YT YouTube2Text

YouTube2Text → Transcripts → Do THIS if You Diagnosed with Type 1 Diabetes | TCOYD Podcast

Do THIS if You Diagnosed with Type 1 Diabetes | TCOYD Podcast — Transcript

by Taking Control Of Your Diabetes® · 6,027 words · 838 segments · language en · Watch on YouTube

Open in transcriber Summarize with AI Download SRT/VTT

Full transcript

0:00Hello everyone and welcome to this
0:02edition of the taking control of your
0:05diabetes podcast. I am one of your hosts
0:08Dr. Jeremy Pettis joined as always by my
0:10good friend and colleague
0:11>> Steve Edelman.
0:12>> Dr. Steve Edelman in fact and if you're
0:14just tuning in Steve and I are both
0:16doctors. We're endocrinologists at the
0:18University of California San Diego where
0:20we do uh research. We see patients. Uh
0:22we were both diagnosed with type 1
0:24diabetes at the age of 15. Steve 20
0:27years before me. Um, and Steve started
0:30taking control of your diabetes now
0:32almost exactly 30 years ago. We're
0:34actually celebrating our 30th uh
0:36anniversary with uh Fund Rager coming up
0:39soon, which is going to be a raging good
0:41time, actually. So, I'm excited about
0:42that. But anyways,
0:43>> thank you, J.
0:44>> Um, this podcast is is a part of a
0:47two-part series. Um, we're going to do
0:49top 10 tips for people living with type
0:511 diabetes. That's this one that I'm
0:53going to kind of run. And then, uh,
0:54we're going to do top 10 tips for people
0:56with type two diabetes that Steve's
0:58going to run. So Steve and I were both
1:00tasked with coming up with 10 tips to
1:03give people in this case uh type 1
1:05diabetes. So I did all 10 of these tips
1:07and Steve has never seen them before.
1:10And likewise I have never seen the type
1:12two uh things before. So um you know
1:16what comments Steve has and vice versa
1:18are going to be like kind of the real
1:19comments as we go through this. So, just
1:22to kind of set the stage, you know, this
1:24is globally I approach this as 10 things
1:27I wish I could kind of tell everybody
1:29with type 1 diabetes. And there's
1:31definitely like a medical slant to it in
1:33terms of, you know, health and things
1:34like that, but there's some like overall
1:37mental health things as well. So, it's
1:39kind of a comprehensive list. So,
1:41without further ado, and in no
1:42particular order, let's get to these uh
1:45tips. So tip number one is just to kind
1:48of level set for everybody out there
1:50living with type 1 diabetes and it says
1:52uh we all get high and we all get low.
1:56So what I mean by that is this is a very
2:00difficult disease and especially
2:01hopefully you have a CGM. You're
2:03literally looking at your blood sugars
2:04all the time. You're seeing when you're
2:07quote unquote failing. Your blood sugars
2:08go high. They go low. You know I always
2:11say you eat you do your blood sugars go
2:13high. you take a rage bulis because
2:15you're pissed off. Your blood sugars are
2:16high. Then you go low and you have to
2:18stuff your face and you just kind of
2:19bounce all over the place. And the point
2:22of this tip is that a large part of that
2:25is type 1 diabetes. And there has to be
2:28some acceptance of that. Now, I'm going
2:31to get into that. Um, we want to control
2:33our blood sugars best that we can, but
2:35nobody's perfect. Nobody has a, you
2:37know, completely flat blood sugar. Steve
2:40and I get high and low all the time.
2:42Steve way more than me. He's a mess. Um,
2:44but it happens to um to everybody.
2:46>> Jeremy gets high all the time. I might
2:48get low, but uh
2:51>> so uh any comments about this tip?
2:54>> Yeah, I think what you're saying is um
2:57people should not expect to be perfect
2:59all the time.
3:00>> Yeah.
3:01>> And type 1 diabetes is hard.
3:04>> And even though we have, you know, CGMs
3:06and pumps that talk to them, you know,
3:08we still give insulin in kind of a
3:10primitive way in the subcutaneous
3:12tissue. It's just unpredictable and
3:15people can drive themselves crazy and
3:17they can drive the people around them
3:18crazy as well. So just be accepting.
