#1811 Bolus 4 - Hamburger Helper
Helps your hamberger help her - make a great meal.
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Key Takeaways
- The Meal Bolt Roadmap: A strategic approach to bolusing includes measuring the meal, evaluating yourself, adding base units, layering a correction, building the bolus shape, offsetting timing, looking at the CGM, and tweaking for next time.
- Hidden Carbs and Fats: When calculating insulin for packaged meals like Hamburger Helper, you must account for the ingredients you add, such as the fat in ground beef and the carbohydrates and fat in the milk, which drastically alter the total nutritional profile.
- Reading Labels Correctly: Pay close attention to "packaged" versus "prepared" nutritional panels. If the label only provides "packaged" data, you must manually calculate the macros of the added ingredients (meat, milk, butter, etc.).
- Fat Impacts Digestion: Meals heavy in fat (like ground beef and cheese sauce) will slow digestion, often requiring an extended bolus strategy to prevent post-meal spikes that occur hours later.
- Utilizing Modern Tools: Calculators like the Juicebox Podcast Bolus Calculator (or AI tools like ChatGPT/Gemini) can simplify the math of complex meals, breaking down the impact of fat, protein, and carbs to suggest initial and extended bolus amounts.
Resources Mentioned
- Juicebox Podcast Meal Bolt: juiceboxpodcast.com/meal-bolt
- US Med: usmed.com/juicebox or call (888) 721-1514
- Omnipod 5: omnipod.com/juicebox
- Juice Cruise 2026: juiceboxpodcast.com/juicecruise
- Juice Box Podcast Private Facebook Group: Search "Juice Box Podcast, type one diabetes" on Facebook
- Tandem Mobi: tandemdiabetes.com/juicebox
- Eversense 365: eversensecgm.com/juicebox
- Dexcom G7: dexcom.com/juicebox
- Juicebox Podcast Support Tools (Calculators & Guides): Go to juiceboxpodcast.com and click "Support"
- Wrong Way Recording: wrongwayrecording.com
Introduction & The Meal Bolt Strategy
Scott Benner Here we are back together again, friends, for another episode of the Juice Box podcast.
Scott Benner In every episode of bolus four, Jenny Smith and I are gonna take a few minutes to talk through how to bolus for a single item of food.
Scott Benner Jenny and I are gonna follow a little bit of a road map called meal bolt.
Scott Benner Measure the meal, evaluate yourself, add the base units, layer a correction, build the bolus shape, offset the timing, look at the CGM, tweak for next time.
Scott Benner Having said that, these episodes are gonna be very conversational and not incredibly technical.
Scott Benner We want you to hear how we think about it, but we also would like you to know that this is kind of the pathway we're considering while we're talking about it.
Scott Benner So while you might not hear us say every letter of Miele Bolt in every episode, we will be thinking about it while we're talking.
Scott Benner If you wanna learn more, go to juiceboxpodcast.com/meal-bolt. But for now, we'll find out how to bowl us for today's subject.
Scott Benner Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise.
Scott Benner Always consult a physician before making any changes to your health care plan.
Sponsor Messages
Scott Benner This episode of the Juice Box podcast is sponsored by US Med, usmed.com/juicebox, or call (888) 721-1514.
Scott Benner Get your supplies the same way we do from US Med. Today's episode is also sponsored by Omnipod.
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Bolusing for Hamburger Helper: The Jingles & Ingredients
Scott Benner Jennifer, we are going to bolus for you ready? Hamburger Helper.
Scott Benner Now before we talk about what's in Hamburger Helper, I would like to spend thirty seconds telling what I think is very important to mention here.
Scott Benner Hamburger Helper has maybe the greatest jingle in the world. I think it's brilliant.
Scott Benner I try to tell people about it all the time.
Scott Benner My family won't listen to me, but listen to this.
Jenny Smith I don't I didn't know Hamburger Helper had
Scott Benner a jingle, like a
Jenny Smith band aid.
Scott Benner Yeah. Yeah. Well, I was stuck on Band Aid. It's like that.
Scott Benner Hamburger helper helps your hamburger helper make a great meal.
Scott Benner Brilliant. Okay?
Scott Benner Because hamburger helper is what it is, and Hamburger Helper is what it's doing. Okay? And right?
Scott Benner And then it helps
Jenny Smith Oh my god. That's hilarious.
Scott Benner Oh my god.
Scott Benner It's brilliant. Whoever wrote it deserves an Emmy or a BAFTA or I don't know what they give.
Scott Benner They have Grammy.
Jenny Smith You broke it down and actually thought of it the way that the person who wrote the jingle was thinking of it having that meaning.
Scott Benner I can't not think of it when I hear it.
Jenny Smith Most people probably have not done that.
Scott Benner But there's more.
Jenny Smith Oh, there's more.
Scott Benner Keeping in mind, it was probably written a really long time ago. Hamburger Helper, which already brilliant.
Scott Benner Hamburger Helper helps your hamburger helper make a great meal. It's helping the helper.
Scott Benner But the way they pause, it's help her.
Scott Benner Because probably when they wrote the song, your wife was making it.
Scott Benner Right? So really think about all the implications. Hamburger helper helps your hamburger.
Scott Benner Help her make a great meal.
Scott Benner It's brilliant. Who wrote it?
Scott Benner We'll find out at the end. A genius, I guarantee you.
Scott Benner They probably also came up with the way to, like, separate ions from water or something like that.
Scott Benner Imagine this person is a brilliant person. (4:25) Nevertheless, Jenny, wait till you find out what's in hamburger helper cheeseburger macaroni.
Jenny Smith Oh, great.
Scott Benner Yeah. It's gonna be good.
Scott Benner It's a box dinner, macaroni entree with pasta and cheesy sauce.
Scott Benner It says it's made with real cheese and real spice that I mean, it would be funny if it was fake spices, but okay.
Scott Benner Just add beef, water, and milk.
Scott Benner And this is part of what I wanted to talk about today.
Jenny Smith Okay.
Scott Benner Because who knows? Are you buying 95% lean hamburger helper hamburger? 90?
Scott Benner 85? 80?
Jenny Smith 70?
Scott Benner They got 70?
Scott Benner I didn't know 70. 80 is the lowest I see at my place with does that sound fancy now?
Scott Benner People like, oh.
Jenny Smith I don't know. I really don't look in that section because we don't eat beef.
Jenny Smith So I I can't say that I look, but because there are many percentiles with many fat concentrations, which is what that percent means that you're talking about.
Scott Benner Okay. So I have the fat breakdowns there.
Scott Benner So when we put this all together, we're gonna but I'll tell you interestingly enough, I think, of course, I I think we've come to realize that when we're talking about this.
Scott Benner We're probably the only two dorks that are really that interested in this.
Scott Benner But four ounces of raw beef, 95 lean is 5.5 grams of fat.
Scott Benner 90% lean is 11 and a half, 85% lean. 1780% is 22.5.
Scott Benner 70% lean is 34 grams. It does it hold that after cooking?
Jenny Smith Well, that's what I was gonna say. This is precooked. Right?
Scott Benner Yeah. Yeah.
Jenny Smith In which the case as the good dietitian that I started out being always taught to tell people, drain the grease.
Scott Benner Oh my god. The first time I said to my wife, take that grease out of the pan, she goes, why?
Scott Benner That's where the flavor is. I said, I'm trying to stay alive. What are you doing?
Scott Benner Like you know?
Jenny Smith Fat equals flavor a 100%.
Scott Benner I don't care. It does.
Scott Benner I wanna stay alive. Do you understand? I don't wanna eat something that I can't pour down my drain.
Jenny Smith Please don't even pour it.
Scott Benner No. Oh oh god. Don't pour down your drain.
Scott Benner Yeah.
Jenny Smith Yeah. But but when you were growing up, did your did your parents have
Scott Benner A coffee can?
Scott Benner Yeah. Coffee
Jenny Smith can. Their refrigerator that they put all the grease into, and then when it was full, they threw it away?
Scott Benner Yeah. Bacon grease, like anything like that.
Jenny Smith That's so funny.
Jenny Smith I've never I haven't thought of that. It's such a long time.
Scott Benner Yours was in the refrigerator?
Jenny Smith My mom always kept because she kept, you know, like, a an old, like, tin can.
Scott Benner A coffee can or something they put in.
Jenny Smith Yeah. Right. Yeah.
Jenny Smith And she would
Scott Benner But they refrigerate it.
Jenny Smith To and she kept it in the fridge so that it wouldn't get gross and whatever on the counter.
Jenny Smith It would solidify in the fridge. Yeah. And then she filled it until it was full and then got rid of it.
Scott Benner Did you have a little bin of coffee grinds under your sink?
Jenny Smith No. Well, our I should say yes. Mhmm.
Jenny Smith But truly only in the spring, summer, fall because then it went into the garden.
Scott Benner Yeah.
Scott Benner Yeah. Okay. Cooked, 95% lean is four grams of fat, 90% lean seven grams, eighty five percent nine grams, eighty percent eleven grams, seventy percent twelve grams.
Scott Benner Also, you're going to use milk in this, two cups.
Jenny Smith Mhmm.
Jenny Smith So And let's say most people now typically use 2%, I would expect.
Scott Benner Really?
Scott Benner I would never.
Jenny Smith You would never? Do you skim or whole milk?
Scott Benner Only whole milk. If I'm drinking milk, I'm going for it, Tony. I mean, that's that.
Scott Benner I can't drink milk water because that's really what it starts to feel like.
Jenny Smith I haven't had a glass of milk probably since
Scott Benner Oh, I wouldn't know when. Yeah.
Jenny Smith I don't even know when I the last time I had a glass of milk. Right.
Jenny Smith I probably grade school when I was with, yeah, California.
Scott Benner And I know this sounds crazy, maybe, or it doesn't.
Scott Benner I think I stopped drinking milk when, like, 11 year old girl started, like, getting breasts.
Scott Benner I was like, I think there's something wrong. And I just seriously, I was like, I don't know what they're doing, but I don't wanna be involved anymore.
Scott Benner Yeah. Yeah. Yeah. I was like, I I really don't know what's happening, but I'm I'm getting out of this.
Scott Benner And I feel like that was twenty years ago.
Scott Benner 1% low fat, two and a half grams, 2% low fat, five grams, whole milk, eight grams.
The Nutritional Math of a Boxed Meal
Scott Benner Oh, okay. So let's say
Jenny Smith And that's in a one cup portion. Right?
Jenny Smith Eight ounces?
Scott Benner Yeah. Yeah. We need two cups. Oh, see?
Scott Benner So when you look at the little hamburger helper thing here, which by the way, way to not make it legible on your website, hamburger helper.
Scott Benner They show you the side of the box, but, you know, not in such a way that you can read the numbers.
Scott Benner Had to go somewhere else to get that.
Jenny Smith I'm curry like, hamburger helper, you brought it up.
Jenny Smith Yeah. I know that you don't eat it in your house.
Scott Benner Oh, no.
Jenny Smith So this must have definitely been something that came up enough when you asked for people's ideas.
Jenny Smith Right? It was was it, like, the top thing on a list?
Scott Benner No. There's two things.
Scott Benner It was on a list. Okay. But I wanna be absolutely clear, and I'll say this like this in case she's listening.
Scott Benner My wife eats like it's still $19.75 every once in a while.
Scott Benner So there is always a box of Velveeta mac and cheese and a box of Hamburger Helper in my house in case
Jenny Smith She gets the anchoring?
Scott Benner I would say in case the mixture of hormones, stress, anxiety, and sadness hit on the right spot on the right day.
Scott Benner You know what I mean? And then I hear the box shaking with the dry potatoes in there and and everything else.
Jenny Smith And you know what's being created?
Scott Benner Yeah. A pan that she doesn't clean.
Jenny Smith Oh my
Scott Benner Taking a taking a moment to take a personal shot at my wife during the podcast.
Jenny Smith Oh, that's okay. I won't tell her.
Scott Benner She's never gonna hear this.
Scott Benner It doesn't really matter. No. Alright. Let's see.
Scott Benner My god.
Jenny Smith My choice would be chocolate, by the way, if it was all that.
Jenny Smith Mine mine would be chocolate.
Scott Benner That's in the house too. Don't worry. Okay.
Scott Benner So a 120 out of a 140 calories, gram of fat.
Scott Benner So a lot of sodium, 630, 780 milligrams in protein.
Scott Benner So I And
Jenny Smith this is just the mix you're talking about without the addeds. Right?
Scott Benner I I have to go to Walmart. I had to get it back again.
Scott Benner Walmart has a good picture of the box. Thank you, Walmart.
Jenny Smith And how much
Scott Benner How often do people say that?
Jenny Smith How much ground beef gets added to this
Scott Benner then? We're gonna go through it right now.
Scott Benner The mix itself, point five fat, 700 milligrams of sodium, 28 carbs, three total sugars, one includes one added sugar, four protein.
Scott Benner And wow. Let me just tell you the ingredients.
Scott Benner Enriched macaroni, cornstarch, salt, enriched flour, modified whey, sugar, tomato, onion, cheddar, cheese, palm oil, citric acid, vegetable oil, yeast extract, garlic Parmesan cheese, annatto extract?
Jenny Smith Annatto, it actually comes from a plant. It's so you could buy white and yellow or orange cheddar cheese.
Jenny Smith Right? The orangey cheddar cheese isn't a different kind of cheddar cheese than the white.
Jenny Smith It's just got annatto added to it, typically.
Jenny Smith Some they might use other things in other but many times places use annatto.
Scott Benner Can I just say I didn't annatto that? Thank you. Thank you so much.
Scott Benner I appreciate
Jenny Smith it. Funny.
Scott Benner Yeah. Send send me out for an Emmy too.
Scott Benner Black pepper, monoglycerides, sodium phosphate, nonfat milk, natural flavors. Oh, silicon dioxide. Oh.
Scott Benner Isn't that silicon?
Jenny Smith It helps essentially.
Jenny Smith It's it's usually used as like a stabilizer, so it doesn't get like I
Scott Benner don't care, Janet.
Jenny Smith Yeah. I know.
Scott Benner It contains milk, wheat, but it may contain egg, soy ingredients.
Scott Benner Okay. So let's move 28 carbs or protein into the calculator.
Scott Benner We're gonna use the calculator today on juiceboxpodcast.com. So 28 carbs
Jenny Smith And 28 is a serving prepared completely?
Scott Benner Yeah. We'll get to that. Hold on a second.
Scott Benner We I don't know if they even tell you that.
Scott Benner Like, that's the thing we're gonna have to figure out because sometimes they're very clear about it and sometimes they are not.
Jenny Smith Well, and sometimes packages will actually have on their nutrition nutrition facts facts panel, panel, they'll they'll actually actually have have a panel of just the nutrition facts for the dry product.
Jenny Smith And then right next to it, if you look at the label heading, you'll actually see per prepared serving.
Scott Benner Mhmm.
Jenny Smith And that's typically then the column that you want to look at for your total package of information besides at the very top of the label looking to see what is a serving size and how many servings are there once you prepare the product.
Scott Benner So help me understand that because I'm I'm seeing exactly what you're saying.
Scott Benner Serving size, one third cup as packaged, one cup prepared.
Scott Benner But then, like, fat, like, it tells me point five grams packaged, but prepared, it just gives me a percentage.
Scott Benner So it doesn't give me a new Yeah.
Jenny Smith Give you a gram number?
Scott Benner I'm not seeing a new a new gram number for anything. Like, total carbohydrates, 28 packaged, 10%.
Scott Benner Prepared 12%, but no new oh, it's interesting. Well, we're gonna add
Jenny Smith Well, I guess you'd have to add, what, 2% to 28. Right?
Scott Benner Yeah. I guess so. But now you're beyond me
Jenny Smith because I
Scott Benner I fell asleep in math class in ninth grade.
Scott Benner I I never woke up again.
Jenny Smith Or, you know, and I'm I'm making an assumption about how to read what they're usually, it's a little bit more explanatory.
Jenny Smith Again, it's the dry package. And then the next column over is usually prepared per recipe.
Scott Benner Right.
Jenny Smith It'll usually say per serving, how much carb, protein, fat, sodium, all the things in grams.
Jenny Smith It doesn't usually just have a percent. That's interesting.
Scott Benner I'm just looking for the instructions now on the box because how much it was on the one thing and now it's on the other.
Scott Benner Oh.
Jenny Smith So, essentially, this label kind of, if it's really only giving you the amount per, you said, third cup dry product Yeah.
Jenny Smith You'd really have to then do the math and say, okay.
Jenny Smith I'm adding to this two cups of milk. So 16 grams of carb. Right?
Jenny Smith And all the extra fat and all of the extra protein.
Jenny Smith Now I'm also adding to this the what else did you see?
Scott Benner The meat?
Scott Benner Interesting because some boxes don't tell you and some do, like, even what you're putting into it.
Scott Benner Oh, hold on a second. Cheeseburger by the way, this is the cheeseburger. I brought that up.
The Art of the Bolus (and Jingles)
Scott Benner Right? Hamburger helper. Helps your hamburger helper make a great meal. It's amazing.
Scott Benner I mean, honestly, really think about it.
Scott Benner It's absolutely amazing.
Scott Benner The guy that wrote it or the woman, let me just say, whoever wrote it must have just sat around for three days happy with themselves when they were finished.
Scott Benner I'm possibly the only person who paid attention to it. I don't know about that or not.
Scott Benner Do you remember the, like, the little hand like, the the little chef hand?
Jenny Smith Oh, the happy little chef hand with the happy face? Absolutely. Remember what that looked like.
Scott Benner On the TV and tell you all about it. It's really it's really wonderful.
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Jenny Smith My grandmother not my mom's mom.
Jenny Smith My mom's mom did a lot of cooking. My dad's mom did a lot more, like, packaged stuff at least once I got to know her.
Jenny Smith And she didn't have hamburger helper. She had tuna helper.
Scott Benner Oh, I've seen that.
Jenny Smith Right. Oh,
Scott Benner my mom would make that.
Jenny Smith It's the same concept.
Jenny Smith It just has canned tuna in it.
Scott Benner Can I tell you when that got made at my house when I was a kid, my expectation was we couldn't afford the hamburger?
Scott Benner Like, so Really? Yeah. So canned
Jenny Smith tuna Tuna
Scott Benner helper. Awesome.
Jenny Smith Maybe that was why it was at grandma's house.
Scott Benner Yeah. Yeah. Yeah.
Scott Benner Oh, see. I might be giving you a look into your life right now.
Jenny Smith Fixed income.
Jenny Smith I don't know. Maybe.
Scott Benner That was always my expectation. Alright. Listen.
Scott Benner Let's add on to this. (17:46) I mean, look.
Scott Benner We can do it a couple of different ways just so you can get an idea.
Scott Benner But, you know, you're using how much beef is going in this here. Hold on a second.
Scott Benner It's just not easy. Like, I do this live so that people can see, like, they do not make it easy for you.
Jenny Smith Yeah. No. No. And if you are the person who wants to be as technical or accurate, instead of just saying, I bet it's about 30 grams per cup prepared, that's what I'm going to count.
Jenny Smith And a 100%, if that's what you do and it works out for you, then you continue using that Awesome.
Jenny Smith Right.
Jenny Smith As your strategy. Awesome. But then there are, you know, people who want the fats and the proteins.
Jenny Smith They want the extra strategy to be able to use things like the assistive navigation device that you've kind of come up with, right, for, boluses the right way with extended boluses, how much, why, how much, you know, and then you really do need to be able to break the package down and make all of the facts as accurate as possible for your benefit.
Scott Benner You know, I just came away from, a an educational thing that I was doing over the weekend where I just, you know, kept hammering into people.
Scott Benner Like, you know, fat changes your digestion. It's important to bolus for it.
Scott Benner You know, this is one of those things. All the fat if you look at the box, there's no fat in this.
Scott Benner And if you don't think about the beef and the and the milk, you know so look.
Scott Benner Here's the deal. Right? You use a pound of 80% lean ground beef, that's 44 grams of fat.
Scott Benner That's So, I mean, a servings a cup, I don't know how much beef you're getting in that or you're not getting in that, but the whole can like, you eat the whole box, this is what it is.
Scott Benner So I think we're just gonna I'm gonna set it up like the whole box, and then we'll we'll do the we'll do the division.
Jenny Smith The math. How many servings per container does it say on the it should.
Scott Benner Serbings size, a third of a cup is packaged, calories, servings per container for, again, they make it really difficult to see the box in a lot of the pictures.
Jenny Smith Because it I would expect as a pasta product, most pasta products are one cup prepared.
Scott Benner Okay.
Jenny Smith Again Wait. It does say that noodle now.
Scott Benner Yeah.
Scott Benner But it does say that on yeah. But you're gonna get some noodles.
Scott Benner You're gonna get some beef.
Jenny Smith Some meat.
Scott Benner Some of the and cheese.
Scott Benner The inundated cheese. I was looking for another pun in there. I couldn't find it.
