#74 Think Like a Pancreas Chapter 2: Glucose Control, Y'all, What is it Good For? with Noelle

Katie: 0:00

This episode of the sugar mamas podcast is sponsored by sugar medical. The very best place to get all your diabetes supply cases and accessories. You're listening to episode 74 of the sugar mamas podcast. And today I'm going over chapter two of the book, think like a pancreas with T one D super mama, Noelle. Noelle is the mom to two very young kids living with type one diabetes. Truly. I cannot even imagine that scenario. You are my hero, Noelle chapter two of think like a pancreas is called glucose control. Y'all what is it good for? It's all about both the short term and long-term benefits that you can get from managing your diabetes. Well, It's a rather eyeopening chapter, to be honest. And one, that's not easy to read at times. All that aside though, this book has been by far the most helpful when it comes to learning about diabetes and teaching me how to manage my daughter's insulin. I call it my diabetes Bible and I refer back to it very often. Author Gary Scheiner was so kind to give me the green light to do this series. And I am truly so grateful. I know it's going to help a lot of type one families, just like it has for ours. It's never too late to get your own copy and follow along with us. Listen, you're going to want your own copy. There is so much in this book, like graphs and charts and tables that you're going to want to see with your eyes. Because there's really just no way I can do it. Justice trying to explain them with my words. I will put a link in the show notes to where you can get your copy either on Amazon or if you want an extra special signed copy from the author, from his website, integrated diabetes.com. Okay. Without further ado, let's get started. You're listening to the sugar mamas podcast, a show designed for moms and caregivers of type one diabetics here. You'll find a community of like-minded people who are striving daily to keep their kids safe, happy, and healthy in the ever-changing world of type one. I'm your host and fellow T one D mom, Katie Roseborough. Before we get started. I need you to know that nothing you hear on the sugar mamas podcast should be considered medical advice. Please be safe, be smart, and always consult your physician before making changes to the way you manage type one diabetes. Thanks. Before we start on my interview with Noelle. I want to take a minute to tell you about our awesome sponsor sugar, medical, sugar medical is the place to get all your diabetes supply cases and accessories. Look, it's no secret that diabetes comes with a lot of baggage. Right. And by that, I mean, you literally have to carry around a ton of stuff all the time. Listen, don't just toss your type one essentials at the bottom of your purse, backpack or suitcase and walk out the door, like some sort of bar. Heavens, no. Keep them neat, tidy and easily accessible with a sugar medical bag. They have styles and sizes for everyone. And every thing headed out for a hike. There's a sugar medical bag for that, going to lunch with a friend or planning a month long road trip across the country. There's a sugar medical bag for that too. Don't believe me, head on over to sugar, medical.com to take a look at all their suite styles and see for yourself. Plus get 10% off all one-time purchases using code sugar. Mama that's code S U G a R M a M a for 10% off. You'll find a link to the sugar medical website, along with the offer code details in the show notes. Thanks. All right, everybody. I am here with Noel and Noel and I are going to be going over chapter two of the book. Think like a pancreas today. The title of the chapter is glucose control. Y'all what is it. good for? But before we jump into all things, diabetes, Noel, I want you to introduce yourself and tell the listeners what your connection to type one diabetes is.

Noelle: 4:12

I am Noelle. I am the mom of two type one diabetics, a four year old and a two year old, both diapers. 21 months.

Katie: 4:19

Wow. That's crazy to me that they were both diagnosed like at the same time in their lives. Can you just tell us a little bit about their diagnosis stories, just a brief explanation of, of how you figured it out both times.

Noelle: 4:30

Yeah, absolutely. Ella, I brought into the doctors cause I could tell something just wasn't quite right with her. There was something going on. And I had said, you know, I looked online and it might be diabetes, but I don't really know. And they told me she was too young to have it. And so we just kind of dismissed that. I thought it might be a UTI. So we just ran up. And then the next day we got a call that we needed to go to the emergency room. They had a team waiting for us and it was in fact type one diabetes. then with Jack, it was a bit more low key because I was pregnant Jack when Ella was diagnosed, the smell of ketones made me so nauseous. I could smell them from a mile away and I just couldn't handle it. And I smelled it on his breath one day and I said, Here we go again. And so I just texted our endo and I, you know, did all the tests cause we had everything at home. And he kind of got a semi diagnosis over a text message. And then they said, you know, you guys kind of know what to do. He was still in range, but his ketones were high. So they just. You know, let's, let's get them on the books on Monday. So his was through the phone, I guess both of them were actually ironically through the phone. But yeah, vastly different experiences

Katie: 5:36

Yeah, cause one, you ended up in the hospital and one, you did it.

Noelle: 5:40

and our living room, you know,

Katie: 5:42

In your living room? My goodness. Goodness gracious. Yeah, I, I was, I also had horrible pregnancies. My first one was the worst with the nausea and, oh my gosh, the smell of certain things. I just, It was awful anyway, so I can empathize with you with the smell of the ketones. I remember my boss, I'm a physical therapist. And one day when I was pregnant, I was just laying on the floor of my office and my boss walked by like, was like, Are you okay? And I was like, no, no, I am not okay. But apparently I don't have the choice right now to quit my job. So I, it was, and then I went into the bathroom and I think I yacked up something else who knows, but I feel for your girl. So I'm curious to know, was the, the news of having a second child was that it, was it any easier the second time around? Was it worse? What, what was your experience with that?

Noelle: 6:27

It was a bit, a bit easier in a lot of, there was no large wave of grief. There was. Day that just was devastating. It was these little moments. So moving his crib to that, we could have like remote access was not something I imagined when I find his nursery. At like carb counting for two kids was just a whole nother level because, you know, it's always the kids that like, just didn't do well in math that ended up having kids that you've got a carb count for. And then just like the, the day before. He got his Dexcom. I just remember like looking at his body and I cry every time I think about it because I just wanted to remember his body without devices. I think we sometimes like, had so much excitement with like pods and Dexcom's and all these things, but it was like a moment of this will be the last time I see you without all of your robot parts attached to you. So that was just smaller, doses of grief as opposed to one overwhelming.

