#1853 Bolus 4 Sushi

Summary

Juicebox Podcast: Type 1 Diabetes

Episode #1853 — Bolus 4 Sushi

Host: Scott Benner
Guest: Jenny Smith
Date: May 18, 2026

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Episode Overview

In this "Bolas4" mini-series episode, Scott Benner and expert diabetes educator Jenny Smith break down strategies for bolusing insulin when eating sushi—a notoriously tricky food for people with diabetes. The conversation aims to provide practical, real-world advice, emphasizing variability in sushi composition, digestion times, and individual responses. Their approach follows the MEAL BOLT method in spirit, but keeps things conversational and relatable rather than technical.

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Key Discussion Points & Insights

1. Understanding Sushi: Variety & Nutrition

• Types of Sushi:
  Discussion ranges across rolls (spicy tuna, California, dynamite), maki, nigiri, and sashimi.
• Variable Portions:
  • Rolls typically have 6–8 pieces; the size (small, medium, large/specialty) and toppings affect the carb and fat content.
• Nutritional Complexity:
  • Sushi rice is short-grain (starchier) and usually made with vinegar and sugar, increasing carb content.
  • Spicy mayo and sauces add fat.
  • Estimates: ~35–38g carbs, ~15g fat, ~20g protein for a typical spicy tuna roll (8 pieces).
  • Fat and protein contents vary widely with the roll's toppings and fillings.

Jenny [06:03]: “I count 38 [grams of carb] because I figured that’s… I figured out what works. The lower 30s were too little.”

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2. Estimating Macros and Insulin Needs

• Estimation Challenges:
  • Online nutrition info may not be accurate; each restaurant’s ingredients and portion sizes are different.
  • “This one’s a science experiment for sure.” —Scott [20:37]
• Macro Examples:
  • Spicy tuna roll: 35–38g carbs, 20g protein, 10–15g fat
  • California roll: 38g carbs, 9g protein
  • Dynamite roll: 45g carbs, 12g protein
  • Maki: 25g carbs, 15g protein
  • Sashimi: Essentially all protein, negligible carbs/fat

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3. The Digestive “Stretch Effect”

• Why Sushi’s Tricky:
  • Cold rice and fat/protein slow down digestion—blood sugar may rise several hours later, not just immediately.
  • Prebolusing is important, but so is extending insulin delivery.

Jenny [11:57]: “There’s a stretch effect to sushi and how it ends up digesting… it can also stretch out the glycemic hit. Sushi is kind of similar… it’s full of protein… So you’re looking at a stretch effect that can be several hours. And that’s where… it trips up a lot of people.”

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4. Bolusing Strategies

• Prebolus:
  • Jenny’s approach: Prebolus ~40% of expected carbs 15 minutes before eating (if BG stable or slightly trending down), then bolus for the rest when food arrives.
    • “If I bolus all up front, I’m going to hit a low before it starts kicking in.” —Jenny [14:29]
• Extended Bolus:
  • Example for a typical roll: 3.5 units upfront, ~1 additional unit over 4 hours (for fat/protein/later rise) with a 9–12 minute prebolus.
• Meal Add-ons:
  • Other components (edamame, soy sauce, wasabi, ginger) have small but significant carb/protein counts.
    • E.g., 2 tbsp soy sauce = 2g carb, 2g protein; 1 tsp wasabi = 3g carb.
  • Don’t forget to bolus for sauces/slurries (“like ketchup—a huge offender” [18:15]).

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5. Real-World Examples & Calculations

• Full Meal Simulation:
  • Example: 2 spicy tuna rolls + 4 pieces salmon nigiri = 76–105g carbs, 30–45g fat, 44–50g protein.
  • Using a 1:10 carb ratio, ISF of 50, target 90mg/dl:
    • 10.5 units up front, +3 units extended over 8 hours.
  • Not accounting for fat/protein leads to big post-meal highs, especially with insulin pumps' automated basal reductions.

Scott [27:47]: “Thirteen and a half units for sushi. It’s a lot of insulin.”
Jenny [27:50]: “We’re not, this is not a judgment. You just have to consider… maybe your meals are usually more like six or seven units… [but] are you having that meal… and then going up to 300 and staying there for five hours? This is your answer, really.”

