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Episode 71- Fearing Insulin on Board, Dosing for Pizza and Donuts, and a Special Surprise
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Sometimes we just want our kids to have a dang donut. But why does this food have to be so hard to dose for? Is it even worth the hassle? Raquel and Amanda think so. They go through how they uniquely dose for challenging high fat foods (like pizza and donuts), discuss insulin on board and how they use that information to make diabetes dosing decisions, and chat what it's like living ALONE with type 1 diabetes. As parents of type 1 kids, we want all the information so we can be as informed as possible and attempt to give our children as normal a life as possible. Join the Type One Together girls for their takes on all these topics and more...PLUS a little life update for one of them :)
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Transcript
00:00:00
Speaker
Before we get into the episode, we just want to give Sweet Dreams a major shout out and thank them for sponsoring this episode. Sweet Dreams is an amazing application that you can download onto your phone And ah you then put in your own or your child's um CGM data, like just see your login and password and everything. And from there, Sweet Dreams, the app, pulls in that CGM data every five minutes. But what's amazing about Sweet Dreams is it is highly customizable.
00:00:39
Speaker
So this app allows you to view blood sugars on the lock screen of your phone, which is incredible, on CarPlay, Apple CarPlay specifically. um It also shows up on your watch and it is just the most highly customizable app for viewing your child's blood sugars every five minutes.
00:01:04
Speaker
not to mention it has the rate of change so if my daughter was at eighty eight and her next reading is ninety i'm gonna see ninety plus two i know that she's nice and steady i'm comfortable that mental math is done for me and it is just like seriously the best um app ever. So we love Sweet Dreams so much. There's gonna be links and information in the show notes if you are interested. um So definitely check this out. Right now, Sweet Dreams is currently only available with Apple products, um but they are hoping to expand that soon. Thank you, Sweet Dreams, for everything you do.
00:01:49
Speaker
Hello, and welcome to the 108 podcast. I'm Amanda. And I'm Raquel. And we're the Type 1 Together girls. We are stripping down life with Type 1 diabetes from two people who live different versions of it every single day. Please remember, Type 1 Together does not give medical advice. We are only sharing some personal experience.
00:02:08
Speaker
Hello. Welcome. but How are you? Um, I'm good. I'm okay. I went to the dentist this morning, which is my least favorite place in the world pretty much. And yeah, it's fine. It's funny. It's a new dentist because I moved and he walked in. He's like, Oh, so like, have you had pretty normal dental care? Like just trying to get my history and stuff. And I was like, well, I have type one diabetes. Like,
00:02:36
Speaker
Here's the whole situation because a while ago, like a few years ago when I moved to LA, I did end up having like quite a few like really tiny minor cavities. And I do because of the overnight low stuff. And I told him though, it was like, it used to be like that. I used to have so many lows, but now when I think about it, like I might wake up once a month, maybe twice a month for a low in the middle of the night. And I like treated very differently than I did when I was younger.
00:03:05
Speaker
So that's kind of cool to think about and like reflect on how that's going to really help. like This technology is really helping not only the health of, well, it's part of health, but you know the dental hygiene as well for these kids. Yeah. Well, it's interesting because it's just funny timing because I took Hattie in summer to the dentist last week on Friday.
00:03:25
Speaker
And I think it was Friday. Yeah. And I was totally expecting it to not be great because like full transparency, I don't spend three minutes every single morning and night brushing their teeth and perfectly flossing. Like it's too hard. They're toddlers. It's crazy. We try our best, but it just doesn't always happen. And then it's not, it's definitely not like I'm waking her up after every low in the middle of the night to brush her teeth. I always try and offer her water, but that's it.
00:03:53
Speaker
And then she grinds her teeth and her teeth are really spaced out. And that she also chipped her tooth when she was a baby, her front tooth. And there was a little bit of trauma left over from that. And so I was like, oh, here we go. It's going to be our first like set of cavities. And to my surprise, there were none, um which I'm so grateful for. And I don't know if it's like,
00:04:18
Speaker
I know that like genetics play a role in you know healthy, strong teeth and whatever, but I definitely had cavities as a kid. I did too. I didn't think about that little. I think I was probably more like 10 or 12 when they started. If that's a thing or not, I have no idea.
