Latest / The Healthy Diabetic / #372: Diabetes Confessions (Part 1) - I Didn't Take Enough Insulin Because of My Fear of Lows. Now I Do This...

Transcript

#372: Diabetes Confessions (Part 1) - I Didn't Take Enough Insulin Because of My Fear of Lows. Now I Do This... · The Healthy Diabetic

0:15
SPEAKER_00: Welcome back.
0:16
SPEAKER_00: This is episode number 372 of the Healthy Diabetic Podcast.
0:21
SPEAKER_00: I'm Coach Ken.
0:22
SPEAKER_00: If you don't know much about my story, I was diagnosed with type 1 diabetes at the age of 25 in 2007.
0:29
SPEAKER_00: And I'm the founder of Simplifying Life with Diabetes, a diabetes health coaching company that bridges the gap between your medical team and the daily complexities of living with diabetes in between your doctor's appointments.
0:42
SPEAKER_00: I believe that every single one of us living or caring for someone with type 1 diabetes only has one job, and that's to figure out what's going to work for you.
0:51
SPEAKER_00: If you're looking for new perspectives and new ideas on how to live with diabetes, you've come to the right place.
0:58
SPEAKER_00: Before we get started, please remember that nothing that you hear in this podcast should be considered medical advice or otherwise.
1:04
SPEAKER_00: Please always consult your medical team before making any changes to your diabetes management.
1:10
SPEAKER_00: Okay.
1:11
SPEAKER_00: I said this was episode number 372, which I think is pretty impressive for our show.
1:17
SPEAKER_00: And it's because of all of you listening right now, we're getting we've gotten to 372.
1:22
SPEAKER_00: We're just going to keep on rolling with this.
1:25
SPEAKER_00: But the other really cool thing about today's episode is this is the first episode in a brand new, I want to call it a series.
1:34
SPEAKER_00: Who knows how long this series is going to be?
1:36
SPEAKER_00: It might be another hundred episodes worth of information.
1:39
SPEAKER_00: I have no idea.
1:40
SPEAKER_00: But I'm calling this series Diabetes Confessions because there's a lot of things that I feel like I talk about and I put out this persona.
1:50
SPEAKER_00: I feel like that I've put out this persona that I'm like this perfect diabetic, and I'm 100% not a perfect diabetic.
1:57
SPEAKER_00: And there's a lot of things that I have done, I want to say wrong in my management, but also things that I'm not proud of.
2:06
SPEAKER_00: That I 100% would tell a client or someone that's working with me on a private setting or in a group setting, whatever it might be, I would tell this person not to do X.
2:17
SPEAKER_00: And I have probably done X.
2:20
SPEAKER_00: So this series is going to be all about me talking about things that I want to confess to all of you that I have done.
2:28
SPEAKER_00: And today's episode is a really important one because I wanted to start off with this specific topic because all of us have probably dealt with this at some point in our management.
2:41
SPEAKER_00: And that's not taking enough insulin to cover a meal because of a fear of going low.
2:49
SPEAKER_00: And I can remember this vividly.
2:51
SPEAKER_00: I can remember this when I first started just constantly not taking enough insulin.
2:57
SPEAKER_00: One, because I wasn't really sure.
2:59
SPEAKER_00: I didn't have the confidence in myself and the decisions that I was making.
3:04
SPEAKER_00: I didn't have the confidence that I knew how to actually count carbs.
3:08
SPEAKER_00: Even though at that point, you know, depending on when you were diagnosed, you had those count carb counting books that you could get from your doctor.
3:17
SPEAKER_00: There was all kinds of different things that you could purchase or buy that just gave you a list of like, you know, you were going to McDonald's.
3:24
SPEAKER_00: Here's what a burger, how much of carbs that a burger would have, or fries, or you go to Arby's, or you go like go to, you know, you know, wherever.
3:34
SPEAKER_00: They had all these different restaurants in this booklet.
3:37
SPEAKER_00: And I would look at that booklet and I'd be like, man, that's a lot of insulin.
3:40
SPEAKER_00: And then I wouldn't take all of it.
3:42
SPEAKER_00: And then I wonder two hours later why I'm still at 250, almost 300.
3:48
SPEAKER_00: So this is this is I feel like this is a big problem for us.
3:52
SPEAKER_00: And my confession today is that I did this all the freaking time.
3:56
SPEAKER_00: And and I feel like it was mostly because I wasn't confident in the decisions that I was making.
4:04
SPEAKER_00: I didn't have an actual system, an actual plan on if I'm gonna look at just look at a plate of food.
4:12
SPEAKER_00: Have I eaten this food before?
4:14
SPEAKER_00: And what was the result?
4:15
SPEAKER_00: How much insulin did I take?
4:16
SPEAKER_00: Because some people dose like that.
4:18
SPEAKER_00: People, some people don't actually like 100% with complete accuracy count their carbs.
4:26
SPEAKER_00: And I'll tell you what, here's another diabetes confession on a different episode.
4:29
SPEAKER_00: We're gonna do talk about this later too.
