#355 Ask Scott And Jenny: Chapter Thirteen

Answers to Your Diabetes Questions…

Ask Scott and Jenny, Answers to Your Diabetes Questions

• How do you estimate how long an increased temp basal will be necessary based on the amount of fat, carbs or protein in a meal?

• Is there a strategy for eating food in a certain order?

• Let’s talk about artificial sweeteners, sugar alcohols and the impact on blood sugar.

• What happens when you fly with an insulin pump?

• Let’s talk about the first years of diagnosis and the impact on long-term health.

• Is it true that younger children are harder to control? Tips on pre bolusing kids, not comparing your graphs and asking the right questions.

• How do you calculate your bump and nudge ratio?

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Pandora - Spotify - Amazon Alexa - Google Play/Android - iHeart Radio -  Radio Public or their favorite podcast app.

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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, welcome to Episode 355 of the Juicebox Podcast. Today's show is an hour of ask Scott and Jenny. I'll tell you about Jenny in a second. But let's look at my notes here about what's involved in this. Out.

Unknown Speaker 0:18
Increase babies.

Scott Benner 0:21
I can't read my own writing, but this is a thing. Well, alright, hold on. Let me count the scribbles. 1234567. Jenny and I are going to talk apparently about seven different things about type one diabetes today. And all those questions were sent in by listeners just like you. I'm sorry, I cannot be more direct than that. I tried to make a list. I wrote them down. I just hold on. Air travel with a pump. Alright, that one I got figured out our kids easier when they get older. Maybe that's what that means. My writing is terrible. Is there a method to bazel increases Temp Basal increases? That might be what that is. Order. ordered. Cathy, that can't be right. Um, figure out bumps. I guess that's about how do you know how to bump and nudge. Bad. Turn COVID. Court Li issues Wait, what? Between Okay, not bad turn between old something issues. Health beegees that health? halt all halls.

Unknown Speaker 1:52
Okay.

Scott Benner 1:55
Um, anyway, it's gonna be a surprise. It's a great episode. I just edited it. I really loved it. I just edited it. The other day is edited a word or do I say it wrong? It's hard to know, I guess. All right, hold on a second. Let me tell you a little bit about Jenny Smith. You know, Jenny, of course, from the diabetes pro tip episodes from ask Scott and Jenny, and defining diabetes. Jenny has type one diabetes now for over 30 years. I wonder if I could do this off the top of my head. I'm gonna go to where I have the information. Give me a second. I'm gonna go to where I have the information about Jenny. But I'm going to try to say it off of the top of my head first. So I'm near Jenny's thing, but I'm not looking at it. Alright, ready? Off the top of my head. Jenny Smith has had Type One Diabetes for over 30 years. She's a certified diabetes educator. Something nutritionist, a certified trainer on most makes and models of pumps and continuous glucose monitors. She's a terrific person. Alright, hold on. Ready? Now let me go to the thing. Jenny Smith has lived with Type One Diabetes for 30 years. She holds a bachelor's degree in human nutrition and biology from the University of Wisconsin. She's a registered and licensed dietitian, a certified diabetes educator, and a certified trainer on most makes and models of insulin pumps and continuous glucose monitors. But of course, most importantly, she is the best Juicebox Podcast Guest ever unless you've been on the show. And then in that case, you're the best one and Jenny's the second best one. I wonder how well I got that from the first thing. We are four minutes into this now are you guys listening to this? I'm so sorry. This episode of The Juicebox Podcast is sponsored today by Dexcom. On the pod the Contour Next One blood glucose meter and touched by type one, there are no ads in the show today. I'm just here to remind you that these are the advertisers and that they're lovely. And if you're interested in them, using my links helps the podcast and I appreciate it. Usually I tell you dexcom.com forward slash juice box, my omnipod.com forward slash juice box touched by type one.org. And I usually say something about Contour Next One but I've got my own link now. So you got to remember this one now. Contour Next one.com forward slash juice box. And now I'm just gonna make sure that that's actually correct because that feels wrong. Nope, it's right. Contour Next one.com forward slash juice box. Check out the Contour Next One blood glucose meter and all of the meters that contour cells. Also do you know it's possible that you're paying more to your insurance than it would cost to buy test strips in cash. You should check that out at the link as well. Do you want a free no obligation demo of the Omni pod sent directly to your home? do that at my link to my omnipod.com forward slash juice box. Dexcom is Guess where all the great information about the G sexist, but that's a lot. So go check that out too. And when you're done, you're gonna need some energy because you've been on the internet now and you're getting sleepy. Touched by type one.org. It'll lift you're right back up again. Let's get to Jenny and the Ask Scott and Jenny questions. Thank you everyone for sending in the questions that you sent. I am sorry that at the moment, I don't remember what any of them were. But I do remember that they were wonderful. Jenny was fantastic. I of course, was delightful. Hey, now please remember, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. One last thing juice box. docs.com is an ever growing list of doctors and other helpful people in the medical industry that you found you the listeners have found and shared with me. We're making a beautiful list. You can add to it if you want or go take from it. It's like that Penny thing at the convenience store. Give a penny take a penny. Give a good doctor. Take a good doctor. When Jenny and I record we usually catch up for a few minutes first, and I don't record it normally. But this time I did. It's just us talking about weird stuff going on around Coronavirus in our lives and I left it in for you. You can eavesdrop on the silly things we say to each other when no one's listening.

Jennifer Smith, CDE 6:31
Because their haircut had been delayed twice. We had had haircuts set up right including my own. You got a friend who has her own shop. And so she was going to do the boys it's in with the boys watching a movie with their little girl who is just a little older than Oscar is. And she was going to do my hair all set up. Now we rescheduled it because things had been like postponed. Now we've rescheduled it again for like mid May. Who knows whether that my boys look like shaggy dogs. Like I was like, even my husband was like their hair needs to be cut like it was getting to the point of like they'd sleep. And that bed head was like just not culpable. How did you no matter how much I just I caught it. Have you ever cut anyone's hair before? Um, I've trimmed their hair before in a pinch like this, okay, but like this was really like it was a haircut. And I it's fine.

Scott Benner 7:27
Kelly, Kelly sent me the other day, time to go to the heavier hair product. And I was like, Yes, I'm gonna need something with a little more control. I had my hair kind of short recently. And so I was just using like a little paste or rod or whatever, just like just a little bit. And now I use it, my hair is just like weak back, we can overpower that. And you know that I'm gonna have to go to a baseball hat pretty soon. And I don't think I have the head to shave my head just to start over again. So I'm not doing that.

Jennifer Smith, CDE 7:57
It's kind of funny. I actually I refer to like those days with diabetes, where you're just like, I don't know what's going on today. And it's just weird and bizarre. I called them I call them bad diabetes hair days where there's no amount of like mousse or gel or whatever that you can throw at it. That makes it like flap down the right way. That's how I count for that.

Unknown Speaker 8:20
How long have you been in your house by now?

Scott Benner 8:23
This is in three days. I'm on to three solid weeks.

Jennifer Smith, CDE 8:29
Yeah, by the end of this week, it'll be three solid weeks. Yeah.

Scott Benner 8:32
Can I make them? admission? Yeah. I know a lot of people say this. But I haven't really noticed that much of a difference in my life, which I'm assuming is bad for me. But, but also, I find it incredibly relaxing

Jennifer Smith, CDE 8:50
that you don't actually have to physically go anywhere.

Scott Benner 8:53
what the expectations are gone now

Jennifer Smith, CDE 8:55
are gone. Right? Yeah. Like, you're not expected to attend the ball down the street or go to some fees like hoopla right?

Scott Benner 9:03
My kids keep my house clean. Talk to my wife the way we always do. There's nothing there that would change and put this podcast out in the schedule. Nothing else in the world matters right now.

Jennifer Smith, CDE 9:16
Yeah, that's the only the biggest things I mean, that are changes for us. Like I love. I love grocery shopping. I love grocery shopping. And at this point, my husband is the one that's actually going now to the grocery store, pick

Scott Benner 9:31
the person

Jennifer Smith, CDE 9:32
because we pick the person and I'm the person that doesn't have you know, so. So yeah, so he's the one going to the grocery store and doing all that I like, I feel kind of a sense of loss.

Scott Benner 9:45
Oh, wow. Now I hear you. I'm the one having to go to the store. So yeah, and I've been twice now. And I'm like a ninja. I just have a little schmutz in my pocket. You know, I'm sure there's a real word for it but the stuff that kills the germs. And I hadn't, you know, I don't touch anything, bang, bang, bang and grab my stuff. Get out of there gela hands, move to the car, get the stuff into the car gel the hands again, get back in the car. You know, get it home, I strip away the packaging and do all the things you're supposed to do then clean the place where I stripped away the packaging, clean my hands again, and I'm done. I'm just like, hmm, probably should be doing this all the time. Not this intensely. But.

Jennifer Smith, CDE 10:28
But something similar. Yeah, actually sounds very much like ginger. You know, she actually posted something the other day about this is, this is what I do my one trip out of the house like and we also in, we've been really trying to like, we get the load of what we need. And then we really like our refrigerator right now is on the minimum. I think the only fresh vegetable we have left in our fridge right now is celery. Like we got to get to the refrigerator or the grocery because I need more than celery and hummus.

Scott Benner 11:03
That's a Facebook post for us. Anyway, we're down to celery, it's time for the celery. It's time,

Jennifer Smith, CDE 11:07
right? But so ginger actually takes she has gloves. She wears them, she actually takes in paper bags to the grocery store so she can get her groceries into the paper bags. Rather than having to push a cart that somebody else pushed, she takes them to the self checkout. So nobody else has to touch her groceries. She puts them into her bags. And then she actually doesn't even take those bags into the house. She like, takes the stuff out, puts them in a new bag to go into the house. And she's like, and I wash and scrub and I sanitize and I she's like, that's what I do.

Scott Benner 11:40
So my friend washing a brand new bag of potatoes in their sink yesterday. And I had two simultaneous thoughts. I thought that's a great idea. And I laughed a little bit. So but I when I put the hand sanitizer on I hand sanitize me and the cart. But But again, I got lucky because when we moved my son out of college, he had a 40 ounce jug of hand sanitizer that he hadn't touched. Oh, it was like finding a gold brick and the top of his like I was up in the top of the shelf. I was like, Oh my god, I'm so glad you're coming home. You're saving all of our lives Look at this. And and and then it made me think like, why does he buy stuff like this and then not touch it and use it for anything? Because he we didn't give it to him. He needed it for something. He got into his head at some point, you know,

Jennifer Smith, CDE 12:28
yeah, he put it in the back of his closet.

Scott Benner 12:29
Yes. There's a 20 year old boy for you. He heard about what was going on. I do remember sending him a text. And I said, Look, I know I bug you sometimes at school about sanitizing your hands, please be a little more mindful about it. Like I was trying to get him moving before this all exploded without worrying him. And so I guess he went to the trouble of buying it, which was not using it away rather.

Jennifer Smith, CDE 12:51
I'll use it when it really gets. Alright.

Scott Benner 12:53
Now he did say he had a little one he been using. So I'm like, maybe he was using I mean,

Jennifer Smith, CDE 12:58
or maybe he was using the big one to refill his little one who wasn't open to me. So

Scott Benner 13:03
let's try not to be too full for

Jennifer Smith, CDE 13:05
giving him a little credit.

Scott Benner 13:06
He's two years into college. He just committed to his major he the other day. He's not exactly out in front kind of kid. Yeah. So anyway. Oh, I want to tell you something real quick. And then we'll start this recording. And All right. Let's get back to our Ask Scott and Jenny list. I say what's

Jennifer Smith, CDE 13:30
on the plan today? Well, I gotta tell you, oh, no, I never know. I appreciate

Scott Benner 13:34
that about you, by the way that you've never once been like, exactly what we're gonna talk about before we talk about, which is why it is a surprise. This time, I actually marked the ones we did with a little word done next to it, which trust me is a major, major consideration for me because I'm not normally even that smart.

Jennifer Smith, CDE 13:54
You're smart. You're just not that organized, right?

Scott Benner 13:56
Well, sure. I keep a lot of stuff in my head. I don't write stuff down. I'm not I don't check boxes and stuff like that. But sometimes like this is a necessary thing to me. All right, I'm gonna start with

Jennifer Smith, CDE 14:09
Well, our list here is also very long. So putting done next to them was Oh, yeah,

Scott Benner 14:14
it's a long list. I'm just telling you. I'm not normally that smart. Bethany asks, Is there a way to estimate how long an increased bazel will be necessary based on the amount of fat carbs or protein in a meal? So she's looking for if there's this many carbs then do it for that long, but I don't know if there is or not,

Jennifer Smith, CDE 14:35
not typically I and that's why we have the we have a standard of what we say start with right for fat end of the meal increase the bazel by 50% over the next six to eight hours. experience will show you whether or not that works well. I for one have found that an increase in bazel for a while That meal in the daytime, I don't need as much of an increase, and I don't need it for as long at night. So for example,

Scott Benner 15:09
if I think,

Jennifer Smith, CDE 15:10
I think it's because during the day I'm, I'm up, I'm moving after the meal time, like if I go and I have a higher fat type of lunch, let's call it pizza or whatever, right? That's the typical example. Usually in the evening, I would need that 50% increase, and I typically need it for about six hours, during the daytime lunch, I usually need maybe a 30% increase, and I only need it for about three or four hours. Okay. And I I have to save from just experimentation. I think it's truly because after lunch, I'm not going to lay down for a four hour nap. I'm up, I'm moving, I'm doing things. I've got things to do around the house or with my kids or whatever. I'm just busier were in the evening time after a dinner like that. Well, I might be doing some things like putting my kids to bed or doing the dishes or maybe in the laundry or something. But for the most part, a lot more like sedentary. I went to the evening.

Scott Benner 16:09
Yeah, that makes sense. I listen, obviously, I think about it in pictures. But in my mind the basals a, it's a heavy jacket. And you mean you put it on while you need it. And when you get too warm, you take it off. So it's easy to say if you have a CGM. But if you don't then just test at more at intervals, I also believe that after experience, you know, the answer will come to you. Let's say it ends up being four hours that you need this basal rate for, you know, the second and third time it ends up being four hours. Well, I mean, then I stopped testing and I assume it's four hours. Right? You know, but you have to try it to know,

Jennifer Smith, CDE 16:45
to know, and the same thing kind of goes for protein, you know, the, the bolusing strategy for the most part, not bazel increased. But the bolusing strategy for protein says try to start it at the end of the meal extend the whole bolus out over the course of a three hour time period. Well, on average, people probably needed somewhere between two and four hours, depending on the portion of the meat, you know, if you're only bolusing for 12 extra grams of protein versus the night that you go for your 16 ounce pound of steak and your bolusing for 40 grams of protein. Very likely, that's going to also define a time to extend it out over Hmm. Because of the portion, right, it's kind of like the load impact versus just, you know, yeah. So that that can help with that too. The other thing for protein is kind of the kind of protein, you may find that leaner proteins such as, like a lean chicken, or even most fish tend to have a lower impact on blood sugar over the hours after even if the quantity is large, you might still have to cover it but maybe not quite as much as something like red meat. Okay. Red meat has not only does it take longer to digest, but it also has a lingering impact. Yeah, so those are some things to consider. I wish people

Scott Benner 18:15
could see that out last night Arden had a an avocado salad and edamame a for dinner. Yeah. And I want to say that i bolused 40 or 50 carbs for that. Like, and that I think is stuff people look at and go there's, that's free, almost that's a vegetable. And then I looked at the fat and the avocado was a big part of it. Like I think the true carb count, if I was really paying attention was probably more like 30 carbs when she put the dressing on and stuff like that, which she didn't use a ton of. But I looked at the fat and I was like, all right, like we're gonna need more power here. This there's going to be more glycemic load here from the fat and not in the way you think of it normally not, not from carbs, but just from its ability to hold it up which I think yeah, I think that might lead us into Jamie's question here. Now Jamie bemused, Jamie says maybe this is a pro tip and you tell me if you think it needs its own miniature discussion? Because this is something I've I don't think we I don't think I put a ton of effort into understanding but I know that some people do. She's asking about eating food in a certain order. Her examples last saving fruit for last, when you aren't as low as you would be when you started the meal or like the other way around, like what do you do? You know? So the

Jennifer Smith, CDE 19:36
timing or the placement of the food intake?

Scott Benner 19:39
Yes.

Jennifer Smith, CDE 19:41
Is to a degree, there is some there is some strategy for what she's kind of talking about. You know, if you are starting on the higher end, blood sugar wise, and let's say you didn't have as much time to Pre-Bolus as you would have really liked to Sure. If you Start the meal with, like, Iceberg lettuce and the protein part of it right, you're gonna have that sitting in your stomach first getting worked on first before you maybe get to your baked potato or your rice peel off, or your fruit on the end or whatever it might be, starting with the lower glycemic or almost no carb kinds of foods first, yeah, puts that into the stomach to get going. We know that proteins and fats take longer time to process and digest to begin with. And well, I mean, I kind of always think of my stomach kind of like a cement mixer. Right? It's not just taking your chicken and digesting it, and then moving on to your berries and then digesting those. I mean, it does all get churned together and processed, you know, with stomach acids and whatnot. But for the most part, yes, if you can start the meal with the things that you know, are going to be slower, letting the insulin kind of get working and going, and then add in the carbs at the end. Absolutely. That's a strategy strategy to use. Yeah.

Scott Benner 21:01
And I mean, I've had I've sent Arden into a meal more times than, you know, I can count where she's, you know, 70, or 65. And the last thing in my text was like, start with, you know, whenever the simplest sugar is, right, is that

Jennifer Smith, CDE 21:15
what the right the apple or apple sauce or whatever,

Scott Benner 21:18
right? I've said before eat the banana first. And I know that's not exactly. I don't think she looks at it and thinks I should eat the banana first, although I don't know. Because yesterday, what did she say to me yesterday? That was she said, Can I have a snack? And I was like, yeah, sure she goes, so what do you want? And she said, Oh, no, wait, it was at the end of breakfast. And she's like, Can I have a little more food? And I said, Sure. What do you want? She said, can I send bacon and an orange? And I was like, yeah, you want a bacon with orange. And we had a little bacon left on a plate. And I had oranges. And I thought, all right, and she looks so happy. She's like, the orange and picking it the bake? And I was like, well, that's a weird mix. Definitely what she wanted. So, you know, I mean, I think that's, I think it's reasonable to be thoughtful about it. Now, I do know, there are some people who steadfastly eat their meals and orders to keep these incredibly stable blood sugars. I don't know, I can't speak to it. And I don't know that I would want to live my whole life that way, either.

Jennifer Smith, CDE 22:22
Right, you know, strategy wise that what you found works, and that makes you happiest, because then you're not dealing with the flux in blood sugar. Great, if that's your strategy, have at it, keep up with it, you know, everybody finds what works, or hopefully, they're learning to find what works, right. But I mean, even even in consideration it if you're looking at a dessert, like at the end of a really big meal, a good example is something like a Thanksgiving dinner, or a holiday meal, or you've had all of these like, heavier, more dense types of foods. And then at the end of the meal, you add like grandma's apple pie with like marshmallows baked on the top of it, or whatever it is, you know, you're thinking, Oh, my gosh, this is all sugar. Well, what else do you have to consider, you have to consider all that other food that's sitting in your stomach. So, so heavy, that might actually be a time that while normally you'd take Bolus and Pre-Bolus everything, not even choosing an extended Bolus. Yeah, at this point, you've got all this extra food sitting in your stomach. And while this is simpler sugar, its impact is going to be drawn out. So you may actually want to do an extended bolus for this dessert. Because otherwise you're going to go low,

Scott Benner 23:43
because it's flopping into your stomach and laying on top. It's not part of what's happening. Right? Correct. Yeah. See, that's the stuff that is it's smart to understand. And I just think I think of it is experiential, like I just might go I know from experience this doesn't need a Pre-Bolus the way it would normally we already and I think of it as like, we already have so much insulin in the processes or I guess what we're saying the same thing. The process is already happening. Now we're just throwing in, you know, like another teaspoon into a gallon of water. And yeah, okay. By the way, all of Jamie's questions are like I think this would be a good pro tip. I think she's trying to produce the podcast here which by the way, there's some really good questions here. I don't think this one needs its own episode. So I'm gonna ask one more of Jamie's questions because she asked specifically. I want to know Jenny's take on artificial sugar. So artificial sweeteners. I know they affect people differently. But in she said In your opinion, which ones seem to have the least impact. She said, I also feel like a lot of people don't realize you can see rise from zero carb drinks. I will tell you that Arden doesn't drink a lot of soda. But if I start seeing her blood sugar gets sticky. I look to see if she's gonna Diet Coke. And that sometimes that holds her up a little higher. It's not like don't get me wrong doesn't make her 300. But it could make an incredibly difficult 140. Right? It doesn't want to give up.