Katie: 7:26

Yeah. And you know, there was So. little when years were so little when they got diagnosed, like a Dexcom probably looks pretty big on a, on a little itty-bitty toddler. Yeah. Oh my goodness. So how old are they now? How old are they both now? Oh my gosh. Having a toddler. It's hard enough having to, with type one diabetes. I can't even imagine. And you work, you're working full time.

Noelle: 7:51

Yes. Yes. Both my husband and I work, I wear, I actually, it's very healing cause I work for a music therapy nonprofits, so they bring music therapy into intensive care units. And so it's a kind of a roundabout of like, I want it to bring what I wish I had in intensive care to other families to kind of heal myself and heal other families that are kind of going through the same thing.

Katie: 8:11

Oh, wow. I that's what an interesting DOB job description. to ask you more about that off the show, because that's really interesting. We were just, we just had an endocrinologist appointment yesterday and they had built this whole like barn out the parking lot with ponies, because it was part of their therapy, like animal therapy for just the hospital we go to, you know, obviously it's more than just type one diabetes. It's like a whole children's specialty. Ward. So all sorts of chronic issues, but I was like, that's so cool. So I'm all for the alternative therapies to make people feel better. Okay. Well, I, you know what, I always, I always ask people about their kids and you know, the kids are important obviously, but I want to know a little bit about you. So before we get started, I just tell me, tell me about you. Like, do you have any hobbies? What's your favorite place to travel? I don't know. Tell me something interesting about you.

Noelle: 8:56

Pre pandemic life. We actually live in kind of small town, wine country in California. So my husband and I love to, you know, go explore. And we're hoping to do that again soon. And then I just do crafts with my kids, like all day, every day. I just love being a mom. That's kind of been our number one these days. It's just hanging out with them, keeping them very busy inside all day, every day. And yeah, it's just a blessing.

Katie: 9:20

Well, that's good. Are y'all still on lockdown over there in California,

Noelle: 9:23

Yes, for the most part and because they're not old enough to get vaccinated, whereas just trying to be mindful, they also

Katie: 9:28

right?

Noelle: 9:28

So we're just trying to, you know, make sure that we're doing what we can.

Katie: 9:32

Yeah. That's true. I didn't even think about the age and the vaccines. All mines. All mine are old. We're old enough to get the vaccine, so yeah, I hear you. All right, so let's dive in chapter two. All about glucose control and why it's good to have good or tight glucose control. So the chapter kind of goes through all of the short term benefits and then also the long-term benefits. So Noel, in your opinion, what do you think the authors just purpose in writing this chapter?

Noelle: 10:00

I think we all have a story of telling someone that our kids have diabetes and them telling us about their great uncle that lost a leg or their cat or something along those lines of all these very scary stories. And I think this was just a very approachable way of saying you're in control. There's so many. Tools you have, and it's just so helpful to just be in that range. And here is why, you know, we always are like, let's get that A1C. Let's do this, but like, here are tangible benefits and let's break it down a little bit easier.

Katie: 10:32

absolutely. I totally agree with you. I think we all have those stories of just people who have lost their brains and like to tell us like the worst possible things that could happen with having diabetes when our kids get diagnosed and You know, while all of those things are true. I, you know, unfortunately I think the author's goal was like, he doesn't want to scare us. He doesn't want to put the fear of God in us. He really wants to motivate us and encourage us, you know, to take good control. Not only to avoid the things that maybe could go wrong in the future, but to enjoy life now, because as we're about to find out, there's a lot of really good benefits to good glucose management that you can. That you can get right, right now. You know, and I, I kind of, I have to remind myself often that. The things that we do to manage blood sugar as well are really the same things that we should do to have just overall good health, right? Like eating a very diet with lots of fruits and veggies and whole grains and you know, staying away from all the processed stuff and the sweet stuff. You know, in moderation. I mean, we, we love our junk food over here. Don't don't get me wrong. We certainly fair amount of it, but, know, exercising, getting enough sleep you know, just, just things like that. Things you do to take good care of your blood sugar are also things that people, everybody not just diabetics need to do to just have overall good health for, for life. So I try to remind me. that, you know, that it's not just this burden like, oh, well my kid has diabetes, so we have to do all these extra things. It's like, well, we want them to do we want to do them anyway. Right. Because we want them to know that it's important to take care of yourself. So how do you feel just with these short and long-term goals that we're about to go through, like, how can we use them to kind of like motivate our kids rather than put the fear of God in them?

Noelle: 12:17

I think for us. I always ask them how they feel. I don't ask them their numbers. I ask them how they feel. And I'm always trying to correlate you feel crummy we're low. So like, these are the things that we need to do to get there. I kind of help them understand just the cause of it and also how to recognize those signs before they get there. And so I think just, you know, making sure that we're. Telling them, you feel great. Your numbers are range. You feel really angry right now. And sometimes it's because you're a toddler it's sometimes it's because you are so high and like, get you water. And how do you feel now? And just that feeling with those numbers and, and talking to them about the benefits as we're kind of going through it. Wow. We're experiencing that. They're so young that they don't understand it. I don't want to put that on. But I want them to understand how they're feeling. What does your body feel like? What are we doing to help your body? So if you're high, let's help your body. Let's get you some water. Let's do all of these things. If you're low, let's make sure you have a snack. Let's just sit down for a second. So it's just having that conversation about feelings for the young ENS. I feel like it's so helpful for this.

Katie: 13:26

Yeah. Well, I mean, definitely just for toddlers alone, like having, giving them a good emotional vocabulary of like, how are you feeling verbalize that to me, rather than something across the room and having a tantrum that's a great practice to do in general, but Yeah. then. Verbalizing that of like, oh, well maybe it's because you're high let's, you know, and then giving them steps to take care of it. I love that. That's that's great. Yeah, no, I totally agree. Yeah, I definitely want Sierra to know I've I haven't used scare tactics with her yet. I mean, I don't, I don't see myself doing that cause I don't think that's a good idea personally. And I've talked to a lot of diabetics that are now adults and they, a lot of them have said that their parents did that when the. You know, especially like teenagers and stuff, that and that. And then it just, it just made them like more resentful, like resentful of their diabetes, you know, resentful of their parents. Like they, it doesn't seem to be a very effective tactic in my opinion. So.

