#1557 Remy's Ma
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When 18-month-old Remy started soaking through diapers and guzzling water, Kara had a hunch.
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Scott Benner 0:00
Welcome back, friends. You are listening to the Juicebox Podcast.
Kara 0:13
Hi, my name is Kara. I'm in my early 30s.
Scott Benner 0:20
The podcast contains so many different series and collections of information that it can be difficult to find them in your traditional podcast app. Sometimes. That's why they're also collected at Juicebox podcast.com go up to the top, there's a menu right there. Click on series defining diabetes. Bold beginnings, the Pro Tip series, small sips, Omnipod, five ask Scott and Jenny, mental wellness, fat and protein, defining, thyroid, after dark, diabetes, variables, Grand Rounds, cold, wind, pregnancy, type two, diabetes, GLP, meds, the math behind diabetes, diabetes myths and so much more, you have to go check it out. It's all there and waiting for you, and it's absolutely free. Juicebox podcast.com, nothing you hear on the Juicebox Podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan. Today's podcast is sponsored by us Med, US med.com/juicebox, you can get your diabetes supplies from the same place that we do. And I'm talking about Dexcom, libre, Omnipod, tandem, and so much more us, med.com/juicebox, or call 888-721-1514, this episode of The Juicebox Podcast is sponsored by Omnipod five. Omnipod five is a tube, free, automated insulin delivery system that's been shown to significantly improve a 1c and time and range for people with type one diabetes when they've switched from daily injections, learn more and get started today at omnipod.com/juicebox of my link, you can get a free starter kit right now. Terms and Conditions apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox, today's episode of The Juicebox Podcast is sponsored by the ever since 365 the one year where CGM that's one insertion a year. That's it. And here's a little bonus for you. How about there's no limit on how many friends and family you can share your data with, with the ever since now. App, no limits. Ever since. Hi, my name is Kara, Kara. How would Kara be spelled?
Speaker 1 2:33
So I see it spelled the same way that I spell my name, C, A, R, A, and so what I do is I tell people it rhymes with Sarah, and that tends to help. It really is based on like, if they knew someone who pronounced it Kara, that's kind of what stuck in their head. If they are familiar with pronouncing it as Kara, that's easier for
Scott Benner 2:50
them. I see So Kara it is. I can do it all right. I care a lot about you being happy Kara, so I make sure I do that correctly.
Speaker 1 3:00
There you go. You have type one. I do not my son. Does your son? Does you look incredibly young? Oh, I, I'm in my early 30s. No,
Scott Benner 3:09
that's crazy. I honestly thought, like I I saw the description for who I was talking to today, and then you popped on camera while we were working out your technical issues. And I thought, Oh, I might have this wrong. Good for you. Oh, thanks. Do people think you look young? Generally, I
Speaker 1 3:27
don't know. I don't know if I've heard that in a while. Okay, maybe the lighting is doing something for me
Scott Benner 3:33
today. Whatever it's doing, take it home with you. Just walk around. Say to people when you want to visit me, we do it right here. This is where I look amazing. Anyway, all right, so how many kids do you have? Just
Unknown Speaker 3:47
one,
Unknown Speaker 3:48
awesome. How old he is? Almost five.
Scott Benner 3:51
Five. Wow. And how old was he when he was diagnosed? Remy Rennie. Oh, like, like, Rennie Harlan, like, the director, like,
Speaker 1 3:59
like, like, some people ask the short for Remington, but R, E, M, y, Remy,
Scott Benner 4:06
like the rat in that movie?
Speaker 1 4:07
Yes, I get that question sometimes like, oh, you named him after the rat in Ratatouille? No, we did not.
Scott Benner 4:13
Oh, Kara, Kara. I would never think you named your kid after a rat in a Pixar
Speaker 1 4:22
film? It depends. It depends on who I'm talking to. Like I was talking to some college students, and they're like, wait after ratatouille. And I was like, Absolutely not. But I
Scott Benner 4:30
appreciate the question. My wife says to me this morning, she goes, Hey, I got put on a committee to help name a drug. And I was like, Hey, hold on a second. I walked over to her. I was super serious. I said, Is there any chance we could call it Scotty b She, she goes, I don't think I'm gonna have that kind of pull on the committee. And I was like, gotcha worth a try. Yeah. I mean, I don't even know. Like, can you imagine, what if it ended up being bad? Like, and I was, and it was on the news, they're like, Scotty Billy kills it. There 50,000 people today. All right, so Remy yes is diagnosed at what age? 18 months old. Oh, gosh, you got me beat there. Yeah, he was little. Wow. How did you figure it out?
Speaker 1 5:13
Okay, yeah. So that fall, he was sick, you know, as babies sometimes are when they're in daycare, and he had different viruses, including pneumonia. And then I, like, noticed that he was really thirsty, he was peeing through diapers. And I was like, Huh? I think that has something to do with diabetes. And so, you know, I Google, and I'm like, okay, he has a Well Child appointment coming up soon. Like, I'll just ask his doctor at that appointment. And so this was, like, December 2021 went to the appointment. My spouse, Remy, his dad, was also there, and the pediatrician was like, Oh, he's just fighting another virus. I'm like, Okay, I'm not gonna panic like he I'm gonna trust what the doctor is is telling us, like, we'll just see how this goes. So then a couple weeks later, he got really sick. We take him to the ER, he gets diagnosed with COVID, and they test for, like, other things too. They give him a steroid, they send us home. They're like, okay, he should be so you should be seeing improvement, like, in the next 12 hours or so. Cool, we go home the next day, he is definitely not better. I'm thinking that he's worse. So we bring him back to the ER, and then he is diagnosed with type one
Scott Benner 6:25
Carrie. You break up once in a while. So I'm just gonna, like, I'm gonna live through it, and the editor is gonna seam it back together. Because we're not losing any of your words. There's just a gap sometimes. So, oh, okay, good to know. So if you pause at the end of a thought, and I'm not there right away, give me a second. Okay, gotcha. Okay, all right. Wow. So you figured out, how did you know, like, what do you do for a living? Or are there people in your family with diabetes that you were just like, oh, that sounds like diabetes to me. Yeah,
Speaker 1 6:51
great question. I don't know exactly. Okay, so I'm a social worker, but not like in the medical field, and I do have some family members with diabetes, but it wasn't like I didn't, I don't feel like I was super educated on diabetes prior to my son's diagnosis. It was just kind of like, somewhere, you know that, like, knowledge is in your brain. You're like, read something once, and you're like, oh, okay, I think these are, like, connected symptoms. And, you know, I googled and was like, Yeah, this. Like, this could be a
Scott Benner 7:16
possibility. That's crazy. You were just like, Oh, I think I know this. Yeah, I don't. I
Speaker 1 7:21
like to read a lot, so I don't know, like, you know where that thought came from? Yeah,
Scott Benner 7:24
hey. Last odd question about Remy his name, do people since you're Remy his mom, Do people ever call you Remy Ma? No, they really should, don't you think?
Speaker 1 7:35
No, well, like his classmates call me Remy his mom because they see me at drop off. But not
Scott Benner 7:40
like adults. Adults don't do that. No, huh,
Unknown Speaker 7:44
no, not to my face. Anyway,
Scott Benner 7:46
she got eight years for shooting somebody. Oh, this was in 2008 I guess she's out by now. Grammy nominated rapper Remy Ma was sentenced to eight years in prison on Tuesday for shooting and wounding an acquaintance after discovering money was missing from her purse. Hey, you know what? Don't take money from people. Lesson learned, yeah, they might shoot you with a handgun they have in their purse. Think a little bit full generation of people, Kara, that aren't aren't properly scared. You know what? I mean, what a shame. We've nerfed the whole world for everybody now they think they can just steal Remy took care of it. She's like, bang, no, that's my money. Give it back eight years. I wonder how much money it was. I bet you not eight years worth of money. Probably not. Anyway, you're a Remy Ma from now on, and we're gonna move forward. I was just like, oh my god, this is gonna be a great episode title.
Unknown Speaker 8:36
It will be. I can't wait to see what you come up with.
Scott Benner 8:39
Yeah, I'm piecing it together already. Well, okay, all right, so you pulled diabetes out of your let's
Speaker 1 8:43
say, I mean, kind of but no one believed me right away. So
Speaker 2 8:47
oh yeah, oh people were like, Oh no, no, no, yeah. So his pediatrician
Speaker 1 8:51
was like, Nope. It's, you know, it's just a virus, you know, we took him to the yard. So I think the fact that, like, when he got really sick and we took him to the yard that first time, I think the COVID diagnosis, like, I think those symptoms were masking, you know, the dka, because he was in DKA, he was in really, really bad shape, wow. So I think, I think that made that tricky for them, you know, the first ER visit,
Scott Benner 9:12
did he come close to a real, like, significant medical issue, not that this isn't, yeah,
Speaker 1 9:17
I think so, right, yeah. So they were, they were pretty concerned about, like, his mental state. They're like, Oh, mom, like, good instincts, like, good thing that you brought him back. I'm like, Yeah, I think he was dying, and he kind of was, they were talking about, like, intubating him. They were really closely monitoring, like, I said, his mental status, like the COVID and the DPA, like, you know, His breathing was really tricky. Thankfully, they didn't have to intubate him. Like, you know, he pulled through. Here we are, yeah, and we were released from the hospital on Christmas eve of December 2021
Scott Benner 9:48
Oh, Merry Christmas too. Yeah, it was, it was a
Unknown Speaker 9:50
rough Christmas, for sure.
Scott Benner 9:52
Nothing good for you in this like your husband said, No, it's not that. And then later, you were like, Oh, I told you I was right about that. Any Did you get any of that at all? Yeah. Hmm,
Speaker 1 10:00
no, not my husband. I mean, we, we don't see that pediatrician any longer. We weren't really a fan of him to begin with. We didn't feel like he was a good listener even before the diabetes thing. So we did switch to a different pediatrician, and we really like her. We also love our like and he, you've actually interviewed him. He has type one himself. And are the educator we saw the CDE, her son has diabetes, and so, like, the care we received in the children's hospital was excellent, even if getting to that diagnosis was like a rough process in some ways.
Scott Benner 10:37
Shout your PD, your endo out. I had him on. It. He was awesome. I thought,
Speaker 1 10:41
yeah. Nadia Kasim Nader, I always say his name incorrectly. Sorry,
Unknown Speaker 10:46
really, really,
Scott Benner 10:52
oh, you say people's names wrong. Do you Cara, Cara, whatever,
Unknown Speaker 10:58
sometimes I do give big
Scott Benner 10:59
opinions about your name being pronounced correctly.
Speaker 1 11:02
No, I really don't. I feel like I offer people a lot of grace. I just try to, you know, give people a heads up if they if they care about pronouncing it
Scott Benner 11:09
correctly. Oh, you were so lovely, actually, before you started, you were like, I just want to, want you to know. And you're like, I won't even if you say it wrong, I'll never even bring it up. And I was like, No, bring it up if I say it wrong. Well, Dr Kazem was awesome. Like, his episode is really, really wicked good. Like, and I'm not even from Boston, and I just said that. So, you know, you said you had a pediatrician who didn't really listen. You had one that that does. Now, what do you think that that brings to you? I
Speaker 1 11:34
think it's so critical for healthcare providers and anyone in the helping profession like profession, to make sure their patients are heard. Yeah, I think that's just really important in general. Like, I know from personal experience, like, right? People want to be heard.