Jennifer Smith, CDE 25:12
So there are I mean, if you wanted, gosh, I'm trying to remember what the university was that did a study on. Like, how much of the on the market artificial sweeteners is considered safe, according to the type of artificial sweetener in the product. Right? So if you've got something like equal, you're talking about the artificial sweetener, aspartame, okay, right? If you're talking about Splenda, you're talking about sucralose. So and then, of course, there is sweet and low, which is this the saccharin kind of component right? Now, there are also what I call alternative sweeteners that I think sometimes get falsely right, that get falsely kind of categorized with artificial stevia, being one of those alternative sweeteners. It comes from a plant Yes, it is processed the the sweetening pieces that come out of the stevia plant get processed in order to make a product that you can like, you know, put into your, your drink tea, coffee, whatever sweetened beverage, you know, sweetened a baked product, with what with whatnot, but the studies around impact from stevia, comparative to those that are truly artificial, by artificial, I mean chemical in nature, they don't come from natural, outdoor plant life. Right, they are created in a lab. So those, there are acceptable limits to like how many packets a day technically you should have, or how many soft drinks you should have with how much or, you know, beverage or how much how much per packet or whatnot, and each of the different sweeteners does have a limit to it. I mean, it's, it's a lot. I mean, most of them, it's like 15 packets a day, you're 25 packets a day. I mean, maybe some people are having that much I,

Scott Benner 27:29
I hope to you,

Jennifer Smith, CDE 27:31
it seems like an awful lot to me. And I

Scott Benner 27:33
know, can I say something now that we've met in person? Yeah, not that this doesn't come across the video, you're in really good shape. Like you take really good care of yourself. And so like Jenny's fit, you know, she she's trying to embarrass us right now, only only I can see her and she's still embarrassed. But I mean, I thought you'd have a take on this, like, you know, I guess some people might be like, here's a glass of unsweetened tea, I'll put five packets of Splenda in it or something? I don't know,

Jennifer Smith, CDE 28:00
you know, right. And I mean, that it's a it's a question that she asks a good question, because it's something that whenever I'm talking nutrition with people in a visit, it often does come up, you know, what do you think about the artificial sweeteners, especially in the women that I work with through pregnancy? Right? It's a very common question, should I be you know, should I stop drinking my diet coke, blah, blah, blah, or whatever it is, you know, I, you know, we there are studies, I think that they're kind of like a 5050. There are studies that kind of err on the side of these are chemical in nature. They're, they're not natural. They're not like going out and pulling the broccoli off of your garden stock, right? It's something that some very smart lab chemistry person put together and hey, it's got a sweet taste. And hey, it doesn't. For many people, it doesn't raise blood sugar. I can't say that's 100% true for everybody. Like you said, Yes. Sometimes you'll see a rise and sometimes no sweetener sweetener.

Scott Benner 29:07
Yeah, I don't know if it's the I don't know if it's the artificial sweetener specifically, or if it's impacting or in a different way or I don't know what it's doing to her but her if she drinks too much Diet Coke, her blood sugar gets more difficult.

Jennifer Smith, CDE 29:20
Right? Right. Yeah. Right. And, and I've actually had some people I used to tea but teach a an in hospital type to class for people with type two diabetes. And even they, it was a very common question, and I can very much remember one older woman. She was like, in her upper 60s, the cutest little lady. And she was like, I can't drink those diet beverages. I just can't drink them. I'm like, Okay, well, why you know, the class is always like a discussion about you know, what works for you, blah, blah, blah. Just like every time I have them, my blood sugar goes right up and So and then obviously didn't have a continuous monitor or anything, she was really only doing it by finger stick analysis, you know, and whatnot. But I mean, she, her records actually showed I mean, she'd have nothing in the afternoon except her diet soda. And by dinnertime, her blood sugar was going up. If she didn't have it, it wasn't going up. It didn't happen. So, yeah.

Scott Benner 30:25
So aside from what you just said, which makes total sense that, you know, limiting the chemicals going into your body, probably a smart move. I don't eat that much sugar to begin with. So when I have a cup of tea, if I use two teaspoons of sugar, I mean, whatever, right? Like it, if Listen, if two teaspoons of sugar in a cup of tea is going to take me down Jenny, then I guess that's gonna take me down. You know, I mean, I, I just feel like that it wins. But

Jennifer Smith, CDE 30:50
I think eight grams of carb there.

Scott Benner 30:52
Yeah, I don't love I don't I don't need a lot of sugar at all. But, you know, at least it feels natural, to some degree, you know, so I didn't make it in a lab.

Jennifer Smith, CDE 31:05
You know, that's kind of what I say even about like the sugar free like the sugar free candies and whatnot that are out there. I mean, it kind of brings in along with artificial sweeteners. Of course, there's also then the alternative, like I said, the stevia. But then there's also another sort of bank of sweeteners, which are those sugar alcohols, right. And sugar alcohols, again, they come from, from plant based foods, most of them come from fermenting fruits and vegetable, carbs or sugars, so that what ends up happening in the body is the fermenting process allows a much slower impact on blood sugar than you would get from all out sugar. So most, you know of those sugar alcohols they provide only about half the amount of impact that true sugar does. And it's kervin action is very very slow. They also if you eat too many of them are not very nice digestive Lee on you. But I always feel like you know if you're going to eat three sugar free Hershey candy kisses, I would rather have the real thing. Yeah. And that's purchase personal at like you said you'd rather have the real sugar in your cup of tea than something that's artificial. And if you account for it in your day, total, you're keeping track of things. calorie wise, most of those sugar free products aren't lower calorie overall than the counterpart of regular things. Oftentimes, when they take sugar away, they have to add back something else that tastes a little bit better. And it's often fat. Yeah.

Scott Benner 32:46
Well, I listen, I will have chocolate once in a while. And there's a company that makes a chocolate chip that I find to be like a really quality chocolate chip. And instead of having like a Hershey Kiss, or something like that, not there's anything wrong with a Hershey Kiss, but there's a, you know, there's a quality issue there, like market chocolate versus, so I'll buy like a bag of chips. And if I want chocolate, I'll take like, I don't know, four or five chocolate chips. Yeah, by the way, the bag of chips is like $3 and it lasts forever. You know? So there's ways to, you know, substitute things and and correct and get more. I don't know, this isn't English, but more real food into your snacking. Even snacking like this, you know?

Jennifer Smith, CDE 33:32
Right, right. Okay. And I do know, I remember, if somebody wanted the actual information about how much artificial sweetener they can take in. It was a study done by the University of Alabama at Birmingham. You can actually go to their website and they give you information on how much saccharin aspartame and sucralose is appropriate. It's based on 150 pound person.

Scott Benner 34:00
So yeah, so be 150 pounds. You're taking this that into effect,

Unknown Speaker 34:03
FYI,

Scott Benner 34:04
restructuring your multiplications and your divisions in your business. Well, all right. Well, this question from Libby may not apply in our new world. But flying in an airplane and pumping with an insulin pump. So does air pressure deliver insulin? Is that why some people find themselves lower after a flight if they're wearing a pump? Jenny Jenny has read she just readjust her jaw six different times and a word. Yeah.

Jennifer Smith, CDE 34:36
Well, I want to I want to address it in terms of being true in also that there are no

Scott Benner 34:45
studies. There

Jennifer Smith, CDE 34:46
are no true studies that are approved by some fancy university or research laboratory that has actually done this. However, there is anecdotal let's call them evidence from people have diabetes where insulin pumps, and they've actually documented what happens when you fly with especially a tube insulin pump, okay? It's more, it's more of a known issue with a tube insulin pump, that in the ascent and descent with a tube pump pressurization can actually either withdraw insulin back into the reservoir, thus creating an air bubble in the tubing, and potentially then causing a lack in pumped insulin. Some people experience not only a high at some point, or a rise that they can't explain because they haven't had any food or anything else happening on a long flight. Or, in this example, a drop down often, and a lot of people refer to them as like the baggage claim lows, where they finally get to the baggage claim. And as long as their hike through the airport hasn't been like six miles, you know, they're huffing it. For the most part, people end up waiting for the bags and have a low blood sugar. And why it's because potentially on descent, there is a pump out of insulin from that piston from the pressure that pushes the insulin through the tubing and delivers almost a bolus of insulin, then that's it's not registered by the pump, you can't go into your insulin dose history and see oh two units was accidentally delivered. The pump doesn't give you that because it wasn't there were no button pushes get it.

Scott Benner 36:33
So it's like having a like a like a flatbed hose full of water and the water is just sitting in it, but you grab one side and give it a squeeze and it runs out the other side. So the air pressure increases and forces the insulin through an air to come out of your set. So that's where it goes

Jennifer Smith, CDE 36:48
correct. And our recommendation to kind of counter it is on ascent and descent, essentially, you disconnect. So for those with tube pumps, you would disconnect disconnect from your sight as soon as your rising or taking off. Once you get to cruising altitude, you go ahead, look at the tubing, if there are any air bubbles, prime the tubing, flush the air bubble out, reconnect cruise through, you know your three hour flight or whatever it is, as soon as you start your descent, go ahead and disconnect when you land. Go ahead again, take a peek at the tubing. If there are any air bubbles or anything, you essentially flush them out and reconnect. Yeah, that way you get rid of both potential problems makes sense.

Scott Benner 37:33
I happen to I'm googling while you're talking. And Medtronic has a little update on their site about just being more like attentive, which I think is any company's way of being like, you know, we don't really know what's gonna happen. So you pay better attention. And I'm not picking on Medtronic, I'm sure there's a version of this language is probably on everyone's site. But you're saying with Omni pod it might not exist?

Jennifer Smith, CDE 37:57
Yeah, there's I've only had, I've only had one person that I work with. Who has definitely she's noticed something happens. She always she never has highs. She has lows.

Scott Benner 38:12
But that's right. So

Jennifer Smith, CDE 38:13
but again, that's an N of one with one pump. And I you know, I've I've flown often enough I've worn Omni pod since 2006. I've flown a lot in that what? Almost 14 years ish, right? And I can't say that I've noticed anything. That's a trend when I fly. That would indicate Yeah, this is definitely happening three quarters of the time. We

Scott Benner 38:39
don't treat them differently during air travel at all. I mean, you know, maybe when you get out of the car at the airport, we're not I wouldn't bolus a 120 you know what I mean? Like I want to get through security and all that stuff with nothing going on. But as soon as we're back through, everything goes back to normal. We bolus normally on the plane and every other Yep. So yeah. Okay.

Jennifer Smith, CDE 39:01
The only thing that I guess it's not really in answer to this, like pressurization. But the one thing I do Do for travel and a lot of people notice is that many times when you're sedentary for more than about a two hour time period, you might actually need a temporary increase in your bazel just from the sedentary nature. You know, when I fly long distance, and I'm going to be sedentary for more than that two hours, I find that I need about a 15 to 20% bazel increase just

Scott Benner 39:28
to cover the fact that you're

Jennifer Smith, CDE 39:29
just not active anymore, just to do right.

Unknown Speaker 39:32
Okay. So, all right. What else?

Scott Benner 39:36
Well, Shannon has one here. Okay, that I don't know if we're gonna have the answer to or not. But let's take a look. It's a long one. So I'm going to synopsize she's curious about the health of older people with type one who have had what she's calling wild blood sugars in the first part of their life, but then learn tighter control later. Will they have you know, issues like that? or other health complications. And the last part is people who had to survive without CGM. Okay, so people who lived before all this technology, you know, like me? Yeah. Like

Jennifer Smith, CDE 40:15
I lived before all this

Scott Benner 40:16
fallacy. Oh, you know, I mean, I would I would say what we've said in the past is you can't bank health. Right. So you, but

Jennifer Smith, CDE 40:29
I don't know it also is not a like it, you know, the question really did really poor control leave lead into issues now that even with good control won't negate them all? we don't we don't know. Right, right. I mean, for the most part that earlier, less than optimal management wasn't good. I mean, it wasn't helpful, right. But does it mean that down the road with more optimized control, especially with the technology that we have, likely the control now is a huge benefit. And the fact that you were likely younger, and had the benefit of youth at that point, versus being older and now having really tight management, that's the benefit now that you're older. And as body systems age, things can break down faster? It is. It's just the life cycle. Right? It would

Scott Benner 41:34
make sense that while your body is older, and you know, by definition, more frail, that the better control, the better off it would be. I also do you remember back when they used to tell you like, Oh, you know, don't worry about blood sugar control in the first couple years when outlawed little kids even when Artem was first diagnosed. I was like, that doesn't make any sense to me, like a little bit it does. Now when I look back on it, like the idea of like, okay, she's young, and hopefully she's vital and healthy. And if you know, we scratch her arm, it's going to heal back over. And so if we scratch some veins on the inside of our body, they should heal. Okay. I don't know that that would be true for everybody. But I get the overall idea. But I think the danger of that idea back then, at least the way I saw it was that you were giving people the idea that blood sugar management didn't make a damn bit of difference. If you were young enough. You know, you've got five years to figure it out. Like I remember being told that when she was two, like, Don't worry, she's little. This won't hurt her right now. Like that does not make any rational sense to me.

Jennifer Smith, CDE 42:36
Yeah, my nephew was actually kind of the same thing. He was diagnosed when he was seven. And that was actually something that their pedes endo actually told them where I heard it. 100% it was, you know, don't worry right now he's not, he's not in his teen years. And you don't have to worry about anything? Well, from a, from a true standpoint, what I know is that we want to aim for more optimal, regardless of what age you are. Yeah, there are, there are some, like factual studies that have actually shown that once kids get to the teen years, with the hormones of growth within the teen years, that starts to make more impact on potential future complications. If glucose levels are poorly controlled, in that timeframe of life, comparative to earlier on, when the hormones are different, there's still growth going on. Obviously, you can see it in your kids as they grow when even when they're little, and they're not a teenager. But the difference being more of those like sex hormones really into the teen years have more of an impact. For whatever reason, I'm in the standpoint of glucose control being better or worse, and then what happens down the road? So

Scott Benner 44:02
trying to imagine like, you know, changing the sentence slightly, like, how about this one? Your four year old can smoke cigarettes, they're young enough, their body will fight it off. Would you say that? No.

Jennifer Smith, CDE 44:13
How about No,

Unknown Speaker 44:14
no, no, just a little crack cocaine. She's only six. Yeah, like, she'll bounce back from that

Jennifer Smith, CDE 44:18
wants to have the beer for dinner every night. Let her have

Scott Benner 44:22
a little she's only eight. It's never gonna impact her long term. Like, none of those things make sense to me. Don't right. And so when I was told that I was like, Listen, I am not buying into this mess. You know, uh, but at the same time, it didn't go well for you in the beginning. I think it is a lot akin to smoking cigarettes. The sooner you quit, the better off the rest of your time is gonna be.

Jennifer Smith, CDE 44:47
That's right. That's I mean, that's the reason that you know, parents are told not to smoke at home with their kids.

Unknown Speaker 44:54
Right, everybody.

Jennifer Smith, CDE 44:57
I mean, it's actually something for my nephew. I told him parents when they said, well, the doctor says it's okay, if you sit at you know, 200 all night, it's pretty safe. And as long as you staying under 250 That's okay. And I'm like that that's not okay. I mean, I really had to, like, emphasize to them that that that's not okay. He might only be seven, eight years old. But these numbers are not where you want him to be.

Scott Benner 45:21
Right? Well, um, here's what it reminds me of. And I probably said this once before, but it fits right here very well. I once helped a person in their late 30s make a pretty drastic transformation to their management pretty quickly. And when it when it kind of, you know, our time together came to an end, this person was really grateful that their blood sugar's were now, like in range and controllable, and, you know, not so variable, but angry and sad that someone hadn't told them about this sooner because they had had diabetes for you know, the better part of 25 years. Right. And and we're really concerned about exactly this question, like, What's going to happen to me in the future? Based on what happened to me, you know, in the beginning, and why would nobody have explained to me that, you know, Pre-Bolus things important, or any of the other little things that we talked about together? And the best I could say, in that moment, because I was out of my depth, you know, what I mean? Like, I don't have diabetes, no one's ever lied to me about my health care for dozens of years. And so I just said, Listen, you know, now, just do a good job, move forward. You can't change the past, you know, any other birthday card euphemisms you can think of, there's no sense in hanging on to anger about this, like you have a real chance. Like, let's see what happens. You know, I keep doing it. And and let's hope for the best and right. I mean, do you really have any other options than hoping for the best?

Jennifer Smith, CDE 46:53
No, there's not. And even, you know, if you knew what wasn't working in the past, it was likely because technology wasn't where it was today, right? I mean, my my mom definitely says, as I've said before, if she had the technology, now, she would have felt a lot more comfortable sending me off to a sleep over that the parents weren't given like a two page sheet of instructions of what to do, you know, she would have been able to follow things from home and felt a lot safer when she sent me to sleepaway camp. And, you know, all of those pieces of management that were there, we did the best that we could, but I'm quite sure that in between the finger sticks, I had a date, I'm sure it looked like a roller coaster, because we didn't know what was going on.

Scott Benner 47:40
I think that at some point in the very beginning, the statement 200 safe overnight, don't let it go over 250 I think that was probably reasonable at some point, you know what I mean, because of the lack of technology. And when they say safe, they didn't mean safe to your health, they meant safe, that you won't drop too far and get really low. Like that was the that was just try to understand that at some point, because of where the technology was, in the past, the entire focus of type one diabetes management was don't have a seizure, right? And don't go into DK, it was literally these two opposites. They didn't care about anything else, because they didn't know to care about anything else, because they didn't have the ability to care about anything else.

Jennifer Smith, CDE 48:25
And for little kids who don't often have symptom awareness.

Scott Benner 48:29
Even more important, even more important back then. Right? They can't tell you the problem ends up being is that as we leapt forward and leaped forward and leapt forward with technology,

Jennifer Smith, CDE 48:39
the education didn't

Scott Benner 48:41
Yeah, and and, and these, you know, tried and true methods of well, 200 safe and don't go over 250 they got passed down generation to generation. So what you're really seeing is that there's one group of people, health care providers, right, who have an origin story. And that origin story builds on how they talk. But a different group of people over here, device manufacturers, right? They're trying for something different. These two people do not intersect in their day to day business and the way they talk with other people. So while this guy's telling you to hundred safe, this company is over here telling you Hey, I think our gear can keep your blood sugar at 85. Which one sounds scarier? When the doctors telling you just to hundreds, okay, you don't want to get low and then the next person is like, Hey, 85 is possible. That sounds scary. Right? And so you're never going to reach the masses. Until healthcare professionals have the ability to believe that the technology does what it does, and are willing to say it out loud. And you know, I don't know. Good luck with that. Good luck getting a bunch of people to say what they think you know, instead of what they think is safe to say. Luck. That's gonna be very interesting. You know, if the FDA would let not let but I guess if if device manufacturers could get into the business of teaching their devices beyond, this is how it turns on and the sound turns off, then they might have the, the onus might be on them to show you how to use it correctly. Right? And because then they could really market their their devices as living healthier, not just easier, because that's how that's how they're stuck. That's how they're stuck marketing right now. It'll make your life easier. It'll be a smaller part of your life flexibility. Yeah, yeah. You don't want to have to disconnect to do this right on the pod. And like, like, and that's the stuff there. I don't want to say stock saying cuz that's a lot of valuable information in there. Yeah. But they don't get to say the rest of it. Like, why don't you try the Basal increase when you have pizza? Like, they can't say it, they can say the pump does a Temp Basal increase? They can't tell you why in the heck you might want to try. Try it. And therefore it's a tool you don't really it's a screwdriver, and you don't know how to use it. You don't know what it's for, you know, just know you have it. Anyway. Alright, that went down a weird road. Um, let's see. Sarah says, Sarah has three names. And her middle name is fun. Sarah says, I'm not sure if this is big enough. There's nothing too small to Jenny and I won't talk about. But is it true that younger children are harder control to control compared with older ones in terms of their blood sugar? Does body size make a difference? I always look at people stable graphs with such envy, as we seem to go up and down so much. That sounds like their daughter's two years old. Is that more normal in younger children? Or is that more proof of my inexperience? Because we're only about a year and a half into this? Well, I think it's probably both an indication of your inexperience and normal. I always tell people, you know, figure out how to use the insulin so you can feed them so you can fatten them up because this is easier when they get bigger. But I don't know if that's just me, or if that's true.