3:20>> Yeah. And really the overall goal I
3:23would say of all of this is people want,
3:26you know, kind of good blood sugar
3:27control, whatever that is. And we don't
3:29want to work so hard. We don't want to
3:31worry about it. So tip one is about the
3:33kind of the mental health side of this
3:35is that you're going to have some highs,
3:37you're going to have some lows, and that
3:39is okay. Okay. I always say too, the
3:40only time you have a completely flat
3:43blood sugar is when, Steve,
3:44>> you're dead.
3:45>> When you're dead, and you don't want to
3:46be dead. So, if you're not dead, you're
3:48going to have some bounce in your in
3:49your blood sugar. So, that brings me to
3:52tip number two, though, is that we can't
3:54just, you know, let our our blood sugars
3:55go uh willy-nilly all the time. So, goal
3:58number two is know your goals. And what
4:01I mean by that is we all kind of know,
4:03yeah, we want to keep our A1C generally
4:05less than seven, but we have very
4:07specific metrics too for what um is
4:11adequate control or ideal control for
4:13people with type 1 diabetes. And in
4:15general, we want your time and range,
4:17your time between 70 and 180 to be above
4:2070%. And then we want to minimize the
4:23time that you're spending hypoglycemic.
4:25Now, I say this because a lot of times
4:27people will know this, but I have
4:30patients that come in and they'll say,
4:31"Yeah, my time and range is 75%, it's
4:3480%." But I just, you know, I I need to
4:36do need to do better. And it's kind of
4:38like, well, why? You know, I think there
4:40is this pursuit of perfection sometimes.
4:43And we didn't pull these numbers out of
4:45our butt as endocrinologists. We know
4:47that if you keep your A1C less than
4:49seven, you keep your time in range above
4:5170%. You're going to live a very long,
4:53very healthy life. and you know, so know
4:56those goals and it'll come to kind of
4:58what to do about that afterwards. But I
5:00think this is an important step.
5:01>> Yeah. The only thing I'll add to that,
5:02Jeremy, is when you think about it,
5:05every percent represents 15 minutes. And
5:08I've learned this from you. 70% really
5:10equates to an A1C of seven. And that's a
5:12great goal, but it allows us to be out
5:15of range 7 and 12 hours a day. And and
5:19think that sort of relates to your first
5:22tip is that even the experts that put up
5:25these high goals realize you cannot be
5:28in range 100% of the time. I mean we you
5:31and I have had days like that
5:33>> when we were on our deathbed but we came
5:35back to life.
5:38>> Um so yeah so all right so know your
5:40goals. That's tip number two which
5:42brings me to tip number three which is
5:45you got to celebrate the wins. So, if
5:47you are meeting your goals, if overall
5:49your time and range is over 70%, your
5:51A1C is um where you want it, not
5:55necessarily your A1C is less than seven,
5:57but maybe it's going in the right
5:58direction. You've went from 10 to 9 to
6:008. Celebrate those wins because guess
6:03what? Like, we need something to
6:05celebrate. I always say with diabetes,
6:07our ultimate goal is what? It's for
6:10nothing to happen. We want to get
6:12through the day without going high,
6:13without going low, without having
6:15problems with our eyes or whatever it
6:17might be. And that's an impossible
6:19situation to obtain. You can't achieve
6:22nothingness. So, you got to celebrate
6:23when you do win. And I have some
6:25examples here. Maybe it's just you
6:27nailed a bullis. You came up against a
6:29burrito you've never seen before, but
6:31you got the you guessed the carbs
6:33slightly right and you you didn't, you
6:35know, you kept it lower than 180. Maybe
6:38just waking up with a good blood sugar
6:39or pulling off exercise. You didn't go
6:42high or or low during exercise. Um you
6:45had a good eye exam. Uh doesn't
6:47necessarily mean no complications, but
6:49maybe if you do have complications,
6:50they're stable. I hate getting my eyes
6:52dilated. I hate it. And so, you know, I
6:55really kind of put that off and just
6:56trying to celebrate when you go in and
6:58maybe you get some good news. A no
7:00hitter we mentioned. Here's a good one.
7:02Correcting a super high blood sugar
7:04without going low. you know, that's kind
7:06of hard to do. So, maybe you were 300,
7:08you took a bunch of insulin, instead of
7:10going to, you know, 50, you just came in
7:12for a smooth landing.
7:13>> Yeah. Take a fresa.
7:16>> Um, and then, you know, I have here I I
7:18texted our friend Leslie Island, who's a
7:20endocrinologist, and she said, like I
7:23said, I would celebrate the victories,
7:24uh, specifically the small ones.