Scott Benner So alright.
Scott Benner So let's do this. So there's 28 carbs in the box.
Scott Benner There's point five grams of fat in the box.
Scott Benner I'm gonna go with 80% lean and say there's, you know, 44 carbs or or or 44 grams of fat.
Jenny Smith Fat. Yeah. Okay.
Scott Benner In there from the from the beef, but then the milk is going to be let's use whole milk.
Scott Benner That's 16 more. Right?
Jenny Smith For Whole milk would be 8 per one cup.
Scott Benner For a cup, it should be eight more. 48, 49. It'd be So 52. Mhmm.
Scott Benner We're just gonna go insulin to carb ratio.
Scott Benner One unit covers 10. Instant sensitivity, we'll just stick it 50 to 50. Yeah.
Scott Benner Make the we'll make the target 90 for this. Nothing on board.
Scott Benner Current blood sugar, I'm not even gonna put into the mix just so we get a number.
Scott Benner And if you ate the entire box of this with those numbers, 2.8 up front, 4.84 over eight it says over eight hours.
Scott Benner So but 7.6 units to cover the entire thing. But now we're
Jenny Smith gonna be the whole box.
Scott Benner That's the whole box. Right. Now we gotta figure out how many servings or how many cups are in a box.
Jenny Smith Well, and that would depend on, I think, the standard box.
Jenny Smith My expectation would be that the standard box serving would be four or maybe five.
Jenny Smith I'm thinking about a pound of beef plus the pasta in the back.
Jenny Smith I would think it would be at least five servings in a box. Okay.
Jenny Smith Maybe even six.
Scott Benner So if we divided it by six, it's a lot it's a it's a fat low carb meals or or lower it's lower lower carb.
Jenny Smith Sure. It yeah. Yeah. It's lower carb.
Jenny Smith It's definitely going to be a lower glycemic as well with the fat and the protein being heavier parts.
Scott Benner Well, you know what? Let's do it.
Scott Benner Let's just do it if you ate a quarter of the box. Right?
Scott Benner Because that's gonna be fairly easy math.
Scott Benner It takes the carbs from 28 to seven, and it takes what?
Scott Benner The fat down to, like, 10. Excuse me. 12 and a half. Is that right?
Scott Benner One, two, three, four, maybe 13. Right? Don't laugh at me. I really did fall asleep.
Scott Benner I I didn't I was tired.
Scott Benner You know, it's possible my iron might have been low when I was younger.
Scott Benner And now you're I have a disability and you're laughing at me. I hope you're happy.
Jenny Smith I'm not laughing at you. I promise.
Scott Benner So then there with the one to ten and fifty, it's, you know, it's a couple units because you're you know, it's it's just it's seven carbs and and 13 grams of fat.
Scott Benner Am I right? I have that correct?
Jenny Smith How much carb did you break it down into?
Scott Benner I mean, if the box is 28, oh, know what we didn't do? Prepared.
Scott Benner No. You know what we didn't do? We didn't do carbs in a cup of whole milk.
Scott Benner That's what we didn't do. We didn't think about the milk.
Jenny Smith Two cups of whole milk added?
Scott Benner One. Oh, no. Two. Two.
Scott Benner You're a 100% right.
Jenny Smith So 16 grams of extra carb.
Scott Benner Okay.
Jenny Smith Right?
Jenny Smith No. Eight 12.
Scott Benner Yes. So we
Jenny Smith 12 grams per cup, so 12 grams and
Scott Benner 20 this is gonna over because I feel like a moron.
Scott Benner So there's 28 carbs for the box, 24 more for
Jenny Smith For the milk.
Scott Benner For the milk.
Scott Benner So that's now we're to 52, and then no more for the beef, but then Nope.
Scott Benner That that means we also we only used one cup of milk the first time.
Scott Benner So the fat is 44 for the beef, and then
Jenny Smith And another 16 for the milk.
Scott Benner For the milk. Okay. So 60. Right? $44.54 60.
Jenny Smith Mhmm.
Scott Benner And the protein stays at four. Okay. So let's start over again.
Scott Benner 5.2 upfront, 5.56 extended, 10.76 for the whole thing.
Scott Benner Now to split that into a quarter, I mean, I hate doing math in front of people because it makes me feel stupid.
Scott Benner But, well, 15 the fact goes down to 15, right, from 60, if we're gonna
Jenny Smith take a
Scott Benner quarter of it.
Scott Benner And what? Twelve, thirteen for the carbs. Right? 26.
Scott Benner Yeah. About that. Right?
Jenny Smith Carbs carbs are really low in this. Because when you look at the label, it also tells you that it's a third cup it's a third cup dry is 28 grams of carb.
Scott Benner Yeah. Right. Like
Jenny Smith But it also says that that as one cup prepared is also 28 grams of carb.
Scott Benner Yeah. So I the whole way nothing seems right about this is what I'm saying.
Scott Benner We get all but this is my point about doing this live again.
Scott Benner Like, if you're trying to make this for your kid Mhmm.
Scott Benner I 100% believe you're just gonna put in 28 carbs.
Scott Benner And and and 28 carbs is your whole number, and then you're gonna break down about how much you think, and you're gonna end up under you're gonna end up under bolusing for this.
Scott Benner Because the thing we haven't talked about is under the category of not all carbs are created equal.
Scott Benner This stuff hits hard. Like Yeah. You know?
Jenny Smith It can.
Scott Benner Yeah. Yeah.
Scott Benner For some people. And, I mean, if you end up giving somebody a quarter of this, you know, and thinking it's I don't know.
Scott Benner Thinking it's gonna hit, like, that 10 carbs or something.
Scott Benner I don't know.
Jenny Smith You know what would be interesting? You know how you brought up macaroni and cheese, but you also brought up the Velveeta macaroni and cheese?
Scott Benner Go ahead.
Jenny Smith So it's making me think of I wonder if a cleaner visual might be does help Hamburger Helper have any of the little prepackaged?
Scott Benner Oh, I don't know if they do that.
Jenny Smith Just carry be and maybe they
Scott Benner don't Maybe we can think about it differently.
Decoding the Microwave Cups and Flavors
Jenny Smith Because you do typically have to have the meat added and all the other things, but I'm wondering if they have another packaged product.
Scott Benner Oh, they do. I found it, Jenny. Don't worry. Okay. Here we go.
Scott Benner Hamburger helper singles, I typed in. To get the cheeseburger macaroni, it comes in a nice plastic cup so you can throw that in a landfill when you're done.
Scott Benner And, let's see what's in that.
Jenny Smith I could add other things to that, but I won't.
Scott Benner Okay.
Scott Benner Listen. Real oh, it comes with the beef. Is a says
Jenny Smith dehydrated beef.
Scott Benner This is it says real beef inside. I don't think they would lie to us.
Scott Benner So ingredients, specifications
Jenny Smith I don't even want you to read the ingredient list because I can't imagine how long it is.
Scott Benner It's extensive. There's a couple of artificial flavors in it.
Scott Benner There's one, two, three, four, five different oils at least, maybe. It's interesting.
Scott Benner There's vegetable, canola, soybean, sunflower, palm, and or coconut.
Scott Benner What are are some days are they out of one and they just go, extra palm today?
Jenny Smith The other funny thing I know we always, like, go off the rail when we talk about this kind of stuff, but it's kind of fun having somebody else to actually, like, like this.
Jenny Smith My consideration is always, who's the little, like, scientist? Because that's really Yeah. This isn't a gardener.
Scott Benner This isn't a farmer who's outgrowing the best tomato.
Jenny Smith This is a scientist sitting in a lab trying to figure out
Scott Benner How do I make this taste like beef and, yeah, cheese and
Jenny Smith yeah.
Jenny Smith Mix. Oh, that didn't taste quite right. So let's add some soybean oil. Nope.
Jenny Smith That's not quite right. Let's add a little canola oil.
Scott Benner Cooking class, like, twenty years ago, and it was led by a woman whose full time job was that.
Scott Benner That's what she did. Actually, if anyone's listening who does that, please come on.
Scott Benner I would love to understand that. Oh, seriously.
Scott Benner Oh, I really wanna find somebody who does that.
Scott Benner Can I just read you a review of the Please? Hamburg helplessness? It's five stars from Regina.
Scott Benner Hey, Regina.
Scott Benner If you left this on walmart.com, the headline is not perfect, but edible and enjoyable.
Jenny Smith I'd like to know what wasn't perfect given the man.
Jenny Smith The heck
Scott Benner This is great for a quick lunch or even a midnight snack.
Scott Benner It doesn't really taste like stovetop hamburger helper, but is completely edible and enjoyable.
Scott Benner Did not boil over like some of the other reviewers said. That person probably prepared it wrong.
Scott Benner A little shaming in there for the other person who microwaved the hamburger helper cup the wrong way.
Scott Benner I liked it, and I will purchase it again. It's very well written.
Jenny Smith It is quite well written for a package, but I'm curious the nutrition facts because it is all put together.
Jenny Smith You have to put nothing in this probably except water. Right?
Scott Benner That's that does seem to be what's happening here. Do you wanna hear a one star review?
Scott Benner Sure. A salty mushy overpriced disappointment. The who wrote who?
Scott Benner This was an absolute failure on every level. First, the taste overwhelmingly, punishingly salty.
Scott Benner There was no pleasant bite or texture whatsoever. Just a homogenous sloppy goo.
Scott Benner The instructions are a lie.
Scott Benner Even following them exactly results in overcooked noodles swimming in a thin yet oddly sticky sauce.
Scott Benner Save your money and your taste. Can I just say I'm sorry?
Scott Benner I'm who the fuck buys this and then expects it not to be something like this?
Scott Benner Like
Jenny Smith That is a 100% my consideration. For one, what did you what did you expect?
Scott Benner I mean, what did you what did you think was gonna happen?
Jenny Smith And then you took the extra time to actually put your thoughts down.
Scott Benner And they're so well written. Like, this is a well thought out review. Terry, 01/09/2026.
Scott Benner What's up? Oh, if you love messes, this is for you.
Scott Benner Do you think they mean the toilet or the cup?
Jenny Smith Or I think they are referring to the first one who gave it five stars and said, clearly, they cooked it wrong.
Scott Benner Not good. Not much flavor.
Jenny Smith Probably boiled a bit over.
Scott Benner Here's my favorite one from Mimi. What is this white stuff?
Jenny Smith It's a good question.
Scott Benner I read the directions, removed the seal and the flavor packet, filled with water to the line, started stirring the macaroni, and white pieces began to appear.
Scott Benner More stirring led to more pieces. I found the inside of the foam cup was coming off so gross.
Scott Benner The cup was she did throw it away. Good for you, Mimi.
Scott Benner Way to make a stand. I so hope that the last sentence of that was I still waited.
Scott Benner It wasn't bad. We didn't do what you wanted to do though when we found this.
Scott Benner Hold on a second.
Jenny Smith Wow.
Scott Benner I by the way, I know we keep saying this, but, like, I'm not above this.
Scott Benner People in my family Jen Jen Jenny's not eating this in in you know, you'd probably have to shoot her to get her to eat it.
Scott Benner But, like, I'm saying that, like, I'm sure something like this is in a cabinet downstairs in my house.
Scott Benner And I understand being in a rush and trying to make something quickly and everything.
Scott Benner I really I genuinely do.
Jenny Smith Sure.
Scott Benner But I still want you to know what it is when you're eating it.
Scott Benner We can all agree it's crazy and eat it at the same time.
Scott Benner Arden made ravioli the other day, chef Boyardee, and she took three bites and she goes, what is this?
Scott Benner And I was like, what? She goes, it does not taste like ravioli.
Scott Benner And I said, what's it taste like? I'll try it.
Scott Benner I came over and I put a couple pieces in my mouth.
Scott Benner I said, this tastes exactly like chef Boyardee ravioli. She goes Uh-huh.
Scott Benner But it doesn't taste like ravioli. I said, no. It doesn't.
Scott Benner But this is what this tastes like. I said, I know because I I was raised on this.
Scott Benner These cans were 45¢ when I was a kid. That's you know? Mhmm.
Scott Benner This is what I got. So
Jenny Smith Yeah. Anyway I remember what were they? SpaghettiOs.
Scott Benner Oh, you get meatballs or no meatballs?
Jenny Smith Oh, god.
Jenny Smith Jenny,
Scott Benner you didn't get the meatballs?
Jenny Smith Oh, god. No. Oh my god.
Jenny Smith I think I had the meatballs only once, and literally, I wouldn't eat the entire I wouldn't eat the rest of it.
Jenny Smith Was like, I don't know what this is.
Jenny Smith This is not meat.
Scott Benner Let me offer the alternative view of that.
Scott Benner I thought the meatballs were the best part of the spaghetti.
Jenny Smith You're like, give me all the meatballs.
Scott Benner Didn't like the sauce in spaghettios.
Jenny Smith Oh.
Jenny Smith It was different. You know, weirdly, I only had them when I went to a particular friend's house of mine.
Scott Benner Mhmm.
Jenny Smith Her mom was not a cook.
Jenny Smith She did the best that she could, but she was not a cook. Right.
Jenny Smith So SpaghettiOs were or mac and cheese out of a box. Those were the typical thing.
Scott Benner Yeah.
Jenny Smith But I was always excited to get the SpaghettiOs, and I always I remember as a kid, I was having higher hopes for what it would taste like the next time I had it.
Jenny Smith Oh. And it
Scott Benner It never It
Jenny Smith never ever
Scott Benner was for you.
Jenny Smith Better, but I can remember, like, the feeling of the noodle, which was very, like was like a rubbery instead of being, like, a real noodle.
Scott Benner If you're a regular if you were accustomed to a real noodle, you're definitely not getting what you were what you were hoping for.
Jenny Smith But I think I like I like the sauce is what I like.
Scott Benner Oh, you like the sauce. Anyway. Look at you fancy.
Scott Benner By the way, right about now, Rob is editing this, and he's saying, these are supposed to be short.
Scott Benner I know, Rob.
Scott Benner I'm sorry, man. Use it as a longer one.
Scott Benner Put ads on it and and make it a longer one for the week.
Scott Benner I don't know
Jenny Smith what Jenny to tell eats SpaghettiOs. There you
Scott Benner go.
Scott Benner So I did I googled hamburger helper pasta cheeseburger macaroni two ounce microwavable cup.
Scott Benner By the way, part of the title is shelf stable nutrition label.
Scott Benner And I wanna say that this is the Google return AI overview return from it. It says Okay.
Scott Benner 220 calories, total fat four, saturated fat two, cholesterol 10, sodium seven twenty well, that's a lot of sodium in a little cup.
Scott Benner Mhmm. Total carbohydrates 36. Wow. Dietary fiber, one.
Scott Benner Sugar's five, including zero added.
Scott Benner Protein, nine. There's a lot of calcium in it. A hundred and twenty milligrams of calcium.
Scott Benner Why does the what about this shelf save stable adding the meat puts the carbs up so much?
Scott Benner You understand what I'm saying?
Jenny Smith Well, that's why I think that the breakdown for the box product, it cannot be correct.
Scott Benner Okay.
Jenny Smith The breakdown, we it's got to be something there's something that we did incorrectly in terms of adding because as a comparative product, I'm assuming that this is maybe it's maybe the package here is also a little bit more than a cup portion once it's cooked.
Jenny Smith I don't know. Yeah. There has to be something off about
Scott Benner Yeah.
Jenny Smith The servings in the box that we counted. I'm just trying to think through yeah.
Scott Benner I'm trying to think
Jenny Smith My brain.
Scott Benner I keep thinking. It's fine.
Scott Benner I we can keep going more carbs than the box prep that you add carbs to add beef to.
Jenny Smith And then protein. How much protein was in the in the meat?
Jenny Smith Because there wasn't a lot in the prepared product. Right?
Scott Benner Four in the box.
Scott Benner What about you're asking about the shelf stable one?
Jenny Smith No. For the box one, there was only four grams per portion.
Scott Benner Yeah.
Scott Benner But there's nine in this in the whole in the cup.
Jenny Smith And that's interesting.
Scott Benner Yeah.
Scott Benner So it's just I I I I don't know.
Scott Benner I think this is part of this series because I don't know how you're supposed to figure all this stuff out.
Scott Benner Also, by the way, when you're making Hamburger Helper, you're making it for one of two reasons.
Scott Benner Well, and the biggest reason is probably Yes.
Scott Benner Convenience.
Scott Benner And now I'm sitting around like an Einstein with numbers floating over my head trying to figure out how to bolus for this thing.
Scott Benner I figure you're gonna have to throw in some insulin and, you know, see how it goes.
Scott Benner And then next time, just adjust off the off your historic number.
Scott Benner It's I'm sure that's how I do it, to be perfectly honest, with stuff like this.
Jenny Smith Is an estimate. Absolutely. Yeah. It's an estimate of yeah.
Scott Benner Alright.
Scott Benner Let's see if we can figure out who wrote the Hamburger Helper jingle before we go.
Scott Benner Hamburger helper helps your hamburger helper make a great meal. It's brilliant. It's really brilliant.
Jenny Smith The fact that you have it memorized is hilarious.
Scott Benner I know the tune.
Scott Benner I just wanna say. I can't sing, but if I could sing, you would know that I I understand the tune of this and everything.
Scott Benner So I asked I asked the our overlords
Jenny Smith Okay.
Scott Benner Why would the one cup with the meat included have more carbs than the pasta only box that we add to?
Scott Benner And I mean, listen. It says the standard serving size for box is 42 grams.
Scott Benner The microwave cup is 57 dry product because you're staring at meat factor.
Scott Benner When you make the box, you're adding a full pound of fresh carb free meat.
Scott Benner This heavily dilutes the carbohydrate ratio in the fine meal.
Scott Benner You get a huge filling portion without the in the microwave cup.
Scott Benner Oh, it says the meat in quotes consists of freeze dried beef bits that weigh almost nothing because there isn't much actual meat volume.
Scott Benner The vast majority of the 57 gram cup, has to be made up of carbohydrate heavy ingredients like the macaroni carb.
Scott Benner So this is saying maybe you're getting more noodles than meat in the prepared
Jenny Smith cup. Prepared one.
Scott Benner Because how are they really getting meat in that cup?
Scott Benner And maybe you're filling up on the beef in the other one and not getting as many noodles when you scoop the cup out.
Scott Benner That's not a crazy consideration.
Jenny Smith No. Not at all.
Scott Benner Yeah.
Scott Benner I thought it was gonna be some I actually thought it was gonna be some chemical thing.
Scott Benner I really did for a second. Alright. Ready?
Scott Benner Cool.
Scott Benner The classic seventies and eighties TV jingle, like a lot of famous retro commercial music, the original campaigns including the famous hamburger helper helped her hamburger.
Scott Benner Oh, it's help her hamburger. They changed it to your when they got older because they don't wanna be sexist.
Scott Benner But it used to say hamburger helper helped her hamburger make a great meal slogan were created collaboratively by the Chicago advertising agency Needham, Harper, and Steers.
Scott Benner Joel Friedman, this ad copywriter, penned a massive chunk of the iconic musical Hamburger Helper Jingles through the eighties.
Scott Benner He wrote the catchy thirty second parody songs for various flavors, which usually featured the mascot singing to the camera.
Scott Benner Right? The little hand, the glove with the hat on.
Scott Benner And Mike Caffatera, he is the ad executive who invented the singing four fingered white glove mascot in 1977, originally called the helping hand.
Scott Benner The mascot is now affectionately known as Lefty.
Scott Benner Oh, in 2016, there was a a viral rap mixtape of it.
Jenny Smith Of course, there was.
Scott Benner I know I know Jenny better than all of you, but of course, there was means what in the hell is wrong with everybody?
Scott Benner Get a job and stop writing a rap jingle to the hamburger helper.
Jenny Smith Kim, go help somebody.
Jenny Smith I don't know. Help somebody instead.
Scott Benner Hi, Jenny.
Scott Benner I don't know what we just let's let's put a bow on this. Oh.
Scott Benner So I'm gonna use I think this is
Jenny Smith the funny I think this is even better than the McDonald's one.
Scott Benner Don't know. That McDonald's one was was pretty great.
Scott Benner Also, I have not been to McDonald's since then.
Scott Benner I just wanna know it didn't trigger me into, like, going to McDonald's, which I was proud of.
Scott Benner Because the other day, somebody showed me one of those marshmallow peeps, and I thought, oh, I'm gonna have a marshmallow peep.
Jenny Smith Yep.
Scott Benner So, you know, you get the I mean, listen.
Scott Benner Also, the jingle thing makes a great not not a great meal, but it makes a great point.
Scott Benner There are a ton of different Hamburger Helper flavors.
Jenny Smith I'm sure there are.
Jenny Smith I I mean quite sure that they probably also hit most of the traditional flavor preferences.
Jenny Smith I would guarantee that there's probably a taco y kind of one. There's
Scott Benner cheesy enchilada.
