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Hello, friends, and welcome back to another episode of 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 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. While you're listening, please remember that 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 or or becoming bold with insulin. Usmed is sponsoring this episode of the Juice Box Podcast and we've been getting our diabetes supplies from USMED for years. You can as well. Usmed.com juicebox or call 888-721-1514, use the link or the number, get your free benefits check and and get started today with usmed. 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 Jenny, we are going to do some Bolus 4 stuff.
B
Oh, fun. These are always fun.
A
I have a list. These are.
B
We're going to do McDonald's again.
A
No, no, we can't do that again. That was. That was good though. People were very fun. People had a good time with that one. So no, we're not going to do that, but we are going to look at the list, a pretty extensive list that people sent in. Do you want to do a. Well, we did McDonald's, so that one's done.
B
Okay.
A
Should we do another restaurant or do you want to just want to do a donut. Why don't we do a short one here?
B
Let's do a donut.
A
Sure.
B
We've not done that. Gosh, that's something, I guess I would think that we would have already done with a pretty common.
A
Let's just do a Krispy Kreme doughnut.
B
Oh, my gosh.
A
Have you ever had one?
B
I have actually had a Krispy Kreme doughnut, yes.
A
All right.
B
When I was in college, I worked with Habitat for Humanity.
A
Okay.
B
And our spring break trips, I was never. I never went and laid on a beach. My spring break, we took what were called collegiate challenge trips. And so we took, like, a big, huge or couple of, like, 15 passenger vans, and we would pack it all up, all of our supplies. We had to get donations, and we would go somewhere out of state. And many of the places we went because we still wanted it to be warmer on spring break, we would go or we would pick a location that was somewhere in the South. So I'd gone to New Orleans, and I've been to Mississippi and to Georgia and North Carolina and West Virginia. Oh, my gosh. They were. All of my spring break trips were spent with Habitat. It was an amazing thing. But my point being that that's where I had crispy cream. Long story. That's how I got crispy.
A
I could travel the country to have a. Have a donut. Well, I'm on their website. Krispy kreme.com. is that what it's called? Let me make sure. Yeah. Krispy kreme.com. and I'm starting with. I think we're into a few of them. Original. Just the original glazed donut. When I think of a Krispy Kreme, I just think of, like, a glazed donut. Okay, you ready?
B
I'm ready.
A
All right, well, I'll tell you the calories, just for fun, it's got 190 calories in it. Calories from fat, 100, total fat, 10, saturated fat, 5. No trans fat, no cholesterol, 100 milligrams of sodium, total carbs, 15.
B
Or probably. Oh, a glazed one. Sorry, I was thinking of a cake donut. Probably about 40 to 50.
A
They say 22.
B
Really?
A
They say total. Carbohydrates, 22. Dietary fiber, less than 1. Sugars, 10, protein, 3.
B
I wonder how big their glazed donuts are. And it's also then not a terrible amount of glaze.
A
Okay, so that's where all the carbs are coming from, you think from the sugar.
B
I mean, the donut itself obviously has the majority of the fat in it. And for that many calories. Half the calories are coming from fat, and there's not really any protein. So that makes sense that it would be approximately 20 some grams of carb based on the calorie value at 4 calories per gram. That's about right for the math of the calories.
A
Let's do it for you. What's your insulin to carb ratio?
B
It depends what time of day it is.
A
All right, well, let's say you're having a donut in the afternoon.
B
So in the afternoon, it's a 1 to 12.
A
12. And sensitivity?
B
My sensitivity is 85 in the afternoon.
A
85 in the afternoon. We're gonna make your. What would you target if you were targeting a blood sugar?
B
My target is 85 in my system.
A
85. Okay. 22 carbs and fat. 10. No protein in this, right? No. Oh, three.
B
Oh, there is a little protein.
A
A little bit of protein. What's Jenny's blood sugar in the afternoon before she eats this donut?
B
My blood sugar in the afternoon generally is somewhere between, like, 90 and 120.
A
I was gonna put 96. How we do that? Okay, I'm gonna assume you have a nice stable arrow because I'm gonna use my strategy simulator online, But I want to hear about you first. So how's Jenny bolusing for this donut? So just the donut.
B
Okay. I have a stable blood sugar.
A
Stable blood sugar.
B
My blood sugar is 85.
