#1917 Around the World
Around the World
Bella was diagnosed at four and spent two decades at an A1C near ten, with an endocrinologist whose method was yelling. She also bet Scott he couldn't guess what state she's from.
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- Twenty-plus years at an A1C around nine or ten, and it was never a motivation problem. Bella was diagnosed at four, giving her own injections by six and doing her own carb math by eight. She bolused for every meal. What she did not have was direction — she describes an endocrinologist whose method was yelling, a lot of demands and very little instruction, and a household where the doctor was the professional and you did not question the professional.
- “Magical thinking” is her own term for how the numbers drifted. Working from a fixed carbs-per-meal plan and perpetually hungry, she would round a portion down in her head so an extra item would still fit the allowance — and she was never taught that she could simply take more insulin to cover more food. It is one of the most honest descriptions of how good-faith carb counting quietly comes apart that this show has had.
- The endocrinologist accused her of an eating disorder she did not have. Once she hit puberty he began attributing her build to anorexia. Bella is emphatic that she never had one, points out that her parents' builds explained hers, and adds that a persistently high A1C explains thinness too. She carries an obvious grudge about it, and describes years of being told she was doing it wrong without ever being told what to do instead.
- Three things moved the needle, and none of them were being yelled at. A CGM, a community post about a pre-meal timing heuristic — wait roughly a tenth of your glucose number in minutes before eating — and then learning that protein and fat are not free, and working with the Warsaw method for higher-fat meals. Her A1C is now 6.2. Her summary of it is that she just needed information and tools. Settings and dosing changes belong to your own care team.
- Better numbers came with a cost she is candid about. As her A1C fell she gained weight, which she found genuinely hard, and she is clear-eyed about why — higher blood sugars had been keeping her thinner. She also describes childhood verbal and emotional abuse, depression and anxiety she did not have language for until she read the definition in a college textbook, and PMDD she was diagnosed with much later. She names therapy, medication, her faith, and her own long work on herself — and explicitly warns against the idea that meeting the right person fixes any of it.
- Rule of 10 — The pre-meal timing page Scott announces on tape — divide your glucose by ten for a starting lead time in minutes.
- 30/60/90 Forecast — Companion page: where a glucose number and a trend arrow may be heading.
- Reading Your CGM Trace — The third page in the set — what the shape after a meal suggests about timing.
- Diabetes Pro Tip series — The fundamentals series with Jenny Smith that Bella found after the Facebook group.
- Mental Wellness series — Episodes with therapist Erika Forsyth on depression, anxiety, and the emotional side of a lifetime with type 1.
- MiniMed Flex — Sponsor of this episode — app-controlled automated insulin delivery.
- Juicebox Podcast Facebook group — Where Bella's nurse pointed her, and where she saw the post that changed her management.
- 988 Suicide & Crisis Lifeline — Free, confidential, 24/7. Call or text 988 in the US. Outside the US, Find A Helpline lists services by country at findahelpline.com.
Every word of the conversation
Welcome & Sponsors0:07
Friends, we're all back together for another episode of the Juice Box podcast. Hey. 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.
Hey. My name is Bella, and my god.
It's hard to introduce yourself, isn't it? This episode of the podcast is sponsored by MiniMed and the Kontoor NextGen blood glucose meter. MiniMed, of course, the innovators behind the MiniMed Flex system, a small, sleek, and discreet insulin automated delivery system controlled from an app. Nothing comes close to freedom you can feel. To learn more, visit minimed.com/juicebox.
There is one blood glucose meter in this house, the Kontoor Next Gen blood glucose meter. That meter is on my daughter's person right now and at all times. It is incredibly accurate and waiting for you at kontoornext.com/juicebox.
It really is.
Try this. Hey. My name is Bella, and I have type one diabetes.
Perfect.
Okay. How long have you had type one, Bella?
I have had it since I was four, and I'm 30 now. So I guess that makes it twenty six years.
Look at you doing the big math. That's excellent. Excellent. Excellent. Excellent.
A Challenge: Guess the State1:59
So you you've you've thrown a challenge down to me before we've began. You said, I wanna see through the through this conversation if you can figure out what state I'm from.
Yeah. Alright.
We'll we'll see what happens.
Yeah. Absolutely. You have this huge catalog of so many people that you've interviewed. And the last person that I've heard you interview, you were able to identify, yeah, the birth order that she was in. Oh, that no.
That that's right. They, What was her name? She's 19.
19 year old.
Yeah. Yeah. Yeah. You can tell by anyway, I can tell. Alright.
Well, we'll we'll see what I I I feel a lot of pressure right now, but that's okay. I and it's good for me. Keeps the morning moving. Let's figure out why you came on the podcast and a little bit about your story. So I mean, I'm gonna guess you don't remember a ton about being four years old.
Is that right?
Yeah. Pretty much.
Well, that's that's fair. When's the first time in your life you remember having, like, conscious thoughts about I have diabetes and it's part of your story now?
Diagnosed at Four3:03
Yeah. I would definitely say it was when I was diagnosed, when I was in the hospital, actually.
You do remember that? Yeah.
I do.
Go ahead.
It was, you know, a little traumatic, as I would say for most people.
Kinda kinda thing that sticks with you, Pella, a little bit. Yeah. So you don't make sure I understand. You don't you don't remember a ton about being four years old, but you do remember about being diagnosed?
I do. Yeah. Go ahead, Tara. So I asked my parents, and they do bring it up from time to time. Because I went in four days before my dad's birthday, and then I came out on his birthday.
So happy birthday, dad. So my mom says that I was you know, had the typical signs of drinking a lot more. And so in the typical fashion of the day, she gave me juices Mhmm. Which was such a great idea, right, but she didn't know any better to satisfy my thirst. And I was four at the time, so, of course, I was potty trained.
And but I started wetting the bed, and she was like, what's going on? And she said I was cranky and which was not, like, my typical behavior Yeah. Not my typical typical mood. And she was like, something's going on. And, you know, I looked tired all the time.
So she took me in, and the story goes that she took me to the doctor. They tested my blood, and they looked her in the eyes and said, you need to go home, pack for a week, and take her to the hospital right away. So she's packing. She's crying. She's trying to get ahold of my dad.
She can't get ahold of him, And so she called my uncle. He says that he'll get ahold of him, and I guess he was, like, working out on the track. And
On the on the track, your your uncle's your father works out on the track or your uncle?
