#1919 Hurricane Levi
Hurricane Levi
Welcome 0:06
Friends, we're all back together for another episode of the Juice Box podcast. If you or a loved one is newly diagnosed with type one diabetes and you're seeking a clear practical perspective, check out the bold beginnings series on the juice box podcast. It's hosted by myself and Jenny Smith, an experienced diabetes educator with over thirty five years personal insight into type one. Our series cuts through the medical jargon and delivers straightforward answers to your most pressing questions. Hey.
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Meeting Tendai and Levi 1:36
Hello, Scott. My name is Tendai, and I have a six year old son, Levi, who has type one diabetes. And we live in Zimbabwe.
Tendai, it's nice to meet you. Am I saying your name right?
Yes. Yes. Awesome.
Is Levi your only child, or do you have others?
Levi is my second child. My first daughter is 17, and Levi is six.
Oh, wow. Look at you. Mhmm. Yes. There other people with type one in your family or Levi's father's family?
Anything like that?
No. There's no history of type one in in mine and my husband's family.
Okay. And and how long ago was he diagnosed?
The Signs She Talked Herself Out Of 2:26
So he was diagnosed in December 2024, just before Christmas.
Oh my. So so it'll be two years this Christmas?
Correct. Yes.
I almost said how old was he when he was introduced to type one diabetes, which is ridiculous because I've asked I've said the word diagnosed thousands of times making this podcast. And I was like, I I I I stopped myself. You'll hear me fumbling through it. Was like, why was I gonna say that? Well, so he's what was he about for when he was diagnosed?
Yes. He was, he just turned four in August of that year.
Okay. And leading up to the diagnosis, things you noticed, or did it it come up very quickly? Was it a slow onset?
Oh, yes. We we we noticed the the usual signs that everybody talks about. So Levi was had been fully potty trained by that age. Mhmm. But I did notice he he went back to bedwetting.
He was drinking tons of water, and and then he started to lose weight.
Mhmm.
As well as towards the towards the end, I did notice some some weight loss. Although, it wasn't until, my mother-in-law mentioned it to me because when you're living with somebody, it's hard to see weight loss. You you get used to that until you don't notice it anymore.
Sure.
But I did notice that he had lost quite a lot of weight. And then, also, by the time I decided to take him to the hospital, he was now, you know, just lethargic, and he would because he's an energetic child. Levi is quite quite a handful Mhmm. Bowls of energy. But at that time, he started to, you know, become weaker.
He would just lie down and fall asleep even in this middle of the living room on the floor. Uh-huh. So I did notice that something was wrong, but I I needed just to mention this because I feel like maybe some people may identify with such a thing that when I was seeing all these symptoms, it did occur to me to take him to see the doctor. But then I couldn't get myself to do it because it was very strange to me to go to the doctor and say, well, my son's not eating much. He's drinking lots of water, and he's going to the bathroom frequently.
Because in my mind, I thought that would come across as, you know, ridiculous. So the doctor would say, well, if he's drinking water, then obviously, he's going to pee more.
Mhmm.
You know? So that's what stopped me from going to the doctor earlier than I should have. At the time we went, I think he was he was close to DKA because we had to rush to the hospital, to the nearest hospital, And then they booked him in, and we were in there for, I think, just a little over a week, close to two weeks.
Mhmm. Two weeks? Mhmm. Really?
Yes. Yeah.
How long between when you when you talked yourself out of going to the doctor and when you actually went to the hospital? How much time was in between there?
I think that took probably a few days. Three to four days.
Okay.
Because I made the decision the night before when he looked just weak. And then I said, no. I've got to go to the doctor, and I went the very next morning.
Mhmm. Mhmm. Yeah. How far was the hospital?
It was, I think, a ten minute drive.
That's okay. Close close to your house or to where you live.
Okay. Yes.
Well well, that's crazy. So out of nowhere for you, it just he was fine one day. The next day, he seemed tired, peed a lot, drank a lot. And then sometime later, you thought he looks, like, weak, ill, close to death? Like, what was the thing that pushed you over the edge?
So he had been, you know, he'd been sleeping a lot more than usual. Like I said, he's very energetic because if he's not jumping all over the place, then something is wrong. So at that point, he was just, you know, sleeping most of the day and not active at all. Mhmm. Then when I was feeding him supper, usually, he would feed himself.
But that particular day, he wouldn't eat. He wouldn't even sit up at all.
Just lifeless. And that mhmm.
He was basically lifeless. I tried to I force fed him, and he threw up a couple of times. And then I thought, nah. Let me just let him sleep it off. I'll rush him to the doctor the following morning.
Mhmm.
And your daughter at that point is maybe 13?
Yes.
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No. At that time, I just because I woke up earlier than usual. So I say to everybody, it was it was actually we call them national holidays here in Zimbabwe. So it was unity day, and everybody was home. Schools were closed.
So I said, I'm gonna rushly by to the to the to see the doctor, and I'll be back real quick. I didn't think it was going to be anything. Mhmm. I thought maybe he was just gonna prescribe him something and would come back home straight after because he was still fairly mobile. He wasn't completely out, but he was, you know, just really weak, but he was conscious.
Mhmm.
So I thought maybe we're gonna get a small prescription and, you know, rush back home. Yeah. Then when I got to the doctor, he he started asking me all these questions, which I was just thinking, okay. You know, what what what do these questions have to do with anything? Then midway through the interview, then he says to me, look.
“Adolescent’s Diabetes” — Get to the Hospital 10:47
I'm not certain, but I think he may have he called it adolescent's diabetes Mhmm. At that time. And I thought, what what is that? I've never heard of such a thing. And he says, yeah.
Anyway, I need you to to get to the nearest hospital because this was the the doctor's surgery.
Sort of like a what would we call that? Like a like a urgent care or something like that? Or Yes. Yes. Right.
And then they and that doctor's telling you, I need you to get to the hospital. They transport you to the hospital, or you have to get yourself there?
He said to me, do you are you good to drive to the hospital? And I said, yeah. Of course. I think I can drive because I still wasn't grasping exactly what was going on. And he didn't give me that much of a sense of urgency, but he did say, you get to the can you drive to the hospital and get there quickly?
And I said, yes. Mhmm. There wasn't a lot of traffic, so I did. And he says, okay. Can you get there now?
And I'm going to follow I'm gonna close the the surgery, and I'm gonna follow you in my own car.
Did that scare you then?
It did.
Yeah.
That was the sign to me that says, okay. So this is this is bigger than I thought it was.
Yeah.
And so on the way, I called my husband and said, look. This is what the doctor is saying. So I'm rushing off to to the hospital, the biggest hospital in the area that we live in. And I also called my parents, and I called his parents as well. And everybody met us there within, I think, twenty minutes.
Yeah. The doctor wanting to escort you over made you think, oh gosh. This is really I mean, he's he's closing the place up and following my my car.
And Exactly.
Yeah. And then starting to think about, like and he asked me, am I okay to drive? I bet what wait. What? Like and then Mhmm.
Yeah. Wow. So there's this Yeah. There's this heavy thing over you that you can't quite conceptualize yet, but the the clues are starting to pull it together for you. And your whole family showed up.
Your parents came. Everybody was there.
My parents were actually making their way from another town, which is far away, but my my my husband's parents actually leave. I think it's a two minute walk from from the hospital. So they were there before the hospital had even finished checking him in.
That's nice. Yeah.
Yeah. So, yeah, the support system was there Right. Quick.
But then how is the how is the medical system? Like, I mean, were were you there two weeks because that's how it is there or because it's not great or because he was so poorly like, was he not doing well? What what's the reason for the long stay?