7:26Example, I perfectly bullish for a
7:28samore a few weeks ago, and I felt like
7:30a boss. So, stuff like that. And this
7:32sounds cheesy, but actually do it. You
7:35know, pat yourself on the back. Hey, I
7:37did a good job because people generally
7:40don't tell you that you're doing a good
7:42job. All this kind of work that you're
7:44putting into your diabetes. There's
7:46times it actually goes well. Celebrate
7:48it.
7:48>> Yeah. You know what? As as as patients,
7:51as we all are patients with, we all have
7:53our doctors. It seems like we focus in
7:55on the bad things for sure. Like what do
7:57you think about ah I messed up my blood
7:59sugar the other day when I forgot to
8:01bowl this and I think what you're saying
8:03is
8:04>> is that we should focus on the good.
8:06>> Yeah.
8:07>> And forget the bad.
8:09>> But but I know you love to celebrate and
8:11I is that why you're you're so high all
8:13the time. You celebrate every good
8:15thing.
8:15>> Yeah. It's a different kind of high,
8:16Steve. Um all right. So I have this
8:19thing here that says I am healthy. And I
8:22gave this talk in person, I think at the
8:24one conference years ago, and I made
8:25everybody say the words,"I am healthy."
8:28Because with type 1 diabetes, a lot of
8:30times people think, "I'm sick. I'm
8:32damaged. I'm going to die. My eyes are
8:34going to go bad. My kidneys are going to
8:35fail." Those things don't have to
8:38happen. And I think I have at the end
8:39here that people with type 1 diabetes
8:41are living longer than even people
8:43without diabetes. So saying, "I am
8:45healthy." That's another way of kind of
8:47celebrating um a win. You're doing the
8:50work. you're you're hanging in there
8:51with type 1 diabetes, which again sucks.
8:53Type 1 is really hard.
8:54>> Yeah. And we we've spoken to many crowds
8:57and and on several videos that people
9:00with type one are living as long as
9:02those without. And you know, all you
9:04need to do is take care of those basic
9:05goals.
9:06>> And so you do get rewarded for all the
9:08hard work.
9:09>> Yeah. Steve has a big birthday coming
9:11up. I won't say how old, but it's got a
9:13zero behind it. And we're we're going to
9:15celebrate that, too.
9:17>> So type ones are living longer and
9:18longer, buddy. You're making me They are
9:20They are I never thought I would make it
9:22this this to this age. So, I I hear you.
9:25>> Um, tip number four, Steve loves this
9:27one. Stockpile. Become a hoarder.
9:30Stockpile everything. So, get extra
9:34sensors, get extra insulin, get, you
9:36know, extra infusion sets. Um, you know,
9:39set your uh refills for insulin on like
9:42auto refill. You can have your provider,
9:44this is a very normal thing to do, um,
9:47you know, write that you you you use
9:49more insulin than you actually do, you
9:51know. So, say you take up to a 100 units
9:53in your your pump per day because a lot
9:55of that can be wasted. You just don't
9:57want to be running out of stuff. There's
9:59nothing worse than being in the middle
10:01of something, anything, and your CGM
10:04falls out and you don't have one nearby.
10:06Well, guess what? You got to go home.
10:08Maybe you have to go to the pharmacy.
10:09That can really ruin your day.
10:10>> Call Steve. Ruin his day.
10:12>> Call Steve. That's my number one thing
10:14that I do actually. Um, and uh, those
10:18are the times that I think I'm really
10:19mad about having diabetes when I feel
10:21like something goes wrong and I don't
10:23have the stuff to triage it. Now I got
10:25to go do whatever. So, put insulin in
10:28your fridge at home, at work. Put, you
10:30know, extra sensors if you can. Um,
10:33stockpile those as much as you can. Um,
10:36because we need our stuff.
10:37>> Yeah. And I think people should know
10:39that you don't have to wait till the
10:41exact month is over or 90 days over to
10:44ask for a refill. They give people a
10:46leeway. So mark in your calendar the
10:49second you're eligible. In fact, even if
10:51you called it in too early, the
10:53pharmacist will say, "Oh, we'll send it
10:54out in a day." And that way you have the
10:57extra amount of time, the extra pills.
10:59And I think the biggest hassle people
11:01are complaining about these days is that
11:02if their sensor goes out,
11:04>> like if you have three Dexcoms, for
11:05example, for a month, you lose one,
11:07you're down to 20 days.
