#1851 That’s So Bridget
Scott and 23-year-old Bridget discuss her college T1D diagnosis , managing Hashimoto's and ovarian cysts , using Mounjaro , and the mental hurdles of taking daily medications.
Companies that Support Juicebox
Key Takeaways
- Being diagnosed with Type 1 Diabetes as a young adult entering college requires a rapid shift to independence and self-advocacy, but it is completely possible to thrive.
- Hashimoto's thyroiditis is a common comorbidity with T1D; untreated thyroid issues can cause fatigue, brain fog, joint pain, and weight gain, making daily medication adherence crucial.
- Finding a manageable routine for daily medications (like keeping pills in the bathroom to take before a shower) can help overcome the human tendency to forget or avoid routine health tasks.
- GLP-1 medications like Mounjaro are being utilized by some T1Ds to help reduce binge eating, lower insulin needs, and drastically improve time in range.
- Pre-bolusing (taking insulin 10-15 minutes before eating) and managing insulin on board before exercise are foundational strategies that significantly improve blood sugar control.
Resources Mentioned
- Juice Box Podcast (Small Sips, Bold Beginnings, Pro Tip Series, After Dark)
- Juice Box Podcast Private Facebook Group
- US Med
- Tandem Mobi System
- Eversense 365
- Wrong Way Recording
- Function Health Test
- Mounjaro / Zepbound
- Dexcom
- Omnipod
Introduction and Resources
Scott Benner Here we are back together again, friends, for another episode of the Juice Box podcast.
Bridget Hi. I'm Bridget. I'm 23. I live in Chicago, and I've been living with type one diabetes for almost five years now.
Scott Benner If this is your first time listening to the Juice Box podcast and you'd like to hear more, download Apple Podcasts or Spotify, really any audio app at all. Look for the Juice Box podcast and follow or subscribe. We put out new content every day that you'll enjoy. Wanna learn more about your diabetes management? Go to juiceboxpodcast.com up in the menu and look for bold beginnings, the diabetes pro tip series, and much more. This podcast is full of collections and series of information that will help you to live better with insulin. If you're looking for community around type one diabetes, check out the Juice Box Podcast private Facebook group. Juice Box 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 Juice Box podcast, type one diabetes on Facebook. Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan.
Scott Benner Today's podcast is sponsored by US Med. Usmed.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. Usmed.com/juicebox or call (888) 721-1514.
Scott Benner Today's episode is also sponsored by Tandem Mobi, the impressively small insulin pump. Tandem Mobi features Tandem's newest algorithm, Control IQ Plus technology. It's designed for greater discretion, more freedom, and improved time and range. Learn more and get started today at tandemdiabetes.com/juicebox.
Scott Benner The podcast is also sponsored today by the Eversense three sixty five. The Eversense three sixty five has exceptional accuracy over one year and is the most accurate CGM in the low range that you can get. Eversensecgm.com/juicebox.
A College COVID Diagnosis
Bridget Hi. I'm Bridget. I'm 23. I live in Chicago, and I've been living with type one diabetes for almost five years now. So coming up on five years.
Scott Benner As you're graduating from high school or a little after?
Bridget So it so it was COVID.
Scott Benner Oh, good job.
Bridget I was a senior in high school when COVID hit. It was at March. And so I graduated, and I decided where I was gonna go to college. And I decided I was gonna go to Loyola, Chicago. Mhmm. And I was really excited. And then a week from move in, they called us and or they emailed us, and they told us that all of our on campus housing was canceled, and the entire semester was gonna be online.
Scott Benner Yeah.
Bridget And so I stayed that fall semester at home back in Indiana. And then I was able to go on campus in the spring, but everything was still online. And I went on spring break with my family, my sister's high school spring break, and I was just taking classes online. And then I was hospitalized. I went to urgent care and because my parents thought I had a UTI.
Scott Benner Okay.
Bridget And the rest is history. Yeah. I stayed in the children's hospital for three days over spring break, and I was 18 at the time. So they let me stay in the children's hospital, which was really nice.
Scott Benner Is this just as you imagined your freshman year of college to be?
Bridget Pretty much. I mean, I can't I can't ask for much better.
Scott Benner This is fantastic. Well, so you started college off at home, first of all. That must have been Yeah. A wet blanket.
Bridget Yeah.
Scott Benner Yeah. Nothing good about that. And then Right. I love that that was my favorite thing is when they moved them back to campus, but then made them go to school from their dorm room. I was like I know.
Scott Benner That was an interesting one.
Bridget It was crazy. Of
Scott Benner all the big ideas. Right. We'll bring them all together in one place, but then slightly quarantine them. But they're probably gonna sneak around and drink and have sex. But, maybe not. Maybe they won't drink and have sex.
Bridget And they made so they made us get COVID tested. Like, I think it was once a week or every other week.
Scott Benner Really?
Bridget And so people would just kinda drop, like like, flies. Like, you would see them in person. I don't know. You would go and get dinner with somebody, and then the next week, they were like, oops. I have COVID. And they were home. Didn't see them. Yeah.
Scott Benner Did they make them leave campus?
Bridget No. No. You just had to stay quarantined. So everybody it was all single occupancy on campus housing, and so nobody could even share bathrooms.
Scott Benner Oh.
Bridget So pretty much everybody I don't know. I mean, you could isolate pretty easily, and it worked out really well. And you just had to wear masks on campus all the time.
Scott Benner Did you did you learn a damn thing?
Bridget Actually, yeah. Because I was in I studying biochemistry at the time, and that later switched. But, honestly, I could focus a lot more on school. I feel like a lot of freshmen in college, they kinda get sidetracked by, like, social things, and I didn't have that option at all.
Scott Benner You're locked in a concrete box. It turns out eventually you think, maybe I should read this book.
Bridget Right. But so so that spring, I start like, I so I was studying biochemistry. I was in a chemistry class. I thought, gee. This homework is really boring. I don't know why I'm falling asleep in the middle of studying, and it was because I was passing out because my blood sugar was, like, 400.
Scott Benner So high. Yeah.
Bridget And I didn't know about it.
Hashimoto's Thyroiditis and Labs
Scott Benner Yeah. Is there is there anybody in your family that has type one diabetes?
Bridget No. I'm the only one.
Scott Benner Do you have any other autoimmune issues like hypothyroidism or anything like that?
Bridget Yeah. Well, so my my labs come back normal, but I have all the antibodies for Hashimoto's thyroiditis.
Scott Benner Do have any of the symptoms?
Bridget I don't know. I'm tired all the time, but that could
Scott Benner That sounds like a yes. Tell me what your labs are. Do you know?
Bridget Yeah. I
Scott Benner know they say normal. What's the number?
Bridget Wait. Let me see. I can pull them up
Scott Benner right now, actually. Everyone else can just this is my public service announcement for people don't get their thyroids managed well.
Bridget I know. Well, they okay. One second. I'm gonna put you on speaker.
Scott Benner Go ahead.
Bridget One second. I just actually got, have you heard of the function health tests?
Scott Benner Function health tests?
Bridget Yeah.
Scott Benner I don't know. Let's figure out what that is.
Bridget I don't know. It's really popular in the city. Like, a lot of my friends have gotten it. But it tests for, like, a a 160 biomarkers, I think. Like, it's kinda crazy, but they tested my thyroid. Mhmm. And so okay.
Scott Benner I'm like
Bridget thyroid peroxidase antibodies were four thirty nine, And it's supposed to be, like, nine. Less than nine is, like, in range.
Scott Benner What's your TSH?
Bridget My TSH was 2.6.
Scott Benner Yeah. It's getting higher.
Bridget Yeah. And then my t four was 1.3, and my t three was 3.3.
Scott Benner Yeah. And they told you you don't need medication?
Bridget They put me on a really low dose.
Scott Benner Okay. Good.
Bridget So yeah. So my my endocrinologist is great. She's very proactive.
Scott Benner No kidding.
Bridget So I'm on a very low dose of that. And
Scott Benner She'd be, like, point two five micrograms or something?
Bridget I think I'm on point seven five.
Scott Benner Oh, that's not that low. That's okay. Good. Good. Good. Yeah. Yeah.
Bridget I'm really bad at taking it.
The Psychology of Taking Daily Medication
Scott Benner So Bridgette. What I Bridget, I can't I can't deal with two girls your age and not being able to take this thyroid medication every day. What what tell me. You're gonna help me for a second. We'll find out about your diabetes. But what stops you from taking one tiny little pill once a day?
Bridget honestly also okay. I guess I don't take a lot of medications. Like, I've
Scott Benner That doesn't sound like you're taking any, even the ones you have, but go ahead.
Bridget I've been decently healthy. And so, like, even I'm horrible at taking vitamins, like, I just forget. But I have the little like, I have the pill right next to my coffee, but the problem is you can't drink it with the coffee. And so I'll get ready in the morning, and I'll make my cup of coffee as I do every day. And I look at my medicine, and I tell myself I should take that. And then
Scott Benner Yourself doesn't listen?
Bridget And then I'm like and then I'm like, oh, I have to wait fifteen minutes. And then by the time fifteen minutes, my memory of a goldfish forgets about it.
Scott Benner Right. Bridget, has your voice always been deeper?
Bridget I think I'm a little sick maybe.
Scott Benner It's also it can be a it can be a symptom of of Hashimoto's. Did you
Bridget know that?
Scott Benner Yeah. Yeah. Okay.
Bridget I've noticed it, like, raspier over the last few years. So
Scott Benner Let's go over them very quickly. You it's just a a simple yes or no. Fatigued? Yes. Weight gain? Yes. Feeling cold easily?
Bridget Yes.
Scott Benner Constipated? Sounds like a no. Dry Not really. Dry skin? Not really. You're like, there was a day I didn't go, but that's not is your hair getting thin or dry? Yeah. Do have any puffiness in your face?
Bridget Yeah.
Scott Benner Depression or low mood? No. Alright. Slower thinking or brain fog?
Bridget Yeah.
Scott Benner Slowed heart rate? You probably wouldn't know. No. Muscle aches, cramps, or weakness?
Bridget Yeah.
Scott Benner Joint pain?
Bridget Yeah.
Scott Benner Here's a fun one. Heavy or irregular periods? Yeah. Okay. Bridget, listen to me. Do you have a father, or was he taken tragically by your mom? Okay. Okay. Alright. No. He does he love you?
Bridget Yes.
Scott Benner Okay. What if you put him in charge of it?
Bridget Yeah. That's true.
Scott Benner He can make him call you every day at a certain time, and then say into the phone, Bridget, take that damn pill. And then you can he can hang up after may this is my, advice. After he hears you swallow it. Okay? So I don't even wanna tell you the process that we use for Arden. But it's
Bridget What do guys have to do?
Scott Benner So for first things first, she won't take it in the morning. Mhmm. She doesn't like eating or drinking anything right away when she gets up. So it's not optimal, but she takes it right before bed. It's still that her doctor said that's fine. I hope she never hears this. I really if any of you hear this and tell her, I'll come and find you. Every night before bed, I go visit her to say goodnight. I hand her a bottle of water. I take the pills out, and I stand there with them and hand them to her. Oh my gosh. If that does not happen, I don't believe she'll take them. I don't think it's through apathy. I don't think it's because she's not a bright person. I don't actually know how to put my finger on what the problem is. But I'm gonna guess that whatever happens to you is what happens to her. So can I just suggest a timer on your phone? Yeah. And pick a time that you know you haven't eaten in a while and you won't eat for a little while so that doesn't get in in in front of your situation and mess you up. And then just take it every day. And then imagine fatigue, weight gain, feeling cold, dry skin, all of it just going away. Wouldn't that be lovely?
Bridget It would be so good.
Scott Benner Imagine this. Let's take a talk about it a different way, Bridget. I'm so sorry. I'm the only one that gets to talk to you this way because if your parents said this to you, you'd be, like, out of the room by now. You'd be, like, these two will not shut up. I'm an adult. And, like, like, oh my god. I can hear it now. Right? If if I if you and I sat around right now and we gossiped about somebody on Instagram, you know how you guys do. Like, you pull up other people's accounts, check, oh my god. Look at her. Do you remember her from high school? Right? You you know what I'm talking about. Okay. Alright. Let's
Bridget We'll not admit to it.
Scott Benner No. No. No. But you okay. Let's assume you you understand what I'm saying. And I said to you, oh, and you said, look at all the stuff about about her. And I said, yeah. You know, there's a pill that'll make that all go away. She won't take it. You would spend the next twenty minutes talking about that girl. You'd be like, what an idiot. Why won't she just take the pill? This is really so explain to me really co as coherently as you can because you have brain fog. As coherently as you can, tell me why you can't commit to just that one thing.
Sponsor Break: Eversense and US Med
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Scott Benner Diabetes comes with a lot of things to remember, so it's nice when someone takes something off of your plate. US Med has done that for us. When it's time for Arden's supplies to be refreshed, we get an email. Rolls up and in your inbox says, hi, Arden. This is your friendly reorder email from US Med. You open up the email. It's a big button that says click here to reorder, and you're done. Finally, somebody taking away a responsibility instead of adding one. US Med has done that for us. An email arrives, we click on a link, and the next thing you know, your products are at the front door. That simple. Usmed.com/juicebox or call (888) 721-1514. I never have to wonder if Arden has enough supplies. I click on one link. I open up a box. I put the stuff in the drawer, and we're done. US Med carries everything from insulin pumps and diabetes testing supplies to the latest CGMs like the Libre three and the Dexcom g seven. They accept Medicare nationwide, over 800 private insurers, and all you have to do to get started is call (888) 721-1514, or go to my link, usmed.com/juicebox. Using that number or my link helps to support the production of the juice box podcast.
ADHD, Stubbornness, and Creating Habits
Bridget I don't I think it's just something it's just so small that I guess I just don't I think it's because it's one of those things that you don't notice the effects right away Yeah. That you're like, oh, I can go maybe one day without it, and then one day turns into three days.
Scott Benner Oh, yeah. Yeah. Yeah. Okay.
Bridget And then you're like, jeez. I can't start now because now I have to be consistent with it. And then
Scott Benner Oh, this is the part I want, Bridget. This is the part I want. This is it right here. Why can't you just start on a Wednesday? How come it turns into, like, well, I'll wait till Monday? Or or or or after my room is clean or, like, whatever, like, arbitrary thing you set up as, like, you know, once, you know, once we get the bathroom straightened out, I can start taking this medication again. Like, you have those thoughts, don't you? Yeah. Oh my god. What is wrong with all you people? Okay. Alright. Listen. How
Bridget I don't know. I think it's a human thing.
Scott Benner To who?
Bridget I don't know. Maybe it's an ADHD thing.
Scott Benner I'm not sure. ADHD?
Bridget Yes. You're funny.
Scott Benner Are you anxious? Do you have anxiety?
Bridget I don't think so. I haven't been I don't know. I'm supposed to go see a psychologist person
Scott Benner Yeah.
Bridget Soon to be psychologically evaluated, but, apparently, it takes four hours.
Scott Benner Why are you being psychologically evaluated?
Bridget I don't well, because my doctor thinks I have ADHD, and she wants to put me on the proper medicine.
Scott Benner I would like this well, listen. Not for nothing. Tell her you're not gonna take it anyway, so what's the difference? And That's true. But now I got two bottles of expensive medication I'm not taking. I'm like,
Bridget now I'm in trouble.
Scott Benner Do you listen to the podcast? Yeah. Am I reasonably famous to you?
Bridget Yeah. You're like a celebrity.
Scott Benner Okay. Well, then just listen to me then. Okay? Like, do the thing my daughter won't do. Listen. Wait. So first first things first. Is the morning bad for you? Why? You jump up and you have coffee right away?
Bridget Yeah. I just I'm I have a mess in the morning.
Scott Benner Do you not shower in the morning? Some people don't.
Bridget No. I do.
Scott Benner Okay. So do you eat before you get in the shower?
Bridget Not all the time.
Scott Benner Do you drink coffee before the shower? No. Why don't you put them in the bathroom then? And then just I don't know if you know this, but when you're showering, there's water falling from the sky. Like, put the pill in your mouth, tilt your head backwards, fill your mouth up with water, and swallow, and then wash yourself, and then get out. By the time you're dry, you can eat.
Bridget I think you're onto something there.
Scott Benner Well, I mean, what was your major?
Bridget Health care administration.
Scott Benner Alright. Are you good at it?
Bridget I think so.
Scott Benner Alright. Well, you could administer this. Okay. I mean
Bridget Oh, perfect. I'll do it. I'll do it.
Scott Benner I know you won't, you liar. What are you lying to me for?
Bridget Well, I know my mom's gonna listen to this.
Scott Benner But don't lie to her. She she's used to lying to her.
Bridget Scott told you. Yeah. She's gonna say Scott told you to take it.
Scott Benner Well, do this for me. Okay? Just commit to thirty days in a row because you will feel so much better in thirty days.
Bridget That's true.
Scott Benner I'm being serious. And if you forget it on the fifth day, wake up the sixth day and take two of them.
Bridget I can do it.
Scott Benner Okay? I'm gonna tell you a little secret that a doctor told me, and this is not medical advice, right, because I'm an idiot. And please no one ever listen to me. Read the disclaimers. But Arden Zendo said, if you're having that much trouble remembering it, just take seven of them on Sunday.
Bridget Oh, and it's fine?
Scott Benner Well, I mean, look into it because, again yep. Look at you. Kids are so smart nowadays. You're like, are you, potentially telling me that possibly that maybe you heard from somewhere? Nothing that we could pin on you, of course. That's what Arden was told. If you absolutely can't remember them day to day, which is the preferred way to do it, then take them take them once a week.
Bridget I can do it. I'll commit I'll commit to it for you.
Scott Benner Are you gonna email me in a month and tell me you did it, please?
Bridget Yes.
Scott Benner Don't don't lie to me, Bridget. I can't take another girl your age lying to me about taking pills.
Bridget I'll add it to my calendar.
Scott Benner What how's that gonna help you? Where's the alright. I parenting's hard. It is easier to parent people who aren't your children, though, because look how you're you're, like, in a good mood, so you're not mad at me or anything like that. By now in this conversation, Arden would just be like she'd look up at me and go, I'm sorry. I stopped listening. What are you saying?
Bridget I wish she admitted to it.
Scott Benner Well, I think she enjoys admitting. I think she likes hurting my feelings. I think she, like, goes, what did you just say? I wasn't listening anymore. Okay. How do you remember to take your insulin? Oh god. Do you remember to take your insulin? Let's talk about the Tandem Moby insulin pump from today's sponsor, Tandem Diabetes Care. Their newest algorithm, Control IQ Plus technology and the new Tandem Moby pump offer you unique opportunities to have better control. It's the only system with auto bolus that helps with missed meals and preventing hyperglycemia, the only system with a dedicated sleep setting, and the only system with off or on body wear options. Tandem Mobi gives you more discretion, freedom, and options for how to manage your diabetes. This is their best algorithm ever, and they'd like you to check it out at tandemdiabetes.com/juicebox. When you get to my link, you're going to see integrations with Dexcom sensors and a ton of other information that's gonna help you learn about Tandem's tiny pump that's big on control. Tandemdiabetes.com/juicebox. The Tandem Mobi system is available for people ages two and up who want an automated delivery system to help them sleep better, wake up in range, and address high blood sugars with auto bolus.
Bridget Yeah. No. Actually well, okay. Have a pump, so it makes it better. Mhmm. Honestly, when I was on a pen, it was a lot worse.
Scott Benner Were you forgetting?
Bridget Yeah. And then I would just be like I live in Chicago. I take public transit all the time. I'm always going to and from something.
Scott Benner Mhmm.
Bridget I like to keep myself pretty busy. And so most of my downtime, like, normally when I would remember to, like, take some insulin or do something, is on the train or on a bus or when I'm walking.
Scott Benner Tell me it's cold, you're covered up.
Bridget Yeah. Well, they're like I don't know. There's always there was always something, and I realized it one day on a train. I think my blood sugar was 300. I had just, like, come back from lunch with a friend, and I forgot to take my insulin. And I'm sitting here, and I'm like, it's gonna be forty minutes until I get home. I have to do something. And so that one day, I did I did I took some insulin on the red line.
Scott Benner Yeah. Well, because your blood your blood sugar was red lining. You had to do something.
Bridget Yeah. Yeah. And so that was a big step for me because, normally, I don't like doing it in public.
Scott Benner Okay. Because
Bridget just, like, at a rest at a restaurant, I'm kind of, like you know?
Scott Benner Yeah. But why
Bridget People do other weird things on the red line, and so I just don't
Scott Benner What else do you see them do on the red line?
Bridget I can't even You heard about the red line in Chicago?
Scott Benner I don't know about it. My wife took New Jersey transit into Manhattan for fourteen years, and I can't even tell you her stories. You're too young, and it would make me uncomfortable. So, like like, seriously, like, it's the train is crazy. I get you. We need you to take your insulin. Yeah. So but now you're saying you're on a pump, and why is that better?
Bridget It's so much better because I can just, you know, pop it out. It looks you're not like
Scott Benner People don't know you're doing it.
Bridget Yourself. Yeah. And it's so much better.
Scott Benner Tell me why you wouldn't want somebody to like, forget the pen part of it. Mhmm. If you had to pull out some weird device that looked like I don't know. That said, like, insulin pump on the side of it, would that stop you from pulling out and using it?
Bridget Oh, no.
Scott Benner No. You okay. It was more about using the pen.
Bridget Yeah. And, like, I don't know, being out and about
Scott Benner Mhmm.
Bridget In, like, public places and germs and thinking about, like, injecting myself
Scott Benner I hear you.
Bridget Amidst those things.
Scott Benner That part of your health you're worried about?
Bridget Yeah. But
Scott Benner Not your thyroid.
Bridget The thyroid. No. I try.
Scott Benner No. I know. Listen. First of all, you don't think I'm coming down on you. Right? That doesn't feel like No.
Bridget This is good. No.
Scott Benner No. You're gay. You're like, no. Someone should be talking to me like this, Scott. My parents gave up. When did your parents give up exactly? Do you remember how old you were? When they were like, this girl's not listening to us.
Bridget Probably when I was, oh, I don't know, 14. I tried to convince them I tried to convince them to send me to, like, a completely different high school. I was very fortunate. I went to Catholic school all my life.
Scott Benner Mhmm.
Bridget But for some reason, I think I watched too many episodes of Gossip Girl. I wanted to go to one where they wore, like, skirts, and so I tried to I tried to get them to send me to a military academy.
Scott Benner Really? Okay. Yeah.
Bridget And it did not. And I made a whole presentation, and I thought it was very persuasive.
Scott Benner And they were like, you have no idea what this cost. We're not sending you there.
Bridget Yeah. And then I was just a mess in high school. So
Scott Benner What do you mean?
Bridget I was just all over the place, like, literally running from place to place. I was student body president. I was doing research Mhmm. At the local university. I was playing tennis. Like, I was so active. I was so busy. I don't think they ever saw me.
Scott Benner Yeah. Hey. Does it And
Bridget then yeah.
Scott Benner I'm sorry. No. No. Go ahead. And then what?
Bridget And then COVID hit.
Scott Benner Okay. And then
Bridget And then Yeah. I was just pouting in my room, I think, the entire time.