Scott Benner Are you cheating? How did you know that?
Jenny Smith I I'm guessing based on the food types people.
Jenny Smith I'm guessing there's an Italian one of some kind.
Scott Benner How about Salisbury steak?
Jenny Smith Interesting.
Jenny Smith I
Scott Benner could talk lovingly for an hour.
Jenny Smith Salisbury steak?
Scott Benner About a hungry man Swanson's Salisbury steak with those fake potatoes in it.
Scott Benner I wish you all could
Jenny Smith have I know you like
Scott Benner I wish you all could have grown up as poor as I was.
Scott Benner Cheeseburger macaroni, hamburger helper, Salisbury, cheesy enchilada, double cheeseburger macaroni, double deluxe beef stroganoff, cheesy ranch burger, cheesy Italian shells, beef pasta, four cheese lasagna.
Scott Benner I said stroganoff. I think I might have gotten to the end of it. Oh, excuse me.
Scott Benner Tomato basil penne, deluxe Philly cheesesteak, three cheese, potatoes stroganoff. My god. This never ends.
Scott Benner How about, Jenny, Hamburger Helper breakfast cheesy hash browns, chicken fried rice ham.
Scott Benner They got a whole offering here.
Scott Benner Tuna cheesy pasta?
Jenny Smith Do they have, like, a pad Thai kind of?
Jenny Smith Well, I'm just trying to think of all of the different, like, flavor preferences.
Scott Benner Tuna cheesy pasta, tuna creamy broccoli. I bet you there's no broccoli in that.
Jenny Smith Either that or you have to add it maybe.
Scott Benner Oh, that's interesting. Tetrazzini.
Scott Benner Tuna helper Tetrazzini. This goes on forever. Double deluxe Philly cheesesteak.
Scott Benner Deluxe beef stroganoff.
Scott Benner I think sometimes they just write the word deluxe on the box.
Jenny Smith I wonder if it actually indicates
Scott Benner A difference?
Jenny Smith A fat like a fat component that might be added maybe. Oh.
Jenny Smith Like, maybe you have to add butter to it or you have to add, like, heavy cream.
Jenny Smith Do you know what I mean? I do know what you deluxe.
Jenny Smith I would expect it's a little bit more, like, luxurious to the tongue.
Scott Benner Did you say luxurious to the tongue?
Jenny Smith I did.
Scott Benner Stop it. It's ridiculous.
Scott Benner Hold on a second. Let's click on double cheeseburger cheeseburger cheeseburger macaroni just a minute to see what changes.
Scott Benner Total carbs, 24.
Scott Benner No fat. Unprepared. It looks exactly the same as the other one.
Scott Benner So what do you do? You put more stuff in it?
Scott Benner Hold on a second.
Scott Benner Cook the ground meat in a 12 inch skillet. It does say to drain the ground meat.
Scott Benner God bless. Stir in water, milk, sauce mix, and pasta.
Scott Benner Heat to boiling. Reduce cover.
Scott Benner Yeah. I don't think it's pound oh, it just calls for a pound and a half of ground beef instead of a pound and three and a third cups of milk.
Scott Benner So it's deluxe when you put more stuff in it.
Scott Benner So that means I could just buy if this is more expensive than the regular one
Jenny Smith Then you might as well just look at the recipe and take the recipe and add add it to the regular one and
Scott Benner Scam if that's if that is.
Scott Benner Oh, brilliant people. People know how to steal your money, don't they? That's a thing for sure.
Jenny Smith Funny.
Scott Benner Alright, Jenny. Well, I gotta tell you, as I've said previously, I've grown up very poor.
Scott Benner I could never get Hamburger Helper, I can't get it down.
Scott Benner Like, it make the smell of it hits me right in the pit of my stomach.
Scott Benner I can't get I can't get close to it even.
Scott Benner So on Hamburger Helper nights, oh, this is gonna get sad.
Scott Benner They made me eat, leftovers or, like, they wouldn't cook me something else.
Scott Benner Or if I and if I didn't want any of that, I just didn't really get dinner.
Scott Benner So anyway
Jenny Smith You couldn't make yourself a peanut butter sandwich I don't like on your white bread?
Jenny Smith I don't like peanut butter. Oh,
Scott Benner okay. No. I would
Jenny Smith usually I know that.
Scott Benner Yeah. I don't like peanut butter, and I would probably tell you I probably haven't had a tablespoon of it in my entire life in total totality.
Scott Benner Wow. I don't there's something about the thick grittiness of it.
Scott Benner I don't I I'm not interested in.
Jenny Smith That's okay.
Scott Benner Yeah.
Scott Benner Anyway, left out a lot of candy bars when I was a kid. I'll tell you that much.
Scott Benner Because they all had those peanuts in them.
Jenny Smith Peanuts.
Scott Benner I also don't like when you bite a peanut, that dry feeling that they have. Oh.
Scott Benner You know how they mash dry in your teeth? Oh. Mhmm.
Scott Benner Oh my god.
Scott Benner I'm gonna go now before you start judging me. Goodbye.
Jenny Smith Okay. Goodbye.
Sponsor Outro
Scott Benner This episode is brought to you by Omnipod.
Scott Benner Would you ever buy a car without test driving at first?
Scott Benner That's a big risk to take on a pretty large investment. You wouldn't do that. Right?
Scott Benner So why would you do it when it comes to choosing an insulin pump?
Scott Benner Most pumps come with a four year lock in period through the DME channel, and you don't even get to try it first.
Scott Benner But not Omnipod five. Omnipod five is available exclusively through the pharmacy, which means it doesn't come with a typical four year DME lock in period.
Scott Benner Plus, you can get started with a free thirty day trial to be sure it's the right choice for you or your family.
Scott Benner My daughter has been wearing an Omnipod every day for seventeen years.
Scott Benner Are you ready to give Omnipod five a try?
Scott Benner Request your free starter kit today at my link, omnipod.com/juicebox. Terms and conditions apply. Eligibility may vary.
Scott Benner Full terms and conditions can be found at omnipod.com/juicebox.
Scott Benner Find my link in the show notes of this podcast player or at juiceboxpodcast.com.
Scott Benner Arden has been getting her diabetes supplies from US Med for three years. You can as well.
Scott Benner Usmed.com/juicebox or call (888) 721-1514.
Scott Benner My thanks to US Med for sponsoring this episode and for being longtime sponsors of the juice box podcast.
Scott Benner There are links in the show notes and links at juiceboxpodcast.com to US Med and all of the sponsors.
Scott Benner I can't thank you enough for listening. Please make sure you're subscribed or following in your audio app.
Scott Benner I'll be back tomorrow with another episode of the Juice Box podcast.
Scott Benner My diabetes pro tip series is about cutting through the clutter of diabetes management to give you the straightforward practical insights that truly make a difference.
Scott Benner This series is all about mastering the fundamentals, whether it's the basics of insulin, dosing adjustments, or everyday management strategies that will empower you to take control.
Scott Benner I'm joined by Jenny Smith, who is a diabetes educator with over thirty five years of personal experience, and we break down complex concepts into simple, actionable tips.
Scott Benner The diabetes pro tip series runs between episode one thousand and one thousand twenty five in your podcast player, or you can listen to it at juiceboxpodcast.com by going up into the menu.
Scott Benner If you're looking for community around type one diabetes, check out the juice box podcast private Facebook group.
Scott Benner Juice box podcast, type one diabetes. But everybody is welcome.
Scott Benner Type one, type two, gestational, loved ones, it doesn't matter to me.
Scott Benner If you're impacted by diabetes and you're looking for support, comfort, or community, check out Juicebox podcast, Type one Diabetes on Facebook.
Scott Benner If you have a podcast and you need a fantastic editor, you want Rob from Wrong Way Recording.
Scott Benner Listen. Truth be told, I'm, like, 20% smarter when Rob edits me.
Scott Benner He takes out all the, like, gaps of time and when I go, and stuff like that.
Scott Benner And it just I don't know, man. Like, I listen back and I'm like, why do I sound smarter?
Scott Benner And then I remember because I did one smart thing. I hired Rob at wrongwayrecording.com.
#1810 Best of Juicebox: Owner of a Useless Pancreas
Your pancreas isn't dead. It actually still does some important stuff. Today Jenny and Scott explain what your pancreas does and what it may be struggling with that isn't insulin related.
Companies that Support Juicebox
Key Takeaways
- The Pancreas Does More Than Make Insulin: While Type 1 diabetes halts the pancreas's endocrine function (making insulin), its exocrine function (producing digestive enzymes) can also be impaired. Poor digestion might not be "just a stomach ache"—it could be an enzyme deficiency.
- Digestive Enzymes as a Missing Link: If you or your child with T1D experience chronic constipation, severe stomach pain, or slow-digesting meals that mess up your bolus timing, over-the-counter digestive enzymes (like lipase, amylase, and protease) might offer significant relief.
- Don't Accept "In-Range" for Thyroid or Iron if You Have Symptoms: If you're experiencing extreme fatigue, an "in-range" Ferritin level under 70 or a TSH over 2.0 might still be the culprit. Push your doctor for therapeutic treatments (like an iron infusion or thyroid meds) rather than accepting a technical "in-range" dismissal.
- Treat the Root Cause, Not the Symptom: Doctors often prescribe medications to cover up symptoms (like pain pills for stomach aches) rather than investigating the root cause (like poor digestion or absorption issues). Advocate for comprehensive testing.
- Gut Health Impacts Overall Autoimmune Health: A compromised digestive system can increase systemic inflammation and trigger or worsen other autoimmune conditions (like celiac or thyroid issues). Maintaining a healthy gut is a crucial part of managing T1D.
Resources Mentioned
- T1D Exchange Survey: t1dexchange.org/juicebox
- Dexcom G6: dexcom.com/juicebox
- Omnipod (Dash and 5): omnipod.com/juicebox
- Integrated Diabetes Services: integrateddiabetes.com
- Figwee App
- Juice Box Podcast Episode 767: Arden's Supplements
- Juice Box Podcast Episode 413: Thyroid Symptoms Explained
Introduction and the Role of the Pancreas
Scott BennerHello, friends, and welcome to episode 792 of the juice box podcast. Do you wanna know what it's about? I'll tell you in just a second. It is likely that you've seen a t shirt that says owner of a dead pancreas, owner of a useless pancreas, my pancreas quit on me, or, you know, any number of variations of that theme. Well, yeah, I hear what you're saying. Feels like that. Right? Won't make you any insulin, but maybe you didn't know that the pancreas does more than that. So even if it's not making insulin for you, it's still helping you with something else that's very important. But for some people, it doesn't do that thing perfectly. Just listen. We're gonna go over the whole thing. It's very important that you understand what your pancreas does and what it might not be doing. And if you're seeing symptoms of that, how you can help yourself. You're gonna love it. And, of course, Jenny's here. So, I mean, even if I suck, Jenny's amazing. 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. That's pretty much it. Except, hey. Don't forget to go to the t1dexchange and take the survey. T1dexchange.org/juicebox. Today's episode of the podcast is sponsored by two longtime advertisers. Dexcom, makers of the Dexcom g six continuous glucose monitor, and Omnipod, the insulin pump that my daughter has been wearing since she was four years old. To learn more about the Dexcom g six and to get started today, go to dexcom.com/juicebox. And if you're interested in the Omnipod five or the Omnipod dash, you can find out about both of them at omnipod.com/juicebox. Now we get to the show. And Jenny, who by the way works at integrateddiabetes.com. Hey. Hold on. Yeah. What's up?
Jenny SmithHow are you feeling?
Scott BennerMy head's a little swimmy, but I can breathe.
Jenny SmithThat's not good. I was gonna actually see if you wanted if you were okay to do this this morning or if you wanted to sleep until noon.
Scott BennerWell, what I thought was if I could do this, then I could do the thing later. Because if this doesn't go well, I gotta make a phone call.
Jenny SmithGotcha.
Scott BennerBut, hey, I was cold all night, like, kind of like
Jenny SmithI can't get warm, like, insert.
Scott BennerOh my god. Why won't I warm up? Then you but I don't know. It's it's super strange. I have no restriction in my lungs whatsoever. But if I start to cough on purpose, then it feels like something's happening. So, hopefully, that won't get worse. Jenny, you have no idea. I am
Jenny SmithI'm sorry.
Scott BennerI don't get sick.
Jenny SmithThanks. I know you told me that the last time we talked. You're like, I'm fine. I don't get sick.
Scott BennerAnd I blew right through.
Jenny SmithNothing ever happens to be cough on me.
Scott BennerIt'll be fine. This thing, I texted my buddy yesterday. He's a doctor. And I said, what's going around that isn't COVID?
Jenny SmithHe
Scott BennerRSV. Goes Is that what it is? Yeah. Yeah. Because he's
Jenny Smithlike I've had so many kids, so many parents. Like, I'm home with my kids. I hope you don't mind. They're screaming in the backyard. They all have or in the background while we talk. They all have RSV. One lady, actually, their whole daycare shut down because three quarters of the daycare had r s RSV. So yeah. You know?
Scott BennerYeah. He's like, it's gonna be head, chest, tired, could last ten days or more, he said. I was like, oh, good. So as I'm asking him that, my son comes home from a place he went. He's like, I'm not okay. And I was like, alright. I was like, get in bed, loaded him up with some Advil, cold and sinus, which seems to clear the head thing. So, anyway, we just need to be better because I'm gonna find a way to go to the World Series. And I I know
Jenny SmithYou are.
Scott BennerI mean, if I can. I'm gonna figure it out if I can. Alright.
Jenny SmithWell, you know plenty of people. I'm quite sure that somebody would probably be very happy to give you tickets, Scott.
Scott BennerI've already floated that on the Internet to see what might happen. So I was like I said, how would you like your kid to have amazing blood sugar?
Jenny SmithYes. Kind of like runs with Jenny. Right?
Scott BennerRuns with Jenny. Oh my god. Yes. She did. What so tell me but we'll leave this all in. Tell me what happened yesterday.
Jenny SmithOh, yeah. It was it's just I it's just funny. I call it diabetes in the wild. Right? Where you, like, you find people or you see their tubing or you see something on someone, you know, whatever. So, yeah, I had a half marathon yesterday running, running, running. It was, like, mile five ish, I think. Mhmm. And I hear like, I always run with only one earbud in
Scott BennerYeah.
Jenny SmithBecause I I I don't like complete, like
Scott BennerMhmm.
Jenny SmithNot being able to pay attention. Anyway, I hear this, like, really stompy feet coming. They could be high, and somebody's, like, breathing heavy to the to the point that I knew that they were running quickly. And this woman, like, speeds up next to me, and she's like, I was trying to catch you. I saw your Dexcom on your arm. And I was like, oh, yeah. She's like, I have a little girl who's, had type one a long time, and she did yes. It was like a two day sort of event. Yesterday was like the five k, the five k dog, jog, and that kind of stuff. And then the day yesterday was the half marathon, and then the kids, like, fun run.
Scott BennerMhmm.
Jenny SmithSo her daughter had done the five k the day before on Saturday. And she's like, you know, I thought we're we're all good, and then she's like, double arrowing down at the end of the event. She's like, I just wanted to know how do you prevent low blood sugars while you're running, she said. And this is a half marathon, not a five k. So we got to talking and, you know, it was just it's always fun to to, like, be able to share and whatnot. And I said, well, I said, to be honest, I've been doing this a long time. And two, I'm a diabetes educator. And three, you should really listen to this super awesome podcast.
Scott BennerJenny's out there selling. I like that.
Jenny SmithBut, yeah, we got to talking and just like some ideas. She's her daughter's also just a couple of days into Omnipod five. Mhmm. So, like, lots of variables in the picture there for this race, that's you know, she's like, we've been doing this a number I her daughter had had type one already for six years. They're not like newbies by any means, but just new technology and everything in the picture and just trying to figure things out.
Scott BennerNew algorithm Yeah. And three days later on a marathon.
Jenny SmithYeah. Yeah.
Scott BennerLook at you out there in the world. It was it
Jenny Smithwas it's always it's always fun. Excellent. You know? We
Scott Benneralright. Cool. So here's what we're gonna do today because just in case I don't leave in the explanation, I have the illness upon me. And I'm going to see I'm gonna keep the one topic today because I think jumping around might get me. I'm gonna stick the one thing.
Jenny SmithSo Now people are gonna think, well, what kind of illness does Scott had? Because all you said was the illness. Yes.
Scott BennerI know it's
Jenny SmithIt could be a random whatever is going around. Right?
Scott BennerHere it is. It it's a I was sleeping in bed on my side and I was I woke up and I'm like, oh, I'm very tired. I should text Jenny and tell her no. I'm like, no. I'm not gonna do that. I'm gonna get up. I'm gonna take a shower. I'll take the dogs out. I can do this. My voice is there. I'm gonna be okay. And I got up and I was like, oh, I'm freezing.
Jenny SmithLet's get back in bed.
Scott BennerI put all my clothes on. I had my hood up to take the dogs outside. I came back upstairs. I I I'm not a person who prepares before a shower. That might be a thing that women don't understand, but I usually get out of the shower and then look for my clothes. But this time, I got all my clothes together because I'm like, I'm not getting out and being cold.
Jenny SmithRight.
Scott BennerI finished my shower. I opened the shower curtain, and I did not get a towel.
Jenny SmithOh, no. So I was like,
Scott Bennerdamn it. Damn it. And I got a towel, and now I'm freezing and threw the clothes on. And then I just did something I never do. I I had fifteen minutes till we had to do this. I just sat down. I was like, I'm just I'm not I'm just gonna sit here. So I'm wearing a sweatshirt right now. By the time we're done, I could be in a tank top. I have no idea how this is gonna go. But what we're going to do today
Jenny SmithYeah.
Scott BennerWe are going to debunk the classic diabetes phrase, owner of go ahead, Jenny. Finish it.
Jenny SmithA dead pancreas.
Scott BennerThat's right. It is time to debunk owner of a dead pancreas. And it there's so I've got my Google. Foo is all done because I don't wanna be wrong. And I but I have a lot of anecdotal information about this.
Jenny SmithOh, good.
Scott BennerSo let's start here. The Cleveland Clinic, a reputable organization.
Jenny SmithYes. Very reputable.
Scott BennerI mean, it would I was gonna say it would have to be great to be in Cleveland, but let's not do that. The pancreas is an pancreas is an organ in the back of your abdomen. It is part of your digestive system. Oh. Mhmm. The pancreas is an organ and a gland. Glands are organs that produce and release substances in the body. Mhmm. The pancreas performs two main functions, an exocrine function, which produces substances, enzymes that help with digestion.
Jenny SmithYou just had lots and lots of enzymes talking about Arden in her supplements. So, yes.
Scott BennerAnd it so I'm gonna there's one more thing here. Let me finish this. It says the endocrine function sends out hormones that control the amount of sugar in your bloodstream. So let's tell people what's in the exocrine system. Oh, Jesus. Tear glands, mammary glands, mucous membranes, your prostate, your salivary glands. I don't know this one. Sebaceous glands?
Jenny SmithSebaceous.
Scott BennerSebaceous oil, sweet glands. And then what is in the endocrine system? Adrenal glands, uh-oh, hypothalamus, ovaries and testes, parathyroid and thyroid gland, pineal gland, pituitary gland, thymus.
Jenny SmithMhmm.
Scott BennerOh, I did really well with the pronunciations, didn't I?
Jenny SmithExcept you called them sweet glands instead of sweat glands. Oh my god. I'm gonna I was totally chuckling. Like, you're like, yeah. You have a fever, I think. Well,
Scott Bennerfirst of all, I do. And but for a person who's, you know, trying to sit up and keep his head still, I thought I did okay there. Okay.
Jenny SmithYou did perfect.
The Gut and Digestive Issues in T1D
Scott BennerYeah. Thank you, sweat glands. Alright. Now the extent that I've seen this in the diabetes community is just this. People have t shirts that say proud owner of a useless pancreas, proud owner of a dead pancreas. And then someone else will come up to them and say, your pancreas does more than make insulin. And then it never goes anywhere from there.
Jenny SmithRight.
Scott BennerBut I've heard that conversation for the better part of the entire time that Arden's had diabetes. And yet, when Arden had problems with digestion, we looked at every other possibility in the world about why her stomach might hurt except for digestion. And she suffered for a couple of years.
Jenny SmithYeah. Yeah. You looked at her digestive system without looking at the pieces that help digestion. Right? It's it's like looking at just the part or giving, which is very common. I have to say it. Oftentimes, you go in with a symptom and you get a medication to take care of the symptom, but the problem is never addressed.
Scott BennerYes. Right? And I can for sure say that because by the time we broke down, and I wanna give my wife credit, my wife tried to get me to take her for a endoscopy for like a year. Mhmm. And I was so certain because of the joint pain and that other stuff, I thought I was so certain it can't be that. But now I'm here to tell you that I am I am fully down the hippie rabbit hole about your gut health. And we're gonna talk about that now too. So I I it's one don't you think it's one of those things most people hear? And they're like, yeah. Yeah. Yeah. My problem is that.
