Latest / The Healthy Diabetic / #394: Diabetes Tips & Tricks (Part 2) - Basal Insulin

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#394: Diabetes Tips & Tricks (Part 2) - Basal Insulin · The Healthy Diabetic

0:14
SPEAKER_00: Welcome back.
0:15
SPEAKER_00: This is episode number three hundred and ninety-four of the Healthy Diabetic Podcast.
0:20
SPEAKER_00: I'm your host, Coach Ken Kenniss.
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, 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 that you face every single day living with this condition.
0:38
SPEAKER_00: I truly 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.
0:48
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.
0:54
SPEAKER_00: As always, before we get started, please remember that nothing that you hear on this podcast should be considered medical advice or otherwise.
1:00
SPEAKER_00: Please always consult your medical team before making any changes to your diabetes management.
1:06
SPEAKER_00: Okay, solo today.
1:08
SPEAKER_00: This is gonna be a really cool episode.
1:10
SPEAKER_00: This is actually part two.
1:12
SPEAKER_00: This is gonna be part two of tips and tricks.
1:13
SPEAKER_00: So remember, I'm doing this whole series on tips and tricks, just things that I've procured over the span of having diabetes for almost 20 years, the types of things that I really focus on working with clients about, depending on where they're at.
1:29
SPEAKER_00: Remember, we're we are really focused and really looking at you know five basic principles in terms of managing your diabetes.
1:37
SPEAKER_00: First principle is your mental health.
1:39
SPEAKER_00: We've got to make sure that's in alignment.
1:41
SPEAKER_00: How are you with your mental health?
1:43
SPEAKER_00: What's your relationship with diabetes and with yourself?
1:45
SPEAKER_00: The second thing is strategic, making good, confident, strategic decisions in your management.
1:50
SPEAKER_00: So that's the second principle.
1:52
SPEAKER_00: The third principle is what kind of consistency and routines that you have in your diabetes.
1:57
SPEAKER_00: The fourth principle is nutrition.
1:59
SPEAKER_00: So really focusing on your relationship with food, how you're thinking about food, how you're thinking about carbohydrates and dosing.
2:06
SPEAKER_00: So really focused on nutrition at a grand scale.
2:10
SPEAKER_00: And the fifth principle is exercise, sleep, and hydration.
2:15
SPEAKER_00: So when we put all five of those principles together, I promise you will be able to thrive with no worry, no concerns and managing this condition.
2:26
SPEAKER_00: It is literally taking me 19 years to figure this whole process out.
2:31
SPEAKER_00: And I'm really excited that I get to go down that route with you know people like you that are living with type 1 diabetes.
2:39
SPEAKER_00: That's how I'm gonna, that's how I'm guiding you.
2:41
SPEAKER_00: That's how I'm guiding you through these specific tips and trick principles.
2:46
SPEAKER_00: And uh it just it's so fun to do these these conversations and have these conversations with people because when the light bulbs go off, it's like, oh my gosh, now you can now you really have a path forward to really make a change and figure out how to live at this condition on your terms.
3:05
SPEAKER_00: So today's tips and tricks, right?
3:07
SPEAKER_00: So tips and tricks, this is part two, we're gonna talk about basal insulin.
3:10
SPEAKER_00: If you haven't watched tips and tricks part one, we talked about insulin.
3:15
SPEAKER_00: I shared a really cool infographic.
3:18
SPEAKER_00: If you're watching on Spotify or YouTube, go watch that because we re dive into all the different types of insulin, what insulin kind of does, and you know, why it's so important to understand the three basic principles of insulin, and which I call activation, peak, and duration.
3:36
SPEAKER_00: So go check out that episode.
3:37
SPEAKER_00: I believe it's 388, I want to say.
3:41
SPEAKER_00: I believe it's 388.
3:42
SPEAKER_00: And just so you guys know, well, this will probably be a quick one, but I'll have any notes in front of me.
3:48
SPEAKER_00: I didn't take any notes for this one because basal insulin is all up in my head.
3:54
SPEAKER_00: It's very simple, but not simple, if that makes sense.
3:58
SPEAKER_00: So let's dive in.
4:00
SPEAKER_00: So, what is basal insulin?
4:02
SPEAKER_00: If you don't know, if you're been if you're brand new to diabetes, this is a perfect episode to start with because this is basal insulin for me is the foundation of everything.
4:11
SPEAKER_00: If your basal insulin is not correct, if it's not right, whether that is you're on a pump and you have multiple ratios, like back before we really had closed loop systems like the omnipod, the the tandem T Slim, and the Omni or the Moby, and now the Twist and the beta bionic pump, I mean, really all these pumps now are having some type of closed loop system where basically the the pump communicates with the CGM and there's an algorithm that works in the background to basically give you insulin drips throughout the day based off of what your blood sugars are doing.
4:49
SPEAKER_00: So if you're having a lot of problems with post-meal spikes, these algorithms can be really helpful because it's going to start giving you some more insulin, right?
4:58
SPEAKER_00: Let's say you are eating 50 grams in a sitting and you you've corrected for that, but really because of all the other factors, maybe more insulin resistant, all the factors that are involved with that decision.
5:10
SPEAKER_00: Maybe you needed a little bit more than 50 grams.
5:13
SPEAKER_00: Maybe you needed, you know, for me, I'm I'm on a one to ten ratio, insulin to carb ratio.
5:19
SPEAKER_00: So if I'm eating 50 grams, I need five units.
5:22
SPEAKER_00: But in that situation, maybe I need five and a half, maybe I need six, right?
5:26
SPEAKER_00: So these algorithms can help you in the back end if you you're still spiking.
5:33
SPEAKER_00: It it can put some, it can basically I call it a drip, right?
5:36
SPEAKER_00: It's gonna drip insulin into the system to help with that bolus or to help you whenever, right?
5:42
SPEAKER_00: If they're really good, I really like them at night because you're not gonna take action on something a low or a high, or it would really be a high.
5:51
SPEAKER_00: You're not gonna take action on that if you're sleeping, right?
5:54
SPEAKER_00: So it can take over for all that.
5:57
SPEAKER_00: And the really cool thing is like when you think about where we used to be before closed loop systems and basal insulin, and using, you know, these closed loop systems are using regular insulin, but it's almost like it's giving you more basal insulin.
6:10
SPEAKER_00: The really cool thing about it is back in the day, we had to be very precise on when we were giving ourselves insulin.
6:18
SPEAKER_00: So we looked at the trends.
