Scott Benner 9/12/20 Scott Benner 9/12/20

#379 Defining Diabetes: Somogyi Effect

Scott and Jenny Smith define diabetes terms

Defining Diabetes: Somogyi Effect

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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
This episode of defining diabetes is sponsored by Dexcom Omni pod, the Contour Next One blood glucose meter touched by type one, and the T one D exchange.

Anyway, the three of them are oddly similar, but completely different. And every one of these ideas needs to be understood. I'm not going to be explaining them by myself. I'm gonna have Jenny Smith with me. I'll tell you a little bit more about Jenny in a second. But first, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. Please always consult a physician before making any changes to your health care plan, or becoming bold with insulin.

If the mood should strike you, and you'd like to find out more about the dexcom g six continuous glucose monitor, please go to dexcom.com Ford slash juice box. If you're looking for a free no obligation demo of the Omni pod tubeless insulin pump my Omni pod.com forward slash juice box. Want to add your voice to some terrific Type One Diabetes Research without ever leaving your home can do it right there from your phone in just a couple of minutes. T one d exchange.org. forward slash juice box. To check out the blood glucose meter that Arden uses the Contour Next One, you go to Contour Next one.com forward slash juice box. And of course touched by type one.org. To see Type One Diabetes advocacy done correctly. My friend Jenny Smith has that type one diabetes for over 30 years, Jennifer holds a bachelor's degree in human nutrition and biology from the University of Wisconsin. She is a registered and licensed dietitian, a certified diabetes educator and a certified trainer on most makes and models of insulin pumps and continuous glucose monitoring systems. She is also a frequent contributor to the Juicebox Podcast. And I find Jenny's input about type one diabetes and the management of insulin and things around type one to be completely invaluable. She is my favorite person. I want to do three defining diabetes ideas. Okay, and then see if we can do a Mini Pro tip about glycemic load index. Sure that makes sense. I pick that one. I pick all the sexy diabetes topics.

Jennifer Smith, CDE 3:18
Absolutely.

Scott Benner 3:19
You know what I realized that for the last number of years now, as the new year rolls over, I have this horrible pit in my stomach. And I think I'm never going to come up with stuff for Jenny to do. And I'm gonna run out of it. And now it's September already. And unlike we don't have enough time to record all the stuff that I'd like to record. I just I think back to the person who told me like, no, you're starting a diabetes podcast that won't last long, you'll run out of things to say and I think more now that that person just didn't realize all the things their work to say, you know,

Jennifer Smith, CDE 3:55
right. Well, and I think so many things engine with being with having your, like online kind of groups and whatnot, I think there are a lot of topics and things that end up coming up that you're like, Oh, good one to talk about for certain

Scott Benner 4:12
for certain of all the trepidation I had about starting a private Facebook group. watching all of those people speak to each other. Like sometimes like really lights me up. I'm like, Ooh, that's such a good thought right there or, or somebody has a half a thought, and they can't get to the rest of it. And you can see the rest of it. And you're like, Oh, I wouldn't have thought of the first part. But I understand how to finish this idea. Right. So anyway, it has been it's been incredibly valuable. At this point. I don't see why this podcast would have to end. And in the beginning, I thought like oh, it could probably only go for a certain amount of time. But I think that might have just been bad advice from somebody. All right. So three defining diabetes episodes today that I think of, I'm going to put them up separately, but I think they could probably all go together. I want to do Dawn phenomenon feet on floor and the one I can't pronounce somehow G. A fellow he's Mogi. Is that what it is? Yeah. All right. Let's start with the one I don't know anything about so you can get warmed up. What is the smoky effect?

Jennifer Smith, CDE 5:18
Do you want to actually spell it for people? Sure.

Scott Benner 5:22
I have it here is so mo gyi and then effect in the classic way, with an E, for all of you who always use an A when you mean a.

Jennifer Smith, CDE 5:35
What the interesting thing

is that this topic is kind of one that's sort of like it's like this 5050. I don't know that that's the exact like percentile breakdown of people who believe versus don't really believe that it's kind of the issue, but it's essentially relative to why you might have elevated blood sugars in the morning. Okay, what ends up happening after you have a low blood sugar is it's a rebound, high blood sugar that you end up with in response to having had the lower blood sugar value, some from what we call kind of counter regulatory hormones that are released in terms of a low blood sugar. Yeah, why sometimes it happens, versus not all the time, I think is probably the reason that people question whether it's a real thing. I guess that's the easiest way to because it

Scott Benner 6:38
doesn't consistently happen every time.

Jennifer Smith, CDE 6:41
Correct. Okay. Exactly. I mean, there is in relevance, it seems to be low blood sugars that are usually less than about 55. And that are more sustained in length that seemed to have this counter regulatory hormone output, and can then result in the higher blood sugar later. Now some of it also is we have a low blood sugar, especially with today's technology, you get an alert right from your CGM. And so then you may treat that low blood sugar. And because those counter regulatory hormones are not like, hey, right now, she or he needs this right now. Yeah, they could have lingering impacts, you end up treating this low blood sugar with what would normally work for you, right? 10 grams, it always works, it brings you up, you never go too high from it. But now with the counter regulatory hormones in the picture along with your normal 10 gram treatment, you end up at like 290. When you wake up in the morning, you're like,

Scott Benner 7:45
yeah, so Okay, so I have, I feel like I have some experience with this, not knowing that it was a thing or had a name, or at least a name that is hard to pronounce. And oddly spelled, but it is, but you know

Jennifer Smith, CDE 7:59
that it's actually named after a person gets up. It is it's named after it's the last name of things, the professor or the doctor who saw it happen, and thus named after him. All right, if I remember correctly,

Scott Benner 8:14
I'll try to figure out who he is. While I'm telling you that before Arden had a CGM. I've said this a ton of times on the podcast, right? I would get her blood sugar up to like 190 put her to bed. She'd wake up at 100. And I was like, look how good I am at this. Right. And then one day, we put a dexcom honor and I realized I was pushing her up to 190. In the early part of overnight, she was dropping to like 55 sitting there for an hour or two. And then she'd rise back up and level off at 90.

Jennifer Smith, CDE 8:50
And you never treated the low because you didn't really without a CGM. You didn't really know that it was happening.

Scott Benner 8:56
Never knew it. I took all that anecdotal data about her waking up at 90 and starting at 190. And I never considered she could have gone below 90 and come back up again. I always just thought she was drifting 100 points down overnight. Yeah, right.

Jennifer Smith, CDE 9:09
And that's she had to be hired to go to bed at night. Because otherwise, if she went to bed at 100, she'd be in the toilet by the time she woke up, even though it was happening sooner. Yeah. And then just naturally rising back up from the counter regulatory release.

Scott Benner 9:24
And I want to keep everyone focused on the idea that the reason Arden drifted down overnight was because I did not have any meaningful idea about how to use insulin like so. She She was just like, you know, because I've been helping this person recently. Who hears me, but can accept it. You know what I mean? They just think oh, no, the low happens at night. I'm like, No, you are messing up your meal bolus, then your overcorrecting afterwards and then she is experiencing a low blood sugar later and no matter how many times I say You know, what's happening now is not about now it's about before, you know, it's it's like this a fee for this person specifically. And I would imagine for a lot of people, it's this fear that's been built into them day after day, week after week, month after month, year after year of thinking like this is just random, and there's no reason for anything that's happening here. Because they can't see the causation. Right? They, they just they see the pencil go in the pocket and they think, Oh, it's the pencil. It's not the pencil. You're you're looking here. What's going on over here is what's happening. And when you talk about a hormonal release, is that from the liver? Mm hmm. Okay. And it's just glucagon, right? Or no, it is. Yes. Yeah. But you can't count on it.

Jennifer Smith, CDE 10:50
You can't count on. You can't count it always happening. From my base understanding of it. Yes. And secondly, you can't count on how much is don't.

Scott Benner 11:03
Plus, I would assume you can't count on an overpowering a certain amount of insulin active insulin, like maybe it could catch a drift where the insulin is almost gone. But if you were to put in a large bolus, it would take you right past that it would power right through any glucagon dump and just tank you. Right. Alright. Okay. Apparently it's Stephen. smudgy. And he's a jersey guy. Sup, Steven? Oh, is somebody who's gonna tell you that they heard this on here and come back and let you know about it. This is the guy it's I don't know. He's an internist. Apparently. All right. Well, no, no, wait. Now there's another smokey. There's a guy and he's an orthopedic. How many Smokies Could you be in the world? Yeah, what I

Jennifer Smith, CDE 11:47
found is it says it's a theater at theoretical phenomenon was named after Michael smudgy, a Hungarian born professor of biochemistry at Washington University and Jewish Hospital of St. Louis. I have it here. Who prepared the first insulin treatment given to a child with diabetes in the US in October of 1922. Smokey showed that excessive insulin makes diabetes unstable, and first published his findings in 1938. That's what I found. And

Scott Benner 12:15
he will not take offense to what I just said. Because he died the year I was born. So he has I don't care for quite a long time. Although you got to give this guy props. Born in 1883 he lived till 1971. Wow, that's amazing. 101 a math? What's math? Yeah, that's almost 100. What? 1883 17 years? 1771? Hold on seven, carry the one. It's eight. He was like, 88.

Jennifer Smith, CDE 12:50
Yeah, he was, wow.

Scott Benner 12:52
Go to public school. So

Jennifer Smith, CDE 12:54
I did not know cap Catholic school from first grade through 12th grade.