Jenny SmithYeah. It's very it is. I mean, you say hippie. It's kind of earthy, crunchy, sort of whatever. But truly, I mean, your digestive system is an enormous part of your immune system.
Scott BennerMhmm.
Jenny SmithIt's an enormous part of you think you think digestion and you think about poop. At least my boys do. Right? Like, they're little kids, so whatever. But if you think about what your digestive system is really supposed to be doing, it's breaking down the food that you've eaten into macronutrients, fats, proteins, carbs
Scott BennerMhmm.
Jenny SmithAnd then it helps to absorb them the right way and put them back into the body, at least the ones that you hope go back into your body.
Scott BennerYeah.
Jenny SmithRight? So if the breakdown isn't happening the right way, you're gonna end up with a lot of digestive issues possibly first or later on. And you're also gonna have a lot of other things in your body that aren't functioning the way that they're supposed to be functioning. But there again, it comes off as a symptom. You may feel the joint pain. You may have an off monthly cycle, or you might have this or that, but it never comes back to, well, gosh. Is it an absorptive issue? Is it another problem with another, like, you know, the the pancreas? Is it something else? So
Scott BennerAlso, while your stomach is basically acting as I'm gonna just say something terrible here, a cesspool for food because it is not going through you quickly enough. Right? It just stuff is sitting in there and it's festering. It is not a healthy environment. The bad bacteria overwhelms the good bacteria. And then you slide down like a it's just an endless shoot. But the problem is, this is crazy. If you look back over the 700 and some episodes of this podcast, we've hit every idea around this except the idea of digestion. We have episodes two sixty three, fat and protein, four seventy one, bolus insulin for fat. And there you go. Like, right, what do most people see? A spike after a meal, and it's probably because their digestion has slowed down. Right? The insulin don't you know, that's how I start thinking about it. Like, if you if it takes longer to digest fat, then your insulin gets in and it's gone while the fat still remains behind and the carbs holding up your blood sugar. And then we attack that from a bolusing standpoint, which makes sense. And then low carb people come in yelling, it's because you eat bad food and they're probably not wrong, but it doesn't get us to the answer.
Jenny SmithIt doesn't and and it also doesn't get to the mean point which, you know, you have long and we've emphasized when we've talked together, it is about a timing thing and understanding insulin. Right? So if you it's it's a multi piece thing that you have to put together. Right? You have to understand, and that's why we've talked about bolus strategizing for fats and proteins versus carbohydrates and the timing of it and what it should look like. But if you've got some other things that are going on digestively that are based on how your enzymes are working with the food, some of that may also be playing in. Mhmm. And, I mean, again, it sort of leads you into this rabbit hole of consideration.
Scott BennerYeah. Well, here's the rabbit hole. We Arden goes finally to get an end what am I saying? Endoscopy. And the doctor first, I'm gonna read you first, I'm gonna read you a a definition. Then we're gonna talk about
Jenny Smiththe doctor. Okay.
Scott BennerGastroparesis is a condition that affects the normal spontaneous movement of the muscles or motility in your stomach. Ordinarily, strong muscular contractions propel food through your digestive tract. You'll notice that the definition for gastroparesis never mentions the word diabetes. Because in a normal person who doesn't have diabetes, if you had slow digestion, they would say to you, oh, you're digesting your food slowly. It's called gastroparesis. When we hear the word gastroparesis, we think, oh my god, here it comes. Right? Diabetes has gotten us and and and here it is. So we we do the we go to the we go to the doctor. He doesn't know Arden. We tell him her blood sugars are very well controlled. Here's the range it's in. And then I realized, he probably doesn't believe us. Didn't ask to see it. And then he goes in, looks in her stomach, and finds food from the night before. He's like, there's lettuce in Arden's stomach from twelve hours ago. She has gastroparesis. Mhmm. So my wife and I are like, woah. Woah. Like, it it hit you like a ton of bricks. You know? Yeah. And and I was like, what what? And then my wife started saying, I think he's just he it's and and we're just doing that, going back and forth and back and forth. And we talked about it. I talked about it. I did a standalone episode seven sixty seven called Arden supplements. But just for thirty seconds here, we went home. I called Jenny. We talked about how to get Arden on a, on a, what is it, a gastroparesis diet. Right? That's what they call it?
Jenny SmithThat's yeah. For lack of a better word. Yes.
Scott BennerRight. Yeah. And all of a sudden, Arden couldn't eat anything with skin on it. She couldn't you know, had to avoid protein. She anything that was difficult to digest well.
Jenny SmithAnd and even I said and now I am not a gastroenterologist. I have don't claim to be one. But I even told you, I was like, she doesn't have gastroparesis.
Scott BennerMhmm.
Jenny SmithI said she's got something else going on that's causing this, and it's been a long term thing that she's I mean, you guys have been dealing with this or had been dealing with this for for a while knowing something was not right. She was constantly complaining of stomachaches and, you know, whatever. I was like, this this isn't classic gastroparesis that just doesn't even sound like gastroparesis. But again, I am not a gastroenterologist.
Scott BennerWell, listen. I'm her I'm her father. And for the year or so prior to that, every time somebody would be like, is it this? I think I've talked to so many people who have gastroparesis, and Arden's boluses don't mimic what gastroparesis does. No. So anyway, because of that kind of anecdotal information, we kept ignoring it. And I wanna make sure I I say this in case my wife ever hears this. I kept ignoring it. I kept saying, no. No. No. It's gotta be something else. And even Arden started, you know, with her kung fu googling and she's like, I've got fibromyalgia. I've got this. Like, my knees hurt, like, everything. Right? So anyway, so we go home and Arden starts eating this incredibly restrictive diet, which by the way does not make her stomach feel any better. And about a week into it, she says, I would rather my stomach just hurt. And it was just the saddest thing. You know, like, I thought, oh god, her stomach's gonna hurt for her whole life. You know, she's been constipated since she was a little kid. She would have I look back now, she'd do this thing where, like, she wouldn't go for days, then diarrhea, and then not go for days, then diarrhea, and pain up in the top of her stomach to the point where she had us, like, like, no lie, like, pushing down with all of our might at the top of her stomach. And and when you got pushed down hard enough, the pain would go away for a minute.
Jenny SmithMhmm.
Scott BennerAnd she was, just do
Jenny SmithAlmost like reflux sort of.
Scott BennerJenny. We would do it for hours sometimes. You know? Like, she'd lay on the floor and have you put your her your heel in her stomach, like stuff like that. And so this week's going on. I'm watching her. The diet is not doing anything. And she says to me out of nowhere, I want you to realize that at this point, I still don't think digestion. Okay?
Jenny SmithRight.
Scott BennerOkay. She says, I wanna go to Five Guys. I'm getting a cheeseburger. I'm getting fries. And I'm getting a milkshake. And I don't care what happens next. And I was like, okay. Like, I don't know what to do. Right? So I said, well, first, do this thing with me. I'll take you to Five Guys. You I'm gonna stop first at a health food store. I heard somebody say something about a digestive enzyme. That's it. I don't know where I heard it online. I saw it written down somewhere through Googling. I have no idea. I'm like, we're gonna get those. You take them while you eat. She was like, I'm gonna be honest with you. She was like, whatever. Like, she was she I'll do it, but I don't believe in this. I don't believe in anything. It had been long enough she'd given up on the idea. So we get them and I we get home. I'm like, here. Take two of them because the lovely crunchy lady at the health food store said take two if it's a high fat meal. She takes two. Her blood sugar never spikes the way it would. It didn't need nearly the insulin it would have needed, and it stayed really flat. And I was like, oh my god. We did it. Except then the next day, was like, have you pooped since you ate the cheeseburger? And she goes, no. There are two things that I would tell you to look at first if you have diabetes. First one I'm gonna tell you about is the Dexcom g six continuous glucose monitor. This little device shows you on the receiver that comes with it or on your cell phone your blood sugar's number, direction, and speed constantly. Like, it's always there when you look at it. And you can set alarms. So, like, say, you don't want your blood sugar to go over, I don't know, one fifty. You make an alarm at 01:50, and when it gets to 01:50, it goes, Beep beep, baby. We're at 01:50. It doesn't say it exactly like that, but there's beeping. Then you look and see the one fifty and say, oh, I might have missed on my bolus. Let me do what I'm gonna do. Or you set an alarm for a lower number. Say you don't wanna know let's say you wanna know when your blood sugar's 85. Beep beep beep. I'm 85. Oh, I hear beep beep beep. I take a look. Oh, 85. And then I take a little I do what I'm gonna do. Whatever you're gonna do, you do it then. You can keep in this range. Seriously, when you when you're aware of the range your blood sugar's in, it's easier to stay in it. It's easier not to ping pong all over the place. Roller coaster. I mean, listen. We talk about it all the time in the podcast. You can check the podcast out later. But this Dexcom g six is at the core. Right? I mean, for that for that management stuff, a 100% needed. But also for safety, security, convenience, how about that up to 10 people can follow someone? So say your kid's at school, you could see their blood sugar on your phone, and so could nine other people of your choosing or not. Whatever you wanna do. Dexcom.com/juicebox. Please head over there today and check it out. You may be eligible for a free ten day trial of the Dexcom g six. You'll only find that out on my site, so hit the link. Guys, you're also gonna wanna get yourself the and, you're also gonna wanna get yourself the Omnipod. It's a tubeless insulin pump. It's really terrific. A tiny little device, fill it up with insulin, put it on, no tubing. Understand you're not connected to anything. You just wear it, and then there's a handheld controller that you say, like, I'm having 12 grams of carbs, and it tells you because you put in settings, it tells you, well, this is how much insulin you'll need for those 12. Push the button, whole thing happens wirelessly. You're not connected to the controller. There's no tubing. You have an insulin pump that you can swim with, that you can bathe with, that you can play your sports with, and sleep comfortably with. No tubing, no controller attached to you. Now that's for the Omnipod five, which is an automated insulin pump system or for the Omnipod dash. Both of them are tubeless. Both of them give you that freedom. Now the Omnipod five is the only tubeless automated insulin delivery system that integrates with the Dexcom g six CGM, and it uses smart adjust technology to automatically adjust your insulin delivery every five minutes, helping to protect against highs and lows without multiple daily injections. That's the Omnipod five, tubeless and automated. Omnipod dash, tubeless, not automated. Still an amazing system. So whether you want an automated system or a system that you kinda take the reins on, one way or the other, you want tubeless, you want the omnipod. Omnipod.com/juicebox. For full safety, risk information, and free trial terms and conditions, you can also visit omnipod.com/juicebox. I know what you just thought. Free trial terms and conditions? You didn't mention a free trial. Well, how about this? You may be eligible for a free thirty day trial of the Omnipod dash. Go find out at my link, omnipod.com/juicebox.
Solving the Digestive Puzzle
Scott BennerHave you pooped since you ate the cheeseburger? And she goes, no. So now it's days that go by. She's taking them under duress because we're making her, but her stomach still hurts and all this stuff. And finally, said to my wife, I'm seeing something with her insulin. I know this is working, but there's gotta be another component to it. I go back to the health food store, explain it to the crunchy lady. And by way, the crunchy lady has a Russian accent, so the whole thing is a ton of fun. Right? And she's like, it's like I'm telling you, it's out of, like, a Rocky and Bullwinkle movie. She's like moose and squirrel. You know what I mean? Like, just like that. Right. And, and so I tell her what goes on. She, walks across the room, grabs this big jug. She says, magnesium oxide. This will make her go. And I was like, right on. Yep. And she goes, here. And take this probiotic too. So I went home. Arden had noticed enough improvement that she took the other stuff. And, like, for three days, I'm like, have you pooped? Have you pooped? She actually once said to me, please stop asking me if I've gone to the bathroom. I don't I don't wanna tell you. And I kept asking
Jenny SmithI am 18, dad. Please don't ask if I have pooped. Well,
Scott Bennerone day I asked her and she smiled and she goes, oh, you idiot. I went days ago and I was like, ugh, why are you doing this to me? So, then her that cycle started happening with with frequency. Eat. Mhmm. Then I I shared it in episode seven sixty seven where I go over the supplements that Arden's taking, but Kelly and Arden were leaving to go to a restaurant one day. They left the house. I thought they were gone. Arden came back in the house. I forgot something, she says. Goes in the kitchen and she grabs the digestive enzymes. And I was like, holy hell, it worked. Because there's no way she would have come back for it if not. Like, just the way, you know. So it's such a cheap and easy attempt. Right? Like, if you have digestion issues or you're not pooping, these are two very safe, very simple supplements that you could give a shot to. Am I wrong?
Jenny SmithYou could. No. You you certainly could give a shot to them. And, again, in terms of, like, long term effects, the the build, especially of the digestive enzymes, if you truly do have some type of digestive enzyme issue, whether it's an absorption issue with them or it is a release of them in the right way in your body, you should notice some definite benefit from using them.
Scott BennerRight.
Jenny SmithBut if you don't, clearly, it's not something you just keep taking to see if it's going to work.
Scott BennerNo. Arden saw an improvement really quickly.
Jenny SmithRight.
Scott BennerLike, a a week. And I Right. And you were like, okay. Well, this is working. Yeah. You know, something else is wrong. Something else is wrong. But now as the weeks have gone by and she's building up what I'm assuming is a healthier gut because there's no, like, rotted food sitting in her stomach for days. Right? Right. And now the probiotics are having a chance to work. I have not now she's at college. And fair is She could be down there right now going, god, my knee hurts. But she has not said anything. And she's on
Jenny SmithAnd she's pretty honest with you about things, it seems.
Scott BennerWell, there's also this there's this look that goes over her once the medical stuff has, like, beaten her down, and you can see it. Like, you can see the, like, I I give up on her face. And it's now she's walking to classes. She's, you know, getting on buses, going somewhere, walking up and down stairs more than usual. I've not heard a word from her about it. And I don't know. I mean, hopefully, it keeps working, but your pancreas does more than make insulin, so this makes sense. So, does it do anything else or just those it just has basically those two functions?
Jenny SmithIt has those two. Right? I mean, essentially, the exocrine, the endocrine. I mean, if you think about it, you go to an endocrinologist. An endocrinologist, especially by people with diabetes, are specifically thought of as being, like, the diabetes doctor. But there are some endos who don't even do diabetes at all. Yeah. Like they are specifically thyroid endocrine physicians. Right? Some are very much just the, you know, the ones that deal with like the ovaries and those kinds of things, that aspect. And they may not know very much at all about diabetes because that's not really what they've gone into.
Scott BennerSo
Jenny Smiththat, again, those are the primary functions. But again, it would be better for the T shirts to actually say proud owner of, like, dead islet cells or dead beta cells. You know? And even that isn't a 100% the truth because we still know that betas still have some little little bit of action even if it doesn't really look like they're doing much of anything. People who have had diabetes for a numbers of years can still have minor output from some of the betas that are still left. So nothing's technically dead.
Scott BennerWell, so the idea I've heard in the past is that those cells are so overwhelmed with inflammation that they can't move and function. Right? And Yep. That's the other part of, like, you're still, like if you're listening, you're like, Scott, don't understand why did her knees stop hurting because you fixed your stomach. Inflammation. Your stomach is is again, it's a cesspool. Nothing's flowing through you. It's rotten in there, and it is. And the bacteria is now off balance. So even throwing in a a probiotic, which, by the way, we tried, like, a year and a half before that, when people are like, oh, it's her stomach. Here, give her all these probiotics and stuff like that. And she kept taking them, and she's like, these are not doing anything because we were throwing them into a pit of vileness. That's why.
Jenny SmithRight.
Scott BennerYeah. It's like throwing an air freshener into a cesspool. That's what we were doing. We were
Jenny Smithlike Yeah.
Scott BennerYeah. So once you got the food moving through her and this is how it went in my head. I'll get the food moving, and then I'll address the bacteria in her stomach. And, I mean, the
Jenny Smithand It seems to be a good combination.
Scott BennerYeah. I mean, so far, I should knock on all the wood in the house. But yeah. I mean, you know, I don't jump on the podcast and say stuff till I've seen it work for a while. You know? What So
Jenny SmithAnd to be true, you know, when we're talking about the comparison of the supplement that she takes or these digestive enzyme supplements, the majority of the kind of ingredients in them are to supplement what should be some of the enzymes that are being put out by the pancreas Mhmm. To again deal with your macronutrients being fats and proteins and carbohydrates. Right?
Scott BennerYep.
Jenny SmithEven the saliva in your mouth does contain some of a carbohydrate based digestive enzyme. So, you know, digestion to some degree starts in your mouth mainly of carbohydrates. As you move further down the digestive system, those other enzymes that are supposed to be coming from your pancreas, like lipase and amylase, and pro protease. Yes. Mhmm. Think of the third one. You'll look on the digestive enzyme label for the ingredients, and those should be within there if you're getting a true digestive enzyme. Because what you're what you're doing is replacing them into the body for whatever reason. Your pancreas isn't doing enough of the job or your body's just not using it right, whatever.
Scott BennerMhmm. So here's a Google search. What can poor gut health lead to? When your body doesn't have enough good bacteria, bad bacteria can thrive. The following can be signs of gut bacteria imbalance, autoimmune problems such as thyroid issues, rheumatoid arthritis, a type one diabetes, digestive issues such as irritable bowel syndrome, constipation, diarrhea, heartburn, or bloating. Now I'm gonna tell you this. After I watched this work with Arden for a week or two, I thought, you know, I have most of the problems Arden has. I've, like, powered through it my whole life, but I I have. Right? And I've got checked for celiac, and I don't have celiac. But even as a child, I can remember my uncle and aunt used to like to take us to a pizza joint near where they worked, on Friday nights. And we'd eat at the pizza place and have a fifteen minute ride home, and I would have to make them stop at the business they owned halfway through so I could go to the bathroom.
Jenny SmithGo to bathroom. Yeah.
Scott BennerMhmm. And even when I was like six or eight years old. And I can remember being in the bathroom and people like, why is Scott in the bathroom for so long? And I wanted to yell because I'm in agonizing pain. Thank you for asking.
Jenny SmithBecause I ate the pizza. Yeah.
Scott BennerBut it was, like, 1979 and
Jenny SmithMy body doesn't like the pizza.
Scott BennerYeah. Stop taking me for pizza, please. So so I said to Kelly, I'm like, I'm gonna take these enzymes, you know, because I've been doing, fiber supplements for years to get ahead of the problem. I I it always felt like what you talked about before. It was like a Band Aid. It was helping, but it wasn't nothing was stopping. You know what I mean? Like, everything got through easier, but it's still like, if I would forget the fiber one day, I'd wake up in the morning and think, oh god. I didn't take the fiber yesterday. Like, uh-oh. Here goes my day. You know? So I start taking the enzymes and the magnesium and the probiotic, and voila, I don't need the fiber anymore. I get up every morning just like the rest of you and take a nice poopy and then live my life. That did not used to happen for me. So and I don't mind sharing it here where more people are gonna hear it than I'd like to imagine right now. But but I want you all to know because when I went into the Facebook group and I said, here's the episode about Arden's supplements, the amount of people who came in and were like, hey, my kid's stomach hurts all the time. My kid's always constipated. This is since diabetes, blah blah blah, adults. But, like, I got a note from a woman in her fifties. She's like, you she's like, you saved me. So I I just wanna tell people. That's all. And I'm trying to draw them in with the the title proud owner of a dead pancreas. I think I can Yes. I think I can get them into the episode of that.
Jenny SmithThat could be. Well, and I think there are a lot of I mean, even if you look at some of the research that's been done on the digestive system in terms of and I I absolutely I hate the term, like, leaky gut. I think it's too it's too broadly used, and it's not it doesn't give any definition to what might actually be going on. But for people that are more predisposed to autoimmune conditions, the potential that their gut may be sort of like, let's call it, you know, like Swiss cheese, if you will. And there are more holes that allow things to get back into the body that should have been being held in the digestive system and then passed out. Right? So if some of these things that are irritants, if you will, get back into the body, they can create enough problem that your immune system sort of goes haywire. Right? Autoimmune disorder. And whether it's thyroid or celiac or type one or the other autoimmune disorders, the the gut is heavily studied in terms of autoimmune conditions.
Scott BennerYeah.
Jenny SmithSo if you can keep a healthy gut while you know that you already have an autoimmune condition, you may be able to potentially hold down or prevent other autoimmune conditions as well.
Medical Frustrations and the Value of Testing
Scott BennerWhy is this not a mainstream idea? Why did that doctor give Arden a medication for pain, a medication for something else. He gave her three meds and a diet that a 90 year old person would be like, I don't wanna eat this. Like, it was it was a it was a restrictive diet. Why didn't he just say, hey. Go to the health food store and buy a handful of digestive enzymes, and let's give that a whirl and see what happens. Like, how did he not know that? I didn't go to medical school, Jenny. It took me two years, but I figured it out. Right?