11:09>> It is annoying because you used to be
11:10able to restart them and you could milk
11:12like a sensor for a month if you wanted
11:15to. You can't really do that anymore.
11:17So, you got to call Yep.
11:19>> you know, when you you you've lost one,
11:21you know, and get, you know, those
11:22refilled because you don't want to have
11:24kind of gaps in your sensors. And this
11:27is a off label tip, but you know, most
11:31endocrinologists will have samples in
11:34their office of CGMs. And so if you're
11:36on a Libre, you can ask for one or two
11:38if you have them. And or a Dexcom and we
11:42have them in our office at UCSD.
11:43>> We do. And it's interesting because
11:45we're not allowed to to have like uh
11:47medication samples at an academic
11:49university. So we don't have any pills,
11:51but we're allowed to get technology. So
11:53we have sensors. We actually have meters
11:55and things like that. So, uh, don't feel
11:57sheepish for saying, "Hey, do you have
11:58any extra sensors? I'm running low or
12:01whatever it might be." Don't abuse the
12:02system, but know that that's an option,
12:04too. Great idea.
12:05>> Yeah. All right. So, tip number five,
12:08eating low carbish.
12:11And you know why I have this here is
12:13that in general, you know, um, nobody
12:17knows how to count carbs. Like, it's
12:18really difficult. Um, but I know what a
12:21carb is. So, you know, I can limit them.
12:24that's a lot easier. You know, you give
12:25me a giant bowl of of rice, I have no
12:27many no idea how many carbs are in that.
12:30If you give me a slice of bread, you
12:31know, I'm going to get a lot more
12:32accurate. So, we try tried to limit my
12:35carb intake. And I know you do, Steve,
12:37too. Yep. Um, I don't have like a set
12:40number in terms of carbs that I aim for
12:43for each meal, but man, your blood
12:45sugars are going to be a lot easier if
12:47you know, you let us wrap your your
12:50burger. You know, you um you avoid the
12:53fries or at least kind of limit them.
12:55>> Small fries.
12:56>> Small fry. You know, I have a picture of
12:58bacon and eggs here. Nothing wrong with
12:59that for for breakfast. No carbs there.
13:03And I also have a big old body of
13:04Bllandon's whiskey, which you and I
13:06like. Guess what? hard alcohol, zero
13:07carbs. Um, good to know. Chicken,
13:10vegetables, these kinds of things. You
13:12know, we are not low carb zealots. We
13:14like carbs. But the the less carbs you
13:17eat, it's just easier to predict in
13:19terms of how much insulin you need and
13:21your blood sugars are just going to be a
13:22little smoother. For sure.
13:23>> Yeah. And that just reminds me of our
13:25doughnut challenge we had. Jeremy and I
13:27ate three donuts in 20 minutes and we
13:29kept our blood sugars in range for 2
13:32hours. But it took a lot of work.
13:34>> It did. between running up the steps,
13:36taking a fresa, pre-bolising,
13:38postbololising. So, yeah, you're right,
13:40Jeremy. I think lowish makes so much
13:43common sense. You cannot say no carbs or
13:47extremely low carbs because carbs are
13:48part of our our life, our lifestyle.
13:51>> Delicious. They're delicious.
13:53>> Um, all right. So, the most important
13:56thing about that doughnut challenge was
13:57that I uh beat Steve. So, going on to
14:00tip number six. So tip number six is
14:03sometimes you have to say f it. And what
14:06do I mean by that? Well, what I mean is
14:09that sometimes your blood sugars are
14:11going to go high and you just have to
14:12say f it, you know. So I have a picture
14:14here. The other day my blood sugar was
14:16or I actually went out. I had some
14:17pizza. I had some beer. My blood sugar
14:19was 250. I said f it and I had a donut
14:22because you know what? Sometimes you
14:23just got to let it roll off your back.
14:25Now, we don't do this all the time, but
14:27the reason I say this is because
14:29sometimes patients will say, gosh, you
14:32know, every time my blood sugar goes
14:33above 250, is that doing damage to my
14:36eyes? And it's it doesn't work like
14:38that. It really is long sustained high
14:41blood sugars. So, if you get these, you
14:42know, spikes, which we all do, correct
14:45your blood sugar, try to bring it down
14:46safely back into range, and get on with
14:48your day. you know, don't hang on to
14:50that because um the important part is is
14:52is keeping in the fight kind of.
