SPEAKER_01 0:00

I think that the the superpower type one diabetics we need to understand is being able to adapt to it and pivot and and understand what's going on.

SPEAKER_02 0:08

But also I've learned since you know being diagnosed as an eight-year-old 30 plus years, um to not always follow the rules but to chase results. And it doesn't mean to be a rebel, but like what works for me as my own personal experiment to hit those targets based off things I've been told or not told. Type one's not our handcuffs, it's our fire of why we should do it better.

SPEAKER_01 0:32

Keep going and keep up the fight. What if type 1 diabetes had more than meets the eye going on? And there's a reason that your blood sugars have been a little bit crazy, but it's not something you can see. I want you to imagine an iceberg out in the the Arctic, right? Boats don't go right next to the iceberg, they steer way clear of it because they've learned their lesson from the Titanic, because there's often more underneath the surface that we cannot see. See, with type 1 diabetes, I wanted to bring in Coach Kelly Schmidt today, and we're going to discuss the unseen variables of type 1 diabetes, the things that make it feel crazy, but it's because you can't see them. So uh without any further ado, one of our coaches on our team and really an amazing human. Kelly, thank you so much for coming on today.

SPEAKER_02 1:16

Yeah, thank you for having me. I'm excited to be here.

SPEAKER_01 1:18

Absolutely. So let's talk about the unseen. And what I love about this discussion is that you and I have very different versions of this and uh kind of stemming from our specialties. So can you give us a little bit of an intro on who you are, what your specialty is and what you're passionate about within type 1 diabetes?

SPEAKER_02 1:36

Sure. Um, so I'm Kelly Schmidt on social media and so forth. I'm known as diabetic dietitian, but that all came to me when I was only 17 years old. So when I was 17, I realized I really wanted to make a difference in those with us with type 1 diabetes. And it wasn't because my own type 1, a lot of it stems back to my dad's story where he is still alive today, but um dealt with a lot of the complications. And um, since that moment that year, that long ago, um, I've been on a mission to help those of us with type one, but our whole body health, not just what our blood sugars read, help to understand what else is going on. Um, and so I became a dietitian. Along with dietetics, I'm also involved with other things and have other certifications from yoga to strength to functional medicine. And I really love looking at data, but also listening to individuals and myself and symptoms and trying to uncover trends to identify like what are the real needs? Where could there be inflammation? Where could there be optimization? Where could there be more support beyond what's just on the plate?

SPEAKER_01 2:40

I love that. And there's such a story behind, I think, most specialists, especially that live with type one. And it's so fun to hear where those backgrounds come from, why we're so passionate about these things. Uh, for those watching, if we haven't met, my name is Matt. And I also had a bit of a challenging, traumatic start to my own specialty where uh I had a near-death experience with a bad, bad low in Europe. And uh really it just shattered my mental confidence in my diabetes management and put me in a position where I was scared to walk outside. I was I was nervous about going low that bad and uh totally just shut down my whole life. And to go from there to years of experimentation and then becoming a globally ranked Iron Man is just I don't even understand how that happened, fully transparent. But um, that's that's the excitement behind today is like how do you make those transformations and how do you get to the root cause, as Kelly's gonna talk about a bit today as well, to create alignment, you know, in your diabetes management. So um we'll go back and forth a little bit, Kelly, but I'd love to hear uh maybe what is a a common misconception about the unseen within diabetes? What could be causing blood sugars to be crazy?

SPEAKER_02 3:51

I think common misconceptions would be a lot of people want to correct very few variables when there's a lot more going on. So individuals if blood sugars are high, really low, they'll like to identify just food, exercise, or insulin. But maybe it's related to stress, maybe sex hormones, maybe the time of year, maybe um what might be going on with their thyroid health, you know, how well are thyroids functioning or if there's any overlapping autoimmunity there can also influence um insulin resistance and more. So I like to zoom out. I like to really listen to the person of what's going on and kind of uncover what variables need further explored.

SPEAKER_01 4:38

So uh I'd love to stick on this side of the topic first and I'll I'll explore mine kind of in the second half of the episode. But looking at um, we'll start with labs because it sounds like you've mentioned a few of those pieces already. What are some key markers that people don't even think about?