00:04:37
Speaker
Yeah. I mean, I don't know either. I know my husband did not ever have cavities as a kid. I don't know if he, yeah. ah regardless But it's just interesting. That's definitely one of the things that I was thinking about and kind of like, you know, just one more panic about. And that a lot of suggestions are to go to the dentist for a cleaning when you have type one every three months, not every six, but I know and like our our kids dentists initially recommended that when we started taking them when Hattie was just two and I was just like oh this just feels like a lot you know and so I didn't end up doing it you know and I always felt like she was judging me slightly for not doing
00:05:27
Speaker
it, but I definitely take them every six months. And then that that dentist stopped working. I don't know what happened to her. And we saw a new one for the first time on Friday, and he was so nice. And he like you know did his little check, scraped something, and he goes, looks good. No cavities. You're doing great. And I was like, oh,
00:05:47
Speaker
It's so good. Wow. Amazing. Yeah. I'm also another part of this. I think that people have asked about is like going in to do dental work and having to suspend your insulin and all of that stuff. Or like, how do you handle that? Which I guess you haven't really.
00:06:02
Speaker
dealt with yet, but I'm going back into the dentist this afternoon to actually deal with the problem that I went in for. And it's going to be like an hour and a half to two hour thing, not of me sitting there getting work done, but just like being there while they do whatever they need to do. They said I could work during it, so I don't really know how it's going to go.
00:06:19
Speaker
And I'm already thinking like, hmm, this is going to be an afternoon appointment. So I'm going to have and like, I definitely want to eat lunch before because I'm probably not going to want to eat right after. So how am I going to handle all of this? You know, yeah I'm actually having like the most steady, beautiful blood sugars. I went on a long walk this morning with a friend, which I think really helped. Like I'm sitting at 98 study right now.
00:06:41
Speaker
but I am nervous once I have lunch what's going to happen. So. Yeah. Yeah. Yeah. What do you do? Cause like I go in with them and just sit right next to her. And so far we haven't had any major procedures that have needed to happen. It's just been the cleanings, but there was one point on Friday where she was dropping by like five, six, seven at a time. And I was like, you know, we have some in my head. I'm thinking we have some room to work with here, but like, this is not,
00:07:10
Speaker
ideal because they could be literal mid clean and I'm like sit up and have some copies. Exactly. Well, I'm really content. That's kind of what I'm thinking. If I'm really dropping, I can kind of like shove that to the back of my throat and squeeze it. And I know it works so fast, but I'm also just, this isn't like a big procedure or anything, so it's not going to be a big deal. But I think generally what I've done in the past and what I'll do this afternoon is just maybe go on exercise mode on my Moby or give a little less insulin. Like I'm just going to ride a little higher. That's kind of what I'm thinking just to be safe. What else can you really do? And I've been low with the dentist as a kid before and I think I just had a juice box. Again, the straw is really helpful if
00:07:56
Speaker
they're doing things. Yeah, it's not ideal at all. It's funny because it's like not ideal, but also or where you're at the place where they literally clean your teeth. you know yeah it's like if it At the end of the day, if you have to give your kid something, it's okay because they'll just immediately get it cleaned right back off.
00:08:18
Speaker
Very true. Well, how are you? That is the big question. I'm good. We, yeah. Okay. I guess we are just going to do it. So um we are going to be welcoming a third baby girl into the world in the spring. So that is very exciting and I don't know when I'm going to be sharing that news online, but that's a fun little tidbit for those of you who listened to the podcast. proously is ah yes so big and Obviously I've known for a while. That wasn't like the first time I've heard, but I cannot wait to meet them. And yeah, I mean, it's going to be interesting to have you share like what it's like having a newborn. Well, I know you how he was diagnosed around
00:09:16
Speaker
time we already had a newborn, but yeah that was a new diabetes life for you, right? So now you're going to be much more equipped on the diabetes side, but it'll still be interesting to see how that all balances out. Yeah. I mean, there's a lot that goes into deciding to have another child after one of your children gets diagnosed. And, you know, immediately after Hattie was diagnosed, we were kind of like, we're done. We're having two kids and that's it and we're done. Um, you know, there was a lot of like kind of weird, um,
00:09:51
Speaker
like morality and ethical kind of thoughts happening of like, if one child has it, that means subsequent children are at a greater increase to get it. Is it like ethically and morally?
