Episode 005 - Your Automode Matters (and no... we're not talking about your pump)

Episode 005 - Your Automode Matters (and no... we're not talking about your pump)

November 08, 2021

Welcome back to Keeping it 100 Radio! Wow, 2021. What a year. We have seen so much growth in the resources we have available to the diabetes community. One advancement I'm most impressed with? The automode feature on pumps like the T-Slim and Medtronic (and hey, even the Omnipod but that isn't FDA approved yet). While I'm not on the automode myself, I've had many clients who are. But to their disappointment, it's an advancement that's overhyped in the health care system. Not because it doesn't work, but because they haven't taken the proper steps to set their foundations in place first. 


Inside this episode, we're going to talk about the number one flaw I see in the automode feature, how you can make the technology work for you and how you can work with it all to finally bring predictability to your blood sugars and end the frustration around dosing decisions.

Thank you to Skin Grip for sponsoring this episode! Check out my absolute favorite patches and save 10% at check out by using the code "LISSIE"!


Hit the play button and let's get started!



Resources inside the episode: 

  1. Check out Skin Grip at skingrip.com and use the code “LISSIE” at check out! 

  2. Learn more about Keeping it 100 HERE

Show Notes: 

  1. ⏰ (0:00): INTRO

  2. ⏰ (2:05): Behind the scenes of Keeping It 100

  3. ⏰ (3:27): New technology and its flaws

  4. ⏰ (7:35): The technology is only as strong as our decision making...

  5. ⏰ (10:42): Assessing baselines should be our top priority

  6. ⏰ (13:14): Decision making process

  7. ⏰ (17:02): What emotions are driving our decisions?

