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#561 Double Whammy

Devon and her child were diagnosed with type 1 diabetes around the same time.

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends, and welcome to Episode 561 of the Juicebox Podcast.

Today's guest is Devin Devin has type one diabetes. She also has a child with type one diabetes, and they were both diagnosed around the similar time. That's not English, but I'm going to leave it in around the same time. You know what I mean? Devon's actually a nurse, that Oh, she'll tell you about it for you. What am I going to explain the whole podcast in the first two minutes? It's ridiculous. Just listen to it, you'll have a great time. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. Please always consult a physician before making any changes to your health care plan, or becoming bold with insulin. I'm hoping to personally with this podcast put 2000 new surveys in the pocket of the T one D exchange and you can help you have to be a US citizen who has type one diabetes, or is the caregiver of someone with type one, and then you go to T one day exchange.org forward slash juice box fill out the survey which takes less than 10 minutes is completely HIPAA compliant and a bazillion percent anonymous. You'll help yourself you'll help other people living with type one, you'll help the show

this episode of The Juicebox Podcast is sponsored by touched by type one head there right now to get your tickets for dancing for diabetes. Are you in the Orlando area and would like to see an amazing dancing extravaganza? The extravaganza doesn't dance there's a lot of dancing that makes an extravaganza but I think you understood touched by type one.org had there right now. The event happens at Let me see where I'll tell you why in a second. You know what, I'm just gonna read it to you. The 21st annual dancing for diabetes showcase features award winning dancers raising funds to support those touched by type one diabetes. It happens on November 13 at 7pm in the Dr. Phillips Center for the Performing Arts. Tickets begin at $15 and are on sale now. Head to touched by type one.org to get them go go go What are you doing? I mean not now listen to the podcast first. Oh geez. I almost forgot to say that. This show is sponsored today by the glucagon that my daughter carries. g vo hypo Penn. Find out more at G Vogue glucagon.com forward slash juicebox.

Devin Clark 2:39
I am Devin Clark, and have type one diabetes. I am the mother of a diabetic two year old as well. He was diagnosed when he was 10 months old. Okay.

Scott Benner 2:53
So like I said a second ago before we were you know, recording this. You just sent a very concise, interesting email. And that got you right on the podcast. Good job. Some people's emails are long, and voluminous and volume in this volume vault helped me Devin filemon it voluminous Thank you. I know the word and it just fell in my head. And still very interesting. You're just got right to the point. So why don't we just find out a little bit about your first pick through and we'll see where the conversation leads. Okay, I want to start with how old you are when you were diagnosed.

Devin Clark 3:34
I was 26 years old and I'm currently 28

Scott Benner 3:38
a couple years ago, were you pregnant or not.

Devin Clark 3:42
I was pregnant. I found out on a Friday that I was pregnant. And then two days later, I was very symptomatic of diabetes. drinking a lot being a lot decided to check my blood sugar at home. And it was not reading on my home meter. So I knew what I had to do. had to go to the ER and it was just about 600 when I got there,

Scott Benner 4:13
why did you Why did you have a meter at home?

Devin Clark 4:16
So with my first pregnancy, I had gestational diabetes. And it was just leftover from that.

Scott Benner 4:23
So when you see that number, do you think I have gestational diabetes again?

Devin Clark 4:28
I did. And the ER doctor thought the same thing. So he told me since I already had some medication leftover from my first pregnancy. I was just on pills at that point to go ahead and take those whenever I got up in the morning because I went in at night. And he said get in with an OB like first thing in the morning and so I took some of the medication I was checking my blood sugar about every 30 minutes, it was not going down. So by about 10am, I was well over 300. And just really eager to get in with an OB at this point. The first one I called was close to our house. And I told them what was going on and how much of an emergency it was going to become. If I did not get in within that day. Yeah.

Scott Benner 5:29
Well, tell people I guess why you know more about medical stuff than other people.

Devin Clark 5:35
So I have a background in ICU nursing. Being an ICU nurse for several years, taking care of patients that are in DK a, some newly diagnosed and some not. That's where my certification lies is in critical care nursing.

Scott Benner 5:56
Yeah. So I didn't know we were going to do this. But would you mind Can we go back to your first pregnancy? How old were you then?

Devin Clark 6:02
Sure. I was. See 25 had to think about

Scott Benner 6:13
it. I gotcha. You're not Irish. Are you? That was a quick turnaround on that second one.

Devin Clark 6:17
No, no. No, they're 14 months apart. Gotcha.

Scott Benner 6:20
The 20 the first pregnancy, you've had up until that time, no medical issues with you. You're just cruising along, Mary decide to get pregnant. And how soon until you figure out you have gestational diabetes, and how do you find out?

Devin Clark 6:38
So just you know, routinely with the glucose tolerance test through the doctor's office? failed the first one the one hour, had to go back and do the three hour one and failed that one really bad?

Scott Benner 6:52
How far into the pregnancy? Did they begin to do that?

Devin Clark 6:56
I believe it was around 28 weeks.

Scott Benner 7:00
Sorry for the pause. I was counting on my fingers. around so embarrassed around seven months ish. Yeah, okay. I really was. I was like, oh, it took too long. It's gonna be obvious, I'm gonna have to say something. So until then, I know you would never you had never been pregnant prior to that. Right? Right. So you didn't know what feeling pregnant felt like, but was there a big difference? After they found the glucose tolerance test as a failure and put you on medication? Did you feel differently after that?

Devin Clark 7:37
Not so much. Um, in the beginning, he had put me on too much of the medication. So it had induced hypoglycemia that I felt I was down into the 50s. And so I cut my dose in half and called them and told them what I did, and said, okay,

Scott Benner 7:58
isn't it great? How often you call a doctor and just say, Hey, I did this, they go, okay.

Devin Clark 8:02
I guess that's just the nurse and me, Oh,

Scott Benner 8:06
I see it with other people, too. Like, a doctor made a recommendation for my son recently. And I said, Well, can we try this instead? And the doctor goes, Yeah, sure. I was like, Well, why did you say the first thing is that if if I mean, if you're so easy to move off that idea, like, it feels like it's not a firmly held idea, and I think it takes a while to understand that. Sometimes doctors are just, it's their best guess to, you know, like, here it is. So, seven months, gestational not knowing it. Did that have any, like, what are the impacts on the baby that we're supposed to be concerned with about stuff like that.

Devin Clark 8:42
So with gestational diabetes, most of the time with the, we'll see the need for insulin during pregnancy, it starts to go up around the 28 mar 28 week mark, to a much, much higher level. And so that's why they do it at that point, and not sooner. Because if you will end up with it. It that's where it really shows gotcha. And, and not before, so they don't want to miss it too soon.

