#1850 Still a Human
Masha shares how her son's Type 1 diabetes diagnosis didn't stop her family's six-month move to Finland weeks later , emphasizing the power of education over fear.
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Key Takeaways
- Bedwetting and sudden, intense emotional changes—such as unusual rage or sentimentality—can be early warning signs of Type 1 Diabetes in children.
- A Type 1 Diabetes diagnosis shouldn't prevent your family from pursuing big life plans. With the right supplies and preparation, traveling or moving abroad is entirely manageable.
- Transforming anxiety into preparedness by identifying worst-case scenarios and creating actionable plans for them is a highly effective way to manage the mental burden of diabetes.
- Pre-bolusing (administering insulin 10-15 minutes before a meal) is a crucial foundational tool that helps prevent post-meal blood sugar spikes.
- Focusing on what you can control today—like sleep, food, and exercise—is far more productive than dwelling on unpredictable "what ifs" about the future.
Resources Mentioned
Introduction & Sponsor Messages
Scott Benner Hello, friends, and welcome back to another episode of the Juice Box podcast.
Masha Hello. My name is Masha. I'm a mom of a seven year old well, actually, two boys, but one of them has type one diabetes.
Scott Benner If you'd like to hear about diabetes management in easy to take in bits, check out the small sips. That's the series on the Juice Box podcast that listeners are talking about like it's a cheat code. These are perfect little bursts of clarity, one person said. I finally understood things I've heard a 100 times. Short, simple, and somehow exactly what I needed. People say small sips feels like someone pulling up a chair, sliding a cup across the table, and giving you one clean idea at a time. Nothing overwhelming, no fire hose of information, just steady helpful nudges that actually stick. People listen in their car, on walks, or rather actually bolusing anytime that they need a quick shot of perspective. And the reviews, they all say the same thing. Small sips makes diabetes make sense. Search for the Juice Box podcast, small sips, wherever you get audio. Please don't forget that nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan or becoming bold with insulin.
Scott Benner Today's podcast episode is sponsored by Medtronic Diabetes, who is making life with diabetes easier with the MiniMed seven eighty g system and their new sensor options, which include the Instinct sensor made by Abbott. Would you like to unleash the full potential of the MiniMed seven eighty g system? You can do that at my link, medtronicdiabetes.com/juicebox.
Scott Benner Today's episode is also sponsored by the Kontoor Next Gen blood glucose meter. This is the meter that my daughter has on her person right now. It is incredibly accurate and waiting for you at kontoornext.com/juicebox.
A Diagnosis Before a Big Move
Masha Hello. My name is Masha. I'm a mom of a seven year old well, actually, two boys, but one of them has type one diabetes. He was diagnosed when he just turned six, maybe a month after. And we were lucky enough that he didn't go into DKA because my mom, she has type two, and she was like, oh, the symptoms, you should go and check check it out. So, like, this is how we found out early. And, of course, it did change our lives upside down, but also I guess, like, why I'm here, like, what the main idea I wanna share is that, like, what happened in our life. We were planning to move abroad to Finland for half a year, And my kid was diagnosed three weeks before our flights. And so, like, this was this kind of, like, two life changing event events stacked side by side. So I wanna share that things are possible and, like, diabetes didn't stop us from going. And even though it's, like, super scary, super terrifying with the new diagnosis, like, we still went and there was, like, zero regrets.
Scott Benner Okay. So you you think you have, like, these two core ideas you need to share?
Masha Yeah. Just, like, lack of fear and, like, education. Like, your podcast helped tremendously in the very beginning. So I'm, like, I was just adamant. I thankfully, again, just, like, things kind of worked out in this weird ironic way that I had three three months booked off work because I really needed a break for other reasons, but, like, I dedicated this time not to myself like I intended to, but to learning everything I could about diabetes. So I guess the main two ideas is, like, yeah, don't be scared of big things like traveling or anything like that. Or, like, we moved for six months overseas to a country where where I didn't speak the language in
Scott Benner No.
Masha With a kid with diabetes and also education.
Scott Benner Okay. Let's start at the beginning then, and we'll get and then we're gonna unpack all of that. So you said you have two children. One of them has type one. How long ago were they diagnosed?
Masha This was in 2024 in July, so it's a year and a half ago.
Scott Benner Okay. And were there any reasons to think that diabetes might be in your future prior to that day?
Masha Not at all. I wasn't it wasn't even on my radar. All I knew is that my great grandmother had diabetes. Nobody knows which type. I remember my mom telling me no. Sorry. Yeah. My mom telling me that she was injecting herself with this huge old school syringe. It was in Soviet Ukraine, so, like, who god knows what it was like. But that was it. Like, I didn't know anything about type one. I only heard it's the bad type, the bad diabetes. Like, that's all I knew.
Scott Benner That's how they talked about it. Mhmm. The bad yeah. You're not the first person to say that. And how about other autoimmune issues in your family? People have celiac or RA, thyroid issues, anything like that?
Masha No. Nobody has anything else. I know if you're asking these questions, I've kinda thought about it, and now I couldn't come up with anything. Like, my mom has type two, but she has a lot of things. So it's Yeah. I don't think it's autoimmune. It's like lifestyle and stress and whatnot.
Scott Benner Mhmm. And, I mean, how about just generalized health? Is this like a situation where you're a young family, you've got a couple young kids, and everything's going great, and then all of a sudden, whack this happens? Or do you even have any, I guess, history with other things going wrong? Any reason to feel like you'd be good at this or, you know, have some practice at the very least?
Masha No. Like, things are going really well, and I was always about healthy eating. So my kids eat vegetables, and they pick salads on their own without me priming them. And, like, I always, like, keep three cornerstones of health, good food, sleep, and exercise. But in like, in terms of kids' exercise, basically, just, like, grinding around. So yeah. And we this was totally out of the blue, and I did not expect this at all.
Scott Benner Okay. Alright. Well and then there you are. So what is the first sign, and how do you know to pay attention to it?
Masha So the first and pretty much the only sign was that he started wetting his bed, which hasn't happened because he kinda trained himself out of a diaper at two, and the kid's never had any accidents since. Well, okay. Maybe one in five years. But that was a big sign, and we thought, okay. This might be stress because we were talking about, like, moving to Finland. This is always a dream of ours. And so we we thought, okay. Maybe this is stress. So we went to the doctor, and the doctor says, oh, it's probably stress. And, also, I used to sleep in his room because he was, like, five at the time, and we took away the mattress. And this started happening, like, a week after. So we thought, oh, maybe it's the stress of mom not sleeping in his room anymore. So we tried everything. Nothing went away. Then he was he was generally a cranky kid, like, from the very beginning, but the level of crankiness just, like, a month before diagnosis was almost unbearable. And so my mom said, like, wetting the bed is a sign of diabetes. You guys should go check his blood sugar. And then we did do the blood work, but my doctor who I'm really, really mad at, like, we didn't get a call from a doctor. We got a call from the lab. This is how we found out. The the lab called us on a Saturday, and we went to the hospital Monday morning where the diagnosis happened. But, thankfully, like, he was not in TKA. He didn't even need any IVs or anything like that, so we caught it early, they said.
Scott Benner What was that time you said that time was difficult? How was it difficult? His health or the way he was acting, or what part of it? Maybe all.
Masha I guess just, like, emotions. He was a very always a very emotional kid, and he's an older brother. He's four years older. And they were always fighting even from when when the youngest one turned two, I feel like that's when the fights just escalated, and then COVID happened. So, like, there was a lot of emotions in general.
Scott Benner Okay.
Masha So he would get upset really easily. He would be yelling, screaming, like throwing things. But I kind of thought this was sort of normal because, like, the they both got on each other's nerves all the time. Mhmm. And so but, like, prior to diagnosis, he would just, like, come up to me and just, like, cry out of out of the blue, basically, who said, oh, I don't wanna grow up. I wanna be a baby and things like that. He would just, like, start crying when he was looking at his old pictures. Like, it was really
Scott Benner He was really emotional. Yeah.
Masha Yeah. Like, really emotional, but, like, he's usually emotional in, like, in in a rage manner, but, like, not in this very sentimental and kinda sad. But but then, of course, the rage was also there. It was just, like, very, like, much more frequent. It was, like, not once a day, like, before, but, like, I don't know, three, five times. Yeah.
Scott Benner Okay. Do you recall what you thought was going on before you realized the diabetes?
Masha Like, it's really hard to say. I I just remember thinking, like, we must have messed it up somehow. Like, maybe he's really stressed about Finland. And, also, like, at the May, just, like, when the symptom like, these symptoms were showing up. Like, my grandma died, so, like, I was really sad. And I was just thinking, yeah, something, like, emotionally must be going wrong. There's like, it's a lot for a five year old to know that he's gonna be moving abroad and Yeah. Mom was sad and all of that.
Scott Benner Gotcha. Any, anxiety in your family? No. No? Okay. Well, so what happened in the hospital? What did they what did they tell you, and how did everything begin? Did you get good technology? Did you get good direction, or did you feel adrift?
Masha Well, when we on a Saturday where we got the call from the lab, we kind of knew that this is what it is. We did the research, and we're like, okay. This is her life. My husband accidentally, about a month ago, he read an article about somebody with type one describing diabetes, like how hard it is and how it's a lot like playing flappy bird, you know, when you can get too high and you cannot get too low. Mhmm. And so, like, that was the idea, and I thought, oh, this is it gets hard, but I didn't know what to expect. And in the hospital, they basically measured his blood sugar. They said, well, this is type one, but, like, wait until we get all the blood work done and stuff like that. And, yeah, like, he was diagnosed, then they said, oh, you have to stay in the hospital for a couple days until we, like, teach you what it is, what to do. They were doing finger pricks before every meal and the hospital food here. Holy moly. Like, I I I'm still scarred by the breakfast. Like, for a type one diabetic, it was orange juice, banana muffin, and frosted flakes or something. I'm like, what are you doing? How is this a diabetic breakfast? So, like, thankfully, my husband was able to go home and bring us some, like, proper foods and, like, omelets. I don't know. Like, food is I'm really obsessed about healthy food. Yeah. So, yeah, this is kinda funny. And so two days, we were doing the finger pricks, and they were doing injections, and they were teaching us how to do injections. They gave us pens.
Scott Benner Mhmm.
Masha And I'm the person who's terrified of needles. I don't even have my ears pierced. So I was like, oh, how ironic that now I have to do this. But it took me a day to basically adjust, and they thankfully gave us a Dexcom g seven on the last day before they let us go home.
Scott Benner Okay.
Masha And so this was I think this was crucial for me to not just go insane, but worry because I was like, okay. We see the numbers. We kinda know, like, very roughly what to do, how to control them. I'm really thankful to the nurse who just gave us, like, a whole bunch for free Yeah. Because I think they were testers. Like, I don't know. Marketing material maybe. Mhmm. Yeah. So this is how it all started. Then we had to make a really big decision. Like, okay. We have these tickets to Finland to fly overseas. So, like, we consulted the doctor. We consulted the nurse, and they all say, well, it's really up to you.
Scott Benner Nobody was helpful. Hey. How far before your planned move was the diagnosis?
Masha So we had tickets in the July. So we put yeah. We planned it probably, like, March where I registered him for school and all of that, and he was diagnosed in the June. So, like, three and a half weeks maybe.
Scott Benner Yeah. Did you end up going?
Masha We did. Yeah. We just figured it was really hard, but we figured, you know, Finland is a civilized country. They have some basic health care. We'll figure it out. We just packed a whole bunch of insulin, and we packed a whole bunch of Dexcom. And we said, well, worst case scenario, we're just gonna be back in a month. And we said we're just gonna use that as a traveling opportunity with insulin and Dexcoms.
Scott Benner Did you sell your home, or did you were you renting?
Masha We wanted to rent it out, but then the opportunity fell through, like, also a week before the flight. So, thankfully, my partner's mom came to, like, help out with the house.
Scott Benner Okay. So you you had a place to come back to if this whole thing blew up. You could've okay. You could've come back.
Masha Because we only were going to we the plan was to go for six months because I didn't wanna lose my job and yeah.
Sponsor Break
Scott Benner Oh, you well, so aren't you interesting? What makes you such a a free spirit with the let's go some let's go to Finland for six months? Where's that come from?
Masha Oh, boy. Do you have time for long stories?
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Relocating to Finland
Masha Okay. So I moved to Canada from Russia all those years ago all by myself as a student. So, like, I was always, oh, I wanna travel. I don't care about physical possessions or owning anything. Like, I just wanna experience the world. And so I was in Toronto for the longest time. And then I met my husband, then we had kids. And then my husband had an idea to move to The States, so we moved for a year, hated it, and returned to Canada. But then COVID started, and so we were kind of we didn't have a house in Toronto anymore, and we ended up in a suburb of Toronto.
Scott Benner Okay.
Masha And the suburbs are really foreign to me. Like, as a Soviet child, like, the cars were a luxury in the Soviet Union. So, like, all of the cities were built for public transport or walking. And so we were stuck here in the suburb during COVID with, like, a car and nowhere to go. And so the idea was to just, like, move away from the suburb to somewhere that's more human, like, people oriented. And so we thought we thought, okay. Finland has a program for visitors. Like, they they had a startup visa, and so my partner had a startup. So he applied for a startup visa, and this is how we basically pick Finland. And the other reason was I really wanted my kids to experience one of the best schools in the world as they claim Finland has.
Scott Benner Mhmm.
Masha So the two reasons.
Scott Benner I like that you didn't want possessions, but you picked up a boy and two children. You can't sell them like a VCR. So
Masha Well, those are yeah. I don't know. Those are human. Like, I don't wanna have a pet because a pet would always need my care. But, like, you know, the children, they grow and they take care of themselves.
Scott Benner Yeah. Masha, I know that humans are not, like, possessions. I was just joking. But Yeah. It's an interesting line to cross. Right? What happened? You fell in love? Is that what ruined your plan?
Masha That's also another very complicated story. Like, my mom and my grandma were always on my case that, like, I have to have children. I have to get married. This is what makes a woman happy. You know how, like, the Soviet patriarchy
Scott Benner Okay.
Masha The Russian does it to you? And I was like, okay. And those were the last words that I heard from my grandma over the phone. It's like, Masha, you have to have children. Yes. But what about me? But then, I don't know. The last words from my grandma really, like, convinced me, and this was my goal. So, like, here I am. No regrets. No regrets here, though.
Scott Benner Can I ask you, was she right? Did it change your life in a way that feels measurable and commiserate with her opinion?
Masha I do not agree that in order to be a fulfilled woman, you have to have children. I do not agree with that, and I think my grandma was wrong in that because they they claim every woman like, that's the happiness.
Scott Benner Okay.
Masha But for me personally, yeah, I think it was the right call. It definitely changed me in a lot of ways, made me more patient, and made me appreciate more things.
Scott Benner Okay. That's awesome. What happened when you got to Finland? Like, you had your your satchel full of insulin and and whatnot. Were you able to find devices, medical care? How did you work your way through all that?
Masha Yeah. So I had a friend in the city in Finland that we moved to, and she said, just, like, email the hospital. And so I emailed them, and turns out that Finland is so much more advanced. So they were texting with me, which I'm like, it's never happened to me here. I never texted with a doctor. But I basically was setting up an appointment with the clinic describing our situation, and they said, yes. Just, like, come in at the time. We'll do the assessment, and we'll see what to do with you. And so, thankfully, everybody spoke some level of English at the hospital.
Scott Benner Okay.
Masha So this is how we were able to talk to them. Like, the doctors, of course, had impeccable English. The nurses, like, it was a hit or miss. But, like, with Google Translate, we were able to get by. So we get to the hospital. They are all terrified of, like, we should keep you here overnight. This is diabetes. This is serious. But we're like, we've gone through that a month ago. We don't really need to be in the hospital. I guess for bureaucracy reasons, they still had to take us through the entire education, like, series, like what to do, what to do with lows, what to do with sickness. So they kept us there for a couple days, not overnight, though. So let us go home. And they also wanted to make sure that we know how to dose. So they brought us food for my kids specifically, and they watched us calculate. And then they watched us do the injections, like, do we do it correctly or not? And once we passed their test, they were like, yeah. We'll see you in three months. And since we were there legally, like, on a startup visa, we registered there and registered with the municipality that we are now kind of citizens of that place. And that gave us access to the basic health care, including top one diabetes care.
Scott Benner Nice.
Masha So that was a really nice surprise, and that made us really confident. Was like, okay. This is gonna work out because they also provided us with free Dexcoms for the six months that we were there. You just basically order a thing online, and the package arrives with however many Dexcoms.
Scott Benner Okay. Did you ever consider staying? Did you like it enough to think we should move here forever?
Masha Yes. And I still dream about that. I really liked it there because I grew up in the North Of Russia and, like, the Finnish culture and the Finnish nature, it smells like, the forest smell like my childhood, basically. I would love to stay there, but I don't know. My my family, they're still in Russia, they say, you know, Russia is unpredictable these days, and Finland has a border. So just, like, stay away, stay across the ocean for now until that whole situation figures itself out. But, yeah, my oldest really loved the school. In Finland, there is so much freedom. The kids are allowed to go to school on their own and take public transit at the age of seven, which is unheard of in North America.
Scott Benner Sure.
Masha So I think I would really love to move to maybe in a couple years.
Scott Benner Do you guys do the kind of work that allows you to be mobile like that?
Masha Yes. We both are software developers.
Scott Benner Okay.
Masha So even though my company I'm only allowed to work outside of Canada for ninety days, it's still ninety days. Like, we can travel and work anywhere pretty much.
Vibe Coding and AI in Diabetes
Scott Benner Kidding. You know, it's so bizarre that that's what you said because you might turn your nose up at this, and I would understand if you did. But all morning, I've been I I'm sure you hate this word, but I've been vibe coding an app that allows you to put food and insulin onto a timeline and slide it around to see how changing the bolus changes the peaks in the valleys.
Masha Wow. I you're not gonna believe it. My husband did an app like that, and there's a thread on Reddit somewhere about that.
Scott Benner Really? It's just such a great like, I trained it on, like, the work saw method and, you know, understood ideas about how insulin works and different insulin timings and stuff like that.
Masha Mhmm.
Scott Benner Let me say this. It's not something you would dose off of. Although, I imagine if you got it correct, you probably could. It is just very visual and I think allows I think it would easily allow people to say, like, oh, I see the value of where I put the insulin and how long the food impacts my system. I think kind of be for visual people, it might be a lot easier than some other stuff. Anyway
Masha I totally agree. I'm so happy you're doing that.
Scott Benner I hope you
Masha share with the world.
Scott Benner Oh, I I'm I'm I'm trying. I swear the, the I I know it's such a I hope they come up with a better phrase than vibe coding because it sounds I feel can I just be honest? I feel like a douchebag when I'm saying it. But at the same time, that's not what's happening. Like, I'm talking to it about what I wanted to accomplish, and it is accomplishing it. I it's making me feel like like a lot of different things are possible all of a sudden. It makes me wanna create an app that that not only can house the audio from the podcast, but maybe one day also have a community right inside of it, you know, a dictionary of diabetes definitions and then links to take you back to longer explanations of it. Like, I I honestly like, I have the whole thing pictured in my head. I just don't have any actual skill. So I'm I'm waiting for AI to either kill us or catch up with my idea. That's my hope.
Masha I think the latter is gonna happen. Honestly, it's so good these days. Like, I don't code anymore. I just basically type in English or sometimes even talk to it, you know, with voice recognition and stuff. It's bizarre.
Scott Benner My son is just starting in the world. He's only 26, but he's got one of those jobs where, you know, he did teach himself a lot of coding. And then all of a sudden, one day, he was like, I don't really have to code that much anymore, but I still am. And I was like, yeah. He works for a company that basically, rents him out to other large corporations that need back end stuff done, but, you know, don't wanna hire people or or have the expertise to walk through the project. So he's been doing that for a while. I think he likes it a lot, actually.
Masha It it sounds really fun. Yeah. Like, we all got into the this job, I guess, for the pleasure of coding, and now we're gonna have to find pleasure in problem solving overall, not just coding.
Scott Benner Something else. Right?
Masha Mhmm.
Scott Benner I'm gonna get back to your kid's diabetes for a second. But to your point about it, it's getting better so much more quickly. I've been using, like, deep research tools to just research the podcast transcripts and then to turn it back into content that will reach people in different ways. It's just it's so good at it. It's incredible.
Masha Mhmm.
Scott Benner I used to sit around and think, there's so much in the podcast that I think just goes dormant and could be reused, but what am I gonna do? Am I gonna sit and transcribe it and then put it together in a written form? I'll have to live six lifetimes to do that. You know? And now suddenly, I'm just like, hey. Here's 25 episodes of the bold beginning series. Can you break out all the important diabetes tips in it? And, like, ten minutes later, it's like, here. Oh, okay. Yeah. Yeah. Really
Masha Live in the future.
Scott Benner Yeah. It really is awesome. Anyway, that's all. I hope it doesn't take your job.
Masha That's okay. I also bake bread, so I'm like, people are always gonna eat, so I'll just be a baker.
Scott Benner I love that. You're like, if it takes my job, I'll just bake bread. That's great. That's fantastic. Well, I I also think, like, you know, it's nice to be able to put something down. Like, I think the podcast works for a reason. I think the talking through it is really valuable. I don't think that'll ever go away. But I do think, like, you know, even just having, like, a I don't know, like, a, like, a touch tone app, like, a daily reminder. Like, just imagine opening up an app in the in the morning, it just tells you, like, just some little tidbit about diabetes or your personal wellness or care that just kinda keeps you grounded and and focused on what you need to do for the day. And then there's a community back there if you wanna go talk to people. I don't know. It seems like it makes a lot of sense to me. So
Masha Yeah. Especially if you give access to the data to the app. And, like, in the morning, it's, like, has a small analysis of your overnight graph or something. Like, that's just invaluable. Oh, yeah. Lives are busy, and we don't have time to do that, like, daily. But
Scott Benner Are you saying are you saying that my app should open up, look at your last twenty four hours, and say, hey. I just wanted to remind you to pre bolus for your meals. It looks like we might have gotten away from that yesterday.
Masha Something like that would be amazing.
Scott Benner Alright. You're hired. I have no money. Let's go. Have the whole thing done in three months, please. We're on a schedule. So funny.
Masha Well, with my little quad, I'm sure we can do great things.
Scott Benner Yeah. That's the guy. I had somebody approach me at a I did an event over the weekend, and a person walked up to me and said, you know, I'm I'm an electrical engineer and then wanted to show me this thing they made, which was like it was crazy. It was this it was a little tiny screen. It was maybe four by two or four by three, and it was just plugged into a into a little battery pack. And as he got within Bluetooth distance of it, it just populated with his Dexcom information. And when he walked away from it, it just went away. And when he walked back, it turned back on again. It was fascinating. And, it looked like something you bought at the store. It was so nice. I said, how much did that cost? She goes, it was about $30 worth of parts I bought online.
Masha Crazy.
Scott Benner And built the whole infrastructure and flashed it onto it. And then he was looking at something on my website, a bolus estimator. And he's like, I could turn that into an app if you wanted to. And I was like, yeah. Okay. So anyway, I I love people that are just excited to to help and do things and, you know, have some
Masha expertise. Mhmm.
Preparedness vs. Anxiety
Scott Benner So how does your child handle the diagnosis? I'm gonna ask about how you handle it in a minute, but is it a tough thing? Are they young enough that they kinda go along with it, or, you know, what what ends up happening in that situation?
Masha Overall, like, I think he felt much better after he started getting insulin. Mhmm. And I think he told me at some point in the very beginning that he does feel better. And he, like, almost overnight well, I guess, over two nights at the hospital, like, he the emotion, like, those really sharp emotions went away. Yeah. And, yes, he was really annoyed with the finger pulps for the couple of first days until we got on the Dexcom. And he was really annoyed with the with the pens too, but also I showed him the syringes that they used to use before pens, I guess, came on. And he was like, oof. Yeah. The pens are so much better. And so I think
Scott Benner There's your Eastern Bloc upbringing. You're like, how would you like to get stabbed with this instead?
Masha Yes. I guess, you know, like the I grew up with always being reminded that there is starving children in Africa. You know? There's somebody there's always somebody who's worse off. And so I guess I yeah. I guess I used that on him too. But we also we really tried like, me and my partner, we really tried to not be heartbroken about it visibly. Like, we were for a little bit, but then I don't know. Like, something shifted in me. Maybe it's, like, the last years with the war and just, like, knowing about a lot of really bad things. I'm like, I don't know. I all I can say
Scott Benner Yeah. Perspective's important. It really is you know, it's funny. I was just listening to a commentator this morning talk about he said he said that I don't keep artwork in my home, but I have this photograph of Anne Frank's father, and he's standing in the attic after he's lost his entire family and the war's over. And he's reflecting and and in this photo. And the guy said, every night before I go to bed, I look at that picture for ten minutes, and I try to imagine what he's thinking about. And Mhmm. Then in the morning, I look at it again for ten more seconds, and I try to remember that my worst day is a lot better than most people's best day. And then, you know, just I don't have I forget how he said it. I don't I don't have problems. I have inconveniences, he said.