Jennifer Smith, CDE 52:07
Ya know? And they're they're kind of a number of questions within the question, right? There's, there are a number of things to kind of bring about our younger kids harder to manage than older kids. I think it's, it's a different strategy of management. Because variables through the life cycles change whether you're two or 82, there's always going to be something that's a little different in young children, you know how fast growth happens. So growth, impact is always going to be more profound than when you get to, let's say, the teen years, especially for like a teen girl, let's say, who's not growing anymore. But now she's got hormones and a monthly cycle and things like that. So that's in the picture, despite growth not being in the picture, right? You know,

Scott Benner 53:00
we talked about it wrong, though. We always say diabetes is always changing. Diabetes is the same, their bodies are changing. That's right. Right, right. So you know, when your kids littler, and like Jenny's saying they're putting on a pound or two every couple of weeks, that's making your bazel not correct, as they get bigger and bigger, right? Or at the same time, they become more active, they start to walk or they start to do more things. That changes the impact. And, and so is it harder, it's the same, it just changes more frequently, or growing, right? And then right, when they get to that point, you're talking about where they're like a, you know, an adult woman who's getting their period. It's still happening, but it's happening cyclically by week, this week is different than that week, and that week is different than this week, and you have to know what week you're in.

Jennifer Smith, CDE 53:49
Correct? Yeah. And then, you know, with little kids too, you know, the other the other part of little kids that can increase the amount of variability which she brings in, you know, I feel like we're all over the place versus some of these graphs that I see it that are just nice and flat. Well, the variability with a small child, 235 years old or whatnot, you know, and I mean, I know myself with even the way that my three year old eat, he could love the same exact breakfast and eat it 100% for five days in a row, and I give it to him On the sixth day, and he eats three nibbles, and he's like, I'm all done, mom. Okay, well, great. Now, if I had to, like Bolus for that, and I work with so many kids that I see this as a consistent problem, right? I mean, that as variability. Now you've bolus for this amount of insulin, and there's not this amount of food there. So you have to offset it in some way. Well, that brings in a potential roller coaster. If you haven't quite yet figured out how to offset what you sort of front loaded with.

Scott Benner 54:54
Right. I I always say that I think the key to Pre-Bolus in kids is to choose what ever amount, you know, they're gonna eat. Like it might just be five carbs, but nope. But have you ever sat your kid down, they've just been like, I'm not eating this at all that they put something in their mouth, right or they switch to something. So if it's a 20 carb meal, and you have that feeling of like, I don't know is this the day the kid just doesn't eat their breakfast Pre-Bolus five, you know, carbs have it right and get some insulin on your side. And then when you see Oh, this foods going in, then put the rest of it in right away, or they throw up their hands or like not today, lady, then you've got some time to decide what else they could eat, you haven't personally insulin for the entire 20 carbs. Now you're sitting there, just staring through the wall going, Oh, my God eat food. Because there's, because there's reasons you don't want to do that. You know, because you don't want to cause a weird relationship with your type one diabetic and food, you don't want them to feel like food is the thing they have to do even when they don't want to. There's some really good psychological reasons not to do that. Ah, you also don't want to get into the roller coaster situation where their blood sugar goes to 300 and then comes crashing down and then they have to feed them and that becomes your day. So you have to Pre-Bolus something. You know, it's so funny that I was corresponding with a person who was gastroparesis one time. And they were saying I really want to Pre-Bolus but I don't know how because some days my body starts to digest my food. And some days it doesn't. Right. And after a long phone conversation, I said, you should do what people do with little kids, and just get a little bit started. And then as you see your blood sugar, wanting to go up getting the indication that your food is being digested, then throw the rest of it in, right, that ended up working for that person,

Jennifer Smith, CDE 56:42
or throw some in and extend the rest of it, or keep

Scott Benner 56:45
eating it out into the future. But get it

Jennifer Smith, CDE 56:46
moving. Get it moving.

Scott Benner 56:48
And when I said that she's like, That's brilliant. I was like, that's not brilliant. That's desperate. I did not know what else to say. Like, well, but you've

Jennifer Smith, CDE 56:56
had enough experience with other situations in which that that sounded like a good alternative.

Scott Benner 57:03
parallels to try it. Yeah, yeah,

Unknown Speaker 57:05
absolutely.

Scott Benner 57:06
Absolutely. I was gonna say that I think that a pit that we all fall in it's one point or another with diabetes. Or maybe life in general, is feeling like there are rules that we don't know. And that we have to find those rules so that we can follow them when obviously, that's not how life really works.

Jennifer Smith, CDE 57:28
There are guidelines, I always feel like it's like this is your guideline to like, the exploration of the woods behind your house, right? There's no rules to follow. It's just don't go near the growling bear in the bush over there best practices, maybe some best practices, you know, that kind of a thing. The other thing that I did want to say is, you know, it's really hard with today's online community with diabetes, which is phenomenal. It is great. I wish I had had it as a teenager and even an adult into college. It would have been fantastic. But I also think that we unfortunately, start to compare to what other postings show. Right? And I I don't think that's fair to do. So in this case, you know, this mom was like, why see these straight graphs all the time? You don't know what went into that straight graph. Yeah. You don't know the food intake, you don't at the activity level, you don't know where they are in diagnosis, or whatnot, there's, there's a lot more that goes into that flat or that curvy or that, you know, up down roller coaster or whatever kind of graph. And so it's easy to stay, it's hard to like, accept, but don't judge your own management off of what somebody else has posted.

Scott Benner 58:56
Yeah, the things that they say are the important parts of getting that so I'm going to show Jenny something that she doesn't see they're gonna see versus that where's my camera? Can you see that? Mm hmm. Okay, so that's three different people I'm tracking on Dexcom. Wait, what are their blood sugars?

Jennifer Smith, CDE 59:12
Ah, one is 98 with a horizontal, straight, steady, and other one is 93 with an angled arrow up, and another one is 130 with a steady straight horizontal arrow,

Scott Benner 59:25
okay. Do you know what those three people have in common? They all have diabetes. They're managing their diabetes. This is gonna sound horrible to somebody. But trust me, I'm not trying to be like that. I'm not being pompous. They're using my style. Sure, that's what they have in common. They're reacting to certain things, doing certain things, not letting some things happen. Like that kind of stuff. There's a it's a system, they have a system on their head. They're following that system. And so at the same time of day, those are three people blood sugars that are pretty much the same, you know, they're there. They're stable in a great spot. Yep. It's because it's, it's the style. It's your style of management. So when when Sarah asks, Is this my inexperience? Not my circle, it might be an experience, it also might be that you're very experienced that something that doesn't work, right, you know, and now you're just beating your head against that wall going out, understand, this is what I was told to do. Why isn't it working? So there's one of those kids on there, I was texting with their mother last night. And I was like, you know, you need to give her some insulin right here. And she's like, I don't want to her blood sugar is only 140. And I was like, I don't care. Like, if you don't stop this 140 and make it 90, then two hours from now, when she goes to bed, she's going to be 200. And then you're going to get into a different space. And so my concept is, if you don't get high, you won't be high, you will be high. Right? And and it turns out if you put those concepts into practice, I mean, the pro tip series you and I did is just it's that's it. Like that's the whole thing right there. If you do those things, that's it. If you if you gave me three more kids, their blood sugar's would be right around there right now, then there's anomalies that happen, like, you know, I don't sometimes, you know, people eat things. They don't say what they eat, or they miss count carbs or don't don't aren't intuitive enough about glycemic load and index and stuff like that. But for the most part, you take the steps. It usually works,

Unknown Speaker 1:01:31
right? I mean, I don't

Scott Benner 1:01:32
know another way to say it. Like, I'm not trying to say it's easy. It's not easy. But there there is a formula in there to leads to that. Mm hmm. So that's two kids in there that are, you know, one of them's probably still asleep, one of them they're in, they're in different time zones, but they all have the same experience

Jennifer Smith, CDE 1:01:49
strategy.

Scott Benner 1:01:50
Yeah. So Sarah, I think you figure out what works. And then stay flexible while your kid is growing. And keep applying the tools. Understanding that the game is changing, right? A little bit. So yeah, if that makes any sense or not.

Jennifer Smith, CDE 1:02:08
And certainly reach out, you know, for help. Remember to ask more. Remember to ask more questions, even at your doctor or endo visit or CDE visit or whatever it is. Remember to ask more in depth questions in order to get more in depth help. Oftentimes, I think people end up going in not really knowing what to ask because they haven't gotten help before. So they just leave it up to the doctor to kind of give information, and then they get nothing back. And they think Well, my bad, dark, dark doctor is not very helpful. But if you don't bring in more I see this happening around gymnastics every day. I see this happening every Tuesday, Wednesday, Friday. Can you help me? Great. Now the doctor has more to go into the data and pull and get a trend. Yeah. And offer better suggests you have to

Scott Benner 1:02:59
you have to step back and have a macro view of diabetes. But you have to have micro questions. Right? Like, right, so like, you can't just yell. I don't understand every night at midnight, her blood sugar's high. But that's your macro view of it. That's not helpful to the person trying to help you. What's your micro view of it? What's happening in the hours just prior to that? Those are the things you need to know. You know, it's this one kid's blood sugar's were not great. Three days ago. And if you looked at the tech, I did it through texting. If you look at the questions, I asked them, most doctors would not look and go, Oh, well, those are the questions that need to be answered to fix this kid's blood sugar. I ask really odd things that answer the questions I need answered. And so my point is, is that those are the questions to me, you ask? Those are the like the micro specific questions. Yep. And I don't know how you Sarah, I don't know how you figure that out other than experience time and don't give up. But I can tell Sarah and anyone listening this? My experience has been that people who are thoughtful and concerned and care and ask questions like the one Sarah's asking, those are the people who make out well, because they're there, they're interested.

Jennifer Smith, CDE 1:04:14
Right? And they're trying and they keep looking until they get an actual answer that helps.

Scott Benner 1:04:19
That's it. They're interested in, they're trying and they care. And to be honest, that's pretty much what you need. Right? As long as you don't give up. You'll find it at some point. You might not find it for me, you might find it somewhere else. But right you'll find something that somebody says that clicks with you and makes it all feel kind of easy at that. Right. Jenny are we at a time?

Jennifer Smith, CDE 1:04:37
You have about nine minutes left nine minutes, or something easy for nine minutes?

Scott Benner 1:04:45
Um Oh, there's no answer to that one at all was like, oh, half an hour conversation and a lot of people asked it to, uh,

Jennifer Smith, CDE 1:04:57
maybe it's a maybe it's a

Scott Benner 1:05:00
Well, let's find out what you think. How do you calculate your bump and nudge ratios? So when I say to somebody, hey, that blood sugar's 140, I'd like it to get back to 90, bump it back down. That's not a, it's not a measurable idea to people, I guess. Okay, so I usually say how much insulin Do you think moves it from there to there and just go with your gut.

Jennifer Smith, CDE 1:05:30
Right. And it kind of starts then with kind of brings you back to the pro tip series of figuring out things like bazel and sensitivity factor. And even, you know, that kind of stuff. Because really, anytime you're playing with the bump the nudge, you're playing with the assumption that you know, a certain amount of insulin, let's say one unit will move your blood sugar, a certain number of points, right. So if you know one unit changes your blood sugar by 60 points. And you know that your cup of coffee in the morning without bolusing. for it, you've noticed that it kind of raises your blood sugar by 65 points on average, well, you know what, then you need to start taking a unit of insulin to stop the 65 point rise, because one unit offsets you by 60 points to drop you from too high, right back to where you want to be. Right. So the bump and nudge is kind of if they're looking for a math, it goes along mostly with sensitivity factor or correction factor. It goes along with how much do I want to knock this down, and how sensitive I am I to insulin at this point in the day, because many people also have sensitivity factors that differ based on nighttime daytime, afternoon or whatnot. I myself have two sensitivity factors, one that lasts through the day time, one that's overnight for me. So you know, I'm more sensitive to insulin overnight. So I don't need a load of correction. If I choose to Bolus for a higher number that gets up there overnight. I don't need as much overnight as I do during the daytime. Yeah,

Scott Benner 1:07:11
I have to say I don't think I take it for granted because of the podcast. And but if I wasn't talking about diabetes as much, I probably would, that idea that I can look at Arden's blood sugar to 11 o'clock and say, that needs a half unit and look at that same blood sugar at 7pm and say, hey, that's a unit or at four o'clock in the morning. It's point two, it just, I don't know how to explain, other than to say, I look at the blood sugar, I look at the situation. And then I know how much to give her. But I don't know how to tell you what I saw. And how it led me to that answer decision. Yeah, other than to say have diabetes for a while. And all of a sudden, you'll just sort of know.

Jennifer Smith, CDE 1:07:54
Some of it is some of its experienced definitely like I you know, I can say that. Gosh, if I know that one unit again, changes my blood sugar by 60 points. But I've also got like a load of fat in the picture. Well, gosh, yeah, need a lot more of a nudge than you would if it was just because of miscounted carbs.

Scott Benner 1:08:12
And I'm not saying that I haven't adjusted a blood sugar at 1am at an hour and a half later been woken up by the same high blood sugar and then thought, oh my god, what we ate for dinner. Now I remember like that's gonna happen, you know. But the good news about that is, is that I was trying to stop at 140. And it's still 140 I didn't stare at the 140 hope for the best watch it turned into a 220 Bolus for it, forget about the pizza, get up again at three o'clock when it's 250. Like didn't even like eat right, don't let it get out of hand so that it's manageable, and then the bumping in the nudging becomes less, in my mind dangerous because you're using less a less a smaller amount of insulin to accomplish something. So I say if you ever seen me speak, which might never see again. But that jokes funny for a couple of reasons. And everyone listening is only gonna get one of them. But that's okay. Yeah, thank you, Jay. which you may never see again, if you know, I'll say look, I'd like to see a stop a 110 or 120 diagonal up because you might stop it with point two or point three or if you're an adult with a unit like a tiny bit of insulin, you come back to 90, and you sit stable again, the likelihood of you getting low after that is small because you've used such a small amount of insulin to begin with. So that's how you keep from overcorrecting. And that's how I think of bumping and nudging. But and

Jennifer Smith, CDE 1:09:34
that is that is really where our where our hybrid closed looping systems, like control IQ, you know, with tandem, that's really where those systems are going. The idea that the bump and nudge becomes less of your play and more of the pumps interaction because it's got CGM data to interact with and it can see a rise happening. It knows Okay, I've got this value, I don't want this person to get above. So it starts nudging it either with a temporary bazel change, or with these little micro, you know, boluses, the control IQ system is in a system so far in what it can do, but I think that's where, you know, further progress into the pump company. Is that where they're going with the technology? Yeah, because they don't want Well, they don't people with diabetes don't want, while you know how to pump and nudge now, you don't want to have to pay attention so much to have to do it all the time.

Scott Benner 1:10:33
I always tell people to bumping and nudging is a teaching towards some point, you should learn from the bumping that you should have done something different meal, you know, like it's not a it's not a long term idea. It's part of a bigger teaching idea. And having said that, when I watch an algorithm change basal rates and you know, put insulin in, I'm like, that's what I do. Wow, I'm not gonna have to do that. And exciting. And by the way, bumping in nudging is, you know, it's my idea, the words, and they're for sale. Like if a pump company wants to buy them for marketing materials, I'm open to having a conversation, you know, just let me know. Anyway, Jenny, I'm gonna say thank you. Hold on one second. Thank you. You can actually hire Jenny Smith, did you know that she works at integrated diabetes. And they have a website aptly named, integrated diabetes calm. So that's where you can find more about what Jenny does in the professional life. I don't know how often I mentioned this, but I like to bring it up once in a while Jenny is not a paid contributor to the podcast. She just really likes being here. So this is not an ad. She's just a friend who likes being on the show. But that doesn't mean you can't you know, there are a couple of bucks. Get some help with your blood sugars. That's what you need. Thank you so much for listening to the Juicebox Podcast. Thank you for supporting the sponsors sponsors like Dexcom that you can find out more about@dexcom.com Ford slash juice box. And how about tubeless insulin pumps? Well, there's only really one, but it's called Omni pod. And you can find out more about that. And get yourself a free no obligation demo sent right to your home by going to my Omni pod.com forward slash juice box. And to find out more about Arden's blood sugar meter, the Contour Next One, you go to Contour Next one.com forward slash juice box, you're seeing a theme here you get it. And of course touched by type one is that touched by type one.org great organization doing wonderful things for people living with type one diabetes, and all they want is for you to know they exist. So go check them out. Touched by type one.org you think we'd get a juice box slash in there, but it's not happening? Okay. I'm not hurt. Oh my god, that was exhausting. I'll see you guys later. Bye. It's hard to talk like that for a long time. Everything's real deep and you're trying to enunciate and to not over speak or understand like, Hello, this is the word of God. You know, all fields like that a little bit. It's been a long week, too. It's Friday. I need to get to the weekend. Actually. I'm turning 49 on Sunday. And I'm feeling every moment of it. I'm not I'm okay. Am I it's hard to tell. Who am I arguing with

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About Jenny Smith

Jennifer holds a Bachelor’s Degree in Human Nutrition and Biology from the University of Wisconsin. She is a Registered (and Licensed) Dietitian, Certified Diabetes Educator, and Certified Trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. You can reach Jenny at jennifer@integrateddiabetes.com

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#354 Sweet Song

Jaime is her take-out name…

Jaime moved to New York from China. She was initially mis-diagnosed with type 2 diabetes before learning that she had type 1. 

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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 354 of the Juicebox Podcast. Today's show is sponsored by oh geez, I don't remember what sponsored by hold on a very back. Sorry about that I'm back. This episode of The Juicebox Podcast is sponsored by Dexcom and Omni pod, find out more about the dexcom g six continuous glucose monitor by going to dexcom.com Ford slash juice box. And to get a free no obligation demo of the Omni pod tubeless insulin pump sent directly to you or just to find out more my Omni pod.com forward slash juice box. Jamie's on the show today she was typed to before she was type one, meeting somebody misdiagnosis type two. But she has an incredibly different perspective than most of the people coming on the show because she came to America from another country to study here. So she knows two different worlds. I want you to remember two things. Don't skip forward because you think I'm just going to tell you 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 medical plan. or becoming bold within some you think I know that Scott. I was going to skip through it. But there's something else I'd like you to check out juicebox docs.com and diabetes pro tip calm. Those are two URLs I've set up. One to get you to the ever growing list of great diabetes doctors that have been sent in by listeners, you can add yours to the list by the way. And at diabetes pro tip calm. All the diabetes pro tip episodes are collected in one place for those of you who would like to listen to them again, or share them more easily. So that's pretty much it. I want you to get ready for Jamie, Jamie's got a little bit of an accent, but you'll stop hearing it in just a couple of minutes. She's got a really great story.

Unknown Speaker 2:06
Hi.

Jaime Song 2:08
Yeah, it's been a while I feel like I'm almost like a completely different person. Since I sent you the email.

Scott Benner 2:18
You know what I really, really thought that's what was gonna be you know, when when we started talking, because you were at the very beginning of an incredibly confusing journey when you sent this email.

Unknown Speaker 2:29
Yeah, it is.

Scott Benner 2:31
So why don't you go ahead and introduce yourself? And then we'll pick through it a little bit.

Jaime Song 2:35
Yeah, sure. Yeah, it sounds like an interview. So my name is Jaime Song, I have a Chinese name as dunking song, but it's hard on like American people to pronounce that. So Jamie is my reservation name and take our name and everything.

Scott Benner 3:01
By reservation, and

Unknown Speaker 3:04
yeah. So,

Jaime Song 3:07
um, so a little bit about my journey is think I, it's a long story, actually. Because right now I'm 29 years old. But why was like 18 probably even earlier, I started start to have those low, low blood sugar symptom. Um, I always want to learn that long word like that fancy word, but I haven't. So I always like sweat. And like, it's always like after two hours of eating, or it's either around midnight, or it's like I had breakfast at 8am. And I start to have this crazy, like, low sugar symptom at 10 or sometimes 12. I've known So, but we didn't figure it out. I I feel I am a constant visitor to hospital because I wasn't like that much of a healthy kid. Why growing up. So, but we, like we see doctors like Western medicine doctors and also Chinese medicine doctors. They didn't know like, what is happening and I was having anemia back then. So until then, like until 2013. I came to United States for my master's program at Columbia University. Somehow I got something checked out and the nurse was saying oh, you need to watch your Avon see, because it's elevated is it was like I didn't remember the exact number is is a 4.8 or five point something so Oh I, so I, I saw, like, Oh, I probably need to exercise. And I remember I started running at that time at the gym of the university also, I I run like all doors and like, start to eat salad before that I never saw like salad as, like a meal like, because I feel like it's just raw vegetables. But um, I did that for a while also i remembering like, in year of 2015, I start to see a specialist, like, she's a handle, but like, in the hospital near our university. And she was like, uh, give me a bunch of like, strip strips, and also the meter. Want me to take my sugar after the meal before you and before bedtime? Like for four months? And as that time she saw it and she says, Oh, it's still okay. Like, I don't I cannot give you any diagnosis right now. But you need to watch your diet and exercise. So I got him I think definitely my a once you was five point something. And

Scott Benner 6:23
then you were thinking, Well, everyone was thinking you were about to get type two diabetes? Is that what was happening?