00:10:08
Speaker
okay to make a decision to bring a child into the world knowing that like their chances are increased, you know which was just a personal thing, not a projection of how we think society should operate. It was just ah within the two of us making a decision. And so early on, when we were completely bogged down and stressed out and freaked out,
00:10:33
Speaker
It was like, no, we can't do this and we're done, which we were really sad about because we went into our marriage wanting four kids. And then just like as time went on and we, the pump changed everything for real, but um And we just like saw her flourish and grow and the strength that she has and it's just part of her. it just it It's not like this big doomsday scary thing. It's just part of her.
00:11:08
Speaker
And if one of our other kids gets it, it'll just be part of them. And it is what it is. And so, yeah, we we were feeling ready, although not necessarily really trying.
00:11:24
Speaker
but But our family and our mom and dad hearts were open to another child. And so ah yeah, we're going to be a little family of girls. Danny's going to be a girl dad for life and we're just really excited. I'm so excited. And yeah, I've never actually thought about that from a morality perspective.
00:11:46
Speaker
from your position, right? Cause I think about that a lot with like, Oh, my kids have a relatively, it's not high, but like higher than the average person. yeah Um, and I've gone through those steps as well of being like, is that okay? But yeah, have kids really badly. Yeah. And I think that we, you and I have talked about this before where Danny and I view parenthood and bringing children into the world as a privilege and not a right.
00:12:15
Speaker
and that it's a like very serious decision that needs to be made and a thoughtful decision. um And so I think it was just like all part of that as you know that that part of our personality. But when it came down to it, we were sort of like, but you you don't know what could happen with any kid at any time. You just don't, you know? like And our our journey to bring kids into the world has been anything but easy. We've had losses and
00:12:48
Speaker
a lot of medical issues and stuff. um And so it was sort of like we've gone through all this and literally nothing is ever guaranteed. And that is not going to prevent us from like choosing to endlessly love like these little things that bring so much joy. And then in turn, it's our responsibility to make sure that life is as happy as it possibly can be for the kids that we've chosen to bring into the world who didn't get a say. yeah Yes, I love your perspective on that. Yeah, I'm so excited. The news is partially out. I've been waiting. Partially out. Partially out. Yeah. We typically like to wait until we're as close to halfway slash past the um anatomy scan and or viability. So we're getting there.
00:13:41
Speaker
So yeah, day one listeners, if you're still here, you're the only ones. Keep the secret, please. Or if you see Amanda on public with her adorable little. bump It's so cute. And then with the bang, your hair is so cute. I needed the the bangs. ah I told you this already, but my hairstylist literally refuses to do any drastic haircut within six months of a major life change, including giving birth to a baby.
00:14:12
Speaker
So I was like, okay, I'm so sick of my haircut and color and I need something fresh and let's do it before the baby gets here. So bangs, banging it out. We're fine. Yeah. All right. Well, we're kind of just going through some different requests that we've gotten.
00:14:31
Speaker
for a while now that we haven't really got today. Yeah, we'll just get into some of the major diabetes things and hopefully you can take away a few things um for you know your own diabetes management and practice in real life.
00:14:48
Speaker
Well, let's start with this one, I guess. Someone wanted to know what it's like for Type 1 adults living alone and working. I can't say I'm like the perfect example to be able to talk about this. My situation has been a little unique, like working for myself, working from home a lot. I did have a job for a little bit. I did ah i was doing marketing for a cycling studio full time at one point, and I was there a lot, and they all very well knew that I had Type 1.
00:15:17
Speaker
is kind of a running joke because they had bananas there for all the customers and they would just like throw a banana at me anytime that my Dexcom would beep. Oh my gosh. Yeah, it was very funny. But yeah, I think living alone can be scary. And I know my family was more worried than I was about that rightfully so you just never know what can happen. And I think having Dexcom follow by the time that happened to me was really helpful and made me feel better. And at that time I had some friends, I was living in Austin when I lived alone. So some friends in Austin who a couple of them followed my Dexcom and then I had like a mom who I babysat for following me because whenever I babysit for them, she would want to make sure I was okay too. Yeah, cute.
00:16:01
Speaker
um And I had, of course, my mom and then my boyfriend at the time was following me. So yeah, I mean. Wait, did you ever like truly live alone? Like no roommates? Yes, I lived alone for like two and a half years.