SPEAKER_02 4:54

Yeah. Well, with type 1 diabetes, I think one that people don't naturally think about is vitamin D. That's one I really like to look at immediately because if that vitamin D, the range is so wide, the range can be 30 to 100. And if someone's 31, 32, the doctor will say, you're fine, you're great. And I've had a lot of clients where their lab's that low, and with a vitamin D level that low, it can actually be related to insulin resistance. And if we can be more sensitive to insulin, there can be more ease with blood sugar control. So I like that lab. That's a go-to, easy one that's commonly drawn. Um, maybe not enough. I like that drawn both seasons, winter and summer, if not all four. But often it's only drawn once a year or not even every year. So I like looking there. That's an easy one, and that's an easy one to remember. An ideal sweet spot for insulin sensitivity to fight that insulin resistance when it low is low. In my opinion, would be between 50 and 70.

SPEAKER_01 5:54

It's this is such a helpful conversation because a lot of uh I would say medical settings create this binary of you're good or you're bad. And it's like, is it getting worse though? You know, like it could be good, but getting worse, or like you said, on the verge of bad, you're 31. Ah, you're fine. It's like, no, there's more than meets the eye. Um, this is slightly off topic, but I've heard, and correct me if I'm wrong, is it true that there's a link between vitamin D deficiency and a diagnosis of type one? Or is it not so much causation but correlation?

SPEAKER_02 6:26

I think I think there's more to explore there for sure, because lower levels of vitamin D can be can make someone who's susceptible to type one to be even more susceptible. Um, right away, I'm immediately thinking of my two kids. And I do make sure I give them vitamin D for this specific reason. But I don't know if I would say low vitamin D can cause type one. I think it's just important for autoimmune disease to have it at adequate levels.

SPEAKER_01 6:52

Yeah, absolutely. Well, and looking at um labs, I know you mentioned vitamin E is an important one to watch. Are there any critical labs that are being missed by doctors, endos, anything like that that should be added?

SPEAKER_02 7:06

How many can I list? I'm just kidding. Um, there's quite a few I like to look at. And part of this probably draws on some of the functional medicine training I have, which will be in more depth. And usually give a list to our clients and my clients of labs that I like seeing, they take them to the endo, and the endo is like, no. Um, and I don't usually anticipate they'll get all of them drawn, but you know, I there's a few buckets we can go into. Obviously, we're gonna have our A1C, we're gonna have our fasting glucose, we're likely gonna have the kidneys done every six months or so. But I'd like to jump to celiac disease. You know, upon diagnosis today, individuals diagnosed with type one will also or should be tested for celiac, and that should be ongoing every five to 10 years. And I don't believe that's happening because a lot of times I don't even see myself getting that option to be tested. So there's one. Um, other areas would though be the thyroid. I love exploring the thyroid, understanding the thyroid, especially in women in transitional seasons from pregnancy to puberty to perimenopause because the thyroid's more at risk of you know going too low or too high, but it's also a risk with type 1 diabetes. So an endocrinologist will only look at something called TSH and T4. But there's about six more labs I'd like to see to understand the true health or what autoimmunity is present there. I like to know what antibodies are present. So if there's autoimmune activity, is there something we can do to calm that down? Um, and then I would jump over to iron. I like knowing iron energy levels. Um, is that related to someone's diet or is it related to digestion? And then I also like looking at um B vitamin status, you know, like vitamin D as in dog, vitamin B12 can also be typically low in some individuals with autoimmune disease. And um, sometimes it's not just supplementing with B12, it's helping our cells absorb that B12 better. And there can be protocols and so forth designed to support that. But um, endos only have so much time, they have so much guidance, and um, I don't fault them. So I just want to make sure I'm not like faulting these doctors, but I think there's just um guardrails in the way to help someone with their whole body health. And at the end of the day, that's what I'm on a mission to do.

SPEAKER_01 9:23

Absolutely. Well, you touched on a couple of things. One is absorption. So uh I know we've talked about this briefly. I've had a couple of interviews too with uh some doctors who kind of touched on the importance of what's being absorbed and stored, not just what's in your blood and how the labs test your blood, but not your tissue. Like, that's really interesting. You know, is it in your system but getting flushed out, or is it actually getting stored and saved? Um, but beyond that, also everybody pause, go watch it again, because even I was like, this is a foreign language. Holy cow, what's all the stuff she just said? So good, but I think that it's so easy to get lost in what labs to get, how to interpret your labs. So a lot of times we're like, whatever my doctor says, you know, and it's like it's so hard because even you, because so everybody who doesn't know Kelly coaches our clients as well. So she's one of our coaches, she's amazing. And I've gone to Kelly and I've been like, Kelly, what should I do? What should my labs look like? And she told me which labs that I should ask for, and my doctor did reject them. He was like, You don't need those. And the reasoning was you don't have any symptoms yet. I'm like, I don't want symptoms, right? Like, let's fix it before it's an issue. So, and this is an unpopular opinion, um, or I guess just more rare than it should be, but I fired my doctor. I was like, All right, then you're out. And I had him for like 12 years. I really liked the guy, but he was unwilling to help me avoid future problems because they weren't currently a problem. I went and found a new doctor. He gave me the labs in a heartbeat and was like, Yeah, you should be preventative with your care. And I think that's a critical shift. Um, now, all that said, so labs, big bucket. Obviously, you've touched on a few critical ones, and I love that. What else is unseen um in terms of like an impact on blood sugar?