6:20
SPEAKER_00: Our doctors helped us look at the trends throughout the day, whether that was right when you're waking up, feet to the floor, dawn phenomenon.
6:26
SPEAKER_00: How's that?
6:27
SPEAKER_00: Are you getting a insulin, a blood sugar spike from that?
6:30
SPEAKER_00: After your first meal, what is your blood sugar?
6:32
SPEAKER_00: Are you getting a blood sugar spike?
6:34
SPEAKER_00: Are you more insulin resistant in the morning, in the afternoon, in the evening?
6:38
SPEAKER_00: There is all of these components and factors we're trying to look at, or the doctor is trying to look at to create these different ratios within your insulin pump.
6:46
SPEAKER_00: And you know, when I was on an on the omnipod and the T Slim, I had like six or seven different ratios in my like scheduled in my pump.
6:55
SPEAKER_00: And at the end, before I went back to MDI, which I'm on right now, manual daily injections, I was on six different ones, I believe.
7:03
SPEAKER_00: It was every and I it was every four hours.
7:05
SPEAKER_00: Every four hours, and maybe it was actually every three.
7:07
SPEAKER_00: I think it was every three.
7:08
SPEAKER_00: Every three hours, I was giving myself 0.8 units and not using the algorithm.
7:14
SPEAKER_00: This was on manual mode, and it really worked.
7:17
SPEAKER_00: It helped because it it because over time I figured out, hey, I need insulin throughout the day at these specific time frames.
7:25
SPEAKER_00: So that that's that's pre really closed loop systems that we have now.
7:30
SPEAKER_00: Now it's pretty cool because you can, you know, just you don't you have your basal settings set, but if you're on the automated mode, if you're on, you know, control IQ, from what I understand, it basically takes over, the algorithm takes over for your basal rates.
7:45
SPEAKER_00: So if you aren't on an insulin pump, right?
7:47
SPEAKER_00: So we talked about the insulin pump.
7:49
SPEAKER_00: If you aren't on an insulin pump, it's really, really important to get your dosage right.
7:54
SPEAKER_00: And also understanding do you take all of your dose at once?
7:59
SPEAKER_00: Do you take that whole dosage at once, or do you split it up?
8:02
SPEAKER_00: I bet you've never heard that before, right?
8:04
SPEAKER_00: So as an example, I'm gonna use myself as an example, right?
8:06
SPEAKER_00: I'm on MDI now, manual daily injections.
8:08
SPEAKER_00: So I'm on a long-acting insulin and I use a fast-acting insulin.
8:12
SPEAKER_00: So I'm using Traceba as my long-acting, and I'm using Lemjeb because it works faster than humolog and novilog.
8:18
SPEAKER_00: Not that much faster, but it is faster.
8:21
SPEAKER_00: And I so those are the two insulins I use.
8:23
SPEAKER_00: I'm not using a fresa right now.
8:26
SPEAKER_00: And if you've listened to the show before, you probably have heard why that is.
8:30
SPEAKER_00: And a fresa is the inhaled insulin.
8:33
SPEAKER_00: And we talk about inhaled insulin on the previous part one of this series.
8:37
SPEAKER_00: So 388, go check it out.
8:39
SPEAKER_00: But so long-acting insulin, that's my basil, right?
8:43
SPEAKER_00: So basil is basically long-acting insulin.
8:46
SPEAKER_00: What I do is the ratio that I take for the entire day is about 24 units.
8:54
SPEAKER_00: And that I'm gonna uptick, downtick that, which I'm gonna talk about in a second.
8:58
SPEAKER_00: It's basically 24 units.
8:59
SPEAKER_00: And what I do and why I love Treceba the most out of Lantis, any of the other long-acting insulins, is because Treceba has pretty much the longest, I believe it's the longest, it has pretty much the longest life cycle, right?
9:14
SPEAKER_00: So regular Lantis is is around 22 hours, I believe.
9:19
SPEAKER_00: It's just about 22 hours.
9:21
SPEAKER_00: It might, depending on how insulin sensitive you are, it might push to 24, but it that's that's all it is.
9:28
SPEAKER_00: Where Traceba is really cool, it's almost a 30 to I think it's almost a 30 hour duration.
9:36
SPEAKER_00: And this is why this is really cool.
9:38
SPEAKER_00: So I split my dosages up.
9:40
SPEAKER_00: I take six units or yeah, I'm sorry, 12 units in the morning and I take 12 units at night.
9:46
SPEAKER_00: The reason I do that is twofold.
9:47
SPEAKER_00: One, because I'm getting, I will, I will absolutely get a overlap of insulin when it peaks, when that when that insulin's gonna peak, I'll get that overlap.
9:57
SPEAKER_00: So I always know that I have a little bit of insulin on board, right?
10:02
SPEAKER_00: That insulin I I I've got the duration or I've got the dosage set right for for me that I always know that I have a little bit of insulin working in the background.
10:13
SPEAKER_00: Just a little bit.
10:14
SPEAKER_00: And that's all I really need.
10:16
SPEAKER_00: Just a little bit.
10:17
SPEAKER_00: So that's the first thing because it because I'm able to overlap it.
10:22
SPEAKER_00: There's never any time when I don't have any background insulin working.
10:25
SPEAKER_00: The second way, the second reason that I really like this is because when I'm taking the morning and the night, sometimes I'm an idiot and I forget to take it in the morning.
10:37
SPEAKER_00: Or I'll be like, oh shoot, it's almost 10 o'clock.
10:39
SPEAKER_00: I've been at the gym training people since 5 30.
10:42
SPEAKER_00: I woke up at 4 30 and I forgot to take my my uh injection for the day.
10:48
SPEAKER_00: My first injection.
10:49
SPEAKER_00: Well, I've already got an overlap, right?
10:52
SPEAKER_00: So I can take it at 10 a.m.
10:54
SPEAKER_00: if I want to, depending on what my blood sugars are doing.
10:57
SPEAKER_00: I might not even take it at all.
10:58
SPEAKER_00: And I'm usually I'm pretty good.
11:01
SPEAKER_00: I'm usually pretty good.
11:02
SPEAKER_00: So that that's why I like those two those two options when I'm taking when I'm on, you know, if you're on MDI, I really like splitting the dosage of your basil.
11:13
SPEAKER_00: So that's basil.
11:15
SPEAKER_00: Okay.
11:16
SPEAKER_00: What what are some instances, I guess, where we might need less basil on, you know, maybe do we need to take the same amount every single time?
11:25
SPEAKER_00: And this is obviously if we're on uh MDI.
