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Scott Benner 0:00
Hello everyone and welcome to Episode 442 of the Juicebox Podcast. Today's show is short but sweet. It's a defining diabetes episode with Jenny Smith.

In this episode of defining diabetes, we're going to let you know about hydration and why it's so important when you're using man made insulin.

Jenny Smith holds a bachelor's degree in human nutrition. Jenny Smith holds a bachelor's degree in human nutrition and biology from the University of Wisconsin certified diabetes educator and a certified trainer and a certified trainer on most makes and models of insulin pumps and continuous glucose monitors. She's also had Type One Diabetes for over three decades. That's 30 years.

This show is sponsored today by the glucagon that my daughter carries g Volk hypo pen, g Volk hypo pan has no visible needle, and it's the first premixed auto injector of glucagon for very low blood sugar and adults and kids with diabetes ages two and above. Not only is chivo hypo pen simple to administer, but it's simple to learn more about. All you have to do is go to Gvokeglucagon.com/juicebox g vo shouldn't be used in patients with insulinoma or pheochromocytoma. Visit Gvokeglucagon.com/risk.

slash risk. Far too often we don't look into the blood glucose meter that we have, we take the one that the doctor gives us, or the one that you know is a somewhere. But how often do we think do I have an accurate meter? Is it easy to use? Is it easy to is it going to give me results that are meaningful for my health. If that's what you want, you can get the same Jordan has the Contour. Next One, you can find out more at Contour Next one.com forward slash juicebox. Now when you get there, you're going to find out a lot, you're going to be able to see the meter and read all about it, you'll find because if you want to look deeper into your data that's coming from that, because if you want to look deeper into the data that's coming from that meter, you can with the help of contours app, you can also learn more about their test trips, and dig in. Not only that, but you can find out more about details like Second Chance test trips, which I think is such a big deal. The idea that if you touch a test trip to a blood drop, and don't get enough, you can go back with that same test trip, touch it again, and get an accurate reading. That's no more wasted test trips, and accuracy that you can trust. Contour Next one.com forward slash juicebox. There are links in your show notes. And at Juicebox Podcast comm for all of the sponsors, check them out. I put the ads up front today because the episodes short and it just felt weird to break it up. So I appreciate you listening. Let's get right into defining diabetes hydration with Jenny Smith. Want to define hydration as it impacts using insulin? So can you tell me why a dehydrated body doesn't move insulin around the way it should?

Jennifer Smith, CDE 4:05
Well, a dehydrated body doesn't move anything around. Okay, so I mean, if you think about it in the general sense, it doesn't move insulin around, it doesn't move sugar around, it doesn't move any of the nutrients from any of the food that you ate around, it doesn't move your cells around. It's like I mean, you can tell dehydration from like a mud puddle, for instance. Right? The less water in a mud puddle, you still have some like physical hydrated goofiness. There you will. But if you can imagine that like partially like wet mud, it's very thick, you would not expect that to run through a straw with ease, right, it would stop it up, which means that if you had some type of something you had stuck in the mud and you really needed to get from point A to point B. It's going to take a heck of a long time for that to actually move through the mud because it's so thick, right? It's goopy. Whereas once you pour a bucket of water into this mud pit, now you've got liquid. And now you can see that you could feel the boat, you could have a leaf pass from one side of the puddle to the other. But that if you imagine that leaf being nutrients, insulin, glucose, vitamins, minerals, everything that moves in the system that's supposed to, it moves freely, because you have more liquid there to move it in the way that your body is supposed to be moving things through your, you know, vessels and cells and everything, okay? So insulin is definitely going to take, it's going to be harder to circulate your insulin from a site, and we put insulin, remember into the sub q tissue, so into like your little fatty layer that sits below the surface of your skin, we're not putting it into a vein to get immediate movement on it. So with less hydration, you've got less hydration under the skin as well. And so you've got this deep hole of insulin that again, is it's not going to get full width removed, it's going to take longer for it to impact. So

Scott Benner 6:17
when it's not moving, it's not being taken up by the cells, right, and they can't release the glucose that's trapped in the cell. So you're injecting insulin into that layer, you need a proper or reasonable level of hydration, so that insulin gets picked up and moved around, and then can do its job. So you can keep piling insulin under your skin basically, and be dehydrated, and then hydrate yourself. And Whoosh. Here it all comes. And now you could have too much insulin in there.