SPEAKER_02 11:09

Yeah, um, I that the thing that's close is probably a life I'm in, and that's a bit of a sandwich generation, and that's where I have middle schoolers, and then I have parents that need more support than ever in my life. And that's that's something you can't really put your finger on, and it's daily moving the needs and so forth. And and what I'm getting at, I guess, is subconscious and conscious stress, and stress is so influential on our blood sugars. I have a client, she was mentioning me just before this interview, and she was like, Um, I got back my um osteoporosis information, and she's like, What I'm doing isn't helping my bone health. And and she just has this loop script in her head going over and over. And while she's taking action, she just has the same stressful script going through her mind, and that's heavily influencing her numbers. Um, so stress is dramatic. Um, sex hormones is dramatic as well. And I mentioned the three seasons in a woman, and I talk about sex hormones and um uh sex health for men and women um in our group calls, but that's a big deal as well from estrogen, progesterone, testosterone in women, but also those in men, including DHEA. So our energy, our mitochondria, there's a lot of things that usually aren't covered in those 15-minute appointments. And and while I'm saying fancy words and fancy hormones, it's how are your energy levels? How is your stress? How is your sleep? How are your habits? How's your exercise? And are you eating more real food than not? And that's the basics to lean toward, lean towards. But then what can support those can be dug up by looking at labs. So if people are feeling overwhelmed with the lab part, just think about go back to basics. Um, where can you optimize, but also analyze how you really are, know thyself. I think that's the most powerful thing we can do for ourselves is know thyself, know what's going on, know what feels wrong, and start to piece together the breadcrumbs from there.

SPEAKER_01 13:06

Absolutely. Well, and you touched on food too. So I think this is uh a little bit of something we can unwrap. It's obviously a very big topic and uh a core focus with type 1 diabetes. Everybody thinks, what should I eat to stabilize my blood sugars? And it's like, well, there's more to it than just that, which we know, but um there are certainly some truths behind that statement as well, because you can eat foods that will support healthier blood sugars. You know, if all you have is soda and cookies, you're gonna have a bad time. Right. Uh, I don't even know if I could time my insulin perfectly to handle soda. That's so hard. So looking at healthy choices that people can make, but also that are sustainable. I think people hear healthy food and they're like, I can't eat cardboard the rest of my life. It's like, no, there's good food out there, you know. Um what comes to mind that people can toss into their meals that has the biggest bang for their buck, so to speak?

SPEAKER_02 14:00

Yeah, I think a lot of new companies, including those who are putting CGMs on non-diabetics, such as Levels or even, you know, um Abbott and DEXCOM, they have these CGMs for non-type ones. And people are more aware of what influences my blood sugar. And the big saying coming out of that, and we've known probably since we've been diagnosed, is no naked carbs. And that's a term of foods that are carbohydrates. So think fruit, grains, sugar, root vegetables. I feel like I'm missing one, maybe beans to a degree. Um, we want to make sure we're not eating those in isolation. So if I'm eating a banana, that'll spike me faster than a banana with something like clothing, hypothetically, metaphorically, peanut butter. Yeah. So protein or fat paired with those carbohydrates can go a long way. Um, food sequencing. I was actually reading, I live in Columbus, Ohio, a Mac or our local magazine, and it was like food sequencing was like the nutrition article. And I was like, this is awesome.

SPEAKER_01 14:57

That's advanced for that.

SPEAKER_02 14:59

I know. Um Columbus is trying to get healthier, I guess. But um, if we pair our protein or vegetable first when we eat our meal, granted, we're not eating a soup or smoothie, we can't really adjust the macros consumed there. But if say I'm having chicken and some veggies and potatoes and a dessert after, if I have the chicken first, then the veggies, then the potatoes, then dessert, it'd be very different than if I had potatoes, veggies, dessert, chicken last. And and research will show if you sequence that more favorably, protein first, protein first, your blood sugar can improve post-meal by 20 to 30 percent. So that's a good strategy. And then I would just say no naked carbs. And people say, this is a blood sugar-friendly meal. And it's like, well, what how's that defined? And and in my opinion, it's what I use a lot in our our group calls is PFFs. So make sure every meal has protein, fat, and fiber. Um, and I'll go a long way, just not for your blood sugar levels, but the microbiome, your full body health, um, and more.

