B (3:25)

And that's interesting. I would expect what I'd expect from both of them in the extended nature of insulin need after. It's not the upfront, but it's the long term would be the. Because of the way that you cook them.

A (3:42)

Okay. Yeah. I'm not sure. I don't know why but like all I know is simple ingredients that are real seem to be. I'm not. Listen, they're still pan cakes. It's not like bolusing for, you know, water.

B (3:53)

But I would expect your recipe is real flour. Right. It doesn't have all of the added preservatives.

A (4:01)

It doesn't. And I, I do spend a little extra money when I buy flour in the house. It's a little better, but it's still, it's got butter. You'll see, you'll hear it when you hear it. But let's start with. Let's let me turn to a new clean page on my.

B (4:12)

The shaking bottle.

A (4:13)

Let's start with the Betty Crocker Bisquick shake and pour Buttermilk pancake mix. 10.6 oz. A serving size is a. This is hilarious. A half a cup of mix is a serving size and they're calling that three pancakes.

B (4:30)

And is that dry mix before you've mixed it with the liquid ingredients? That's the next question.

A (4:36)

I think if it's three, I don't know. I don't know what they're saying. So let's look on the. It's 10.6 ounces.

B (4:45)

That would be my consideration. It's that you've got a half a cup of dry mix and what you add to it, liquid wise, it sounds like it's just water. You don't have to add milk or other nutrient containing foods. So if it's just water the whole container, I would expect Takes a certain amount. So if you break it down to a half a cup of the dry mix, how much water goes in that probably makes three. Does it give a diameter?

A (5:12)

You know, I don't. I have to be honest. I think it might mean the mix with the liquid in it.

B (5:18)

Oh, yeah.

A (5:19)

Because it's saying there's five. I'm trying to think of. I have used this before. So 5 servings of a half a cup. Yeah. I bet you there's about two and a half cups of liquid in there. Yeah. I'm gonna go ahead and say that this means a half a cup of the actual mixed.

B (5:35)

These are some tiny pancakes, man.

A (5:37)

Well, that was my point, is that.

B (5:39)

This is where they're like three panc. Got to be like three inches across.

A (5:43)

Exactly. They got to be the tiniest goddamn pancakes you've ever seen in your life, is my point. So again, this is where they're going to mess you up. Because no one's making a pancake that's two and a half inches across.

B (5:53)

No.

A (5:54)

No. So anyway, a grain of salt on the. On the serving size. But let's just say. Why don't we just say that you eat half of the container? That makes sense. Okay, so.

B (6:07)

So let's call it five servings in the container.

A (6:10)

Yeah, there's five servings in the canner. You're going to have. Let's just say you're going to have two of them. You're going to. Two servings. So this is six grams of fat. It is. Where are the car. Oh, it's 90. 90 carbs. 45 for a serving. 45 for a serving. So 90 for two servings. You get 90 carbs. You're getting six grams of fat, a lot of protein, a lot of sodium, by the way, you're gonna see we're eight. Almost a thousand milligrams of sodium.

B (6:45)

Wow.

A (6:46)

480 per serving fiber. A gram for a serving. So two grams sugars, including nine grams of added sugars. You're getting. You're getting 10 grams of sugar in a serving. So 20 grams of sugar in that. Because there is at. I mean, most of it's added, actually. They are adding a lot of sugar to it. Protein. Six. So you're getting 12 protein total.

B (7:07)

Okay.

A (7:08)

Don't worry. There's calcium and iron in them. You're gonna live forever. The ingredients are enriched flour, bleached wheat flour, malted barley flour, niacin, iron, thiamine mononitrate, riboflavin, folic acid, sugar, defatted Soy flour. I don't know what that means. Leavening agents like baking sodum, sodium aluminum phosphate and monocalcium phosphate. There's also palm oil, dextrose, buttermilk, salt, something that's called datem, but it's all in caps. That scares me for some reason. I'm gonna look that up later. Contains wheat, soy, milk, ingredients. Okay, well, let us go to our breakdown list. We have measured our meal. Our meal is 90 grams of carbs. We are one unit for 10. So that's gonna be nine units of INS. We're going to evaluate ourself. Again, this is the morning. I would have to say another evaluation here is. I mean, how many people are making pancakes and not putting bacon or some sort of like a breakfast meat with it? Which is. I know that's not what we're talking about right now, but like, you know, like that's going to hold up the whole. The whole thing.

B (8:23)

Well, and I think in the realm of. Again, you're listening, body, a lot of people are all actually trying to do that. They may not have before, but they may be trying to do that to mitigate the impact of what they expect the pancakes to do.