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6. Tools for Learning and Adjustment

• Use of Estimators & Technology:
  • The “Bolus4” estimator at juiceboxpodcast.com helps visualize how carbs, fat, and protein alter suggested insulin and timing.
  • AI tools can help calculate—but personal trial and observation are key.
• Experimentation Mindset:
  • Approach each sushi meal as an experiment: Use each experience to dial-in better estimates and bolus strategies.
  • “This is where you make a decision to try something and you say to yourself, this is entirely an experiment.” —Jenny [23:25]

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Notable Quotes & Memorable Moments

• Jenny [06:03]: “I count 38 [grams of carb] because I figured that's…what works.”
• Scott [07:45]: “This one's going to be…one you are going to get to eat a lot of sushi while you figure out how to handle this, right?”
• Jenny [11:57]: “There’s a stretch effect to sushi… can be several hours. That's where it trips up a lot of people.”
• Scott [12:33]: “Let’s put a reasonable pre-bolus on here, right? But… not too long because this is going to get going here.”
• Jenny [14:29]: “If I bolus all up front, I’m going to hit a low before it starts kicking in.”
• Scott [18:15]: “Ketchup is like sugar! Basically it is.”
• Scott [20:37]: “This one’s a science experiment for sure.”
• Jenny [23:25]: “This is where you make a decision to try something… an experiment. I'm going to put in these strategies and I'm going to see how it hits.”
• Scott [27:47]: “That's ten and a half units... thirteen and a half units for sushi.”
• Jenny [27:50]: “We're not, this is not a judgment. You just have to consider…”

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Timestamps of Key Segments

• [00:00] — Introduction and overview of Bolus4 series
• [04:02] — Sushi rolls: how size, ingredients, and toppings change macros
• [05:06] — Sushi rice: why it’s higher in carb (short grain, sugar-vinegar mix)
• [06:38] — Variability in nutritional info and the need for experimentation
• [11:29] — Why sushi acts differently: cold rice, digestion, "the stretch effect"
• [14:08] — Jenny’s dual-phase bolus strategy
• [16:23] — Impact of add-ons: soy sauce, wasabi, ginger, and edamame
• [19:27] — Sashimi, soup, and their unique impacts
• [20:37] — Bolusing for full meals and using tech/AI for estimates
• [23:25] — The necessity of experimentation and adjusting over time
• [25:03] — Real-world multi-roll meal macro calculation
• [27:47] — Insulin needs: comparing big sushi meals to “normal” meals
• [29:15] — How pump algorithms can make things worse if not planned for
• [30:01] — Estimators as learning tools and discussing with your doctor

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Practical Takeaways & Pro Tips

• Every sushi outing is an experiment—track what you eat, how you bolused, and what happened to adjust next time.
• Break meals down by macros—don’t just focus on carbs; fat and protein matter for late rises.
• Use extended/dual bolus features or split injections for meals with prolonged carb/fat absorption (like sushi).
• Prebolus part of the insulin, finish when eating for more control.
• Account for “hidden” carbs in sauces and condiments!
• Be flexible and observant—monitor with CGM and tweak for next time.
• Leverage available tools—online estimators, AI, and your own data.

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Episode Tone

Conversational, supportive, playful, and realistic. Both Scott and Jenny emphasize a non-judgmental, experimental approach with humor and empathy for the everyday realities of diabetes management.

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Next Up

Scott [30:53]: "The next time we get together, we're going to do Mexican and Chinese. You're going to love it."

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To learn more about bolusing strategies and diabetes management, visit juiceboxpodcast.com, or try the Bolus4 estimator tool for calorie and insulin calculations.

Transcript

[A]

Here we are, back together again, friends, for another episode of the Juice Box Podcast. In every episode of Bolas4, 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. The episode you're about to enjoy was brought to you by Dexcom, the Dexcom G7, the same CGM that my daughter wears. You can learn more and get started today at my link dexcom.com juicebox Today's episode is also sponsored by the Omnipod 5. And at my link omnipod.com juicebox you can get yourself a free. Free. What'd I just say? A free Omnipod 5 starter kit. Free. Get out of here. Go. Click on that link omnipod.com juicebox check it out. Terms and conditions apply. Eligibility may vary. Full terms and conditions can be found@ omnipod.com juicebox links in the show notes [e-mail] Jenny hello. We are. Hey. Hello. Hello, Hello. All right, we're gonna talk about a food today for Bolas4 that I've never eaten. Well, that's not true. I had one piece one time, but I have never had beyond that sushi in my entire life.