Jaime Song 6:29
Yeah, I think so. Like, she's more like towards that. Because also she wasn't sure she said, I don't know if you are type one or type two. But until now I realize she could have test my all my antibodies, or like, yeah, to make sure like to figure out what is happening but she didn't she just let me go home. So I saw nurse like a world like that Titian to like she taught. She taught me how to eat berries, like how many very detailed and how to control my diet. But then last for a while. I was eating healthy, I was exercising. But I and then I had a room another roommate, like, right, like me a lot like sweets. So wait, drink Coke, like, whatever, like even doulos like there was there's a Xiang famous food near Chinese University also, you know, like Chinese, Mr. Chinese. So our diet is more like, heavy on carbs. So I basically like last day, like, at that time, I feel like something changed at my house. Like I was thinking because our exam apartment wavefront is like, more towards like, indoor, like, the window doesn't have that much light. So I was like, during the weekend, I can sleep through like noon or something. I was quite sleepy. Also, I feel lazy or like lethargic. Almost like, since I was 15 or 12. Because I start to I can a lot of weight when I was in middle school like Klaus I was I don't know how much pounds, but I was like 45 kilograms. Why was tough, but I jumped to maybe almost

Scott Benner 8:38
like 60 Why was like a, you know, over for period of time. And that was that was all wait, you didn't get like incredibly taller at that time or something like that to?

Jaime Song 8:49
Not really because my height is five, four. Okay. Um, so it's around that I hide almost all the time. So I can wait, I was skinny. But because while I was in middle school, my mom suddenly start to cook very, for her cooking skills. Like I turn into another person. Like, it's really delicious. It's got better. So so so I start to eat more. And also the the work has schools start to pick up so I don't run outside all the times. Instead, I stay inside and do my homework all the time. So again,

Scott Benner 9:31
a lot of Wait, can I ask you? Have you ever had your thyroid levels checked?

Jaime Song 9:37
Carol level? I think so. Yeah, I think that's why so my endo. Like why go my final diagnosis. Before that. My endo saw my thyroid level. She was saying something.

Scott Benner 9:51
Yeah. Because my thought there is if you had a significant weight gain out of nowhere and you're lethargic, and you're sleeping a lot that that all could lead to hype. hypothyroidism. Oh, which Arden has and oh, I see and it's very similar. I've you know, Arden didn't gain weight with it she just got really tired and, and and Arden's the same way if you blackout her windows, she'll sleep forever. Forever. Yeah,

Jaime Song 10:22
yeah, I heard you talking about this before on the podcast.

Scott Benner 10:27
Yeah. Oh worth looking into. Can I let me pick through a couple other questions too. So,

Jaime Song 10:32
where did you grow up? I grew up in China. What?

Scott Benner 10:37
How would we like where abouts in? Like, is there a problem? How do they How do they split China up?

Jaime Song 10:43
So it's a it's in the middle, if you have ever heard of Shaolin Temple is CRC. Okay, so our province is called Hernan. And our city is jungle. So it's not like really famous city like Beijing and Shanghai, but it seemed the right right in the middle.

Scott Benner 11:02
And you were there until it was time to come to? To do your graduate work?

Jaime Song 11:08
Yeah, almost. I had my college not far from my home.

Scott Benner 11:13
How does that work? not to get too far away from diabetes for a second. But how does somebody how does someone from the middle of China who assuming obviously is a really incredible student, how do you find your way to Colombia?

Jaime Song 11:24
Um, I think while I was in college, my cousin was telling me someone, her, her like, classmate because she was having a master's degree is getting those tests called gr. e. And TOEFL. And I was thinking about it, because either I'm going to graduate school in China, or I'm thinking about here. So I definitely want to go outside and check it out. What is out there? So I start Yeah,

Scott Benner 11:57
did you take care? Yeah, I do. I do tend to be a doctor.

Jaime Song 12:02
Oh, no, I think it's because I'm, I was studying math.

Scott Benner 12:07
Mr. E is the prayer physician. Oh, yeah.

Jaime Song 12:10
Yeah, I think so. It's a separate thing. So Jerry is more for signs.

Scott Benner 12:17
Subject, okay. Okay, so let's pick a little more through so because you said something here we have friends who are Indian. They, they say that the incidence of type two diabetes in Indians living in America is incredible. Because of that, again, their diets are so like, really, like, carb heavy, and like, you know, sauces and stuff like that. Yeah. And so you grew up with the same thing. Now? How about back at home or their or their family members with diabetes?

Jaime Song 12:48
No, actually, no, not. Or, like, my grandparents, they they passed away quite early. Also, at that time. They don't have this sort of thing to check out. Check it out. But none of my parents siblings who work themselves have heaven.

Scott Benner 13:09
Gotcha. And so there's nobody who can help you at home and you're just you're here trying to figure it out on your own. Do you go to the doctor at a private physician? Or do you go through the school?

Jaime Song 13:20
Um, so at that time, I I call that first like, I usual a once a school and then I graduate, I start to work, so yep.

Scott Benner 13:33
Now you're now you're a real person with a job? Yep. Okay, so is it at some point, someone figured out a weight? I had one more question that I'm sorry. You said that with the with your diet being like heavy the way it was at home and you got here you describe like, you know, like to like drink soda and eat carb heavy meals, or all those things were available at home or was it sort of the situation where you got here and you're like, Wow, look at all of these options I didn't have before.

Jaime Song 14:05
Oh, you mean heavy carbs?

Scott Benner 14:07
Well, I even like Coke and like stuff. Yeah. Is that universal? Or did you get here? Yeah. Presented much of things.

Jaime Song 14:15
I think is universal like, um, because why was little like, I feel I was drinking soda growing up. I am such crazy fun about coke.

Scott Benner 14:31
Was it like a sign? Was it like a Hey, this is American. This is cool. Like that kind of feeling?

Jaime Song 14:37
Ah, not really. I feel like life wise. It's miserable. Sorry, no offense. No,

Unknown Speaker 14:42
no, no.

Jaime Song 14:44
Um, because I feel like um, oh. I would say the western food I had at home like we had Pizza Hut at home. It's more like a sit down like diner like cheese factory. We're like more fancy diner like in China. So all the pizza burgers KFC, like McDonald's are customized to Chinese like taste. I would say I would rather have KFC in China than here. Because, yeah,

Scott Benner 15:18
it sounds to me like, America is planning like, we're attacking you with bad restaurants.

Jaime Song 15:27
No, it's delicious. Actually. I feel like when I was growing up, KFC would be like, a more better meals and like as a meal say it's more expensive and also like,

I couldn't have it every day. or right.

Scott Benner 15:44
Was it tailored? Was it tailored to Chinese culture? Or was it chicken and mashed potatoes?

Jaime Song 15:50
I think it's tailored to Chinese culture. It's mainly I feel like I I always had that impression like McDonald's and KFC. Chicken burgers. Only a few like, beef burgers, but here I feel like most of the beef, most of the burgers like Shake Shack. Five Guys. Also like my McDonald's, they have more like beef burgers,

Scott Benner 16:20
right? I understand. Okay. That's really it's crazy. How did you speak any English when you got here?

Jaime Song 16:28
Oh, yeah. Yeah. Because as TOEFL is a language test, it has like writing, speaking, listening. And what else? Yeah. So it has everything. So you have to get certain braid to get get getting into a good school.

Scott Benner 16:45
Gotcha. Gotcha. That's really cool. I you're, I mean, what are you doing now? You said you're out and you're working? What kind of job do you have?

Jaime Song 16:53
Yeah, so I work in pharmaceutical right after my graduation as a analyst, more like statistical analyst because I went to a stats program. Now I'm, like software year, like, completely different,

Scott Benner 17:12
just not with farm anymore.

Jaime Song 17:14
No, I'm with a bank. I'm with JP Morgan right now. Wow.

Scott Benner 17:19
Geez, you killing it?

Jaime Song 17:23
Yeah, it's not really hard. It's just some.

Unknown Speaker 17:28
You said it's not hard.

Jaime Song 17:30
Yeah, I will say I feel I am a average person. especially among Chinese. So yeah, I feel like if you just apply, apply, keep applying. So you get it.

Scott Benner 17:44
Jimmy, smart. People always think they're not smart. It's very interesting. I'm average for you know, a statistical you know how that goes. So at what point? Because Do you consider yourself type one now?

Jaime Song 18:01
Yeah, I think so. Yeah. Because the funniest story is, actually I got my first diagnosis in China. Because I was drinking sodas and now care about my life at it at all. While I was traveling back to China, I think 2018 February. So my cousin was staying with us. She's a nurse. So she was saying, oh, why don't you get your sugar check? I know you have this problem. I said okay, so we checked the fasting sugar. It was like eight point something nine point something. It's right now I'm thinking probably 140 something as measure here. So that was like quite high and she checked a few times or twice or three times. And then she said you need to see a doctor. So me and my mom just hop on a taxi and went to our big hospital there to see the doctor. I saw we were just like, like we always do we sorry, we check like we check with a specialist. I thought we were going home but she was saying because I only had vacation for like three weeks or something that was almost like halfway through it. She was saying oh you need to be like stay in hospital if you want to check all your things. So we did over wore checked because I was complaining. I was having a low blood sugar. I I don't have really any feeling when the sugar is really high. So they'd either over or check like even something like eat they had some fancy check is like checking. I think they did that safety or something. they inject something into my arm. And they can scan me to see the shape of my pancreas. They were sick. Yeah, things as it were sinking, I have some tumor on my pancreas or something is causing me low blood sugar. Because I didn't find any tumor and they put on us like CGM ami, actually, it's quite like, I feel is a dinosaur model or like something where So anyway, like, they check if I will have low sugar symptome also they, they will because I'm in hospital, they will come like, even during the night, they will come like every two hours to collect my blood and check my sugar. And after that, they were saying, Oh, you are like, type two you need. This is my foreman, and another drug I forgot. So take Metformin and just

pass your blood and do this.

Scott Benner 21:05
And so when you so you're in China, they're doing these tests, they felt like this was tight to still there.

Jaime Song 21:13
Yeah, yes. Because this because I feel I'm 130 pounds at a time. So if I Oh, you're not really skinny person. And from my sugars, they also stats, they were saying oh, you you're probably have to. It's also

Scott Benner 21:33
funny how they do that with certain ages and certain body types. They just make a leap. And they decide, though this is type two diabetes and like you said they probably could have checked for anybody's for type one and had a better answer. But then you got to put on Metformin. How did that process go? Like how does treating a type one like a type two affect your life?

Jaime Song 21:54
Yeah, sure is mostly like emotional, like impact. Because I came back here, I started to see my primary care physician to continue my prescription for my my foreman. And I thought because at that time I start to pick up all the exercise, I run our building have some class, I almost like attend them all. So I exercise like two hours a day. At least list so as I have I am losing weight. Also. I feel like promising. I was thinking Oh, if I keep exercising and eating healthy meals, I will be off this I will be cured. Yeah, you'll get rid of this. Right? Yeah, yeah. So but I still want to confirm this one with a specialist here again. So I went to Columbia in niomi Diabetes Center

make made an appointment. And

and I think I only called the appointment like until like five months later. But before that I was attending classes. They require you to attend class to see a doctor. But that's apparently like a type two class. Right. So my. The certified diabetes, diabetes. Yeah. educator. Yeah.

Scott Benner 23:30
You call that a CBE? That can be their their? Their name? Yeah,

Jaime Song 23:35
yes. Yeah. My city is like she was hosting. She's teaching those classes. She was saying, oh, there's probably something wrong with your case. Let me like, give you an appointment like four and Oh. So in the meanwhile, you just keep your diet like, better this way. And that.

Scott Benner 24:00
Yeah. So how hard was that for you to just change your diet immediately. Did you think Did you struggle with that?

Jaime Song 24:08
I don't think so. I was more like, afraid of that. So I changed immediately. Like snap your finger like, I never. I feel like that. That was another extreme. Like I barely eat. I feel like my my eating like dropped like, must be like 50% so I lost a lot of weight at that time. Also, I was afraid to eat. I was very careful with everything I'm eating.

Yeah, but

Scott Benner 24:40
that sounds did that. Did did your change of diet affect your tiredness? Did you stop feeling so tired as you lost weight?

Jaime Song 24:49
No, I think it's getting worse. Okay, sure.

Scott Benner 24:51
Okay. Yeah. And would you call that like you have like, like, brain fog or you're kind of foggy when you're trying to think again. Do you have like muscle aches, joint pain? That kind of stuff, too?

Jaime Song 25:03
Yeah, I think I have brain fog fog, like for a long time, especially before my period like something like, yeah, I think before. Yeah, it got.

Scott Benner 25:15
So let me suggest this to you if you have someone look at your thyroid panels again. Mm hmm. And the numbers aren't out of range, but they're like a little high or a little different. So ask the doctor to give you medication anyway. Sanjay say can I just try it anyway? Because I've heard of a lot of people whose tests come back in range, but who have hypothyroidism and and here are my symptoms. My symptoms really seem to match hypothyroidism. Because I'll tell you why. My my wife realized she had hypothyroidism after she gave birth to Arden. And for seven years, doctors wouldn't listen to her about it. Seven years. And it really impacted her body and her health and everything. And then one day in a doctor's appointment, we just said to the doctor, I don't care what the panel say, Give her the medicine. And two weeks later, she felt better. Oh, so I don't don't struggle with it. Just because that number is sitting in a range because it's very common for people to have hypothyroidism and not be in that range. Or I should not be out of the range. I'm sorry.

Jaime Song 26:21
Yeah, I see. Yeah, I would definitely check out with my doctor but but I think right now is everything turns wrong. Like I think is I'm all already above a year actually, I feel like a year is really a threshold. Because I remember myself like crying. Like why her my doctor calling me like Oh, your antibodies came out you I think you are definitely a type one diabetes.

Scott Benner 26:49
Patient crying because you were happy to have a good diagnosis.

Jaime Song 26:53
crying because after eyes Oh, I I saw I'm have to I'm still getting control of this. But now it's like, I need to be on like being a bit dependent on insulin forever. So I feel like that was a shock. Okay.

Scott Benner 27:14
Yeah, I can see did did that push it into any kind of did you experience any kind of depression around this time?

Jaime Song 27:20
Oh, no, I think I was a little bit depressed at the moment, like a few months. Also, I didn't really use insulin that much either. Even though I was prescribed also I think as my first try I use like two units for like 40 something carbs or I got like low. Okay,

on the first time, so I was even more scared.

But I think everything changed after one event. Maybe because 2018 like 2018 July God the first like, Type One Diabetes diagnosis and 2018 December I went back home again. And they put on CGM like I was doing over or checked because in China like if you go to hospital they will check everything for you. Now here like why tell if I tell my doctor I have stomach work like something else happening I will have to go to see a separate specialist. So they are even though they are specialists, they will probably they will call consultation for other doctors but they will check everything for you to the all the labs. So they put on the freestyle CGM ami. So I saw Oh, actually, I can see my sugar this way instead of poking myself like 10 times a day. So after I came back I I get my doctor to get me like freestyle CGM. But that was my primary care physician. So I didn't know like I didn't. I lost touch with my endo. Like, ever since. So I was like, I wasn't sure like what it was. I'm using. So actually, I made an appointment with my uncle A few months later on, she was saying oh, here as a Diabetes Center, actually using Dexcom because it's more accurate during the night, right? Also I feel I'm I feel like swiping is so stupid. I have to scan a layer every time. I feel like I'm a food like a frozen foods like from Trader Joe's. What was checkout I knew to scare myself.

Scott Benner 29:58
I never thought of it that way. But you're just passing yourself over top of that glass thing. Beep

Unknown Speaker 30:05
Yep.

Scott Benner 30:06
Yeah, that's fine. It's very funny. Jamie, that's hilarious, actually. I mean, I think, you know, if Next comes, if you can afford next comments, I think it's a huge leap over the Libra. And you know, people say, Well, we braise less expensive. So it's all I can afford, which I think if that's the case, there's nothing wrong with it. But I have heard ideas of it being less accurate, too. So it's, it's a, it's a tough call, like, you know, there's a lot of a lot of different things that impact what you can afford and what you can use. And I think you do your best. So how so? I guess let me just start here, like, like with the type one, how long have you been living with your type one diagnosis now?

Jaime Song 30:53
thing is

one year and three months

Scott Benner 31:00
with the Type One Diabetes diagnosis. Yeah. Okay. And you said something at the beginning, you said that when I sent you this email, I was a completely different person. And you've described pretty well now how, like, what the person was you were back then. But what what is your situation now? How do you how do you see yourself now, if you were to write me again today to tell me about your diabetes? You know, how would you How would you characterize yourself?

Jaime Song 31:27
I think, probably, um, I feel like more. Right now, at that time, while I was reading you the email, I feel like diabetes is like, 99% of my life. Right now. It's like, it's just a sitting quietly in a corner is like five person or like, 3% of my life.

Scott Benner 31:51
I like the I like the the vision of it just sitting quietly in a corner. I think that's how did you get to that place?

Jaime Song 32:00
I think it's a lot of, I think you're just some

Ah, I think it's like, it's like, debugging, or like, if you don't do the right thing, it won't work. If you just constantly struggling emotionally, and banging or had to say things repeatedly, by doing the wrong thing, it will never get better again, like, will never happen.

Scott Benner 32:27
So you just looked at the steps that needed to be taken and you make sure to take them.

Jaime Song 32:32
Yeah, I think you just saw need to, because right now I'm, like, constantly seeing or, because my allowance is really like, perfect, quote unquote. My one C has been like 5.5. Wow. Like, twice, or it was, once I use insulin is always like four or 5.8. Like, when I'm sloppy six point something. So I'm always like, 5.5.

Scott Benner 33:03
That's amazing. How, how have you been? I mean, where did you is the doctors, I guess the question I should ask is, the doctors you met put you on a plan that is really helping you?

Jaime Song 33:13
Yeah, I think that's definitely helpful. I think the way my Diabetes Center is doing things is very, like, logical and organized. And I got all the information I need. And they're always there for me. And also, I feel like because I only I'm on, I was on injection until you think September or August. I use my pen to inject insulin at the time. But I was browsing this beyond hype one. forum, I put up a question there. I was, I was asking because I was listening to your podcast a lot. You're talking about Omni path. So I want to check it out. I say I reached out to them in the beginning, because I I don't really use as think as much insight as other tech one right now. So in the beginning, first time, I call them call the Omni pod saying oh, I want to check it, check it out. If I'm I'm able to do this. But they said what's your injection dose? I I told a number to them. And they say oh, you don't have minimum. So probably cost back later. Also, my city was saying, Oh, I think we still have a little bit time. So you can just use a injection for now.

Scott Benner 34:44
Are you wanting to get away from injections?

Jaime Song 34:46
Yeah, I'd certainly do like because I'm a big fan of like all the garbage trash. Food like cakes.

Unknown Speaker 34:59
Babies like Listen, I really would like to get back to.

Jaime Song 35:05
Yeah, because I heard while your back pocket podcast was saying he wanted to eat a chocolate muffin, and you have to create a blanket of insulin for her to absorb all the carbs,

Scott Benner 35:20
it's those chocolate muffins at her school are difficult. But I haven't figured I have figured them out. But they did take some. They took some trial and error for sure there's a, a pretty hefty amount of I don't know what it's also interesting because I never with her. So when she has, I don't get to see them. I don't get to look at the nutrition labels. You know, we just sort of wing it. She's always, you know, kind of rolling now out of our class real quick to go grab one and then goes back and it took us I bet he ate about eight or 10 of those muffins before we got that straight. But yes. And you live you live in New York, right? Are you? Yeah. It's a city full of bagels and muffins and pizza. And you know, a lot of stuff like that. And you're trying to live your life. And that's what you want to do. Are you still are you still exercising the way that you did?

