#1845 Live Tech Support
Scott helps Danette, an overwhelmed mother managing her daughter's type 1 diabetes. He advises going back to basics, resetting basal insulin , and prioritizing sleep to combat burnout.
Companies that Support Juicebox
Key Takeaways
- When diabetes management feels overwhelming and chaotic, go back to the absolute basics by simplifying your approach and focusing first on foundational settings rather than complex variables.
- Accurate basal insulin is critical; if basal rates are incorrectly set (often too low), meal boluses and correction factors will struggle to work effectively, leading to unpredictable blood sugars.
- Taking a "pump break" and returning to Multiple Daily Injections (MDI) can be a valuable tool to reset expectations and isolate basal needs without algorithmic interference.
- Caregiver burnout and a lack of sleep drastically impact your ability to make clear, rational decisions regarding diabetes management, often leading to over-correcting or over-worrying.
- Avoid "chasing ghosts"—such as constantly blaming bad insulin or cannula issues—before confirming that your basic insulin-to-carb ratios and basal rates are properly dialed in.
Resources Mentioned
Introduction & Support Resources
Scott Benner Here we are back together again, friends, for another episode of the Juice Box podcast.
Danette My name is Danette, and I'm from the Midwest.
Scott Benner Hey. Do you need support? I have some stuff for you. It's all free. Juiceboxpodcast.com. Click on support in the menu. Let's see what you get there. A one c and blood glucose calculator. People love that. That's actually, I think, the most popular page on the website some months. A list of great endocrinologists from listeners. That's from all over the country. There's a link to the private Facebook group, to the Circle community, and we have a a fantastic thing there, American Sign Language. There's a great sign language interpreter who did the entire bold beginning series in ASL. So if you know anybody who would benefit from that, please send them that way. Just go to juiceboxpodcast.com and click on support. While you're there, check out the guides, like the pre bolusing guide, fat and protein insulin calculator, oh gosh, thyroid, GLP, caregiver burnout. You should go to the website. Click around a little bit on those menus. It really there's a lot more there than you think. 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 The show you're about to listen to is sponsored by the Eversense three sixty five. The Eversense three sixty five has exceptional accuracy over one year and is the most accurate CGM in the low range that you can get. Eversensecgm.com/juicebox.
Scott Benner 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. Learn more and get started today at tandemdiabetes.com/juicebox. The podcast is also sponsored today by US Med. Usmed.com/juicebox.
Scott Benner You can get your diabetes supplies from the same place that we do. And I'm talking Dexcom, Libre, Omnipod, Tandem, and so much more. Usmed.com/juicebox or call (888) 721-1514.
Danette's Daughter's Diagnosis Story
Danette My name is Danette, and I'm from the Midwest.
Scott Benner Danette, that was awesome. Thank you. Some people struggle to introduce themselves. Danette, you have diabetes? You have a child with type one?
Danette I have a child. My daughter, she's seven and a half. She was diagnosed five years ago on 02/01/2021, and I am also the mother to a son who's 10. They're almost three years apart to the day.
Scott Benner Wow. Wow. Wow. Wow. Do you have any type one or other autoimmune in your family or any reason to think that maybe you'd have a child with diabetes one day?
Danette No. The doctor said, quote, it has to start somewhere.
Scott Benner What an upbeat thought.
Danette I've got type two on my side of the family. My husband has some type two on his, but no type one that we know of. No other autoimmune that we can think of.
Scott Benner Really? No celiac or thyroid or anything like that floating around?
Danette No. Not at all.
Scott Benner I find a lot of people have thyroid and don't tell anybody about it. It's an interesting thing too. Does your family talk about health? Was it a thing you feel like you would know about if it existed?
Danette Yes and no. I think we hear about health problems after the fact. Like, seventeen years ago, my mom had a very massive heart attack, and it was kinda like brought all the family together. But up until that point, didn't really talk about health. It was like, yeah, my type two is bad. My health was bad. I didn't take my medication. Oops. I had a heart attack, that kind of thing. But nothing really at the forefront, like preventative, keeping on top of things. I think now that, you know, our parents or grandparents, they wanna be around, and so now it's more of a focus. But back then, it wasn't really.
Scott Benner Oops. I had a heart attack would be a great episode, Nave, if you would have just said it a little later in the episode. So okay. I'm just gonna ask a little further. Just like vitiligo, psoriasis, anything even, like, inflammation related, like, just terrible seasonal allergies or anything like that?
Danette Nope.
Scott Benner How about that? Okay. Did she have a virus previous to the diagnosis? I mean, she's two and a half. Right?
Danette You know, not that I could think of. You know, I kinda look back at the pictures and you see, like, wow. You could really tell that she was getting sick.
Scott Benner Mhmm.
Danette Compared to my son, she was always kind of a chunker. So it was like she was starting to lean out. We thought, oh, she's going through a growth spurt. You know, that's just normal. Oh, she's wetting through her diapers because we have a bad batch of diapers, and so we were getting the overnights and that kind of thing. And then it just got progressively worse. I don't think she was sick before. Nothing that we could pinpoint. I mean, it was during COVID. We avoided that. They were still in daycare. Didn't really get sick.
Scott Benner No hand, foot, mouth?
Danette No. No. She actually got hand, foot, and mouth after she had diabetes. Oh. We had a little stint in the hospital for an overnight because of ketones and things like that. And when I was changing her diaper, I noticed the rash on her bottom. And then she was saying that her applesauce tasted spicy. And so when I looked at her tongue, like, she had the dots on it, but that was after her diagnosis.
Scott Benner Spicy applesauce. Yeah. I don't think that would be good. Maybe it would be. I don't know. I don't wanna think about it right now because I'm hungry. I haven't eaten yet today. I was like, oh, applesauce. I'm like a child. I love applesauce. My goodness. Okay. So she's diagnosed. You notice her leaning out. You go to, like, a family clinician. Do you end up at a hospital? What's the process of figuring it out and getting moving?
Danette So how we figured it out was both of my children were cursed early on with they just stopped napping around, like, 18, two years old. And so she'd been really lethargic. She was drinking a lot of water, but we didn't really put two and two together. And I had gone away on a day trip with some friends, and my husband had reported that my daughter was very cranky and lethargic, like, just not feeling herself. And he chalked that up to I was gone all day. Mom wasn't home. So this was on a Saturday. On Sunday, she took, like, two or three naps, which was unusual. And she was very clingy. She was eating fine. But then on Monday, I was working from home at the time, she just didn't seem right. She looked flushed. She'd gone down for multiple naps, and I told my husband, I said, if she's not feeling better by tomorrow, I'm gonna take her to our family GP. And so I went up to change her diaper, and when I laid her on the changing table, her eyes kind of rolled back in the back of her head like she was gonna just, like, pass out. And so I told him, I said, I think I should probably take her to an ER. So there's one pretty close by our house, and we took her there. And she was very disengaged. She wasn't looking around. She wasn't excited to be in the car. And so when we checked in, you know, the nurses are giving her the bracelet and getting my questionnaire completed, and she just looked very distant. And so I still had no idea what was wrong with her. But then when we got back to the room, the doctor comes in and says, well, we're gonna do some blood work, and we're gonna do urinalysis, but I'm pretty sure she has diabetes.