The Ward, the Nurse, and the Pediatrician 13:37
Okay. So now with with with hindsight, I think I can put it this way to say being in a third world country, Zimbabwe. Right? I think our medical system is not is not that bad. Mhmm.
But it could be better. And now, there's certain things that they do really well, you know, in our country, like, with things like I don't know. Maybe they really did well with COVID. They do well with, you know, immunizations and others, you know, pandemics and HIV and whatnot. But with, in particular, type one diabetes, I think it's still something that is being discovered for the most part because I'll tell you one incident that happened while we were at the hospital.
I think this was maybe day three or four. So we were in the children's ward, right? And being in the children's ward, obviously, there are other children with different conditions. And being Christmas time, most of these kids were getting treats and all these snacks and, you know, nice things. Meanwhile, our our doctor has put Levi on a strict diet at that point.
So he was not having, most of his favorite foods. He wasn't having snacks. He wasn't, you know, having everything else that other kids in the same room were having.
Oh, okay.
So then there's a there's a senior nurse who was just doing her rounds. I think she was just going around looking at the patients. And then she sees me struggling with Levi. Like I said, Levi is, you know, is a handful. So he was really giving me a hard time.
He wants he wants sweets or whatever because he's seeing everybody around having those. And I'm saying, you can't you can't have those right now. And then so she comes in. I think she meant well. She wanted to help.
Then she says she's trying to talk to him. And she says to him, look. You can't have sweets. This is why you are here in the first place. Oh.
So
Awesome.
Can't have sweets. And she's a she's a senior Mhmm. In that hospital.
Who thinks that your four year old who's being diagnosed with type one diabetes is there because of his poor life choices?
Exactly.
Gotcha. So
that's that's the dynamic already. You I I'm sure you get the picture.
Sure.
And, also, our pediatrician, when when he was now when we were about to go home and he's great. We're really happy with everything that he's he taught us. But I have to give him credit for something that he said to me when we were now leaving to go home. He said to me, look. I know the textbook stuff about this condition.
And he said to me, I need you to to get in touch with other parents that have kids with this condition because they're going to tell you things that I can't tell you. I don't have a child with type one, and I don't live with the condition, you know, on a day to day basis. So there's certain things you're going to learn more out there than I can ever tell you.
Well, that's that's good honest inform that's good honest information at least. Yeah. But not Yeah. Not incredibly encouraging, I would matter imagine when you're in the hospital. And the people in the hospital are like, listen.
We don't know the first thing about this. So can you go make a friend who knows about it? And you're like, probably not.
Yeah. That's yeah. It it it gave me mixed feelings, but I've noticed that, yeah, she definitely this whole this world is it's it's a crazy world to be thrown into. Sure.
No matter where you are.
She couldn't possibly know. You don't know what you don't know
Right.
As far as this condition Hey.
You understand. You listen to the podcast. Right?
I do. Yeah. I do listen to it as often as I can.
Yeah. So then, you know, when I talk to people from Canada, I tease them, and I ask them if they ride a polar bear. So it would be unfair if I didn't ask you if there's, like, lions walking around where you live. You
know, I, no. Unfortunately,
they are
not this heavy. I wish they were. Do you? We We we do have in my country, we do have, you know what they call the big five in terms of wildlife.
Okay.
Biggest, game. So we do have a lot of that, apparently.
Can I guess? You have to yes. Sure. Hippos, elephants, rhinos. I'm not gonna get the other two.
Giraffe?
Lions.
And lions. Did I get them?
Yes. Yes.
Yes. I've been to the zoo. I know what's going on. Yeah. Yeah.
Oh, wow. That's and and, like like, roaming naturally, or are they in preserves? Or how how is that handled?
Yes. They are in game reserves.
Wow.
Just in selected areas around the country. So you're you're not going to see them roaming. But but there are certain you know what? What they call them we call them rural areas. There are certain rural areas where you're going to find that elephants do roam freely, and they you you could probably see an elephant just a few feet from your your yard in in other places in the country like, I think it's, I don't know, Binga, is it?
I'm not sure.
Do people keep
them? Geography is not good.
No. Your geography is don't worry. You're asking the wrong person. I'm trying to imagine what time zone you're in right now. What do people keep them ever on, like, farms or on their property, or is that not a thing that happens?
No. No? They they wouldn't. They are protected, obviously, by the government. So they would be they just roam freely.
You wanna hear the weirdest thing?
Specific areas. Yeah.
You wanna hear the weirdest thing about America ever? Do you do you know that Texas has the has more big cats in it than that are privately owned than anywhere else in the world? Oh, really? Isn't that weird? People in Texas
People keep them as pets.
Yeah. Tigers and lions in Texas. I mean, let's go. That's strange. Yeah.
I thought so too. Nevertheless, it's absolutely true. Well, okay. So you're you're at the hospital for, you know, a a bit of time. Are you actually able to cobble together a plan while you're there, or are you just in a panic trying to go out and meet a friend who has diabetes?
So during our stay, our doctor gave us like like I said, he gave he puts my son on a on a diet. He recommended the diet that we should follow, and then he also gave us some reading material just to get to know what's going on and how this condition came you know just information about the condition. So we did have that support because, obviously, the meals were were provided by the by the hospital, and he would come in and see us three times a day, morning, afternoon, and evening, just to check check on everything, Also, to to keep keep tabs on the readings because we were not on we didn't have a continuous glucose monitor during our time in the hospital. We were we were just using the the glucometers to test your sugar levels. Yeah.
Are the are the tools provided by by the government, by the hospital, or do you have to acquire them privately? How does it work there?
Medical Aid, Cash, and $90 Sensors 21:54
Okay. So here, we have we have medical aid. I think you call it medical insurance, same thing. So my medical aid from where I work, I work for a bank, it doesn't cover. They don't provide CGMs, but my husband's workplace does.
So we've been fortunate enough to get those from using his medical aid.
Okay. Yeah. Here, you could only use one. So if usually, a family is covered under one person's employment, that that's great that you have two opt I guess that's not completely true. I've I've seen people do it both ways.
So you were able to put your son on your husband's aid, which got him the CGM?
Yes.
I see.
And then on my aid, that's where we get the insulin and
Oh, that's interesting. You can get some from yours and some that that's actually very reasonable. It's what is it expensive for you? I can I pick in a little bit? Like, what what's a good income where you live?
What's an average income?
I want to say if you're going to be comfortable, have everything taken care of, you could probably do well with maybe 1,200, 1,500 US dollars a month
Okay.
Take home. But then I say that with a bit of reservation because, obviously, it depends on your lifestyle. Some people can get by with 500.
Okay. But you have I mean, you're a family of
just depends Yeah. On on your choices.
Yeah. And you're a family of four, but living with his mom or your mom?
No. It's just the two of us and not two kids.
Oh oh, I oh, so okay. I I misunderstood at some point where the a parent was. So you're a family of four. You're both making an income?
Yes. Yes. We're both And making an income.
And does and is diabetes manageable for you? Is it impossible? Is it somewhere in the middle?
I think it's somewhere in the middle. I think we I think we're doing better now than we were last year and then than we were in the first year.
Okay.
It's helped to listen to the podcast every day because there's definitely things that I I have discovered that I I didn't know about. I like, for instance, I didn't understand the difference between the two injections that we have to give him. We he's he's on multiple daily injections.
Right.
So he's not on a pump. But when we first came out of the hospital, it was really confusing to me which which the differences between the injections because we give him two. He's got a short acting. That's NovoRapid. And then he's got the long acting, which is Protofen.