A (8:41)

Right. I'm saying the only issue there is, like you're trying to add protein with it. So in the morning, protein might mean bacon, and then bacon is going to mean fat. And then you're going to have, you know, you're going to get the lift from the fat later too.

B (8:53)

Right.

A (8:54)

Okay, calculate our food bolus. We've done that. We have nine units. What do you think, Jenny? You want to. You wake up in the morning, it's Saturday morning. You are having the experience that Arden's been having lately. A hot shower is shooting her blood sugar up. Never used to happen. All of a sudden, hot showers, Boom. Like she's going.

B (9:12)

And it's not just her CGM that's being weird, it's actual bifinger stick. She's rising too.

A (9:17)

She's jumping up in hot showers lately. Okay, so you get out of the shower, you come downstairs. Mom, it's Saturday. What are we doing? Oh, you're lucky I'm a great parent. I've bought you a bottle of pancakes and again, I've made them. So, you know, if there's shade, it's for everybody.

B (9:32)

There you go.

A (9:32)

And my blood sugar is 150. Now I need a half a unit to move the blood sugar. Probably more.

B (9:39)

Is your blood sugar still rising according to the CGM trend, or is it stable at 150.

A (9:44)

Let's call it stable just to make this easier.

B (9:45)

Okay.

A (9:46)

Okay. So I need a Correction for my one unit moves us 10 carbs, one unit moves us 100 points. That's for our examples. So now I'm looking at a nine and a half unit meal meal bolus. Do you. And what I hear from people all the time is like, oh, big boluses scare me. So I think that they can. Often people look at them go, that's a lot like, you know, I don't know if I'm going to put all that in there. I would say, you know, I think your rule of thumb here for double whatever you find works for you. So if you found like Jenny use in other examples, if 12 minutes is a good pre bolus for you, for something like this, you're going to need 25 minutes. This episode is brought to you by Omnipod. Would you ever buy a car without test driving it first? That's a big risk to take on a pretty large investment. You wouldn't do that, right? So why would you do it? When it comes to choosing an insulin pump, most pumps come with a four year lock in period through the DME channel and you don't even get to try it first. But not Omnipod 5. Omnipod 5 is available exclusively through the pharmacy, which means it doesn't come with a typical four year DME lock in period. Plus you can get started with a free 30 day trial to be sure it's the right choice for you or your family. My daughter has been wearing an Omnipod every day for 17 years. Are you ready to give Omnipod5 a try? Request your free starter kit today at my link omnipod.com Juicebox terms and conditions apply. Eligibility may vary. Full terms and conditions can be found@ omnipod.com juicebox find my link in the show notes of this podcast player or@juiceboxpodcast.com.

B (11:30)

And the Bolus size really does scare you. A stepping stone to getting there. If you really love this product, would really be do that 25 minute pre bolus with half of what the bolus recommended is. If it's nine units, take four and a half. Take that with the pre bolus and then as soon as you start eating, take the other because we all know the insulin action time is not right here and now. As it's delivered, it still takes a little buildup time to get it working. So that's a. It's this strategy that while it may not be beneficial for keeping your blood sugar under 180 at least you're getting the whole bolus without as much fear is truly what's in the picture.

A (12:13)

Yeah, I'm going to say, you know, just from a person who's, you know, raised a kid with type 1 diabetes, I like Carrie's sugar free syrup. Of all the ones that we've tried over the years, that one seems to taste the most like syrup carries. Yeah. A C, A R, Y, S. Do you have one that you tell people about?

B (12:32)

You know, there are two that I think have quality flavor, which I've heard from a couple of people they really don't like. One of them, the Lacanto brand, I don't have an issue with the flavor of it. The other one is the Rx sugar. That one has a really nice maple sugar. It's allulose, sort of non sugar alternative kind of in it.

A (12:57)

It.

B (12:57)

So those tend to work. Well, I've never seen an issue with the Rx sugar. While there are again, on all of these alternative sugars, carb counts on them probably like the carries. I don't know if Arden has to count any of the carb grams on there, but I don't for the Rx sugar. But I'm also not eating like a half a cup of it.

A (13:17)

I don't see the carries doesn't add rocket fuel to pancakes for her. So. Okay, I take that as a, as.

B (13:24)

A sign that she probably doesn't need to cover it.

A (13:27)

Now listen, I happen to know because during COVID I went on an extensive research to find out why the waffles at a local diner were so good. I was really bored during COVID and I found out what syrup they were using. So I'm going to tell you that the one you get in a diner that you probably think of as tasting good has a serving size of 2 tablespoons, which no person in the history of the world has ever used on pancakes. But let's just say 2 tablespoons, not only are you going to get a hundred calories from that, but you are going to get 26 grams of carbs from 2 tablespoons of this. If you're doing 90 grams worth of pancakes and a quarter of a cup of syrup, which I'm still being generous for people, but let's say that. Let's say It's.