11:28
SPEAKER_00: If you're on an insulin pump, it's already set for you, so you don't have to deal with it.
11:33
SPEAKER_00: If you're using the algorithms, that's even better because it's it's just gonna drop, you know, insulin into the system when it reads, when it when it can't or when it needs to.
11:44
SPEAKER_00: So being on MDI, here's a couple reasons why I might take more or take less of that 24 units per day.
11:51
SPEAKER_00: If I notice, here's the first one.
11:54
SPEAKER_00: If I notice that my blood sugars are really sticky, right?
11:57
SPEAKER_00: We've all probably dealt with that.
11:58
SPEAKER_00: If you've been diabetic for type one diabetic for a long time or long enough, you've experienced the my ratio is not working.
12:08
SPEAKER_00: I'm just stuck over 200 and it will not come down.
12:11
SPEAKER_00: And it could be a technology piece, it could be an insulin, and there's so there could be an insulin piece.
12:15
SPEAKER_00: There's so many different things that it could be of why this is not coming down.
12:19
SPEAKER_00: But also a lot of times it's because you're insulin resistant, or it might be an insulin problem.
12:25
SPEAKER_00: So you're like pounding on the insulin and it's still not coming down.
12:28
SPEAKER_00: You've ate something you're only supposed to take, let's say, myself, one to ten, it's in a carb ratio.
12:35
SPEAKER_00: I eat 40 grams, I take enough, I take four units, and I don't exceed that, but I still spike to 200, even though I did pre-bolis, and we're gonna we'll have an episode on pre-bolishing, which is gonna be fan-freaking tastic because there's so much to talk about pre-bolicing.
12:51
SPEAKER_00: But, you know, I did pre-bolish and I'm still driving to 200.
12:57
SPEAKER_00: And that four units didn't one stop the spike, and two, it's not bringing anything back down.
13:04
SPEAKER_00: So, in reality, the way I think about it, if that happens and I pre-bolish, I took enough insulin for what I'm actually consuming, it has to be an insulin resistance problem.
13:14
SPEAKER_00: Something's going on with my body not being able to uptick the insulin in the right way, or it is an insulin problem, right?
13:20
SPEAKER_00: So maybe the insulin taking in a pen or whatever is going bad, right?
13:26
SPEAKER_00: That could be what that could be an option.
13:29
SPEAKER_00: But before I get to that decision of throwing out a pen because it might be bad, I'm gonna do a couple other things.
13:36
SPEAKER_00: So obviously I'm gonna take more insulin first, wait 30 minutes, maybe 45.
13:41
SPEAKER_00: My insulin, it should be doing its job, right?
13:44
SPEAKER_00: As long as I don't have this, you know, arrow that's still spiking my blood sugar, okay, and I've got a steady arrow and I'm taking extra insulin, it should turn that arrow down a little bit and start dropping it within 20 minutes.
13:58
SPEAKER_00: It should.
13:59
SPEAKER_00: If it doesn't, okay, now what the what is the what do we need to do then then, right?
14:05
SPEAKER_00: When we talk about going back to basil, okay, when we talk about the basal piece of this situation, if you do not take enough basil, especially when you're insulin resistant, okay, you're gonna you're gonna see it.
14:20
SPEAKER_00: There's times when I miss a dose for whatever reason, I'm just like, accru it, I'm not gonna take, I'm only gonna take the six to eight units today.
14:27
SPEAKER_00: There's times when I do that and I can notice that there's like I just need a little bit more insulin, and that little bit more insulin is to cover what I'm missing in my in my basal dose.
14:38
SPEAKER_00: So the biggest problem isn't the dose.
14:42
SPEAKER_00: It's not the splitting the dose up.
14:44
SPEAKER_00: Obviously, it's you know, do are you getting enough insulin?
14:47
SPEAKER_00: But the basal piece for me really comes into play in that factor of like, are you getting enough throughout the day when you're not eating?
14:57
SPEAKER_00: Right?
14:57
SPEAKER_00: Let's you're going three, four, you've been, it's been three, four, five hours, okay, but your blood sugar is still stable.
15:03
SPEAKER_00: Here's the other thing that you you if you haven't listened to anything that I've said so far, listen to this piece.
15:09
SPEAKER_00: Basil insulin's job.
15:11
SPEAKER_00: And its only job is to keep your blood sugar steady.
15:15
SPEAKER_00: That's literally its only job.
15:17
SPEAKER_00: If you are taking, if you have basil on board, right?
15:21
SPEAKER_00: Let's say you're taking you're on MDI and you take a shot at night before bed and you haven't eaten in four or five hours.
15:26
SPEAKER_00: If you're dropping in the middle of the night with no food on board, where you're going through fighting digestion, your body's fighting digestion to pull nutrients and get those nutrients to where you need it to go, and you don't have any other bait bolus insulin on board from when you ate, if those two factors aren't in play and you're still dropping, it's a red flag that your basil's too high in the moment.
15:49
SPEAKER_00: Okay.
15:49
SPEAKER_00: That's one thing.
15:50
SPEAKER_00: The second thing is basil's not designed to stop a spike, right?
15:55
SPEAKER_00: So in the same situation, if your blood sugar spikes and you took basil at night, but you haven't, you don't have the two factors of food in bolus insulin, insulin from the bolus insulin you took for your meal or a snack, there's none of those two factors in play, but your blood sugar spiking, okay, that's determinate that that is a red flag that there's also probably not enough insulin, or something else is happening.
16:22
SPEAKER_00: Maybe it's a hormonal piece.
16:23
SPEAKER_00: If you're sick, that could be a hormonal piece that's coming through.
16:26
SPEAKER_00: If you're a female fighting through menopause or not menopause, but menstruation, that could be a thing.
16:34
SPEAKER_00: So how many of these factors and variables can you take out of play to try to figure out what's going on?
16:42
SPEAKER_00: The high piece with the basil is an interesting piece because it might not be you don't have enough basil, it might just be a hormonal piece, or there might be another factor involved.
16:50
SPEAKER_00: For me, 100% if I'm dropping in the middle of the night and I don't have those other factors on board, there's no insulin on board from a bolus, and there's no digestion going on from food, like I'm like five, maybe even six hours out from eating, I know it's probably too much basil.
17:12
SPEAKER_00: So that's the first place I would start when I'm making adjustments.
17:15
SPEAKER_00: Okay.
17:16
SPEAKER_00: So again, basil is not designed to drop you, and it's not designed to fix an arrow or bring you down from a high.