Jaime Song 36:09
Yeah, actually, I recently because I also read that American Diabetes magazine Association magazine, it was saying, if you I used to run also, like, almost I exercise after each meal, like, but I own like elliptical like slow motion, like, not really intense. So I recently read like, because also I'm gaining weight. So my city is saying try cardio exercise. So I start to run. And I'm joined, I joined a club, a running club with all the massive runners. So I trained. I only joined them once one month now. And I trained with them like 6am in the morning, twice a week. And then I read about this on the magazine saying, if you exercise in the morning before breakfast, it will be better on your sugar tolerance and our bed saying it's better on your finger. Okay,

basically. So

also, I saw that if I run in the morning, like say, eight miles, I'll be meeting, I'll be meeting like less insulin design normally would. So I have been trying to run my five miles every morning. For like, two weeks now I feel is working very

well for me. Well,

Scott Benner 37:38
that's excellent. Where did you find the podcast?

Jaime Song 37:42
Um, oh, yeah, I found the podcast on the magazine. I'm American.

Scott Benner 37:48
Oh, uh, when they did that thing last year on the on diabetes podcast in the ABA magazine.

Jaime Song 37:54
Yeah, yeah. I think that.

Yeah, I think that's the only reason like, I got out of the depression. Like, I was feeling like miserable, like, deprived and so depressed until I heard your podcast, you are so funny. And you're always like, making joke of all those things. And also, yeah, talking about eating away. Like, I feel like, it's no big deal. You just have to

Scott Benner 38:26
do our thing. And does it helps to feel that way like that. It's just you got to see that's how your brain works, though. Right? Like I, I basically said, they're like, if you just do this, this, this and this, it should work out. And that that makes you happy. Like the idea that there's a process there?

Jaime Song 38:43
Is that Yeah. Is that right? Yeah. Yeah. That's cool.

Scott Benner 38:46
Well, I'm very happy that you found it. And that it that it helped you. Sincerely, I'm huge in the center of China, from what I understand. I'm just kidding. I don't think. Yeah, you are. I don't think anyone listens in the center. It's, it's really wonderful to hear you say that. And it's, it's hard to know how to, to answer somebody when they say something like that. It feels it's nice. And at the same time, it's, it's, uh, I know what the podcast is. And I know how it helps people. And still when somebody says it right to your face. It's, it feels strange. So I really appreciate you saying it. I'm happy for you. I wish I could be less awkward about answering.

Jaime Song 39:29
Yeah, I really yeah.

I really appreciate this because I feel I really like turn my life around completely. Like, yeah, this your podcast is I it has huge impact. Like, I don't know how many people like me, but like it's, yeah, it's amazing.

Scott Benner 39:51
Well, that's cool. I just looked actually and in the last, it has been downloaded 500 times in China in the last like year and a half which is not You know, not a not a lot in the grand scheme of things, but it is a lot when you consider I don't have any impact in China. I don't think. So that's, that's really cool. Well, I don't like you threw me off a little bit saying nice things. I'll tell you what, if you could give me like one minute actually Arden's sleeping in today, and I just need to change to her and some I'll be right back. Okay.

Jaime Song 40:27
Yeah, sure. Sure. Take your time. Thanks. Yep.

Scott Benner 40:31
So what are you doing after the podcast? Don't worry, I'm not hitting on you. I'm just saying maybe you should take a look at the Omni pod tubeless insulin pump and get yourself set up with a free no obligation demo. Alright. Hold on. I got an itch on my head here. It's very distracting. This is not what a pod sprayer for. Hey, on the pod. Appreciate you by the ad where I'm scratching my head. Don't worry. I'll do the IBM Oh my god, that was weird. Check for something I could have an element. When you go to my omnipod.com forward slash juice box, you are going to be presented with information. Wow. Huh? God damn. Sorry, about my voice broke. All right, hold on a little water. Goodness me. You're going to be presented with information about the Omni pod tubeless insulin pump. Now this is information that you want to have trust me, my daughter will be turning 16 in just a couple of days. She's been wearing it on the pod every day since she was four years old. It is in fact, exactly what it says it is. and not many things in life are. It is little, it is convenient. It is tubeless. It is discreet. If you want it to be. You can wear it loud and proud. Or you can hide it away. It doesn't matter. It's not going to cause you to need tubing snaking all through your clothing. It's not going to make you disconnect to shower, to take a bath to go for a swim, to play soccer hockey, go for a run whatever you do, where this tubing would be a problem for you. The Omni pod will not be a concern. And on the pod is so sure that you're going to like it. They're happy to send you a free, no obligation demo. That's why you go to the link, Miami pod.com forward slash juice box. Fill in a tiny bit of information about yourself. And on the pod will whisk right into the mail. A demo for you to wear. And that way you can swim and run and sleep and do whatever it else is you do and do whatever else it is you do that you'll also be doing with your insulin pump. You can give it a test drive. That's not bad, right? I mean, they call it a pod. What do they call it? They used to call it a demo kit. Now they're calling it a pod experience kit. But I like test drive. Nevertheless, let's not confuse the marketing. Get yourself a free no obligation pod experience kit from Omnipod. Today, you will be happy that you at least tried and there is no no harm and trying. Right? Give it a shot. Imagine yourself in your desk chair, leaning against the wall in your kitchen. I don't know where you lean in the kitchen counter later when I'm in the kitchen. You've got your phone there, your laptops out and you've just gotten you're on the pod demo squared away. It's on the way to you and you're feeling good about yourself. But you want to feel even better. This feeling should send you directly to dexcom.com Ford slash juice box. Why you ask? Well, because everything you want to know about the dexcom g six continuous glucose monitor that you don't already know they haven't learned here on the podcast is available@dexcom.com Ford slash juice box. I'm typing it in right now. The website pops up and boom, there it is gorgeous. The dexcom g six there's a transmitter, the receiver you can see that you can use it on your iPhone or Android shows you the sensor. My goodness gracious, everything's right there. super exciting. Now super exciting for everybody in the world. Probably not everybody, but for someone using insulin. This may not be judged against any other exciting things. Understand I'm saying it already won Dexcom is the most exciting thing you could do for your type one diabetes.

Keep in mind if this was an omni pod, I would say the most exciting thing you could do for God. You know you what I'm saying? You know where I'm at on this. There's no parsing words. I'm an omni pod and Dexcom fan. We use them both. We've loved them both for a decade or more. And I know what they bring to your life. But at the moment, we're talking about Dexcom. So the Dexcom to the best, sort of like when you're talking to friends about who's most attractive. It's whoever you're talking to. Right? Patty? Oh, but you, you're gorgeous. Anyway, Dexcom, the G six, no finger sticks, glucose readings right on your smart device, customizable alerts, and alarms, seeing the data that gives you the answers to how you can use your insulin more effectively. That's how I use it. I mean, sure, it's indicated for kids, too. And plus, and it's got Siri integration. And of course, you can share your data with loved ones up to 10 people. But you know, at its core, the Dexcom is that great information, that tells me I'm rising, I'm falling, how fast so you can do something about it. Be healthy and safe. That's what you need to know. dexcom.com forward slash juicebox. Dexcom is the most attractive of my friends, right? Until Omnipod gets here and then I'm just going to go off in a corner and I'll be like, Hey, Dexcom I'll be back on one second. Hello on the pod. You're so pretty. links in the show notes of your podcast player. Where Juicebox podcast.com. Upgrade your health.

Okay, so I have questions that have nothing to do with diabetes. Do you mind?

Jaime Song 46:31
Yeah, not at all. Go ahead. How?

Scott Benner 46:36
I love crazy rich Asians the movie?

Unknown Speaker 46:39
Ah, do you?

Scott Benner 46:40
Is it a caricature that you think is ridiculous? And the only something that Americans would like? Or is there any accuracy to it? Why is it that every time it comes on cable, and I noticed some like oh look, there's that movie again? And then I end up watching it?

Jaime Song 46:54
Um, I liked the movie too. But I feel I saw a little bit Hollywood pies.

Scott Benner 47:03
Oh, I wouldn't I would imagine I was. I was imagining I didn't think that everyone in China was running around incredibly wealthy wearing like, million dollar outfits and stuff like that. But yeah, but but but how does the How does it compare? How much cinema Do you get in China first, I guess?

Jaime Song 47:20
thing every few blocks or a lot? Yeah.

Scott Benner 47:25
So are there movies that are made in China that you grew up watching? Or do you see a mix of those plus, like imported movies?

Jaime Song 47:34
I think is some probably more Chinese movie now. In China, China.

Scott Benner 47:41
So there's a there's a there's a like a Chinese Hollywood somewhere.

Jaime Song 47:46
Oh, probably because I feel like entertainment is pretty like active right now.

Scott Benner 47:51
Yeah. How can you guys in China, people always say and I have no idea about this. So I'm dying to know that your technology is way better. Your Wi Fi is way better, like infrastructure. Is that true?

Jaime Song 48:05
Ah, I will say yes. I feel I would have I go back I will be like go back to the future.

Scott Benner 48:12
Ah. So you guys so you like like your cell phones are like better?

Unknown Speaker 48:19
Ah,

Jaime Song 48:20
actually, I never use a Huawei phone. But my parents use and also one thing different is like, you know, in Chinese show drama shows it used to be like the the they're using iPhones in the show. But now it's all hallway show. A Huawei phones?

Scott Benner 48:39
Oh, okay, so Chinese made phones? Yeah, yeah. And seriously, the Wi Fi way better, right.

Jaime Song 48:46
Wi Fi actually, I think there are always Wi Fi like,

in shops

bought I don't think Wi Fi is on the road yet.

Scott Benner 48:58
Or wait, but you live in New York. So it's there in New York. Most people don't have it the way they have in New York where it's kind of covered everywhere.

Jaime Song 49:07
But New York Wi Fi. I don't know if I connected the wrong world. I'm too impatient. Like it's always Oh, I'm listening to your podcast and sighs it stopped because I connect to New York City WiFi,

Scott Benner 49:20
and then it doesn't work as well.

Jaime Song 49:22
Yeah, I don't think so. We're like, I just turn it off. Because I have like unlimited

Scott Benner 49:29
data, you can do that. So is there I guess the question I want to, I want to understand is I understand coming here to to, like, want to, like absorb what Colombia has. Mm hmm. And do you stay behind because you like it here because there's better opportunity here. Like that's it. It's an interesting thing to me like to move away from home even if it wasn't from country to country if you you know, move away from home and then don't go back is it just this is where you feel like you live now.

Jaime Song 49:58
Um, I will say Still thinking if I would go back or not because I'm the only child in the family also, but I feel like right now because with I'm using Omni pod I'm using Dexcom is like if some in the future something comes out I feel like it probably gonna be here.

Scott Benner 50:21
Right? So you consider that you might want to go home just I guess because your parents when they get older and that you're the only child. Yeah, but you feel kind of held here by your about the, from the medical supplies you can get here.

Jaime Song 50:36
Yeah, I think so. Also, I have I feel like I've been living here like six years.

Scott Benner 50:44
Starting starting to feel like home.

Jaime Song 50:46
Yeah, I feel like it's more homes on my my CD because I also practice Japanese martial art. Like for three years now. My teacher, my Sensei, my son pies like my, my dojo, which is a place I practice is like, community to me. I'm

Scott Benner 51:09
building a life here.

Jaime Song 51:11
Yeah, exactly.

Scott Benner 51:12
I find it. It's not. It's bizarre that you know, medical devices, it's hard to get them everywhere they need to be. I've been having a messaging conversation with somebody from Iran, who's trying really hard to get on the pod index comm for their kid and they can't figure out a way to get it accomplished. Because they just it's not for sale there. Oh, so I guess Same thing with China. That's just you can't buy those things there.

Jaime Song 51:40
I think freestyle you could buy them. I look it up once to see if there's Dexcom. But I don't know if they have or the news doesn't say so. Yeah. And yeah, I believe there must be like, actually, influence in China is pretty good. I will say if I have a job and everything, I would say probably I'm even spending less than here. But if tax calm is now there probably I was still stay here for a while.

Scott Benner 52:16
How does insurance work in China? If you have a job? Do you get it through your employer? Do you pay for it? Do they pay for it? How does that work?

Jaime Song 52:24
Oh, I should? I don't know.

Yeah, but I would say because my mom is a teacher. their insurance is pretty good. Also, there's like difference between like, if you stay in hospital if you are inpatient or outpatient also, like, because I feel I teachers probably have the very good insurance because they are consider like the same benefit as government or whatever.

Scott Benner 52:56
So, yeah. Is there is there a way for you to take what you do and do it in China? I would imagine so right. I mean, you're working for a bank so that

Unknown Speaker 53:05
Yeah,

Scott Benner 53:06
yeah, I it's weird. I wouldn't think you'd go. But I to be perfectly perfectly honest. My brother just went from New Jersey to Wisconsin for college, and he never came back. Because he built a life there. You know, like he met people and got a job. And it's just where he lives. Now. I think it's incredibly common. It just wouldn't, it feels like when it's that far away. Like I didn't know how hard it was to be, you know, away from your parents that far. And that's tough. But you sounds like you have a real incredible base here between your dojo. And you know, your job and you live in New York it talk about that for a second. Because New York City is an interesting place because there are so many people yet no one's really talking to each other. Right? So are you are you alone with people? Or do you not feel alone? When you're when you live there?

Jaime Song 53:55
Um, I feel like half on have actually, on one hand, I have my community, I have my running club, I have my dojo, I have my work. Also, I'm living with a roommate. We have known each other since I got here. Um, but on the other hand, I feel like, Oh, my parents are getting old. But I'm away. So I feel a bit guilty

Scott Benner 54:22
about that. Of course, no, I understand. How long does it take to fly home to see them?

Jaime Song 54:27
Um, if I I always have two flights, the directing flight to Beijing takes 13 hours. And then I take another flight to my home one hour.

Scott Benner 54:42
So how long do you usually sit in Beijing?

Jaime Song 54:45
Um, I will. If I say I I'll take a long like layover and we'll call call my friends and we'll go out and eat all the foods.

Scott Benner 54:58
How how's How is it Traveling that far now that you're using insulin is that have you done that trip yet with?

Jaime Song 55:05
Yeah, I have actually there are some because I think why I travel internationally I I just put my insulin all the pens in the ass pack. Something I got I was going to kind of soak it in the water and it will become cold and

Unknown Speaker 55:21
free. Oh pack. Yes. So yeah, something

Jaime Song 55:25
like that.

Now I'm with Omni pod. Actually, I try it because my Qingdao like always, like not sometimes like when I'm showering sunlight scraped the white it came off. Or like sometimes I have to change it like, not the time I plan because this weekend is a long weekend. I'm traveling to North Carolina to see my friends. So I was thinking probably because I saw that can inject the insulin into the pot and carried outside like put it on whenever I want.

So I tried. I tried it like

on Tuesday I work actually i in the morning before I left, I inject insulin i saw i heard two beeps. Then I went to work after I put it on like around. It's definitely above two hours. And it doesn't let me activate that part. So I didn't read the really thick manual of the a PA that's my fault.

Scott Benner 56:34
Yeah, I think right. So I get what you're saying you were trying to transport the insulin inside of the pod that wasn't set up yet. Except that after a certain amount of time, it just errors if you don't turn it on, right?

Jaime Song 56:45
Yeah, yeah. So

Scott Benner 56:47
I gotcha. So do you have a very small shower? Or do you just take very active showers? How did you knock off your

Jaime Song 56:55
Yeah, that's, that's totally on me. Because, you know, like, we have a dent on the wall like you can put in like shower gels and everything. It has a an edge. So I was like, I just bending over to scrub my feet. And I was like, probably like, I scrub the wall on that ash. So it's just take it

off completely. Like

I was so surprised, because normally, it takes me so much strings. And if I have like, marks, like when I take it off, it

sticks, so Wow.

Scott Benner 57:30
Yeah, you just hit it just right and it pop and pop right off.

Jaime Song 57:33
Yeah, it's like, not even like sticky edge on it anymore. So have

Scott Benner 57:40
to be honest, you made me jealous for being younger and single. When you're like this weekend, I'm gonna go to North Carolina. Going to North Carolina for three days is like a major upheaval of my life. And I love the idea that you could just kind of pick up and go. It's very cool. Somebody that somebody you met in college?

Jaime Song 57:58
Oh, yeah. Yeah. From my master program. She's getting a PhD over there. So I've never been to North Carolina, so I'm going to check it out.

Scott Benner 58:08
That's nice. I get to celebrate with her a little bit.

Jaime Song 58:11
Yeah, I think she's, although she's statistician. She also is a choreographer and musician. So I probably gonna dance with her or like, um, and also I want to keep my running schedule. I will run with her probably

Scott Benner 58:29
in North Carolina. Well, hopefully it's got to be warmer there right now than it is here. I would think. I hope so. Yeah, yeah. How, by the way, how bad are New York winters? They're terrible, right? Just

Jaime Song 58:44
I will say, yeah, it's so much colder than my hometown. And I when I got here, I was like, Ah, it's snow. Like, this is so beautiful. And after two weeks, it's still still snowing. I feel like oh, no, not again. Stop being beautiful. A while

Scott Benner 58:59
ago, the most interesting thing for anybody who's never been in New York City, isn't always it on very cold, windy days. The wind only blows through the city one way so you can be on a cross street where there's no wind, all the sudden, to an intersection, and it feels like there's like a giant God sized fan blowing down the street. Right? And yeah, and if you get stuck on one of those streets, and you're walking up and down the way the winds blowing, it's it's very, I mean, it's to be expected. I guess there's so many buildings, but the buildings block the cross streets. It's very weird The first time you experienced it. It's a strange thing. Very much.

Jaime Song 59:36
Yeah, it is like I heard a story like because our office was at Wall Street area once. So while my colleagues actually came out of the building and his glasses were all blown away.

Scott Benner 59:50
That sounds completely right.

Jaime Song 59:51
Yeah.

Scott Benner 59:54
Yeah, it's a very it's a wind tunnel going in one direction and the other direction there's just a void of air. There's nothing happening no noise and it's all it's all fine. But I know I mean, it really is how, how I'm how immersed Are you in culture here? Like when like Christmas time, Christmas time is coming up soon? Like, is that a big deal for you? Or is it just another day like thanksgiving to like, how do you handle those kinds of holidays?

Jaime Song 1:00:22
Um, I will say yeah, I'm also like, half and half. Like, I school, I used to go to Thanksgiving dinner with my, like, American friends and but at work is like, my friends aren't going away home. So I feel like, I almost like spend all those like, American holidays, especially when I'm working more and more. Now I'm spent spending it like, you know, Chinese way I will go with my roommate for like, a celebration for hapa or like, my Japanese friend or like, it's different.

Scott Benner 1:01:03
Yeah, that's excellent. So it sounds like you have a cross culture of friends. So that's, that's nice. Like I we live in a diverse place. And it's just it's great because Arden and Cole have friends from just all different kinds of backgrounds. And they are always you know, they're always doing different things and seeing how other people celebrate different holidays. It's very cool. So it sounds like it sounds like you're living a very Metropolitan lifestyle to be perfectly honest.

Jaime Song 1:01:32
Yeah. At least a full wise it is in York City.

Scott Benner 1:01:36
You can find almost anything there which might not be good for you, Jamie. I'm starting to think but

Jaime Song 1:01:42
yeah, but still one thing I'm thinking about is I hear like everything is labeled clearly and it's also like label crackly I would say.

Unknown Speaker 1:01:53
Yeah. at home. It's not always right.

Jaime Song 1:01:56
Yeah, I hope like I brought something back like it's some sesame like powder. You can actually put in hot water and drink it is more like a soup or something. So it says like, fun day something carbs. So I pulled in my insulin, but my is my sugar jumped to like 200 or something? Well, so I never tried it. Again. Probably I will. was more insulin.

Scott Benner 1:02:22
Yeah, sometimes in American we complain about the government and the things that they do. And you know, the regulations they put on industry, but that's a good example. You know, there's a part of the US government that makes sure that foods are labeled correctly, and they come down hard on businesses that don't do it. And therefore those businesses make sure it's right. And And that ends up helping somebody like you, I just I really like tickled by the idea that the podcast helped you. With your with your with your goal of eating cake. So I I think it's true that Jamie is actually having her cake and eating it as well. Can I we're right up on an hour. But I am I wanted to ask you to say your name again. In the in Chinese

Jaime Song 1:03:06
a bullying song.

