#540 Diabetes Variables: Stress

September 10, 2021Scott Benner

Diabetes Variables: Stress

Scott and Jenny Smith, CDE share insights on type 1 diabetes care

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends, and welcome to Episode 540 of the Juicebox Podcast.

Jenny's here today to do another diabetes variable with me. And today's topic is stress. While you're listening today, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, please always consult a physician before making any changes to your health care plan for becoming bold with insulin, know this as well. Jenny does this for a living. If you want to check her out. Go to integrated diabetes comm you can hire her. Hey guys, please don't forget to go to T one d exchange.org. forward slash juice box and fill out the survey you'll be helping people with type one diabetes and supporting the show. If you do that, it really does just take a few minutes. It's HIPAA compliant. Absolutely anonymous, you do need to be a US resident who has type one, or is the caregiver of someone with type one. But otherwise, if you haven't done it already, please go fill out the survey just takes a few moments.

This episode of The Juicebox Podcast is sponsored by the Contour Next One blood glucose meter. Head over to Contour Next one.com Ford slash juicebox. To find out more links to Contour Next One comm forward slash juicebox as well as all the sponsors are right there in the show notes of your podcast player. We're at Juicebox podcast.com. When you support the sponsors, you're supporting the show, so allow me to thank you right now if you've used any of those links, or if you're considering using any of them. Alright, let's get to Jenni. How does stress impact blood sugar's?

Jennifer Smith, CDE 2:12
Do you want to talk or should I?

Scott Benner 2:14
Well, I mean, it seems it seems obvious, but it's not because I've spoken to people who get stressed out and their blood sugar's go down. So I'm wondering what you've seen from people on both sides of this.

Jennifer Smith, CDE 2:30
I've seen more people who have an impact of stress with a rise in blood sugar or an increase in their insulin need. It isn't to say though, and a good friend of mine, her level of stress, just like her level of like adrenaline rush causes her to need less insulin. Okay, like race morning, she is cutting her insulin down while the rest of us are like rage bolusing

Unknown Speaker 3:02
blood sugar.

Jennifer Smith, CDE 3:03
She's like, what do you guys all doing? Like you're sitting at like 82 like going down? down this high. Right? But yeah, I mean stress the same thing. For the most part stress will cause a rise in blood sugar relative to that like mental strain. It's kind of putting I mean, and then you have to determine the type of stress right? Is it a mental stress? Is it something that you're really working through? Is it a lengthy stress like several days worth of something happening? I mean, one stress I can say personally really increased my insulin needs was when my dad passed away, okay. I mean that week with going to family helping my mom out with a week and a funeral and everything in the process. I was using like a 75% temporary increase in my basil. Okay,

Scott Benner 4:00
well, it was a lot I'm looking here and long term stress can increase depression caused headaches heartburn, insomnia, weakened your immune system. Make your breathing rapid puts you at a risk for a heart attack. It can bring up your blood sugar, your blood pressure, pounding heart fertility problems, stomach aches, low sex drive, erectile dysfunction, miss your periods, tense muscles and high blood sugar. Yes. So when you're under stress, it is not healthy for you know, that's obvious, but it actually can impact your blood sugar. And I don't know if people would consider that or not.

Jennifer Smith, CDE 4:37
Yeah, and you know, in terms of that effect, you also then have to look at the length of time that the stress is going to happen for and if it's already impacted these other health pieces. If you've ever been under significant like work related stress in the past year, then you may have caused injury really too many other pieces. Have your body which until they get healed is likely causing inflammation and inflammation in and of itself also increases blood sugar increases your insulin D input increases resistance to insulin. So stress is bad.

Scott Benner 5:18
And well, I guess what I'm thinking is, like we talked in other variable episodes about, like, you know, I said, My daughter gets into the shower and her blood sugar goes down where a lot of people, you know, would say that might be heat, I kind of think that she's relaxing. Sometimes I think of it that way, like, and can you just chill out? And is that possible in our society, the way the way our days are set up, right? Like this is way more about, you know, your general health than it is about maybe blood sugar health, like sure. stressful moments can make your blood sugar rise, you should be aware of that. I've seen notes from people who have car accidents fender benders, right? And boom, you know, their blood sugar goes up, you think, well, that might be adrenaline, but then it stays like that for hours and hours. And if that's

Jennifer Smith, CDE 6:03
more that fight or flight, that's, that's

Scott Benner 6:05
okay. But yeah, I mean, I realized that this is somebody telling you be generally healthier, and you'll be generally healthier, which is obvious. But it's, um, stress can cause your liver to release extra sugar into your bloodstream, which over time puts you at risk for type two by diabetes. This is telling me here, meaning that if you're a long term stress, you're hurting yourself long term. Right? Wow. So is I have to say I use a breathing app on my phone. It's really helpful. I mean, just got one on my watch. Yeah, yeah, a couple times a day, it, it pings me, and I spend 60 or 90 seconds doing some sort of in and out breathing. It's kind of nice. I mean, I'm sure it would be better if I moved to Wyoming and lived on a hill and a cabin, I'm sure I'd be less stressed. Although I gotta be honest with you. I'd the entire time I'd be like a bear is about to kill me. I'd be incredibly stressed out by that. But you have to find a way to overall lower your stress. But in the moment, so in the moment when it happens. Do we Bolus weren't

