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- [00:01]
A
Welcome back, friends. You are listening to the Juice Box Podcast in every episode of Bolus 4. Jenny Smith and I are going to take a few minutes to talk through how to bolus for a single item of food. Jenny and I are going to follow a little bit of a roadmap called Meal Bolt. 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. Having said that, these episodes are going to be very conversational and not incredibly technical. We want you to hear how we think about it, but we also would like you to know that this is kind of the pathway we're considering while we're talking about it. So while you might not hear us say every letter of Meal Bolt in every episode, we will be thinking about it while we're talking. If you want to learn more, go to juiceboxpodcast.com meal-bolt but for now, we'll find out how to bolus for today's subject. This episode of the Juice Box Podcast is sponsored by Skingrip, durable skin safe adhesive that lasts. Your diabetes devices, they can fall off easily sometimes, especially when you're bathing or very active. When those devices fall off, your life is disrupted and it costs you money. But Skingrip patches, they keep your devices secure. Skingrip was founded by a family directly impacted by Type one, and it's trusted by hundreds of thousands of individuals living with diabetes. Juicebox Podcast listeners are going to get 20% off of their first order by visiting skingrip.com juicebox nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your healthcare plan. Have you ever been in the mall and seen Cinnabon?
- [01:58]
B
Of course. In fact, I used to go Christmas shopping with my parents every whatever that Black Friday, right? And we always came in the food court area because that was where my dad liked to park.
- [02:14]
A
Okay.
- [02:15]
B
And that was the first smell, always was Cinnabon.
- [02:20]
A
Cinnamon and sugar and hot. Right? It's awesome. All right, so we're just going to do a classic roll here today, but it's on the list and people asked about it first. I want to say I have a ton of sympathy. I, as some of you may know, in high school, took three years of baking. I didn't go to regular high school. I went to tech school. I honestly, I only went to get out of high school and I only chose baking because it had the most pretty girls in it. When I did the walkthrough. I swear to God that's true. At the same time, I love baking now. And I'm actually. I've said this in the podcast before. I could make 150 loaves of bread at one time if you gave me a mixer and a bench big enough. Like, I know how to do that. But we used to make cinnamon buns every week and we sold them. So, like, we had a working bakery and we sold them. Right. So I never even ate them cooked. We used to take the dough, brush butter on it, melted butter on it, take the cinnamon sugar, throw it over top of it, eat the dough raw. You've never had that. Jenny's gonna vomit. But it's awesome. Just so you know, it's really awesome.
- [03:25]
B
I've had raw cookie dough. I mean, I have had raw cookie dough.
- [03:28]
A
Yeah, raw cookie dough is also awesome. But we're gonna do a Cinnabon classic roll. This is directly from their website. So let's just. Let's look at our list. First thing we wanna do, right, is list the carbs, the fat, the protein, understand the glycemic impact and the load of this food. A serving size is one roll, which is 241 grams. That's pretty big.
- [03:51]
B
And wait, that's weight again?
- [03:53]
A
Yes, that's the weight. How many calories are in it?
- [03:59]
B
Oh, my God. A lot.
- [04:02]
A
This should be what the price is, right, is 880 calories.
- [04:06]
B
I was gonna guess 700 something.
- [04:08]
A
There are 37 grams of fat. Sixteen of those grams are saturated fats. There's no trans fats. There is 55 milligrams of cholesterol in it. 1,000.
- [04:19]
B
And for. For Mclella. Cause you brought that up with one of the last ones, too. How much cholesterol are we aiming for in a day? Cause I think if we, you know, if we give value to cholesterol.
- [04:31]
A
Go ahead. You want to pull that up? You know that. You know that off the top of.
- [04:34]
B
Your head, I'm asking you if you.
- [04:36]
A
Know I'm going to guess it's less than 55 milligrams.
- [04:40]
B
It's not.
- [04:41]
A
No. Okay. All right, hold on a second. Is the. You said it, like, made me think. So I don't know. How much cholesterol do I want in a day if it's. I have no idea. I don't even know how to, like, guess at that.
- [04:51]
B
You have no idea how to guess? Okay.