Scott Benner 1:03:09
Yeah, you're right. I would not be able to say that. Can you in Chinese say you're listening to the Juicebox Podcast? Or does that not translate?

Jaime Song 1:03:18
Oh, I can try. I'm watching the agenda teen gorgeous podcast or full cup playing that Dr. shoting or fish on she wants to go broke.

Scott Benner 1:03:35
Thank you. I don't know what I'm gonna do with that. But it made me happy. I just, I just got done. Actually, I didn't just get that I'm doing tomorrow morning. with somebody who's gonna jump on real quick in Spanish and go over the signs and symptoms of type one diabetes in Spanish. We're gonna put that up along with something else. But you're making me think that I should be doing it more languages because I have to admit, like I like, I mean, you listen to the podcast, you know, there's, there's been like 280 episodes so far with mainly English speaking people. Like every once in a while somebody comes from, you know, Czech, or, you know, I've had people from, you know, other countries, but they're still mainly English speaking Australia, the UK, you know, that sort of thing. But you in your email, and when we've been going back and forth, you're like, Listen, my English isn't great. And like, you're like that, but you really are. I had absolutely no trouble understanding you at any point during this conversation. So, I mean, obviously you work with mostly English speaking people all day. Yeah, sounds very cool. I I'm thrilled that it reached you like this. Do you think there'd be any value in me adding the signs of type one diabetes in Chinese?

Jaime Song 1:04:49
Yeah, I think I think so. Because I feel like um, but I don't really know what is care, care like diabetes. Carry in China like because I'm mostly like, just do the checkup and go because they have some like classes and also, before I have type while we saw like, diabetes is same for senior people. Um, so I feel like people need to conquer their fear for insulin and also there's certain like misunderstanding thinking Chinese medicine can cure anything like, say type one diabetes, or like it might be helpful but still you need to take insulin so I feel like people need definitely need more information about Type One Diabetes there.

Scott Benner 1:05:45
Yeah, great. I really appreciate you coming on and doing this.

Jaime Song 1:05:48
I appreciate your time too. This is fun. Good guy.

Scott Benner 1:05:53
Thank you so much, Jamie for coming on and sharing your very unique experience. Thank you also to Dexcom and Omni pod for sponsoring this episode. You can get a free no obligation on the pod at my Omni pod.com forward slash juice box. And of course learn all about the Dexcom g six continuous glucose monitor@dexcom.com forward slash Juicebox Podcast remember those links there right there in your podcast player notes or at Juicebox podcast.com. I got you covered. You'll find your way there.

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#353 Quite a Pickle

Diabetic Dyl Pickle that is…

Dylan is a young man living with type 1 diabetes, hypothyroidism and fibromyalgia. He also shares his experiences with the world.

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You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Pandora - Spotify - Amazon Alexa - Google Podcasts - iHeart Radio -  Radio Public or their favorite podcast app.

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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. Today's episode of The Juicebox Podcast is sponsored by the Contour Next One blood glucose meter. And by touched by type one. You know what? I should have said that backwards I'll tell you I think that one touched by type on has buy in and be Why? And I said this and buy and I think it ruins the flow of language. Watch this Hello friends. Today's episode of The Juicebox Podcast is sponsored by a dozen hidden works that way too I say touched by type when I go by touch by type one. Today's episode of the Juicebox Podcast podcast is sponsored by there's no way out of this is there Hold on a second. And how the music's playing. I gotta think faster. Well, first of all, this episode of the podcast is with a young man named Dylan and he is absolutely delightful. Dylan has type one diabetes, hypothyroidism, and Fibromyalgia is a wonderful Facebook page where he's trying to tell people about type one diabetes, and he'll explain about some of the experiences both good and bad he's had trying to share been pushed around a little bit online. But I think the way he handled it is really excellent. I want to tell you 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. Right now how do I talk about the sponsors without saying by and by consecutively? Today's episode of the Juicebox Podcast game sponsorship from touched by type one, and the Contour Next One blood glucose meter, please go to touched by type one.org or Contour Next one.com. For more information, you may even be eligible for an absolutely free Contour. Next One meter you'll find out the link. And they're also linked in the show notes of your podcast player at Juicebox. podcast.com. I mean, whenever you're ready.

Dylan Giuliano 2:14
I think I'm ready.

Scott Benner 2:16
I bet you are. Don't worry. It started off with just start off with your name.

Dylan Giuliano 2:20
Hello, my name is Dylan Giuliano. I've had type one Davies for four years and I work for jdrf. I am a Youth Ambassador. And I have a Facebook Instagram and YouTube page called diabetic dill pickle.

Scott Benner 2:36
So you are the kid that people called diabetic dill pickle. Yeah, that's pretty cool. So I see the word play. Right. Dylan? dill pickle. I'm right there. But where does that come from though? Is that something from your life? Or did it just come up to you when you're trying to think of a name? How did that? How did you end up with that?

Dylan Giuliano 2:54
Well, technically, I just thought of it in my head. My parents my just thought of it was actually technically

Scott Benner 3:01
my nickname. That's what I'm getting at. Like so people called you like dill pickle before?

Unknown Speaker 3:07
Yeah.

Scott Benner 3:08
Yeah. You know what I call Arden?

Unknown Speaker 3:11
What? boogers.

Unknown Speaker 3:14
It's funny for no

Scott Benner 3:16
for no reason. She doesn't have like, a bunch of boogers in her nose or anything like that. I just call her boogers. She walks into a room and I'm like, hey, boogers. What's up? And she just like, hey, and then it goes on from there. My wife actually said the other day. Why do you call her boogers? And I was like, I don't know. Don't you like it? And she goes, No, I'm like, No, no, I love it. So anyway, there's worse nicknames, right? Yeah. Her nickname seems to to move around a lot. We used to call her boo when she was little like before the monsters movie. And then they started using it in the monsters movie. And I was like, I can't do that anymore. It seems like we're ripping off Pixar. And we've gone through a number of nicknames. My brother has the best nickname in the world. And I'll tell it to you right now, but it's completely out of context. And I won't explain to you why it's his nickname. Okay. Okay, this is back when he was like 14 or 13. Originally, his nickname was good job, Bob. But eventually it became good job Bob the half naked Bruce Lee boy. And I can't tell you, but you can try to imagine how you would come up with a nickname where you're naked and Bruce Lee. half naked actually. all I'm gonna say to you, Dylan is that I don't think you should practice your karate in front of an open window without your shirt on. Okay. Okay. Good for you. Alright, man. So listen, how old are you? I'm 12 Oh, cool. And how? How old were you when you were diagnosed?

Dylan Giuliano 4:47
I was seven when I was diagnosed. Do you

Scott Benner 4:49
know that? That's been five years.

Dylan Giuliano 4:52
Well, actually, it's four.

Scott Benner 4:54
Okay, my math my math is wrong.

Unknown Speaker 4:59
Yeah.

Unknown Speaker 5:02
So, you're

Dylan Giuliano 5:04
all good. Well, technically, I was almost a basically, I was almost eight when I got

Scott Benner 5:09
sick. So my math is right. Your assertion isn't? Right, right. I so, so diagnosed around the time you were towards sort of the end of being seven. And yeah, and now you're 12. How are things? Well, no, wait, I was gonna ask you one thing I'm gonna ask, do you remember being diagnosed at all?

Dylan Giuliano 5:29
Yeah. So basically what happened? I was told the kid, I've been in many different rooms, like probably like three or four rooms, because they didn't know what one to choose me. And so I had in, they checked my blood sugar, and I was like, 590 it was, it was crazy. And they just thought I had the flu, but

I guess not.

Scott Benner 5:57
Yeah. So obviously, right. So up until or if you just had the flu, then this has just been one horrible practical joke on you for the last five years, or four years. Excuse me. But so you went into the hospital because you had like flu like symptoms

Dylan Giuliano 6:12
are basically my mom took me in like three or four doctor visits.

Scott Benner 6:18
So over time, she saw that you weren't feeling well, and she kept taking you back. And they weren't really doing anything about it. And then Is that it?

Unknown Speaker 6:27
Oh, yeah.

Scott Benner 6:28
Yeah. So you had to go a number of times before you before they could come to a conclusion. So it took them all the way to the hospital to check your blood sugar? Yeah. Wow. How long are you in the hospital?

Dylan Giuliano 6:40
Um, maybe like a week? Yeah, about a week? No kidding.

Scott Benner 6:45
To turn it into like a little vacation or were you just not kind of feeling better fast enough.

Dylan Giuliano 6:51
I just really wasn't feeling better fast enough. That sucks. How do

Scott Benner 6:55
you feel now?

Dylan Giuliano 6:57
Right now I feel way much better. Like I still have like a couple diseases mine but not all of them. Like I have fibromyalgia and low thyroid and stuff like that.

Scott Benner 7:12
You're just collecting, like, autoimmune issues as you walk down the path?

Unknown Speaker 7:18
Yeah.

Scott Benner 7:19
There's one. I'll take that one with me. So Alright, let's let's take a second for a second because you mentioned some interesting stuff. So hypo thyroidism. Yes. Okay. And you take Synthroid

Dylan Giuliano 7:33
Lords are low thyroid, and yeah,

Scott Benner 7:38
yeah, I do take a secondary medication. Like cider mill or no, no, just just the one. Okay. And what does it feel like? Well, how I guess what age did you start taking that medication?

Dylan Giuliano 7:53
Um, if I could guess, maybe

Scott Benner 8:01
this month, months ago, just months ago, actually. So within like, the last year you found out about hypothyroidism?

Dylan Giuliano 8:07
Yeah, gotcha. Just about a month ago, just about a month ago.

Scott Benner 8:11
Oh, she's very recently.

Unknown Speaker 8:12
Yeah. How were you

Scott Benner 8:13
feeling prior to being diagnosed?

Unknown Speaker 8:18
Um,

Dylan Giuliano 8:22
like, my stomach and stuff like that was hurting and I barely couldn't drink. Well, I barely didn't eat. I was just keep on drinking and drinking. just kept taking naps and stuff.

Scott Benner 8:36
stomach pain and tired, right? Yes. Yeah. Okay. So Arden has hypothyroidism too. And that's exactly how it presented to her. Her stomach hurt all the time. She actually was still hungry. So she ate through it. And

Unknown Speaker 8:53
oh, wow, she

Scott Benner 8:54
was incredibly tired. And she would have really and please, you can tell me if you want to, but she had a situation where she wouldn't go to the bathroom for a number of days. And then all the sudden she would go a lot if you know what I mean. And yeah, it wasn't exactly pleasant. Did that happen to you as well? Yeah. I see. Is there any chance that this episode is going to be called? diarrhea dill pickle, now maybe? I wouldn't do that to you Don't worry don't. But it's making me happy thinking about it. So it's really horrible. Like when your thyroids not operating properly. And you don't have the medication. It's crazy. Arden was exhausted like she could barely lift her head up sometimes. I don't know how she went to school some days and really terrible stomach pains. Wow, really, really bad. And then of course, you know, she'd eat meat need nothing would happen and then all of a sudden her body would just, you know, expel everything and then The process would just start over again. And there was no real relief from it. And, you know, we had you know, she gets tested for, you know, just like most people who go into their endo appointment shirt, her thyroid levels are tested yearly. And you know, the year prior, there was nothing. Had you ever now knowing about it the day ever that you know of see any indication from your blood test that something like this was coming?

Unknown Speaker 10:25
Yeah.

Scott Benner 10:27
So you could see your levels changing over time?

Unknown Speaker 10:29
Yes.

Scott Benner 10:30
Okay. So you didn't suffer too long before you thought? This is? hypothyroidism? I have to go back to the doctor.

Dylan Giuliano 10:37
Oh, m kinda.

Scott Benner 10:39
Would you think it was at first?

Dylan Giuliano 10:41
So at first, I kind of thought it was Moto, because of like, maybe a couple months ago. I got moto for a little bit.

Scott Benner 10:52
I thought you were gonna say it a couple months ago. I kissed a whole bunch of girls. Oh,

Unknown Speaker 10:57
God.

Scott Benner 10:59
Is that not what happened? No. How did you get moto then? I don't know. I don't know. I don't either. I don't really know anything about it. I had it once when I was younger. Like when I was like 19. I think I had it. It really sucked. I was like really beat up and it mimicked a lot of how Arden was when her when she didn't have her Synthroid. Like I was really super tired. That's how moto makes you feel. So you kind of like commingled those two ideas from it and thought, well, maybe this is just like, a leftover effect of the Moto.

Dylan Giuliano 11:28
Um, I think so. Yeah.

Scott Benner 11:31
Are you in charge? So how so you know what, let's do something here that might be interesting. How does it work? When you're a little kid, and you feel sick? Do you? Do you try to handle it on your own? Do you just dump it on your parents and hope they figure it out? Like what's, how does that all work?

Dylan Giuliano 11:50
So basically, I try and figure it out first, but usually, like we're all trying to help it out. together. And so we, um, yeah, I technically work with my parents the most.

Scott Benner 12:06
Do they notice that you don't feel well? Or do you tell them?

Dylan Giuliano 12:10
Oh, yeah, I just tell them that. I don't feel good.

Scott Benner 12:13
So if you wouldn't have said anything about your stomach pain, you think they didn't know until you told them?

Dylan Giuliano 12:17
Maybe? Well, I kind of looked pretty pale. So I'm pretty sure they probably could tell

Scott Benner 12:24
from your from your skin color. Yeah, that is the key to everything. When Yeah, when Dylan's when Dylan's pale. Something's wrong.

Unknown Speaker 12:33
Yeah.

Scott Benner 12:35
All right. Dill Pickle. Now let's, um, okay, so because I find that interesting, right? Because as a parent, I know that I try really hard to pay attention to my kids and how they're feeling and how they're acting, right? Because sometimes people will just power through things. You know, they think oh, or you lose track of it. You know, that happens. Sometimes you have a pain. Don't I just burped hold on? Oh, my gosh, I had a little soda this morning, which I never do. And I'm very bubbly now. Excuse me. I'm so sorry. So, sometimes, do you ever burp? Yeah. Do you have one now that you could share with us?

Dylan Giuliano 13:14
On No, no, I usually like never drink soda.

Scott Benner 13:18
Gotcha. I don't either. Diet soda was sitting downstairs, I thought let me be crazy. You know, not not a very crazy person. So it's like, Hey, give me Nazi over here with a diet soda. Anyway, you watch your kids, right? So you know, I do. I don't know what all parents do. I mean, some people might be listening now who are terrible parents and pay no attention to their children whatsoever. I've no idea. But I tried to pay attention. And if you see something happening over and over, you kind of say to your kid like, Hey, how are you feeling? Or I've noticed you're limping. Or why is it you're not using your right hand or you know, whatever it ends up being. And sometimes kids are like, it's fine. It's fine. It's fine. And you have to persevere a little bit and be like, No, I'm still seeing it happen. Like, let me see. And sometimes, they're so sick. They just come to you. And they're like, Oh, my God, I just vomited all over the hallway. Like, do you know what I mean? Like there's, yeah, some there seems to be no. Middle Ground, really. But what I was really interested in was like, how long did you persevere with stomach pain and being tired before you mentioned it? Or did your parents kind of figured out pretty quickly along with you?

Dylan Giuliano 14:24
Um, but maybe, maybe then, like, a day?

Scott Benner 14:29
Yeah. So pretty quickly, they got involved. Yeah. And then do you go right to the doctor, or do they try all the like, regular stuff like, Did your mom say have you gone to the bathroom lately? It was like the first thing she said.

Dylan Giuliano 14:42
Well, actually, um, I've been to the doctor like three, maybe three or four visits.

Unknown Speaker 14:51
And

Dylan Giuliano 14:54
like, yeah, it was pretty crazy.

Scott Benner 14:56
So as always, what happened that you told her you're stomach hurt, and she took you right to the doctor, and then they couldn't find anything. And you had to go back a couple times.

Dylan Giuliano 15:05
But she took me to a regular doctor.

Scott Benner 15:07
Right? Instead of an irregular doctor. Yeah, yeah. So not a diabetes doctor. No, right. I feel like I knew what you meant. But okay, so I had an irregular doctor one time, but that's a different story. So you went to like your regular like pediatrician and you're like, and she's like, hey, Dylan. stomach hurts.

Unknown Speaker 15:27
And um,

Scott Benner 15:28
yeah. Did he like poke you or give you something? Or did he ask if you pooped? Who asked you? If you would have gone to the bathroom? Somebody had to have asked?

Unknown Speaker 15:37
Oh, if I can remember.

Unknown Speaker 15:41
No one asked.

Dylan Giuliano 15:43
I'm trying to remember.

Scott Benner 15:47
I think is the doctor. But the doctor did ask you. Yeah, gotcha. And then you said, Yo, man, here's what's going on. Like it don't come out. Then all of a sudden that comes out crazy. Yeah. How did you say it? Tell me what you said?

Dylan Giuliano 16:04
Well, so basically, I couldn't go to the bathroom for a little bit. So and then I just went to the bathroom. There it goes.

Unknown Speaker 16:14
He said, There it goes. Yeah.

Scott Benner 16:18
That could be the name of your episode. There it goes. Let her fly. Don't pickle. So

Dylan Giuliano 16:26
well, okay. So then what did he do? So actually, it like my, I've actually, it's been holding for a little while. It's like hard to go. So then it probably took like a few days for it to feel better and stuff.

Scott Benner 16:42
So initially, the idea was just like, well, you'll feel better. Like he probably thought you had like a little virus or stomach flu or something. Yeah. Right. So he was just like, oh, that happens to people and you go head home and you'll feel better, but then you didn't feel better. Did you go back to him again, and you go somewhere else?

Dylan Giuliano 16:59
I went somewhere else.

Scott Benner 17:01
Because he wasn't helpful or because your mom started thinking diabetes.

Dylan Giuliano 17:06
Um, well, my mom actually finally talked to the endo, endocrinologist.

Scott Benner 17:11
Ah, and then the endo said, hey, let's do a blood test. Yes, gotcha. So the endo kind of solid for Yeah, signs there because they're very, they're very clear signs of hypothyroidism, untreated, the stomach pain, just like you described is clear. I don't want everybody whose kid tummy hurts not to think they have hypothyroidism. But you know, it's it's pretty. What Dylan's describing what Arden went through is it's severe. And it is, it's noticeable. It's not just a little stomach pain. It's not. And it persists. Well pass, any common sense would tell you that an illness would would last. So. So if people see the signs, you get a simple blood test. And they'll let you know now the hard part and you're just finding out in the beginning is that getting that medication? Correct? is really hard. Like the dose right? Yeah, you going through that right now?

Dylan Giuliano 18:05
I'm kinda Yeah.

Scott Benner 18:08
Have you changed it yet? Or do you think it's working? Are you feeling better?

Dylan Giuliano 18:13
I think I should probably just keep it the same. Just because?

Scott Benner 18:19
Because it's working.

Unknown Speaker 18:20
Yeah. Okay.

Scott Benner 18:22
So can you explain to people after you start taking the Synthroid, and it starts helping you? Like, what's the what's the change from how you felt to how you feel with the medication, I don't think that the blood glucose meter you have should just be the one that somebody gave to you. I think you should have the best, the most accurate, the easiest to use the most pleasing to your eye, the one that fits in your hand, like what fits well, on your hand, you know, fits well in your hand like something if it's holding your hand, it has a beautiful bright light for when you're testing at night, and test trips that allow you to go back to the blood drop a second time, if you don't get quite enough the first time. That saves a lot of test trips, and a lot of hassle. I believe that you deserve a meter that can chart your blood sugar tests in an app on your iPhone or Android phone to give you the data that you need later, to see how things have been going, huh, don't you feel like you deserve that as well. Of course you do. Now, like a dream. It will come true when you go to Contour Next one.com. That's where you're going to find out about the meter. That's where you're going to find out. If you're eligible for a free meter. There's a little button at the top of the page, give it a little click, you might be one of the lucky ones. But if you're not, it's super simple to tell your doctor I'd like to change my blood glucose meter. I've been using this old meter forever. I don't even know if it's accurate. I haven't even ever checked Have you ever looked online to see if you meters one of the really accurate ones or one of the ones where people are like, Well, you know, it's a blood glucose meter? Have you? I bet you haven't. But you know which one of those meters is right at the top of that list. I know you know that I'm gonna say the Contour. Next One. So it's worth a shot. blood glucose meter is an absolutely integral part of your life with type one diabetes, and you shouldn't be using an old busted up one, you just shouldn't Contour Next one.com go there today, there are links in the show notes of this podcast player, and at Juicebox podcast.com. If you can't remember, Contour, Next One. But I mean, the name of the meter, you want the meter? The websites the same? feels like you're gonna be able to remember. Go check it out, get it done. Don't wait. When you think about people helping people, who do you think about besides Dylan today? Who's doing a really wonderful job of sharing his life with Type One Diabetes? What do you think when you think of an organization that's out there? Doing things for people with type one diabetes, do you think of touched by type one? Well, if you don't, you should, you should check out touched by type one.org. They're also on Facebook, and Instagram. And they're doing amazing things for people with type one diabetes every day, not once a week, or six times a month, every single hour of every single day. They're helping people with type one. And they have an overarching goal of finding a cure. So they even donate money to that. This seems like something you'd like to know about, I imagine. And Firstly, all you have to do is make with the typing. Touched by type one.org. There's about 20 seconds of music left, should I cut it off? Or would you like to just bop your head and maybe dance a little while you're vacuuming or whatever you're doing? You know what things have been stressful lately? Why don't we dance?