[B]

Oh, you're missing out. That's what my boys. If we have something special, a birthday, a celebration, something which, by the way, Oscar just got his black belt.

[A]

Oh, cool.

[B]

He tested last Saturday and was out of 20 some testers, there were only three who actually were past all of the pieces through like a Four and a half hour test.

[A]

What a nice accomplishment it is.

[B]

So he again, getting back to sushi, you know, we were like, well, we'll go out and we'll celebrate. Right? What would you like? And I already knew, like, he's like, the sushi place.

[A]

Yeah, that's awesome. That's really.

[B]

Sushi's the thing.

[A]

Well, I have a specific, specific order here lined up for us to try to work through. Spice spicy tuni. Tuni spicy tuna roll. It says specifically dunked in soy sauce, wasabi and ginger slurry. No idea what that means. Maki nigiri sashimi. Boy, this is going to be fun for everybody to listen to. Tamakia Impact of sushi rolls. Rolls, California rolls, Dynamite rolls. That's. That's what they're looking for. So I'm going to let you go because I don't. I mean, how do you break this stuff apart? I. I let you know, for context for everybody. I asked Gemini to break down the nutritional value of these things. So I have something in front of me. But I'd be much more interested to hear what you think about it.

[B]

Yeah. So in general roles. Roles is the whole entire role that you get. Right. You may get in a role that, depending on the location, somewhere between six to eight pieces in a roll, the rolls can be considered small, meaning it's the diameter. Medium or the large are usually more like the specialty rolls. They've got a lot more sauces. They might have crispy onions on the top or that kind. So they're much larger and they're stuffed with a lot more, usually like ingredients, not necessarily a lot more rice. But as you can see, portion wise, as that diameter gets larger, each piece is going to be more carbohydrate. Right. So when you talk about something like a spicy tuna roll, essentially you've got rice, you've got the tuna, and you've got usually, usually the spicy part also has fat. It's usually mayonnaise with some type of spice to it.

[A]

Okay.

[B]

And the interesting thing about sushi rice is that one, it's a really. It's like a short grain rice, so it's much starchier. It's also the way that they make the sushi rice that increases the carbohydrate content of it.

[A]

Yes, because I read a little bit about that. Like, they like to make the rice sticky. There's like a sugar mixture, vinegar kind of mixture or something like that. Right?

[B]

Okay, absolutely. So again, not just rice, but you've got something increasing the carbohydrate content. So when you look at just like a spicy tuna roll in general, let's say it's eight pieces in the roll, you're probably looking at about four grams of carb per piece.

[A]

Okay.

[B]

Okay. So eight pieces times four grams of carb a piece is. What about. Let's call it 32. That's kind of on the lower end, honestly.

[A]

Okay.

[B]

For a spicy tuna roll, I'll tell you what I count, I count 38 because I figured that's. I figured out what works.

[A]

That's my number.

[B]

And I do it often enough that. And it's also, again, based on the place that I've gone over and over, kind of the content, I've. I've figured out the lower 30s were too little. And it is, this is the case where it truly is. It's an estimation. It's your best estimation. Even if you fed a picture of what was on your plate to something like an AI, this is where you could get very varying results.

[A]

Wildly different probably.

[B]

They could be very wildly different. But in general, even if you just said, okay, a roll, 35 grams of carb in something like this, again, the middle part is all protein and the fat is the spicy kind of mayo sauce. And then you also have the carbohydrates that essentially come from the rice.

[A]

Okay.

[B]

Protein becomes the secondary question. Not only carbs, but it's not a little amount of protein that they're putting in an entire roll. It looks little piece by piece, but if you consider how much probably goes in the entire roll, you're probably looking at a couple of ounces.

[A]

It's funny that, because the breakdown I got online, which I have no idea if it's right or not, and it's why this conversation is so interesting around this food specifically. It's almost a one to one carbs to protein for the roll. I don't know if that's accurate or not, but that's how, that's how it broke it down.