Jenny SmithYeah. Did you really you wanna really dive into that? That's a big hot topic in terms of what get again, I think the best thing to say is that there are a lot of Band Aids that are being given.
Scott BennerMhmm. Yeah. Instead of
Jenny SmithAnd instead of let's really let's really study and figure out. Let me listen to all of your symptoms, and let's figure this out from the standpoint of actually attacking the true problem. And I've encountered that in terms of, you know, like, my own health stuff. I was amazed when I first started seeing a naturopathic physician.
Scott BennerMhmm.
Jenny SmithSomeone who had gone to medical school and then had gone back after getting her MD, to focus on women's health and many of the things that are very specific to females versus males.
Scott BennerYeah.
Jenny SmithAnd, you know, she's like, well, all these things, you know, why why wasn't this tried, or why wasn't this looked at? Or let's get a check to make sure that all of these types of things in your body are actually at the right level. And there were a number of things. I mean, even just vitamin d. Mhmm. She's the she's the one that got my vitamin d level back up by simply telling me to take a drop that went under my tongue instead of a supplemental tablet that went into my my digestive system and it didn't get absorbed.
Scott BennerYeah. Some people can absorb it, some people can't. And now Correct. Let us let us go back. Everyone knows that I have trouble absorbing iron. Oh. Mhmm. Isn't that interesting? So, you know, I can't so even if I take an iron supplement, it doesn't move my iron level up. I have to take it with ascorbic acid or vitamin like vitamin c. I don't know why that makes the gut lining pull it up better, but it does. And it's it's a similar thing. And when you start putting the pieces together and drawing lines from a to b, Arden has diabetes. And, you know, she was we thought she was fine, but she was young. Who knows? Maybe her stomach's been hurting forever, and she just didn't know to say anything. My stomach hurt when I was a kid. And so even that, like, when that happens, you think, oh, maybe it's just genetic. Like, my stomach hurts. Her stomach hurts. I guess this is what we get. And then you just start putting everything together. Now one of the other things that made this difficult to figure out was Arden's hormonal issues. Mhmm. So incredibly long period, eleven to fourteen days. It would restart after two or three days, go back to eleven or fourteen days. Like, it just she was constantly bleeding. She would get a vicious nosebleed once a month, like, on on, like, clockwork. Her acne, a couple of years ago, just out of nowhere, just it was really terrible. Like, she's tried everything that you can think of to fix your acne. Right? And we had gone through so many things. And doctor Benito, who did the thyroid episode with me, she said, well, I think Arden's going to need metformin. And I was like, okay. And she goes, I think it's gonna be an insulin resistant thing. I think she's gonna need metformin. But before we try that, would you go buy this supplement called
Jenny SmithMhmm.
Scott BennerAvacetol? And when I said that to Jenny to kinda check things, Jenny's like, oh, yeah. People use that all the time. And I was like, oh, hell. So Avacetol, a little powder, you melt it in the water. You boom boom boom, you drink it, you can't taste it. And I don't know how long it took, not long, a month or two, and her period started regulating. The the nosebleed stopped. Her acne started going away. I mean, jeez, you know, Girl poor girls. You guys, it's and then you gotta live with boys. Who
Jenny Smithhave no clue.
Scott BennerIt's too much.
Jenny SmithSo sorry to all you boys, but really like
Scott BennerI think it's right. I think it's too much. All this happens and then there are boys there who are like, Sunday, I'm watching football.
Jenny SmithRight. Yeah. Yes.
Scott BennerOr whatever they do. So, anyway, so that's it. Alright. Alright. So are we missing anything around gut health, what the pancreas does, or any of the issues that you know Arden went through? Did I miss anything?
Jenny SmithI don't think so. I mean, if you really wanted to dig deeper into each of those little pieces or enzymes, you certainly could, but, you know, that's what Google's for. Yeah. Right?
Scott BennerI'm not here to tell you what to do. I'm here to tell you what happened. You can figure it out. Right. You know? Right.
Jenny SmithBut to let people know that clearly your your pancreas has a lot of other definitely good things that it should be doing. Mhmm. And if you're noticing anything digestively, it could be a piece of maybe some of that quote, unquote dead pancreas that isn't quite working the way that it's supposed to.
Scott BennerI'll tell you this is interesting because I don't think many people I think a lot of people who have, like, constipation problems will be like, I heard to take magnesium. But there are, three different kinds of magnesium, maybe more. I have no idea. And I remember somebody telling us to give Arden magnesium, and we gave her the wrong kind. So a year and a half ago, we coulda had this right. But instead of magnesium oxide, we gave her hold on a second. I'll tell you what it was.
Jenny SmithAnd now I'm like, I don't know what her supplement magnesium citrate maybe?
Scott BennerWe gave her magnesium citrate or glycinate. So no kidding. There's glycinate, citrate, and oxide. We tried glycinate and citrate. And when it didn't work, Arden's like, I'm not taking these things anymore. We have one more to go.
Jenny SmithWell, and many people actually with diabetes are low in a number of different things, magnesium being one of them. Mhmm. Sometimes zinc is also on the lower end. I always recommend if you're considering some symptoms and some of the things that again I mean, Google's great, but it is a rabbit hole of information that you can really get into and not quite you end up coming out thinking you got 50 more things than you've thought you had.
Scott BennerYeah.
Jenny SmithRight? So a simple I mean, blood test will tell you where these levels are
Scott BennerMhmm.
Jenny SmithTo be able to start at the right place. Because obviously, if you're not low in something or whatnot, there's really not a need for you to go crazy on supplements.
Scott BennerWhat about though in the case of, like, when Addy came on and talked about thyroid, she also talked about ferritin levels. And she said she said, I don't care what those tests say. If you're a woman of menstruating age, your ferritin needs to be above 70. But the but the test won't say that. But this is from her own practice and anecdotal, you know, experiences. So Right. That's the other problem because we see it happen with thyroid all the time. They're like, I have all these thyroid systems. They're like, oh, labs are in range. And then no and then that's it.
Jenny SmithRight. But the labs a good example is vitamin d for a second one. Mhmm. I mean, labs typically have you in target as long as you're between 30 and a 100. And optimal truly I got this from my naturopathic doctor. She's like, optimal is much tighter. It's actually 50 to 70. That's where you wanna sit. Mhmm. So, I mean, when I started out, mine was 18. My doctor thought that had to completely be wrong. He's like, let's do the test again. Oh, no. It came back at eighteen. And I was like, oh, well, look at that.
Scott BennerWhat did you experience when you got the level up?
Jenny SmithWhen I got the level up, I can definitely say that insulin and this was years ago, but I can definitely say that my insulin sensitivity, I guess, for lack of a a better word Mhmm. Was more stable. Because, of course, vitamin d works on a cellular level in terms of how it responds to glucose as well as insulin. So I just know that if I keep in target, if I keep in range, I notice more consistency just in overall, like, glucose and insulin sensitivity.
Scott BennerOkay.
Jenny SmithThat's Great. So that's big thing that I noticed.
Closing Thoughts and Poop Talk
Scott BennerAlright. So I wanna say this at the end because we are finished. I wanna tell people, notice here at the end, I'm not trying to sell you something. Jenny's not telling you to go to a link to get more information. There are no clickable links when you buy magnesium oxide that I make money. Nothing like that. Just here to tell you what happened to Arden because it was it was it was really horrible. And it was daily and she was held down by it. It I think emotionally and I was too. And I started feeling like I am definitely failing her on this because there must be some sort of an answer. And and then when I see everybody talking about it online, I can't believe how many people jumped up and said, what what's that? Magnesium what? What's the what's the enzyme? Tell me about that. I don't digest food well. I'm constipated. But yeah. All the time. Like and sometimes sometimes I hear people say it almost like it's a badge of honor. I poop once a week. Like it's like it's almost like it's dainty. Do you know what I mean?
Jenny SmithRight.
Scott BennerMhmm. Not dainty. How many times do wanna poop, Jenny?
Jenny SmithDaily.
Scott BennerYeah.
Jenny SmithAbsolutely daily. In fact, I thought it was the weirdest question when I first started taking my my first child to the to the pediatrician. He was like, well, how many times a week does he go into the bathroom? I'm like, my kid goes to the bathroom every day. People are supposed to poop every day. Your body is supposed to transit things in and move on out. That's the and at lee I mean, honestly, good good digestion is at least twice a day. And if you go even further to the more earthy crunchy, you should be pooping after every single meal.
Scott BennerTrue. Because the new food comes in and pushes the old stuff out.
Jenny SmithThat's right. You gotta clean bacteria. It's moving it in. It's getting it out. It's doing what it's supposed to be doing.
Scott BennerThat's a healthy thing. And that's the thing we make fun of people for, by the way.
Jenny SmithOh, absolutely. Yeah. Yes. And I mean, this should be well formed poop. I mean, if you wanna get in-depth about it. Right?
Scott BennerI do, Jenny.
Jenny SmithIt shouldn't be it shouldn't be disgusting. It shouldn't be, like, liquidy, whatever. This good poop couple times a day should be well formed. It should come out easily. You should not have the strain to go to the bathroom. Mhmm. Yeah.
Scott BennerIt shouldn't be stuck under the toilet seat when you're over?
Jenny SmithNo. It should not.
Scott BennerThose those are moments reserved for days of drinking and then what happens at the end or illness. When you really Or illness. Think about having a virus or something like that, what happens as you're getting better from the virus? You, like, evacuate because your body is like, there's a lot of badness in here. Let's throw it out.
Jenny SmithLet's move it on out. That's exactly right.
Scott BennerYeah. Alright. We've done it. Jenny, we've saved lives here.
Jenny SmithI think she called this like the pooping episode or something.
Scott BennerProud owner of a dead pancreas that though, I don't know. There's nothing there. It's too
Jenny SmithThere's nothing there. No.
Scott BennerAnyway, I I really I I have to say, I almost feel like I wanna apologize to the people listening for not figuring it out sooner. Like, that that terrible feeling I had watching Arden struggle, when you start getting the emails and the notes online, I actually, for a second thought, like, oh, I let all those people down too. I really felt like that for a minute. You know?
Jenny SmithWell, I think this goes a level further in terms of I mean, you shouldn't have to apologize, and I don't think anybody obviously I mean, they're probably listening thinking, oh my gosh. Like, please don't apologize for something that you should you had nothing to do with. Right? I think it goes again to a deeper level of overall medical evaluation. And, I mean, it truly takes it into the you mentioned metformin before. Right? As a potential thing that a doctor was recommending for Arden. Well, I've even worked with a number of women who actually I knew from all of their issues that they probably had PCOS. Right? Polycystic ovarian syndrome. I could I knew insulin resistance, all the things that they were having. I was like, just get a prescription for metformin. Just get one. And I had a couple doctors tell them, there's no reason for you to use this. I don't know why this would have been recommended. So, you know, I think from an overall, sometimes you end up having to be your best you do end up having to be your best advocate, but you also have to have an idea of where to start.
Scott BennerYeah.
Jenny SmithAnd when you can say like you did, but this medicine is just a Band Aid.
Scott BennerMhmm.
Jenny SmithIt's something that's gonna cover up a symptom. I wanna know why the symptom is here. Let's dig deeper. I wanna find the reason that I'm having this or these symptoms and take care of the reason so I don't have to take six other things.
Scott BennerYeah. Well, I I still don't know where Arden's path is gonna lead on this. Like, maybe she'll
Jenny SmithRight.
Scott BennerEnd up on metformin because maybe she has PCOS because that's one of the things that we I mean, we looked into a PCOS clinic down south where they do a they do a, like, a surgery to try to correct it. And, I mean, like, that's how bad things were. Like, they go in there and, like, just it's crazy. You know what I mean? And but that's how far down the rabbit hole we were. We were like, you know, this pain is not stopping. Like, what's she gonna So maybe maybe I have to say doctor Benino still said we wanna give the ovacetol more time on Arden's acne. But if it doesn't clear up the entire way, I don't think we're done yet. So Sure. We'll have to wait and see. Yeah. Anyway
Jenny SmithHas her insulin since the enzymes especially, has her have her insulin needs gone down? And I know you've adjusted those
Scott Bennera bit. Did, and then she went to college. And now she's now she's eating, I think, Styrofoam sprinkled with high fructose corn syrup. So all the
Jenny SmithYeah.
Scott BennerLittle things that we adjusted out of Arden's diet, like dream field pasta instead of regular pasta or low fat, you know, I don't know, sauce that goes on something. It's it's everything's frozen pizza and french fries, and so I have no idea. It took us weeks to, like, get on top of it because she kept saying, I can do this. Like, I can do it. But her blood sugars were going two twenty after meals. They weren't coming down. So finally, a little while ago, I I I called her up and I said, hey, Arden. Listen. We need to talk for a minute. And she's like, okay. So we got on FaceTime, and I said, I know you're trying. I don't think you're not trying, but bolusing for this food is it's hard. So why Yeah. Why don't you let me help you a little bit? So we did Jenny's, post date with Loop, which worked really well. So big, big bolus up front for this whatever this disaster is they're feeding her. And then about 60 to I don't know. About an hour to hour and a half later, about a 15 or 20 carb bolus that the
Jenny SmithEntry.
Scott BennerTo give the loop some autonomy to make harsher More Yeah. Adjustments. Yeah. I don't think that's not something you can do with any other algorithm. Right?
Jenny SmithIt is not. Yeah. No. The easiest, I think, is you can't you can't forward stamp anything in any other in any other system.
Scott BennerMhmm.
Jenny SmithI think the closest would be knowing that something's coming, the ability to potentially start an extended bolus with Control IQ
Scott BennerYeah.
Jenny SmithTo hit out further. But even with that, it's only a two hour extension, and there's no visual to absorption of of food. Right?
Scott BennerYeah.
Jenny SmithThat's where, you know, the looping types of systems are very unique in that they truly do allow the system to still pay attention to why is this blood sugar where it is? There's still food in the system.
Scott BennerMhmm.
Jenny SmithLet's take care of this completely, not just attack a blood sugar because the blood sugar is here. There's a reason behind it.
Scott BennerCan you see her graph? This is twenty four hours. So we're back to it now. Right? Mhmm. But before, oh my god. Like, I I was like, we we don't know. It's it's the food. It took you a couple of days to figure it out because our settings because she had because of all these adjustments, she was using significantly less insulin all of a sudden. Then she started eating there and then I was like, oh my god. We've gotta move everything back again. But I wasn't with her and it seemed like a lot to move it because what if it goes wrong? Like, you know what I mean? So we moved it really slowly over a couple of weeks which I I'll tell you, I don't think back in the day I could have done it like that, but now I have a little more of a, like, a long view. I'm like, it sucks that her blood sugar's high, but I'm not gonna
Jenny SmithRight.
Scott BennerI'm not gonna have her pass out walking to class because we're we move things too quickly.
Jenny SmithNo. Not at all. I mean, I you know, college, I had none of the technology. I mean, I was on injections in college and I had a glucometer that I carried around with me. So I didn't have any of the information. But even I found out really quickly what the difference between going to, like, the burger joint, which wasn't it was a veggie burger. So wasn't really a real burger, but the the burger joint on campus versus going just to the cafeteria. I figured out pretty quickly that I just ended up living mostly on salads
Scott BennerYeah.
Jenny SmithAt school a lot of the time because they seem to work out better from a standpoint of what I was finding on my next finger sticks.
Scott BennerWell, as I Google the words freshman 15, college students have been warned about the dreaded freshman 15, the extra 15 pounds that so often accompany the first year of college. It turns out, from our experience, it's because the food is terrible.
Jenny SmithOh, it's bad.
Scott BennerYeah. You're all making enough money to give the kids real food. It shouldn't be that hard. Right? And it's presented so nicely, Jenny
Jenny SmithOh, yes.
Scott BennerThat you go through like, Arden looks like she's getting lunch at, you know, at at the Taj Mahal. Yeah. Yeah.
Jenny SmithFoo foo place. Yeah. Yes.
Scott BennerThen she sits down. She's like, this food is terrible. I'm like, okay. And then I you know, finally, I'm like, send me pictures so I can help you with the thing. And I think at first, I think she's eating a lot of french fries when she was like like, when she first got there, I think she was a little, had problems that I don't wanna talk about on here with a with a roommate. Yeah. But there was a lot of, anxiety in the first couple of weeks, and I think she was I think she was treating the anxiety with the french fries.
Jenny SmithWith food? Yeah. And then Probably.
Scott BennerAnd then when I told her, I'm like, need to see what you're eating, she wouldn't answer me. That's the first time that's ever happened. Arden, show me your plate. Like, not no. She just didn't answer.
Jenny SmithShe just didn't answer you.
Scott BennerYeah. And I was like, okay. Let's hopefully
Jenny SmithDoes she do a lot I mean, the food on campus, I'm curious if it even has any nutrition facts or is she mostly estimating?
Scott BennerWell, she's estimating. But she just she realized just a lot is the measurement she needs. So we we so far have not given have not found a way to give her too much insulin for a meal.
Jenny SmithFor a meal. Yeah.
Scott BennerSo
Jenny SmithAnd I wonder if I mean, you know, whether she'd use it or not depends on the person. But there are some really good visual apps like the Figui app is really nice from a visual standpoint because you can adjust. Like, you type french fries in, for example, it shows you, like, a portion of french fries on a plate. Mhmm. And then you can adjust the portion. There's a little slide rule below the picture. Oh. You can make the portion on the plate look smaller, or you can make the pile of fries look larger. And right below it are all the nutrition facts. Carbs, proteins, fats, salt, everything.
Scott BennerWhat's it called?
Jenny SmithFigwe, f I g w e e. It's a great app. It's really sweet because instead of looking through like, Calorie King is the long term used one Mhmm. But it's just a list. And it might tell you three ounces or four pieces or whatever. And a lot of people, they don't know what three ounces looks like or even what a half a cup looks like anymore. So if you're looking through a list, you're gonna get annoyed and irritated, and most teens and college students are not gonna use that. Yeah. But this being a visual, it's it's really kinda sweet.
Scott BennerI'm looking. It's pretty cool. Right. We have no connection to that unless Jenny's making money and I don't know it.
Jenny SmithNo. Absolutely not. No. I've used it for a number of years, actually. I found it at a conference probably five or six years ago.
Scott BennerAlright. I'm gonna say one last thing. Here on the podcast, I am and on the Facebook group and anywhere you've ever heard me talk about diabetes, I say, I don't care what you eat. It's not my business. I just want you to know how to bolus for it. But if you don't think that every once in a while, I don't go, you guys, like, what are you doing? Like like, you can't you can't eat every terrible thing and then say, I don't know what's happening. Like like Right. You know, you can't put a cupcake on a piece of pizza and wash it down with a soda and go, can you believe my blood sugar went up? I'm bullish. Like, it's there are times when I when I wanna just say, come on. Like, please and this happened that feeling ended up being how we sort of figured out Arden's thing. Right? Like Mhmm. Fats are sitting in her too long. Stuff like this is happening. Blah blah blah. She's not digesting it. And keeping in mind that the doctor wanted to give her a pill that he said would numb her stomach so it wouldn't hurt anymore.
Jenny SmithSee, again, covering a symptom.
Scott BennerYeah. He didn't
Jenny Smithwanna cover up a symptom.
Scott BennerHe didn't wanna help her. He just and by the way, on our first visit, before the the look down her stomach, he handed us samples in the room.
Jenny SmithOf course.
Scott BennerI was like, this sucks. You know what I mean?
Jenny SmithAnd that that could be a whole episode all about would go there.
Scott BennerHighly recommended by a number of physicians that I know in the area.
Jenny SmithOh, sure.
Scott BennerThat's how we ended up there. So anyway. Alright. Jenny, thank you so much for doing this with me.
Jenny SmithAbsolutely. Yes. Always. Cool.
Closing and Sponsor Messages
Scott BennerI'm gonna thank Dexcom, makers of Dexcom g six, and remind you that you may be eligible for a free ten day trial. Find out more at dexcom.com/juicebox. And, of course, maybe you'll want a thirty day free trial of the dash, and you're eligible. Could be. Maybe you're gonna wanna find out about the Omnipod five automated system. Either way, the link you want is omnipod.com/juicebox. I know it's the end of the year and people are like, it's the holidays. I'll wait till. Don't wait. Just don't wait. Just jump in. Get going. If it's what you want, there's no time like the president. Not the president. The present. There's no time like the present. Omnipod.com/juicebox. Links in the show notes. Links at juiceboxpodcast.com. I'd like to thank you so much for listening, remind you that the private Facebook group is an amazing place to be. Juice box podcast type one diabetes, completely free Facebook group. Everything about the podcast is free. Thank you to the sponsors. That's why that's why I don't have to charge you for episodes and stuff's not behind paywalls or how come I don't do, a a fifteen minute episode where I kinda tickle your ass with a feather but don't give you all the information then drive you back to my website where I'm like, sign up for coaching. I don't do that crap. I'm not up for that. I don't like it. Everything everything I offer is free. Go go use the Facebook page, meet the people, build a community for yourself. I'll I'll make sure it's there for you, and it's it's a nice place to be. You go ahead and take advantage of it. Same with the podcast. All the episodes, absolutely free. I I my pleasure to make them, seriously. Anyway, what am I supposed to say here? Thanks so much for listening. Come back soon. There'll be more episodes of the juice box podcast. Please subscribe or follow in your podcast app. If you're not listening in a podcast app or an audio app, please check them out. Spotify, Apple podcast, Amazon music are some of the most popular ones. They work great. They're free. I think that's it, friends? Alright. I'll talk to you soon.