Scott Benner Now he knew by looking at her, or do we smell her breath maybe?
Danette I don't recall the ketone smell. I don't recall any, like, Kussmaul respirations. She was just so lethargic, and I don't know. He just knew.
Scott Benner Okay.
Danette And that was just kind of, like, a blow. I had no idea, like, how he could have guessed it, but he's like, we see this all the time. We're just gonna get you admitted, and you'll probably be in the hospital a couple days, we'll go from there.
Scott Benner Wow.
Danette So he seemed to know right away.
Scott Benner Yeah. Prior to him saying that, you just thought, what, she's sick? She had a cold or the flu? Or
Danette No idea. She had never really been sick before. Not like that.
Scott Benner But she was your second. Right? So you had one already?
Danette Yeah.
Scott Benner Yes. So you'd even been through a little bit of that. You not even nervous at the hospital? Were you just more confused?
Danette It was, like, really confused. Like, how could this be happening? You know, she's so little. It was just kinda out of the blue, like, not even on the radar.
Scott Benner I hear you. Okay. Is it more of a shock to you or your husband? Who do you think took it harder? Do you think somebody handled it better than anybody else?
Danette I think we were both kinda taken aback by it. I think early on, my husband was just like, we gotta get through this, and he kind of compartmentalized it and never really kinda dealt with the fact that she had diabetes. It was like in the middle of COVID and all this crazy stuff. Right? Mhmm. Until he'll even admit, like, he had never really processed the fact that she had diabetes, so I could think it hits him harder sometimes thinking about it. But, yeah, it was just completely off the radar.
Scott Benner During COVID, meaning, like, during lockdown portion of it?
Danette So we were about a year in because we locked down in, what, February or March 2020, and then she got diagnosed in 2021.
Scott Benner Okay.
Danette So we were still working from home. So I guess in that regard, like, our companies hadn't really
Scott Benner We were in the part of COVID where we were all like, I guess we'll just live in our houses for the rest of our lives. Yeah.
Danette Yeah. Pretty much.
Scott Benner Right. Right. I gotcha. Alright. So that part.
Early Struggles and the Value of a CGM
Scott Benner What did they start you off with? Technology? Was it harder to get educated? You know, what did that extra layer of separation create? Do you think it ended up being good or bad in the long run?
Danette Hard to say. I it was just a complete shock. You know, they told us if you count your carbs and you just give insulin, it's gonna be fine. Right? And so I'm like, oh, this is, the best disease to have because I can count. Right? Perfect. Been a nightmare since then. But, yeah, we left with Lantus and Chemalog with syringes. I think we were on a the quick pen.
Scott Benner Mhmm.
Danette Left with a ton of lancets and finger sticks and things like that. I was, like, such in a daze. I didn't even really understand the benefit of having a CGM, so I was against her having something on her body, which at this point, I think that we should have done that from day one. Uh-huh. You know? But there was no one telling me, well, this is why you need it. This is why it's important. So from the very get go, was kinda like sink or swim, figure it out yourself, which is a very difficult position to be in.
Scott Benner Yeah. I have to tell you, I'm still laughing at your assertion that while I can count, this is gonna be a breeze. Like, that really still has me amused.
Danette Oh, yeah.
Scott Benner Oh, diabetes about counting. I got ten fingers. I got ten toes. I know my gazinthus. This is gonna be no problem at all. And then immediately didn't pan out that way.
Danette Oh, no.
Scott Benner Yeah. Yeah. Still hasn't, I imagine. Yeah. What an interesting, like, first reaction. I love that. I don't know why that just that tickled me. I'm sure it didn't tickle you when you realized that none of that worked out. But so why didn't you want the CGM initially?
Danette I think it was just hard to see what I I don't know. Like, they just came in. They handed me a pamphlet. They said, take a look at this. We can give you a sample, and then they basically walked out. No one said, this is the value. You won't have to do these finger sticks. You'll have data at your fingertips. So that along with the packet of, like, you know, we could apply for some kind of financial aid to begin with because she was diagnosed to get some of the hospital covered, and it was just so much information at once
Scott Benner Yeah.
Danette That there was no one there to say, this is why you need this. This is why it's important.
Scott Benner Do you think that if it would have gotten presented to you differently, you would have had the bandwidth to even think about it or is no way to know?
Danette Oh, I probably would have. I think so.
Scott Benner Okay. Well, then how did you find out about it eventually? How did you eventually bump into the idea that, oh, that thing they mentioned, I should look at that again?
Danette So my sister-in-law, not by blood, she has a lot of people in her family of type one. And she was like, Dee, you gotta get this CGM. Like, this is gonna be very helpful. So having someone in my family say, this is why it's important. And then we didn't have a CGM, I'm gonna say for about two months. Mhmm. And then we were still doing finger sticks randomly before meals and things like that. And one day, we were about to have dinner, and my daughter just looked very tired, like, uncharacteristic. And I did a finger stick, and she was, like, 40. Mhmm. And I was like, okay. We need data. We need to know when this is gonna happen because we're just getting those snapshots. It's not really giving us the big picture.
Scott Benner Yeah.
Danette I think that was the point where I kinda realized the utility of why we needed it.
Scott Benner Okay. Well, I'm a big fan. So I Yeah. Yeah. I think if you're using insulin, you should be wearing one if it is all possible. Did you do diabetes long enough without one to feel the benefit, or was it really just that one time situation that made you think, oh, this is scary. I don't wanna do this again. I'm gonna grab the thing. Do you know what I mean? Like, if somebody asked you to explain to them what's it like to manage without it versus what's it like to manage with it, do you think you have experience without it to talk about it?
Danette No. I think at that point, we were still kinda in a daze. Right? We didn't know what was going on between meals, finger sticks in the middle of the night, high all the time, low sometimes. I went back through some of our information. I was looking at, you know, those little handwritten sheets they give you in the hospital, like log your dose, log your carbs, log your blood sugar before and after meals. Mhmm. It was just all over the place, and we just didn't know what to do with that information.
Scott Benner So you're just writing these random numbers down, but not having any actionable idea of what to do next now that you saw the numbers. Yeah. Mhmm. I mean, I had an incredibly difficult time trying to make sense of all those random numbers too. You know? The CGM is just a I mean, to say it's a game changer is just not enough. You know? It's not an effusive enough of a description of what it does for you if you're using insulin, and it just opens the whole thing up. How quickly did you I mean, I obviously see the benefit of the CGM pretty quickly, but how quickly after that does it actually translate into better outcomes, or does it not? Does something else need to happen?