B (14:13)

It's another 52 grams.

A (14:15)

Yes, yes. It's another 52 grams of insulin of carbs, which is now putting your. I'm going to have to do some Math here. That's 142. Is that 14 plus the correction, that's just about 15 units for that. Then if you're going to put. Yeah, yeah. Jenny's like, I haven't taken 15 years of insult in three days.

B (14:34)

That's not true. Not all at once. Oh, my God.

A (14:36)

My point is, is that you can't, you can't come online all the time and tell me, I don't know how to bullish for pancakes. If you're not addressing them for what they really are, that's all. Like, you're going to have to come at it for what it really is. You can't say, oh, that number seems too big, or I've never Bolst that much for, like, this is what it is.

B (14:53)

And I think a valuable piece to point out too is, you know, you brought up a waffle House waffle, Right? Let's say you have figured out your pancakes at home. You know the portion size, you know exactly what goes into them. When you go to your local pancake place, it will be different. Is it a little easier to swag the pancakes you're eating? Sure. Because you have something that you figured out to work, but also your pancakes at home might be 4 inches, and this pancake that comes out to you now is the whole plate. Right. And so then you end up, let's say you swag it pretty good in terms of the grams of carb. But now in terms of worry about that amount of insulin, you put that in your pump and you're like, my gosh, 14 units of insulin. I usually take five for what I eat at home. Yeah, what you need is what you need. Right. Based on how much you're eating and how much you're calculating. So as long as your insulin to carb ratio is the same, sure, you might use five units at home, but you may very well need the 14 units because of the difference in portion.

A (16:04)

I would say that, you know, when we talk about, you know, looking at your CGM down the line, an hour, three hours, and evaluating what happens so you can tweak it for next time. If that amount of insulin scares you to the point where you're like, I can't. I just can't do all that. Like, I don't not understand. But then when you're doing your evaluation and you end up having to make a correction, look at that insulin. Like, the amount that you used to correct with. Is that the amount you skipped in the initial bolus? Like, is it close? Like, that'll help you get to the idea of what you actually need. I'm not saying run out there and make some like super aggressive bolus. Like you might be the person who doesn't need it. Like, you know, like you're going to have to work into this. But this is the thought process for going through this. And, and I'll just say here at the end. If you go to juicebox podcast.com and type pancake into the search bar, you'll get a simple recipe that I use when I make pancakes at home. It's a cup of flour, it's all purpose flour. It has two tablespoons of sugar in it and it has two teaspoons of baking powder, a teaspoon of baking soda, a pinch of salt, a cup of milk, one large egg, two tablespoons of melted butter and some vanilla extract. And is it like drinking water embolusing? It's not. It's still like pancakes, but it's not like the packaged pancakes, the box pancakes that were there.

B (17:20)

So what is your. Since you know and you have had both, what do you see is your difference in strategy? Knowing that who you're feeding that she's still going to eat the same amount of pancakes either way, right?

A (17:37)

She's tough because she'll like, she'll grab them and then start eating and they go, get it. Give me another one of those. And some days she's like, give me some syrup. Or some days she's like, I'm just going to eat them dry. Like, see it's a little bit the syrups sugar free. But what I like is I take a couple of different shots, strategies and I throw them together nice long pre bolus. It's got to be 20 minutes at least, right. I like to see a falling blood sugar when the food hits. And then I put a basil over top of the first hour at least. Right. Like, because my goal is not to leave 90. Right. Like, especially on stuff like this. Like I'm more aggressive on the things that like could possibly lead you to an afternoon of 350 blood sugars.

B (18:14)

Right.

A (18:14)

I don't mind missing on something that goes to 160 and we have to fix it like whatever, like. But I don't want to get, I don't want it to ruin the day. So I would lay a basil, like a temp basil over top of the bolus. And you know, Arden's using Trio right now, the do it yourself app. It's very simple to do. I'd put the bolus in 20 minutes before if she had a Lower stable blood sugar going. If she came downstairs out of that hot shower and she was 170 and she said, I want pancakes, the next words that would come out of my mouth are bolus. Like, before I even go to look to see if we had an egg in the refrigerator now, like, just now, you know, and it's momentum, like, Jenny, it's timing and amount. Like, I know this is fun to break down like this, but, like, it's the right amount of insulin at the right time for the situation. So. And then I like that you can bail on the temp basil if you start getting too low. And then to me, the L or the look at the CGM in Meal Bolt, I keep watching. If I see a drift up, I'm right back on. I smack its hand like it's trying to shoplift. You know what I mean? Like, right back at it again.