4:31
SPEAKER_00: I don't necessarily do that either.
4:32
SPEAKER_00: I don't 100% count carbs.
4:34
SPEAKER_00: I don't look it up 100% on an app.
4:38
SPEAKER_00: I don't look up look it up 100% looking at food labels and make sure that it's it's down to the T.
4:44
SPEAKER_00: And one of the reasons, because of the reasons I don't do that, is because of eating specific foods so many times and either having success or failing.
4:54
SPEAKER_00: Okay, that's a that's that's a snippet of another episode.
4:57
SPEAKER_00: But let's get back to Lowe's, not taking insulin because of lows.
5:00
SPEAKER_00: It is it is, I believe, 100%, maybe 95%, based off of your confidence and the trust that you have in the decision that you're making.
5:12
SPEAKER_00: We just talked a lot, and I think it was two episodes ago, of the importance of trust and how you are dealing with this condition.
5:21
SPEAKER_00: When when I say to you guys that everything in my management evolved so fast when I was able to trust in the decisions that I was making.
5:30
SPEAKER_00: And not just being able to look at something and say, okay, it's that many carbs.
5:37
SPEAKER_00: And I need that much insulin.
5:38
SPEAKER_00: There's that many carbs, that much protein, that much fat and fiber.
5:42
SPEAKER_00: This is how much insulin I need, or whatever it might be.
5:45
SPEAKER_00: It was not just that, it's also looking at that or counting the carbs and saying this is how much insulin I need and believing that, but then on the flip side, maybe it didn't work.
5:59
SPEAKER_00: Maybe I'm more insulin resistant for some reason right now, and I actually needed more.
6:03
SPEAKER_00: Maybe I miscalculated and I might need more, and I might have needed more.
6:09
SPEAKER_00: So the decision didn't turn out the way I wanted to.
6:13
SPEAKER_00: And here's where the trust and the belief that you are on the right track and the belief that you can do this 100% all the time comes into play.
6:21
SPEAKER_00: Even though that decision didn't go the way I wanted it to, it doesn't affect my day-to-day.
6:28
SPEAKER_00: I'm not pissed off about it.
6:29
SPEAKER_00: I'm not irritated about it.
6:30
SPEAKER_00: I'm like, oh crap, yeah.
6:32
SPEAKER_00: Maybe I miscalculated.
6:35
SPEAKER_00: Maybe something I missed some other factor or some other variable that wasn't in front of me or I didn't think about.
6:41
SPEAKER_00: That right there, not being irritated about it, not beating yourself up about it, that's what's happening.
6:48
SPEAKER_00: That's what I believe is having real trust, not just in blood sugars, but stability in the way you think and feel and deal with this condition.
6:57
SPEAKER_00: Because I promise, I promise you, I've lived it, I've lived it for so long.
7:03
SPEAKER_00: The distrust, just the irritation, the this is a chore, this is I feel so alone.
7:10
SPEAKER_00: I've dealt with all of it.
7:12
SPEAKER_00: And the only way I got past all of it, the only way that I got past all of it was to start believing and trusting in the decisions, even if they didn't go the right way.
7:26
SPEAKER_00: Now, here's the coach in me coming out to you.
7:31
SPEAKER_00: There is a difference between you saying that you trusted that you trust your decision and not getting really irritated or fed up or pissed off about the decision when it didn't go the way you wanted to.
7:44
SPEAKER_00: There's a difference between that and using specific words that bring you down.
7:51
SPEAKER_00: What do I mean by that?
7:53
SPEAKER_00: Well, let me give you a couple examples.
7:55
SPEAKER_00: Man, I'm a dummy.
7:57
SPEAKER_00: I should have taken more insulin.
8:00
SPEAKER_00: I had these other factors in play, so I I definitely should have taken more insulin.
8:04
SPEAKER_00: Dang it.
8:05
SPEAKER_00: Alright, well, next time.
8:08
SPEAKER_00: That's different than this.
8:11
SPEAKER_00: Well, I'm a dumbass.
8:13
SPEAKER_00: Yeah, now I'm gonna have to be fighting with this roller coaster for the next two or three hours because I didn't take enough insulin.
8:18
SPEAKER_00: I should have taken more insulin here.
8:20
SPEAKER_00: Why am I why am I constantly doing this to myself?
8:23
SPEAKER_00: Gosh, it's just it's so ridiculous.
8:26
SPEAKER_00: Those are two different mindsets, they're two different frames.
8:29
SPEAKER_00: Maybe you beat yourself up about it for a hot second.
8:32
SPEAKER_00: Maybe you don't.
8:34
SPEAKER_00: Regardless, it's just a hot second.
8:36
SPEAKER_00: And then you move on.
8:37
SPEAKER_00: When I heard about the 180, I'm sure you've heard about this before, the 180 some decisions that we're supposed to be making every single day, or that on an average, I don't even know if it's an average, uh, 180 decisions that a type 1 diabetic is making every single day.
8:52
SPEAKER_00: The the 180 decisions gave me so much anxiety when I first heard about this.