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Frustrations with Pump Therapy and Outcomes
Danette Outcomes. I think that's why we're talking today. So when I look back at the numbers, right, it was just all over the place. I mean, high blood sugars and, of course, we're new a newly diagnosed family. We don't know what to expect. Our endocrinologist is saying, oh, you're doing fine. This is great. You know, better high than low, that kind of thing. Mhmm. The outcomes weren't where we I wouldn't say where we expected because we had no expectation. Right? So it's, oh, just dose her after her meals. And when I had expressed concern that the blood sugars were very high, then the endocrinologist says, well, dose before, but, you know, part of the risk of that is if she doesn't eat, then, you know, what are you gonna feed her? So putting fear in our mind right away.
Scott Benner Yeah.
Danette So it became, like, the what ifs, like, started almost immediately. So I would say that we struggle with the outcomes. We struggled with the feedback that we're getting, the advice that we were getting. Like, Oh, you're doing fine. A1c can be this high. You know, there's really no risk right now to having these terrible blood sugars. And when I'm not happy with them, you're touching the pump too much. You want to control this disease too much, and it's not controllable. You know, she's a child, that kind of thing.
Scott Benner Okay. Yeah. So tell people how you and I come together today.
Danette Do you want me to cry an hour later?
Scott Benner No. I mean, whenever you want is fine. But I didn't know you're gonna cry. But no. But Explain how we got here and why we're recording.
Scott Benner Danette, are you there?
Danette I am.
Scott Benner Oh, honey, are you okay? I'm sorry.
Danette No. It's fine.
Scott Benner Take your time.
Danette It's funny. My husband's like, you know, you can't record this at work. You have to come home home for this.
Scott Benner Are you at work crying right now?
Danette I am, but I'm in, like, a maternity room, so no one's gonna come in
Scott Benner here. Okay. So you hear a lady crying in the maternity room, no one's going in. You're completely safe. What's going on?
Danette I'm just really frustrated about the level of care that I'm providing to my daughter.
Scott Benner Okay. Alright.
Danette You know, I feel like I am a right brain person. We were kinda hesitant about a pump to begin with because it's like she was so little, and just the idea of something on her was hard. But I mentioned before how she had a hand, foot, and mouth, and we went to the doctor, and we were, you know, triage in the ER. And one of the nurses came in, and, like, she told me that we really needed to get on a pump and that she was a type one diabetic. And she says, I'm a nurse. I have three children. I have a great life. I have a strenuous job, and my diabetes doesn't prevent me from doing anything.
Scott Benner Mhmm.
Danette And so that kind of set me up on our pump journey, and I feel like everything we've tried, we've never gotten good outcomes.
Scott Benner Okay.
Danette We struggle with and when I say terrible time and range, I'm talking, like, 50%, you know, blood sugars averaging in the high one eighties. And children's hospital, they just say, oh, you're doing great. You know? You need to focus on your sleep. You need to be present for your child. And it's hard to do that. And I feel like we've had a lot of, like, insane obstacles that you know, I I listen to the podcast, like, religiously. It's, like, in the background constantly just trying to glean any kind of help. Yeah. And I feel like I know all the steps that we need to do, but they just, for some reason, don't translate.
Scott Benner Okay. So let's first of all, I want people to know that you sent an email, and I have a lot of experience receiving emails from people, and you can kind of see when a return email isn't kind of enough. Does that make sense? Like, was nothing you sent me in that email could I have properly responded to, if that makes any sense. What is it? I said, hey. Do you wanna jump on the podcast and we can just talk it through? Right? Is that how I did that? Yes.
Scott Benner Okay. I have to be honest. I think to do that more often than I actually do it, but I don't know exactly what it was about your note that made me think we should. But
Danette I think it just oozed desperation.
Scott Benner It oozed desperation. So let's go over a couple of things that your health care providers are telling you that is valuable even though it's not it doesn't feel supportive at the moment. Right? But they're not wrong that you gotta get some sleep because it's gonna make you crazy and you're not gonna be able to think. And but to say, don't worry about this a one c. Don't worry about this blood sugar when you're worried about it is not valuable at all. You're not gonna just stop worrying about it. It's impactful to you. I think you're right, by the way, to be concerned about it. I also think that there's a tiny bit of right with them where the world's not gonna blow up if it takes you another month to figure this out or something like that. But you're probably imagining it never gets straight, and it's five years from now and you're still doing this because it's already been five years. Right?
Danette Yeah.
Scott Benner Yeah. So I think I understand about where you're at. So let me start slowly. You have a CGM. Is that right?
Danette Yes.
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Danette So we started out on the Omnipod, I think, probably about six or eight months in. Never really had a lot of success with it, but I'm, like, trying to force the fit because, you know, everyone on the podcast is using Omnipod. Everyone in the and I know that's a generalization. A lot of people on the Facebook group are using Omnipod, and then you can tailor the base. Well, you can do all these things. And for a while, for us, it was more of a way to stop doing so many shots. Right?
Scott Benner Yeah.
Danette So we did the Omnipod, and it was just a real struggle. And so then when the Omnipod five came out, I was very adamant about wanting to get on that to kind of relieve some of my overnight stressors. And our provider hit or miss. I mean, he was kinda, like, on the verge of retirement, so he had flat out told me that he didn't think pump therapy was a feasible option for a child because, you know, they're too active. They get bumped off. You get the same outcomes as MDI. So no support there.
Scott Benner I'm gonna stop you for second. Where do you live? Not not exactly, but, like, how come everybody's all shucks in you all the time?
Danette Exactly. I don't know.
Scott Benner Okay. Okay.
Danette So I have since changed my attitude. Now I'm a more, you know, you work for me and this is what I want. Mhmm. But now we kinda have I wouldn't say friction when I go. Probably. I mean, they probably can't stand to see me, actually.
Scott Benner I wouldn't say friction, but I think they hate me.
Danette Pretty much. They basically handed me off to a new nurse practitioner because I disagreed so much with the other one that we saw. Like, I flat out told her wholeheartedly, I do not agree with your recommendations. And, yeah, I think they're just used to people maybe having better outcomes and who don't struggle as much, who just, like, go to the appointments and get their a one c and go on, and that's it.
Scott Benner Why do you assume the other people are having better outcomes? Why don't you assume that the other people are having middling outcomes and they're just agreeing with the doctor and not paying attention to it after that?
Danette Could be.
Scott Benner Yeah. Yeah. Don't be hard on yourself
Danette Yeah.
Scott Benner There. You're making a hell of a leap there that everybody's doing well but you. Mhmm. You know? I would imagine if I had to guess, I'd imagine that everybody's been given, like, oh, you're doing great. Get some sleep. You know, that kind of, like, homespun wisdom thing. And they're all just going, okay. Well, then she said I'm doing good. So I'm good, and then I'm not gonna think about it anymore.
Danette I think
Scott Benner you're Mhmm. You're maybe in that situation where you're the only one making sense, and you're being left to feel like you're the crazy one.
Danette Yeah.
