highs.
We are kind of wrapping up thechapter here, but you know,
sometimes you just high bloodsugars just seem like
unexplainable, right?
Like you've tried to figure itout and you just can't it's like
your blood sugar's just high forseemingly no reason.
(01:05:15):
The author does give a goodreview, however, of like things
that can cause high blood sugarson pages 2 82 and 2 83.
And then a lot of that wasdescribed in chapter eight.
So if if you know, I, I won't,I, I'm not gonna list all those
things here, so you can go backand listen to the chapter eight
episode or look through chaptereight yourself.
But then he does offer somequestions to ask yourself when
(01:05:36):
the highs truly seem to be unexexplainin.
So he says, ask yourself, is theinsulin spoiled?
I feel like that doesn't happenas much as people seem to make.
You wanna think it happens, butagree.
So, yeah.
So has the insulin gone bad?
Maybe you forgot to take yourinsulin.
Maybe you forgot to take yourbasal insulin or your bolus
insulin.
You know, that can happen is theinsulin absorbing properly.
(01:05:59):
So author gives some reallygreat examples of how to, you
know, properly rotate yourinjection sites and your pump
sites to avoid like having thosefatty deposits filled up, which
can prevent insulin from beingabsorbed AB absorbed that's on
page 2 86.
And then he says, ask yourself,was there a gap in insulin
coverage?
Like maybe.
(01:06:19):
Like, maybe again, you didn'ttake your basal insulin kind of
like at your scheduled time oryou forgot to take it all
together, or maybe you suspendedinsulin.
Like if you got in the pool andyou were swimming and so your
basal insulin, wasn't runningfor two hours.
I know for Sarah, whenever Isuspend her insulin before she
gets in the pool, like as soonas she gets out of the pool, I
(01:06:40):
have to turn her insulin back onand give her a bolus for what
she missed.
Yeah.
So like, if she, like right now,her basil rate is right at like
about a unit, a little higherthan that actually, which I
think is really high for a 10year old girl, but whatever.
So if she's in the pool for twohours and I've suspended her
insulin, like when she getsoutta the pool, I have to Bo
list for that.
Like I have to give her twounits of insulin right away,
(01:07:01):
even if she's sitting at like70, because I have seen pattern
over and over again that shewill immediately start to shoot
up.
Yeah, after she gets outta thepool.
Uh, And then, oh, really.
Yeah.
Yeah, it's crazy.
Isn't it?
Samantha (01:07:14):
Yeah.
It's kind of weird, honestly.
Yeah,
Katie (01:07:16):
I know.
And then the last question is,has your pump failed or
malfunctioned that can obviouslycause gaps in your insulin
coverage and can cause yourblood sugar to go really high?
Do you have any kind of likeanecdotal advice or stories
concerning any of thosequestions?
Samantha (01:07:33):
For us we're big on,
like, I do agree, like take your
basil when you, like, if you areMDI, definitely taking it.
Like for me, I, I take it when Ilike first wake up, so I like, I
have thyroid medicine that Itake and I take that with my Aus
in the morning.
But for anyone else, I mean, Iknow they typically suggest that
you take it at night, so maybetaking it, like, like they say,
(01:07:55):
like when you brush your teethor like prepare something, like
always make sure you do it in aroutine because that's something
so easy to.
Advice wise for that, but pumpfailures.
Yeah.
Oh gosh.
That's like something huge forus because I do feel like, I
don't know if it's just how rushshe is because.
Um, We have so many podfailures.
I don't even know really what tosay.
(01:08:17):
A lot of the times for us,that's what it is.
The pods failed.
Like it either came the adhesivepeeled off or we have that a
lot.
Katie (01:08:24):
Yeah.
We have only, I feel like we'veonly really had like maybe three
or maybe four pod failures, liketrue pod failures.
Or like truly like the cannulacame out and I didn't realize
it.
Yeah.
Or the cannulas totally bent.
And I didn't realize it butother than that, I've realized
that most of our high bloodsugars are just user error.
Samantha (01:08:43):
like, oh my gosh,
don't you love that one?
You're like, oh, this poddefinitely failed.
And then they're like tanking 60double errors down.
And you're like, God tank it.
Yeah.
It's your body.
It's not the pod.
Katie (01:08:54):
Yes.
Or it was my poor treatmentdecision or whatever the case
may be.
Yeah.
Like I.
But I like, I do like to blamethe pods sometimes even though
it's usually not the pod, it'susually me or something else,
Samantha (01:09:05):
you know, I'm like,
God dang these pods in reality,
I like gave her way too muchinsulin for that, but whatever.
Right,
Katie (01:09:11):
right.
But I mean, the author kind ofends the chapter with like, if
you are off of your insulin, forwhatever reason, whether you've
suspended it, cuz.
You've gotten in the pool orwhatever the case may be.