SPEAKER_01 16:00

It's so unfortunate that that acronym sounds like scoffing. No. It's true, it's so helpful. Uh I will add too, because and I agree with you, and I will say a lot of people think eat this way always. It's like the template, and uh nothing else changes. Like that's the one thing to focus on. Whereas context matters. So if I eat proteins, fats, and fibers first, but I'm currently at 60, a lot of people are like, so I still pre-bolis, right? It's like, no, you're currently low. You don't want to give insulin a head start. So I think that's where a lot of people get lost in the advice is that they are looking for templated advice of what's the one food. Hey, you should eat eggs. You know, like what's the one thing to eat? What's the magical exercise? What is the pre-bolus time? It's like there is no standard because we're all different. And then each time we change something, somebody doesn't like eggs, and so instead they eat egg whites. Well, now you've lost the fat, so it's not as slowed down with digestion, therefore the pre-bolus changes, you know, and it's like I think that the the superpower type one diabetics need to understand is being able to adapt and pivot and understand what's going on. And for those who are willing to dig into the understanding piece, like we talked about the iceberg at the beginning, that's the beneath the surface part of the iceberg is understanding the matrix that goes into what a blood sugar is.

SPEAKER_02 17:26

Yeah, yeah. And it's so true, like so many of our clients will be like, so 15 minutes before the meal I pre-bullis. And that's just like the blanket thought. And it's like, well, what's the meal composition? What's your number? How's your movement? How's your activity? How's your day? Then we can talk about it. And then their heads explode. But um, I love how you have simplified so much into very easy to remember like formulas. Like we coach a strategy on how to pre-bull us on our calls and so forth. Um, and it's not cookie cutter. If it were, um, that we wouldn't be having this conversation. So there are a lot of nuances, and I think with type one, we have all learned in some shape or form to advocate our needs. Or if we're not there yet, hopefully people are learning how to ask questions and speak up and seek help. But also I've learned since you know being diagnosed as an eight-year-old, 30 plus years, um, to not always follow the rules, but to chase results. And it doesn't mean to be a rebel, but like what works for me as my own personal experiment to hit those targets based off things I've been told or not told. Um, and and that's like my motto for life is chase results and don't always follow the rules. Um, I don't know if that's a good one, but again, it's not a rebellious tone, but it's like there's different ways to tire shoes. And and with type one, we have to be aware of that and curious of what can make it better.

SPEAKER_01 18:51

Absolutely. Yeah, I mean, I've been telling my daughter she's almost five, and she's trying to understand the rules of life. I'm like, hey, sometimes you challenge the rules, like sometimes it doesn't make sense to follow the templated rules. Trying to be careful though, not like creating a rebel, right? Where she's like, no one needs the government, like whoa, whoa. But it's true, you challenge the status quo. Uh, I think a lot of times we're handed a template of static rules, like debris bowls. It's always 15 minutes, right? And fortunately, unfortunately, there is a better way with dynamic strategies that are dependent on context. But like you said, even with our clients, week one of the program, their heads are spinning. They're like, What? There's like 50 things that affect blood sugars. And it's like, calm down, it's gonna be okay. In like three weeks, you're gonna love this, you know. Um, but that's the challenging part. And you mentioned formulas, so like I'll lay it out simply for everybody here. Um, two plus two is four math. Uh diabetes math is A plus B equals C. For some people, that is two plus two equals four, but for other people, they don't have twos, they have ones. So it's one plus one equals two. It's still a balanced equation, but the numbers are different because we're all living different lives, right? So that's the idea of a formula is just changing out your variables so that maybe it's not a 15-minute pre-bolus. I'll be transparent. My pre-bolus is 20 minutes. That doesn't mean good or bad, it just is. It's a number, right? So um, and these things can be manipulated. I mean, we've talked about this, Kelly, but your insulin sensitivity can be manipulated. Yeah, you can manipulate insulin to work faster and be activated. When I was in the middle of my Iron Man training, holy cow, I couldn't eat enough food to keep up with my insulin. It was crazy, and now it's back to normal. So, yeah.

SPEAKER_02 20:36

When's the next race?

SPEAKER_01 20:38

We we just had a baby for everybody who doesn't know, and there's no chance I can fit in Iron Man training right now. As much as I miss it, it's just fair.