Noelle: 14:17

like as parents, we, we model how they're going to approach it. And I think making sure to just educate them. Is the best way. I, I'm not going to tell them, you know, this causes you to have this. I'm just going to say how going on with you. What's what's happening and have that kind of conversation, as opposed to, like you said, these scary conversations.

Katie: 14:37

Yeah, I want them to use it as a, just a. I want them to appreciate their bodies for what they are. Right. We only get one, it's really a miraculous thing. And you, you only get one chance, so let's take care of it, and you're gonna feel a lot better if you, if you do that from the get go. All right. So let's talk about the immediate benefits of managing type one. Well I'm just going to kind of go down the. So y'all are going to get to hear me talk a lot today, Noel. I've got some questions for you at the end of the list, but if there is something that you want to add in or interject, just wave at me. Okay. Okay. All right. So immediate benefits, the number one on the list is increased. I think that kind of almost goes without saying, just because, you know, your blood sugar is high. Most people feel really, really awful. You don't really want to do anything. Your blood sugar is really, really low. You feel sluggish, clammy, anxious. Again, you just don't really want to move and do anything. And both high and low blood sugar can be an indication that your body might not be getting the fuel that it needs. Cause glucose fuels every cell in our body. So if your blood sugar is low and you don't have. Might not be getting the fuel or if your blood sugar's high you have the fuel, but your body isn't utilizing it well. So you can have increased energy. Number two is more restful sleep. So I think the idea behind this bullet point is that. Specifically high blood glucose can interrupt your sleep because it actually affects the kidneys. Your kidneys are trying to filter out all this extra sugar when your glucose is high. And so when they dump all the sugar, it takes a lot of water with it and that can fill up your bladder really quickly. that can wake you up in the middle of the night and make you have to go to the bathroom or for a little kid might make you have an accident or what the bed, so your sleep is getting interrupted. Of course we, as parents know. Low blood sugar too, can also affect your sleep because you're waking your kids up at night. It, it affects my sleep as a parent. So it's of low and high blood sugar can affect sleep. I do also want to say that. When it's kind of a vicious cycle, because if you're not sleeping well, or your child with diabetes, isn't sleeping well, can also increase cortisol levels in their, in their body. And cortisol is a hormone, a stress hormone that makes you more insulin resistant. So then it's harder to get the blood sugars down, even if you're dumping into insulin, into them. It's kind of a vicious cycle, unfortunately. Number three on the list is improved physical performance. So I just want to make a note that we're not only talking about athletes here, because I think when people hear physical performance, they're thinking of a basketball player or football player. is just for everybody. If you want to walk up your stairs easily without huffing and puffing and a sweat, you know, carrying groceries inside. This is for you too. But elevated blood glucose levels can reduce strength, stamina and speed and flexibility. So as sugar is sticky, right? We all know that, right? You spill like a drink apple juice on the counter. If it dries, it's actually sticky and that can actually do the same exact thing in your body so that extra sugar can stick to tendons ligaments, and that, you know, that can make your tendons and your ligaments rigid and not very flexible, which can lead to muscle strains and sprains. it can actually block the connection to. To nerves to muscle, like, you know, your, your nerves are constantly communicating with your muscles, making them contract and the extra sugar can actually block that connection. So it makes reaction times slower makes you sluggish can inhibit your reflexes. And then it also inhibits the body's ability to carry oxygen to our muscles which if your muscles aren't getting the oxygen they need, and you're trying to. Climb stairs or play a basketball game. You're definitely going to be feeling it for sure. So I found this interesting. He actually gave a range at what point physical performance is best and it's between 80 and 140 milligrams per deciliter. Or if you're doing mil millimoles, it's 4.5 to eight. Any thoughts so far on those three that we've gone over?

Noelle: 18:28

I can definitely tell the sleep one so much. And they're performing the physical performance. I can, you know, kids run and they play and they do that. But you can definitely tell when, when we're starting to get a little high and we're starting to. A little cranky physically because of that. And I also just love having those numbers. I feel like sometimes we have what I consider high and low is so vastly different than what someone else considers high and low, and to just have like a tangible number to be like, this is kind of where, where the best part is, is really good.

Katie: 18:59

And I think for, like, for parents that have kids who are athletic, you know, whether they're involved in just little league or school sports or whatever it is like, you know, this takes a lot of trial and error Sarah dances and we have to, and we're just a very active family. We go on bike rides all the time and we're just, we're pretty active. So I feel like this is something that you really have to figure out. What's going to work for your kid because every kid responds to physical activity differently. You know, the adrenaline adrenaline of a basketball game might cause them to spike. There's so much trial and error with it. You know, whether you're doing injections or on a pump, I think it's just, I just say that to encourage parents and others, ideally 80 to one 40 is where you want to be, but it's not like. It's going to take some work to figure out how you're going to get there. Right. It's going to, and as we all know what works one day might not work the next. So, Yeah so back to the immediate benefits, number four on the list is appetite reduction. This was an interesting one to me. High glucose can actually make you crave more food because typically when you, your glucose levels are elevated, it means your body's not getting the fuel that it needs. So that sending signals to your brain of like, oh, we need eat more food. We don't have the fuel we need to, to keep on functioning. And then as we've already talked about when your numbers are in range, it promotes better quality of sleep and the pre when you're sleeping well the hunger controlling hormone leptin is like at the level that it needs to be at, apparently when you're sleep deprived, that hormone leptin. Controls our hunger and our appetite is diminished. So that can just make us more hungry. All these dang hormones. All right. Number five on the list is brain power. You know, we've, we've kind of talked a little bit about this already, but when your blood sugar is high, it's hard to focus. It's hard to recall information you, you know, you're not as creative as you possibly could be, not as productive. There's actually studies that have shown that glucose when glucose goes up, so to your mental errors, And then as we all know, low blood, low blood sugars make concentrating difficult. It can make people feel very, very loopy and act very loopy sugar isn't getting to your brain. I don't know if people know this, but your brain only. Relies on sugar, on glucose. There's no other fuel in the body that can supply the energy to the brain. Other parts of the body can utilize other things like can break down fat and protein and all that, but your brain can only utilize glucose. So when your blood sugar is low, your brain's not getting grit in the food that it needs. And then number six is stable moods and emotions. And. Again, blood sugars are high, can make you irritable and patient. It can do some really crazy things, kind of just overall, generally negative when you have high blood sugar and then low blood sugars can, can really change your personality. Like people can either. Curl up into a corner and become antisocial and just be out of it or they can get, like, my daughter gets extremely talkative and Sarah is not really a chatterbox, but when she's low, she's just blah, blah, blah, blah. It's pretty amusing, honestly. What? Okay, let's stop here. do you have anything you want to add to those three that we just talked about?