Scott Benner 11:49
Yeah, no. I just wondered if you had, like, an actual like, hey, this happened before, and now we're talking to somebody who's a little more locked in. And, I mean, is it your comfort? Like, do you just you feel more heard, and what does that bring to you when you have that feeling, you know what I
Speaker 1 12:06
mean? Yeah. I mean, so, like, our current, I mean, pre nutrition, she's great. And it's not that she's really involved in Ronnie's, like, diabetes care, yeah, I don't know if I have, like, much more to say about just the importance of being heard it, I think it makes for better relationships in general, but especially with a healthcare provider, right? You're in a vulnerable position. You want to feel like your voice matters and that you have something to add to the conversation, and instead of being, you know, talked over or dismissed,
Scott Benner 12:36
yeah, no, I hear okay, all right. What makes you like I don't know, pick up a keyboard and say I'd like to be on a podcast. Today's episode is sponsored by a long term CGM that's going to help you to stay on top of your glucose readings the ever since 365 I'm talking, of course, about the world's first and only CGM that lasts for one year, one year, one CGM. Are you tired of those other CGM, the ones that give you all those problems that you didn't expect, knocking them off, false alerts not lasting as long as they're supposed to. If you're tired of those constant frustrations, use my link ever since cgm.com/juicebox, to learn more about the ever since 365 some of you may be able to experience the ever since 365 for as low as $199 for a full year. At my link, you'll find those details and can learn about eligibility ever since cgm.com/juicebox check it out. Today's episode is brought to you by Omnipod. We talk a lot about ways to lower your a 1c on this podcast, did you know that the Omnipod five was shown to lower a 1c that's right. Omnipod five is a tube, free automated insulin delivery system, and it was shown to significantly improve a 1c and time and range for people with type one diabetes when they switched from daily injections. My daughter is about to turn 21 years old, and she has been wearing an Omnipod every day since she was four. It has been a friend to our family, and I think it could be a friend to yours. If you're ready to try Omnipod five for yourself or your family, use my link now to get started omnipod.com/juicebox get that free. Omnipod five star kit today. Terms and Conditions apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox,
Speaker 1 14:33
and listening, you know, for a while, like, we found out about you pretty early on our CDE, let us know about the podcast when we're in the hospital, and I joined the Facebook group, I think, like, while we were maybe still in the hospital, or soon after, and then you had posted something in the group about, like, I don't understand. And I had listened to, maybe, I think I listened to a few of those episodes. But anyway, and so my question was, I don't understand why doctors. Don't do a finger poke when patients are presenting with symptoms of type one, especially when there's a family history, like there is in my family, so that I am someone who really cares a lot about prevention, and so that I know the answer to this question, but I also still feel like we can do better in general, for our kids and for adults.
Scott Benner 15:21
So this is a thing that that I find newly diagnosed parents seem to feel very, very strongly about this, okay, like, why doesn't everybody just do a finger pick? You know, at every, every doctor's appointment, when something like this comes up, and I wonder if that comes from, like, you just having the experience where you're like, you realize now, like, oh, we were in there, somebody would have just done this, then the rest of that time, that gap wouldn't have been there, I guess. Like, what was the gap of time between that first visit and when you actually got a diagnosis? And, you know, first, how long was that?
Speaker 1 15:58
Yeah, so, you know that, well, child appointment, and then the actual like, diagnosis in the emergency department wasn't that long. It was probably only about a month. But like, you know, looking back at pictures and looking at how he was, you know, he was so sick that fall, so I don't know exactly, I can't tell you exactly, like, when his symptoms started, so it was an incredibly long period of time, but I do feel like it would have been maybe possible to avoid DKA I had at that well child appointment, the doctor or whoever did that finger poke. And so it's not like, you know, the diagnosis still would have been there, but we would have avoided conversations about intubating our 18 month old child, you know, right before Christmas Eve, which
Scott Benner 16:42
is a thing you probably still think about
Unknown Speaker 16:44
now, yeah, sometimes. I
Scott Benner 16:45
mean, clearly I'm talking about it right now. Yeah, no, but I mean, seriously, like, that's a it's your first kid, right? You don't even know what you're it's 18 months. You're just, you don't even know what you're doing yet. You know what I mean. And then this pops up exactly, yeah, you said you had diabetes in your family. Where is that?
Speaker 1 17:01
Yes, so technically, it's on both sides. So on my husband's side, his maternal grandfather had type one. I never met him. He died before we were together, so I don't know much about that, but on my side, so my dad has type two currently in remission. So his brother, my uncle, who has since deceased, probably had type one or Lata, and he died due to diabetes complications. And my grandfather, so my dad's dad and my uncle's dad, he also probably had type one, or, you know, Lata, he died due to multiple health complications, including diabetes. So, yeah, it definitely runs in the
Scott Benner 17:46
family. Jeez, it does. How about other autoimmune issues, like thyroid or celiac or anything like that?
Speaker 1 17:51
No, not that I know of. Yeah, no, I have an autoimmune disease, but that was diagnosed like in the last year ish, what is yours? It's this kind of random kidney thing. It's called AGI nephropathy. It's more common in like, young men, and they don't really understand why I have it. There's not a lot of information about it. So technically, I'm in stage one
Scott Benner 18:14
of kidney disease. What's I was gonna say? What's the impact on your life right now?
Speaker 1 18:17
None, right now. So I had, you know, I was on a steroid treatment and lots of other medication, which took care of the problem pretty quickly. And so I'm also, I'm technically in remission, so it's something that I follow up with my kidney doctor, my nephrologist, on yearly basis.
Scott Benner 18:33
Is there a thought that you can manage it and it won't become more of an issue?
Speaker 1 18:37
Yes, that is the thoughts and the hope, you know, on the one end of the spectrum, like, you know, severe would be needing dialysis one day, but I've responded really well to treatment, and the hope is to keep in remission. And, you know, if symptoms come back, to just continue, like treating it, and hopefully it continues to respond. Well,
Scott Benner 18:54
it's awesome that they found How did they find it? I was having a lot of
Speaker 1 18:57
swelling, which wasn't going away, and so I asked my primary care doctor about it, and she listened right away and got on it. And had, I had some testing done, they found, you know, protein in my urine, referred me to a nephrologist right away and had more lab work. I had a kidney biopsy, yeah, geez. And so that's then when I got the actual, like, diagnosis.
Scott Benner 19:20
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Speaker 1 20:48
That is a great question. Um, yes, I would like to my partner needs some more time to consider.
Scott Benner 20:55
Is everyone on board? Yeah, I
Speaker 1 20:57
don't know if that's something we want to spend a lot of time talking
Scott Benner 21:00
about, because there's a guy holding half the cards in this deck. And, yeah,
Speaker 1 21:04
that's how it works. And, you know, and friend Remy was initially diagnosed, both he and I were like, oh, like, I think we're one and done, but some time has passed and I am more open to expanding our family.
Unknown Speaker 21:14
Yeah,
Scott Benner 21:16
interesting. What do you think, without digging too deep, just high level is the hold up on the other side, the diabetes and the health stuff,
Speaker 1 21:25
yeah, that is, that is part of it, for sure, okay? And just in general, like, you know, Parenting is hard, so, oh yeah, lots of factors. Can I just tell you,
Scott Benner 21:35
it was maybe three nights ago now, Saturday, whenever Saturday was Tuesday, already, I feel like it's like Three nights ago, I gave my wife a hug in the kitchen, and I whispered in her very gently. If I would have known all this, I never would have spoken to you. I just would have stared through you and kept going. I didn't know all this was gonna happen. You know what I mean? I do. I do know what you mean. Yes, it's like, I was like, I I just had this moment a couple of days before where I was talking. I was, you know, we still talk, but we've been married for a while, so it's not necessary all the time. But we were talking, and I said, I don't feel this is going to sound crazy, because I'm a pretty hard worker. I was like, I don't feel like I'm working hard enough. And she's like, What are you talking about? It's like, I don't have a lot of ideas and things I want to do when I just don't feel like I'm doing them quickly enough, and I'd like to do that. I feel like I see a space here to do something like that, and I'm really going to get to it. And the next like, it couldn't have been four hours later, like, our son comes home and says something, and I was like, oh, here goes the next five months of my life, there you go. And then it's not like, 48 hours later, Arden wakes up in the morning. She goes, I'm sick. I'm like, oh, okay, all right.
Unknown Speaker 22:50
Like, okay, there's always something. It never
Scott Benner 22:53
stops. It's never and that people keep saying, like, I heard somebody told me today. They're like, oh. They say when they go away, like when they get married, it gets easier. I'm like, Well, how old am I going to be at that point? First of all? But I don't think it will. I just think it'll change.
Speaker 1 23:06
It just changes. Yeah, I've heard someone say, you know, when they're little, like their problems are little or, you know, like we're trying to feed them and learn ABCs and things. And then as they grow, their problems become more complicated and more expensive and sometimes work time consuming. So, yeah, even when they're adults, if you're still involved in their life, like that, takes time. This is
Scott Benner 23:27
my point. I just, I actually, I was like, I don't even think we should be trying to save for like, retirement at this point. I was like, we should just, like, light everything on fire, go out and blaze the glory and be done, right? Yeah, just enjoy ourselves while we can. I really, because I don't see how I'm going to live to ad to begin with
Speaker 1 23:42
that. Yeah. I told some students the other day that aging is a privilege, you know, in some ways, and they were like, what? Like,
Scott Benner 23:50
yeah, it just means you didn't die. It's awesome. Yeah, you said a social worker in what setting?
Speaker 1 23:56
Yeah, so that's, that's a good question. I am a macro social worker, which means, like, I don't practice therapy, I don't do direct work. I used to, I've done direct services in the past, but I work for a nonprofit that provides. Well, I work, I work on the prevention team. So primarily, what Children's Advocacy centers do is they help kids who have been sexually abused. That's the clinical side of things. I'm on the prevention side, so I provide education in the community to both children about body safety and to adults like recognizing signs, but also like having good policies and procedures and their organizations and knowing how to report something if they have a concern.
Scott Benner 24:37
Wow, that's awesome work. How'd you get involved in that.
Speaker 1 24:41
So prior to doing this, so I started off, like, right out of grad school, I was a foster care worker, and that was not the job for me. So I, like I said, I'm very passionate about prevention. That's always been something I've been interested in. And so I learned about this prevention position at the Children's Advocacy Center, and that felt like a great fit. So I've been doing that. About five years.
Scott Benner 25:01
That's awesome. Good for you. Is this a more prevalent problem than I would imagine it
Speaker 1 25:07
is? We could, Scott, we could dedicate a whole podcast episode to that, but I know that's not why I'm here, so I won't use this opportunity for my soapbox. But it is, yeah, it's much more prevalent. The kind of like National statistic is one in 10 happens a lot more than I get it. That's a stigmatized topic, and so that's kind of what I'm passionate about, is de stigmatizing conversations around it, so that people can get the help that they need, rather than not telling and then not getting help.
Scott Benner 25:34
One in 10, somebody they know, a lot of people. Yeah. Is it somebody they know, generally somebody they don't know. Does it happen in all kinds of communities, like even ones where you'd think like, oh, white picket fence, everything's good here.
Speaker 1 25:48
Yes. So it happens in every community, and it's often someone they know, because that's someone that has maybe built some rapport with them. So it could be someone in their family, or it could be someone close to the family, or, you know, someone else in the community who, again, like it's not that only the child has trusted this person, but also the family or caregivers have as well, and then that person gets access to the child.