00:16:19
Speaker
Yeah, what? Yeah, maybe we okay, this is kind of a memory, but I don't know if we've actually gone through this. I that is the one thing that I wish I had the opportunity to do. um Obviously, I'm very grateful that everything worked out with my husband because we were were high school sweethearts. So we just like went straight from being at college away from each other to living with each other. But oh man. Yeah. Okay. Tell me about it. It was really fun. I actually lived in a 300 square foot studio for a while and it was adorable actually. It was like an L shaped and it was like my bed was on one side and the little mini kitchen.
00:17:04
Speaker
And it was at a big apartment complex near the lake in Austin so it was like very lively and there was a huge dog park and I had just gotten Cody so every day all of us would go down to the dog park at the same time and it became a nice little friend group. And, you know, I was dating at the time so like I wasn't alone every single night.
00:17:22
Speaker
Um, but yeah, I think if you're someone who doesn't wake up to alarms and having something like a sugar pixel could be really helpful. And I don't know, like you just do it. You figure it out. I almost, I felt almost better about it than when I lived with roommates because then you're not dealing with like bothering them, not that they cared, but you never want to feel like you're bugging them with all the alarms and stuff. And I never even asked my roommates for help with anything. Like I would tell them about what to do, but that never happened, you know?
00:17:53
Speaker
Yeah, I think that is what my thought immediately goes to is like, were there ever points in time where you were so tired from a low or a stubborn high, whereas like you knew you had to do something for your health and safety and you just like literally didn't have the energy to even get up? Did something like that ever happen? Not just from a low, like there was a time where I was really, really sick. Yeah. Diabetes with that was really tough and I remember asking for help, whether it was like driving me somewhere or getting me Gatorade or remember once, like little things like that. But I don't know. I just was, I've always just kind of had this weird ownership over my diabetes and there was never a point where I needed anything. Like I had juice, I had glucagon if I really needed it, which knock on what I never have. Like I just felt okay in that department. and That's just the honest answer. and I know a lot of people have a lot more stories, but yeah I would just figure it out. So.
00:18:52
Speaker
Yeah. i'm trying to but It was really fun to live alone. Very, very fun. I'm glad I had that experience. And then I moved into another one bedroom apartment by myself, but then ended up only living there for two months. Cause that's when I went on my little adventure, which I won't get into the whole thing, but like lived in Arizona, LA, then moved to LA. Then when I moved to LA at first, I lived with a roommate.
00:19:12
Speaker
And at that point, I was much more of an adult, like not as much fresh out of college and I wasn't super good friends with the roommate. So I definitely explained that I had type one, but I don't even think I like showed her the movie on or anything. I just.
00:19:26
Speaker
I felt okay about it, so yeah. Yeah, it's interesting. I do think that if Harry ever decides to live alone, that I would... First of all, I think I'm gonna... gonna... I can't tell how I would feel about it now because she's still too little and I don't know how she's gonna handle her diabetes, but the one thing right in this moment that exists is, like you said, the sugar pixel.
00:19:52
Speaker
So I think I'd feel a lot better knowing that she has like that she would have this sugar pixel right next to her bed and maybe even the but little thing that vibrates under her pillow. Yes. And then like a drawer a drawer full of low snacks that she can super easily roll over and just like reach. Yes, exactly.
00:20:18
Speaker
and to add on to the part about me having friends that followed me, my really great friend, Ashley, we had a plan in place of, okay, I think at one point I even gave her a key. Like this is how you actually get into my apartment if I need help. And I think that is something everyone should do. Even if you find one person in your area that has type one, it's not a mom or a dad that's like nagging you, right? It's a friend and they get it and they actually know how to fix the problem if it happens. Cause my parents were, you know, a few hours away in Dallas. So,
00:20:48
Speaker
There was no hope there. Yeah, I agree. The sugar pixel is great. And then in terms of working, I just kind of carry the belief that no matter if it's a relationship, a job, a workout class, like I like to tell people ahead of time. Most of the time that I have diabetes, I wouldn't necessarily suggest saying it in the interview process because you just never know, even though they're technically not supposed to consider that, you never know.
00:21:10
Speaker
happen. But I think once you get a role, just being upfront about it, laying it all out there because it just alleviates the stress leader when something comes up and then you're like, Oh, but I didn't properly tell them about it. Like a very minor example is a workout class. I love when I first got to a studio being like, just, you know, I have type 1 diabetes. If I have to leave the room, that's why. Because otherwise I'm sitting there looking at my Apple watch being like, Oh my gosh, I may have to leave. And what are they going to think about me? And is that rude and all of this stuff? Yeah.