17:24
SPEAKER_00: That's not what it's designed for, right?
17:26
SPEAKER_00: So, as an example, again, let's just say your target, we're gonna, because we're always talking about target blood sugar, not time and range.
17:33
SPEAKER_00: Time and range is important, but target blood sugar is more important.
17:36
SPEAKER_00: Every decision that you make should be based off of what your target blood sugar is, not off of getting back in range.
17:43
SPEAKER_00: Because if you're 250 and you need to get back in range, and you're in your the top end of your in range is 180, that's too high.
17:52
SPEAKER_00: That's too high.
17:52
SPEAKER_00: You should be getting down at the bottom part of your in range.
17:56
SPEAKER_00: So, as an example, my target blood sugar, right?
18:00
SPEAKER_00: So let's go here first.
18:01
SPEAKER_00: My if you haven't heard me say this before, my time and range, the low point and the high point.
18:07
SPEAKER_00: My low point is 65, right?
18:09
SPEAKER_00: That's what it's set in my CGM.
18:11
SPEAKER_00: So at 64, I'm out of range.
18:12
SPEAKER_00: My high point is 150 because I'm trying to stay really tight.
18:15
SPEAKER_00: And I I trust myself in with these, with this range, right?
18:20
SPEAKER_00: It's a very tight range.
18:21
SPEAKER_00: I do that intentionally.
18:23
SPEAKER_00: So at 64, I'm out of range.
18:26
SPEAKER_00: 151, I'm out of range.
18:28
SPEAKER_00: So I'm trying to stay within that range.
18:31
SPEAKER_00: That's where my 70, 80 plus time and range should be within the 65 to 150.
18:39
SPEAKER_00: But every decision that I'm making, whether I am high and I need a bolus, whether I'm low and I need a treat, is based off of getting as close to 100 as possible.
18:49
SPEAKER_00: Unicords all day long, people, unicorns all day long.
18:52
SPEAKER_00: If you're brand new to diabetes, when you get on 100 and it's there for a decent amount of time, it's called a unicorn because it's very challenging to get there.
19:01
SPEAKER_00: But 100 is my target blood sugar.
19:03
SPEAKER_00: I work with clients and they don't like that because it's too low and they're afraid of that number.
19:09
SPEAKER_00: Cool.
19:09
SPEAKER_00: Then we set it to 120, 130, 140.
19:12
SPEAKER_00: I've had clients, their target blood sugar is at 140.
19:15
SPEAKER_00: And then once they get comfortable at 140, now we're gonna lower it a little bit because you don't want to always be at 140.
19:22
SPEAKER_00: And the idea, again, this is it doesn't happen all the time and it's not where you're not gonna sit there all the time.
19:29
SPEAKER_00: The idea is where do you feel the most comfortable?
19:33
SPEAKER_00: Where can where do you feel the most comfortable?
19:35
SPEAKER_00: If you weren't eating, if you didn't have any insulin on board, if you're just living your life, what would you be comfortable with having your blood sugar at?
19:43
SPEAKER_00: I will tell you that if all of my decisions were trying to get to 80, I'd probably have a lot of lows because I'm gonna, I sometimes over-treat a high.
19:53
SPEAKER_00: And an 80, as it's supposed, that's that's where normal people that have, not normal people, but people that have healthy pancreases, the the normal blood sugar for someone that has doesn't have a messed up pancreas like we do, is 75 to 90.
20:10
SPEAKER_00: So an 80 is a great number, an 85 is a great number.
20:13
SPEAKER_00: And I've talked to people that that's their target.
20:16
SPEAKER_00: And I'm like, freaking awesome.
20:17
SPEAKER_00: That's amazing.
20:17
SPEAKER_00: High five to you.
20:18
SPEAKER_00: For me, I do really well when I'm trying to be in between 90 and 110.
20:24
SPEAKER_00: I'd say 120.
20:25
SPEAKER_00: Hypothetically, I would want a 15-point swing, no more than that.
20:30
SPEAKER_00: So it really should be 115, right?
20:31
SPEAKER_00: So it's we're looking at what is that?
20:33
SPEAKER_00: That's 85 and 115 for me.
20:38
SPEAKER_00: A 15-point swing.
20:39
SPEAKER_00: I'm I'm perfect, I'm great to go.
20:41
SPEAKER_00: I'm making my decision to be as close to that as possible.
20:44
SPEAKER_00: Because being at your target is very challenging, no matter what the number is.
20:48
SPEAKER_00: I don't care if it's 139.
20:51
SPEAKER_00: It's to get to that number is challenging.
20:53
SPEAKER_00: You're gonna give yourself a buffer.
20:55
SPEAKER_00: And I also say that, give yourself a buffer because when we think of the anxiety of all of this, because I've had it with people before, we set a target number, and there's a lot of anxiety because they're a little bit higher than that.
21:09
SPEAKER_00: Or they're a little bit lower than that.
21:11
SPEAKER_00: When they're a little bit lower than that, the anxiety comes in play of like, okay, well, I'm scared to go low now.
21:16
SPEAKER_00: Okay, understand that.
21:18
SPEAKER_00: The anxiety comes into play when they're five, 10 milligrams per deciliter higher than their target.
21:25
SPEAKER_00: It's like, oh man, I'm terrible.
21:26
SPEAKER_00: I can't do this.
21:27
SPEAKER_00: It's like, no, that's why we give ourselves a buffer.
21:30
SPEAKER_00: Give yourself a buffer.
21:30
SPEAKER_00: But know that you're not making decisions based off of getting back in range.
21:35
SPEAKER_00: You're making decisions based off of your target blood sugar.
21:39
SPEAKER_00: Cool.
21:39
SPEAKER_00: Back to basal insulin, right?
21:41
SPEAKER_00: So we've talked about three different components to basal insulin.
21:44
SPEAKER_00: Okay.
21:45
SPEAKER_00: We've talked about how you think about dosing for it, right?
21:50
SPEAKER_00: What, how are you dosing for it?
21:51
SPEAKER_00: Do you need to split it up?
21:53
SPEAKER_00: If you're on MDI, are you using automated mode or are you using the algorithms?
21:58
SPEAKER_00: If you're using the algorithms, a lot Of this doesn't even really matter to you because the algorithm takes over, pretty much takes over for your basal insulin.
22:06
SPEAKER_00: That's how I understand it and how I think about it because you're still taking you're still bolusing for food.
22:12
SPEAKER_00: So when you're bolusing for food, and then the insulin that you're getting for that for that food maybe isn't enough, and then the system gives you more.
