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Scott Benner 0:00
This episode of defining diabetes is brought to you by Dexcom Omni pod. The Contour Next One blood glucose meter and touched by type one. Please visit touched by type one.org dexcom.com forward slash juicebox. My omnipod.com forward slash juice box or Contour Next one.com. To find out more about the sponsors. In this episode of defining diabetes, Jenny Smith and I will be defining bump and nudge. Now you know, Jenny, she's in all the pro tip episodes and defining diabetes and ask Scott and Jenny. She's also a person who's been living with Type One Diabetes for over 30 years. Jenny holds a bachelor's degree in human nutrition and biology from the University of Wisconsin. She's a registered and licensed dietitian, a certified diabetes educator, and a certified trainer on most makes and models of insulin pumps, and continuous glucose monitoring systems. Jenny services are for hire, check her out at integrated diabetes.com.

We're gonna get started in just a moment. But before we do, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, please always consult a physician before making any changes to your health care plan. or becoming bold with insulin.

Do you have an absolutely spectacular endocrinologist certified diabetes educator diabetes, nutritionist if you know anybody who's helping you with type one, you have one like that, that you'd love to share with other people? Where are you looking for one that fits that description? Check out juice box docs.com. If you do JUICEBOXDOCS, it's a place where I'm collecting an amazing list of fantastic support for people with type one diabetes, it's absolutely free. If you have somebody great to add, check it out. If you're looking for somebody, check it out. I want to do bump in nudge as a defining diabetes. And I actually want to do it later as an add on to the pro tip series. But for now, this is just a small definition. Listen, I don't pay any attention to what other people are saying in this space, which is sort of part of how I've come to say things in my own way. I don't know if I made this up or not. I feel like I put these two words together. Maybe you know, I don't know if I did or not I think I did. But when I first started saying oh, you can just kind of bump or nudge. To me in my mind. Somebody asked me this recently. They're like, I've always been dying to know when you say bump. Are you talking about insulin or food? And when you say nudge, are you talking about insulin or food? I was like, Oh, that's interesting.

Jennifer Smith, CDE 3:05
I know how I think of it. But yeah,

Scott Benner 3:08
I bump with insulin and nudge with food. What do you do?

Jennifer Smith, CDE 3:13
So it's kind of funny, I bump with food. And I know.

I kind of think of it the opposite way. But yeah,

Scott Benner 3:23
so it doesn't matter how it occurs to you. It's the idea of, you know, staying between the lines on the road, right? Just, you know, the the way you'll hear me if if you hear me in public talking about it, I'll just say, you know, when you're driving and you begin to drift and you touch the yellow line on the right, you don't yank the wheel back to the left, because then you end up swerving into the other lane, you just want to kind of bring the wheel back almost an imperceivable amount and bring yourself back in line again. Yep. And that's how I think about blood sugar. Say I see a 110 diagonal up, I want it to be 90. And, you know, the way that that made sense to me originally was what I noticed, you know, in the beginning, was that it took a much less insulin to stop 110 and bring it back to 90 than it did to stop 150 or 200. And then when I started using more and more insulin that started creating lows later, which then created a need to feed the insulin right. And, and I thought okay, well, I'll just keep bumping it back down again. And then, you know, I was like, Oh, why am I always treating with 15 carbs? Like who who did that to me, you know what person said 15 carbs 15 minutes, you know, and that was such a long time ago doesn't apply to now I have this technology and someone works differently. Blah, blah, blah. So I started I started doing this thing where like, I don't even know how to describe it. Like I put the juice box in Arden's mouth. And when I was like, That's enough, and I'd be I'd be like, that's it. It's over. She didn't want it anyway. So she was cool with not drinking more, right? To try to nudge you know, a blood sugar that's falling. Just Just get it back level again, right. You hear people talk about You know, I use for Skittles, or they know like, you know, but but most people, once they rip the package open, it's that feeling of like, well, there's 15 Skittles in here, and I'm not wasting, I'm gonna eat them all, I prefer to you throw away eight of the Skittles, you know, but and so this idea of bumping and nudging is an idea of how to keep stability, you know, with your blood sugar. Now, when I developed that, you know, for Arden and then shared it on the podcast, I didn't realize there was going to be more to it moving forward. And that's why there is, if you're listening to this, there is a pro tip somewhere about bumping and nudging, you should go find it. Because if you find yourself bumping and nudging too much, something's wrong somewhere, right? So it's a great tool for variable days, you know, when things aren't quite going right, but doesn't, you know, I think of it, I use it mostly still around Arden's period, because I have settings for Arden, that when she's not hormonal, it doesn't look like she has diabetes. And the minute hormones come into the picture, you know, there's needs that change for insulin, but I don't want to go make all like, I'm not gonna make a across the board changed all of her settings. So that four days later, when her hormones like settle back down, like I don't want to go back and forth. So I find myself bumping more nudging more in those uncertain times. I probably just talked way too much about it. But I do really want to think about I want to hear about how you use it in your life.