[B]

I would expect the protein to be less grams in a roll.

[A]

Okay.

[B]

And again, this is based on facility, right? The restaurant.

[A]

This one's going to be your point about it all being different. Every. I mean, this is really going to be one. You are going to get to eat a lot of sushi while you figure out how to handle this, right? Yes.

[B]

Yeah, yeah, absolutely. My estimate would be that a sushi roll, again, spicy tuna, specifically for this one, is probably three ounces of protein.

[A]

Okay. For the whole roll, six to eight

[B]

for the whole entire roll, which is

[A]

like six to eight pieces maybe, which

[B]

is about six to eight pieces is a typical roll. And so, you know, with 7 grams of protein per ounce, if we're looking at 3 ounces, that's around 20ish grams of protein for the entire thing. Whereas the carbs really are more, again, if you're estimating on the lower end, 35 grams, it definitely does outweigh the protein.

[A]

And then there's fat in that as well. But.

[B]

And then the fat would be again on top of the roll typically or sometimes mixed within, depending on how they make it. My estimate is usually somewhere around 10 to 15 grams because again, it's mayonnaise.

[A]

Okay, this thing said 11, I'm going with you with 15. And so that whole roll, then you're thinking maybe 35 carbs, maybe 15 fat, maybe 20 protein, ice. You know, when we do these, I keep insulin to carb ratio at 10 sensitivity at 50, targeting a 90 blood sugar, it's saying 3.5 up front and another 1.07, 1.1 over four hours. I don't know if you agree with the four hour stretch or not, but basically the theoretical requirement here is like almost 4.6 units for that. Today's episode is brought to you by Omnipod. Did you know that the majority of Omnipod 5 users pay less than $30 per month at the pharmacy? That's less than $1 a day for tube free automated insulin delivery. And a third of Omnipod 5 users pay $0 per month. You heard that right. Zero. That's less than your daily coffee. For all of the benefits of tubeless, waterproof automated insulin delivery, my daughter has been wearing an Omnipod every day since she was 4 years old and she's about to be 21. My family relies on Omnipod and I think you'll love it. And you can try it for free right now by requesting your free starter kit today at my link omnipod.com Juicebox Omnipod has been an advertiser for a decade, but even if they weren't, I would tell you proudly. My daughter wears an Omnipod omnipod.com Juicebox terms and conditions apply. Eligibility may vary. Why don't you get yourself that free starter kit? Full terms and conditions can be found@ omnipod.com juicebox you can manage diabetes confidently with the powerfully simple Dexcom G7. Dexcom.com juicebox the Dexcom G7 is the CGM that my daughter is wearing. The G7 is a simple CGM system that delivers real time glucose numbers to your smartphone or smartwatch. The G7 is made for all types of diabetes, type 1 and type 2, but also people experiencing gestational diabetes. The Dexcom G7 can help you spend more time in range, which is proven to lower a 1C. The more time you spend in range, the better and healthier you feel. And with the Dexcom Clarity app, you can track your glucose trends. And the app will also provide you with a projected A1C in as little as two weeks. If you're looking for clarity around your diabetes, you're looking for Dexcom. Dexcom.com Juicebox when you use my link, you're supporting the podcast Dexcom.com Juicebox Head over there now.

[B]

I do agree with the four hour in terms of like that extended part, mainly because sushi is interesting. If you look at it just from a rice perspective, it's a pretty quick high glycemic index. It could be a quick hit. So pre bolusing becomes really important here. But there's a stretch effect to sushi and how it ends up digesting. I mean, you don't eat sushi warm.

[A]

No. Okay.

[B]

Right. So we eat sushi cold rice, like many starchy foods. And I'm sure you've heard about the noodle idea, right? You cook the noodles, you cool them down, you reheat them, or you even eat them cold. And it reduces the glycemic hit, but it can also stretch out the glycemic hit. Sushi is kind of similar, along with the fact that it's full of protein, depending on what else you're eating. With this spicy tuna roll.

[A]

Yeah.

[B]

So you're looking at a stretch effect that can be several hours. And that's where I think it, it kind of trips up a lot of people thinking, well, gosh, it's, it's rice.