22:22
SPEAKER_00: I would call that not giving you more bolus.
22:25
SPEAKER_00: I would call that okay, it's dropping some insulin in there so we can try to prevent going high, which is exactly what we would do back in the day without before the close-up systems, because you'd have multiple basal rates set in your pump from looking at trends in your CGM.
22:42
SPEAKER_00: Okay, this nine times out of ten you go high here.
22:45
SPEAKER_00: Okay, we're gonna increase your basal an hour before, 45 minutes before, right?
22:50
SPEAKER_00: Because you can't set a basal rate at the time that you are actually going high because it's too late.
22:57
SPEAKER_00: You can't take action at the exact time that you're going high, it's too late, right?
23:02
SPEAKER_00: That's why when we even talk about bolus insulin, which we will, there's a lot to talk about with bolus insulin, bolusing for food and bolusing.
23:12
SPEAKER_00: When we talk about that stuff, if you have a blood sugar spike and then you're taking insulin for that blood sugar spike, it's almost too late.
23:19
SPEAKER_00: And this is why.
23:20
SPEAKER_00: It's almost too late, and we'll talk about this more pre- when we talk about pre-bolusing, but it's it's almost too late because you have to remember that the durate or the activation of that insulin.
23:30
SPEAKER_00: If you're on humolog, novolog, as an example, it takes 15 to 20 minutes, maybe sometimes 25 minutes, depending on how insulin resistant you are.
23:38
SPEAKER_00: If you're really insulin resistant, it might take close to 30 minutes for that blood sugar to get through the skin, get to the into the tissue, or get through the tissue, get in a bloodstream, and attach itself to the cell to start bringing your blood sugar down.
23:50
SPEAKER_00: That whole process takes about 15 to 20 minutes.
23:53
SPEAKER_00: That's why our doctors tell us when you take insulin or when you go to eat a meal, take your insulin and then wait 15 minutes.
24:01
SPEAKER_00: I hope they're telling you that.
24:02
SPEAKER_00: If you've never heard that, man, you might need to go find another doctor because they just don't understand that every single person should be that's like dosing 101 for food, is you have to pre-bolish.
24:14
SPEAKER_00: If you pre-bolish, and even if you if you pre-bolish at the the right amount, at least 15 to 20 minutes, depending on what again, depending on the factors, which we're going to talk about later on a different episode, depending on the factors, depending on the type of insulin you're you're using, as long as you're keeping in mind all those factors and the actual activation time or what I call activation time of your insulin, you if you nail your pre-bolus, but don't nail your actual bolus, like you take a little bit less than you really should, you will have enough time to catch it because you gave you because the insulin is in front of that blood sugar spike.
24:50
SPEAKER_00: And that's what pre-bolus is for, because of how long it takes for the insulin that you're actually taking through a pump or through an injection to get into the cell and start dropping your blood sugar.
25:00
SPEAKER_00: So, but again, we'll talk deeper into that in another episode when we actually sit down and talk about pre-bolusing.
25:07
SPEAKER_00: But yeah, so that was basal.
25:09
SPEAKER_00: And basil is one of the foundational things.
25:12
SPEAKER_00: I think there's three specific things if you have these things in alignment, and I'm gonna talk about actually talk about basal setting here in a second.
25:20
SPEAKER_00: But if you have these three things in alignment, it makes diabetes way easier.
25:25
SPEAKER_00: Having your basal rates or understanding how much extra insulin outside of your boluses for your food and your correction doses that you need, right?
25:36
SPEAKER_00: Old school, not old school, not that long ago, but when when I used to be on an insulin pump and I would look at this, look at the amount of insulin, right?
25:44
SPEAKER_00: Because these things are really cool being able to look at how much basil you got throughout the day and how much bolus and correction you got out throughout the day.
25:52
SPEAKER_00: Usually I wanted to be about more than 50% of all of the insulin that I'm taking for the day coming from basil.
26:00
SPEAKER_00: And the reason I say that is because most of the time, when you are looking at that metric, that's telling if your basal is higher than your bolus in your insulin pump, it's telling you that you're not having to correct as much because bolus and correction would be in this, would just be showed up as bolus, unless some of the new pumps or whatever split those three out.
26:23
SPEAKER_00: So when you make a correction for a high to bring yourself back down to your target blood sugar, when you do that, that's going to the at least when I was on an insulin pump, it would show up under bolus, not basil, right?
26:36
SPEAKER_00: So I was always trying to have my the percent, the amount of insulin that I'm taking in one day be higher for basil than bolus, because that's telling me that one, I'm not overeating, right?
26:49
SPEAKER_00: And two, and I should know that.
26:51
SPEAKER_00: And two, I'm I don't I didn't have to use as I didn't have to use a lot of insulin for corrections, right?
26:59
SPEAKER_00: So I'm not super high all the time and have to put all this extra insulin in.
27:03
SPEAKER_00: So that's just another thing with another metric that you can kind of look at if you're doing an insulin pump.
27:09
SPEAKER_00: I lost my train of thought, but I think you guys get the gist.
27:12
SPEAKER_00: Basal insulin is very important.
27:14
SPEAKER_00: Remember, the number one thing that you have to understand with basal insulin is it's not designed.
27:21
SPEAKER_00: It's not designed to drop your blood sugar.
27:23
SPEAKER_00: It's designed to keep you steady.
27:25
SPEAKER_00: And that's why it's so important at night to have your blood sugar, your basal rates or have enough basil through the night to help with whatever spikes that you have, preferably, I mean, again, not from eating, but just from hormonal things and things that are out of your control, which I would call hormonal things.
27:43
SPEAKER_00: Think hormonal things that we talked about earlier.
27:46
SPEAKER_00: So, one last thing that I want to mention with basals.
27:50
SPEAKER_00: And this is really important to understand.
27:53
SPEAKER_00: When you think about basal rates, when you think about how you're going to kind of manipulate this, because I believe that anything that we do in type 1 diabetes, anything, we can manipulate it.
28:05
SPEAKER_00: You can manipulate how you're dosing for food, which means you don't always have to take all of it at once.
28:10
SPEAKER_00: That's again another episode.
28:12
SPEAKER_00: You can manipulate your blood sugars in very specific ways if you understand the factors and variables, which is what I help you learn in coaching.
28:21
SPEAKER_00: This is what we troubleshoot, this is what we talk about, this is what I educate you about in coachings, how to manipulate your blood sugars.
28:27
SPEAKER_00: Because when you understand how to manipulate everything, it all becomes clear and it becomes way easier to manage.