A
Yep.
B
Right or no? What did you say?
A
I made your blood sugar?
B
96, but the target was 85. 96. Okay. How is Jenny pre bolusing? 10 grams of fat, 22 grams of carbs. Does it tell how many grams of added carb or added sugar?
A
Added sugar? Sugars, 10. Protein. It doesn't quantify anything as added sugar.
B
So total carbs, though, are 22 and sugars are 10.
A
Yes.
B
So my pre bolus is 15 minutes in the afternoon.
A
Okay.
B
Sometimes 20, depending on the time of the month, but 15. Let's say this is a sensitive normal time.
A
Does this need an extended bolus for
B
you with only 10 grams of fat? This type of thing doesn't need an extended bolus?
A
No, for you?
B
Not at all. For me, I would take all the carbs. I wouldn't even. I wouldn't cover fat or put it into my system, which I could if I wanted to. I wouldn't put it in there. I would just put the carbs in.
A
Okay. And that's a thing that you think you'd have Success with. So what would your. What do you think the bolus would be? 2 units. Are you considering the fat or just not stretching it for the fat?
B
I'm just not stretching it for the fat.
A
Okay, well then it's going to be more like what, 2.8? Something like that.
B
I mean with my ratio again, I don't do the math in my head anymore. My dog does it for me.
A
Well then just put me in the world. You grab the donut. How much do you throw in for it?
B
Somebody goes, that's 22 cards I would put. If I was just out in the world and I was bolusing on my own, I would take two units for it. So I'd be a little bit heavier than my 1 to 12 calls for. It would be less than two units if it was a 1 to 12. Okay, right. But I would just say two.
A
The, the thing on the website says two units up front, 0.85 over three hours.
B
Oh, okay. For the fat, I'm assuming for the website because it does always consider the fat for you.
A
It's not going to not. But you know, but this is interesting. So. But you know from your own life that that's not going to need that for you.
B
I do. And I can also say that experience for many years on mdi, I would never have covered extra for something like this. With the system I use now, which is trio, I also would not cover extra mainly because I know that the system is already got my back.
A
Okay.
B
Especially with dialed in settings. Right. I mean all of this bolusing for anything boils down to are your settings in a pretty good place to begin with. And so on other systems, however, I wouldn't have even done it on a basic pump that doesn't have an algorithm in it because again, nothing is being taken away. Right. I might consider other algorithms and the potential response algorithms that are the adaptive algorithms that do more of a hard set just pullback suspend based on what the trend looks like that maybe you need to consider what ends up happening because it's pulled back. And that then adds in to some potential.
A
Yeah, so you make lingering. You make this 2 unit bolus for these 22 carbs which seems pretty small, but it's got a lot of sugar. It hits you fast while you're climbing. The system has pulled back, Basil. It's not resisting anything there at all. So maybe you do need that 0.85 correct pumped in over the hours afterwards.
B
And again, it may not be just because of the fat, it might be because of what your system has actually tried to help you with. I also think, you know, if pre bolus has been pretty well done, then on some of these systems you may actually see some pretty nice containment of your blood sugar. You started my blood sugar at 96 and if I pre bolus right and I eat this, I'm also not one to like shove it all down my.
A
You might go slowly while you're eating. Yeah, yeah, yeah, right.
B
If I'm going to eat a donut, I'm going to like enjoy the bites of the donut.
A
I would imagine if you're bolusing for this, you would want to see like a down, like a diagonal down arrow or a falling blood sugar before you started to eat. 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 I used to hate ordering my daughter's diabetes supplies. I never had a good experience and it was frustrating. But it hasn't been that way for a while. Actually for about three years now because that's how long we've been using usmed usmed.com juicebox or call 888-721-1514. Usmed is the number one distributor for Freestyle Libre systems nationwide. They are the number one specialty distributor for Omnipod Dash, the number one fastest growing tandem distributor nationwide. The the number one rated distributor in Dexcom customer satisfaction surveys. They have served over 1 million people with diabetes since 1996 and they always provide 90 days worth of supplies and fast and free shipping. USMED carries everything from insulin pumps and diabetes testing supplies to the latest CGMs like the Libre 3 and Dexcom G7. They accept Medicare nationwide and over 800 private insurers. Find out why USMED has an A rating with a Better business bureau@usmed.com juicebox or just call them at 888-721-1514. Get started right now and you'll be getting your supplies the same way we do.