  8. ⏰ (20:08): Wrap-up




Elisabeth Poyner  

Welcome to Keeping It 100 Radio I'm your host Lissie Poyner. Type one diabetic, certified health coach, personal trainer and founder of Needles and Spoons Health and Wellness. Inside this podcast you'll find the real and raw conversations around diabetes management, including lessons we don't learn in our endo's office, my best tips and trainings and conversations from experts I trust inside the community, so you can create more predictability in your diabetes management and feel empowered while doing so. Let's dive in.  And before we get into this episode, I want to let you know that this episode is sponsored by Skin Grip. This is the only patch company that I trust with my diabetes devices. Before Skin Grip my Dexcom would last maybe four or five days before falling off, and it was making it so hard to lift weights, hike with my pups, or just wanting to do the everyday things that I love. Now, I feel confident traveling work now and navigating life with diabetes without having to worry about dealing with insurance more than I have to, begging for replacements and resorting to fingerpricks. Because we all know that that sucks. You can check out Skin Grip by going to sting grip, calm and save 10% on your order by using the code lissie L-I-S-S-I-E at checkout.  What is up Keeping It 100 family? So I'm recording this episode a little bit on a whim because I was recording some content today on TikTok and I made a post on Instagram. And if you're not sure what post that is, reflect back to August 5th 2021. But what I found was that, you know, there's only so much detail that you can go into on like a minute long TikTok or a simple Instagram caption or even stories. And the conversation that I want to have today is something that I really wanted to dive in deep on because it's not really something that's fully, I feel, communicated in the diabetes world, especially in our endocrinologist's office. So if you don't know me, my name is Lissie Poyner. I'm a certified Holistic Health Coach, personal trainer and neuro linguistic programming practitioner, and I support type one diabetics through our signature program called Keeping It 100. What Keeping It 100 is it's really an immersive hybrid coaching experience that takes our clients through the holistic approach of type one diabetes. So yes, we do support them with their A1C and their blood sugar control and their time in range. But this is all really just a byproduct of the complete work that we do. So aside from the blood sugars, we're supporting our clients with the entire, you know your entire life with diabetes, because we all know it's not so simple as just take your insulin, count your carbs. And that's life with diabetes, it might be what we're told, but it's a lot more over complicated than that. So we help them with their relationship with food, their relationship with exercise, their trust in their bodies and their blood sugars, so that they can leave with a much more empowered relationship with diabetes, and welcome new experiences. Because that's exactly what we want, right? We do not follow a restrictive approach, we do not believe that you should be doing less with your diagnosis, we believe that you can actually accomplish just what you set out to, plus more with Type One Diabetes. So that's exactly what we support our clients with with a science based approach. And, you know, we have support from myself, my co-coach Jess, who is a registered dietitian, and certified diabetes educator. We have an accountability coach, we have a full team supporting our clients. So inside the program, we have had a ton of clients come to us recently, with pretty much new technologies, which is amazing, right? We have these new technologies coming to us, we're in the year 2021. Which, who on earth thought we would get here, right? Especially after 2020. But you know, we have all these new technologies, which are absolutely incredible, because you know, if we can't find a cure for diabetes, we might as well have technologies that make our life easier with them. So I was diagnosed seven years ago, and I started on MDI and fingerpricks, and it's not because CGM 's weren't available, it's just that they weren't really accurate enough to justify my need for one. So I come from kind of that age and I know that there's probably some listeners who have had diabetes way longer than me and you know, remember very different times. So seeing this new technology come around, you know, for example, the T:slim with Control IQ and Basal IQ, and let's say Medtronic with their auto mode and, you know, Omnipod with their loop system with the Dexcom, it's not FDA approved. So, you know, not fully recommending that. But you know, seeing all this technology come to light is very, very exciting, because it just shows us how much more there is to look forward to. Hopefully there's a cure in there sometime. But you know, without a cure, let's at least hope for technology advances. So we find that a lot of our clients are coming to us with this new technology, which is awesome, but it's mostly because their endocrinologists, you know, they'd seen that the lack of control that they had in their blood sugars, which was no to no fault of their own, it's never to any of our faults, right, we have so much more to do with our lives then be a full time functioning pancreas, and it gets really overwhelming. So, you know, their control is not fully there. And they go to their endo, and, you know, basically push comes to shove, and they recommend the, you know, pumps like the T:slim or the Medtronic. And there's this built up expectation that basically, this pump is going to do everything, or as much as it can, it'll adjust your basals, it'll suspend it, when you go low, it'll help you with corrections, you know, there's really not much that you have to do other than count your carbs. And this is a very high expectation to set in my opinion. But that's just my personal opinion. But it's a sounds great, right? If we can spend that much less mental energy on our diabetes, we're gonna have so much more more mental space, to spend on things that we actually love, or things that we want to do, you know, we can spend more time focusing on our jobs or our families and our relationships and actually feel present in the moment. So this is by no means saying that the technology or the encouragement of the technology is wrong, it's very beneficial. And it's very advanced, and something that we did not really think that we would see. So it's amazing that we even have access to it. Because again, things like this aren't always accessible to everybody. And I always like to highlight that because it is such a deep privilege to have access to technologies