The two injections meant you know, they were they were the same to me at first.
Right.
So it was only when I listened to your podcast and when I talked to my sister-in-law, who's a nurse, and she explained as well to me, okay. So this is what this one does, and then this is what this one does. But then there's also things like the things that you explain on your podcast about, you know, policing and basal and timing and everything and how to balance those two. That was a bit of a mystery in the beginning. It was just a mess how I think we were handling it.
But I think it's gotten better now. There's still a lot of room for improvement because I'm yet to to master the calculating the carbs, I think.
Is that because our food's not labeled properly, or how how why does that cause you an issue?
Organic Food With No Labels 25:57
Mhmm. Because our our food here in Zimbabwe, it's it's mostly organic. It's easier to find organic food than, the processed foods. So, being organic means there's no labels.
You
basically have to you say that you know or you don't know or you are guessing at least how many carbs or how much protein or fat is in a particular, meal that you've you've pre prepared. So I think that's where I'm I'm yet to to really try and zero in on that and master that.
And Yeah. Is it are you able to use the Internet to help you, or how do you are you is it trial and error?
I've tried the Internet. Yeah. The Internet has helped. This it has definitely helped, but also is most most of it has been trial and error just by observing. I can observe that our staple food here, we call it Sada.
I've observed what salsa does and what the quantities are and how much insulin work well with what quantity of salsa.
And that's all like a it's a that's like a porridge. Right? Like a cornmeal porridge?
Exactly. But it's thicker.
Thicker. Okay.
Mhmm.
And something yeah. I believe it or not, I actually, I'm doing a little bit of, like, research because I wanna be able to talk to you about it. And I just asked it it might surprise you. I asked Chad GPT for five common meals in Zimbabwe. Sazo Sazo was the first.
And then it lists and then it lists it with beef or chicken or goat. Uh-huh. Ready? Hold on. Murawu Andovi, leafy greens cooked with peanut butter.
Is that right?
Yes.
Yeah.
Exactly. Yeah.
Yeah. And so these are things that you just contextually you just have to guess. So do you know even like, did they give you settings for him, carb ratio, basal? Or do you have to figure the whole thing out, or did they at least get him set up by his weight to begin with?
No. That that part, I really had to go onto your your website to try and figure things out on the and then to also Google the rest of the stuff.
Are you using, like, my settings estimator and things like that?
I used that one time
Yeah.
When I was trying to because we had we had a disaster with pizza one time, and I just went and I said, no. No. No. By the way, they have something on there. So let me go and try and, you know, work it out.
And I went there, and I think it worked well. I may not have given it the amount of time that I
should have. To give it more time.
I think I need to give it more time
Yeah.
Because it doesn't look like it it's too difficult. I'm just yeah. Just got a full plate on my on right now, things to do with school and everything. But I I think I'm gonna crack it. If I give it more time, I'm sure we'll be on top of things pretty quickly.
I'm sure you will too. I have to just to take a turn here for a second. This conversation, you're filling my heart up so much today. Thank you so much.
No. Great.
No. I really to hear that this has been valuable to you in a place on the globe that I never even imagined anybody would hear this at is, it's it's very fulfilling to hear this conversation. Like, it's I I I really do appreciate you taking the time to do this. You know, when I try to quantify what I do, it it's difficult. Like, I don't always understand it.
And sometimes people might hear me on here saying, like, you know, the podcast is and it is. It's the it's the best downloaded diabetes podcast in the world, in The United States by leaps and bounds. But and but in, like, 45 other countries, it ranks. And we've we we are it ranks in Zimbabwe. And there's part of me that when I see that, just assume that's a bot or, like, you know, something, but it's it's you and, you know, maybe others too.
I mean, in fairness, it could just be you. But it No. No.
How a WhatsApp Group Found the Podcast 30:20
Let me tell you. I heard about you from another parent of a child with type one. You know, these people that I started to connect with following
No. Tendi, shit. You're gonna make me cry. Hold on a second.
So I'm I'm in a city called Vulawayo in Zimbabwe, and this lady is in Harare. That's the capital city. So she said to me, can you go and listen to the juice juice box podcast? And then in the WhatsApp group that we have with several parents, I'm not sure how many we have, but there's quite a number of us. Yeah.
This it includes parents from South Africa as well. And everybody does mention, you know, recommend, especially when we welcome a new parent into the group. One of the first things that parents say there are you need to go and check this podcast out, and it's got a lot of information. So, yeah, I don't think you have the slightest idea of your reach in terms of helping people to understand this condition and manage it better.
Well, thanks to you. I have a much better idea. And you did make me cry a little, but I just not a lot. So I I would tell my family my eyes are just watering, and they're like, you know, you're crying. And I'm like, I don't know.
It doesn't feel like crying yet. Well, gosh. That that's that's really amazing. I really do appreciate you sharing that with me. So around cost, I just wanna make sure again, like, you feel comfortable with it, but is it a lot of out of pocket for you, or is this the medical aid cover it all?
Yeah. It's it's there is a lot of out of pocket because in the beginning, we we we did have to pay cash for the for the CGMs before I knew that I could get medical aid to pay for it. So in the first couple of months, we were paying cash for it.
Tell me. When you bought CGMs, how many zig is that to buy them?
Okay. So so interestingly, we actually don't use a lot of SIG in in this country, especially in the in the part of the country that I'm in. We mostly use the United States dollar.
Oh, you're using US dollars there? Oh, okay. Well, then I don't have to figure it out. Good. What what were you paying for CGMs?
It
It's it's $90 in some places. Seven between 75 and $90 depending on the pharmacy that you you you you've gone to.
For how many?
That is one.
Oh my gosh. For for seven days?
No. Fourteen fourteen days. Most of them last fourteen days.
They last fourteen days. Okay. So but so you're paying, like, $200 I mean, somewhere between a 150 and $200 a month for two CGMs.
Exactly.
Yeah. Gosh. Okay. So you're using what the leap you're using Libre there?
No. No? We we're using we use LYNX.
LYNX. I don't know it.
And it's a really good one.
Okay.
And then there's another one called Sinocay. That's the one we started off with, then we moved on to Lynx. I did get a Libre from from a relative from England.
I would Then
we tried it.
Shoot, Hendi. Yeah. I thought I heard a little bit of British in your accent, like, ten minutes ago. I should have said something. I would have seemed like a genius.
Damn it. But
I don't know. I don't think I don't know what it was, but my country was colonized by Britain. So maybe
That's it. That could be it.
But I've never been there. I've never been to
No kidding. Okay. No. So you had somebody send you a Libre, but you so you have two two CGMs there that you like that I've never even heard of before. So DexCom doesn't make it into into that part of Africa.
I wanted to try out the Dexcom. I even have one, which we also got from from the same relative. But then I think I need to somebody said I need to change my Google account
to Africa. Yeah.
Because there's no support services in ZIM. Same thing for Libre. So those those people in ZIM who use Libre have configured their settings to make to make it look like they are in South Africa.
Yeah. I was just gonna
can download the app.
Yeah. Yeah. I was just thinking. I I just heard I don't think it's out yet, but I did this interview with this lady. Her son was diagnosed in South America on a ski trip, and she had type she has type one, the mom.
So when she flew to meet him at the hospital because he was there not speaking the language, being diagnosed as, a teenager. Right? And, she flew there to help him. She put a bunch of her supplies together, brought them down, and then tried to slap a Dexcom on him, but it wouldn't work because her app was was coded as she lived in America, so it wouldn't let her start it. And that's gotta be the same problem.
I see. I wonder why they do that.
Yeah. It doesn't. It sucks. It really does.