Scott Benner 12:59
We've just let down the Catholic and public school systems in one fell swoop. Really good. All right. So is there anything else to say about the smokey effect? It causes? It causes high blood sugar high blood sugar in the morning due to low blood sugars overnight because of a glucagon dump. That happens from a low if in fact, any of this is happening. Wow. All right, then. That's a rock solid. It's a rock solid description. It's a rock solid description of something that may or may not exist.

Jennifer Smith, CDE 13:33
Well, and I think the interesting thing about it too, in terms of like pushing it a little further is that it's really something that's considered or named after just that morning, high blood sugar and the potential reason for that morning, high blood sugar beyond another thing that we're going to define which we'll talk about high blood sugars in the morning, too. Yeah. But during the daytime, it's not like you don't have this counterregulatory potential impact either. So you could, again, have a low blood sugar during the day. And you could also have counterregulatory hormone impact in the aftermath. Again, treating it as you normally treat it, let's say 10 grams of carb is your staple treatment, it always works. And now all of a sudden, today for some reason, you're at, you know, a high 200. And you're thinking well, why, you know, so again, it could be the relative nature of the number or the low that you were at, and possibly how long the low was sustained, in terms of those counter regulatory hormones.

Scott Benner 14:45
If you'd like to hire Jenny to help you with your type one diabetes, check her out at integrated diabetes.com Thanks so much to the Omni pod tubeless insulin pump. If you'd like to get a free, no obligation demo of the Omni pod, do it now at my office. The pod.com forward slash juice box, learn more about the dexcom g six continuous glucose monitor, see those trends, see your direction, see your speed dexcom.com forward slash juice box, get the best blood glucose meter on the market, in my opinion, at Contour Next one.com forward slash juicebox. You want to see people doing good things. For other people with type one diabetes, you need to go to touched by type one.org. And of course, to get involved simply, in some type one research that helps everyone with Type One Diabetes. And to do that right there from your cell phone or from your sofa without ever leaving your house and just a few minutes, T one d exchange.org. forward slash juicebox. You go to those links, you are doing something good for yourself good for somebody else and supporting the podcast. All of those links are available right here in the show notes of your podcast player. And they're also at Juicebox podcast.com. Click the links support the show. You all should know by the way, when I say click the links support the show. The pentameter of that reminds me of save the cheerleader save the world. From heroes, you remember that TV show on NBC. Anyway, here's a little look into my head. There are countless other episodes of the finding diabetes available for you right now. And that's probably a lie because they are accountable. There's not so many of them that I can't count them. But I'm not going to count them a couple of ways to get them. Go into your podcast, app search defining diabetes, they'll all pop up. Go into the stream in your podcast app all episodes, scroll down, you'll see them you can go to Juicebox Podcast comm and scroll down a little bit. Right, and you'll see all kinds of stuff. Let me tell you some of the stuff you'll see on the main page all the after dark episodes. Right now we have after dark divorced, and co parenting after dark sex with type one from a male perspective sex with type one from a female perspective, depression and self harm, trauma and addiction, weed smoking, drinking with Type One Diabetes, there's also all kinds of episodes that are focused on algorithm pumping. And then you know what you get actually click books you look up. Oh, hold on. Excuse me. Also, I have all the pro tip episodes right there on the front page, and recent episodes. Now if you go to, then you click on a link up top right, it says Juicebox Podcast, you click on that. Now all of a sudden, you're looking at the defining diabetes episodes. There's fat and protein rise compression low and interstitial fluid rage, bolus bumping nudge feeding insulin, these little diabetes terms that maybe you're just like, I don't know what they mean when they say insulin resistance. But I have an episode Virginie I explained that to you. ketones stop the arrows brittle diabetes low before high Pre-Bolus trust what you know will happen will happen glycemic index and glycemic load as a defining diabetes. But you know what we have coming up a pro tip about it. There's non compliance and algorithm and on and on and on and on. If there's a diabetes term that's been set out loud, Jenny and I have defined it on defining diabetes. Two new ones that are out right now around this, like I mentioned the beginning, I think go together with this one. The other two are feet on the floor. And this Moji effect, there's some Mogi effect. I don't know how to say that word, but you'll see it it'll be the only word that sounds like some Oh gee, when you read it, looking for a great doctor or other type of diabetes practitioner, check out check out Whoo, there goes my voice. Check out juicebox Doc's calm and ever growing list of podcast listeners favorite practitioners? absolutely free go in there, find one or send me one to add. Diabetes pro tip episodes can actually be found in all the places I just described in your podcast that ended diabetes pro tip.com. If you're enjoying the podcast, please consider sharing it with someone else.

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Scott Benner 9/12/20 Scott Benner 9/12/20

#378 Defining Diabetes: Dawn Phenomenon

Scott and Jenny Smith define diabetes terms

Defining Diabetes: Dawn Phenomenon

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Scott Benner 0:00
This episode of defining diabetes is sponsored by Dexcom Omni pod, the Contour Next One blood glucose meter touched by type one, and the T one D exchange.

I almost made this one larger episode with three topics in it. And then I decided if I didn't break them apart, future listeners wouldn't be able to find them. So this is a defining diabetes episode about the dawn phenomenon. But there are two others that go with it. The other one's called defining diabetes, feet on the floor. And the third one defining diabetes smokey effect. I know I'm not saying that right. So muchi, some moochie, you'll find it. Anyway, the three of them are oddly similar, but completely different. And every one of these ideas needs to be understood. I'm not going to be explaining them by myself. I'm going to have Jenny Smith with me. I'll tell you a little bit more about Jenny in a second. But first, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. Please always consult a physician before making any changes to your health care plan, or becoming bold with insulin.

If the mood should strike you, and you'd like to find out more about the dexcom g six continuous glucose monitor, please go to dexcom.com Ford slash juice box. If you're looking for a free no obligation demo of the Omni pod tubeless insulin pump my Omni pod.com forward slash juice box. Want to add your voice to some terrific Type One Diabetes Research without ever leaving your home can do it right there from your phone in just a couple of minutes. T one d exchange.org. forward slash juice box. To check out the blood glucose meter that Arden uses the Contour Next One, you go to Contour Next one.com forward slash juice box. And of course touched by type one.org. To see Type One Diabetes advocacy done correctly. My friend Jenny Smith has that type one diabetes for over 30 years, Jennifer holds a bachelor's degree in human nutrition and biology from the University of Wisconsin. She is a registered and licensed dietitian, a certified diabetes educator and a certified trainer on most makes and models of insulin pumps and continuous glucose monitoring systems. She is also a frequent contributor to the Juicebox Podcast. And I find Jenny's input about type one diabetes and the management of insulin and things around type one to be completely invaluable. She is my favorite person. This is the one that everyone gets told about right? At some point overnight, I don't know around 3am or maybe all the way up to eight o'clock, your body's just gonna make your blood sugar higher. Maybe

Jennifer Smith, CDE 3:17
I would see in a good. I mean, if I had to give a percent to it, I would say a good 95% of people. Once they know to watch or something and or you know, let's say they've been listening to a lot of like the pro tips episodes. And they're like trying to do bezel evaluation and whatnot. And they're like, Huh, look at that. This is what's actually going on. And I keep fighting it with this and this and this. And it's actually not that problem. It's relative to the basal insulin, right. So the dawn phenomenon is another reason for having a high blood sugar when you wake up in the morning. But it's specific in that these are hormones that are supposed to be being released in this time period of sort of the sleep wake cycle. Yeah. And they're there whether you have diabetes or not. Right, right. It's just that the person with diabetes, obviously with glucose monitor, and we can see what's happening, and it's not controlled. So we have to cover with more insulin in order to offset these hormones, growth factor hormones, cortisol, all these things that are sort of ramping up around to three o'clock in the morning, usually through about eight o'clock in the morning, they're ramping up, and that ramp up in hormone will start to drive blood sugar up if you don't counter it with extra insulin. Most people counter it with extra basal insulin at a certain time period. Their basal rate may go up a notch to impact the coming increase in insulin need.

Scott Benner 4:53
And people on MDI see it more drastically when they inject their Basal insulin in the morning because in those last six and eight hours of a 24 hour basal insulin, sometimes you see a decrease it, especially with the older ones, right level Marin lantis. Correct. And, and so it might look even worse, I have a question that you may or may not know the answer to. What if I'm a shift worker? And I'm awake from three to eight? Do I still see it?

Jennifer Smith, CDE 5:24
No. Again, it's more specific to your typical sleep cycle. Okay, it's attached to sleep not time, right? So if you're a shift worker, and your shift remains pretty stable, right? Let's say that you sleep from noon until 8pm. Every day, your smokey effect might actually be from 3pm until 8pm, then or four 4pm until 8pm. It would be within a sleep cycle, just because it's not technically three o'clock in the morning.

Scott Benner 5:56
You just had smokey, do you mean dawn?

Jennifer Smith, CDE 5:58
What? Oh, Dawn? Yes. Hey, sorry. Yeah, so the dawn really is going to impact you in those waking hours, or those pre waking two waking hours, regardless of when your sleep cycle is. So

Scott Benner 6:12
this 3am to 8am, you know, quote, unquote, norm that people see is probably such a large swath of time, because people go to bed at different times. And so it's maybe more about how long you've been asleep, and how long it is until you wake up, like somewhere in that space. Like, you know, if I went to bed at 10pm, every night, and I saw this increase at 3am, then you're saying that if I was on shift work and went to bed at 10am, every day, I might see the same thing at 3pm.