B
Yeah, I usually say, you know, if you were stable, like a trend of one or two dots kind of already headed down, each dot on Dexcom at least is a five minute incremental shift. And so you' visual of momentum from the insulin already. Right. Kind of that tug of war game that you talk about. It's. The insulin's got a little more tug now. Great. I can put the carbs in because the insulin is definitely showing impact. And I know that these carbs, especially with glaze, they're gonna start to hit.
A
Yeah. The original glazed cake donut, Jenny has 15 grams of fat in it and 40 carbs.
B
Oh, see, there's where I probably was thinking. I guessed originally 40 to 50.
A
Yeah.
B
So the donut you gave that was 22. Isn't a. Isn't a cake donut.
A
No, it's a regular old just glazed donut. Yeah. This is the cake donut, which I. I prefer a cake donut over a regular donut.
B
I was thinking more of a cake
A
donut, honestly, just to see what that does with Jenny settings. That turns this into 3.46 up front and then it wants 1.2 over three hours. It's like four. It's over four and a half units, even for you. And I say even for you because your, your sensitivity is 85 and your, your carb ratio is 12, so.
B
And that's also a lot of insulin at one time for.
A
For you. Yeah. Yeah. What would that do? Do you think you'd. Do you think you'd have success with this or do you think you'd struggle with this? Think you'd get low?
B
I think I'd have to have it as my first experiment and evaluate again. A true experiment is always without an algorithm.
A
Yeah.
B
It just is because you get the true action of your decision in timing and the true action of insulin. That's just solidly there. There's nothing giving and taking. I've grown very much connected to my algorithm. I like it a lot, as do most people.
A
Yeah. Fills in a lot of holes and takes away a lot of your thoughts later. Right.
B
So as you ask about, do you think I'd get low? Do you. You know, what do you think would happen? I expect because my system does a pretty darn good job of preventing lows, I think it would try really hard, given the load of insulin, though, being 4ish units. Right. And depending on what my assumed timing would be, I might actually dip a little bit initially that it maybe it couldn't pull back enough. That one has 15 grams of fat, right?
A
Yes.
B
And so I might also expect. I mean, I like fat. I'm not like low fat by any means. So 15 grams is. What I'm saying is 15 grams isn't really a concern to me either. But if it did do any pulling back, then the end effect might also be a little bit of a curve up. So I would view it as anything that's new. It's an experiment, and I see how it works.
A
You know, marketing is a thing because I, for some reason in my head thought Krispy Kreme doughnuts were, like, cleaner somehow. And I know now as I'm looking at the ingredients, I'm like, this is ridiculous. Why would I even. Why did I think of them as a better alternative than, like, say, Dunkin Donuts? I think it's just the colors. I think it's because they use green around. I think it fits. I actually think the marketing works.
B
That could be. Or it looks. The logo also looks really old school.
A
Yes, I think.
B
Right.
A
Yeah. Krispy Kreme says to me, hey, we're gonna have a donut like a gentleman
B
or your grandma baked it.
A
Right. And Dunkin Donuts says to me, let's go. We're all gonna die together.
B
Yeah, absolutely. Dunkin Donuts is kind of like. It's like plastic donuts compared to Krispy Kremes. And because, you know, Dunkin Donuts, it's a very, like, bold. It's pink. It's like. It's almost, like, loud.
A
It really. I think that might be it. I think Dunkin Donuts says to me, like, let's get in this pickup truck, set it on fire, and see how long we can drive it before it blows up. And Krispy Kreme does feel like, oh, my mom. My grandma made it for me.
B
Right. It's just the label and every. I mean, I don't even know. Krispy Kreme's clearly been around a lot longer, I think, than Dunkin Donuts.
A
I don't even know. All right. They have filled donuts. You want to do chocolate, iced custard or do you want to do original glazed cream filled? Oh, there's also a New York cheesecake filled donut.
B
Oh my gosh.
A
I can't just look at this stuff. Hold on a second.
B
Imagine what.
A
All right, let's do the chocolate ice custard. Because that's really just Boston cream. Right? Isn't that what that is? Basically. Woo. Let's go. Not as much as I thought because you take the cake factor away. Oh, that's interesting.