Noelle: 22:03

I'm laughing about the, you know, the emotions, because it is so hard to tell the difference between a toddler, tantrum and numbers going out of whack. And sometimes I'm just like, what is happening? They're just like two little drunk people sometimes at their lows. I'm like, what is going on? But Ella is very much the opposite where she's like very quiet. If she's in a low, she wants to be by herself. She doesn't want you to bother her. She will tell you, like, I'm going to go get my tablet myself, do not come in here. I just want to be alone. Okay.

Katie: 22:31

Um,

Noelle: 22:31

the bed when she's loved. She's very dramatic when she's low. And when she's high, they fight like dogs and, you know, we're just. Yeah, so we're figuring it out. But I definitely, that one just made me laugh because I was like, yep.

Katie: 22:42

yeah.

Noelle: 22:42

you've got to figure out, is it because you're cranky because you're cranky or are you high or are you low or what's going on itself?

Katie: 22:48

Yup. Yup.

Noelle: 22:50

okay.

Katie: 22:50

I know Sarah was putting on her rollerblades the other day and she needs some help in her blood sugar had been running high for a little bit and You know, Sarah, Sarah can be fierce regardless. Like, you know, she's, she's a force to be reckoned with. And, and I say that in the best possible way, but she needed smell and get on those roller blades and she was just so snippy and mean, and, and I just stopped her and I was like, sweetheart, just take a deep breath. Do you think that the way you are talking to me is going to motivate me to want to help you, but like, just listen to the words that are coming out of your mouth. And she was still angry, but her blood sugar was high and she, she went out and did some rollerblading and it got better after that. But Yeah. I mean, same for, I mean, Sarah is 10, but still sometimes you kind of wonder like, wait, are you acting this way? Just because you're. a, pre-teen almost, and you're just in a bad mood. Cause you've been at school all day. Are you, is it because your blood sugar is high or both? It could be both.

Noelle: 23:45

Yeah.

Katie: 23:47

Yeah. absolutely. All right. Well, let's see, we've got next fewer illnesses. Okay. So bacteria and viruses love sugar. So when your sugar is up, they just feed on that sugar and it causes them to multiply and breed and multiply and on and on. And then w when. When your sugars are elevated, also illnesses, infections are a lot more common. And then when, if they, it, once you get one, it's harder to fight off when your blood sugar levels are high, because that it's just hard to get rid of that bacteria and whatnot. Cause it's just continuing to grow faster. Healing is next on the list. Number eight. So as we've already talked about glucose is the fuel for our. And that includes our immune system. So having tight glucose control just helps the body to heal whether, whether you're having major surgery, a knee replacement, or you just have a cut, you know, that you got playing outside it can help you to heal, to heal quicker. Injuries and illnesses, softer skin is next on the list. Number nine did not really think about this, but that kind of goes back to the, the it's called urine. Diarrhesis that we were talking about earlier, like when your blood sugar is high, your kidneys are trying to get rid of that. And so they're pulling it out of your body and it's just taking all this water with it. And so it's, it's dehydrating you and when you're, you know, then when you're dehydrated, your skin can get really dry. It can crack. And then, we just talked about, if you have cracked skin that can actually really increase your risk for, for all sorts of infections. Cause your skin is your first line of defense. in your immune system, that's the first line of defense to keep out the yucky stuff. Number 10 is healthier gums. So apparently I didn't know this, but when your blood sugar is high, I mean, it goes, I guess it kind of goes without saying, considering what we just talked about, but the bacteria that lives specifically in your gums near your teeth can multiply extremely rapidly. And when that happens, you develop all sorts of plaque. It can, of course we know plat can lead to other problems with your teeth periodontal disease. And this was not in the book. As a physical therapist, working in a hospital, your mouth is like the gateway to your heart. Like if you're, if you have poor dental hygiene, there's a pretty good chance that your heart is at risk for some serious complications. Gum disease is associated with an increased risk for heart disease, which is why, know, if you're going to have any type of surgery they always ask you about like what dental work you've had done recently, because if it was. really recently, or if they know you're getting ready to have some before your surgery, they'll like put you on a preventative antibiotic because any breakdown within the mouth can lead to serious, serious infections, which usually affect the heart. So. Number 11 is personal safety. again, high blood sugar, your reaction times are slower. It's just your mental errors go up. Low blood sugar. You're loopy. You're disoriented. It's almost like you've had too much drink. So you definitely don't want to be. clearly not operating heavy, heavy equipment, but even if you, you know, a parent is a type one diabetic, you might not want to be riding your bike down the street or rollerblading or whatever it might be. Cause you know, I'm thinking about my sons. They, they don't have diabetes, but playing baseball, like if your reaction times are slower and there's a baseball coming at your head, you want to be able to react pretty darn quickly to catch that ball. Yeah. Let's stop there before we there's three more. But did any of those speak to you?

Noelle: 26:58

The gums definitely did. Cause we actually, our dentist has, or the one of the ladies our dentist has diabetes. And so she like is super understanding that we're not going to brush teeth at 3:00 AM when we're dealing with the low, but she's also just like super great about kind of talking to us about what we need to do. And we go in three times a year just so that they can always just make sure everything is good. And so that one has always been top of mind for me, just out of fear and just trying to make sure that that's something that we a habit with and then personal safety as well. You know, there is nothing worse than when tanking and she's like dedicated to going on a bike ride and you're like, okay, we got to prep. You know, that's the

Katie: 27:39

Yeah.