8:57
SPEAKER_00: And and I'm gonna preface this.
8:59
SPEAKER_00: I heard about this maybe three or four years ago.
9:02
SPEAKER_00: Maybe, and I've been a diabetic for 18 years, almost 19.
9:06
SPEAKER_00: And this gave me massive anxiety three or four years ago.
9:09
SPEAKER_00: I was just starting my coaching career in diabetes, like really getting into coaching and helping people.
9:16
SPEAKER_00: And I heard this, and I'm like, there's no way.
9:20
SPEAKER_00: Am I doing something wrong?
9:22
SPEAKER_00: Am I doing something wrong?
9:24
SPEAKER_00: There's no way I make 180, 80 plus 180 plus diabetes decisions a day.
9:29
SPEAKER_00: There's no way.
9:29
SPEAKER_00: There's no freaking way.
9:31
SPEAKER_00: So I tested it.
9:33
SPEAKER_00: And really, on an average, because that's what we're looking at, there's gonna be times where like I don't travel every single week, and I'm not on a plane every single week.
9:41
SPEAKER_00: I'm not driving four, five, six, seven, eight hours every single week.
9:44
SPEAKER_00: On an average, the days that I am in my normal routine, I only make between 25 and maybe 35 on the high end.
9:56
SPEAKER_00: Actual diabetes decisions.
9:59
SPEAKER_00: That's including what is my blood sugar.
10:01
SPEAKER_00: Looking at my looking at my CGM, what is my blood sugar?
10:05
SPEAKER_00: That's including those times.
10:06
SPEAKER_00: Do I need to make a decision right now?
10:08
SPEAKER_00: No.
10:09
SPEAKER_00: I'm good.
10:09
SPEAKER_00: Or yes, I actually do need to take action, bolus, or take a correction or whatever it might be.
10:16
SPEAKER_00: I only make around 25 to 35 diabetes decisions on average every single day.
10:26
SPEAKER_00: And that's not because I'm this amazing diabetic, because I'm not.
10:32
SPEAKER_00: My last A1C, again, this is diabetes confessions.
10:36
SPEAKER_00: My last A1C was 6.4.
10:38
SPEAKER_00: The time before that, it was 6.2.
10:40
SPEAKER_00: The time before that, I was 6.1.
10:42
SPEAKER_00: So there was something that's happened over the past three or four months that has increased my A1C.
10:50
SPEAKER_00: And it's because of irregularities in CGM numbers.
10:55
SPEAKER_00: So not dosing the way I think I should be dosing because the CGM says one thing, and I'm really something else, whether it's higher or lower.
11:05
SPEAKER_00: And I'm not making decisions appropriately because of that.
11:10
SPEAKER_00: And sometimes, because it doesn't always happen, it takes me a couple days to figure this out.
11:15
SPEAKER_00: So now for two or three days, I'm like sitting at a hundred and you know, 200 instead of 120, 130 that I like I want to.
11:25
SPEAKER_00: Because if CGM says I'm over 200, but I'm actually like 130, 140, maybe 150.
11:33
SPEAKER_00: Right?
11:33
SPEAKER_00: I mean, I've had that kind of discrepancies in the numbers.
11:37
SPEAKER_00: So I having to deal with that mentally too is a challenge.
11:40
SPEAKER_00: But the difference is how do you how do you bounce back from all these things?
11:47
SPEAKER_00: And and the mental piece of dealing with this condition is is I've seen it time and time again with myself and the people that I work with, time and time again, that once that becomes in alignment, it's not gonna be perfect all the time.
12:00
SPEAKER_00: We're not looking for perfection because that is not realistic and it's not sustainable.
12:06
SPEAKER_00: Things are not always gonna happen the way you always want them.
12:09
SPEAKER_00: They're just not.
12:10
SPEAKER_00: But I've seen it time and time again, when I can get someone to trust in their decisions wholeheartedly, with no issues, with no problems, regardless of the outcome of the of the decision, everything changes.
12:25
SPEAKER_00: Confidence increases, the trust and belief in that you can have really, really good, stable numbers.
12:32
SPEAKER_00: And what do I mean about really good stable numbers?
12:35
SPEAKER_00: My definition of really good stable numbers is completely different to our doctors.
12:41
SPEAKER_00: 100% completely different.
12:43
SPEAKER_00: Good stable numbers for me is like as close to my target as possible because there's a difference between target and target range.
12:51
SPEAKER_00: Target range, obviously, is our 65 to 180 or whatever it is, 70s for some people to 180.
12:58
SPEAKER_00: Mine is actually 65 to 150.
13:02
SPEAKER_00: That's my target range.
13:04
SPEAKER_00: I'm not talking about that.
13:06
SPEAKER_00: Because I could be if if your target range is 70 to 180, which is standard, you could be 170 all the time, and your A1C is going to be at like close to seven.
13:16
SPEAKER_00: If you're 170 all the time, that's completely different than being at 100 all the time, which is where my target is.
