Juicebox Podcast: Type 1 Diabetes
Episode #1651: CGM Graph Reading
Date: October 13, 2025
Host: Scott Benner
Guest: Jenny Smith
Overview
In this innovative episode, Scott Benner and diabetes educator Jenny Smith take on the creative challenge of giving memorable names to the various shapes and patterns seen on a Continuous Glucose Monitor (CGM) graph. Their goal is to establish a shared vocabulary for discussing these graphs in future audio-only episodes, empowering listeners to more intuitively understand and communicate about their blood sugar trends. Throughout, the conversation is engaging, playful, and deeply practical for people living with diabetes.
Key Discussion Points & Insights
1. Why Name CGM Graph Shapes?
- Scott’s Vision: Scott introduces the purpose of the episode: to come up with catchy, accurate names for common CGM graph shapes. This makes subsequent audio-only discussions about CGM data much clearer for listeners who don’t have a graph in front of them (01:46–02:22).
- Jenny’s Buy-in: Jenny is enthusiastic about the idea and ready to brainstorm terms that people can visualize easily (01:45–02:24).
2. Naming and Describing Graph Patterns
Together, Scott and Jenny brainstorm notable CGM data shapes, their typical causes, and what each might be called for clarity and relatability.
Patterns and Names
-
Bell Curve: Gentle rise, plateau, and gradual descent, ideally how post-meal blood sugar should look.
"It should look somewhat like a bell curve if people are familiar with that term."
— Jenny (02:24) -
Flat Line: Stable, in-range reading with no significant deviation.
"So a flat line that's going on forever... steady and in range with no real deviation. We'll call that a flat line."
— Scott (03:36–03:49) -
Mountain Peak: Sharp rise after eating, followed by a sharp drop (post-meal spike and return).
"A post-meal spike that drops back down again—a mountain peak."
— Scott (04:10) -
Two Hump Camel: Rise, dip, then another rise (often from mixed macronutrient meals).
"So we're gonna call it a two hump."
— Scott (05:29) -
Roller Coaster: Repeated sharp swings up and down, often due to "chasing" highs and lows with insulin/carbs.
"Up, down, up, down forever is a roller coaster. I think of it as like you're chasing the blood sugar."
— Scott (06:30–06:49) -
Staircase: Stepwise increases (or decreases), resembling a staircase; may result from slow-acting food or algorithm micro-adjustment.
"More like staircasing up. And it can happen in the down, too."
— Scott (07:15–08:07) -
Cat: Two meal spikes close together, with drops that don't return to baseline ("cat ears" or a "cat face" on the graph).
"They'll draw cat eyes on it or whiskers or something like that."
— Scott (08:54) -
Price Is Right Climber/Bob Barker: Gradual, steady, slow climb, often overnight due to dawn phenomenon.
"I think of that one as the Price is Right game... the mountain climber game."
— Scott (09:57) -
Cliff Dive: Rapid and dramatic drop, typical of sudden hypoglycemia or sensor compression.
"That's what I call it: falling off a cliff. You call it cliff diving."
— Jenny (11:10) -
Compression Low: Unusual, abrupt, non-linear drops, often from sensor compression.
"Sometimes you get, like, the disappearing... Like, it's there and then it's gone. And when it comes back, it's 15 points lower and right. And then stable again."
— Scott (11:59–12:19) -
Plateau: High but stable line—missed insulin for a meal, basal holds blood sugar at a too-high level.
"So you've woefully missed on a meal, probably. Right. And your basal's holding you steady but it's holding you steady way too high forever."
— Scott (12:25–12:41) -
Alpine/Mountain Range: Multiple back-to-back spikes from meals or snacks (meal stacking), resembling a rugged range.
"Would be almost like a mountain range."
— Jenny (16:30) -
Drift: Gentle, consistent rise or fall over hours, usually due to basal issues.
"Gentle rise or gentle fall across an entire day. I call that a drift."
— Scott (17:20) -
Hormonal Surge: Predictable spike linked to hormones (puberty, stress, menstruation, cortisol).
"So, okay. All right. So. Oh, why don't we call it a hormonal surge?"