Scott Benner 9:21
What is the management for it after it's found? It's just a medication, or is there more to it?

Devin Clark 9:27
So it's different with every pregnancy that I've found. For me, I had to take an oral medication glimepiride some women have to take insulin, but I never had to with my first pregnancy.

Scott Benner 9:44
Gotcha. All right. You know, it's incredibly interesting the way things kind of ebb and flow around here because it has been less than five days and somebody said to me, You never had anybody on who's had gestational diabetes, and I was like, really? And then, you know, you said it was Go well I took care of that. But I would like to have someone on who had to use injections throughout their pregnancy and so if you're hearing this and that's you and you want to be on reach out, but Okay, so you got through that pregnancy fine with the oral You know, it sounds like you cut the dose and then it worked. Okay. It did. Yeah,

Devin Clark 10:17
I had no issues after that point. What happens

Scott Benner 10:18
after you give birth? Do you still need that medication? Or does that need go away? If you're just gestational?

Devin Clark 10:24
So the doctors supposed to tell you to check your blood sugar daily for a certain amount of time? Which I did, and then if I felt weird off, you know, anything like that, I would check it again. And I went back to pre diabetic state. Some women end up developing type two diabetes, with having a history of gestational diabetes you have you're predisposed for developing type two.

Scott Benner 11:01
I wonder I'm gonna you know what I just made a note for myself. I have a list that just says Jenny and I just wrote gestational diabetes on it. So get her on him and pick her brain about that. Okay, so that all goes well. You have a baby baby's healthy. little while later you're like cool, make another baby. And in between those two babies, you You seem okay are looking back. Did you have any indication for type one?

Devin Clark 11:27
No, I was perfectly okay. Like I said, you know, anytime I would feel off I would check my blood sugar first thing and I never got a reading that was over 90. And so the first indication of me having diabetes was feeling symptomatic two days after I had a positive pregnancy test.

Scott Benner 11:54
Hey, so you're proactive then you I guess from your background? You were like okay, well, I've had gestational diabetes. Now I'm more likely to have an issue with insulin, and you've started paying attention to it on your own. Yes. Wow. You're very that's smart and brave, too Don't you think most people would just be like I'm gonna cross my fingers and hope that doesn't happen to me. But you didn't so do you know it? Like do you know what drove you to pay attention and just test once in a while I imagine you like testing a couple hours after pizza and stuff like that. Like you were doing those sorts of things.

Devin Clark 12:32
I can remember one time my husband and I went to go see a movie I had some popcorn and coke maybe and I started feeling kind of dizzy and when I got home I was 81 and that was one of the times where I felt off and just decided to check myself just you know knowing that I am at a higher risk of developing type two at that point.

Scott Benner 12:59
What the does he make you think it didn't make you think you were low right it made you think something else?

Devin Clark 13:05
It made me think that I might have had like possibly a rebound hypoglycemia

Scott Benner 13:12
from like, what do they call it hyper insulin? hyperinsulinemia Yeah, okay. Oh, no kidding. All right, like you're really on top of this. Did you always want to be a nurse?

Devin Clark 13:25
No, at first I wanted to be a doctor and you know whenever I started and pre med at college, I did not like the coursework so I switched to nursing and fell in love with it.

Scott Benner 13:37
Cool. That's really cool. Any autoimmune in your family line? Yours personally than your husband's? No, nothing. celiac? No thyroid, hyper hypo graves.

Devin Clark 13:55
Now no autoimmune thyroid. Just right I did have several family members with just general hypothyroidism but not hashimotos non hashimotos I have hashimotos I ended up Yes, I ended up with it the same time I was

Scott Benner 14:15
diagnosed with type one. Wow, you got a two for one deal?

Devin Clark 14:19
Yes. So I started taking Synthroid and insulin at the same time

Scott Benner 14:23
overwhelming especially being pregnant a bit I would cry Did you cry?

Devin Clark 14:30
I think I did. You know whenever I realized the especially when I realized the medication wasn't working the glimepiride I think I was in tears calling an obese office telling them that I needed insulin and I thought I was developing type one diabetes

Scott Benner 14:46
was gonna say cuz you were diagnosing yourself with that phone call.

Devin Clark 14:50
My endo told me at my first appointment that she thinks I was the only person to self diagnose at home.

Scott Benner 14:58
Wow, no problem. You're up. On top of it since the first kid well so with the with the second baby day two because you're checking good for you by the way you know really interesting had you not done everything you did I wonder how long it would have taken you like if you were just the cross your fingers I'll just gonna hope this doesn't happen to me I wonder how far you would have gotten into that second pregnancy before you recognized it I wonder if it would have made it to seven months or if you would have been in decay sooner and if it wouldn't have hurt the pregnancy to

Devin Clark 15:30
um so I thought about it in depth and talked about it with my endo and we came to the agreement that it probably would have ended my pregnancy being so close to the beginning of pregnancy whenever this happened especially at that point when the baby is forming all the nervous system portion that is it can be very devastating to the development of the fetus such

Scott Benner 16:03
a critical moment Did you write Did you hear Jill at the beginning of the year beginning of 2021 my first episode I did she was diagnosed right as she was pregnant and and didn't wasn't you wasn't like hey I'm checking my blood sugar because I know about all this stuff like she just it just came out of the blue for it's fascinating but okay so you you call the doctor do their job for them and and how does like what's that next step you don't go to the hospital you're right to the end oh

Devin Clark 16:35
so I got in with my ob who was older he had been practicing for a while he had a lot of experience with type ones in pregnancy. Thank goodness so he immediately got me on the gold standard for him which was regular an MPH which I hated.

Scott Benner 16:58
This is two years ago right?

Devin Clark 16:59
Yes. And so I didn't stay on that for very long. Being a nurse you have to it's it's difficult because you have to be on an eating schedule. If you're taking regular an MPH and I told him that I said I can't just you know jog what I'm doing at work and say hey y'all I gotta go eat. So I was

Scott Benner 17:25
having a heart attack but it's time for me to nosh so I have to go somebody impressions over I got a roll up out of here now you're not you're not able to do that. Also Isn't that great? I so thought you were going to tell me this was a guy who'd been through it so many times he really knew what to do blah blah blah and you were like he seen so much and then gave me insulin from 1963 like that was super interesting. So did you say you push the doctor to go to a faster acting insulin?