like these. So all our clients come to us with these new pumps and these new systems, and they're so excited because they feel like it should be doing all these things for them. And they feel like they should have their control back. And it turns out to their disappointment that the technology just is not working for them. And they almost resent it a little bit. And they feel like they're doing something wrong, because it's like, we have this amazing technology, it's supporting me in so many different ways. But my I'm not seeing the results in my blood sugar, and honestly, I'm way more frustrated than I was when I was on MDI or when I when I didn't have the Control IQ on. And from what we see there is, you know, a lot of reason for that. Because here's the thing, the technology is only as strong as our decision making is. And it's kind of this oversimplification and generalization that when we have this technology, that we are just suddenly not going to have to make decisions anymore, or that the decisions will become less, when in reality it it takes our decision making to be really strong and built up and our baselines to be really strong and accurate for that technology to fully work in our favor. So this is what we usually see. You know, our clients kind of come to us and they have the Control IQ on let's just say they made the switch from MDI to the pump. And they were given one solid basal rate, one carb ratio, one correction factor. And you know, it seems simple. It seems good. It seems simple. But these baselines, these foundations to their entire diabetes management and blood sugar management aren't as accurate as they should be. So mix that with our decision making, which you know, sometimes we don't have accurate carb counts, sometimes our emotions drive our decisions. Think about rage bolusing or overcorrecting or overtreating. When we mix all those things together, it's almost like a recipe for disaster, because our body's doing one thing due to our decisions, and then the pump is doing another thing because of our inaccurate baselines. And then the Control IQ systems or the auto mode systems are doing a whole nother thing based on the arrows and direction that our blood sugar is going. So we're just seeing these insane spikes and drops and insulin suspensions and corrections when we may not need them. And it's just causing this entire blood sugar spiral. We have seen this time and time again with our clients. And it makes them want to throw their hands in the air and say, why am I on this system if it's not working for me? And that's just not it, coz the technology is very advanced, it can work for you. But only if we have the right foundations in place. It's just like anything else, we always need foundations in place iIf we want to go even further and accelerate our growth, think of even just like, you know, the Olympics have been on. So think of gymnastics, you need to learn a cartwheel before you can learn a backflip, or you need to learn a back handspring before you can learn your backflip. If you don't have that foundation, you can't, you know, keep growing and and grow even stronger. So maybe that wasn't the best metaphor. But that's kind of how the way I think about our diabetes management. So when we do this, we go through an entire process. And keep in mind our program has support from not only me, but it has support from a registered dietician, a certified diabetes educator, and all of our clients have support from their endocrinologist as well. So we are all working as a team in testing our baselines and then they're taking that information to their endocrinologist who are helping them make the most accurate changes and best changes for their body. So we support our clients in helping them make sure that their baselines are as strong as possible. So we take them through, you know, first assessing their management baselines. So when we're talking about management baselines, we're thinking about all the things that make sure that we're getting the most accurate doses. So of course, this is never, like perfect, because there are so many different variables in a day, so many different factors that we're seeing. But to get as close as possible, we need to go through, you know, our basal rates, our insulin to carb ratios and our correction factors. And we have support from our certified diabetes educator to walk our clients through that testing process, and know exactly what information they need to communicate with their endocrinologist to get the most accurate doses for their body. So we go through that testing process, make sure that our insulin regimen is as strong as possible. But then the thing that's missing from the physician's office is actually assessing our behavioral baselines. So I know what you're thinking like, what the hec? But this actually plays such a huge role in our diabetes management. And we're when we're looking at behavioral baselines, we are looking at our everyday habits. So think about literally from the moment you wake up to the moment you go to bed, there are blood sugar supporting habits in our day, or that can be in our day, that can help our blood sugars, and overall help our decision making. And this is not to say that your day has to be overrun by diabetes decisions about diabetes habits, we do this in a very unique way where everything is anchored in together so that our habits feel a lot less overwhelming, they don't feel like our entire day is surrounded by a diabetes or those habits, we do this in a very structured way, and a very natural way so that these decisions come naturally, they don't feel hard. And they just overall support our blood sugars in in the best way possible. So we're looking at our everyday habits, we're looking at our decision making processes. So when we're looking at our decision making processes, we want to consider literally, how are we making these, these decisions? So if you're like me, like I was diagnosed when I was 19, so I was pretty much leaving my endocrinologist appointment with an insulin pen, some rates, and, you know, some doses and my finger pricker and said, all right on your way. So literally, from the time we were diagnosed, or if you were diagnosed as a younger child, from the time that we're transitioned into our own management, we're kind of just living through the moments, right? We're kind of kind of like just always trying to get by and do the best we can. But we're never really given the time to make sure that those decision making processes or as powerful and strong as possible.So that is exactly what we do in Keeping It 100. We really slow things down and narrow things in to walk through our diabetes decisions starting from how are we carb counting? Are we guesstimating? Are