Masha Mhmm.
Scott Benner And and I thought that was really something. And and it's interesting that I just heard somebody say that. Now you're saying the same thing.
Masha I totally agree with that. And I think we, like, we did try to talk to him in this way and they're like, okay. This yes. This is inconvenient. Yes. This is very annoying. But, you know, we're still gonna live. He never skipped a pool hangout with his friends. Like, never did like, diabetes hasn't stopped him. Like, we made sure that diabetes doesn't stop him from anything. Yes. It adds a lot of, like, inconveniences, the things we have to now think about, but it doesn't mean that we cannot do those things. So, like, from the get go, we kinda said, this is our life now. Let's just move on. We're gonna eat everything. We're gonna travel. We're gonna see. We're gonna, I don't know, go to water parks and whatnot, deal with those things, but let's not focus on diabetes. I forgot it was your podcast. Like, I heard this somewhere that I'm not organizing my life around diabetes. I'm organizing diabetes around my life, and I really like that.
Scott Benner Yeah. You just have to you just have to find the t shirt slogan that works for you, basically.
Masha Pretty much.
Scott Benner Yeah. And and your attitude, do you is it cultural? Because I've been doing this a very long time now, and you're not the first person from Russia I've spoken to, and I've had some people on, from Czech Republic and just that kind of part of the world, and I find their attitudes all seem to match up with what you're saying.
Masha Probably, it's really yeah. Like, if I had to guess, like, especially people who have immigrated, they've decided to leave, like, the bad parts behind. And, like, we have a much better life here, like, wherever you move. Like, even if I move to Europe or, like, to a more singlish country than Russia. Like, we just value and, like, appreciate things a lot more, I find
Scott Benner Yeah.
Masha And take less like, fewer things for granted. That's that's what I've noticed.
Scott Benner Yeah. Just nice not freezing your ass off, I would imagine. I
Masha mean, I'm in Canada.
Scott Benner Well, yeah. Why'd you do that, by the way? Why didn't you go some why don't you go somewhere warmer?
Masha I don't like war. I don't I grew up on the White Sea, and White Sea is the part of the the part of the Arctic Ocean. And I just don't deal with the heat. Like, I don't like it.
Scott Benner Oh, that's interesting.
Masha My winter.
Scott Benner Yeah. So it's not just it's not just psychologically, you don't think your body does well in warmer climates?
Masha I just don't enjoy that. I don't enjoy sweating, and I don't
Scott Benner Yeah. Nobody enjoys that.
Masha Yeah. So, like, even in Toronto, the summers used to be, like, really hot and humid, and I don't like that. I'd rather be cold than warm. So
Scott Benner You can come stay in my house because there's two feet of snow outside. It'll keep you nice and cold. I don't know why it won't stop snowing here. It hasn't snowed like this in the last twenty years of my life, and then all of a sudden, here we go.
Masha This winter has been something for sure.
Scott Benner So now we understand how your son adapted. Did you have luck applying? Because, you know, it's all well and good to have ideas. What that was something about best laid plans. Right? But did you have luck following that in your mind? Like, were you were not gonna let it hold us back, or did did the emotions of it get to you?
Masha I think that us moving and kind of seeing that it's working, it really, really, really helped me psychologically to process all of it. Because now looking back, I'm like, you know, even when we're in Finland, like, we first flew to London. We'd stayed in London for a week, then we flew to Finland. So it was, like, already kinda traveling, like, taking airplanes a lot and being in airports. So doing that so close to the diagnosis, it really helped me see, like, okay. We're doing it. It's working. Mhmm. Like, of course, there's highs and lows, and, like, it's terrifying. It's, like, those emotions. Like, sometimes there's a interrupted night of sleep, which is also very annoying, but, like, we managed to pull off this overseas move. He was really happy in school. He made friends. He tried all sorts of weird Finnish foods. And, like, I think that really helped me see, like, okay. It's really it's not just like the world. It's not just a slogan on a T shirt, but we're living it. And I always not always, but, like, sometimes I wonder what would have happened if we didn't have this. It would probably have been much harder on me. But having pulled off that huge, like, undertaking with moving our kids overseas and just, like, trying to arrange a new life, even temporarily with diabetes and talking to people, to the new doctors, like, kind of navigating the new system, and we managed to do that successfully. I think that really boosted my self confidence, and and I kind of moved on from there. Like, we moved back, and I've never even looked back. I guess diabetes is annoying. It's scary. I try not to think about what ifs because what's the point? I'm trying to focus on, like, what can we do today? Yeah. But my brain does go sometimes like, oh, the teenage years when the sleepover starts, like, what if he's gonna, like, I don't know, forget to do his insulin or something. But I'm like, he's seven now. Let's focus on today and then maybe the next month Yeah. And I'll manage whatever happens.
Scott Benner Not gonna worry about things you can't control that you're not even sure if they're gonna arrive or not. So Yeah. So I'm hearing a lot here. This is really interesting. So my first question is is, was the move to Finland so preplanned that you couldn't back out, or could you have backed out if you wanted to and it was a decision you made to go?
Masha We totally could have backed out. There was nothing like, there's no money involved. The only thing we've done is I pre rented an apartment for the first couple weeks, and I registered them to school. So
Scott Benner You could have eaten that cost if you wanted to and stayed behind and and not left.
Masha Yeah. Yeah. Pretty much.
Scott Benner Okay. You made a decision to be bold, and then you got some early wins, and then you built off of those wins. Is that right?
Masha I think so. Yeah. Yeah. I think that's what happened. And because we also have said, like, okay. Worst case scenario, we don't have anxiety. I don't think I'm an anxious person, but I maybe that's how my anxiety manifests itself. Like, I always need to know all the what ifs. Like, I just need to be prepared. It's like the worst case scenario, this is what we're gonna be doing. So we're like, okay. What's the worst case scenario? There is no doctor. There is no Dexcom. There's no access to insulin, and we were ready to pay for insulin and turned out that we had to pay for it, but it was really cheap. It was, I don't know, €90 for six months supply, like, something like that.
Scott Benner Okay. It's interesting, isn't it? If you worry about something and then get your answer and continue to worry, you're anxious. But if you worry about something, get your answer and let it go. You're prepared.
Masha Me yeah. Yeah. That's a good distinction. Yeah. Like, I I don't worry about it if I know what I what my options are. I worry when there's a lot of unknowns. So, like, I kinda need to at least come up with some ideas. So, yeah, like, worst case scenario, we would just be back in in time for a school year just time because we school in Finland starts in August, and school here starts September. So we're like, okay. You guys go to school for a month. See what it's like. And if things don't work out and we have to be back, we'll just be back.
Scott Benner I tell this story a lot on the podcast. I hope it's not boring for people, but I once was, somewhere with my brother-in-law, and I said, I don't know how it came up, but I was like, you don't have an escape plan if your house catches on fire and you're on the 2nd Floor and you can't get downstairs? And he said, no. Like, are you anxious? And I'm like, I'm not anxious. I'm ready. And then I described how I would get out of my house on my secondary egress and and all that stuff. And I said, but I've never thought about it since then. Like, I don't sit around wondering, oh gosh, what am I gonna do if the house catches? I assume my house isn't gonna catch on fire. I had kids, and I thought it was important to think, well, if we get trapped upstairs, how would I get people out? And now that I've got my answer, I'm never gonna think about it again. But you've never thought about it. He said, no. I I I would never think about it. But the whole family is, like, littered with anxiety. So I just feel like they're they're wasting their they're wasting their worry in the wrong places is how it feels to me. I know anxiety is not that simple, but it's neat to talk to you about it because you're like, oh, I, you know, I have a lot of things I was concerned about. I figured them out and that's that now. It feels like you have a book that you you put your ideas into, and now you're just believing that they're gonna work the way you set it up or the way you thought.
Masha Pretty much. Yeah. Or if they don't work out, they could at least say no where to go. I know who to ask.
Scott Benner And you can just adjust. Mhmm.
Masha Yeah. Yeah. Because life is so unpredictable in a lot of ways. So
Scott Benner because how how could you be anxious while you're coding? Because you're sitting there writing, writing, writing, and you you, you know, you you press enter, and then if something breaks, and then you gotta go find where appropriate. You have to almost want the problem to do that job. Do you know what I mean?
Masha Yeah. Yeah. There's something to it. I also thought, like, if us both being in software affected how we dealt with diabetes because we always get praise from the diabetes team. It's like, oh, like, you manage it so well, and, like, you ask such good questions. I'm like, probably our systemic and maybe, like, lot. I don't I don't wanna call it logical. It's not, like, other people that are logical. But, like, there's some structure that we bring to diabetes itself probably due to our profession.
Scott Benner I had to do something. Right? To choose between some entrants on something, some entries. And I was like at first, I was like, I'm just gonna do it randomly. And then I thought, well, some of these are like, they have more impact than others. And, like, I don't know how to like, I just and I sat here. I was just I was just just making myself crazy trying to figure out how to do it. My son comes in and goes, what are you doing? I said, I'm thinking about doing this a different way. And he he's like, oh, yeah. Well, you could just, you know, list out all of the things then add a point system to them and then, like, add it up and weigh it. And then and I was like, oh, is that how your brain works? I was like,
Masha oh, I
Scott Benner was like, well, that was interesting. He just he didn't even pause. He just rattled it right off, and I thought, oh, my gosh. That's that's the part of him that's not for me, is what I thought while it was happening. And that's exactly it must be what my wife does too because they they think very similarly. So you and your husband have a similar brain. I just have to ask for a second. Is that fun, or is it annoying sometimes?
Masha It is annoying sometimes, but I think it's more fun because, like, we understand each other. And, like, we can talk about work as well Mhmm. In-depth, which I really enjoy. Like, I learned a lot from him. He's he's working in crypto now, and I don't know anything about crypto. So, like, learning about that has been fun.
Scott Benner Okay. But you do you ever feel like, I wish one of us had a different side so we could like, you almost have wanderlust, don't you? You said you you're dreaming of going back to Finland.
Masha Yeah. Yeah. Oh, yeah. I I find it hard to settle. But, like, you know, with kids, kids need stability, all of those things that people tell you. So, like, we do travel a lot.
Scott Benner All those things that people tell you. I like that you're raising your family based on something your grandmother said and other things you've heard from people. But in if if it was up to you, you guys would be walking around the planet with a satchel over your over your shoulder, baby. Right?
Masha I totally would, but, like, now I do drag my kids to travel a lot with me, and sometimes they complain. Because, like, when we were in Finland, we took a lot of, like, smaller trips across Europe, and they said, oh, can we please not travel for a little bit? I'm like, you spoiled little brats.
Scott Benner You're ruining my life. I got plans. That's really something. Do you worry about your other child getting type one?
Masha We did do a test. I forgot what it's called, but when they test your antibodies
Scott Benner TrialNet?
Masha Try yes. Try that. We did it after we were back from Finland, so a year ago.
Scott Benner Okay.
Masha He is negative for now, but, of course, I do worry about that sometimes. But it's one of those things. It's like if it happens, it's not really preventable. Like, yes, there's this new drug that can postpone it. I'm already doing what's under my control. Like, I it in I make sure that they eat well, they exercise, and sleep is really hard in the in this house. They never slept as babies. And, like, but I do try my best. So I'm like, this is all I can do. I cannot control other things. So
Scott Benner Yeah. No. I I agree with you. You know, people talk about, you know, what is that? TZL, that drug that you were just you just brought up, but it's like something like 13 infusions, thirteen days in a row, and it may stave it off for a certain amount of time, but they're not sure.
Masha And Mhmm.
Scott Benner It's a tough hill to climb. I just interviewed somebody the other day who had got an islet cell transplant in, one of the studies that's going on out of Chicago, and I don't think the episode's out yet. But and she's gotta get an infusion every twenty one days to keep the, you know, keep the cells viable and so that her immune system doesn't attack and whatnot. I mean, Arden is just about she's gonna be 22 this summer. So she's 21 right now. She was diagnosed right after her second birthday. Arden's had diabetes solidly for nineteen years. Last night was the first time I told her about anything like that. I was like, hey. I interviewed this lady, and she got this, you know, this thing. I said, would you do that? And she said, I don't feel like I would do it until people had been doing it for a while. And I was like, you sure? And she said, yeah. And I I said, you know, that's it. Like, you know, maybe no more diabetes, no more giving yourself insulin, all the other things that come with high or low blood sugar is just gone. She said, no. I still think I'd wanna wait a little bit and see how make sure it's okay. And, then she joked with me, and she said, and what's the what's the protocol for this stuff? I said, well, they say it's like a an infusion every twenty one days, but woman told me they're hopefully working on, like, a once weekly injection to be able to do at home. I said, of course, this is, like, you know, in the testing phase. So this isn't like it's retail or anything like that. And she she joked and she said, I would just forget to take the shot, and then those those cells would die, and I'd be right back here again.
Masha Oh, right. That's so interesting. She must feel like it's really under control then.
Scott Benner I you know, that's it made me feel really comfortable because she wasn't in, like, a mad dash. She didn't say, yeah. Like, she didn't lean over to me and go, hey. Can you in that podcast get me in that study? Like, you know what mean? Like, she wasn't which, by the way, I don't know that I my maybe that I couldn't, like but I but at the same time, like, she never I wouldn't ask and she didn't offer she didn't even offer up as an idea. So, yeah, that that's what I thought too. Like, my gosh. She must be pretty comfortable, You know? And that made me feel good that she felt that way. Yeah. Really did. I hope it makes other people feel good too.
Masha True. Like, technology these days, it's Yeah. It's really incredible. Because I did talk, like, when he my kid was diagnosed, I got a few connections from people who also have either kids with Taipan or Taipan, like, themselves. And I did talk to a lot of them. And for example, like, there was one family whose kid is now oh, he was 18 at the time. So now must be, like, 19, whatever. And he was diagnosed at four. And so the mom told me, like, she couldn't work because she had to, like, be in school around. And, like, she he got low at school. And, of course, if there was no CGM, so, like, it was a whole new thing. So I'm like, these days, I would call it easy compared to what people had to do even ten, fifteen years ago.
Scott Benner Yeah. I mean, I I tried to be respectful of people coming in later to this where the technology is much more advanced. They don't have any any perspective for, you know, long needles that, had to sharpen. A woman just left a comment on one of my Instagrams the other day, and she said that the big needle she used to give herself in some long time ago, they had to be boiled. And that sometimes she she was so hungry, she couldn't wait for them to cool off. And that was one of the things she thought about. Like, she would use warm needles because she was just, you know, just starving and wanted to eat. You know, most people don't have that perspective. If you were diagnosed a year ago and somebody, like, slapped the CGM on you that works so good. But then later, hear those people complain like, oh, the CGM didn't last ten days. And I was like, oh, wow. That's that it almost felt like it it almost sometimes feels to me like your kid going, I'm tired of traveling. You know what I mean? Like, oh, no.
Masha Yeah.
Scott Benner Boo hoo, are you? Not that I don't and I wanna be clear. Not that I don't think the thing should last ten days if it says it last ten days or whatever the hell, you know, and I want companies striving towards that. But if that doesn't happen, I do wish people had, you know, I don't know, a time machine or a crystal ball so they could see what it could be like and maybe that could help them feel more comfortable or happy instead of feeling let down or, you know, burdened. I don't know.
Masha It's you know? Totally. I no. I totally agree. And I think those conversations that happened early for me really, really helped. There was also this 60 year old that I talked to. He also lived with type one for forty something years, and he has a grandchild who was one and a half when he was diagnosed. So, like, he knows a lot about diabetes. And he told me that diabetes is the best chronic condition you can get because it forces you to live a healthy life. It forces you to eat healthy, to exercise, to keep track of your vitals. And I've really it's really stuck with me. I'm like, yes. Yes. Like, that's a really good outlook. So, yeah, Like, I tried to put as many things on a t shirt as I could because these really help me when things get tough. I'm like
Scott Benner Yeah.
Masha Always go back to them.
Scott Benner No. No. I've I've said that before, and I I believe that too. Just just forces you to pay attention to things. Mhmm. That can only be good. All the health issues that come from a slow, you know, I don't know, years and years of of neglecting something or not knowing something's important or whatever, and then you get to the you get to the part where it's a problem and you can't go backwards anymore, at least you're up and you're looking at it and trying to be healthy, you know, at the very least and and make good decisions. I I take this point that it does focus you on that stuff.
Masha Mhmm.
Scott Benner I'm interested because now you and I have been talking for a little while, and there's a certain part of you that I get why you like me and and why you might have listened to the podcast. And I am very comfortable with you because I think of your cultural background and it makes you kind of think more along the way up the lines in the way I think because I grew up kind of broke here in America. And so, like, I'm having a very comfortable happy conversation with you, but I cannot I can't not ask you, like, when you have a, like, a, like, a software engineer's brain, like, how how do you find me palatable? Because aren't I all over the place to you?
Masha I guess when you talk to people just like I guess people like myself when the it's not focused. Like, I really liked your episode with Jenny that you did.
Scott Benner Mhmm.
Masha They are laser focused on the diabetes stuff.
Scott Benner Right.
Masha And those I have to admit, yeah, they are a little more a little easier for me to
Scott Benner I was gonna say, like, you must not be okay with, like, these rambling. I'm wondering how you're making it through this right now, to be perfectly honest.
Masha I'm still a human.
Scott Benner Yeah. Okay. I know I'm still a human. I
Masha do enjoy talking to people. Yeah. I also listen to a lot of podcasts that are kinda, like, just people talking on two x. But so when I was again, like, one of the people I was connected to, she has a son who has type one as well, and she's she's a nurse, so she's obsessed. I'm not as obsessed with that lady, but she gave me your podcasts with the series. She said, you have to start with this I already forgot what it's called, like, basics of diabetes where you talk about all the definitions and all of the terms. Then she said, you have to move on to the pro tips.
Scott Benner Mhmm.
Masha And then when we were about to get an Omnipod, because in Canada, you have to wait for a year on MDI in order to be able to apply for a pump unless you wanna pay for it yourself, which we didn't wanna do. So when we were getting ready to get an Omnipod, she sent me all the Omnipod series where you talk to people about Omnipod. So those, I I'm so thankful to you for putting them out because those are perfect learning material Yeah. Especially coming from a person who is a parent. And also, like, in case with Jane, like, she has type one, like, perspectives are invaluable.
Scott Benner Yeah. For sure. I would hold up those series to any when people say to me, I think you have ADHD. I'm like, no. I don't. I can concentrate if I need to. Don't worry. I just I just find talking this way more entertaining to me. I also find that very linear conversations also, seem boring to me sometimes. Like, I like I like hearing keywords that seem interesting and taking turns and going down little rabbit holes and and talking about stuff.
Masha Yeah. I agree. It kinda shows, like, opens up a person for you and then you're not just, like, diabetes day because there's a lot of diabetes in our lives anyway, and
Scott Benner Sure.
Masha This is a nice way to go deeper on to the
Scott Benner I completely agree.
Masha Person is like yeah.
Scott Benner You or your husband I'm sorry. You you've been referring to him as your partner, but you you and that boy that you let make those babies with you. Like, are are you guys, kinda co parenting diabetes, or does it fall one way or the other to or do you guys have certain jobs that, you know, one person does, certain jobs the other person does? How do you do it?
Masha He is my husband. It just I don't know. I really like the word partner, so that's why I've been using it. But he so my kid had a rash for Dexcom, and now, like, for Omnipod, like, we dealt with rashes here and there. So I never learned to put on Dexcoms. I don't know how to do that because the process is that we put hydrocolloid something something
Scott Benner Okay.
Masha Thing on top of his arm with a little precut hole, and then we put a Dexcom on top of that.
Scott Benner Mhmm.
Masha And this really protects his skin. It's been working really well, but I he figured out the system. I never learned to do that, so I never do that. I do sleep with all the devices. So, like, if there's an occasional high or low sugar, so I deal with that mostly just because I lost sleep when they were born anyway. So, like, what's another
Scott Benner They're like,
Masha I'm used it. Sleep. Pretty much. Yeah.
Scott Benner Oh, you know, I interviewed a a woman recently, and she's like, listen. My husband could do it, but he just gets very grumpy and he complains about it. So I just do it so that doesn't happen. I was like, oh, no kidding. Right now, it falls to you. Please take my word for it when I tell you it's not sustainable long term. Like, you really do need to sleep.
Masha Yeah. No. But we've been we've been sleeping mostly. Like, that's now a rare occasion, but I do have to wake up, which I'm really thankful for, like, the system we have figured out. Yeah. And also what's interesting between me and my partner, I find that I'm more okay with the low blood sugar, so I'm always, like, giving more insulin. And sometimes, like, there's an occasional low, and he is more comfortable to be on the higher side. So, like Oh. That's also, like, a very interesting dynamic I find. I don't have any solutions yet, but we keep kinda talking and discussing the situations when they do arise.
Scott Benner Oh, oh, interesting. Okay. How involved is your child in the care? Are you guys making all the decisions? I mean, he's still pretty young. Right? So are you making all the decisions? Are you doing it together in hopes that the the understanding grows? What's your you mentioned, you know, worrying about the future and not being worried about it, but you must have some sort of a plan for building this out.
Masha Yeah. So when he was an MDI, we did everything. And there was a nurse who came into school for two lunch periods, and she administered insulin. Now she still comes and but she now uses a pump. And so we are planning this summer when he goes to camps for him to finally do it himself. Like, he does it. He gives himself insulin, so he knows how to use a controller. But the calculation, like, amount of carbs, I just like, he knows it's an an apple. A medium apple is, like, roughly 15 grams. So, like, those basic things. When there's complicated stuff, we usually do that, and I do not always have it in me to use every interaction as an education session. But that's the idea. Like, we're gonna start slowly build that muscle for him. I don't know how many years it's gonna take because even, like, our carb counting is not perfect, and there's so much more to count for than just carbs.
The Power of Pre-Bolusing and Success
Scott Benner Yeah. One of the issues that people are tripped up by most are just estimating their meal correctly and, you know, understanding the impacts of the the entire, you know, concoction sometimes and make you know? Mhmm. Yes. Where fat is and stuff like that. But I think it's carb counting and pre bolus thing. I think those are the two things around meals that that cause people the biggest concerns, you know, and and get in the way of success over and over again.
Masha Yeah. I just wanted to bring up a little point about pre bolus thing because I learned about it from your podcast as well. And we started doing it pretty much right away. Like, we got home, and this is this is he first gets insulin, and then he eats. And I think when we're in control, like, we try to do the fifteen to ten minutes depending on the thing. But now I feel like he built a muscle, so, like, he's always gonna have first insulin, then maybe run around the house, and then food. So thank you for teaching us about pre ballsing in the beginning.
Scott Benner Oh, you're welcome. It's a it's a pleasure. I find it really changes things for people, and, you know, it's it's just incredibly overlooked at the educational level in a lot of in a lot of doctor's offices.
Masha Especially for children because I feel like doctors have way more fear of lows, and they're like, oh, like, you'd better be high than low, but I don't think that's the right attitude to teach from the very beginning.
Scott Benner Me either. Yeah. Me either. Yeah. You know, I found myself asking online the other day because I've been thinking about it a lot. It's like, what are predictors of success? I think my two, from my conversations, are people who are interested and continually trying to learn. I think that's a great predictor for success. And I think also having the autonomy and the knowledge to keep your settings up to date is the other one.
Masha Mhmm.
Scott Benner Those are my those are my two that I think I I think are one and two. But I'm wondering, you've been at it for a little while now. Do you have you gotten any insight on things you do that lead to successful outcomes?
Masha I also don't know, like, how to count success. Like, our time in red chip is not the best, and we have this kid who's a snacker, and he doesn't always tell us. Like, we're working on that. Like, he at least tells us Mhmm. That he ate something. So I think I consider success as of right now at this stage in my life is that we have more or less, we have sleep. Maybe we wake up, like, once every three, four weeks, which I find is way, way better than the first month after diagnosis. And, yes, the kind of the feeling empowered to change our care. Because I remember after diagnosis, I think they gave us a really large, long insulin dose, and he was all constantly falling. And I was afraid to give less insulin. I had to, like, talk to the doctor or we have to, like, email. So I I had to get a a hold of the doctor to be allowed to change that number. And I think after two weeks of trying to do that, I'm like, I'm not doing this anymore. I am managing this thing. I have the numbers. I have all the data to make my own decisions, and I felt empowered after that. So I think always yeah. Just, like, having once a month, maybe a review of what's happening and adjusting as it goes because it changes all the time. Like, for example, we had about, like, sickness in January, and some of the sickness is really visible. Like, the fever, the runny noses, but some of the sickness, like, something is going on, but, like, you're kind of okay just to glow energy. And that, like, my type one kid had it, and we could not figure out, like, what was happening. But then it turned out that if you had a very light virus or something so just being able to adjust and not wait, I guess, until your care appointment Yeah. Because it only happens once. For us, it happens once every three months.