Scott Benner 26:13
So for every 50 people I know, how many of them are psychopaths, what do you
Speaker 1 26:16
think? Oh, man, I am not qualified to talk about that. No, you're
Scott Benner 26:21
not qualified to talk about it, but you might think about it, right, and just get the help I need, right? Yeah, no, but I'm seriously though, when you see this side of the world, when you see that side of the world, is it difficult not to look into a crowd of people and think there's a terrible person in this group? Like, statistically speaking,
Speaker 1 26:38
a great question. So, yeah, once you're, I think, in the field of social work, and especially like the side of child welfare and the work that I do, you definitely see the world differently. I don't like think about terms, like, of bad people, but I think about, like, you know, everyone has probably faced something hard, and not everyone's talking about the hard things they have faced. So it definitely, I think, makes you just more empathetic and aware and just not afraid to talk about hard topics like this
Scott Benner 27:05
I can imagine. All right, so this, yeah, poor Remy, 18 months old. I mean, honestly, Arden was two years old, and I thought, Oh, how you know, but 18 months how much did he even weigh at that point? Oh,
Speaker 1 27:17
man, well, so he definitely had lost some weight with the undiagnosed diabetes at the time, I don't remember, I'd have to look, but he didn't walk for two weeks afterwards. That's something that, like, sticks out in our minds sometimes, like something I don't think about very often. But, you know, he was so ill, so like, he had COVID and this diabetes diagnosis at the same time. So he was really, really sick, really tired. He was little. He was still nursing at the time too. I remember, like, Finally they let me, you know, he had, like, less tubes connected to him, and so I, like, climbed up into his hospital bed, and the nurse walks in, and we're nursing, and she's like, Oh my gosh, I don't what are we supposed to do about that? Like, how do we dose? Oh, the nurse didn't know. I don't know. Like, it's not his primary source of nutrition. But anyway, so it's not something that we,
Scott Benner 27:59
like, worried about. Take a look at this thing. How many carbs you think are in it? I don't know. It's not a thing you've been thinking about ever in your life, either. Oh, no. How long did it take you to figure out a plan and a pattern for all that, for, like, nursing or, like, I mean, just in general, having an 18 month old, newly diagnosed kid. Like, I mean, is there a let's start at the beginning. Do you get a CGM? Do you get a pump? Like, how do you figure out, like, carb counting for nursing? Like, the whole thing,
Speaker 1 28:26
yeah, yeah. So I didn't, I didn't worry about carb counting for nursing, just because, like, it wasn't really, like, I don't think he was getting very much, like, it wasn't pumping anymore, so more for comfort. So I really did not worry about that. But I know other people who you know early on diagnoses were trying to figure that stuff out. But yeah, so he we did get a CGM in the hospital, which I'm very grateful for. Walked out, you know, with the Dexcom on his body. We started out MDI, but we were told in the hospital, but because of, I think, his age, we were, you know, they were pushing for us to get an automated insulin pump pretty quickly, which we did. It only took us, like, a couple of months of being MDI before we're able to get the Omnipod dash. He's now in the five so, yeah, pretty early on.
Scott Benner 29:08
And so you were dosing from a pump really early. What did a Bolus look like for a meal? How much insulin?
Speaker 1 29:13
Oh, man. I mean, it was, it was small, for sure. And we were more strict on carbs, I think, in the beginning, than we are now. So yeah, getting really little amounts, and that was kind of part of the push for the pump, was that you could do smaller amounts more easily, right? Than trying to draw up a Bolus with a needle. It could be more precise. So yeah, he was having pretty small amounts of insulin.
Scott Benner 29:39
What do you mean? Careful about carbs. What were you how were you managing it? Yeah, we were
Speaker 1 29:43
so, you know, we were doing, like, carb free snacks, as they recommended. He was going to daycare, and so he did. He didn't go back right away. I think it was like, a couple weeks later he went back. And we were, you know, still learning ourselves, but trained them how to drop inside. In and we would send this little, like, rich sheet. And we still do that currently, we send a little written sheet with the carb counts for his snacks and meals. I don't remember the original question. Oh, careful with carbs. Yeah, we were trying to, I mean, we were still feeding him like bread and pasta, but I think we were just trying to be more mindful about having a balanced diet, you know, having like, protein and veggies at the same time.
Scott Benner 30:23
Has that changed now? Or did it just get easier when you learned how to bowl, a seat, better,
Speaker 1 30:29
a little bit of both? So he was only going to daycare a couple days a week, and they provided food, which is really cool, like that was included in the cost. So we would look at the menu ahead of time and kind of say like, Oh, they're serving cereal. He will not be eating cereal, you know, that kind of stuff. And now this year, especially, he is in preschool full time, and meals are also provided. So he eats the same meal as everyone else. If he wants it, I tell him what the menu is. He loves pizza, but then crust. So when they serve deep, deep dish pizza at school, he opts to not have that, which is fine by us, but he eats all the other I mean, you know, like, there's like 90 carbs in a meal, sometimes for lunch, so like, he's having that along with his classmates. Now we do send his own snacks, because, again, the snacks they serve are cereal. I love cereal, like, it's a great snack, right? It's not full of nutrition. He also doesn't like cereal, but anyway, so we do send his own snacks, just to keep it a little easier, stay more stable blood sugars. But he's eating lunch along with his classmates.
Scott Benner 31:30
Yeah? You're like, listen, I know it's not good for me, but who doesn't love a handful of apple juice? Yeah?
Unknown Speaker 31:35
Classic cereal. It's like comfort food.
Scott Benner 31:39
Yeah? You know, I just, you just made me realize something you said that there was this year that I I beat the school over the head until they made carb and calorie and all kinds of nutritional information available for everything that they served in the cafeteria. They still do it to this day at the school like I'm telling you, I made that happen, and then I never looked at it once. They because, you know, when I went on my crusade, I didn't know what I was doing yet, and by the time I figured out how to Bolus for things without knowing exactly what was in it all the time, I got the whole thing worked out with the school. So by the time was available, I don't think I ever looked at it once, yeah, but other people have it now, so I'm happy about that. But right, yeah, I just realized that the the poor woman who was like, shackled to me to get this accomplished, realized she'd probably come over here and hit me with a stick or something. My god, that's like, because she's like, we don't want to do like, they did not want to do it. Oh, I'm sure they did. No, they they weren't looking to be involved in this. But they got one day, got tired of me calling and going, how many cars been in today's lunch? And they'd be like, I'll put you through to the lady in the kitchen. I'm like, Okay. And then one day they were just like, maybe we could put this on the menu. I was like, that'd be awesome, yeah. And it wasn't that easy for some reason. My goodness, what have you seen from Remy growing up that would say to you that diabetes has made an impact and changed his life from where you thought his life was going to be, and where are there spots where you can't believe Nothing's different?
Speaker 1 33:14
Yeah, I think early on so like when you know we're in the hospital and they tell us a diagnosis, like I remember, and this is, like, my memory of it, right? So I'm not saying this is how the doctor was, but I remember one of the doctors being almost excited and probably more relieved that they figured out what was going on, right? Because he was in such bad shape. And so I remember being, like, kind of devastated, because I had a little bit of an understanding of what this diagnosis meant, because of my family members, like knowing, like the longevity of it is what was really hard for me to swallow at the beginning. This is something he would have forever. I'm over that now, I think for the most part,
Scott Benner 33:50
you had a situation where he was celebrating a thing that you thought killed your uncle, right?
Speaker 1 33:55
Right? Uncle is still alive at the time, but yes, and doing knowing the devastating consequences that, you know, improperly managed diabetes and have on one's
Scott Benner 34:04
body. And your uncle passed recently, in the last couple of years? Yeah, oh my gosh. How old was he? Like, in his 60s? Jeez, gosh, yeah, yeah. Well, I mean, guess maybe another story, yeah, no, I'm just saying, I'm, you know, I'm sorry he's gone, but probably good for you that it wasn't you know, before, because it would have hit you much harder. I would imagine. Yeah, I think so, yeah. Well, so, okay, so is there anything you can look at like, I see people worried all the time that this is going to change my kid's life, right? They're just not going to have the life that they that we expected, or we wanted or whatever, like that. But are you having that like, is that your experience is, Has it changed things drastically? Or do you think,
Speaker 1 34:44
no, I don't think so. You know, at first, like, yeah, just the longevity of it was something that was like, Oh, this is so sad that this is this burden that he will carry with him his whole life. But we, you know, since then, and his doctor did a good job too. So we live in a beach town. Yeah. And we love going to the beach and spending our time outside. And he was like, hey, these, the technology they have is waterproof, like this is not going to prevent him from living his life. And so, yeah, we haven't, you know, let that really impede his activities. I think it has made us think more critically. I mean, it has impacted like, babysitters, right? Like we don't have, we don't just choose anyone to be a babysitter. There's some extra training involved, as parents, know, and that's fine. That's something that we are fine to manage. Yeah, I don't think we're concerned about, like, stopping him, you know, from living a full, it's awesome, happy life. He does. He's really interested in outer space, and so he talks about wanting to be an astronaut. So I have not, you know, explained to him that, like, I'm not sure if that is an option for someone type one but hey, who knows? Maybe that will be fine one day to go to space with type one diabetes. They stuck
Scott Benner 35:49
those two people in that space station for they were they tell them they're gonna be up there for three days and nine months later, they're like, we'll come maybe, I think we got a guy we can send. Yeah, I don't think you can. Yeah, hopefully he won't want to be
Speaker 1 36:01
an astronaut. Yeah, I'm not, not worried about that. But he did
Scott Benner 36:05
mask. I know this is like, premature, because he's five, but, yeah, there's an episode of the podcast with the person who wanted to be an astronaut has type one couldn't be but she flies the space station.
Speaker 1 36:15
I think I heard, I think I heard that one, yeah, and I do think about that too, like there's so many other ways he could be involved, if that really is his true passion. So, yeah, he talks about wanting to be a doctor when he grows up. He really does well, you know, but I think, as probably some other type ones do too, they're used to the pokes and the fraud, so he's pretty interested at any kind of, like, medical appointment. It's
Scott Benner 36:38
awesome. Oh yes, no kidding. Like, you know it's, it's interesting. The kids at such a young age have thoughts like that. Like, I wonder how often they it actually bears out. Like, you know what? I mean, I wonder how many five year olds are like, I want to be a blah, and it actually happens, right? I'd be super interesting. There's no way for us to know, by the way, but I would be super interested. It's a great
Speaker 1 36:58
question. Well, especially because his endo also has type one, so I think that's like, a cool role model for him that you might not see represented everywhere.
Scott Benner 37:07
Do you find that helpful? Like, I mean, you don't have another experience, I guess. But I would imagine, like, I mean, listen, Dr Kasim, he's obviously really thoughtful about diabetes. Like, from my perspective, but still, like, does it bring you a comfort when the person who's giving the information is living it as well? It
Speaker 1 37:27
does, yeah, especially early on. You know, when you're going through that training that, first of all, I have a lot of questions and critiques of the training they provided us, but that's like, kind of a separate conversation anyway, when they're telling you, like, all the complications, I think that was like the final training went through, like, all the, all the complications that can happen with diabetes. And so I remember early on some appointments my husband and I, and my husband in particular, being like, Okay, tell me, like, kind of like asking for reassurance, right? Like, he's diagnosed so young, does that, you know, increase his chance of having complications? And just he, our endo was so reassuring about like, you know, we have great technology. We've got more data now, more studies to show, like, you know, looking at this time and range, looking at agencies, that the risk for complication, you know, decreases. So that that was reassuring.
Scott Benner 38:15
You know, how I feel, because you've probably heard me say it, but also because I we've shared the experience. I've had that experience too, where they're like, Oh, don't worry. Like, I actually had somebody say to me, the complications, they won't come for like, 30 years. And I was like, she's two, right? Like, so you tell me when she's 32 she's gonna have diabetes complications. Like, that's not comforting. I don't know if you thought it was maybe, but yeah. And having said that, I don't expect Arden to have diabetes complications in our early 30s. But I think that's because we figured out what we figured out too, like, dig in more. What did you mean? You didn't like the initial education?