00:21:37
Speaker
And that just sucks. I'd rather people just know what's up. Right. So interesting. Just the idea of like having to, there's no true anonymity if safety takes priority. Right. Yeah, that's a good way to put it. Yeah. That's a hard one. Which one do you want to do next? Hmm. So someone's asking about insulin on board or specifically saying insulin on board scares them, which I think that's a common fear for a lot of us, so let's dive into that.
00:22:09
Speaker
Yeah, this one is such a good topic because it can feel scary to have insulin on board if you don't understand how the amount of insulin on board is going to be reacting in your child's body with whatever food might be left digesting. And so I think the number one key here is telling yourself to stop and pause and think back to the last food they ate and then think of the composition of the food that they ate.
00:22:39
Speaker
And I mean, you can go in like so many different directions here, but you know, this, this, so diabetes is like obviously so all consuming and the thing that helped me get past like hating it so much was relieving the mental load and the mental burden. And so one thing I will say is just with practice in time, the idea of trying to keep track of every single thing your child ate, gets easier and it becomes more intuitive. So it's not necessarily going to feel like, okay, they started their first bite at 1207. It was this exact mac and cheese with this exact amount of apples and you know whatever. like It doesn't have to be like that. So you can just kind of loosely think to yourself, okay? At 12 o'clock, she had about 40 grams of macaroni and cheese that stays in the body.
00:23:34
Speaker
longer than usual. It's not the fastest acting. She had some apple, there's fiber, so that's going to help slow digestion. And then she like drank a ton of orange juice right at the beginning. So that's where the spike came from. And there's all this insulin on board because it was a carb heavy meal. So let's say like, Oh gosh, there's four units of insulin on board. And it's been an hour since my child eight well if their blood sugar is not necessarily swinging drastically up or down then it doesn't need to like consume you and worry you at this point in time because your thought process should be more of.
00:24:18
Speaker
It's been one hour. They have this food in their body that is slow digesting and it should match up with the insulin and it's, you know, action time. So that's mainly how I think about it. But there are some points I will say where she'll have a super carb heavy meal and that'll be at noon. And then she wants a snack or something sweet at two that requires another unit or two of insulin and suddenly there's six units of insulin on board, right? And then like 30 minutes later, some kid walks by with a freaking popsicle or something. And so I think that it's more about looking at the trajectory of your child's graph, thinking about the composition of food and the way it digests in the body.
00:25:15
Speaker
and like choosing to give insulin in the moment or being prepared to give more if needed. I don't know, did that even make sense? It said it so well.
00:25:30
Speaker
like i totally agree. I'm not going to repeat everything because that is what I believe. I just don't think I look at it very often unless I'm about to have some sort of activity yeah or kind of on the fence where like I probably could use more insulin, but I'm not really sure. like But if you see that you're shooting up to the 300s or you're double arrows up or whatever, that signals to me there's not enough insulin in the body.
00:25:56
Speaker
there needs to be more insulin. Like it's that simple. And yes, sometimes I do end up having to prevent a low before it happens, but thankfully we have the tools to be able to do that. And I also pay attention to it before bed. I will say before activity and before bed is really when I care. But like you said, when it comes to eating another snack, I think I have a feeling this person is concerned about stacking as well. yeah And when it comes to eating more food, if you're eating more carbs, you need more insulin. It's just that simple.