B
You're filling it with something.
A
Yeah. So it's 37 carbs, 17 sugar, 16 fat. There's more fat than I thought. Getting away from the cake aspect, but still that's, you know.
B
Okay, so it's interesting and that's why I asked about the original donut, that glazed kind of donut that you mentioned before. In terms of total carbs versus sugars, most often I've seen a lot of people doing it and I think if you don't really know from a pre bola strategy where to possibly start with a thyme is. I've seen a lot of people having success, okay. With taking the total sugars or the added sugars if it is on a label and using that as a default starting pre bolus.
A
Say that again for me.
B
Yeah, I've seen. So this one has what, 30 some grams of total carb.
A
Total carb, 37 sugar. 17.
B
17. So it's about half sugar. Okay, Right. But what I've seen people doing, again, this is not medical recommendation or anything disclosure, blah, blah, blah. I am just saying what I have seen people do. And some people have real good success with a starting place. They need to tweak it, but as a starting place, taking the total sugars, which are the hit point. Right.
A
Okay.
B
And they're using that as a marker of how many minutes do I even need to pre bolus. Let's start with the total sugars as a pre bolus time. So this 17 minutes, right. I mean you might just round it to 15 to be easy.
A
But is there a scientific reasoning behind that?
B
I have looked and looked. I don't see a scientific reason.
A
But you see people have luck with it.
B
I have seen people have luck with it and I have seen commentary on people using that as a strategy.
A
Hmm, that's interesting. I'm making a note about that. Okay.
B
But I wanted, you know, more about it. Just that when you do have a label and you can see, gosh, this is this many grams of carb, but oh my gosh, 50% of it is added sugars or the total sugar, you know, kind of added stuff in. I mean, donuts have flour, so that's carbohydrate from natural grain. Right. It's processed, but that's another. But at least it's not added. It's something that came with the flour that they use.
A
I see.
B
Whereas the added is really what you're aiming for to see the hit from because it's so fast. And so it's often, like I said, it's often a starting place that I see people using and saying, gosh, I'm just going to use the added sugars here as a marker. Now that also deeper level is where's your blood sugar? Where is it heading? Where does it come from? What insulin on board. I mean, there are many other factors to consider too, but it's a starting place.
A
I'm going to do this just for this one.
B
I can't believe you've never seen that, by the way.
A
I mean, I feel like I have, but, you know, as a good podcast host, I had you repeat it so that people could hear it for. Yeah, yeah. It's a trick of the trade, Jenny.
B
Hopefully I explained it well enough because
A
I think you did okay. Hey, here's the ingredients for this chocolate iced custard filled donut. And I'll only do this for this one donut. Then we're gonna go do a couple more donuts from Krispy Kreme. Oh. Enriched flour, wheat flour, niacin, reduced iron, thiamine, mono nitrate, riboflavin, folic acid, water, palm oil, soybean oil, sugar, yeast, hydrogenated soybean oil, soy flour leavening, you know, baking soda, salt, mono mono glycerides, wheat gluten, soy lecithin, skim milk, cellulose gum, asorbic acid, calcium propinate to maintain freshness. Egg yolk enzyme. It says egg yolks comma enzymes in the filling. Water, high fructose corn syrup. Corn syrup. I like that. There's two different corn syrups. Hydrogenated coconut oil, modified food starch, sucrose, fatty acid esters, salt, natural and artificial flavor, phosphoric acid, sodium benzonate, polysorbate 60, potassium sorbate to maintain freshness. Colored with beta carotene icing is sugar water, cornstarch, cocoa, corn syrup solids, palm oil, soybean oil, chocolate liqueur, soy lecithin, salt enzyme, modified soy protein, mono and diglycerides, polysorbate 60, sodium and something called hexametophosphate. Enjoy your donut. Damn, there's a lot more in that than I thought there was going to be. What the hell? Wow.
B
I, Yeah, I, I mean, in donuts, like, if you've ever looked up at donuts, aren't that difficult to honestly make.
A
That's what I thought when I was looking at it. Yeah. Like it's just a little cake. It's a little piece of cake. Right With.
B
And the funny thing, as you're going through them, I'm thinking like. And you brought it up like they've got not only high fructose corn syrup, which is really corn syrup that they've essentially added some enzymes to, and the fructose in it makes it a little sweeter than regular corn syrup. But they use both high fructose corn syrup and corn syrup. Clearly there's something fancy in the recipe that makes it taste the right way.