14:54>> Yeah. And I think it's just important to
14:56remember it relates to your very first
14:58tip. You know, happens and you got
15:01to be able to accept that and and grow
15:04with it. And if you feel like screaming
15:06at the top of your lungs, just do it.
15:09>> Yeah.
15:09>> And so it's one of these days when
15:12everyone has eyelid cell
15:13transplantation, you know, these rules
15:15will be worse
15:19Well, and I have there's two ways to to
15:21say effort. There's in like real time.
15:24You didn't know what was going on. You
15:25ate a donut. Your blood sugars are high.
15:26Like I said, you say effort. You go
15:28about your business. The other one is is
15:30the pre-planned effort, which is, hey,
15:33I'm going on vacation, you know, next
15:35week or I'm going to be away this
15:36weekend or I'm going to be at a
15:38conference eating weird food and staying
15:39up late. I know my blood sugars are
15:42going to be not ideal and I'm going to
15:45have to be okay with that. You know, it
15:47it's very difficult to say like, I'm
15:49going to go outside of my routine. I'm
15:51going to have fun on vacation and expect
15:53perfect blood sugars. If that happens,
15:55great. But there can just give yourself
15:57some grace that some small periods of
16:00less than ideal control is okay.
16:02>> That's much better than a surprise
16:04effort when you did everything to
16:06prevent the effort. So, no, I like I
16:09love that idea. It's a pre-planned
16:11effort.
16:12>> Yeah, we should pre-plan an effort real
16:14soon. Yeah.
16:16So, uh, um, and by the way, to that
16:19point, you know, we go out to pasta
16:21dinners. I mean, we do these things
16:23like, you know, um, we abandon these
16:25rules, you know, from time to time. We
16:27do our pre-planned efforts. We probably
16:28don't sit down and say that's what we're
16:30doing, but we do. We do it together.
16:31Yeah.
16:32>> And we all do our best. I mean, we sit
16:33down to a pasta dinner. We do the
16:35pre-bolas. We we carry our fresa with
16:37us. And sometimes we do it. And if we
16:39don't, it's not the end of the world.
16:41And it probably isn't too far over our
16:43upper limit.
16:45>> All right. All right, tip number seven.
16:46This definitely more of a medical one.
16:47So, when you see your provider, um,
16:50don't forget about your non blood sugar
16:52issues. So, what frequently happens when
16:54a type one comes in to see us is we pour
16:57over the the CGM and what, you know,
16:59pump they're doing, their carb ratios
17:01and things like that, and then they walk
17:03out the door and I look at their chart
17:05and say, man, their cholesterol was
17:07actually high, their blood pressure was
17:08high. We didn't talk about that at all.
17:10Um, because we get hyperfocused on blood
17:12sugars. Super important. But make sure
17:15at every visit you're talking about your
17:17blood pressure. Know your goal. It's
17:19usually less than 130 over 80. Know what
17:22your cholesterol is, specifically your
17:24LDL. Usually want that less than 70. And
17:27guess what? Treating blood pressure and
17:29cholesterol is easy peasy. They're
17:31generic once a day medications um that
17:34are very effective, generally very well
17:36tolerated, don't have side effects. What
17:39a a difference than all the work we put
17:41into our blood sugars, right? Okay, we
17:42still got to control our blood sugars,
17:44but if you have an A1C of six and your
17:46cholesterol and blood pressure are
17:47through the roof, you're screwed, you
17:49know? So, don't forget these things.
17:50Sometimes people will say, "Well, my
17:51blood sugar is great. Like, I'm going to
17:52live forever." Not if you're ignoring
17:54these other things.
17:55>> Yeah. You know, time with your doctor is
17:57limited. So, do your homework ahead of
17:58time. If your cholesterol levels under
18:00control, you don't even have to bring it
18:02up. If your if you have a blood pressure
18:04cuff at home, you don't have to spend
18:05any time of your, you know, very
18:07precious few moments with your doctor.
18:09So, but if you have issues, just like
18:12you said, Jeremy, beyond glucose
18:14control, bring it up. But the more
18:17homework you do, the more time you can
18:18focus in on your main problems with your
18:20visit.