He my dad was just working out on the track. He was just running.
Oh, okay. He was out running.
Yeah. He was out running.
What time of year was this? You remember?
July.
July. Okay. Yes. I was hoping that it was a winter month so that I could I could narrow down the states you live in to warm weather states. I was trying to trick you.
Okay. Yeah. Very smart.
We'll see. How many brothers and sisters? Do you have any?
It was July 8.
July 8. Okay. Do you have brothers
and sisters? I have an older sister. She's nine years older. She's my half sister.
Okay. Okay. So a nine year
old sister. Estranged.
You don't talk to your sister?
I do not.
Do you talk to your dad?
Yes. I do. Actually, he's supposed to come and see me in a tomorrow.
Nice. I guess I gotta ask, do you speak to your mom still?
I do. Yeah.
You do.
So just I have a good relationship with mom.
The sister then.
Just the sister.
Okay. Okay. Alright. So your mom gets a hold of your dad out there working out trying to be thin or no? Does she head off to the hospital by herself with you?
So he gets the voice mail once, you know, once he's done working out, and, he meets her there at the hospital. And, that's that's kind of all I have of the story there.
Do you And then think, Bella, do you think that story is your memory, or do you think it's been told to you so many times that you remember it?
Oh, yeah. For sure that
Okay.
The latter.
Right. Right. So then when the the actual hospital stay, they told you to be ready for a week. Were you there for that long?
I definitely remember being there for multiple days, so I could see it definitely being a week. From what I remember, there was a nice nurse, and we were doing some arts and crafts. And I actually had one of those arts and crafts for a long time. I don't remember if I eventually turned away when I was older, like a like a angsty teen, like, I don't need this anymore. But
You wish you had it
now? Maybe.
Maybe. Well, okay. Yeah. Alright. So what about growing up with type one?
I mean, is it I mean, twenty six years ago is what year? It's 2000.
It was 2000. Yeah.
So my god. You were, okay, you were diagnosed at four years old the year that the year my son was born. That's interesting. So I'm putting myself back in that space and that situation. That's Mhmm.
Six years before Arden was diagnosed. When Arden was diagnosed, they only gave you so were you getting would you have, like, Humalog and Lantus? Or do you were were you still the back end of regular and Miles per hour? Do you remember?
I genuinely don't remember.
Okay. Alright. What's the first time you remember, like, how you managed? Like, when you look back, do you think, like, did you give yourself your own shots at some point? Were you
Giving Her Own Shots at Six8:21
on a pump? I was my parents and I were really proud. So I was six years old when I started giving myself my own shots. Nice. My own injections.
Yeah.
And how often how often did you do them?
For every meal, of course. And then, I had, morning and a nighttime long acting.
Okay. Alright. So you were using probably Humalog and Lantus or something like that?
Probably. Yeah.
Okay. And so are you doing the math at your meals at six or no? You're just your parents are handing you a needle and you're you're doing the the work?
I would say probably at eight, I was doing the math. I remember distinctly being very proud, at winning, like, around the world. I don't know if you know that game, like, school game, around the world in math class.
I thought that was a guessing game. So I guess I don't know what you're talking
about. What?
I thought that I thought that wasn't that like a party game? Like sorry. No.
Thinking of, like, seven minutes in heaven?
I don't know. Maybe. Is that what I'm thinking of? I can't believe you just pulled that out, like, it was a real thing. Is that when they shove you in a closet?
Yeah. Okay.
Alright. I don't know what I'm thinking of then. No.
Absolutely not. Obviously, it's
not what you were doing when you were eight years old. That's not what I was saying.
Not in the not in the math classroom. No.
Not in the math classroom. Okay. So you remember go ahead. You were very proud. Sorry.
So, basically, the teacher would hold up a flashcard, like a multiplication flashcard, and one person would stand up next to, like, the the front row desk. And so it was, like, one person against the other student. And whoever got the flashcard correctly would move on to the next student and then the next and the next. And, if you got, like, you know, through all of the students, then you won around the world.
And you won this because your math was so excellent. Your math
was so excellent due to diabetes.
There you go. And today, you're an accountant.
My mom is, actually.
Oh, no kidding.
Today, I am a special education teacher.
Oh, that's lovely. Look at you. Okay. Alright. So you had you had some nice moments growing up.
Do you know what your outcomes were like or even what goals were were set as? Like, what did healthy mean to you when you were younger?
An Endo Whose Method Was Yelling10:49
Yeah. Healthy meant just playing sports a lot. I really love just being outside and playing sports with my dad and my cousin. And, yeah, I just I just loved being outside. And then going I hated going to the endo, honestly, because he his form of doctoring was yelling.
Really? And yes. And then once I hit puberty, his form of doctoring well, that's that's such a great verb, was accusing me of being anorexic.
What were
Which
Okay. Were you? Were you?
No. No. No. I never actually had any form of ED, and which is so funny because you can tell I have a bone to pick with him.
So I can't you know, I'm I'm trying to get to it. Don't worry. Go ahead.
Yeah. Yeah. Yeah. My mom is a very petite woman, and my dad is very tall. So I'm just like, sir, the math is right in front of your eyes.
Like, I don't understand why you think me being a skinny tall girl, like, is an issue.
Oh, so that was it. It was your body style that made him think that? Yeah. And you're saying he could have easily looked at your parents and saw that you had a tiny mom and a really tall thin dad and thought that makes sense that she's built this way.
Yeah. I mean, my don't get me wrong. My dad was not thin. He's he's he's a big boy, he's also very tall, and my mom is very thin and tiny. And, also, as an endocrinologist, he also should have seen that my blood sugars were very out of control.
And, obviously, we all know that when you have a high a one c, you tend to be skinny.
So, also, you're, what do you mean out of control? Like, how where were your a one c's at?
I mean, about 10.
Pretty consistently? Like, stably 10, or did they bounce around?
I mean, nine, ten. It was it was pretty bad.
Okay. Why do you think that was?
Magical Thinking and a Sixty-Carb Rule13:16
I think lack of education. You know, the we didn't have the juice box podcast. So
You just think we just don't think you like I mean, but but seriously, like, you miscounting carbs? Are you even being told to count carbs? Are you not injecting for everything you eat? Are you, like, forgetting the basal?
