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- [00:00]
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. 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, Nothing you hear on the Juice Box Podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your healthcare plan. Jenny. I am on hersheland.com where I am staring at the nutritional facts for Reese's milk chocolate peanut butter cups. Oh. It allows me to choose from all different counts. I'm just gonna pick the smallest one. 1.5 ounces.
- [01:42]
B
That must be the. The one that's the original.
- [01:45]
A
I guess it's two little cups.
- [01:46]
B
Probably two little cups in a package.
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A
Yeah. I mean, we could try to.
- [01:49]
B
Which I'd be curious. Does the package say one cup is a serving, or does it say both cups are the serving size?
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A
I'm gonna pull up the 1.5 to see. Yeah, 1.5 is two cups. That's. But is that the. Is it one cup the serving size? Good question. One package is gonna be the serving size.
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B
So one full package.
- [02:12]
A
Okay, so two. Just like you're imagining in your head. 1.5 ounces for the whole thing. Total fat in this one package. 12 grams. Actually, more saturated fat here. I guess that's probably the chocolate, right? 4.5 grams. Cholesterol is not an issue. There's 135 milligrams of sodium, 24 carbs. So I guess each cup is 12 carbs, 22 sugars, 2 dietary fiber. Apparently there's some iron, calcium. There must be iron, calcium, and potassium in everything, because no matter what junky food comes up, it always has those three simple ingredients. It says milk chocolate, which is sugar, cocoa butter, chocolate, skim milk, milk, fat, lactose, lecithin and whatever PGPR is. And then peanuts, sugar, dextrose, salt, TBHQ and citric acid to maintain freshness.
- [03:02]
B
It says so it doesn't get all hard as a rock in the package before you eat it 20 years from now in your bunker.
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A
I just wanted to find out what PGPR is.
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B
I don't know what that is either.
- [03:15]
A
Polyglycerol, Poly rich o'. Nelate.
- [03:19]
B
It's a fat.
- [03:21]
A
It's a food additive. The food additive specifically an emulsifier used to improve the flow properties of chocolate and stabilize low fat margins. Sexy. That makes me want to eat it now. Okay, so Reese's. You know, it's funny, you hear people say all the time like, and I wouldn't treat a low blood sugar with chocolate either because like, like you want, you know, fast acting simple sugars. But you'd be surprised how many people I see online who do treat their lows with chocolate. Like I think they don't know to go more simple sugar. But let's just say we're not treating with it. We are eating it.
- [03:57]
B
Eating it.
- [03:58]
A
Yummy, right? All right, so we figured out what everything is as far as the impacts. How are we going to handle this? Is this a snack? I mean, is there anybody out there eating a Reese's along with a meal? I can't imagine.
- [04:15]
B
Well, maybe at the end of a meal as a treat. I mean for kiddos, you know, working with enough kids. Many kids do want to sweet something. It's either a cookie or it's this time of the year, might be a popsicle or a fudgesicle. So I can see this being something at the end of a meal that's maybe your treat or your dessert, let's call it.
- [04:36]
A
Okay.
- [04:36]
B
I think what's fair about considering a chocolate type of candy is also chocolate. As you said, it's not the greatest thing for low blood sugars because of the fat content. And if we look at this, my guess would be two of them. There's probably 10 to 12 grams of fat. I can't remember what you said before. 12:12. Okay, so if you ate both of these calories then are probably about 50% of the total comes from fat.
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A
Okay, 210 calories for the pack.
- [05:09]
B
Sure. So if you have 12 grams of fat times nine is a little more than 100. Okay, right. But I think that's valuable to understand because when you're treating a low one of the first three ingredients on Something to treat should be dextrose or glucose. It just should because that's. It's the simplest form of glucose or sugar that there is. It doesn't take digestion, it gets in and it hits. So enjoy your Reese's, but don't use them as a treatment for a low. The other piece that I think people would look at besides just total carbs is in candy. There's total sugars too. And when you look at total sugars and you're talking about bolusing strategy, that's another piece that can be very valuable. When you talk about fat, kind of like potato chips, you might think, well, there's fat in here, so maybe they're going to be. It's going to be slower, so maybe pre bolus isn't as important. But when you look at this, you have to look at the label. I don't know what's the total sugars compared to the total carb?
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A
22 sugars, 24 carbs.
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B
Right. So this is all sugar.
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A
Yeah.
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B
There's really not. They say that there's peanuts in this.
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A
But like, I don't know how many peanuts.
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B
You're saying I don't know how many peanuts those total sugars are. That's like. It's a lot of added sugar. It's a heck of a lot of added sugar. And some labels even break it down further and tell you not only total, but they'll tell you how much of that is actually been added as sugar. And sometimes you'll be surprised to see that total sugar might be this much, but maybe the added sugars aren't that considerable. And then your pre bolus strategy might shift a little bit. But this I would guess is pretty close to 22, if it's even there. So pre bolus strategy, then.
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A
Yeah, yeah, go ahead.
