Juicebox Podcast: Type 1 Diabetes

Episode #1662 Bolus 4 - Tomatoes (10/25/2025)

Hosts: Scott Benner (A) & Jenny Smith (B)

Episode Overview

This episode of the Bolus 4 mini-series focuses on how to bolus insulin for tomatoes—a food often overlooked as a carbohydrate source but commonly consumed, both raw and in various dishes. Scott and Jenny dissect the considerations, share personal anecdotes, and provide practical strategies for integrating tomatoes into diabetes management using the Meal BOLT framework. The tone is conversational, accessible, and occasionally humorous.

Key Discussion Points & Insights

Tomatoes: Fruit or Vegetable? (01:25–03:18)

• Jenny (B) quizzes Scott on tomato stats, revealing tomatoes are the second most consumed "vegetable" in the U.S. (311.5 lbs/year, including all forms).
• Discussion:
  • Tomatoes are botanically a fruit but are classified as vegetables culinarily and for trade (per an 1893 U.S. Supreme Court decision).
• Memorable Fact:

  "Tomatoes are technically a fruit, but they are very low carb and low glycemic. So they get grouped in with vegetables."
  — Jenny (02:19)

Carb Counting: How Many Carbs in Tomatoes? (03:18–04:47)

• Raw tomatoes: ~4–5g carbs per medium raw tomato.
• Grape tomatoes: ~1g carb each.
• Restaurant salads: Be cautious, as restaurant salads often have hidden carbs (15–20g or more), especially at chain restaurants.
  • Scott: "That’s the way people miss on their meals all the time. Like a little bit here, a little bit there, a little bit there..." (12:28)

Practical Bolusing Considerations: “Do Tomatoes Need a Bolus?” (05:08–06:52, 10:39–13:10)

• Low-Glycemic Index: Tomatoes digest slowly; they’re unlikely to spike blood sugar significantly.
• Situational Approach:
  • Active scenarios: If eating tomatoes during physical activity (e.g., gardening), a bolus may not be necessary.
    • Jenny: "If I'm going out for yard work, probably not, but absolutely if it's part of a meal." (06:14)
  • Meals: Incorporate the carb count into your total meal bolus—Jenny often counts ~10g for a bowl containing a medium tomato and cucumber.
• Pre-bolus?: Not usually needed due to low glycemic impact.
• Meal Context: Salad veggies (using "fist size" estimation) ~3–5g carbs.
• Insulin-to-Carb Ratio Impact: Whether missing 2–5g matters depends on your ratio; negligible for most, more important for those with high insulin sensitivity.

CGM & Tweaking: Learning As You Go (11:18–12:00)

• Testing: If unsure about the glycemic impact, check CGM 1–2 hours after eating tomatoes.
  • Jenny: "Sure. Take a peek at the one hour mark, especially if you didn't bolus for it." (11:39)
• Regular Consumption: Once confident, detailed checking isn’t necessary, but remember to include all carbs from meal additions (salad, burger toppings, ketchup).

Personal Anecdotes & Banter (06:55–10:19)

• Scott’s Aversion: Scott reveals he’s never eaten a raw tomato, which leads to playful banter:

  "I swear to God, I've never eaten a tomato in my life... It's something about the skin and the squish and the mush altogether. It's too many different."
  — Scott (06:56)

• Jenny’s Traditions: Grew up eating tomatoes straight from the garden; likes them with salt, pepper, feta, or as salsa—encourages Scott to try more.
• Texture Talk: Scott’s dislike is about the combined textures—likes grapes only if they’re cold and firm. Has never eaten salsa either!

  "I don't even know that I know what a tomato tastes like if it's not sauce or ketchup. And I also have never had salsa before in my life."
  — Scott (09:34)

• Jenny’s Response: Roasts Scott, “You're weird.” Encourages him to try salsa, suggests different meal combos.

The Meal BOLT Framework Recap (00:00–01:22, 13:19–End)

• Meal BOLT Steps:
  1. Measure the meal (carbs, protein, fat, glycemic index)
  2. Evaluate yourself (current blood sugar, IOB, activity, stress/illness)
  3. Add the base units (carbs ÷ insulin/carb ratio)
  4. Layer a correction if needed
  5. Build the bolus shape (standard vs. extended)
  6. Offset timing (consider pre-bolus or combo bolus)
  7. Look at CGM later
  8. Tweak for next time
• Scott: "We measure our 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..." (13:19–13:59)
• Importantly: Although the show is conversational and informal, the hosts are following Meal BOLT principles in every food discussion.

Notable Quotes & Moments

• On missing “small” carbs:

  "A big thick slice on a burger could be two carbs. And not that that's going to like throw the whole thing off, but when you’re swagging to begin with...now we’re seven down..."
  — Scott (12:03)

• On carb sensitivity:

  "For me, let's say my insulin to carb ratio is 1 to 20...If you're at a ratio of 1 to 4, that's a half a unit of insulin that you miss."
  — Jenny (12:38)

• On practical advice:

  "If you're trying some of these things for the first time...take a peek at the one hour mark, especially if you didn't bolus for it."
  — Jenny (11:37)

Segment Timestamps

• 00:00–01:22 — Introduction & Meal Bolt framework explanation
• 01:25–03:18 — Tomato trivia: Fruit or vegetable?
• 03:18–04:47 — Carb counting in tomatoes and salads
• 04:47–05:58 — The hidden carbs in restaurant salads
• 05:08–06:52 — The necessity of bolusing for tomatoes
• 06:55–10:19 — Personal preferences and banter about raw tomatoes
• 10:39–13:19 — Review of bolusing/measuring logic; recap of main takeaways
• 13:19–End — Detailed description of Meal BOLT and closing remarks

Takeaways for Listeners

• Tomatoes are low-carb and low-glycemic, making them unlikely to cause significant blood glucose spikes for most people.
• Whether you bolus for tomatoes depends on amount, context, insulin sensitivity, and activity level.
• When in doubt, factor in the carbs (especially at restaurants or in combined dishes), check your CGM after eating, and tweak your approach for next time.
• The Meal BOLT framework can help you systematically approach any food, even seemingly insignificant ones like tomatoes.

For more on the Meal BOLT approach, visit juiceboxpodcast.com/meal-bolt.

End of Summary