I I was not pre bolusing long enough. I did I did bolus on, like, every single time. Mhmm. And I also, with reflection, believe there was a lot of magical thinking because I was so hungry all the time. Like, I was I had a, like, a high metabolism for sure.
So we have, like, a set like, you eat 60 carbs at every meal type of deal.
Okay.
And so if I wanted, like like, 20 more carbs, but I was at, like, 50, I was like, oh, well, like, that might have only been 45 and, like, so maybe I can have this biscuit that's 20, but, like, 15 carbs is not so far from 20. So it's okay.
You start lying to yourself about the the truth about the math of what you're eating.
Exactly.
And then so eating more, but then not giving insulin later for that.
Yeah.
Okay.
Because you're not because I wasn't really taught, you know, to give more in those situations so that I can cover the carbs. It was just like, oh, no. You only have 60 and, like, this is how much.
Okay. I gotcha. But then you go to the doctor and your a one c is higher. Does that not say to you, I must not be using enough insulin?
I think the culture that I grew up in, my parents and I, we were just taught, like, the doctor is the professional, and you listen to the professionals, and that's that. Like, you don't question. You don't you don't get creative.
What what culture? You did this
I see what you're doing.
You did this spelling, not me. Go ahead. What culture? I mean, I can see I can you know what I mean? Like, I I I can guess, but it's so if you can tell me, it'll it'll go quicker when I tell you probably live in California.
But go ahead.
So they grew up my mom I guess, like
You don't wanna say?
Screw up.
You don't have to say. No.
No. No. No. No. No.
I at first, I I didn't wanna say because then it would give you a hint as to if he grew up.
Listen. You can't you can't defend. I get to ask questions. Questions. Go ahead.
Yes. Yes. That's true. Okay. They both grew up very, very low income, like, you know, stamps and all that.
Mhmm. So I think that has, like, a huge impact on, you know, having great respect for those who have a much higher education than you. And then, also, they both grew up Catholic. And, again, like, that's, like, rule following and all of that.
Okay. So by culture, you mean, maybe looking up to people who have, you know, achieved more than they feel like they have and Mhmm. That they were Catholics, so there was a lot of you do what you're told.
Right.
Okay. Little do what you're told, little bit of that. I got you. So then but then if the doctor's yelling that you're I'm assuming that yelling was your a one c is 10. Right?
Mhmm.
Okay. Then why didn't we then not do what we were told and take care of it? Was it because you didn't get actual information about what to do next? You know what I mean? Like, sometimes they're like they're like, just fix it.
And then you're like, well, how? And then there's no answer to that.
Yeah. I mean, from what I remember, that's basically what it felt like.
Okay. So a lot of demands, not a lot of direction.
Mhmm.
Okay. So how does that strike you then when you're a kid? Like, you're being told you're doing the wrong thing. Meanwhile, you said your your bowl is synced for all your food. You feel you probably feel you probably feel like, hey, I'm putting a lot of effort into this.
I'm not I'm not getting outcomes. You're telling me I'm wrong, but you're not giving me any direction. So what does that, like, turn on yourself and makes you just feel like you're messing it up?
Yeah. It just felt very stressful.
Okay. Constantly. I would I would imagine. Yeah.
Yeah. I mean, like, I grew up as a kid that was very placating, just for the way that I grew up.
What do you mean by that? So
What Was Happening at Home18:28
both my parents were abused in different ways, and my dad especially let me know, and he probably should not have because it took a toll on, like, my mental health. And so and then he kind of, like, passed down some of that to me.
So your father so your father was abused. He he abused you and told you about what was done to
him. Right. Okay.
And
Which kind of, like, was an excuse.
For what he was doing. Mhmm. Okay. And how and I'm sorry. We got to that kind of, like, oddly.
So I started off by asking you if you're being told what to do and your family's a bunch of rule followers, how come the out the outcome isn't different? And I think we get to it's probably because there was no actual direction about what to do. Just you're not doing well, like, do better. And then what happens? Does your dad do the same thing?
He tells you do better?
Mhmm.
Okay. And again, you're a young kid and you don't have any context for what do better means. So the doctor doesn't tell you what to do. Your dad doesn't tell you what to do. Everyone's yelling, some people are hitting you?
No. No. It's it's just verbal and emotional abuse and it's just like trying to figure out how best I can please people.
So you're being badgered and that turns you into a people pleaser?
Mhmm.
Gotcha. Is that still a problem for you today?
Yes. But I have grown quite a bit this past decade once I figured out that that's what was going on when I was a kid.
Yeah. Did you go to therapy to figure it out?
Finding the Words for It20:32
I started going to therapy in high school when I realized I was depressed, but I didn't figure out that I had been experiencing, like, verbal and emotional abuse until college when I was when I took, like, a psychological class and was reading, like, the definition and symptoms in a book. And I was like, oh my gosh. Like, that's me.
Yeah. Oh, isn't that something? You you found out in a book what was happening to you?
Yeah. Well, that's
was that really
They call it
Good.
They call it Sorry. They they call it something when it's, like, co co something. It's it's not normal where, like, a parent relies on the kid.
Oh, codependency.
Codependency. Thank you. Mhmm. And that's basically what was happening. Like, the like, my dad was relying on me as, like, his therapist, and he and we shouldn't be doing that.
Yeah. No kidding. When you read in when you're in college and you read about like this thing that you're like, oh, that's my life. Is that relieving to you or is it is it just tell you, gosh, I probably have some things to figure out? Like, where do you go from there once you read that?
Yeah. I I'd say it's both. It was it was definitely like a relief. It was it was like, wow. This this makes a lot of sense as to why I am the way I am.
Meaning people pleasing? Yeah. Depressed too?
Depressed, people pleasing, anxious.
Describe the depression.
Well, it's it's difficult because the anxiety and depression, like, kind of work together. Like, the anxiety will push me out of the depression to, like, go and, like, work so hard, but then, like, to get good grades and, like, to overachieve and things like that. But then the depression is like, oh, like, all these people hate me and, like, I I suck at, like, everything even though, like, I've achieved so much. So it's
You're doing well.
It's really negative self talk.
Yeah. Yeah. You're doing well on the outside, but you're you're telling yourself well, you're not telling yourself, but yourself is telling you that it's a failure and people don't like you. And so all that Mhmm. All that is likely from how you were treated at home, you feel.