00:26:25
Speaker
And it doesn't matter to me that I already have sometimes nine units on board for me, right? I'll still give whatever is necessary for that food. So. Yeah, it's important. It is important. I think the fear of it can often be like, you know, just the the fear can be a lot stronger if you're not confident in your carb ratios. And that happens because if you're not confident in your carb ratios and you see swings in your blood sugar all the time and you never guess accurately if the blood sugar is going to go high, low, or stay the same,
00:27:01
Speaker
then you're not going to feel very confident giving that next bolus when your child wants food an hour after they've already eaten. And you're going to be nervous that this time that insulin on board is going to be the insulin on board that makes them tank, right? it ta Yeah. And so I think that that's the key is like first start by really narrowing down your carb ratios. And remember that for smaller bodies, a shift of just one to two can make a big difference. So what I mean by that is literally at the end of last week, Hattie started having lows after almost every single meal. And it was like an hour to 90 minutes after. That to me tells me
00:27:50
Speaker
there's too much insulin in her system for the food because even it didn't matter if the meal was full of fast acting carbs or really slow digesting carbs, she was still going low. And so I went in and changed most of her carb ratios across the board by only one or two points. So her lunch that used to be one to 15 is now one to 17. So there's just like that much less insulin and she's now been in range almost a hundred percent in the last day and a half. And so, yeah, it's just, that's not to be all braggy, but it's just to be like, when you get the carb ratios right, stacking insulin is not actually what's happening. You're just giving the insulin for the food. Yes. And with these pump systems that exist, I think it allows us to even be less worried about it because if it is a little too much insulin, the automated systems are going to pull back. So I will say if you're on MDI,
00:28:48
Speaker
I might be looking at it a little bit more than I am with being on a pump. um But like you said, if you have the settings and everything right, you should be able to just give the insulin for more food and then you're good. very true. Okay, let's do one more and then we'll wrap this one up. um Okay, so someone's asking, how do you dose for pancakes, pizza, fries, donuts, the high carb and high fat meals? What do you specifically do?
00:29:16
Speaker
Me first. um I give a lot of insulin and then I give a lot more insulin, usually with a second bolus. I feel like that's all I talk about. I'm like split bolus, split bolus, which also could be a tip for the insulin on board thing. um You can always give a little bit and then give more later if you're on a pump. But I do, I will say, I often couple those things with some activity, which isn't always realistic for kids, but it could be if you want to have like a little dance party or something like that.
00:29:44
Speaker
But even this last weekend, I had a big brunch, then we ended up getting a little donut at this cute shop we walked by. And I ended up cleaning the whole kitchen right after, and I had like a beautiful, steady line. And I know that that line would not have been the same if I wasn't as active right after.
00:30:00
Speaker
um sometimes all even like I actually ate the donut kind of like while I was cleaning like I had a bite then I cleaned then I had a bite and sometimes that I know that's so unrealistic for kids but if they're adults listening like sometimes spacing out how fast you eat the item also helps so Yeah, that's kind of what I do. i I go for it. I give a lot of insulin with no fear or with a little fear and then I watch it like a hawk. So yeah, i I am more like food composition and digestion based and so every high carb, high fat food item that my daughter consumes
00:30:41
Speaker
is a really quick thought process of how much of these carbs are super fast acting and are typically going to result in a severe spike and how much of the fat and the process of it all going is going to like be the effect of a delay. right and so An example is like a donut, I would dose, I would do split bolusing.
00:31:05
Speaker
for sure, but I would dose a higher percentage of the total amount of carbs up front to cover how fast acting the frosting is. yeah But then I would finish it off with the smaller percentage of the dose after she's done eating 45 minutes later, an hour and a half later, it's all also hyperdependent on the current trajectory of the blood sugar and where the starting blood sugar is at. you know So if we're going into eating donuts and she's 180, she is going to be getting 80% of that dosage 20 minutes before the donuts are arriving because I want that insulin in her, I want it working, I want her to start dropping because that donut as soon as she eats it is going to
00:31:58
Speaker
be immediately halting the drop and then turning back around. you know But if she's low, if she's starting to eat a donut and her blood sugar has been 70 flat for an hour, I'm probably going to let her eat. like She's five, she's going to eat a donut in 30 seconds.
00:32:17
Speaker
So I'll let her eat it, and then I'll dose 80%, 90% as soon as she's done, making sure that like yeah like I want to see the bump up first. Yes. I'm really explaining my nitty-gritty details because I feel like that's where my mind goes through, but then when I'm explaining out loud, I like can't. put it all into words. I agree, like that part's so important knowing what the food, that food specifically will do. Because what you explained is exactly what I think is the right general move for a donut, right? But then with like pizza, for me, I need a lot less upfront and then I need get a lot more theater. So it's kind of figuring that out over time.
