#1441 Small Sips: Timing and Amount

Summary

Juicebox Podcast: Type 1 Diabetes

Episode #1441: Small Sips: Timing and Amount
Host: Scott Benner
Guest: Jenny Smith
Date: February 22, 2025

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Episode Overview

In this quick, focused “Small Sips” episode, Scott Benner distills one of the core lessons echoed throughout the Juicebox Podcast: the pivotal importance of timing and amount in insulin management for people with type 1 diabetes. Together with diabetes educator and long-time collaborator Jenny Smith, Scott breaks down how this concept powers practical, successful glucose control—no matter what eating style or insulin type is in play.

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Key Discussion Points and Insights

1. The Central Rule of Diabetes Management: Timing and Amount

• Scott’s Core Principle:
  “If I only had 30 seconds to explain diabetes to you, I would tell you that everything is timing and amount. It's the amount of insulin, using the right amount of insulin at the right time.” (A, 00:52)
• Scott refines the explanation: while diabetes is complex, at its heart, using the right insulin amount at the right time is foundational to better outcomes.

2. This Universal Principle Applies Regardless of Diet

• Jenny highlights how the concept holds true across dietary preferences:

  “I think that's valuable in all walks of nutrient intake or fueling plans… The real low carb eaters, the all fruit eaters, whatever. It's 100% about timing.” (B, 02:31)

• Even those on specialized regimens (like ketogenic, high-protein, or regular-carb diets) focus on when insulin is given for optimal glucose responses.

3. Examples of Practical Application

• Scott shares an anecdote:
  “I've sat at lunches with type ones who are eating no carbs at all, just taking in protein, but they know they're going to get a bump from the protein later… 45 minutes later she's like, I have to bolus now.” (A, 03:18)
• Jenny explains use cases for different insulins:

  “Many people are using R because it hits in a slower pattern, much like the fats and the proteins in the diet… Slower onset, much longer than our today's quote unquote rapid insulin.” (B, 03:51)

4. Timing Errors and Their Consequences

• Scott gives practical warnings:

  “You can use the right amount at the wrong time, you could pre bolus too long and get low. That's the right amount of insulin at the wrong time.” (A, 04:23)

• This underscores that both amount and timing must align for desired outcomes.

5. Data-Driven Confidence

• Scott shares a personal example of his daughter’s overnight glucose graph to illustrate the method’s effectiveness:

  “…Arden has not been under 70 or over 120 for the last sleeping six hours of her life. And she's 76 right now. That stability in that graph is being controlled by… the right amount of insulin being used at the right time.” (A, 04:52)

• Emphasizes that, although advanced tech can help (algorithms, GLP-1, pumps), the basic principle is unchanged.

6. You Don’t Need Perfection Every Time

• Scott reinforces realistic expectations:

  “It might take you a long time to figure it out. I'm not saying on the first try it's going to go awesome. Like, I'm not saying that if you have like a Twinkie sandwich with a cupcake chaser that it's going to, like, you know, be as easy. But…if you put that insulin in the right places it would, generally speaking, work for you.” (A, 05:33)

• Jenny adds how learning from repeated, familiar meals builds confidence and skill for harder situations:

  “It's the meals that you regularly eat over and over that then give you a confidence level of trying something maybe a little bit more aggressive...” (B, 06:19)

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Notable Quotes & Memorable Moments

• Scott:

  “If I was falling off a cliff and you're like, ‘Scott, help me with my diabetes,’ I'd yell ‘It's all timing and amount!’” (A, 06:53)

• Jenny:

  “It's all good. It's all about timing. That's it.” (B, 06:51)

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Timestamps & Key Segments

• 00:52 — Scott’s 30-second “essence of diabetes” explanation: timing and amount
• 02:31 — Jenny on why timing matters regardless of diet
• 03:18 — Example: protein-only meal and delayed bolusing
• 03:51 — Jenny on why some people use older “R” insulin for slow-release foods
• 04:23 — Scott on timing mistakes (pre-bolusing too early or too late)
• 04:52 — Overnight graph data from Scott’s daughter illustrating stable control via timing and amount
• 05:33-06:07 — “Twinkie sandwich with cupcake chaser” analogy on challenging foods
• 06:19 — Jenny: mastery grows through repetition with familiar meals
• 06:51-06:54 — The final summation: “It’s all about timing. That’s it.”