Jennifer Smith, CDE 6:46
Right, that makes sense. Exactly. Okay.

Scott Benner 6:50
Yep. So that's attached to your sleep, not the time of day. And it would smokey be the same thing, then? Is it? Let me think, hold on, I'm actually have to think this through.

Jennifer Smith, CDE 7:04
That would be a really interesting, I guess it would be the same thing. If you think about high blood sugars in the morning, and you've got your bazel dialed in, you know that it's controlling the dawn phenomenon. And now today, let's say you look at your CGM. And you see that you have a, you had a low blood sugar, you didn't realize you didn't treat it overnight. And now you wake up with this high blood sugar in the morning. That would be more the smoky, regardless, again, of whether or not you're sleeping from 10pm until 8am, or you're sleeping from noon until 8pm.

Scott Benner 7:37
Okay, I have to I have to figure something out in the world and name it after myself. I love that this guy's been dead for 50 years, and we're saying his name. And that is such a fun name. Yeah, yeah. And some doctor in New Jersey got some juice off in the other episode because I googled wrong.

Jennifer Smith, CDE 7:55
Exactly. That's, that's kind of fun. I know, my name wouldn't be very fun to name something after Smith.

Scott Benner 8:00
So so if you're on a pump, and you have dawn phenomenon, you're gonna need an increase in basal insulin, prior to when you see the rise through the rise.

Jennifer Smith, CDE 8:12
Correct. Now, there's an interesting, and you might have thought to maybe bring it up. But here's an interesting thing that some people even see, they might see a small incremental increase. So let's say they adjust their bazel slightly, it's not too much, let's say point 05. It's tiny, incremental change. But then, when they've done their bazel testing, that seems to work. But now that they're noticing more, they see, when they finally do get up, there's this more considerable rise in blood sugar, which a lot of people sort of, and we refer to as like the foot on the floor syndrome. Technically, like a syndrome or like anything, it's, it's just, it's literally you get out of bed and 30 minutes later, your blood sugar could be going from 82, all the way up to 150. And you're like, what the heck yeah, did my bazel testing What's going on here? And I think, in that regard, it's actually easier to pay attention over the course of a couple of days. And see, what is your average Rise of the foot on the floor like impact that you're getting, let's say over the course of three days, you look at this and you're like, yep, my blood sugar went up. 40 points, it went up. 60 points, it went up. 50 points. Great. You're getting an average of 50 point rise in your blood sugar. You know, soon after you wake up in the morning. It's rather than fiddling with your bazel it's actually easier to just Bolus

Scott Benner 9:45
that's what I tell people to do.

Jennifer Smith, CDE 9:47
That's for the rise you're expecting.

Scott Benner 9:49
Yeah, that's what I do for Arden and that's what I that's how I talk to other people about it. Dawn phenomenon, totally tackable with basal insulin, you know on a pump Obviously easier, but making sure that you don't have a deficit of bazel. If you're MDI, in that timeframe, doing that by, you know, moving around on the clock when you inject your bazel. The other one, I guess we're going to do well, okay, so I hope everyone enjoyed that there's going to be another one about feet on the floor, so go listen to that one, too. If you'd like to hire Jenny to help you with your type one diabetes, check her out at integrated diabetes.com. Thanks so much to the Omnipod tubeless insulin pump. If you'd like to get a free, no obligation demo of the Omni pod, do it now at my Omni pod.com Ford slash juice box, learn more about the Dexcom g six continuous glucose monitor, see those trends, see your direction, see your speed dexcom.com forward slash juice box, get the best blood glucose meter on the market, in my opinion, at Contour Next one.com forward slash juicebox. You want to see people doing good things. For other people with type one diabetes, you need to go to touched by type one.org. And of course, to get involved simply in some type one research that helps everyone with Type One Diabetes. And to do that right there from your cell phone or from your sofa without ever leaving your house and just a few minutes, T one d exchange.org forward slash juicebox. You go to those links, you are doing something good for yourself good for somebody else and supporting the podcast. All of those links are available right here in the show notes of your podcast player. And they're also at Juicebox podcast.com. Click the links support the show. You all should know by the way, when I say click the links support the show, the pentameter of that reminds me of save the cheerleader save the world, from heroes to remember that TV show on NBC. Anyway, here's a little look into my head. There are countless other episodes of the finding diabetes available for you right now. And that's probably a lie because they are accountable. There's not so many of them that I can't count them. But I'm not going to count them a couple of ways to get them. Go into your podcast, app search defining diabetes, they'll all pop up. Go into the stream in your podcast app, all episodes, scroll down, you'll see them you can go to Juicebox podcast.com. and scroll down a little bit. Right. And you'll see all kinds of stuff. Let me tell you some of the stuff you'll see on the main page all the after dark episodes. Right now we have after dark divorced, and co parenting after dark sex with type one from a male perspective sex with type one from a female perspective, depression and self harm, trauma and addiction, weed smoking, drinking with Type One Diabetes, there's also all kinds of episodes that are focused on algorithm pumping. And then you know what you get actually click books to look up. Hold on. So Excuse me. Also, I have all the pro tip episodes right there on the front page, and recent episodes. Now if you go to, then you click on a link up top right it says Juicebox Podcast, you click on that. Now all of a sudden, you're looking at the defining diabetes episodes. There's fat and protein rise compression low and interstitial fluid rage, bolus bumping nudge feeding insulin, these little diabetes terms that maybe you're just like, I don't know what they mean when they say insulin resistance. But I have an episode Virginie I explained that to you. ketones stop the arrows brittle diabetes low before high Pre-Bolus trust what you know will happen will happen glycemic index and glycemic load as a defining diabetes. But you know what we have coming up a pro tip about it. There's non compliance and algorithm and on and on and on. If there's a diabetes term that's been set out loud, Jenny and I have defined it on defining diabetes to new ones that are out right now around this, like I mentioned the beginning. I think go together with this one. The other two are feet on the floor. And this Moji effect, the sum Mogi effect. I don't know how to say that word, but you'll see it it'll be the only word that sounds like some Oh gee, when you read it. Looking for a great doctor or other type of diabetes practitioner. Check out check out whoo there goes my voice. Check out juicebox Doc's calm and ever growing list of podcast listeners favorite practitioners? absolutely free go in there, find one or send me one to add.

Diabetes pro tip episodes can actually be found in all the places I just described in your podcast that ended diabetes pro tip.com. If you're enjoying the podcast, please consider sharing it with someone else.

Please support the sponsors

Donate

Scott Benner 9/9/20 Scott Benner 9/9/20

#377 Chainsaw Antelope

Justin has had type 1 for most of his life

40 year old Justin was diagnosed with type 1 diabetes at 6 months old. He's here to talk about his life, retinopathy, neuropathy and his new path.

Dexcom 20 Rule

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:02
Hello friends, welcome to Episode 377 of the Juicebox Podcast. On today's show, we're gonna be speaking with Justin, he's 40 years old, and he's had Type One Diabetes for 40 years. Justin's here to talk about his life, but type one that includes some retinopathy and neuropathy. His message is uplifting, and his path is much improved. Please remember, while you're listening 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. are becoming bold with insulin. Hey, do you have a great endocrinologist for Are you looking for one check out juice box docs.com. My website where listeners to the podcast share their great practitioners and it's also the same website where they sent me they're great practitioners. So if you have one, check it out and send it over. If you're looking for one the list grows every day so we might just have something for you juicebox Doc's calm of course is a free service to the podcast as is diabetes pro tip calm. Are you looking for all of the diabetes pro tip episodes in one place? diabetes pro tip.com. They're also here in your podcast app, and they started Episode 210.

This episode of The Juicebox Podcast is sponsored by the Contour Next One blood glucose meter meter murderer murderer. This episode of The Juicebox Podcast is sponsored by the Contour Next One blood glucose meter. Please go to Contour Next one.com Ford slash juice box to learn more about the Contour Next One. The show is also brought to you by touched by type one.org. Head over to touched by type one.org. There are a great diabetes organization doing wonderful things. They have a ton of programs. One of them might be right for you touched by type one.org.

Justin 2:05
My name is Justin lemon. I am 40 years diabetic type one currently on the Omni pod and the Dexcom system. My hometown is right in the middle of Wyoming a little town called lander has about 1000 people in it. I'm currently down in the capital, Cheyenne, Wyoming. So

do work down here and

Scott Benner 2:37
that's me. How old are you, Justin? Oh, I'm 40 years old. You said you were diagnosed four years ago?

Justin 2:44
No, I've been I've been type one diabetic since I was six months old. Oh my gosh. You said 40 years ago? Yes. Yes.

Scott Benner 2:52
My gosh. All right. So you've had diabetes? Pretty much your entire life. My whole life? Yes. And you live Have you lived in Wyoming that entire time.

Justin 3:02
I moved from I was born in Phoenix, Arizona. I was diagnosed down there. And then my mom moved us back home to lander and I've been there ever since. Yes.

Scott Benner 3:14
Do you have any idea how old you were when you move back?

Justin 3:16
I was five years old. So I've been here. 35 years.

Scott Benner 3:19
This is perfect. Justin, I am thrilled to speak with you.

Justin 3:22
Well, it's great to speak with you to Ivor I've listened to almost every one of your podcasts. So this is an honor. No,

Scott Benner 3:29
please the honors mine. Thank you. I really appreciate you doing this especially because you're gonna come from, you know, a bit of a different perspective than a lot of people have in a lot of ways, you know. Right. I guess my first question for you is when were you first aware that you had diabetes? What's your earliest remembrance of it?