13:22
SPEAKER_00: So every decision that I make is to get me back down to 100 or get me to 100, whether I'm low or high.
13:29
SPEAKER_00: And that's how I make all my decisions.
13:30
SPEAKER_00: I don't make my decisions based off of what this what my CGM number says and how much carbohydrates I'm consuming.
13:39
SPEAKER_00: That's not that's that's a part of the decision, but the ultimate decision is to get back down to 100, which is what I want to be at.
13:46
SPEAKER_00: If I if I had a magic ball, if I could like say this is what my number I want to be all the freaking time, it would be 100.
13:55
SPEAKER_00: If I could 100% do it, maybe it would be 80, because that's closer to like actual range of someone or someone's blood sugar that doesn't have type 1 diabetes is anywhere from 75 to 85.
14:10
SPEAKER_00: 90, you're creeping a little bit too high on an average.
14:14
SPEAKER_00: So but 100 for me mentally, that's doable.
14:19
SPEAKER_00: Now, am I ever 100 all the time?
14:23
SPEAKER_00: No.
14:24
SPEAKER_00: God, no.
14:24
SPEAKER_00: No, no, no, no, no.
14:26
SPEAKER_00: But the decisions are to get me down to 100.
14:29
SPEAKER_00: As an example, my average last night was probably around 120.
14:35
SPEAKER_00: I was fluctuating between 100 and 120.
14:39
SPEAKER_00: I woke up at this morning at 113, which, if I'm my blood sugar is between 100 and 120 when I wake up, I know I'm gonna have a fabulous day.
14:49
SPEAKER_00: As long as I know I didn't have a bunch of spikes last night, which last night I didn't.
14:53
SPEAKER_00: These are the things that we figure out, that we pull from the data from a CGM.
14:59
SPEAKER_00: Hopefully, you're not using a glucose meter because you're gonna get way more data from a CGM, I believe.
15:05
SPEAKER_00: But these are the things that we're trying to look at.
15:09
SPEAKER_00: Where can we take a step into our management and make a better decision or make a different decision, whether it's with food, whether it's with sleep, whether it's with exercise, whatever it is.
15:23
SPEAKER_00: And when we going back to what the title of this confession is, not taking enough insulin because of fear, think about the the tools that you have in your arsenal.
15:36
SPEAKER_00: I I talk about this all the time with with the clients that I have that have this specific fear.
15:42
SPEAKER_00: The number one problem, there's two problems in this scenario.
15:46
SPEAKER_00: And if you experience or if you're if you're having challenges or suffering from fear of taking insulin because of lows, typically, not every time, but typically, it's because someone has had a very traumatic experience with lows.
16:02
SPEAKER_00: So we talk about the two different types of lows in that scenario.
16:05
SPEAKER_00: That's the first thing that we talk about.
16:07
SPEAKER_00: And sometimes that can pull someone out of that fear and start allowing them to trust at least the dosage.
16:14
SPEAKER_00: Maybe not the 100% trust the decision, but at least start trusting that they need to at least take the amount of insulin that their pump or the calculations say they need to take for the carbs that they're consuming.
16:30
unknown: Right?
16:30
SPEAKER_00: So they do two different types of lows.
16:32
SPEAKER_00: There are two types of lows, I believe.
16:34
SPEAKER_00: There's not just lows, because lows can be completely different based off of symptoms.
16:39
SPEAKER_00: And how you treat that low could be totally different based off of symptoms.
16:44
SPEAKER_00: So, what do I mean by that?
16:45
SPEAKER_00: So if you haven't heard me talk about this, this is gonna be new for you.
16:49
SPEAKER_00: Maybe you have heard me talk about this.
16:51
SPEAKER_00: We have two different lows.
16:53
SPEAKER_00: So we've got severe lows and we just have lows.
16:56
SPEAKER_00: Severe lows are all based off of both of these are based off of how what your symptoms are.
17:01
SPEAKER_00: And your number of your severe low versus your just regular low are gonna be different than everyone else's because of your symptoms, because the symptoms matter.
17:12
SPEAKER_00: So how I define a severe low is debilitating.
17:17
SPEAKER_00: Maybe not debilitating where I'm passing out, but debilitating where it's like, man, I can't think straight right now.
17:23
SPEAKER_00: I've got the crazy shakes, I'm sweating, like I'm having a very challenging time just being present in what I'm doing.
17:32
SPEAKER_00: We've got brain fog, whatever it might be, that might be a severe low.
17:36
SPEAKER_00: Something that you potentially will need someone else's support to help you bring up your low.
17:43
SPEAKER_00: Maybe you've got a service animal or service dog, and they're bringing you treats because you can't physically get up.
17:50
SPEAKER_00: Or you you've, you know, you're just you're having a very challenging time.
17:53
SPEAKER_00: That's a severe low.
17:54
SPEAKER_00: Those types of lows, I believe, because it happened to me, are the lows that have happened, whether it's once or multiple times in our management or in our journey with this condition, that has put this barrier around us taking insulin.
18:11
SPEAKER_00: Because for some reason, when I take five units, I go low.