Devin Clark 17:57
I did. I told him that I would be comfortable with switching at that point. So I believe he had left me on the regular but gave me lantis at that point. But I was able to get in with an indo about a month later. So he wasn't doing my diabetes care for very long. And whenever I got in with an endo, they ordered me a pump immediately.

Scott Benner 18:26
Can we divert for a second here? Can you help people? What am I want to say? Can you help people understand how you advocate for yourself in that situation and how you don't need to be concerned with the doctor's feelings because you really basically are saying to that first doctor Hey, thanks for your help. I don't agree with what you're doing. I'm going to go somewhere else now but how do you say that politely or do you not have to what you're finding

Devin Clark 18:55
it really just depends on you. You know you're paying the doctor to do a job and so if you don't feel like they're doing the job to your specifications or standards and you let them know you can also look up scholarly articles for current evidence based practice about what needs to be used as far as medications or what needs to be done like procedure wise to treat whatever you have going on.

Scott Benner 19:27
It's funny I never until Not that I haven't thought of it. The way you just said it but it just popped into my head it's like you're hiring a contractor to put a floor in your bathroom and you walk in and go whoa. I don't want you to do it like this. And and they say no, this is how we doing you learn we'll get out. Something else though with that. That's really cool. But you did it with a lot of confidence where I think most people don't have the confidence that you're instilled with because of your because of you know your experience. You see so many people just they take it and they put the head down and go on to the doctor said to do. So it's just it's really cool that you did that. So you go over. I'm thinking you had a pump before the pregnancy was over, but I'm gonna ask how did the rest of this go?

Devin Clark 20:12
So I got in with an endo, my plater, who ordered me a pump, and it took about a month for that to come in. So at this point, I'm about let's see, at the end of April, getting my pump and so about two and a half months pregnant. So not too bad. But the pump was like a lifesaver. So, so much,

Scott Benner 20:41
Which one did you end up with?

Devin Clark 20:43
I ended up with the Medtronic 670 G, which I ended up not liking. But you know, whenever I first started, I didn't know that I just ordered it for me right now. And you know, I hadn't researched insulin pumps or anything at that point. So I didn't know to ask for something different. But yeah, I wasn't. I wasn't a fan of it. In the long run, ended up switching after my pregnancy.

Scott Benner 21:15
Did you have a CGM during the pregnancy or just the pump? It was

Devin Clark 21:18
the Guardian CGM that goes with it.

Scott Benner 21:23
That's the 670 g that does all the Yeah, together. Okay. So do you have a Dexcom now or libri?

Devin Clark 21:31
I have a Dexcom g six.

Scott Benner 21:33
And you sound very happy about it. It feels like you just said I bought a Tesla.

Devin Clark 21:38
I was so happy. Like, you know, in online forums, I will advocate for people switching off of the Guardian, because I found that to be highly inaccurate, whereas the Dexcom has been very accurate for me and my son.

Scott Benner 21:55
Devin, here's the part where I usually say this, Hey, sorry, Medtronic, I don't pre screen these people. I don't know what pump she's used before she got here, do a better job. And people won't say stuff like this. Okay. So I mean, no, I think one person, there was this. I wish I can't remember his name. He was so great to talk to, I think we, Jenny and I did an episode about kind of breaking down the 670 G and, and it was from Jenny's perspective, and she just did not enjoy using it. And a listener who has it and really loves it sent me this just like this email is so mad as I was like, it was like we said something bad about his wife. And he was defending her. And I was like, Well don't, you know, say, come on the show and tell me, you know, like, I don't care what pump you use. I was just her opinion, you know? And he loved it. So I was like, great. Come on. Come on, tell people you love it. You know, it's fine with me. But you Okay, so now? I mean, really? it? I didn't want to bury the lead at the beginning because it seems wrong to us. Well, it doesn't seem wrong. Let me be clear, Devin, it is wrong to use your child's diagnosis as a cliffhanger in a story. So that's why you know, I wanted to just say up front, kind of all the facts. So you you, you have type one diabetes. And then oh my god, I forgot. And you were How did you? How'd they catch the hashimotos? They just do a full blood workup on you.

Devin Clark 23:17
Yeah, especially with a family history of it. My mom and both grandmother's have hypothyroidism. So they just wanted to go ahead and make sure and my levels were way

Scott Benner 23:31
off. They image your thyroid. They did they

Devin Clark 23:35
measured my thyroid and also thyroid antibodies, which were very elevated. So that's how I got diagnosed with hashimotos. At that point,

Scott Benner 23:44
do you have any symptoms from hashimotos now or just the Synthroid handle it for you?

Devin Clark 23:51
I'm actually off the Synthroid. I only took it during pregnancy I get lab work done every four months because it is it's imminent that I will have to start taking it again okay um but for now my my levels are fine

Scott Benner 24:04
oh no kidding in range so I don't think of I don't think of hashimotos is in range I think of it is symptomatic or not symptomatic. I'm assuming you feel the same way. Yes, yeah. Okay, so you just don't have anything going on right now. It's tough because it Devin I will say this, it sneaks up on you. So be careful not that it seems like you would definitely know but you know it'll it'll start like with you know, something like you're losing more hair in the shower and you'll you won't think of it as that or you're a little tired or you get kind of snappy with people and you want no you don't I mean, like it just, it sneaks up on you. So be careful. But every four months Geez, you must have like an open vein. Do you just have like a tap?

Devin Clark 24:43
I feel like I need one. I

Scott Benner 24:45
just need like a little a little screwed open up or something like that. Okay, so used to Synthroid through the pregnancy. Stopped afterwards. Yes. Okay. Baby comes out. Yay, baby. And then why How long until your second child is diagnosed with type one?

Devin Clark 25:04
So he was diagnosed during my pregnancy with my daughter. I was diagnosed in March of 2019. And he was diagnosed in July of 2019.

Scott Benner 25:19
Wait hold on a second. I'm either confused or you had a third baby. No we only we have two Okay, so let me start let me make sure I understand So your first child has type one night Your second All right, sorry. Okay, got it. I was like if she got pregnant a third time so that second kid could die. I was like then I don't know how you're have time to be a nurse if that's what nursing sounds art, you know. But okay, so first child, so how old he she I'm sorry he.

Devin Clark 25:49
He is two and a half now. He was 10 months old when he was starting.

Scott Benner 26:04
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Don't forget to go to touched by type one.org to find out everything that they're doing over there. And if you're in the Orlando area, and interested in some dancing extravaganza, get yourself some tickets and head over to the show. That's right. It's time for dancing for diabetes. Again, everything you need to know is it touched by type one.org. There are links in the show notes of your podcast player. And at Juicebox podcast.com. To the G vo Kibo pen touched by type one and all of the sponsors, please click the links and support the show.