B (19:22)

And with Trio, you've probably like me. I've been using Trio for a year now. And honestly, what I've found is it's less likely to need to do that back end slapping.

A (19:33)

Yeah, no, it does.

B (19:34)

Mainly because it does a good job of that additive. Depending on how you have your dials turned in, it does a pretty good job of hitting for you before you have to step in, which is nice because you can kind of step away for a bit right in the end.

A (19:50)

It's in the podcast somewhere, Jenny and I've talked about it. I've said it over and over again, but I leave over heavy carb situations. I lay a blanket of insulin over top of it, like a weighted blanket, so it can't stand up.

B (20:02)

And in this case, I think that weighted blanket effect, so to speak, is relative to. As I pointed out initially, both types of pancakes require cooking them in oil or butter or something.

A (20:16)

Yeah, I do butter on the pan and very little. Like, I actually butter the pan and then I wipe it off, like, so I just don't want it to stick. That's all I care about. But I do see you're not wrong. I've seen people look like they're deep frying their pancakes. Yeah, that's a more Southern thing, too. I've noticed when I'm traveling sometimes, too, is that maybe whiskey could be.

B (20:34)

It could definitely be. I think it's also restaurant style. Is definitely heavily cooked in some type of oil or butter on the surface.

A (20:45)

They're trying to kill you for sure.

B (20:49)

Yes.

A (20:50)

Actually, I guess what they're trying to do is give you enough butter that you're like, I'm Coming back there one day.

B (20:54)

Yes.

A (20:55)

Yeah. Okay. All right. This is good.

B (20:56)

But that's that long term effect. You're not only thinking about carbs, but you're thinking about that lingering.

A (21:02)

Yeah. I mean, I'm gonna tell you, this all changes. You add bacon to this or we're from the northeast pork roll to this. Yeah. Right. And now my checking, like, isn't just one, two hours later because if I get pancakes right. Two hours later, I'm done. It's good. But you add bacon or some fatty meat to it, now it's three, three and four hours later. Like you still have to be looking.

B (21:23)

Sure.

A (21:23)

So. Okay. All right. I appreciate it.

B (21:25)

Awesome.

A (21:25)

Thanks.

B (21:25)

Thank you.

A (21:34)

A huge thanks to my longest sponsor, Omnipod. Check out the Omnipod 5 now with my link omnipod.com juicebox you may be eligible for a free starter kit. A free Omnipod 5 starter kit at my link. Go check it out. Omnipod.com Juicebox terms and conditions apply. Full terms and conditions can be found@ omnipod.com juicebox in each episode of the Bolus 4 series, Jenny Smith and I are going to pick one food and talk through the bolusing for that food. We hope you find it valuable. Generally speaking, we're going to follow a bit of a formula, the meal bolt formula. M, E, A L, B, O, L, T. You can learn more about it@juiceboxpodcast.com forward slash meal bolt. But here's what it is. Step one. M, measure the meal. E, evaluate yourself A, add the base units. L layer A, correction B. Build the bolus shape O, offset the timing. L, look at the CGM&T tweak for next time. In a nutshell, we measure our meal. Total carbohydrates, protein, fat. Consider the glycemic index and the glycemic load. And then we evaluate yourself. What's your current blood sugar, how much insulin's on board, and what kind of activity are you going to be involved in or not involved in? Do you have any stress, hormones, illness? What's going on with you? Then A. We add the base units, your carbs divided by insulin to carb ratio. Just a simple bolus L layer of correction, right? Do you have to add or subtract insulin based on your current blood sugar? Build the bolus shape. Are we going to give it all up front 100% for a fast digesting meal or is there going to be like a combo or a square wave bolus? Does it have to be extended? I'll Set the timing. This is about pre bolusing. Does it take a couple of minutes this meal, or maybe 20 minutes? Are we going to have to again consider combo square wave boluses and meals? Figure out the timing of that meal and then l look at the cgm. An hour later, was there a fast spike? Three hours later, was there a delayed rise? Five hours later, is there any lingering effect from fat and protein? Tweak, tweak for next time. T what did you eat? How much insulin and when? What did your blood sugar curve look like? What would you do next time? This is what we're going to talk about in every episode of Bolus 4. Measure the meal, evaluate yourself, add the base units, layer a correction, build the bolus shape, offset the timing, look at the cgm, tweak for next time. But it's not going to be that confusing and we're not going to ask you to remember all of that stuff. But that's the pathway that Jenny and I are going to use to speak about each bolus. I can't thank you enough for listening. Please make sure you're subscribed or following in your audio app. I'll be back tomorrow with another episode of the Juice Box podcast. The episode you just heard was professionally edited by Wrong Way Recording wrongwayrecording. Com.