00:32:57
Speaker
The pizza one is really interesting, especially because my brain naturally goes to where we always go for pizza, which is like our local brewery joint down the street. And there is frozen yogurt right next door. And so we are in this habit of going to get pizza for the kids and then they get a frozen yogurt after. And so I dose kind of willy nilly on the fly, depending on where her starting blood sugar is at, like,
00:33:23
Speaker
How hungry is she actually for the pizza? Is she just gonna take a few bites so that she can you know be awarded? you know That's not actually how we work with food in our house, but whatever, given the ice cream after. But typically with pizza, if it's just pizza,
00:33:42
Speaker
Let's say she's eating a slice that I know is about 30 grams total. I'm probably going to start with a dose, depending on her starting blood sugar, start with a dose of 10 to 15 grams and then add on another 10 or 15 grams when she's done eating. And I start to see that spike that's greater than eight or 10 points every five minutes. And then if she's still really spiking, cause sometimes let's, okay, let's do it in thirds. Let's say I pre-dose for 10 grams. She eats the entire piece of pizza.
00:34:12
Speaker
and she's flat for 20 minutes, but then I see her start going from 120 to 130 to to 158. Then I'm like, okay, I'm gonna dose the extra 10 grams. If that keeps going and it's 158, 170, 190, then I'm doing another like 15 grams. So she's actually getting a dose for 35 grams worth of pizza, even if it was truly 30 grams and that is covering the delayed digestion and the fat that's going to delay or that's going to digest later. So it's all just on the fly. And I think that some people really want a simple math equation that works every time and nothing like that truly exists for diabetes management. It just doesn't. It doesn't. I put on one of the Mental Health Monday stories yesterday, like you're never going to arrive with diabetes, right? Because this parent was saying they so
00:35:11
Speaker
Like they're making progress, but they're not where they want to be. And the unfortunate reality is that you're never going to arrive. Like there's always this kind of figure it out on the fly, which sounds really frustrating when you first hear it, but then hopefully can give you some relief and some grace in knowing that things are going to change. And the problems that happen, they're not always your fault. You're always trying to learn from what's happening that week or that day. Yeah.
00:35:33
Speaker
So it's tough, but it is tough, but I think you're right. The whole like forcing yourself to stop and not necessarily. Sorry. Say like, I need to get to this place where like the, however much, what am I saying?
00:35:55
Speaker
i feel like right I feel like there was a point where I thought to myself, and this was before I really like started sharing openly about like with Type 1 together about my wants and needs and nuances and stuff, and I was really only finding the profiles that were very keto-based and look at my blood sugars were 90% range. and we're having a high day and the blood sugar was like 140. I was like, what the fuck are you talking about? Like those profiles really messed with me. And I had this unrealistic expectation of my daughter needs to be 95 to 98% in range. And we've if we start inching down to 92% in range, that's not good. And she shouldn't be higher than 140 or 150.
00:36:42
Speaker
And, you know, like loads to the fifties for an hour and a half is really not a big deal. Cause then at least your A1C is low, like really dangerous, not smart stuff. And it, I snapped out of that at some point when I was like, okay, no, nevermind. I'm prioritizing childhood and saying yes and not messing with her eating habits first, and then really trying to figure out the composition of food and how that how food digestion matches with insulin action. And once I got that, then I realized a more realistic time and range for the fact that she goes to school. I'm not always with her. I also need a break. Other people are going to do it. Looks closer to 80 or 85% and that that's still good. Yes.
00:37:33
Speaker
Yes. And that I'm not saying that as anyone who's listening and wants to know what they should what their goal should be. That is not what your goal should be. Your goal should be what works for your family, your lifestyle, your child. And if that looks like 65% and that's your goal and you can get there, then guess what? You're winning. I wish that the C-test had like a combo where it also integrated like your balance in life, not that you can ever have a balance, but like, how's your mental wellbeing and your lack of burnout hopefully combined with actual blood work? Like, if there was a way to measure that, I feel like we would be honest.
00:38:14
Speaker
Because you're just losing otherwise. Exactly. And it needs to like take into account, hey kids, do you feel like a child first? Or do you feel like a science experiment and only diabetes? And it's like, what's the 5.2A1C if your kid says, I'm only a science experiment for my parents? like that's just What's all the work for? What's all the hard work for if people get to live a little? so Okay, gotta to hop off, but um everyone, we would love and appreciate if you could write us a quick review. Please, please, please, it helps the show grow and will only take
00:38:53
Speaker
Like 10 seconds, so. Yes. The whole rate review subscribe. We really, truly appreciate it. And we're trying to get, like we've said before, out there to as many families as possible, but especially as many die newly diagnosed families so that they know they're not alone. All right, everyone. We'll see you next week. Bye. Bye.