Noelle: 27:39

tell them is like, we just need to have game plans is just like, okay, if you're going to go outside, if you're going to go run, we're going to do a fruit strip before, because I know I'd much rather you at one 40 down the street because I know going to drop and we're going to have, you know, a bit of a, a bit of a balance here. Not when I can always tell when we're starting to drop, because it's like, it's kind of like riding a bike, you just start that little wobble and you go in and you keep going and you're like, yep, here we go. So

Katie: 28:07

Yeah.

Noelle: 28:07

that one stood out to me as well.

Katie: 28:08

well, and just start them young with the whole being prepared thing. Like Sarah just got a new bike for Christmas and it has a basket on the front of it. And, you know, she, she loves to ride her new bike and sometimes she'll, she'll go out with me and even leave the street on her bike and, you know, she's got her phone with her and everything and, and there's been times where I'm like, do you have your bag? Do you have your, you have a couple of juice boxes and she's like, I'm just going out for like 10 minutes. Do I really need that? And I'm like, you really do. Like you, you know, Again, it's like, I don't want to stress her out, but I guess I just want her to know it's important to always be prepared. Cause you, you really just never know what's going to happen. All right, we've got three more on the immediate benefit list. This one is for the ladies predictable periods. So research has shown that women with near normal A1C is have more predictable periods which is. And, you know, especially if you're not on a birth control and you want to know are around about time when your cycle is going to start. And I just, he makes a note that like with predictability comes power, the author does. And I really liked that because it's so true. Like if you, if you can predict when something's going to happen, you can plan for it. And then you can make decisions that are more proactive, like getting ahead of the game, rather than always waiting for things to happen to you and then having to react to it. So I like that. Number 13 is cash in your pocket. Gosh, this one, this one really spoke to me. So for kids, I mean, obviously they're, most of our kids are too young to have a job, but less days missed at school and work. You know, if your kid's not in school as a parent, you're probably going to have to be taking days off of work. And you're either going to have to be eating up your PTO or not getting paid for the time that you're not working. If you are healthier, And your blood sugar is in better management. You're probably going to have less doctor's appointments. going to have less illnesses, which means less doctor's appointments. And you're going to be more rested. You're going to get, probably get better sleep, which can make you as a parent of a type one diabetic, more

Noelle: 29:59

Yeah.

Katie: 29:59

and created at your creative at your job. Or if you're an adult with type one more productive and creative, your job. And then the last one is peace of mind, which actually this one, he puts at the end of the chapter, but I, feel I flung it in here. Because there's just something so satisfying in knowing that you are trying your best and you're working hard. And, we all know that the being on the roller coaster of diabetes, where you're having these constant swings to high, to low, to high, to low. It's physically draining. I'm sure for the type one diabetic it's emotionally draining for the diabetic and the parent, and definitely mentally draining to be on that rollercoaster. all really good reasons to be motivated, to take better control of your glucose and your diabetes. So of the three we just talked about, which one spoke to you the most?

Noelle: 30:43

At peace of mind when, when you did that one in I'm like, yes, yes, yes. Just knowing that the work that you're doing is working and it's setting them up for a healthy childhood and also just like creating habits for them for the future. So, yes.

Katie: 30:59

Yeah. I want to do so I've, you know, we've kind of talked about the benefits that we've seen in our children, or we can talk about it now, but I, I wanted to make a note about, like, I feel like Sarah is a really, really good sleeper and You know, I, I, and she gets a lot of good sleep because we're, we have pretty good control, especially at night. That was like my number one priority. I'm like, I don't care what your numbers look like during the day. As long as we can get the sleep we need at night, I can conquer anything I need to conquer during the day. So. Just for us. One of the major benefits is, is the good sleep that we get at night. You know, her basil rate, we've took the time to figure that out. And then we make adjustments. We need to, to make sure she's not going too high or too low in the nighttime. So that that's huge for me. And then the negative consequence, since I've seen, especially of Sarah having well high blood sugar, we already talked about, she can get real snippety real quick. But the low blood sugar. You know, when Sarah is trying to do schoolwork and her blood sugars low, it's pretty much impossible. Like she can not just, she just cannot focus. She can't, it's like, it's like the information just isn't processing correctly in her brain probably cause her brain is not getting the glucose that it needs. So it's really just interesting to see, to see kind of the, the relationship between her blood sugar and then her performance with, with schoolwork. What have you seen in your kiddos?

Noelle: 32:15

Kind of similar. I, I think with the lows, it's just trying to teach them things is And then with the highs, they're just so frustrated that they're just. Yeah, you got to get that balance and you've got to, and also just making sure that that consistency is there for us and for them, it's just so big in all of this, just because, you said, like when we're just up and down in that roller coaster, it's just, you know, it, this helps kind of this is why you do it. Here are the facts, you know, here's everything that makes the most sense for.

Katie: 32:51

Yeah. And something that he didn't talk about in the book is just, you know, I see just the benefit of my relationship with Sarah. When things are well controlled, I'm not having to. Interrupt her life as much, and, as a 10 year old little girl, like she doesn't want her life to be interrupted. She wants to play with her friends when she wants to play with her friends and, and all that stuff. She doesn't want to have to miss dance class and all that. So just me having to kind of. Interrupt her life less frequently and nag her less frequently. I try not to nag, but you know what I mean? Like check in on her less frequently. I think that really helps to kind of protect our relationship.