28:34
SPEAKER_00: Doesn't mean it doesn't, it's not hard.
28:36
SPEAKER_00: We're not taking away the idea that diabetes is hard.
28:40
SPEAKER_00: Because it is.
28:41
SPEAKER_00: There's days that it's just not gonna freaking make any freaking sense whatsoever, and you're gonna be able to throw your hands up in the air, and it's just gonna that's what it is gonna be.
28:50
SPEAKER_00: But for the most part, I would say 80% of the time, if I can get you to 80% of the time, nothing trips you up.
28:56
SPEAKER_00: There's you don't have a bunch of spikes, you're at 80% time and range in whatever your time and range is, because that's still pretty good, and we're as close to our our average blood sugars as close to our target as possible.
29:11
SPEAKER_00: That's what manipulating your blood sugars can do for you.
29:14
SPEAKER_00: So when we think about that, the easiest place to start when we talk about basal is when you're sleeping.
29:22
SPEAKER_00: I used to do this all the time with clients.
29:23
SPEAKER_00: It's not as prevalent anymore with the algorithms, because again, we're not setting a bunch of basal rates.
29:31
SPEAKER_00: But the most important thing in the evening is taking away the factors, right?
29:35
SPEAKER_00: So when we think about basal testing, we take away as many factors as possible, right?
29:40
SPEAKER_00: Hopefully you're not sick.
29:41
SPEAKER_00: Hopefully, as a female, you're not menstruating.
29:43
SPEAKER_00: Those are two things that we that we have no control over.
29:46
SPEAKER_00: You can plan for it if you're a female and you're looking at your cycle, okay?
29:51
SPEAKER_00: You're a female and you're looking at your cycle and you see over time, right, that you know, a week before, three days before, the week of, you need more insulin and you need less insulin.
30:02
SPEAKER_00: Planning for that is important also.
30:05
SPEAKER_00: But that's something that's out of our control when we're trying to sleep, right?
30:09
SPEAKER_00: So the things that the really two or three things that are in our control is one, did you exercise, right?
30:17
SPEAKER_00: Because if you're struggling with sleeping and you're going a little bit high, exercise and boosting your insulin sensitivity at night might be a really good tool to help keep yourself stable.
30:29
SPEAKER_00: So the insulin that you are taking for dinner or whatever it is, a snack before you go to bed or whatever it might be, hopefully it's a lower carb snack before you go to bed.
30:38
SPEAKER_00: Remember, we don't want to be fighting a bunch of digestion.
30:41
SPEAKER_00: We don't want things to be digesting for the next six hours when we're trying to go to go to sleep.
30:46
SPEAKER_00: But exercise is another really good thing to push insulin sensitivity before you go to bed.
30:51
SPEAKER_00: Um also, it's if you're pushing insulin sensitivity, and let's say you're like me and you're on MDI as an example, I'm taking that shot at night.
30:59
SPEAKER_00: So it's gonna peak, you know, towards the the mid middle of the night, maybe closer to the morning.
31:05
SPEAKER_00: It's gonna peak.
31:07
SPEAKER_00: And which also means that my body's gonna be able to uptake that insulin way, way easier.
31:13
SPEAKER_00: And in this context, if you're spiking insulin sensitivity and you've got insulin, your basal insulin on board, and you're dropping, okay.
31:23
SPEAKER_00: Maybe we can say that you're dropping because of the insulin sensitivity, and you're dropping because of that you've got that, you know, you've got basal on board, but in the grand scheme of things, most people aren't boosting their senses insulin sensitivity in the evening.
31:39
SPEAKER_00: But you could.
31:40
SPEAKER_00: It could be a tool that you could use to help with fluctuating blood sugars at night.
31:44
SPEAKER_00: Okay, so we've got that piece.
31:47
SPEAKER_00: We've got the exercise piece.
31:48
SPEAKER_00: The next piece that's really easy to manipulate, and I call it pulling on levers.
31:53
SPEAKER_00: Next lever that we can really pull on is the food piece.
31:55
SPEAKER_00: Because what you don't want is you don't want to eat dinner, a full dinner at 8 p.m.
32:01
SPEAKER_00: and then go to bed at 9, 9.30.
32:03
SPEAKER_00: You're still, your body's still driving digestion.
32:06
SPEAKER_00: Your body's still pulling nutrients.
32:08
SPEAKER_00: And it's also probably going to be a lot more challenging for at least for some people, to actually fall asleep in that, in that instance.
32:16
SPEAKER_00: So you want to take away digestion as much as possible.
32:20
SPEAKER_00: You can have a little bit going on, but you don't want you don't want a bunch of protein, a bunch of fat, and a bunch of carb or carbohydrates because you just sat down and ate a big meal and then you're trying to go to sleep in an hour and a half.
32:32
SPEAKER_00: You don't want that to be happening because you might also be dealing with a bunch of blood sugar regulations, especially if you don't have your dosing in in check in terms of taking enough insulin and pre-bolishing in the right fashion.
32:46
SPEAKER_00: Right?
32:47
SPEAKER_00: So you don't want to fight those battles.
32:49
SPEAKER_00: So you've got the exercise piece, you've got the food piece, and then you've obviously got your your uh dosing if you need to dose at all.
32:59
SPEAKER_00: Right?
32:59
SPEAKER_00: Let's say you're sitting at 180 and your target is 130, and you haven't really eaten, right?
33:08
SPEAKER_00: This is, you know, you haven't eaten dinner, you're not gonna eat dinner.
33:10
SPEAKER_00: Or you've already eaten dinner, it's been a long time ago.
33:13
SPEAKER_00: If you're if you're sitting a little higher, maybe you need a couple units, maybe you do, to help with that.
33:17
SPEAKER_00: Because remember that that basal insulin that you're either taking because you're me and you're taking a shot at night, isn't gonna bring that all the way back down.
33:24
SPEAKER_00: So that's the that's the correction piece, I guess.
33:26
SPEAKER_00: So you got those three components that you can really focus on manipulating, and they're very easy to manipulate.
33:31
SPEAKER_00: Just give yourself time.
33:33
SPEAKER_00: Don't eat a tons of food right before bed, you know.
33:36
SPEAKER_00: Drink some water, maybe.
33:37
SPEAKER_00: That's also gonna boost some insulin sensitivity.
33:39
SPEAKER_00: What I have really realized, and that this is this has not always been the case.
33:44
SPEAKER_00: And it really should have been, but it wasn't because I took me a long time to understand and learn this and really, really understand it within my own body.