A
Some of that in too. All right, so I'm going to do one more. One of their fancier donuts and I almost did the, I almost did the New York cheesecake one.
B
I was going to ask if, you know tomorrow is Valentine's Day, whether you celebrate it or not, do they have anything special? I know a lot of times, yes,
A
there are Valentine's donuts here. After we do this one, I'll look at one of the Valentine's donuts. Instead of going to the New York cream cheese or whatever it was, I went to the Oreo cookies and cream filled donut. And those Oreos really throw on a little punch. This one has 49 carbs, 28 sugars, 20 fat. That's. That's, That's a big jump.
B
It's a loaded donut, man.
A
It's a loaded donut.
B
I wish I could see what these things look like.
A
You have the Internet. You can do it.
B
I know, I don't. I usually like to let you.
A
I know, I know. There's a way we do this.
B
Yeah. Yeah.
A
49 carbs, 20 fat, 4 protein.
B
How much sugar?
A
Sugar? 28. Now would you tell somebody to pre boast 28 minutes for this? You. Jenny's like, I might look at how much.
B
So 49 grams of total carb. Is that what you said? And 28 of that is sugar.
A
That's a lot of sugar.
B
Added sugar. That is. More than half of this donut is sugar.
A
Yeah. You know what that makes me feel like?
B
Do you know how many teaspoons of sugar that is? I gave you the math for this before.
A
You think I remember that? Stop it. Go ahead, you tell me. I don't know.
B
Seven teaspoons of sugar.
A
Seven. Like Seven measuring teaspoons of sugar. God damn. Yeah. In one of those donuts.
B
That's just added sugar, right? That's just the added sugars. So just as a reference you said, I mean you were very surprised. Like 28 minute pre bolus. I'm thinking if there's nothing else in your stomach and you're eating this and
A
you might need the insulin to be running away to grab this when it hits you, right?
B
Absolutely.
A
By the way, this pushed me. I know this was supposed to be about donuts, but this pushed me to Oreo.com because those Oreos really zhuzhed up those. So chocolate, let's see. Chocolate sandwich cookie. I'm trying to just find a regular Oreo. Wait, this website is fancy as hell. You ready?
B
I don't even know who makes, is it, who makes Oreos?
A
I mean, Nabisco. Is that right? Isn't it all like some oil company now or.
B
Oh absolutely.
A
Missile manufacturer or something? 100%.
B
They're all people that you're like, yeah, you should make my food. That sounds like a great idea.
A
Honestly, I think. Listen, I don't know a lot about a lot but I think if you look into it, a lot of the big like agri companies are just owned by consortiums of finance of money that you know, I think that.
B
Yes.
A
Same group that used to own cigarettes or maybe still does. Like it's possible RJ Reynolds is making your. Your bread or something like that. But let's say that Jenny gets out of her mind is going to eat six Oreo cookies. Jenny, it's all over. Life's gotten sideways. All right, You're.
B
I go to the store and I'm just gonna sit in my car.
A
You're gonna sit and you're gonna eat six Oreo cookies. Now three Oreo cookies is. Sorry, this website I think is meant to, is not to. It doesn't want you to be able to read it. So three Oreo cookies has 7 grams of fat. So I'm gonna put in 14 grams of fat and I really have to pick through this trans way to not put the carbs anywhere near the top carbohydrate. Oh, that gives you total carbs 25. So six of them is going to be 50. Protein. Is there protein? Yeah, you're going to get two grams of protein.
B
Woohoo. My muscles are saying thank goodness things
A
are coming together now. The, my muscles are saying thank you. The added sugar for this is 14, but you're having 6 so it's 28. The calculator which by the way, I, you know, the estimator is I don't think even able to take into account the idea of like how hard the sugar is going to hit right away because it's still like, look, for you it'd be 4.3 upfront, 1.12 over 3 hours, like a 5 1/2 unit bolus with a 10 minute pre bolus. But I want you to talk more about it again from your perspective. You're going to eat six Oreo cookies. How are you gonna bolus for six Oreo cookies?
B
Go for a run after I eat.
A
I'm eat them while I'm running.
B
I'm sorry, would that work?