18:15
SPEAKER_00: This is how I've been with clients like this.
18:18
SPEAKER_00: No matter how much they're eating, maybe they even might need seven units, but that five units is a barrier.
18:25
SPEAKER_00: They cannot take more than that because they have this severe fear of low.
18:29
SPEAKER_00: It comes from those traumatic times of going low.
18:33
SPEAKER_00: Or it might come from something else.
18:34
SPEAKER_00: Maybe they saw a family member go really, really low one time and have a hard time.
18:39
SPEAKER_00: Maybe their doctor is in their ear saying, if you go too low, you might die.
18:45
SPEAKER_00: Or if you go too low, you might, you know, pass out.
18:48
SPEAKER_00: No one wants to do that.
18:49
SPEAKER_00: No one wants to die from a low.
18:51
SPEAKER_00: It's freaking crazy.
18:53
SPEAKER_00: But the difference is understanding where your number is.
18:58
SPEAKER_00: Okay, so for me, a severe low would be anything under 50.
19:03
SPEAKER_00: Sometimes even has to be 45 because I'm hypoglycemic unaware, right?
19:08
SPEAKER_00: So I don't really feel lows, and I don't feel I don't know if I've I don't know if I've ever really in 18 years really felt symptoms for a hop.
19:16
SPEAKER_00: When I was diagnosed, I was 450 and I felt like I'd go run a marathon.
19:21
SPEAKER_00: So like if the symptoms that we're having mean everything.
19:26
SPEAKER_00: And and when you should be like trying to take action.
19:29
SPEAKER_00: And obviously, for me, I want to take action before I get to those to those symptoms.
19:36
SPEAKER_00: Before that happens, why the city, this is which is why the CGMs and God I say it, the alarms are very helpful because they can help us be proactive and not getting to that really severe low.
19:50
SPEAKER_00: Okay, so that's severe lows.
19:51
SPEAKER_00: And we have the other aspect of this.
19:53
SPEAKER_00: We've got just lows.
19:55
SPEAKER_00: Lows are gonna happen, people.
19:57
SPEAKER_00: I don't want to tell you, right?
19:59
SPEAKER_00: The minute you start saying to yourself, I don't want to go low, so I'm gonna keep myself higher, is a recipe, I believe, for distrust, burden, and potential diabetes burnout mentally.
20:15
SPEAKER_00: Because you're constantly gonna be fluctuating all the over the place.
20:19
SPEAKER_00: I've seen it happen.
20:21
SPEAKER_00: And I don't want you in that space.
20:23
SPEAKER_00: So being able to define what your low might be when you need to, you know, start being proactive and take action on bringing yourself back up.
20:34
SPEAKER_00: Symptoms, how I kind of define a low is I'm just low.
20:39
SPEAKER_00: Maybe I have a little bit of symptoms, but it's not debilitating.
20:43
SPEAKER_00: I can walk my happy butt to the fridge, get my juice, get my, you know, candy, get my whatever my low treatment is.
20:50
SPEAKER_00: I can walk, get it, sit down for a second, it's gonna come right back up.
20:56
SPEAKER_00: Right?
20:56
SPEAKER_00: They're not comfortable, no 100%.
20:59
SPEAKER_00: Like they're not comfortable.
21:00
SPEAKER_00: And I and I'm I don't want you to go low, but to say to ourselves that we're never ever gonna go low again is not realistic.
21:09
SPEAKER_00: When you have a plan and when you understand what your number, what your your duration or your number is, right?
21:17
SPEAKER_00: So again, for me, severe low is under 50, maybe even 45.
21:22
SPEAKER_00: So an actual low for me is gonna be like 65, 65 to probably 85.
21:28
SPEAKER_00: That's gonna be probably 80.
21:30
SPEAKER_00: Because if it gets, if it's at 85 and it's coming back down, I know I need gonna need to take action.
21:35
SPEAKER_00: If it's under 80, if it's under 75, like I'm probably having a little bit of a symptoms, but not again, not really that much because I don't really feel lows.
21:45
SPEAKER_00: I promise, like I like this whole thing of not fearing lows is is kind of cool, but it also sucks.
21:51
SPEAKER_00: The reason I say that is because I don't really have severe lows.
21:56
SPEAKER_00: Because I mean I mean I've literally been 34 before before.
22:00
SPEAKER_00: Felt it, didn't feel great, but I could I easily was able to walk to the fridge and grab some food.
22:08
SPEAKER_00: It was it was not challenging, it was not difficult.
22:11
SPEAKER_00: I haven't been that low in a long time, and I haven't I don't ever really go that low.
22:16
SPEAKER_00: I haven't had a lot of situations where I was that low, but I have had a couple that were challenging and scary, but I was able to deal with them myself.
22:26
SPEAKER_00: Other people don't have that same thought process or that have that same ability.
22:31
SPEAKER_00: So it's important to understand what your numbers are so you can be proactive if you see that down arrow and be highly in tuned with the symptoms.
22:42
SPEAKER_00: So you got your severe low, be debilitating, you got your lows, not debilitating, might not still feel great, but you can still take care of it.