Yeah.
Yeah. And then you go to a therapist and but they go, like, magic wand. Right? And then it just goes away. Or do you talk for That's okay.
You talk for a number of years till you get through it?
No. No?
Did did are you married now or dating or anything?
I am. Yeah.
Did you meet a meet a guy that was helpful with you for this stuff?
Yeah. I mean, I I I don't wanna say that he I don't I don't want anyone to think that, like, you if you're in my situation, all you gotta do is, like, go out and find the right person. They're gonna fix you because that's not what happened. Like, I worked on myself for so long, and I found out as well that I have PMDD, which is premenstrual dysphoric disorder. So my depression actually gets worse around that time of the month.
So it is also, like, hormonal as well.
Yeah.
So I found, like, the right medication to help me through that. And
Very nice. What what what medication helps with that?
It's Lexapro.
Okay. Hey, Bella. I'm sorry. Is there a fan on behind you or something that's making a consistent noise?
No.
No? Okay. Lexapro, how long you've been using that?
Four years.
Okay. And describe what it's done for you.
It has helped me with mood swings and helped those negative voices, like, help me check those negative voices.
Any value for the anxiety? Any value for anything else that you're seeing a benefit anywhere besides that?
Yeah. I would say the anxiety has quieted as well. I no, baby. My cat wants to go on my lap right now, but I have my laptop open. Yeah.
I would say it's turned my PMDD into regular PMS symptoms.
I gotcha. So you went from bad to
yeah. Yeah.
That's not bad. It's a good that's a good reduction in Absolutely. Yeah. How about the way you deal with other people? Was that ever an issue or did was most of this internal for you?
Like, did you well, my question is is did you lash out at other people the way you probably should have fought back against your parents?
I would sometimes snap, and I don't know if that was oh, oh, hello. Can you hear my cat burn?
No. Don't listen. That people will find that delightful if they can hear your cat burn. Don't worry about that. I'm actually worried about I I think I should take a five second break and go feed this lizard because he's running around like crazy, making all kinds of noise.
And he's just
Oh, I can't hear it.
He oh, you can't? Good. He is just desperately looking for a bug. And I feel like if I just gave him one, he would relax a little bit. Oh.
Sorry.
You should do that.
Do you want me to do that? Alright. Hold on one second. I'm actually going to because I think it'll help me, to not have to worry about it. Give me one second while I pause.
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Alright. I'm back. We're being recorded again. What I just did can only be described as horrifying, but it's what they eat. So now it'll it'll take I said him.
It's her. I feel bad about misgendering the lizard.
How dare you?
But she's gonna start, like, walking around. She's flicking her tongue. She's figuring out, like, there's something in here that smells like food. She's doing it right now. Like, she slowed down completely and is, like, is now, like, kind of instead of running around, she's I wish you could see her.
She's like a snake with legs. Here she goes. She's climbing up the side of the wall. Up. She's by the cup.
There's there's there's more flicking flicking. They're in there. Go ahead. Go get them. She she she doesn't understand English.
I and I don't know any other languages. So, I mean, if she
That's a shame.
Yeah. If do do you speak any other languages? Okay. There we go. We're getting there.
I'm also learning Romanian.
Romanian?
Yeah. For what? My husband's Romanian. Oh, go and visit the old the old country.
Oh, very nice. Your husband's Romanian. You have a little Spanish. I got I okay. I mean, I I
I can I can converse in Spanish, actually?
You have a very clean, American accent
Thank you.
Which which trends West Coast. Am I right?
Okay.
Like, okay. I think I hit it early and you just you don't wanna say.
I will tell you that I have a lot of international friends.
Okay. You have a lot of international friends? What does that mean? You live near an airport? What's going on there with that?
Okay. So Maybe. So your story is it's interesting. When we started talking before we recorded, you were like, you know, I have something to share, and I don't think it's really an after dark. But so far, you've talked about a lot of I mean, I don't find it to be after dark's a weird thing for me because I don't particularly enjoy calling the episodes after dark.
It's just a way to let people know we're gonna be talking about stuff like this. Mhmm. But I don't see this as anything different than anybody else's, you know, day to day struggles or lives or whatever. Yeah. It's just stuff that happens.
So Okay. Yeah. Yeah. Yeah. Okay.
So let's make sure we understand where we're at here so far. You are a young girl, back in our story. You're going through a lot. You get to college. You start figuring out what's going on.
You go to therapy. You move through those things. But through that time, is your a one c changing at all? Or are you in college at a nine or a 10?
I think I got it down to like an eight. I am like like moving all around a lot more, of course. Ow, gosh. She just headbutted me, my cat sugar.
The cat's coming for you.
Yeah. I mean, like, in a good way. She just wants attention. She's so sweet.
But I
can Don't you find it ironic also that her name is Sugar?
Well, you have diabetes.
Yeah. But I didn't name her. She chose me.
Oh, you you when you got the cat, it already had the name Sugar?
Yeah. I adopted her and she was like she literally reached her paw paw out to my mom and she my mom's like, oh my gosh, she wants us. And I looked at her and I was like, I
don't know if
I want a gray cat.
Well, here it is. So you get it how do you get it down to an eight? You think it's just activity, like walking around? Was a big campus you were walking around all
the time? Think it yeah. It was a big campus. I think I just was walking around, and I started to utilize the gym more. And I started boxing, so, like, I was lifting weights as well so I could get stronger.
Mhmm. And
so just activity alone, did you change how you ate at school versus home? I
was I was working, and I didn't wanna ask my parents for money. So I was eating, like, cans of peas and, like, salads and stuff, and I was not eating super healthy.
Why didn't you wanna eat why didn't you wanna excuse me. Why didn't you wanna ask your parents for help?
Because they just worked so hard, and I and I don't know. I just didn't wanna, like, take from them.
Okay. So they grew up broke, but as you were in by the time you were in college, were they still on the broke side?
Were middle class.
Middle class by then. Okay. So they could have afforded to help you eat.
Yeah. For sure.
No one ever said, hey. What are you eating? Do you need a do you eat 50? Nothing
like that. My dad would come up and buy me groceries, but I just hated to, like, use their money. So I would just kinda rely on the money that I got from working on campus. Okay. And I also just hated to, like, go to the store using the bus.