A
Can you just eat them while you're running? Would that like.
B
Oh my God, I'd probably throw. There's nothing to drink along. Oh God, I can't even imagine doing that.
A
Have you had an Oreo in the last 10 years? They're not as good as they used to be. I just want to say, I don't know, I.
B
Probably the last time I honestly had an Oreo cookie was in college.
A
Okay.
B
Probably. Yeah. I mean, I know what an Oreo tastes like. Yes.
A
So these you think about how you're gonna bullish for the 50 carbs for the regular 6 Oreo cookies, which again, while I look at the double stuff,
B
my estimate would be. So it's 50 grams of carb because you said three has 25. Right, right. And my expectation is that half of that total carb is coming from sugar. Would be my guess.
A
28, right?
B
I think 28. Okay. So I would absolutely. Let's say my blood sugar is in. Target the unicorn number of 100. Nice and level. Let's just say it is. It's not moving. I'm going to give this a minimum of a 20 minute. Knowing my response to a minimum of a 20 minute pre bolus.
A
Okay.
B
And if in 20 minutes I should be seeing already a downward tick, just with my knowledge of how insulin works with me in this situation, I should be seeing, I would give this. It's coming down. I might even be hitting 80 before I take my first bite. So again, here is that timeframe is an estimated pre bolus time. But I'm really paying close attention to my CGM in a scenario like this where I haven't eaten Oreos since college, where I didn't have a CGM and it was my best guess and I, I don't have any clue what happened after I ate the Oreos in college.
A
Do you think it's a mistake that on the mega stuff Oreos, it's harder to find the nutritional information on their website because I don't think it's a mistake.
B
Aren't they. They're double stuffed. Right.
A
They're calling this one mega stuff.
B
Oh, so they're more than double stuff.
A
It feels. By the way, it feels funny to type in Oreo mega stuff. And then nutrition afterwards. It feels like those are two. Two words that don't go together.
B
I'm also curious what the portion size would be because the regular Oreos are. Three is a single portion.
A
Yeah. I'm finding a bag right now to look at the label on the bottom.
B
And I'm curious if, because they're mega stuffed, maybe only one is a portion of. Or are they telling people, or are they suggesting to people that it's two?
A
I see what you're saying.
B
Do you know what I mean? Like, are they.
A
Serving size is 2 cookies.
B
Okay.
A
On the mega stuff, total carbs for those two cookies are 25 and total sugars are 17. So because you're getting the same cookie amount, you're just getting more of the cream inside. I mean, I'm calling it cream.
B
Sugar actually goes up. You get one less cookie, but you get more stuffing. So the carbs remain the same as three regular Oreo cookies. Yeah, but the total carbs are actually. The total amount of added sugars is slightly more.
A
Yeah. And if you had six, six of these, you'd have 75 carbs. You'd have 17, 20, 36, 46, 49, 54 sugars. Is that right? Is that 17 times three, 54. And I think I just let people in real time. See, my poor math. I could have just multiplied, but for some reason, that's not how my brain does it. Fat in this three and a half. So three, six, nine, ten and a. It'd be ten and a half if you had six of them.
B
So there's less fat in the double stuff.
A
Yeah.
B
Must just be all sugar. Then the cookies must have the fat because the other ones have more fat.
A
In three cookies, that puts your bowls up to about seven and a half, by the way, in case you're wondering. Anyway, let's go back to the Krispy Kreme broke because Jenny asked about the
B
Valentine's, if they had anything fancy.
A
Yeah, well, I mean, I think the Oreo one looks. It's fancy.
B
It looks fancy.
A
Yeah. They put extra stuff on it.
B
You know, the funny thing is that when considered, this is where my brain goes in consideration of, like, My intake, which you can take it as it is. If I'm going to eat 75 grams worth of carb, it ain't gonna be this donut. Yeah, it's not gonna be a donut. It's not gonna be cookies. But again, that's me. This is not a you should do this or whatever. It's a. If I want that, I'm going for really good sushi someplace, and I, like, want this to be food that I can enjoy that I'm sitting.
A
Three times a year, Jenny sends me a picture of her plate from a restaurant. She's like, I'm doing it. Look at me. Look at me eating. You know what? I take your point about the Valentine. It'll be beyond Valentine's Day, obviously, when people get this. Also, you're reminding me that tomorrow's Valentine's Day. There you go.