Yeah. We're already paid for it. What do you care?
The desk phone.
Yeah. Yeah. Yeah. You know?
I don't I don't want to see them go to waste because we've got three of them right now that we can't use because of this problem.
Right. Not something
gonna hold on to them and then figure it out.
School, and a Headmaster’s “No” 35:46
Yeah. So now he comes home. He's diagnosed. Does is he in school at that point? How do you manage all of this?
So he was in preschool at the time. Mhmm. And I I had to quickly message his teacher just before schools opened in January. That that was the second week of January. So I told her, and I said, so this is the this is what's going on with Levi, and I'm going to need help with a, b, c, d.
And they were very, very helpful. I have to say They was open to to learning about everything that was going on, and they reacted very quickly.
That's lovely.
So luckily, my employer was able to give me the time to work from home whilst we tried to to to
Figure it out.
Get to understand and figure the whole thing out. So I had, I think, about a month of working from home and being able to go to school and react as quickly. However, I wanted to mention that when when he was now coming into into primary school
Right.
So he started primary school this year. And I was looking for I decided to change him and put him in a smaller school than the one we originally wanted to take him to. So I had an interview with the the headmaster of the school. I think it was the deputy head or something. And I said, look.
Could we please have our son come here? It's a it's a very one of the most popular private schools in Laulauayo here. And I explained to him what the condition was and and everything. And to my absolute horror, he said to me, look. We already have a child with type one, and we're not we're not jumping up and down to get another one.
We're not we're not too keen on this. Why don't you keep that kid? My Yeah. God. That's gonna break your heart.
Yeah. Yeah. It's a strain on our teachers and all this and all that. So so we went back to the big school where we had we had already planned to take him since he was a baby. And to my surprise, they were, you know, more welcoming and more receptive.
Of course, there's they they had a healthy amount of fear
Mhmm.
And, you know, just hesitation about, okay. Can we do this?
So did they
really been helpful.
Yeah. The school he ends up at, did they have background in this, or were they just willing to learn?
No. I think I think there could be one or maybe one or two other kids, but they are older kids. So the teachers don't have to intervene as
much. Involved.
Yeah. They have to with with Levi who's six. Yeah. Six in August.
It would be interesting to hear from that that deputy headmaster, like, what what what makes it such a struggle? Like, maybe that child comes there with no I mean, to, like, listen to what you left the hospital with. You weren't sure the difference between basal and bolus insulin. Right? That maybe that kid's in that situation, and they're like, no.
You don't understand. This is a shit show. And and they don't they we can't do two. You know? And, yeah, that's it is very interesting.
It's a lot. It is a lot because I've asked the teacher his teacher right now, she has to help him with injections. I had to ask her because, of course, now I'm trying to get him to to inject himself. He can he can inject himself.
Oh, awesome.
If you mhmm. If you of course, you have to measure out the units for him. Mhmm. But she still has to help with that. She has to communicate with me when she sees the signs of a of a hypo.
Yeah.
And I have to call her when I get the the alerts to say, okay. He needs an injection now or things like that. But they've been really great with that.
Myths, Cures, and Textbook Information 39:51
That's awesome. Hey. Is there a cultural belief about lifespan or health with type one diabetes? Is, like, did you get the big speech in the hospital? Like, his life's gonna be different or shorter, or do they tell you anything?
No. No. They never told us any of that. But there is no shortage of, of advice that you get in myths from society about how it can be cured by, you know, by this plant or that diet and things like that.
Are you in the Facebook group by any chance in mind?
Yes. I've yes. I am.
There's a post in there the other day. Some lady said she was on a vacation, and I I I forget if it was an Uber driver. Somebody told her if the kid just sat in a cold, dark room, it would go.
Oh my gosh.
So do you get a lot of you get a lot of that around there? A lot a lot of a lot of grandmoms telling you how to handle it?
Yes. We do get a lot of that.
Yeah.
So I always try to explain that. Look. There's a difference. There's two two types. And so the other one is reversible.
The other one isn't.
Yeah. I I just I asked because it's been a long time ago now. And by a long time ago, ten years ago, I did a talk in the Dominican Republic. I did a diabetes talk in the Dominican Republic. And while I was there, the the the, you know, the community there was sharing a story with me about a thirteen year old who had passed away from, like, advanced issues from type one diabetes, and and the child had only had it for five or six years.
But that's how that's it's sad, but that's how little the understanding of the management was in the air. It was almost like, well, you have it, but, you know, I think I if I'm if I'm not mistaken, they were allotted one test trip a day.
Oh, no.
Yeah. So so really difficult. But so you you I mean, you you described where you live as as third world, and I don't know what that means. Like, I I I find myself think sitting here thinking, like, you described an amount of money that you could live on for a month that some people here pay for their car payment. And and so I was I'm like, I I know I don't have context for for your situation.
You know? Mhmm. But I so I was wondering, do people hear type one and go, that's like, I was wondering if maybe you heard, you know, death sentence and thought, no. No. I'm gonna go figure this out on my own.
Or
I don't think I don't think my mind went there Mhmm. At first. I was I was taking it one day at a time, literally, because I also don't remember a lot of what was going on during those days. It was all a blur.
Sure.
But I was just taking it one day at a time. I never thought beyond the next couple of days. Mhmm. Yeah. Do you think that could have helped.
Yeah. You think that, I I mean, do you have context for if you didn't go out into the world to learn about this, what would following doctor's advice get you?
Yeah. We we would we would be struggling.
Okay. You mean
I think we would be.
What what do you think the struggle like, what do you think the struggle would look like?
Just to understand what is even going on.
Okay.
Because it's a lot with with diabetes. So we got basic information. Like I said, it was what he called textbook information.
Mhmm.
And that that had nothing to do with you understanding that rice does that that sugar levels react differently to rice than to salsa than to pasta than to pizza.
Right.
And there was nothing said about insulin on board. There was nothing said about, you know, even the ratios, the carb to insulin ratios, or things like physical activity at school. All of that
Nothing at all. To you know? So the basic information they gave you was his pancreas isn't making insulin anymore, and you're gonna need to inject this?
You inject five units of this one in the morning
Oh gosh.
And in the evening, and you inject five units of this one thirty minutes before every meal. And you test and you correct and
And that's got yeah. Are they testing his his a one c?
We we've gotten it. We've we've we've had that done twice since his diagnosis.
Yeah.
I figure we're getting the test once a year.
What what what was his last day once a year? Do you know?
It was eight, nine.
Eight or nine. Okay. And then on Nine. And on his does his CGM give you information about about, like, time and range or an average a one c?
Yeah. It does. It gives us time and range. It give it gives us, you know, the average glucose level over the last three hours, six hours, twelve, twenty four. Then, of course, you get the the reports once it's it's done Mhmm.
The the fourteen days.
And what are your goals? What are you trying to accomplish? What are you trying to get to as far as as far as those outcomes go?
We're trying to be in range maybe I I I think 100% of the time would be very ambitious. I'm just trying to get to maybe be in range maybe 80% of the time.
Mhmm. What what what's the range you're you're trying to stay in?
So we're trying to stay between five and ten. Okay.
Five.
If that's if that's okay.
Hold on a second. I have to pull up my little my little a one c estimator available at juiceboxpodcast.com. And five and ten. So somewhere between 99 and a 180, you're shooting for. Mhmm.
Right around there. Yeah. Okay. Mhmm. 90 and $1.80.
Okay. Well, I mean, that's a very reasonable range. Are you having luck with that, or is he I mean, if his a one c is eight or nine, he's higher more than you want him to be. Right?