SPEAKER_02 20:47

But I think another point that's underneath the iceberg is I had a client, you know, I'll help people who aren't type one, and they'll be like, you know, you you're lucky you have that um pressure to exercise often because you have type one. I was like, oh, I'm lucky. But I will say I don't I rarely go two days straight without exercise because we need that if our body's benchmark is consistent movement to support that insulin sensitivity. I don't go more than 48 hours to have that exercise to keep my insulin sensitivity present. Um, but it it's just another thing beneath the iceberg to know and learn um the hard way or an easier way from ideal guidance.

SPEAKER_01 21:32

It's so true. Um, yesterday I woke up the earliest I've woken up since we had the baby, like a month and a half ago. And it's only because I knew that waking up to go for a run would help my blood sugars because it's been a couple days. Yeah. So as much as it's hard to say we're lucky to have that one, I will say I have I've seen the silver lining. There are positives. And honestly, before I was diagnosed, I was diagnosed at 19. In college. And I was eating California burritos at two o'clock in the morning, playing video games with my friends. I don't think I would be eating as healthy as I was now if I didn't get diagnosed. You know, like I had to become aware of food and food science. And of course, it led me down a more specific path than most people, becoming a certified master fitness trainer and nutritionist. But uh, it for sure made me healthier and it's kept me consistent with exercise. You're absolutely right.

SPEAKER_02 22:26

Yeah. Consistency is key and course correcting. That's a word I use daily. It's like course correct, be aware and analyze what happened the day before and what influenced your blood sugars and what you can learn from it and how you can optimize it. And that sounds like a lot of work, but it's now second nature. Just quick reflection. What did I have yesterday? How did my blood sugars trend? And I'm doing that a lot too, because I'm in this season as a female of like cycling hormones and my insulin needs change every week. And I'll tell you, it took me a decade, two decades to figure that out. Um, so that's also another thing beneath the iceberg to know.

SPEAKER_01 23:02

Absolutely. Yeah. Hormones. I mean, you guys got it rougher than we do for sure, but uh on both sides, right? Hormones, counterregulatory hormones, all sorts of stuff beneath the surface, where it's like, why are my blood sugars so hard today? Oh, it's because I was stressed out from that work meeting. Like that still counts, you know.

SPEAKER_02 23:20

Yeah, yeah. From from feet on the floor to dawn phenomenon, though that's probably the trickiest area. But when you start to understand the why, the how and what to do, it can be life-changing to change your day and then add those days together and it can carry on.

SPEAKER_01 23:35

Oh, absolutely. Uh, when I was MDI and first diagnosed, I used to think that mornings were just harder. I didn't know anybody with hype one either. So I was like, it must just be me, you know. Uh, but I would wake up every morning like 160, 170. I could not figure out how to get my fasting numbers lower. And my pre-bolus, get this, was 45 minutes. If I ate any earlier than 45 minutes, 250. Like it just would not work. And I didn't know what to do about it. And of course, now we look about are we talking about insulin timing and how to dose appropriately for feet on the floor, how to maybe adjust basal for some phenomena, like a lot of different pieces to move. But man, in the absence of understanding, madness awaits around the corner, you know, just absolute frustration of like I did the same thing twice. Why didn't it work? Um, yeah, it's ridiculous.

SPEAKER_02 24:26

Yeah. And I think, and immediately, you know, the inner dietitian in me is like, well, maybe you're still growing, there's probably growth hormone there, and et cetera. But um, I love how you are an image in our community of succeeding really hard things. And, you know, just to do an Iron Man where, you know, most people are, you know, one of our clients was told to run. I don't know if you if you're aware of that. And I'm like, his doctor told him not to run. And it's like, type one's not our handcuffs, it's our fire of why we should do it better. Um, but I love how you do that for so many people and you're so motivational to so many young individuals, athletes or not. Um, so I think that's really amazing. So applauding you for that.

SPEAKER_01 25:09

That means a lot. Thank you so much. Um, and I gotta get that doctor's address, he's gonna hear from me. That's messed up. But uh, well, and and we can explore that side of it too. So, um, in my perspective, the unseen side of diabetes that I've experienced is the subconscious, right? What drives our decisions and how um I definitely did not plan on being an Iron Man. In fact, I started in triathlon because my pastor was like, Hey, you want to do a triathlon? I'm like, What was a triathlon? I didn't even know. And uh, I did it, it was fun. And then I heard about Iron Man's. I was like, Well, they have this one called the half Iron Man. I was like, that sounds more achievable. I'm gonna do the half, you know. Um, I did it, and then my wife asked me, would you ever do a full Iron Man? I was like, if they ever cure type one diabetes, I will. Because I thought it was impossible. Like, actually, I told her that I was like, I don't think I can. I don't think it's possible. Um, and that's also kind of when I knew I had to. It's like, well, shoot, I gotta prove it.