Justin 3:49
I knew I was diabetic. I mean, about the time I was five. I used to run away from my mom as she'd come and try to give me my shots for the day. So I was really horrified of needles back then. So that's that's a memory that sticks in my head.

Scott Benner 4:07
It's a she's she'd been doing it for a long time. But once you got mobile and a little more aware of what was happening, you tried to escape.

Justin 4:14
Yeah, once I could once I could once I was mobile, I could run

Scott Benner 4:21
that. I'm assuming you said your daily shot to where you were probably getting something in the daytime and maybe at mealtime.

Justin 4:29
Yes, I was at that point. I was getting two shots a day morning and evening. I was on Helio in our in human

Unknown Speaker 4:39
and in our um, at the time,

Justin 4:41
so fast acting and slower. Yeah.

Scott Benner 4:45
You ever speak to your mom about what it was like the ratio with the diabetes?

Justin 4:50
Um, yeah, the early part of my life was a struggle. When I was diagnosed, my glucose levels were about 100 and something so A lot of headaches, a lot of screaming and crying as a kid. She couldn't take me out to eat dinner that out in public like, because all I do is scream and holler and cry a lot. So it was a difficult time for her for sure.

Scott Benner 5:17
Do you think that your blood sugar's were like crazy out of whack?

Justin 5:23
I think so with the technology back then, you know, the shots and maybe checking glucose four or five times a day, I really didn't have her she didn't have control over it, but it was just, you know, technology at that point hadn't caught up

Scott Benner 5:40
was what it was. Do you have? Um, have you ever gone back and looked at looked at old medical records?

Justin 5:47
Um, I have not actually, that would be a good thing to do. It's interesting. Like,

Scott Benner 5:51
I just wondered, like, what was? What was the goal back then? And does your mom feel like she was meeting a goal? or was she just doing what she could do? like trying to, like, hold water back with her hands? kind of a thing?

Justin 6:02
Yeah, I think she was just trying to maintain because I mean, she was a single mother with two boys. She had to deal with both of us. I think she did what she could to. Yeah, try to make life as normal as possible for me.

Scott Benner 6:20
I'm sure she did. It's just it's fascinating to have this perspective now, like 2020. Looking back 40 years? Oh, yeah, you know, and being able to talk to somebody who's also young enough to be able to articulate it old enough to have had the experience. It's just, it's really interesting. How involved was your mother throughout the process? Like, she was an age where you were just on your own.

Justin 6:47
Uh, let's see, I started about eight or nine years old, I started giving my own shots. So I dropped my insulin, and I'd have her look at my insulin to make sure or look at my needle to make sure everything was correct. And then I just gave my own shots at that point.

Scott Benner 7:05
Okay. And did you do it pretty faithfully? Or were there times that you kind of abandoned it? Or do you remember?

Justin 7:14
No, at that point, you know, being diabetic my whole life, I really didn't see it as a different lifestyle. It's the only thing I grew up with. So the only thing I really knew, so I just knew it had to be done and just kind of took over at that point,

Scott Benner 7:29
no rebellion against it at all, at any point.

Justin 7:33
No, and I'm still not that way. Even today, you know, how you can get like, diabetes, burnout and stuff like that. It's just, it's really not there for me. I just try to find ways to solve the problem instead of let it get to me. So

Scott Benner 7:50
I'm, I'm I'm looking at residential property in Cheyenne, Wyoming right now. And it's more expensive than I thought it was going to be. I was very snobby, I guess when I looked.

Justin 8:03
Right. It's it's very expensive. We have a military base around here. And everybody knows what the military housing stipend is. So that

increases prices around here.

Scott Benner 8:17
Okay. Oh, they can price the houses to how much money they know you have.

Unknown Speaker 8:21
Oh, yeah,

Scott Benner 8:21
yes. Interesting. Yeah, I'm sure everybody tries that, but that's really interesting. Anyway, I'm currently we're like,

Unknown Speaker 8:28
oops, sorry. No, no place.

Justin 8:30
We're currently like, an hour and a half out of Denver. So, I mean, we're right next to the city for the most part.

Scott Benner 8:38
Gotcha. Oh, so you're getting rural without being too far from the city. I am looking at a $500,000 house. That's only one level. And that is kind of small. Actually. That's interesting. All right. I'll stop doing that now. When I have a lot of questions, I guess how was dating in high school?

Justin 9:01
Um, well, I mean, even even past high school datings It's a challenge at times. A lot of educating my girlfriends or they they didn't understand some of the issues that I was going through like when my glucose would go low or if they were high and I'd have a change in personality so as we get more angry or stuff like that, I think the A lot of my girlfriend's just couldn't wrap their head around it.

Scott Benner 9:36
It's got to be difficult. I mean, honestly, I did you spend time educating them about it or did that sort of not exist that ability?

Justin 9:44
Oh, yeah, that's something my mom and put into my head my whole life like let everybody know you're diabetic, everybody you work with as you're diabetic. That way if something does go wrong, at least they know that I am diabetic and into Go down those avenues first instead of fine.

Scott Benner 10:04
and wondering why? Why is Justin not standing up anymore? At least he has. So your mom's playing basically was at least to a 911 comes, there'll be 50 people yelling, he has diabetes.

Justin 10:15
That's right. Yeah. Gotcha.

Scott Benner 10:17
probably pretty good.

Unknown Speaker 10:20
So

Scott Benner 10:22
is it? Did you find somebody eventually? Who jived with you having diabetes? I guess I'm asking if you're married, or you haven't?

Justin 10:32
No, no, currently single. And that's, it's kind of in the later part of my life. Now, it's, it's a little bit scary to be alone, you know, with diabetes, because I'd like to have that backing of knowing that someone was there if something was to happen, but I'm pretty self sufficient. So I try to do things to where I'm always around a group of people or I'm with people that know what's going on to where, if something were to happen, then they could help out.

Scott Benner 11:04
So now being honest, Justin, would you say that diabetes has interfered with romantic relationships? Or do you think that your situation would be similar without it?

Justin 11:15
Well, it's Yeah, it's a good question. Because some of the stuff I wanted to talk about today, like diabetic neuropathy and stuff, Yes, it does. cause some issues in relationships today. But I think with with open dialogue and stuff with with my partners, then we can work around anything, you know. Okay, so

Scott Benner 11:39
yeah, that's the goal, right? Um, when did you begin to pump?

Unknown Speaker 11:45
Yes, yes.

Justin 11:48
So I got on my first insulin pump in 1998. And I've been on one ever since I went for tube pumps at first. And the Dexcom system wasn't out at that point. So or at least wasn't available to me at that point. So I don't know the early years on the pump. I really don't count just because the decks calm has really brought it full circle for me to be able to track everything. Yeah.

Scott Benner 12:18
So that time probably wasn't much better than injecting I'm assuming you were doing MDI at some point, right? You got off the nnr. And you were using the the newer insulins?

Justin 12:31
Yep. At that point, I searched in 98. I switched to human log, and then novolog, depending on my insurance, of course, but

Scott Benner 12:42
you did that first insulin for 19 years, then? Yes. Wow.

Unknown Speaker 12:46
Yes. All right.

Scott Benner 12:48
And how did you did it feel like starting over? When you change, just the insulin change? I'm wondering about

Justin 12:56
the insulin change. It took a minute to shift over to have my body get used to it. Yeah, I was, I can't tell you that the timeframe in there. I don't really remember. But the hardest part for me was the counting carbs. So when you when you go out to eat or whatever, when I was in college, and I went out to eat and you just kind of didn't know by looking at it, what kind of insulin you needed or, or that kind of stuff. So that was that was a bit of a challenge. But dialing that in? That was my saving grace for the most part.

Scott Benner 13:38
Yeah. Did you have? I guess, did you start off aggressively or more cautiously when you switch to the rapid acting's did like, I'm wondering if you had a bunch of lows, or if you took your time learning about it.

Justin 13:51
I did have a bunch of lows, but it wasn't because I was aggressive. It was just because of the switch and insulin. So I mean, I would hit 80. And, and then it go from 80 to like 46 in a matter of 15 minutes, you know, so I was just it was a real hard transition. And it pretty much wiped my body out for a minute. But after I got used to it. That's right. After I got used to it, it was

a blessing in disguise, I guess you'd say?

Scott Benner 14:25
Would you say that you weren't thrilled about it at first or you were excited for it?

Justin 14:30
I was excited to go on a pump. I was giving so many shots that it was deteriorating my muscle. So like the back of my arms look like craters on the moon because my muscle was deteriorating, and it just looked awful.

Scott Benner 14:46
Is that cleared up?

Yes, definitely. It's exciting. Good for you. All right. So you're putting insulin in and you don't really know what you're doing still, like you're testing with meters, which is you know, what you Had. Right? And you're in a college age at that point, is that right? Yes. Okay, so how long did that? How long was that your life?

Justin 15:13
Um, let's see, I got I got on the Dexcom for about four years ago now. So I'd spent from my 98 till 2016 without adex calm. And at that point I and I realized that I needed to check my glucose more, so I was giving probably 1415 finger sticks a day to test my glucose levels. And once I found the dex calm, I was like, Oh, no more finger pricks. All right, this is great.