Yes. Definitely. There's lots of work to be done. Yeah.
And what would you say that is? Is that your understanding of the insulin? Is it the food? Is it the time you're able to spend with him? Like, what do you think I is
think it's the time that I'm able to spend with him because I'm only with him when I get back home from work. Mhmm. And then he's at school from from seven up to twelve, and then he's with the nanny from the until I get back home.
Is he experiencing many hypers? Any a lot of lows, or is he mostly higher?
It's a it's a combination of both, to be honest, because sometimes it it has to do with maybe he went to school and then they went for swimming. Mhmm. Or he went and did some type of sport, and then the the particular teacher or coach that was with him during that time didn't know to watch for the for the alerts, and then they didn't give him the the glucose tablets that he needed.
So he can get he can get low and stay low. And are you mostly are you not being as aggressive with insulin because you're worried about him getting very low when he's away from you? Or
Yeah. Sometimes I'm conservative because the the another thing is that I've noticed it's winter here right now.
Okay.
Just started the winter season, and I've noticed that he's more insulin sensitive for some reason.
Some people talk about that.
Yeah. To pull it back a little bit, and I'm still trying to figure figure out what the right dosage should be. Yeah. And I think I changed it yes just yesterday.
The Basal Insulin Nobody Uses Anymore 48:30
And what insulin is he using right now?
We're using NovoRapid and Protofen.
NovoRapid. Okay. And how how much does he weigh?
He's twenty twenty two kgs.
Okay. And and you're so you're shooting does that basal insulin go in once a day?
No. We gay we give him basal in the morning.
Yeah.
We give him for the morning, I I give him between between seven and nine units of, the basal. And then in the evening, I give him five.
So they have you're splitting it because that's the directions for the medication or because it's what you found worked better?
That's what the doctor told us to do.
The doctor told you know, can you spell the name of that that basal insulin for me?
It's p r o t o p h e n.
Got it. Yeah. So they say it it I wonder if that's Levemir. Hold on a second. I'm gonna try to find out.
Okay.
Is because if they're asking you to split it it's not Levemir. It's Miles per hour. Okay. So he's using Miles per hour and NovoRapid. Mhmm.
Do they not do you not have available something like hold on. List basal insulin's available.
I know people who use Tresiba.
Yeah. That's what I'm wondering about.
You know, I kept meaning to ask him about it because I I I haven't heard of other people who use Protofim for basal Yeah. As
I think the reason I didn't recognize the name is because it's so old. Most people don't use it around here anymore. If you have access to Tresiba, I would switch to that.
Okay.
Yeah. That would be one injection every twenty four hours.
And Oh, really?
Yeah. And I would wonder if you wouldn't see a fairly reasonable reduction in his a one c too.
Okay.
Yeah.
Alright.
Yeah. I think that would be a a great idea for you, actually. I mean, ask the doctor and see what they say.
Yeah. I kept meaning to ask him, but the last appointment, I think it slipped my mind. I'll give him a call. Thanks for that.
No. Of course. Did hey. Treat that like that's an important thing to do because because I think it really could end up being meaningful for him.
Yeah. Yeah. Okay.
And save him a shot at the very least a day.
Yeah.
Yeah. Are are there pumps there? Are you thinking about pumps?
We've thought about pumps, but right now, we we had to shelve it because I for me, it was just having aside from the cost, of course, because I don't think our medical aids would cover pumps.
Okay.
Because they're already bulking at the CGM. So Really? Yes.
Okay.
It it was quite
A fight.
I had to do a lot of research to get them to cover that. I think they may have been hoping I didn't know that I was entitled
to it. Oh, I see. There's a lot of whistling and looking at the ceiling. Yes. Yeah.
Yeah. Yeah. So it
happens a lot around GA. If if you don't know your entitlements, you might miss out on things Mhmm. That you should be getting. So you really need to do your research, and so we got them to cover that. And I think pumps I don't even know if there would be support.
I don't know anyone who is on a pump, I think.
I see.
One or two other parents in Harare, but they may have had to go to South Africa to to to get set up and and all that. So I know very little about
that About about a pump.
And the costs.
Well, I would tell you that whether you can get a pump or not, if you can get your hands on Tresiba as the basal insulin, I think that would be a big deal for him. Okay. Yeah.
Alright.
For real. Because you are I mean, listen. You're educating yourself. You're paying attention. You're doing the best you can with the communication tools you have for during the day when he's not with you.
People are looking out for him for the most part. With that much effort, I think you should be seeing I think you could easily see an a one c in the sevens. And
Okay.
And if that's and if that's the case, I'm I'm asking myself what's holding you back, I think it might be the Miles per or or, you know, or not having a more modern basal insulin. And Tresiba is maybe like, I did a little bit of googling here. It looks like you can get, what you're using now. You can get Lantus, Basagar, some might might be Semigle, Glargivin, Levemir, Tresiba, but I think if you're asking me, I'd shoot for the Tresiba.
Okay.
I don't think you want I you know, Lantus would be great if you could get it. Levemir, you might have to split the way you are now doing one every 12 to get really good effect out of it. But, honestly, any of them, Lantus, Levemir, Tresiba, would be better than what you're doing, I think.
Okay.
Alright.
Just trying to write that down
so that I I would go Tresiba first. If you can't get Tresiba, ask for Lantus, l a n t u s. If you if you can't get Lantus, see if they have Levemir. Although, I'm hearing it's being discontinued in America, but I don't know if that means it's being discontinued in other places.
I see.
Yeah. So k. I I honestly, I think that'd be a big deal for him.
Oh, great. Yeah. We'll we'll definitely
Add some more stability to his background insulin, add more stability to his blood sugars. I would bet it would balance out his time and range and give you a a more of a fighting chance when you're making decisions.
Great.
Alright. Let yeah. Yeah. We're not done yet, but let me know if you're able would you send me a note and let me know if you're able to get ahold of that?
Yeah. Sure. Okay. I'll give you an update because
Thanks.
We actually scheduled to see him this Saturday. Oh, awesome. A conversation we're going to have.
Awesome. Tell him the guy from the Juice Box podcast said to give it to you. And if that carries any weight in Zimbabwe, I'm running for president. What do you think of that? So
It does. Trust me. It does.
That that's crazy. I can't wait to go downstairs and tell my wife about this after we're done. I tell my own kids stuff, and they don't listen to me. And you're telling me that people in there in Zimbabwe going, like, you gotta listen to this guy, Scott, on that podcast.
You should come and maybe have a few conferences because I'm sure you would be surprised with the turnout.
No kid. I I was surprised in in the Dominican. I spoke at a big I spoke at a big event there. It was really it shocked me. But it was so long ago, I I it's kinda out of my out of my it's been so long since I was there.
It's hard to remember. I actually the one thing I'll tell you is that I got there, and I had this whole talk set up to give. And I I looked around at my surroundings, the you know, where people lived, what the level of, income seemed to be, what and I thought, oh, my talk is completely wasted here. I had to I actually, was supposed to go to dinner that night. Instead, I went back to my hotel, and I I sat down and rewrote everything I was gonna say because they Oh.
They would have had no context for what I was gonna say. And, yeah, it was real you know, for similar reasons back then, availability to to technology and and, the way they even think about it. It was all just it was different than how so much different than how I thought about it that I thought, oh, what I'm gonna say isn't gonna be helpful. So I changed my I changed my talk up. But, listen, if anybody wants to fly me to to Africa to give a talk Lovely.
I'm in. Yeah. Like, I would are you kidding me? How many shots am I gonna have to get to go do that? They're gonna make me do a bunch of inoculations?