[A]

It's also small. I know that's, it sounds crazy, but it's not that big of an amount of food. And actually to your point, the bolus estimator that is@juicebox podcast.com bolus4b o l u s the number four. It's saying pre bolus time. And I have this set up as the current blood sugar. I didn't even put it in, but I, I, I just put the, the BG trend is stable. It says, it says nine minutes would be a pre ball starting place. Yeah, yeah. If I, if I put in a, a current blood sugar of 120, it stretches it out to, you know, 12 minutes, but it's to your point of like food get, you know, let's put a reasonable pre bolus on here, right? But not, you know, but at the same time not too long because this is going to get going here.

[B]

And my sushi strategy, again, my n of one personal experience has been with many, many sushi eating experiences.

[A]

Many, many, many.

[B]

The best of which by far was in Lima, Peru, which is very weird. It was the best sushi that I've ever, ever had.

[A]

Didn't expect that.

[B]

It was amazing. But my sushi experience has taught me that I can bolus. Knowing what I've ordered as soon as our order gets placed and knowing now about how much sushi I eat, I pre bolus. It's 15 minutes as long as my blood sugar is in target and even if my blood sugar is just slightly trending down, I, I still do the same pre bolus but I don't pre bolus all of the carbs.

[A]

Okay.

[B]

Instead I pre bolus about 40% of the carbs that I expect I'm going to eat of the rolls that we've ordered. And when the meal arrives, I enter the rest of it.

[A]

You put the rest in use the classic how to pre bolus for a little kid trick.

[B]

It is kind of that. Exactly.

[A]

Get a little bit going.

[B]

It's more based on what I know the extensive reach of sushi for me looks like. And if I bolus all up front, I'm going to hit a low before it starts kicking in, right. So I pre bolus enough that I catch the first digestive, if you will, of the initial and then because I bolus for the rest at the beginning of starting to eat, then you have

[A]

a heavier blanket on the second burst basically. Yeah, yeah, yeah. It's interesting just so people can track along. And I think this why this estimator is really helpful to kind of learn from 3.5 upfront, 1.07 on the back end for those four hours if you just take the protein out. So I don't count protein on this meal. It keeps the initial bolus at 3.5, but the, the Warsaw wave now goes to three hours and comes down by like point four, like a half a unit. So if you're going to get a big push later, not only have you not stretched it out long enough now just by not considering the protein, but you also, you know, you also are not having enough insulin. Again, same idea. If you don't think about the fat. If you just go like this sushi rolls, 35 carbs, this goes down to a 3.5 bolus with no consideration for later. And that must be what people are seeing, right? They're not treating, they should be treating this food almost like a burger and fries as far as like that secondary

[B]

hit and the fancier the rolls get. Again, those specialty rolls they tend to have, sometimes they have a fried component to them because the shrimp inside might be fried or you might actually have fried like squid or eel. Like there might be a fried fish component that's inside as well as the mayonnaise based types of sauces. Or the avocado that might be inside of your, you know, California roll, for example.

[A]

Okay.

[B]

Depending on how much you' and then what you might also be eating it with. Like, I know we always, before our sushi even comes, we really like the edamame. Have you ever done the edamame?

[A]

Arden loves edamame. Yeah, yeah.

[B]

So much fun to eat. Like, my boys could each eat their own bowl of salty hot edamame. So we usually share some of that ahead of time, which is actually great because it adds a fiber coating component, a protein component before the sushi actually also kind of gets digesting and rolling. So think about what you're doing before you eat the roll.

[A]

Well, let's talk it through a little bit. So soy sauce has carbs and protein in it that I didn't expect. Even. Not a lot.

[B]

It's more minor.

[A]

Yeah, a tiny little bit. But, you know, two tablespoons, two carbs, two proteins. The pickled ginger doesn't have any.

[B]

Pickled ginger is so good.