Scott Benner Because you were so, like, you were doing so many things and suddenly couldn't do anything.
Bridget Yeah. It was horrible.
Scott Benner Right. Right. Any other autoimmune in your family? Your mom have thyroid too or somebody have celiac or anything like that?
Bridget Yeah. My mom and my brother both have Hashimoto's.
Scott Benner Oh, you guys are English or Irish?
Bridget Yeah.
Scott Benner Yeah. Yeah. I could smell it through the phone.
Bridget Probably.
Scott Benner No. I mean, it's it's well, because well well, because isn't it isn't Saint Patrick's Day?
Bridget Saint Patrick's Day. Yes.
Scott Benner See? How come you're not drunk? What's going on, Bridget? Is that after this?
Bridget That was this weekend.
Scott Benner Take your thyroid medicine
Bridget first. This weekend. Right.
Scott Benner Hey. How many days has it been since you took your thyroid meds?
Bridget Actually, I took it this morning.
Scott Benner Good for you. But prior to that, did you take it the day before?
Bridget No. Prior to that, I probably hadn't taken it since, like, last Thursday maybe.
Scott Benner Oh, Bridget. Okay. Well, take
Bridget a I know.
Scott Benner Take a couple. Not a doctor, not a vice, Bridget. I wouldn't listen to me if I was you. Okay?
Mounjaro and Insulin Resistance
Bridget Well, started Mounjaro
Scott Benner Oh, yeah?
Bridget Two Fridays ago.
Scott Benner No. I took my Mounjaro on Sunday. Yeah. Well, I mean, mine's called Zepbound, but you know what I mean. Same business.
Bridget Right. Same thing.
Scott Benner You're taking it for weight or or in or for blood sugar?
Bridget Blood sugar. My my endocrinologist prescribed it to me because I was having issues where I would, I guess, binge at night, and I was just explaining I don't really feel hungry. I think it's the I don't know. I'm on type one diabetes TikTok. I don't know if you've seen it. But Did
Scott Benner you fall down the the amylin rabbit hole? Yeah.
Bridget Yeah. Yeah. And so I've convinced myself that I have no
Scott Benner Ability to stop yourself if you're eating? Yeah. So TikTok told me I was hungry.
Bridget But then I have realized that, oh, maybe I am going to bed, and my blood sugar's a little high. And
Scott Benner Mhmm.
Bridget Also, I've gained some weight over the last few weeks. I was I was running a lot, and then the winter hit, Chicago winters are brutal.
Scott Benner Yeah.
Bridget So I just kinda stopped working out
Scott Benner I hear you.
Bridget And eating healthy.
Scott Benner Any I figured if I'm not gonna work out, I might as well eat the drywall.
Bridget It's a it's a lost cause at that point.
Scott Benner Just, like, tumbling down. Like, he was like, this is it. I'll be dead in a week. So so you have all so is what you're telling me, you have all the tools for success, and all that is left is for you to put that pill in your mouth every day and shoot that stuff in your ass once a week
Bridget Exactly.
Scott Benner Or wherever you're shooting it. Yeah. Do you have any weight you wanna lose?
Bridget I don't, like, I don't know. 10 pounds.
Scott Benner Okay.
Bridget I have lost a few pounds since being on it. Mhmm. But my before I went on it, my time in range according to my Dexcom was, I think, like, 50%.
Scott Benner And now it's what what what's it, like, 80 now?
Bridget Yeah. Now it's 80%.
Scott Benner Yeah. Did I get that number right?
Bridget Yeah. Which is crazy.
Scott Benner I also thought you were gonna say 14. I didn't say it fast enough. It pissed me off. Just because I don't know if everybody knows. When you're younger, you don't think this it's it's really generalizations are for a reason. Like, it's easy to figure things out. Like, so, yeah. I mean, your time range is I I imagine you're having fewer lows because you're using less insulin. Right? Mhmm. And you're fighting with less peaks after meals.
Bridget Yeah.
Scott Benner Fewer peaks. Yeah. What dose did they give you?
Bridget I think I'm on two point five.
Scott Benner Okay. And it started working right away?
Bridget I think so. It could've just been the placebo.
Scott Benner Well, the what the no. Your blood sugar does have a placebo effect. That's I'm saying, did your insulin needs drop in the first couple days after you shot it the first time?
Bridget Yeah. Well, my so my endo, she as soon as I started it, she told me to switch my basal.
Scott Benner Mhmm.
Bridget And so she lowered my basil. And then pretty much immediately, at least the next I think I took it at night. And then the next morning, I did realize that I wasn't as hungry. And so Yeah. I think I reached for a banana. Normally, a banana would bring me up to 300. And
Scott Benner Are you pre bolus in the banana?
Bridget Most of the time, yeah.
Scott Benner How long? How long are you pre bolus in a banana?
Bridget Like, right before it.
Scott Benner You can really that's not a pre bolus. That's
Bridget just a bolus.
Scott Benner No. That's bolus thing. I'm talking about ten, fifteen minutes, fifteen minutes maybe. All that sugar.
Bridget Yeah.
Scott Benner Alright. But but go ahead. But it's slowing down your digestion. You didn't spike from the banana. How far did you go up from the banana? 300.
Bridget I think it was only I mean, I since I've been a little bit more cautious of what I'm eating
Scott Benner Mhmm.
Bridget I don't know if that's directly associated with the menjaro, but at least, like, I'm pulling myself together only before
Scott Benner you don't listen. I haven't been hungry in three years. I I said that. I I know.
Bridget And so I, like, I only spiked to one seventy, I think, which was a crazy improvement for
Scott Benner me. You ate a banana without prebolising and went to one seventy?
Bridget Yeah.
Scott Benner That's pretty great. Yeah. But that's not a reason not to prebolise.
Bridget I know.
Scott Benner But but look at you're not gonna have to do as far in the future.
Bridget Right.
Scott Benner Imagine if you would have given yourself insulin, walked into the kitchen, decided on a banana, and then said, I should wash my hands or get a glass of water, or maybe I have to pee. Do something else to busy yourself for a second, and then came back and ate that banana. No bullet. No no no jump at all. It would have been beautiful.
Bridget That's true.
Long-Term Health and Ovarian Cysts
Scott Benner First of all, think I should be interviewing more people your age. I feel like, intellectually, I'm worried about it in my twenties, so this is really perfect for me. I feel like this is going really well. I don't know about you. But when you think about your health, big picture, or maybe you don't. You'll tell me if you don't. Right? But I'm not talking about just today or next week something like that, or I feel like I gained weight or, like, you know, that kind I'm talking about, like, when Bridget steps back and looks at her life and says, I've been alive for fifty years now, and my body, my health is in what position? Like, where do you see yourself, and how much of your own effort and focus do you think is gonna be responsible for getting you to the place where you are? That makes sense.
Bridget Yeah. I so funny enough, that function health test this is not an ad, I promise. That function health test that I took put me at age 30.
Scott Benner Oh, jeez. Sorry. Yeah. Yeah. Yeah.
Bridget I was like, crap. So considering that I do like and I think right now at 23, I'm definitely taking my health a lot more seriously than I was at 21.
Scott Benner I'm glad.
Bridget I've pretty much stopped drinking. I focus more on, like, walking and strength training, so I'll have muscle when I'm old. Mhmm. But mostly, I think about my fertility and my ability to have kids because I would love to have kids.
Scott Benner Really? Even after, the pain in the ass you've been for your parents, you you think
Bridget Exactly.
Scott Benner You you still think karma. You still think it would be a good idea? Can you imagine? Try to imagine a little kid, somebody who you're paying for, who, by the way, because of what they cost is the reason you're not in Turks and Caicos this summer. Okay? Like, right? Like, imagine that kid says to you, I can't remember to take my vitamin every day. You'd be like, you little son of a bitch. I have been killing myself for you, and you're not gonna take that vitamin? The only thing I ask you to do, you can't do right? Oh, can you can you write the script in your own head?
Bridget Yeah. It would be an issue.
Scott Benner Mom yell these things at you ever or no? Yeah. Why don't you listen to her? She takes her thyroid med every day, doesn't she?
Bridget No. She's actually an angel on this planet. Yeah. She takes her thyroid medicine every single day, and my brother still lives at home. Mhmm. And so they're kind of, like they're in it together. And they have, like I think they're vitamin a. It's like a thyroid, I don't know, a little drop thing that they take.
Scott Benner And Oh, I love those two people. My son listens to me about this, by the way. Every day, every vitamin I hand him, everything for his thyroid, takes it when he sees Arden, like, messing about it, but he goes, just take the stupid pill. She's like, listen. Last night, that girl asked for the vacuum cleaner. Okay? Dad, could you bring the vacuum cleaner upstairs for me? So I brought it up. I'm a decent person. And I brought it upstairs, and I put it down. I said, hey. While you're vacuuming because she's gonna vacuum her room. I said, there's a little, like, a couple dust bunnies out here in the hallway. Would you just hit those for me while you were going? She goes, I was going to, but now that you told me to, I don't want to. And I said, well, that's a mental illness. Just vacuum up the dust from She's like, if I said to Cole, like, hey. Like, there's some, like, dust out here. He just vacuumed the whole hallway. Why are boys easier about stuff like this than girls? What is it? Like, what what is it? Can you help me? Do you know?
Bridget So I actually just did the same thing.
Scott Benner You could tell me your story. Go ahead. So
Bridget well, so I live with my boyfriend. We've been together for almost three years. He's perfect. He remembers to take his vitamins. He's clean.
Scott Benner And Is that the bar we're setting for boys now? Scottie doesn't smell. I'm gonna marry him. Go ahead. He's clean. What else?
Bridget We were cleaning for Saint Patrick's Day because I have a balcony and, like, I live downtown. And so we were having a bunch of my friends over, and he was, like, steam mopping the floor, and then I was vacuuming before him. And he, like, pointed out, I think, a dust bunny. It was it was like a clump of dog hair. We have a little Australian shepherd. Mhmm. And he's like, could you vacuum that up? And I said, I'm going to, but now that you asked me to, I'm angry.
Scott Benner Yeah. So explain that to me. What is wrong with you? Like, do you know, or do you do you have any way to explain it to me? Does can anyone come on the podcast and explain it to me? Because it's a a baffling part. I was staring at Arden the other day. She goes, stop looking at me like that. I'm like, I can't. I'm like, I wanna choke you to death. I'm like, why are you not just doing where do you think that reaction comes from?
Bridget I think it's just because I was planning to do it and because somebody told me to do it. It's just, like, frustrating.
Scott Benner No. I mean, I understand what happened, but what's in when you go see that psychological psychological exam, ask him about that.
Bridget I will. Because I think it's it's also probably just being stubborn. It's definitely being stubborn, and it probably also stems from, like, when my mom would, like, ask me to clean the bathroom, and I had already done it. And then I would feel like, jeez, I shouldn't have cleaned it because she asked me so funny. I don't know. I wonder what like a little it's it's definitely an immature reaction, and I recognize that.
Scott Benner Yeah. Well, it's not gonna go by the way, it's not gonna go away. My wife still says to me sometimes, you're not my father. I'm like, your dad's dead, and I'm in my fifties. I don't think you're I'm your father. But my wife has a story though, like, in the way she was treated. Like, like and it stuck to her. Like, she my wife will tell you a story of the day her father was, like, changing a light switch and it was time to put the cover back on the switch. And, you know I mean, I don't know what you know, Bridget, but, like, it's two screws. You can't do it wrong. Right? Like, if the screws go in, you've accomplished it. There's no we you didn't do it incorrectly. She asks to help, and she takes this the cover. She puts it on. She puts the two screws in, and then she said her dad pulled both screws out, took the cover off, put it back on, put the screws back in again. They're Irish and, and and English too, case you're wondering where your crazy might come from, all of you. Yeah. Also, why why can't I just tell you that Jesus will put you in a pit of fire if you don't take your thyroid meds? Can't you just want that work on you or no?
Bridget I don't know. The pit of fire yeah. That might do it.
Scott Benner I mean, seriously, you went to Catholic school. Can't I just tell you God would be disappointed if you didn't pre bolus? Isn't that that is it not that easy or no?
Bridget No. It should be that easy because that's what they told us
Scott Benner that's so I they indoctrinate you pretty good. Why can't I just use that? Oh my goodness.
Bridget You're onto something.
Scott Benner You can
Bridget I think you're onto something there?
Scott Benner Saying that, but nothing's happening. Also, you have no idea how difficult it is to talk to you. You sound exactly like my daughter's friend, Olivia.
Bridget Oh, no.
Scott Benner Like, speech pattern Oh, insane. Yeah. Every like, you're not all the I don't think you're all the same. That's all I'm saying. But you have your voice is so similar to hers. I have to stop my I'm this close to writing a sticker on my face that says it's not I'm not talking to Liv. So Oh my gosh. And she's from, like like I think her family's, like, from Indiana too, so I think they have a little bit of that, like I mean, that's close to Chicago. Right?
Bridget Yeah. Yeah. Yeah.
Scott Benner I know geography a little bit.
Bridget Well, so Northern Indiana claims Chicago, but Southern Indiana or Central Indiana wouldn't.
Scott Benner No.
Bridget And the Central Indiana accent is crazy.
Scott Benner I don't
Bridget know if you've heard it.
Scott Benner Well, I mean, I've I've probably heard it, but I don't know it off the top of why is it crazy? Can you do it?
Bridget Mine well, so my nana has a very thick, like, Central Indiana accent, and she says, like, wash.
Scott Benner Oh, like, gonna wash the clothes?
Bridget Yeah.
Scott Benner Yeah. And my grandmother would have said that.
Bridget I'm trying to think what else. But, yeah, Northern Indiana, like, we root for the bears. We basically live in Michigan.
Scott Benner The bears were so bad for so long that a quarterback showed up with nail polish on, and you guys were like, that's fine. We're not even gonna worry about that. Yep.
Bridget But he's the I don't I don't do sports like that, but I heard he's great.
Scott Benner Yeah. I I saw him play this year. Didn't do bad. Okay. So this diabetes thing. Let's talk about being young and having diabetes. Okay?
Bridget Yeah.
Scott Benner I mean, obviously, start of college, they they whisk you away. You're sitting in the children's hospital. Can you go back to that time for me and tell me what was going through your head? And if it was, like, were you sitting there just going, like, diabetes? Like, what the hell? Or did you accept it pretty easily? Did you fight against it?
Bridget Yeah. I think I think I accepted it pretty easy. Like, I don't I didn't really know a lot of people with diabetes. And, again, like, luckily, I was at a children's hospital, and I received great care and great training, which isn't the experience for a lot of other 18 year olds or older people diagnosed with diabetes. So really fortunate with my diagnosis in general. And, I guess, transitioning, like, from being a person who was relatively healthy to suddenly having a chronic disease that I'm likely gonna have the rest of my life, you know, knock on wood. Like, that part was tricky. I I went from I don't know. Like, I have a lot of friends from high school that I still don't really know, like, how to talk about it with them.
Scott Benner Really? Okay.
Bridget I don't know. The time before diabetes just feels so fuzzy to me. Mhmm. And I was also just down a completely different path. Like, I was studying biochemistry. I thought I was gonna get a PhD and, like, work in research for the rest of my life. And then I switched because I wanted to make a better impact for people living with chronic diseases, and so I switched to health care administration so I can maybe, you know, fix the The US health care system, which is a whole issue within itself.
Scott Benner Yeah. Good luck. Go get them.
Bridget Right. And and luckily, Loyola did have a health care administration program. And so, like, my mindset just completely shifted from I'm gonna be young. I'm gonna have fun. I'm gonna I don't know. I'm gonna do everything a young person can do to I wanna live life, like, the best way possible. Mhmm. And I think for a while, I was a little angry, but I was never angry at the fact that I had diabetes. I was always just angry at, like, ugh. I have to put on an a new Dexcom and, like, I can't do this because I have to do this. And there were just a lot of take like or what's that called? Like, trade offs.
Scott Benner Yeah. A lot of new responsibilities. Yeah.
Bridget Yeah. And that was kind of hard to adapt to. And, you know, everything happened while I was in college, and so also graduating college was I was a completely different person Mhmm. Coming out of college than I was entering college.
Scott Benner Sure.
Independence and Hiking in Spain
Bridget And so that was really interesting. I ended up as soon as I graduated, I flew out, like, literally the next day. I flew out to Spain with my dad, and we backpacked El Camino De Santiago. Have you heard of it?
Scott Benner No. Tell me.
Bridget So it's like a 500 mile trail from the South Of France to the Northwest Corner of Spain.
Scott Benner Wow.
Bridget And it's beautiful. It's it's a Catholic pilgrimage, but so many people do it for so many different reasons. You stay in hostels the whole way. I was gonna do it alone, but my dad was like, heck to the no. You're a woman, and you could, like, have a low and, like, fall on the trail or something. And so he came with me, and we actually had a great time. And I think that was really therapeutic for me because I just kind of let a lot go on that. It was a month long trip in Spain.
Scott Benner Yeah. How did it help you let go of some of it?
Bridget I just think I needed some time to, like, look back and just relax.
Scott Benner Mhmm.
Bridget And thirty days in Spain, I'll do that for you. So
Scott Benner So nothing to do, and you took care your diabetes. Okay? You had some support from your father. He came to the realization, like, this is gonna be okay?
Bridget Yeah. And I think, like, at that point, I, like, let all my anger go
Scott Benner Okay.
Bridget About being diagnosed. And so that was really, yeah, I guess, therapeutic.
Scott Benner Yeah. Did you at the time, or do you now in hindsight, like, feel, like, the support from your dad, like, coming along with you like that? Or did you feel like he was, like, lording over you and wouldn't let you go do something by yourself?
Bridget No. No. He I think I think he understood, like, how I need support. Because even, like, before, my he was never super involved in my diabetes, but mostly just because I never asked him to be. Mhmm. And, like, same with my mom. My mom was a little bit more involved. Sometimes you just need help changing a site or Yeah. You're like, oh my gosh. If I look at one more piece of candy, I think I'm gonna throw up. So just, like, having somebody there to, like, see you and, like, see what you're going through, I think that
Scott Benner Was helpful.
Bridget Yeah. It was really helpful.
Scott Benner Okay. Yeah. Yeah. So support doesn't have to look like somebody doing something for you all the time. Sometimes it could just be the knowledge that they're there if you need them.
Bridget Right.
Scott Benner Right. But, also, I mean, with five years of hindsight, should 18 year old you have been put in charge of all this? How'd you do with it? Like, maybe I'm wrong. Maybe you were like, yes, Scott. I was ready for that, I took it over, it's fine. Or do you look back now and go like, I probably could've used more help?
Bridget Honestly, I've been really independent my whole life. I'm a middle child, but I'm an eldest daughter. So
Scott Benner Okay.
Bridget I don't know. I did I did, like, solo travel. At that point, I was going to all my, like, all my own doctor's appointments. Pretty much as soon as I got my license, I was really independent. Mhmm. And so I think it was just something that I knew I had to step up to and step up to the plate and really take care of myself. And luckily, I had friends who I lived with in college, like, right after I was diagnosed.
Scott Benner Yeah.
Bridget And Loyola is a a great place because almost everybody's studying to be a nurse or a doctor. Mhmm. And so I had a lot of, like, support on that end too.
Finding the Right Insulin Pump
Scott Benner What were your outcomes like? Like, so you were you're taking care of yourself. It it's on you, and you're handling it and everything. But are you like, where's your a one c? I mean, you see your time in range is like 50%. Like so it's not like, that part of it isn't paying off, but at least you feel, like, personally, I don't know, confident?
Bridget Yeah. When I was first diagnosed, my a one c was pretty low. I I think it was oh, it might have been in the sixes, like, right when I was diagnosed.
Scott Benner Pought it pretty early.
Bridget Yeah. Yeah. Well, no. No. No? My a one c was 14 when I was diagnosed.
Scott Benner Oh, okay.
Bridget Yeah. And I wasn't in DKA. Like, I wasn't about to, like, you know, fall into a coma. Mhmm. But they caught it at the perfect time, luckily. Yeah. By the I think it was, like, the next June or July. Does that even make sense? Three months after, I got it way down, but it was because I was having so many lows.
Scott Benner Oh, oh, I see. So you so your a one c wasn't actually good. It was just showing well because you were getting low a lot and staying low a lot.
Bridget Yeah. And and that was when I was on pens. I was on pens from April 2021 until August 2021. Mhmm. And then I went on Omnipod, and the Omnipod made it a lot better. And then I, like, realized I was hitting it off, and I would leave the controller, like, back at my apartment on accident. And so I'd be kind of in trouble there. And so I decided that tubing might just be better for me. So that's why I'm on tandem.
Scott Benner So you switched from the pump that you were enjoying to a different pump because it had a tube on it. You thought, well, maybe I'll stop forgetting this thing?
Bridget Yeah. And sometimes I do still forget it, but for the most part
Scott Benner Don't worry. I can still forget it, Scott. I'm good. Really good.
Bridget Yeah. But for the most part, I'm, like, really
Scott Benner You're good.
Bridget It works a lot better for me.
Scott Benner Okay. Yeah. No. I understand. I I actually I understand what you're saying. So but, I mean, it's connect it you mean, does the term she'd forget her head if it wasn't attached apply to you?
Bridget Yeah. Definitely.
Scott Benner Oh, okay. Well, then there you go. Then it's attached now.
Bridget And I have, like, different insulin pens, like, stashed in case I do forget it. Like, I have one in at work. I have one in the car. I have one pretty much everywhere. Mhmm. Like, just in case. It might not be, you know, full strength at this point because it's kinda been stashed there for a while, but it does the job if I'm in a pinch.
Scott Benner Yeah. I hear you. So you started off I don't think you started off any differently than I would expect for your age, for your situation, for the fact that you were kinda on your own a little bit doing it.
Bridget Mhmm.
Scott Benner Right? So there's some time to figure things out. You've got some lows that you you don't like. You make some adjustments, things get a little better, you make another adjustment. You know, you get hit with the the thyroid diagnosis in there somewhere. Right? Mhmm. That's still a thing you're working through. But now you added another tool with the Mounjaro. Mhmm. And you're taking your health seriously at at, I think, a really young age, which is terrific, by the way, and about where I would expect it to happen as far as, you know, maturity goes. Like, this is my like, I always kinda joke with Arden. I was like, I only have to help you with these pills for, like, two more years, and then your brain will form all the way, you'll do it yourself. Not that she's not awesome. Like, it's not my intention to say. My question would be is what pushed you towards that that health testing? Like, what was the thing that got you like, oh god. I gotta do something.
Bridget First of all, my grandma is really, really into functional medicine.
Scott Benner Okay.
Bridget She listens to this to this guy's podcast who, like, created the whole thing, the whole testing.
Scott Benner Okay.
Bridget It is backed by medical professionals. I've checked it out. But she's she offered to pay for it for Thanksgiving or for Christmas on Thanksgiving because
Scott Benner I just I I was like, oh my god. Your parent your your family just Thanksgiving gifts?
Bridget We love Thanksgiving.
Scott Benner Yeah. My god. We love it so much. It's a gift giving holiday. No. But but I understand. On Thanksgiving, you were talking about she offered to pay for it for you.