SPEAKER_00 26:08

So religion.

SPEAKER_01 26:10

Right. And so um the the full journey though, start to finish was came back from a trip to Paris where I almost died from an urgent low in a hospital where Lady couldn't speak English, I couldn't speak French, and I I truly thought that was the end for me. It was absolutely terrifying and went through all my low snacks in my bag, barely pulled out of it, and then took an emergency flight home the next day. I was like, something weird's going on. I can't um spent the next six months being afraid to go outside, mostly because um I was afraid of leaving the safety of home where I had cupboards full of food, right? And so I had to take baby steps and convince myself that if I had a backpack full of 400 grams of carbs, like kids you not, I actually packed it full of juice boxes and bananas, everything possible. So silly thinking back now, but that's what I needed was that that comfort. Um, and I walked to the end of the driveway, which in San Diego is like not even 50 feet, you know, it's like it's nothing. But to me, that was overcoming fear. And uh during that period of time, my blood sugars were running in the 300s, and my endo caught wind of that, and she called me and she yelled at me, like, what are you doing? Because she knew I was in better control typically. Uh, and I said, Well, I'm I'm super scared of going low, so I'm just gonna run high for a little while. Is that okay? She's like, Absolutely not. What are you thinking? And I'm glad she did have that strong response because I was totally gonna just ride that for as long as I could. And I was like, Well, just a couple weeks. And she was like, No, you're causing damage actively. And I was like, Couple days, and she's like, No, there is no bargaining, like, fix this. And what I know now that I didn't know then was I knew I needed to have lower numbers, but I was so scared of lower numbers that my fear was driving my decisions or my behavior, right? And to me, this is one of the strongest unseen variables of type 1 diabetes is our subconscious desires or drives based out of fear or based on our desires. So for me, um, obviously going from being a scare to go outside to becoming an Iron Man was not an overnight thing. It was years and years and years and a very long process. But uh, this idea of exposure therapy of get to the end of the driveway, okay, I survived. Get to the end of the block, okay, I survived. And you know, still had my 400 carbs. Um, I actually carried that same backpack across the the finish line of the half iron man with 400 carbs. And so it's like I'm not leaving this thing behind. It's my little uh safety net, like what do you call them? Security blanket, you know?

SPEAKER_03 28:45

Yeah, definitely.

SPEAKER_01 28:47

But I I see this happening with a lot of our clients as well, where they're like, I can't figure out how to get to an average of 5.5, let's say, or like even a 6.0 or 6.5, like I can't get below a seven. Like, well, what's actually going on behind the scenes? Let's talk about psychology and your mindset. Uh, well, I had this bad low forever ago. If it gets below 120, it just drops out of nowhere. Like, well, that there may or may not be truth to that. You might notice it drops faster below 120 because you let it get to 120, and by that time it's picked up momentum, you took your insulin an hour ago and now it's really moving. You know, I think that there's something more behind the scenes. So I think it's important that people explore their psychology, their fears, their drivers to understand what makes up their identity, you know, and and then in that same realm is the standards that we build for ourselves. I just did, I'm talking a lot right now, so I apologize.

SPEAKER_00 29:44

No, that's great.

SPEAKER_01 29:46

Uh, I just did a training for our private community yesterday on standards and how we have to raise our standards so that uh the standard set for most of us is 70% time in range and a 781c. And when you raise your standards to 90%, 95, 100%, all of a sudden 70% feels terrible. So you're like, that's way less than what I'm capable of. And so you get to 85% time in range, and you're like, that's it. This is the threshold of action. I'm doing something about this before it gets below 85 because I know I'm capable of 95%. Because I had this discussion with one of our clients where she got to 83%. And I didn't know that. But she said, Matt, the last two weeks have been horrible. My my control is out of line. I can't figure it out. It's like, oh my gosh, I'm so sorry to hear that. Tell me more. What's been going on? She's like, I'm so embarrassed to say this, but like my time and range is at 83%. And I had to like not laugh, right? Because I'm like, a couple months ago, you were at like 40%.

SPEAKER_02 30:47

I feel like I know who you're talking about.