- [04:53]
A
No, I really don't. Like 200.
- [04:55]
B
It's actually, if you're looking at A baseline, and it fluctuates depending on the source that you're looking at. But the goal is not to have more than about 300 milligrams in a day.
- [05:06]
A
Okay, less than 300 milligrams per day. How about. I'm going to ask for sodium because I'm online now and I don't know. Okay, so this is interesting. The daily recommended allowance of sodium for most adults is less than 2,300 milligrams. So it does say. However, the American Heart association, other health organizations suggest that an ideal limit for most adults is 1500. This cinnabon has 1150mg of sodium in it. That surprised me. How many.
- [05:38]
B
And for value to the sodium, too, at 2300. Do you know the portion of actual salt?
- [05:45]
A
Oh, I don't. Like in like teaspoon or like that kind of measurement. I have no idea.
- [05:50]
B
So a teaspoon of salt, a teaspoon, a measured teaspoon, not your food teaspoon that you eat with is. It's a little more than 2,300, but 2,300 in just a teaspoon. So then when we talk about the average American, what are we getting? Especially considering a lot of the foods that we're talking about? Right. Sodium starts to add up fast because in packaged, processed foods, sodium is a preservative. It's also an enhancer of certain flavors. Like, it brings out sweetness the right way if you have some salt. That's why we add salt to things like baked sweet goods. That's why there's as. I don't remember what you said for the Cinnabon, but it's like a thousand something, right? Per 1.
- [06:32]
A
1150.
- [06:33]
B
Right. It marries lovely with the sugar in that Cinnabon and it gives you that palate appeal when you're eating it.
- [06:41]
A
So the salt's not necessarily for anything structural. It's to give you the salt, sugar.
- [06:47]
B
Fat, kick, and some preservative kind of component to it. And.
- [06:51]
A
Yeah, well, this Cinnabon does have. Don't worry, you're going to be fine. It has 2 grams of fiber in it.
- [06:57]
B
Oh, good.
- [06:58]
A
12 grams of protein. It's almost healthy eating. Added sugars, 59 grams total sugar, 61 total carbs. 129.
- [07:09]
B
So you said 61 grams of sugar. Yes, 100. And how many grams of carb?
- [07:15]
A
29.
- [07:16]
B
One hundred and twenty nine grams. So again, almost, what, 50% sugar I'm looking at.
- [07:22]
A
Is there a recommendation for carb intake?
- [07:25]
B
Depends again on Source. If you're looking at general sources, the carb intake could be anywhere between 150 to 300 grams a day of total carbohydrate. And again, it has to then be broken down by what's your age, what's your exercise component, and you know, all of those types of things. Yeah, we know that there are many different types of fueling plans on the planet and you have choices with nutrient content, but that's the General is about 150 to 300.
- [07:58]
A
I bring it up not to like, I'm not to shame anybody, but because I, I think it's not a thing you would think of. I think if you were just rolling through the mall and you grabbed a cinnamon bun, you'd be like, oh my God, this is a lot. And then your brain would do what is a lot for you? And you'd be like, what is this, like 65 carbs? Maybe that would be a lot. Right. And now you're half wrong. And your blood sugar is 400 for the next four hours easily. I mean, I'm looking here, you know, what you just said is, you know, the Internet obviously agrees with Jenny because Jenny is smarter than the Internet. But you know, for a 2000 calorie diet translates roughly to 200 to 25 to 325 grams of carbs a day. So having this Cinnabon is giving you basically half of the carbs you're supposed to have that day. But that's not how you eat. You do not go to the next meal and go, well, I'm going to have a salad because I had a Cinnabon this morning. Like, if you did that could probably navigate it. Okay. You know, right. You're going to keep eating the regular way that you eat. And by the time you get to the end of the day, your calories and everything are gonna be, they're gonna be crazy. By the way, this does not even list the calories on their website.
- [09:06]
B
It doesn't list the calories. Well, you said it was about 800 some calories.
- [09:10]
A
No, wait, I'm sorry, it does. Excuse me, I'm sorry. 880 calories. I'm sorry. I started thinking like, they were like, oh, let's not tell anybody that. But even that, you know, 880 calories, 2,000 calorie diet, you're halfway into the food you should eat today. That's really something.