Mm-hmm or your PO your pump hasfailed.
Like you really need to get someinsulin in the system as quickly
as possible, because it it'scrazy, but you DKA can really
(01:09:31):
start to happen within likehours of not having your
insulin.
Which is insane to me.
We actually saw this a coupleweeks ago when we were in
Arizona and Sarah got so sick,like just insane, but you know,
DKA, diabetic ketoacidosis iswhen basically your body doesn't
have access to insulin, and ifit doesn't have access to
insulin, it can't use glucosefor fuel.
(01:09:51):
So it has to start breaking downall the fat.
And when fat gets broken down tobe used for energy, it gives off
all these byproducts, which arekeytones and keytones are very
acidic.
So it can really mess with thepH balance of your blood and it
can turn it.
Really, really acidic reallyquickly.
And then when it gets too high,your body just cannot get rid of
(01:10:12):
it fast enough.
Like you just can't flush itoutta your system.
So, you know, the author sayshe, he gives three steps to
reversing.
The problem if keytones arepresent.
So not if you're in DKA, like ifyou, if you suspect that your
child is in, or you are in DKA,which the signs for that are
nausea and vomiting breathingmay be very deep or in irreg,
(01:10:32):
fruity odor on the breath, dryskin, dehydrated from excessive
urination, intense thirst, drymouth blurry, vision headache,
and muscle aches and pains.
Like if there's keytones and yoususpect DKA, you just need to go
straight to the hospital.
Like don't even try to messaround with that.
But if there's, you know, ifit's early on and the keytones
are present and they're like,Not causing any of those big
(01:10:56):
symptoms.
Like he gives three steps to tryto reverse it.
He says inject rapid actinginsulin consi, consider doing it
into a muscle to get the insulinmoving quicker drink tons and
tons of water to try to flushout the keytones.
And then if you're on a pump,you wanna change the cartridge,
the tubing the infusion set, orthe pod, if you're on Omnipod
and then use a fresh VI ofinsulin to try to get those
(01:11:19):
keytones out of there, becausefailure to correct could, like I
already said, put you into DKApretty quickly.
And this is a interesting fact,more than 80% of type one
diabetic inpatient hospitaladmissions are due to DKA each
year.
So if diabetics are going to thehospital type one diabetics,
it's usually cuz they're in DKA.
So have you ever been, I mean,other than.
(01:11:42):
At diagnosis.
Have you ever been in DKA oryour daughter ever been in DKA?
Samantha (01:11:46):
Only once when I had
the flu, I was probably in high
school and my mom was like,okay, like your blood sugar has
been high for like two wholedays.
Like we should probably go tothe hospital and I was like,
okay, I'm just gonna runupstairs really quick and brush
my teeth.
Well, I guess I passed, I guessI passed out.
My sister tells me I took 20years off of her life all the
time.
She bet you went upstairs time.
And I passed out by bathtub andI don't remember it happening of
(01:12:08):
course, but they ended up likedragging me down the hallway and
I woke up in the, the ICU oh mygosh.
It's funny to us now becausethey just get so they're so
like, if anyone tries totrivialize diabetes, they, my
sisters go hard on the like.
Okay.
Well, you've never like druggedyour sister down a flight of
stairs to take her to thehospital.
(01:12:29):
You obviously don't understand,like I put them through
Katie (01:12:32):
it.
Oh my gosh.
Yeah.
Wait, sorry back.
So you were in high school.
So were you like going through aphase of just wanting to ignore
your diabetes or what happened?
Oh, a
Samantha (01:12:40):
hundred percent.
A hundred percent.
When I first got to high school,I went from a private school to
a public school and I was on, Ihad the Medtronic pump and a kid
who I'm like friends with now,but I was a freshman was like,
are you wearing plasticunderwear?
Cause my pump tubing was takingoutta my pants.
Well, that was all I needed tonot wanna wear my pump to school
(01:13:01):
and oh yeah.
Yeah.
I hate it.
Oh yeah.
Did it, did myself dirty.
So, and my sister.
So now they're all like, if Ilook, if I take a long nap, if I
look grouchy, if I'm tired,they're like, what's your sugar,
are you okay?
I'm like, oh my God, you guys.
That was like 17 years ago.
Katie (01:13:21):
Oh, but that, isn't it.
It's a little bit of that issweet, right?
That they're so concerned aboutyou.
Yeah, I know.
I'm you scared'em to death.
That's what you traumatized by.
I,
Samantha (01:13:30):
I did.
That's what I like, they feellike they're gonna die young.
We just worried about diabetesand they're not
Katie (01:13:35):
diabetic.
I know.
I feel like I need to have youback on sometime to just talk
about that whole teen phase ofyou wanting to ignore your
diabetes.
Cuz I feel like a lot.
That's like a lot of parents'fear is like it happens their
kids.