Bridget Yeah. Got it done. So yeah. So I thought
Scott Benner it's done. That come from? Where does the offer come from? Does she look over at you and go, oh, Bridget, honey, what's happening?
Bridget Well okay. So I have I've had these ovarian cysts for, like, a little over a year now. They put me in the ER the day after Christmas this year.
Scott Benner This is so painful. This to Arden too.
Bridget Yeah. Yeah. And it's not PCOS, but they like, I just have two I have one one cyst on either side, but they're, like, five centimeters big. Like, if you imagine a hair tie, that's the size of both of my cysts on either ovary.
Scott Benner Yeah.
Bridget And so I was like, oh my god. I need to figure out a way to get these out because they won't operate on them because they're not greater than, like, I think, six centimeters.
Scott Benner Arden had one removed, and Okay. And truth is is, like, others came back. Like so, like because they went in laparoscopically and took it off her, like it was right by her fallopian tube.
Bridget Yeah. Yeah. And so I was kind of asking them to just do surgery on me. I was like, I want them out. But then they kind of said that they typically come back.
Scott Benner Yeah.
Bridget And right now, I'm not on any birth control. I'm just trying to, like, you know, deal with my body. Yeah. Trying to get my body into control.
Scott Benner Yeah. You girls would have a lot to talk about if you were because she's in the same she's like, I don't wanna take birth control. Do you find I'm wondering if after time you'll find the any impact from the Mounjaro or even just losing weight or if it changes your your your periods. Even, like, lessening your your menstrual cycle might be helpful. There's another good reason to take your thyroid meds and
Bridget Yeah.
Scott Benner You know, all that stuff. Oh, I'm sorry. I've been in the I've been in the emergency room twice with Arden with that pain. Yeah. Just feels like someone's cyst stabbing me.
Bridget Oh my god. And thank goodness. I was still home for Christmas because we were, like, gonna drive to my grandparents the next day. And thank god I was, like, in my childhood bathroom, like, on the verge of passing out, like, laying on the tile floor, like, throwing up. I was like, okay. This is not normal. So I called my mom, and she, like, saved me.
Scott Benner Yeah. They give you a
Bridget never seen me in, like, that much pain. I've never felt that much pain.
Scott Benner Yeah. It's really upsetting. Yeah. Did they give you a tour at all?
Bridget Yeah. They gave well, first of all, gave me morphine, and then they gave me Toradol.
Scott Benner To to go home with. That does help.
Bridget Yeah. And then I didn't have any pain, like, the rest of my menstrual cycle. So
Scott Benner You got rid of it. How long did it take to get through from the sharp pain to getting rid of it?
Bridget It was like, oh, maybe three hours.
Scott Benner Felt better after the pain meds and the pain didn't come back?
Bridget Yeah. Okay. And they so I went back to my gynecologist, and she said that she thinks it twisted and then maybe twisted back.
Scott Benner Oh, he might have got lucky. Yeah. Yeah. Yeah.
Bridget So they did think it was appendicitis because of where the pain was coming from. And Yeah. My right cyst is bigger. And so there's just a lot of pain over there.
Scott Benner Yeah. Art Martin's had it present like classic appendicitis. She's had it present like classic gallbladder too.
Bridget Okay.
Scott Benner But it's it's neither. It's that. Yeah.
Bridget Yeah. And so they gave me anti nausea meds, and they gave me some morphine, and that did help. And then they put me through, I think, like, a CT scan, and then I got another ultrasound. And the doctor came back, and he was like, it's just your period. Yay. I was I was like, okay.
Scott Benner Awesome. Hey. This is gonna happen next month too. Right? The period? Like, that's gonna keep happening? What stops you from wanting to take the birth control pill?
Bridget I don't know. I was on it during high school, and I don't know. I it was fine. But, again, I have problems, like, remembering to take medicine. So
Scott Benner You're like, it's not gonna work. So It
Bridget just it just wasn't a good idea. And then
Scott Benner Does it make you crazy?
Bridget I thought it did.
Scott Benner Yeah.
Bridget But I was also just a high schooler. Like
Scott Benner I wonder too because Arden tried it in high school, and she's like, I don't wanna do it again. It made me crazy. And I was like, okay.
Bridget Right. And so I'm just I don't know. I'm I'm open to it. I ended up getting an IUD. Mhmm. But then they found the cyst, and so they took out the IUD.
Scott Benner Would that not have helped, though?
Bridget They said that the IUD might have caused it.
Scott Benner Really?
Bridget Yeah. Because apparently, the excess estrogen, like Oh. I don't know. Something like you get some sort of hormone that stops cyst prevention.
Scott Benner Okay.
Bridget There's like a whole a whole thing to it, but it again, they don't really do a lot of research on
Scott Benner No. They don't care. They're like, you're fine. You're a girl. We have other ones. If you're if you break, we'll have we'll have more. And, yeah, girls really do not get treated well, with their reproductive stuff. Right. Yeah.
Bridget And so I just don't think I don't think they know a lot, unfortunately.
Scott Benner Yeah. No one knows a lot. I don't wanna break your I'm sure you're still young and hopeful, Bridget, but you're gonna meet a lot of peep I started coming to the conclusion yesterday that maybe one in every five people I bumped into seems to have it together somehow. Yeah. So and god knows that we all think we're that one person, so that's why it gets sideways so easily.
Bridget God knows I am not one of those five people, but I try. I try.
Scott Benner I'm a 100% sure I am, and I'm probably not. Wow. It's a lot. Do you ever feel like do you ever have those moments where you're like, why me? Or just a lot to deal with?
Bridget I don't know. Supposedly, when I was diagnosed, you know, my whole family was there. They were all on spring break, and my brother told my dad, like, thank god it wasn't me. Yeah.
Scott Benner What a guy.
Bridget But I think he was he was coming from a good spot. Like, I'm glad it was Bridget and not, like, him or my younger sister. I think just because they knew that, like, if anybody could take it positively, it would be me.
Scott Benner You think your attitude leans more towards forgiveness on this?
Bridget Yeah. Definitely.
Scott Benner They would have been pissed?
Bridget Yeah. Definitely.
The Power of Positivity and Acceptance
Scott Benner What about you? Would you like have you always been like that?
Bridget Yeah. I'm just my my family has a thing, and they say that's so Bridgette. And it's like I don't know. When I was first diagnosed, we had all my senior, like, pic you know how you, like, put your senior picture in the front yard and
Scott Benner Yeah.
Bridget Yeah. Like, yay. This person graduated. My uncle sent me a picture, and it's, like, me smiling. It's, you know, my senior picture, and I look so happy. And he goes, that's still Bridget living with diabetes. And it's Do you like happy go lucky.
Scott Benner Yeah. Do you like that, or do you is that pressure to you?
Bridget No. I don't mind it. It's I think it's it definitely gives me I don't know. Recently, I'm taking I'm also getting my MBA right now. Mhmm. And we talk a lot about, like, identity. And so, like, saying I'm a happy person versus saying I'm happy. Like, you associate yourself with permanently, like, being happy versus, like, just a verb or an adjective just saying you're happy.
Scott Benner Okay.
Bridget And so I think, like and maybe this is crazy, but, like, other people saying, like, oh, she's such a happy person. Bridgette's so positive
Scott Benner Mhmm.
Bridget Versus, oh, she was very positive on this one day. I think that, like, helps me to an extent. And, like, people at work do it too. Like, oh, she's the happiest person or she's so positive. And I'm like, you know, I am pretty happy.
Scott Benner And but it doesn't make you feel like, oh, I'm now I'm the happy person. If I don't act happy, these people are gonna be disappointed on me. You don't have that pressure.
Bridget No. Definitely not.
Scott Benner It helps you that way. Listen. I think, you know, I mean, it's an oversimplification. Obviously, it doesn't work for everybody, but I do think a lot of how things go were really does kinda stem from your attitude about it. Mhmm. I do think you kinda get what you expect sometimes. Yeah. You know, if you expect things to go well, then you generally seem to feel like they go well.
Bridget Yeah.
Scott Benner And if you're always running around going, this sucks and why me? And it's not fair, then I think things are gonna feel that way. I mean, obviously, the die obviously, it's not fair. The thing I mean, with the cysts and the diabetes and I'm making funny about the pills, but, like, having to take a pill every day fucking sucks. You know what I mean? Like, there's nothing great about that. Yeah. You're know, you can argue it either way. Yeah. You're lucky to have the medication, have access to it and everything. You know, I could easily hit you with, like, there's plenty of people in the world who need that med. They'd be happy to take it, Bridget. But, like, I don't think I just don't think that's how things work. You know? So I don't think you're not taking it because you're you know, don't wanna be healthy or because you're not a good person or whatever somebody might think from the outside. I think it's hard to remember to take a pill every day. Yeah. You know?
Bridget Yeah. I definitely, like, approach life, you know, through a lens of it's never that important. And, like, some things are very important, and so I don't wanna, like
Scott Benner Yeah.
Bridget You know, discard that. But definitely, like, sometimes you'll have a bad day with diabetes, and you just have to say, like, jeez, that was, you know, a bad day. And I'm like, today is just not a good day.
Scott Benner Just wake up tomorrow and start over again.
Bridget Exactly.
Scott Benner Yeah. Oh, I like that. That's a good idea. I think that's a great idea.
Bridget I babysit for a family with a daughter with type one. She's, like, two. Aw. And she was diagnosed at one, and so they're, like, they're very new to it, and they're, like, kind of freaking out.
Scott Benner Yeah. I bet.
Bridget And I met them through, like, a type one diabetes, like, network kind of thing. Mhmm. And they, you know, they try to they try to be perfect. You just have to I don't know. With diabetes, you're gonna have it for so long. It's not your life, but, you know, it's a major part of your life. Mhmm. And so you just have to be good enough, and that's kind of been my perspective. And so I think them seeing me, a 23 year old year old girl who, like, decently has she has a job. She's living in Chicago. Like, she's happy. And so Yeah. Seeing that, I think it's provided a lot of hope and, like, my attitude towards diabetes. Like, that's been really helpful for them. But
Scott Benner I love it. I think no. I think I you sound like you're doing great, actually. I would I would wanna make sure to leave you with that idea that it sounds like you are really doing well. I I'm sure things are just gonna continue to morph and change over time as you get older and but already, like, I see, like, you know, you wanna be healthy for yourself. You wanna have kids. You're gonna wanna be healthy for kids. Like, you're gonna keep making good decisions as you go. Mhmm. And like you said, every day is not gonna be perfect, and every hour is not gonna be perfect. And it's hard to hard to swallow that when your two year old's running around with diabetes, and every number feels like the end of the world. And Mhmm. You certainly don't want your blood sugar to be 200. You don't want it to be two fifty. You don't want it to be 300. You don't want it to be four. You don't want those things. Right. But there's a balance between knowing that they're not optimal, working towards keeping them from happening, and not beating yourself up when they do happen if they happen. There are two different schools of, like, consideration in there. Like, yes, I don't want your blood sugar to be high. I don't want your blood sugar to be low. I also don't want you to spend a week or a day or a month, like, feeling badly about it if it happens because it's probably gonna happen. And, you know, the I think the key is to address it as quickly as possible, stop it without causing a different problem, and look at ways to hopefully help from, you know, it happening again. For you, it sounds like we know what you should be doing. Right? You should be Mhmm. Pre bolus ing a little better and probab I mean, what's your a one c right now?
Bridget I just got it back. I think it was $7.06.
Scott Benner Yeah. You pre bolus your meals, it'll be $6.06.
Bridget Mhmm.
Scott Benner Just like that. Just take your insulin fifteen minutes before you eat. It'll go down a full point, I bet.
Bridget Yeah.
Scott Benner Take your thought by the way, you're, it's also harder to control your insulin, with an unregulated thyroid problem too.
Bridget Oh, that makes sense.
Scott Benner It's all gonna help. And so don't don't let the I'm a fan of the Mounjaro, and I I'm I like that you're doing it. But don't let it mask the other things and make you ignore them.
Bridget Right.
Scott Benner That makes sense? Yeah. Take the damn pill, pre bolus your meal, shoot the Mounjaro once a week. You'd be you you probably be you probably live to be 200.
Bridget Right.
Scott Benner You know what I mean?
Bridget Right.
Scott Benner Hey. Any of those nodules on your thyroid, they say they have to come off, or they didn't mention that?
Bridget I don't think I at least I haven't noticed any. Like, it's definitely larger, but I haven't noticed any nodules.
Scott Benner You know, the the metal help with that too. Right?
Bridget Yeah. Yeah.
Scott Benner Did they palpitate it, like, with their hands, or did they give you, like, a like, did they scan you?
Bridget They just they always just feel it.
Scott Benner Feel it. Okay. And they're not feeling nodules.
Bridget Right.
Scott Benner Take them So far. Take just take them in, please. Yeah. Alright. Can you check-in with me in a month? Will you send me an email? No one ever does. You know that. Right? Whenever I'll I do it. When I say just email me in a month, tell me how it's going, no one well, some people get back to me, but not as many as I
Bridget want. Right.
Scott Benner Alright, Bridget. Is there anything that we haven't talked about that we should have, anything we skipped over, or anything you wanna yell at me about? Or if you wanna say wonderful things about me, now would be the time.
Bridget Mhmm. I just wanna say, like, I've listened to your podcast since 2021. You know, you have instilled so many, you know, very solid piece of the pieces of advice in my life. Like, I think one time I don't know when you said this, but you said, like, always stay low. Like, you'd always rather have Arden go low than go high.
Scott Benner The saying is, I would rather fight with a lower falling blood sugar. I would rather stop a lower falling blood sugar than fight with a high one. Yeah. It's just kind of a mindset more than anything else. I don't want her to be low. That's not what I'm saying. Right. Right. Don't misrepresent me, Bridget.
Bridget Right. I'm sorry.
Scott Benner I'm sorry. Okay. Go ahead.
Bridget But you you've instilled so many great, like, foundational pieces of advice that you really have made such a difference. And even, like, when I first emailed you back in, I think, October, I was training for the Chicago marathon. Mhmm. And I finished. I ran
Scott Benner Oh, good for you.
Bridget But you were interviewing another runner, and he just talked about, like, pausing his insulin or, you know, making sure there's no insulin on board when you start running. And, honestly, that made such a difference in my running journey.
Scott Benner Good for you.
Bridget Like, I was able to achieve my goals and run a marathon, and I felt like a, you know, like a normal person, I think, on marathon day.
Scott Benner Yeah.
Bridget So that made such a difference, but I just wanna say thank you. You're a celebrity in my house.
Scott Benner So that it's first of all, I'm very happy that any of this helped you. I appreciate your kind words. I would take this moment to tell you that if the thing I said about the running helped, maybe the other stuff will help too.
Bridget That's true.
Scott Benner Right?
Bridget You're always right. You should know that.
Scott Benner Hey. Listen. That's true. I do I do want that to be that should be a saying or a t shirt or something like that. Scott's always right. I will wear it around the house, and they'll throw rotten food at me. The laughing that would happen. I can hear Arden now. You don't know yourself, she would say. My my wife might say you don't know yourself. Arden would say those people don't know you. So, nevertheless, take the pill every day. Even if you even even if it if you forget it, take it at night. If you wanna take it at night instead of the morning, just do that. Just do it every day. If you forget it one day, take two the next day. Like, that that's easy. Do not whatever that thing is I'm gonna get a therapist on here to figure this out. But whatever that thing is that people go like, oh, I didn't do it. I'll have to wait till Monday. My god. Please, all of you, don't do that. That's ridiculous. You know, there's no no time like the present. Just jump back in again. You were really lovely, seriously. Yeah.
Bridget You were lovely too.
Scott Benner Oh, my
Bridget god. I told my mom I was gonna come on the podcast, she was like, what are you gonna talk about? Don't say anything in a she's a lawyer.
Scott Benner Don't say anything inappropriate. Don't
Bridget say anything crazy. And I said, I'll be good, mom.
Scott Benner Yeah. You were terrific. Was good.
Bridget Yeah. Thank you.
Scott Benner And, also, I mean, your mom and your brother are on this health journey with their thyroids. They could include you. How come we don't have a text chain?
Bridget That's true.
Scott Benner Right?
Bridget Everybody take their medicine today.
Scott Benner This is doable. Oh my god. You would yell in three seconds if your mom texted you every day. You'd be like, that is enough, lady. I don't understand the human psychology, but it's pretty funny. Alright. Hold on one second. I'm gonna say goodbye when nobody's listening. Okay?
Bridget Okay.
Outro and After Dark
Scott Benner The podcast you just enjoyed was sponsored by Tandem Diabetes Care. Learn more about Tandem's newest automated insulin delivery system, Tandem Mobi with Control IQ plus technology at tandemdiabetes.com/juicebox. There are links in the show notes and links at juiceboxpodcast.com. The podcast episode that you just enjoyed was sponsored by Eversense CGM. They make the Eversense three sixty five. That thing lasts a whole year. One insertion. Every year? Come on. You probably feel like I'm messing with you, but I'm not. Ever since cgm.com/juicebox. This episode of the Juice Box podcast was sponsored by US Med. Usmed.com/juicebox or call (888) 721-1514. Get started today with US Med. Links in the show notes. Links at juiceboxpodcast.com. Okay. Well, here we are at the end of the episode. You're still with me? Thank you. I really do appreciate that. What else could you do for me? Why don't you tell a friend about the show or leave a five star review? Maybe you could make sure you're following or subscribe in your podcast app, go to YouTube and follow me, or Instagram, TikTok. Oh, gosh. Here's one. Make sure you're following the podcast in the private Facebook group as well as the public Facebook page. You don't wanna miss please, do you not know about the private group? You have to join the private group. As of this recording, it has 74,000 members. They're active talking about diabetes. Whatever you need to know, there's a conversation happening in there right now. And I'm there all the time. Tag me. I'll say hi. If you're living with type one diabetes, the After Dark collection from the Juice Box podcast is the only place to hear the stories that no one else talks about, from drugs to depression, self harm, trauma, addiction, and so much more. Go to juiceboxpodcast.com. Up in the menu and click on after dark. There, you'll see a full list of all of the after dark episodes. If you have a podcast and you need a fantastic editor, you want Rob from Wrong Way Recording. Listen. Truth be told, I'm, like, 20% smarter when Rob edits me. He takes out all the, like, gaps of time and when I go, and stuff like that. And it just I don't know, man. Like, I listen back and I'm like, why do I sound smarter? And then I remember because I did one smart thing. I hired Rob at wrongwayrecording.com.
#1850 Still a Human
Masha shares how her son's Type 1 diabetes diagnosis didn't stop her family's six-month move to Finland weeks later , emphasizing the power of education over fear.
Companies that Support Juicebox
Key Takeaways
- Bedwetting and sudden, intense emotional changes—such as unusual rage or sentimentality—can be early warning signs of Type 1 Diabetes in children.
- A Type 1 Diabetes diagnosis shouldn't prevent your family from pursuing big life plans. With the right supplies and preparation, traveling or moving abroad is entirely manageable.
- Transforming anxiety into preparedness by identifying worst-case scenarios and creating actionable plans for them is a highly effective way to manage the mental burden of diabetes.
- Pre-bolusing (administering insulin 10-15 minutes before a meal) is a crucial foundational tool that helps prevent post-meal blood sugar spikes.
- Focusing on what you can control today—like sleep, food, and exercise—is far more productive than dwelling on unpredictable "what ifs" about the future.
Resources Mentioned
Introduction & Sponsor Messages
Scott Benner Hello, friends, and welcome back to another episode of the Juice Box podcast.
Masha Hello. My name is Masha. I'm a mom of a seven year old well, actually, two boys, but one of them has type one diabetes.
Scott Benner If you'd like to hear about diabetes management in easy to take in bits, check out the small sips. That's the series on the Juice Box podcast that listeners are talking about like it's a cheat code. These are perfect little bursts of clarity, one person said. I finally understood things I've heard a 100 times. Short, simple, and somehow exactly what I needed. People say small sips feels like someone pulling up a chair, sliding a cup across the table, and giving you one clean idea at a time. Nothing overwhelming, no fire hose of information, just steady helpful nudges that actually stick. People listen in their car, on walks, or rather actually bolusing anytime that they need a quick shot of perspective. And the reviews, they all say the same thing. Small sips makes diabetes make sense. Search for the Juice Box podcast, small sips, wherever you get audio. Please don't forget that nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan or becoming bold with insulin.
Scott Benner Today's podcast episode is sponsored by Medtronic Diabetes, who is making life with diabetes easier with the MiniMed seven eighty g system and their new sensor options, which include the Instinct sensor made by Abbott. Would you like to unleash the full potential of the MiniMed seven eighty g system? You can do that at my link, medtronicdiabetes.com/juicebox.
Scott Benner Today's episode is also sponsored by the Kontoor Next Gen blood glucose meter. This is the meter that my daughter has on her person right now. It is incredibly accurate and waiting for you at kontoornext.com/juicebox.
A Diagnosis Before a Big Move
Masha Hello. My name is Masha. I'm a mom of a seven year old well, actually, two boys, but one of them has type one diabetes. He was diagnosed when he just turned six, maybe a month after. And we were lucky enough that he didn't go into DKA because my mom, she has type two, and she was like, oh, the symptoms, you should go and check check it out. So, like, this is how we found out early. And, of course, it did change our lives upside down, but also I guess, like, why I'm here, like, what the main idea I wanna share is that, like, what happened in our life. We were planning to move abroad to Finland for half a year, And my kid was diagnosed three weeks before our flights. And so, like, this was this kind of, like, two life changing event events stacked side by side. So I wanna share that things are possible and, like, diabetes didn't stop us from going. And even though it's, like, super scary, super terrifying with the new diagnosis, like, we still went and there was, like, zero regrets.
Scott Benner Okay. So you you think you have, like, these two core ideas you need to share?
Masha Yeah. Just, like, lack of fear and, like, education. Like, your podcast helped tremendously in the very beginning. So I'm, like, I was just adamant. I thankfully, again, just, like, things kind of worked out in this weird ironic way that I had three three months booked off work because I really needed a break for other reasons, but, like, I dedicated this time not to myself like I intended to, but to learning everything I could about diabetes. So I guess the main two ideas is, like, yeah, don't be scared of big things like traveling or anything like that. Or, like, we moved for six months overseas to a country where where I didn't speak the language in
Scott Benner No.
Masha With a kid with diabetes and also education.
Scott Benner Okay. Let's start at the beginning then, and we'll get and then we're gonna unpack all of that. So you said you have two children. One of them has type one. How long ago were they diagnosed?
Masha This was in 2024 in July, so it's a year and a half ago.
Scott Benner Okay. And were there any reasons to think that diabetes might be in your future prior to that day?
Masha Not at all. I wasn't it wasn't even on my radar. All I knew is that my great grandmother had diabetes. Nobody knows which type. I remember my mom telling me no. Sorry. Yeah. My mom telling me that she was injecting herself with this huge old school syringe. It was in Soviet Ukraine, so, like, who god knows what it was like. But that was it. Like, I didn't know anything about type one. I only heard it's the bad type, the bad diabetes. Like, that's all I knew.
Scott Benner That's how they talked about it. Mhmm. The bad yeah. You're not the first person to say that. And how about other autoimmune issues in your family? People have celiac or RA, thyroid issues, anything like that?