Speaker 1 38:49
Yeah. So I felt like so much of it was it was too general. And I get that they're trying to reach a lot of people right in different times in their lives. There it was not just for kids. It was for adults, it was for people across like the diabetes, you know, Spectrum wasn't just toddlers with type one, and so I felt like so much of the information they were giving us like, you're so overwhelmed at the beginning, right? You're eager to learn, but also it's this, it can be this shocking diagnosis, and there's so much to take in, and you want to get it right, and you want to do it well, trying to do your best for your child. And so much of the information they were telling us. Like they felt like they were so focused on like, okay, when they're playing sports as high schoolers, this is what you need to do. And I was like, Listen, I have an 18 month old, like, I am not thinking about him playing sports. Like I needed to talk to me about how when he says he wants a snack, and then I do some for that snack, and then he doesn't want that and want something else. And they're like, Oh, well, it's different for toddlers, like I kept asking questions that I thought were relevant and important to our lives, and they're like, oh, sorry, this doesn't apply to you. Oh, sorry, you'll have to talk to your endo about that. And I was like, why am I wasting my fucking time with these trainings if you're not going to give me the information that I'm asking for and that I feel like I need so that that's my critique
Scott Benner 39:57
of those trainings. Awesome. Hey, a little bit of your Remy monkey. Him out there. Oh
Speaker 1 40:01
yeah, oh yeah. There's more. Where that comes from. Trying to behave myself. They're lucky
Scott Benner 40:05
you didn't have your purse with you.
Unknown Speaker 40:08
They're lucky they were virtual. I can't
Scott Benner 40:10
figure out what part of the country you're from. Like, I feel like I want to say California.
Speaker 1 40:13
No, well, I am from Michigan. Oh,
Scott Benner 40:18
oh, you Oh, beach. You mean a lake? Beach, not a not a lake, yeah, it's your voice is so clear, clean, I would put it like it doesn't have a ton of accent,
Speaker 1 40:28
that Midwest accent, yeah, I think that's because I've lived in different parts of the state, maybe travel a little bit, I don't know. But thank
Scott Benner 40:35
you. Thank you like because you know some of you guys sound like you're Canadian, yes, yeah, there's some bastardized version of it, at least. Right, right? Yeah, exactly. But then you cursed. I was like, there's a whole layer to you. I don't understand.
Unknown Speaker 40:47
Yeah, that's the east side of me in there. Yeah, no
Scott Benner 40:50
kidding, because, like, you're like, Oh, I went to the library to record this. I'm like, library. I didn't even know there were libraries. That's awesome. Love libraries, yeah, and you're helping people. And I thought this is just a nice lady, but just not you're a thug. I get it. I hear it in your voice now. I got it. I see what? You're hiding in there. You're hiding in there. Yeah, that's why you didn't want to talk about your husband's not being sure about having other kids, because you were going to go while murder assault. And you're like, let me tell you what I really think about this mother. Hold on a second. I let this guy be with me and look how he's treating me now.
Speaker 1 41:26
No, he, he is wonderful. He, you know, I feel when I see people talk about their spouses, their partners, not being kind of like equal partners in diabetes care for whatever the reason. Like, I feel so sad for them, because that is not the case in our household. No, that's awesome. My husband is so involved and is just incredible. So I am so grateful for that. That's
Scott Benner 41:45
very good news. I feel for every person who comes on here and says that, you know, I can't get my spouse or to be even interested in this, it must feel I don't extra alone in that situation. You know, wow. Okay, so you're, you have a little list here. You said, I believe other people can have a less traumatic experience. Was that just you saying, I wish everybody would finger prick at a at a doctor's appointment. Do you have more thoughts about
Speaker 1 42:09
that? Yeah, kind of well. So like looking, you know, there's some information out there, some studies that looks at the percent of children who are in DK when they're diagnosed, and it to me, it feels like it's too high. So like, yes, our experience, but I know that we're not alone. So I'm seeing a pattern of parents, yeah, not being believed, maybe the first time around, or really having to, like, push and advocate for more testing to get this diagnosis, and then their kids in really rough shape. And DKA is not anything that anyone wants, right? So if we could avoid at least that, like, at a minimum. Can we avoid kids going into DKA? I think that would be a win, or it could be decrease, because right now, it's at about what, like 30 to 40% of kids are in DKA when they're diagnosed, and that feels too high to me. Can we get that down to like, 10 or 20% that's where I'm coming from
Scott Benner 42:58
with that. It's a very simple, solid answer to a problem that doesn't seem to ever get any traction. And I've said this before, but I've seen pretty big organizations try to make it happen, and they just can't seem to make get it off the ground for some reason, I guess. Yeah, everything's so splintered and fractured around the country, it's hard to hard to get a rule up and running for everything, but I take your point,
Speaker 1 43:20
right? Yeah, it's a symptom of a bigger problem of our healthcare system and how it operates. And I don't blame, like our pediatrician, necessarily, do. I wish he would have listened better, sure, but I know that we're not alone in that experience, and so I don't see him as the problem it's I do see it as, like a systemic issue, but I'm sure that there's, you know, folks with other diagnoses who are like, advocating, you know, probably for similar things, like, you know, pay attention, please. But like at the same time finger poke feels so non invasive. I mean, they do regular blood draws of children, or at least at certain points in their lives, right? Testing for lead, testing for different things. And so this, to me, feels like kind of a lighter or an easier ask to incorporate. But there's, we're just going up against a lot of things in our healthcare
Scott Benner 44:06
system, right? And maybe every kid who has flu, like symptoms, doesn't need their blood sugar check. But if you maybe you could make a short checklist. If you you know, five things, do you hit? Yeah, maybe then go to that screener, yeah. How hard could it be? Is that's the horrible part. Is, when you're thinking about it, it feels like this shouldn't be that
Speaker 1 44:22
difficult. Shouldn't be that difficult. Yes, yeah, that's not how the world works, not
Scott Benner 44:26
so far. But I've only been alive for 53 years, so maybe it's coming. It's not maybe, by the way, it's not give up now, I don't know.
Speaker 1 44:34
I agree, like, you know, I'm sure. I know we've come a long way, right? And like our healthcare providers do, I think most of them truly care and like want to do the best they can for their patients and but I do also think it's okay for us to ask for them to be better.
Scott Benner 44:48
Yeah, no, I think it's imperative that we continue to ask everybody, politicians and doctors and anybody who's out there helping people to do their best. It's, I don't know if it's gonna make them but I don't think you should stop asking them to. So I agree, yeah, if you get complacent, then you have a real problem as a society. I think, honestly, you start accepting crap, you're going to get that plus some,
Speaker 1 45:11
I agree, and we see that it's possible. You know, in other nations, there does seem to be some traction for this. And I know I understand that the US sometimes lags behind some other countries in this area, but I do have hope that, you know, we can make things
Scott Benner 45:27
better. Good for you. I like that. You're hopeful. You're still in your 30s, and you've got a young kid. You're hopeful, yeah, yeah. Give you 10 years, she'll be like, listen, Scott, here's what I've learned. Nothing's getting better. I started smoking meth. You Yeah, I want to be fair to everyone. She said, I'm not there yet before I said the math thing.
Unknown Speaker 45:48
Thank you. Thank you for that clarification. You're very welcome.
Scott Benner 45:54
Oh, my God, so sorry. There's a tiniest bit of lag in your signal. I think it's what caused that. Just out. I just was like, Oh, let me be clear about that. Also, the library needs to apologize to rob, who's gonna later yell at me for all the edits he had to do in this
Speaker 1 46:07
episode. Yes, I was trying to avoid this issue by being like, plugged in at the library. I thought it'd be a more, a better internet connection than at home. But apparently, when
Scott Benner 46:17
I say this, Rob, leave that last one in where, where it gapped, where she said, avoid this issue, so that people can hear what we're talking about and then let everybody know that what Rob just left in where it said, avoid it's happened maybe like 30 times since you've been talking. Watch how you'll never know, because Rob's a genius, and he fixed it, and you should go to wrong way recordings and and hire him. Thank you, Rob. Yeah, Rob, wrong. Everybody wrong. Let me give it to you. Wrong way recording.com head over there. Now he's mastering an album this week. He told me for a band, and he does a great job on my podcast. And if one of you had a podcast that made some money and could afford to hire Rob, it would probably offset his life in a way that would let him, you know, charge me less, so I need to get Rob more work so that he can, he can make more money and be nicer. By the way, Rob's such a fair guy. His pricing is so fair. You're gonna love it when you talk to him, but I'm just teasing. Nevertheless, he does awesome work. Now back to your list. Oh, he's, he's opened my life up. A lot of the things here, we'll say one more thing. You know, you hear people say all the time, what's more valuable than time, right? A lot of the offerings you're getting back from the podcast about, like, online community stuff and more written content, stuff like that, it's all because Rob's editing and it actually gives me time to, like, pick my head up and do something. So my life for years was record the podcast, edit the podcast, sleep now. I'm not kidding either. So he might have saved the podcast, honestly, because I could have, like, I don't want to give him too big of a head, but like, I'm not 100% sure how long they could have done this for at the pace I was going. Nevertheless, your list says one last thing that I'm interested in spending time. We're grateful for meeting and spending time with other families with type one. How did you meet them? What did the time bring to you? What do you think? Why do you think that's
Speaker 1 48:11
been important? Yeah, so our our clinic, actually was able to connect us. So we, early on, we met some other families who also have boys the same age, diagnosed with type one, which is pretty incredible. We were meeting more regularly at the beginning, like about every month or so, but as people get busy, that's I think happened maybe like every other month or so, or like quarterly. And it's just it's so wonderful to be able to connect and, you know, empathize with each other and understand where we're coming from. And I'm happy to talk about diabetes with the general population, so to speak like and educate people if they have questions, it's not something that, you know, we feel like, ashamed or like need to hide. And I think because Remy was diagnosed so young, like he doesn't know any differently. And so I just, I'm trying to, like, kind of normalize that for him, and for it to not be a secret. And I like that he's in let people see it, I guess. Yeah, and, like I said, I'm happy to talk about it, but at the same time, it's also important to have that community where you don't have to be explaining things to and they just get it. And it's nice, I think, for kids to see other kids wearing little pods on their bodies and CGM and having to, you know, respond to the alarms going off when we're at the park or playground or where we are, and we just get it, yeah, it's just been really valuable community for us, and we're very grateful to have that.
Scott Benner 49:31
Listen, I know that I talk about everything, so it doesn't really bother me, but so many people articulate to me that they are not interested in explaining their lives over and over again to people, and that you need to have those conversations, but you don't want to go through the rigmarole of explaining the whole thing, and it's just such a big deal. I can't say enough how much I think community does for people. Community can mean a lot of different things. It could be online, it could be in. Person, but in the end, I think it's exactly what you're saying is somebody who understands and is living the same situation, so that you don't have to do all the unsaid things that go on in most conversations, because all of a sudden you're explaining the subtext, and it sucks. Yes, yeah. No kidding. In fairness to me, I love talking, so no way. So I don't really care. I think I said on the podcast recently, like somebody was talking about that, like, I don't want to share this. And I thought, Oh, my God, everybody in my family knows everything about me. And I said, and I said to the point where I said, probably, they probably know more than they want to know. And so then I later went and said that to my family. They're all clicked together. They all looked at me like, yes, yes. We all know way more about you than we want to know. I was like, oh, oh, gosh, that's hurt my feelings. But okay, oh, that's
Unknown Speaker 50:49
so funny. They're like, Yeah, of course, dad. Like, this is not news to us.