B
Lovely for your wife that you remember now.
A
She was gonna get flowers. Oh, I love you, chocolate. Oh, I love you, chocolate donut. Teddy bear Cookies and cream donut. Your berry sweet donut. And sprinkled with love donut. So they have four. Here's why I'm bringing this up. Because if someone ends up at Krispy Kreme tomorrow or this week, they're gonna go, oh, my God, it's Valentine's Day. And there's gonna be blend in there. And then it's gonna come home and it's gonna go on your counter, right? And then your kid's gonna walk by, and there's gonna be a red heart donut with a bow on it. They'll be like, mom, I'm gonna have a donut the thing. And. Yeah, yeah. And then the red heart donut has 44 carbs in it and 26 sugars and 18 fat.
B
Okay.
A
Yeah. It's not getting crazy beyond what they're. What they're doing with most. Actually, I will say they do seem to keep their donuts. They're all pretty similar. Like, the stuffed ones are hitting nutritionally about all the same. Like, one doesn't seem oddly different than the other. The teddy bear is 46 carbs, 28 sugar, 9 fat. Yeah, these. These are all sort of like, you
B
know, if I was to pick one, Honestly, I don't even know. I don't know what they look like. You said there's, like, a red heart one. Right? And then the. I'd probably pick the teddy bear one. Honestly, like, if I was gonna pick one just out of cuteness and. But then I'd feel bad eating it if it had A face or something.
A
I'm gonna set it to you so you can see it. Hold on a second. And then they have a regular. It looks like they're glazed donut, but with icing on top and jushed up with like red and sprinkles and stuff. That's 37. Okay. And 15. That's interesting. Like so. So their glazed donut with icing on top is 37 carbs. And it really does look like that's all it is.
B
Okay, Right.
A
But then if you go to just the glazed donut, I'm interested to see, like, just the glazed donut has 22. So the glazed donut says 22. You put icing on top of it, it takes it up 15 more carbs just for the icing. Anyway, I think that's partly heavy. Yeah, I. Partly. I feel like that's some of the value in these conversations, actually, is that I just don't know that our brains do the math real quick when we look at things like, oh, donut, it's Valentine's Day. Like, you know, that kind of.
B
Or underscore. I know. I think a lot of people unconsciously under count for things like frosting. Like, it. I know that there's sugar there, but gosh, it can't have 25 extra grams worth of carb in it.
A
Yeah, right. Yeah, especially. You make a good point. Because if somebody's eating the. The glazed donut as part of their life with 22 carbs, then you're like, oh, this glazed donut has icing. There's no way you're going to add 15 carbs in your mind to. Right to that. I sent you the teddy bear so you can see it. Oh, I know. It's a little. I don't know if it's cute or odd. You like it? Jenny likes it.
B
It's kind of. It is kind of cute, honestly.
A
Aww. Yeah. Well, you eat that cute teddy bear and it'll go inside you and try to kill you from the inside out. That's right.
B
There you go. I was so cute. You shouldn't have eaten me.
A
Yeah, you'll experience your own bear attack. Not the way you see in the YouTube videos.
B
You're right.
A
Jenny, thank you for doing Krispy Kreme.
B
No, thank you.
A
I appreciate it. I'll talk to you soon. And happy Valentine's Day.
B
You too.
A
Is that why you're wearing red?
B
Kind of.
A
Yeah. Yeah.
B
I mean, we don't really do anything for Valentine's Day, honestly. I mean, Nathan will usually bring me flowers or something. But honestly, it's truly is just like a money making, like, you know, it's
A
so I expect my wife to apologize to me tomorrow around 3 o' clock. And she'll go, I did not get you anything.
B
She says, I didn't get you anything. And you're like, great, here are your flowers.
A
I got flowers for you. And then she'll say thank you. Actually, Jenny, I think this is a good point to put. I don't think I've ever said this before. I'll just slide this in at the end of the episode. On all occasions, birthday, Valentine's Day, anniversary, those sorts of things. I go out on the morning of, I hand select flowers and come home and arrange them myself. I think it's a nice little addition. It's not just here I bought flowers. It's like I saw these, I took time, they look like they were nice together. I put some time into it. She's never once seemed impressed by that. But I think it's a big deal.