Noelle: 33:27

Absolutely. I think that's such a balance when we did art therapy. One of the doctor said you guys are in such a unique position because as parents. The cause of pain and comfort when you are doing injections, when you're putting plots on when you're doing fingerprints. And that just reminded me to like both of us grace, when we have to interrupt their lives to be, you know, the pair of the helicopter and be like, you need to, you know, we need to be doing those things, but I think it was just an acknowledgement of this is what's happening in your life. And let's just do what we can to just protect that relationship. Like you said,

Katie: 34:00

absolutely. All right. We're going to move on to the long-term benefits of managing type one. Well, and this list is just about as long, but honestly, and I'm, we're going to go over it. But if I had to sum the whole list up, it really comes down to um, I don't, I don't like, especially the capillaries, which a capillary is those itty bitty, teeny, tiny blood vessels that are like, they're like the last drop off point for the nutrients and the oxygen that every cell in your body. Needs, right. It starts with these giant arteries at your heart and your heart pumps that out. And once it gets to like your toe, your big toe, you know, the, the tendon that attaches to the top of your big toe, it's this hair thin itty-bitty vessel called a capillary. And you know, we're about to find out. Not having a control can do damage to the bigger arteries as well, but it really, really comes down to those little tiny capillaries. So the first on the list is healthy eyes, which, you know, we probably all heard the term diabetic retinopathy, but the retina is the part of the. At the back of the eye, and basically it sends signals to your brain. just kind of tell your brain what you're seeing, and then your brain can interpret that from there. But when your blood sugar is high, the capillaries that supply blood and oxygen and nutrients to those, to the retina can get damaged. And when they're damaged, Your retina can't work properly and that can lead to blindness. I thought this was interesting. It says studies have shown that for every one point reduction reduction in A1C, there is a 30% reduction in the risk for retinopathy. That's huge like that. That's a huge. Decrease in the percentage of risk. And for if somebody is already experiencing like the beginnings of retinopathy, getting better glucose control and tight management can actually slow the progression. Next on the list is healthy kidneys. Unfortunately diabetes is the leading cause of kidney failure. So we, you know, we've mentioned the kidneys main job in the body is to kind of like filter out and remove waste and toxins from the, from the body, from the, blood mostly they also play a huge role in regulating your blood pressure. But again, elevated blood sugar damages, the tiny blood vessels, or capillaries that form those filters in the kidneys and that allow the kidneys to work. So when they're damaged, they, they can no longer do their job. But same statistic here for every one point reduction in A1C, a 30% decrease in the risk for developing kidney disease. And believe me, if that's not motivation enough to take care of your blood sugar. I don't know what it is. My sister is a dietician and for years she worked at the Mayo clinic and the kidney dialysis center. And it's not the place you want to be. It's not

Noelle: 36:41

Yeah.

Katie: 36:41

want to be. So how to use the insulin, learn how to take care of yourself for sure. A strong heart is number three on the list. as we've talked about, sugar is just sticky. And when you have sticky sugar running through your blood, it can cause other things to stick on the walls of your Otter arteries, like fats and cholesterol, which can then build up and form plaques. Th that plaque makes your arteries really tough and rigid, which, When they're tough and rigid your blood just can't flow easily through them that can lead to high blood pressure. And then scary is if that plaque breaks off, it can form a clot and it can block the flow of oxygen heart or your brain which leads to a stroke. Cause anytime your brain is not getting oxygen, it's considered a stroke. And then of course, anytime your heart is not getting oxygen. It's a heart attack. Let's see. Oh, so he makes a note here that, you know, the same things that you do to manage your blood Well, blood sugar. Well unless you're just a total insulin ninja and you can tackle any meal regardless of what it is. But the same things we do outside of using insulin to manage our blood sugar as well are the same things we do to take care of ourselves, exercising, decreasing, stress, eating healthier the, all those things, lower blood pressure, lower cholesterol levels, and reduce the risk for heart disease. any of those stand out to you?

Noelle: 37:58

creating healthy habits as a family, or it's just so important. And I think that such a good example for them that. The same things you're doing, like we're all doing this to be healthy. just, I had a heart and lung bypass when I was born. So I always have to be careful about cholesterol and blood pressure and all of that. And so I'm always of that and having that conversation of like, we need to be healthy because we need to be healthy and it doesn't have anything to do with diseases. It's just like, you know, this is the body you have and take care of it because you don't get a second.

Katie: 38:28

Yeah, no, you absolutely. Don't like, so let's take care of the one we have. Yeah. Sarah, every now and then Sarah, you know, if I let's say, if we're going to go out and get donuts, you know, we'll have a donut and then. Say, can I have another donut? And of course the brothers are also asking for more donuts and, you know, even before a diabetes, my answer was no like one donut is enough. In fact, I mean, I didn't say this to the kids, but um, you know, in fact one doughnut is probably too much, so let's be honest here. Like donuts are not good for you at all. But at the same time, donuts are yummy and, you know, it's, it's kind of a fine line between like, You only have one life, so take care of your body and you only have one life. So let's live it up and eat some donuts. You know what I mean?

Noelle: 39:06

Moderation all day, every day.

Katie: 39:08

Yes. But Sarah, I think sometimes she, she thinks I'm telling her no, because of diabetes and I'm like, sweetheart, I'm, I'm just saying no, because like, it's just not good for you. It's not good for anybody to eat this junk food. Like we got to take care of ourselves. Okay. Let's see. So number four on the list is adequate blood flow, which we've talked a lot about, Right? Sticky sugar can clog up your blood vessels. Sticky sugar can ruin those teeny tiny capillaries. They can get damaged. If blood's not getting to nerves, muscles, your brain, then your body just can't function. Like it need to, it needs to. Oh, when adequate blood flow, can't get to your major muscle groups. And this is actually covered a little bit more in another bullet, but it causes pain and cramping, and that's called claudication. And that can be extremely painful. Really? The list goes on and on and on. It affects every part of your butt. When you're not getting good blood flow, it really affects every part of your body, eyes, nerves, muscles, everything. Proper nerve function. So your nerves are like the electrical wiring for your body, right? They're sending signals from your brain and your spinal cord to every other part of your body. They burn sugar for energy, just like the rest of our body does. And they, but so they're, they burn sugar, but then the nerves also need oxygen and glucose to function. So. You know, they they're making our muscles move. And it's not just those reactions that we have control over, like moving our arms and legs. It's also. The autonomic nervous system, which is the, that automatic system that runs in the background all the time that we don't even have to think about. And that's controlled by, by our nerves, obviously. So things like blood pressure temperature control, your sweat, glands, digestion, bladder function, sexual function, and heart function. That's all part of the autonomic nervous system. And. Those nerves can also be damaged if your blood glucose is too high for long periods of time. Um, And that is called autonomic neuropathy. So I know we haven't experienced. And hopefully we never will, but I know like a lot of people seem to have trouble with, especially with digestion. Seems like there's that that can just slow down digestion cause the nerves aren't working properly. And, then can you even imagine, like if digestion is affected, that's going to make the insulin, it's going to make it so much harder to manage because now you're how long is it going to take to digest this food?