18:21>> And then I I would tell everybody to
18:23kind of put on their calendar. Sometimes
18:24they'll say people will say like every
18:26January is I know that I need to get my
18:28eyes done, get them dilated. I just said
18:30how I hate, you know, doing that at
18:32least, you know, every year. Sometimes
18:34we'll do every two years if people have,
18:36you know, ideal control, no issues. um
18:39get your blood work done at least every
18:41year that'll have your cholesterol on it
18:42and then your blood pressure every time
18:44you kind of go in. So, just kind of have
18:46this maintenance program. And Steve,
18:48you've done like these great diabetes
18:50warranty programs. And guess what? If
18:52you do it, you know, we just said that
18:54people are living longer with type 1
18:56diabetes. And a big reason is because of
18:58this that you're going in because you
19:01have diabetes, but they catch your
19:02cholesterol earlier than they might have
19:04or your blood pressure or, you know,
19:05you're on top of your diet or you're
19:07exercising more than you otherwise would
19:09have. So, take care of your blood
19:11sugars, but remember this other stuff,
19:13too.
19:13>> Yeah. I I'd get a home blood pressure
19:15cuff. Don't ever try when you go into
19:17the doctor, you know, you're running,
19:18you're late. The doctor's ex-wife is the
19:20one that collects your co-pay. Your
19:22blood pressure is through the roof. You
19:24We want multiple values at home. And if
19:26it's always normal, you can space out
19:29the number of times you do it.
19:31>> All right, tip number eight. So, it
19:33says, "But what about my blood sugars,
19:34Jeremy?" So, we haven't really given any
19:36specific tips to blood sugars. So, this
19:38one is kind of some rapid fire blood
19:40sugar tips for people with type 1
19:41diabetes. Number one, no-brainer, use a
19:44continuous glucose monitor. Um, in 2025,
19:49yeah, like we still have to say this
19:50though, right? Okay.
19:51>> Um, that there's still a number of
19:53people that aren't using it, but to me,
19:55this is like just a must for everybody
19:57with type 1 diabetes. You can get these
19:59generally covered. But I do say and set
20:02the alarms, right? So, talk about that,
20:05Steve. That's your thing.
20:06>> Yeah. The most doctors will never even
20:08bring up where you should set your
20:10alerts and alarms. Everyone should set
20:12their low alert at 80, maybe 70 if
20:15you're really sensitive. However, the
20:17upper alert is extremely important. It
20:19tells you uh to hey, my blood sugar is
20:22above the range that I want it to be.
20:24I'm going to look at that number, look
20:25at the trend arrow, and decide if you
20:28want to do a correction or not. So, when
20:30you see a patient with high blood sugars
20:31across the board on their download,
20:33they're about averaging 200, 220 all day
20:36long, guess what? Their upper alert is
20:38set at 250. And if you want to see me
20:41lose my in clinic, come in there
20:43and set your alert at 250. And um I
20:46understand there's alarm fatigue, so you
20:48have to do a lot of things. You you can
20:50set your upper alert a little lower
20:52during the day, a second time frame at
20:55night, so you don't get bugged. Pick a
20:57sound that doesn't bug you, like the
20:59factory.
21:01There's some nicer sounds that you can
21:03do. And but people don't realize this
21:06will help you lower your time and range
21:095 to 10%. Raise
21:11>> increase your time and range more time
21:13and range. So yeah, I mean I always say
21:15that a CGM alarm should be a call to
21:18action.
21:19>> So when it goes off, you got to do
21:21something. If you find that it's going
21:22off and you're ignoring it, then it's
21:24not at the right level. So you know,
21:26typically we start at 180, but then you
21:28know you can tighten it up down to 170,
21:30160 if you want. And you got to find
21:32that balance between like my my control
21:35is getting better and I'm not losing my
21:36mind with all these alerts going off all
21:38the time.
21:39>> What's your set at?
21:40>> So right now mine's at actually 180. Um
21:43cuz usually I find that like my system
21:45right now is actually doing a pretty
21:47good job correcting me up until then.
21:49>> Got it.
21:49>> And if I take a bulis a little bit
21:51earlier, sometimes I go low. So anyways,
21:53>> no, that that that's a great point.
21:55Yeah. So it depends what system we're
21:57on.