Devin Clark 27:18
He was 10 months old when he was diagnosed.

Scott Benner 27:20
And how long had you had type one when he was diagnosed? formats. Okay. So for clarity, you're pregnant for four months have had type one diabetes and hashimotos for four months, and then your first child is diagnosed with Type One Diabetes. Right? Then you cry for sure. Yes. By then the pregnancy hormones are on top of you, you would have cried if like I offered you like a tissue had been like you're so kind to me. So I'm so sorry. First of all, that does not seem like a fair collection of circumstances. Very certainly. Is your husband around? Like how do you manage childcare to begin with? And then what happens when he's diagnosed?

Devin Clark 28:03
So he is he's here he helps a lot. But my son was staying with my in laws. Whenever he went into DK, my husband and I were away on an anniversary trip.

Scott Benner 28:20
Happy anniversary. Yeah. Wow. That sucks. How long had you been married?

Devin Clark 28:28
a year. Oh, my

Scott Benner 28:30
goodness, I Devin there. First of all, let's just pause here. And I'll tell a stupid story about myself so that we can stop thinking about you for a second because I'm sure some of you out there. There are times I've been married for a very, very long time. And there are times that my wife and I just look at each other. And we're like, I just didn't realize all this would happen. You know, like I mean, I thought stuff would happen. I thought some stuff would go right? Some stuff would go wrong, we make a little money, we lose a little money, we try to buy a house, maybe we get a better car at some point. We'd fight we wouldn't fight. You know what I mean? Like I thought all that would happen. I didn't think that my wife would get thyroid problem that would go undiagnosed for seven years and really Ravager and then my daughter would be diagnosed with Type One Diabetes. And then my daughter would be diagnosed with hypothyroidism. And then later my son was diagnosed with hashimotos. And I for some reason lived for like a decade with an iron level that was so low and had no like, I didn't think all of that was going to happen. And it's hard. It I mean, when it's all spread out, like you can kind of fight it and then rest and fight it again. It's almost like a boxing match, you know, but you don't usually get in the ring and have a baby in your belly and then two boxers come at you at the same time. Like that's just, I almost curse that's really crazy. And you're young to did that. Do you ever feel like holy crap like maybe 10 years from now I could have had This but like, I'm in my mid 20s.

Devin Clark 30:03
Yeah. But at the same time, you know, I'm just very thankful for my knowledge. Without it, I don't know how I would have done any of this.

Scott Benner 30:14
Yeah, that that is occurring to me that if you didn't have the training and the education that you did, that this really would have probably steamrolled you, I imagine. Yes, yeah. Well, well, yeah. Then Let's be happy for that. Okay. Okay, you're on a bureau. Oh, my God, I keep thinking, like, it's hard to I'm sorry, I'm sidetrack now, because it's hard for me to think of you as four months pregnant when you get the news about your, your, your baby, but what is that? Like? How did you so he's with your parents in laws, their parents, and you're away. And then what happens?

Devin Clark 30:51
So um, I get a phone call from my mother in law, she says, Hey, we're going to take him to urgent care. And I'll call you and let you know what's going on. Because at this point, he's just not acting right? He's lethargic. And he doesn't look good. Like, he looks dehydrated, like his eyes are kind of sunken in, they facetimed with me. And but she said, Oh, he's got like, a little low grade tip. And I said, Well, maybe he's got like an infection or something. So bring him in. The PA, who had previously worked with he, he called me and said, We don't know what's wrong with your son, but we just tried to stick in for an IV and he didn't even flinch. So we're going to send him to the emergency room. And at that point, I got really nervous. And so I sent him to the hospital where I used to work. And I had one of my friends send me a text message said, she said, Hey, I have Jack's, and we're going to take care of him. And so you know, made me feel a lot better. The next phone call I got was from the ER doctor. He said, Do you have your husband by you? I'm going to go over the test results we got since we had some blood drawn. And I said he's standing right here. He said, jack says glucose level was 1432. And I just hit the floor screaming. Like, I knew what it was at that point. Wow. So we had an sent to a different hospital with a pediatric endocrinologist because they didn't feel comfortable handling his care because he was so young. But the the other hospital was close to our house instead of two hours. So why were my in laws were? So you know, worked out?

Scott Benner 33:04
Well. Devin, I've heard a lot of people told me the stories about how they are their children were diagnosed with Type One Diabetes. And this was more jarring to me, because I knew that you understood what was being said to you through the steps. Like I found myself wondering, like, what does it mean when you try to take blood from a baby and it doesn't flinch? Like what would that be an indication of I'm sorry to ask you a because now I feel like I'm asking you a medical question. And you're relating it in your head to your son that makes me feel badly for asking. But from a medical perspective, like what does that say to you as a nurse.

Devin Clark 33:42
It says to me that he is close to being in a comatose state. That's what I thought, that's the body shutting down.

Scott Benner 33:49
That's when I started getting upset when you were telling the story of me, I get the chills, and I felt like it was gonna cry. You did a really good job. You were trying to make me cry. You really did it. But that's all I can think of is that every step along the way. You were going to you were going to know the the underlying inference of the statements. Can I ask that after the shock of the glucose went by? Was it more relieving than some of the other things you were thinking?

Devin Clark 34:17
He also went over the results of his blood gas. That was really, really bad. So he was in severe decay. And I just kept growing as he was telling me the numbers because I knew what they all meant.

Scott Benner 34:31
Well, that part seems unfair to I've used the word unfair twice now. But it does, like there's something about but there's something in there. I think most people will never get to appreciate what the doctor is trying to do for you in that moment, like get you to the care without making you understand what they understand because of the emotional aspect of it. But there's no avoiding it for you. Yeah, they don't tell you the worst stuff in Till the worst stuff is, is you know there and they have a way of kind of like good doctors have a way of gliding you through it a little bit, but you couldn't you couldn't take that ride. So how far were you from where your son was? At that moment?

Devin Clark 35:16
Six and a half hours away?

Scott Benner 35:18
by car? Yeah. Oh my gosh. So you guys pack up and head?

Devin Clark 35:24
Yeah. So we actually went to a baseball game right after that we were actually waiting for an Uber to come to our hotel and pick us up when I got the phone call. And we had friends of my husband meeting us there and so we ended up going to the game, but we ended up driving home right afterwards. And then to the hospital The next morning,

Scott Benner 35:50
Devin this guy you're married to he got a nurse. A good mom and a girl that will go to a baseball game for their anniversary.