Jennifer Smith, CDE 6:48
No, that's the that's the same I and I think it goes back to making sure that for the most part, your settings are well set, because the variables are the place where you would expect to need the bump and nudge concept. You know, on the days, like you said, from a hormone standpoint, or I ended up spending, you know, six hours at the park today versus only being there for an hour, like on other days, right? Those days might be the ones where you use a little bit more bumping and or nudging, depending on what's going on. But overall, on your standard day to day, if settings are right, you really shouldn't need to be using that concept all the time. Yeah. And if you are, something's not quite right, or you're maybe not using the advantage of some of the smarter features on of your pump.

Scott Benner 7:44
So that you don't have to do that all the time. It's an interesting tool in that it's functional and diagnostic at the same time, you know, when you need it, it's a it's an amazing functional tool for type one diabetes. But if you need it too much, it is a red flag. It's a Hey, we're there's something going on here. And so bumping nudge to me is more of it started as a functional tool for me, it'd be it morphed into a diagnostic tool for me. And and it's just as simple as I find myself thinking, we're bumping a little too much lately. You know, what Arden might need a little more insulin, you know, we're not doing a little show or whatever. And Jenny has the exact opposite thought she thinks I'm pumping a lot lately. Maybe my insulin is too strong. And but it doesn't matter. However it makes sense in your head is what matters. And you can, by the way, make up two different words. I don't care. You know, I mean, off the top my head, and I don't know what they would be. But again, I'm sure you could type in bump synonym into Google and figure it out, make it your own thing. But I think that um, it's just it's very important because we watch blood sugar's move, and don't do anything about it thinking, This is my ratio, I did the right thing. This is right. And, and then what happens later is people say to me, Well, how do you know how much and that's the stuff I want to dig into into in a pro tip episode. So I'm going to leave this one here. It's a good definition for what bumping nudges if it sounds interesting to you go find the diabetes pro tip episodes. And I mean, personally, I wouldn't jump right to bump and nudge I'd listen to all of them but you'll get to it at some point. I genuinely believe Jenny By the way, I'm gonna leave this in this episode here that those episodes that you and I have done together. I think they move people's a one c point and a half. Like I think people are seeing like a point and a half out of it. I think I and then there's gonna be

Jennifer Smith, CDE 9:45
great to get some statistics just off of that, you know, even even a question or a survey to say hey, you know, for those of you who are listening to the pro tips, how much if any change Have you had in your a one See, that'd be great to collect,