22:51
SPEAKER_00: Now, what I want you to do is I want you to ask yourself, how many of those severe, debilitating lows have you had?
23:00
SPEAKER_00: And if the answer is a lot, I'm not even gonna throw numbers out there, but if the if you think the answer is a lot, okay, for me, it's probably been severe lows that were debilitating, very challenging to deal with, probably five or six, definitely less than 10 in 18 years.
23:21
SPEAKER_00: And that's again, that's not because I'm amazing diabetic, that's just because of not feeling the low.
23:27
SPEAKER_00: I've been under that 45 before, where the CGM says it is, and then you do a manual finger prick, and yes, it's correct.
23:34
SPEAKER_00: I've been that low, but not haven't felt it.
23:37
SPEAKER_00: So the mental load of that isn't the same for me because I don't feel them.
23:43
SPEAKER_00: So for me, in a in a in a session, in a coaching session, for me, like once we understand that those perspectives, those two perspectives, it makes things a lot easier to deal with.
23:54
SPEAKER_00: Because most people will come back when I ask them that question, how many of those severe loads have you had in the past 30 days?
23:59
SPEAKER_00: So many people will say zero.
24:01
SPEAKER_00: That that you know deal with this fear of taking insulin when they're bolusing, taking too much.
24:10
SPEAKER_00: And they haven't had one of those situations in 30 days, 60 days, sometimes even 90 days, sometimes even years, but they still have that mental block in their brain that's telling them this is too much insulin, you are going to go low.
24:26
SPEAKER_00: So when we can put in place these strategies on how to deal with this and always be prepared, right?
24:35
SPEAKER_00: There should never be a situation, whether you're leaving the house, whether you're going out with friends, whether you're a kid and you're going to school, or you're going out to a restaurant, you're there should never, ever, ever, let me say it one more time, never be a time where you don't have low treatment on you, regardless of what type it is.
24:55
SPEAKER_00: Because if it's if it's debilitating, severe low, you need to have something that's going to work really freaking fast to bring you back up.
25:03
SPEAKER_00: If you're on just a low, for me, me personally, I like fruit.
25:10
SPEAKER_00: Because not only is the low important for me to bring up, but also the health of my body, the health of my system, the health of my being is important to me.
25:24
SPEAKER_00: So if I know I don't have tons of severe lows, and this low that I'm dealing with right now, maybe it's stable, maybe it's a stable era, maybe it's coming down a little bit.
25:35
SPEAKER_00: I know that I've got time.
25:37
SPEAKER_00: That I can just eat a banana.
25:39
SPEAKER_00: A banana is gonna take a little bit longer than maybe a juice box, maybe a little bit longer than candy, because it's not pure, pure, pure sugar.
25:49
SPEAKER_00: So for me, I want to eat something healthy if I can.
25:52
SPEAKER_00: If if I can't, and I had the severe low, I'm gonna eat like whatever literally is in front of my face.
25:58
SPEAKER_00: I will eat it because it's more important to bring your blood sugar up than try to eat something healthy.
26:04
SPEAKER_00: So I literally have low treatment for both situations.
26:09
SPEAKER_00: Whether it's glucagon, maybe you've got glucagon.
26:11
SPEAKER_00: And for so many of us, that's an important piece.
26:14
SPEAKER_00: If you don't have glucagon in the fridge, if you don't have glucagon with you and you you're dealing with these lows all the time, that's another really good tool that you can use.
26:23
SPEAKER_00: I mean, shoot, they got the nasal glucagon now, or you know, glucagon now that you can use to bring yourself up really, really fast.
26:30
SPEAKER_00: So, whatever tools that you need to use, like let's use them.
26:34
SPEAKER_00: I just, for me, I know if I'm gonna have a low, I want it, I want it to be something that is predominantly healthy because one of my main values is health.
26:47
SPEAKER_00: I don't care about the blood sugar.
26:49
SPEAKER_00: I care about the blood sugar, but I can bring the blood sugar up with something healthy.
26:53
SPEAKER_00: Sometimes I don't have that available.
26:55
SPEAKER_00: Most times I don't, or most times I do.
26:58
SPEAKER_00: So that's an important piece, making sure that you're always, always, always having low treatment.
27:03
SPEAKER_00: Especially if you are experimenting with different things.
27:08
SPEAKER_00: Right?
27:09
SPEAKER_00: You're experimenting with basal rates, you're experimenting with your insulin to carb ratio, you're experimenting with exercise and having insulin on board or not having insulin on board.
27:19
SPEAKER_00: Like whatever you're experimenting with, making sure that you always have low treatment 100% is important.
27:26
SPEAKER_00: Because I've been in that situation too, where I'm like, shoot, I'm going low, I'm experimenting with this, you know, exercise, whatever it is.
27:36
SPEAKER_00: And shoot, I don't need low treatment.
27:38
SPEAKER_00: This is not good.
27:39
SPEAKER_00: Okay, what am I gonna do?