[A]

Wasabi paste has carbs in it. Again, teaspoon of wasabi paste looks like about 3 grams of carbs. So that slurry you're talking about, you know, when it, it's all put together. And by the way, whoever said slurry, like, I thought they were making that word up. And it's obviously a real thing, but it's 10 carbs, two proteins. So it's one of those things. It's, it's almost like ketchup. Like, it's really easy to be like, oh, I didn't, I didn't really account for that. But we go back down to this meal. If you're, you know, if you're putting. I don't know what you do with that slurry. But all of a sudden, you know, there's two more proteins, 22, and there's 10 more carbs. So now it's the roll and the slurry. It. Boom. You know what I mean? Like Here we go again. It's. It's now four units up front. That went up by a half a unit. And the Warsaw wave kind of stayed similar, but now we're up to over five units. Just with, with that, that one you

[B]

add on a good component in looking at a lot of meals that have these little saucy kinds of things with them. Right. I mean, ketchup is a huge offender.

[A]

Yeah. Oh, no. Yeah, all the time. Nobody ketchup. Ketchup is like sugar, you know, Basically it is.

[B]

And in this example, with your insulin to carb ratio standard at 1 to 10, for ease in calculation, if this little slurry. Great word, this little 10 grams of carb, that's a unit of insulin that you miss.

[A]

Yeah, yeah, yeah.

[B]

And that can definitely make a difference. I mean, that's a 50. If, if your insulin to carb and your correction factor are truly well calculated, then one unit of missed insulin can also create 50 more rise than you would expect.

[A]

Just like that.

[B]

Right.

[A]

Would a person eat a spicy tuna roll and a California roll or is that too much food?

[B]

Oh, no.

[A]

Okay.

[B]

If you wear my children especially. Oh, the more rolls the better.

[A]

Well then I'm telling you here, I'm looking at California roll. And again, the spicy tuna roll estimate that I'm looking at was under your estimate. It says California roll, 9 protein, 38 carbs. Dynamite roll, 12 protein, 45 carbs. Standard maki, 15.

[B]

Maki is just simple.

[A]

Yeah, but still it's 15. It says 15 grams of protein, 25 carbs. Like, you know, sashimi has a lot of protein in it.

[B]

It is, it's really. Sashimi is just, it's without rice entirely. It's pretty much protein though. But again, if you are the person who goes, and let's say you get the steamed edamame, maybe you get the. Oh, what is their soup called that they have. I really like it now. It escapes me, the name of the soup, Miso soup. Okay, there we go. I mean, again, pretty, pretty negligible. But if you are truly just doing a big plate of sashimi, you've got a lot of protein there that you're. You should be expecting a hit down the road.

[A]

Three to four and a half ounces of thick slices, 22 to 25 grams of protein.

[B]

Right. So in a. And again, then they're pieces, they're not rolls. So per piece, usually somewhere. I usually say somewhere around 5 to 7 grams per piece. Okay. In general.

[A]

So listen, I, I'm going to tell you right now, I think this conversation will help wrap your head around it. But this is just. This is just Gemini. It's just Google Gemini. I didn't do it in chat GPT. I didn't do it in Claude. I don't know if it would come up with different things or not, but at least it's a starting point because you're telling me that this one's a science experiment for sure. Mm. And so at least start at a reasonable guess. And all I did was took someone's order. It's a. It's a listener who sent this to me.

[B]

Yeah.

[A]

Spicy tuna roll, dunkin soy sauce, wasabi and ginger slurry maki. I read it to you already, right. I put it in and I said I need a nutritional breakdown for all. Be complete, be accurate. I need fat, protein and carbs. And it just spit it back at me. I don't know if it's right or not. I mean, what the hell does right even mean? Like, you know, if each restaurant's gonna be different and each person's gonna feel impacted differently by it, and maybe your settings are right and maybe they're not, but still, like, you gotta start somewhere.

[B]

Yeah.

[A]

And it could be fun to be perfectly honest with you. Like, sit down at the table.

[B]

Absolutely.

[A]

Yeah. Whip open your app, ask your, ask your, ask your, you know, your world dominating minion in your pocket what it. What it thinks.

[B]

The more you feed it, you know, this little helpful minion as like that consideration, truly, as you feed it the information, you can say, okay, I'm having a California roll. It is eight pieces. Each piece looks like it's about an inch in diameter. So the more information you can give. This type of system, it doesn't have parameters for distinct rules. Right. You have to feed it the information to get back the best cumulative that it's pulling from. From all sources that it's looking at. Right?