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Additional Resources Mentioned

• Diabetes Pro Tip Series:
  For those noticing patterns or wanting to go deeper, Scott recommends the Pro Tip Series (episodes 1000–1025), which dives into glycemic index, insulin strategies, and more practical advice.
• Bold Beginning Series:
  For newly diagnosed families and individuals, the Bold Beginning Series (from episode 698; co-hosted with Jenny Smith) covers the foundational questions after type 1 diagnosis.

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Summary

This episode condenses the most actionable, transformative diabetes management concept—timing and amount—into a concise and practical lesson. Listeners are reminded that while there are nuances and life with type 1 diabetes is never perfectly predictable, honing these two aspects is universally effective. Whether through personal anecdotes, technical insulin choices, or the data stories of others, Scott and Jenny drive home that fluency in “timing and amount” is both the core skill and the path to greater confidence and freedom with diabetes.

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For more information, including Scott and Jenny’s in-depth teaching, listeners are invited to revisit the Pro Tip and Bold Beginning series via the Juicebox Podcast website or Facebook group.

Transcript

[A]

Hello friends. Welcome to the SIPS series. These foundational strategies were nominated by listeners. They told me these are the ideas in the podcast that truly made a difference for them. So I distilled them down into short, actionable insights. They're there's not going to be any fluff or complex jargon, just practical, real world diabetes management that you can start applying today. And I know your time is valuable, so we're keeping these short. Another small SIP will come out once a week for the foreseeable future. If you like what you hear, check out the Pro Tip series or the Bold Beginning series for more. Those series are available in the [e-mail] and you can find complete lists of all the series, including in the featured tab on the private Facebook group. Please remember that nothing you hear on the Juice Box Podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan or becoming BOLD with Insulin. The questions you have, I guarantee you there's answers to them in the Juice Box podcast and it's all free. So another thing Jenny, that I will just, I'll bang a drum about for as long as I have this podcast or a way to talk to people with diabetes is that I used to say that if I only had 30 seconds to explain diabetes to you, I would tell you that everything is timing an amount. It's the amount of insulin, using the right amount of insulin at the right time. If you do that, obviously it's not as easy as it sounds, but if you use the right amount of insulin at the right time, diabetes works out much better.

[B]

Right? 80, 80% of the time. It's gonna work better. Yes.

[A]

Yeah, it's not a. Listen, nothing's a perfect system. I've had people come after me before because they're like, you can't say something so definitively because somebody will get confused. And like, I understand that idea. But at its core, managing insulin is timing an amount. It just is. Like you have to use the right amount of insulin at the right time. You can use the right amount of insulin at the wrong time and that won't matter. Right? You could make a perfect bolus and not pre bolus a meal and still get high.

[B]

I think that's valuable in all walks of nutrient intake or fueling plans that people are choosing. The real low carb eaters, the all fruit eaters, whatever. It's 100% about timing. Even the people who are eating a ketogenic diet are timing that insulin that they're Using in the right way to hit and smooth the blood sugar for the nutrients that they are eating.

[A]

Yeah.

[B]

Same for carbohydrates. If you're going to be a all fruit eater, you know, 800 grams of carb in a day, you still really have to know it boils down to insulin action. When do you need to take the insulin? When does it finish working? When does it hit where it want it to hit?

[A]

I've sat at lunches with type ones who are eating no carbs at all, like just taking in protein, but they know they're going to get a bump from the protein later. I'm thinking of an example now where I sat with a person who was just eating the patties out of a cheeseburger. Right?

[B]

Sure.

[A]

And 45 minutes later she's like, I have to bolus now.

[B]

Yep.

[A]

That's timing and amount. Right. Like if you're like, I don't know, keto the right word. Like if you're super keto or you're ultra low carb or something and you're using, I don't know, you're using old time insulin still. Right. Maybe using our, our insulin.