Scott Benner That's such a great answer that I think I'm gonna start asking that question more often to people. And I I like that you started with, I don't know, like, well, you know, how are we measuring success? But I think it's important to say that you should measure success however you measure success.
Masha Sure.
Scott Benner Yeah. Not based on somebody else's idea of it. Well, that was really great. Thank you. I when you hear me ask other people in the future that, just know that that answer is a big reason why I kept asking them. Thank you.
Masha Thank you.
Scott Benner Yeah. That was awesome. Am I missing anything? Have we forgotten to talk about something? Is there something that's come up that I have directed you away from or, you know, that we haven't gotten to?
Masha No. I don't think so. Like, the main points I wanted to share it is that I'm super happy that we didn't get scared off from the big plans, and I hope people do not get scared. Like, it is a scary disease. Like, I totally understand it. I am scared half the time as well. But being scared and doing things because life just has so much to offer, and that's not diabetes, and you can kinda squeeze it in. I always joke that now I have a little tiny brain growing in my, like, main brain that's diabetes only focused, but, like, the rest of my brain can kinda focus on everything else that's going on in life.
Scott Benner Your brain has an AI agent that's only thinking about one task? Is that what you're telling
Masha Oh, I never thought about that. That's exactly
Scott Benner what's happening. Right? You're like, I'll just task this bot to think about this over here.
Masha I'm Yeah. Yeah?
Scott Benner Yeah. Do you see I mean, I didn't ask you what kind of software you developed, but, obviously, you know a a fair amount about all this. So I don't know that we're not that close to all this, by the way. Like, I've already seen people just drop their graphs into a chat GPT kind of a situation without any context, and I've seen it give back rather valuable input. So and I'm talking about without knowing insulin sensitivity and, you know, and that kind of stuff. But, I mean, if you could get a prompt to think about, you know, how the insulin is, you know, breaking down and and being used and how foods digested over time, you know, based on its fat protein content, sugar, that kind of stuff, I don't know that you can't, at some point, just say, like, look. This is what I'm thinking of eating. Where do I put the insulin? This is my insulin sensitivity and my carb ratio, and it can't just tell you.
Masha Mhmm. And it can't even tell the time because, like, you can like, it has all those data points. Like, you can tell, like, oh, for this food, don't do, like, a long pre bolus to, like, a three minute. For this food, do, like, a half an hour
Scott Benner or something
Masha like that.
Scott Benner Yeah. Because, I mean, listen. Not that everybody wants to live their life that way, but if I really also buy into the idea that people really eat about the same 20 or 30 things over and over again. So if you walked through it the first number of times until it became a muscle memory thing, it's not like you'd have to go back to the prompt over and over again. You could then eventually say, alright. I know I'm about to eat this. I'm gonna put in this amount of insulin, wait about this long, and then I'm gonna eat and it's gonna work. And I actually think it's all here already, which is somebody needs to package it together. The algorithms that are, you know, coming from the companies, I don't think they're considering it quite as much. But if you look at, like, loop and trio and, like, the ability to, like, you know, tell it that you're eating fat and it to, you know, set up extended boluses and and, you know, touch points in the future where it's trying to address those sorts of things. Obviously, those systems are doing that already. I don't know. It just feels like it's all there. Just somebody needs to do it and then have the nerve to release it, and that's maybe the biggest problem. You know?
Masha I agree. I agree. I always say that the future looks bright if only people stop fighting with each other. Yeah. Because I feel like that takes away a lot a lot of energy from trying to solve the the other the more important humanities issues.
Scott Benner No. That's for sure. Okay. Well, you were terrific. I really
Masha Thank you, Scott.
Scott Benner No. I really enjoyed this, and I'm really learning something about myself. I should probably move to where you're from. I think I'd love everybody. I I mean, seriously, everyone who comes on from that part of the road, I'm like, what a sensible person and and lovely to speak to. No bull this was awesome.
Masha Yeah. We never learned how to do small talk. That's true.
Scott Benner That's okay. I I I keep up that side of our relationship. It'll be fine. You could just nod at me and go, there he is. He's talking. It's fine. We like him for other reasons. Well, I really I genuinely appreciate you adding, you know, your story to this to this whole thing as we, you know, climb towards 2,000 episodes of, you know, stories and and people's lives. I think it it already has and will continue to come together and be helpful for others. So, you know, the time you took today will be invaluable for others going into the future. So thank you very much.
Masha Thank you, Scott. Thank you for all that you do for the diabetes community.
Scott Benner It's a it really is a pleasure. You have no idea, like, how happy it makes me. So thank you. I appreciate you saying that. Hold on one second for me. Okay?
Masha Mhmm.
Outro & Sponsor Messages
Scott Benner I'd like to remind you again about the MiniMed seven eighty g automated insulin delivery system, which, of course, anticipates, adjusts, and corrects every five minutes 20 four seven. It works around the clock so you can focus on what matters. The Juice Box community knows the importance of using technology to simplify managing diabetes. To learn more about how you can spend less time and effort managing your diabetes, visit my link, medtronicdiabetes.com/juicebox. Having an easy to use and accurate blood glucose meter is just one click away. Contournext.com/juicebox. That's right. Today's episode is sponsored by the Contour NextGen blood glucose meter. Okay. Well, here we are at the end of the episode. You're still with me? Thank you. I really do appreciate that. What else could you do for me? Why don't you tell a friend about the show or leave a five star review? Maybe you could make sure you're following or subscribe in your podcast app, go to YouTube and follow me or Instagram, TikTok. Oh, gosh. Here's one. Make sure you're following the podcast in the private Facebook group as well as the public Facebook page. You don't wanna miss please, do you not know about the private group? You have to join the private group. As of this recording, it has 74,000 members. They're active talking about diabetes. Whatever you need to know, there's a conversation happening in there right now. And I'm there all the time. Tag me. I'll say hi. How would you like to share a type one diabetes getaway like no other? Join me on Juice Cruise 2026. You may be asking, what is Juice Cruise? It's a week long cruise designed specifically for people and families living with type one diabetes. It's not just a vacation. It's a chance to relax, connect, and feel understood in a way that is hard to find elsewhere. We're gonna sail out of Miami, and the cruise includes stops in CocoCay, San Juan, Saint Kitts, and Nevis aboard the stunning Celebrity Beyond. This ship is chosen for its comfort, accessibility, and exceptional amenities. You're gonna enjoy a welcoming environment surrounded by others who get life with type one diabetes. I'm gonna host diabetes focused conversations and meetups on the days at sea. There's thoughtfully designed spaces, incredible dining, and modern amenities all throughout the celebrity beyond. Your kids can be supervised, there's teen programs so everyone gets time to recharge. Not just the the kids going on vacation, but maybe you get the kickback a little bit too. There's gonna be zero judgment, real connections, and a whole lot of sun and fun on juice cruise 2026. Please come with me. You're going to have a terrific time. You can learn more or set up your deposit at juiceboxpodcast.com/juicecruise. Get ahold of Suzanne at cruise planners. She will take care of everything. Links in the show notes. Links at juiceboxpodcast.com. Have a podcast? Want it to sound fantastic? Wrongwayrecording.com.
#1849 Bolus for Zaydino
Natalia from Hong Kong asks Scott why her 7-year-old son's blood sugar spikes on weekends. They discuss navigating pizza , fat and protein impacts , and Omnipod 5 bolus strategies.
Companies that Support Juicebox
Key Takeaways
- Simple solutions often work best for skin reactions; a basic, fragrance-free body wash can sometimes resolve adhesive irritation better than complex barrier routines.
- Daily routines and activity levels drastically affect insulin needs; children are typically more active during the school week, which can make less active weekends more challenging to manage.
- High-fat and high-protein meals (like pizza and french fries) slow down digestion and cause delayed blood sugar spikes, requiring more insulin delivered over an extended period.
- When an automated insulin delivery system (like Omnipod 5) suspends basal insulin to prevent a low, it can lead to a background insulin deficit that exacerbates a later post-meal spike.
- Pre-bolusing remains one of the most effective tools for preventing post-meal spikes, even when eating tricky foods or managing changing activity levels.
Resources Mentioned
Introduction and Sponsors
Scott Benner Welcome back, friends, to another episode of the Juice Box podcast.
Natalia Hi, guys. My name is Natalia, and I live in Hong Kong. I have a seven year old boy now who is type one diabetic. He was diagnosed last June.
Scott Benner I created the diabetes variable series because I know that in type one diabetes management, the little things aren't that little, and they really add up. In this series, we'll break down everyday factors like stress, sleep, exercise, and those other variables that impact your day more than you might think. Jenny Smith and I are gonna get straight to the point with practical advice that you can trust. So check out the diabetes variable series in your podcast player or at juiceboxpodcast.com. If you're looking for community around type one diabetes, check out the juice box podcast private Facebook group. Juice box podcast, type one diabetes. But everybody is welcome. Type one, type two, gestational, loved ones, it doesn't matter to me. If you're impacted by diabetes and you're looking for support, comfort, or community, check out Juice Box podcast, type one diabetes on Facebook. Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan.
Scott Benner This episode is sponsored by Able Now, tax advantaged savings accounts for eligible individuals with disabilities. If you or your child lives with diabetes, you may qualify for an ABLE account because of ongoing medical needs, and many people in the diabetes community do. With ABLE Now, you can save for future expenses without affecting eligibility for certain disability benefits such as Medicaid. Learn more and check your eligibility at ablenow.com. You spell that ablenow.com.
Scott Benner Today's episode is also sponsored by usmed.com/juicebox. You can get your diabetes supplies from the same place that we do, and I'm talking about Dexcom, Libre, Omnipod, Tandem, and so much more. Usmed.com/juicebox or call (888) 721-1514.
Scott Benner The podcast is also sponsored today by Omnipod. Check out the Omnipod five now with my link, omnipod.com/juicebox. You may be eligible for a free starter kit, a free Omnipod five starter kit at my link. Go check it out. Omnipod.com/juicebox. Terms and conditions apply. Full terms and conditions can be found at omnipod.com/juicebox.
Meet Natalia and Zaydino
Natalia Hi, guys. My name is Natalia, and I live in Hong Kong. I have a seven year old boy now who is type one diabetic. He was diagnosed last June. So I would like to just I have some questions which I would just like to talk about, ask Scott about. Let's see how it goes. So thank you for having me, Scott. Really appreciate it. Yeah.
Scott Benner Well, I appreciate you doing this because I know it can feel exposing to come somewhere and say, I don't know what I'm doing and you know? Because you said right before we started to record, like, I don't even know if I have anything to say at certain points, but I don't think that's the Yeah. The value in this conversation. Also, I'm just gonna reiterate, although I said it at the beginning of every episode, not a doctor, not advice, but I'm happy to try to talk to you about it and see if we can figure something out. So
Natalia Great. Thank you.
Scott Benner No. It's it's a pleasure. I appreciate you allowing it to be recorded so other people could hear. Mhmm. So your son's seven, and he was diagnosed ten months ago. Is that about right?
Natalia Yeah. It's ten months already. Wow. Yeah. It's been ten months. I mean, every day has been like a roller coaster. In the beginning, we were on you call it the MDI, the injections.
Scott Benner Mhmm.
Natalia So he was on it for three months. And after that, we started putting him on the o p five, Omniport five.
Scott Benner Okay.
Natalia So that has been helpful. But, yeah, he has his moments of not wanting it and not liking it. So because his skin started getting too red and too inflamed over time.
Scott Benner Yeah.
Natalia So, I mean, it's been taken care of now. It's doing much better.
Scott Benner You figured out how to prep the site so that it doesn't happen?
Natalia Yeah. So I tried everything, and then we have a good support group also over here, which they keep telling us what to do. But what really worked, I took him to his own pediatric doctor, and she just gave, like to put, like, a very basic, body wash. You know? No fragrance, all that kind of stuff. And, literally, that's someone that overnight literally worked.
Scott Benner Oh. So That's awesome.
Natalia Said to put the skin prep spray and the nasal spray and the all these kind of things and use different patches and the prep and the first and the last. I just left everything.
Scott Benner Yeah. Because you got a good result with the one I right. Why complicate it? Yeah. I would have asked you, do you use alcohol to clean the site?
Natalia So now I use the alcohol once before I put it on.
Scott Benner Mhmm.
Natalia The techs command that, and nothing happens. He's absolutely fine.
Scott Benner Oh, there you go. Sounds like you might have found the answer.
Natalia Yeah.
Scott Benner You wrote to me. Is that right? Yeah. Why don't you go over that email for a second? Just tell me where you're at and where the struggles are.
Weekday vs. Weekend Variables
Natalia Okay. So the thing is that daily routine I'm just because see, he's diabetic. He's growing up, and he's at an age where he wants to do his own things also. Can't blame him. But it's just a scary fact that when we go out, that's the problem where we go for a restaurant. And now he's getting so scared that I have to count everything what he has, and he loves eating. Mhmm. So if he can't eat a pizza, I don't allow him the pasta. I don't allow him the hot dogs. You know? So then it's just like, why don't we stay home and just eat what I can in a bigger quantity? So, you know, that's become a thing. So I was just a little worried. How do I, like, embrace all that? Because his levels would go to, like, a 22. You know?
Scott Benner That's like a 400. Yeah.
Natalia It would, like, hit the roof for hours, and to get him down six to eight hours would go nowhere. You know? So his daily routine, breakfast, lunch, dinners, school snack, coming home snack, everything is fine. But the weekends come in, and it just goes through the roof.
Scott Benner Okay. Well, I'm gonna ask you a few questions first. Yeah. So on the weekends, does he become more sedentary?
Natalia What would that mean?
Scott Benner Well, does he not move around as much on the weekends as he does during the week?
Natalia Relatively. Yeah. Yeah. Yeah. Okay. Yep. He's mostly home. He just likes to relax, do nothing, or we just go out for, like, a walk or to the park. So but nothing much.
Scott Benner But not as much as getting up, running to school, running around at school, all that stuff. Yeah. Okay. Alright. So Yeah. I'm gonna take some notes. Not usually something I do, but okay. So during the week, he's moving more weekend Yep. He's more still. Okay.
Natalia Mhmm.
Scott Benner And does he eat differently on the weekend than he does during the week? Like, you know, during the week, is it simpler?
Natalia So in the morning, his breakfast would include a normal egg or a milk or a bun or a bread because even the cereal spikes him a lot. Oats spike him a lot. Mhmm. So that's been cut down to maybe on the weekends, I give him cereal. But the problem is he's not so active, so the cereal goes even higher on the weekends.
Scott Benner Yeah. So cereal, he's not getting during the week?
Natalia No. He's not getting during the week.
Scott Benner More like you cut out for a brief second. But during the week, like an egg, something like that.
Natalia Yeah. For the egg or a half glass of milk with a bun and butter. So everything is, like, you know I got it. Portioned.
Scott Benner Yeah. So you would call the week more knowable.
Natalia Manageable.
Scott Benner Yeah. Yeah. Well, because you're doing the same thing over and over again too. Yeah. I see. Okay. Is there any chance that on the weekend, you're just not counting the carbs as well as you are during the week, or do you think it's more about the makeup of the food?
Natalia So on the weekend, I can. I'm counting the carbs, but it's like since there is I feel he's very like, you know, if there's activity, he works very well. The levels work very well with him.
Scott Benner Mhmm.
Natalia But when it's not, and he's sitting, he's just watching. So it suddenly just spikes out of the blue. Even if it's the same breakfast. Yep. Even if it's the same one, weekends treat him differently.
Scott Benner Yep. Okay. And on the weekend, what are we eating? I guess, maybe take me through an average day of his meal during the week and an average day during the weekend and do breakfast, lunch, and dinner.
Natalia Okay. So the weekday?
Scott Benner Mhmm.
Natalia He loves eggs. He loves milk and bun or bread and butter. So these come to around 24 carbs because the bread I get is, like, less in carbs and stuff like that. So that's like morning is that, egg, milk, bread
Scott Benner Mhmm.
Natalia In some form, and yogurt, the small baby yogurts which he gets. And then he has a snack, 10:00 in school. That, I try to make it as free carbs because then the nurse has to keep running to him to give him the dose, which I don't want. So it's mostly like a seaweed or cheese or cucumber or something around these things mostly. Then he has lunch. Lunch is his turkey sandwich or a roast beef sandwich or a egg sandwich with just literally a slice of turkey, cheese, butter. Mhmm. That's it. And apple. He loves, like, one apple and one sandwich. Even on the weekends, if he's home, I make the same thing for him at home for lunch. And then he has a snack, which is, like, either crackers or as you also said, the Ritz crackers affects your daughter. It hits her a lot. I was hearing you say that once. Mhmm. So, you know, stuff like that, like, just crackers and biscuits and because when he comes home, he likes to have his stuff. So fruits, milk, whatever he wants to eat, I dose him accordingly. And then dinner is mostly the basmati rice because the sticky rice take him to another level.
Scott Benner Yeah. Yeah.
Natalia Then it's, like, homemade, either grilled chicken or chicken with some kind of tomato and onions, all home cooked. Mhmm. So it's all pretty much, like, manageable, very easy to make, and with some cucumbers and carrots, and that's about it.
Scott Benner Going out to dinner is more difficult?
Natalia So dinner, I have tried. Now we don't go out for dinner because the dinner foods make him it's like a whole nighter. So Mhmm. It's really hard for that to work out. So we do lunch outside. Okay. And dinner is mostly home. Yeah.
Scott Benner When you have gone out to dinner in the past and it's been difficult, I like how you said it it turns into an all nighter. What kind of food was doing that?
Natalia So mostly living in Hong Kong, we get, like, Chinese food, Japanese food. So it's mostly sushi or Chinese food, you know, with the sticky rice and nice little gravies and chickens and fried chickens and Korean fried chicken, so stuff like that. And if everyone's having it, it's hard to keep him away from all that. So now we also try not to order and have that kind of food.
Scott Benner Sure. Well, that's nice of you to do it with him. How big is your family?
Natalia Well, I have a daughter, and this is my son. So two kids and my husband and me.
Scott Benner Okay. The four of you. Mhmm. So do you understand what's happening and you're having trouble impacting it, or are you having trouble understanding what's happening?
Sponsor Break
Scott Benner As I told you earlier, Able Now is sponsoring this episode. Able Now, of course, tax advantaged Able accounts for eligible individuals with disabilities. If you or your child lives with diabetes, you may qualify for an Able account because of ongoing medical needs. Many people in the diabetes community do. With Able Now, you can save for future expenses without affecting eligibility for certain disability benefits such as Medicaid. And thanks to updates to federal law, Able accounts are now available to more people than ever before. That means more individuals and families can use ABLE now to save and invest. Funds in an ABLE now account can be used for a wide range of everyday needs, including education, transportation, health care, assistive technology, and more. There's no enrollment fee, and you can open an Able Now account with a small initial contribution and build from there. Learn more and check your eligibility at ablenow.com. That's Able Now dot com, ablenow.com.
Scott Benner This episode is brought to you by Omnipod. Would you ever buy a car without test driving at first? That's a big risk to take on a pretty large investment. You wouldn't do that. Right? So why would you do it when it comes to choosing an insulin pump? Most pumps come with a four year lock in period through the DME channel, and you don't even get to try it first. 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. Plus, you can get started with a free thirty day trial to be sure it's the right choice for you or your family. My daughter has been wearing an Omnipod every day for seventeen years. Are you ready to give Omnipod five a try? Request your free starter kit today at my link, omnipod.com/juicebox. Terms and conditions apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox. Find my link in the show notes of this podcast player or at juiceboxpodcast.com.
The Impact of Fat and Protein
Natalia I just find, like, I feel I'm dosing wrong because I was hearing you with your fat protein and all these talks about it.
Scott Benner Yeah.
Natalia So I just wanted to ask the carbs. Like, for example, we were on our Singapore trip right now. We were on a good vacation. He was actually okay. Yeah. His highest took on the trip would be a one eighty, which I wouldn't consider high. So he was, like, active. We were eating. We were going places and walking and doing many things. So that was, I think, working out so well for him
Scott Benner Yeah.
Natalia That we would tell our friends also who we stayed with. We're like, sorry, but, you know, we are staying away from such and such foods. So they took us to places where we would have grilled chicken or, you know, some kind of healthier options. And then once when we went for the pizza and all the Western, you know, all the high fat foods
Scott Benner Sure.
Natalia I tried to manage, like, from one slice of pizza, I cut it into a quarter pizza slice. And so, you know, I was trying to manage with that with a grilled chicken being pushed in with little veggies pushed in, which I can't do all the time. If we're going to a pizza pasta place, you only get that kind of food. Right. And what happened on a vacation is I cannot count because in the restaurants, there is no count for it. Mhmm. I started dosing him extra.
Scott Benner Good.
Natalia I feel it was the first time I did that. I was scared something would happen, but everything was okay, and it worked. Yeah. So since I've come back, I feel I am giving I'm just throwing in an extra five if I'm at home. I'm throwing in an extra 10 if I'm out Yeah. But still avoiding the full, you know, like, three slices of pizza and fried stuff.
Scott Benner Let me run over a couple of ideas for you. Okay? Yeah. So the first one about the activity, that's very real. Okay? So when you have less activity, your body becomes more resistant to insulin. It's just kinda the way it works. Right? I can get you a more technical answer, but it's about how the glucose is handled by your body. Okay? So Yeah. We are in this Omnipod five setting Yep. And it's adjusting to your daily needs. Yep. And so during the week, I think you're getting a there's a combo of a number of things here. Yeah. He's eating the same stuff over and over again. And Yeah. You sent me kind of a sample menu. He's eating things perfectly honest with you. They're very healthy choices. You know? Yeah. I'll breed for people. Turkey, roast beef, eggs, apples Yeah. Fruit, you know, basmati rice, great pivot there away from the white rice. Meat, vegetables, eggs, like stuff that's not terrible to bolus for because they're not very high in fat. They're not fried. It's not processed food. Right? It's as helpful to the process as possible, these types of foods. So you've got the food on your side, and then you have the exercise on your side, the activity On top of that, the Omnipod five is saying, okay. This is about how much insulin we need for these days, and you start to pick up a rhythm at Monday, Tuesday, Wednesday, Thursday, Friday. Then all of a sudden on Saturday, he stops moving. You lose the value of the exercise. And on top of that, you're making maybe the same decisions with the food, and it's going okay right up until you try to go out. And then, you know, you see chicken, pizza, all that stuff there. Right? Yeah. Yeah. That all sounds about right. Right? That's how it's going?
Natalia Yep.
Scott Benner Okay. So I understand that when you get out of the house, it's hard to count carbs.
Natalia Yep.
Scott Benner Just how it is. Right?
Natalia Mhmm.
Scott Benner But what it's gonna take is practice. Yeah. It's not a great answer. I mean Yeah. I could tell you right now, you probably could open up an AI app on your phone and tell it where you're at and probably get a more accurate feeling for the carbs and everything. But if you don't start incorporating the impact of the fat that's happening to his blood sugars, the carbs aren't gonna really matter. Yeah. You know? I mean, not that not that it's not gonna be helpful. Yeah. You know, if a chicken sandwich out at a restaurant is actually 60 carbs and you were guessing 40, of course, that's gonna be a big deal.
Natalia Yeah.
Scott Benner But if there's, I don't know, seven, eight, nine grams of fat in it, that could end up costing him another unit of insulin, and the timing gets changed as well. Yeah. And do you understand why that is? Because it changes the the digestion process?
Natalia Right.
Scott Benner Okay. So you eat all those carbs, and one of the ways those restaurants make flavor is with sugar. So there's probably more carbs, probably more sugar. And on top of that, more fat, a lot of it ends up being fried, which you're not frying anything at home. You take in that kind of oil, degrease the fat, etcetera, and it slows down your digestion. So those carbs, which are probably more than you guessed to begin with, are sitting in his stomach impacting a longer timeline. And that's how you said, you know, it turns into an all nighter. Right? Because those carbs are in there impacting him all night long. There are ways to stagger your boluses to get in front of those rises and the lung digestion. Yeah. So did you find the calculator? I'm so I think I'm supposed to call it an estimator. Did you find the estimator on my website? Yeah. You did for the fat and protein, and did that help you?