[A]

Yeah. And this isn't a. I mean, listen, this isn't an AI conversation, but as long as it got brought up, I'm using Claude now mostly. And they recently added like some memory to it. Like you can build in skills and. And so like you could build a. I don't know what you would call it. I don't know if it's a skill, if it's. It's not important. Again, this is not a. This is not a Claude lesson, but you can basically teach it things about yourself. So you could say, you know, give me the starting points for this meal and then get down to the point where you realize like, well, this is what it actually took. I mean, you could easily add onto this and say, this is my carb ratio. These are my settings. Here's what I tried this time. Here was my end result. What should we try next time? And then say, you figure it out and it ends up being like, this meal is this many carbs and this much fat stretch out over this much time. I've added in the protein, blah, blah, blah. You got it worked out. You go ahead and tell it like, that's what worked for me. Right?

[B]

Yeah.

[A]

So now the next time you ask it for something, it'll probably be able to like, say, oh, you know, I know the, the carbs say this, but you know, the last time that happened, it ended up being more like this for you maybe try this. And I'm telling you, like, that's not that difficult to figure out. So especially for these sorts of things, I mean, the reason sushi comes up is because everybody seems to struggle bolusing for sushi. Like, you know what I mean?

[B]

When I'm seeing people online, 100%, unless you test it and fiddle with it and expect that it's. This is again, not specific to sushi, but this is where you make a decision to try something and you say to yourself, this is entirely an experiment. I'm going to use all the information I have from similar foods that I've learned to navigate well and I'm going to put in these strategies and I'm going to see how it hits.

[A]

Yeah.

[B]

And then you end up making a change.

[A]

Right. But, but this is so much more focused and I think simple, by starting with at least a better jumping in point, really on the numbers, instead of just sitting down one day and going like, I don't know, I'll try this, eating it, having your outcome going, I'm going to go back next Friday night and give it a whirl again, like, although, you know, I'm sure you come to the same conclusion eventually. No.

[B]

Right, Correct. So, I mean, in a real world, like you said, would you eat just one roll? Oh, oh, no, no, no, no, no, no. So let's, I mean, let's put together a real life scenario, right? Let's say, I mean, this person fed you a whole bunch of different things. But if we did what people tend to do, maybe, especially if you're eating out for lunch on your own, let's say we take something like two spicy tuna rolls and take some of the things from what you did. Two spicy tuna rolls. And we take, we like the salmon. So how about like the salmon nigiri or nigiri. I never know how to say it exactly right. And we say we're gonna have. Let's see, four pieces of that.

[A]

Okay.

[B]

Okay. So as a cumulative, then what are we looking at in terms of macros? Like, our carb count goes up considerably from one roll.

[A]

I've been tracking you. I got what you were saying. The two rolls and the. And the fish, 76 carbs, 30 fat, 44 protein.

[B]

And that's on the light side. Okay, that really would be on the light side. I mean, if you're looking at the nigiri. Nigiri. I mean, in pieces, you're probably looking at 35 grams. Ish. About. From a carb standpoint.

[A]

Okay. Oh, just for that. Yeah, yeah, yeah, yeah.

[B]

I mean. And from two spicy tuna rolls, again, if you use average 35 for a spicy tuna roll, but two of them, that's 70 grams of carb.

[A]

Yeah.

[B]

Like, we're looking at a large amount.

[A]

You're more like 105 in that at

[B]

that point, at least. Right. And then the protein. Right, protein. For. What did we count for the sushi rolls? I think it was like 30. 25 or 30. Right. So that's again, adding up how much protein in each of the rolls. If we go on the low end, 20, 25 per roll, that could be 40 to 50.

[A]

I'll put in 50. And what do you think about fat?

[B]

And then fat again, spicy tuna, each roll being. I think I said somewhere between 10 and 15, so probably somewhere between 20 to 30 grams of fat. And then you're looking at the other. Right, the other salmon. Containing salmon's a little bit of a fattier fish. It probably has more fat. It doesn't have a sauce on top of it. But you're looking at carbs, protein, probably similar to the tuna rolls. And you're also looking at fat less for that. I would say probably 10 to 15 again, total fat for those pieces.

[A]

Okay. But.

[B]

So you've got. You've got huge macro hits here.