Dylan Giuliano 22:37
I was actually not as tired pooping regular basically.

Scott Benner 22:42
You weren't as tired? No. Right? And then your your kind of your valves and everything went back to kind of normal using the bathroom the way you expect. Yeah, all of a sudden, all that stuff. So how quickly did it happen after you start taking the medicine?

Dylan Giuliano 22:58
If I could, maybe.

Scott Benner 23:03
Maybe week, a couple weeks, and you felt better? Yeah. That's cool. That's excellent. Any other changes that you have your parents noticed? Like, were you in a bad mood? Or like anything else happening that the medications changed? Or have you not noticed anything else?

Dylan Giuliano 23:18
Yeah, I was kind of like in a bad mood and stuff.

Scott Benner 23:21
Yeah. The people whose thyroids are off can be short tempered, I guess is the way to put it. Yeah. Right. And, and that's another thing you could be looking for.

Dylan Giuliano 23:33
Yeah, I was actually kind of depressed and stuff like that.

Scott Benner 23:36
Yep. I'm glad you're feeling better. That's really cool. All right. So all right, one thing down. And we'll get to the diabetes in a second. But you mentioned something else that is incredibly interesting. Because it's, it's hard to get a diagnosis for. But how are you? You know, how are you diagnosed with fibromyalgia? First of all, tell me a little bit about it. Like what what does that how does it make you feel and how does it impact your life?

Dylan Giuliano 24:02
Like so like, my elbows and arms and stuff for just like affecting so my mom was just like, wait, why is your elbows like so red or something? And so she just took me in. I just had fibromyalgia. So they saw something on your skin. Like, basically, there's like pain all over myself.

Scott Benner 24:24
Okay, but you saw something visibly on your skin like redness? Oh, my elbows. Yeah. Okay. And that's what got and did you have joint pain and that kind of stuff going on? Yeah. Is it in your muscles or in your joints? I know that's a weird thing. But like your muscles hurt. Do you feel weak? Or do you have like pain in your knees and hips and things like that?

Unknown Speaker 24:47
both

Scott Benner 24:48
areas that it happens like that. So you just have sort of like an all over body pain? Yeah, does it cause muscle pain or muscle stiffness to your muscles get really tight like You worked out too much. And they're like, super like in a knot, or do they just hurt in general?

Dylan Giuliano 25:06
Um, they

Unknown Speaker 25:10
kind of both actually

Scott Benner 25:12
do. How do you help that? Like, do you ask people to give you like massages? Or like, how does that work?

Dylan Giuliano 25:19
I just

add on stuff. And just hopefully that goes away and I stretch.

Unknown Speaker 25:27
Stretching.

Dylan Giuliano 25:29
Yeah, stretch and I take Advil.

Scott Benner 25:32
Is that what the doctor asked you to do? Or do you just do that? Because the pain is bad. And you we kind of can't? Do you want to do something?

Dylan Giuliano 25:38
Yeah, I probably because my, um, because I just do it because I feel like, worse and stuff like that. So I usually just take Advil and stretch, and my pain was very bad.

Scott Benner 25:56
Yeah, what's the impact of the pain? That's what I was gonna ask you like, is it does it keep you in bed? does it keep you from doing things you want to do? But how does it affect you?

Dylan Giuliano 26:06
Um, so basically,

Unknown Speaker 26:10
huh?

Dylan Giuliano 26:14
I can't really run around and stuff. Okay.

And Mmm

Scott Benner 26:23
hmm. What happens if you run around?

Dylan Giuliano 26:26
Like my joints and stuff to start to hurt and stuff like that? And I just feel run down.

Scott Benner 26:34
What's the dike? Like? How did they diagnose? Fibromyalgia? Is that a test they give you? Or is it just because? Is it one of those things that it doesn't have a diagnosis, but it's nothing else. So they call it that or how do they do that?

Dylan Giuliano 26:48
I actually don't know. I just saw a rheumatologist.

Scott Benner 26:52
Okay. And that's and so is there's no medication beyond Advil. I don't know. But you're not taking anything is what I'm saying. No. Okay. So it's not like they were like, oh, here's the Fibromyalgia medication like, yeah, diabetes, no, like, Hey, you have diabetes. Here's insulin. They weren't like you have fibromyalgia. Here's this. It wasn't like, Oh, right. So stretch. Is diet impactful. Do you have you changed your diet?

Unknown Speaker 27:20
Yes. How?

Dylan Giuliano 27:23
I'm just eat a little healthier. And then it just started helping thing helping my joints and stuff.

Scott Benner 27:32
No kidding. So what are some foods that you are eating that you're not eating anymore?

Dylan Giuliano 27:36
So I'm actually back then I used to eat some wheat and stuff. But now I'm just good friends. So it helps my joints and stuff. Cool. That's cool. So eating gluten free is helping? Yes. A lot.

Scott Benner 27:50
And are you do you have celiac or No,

Dylan Giuliano 27:53
No,

Scott Benner 27:54
I don't. So it's not for reasons of celiac. It's for reasons of like inflammation and things like that. Yes.

Unknown Speaker 27:59
Yeah. Gotcha.

Scott Benner 28:03
on a day to day basis, is it? Like I know that some people say there's flare ups? Like there's some days that are worse than others? And there's hard to figure out why sometimes, but are you in the middle of a good day or a bad day right now?

Dylan Giuliano 28:17
Right now? I'm in a good

Scott Benner 28:20
pool. And it now if you just got up and went outside and ran a marathon, would it start hurting right away? Or on a good day? Does it not bother you when that happens?

Dylan Giuliano 28:30
Um, it wouldn't really hurt me

Scott Benner 28:33
on this day. Oh, no kidding. But then when it happens, it happens and then running would be bothersome. Yeah. Wow. That sucks, man.

Dylan Giuliano 28:41
But usually when I get sick, it gets like worse. So if

Scott Benner 28:45
you get a cold like a like what they call regular people sick you get to get a cold or something like that. Then that kind of. Yeah, it's worse as well. Okay. Yeah. Any other brothers or sisters?

Dylan Giuliano 28:57
Well, I actually have one brother. He's an older brother.

He is 13

Scott Benner 29:03
Nice. Is he Karl the cucumber? What? No, pickles are cucumbers that are pickled. So I don't know if his name was Carl and you guys call? Nevermind. Dylan? If you're not gonna laugh at my dumb joke. I don't know what to do. It's not is it Chris the cucumber? Like what's his the you don't have to tell me his name. Is he named after any kind of sides? coleslaw? No big potato salad. No, what's his neck? Does he have a nickname?

Dylan Giuliano 29:32
Yeah, so basically, his real name is Anthony. But we like to call my mom and stuff like to call it man. Just because I don't know. Why is he tiny? No. Is he a superhero?

Scott Benner 29:48
I don't know. I thought you're gonna say was Tony the Tiger. I would have been a great nickname for a kid named Anthony.

Dylan Giuliano 29:54
Probably. Probably would.

Scott Benner 29:56
Yeah, if you put me in charge of his nickname. He'd be Tony the Tiger or I'd probably just On boogers, because I'd be lazy about it and want something easy that I can remember. Do you think my daughter enjoys being called boogers?

Unknown Speaker 30:09
Ah,

Scott Benner 30:10
probably not. Oh, I 100% think you're right about that, by the way, complained about it openly. But she does make a weird face at me. When I do it. I actually have a test or something right now I'm texting her get loop green. Her loop is not looping. Do you? What do you how do you manage your diabetes? What do you use?

Dylan Giuliano 30:33
I use and pan and a dexcom

Scott Benner 30:37
Dexcom in Penn. Nice. They're a sponsor of the show.

Unknown Speaker 30:43
You know that?

Dylan Giuliano 30:44
Yeah, I've actually heard it from a couple episodes ago.

Scott Benner 30:47
Thank you. So Dylan, um, no insulin pump. That's cool. Arden's looping. So I'm trying to get out of like right now that there's so there's no connection between her. Her pump and her Dexcom and her phone aren't connected right now. So because of that her the algorithms going back to whatever her standardized bazel rate is. And it's not adjusting her bazel up and down, which has been fine for the last hour or so I've just let it go because it's working. But now all of a sudden, her blood sugar's trying to drift down. And I need the loop to cut her bazel off, but it's not connected. So it's not doing it. Oh, so I've sent her a text and asked her to do that. And whether or not she does that is anybody's guess. But what I need her to do, basically is to turn Bluetooth off and turn it back on. And then it should connect again. So we'll see. So I might have to texture once or twice while we're talking because it seems like she's in a part of the building where she's not getting good coverage, because my texts are going through slowly. So do you are you homeschooled? I actually yeah, I'm homeschooled. And have you been always? Or is that something that started after the diabetes? Or what are you guys doing?

Dylan Giuliano 32:11
It's actually started after the diabetes. Because like I used to get always sick and stuff like that. Like, I probably would get sick like every week. If I can guess it'd be like every week

Scott Benner 32:27
diabetes related or something else?

Dylan Giuliano 32:30
I don't know. Basically both.

Scott Benner 32:33
Do you like it low blood sugars? And it was hard to deal with at school? Yeah. And how do you enjoy? Who teaches you at home? like where do you get your lessons from?

Dylan Giuliano 32:43
Um, well, I get my lessons from my teachers. So, but Well, actually I do k 12.

Scott Benner 32:53
I don't understand. So wait, the school sends you lessons and like your mom and dad help you with them? Or how does that work?

Dylan Giuliano 33:00
So, um, I'm actually in public school. online school. Sorry.

Scott Benner 33:06
Oh, online public school at home? Yeah. Nice. That's cool. You know, you could use Instagram to learn if you needed to. You could just like, between, let me just say this, between cardi B and Drake. I think there's a lot of wisdom in the world. And I think you'd be able to get it from them. I don't. Do you believe in that what I just said or do you think I'm being sarcastic and joking with you always sarcastic? I am being sarcastic. But there there is a lot of good information in the world. It none of it comes from cardi B. I you know, I'm lying. She says some stuff that is hilarious. I sometimes she's talking I'm like that woman is a genius. And, and yet her messages is marred by some some of her tone. Nevertheless, you so you have a so you have an online system. That's through the public school system, but you do it from home. And so when you get up in the morning, like it's super early where you are right now, right?

Dylan Giuliano 34:04
Yeah. 657 right now,

Scott Benner 34:06
like I tried. I was like Dylan, you can do this later. And you're like, Nah, I'm too excited. Let's do it now. And I'm like, that's cool. So you're really excited to be on this podcast, aren't you?

Dylan Giuliano 34:15
Yes. Like I couldn't sleep last night.

Unknown Speaker 34:19
Seriously?

Dylan Giuliano 34:20
Yeah. That's how excited I was. Why?

Scott Benner 34:23
What did you think was like, what was your excitement coming from?

Dylan Giuliano 34:27
I don't know. It's just when I was in your livestream a couple of days ago. So like, I was just like, Yes, I just remembered that was by Juicebox Podcast, so I just got super excited and I couldn't sleep.

Scott Benner 34:40
Is it my fault? You didn't sleep? No. He shorted it sounds like as I went online, you saw I got excited and didn't sleep that I feel like I did this to you know, Oh, is it gonna make the rest of your day like sleepy?

Unknown Speaker 34:54
No, no.

Scott Benner 34:55
So what are you going to study today

Dylan Giuliano 34:58
um, No, actually,

Scott Benner 35:02
who decides? Is that just you? You log on and it's like, hey, Dylan, today you're doing this.

Dylan Giuliano 35:08
Oh, technically. So I have live classes and lessons basically. So like, my live classes are Mac era science and history.

Scott Benner 35:20
So Dylan, let me make sure I understand you sit in front of a computer where you see video of a classroom happening. Kinda like can you interact with it?

Dylan Giuliano 35:30
Sure. So it's like,

these teachers are actually talking to you on mics, and they're like, teaching you some stuff. And it's pretty cool. Actually.

Scott Benner 35:43
It's insane. I had to get up and get on a bus. And then a Dylan, I'm gonna tell you right now.

Dylan Giuliano 35:50
So basically, it's actually after PowerPoint. It's PowerPoint. Okay.

Scott Benner 35:54
Okay. So like they did. It's a presentation about that. And if you have a question, you can be like, yo, just now on number five. I don't understand. Stop. Go back and explain it. Yeah. Okay. Yeah. You have interaction with somebody? Yeah, I don't do you want to hear about my walk to the bus stop. out of my house right? down this long Hill. Then I got to make a left. Then I walk a full block. Right. Then I make a right, a right. Make a walk another full block. Then I make a left walk three blocks up over a big hill. That was my bus stop. It took me 20 minutes to get to my bus stop every morning. Wow, one cared about children in the 80s Do you understand? No one. No one cared. They were just like, they were like, Look, if that one dies, it dies, whatever. You know, like there's more kids. Nobody protected children the way they do now. And then it would be raining. And you know, and you would just go out and just be like, Oh, I'm gonna get soaked going to the bus stop. Don't be so all day long. And you know who will care Dolan? Who no one I just explained it to you. No one cared. Okay, so you get to school your shoes were soaked. Your jeans were soaked. What would you do? If you got to school and you were stuck? You would go tell somebody? Hey, look, I'm all wet. I gotta call my mom. Right? Yeah. That's not what happened in the 80s. Dylan in the 80s. They'd go, no one cares. Go back and sit down and don't get the floor wet. And you'd be like, how am I gonna get the floor wet? I'm dripping like a wet towel. Right? No one. Yeah. Different World. Different World. Dylan. I'm telling you right now. You live in a golden age of being a kid. Did it stand. There's you're at home right now because you don't feel well. And you get to go to school online. If I didn't feel well, when I was little. You know what my dad said? What? Nothing because he had left for work hours before school started. And he didn't not to put too fine a point on it. What done? What did my dad do?

Dylan Giuliano 37:51
did nothing. Yeah,

Scott Benner 37:52
right. He didn't care. He didn't give it. He was like, yeah, that kid will grow up. It'll get a job. Whatever. You don't I mean, like, right. Your mom and dad care about you. Look at all the effort Your parents are putting into helping you feel better. To make you a keep you educated. It's really cool. I really am really impressed that that with all these I mean, because you're having a lot of dealing. Can we curse you and I together just a little curse? Do you cry? Sure. I'm fine. You do? Yeah. I'll bleep this out later. But you're going through a lot of you don't I mean, like you got diabetes sucks. This fiber mile just sounds like a headache. And then you and then the hypothyroidism I know from Arden is not fun. And, and and you're dealing with all this stuff. You got a great attitude. And on top of that you're trying to help other people. Yeah, dude, why are you such a nice person? I don't know who just happens natural. Yeah, yeah. Good for you. That's nice. I'm a nice person to people don't think it. My wife, people, my wife always be like, isn't that woman nice? I'm like, I'm nice. You never hear anybody say it. And she's like, it's because you're saying it. I'm like, man, I don't think that's why I think people don't think I'm nice, but I am. But you're really you're superduper double nice. So to see. You're welcome. That's how I know you're nice. You thanked me for saying something nice about you. I would never do that. If you said something nice about me. I tried.

Unknown Speaker 39:18
I'm here.

Scott Benner 39:20
You're a nice guy. I'll see now I say thank you because I feel pressure. But in the past, I would just say of course I am done. You're 100% right. You know, I'm just kidding. I wouldn't say that. It is a it is a very good thing you're doing trying to share your life and I want to talk about that a little bit as much as you're comfortable. So you have a Facebook page. You have like the YouTube you're a kid you probably probably have everything right? Like you have different like pathways to people. Yeah, I need to share your life with Type One Diabetes, right? And talking to people about what's going on and everything and first of all, are you enjoying doing that?

Dylan Giuliano 39:56
Yes. I very enjoyed it.

Scott Benner 39:58
What about it? Is, like rewarding.

Dylan Giuliano 40:02
I just like to educate people and tell people about like, type one and stuff.

Scott Benner 40:08
That's very nice of you. Now, we're gonna curse again and again, it'll get bleeped out. Okay, some of

Unknown Speaker 40:16
you online.

Dylan Giuliano 40:17
Yes, like I got bullied a lot of times.

Scott Benner 40:21
And is this from people like that you can actually see like, you know who they are like, are they adults? Are they kids?

Dylan Giuliano 40:28
I honestly don't know. I can't tell. No.

Scott Benner 40:32
Okay, so So are they, you can't tell if there's somebody who has diabetes who's like you're doing this wrong, like, what do they What have you what has been said to you in the past? I hope this isn't hard to talk about, but what is it what has been said to you?

Dylan Giuliano 40:44
So basically, actually, I think they're most mostly adult. So like, many people like this, there's just one lady who said, who told me, I don't know how to, like, take care of myself. And like, like, when I was in the hospital, they said, Oh, I thought you were low carb. And you should probably stay healthy again, and stuff like that.

Scott Benner 41:07
So someone just kind of like came at you when you ended up until you're trying to share with somebody, hey, I'm in the hospital. Now this is going on. And instead of them saying, Oh, I hope you feel better. Someone actually said, Oh, I thought you were low carb. This shouldn't be happening to you, or you should get back to that or something like that. So that seems like a good time to again, remind people how old you are. Don't I'm 12? Yeah, it's a good time to tell a 12 year old they're making a mistake, because you're completely in control of your life. Right, Dylan making all your own decisions. Your parents have nothing to do with it. No, of course not. You're a kid. Right? Right. Like you. You just you're rolling along doing your best, everyone's doing their best and you're trying to share. Now, let's discuss what kind of a monster would say something like that to a 12 year old? What did you imagine in your mind when you looked at it? You know what? No, no. What was your reaction? When that was said to you? How did that make you feel?

Dylan Giuliano 41:56
I just felt very sad. Because an emotional because, like, I've never had that happen to me before. Like, I was probably like my first time that ever happened. So I just got very sad and stuff. No,

Scott Benner 42:09
no, I'm sorry for you seriously. And I am going to, I'm going to try my best right here to give you some guidance that I think will help you because if you're going to keep sharing with people online, like this are some things you're going to have to understand. And I have a unique perspective on this. You have come to the right place, Dylan, this is your online class today on dealing with people who feel like they have an input into what you're doing. Okay. Okay. So you're in an interesting situation. You are sharing stuff online. So you are putting yourself out there, you're opening yourself up to anyone's interpretations, desires to speak to you, right? So yeah, you've taken that risk. And so that's something you've done on your own, I'm assuming with your parents, I assuming your parents understand what you're doing online, and they're okay with it. Right?

Unknown Speaker 42:59
Yeah. Yeah.

Scott Benner 43:00
Right. Okay. So, you've done that. That's your decision. You've put yourself out there. What you have to realize from there is that not everyone is going to jive with what you're doing. Right? So you're going to talk to some people who you're going to hit right in the heart and they're going to be like, I love this Dylan kid. You know, like, I love what he's saying. I love what he's trying to share. I'm with this. Those people are going to be you know, for the lack of a better word fans of what you're doing. Now, there are going to be some people who don't agree with you. Now, when those people are mentally healthy, they just won't pay attention to you. Right? Like, like, for instance. Do you like baseball? Yeah. Okay. Do you like football? Yes. Do you like soccer? Yes. Like, ah, do you like ice hockey? Huh? Do you like ice hockey?

Dylan Giuliano 43:52
I'm not really big fan of ice hockey.

Scott Benner 43:54
Okay, so do you watch baseball games on television? Yeah. Do you watch ice hockey games on television? Yeah, you do or you don't? kinda guy but you don't love it? No. Okay. So if I put a baseball game up at a hockey game up, what would you watch? Probably a baseball game. Okay. If you decided to watch the baseball game instead of the hockey game, would you then send an email to the hockey game and tell them you suck? I'm not watching you. I'm watching baseball instead. No, ah, why would you not do that?