we using accurate carb counts? Are we looking things up? Are, like are these car counts as accurate as possible? Or am I just guesstimating based on experience? So that's part one, you know, looking at what questions am I asking myself going through this process? How confident am I going through the decision making process? What hurdles were in my way? And you know, most of all, what would I change for next time? Because when we're able to go through that cycle and actually strengthen it, so, you know, encourage or build up our carb counting skills, build the amount of or not only ask ourselves more question, but questions, but ask ourselves the right questions. So there is a quote from Albert Einstein. And it says, If I had one hour, I'm kind of spitballing here. But if I had one hour to solve a problem, I would spend the first 55 minutes finding the right question to ask for when I find for when I have the right question, I only need 5 minutes to find the answer. And that's kind of the process that we go through in this decision making process. So we are not only asking or encouraging our clients to get curious and ask questions, but it's going through the strategy so that they know exactly the right questions to ask. So there's a very different, there's a very, you'll get a very different outcome when you're looking at your plate. And you're asking the question, how many carbs in that are in this? versus when you're asking, how is my body going to digest this?So you're going to get very different answers, and it's going to leave you lead you to very different results in your, your dosing. So we really support our clients in building up that decision making process and making it as strong as possible. Because when that decision making process is as strong as possible, there's less need for intervention, because we're getting the most accurate dose as possible. And we're gonna basically not have to spend all of our time thinking about our decisions towards the end, and we're not going to feel we have to correct all the time where we have to think about where we're going, we're going to trust our decisions, we're not going to need to intervene. And we're not going to go through all of that burnout that happens at the end of the day, or you know, it builds up and we go and we experience burnout, burnout is very natural and real. So we take them through the decision making process, and then we always discuss, you know, what emotions are driving our decisions? Because, again, diabetes is not as black and white as take your you know, count your carbs, and do your calculations and take your dose, there are real life emotions involved. We are human, and we have very human experiences, and our very human experiences are what lead us to make a judgment call because our you know, our intuition kicks in and our intuition and our ego wants to keep us safe. So if we experience a low, we, our intuition and our egos wanna keep us safe, and it's going to tell us to under dose or eat more carbs so we don't have that low. You know, we've all been through very similar experiences. So we have things like fear or um frustration, or exhaustion, or anxiety that drives some of our decision making. And it leads us to things like under bolusing or rage bolusing, or, you know, overcompensating with low low treats, or you know, any of the above, you know, any other scenario. So, another thing that we strongly look at when assessing or behavioral behavioral baselines is what emotions are driving our decisions? And how can we acknowledge those emotions and deviate them into something more empowering and confident?. And that's not to say that this is an easy process, you know? It's never as easy as just think positive, or just do this and think this way. It is a very, you know, it's always like growing a muscle, it's slow, it takes time, and it doesn't feel natural at first. So we take them through that process using, you know, different coaching, coaching techniques, different techniques that I have learned through my NLP practitioner certification, and we go through that entire process. And typically, what we find after kind of creating this nice harmony between our insulin management baselines and our behavioral baselines is that we find this really nice balance. And there's almost less need for the auto mode system, or the like Basal IQ and Control IQ to actually kick in, because our decision making processes, our emotions, our baselines are all so strong and so in tune, that we don't really need that much intervention. So when we do need intervention, you know, it's, it's the technology's working for us. And a lot of times our clients leave, not even really wanting that Control IQ or not really wanting that auto mode system to be on, because they feel so empowered and so in control over their management and in their bodies.  So I just wanted to create this episode really just to go through, like, if you're somebody experiencing the same thing, or maybe you're considering a pump with the, with the auto mode systems, I want to encourage you to build up your own autopilot first. You know, we are humans, we have these autopilot decisions. And the more that we can build that up and make that empowering and as strong as possible, the more that we're going to be able to welcome new experiences, the more that we're going to be able to feel confident, going into new scenarios, going into our endocrinologist's office or looking at the data, we're gonna feel so empowered by these things, that it's gonna, it's, it's just gonna feel natural. So, again, if there's anything that you take away from this episode, I just want to encourage you to get curious, build things from the ground up, because the more work that we put into strengthening the baselines and the foundations, the stronger that everything else will be, right? We want to make sure that when we're building a house, the the foundations are strong, and that they're built the best because you can't have a house without those foundations. Again, another pretty poor metaphor, but you know what I'm talking about. So, build up those baselines, build up those foundations, and you are going to be in a much better position. And if you need support along the way, obviously just reach out on Instagram. We are always here to support you. Thank you so much for tuning into this episode. I would love to hear your biggest takeaways because it helps me know what other content to record. So just go ahead and take a screenshot of whatever platform you're listening to and tag me on Instagram in an Instagram story @needlesandspoons_ and just let me know your biggest takeaway. I would love to hear it! Alright, until next time,

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