Natalia Yeah. It was just too much, so I didn't
Scott Benner Oh, you got a little overwhelmed by it. Okay. Yeah. Yeah. Talk about it now. That's okay. So can you tell me how much he weighs?
Natalia He weighs around twenty kilos.
Scott Benner Twenty kilos.
Natalia That'd be into two point two four pounds. So around forty something.
Scott Benner Oh oh oh, I fret. You said he was seven. He's little. Yeah. How old is your daughter?
Natalia She's 10.
Scott Benner Oh, you have a young family still. Yeah. Yeah. Lovely.
Natalia Pretty small.
Scott Benner Yeah. Was the diabetes a surprise, or is there autoimmune in your family?
Natalia Oh, that's another story. No one has it in the family.
Scott Benner How about other autoimmune stuff? You see thyroid or celiac, anything like that with people?
Natalia Nothing. Nothing. No. Or as I joke with my mom that maybe our grandmothers had it, they never knew about it. Yeah. I don't know.
Scott Benner What's your background? What culture?
Natalia I'm originally from Pakistan.
Scott Benner Yeah. Do they talk about their health, the family?
Scott Benner You've probably heard me talk about US Med and how simple it is to reorder with US Med using their email system. But did you know that if you don't see the email and you're set up for this, you have to set it up. They don't just randomly call you. But I'm set up to be called if I don't respond to the email because I don't trust myself, a 100%. So one time, I didn't respond to the email And the phone rings at the house. It's like, ring. You know how
Natalia it works.
Scott Benner And I picked it up. I was like, hello? And it was just the recording. It was like, US med. Doesn't actually sound like that, but you know what I'm saying. It said, hey. You're, I don't remember exactly what it says. But it's basically like, hey. Your order's ready. You want us to send it? Push this button if you want us to send it. Or if you'd like to wait, I think it it lets you put it off, like, a couple of weeks or push this button for that. That's pretty much it. I push the button to send it, and a few days later, box right at my door. That's it. Usmed.com/juicebox or call (888) 721-1514. Get your free benefits checked now and get started with USmed. Dexcom, Omnipod, Tandem, Freestyle, they've got all your favorites. Even that new islet pump. Check them out now at US Med dot com slash JuiceBox or by calling (888) 721-1514. There are links in the show notes of your podcast player and links at juiceboxpodcast.com to US Med and to all the sponsors.
Natalia Oh, yeah. Yeah. They do all their checkups and stuff, but it's just been, like we've been here, what, sixteen years now
Scott Benner Mhmm.
Natalia In Hong Kong. So, like, both my kids have been born here. So it's just like he overnight, he was looking weak, and it just so happened that after school finished last year, I took him to the pediatric, and she said, just do some blood tests. And overnight, like, the blood test was in the morning. The doctor called at seven in the evening and said, take him right now. His level was something like 40.2.
Scott Benner Okay. And
Natalia it was just like an ICU. It was an overnight thing. Like, no one even saw it coming. But I guess the symptoms I was telling my doctor were there where he was thirsty overnight, you know, all night long, going to the loo every now and then. So the signs were there, but I didn't know what it was. So because of that. Yeah.
Scott Benner Did it come on very quickly, or in hindsight, had he been losing weight for a while or sick for a while?
Natalia He was looking weak since a month, maybe.
Scott Benner Okay. Feels like you caught it pretty quickly.
Natalia I wouldn't say that, but, yeah, that's what everyone says. But, yeah, I I felt so bad when that happened. But yeah.
Scott Benner That's pretty common, just so you know. Yeah. Yeah. Nataimas It is what it is. Most people talk about that and and have that feeling. Yeah. I'm noticing here on your menu that you sent, you have different carb ratios for is it different times of day?
Natalia Yes. So for the morning, it was just something that the, what you call, the diabetic, educator we were in touch with, she said this because he was going a little high and low at different times.
Scott Benner Yeah.
Natalia So we just changed this around, and we just did it, like, nineteen thirty one forty one according to morning, afternoon, night.
Scott Benner Was that before the pump or after the pump that they noticed that?
Natalia After the pump. Yeah.
Scott Benner Actually,
Natalia even before, sorry, even before the pump, the endocrinologist had him with, like, it was pretty much same, but it just wasn't you know, the curve was just going up and down a bit. There was no consistency.
Scott Benner So let's talk about that before we get into the menu. So if these variable insulin to carb ratios were set prior to pumping, then what they were doing is trying to probably get in front of problems you were seeing at meals based on injected basal insulin, which doesn't work as stably as it does from a pump. Yeah. So I also would wonder if maybe you don't need to find out what his carb ratio is and set something a little more stable because you have, insulin correction factor here of one unit moves in 41, one unit moves him 19. So you have it more aggressive at breakfast at nineteen. Yep. It's aggressive for the snack. It gets less aggressive at lunch, and then actually, oddly, much less aggressive at dinner. Yeah. So is he getting high at night before bed?
Natalia Not at all.
Scott Benner No? Okay.
Natalia He gets low. Like, low is what I would call it. I know there are different lows, but he goes around 90. 72 in this range. So but it's still manageable, but sometimes he does go low. He has, like, few sips of juice. Yeah. And he's back okay, and then he's sleeping.
Scott Benner 70 and falling or just 70 and stable and you get nervous about it?
Natalia I used to get nervous even less than 72.
Scott Benner Okay.
Natalia But now I let it go to, 70.
Scott Benner Okay. You're getting it.
Natalia Yeah. It's hard.
Scott Benner Takes time. Took me I was crying for two years, just so you know. The first two.
Natalia Yeah. Like, today, I tried to do that with the nurse in school because I've told them at a five point three, make sure you give him juice. Make sure you do this, and you stop and do this, this, this. So today when he was on a 4.9, they panicked, they're like, he's 4.9. He needs to choose right now. I was like, no. Let's wait because I'm seeing him. He pulls up himself. Yeah. So, you know, I mean, I'm just trying just slowly, slowly, and they're trying. So it's like a whole Yeah. No. No. It's like a village.
Scott Benner I I understand. It takes time. Well, I hope you take some comfort in the knowledge that eventually you will get better at this and it will feel easier. I don't think it's actually easier, but it's gonna feel easier. So do you know what his total daily insulin is right now? About how much does he use in twenty four hours?
Natalia I forgot. Let's see. One second.
Scott Benner Take your time, please.
Natalia So he would be like, total daily would be roughly around three or four units a day.
Scott Benner And that's of bolus insulin? Yeah. And then how much basil is he getting?
Natalia I think basal also is around three. That's the background one. Right? With the Yeah. Automatically it being given to him.
Scott Benner Do you know what his basal rate's set at in the pump?
Natalia Basal rate.
Scott Benner So how much insulin does he get every hour from basal?
Natalia Every hour, point zero five.
Scott Benner Point zero five? Yeah. Do you think he's honeymooning? Are there times when you think, like, oh, gosh. He doesn't really need insulin?
Natalia No. Not really. No. I think he needs it. Yeah.
Scott Benner Okay.
Natalia Like, I would say the knight, Tatshaw, so far since this week, since we've come back, has been the best ever where he is literally on a 90 a 108 would be his highest.
Scott Benner Mhmm.
Natalia So he would just be, like, nice flat line.
Scott Benner Nice. Okay. Well and are there times of the day where he's just not getting basil too? Can you see with the pump? Does it cuddle away at times?
Natalia Sometimes. Yeah.
Scott Benner Okay.
Natalia Or maybe an hour or so, but, yeah, not more than that. It just keeps giving it.
Scott Benner Okay. Give me one second. I'm having a studio built in my house for the podcast, and right now
Natalia Okay.
Scott Benner They are, like, cutting into the wall. This got so loud. I was afraid it was gonna bother you.
Natalia No. No. So 820, you can see he's got a point zero five today.
Scott Benner Mhmm.
Natalia And then at 09:15, he's got another 0.05. So it's, like, almost an hour later.
Scott Benner Yeah. It's a tiny bet he's getting.
Natalia Tiny. Yeah. Really less.
Scott Benner Yeah. Well, I'll tell you the other thing to find some comfort is that as he gains weight and his insulin needs grow with that, this all gets a little easier too. Like, when you're working with these really small numbers, there's a lot less room for, you know, making a mistake. But, also, the good news is it's not a ton of insulin. So if something goes wrong, it should be fairly easy for you to get in front of it one way or the other. So I have, like, an estimator on my website that starts with someone's weight and sort of gives you, like, a breakout of where you might expect their insulin to be. Mhmm. If I make him highly sensitive, that puts him at, like, theoretically, like, nine units a day. And I have a slider I can make it less aggressive. But when I do that, it wants to put less basal on. Takes his basal to about point one five an hour. So you are not far off at all from what you're seeing being pretty accurate to what the math would tell you Yeah. Which is kinda great. So forty four pounds, seven units a day total. This has him about point one five an hour, but there's an argument to be made that, you know, he's probably getting that much sometimes and nothing other times and balancing out to what you said, like, three. So let me take a little calculator here for a second. Do the point one five times 24. And sure enough, that's 3.6 a day. So, again, so the numbers are lining up. So I'm fairly comfortable that, like, based on his weight at least, that your settings are pretty good. Okay? So I like that.
Natalia Okay.
Scott Benner Now the sensitivity factor, if it's working for you, I'm certainly not gonna tell you to change it. Whatever you're seeing is much different than what the math says. So I say just go with what's working for you
Natalia Okay.
Scott Benner On that spot.
Natalia So how would that change?
Scott Benner It's gonna take more insulin to move him as he gets bigger.
Natalia Okay.
Scott Benner That's all. And I think there might be a time when you'll just pick one. Well, because you have it at eighteen right now.
Natalia Yeah. Eighteen. Yeah.
Scott Benner Is that that can't be right, though. You think one unit moves him 18 points?
Natalia Oh, good question. Like, when he's high, he doesn't even do that. So I had started giving him, like, point five so he can come down nine units, but that's not true.
Scott Benner What I'm gonna tell you is that at this little bit of insulin, his insulin sensitivity, the math says it's like one unit moves him 250.
Natalia Wow. Okay.
Scott Benner I don't know what to tell you about what to do or not do with that, especially when it's Omnipod five because Omnipod five has let me pull this up here. I'm a little embarrassed. I just made a video for Omnipod about this, and now I'm having to check my own thing to make sure to make sure I'm about to say the right thing. I feel silly.
Natalia Well, that's okay.
Scott Benner Because I stood in the studio and said it over and over again all day while they were way too close to me with that camera. I'm not gonna lie to you. I was uncomfortable at points. I didn't like to see my face that big. You know what I mean? When they were working on it, I said, please. They were like, oh, it's going along great. We can't wait to send it to you so you can see it. I was like, do I look old? It's all I it's all I kept asking. I was like I was like, do I look old? I look old, don't I? Just don't tell me. It's okay. So I have another calculator here, estimator about how to bolus. Right? So your insulin to carb ratio and we need to kinda pick one. So let's just go with breakfast for a minute, and we're gonna say 19 for the carb ratio. I mean, I'm gonna put the 18 in for your sensitivity Mhmm. And say that his blood sugar target is 90. Okay?
Natalia Okay.
Scott Benner And now I'm gonna look at his breakfast here. You say there's 24 carbs for breakfast, and there's an egg, there's milk, there's a bun, there's bread in there. Yes. And you are giving him 1.3 units, which by the way, in this calculator with your settings, it's 1.26. So 1.3, exactly the same thing.
Natalia Oh, okay.
Scott Benner What I'll say is the milk, high fat milk, low fat milk, do you know how what kind it is?
Natalia It's full fat.
Scott Benner Yep. Okay. So we're gonna do some more gazintas here and try to figure out you think it's a cup of milk?
Natalia Half a cup.
Scott Benner Okay.
Natalia So on the true calculation on the packet, it says, like, one cup is around 12 grams of carbs. Okay.
Scott Benner But how much fat is in it?
Natalia See, now that's the thing I don't calculate at all.
Scott Benner But is that bolus working for you, or is he getting high later?
Natalia It's working.
Scott Benner How high does he get after breakfast?
Natalia Mornings, would start at ninety maybe. 90 or 01:08. And the best thing is I pre bolus him twenty minutes. That is the game changer.
Scott Benner Very nice. Yeah. Have to be.
Natalia So he goes up to one forty four or one sixty two.
Scott Benner Okay. So he's not moving much at all on that?
Natalia Not bad. Yeah. Not bad. Yeah.
Scott Benner Let me just say this. At some point, when he goes to one forty or one sixty, the algorithm is coming in and giving him more insulin to bring him down.
Natalia Yeah. Probably. Yeah.
Scott Benner So a cup of whole milk has eight grams of fat. There's four grams and a half a cup. Just adding that to this doesn't change anything. But there's butter on the bun?
Natalia Yes.
Scott Benner I'm gonna see what happens here. Look for the fat in a tablespoon of butter. Gonna try to make so here you go. A tablespoon of butter. Do know much fat's in a tablespoon of butter?
Natalia Not much. 12. I don't even add that. Wow.
Scott Benner So if I have 16 in fat and I resimulate it again, it's not a lot, but it adds a point three eight bolus over time.
Natalia There we go.
Scott Benner And I'm gonna guarantee you that if you go look at what's happening, he's going up and, you know, one forty or so, which by the is great. You're doing terrific, by the way. I have a feeling when we get to the end of this conversation, I'm gonna find out that you're a bit of a type a personality and tell you. I'm gonna start asking you what you went to college for, and it's gonna be accounting or something like that. And so
Natalia Don't ask me because you're almost right.
Scott Benner Okay. Alright, everybody. Natalia is an actuary or an engineer. And No. No. It's not that much. It's not that bad. It's not that bad. Just finance. Oh, yeah. There we go. Okay. Yeah. So when I put in the fat for that meal, the initial bolus is still at 1.26 or 1.3, but it's asking for point three eight, so point four units over the next three hours. Omnipod five doesn't do extended boluses.
Natalia That's my biggest concern. I've been hearing so many podcasts, a few, but how do I do it?
Scott Benner All I would do is, like, an hour after he eats, I'd bolus point four.
Natalia Okay.
Scott Benner That's it. What I would really do since we're talking about it is I'd do it one morning the way you always do it, 1.3.
Natalia Mhmm.
Scott Benner And then I'd wait to see when does he start to rise.
Natalia Okay.
Scott Benner I'm gonna make up a number. Say he starts to rise seventy five minutes later, I'd put in the point four. I would pre bolus the meal. You're doing a great job pre bolus the meal. I pre bolus the meal Mhmm. Then I'd pre bolus the fat rise with the point four.
Using the Bolus Estimator
Scott Benner And you can use my estimator. It's juiceboxpodcast.com/bolus, the number four, bolus four.
Natalia Bolus four. Yeah.
Scott Benner And all I did was put in insulin to carb ratio 19, insulin sensitivity 18. I made the target 90. I put in 24 carbs from your thing here, and I put the fat in, 16, and it gives you a little you know, there's a meal wave and the Warsaw wave that kinda breaks them out for you, tells you about how long to stretch them out.
Natalia Okay.
Scott Benner And that's it. Like so I'm gonna do it again with you, I'm gonna look at the next meal.
Natalia Okay.
Scott Benner This poor kid, you're giving him seaweed for a snack. Is that what he used to eat, or is that a diabetes thing?
Natalia It's a diabetes thing. But he loved it anyway. Yeah.
Scott Benner Hey. Listen. It sounds like you're all gonna be healthier by the time this is over.
Natalia Yeah. Seems like it.
Scott Benner So now let's do the turkey or sandwich and the apple again.
Natalia Okay.
Scott Benner Tell me what kind of a rise do you get from that, if any.
Natalia So that would be lunch. Right?
Scott Benner Yep.
Natalia So lunch is also okay because luckily, it's a fifteen minute eating window, and then they get to play for, like, twenty five minutes.
Scott Benner Okay.
Natalia So that really works for him.
Scott Benner Oh, and that's why your carb ratio is weaker.
Natalia Yeah. He would go too low then.
Scott Benner I see. So you're getting around that by weakening the carb ratio, and that's working for you. Okay.
Natalia Yeah.
Scott Benner But also on the weekends, when you're trying to have lunch and it's pizza, that's also why you're struggling with the pizza because your carb ratio he's getting half the insulin for twice the carbs.
Natalia Yeah. You're right.
Scott Benner So yeah. So everything is settings. It's all timing and amount. Okay? Okay. So I guess so I'm gonna talk to that part of your brain. Everything is timing and amount. Okay? So you you look at that 24 carb breakfast. You see the problem you're having with it. You realize in that scenario, it's not accounting for the fat that probably caused you the problem. Also, nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan. Now on the lunch one, you've got the carb ratio goes from 19. One unit covers 19 to one unit covers 31, and you have found a great balance there because of the activity. But at that same time of day, at a pizza restaurant, you're not only don't have the activity, but you've added fat that you're not accounting for, lesser quality food. And for every carb he eats, you're getting half the amount of insulin. In a scenario where you probably need more, you're starting with less and not accounting for the pizza. That makes sense?
Natalia Yeah. Yeah. Okay.
Scott Benner Look at that. What do
Natalia you think of it that way? Yeah. That's
Scott Benner okay. That's that's what I'm here for.
Natalia Yeah.
Scott Benner My silly brain's not good at much, Natalia. This, it understands.
Natalia That's a lot to understand. It's way more than we understand.
Scott Benner Listen. I sincerely mean this. I'm not denigrating myself, but I'm probably not nearly as intelligent as you are. I'm not good at math. Whatever degree you have, I couldn't possibly get. All I had was a kid with diabetes before all this stuff existed and my desire to really pay attention to it and try to figure out what was happening. And Yeah. Then I saw what I saw, and contextually, I speak about it very differently, which I think is why, you know, when I stand up in front of a crowd and I say things like all the silly t shirt slogans I say about diabetes, that comes from, like, kinda, like, the I think I talk in pictures. But then over the years, making these episodes and bringing my friend Jenny in and talking about it with her, like, she really, like, helped reframe me the way I think about it, and I was able to kinda rewrite the way I think about it too.
Natalia Yeah. It's great. The work you do is great over here because in Hong Kong, we don't have the exposure. You know? We just have very, I would say, a very I mean, we don't even have bumps over here. We have to order them from other countries. Yeah. So they don't even have the whole thing where they have that support over here where you can like you were saying, take in the fat, taking this, taking that.
Scott Benner No one's gonna tell you about that. You know, I've done a couple of Zoom chats with expats in Hong Kong
Natalia Yeah.
Scott Benner Couple times around diabetes. Nice little group of people. So I understand why the lunch works, and I understand why you also are less aggressive at snack time
Natalia Mhmm.
Scott Benner Afterwards. That all makes sense. But now at dinner, that part throws me off because rice, meat, you know what? It's just not a lot of carbs, really. You're doing meat and veggies with some rice. Basmati's got the index on the Basmati's lower, and you've got the 41 work. Is he super active after school? Does he come home and run around and everything?
Natalia Excuse me. So he's basically he has football, and he comes home on Thursdays, and then he has other activities going on. So he's quite, like, all over the place until, like, we're ready to eat dinner by 05:30.
Scott Benner Okay. That's why you're getting away with the insulin to carb ratio of one to 41 at dinnertime. Plus you're doing most of your carbs are from vegetables and rice at dinner as well.
Natalia Yeah.
Scott Benner Yeah. Yeah. Okay. And there's not a ton of fat in no. There's no fat really in what you're eating at dinnertime.
Natalia Yeah. I avoid doing all those things. So it's either rice or it's roti, the homemade ones. So Mhmm. We use the whole meal. Yep. Yeah. We use that for that. So
Scott Benner Okay.
Natalia He was tested for the celiac disease. He had the whole endoscopy and stuff done where he was cleared from it. So we've kept it as normal. No gluten free or anything going on. So, I mean, I don't see that that's affecting him.
Scott Benner Yeah. No. It seems like you're okay there. Also, a lot of those gluten free prepackaged meals are a lot more carb heavy than you think too.
Natalia I agree. Yeah.
Scott Benner So I'm glad you don't have to use them. But now I think what we gotta figure out is this vacation menu here are the weekends. Like, you know what I mean? Because I mean, I'm happy to walk through it with you, but you already know the problem. Right? Carb ratio is wrong, and his activity is different. Yeah. Yeah. Yeah. So the bigger question is then if the pump is already set up, you don't wanna be changing constantly, you know, your settings and everything.
Natalia Yeah.
Scott Benner I think, honestly, when you're 19 and 31, you could just do the math and find out what the difference is so that when you dial up the insulin how are you gonna do that? You're gonna have to either lie about how many carbs it is or just put in extra.
Natalia Yeah. Just fake carbs. Right?
Scott Benner But I'm not sure what the algorithm's gonna handle better. Because what we would prefer is that on Saturdays, you know, at that time of day, that his carb ratio was more like 19 than 31 if you're gonna go do those kinds of meals. Yep. But you're also gonna want to really look at the fat on some of these things. Like, let's just use the pizza, for example. Like, I've never been to Hong Kong. So what am I getting for pizza there? Is it like pizza?
Natalia Pizza Hut. Yeah.
Scott Benner Yeah. Yeah.
Natalia We do Pizza Hut. Yeah.
Scott Benner Okay. So let's take a look at that real quickly.
Natalia And I don't even use the manual mode, so I don't put it on the extended bolus. I don't know if that impacts it or me just making it $60.40 is also the same thing or not.
Scott Benner You're not putting it in manual mode, making it sixty forty. Impacting what? I'm sorry.
Natalia Impacting his levels.
Scott Benner I mean, I think what's happening is you're trying to eat stuff with more fat, more protein. The pump itself believes that his total daily insulin is seven on a day when it's not gonna end up being more like 12. Yeah. You know? So the you've got everything going at you. You're changing how you normally live, and the algorithm doesn't know it's Saturday, and the algorithm doesn't know you're going to Pizza Hut. Right? So and you're counting carbs and not covering the fat too. So just because I'm on the website here, cheese pizza, pepperoni, supreme, meat lovers, which one would you
Natalia So just plain cheese.
Scott Benner Yeah. Plain cheese. Okay. I asked for the nutrition levels, and Pizza Hut's trying to sell me a pizza. Hold on a second. Oh, wow. And the calorie information, and I clicked on it, and it says, what's my ZIP code? Am I gonna have to give it my ZIP code to get the calorie information?
Natalia It wants you to get one.
Scott Benner It does. Silly little website. It's tricking me. Alright. I have to find a better website than the Pizza Hut website.
Natalia I got a 12 inch eight slices one. Carbs and Pizza Hut pepperoni pizza. Okay.
Scott Benner Gosh. There's so many different kinds of pizzas.
Natalia Pizza.
Scott Benner You should come here and have a pizza in New York, Philly.
Natalia Yes.
Scott Benner Pretty much. Have you been here?
Natalia I've been to New York. My husband's family lives there.
Scott Benner So Very nice.
Natalia Been there a few years ago. But with kids coming all the way to America is a bit much.
Scott Benner Yeah. Just for pizza? You don't think it's you don't think it's gonna be worth the trip?
Natalia Generally, I mean, like, it's we have other places we can go to.
Scott Benner Alright.
Natalia I've lived in Arizona with my uncle for, like, one semester of college. I didn't like it. I came back.
Scott Benner Too hot. Right?
Natalia Oh, just like I was 15 probably. Oh, yeah. Home. Yeah.
Scott Benner Not looking for that. The only thing I really know about your part of the world is I do keep grass lizards from Japan. The little green ones with the super long tails.
Natalia Oh, wow.
Scott Benner Hold on one second. Let me tell my wife that my dog ate. Okay. My dog got sick. He had to have his medicine today.
Natalia Oh, wow. Okay.
Scott Benner My wife's like, did he have his medicine? Okay. So 12 inch medium pan pizza. Yeah. So just using the pizza I'm gonna make a an example here for you. If we put him at 31 for his insulin to carb ratio, and then we say that he has and is one slice true, or is he gonna have two slices?
Natalia Two. Yeah. Two. Two slices?
Scott Benner Okay.
Natalia Let's see how it goes. Yeah. 60?
Scott Benner Yeah. This says 27 here, but we'll go with 60. Yeah. And now the fat is 20. And believe it or not, there is protein in it.
Natalia There's 11 grams of protein in it. So you're getting 22 of protein. We haven't even talked about what protein does yet. Okay.
Scott Benner But protein gets stored as glucose.
Natalia Glucose. Yeah. I was hearing your
Scott Benner Yeah. You see, kinda have to do that there too. So 60 carbs, 20 fat, 22 protein, right, is 1.9 units up front and point four three units stretched out. So you're probably doing two units if you're counting all that correctly, and it really is more like 2.4. But I think the greater point is that that's at the insulin to carb ratio of 31. Yeah. If you change his carb ratio to 19 and do the same math again Yeah. This goes from 1.9 up front to 3.1 up front.