#1809 Gremlins
Valerie shares her LADA journey—misdiagnosed at 39, now thriving on the iLet—and how positive experiences helped her overcome a childhood marked by foster care and adversity.
Companies that Support Juicebox
Key Takeaways
- LADA (Latent Autoimmune Diabetes in Adults) is often misdiagnosed as type 2 diabetes initially—Valerie lived with a type 2 diagnosis for 1.5 years before a dermatologist's lab work led to the correct type 1 diagnosis.
- High ACE (Adverse Childhood Experiences) scores can be counterbalanced by positive childhood experiences (PACEs)—Valerie scored 4 on ACEs but 7 on PACEs, which she credits with helping her thrive despite a traumatic childhood.
- The iLet bionic pancreas pump appeals to those seeking less daily management involvement—users simply announce meals as "usual," "more than usual," or "less" without carb counting, though you can still "fake carb" to add insulin when needed.
- Living alone can significantly influence insulin dosing decisions—fear of severe lows without someone to help may lead to more conservative approaches, even at the cost of slightly higher blood sugars.
- Self-advocacy in healthcare is crucial—Valerie found her own endocrinologist after being referred to retired or non-responsive offices, and manages her diabetes largely independently while using her endo primarily for prescriptions.
Resources Mentioned
- Juice Cruise 2026 - Week-long cruise for people and families living with type 1 diabetes, sailing from Miami
- Contour Next Gen Blood Glucose Meter - Highly accurate meter with SmartLight technology and second-chance sampling
- Medtronic MiniMed 780G System - Automated insulin delivery system with meal detection technology and multiple sensor options
- Omnipod 5 - Tubeless insulin pump system with automated insulin delivery
- iLet Bionic Pancreas - Simplified insulin pump requiring only meal size announcements (usual/more/less)
- Dexcom CGM - Continuous glucose monitoring system, including the upcoming 15-day sensor
- Tandem Mobi - Compact tubed insulin pump
- ACEs/PACEs Assessment - Adverse Childhood Experiences and Protective and Compensatory Experiences questionnaires (tool being developed for juiceboxpodcast.com)
- Juice Box Podcast Facebook Group - Community support for those impacted by diabetes
- Small Sips Series - Curated takeaways from the Juice Box Podcast voted on by listeners
- Wrong Way Recording - Podcast editing services
Introduction
Scott BennerHere we are back together again, friends, for another episode of the Juice Box podcast.
ValerieHi. I'm Valerie. I'm here to represent the LADA group of people who get diagnosed with type one in the later onset of their life.
Juice Cruise 2026
Scott BennerHow 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, 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, and there's teen programs so everyone gets time to recharge. Not just the the kids going on vacation, but maybe you get to kick back a little bit too. There's gonna be zero judgment, real connections, and a whole lot of sun and fun on Juice Cruise twenty twenty six. 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. Link's in the show notes.
Link's 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. 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. Today's episode of the juice box podcast is 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. Today's episode is also 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, medtronic diabetes dot com slash juice box.
Meeting Valerie: LADA Diagnosis Story
ValerieOkay. Hi. I'm Valerie. I'm here to represent the LADA group of people who get diagnosed with type one in the later onset of their life. I got this diagnosis.
You know, most people get the type two first, and then I got the correct diagnosis.
Scott BennerHow long ago was this?
ValerieExactly twelve years ago, and it was the same time of month, February. Because I remember I was working on the cruise ship in the medical department, and it was, like, the cruise from hell because that particular cruise had a norovirus outbreak.
Scott BennerOh gosh.
ValerieYeah. And I would only come on and fill in as the secretary. I would relieve the person for their vacation time, so I'd only be on for, like, eight weeks. But every time I walked on ship, I knew that there could be an outbreak. I was just always prepared for if it was gonna happen, just you had to deal with it.
Scott BennerAre you in the industry still?
ValerieI'm not the cruise. I'm still in medical. I've been in medical for decades, like admin, yeah, roles. I'm now back at the hospital where I used to work for. Then I went to work for the cruise line, but I worked in the corporate office, and then I ended up just filling in on the ship for the secretary. So I've worked for the cruise line for, like, fifteen years.
Scott BennerI wonder what they've changed about cruises that the those outbreaks don't seem to happen like that as much anymore.
ValerieThey're very vigilant on the washi washi of your hands. The people who walk on board, they know that if they present with symptoms, they're so hopefully supposed to report them and, you know, get the treatment. Don't, like, go to the buffet and spread your love, I would hope.
Scott BennerWell, you know, though, I I think you're you're onto something, though, because outside I've been on a few cruises recently, and outside of the restaurants are hand washing stations. On some cruises, there's a person there looking at you going,
ValerieWashing. Washing. Get those hands.
Scott BennerWash your hands. Don't walk past this. And and I actually noticed that on an it's funny. On a less expensive ship, there's someone there telling you to wash your hands. And on a more expensive ship, what I noticed is nobody doesn't wash their hands.
Everybody just sort of does it. And, you know, it's interesting. Okay. So twelve you say twelve years ago?
ValerieYeah. Twenty oh, I was '39.
Scott BennerYou were '39. Okay. So you're Yeah. '51 now?
ValerieMhmm.
Scott BennerOkay. Twelve years ago, do you have any people in your life who have type one diabetes, people you're related to? No. Nothing. What were your first symptoms?
How do you recall the whole thing happening?
ValerieI was only tired and thin because when you work on the cruise ship, it's, like, ten hour days. Like, I'm medical staff, but I don't you know, I'm not treating the patients. I'm just doing all the coordination of the paperwork. If they're gonna stay on board, not stay on board. That's all.
Yeah. I mean, I have family history of other diagnosis that I was worried that maybe it would yeah. But I didn't think I would yeah. I didn't know. And then all the years that I've reviewed medical records, it was rare that I ever saw a type one diagnosis.
Scott BennerHey, Valerie. What other family things were you worried about getting?
ValerieOh, the epilepsy. The one time I worked on a ship, this nurse came down and was, like, yelling at the doctor. And I'm like, why is she yelling at the doc? Like but she had to go deal with a medical emergency on board because someone had a seizure.
And then when the person woke up, got alert, oriented, she's like, oh, I took the amount of insulin that my doctor told me, and then the food didn't come out on time, and she ended up having a seizure. Oh. So I saw that before I even, like, got, you know, the wrong to right diagnosis. So I was afraid that I would, I don't know, have seizures or I don't know.
Scott BennerDid you mean family? Like, the other other medical issues inside of your family?
ValerieYeah. So the my father's already passed away, but he had the epilepsy.
Scott BennerOkay.
ValerieAnd then my mother has a mental, but now she's Alzheimer's. My mother had schizophrenia.
Scott BennerOh, your mom was schizophrenic. And but she's she's still alive now. She's how old is she?
ValerieYeah. She's early eighties, but, you know, in dementia state. I moved her back to Thailand.
Scott BennerOh. Oh, is that where you're from originally or they're from?
ValerieI was born in America, but I'm half Thai and half, like, Greek.
Scott BennerGotcha. Well, there's probably a story in there about growing up with your mom.
ValerieYeah. Yeah. Yeah. I'm I'm one of those I I lived with my parents.
I'm fortunate to have, you know, the people see something, say something.
I was removed by CPS.
Scott BennerOh, no kidding. Yeah. At what age?
ValerieI thought it was eight, but it was seven.
Scott BennerSeven. Interesting. Okay. In the years leading up to your diagnosis, any medical issues that made you as an adult think like, oh, one day something's gonna happen?
ValerieNo. You just have, like, a little bit yeah. I guess normal level of anxiety. Like, I don't want to go see the doctor even though I work with doctors. You know what I mean?
So Okay. That's funny. That's I I think that's about it. Like, I just and then the cost. You get a medical condition and it's very expensive, or what I've had seen working in the roles that I had.
Scott BennerYeah. That's the kind of stuff you're worried about. Yeah. Initially diagnosed with diabetes, and you're just you're just run down and you're thin. Is that happening on the ship or is that happening on land?
ValerieOh, it happened on ship.
Scott BennerOkay.
ValerieAnd it was toward the end of the contract because I would only come on for, like, eight weeks. And then I would go home and I would get I would have another land job.
Scott BennerOkay. And then how how long did you stay on land before you went back to the ship?
ValerieFour months. So it, like, yeah, it would be two months on ship, four months off.
Scott BennerOkay. I was just talking to a guy that works on I was just on a cruise, and I was talking to one of the guys that works on a cruise, and he he was in the middle of, like, a six like, a five month thing.
ValerieOh, yeah. So most of the contracts are a lot longer.
Scott BennerYeah. Yeah. He was at the end of it, and he's like, we've had a couple of people I forgot what he said, but he was like, I'm thinking of signing on for an extra month. And I was like, so you'll be on this for
ValerieI would say no because you're so run down, and they would do that too. We would see that, but then they would just yeah. It's it's hard work every day. You're yeah. Sharing space.
Like, you don't really have any Yeah. Alone time because you're always
Scott BennerOn top of
Valeriesomething. Working or busy. Yeah.
Scott BennerCan I ask you, do you ever forget you're on a giant floating thing?
ValerieA little bit.
Scott BennerYeah. You ever walk through a door and go, oh, the ocean's there. I forgot about that.
ValerieNo. No. Not like that. I like, I had a inside cabin. It's not like I had, like, you know, a balcony or even a porthole.
Scott BennerThey didn't let me look outside, Scott.
ValerieYeah. No. Okay.
The Wrong Diagnosis: Type 2 Misdiagnosis
Scott BennerSo what again, first symptoms are tired, losing weight, you're on the ship. Do you get so sick you go talk to somebody, or does somebody say something to you?
ValerieNo. So I had a urinary tract infection Yep. And then I did the two courses of the antibiotic. And then when they repeated the urine after the second, there was sugar in my urine. Oh, gosh.
That's how they got the type two diagnosis.
Scott BennerI see. What do you think made them jump to type two?
ValerieBecause of my age. Uh-huh. And then they're like, oh, you know, there's, you know, medicines that's treat. Like like, I was I'm oh, I hate pills. So, like, it took a couple days and the doc is like, okay.
Then I'm like, fine. Write me the script. I'll go and get the medicine. But I don't, you know, I don't believe this diagnosis. Like, they did a lab draw.
We could do labs onboard. So when I saw the labs that put me into that kinda, like, pre diabetic diabetes stages, you know, and I was like, okay. Now I guess I believe I have diabetes, but I don't understand how I have diabetes.
Scott BennerHow long did you live with a type two diagnosis?
ValerieA year and a half. I would have always kinda, like, dermatological kinda stuff, and so how I got the specialist and the right diagnosis was the dermatologist. Because I would be like, okay. I'm not sure what's going on. He did labs.
Some of the labs were kinda off, and he's like, you should see an endocrinologist. I'm like, okay. Great. The people I worked with on the ship at the time, one of the nurses is like, oh, you should get an endocrinologist. I knew the doctor that I was particularly working with on board.
He would never write me that specialist, you know, because he's like, oh, no. You just take this med and that that's fine. You know? So I'm just lucky that I already had established dermatologist that did labs and I got the right diagnosis.
Scott BennerWhat dermatology issues did you have that that you were seeing a dermatologist that much?
ValerieIt would be acne. I would sometimes have eczema, but I I don't think I saw him for eczema. I would go, like, urgent care if I had a little, like, little bit of a flare up.
Scott BennerOkay.
ValerieAnd I always had great skin, and then I'm like, oh, this like or something. I and then that particular time I had, like, it's all over my back. Like, it's just these weird spottches, but it wasn't acne. Like, it's just like you're there's something off. I you know, I'm like, okay.
This is something's not right. Let's can I don't know? What is this? Tell me. Do I need to be on a med?
Scott BennerWas that a thing that happened only after the type two diagnosis?
ValerieYeah. I say so. Yeah.
Scott BennerOkay. Okay. Yeah. And then he got you to an endo?
ValerieMhmm.
Scott BennerThat and that's a year and a half later?
ValerieYes. Oh, no. So well, a year and a half later from the type two is when I got the referral to see Endo. And then that was a problem because he's like, oh, you know, like, he referred me to someone who had already, like, just recently retired.
The other two offices, no one sorry. No one worked in those offices or they never called me back. So because I would walk on the ship, and then in my role, I would help with the crew referrals. So I, like, I already knew how to advocate for myself or call the offices, be like, you know, I have these labs. It says I can see an endocrinologist.
Are you taking new patients? So I ended up finding an endocrinologist on a different island that I live on because no one in the offices on the island that has more endocrinologists had appointments or people even worked in their office. I don't know.
Scott BennerWait. An an island you lived on. Where were you living?
ValerieOh, so I live in Hawaii, and I yeah. There's a bunch of different islands I lived on. I live on the main island that has the majority of the people.
Scott BennerAnd where are you now? You still there?
ValerieYeah. Mhmm. Oahu.
Scott BennerTell people what time it is.
ValerieOh, it's yeah. 04:16 in the morning.
Scott BennerI mean, we could have, like, done this later in my day, which would have been later in your day. Why are we doing it at this time of day?
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Early Morning Recording and Hospital Work
ValerieOh, because it's before work and it's less noisy. Because I live somewhere where the yeah. I live in town and the noise starts early. The fire station is two blocks away. Like, at some point, it is so noisy, like and I don't have, like, a quiet room.
Scott BennerI see. So that's why we're doing it this early.
Scott BennerAnd have you been to sleep?
ValerieI have. Yeah. I did. I only probably got, like, five hours asleep.
Scott BennerOh my gosh. What time do you leave for work?
ValerieI leave for work at six. Wow. I come in at 06:30 when the nurses are about to change over.
Scott BennerAnd you're still doing, like, clerical, psychotropic, that kind of thing? Yes. How has that changed with computers over the last ten like, how has your job morphed?
ValerieIt's the same, but now the role I'm in sitting at a nursing station, I'm constantly interrupted. Before, I'd have my own office or a cubicle. I'm constantly, like like, it you know, is it a facility thing I gotta report? Is it a IT thing I gotta report? Like, the, you know, computer on wheels is not working so the nurse can't administer meds?
Is it a biomed issue? Depending on what device ain't working? I gotta put in a biomed. You know? So it's
Scott BennerActually Yeah. You're also making me think about I was at the at the hematologist recently getting an iron infusion. And it's a office I've gone to for, like, many years. And all of their staff, the ones who were, like, parked at a computer a lot of the times, they are just in cutouts in the wall, basically.
Like there's no doors, and there's usually two or three of them in a fairly tight space. Yeah. Is that what you're talking about?
ValerieNo. I'm at a nursing station where it's wide open.
Scott BennerLike an island almost.
ValerieYeah. I Okay. Yeah. I sit in an island. Gotcha.
Okay. Where people walk behind me, they walk in front of me, they stare at me, and I'm on the phone.
Scott BennerWell, also, you're on an island on an island.
ValerieSo Yeah. Exactly.
Getting the Correct Type 1 Diagnosis
Scott BennerGet you one more. You might be floating. Okay. When you get the type one diagnosis, do you remember feeling any certain way about it? Was it disappointing, or was it
ValerieI do. I remember going I for some reason, I knew that my a one c had to be under seven. He told me that you don't need to be on insulin now, but sometime in the next five years, you will need to be on insulin. So I'm like, okay. So what are we waiting for?
So so I do remember that. And then I knew there was also a level of stress because he had to fill out paperwork that said that I can go back to work on the cruise ship.
Scott BennerMhmm.
ValerieSo I was just like, okay. Because that's a role I had before working for them is reviewing the records. Like, if you get ill on the ship as a crew, you have to get, like, a fit for duty, no restrictions, then you can go back to work on the ship.
Scott BennerSure.
ValerieSo I knew I was like, oh god. Can I go back to work? Like, I'm fine. Like yeah. Like
Scott BennerYou just wanted you wanted to get back to start making money.
ValerieYeah. Exactly. Like, it's that's, like, my insurance. You know, it's, like, pays my rent. Like, I'm like, oh, yeah.
No. No. No. Like, hopefully and then I'm like, okay.
Scott BennerAnd so your biggest concern was getting back to work. But, what I'm hearing that's interesting is that you get a type one diagnosis, but it tells you
Valerieyou On the LADA. It's the LADA. It's type one, but, like, it's a slower the slower Sure.
Scott BennerOh, no. No. I understand. What I'm saying is he was saying that he thought that onset would last five years?
ValerieYeah. I started insulin maybe a year later.
Scott BennerI was gonna say it didn't make it five years. Right?
ValerieYeah. No. No. No. No.
So I don't know. I did there's this group that would come here and do conferences. So I did, like, the type two track one year.
Scott BennerMhmm.
ValerieAnd then when I got the right diagnosis, I did the type one track. And then I'm like, okay. Well, if we're watching, like, I wanna do the Dexcom thing. So I paid for my own Dexcom before I started insulin because I'm like, what are we watching for? Like, I just I don't it's still to this day, my big concerns is that, you know, I don't wanna be a patient in the hospital with DKA, so that hasn't happened.
And I don't wanna have a seizure or have someone have to use glucagon on me. Okay. Those were my big kinda, like, concerns now, you know, having the right diagnosis.
Scott BennerHow did you know to get a CGM when they were like, hey. We're looking for stuff to happen. How did you figure to do it?
ValerieIt's because I went to one of the conferences, and this is go this type is a little different. That that's how I knew.
Scott BennerOkay.
ValerieBecause and then I was like, I don't like, I didn't mind finger sticking myself, but finger sticking myself, like, before meals, after meals, like, I could do it, but it was like, it just seemed torturous and why, like Okay. Yeah. Yeah. No.
Scott BennerOkay. Yeah. No. I mean, CGMs are fantastic. When diabetes shows up in full force
And it becomes what it is, you know is there a big shift from LOTA, or does it feel like it's such a slow progression that you kind of understand it slowly and so when it gets there I
ValerieI think it's still low. I went many years without lows and then a little bit more like, more. But still not too bad. But, you know, you treat it, it goes up. I've been on about the same amount of insulin from the beginning, so it must definitely be your body weight.
And it's just the timing of insulin, how much you're gonna eat, and trying to stay in range. And then I I'm like the opposite. Like, I'm not bold with insulin. I had always started giving myself, like, I don't know. I've always given myself, like, the least amount or enough to keep myself in range, but, like, I was just always afraid that I'll give myself too much.
Scott BennerDo you live alone?
ValerieI do. I do live alone.
Scott BennerIs that part of the decision?
ValerieA little bit. Yeah. Because I yeah. I would say so. Yes.
Scott BennerHow much more aggressive do you think you would have been or maybe still would be if you had somebody else around?
ValerieMaybe. Just because then someone would get me I'm just afraid of passing out one of the nurses. Like, did you ever go down? I'm like, no. Like yeah.
So yeah. Just if I yeah.
Scott BennerI understand. What what's your a one c right now?
ValerieOh, I just had labs, but I'm not gonna look at them until Wednesday. Like, now like, I've never cared for that. It was the last one was 6.4. Okay. Most of them were under five.
I did have a 5.2, and I had zero lows. So I've always gone by, like, the fluctuations in my blood sugar number, not the actual number.
Scott BennerValerie, how much how much more aggressive could you get with a mid six to a a five? Yeah. Seriously, what what do you mean by, like, I didn't I'm not more aggressive? Like, well, how would you be more aggressive?
Scott BennerYou know I mean?
ValerieYeah. True. I guess not. I just you know, after I eat, if it goes up, I, like, watch it.
I just look at the arrow.
Scott BennerI see.
ValerieI just you know what I mean? Like No. I do. I wanna understand.
If my blood sugar is in the low two hundreds as long as I have insulin on board, and then within that three hours, it slowly comes back down.
Scott BennerSee.
ValerieI'm okay with that.
Scott BennerWhat number do you go, no. I'm gonna have to do something right now?
ValerieOver 200. If the air like, yeah. If it's over 200 and the arrow is going up, I would consider announcing a little bit more. Because now I'm on the islet. I I changed pumps.
Scott BennerKnow what We're get we're getting to that. Don't worry. Yeah.
ValerieYeah. Okay.
Scott BennerSo yeah. Don't don't worry. We got the whole thing covered. So over 200 rising, you would have been a little more aggressive.