33:53
SPEAKER_00: Insulin sensitivity is the number one thing we're trying to we're trying to focus on in diabetes.
33:59
SPEAKER_00: Yes, we have all the decisions in terms of dosing.
34:01
SPEAKER_00: Yes, we have all the decisions in terms of what we're eating and counting carbs and dosing for those carbs and all that stuff.
34:07
SPEAKER_00: That's important.
34:08
SPEAKER_00: But I'll tell you what, let's let's go back 10 years with my journey.
34:14
SPEAKER_00: Right?
34:15
SPEAKER_00: I used to be on a one to five, one to seven-ish insulin to carb ratio.
34:20
SPEAKER_00: When I started understanding insulin sensitivity, everything changed.
34:24
SPEAKER_00: Everything, everything changed.
34:26
SPEAKER_00: And this, and I have I'm not even talking about really changing up your eating habits yet.
34:30
SPEAKER_00: I'm literally just talking about boosting insulin sensitivity through sleep, hydration, exercise, and exercise, and preferably not having tons of cortisol spikes and stress.
34:41
SPEAKER_00: Not even talking about, not even talking about nutrition yet.
34:44
SPEAKER_00: When I understood that and I really focused on intentional exercise at specific times of the day and utilized exercise movement, whatever you want to call it, at different points of the day, now I'm on a one to 10, 1 to 12 insulin to carb ratio.
35:01
SPEAKER_00: I don't need as much insulin throughout the day.
35:04
SPEAKER_00: And if I'm really diligent with my exercise, which I'm not always, I'll be honest with you, I'm not always super diligent with the exercise piece.
35:13
SPEAKER_00: But the days and weeks that I am, my God, I could easily go to one to 12, 1 to 14.
35:18
SPEAKER_00: Easy.
35:19
SPEAKER_00: No problem.
35:20
SPEAKER_00: When I was giving those examples about basil and like missing a dose and not even worrying about it and not even spiking, that's why.
35:27
SPEAKER_00: Because I've boosted my insulin sensitivity so much.
35:30
SPEAKER_00: When your insulin sensitivity is constantly heightened, you don't need enough as much insulin.
35:36
SPEAKER_00: And this is why I get so frustrated with the medical system, because they think they give you an insulin to carb ratio, and that that is like what you should take no matter what, every single time.
35:46
SPEAKER_00: That is not the case because different foods are going to react differently.
35:50
SPEAKER_00: Different foods are going to drive insulin resistance.
35:54
SPEAKER_00: So, as an example, if your nutrition isn't on point, if your nutrition is mostly evolved around eating ultra-processed foods or even mild processed foods, you don't get a lot of vegetables and greens and you don't have tons of fiber, you don't have tons of protein, and your nutritional habits, you're driving insulin resistance.
36:20
SPEAKER_00: And you're probably taking a crap load of insulin.
36:22
SPEAKER_00: And one of the reasons, not the only reason, one of the reasons is because of your relationship with food and what you're actually eating, because the quality of what you eat matters.
36:31
SPEAKER_00: And we're going to talk about the quality of nutrition or quality of food and another tips and tricks episode.
36:37
SPEAKER_00: But the hear me right now, I promise you.
36:39
SPEAKER_00: If you go to McDonald's, if you go to Starbucks every day, if you go to these restaurants that we all know aren't the greatest for you, you're driving insulin's resistance.
36:49
SPEAKER_00: And and you're dry, you maybe you're driving it a very little amount, but think about as an example, let's say that you get a latte every single day.
36:58
SPEAKER_00: Let's say you get a coffee every single day with sugar in it.
37:02
SPEAKER_00: Okay, there's nothing wrong with that.
37:04
SPEAKER_00: But I need you to understand that you're driving, you're gonna drive insulin, you're you're like turning on a faucet in this sink has a plug in it.
37:14
SPEAKER_00: It's not able to drain.
37:16
SPEAKER_00: It keeps filling up.
37:17
SPEAKER_00: This faucet's barely on.
37:19
SPEAKER_00: You're every time you eat something that's ultra-processed, and it's gonna, it's going to create, and it does create, because not all foods are gonna create an inflammatory response, because that's what we're really talking about when we talk about ultra-processed foods.
37:31
SPEAKER_00: When you're eating ultra-processed foods, or you're eating at least what's talk, let's say foods that are creating an inflammatory response that drives insulin resistance because it's the defense mechanism for your body.
37:40
SPEAKER_00: It's driving insulin resistance, it's driving stress hormones, it's driving cortisol, it's driving all these things.
37:46
SPEAKER_00: Okay, so we want our insulin sensitivity to be heightened and our insulin resistance to be lower as much as possible.
37:54
SPEAKER_00: And again, it's easier said than done.
37:56
SPEAKER_00: I know it is, I know it is, but the all of the decisions that you're making is to drive insulin resistance.
38:03
SPEAKER_00: Outside of the, outside of physical activity and exercise, the benefits that you get from the physiological piece, not the blood sugar piece, if you didn't get any of that from exercise, and it was just like, okay, if you go exercise every day, you're going to drive insulin sensitivity.
38:20
SPEAKER_00: That still would make me go to the gym every single day.
38:22
SPEAKER_00: That still would make me go for a run every single day.
38:25
SPEAKER_00: That still would make me go take that cycling class or that Pilates class, that yoga class, or go for a walk or whatever it is.
38:31
SPEAKER_00: Even if I wasn't getting all the physiological benefits out of exercise, and it was just because of blood sugar, that to me is still, it would be the number one reason why to do that.
38:42
SPEAKER_00: And we have to understand that.
38:44
SPEAKER_00: So, going back to what I said earlier, your number one job is to boost insulin sensitivity.
38:48
SPEAKER_00: I promise, if you, if you, if you're thinking about that as part of your decision-making process, is this gonna boost my insulin sensitivity or is this gonna is this gonna boost insulin resistance?
38:59
SPEAKER_00: I tell you what, when I eat pizza once or twice a month, I know that decision is driving insulin resistance because it's super ultra-processed.
39:10
SPEAKER_00: The wheat, the whatever's on it, the cheese, the the sauce, the just it the way it pizza is just ultra-processed, unless you're making it yourself.
39:19
SPEAKER_00: Maybe you're making homemade pizza with sourdough or whatever it is.
39:25
SPEAKER_00: You're not driving insulin resistance that high.
39:27
SPEAKER_00: So if you like pizza like me, yeah, we should probably should make more pizza at home.