Scott Benner Yeah. Right? Yeah. And it's probably making you crazy. So we're gonna Yeah. Try to avoid that. Okay. So I'm sorry. So you have Omnipod five right now?
Danette So we were on the Omnipod five. We did that for about, let's say, a year. I can't remember. It was a while. And it was just not working out. Like, we couldn't get the settings right. My daughter was having a lot of lows because it would kick out too much insulin in auto mode. So then we were having to do manual during the day, auto at night, making all these adjustments, and she started to get really bad reactions to the adhesive. I was constantly calling in pods because they would just stop working after twenty four to thirty six hours. My daughter was having a lot of swelling at the sites, pus in the cannula. It was interrupting the insulin delivery and then, you know, leading to the higher blood sugars. So I was very adamant against a tubed pump, but last June, we kinda finally hit our limit. And I was like, you know what? Let's just try the tandem Mobi. It's small, and we'll just deal with it. We were on that for a while, and the outcomes were a little bit better. We were starting to see improvement. Then we started having this weird thing where my daughter was getting a lot of air in her tubing, and no one could figure out why. We got the pump replaced, and she kept having these air bubbles, like, near the pump site. So it wasn't just after a couple days, yes, you get air in the cartridge and that travels its way down. It was like we were constantly flushing the tubing and constantly having air, and no one could figure out why. So we also kind of had a little bit of a butting heads with the nurses at school because they would just dose her, and then she would be three hundred, and they would just continue to dose. And I was like, well, I picked her up early today, and I checked her tubing, and she had air. And they're like, well, there was no air when we checked. I'm like, okay. I'm not saying anything about when you checked it, but when I did, there was air. And so we just got to the point where it's like, okay. At school, we can't control our numbers. We just need to go back to MDI. I guess, start from scratch and try to get the basics down.
Scott Benner Okay.
Danette So we've gone through, like, all of the difference not all of them, a lot of different options. Right now, we're trying to explore the twist pump, but it's not covered by my insurance. I found this out yesterday, so we're trying to do an appeal Just because we're losing a lot of freedom with MDI, my daughter, she would send me pictures from the bus. Like, hey. I wanna eat this piece of candy. This is how many carbs it is, and we would walk through the app together about how to dose herself when she was on the Mobi. So we've tried lots of different things, but we've never had steady, stable, predictable numbers.
Analyzing the Numbers: Basal vs. Bolus
Scott Benner My guess is is that either you are doing something, like, egregiously not right and that you're unaware of, or her body is somehow not conducive to the cannula? Is it possible she's allergic to the cannula material? Is it you know what I mean? Like because you're a person who's paying a lot of attention.
Danette Right.
Scott Benner And I hear your frustration, and you're not getting outcomes even close to the amount of effort you're putting in. Is that about how it feels? Yes. Okay. And what's her a one c right now?
Danette It's 6.9.
Scott Benner Okay. And her time in range is about 50%, you're saying? Ish?
Danette Well, yeah, the last week has been hard because so, you know, I am a religious listener, and I hear all the time about how you say, you know, people just look for ghosts. And, like, I see ghosts, like, legitimately.
Scott Benner All the time.
Danette Yeah. Or when you say people like, oh, well, the insulin went bad. It had it couldn't be the insulin. You know? So last week, when we would decide to go MDI to kinda get things under control, we were gonna use spring break as, like, a baseline.
Scott Benner Mhmm.
Danette Well, she gets a near infection, and she gets on antibiotics, and we switch to an insulin pen. And her sugars are completely unmanageable. I mean, like, ridiculous. I'm giving her so much insulin. Now I'm not a fan of big boluses because I feel like I can't trust my own data that I have from any of her systems. But one day, I was like, you know what? We've got glucagon, and if I have to use it, I'm gonna use it. And for one morning on breakfast, I gave her seven units of insulin to cover breakfast and her antibiotic. Her normal dose is about two and a half to three units. That was a big step for me.
Scott Benner Yeah.
Danette And I'm thinking, okay. We're just gonna do it, and she still went to three 100. And so I'm crying all day. I send you my crazy schizophrenic email, and I said, you know what? I'm just gonna open a vial of insulin and give her a shot with a syringe. And that was the first time in a week that with any predictable forum, we got movement in her blood sugar. I'm like, are you kidding me? Did I legitimately have bad insulin in this pen that I've been using for a week with no relief whatsoever? But, yeah, it just seems weird. Like and then another thing I think about you saying is, like, oh, people aren't brittle diabetics. You just don't know how to use insulin. Like, is she the brittle diabetic? Like, is she the the unicorn Well if you will.
Scott Benner Yeah. So let's reset your expectations a tiny bit for a second, though. A six nine a one c is good.
Danette Okay.
Scott Benner Yeah. Is she getting low a lot?
Danette Okay. So the way I think about it, I'm not really thinking in terms of a one c. Right? Because if you see these graphs, the CGM data that is, like, 300 or two fifty for hours and hours and hours.
Scott Benner Yeah. We don't
Danette want that.
Scott Benner Like Yeah. Right.
Danette Me, it's like, okay. What are her lows? Because, like, my GMI or whatever on the Dexcom is always higher than what her a one c is. So then I try to really not spiral into, well, can I even trust this data? Is she running low all the time? Mhmm. Whatever. You know? So it's just so much information, but to be in range 50% of the time, it's not good. I'm not looking for that five A one c. You know what I mean?
Scott Benner Yeah. I'm not arguing with you. I'm trying to say, like, unless she's incredibly low for long amounts of time, you're not missing by a lot. You're missing somewhere, obviously, if you're seeing two fifties or three hundreds that are lasting for a long time. Let's start slow here. How much does she weigh?
Danette Sixty pounds.
Scott Benner Sixty zero? Six zero?
Danette Six zero.
Scott Benner Okay. And how much insulin does she use a day?
Danette About twenty to twenty five units.
Scott Benner Okay. And that doesn't seem like it's enough?
Danette Sometimes.
Scott Benner I wonder like, what are reasons why she could be insulin resistant? Do you know what I mean? Like, I mean, she's a kid. Right? So she's active. She's moving around.
Danette Right. And that's another thing. Like, with the pumps, especially, we were having to have all these different basal rates around her physical activity because when she's active, she is so sensitive to insulin. And so it's just, overall, just extremely difficult to manage because I cannot expect her to sit still after a meal because of insulin. But then once she's high, it seems like it takes a lot to bring it down.
Scott Benner What's her basal at?
Danette So right now on MDI, we're at six and a half units of Tresiba.
Scott Benner Okay.
Danette And that seems to be a little on the high side because she's kind of drifting down between meals and overnight. I think it might be a little bit too much.
Scott Benner Okay. So overnight, she's drifting down by getting low or drifting down?
Danette Just difficulty all around. Like, I can never get her to bed at a normal number. Like, she's got sports and things like that, and she's rebound highs, and we're fighting with those. And so then by the time she finally is in range, she needs an applesauce because I was too heavy on the bolus. It's just different because we've been doing MDI for two weeks. Yeah. So it feels like it's all over the place.