Scott Benner 15:48
And even with those that many sticks, you were still having issues. So what was your What was your agency as an adult? during that time? Ah,

Justin 15:59
that's a good question I was sitting in the mid to upper six is 6.5 to 6.8,

Scott Benner 16:08
which is really very good. And were you experiencing a lot of lows along with that, or?

Justin 16:13
I do. And that's I had listened to in one of your podcasts, you know, you're a one C is the average of the, you know, three months or whatever. And it was hard, because I, I'd have a lot of highs, and I'd have a lot of lows, but it was averaging out and making my look good. And that wasn't really what I was looking for. I wanted the happy medium,

Scott Benner 16:37
but you need the stability for certain. But I'm just I'm interested in hearing the story about you coming to that conclusion. I'm wondering how your Well, I guess I don't know how frequently you see an endocrinologist?

Justin 16:49
Oh, you're a great question. I've got my first endocrinologist now. appointment in April, and I haven't had one for 20 years, my mom had taken me to the Barbara Davis center in Denver when I was a teenager. But after that, I really just learned everything I could off the internet.

Scott Benner 17:11
Where did you get your prescriptions from?

Justin 17:14
Just our local doctor in town.

Scott Benner 17:16
And he was completely comfortable doing that? Yes, yes. Thing is what I'm getting at.

Justin 17:22
Right. And they they don't know. I mean, at this point, I know more about diabetes, and most of them dead. So they're just kind of go off what I would say talk to them about, like, I'm getting highs and lows and not being able to figure it out. None of the none of my doctors could answer any of those questions. That's why I turned to the internet. Mainly, it's because I wanted answers to the questions. I couldn't find answers for

Scott Benner 17:50
this. Partly so I'm a little stuck, like it's my inclination to say Is this because of where you live, but you're also close to Denver. So you're not completely rural, but are there just not a ton of endocrinologist clamoring to be endocrinologist in Wyoming or?

Justin 18:04
Well, the orange, there are in Cheyenne down here, and I've been down here about a year now. But in lander, it was when I was growing up, there's 6000 people in my town. And now there's only about 8000 people, and there's no endocrinologist there at all, I have to drive two and a half hours to see an endocrinologist. So

it just didn't happen.

Scott Benner 18:28
That makes a lot of sense. I'm just trying to, you know, it's funny, because some people listen, you know, I see the map where people listen, and people listen in every state in the country and all over the world, actually. But it's it's more ever, it's more concentrated on the coasts a little bit. And I know there's more people there. But there's still it's this proportion that that there's more in some places, and I'm always talking behind the scenes with people about, you know, we have to go to places where they don't have care like this to talk to them. So, you know, it was funny when I'm, like, I'm trying to get something together in Iowa right now. And I was just in Oklahoma recently. And it's funny, because these more these smaller places that think of themselves as I don't know, I guess I can't put myself in their shoes, but a lot of them start the conversations with, like, I'm really, we're grateful you're considering coming here. And the first couple times it was said to me, it threw me off. And I was like, Why? Why are you grateful? Like, what does that mean? You know, like, what's, and then I realized that, you know, even like speakers or stuff, like they don't get people coming there. And, and I and I just said to my wife, I'm like, I think that what the podcast has taught me is that this information in people's hands is valuable. And the sooner they have it, the better. But some of them are disconnected from I mean, listen, it's hard to find people who understand podcasts, though. There's a lot of them but right you know, to find a person who says, Oh, I know what to do. I'll get a podcast app and I'll do this tonight. It's, it's not that well understood. Still, it's growing, but not that well understood. My idea is to go to places like Iowa or Wyoming or those kinds of places have a conversation with a few hundred people and light a fire. So that maybe then they start talking to each other or speaking back to their doctors. And that the idea that you don't have to be at the, at the will, of your, you know, your blood sugar is, you know, is real. My daughter sending me a text that I don't understand, oh,

Justin 20:35
this is gonna be our glucose, all right?

Scott Benner 20:37
No, no, no. She says, Are you here? And I said, Why? And I have a horrible feeling. She's about to tell me she has a half day and I didn't know it.

Justin, I probably shouldn't be in charge of humans. Oh, when it was over? Oh, get a ride. Let's see what happens.

Justin 21:01
Tell her to get her an Uber.

Scott Benner 21:04
It's, it's not a far walk. It's just a little too far away. Right?

Justin 21:10
Do you need to hang up? We can we can get back at it. And are you after you grab your daughter?

Scott Benner 21:15
Do you have like, if this went over 10 minutes from what we were thinking about? Would that be okay?

Justin 21:21
Oh, yeah, no, you're fine. Hold on a

Scott Benner 21:23
second. Let me see if she can get a ride first. And then we'll do this people are like, I can't believe I listened to this guy about insulin. He can't he doesn't even Doris,

Justin 21:31
I love it. This has been I mean, your podcast has been my golden nuggets for me. I mean, it's changed my life, because it's finally someone that talks about insulin pumps and, you know, a day in the life of someone on an insulin pump. So it's been really helpful for me.

Scott Benner 21:51
And so is that the first thing that it helped you with is just like an idea of community, people speaking about the things you want to talk about that you just can't find in your personal life.

Justin 22:03
That's exactly and you know, because I was still seeing when the earlier is on, or that when I had the Dexcom family and I was on the Omni pod. You guys talking about you talking about what you did to help your daughter out and put like stuff like Pre-Bolus in before you eat and letting your glucose go down before you actually starting to eat like I would have never known had I not listened to your podcast. I mean, there's only so much you can really find on the internet. So.

Scott Benner 22:35
So just let me ask you something, because you had it happen to you for so very long. When you watch the same thing happen over and over again every day. And it didn't occur to you to just try something different. Like I'm not it's not a admonishment of you, I'm trying to figure out like, do you just feel like I'm doing what I'm supposed to do. And what's happening is what's supposed to happen.

Justin 22:55
I really wasn't happy with the outcomes I was seeing. So I wanted to do something to change that outcome. And I didn't want to do the same repetitive, like, let's just continue doing the same thing. And then hearing you say be bold with insulin that was just okay, well, let's try it. You know, like, I'll keep extra food on hand just in case I go low. But let's, let's see what I can do here. And let's actually test the parameters of the insulin and and see what I can see what the insulin does and how it works. And what I need to do to adjust that to fit my lifestyle. That makes

Scott Benner 23:33
me happy, Justin, I appreciate that, that struck you that way and that you gave it a chance that's a big, did it feel like a big leap to just use a bunch more insulin?

Justin 23:44
It did because I was at that point. I was like, Okay, so that's one unit of insulin for every 15 grams of carbs. And so I was following the protocol and things weren't working out. So I was like, Well, let me try this or let me adjust basal rates a little bit or when we increase my basal rate for that the next hour or two hours or decrease it so just trying to tailor it to my body because you know, when you go high or go low, you just don't feel right. So I was sick and tired of not feeling good. Yeah.

Scott Benner 24:22
I'm interested about how your doctors reacted when you or was there not? Did they not notice because I guess you're a one sees not bad, but your variability is probably much better now.

Justin 24:32
Yes, it is definitely better, um, with the doctors that I have in town. They really weren't that in depth on diabetes. So I didn't I really couldn't talk to them about that. So

Scott Benner 24:48
you really haven't had the ability to like celebrate this with anybody then right?

Justin 24:53
No, no, this is like, this is great for me. pat on the back like you did a good job. Let's continue to move forward.

Scott Benner 25:00
Austin's diabetes coming out party we're having today. Yeah. Oh, that's really boy. I'll tell you what, that's super interesting, isn't it? Because people who live in more metropolitan areas are surrounded by doctors, your people all the time, say I didn't like my endo. So I went and found another one, which I think is great, except there's actually another one for them to go find. And, but but many people in the country and around the world, they don't have that same opportunity to just pile up to go doctor shopping, I guess.

Justin 25:26
Right? I mean, and for me, I mean, like I said, it's been 20 years since I've had an endo and I'm, I'm excited. I don't even know what to expect. Like, when I go in, I really don't know what to what to expect from an endo anymore. So

Scott Benner 25:43
what is your data tell you a one says,

Justin 25:46
As of right now, I'm sitting at a 6.1. And that's from IPS. From the charts that I've seen, but off of my clarity,

Scott Benner 25:58
Yeah, I'm fine. I'm assuming the endo is just gonna look at you and treat you like you're a great guy and give you your prescription send you on your way, he's probably not gonna feel like he is a he or she's gonna have a thing in the world to tell you.

Justin 26:10
Well, there is there's a lot of stuff like I mean, I have diabetic retinopathy. So I've been getting the PRP laser and the injections in my eyes. Okay. So I have questions for him on that and different things that I want to talk about that and then the diabetic neuropathy stuff

Scott Benner 26:31
will get out of them for sure.

Justin 26:33
Yeah, definitely.

Scott Benner 26:35
So you have vision issues? Yes, I do. Okay, and then you're about to say there's something else as well.

Justin 26:43
Um, the last few years, I've noticed that diabetic neuropathy. So I'm, I'm losing like, sensation, like, I took a chainsaw to the knee a couple years ago. And I didn't even feel it. I hiked out of the back country and took myself to the hospital. And they were floored that I could walk into the hospital and actually tell him that I needed help. So it's that stuff. It's really scary, because I spend a lot of time in the backcountry snowboarding in the winter and whatnot. So I don't want to have it to where, you know, I think it's just me being cold. And my glucose is just plummet editor, and I really can't feel stuff. And do you

Scott Benner 27:27
attribute these things to? Basically the care you had in the beginning of your life?