I don't think so, really. You may I don't know. You may get a malaria shots, I doubt, though.
I I can handle that. I would I get to go on a safari while I was there? I would like to do that.
Oh, yeah. There's you would I think you would love it. Yeah. If you love the outdoors and
Yeah. I do.
And animals and and nature. Yeah. There's really some some beautiful places to to visit.
I'm looking at my list of advertisers right here trying to think of which one would wanna send me to Africa. I'm pretty sure none of them are is the answer, but I'm putting the call out right now. Yeah. Oh my gosh. Well, okay.
So he's in school. There's some struggles. You're getting through them. You're getting good support from the school, which is awesome. How involved if this is cultural, I'm not sure what my question is, and I don't wanna cause you a problem.
But is your husband involved in his care too? Is it all on you? Are you guys splitting it? How do you do that?
Anxiety, Control, and Letting People Help 58:14
Yes. He's he's involved in the care, a lot, more so on the financial side, only because I I think I've had I've really had a a tough time relinquishing control over this thing because I I obsessed over it in the beginning and getting all the information and and all that. So I felt I'm I'm only now starting to to release a little bit of of responsibilities even to my daughter. She's she's great.
Mhmm.
She also helps quite a lot. But, yeah, everybody's involved. My husband is a bit, you know, hesitant with the injections, but he's good with everything else. Okay. The alerts and just keeping an eye on on everything.
And, also, our parents are great.
Yeah.
Mother-in-law has been awesome. And my sister-in-law
Not scared to help and give insulin and stuff like that?
Exactly. Yeah. Yeah.
That's great. Hey. Do you have guilt? Do you feel guilty about it or anxiety from it? How would you describe why you're holding on so tight?
I think it's anxiety. Because when when I when I was researching about it, I at first, I did ask myself what I could have done wrong that led to to this condition. But when I when I realized what it was, I didn't have any guilt at all, but I am anxious, especially with, you know, the the these long term effects that come with with poor management.
I'm
really anxious about that. But, yeah, I think I'm I'm one person who likes to do everything myself.
I have
a tough time delegating.
Were you like that before the diabetes too?
Yeah. I've always been like that.
Yeah. Do you have are there any other autoimmune issues in your family? Do people have hypothyroidism or celiac or anything like that?
My brother has hypothyroidism. Yeah.
Mhmm. Have you ever been tested for it?
No. I've never.
Make sure they test make sure they test Levi once a year for it. Okay?
Okay.
Yeah. Alright. You wanna watch for that. Symptoms are, you know, unexplained weight loss or weight gain, hair loss for you could be brittle nails, weight gain. No matter how much you sleep, you can't feel rested, always always cold, heat intolerant, stuff like that.
Okay.
Yeah. Alright. So make sure you're you're paying attention for that because it's once you get one, it's not crazy to get another one. Didn't surprise me that your brother has hypothyroidism, for example. Mhmm.
So, you know, just keep keep an eye. Anybody anemic?
My mom.
Your mom is? Yeah. Mhmm. Again, not totally surprised. So One.
Yeah. Autoimmune issues
Both ties in.
Yeah. Autoimmune issues can kinda run-in families. You don't always all get the same one, though. Okay. Yeah.
And anxiety, while not an autoimmune issue, is a thing that I like, from my personal experience talking to so many people, I see a lot of anxiety in families who have type one.
I had anxiety myself, but that was I think that was linked to that was in the few months before I got diagnosed with with epilepsy myself, I used to have a lot of anxiety.
Did you?
But I think that was because of stress from work.
Mhmm. Yeah. Well
I didn't think that was connected.
What what's more stressful, work or that diabetes? Hard to tell some days? It's hard to tell. Good
question. I really couldn't make up my mind. But I think that's the the diabetes was stressful when I didn't know what what I was doing. But I know that it's something that I can I can perfect at some point? Yeah.
Not perfect, but get as close to perfection as possible. And the fact that I I have some sort of control over, you know, how things may go make makes it less stressful than work, I think.
You've said a few things while we've been talking that I I'm I I don't wanna ask because I think it sounds distasteful to ask, but it feels like you're mimicking some of my words back at me. So are you learning those ideas from the podcast?
I don't know because maybe it's possible because I do listen to to your podcast every morning when we're getting ready, you know, in the morning to go out. We we usually have your podcast playing, and, you know, that could be that could be it. Mhmm.
Well, that's just it's all good things about, like, you know, just having expectations for, you know, getting better at this over time and stuff like that. Like, it it's nice to think that you're you're finding value in it at all, honestly. Does your husband ask like, does he make fun of you for listening to a podcast from a guy in New Jersey? He does. Right?
You know what? He he has he has several times, something has been said on the podcast, and he's he's looked at me and said, can you replay that? Can you rewind? I didn't hear that.
Well, you know me. You're making my day. I have to tell you. Yeah.
I think it could be a joke and something that you would have said that
Oh. You know, The guy part of me. He likes that part. I gotcha. Okay.
Yeah. I gotcha. Well, that's like, hey. However however you get them listening, who cares exactly? Right?
Hey. How old are you? I didn't ask you in the beginning.
I'll be 40 in July.
You'll be 40 in July. Oh, happy birthday. I'm I'm July too on the twelfth.
Oh, nice. Yeah. Nice.
Yeah. Do you find any of that zodiac stuff to be true about Cancers?
No. I've never
You're not emotional or, like like, have you ever read, like, the I I don't believe in a straw I wanna say I don't believe in astrology at all, but Arden read me something the other day, I was like, that all does really sound like me.
I've never I've never paid attention to any of that stuff, actually.
Me either.
Been in front of me.
Until yeah. The other day, she just like she's like, hey. Does this describe you? And she read a whole bunch of stuff, and I was like, oh, I think it does. Then we read some other ones.
I'm like, these all this I think these are just written so they describe everybody. But but They're generalized like that. Yeah. Are you getting sleep? Are you sleeping okay?
I think I sleep okay.
You're not worried about Right
now, I'm not sleeping much because I'm also studying. I'm doing further studies, so I I don't get to sleep because of that.
But the diabetes isn't keeping you from sleeping?
There've been days. There there've been days, especially in the beginning when we couldn't figure a lot of things out. But now I know I know what to do, especially with the CGM. The arrows tell me how to how to react or how to respond to an alert Yeah. Which usually keeps us good for the next few hours.
Especially if I'm with him, I'm able to to get ahead of of it so I can get some sleep.
Using AI to Count Sadza 1:06:05
Good. Good. You know, I have to tell you, like, I I I I I try I don't wanna be, like I don't wanna say something that sounds stupid, I guess. I'm trying to be careful here. But you have you have an AI model?
Do you have, like, chat GPT there or something you can use to break down the the food? Because that's gotta be like, it just occurred to me. Like, why don't we why don't we do this? Can you give a nutritional breakdown for salsa? I need fat, protein, and carbs.
Let's see what happens.
Okay.
I'll give a plain serving estimates, and salsa changes a lot depending on how much maze or meal is packed into the portion, it says. And now it's looking online for answers. So let's see what happens. And while it's doing that, I'm gonna ask a different model, the same question to see if we get a reasonably similar answer. Alright.
So I I did chat GPT first. It says that a 100 grams cooked salsa should be between twenty and forty five carbs, between two and five grams of protein, and it only has about a gram of fat in it. A medium serving, which they're calling 45 to 55 carbs. So four to six protein. Okay.
So the wide range has become a size that can be soft or thick. Water adds weight, but not calories. So a wetter size that has fewer carbs per 100 grams than a dense one. So that might be helpful to know too. If it's denser, it might have more carbs in it if it's wet or less.