- [09:24]
B
And is this an occasional. You know, we never really went to Cinnabon, even though it smelled so good when we went to the mall. But I mean, have I had a bite of one? Sure, I have, you know, but have I ever eaten an entire one by myself? I haven't.
- [09:42]
A
It's a cake at that point, right?
- [09:43]
B
It's a cake. It's a treat at that point. And that's how I would view it. I would say, as anybody should. This is the. Okay, once a year, once every other, you know, six months, I'm doing something like this. As we well know about our standard American diet, this has become more regular. And because nobody knows how much caloric value they need in their day, they don't know the breakdown of what their fats, proteins and carbs should be allotted as this is just another thing that they've added in.
- [10:14]
A
Yeah, and truth be told, too, like, once you figure out I can't eat a whole Cinnabon all the time, don't worry, they've marketed to you with quick bites. The center of the rolls, just the cinna sweeties, the bond bites like, you know, see, they're little and you just go, oh, it's just a little. And yeah, five seconds later you've had more than the cinnamon. By the way, they also sell their frosting by the pint.
- [10:36]
B
By the pint?
- [10:37]
A
Yes. You can buy pints of the frosting if you want.
- [10:40]
B
For what? I don't know why you'd want the frosting. You need maybe people for, I don't know, maybe somebody frosts with it for something.
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A
Fair enough, fair enough. Okay, so we.
- [10:49]
B
Anyway, bolus strategy.
- [10:50]
A
So let's get our bolus strategy down. We've listed our carbs, the fat, the protein. We understand everything. We know the glycemic impact is going to be. It's going to be fast, right? It's going to hit you really hard, really quickly if you don't bolus for it. I mean, is there a load here with this?
- [11:04]
B
Well, that's the, that's the question of this, right? We expect, because of the high carb and the 50% sugar kind of content of this, a quick hit. But after that quick hit, what are you gonna get stuck with? I mean, this has almost 40 grams of fat. Do you know how many tablespoons of oil that is?
- [11:23]
A
I don't. Please tell me.
- [11:24]
B
4.
- [11:25]
A
Oh, just. Oh, yeah, that's a thing.
- [11:28]
B
Like if you visualize it that way, right, you say, okay, this is like butter, butter, butter, butter. Or a tablespoon. Tablespoon, tablespoon, tablespoon of oil. Like when you break down food, that's how Jenny, now you Know how Jenny's brain works?
- [11:42]
A
Listen, I think about it that way, too. It's what stops me around some foods. Would I take four. Would you say tablespoons?
- [11:49]
B
Tablespoons.
- [11:50]
A
Wow. Would I take four tablespoons? It's like a quarter of a cup, isn't it? Would I take a quarter cup of oil and just knock it back right now? I would not. Would I eat a Cinnabon? Yes, I would. And so, like. Okay, yeah. It's important to think of it that way. So what you're saying is we're going to get this crazy hit from the sugar, but there's a lot of fat in this, so it's probably going to hold itself up.
- [12:12]
B
Yes.
- [12:12]
A
And also, I guess, doing the evaluation. By the way, did you just get to the mall or have you been there for a while? Because if you've been at the mall for an hour and a half and your blood sugar's crashing, you might have just gotten the best Cinnabon pre bolus in the world, right?
- [12:28]
B
Yes.
- [12:28]
A
But if you just walked in like your dad, cruising through the food court, ooh, it hits you. You haven't even moved around yet. All the walking in the world's not gonna save you after that. Like, you know, it's not gonna hit you the same way. So you gotta evaluate where you are, where your blood sugar is. I mean, figure it out. You know, we're using 1 to 10 as our example ratio.
- [12:47]
B
So which 1 to 10 is not a. It's kind of middle of the ground in terms of.
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A
We're doing it for math ratios and.
- [12:55]
B
We'Re doing it for a math. But 1 to 10 is a pretty average ratio. It's not excessively aggressive, it's not excessively sensitive. It's kind of right in the middle. But when you look at like, how much insulin.