27:41
SPEAKER_00: I remember this is actually a funny story.
27:43
SPEAKER_00: I remember I was at, I was training, I was at Lifetime Fitness at the time.
27:47
SPEAKER_00: And I had this evening client, I think it was just a 5 30 to 6 30 client, super busy in the gym.
27:52
SPEAKER_00: I mean, really busy.
27:53
SPEAKER_00: And I start going low.
27:55
SPEAKER_00: And I'm like, we're talking severe low symptoms.
27:58
SPEAKER_00: I'm like shaking, I'm freaking out.
28:00
SPEAKER_00: I'm like, and I'm telling my my client, like, we're like in the middle of our session, and I'm like, I'm so sorry.
28:06
SPEAKER_00: I gotta go take care of this.
28:07
SPEAKER_00: He's like, go.
28:09
SPEAKER_00: I had to run, grab my wallet, run all the way downstairs to the cafe, get like a smoothie, a bar, or something, then I could just like smack down real quick to bring my blood sugar up.
28:20
SPEAKER_00: And it literally took like 45 minutes to come up.
28:23
SPEAKER_00: I mean, it I was probably it was probably 20 minutes out of the severe low, but that was a scary situation out in public, you know.
28:33
SPEAKER_00: But I dealt with it.
28:34
SPEAKER_00: I dealt with it.
28:35
SPEAKER_00: I brought it up and I'm like, well, I'm never gonna do that again.
28:38
SPEAKER_00: And now I always have low treatment with me.
28:41
SPEAKER_00: Always.
28:42
SPEAKER_00: Never, ever, ever am I leaving the house without something to eat or drink.
28:48
SPEAKER_00: Never.
28:49
SPEAKER_00: It is like one of my biggest things.
28:52
SPEAKER_00: So the last piece I want to leave you with this, with this kind of confession, because again, I've done this before.
28:59
SPEAKER_00: Not taking enough insulin for meals because of the fear of lows.
29:04
SPEAKER_00: Whatever that number is for you, I want you to go back and ask yourself when's the last time that you had a very real bad low that you couldn't take care of.
29:13
SPEAKER_00: And then I want to ask you, I want you to ask yourself, how many lows have you had in the past 30 days?
29:19
SPEAKER_00: Actual lows that, you know, again, not debilitating, but you had to take action on.
29:24
SPEAKER_00: If it's a lot, here's my suggestion to you.
29:28
SPEAKER_00: We need to reflect on the decision that we're making.
29:32
SPEAKER_00: Maybe it's an insulin-to-carbatio problem.
29:36
SPEAKER_00: Maybe you're taking too much insulin.
29:39
SPEAKER_00: Maybe you have too much insulin on board.
29:42
SPEAKER_00: Maybe you've got insulin on board, and then you go exercise and you don't really know how to navigate exercise, you don't know all the rules of exercise with insulin, whatever it might be.
29:51
SPEAKER_00: We need to figure this piece out because there's no reason that you should constantly go low and feel low all the time.
30:00
SPEAKER_00: It's gonna happen sometimes, but if it's happening all the time, it's most likely an issue with correction factor, insulin to carb ratio, or basal.
30:12
SPEAKER_00: It's most likely.
30:14
SPEAKER_00: Or you're just not counting your carbs and guessing when you eat something and you're just taking way too much insulin.
30:20
SPEAKER_00: That might be it too.
30:21
SPEAKER_00: So I really want you to reflect on the decisions that you're making.
30:26
SPEAKER_00: If you're just winging it and taking insulin, maybe you need to take a step back and go back to actually trying to count the carbs and be as close as possible.
30:37
SPEAKER_00: That's the first step.
30:38
SPEAKER_00: And then the next step is to learn all the factors because again, if I'm just taking carbs, even if it's exact, right?
30:45
SPEAKER_00: I've looked a food label and it says exactly this bar, this protein bar, this bar, this drink, whatever it is.
30:52
SPEAKER_00: It's 40 grams.
30:53
SPEAKER_00: Okay, cool.
30:53
SPEAKER_00: I my insulin carb ratio is one to ten.
30:55
SPEAKER_00: All right, cool.
30:56
SPEAKER_00: 40 grams, I'm just gonna take four units.
31:00
SPEAKER_00: Cool.
31:00
SPEAKER_00: But that might not be enough.
31:02
SPEAKER_00: Or it might be too much.
31:04
SPEAKER_00: So these things matter.
31:06
SPEAKER_00: But right now, all I want you to do deal with is I need to take insulin, enough insulin for what I'm actually consuming, unless you know all the other factors that are in play.
31:18
SPEAKER_00: Okay.
31:19
SPEAKER_00: Diabetes confessions.
31:20
SPEAKER_00: I'm gonna have a lot of fun with this series just talking about stuff that I normally talk about, but maybe you guys think that I've never done these things before, because this is a big one.
31:31
SPEAKER_00: I've dealt with I've dealt with a fear of taking insulin before for a long, long time when I first started.
31:37
SPEAKER_00: And it was a it was a it was a problem.