Yeah.
I know it does.
I'm just
Samantha (01:13:49):
like, cause kids are
mean right?
Like they just like say thewrong thing and then that just
like totally changes yourperception of yourself.
Really?
Katie (01:13:58):
Yeah, I know.
And in middle school and highschool, it, like you said, it
only takes one thing to.
Set off and, yep.
Okay.
I'm gonna start praying now.
Samantha (01:14:08):
I know makes me panic.
My, my daughter heard girls justwanna have fun for the first
time.
A couple months ago, I was like,mom, this is gonna be me.
I swear to God.
I had an instant panic attack.
I was sweaty.
I'm like, oh my God, I can'thear this.
I cannot think that.
Please don't wanna have fun.
I need you to like, stay homeand just live with me
Katie (01:14:27):
forever.
I know right there will be nopartying in drinking for you in
college.
Not absolutely not.
No girls
Samantha (01:14:34):
having fun whatsoever.
Katie (01:14:37):
Girls just wanna have low
car snacks and take their
insulin.
That's what the song should say.
Girls just
Samantha (01:14:43):
sit really calmly next
to their mom until they're 80.
Oh,
Katie (01:14:50):
well, I would love
actually, I would not love that.
Let's be honest.
I'm ready.
I'm like, when can, y'all getout of this house, but I, I
it's.
Yeah.
I, I just, can my
Samantha (01:14:59):
husband think about it
in the same way?
He's like, Sam, she'll be fine.
If she goes away for the day,let's go on a date.
And that then there we are checkhim the Dexcom every five
minutes, minutes waiting for thefour to hit five.
I'm like, oh God, come on.
Katie (01:15:09):
Yeah.
Yeah.
I know.
I, I hear you.
I know.
All right.
Well, Sam, thank you.
I know that was a longerrecording and I just really
thank you for your time.
And I loved hearing all of yourlittle stories and your tips and
tricks.
I think, I just feel like youhave like.
You know, you have like doublethe amount of insight and wisdom
since you've lived with thisstuff for so long, and now you
have a child with diabetes and Ifeel like you had a lot to
(01:15:33):
offer, so thank you.
Samantha (01:15:35):
You are so welcome.
It was so nice to be honest,honestly, so nice to like, I
feel like a lot of people woulddo so much better.
Like just talking to someonewho's going through the same
thing.
Like it's, mm-hmm, it's, it'slonely when you don't have a
kind of someone that understandscause no one does, unless you're
doing exactly what they'redoing, you, they don't get it.
Katie (01:15:56):
I know.
I know, I agree.
The bummer.
I know.
I know.
That's why I've tried tosurround myself with I've like
forced people to be friends withme.
I'm like, oh, your kid hasdiabetes.
You will be friends
Samantha (01:16:06):
with me.
we're like, oh my God, I saw youhad, we had so many times we've
like walked up to people andbeen like, Oh, my God.
I saw your deck come.
Oh my gosh.
On the pod.
And majority of the time theylook at us like, go, like, I do
not wanna be your friend.
Cause we're like in Disney or onthe beach, you know, like
whatever.
And we're like, OK, bye.
Like I just wanted, saw diabeticin the wild and wanted to be
(01:16:27):
your friend, but it's fine.
It's totally okay.
Katie (01:16:29):
I know.
I know you don't wanna exchangenumbers?
No.
Okay.
No, you wanna be
Samantha (01:16:34):
my friend forever.
Okay.
All right.
That's fine.
All right.
See ya.
Katie (01:16:38):
oh, I know.
I feel like I get most of thetime.
Those are the looks I get too.
There was this one time I wassitting at a, I was watching my
son's baseball game and Sarahwas sitting on my lap in this,
like, she must have been, Idon't know, 30, maybe mid
thirties.
She like grown woman comes up tome and like flexes her arm in
front of my face.
And she had a Dexcom on her arm.
Oh my God.
And I was like, it like took mea second cuz like my eyes had to
(01:17:00):
focus cuz it was that close tomy face.
And I was like, oh and I liketurned around and she's like, I
just wanted to come say hi, I'ma fellow diabetic.
I was like, oh I would've lovedher.
See, I did love her.
Like after the initial shockwore off, I was like, I'd like
to be your best friend, butanyway, she had to go cause she
had to go home or something likethat, but I wanted
Samantha (01:17:18):
you to come home with
me for dinner, but it was nice
to meet
Katie (01:17:20):
you talk later.
Right.
Right.
So I thought that was fun.
I like when people do weird,crazy stuff like that, like be
weird.
Be awkward.
I, I
Samantha (01:17:28):
appreciate it.
It consult working inhealthcare.
I think you're you're are you aphysical therapist?
Yes.
Physical therapist.
Yeah.
Yeah.
Oh yeah.
Yeah.
So patients like make you wannabe weird and you just accept it
for what it's oh.