- [13:08]
A
Well, that's 13 units, right, for this. But imagine if you're one to five now, that's 26 units of insulin to have this Cinnabon. And, you know, listen, I talk to a lot of people. There are some people out there that have balls of steel, right? But, like, most people are not going to be like, I'm having a cinnabon. Here's 26 units of insulin. That's going to freak them out. And that's. You know what I mean? So.
- [13:30]
B
And might you not need all of that? I mean, this kind of goes with building the shape of your bolus and your strategy. Do you think that. Now, let's say you're at the mall, right? You Brought it up or walking around? Walking around and whatever, as you said. Are you going to walk around more after this? Then let's think about how that's going to work itself out in terms of the bolus strategy. Are you going to take a whopping 13 or 26 unit bolus and then go walk around the mall? Especially if it's like the Mall of America.
- [14:03]
A
Yeah. Jenny lives in the middle of nowhere. That mall is like an hour and a half from her house. She doesn't want to have 26 units of. Of insulin rolling while she's on the highway coming home. And all of a sudden it clears out and she's like, oh, I'm gonna die in my car. Great.
- [14:15]
B
Not a good idea.
- [14:17]
A
Yeah. So then you understand how people would maybe err on the side of caution and say, well, if I'm gonna eat this, I'm gonna take the high blood sugar from it because I don't want to be in a bad way. And, I mean, then we can sit here and philosophize about how not to have that happen, but this is gonna be one of those things where I think you're choosing from the lesser of an evil when you make a decision about this. I would have a hard time. Listen, I think Arden's ratio, if she ate this whole thing, I mean, she'd be looking at like 15, 20 units of insulin.
- [14:48]
B
Right.
- [14:48]
A
It would be a hard pill to swallow to bolus that much in the mall.
- [14:53]
B
And so you might choose an extended. Because then in that extension, you could potentially cancel the extended part of it. If you see things dropping or changing in a way that you're not comfortable with, it is always an option. And also because as I brought up, the fat content, there is a stabilizing piece to that fat. Yes. The sugary parts, especially the frosting, that's gonna probably hit you. I'd be actually curious. This bun, it has the frosting on it. So these nutrition facts include the frosting.
- [15:25]
A
It must. Because they come with the frosting. Right?
- [15:27]
B
Okay.
- [15:27]
A
Yeah.
- [15:28]
B
Cause I was curious if the frosting is truly all sugar or if the frosting is more like. You'd make cake frosting. I know. It's like a thinner sort of icing. It's not really frosting. It's like an icing. But I was curious if there was fat in the icing, too.
- [15:40]
A
Yeah.
- [15:41]
B
Because my idea would be you're eating that along with the sugar and the cinnamon and the frosting part of it. That's gonna be the bigger hit piece. It's not really the bun part of it, because that's got a lot of the fat in it.
- [15:56]
A
Well, I'm looking at. Because they do sell the frosting. You know, a frosting pint has 7 grams of fat per serving. Oh, a serving size is a 16th of the pint, 23 grams. So there's. Yeah, I mean, there's some fat in it, nevertheless, like the people. This was not one person who said, I don't know how to bullish for a Cinnabon. Right. Like, in my mind, if you're good at bolusing for things that you understand, your biggest problem with Cinnabon might be you're just undervaluing what's actually in that thing.
- [16:26]
B
The content. Yeah, absolutely.
- [16:28]
A
I see those posts online all the time that people will panic at a restaurant, put up a picture and be like, please, anybody, give me, like, a guess. What do you think's in this? And the guesses are all over the place every time, especially when it's sweet stuff. Even after they've, like, given you some reference points, you see how big it is. You can kind of imagine your mind. You will see for sure. People come in with younger kids who haven't been at it for a long. They're like, that's 20. Someone else is like, that is 60.
- [16:55]
B
Right.
- [16:56]
A
That's a big difference. Right. And then I'm even sometimes, like, I'll be like, I don't know, I'd go more like 40. And then I would just keep hitting it if it, like, if it looked like it was going to head. But I'm also of the. I mean, I'm of the opinion on something like Cinnabon. I want a Bolus that's showing me like a diagonal down arrow. That's a thing you bolus for. And when I see 90 diagonal down, I start thinking like, all right, let's work this Cinnabon out of the bag now.