Devin Clark 35:59
Oh, the baseball game is it that's all me. I got him into baseball.

Scott Benner 36:05
Does he? Like you get extra gifts that like gift giving occasion?

Devin Clark 36:08
Yeah, I should I'm gonna pass that along to him. I

Scott Benner 36:12
mean, really? He's not paying attention if he's not what I'm What? So did you travel somewhere to see like your favorite baseball team play?

Devin Clark 36:18
I did. So we live in Louisiana. And an Astros fan, the Houston Astros. We went to Dallas to see them play the Rangers

Scott Benner 36:28
Look at you. This is perfect. I would like to, if anything happens to this guy. And you know, and my wife at the same time, I'm going to, I'm going to ring you up. But you're a little young. But I but I would like to go to baseball games. I want somebody who's like, hey, let's go to a baseball game as a celebration. That is very cool. So So timing wise, you couldn't get out of there. So you're like, we're just gonna go to this game anyway? Or was this year like, we might as well stay and do one decent thing before we leave like situation?

Devin Clark 36:58
Well, that was my husband's idea. I wanted to come home immediately. And he said, Well, what are we gonna do like, there's nothing that we can do at this point, other than just sit there in the hospital. Might as well just go to the game that we've already paid for, and go in the morning. So he wanted to stay overnight in Dallas and then drive all the way back and I said, No, we're gonna leave and go home, which home would be about four hours from Dallas, and then another two to my in laws. The next day,

Scott Benner 37:30
husband's never going to live that down. You can be polite on here if you want. But I once had, we were on the way to a flyers game when my wife and I were dating, and she got really kind of like sick to her stomach. And I was like, oh, we're so close to this day. And what I was really thinking was these tickets are really expensive, and I'm not sick. And I know that 25 or six years later, if you were to bring that up right now she'd be like, you were such an idiot for making me go to that game. So I feel bad. I feel badly now as an older person. And one day your husband will tell. But I get his idea. Like I really do like, big What are we going to do? But at the same time I get you want to just go right away?

Devin Clark 38:10
Yeah, I can tell you, you know, as much of a fan as I am. I can't tell you a single thing that happened during that game,

Scott Benner 38:18
I would imagine. Yeah, I would imagine that you're just in a blur, right? Yeah, yeah. Geez. All right, um, son's diagnosed, you already have type one, although you're pregnant, you're just you know, the pump thing. How long till somebody suggests the pump for your son.

Devin Clark 38:36
Um, it was suggested immediately in the hospital by his endo, to go ahead and get an on one. And I was like, Well, let me let me think about it. So we ended up doing MDI for three months before we got him on apart. Okay, I just I wanted to feel comfortable with his management in that way before we moved into something different.

Scott Benner 39:03
So while you're learning about his management, in honesty, you're learning about your own at the same time.

Devin Clark 39:08
Oh, yeah, I'm freshly diagnosed you know, trying to figure out diabetes and pregnancy and that's just a whirlwind and its own and then diabetes and infancy is just another you know, headache on top of it.

Scott Benner 39:25
Well, you're being polite. Those are two sides of a tornado. You know what I mean? Like it's the the infancy thing is tough, because I mean, what could he have weighed?

Devin Clark 39:35
Oh, I think at that point, he was about 15 pounds,

Scott Benner 39:41
so using barely any insulin to get his blood sugar to move. And you're getting ready for an insulin resistance in a couple of months. Right? Yeah. How hard did that hit you? When that time came.

Devin Clark 39:57
Um, it honestly wasn't terrible. I stayed on top of it. I, for the most part, did my own adjustments at that point. Now I still did get with the suggestions that my endo made. If they didn't work out, I'd tweak it a little bit, and let them know.

Scott Benner 40:22
Stay on top of it. That means as your needs increased, you increase the insulin. Right? Yeah, I think that's the, the disconnect for people. So often is they they just get settings and they're like, well, these are the settings and then like, my blood sugar's high all the time, I understand what's wrong. So maybe you need more insulin? Well, no, these are my settings. It's not how it works. But I know that in the beginning, managing I mean, we're half units, like too much for your son.

Devin Clark 40:54
Sometimes we actually had him on a u 25. Insulin homologue, to be exact. So sometimes, we would just end up giving him a half unit of u 25. And that was enough for his bottle, or whatever he was eating.

Scott Benner 41:16
Yeah, I didn't know how to ask if you can. I didn't I find with sound silly or not where you breastfeeding was going to be my question, but I'm assuming your body had done about enough by that.

Devin Clark 41:29
I was not breastfeeding. But I see people online that struggle doing that

Scott Benner 41:36
with with type one. And without but yeah, but with type one specifically. So so you have to how often? Is he getting a bottle?

Devin Clark 41:47
He was getting a bottle every four hours at that point, I believe.

Scott Benner 41:51
Okay, so you how do you do that? Do you inject and start the bottle right away? Or do you get feed the bottle and then put the insulin? How are you handling it?

Devin Clark 42:01
Um, so they had him on, I think in pa h in the background with the diluted homologue. So we had to be on a schedule. And sometimes it didn't work out because you know, the predictability of mph with a rapid acting is kind of easy sometimes. So in general, it was normally sometimes between three and four hours. And then we would oftentimes have to wake up in the middle of the night and give him an extra one.

Scott Benner 42:47
So you were testing? Were you testing him while he was sleeping?

Devin Clark 42:51
Yes. In the beginning, it took us two or three weeks after he was out of the hospital to get him on. A CGM.

Scott Benner 43:02
What did you find was happening overnight. Like what was what was happening that you couldn't see prior to the CGM.

Devin Clark 43:11
He had a hormonal search right after he would go to sleep and it would sustain and then drop off about 4am.

Scott Benner 43:20
What did that do to his blood sugar's?

Devin Clark 43:23
So whenever he got asleep and had the growth hormone surge, it would elevate it a good bit. So he would shoot up to, you know, like, 300 or so. But then since he was also in the honeymoon stage, he'd start working his way back down, and oftentimes find himself flow. Somewhere around four to five ish.