21:58>> Yeah. which is point number two of tip
22:00eight. Um, which is, you know, get on a
22:03hybrid closed loop system. Um, we have
22:06so many of these pumps now. Um, we've
22:09done multiple podcasts on it. Still
22:11there's people that are resistant to
22:12going on these systems, but they're
22:14getting better and better. I didn't used
22:16to kind of push pumps on people, but now
22:18it's kind of the first thing I do if
22:20somebody's not on a pump, you got to get
22:22on one of these systems. If you are in
22:23one of the systems, educate yourself on
22:26the different options because they're
22:27constantly changing, evolving, what
22:30systems are or sorry, what CGMs they
22:32work with. That's been a huge uh advance
22:35that you're not locked into one
22:37particular CGM or the the other
22:39providers have a very difficult time
22:41keeping up to date with this. So,
22:43educate yourself on the different
22:44systems. We have all kinds of resources
22:46on this podcast, on our website, etc.
22:49>> Yeah, that's the bottom line. And you
22:50know, I'm like you, Jeremy. They used to
22:52say, "Oh, take pump MDI. Just take your
22:55pick." But I have to say, there's no way
22:58your your insulin pen can communicate
23:00with your CGM device. However, let me
23:02just say for all the MDI users out
23:04there, you can do extremely well and it
23:08just may having a pump may not fit in
23:10your lifestyle and you shouldn't feel
23:11guilty or bad about it.
23:12>> Totally good point, Steve. If you're
23:14doing really well on shots, um, then if
23:17it's not broke, don't fix it. Um, so but
23:19if you're still having highs, lows, it's
23:21something to consider.
23:22>> Yep.
23:22>> All right,
23:23>> point number three within tip eight. Um,
23:26pre-bolis,
23:27>> we'll be done in about four hours.
23:29>> Pre-bololis for every meal and snack. So
23:31we usually say 10 20 minutes before you
23:33eat. Insulin works just really really
23:35slow. So you have to tell your your
23:37system that you're eating essentially.
23:39What I do honestly is I enter 30 gram of
23:42carbs um 20 minutes before I eat any
23:45meal. And I just start there because I
23:48know I'm going to eat at least that
23:50much. I get some insulin into my system.
23:52It's kind of a foolproof plan. Anybody
23:55can do that. And then when I sit down to
23:57eat, if I eat more than that, then I'll
23:58kind of enter it as I go. And I find
24:01that that system works really well to
24:03kind of help avoid the the postmeal
24:05spikes that we all get.
24:06>> Yep. I put my insulin to carb ratio at
24:081:10. I just picked that number because
24:12I know how much insulin I need for meals
24:14that I've been eating for 30 years. So,
24:16if I say I need five units, I put in 50
24:19grams. So, I do it in reverse. And that
24:22works pretty well for me. Everyone's got
24:24their own method.
24:25>> Yeah. And then it just says um consider
24:28um adding a Fresza to your regimen. So,
24:30we've talked a lot about a Fresza, too.
24:32It's inhaled insulin. It works very
24:33quickly. Um you can add it to your pump.
24:36You can use it with NDI. There's lots of
24:38different ways to skin a cat with a
24:39Fresza and it's a nice tool to have.
24:41>> That's 8.5.
24:43>> Yeah, it is. Thank you, Steve. So, um
24:48that was uh tip number eight in
24:51conclusion. Now, tip number nine, uh
24:54this is an important one for Steve and I
24:56is get a dab buddy. So, what do I mean
24:59by that? Well, that's somebody else that
25:00has type 1 diabetes. So lucky enough to
25:03have Steve, a good friend, um who's a
25:05good friend, but also somebody that you
25:07can just call and to, you know, if
25:09you want to. There's a real camaraderie
25:11around having diabetes. So having that
25:13person, um can be so helpful. And I love
25:17my kids, my partner, but uh there's
25:19something special about somebody else
25:20that have uh type 1 diabetes. Now, you
25:23might not know somebody, you know,
25:25online can be, you know, a substitute
25:27meeting people. Um, our one conference
25:30that we just had, we had, you know,
25:32literally 700 people with type 1
25:33diabetes in person. We do this every
25:35August. All kinds of diabetes uh,
25:38buddies were kind of made that that
25:41conference and these people carry these
25:43relationships honestly through the rest
25:44of their lives and it can be really
25:46really powerful. Yeah, just I would say
25:48search out for groups in your area. Call
25:50the Breakthrough T1D office. They may
25:52have some several groups, online groups.
25:56Uh, and there's even dating systems for
25:58people with diabetes.
25:59>> Yeah. And Steve's phone number is 619555
26:048675309.