Masha No. Nobody has anything else. I know if you're asking these questions, I've kinda thought about it, and now I couldn't come up with anything. Like, my mom has type two, but she has a lot of things. So it's Yeah. I don't think it's autoimmune. It's like lifestyle and stress and whatnot.
Scott Benner Mhmm. And, I mean, how about just generalized health? Is this like a situation where you're a young family, you've got a couple young kids, and everything's going great, and then all of a sudden, whack this happens? Or do you even have any, I guess, history with other things going wrong? Any reason to feel like you'd be good at this or, you know, have some practice at the very least?
Masha No. Like, things are going really well, and I was always about healthy eating. So my kids eat vegetables, and they pick salads on their own without me priming them. And, like, I always, like, keep three cornerstones of health, good food, sleep, and exercise. But in like, in terms of kids' exercise, basically, just, like, grinding around. So yeah. And we this was totally out of the blue, and I did not expect this at all.
Scott Benner Okay. Alright. Well and then there you are. So what is the first sign, and how do you know to pay attention to it?
Masha So the first and pretty much the only sign was that he started wetting his bed, which hasn't happened because he kinda trained himself out of a diaper at two, and the kid's never had any accidents since. Well, okay. Maybe one in five years. But that was a big sign, and we thought, okay. This might be stress because we were talking about, like, moving to Finland. This is always a dream of ours. And so we we thought, okay. Maybe this is stress. So we went to the doctor, and the doctor says, oh, it's probably stress. And, also, I used to sleep in his room because he was, like, five at the time, and we took away the mattress. And this started happening, like, a week after. So we thought, oh, maybe it's the stress of mom not sleeping in his room anymore. So we tried everything. Nothing went away. Then he was he was generally a cranky kid, like, from the very beginning, but the level of crankiness just, like, a month before diagnosis was almost unbearable. And so my mom said, like, wetting the bed is a sign of diabetes. You guys should go check his blood sugar. And then we did do the blood work, but my doctor who I'm really, really mad at, like, we didn't get a call from a doctor. We got a call from the lab. This is how we found out. The the lab called us on a Saturday, and we went to the hospital Monday morning where the diagnosis happened. But, thankfully, like, he was not in TKA. He didn't even need any IVs or anything like that, so we caught it early, they said.
Scott Benner What was that time you said that time was difficult? How was it difficult? His health or the way he was acting, or what part of it? Maybe all.
Masha I guess just, like, emotions. He was a very always a very emotional kid, and he's an older brother. He's four years older. And they were always fighting even from when when the youngest one turned two, I feel like that's when the fights just escalated, and then COVID happened. So, like, there was a lot of emotions in general.
Scott Benner Okay.
Masha So he would get upset really easily. He would be yelling, screaming, like throwing things. But I kind of thought this was sort of normal because, like, the they both got on each other's nerves all the time. Mhmm. And so but, like, prior to diagnosis, he would just, like, come up to me and just, like, cry out of out of the blue, basically, who said, oh, I don't wanna grow up. I wanna be a baby and things like that. He would just, like, start crying when he was looking at his old pictures. Like, it was really
Scott Benner He was really emotional. Yeah.
Masha Yeah. Like, really emotional, but, like, he's usually emotional in, like, in in a rage manner, but, like, not in this very sentimental and kinda sad. But but then, of course, the rage was also there. It was just, like, very, like, much more frequent. It was, like, not once a day, like, before, but, like, I don't know, three, five times. Yeah.
Scott Benner Okay. Do you recall what you thought was going on before you realized the diabetes?
Masha Like, it's really hard to say. I I just remember thinking, like, we must have messed it up somehow. Like, maybe he's really stressed about Finland. And, also, like, at the May, just, like, when the symptom like, these symptoms were showing up. Like, my grandma died, so, like, I was really sad. And I was just thinking, yeah, something, like, emotionally must be going wrong. There's like, it's a lot for a five year old to know that he's gonna be moving abroad and Yeah. Mom was sad and all of that.
Scott Benner Gotcha. Any, anxiety in your family? No. No? Okay. Well, so what happened in the hospital? What did they what did they tell you, and how did everything begin? Did you get good technology? Did you get good direction, or did you feel adrift?
Masha Well, when we on a Saturday where we got the call from the lab, we kind of knew that this is what it is. We did the research, and we're like, okay. This is her life. My husband accidentally, about a month ago, he read an article about somebody with type one describing diabetes, like how hard it is and how it's a lot like playing flappy bird, you know, when you can get too high and you cannot get too low. Mhmm. And so, like, that was the idea, and I thought, oh, this is it gets hard, but I didn't know what to expect. And in the hospital, they basically measured his blood sugar. They said, well, this is type one, but, like, wait until we get all the blood work done and stuff like that. And, yeah, like, he was diagnosed, then they said, oh, you have to stay in the hospital for a couple days until we, like, teach you what it is, what to do. They were doing finger pricks before every meal and the hospital food here. Holy moly. Like, I I I'm still scarred by the breakfast. Like, for a type one diabetic, it was orange juice, banana muffin, and frosted flakes or something. I'm like, what are you doing? How is this a diabetic breakfast? So, like, thankfully, my husband was able to go home and bring us some, like, proper foods and, like, omelets. I don't know. Like, food is I'm really obsessed about healthy food. Yeah. So, yeah, this is kinda funny. And so two days, we were doing the finger pricks, and they were doing injections, and they were teaching us how to do injections. They gave us pens.
Scott Benner Mhmm.
Masha And I'm the person who's terrified of needles. I don't even have my ears pierced. So I was like, oh, how ironic that now I have to do this. But it took me a day to basically adjust, and they thankfully gave us a Dexcom g seven on the last day before they let us go home.
Scott Benner Okay.
Masha And so this was I think this was crucial for me to not just go insane, but worry because I was like, okay. We see the numbers. We kinda know, like, very roughly what to do, how to control them. I'm really thankful to the nurse who just gave us, like, a whole bunch for free Yeah. Because I think they were testers. Like, I don't know. Marketing material maybe. Mhmm. Yeah. So this is how it all started. Then we had to make a really big decision. Like, okay. We have these tickets to Finland to fly overseas. So, like, we consulted the doctor. We consulted the nurse, and they all say, well, it's really up to you.
Scott Benner Nobody was helpful. Hey. How far before your planned move was the diagnosis?
Masha So we had tickets in the July. So we put yeah. We planned it probably, like, March where I registered him for school and all of that, and he was diagnosed in the June. So, like, three and a half weeks maybe.
Scott Benner Yeah. Did you end up going?
Masha We did. Yeah. We just figured it was really hard, but we figured, you know, Finland is a civilized country. They have some basic health care. We'll figure it out. We just packed a whole bunch of insulin, and we packed a whole bunch of Dexcom. And we said, well, worst case scenario, we're just gonna be back in a month. And we said we're just gonna use that as a traveling opportunity with insulin and Dexcoms.
Scott Benner Did you sell your home, or did you were you renting?
Masha We wanted to rent it out, but then the opportunity fell through, like, also a week before the flight. So, thankfully, my partner's mom came to, like, help out with the house.
Scott Benner Okay. So you you had a place to come back to if this whole thing blew up. You could've okay. You could've come back.
Masha Because we only were going to we the plan was to go for six months because I didn't wanna lose my job and yeah.
Sponsor Break
Scott Benner Oh, you well, so aren't you interesting? What makes you such a a free spirit with the let's go some let's go to Finland for six months? Where's that come from?
Masha Oh, boy. Do you have time for long stories?
Scott Benner I have time for long stories. Don't worry. Go ahead. Contournext.com/juicebox. That's the link you'll use to find out more about the Kontoor Next Gen blood glucose meter. When you get there, there's a little bit at the top. You can click right on blood glucose monitoring. I'll do it with you. Go to meters. Click on any of the meters. I'll click on the Next Gen, and you're gonna get more information. It's easy to use and highly accurate. SmartLight provides a simple understanding of your blood glucose levels. And, of course, with second chance sampling technology, you can save money with fewer wasted test strips. As if all that wasn't enough, the Contour Next Gen also has a compatible app for an easy way to share and see your blood glucose results. Kontoornext.com/juicebox. And if you scroll down at that link, you're gonna see things like a buy now button. You could register your meter after you purchase it. Or what is this? Download a coupon. Oh, receive a free Kontoor Next Gen blood glucose meter. Do tell. Kontoornext.com/juicebox. Head over there now. Get the same accurate and reliable meter that we use.
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Relocating to Finland
Masha Okay. So I moved to Canada from Russia all those years ago all by myself as a student. So, like, I was always, oh, I wanna travel. I don't care about physical possessions or owning anything. Like, I just wanna experience the world. And so I was in Toronto for the longest time. And then I met my husband, then we had kids. And then my husband had an idea to move to The States, so we moved for a year, hated it, and returned to Canada. But then COVID started, and so we were kind of we didn't have a house in Toronto anymore, and we ended up in a suburb of Toronto.
Scott Benner Okay.
Masha And the suburbs are really foreign to me. Like, as a Soviet child, like, the cars were a luxury in the Soviet Union. So, like, all of the cities were built for public transport or walking. And so we were stuck here in the suburb during COVID with, like, a car and nowhere to go. And so the idea was to just, like, move away from the suburb to somewhere that's more human, like, people oriented. And so we thought we thought, okay. Finland has a program for visitors. Like, they they had a startup visa, and so my partner had a startup. So he applied for a startup visa, and this is how we basically pick Finland. And the other reason was I really wanted my kids to experience one of the best schools in the world as they claim Finland has.
Scott Benner Mhmm.
Masha So the two reasons.
Scott Benner I like that you didn't want possessions, but you picked up a boy and two children. You can't sell them like a VCR. So
Masha Well, those are yeah. I don't know. Those are human. Like, I don't wanna have a pet because a pet would always need my care. But, like, you know, the children, they grow and they take care of themselves.
Scott Benner Yeah. Masha, I know that humans are not, like, possessions. I was just joking. But Yeah. It's an interesting line to cross. Right? What happened? You fell in love? Is that what ruined your plan?
Masha That's also another very complicated story. Like, my mom and my grandma were always on my case that, like, I have to have children. I have to get married. This is what makes a woman happy. You know how, like, the Soviet patriarchy
Scott Benner Okay.
Masha The Russian does it to you? And I was like, okay. And those were the last words that I heard from my grandma over the phone. It's like, Masha, you have to have children. Yes. But what about me? But then, I don't know. The last words from my grandma really, like, convinced me, and this was my goal. So, like, here I am. No regrets. No regrets here, though.
Scott Benner Can I ask you, was she right? Did it change your life in a way that feels measurable and commiserate with her opinion?
Masha I do not agree that in order to be a fulfilled woman, you have to have children. I do not agree with that, and I think my grandma was wrong in that because they they claim every woman like, that's the happiness.
Scott Benner Okay.
Masha But for me personally, yeah, I think it was the right call. It definitely changed me in a lot of ways, made me more patient, and made me appreciate more things.
Scott Benner Okay. That's awesome. What happened when you got to Finland? Like, you had your your satchel full of insulin and and whatnot. Were you able to find devices, medical care? How did you work your way through all that?
Masha Yeah. So I had a friend in the city in Finland that we moved to, and she said, just, like, email the hospital. And so I emailed them, and turns out that Finland is so much more advanced. So they were texting with me, which I'm like, it's never happened to me here. I never texted with a doctor. But I basically was setting up an appointment with the clinic describing our situation, and they said, yes. Just, like, come in at the time. We'll do the assessment, and we'll see what to do with you. And so, thankfully, everybody spoke some level of English at the hospital.
Scott Benner Okay.
Masha So this is how we were able to talk to them. Like, the doctors, of course, had impeccable English. The nurses, like, it was a hit or miss. But, like, with Google Translate, we were able to get by. So we get to the hospital. They are all terrified of, like, we should keep you here overnight. This is diabetes. This is serious. But we're like, we've gone through that a month ago. We don't really need to be in the hospital. I guess for bureaucracy reasons, they still had to take us through the entire education, like, series, like what to do, what to do with lows, what to do with sickness. So they kept us there for a couple days, not overnight, though. So let us go home. And they also wanted to make sure that we know how to dose. So they brought us food for my kids specifically, and they watched us calculate. And then they watched us do the injections, like, do we do it correctly or not? And once we passed their test, they were like, yeah. We'll see you in three months. And since we were there legally, like, on a startup visa, we registered there and registered with the municipality that we are now kind of citizens of that place. And that gave us access to the basic health care, including top one diabetes care.
Scott Benner Nice.
Masha So that was a really nice surprise, and that made us really confident. Was like, okay. This is gonna work out because they also provided us with free Dexcoms for the six months that we were there. You just basically order a thing online, and the package arrives with however many Dexcoms.
Scott Benner Okay. Did you ever consider staying? Did you like it enough to think we should move here forever?
Masha Yes. And I still dream about that. I really liked it there because I grew up in the North Of Russia and, like, the Finnish culture and the Finnish nature, it smells like, the forest smell like my childhood, basically. I would love to stay there, but I don't know. My my family, they're still in Russia, they say, you know, Russia is unpredictable these days, and Finland has a border. So just, like, stay away, stay across the ocean for now until that whole situation figures itself out. But, yeah, my oldest really loved the school. In Finland, there is so much freedom. The kids are allowed to go to school on their own and take public transit at the age of seven, which is unheard of in North America.
Scott Benner Sure.
Masha So I think I would really love to move to maybe in a couple years.
Scott Benner Do you guys do the kind of work that allows you to be mobile like that?
Masha Yes. We both are software developers.
Scott Benner Okay.
Masha So even though my company I'm only allowed to work outside of Canada for ninety days, it's still ninety days. Like, we can travel and work anywhere pretty much.
Vibe Coding and AI in Diabetes
Scott Benner Kidding. You know, it's so bizarre that that's what you said because you might turn your nose up at this, and I would understand if you did. But all morning, I've been I I'm sure you hate this word, but I've been vibe coding an app that allows you to put food and insulin onto a timeline and slide it around to see how changing the bolus changes the peaks in the valleys.
Masha Wow. I you're not gonna believe it. My husband did an app like that, and there's a thread on Reddit somewhere about that.
Scott Benner Really? It's just such a great like, I trained it on, like, the work saw method and, you know, understood ideas about how insulin works and different insulin timings and stuff like that.
Masha Mhmm.
Scott Benner Let me say this. It's not something you would dose off of. Although, I imagine if you got it correct, you probably could. It is just very visual and I think allows I think it would easily allow people to say, like, oh, I see the value of where I put the insulin and how long the food impacts my system. I think kind of be for visual people, it might be a lot easier than some other stuff. Anyway
Masha I totally agree. I'm so happy you're doing that.
Scott Benner I hope you
Masha share with the world.
Scott Benner Oh, I I'm I'm I'm trying. I swear the, the I I know it's such a I hope they come up with a better phrase than vibe coding because it sounds I feel can I just be honest? I feel like a douchebag when I'm saying it. But at the same time, that's not what's happening. Like, I'm talking to it about what I wanted to accomplish, and it is accomplishing it. I it's making me feel like like a lot of different things are possible all of a sudden. It makes me wanna create an app that that not only can house the audio from the podcast, but maybe one day also have a community right inside of it, you know, a dictionary of diabetes definitions and then links to take you back to longer explanations of it. Like, I I honestly like, I have the whole thing pictured in my head. I just don't have any actual skill. So I'm I'm waiting for AI to either kill us or catch up with my idea. That's my hope.
Masha I think the latter is gonna happen. Honestly, it's so good these days. Like, I don't code anymore. I just basically type in English or sometimes even talk to it, you know, with voice recognition and stuff. It's bizarre.
Scott Benner My son is just starting in the world. He's only 26, but he's got one of those jobs where, you know, he did teach himself a lot of coding. And then all of a sudden, one day, he was like, I don't really have to code that much anymore, but I still am. And I was like, yeah. He works for a company that basically, rents him out to other large corporations that need back end stuff done, but, you know, don't wanna hire people or or have the expertise to walk through the project. So he's been doing that for a while. I think he likes it a lot, actually.
Masha It it sounds really fun. Yeah. Like, we all got into the this job, I guess, for the pleasure of coding, and now we're gonna have to find pleasure in problem solving overall, not just coding.
Scott Benner Something else. Right?
Masha Mhmm.
Scott Benner I'm gonna get back to your kid's diabetes for a second. But to your point about it, it's getting better so much more quickly. I've been using, like, deep research tools to just research the podcast transcripts and then to turn it back into content that will reach people in different ways. It's just it's so good at it. It's incredible.
Masha Mhmm.
Scott Benner I used to sit around and think, there's so much in the podcast that I think just goes dormant and could be reused, but what am I gonna do? Am I gonna sit and transcribe it and then put it together in a written form? I'll have to live six lifetimes to do that. You know? And now suddenly, I'm just like, hey. Here's 25 episodes of the bold beginning series. Can you break out all the important diabetes tips in it? And, like, ten minutes later, it's like, here. Oh, okay. Yeah. Yeah. Really
Masha Live in the future.
Scott Benner Yeah. It really is awesome. Anyway, that's all. I hope it doesn't take your job.
Masha That's okay. I also bake bread, so I'm like, people are always gonna eat, so I'll just be a baker.
Scott Benner I love that. You're like, if it takes my job, I'll just bake bread. That's great. That's fantastic. Well, I I also think, like, you know, it's nice to be able to put something down. Like, I think the podcast works for a reason. I think the talking through it is really valuable. I don't think that'll ever go away. But I do think, like, you know, even just having, like, a I don't know, like, a, like, a touch tone app, like, a daily reminder. Like, just imagine opening up an app in the in the morning, it just tells you, like, just some little tidbit about diabetes or your personal wellness or care that just kinda keeps you grounded and and focused on what you need to do for the day. And then there's a community back there if you wanna go talk to people. I don't know. It seems like it makes a lot of sense to me. So
Masha Yeah. Especially if you give access to the data to the app. And, like, in the morning, it's, like, has a small analysis of your overnight graph or something. Like, that's just invaluable. Oh, yeah. Lives are busy, and we don't have time to do that, like, daily. But
Scott Benner Are you saying are you saying that my app should open up, look at your last twenty four hours, and say, hey. I just wanted to remind you to pre bolus for your meals. It looks like we might have gotten away from that yesterday.
Masha Something like that would be amazing.
Scott Benner Alright. You're hired. I have no money. Let's go. Have the whole thing done in three months, please. We're on a schedule. So funny.
Masha Well, with my little quad, I'm sure we can do great things.
Scott Benner Yeah. That's the guy. I had somebody approach me at a I did an event over the weekend, and a person walked up to me and said, you know, I'm I'm an electrical engineer and then wanted to show me this thing they made, which was like it was crazy. It was this it was a little tiny screen. It was maybe four by two or four by three, and it was just plugged into a into a little battery pack. And as he got within Bluetooth distance of it, it just populated with his Dexcom information. And when he walked away from it, it just went away. And when he walked back, it turned back on again. It was fascinating. And, it looked like something you bought at the store. It was so nice. I said, how much did that cost? She goes, it was about $30 worth of parts I bought online.
Masha Crazy.
Scott Benner And built the whole infrastructure and flashed it onto it. And then he was looking at something on my website, a bolus estimator. And he's like, I could turn that into an app if you wanted to. And I was like, yeah. Okay. So anyway, I I love people that are just excited to to help and do things and, you know, have some
Masha expertise. Mhmm.
Preparedness vs. Anxiety
Scott Benner So how does your child handle the diagnosis? I'm gonna ask about how you handle it in a minute, but is it a tough thing? Are they young enough that they kinda go along with it, or, you know, what what ends up happening in that situation?
Masha Overall, like, I think he felt much better after he started getting insulin. Mhmm. And I think he told me at some point in the very beginning that he does feel better. And he, like, almost overnight well, I guess, over two nights at the hospital, like, he the emotion, like, those really sharp emotions went away. Yeah. And, yes, he was really annoyed with the finger pulps for the couple of first days until we got on the Dexcom. And he was really annoyed with the with the pens too, but also I showed him the syringes that they used to use before pens, I guess, came on. And he was like, oof. Yeah. The pens are so much better. And so I think
Scott Benner There's your Eastern Bloc upbringing. You're like, how would you like to get stabbed with this instead?
Masha Yes. I guess, you know, like the I grew up with always being reminded that there is starving children in Africa. You know? There's somebody there's always somebody who's worse off. And so I guess I yeah. I guess I used that on him too. But we also we really tried like, me and my partner, we really tried to not be heartbroken about it visibly. Like, we were for a little bit, but then I don't know. Like, something shifted in me. Maybe it's, like, the last years with the war and just, like, knowing about a lot of really bad things. I'm like, I don't know. I all I can say
Scott Benner Yeah. Perspective's important. It really is you know, it's funny. I was just listening to a commentator this morning talk about he said he said that I don't keep artwork in my home, but I have this photograph of Anne Frank's father, and he's standing in the attic after he's lost his entire family and the war's over. And he's reflecting and and in this photo. And the guy said, every night before I go to bed, I look at that picture for ten minutes, and I try to imagine what he's thinking about. And Mhmm. Then in the morning, I look at it again for ten more seconds, and I try to remember that my worst day is a lot better than most people's best day. And then, you know, just I don't have I forget how he said it. I don't I don't have problems. I have inconveniences, he said.
Masha Mhmm.
Scott Benner And and I thought that was really something. And and it's interesting that I just heard somebody say that. Now you're saying the same thing.
Masha I totally agree with that. And I think we, like, we did try to talk to him in this way and they're like, okay. This yes. This is inconvenient. Yes. This is very annoying. But, you know, we're still gonna live. He never skipped a pool hangout with his friends. Like, never did like, diabetes hasn't stopped him. Like, we made sure that diabetes doesn't stop him from anything. Yes. It adds a lot of, like, inconveniences, the things we have to now think about, but it doesn't mean that we cannot do those things. So, like, from the get go, we kinda said, this is our life now. Let's just move on. We're gonna eat everything. We're gonna travel. We're gonna see. We're gonna, I don't know, go to water parks and whatnot, deal with those things, but let's not focus on diabetes. I forgot it was your podcast. Like, I heard this somewhere that I'm not organizing my life around diabetes. I'm organizing diabetes around my life, and I really like that.
Scott Benner Yeah. You just have to you just have to find the t shirt slogan that works for you, basically.
Masha Pretty much.
Scott Benner Yeah. And and your attitude, do you is it cultural? Because I've been doing this a very long time now, and you're not the first person from Russia I've spoken to, and I've had some people on, from Czech Republic and just that kind of part of the world, and I find their attitudes all seem to match up with what you're saying.
Masha Probably, it's really yeah. Like, if I had to guess, like, especially people who have immigrated, they've decided to leave, like, the bad parts behind. And, like, we have a much better life here, like, wherever you move. Like, even if I move to Europe or, like, to a more singlish country than Russia. Like, we just value and, like, appreciate things a lot more, I find
Scott Benner Yeah.
Masha And take less like, fewer things for granted. That's that's what I've noticed.
Scott Benner Yeah. Just nice not freezing your ass off, I would imagine. I
Masha mean, I'm in Canada.