Katie (01:17:38):
Patients are so weird.
Like if you ever had a normalpatient, I don't think I ever
have
Samantha (01:17:42):
never, never.
And I love them.
I love the weird ones.
Katie (01:17:45):
I know I do too.
Like the weirder, they.
No, listen, I don't like themean ones.
I hate the mean ones.
Dito.
Those are so bad, but the weirdones, I'm like, I'm, I'm here
for you.
Samantha (01:17:55):
Come over here to me
and snuggle me.
That's thought exactly how Ifeel.
I'm like, give me these weirdo.
I love them.
Katie (01:18:01):
I know.
Which is why I think I'm gonnado really well when my kids are
middle schoolers, cuz middleschoolers are just so weird and
awkward Dito.
But I
Samantha (01:18:07):
think I'm yeah, my
daughter's friends think I'm
like so funny and she thinks I'mthe biggest loser.
She's like, mom, stand up.
I'm like, come on.
I love it.
Aw.
Let's do something weird.
And she's like, no.
Oh my gosh, whatever.
Katie (01:18:20):
fine.
They'll they'll well, they'llappreciate it.
When they're older they can lookback and yeah, come on.
That's pretty cool.
I
Samantha (01:18:26):
guess okay.
You were a little funny.
Yeah.
Katie (01:18:30):
all right.
I'm gonna let you go.
But Hey listen.
When I hit stop, don't like giveit like 30 seconds because it
needs to upload real quick.
Okay.
Okay.
Samantha (01:18:39):
Okay.
Katie (01:18:40):
All right, guys, that is
it for the show today.
I have a few updates.
First of all, I would like youall to know that both Samantha
and I are now using the Omnipodfive automated insulin delivery
system.
And Samantha has braved theautomated mode and she is loving
it.
She wants everybody to know thatshe's now using auto mode.
(01:19:01):
Most of the time and they'reabsolutely loving it.
And that is the same for us.
I have only flipped it intomanual mode once or twice to do
a bigger extended bolus for aheavier meal.
And other than that, it's beenan automatic mode or auto mode.
What automated automated mode.
that's what it's called.
And we are absolutely loving it.
I mean, our control has been, Iwould say.
(01:19:24):
A great deal better than it wasbefore.
Our standard deviation has gonedown and I'm excited to go to
our next indoor appointment andsee what our A1C is.
Also probably more importantlythan A1C our time and range has
been pretty darn and good.
I would say it's been Over 70%,usually closer to like 80, 85%
(01:19:44):
on most days.
So that's pretty awesome.
In my opinion, I also wanna letyou know that I just put
tropical punch Koolaid on myWalmart order for my next
Walmart pickup.
And I was laughing when Ilistened to that part of the
show when I was editing it.
And I thought, oh, I forgotabout that.
I gotta add it.
Grocery pickup.
So I did that and I will let youknow how it goes.
(01:20:06):
It made me sad to talk about thered Lily emergency glucagon
kits, because just recently welearned in the diabetes news
world, that those kits are gonnabe discontinued soon, so they
will no longer be available.
I think it's just becausethere's so many like
autoinjectors now, like the GVOhypo pin and the basi nasal
spray that those Lily red Lilyold school glucagon kits just
(01:20:28):
don't get used as much.
Let's see.
Last update.
Samantha mentioned being a hugepre bolus family.
We are also a huge pre bolusfamily.
Our control is so much better.
So, so much better when we prebolus typically in the mornings
for us, for breakfast, it's a 30minute pre bolus and other meals
of the day.
It's more like a 15 or 20 minutepre Bowlus.
And then we've become reallygood at learning which meals
(01:20:50):
you, we do not pre bolus for.
And I know everybody'sdifferent, so I'm not telling
you what to do.
I'm just telling you what worksfor us.
But we recently learned thatribs, barbecue ribs is another
meal that we cannot pre Bolesfor because Sarah goes crazy low
before those ribs digest and thecarbs that she had with her meal
(01:21:11):
have a chance to get into herblood sugar and get into her
system.
So ribs, no pre bowls for us.
Also see pizza and feta Alfredo.
Okay.
I mentioned several episodes inthis episode.
I mentioned the episode aboutreading the Dexcom dots and not
the arrows.
I'll put a link to that in theshow notes.
I mentioned the episode aboutalcohol and diabetes.
(01:21:33):
I will put a link to that one inthe show notes as well.
And then I mentioned the episodeabout the Medtronic in pin,
which is the smart insulin pinthat has Bluetooth technology
built into it.
I will also put a link to thatin the show notes, as well as a
link to where you can buy yourvery own copy of think like a
pancreas and follow along withus.
All right, guys.
I hope you have a fabulous week.
(01:21:54):
I will chat with you soon, butuntil then stay calm and Boless
on.
Bye.
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