SPEAKER_01 30:50

We forget so quickly how far we've come and we don't celebrate that, right? Yeah. Uh, and so I did this training on raising your standards, yes, but also giving yourself grace for when your standards are not standards, when your um your momentum slows or when you lose progress, right? It's like acknowledge the journey that you've been on. Um, but the true challenge is that we're we're seeking balance and alignment and how not everyone needs to get themselves grace because you might be at a place where you're at 60% time in range and that you you were at 70, now you're at 60, and it's like, well, it gets better. Don't lean on uh search for excuses or justification, lean on raising your standards. But then there are those clients that we have as well who are 98% time in range, and they're like, oh, gosh dang it, it's not 100%. I'm like, whoa, whoa, grace, acknowledge the journey. You're doing amazing, you know. And oftentimes it's equal and opposite. It's whatever you find yourself leaning towards. If you're looking for justification, I should probably lean towards raising my standards. If I'm leaning towards perfection, I should probably give myself grace, you know. Um, and it's just this, it's a constant shift, you know, this battle that we're trying to seek balance. But um, it's these subconscious drivers, ultimately, is what it is, that uh, in my opinion, are one of the core factors that people don't see, but will continue to have an impact on their actual blood sugars. So, like for me, I was scared of lows, so I ran my blood sugars high. Why are your blood sugars high? Oh, you need more insulin. No, I need to fix my fear of lows because until I fix the fear of lows, I will not get down to a lower average. It's against my nature. It's a protective mechanism. And we have clients who go low all the time because they're scared of highs. And they're like, no, if it gets above 130, I'm gonna get complications. So they stack insulin, push lows. They're not gonna fix the low blood sugars until they fix their fear of highs. It's just it's it's complex, but uh it's an important discussion.

SPEAKER_02 32:50

It is, and even no matter how well we know this stuff, we know this so well, just even having the opportunity to connect often and talk about it is even re-invigorating and motivating, I think too. Um, and I always use I use a lot of sayings, and half of them I've made up, and hopefully they make sense. But I always tell clients, you know, in nature there's no finished product, and in health, there's no finished line. And no matter what, there's gonna be moments you need to tread water, but our standards should still be optimal for good self-care, let that be stress or good self-care for overall health. And it's it's a balance, and and there's a lot going on above the iceberg and below. And um, I think conversations like this can just continue to help people stay curious, curious and hopefully consistent. Um but yeah, I think that's so good and so important to point out because I'll even have seasons that I'm scared of my lows, um, even though I know better. But it's you know, it's it's a journey. It's a journey.

SPEAKER_01 33:50

Absolutely. Well, and I'll add something too. Um, hopefully it humanize me because people are like, Oh, I just got perfect blood sugars. I don't. I still have mistakes that I make for sure. Um, I still get nervous around lows where people are like, oh, he beat his fear. I didn't beat it, I figured out how to sidestep it, you know. And for me, sidestepping it was developing certainty around blood sugars. But um, there's still moments where my blood sugars will drop, and I'm like, wait, I don't know why it's dropping. Oh shoot. And I get nervous. I'm like, what's happening? You know? Um, so I'm very much human. I still experience these uh these moments of anxiety, and I think it's also important to define fearlessness. Uh, we used to have a program called the Fearless Diabetic many, many years ago, and people were like, Oh, so you like fix fear? I'm like, No, no, no. You learn how to be brave in the face of fear, right? And that's what it is. I during my Iron Man, I was terrified. I thought for sure I was gonna end up in the hospital. There were a couple of positions in the race where I was like, either I cross the finish line or I end up in the hospital. Like, that's the decision that I made. And I was like, I'm gonna figure it out or I'm gonna have a rough day, you know. Um, and I I was definitely scared, but I think that um if you can do it safely, then there is something to be said about doing things scared and accepting that's part of the journey, part of growth as well.

SPEAKER_02 35:11

Yeah, yeah. It's all about living high quality life. I think of the saying time flies when you're having fun, but research shows time fly, time flies when you're having fun and have a goal. Um too. So I think this is all motivating. It's inspiring me to have more goals and higher standards. Um, and to continue to do my best to share great advice that people aren't informed of that aren't always highlighted or discussed, or even come close to conversations at our into appointments. Um, there's only so much time there, and there's only so many questions we can ask or know to ask.

SPEAKER_01 35:47

It's so true. Yeah, and it's an ongoing journey, like you're saying, there is no finish line. You know, we have to keep going and keep pushing forward, advocate for ourselves, look in ways to raise our standards. Uh, but you touched on something interesting too, is the the conversations and the kind of the community tab that's open with type 1 diabetes. It's it's this unique thing where when you're around people who have raised their standards, you subconsciously are drawn towards those standards. Uh, and same thing to be said about those who have lowered their standards. If I'm hanging around people who are at 50% time and range, I am gonna think 70% is amazing. And that's exactly what happens in doctors' offices. They're like, oh, if you can get to 70%, you're good. Why? Because most of their patients are not that high. Most of their patients are sitting at 50, 40, 30 percent because they don't care. So they see everybody else coming at 70, and they're like, round of applause, you've done it, you actually try, you know.