[A]

Yeah. So if you. If just following along with what you're saying, 105 carbs, 45 grams of fat, 50 grams of protein, fat in the protein. Not something most of you are counting to begin with. I'm going with a stable blood, a stable trend on your. You know, and let's just say you started at a 90 blood sugar, which let's. You're probably not. Okay. But like, let's just say that you are. That's ten and a half units. This is a one to ten, right. Insulin sensitivity of 50, so it's ten and a half units up front, three units over. It's now saying eight hours, like, like, you know, so three units stretched out over eight hours still with like a nine minute pre bolus, it's thirteen and a half units for sushi.

[B]

It's a, a lot of insulin.

[A]

Yeah, yeah, yeah.

[B]

And again, we're not, this is not a judgment.

[A]

Right, of course.

[B]

You just have to consider though that if this is your meal, you have to also, from a mindset standpoint, maybe your meals are usually more like six or seven units. And you looking at this amount thinking, my goodness, that's gotta be raw. Things gotta be raw.

[A]

But are you having that meal with your six or seven units in and then going up to 300 and staying there for five hours? This is your answer, really? And again, just to make the point to everybody, if I just took ten and a half up front, three over eight hours, if I just take out the 50 protein, it changes the back end, but it doesn't change the front end very much.

[B]

Right.

[A]

If I take out the fat and no one's teaching you to bolus for fat. The complexity of this extended bolus is completely gone now. It's just telling you this is ten and a half units for the meal. And we just said it might be not only ten and a half, but my God, you know, another three units and stretched out over eight hours afterwards. That's a three unit impact. You're not getting at all with the amount of insulin. Right. Because you're not using it and you're not addressing the timeline after the food at all. Either you're just looking at your regular old basil, or, you know, if you're injected, it's just basil. If you're on a, you know, a regular old pump is just basil. If you're on an automated system, not only is it not there, but the automated system is probably taking the basil away.

[B]

It might be.

[A]

Right, right. And now you have. Now not only do you not have the three over the time, you have no basil either. No basil either. You could be, yeah, you could be different deficient, significantly. And you're seeing this crazy rise. And then you get on the phone to the pump coming, damn, pump don't work.

[B]

Something's wrong. Something's wrong. It took all my insulin away and I was sitting high. Well, you have to understand how the algorithms work.

[A]

Yeah, yeah. And you have to understand these, these impacts. I'm telling you right now, this estimator is a great way to Learn this. I like just throwing in numbers and seeing like how does not accounting for this or not accounting for that or accounting for that correctly. How does that change the amount of insulin, the time that that insulin needs to be active? I think it's a really great learning tool. I really did build it as a learning tool.

[B]

Yeah.

[A]

You know, if you want to use it. Otherwise I probably can't stop you. But you are going to answer a couple of disclaimers on the way through. Ask your doctor about it. I would open this up at my doctor's appointment and say like, hey, what do you think? How come nobody ever mentioned fat to me? Can we talk about how to do this better? And if you're really like technically interested, keep scrolling down. It explains to you how the whole page works and the, the estimator works and everything. Really. Just letting yourself know about that is, is probably the, the secret to the success a lot more. I'll even under, I might even say it might even be even more valuable than understanding exactly how many carbs and fat and protein are in the, in the sushi that you're eating. So thank you for doing this. I really do appreciate it.

[B]

It was super fun. Definitely type of food that I, I, I really like. We don't do very often, but I really like it. So thanks.

[A]

Well, the next time we get together, we're going to do Mexican and Chinese. You're going to love it.

[B]

Ooh, that's fun too.

[A]

Bye.

[B]

Bye.

[A]

This episode of the Juice Box podcast is sponsored by the Omnipod 5. And at my link omnipod.com juicebox you can get yourself a free free What I just say? A free Omnipod 5 starter kit. Free. Get out of here. Go. Click on that link omnipod.com juicebox check it out. Terms and conditions apply. Eligibility may vary. Full terms and conditions can be found@ omnipod.com juicebox links in the show notes links@juicebox podcast.com Dexcom sponsored this episode episode of the Juice Box podcast. Learn more about the Dexcom G7 at my link dexcom.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 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, or you can listen to [e-mail] by going up into the menu. Have a podcast? Want it to sound fantastic? Wrongwayrecording.com.