Jennifer Smith, CDE 7:13
in the moment for stress is kind of like the adrenaline Bolus consideration, right? Do I Bolus for the stress in terms of like the car accident example. And my blood sugar's now shooting through the moon, you could Bolus at least minor amount. Because obviously, the incident as well as the skyrocketing blood sugar is not going to create anything that's more even flow. It's just gonna keep increasing your anxiety.

Scott Benner 7:45
Let me ask you a question. A personal question before we wrap this one up?

Jennifer Smith, CDE 7:49
Yeah. Do you?

Scott Benner 7:51
Are you so in tuned with yourself? That you always know because it's unfair, like you're here, like this front facing image of you is Jenny, who knows about diabetes, but you're a person to like I actually want to do and I want to interview completely about burnout just one day, like, like, away from all this, like the baby stuff. And but if you're stressed out, if your kids are struggling with something, and your husband's being a jerk, and somebody else is doing a thing, like Do you notice that? And how quickly Are you able to say to yourself, my life is more stressful right? Now I need more basil? Like does that in a real world situation? Does it work?

Jennifer Smith, CDE 8:34
in a real world situation, if you have enough awareness of everything that's happening, it can work to use a temporary increase to basil. I mean, many people I know who are using a pump, you know of whatever kind of pump you're using, have either a basil profile that may be termed stress, or they have a temporary basil kind of setting that's specific to stress increased need. I've got an override that's already programmed for stress. Thankfully, I don't use it very often right now. It has happened. I mean, in terms of like life, things happen, you know, somebody might need some additional help in the family. And beyond that you don't have time to take off of work. So now you're juggling and juggling and sleep, you might get three hours a night instead of your eight hours a night and that can definitely increase you know, but personally, yes, I've, I feel like at this point, I know myself well enough to be able to say my kids spilled the milk all over the table. That's not going to cause my blood sugar to go to 250 I'm just gonna tell him to get a cloth and clean it.

Scott Benner 9:49
I asked because I've become much more in tune with the idea that people have anxiety since I've been doing the podcast because I am a person I get up in the morning. You know what I'm thinking about nothing. I go do the thing I'm supposed to do, I do it as well as I can, if it works out great. If it doesn't, whatever, you know, and I move on, right? But I see my wife get out of bed. And she, you can like, look her in the face. And she's going through a checklist already. She knows what's happening today. And if what's happening today is something she feels like she can't keep up with. It stresses her out. And I've just talked to too many people at this point, who live in that reality. And I just wonder. I mean, it's, it's too simplifying to say to them lower your stress, because they're like, yeah, da, thanks. I can't, you know, so. I don't know. Just

Jennifer Smith, CDE 10:41
I know myself, you know, in terms of like, as you asked me, personally, I know myself enough to also say that I'm kind of like your wife in terms of like the morning time. I'm German. I'm a little bit like, like strategy, figure it out, apply it kind of you know, so in the morning, especially on the weekdays, I know my checklist of things, I have to do this, I've got this many people to talk to, I've got to attack emails, I've got a project, I've got a podcast with you. I've got, I've got this checklist of things. And I keep moving through it through the course of the day. But a stress to me, that would increase like my need for insulin overall would be something major happened to like a family member, and it's blowing all those things on my checklist, like they're now off the list. And like this is an immediate and I'm like, okay, must assess and redo and plan differently. And I

Scott Benner 11:43
only worry about my kids and my wife like that. I don't worry about anybody else. Like when I get in bed at night, I can see Kelly going through that like wind down thing she does. Like I feel terrible. Because all I'm really concerned about what is like are the blankets where I wanted to be and do I have my pillow flip the right way and is my phone on its charger. And once it is on like goodbye. And then I'm just asleep. where she's, you know, trying to decompress and trying not to think about tomorrow. And I feel terrible for anyone who's caught in that because it really is, it really seems like a place he can't get out of

Jennifer Smith, CDE 12:20
you. In terms of like overall stress that's I use that that breathing app like you talked about, I use that because especially in the evening time I really tried to stay away from like, technology itself, right within about 30 minutes of actually like getting in bed and trying to like fall asleep. Because that I found is a big impact for me. I have like one of those mindful adult coloring books.