31:40
SPEAKER_00: It was a really big impactful thing in a negative way on my blood sugars because I'd be constantly high all the time.
31:47
SPEAKER_00: I'd be constantly chasing and riding the roller coaster every single day, all day long.
31:54
SPEAKER_00: And that shouldn't be what we're doing.
31:57
SPEAKER_00: So having a routine, which is pillar three, having a routine and having consistency in your day is important.
32:03
SPEAKER_00: It's important.
32:05
SPEAKER_00: Having consistency on how you're actually going to dose for insulin is important.
32:09
SPEAKER_00: Are you someone who likes to be pretty darn accurate and count all the carbs?
32:14
SPEAKER_00: Maybe take a picture.
32:15
SPEAKER_00: Maybe that's the first place you start because all these apps nowadays, if you're not using Glucose Sense, the Glucose Sense is an amazing app that I use and I and I use with all my clients.
32:26
SPEAKER_00: Literally, you can take a picture of the foods that I'm consuming, and it gives me a pretty accurate number of how many carbohydrates it is, which makes it a good place to start in terms of like if you're if you're out to eat and you don't really know how many carbs this is because it's something that you haven't eaten before, they don't have it listed anywhere, or whatever it is, it makes it way easier to get as accurate as possible and allow you to not have to just guess.
32:51
SPEAKER_00: I'm eating pasta, shoot, maybe this is 60, maybe this is 80, maybe it's 120.
32:56
SPEAKER_00: I have no idea.
32:59
SPEAKER_00: Well, there's solutions to that now.
33:01
SPEAKER_00: So whether you do that type of thing or you just guess, it's important to understand how to deal with all this.
33:07
SPEAKER_00: So you're not riding the roller coaster because every single one of you who are listening to this right now deserves not to have the ride ride the roller coaster and deserves to have stable blood sugars, hours, two hours, three hours, four hours plus after you eat and not have to chase.
33:25
SPEAKER_00: We all deserve it, and it's possible, but you just have to understand how to strategically dose for your food.
33:33
SPEAKER_00: So, yeah, it's important.
33:35
SPEAKER_00: So, diabetes confessions, episode one.
33:38
SPEAKER_00: I'm excited that we got to talk about this.
33:40
SPEAKER_00: It's been weighing on me for a while.
33:42
SPEAKER_00: So I'm glad I got to just kind of give a taste of it, give my thoughts.
33:47
SPEAKER_00: I hope this conversation has helped you.
33:50
SPEAKER_00: If you are dealing with, you know, a fear of taking insulin.
33:54
SPEAKER_00: There are ways and conversations and things that we can talk about that will get you out of this perpetual mouse race or whatever you want to call it.
34:05
SPEAKER_00: I've dealt with it myself and I deal with it all the time with people.
34:09
SPEAKER_00: So trust is the number one thing in diabetes management, I think.
34:14
SPEAKER_00: It's more important than dosing for insulin.
34:17
SPEAKER_00: It's more important than pre-bolishing, which those two things are up there.
34:21
SPEAKER_00: Because if you don't trust yourself, it doesn't matter how good your blood sugars are.
34:25
SPEAKER_00: You're constantly going to feel like this is a burden.
34:28
SPEAKER_00: You're constantly going to feel like you're alone, you're constantly going to feel like pissed off because you have diabetes.
34:34
SPEAKER_00: But when you trust your decisions, you literally will dose and walk away because you trust it.
34:40
SPEAKER_00: Even if it doesn't go the right way, you still trust it.
34:43
SPEAKER_00: That is by far how every single one of the people I've worked out with, and myself included, have got to this place where we have no fear of taking insulin anymore.
34:58
SPEAKER_00: We have no fear of going low anymore.
35:02
SPEAKER_00: And we have no fear or distrust in our decisions.
35:06
SPEAKER_00: We like we literally, that's as much that's as much insulin I need for this meal.
35:11
SPEAKER_00: Cool.
35:12
SPEAKER_00: I'm gonna take that much insulin and I'm gonna walk away.
35:14
SPEAKER_00: And now I can live the rest of my life.
35:17
SPEAKER_00: Going back to my life.
35:19
SPEAKER_00: And that decision only took me 20 seconds.
35:23
SPEAKER_00: That is completely different than this being on your brain 24-7.
35:27
SPEAKER_00: That's the power of trust.
35:29
SPEAKER_00: Trust yourself, get to a place where you can trust yourself.
35:32
SPEAKER_00: It's not gonna be perfect, like I said before.
35:35
SPEAKER_00: There's times where I'm just like the technology isn't working, CGMs are off, you know, by a lot.
35:41
SPEAKER_00: I gotta go back to manual finger sticks, and I'm not, I'm I'm starting not to trust myself again, but I find my way back.
35:49
SPEAKER_00: You find your way back.
35:51
SPEAKER_00: But you gotta get to the point first where you completely trust yourself.
35:55
SPEAKER_00: Trust is everything.
35:56
SPEAKER_00: Thank you so much, everybody, for listening, and I will see you next time.