Scott Benner Well, yeah. Why'd you do that, by the way? Why didn't you go some why don't you go somewhere warmer?
Masha I don't like war. I don't I grew up on the White Sea, and White Sea is the part of the the part of the Arctic Ocean. And I just don't deal with the heat. Like, I don't like it.
Scott Benner Oh, that's interesting.
Masha My winter.
Scott Benner Yeah. So it's not just it's not just psychologically, you don't think your body does well in warmer climates?
Masha I just don't enjoy that. I don't enjoy sweating, and I don't
Scott Benner Yeah. Nobody enjoys that.
Masha Yeah. So, like, even in Toronto, the summers used to be, like, really hot and humid, and I don't like that. I'd rather be cold than warm. So
Scott Benner You can come stay in my house because there's two feet of snow outside. It'll keep you nice and cold. I don't know why it won't stop snowing here. It hasn't snowed like this in the last twenty years of my life, and then all of a sudden, here we go.
Masha This winter has been something for sure.
Scott Benner So now we understand how your son adapted. Did you have luck applying? Because, you know, it's all well and good to have ideas. What that was something about best laid plans. Right? But did you have luck following that in your mind? Like, were you were not gonna let it hold us back, or did did the emotions of it get to you?
Masha I think that us moving and kind of seeing that it's working, it really, really, really helped me psychologically to process all of it. Because now looking back, I'm like, you know, even when we're in Finland, like, we first flew to London. We'd stayed in London for a week, then we flew to Finland. So it was, like, already kinda traveling, like, taking airplanes a lot and being in airports. So doing that so close to the diagnosis, it really helped me see, like, okay. We're doing it. It's working. Mhmm. Like, of course, there's highs and lows, and, like, it's terrifying. It's, like, those emotions. Like, sometimes there's a interrupted night of sleep, which is also very annoying, but, like, we managed to pull off this overseas move. He was really happy in school. He made friends. He tried all sorts of weird Finnish foods. And, like, I think that really helped me see, like, okay. It's really it's not just like the world. It's not just a slogan on a T shirt, but we're living it. And I always not always, but, like, sometimes I wonder what would have happened if we didn't have this. It would probably have been much harder on me. But having pulled off that huge, like, undertaking with moving our kids overseas and just, like, trying to arrange a new life, even temporarily with diabetes and talking to people, to the new doctors, like, kind of navigating the new system, and we managed to do that successfully. I think that really boosted my self confidence, and and I kind of moved on from there. Like, we moved back, and I've never even looked back. I guess diabetes is annoying. It's scary. I try not to think about what ifs because what's the point? I'm trying to focus on, like, what can we do today? Yeah. But my brain does go sometimes like, oh, the teenage years when the sleepover starts, like, what if he's gonna, like, I don't know, forget to do his insulin or something. But I'm like, he's seven now. Let's focus on today and then maybe the next month Yeah. And I'll manage whatever happens.
Scott Benner Not gonna worry about things you can't control that you're not even sure if they're gonna arrive or not. So Yeah. So I'm hearing a lot here. This is really interesting. So my first question is is, was the move to Finland so preplanned that you couldn't back out, or could you have backed out if you wanted to and it was a decision you made to go?
Masha We totally could have backed out. There was nothing like, there's no money involved. The only thing we've done is I pre rented an apartment for the first couple weeks, and I registered them to school. So
Scott Benner You could have eaten that cost if you wanted to and stayed behind and and not left.
Masha Yeah. Yeah. Pretty much.
Scott Benner Okay. You made a decision to be bold, and then you got some early wins, and then you built off of those wins. Is that right?
Masha I think so. Yeah. Yeah. I think that's what happened. And because we also have said, like, okay. Worst case scenario, we don't have anxiety. I don't think I'm an anxious person, but I maybe that's how my anxiety manifests itself. Like, I always need to know all the what ifs. Like, I just need to be prepared. It's like the worst case scenario, this is what we're gonna be doing. So we're like, okay. What's the worst case scenario? There is no doctor. There is no Dexcom. There's no access to insulin, and we were ready to pay for insulin and turned out that we had to pay for it, but it was really cheap. It was, I don't know, €90 for six months supply, like, something like that.
Scott Benner Okay. It's interesting, isn't it? If you worry about something and then get your answer and continue to worry, you're anxious. But if you worry about something, get your answer and let it go. You're prepared.
Masha Me yeah. Yeah. That's a good distinction. Yeah. Like, I I don't worry about it if I know what I what my options are. I worry when there's a lot of unknowns. So, like, I kinda need to at least come up with some ideas. So, yeah, like, worst case scenario, we would just be back in in time for a school year just time because we school in Finland starts in August, and school here starts September. So we're like, okay. You guys go to school for a month. See what it's like. And if things don't work out and we have to be back, we'll just be back.
Scott Benner I tell this story a lot on the podcast. I hope it's not boring for people, but I once was, somewhere with my brother-in-law, and I said, I don't know how it came up, but I was like, you don't have an escape plan if your house catches on fire and you're on the 2nd Floor and you can't get downstairs? And he said, no. Like, are you anxious? And I'm like, I'm not anxious. I'm ready. And then I described how I would get out of my house on my secondary egress and and all that stuff. And I said, but I've never thought about it since then. Like, I don't sit around wondering, oh gosh, what am I gonna do if the house catches? I assume my house isn't gonna catch on fire. I had kids, and I thought it was important to think, well, if we get trapped upstairs, how would I get people out? And now that I've got my answer, I'm never gonna think about it again. But you've never thought about it. He said, no. I I I would never think about it. But the whole family is, like, littered with anxiety. So I just feel like they're they're wasting their they're wasting their worry in the wrong places is how it feels to me. I know anxiety is not that simple, but it's neat to talk to you about it because you're like, oh, I, you know, I have a lot of things I was concerned about. I figured them out and that's that now. It feels like you have a book that you you put your ideas into, and now you're just believing that they're gonna work the way you set it up or the way you thought.
Masha Pretty much. Yeah. Or if they don't work out, they could at least say no where to go. I know who to ask.
Scott Benner And you can just adjust. Mhmm.
Masha Yeah. Yeah. Because life is so unpredictable in a lot of ways. So
Scott Benner because how how could you be anxious while you're coding? Because you're sitting there writing, writing, writing, and you you, you know, you you press enter, and then if something breaks, and then you gotta go find where appropriate. You have to almost want the problem to do that job. Do you know what I mean?
Masha Yeah. Yeah. There's something to it. I also thought, like, if us both being in software affected how we dealt with diabetes because we always get praise from the diabetes team. It's like, oh, like, you manage it so well, and, like, you ask such good questions. I'm like, probably our systemic and maybe, like, lot. I don't I don't wanna call it logical. It's not, like, other people that are logical. But, like, there's some structure that we bring to diabetes itself probably due to our profession.
Scott Benner I had to do something. Right? To choose between some entrants on something, some entries. And I was like at first, I was like, I'm just gonna do it randomly. And then I thought, well, some of these are like, they have more impact than others. And, like, I don't know how to like, I just and I sat here. I was just I was just just making myself crazy trying to figure out how to do it. My son comes in and goes, what are you doing? I said, I'm thinking about doing this a different way. And he he's like, oh, yeah. Well, you could just, you know, list out all of the things then add a point system to them and then, like, add it up and weigh it. And then and I was like, oh, is that how your brain works? I was like,
Masha oh, I
Scott Benner was like, well, that was interesting. He just he didn't even pause. He just rattled it right off, and I thought, oh, my gosh. That's that's the part of him that's not for me, is what I thought while it was happening. And that's exactly it must be what my wife does too because they they think very similarly. So you and your husband have a similar brain. I just have to ask for a second. Is that fun, or is it annoying sometimes?
Masha It is annoying sometimes, but I think it's more fun because, like, we understand each other. And, like, we can talk about work as well Mhmm. In-depth, which I really enjoy. Like, I learned a lot from him. He's he's working in crypto now, and I don't know anything about crypto. So, like, learning about that has been fun.
Scott Benner Okay. But you do you ever feel like, I wish one of us had a different side so we could like, you almost have wanderlust, don't you? You said you you're dreaming of going back to Finland.
Masha Yeah. Yeah. Oh, yeah. I I find it hard to settle. But, like, you know, with kids, kids need stability, all of those things that people tell you. So, like, we do travel a lot.
Scott Benner All those things that people tell you. I like that you're raising your family based on something your grandmother said and other things you've heard from people. But in if if it was up to you, you guys would be walking around the planet with a satchel over your over your shoulder, baby. Right?
Masha I totally would, but, like, now I do drag my kids to travel a lot with me, and sometimes they complain. Because, like, when we were in Finland, we took a lot of, like, smaller trips across Europe, and they said, oh, can we please not travel for a little bit? I'm like, you spoiled little brats.
Scott Benner You're ruining my life. I got plans. That's really something. Do you worry about your other child getting type one?
Masha We did do a test. I forgot what it's called, but when they test your antibodies
Scott Benner TrialNet?
Masha Try yes. Try that. We did it after we were back from Finland, so a year ago.
Scott Benner Okay.
Masha He is negative for now, but, of course, I do worry about that sometimes. But it's one of those things. It's like if it happens, it's not really preventable. Like, yes, there's this new drug that can postpone it. I'm already doing what's under my control. Like, I it in I make sure that they eat well, they exercise, and sleep is really hard in the in this house. They never slept as babies. And, like, but I do try my best. So I'm like, this is all I can do. I cannot control other things. So
Scott Benner Yeah. No. I I agree with you. You know, people talk about, you know, what is that? TZL, that drug that you were just you just brought up, but it's like something like 13 infusions, thirteen days in a row, and it may stave it off for a certain amount of time, but they're not sure.
Masha And Mhmm.
Scott Benner It's a tough hill to climb. I just interviewed somebody the other day who had got an islet cell transplant in, one of the studies that's going on out of Chicago, and I don't think the episode's out yet. But and she's gotta get an infusion every twenty one days to keep the, you know, keep the cells viable and so that her immune system doesn't attack and whatnot. I mean, Arden is just about she's gonna be 22 this summer. So she's 21 right now. She was diagnosed right after her second birthday. Arden's had diabetes solidly for nineteen years. Last night was the first time I told her about anything like that. I was like, hey. I interviewed this lady, and she got this, you know, this thing. I said, would you do that? And she said, I don't feel like I would do it until people had been doing it for a while. And I was like, you sure? And she said, yeah. And I I said, you know, that's it. Like, you know, maybe no more diabetes, no more giving yourself insulin, all the other things that come with high or low blood sugar is just gone. She said, no. I still think I'd wanna wait a little bit and see how make sure it's okay. And, then she joked with me, and she said, and what's the what's the protocol for this stuff? I said, well, they say it's like a an infusion every twenty one days, but woman told me they're hopefully working on, like, a once weekly injection to be able to do at home. I said, of course, this is, like, you know, in the testing phase. So this isn't like it's retail or anything like that. And she she joked and she said, I would just forget to take the shot, and then those those cells would die, and I'd be right back here again.
Masha Oh, right. That's so interesting. She must feel like it's really under control then.
Scott Benner I you know, that's it made me feel really comfortable because she wasn't in, like, a mad dash. She didn't say, yeah. Like, she didn't lean over to me and go, hey. Can you in that podcast get me in that study? Like, you know what mean? Like, she wasn't which, by the way, I don't know that I my maybe that I couldn't, like but I but at the same time, like, she never I wouldn't ask and she didn't offer she didn't even offer up as an idea. So, yeah, that that's what I thought too. Like, my gosh. She must be pretty comfortable, You know? And that made me feel good that she felt that way. Yeah. Really did. I hope it makes other people feel good too.
Masha True. Like, technology these days, it's Yeah. It's really incredible. Because I did talk, like, when he my kid was diagnosed, I got a few connections from people who also have either kids with Taipan or Taipan, like, themselves. And I did talk to a lot of them. And for example, like, there was one family whose kid is now oh, he was 18 at the time. So now must be, like, 19, whatever. And he was diagnosed at four. And so the mom told me, like, she couldn't work because she had to, like, be in school around. And, like, she he got low at school. And, of course, if there was no CGM, so, like, it was a whole new thing. So I'm like, these days, I would call it easy compared to what people had to do even ten, fifteen years ago.
Scott Benner Yeah. I mean, I I tried to be respectful of people coming in later to this where the technology is much more advanced. They don't have any any perspective for, you know, long needles that, had to sharpen. A woman just left a comment on one of my Instagrams the other day, and she said that the big needle she used to give herself in some long time ago, they had to be boiled. And that sometimes she she was so hungry, she couldn't wait for them to cool off. And that was one of the things she thought about. Like, she would use warm needles because she was just, you know, just starving and wanted to eat. You know, most people don't have that perspective. If you were diagnosed a year ago and somebody, like, slapped the CGM on you that works so good. But then later, hear those people complain like, oh, the CGM didn't last ten days. And I was like, oh, wow. That's that it almost felt like it it almost sometimes feels to me like your kid going, I'm tired of traveling. You know what I mean? Like, oh, no.
Masha Yeah.
Scott Benner Boo hoo, are you? Not that I don't and I wanna be clear. Not that I don't think the thing should last ten days if it says it last ten days or whatever the hell, you know, and I want companies striving towards that. But if that doesn't happen, I do wish people had, you know, I don't know, a time machine or a crystal ball so they could see what it could be like and maybe that could help them feel more comfortable or happy instead of feeling let down or, you know, burdened. I don't know.
Masha It's you know? Totally. I no. I totally agree. And I think those conversations that happened early for me really, really helped. There was also this 60 year old that I talked to. He also lived with type one for forty something years, and he has a grandchild who was one and a half when he was diagnosed. So, like, he knows a lot about diabetes. And he told me that diabetes is the best chronic condition you can get because it forces you to live a healthy life. It forces you to eat healthy, to exercise, to keep track of your vitals. And I've really it's really stuck with me. I'm like, yes. Yes. Like, that's a really good outlook. So, yeah, Like, I tried to put as many things on a t shirt as I could because these really help me when things get tough. I'm like
Scott Benner Yeah.
Masha Always go back to them.
Scott Benner No. No. I've I've said that before, and I I believe that too. Just just forces you to pay attention to things. Mhmm. That can only be good. All the health issues that come from a slow, you know, I don't know, years and years of of neglecting something or not knowing something's important or whatever, and then you get to the you get to the part where it's a problem and you can't go backwards anymore, at least you're up and you're looking at it and trying to be healthy, you know, at the very least and and make good decisions. I I take this point that it does focus you on that stuff.
Masha Mhmm.
Scott Benner I'm interested because now you and I have been talking for a little while, and there's a certain part of you that I get why you like me and and why you might have listened to the podcast. And I am very comfortable with you because I think of your cultural background and it makes you kind of think more along the way up the lines in the way I think because I grew up kind of broke here in America. And so, like, I'm having a very comfortable happy conversation with you, but I cannot I can't not ask you, like, when you have a, like, a, like, a software engineer's brain, like, how how do you find me palatable? Because aren't I all over the place to you?
Masha I guess when you talk to people just like I guess people like myself when the it's not focused. Like, I really liked your episode with Jenny that you did.
Scott Benner Mhmm.
Masha They are laser focused on the diabetes stuff.
Scott Benner Right.
Masha And those I have to admit, yeah, they are a little more a little easier for me to
Scott Benner I was gonna say, like, you must not be okay with, like, these rambling. I'm wondering how you're making it through this right now, to be perfectly honest.
Masha I'm still a human.
Scott Benner Yeah. Okay. I know I'm still a human. I
Masha do enjoy talking to people. Yeah. I also listen to a lot of podcasts that are kinda, like, just people talking on two x. But so when I was again, like, one of the people I was connected to, she has a son who has type one as well, and she's she's a nurse, so she's obsessed. I'm not as obsessed with that lady, but she gave me your podcasts with the series. She said, you have to start with this I already forgot what it's called, like, basics of diabetes where you talk about all the definitions and all of the terms. Then she said, you have to move on to the pro tips.
Scott Benner Mhmm.
Masha And then when we were about to get an Omnipod, because in Canada, you have to wait for a year on MDI in order to be able to apply for a pump unless you wanna pay for it yourself, which we didn't wanna do. So when we were getting ready to get an Omnipod, she sent me all the Omnipod series where you talk to people about Omnipod. So those, I I'm so thankful to you for putting them out because those are perfect learning material Yeah. Especially coming from a person who is a parent. And also, like, in case with Jane, like, she has type one, like, perspectives are invaluable.
Scott Benner Yeah. For sure. I would hold up those series to any when people say to me, I think you have ADHD. I'm like, no. I don't. I can concentrate if I need to. Don't worry. I just I just find talking this way more entertaining to me. I also find that very linear conversations also, seem boring to me sometimes. Like, I like I like hearing keywords that seem interesting and taking turns and going down little rabbit holes and and talking about stuff.
Masha Yeah. I agree. It kinda shows, like, opens up a person for you and then you're not just, like, diabetes day because there's a lot of diabetes in our lives anyway, and
Scott Benner Sure.
Masha This is a nice way to go deeper on to the
Scott Benner I completely agree.
Masha Person is like yeah.
Scott Benner You or your husband I'm sorry. You you've been referring to him as your partner, but you you and that boy that you let make those babies with you. Like, are are you guys, kinda co parenting diabetes, or does it fall one way or the other to or do you guys have certain jobs that, you know, one person does, certain jobs the other person does? How do you do it?
Masha He is my husband. It just I don't know. I really like the word partner, so that's why I've been using it. But he so my kid had a rash for Dexcom, and now, like, for Omnipod, like, we dealt with rashes here and there. So I never learned to put on Dexcoms. I don't know how to do that because the process is that we put hydrocolloid something something
Scott Benner Okay.
Masha Thing on top of his arm with a little precut hole, and then we put a Dexcom on top of that.
Scott Benner Mhmm.
Masha And this really protects his skin. It's been working really well, but I he figured out the system. I never learned to do that, so I never do that. I do sleep with all the devices. So, like, if there's an occasional high or low sugar, so I deal with that mostly just because I lost sleep when they were born anyway. So, like, what's another
Scott Benner They're like,
Masha I'm used it. Sleep. Pretty much. Yeah.
Scott Benner Oh, you know, I interviewed a a woman recently, and she's like, listen. My husband could do it, but he just gets very grumpy and he complains about it. So I just do it so that doesn't happen. I was like, oh, no kidding. Right now, it falls to you. Please take my word for it when I tell you it's not sustainable long term. Like, you really do need to sleep.
Masha Yeah. No. But we've been we've been sleeping mostly. Like, that's now a rare occasion, but I do have to wake up, which I'm really thankful for, like, the system we have figured out. Yeah. And also what's interesting between me and my partner, I find that I'm more okay with the low blood sugar, so I'm always, like, giving more insulin. And sometimes, like, there's an occasional low, and he is more comfortable to be on the higher side. So, like Oh. That's also, like, a very interesting dynamic I find. I don't have any solutions yet, but we keep kinda talking and discussing the situations when they do arise.
Scott Benner Oh, oh, interesting. Okay. How involved is your child in the care? Are you guys making all the decisions? I mean, he's still pretty young. Right? So are you making all the decisions? Are you doing it together in hopes that the the understanding grows? What's your you mentioned, you know, worrying about the future and not being worried about it, but you must have some sort of a plan for building this out.
Masha Yeah. So when he was an MDI, we did everything. And there was a nurse who came into school for two lunch periods, and she administered insulin. Now she still comes and but she now uses a pump. And so we are planning this summer when he goes to camps for him to finally do it himself. Like, he does it. He gives himself insulin, so he knows how to use a controller. But the calculation, like, amount of carbs, I just like, he knows it's an an apple. A medium apple is, like, roughly 15 grams. So, like, those basic things. When there's complicated stuff, we usually do that, and I do not always have it in me to use every interaction as an education session. But that's the idea. Like, we're gonna start slowly build that muscle for him. I don't know how many years it's gonna take because even, like, our carb counting is not perfect, and there's so much more to count for than just carbs.
The Power of Pre-Bolusing and Success
Scott Benner Yeah. One of the issues that people are tripped up by most are just estimating their meal correctly and, you know, understanding the impacts of the the entire, you know, concoction sometimes and make you know? Mhmm. Yes. Where fat is and stuff like that. But I think it's carb counting and pre bolus thing. I think those are the two things around meals that that cause people the biggest concerns, you know, and and get in the way of success over and over again.
Masha Yeah. I just wanted to bring up a little point about pre bolus thing because I learned about it from your podcast as well. And we started doing it pretty much right away. Like, we got home, and this is this is he first gets insulin, and then he eats. And I think when we're in control, like, we try to do the fifteen to ten minutes depending on the thing. But now I feel like he built a muscle, so, like, he's always gonna have first insulin, then maybe run around the house, and then food. So thank you for teaching us about pre ballsing in the beginning.
Scott Benner Oh, you're welcome. It's a it's a pleasure. I find it really changes things for people, and, you know, it's it's just incredibly overlooked at the educational level in a lot of in a lot of doctor's offices.
Masha Especially for children because I feel like doctors have way more fear of lows, and they're like, oh, like, you'd better be high than low, but I don't think that's the right attitude to teach from the very beginning.
Scott Benner Me either. Yeah. Me either. Yeah. You know, I found myself asking online the other day because I've been thinking about it a lot. It's like, what are predictors of success? I think my two, from my conversations, are people who are interested and continually trying to learn. I think that's a great predictor for success. And I think also having the autonomy and the knowledge to keep your settings up to date is the other one.
Masha Mhmm.
Scott Benner Those are my those are my two that I think I I think are one and two. But I'm wondering, you've been at it for a little while now. Do you have you gotten any insight on things you do that lead to successful outcomes?
Masha I also don't know, like, how to count success. Like, our time in red chip is not the best, and we have this kid who's a snacker, and he doesn't always tell us. Like, we're working on that. Like, he at least tells us Mhmm. That he ate something. So I think I consider success as of right now at this stage in my life is that we have more or less, we have sleep. Maybe we wake up, like, once every three, four weeks, which I find is way, way better than the first month after diagnosis. And, yes, the kind of the feeling empowered to change our care. Because I remember after diagnosis, I think they gave us a really large, long insulin dose, and he was all constantly falling. And I was afraid to give less insulin. I had to, like, talk to the doctor or we have to, like, email. So I I had to get a a hold of the doctor to be allowed to change that number. And I think after two weeks of trying to do that, I'm like, I'm not doing this anymore. I am managing this thing. I have the numbers. I have all the data to make my own decisions, and I felt empowered after that. So I think always yeah. Just, like, having once a month, maybe a review of what's happening and adjusting as it goes because it changes all the time. Like, for example, we had about, like, sickness in January, and some of the sickness is really visible. Like, the fever, the runny noses, but some of the sickness, like, something is going on, but, like, you're kind of okay just to glow energy. And that, like, my type one kid had it, and we could not figure out, like, what was happening. But then it turned out that if you had a very light virus or something so just being able to adjust and not wait, I guess, until your care appointment Yeah. Because it only happens once. For us, it happens once every three months.
Scott Benner That's such a great answer that I think I'm gonna start asking that question more often to people. And I I like that you started with, I don't know, like, well, you know, how are we measuring success? But I think it's important to say that you should measure success however you measure success.