Noelle: 41:30

I don't know.

Katie: 41:30

All right. Let's see. Protective nerve sensation. This was a startling statistic. It says 60 to 70% of people with diabetes develop some sort of nerve damage. This, it does not say how severe that nerve damage is. It just says some sort of nerve damage nerve damage is called or the most nerve damage that you see in a diabetic is called peripheral neuropathy, which affects the feet and the legs, which is why you hear those horror stories of somebody's uncle or aunt or grandma. Lost their feet or their legs due to diabetes. It kind of starts out peripheral neuropathy starts out as numbness and tingling and can progress to just constant and severe pain. Unfortunately. So tight control of your blood sugar can prevent it from happening in the first place, but if it's already starting, it can, you can, it's never too late. You can start taking better control of yourself and. Stop the progression of it or greatly slow it down. The progression of it. What do you think let's stop there. Any of those stand out to you?

Noelle: 42:24

That's 60 to 70% stopped me in my tracks. That one was, I was a rough one to read. And it's, you know, just, again, a reminder that, you know, set these habits as children and kind of hope that they carry that on and just, you know, be mindful of these things. But yeah, that one was, I was like, oh yeah, These are the reasons we are up at 3:00 AM getting that high blood sugar in range kind of thing. Absolutely.

Katie: 42:45

Yep. absolutely. Let's see. Number seven is minimal pain, which I just put see above with the peripheral neuropathy. So take care of yourself. You'll have minimal pain, so healthy feet. Okay. So when you have neuropathy that affects the sensation of your, especially your feet. And then if you cannot feel what's going on at your feet, you know, usually our feet are covered up with shoes. If you can't feel what's going on down there, you are a lot more susceptible to injury. Even if you just have a rock in your shoe, if you can't feel that, and that rock stays in your shoe for weeks on end, it can start to dig a hole in your skin. And you wouldn't even feel it because of the neuropathy because your sensation is that. Is that bad? I just, this one stood out to me cause I just had a bunch of images just come flooding into my head with this one because I working in a hospital as a physical therapist, getting people out of bed, checking their strength. Like I have seen some feet life. I have seen some toes that are black, some feet that

Noelle: 43:47

Yeah.

Katie: 43:49

I mean, you wouldn't believe took off one guy shoe one day or sock. They're not wearing shoes in their hospital bed. I took off his sock and there was like a, a dime sized hole in his heel. And I was like, you know, was here? And he's like, what are you talking about? And he like picks up his foot and he checks the bottom of his heel and he's like, Oh my gosh, no idea that that was there. So, of course I'm, you know, got to call the nurse. She's got to call the doctor, but that's what it can do. I mean, you can literally have holes in the bottom of your feet and not know about it because your sensation is that impaired. Yeah. go ahead.

Noelle: 44:20

We do Sparties with the kids. So we like, you know, we kind of make it a fun experience of like taking care of their feet, taking care of their hands, all their old pod sites. And we just like make it a full experience because I want them to be mindful about some of these things. And I also want to like, make it a little bit fun, but know, those pots, especially because they're so little in these pods that it's, you know, their scar tissue is already built up over, you know, three years. And that's of the other things we do is we do like pedicures and we just make sure your entire body is good and everything's clean and everything's well taken care of.

Katie: 44:52

Yeah. And Yeah. paid, starting them young paying attention to the bottom of their feet because they do get ignored. I mean, think about it. Yeah, Well then of course, when you have a hole in the bottom of your foot and your diabetes is not well controlled, that can lead to infections, as we've already talked about. And once you have an infection, it makes it very hard to, to heal. And it can even lead to like cell death and gangrene, which is people have to end up having their you know, extremities amputated. So, Ugh, such a horrible thing to talk. I'm sorry, I'm sorry, listeners, but you do need to know. All right. Number nine on the list. Solid memory. I did not know this. This was interesting to me. So it's recently been discovered that diabetes is a risk factor for Alzheimer's. If there's one disease that I don't want to go down with in this life, it is Alzheimer's. So gosh, it can just recap it. The person suffering from it and the family members too. So but you know, in again, back to the capillaries, it's it usually comes down to those teeny tiny blood vessels that feed the brain, the glucose, it needs, they get damaged and it just, it doesn't have the nutrients it needs to, function properly. So this was interesting to me also chronic high blood sugar is associated with slower processing processing speed and lower verbal intelligence. But to me, it's kind of like, which came first, the chicken or the egg, because I feel like chronic high blood sugar is probably not what caused the lower verbal intelligent. It might, it might be correlated with it, but I feel like there's probably a lot of other socioeconomic factors going on there with You know, you might, you might not just have access to the education you need and all those things and then severe and repetitive hypoglycemia. So if you, you or your kid are constantly having low blood sugars, severe low blood sugars, it's correlated with memory and learning deficits in children. Number 10 on the list is flexible joints. So we've already talked about this, right? That sticky sugar can stick to your tendons in your ligaments causing them to become stiff and rigid. It can also stick to collagen and collagen is the protein that's found in bones, cartilage, and connective tissues. So again, all those tissues just get thick and hard and rigid, and it can cause a lot of pain and stiffness in your joints. Okay. This is a big one. Number 11, good mental health, right. So. Depression is three times more common in adults with diabetes than it is in the general population. That statistic was only for adults, but I would venture to say it's probably true for kids to just my guests. They're kind of unsure what causes this, right? Like, is it related to their stress of dealing with a chronic illness? Could actually be due to changes like biochemical changes when your blood sugar is too high or too low for long periods of time. And then the fluid surrounding the brain, blood sugar, the sugar, you know, blood sugar being too low or too high or all of the above. But there have been studies that have shown that with better glucose control people report an overall higher quality of life, improved quality of life in many different aspects. So improved physical quality of life, emotional and just overall health. Successful pregnancies is number 12 on the list. So this is just so sad to me that like I apparently back in the day they advised women. Who had type one to not even attempt to have children. So I'm really glad that's changed. I'm really glad they figured out that women with type one can have very successful pregnancies and multiple children. But it is important to have good control during your pregnancies because it reduces the risk for both the mother and the baby for lots of different things, heart health, lung health All right. Last on the list. Optimal growth muscles and bones get longer and grow better when your glucose levels are well controlled. Poor glycemic control delays pubertal development and reduces one's final height. So your kids were really young when they got diagnosed. So you might not have noticed this, but when Sarah. After Sarah got diagnosed and started on insulin, she grew, it seemed like a foot. I mean, the, the girl just started growing. She gained 10 pounds. And it, you know, it's one of those things where you look back and you're like, how did I not notice that she was this skeletal, teeny tiny thing. So. Anyway. I mean, I, you know, she's a kid and so she's going to be growing anyway, but we, saw an immediate change in her body's ability to grow. Once she got on insulin and her and her glucose was being well-managed.