Scott Benner 50:52
Yeah, yeah. Like, sometimes I'm saying something, and Kelly's like, oh. And I'm like, you know, people online love this. You know, she always, like, says the same thing in return. She's like, they don't have to live with you. And I was like, No, I hear what you what you're saying. Yeah. She's like, good for them. Or sometimes, like, the way I talk about things, I'm like, you know, on the podcast, this is really helpful, because I speak kind of like long form, and it helps people understand and they can follow better. And she goes, this is not a podcast. I don't need an explanation. This is our family. But here's the thing that I can't help, right? And it's a little unfair to me. I just want to stick up for myself for a second. Go for it. I don't talk like this because it's a podcast. I just happen to have a podcast, and this is how I speak. So I do talk in pictures, yeah? And I I over explain things and stuff like that. So, like, it's not like, I'm like, I'm not on here. Like, oh, you know what the people want. I'll give them that. Like, this is just who I am. It just happens to work out for this. But in your regular life, like, it's not lost on me that I tell a story. I'm like, three minutes into it. They're like, when does this story start? I'm like, all this backstory is very necessary. Yes,
Speaker 1 51:58
it is. Yeah, my stories can be long and winding. And I'm like, Hold on, let me get back to where I was. But like, I need to share this one thing that's not really relevant. But like, I think it's relevant
Scott Benner 52:07
that you have this, yeah, no, it feels like a episode of The Dukes of Hazzard when I was a kid. Come on, in the voice would first be like, first, it's important for you to know, and then, like, and I feel like that. I feel like, look, there's a whole part of this you need to know, and then I can tell you the rest of it, because it's going to bring it all together for you. And sometimes it seems necessary. Sometimes it's not. Sometimes people like, you know, we could have figured out the second part without the first part. And I was like, Oh, I didn't know that's part of the process. I also want to say how angry I am at racism for killing the Dukes of Hazzard. Like you can't even watch it in reruns now, and probably for good reasons. But what a fun TV show. When I was, like, they just made cars fly through the air. It was awesome. Yeah,
Speaker 1 52:48
I never watched it, so I can't really, like, empathize with your point of view on that. But well,
Scott Benner 52:52
it's a giant car with a confederate flag on the top of it. I see where some people might be touchy about it. I'm not saying otherwise. I'm just saying, like, it was so great. Like, they just, like, cars just flew through the air, and people said stupid things, and they raced around on dirt streets, and that's all I really remember about. It's like the A team. But for hillbillies, no offense to hillbillies, by the way, had I not been, I don't know if I've ever been honest about this in the podcast or not, but had I not been adopted, I would have been raised in the mountains of the Carolinas.
Speaker 1 53:21
Yeah, I have some I have some family roots I can trace back to that as well. I definitely have some hillbilly in me. I mean
Scott Benner 53:27
it in a loving way, because apparently I am one, at least with the stuff they built me with. What do they call that? Genetics, right? Genetics? Yeah, or biology, I swear to you, one time I spoke to somebody in my what would have been my family like, my wife was like, she was like, I want to know about health stuff for the kids. So I'm like, All right, so we went to an attorney, paid an attorney to look into it, like they had to open up their records, like I had to, like, it's how we found out that my birth mother had passed away already, and that nobody, there's no birth record for a father, and this whole thing, like this, the whole problem, right? And I get somebody on the phone, and an hour later, I come out of there, and my wife's like, How'd it go? And I was like, Do you think you'll talk again? And I went, I don't think so. No. I was like, my wife's like, what's your takeaway? I said, I lived my whole life thinking that my mom was a princess who got whisked away to live in a castle and couldn't take me. I'm like, I don't think that's what happened. Better not to know. It's hard to know. It's hard to know. Yeah, also recently, I might have gotten because of one of these online I didn't think I was gonna say this on the podcast. I think I got, I've never on like, 23andme been like, that close to somebody like, you know. And so this person pops up, and we are really closely related. And I was like, All right, so we, like, started messaging back and forth, and, like, going back and forth. And like, I think my he's, like, said something like, I think my father could be your brother, or something like that. And then he like, and if he's listening, I'm sorry, but like, I gotta be honest, because I make a podcast. Is my whole stupid job. But, like, I clicked on a couple links, and I was like, Yeah, I'm okay, yeah, I think half brother actually. But still, I was like, I'm alright, yeah, I'll just be alone. There's nothing wrong with that. Nevertheless, no offense, yeah, no offense to anyone. But, you know, I think maybe I just, I'm not that interested. You get to choose your family. Well, I definitely do get to choose. And if I'm choosing, I'm saying no to that one. That's all I'm saying. So the rest of you who aren't adopted are like, yeah, man, we're all related to people who were like, Oh, I can't believe he's coming to Easter like, but I've never been in that situation before, right? It's not the same. Yeah, every family event I'm at, I'm not like, if you're like, a wacko, I'm like, not really related to you. I can be like, Wow, you're an idiot, but I have no ties to you whatsoever. I get to pretend that I'm better, but I'm not. But hey, it's an illusion. I get to hold up at least once in a while. Anyway, what have we not talked about? Like, you have I skipped over anything or not gotten through things that you wanted to say, like, make sure you get everything
Speaker 1 56:08
out. Thanks. So no, I think, like, the only thing, it's not really important that we talk about this. But when you asked me earlier, like, did his diagnosis, like change, kind of the vision we had for his life? Like, do we feel like it's stopping him from doing anything, and no, the diabetes diagnosis is not But interestingly, at the same time, he was diagnosed with diabetes. So you know, one of the things they do to check for brain swelling, they did a scan of his brain, and they're like, Hey, we found this really large
Scott Benner 56:34
mass in his brain. What? We
Speaker 1 56:39
don't know what it is, so we're gonna refer you or neurology, yeah, so they found it by accident, right? And we're like, oh, okay, so he has type one, and he might also have brain cancer. He does not have brain cancer, let me just say that. But like, at the time, we didn't know, and so we couldn't get into neurology for, I think, like, a couple months, for, like, a follow up scan. And so thankfully, what they found is benign. It's called an arachnoid cyst. It's very large, like the doctors are impressed every time about how large it is, that it's not affecting his development, or, you know, impeding him in any way. So they do kind of recommend against roller coasters and contact sports because of the increased risk of, like, a brain bleed that might then require some kind of intervention. So we did learn that kind of by accident, so they've been monitoring that, but it seems like he's gonna be okay and can just live with this huge cyst on his brain.
Scott Benner 57:24
Wow. But that must have, Jesus, that's unfair. That must have freaked you out, and probably still does to some degree, even though they're telling you it's okay Justin, it's still like, mess with you a little bit,
Speaker 1 57:35
not really. It's something I really don't think about very often, except them when they like, give us that call, like, Oh yeah, it's time to schedule, like, his yearly schedule. Yearly scan. We're like, Oh yeah, okay. You know the experience for him the second time. So the first time he was, like, sedated, so he didn't know what was going on. So, like, that was a pretty peaceful experience. But the next time he wasn't sedated, and they had to, like, you know, we couldn't be in the room with them, they had to, like, strap him down. So that was traumatizing, because we could hear him, you know, screaming and crying for us in the 30 seconds he was away from the room. From the room, so that was hard. So then we prepped him better next time around. But honestly, no, it's something I do not worry about,
Scott Benner 58:08
really at all. Good for you. Why are you so healthy? Oh, I'm not, but
Unknown Speaker 58:13
that is not what
Unknown Speaker 58:14
I'm here to talk about today.
Scott Benner 58:19
You're like, why you got that one way, wrong, buddy.
Speaker 3 58:21
I mean, I do my best, but hold this whole
Scott Benner 58:25
thing together with spit and bailing wire
Unknown Speaker 58:30
pretty much one day at a time. Are you from
Scott Benner 58:32
that part of Michigan that people talk
Unknown Speaker 58:35
about? Sorry, which part you
Scott Benner 58:37
know which part I'm talking about? Come
Unknown Speaker 58:38
on. Well,
Speaker 1 58:40
so depends. So I was born in the UK. Um, that's not where I grew up. I grew up in the middle of the states, but I don't, I don't live there any longer, yeah,
Scott Benner 58:47
my favorite disparaging thing I've ever heard someone say about where they were born was not said on this podcast, but it's a friend of a friend who said to me, once I'm from the lower, slower part of Delaware, and I went, Wow, is that a thing? People say, Oh, wow, I've never heard that before, but isn't there like, a bit of the, like, I own a little bit of land, and I don't see people that often, part of Michigan?
Speaker 1 59:09
Well, yeah, there's quite a bit of that part of Michigan. I would say
Scott Benner 59:13
anyway, the lower, slower part of Delaware was said to me 35 years ago, and it still sticks in my head, because I was like, that's a hilarious thing that only somebody from a place would know to say nevertheless. And who even knows if that's true. You might be in southern Delaware right now and say, No, I'm fine, and I'm sure you are. I'm sure you are. Who am I to judge? Nobody. I would like to stop this recording, though, and let me then and have you tell me your top two craziest family stories, because I feel like you've got a couple. Oh, man, okay, yeah, get one in your head. Then we'll stop the recording, if you can tell me, okay,
Unknown Speaker 59:48
okay, I for sure have one kind of two.
Scott Benner 59:51
Yeah, okay, all right. Is it going to beat the girl who told me that her parents got divorced and she was very upset she was still living in her. Home, she was young, she didn't know what to do, and she went to her older sister who was no longer living at home, and said, Hey, I'm very upset about mom and dad getting divorced, and I don't know what to do. When the older sister said, Try meth. Oh, no, I don't I don't have a story. Story that good. Okay? That poor woman, by the way, if I'm not sure if her episodes been up yet or not, okay, she was hooked most of her adult like she had just gotten off at a couple years before she recorded with me, like it stuck to her for decades. It's just, yeah, one bad piece of advice from one lunatic in your life. You know what I mean? Like, I don't know anyway, you must see stuff like that all day long
Speaker 1 1:00:34
with your job. Yeah, addiction. Addiction is really hard, for sure. I feel, I feel terrible, okay, all right. I'm glad I don't, yeah, work in that field. I
Scott Benner 1:00:42
just gonna say I feel lucky that it's not a thing that has attached itself to me. And, you know, I do see those addictions as health issues. And you know, I think you're just lucky if you don't have it to be perfect. Yeah, I agree. But do you have something else to say you want recorded? No, okay. All right, we're done. Thank you so much for doing this. Hold on one second.
Are you tired of getting a rash from your CGM adhesive? Give the ever since 365 a try. Ever since cgm.com/juicebox beautiful silicon that they use it changes every day. Keeps it fresh. Not only that, you only have to change the sensor once a year. So, I mean, that's better. The conversation you just enjoyed was brought to you by us, med, us, med.com/juicebox, or call 888-721-1514, get started today and get your supplies from us. Med. This episode of The Juicebox Podcast is sponsored by Omnipod five. Omnipod five is a tube, free, automated insulin delivery system that's been shown to significantly improve a 1c and time and range for people with type one diabetes when they've switched from daily injections, learn more and get started today at omnipod.com/juicebox of my link, you can get a free starter kit right now. Terms and Conditions apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. If you're not already subscribed or following the podcast in your favorite audio app, like Spotify or Apple podcasts, please do that now. Seriously, just to hit follow or subscribe will really help the show. If you go a little further in Apple podcasts and set it up so that it downloads all new episodes, I'll be your best friend, and if you leave a five star review, ooh, I'll probably send you a Christmas card. Would you like a Christmas card? Hey, kids, listen up. You've made it to the end of the podcast. You must have enjoyed it. You know what else you might enjoy? The private Facebook group for the Juicebox Podcast. I know you're thinking, Oh, Facebook, Scott, please. But no. Beautiful group, wonderful people, a fantastic community, Juicebox Podcast, type one diabetes on Facebook. Of course, if you have type two, are you touched by diabetes in any way? You're absolutely welcome. It's a private group, so you'll have to answer a couple of questions before you come in. We make sure you're not a bot or an evildoer, then you're on your way. You'll be part of the family. The episode you just heard was professionally edited by wrong way recording, wrongway recording.com, you.
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#1556 Weight Loss Diary: Eighteen
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio - Radio Public, Amazon Alexa or wherever they get audio.
Eighteenth installment of my GLP journey
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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.
COMING SOON
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#1555 Dexcom President and Chief Operating Officer
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Jake Leach brings Dexcom news from ADA and answers some listener questions.