You're like, listen. I was hungry, but not hungry enough to get on the bus. Okay? That's all. I I the I've got a line.
So you're eating cans of peas?
These are good.
Yeah. I know. But that's happened more than once. You're like, for like, I'm hungry. I'm gonna crack open a can of peas now.
When the Injections Stopped Working33:59
Yeah. Also, Scott, this was the time that my legs were just and my stomach was were just, like, rejecting shots.
What do you mean?
Like, they were rejecting the the needles. I was trying to poke myself, like, up to five times and having such a tough time. Like, my skin was becoming tough.
Were you injecting in, like, the same areas over and over again?
I would go, like, all around the world.
So so you it's not that you were, like, injecting one, like, small area over and over and it got, like, scarred. No. You what do you mean? What would you do were you bit by a radioactive spider at any point in that time? Or, like, what do mean your your skin?
But that doesn't make any sense.
Yeah. I don't know. I just couldn't find, like, any space in my body that, you know, I
was supposed to go in?
Yeah. Where the needle would go in. It was getting crazy. And so finally, I was like, this is ridiculous. So I started looking into an insulin pump by then, and I wish I had done it sooner because it's changed my life as I'm sure thousands of people, can attest to.
So insulin pump takes your eight a one c to where?
The Pump, Then the CGM35:22
Now I'm at a 6.2.
And did you have a CGM in college?
No.
Do you have one now?
I do.
Okay. How long have you had a CGM?
Let's see. I got the CGM. Which one did I get first? Well, anyway, I got them about the same time.
In somewhere around college time.
So I got the insulin pump in 2017, I wanna say, or so.
Okay.
And then I got this actually, I got the CGM much later. I got it in, like, 2021.
Oh, so you've only had a CGM for about four or five years?
Yeah. Because I remember teaching and the and I had to, like, check my blood sugar and the kids all literally, everyone just stopped. You coulda heard a pin drop, and they all just looked at me. And I was like, I'm I'm fine, guys.
Just look at him and go, hey. Listen. My dad was abused. Do you want me to tell you about that? Alright?
Oh my gosh. That'll that'll that'll that'll shut you up, kids. But you hear the stories that I was told. You're getting off light watching you're getting off light watching me test my blood sugar.
They were so kind, though.
Oh, that's nice. So so you've had a CGM for five years or so. Are you automated now or you automatic? You are. What what system are you using?
So I'm on the Dexcom Mhmm. And Omnipod five.
Okay. And before Omnipod five, you were using Omnipod dash?
Right.
Okay. So you've only ever been Omnipod?
Only Omnipod. Yep.
Okay. And that took your a one c from the eights down further. And then were you getting low a lot with out of CGM, or how did you were you testing a bunch? How did you manage your your, you know, understanding what your blood sugar was?
No. I would say I was still kind of high, honestly.
Even with okay.
Yeah. Even with the Omnipod, I was still kind of high. I guess my set like, I I was scared to, like, dial in my settings too much.
Mhmm. How do you
Until I got my CGM.
So you got your CGM. And how long have you been married?
Our first anniversary was June 14.
Oh, you've only been married a year?
Mhmm.
Oh, congratulations.
Thank you so much.
One year's paper. What did you get? Was there a gift? Listen. I'm gonna be married thirty years in, two weeks.
I haven't gotten my wife anything. The only thing that's making me feel better is that I know for sure she didn't give me anything. So I'm good.
We we went out and we had a great time at Dave and Buster's, and which is what we like to do. We prefer experiences. But I also made him he likes those ranking videos. I don't know if you've seen those on YouTube.
What do you mean?
Like, you rank like, a lot of a lot of people, they'll rank, like, their favorite movies, and it'll be, like, a b c d e. Yeah. Or, like, there's an s tier. And so I did that, but, like, with our dates. And so I had pictures from, like, a lot of our dates this past year.
And so I just ranked, like, the dates based on, like, romance, food, funny moments, and things like that.
What a nice night date.
Then did, like, a like a overview of them and he loved it.
That's really cool. What did he get you?
I don't remember.
Oh my gosh. This is where guys go wrong. We're not good at gift giving. Women are much better, I think. I'm generalizing.
I believe women are much better at gift giving than men are. You know, big big picture.
So You know what? Yeah. He was also working nights, so I understand.
Yeah. Working nights in the hospital?
Yeah.
Okay. What kind of doctor is he?
A hospitalist.
And did your well, I guess I should ask you. You've been married for a year, but how long have you been together?
We started dating ow. She just bit my neck.
Sugar bit your neck?
Yeah. Is
she a vampire cat?
She's not Romanian.
I was trying to get to that, Bella. How come you didn't let me get to it?
She didn't I'm quicker.
She didn't whisper in your ear, I want to suck your blood. Nothing like that happened first?
No. No. She was she was being very sweet actually, which is, I guess, very vampirical.
What if your husband is a vampire and he's just setting you up?
That's a long setup. How
long have you been together now? What you were getting ready to say when the cat attacked you?
Yeah. June '23.
Okay. So twenty four, twenty five, twenty so you've been together about three years?
Mhmm.
And how long have you had a CGM for?
Since, like
About five years.
'21. Yeah. Five years.
And when did your a one c start coming down?
Oh my gosh. Oh, well, it really came down in '20 in, like, January '23
Okay.
Or or late twenty two.
So a little after you had a CGM?
Yeah. Yeah. Yeah.
And what did what changed?
The Post That Changed Everything41:15
Well, I got the CGM, and I was actually looking to move out of state. And one of my nurses that I've had since I was diagnosed, she suggested your Facebook group. And so then I started listening to your podcast, and I was convicted to start prevo listening. Actually, no. No.
No. Before that, I saw a post by someone. I don't remember, so I apologize to that person, but thank you. They told me about the 10% rule to prebolise 10% of your blood sugar, and I have followed that, like, bible since. That's working.
That's working. That person.
Mhmm. No kidding. So to explain it explain it to people.
Yeah. So if your blood sugar is, like, 100, then you're going to pre bolus by ten minutes. So you're gonna wait ten minutes, and then you're gonna start eating after you take your shot.
Well, I'm interested that you brought this up because I have added pages to my website about this. I haven't told anybody about it yet. So can I tell people about it now?
Please do.