And then I used I also used something called Claude. I don't know how many of these you guys have there, but, a rough nutritional breakdown for a typical one cup serving, which is about 240 to 250 grams of cooked salsa. Again, 40 to 45 carbs, four to five proteins, and fat, one to two grams. So does that is that about what you imagine, or is that helpful information?
I think this is helpful. I've never I don't think I've ever broken it down like this.
I have to tell you. I just it makes a ton of sense to me because do you guys eat boda? Am I saying it right? What? Or Capenta with Sada?
Capenta is not a favorite of mine.
No? Okay. Well, I don't know what I'm doing. I'm just going by I'm just giving you a list of what's been sent back to me. But what I think is, no kidding, if you have access to ChatGPT, it's as simple as give me a nutritional breakdown for the food and ask for fat, protein, and carbs.
Do know it's it's actually quite funny because I use chat GPT almost daily for my school. Yeah. I never thought to to ask for a breakdown for for food.
I would give it a I'd give it a shot. And and if you go if you wanna go back to my website, there's a a bolus estimator there. So you could if you you if you know his settings, his insulin to carb ratio, his sensitivity, you can plug that all into that little estimator and then put in the carbs, the fat, the protein, and it'll give you a suggestion about where to start with the bolus.
Yeah. Yeah. It's crazy. I never thought to to prompt charging p t about that. But I did go to to your the calculator thing on your website.
The only thing that that threw me off was how to how to get how to determine sensitivity.
His insulin sensitivity.
So The metrics. Yeah.
That number is
only know that he's more sensitive or he's less sensitive, but the numbers
don't move. So what you what you would do there is that's how much how much how many how far, like, what number does one unit of insulin move him? So when you put in the the the fast acting insulin, like, I guess the the question here would be if his blood sugar is oh, I have to bring up the I have to bring up till I can talk to you in in your I'm not good at talking in millimoles. Hold on a second. If let's say his blood sugar was let's say it was 10, and you wanted it to be so for people listening, it was a 180.
His blood sugar was 10, and you wanted it to be 80. How much insulin moves him from one eighty to 80? Do you know? Do have a guess?
So that's from 10 to Four.
Yeah. To 10 to, like, four and a half. So think about it like five. How how much insulin moves in five millimoles? Wow.
Because there's also the time factor to say how quickly does it get him there. Right?
Exact maybe time a day for his activity and stuff like that? Mhmm. Yeah. So
Okay. Maybe if I if I give you the if I give you the correction scale
Okay.
Does that does that give you
Maybe but first
a better picture.
At first, tell me what does he weigh? How many kilograms does he weigh?
Twenty two. Twenty two. So
he's about forty nine pounds, maybe forty eight pounds. And I so you're not using a a a modern basal insulin yet. So there's a little bit here that I don't know. But my the guess here from this is that a unit of insulin moves him about a hundred and forty six milligrams per deciliter, which should be let me find out how many millimoles that is. I know the people who know this are like they just know it because they do the math real quick.
So a hundred and forty six would be about eight millimoles. Okay. Yeah. So would a unit move him about that far, do you think? Oh, wait.
I have it here. I'm so sorry. Yeah. Yeah. Eight.
My my my estimator does that. I did I never clicked on it before. Oh, it works. Congratulations. So there's, like, there's a settings calculator here, that helps you guess by weight about what settings would be.
So Oh. So my point is is that if to to check, you could check to see does one unit of insulin move him about eight millimoles. If that's right, then you understand his insulin sensitivity to be one to eight.
Okay.
Okay? And and then and then you can you know, when you use the calculator, that's about the sensitivity you would put in. And his carb ratio is what do you think? Like, how many car like, the how many carbs does a unit of insulin cover for?
Let me see where I look. One second.
Take your time. Because this has a guess based on his weight, so I'm interested to see how close this is to your reality.
Okay. So I well, on average, maybe if if we give him if if he's having a meal with maybe thirty thirty calves
Mhmm.
That could go with roughly two two to three units.
Two to three units. And that's
the short acting Okay. Of the the normal rapid. Yeah.
And that's probably because you're not getting a lot of backing from the the background insulin. Oh. So it's possible it's hard to talk about right now because you're using that, but it's possible that if you can get him moved to Tresiba, what you're gonna find is that he's gonna use about six units of Tresiba a day. Oh. And then then you might find that a unit of insulin covers about 40 carbs for him with the basal insulin.
With the NPH, I honestly don't know how to talk about that. Like, I'm I'm not sure. But if you're finding if you're finding that it it takes two units to move him for 30 carbs, then at least that calculator could probably give you an idea of, like, well, about how much is here based on your settings. And then you could, you know, you can hold that up against what you've been finding. And my thought here is what if you what if you say, oh, well, I would put in, I don't know, three units for this meal, but this this estimator is telling me it's more like four and a half.
And maybe that's why his a one c is eight and not seven or not six. Do you see what I'm saying? But, again, I might hold that thought until you shake that Tresiba out of that doctor on Saturday. I think that's that's that's the that's the way to go. If you wanna point your anxiety at somebody, point it at the doctor and ask for Tresiba.
So Yeah. See what you can get.
Definitely going to ask for it.
Yeah. I mean, it would be a big deal. And and listen. Once you have that hopefully, you get it and it works well for you. Go tell your friend group too in case they're doing the same thing because you're managing with insulin that we don't really even use here anymore.
Okay.
You know? Yeah. And if you have the other stuff available, then then I say go for a more modern Bazel and so on.
Okay.
Yeah. Is there anything that we haven't talked about that you wanted to? I don't wanna skip anything that you wanna talk about.
No. I think, yeah, I think I got everything out that I wanted to.
Good. I wanna tell you and people listening, I'm not telling you to let an AI model manage your your insulin. But a person in your situation, I don't know why you wouldn't at least try to get a background from it and say, look. My son is this old. He weighs this much.
He takes this this insulin at this time of day, this much. He takes this he takes another shot of twelve hours later, that much. This is what he's using for meals. Remember that. And now here's what we're eating.
Can you help me bolus for this? And see if it can and see if it can give you some direction. Yeah. I don't Okay. I don't listen.
Again, everyone should talk to their doctor first. But
Of course. Yeah.
Thank you for saying that. Nothing you hear on the Juice Box podcast should be considered advice, medical, or otherwise, always consult a physician before making any changes to your health care plan. But I'm seeing some people online who are doing this, and it's helping them a lot. A lady put up some graphs the other day, and she's like, I didn't know what to do. I had trouble understanding the podcast.
I've been talking it through with a large language model and look at my kids' graphs. So, basically, just treating it like a sounding board for what and and giving it as much information as they could about what was going on, and it was helpful for her.
It's interesting because I just I don't know why I never thought of
it Yeah.
This whole time.
Yeah. Maybe maybe because it's a little silly, but it works. So for a lot of people, so maybe it's worth the shot.
Makes a lot of sense.
Sure.
Yeah.
Listen. I was in a store the other day. I had to buy lumber, just two by four, you know, to build something with. And I got there and realized I'm like, I don't wanna buy extra. I just wanna I wanna be able to make you know, I don't wanna have a bunch left over.
And so I I opened up my phone, opened up ChatGPT. I was talking to it in the store, and I was like, I'm building a frame in this area. Like, here, here, here. It's gonna have four sides, then four legs, and then four other sides. I'm gonna make a stay a stand out of it.
I don't wanna buy extra two by fours. Tell me exactly how many I need to get these pieces out of it. And it did the math in, like, a split second and told me. And I was like, right on. And then I bought four two by fours, and I left.