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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
We had so much good content this week, it didn't all fit between Monday and Friday. So because of that, you're getting a special episode today, ad free, with Jake leach from Dexcom.
Today's episode doesn't have any ads, but if you need something that one of the advertisers makes or supplies, please consider using one of my links. They're in the show notes of your podcast player and at Juicebox podcast.com when you use my links to get more information or to make your order, you are supporting the podcast while we're talking about that so many of you listen that aren't subscribed or following in a podcast app. And if you could do that for me, it would really help the show. Go into Apple podcasts and hit follow or go into Spotify, hit subscribe. You know these apps, they call it different things, but follow or subscribe, set yourself up to get new downloads doing just that simple task, that free thing that you can do, you will be supporting the production of the Juicebox Podcast and helping to keep it free and plentiful. Nothing you hear on the Juicebox Podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan or becoming bold with insulin if you're looking for community around type one diabetes, check out the Juicebox Podcast. Private Facebook group. Juicebox Podcast, type one diabetes, but everybody is welcome. Type one, type two, gestational loved ones. It doesn't matter to me if you're impacted by diabetes and you're looking for support, comfort or community. Check out Juicebox Podcast, type one diabetes on Facebook. That's good to see Jake. I just hit record. Just so you know, yeah, sounds good. How's art and doing really well. I appreciate it. She's 21 she's had diabetes 19 years now. She's still in college. She had a little thing where she she woke up in her sophomore year, beginning of her sophomore year, and she's like, I don't think this is the right place, but she kept going, and then she's like, I'm gonna switch gears. And I was like, okay, so she went from Savannah and came home and changed to a psychology degree. Wow, cool. We had an issue where she had to get an injection. But she has sort of a, she's got a bit of a needle phobia, which is, I guess, an odd thing to for some people to think about with type one diabetes. But, yeah, we were, like, commuting to her to help her with stuff, and it was like, it was getting too much. So,
Jake Leach 2:34
yeah, no, it's, it's incredible. It's, actually, that's really interesting. You're talking about the needle phobia. But I could see, you know, with the more modern technologies we've all been working on, continuing to develop and innovate, it does kind of get to a point where someone with needle phobia can, or, you know, has an issue with needles, doesn't have to always face that, because the technology is
Scott Benner 2:53
so much better. Oh, for certain. I mean, you know, I didn't realize it at the time when you guys went from, I guess it was g5 that had the plunger, right? Yeah. G6 was the first auto applicator for us. It was just a button, push, yeah. And I remember the time when you made the switch, there was a segment of people who came to me and said, this is such a big deal. And I couldn't wrap my head around I was like, why does it matter? Like, that one wasn't bad. Like, you pinch it, you push the thing, you pull the collar back. It
Speaker 1 3:18
was over. It wasn't, you know, I didn't find it to be difficult. It's not till now that I realized that some people do not want to see how the sausage is made. So, oh, yes, I when we were designing the auto applicator for g6 I remember I had a video of a woman that was she had posted on the Internet, and it was, she was chasing her daughter around with a g5 trying to put it in her arm, or, you know, in her abdomen, yeah. And I showed it to the team, saying, Okay, this is what we're going to try and solve, exactly the anxiety of having to chase your, you know, four year old around to put a sensor on them. And so, yeah, it was the team got a kick out of it. They really it helped get everybody excited. I think you don't realize sometimes, till you look at it, there's a great story. Somebody at Omnipod told me that they used to have a photo of Arden up as like, a five year old in the office, and she had the pod on. And they always thought, like, oh, it's, you know, it's so, so small. It's so great. And they saw it on a little kid, and they thought, I wonder if we can make this any smaller, you know, because on her, it looked huge. And then they shrunk it down. And, you know, little stuff makes a big difference to people. I guess it's my point, absolutely. Yeah. So what have you guys been up to? What are you here to tell me about? Oh, we've been doing all kinds of stuff. You know, we've got new innovations coming on the g7 platform. We've been working on stello. We've been, you know, broadening awareness. You know, it wasn't that long ago that CGM is really kind of a tool focused on more intensive insulin users. And I think that's, you know, that's where the initial evidence for clinical outcomes, all that stuff was generated. But now, you know, as we continue to grow and conserve more customers, as we look at this type two population, you know, type two diabetes continues to increase. Around the world, and CGM is an amazing tool to help people better manage it. Lot of it in type two, as you know, you know, a lot of it's around kind of lifestyle and, you know, food and activity levels. And so, you know, CGM is a great tool to help people manage that differently and more effectively. And so we're just really out there trying to drive the messages around type two. And we have a type two report, basically a state of type two in the United States, specifically around CGM. We did this for in our European region earlier, or, I guess, late last year. And so now we're we did it again the US. We talked to over 100 healthcare providers. We talked to a lot of people. Over 300 people have diabetes, type two, and most of those folks are not taking insulin, so they're treating their type two with oral medications or other other medicine, non non insulin, and really just getting after their experience with CGM, the benefits. And really around the prescribers asking them, and you know, they very much see CGM as a as a critical tool for managing all of type two, not just those insulin users. What are they
Scott Benner 6:08
reporting back? What are people getting out of seeing the CGM data?
Jake Leach 6:11
So I think the main thing is that they all believe that 100% of these folks said CGM in combination should be used in combination with GLP ones and sglt twos all the time. You should always have CGM alongside so that you can see basically, how those, those different medications are helping, you know, helping improve blood glucose, but also the medications, again, as you know, they're not the only solution, right? A part of this is changing choices and habits and forming healthier habits to manage diabetes. And a CGM is perfect tool to show that, because it's just that instantaneous feedback of of a meal or, you know, activity level that causes glucose to be so much better controlled, they learn that very quickly, right people when they see that, you see in your own data. It's extremely quick to figure it out.
Scott Benner 7:03
So, you know, it's a lesson you hear people with type one talk about all the time. I mean, genuinely, I interviewed a person this morning, 44 years old. She was diagnosed when she was 22 and she said she kind of was able to pretend she didn't have diabetes. That was her coping mechanism. Then she got on a CGM, and then suddenly saw what was happening and realized, like, I can't, how am I going to ignore this, you know? And I even think back to, I mean, I don't know how long you guys have been coming on the podcast, but way, way back, Kevin told me I'm wearing the product, you know, like, I don't have diabetes, but I'm wearing it. And here's a list of three foods I don't think I'm going to touch anymore, just seeing what it did to my blood sugar while I was wearing it. Yeah. So I guess my point is, is that when we can talk to type ones who lived before CGM, and hear from those adults who are seasoned, and they're veterans of the fight, and they can tell you how big of a deal it is to see the feedback, it's interesting that we almost didn't, like, immediately just apply that to type two like, why did we have to, like, go talk to people to figure that out? You know what I mean? Like, it's, it's really great. I mean, it's fantastic that it's getting out there. So, but how does it get out there? Like, are you counting on an endocrinologist or a GP? Are you counting on the people who do you want to say, hey, you should try this thing if your loved one is newly diagnosed with type one diabetes and you're seeking a clear, practical perspective, check out the bold beginning series on the Juicebox Podcast. It's hosted by myself and Jenny Smith, an experienced diabetes educator with over 35 years of personal insight into type one our series cuts through the medical jargon and delivers straightforward answers to your most pressing questions, you'll gain insight from real patients and caregivers and find practical advice to help you confidently navigate life with type one. You can start your journey informed and empowered with the Juicebox Podcast, the bold beginning series, and all of the collections in the Juicebox Podcast are available in your audio app and at Juicebox podcast.com
Speaker 2 9:01
in the menu. Short answer that is, everybody right. I think it's a big focus of ours is just raising the awareness that CGM technology exists. Many people who have private insurance are start. We're starting to see coverage for all diabetes. You know, got three of the largest PBMs now have have Dexcom CGM on their lists of covered, covered devices. So we still have work to do with, you know, Medicaid and Medicare and, you know, all the pairs, like we always do, but we're starting to see lots of real world evidence being generated by people using both g7 and stello that have type two, and we're starting to see their their outcomes and how much improvements, no surprise, the improvements that they're making when they start using CGM. You can within the first month, we're seeing significant improvements in time and range. I love these studies, where we show, you know, a whole large population of folks go on CGM at this point in time, at the beginning, before they view. To CGM their their first week, they know they've low time and range, nowhere near the 70% goal for type two diabetes that the ADA has put out there. And then you know, within that 30 days, you know, you use three sensors, and before you know it, they're hitting a time and range goal that you know probably maybe felt not attainable without the right tools. And so you put CGM in their hands, and it's, it's really exciting to see, and that's while they do have a physician, I mean, a lot of that's just their own, their management themselves. They're now have data. They can do something about it. They can, they can hit their goals that have been really hard for them in the past to be able to achieve. So I love those studies. There's lots of people starting to use CGM, but it's awareness around the physicians. You know, if you have coverage, we want you to get a prescription and get it covered by your insurance company. If you don't have coverage, you've got, you've got the stello option. You know, sign up for a subscription, get it. You know, less than $100 a month, you could have CGM full time, right? Do you think those people are just seeing the impact of food and making different food decisions. Because, I mean seeing a turnaround that quickly in a few weeks, right? Like, it's not like they up their medication if they're on an oral or something like that, right? They just, they saw what was going on, and they're like, Oh, I'll make different decisions here. That's the vast majority of his different decisions. I think one of the other things I love to hear about is when users understand that, you know, modest levels of activity can have a significant impression. You know, just a walk, you know, just just a moderate walk around the block. We're not talking about running, running on a treadmill. That can also really help their glucose levels and so just a little bit activity. But I think, you know, the biggest impact is usually around diet, you know, food choices, meal compositions, all the things that we you know, may have been told before. You know, through through diabetes education, but when it's your own data on, you know, coming out in real time, and you can see that those numbers, you can see the graph. You can see the on Stella, we've got the spike detect feature that really helps try and focus in on the more impactful spikes during the day, and what helped you think through what happened there, and what could you do different? I it's an amazing education tool, and I just love hearing when folks are able to make some changes on their own, simply that improves their health.
Scott Benner 12:16
Like, what's the level of like? I guess. Where does your A, 1c, have to be if you're type two, like, before you're eligible, because insulin resistance can start way before your your a 1c, goes up, right? And if you're going to see a ton of people on glps, mostly have a lot of success, that success is going to be because they probably have insulin resistance that might not have thrown them into pre diabetes for years. Like, to me, like, that'd be a place to grab those people?
Jake Leach 12:41
Yeah, yeah. There's definitely approximately 100 million people in the US that have pre diabetes, and, you know, hundreds of millions more around the world, and the vast majority don't know they have diabetes, pre diabetes, right? They haven't been diagnosed. They're not aware. That's the group where raising awareness that the technology exists to give it a try. There's definitely people who, you know, didn't understand their their metabolic health or their glucose health until they tried stello, and then they realized, wow, okay, there's some stuff going on here. To take a closer look. Yeah, it's an amazing tool. Now that it's available over the counter, it's such a new a new thing, but raising the awareness, get it out there, by all means possible is kind of the way we're looking at it.