- [17:23]
B
Right.
- [17:23]
A
You know, because I think, like, I think it's going to hit so fast. Like, you need a lot of momentum on your side to just try to keep it from just making you 220. And I think 20 minutes. Right.
- [17:34]
B
And straight up. Right. Well, and another strategy for things like this, for those who are more hesitant to take that calculated dose, thinking, gosh, 13 units, that's a lot of insulin to take right now, you know, do you usually eat 129 grams of carbohydrate at one time? That's where. Knowing. Right. So it's kind of like a bolus strategy. Even when Sitting down at a restaurant, bolus for the amount of food that you would normally eat at a meal time. When the plate comes to you, go ahead and adjust that and bolus more or follow your CGM trend and bolus. Then when you see some shifts and changes for the rest. Right. So in this, my strategy would really be, well, I know that I can eat about this many grams of carb. I'm going to bolus for this and if I get through that, then I can always add more insulin. So it's almost like a stepwise approach. Is it always going to give the 100% perfect results? No, but there is a comfort level then to acknowledging, okay, I am used to always taking five units of insulin at a time. Great. One to ten, that's 50 grams of carb. And I can try that with something like this.
- [18:47]
A
This bun's pretty big, right? So, you know, and you're considering how to build the, you know, the shape of your bolus out. Like how much is pre bol, how much is extended, et cetera. We talked about how much fats in it do you have to consider the bulk of food that you're putting in your stomach too, like. Right. Because now that's going to slow your digestion down as well. Right? Because there's a lot in there being worked on. So the bigger this thing is, the more bulk, the more like flour that's in there. Like, I guess what I'm saying is if it was somehow a third of the size but still carried the same punch of sugar, it might not take as long to get through you as it would with all this fat and then the size of it as well.
- [19:24]
B
Right. And then what you drink with it makes a difference. Right. A lot of people would sit and eat something like this and maybe have even like a cup of coffee or something that's a sweeter drink or, you know what I mean? So if you sit down with this, a way to also ensure more appropriate digestion. Have some water, just drink some water with it.
- [19:44]
A
Try not to attack yourself from all sides. Right. We're going to get to some of those coffees, by the way, at some point while we're making these. This one here for me, the look at the CGM part part, my goodness, I'd be watching this thing like a hawk, you know, because I think there's too many different possibilities for too many different excursions, high or high or low.
- [20:04]
B
And if this is your every six month kind of treat that you really have nothing to base something on. Absolutely. Pay a Lot more attention. See, is it dipping? Is it going up? Is the rate of change really, really extreme now compared to just a slow rise? And then you have some strategies that you've before based on what you see happening on your cgm. Apply those strategies now.
- [20:30]
A
Right. And I, I took your point from earlier. Like, I don't imagine that there's somebody who's at the Cinnabon every day. You know, I, I mean, that would be. Also, I don't even know how you could afford that. But nevertheless, like, no one's telling you not to have a Cinnabon. Like, if you, like, just. This is probably what's going to happen if you do it. Like, you're going to get some version of this happening at some point. So good luck.
- [20:51]
B
Yes.
- [20:51]
A
Now you're gonna make me think twice about Cinnabons the next time I'm there. Probably.
- [20:54]
B
Don't worry, I didn't bring it up. You did.
- [20:56]
A
No. Yeah, it's my fault. Did you know that Skingrip has donated over $100,000 in scholarships to help people with diabetes? The people at Skingrip, they know what it's like to live with type 1 diabetes. They know what it's like when your devices fall off at the absolute worst time. And they're here to help. Skingrip.com juicebox Save 20% off your first order when you use my link. That's what you get for being a juice box podcast listener. In each episode of the Bolus four 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 meal-bolt but here's what it is. Step 1. 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 gonna be involved in or not involved in? 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. Hey, thanks for listening all the way to the end. I really appreciate your loyalty and listenership. Thank you so much for listening. I'll be back very soon with another episode of the Juice Box Podcast. The episode you just heard was professionally edited by wrong way recording wrongwayrecording.com.