Natalia Okay.
Scott Benner And point seven over the four hours. So that's almost a four unit bolus, 3.86, 3.9. It's 3.9 bolus up from 1.9 that you were using before. So you're using half the insulin that you need and not trying to impact the fat at all. So, basically, think of it this way. You gave the pump two units of insulin to do the job that it needed four units of insulin to do. Right. And on top of that, it doesn't consider fat the way you and I are talking about it. So as he's drifting up, it's not treating him like the food's the issue. It's just treating him like he's drifting up. So you've got this accelerant on his blood sugar, this, you know, this fire you've lit in his belly of fat and protein and carbs and all this other stuff. And you're handing the pump a garden hose and telling it to put it out. It needs a fire hose. Yeah. And so instead of putting that burden on the pump, which, by the way, what does he get to after the pizza? How high?
Natalia He goes to he's been to a 22, which is around, for you, 400.
Scott Benner Okay. So what I would do there is, of course, not as long of a pre bolus for pizza because you don't want him to get low first, and that pizza does not go in and start working as quickly as some of these other foods do. Right?
Natalia Right.
Scott Benner So maybe a slightly shorter pre bolus. Again, the timing and the amount to get the bulk of that insulin where you need it to be. But then when you start to see that first rise, you're gonna have to bolus again. And whatever that pod's gonna do I mean, with a kid who's using seven units a day, it's probably hitting him with, like, point o five, point o five. That's not
Natalia gonna do Nothing.
Scott Benner No. Especially when you're two units deficient already. Yeah. Right? So I think that's your answer there with that food, which is use the more aggressive carb ratio and account for the fat and the protein.
Natalia So does this make sense if I change the 31 to a 19 next time I do this when he has his pizza. And then I for the weekdays, I change it back.
Scott Benner Yeah. I mean, you can whatever is workable for you. Yeah. See, whatever works best in your life.
Natalia I'm just asking, should it have a consistency, or is okay to just keep changing it?
Scott Benner Well, I mean, listen. There's an argument to be made here. Taking the weekend out of it or taking the pizza kind of extra stuff that you don't usually taking that out of the conversation for a second. There's an argument to be made here that you're it's got nothing to do with the carbs. It has to do with his activity.
Natalia Okay.
Scott Benner You're managing lows from activity Mhmm. By using less or more insulin at meals. That's all that's really happening here. Everything's timing and amount. It's the right amount of insulin at the right time. And the timing has a lot to do with the variables around you. Right? Is he active? Is he not active? For some people, it's heat. Are they hot? Are they cold? Are they Yeah. You know, whatever people's variables are, you know, for ladies, a lot of times, a lot of hormonal stuff. Right? Yeah. That's why you hear people talk about diabetes like this way. Like, it's unknowable. Like, oh, I do the same thing every day, and I get a different outcome. Yeah. But you're doing the same thing every day, but the day's not the same. It looks the same to you because all you're talking about is eggs and milk and bacon and 08:00 in the morning. You're not talking about hormones. You're not talking about growth hormones, which he's by the way, you're not gonna see yet. But in a couple more years, wait till you see his blood sugar go up overnight when he goes to sleep. That's gonna be fun. So it's the variables around it that change the impact the the invisible impacts, really. But that's why when people say I do the same thing every day and I don't get the same outcome, they're wrong. They're doing the same thing every day, but all the things that are happening are not the same. It's the unseen stuff. For you, I can see why this would have gotten past you, to be perfectly honest, because they got you those carb ratios set up, and you're like, wow. This is working. And then why the hell doesn't it work on Saturday? That doesn't make any sense. Then all of a sudden, you say, oh, it's diabetes. It's just, you you can't know. But we looked at it for five minutes, and you know now. So Right. It's pretty much it. I mean, there's I I hate to say it. There's not a lot to it. You know what I mean? Which is why I can hold it in my head. Trust me. If there is more to it, I'd be the wrong person to ask.
Natalia Can I just ask you to repeat this whole thing with the bolus? I opened your bolus estimator.
Scott Benner Yeah.
Natalia So can we, like, walk through this together?
Scott Benner Sure. Sure. Yeah. So at the top there, there's insulin to carb ratio.
Natalia Variables. Yeah.
Scott Benner Yep. And there's insulin sensitivity.
Natalia So we put in 31 here. Right?
Scott Benner Yep. And then Okay.
Natalia SF is 18. Yep. Then target blood glucose would be
Scott Benner I made it 90. Okay. Yep. And then you just kinda scroll down a little bit and put in carbs. By the way, I'm not boasting because I don't know how to code, so it was Claude that did it. But, once you leave the website and come back, it'll leave his carb ratios and his sensitivity. All those numbers you put in, it'll remember when you come back to the website, but it doesn't store any of your data.
Natalia Okay. So what is the calc gap? What does this mean?
Scott Benner Okay. So I'm not gonna lie to you. It's a simulation. It'll halt if the output exceeds it. So Okay. It's kind of a safety that's built into it.
Natalia So it's I don't have to put anything here.
Scott Benner You can just leave it at it should be at 25. Right?
Natalia 25.
Scott Benner Yeah. Just leave that. The FPU adjustment factor, if you wanna sit down and really read and understand the Warsaw method, which is probably not gonna be necessary for you with such a little kid at such a little weight. But there are some people who need a different adjustment factor to make the Warsaw method work better for them. I'm gonna tell you right now, I'm not the right person to ask about that. But Okay. It's set at 50 as a default. If it's working for you, I'd leave it there. Okay?
Natalia Okay. Let's leave it. Yeah.
Scott Benner Yeah. Okay. And then carbs, fat, protein.
Natalia So carbs, we have 60. Yep. Fat, we have 20.
Scott Benner Mhmm.
Natalia Protein, 22.
Scott Benner It's 22. Now I did not fill in the current BG number there. Okay? So because we're just talking, like, theoretically. But if you put in there, he's one fifty, like, I'm still looking at your bolus with 6020, 22 as the settings, and it's 1.940.43. Meal wave, 194. Warsaw, 1.43. But if I suddenly make his blood sugar one fifty, then, of course, it's gonna add a correction in. The initial bolus went up to 5.27 to cover his higher blood sugar.
Natalia Oh, wow. Okay.
Scott Benner You're not just bolusing for the food. If he's one fifty, you're bolusing for the food and the elevated number.
Natalia Okay. So let's go through with this. So current BG, we kept at one fifty.
Scott Benner Mhmm.
Natalia That the IOB units
Scott Benner If he's got insulin on board, you can put it in there so it's part of the part of the thing. But, you know, also, if it's been a few hours since he's eaten and he's got a stable blood sugar, I'm gonna kind of assume that the insulin's already done what it's gonna do.
Natalia Okay.
Scott Benner And it actually does help you there. You can put in a an arrow for the trend arrow because right now, I have is one fifty. It's a five two seven bolus. Also, let me mention with the one fifty, when I take the one fifty out, not only is it a one point nine four initial bolus, but it says make the pre bolus nine minutes. You put the one fifty in, and you'll notice when you resimulate it, it turns the pre bolus into more like fifteen minutes. So what it's telling you is like, look, you wanna try to get that one fifty number down more before you start eating is what it's saying.
Natalia Right.
Scott Benner Yeah. And don't take any of, the 15 or the nine. It's not gospel. It's Right. It really is just, you know, a place to start to think about it. Anyway, if you make the arrow stable, that's one thing. If you make it a rising arrow
Natalia Okay. So whatever it is I see from the Yep. The controller. Okay.
Scott Benner And, actually, when you scroll down, it says show calculation steps. If you wanna click on that, it shows you all the math that it's taking into account. And you can continue to scroll down, and there is an incredibly technical explanation of what this thing is doing.
Natalia Okay. Great. I didn't know how to use this. Yeah. Okay.
Scott Benner Makes
Natalia sense. So mean wave would be 5.27 units. That would be
Scott Benner Yep. Upfront. Yep. What it's saying there is it would like to see point four three units spread out over four hours.
Natalia Over four hours.
Scott Benner But you don't have that ability.
Natalia Okay.
Scott Benner So there's where you're gonna have to just pick a time to jump in and put in a little bit of extra to try to stay ahead of the now listen. If ninety minutes later, you're not seeing a spike and it never comes, well, then, okay. The bigger bolus did it. But if you see it
Natalia I get excited in two hours. I said, I think I did it at at the fourth hour comes.
Understanding Basal and Automated Systems
Scott Benner Think I did it. Nope. Well, see, also on the AID systems, all of them. Right? There's this sort of, like, in plain language, the algorithm believes that you've given it the right amount of insulin and that you've accurately described the impact that it's going to see. You know, if your pre bolus gets him to, I don't know, 85 and he's super stable, well, then the algorithm's working off the bolus. So it'll oftentimes take the basal away because the bolus is basically handling the food and the basil needs all at once right now. Okay. Right?
Natalia Okay.
Scott Benner So if it's doing that and you're wrong or there's other impacts from food, then not only is it not enough insulin, but it's also probably got a deficit of basil. So there's nothing there to stop the rise from happening. Right? And then it starts to just like, the way I think about it is this. Basil insulin, if you think of the blood sugar as a number, I think of basal as just enough weight to keep that number where you want it to be. So Okay. Think of your, you know, your left hand is pushing up and your right hand is pushing down, and so the body is, you know, natural body functions are making your blood sugar go up. Right? You're not making insulin. You eat a cookie, your blood sugar's gonna go up without insulin. It's never gonna stop. Right? Yeah. So you need to put enough basal on top of that just for your body functions to keep you level. So think of it as, like, resistance that keeps the number where you want it. That's basil's job. Keep you at a number that you want stably. So the basil's doing that. You take that basal away, there's nothing stopping that number from rising all of a sudden. And so when you bolus on an algorithm, you put in all this insulin, and it's saying to you, okay. Well, we have a stable number. So the insulin that's in there is not only handling the food or the correction that we asked for, but it's also handling the basal needs. So you'll see that a lot of the algorithms just shut the basal off. And sometimes there won't be basal insulin happening for an hour or two.
Natalia An hour.
Scott Benner Yeah. Yeah. Yep. Right? And just imagine if you didn't use enough insulin and it's shutting the basal off because it believes you when you told it how many carbs and what's the impact gonna be of this food. So it's taking insulin away on the other side, then that fat rise comes in and hits you, and you've not only don't you have anything currently laying on top of it to stop it, but you haven't had anything there for hours, so you're deficient on top of that. Does that make sense?
Natalia Right. It
Scott Benner does. Right? And then that's where the rise comes from.
Natalia Yeah. Yeah. This is the information I feel I was missing. It was just not making sense.
Scott Benner Sure. No. I understand. Yep. That's it. What I just said to you right there, I don't wanna give away the whole secret. That's pretty much why people listen to the podcast. Yeah. The idea that nobody talks about this part of it. I mean, you could get lucky and get an endocrinologist that would explain it to you, but mostly, it doesn't. Yeah. I'll tell you, I'm giving a talk tomorrow at a hospital, and I said I'd like to talk about this. And they were like, oh, we don't tell anybody to do that. I was like, yeah. That's gonna be a problem. You know? Yeah. So, I think that's it. I mean, in all honesty, like, I would imagine this weekend's gonna go way better for you. Might be pizza time again. Who knows?
Natalia I hope so. Yeah. So is this what you said is, like, a extended bolus, basically?
Scott Benner Yeah. If you had a regular pump, right, like, wasn't running an algorithm, or there are some algorithm pumps that handle extended boluses off top of my head, tandem does. Yeah. Yeah. So if you had a tandem pump, you'd say, look. I wanna do this exact setup. I'd wanna do 5.27 up front, point four three over four hours, and and then it would do that there.
Natalia Okay.
Scott Benner But Omnipod five doesn't do extended boluses in automation, so you're just gonna have to make the point four three bolus at an advantageous time, which would be before you see the fat rise, but not so much before that it makes you low.
Natalia Okay.
Scott Benner Alright? So the timing of that is gonna be a little bit of you're gonna have to have a couple of pizzas to figure that out. Yeah. You know what I mean?
Natalia I have to go through it. Yeah.
Scott Benner Yeah. Little practice pizza, we'll call it.
Natalia Okay. Sure. Alright. Thank you so much.
Scott Benner Oh, you're welcome. Same thing with all this other stuff. If you're doing chicken and it's a chicken tender or chicken nugget
Natalia Yeah. Oh, the breadcrumbs and stuff.
Scott Benner Yeah. But don't forget too that because they probably deep fry them, there's gonna be fat there.
Natalia Yeah.
Scott Benner So look for the french fries. French fries
Natalia are Right?
Scott Benner Cheeseburger and fries. I don't know if you guys eat meat, but a cheeseburger and fries, you're gonna get the fat from the meat and the fat from the fries. It's gonna be a double whammy of fat. And trust me, just for fun sometime, which, by the way, is why I set this simulator up so people could look at it. Yeah. Like, you have this set up now, 60 carbs, 20 fat, 22 protein, a 150 blood sugar, and you're seeing what it is. But just imagine for a second let me just Google, like hold on a second. I'm just gonna use McDonald's because I don't because it's something everybody knows.
Natalia Like, he's even stopped having chicken nuggets because I'm just too scared of it.
Scott Benner Yeah. No. No. But you're gonna have it now. I can hear you thinking about it. I know you're gonna be okay. Yeah. Large McDonald's french fry, 23 to 24 grams of total fat, 66 grams of carbs. So if we add say he has what you just described now, but with a McDonald's fry on top of it, that takes it to a 126 carbs, and it takes your fat to 85. Yeah. Okay. Now I'm gonna ask you without thinking about the numbers for a second. Just use your old brain. If he had french fries, how much insulin would you give him for french fries?
Natalia Point five, what?
Scott Benner Yeah. Right. It takes his bolus up to 7.4 initially and 1.3 over time. So where you would have added point five or one, you would have really needed two, almost three units.
Natalia Yeah. Yeah.
Scott Benner And that's the kind of stuff, like, when people say don't have any luck at restaurants, this is what they're not doing.
Natalia No. There had to be a reason.
Scott Benner Yeah. This is it.
Natalia Yeah.
Scott Benner Alright. You're done. I fixed it. We're all good.
Natalia Thank you so much.
Scott Benner What time is it for you are? It's so simple. Well, listen. Once you hear my dumbass explain it to you, you actually start thinking, It maybe it is simple. No.
Natalia I'll use the calculator and really I mean, now it's making sense. So Good. Slowly. Let's see.
Scott Benner Yeah. You go to my website up in that menu, this is for you or for anybody listening, not only is there, like, in a little a one c estimator up there, there's, a basal estimator if it explains how the math works behind basal insulin where you can just, you know, put in your weight, and it'll give you some suggestions about where to start looking. There's also the bolus estimator that we were just using. There's also just a fat and protein estimator. It doesn't do the whole, like, the whole meal, but it shows you how it works. Just adding fat and protein to your carb ratio to give you some examples of it. And then there's the setting simulator, which is literally just you set your weight, and then it gives you a starting point for everything from carb ratio, basal sensitivity factor, like, kind of the whole thing. So as he's growing, you might wanna go to that simulator once in while and just kinda check yourself. Like, maybe our settings have moved because he's gonna gain weight. He's gonna keep growing, and those doctors are never gonna mention these settings again to you.
Natalia Yeah. That's every three months I have to go to them, but it's just like, you know, you should do better. And I'm like, how? You know? They don't teach the how.
Scott Benner Yeah. Yeah. Yeah. Well, go back and look at that setting simulator. Like, if things are getting wonky, then just go look again. Anyway, I think those things should be helpful to people. Again, they're not there's disclaimers all over the stuff. It's for educational purposes. You should talk to your doctor first. I barely graduated from high school. Okay? So I'm not I'm not joking. That's fine. Alright.
Natalia It's whatever you make of yourself. Right?
Scott Benner I believe that too, but I just want you to know where you're getting that estimator from. That came out of my brain, so be careful. Wow. That's fine. Alright. Alright. Do you have any other questions or anything else you'd like to talk about?
Natalia Just one more thing. I for the longest time, I thought Basil was just background insulin. He would get only at night. I think it's because of the injection time where Tresiba was just given one unit at nighttime. So I don't know why that has been stuck in my head. And when I talk to people, they're like, oh, you should turn up the temp basil. And, you know, I was like, how is that connected to bolus? Mhmm. So
Scott Benner Well, listen. Now that you've talked to me, go listen to the pro tip series.
Natalia Okay.
Scott Benner Okay? It starts at episode 1,000 where you can go to my menu and go down to pro tips. Jenny and I walked through the whole thing. If you just listen to it straight through, I'm gonna tell you right now, you listen to that thing straight through and halfway understand it, it's an a one c in the sixes.
Natalia Okay.
Scott Benner Okay? And we'll go over all that stuff. But it's funny because I actually did add there's an interactive defining diabetes page on here, which it's just definitions because I did find that people, like, would say, like, well, I didn't know what basil was. And I have kind of colloquial ways of talking about it. And the basil, I just did with you. I just think of it like basil holds you at a number.
Natalia Yeah.
Scott Benner And you decide what you want that number to be. I don't care if you wanna, you know, away from food and away from, you know, active bolus insulin. If you wanna try to be 80, there's a basil that holds you at 80. If you wanna be 90, there's a different basil that'll hold you at 90. And then once that's done, that's done. Yeah. But if that's wrong, to imagine that the basil I know these are big numbers because he's so small. But try to imagine your basil supposed to be one unit an hour, but you have it set at point five an hour. Yeah. So you're deficient every hour a half a unit of basil. You probably got a high blood sugar on top of that. But then you go to bolus for food, and then even if you have your carb ratio right and you've counted the carbs correctly and you say, okay. Well, this meal is four units. Well, it's four units, but you're deficient a half a unit of basil every hour for the last four hours. So your four unit bolus might not even touch your food. You replace the basil and the need that you have with a higher number, you probably didn't even put any insulin to cover food. So just remember it this way. When the basal's wrong, nothing else works.
Natalia Okay.
Scott Benner Okay?
Natalia And the way to see that is in the nights or during the day as well?
Scott Benner It's just easier at night to look at and then kinda work off it during the day, can kind of adjust off of it. But Omnipod five is gonna make the changes for you anyway. There's not a lot you can do about it. But you could you could if you really want to teach yourself on the weekends, you could put them into manual and try to get your settings right to, you know, kinda give yourself a I don't know. Like, you could basal test in manual. You know, you could do a little testing in manual just to see how good your settings are.
Natalia Right.
Scott Benner You know? And then after that, it sounds like you got the pre bolusing down already. You got you know, most meals, you need to pre bolus.
Natalia Yeah. For all of them, I do it. Yeah.
Scott Benner And that's pretty much it. Listen, Nithanya, seriously, I'm gonna tell you something I I don't tell everybody, but when I hear it, I say it. You're gonna be fine because Yeah. You're paying attention and you ask the right questions. That's pretty much it. Yeah. And you're trying.
Natalia Just trying my best.
Scott Benner Yeah. No. You're doing great. And it's gonna work out because you're paying attention and you're asking good questions. You found good information, and you're putting in the effort. I guarantee you wake up six months from now, look back on yourself today, you won't recognize yourself. Yeah. You know? You okay? Are you sleeping? Yeah. Yeah. You're getting good sleep? You're not, like, up all night long?
Natalia Really? No. I get good sleep. Yeah.
Scott Benner Good. Good. The and the algorithm probably helps you with that. The Omnipod five is a lifesaver there, I would imagine.
Natalia It's just that the whole house has iPads ringing if it goes below four. So, I mean, that's the time we wake up. And by default, we give the juice and stuff. So, I mean, I guess it's a way of life now.
Scott Benner Yeah. It is. You'll be okay. You really will be. Yeah. Yeah. I appreciate you doing this with me. I hope this went kind of the way you were hoping.
Natalia Really, really good. Yeah.
Scott Benner Oh, good.
Natalia I had no idea what would come out of it, but
Scott Benner That's excellent.
Natalia I'm looking to it now. I know which direction to go with, but thank you so much.
Scott Benner You're welcome. You're very welcome. Hold on one second for me. Okay?
Natalia Yeah.
Outro
Scott Benner Alright. I'm sorry. I started the recording back up, everybody. So I'm still here with Natalia. We were talking about what to name the episode, and I said, oh, you never said your son's name, or I would have made this episode bolus four and his name, but you said it's okay. So what's his name?
Natalia His name is Zaid, but everyone in school call him Zaidino. So if I show him that, he would be really happy. You'd be
Scott Benner very fine. So spell the nickname. Spell it. Z a
Natalia z a y d I n o.
Scott Benner D I n o. Okay. And I wanted to put this here so that all of you, when you got to the end, you're like, why the hell was this episode called that? So so that's exactly what I'm gonna call. I'm telling the editor right now. Rob, this is Bolas Forzedino, z a y d I n o. Okay. Thank you so much again. I'll let you go. A huge thanks to my longest sponsor, Omnipod. Check out the Omnipod five now with my link, omnipod.com/juicebox. You may be eligible for a free starter kit, a free Omnipod five starter kit at my link. Go check it out. Omnipod.com/juicebox. Terms and conditions apply. Full terms and conditions can be found at omnipod.com/juicebox. A huge thanks to today's sponsor, AbleNow. AbleNow offers tax advantaged able accounts for eligible individuals with disabilities. If you or your child lives with diabetes, you may qualify because of ongoing medical needs. With Able Now, you can save for a wide range of disability related expenses without affecting eligibility for certain disability benefits such as Medicaid. And thanks to recent federal law updates, more people are eligible than ever before. Learn more and check your eligibility at ablenow.com. You spell that, ablenow.com. There's links in the show notes and links at juiceboxpodcast.com. The conversation you just enjoyed was brought to you by US Med.
Scott Benner Usmed.com/juicebox or call (888) 721-1514. Get started today and get your supplies from US Med. I can't thank you enough for listening. Please make sure you're subscribed or following in your audio app. I'll be back tomorrow with another episode of the Juice Box podcast. If your loved one is newly diagnosed with type one diabetes and you're seeking a clear practical perspective, check out the Bold Beginnings series on the Juice Box podcast. It's hosted by myself and Jenny Smith, an experienced diabetes educator with over thirty five years of personal insight into type one. Our series cuts through the medical jargon and delivers straightforward answers to your most pressing questions. You'll gain insight from real patients and caregivers and find practical advice to help you confidently navigate life with type one. You can start your journey informed and empowered with the Juice Box podcast. The bold beginning series and all of the collections in the Juice Box podcast are available in your audio app and at juiceboxpodcast.com in the menu. Have a podcast? Want it to sound fantastic? Wrongwayrecording.com.
#1848 Boggs Family
Scott and Shannon Boggs discuss her daughter's traumatic DKA diagnosis, managing Hashimoto's, the hidden burdens of diabetes service dogs, and navigating social media fame while protecting your peace.
Companies that Support Juicebox
Key Takeaways
- Trust your intuition as a parent and advocate for a change in doctors if your child's endocrinologist dismisses consistently high blood sugars or ignores other autoimmune symptoms.
- Type 1 diabetes is frequently accompanied by other autoimmune conditions, such as Hashimoto's or celiac disease; regular screening and paying attention to subtle signs like lethargy or skin changes is vital.
- While a diabetes service dog can be a wonderful asset, they also require significant financial resources, continuous training, and add extra daily responsibilities that aren't ideal for every family dynamic.
- If you build a social media following around diabetes, prioritize community connection and authenticity over algorithmic metrics to protect your peace and avoid burnout.
- As children with T1D grow older, parents must gradually relinquish control—allowing teenagers to manage their own routines and choices fosters the lasting independence they need for adulthood.
Resources Mentioned
Introduction and Sponsors
Scott Benner Welcome back, friends. You are listening to the Juice Box podcast.
Shannon Boggs My name is Shannon Boggs. I am the mom of three kids. My oldest has type one diabetes. She was diagnosed about three years ago. Over the last three years, we've been learning to navigate the highs and lows and figure life out.
Scott Benner If you'd like to hear about diabetes management in easy to take in bits, check out the small sips. That's the series on the Juice Box podcast that listeners are talking about like it's a cheat code. These are perfect little bursts of clarity, one person said. I finally understood things I've heard a 100 times. Short, simple, and somehow exactly what I needed. People say small sips feels like someone pulling up a chair, sliding a cup across the table, and giving you one clean idea at a time. Nothing overwhelming, no fire hose of information, just steady helpful nudges that actually stick. People listen in their car, on walks, or rather actually bolus ing anytime that they need a quick shot of perspective. And the reviews, they all say the same thing. Small sips makes diabetes make sense. Search for the Juice Box podcast, small sips, wherever you get audio. Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan.