B
I think that's lovely.
A
Don't marry an Irish Catholic girl. Their hearts are buried under ice. That's all.
B
I married an Irish Catholic boy.
A
Yeah, he knows what Jenny knows what I mean. Okay. All right, no shade on the rest of you. I'm sure some of you are very warm and cuddly. Not as cuddly as that donut with a bear on it, though. See you guys. A huge thanks to US Med for sponsoring sponsoring this episode of the Juice box podcast. Don't forget usmed.com juicebox this is where we get our diabetes supplies from. You can as well use the Link or call 888-721-1514. Use the link or call the number. Get your free benefits check so that you can start getting your diabetes supplies the way we do from US Med. Today's episode is also sponsored by 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 okay, well, here we are at the end of the episode. You're still with me. Thank you. I really do appreciate that. What else could you do for me? Why don't you tell a friend about the show or leave a five star review. Maybe you could make sure you're following or subscribed in your podcast. App. Go to YouTube and follow me. Or Instagram TikTok. Oh gosh, here's one. Make sure you're following the podcast in the private Facebook group as well. Well as the public Facebook page you don't want to miss Please do you not know about the private group? You have to join the private group. As of this recording, it has 74,000 members. They're active, talking about diabetes. Whatever you need to know, there's a conversation happening in there right now and I'm there all the time. Tag me. I'll say hi. My Diabetes Pro Tip series is about cutting through the clutter of diabetes management to give you the straightforward, practical insights that truly make a difference. This series is all about mastering the fundamentals, whether it's the basics of insulin dosing, adjustments or everyday management strategies that will empower you to take control. I'm joined by Jenny Smith, who is a diabetes educator with over 35 years of personal experience, and we break down complex concepts into simple, actionable tips. The Diabetes Pro Tip series runs between episode 1000 and 1025 in your podcast player, where you can listen to it@juiceboxpodcast.com by going up into the menu. Have a podcast. Want it to sound fantastic? Wrongwayrecording. Com.
Host: Scott Benner
Guest: Jenny Smith
Date: March 16, 2026
This episode of the "Bolus 4" series dives into real-world strategies for bolusing (insulin dosing) for a single food item: Krispy Kreme donuts, with some bonus exploration of Oreos. Host Scott Benner and diabetes educator Jenny Smith walk step by step through their decision-making process, sharing personal approaches, nutritional insights, and nuanced tips for handling these high-sugar, high-fat treats with confidence rather than fear. The tone is friendly, anecdotal, and practical, designed to help listeners think through the process rather than deliver clinical, formulaic instructions.
[03:01–10:44]
How Jenny would bolus:
[09:16–10:47]
Quote:
"If pre bolus has been pretty well done, then on some of these systems you may actually see some pretty nice containment of your blood sugar." (10:18 – Jenny)
[13:56–15:27]
Quote:
"A true experiment is always without an algorithm... because you get the true action of your decision in timing and the true action of insulin." (15:04 – Jenny)
[16:27–17:29]
Memorable Moment:
"Let's get in this pickup truck, set it on fire, and see how long we can drive it before it blows up. And Krispy Kreme does feel like, oh, my mom. My grandma made it for me." (17:19 – Scott, comparing Dunkin’ and Krispy Kreme’s branding)
[17:35–20:51]
[21:03–23:24]
[25:05–32:10]
Bolus talk for Oreos:
Personal take:
If Jenny is going to eat 75g of carbs, it won’t be for donuts or cookies, but for something more worthwhile, like really good sushi.
[33:04–34:49]
Key conclusion:
It’s easy to unconsciously undercount for icing or decorative extras; they add significant carbs.
Quote:
“A lot of people unconsciously under count for things like frosting. Like, I know that there’s sugar there, but, gosh, it can’t have 25 extra grams worth of carb in it.” (35:20 – Jenny)
[35:49–34:12]
Scott and Jenny make bolusing for a treat like a Krispy Kreme donut a matter of thoughtful experimentation rather than guesswork or fear. The conversation stresses preparation (know your ratios and systems), observation (watch CGM trends), and iteration (adapt as you go)—all with an attitude of self-kindness and real-world practicality. The episode blends technical nuggets, playful banter, and candid advice, offering listeners both a window into Jenny’s process and enduring, applicable strategies for managing the occasional sweet treat.