Juiceboxpodcast.com/rule,rule,101zero. It's not like a rule rule, but it's it's what I it says right on the website. Rule is just what the community calls it. A juice box idea for thinking about pre meal timing divided b g by 10 starting lead time in minutes. So there's a little thing here.
You can, like, click in. Let's say your blood sugar is one fifty six, then your pre bolus should be sixteen minutes. If you're above your target, if you're in range and you can like it's so you can there's a little slider here. Right? And it will tell you, like, you can slide up and down your BG, you can type your BG in.
So 135 is an in range blood sugar. Fourteen minutes is an illustrated illustrated start window, and that's it. Now it explains kinda what the the rule. I know it's, like, not really a rule, but they it's a mental shortcut for pre bolus timing. And then when you're done with that page, if you want to continue on, at the bottom, you can go to the thirty, sixty, 90 forecast.
And once you get to that page, it'll tell you where possibly your blood sugar will be in thirty minutes. So it's an interesting way to, like, before the bolus, after the bolus. So again, you put in, like, a one fifty six blood sugar and then attribute an arrow to it. Very fast rate up, fast rate up, slow rise, all that stuff will call it a slow fall. So if you have a one fifty six blood sugar with a slow fall, a diagonal down arrow, in thirty minutes, your blood sugar might be about one twenty six.
It just kinda shows you what fall rates can it's just it's just so that you can kind of visualize those arrows direction and where you might be headed. Does that make sense?
That is so cool.
Thank you. And there's like a little slide here you can like change to mess with it. It's to kinda help yourself like visualize things better.
I love that. Did you make that with AI?
Of course, did. And it's it's my ideas that I turned it into hold on. Then there's the thing at the end that's called after. So it's like, it's before the rule of 10, during the thirty, sixty, 90, and then after reading your CGM trace. And then you can sort of do this.
It it gives you little things like you saw this. You saw a BG spike then came back down on its own. The timing clue about that is that the insulin eventually caught up, and brought glucose back in range, which suggests the dose was probably about right. But the spike tells you the insulin wasn't working yet. When the carbs arrived, the insulin didn't get enough of a head start before it had to compete with the meal.
So what you can explore is whether a longer pre bolus window fits a similar meal, blah blah blah. So, anyway, it gives you, like, you saw a BG spike, then it came back down on its own. You saw a BG went low within an hour of eating. BG went up gradually and kinda stayed there. BG shot up and stayed up.
BG went low two to three hours after eating. So there are three different web pages that all connect to each other and kinda help you before, during, and after your meal. I was I've been working on that for a while. I can't believe I haven't told anybody about that yet. You guys there's so much on that website I never tell you about.
I apologize. But it's called it's called rule of 10. It's in the menu at the top if you wanna go to it. Rule of ten, thirty, sixty, ninety forecast, and reading your CGM trace. So those are three new pages on the website.
And I can't believe it's a
thing. Amazing.
Thank you. You'll check it out. You'll love it. But but you but you saw somebody talking about that online, and you're like, oh, that's a a rule of thumb that I could probably make sense of.
Protein Isn't Free, and the Warsaw Method46:19
Yeah. Absolutely. So I started doing that, and things just started getting better and better. And then, you know, people were talking about your podcast. I was like, like a lot of people say, I'm not a podcast person.
But I started looking around, and then I started doing other things and learned about how protein actually isn't free carbs like I was told when I was a kid.
Mhmm.
And then recently heard about the Warsaw method, and I've been implementing that. And I really appreciate whoever made the website, the calculator. So I've been implementing that, and I'm telling everybody about it.
I The the one on
my only half.
The one on my the one on my site? The the the estimator on my site? Is that what you're talking about? Or you talking did you find a different one?
I, no. It's a different one. I I apologize.
Don't you have to apologize. You can I'm
It's sure the Omni calculator.
Okay. I'm sorry. I'm assuming they're all based on the same math. Yeah. Wait.
But if you want, you can check mine out too. When you're when you're on the site later, take a look at it.
I will.
Yeah. But the Warsaw method of understanding how to cover fat with insulin, huge help.
Oh, absolutely. Yeah. It's crazy. Especially with pizza, I'm like, oh my gosh. I'd literally every time I eat pizza, I'm like, oh my gosh.
I stay within range.
It's awesome. So what you're basically telling me is that you just needed some tools to figure out how to do this stuff. A little bit of information, a little bit of tools.
Yeah. Basically.
So yelling at you was never gonna get you to understand that fat can impact your blood sugar.
Crazy.
Fascinating. Who knew?
Right. Knew?
Knew? Certainly not me. I am really touched and thrilled that this podcast has been so helpful for you and the group and the community around it. And I would say to people who say I'm not a podcast person, I think you're just not a crappy podcast person. And I understand.
I've I've heard some bad podcasts in my life, but this isn't one of them. So, you know
Yeah. No. I greatly appreciate it. If you're you know, even if you set it, like, on while you're cleaning, you'll still glean, like, a lot of great information. And I really wish that I'd found it sooner.
I appreciate that. I'm glad and I appreciate you taking the time to tell people that too because
Oh, yeah. I tell everyone that. Like, anyone I meet who is either in the health care field or has diabetes, whether it's type one, type two, three c, whatever, you know, I tell literally everyone about your podcast, about the Facebook group. I tell them about the Warsaw method.
Look at you. You know, when you're out there spreading the good word as they say.
And the actual good word as well.
Finally, something actually, based in Catholicism is happening to you Catholic.
I'm not Catholic, actually. Oh,
you what they call a reformed Catholic? Or
No. Absolutely not.
No? You just ran from the whole thing when you saw your parents?
My parents are not Catholic, actually. They were raised Catholic, but if you don't mind
Oh, they they they they're reformed Catholics. Gave it up. They gave it up way before they had you.
So they stopped going, but I if I may Mhmm. I could not have gotten through my childhood situation without, like, the holy spirit guiding me. And, like, with the the abuse and the the diabetes and just everything, I really felt like the holy spirit was guiding me.
You you found another church, or you just found
I I continued to go to, like, protestant churches, and then eventually, a friend from high school invited me to his church. And that became my home church for twelve years until I got married, and we had to move for my husband's job. But I was very involved. I had helpless food pantry and went on a mission trip and helpless children's ministry. And, oh my gosh, I love my church so much, the way they're involved in the community.