Masha Sure.
Scott Benner Yeah. Not based on somebody else's idea of it. Well, that was really great. Thank you. I when you hear me ask other people in the future that, just know that that answer is a big reason why I kept asking them. Thank you.
Masha Thank you.
Scott Benner Yeah. That was awesome. Am I missing anything? Have we forgotten to talk about something? Is there something that's come up that I have directed you away from or, you know, that we haven't gotten to?
Masha No. I don't think so. Like, the main points I wanted to share it is that I'm super happy that we didn't get scared off from the big plans, and I hope people do not get scared. Like, it is a scary disease. Like, I totally understand it. I am scared half the time as well. But being scared and doing things because life just has so much to offer, and that's not diabetes, and you can kinda squeeze it in. I always joke that now I have a little tiny brain growing in my, like, main brain that's diabetes only focused, but, like, the rest of my brain can kinda focus on everything else that's going on in life.
Scott Benner Your brain has an AI agent that's only thinking about one task? Is that what you're telling
Masha Oh, I never thought about that. That's exactly
Scott Benner what's happening. Right? You're like, I'll just task this bot to think about this over here.
Masha I'm Yeah. Yeah?
Scott Benner Yeah. Do you see I mean, I didn't ask you what kind of software you developed, but, obviously, you know a a fair amount about all this. So I don't know that we're not that close to all this, by the way. Like, I've already seen people just drop their graphs into a chat GPT kind of a situation without any context, and I've seen it give back rather valuable input. So and I'm talking about without knowing insulin sensitivity and, you know, and that kind of stuff. But, I mean, if you could get a prompt to think about, you know, how the insulin is, you know, breaking down and and being used and how foods digested over time, you know, based on its fat protein content, sugar, that kind of stuff, I don't know that you can't, at some point, just say, like, look. This is what I'm thinking of eating. Where do I put the insulin? This is my insulin sensitivity and my carb ratio, and it can't just tell you.
Masha Mhmm. And it can't even tell the time because, like, you can like, it has all those data points. Like, you can tell, like, oh, for this food, don't do, like, a long pre bolus to, like, a three minute. For this food, do, like, a half an hour
Scott Benner or something
Masha like that.
Scott Benner Yeah. Because, I mean, listen. Not that everybody wants to live their life that way, but if I really also buy into the idea that people really eat about the same 20 or 30 things over and over again. So if you walked through it the first number of times until it became a muscle memory thing, it's not like you'd have to go back to the prompt over and over again. You could then eventually say, alright. I know I'm about to eat this. I'm gonna put in this amount of insulin, wait about this long, and then I'm gonna eat and it's gonna work. And I actually think it's all here already, which is somebody needs to package it together. The algorithms that are, you know, coming from the companies, I don't think they're considering it quite as much. But if you look at, like, loop and trio and, like, the ability to, like, you know, tell it that you're eating fat and it to, you know, set up extended boluses and and, you know, touch points in the future where it's trying to address those sorts of things. Obviously, those systems are doing that already. I don't know. It just feels like it's all there. Just somebody needs to do it and then have the nerve to release it, and that's maybe the biggest problem. You know?
Masha I agree. I agree. I always say that the future looks bright if only people stop fighting with each other. Yeah. Because I feel like that takes away a lot a lot of energy from trying to solve the the other the more important humanities issues.
Scott Benner No. That's for sure. Okay. Well, you were terrific. I really
Masha Thank you, Scott.
Scott Benner No. I really enjoyed this, and I'm really learning something about myself. I should probably move to where you're from. I think I'd love everybody. I I mean, seriously, everyone who comes on from that part of the road, I'm like, what a sensible person and and lovely to speak to. No bull this was awesome.
Masha Yeah. We never learned how to do small talk. That's true.
Scott Benner That's okay. I I I keep up that side of our relationship. It'll be fine. You could just nod at me and go, there he is. He's talking. It's fine. We like him for other reasons. Well, I really I genuinely appreciate you adding, you know, your story to this to this whole thing as we, you know, climb towards 2,000 episodes of, you know, stories and and people's lives. I think it it already has and will continue to come together and be helpful for others. So, you know, the time you took today will be invaluable for others going into the future. So thank you very much.
Masha Thank you, Scott. Thank you for all that you do for the diabetes community.
Scott Benner It's a it really is a pleasure. You have no idea, like, how happy it makes me. So thank you. I appreciate you saying that. Hold on one second for me. Okay?
Masha Mhmm.
Outro & Sponsor Messages
Scott Benner I'd like to remind you again about the MiniMed seven eighty g automated insulin delivery system, which, of course, anticipates, adjusts, and corrects every five minutes 20 four seven. It works around the clock so you can focus on what matters. The Juice Box community knows the importance of using technology to simplify managing diabetes. To learn more about how you can spend less time and effort managing your diabetes, visit my link, medtronicdiabetes.com/juicebox. Having an easy to use and accurate blood glucose meter is just one click away. Contournext.com/juicebox. That's right. Today's episode is sponsored by the Contour NextGen blood glucose meter. Okay. Well, here we are at the end of the episode. You're still with me? Thank you. I really do appreciate that. What else could you do for me? Why don't you tell a friend about the show or leave a five star review? Maybe you could make sure you're following or subscribe in your podcast app, go to YouTube and follow me or Instagram, TikTok. Oh, gosh. Here's one. Make sure you're following the podcast in the private Facebook group as well as the public Facebook page. You don't wanna miss please, do you not know about the private group? You have to join the private group. As of this recording, it has 74,000 members. They're active talking about diabetes. Whatever you need to know, there's a conversation happening in there right now. And I'm there all the time. Tag me. I'll say hi. How would you like to share a type one diabetes getaway like no other? Join me on Juice Cruise 2026. You may be asking, what is Juice Cruise? It's a week long cruise designed specifically for people and families living with type one diabetes. It's not just a vacation. It's a chance to relax, connect, and feel understood in a way that is hard to find elsewhere. We're gonna sail out of Miami, and the cruise includes stops in CocoCay, San Juan, Saint Kitts, and Nevis aboard the stunning Celebrity Beyond. This ship is chosen for its comfort, accessibility, and exceptional amenities. You're gonna enjoy a welcoming environment surrounded by others who get life with type one diabetes. I'm gonna host diabetes focused conversations and meetups on the days at sea. There's thoughtfully designed spaces, incredible dining, and modern amenities all throughout the celebrity beyond. Your kids can be supervised, there's teen programs so everyone gets time to recharge. Not just the the kids going on vacation, but maybe you get the kickback a little bit too. There's gonna be zero judgment, real connections, and a whole lot of sun and fun on juice cruise 2026. Please come with me. You're going to have a terrific time. You can learn more or set up your deposit at juiceboxpodcast.com/juicecruise. Get ahold of Suzanne at cruise planners. She will take care of everything. Links in the show notes. Links at juiceboxpodcast.com. Have a podcast? Want it to sound fantastic? Wrongwayrecording.com.
#1849 Bolus for Zaydino
Natalia from Hong Kong asks Scott why her 7-year-old son's blood sugar spikes on weekends. They discuss navigating pizza , fat and protein impacts , and Omnipod 5 bolus strategies.
Companies that Support Juicebox
Key Takeaways
- Simple solutions often work best for skin reactions; a basic, fragrance-free body wash can sometimes resolve adhesive irritation better than complex barrier routines.
- Daily routines and activity levels drastically affect insulin needs; children are typically more active during the school week, which can make less active weekends more challenging to manage.
- High-fat and high-protein meals (like pizza and french fries) slow down digestion and cause delayed blood sugar spikes, requiring more insulin delivered over an extended period.
- When an automated insulin delivery system (like Omnipod 5) suspends basal insulin to prevent a low, it can lead to a background insulin deficit that exacerbates a later post-meal spike.
- Pre-bolusing remains one of the most effective tools for preventing post-meal spikes, even when eating tricky foods or managing changing activity levels.
Resources Mentioned
Introduction and Sponsors
Scott Benner Welcome back, friends, to another episode of the Juice Box podcast.
Natalia Hi, guys. My name is Natalia, and I live in Hong Kong. I have a seven year old boy now who is type one diabetic. He was diagnosed last June.
Scott Benner I created the diabetes variable series because I know that in type one diabetes management, the little things aren't that little, and they really add up. In this series, we'll break down everyday factors like stress, sleep, exercise, and those other variables that impact your day more than you might think. Jenny Smith and I are gonna get straight to the point with practical advice that you can trust. So check out the diabetes variable series in your podcast player or at juiceboxpodcast.com. If you're looking for community around type one diabetes, check out the juice box podcast private Facebook group. Juice box 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 Juice Box podcast, type one diabetes on Facebook. Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan.
Scott Benner This episode is sponsored by Able Now, tax advantaged savings accounts for eligible individuals with disabilities. If you or your child lives with diabetes, you may qualify for an ABLE account because of ongoing medical needs, and many people in the diabetes community do. With ABLE Now, you can save for future expenses without affecting eligibility for certain disability benefits such as Medicaid. Learn more and check your eligibility at ablenow.com. You spell that ablenow.com.
Scott Benner Today's episode is also sponsored by usmed.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. Usmed.com/juicebox or call (888) 721-1514.
Scott Benner The podcast is also sponsored today by Omnipod. Check out the Omnipod five now with my link, omnipod.com/juicebox. You may be eligible for a free starter kit, a free Omnipod five starter kit at my link. Go check it out. Omnipod.com/juicebox. Terms and conditions apply. Full terms and conditions can be found at omnipod.com/juicebox.
Meet Natalia and Zaydino
Natalia Hi, guys. My name is Natalia, and I live in Hong Kong. I have a seven year old boy now who is type one diabetic. He was diagnosed last June. So I would like to just I have some questions which I would just like to talk about, ask Scott about. Let's see how it goes. So thank you for having me, Scott. Really appreciate it. Yeah.
Scott Benner Well, I appreciate you doing this because I know it can feel exposing to come somewhere and say, I don't know what I'm doing and you know? Because you said right before we started to record, like, I don't even know if I have anything to say at certain points, but I don't think that's the Yeah. The value in this conversation. Also, I'm just gonna reiterate, although I said it at the beginning of every episode, not a doctor, not advice, but I'm happy to try to talk to you about it and see if we can figure something out. So
Natalia Great. Thank you.
Scott Benner No. It's it's a pleasure. I appreciate you allowing it to be recorded so other people could hear. Mhmm. So your son's seven, and he was diagnosed ten months ago. Is that about right?
Natalia Yeah. It's ten months already. Wow. Yeah. It's been ten months. I mean, every day has been like a roller coaster. In the beginning, we were on you call it the MDI, the injections.
Scott Benner Mhmm.
Natalia So he was on it for three months. And after that, we started putting him on the o p five, Omniport five.
Scott Benner Okay.
Natalia So that has been helpful. But, yeah, he has his moments of not wanting it and not liking it. So because his skin started getting too red and too inflamed over time.
Scott Benner Yeah.
Natalia So, I mean, it's been taken care of now. It's doing much better.
Scott Benner You figured out how to prep the site so that it doesn't happen?
Natalia Yeah. So I tried everything, and then we have a good support group also over here, which they keep telling us what to do. But what really worked, I took him to his own pediatric doctor, and she just gave, like to put, like, a very basic, body wash. You know? No fragrance, all that kind of stuff. And, literally, that's someone that overnight literally worked.
Scott Benner Oh. So That's awesome.
Natalia Said to put the skin prep spray and the nasal spray and the all these kind of things and use different patches and the prep and the first and the last. I just left everything.
Scott Benner Yeah. Because you got a good result with the one I right. Why complicate it? Yeah. I would have asked you, do you use alcohol to clean the site?
Natalia So now I use the alcohol once before I put it on.
Scott Benner Mhmm.
Natalia The techs command that, and nothing happens. He's absolutely fine.
Scott Benner Oh, there you go. Sounds like you might have found the answer.
Natalia Yeah.
Scott Benner You wrote to me. Is that right? Yeah. Why don't you go over that email for a second? Just tell me where you're at and where the struggles are.
Weekday vs. Weekend Variables
Natalia Okay. So the thing is that daily routine I'm just because see, he's diabetic. He's growing up, and he's at an age where he wants to do his own things also. Can't blame him. But it's just a scary fact that when we go out, that's the problem where we go for a restaurant. And now he's getting so scared that I have to count everything what he has, and he loves eating. Mhmm. So if he can't eat a pizza, I don't allow him the pasta. I don't allow him the hot dogs. You know? So then it's just like, why don't we stay home and just eat what I can in a bigger quantity? So, you know, that's become a thing. So I was just a little worried. How do I, like, embrace all that? Because his levels would go to, like, a 22. You know?
Scott Benner That's like a 400. Yeah.
Natalia It would, like, hit the roof for hours, and to get him down six to eight hours would go nowhere. You know? So his daily routine, breakfast, lunch, dinners, school snack, coming home snack, everything is fine. But the weekends come in, and it just goes through the roof.
Scott Benner Okay. Well, I'm gonna ask you a few questions first. Yeah. So on the weekends, does he become more sedentary?
Natalia What would that mean?
Scott Benner Well, does he not move around as much on the weekends as he does during the week?
Natalia Relatively. Yeah. Yeah. Yeah. Okay. Yep. He's mostly home. He just likes to relax, do nothing, or we just go out for, like, a walk or to the park. So but nothing much.
Scott Benner But not as much as getting up, running to school, running around at school, all that stuff. Yeah. Okay. Alright. So Yeah. I'm gonna take some notes. Not usually something I do, but okay. So during the week, he's moving more weekend Yep. He's more still. Okay.
Natalia Mhmm.
Scott Benner And does he eat differently on the weekend than he does during the week? Like, you know, during the week, is it simpler?
Natalia So in the morning, his breakfast would include a normal egg or a milk or a bun or a bread because even the cereal spikes him a lot. Oats spike him a lot. Mhmm. So that's been cut down to maybe on the weekends, I give him cereal. But the problem is he's not so active, so the cereal goes even higher on the weekends.
Scott Benner Yeah. So cereal, he's not getting during the week?
Natalia No. He's not getting during the week.
Scott Benner More like you cut out for a brief second. But during the week, like an egg, something like that.
Natalia Yeah. For the egg or a half glass of milk with a bun and butter. So everything is, like, you know I got it. Portioned.
Scott Benner Yeah. So you would call the week more knowable.
Natalia Manageable.
Scott Benner Yeah. Yeah. Well, because you're doing the same thing over and over again too. Yeah. I see. Okay. Is there any chance that on the weekend, you're just not counting the carbs as well as you are during the week, or do you think it's more about the makeup of the food?
Natalia So on the weekend, I can. I'm counting the carbs, but it's like since there is I feel he's very like, you know, if there's activity, he works very well. The levels work very well with him.
Scott Benner Mhmm.
Natalia But when it's not, and he's sitting, he's just watching. So it suddenly just spikes out of the blue. Even if it's the same breakfast. Yep. Even if it's the same one, weekends treat him differently.
Scott Benner Yep. Okay. And on the weekend, what are we eating? I guess, maybe take me through an average day of his meal during the week and an average day during the weekend and do breakfast, lunch, and dinner.
Natalia Okay. So the weekday?
Scott Benner Mhmm.
Natalia He loves eggs. He loves milk and bun or bread and butter. So these come to around 24 carbs because the bread I get is, like, less in carbs and stuff like that. So that's like morning is that, egg, milk, bread
Scott Benner Mhmm.
Natalia In some form, and yogurt, the small baby yogurts which he gets. And then he has a snack, 10:00 in school. That, I try to make it as free carbs because then the nurse has to keep running to him to give him the dose, which I don't want. So it's mostly like a seaweed or cheese or cucumber or something around these things mostly. Then he has lunch. Lunch is his turkey sandwich or a roast beef sandwich or a egg sandwich with just literally a slice of turkey, cheese, butter. Mhmm. That's it. And apple. He loves, like, one apple and one sandwich. Even on the weekends, if he's home, I make the same thing for him at home for lunch. And then he has a snack, which is, like, either crackers or as you also said, the Ritz crackers affects your daughter. It hits her a lot. I was hearing you say that once. Mhmm. So, you know, stuff like that, like, just crackers and biscuits and because when he comes home, he likes to have his stuff. So fruits, milk, whatever he wants to eat, I dose him accordingly. And then dinner is mostly the basmati rice because the sticky rice take him to another level.
Scott Benner Yeah. Yeah.
Natalia Then it's, like, homemade, either grilled chicken or chicken with some kind of tomato and onions, all home cooked. Mhmm. So it's all pretty much, like, manageable, very easy to make, and with some cucumbers and carrots, and that's about it.
Scott Benner Going out to dinner is more difficult?
Natalia So dinner, I have tried. Now we don't go out for dinner because the dinner foods make him it's like a whole nighter. So Mhmm. It's really hard for that to work out. So we do lunch outside. Okay. And dinner is mostly home. Yeah.
Scott Benner When you have gone out to dinner in the past and it's been difficult, I like how you said it it turns into an all nighter. What kind of food was doing that?
Natalia So mostly living in Hong Kong, we get, like, Chinese food, Japanese food. So it's mostly sushi or Chinese food, you know, with the sticky rice and nice little gravies and chickens and fried chickens and Korean fried chicken, so stuff like that. And if everyone's having it, it's hard to keep him away from all that. So now we also try not to order and have that kind of food.
Scott Benner Sure. Well, that's nice of you to do it with him. How big is your family?
Natalia Well, I have a daughter, and this is my son. So two kids and my husband and me.
Scott Benner Okay. The four of you. Mhmm. So do you understand what's happening and you're having trouble impacting it, or are you having trouble understanding what's happening?
Sponsor Break
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The Impact of Fat and Protein
Natalia I just find, like, I feel I'm dosing wrong because I was hearing you with your fat protein and all these talks about it.
Scott Benner Yeah.
Natalia So I just wanted to ask the carbs. Like, for example, we were on our Singapore trip right now. We were on a good vacation. He was actually okay. Yeah. His highest took on the trip would be a one eighty, which I wouldn't consider high. So he was, like, active. We were eating. We were going places and walking and doing many things. So that was, I think, working out so well for him
Scott Benner Yeah.
Natalia That we would tell our friends also who we stayed with. We're like, sorry, but, you know, we are staying away from such and such foods. So they took us to places where we would have grilled chicken or, you know, some kind of healthier options. And then once when we went for the pizza and all the Western, you know, all the high fat foods
Scott Benner Sure.
Natalia I tried to manage, like, from one slice of pizza, I cut it into a quarter pizza slice. And so, you know, I was trying to manage with that with a grilled chicken being pushed in with little veggies pushed in, which I can't do all the time. If we're going to a pizza pasta place, you only get that kind of food. Right. And what happened on a vacation is I cannot count because in the restaurants, there is no count for it. Mhmm. I started dosing him extra.
Scott Benner Good.
Natalia I feel it was the first time I did that. I was scared something would happen, but everything was okay, and it worked. Yeah. So since I've come back, I feel I am giving I'm just throwing in an extra five if I'm at home. I'm throwing in an extra 10 if I'm out Yeah. But still avoiding the full, you know, like, three slices of pizza and fried stuff.
Scott Benner Let me run over a couple of ideas for you. Okay? Yeah. So the first one about the activity, that's very real. Okay? So when you have less activity, your body becomes more resistant to insulin. It's just kinda the way it works. Right? I can get you a more technical answer, but it's about how the glucose is handled by your body. Okay? So Yeah. We are in this Omnipod five setting Yep. And it's adjusting to your daily needs. Yep. And so during the week, I think you're getting a there's a combo of a number of things here. Yeah. He's eating the same stuff over and over again. And Yeah. You sent me kind of a sample menu. He's eating things perfectly honest with you. They're very healthy choices. You know? Yeah. I'll breed for people. Turkey, roast beef, eggs, apples Yeah. Fruit, you know, basmati rice, great pivot there away from the white rice. Meat, vegetables, eggs, like stuff that's not terrible to bolus for because they're not very high in fat. They're not fried. It's not processed food. Right? It's as helpful to the process as possible, these types of foods. So you've got the food on your side, and then you have the exercise on your side, the activity On top of that, the Omnipod five is saying, okay. This is about how much insulin we need for these days, and you start to pick up a rhythm at Monday, Tuesday, Wednesday, Thursday, Friday. Then all of a sudden on Saturday, he stops moving. You lose the value of the exercise. And on top of that, you're making maybe the same decisions with the food, and it's going okay right up until you try to go out. And then, you know, you see chicken, pizza, all that stuff there. Right? Yeah. Yeah. That all sounds about right. Right? That's how it's going?
Natalia Yep.
Scott Benner Okay. So I understand that when you get out of the house, it's hard to count carbs.
Natalia Yep.
Scott Benner Just how it is. Right?
Natalia Mhmm.
Scott Benner But what it's gonna take is practice. Yeah. It's not a great answer. I mean Yeah. I could tell you right now, you probably could open up an AI app on your phone and tell it where you're at and probably get a more accurate feeling for the carbs and everything. But if you don't start incorporating the impact of the fat that's happening to his blood sugars, the carbs aren't gonna really matter. Yeah. You know? I mean, not that not that it's not gonna be helpful. Yeah. You know, if a chicken sandwich out at a restaurant is actually 60 carbs and you were guessing 40, of course, that's gonna be a big deal.
Natalia Yeah.
Scott Benner But if there's, I don't know, seven, eight, nine grams of fat in it, that could end up costing him another unit of insulin, and the timing gets changed as well. Yeah. And do you understand why that is? Because it changes the the digestion process?
Natalia Right.
Scott Benner Okay. So you eat all those carbs, and one of the ways those restaurants make flavor is with sugar. So there's probably more carbs, probably more sugar. And on top of that, more fat, a lot of it ends up being fried, which you're not frying anything at home. You take in that kind of oil, degrease the fat, etcetera, and it slows down your digestion. So those carbs, which are probably more than you guessed to begin with, are sitting in his stomach impacting a longer timeline. And that's how you said, you know, it turns into an all nighter. Right? Because those carbs are in there impacting him all night long. There are ways to stagger your boluses to get in front of those rises and the lung digestion. Yeah. So did you find the calculator? I'm so I think I'm supposed to call it an estimator. Did you find the estimator on my website? Yeah. You did for the fat and protein, and did that help you?
Natalia Yeah. It was just too much, so I didn't
Scott Benner Oh, you got a little overwhelmed by it. Okay. Yeah. Yeah. Talk about it now. That's okay. So can you tell me how much he weighs?
Natalia He weighs around twenty kilos.
Scott Benner Twenty kilos.
Natalia That'd be into two point two four pounds. So around forty something.
Scott Benner Oh oh oh, I fret. You said he was seven. He's little. Yeah. How old is your daughter?
Natalia She's 10.
Scott Benner Oh, you have a young family still. Yeah. Yeah. Lovely.
Natalia Pretty small.
Scott Benner Yeah. Was the diabetes a surprise, or is there autoimmune in your family?
Natalia Oh, that's another story. No one has it in the family.
Scott Benner How about other autoimmune stuff? You see thyroid or celiac, anything like that with people?