39:32
SPEAKER_00: That'd be it, that'd be the alternative thing to do.
39:35
SPEAKER_00: So your number one job is to drive insulin resistance.
39:37
SPEAKER_00: Or I'm sorry, drive insulin sensitivity.
39:39
SPEAKER_00: That's your number one job as a diabetic.
39:41
SPEAKER_00: That is what we are being that's what we should be focused on.
39:44
SPEAKER_00: Everything else falls in line.
39:45
SPEAKER_00: How much insulin you're taking, when you're taking it, how you're taking it.
39:50
SPEAKER_00: Do you need other tools to be pulled out of your toolbox when you're making that decision?
39:55
SPEAKER_00: What is your blood sugar now?
39:57
SPEAKER_00: Like all of those decisions are also part of the insulin sensitivity thing.
40:01
SPEAKER_00: What things can you do throughout the day to drive insulin sensitivity?
40:05
SPEAKER_00: And the most, the easiest levers to pull with insulin sensitivity is exercise and movement, getting enough sleep, hydration, and not eating a lot of ultra-processed foods because those are directly in your control.
40:19
SPEAKER_00: All the other stuff, the hormonal stuff, a lot of that stuff's out of your control that's going to drive insulin resistance.
40:24
SPEAKER_00: That's a lot of out, a lot of it's out of your control.
40:26
SPEAKER_00: And for you females, I'm sorry.
40:29
SPEAKER_00: I'll just say that.
40:30
SPEAKER_00: You guys are set up to fail from the time that puberty happens to childbearing age, to menstruation, to perimenopause, menopause, postmenopause.
40:40
SPEAKER_00: My God, it sucks.
40:41
SPEAKER_00: Guys, we have no excuse.
40:43
SPEAKER_00: We have zero excuse of not making this all work.
40:46
SPEAKER_00: Telling you.
40:47
SPEAKER_00: A lot of our hormonal displacement stuff is self-inflicted, guys.
40:52
SPEAKER_00: And a lot of our hormone, not all of them, but a lot of our hormonal displacement stuff is self-inflicted, I would say.
40:59
SPEAKER_00: Where females, not so much.
41:00
SPEAKER_00: Not always.
41:01
SPEAKER_00: Some, but not always.
41:04
SPEAKER_00: Yeah.
41:05
SPEAKER_00: So that's basal insulin.
41:06
SPEAKER_00: I hope this was helpful.
41:07
SPEAKER_00: I got off on a couple tangents.
41:09
SPEAKER_00: My apologies, but basal insulin, don't make it hard.
41:12
SPEAKER_00: If you're on an algorithm, if you're using the algorithm, freaking awesome.
41:14
SPEAKER_00: High five to you.
41:15
SPEAKER_00: But don't think that the algorithm, this is that I I want you to understand this.
41:19
SPEAKER_00: If you are using an insulin pump and you're using the algorithm, awesome.
41:23
SPEAKER_00: Keep using it.
41:23
SPEAKER_00: But you have to understand that that thing is not going to save you every single time.
41:28
SPEAKER_00: It's designed to help, but it's not going to save you.
41:31
SPEAKER_00: And I would definitely say that there's going to be times that you're going to have to intervene to get down to target because just insulin's not fast enough.
41:42
SPEAKER_00: And these algorithms, as at least right now, they're not fast enough.
41:46
SPEAKER_00: Right.
41:46
SPEAKER_00: If you're at 130 and you're rising and you're and in 40 minutes, you're going to be at 200.
41:54
SPEAKER_00: Even if you get insulin right at 130, and even if it recognizes the up arrow, not a straight up arrow, just an up arrow, that it's coming up.
42:03
SPEAKER_00: What is it?
42:03
SPEAKER_00: I think the decks come.
42:05
SPEAKER_00: I'm not going to say because I don't remember the the arrow time frames.
42:09
SPEAKER_00: But you just got to a small arrow coming up.
42:12
SPEAKER_00: Even if you get insulin right at 130, okay, most likely you're going to probably get to like 175, maybe 180, maybe 200 before that arrow comes back to stable.
42:25
SPEAKER_00: Because it take, remember, it takes 20 minutes for that insulin to get into the tissue into the cell and start lowering your blood sugar.
42:32
SPEAKER_00: So not only are you fighting the arrow and the rise, but you're also fighting what the number is, right?
42:38
SPEAKER_00: So people say, like, oh, well, I corrected and I was 160, and I corrected for that 160 when I was rising.
42:45
SPEAKER_00: Like, okay, hold on a second.
42:46
SPEAKER_00: Were you correcting for 160 or were you correcting for 200?
42:49
SPEAKER_00: Because in 20, 30 minutes, depending on how fast that thing's rising, you're at 200.
42:54
SPEAKER_00: You correcting at six 160, you correcting for 160, it's too late.
42:58
SPEAKER_00: You got to correct for high a higher number, right?
43:00
SPEAKER_00: So if your correction factor tells you you need one and a half units at 160, you might need more than that.
43:05
SPEAKER_00: I'm not going to say how much because I'm I'm not a doctor and I'm not, I can't tell you how much more insulin you need, but I imagine that you would need more insulin because you're you're don't correct for the number.
43:17
SPEAKER_00: Correct for the situation.
43:18
SPEAKER_00: So yeah, that's not even a basal thing.
43:20
SPEAKER_00: But yeah.
43:21
SPEAKER_00: All right.
43:21
SPEAKER_00: Well, that's it.
43:22
SPEAKER_00: That's all the time we have for today.
43:24
SPEAKER_00: Wow, that was 50-some minutes.
43:26
SPEAKER_00: That's crazy.
43:26
SPEAKER_00: This was only supposed to be a 15-minute conversation.
43:29
SPEAKER_00: Oh, guys.
43:31
SPEAKER_00: I hope that you guys get through these whole episodes.
43:33
SPEAKER_00: Like, I really hope that you get through the whole entire thing.
43:37
SPEAKER_00: I can't really tell from the stats if you guys are getting through the whole thing.
43:41
SPEAKER_00: I don't know.
43:42
SPEAKER_00: I would imagine some of the episodes with me and Graham where we get off on stupid tangents, you probably aren't listening to the whole thing.
43:48
SPEAKER_00: But hopefully you are.
43:49
SPEAKER_00: Hopefully you're getting through the whole thing because there's pockets of every single episode that are gonna have lots of value for you.
43:57
SPEAKER_00: So I hope you're getting through the whole thing.
43:59
SPEAKER_00: But thank you so much for listening, guys, and I will see you next time.