Scott Benner 10:01
I'll say this out loud here, most people won't understand these words. But if the Helmsley foundation is listening, I and you want to find out if a podcast can actually make your health better, hit me up. I need a little help with the website in the data collection. And you know, a couple of dollars might not hurt that. Cuz I don't know how to do it on my own, that's for certain. Okay, so that was bumping and nudging. Hey, here's some quick contact information for the sponsors. If you're interested to get the dexcom g six continuous glucose monitor, you're going to want to go to dexcom.com Ford slash juice box, and hit the button that says get started with Dexcom g six, it's just that simple. If you get there and you want to read a little bit, definitely check into it. Zero finger sticks, customizable alarms, and alerts, smart device compatibility with Android and iPhone, the ability to share data, or data just depends on where you live in the country or the world. Although right now, some people are like it's data, or data, you're fighting with each other, but you're just fighting with a voice in your head. So don't do that. Anyway, no matter how you say you can share that data with up to 10. People, it's amazing, right? Your kid could be at school being tracked by their mother, father, grandmother, school nurse, maybe even have your neighbor follow along just to know in case of emergencies, you know, for people who like their neighbors, so all seven of you who like your neighbors, that's an option. Anyway, dexcom.com forward slash juice box, you're also going to want an omni pod tubeless insulin pump that you're going to get my Omni pod.com forward slash juice box. And on the pod has quite a little deal where they'll send you a free, no obligation demo of the Omni pod to your home so that you can wear it. While why I've worn it on the pod demo before. It's astonishing how quickly you forget you're wearing something. And you'll really get a feeling for what it's gonna be like to have a tubeless insulin pump, right, just this little device that's with you, and nothing else to clip to your belt or stuff in your bra or do anything like that. And there's no obligation. So I mean, if it doesn't cost anything and not holding you to it, you might as well give it a try my omnipod.com forward slash juice box Podcast course if you go to Contour Next one.com. There's a button at the top of the page to see if you're eligible for an absolutely free blood glucose meter. And I have to tell you, I've a little more context now because at the moment, I'm wearing a Dexcom Pro to get the feeling for it. You'll hear me talk about that later. But because I'm doing that I'm testing a lot. So not just with Arden, but I'm testing myself to get a feeling for you know where the CGM sitting with accuracy. And all that stuff that I've been telling you has been my experience about using the meter with my daughter goes double for me. Small, convenient, accurate. pocket size. It's great, the light works great at night. And trust me My eyes are don't I mean, not what they used to be Contour Next one.com. And of course, touched by type one, please, please, please go to touched by type one.org to check out the good work that these amazing people are doing. For children living with Type One Diabetes. And people with type one diabetes in general. They raise money to support a cure. They put on all these kinds of great programs to support the community, you can be part of it touched by type one.org. plays out, I'd like to remind you about a couple of other I don't want to call them bonuses, extras freebies, that the Juicebox Podcast offers. First one I mentioned at the top of the show juicebox Doc's calm it's my list of listeners, favorite practitioners, CD ease, endocrinologist, anybody who's helping you with your type one diabetes, these are people who are forward thinking, technology friendly, aren't going to give you a bunch of problems when you come in and show them a graph where you haven't been low, you know, in three months, maybe more than like 2% of the time and you're a one sees in the sixes or the fives you're gonna want somebody who celebrates that with you. Not yells at you. So if you don't have that kind of a doctor check out the list. If you do have that kind of doctor, add them to the list juicebox Doc's calm I'm going to talk right past the music Do you mind? me Get Ready? Mm hmm. In the call me one take Scott. Watch this. No, no, hold on. Don't worry. Got a little thing caught here. Hold on a second. I might be Hold on. Make a drink. You know what? I'm all clear. Okay.

Diabetes pro tip.com. You know, at this point that there are I don't even know how many 20 Pro Tip episodes with Jenny Smith and I, if you need to find them quickly, diabetes pro tip.com no s take off the last s for savings. There's actually no savings because the podcast is free. But you know what I mean? diabetes pro tip calm if you're looking to revisit or share those episodes do that. These defining diabetes episodes are also there. If you scroll down, I think ask Scott and Jenny is there as well. If it's not, I should put it there. And maybe I will. What else? Oh, the private Facebook group juice box discussion group. 3500 members strong at this point. absolutely free place for people to talk about their type one diabetes? Are you low carb, great. These people talk about with you? Are you like, Hey, I don't do low carb, no problem. The low carb people and I guard people don't even fight with each other. It's a utopia. Seriously, people are there talking about management ideas, sharing their successes, giving each other encouragement, thoughts, whatever you need. It's there. And it's a great place. Now if you're a jerk, don't show up there. If you're looking to do the normal, old, you know, Facebook, arguing with people thing, this is not the place for that this place is lovely. If you're the kind of person who could be lovely to juicebox discussion group on Facebook, find it do a little search. There might even be a link here in the show notes. Hmm, what else have I done? What have I done? That's from The Nightmare Before Christmas, you wouldn't be able to tell? Because I have a terrible singing voice. Oh, leave a great review for the podcast. If again, that'd be terrific. Right there in your Apple podcast app, five stars. I love this pocket. Actually just don't do that. Right, something thoughtful. It helps other people be able to trust that they should check out the show. So if you've had a great result from the podcast, and you'd like someone else to also have a great result. A wonderful review would help that along the way. Not only that, share the show with someone else. pimp it out. Be like, hey, this helped me here's how, here's how you check it out. That's how the show will grow. I felt like that was gonna rhyme in that it didn't wait. It did show and grow rhyme right. That's how the show will grow. That was weird. I thought it was gonna rhyme. It did rhyme and then I doubted if it rained. I don't even know what that says. Thanks so much for listening to this episode of the Juicebox Podcast. There of course will be many, many more. We're not like podcasts. It's like here's one and then wait four weeks. Here's another one. This one sounds terrible. But I'll let them listen to it. Anyway. That's not what you're getting here is the well run show. Understand. You come back. you subscribe. Are you subscribing? Do you? You've hit subscribe in your podcast app, right? Oh my god. Are you listening online? What do you mean like 150 years old? What are you doing? Get a podcast app on your phone and hit subscribe. People. I just had an imaginary argument with a person who doesn't exist. Yeah, I think it's time to stop this.