Noelle: 49:10

Yeah, we, I was going through old photos the other day and I had that same realization. Like I think Ella put on five pounds within. a month and a half and she has a little, so it was very noticeable, but it's something to keep in mind as they grow, especially because like, you know, puberty numbers I heard are a whole nother level. And so just being mindful of their growth and all of that, it's just important.

Katie: 49:36

Yeah, Absolutely. And I guess I just want to say, you know, we, we want to have good control all the time. Right. But let's be honest. That's just, there's just some days that are just awful. And these, especially the long-term benefits that you can see, or, or you could say the long-term complications, like. Those are usually in cases where your glucose, your blood sugar has been running high for a very long time. I mean, right. All of our kids' blood sugars were probably running high for at least a month before they got diagnosed. So. You know, th this is in the face of diabetes. That is just very out of control. That's not to say that damage isn't being done when our kids have really big spikes in their blood sugar. But I guess I just want to say that to put people's mind at ease that like, this is over a long period of time. Do you agree?

Noelle: 50:24

Absolutely. Yeah.

Katie: 50:25

Okay. Last question, before we wrap it up today. So I feel like this list can really put P parents or just people living with diabetes into a quick panic real quick. Yeah. And in fact, I've heard a lot of people say, you know, somebody will post this book on social media and be like, I'm really loving this book, if you want a good book recommendation. And there's always people that comments, I couldn't get past the second chapter. Right. Have you seen that?

Noelle: 50:51

Yeah.

Katie: 50:52

They're like, I couldn't do it. I, I was too anxious, so I want to know how you deal with the worry. So how do you keep from worrying about all the unknowns of the future and what could, what could potentially happen?

Noelle: 51:03

Yeah. I mean, I think it's giving yourself, like giving your child grace every day. I mean, we have all the tools to be as successful as possible and sometimes just acknowledging like today was a funky day, but the good and bad news is with diabetes. You got another day right behind that. So, you know, just, just having that, just reminder that, you know, You can have a good day. You can have a bad day, but we have all the tools that we need to make those changes. And that there's so much technology that they didn't have for some, especially for some of these, like, long-term scary, scary things that, you know, we, we now have a bit more control and we're now able to be a bit more mindful about how to better manage our children and their diabetes and give them a little bit of their own ownership, which I think wasn't quite there 10 years.

Katie: 51:49

Yeah. I, I, same. I have to give myself a lot of grace. I, you know, I we're, we are a church go and family and everybody everybody's probably like, oh no, she's about to get all religious. But whether you believe in all that stuff or not, there is one Bible verse that I really love. It's Luke 1225 through 26. And it says, who of you by worrying can add a single hour to your life since you can not do this very little thing. Why do you worry about the rest? And I have to remind myself of that all the time, like worrying about what could be or what could happen. 20, 30, 40, 50 years down the road is not going to change anything about. Today, you know, it's not gonna, it's not gonna add a single hour to my life. It's not going to change a thing. it, even without diabetes, like anything could happen at any point in time. Right? I, I won't even say it cause I don't want to freak people out, but you know what I mean? Like you just never know what's going to happen in life. What life is going to give you? You don't, you don't know. And so I just feel like there's no sense in worrying I'm doing my best. Right. And I know that. And, and so I know that I'm doing my best. That's the that's literally the best I can do is my best. And. I can't worry about the future because it's not going to change anything. And I'm just draining the joy from today. If I'm worrying about tomorrow all the time. that helps me a lot.

Noelle: 53:07

Yeah, I think that's something we all need to remember.

Katie: 53:09

Yeah. All right. Well, Noel, I have loved chatting with you. I feel like I need to have you back on some other time just to talk about like life in general with type one, especially with those two toddlers, let's do that. Maybe, you know, let, let let's let's schedule something sometime. Cause I would love to, uh, yeah, I have a mom coming on pretty soon who has three kids with type one. But all of her kids are a lot. They're like. Mid to older teens and then like, I think eight or so. So I would love to hear about it from the toddler mom perspective.

Noelle: 53:40

Yeah. It's I admire all of you guys cause you're like the big kids are just a whole nother level, but yeah,

Katie: 53:46

Okay. All right. Well, you have a fabulous day. Thank you. for coming on. Thank you. so much for your time. You're welcome. That's it for our show today. I hope you found that helpful. And I invite you to use all that information as motivation and encouragement, rather than getting overwhelmed and scared by. Remember guys, we only get one life and one body. So let's take care of them. Well, again, get your copy of think like a pancreas by Gary Shiner today. So you can follow along with us. There will be links in the show notes for that as well as a link to Gary's company's website, integrated diabetes.com. If perhaps you need help with your diabetes management in a more personal one-on-one setting, take a look and join us next week for chapter three, called beyond the basic. All right. I will chat with you soon until then stay calm and bolus on.