[B]

Many people are using R because it hits in a slower pattern, much like the fats and the proteins in the diet. More, more fat in the ketogenic diet. Truly. But even for those eating more of a high protein diet, you're going to get better impact from R or regular insulin. Slower onset, much longer than our today's quote unquote rapid insulin.

[A]

But that's timing still.

[B]

It is.

[A]

That's just, you're matching up. They go back and take an older insulin because of the way it works. Because of the way the timing of the insulin works.

[B]

Yes.

[A]

Going back to the idea that you could use the right amount at the wrong time, you could pre bolus too long and get low. That's the right amount of insulin at the wrong time. But you know, just like in that M and M story, if you put the right amount of insulin in at the right time, you might not see a blip on your graph ever. I was looking at Arden's graph last night and I can pull it up now to look at it again. Like Arden's over, like this is overnight. Right. So here's her overnight graph. You can probably see it enough.

[B]

Yes.

[A]

Okay. So Arden has been, this is like the last six hours. Arden has not been under 70 or over 120 for the last sleeping six hours of her life. And she's 76 right now. That stability in that Graph is being controlled by. I mean, Arden's using trio, so she's on an algorithm. She has a GLP going. So, like, she's got a lot of things helping her. But in the end, right, that insulin is being put in, taken away by the algorithm. Little here, a little here. Hey, the bolus is there. The Basil is usually 0.85 overnight, but you'll see it go to 0.5. Sometimes you'll see it go up to 0.95 to 1. Like, all you're seeing happen is the right amount of insulin being used at the right time. And when it's done perfectly, that's a stable line that you get. You can do that with a meal. Like, you just can. It might take you a long time to figure it out. I'm not saying on the first try it's going to go awesome. Like, I'm not saying that if you have like a Twinkie sandwich with a cupcake chaser that it's going to, like, you know, be as easy. But the truth is, you could eat a Twinkie sandwich with a cupcake chaser and use all. I don't know how the hell you'd figure it out. You could put that insulin in the right places and it would, generally speaking, work for you.

[B]

Sure.

[A]

And I think that once a person learns how to manage, like something, you know, with a crazy glycemic impact, regular meals are. You're like, oh, this is pretty easy. You know what I mean?

[B]

It's easier. Right? And it's the meals that you regularly eat over and over that then give you a confidence level of trying something maybe a little bit more aggressive for something like, I can't believe you made up a Twinkie sandwich. I know somebody has probably done that. But anyway, that's what you're going to try to do.

[A]

I want to just tell you, if I'm going there, it's not a Twinkie. I don't. I think the cake is weird. I don't like the cream. It's not for me.

[B]

Anyway.

[A]

Go ahead.

[B]

It's all good. It's all about timing. That's it.

[A]

You can hear more about this in episode 255. Comes up in 223, something called Johnny's mom took notes. Sounds like Johnny's mom was listening to the podcast and listened and understood. And in understanding glycemic index and load in, I think the pro tip episodes so timing and amount again. If I was falling off a cliff and you're like, scott, help me with my diabetes I'd yell it's all timing and amount. Are you starting to see patterns but you can't quite make sense of them? You're like, oh, if I bolus here, this happens, but I don't know what to do. Should I put in a little less, a little more? If you're starting to have those thoughts, if you're starting to think this isn't going the way the doctor said it would, I think I see something here, but I can't be sure. Once you're having those thoughts, you're ready for the Diabetes Pro Tip series from the Juice Box Podcast. It begins at episode 1000. You can also find [e-mail] up in the menu and you can find a list in the private Facebook group. Just check right under the Featured tab at the top. It'll show you lists of a ton of stuff, including the Pro Tip series, which runs from episode 1000 to 1025. If you or a loved one was just diagnosed with type 1 diabetes and you're looking for some fresh perspective, the Bold Beginning series from the Juice Box Podcast is a terrific place to start. That series is with myself and Jenny Smith. Jenny is a CDCEs, a registered dietitian and a type one for over 35 years. And in the Bold Beginnings series, Jenny and I are going to answer the questions that most people have after a type 1 diabetes diagnosis. The series begins at episode 698 in your podcast player, or you can go to juiceboxpodcast.com and click on Bold Beginnings in the menu. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of the Juicebox Podcast.