Scott Benner 13:22
I've shared it a lot on the podcast, but I'll fit in enough of it here that you know people will know I'm serious about this. I started taking a GLP two years ago. I just told you that I'm 62 pounds lighter than I was, but what I learned was it had very it did not have nearly as much to do with what I was eating as it did. I don't really know a way to describe that. Like, I used to be anemic all the time for no reason. My body never absorbed iron. I went on a GLP that stopped immediately. I used to my digestion didn't work well, that stopped. It fixed things about I hate to say it like that, but it changed things about me. I don't even completely understand. Yeah, my back doesn't hurt anymore. It used to be, I'm so embarrassed, but like, if we all went out to dinner and ate the same thing, I'd be four pounds heavier the next day just retaining water. Yeah, no, I don't drink, I don't smoke, I don't do drugs, I don't like, I'm active. Like, didn't matter, didn't matter what I did. And then, you know, I started using the GLP. So my point is, is, if that's true, and I believe it is. And I've just recently had an interview with a doctor who's kind of behind the scenes on helping to talk more about how diagnosis are going to go in the future. He seems to feel like it's not just going to be type one, type two, you know, but he said you're going to see dual diagnosis as soon for people with type one who also have insulin resistance, that's going to be he believes like a real diagnosis. I think that explains why some type ones go on a GLP and see great benefit, and some don't see any difference at all. That's right, I guess where I'm coming from is I wish somebody would have told me this 20 years ago. I know it didn't exist, but I can I see what my life's like now. And I. Wish I would have had this sooner. I
Speaker 2 15:01
guess it's the Yeah, the GOP, one class of drugs at all that, although they have been around for almost that long, 20 years, the new formulations, the once weekly is like all those things have really enhanced the the outcomes. And I think the outcomes are incredible. You know? I think what, what we've seen is particularly in in diabetes, the best outcomes are generated when when you're using the right medication, often on GLP, one alongside with the CGM. So understanding, you know, just even the medication adherence part, is something that we know doctors recognize when they're writing prescriptions is like, you know, if you can see how impactful the medication is to you, you're more motivated to take it, right? And so I think when you have a CGM, and it's showing you that, while also helping educate you on on, you know, meal compositions, activities and tracking things and a little bit of accountability too, right? If you learn a sensor, you know, there's a, there's an accountability component there too. So I think all that together is how it works produce, you know, fantastic outcomes for people. I can also see the impact it would have on the physicians who might not believe in it until they see it on the data, you know, because there's still plenty of people I've, I've had doctors say to me, like, well, you're gonna have to use that for the rest of your life. And I was like, no. I mean, no one says that to a thyroid person who needs thyroid replacement hormones. If this is what it needs, this is what I need. And you maybe it would stop people from having that experience where they've, you know, lost the weight, then the doctor takes the med from them, and then they're right back in that same situation again. I see a ton of benefit from it. So I wish you a lot of luck. I hope it, uh, I hope it goes well, getting it out there. Yeah, no, we're gonna keep, uh, we'll keep driving. And, you know, the job's global. There's, there's so many people around the globe that either have access to CGM and aren't using it yet, like they have coverage in some form, or that don't yet have coverage. We're out there every day, bringing the advocacy, bringing the clinical evidence. We have a very large clinical trial we're running right now in people type two who don't use insulin specifically, a randomized, controlled trial to show the outcomes that can be generated by wearing a Dexcom CGM for that population. And I think that will be an important evidence to use globally, not just here for the United States, to get more access and coverage, because CGM saves money in the first year. There's not too many therapies that, net the cost of the drug or the device are going to save you money in the beginning, but with CGM, people you know, have the information they need to better manage their diabetes. They're not going to the hospital as often. They're not showing, you know, not using as much of the healthcare system, because they are living healthier. All those things bear out pretty quickly, so you don't have to wait like, you know, months and months to get the outcomes.
Scott Benner 17:40
I have two hurdle questions. Do you have any data that says what the hurdle is? Once somebody actually has one to putting it on, and I know that we're not exactly a society of like, preemptively getting in front of something so like, because I'm thinking about like a friend of mine who whose family is still in India, and they talk about how much pre diabetes and type two is in their family, and there's a large population of people who, I mean, you would imagine that country would get a huge relief if they'd never progressed all the way to type two diabetes or pre diabetes,
Jake Leach 18:13
that's right, yeah. So I think the there has to be some level of engagement by the user to take the action, right? They got it. They have to have the interest level. They have to have the knowledge that, for example, CGM exists, and curiosity around using it, right? And so the biggest thing that we found is just making sure people know the technology exists, what it can do for them. And then also, we use our warriors, quite frequently, to talk about their experiences, to think there's nothing better than someone explaining. I mean, I can tell you how great CGM are all day long, but if you have someone who has a very personal story about how CGM changed their life, then I think that's resonates really well across users and so we are we have more and more now of our warriors are type two, in addition to all the type one warriors that we have around the world. I think we have over 30,000 warriors today that are out there telling, telling about their, you know, talking about their stories, their personal experiences with with their Dexcom CGM, and how to change their life. And that's that's worked well for us. But it's just, yeah, the job will never end in terms of making sure the technology people are aware of it. It's, you know, less than two mil, 2% of the people in the world using that have diabetes are using CGM. So there's still hundreds of millions of people that could benefit from the technology that don't have access to it. So that's, that's our focus as an industry, too. It's not just Dexcom. I think we're all focused on making sure people can get access to this technology. How would you be able to or would you be able to keep up with, like, What if everybody just woke up tomorrow?
Scott Benner 19:42
Was like, That guy's right. What would you do to ramp to ramp? But Jake would be like, I would just give I'd go home. I'd be like, I did it. I'll see you later.
Speaker 2 19:51
No, no, no in any like that. If something like that happened, I you know there isn't the capacity out there between us and all the. Folks that make CGM out there, there's not the capacity to service all those people overnight. But, you know, it never happens like that. It happens in stages of access. But, you know, I can tell you, one of the things that I'm always it's exciting, but also it's a lot of work all the time, is that ever, pretty much every quarter for us, is a record number of sensors manufactured. And it's been like that for many, many years, and we intend to keep it that way. So I think that scaling is a big part of what we do. We've learned a lot of lessons along those journeys from g5 to g6 to g7 and then to our next generation platforms as well. Big part of this is not just a feature set. Now. It's about building sensors in large scale, high reliability product for large scale. That's a big part of what we do. How much time does it take if you identify a defect in the process or something going wrong more often than it should? How long does it take to identify it and then change production so that it I'm trying to figure out what that window is, yeah, it's actually pretty quick in terms of our ability to, if we see an issue, to be able to correct it. And then for it usually takes a couple of months before users start seeing it in the field, because it goes through distribution channels and things. It can be pretty quick. But it also depends maybe on geographies. And, you know, in the United States, the largest volume is, you know, lot of stuffs running through pharmacies in the US. It's, you know, some of the highest volumes of that stuff goes, goes the fastest. But yeah, I think our goal is always to continue to come out with new, innovative features continue to enhance the reliability of the product. America. 15 day g7 is another improvement in accuracy. We've spent some time looking at all the g7 performance out there since we launched it a couple years ago, and we're able to take that and build some of those learnings into the new algorithm that's in the 15 day product. And so it's got even better, better performance.
Scott Benner 21:52
That leads me to a question that people send in, if there's people running around who are like, Look, I can't get my sensor to go past seven days. It just doesn't work for me past seven days. And they've come to grips with that, is changing to the new one that's going to last 15 days. Is that going to change their experience, or are they just going to be wearing a 15 day sensor that lasts them seven days once? What? You know? What I mean?
Jake Leach 22:10
Yeah, it's a really good question. Scott, I think it depends a lot on what their particular issue or situation is, right? Is it Are they having challenges with adhesive or are they having challenges with sensor probe remain accurately measuring glucose over that whole time. So I think it'll be a little different. We are as we've always have. We're always continually enhancing adhesives, so we've got another couple that are in the mix here in the near term that further enhance the adhesion of the product while balancing skin irritation and ensuring that we don't we don't get those. We every time we've made this adhesive change, we focused on folks that have sensitivities and making sure that we're not causing more of an issue there. Especially with g7 we actually had a significant improvement. We launched the new adhesive on the g7 product in terms of less, less reactions. So, but it's something we're always mindful of. But, yeah, I think, you know, depending on what the person's issue is, you know, they may also a 15 day. If their 10 day isn't lasting, their 15 day may also but one thing is, we replace sensors. You know, particularly if you get a sensor error, we're going to replace that sensor every time. If you have an issue, what I generally see is people, over time, learn what, what, where it was specific, where location works best for them, what adhesive combination works best for them. Frequently, a new user, if they do have an issue, they figure out over time how to resolve it as they use more and more sensors. But you know, it's part of the fact of CGM. Not all CGM sensors specifically last the full duration. It's a smaller percentage, but it does happen, and that's part of just the state of the art of the technology, and something that we're always working on, enhancing, extending. I mean, we took us a while to make sure we were ready to do 15 day because of that, we want to make sure that the vast majority of sensors make it to the full 15 days. And part of that was bringing it to stello first. We brought it Stella first. We've seen good performance with Stella 15 days, and now we're ready to continue extending it on to g7
Scott Benner 24:07
Listen, I've seen you pressured a number of times over the years. I've never thought that you guys have rushed just because you were getting pressure. I mean, I'm seriously like the Apple Watch functionality, like you could have buckled a bunch of times and just said, Look, here it is. It might work. It might not like, you know what I also wonder, I mean, you and I have talked about this before, but like, it's still like a an inanimate thing being inserted into a living person. Like it's, it's not a perfect scenario, right? Like, sometimes people get luckier and some don't. Sometimes, like you said, they find a place or a way and then it fixes their problem. I feel bad all the time when people tell me their their problems, and they say, What are you doing? I go, I have Arden wears right through the 12 hours. Like, yeah, she doesn't. She very, very, very rarely has a problem. I will tell you. We've seen a few of the insertions where the where the sensor wire ends up outside of the CGM, and you pop it off and throw away and put another one. But other. Than that. I don't know how to respond to them. She doesn't have adhesive allergies, and the thing lasts for so I just knock on wood, and I go, go, we're finally getting lucky about
Jake Leach 25:07
something. Yeah, the point when you started that was the that idea of, yeah, it's a sensor probe under the skin that, and that's in, you know, in terms of the science that's, that's what we work on the most, in terms of the way the body reacts to the sensor and different insertions. Sometimes it's, you know, works perfect, and other times, that particular just insertion has nothing to do with the physical sensor itself. It's a perfectly good sensor, but you know, your body's reaction to it in that, that state and time you know you get, maybe it doesn't last the full 10 days. So it's part of the science that we strive and work on and continue to enhance longevity. But yeah, I think anybody who does have issues, we always want them to come contact us. We want to hear about them, and we want to, you know, help them figure it out. That's, that's our number one, number one policy for customers. We're here to support you. We want to figure it out. We're not always perfect, but we strive to be, and we always strive to get better and better. Yeah, hey, I want to make sure.
Scott Benner 25:59
Do you have anything else for your announcement? Can I ask you a couple other questions?
Jake Leach 26:02
Well, I think other questions? Well, I think there's one really cool thing I wanted to tell you about. In g7 we've got a photo meal logging feature that we're launching here imminently, that allows you to take a picture of your food that you're about to eat. And so instead of having to manually log it, it does an automatic you take the picture. It uses AI to determine what the food is, gives you a description of it. It's pretty cool. I've been using it quite a bit. The demo version. It's pretty cool to be able to log your meals that way, and then it gets recorded into the into your glucose history. So you've got that capability to log those meals. And then, if you can imagine, once we have that out there, and people start using it, there's a whole host of things we can do in terms of meal recommendations, helping physicians understand meal compositions for patients and how to help them enhance things so that that feature is launching here very quickly, on g7 first, actually, we're bringing it g7 first. We're going to bring stello later this summer.