Scott Benner I found myself wondering, and this is probably a great place to repeat this. I am not a doctor, and this is definitely not advice. And what I'm wondering is, are you seeing lows mainly after meals or after correction boluses?
Danette I don't even know.
Scott Benner Because I wonder if maybe your basil is not just it could be more aggressive, and then your carb ratio could be less aggressive. Like, what's your carb ratio at?
Danette For breakfast, it's one to nine. Lunch is one to 14. Yeah. It's like one to 14 the rest of the day.
Scott Benner Okay. So, again, I might say a ton of stuff that's wrong, but you sound like you're a little out of your mind over this. So, like, let's just try to, like, kinda spitball here and see what we can kinda figure out. Okay? What I'm wondering is, is there a way to use more basal and less meal insulin to overall affect what's happening? Like, is that possible? Because if she's using twenty five a day, if you were gonna accept the fifty fifty split as, like, a place to start, basil to bolus, then she'd be, like, a half unit an hour or twelve units a day in basil, but you're doing half of that at six.
Danette Yeah.
Scott Benner Right?
Danette I mean, when we were on the Moby, like, if we had a good day so when I proposed to our care team that I wanted to take a pump break, I looked at all the days that she was in range 75% or more, and then I looked at the split between basal and bolus insulin. And the average bolus or the average basal insulin was, like, 5.75 units.
Scott Benner 5.75. Mhmm. Okay.
Danette I didn't wanna take into consideration those days where she had an air bubble or something and, like, control IQ is cranking out all this extra insulin, and she's getting, like, quote, unquote, twelve units a day when she obviously didn't if she was, like, three hundred all day. On those good days, her basal was as low as four and a half.
Scott Benner Does she have hypothyroidism? No. Have you ever had her TSH checked? Mhmm. Do you know what it was?
Danette I don't recall. She had all that run last year. She's due for it again.
Scott Benner Do you remember it being in range or how they talked about it?
Danette Everything was in range.
Scott Benner Did she have any symptoms of hypothyroidism?
Danette I don't believe so.
Scott Benner No. She's not tired all the time or No. Moody, cranky? Mm-mm.
Danette No? Okay. Great disposition. I mean, she rolls with everything.
Scott Benner Yeah. I'm trying to think of reasons why the insulin might not be working as well or is effectively. Not sure. There's part of me, by the way, that thinks that when we're completely done this conversation, we should immediately make a transcript of it, roll it through a large language model, and then see what it spits back out too. I'm Mhmm. Sort of interested in that because you've been through too much. Like, it seems to me that you've climbed up every tree there is to climb up, and you are probably confusing yourself at this point. You know, God bless her, where she's brittle. You know what I mean? Like, or something that's happening that we're unaware of or something like that. I don't know. Like, it just seems to me one to nine is I mean, when Arden's on a GLP, her carb ratio is one to nine, and she weighs a hundred and twenty five pounds.
Danette Mhmm.
Scott Benner And, you know, is eating probably more aggressively than your little kid is over there. I'm just wondering if you don't have enough basil going, is everything just not working because of that? And that could be overly simplified. I have no idea. Does that make any sense to you, or does that sound crazy to you? I don't know you. Like, I'm just trying to work through what you said to me. So, like, if I said to you, you're using six units of basil right now, try eight tomorrow. Do you think that would, like, ruin things? Like, do you think it would crash her or something like that?
Danette I don't know. So like I said, last week, we just had a hell of a time with the insulin and things like that Yeah. Plus the antibiotic. So it was gonna be our opportunity to kinda reset. What I wanted to do is really dial in her settings, send her back to school with the shots, and be on our way. But because of the illness and the antibiotics and all that stuff, it was just not an ideal week to do that. So now we are trying to do that with her at school, with the activity. The only good thing about that is that she's got, you know, scheduled meals throughout the day, so she's not constantly eating like she was during spring break. But I don0't know. So for example, on Tuesday, she got her snack, and they dosed her for it plus a correction. She went low. So is that because the correction was too much? Is it because the basal was too much? Once I get her stable overnight, she's drifting down. Her line is not flat. So that makes me think that the basal is either too aggressive because she should just be flat. Right?
Scott Benner Yeah. Say it again for me. I'm sorry. Literally, just start over and say it one more time. I was thinking about something and I got lost for a second.
Danette Once I get her number in range Mhmm. Her number doesn't plateau out. She keeps drifting. Down. Down.
Scott Benner How many hours after her last bolus?
Danette Like, more than four or five.
Scott Benner And she drifts to a low spot or a place where you have to stop it?
Danette Yeah. We're treating. So high sixties.
Scott Benner Okay. So try to imagine a world where because right now, you're covering one unit is covering nine carbs. Okay? And she's getting what? Point two five an hour basically or six units a day of basil. And she's getting 25, basil and bolus combined.
Danette Mhmm.
Scott Benner So if you look at a sixty pound person just with a standard basal rate, you're looking at, like, fifteen units a day total daily insulin. But we're saying that's not what she's doing. She's doing 25. I'm using an estimator that's on my website right now. I don't know if you've seen that before or not. So, basically, what I did was I put her weight in at sixty. And on a physiological factor profile of standard, it says her total daily insulin should be about fifteen units a day. Seven and a half total basal and an insulin to carb ratio of one to 33. But that's not her situation. She's using twenty five a day. Now is she using twenty five a day because you're creating lows and feeding her more often than you have to?
Danette I don't think so.
Scott Benner I don't know. But if you don't think so, okay. So I just make her highly resistant on the chart, which then puts her theoretical total daily insulin at, like, 24 and a half, which is matching what you're telling me. When that happens, it's indicating that her basal need should be about 12 a day or point five an hour, but that her carb ratio should be one to 20. So my thought here is is if you meaningfully upped the basal and meaningfully decreased the carb ratio, maybe that's where the balance is. Like, maybe you are as simply as if the basal is not right, nothing else is gonna work. Is it possible that that's the situation and that she's been gaining weight and changing and you've been switching from shots to this pump to that pump so much that you just aren't seeing enough to make a reasonable decision.
Danette Probably.
A Strategy for Resetting and Moving Forward
Scott Benner Is that possible? So if that's the case and if that's a thing you wanna look into, we just have to figure out a way for you to test it for a couple of days. So my thought would be spring break's over. Right? Yeah. Yeah. My thought would be to choose a lot of meals that you know how to bolus for. Do you see what I'm saying? And something that you're really good at. Because right now like, forget all the math for a second. Like, think of a lunch that you give her, and you know that if she gets a certain amount of insulin, it's gonna go well. Right? Like, what is that lunch? How much insulin is that?
Danette You know, I really couldn't even tell you.
Scott Benner Okay. Alright.
Danette There's just so many variables. Feel like this is why I look at her numbers constantly because I don't know if I'm gonna get what I expect.