Scott Benner 43:47
I'm incredibly comfortable talking to you, Devin. I'm trying to figure out why. So when you first popped on and you had a more southern drawl, I thought I gave a to let you inside of my head. I was like, I said to myself, talk slower Scott, like, like, just don't like try to dial yourself back a little bit. But you speak more quickly than I expected you to. And at the same time, you have the there's the comforting part of the of the accent. So I've come to realize that the southern accents lo me to like, they make me calm, I guess. But I still have to Anyway, I'm enjoying talking to you. I hope you are too. And you're such You're so good about the knowledge piece of it. Like I I've not asked you a question yet that you were like, Oh, I don't know. But you said you were nervous when we started. Are you nervous now? I'm a little more comfortable. Only a little more. A bit more. I'm doing my best here that would feel better. gone all the great roads. I've made fun of your husband, women love. I can't believe you're a great baseball fan. That's amazing. You're doing a terrific job. like managing your well yourself and your son and you know, through an infant diagnosis is it's just that much more difficult. Really, it's, it's, it's fantastic as as time has passed Now, is there much overlap with your management and your sons? Where are you just like literally two separate people.

Devin Clark 45:28
We are two separate people. But we are also using the same system just for you know, ease of use for myself and my husband. You know, just in case, you know if something bad were to happen. So, we are on the DIY loop.

Scott Benner 45:50
Oh, you're looping, okay? Yes. All right. So you're both looping. So you're using Omni pod or the Medtronic pump to loop?

Devin Clark 45:59
We're both on Omni pod. Got it?

Scott Benner 46:02
So you're looping. And you're both in the same thing. But you have? Well, that's what I'm wondering like you have you have hormones throughout the month. But isn't he growing? Doesn't he too?

Devin Clark 46:13
Yes. So his needs will dramatically go up during a growth spurt. And then they'll kind of taper back off for a little while, and then they'll go back up quickly again, and then it's, you know, just kind of like an

Scott Benner 46:32
ebb and flow. His aren't as predictable as yours. Oh, no. Yeah,

Devin Clark 46:36
my my settings pretty much never change. But his change frequently.

Scott Benner 46:43
That's, that's interesting. Okay, so you're not too much more difficult to manage during different parts of menstruation? You're, you're pretty stable. What does that mean for you? What are your goals?

Devin Clark 46:56
So I've maintained a good time and range. I'm not like, you know, super hardcore, I'm okay. In the 80s. My a one C's been in the fives. consistently. And, you know, I also eat my fair share of junk food. I'm pretty proud of that.

Scott Benner 47:22
You should be what would make you feel hardcore. I mean, that seems pretty hardcore to me. But

Devin Clark 47:29
well, you know, I know a lot of people try to maintain a flat line. And I, you know, I know that's not possible. You know, without a lot of hard work, which I'm not really willing to put in, because I have two people to manage. And I also have, my daughter has katatak hypoglycemia. So I have three blood sugars I have to manage.

Scott Benner 48:01
I'm glad you brought that up, because I want to find out about that in a second. But I just want to tell you, I think what you're doing is really bad ass. And if your blood sugar is not constantly at five, I don't think that's a big deal. I think that's kind of amazing. Are you able to achieve the similar for your son?

Devin Clark 48:17
Um, so his is gonna run a little higher. His endo has already told me you know, two years old is a very hard age to manage. So we just had our first Well, no, our first but first in a while, what I would say hire a one C for him, which was seven. Whereas he's been in the sixes. And I've been okay with that. And so when she told me it was seven, I was like, beating myself up. And she was like, Oh, no, no, this is great.

Scott Benner 48:52
Are you are you would you say, I guess I should say, Would you say I should say which I've made that very confusing. Let me start over. Would you say that stability within a range is your main goal for him? Yes. So you're just trying to avoid bouncing more than anything, right? Is the higher number in your head because does he drop out of nowhere pretty easily?

Devin Clark 49:20
He can. Sometimes he can be a little unpredictable. And just depending on where he is, in his stages of growing, yeah. And then we've also found that sometimes his pancreas is still putting out just a hair of insulin that'll cause him to get really bad. You're getting

Scott Benner 49:41
help so that you don't want anymore, right? Yeah. And I'm assuming to his diet is more commensurate with a younger person's

Devin Clark 49:51
chicken nuggets.

Scott Benner 49:54
entire industry made out of chicken nuggets for little kids. Yeah, and that's tough. I actually was talking talking to somebody the other day with a two year old. And they're like, I don't understand. It's just chicken nuggets. They're the good ones. I was like, Huh, they're frozen. They're not that great. Yeah, I know you think they are, but they aren't like, the only way you're going to get away with chicken nuggets is if you buy ground chicken yourself, or make them out of, you know, chicken breast and like, then you'll get a more stable thing. But the breading on the frozen ones and whatever they put in them so that when they unfreeze, you don't have botulism. Makes it makes it harder, you know, just yeah, I hear you. Well, I mean, that's amazing. Does anyone ever tell you you're doing a great job? Yeah, sometimes good. Because if they don't, I will tell you. You're doing a great job. Thank you. Yeah, you're welcome. It's astonishing. You're still at the age where if you told me, I have type one diabetes, and I mainly go to concerts, and I don't have kids yet? I would that's still your age. You don't I mean, like you're getting a lot accomplished. Do you feel like an old soul? Or? sometimes sometimes, sometimes you feel like, I should have kept that guy away from me?

Devin Clark 51:08
Well, I'm also an only child. So I, I've kind of heard that my whole life.

Scott Benner 51:14
Yeah. Oh, no kidding. It's kind of a little more stoic way of being and, and you're a protector, too. I would imagine. If you love nursing so much. You must really like the caretaking aspect of it. Yeah. Yeah. Cuz that's especially you couldn't not? I mean, I don't know how to be a nurse. If you didn't feel like that. I guess it would just seem like a would feel like a nine to five punch in job than if if that was if that was the case. Okay, so I have to ask, you mentioned your daughter's blood sugar. She has one.

Devin Clark 51:41
She has katatak hypoglycemia. That just

Scott Benner 51:45
sent me to Google. Hold on a second. Okay. All right. A medical term, used in two ways broadly to refer to any circumstance in which low blood glucose is accompanied by ketosis were to in a much more restrictive way to refer to recurrent episodes of hypoglycemia, excuse me, hypoglycemic symptoms with ketosis, and often vomiting in young children. Which one, are you? Number one, number one, good, anything that doesn't involve vomiting is better than anything that doesn't go right. So how does this Well, I guess, how does this show up first?

Devin Clark 52:31
So you know, I'm already hypervigilant, having a second child after having one with type one. So I made it to about a year without checking her blood sugar. Yeah, Amy. And one morning, I go to get her out of her crib. And I've noticed that the crib is soaking wet. And I said, Oh, no. So she's also a little more fussy than normal. So I checked her blood sugar, and it's 50. And I'm like, okay, that's not what I was expecting. So I called the pediatrician, got an appointment. She had had, like, a few episodes of diarrhea about a week prior, and I said it was probably linked to that, but to also keep checking her blood sugar given the family history. So we did, and about a week after that happened, I go to get her out of her crib, and I smell ketones. And I get my blood meter out and it was 3.6. And I call my son's info and I'm like, I need to get my daughter an appointment with y'all.