Scott Benner 26:57
Okay, are you going to sunset g6 at some point. And do you know when that is? Yeah, at
Speaker 2 27:03
some point we will. I think you know, our goal has been making sure we support customers across the whole spectrum, particularly aid users. And so Omnipod just launched their iOS app version that's compatible with g7 another lot of people waiting for that, that is going to help with the folks have been waiting to upgrade to g7 now they can. So at some point we will sunset g6 but we're not we're not ready to do that this point in time. We want to make sure everybody has a chance to get their upgrades through before we'd start talking about g6 discontinuation. So you brought up a second ago that the photo logging is AI looks at it and recognizes the food. I've been wondering what else you you might be thinking about with AI. And I'll tell you from just from my perspective, I've done some things, like built my own large language models that are just made out of the transcripts of the podcast. And all that is, is what, maybe 2000 conversations about diabetes at this point. There's almost nothing you can ask it that it doesn't know about diabetes now, and as you're talking about what you're talking about, I'm thinking, How long, I mean, we don't all eat that many different things, right? So how long is it going to be before I take a picture of the plate and it's already seen me eat this 10 times, and it goes, this is this much insulin? We're going to extend it this far? Like, is that a world we're looking for? I mean, I think there, as you know, there's enough variability in diabetes that it may not be just quite that perfect, but it will certainly be able to be Hey, when you ate this last time, here's what happened to your glucose. Good job. Great meal. Keep doing it. Or it could be, hey, here's a way you could do this differently. Maybe change a portion or something, swap something out for a protein, swap some carbs out, like, just basically switch it up a bit to really help them. It's like a great in the moment teaching tool, yeah. So I think we are, you know, AI is going to it's helping us in all kinds of different ways. As you, as you mentioned, it's a wonderful resource for information properly, kind of managed, right? We've been using it in the stello insight report, the generative AI and the AI technology that Google has their their vertex and Gemini technologies, those, it's really fun and cool to play with. We continue to come up with new use cases. You're going to see a lot, I think you're going to see a lot from from Dexcom and many other companies. Just in the way that we use AI technology for all different aspects of our lives, we're clearly very focused on applying it to diabetes and and continuous glucose monitoring, and I think it's going to make the products more engaging and going to give you better insights, ultimately, right, that are highly personalized and simple and easy to use, and really amplifies the value that we're already bringing. This is a very forward looking and if you're thinking about it, you might not be able to say it even but say it even, but you have everybody's data, if you've got their graphs, and you've got their logging of insulin and carbs. I mean, at some point that's got to be enough information to teach an A I D system with right to be predictive. Yeah, you could do absolutely. I mean, we we actually have one of the tools that we have with. And our research development team is a physiologic simulator that based on, you know, different activity levels, food levels, everything. Can predict glucose excursions, and you can, you can, basically can recommend the amount of insulin to take or a different type medication. We've used that to help develop quite a few things, including our basal optimization algorithms for insulin optimization, we've started using it for aid algorithms. We used it when we did the control IQ development. So we've been using simulators for a long time, and now the AI tools are just making them more powerful. So I absolutely think, I think that, and the real benefit here is you can really short circuit and speed up some of the innovation when you can do simulations and in silico modeling versus having to do large clinical trials, there's still often a point where you need to do some some trials to really prove safety. But, you know, the in silico stuff really gets you a long way. And so I think that's clearly one of the areas that AI is going to help us. I imagine that's how you figured out predictive low alerts. Yep, that's exactly how the predictive LOW Alert was developed. Was developed off of a lot of user data that you know. The whole goal with that was to make sure you know the urgent low soon. We didn't want to be alerting you if you're not really going to go low soon, right? And it's kind of funny, because if you wear that as someone who doesn't have diabetes, you'll you'll cut sometimes get those alerts just because the way your glucose dynamics look, but you know, those that particularly have diabetes or are dependent on insulin, it's very accurate in terms of its ability to predict without giving you too many nuisance alarms, that balance was purely driven by analyzing user data and figuring out the right time to alert. Yeah, I have a question from somebody that wants to know if you're exploring other ideas for different sensors. They brought up biomarkers, guys, they were really specific, or CCL two from subcutaneous tissue, like somebody who's listening knows more than I do. But are you? Are you looking into branching out different things? Yes, we are. We're, you know, if you think about the platform we have this wearable subcutaneous sensor probe that continuously measures an analyte. Today, it's glucose. There's quite a few others that we've been working on, both enzymatic and some that are not enzymatic. The use cases are pretty powerful. There's quite a bit of both chronic disease and other health conditions that you can better manage if you had some of these markers. And so, glucose is still our focus because of the significant need out there, but we've been for years working on a number of different programs that extend sensor sensing beyond glucose. We'll start talking more about those here soon. You definitely feel like there's an opportunity to increase the impact we can have by adding some additional analytes to the sensor.
Scott Benner 32:44
This is for me, but I'm 53 do I live to see a sensor that doesn't have to be inserted
Jake Leach 32:51
that's accurate enough to give insulin off of or is it just, do we just not possess that technology at this point? It definitely doesn't exist today, at least anything we've seen, and we've seen quite a bit, and we've evaluated a lot of non invasive so no, no sensor under the skin, and no, no sensor in contact with the actual glucose molecules. We've not seen anything that even comes close to the performance you would need to actually do the things we do today. You know, one of the things I've seen is there's some interest in, you know, them being able to categorize risk for high glucose, right? So, you know, those types of systems could potentially say, Hey, you're have a higher risk of exposure for glucose, so you might want to go wear a CGM. I mean, I think that's, that's the closest I've seen to a technology something like that. But when it comes to making food choices and better, and particularly managing diabetes with insulin. There's nothing that I've seen that's even close to being able to do that. But I love, I love all the, you know, I love the efforts. It's we stay close to the number of companies that are developing technology in this space. It just hasn't, hasn't come to fruition.
Scott Benner 33:59
I only ask because of the number of people who are duped by the fake ad of the pulse ox meter that says that it's a glucose monitor, and you don't have to get I don't know if you've seen that one, but it's been going people are taken in by that with the frequency I have a really big like, my group has like 70,000 people in it, right? Like they're active every day. And so the amount of people that I see who are taken in by that really what it makes me feel like this, but in their heart, they really wish that was true. Yeah, you know, yeah. So I was just asking the question to break their heart so they can stop
Speaker 2 34:27
thinking, yeah. I mean, I do think, I mean, it is, it's a it's been something that billions and billions of dollars have been invested in. I think it's just the science. When you get down to the physical science of it, it's just hard to you look at a pulse oximeter, it could tell, you know, blood oxygen based on the color of the blood, but you glucose, there's no color change. There's RFS been tried. So many things have been tried with great promise, but it doesn't play out when you get down to the actual physics. It shows the value of glucose sensing. And everybody who's who wants to try to get into that, that type of development, they're basically further. Validating just how important glucose is as a biomarker, just yeah, the sensing mechanism. I think we do the best at it, and we're going to keep innovating. I'm going to see if you'll tell me when g7 15 day is going to come out. But before I do, I want to know if there's any other stuff in the pipeline that you're able to talk about, smartphone, watches, pumps, any integrations that are coming. Nothing to talk about at this point. We're going to keep you know, driving new versions of our apps, new features. The photo, meal logging is a big deal. It goes across our whole platform. We got continued enhancements in identity management, right? Just making it easy, passwords and things you forget, those are linking, linking between partners, right? We've got our aura partnership with Stella, which has been very exciting to see the number of folks that are linking their stellos up with their aura apps. But there's improvements we can make in that process. There's just so many things we can do to further enhance the, you know, the experience around the products, and that's what we're focused on. Okay, awesome. Well, I appreciate it. Can you tell me when 15 day g7 is available later this year? Yeah, later this year? Yeah, definitely, yeah, it'll come out later this year. Yeah. Team's working hard right now, building inventory, getting them, getting ready for the launch. So it's coming
Scott Benner 36:08
right?
Speaker 2 36:09
Is there any connection between when people have problems with their g7 is there any connection to where it's being produced and the problem coming out of a certain place, or, like, at a certain time period or something like that? No, it definitely so the it's a really good question, because we do have multiple manufacturing sites now. For many years, we just manufactured sensors in San Diego, and then we opened a site in Arizona, and now we open a site in Malaysia as well. So we build sensors for the world in all those different locations. We have the exact same equipment in every single facility. We use the same automation equipment we use. The teams are all kind of trained in with the same technologies. Our experts are, you know, spend time in all of our factories making sure things are running so it definitely we don't have specific, you know, differences between factories. Even the way that we measure the performance the factory is exactly the same. And I can assure everyone that when I look at the performance of our product in the field, as well as what we've got coming out of the factories, very diligently, I actually spend a good amount of my time following up on that and making sure that we're always making a better sensor every day. And we do have consistent performance across factories. You know, we do have issues. They do pop up and we fix them quickly. It's part of just the scale that we operate at and continuing to build record new sensors every quarter. We're just continuing to learn and enhance and get better and better. I definitely want to make sure everyone understands that it is the same process, same performance across factories, no matter where it comes from. I mean, it just thinking about it from common sense. If you did identify a place that was making a mistake, I would assume you'd be able to fix it. You'd know what the mistake was. So, yeah, it's just the randomness of production. When something goes wrong, yeah, I think when if something, if it's, if it's something on our side, like a, say, a deployment issue, yeah, it's basically just sometimes, you know, there's a small percentage of sensors that, when you try to deploy them, they fail, and so we're always studying those. We want to hear about them from users. We want to replace them right away when that does happen, and G sevens continue to get better in terms of its its performance now which 15 day coming out in the higher accuracy and longer where. So we're continuing to invest in both future innovation, but also just continued reliability enhancements and making making the products
Scott Benner 38:21
better. Listen, I tell people the same thing all the time, but I always there are moments when I think they just think, well, yeah, Dexcom, they buy an ad on your podcast. What are you going to say? But you know, my daughter's been doing this for 20 years. We started with a meter. If I took you back then and gave you the first Dexcom, you'd be like, Thank you. I'll take you. Don't need to make it any better. This is perfect. Thank you. If you go back 40 years and find some old head who was on regular and mph, they'll tell you, if it doesn't work all the time, put another one on, because this stuff is awesome. I mean, listen, I've been watching you forever, you guys, you get better all the time. I've never seen you not working on making things better, sleeker, you know, more accurate. And listen, every time something comes up, I think if it's just like a fun thing, that's all like, the magnet thing with the g7 now, like, if you ever, like, you know, it goes on, but the magnet doesn't turn it on. You just get a magnet. You like, move it around and it pops on you. Like, hey, I figured it
Speaker 3 39:12
out that was, yeah, I saw some of that on social media too. At first, when I saw it, I was like, wow, that's interesting. And then I looked into it, I was like, oh, yeah, nope. That there was a particular failure mode we had that you could do that with, but we fixed that.
Scott Benner 39:24
Yeah, no. And, like I said, it doesn't happen anymore, but for like that couple of like, I mean, I think it happened twice, but it's interesting, though, because you watch a person online with a more of an engineering brain, who goes, like, look, there's a magnet in there. I think that the reason that battery doesn't start running until you put it on is because that magnet is doing something when it when it separates. So I would just hold the magnet up to it again and pull it away a couple times. I was like, That guy's a genius.
Jake Leach 39:47
I love the ingenuity and the passion of the community out there, and a lot of the feedback that we get from users gets put right into the product just because of that, because, you know, we're they're thinking of wonderful things for us to do. And. As well as what we're doing internally,
Scott Benner 40:01
they're the ones using it, right. So, yeah. So anyway, man, Jake, I really, I appreciate your time, and I hope you I know we're recording this ahead of time for ADA, but I don't know if you're going, but I hope you have a good experience. If you head off to the conference, yep, yep, I'll be there. Excited to be there, excited to meet with lots of our customers and physicians and, yeah, catch up. Awesome. All right, it was good to talk to you. You too. Scott, thank you.
My diabetes Pro Tip series is about cutting through the clutter of diabetes management to give you the straightforward, practical insights that truly make a difference, this series is all about mastering the fundamentals, whether it's the basics of insulin dosing adjustments or everyday management strategies that will empower you to take control. I'm joined by Jenny Smith, who is a diabetes educator with over 35 years of personal experience, and we break down complex concepts into simple, actionable tips. The Diabetes Pro Tip series runs between Episode 1001 1025 in your podcast player, where you can listen to it at Juicebox podcast.com by going up into the menu.
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