Scott Benner Okay.
Danette We get different outcomes with the exact same situation. And, you know, when we talk to a nurse or a provider, it's like, well, that's just diabetes. And for me, that doesn't work because I want stability. I don't wanna have to call the nurse and say, hey. She just had this thirty point drop. You need to give her an applesauce. You need to give her juice. I don't wanna have to pay attention.
Scott Benner What's her insulin sensitivity? One unit moves or how far?
Danette So we have that at one fifty during the day because when she's on the pump, based on the types of auto corrections that she was getting, like, even a quarter unit or point two was making her go low with her activity schedule.
Scott Benner If this was me, I would be simultaneously moving the basal more aggressively while I make the carb ratio less aggressive. Just hoping that that puts me in a good enough place that I don't really have to worry about corrections for a minute because just the math on 25 units a day at her weight is saying point five an hour basil, one unit covers 20 carbs, one unit moves her 75. And I don't know if any of that would be right or not. Mhmm. But what I do know is it's nowhere near what you're doing. Let's just imagine for a second that 12 basal is right for her. I mean, that's it's aggressive for a sixty pound person. What I'm gonna say is is that it's possible that once you get these things kind of adjusted in better, you might find that her total daily insulin is not 25.
Danette Right.
Scott Benner It's gonna probably be lower than that by the time you do it, but you're not gonna be able to get to it if you're under baseling or over bolusing things, making her low, feeding her again, then drifting lower all night long and having to add food, which eventually needs insulin. So I don't know how much extra insulin you're using because of the the way things are happening. But I think if this was me, I'd move her basal up. I would be less aggressive on carb ratio using some foods that are not super fatty or difficult to bolus for or really sugary for a while just to get stable.
Danette Mhmm.
Scott Benner Because I don't wanna sound like an old timey CDE here, but, like, it feels like what you need is, like, some good old fashioned basil testing
Danette Right.
Scott Benner To get that set in. And then once you're comfortable knowing, hey. Look. This basil's working. Now you could dial in the carb ratio a little bit and say, okay. You know, I'm good at this meal. Seems like one unit is covering x amount of carbs. Then get that closer. Then once you've got those two things figured out, then you can start fiddling with the sensitivity a little bit and trying to figure out what that is. Because your numbers are, like like, everything doesn't sort of make sense, which to me says the basal's not right.
Danette Right.
Scott Benner That's really I mean, that's it. To me, it doesn't she's getting six a day basil. I think it would be fair to try eight and then see what happens. It's Tresiba. Right? So what's it running like that weird clock? What do they say it's in there for? Thirty six hours till it's gone or something like that? Right? It kinda overlaps with the next injection. So if you wanted to move up more slowly, I would think that would make sense. Like, if you're six, go to six and a half, wait till your next injection. She's not getting low. Great. Let's go to seven. You know? And then with an eye on maybe seven and a half as maybe the baseline, And then, hopefully, you're using less insulin at meals because you've got more basil going. You will use less insulin at meals because you've got more basil going. Right?
Danette Right.
Scott Benner And then just keep kinda dialing that in. It probably shouldn't take you more than, a week to get that straight if that ends up being the issue. But I don't know what else it could be. Like, I mean, I am a little you know, she's had pus in her cannula, that kind of stuff. I don't think it's worth ignoring that maybe she's having allergic reactions and her sights aren't working well. Like, maybe that's why she's needing more insulin. But still, if that was the case, I mean, she's MDI right now. Right? So, I mean, even if that was the case, that's not gonna be a thing you're gonna notice right now. So if you got the settings great on MDI and then went back to a manual pump and they didn't work, but she was having inflammation around the cannula and stuff, then maybe you'll say, okay. She seems to be having a reaction to the cannula material, which is why her insulin needs are going up. Does any of this making sense at all to you?
Danette Yeah. It's just hard to think about when to implement that.
Scott Benner When to implement what?
Danette Like, to start titrating up and evaluating meals and things like that.
Scott Benner We're not gonna give her any more insulin than she's getting now. We're just gonna move it into different places.
Danette So
Scott Benner weekends here. Right?
Danette Mhmm.
Scott Benner She goes to school on Friday. When do you shoot the basil, in the morning or in the evening?
Danette Evening.
Scott Benner Awesome. So Friday night, move up a half a unit, and then live through Saturday using less insulin for meals. By how much? I I don't that's the thing is I don't really know. But, I mean, we could do some, like, rough math. Let's do this. So if she goes up just a half a unit a day, then what's the percentage of that?
Danette But won't it take time to see that? Because we're working that's another thing also is that we're working with an educator from Integrated Diabetes, and she said that Tresiba can take a couple days to
Scott Benner To change.
Danette Yeah. Yeah. So, like, you had to evaluate it, like, two days at a time, basically.
Scott Benner Yeah. Because it's not an in and out in twenty four hours kind of thing. It overlaps on itself. So some of some of the injection from Friday night is still going on Saturday night. But my point is is that you just a half the unit up on the basal, okay, And then, I don't know, change the insulin to carb ratio, make it a little weaker. Just a little bit. Just to kinda make up for it in case you're worried. But I don't imagine that another half a unit of Tresiba is gonna suddenly make her low all day long. And by the way, if it does, then you're gonna feed the insulin, and then, you know, you won't do it the next day. Like, it's gonna be like a a life and death situation if you move a half a unit at a time, almost a rounding error. Mhmm. To me, that's the only thing that makes sense is to get a better balance of the insulin going. But if it doesn't make sense to you I mean, I would go talk about it with other people. If you're using somebody integrated, I have that conversation with them. I wouldn't ask your doctors. They don't sound like
Danette Oh, no.
Scott Benner Yeah. They're just gonna say, oh, shucks, ma'am. You're looking too close at all this.
Danette Yes. Pretty much.
Scott Benner We got the sugar. It's what are you gonna do?
Danette Yeah.
Scott Benner Yeah. Are you sleeping? No. No. Because you sound a little frazzled. Is that fair?
Danette Oh, yeah.
Scott Benner Yeah. Yeah. Yeah. Because you're in a really interesting situation. You're not the first person I met like this. You're like, I'm at my wit's end. I need something to do. What would you do? And I say, what about this? You go, I can't do that. I didn't laugh at you because you're in a dire situation today. No. But, like, but earlier when you said it, I was like, this is incredibly common because you're at the point now where you can't even fathom doing anything differently. Right? Like, it's just like, how do you even, like, contextualize making another change when all you've been doing is making changes for five years and nothing's working?
Danette Right.