SPEAKER_02 36:44

And then they say, Come back in six months, you're doing well enough. Don't come back in three.

SPEAKER_01 36:48

Yeah, instead of continuing your momentum, let's just chop you off the knees and call it good. You know, it's like man, let's let's raise the standards globally. So, what I mean to say by that is the environment that you put yourself into is going to have an impact. And I forget who said it and came up with the original concept, but ultimately uh you are the sum total of your five closest friends, right? And the same thing can be said about professional atmospheres. If you're in an environment where everybody is chasing their dreams, you'll feel pulled to that. If you hang out with Olympic athletes, you're going to get in better shape. If nothing else, it's going to be because you're ashamed of not being as good of shape as them. But their habits, hey, you want to hang out, we're all going for a run. You're going to get fit, you know? Um, so I say that because we also have obviously our event coming up, but the event itself is not just to learn about blood sugars, right? Which we could teach, you know, we've helped thousands of people get to 90% time and range or better. And it's amazing. I love the metric side, but it's also about quality of life and finding alignment in strategy. So it's not you white knuckling diabetes the whole time, but actually having fun with it. Like you're saying, time flies when you're having fun and have a goal. I think those are both very important.

SPEAKER_02 38:02

Yeah. Yeah. And I am excited for the event because it'll be a great opportunity to come together and help people how to do things with higher standards per se, but to think differently. To think differently. And I think curiosity is the most saving thing we can have within ourselves. Um, so I'm stoked for that opportunity to impact others in that way, but also to share some of the gems that we share within um in the business.

SPEAKER_01 38:29

Absolutely. Yeah, and and that raising standards conversation doesn't have to end with the event either, but um, the environment is the last piece I wanted to touch on with that, which is that you're gonna be surrounded by a hundred other type ones, which by itself is fun because you're gonna hear alerts going off and you're like, that person's low, get them a juice box. You know, like you're gonna hear and be like, I'm I'm home.

SPEAKER_00 38:52

How can I help you?

SPEAKER_01 38:53

Yeah, exactly. Like, need to go for a walk. I heard that high alarm. Um but beyond that, it's not just a room full of type ones, it's a room full of type ones who have raised their standards. Like the purpose of this event is to improve. And when you're around people like that, again, you naturally raise to the level that is uh the average of the room. So that's one of the parts that I'm most excited about is just being around motivated individuals, or at the very least, those who've decided to do something. And then by getting in the room, they will become motivated. It's gonna be amazing.

SPEAKER_02 39:24

Yeah, it will be great. And to confirming those dates, that's November 5th, 6th, 7th.

SPEAKER_01 39:31

Close. But you can get there a day early. Yeah. So we'll hang out.

SPEAKER_02 39:35

Shame on me.

SPEAKER_01 39:36

Yeah, November 6th and 7 and 8. Yeah. So uh we have our our day one and two is core of everything we talk about here. Actually, uh, it's a new concept we've discussed called the glucose type. So it's a way to mix the metrics, but also your personality type. Think of it like the Enneagram for type one diabetes, but looking at it through a the lens of personalization of diabetes care. And then day three is an implementation workshop for those who want help and assistance from the coaches and also from us to come alongside them.

SPEAKER_02 40:06

Awesome. Well, I'm excited. It will be such a gift um to be part of and um for people to attend. So absolutely.

SPEAKER_01 40:16

And I mean, if you're like Kelly, getting there a day early. I we actually have a lot of clients who are turning into a vacation because it's in sunny San Diego, which is my hometown. So yeah, come early, stay late, have some fun, go to SeaWorld. But um, it'll be a blast. So we'll put a link in the description of this one for anybody who's interested. If you haven't gotten your tickets yet, uh, it is still early bird pricing for now, but the seats are filling up pretty quick. So I'd recommend grabbing one. You can go to t1dmasterylive.com.

SPEAKER_02 40:44

Awesome.

SPEAKER_01 40:45

All right. Well, thank you, Kelly, for your time today. Love having discussions like this and really just exploring what could be with type 1 diabetes. Big deal.

SPEAKER_02 40:55

Yeah, awesome. Thanks for having me. And until next time.

SPEAKER_01 40:58

Sounds good. Everybody else, use that link in the description. We'll see you at T1D Mastery Live and keep up the fight.