Scott Benner The episode you're about to listen to was sponsored by Touched by Type One. Go check them out right now on Facebook, Instagram, and, of course, at touchedbytype1.org. Check out that programs tab when you get to the website to see all the great things that they're doing for people living with type one diabetes. Touchedbytype1.org. I'm having an on body vibe alert. This episode of the Juice Box podcast is sponsored by Eversense three sixty five, the only one year wear CGM. That's one insertion and one CGM a year.
Scott Benner One CGM, one year. Not every ten or fourteen days. Ever since cgm.com/juicebox. Today's episode is also sponsored by the Tandem Mobi system, which is powered by Tandem's newest algorithm, Control IQ Plus technology. Tandem Mobi has a predictive algorithm that helps prevent highs and lows and is now available for ages two and up.
Meeting Shannon and Navigating Hashimoto's
Scott Benner Learn more and get started today at tandemdiabetes.com/juicebox.
Shannon Boggs My name is Shannon Boggs. I am the mom of three kids. My oldest has type one diabetes. She was diagnosed about three years ago. Over the last three years, we've been learning to navigate the highs and lows and figure life out.
Scott Benner Oh my gosh. How many you have three kids? What are their ages?
Shannon Boggs They are 11, nine, and six.
Scott Benner Okay. Wow. Are you a a young family? Are you, like, in your thirties or forties? Or
Shannon Boggs Yeah. I'm 35.
Scott Benner Look at you. Alright. Very nice. Any autoimmune in the family, or was type one the first time you heard those words?
Shannon Boggs So we had really not we weren't really super familiar with type one. My aunt hasn't, I mean, my husband has an aunt who grew up, like, twelve hours away from him who has type one. So when she when my daughter, Raelyn, was diagnosed, they were immediately like, who has type one in your family? And I didn't know of anybody, and he was like, I have an aunt that does. So that would be Raylan's great aunt.
Scott Benner Mhmm.
Shannon Boggs And then we have some celiacs on both side of our family, which so far she's negative for, but she does have this last year, she was diagnosed with Hashimoto's.
Scott Benner Your daughter was? Yeah. I like that you said celiacs, plural. I wasn't sure if you were being plural or descriptive when you said celiacs. Like, multiple celiac or people who we refer to as celiacs.
Shannon Boggs So yeah. Yeah. I met multiple people with celiacs.
Scott Benner You know those people,
Shannon Boggs the celiacs. Yeah. Yep. The celiacs.
Scott Benner What led you to think about the Hashimoto's? Was it just generalized testing that caught it, or did you see something?
Shannon Boggs So when she was at when she was diagnosed, they immediately told me that there's other two other autoimmune diseases that usually go hand in hand. Sometimes they'll get one or two. Sometimes they'll have all three. And they tested her at diagnosis and said that she had the markers for
Scott Benner it. Okay.
Shannon Boggs We checked it regularly, I think, like, every six months, and it started kinda climbing up. And I guess maybe six months ago, it was high enough that they went ahead and put her on levothyroxine for it.
Scott Benner Do you have any idea how high her TSH was when they put her on it, and were you seeing any symptoms from it?
Shannon Boggs I think it was about I wanna say it was, like, a 12, and I started seeing flaky a lot of flaky skin on her scalp that was itchy, and she was tired and started kinda gaining weight a little rapidly.
Scott Benner Mhmm.
Shannon Boggs So that has gotten better. She's had to move up on dosing, and we might have to bump her up again. We're waiting to see.
Scott Benner Well, as she grows, she's gonna need more. Yeah. Be careful of that because they'll lose sight of that sometimes. Hey. Prior to the because twelve's pretty high. So prior to that, did you see symptoms like, looking back, can you see other symptoms now before they treated for it?
Shannon Boggs Yeah. And, you know, I wanna say when she was, like, at a four, they didn't medicate her yet. And I was starting to see and ask, and they were like, well, I don't think we need to yet, but maybe next appointment, we will. But I started kinda noticing her being a little tired.
Scott Benner Yeah. If I was your doctor, I would've given it to you to four if you saw symptoms.
Shannon Boggs So Yeah. And, you know, I really wasn't educated on it. I remember our we had an endocrinologist that at first didn't take much very seriously. We we had to really fight to kinda get a new new one that would listen to us better, but she would say things to me like, well, if her blood sugar goes to 400 every day after breakfast, I'm fine with that as long as it comes back down eventually. And I was like, well, I don't really like that. Like, I would really rather have her a little bit more in tight control, and she just seemed very, like, not worried about things. So when I asked about the Hashimoto's, and I was like, what what is this? What do we need to do? Should we do some stuff with diet? She was like, oh, no. It's easy. All you do is take a pill.
Scott Benner Where'd you find this lady? A swamp? Where where did where did you
Shannon Boggs I'm telling you. Mhmm. It was interesting. First our first two years with her was very interesting because that's who we got at diagnosis. That's just who was there, the day that we went in, and she was in DKA. So then they kept telling me I couldn't switch. You are you're stuck with whoever you're with. And I was like, what? This can't be right.
Scott Benner Is she older or younger? Or what was
Shannon Boggs I would say she was, like, mid forties, but she was pregnant with her first baby. And she then she went out on a long maternity leave, and she went out early. So I just feel like her focus wasn't really at work at the time.
Scott Benner She's like, Shannon, listen. I hear you have questions, but I just bought a house. So, I I don't I gotta go.
Shannon Boggs She was crazy.
Scott Benner The 4 hundreds, as long as it comes back down, I mean, that's fat. Was she was a a pediatric endocrinologist?
Shannon Boggs Yes. I had when I tell you what I had to jump through to get to a new endocrinologist in the same office, and we're very happy now Yeah. I mean, it took months and months. And I was like, you and we don't have another children's hospital within, like, a four hour radius
Scott Benner of us. Yeah. Yeah.
Shannon Boggs Because I would have just left.
Scott Benner Was the office surprised when you said it to them, or were they like, oh, no. We know? Like, I wonder what that
Shannon Boggs was like. They just they just kept saying that they were shorthanded. Nobody was taking new patients, and I had to stick it out with her. And I was like, no. This is not right. Like, I have to be able to do something else. She needs a different Yeah. Doctor.
Scott Benner Yeah. She shows up every day. It's not a good reason for me to put my child's care on her. Yeah. Tell me again, your daughter is how old when she was diagnosed?
Shannon Boggs She was seven.
Scott Benner Seven. Okay. So, yeah, like, you know, maybe we wanna help her. Yeah. Well, what kind of direction did you get about the diabetes then? If that was, like, did they give you tech? Did you have to ask for it? Did they teach you how to use it?
A Scary DKA Diagnosis Story
Shannon Boggs That was a mess. So we went in on a Friday. Our diagnosis story alone was kinda pretty traumatic, and we had no idea. Like, diabetes was not on our radar. Yeah. We just we thought she was sick with a virus, and it escalated pretty quickly. And I just knew something wasn't right. Immediately, I'm just gonna go through the little the little steps of our diagnosis. So she woke up. Then on Wednesday, she was doing double backflips in gymnastics class, and she was fine. On Thursday, she was a little tired and didn't wanna go to school. And I remember thinking, like, maybe we're overdoing it with these gymnastics classes. Maybe because we had a long drive, we're getting home late at night, and she was like, no. I really wanna go to school. Well, on Thursday, they called me by lunchtime and said that she had a sore throat. So I'm like, okay. Pick her up. She looks very tired, but says she's okay. I'm taking pictures of her throat, like, sending it to the pediatrician. Do you think this is, like, strep throat? Do you think I should have her swabbed? And she's like, it looks viral to me. She went to bed that night and was drinking she was drinking water and ate, like, a little bit of soup but didn't eat much. And the next morning, she threw up.
Scott Benner Well,
Shannon Boggs her friend that she was riding to gymnastics with had the exact same symptoms the week before. Oh. So that mom and I are chatting, and she's like, oh, it sounds like the same thing my kid had. I'm like, okay. So I let it ride. That was, like, 5AM when she threw up. And around lunchtime, I was like, something's not right. I would go in her room to check on her. Her eyes were, like, open, but she was sleeping. And she would talk to me, but it was very, like, just
Scott Benner unnerving? Like yeah. Like, she
Shannon Boggs wasn't I it took me a lot to get her attention.
Scott Benner Yeah.
Shannon Boggs So we live on the Eastern Shore Of Virginia. It's like a little peninsula. We have to drive over an 18 mile long bridge to get to the children's hospital, and it's an hour and a half away.
Scott Benner Did you go to King's Daughters? Yeah. Yes. That's where Arden was diagnosed. No way.
Shannon Boggs I have no idea. Oh, okay.
Scott Benner We were on vacation in, Virginia Beach when she was diagnosed.
Shannon Boggs Oh, wow. Yeah. So my husband used to work at that bridge, the virgin the one that I'm talking about. And the day that this happened, we had a nor'easter, and the bridge closes for weather like that. Mhmm. So I was waiting for my pediatrician to call me back. I got almost to the bridge, which is an hour from my house, and they were saying that the bridge was closing. So my pediatrician was like, if this doesn't work, I want you to turn around and drive to Maryland, which would have been three hours the opposite way. Jeez. We have a little local hospital, but they don't they definitely don't have endocrinology where we're at and not for pediatrics. So she knew that they I think she knew by that point what was going on. Because when I put Raelyn in the bath that day after she threw up, I was looking at her, and I said, she looks like she lost weight. So I weighed her, and I realized that she had lost eight pounds.
Scott Benner Oh gosh.
Shannon Boggs And I was like, and you know what? It's gradual. Like, you don't see it when you're around them every day.
Scott Benner Yeah.
Shannon Boggs So when we we finally got to the bridge, they let us across because they knew who my husband was. There was, like, water splashing over the bridge. And we finally got to north, like well, when we were on the bridge, she started with the labored breathing. And I'm looking back like, what is happening? Now it's got she was throwing up. Now this is, like, respiratory? And, I mean, we were really scared. We just didn't know. We could barely wake her up at that point. Well, the whole city of Norfolk was flooded. We could not get our car through the water. All the streets were just flooded.
Scott Benner Okay.
Shannon Boggs So I was like, what are we gonna do? And he's like, maybe I can park at this gas station. I'll put her on my shoulder, and we're just gonna run and just try to have to get there that way. He was like, hold on. I knew one more route, and he went that route. We were able to get in the parking garage. So we walked in and realized that neither one of us even had our wallets. My wallet had fallen out in my purse in the driveway. We had no insurance card. So we walk in, and I explained to them. I think the only thing I said to them was my daughter's throwing up, and she's lost eight pounds. So they immediately take us back to triage. And when they put the pulse ox on her, I noticed that her fingernails were turning blue. And I I said it to the nurse. I was like, are her fingernails blue? And she was like, yeah. I was just looking at that. So we go back to the waiting room, and it was probably 20 people in the waiting room. All of sudden, the doors opened up. They called us back, and they were flocked around us, doctors and nurses. Like and at this point, she was over my husband's shoulders, and she was pretty much unconscious. And they were just screaming, she's in DKA. She's in DKA. And we're looking at each other. We we were like, what is DKA?
Scott Benner Yeah.
Shannon Boggs And the doctor looked at my husband and was like, I'm pretty sure she's a type one diabetic. I'm gonna have to run some more tests. And that's when they were like, do you guys have any other diabetes in your family? So we were there on a Friday. So all of the the staff members for endocrinology are off for the weekend. So they had the nurses on can't well, we were in ICU for a while because she had to we had to wait for her blood sugar to come down. And that was scary because they had her on the insulin drip, and I remember them saying, like, we have to do it slow because we could you know, it can cause brain damage if you do it too fast. And I just remember, like, we just she just wasn't waking up. Like, it seemed like so long. I guess it was, a day and a half. And when she finally came to, she didn't act right. Like, she didn't act like her same self with her personality, which, obviously, that's a lot to take in.
Scott Benner Yeah. But nothing cool happened like she could speak another language or something like that. Right?
Navigating the First Few Months
Scott Benner When you think of a CGM and all the good that it brings in your life, is the first thing you think about, I love that I have to change it all the time? I love the warm up period every time I have to change it. I love that when I bump into a door frame, sometimes it gets ripped off. I love that the adhesive kinda gets mushy sometimes when I sweat and falls off. No. These are not the things that you love about a CGM. Today's episode of the Juice Box podcast is sponsored by the Eversense three sixty five, the only CGM that you only have to put on once a year and the only CGM that won't give you any of those problems. The Eversense three sixty five is the only one year CGM designed to minimize device frustration. It has exceptional accuracy for one year with almost no false alarms from compression lows while you're sleeping. You can manage your diabetes instead of your CGM with the Eversense three sixty five. Learn more and get started today at eversincecgm.com/juicebox. One year, one CGM.
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Shannon Boggs Yeah. No. No. So the nurses on that floor, when we went to the the second the step down unit, they taught us everything. And on Monday morning, they were like, okay. We've got a meeting with the diabetic educator, and we're gonna go ahead and release you. They were like, you guys are doing great. You guys are like the poster parents of type one diabetes, and you're gonna do fine. And meanwhile, we felt like we were taking a newborn home that we had never, you know, that we had no idea how to take care of. They didn't send us with a Dexcom. No talk of an insulin pump or anything like that. But a Dexcom, I was really wanting. And, I mean, I'm just I just remember looking up things online as we're laying in the room that weekend at the hospital, like, for support, and that's how I found your page. And I started listening to the Juice Box podcast, and I joined the Facebook group and, you know, just found other moms that I was like, okay. There's other people out here that are going through this and that have done this. And I remember just looking for inspiration that, like, it was gonna be okay.
Scott Benner Yeah. Because that that half assed bull they gave you in the hospital, you're doing great, that wasn't taken. Right?
Shannon Boggs No. It wasn't. And so two weeks went by. They said, I want you to wake every two hours overnight and check her blood sugar. Mhmm. And I thought I was gonna go off the deep end. I wasn't sleeping. I was worried to death. I was terrified. I had two kids younger than her that I was caring for. I remember calling my insurance.
Scott Benner Your youngest would have been, like, three. Right?
Shannon Boggs Yeah.
Scott Benner Yeah. Okay.
Shannon Boggs Yep. I remember calling my insurance company, and they're like, yeah. Like, we'll cover a Dexcom. I don't know why they won't let you just have a Dexcom. And I called them, and I was like, guys, it's been two weeks. Can we get a Dexcom now? Like, I I understand that you want us to learn things the old school way, but I feel like after two weeks, we figured that out, and I'm ready to be able to sleep and just feel a little bit more comfortable. So we kinda had to fight fight to get it, but we did, And that was definitely a huge relief.
Scott Benner And you figured out that kind of stuff online, like what you needed?
Shannon Boggs Yeah. Oh, yeah.
Scott Benner About a CGM and everything. I was just gonna say, if they didn't mention it to you, like, where else do
Shannon Boggs you know? No. No. They didn't.
Scott Benner There any chance was doctor Satton Smith there? Do you know that name?
Shannon Boggs So she had just retired Oh. I think. I heard really great things. Is that who diagnosed Arden?
Scott Benner Yeah. Yeah. She was the night we went home, they kept her for I think they kept Arden, like, four or five days. Yeah. And then that that night, we're like, in a rental house, like, you know, I think I tested Arden's blood sugar at, like, four in the morning or something, and I thought, like I'm like, she needs insulin, but I didn't know. And it was like Yeah. Yeah. And so I just she gave me her number. She said, could call I, like, woke her up in the middle of the night. And I was like Oh. I just tested her blood sugar, and it was this. Do you think I should give her insulin? And she was like, yeah. I I think you can. And I was like, are you sure? She's like, I mean, I guess. And I was like, okay. But she was really lovely. I heard she just retired. I wondered if you caught her or not.
Shannon Boggs Yeah. No. We didn't. Yeah. But, man, I mean, I've called numerous people in those beginning days, parents or or people living with diabetes. I had a few client. I'm a hairstylist, so I had a few clients that, had type one, and I remember just them answering my phone calls late when I was scared. And I just will never forget those people that were there for me in the beginning for sure.
Scott Benner Hey. Before we move forward, I just have to know where I'm gonna wander the whole time we're talking. How does your husband work on a bridge? What does that mean?
Shannon Boggs So the bridge was he doesn't work there anymore, but, it's 18 miles long, and it's a privately owned bridge. So he was law enforcement there.
Scott Benner Okay.
Shannon Boggs But they do before he was law enforcement, he drove the rollback, and he dealt with, like, you know, broken down vehicles. They also do drive acrosses because they're believe it or not, there's a ton of people that are terrified to drive across. So he would drive their car across while they would talk talk to him in a passenger seat.
Scott Benner No kidding. Well, that's Yeah. Oh, because so, like, the bridge is almost like its own little city then.
Shannon Boggs Yep. And they're you you know, they have people taking tolls, so he would have to relieve the toll collectors for their, like, lunch breaks. He would take toll for a little while and stuff like that.
Scott Benner That's how long did he do that for?
Shannon Boggs He was there for thirteen years.
Scott Benner No kidding. That's really kind of interesting.
Shannon Boggs Yeah. It's funny how it all works because it was a really good job. It paid pretty well. They have good insurance, and it's always it's a lot of people, once they go there, they stay until they retire.
Scott Benner Mhmm.
Shannon Boggs But the hours were really hard. He worked twelve hour shifts. It was an hour away from our house. So, you know, it was, a fourteen hour day.
Scott Benner Yeah.
Shannon Boggs And then he would work a month straight of overnights. And I'm home trying to keep these three kids quiet so he can sleep during the day.
Scott Benner Oh, yeah. Yeah.
Shannon Boggs You know, it was a mess, but he ended up with another job. And the new job he took in April, Raylan was diagnosed in September, as a program that covers a 100% of her diabetic stuff. So we don't have to pay out of pocket for anything now.
Scott Benner Oh, that's wonderful.
Shannon Boggs And it was like, man, that was really a blessing that he took that job.
Scott Benner Yeah. You remind me. I have to make a copay on Ardent's pumps. I'm gonna write that down. Oh. I got an email today, and I've I've ignored it so far. You settle in, I imagine, as time kinda, like, goes on, you get the CGM that was, I'm I imagine very valuable. What's the next step, and how do you how do you recall, like, the first six, eight months of diabetes? Do you do you feel like you were like, did you have it like they told you, or did it not feel that way?
Shannon Boggs I think that, you know, after about that time, we started feeling more comfortable. I remember she was diagnosed September 30, so Halloween was the next month. And I was like, what are we gonna do? Do we let her have candy? Do we let her trick or treat? You know, all those little things that I stress that now seem so little because you're used to it.
Scott Benner Yeah.
Shannon Boggs But I just remember all the firsts trying to navigate her playing sports for the first time and going to the school. And, you know, we don't have a school that at the time, they didn't monitor blood sugar. I had to watch my phone all day and call if something was wrong and then get them to go get her. Since then, last year, she and I went to the Virginia assembly with the follow t one b's that help, like, put laws in place for diabetic.
Scott Benner Mhmm.
Shannon Boggs And we were able to pass a bill that now her nurses can finally follow her blood sugars after three years, and they see it right in the office, and they can go get her if she's high or low.
Scott Benner You had to pass the law so somebody could use follow?
Shannon Boggs Right. Yeah. It wasn't a thing in Virginia until about maybe it was right before Christmas break when they finally were allowed to do it.
Scott Benner Yeah. I remember right as Arden was getting into school, our governor passed the law that kids could give themselves insulin in their classrooms, which was a big deal. At back Yeah. Back then, like, you couldn't. You had to leave the room and go to the doc to the nurse's office. And I I look back now, and I think of how much that saved us over the years. Oh, yeah. Just being able to do insulin in the classroom.
Shannon Boggs I mean, even last year or the the second year she was diagnosed, she got tired of wanting to go to the nurse just to treat a low blood sugar. They would make her go in there to treat a low. She'd have to walk all the way down the halls and in there. And I had to sign, like, paperworks that they weren't liable if she were to treat her own lows in the classroom because she wanted to be able to have her own snacks at her desk and just Yeah. You know, drink a juice and keep on working.
Scott Benner Right.
Shannon Boggs And she's like, she loves to be able to do that. She's very independent now.
Scott Benner How is she doing with all this? Like, was it a big transformation for her? Did she accept it?
Shannon Boggs She says things still like, I just you know, I remember that was before I had diabetes, and she'll say things like that. But she does pretty well. We're not super restrictive with her. We're bold with insulin like we learned, you know, from you guys.
Scott Benner Okay.
Shannon Boggs And she does pretty well. This this summer was a turning point. She wanted to go to a camp. She went to diabetes camp the year before, but this year, she wanted to go to a camp that was not a diabetes camp. It was just a regular old camp. They don't even have a nurse, and they don't have good cell phone service. And the year before, I wouldn't let her go. And this past summer, I was like, alright. We're gonna do it. We're gonna give it a try. And she did really well.
Scott Benner Awesome.
Shannon Boggs Yeah. She it was it was not very restful for us because there was a lot of times where we couldn't see her numbers at all, and I just had to hope and trust that somebody in her cabin, especially overnight, would wake up and hear it. I didn't worry about it during the day because I knew, like, during the day, she could feel her lows, and she's got it. But the night times were hard, and she but she did great. She's gonna go back this year. So Oh,
Scott Benner that's so
Shannon Boggs good. Good for her.
Scott Benner What pump is she using?
Shannon Boggs She's on the tandem Moby.
Scott Benner The Moby. Okay. Is she liking that?
Shannon Boggs Yeah. She loves it.
Scott Benner Very cool.
Shannon Boggs She was an Omnipod user, and we went to Friends for Life, not this past year, but the year before. And they were doing the demos, and she tried it, and she loves it. She doesn't wear it tubeless. Like, you know how you they've got the little sleeve. She doesn't wear it like that. She likes the long tubing and it and, like, a good old fashioned little pump clip.
Scott Benner Oh, okay. Yeah. She wears it, like, just like a like an insulin pump. Like,
Shannon Boggs Yeah. To look for her belt or something. In the summer. She'll unhook and hop in the pool, and she loves her movie.
Scott Benner Oh, that's awesome. That's great. I I love it when people find stuff they like that that that works for them.
TikTok Fame and Building Community
Scott Benner So how did you I mean, at this point now, well, I feel like we've got enough of your story here. How did you become the lady from TikTok? Like, how does that happen?
Shannon Boggs You know, it's funny. We had, like, a random TikTok account from, like you know, when when it was it was, like, COVID days, I guess, really. And the kids would get on there, and we would do, like, learn little dances when there was nothing to do. And when all this happened, I remember a girl, one of my friends that that works with me was like, you should, you know, do some videos and try to help other kids. Like, she was like, you know, maybe see what she's going through that they're not alone. So I talked to Raylan about it, she was like, yeah. And I would like to find some friends. Like, for the longest time, she was convinced she was the only girl with diabetes. Mhmm. Because where we live, there is like there was, at the time, like, five little kids, but they were all boys. And she's like, I just want a friend that has diabetes that, like, I can hang out with or talk to that's a girl that's kinda, like, closer to my age. So we kinda set out for doing that. And I think our first video was her doing a Dexcom change with her sister. And, man, that used to take us a long time, like an hour, because she was so scared and said it hurt. And so I think we did you know, we posted a video like that, and it just blew up, but it was, like, crazy, the the support, the people that you know, it locked me right into the diabetes community of all those people that are living this life with us. Yeah. So she has found we found a lot of friends online, a lot of people that we've met in person. We had a family. It's a mom with type one and a daughter with type one. They came. We put a video out there trying to find somebody for her to connect with, and they came and went camping with us. And since then, we probably visit them, like, three to four times a year. We go up to see them in New Jersey, and they come down here. And it's just built a lot of friendships. It's helped her motivate other kids, especially the younger ones. But then she also loves to follow, like, the older people that she sees, like, the teenagers.
Scott Benner And Yeah.
Shannon Boggs Actually, next week, we're going to see Riley Arnold. Do you know her? She's the one that's in dancing with the stars.
Scott Benner I know the name, but I I don't know exactly. Yeah.
Shannon Boggs Yeah. So I I mean, I don't know her either, obviously. But for Christmas, I got Braylon Taditz. And we're going to Virginia Beach next week to see her dance because Braylon's a dancer, and her goal her main goal in life is to be, like, a competitive dancer.
Scott Benner Oh, wow.
Shannon Boggs So I thought that that would be cool for her to see.
Scott Benner My goal for the last two weeks has been get our radon level down in our basement. I I did it. I don't have as many fun goals as children do, apparently. I just realized I was like, what's my goal? And I was like, oh, I've reached I've reached my goal. I found that crack in the foundation, and I sealed it. Oh,
Shannon Boggs that's good.
Scott Benner That's good. So boring. I'm aware of you, and I don't and I don't really pay attention to social media.
Shannon Boggs And Yeah. It's probably because I tag you and stuff all the time. People come to my videos, and I send them to your way.