Scott Benner I would say go back to basics on this one. If the basal's not right, then the boluses aren't gonna work. Gonna be higher. You're gonna be low. You're gonna be feeding insulin, or you're gonna be shooting more to get a a down. Get the basal right. Work on the carb ratio after that, then look at the insulin sensitivity at the end, which should be pretty easy by the time you have the two together. Mhmm. I think that's what you should be doing. I mean, the truth is is, like, if you just brought her here and left her here, I think I could get it straight for you. But it's because I've been sleeping, and I haven't been staring at this mess for five years. So I wouldn't be burdened by any of the what ifs. You said it earlier. Like, you're seeing ghosts at this point. Like, well, what if it's the cannula? What if it's the insulin? What if it's this? What if it's that? I say, stop thinking that it's any of that and just go back to the three things that we know definitely impact blood sugar. And if we can't get that right, then we could look at the what ifs again.
Danette Mhmm.
Scott Benner That makes sense?
Danette Yeah.
Scott Benner Yeah? You sure?
Danette Yeah. I think
Scott Benner so. Okay. Do you feel any better now that we've talked?
Danette I mean, yes and no.
Scott Benner Why not? Tell me the no parts.
Danette It just seems like there are just so many different things. Like, oh, well then, I don't know. It it's always something. You know?
Scott Benner I asked you to stay in the three things and you're beyond them again. So are you anxious?
Danette I'm not an anxious person until it comes to this.
Scott Benner Okay. And because you feel like a failure?
Danette Yeah. Or I can't control it or she's not with me. So let me just go ahead and up her basal and send her to school. And, you know, the nurses won't let me text her to have a couple of gummies here and there. I have to wait for them to do it and hope there's not an emergency across the street that they're attending to. These are all just I don't wanna say stupid, but,
Scott Benner what ifs. Yeah. I understand. But so, are you a control freak?
Danette I mean, apparently.
Scott Benner Would you have seen yourself that way before? What would your husband say if I asked him? That the baby Oh
Danette my god. He would say, of course.
Scott Benner No. Okay. Well, then can I give you the greatest advice that you'll never get from your husband and wouldn't take from him if he gave it to you?
Danette Stop being crazy.
Scott Benner You should calm down. Yeah.
Danette Yeah. Yeah. You said that before. Yeah.
Scott Benner Just just listen. If I could just get my wife to listen to me one time. My wife's been telling me the same thing.
Caregiver Burnout and the Importance of Sleep
Scott Benner I want you to know that I got married in 1996. It is 2026 right now. I dated that girl before we were married. Okay? So I think we've been together something like thirty three years or something like that. My wife's a very hardworking person. Okay? She is, what we used to call type a, but now we call anxious. I said to somebody the other day, I can't wait to find out what we call it next time. Because, you know, remembering it used to be like, oh, they're wound pretty tight. Like, we've had all these little sayings for anxiety, like, throughout the world. My wife's an anxious person. She's also a go getter. She's a type a. She however you wanna think about it. You give her a job, she can do a really good job. Okay? And she's in an industry where something's always happening. Something's always happening. Probably 10 things are always happening. Probably a 100 things are always happening. She's always behind. My wife always says to me, when I get caught up, I can stop working so much. And I say to her, it's been thirty years. You haven't caught up yet. Maybe it's time to stop thinking that's gonna happen. But she's like, no. No. No. No. I'm gonna get it. That's the place you're at. In the end, those doctors are a little right. It is diabetes to some degree. Like, it's not a thing you're just gonna know black and white all the time. And if you don't have that art part of it, if you can't just go, well, let's turn this up and see what happens. You know what I mean? Like, if you can't do that part, then you are busy trying to cage a tiger made out of water. It isn't a thing you're gonna be able to make perfect, but you can get it close enough that perfect doesn't matter. And I think that's where somebody like me with this sort of like, hey. Let's just see what happens attitude. Mhmm. I think you're probably stuck in years of what you perceive as failure, which I would tell you is not failure. It's just not perfection. And you're stuck in a little bit of that feeling of I'm letting her down. I can't stop looking. I can't look away. If I look away, what if this happens? Like, those are a lot of uncontrollable things. It's probably how you get yourself in the situation. And I don't mean like you did it to yourself, but how you find yourself in the situation where a person who doesn't know you that well, who's only seeing you every three months says to you, maybe you should just be happy with what you got, which I think is their way of saying, lady, calm down.
Danette Yeah.
Scott Benner But they can't say that to you because, you know, laws and polite and everything. But I think your settings are wrong. That's it. I think your settings are probably a little wrong. And once you got them a little closer, you wouldn't be chasing stuff around all the time. You probably wouldn't be over or under reacting to something causing the next problem because that's all that's happening. You need to start over. You need a baseline to start over at. I mean, you got the right idea, and you tried to do it at spring break, and then she got that infection. That must have felt like a cruel joke when that happened. Oh, yeah. Yeah. By the way, you're like, well, it's okay. Spring break will come next year again. I don't know. Like, you have to tell me honestly, do you think you can just I mean, I don't know. Do have weed? Like, is there a way you can calm down for a little bit and relax and just kinda, like, turn your focus down by 40%?
Danette I don't know. I guess if I'm intentional about it.
Scott Benner Yeah. That was very honest. You're like, not sure. Hey. Is your mom anxious?
Danette No. No?
Scott Benner Like, when it comes to this kind of stuff, like, the diabetes is the only thing that makes me anxious. That's something. I mean, I will tell you, I was talking to someone at work, and we're just kinda talking about life.
Danette He was like, oh, that must be really hard to constantly worry about your daughter. I was like, you know, I'm good at everything I have ever done. Like, no effort whatsoever successful. You name it.
Scott Benner Mhmm.
Danette I can try things that I've never done before and just be good at them except for this. That's what it feels like.
Scott Benner Yeah. I think it may be the goalposts are getting not just moved on you, but maybe they're they've given you 10 goalposts and they're all moving at the same time, and you're trying to put them all where they belong. And that's just not how this is gonna work. Exactly. You know what I mean? I hate to do this to you. Like, it's timing and amount. You just have to put the right amount of insulin at the right time, and it'll work
Danette for you.
Scott Benner And so if you can at least, I think step one would be just try to believe that for a second and stop wondering what else could be happening.
Danette Mhmm.
Scott Benner And then step two would be, I know that Tresiba doesn't they want you to have two days worth of data before you know if you're making a change or not. But, I mean, honestly, you only have the weekend. You have a Friday night injection, a Saturday night injection, and maybe a Sunday night injection to make a decision before you're gonna send her back to school on Monday and feel like, oh god, what did I do? They're not gonna let me call her. I can't give her a gummy bear, like, before all that hits you. So you're just gonna have to do it. And so maybe it's gonna take a bunch of weekends instead of a week. Like, maybe you're gonna have to go little more on Friday, little more on Saturday, pause, get to Friday, do it again, and it might take you maybe two or three weekends till you get the basal where it's supposed to be, and you start getting a better feel for what the carb ratio actually might be.
Danette Mhmm.
Scott Benner That's possible. I mean, it sounds like a plan to me at least. Yeah. Oh, god. Was this helpful at all? Aren't you glad I didn't try to text this back to you? Oh my god. What'd you say? I said, aren't you glad I didn't try to just answer your email? Because I would have said something that would have just frustrated the hell out of you without the conversation, I think.