Unknown Speaker 12:50
adult coloring book, it's just kids,

Scott Benner 12:56
let me clarify for Jenny. They're there. Because my wife actually has these two. They're very intricate, pretty pictures, not naked people having sex. I got your

Jennifer Smith, CDE 13:05
intricate pretty flowers and deer and fish. And yes, there was funny to watch you catch yourself. Anyway, but things like that to kind of do that decompress. And while my brain has an idea of what's coming in the next day, I'm really not too like focused on it until the next day, because I've found that I don't sleep.

Scott Benner 13:27
Here's an interesting question. And I will let this go after that. But say I'm pre diabetic, right? I'm like, type two diabetes is coming for me. And I'm also an incredibly anxious, stressful person. Is there a world where and I'm not pushing medication. But if a doctor prescribed like, like an SSRI or something like that, to take care of the anxiety that as the anxiety went away, and the stress went away, the blood sugar impact would go away as well, to some degree, I mean, could you get some win out of that?

Jennifer Smith, CDE 13:58
You could get some win out of that. I mean, we always try to encourage people in terms of like lifestyle change to actually make a lifestyle change rather than a medication addition. But yes, in all, whatever type of stress reduction you put into play, could have enough impact that that person on the path that they're on whatever stress management strategy they're putting into place could make them turn the road down the path that's going to prevent that now they're going to have to continue whether it's now I start taking a mile walk every morning, because it decompresses me, I think through what's coming for the day, and I'm ready, maybe they choose to start eating broccoli now rather than a handful of potato chips at lunchtime. So there might be other little things that they could do along the way that impact the stress that's on their body helps them to feel better or decreases the chance of type two or any other health condition itself, which in and of itself is a decrease for anxiety as well. Right? If you know you're doing something good to prevent something,

Scott Benner 15:05
even if it bolsters you, I have to say it would be criminal Not to mention in a even in a short conversation about stress, that activity, you know, of any kind is, is really good for your mental health, it just really is. So, okay, well, thank you very much. Friends, if you're enjoying the variable series, I'm going to list all of the available variable episodes in just a moment. But first, I need to tell you actually, I want to tell you about the Contour Next One, blood glucose meter, you know, bare bones, simple cell, it's really, really accurate. And that's incredibly important, especially in a world where sometimes we just get the meter that someone gives us, you can actually make a choice, you can choose an accurate, reliable meter. And the Contour Next One, in my opinion is exactly that. Not only is it easy to carry, easy to read, easy to see at night, but it has Second Chance test strips. So you can go in for some blood, get some but not enough and head back for the rest without impacting the accuracy. We're ruining the test trip. I don't know what else you want in a blood glucose meter. I mean, if you want it to be Bluetooth enabled so that you can launch an app on your phone and see your records. It does that. And it works fine if you don't want to use the app. So there's a lot of flexibility in there for you lets you choose. I mean, really, it's just a great meter. So why don't you check it out, it's super simple to look into Contour Next one.com, forward slash juicebox. He may be eligible for a free meter, there's a test trip savings program that you might find eligibility in. And it's possible that all of this could cost you less in cash than you're paying right now for your current meter through your insurance, I think I'm not sure. But it could work out that way. And if not let your insurance pay for Contour Next one.com forward slash juicebox. If you have to have a blood glucose meter, you might as well get a good one.

First, I want to thank Jenny for lending her expertise to the shell. Don't forget, you can find her an integrated diabetes calm. I want to thank you for listening. And I'd like to remind you that there are others in this variable series. trampolines, temperature travel, exercise, hydration, food quality, leaky sites, or tunneling video games and today's stress. There's one coming every week, this variables list is compiled by listeners just like you, we did it over on the Juicebox Podcast Type One Diabetes private Facebook page, if you're not a member, you should go check it out. We do stuff like this all the time over there. Listeners just like you made a list that is so long that there'll be variables episodes coming for ever I feel like but for now, just once a week, I'm gonna let you go in just a second. But if you're not part of that Facebook group, I wish you are. It's private. And it's full of people just like you. It's a matter of fact, I think this month, September 2021, I'll be celebrating 4 million downloads of the Juicebox Podcast. And I think I'm gonna do it with a like a q&a, I'll probably just jump on Facebook Live, or do it through zoom or something like that. And if you want to know about that, I'll be announcing it there. So I hope you'll become a member. There's you know, it's absolutely free, obviously. I mean, I hope that's obvious Juicebox Podcast, Type One Diabetes to private group, you'll have to answer a couple of questions to prove to the algorithm that you're a human being. And then after that you'll be in and talking to other listeners, just like you. Hey, thanks so much for listening, and for supporting the show. I really appreciate it. I'll be back soon with another episode of the Juicebox Podcast. Please continue to share. Subscribe in a podcast app, tell a friend. Leave great reviews wherever you listen, that kind of stuff is all very supportive and super, I mean helped it. Take the T one D exchange survey. Support the sponsors. All right, that was choppy at the end, but you get the point. I appreciate you. Thank you so much for supporting the show. I'll be back soon.