Juicebox Podcast: Type 1 Diabetes

Episode #1619: Bolus 4 Oatmeal
Release Date: September 4, 2025
Host: Scott Benner
Guest: Jenny Smith

Episode Overview

This episode launches the "Bolus 4" mini-series, where Scott Benner and diabetes educator Jenny Smith dissect how to bolus for specific foods—starting with oatmeal. Using their conversational style, they explore obtainable, everyday strategies for living boldly with insulin, aiming to reduce fear and foster confidence in type 1 diabetes management. Their roadmap, the "MEAL BOLT" formula, loosely shapes the discussion. Today’s subject: how to bolus for quick-cook oatmeal, one of the most common, deceptively tricky breakfast options for people with type 1 diabetes.

Key Discussion Points & Insights

1. Purpose & Format of the "Bolus 4" Series

• Building a Food Library:
  • Scott’s aim is to create a pragmatic “food library” of simple items before progressing to trickier restaurant meals (e.g., Texas Roadhouse rolls) [01:00].
  • Quote: “My idea is to create like a food library of basic, simple foods…Once we feel like we have that library kind of like completed, I want to go to menu items.” – Scott [01:17]
• Teaching Real-World Swagging:
  • The episodes are conversational, designed to help listeners develop “swag”—educated guesswork—in managing carb counts and insulin [03:16].

2. Diving Into Oatmeal

• Defining the Food:

  • Oatmeal comes in many varieties, but most people eat instant or quick-cook oats, particularly flavored packets (like Quaker’s Maple & Brown Sugar) [03:58].
  • Serving size: 1 packet (~33g carbs, 3g fiber, 12g sugars, 4g protein) [04:46–05:20].

• Oatmeal Varieties and Glycemic Impact:

  • Differences noted between quick-cook (higher GI, more processed, mushy) vs. old-fashioned/overnight oats (lower GI, more fiber and protein) [05:57, 06:44].
  • Quote: “Quick cook are really…processed. They're more ground up...they're more like mush.” – Jenny [08:27]
  • Flavored quick oats have higher glycemic impact due to added sugars.

3. Calculating the Bolus: Numbers and Ratios

• Bolus Baseline:

  • The example uses: 1 unit insulin covers 10 carbs, 1 unit corrects 100 mg/dL [08:58].
  • For 33g carbs: ~3.3 units required [09:29].

• Sugar’s Role in the Spike:

  • About 1/3 of the carbs are added sugar, leading to a faster spike [09:48].

• Anticipating the Glycemic Response:

  • “You’re getting a slow digestion material with a quick spike.” – Scott [10:53]
  • Morning is a tough bolus window: increased resistance upon waking, potential for adrenaline effects, and usual lower overnight basals [11:00].
  • Quote: “That’s where you get a 320 blood sugar that lasts for three hours. Right.” – Scott [11:24]

4. Practical Bolusing Strategy for Oatmeal

• Prebolus Timing:

  • Aggressive prebolusing, even up to 30 minutes before eating, is recommended to keep ahead of the glucose spike from added sugar [12:09–13:23].
  • Quote: “That bolus goes in almost as soon as you are getting out of bed.” – Jenny [12:51]
  • If oatmeal were just plain oats, a briefer (15–20 min) prebolus would suffice [14:56–15:18].

• Correction Layering:

  • If blood sugar is above target pre-meal, add a correction bolus per ratio [14:02].

• No Need for Extended Bolus:

  • No fats or proteins to slow absorption—rapid insulin matches the oatmeal profile [14:15].

5. Refining Your Approach (Using the CGM and Tuning the Bolus)

• Monitor and Adjust:
  • Check CGM roughly an hour after, then 3 hours later; use the data to adjust ratios and prebolus times on future attempts [15:23].
  • Quote: “Take some notes for yourself and tweak it for next time…adjust your pre bolus time, maybe a little longer, a little shorter, and give it another whirl.” – Scott [15:23]
• Learning by Iteration:
  • Scott recounts a fan’s philosophy: “My strategy for ice cream is I keep going back and eating ice cream until I figure it out.” [16:00]

6. MEAL BOLT Framework (What Guides Each Episode)

• Acronym Steps:
  • Measure the meal
  • Evaluate yourself (current BG, insulin on board, activity, stress, etc.)
  • Add base units (carb count ÷ ratio)
  • Layer a correction
  • Build bolus shape (regular or extended)
  • Offset timing (prebolus)
  • Look at CGM after
  • Tweak for next time
• Quote: “We’re not gonna ask you to remember all of that stuff, but that’s the pathway that Jenny and I are gonna use to speak about each bolus.” – Scott [End, ~17:30]

Memorable Moments & Notable Quotes

• On Oatmeal’s Appeal:

  • “Oatmeal looks like small pieces of cardboard in mush to me. Is that not what it is?” – Scott [05:40]
  • “I don’t know. I'm sorry that's what you think.” – Jenny [05:47]

• On the Importance of Swag:

  • “I think these small episodes will teach people to swag better in the end.” – Scott [03:16]

• On Learning Through Practice:

  • “Keep going back and eating ice cream until I figure it out.” – Unnamed listener via Scott [16:00]

Timestamps for Key Segments

• 00:00 – Episode Introduction & Series Purpose
• 03:16 – Why working through single foods teaches swag
• 03:53 – What is oatmeal? Defining the variety
• 04:46 – Nutrition breakdown for Quaker instant oatmeal
• 05:57 – Oatmeal preferences and texture debate
• 07:57 – Oatmeal’s taste and texture explained by Jenny
• 08:58 – “One unit covers 10 carbs” ratio for calculation
• 09:48 – Added sugar and glycemic index discussion
• 11:00 – Bolusing challenges in the morning
• 12:09 – Prebolus strategy for oatmeal
• 13:23 – Aggressive prebolus needed for quick oats
• 14:15 – Is an extended bolus needed?
• 15:23 – Checking and adjusting with CGM
• 16:00 – Iterative food experiments: the ice cream story
• 17:30 (End) – Recap of the MEAL BOLT framework

Conclusion

This kick-off installment of “Bolus 4” distills the complex art of dosing insulin for tricky high-carb foods like oatmeal into clear, actionable steps. By blending humor, personal stories, and practical instruction, Scott and Jenny empower listeners to become more confident in their carb estimates, bolus timing, and use of technology (CGMs) to refine their approach over time. The key? Thoughtful prebolusing, tuning with data, and a willingness to learn through repetition—building a toolkit for managing both everyday foods and those infamous Texas Roadhouse rolls in the future.