Unknown Speaker 6:47
Yes. Okay. Correct.

Scott Benner 6:49
And so is it fair to say that hydration from your experience is different from different people? Like maybe I need more or less than the next person does? Is it on? Like, you know, because you I can hear people in my head going, I can't make my kids drink water? You know, because it's hard. You know,

Jennifer Smith, CDE 7:07
it is? I mean, from a standpoint, does a two year old need the same amount of fluid as a big, you know, 200 pound man. But in general, age wise activity level wise, a good judge of hydration is the color of your urine. Yeah, that's the best that there is, if you know, if you're well hydrated, your urine should be a very, very, very pale lemonade, like, minimal, like yellow color to it, right? If you've got this dark colored Pea, so sorry, drink some water.

Scott Benner 7:46
And so it you know, cuz you'll see people all the time, say like, you know, we'll put up a graph, or they'll ask a question online. And somebody will inevitably come in and say, like, are you hydrated. And it's one of those things that I think just gets missed, in general by people like your brain always jumps to, like the worst thing like my candle is bent. You know, like, but but you need. I am a proponent of, especially when Arden used to get up in the morning and go to school. I just, I'd be holding water Here, drink something before you. Even if it's just even if it's eight ounces, just please like, put it in real quickly. And I think I finally finally created a habit with her. Because now she drinks water in the morning. And I'm sorry for all the people who can only hear my Philly accent when I say water. But I know there's plenty of people listening right now going oh my god, he said it again.

Jennifer Smith, CDE 8:41
I don't hear a difference. I don't know. My kids. I must say water different than you. I guess it doesn't sound different to me. But I don't listen to myself say water.

Scott Benner 8:50
You say water and I say Water. Water. Yeah. And then my children. Even my kids are like, because they didn't grow up in Philly. They grew up here where we are. So they're just like you're saying it wrong. And then they laugh at me. And I'll get notes from people. Like I got a note from a guy one time. It's like, could you just please say water more often say Great, thanks. Glad the podcast is valuable for you. But But you have to be hot when. So hydration is a tool of diabetes management, whether you think about it or not.

Jennifer Smith, CDE 9:20
And it's also one and I think we've met we've talked about it before. We've talked about CGM. Huge, huge impact on the ability for the CGM to be accurate. Yeah, if you are hydrated because the CGM is measuring interstitial glucose, which is just really the glucose that's floating around in the fluid in your body that that in which is in your bloodstream, right that you do with a finger stick. If you're dehydrated, you are not going to have as accurate and your sensor might actually give you more errors.

Scott Benner 9:53
Yeah, it's harder for it to make sense of it when right things aren't floating by constantly that it can measure right All right, I just feel like that's such a simple thing. And at the same time, these defining diabetes episodes, I'm reminded over and over again, it's more and more frequently, I just saw a father of a young child say today, I'm here, I appreciate everybody, but it feels like you're speaking another language because of all these terms that I just don't understand or, or how they intersect Even so, I know, it seems it'll seem simple to the people who know already, but it needs to be here within the body of the podcast, like, you need to be hydrated for your insulin to work properly. And that's, that's just that, it's, it's super simple. And, you know, it's, it might not be as easy as give your kid a glass of water and watch their blood sugar go down. But it also might be and so it depends on how much insulin you have on board and what your situation is. And so please stay hydrated. I know that sounds like I'm not like somebody's mom telling them to drink water. But that's really important.

Jennifer Smith, CDE 10:58
Right? Sometimes it's just really important. Yeah, yeah. Well, thank

Scott Benner 11:01
you.

A huge thank you to one of today's sponsors, Gvoke glucagon. Find out more about chivo Kibo pen at gvokeglucagon.com/juicebox, you spell that Gvokeglucagon.com/juicebox you see ag o n.com. forward slash juice box.

And while you're on the internet, check out the Contour Next One blood glucose meter and all the great information at ContourNext.com/juicebox. If you'd like to contact Jenny, she's at integrateddiabetes.com