Justin 27:33
Yeah, I think that since technology wasn't there, and you know, my mom did everything she could to keep me on an arm. So yeah, I think it's just I mean, modern technology is the key to diabetes right now. I think

Scott Benner 27:46
so too. Hey, let's take a detour for a second. What kind of work I do.

Justin 27:52
Right now I'm, I'm an auditor for the state of Wyoming. I contract for the federal government to do royalty audits for oil and natural gas. So I've got an office job now.

Scott Benner 28:07
I was just like, trying to wonder why you were chainsawing. Somewhere near nothing. But that's just Oh, I can't understand why. In my head.

Justin 28:15
Well, that was that was a little side hustle. I guess you'd say. Everyone's doing it to make a little bit of extra income back then.

Scott Benner 28:24
Gotcha. Gotcha. All right. Just like snowboarding with a chainsaw. I don't know. Yeah. So Wyoming thing I don't get.

Justin 28:31
You know, we're not that we're not that up kill.

Scott Benner 28:35
I'm telling you, my wife and I sat around last night for about an hour. Just searching out. rural land with a house on it. We didn't even know what state to look at. We were just looking all over the country. We're like, this one's nice. This one's nice. Trying to imagine getting away from weather so many people.

Justin 28:58
But I can't even imagine, you

Scott Benner 29:00
know, have you do you leave Wyoming much or have you ever?

Justin 29:04
Um, I do I like to travel. I mean, I've been all around the world, but I really haven't been to the east coast much. There's so many and I know that's where most of the population is that is on the east coast. Right?

Scott Benner 29:15
Right. Now if I could, I can step into my backyard and with a baseball, I could probably hit on 234 or five. My son My son could my son could probably hit about eight houses with a baseball for my backyard. Like in all different directions. That probably sounds crazy to you that

Justin 29:36
too. So I do live in town but my My home is right in town but I'm 10 minutes away from National Forest. By at that point, you barely see anybody out there.

Scott Benner 29:48
What are the winters like they're they really rough.

Justin 29:52
They can be down in Cheyenne, we've got the wind it's it's the wind tunnel on Interstate 80. So they There's a lot of wind down here. There's probably three or four inches of snow on the ground right now. That happened last night. But for the most part, I mean, decent winters. We don't see in my hometown. I mean, there'll be maybe a week during the winter that it's below zeros for the most part, but I have seen 40 below. Oh my god air.

Scott Benner 30:26
In it, I guess Denver's your airport. Right from where? Where you live? Yes. Okay. Yep. All right. So So, I want to hear a little more about how the retinopathy affects your life like day to day. Especially, is it tactile in your hands, your feet like, is it everywhere? Let's head over to Contour Next one.com forward slash juice box together. It pops up. What do I see first, the Contour Next One blood glucose meter, hyper accuracy, hypo price, see what they did. They're hyper hypo, like the accuracy is high, and the price is low. You get it, you can get the number one branded over the counter test strip at an affordable price, cacher copay. Remarkable accuracy and an affordable price for the contour next test strips may be less expensive than your insurance copay. And it's worth comparing. Head over to Contour Next one.com forward slash juicebox. To find out more, when you get there, you're going to see that this meter is let's Arden's meter, you're gonna look right out and go, that's the meter Arden uses, I find it to be incredibly accurate, have a bright, strong light for nighttime viewing, it fits well in my hand and in art. And it has that second chance tester, right you can touch the blood not good enough, go back, get what you need. without ruining the test strip, you still get an accurate reading. This meter is the bee's knees to understand. That's a thing from like the 20s I think, but yet it holds true. There's even an app if you want to use to help you make sense of those blood glucose numbers. And that app of course is available for free for Android or iPhone. I'm gonna spend just a second seeing what the heck Bee's Knees means. A highly admired person or thing. The cat's meow even? Well, I don't like that. I like bee's knees. Okay. While you're on that internet, check out touched by type one.org. Because they may have programs that you're interested in, touched by type one.org actually find them on Facebook or Instagram because the founder is super pregnant. And she's adorable. Check out her pictures, Elizabeth is about ready to have her first baby. So maybe you'll find that on Instagram, or Facebook touched by type one. No pressure, Elizabeth but Scott is a terrific name for a baby. Last thing, T one D exchange, right? If you're looking to support Type One Diabetes Research in an anonymous way. It's 100%. HIPAA compliant will not take more than 10 minutes of your time. And it's not asking deeply probing questions, but the information will be taken to do something amazing with this is what you're looking for. And it supports the podcast, T one d exchange.org. forward slash juicebox. I took the survey in about 10 minutes, seven to 10 minutes, I think I took it as the parent of a child with type one. You do have to be a US resident. But it can be for you the adult with type one or if you're the parent of a child, either or can do it. Then once a year, they'll come back ask you a few other kind of update questions. But other than that, that's it and you're going to do good. This research has been used to change ADA requirements for a one sake. It's been used to get CGM for Medicare patients. It's been used for really cool stuff. So if you want to improve the lives of type ones, and you want to support the podcast, p one d exchange.org. forward slash juice box like I said, super anonymous, HIPAA compliant. You'll never have to go to a doctor's office or visit a site. Just an easy way to give back. You know, before we get back to the show, I have to admit something. This is the first time I've lived in an ad. Scott is not a great name for a baby.

I want to hear a little more about how the retinopathy affects your life.

Justin 34:51
Um, well, the the retinopathy

it affected my peripheral vision so the laser that I can see About 2020 through the main focal point of my eye, but as you get off into the peripheral, I'm not able to see very well anymore. Of course, like night driving and glares from lights and stuff like that affect my eyes quite a bit. Has there

Scott Benner 35:17
been any improvement with any of your symptoms? Since you've got your stability better, and, and the variability of your blood sugar has lessened? It has Well, not that you could reverse. Yeah,

Justin 35:32
but I think that's

right. Well, I think that I mean, I've, I've kind of hit that plateau to where everything's like, starting to come into a norm and my vision is getting better. But I mean, even last year, I spent, oh, a month, month and a half without vision in my left eye, all I could see was a blood clot. So I had those capillaries bursting and bleeding in my eye. So

Unknown Speaker 36:02
he's the only

Justin 36:04
the laser helps. It affects my vision, but the laser helps and the shots, let the swelling go down from the laser. So then, I mean, it takes a round of shots in my eyes after that, to be able to actually see really well again.

Scott Benner 36:23
Thank you, for the person Justin I've ever spoken to who's gotten the shot in their eye? Can you tell me what it feels like?

Justin 36:29
Um, for the most part, you don't feel it, because they know me pretty good when it drops, and then they'll give you a numbing shot. Um, it's weird, though, because a couple of times, you know, it feels like it pops. Like you're poking a needle into a ball, you can feel that later got through.

Scott Benner 36:46
So just you just said a tingle right up my, my spine. We're pop is what got me in case you're wondering.

Justin 36:54
Well, I'd rather have the shots than laser because the laser treatment is just, it's frightening. It really is when you're going through how so I'm the bright light flashing when the laser hits your eyes. In the beginning, I felt it. I mean, they strap your head into a machine, to where sometimes it feels like the laser hits the back of your head and it yanked your head back. And this is I'm all numb. Yeah. And from shots and everything. So I'm not feeling it. But the laser like in my head is causing my body to move in ways that I didn't like want it to. So that's right.

Scott Benner 37:37
I am sorry, that that's part of your, your reality that that is, that's terrible, I hope very much that that story becomes less and less as the technology becomes more and more available for people. You know, right? I think the next stage really is cost, right? Like it has to get to a place where anybody can afford to have it.

Justin 37:59
You got to hit that equilibrium cost and what Pearson's will be able to afford Yeah, well, it's, I mean,

Scott Benner 38:11
is it one of those things, like if I went back in time, and I found you in your 30s, and I said, Listen, you're probably gonna have side effects, Miss diabetes, but I can give you this thing, but you're gonna have to pay cash for it like you think back then you would have been able to make the leap for that.

Justin 38:26
I would have made it happen. I mean, I worked on the drilling rigs, I was making enough money at that point to where I can afford

these,

Scott Benner 38:37
you could have done it. Yeah. Sort of what I'm getting at is like, there are people now I mean, listen, it's very expensive, there's gonna be plenty of people who can't afford it out of pocket one way or the other. But right now someone's listening who could do it out of pocket. And isn't. And I'm wondering if I talk to those people 20 years from now, they're gonna say, I wish I would have dug into my pocket and bought this thing. Like I'm trying to figure out, you know,

Justin 39:02
it's one of those things, especially with your eyes, like, if I will do whatever it takes to not go blind. So whether that be finding the money to pay for the treatment, or finding ways to better control my glucose or anything, whatever it takes I would do to to have a better lifestyle.

Scott Benner 39:27
Yeah, no, I mean, visions just, it's, it's one of those things, right? Yeah,

Justin 39:31
it's scary. Yeah. When when you have capillaries burst in your eye and you can't see anything but a red splotch. That's when you realize like, I need to. I need to do whatever it takes to make this better.

Scott Benner 39:45
Yeah. Um, geez, I think Arden's actually home by the way.

Justin 39:50
Oh, good.

Unknown Speaker 39:52
Look at her.

Justin 39:53
I was gonna ask her co founder. I'm sorry.