Scott Benner 53:50
Give a plan or a punch card where I get like a free sandwich at the end of these visits or something like that.

Devin Clark 54:00
So long story short, we couldn't get her an appointment in time. We had to get her to go in patient about two weeks after that. When I woke up, she woke up she was kind of out of it. Her blood sugar was 41. So we brought her to that hospital that evening, and I did fast with her to try and get her blood sugar to go down to take labs, which is when they had diagnosed her with it. At that point,

Scott Benner 54:36
what's the diagnosis mean?

Devin Clark 54:40
So her, this is normally a diagnosis that amount nurse child would get and if you could see my daughter, she is anything but she she's very well fed and plump and So that's why they were kind of scratching their heads. You know why she had this, but she develops ketones in a starvation period. Where you know, her body is so low on glucose, it's trying to get energy somehow. So it starts developing ketones for energy in a state of low glucose.

Scott Benner 55:30
How do you? Is it manageable some way like is there any way to impact it, you have to eat on a different schedule, you have to eat

Devin Clark 55:37
on a schedule, she cannot go any more than three hours during the waking hours, without having at least a snack. And at night, we have to put cornstarch in her milk, which we also had to deal with my son when he was first diagnosed with type one. So so for him it about

Scott Benner 55:59
that for him, you did it to keep his blood sugar up. And for her, you're doing it to keep the milk in her stomach longer. Yes, similar reason, similar thing, but different reasons.

Devin Clark 56:09
And also to keep her blood sugar up because it takes longer for your body to process a starch.

Scott Benner 56:15
And then if, okay, so if your body's still seeing it, and has blood sugar, it won't do the ketose the ketone thing? Right, okay. Forever. Is this a forever thing?

Devin Clark 56:30
It normally goes away. Later in childhood, sometimes it doesn't.

Scott Benner 56:37
But that's a short answer. Yeah, no. I'd have been like, Great, thanks. But you were probably just like, Whatever. I'm doing well, now I can do this now. Yeah, wow. I'm assuming no more kids. No more kids. I'm sure they're delightful and everything, but you get one more thing to do. And you're going to, you're going to be losing your mind, I would imagine. How is it managing all three of these things? Like what? How do you? I mean, you seem unless you're pretending for the podcast, you seem relatively normal and together. So Howard, how did you find a balance? Um, where have you not?

Devin Clark 57:19
I don't know if I have I just kind of get up and do it every day. That's why um, now I you know, mental health very important. I do see a therapist. Yeah. I don't know what I would do if I didn't.

Scott Benner 57:38
I was you I'd shrink it down and just put it on my shoulder. The therapist. Just come along for the ride. Yeah, I don't see how you wouldn't want to do that. I mean, perfectly honest. That's a it's just a lot. It would be a lot if you had diabetes, it would be a lot of your kid did. I think it would be a lot of with this. You know, ketotic hypoglycemia thing too. But all three of them togethers it with a young family is something else. I'm assuming your husband does everything else in the world, right? Like you don't have to, like take out the garbage or move something. You just stare at him? Right? play with the kids and come on. You gotta be kidding me. Now, he can't do there's nothing you shouldn't even know what a garbage day is. Like, if I said you a devil, what day is trash? Come? You should have to go. Um, I think Tuesday. That's that would be the answer I would want from you. Yeah, tell him he's got to get moving here. Yeah, there's, there's a lot going on. Holy crap. So see a therapist weekly.

Devin Clark 58:38
I see your once a month now.

Scott Benner 58:39
Is it just sort of maintenance? How does that go? I mean, do you mind telling me? No, no, it's fine.

Devin Clark 58:45
Yeah, it's it's just, you know, a check in make sure everything is going okay. Um, but I just, you know, find it very important to have somebody to talk it out with and my therapist also is diabetic, so she understands where I'm coming from. And a lot of aspects, was that on purpose? No, it was not. It was definitely a God thing. That we were both diabetic,

Scott Benner 59:20
you're like, so here's the story, you start telling a story about diabetes. Do I know exactly what you're talking about? Yes. Nice. That's a little bonus there. They should put that right on the sign. Honestly. I would I'd be like I have diabetes. Just cater to a diabetes crowd. Because I think it needs a level of understanding that you probably can't have without diabetes. Right? You know, or otherwise, it just sounds like you take insulin, your son takes insulin and your daughter has to drink milk with corn starch in it. Like you don't I mean, like not really understanding the gravity of what's happening and hearing it clinically. I would imagine might not be pack some people the same way. So good. That's amazing. We are coming up on an hour. I want to make sure that we've talked about everything you thought we were going to talk about.

Devin Clark 1:00:11
I believe so. In my mind, I thought we might talk about labor a little bit more, but that's totally fine if we don't.

Scott Benner 1:00:21
Yeah, it's not that we can't. That's why I asked here at the end. So you are using the Do It Yourself loop that you just download from the internet. Which sounds crazy every time I say it out loud, even though I know it's not. I personally think that the algorithm is amazing. And does really great work. Do you use auto Bolus,

Devin Clark 1:00:44
or I I do I use auto Bolus? I had my son on it for a little while. I found it to be a little aggressive for him. So I switched him back to Temp Basal

Scott Benner 1:00:56
gotcha. I think if Kenny was here he would say that you could adjust the percentage that the audible is works at in the programming somehow but to ask me how to do it would be a mistake. But I think it's at 40% Does that sound right? So if it thinks you need a unit it gives you point four it waits five more minutes, I think then it gives you 40% of the next indication. I think that's how it works.

Devin Clark 1:01:24
It does until it finds a level of status or it starts to go down. It'll start it'll keep giving you insulin Yeah, but

Scott Benner 1:01:33
I think there is somewhere in the programming of it where you could just say to look if you think I need a unit give me a unit. I think you can make that 40% 100% not that I'm saying to do it. I'm just saying I think it's possible to adjust them.

Devin Clark 1:01:44
Um, I think that is an open APS not 100% sure, but the the one that I have, I don't have that option.