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B
This is candy. You're eating it alone. Just like everything that we're trying to look at. You're eating it in a right now, this is it. Nothing else with it. You definitely need pre bolus for this. If your blood sugar's in target higher than you want it rising, definite pre bolus, my estimate would be at least 20 minutes, 15 to 20 minutes for a pre bolus for this. Right. In those circumstances. And if again, blood sugar's high or rising already longer.
- [07:22]
A
What if I can't pre bolus? We haven't talked about this in a while, but if. Then we just make. So I'll just tell you what I would do. Yeah. If Arden wanted that. I don't even know if she likes these. I don't think she does, actually. But if she wanted these and she's like, I'm having them right now. I can't pre bolus. I would do the bolus for everything that's on the label. And then I would imagine there's going to be a spike. And I would try to, basically, I would try to, yeah, I'd try to pre bolus the spike. So you're not pre bolting the food now, you're bolusing for the food, pre bolusing the spike. Because the spike hopefully isn't going to come for 20 minutes or so. So I would over, you know, there's episodes called over bolusing and there's bolusing strategies in the Pro Tip series and everywhere else. I would make a more aggressive bolus than the label called for if there was no pre bolus. Absolutely.
- [08:10]
B
It's actually a concept by John Walsh. He calls it the super bolus. We've talked about that before. Right. It's if you can't pre bolus, then give an overage. Right now you're still going to get more spike than if you had pre bolus, but it's not going to be as high as if you don't give extra right now.
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A
Yeah.
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B
Yes.
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A
So I would definitely do that. So you're saying 20 minutes. If you're a person who can say, I'm going to have Reese's peanut butter cups, I can wait 20 minutes, then go ahead.
- [08:35]
B
And if you can, if it's right after Halloween trick or treating and your bucket is full of these because that's what was given out in your neighborhood, then you probably have a child who is, I want the Reese's now. You know, dad or mom or whatever.
- [08:47]
A
And yeah, I would say, like, because we went over it earlier, like, if you're 70 and falling, don't reach for chocolate. But if you were out trick or treating and you're 120 diagonal down, this is a perfect time for a recess.
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B
There you go. And maybe not pre bolus or bolus at all. You could probably just keep walking.
- [09:05]
A
Exactly. Like, so there's just ways to think about, you know, in the end. Jenny, like, I probably don't say this enough and I've probably said it too much, but everything about diabetes is timing and amount. I mean that about the insulin and I mean that about the food. You know, I've said it before, I'll say it again. Like, we spend so much time thinking about how the insulin impacts the food. We don't often think about how the food impacts the insulin or how the food impacts the number. And I think those are important ideas too. So.
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B
Yes.
- [09:34]
A
Anyway, this is how you would bolus for a Reese's Peanut Butter Cup. One and a half ounces. Don't forget that you also may be getting in your Reese's Peanut Butter cup artificial flavors that we didn't notice before. And this recipe may also include bioengineered ingredients. I'm sure it probably does, according to allbulkfoods.com yeah. So good luck, everybody.
- [10:00]
B
Enjoy.
- [10:01]
A
Ginny, what would you do here? Chocolate. And the only way I eat chocolate is there's a chocolate chip that I like, and we keep like a little dish of them in the house covered. And so if I have a chocolate chip, I grab a few chips. That's where I get my chocolate fix when I need it. It doesn't happen completely often, but they're always available because I find that otherwise I do end up with, like, not gonna out anybody's company, but like, you know, chocolate that comes in a wrapper that often I eat it and I think this doesn't really taste good. No.
- [10:36]
B
I'm not really a milk chocolate person, personally. I have a piece of chocolate every day, so. But my chocolate is usually the 90%, at least 85%, 90%. It's the dark chocolate. And it's because me personally, my taste buds are much more satisfied with the richness of that dark chocolate. And it's not such a sweet overload. I think that's what ends up having people come back more and more and more to, like, they can easily eat the whole Hershey bar. They could easily eat both of the peanut butter cups because it's that combination of those ingredients that companies have figured out. Again, it's sugar, salt, fat. And they combine them in such a way that it hits your tongue, which goes right to your brain and says, more. That's awesome. I want more.
- [11:28]
A
I'm gonna. I'll share. I use the. Is it Giardinelli chips?
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B
Oh, Ghirardelli.
- [11:34]
A
Is that how you say it? Oh, you know what it's problem? Oh, yeah. I probably confusing that with somebody I know. Ghirardelli chip. I just said somebody's last name. Anyway, hi, everybody. If you hear that. And I do very similarly, like, I'll buy a bag of milk chocolate, a bag of dark chocolate chips, and actually just throw them in the bowl and I mix them up. So when you grab it, you get like. And I think when you grab it, you end up with like, I don't know, seriously, like eight chips maybe. And then you're like a tablespoon. Yeah. And you're like, okay, there, that was that. And then you're kind of on your way again. Anyway. Okay, well, I appreciate you doing this with me. Thank you.
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B
Of course. No, that's great. Thanks.
- [12:17]
A
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 at juiceboxpodcast.com forward/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 and 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? 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 a 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. Foreign 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.