So And and I and I even said to her, I was like, hey. Are you accounting for all the cuts I have to make? Like, not just giving me, like, the number of inches I need, you know, or the amount of distant and it said, no. I already I already thought about all that. I was like, oh, awesome.
So, anyway, I don't wanna get replaced in Zimbabwe by chat GPT, but I do want I do want you guys to be healthy and happy. So I think any any tools you can find that are valuable, you should use
them. Yeah.
You know? That's also hey. What time is it there? You're about eight hours ahead of me?
Right now, it's 07:21 in the evening.
Okay. You're six hours ahead of me. Okay. I could I wasn't sure if you like, you said you weren't good at geography, and I couldn't figure out if you were East, West, or Central Africa. So
Neither can I? Trust me. I don't even know where Harare is from where I am. So
Do you not get to leave ever? Have you ever been to another country?
Yeah. I've been to I've been to South Africa. I've been to Botswana, and I've been to Mozambique.
Mhmm. Have you ever left the have you ever left the the continent?
Nope. No? Not yet.
Is there a place you'd like to see?
Yeah. Of course. I want to see, you know, I want to see New York, Los Angeles, Las Vegas, France.
Those places will flip you out. I listen. I watched my I watched somebody once come into New York City through the subway from the airport. So Okay. I got to walk up from underground into the middle of Manhattan with them for the first time.
Mhmm.
And they walked up out of that hole, and their head just kept going back and going back and And going the bill the she she was from she was from Wisconsin from the middle of
Oh, okay.
And she's like, oh my god. This is insane. I've never seen anything like this before. Until you see all those skyscrapers stacked on top of each other, it is it's only a thing you can it pictures don't do it justice when you're standing on the ground. Really So, it's really if you make it over here and you can get a look, it'll it gives you a different perspective.
That's for sure.
So you're telling me that, this person from Wisconsin, the difference between where where she's from and
Manhattan was starkly, shockingly different.
Still shocking.
Okay. Yeah. There's the 100 story buildings there, and they're just one after another. And you're this tiny little speck on the ground looking up at them. And Wow.
Cars are going in a thousand directions. All you can hear are cars, motors, tires, people talking, feet moving on a breezy day. There's this really interesting thing that happens in Manhattan that the that the wind only goes in one direction. So you could be walking down one road, be in a wind tunnel, then get to another, like, to an intersection, and it just stops. And but but it's just a very different place to be.
So, yeah, I've never been to Vegas, but I am going next year, for my for the first time to see it. I'm gonna go see a concert in the sphere. Oh, okay. That big like, have you ever have you seen that? The it's like this giant building that's literally in a sphere, and you I'm going there next next year to see Metallica, I guess.
Never heard of that. I I know there's a there's a Las Vegas Strip. I don't know.
Yeah. That's all I know. I think that's just casinos and hookers. I'm not really sure if that's anything else. You might wanna skip that.
You might wanna skip that. Unless you're I don't what know you're looking for. So maybe you maybe it's up your alley. I have no idea. But It's
just to see, the most common places that we hear that that America is famous for.
Yeah. But New York will it's different than any other place, but it is very it is very much, I guess, an American icon in New York City. Yeah. Philadelphia is pretty awesome, but it's nowhere near, New York. I hate to say that because I'm from Philly.
But
Ah, okay.
Yeah. Alright.
I have a friend who's who says she stays in Philadelphia somewhere. Mhmm. An old high school friend of mine.
No kidding. Yeah. No. I'm very I'm close to there now, actually. I don't wanna tell people exactly where I am, but I'm within an hour of Philadelphia.
Because I have had people send things to my home before, which I appreciate it. Thank you all. But it freaks me out, so don't do that. Okay? But but, nevertheless, I really do appreciate you doing this with me.
This has been a lovely conversation. I hope you found it valuable.
I did. Thank you very much.
Hurricane Levi 1:23:37
Yeah. I appreciate it. What should we Beau, of course. What should we call this? There's no way that I I at one point, you said you said you said that we had a pizza disaster.
I thought, is Zimbabwe pizza disaster too good? Is that too much of a title?
You could call it hurricane Levi. Yeah. Because we spoke about, you know, how energetic he is, and sometimes that's what I call him.
What do you call him? Say it again.
Hurricane Levi.
Hurricane Levi? Okay. I know you've mentioned it, like, four times. That kid does you were like, he's a handful. He is a
handful. I I think I should have had him because my kids are far apart in age.
You're a little tired.
Had him in my twenties when he was younger.
Well, let but let's be honest, Azil. Is he more like you or your husband?
He's more like my husband. Definitely.
I see. So you got two little boys. You're you're wrangled over there. Yeah. Yeah.
Well well, thank you so much. If you hang on the line for just one more second, I'll I'll tell you a couple of things about how this will come out. But but you're all done, and I do I really do appreciate it. Hold on one second. You.
Of course. So it's a pleasure. Something new just arrived from MiniMed. It's the MiniMed Flex system. Think about everything people love about MiniMed technology, designed for great outcomes, helping keep you in range, and made to be easy to use.
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Kontoornext.com/juicebox. That's right. Today's episode was sponsored by the Kontoor Nextgen 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, or 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 Podcasts or Spotify, really any audio app at all. Look for the Juice Box podcast and follow or subscribe. We put out new content every day that you'll enjoy. Are you tired of scrolling past clips that last five seconds? Are you an adult?
Would you like to have a long conversation? Juicebox podcast is the place to be. Follow and subscribe. I'll be here tomorrow with another episode. I hope to see you again.
- Tendai noticed every classic symptom — bedwetting after potty training, constant thirst, weight loss, sudden lethargy — but delayed the doctor because she was afraid the complaint would sound trivial. Levi was near DKA by the time she went. If the symptoms are there, make the call; you are not wasting anyone’s time.
- Levi’s basal insulin, Protaphane, is NPH — an older intermediate-acting insulin that must be split morning and evening and delivers an uneven background. Scott’s suggestion was to ask about a modern basal like Tresiba, Lantus, or Levemir. Any change to an insulin regimen is a conversation for your care team, not a swap to make on your own.
- Unstable background insulin distorts everything downstream. When basal is doing an unpredictable job, meal ratios and correction math stop making sense — which is why Scott held off on tuning settings until the basal question was answered with Levi’s doctor.
- Zimbabwe’s food is largely unprocessed, so there are no nutrition labels to read. Tendai learned sadza by observation. Scott walked her through asking an AI model for a fat/protein/carb estimate of a specific dish — a starting point for a conversation with a care team, never a substitute for one.
- Autoimmune conditions cluster in families — Tendai’s brother has hypothyroidism and her mother is anemic. Scott suggested Levi be screened for thyroid issues about once a year, and described the symptoms worth watching for. Ask your endocrinologist what screening schedule makes sense.
- MiniMed Flex System — Sponsor — small, app-controlled automated insulin delivery using SmartGuard technology.
- Contour Next Gen Meter — Sponsor — the blood glucose meter Scott’s daughter uses. Often cheaper in cash through this link than through insurance.
- Bold Beginnings Series — For the newly diagnosed — Scott and Jenny Smith answer the questions everyone has in the first weeks.
- Diabetes Pro Tip Series — Episodes 1000–1025 — the fundamentals of insulin, settings, and everyday management.
- Juicebox Bolus & Settings Estimators — The A1C, settings, and bolus estimators Scott used on air with Tendai. Educational tools — confirm anything with your care team.
- Juicebox Podcast Facebook Group — Where the myths post Scott mentions came from — a private group, 86,000+ members talking type 1 every day.