Scott Benner 1:01:59
Gotcha. So you're not using Ivan's branch you're using a different one? Yes. That's a lot of words that most people didn't understand just now. But it's uh, I mean, I can tell you from my perspective Arden's using Ivan's open APS and it's amazing. It just it really is absolutely spectacular to watch. You make a mistake on a meal. And for it to go, Oh, you're gonna need more insulin and just put it in. It's crazy. Like, you know, you can miss on a meal reasonably. And the auto Bolus, I don't know what your findings are, but I think the auto Bolus will stop Arden from being more like you know 200 at least if we've you know what I mean if we've missed on the amount of insulin she needs it can it can get her stopped usually by 200 Yes, if you just ignore you know, if we were in a situation where we just ignored it and let the auto Bolus kick in Do you have a similar finding?

Devin Clark 1:02:57
I do personally know for my son we had to make a lot of settings adjustments trying to go from Temp Basal to to the audit Bolus with him and we found where we landed was still a little off but in talking with his endo about it we found that we probably weren't going to get to the level we needed to be without using diluted insulin because he was using such small amounts is basil right sometimes your point oh five oh

Scott Benner 1:03:37
my gosh. upsample What's the way now? Present day 33 pounds because he was 10 months old when he was diagnosed he's still only like two right? Yeah. Wow. Yeah, that's that makes total sense. Are you interested in on the pod five trying that for him when it comes out?

Devin Clark 1:03:55
I am very interested in that

Scott Benner 1:03:58
to get rid of the Reilly link alone would be amazing, right? Yes, I agree. I'm it's April now when you and I are recording you know, people will hear this probably will have, you know, Halloween decorations up but I'm like, I'm trying my hardest through all the channels I have, like I'm pushing. I'm like, Can I just like can I see the only about five plays nicely. So I'm excited too. I think that carrying a link between something and the pod is Arden's least favorite part of it. So So yeah, I agree with you. Do you think you would change yourself too, if you found it working?

Devin Clark 1:04:35
Ah, it really just depends on what the hard settings are. That, you know, things that I couldn't change, like, target and such. I know. Whenever I was on Medtronic, they had a certain level I couldn't go below. Yeah, and I know it's the same for tandem and I'm sure shirts. For FDA approval, it's going to be the same for the Lv pod five,

Scott Benner 1:05:04
you would imagine I'm hopeful that you can make your setting so that they do more what you want, as far as outcomes go like that's I don't know, but that's why I'd like to get my hands on it to find out because I'd love to try. Yeah, I'm excited. Um, how long have you been doing it?

Devin Clark 1:05:23
I actually got my son doing it first. I started with him in January of last year, so he was 15 or 16 months old. And then I started in August of last year,

Scott Benner 1:05:45
in about every way I can measure from this conversation, Devin, you are a badass. Seriously, like, Oh my god, are you kidding me? I saw that thing. And I was like, No, I need help make somebody help me. I scared No, no, thank you computer don't want to do it. You sound like you just do whatever's best and jump in. That's very cool. I had a question for you just put that in my head. Oh, do you listen to the podcast at all? How did you find me?

Devin Clark 1:06:12
online on Facebook, actually. And then my son's endo had suggested you to me at some point, I think last year, and I was like, Oh, yeah, I heard about that. So yeah, I started listening. I actually started with when you interviewed Kenny Fox, cuz I was trying to get my loop settings, right?

Scott Benner 1:06:38
Oh, I found so I got you through the loop stuff. Very nice. I like that. And you're and by the way, your endo limits. Just take a second here to say hi, how are you? Thanks so much. Really appreciate it. You're the best endo in the area there. I'm CL willing I am to pimp somebody out if I'm just happy to say Yes, you did a great I don't even know if he's a good endo. Or she I don't know anything about I just happy that they like the show. That's really cool. Like, I mean, being serious that it's, it's very cool that a doctor would say hey, you should try a podcast. And it's interesting that you found the podcast through Facebook, because I I know this shouldn't be surprising, but I'm always like stunned by that a little bit. You know, the the podcast has a Facebook page that's public and you know, basically it just tells you when new stuffs coming out and stuff like that. But then there's a private one where people talk constantly and I think the Facebook page must have gotten a good reputation because now people come into it. Thinking I heard that if you're in this Facebook group, you're a one see goes down and you get better, you know, variability and they get in there and eventually they're just like hey, I'm all this stuff you guys are doing Where did you learn this? And people are like the podcast and they go what podcast and I'm like oh my god that's so crazy. You know you mean like they're there and they don't even understand that the podcast exists or why what how the Facebook page got there it's pretty cool how the I don't know if the snake is eating its own tail now or I don't I don't know what the the euphemism is there. But it's it's pretty, pretty great. Is Do you find that to be a good Facebook group? Yeah, definitely. Yeah, I like I think it's a it's got a good vibe. So I'm always happy about that. Well, I'm glad you found it. And if any of it's helped you It sounds like you didn't need much help you seem like you know what the hell you're doing. So just very cool that you're here. Thank you. Thank you. A huge thank you to one of today's sponsors. g Vogue glucagon. Find out more about chivo Kibo pen at G Vogue glucagon.com forward slash juicebox you spell that? g VOKEGL Uc ag o n.com. forward slash juicebox. And I don't want to forget to thank Devin for coming on the show and sharing her very unique story. Thank you so much, Devin. And if you love watching dancing, well Well, well, we've got a surprise for you touched by type one is dancing for diabetes. Find out why, where and how. At touched by type one.org.

Are you enjoying the Juicebox Podcast? Please share it with someone else who you think might also enjoy it. Are you really loving it? Like is it hitting you right in the soft, gooey spot in the middle and you're like, Oh my gosh, I love this podcast. I have so many wonderful things to say about it. If you are, leave a five star rating and a beautiful review wherever you listen, like if you listen to a podcast app, go into the app and see if you're allowed to rate the show. And if you are rate rate rate, rate, how many five rate great, great, great, great, great rate and then say something really meaningful about the show that might help a new listener to want to listen. Thank you so much for listening, the show is doing terrific. It is because of you it is because of your sharing. I really couldn't say thank you enough or, or even find the words I think to express how grateful I am. Thank you so much for being here. I'll be back very soon with another episode. Oh, I'm sorry, I meant to also say T one d exchange.org. forward slash juicebox. us resident with type one us resident who is the caregiver of someone with type one, take the survey, you can do it on your sofa from your phone, it takes less than 10 minutes. I'm being serious. They're not difficult questions. They're not probing or deep or super personal. You're going to be helping people living with Type One Diabetes, when you complete the survey, you're going to be helping the show. If you can do that. I would really appreciate it. I'm trying to personally with the power of this podcast, push 2000 new surveys to the T one D exchange before the end of November before the end of diabetes Awareness Month. If you could just give me 10 minutes on this. It would mean a lot

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The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!

See this donate button in the original post