Natalia Nothing. Nothing. No. Or as I joke with my mom that maybe our grandmothers had it, they never knew about it. Yeah. I don't know.
Scott Benner What's your background? What culture?
Natalia I'm originally from Pakistan.
Scott Benner Yeah. Do they talk about their health, the family?
Scott Benner You've probably heard me talk about US Med and how simple it is to reorder with US Med using their email system. But did you know that if you don't see the email and you're set up for this, you have to set it up. They don't just randomly call you. But I'm set up to be called if I don't respond to the email because I don't trust myself, a 100%. So one time, I didn't respond to the email And the phone rings at the house. It's like, ring. You know how
Natalia it works.
Scott Benner And I picked it up. I was like, hello? And it was just the recording. It was like, US med. Doesn't actually sound like that, but you know what I'm saying. It said, hey. You're, I don't remember exactly what it says. But it's basically like, hey. Your order's ready. You want us to send it? Push this button if you want us to send it. Or if you'd like to wait, I think it it lets you put it off, like, a couple of weeks or push this button for that. That's pretty much it. I push the button to send it, and a few days later, box right at my door. That's it. Usmed.com/juicebox or call (888) 721-1514. Get your free benefits checked now and get started with USmed. Dexcom, Omnipod, Tandem, Freestyle, they've got all your favorites. Even that new islet pump. Check them out now at US Med dot com slash JuiceBox or by calling (888) 721-1514. There are links in the show notes of your podcast player and links at juiceboxpodcast.com to US Med and to all the sponsors.
Natalia Oh, yeah. Yeah. They do all their checkups and stuff, but it's just been, like we've been here, what, sixteen years now
Scott Benner Mhmm.
Natalia In Hong Kong. So, like, both my kids have been born here. So it's just like he overnight, he was looking weak, and it just so happened that after school finished last year, I took him to the pediatric, and she said, just do some blood tests. And overnight, like, the blood test was in the morning. The doctor called at seven in the evening and said, take him right now. His level was something like 40.2.
Scott Benner Okay. And
Natalia it was just like an ICU. It was an overnight thing. Like, no one even saw it coming. But I guess the symptoms I was telling my doctor were there where he was thirsty overnight, you know, all night long, going to the loo every now and then. So the signs were there, but I didn't know what it was. So because of that. Yeah.
Scott Benner Did it come on very quickly, or in hindsight, had he been losing weight for a while or sick for a while?
Natalia He was looking weak since a month, maybe.
Scott Benner Okay. Feels like you caught it pretty quickly.
Natalia I wouldn't say that, but, yeah, that's what everyone says. But, yeah, I I felt so bad when that happened. But yeah.
Scott Benner That's pretty common, just so you know. Yeah. Yeah. Nataimas It is what it is. Most people talk about that and and have that feeling. Yeah. I'm noticing here on your menu that you sent, you have different carb ratios for is it different times of day?
Natalia Yes. So for the morning, it was just something that the, what you call, the diabetic, educator we were in touch with, she said this because he was going a little high and low at different times.
Scott Benner Yeah.
Natalia So we just changed this around, and we just did it, like, nineteen thirty one forty one according to morning, afternoon, night.
Scott Benner Was that before the pump or after the pump that they noticed that?
Natalia After the pump. Yeah.
Scott Benner Actually,
Natalia even before, sorry, even before the pump, the endocrinologist had him with, like, it was pretty much same, but it just wasn't you know, the curve was just going up and down a bit. There was no consistency.
Scott Benner So let's talk about that before we get into the menu. So if these variable insulin to carb ratios were set prior to pumping, then what they were doing is trying to probably get in front of problems you were seeing at meals based on injected basal insulin, which doesn't work as stably as it does from a pump. Yeah. So I also would wonder if maybe you don't need to find out what his carb ratio is and set something a little more stable because you have, insulin correction factor here of one unit moves in 41, one unit moves him 19. So you have it more aggressive at breakfast at nineteen. Yep. It's aggressive for the snack. It gets less aggressive at lunch, and then actually, oddly, much less aggressive at dinner. Yeah. So is he getting high at night before bed?
Natalia Not at all.
Scott Benner No? Okay.
Natalia He gets low. Like, low is what I would call it. I know there are different lows, but he goes around 90. 72 in this range. So but it's still manageable, but sometimes he does go low. He has, like, few sips of juice. Yeah. And he's back okay, and then he's sleeping.
Scott Benner 70 and falling or just 70 and stable and you get nervous about it?
Natalia I used to get nervous even less than 72.
Scott Benner Okay.
Natalia But now I let it go to, 70.
Scott Benner Okay. You're getting it.
Natalia Yeah. It's hard.
Scott Benner Takes time. Took me I was crying for two years, just so you know. The first two.
Natalia Yeah. Like, today, I tried to do that with the nurse in school because I've told them at a five point three, make sure you give him juice. Make sure you do this, and you stop and do this, this, this. So today when he was on a 4.9, they panicked, they're like, he's 4.9. He needs to choose right now. I was like, no. Let's wait because I'm seeing him. He pulls up himself. Yeah. So, you know, I mean, I'm just trying just slowly, slowly, and they're trying. So it's like a whole Yeah. No. No. It's like a village.
Scott Benner I I understand. It takes time. Well, I hope you take some comfort in the knowledge that eventually you will get better at this and it will feel easier. I don't think it's actually easier, but it's gonna feel easier. So do you know what his total daily insulin is right now? About how much does he use in twenty four hours?
Natalia I forgot. Let's see. One second.
Scott Benner Take your time, please.
Natalia So he would be like, total daily would be roughly around three or four units a day.
Scott Benner And that's of bolus insulin? Yeah. And then how much basil is he getting?
Natalia I think basal also is around three. That's the background one. Right? With the Yeah. Automatically it being given to him.
Scott Benner Do you know what his basal rate's set at in the pump?
Natalia Basal rate.
Scott Benner So how much insulin does he get every hour from basal?
Natalia Every hour, point zero five.
Scott Benner Point zero five? Yeah. Do you think he's honeymooning? Are there times when you think, like, oh, gosh. He doesn't really need insulin?
Natalia No. Not really. No. I think he needs it. Yeah.
Scott Benner Okay.
Natalia Like, I would say the knight, Tatshaw, so far since this week, since we've come back, has been the best ever where he is literally on a 90 a 108 would be his highest.
Scott Benner Mhmm.
Natalia So he would just be, like, nice flat line.
Scott Benner Nice. Okay. Well and are there times of the day where he's just not getting basil too? Can you see with the pump? Does it cuddle away at times?
Natalia Sometimes. Yeah.
Scott Benner Okay.
Natalia Or maybe an hour or so, but, yeah, not more than that. It just keeps giving it.
Scott Benner Okay. Give me one second. I'm having a studio built in my house for the podcast, and right now
Natalia Okay.
Scott Benner They are, like, cutting into the wall. This got so loud. I was afraid it was gonna bother you.
Natalia No. No. So 820, you can see he's got a point zero five today.
Scott Benner Mhmm.
Natalia And then at 09:15, he's got another 0.05. So it's, like, almost an hour later.
Scott Benner Yeah. It's a tiny bet he's getting.
Natalia Tiny. Yeah. Really less.
Scott Benner Yeah. Well, I'll tell you the other thing to find some comfort is that as he gains weight and his insulin needs grow with that, this all gets a little easier too. Like, when you're working with these really small numbers, there's a lot less room for, you know, making a mistake. But, also, the good news is it's not a ton of insulin. So if something goes wrong, it should be fairly easy for you to get in front of it one way or the other. So I have, like, an estimator on my website that starts with someone's weight and sort of gives you, like, a breakout of where you might expect their insulin to be. Mhmm. If I make him highly sensitive, that puts him at, like, theoretically, like, nine units a day. And I have a slider I can make it less aggressive. But when I do that, it wants to put less basal on. Takes his basal to about point one five an hour. So you are not far off at all from what you're seeing being pretty accurate to what the math would tell you Yeah. Which is kinda great. So forty four pounds, seven units a day total. This has him about point one five an hour, but there's an argument to be made that, you know, he's probably getting that much sometimes and nothing other times and balancing out to what you said, like, three. So let me take a little calculator here for a second. Do the point one five times 24. And sure enough, that's 3.6 a day. So, again, so the numbers are lining up. So I'm fairly comfortable that, like, based on his weight at least, that your settings are pretty good. Okay? So I like that.
Natalia Okay.
Scott Benner Now the sensitivity factor, if it's working for you, I'm certainly not gonna tell you to change it. Whatever you're seeing is much different than what the math says. So I say just go with what's working for you
Natalia Okay.
Scott Benner On that spot.
Natalia So how would that change?
Scott Benner It's gonna take more insulin to move him as he gets bigger.
Natalia Okay.
Scott Benner That's all. And I think there might be a time when you'll just pick one. Well, because you have it at eighteen right now.
Natalia Yeah. Eighteen. Yeah.
Scott Benner Is that that can't be right, though. You think one unit moves him 18 points?
Natalia Oh, good question. Like, when he's high, he doesn't even do that. So I had started giving him, like, point five so he can come down nine units, but that's not true.
Scott Benner What I'm gonna tell you is that at this little bit of insulin, his insulin sensitivity, the math says it's like one unit moves him 250.
Natalia Wow. Okay.
Scott Benner I don't know what to tell you about what to do or not do with that, especially when it's Omnipod five because Omnipod five has let me pull this up here. I'm a little embarrassed. I just made a video for Omnipod about this, and now I'm having to check my own thing to make sure to make sure I'm about to say the right thing. I feel silly.
Natalia Well, that's okay.
Scott Benner Because I stood in the studio and said it over and over again all day while they were way too close to me with that camera. I'm not gonna lie to you. I was uncomfortable at points. I didn't like to see my face that big. You know what I mean? When they were working on it, I said, please. They were like, oh, it's going along great. We can't wait to send it to you so you can see it. I was like, do I look old? It's all I it's all I kept asking. I was like I was like, do I look old? I look old, don't I? Just don't tell me. It's okay. So I have another calculator here, estimator about how to bolus. Right? So your insulin to carb ratio and we need to kinda pick one. So let's just go with breakfast for a minute, and we're gonna say 19 for the carb ratio. I mean, I'm gonna put the 18 in for your sensitivity Mhmm. And say that his blood sugar target is 90. Okay?
Natalia Okay.
Scott Benner And now I'm gonna look at his breakfast here. You say there's 24 carbs for breakfast, and there's an egg, there's milk, there's a bun, there's bread in there. Yes. And you are giving him 1.3 units, which by the way, in this calculator with your settings, it's 1.26. So 1.3, exactly the same thing.
Natalia Oh, okay.
Scott Benner What I'll say is the milk, high fat milk, low fat milk, do you know how what kind it is?
Natalia It's full fat.
Scott Benner Yep. Okay. So we're gonna do some more gazintas here and try to figure out you think it's a cup of milk?
Natalia Half a cup.
Scott Benner Okay.
Natalia So on the true calculation on the packet, it says, like, one cup is around 12 grams of carbs. Okay.
Scott Benner But how much fat is in it?
Natalia See, now that's the thing I don't calculate at all.
Scott Benner But is that bolus working for you, or is he getting high later?
Natalia It's working.
Scott Benner How high does he get after breakfast?
Natalia Mornings, would start at ninety maybe. 90 or 01:08. And the best thing is I pre bolus him twenty minutes. That is the game changer.
Scott Benner Very nice. Yeah. Have to be.
Natalia So he goes up to one forty four or one sixty two.
Scott Benner Okay. So he's not moving much at all on that?
Natalia Not bad. Yeah. Not bad. Yeah.
Scott Benner Let me just say this. At some point, when he goes to one forty or one sixty, the algorithm is coming in and giving him more insulin to bring him down.
Natalia Yeah. Probably. Yeah.
Scott Benner So a cup of whole milk has eight grams of fat. There's four grams and a half a cup. Just adding that to this doesn't change anything. But there's butter on the bun?
Natalia Yes.
Scott Benner I'm gonna see what happens here. Look for the fat in a tablespoon of butter. Gonna try to make so here you go. A tablespoon of butter. Do know much fat's in a tablespoon of butter?
Natalia Not much. 12. I don't even add that. Wow.
Scott Benner So if I have 16 in fat and I resimulate it again, it's not a lot, but it adds a point three eight bolus over time.
Natalia There we go.
Scott Benner And I'm gonna guarantee you that if you go look at what's happening, he's going up and, you know, one forty or so, which by the is great. You're doing terrific, by the way. I have a feeling when we get to the end of this conversation, I'm gonna find out that you're a bit of a type a personality and tell you. I'm gonna start asking you what you went to college for, and it's gonna be accounting or something like that. And so
Natalia Don't ask me because you're almost right.
Scott Benner Okay. Alright, everybody. Natalia is an actuary or an engineer. And No. No. It's not that much. It's not that bad. It's not that bad. Just finance. Oh, yeah. There we go. Okay. Yeah. So when I put in the fat for that meal, the initial bolus is still at 1.26 or 1.3, but it's asking for point three eight, so point four units over the next three hours. Omnipod five doesn't do extended boluses.
Natalia That's my biggest concern. I've been hearing so many podcasts, a few, but how do I do it?
Scott Benner All I would do is, like, an hour after he eats, I'd bolus point four.
Natalia Okay.
Scott Benner That's it. What I would really do since we're talking about it is I'd do it one morning the way you always do it, 1.3.
Natalia Mhmm.
Scott Benner And then I'd wait to see when does he start to rise.
Natalia Okay.
Scott Benner I'm gonna make up a number. Say he starts to rise seventy five minutes later, I'd put in the point four. I would pre bolus the meal. You're doing a great job pre bolus the meal. I pre bolus the meal Mhmm. Then I'd pre bolus the fat rise with the point four.
Using the Bolus Estimator
Scott Benner And you can use my estimator. It's juiceboxpodcast.com/bolus, the number four, bolus four.
Natalia Bolus four. Yeah.
Scott Benner And all I did was put in insulin to carb ratio 19, insulin sensitivity 18. I made the target 90. I put in 24 carbs from your thing here, and I put the fat in, 16, and it gives you a little you know, there's a meal wave and the Warsaw wave that kinda breaks them out for you, tells you about how long to stretch them out.
Natalia Okay.
Scott Benner And that's it. Like so I'm gonna do it again with you, I'm gonna look at the next meal.
Natalia Okay.
Scott Benner This poor kid, you're giving him seaweed for a snack. Is that what he used to eat, or is that a diabetes thing?
Natalia It's a diabetes thing. But he loved it anyway. Yeah.
Scott Benner Hey. Listen. It sounds like you're all gonna be healthier by the time this is over.
Natalia Yeah. Seems like it.
Scott Benner So now let's do the turkey or sandwich and the apple again.
Natalia Okay.
Scott Benner Tell me what kind of a rise do you get from that, if any.
Natalia So that would be lunch. Right?
Scott Benner Yep.
Natalia So lunch is also okay because luckily, it's a fifteen minute eating window, and then they get to play for, like, twenty five minutes.
Scott Benner Okay.
Natalia So that really works for him.
Scott Benner Oh, and that's why your carb ratio is weaker.
Natalia Yeah. He would go too low then.
Scott Benner I see. So you're getting around that by weakening the carb ratio, and that's working for you. Okay.
Natalia Yeah.
Scott Benner But also on the weekends, when you're trying to have lunch and it's pizza, that's also why you're struggling with the pizza because your carb ratio he's getting half the insulin for twice the carbs.
Natalia Yeah. You're right.
Scott Benner So yeah. So everything is settings. It's all timing and amount. Okay? Okay. So I guess so I'm gonna talk to that part of your brain. Everything is timing and amount. Okay? So you you look at that 24 carb breakfast. You see the problem you're having with it. You realize in that scenario, it's not accounting for the fat that probably caused you the problem. Also, nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan. Now on the lunch one, you've got the carb ratio goes from 19. One unit covers 19 to one unit covers 31, and you have found a great balance there because of the activity. But at that same time of day, at a pizza restaurant, you're not only don't have the activity, but you've added fat that you're not accounting for, lesser quality food. And for every carb he eats, you're getting half the amount of insulin. In a scenario where you probably need more, you're starting with less and not accounting for the pizza. That makes sense?
Natalia Yeah. Yeah. Okay.
Scott Benner Look at that. What do
Natalia you think of it that way? Yeah. That's
Scott Benner okay. That's that's what I'm here for.
Natalia Yeah.
Scott Benner My silly brain's not good at much, Natalia. This, it understands.
Natalia That's a lot to understand. It's way more than we understand.
Scott Benner Listen. I sincerely mean this. I'm not denigrating myself, but I'm probably not nearly as intelligent as you are. I'm not good at math. Whatever degree you have, I couldn't possibly get. All I had was a kid with diabetes before all this stuff existed and my desire to really pay attention to it and try to figure out what was happening. And Yeah. Then I saw what I saw, and contextually, I speak about it very differently, which I think is why, you know, when I stand up in front of a crowd and I say things like all the silly t shirt slogans I say about diabetes, that comes from, like, kinda, like, the I think I talk in pictures. But then over the years, making these episodes and bringing my friend Jenny in and talking about it with her, like, she really, like, helped reframe me the way I think about it, and I was able to kinda rewrite the way I think about it too.
Natalia Yeah. It's great. The work you do is great over here because in Hong Kong, we don't have the exposure. You know? We just have very, I would say, a very I mean, we don't even have bumps over here. We have to order them from other countries. Yeah. So they don't even have the whole thing where they have that support over here where you can like you were saying, take in the fat, taking this, taking that.
Scott Benner No one's gonna tell you about that. You know, I've done a couple of Zoom chats with expats in Hong Kong
Natalia Yeah.
Scott Benner Couple times around diabetes. Nice little group of people. So I understand why the lunch works, and I understand why you also are less aggressive at snack time
Natalia Mhmm.
Scott Benner Afterwards. That all makes sense. But now at dinner, that part throws me off because rice, meat, you know what? It's just not a lot of carbs, really. You're doing meat and veggies with some rice. Basmati's got the index on the Basmati's lower, and you've got the 41 work. Is he super active after school? Does he come home and run around and everything?
Natalia Excuse me. So he's basically he has football, and he comes home on Thursdays, and then he has other activities going on. So he's quite, like, all over the place until, like, we're ready to eat dinner by 05:30.
Scott Benner Okay. That's why you're getting away with the insulin to carb ratio of one to 41 at dinnertime. Plus you're doing most of your carbs are from vegetables and rice at dinner as well.
Natalia Yeah.
Scott Benner Yeah. Yeah. Okay. And there's not a ton of fat in no. There's no fat really in what you're eating at dinnertime.
Natalia Yeah. I avoid doing all those things. So it's either rice or it's roti, the homemade ones. So Mhmm. We use the whole meal. Yep. Yeah. We use that for that. So
Scott Benner Okay.
Natalia He was tested for the celiac disease. He had the whole endoscopy and stuff done where he was cleared from it. So we've kept it as normal. No gluten free or anything going on. So, I mean, I don't see that that's affecting him.
Scott Benner Yeah. No. It seems like you're okay there. Also, a lot of those gluten free prepackaged meals are a lot more carb heavy than you think too.
Natalia I agree. Yeah.
Scott Benner So I'm glad you don't have to use them. But now I think what we gotta figure out is this vacation menu here are the weekends. Like, you know what I mean? Because I mean, I'm happy to walk through it with you, but you already know the problem. Right? Carb ratio is wrong, and his activity is different. Yeah. Yeah. Yeah. So the bigger question is then if the pump is already set up, you don't wanna be changing constantly, you know, your settings and everything.
Natalia Yeah.
Scott Benner I think, honestly, when you're 19 and 31, you could just do the math and find out what the difference is so that when you dial up the insulin how are you gonna do that? You're gonna have to either lie about how many carbs it is or just put in extra.
Natalia Yeah. Just fake carbs. Right?
Scott Benner But I'm not sure what the algorithm's gonna handle better. Because what we would prefer is that on Saturdays, you know, at that time of day, that his carb ratio was more like 19 than 31 if you're gonna go do those kinds of meals. Yep. But you're also gonna want to really look at the fat on some of these things. Like, let's just use the pizza, for example. Like, I've never been to Hong Kong. So what am I getting for pizza there? Is it like pizza?
Natalia Pizza Hut. Yeah.
Scott Benner Yeah. Yeah.
Natalia We do Pizza Hut. Yeah.
Scott Benner Okay. So let's take a look at that real quickly.
Natalia And I don't even use the manual mode, so I don't put it on the extended bolus. I don't know if that impacts it or me just making it $60.40 is also the same thing or not.
Scott Benner You're not putting it in manual mode, making it sixty forty. Impacting what? I'm sorry.
Natalia Impacting his levels.
Scott Benner I mean, I think what's happening is you're trying to eat stuff with more fat, more protein. The pump itself believes that his total daily insulin is seven on a day when it's not gonna end up being more like 12. Yeah. You know? So the you've got everything going at you. You're changing how you normally live, and the algorithm doesn't know it's Saturday, and the algorithm doesn't know you're going to Pizza Hut. Right? So and you're counting carbs and not covering the fat too. So just because I'm on the website here, cheese pizza, pepperoni, supreme, meat lovers, which one would you
Natalia So just plain cheese.
Scott Benner Yeah. Plain cheese. Okay. I asked for the nutrition levels, and Pizza Hut's trying to sell me a pizza. Hold on a second. Oh, wow. And the calorie information, and I clicked on it, and it says, what's my ZIP code? Am I gonna have to give it my ZIP code to get the calorie information?
Natalia It wants you to get one.
Scott Benner It does. Silly little website. It's tricking me. Alright. I have to find a better website than the Pizza Hut website.
Natalia I got a 12 inch eight slices one. Carbs and Pizza Hut pepperoni pizza. Okay.
Scott Benner Gosh. There's so many different kinds of pizzas.
Natalia Pizza.
Scott Benner You should come here and have a pizza in New York, Philly.
Natalia Yes.
Scott Benner Pretty much. Have you been here?
Natalia I've been to New York. My husband's family lives there.
Scott Benner So Very nice.
Natalia Been there a few years ago. But with kids coming all the way to America is a bit much.
Scott Benner Yeah. Just for pizza? You don't think it's you don't think it's gonna be worth the trip?
Natalia Generally, I mean, like, it's we have other places we can go to.
Scott Benner Alright.
Natalia I've lived in Arizona with my uncle for, like, one semester of college. I didn't like it. I came back.
Scott Benner Too hot. Right?
Natalia Oh, just like I was 15 probably. Oh, yeah. Home. Yeah.
Scott Benner Not looking for that. The only thing I really know about your part of the world is I do keep grass lizards from Japan. The little green ones with the super long tails.
Natalia Oh, wow.
Scott Benner Hold on one second. Let me tell my wife that my dog ate. Okay. My dog got sick. He had to have his medicine today.
Natalia Oh, wow. Okay.
Scott Benner My wife's like, did he have his medicine? Okay. So 12 inch medium pan pizza. Yeah. So just using the pizza I'm gonna make a an example here for you. If we put him at 31 for his insulin to carb ratio, and then we say that he has and is one slice true, or is he gonna have two slices?
Natalia Two. Yeah. Two. Two slices?
Scott Benner Okay.