— Scott (19:41–19:46) -
Fat Rise/Restaurant Hit: Late, sustained, and gradual high after a heavy, often fatty meal (such as pizza).
"I prefer to call it... it's a fat rise in my mind."
— Scott (20:08–20:10) -
Shark Fin: Quick, sharp spike, then a prolonged slow return to baseline—a rapid high followed by a slow fall.
"The shape of it looks like a shark fin. So it's sort of like a... like a quick spike and then a slow drift."
— Scott (20:32)
Discussion of Combined and Transitional Patterns
- Sometimes two shapes occur in succession (e.g., a bell curve followed by a plateau). The team notes this but hasn't named these transitions yet (21:10–21:44).
3. Causes and Context for Graph Patterns
- The duo discuss the causes of different graph shapes, such as food type, insulin timing, hormonal cycles, activity, or sensor/algorithm effects.
- Example: Growth hormone surges in kids yield classic overnight spikes unrelated to food, often plateauing if unchecked (22:37–23:45).
"Usually it's drastic. In fact, it's one of the most frequent things that I hear parents complain about."
— Jenny (23:18)
4. The Bigger Vision for Teaching & Community Input
- Scott and Jenny plan to use these names in short, descriptive episodes breaking down listener-submitted graphs—first by shape, then by cause, eventually working up to more complex, layered graph patterns (24:58–27:00).
- They will invite community feedback to refine these terms, seeking consensus and usability (19:10–19:11).
Notable Quotes & Memorable Moments
-
On the Value of Landmark Naming:
"If we have some data that we're talking about and we know it's relative to a hormonal change, it may make sense to call it hormones."
— Jenny (19:21) -
Why Audio-Only Works:
"I have been blocked, mentally blocked on this for years. This is obviously something that I've been thinking about for a long time. But I kept just saying, well, it's not a video podcast. If you can't see it, then what's the point? But I don't think maybe that's true. I think maybe there's a way to talk through it and describe it."
— Scott (27:45) -
Describing Parental Challenges with Growth Hormone Spikes:
"Usually it's drastic. In fact, it's one of the most frequent things that I hear parents complain about. How do I get over... this end of night thing that happens?"
— Jenny (23:18) -
On the Mission:
"We'll get examples of them. You and I will record a short episode describing each shape and then we'll let people send in graphs... and then we'll talk through how we think it happened."
— Scott (26:58)
Timestamps by Segment
| Topic | Timestamp | |----------------------------------------------|-----------------| | Purpose of naming CGM shapes | 00:00–02:22 | | Bell curve, flat line, mountain peak | 02:24–04:32 | | Two-hump camel & roller coaster | 04:32–06:49 | | Staircase and Cat ("cat ears" pattern) | 06:49–08:54 | | Price Is Right climber/Bob Barker shape | 09:34–10:49 | | Cliff dive, compression low | 11:03–12:25 | | Plateau, mesa, butte | 12:25–13:28 | | Multiple peaks (mountain range/alpine) | 16:30–17:20 | | Drift, basal drift | 17:20–17:43 | | Hormonal surges | 19:10–19:48 | | Restaurant hits, fat rises, shark fin | 20:05–20:32 | | Naming challenges & combined patterns | 21:09–21:58 | | Growth hormone and overnight rises | 21:58–23:45 | | Implementation plan for podcast series | 24:58–27:17 | | Scott and Jenny reflect on the mission | 27:45–30:49 |
Tone and Style
Scott and Jenny’s tone is collaborative, warm, and accessible, laced with humor (“We can’t call it cat head!”), pop culture references (“Price is Right climber,” “Bob Barker”), and a focus on concrete, relatable analogies. This approach makes complex diabetes management concepts both understandable and memorable.
Final Thoughts
This episode provides a fun yet practical foundation for understanding and talking about CGM data without visuals. The lively naming process sets the stage for future podcast series, promising deep dives into real-world diabetes data, troubleshooting, and community engagement. Whether you’re a seasoned T1D veteran or new to CGM, this episode will likely reshape the way you think and talk about your numbers.