Scott Benner 39:55
I was wondering. I actually just did Find My iPhone to see where she was. And it says she's here. Yeah, she's Home, Oh, cool. Um, my son at that age would have had a stroke. If I was like, just find your own way home was a different kind of person who would have been like, I can't believe you've abandoned me here. I will not embarrass him and tell you a story about once when I asked him to cross the street, because you probably fought a grizzly bear. And you would find this story very embarrassing. Sorry, I won't do that. I got

Justin 40:22
good. I did things to that, that are like, way outside of what my norm would be, you know, I get scared during times. But do you think that's because your daughter had diabetes? Do you think that's why she's a little more,

Scott Benner 40:35
he's a little more like me, my son's a little more like my daughter, or like my wife. But that was a Freudian slip, I'm imagining. And, and he just does a little more reserved, and things he hadn't done before. He wouldn't. He wouldn't just jump into he's so much different. Now. He's going to be 20 in a couple of days. And I've seen him do a half a dozen things in the last six months that Oh, wow. Never would have done before. So he grew out of it. But there was a time when he was younger. Wow, this, this story actually has to do with me not understanding his schedule. There's a time when he was younger, when after school, he went with a bunch of friends to a restaurant. And they won't they walk to it. And while they were there, I realized that he had an orthodontist appointment that I'd forgotten about. And right when I remembered it, there was still time for him to get there. And the ortho appointment was quite literally across the street from where he was. Now. It's a traffic light with, you know, two lanes of traffic. So I said to him, I'll meet you at the doctor's office. But I can't get to you in time to get to the doctor's office, but you can get to the doctor's office. As like I said, so just go and he goes, how am I going to do that I'm like, go to the traffic light, wait for to turn green wait for there's no cars that come and go across the street. And I got a text from him five minutes later. And it just said, I can't do it. Like he could not bring himself to cross that street. So I picked him up and we went and he was a little late, and he's not that person anymore. But back then Arjun would have just been like, Yeah, okay. And then she would have ardent would have wandered into traffic, if she thought it was like what she needed to do. She's different. And is that her or her diabetes? You know, just there's no way to know, I've seen her be extraordinarily tough for her age a number of times. And there is times when I think it's because she's been through things that are just difficult. And difficult things just seem like something new to her, you know? So yeah, I think it's one of the I think it's one of the benefits of diabetes, which I'm sure that's not a sentence. It's spoken often, you know, the benefits of diabetes. But anyway, yeah, I think to your to your question, I think it I think it has something to do with that, honestly.

Justin 42:51
Well, because I'm, I mean, I view my life as being like more going to tell me to do something, I'll do it, or I'll figure out a way to do it. And it's just like, that's just kind of how I grew up. So I don't know, I can't honestly say it's diabetes, either. But diabetes is my whole life. So I can say it's not diabetes, either. So

Scott Benner 43:15
sometimes when someone's harsh with me, they're like, Oh, I'm sorry. I'm like, Listen, I've been married for 23 years. You can't scare me, like you think scares me. You're out here, right? Absolutely out of your mind. And I add to that, you know, my daughter has type one diabetes, like, there's not a lot that like we you know, you see people get flustered about things, sometimes you're like, This is nothing. And it's the worst thing happening to them. But they just they lack perspective

Justin 43:42
on it. Right? And just how calm you. I mean, from your podcast, how calm you are, when you're on your daughter's glucose would go low and stuff like that. I was just like, wow, okay. Well, you know, when you're dealing with this year's self, like I was, I wake up in the middle of mine in the middle of the night, and my glucose was like, 40. And I would freak out, you know, you kind of get scared and you want to eat the refrigerator at that point. So

Scott Benner 44:09
Well, listen, I also had the perspective of seeing or have a seizure twice. So Oh, really? Yeah. So I have the, you know, I have a little more perspective on that than people who haven't seen that. And do I want my daughter to have had a seizure? I don't, but I am calmer now with a 45 blood sugar than I was before I saw seizure. Now I'm like, Oh, she's not seizing, let's fix it. You know, I think everything's like that, to some degree. You just got to keep having experiences that you can kind of build on top of Of course, with diabetes, some of the experiences you have to have are frightening and scary. But, but, you know, once you have them, you're better off I think. I just Oh, go ahead. I was just gonna say I'm having more fun chatting with you. And we're not getting to why you why you wanted to be on the show. So why, you know, you you were very direct and you wanted to be on so I was I'm excited to hear what you have to share with people?

Justin 45:02
Well, I mean, a lot of this a

lot of this is finding from like my diabetic retinopathy and this this new neuropathy thing, stuff that's happening to me it just, I don't know, I feel like I'm losing control. So I want to gain that control back by getting this new info and stuff like that. But it's, I don't know, it's a flood of emotions. Because when you when you've got it, right, you feel like you're on top of the world. But when you don't have it, right, you feel like your life's crumbling around you.

Scott Benner 45:39
And you're saying, so when you see a blood sugar, that isn't what you're hoping for. It feels like it's hurting you. Like, like, well, it's psychologically,

Justin 45:49
Sunday is when

glucose is high, and say, like, right around to hundreds. And it doesn't matter how much influence you give, it doesn't matter what you do, it just doesn't seem to come down Did you can't get it to annoy him. So sometimes that stuff can be really frustrating. But you got to realize that it's going to kick in, you're going to give enough insulin, things are gonna happen and things will finally start moving. Once you know everything gets. Everything gets going, now you your insulin starts to work and everything like that. So.

Scott Benner 46:28
So it's hard, it's hard to trust that that's gonna happen, or it's hard to live in that space while it's happening. Yeah,

Justin 46:35
it's hard to live in the space while it's happening, because I mean, me, I won, I won 110 100 glucose all the time. And I'm not willing to accept it any other way. I guess. So. When it does it go outside and you feel like you're losing that control? It's, it's hard to control those emotions. Yeah,

Scott Benner 46:55
I hear that. I, I gained a little more perspective by using an algorithm, because we're in the teaching time of that. Arden's blood sugar's weren't where I was hoping they'd be either. And, you know, you come I came to the realization that this this numbers not good with me. I don't want it to be like this. But I think I can get to a point where it'll hardly ever be like this. So it's okay for a minute while we figure it out. Right, and I gotta raise that. Yeah, right. I think day to day, that idea would help you that more days than not your 110. Right.

Justin 47:35
Yeah. Yeah, for the most part. I mean, I'm sitting as of right now. Let me check my watch real quick. As of right, now, I'm sitting right at 101. So

Scott Benner 47:47
listen, Arden's blood sugar 70 right now,

Justin 47:50
that's even better in my opinion. So she

Scott Benner 47:53
she headed home this day. Um, you know, she heads into school. There. Her French class made different foods, French foods today, right? There's a lot of baked stuff and powdered sugar and stuff like that. And I, you know, I, I knew they were taking it in. And for some reason, it never correlated with them eating it. In my mind. I was like, I didn't think of that. So she texted me this morning. So she gets up in the morning, her blood sugar tried to go up and we stopped at around 120 and, and it was holding at 120 and getting ready to go back down again. When she texted me a picture of like baked goods. And I don't I'm looking at it now. I don't know what the heck any of this is. And there's like a dollop of chocolate on the plate of Ben. Yeah, he was, you know, you know, powdered sugar, that's something else. It's got like icing on top of

Justin 48:45
it's like a ton of carbs.

Scott Benner 48:48
Right. I don't know how much it is. And the other thing is Arden's not a sweets person. So I don't know if she's gonna take one bite of it and go, I don't want this. So I just said, I don't know, Bolus, 45 carbs. And we'll like, you know, for 45 carbs, and we'll see what we'll do. So we did five minutes. And a little while later. I mean, it's not like she texted me back and said, Wow, that stuff was amazing. I ate it all, you know, so I just a little while later, a blood sugar started to jump. And I got a I got an alert and I looked and she was like 159 with an arrow straight up. And so we just crushed it with a bunch of insulin. You know, like we just, like threw like four more units on it. And and I thought to myself, this will work. And we need to be ready in the future to take bazel away or stop it with food. And so far we've been able to stop the drop with just reducing bazel and it looks like we've got it. I mean, she's right at 70. So I sent her a text while I was talking to so if you want to eat something, eat if you're not, don't worry about it right now. But that whole process took I don't know two and a half hours maybe like she went from you No 122 it got the 190 at one point. And and now it's back to 70. So I, to me, the comfort, listen, I can't tell you how to feel. But I think you have to save yourself most of the time on 110. I don't want this spike. But I also don't want the psychological damage that comes to me from wringing my hands over it. So I'll just address it the way I know is gonna work and I'll move forward, I never look back with diabetes, you always have to kind of be moving forward. You know,

Justin 50:29
right. And and that's the thing you can't have. Without you don't get instantaneous results. I mean, a lot of it takes time. And I got to learn to like, accept the fact that it's going to take more time to get some of these sugars under control.

Scott Benner 50:46
Well, how did you get how did you get to the 110? And the stability? What what from the podcast or from having the technology helped you?

Justin 50:54
Oh, it was right from your podcast, because I had my low parameter set at 80. And my high parameter set at 180. So then you're like, well drop it. So I went to 150. And I got more alerts for a while, but then I dialed that in, and that dropped it to 130. And then that started working. And I was like, okay, is it takes the change, to actually prepare yourself and train yourself how to stay at these glucose levels. So I'm about to switch my upper parameter. This week, I think to go to 110. I'm gonna try 110, maybe 120. If I need to the 110

Scott Benner 51:39
and you're a baller, Justin, you understand me? That's amazing.