That's beautiful.
Amazing. Like, they I'll just say the Lord saved my life.
Oh, that's wonderful. I'm that I'm thrilled for you. I'd I'd be happy to hear that anything saved your life. That's a fantastic thing. So you even though your parents didn't give you, I mean, they they seem probably disenchanted with their religious upbringing.
But even though they
They come to Christ. They did. They they were always they were always Christian, just not Catholic.
Gotcha. I gotcha. No. I I understand. Well, that's really fantastic.
And you're still practicing now?
Oh, yeah. Oh, yeah. I'm very, very much involved. Very, very enchanted. Lovely.
Lovely. And
you have kids or no? I didn't ask.
Not yet. We're waiting for him to be done with residency.
Oh, and then we're gonna start I was gonna say bang them out, but that's what I meant. You're gonna start you're gonna you're gonna have a bunch of them or you're have one. What's your play?
Probably about four.
Four? That's one for each appendage. You'll have to hold two with your feet, two with your hands. It's gonna be something.
He also has two
Oh, no.
No. Two arms.
No. We we we can't help with that stuff. There's football on. Do you understand? No.
He can't he really can't wait to be a dad.
That's awesome. How old are you again? You're 30?
We're both 30. Yeah.
About 30. Well, you better I mean, I don't but, you know, it's it's time. You know what I mean?
Trust me. I know. It's hard to wait, but at the same time, like
You're waiting for money? Like, the for things to stabilize?
No. No. No. No. We're not waiting for money.
No? We're just we don't wanna be so stressed. You know?
I mean, I I know. I I've got two kids. I know exactly what you're talking about.
Yeah. You totally understand.
Yeah. I do.
Because, like, he he'll be working nights and then also, like, twelve, fourteen hour shifts, and it's just why when when we have the ability to wait, not everyone a lot of people don't have the ability to wait. But, like, when we have the ability to wait, why not take that advantage?
I mean, it's it's smart to do it when you think it's best. That's all. Yeah. That's that's awesome. So he's what?
He's in residency still?
Yeah. Yeah.
But not much longer.
He has two more years. So, like, next year is when we'll start.
Yeah. Yeah. That's right. We only he only needs about three day break after residency before the baby comes. So Exactly.
Yeah. Yeah. Plus, it would give him something to be excited about that last year.
Exactly. Unless
you get pregnant immediately and ruin it, which I do, which does happen sometimes. You know? Talk to so many guys and they're like, we're gonna have a baby. I'm gonna have sex all the time. And then they're back, like, five minutes later, like, well, she's pregnant.
I was like, I don't think you're supposed to do it the first time, but it happens the way it happens. You know what I mean? Take all the fun out of babies. But if you're gonna do four, he'll at least get three more tries after that.
That's right.
It's gonna be fantastic. And are you gonna continue working when you have kids, or are you thinking about staying home?
So, you know, I'll take care of them until they're school age. So I'll stay at home until they're school age and then go back to work Nice. As a special education teacher. So, yeah, I'll keep up with my, professional degree
Nice.
In that way.
And you are prepared for I mean, it sounds like to me like you're fine with your blood sugars, but, know, you if you're having hormonal fluctuations already, you're prepared for all that. You you know the you know the playbook. You're probably gonna need more insulin when you're pregnant kind of thing. It's gonna ramp up and then suddenly you give they say you pass the placenta and your needs almost immediately go back to where they were before you were pregnant. It's great.
Like Really? Yeah. You gotta listen to some of those pregnancy episodes. Get get get yourself ready.
After the A1C Came Down54:37
I actually have been on a weight loss journey. So I I did kinda wanna talk about this a little bit. So when I when my a one c went, like, crashing down to 6.2, which I was very, like, amazed by and, like, happy with, but I gained, like, 25 pounds immediately. And then over the past year, I gained another, like, 15 pounds. And that's been, like, really difficult mentally
Yeah.
Because I've always been finally started
you finally well, you're not for nothing. You're probably skinnier because your blood sugars were higher.
And Exactly.
And now you're taking the right amount of insulin. And what'd you learn that you were probably eating more calories than you needed?
I think a little bit, but yeah. I think probably a little bit more, but not like an excessive amount. Okay. I also think that this is probably the weight that my body prefers. And as we all know, like, the scale doesn't tell you how much muscle you have, and I know I do have, like, quite a bit of muscle.
Yeah. But at the same time, it's just difficult Mhmm. To, like, look in the mirror and not see, that that
Who you think you are?
I'm not, like, saying that I'm, like, a model, but I'm saying, like, my body was, like, that model size.
And now So what are you doing? Are you exercising, changing how you're eating, what you're eating?
I am. I'm counting my calories. I'm counting my fat and protein. I'm sorry. My fiber and protein, and I'm weightlifting.
And so I actually have increased my weights recently and noticed that I am going low a lot more often. So I'm currently in a state of, like, recalibrating, you know, my my settings and all of that. So I bring that up because I'm like, well, I will continue to weight lift when I am pregnant in order to, like, offset the
Kinda keep your needs
from there. Yeah.
Yeah. Oh, that that's fantastic. And, yeah, I mean, if you have you lost weight as your weight as you're working out too?
Not that I can see. No. Just more activity. Stable.
Okay. So you think your insulin needs have changed, but your weight hasn't changed?
Right.
Okay. Oh, it's interesting. Have you considered the GLPs or you you think you're gonna be able to handle it the way you're handling it?
The I don't qualify for the GLPs.
Because of you're not
because I'm not heavy enough.
Your weight your weight's not.
So I am five nine and I weigh one seventy four.
That should get you a GLP. No? No. Okay. Well, I I assume they're going to be prescribing them for type ones the next I mean, I don't know how soon, but it's gotta be sooner than later because there are studies going on right now for it.
So if it's something you're interested in, it it might be it it might be something that's prescribed just, you know, to help with type one diabetes in the in the near future, which I think would be awesome. Well, that's cool. I mean, it's it's good if you do, like, see what was going on, make changes, work towards stuff. I mean, that's Mhmm. That's really fantastic.
Twenty Questions58:09
So now is it time now for us to guess where you're from? Yeah. Alright. So I think I unfairly know your last name, which is right. That kinda gives me a hint about your ethnic background.
Does it?