Natalia Let's see how it goes. Yeah. 60?
Scott Benner Yeah. This says 27 here, but we'll go with 60. Yeah. And now the fat is 20. And believe it or not, there is protein in it.
Natalia There's 11 grams of protein in it. So you're getting 22 of protein. We haven't even talked about what protein does yet. Okay.
Scott Benner But protein gets stored as glucose.
Natalia Glucose. Yeah. I was hearing your
Scott Benner Yeah. You see, kinda have to do that there too. So 60 carbs, 20 fat, 22 protein, right, is 1.9 units up front and point four three units stretched out. So you're probably doing two units if you're counting all that correctly, and it really is more like 2.4. But I think the greater point is that that's at the insulin to carb ratio of 31. Yeah. If you change his carb ratio to 19 and do the same math again Yeah. This goes from 1.9 up front to 3.1 up front.
Natalia Okay.
Scott Benner And point seven over the four hours. So that's almost a four unit bolus, 3.86, 3.9. It's 3.9 bolus up from 1.9 that you were using before. So you're using half the insulin that you need and not trying to impact the fat at all. So, basically, think of it this way. You gave the pump two units of insulin to do the job that it needed four units of insulin to do. Right. And on top of that, it doesn't consider fat the way you and I are talking about it. So as he's drifting up, it's not treating him like the food's the issue. It's just treating him like he's drifting up. So you've got this accelerant on his blood sugar, this, you know, this fire you've lit in his belly of fat and protein and carbs and all this other stuff. And you're handing the pump a garden hose and telling it to put it out. It needs a fire hose. Yeah. And so instead of putting that burden on the pump, which, by the way, what does he get to after the pizza? How high?
Natalia He goes to he's been to a 22, which is around, for you, 400.
Scott Benner Okay. So what I would do there is, of course, not as long of a pre bolus for pizza because you don't want him to get low first, and that pizza does not go in and start working as quickly as some of these other foods do. Right?
Natalia Right.
Scott Benner So maybe a slightly shorter pre bolus. Again, the timing and the amount to get the bulk of that insulin where you need it to be. But then when you start to see that first rise, you're gonna have to bolus again. And whatever that pod's gonna do I mean, with a kid who's using seven units a day, it's probably hitting him with, like, point o five, point o five. That's not
Natalia gonna do Nothing.
Scott Benner No. Especially when you're two units deficient already. Yeah. Right? So I think that's your answer there with that food, which is use the more aggressive carb ratio and account for the fat and the protein.
Natalia So does this make sense if I change the 31 to a 19 next time I do this when he has his pizza. And then I for the weekdays, I change it back.
Scott Benner Yeah. I mean, you can whatever is workable for you. Yeah. See, whatever works best in your life.
Natalia I'm just asking, should it have a consistency, or is okay to just keep changing it?
Scott Benner Well, I mean, listen. There's an argument to be made here. Taking the weekend out of it or taking the pizza kind of extra stuff that you don't usually taking that out of the conversation for a second. There's an argument to be made here that you're it's got nothing to do with the carbs. It has to do with his activity.
Natalia Okay.
Scott Benner You're managing lows from activity Mhmm. By using less or more insulin at meals. That's all that's really happening here. Everything's timing and amount. It's the right amount of insulin at the right time. And the timing has a lot to do with the variables around you. Right? Is he active? Is he not active? For some people, it's heat. Are they hot? Are they cold? Are they Yeah. You know, whatever people's variables are, you know, for ladies, a lot of times, a lot of hormonal stuff. Right? Yeah. That's why you hear people talk about diabetes like this way. Like, it's unknowable. Like, oh, I do the same thing every day, and I get a different outcome. Yeah. But you're doing the same thing every day, but the day's not the same. It looks the same to you because all you're talking about is eggs and milk and bacon and 08:00 in the morning. You're not talking about hormones. You're not talking about growth hormones, which he's by the way, you're not gonna see yet. But in a couple more years, wait till you see his blood sugar go up overnight when he goes to sleep. That's gonna be fun. So it's the variables around it that change the impact the the invisible impacts, really. But that's why when people say I do the same thing every day and I don't get the same outcome, they're wrong. They're doing the same thing every day, but all the things that are happening are not the same. It's the unseen stuff. For you, I can see why this would have gotten past you, to be perfectly honest, because they got you those carb ratios set up, and you're like, wow. This is working. And then why the hell doesn't it work on Saturday? That doesn't make any sense. Then all of a sudden, you say, oh, it's diabetes. It's just, you you can't know. But we looked at it for five minutes, and you know now. So Right. It's pretty much it. I mean, there's I I hate to say it. There's not a lot to it. You know what I mean? Which is why I can hold it in my head. Trust me. If there is more to it, I'd be the wrong person to ask.
Natalia Can I just ask you to repeat this whole thing with the bolus? I opened your bolus estimator.
Scott Benner Yeah.
Natalia So can we, like, walk through this together?
Scott Benner Sure. Sure. Yeah. So at the top there, there's insulin to carb ratio.
Natalia Variables. Yeah.
Scott Benner Yep. And there's insulin sensitivity.
Natalia So we put in 31 here. Right?
Scott Benner Yep. And then Okay.
Natalia SF is 18. Yep. Then target blood glucose would be
Scott Benner I made it 90. Okay. Yep. And then you just kinda scroll down a little bit and put in carbs. By the way, I'm not boasting because I don't know how to code, so it was Claude that did it. But, once you leave the website and come back, it'll leave his carb ratios and his sensitivity. All those numbers you put in, it'll remember when you come back to the website, but it doesn't store any of your data.
Natalia Okay. So what is the calc gap? What does this mean?
Scott Benner Okay. So I'm not gonna lie to you. It's a simulation. It'll halt if the output exceeds it. So Okay. It's kind of a safety that's built into it.
Natalia So it's I don't have to put anything here.
Scott Benner You can just leave it at it should be at 25. Right?
Natalia 25.
Scott Benner Yeah. Just leave that. The FPU adjustment factor, if you wanna sit down and really read and understand the Warsaw method, which is probably not gonna be necessary for you with such a little kid at such a little weight. But there are some people who need a different adjustment factor to make the Warsaw method work better for them. I'm gonna tell you right now, I'm not the right person to ask about that. But Okay. It's set at 50 as a default. If it's working for you, I'd leave it there. Okay?
Natalia Okay. Let's leave it. Yeah.
Scott Benner Yeah. Okay. And then carbs, fat, protein.
Natalia So carbs, we have 60. Yep. Fat, we have 20.
Scott Benner Mhmm.
Natalia Protein, 22.
Scott Benner It's 22. Now I did not fill in the current BG number there. Okay? So because we're just talking, like, theoretically. But if you put in there, he's one fifty, like, I'm still looking at your bolus with 6020, 22 as the settings, and it's 1.940.43. Meal wave, 194. Warsaw, 1.43. But if I suddenly make his blood sugar one fifty, then, of course, it's gonna add a correction in. The initial bolus went up to 5.27 to cover his higher blood sugar.
Natalia Oh, wow. Okay.
Scott Benner You're not just bolusing for the food. If he's one fifty, you're bolusing for the food and the elevated number.
Natalia Okay. So let's go through with this. So current BG, we kept at one fifty.
Scott Benner Mhmm.
Natalia That the IOB units
Scott Benner If he's got insulin on board, you can put it in there so it's part of the part of the thing. But, you know, also, if it's been a few hours since he's eaten and he's got a stable blood sugar, I'm gonna kind of assume that the insulin's already done what it's gonna do.
Natalia Okay.
Scott Benner And it actually does help you there. You can put in a an arrow for the trend arrow because right now, I have is one fifty. It's a five two seven bolus. Also, let me mention with the one fifty, when I take the one fifty out, not only is it a one point nine four initial bolus, but it says make the pre bolus nine minutes. You put the one fifty in, and you'll notice when you resimulate it, it turns the pre bolus into more like fifteen minutes. So what it's telling you is like, look, you wanna try to get that one fifty number down more before you start eating is what it's saying.
Natalia Right.
Scott Benner Yeah. And don't take any of, the 15 or the nine. It's not gospel. It's Right. It really is just, you know, a place to start to think about it. Anyway, if you make the arrow stable, that's one thing. If you make it a rising arrow
Natalia Okay. So whatever it is I see from the Yep. The controller. Okay.
Scott Benner And, actually, when you scroll down, it says show calculation steps. If you wanna click on that, it shows you all the math that it's taking into account. And you can continue to scroll down, and there is an incredibly technical explanation of what this thing is doing.
Natalia Okay. Great. I didn't know how to use this. Yeah. Okay.
Scott Benner Makes
Natalia sense. So mean wave would be 5.27 units. That would be
Scott Benner Yep. Upfront. Yep. What it's saying there is it would like to see point four three units spread out over four hours.
Natalia Over four hours.
Scott Benner But you don't have that ability.
Natalia Okay.
Scott Benner So there's where you're gonna have to just pick a time to jump in and put in a little bit of extra to try to stay ahead of the now listen. If ninety minutes later, you're not seeing a spike and it never comes, well, then, okay. The bigger bolus did it. But if you see it
Natalia I get excited in two hours. I said, I think I did it at at the fourth hour comes.
Understanding Basal and Automated Systems
Scott Benner Think I did it. Nope. Well, see, also on the AID systems, all of them. Right? There's this sort of, like, in plain language, the algorithm believes that you've given it the right amount of insulin and that you've accurately described the impact that it's going to see. You know, if your pre bolus gets him to, I don't know, 85 and he's super stable, well, then the algorithm's working off the bolus. So it'll oftentimes take the basal away because the bolus is basically handling the food and the basil needs all at once right now. Okay. Right?
Natalia Okay.
Scott Benner So if it's doing that and you're wrong or there's other impacts from food, then not only is it not enough insulin, but it's also probably got a deficit of basil. So there's nothing there to stop the rise from happening. Right? And then it starts to just like, the way I think about it is this. Basil insulin, if you think of the blood sugar as a number, I think of basal as just enough weight to keep that number where you want it to be. So Okay. Think of your, you know, your left hand is pushing up and your right hand is pushing down, and so the body is, you know, natural body functions are making your blood sugar go up. Right? You're not making insulin. You eat a cookie, your blood sugar's gonna go up without insulin. It's never gonna stop. Right? Yeah. So you need to put enough basal on top of that just for your body functions to keep you level. So think of it as, like, resistance that keeps the number where you want it. That's basil's job. Keep you at a number that you want stably. So the basil's doing that. You take that basal away, there's nothing stopping that number from rising all of a sudden. And so when you bolus on an algorithm, you put in all this insulin, and it's saying to you, okay. Well, we have a stable number. So the insulin that's in there is not only handling the food or the correction that we asked for, but it's also handling the basal needs. So you'll see that a lot of the algorithms just shut the basal off. And sometimes there won't be basal insulin happening for an hour or two.
Natalia An hour.
Scott Benner Yeah. Yeah. Yep. Right? And just imagine if you didn't use enough insulin and it's shutting the basal off because it believes you when you told it how many carbs and what's the impact gonna be of this food. So it's taking insulin away on the other side, then that fat rise comes in and hits you, and you've not only don't you have anything currently laying on top of it to stop it, but you haven't had anything there for hours, so you're deficient on top of that. Does that make sense?
Natalia Right. It
Scott Benner does. Right? And then that's where the rise comes from.
Natalia Yeah. Yeah. This is the information I feel I was missing. It was just not making sense.
Scott Benner Sure. No. I understand. Yep. That's it. What I just said to you right there, I don't wanna give away the whole secret. That's pretty much why people listen to the podcast. Yeah. The idea that nobody talks about this part of it. I mean, you could get lucky and get an endocrinologist that would explain it to you, but mostly, it doesn't. Yeah. I'll tell you, I'm giving a talk tomorrow at a hospital, and I said I'd like to talk about this. And they were like, oh, we don't tell anybody to do that. I was like, yeah. That's gonna be a problem. You know? Yeah. So, I think that's it. I mean, in all honesty, like, I would imagine this weekend's gonna go way better for you. Might be pizza time again. Who knows?
Natalia I hope so. Yeah. So is this what you said is, like, a extended bolus, basically?
Scott Benner Yeah. If you had a regular pump, right, like, wasn't running an algorithm, or there are some algorithm pumps that handle extended boluses off top of my head, tandem does. Yeah. Yeah. So if you had a tandem pump, you'd say, look. I wanna do this exact setup. I'd wanna do 5.27 up front, point four three over four hours, and and then it would do that there.
Natalia Okay.
Scott Benner But Omnipod five doesn't do extended boluses in automation, so you're just gonna have to make the point four three bolus at an advantageous time, which would be before you see the fat rise, but not so much before that it makes you low.
Natalia Okay.
Scott Benner Alright? So the timing of that is gonna be a little bit of you're gonna have to have a couple of pizzas to figure that out. Yeah. You know what I mean?
Natalia I have to go through it. Yeah.
Scott Benner Yeah. Little practice pizza, we'll call it.
Natalia Okay. Sure. Alright. Thank you so much.
Scott Benner Oh, you're welcome. Same thing with all this other stuff. If you're doing chicken and it's a chicken tender or chicken nugget
Natalia Yeah. Oh, the breadcrumbs and stuff.
Scott Benner Yeah. But don't forget too that because they probably deep fry them, there's gonna be fat there.
Natalia Yeah.
Scott Benner So look for the french fries. French fries
Natalia are Right?
Scott Benner Cheeseburger and fries. I don't know if you guys eat meat, but a cheeseburger and fries, you're gonna get the fat from the meat and the fat from the fries. It's gonna be a double whammy of fat. And trust me, just for fun sometime, which, by the way, is why I set this simulator up so people could look at it. Yeah. Like, you have this set up now, 60 carbs, 20 fat, 22 protein, a 150 blood sugar, and you're seeing what it is. But just imagine for a second let me just Google, like hold on a second. I'm just gonna use McDonald's because I don't because it's something everybody knows.
Natalia Like, he's even stopped having chicken nuggets because I'm just too scared of it.
Scott Benner Yeah. No. No. But you're gonna have it now. I can hear you thinking about it. I know you're gonna be okay. Yeah. Large McDonald's french fry, 23 to 24 grams of total fat, 66 grams of carbs. So if we add say he has what you just described now, but with a McDonald's fry on top of it, that takes it to a 126 carbs, and it takes your fat to 85. Yeah. Okay. Now I'm gonna ask you without thinking about the numbers for a second. Just use your old brain. If he had french fries, how much insulin would you give him for french fries?
Natalia Point five, what?
Scott Benner Yeah. Right. It takes his bolus up to 7.4 initially and 1.3 over time. So where you would have added point five or one, you would have really needed two, almost three units.
Natalia Yeah. Yeah.
Scott Benner And that's the kind of stuff, like, when people say don't have any luck at restaurants, this is what they're not doing.
Natalia No. There had to be a reason.
Scott Benner Yeah. This is it.
Natalia Yeah.
Scott Benner Alright. You're done. I fixed it. We're all good.
Natalia Thank you so much.
Scott Benner What time is it for you are? It's so simple. Well, listen. Once you hear my dumbass explain it to you, you actually start thinking, It maybe it is simple. No.
Natalia I'll use the calculator and really I mean, now it's making sense. So Good. Slowly. Let's see.
Scott Benner Yeah. You go to my website up in that menu, this is for you or for anybody listening, not only is there, like, in a little a one c estimator up there, there's, a basal estimator if it explains how the math works behind basal insulin where you can just, you know, put in your weight, and it'll give you some suggestions about where to start looking. There's also the bolus estimator that we were just using. There's also just a fat and protein estimator. It doesn't do the whole, like, the whole meal, but it shows you how it works. Just adding fat and protein to your carb ratio to give you some examples of it. And then there's the setting simulator, which is literally just you set your weight, and then it gives you a starting point for everything from carb ratio, basal sensitivity factor, like, kind of the whole thing. So as he's growing, you might wanna go to that simulator once in while and just kinda check yourself. Like, maybe our settings have moved because he's gonna gain weight. He's gonna keep growing, and those doctors are never gonna mention these settings again to you.
Natalia Yeah. That's every three months I have to go to them, but it's just like, you know, you should do better. And I'm like, how? You know? They don't teach the how.
Scott Benner Yeah. Yeah. Yeah. Well, go back and look at that setting simulator. Like, if things are getting wonky, then just go look again. Anyway, I think those things should be helpful to people. Again, they're not there's disclaimers all over the stuff. It's for educational purposes. You should talk to your doctor first. I barely graduated from high school. Okay? So I'm not I'm not joking. That's fine. Alright.
Natalia It's whatever you make of yourself. Right?
Scott Benner I believe that too, but I just want you to know where you're getting that estimator from. That came out of my brain, so be careful. Wow. That's fine. Alright. Alright. Do you have any other questions or anything else you'd like to talk about?
Natalia Just one more thing. I for the longest time, I thought Basil was just background insulin. He would get only at night. I think it's because of the injection time where Tresiba was just given one unit at nighttime. So I don't know why that has been stuck in my head. And when I talk to people, they're like, oh, you should turn up the temp basil. And, you know, I was like, how is that connected to bolus? Mhmm. So
Scott Benner Well, listen. Now that you've talked to me, go listen to the pro tip series.
Natalia Okay.
Scott Benner Okay? It starts at episode 1,000 where you can go to my menu and go down to pro tips. Jenny and I walked through the whole thing. If you just listen to it straight through, I'm gonna tell you right now, you listen to that thing straight through and halfway understand it, it's an a one c in the sixes.
Natalia Okay.
Scott Benner Okay? And we'll go over all that stuff. But it's funny because I actually did add there's an interactive defining diabetes page on here, which it's just definitions because I did find that people, like, would say, like, well, I didn't know what basil was. And I have kind of colloquial ways of talking about it. And the basil, I just did with you. I just think of it like basil holds you at a number.
Natalia Yeah.
Scott Benner And you decide what you want that number to be. I don't care if you wanna, you know, away from food and away from, you know, active bolus insulin. If you wanna try to be 80, there's a basil that holds you at 80. If you wanna be 90, there's a different basil that'll hold you at 90. And then once that's done, that's done. Yeah. But if that's wrong, to imagine that the basil I know these are big numbers because he's so small. But try to imagine your basil supposed to be one unit an hour, but you have it set at point five an hour. Yeah. So you're deficient every hour a half a unit of basil. You probably got a high blood sugar on top of that. But then you go to bolus for food, and then even if you have your carb ratio right and you've counted the carbs correctly and you say, okay. Well, this meal is four units. Well, it's four units, but you're deficient a half a unit of basil every hour for the last four hours. So your four unit bolus might not even touch your food. You replace the basil and the need that you have with a higher number, you probably didn't even put any insulin to cover food. So just remember it this way. When the basal's wrong, nothing else works.
Natalia Okay.
Scott Benner Okay?
Natalia And the way to see that is in the nights or during the day as well?
Scott Benner It's just easier at night to look at and then kinda work off it during the day, can kind of adjust off of it. But Omnipod five is gonna make the changes for you anyway. There's not a lot you can do about it. But you could you could if you really want to teach yourself on the weekends, you could put them into manual and try to get your settings right to, you know, kinda give yourself a I don't know. Like, you could basal test in manual. You know, you could do a little testing in manual just to see how good your settings are.
Natalia Right.
Scott Benner You know? And then after that, it sounds like you got the pre bolusing down already. You got you know, most meals, you need to pre bolus.
Natalia Yeah. For all of them, I do it. Yeah.
Scott Benner And that's pretty much it. Listen, Nithanya, seriously, I'm gonna tell you something I I don't tell everybody, but when I hear it, I say it. You're gonna be fine because Yeah. You're paying attention and you ask the right questions. That's pretty much it. Yeah. And you're trying.
Natalia Just trying my best.
Scott Benner Yeah. No. You're doing great. And it's gonna work out because you're paying attention and you're asking good questions. You found good information, and you're putting in the effort. I guarantee you wake up six months from now, look back on yourself today, you won't recognize yourself. Yeah. You know? You okay? Are you sleeping? Yeah. Yeah. You're getting good sleep? You're not, like, up all night long?
Natalia Really? No. I get good sleep. Yeah.
Scott Benner Good. Good. The and the algorithm probably helps you with that. The Omnipod five is a lifesaver there, I would imagine.
Natalia It's just that the whole house has iPads ringing if it goes below four. So, I mean, that's the time we wake up. And by default, we give the juice and stuff. So, I mean, I guess it's a way of life now.
Scott Benner Yeah. It is. You'll be okay. You really will be. Yeah. Yeah. I appreciate you doing this with me. I hope this went kind of the way you were hoping.
Natalia Really, really good. Yeah.
Scott Benner Oh, good.
Natalia I had no idea what would come out of it, but
Scott Benner That's excellent.
Natalia I'm looking to it now. I know which direction to go with, but thank you so much.
Scott Benner You're welcome. You're very welcome. Hold on one second for me. Okay?
Natalia Yeah.
Outro
Scott Benner Alright. I'm sorry. I started the recording back up, everybody. So I'm still here with Natalia. We were talking about what to name the episode, and I said, oh, you never said your son's name, or I would have made this episode bolus four and his name, but you said it's okay. So what's his name?
Natalia His name is Zaid, but everyone in school call him Zaidino. So if I show him that, he would be really happy. You'd be
Scott Benner very fine. So spell the nickname. Spell it. Z a
Natalia z a y d I n o.
Scott Benner D I n o. Okay. And I wanted to put this here so that all of you, when you got to the end, you're like, why the hell was this episode called that? So so that's exactly what I'm gonna call. I'm telling the editor right now. Rob, this is Bolas Forzedino, z a y d I n o. Okay. Thank you so much again. I'll let you go. A huge thanks to my longest sponsor, Omnipod. Check out the Omnipod five now with my link, omnipod.com/juicebox. You may be eligible for a free starter kit, a free Omnipod five starter kit at my link. Go check it out. Omnipod.com/juicebox. Terms and conditions apply. Full terms and conditions can be found at omnipod.com/juicebox. A huge thanks to today's sponsor, AbleNow. AbleNow offers tax advantaged able accounts for eligible individuals with disabilities. If you or your child lives with diabetes, you may qualify because of ongoing medical needs. With Able Now, you can save for a wide range of disability related expenses without affecting eligibility for certain disability benefits such as Medicaid. And thanks to recent federal law updates, more people are eligible than ever before. Learn more and check your eligibility at ablenow.com. You spell that, ablenow.com. There's links in the show notes and links at juiceboxpodcast.com. The conversation you just enjoyed was brought to you by US Med.
Scott Benner Usmed.com/juicebox or call (888) 721-1514. Get started today and get your supplies from US Med. I can't thank you enough for listening. Please make sure you're subscribed or following in your audio app. I'll be back tomorrow with another episode of the Juice Box podcast. If your loved one is newly diagnosed with type one diabetes and you're seeking a clear practical perspective, check out the Bold Beginnings series on the Juice Box podcast. It's hosted by myself and Jenny Smith, an experienced diabetes educator with over thirty five 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 Juice Box podcast. The bold beginning series and all of the collections in the Juice Box podcast are available in your audio app and at juiceboxpodcast.com in the menu. Have a podcast? Want it to sound fantastic? Wrongwayrecording.com.