Scott Benner No. That's lovely, but that's not why. Like, I mean, I'm just I'm aware of you otherwise. Like, there's a few there's a few people whose stuff just kinda transcends and and makes its way to, like because I have that stuff. So when I open it up, I'm not following many people. I don't have, like, a yeah. And it pops up and, like, there's I see, Marley a lot. I see you Mhmm. A lot. Like, when it goes from, hey. We'll make a video, and you're used to, you know, dancing and 20 people sing it. And then it's a thousand people, and then it's 10,000, and then it's a 100,000. Like, like, what's the process that happens within your family? Right? Because now, like yeah. I mean, I've seen some of your your videos. Like, your your daughter has been very vulnerable in some of them. So, like Mhmm. Is there a moment where she thinks, like, I didn't realize all this many people were gonna see it, or does that seem not like a concern for kids? Like
Shannon Boggs She is very, like, outgoing, and I don't know. She's just very people y. If you met her in person, she'd be your best friend in two minutes. Yeah. So she's never felt like that. Now I know that that she's a little older. We don't post quite as much of her doing this stuff because she's so busy, and it's such a pain for her to do it. You know how it is. Like, when they get older. You know, we're on from one sport. We're getting out of school, and she's got practice in an hour. She's gotta do a site change, and she just wants to get it done. So I wait for her to tell me, hey. I think I wanna do a video today. I wait I, like, totally follow whatever she wants to do. And sometimes, it's weeks before she wants to talk about diabetes. But I can tell you if there's one minute where I look at her and say, you wanna do a dance? She's like, yeah. Let's do that.
Scott Benner Yeah. That kind of stuff is yeah. That's a gimme, right, at her age. Like, tell me how many followers do you have, like, on TikTok and Instagram and all that? Do you know? I
Shannon Boggs do. I think on, like, TikTok, we're, like, 780,000.
Scott Benner Mhmm.
Shannon Boggs We didn't start posting on YouTube or YouTube and Instagram and all that till way later, but I think we hit, like, 200,000 on Instagram this year.
Scott Benner And and what does that mean for a post? Like, you put up a you put up a video on on TikTok. How many people see it generally?
Shannon Boggs Oh, gosh. I don't know. TikTok's kind of like I feel like shadow banning me lately, so we don't get a lot of we don't get a lot of stuff seen on there. We do better, like, on Instagram and Facebook lately.
Scott Benner But Okay.
Shannon Boggs I would say on average, if it's if it's a diabetes video, it does better because a lot of our community is from the diabetes community.
Scott Benner Right.
Shannon Boggs Because we we do a lot of lifestyle stuff too. We do travel. We do, you know, we do some stuff with our service dog. We do some stuff that's just funny, a mom and dad stuff. We try to not our page really isn't all about diabetes.
Scott Benner Right.
Shannon Boggs But those videos always definitely do the best.
Scott Benner Is that a job? Like, do you have an income that you're just like, wow. This is or is it just like a little bit of money that's like, this is nice?
Shannon Boggs Honest with you. It's yeah. It's not. There's been months where we have really taken off. I had no idea you could make money on social media. That was never a goal for me.
Scott Benner Right.
Shannon Boggs Right. I think so looking back, I've learned that when you get 10,000 followers on TikTok, you can apply for the creator's reward program. I think we had a 150,000 followers, and I had no clue. We were just having fun. Yeah. And we still we still treat it like that. My husband and I work full time. And then if we have a good month and we make some money on there, we'll take the kids on a trip or, you know, we're stashing money in their savings account. It's just, like, extra because I feel like it's something that we personally would never just rely on as an income.
Scott Benner I just want people to to hear because I think that I see a lot of people who it seems to me are trying really hard to make a living at this. And
Shannon Boggs Oh, yeah.
Scott Benner And then, you know, a year later, I don't see them anymore. And it's a whole new group of people trying, and I'm I just I don't know.
Shannon Boggs I agree. It's very it's very oversaturated now right now. And I, you know, I feel like you can't like, for me, I didn't wanna have a niche where my niche was all gonna be diabetes. We're just gonna talk about diabetes because first of all, I don't have diabetes, and I don't wanna rely on my kid
Scott Benner to have to content. Yeah.
Shannon Boggs Yeah. Because she's a kid. She doesn't wanna have to do that all the time. Like I said, I take it totally as it comes when she comes to me and is like, hey, mom. I thought we could share this today, or I thought something would be funny today if we post this. Then we do it, but I'm not constantly after her for every site change she does or let's talk about
Scott Benner Right.
Shannon Boggs This today because I still want her to have a life and just be a kid.
Scott Benner I also think you can get caught up in that thing where you make a couple bucks doing it, and you think, oh, if I only had more followers or more views, and then you're, like, desperately making content constantly. And
Shannon Boggs Like, I never look at my analytics ever. Mhmm. People are always like, well, what time does your video do better? I don't have a clue. I've never looked at that. Yeah. I really truly don't. We post whatever we feel led to post and whatever we think is gonna bring joy to people at the time when we feel like it. I don't plan things ahead. I don't have drafts ready to go. Like, I wake up and I'm like, I think this is what I'll talk about today. Truly, that's kinda how I take it.
Scott Benner I woke up one day a couple years ago, and I was like, maybe I'll do videos every day. And then I think I was, like, a day and a half, and I was like, oh, I'm definitely not doing this.
Shannon Boggs Yeah. It's a lot. It's a lot editing and
Scott Benner I don't wanna be involved. Is is but but it's funny you use the word oversaturated. I literally just had this conversation with somebody where I kinda kinda was sounding like an old man, like, complaining, but I've lived through this already. I watched I watched the diabetes blogging community get oversaturated, and it ruined it. Yeah. And now I think it's happening with social media now.
Shannon Boggs Yeah. I see that too. I mean, every time I turn around, there's there's somebody new on there, and I'm like, oh, I've never seen them before. You know?
Scott Benner I don't need to see everyone change their pump. And the other thing that I've noticed along the way, and maybe you'll tell me I'm crazy or maybe you'll notice it too, is when you try to, like, fit a niche to how social media works, you end up doing things that I find odd. Like, there's just no doubt that pretty younger people, their videos do better. Mhmm. There's the more skin that an adult shows, the better the video does. Like, there's stuff that actually leans into this stuff, and I just think it's weird when you're just like Yeah. You know what I mean? Like, hey. What you know, here's my ass. Oh, look. My CGM. Yep. What are we doing?
Shannon Boggs Yep. Yeah. I get it.
Scott Benner And even the explainers, I like it a lot. I mean, Marley's a great example. I think what she does is really cool. But I mean, like, as a as a as a content thing, I don't know how long she can keep that up. And I also don't know at what point do people just go like, oh, I get this. Like, I've seen it already.
Shannon Boggs Yeah. Yep.
Scott Benner Her is an example. She wants to do that forever. I think that's awesome. I really think it's really valuable, but I don't know that it's a business forever. Yeah. And it does tail off. And people who keep it going for more than a year, that's really special. Like, as long as you've been going, that's amazing. Like Yeah.
Shannon Boggs But I do think that it's because we, you know, kind of converted into we share a little bit of everything, and that's what I wanted. I
Scott Benner don't Yeah.
Shannon Boggs Because I have two other kids, and I wanna make sure I'm including them.
Scott Benner Right.
Shannon Boggs Right. I don't ever want them to feel like their sister gets a spotlight, and our page is all about her. So I try to include them too, and I'm like, you know, we do we do a lot of other stuff because that Right. You know, just for that reason mainly.
Scott Benner You're not gonna avoid that. Like, I I've said I've said here before, but, you know, I don't know if I could have possibly spent another waking minute with my son when he was younger. Like, he played so much baseball, and I was always with him. Yeah. And they're reasonably well adjusted people as adults now. And still, I don't know, a year ago, we're having a conversation. He's like, yeah. When I was growing up, I felt like it was all about ardent or diabetes. And I thought I thought
Shannon Boggs I know.
Scott Benner Oh my god. Like, we put so and you start listing it. As an adult, he goes, no. I hear what you're saying. It's just how I felt. And then we turned to Arden, and she's like, I felt like we were always at Cole's baseball games. And I was like, you've gotta be kidding me. What are we trying so hard for if everyone was gonna be upset no matter what? But, yeah, it it just is and then you you amplify it, and then it feels like, I know that I I experienced this too. Like, to some people, I'm famous, which is Yeah. Which is ridiculous. And I and I wonder if you haven't felt the same way.
Shannon Boggs Right. Yeah. When people come up to me or I'll get a comment, and they'll say, saw you at the mall today, and I was so afraid to say hi or whatever. And I'm like, guys, I'm just a normal person. We're all just normal people. Come say hi. We are not famous. Yeah. You know, it's just funny. Like like I said, I work full time. My husband works full time. Neither one of us retire or plan on retiring early from social media. As long as we're having fun with it, I think that's great. But it's never something that we're like, we're gonna quit and just rely on this because I want it to be fun.
Scott Benner I saw this great video the other day. It had nothing to do with diabetes, but this this person, she was like, oh my god. Like, everyone's always asking me how much money do you make because I've got a couple of videos. Like, she had, I guess, a video that did, like, 30,000,000 and a video that did, like, 20,000,000 or something like that. She's like, now that I had these videos making all these millions, like, you guys wanna know how much I'm making. I'm happy to show it to you, and she's typing on her computer. And then she picks up her phone and turns around. She made, like, $10. And Yeah. Yeah. And and I was like, that's what more people need to see.
Shannon Boggs Yeah. So it's definitely not about the money. It's just really just about having fun for us.
Scott Benner Yeah. Also, if you're a reasonable person and an adult, you you can't build a business that a company outside of your control could turn a dial and change an algorithm a little bit and be like, oh, now you don't exist anymore.
Shannon Boggs Yeah. Like, that's Exactly. Yeah. I mean, I've had a lot of friends that have over a million followers. They've left their creator rewards program because once you're in there and you have you know, they I feel like they kind of put your views way, way, way, way, way down so that they don't have to pay you.
Scott Benner They don't want to they don't wanna pay you at that point.
Shannon Boggs Yeah. Exactly.
Scott Benner Yeah. They'll use you for the content, and then, like, the carrot and the stick that it's gonna work out. Yeah. I just, yeah, I just see a lot
Shannon Boggs of Yeah. That It's not reliable.
Scott Benner Desperation of, like like, this video has gotta work, and it's just it's a lot. I I Yeah. I don't I'm you know, as I explained to the person I was talking to the other day about this, like, I'm I'm insulated. I'm I'm in a bubble that I created, and it's kinda my own. And, like, so I'm not at the whim of, like, what TikTok decides to do or it doesn't matter to me if anybody follows me on Instagram. Like, that kind of stuff doesn't, like, impact me, but it's a very specific thing that I don't think exists for a lot of people. And Mhmm. You know what I mean? Like, I just it would make me crazy. Like, Apple messes with their their algorithm. Yeah. And it's upsetting. I am not gonna lie to you. Like, they made a change, like, two years ago, and I was like, I need to get into a car and drive to Cupertino and bang on the front door. Like, what are you guys doing? And then suddenly, they put it back. And you're like, what was that? And then and then it goes the other way, and then you're like, I don't know. Like, what are you doing? And, you know, this podcast sits in the top 30 of The US medicine category for, like, eight years. Like, I'm rock solid. Like right? But, like,
Shannon Boggs still You should be so proud. You have done so well. You have brought so much good to so many people. And I'm telling you, anytime somebody comes to me, it's the first thing I tell them. Go to juice box podcast.
Scott Benner Thank you. You're very, very nice. I I was trying to complain about Apple for a second, but that was nice too. Kinda draw trying to draw a picture for somebody. Like, it's bizarre that you could be doing the same thing today as you did yesterday, and you're reaching the same number of people, but they just change your metrics. And you're like Yeah. Oh, okay. And then now what? Like, what if they don't put it back? Or what if they, like, what if they zhuzh it up the wrong way or the right like, is any of it real? Like, you get to the point where you just go, I don't care about any of this. Like, I measure this podcast now by, like, the people I hear who are who find it valuable.
Shannon Boggs Yeah.
Scott Benner That's it. If I'm hearing those voices and those stories every day, I just assume it's working.
Shannon Boggs It's almost like diabetes where you can do the same thing and eat the same thing every day, and you won't always have the same results.
Scott Benner Yeah. Hey. That's a great way to put it, Apple. You're like having diabetes. It's super interesting. And I think from the outside, it is very easy for people to look and think, well, you know, Shannon and her family, they're famous. They must be rich from this or, like, but
Shannon Boggs I think you're right. Yeah. I think you're right.
Scott Benner It's just really
Shannon Boggs And I just always try that's why I'm always, like, transparent. I'm like, no. We, you know, we're having fun. We're doing our thing. We're hoping to bring smiles to people. And if there's anything extra left over, like, we're we're using our money this year. We're going back to friends for life. I told my kids that that's what our trip is this year.
Scott Benner We'll we'll get to meet. I'm gonna
Shannon Boggs be there.
Scott Benner Yeah. That's lovely. I'm going down with, John from Sugar Pixel.
Shannon Boggs Oh, cool.
Scott Benner Yeah. We're have a big there's gonna be a big sugar, am I supposed to say it? Whatever, Sean. There's a big, John will get so mad at me. There's gonna be a big Sugarpixel at Juice Box podcast booth with Friends for Life for sure.
Shannon Boggs That is awesome. Yeah. Yeah. We will be there. We'll come see you.
Scott Benner Oh, that'd be lovely. Yeah. Yeah. Even when people are like, you should, you know, do something with me on my channel. I'm like, I don't I don't first of all, I don't have time for all that. And secondly Yeah. I know you think it's gonna be valuable, but it doesn't work that way. Yeah. I'm talking to you because I think it's interesting. Like, I'm not gonna get one extra download even if you and I by the way, please do share it, but it's not gonna like, people from Instagram aren't suddenly podcast listeners because you're on a podcast. Like, some of them will go, but it's not a it's not a number that is, like, shocking. It's just the same as if you, you know, vice versa. Like, you're not gonna get some crazy bump from being on the podcast. Like, it just
Shannon Boggs Right.
Scott Benner The social media world doesn't work that way anymore.
Shannon Boggs Yeah.
Scott Benner It used to. I mean, getting on someone's side you know what I mean?
Shannon Boggs I just feel like once you find your audience, they're there. They're gonna be your people because they like you for who you are. You know what I mean? Like, I feel like a lot of people yeah. They're they're they're just like they genuinely you know, like one of us in the family or all of us in the family, or they look forward to seeing our our our adventures or whatever. You know?
Scott Benner I hear you. Yeah. Let's see. It is really interesting. I don't know. I'm I'm always, like, a little vexed by it. Like, I think it's interesting. I I'm happy that it works. At the same time, I feel weird when I see people just, like, they're trying so hard. And I'm like, even if you get there, wait wait till you get there and find out it's a $124. Yeah. I know people who make videos for companies. And I finally, one day, was like, what what do they pay you for that? And then Yeah. And they told me, and I was like, oh my god. Really? I was like I was like, that's it? It's like a it's like a few $100 to make a video?
Shannon Boggs And I remember Yeah. Talking to somebody that had 2,000,000 followers, and we were on a brand trip. And she told me, don't ever rely on the platforms themselves to make you money because brand deals is where you will actually make money. And they're not always easy to get. Yeah. Like, it just depends. You know? I I've lucked out, and I have certain brands that I work with that will contact me regularly, and I'll work with them a few times a year. Some things that I already use at home that I love, products that I love already. As far as, like, the actual platforms, plus, you know, people get hacked and banned and their pages taken down. It's just not very reliable, I feel like, for a forever income.
Scott Benner No. No. For certain. And it is it is weird to say because it sounds like it sounds so bullshit, but I am wearing Cozy Earth sweatpants right now. It's so easy for me to do their ads because I'm just like, I do I really do love this stuff. I know. Yeah. That's how I am. I take your point. Like, I mean, I have a lot of advertisers in the diabetes world, but I reach a lot of people. So it's sort of a no it's a no brainer for them Yeah. You know, to be involved with it. When I first started doing it, like I mean, I've been doing this for this is my twelfth year.
Shannon Boggs Wow.
Scott Benner I think I talked Omnipod into buying an ad when I basically I used to write for their blog, and it it wasn't I think I wrote, like, six blog pieces a year. I just said, like, please don't make me write the blog anymore. Just give me the money, and I will give you ads on my podcast in exchange. And they were like, well, how many people are listening to the podcast? I'm like, well, nobody really. I was like, but I was like, I'm gonna build it up. I promise. And they were just kind enough to be supportive back then because there was no reason to
Shannon Boggs Yeah. That's awesome.
Scott Benner And then it was one company that gave me it wasn't even it's not like it was enough money to, like, to put in as much time as I was putting it. It was enough money to, like, show to my wife, like, look. I got money for this. Like, let me do it for a while.
Shannon Boggs Yeah.
Scott Benner And let's see what happens. Yep. And now 1,821,000,000 1,800 episodes, 21,000,000 downloads later, like, it's it's this crazy thing, but it started off by me just thinking like, oh, I can't keep writing this blog. Like, told you, like, blogging died. They people there were 4,000 diabetes blogs at the peak. Like, who the hell is reading? Nobody's reading all those. Yeah. I pivoted to the podcast thing, and I think I just got there first. I think that was kind of, you know, what happened. I I did have this moment today where I was thinking about all the times that people try to talk me out of this or kind of make me feel bad about it along the way. And it was like from day one, before I even started it, a guy told me, I won't say his name, a guy told me, well, you can start a podcast about diabetes, but you're gonna run out of stuff to talk about very quickly.
Shannon Boggs Oh, wow.
Scott Benner And I actually thought that doesn't sound right. But okay. But that still was in my head. Like, I'm gonna run out of things to talk about. Then I started it up, and four or five months later, this person reached out to me and they were like, hey, you don't know me, but I'm gonna start a diabetes podcast and I need help. And I was like, okay. So, like, I talked to that person and, like, helped them with microphones and stuff like that. And at the end of the phone call, they said, I'm gonna do it differently than you. I don't like the way you do it. And I was like, oh, cool. Thanks for calling. I was like, what is and then that vibe was and that stuck on me for a while because, like, the old school bloggers hated me. And they were like, he's talking about how he takes care of his daughter. He's like sharing what they do. You can't do that. That's really dangerous. And now twelve years later, I have I have literally tens of thousands of notes here I could show you from grateful people.
Shannon Boggs I just love how you come at it with a different you always have a different perspective because there's always different people that are coming from the diabetes space in a different way. Like, today, I'm here as a mom, and tomorrow, you might have somebody that's lived with it for fifty four years. Yeah. Like, that's what's what I think is really cool about what you do.
Scott Benner I appreciate it. You just picked a funny number because I've already interviewed a woman today who is 54 years old and has had diabetes for fifty one years and just got Addison's disease. And, like That's funny. And she was talking about that. You know? And, like, I don't even do what I'm doing with you very often, which is interviewing somebody who anybody's ever heard of before because I really like to hear people's, like, un like, even you Nobody knows. Yeah. But even you, like, the first twenty minutes we talked, like, I enjoyed hearing your story, but you've probably told people that a 100 times. Yeah. You know what I mean? Like, I like people who are, like, saying it out loud for, like, the first time and listening to them, like, pick through their lives and and because that's when they come up with kinda stuff or things that are worth sharing or they say something valuable for someone else. I don't know. I like I like interviewing people who've never had a microphone in their face one time. I think Yeah.
Shannon Boggs I get that.
Scott Benner Yeah. I think it's an I think it's I mean, not the other people aren't interesting, but it's just for long term for having legs. You just need to keep hearing different stories.
Shannon Boggs Yeah. I couldn't agree more.
Scott Benner As much as you can. So is your daughter only good on, like, the videos? Or, like, if she came on the podcast, she could she hold a conversation for an hour? Like, what's
Shannon Boggs I think she could hold a conversation. She's super yeah. She's not shy. She's super chatty.
Scott Benner Would she talk about her diabetes? Yeah. Yeah? If she wants to, you should tell her, I'd I'd love to do it with her because
Shannon Boggs Yeah.
Scott Benner It's interesting to hear so I'm gonna now say the opposite thing I just said to you. You're an adult. You know, you know what you think and you you feel like, you know, you say things over and over again. But a kid who's articulate and willing to talk about it, she'll share stuff that other kids you can't pry out of other kids because she's a little Yeah. She's a little media trained. So she'll do like, she'll she'll get talky and so, yeah, it'd be cool. There's no pressure, but if she wanted to, I think that would be really cool.
Shannon Boggs Yeah. Okay. I'll definitely ask her.
Scott Benner Again, it took me, like, two years to get you to do this. So, like
Shannon Boggs I know. I know. I had it scheduled with you a while back, and I woke up with a stomach bug the day that we were supposed to do it. It was awful. I felt so bad to cancel.
The Realities of Diabetes Service Dogs
Shannon Boggs So it's funny. Like, you know, you see so we have a service dog, and we apply I literally started looking up service dogs when she was still in the hospital because I saw people talking about it.
Scott Benner Mhmm.
Shannon Boggs And our service dog is great. I love her. She's wonderful. Don't get me wrong. But I feel like so many people, including me, you know, we've shared videos of her. Now I feel like everybody that has a kid with diabetes thinks that they need a service dog. So I have put that out there. Like, please don't feel like you are less than as a parent because you don't have a service dog. Because now that we have a few years under our belt, we definitely don't rely on her like we thought that we would. She's great. She's a great backup. But, also, I just you know, I said this on another podcast that I was on, and they were like, oh, I didn't even think about that. Like, the dog will go to school with Raylan, and Raylan has to think about when is she gonna take her outside for a break. When is she gonna make sure she has water? Then she has to clean up after her. She has to find a spot that's out of the way in each class that she goes to because she's changing classes. And then she's got all the extra stuff for the dog plus all of her diabetes stuff plus her book bag and laptop. So it's it's a lot. So I always tell people, like, if you it's just something that I want to tell parents. Like, consider that. Because some days she's like, mom, it's just too much today. I have I have a test. I have this. We have this going on at school. And after school, she's like, I don't think I'm gonna bring her to school today. And I'm like, okay. That's fine.
Scott Benner You can leave her in. That is exactly I don't know if I'm more more cynical person or whatnot, but I and I've had tons of people on to talk about their dogs, and I'm happy to have the conversation with them. But you couldn't get me to get a diabetes service dog by putting a gun to my head. I'd be like, no. Thank you.
Shannon Boggs Yeah.
Scott Benner I mean, I the CGM works fine. I'm good. Yeah. And I don't I'm not looking for all that, all the the extra stuff. Like, nothing like, I have dogs already. Like, you know, and
Shannon Boggs It's a lot that people don't think about. And she's great when when it's summertime, and she's out in the yard, and we're running around without the phones, and she doesn't have a blood sugar reading on her, or we're swimming or in the water. If we post a video and we go to anywhere, anywhere without the dog, people immediately in the comments are like, where's spy? And it's like, she even Raylan's like, these comp mom. They think that she has got to go with me everywhere. Like, my goodness. And sometimes the dog needs a break. Like, she's maybe she went to school with her that day, then she needs to come and have a break in the afternoon. And, like, lord forbid, we go to Walmart without her.
Scott Benner Well, you know what? It's interesting too because you you run the risk of telling your daughter, hey. You can't exist without this dog. And Yeah. And there are plenty of people living with type one diabetes don't don't even have a kitten. So, like, they're, you know, they're they're okay. I mean, again, if it's something somebody wants and it's valuable for them, I mean, god bless. I don't I couldn't possibly care less. But I don't want you to, like, run around feeling like this like you said, like, this has to happen or I'm somehow not doing everything I'm supposed to do. I'm gonna tell you, I think you could be perfectly fine your whole life and not have a diabetes service dog. Yeah. And by the way, they are incredibly expensive most of the time, and there are a lot of companies out there that will take advantage of you and sell you a very overpriced dog that isn't gonna sniff your socks. So and then later, they'll tell you, oh, whatever. Sorry.
Shannon Boggs Yeah.
Scott Benner Yeah.
Shannon Boggs Yeah. Yeah. Yeah. I I tell everybody to do their research. I've had parents message me, say, like, you know, they feel bad not having a dog for their kids, and I'm I've told them exactly what I just told you. Like, please do not ever feel like that because if I had have probably given it more time and gotten used to it before we jumped into it, I don't think we would have felt like, oh, we have to have this dog. She is definitely a blessing in our life, and we love her to death. And she has definitely woken us up and caught Raelon's high and low blood sugars for sure.
Scott Benner Mhmm.
Shannon Boggs But like you said, with the technology that we have these days
Scott Benner It does look too.