We're talking about after a meal?
ValerieMhmm. Yeah. I might looking at what my onboard insulin is, like, I have a certain number that I'm like, four is usually what I would want after a meal to continue, like, a stable
Scott Benneryou were thinking about it. Okay.
ValerieYeah. Or that you know, it's always been two to four for meals, maybe six in the morning. I think yeah.
From Pens to Pump: The Omnipod Years
Scott BennerWhen you're first diagnosed, I imagine you're using pens, but then do you get to a
ValerieOh, no.
Scott BennerYes. Right? And then to a pump, what was your first pump? The
ValerieOmnipod. And then I wanted to point out something because I've listened to you for a while. It seemed like most people were starting on that basal insulin. From the beginning, my endocrinologist had charted that. We're gonna watch her, and then we're gonna start her on mealtime insulin.
Insulin. So I had saw that because I would review records, and I made sure I got a copy of my record.
Scott BennerMhmm.
ValerieI started on the mealtime insulin, then I went to the Omnipod, and then I then I tried the basal bolus thing. That's my progression of trying
Scott BennerWait. Okay. Wait. So you started on just mealtime insulin?
ValerieMhmm.
Scott BennerAnd then they put you on a pump?
ValerieMhmm. Oh, I asked to be on the pump because I was against the pump in the beginning because I didn't want two devices on my body. But then I realized, like, the only way you can get insulin in your body is through the injections. And then I have to do this for the rest of my life, so I might as well get an infusion set to rotate.
It's either I'm rotating my injections or I have to rotate an infusions thing.
Scott BennerAnd you just figured, like, let's get a pump. Okay.
ValerieMhmm.
Scott BennerAlright. And how long do you use Omnipod for?
ValerieProbably, like, about ten years.
Scott BennerOkay. Alright. Yeah. So you're on a pump pretty quickly.
You've used it for a long time. And now and so Eyelet's a a recent switch?
ValerieYeah. So I've been on it about a year, and for me, it was just for me, it's always been about mealtime insulin dosing, and so that's and then I, you know, I I would count carbs, but I've I can only eat a certain amount of food in a setting. I've never been able to eat and eat and eat. So I wanted to see what that algorithm did and also see if I can get more days out of the infusion set because Omnipod is only that
Scott BennerThree days.
ValerieYou know, hard three day, eight hours.
Scott BennerSo Yeah. Two of your concerns are you'd like to wear a a set longer.
ValerieMhmm.
Scott BennerIt's not about your effort. Like, did you
ValerieIt is. It's like like every time you eat, you have to announce. Every time I eat, I have to inject, basically. So, like, what can give me less input? You know what?
Or, like, what I have to
Scott Bennerto be less involved at this point?
ValerieYes. Exactly. Okay. I want less involvement.
Switching to the iLet Bionic Pancreas
Scott BennerOkay. And so you see I let and you're like, well, this thing says I say small meal I I I I tell me. What are the three choices?
ValerieOh, yeah. So it is here, I'll look at it. It's usual, more than usual, and then less.
Scott BennerHow long have you been using it?
ValerieAbout a year.
Scott BennerAbout a Okay.
ValerieSo, like, yeah. I I'm getting my shipment this week.
Scott BennerYou might say breakfast more than usual if you're gonna have
ValerieMhmm.
Scott BennerA bigger breakfast or breakfast usual and same thing, lunch, dinner, that's it. Now and you're wearing your CGM, so you're seeing your outcomes.
ValerieMhmm.
Scott BennerOkay.
ValerieYeah.
Scott BennerSo now I don't know if people understand, but with an eyelet pump, like, you cannot make an adjustment. Right? You can't say I'm 200 and I'm I'm going up Nope. And I want more insulin. So But
ValerieI I've learned how to add more insulin. You just announce again. I I figured it out. I've you know, I file I was compliant the first three months. Now I do what I want.
Scott BennerYou're fake carving as they say?
ValerieYes. But it's not because yeah. My endocrinologist said that too, but I look at the I know how to look what the insulin on board is and I've always gone on what is the insulin on board and what does my CGM tell me.
Scott BennerOkay. So when you first get this pump and they tell you, like, announce your thing and don't touch it
ValerieMhmm.
Scott BennerWhat were your outcomes like after that?
ValerieI say it was pretty good. It couldn't figure out certain foods like sticky rice, but I did I I just let it go high, but then it would slowly bring it down and not like, definitely this one, less lows. Not like I had too many lows before, but I would have them. So the outcomes, I'd say, pretty good. They would be kinda high, and I would just kinda, like, let it be because it would come down.
But now I'm, I know what to announce to bring it down faster without having a crash.
Scott BennerI gotcha. What do you mean how how did you have fewer lows when you weren't having that many lows to begin with? Is it because it's going up and staying higher more more this time?
ValerieYeah. I don't know. I wouldn't have like, when I I don't know how I wanna go about this.
Scott BennerTake your time.
ValerieYeah. So I would have more lows when I was menstruating before. I would have, like, that one week where no matter what I did, it was just, like, all over the damn place. But and I would have to, you know, do something to
Scott BennerIs that the week you need more insulin, or the week you magically seem like you don't need very much at all?
ValerieMore. Right before would be more, and then after would be kinda it would stabilize and I wouldn't you know, I I would have less input or less, like, I have to fix this or less, like, why is it higher than usual and it shouldn't be that high?
Scott BennerOkay. Yeah. So you had when you were having a hormonal impact that was needing more insulin you were finding
ValerieAnd more fluctuations where it would be like, and then yeah.
Scott BennerYeah. And you were finding the islet more difficult then?
ValerieOh, no. So I started the islet after the, like that's when I was on Omnipod.
Scott BennerOh, when you were on Omnipod, that's how you had you were having trouble during that week. I see. And the islet's handling that better, worse, different, same?
ValerieI it's better. It's definitely better. I'm, like, less input, less, like, having to treat a low and be stable.
Scott BennerValerie, when you were on Omnipod, was it Omnipod five, or were you just using Dash and making decisions on your own?
ValerieOh, you know, Omnipod five, and I I would use it in manual mode.
Scott BennerOkay. So you weren't using the algorithm. You were you were making decisions.
ValerieI did a little bit. I tried it, but it just the meals, it yeah. I couldn't figure out the meals.
Self-Management and Endo Relationships
Scott BennerYou couldn't figure out helps you when you need help? Is it an endocrinologist office? Do you have a community around you?
ValerieSo, no, I have a endocrinologist, but they don't really help me. I'm the one that does everything.
Scott BennerYeah.
ValerieI just basically go in, like, I need these scripts. You can talk about my graph all you want, but I I don't I yeah. I've pretty much from the beginning, I've been doing it myself.
Scott BennerSo even when you're having difficulty
ValerieMhmm.
Scott BennerYou find their input less valuable than just guessing into the wind?
ValerieYes. Okay. I do.
Scott BennerNow you work you work around medical people. What do you take from that when you do you think you're I mean, what's the reasoning? Are they are they not valuable or do you work around medical people and realize they're just people too so you don't see them as special? Or, like, what's the
ValerieOh, what yeah. That's interesting. Maybe because what I see at the hospital where the two nurses have to sign off on the insulin, or maybe because my doctor was on another island and I just, yeah, I I just never wanted the input.
Scott BennerThe endo you have, if you if you went in if you went in tomorrow and sat down and said, hey. Look. I'm having a problem. I don't have any idea what's wrong. You tell me what to do.
Do you think they'd get you to a solution?
ValerieI guess so.
Scott BennerYeah? Yeah. But do you think it would take more than one visit or more than six months or what, like, what would your fear be?
ValerieI don't know. Maybe because of how like, I started the insulin. I don't yeah. I don't know. I don't I don't maybe because I had feedback from one of the they're like, oh, no.
You don't have to worry. But I I don't know. Yeah. I just
Scott BennerNo. It's interest it's just interesting you don't, like, you know, that something's not not leaping to mind. Okay.
ValerieMhmm. No. I just like I I know I have to do this for the rest of my life as long as no one's calling 911 on me and, like, they're not doing a wellness check, I think I'm okay.
Scott BennerThat's how it feel. Okay. I get no. That's what I'm looking for. It's like, how does your day to day I don't know.
Why are you laughing, Valerie? What are you laughing for?
ValerieI don't know.
Scott BennerBecause it's 04:30 in the morning?
ValerieYeah. Guess so. Yeah.
Scott BennerSo it's more about getting along, not passing out not having something horrible happen that's, you know, getting you out of here too soon. You're just trying to stay down the middle as much as you can without putting too much effort into it.
ValerieYes.
Scott BennerOkay. Yes. Are you dating? Do you date?
ValerieNot really. No. But I I am seeing someone that we've been friends for a while.
Scott BennerMhmm.
ValerieSo yeah.
Scott BennerDid you date more before the diabetes or no?
ValerieNo. No. I didn't even then. Yeah.
Scott BennerYou don't like people?
ValerieI have no. I I like people. I have friends. It's yeah. It's just yeah.
Not I have a good friend network. I just it's yeah.
Scott BennerYeah? Not You're not looking for it?
ValerieNo. Not really.
Scott BennerYou think it's because of the dynamic you saw between your parents?
ValerieProbably a little bit. I wish my mother had divorced him, but she stayed with him until he So, yeah, definitely. It's definitely the dynamics that I saw my, yeah, biological parents. Yeah.
Childhood Trauma and Resilience
Scott BennerValerie, you just shocked me a little bit. You're telling me that if if I put you in a room with your schizophrenic mom and your dad.
ValerieUh-huh.
Scott BennerYou'd boot your dad out first?
ValerieYes.
Scott BennerThat's a hell of a statement, isn't it?
ValerieDefinitely. That's
Scott Bennera hell of a statement. My goodness. What was his deal? Was he a drinker?
ValerieI don't know, but the adoptive mother made a comment that maybe he was, but I I don't ever remember that.
Scott BennerYoung. Yeah.
ValerieNo. I was young. And I knew he worked as an accountant in a liquor store. There was never any alcohol at home. I yeah.
Because I was so young, so he could have been, but I don't remember.
Scott BennerWhy were you so harsh about him when you thought about him? He hit you?
ValerieOh, it's yes. Yes. That's how I got removed from them was the abuse. Like, people saw it, and that's how I yeah.
Scott BennerThat's how I
ValerieIt's alright. I'm it it is what it is.
Scott BennerTime ago. I understand, but still.
ValerieYeah. Mhmm.
Scott BennerDid he hit your mom?
ValerieYes. I used to, like, kinda, like, intervene. Oh. I'd be like, no. Yeah.
I don't yeah. I'm that young, and I was like, yeah. No. That's not right.
Scott BennerOther, siblings or just you?
ValerieI have a younger sister.
Scott BennerDid they remove her?
ValerieThey did not. She stayed with them until both their medical and things got worse, and then she ended up, like, with a guardian, like, high school.
Scott BennerIt's interesting. You had a younger sister when you were seven or eight years old. CPS removed you and left her. What? Because they didn't hit her?
ValerieI think so. Yeah.
Scott BennerWhat a bizarre thing. And then where where they put you? Did you stay there your whole life or did you bounce?
ValerieI, unfortunately, bounced. I would've stayed with the first one, but she broke her back, and then that's what started the multiple homes after.
Scott BennerHow many homes do you think you were in till you were 18?
ValerieAbout 14. But I I the last one did legally adopt me. Oh. So I got, like you know, before I would be kicked out of the system, I the family adopted me.
Scott BennerDid they do that for you for to help you with insurance, or do you think it was a a love situation?
ValerieIt it was a love situation, but for me, like, because of what I went through, I I can't bond.
Scott BennerYeah.
ValerieI don't know. I bond, but I bond in my own way, if that makes sense.
Scott BennerOh, no. I I completely understand. I'm actually, reasonably fascinated with this and have been I'm making a series with Erica right now about the ACEs and PACEs testing.
ValerieOh, yeah. Adverse childhood experiences.
Scott BennerYeah. I was gonna say you probably know that acronym.
ValerieOh, I know. I I got a high ACE score.
Scott BennerI did.
ValerieI'm not
Scott BennerI was gonna say I bet you would ace the ACEs.
ValerieOh, yeah. I would.
Scott BennerYeah. Yeah. We, we just put together well, we're in the middle of putting together a series on it, and I'm building an online tool that people can use to take the quiz so that they can kind of
ValerieInteresting.
Scott BennerYeah. See where they are. Probably outside of the more mental health stuff that I do in the podcast, I don't talk about it as much in, like, conversations like this, but I am endlessly fascinated by what people do and why they do it.
ValerieMhmm. Oh, yeah. Yeah. Yeah. Yeah.
I'm I'm amazed I'm not a psychopath for what I've been through.
Scott BennerHey. Valerie, it's not too late. Don't worry. You still
ValerieYeah. I still get well. I see at the hospital on a daily basis, I'm like, I'm doing well. You do it?
Scott BennerIs that something
ValerieI'm doing real well.
Scott BennerYou look at other people and you're like, I guess I'm not doing that badly. Yeah.
ValerieExactly.
Scott BennerThese poor sons of bitches. Yeah. Well, no. No. No.
I hear what you're saying. You know, I'm I'm working on something now. I I I really I'm gonna put it on the website pretty soon. I think it's interesting how accurately for some people that quiz can kind of guess at what your future issues might be.
ValerieOh, I would like to yeah. Because I everyone has issues. You know I mean? So yeah. No one's perfect.
Scott BennerDo you find that beyond, like, you know, having trouble, like, forming bonds, do you have other issues as well? And how many of them impact your diabetes care, do you think?
ValerieOh, I don't know. Oh, maybe I don't think it impacts I maybe obsess over, like, food and nutrition. It doesn't it's just yeah. I'll spend too much time or I'll, like, I'll eat this and maybe not eat that or yeah.
Scott BennerOkay. You you said your mom is in Thailand?
ValerieMhmm.
Scott BennerYes. Was your father Thai as well?
ValerieNo. He, like a Greek European mix.
Scott BennerOkay. Where did they meet? Do you know?
ValerieMhmm. Yeah. My mother was a nurse in a hospital. They lived in the same apartment building, and I got from my younger sister.
Scott BennerYeah.
ValerieOr not that or just the backstory. So he was going to maybe marry someone else, but then he got my mother pregnant. So he ended up having to marry my mother.
Scott BennerOh, he's he's do you think he was angry at you then?
ValerieMan, I had no oh, so no. I I know he grew up abused. So when I got legally adopted they gave the family, like, social service records and stuff, and that's how I learned my mother's diagnosis and that my father was, like, one of five kids and the only one that survived out of the five. Then, like, how like, the abuse that he put on me was something that he had already saw.
He thought that was normal child rearing, I guess.
Scott BennerReally? Yeah. No. I I I'm not surprised. Listen.
I'm not surprised by that at all. That's what that's what all the that's what all the studies say.
ValerieRead that, I was like, oh, that's probably why she didn't leave him or, like, she has a mental illness. That's the reason why she stayed or Mhmm. Yeah. I don't I don't know.
Scott BennerYeah. She probably felt like she needed the help too. Right?
ValerieMhmm.
Scott BennerEven if it wasn't great help, it was probably better than I'm gonna guess how she felt by herself.
ValerieYeah. I think so.
Scott BennerIs it hard for you not to really I mean, what's it like to have known them and then been taken from them?
ValerieOkay. I would like, when I felt when I got older, I would kinda go visit occasionally. When I was younger and I had these forced visits, I would get really, like, sick. Like, after the visit, I would be, like, projectile vomiting or, like, why do I have to do this?
Scott BennerI don't upset.
ValerieYeah. Yeah. It was just it's too traumatizing, like, having to but I would have to go do these, like, visits.
Taking the ACEs and PACEs Assessment
Scott BennerYeah. Hey. Can I get your input on my on the website I'm making?
ValerieSure.
Scott BennerYeah. So it it puts up a question in front of you. You answer yes or no, but there's a small icon at the bottom that if you get overwhelmed, you can click on it and do a grounding exercise. Do you think that's a good idea?
ValerieYeah. Yeah. Definitely.
Scott BennerWould you answer the questions with me for a second? Sure.
ValerieYeah.
Scott BennerAre you sure?
ValerieYeah. Positive.
Scott BennerDid an adult often swear at you, insult you, or humiliate you? No. No. Yeah. Did an adult often push, grab, slap, or throw things at you?
ValerieYes. Yes.
Scott BennerDid an older person ever touch or fondle you sexually? No. No. Did you often feel no one in your family loved you or thought you were special?
ValerieI'm gonna say no.
Scott BennerInteresting. Did you feel often you didn't have enough to eat or no one to protect you?
ValerieYes.
Scott BennerWere your parents ever separated or divorced? No. Was your mother or stepmother offer often hurt or physically threatened? Anyone who used drugs or was an alcoholic? You're not sure.
Right?
ValerieI'm not sure.
Scott BennerWe'll say no.
ValerieBecause I lived in different families. They smoked, but they didn't really drink too much, like, the multiple families I lived with. So and if they did, they would only have one, you know, after dinner. We'll say wasn't like a like a habitual thing. So I'm gonna say no.
Scott BennerBut I'm gonna ask a question. Are some of these answers coming from other families, not your
ValerieNo. Most of them are coming from the biological families. But I'm kinda like, you know, the drinking one, I'm trying to like
Scott BennerThink through the rest of them.
ValerieYeah. Think think through the rest.
Scott BennerAlright. Yeah. Two, two more, in the set. Was a household member depressed, mentally ill, or suicidal? We got a yes there.
ValerieYes. Yeah. Yes. Definitely.
Scott BennerDid a house member go to prison? No. No. Okay. So now that's the 10 aces questions.
And then you can the way it's set up then, you'll continue on to what they call the paces. These are positive things that can kind of counterbalance stuff like that. So could you talk to your family about your feelings? Yes. Did your family stand by you during difficult times?
ValerieI'm gonna say yes.
Scott BennerMhmm. Did you enjoy participating in community traditions?
ValerieOh, yes. Definitely.
Scott BennerDid you feel a sense of belonging in high school?
ValerieYes.
Scott BennerDid you feel supported by your friends?
ValerieYes.
Scott BennerDid you have at least two non parent adults who took a genuine interest in you?
ValerieYes.
Scott BennerDid you feel safe and protected by an adult in your home?
ValerieYes.
Scott BennerSo this is interesting because you have, an ACE score of four, so four of the the first set, but you have a seven on the positive side.
ValerieMhmm.
Scott BennerSo it your capacity to, like, you know, is greater to maybe have success after. It's it's tough to use the words because words are tough, like, find but find happiness.
ValerieThrive. I am better at thriving. Maybe that's the word.
Scott BennerYou weren't you literally answered yes to every positive childhood experience.
ValerieMhmm. Even though I had, like, not such a great one.
Scott BennerExactly.
ValerieYou know what I mean? Like but I still yeah. I don't yeah.
Scott BennerYep. It gives you some things to kinda carry forward.
ValerieSo Mhmm. Oh, definitely.
Scott BennerYeah. You're no kidding. Actually, the website does too. And it indicates to you a couple of things that might happen to you. So if you see like a sharper kind of ambiguous tone in a text message
ValerieMhmm.
Scott BennerDo you have, like, do you have any kind of feeling towards that? Does it make you feel like extra vigilant?
ValerieYou know what? Right now, it depends on my mood and where I'm at in my blood sugar. That's what I've noticed in this progression of this
Scott BennerOkay.
ValerieDisease. I'm gonna say, I am good, but if I'm yeah. And maybe higher than usual or low like, yeah. I do notice that Yeah.
Scott BennerIt's more
ValerieMost of time, I'm good and grounded, but I do notice that sometimes I'll get a little bit more, I don't know, anxious or, like like yeah.
Scott BennerWell
ValerieMy my demeanor will be a little bit different.
Scott BennerIt's interesting. It really is. When you get constructive feedback at work, do you have, like, a or do you have, like, a defensive feeling about it? You're good about it. Boy, that
ValerieI'm pretty good, like, most of the time. I'm not a morning person even though I'm up this early talking just because that when that phone start ringing at, like, six I'm there at 06:30 and then the extra noises, I'm I get kinda irritated really fast.
Scott BennerSally, your story is really kinda uplifting. Really? Yeah. Well well, because if a outsider's from my perspective
ValerieMhmm.
Scott BennerHard to say otherwise, you had a pretty start.
ValerieMhmm. Definitely.
Scott BennerAnd that that bouncing probably took ten years to, you know
ValerieYeah.
Scott BennerOf that. But talking to you as an adult, you're a mostly positive person.
ValerieI am. I am. I don't dwell it's it's I think it's a waste of energy. And I I don't have depression, luckily.
Yeah. I just I, yeah. I do my best to move forward. I just I try not to dwell on.
Scott BennerDo you think that the experiences you had growing up after you were removed from the home were such that the positivity of them and the support that came from them was able to kinda counterbalance your beginning?