26:06>> Um, and the last tip, Steve, um, is tip
26:09number 10, and it is it says you are
26:11going to be okay. So, it says here
26:15again, type 1 life expectancy is now
26:17longer than people without diabetes. So,
26:19um, this disease really is a struggle. I
26:21always say that. I think it's unique in
26:23terms of what we ask patients to do. You
26:26know, look at your blood sugar, uh, make
26:28these calculations, take insulin, but if
26:30you don't get the dose right, guess
26:32what? You can go high, that cause
26:33problems. You can go low, that makes you
26:35feel like crap. And you got to do that
26:37over and over and over and over again.
26:39You know, we don't do that with any
26:41other medical condition that I can think
26:43of. So, it's no um surprise that people
26:47struggle getting their blood sugars in
26:48control or even if they are in control.
26:50I always say people with an A1C of 6.5,
26:52they're not having a good time, you
26:54know, like they still have diabetes.
26:55They're doing a lot of work to get
26:56there. So, this is just one of saying
26:58kind of again um to give yourself some
27:01grace. It's going to be okay. If you're
27:03doing the work, um people are living
27:05long healthy lives and doing whatever
27:07they want.
27:08>> Well said, Jeremy. You know, there's
27:10never been a better time to have type
27:11one. The technology is getting better.
27:14Other therapies for type one are going
27:16to be available. So, I think things are
27:19looking up and it's certainly different
27:22than when I got diabetes and I had
27:24bamboo insulin syringes and peeing on a
27:27stick.
27:27>> Yeah.
27:27>> So, when you you slid off the tail of
27:30your bronosaurus into your neck,
27:33>> I mean things are, you know, having type
27:36one is not a death sentence anymore.
27:38>> So, you love when I do this, but let's
27:39recap. Okay, so let's go through my top
27:4210. Number one, we all get high, we all
27:44get low. Number two, set your goals.
27:47Know your blood sugar goals. Number
27:49three, celebrate your victories. Four,
27:52become a hoarder. Stash your stuff
27:53everywhere. Number five, eat low
27:55carbish. Number six, sometimes you have
27:58to say, "F it." Mhm. Number seven, don't
28:01forget about other stuff. Health
28:02maintenance, blood pressure,
28:03cholesterol, eyes, kidneys. Number
28:05eight, my laundry list of blood sugar
28:07tips where I I hit about 10 things in
28:09number eight. Number nine is get a
28:11Steve, get a diabetic. And number 10,
28:13you're going to be okay. And I'll end
28:16with this very famous quote. Type 1
28:18diabetes is the best thing that ever
28:20happened to me. Said by me just now. And
28:23also, I've said it before, but it's a
28:25very good quote. So, with that, I hope
28:27you guys enjoyed our top 10. We're going
28:29to turn the page and record a type two
28:32one now. Um, but this has been great.
28:34Thanks for doing this with me, Steve.
28:36And I do want to say, um, it does matter
28:39when you guys, uh, hit like or subscribe
28:42or follow us or leave comments. This is
28:45uh for better or worse the currency in
28:46this day and age in terms of getting
28:48sponsorship etc. And uh we put this all
28:50out for free. So we just hope if you
28:53like it that you you let us know.
28:55>> Jeremy, you're the best diet buddy
28:56anybody could ever have.
28:58>> Thanks buddy.
28:58>> I love you.
28:59>> You're my my second best I would say.
29:01But yeah, just kidding. Love you buddy.
29:03Well, thanks for listening everybody and
29:05we will uh you'll hear us on the next
29:07one.

About this transcript

This page contains the full transcript of Do THIS if You Diagnosed with Type 1 Diabetes | TCOYD Podcast by Taking Control Of Your Diabetes®, generated from the public captions YouTube serves with the video. The transcript has 6,027 words across 838 segments, with the original timestamps preserved so you can click any line to jump to that moment in the embedded player.

What you can do with it

Use the transcript to take notes, quote the speaker, build a study guide, generate a summary with ChatGPT or Claude via the YouTube Summary tool, or export it as a timed subtitle file with YouTube to SRT. You can also re-open it in the transcriber to choose a caption track available on the video.

Free YouTube transcript tool

YouTube2Text is a free YouTube transcript generator — no signup, no daily limit. Paste any YouTube link and get the full transcript instantly, with timestamps, click-to-jump, caption language selection, AI prompts for ChatGPT, Claude, and Gemini, and exports to TXT, SRT, VTT, or Markdown.