Dylan Giuliano 44:25
Because it's just disrespectful. I mean, and unnecessary.

Scott Benner 44:28
And Dylan, let me say insane. It's absolutely insane. Why would you I don't understand why someone would take the time to let someone know I don't watch your thing. I don't get I don't get that. I don't understand why someone wouldn't see you online and if they disagreed with you or didn't like the way you presented yourself or whatever, why they wouldn't just think Hmm, well, this is the thing I won't follow anymore. And I'll unfollow this. Why is it that they need to Do they feel the need to jump in? And give their opinion?

Dylan Giuliano 45:05
I don't know, like many people, just like, make fun of me because of my videos and like on YouTube and Instagram and Facebook and stuff like that for all for basically.

Scott Benner 45:17
So that's happening, what keeps you doing it? Why do you keep doing it?

Dylan Giuliano 45:21
Well, I can just push away the bullies and just stay positive and try my best to ignore them. And I just block them. And just keep going.

Scott Benner 45:34
And because there are probably plenty of people who are enjoying what you're doing, and they're getting something out of it, right? Yes. Excellent. That's right. Like

Dylan Giuliano 45:41
many people are just like, Oh, my gosh, you're thanking me so much. You're helping me a lot and stuff like that.

Scott Benner 45:49
So there are people who relate to you. And those people are being genuinely helped through just the community really just feeling like they're not alone, you know. And that, did you hear the episode with Tommy?

Unknown Speaker 46:03
Yes. And Tommy's

Scott Benner 46:04
more your age. Right? Did you enjoy listening to Tommy?

Unknown Speaker 46:07
Yeah. Cool.

Scott Benner 46:09
Now, do you think that a 55 year old guy would enjoy listening to Tommy as much as you did? Probably. Yeah. I think so too. I think people's stories are universal. And I think that if you really stop and listen, that you'll hear something, and something that's being said, that's valuable to you. And that's very cool. And I think that those people could find that with you, too, if they wanted to. Instead, they want to be mean, I guess, and and I don't know why that would be I also, you sometimes also run into people who are like, Hey, here's what you should be doing. Here's what you're doing. But this is what you should be doing. Have you had Yeah. Have you had that one yet? Yeah. Yeah. So they think you have some sort of a spotlight on you. People are paying attention to you. And they want you to be saying something different than what you're saying. Yeah, yeah. You know, what those people should do? What What do you think they should

Dylan Giuliano 47:07
just leave? Don't come back or something? Yeah,

Scott Benner 47:12
they should either start their own thing and say what they want to say and see if people will follow them. Where they should shut up. Because, right, because what is the point you only have your perspective to share? That's Oh, yeah, that's all you have. I can't, I can't come on this podcast and be somebody other than who I am. Mm hmm. So I will share with you. Because I know this has been hard for you. And I know you like the podcast, that I get emails once in a while and notes from people who are like, you're not doing a good job with the podcast. You should Yeah, you should be doing it like this. You did you made this decision and not that decision. I'll tell you one thing that people don't know, don't is that sometimes guests come on the show. And they're nervous. And they don't speak the way that makes it interesting to listen to, sometimes there's slower, or they kind of, you know, they don't maybe have command of their thoughts the way they thought they were going to when they come on. And when that happens. I jump in and talk more. Okay. And I think that that's noticeable for most people. Like I think when people listen, you go into Scott talked a little more this week, the news last week, probably a reason for that. But every once in a while, you'll get a note from somebody who's like you talked over that person and didn't let them speak. And what I want to say to them is Listen, I was doing what I thought was best there. If you don't agree. You're welcome to buy a computer and software and get hosting and a microphone and a processor and make your own podcast and edit it and put it up and find people to listen to it and see if you can do something that you would be interested in. Because, wow. Right? Because that's all this podcast is honestly, it's something that I would be interested in listening to. If I was looking for a podcast about diabetes, I am not here to make bland content that everyone's going to like because there are people who do that. And those podcasts aren't very popular for a reason. So I like you being unique. I like you doing your thing. And the people who love it. Love it and the people who don't. That's okay, too. Yeah. Good for you. How do you get so strong in this scenario? Like seriously? I, I am. I've had practice. Like I wrote a book A long time ago and some people really liked it and some people didn't like it. And that was my first real practice and being like, wow, not everybody's gonna like everything. I say, Okay, I have to be okay with that. But you're 12 you're living with diabetes, fibromyalgia, hypothyroidism. And on top of that, some people come along and they're they're not nice to Like how did you find the like, where do you find the goodness inside of you to like, just deal with it so well?

Unknown Speaker 50:05
I don't know.

Scott Benner 50:08
You're supposed to say good parenting there. That was for your mom I set you up there don't so you know my parents have raised me really well. Good deal and how did you find the kindness inside you to deal with that so well,

Unknown Speaker 50:19
I

Scott Benner 50:22
actually don't know Dylan take three. When I asked you the question. You're gonna say it's great parenting. My mom and dad are beautiful people ready? 123 Where do you find the goodness inside of you to do that? So well.

Dylan Giuliano 50:31
Great parents. I agree

Scott Benner 50:33
with you man. Good parenting is always the key. You know, amen. Just really people who have your best at heart and they're looking forward to you're really filling you full of goodness in life. So you can give it back out again. That was for your mom and because she's gonna listen to this, okay.

Unknown Speaker 50:47
Okay,

Scott Benner 50:47
kids never understand. Every once in a while, man, you got throw a bone to your mom. You know what I mean? Like just the text message during the day. Hey, Mom was thinking about you. Hope you're having a good day. Boom. Perfect. I'm telling you don't know how to do it. You got to do it like that. Even just your role, Pastor. Is she in the house with you now? Yeah. Let me tell you something right now, though. At some point today, not as soon as you get off our show. Now. Out of nowhere, you make eye contact with your mom and you go, Hey, mom, and she looks over at me. She goes, Hey, Dell. And here's what you said. I just want you to know I love you. And then she goes, Oh, thanks, buddy. Come give me a hug. And she'd be like, Yeah, come over, give her a nice hug. And you move away made her day.

Unknown Speaker 51:28
Right? Yeah.

Scott Benner 51:30
Now you do that today. And like months from now, she's gonna hear this podcast, and she's gonna be like, that's why that kid hugged me that day. You know, right, right. Yeah. But it's, but it's seriously a nice thing to be kind to other people. All right. I joke. I joke around a lot on this podcast, I'm sarcastic. And I do that for a number of different reasons. It's a pretty purposeful when I'm doing it. And and yet I am, I have a real kindness inside of me that that doesn't reflect in sarcasm. I really, I want just like you do to share something with somebody that might help them. And so yeah, have you ever shared something with somebody that you've seen reflected back? Like, they've come to you and said, You've helped me and how does that make you feel?

Dylan Giuliano 52:16
I think it feels like, great. When you

Scott Benner 52:20
get that kind of response back and you get that great feeling is it like, I'm happy to have helped someone, or, or I feel badly and I just need to feel a little better for a second. And it's nice that I was able to do something that this person liked. And I get to feel good about myself for that. Like is it all of that none of it, some of it?

Dylan Giuliano 52:41
All of it. Because when I actually grow up, I'm actually going to be an endocrinologist

Scott Benner 52:48
for type one, so that's why I'm kind of getting the hang of doing my page and stuff. So you're trying to teach yourself how to talk to people with diabetes, so that one day you can become a doctor and help people with their diabetes. Yeah, that's pretty thoughtful. I didn't plan ahead like that in life. And that's like, I have a podcast, but no, sorry. But, but so that really occurred to you like I'm gonna like, I'm gonna learn how to talk to people better. Now, where did that come from? Do you not like the way you're spoken to about your diabetes? Or do you wish it was different?

Dylan Giuliano 53:27
i? I don't know.

Scott Benner 53:30
You don't? Do you have any feelings? Like when you're talking to the doctor that you're like, I wish this guy understood better? Or I like the way they're talking to me. Do you ever leave? Feeling like you wish your appointments would go differently for you? Or do you not really think about it that way?

Dylan Giuliano 53:45
My doctor is great, though.

Scott Benner 53:47
Yeah, really cool.

Unknown Speaker 53:49
Yeah, nice.

Scott Benner 53:50
They let you steal rubber gloves and blow them up like balloons. That's what that's what we do when we're waiting too long, or that I play. Like volleyball with a rubber glove, we blow it up. And then she sits up on the examining table. They sit in the chair and we just bounce it back and forth to each other. It's how we pass the time waiting for the doctor to come in. But it's very cool that you have a doctor that you really like. Yeah, yes, a lot of people don't get that. And so it's nice that you have it. So what's your favorite thing in school? Like what's the what's the thing that you do online that you've enjoyed the most? Like, what are you the best at is it math or?

Dylan Giuliano 54:28
i? I like science and math.

Scott Benner 54:32
Yeah. Yeah, not so much the writing and the history.

Dylan Giuliano 54:37
Not really.

Scott Benner 54:38
Not right. You don't want to know what the Bolsheviks are doing? Or we're doing hundreds and hundred. No, you're not worried about that. So much. I watched Arden's writing a history paper right now on the Cold War, and she doesn't seem thrilled. You have a couple of years before you're gonna get to something like that. But yeah, she doesn't seem to be thrilled at all. Um, have we ever met You and I,

Dylan Giuliano 55:01
I think yeah, I think we have I mean, summit. You were there, right? I feel like

Scott Benner 55:07
you weren't like it's the type one nation summit. No. Were you listening to the podcast back then when you met me? Or is that where you figured out to listen?

Dylan Giuliano 55:14
I kinda.

Scott Benner 55:16
That's about when you started listening. Yeah. Let's What do you like about the podcast?

Dylan Giuliano 55:22
I just like to hear people with type one. Tell about their feelings and stuff. Nice. Because I went to my agency went to 7.8 6.9.

Scott Benner 55:37
Wow, from listening to the podcast. Yeah. No kidding. You should probably send me some money in the mail or something. I'm kidding. I'm 100% joking about that. I although if one day, there's a diabetic, they'll pick a T shirt. Maybe I would like to get one of those. But we'll see if things blow up enough. You know, they mean, by the way, if you become an endo, Monday, how are we going to keep the pickle for it? Same going for that?

Dylan Giuliano 56:05
I don't know. I'll probably just keep it going and stuff like that.

Scott Benner 56:11
I have a question. And I'm being serious. What do you like pickles? Yes, you do that? Do you prefer a dill like a spear? Or a bread and butter? Kind of like a sandwich style pickle? Or what's your favorite pickle?

Dylan Giuliano 56:24
I kind of like dill. Yeah. Like, don't people

Scott Benner 56:28
eat him right out of the jar? Do you want them along the side of a sandwich or on a sandwich we're looking for?

Dylan Giuliano 56:34
I don't know. I'm kind of like both.

Scott Benner 56:37
You anyway, you'll do it? Yeah, there's no way that you wouldn't be like, Hey, have you ever passed on a pickle? Have you ever looked at and said, I don't like a bread and butter pickle? No, thank you. No, no, there's no, no one that you've ever seen that you haven't? Like? No, I'm going to share something with you now. I don't think I've ever had a pickle. What I mean, I'm sure I've been into one into a cheeseburger once or twice that I didn't realize was there. But I would recoil immediately and get rid of it. Wow. Yeah. I don't know. I'm not a pickle person. But I defend your right to love pickles. By the way. Very cool. don't I? If we not covered anything you were hoping we talked about? Like, are you sitting there right now going? How come? He hasn't asked me about this?

Unknown Speaker 57:26
Huh? No, no.

Scott Benner 57:28
Well, if people don't like this episode, and they send me an email and say I did a bad job. What would you say?

Unknown Speaker 57:38
You just blocked them, wouldn't you? You'd be like,

Unknown Speaker 57:41
yeah, call block.

Unknown Speaker 57:41
Do

Scott Benner 57:45
Yeah. So is it? How does it if you block I've never blocked somebody before. But if you did that, does it make you feel bad that they didn't get something out of it? Or do you feel like goodbye soccer? Like, which? How do you make you feel?

Dylan Giuliano 58:01
Like I kind of feel sad? Because like, they were kind of like rude. and stuff. I just had to block them.

Scott Benner 58:13
Do you think there'd be a way for somebody to say something to you? That wouldn't have been rude, where they could be like, hey, Dylan, you know, I really, I love what you're doing here. But one time you said this. And now you seem to be saying something different? And it's conflicting? And I don't understand or like, like, would you have a conversation with somebody if they were just confused?

Unknown Speaker 58:32
Yeah, yeah,

Scott Benner 58:34
I do that sometimes I send emails back sometimes I'm like, Look, I feel like you might be just don't understand what's going on here completely. And, you know, I can't really explain it to you. But if you can just accept that, you know, there was a reason that that happened. And that that kind of thing. It's a very weird thing to have a one way conversation with the person because they'll know the thing you might not realize that I'm starting to realize more and more from the podcast is that people listening to you or reading you feel like they know you a little bit. And then when you do something that they don't expect, it feels wrong to them. But what I would say is you're just doing you and that's why they were looking in the first place. So yeah,

Dylan Giuliano 59:19
I just feel like they aren't they they're rude. And I just tried to chalk talk to them.

Scott Benner 59:27
Yeah, good for you. And then if they don't listen, come block. Done. Yeah, smack them in the face with a pickle. Yeah. If you were going to if you were going to throw a pickle at somebody, what kind of pickle would be the best pickle to throw? I have my answer. I don't know. I think Paul. Good. Good. What do you got? Which one?

Dylan Giuliano 59:51
Probably does a Sally's like hot pickles. Oh,

Scott Benner 59:56
it's it's you'd fling you'd fling a spicy pickle at somebody. If you were gonna do Yeah, see now I was thinking immediately, you know, those little like girkin like the little tiny like solid, like maybe into too long and thankfully, I feel like I get your, like pointer finger behind it and really kind of like with a madam. You know, like boom. And then like because and they wouldn't hurt anybody but they hit they'd be like a little like, like a little thud like on their forehead. You know what I mean? Like, I think that would be fun.

Unknown Speaker 1:00:22
Yeah, yeah, yeah.

Scott Benner 1:00:25
Okay, throw in pickles is definitely bites it does sound like fun to me throw a pickle at somebody.

Unknown Speaker 1:00:34
It does,

Scott Benner 1:00:36
although the little sandwich style ones that are kind of cut in slices. Like now I'm like, you can kind of frisbee them. You know what I mean? Like, like, maybe because they're wet. They'd like sit and stick like now I'm imagining just like, sticking pickles to someone's like forehead. That's all I don't I hope I haven't let you down. I don't know. I know. You want to come on so badly. And I it's hard to know what to talk about sometimes. And I did. I did my best to to make this fun for you. Did you have fun?

Dylan Giuliano 1:01:05
Yes, I had a ton of fun. I just appreciate you putting me on this podcast. Thank you so much.

Scott Benner 1:01:11
It's my pleasure. What would you want? I guess if there's one thing about diabetes that you wish people knew what what would it be? How to handle it? You just wish they knew better? How to help themselves? Yeah. Do you struggle to help yourself? Sometimes? Yeah. Yeah. And and so any information coming in from the outside? is valuable? You think? Yeah, yeah. Cuz then you can take it and sort of like, mold it to yourself and and take some ideas that work for you and leave others behind that you don't like and and find a process that works for you.

Dylan Giuliano 1:01:49
Yeah, out awesome. And people would probably be much nicer and stuff.

Scott Benner 1:01:55
You think if they're okay, hold on a second. So you think that Do you believe that some people are struggling with their diabetes, and therefore maybe they lash out in different ways? Yeah, yeah. So you're looking for people to have a more harmonious life? All over?

Unknown Speaker 1:02:15
Yeah, yeah.

Unknown Speaker 1:02:16
Okay.

Scott Benner 1:02:18
I understand. Dylan. What do you do for your mom today?

Dylan Giuliano 1:02:25
Um, listen the eyes. Tell her I love you and give her a hug right out of

Scott Benner 1:02:31
nowhere. Oh, Dylan. Hold on. People are calling. Let me see what's going on here. This is like a bad call, like, you know, like, they try to sell you like solar panels or something like that. Yeah. So it's what I'm getting right now. I didn't mean to let that interrupt you. I'm so sorry. And do it out of nowhere. hours from now, like, hours from now. Just boom, get a make her day. She's gonna like she'll get in bed tonight. And she'll be like, she'll say to your dad, she'll go. You know, at some point today, Dylan just came up to me and said he loved me and gave me a hug. It was so nice. She's gonna be all like Wi Fi and everything and feeling really good about it. Right? And then, like, essential, listen to this later and should be like that little kid. He didn't mean that. But you would meet it if you said it, right.

Unknown Speaker 1:03:10
Yeah, so

Scott Benner 1:03:12
what am I telling you like everyone smile for anybody listening? Let's do it this way down. Whether you're 12 years old, I'm 48. Right? anywhere in between. If you have access to your parents, give them a call. Say hi to him. Tell him you love him, right? Mm hmm. There's people out there. They're breaking their butts for you. You know, these people? I mean, are you wearing pants right now though?

Dylan Giuliano 1:03:33
Um, yeah. Who

Scott Benner 1:03:35
paid for those pants?

Unknown Speaker 1:03:37
My mom and dad are out

Unknown Speaker 1:03:38
there hustling for you? Do they feed you? Yeah, every day. Yeah. How much food costs?

Scott Benner 1:03:45
super expensive. Unbelievable. They get you that medicine. They take you to the doctor. Um, you see what I'm doing for these kids over here? in grades? You know what I mean? Right. Like, just once in a while hug would be nice. Just to like, Hey, are you you know how many? How many pictures of yourself? You're a kid on the internet? How many pictures of yourself that you taken a week? 100?

Unknown Speaker 1:04:06
Maybe?

Scott Benner 1:04:06
Yeah, send one to your mom once in a while. Be like, yo, look who's here. Dylan who loves you? Right? Plus, you don't want to know like you don't want to like Carl the cucumber better than she likes you. Do you? Hey, if you call your brother Karl the cucumber? Is he gonna punch you or no?

Unknown Speaker 1:04:26
Probably.

Scott Benner 1:04:28
That'll just be between me and you. And the countless 10s of thousands of people who are listening to this. Okay. But don't let Don't let him know. Okay, Dylan, you're a good kid. Man. I really appreciate you doing this. Thank you so much.

Dylan Giuliano 1:04:41
You're welcome. Thank you for inviting me on to the Juicebox Podcast. I appreciate it. I really

Scott Benner 1:04:47
I that means a lot to me. I'll tell you what, do this before we leave. Take a breath, get yourself centered, and say Hi, this is diabetic. They'll pickle and you're listening to the Juicebox Podcast.

Unknown Speaker 1:05:00
Okay,

Dylan Giuliano 1:05:08
because this is doing diabetic to pickle and you're listening to the Juicebox Podcast.

Scott Benner 1:05:14
Very nice. Do it again real fast.

Dylan Giuliano 1:05:17
Hello, this is dialectal pickle and you're listening to the Juicebox Podcast

Scott Benner 1:05:21
doing I really appreciate that. A huge thank you to Dylan for coming on the show and being so honest about his fibromyalgia, type one diabetes, troubles, he's gone through online sharing with people, everything. I mean, guys, he was 12 when he recorded this, check him out on your favorite social media place. He's diabetic, dill, pickle, DUI L and then pickle is spelled like, you know, people spell pickle. All right, what else? Oh, a couple nice things you could do here. Check out touched by type one.org. And go to Contour Next one.com to find out if you're eligible for an absolutely free blood glucose meter, and not just a blood glucose meter, the bestest one that they have. And by they, I mean the world. It's the best one in the whole world. In my opinion. My opinion counts, so does yours. So go see what you think. I just want to say here at the end, that I very much appreciate that you're listening. And that many of you share the show with other people who you think will, you know, find it valuable or helpful or fun? I don't know what you think. But when you think it and you share, it makes me feel warm inside. So thank you very much. Expect at least one more show this week. Maybe two. Hey, those of you who are new to the show and think you're caught up, head back into the archives see what else you can find. There are over 350 episodes of the Juicebox Podcast. Some people who you're listening with have heard every one of them. Don't you want to be one of those people? I want you to be one of those people. Seriously, though, there are a lot of great episodes back there. I hit somebody sent me a message the other day and I'm like, I don't understand why you haven't talked about this. And I was like what what do you mean? And then I asked him how long have you been listening to the show? She's like three months. I talked about that three years ago you got to go look bingeing isn't just for Netflix.

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