Shannon Boggs Yeah. Even people she's born in middle school, and when she gets to high school, her dog will be pretty much retired by that age. We'll have to think about, are we gonna get another dog?
Scott Benner Are you gonna
Shannon Boggs do see her wanting another dog because I think she's very independent, and she's not gonna want the extra k you know, asshole.
Scott Benner Turns a fun pet into, like, a anchor too. It's like yeah. Yep. I can just I'm picturing you and your husband laying in bed one night trying to go to sleep, one of you just turns to the other one and goes, why why did we we didn't need that dog.
Shannon Boggs Cool. And, like, also, our dog is not trained as tightly as some of the other dogs. Like, some of them are waking their the parents up at a blood sugar of one forty
Scott Benner Okay.
Shannon Boggs Because they think it's a high blood sugar, and I'm like, woah. Man, I'm glad she doesn't do that because I think that would just drive me crazy.
Scott Benner I would prefer if the algorithm just gave a little insulin at one forty. That sounds maybe
Shannon Boggs better. Exactly.
Scott Benner My gosh. Yeah. Again, I it's no shade for anybody. Like, I No. Again, if it's something you like, I I couldn't again, I couldn't possibly care less. I'm happy for you if you're happy. But my goodness. I mean Yeah.
Shannon Boggs It's just it's a commitment that everybody needs to consider. Like, we've had a lot of medical stuff pop up with ours that on top of what we spent to get her I mean, she was in the ICU at a college hospital one time something that will still never diagnose, and we got a $13,000 bill.
Scott Benner Oh my god. Are you serious? Yes. So
Shannon Boggs I always tell people, like, make sure you consider
Scott Benner all of the things Let me just
Shannon Boggs the things that could
Scott Benner pop up that you're
Shannon Boggs not expecting.
Scott Benner Oh my god. Let me give you a little insight into what would happen if that happened to me. I'd be like, Kelly, this dog you told me we had to get, there's a bill here for $13,000 for it. It's a good it's a good thing. And then I just would curl up into a ball and lay on the ground. Yeah. Yeah. Yeah. Yeah.
Shannon Boggs It was a struggle.
Scott Benner It was bad. I was like, oh my god. Yeah. That would've that would've sent me into a very quiet I would've just walked away quietly. And you and would've been like, oh, Scott seems upset. Like
Shannon Boggs Yeah. It was a shock. It was a shock.
Scott Benner I don't know. Don't wanna know how many times your husband drove back and forth that bridge for $12,000 or how many people's hair you've had to cut to make that money or whatever. Yeah.
Shannon Boggs That's what I'm saying. I'm like, don't ever think because your fundraiser's over that that's the end of it because these dogs are still pets at the end of the day that can Yeah. You know, have emergencies.
Protecting Your Peace on Social Media
Scott Benner You know, you bring up fundraiser. I'm gonna pivot a little bit to something and that I have, like, a unique perspective on. I wonder if you have an opinion about it. And so being a person who runs, a really large community, there's certain things we just can't do. And some of them are obvious. Like, you can't let people go on on about their religion and and preach. You can't let Yeah. People talk about their politics. It just doesn't work. You can't like, you know, you can't put up a story about somebody with diabetes who was detained by ICE and passed away and say, well, this isn't statement. Well, trust me. It's gonna be in about ten minutes. Like, you know, that there's certain things you can't do. Right? One of the things you can't do is you can't let people put up links to their diabetes walks, to their I'm trying to raise money for a service dog. Yeah. I have an Instagram where I'm trying to like, anything like that. Like, we just we don't it just turns the it turns the group into a billboard. And Yep. And you and you can't do it. But it's
Shannon Boggs Also, it's so many scams. You don't know what's real and what's not real.
Scott Benner Yeah. I that's the other side of it is you're you put that post up, but you're opening up everybody who sees it into being scammed. Most people are very kind, so they're not gonna think twice about it when someone says, hey, know, can you meet me in a Walmart parking lot and bring a CGM? I'm on vacation. And I would love that for the people who, by the way, who are really in that situation and the people who wanna help them. They also don't realize that Facebook doesn't allow that. It brings bad attention to the group. Like, there's a lot of Mhmm. There's a ton of reasons. So I end up being the person who has to be like like, no. I'm removing your post about, like, your JDRF walk or you're trying to raise money for your dog or like. And then I feel like I feel like the Internet is full of, like it's, like, about a thousand people who think I'm the biggest asshole in the world because of stuff like that, but there's just nothing. I need another voice to tell them all that, like, I can't I
Shannon Boggs agree with you. I do the same you know, I get a lot of DMs. Will you share this? So and so was it an accident? My uncle's having cancer treatments. You know? And you look. You're I couldn't agree more. You just can't do it. I don't know what's real. I don't wanna open that up to my followers not knowing if this is a scam that we're falling into. So I choose the same thing. Unless it's somebody that I personally know, like, in my town that has asked me for something, I might share it, like, on my story or something and explain what it is. But if it's a stranger that I don't know, I just am too scared to open that door just mainly because I don't want people getting taken advantage of. But you running a group, I agree. You can't if you let one person do that, your whole page becomes it, and that's not what your page is for.
Scott Benner Yeah. It's it's there to help people so they can talk to each other. You you know what Like, that's what it's there for. You can't and also the algorithm ignores that stuff to begin with. Like, Facebook's not showing anybody your JDRF walk post. It's just it's not gonna show it to anybody. And then for every person who's just like, hey. You know, hey. Here's my kid's Instagram. She talks about diabetes sometimes. Like, cool. Like, that I'd be happy to leave that up except that for every person like that, you know, maybe for every 10 people like that, there's one person who really, like, maniacally is trying to start a business. They want money and they want followers. Mhmm. They're vicious about it. There's one in I have one in mind right now. I would never tell anybody who it is. Yeah. But the person came into the group, acted all like, oh, I'm just here. Like, you know, I just need help for my family and blah blah blah, and then was very quietly building up, like, you know, Instagram, TikTok, Facebook, and DMing everybody to, like, fill up their followers list and everything. And we I finally figured out it was happening. Mhmm. You have no idea. Like, I'm such a decent person. Like, I reached out, and I was like, hey. You can't do that. Like, please don't do that. Yeah. And my my moderator was like, just ban them. And I was like, I'm like, maybe they really you know, like, and the per the person apologized in circles. I'm so sorry, blah blah blah. Thank you for telling me. It never happened again. I don't know that they paused for an hour, just right back at it again. And so we figured out that they were still doing it, and we banned the account. And then they came back in through a spouse's account and just started doing it again. Oh. And then we figured that out and banned that account, and now that person is out in the world with a reasonable following.
Shannon Boggs Yeah. I would love to talk to you about this when we're off camera because I think I know who it is, and I got a little attacked by the same person too.
Scott Benner And then and and then it's just, like, it's crazy because then, like, then they're they talk badly about me. And I'm like, wait. What what like, I see what you're doing. Like like like, I'm you're
Shannon Boggs I mean, even even on me personally on your page, I go under I'm only following your page under my first, and it's not even my last name. So that's why when somebody tagged me or something, you didn't
Scott Benner even who I you one time. Yeah. Yeah. Yeah. Yeah. Yeah.
Shannon Boggs I don't comment under my page that we, like, have social we do a social media under the Boggs family. Right. I don't even comment on your page on that. Like, it's just strictly under my and that's I have my private account that's just for my local hometown friends.
Scott Benner Right.
Shannon Boggs Yeah. I mean, I've never tagged any of my stuff on yours. You know what I mean?
Scott Benner Like No. Of course. Yeah. We banned Yeah. All the pages. We banned pages. And that, by the way, that makes people upset. Like, why won't you let me be? And in the end, what I've learned is
Shannon Boggs break.
Scott Benner What I've learned is is that that group is it's so big, and it's so active that when other people are out in the world just desperate to make a business or or or a It
Shannon Boggs will never work. You have you can't go looking for followers. They just have to find you
Scott Benner Yeah.
Shannon Boggs By if it's meant to happen. You know?
Scott Benner But once they get a couple from a post, then it's like crack. Then they can't stop. They're like, oh, they wanna do it again and again and again. Like, oh, I posted and I got 10 followers. I'm gonna do it again. I'm like, no. You're not like, I work with companies, and I'm like, look. I'll post for you every once in a while, but we're not doing it ad nauseam. Like, these the way I explain it to everybody is those are people. They're not fish in a barrel. You you know what I mean? Like, you don't get to go hunting in that barrel. Like, those people need to feel safe here. They need to not feel like they're being sold to constantly. Yeah. And, you
Shannon Boggs I agree.
Scott Benner And and there have been elaborate scams. There's this one there was this one per one account. I don't even say guy or girl because God knows who you're actually talking to. Right? But there was one account that posed as an adult in, like, their mid to late twenties. And every time they posted, they would get two responses pretty immediately. One from both from middle aged women. And one of the women's voices was very motherly towards him, and one of the voices was very flirty towards him.
Shannon Boggs Oh, pretty.
Scott Benner It took us a while to figure out that the it was the same all three accounts were the same person. And so we banned them out and got them like, got rid of them. And I don't tell anybody anybody's business. They just but they were popular. And then people started saying, hey. Where's this person? And I'm like, look. I you know, they're not here anymore. I don't wanna say because I don't wanna, like you know you know mean? Like, I don't wanna, like Yeah. Whatever. I'm not trying to tell anybody's business. And so, like, I won't say, and then they're like, well, you should let them back there. I'm like, oh my god. You this is me? I'm like, I'm getting blamed? And I'm like, ugh. I'm just trying to live my life. It's a weird position to be in because I don't I'm not looking to be a gatekeeper on something. Yeah. Yeah. But you put it very well, like, you don't know who's scamming. I don't wanna open people up to that, and I don't have time for all this to begin with.
Shannon Boggs And, also, what you're doing already works, and you've had these rules in place for so long. Like, I wouldn't change anything
Scott Benner Yeah.
Shannon Boggs Just because people if they don't get if they get mad, go somewhere else. Don't worry about you know what I mean? Like, that's you don't have to be in my on my Facebook page.
Scott Benner Yeah. I used to have a bit of, like, a complex about, like, well, I don't wanna, like I don't wanna ban anybody because I know how valuable the space could be for them. Yeah. And there's a moment where I was like, I can't I can't that can't be my problem anymore.
Shannon Boggs No. You're right. You gotta protect your peace for sure. That's number one.
Scott Benner Yeah. That's a good way to put it exactly. So anyway Yeah. What have I not talked to you about that what I should have brought up? Did I miss anything?
Shannon Boggs I don't think so. I think we covered let's see. We covered
Scott Benner Did you I didn't even know if you didn't even put notes in, did you? Didn't even know if No.
Shannon Boggs I don't know that you sent me any. Just figured we were winging it.
Scott Benner Yeah. It went very I well, yeah. I I assumed you knew how to talk about diabetes. Yeah. What's it can I ask you a question?
Shannon Boggs Yeah. Sure.
Scott Benner How long did it take you to hold that phone up in front of you before you stopped feeling like an asshole? You know what I mean? Like like, you're like, oh, I'm dancing in front of my phone here. Or or do because you used it with your kids for fun, was it already, like
Shannon Boggs I think it was already, yeah, just kinda, like, so so natural. I think you have to get you have to get used to people are gonna talk about you no matter what. Mhmm. And especially people that know you in real life, and then they see you, like, blow up on social media. I think it sparks a lot of, like, jealousy, but I'm still the same person that I've always been. And, you know, I just had to get get it out of my head. Their opinion is none of my business.
Scott Benner I learned, like, such a long time ago that if you're gonna do anything like this, there's a wall, and you just don't care about what's on the other side of the wall.
Shannon Boggs Yeah. You just have to. I mean, once you put put yourself out there and your, you know, opinions and I mean, anything, even you know how it is. If you talk about how you don't eat a low carb diet, you have certain people coming after you saying, oh, well, you shouldn't do this. Or if you're feeding your kids a low carb diet diet, then they're going after that person. So there's always gonna be people that yeah. There's there's always gonna be people that are that are not pleased with what you're talking about, and it's like, well, you just have to get over it.
Scott Benner Low carb is such a fun one. It used to be the peep they used to be so much aggressive. It's calm either it's calm down or they've learned to leave me alone because I don't pay attention to them. I'm not sure which one it is exactly. Yeah. But that one's interesting or just anything, really. Like, anybody my favorite one my group has, like, I think we're, like, up to, like, 84,000 people. Right? Mhmm. The activity's insane every day. And the other day, somebody comes on and goes, you know, you shouldn't be asking people on the Internet for their advice. And I was like, you're in a community for type one diabetes. Like, look at all the posts. They're all Yeah. Like, do you not know what the Internet is? And I was
Shannon Boggs like It's not like you can just walk out on the street and ask your neighbors because so many people don't have diabetes. Yeah. Like, you have to branch out to find a community.
Scott Benner I I I just I love it when somebody seems to not understand fundamentally what the Internet is, and then they're they're like, you you shouldn't ask other people this. I'm like, oh my gosh.
Shannon Boggs No. I mean, I truly have gotten so much help by being like, hey, guys. What do you do for this? Or, you know, what's what's your opinion?
Scott Benner How do I deal with this?
Shannon Boggs Because I'm still navigating so many new things. Even though we've had it for three years, I'm we're getting ready to hit the preteenage. And I know when I go into the teenage age, we're gonna go through a whole another wave of struggles and trials that I'm gonna have to figure out how to navigate. So I feel like the Internet is so important.
Parenting Through the Teenage Years
Scott Benner Yeah. Me too. But it's gonna change so many different times. You you can't even fathom it right now. Yeah. Like, it's gonna pivot so many things.
Shannon Boggs Hardest part for you as far as being a dad? What age group or what moment that you're like, this is probably the hardest?
Scott Benner I think the hardest part was when she was sort of like, hey. I can do this myself, and yet she wasn't really there yet.
Shannon Boggs Mhmm. And What age was that?
Scott Benner It felt like it happened a little bit in high school where, like, you don't need to, like you know, dad, you don't need to do this. Like, you know what I mean? Like or, you know but still enough where she needed help or that didn't last long. It just happened once in a while. Like, every once in a while, she seemed like, why are you like, I don't need your help. And then five seconds later, she needs your help. Yeah. And then college, she was, you know, we were she was doing great. I wasn't really very contact you know, I wasn't contact her that much. I was more of, like, I was more of, like, diabetes Google for her. You know what I mean? She'd be like, how do I do this? What's this thing? And she'd go off and do it on her own. But now in the last couple of years and she's gonna be 22 this summer. Like, I'm not saying I'm, like, involved, but, like, she's going and this is where I'm personally having the most difficulty. If she's going through a very healthy, you know, part of her life where she's figuring out, like, who she is and and she's, you know, pushing back a little and separating from a lot of different things, which you would expect kids to do, and I've my son did, and you you want them to do that. Except when that thing turns into, well, I don't wanna change my CGM until, like, the last possible second, or I know my pump's not working well for the last eight hours, but I'm not changing it until after dinner.
Shannon Boggs Yeah. We go through that a lot.
Scott Benner Yeah. And you're sitting there thinking, like, just change it now. It'll make the next twelve hours of your life so much easier if you just do this now. But you don't say that because you understand that she's she's learning about herself and diabetes in the world and her as an adult. And I do believe she'll I do believe that it's gonna be a process that she'll come back. I I don't wanna make it sound like she's, like, off the off the reservation. Like, Arden's got, like, a six. I think her a one c is, like, six, seven right now. But that's completely managed on her own while she's in while she's in college. It's fantastic. You know?
Shannon Boggs Absolutely.
Scott Benner You give it back to me right now. I'll have it at a $5.06 in a month.
Shannon Boggs Yeah. Yeah.
Scott Benner That's not what we're doing anymore. And so the difficult part is just shutting your mouth.
Shannon Boggs Yeah. I'm having to learn that.
Scott Benner Like Yeah.
Shannon Boggs I have to you know, we give my daughter a lot of freedom. She proves us to be that she handles it well. Mhmm. But when she's away at a friend's house for a weekend and we let her go overnight, like, maybe to her cousin's house and stuff, I will not hear from her. I used to hear, you know, hey. Send me a picture of food. What should I bolus for? I don't hear anything. And her blood sugar is usually pretty darn good, like, range the whole time.
Scott Benner Mhmm.
Shannon Boggs And I've had to learn, like, don't check up on her. Don't you know, unless she's really low. Like, she's like, don't call me unless I'm, like, in the sixties and I've been there for a while. Like, give me a chance to you know? So I I know that as we get into high school, it's gonna be more of that just trying to let go a little bit of the of the control and let her be her own person and make those own decisions.
Scott Benner There are plenty of people who are listening whose kids it's not gonna work out for. Like, diabetes is a lot about personality. Yeah. Right? Like, the way you would handle diabetes is the way you'd handle a job or going to college or not going to college. Like like, the way people think about things, and it's gonna impact diabetes too. I think I know Arden pretty well, and I think I know where she's gonna land. I think as an adult, she's gonna be like a low six a one c kind of person.
Shannon Boggs Yeah. And that's what I would hope for for my daughter. I think that's great.
Scott Benner Yep. And there's a couple of little decisions along the way that right now don't get made timely enough that are keeping that from happening. Same. But this is certainly not hurting her. And I do think well, you know, Sean, I've just I've interviewed so many freaking people that what I know is is that when a kid is diagnosed younger and they go off to college, there's a chance they're just gonna not pay attention at all. And and the college is gonna be a one c's and tens and eleven's, there's nothing people can do about it, etcetera. And then they graduate, become adults, and then they end up getting themselves together normally for the love of someone else. It's always like, met a girl or I met a guy. I wanna get married. I wanna be healthy. I had a baby. I wanna be here for them. Like, people have those real, like, human moments, and then they usually turn to their diabetes and fix it up. Don't I think Arden's gonna go through that process, but I still know that that's a human process. And so as if she's handling it this well right now, I don't wanna be the one telling her, no. You're taking the service dog to school. I don't care if you have a test. Like, know I
Shannon Boggs mean? Exactly.
Scott Benner Right. Right. So, like, I just say I go, okay. This is good. And if something happens that's I mean, I still follow her. You know? I don't look at her blood sugar very often. But if but if something happens, not a lot, And I'm very careful about it because the way you approach her is important and the tone and it's all very important. Right? But you don't want her to feel like she's being watched or judged or that she's failing because she's trying really hard to begin with. There's a lot to consider in there. But, like, I might go to her and go, hey. Look. You know, you know, you're two twenty right now. You put 30 carbs in. Like, I saw you eat. Like, that was 50 carbs. Like, you know Mhmm. You missed. You know what I mean? You know, I think you need to bolus more. And sometimes she'll say, I got it. And sometimes she'll say, how much do you think? And every once in a while, you can tell when she's tired. She might just slide the phone towards me like, oh, okay. Well, let's let this Jack do it because he knows what he's doing. You know what I mean? Like and there's Yeah. And there's and you're
Shannon Boggs also You created such a healthy space for her, and I like that and appreciate it because that's a lot of how we do things. Mhmm. I see a lot of parents with really, really great control with really young kids that don't know any different because they were diagnosed. Yeah. Yeah. Yeah. And if they were diagnosed at a young age, they don't have a lot of to compare it with. And if if they're not in school with other kids eating things and my thing was, like, just want her to live as normal as she can, and I want her to have a good relationship with food. I don't wanna create, like, a negative relationship with food.
Scott Benner Very important.
Shannon Boggs By restricting her too much.
Scott Benner You also don't wanna build a a bad relationship with you.
Shannon Boggs It yeah. That too. That too.
Scott Benner And you don't wanna be so lenient that you hurt her health. Yes. It gets a very fine line to walk. It's Yeah. It is not easy. That's for sure.
Shannon Boggs I know. I mean, we've definitely had our struggles, highs and lows with it, but I do feel like we're in a good spot now. You know, she's making good she's starting to realize what spikes her and what she thinks. Like, this past month, she's like, mom, don't I think I'm gonna eat chips anymore for a while. I'm gonna try to get into good shape, and she's running a five k. She's, you know, dancing, doing softball. And I was like, okay. And the other day, she said, have you noticed how good my blood sugar's been since I stopped eating chips? I was like, yeah.
Scott Benner Yeah. I didn't wanna mention it. But yep.
Shannon Boggs I loved that she made that decision on her own, but she also noticed Yep. That it's better.
Scott Benner We left Arden's appointment one time, and we just got out in the parking lot. And she was like, is there something I could do to make this easier? And about her diabetes and and blood sugars and everything. And I said, honestly, I hate saying this to you. I was like, but could you stop eating cereal for a little while while I figure while I figure this out? Words. Yeah. I'm like, because I just didn't it was a long time ago. I just didn't have it. I I could bolus your cereal now. Like, it's no trouble. But, like, back then, I did not know what I was doing. Yeah. And I was like I was like, if you could just give me a month without the cereal so I could figure the rest of it out, I think I could figure the cereal out after that. And she was like, okay. I don't think she ate cereal for years after that. Yeah. She was just like, oh, and it just kinda left her the cycle was broken with it, and it just didn't happen anymore.
Shannon Boggs We still haven't quite figured out cereal, but what we have figured out is she can have it at lunch or dinnertime, and it does a lot better than first thing in the morning. So she avoids it in the morning, and every now and then she'll ask for a bowl at, like, bedtime or, you know, before dinner, and it's just so much better. It's just that morning that we really struggle.
Scott Benner The morning's probably pretty simple. It's probably overnight. She's probably getting less insulin overnight to keep her from getting low. She wakes up, gets feet on the floor, so she gets that big kinda Yeah. Like, adrenaline push, and there's already an amount of insulin that's missing from the lower overnight use. And then the sugar hits her quicker, the Yeah. And the milk and and the the carbs hold her up, and you're you lose before you start. Like, you you'd have to bolus probably while she's in bed to replace the the lost basil and then still do a good twenty minute pre bolus before she eats the cereal.
Shannon Boggs Yep. Yeah.
Scott Benner Then you're probably but that's a lot of timing while you're trying to go to the to school or to run out the door for something or something like that. Yeah. I take your point. Well, listen. This was Roy, and it was nice to get to meet you and talk to you like this.
Shannon Boggs Yeah. Thanks for having me. I appreciate it.
Scott Benner No. It's so it's it's it's really been lovely. We'll get off here. I'll tell you about how long until it comes out and, a couple other things. And, alright, I'll talk to you later. Thanks.
Outro
Scott Benner This episode was sponsored by Touched by Type one. I want you to go find them on Facebook, Instagram, and give them a follow. And then head to touchedbytype1.org where you're gonna learn all about their programs and resources for people with type one diabetes. The podcast you just enjoyed was sponsored by Tandem Diabetes Care. Learn more about Tandem's newest automated insulin delivery system, Tandem Mobi with Control IQ plus technology at tandemdiabetes.com/juicebox. There are links in the show notes and links at juiceboxpodcast.com. I'd like to thank the Eversense three sixty five for sponsoring this episode of the juice box podcast and remind you that if you want the only sensor that gets inserted once a year and not every 14, you want the Eversense CGM. Eversensecgm.com/juicebox. One year. One CGM. Okay. Well, here we are at the end of the episode. You're still with me? Thank you. I really do appreciate that. What else could you do for me? Why don't you tell a friend about the show or leave a five star review? Maybe you could make sure you're following or subscribed in your podcast app, go to YouTube and follow me, or Instagram, TikTok. Oh, gosh. Here's one. Make sure you're following the podcast in the private Facebook group as well as the public Facebook page. You don't wanna miss please, do you not know about the private group? You have to join the private group. As of this recording, it has 74,000 members. They're active talking about diabetes. Whatever you need to know, there's a conversation happening in there right now. And I'm there all the time. Tag me. I'll say hi. If you'd like to hear about diabetes management in easy to take in bits, check out the small sips. That's the series on the Juice Box podcast that listeners are talking about like it's a cheat code. These are perfect little bursts of clarity, one person said. I finally understood things I've heard a 100 times. Short, simple, and somehow exactly what I needed. People say small sips feels like someone pulling up a chair, sliding a cup across the table, and giving you one clean idea at a time. Nothing overwhelming, No fire hose of information. Just steady helpful nudges that actually stick. People listen in their car, on walks, or rather actually bolusing anytime that they need a quick shot of perspective. And the reviews, they all say the same thing. Small sips makes diabetes make sense. Search for the Juice Box podcast, small sips, wherever you get audio. If you have a podcast and you need a fantastic editor, you want Rob from Wrong Way Recording. Listen. Truth be told, I'm, like, 20% smarter when Rob edits me. He takes out all the, like, gaps of time and when I go, and stuff like that. And it just I don't know, man. Like, I listen back and I'm like, why do I sound smarter? And then I remember because I did one smart thing. I hired Rob at wrong way recording dot com.