ValerieI think so. Definitely.
Scott BennerYeah. People's people saved you. Yeah. That's something.
ValerieYeah. Definitely.
Scott BennerAre you in touch with any of those people, like, along the way?
ValerieNo. It was interesting when I was still living in the Chicago area. I had one of the kids in one of the schools ended up in the school that I was in, so we kinda kept in touch then. But no. And I did try to go back when I still like, it was decades ago.
I've been out here, like, twenty six years now.
Scott BennerYeah.
ValerieThat the first family, I'd like I would've stayed with them if she didn't break her back. So I did try to reach out back to them because I knew where to find where they lived and you know? Yeah. But they had probably already moved to where they had, like, a farm up in Minnesota, so they probably had that was their retirement plan, so they're probably yeah. So I did try.
Scott BennerSo had she not gotten injured, you think that would have been your kind of forever family?
ValerieMhmm. Yeah. They would have been my forever family.
Scott BennerWow. How old were you when you were separated from them?
ValerieI think I was only there for a year, so eight or nine.
Scott BennerBut you still remember it kinda fondly?
ValerieMhmm. Oh, definitely.
Scott BennerYeah. Do you go to therapy or have you?
ValerieI do. It's mainly more for documentation purposes slash a sounding board when, like, my insurance ain't gonna cover something or yeah. So, yes, I do. I talk to someone once a month as yeah.
Scott BennerWhat do you mean when your insurance doesn't cover something?
ValerieOh, so yeah. Like, during the pandemic, I had to switch insurances to the other company, and then they were covering my Omnipod, and then they stopped covering my Omnipod. They were like you know, I used to it went from, like, a reasonable co pay to no co pay to, like, oh, if you want this device, it's now a thousand dollars. And I'm like, what? You know, like, certain times a year, the formulary or whatnot.
So I went maybe a year without the Omnipod, which is fine. Like, I can do injections. It's for me documenting stuff like that.
Scott BennerBut how does a mental health therapist help you with that? I'm missing something.
ValerieSounding board, it's there. Maybe if I did get more sick because I didn't have my device or whatnot, it's
Scott BennerOkay.
ValerieSomething that will hold up in a court of law. I don't know. Maybe because I used to do depositions. I don't know. It's
Scott BennerAnd do you find it help do you find therapy just helpful in general just to be able to kinda unload on somebody?
ValerieYeah. It's it's another viewpoint into whatever it is that I might have problems with or yeah. Mhmm. Yeah.
Scott BennerWow. That's really great. You are I mean, for how things started for you, you were an incredibly together person.
ValerieI am. I'm amazed.
Scott BennerYou never killed a bunny rabbit or pulled the wings off of flies or anything like that?
ValerieNo. What could No. I recently did kill a spider.
Scott BennerWhy? No. I'm just kidding. Because was it trying to murder you in your home?
ValerieNo. It was just like, yeah. Don't do a web here. Yeah. It's not very Buddhist of me, but I did recently kill a yeah.
Scott BennerYou were like, listen. I'd let you live if you weren't messing up the corner of my room.
ValerieSometimes I'll just scoop it up and stick it in the toilet and, like, you can have a watery grave, but Listen.
Scott BennerIf you can live through this and get to the other side, then god bless you on your way.
ValerieYeah. Definitely.
Scott BennerGod prayed Buddhist love the art.
ValerieI'll say a prayer for you. Okay. Go.
Scott BennerAre you Buddhist? Is that your religion?
ValerieNo. But that's because my mom from Thailand, like, I like their ritual and cultural stuff the most. Like, because I lived in different families. They did have different traditions. I did live with a Jewish family for a while, so we would have so every culture has their own kinda traditions to, you know And you gotta see
Scott Bennera lot
Valeriemothers the most, but I I don't claim any religion.
Scott BennerListen. I was gonna say, speaking to you, if if you told me you were religious, I would say that would have shocked me.
ValerieSo Yeah. No. I know. Yeah. No. No. No. No. No. No.
Lessons from Foster Care: Different Families, Different Perspectives
Scott BennerI'm assuming you gave up on asking into the darkness a while ago. Yeah. So 10 you're years old, you're like, you broke her back? Are you kidding me? Yeah.
Yeah. Yeah. I know. My goodness. Yeah.
Oh, gosh. Yep. What have you taken away from being around so many different people? Like, is there something valuable from having kind of absorbed the way others see the world in so many different settings?
ValerieI guess so. Like, it's just to have a open mind and
Scott BennerValerie, can I tell you? Because I'm adopted. Right? Mhmm. But I was adopted as a baby.
Yeah. But the entirety of my life growing up with my family, what I would notice is that if something happened or there was, like, a decision to be made or people got upset or happy, Like, my response to a lot of things was never the same as theirs. So I had my response, but I was also able to see their response, which was often different Yeah. From mine. And I have brothers who I have brothers who are natural to my my adopted parents.
So, like, the four of them would almost react similarly. And I was over there going, like, I don't think this is the takeaway from this. But Yeah. But I found it, like, it's interesting to not feel like you have to adhere to something.
ValerieOh, yeah. Definitely.
Scott BennerYou know what There's, I like, family traditions or religious traditions or something like that. And you I was always able to kinda stand slightly off to the side of it and go, like, well, I'm just here because you you you rented me. Yeah. And I I never felt stuck to one thing because that and I felt like that gave me the opportunity to sample a lot of different people's ideas and I found that really helpful.
ValerieMhmm.
Scott BennerBut I was wondering if you were too busy being horrifyingly shipped around from person to person to appreciate that or if you took something from
ValerieI was okay with it because the families were good. They were trying to, like, do, like, adoption placements. Like, I had two, and those didn't come out as well. Maybe because they wanted another kid, but then their dynamics, they needed to work on stuff.
They and they thought maybe having an a child would help their dynamic, but then I was like, yeah. And then the last family, it just worked out. Like, I don't know. I was like, I wasn't planning or wanting to be adopted, but I'm like, okay. Like, this yeah.
Scott BennerWere you getting older at that point?
ValerieMhmm. Yeah. I was getting older, and I always did well in school and, you know yeah. And I was like, okay. This this could be the forever home.
Scott BennerDid some people have more difficulty being loving towards you than others, and did some not try at all?
ValerieWell, some overdid it a little bit. Oh. Yeah. Like, I don't know. Like, I was just like, where is this coming from?
Yeah. Yeah. No. And then some were, and then yeah. I just remember one, it was it was yeah.
I yeah. Yeah. Not good. Maybe I'm just wasn't accepting to the over of loveness. I don't know.
Scott BennerOh, they were trying really hard and you weren't open to it.
ValerieYes. Yeah.
Scott BennerI gotcha.
ValerieI'd say that's that that would be it.
Scott BennerYeah. Makes sense. I mean, as I'm listening and and after hearing you, like, answer those questions, like, I'm struck by how lucky you are that, you know, through that whole thing, like, nobody touched you inappropriately.
ValerieLike Yeah. No. Yeah.
Scott BennerSo lucky. When I You know what
ValerieI mean? Occasionally, I talk my sister would like, biological one. We talk, but we're still a little bit estranged.
Scott BennerMhmm.
ValerieAnd she has a different autoimmune. She has that PCOS, and then she's had multiple surgeries. And and then I try to get, like, feedback of what she remembers living with them for, like, the medical issues and that sort of stuff. Wait. What does she have?
Remember her saying that because she goes to therapy. She's like, oh, they think that, you know, that he touched us or whatnot. But I don't ever remember any sort of that going on at all.
Scott BennerCould have been after you left even. Yeah. Yeah.
ValerieYeah. So I you know, I'm pretty certain that didn't happen.
Scott BennerWhat autoimmune issue does your sister have?
ValerieOh, that polycystic ovarian syndrome.
Scott BennerShe has PCOS?
ValerieYeah. Oh, and And then, you know, they they get gross and then they have to have a surgery, and I think she's had at least two surgeries. And then she would get sick a lot. Like, I'm amazed that I don't really get ill very often. I would just have dermatology stuff.
Scott BennerYeah. Did those surgeries help her?
ValerieI think so. Yeah. Because they they get the growths off. But then, you know, few years later, then she has to
Scott BennerDo it again. Yeah. Yeah. That sucks. What would she have?
Like, real heavy irregular periods, pain?
ValerieYes. Exactly. Yes.
Scott BennerRight.
ValerieYes.
Scott BennerYou've had some skin how do have you ever had your thyroid tested?
ValerieYeah. Yeah. Yeah. I I think when I first got that diabetes diagnosis, like, got the labs. I have an internist.
I've seen him for a long time. And I'm like, are we sure that I like, I have diabetes? And then he redid the labs, and then he made a comment. He's like, oh, look.
It was, like, a little less than the labs that I brought in.
Scott BennerOkay.
ValerieAnd he's like, oh, look. You don't even have diabetes. But then I was like, oh, can we check other stuff? So and then the endocrinologist, he adds that on the labs. Yeah.
But, you know, for most medical things, unless you complain about a symptom, they're not gonna check it.
Scott BennerNo. Of course.
ValerieYeah. Do
Scott Benneryou still have, skin issues to this day, or are they something that's stopped?
ValerieOh, if they're kind of resolved, but, yes, I say, yeah, it does happen, but not too often. But it does happen.
Scott BennerOn your back mostly?
ValerieBack. Oh, yeah. Now recently, I have stuff all over my chest. It's like they're skin tags, and my dermatologist said it's like, oh, it's just like you're getting older. I'm like, great.
This is Awesome. Yeah. Mhmm. Great news. I'm gonna have to see you more regularly.
This is what happens when you get old. Like, I have to come see you more often. I don't wanna come see you.
Scott BennerI started to get, like, age spots in some places, and I was like, oh gosh. Maybe I should just give up.
ValerieYeah. No. I thought they were warts, but they're not warts because of where they're lying on my chest.
Scott BennerOkay.
ValerieThey're warts when they're on, like, your hands, but they're very similar to the stuff that were, you know, around my pinky. So I thought they were warts. They're not warts. They're skin tags that have to be burned off. Yeah.
Scott BennerDo you get them removed?
ValerieI am. Yes. I have another there's so many of them. It's ridiculous. It used to be just a little spot, and I'm not sure how they all multiplied.
Scott BennerMaybe they're like gremlins. You're not getting them wet after midnight, are you?
ValerieExactly. So I'm like, he did. He's like, I already done about 30. I'm like, yeah. The I don't have any expectation you're gonna get all of these, so just do whatever, and I'll see you in the next appointment.
Scott BennerDo they freeze them until they fall off?
ValerieNo. It's he's burning them. It's I don't think it's freezing. It's, yeah, it's a whatever device and
Scott BennerOh my gosh. And you said wait. 30 have been they at some points?
ValerieYeah. Mhmm. I have so much more. Like, I have my appointment next month. So Mhmm.
So he's not gonna get all of them. It's just that, hopefully, the skin will will renew and it will, I don't know, look better.
Scott BennerWhen you think about dating, do you does that concern you, or are you old enough you don't give a crap about stuff like that?
ValerieOh, yeah. I'm old enough. I don't give yeah. I don't care. Yeah.
Me at the nursing station, like, the docs come and, like, the nurse have to drop everything. They're juggling, like, four patients. They gotta drop everything, go deal with whatever at the bedside. I'm just like, yeah. You can wait.
Scott BennerMy gosh. Listen, we're getting
ValerieThey don't wanna deal with me. I'm like, no. You can wait. Do you see how this person running around? I'm like, mm-mm.
You can wait.
Scott BennerHer blood sugar might be high. She gets, a little surly out here.
ValerieYeah.
iLet Pump Review: Pros and Cons
Scott BennerSo let I wanna hear a little more. This is you know, we're getting up on an hour, but, like tell me any of your takeaways from using the Islet pump. What have you enjoyed? What have you not enjoyed?
Like, how would you explain it to other people?
ValerieI enjoy it. It is the algorithm, I say, I like better than the Omnipod. And if you do want to give yourself more insulin that you think you're too high, you can. You just have to announce again. But I say it it it is pretty good.
It just it can't figure out the carb count because you can't put a carb count in there, but it is yeah. It is pretty good.
Scott BennerGive me some becauses. I like it better than Omnipod because
ValerieOh, number one, it's the infusion set. I can get the three to four days out of it.
Scott BennerOkay.
ValerieAnd then it's always been around the flexibility about the mealtime dosing. I still sort of do, like, the pre bolus where I'll announce, and then I'll wait, and then I'll eat. But I know I don't have to, but I've just always had that kinda like, I know the insulin, it takes a half hour or more to peak that I rather you know, I have my food. I know what I'm gonna eat.
I just am patient and wait for the data to change and then eat. But I know I don't need to do it, but it's just already a habit that I do that.
Scott BennerWhy do you say you don't need to do it? Because they tell you not to?
ValerieNo. I'd say when I did the three months, I I wasn't pre bolusing, or I was just like, and it it did it did do well. You know?
Scott BennerSo If you don't prebolise with the islet in the first three months, where does your blood sugar go after you've eaten? And then
ValerieIt it'll go it would do the low two hundreds, but come down and no lows. This one, like, I never had my blood sugar up in the three hundreds. The islet occasionally would get it up there. But then I would just kinda like, I have no symptoms.
I'll just let let's see what the algorithm does, and it did, you know, bring me down.
Scott BennerBut if you wanted to avoid peaks in the two hundreds at meals, the pre bolus thing helped?
ValerieYes.
Scott BennerGotcha. Alright. Finish this sentence. I miss about Omnipod. What do you miss about Omnipod?
ValerieOh, that I could wear more dresses. This pump, I find I I have to clip it on. I yeah. The dressing part. Like, I I still wear dresses, but I it's I liked that I could yeah.
Scott BennerOmnipod was aesthetically easier for you?
ValerieYes. Aesthetically and just clothing. Here, like, I have to, like, make sure I dress this in a certain order of what I put on. Mhmm. Yeah.
Scott BennerHey. If, how long does the infusion set on the eyelet work for?
ValerieI can get three to four days because it's the amount of insulin that's left in the device, and then it'll remind you that it's you should change it out. But now I'm like, I still have 30 units and that will last me the two meals for today. Because I during work, I don't eat breakfast because as soon as I walk into the hospital, it's it's crazy.
Scott BennerYou're not getting that much more out of it time wise in the Omnipod?
ValerieNo. No. But do you like
Scott Bennerhaving extra time with it?
ValerieYes. Yeah.
Scott BennerOkay.
ValerieIt's just you know, you're like, yeah. It's I like I can't wait to get that fifteen day Dexcom. That's my appointment on
Scott BennerI see.
ValerieYou know, this Wednesday. Yeah. His domain he's like, oh, no. It's just gonna be a system upgrade. I'm like, no, dummy.
You need to write me another script. Mhmm. So yeah.
Scott BennerThat dummy.
ValerieYeah. Well No. Because he's, like, he's so, like, yeah. No. It's just gonna be, like yeah.
You yeah. Yeah. You're clueless. Like
Scott BennerWhat I around the diabetes, what I've taken from our conversation is that what's most important to you is ease of use, fewer touches on diabetes, less thinking about it.
ValerieYes. Yeah. Exactly. And that's that that was the marketing of the eyelet. So that's I'm like, okay.
Let's try this.
Scott BennerIt spoke to you on that on that level.
ValerieTo me. I'm like, I need I need less. I already gotta do so much in my daily life.
Scott BennerYeah. Yeah. Yeah. No. I hear that.
What's interesting is, like because a lot of people come on here and talk about, like, oh, I'm trying to get this number here. I'm trying to be specific about this. You're like
ValerieFor me? Yeah. Yeah. I I don't look at my a one c. I look, okay.
And then I remember one appointment I was just like, what a one c do you want? Because I'm not trying. I'm just trying not to end up in the hospital and
Scott BennerMhmm.
ValerieNot have Lowe's. That that those were always my goals from the beginning. Interesting. Yeah.
Scott BennerNo. I mean, everybody's got different goals. And, you know, it's interesting to hear your progression, your life, and where I think you're
ValerieLike, I I wanna see in ten years from now because progression. Like, I'm not really having many issues besides dermatology issues. So, like, yeah, I wanna see I don't know. Yeah.
Scott BennerDo you have any worries or concerns for the future? Not really.
ValerieWhat I see in the hospital is kinda disturbing. So, yeah, we'll see. I don't yeah. I wanna lose a part of my body. I yeah.
Scott BennerYou do see that that will
Valeriehappen, but, you know, I yeah.
Scott BennerBack of your head, you're thinking about it.
ValerieMhmm. Yeah.
Scott BennerWhat would make you change pumps? What would somebody have to
Valeriepresent smaller. I saw someone with that, the Mobi, and it's littler. I'm like, can you run that, like, on manual? Or yeah. I don't know.
ValerieIt was I liked it because it was smaller. And then you can, like, attach it to yourself kinda like the Omnipod.
Scott BennerValerie, I'm confused about one thing. Yeah. You are using a pump right now, Islet, that is so hands off. You have no control over it really other than to say Mhmm. It's breakfast, lunch, it's dinner, this is big, medium, small.
But you didn't run the Omnipod five in automation. And when you think about the Mobi, you wonder if you can run it manually.
ValerieYes. Yes.
Scott BennerWhat's wrong with you? Why can't Control. You
ValerieIt's just the control. Like like yeah. I want control, but then I want less. Like
Scott BennerOr none.
ValerieOr none.
Scott BennerYeah. I would talk to my therapist about that if I was you.
ValerieOkay. Okay. Sounds good.
Scott BennerYeah. Yeah.
ValerieWell, I did try the Omnipod and the algorithm, but I just didn't yeah.
Scott BennerDidn't what? Yeah. You do that sometimes, Valerie. You don't finish your thought. You didn't what?
ValerieI I didn't like it. I don't I it it just would get too high, and I'm like, why isn't it changing the arrow when I know I can intervene and
Scott BennerWhy didn't you intervene?
ValerieChange that arrow. Because I thought the algorithm would do it. I guess I could have, but then I'm like yeah.
Scott BennerAnd when you got to the islet and it also wasn't stopping high blood sugars, you're like, oh, I'm gonna intervene.
ValerieAt some point, I finally did.
Scott BennerYeah. So this might have less to do with the system and more to do with your
ValerieYeah. I I agree. I agree.
Closing Thoughts
Scott BennerHave we missed anything that you wanted to talk about or anything that we, you know, anything I didn't remember to ask you about?
ValerieWe covered everything. Yeah.
Scott BennerYou happy that you did this?
ValerieI am. I am. Good. Yeah.
Scott BennerWhen you said you've been listening for a long time, contextually, is that years?
ValerieYes. Years. So as soon as I got the right diagnosis, I made sure to find the community and then just yeah. So I've been listening to you for, yeah, years and years.
Scott BennerYou've been listening to this for, like, nine, ten years?
ValerieYeah. I'd say so.
Scott BennerOh, wow. Thank you. Mhmm.
ValerieThat's very nice. Definitely.
Scott BennerIt's lovely to hear. Thank you very much.
ValerieEpisode. I just kinda come on and I look and I'm like, okay. Let's listen to this one. Yeah. No.
It's good to hear other people talk about how they're managing it and yeah.
Scott BennerNo. It makes me happy that it's there for you when you need
ValerieMhmm. Yeah. Definitely.
Scott BennerReally awesome. Well, Valerie, I appreciate this. I go ahead to work.
ValerieOkay.
Scott BennerLive your life as you will.
ValerieMhmm. I will.
Scott BennerI really do appreciate you doing this. Your story is gonna add to the podcast wonderfully. Yes. If you hold on for one second, I'll just tell you a couple things before we go.
ValerieOkay. Sounds good.
Sponsor Messages and Outro
Scott BennerThank you. I'd like to thank the blood glucose meter that my daughter carries, the Kontoor Next Gen blood glucose meter. Learn more and get started today at kontoornext.com/juicebox. And don't forget, you may be paying more through your insurance right now for the meter you have than you would pay for the contour next gen in cash. There are links in the show notes of the audio app you're listening in right now and links at juiceboxpodcast.com to Kontoor and all of the sponsors.
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. Thank you so much for listening.
I'll be back very soon with another episode of the juice box podcast. If you're not already subscribed or following the podcast in your favorite audio app, like Spotify or Apple podcasts, please do that now. Seriously, just to hit follow or subscribe will really help the show. If you go a little further in Apple Podcasts and set it up so that it downloads all new episodes, I'll be your best friend. And if you leave a five star review, oh, I'll probably send you a Christmas card.
Would you like a Christmas card? Have you tried the small sip series? They're curated takeaways from the Juice Box podcast, voted on by listeners as the most helpful insights for managing their diabetes. These bite sized pieces of wisdom cover essential topics like insulin timing, carb management, and balancing highs and lows, making it easier for you to incorporate real life strategies into your daily routine. Dive deep, take a sip, and discover what our community finds most valuable on the journey to better diabetes management.
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