That isn't that my married name that you know?
I how is that possibly your that's the Romanian last name?
Is it the one that starts with a v? Which one are you looking at?
Yeah. The v.
Yeah. That's my married name.
That's your married name. Oh, now I don't know what's going on. Okay. So so you have okay. So you have, like, a clean accent.
So I don't hear any I don't hear Midwest. I don't hear Southern. You're not from around here. You could maybe be no. You're not a New Yorker.
Alright. So you're not from New York. You're not from Texas. You're not from the Mid States. You're not from the Midwest.
I think you're from Arizona or California. You talked about moving. You talked about I don't know. I'm going why are you giggling? This is not funny.
Is so fun for me.
It's fun for you. Okay.
Yeah. It's like taking a BuzzFeed quiz, but like
Yeah. Well, a little bit more difficult with nobody no questions being asked. I gotta come up with the questions and the answers.
You can ask more questions.
Well, I don't wanna turn do you wanna turn it to 20 questions?
If you want.
Wait. Unless unless you wanna like, don't like, if I've if I've already guessed it correctly, you have to tell me.
Okay.
Okay. So have I?
No. No.
Alright. 20. Oh, alright. Ready? I guess I'll ask 20 yes or no questions.
We've never done this before. So you and I doing this together for the first time.
Are you I love it.
Are you on the are you on the left side of the country? Like, let's first like, knock the country right down the middle. Are you on the left side?
No.
No. Alright. Florida.
No.
No. You're on the right side of the country. I did one time here, Michigan for a second, but it wasn't it wasn't a lot. Plus the husband's probably got an accent. It's probably ruining your accent.
You are a little giggly. Could be Rhode Island. You're not from Virginia. Alright. Ready?
You're not from Virginia. Right?
Correct.
Why are you having so much fun? I I don't hear Pennsylvania. I'm just gonna use up my my this way. Right? No Pennsylvania?
No Pennsylvania.
No Pennsylvania, not Florida, not Virginia, not god. I'm just gonna say New York in case you're from Upstate.
No. No.
Not Michigan. Right side of the country going to Maryland?
No.
North Carolina?
Yeah.
I don't know. You didn't say anything that gets me to figure it out. I think you were holding stuff back that would have helped me figure it out. You did.
No. I was not.
You were not. You in the beginning, you didn't wanna answer a question. You're like, well, I don't wanna give you any answers. Alright. Well, you don't live in the state that you were born in right now.
Is that correct?
I I do live in the state I was born in.
So you moved out and moved back?
No.
I thought you moved at one point.
No. I said I was I wanted to move.
You wanted to move. Alright.
But there were some things that happened. Hurricane Ian happened.
Okay. So you couldn't move?
Correct.
You're not from New Orleans. I don't I mean, what am I missing here? You're not from Alabama. I mean, you said your parents were broke. I guess you could be from Kentucky or Alabama, but I would think you'd have an accent then.
You just have to tell me I give up.
Oh, Scott. Oh, Scott. You were so close.
I was so close. Oh, wait. I do hear
So many times.
There's so there's a little southern in there now. A tight oh, is South Carolina? No. What is that? Oh, and I hear it.
Where is that from? Just tell me.
Michigan1:03:17
I'm from Michigan.
I said Michigan.
You said not Michigan.
No. No. No. No. No.
I I said, oh, I talked myself out of it?
You talked yourself out of it so many times.
Damn it. Damn. Damn. Damn. Damn.
Damn. Accent, broke parents. Mhmm. I was right there. Not the way
You're so close.
You're not you don't you don't have any Spanish background?
No? No. I mean, I've been to Mexico
That doesn't count.
Taught myself Spanish since I was a kid.
Well, you threw me off knowing Spanish. And I and that married last name, I don't He stole that from somebody. That's not that's not Count Dracula, whatever that is.
That's from me. No.
No. It's not. Stop it.
Yes. Is. Look it up.
Look it up. I don't have
Are you familiar?
I don't I don't have time to look it up. Okay? Today is Arden's birthday, and she is texting me Oh my god.
About Happy birthday. No.
Thank you. I'll let her know. She's texting me about, like, are we going? Are we going we're supposed to go pick out a cake for to take to dinner with us tonight. So Alright.
I can't believe I had because I got Michigan early on once I split the country in half, and then I gave up on it.
You did. You kept saying not Michigan.
So I know it. I I just wanna say I know everybody in Michigan is not broke. There are broke people everywhere. Just like I by the way, I was completely broke growing up when I was in Pennsylvania. I don't know.
I was just generalizing trying to find something. You know what I do. I can't believe it didn't work this time. That's fine. Will you win?
That's fine. Yeah. The thing that I didn't wanna tell you earlier was that my dad's side is Irish, and my mom's side is mainly English German. So I felt like that would have told you Michigan. Or at least if you know anything about Michigan, then that would have
I know.
Given you a hint.
I know m and m's. Car industry used to be there. I know these things. I know the I know every
Our industry is so here.
I know everybody thought the lions were gonna be good, but they still suck. What do you think of that? You care about comments. Alright. Listen.
Go make a bunch of babies with that doctor boy of yours and and
I will.
And go forth and prosper. I appreciate you doing this with me. Hold on one second. Okay?
Okay.
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Today's episode was sponsored by the Contour Next Gen blood glucose meter. It's the meter my daughter uses. She has it on it right now, and you're one click away from having it too. And don't forget using Juicebox podcast links helps support the show. Friends, my diabetes pro tip series is about cutting through the clutter of diabetes management to give you the straightforward practical insights that truly make a difference.
This series is all about mastering the fundamentals, whether it's the basics of insulin, dosing adjustments, or everyday management strategies that will empower you to take control. I am joined by Jenny Smith, who is a diabetes educator with over thirty five years of personal experience, and we break down the complex concepts into simple actionable tips. The diabetes pro tip series runs between episode one thousand and one thousand twenty five in your podcast player, where you can listen to it at juiceboxpodcast.com by going up in the menu. If this is your first time listening to the juice box podcast and you'd like to hear more, download Apple Podcast or Spotify, really any audio app at all. Look for the juice box podcast and follow or subscribe.
We put out new content every day that you'll enjoy. Are you tired of scrolling past clips that last five seconds? Are you an adult? Would you like to have a long conversation? Juice box podcast is the place to be.
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