Danette Yeah. Yeah. I mean, it just seems almost too simple. Like, for example, we took her all the way up to, seven and a half units of Tresiba. She was going low, so took it back down. Like, all this back and forth is just so maddening.
Scott Benner You know? Put her to seven and a half, did you change the carb ratio?
Danette Well, because we were on that bad insulin, we didn't make any changes. I did make a change today because yesterday, uncharacteristic. So we'd switched to the fias because we just weren't getting a lot of you know, we want that fast reacting insulin because they are not prebolising her at school, which is fine. It is what it is. But she's recess, like, right after lunch, and it's starting to get warm outside. So she is running super hard, and we're having to back off her doses. And now we can't do an extended bolus, which was helping us on the pump, right, to kind of do an eighty twenty split over an hour. And now we're losing that ability, so it's kind of relearning how we're gonna approach dosing. So it's just like you said, it's just so many things at once.
Scott Benner You have made more changes to that kid's regimen in five years than I've made in twenty years. Yeah. Yeah. Stop talking about diabetes for a second because you just said something that I wanna dig into in this last little bit here. I know you gotta go. You're probably like, how long is that lady pumping? I didn't even think she had a baby. You said I'm successful at a a lot of things. I just set upon doing something and I do it, which means that your gut usually gets you there. Right?
Danette Yeah.
Scott Benner Like, gut decisions work out, generally speaking. And so this is maybe part of the issue. It feels like you're trying to find the answer so hard. You're just not doing what common sense says. Like, so in a regular life situation, like taking the diabetes out of it, I changed this. I moved that. I did this over here. I can't get like, what would you tell yourself? You'd say go back to one. Simplify. Right? Like, just Mhmm. Simplify. Let's push out the external extraneous stuff. Focus on the keep ourselves alive ideas. Let's sit in the house and watch movies all weekend. Right? Like, life's overwhelmed. What do you do? Life gets overwhelming. You get to the weekend. You put a ball game on Friday night. You watch a movie on Saturday. You stare at a goddamn wall on Sunday, and you go back to work. Because you didn't, you were gonna, like, end up in a clock tower somewhere. Like right? So do that to diabetes. Just go back to go. Like, start over again. Mhmm. Forget all you think you know about what's happening, and just what does your gut tell you to do? Right? Like, get her basal right, set her carb ratio, work on the rest later. You keep saying, well, she's gonna run around. It's hot. There's this. There's that. You can't balance all that. Your brain isn't capable of that. I don't know we could feed all that into a machine and get out the right answer. So just control the parts you know, do it at a basic level, go to basic life support, control the parts you understand, see where that gets you, and build slowly. I think it's possible you maybe started too many projects all at once, so you don't know what's impacting what anymore. Mhmm. Does that ring true to you at all?
Danette Yeah. That's fair.
Scott Benner Yeah. Alright. Well, I fixed it. There. Good. Well, there you go. Do that then.
Danette If I can unsubscribe and I can stop listening then.
Scott Benner Well, hey, listen. If this works for you, you better download every episode. Just let it play overnight. I don't care if you listen or not. I feel like this has been a valuable conversation, but I don't know if it has or not. And you won't know for a while either. Yeah. Will you, like, reach out and let me know what's going on?
Danette Yes. I will.
Scott Benner Okay. If this actually works, you're gonna come back and record for, like, another half hour. Will you do that for me?
Danette I will.
Scott Benner And if it doesn't work, you can come back and yell at me. That'll be fine. Gosh. I hope you can on top of what I just said, you're married. Right? That guy didn't kick that boy out. Right? So No. I would tell him, on Friday night, I'm going to sleep, and you're taking care of that kid. And on Saturday night, I'll do it for you. But you and I are both sleeping ten hours at least once this weekend because I think that will help you. We didn't talk about it a lot, but from my personal experience, when you start getting low on sleep like this, that's when you start sounding like you're sounding when you're talking about stuff. You seem frazzled, and I'm telling you, like, sleep drips away slowly. You don't recognize it as it's escaping out through the seams, and it's not a thing you can power through even though you think you can. You get some good sleep, a lot of this might make more sense.
Danette Yeah. That's true.
Scott Benner Yeah. I'm being dead serious with you. Like, the light of day on good sleep, you make a lot of better decisions than you are right now. I listen. I've been married a long ass time. I don't have a serious conversation about anything after 8PM. Because when people are tired, and the later it gets, the worse it goes. And you're in the middle of that conversation, and you think you're right. You think it's important. You think it's right. You think it's life or death. I have to make this point right now. And you wake up in the morning, you think, what in hell were we arguing about last night? And I'm telling you that's all being tired. Mhmm. So I would do trade offs the next couple of weekends. Everybody gets a full night's sleep at least once on a weekend, get her stuff going a little better. Your life could look just completely different in a month. You know? But you gotta stop chasing all the ghosts and thinking you're actually gonna catch them all, name them, put them in order, make sense of them. None of that is probably even important. I heard you quote the podcast a bunch of different times in this hour. Don't forget, often, the best thing to do is nothing.
Danette Mhmm.
Scott Benner Yeah. Often, there's nothing to do. People just overengineer everything and touch too many buttons and, you know, and I mean life, not just diabetes. Yeah. Yeah. Chill out. Watch a movie. Go out for dinner. When's the last time you had sex? Do that. Try to chill out a little bit.
Danette All the things. I'll do all the things.
Scott Benner Yeah. Yeah. Do them all. Right. Act like you're 20. Was the weed idea good or you you don't do that?
Danette No. I don't do that.
Scott Benner Well, find something. Don't drink. Okay? I'm pretty sure drinking is bad. Alright. We're good?
Danette We're good.
Scott Benner Alright. Hold on one second for me. Okay? We're gonna
Danette stop. The
Scott Benner podcast episode that you just enjoyed was sponsored by Eversense CGM. They make the Eversense three sixty five. That thing lasts a whole year. One insertion. Every year? Come on. You probably feel like I'm messing with you, but I'm not. Eversensecgm.com/juicebox. The conversation you just enjoyed was brought to you by US Med. Usmed.com/juicebox or call (888) 721-1514. Get started today and get your supplies from US Med. Today's episode of the Juice Box podcast was sponsored by the new Tandem Mobi system and Control IQ Plus technology. Learn more and get started today at tandemdiabetes.com/juicebox. Check it out. 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. Have you tried the small sip series? They're curated takeaways from the Juice Box podcast voted on by listeners as the most helpful insights for managing their diabetes. These bite sized pieces of wisdom cover essential topics like insulin timing, carb management, and balancing highs and lows, making it easier for you to incorporate real life strategies into your daily routine. Dive deep, take a sip, and discover what our community finds most valuable on the journey to better diabetes management. For more information on small sips, go to juiceboxpodcast.com. Click on the word series in the menu. Have a podcast? Want it to sound fantastic? Wrongwayrecording.com.