Justin 51:42
I'm gonna get it

Scott Benner 51:43
for you. I'm at 120 on my phone Arlen gets alerted at 130. That seems to work for us pretty well. But I like I like 110. I like to your goal is to be between 80 and 110. Most of the time?

Justin 51:57
Yeah, good

Scott Benner 51:58
for you, man. I'm happy for you. That's excellent. And you're not finding it difficult to do.

Justin 52:03
I mean, it takes about a week or two. I mean, cuz for the most part, I'm used to 130 now. So by the time I'm alerted at 130, I feel like I could use a little bit more time. So that's why I want to drop it back down. So I don't have the fluctuation as much. But do you feel though going

Scott Benner 52:25
at that, number one, do you feel low at that number?

Justin 52:29
No, I don't. And actually,

I mean, I'll get to 70. I just started feeling it. Once I got on the Dexcom I started feeling my lows, again, I used to not feel them at all, not even now. I mean, I was walking around at a glucose level of 10. Before I went into a coma for three and a half hours. So

Scott Benner 52:49
never knew you were low. Never knew as that was in 98. So that's the bouncing around of the blood sugar bit taking away that feeling from you the up and down up and down constantly, your body probably just finds a way to ignore it eventually.

Justin 53:04
Yes, it does well, and once I got this stability back, I mean, that's where everything started opening up again, like, Oh, you've got a sweet smell on your breath that I never even would have known Besides, you know, one of my friends saying that when I was little

different things like that. It's

it's just a learning process, you know?

Scott Benner 53:26
Yeah. And it's, it's a, you're a great indicator for what we say about, you know, keeping the stability, you know, as stable as possible, right? No bouncing around blood sugar. You know, I think it's silly when people argue like, it's, it's worse if it bounces up and down than if it's just high. Like, why don't we just both? Why don't we all agree that neither of those things are what we're looking for. Right? Right, everybody? Isn't it interesting how people's minds work? It's always either or. Nobody's Exactly. It couldn't just be both. How about I want I need stability. And I need a lower number. Like, why is that a problem to say, but, but I mean, you have real things going wrong with you that aren't going wrong anymore. Like the fact that you feel your lows again, I think it's pretty astonishing.

Justin 54:11
Yeah, that's my glucose levels get to like 180 I actually started to get a headache. And there were times when I was 400. And can feel a headache. So

it's a blessing in disguise. Really,

Scott Benner 54:24
no, it really is interesting. And now and you don't want the headache now. So so you make the you make the alarm lower, so you have more time to react. And I mean, just in case people are hearing it for the first time in 30 seconds. The lower you make your Dexcom alarm, the sooner you find out that your blood sugar is right. The sooner you find out it's rising, the less insulin you need to stop that rise.

Justin 54:47
Exactly. Because you get for me when you get over 200 it's gonna take double the amount of insulin to get you down so you may as well like attack this when when you have a stronger accent. To say,

Scott Benner 55:01
Justin, when you're using less insulin to stop a high, what is less likely to happen later? Hello, right. That's it. Yeah, you're like, well,

Justin 55:10
and I don't want your listeners to think that I'm perfect. I mean, because by all means I'm not I still have crazy glucose sometimes but it's just managing that it's it's knowing that you need to react to your your arrows going up or your arrows going down. That makes mean, that's the key to the whole thing is just it just tracking it. I think

Scott Benner 55:35
that it also since we're disclaimer in the statements. The other thing is that if your basal insulins not right, a lot of this won't work. So you you really do have to get your bazel is that the first step you you took,

Justin 55:49
um, when I first got on upon paper, they did me my standard basal rates. It took me a long time to figure out bagels without an endocrinologist there. I got it down, though. And I'm looking to go even smaller increments to where I can I can dial dial my head bazel down perfect. But once you get it to where you think it's perfect, yeah, that it's like changing season you go in from winter to spring, and your glucose changes a little while back. So

Scott Benner 56:22
I don't I perfect for bazel it's tough, like I'm more around like just stable, like stable. You don't I mean, like if you're working consistently, when you're you don't have food or bolus insulin and you that your blood sugar is thing. You know, it's not bouncing around, like the bouncing around is an indication, you know, your basal is probably too high or too low, or, you know, you're you're maybe you're making up for your bazel deficiency with meal insulin, you don't even realize that. There's that, but but you took it It took you a while to dial it in. But is that because you were going making a change? Like, every three months?

Justin 57:00
And no, no, I noticed, like, over 10 year periods, like about every 10 years, I'm going to change your body changes. I mean, for me, this is what I've noticed, my body changes a little bit, and I'm gonna have to change my baby's lifestyle changes. So you move from one house to another and you got a different schedule, so you're on a different thing. So you have to adjust a little bit or you go from summer to winter and Nagar you move from pedaling a road bike to snowboarding in the back country. And like it's it's the lifestyle change correlates with the basal rate change for me.

Scott Benner 57:45
Hey, good, I think everybody has that sometimes they don't see it, you know, like, sometimes you get, you get a little busy looking within these few days that you don't see that a bigger thing has happened.

Justin 57:57
Right, you got to look at the micro and the macro at that point hundred percent.

Scott Benner 58:00
Yeah, if you ignore one or the other, you're just gonna make an assumption that might be might be wrong.

Justin 58:07
Or just or even worse, you know, you start cheap chasing glucose levels. So you pump a bunch of insulin for your glucose levels rising, then you go low and then going low, then you compensate for that. And then all of a sudden, you have these spikes and dips that you're like, Okay, I can't even control this at the moment. So

Scott Benner 58:25
yeah, once you're behind, you're the only unless you get lucky once you're behind and you're chasing, the only thing to do is to just take food out, get yourself level again, start over that right, I think is some great, that's a great tip that we don't talk about enough is it you know, when you're chasing, just

Unknown Speaker 58:43
bail, like, stop, yeah,

Scott Benner 58:45
stop and let it find its level and then bring it down and, or crush it and stop it with juice, but don't over treat it, you have to stop the rollercoaster to so you can get off. You know? That's some pretty Yes,

Justin 59:00
exactly. And if it's

if it makes for higher glucose readings for 24 hour, hours, it doesn't matter what it takes, just get back to normal,

Scott Benner 59:09
you have to find some stability and get out now if your blood sugar is high all the time. See, it's tough, Justin when you talk about it, because you understand more about it now than you did. Like, you know, some people like oh, my blood sugar is always high. Well, that's, you know, there's a way for that not to be like none of you, you know, with the exception of people who have gastroparesis, or, you know, some other fairly uncommon problems. You know, most of you your your blood sugar is high because you don't have enough insulin at the right time. So it's not you don't have the special kind of diabetes that nobody can tame. And thinking that way is it's sort of it's it's like a double edged sword for people. It takes away their guilt, because they're like, Oh, this is just what it is. I can't do anything about it. But it also makes them complacent about it. And they don't try to fix it because they think this is what it

Unknown Speaker 1:00:01
Yeah, yeah, you got

Justin 1:00:02
it, you got to take control. You gotta, I mean, you got to be proactive in your diabetes, you can't just sit back and let things happen. Or she'll end up with diabetic retinopathy or losing a foot because of circulation or something, something like that. And you really don't want to go to those extremes. So,

Scott Benner 1:00:21
Justin, even if something that horrible doesn't happen, even if something that horrible doesn't happen, you're still stuck in a life where you're always messing with the diabetes. It's always there poking you in the ass. You know what I mean? Like, Hey, I'm here, I'm here, I'm here. I mean, like, you're always like, bothered by it, it takes that upfront effort to find the kind of balance and stability that doesn't require a ton of upkeep all the time.

Justin 1:00:45
Right. And I think for me, it was like, realizing that I'm gonna have diabetes for the rest of my life. There's, there's nothing I can do about that. So let's fix what I can fix and not worry about the things that I can't fix

Unknown Speaker 1:00:59
for you.

Scott Benner 1:01:00
Good for you. What else? Is there anything else you did that? That was, you know, key to this for you.

Unknown Speaker 1:01:07
Uh,

Justin 1:01:09
a lot of it was being in a rural place to where nobody had the answers. So it pushed me forward to try to find answers. And I think that that's what's helped push me so far. And then finding your podcast. And then there's having all the all these different, like, day to day things that are happening. I was just like, this is great, because I really had no place to go. I was trying to search for something for answers. And for people who had the answers, and it was kind of leading nowhere at times. So to get your podcasts and it's great.

Scott Benner 1:01:45
How long did you find it again?

Justin 1:01:47
Oh, let's say this was

for I listened. I probably found it three years ago. Well, somewhere in there, but I listen, I've listened to every episode from year beginning till now. So

Scott Benner 1:02:04
I just do recommend that everybody does that.

Justin 1:02:08
I think so. And I've recommended it to a lot of people around here because this lady I work with she's a type two diabetic, but she just ordered her first set Omni pods. So I was just like, Oh, this is this is great. If you need any help, there's a great podcast out there. And then I told her that she can come downstairs and talk to me anytime she wants. So very

Scott Benner 1:02:29
nice. If you could feel Yeah, more more and more type twos are using insulin through pumps. So it is yeah.

Justin 1:02:39
It's it's like making type one and type two almost the same.

Scott Benner 1:02:44
The tools, right, at least that you're using are are similar, which is good for type twos, because then there are now more people to talk to about it. You know, before there's a disconnect between the two, and they don't really crossover. And type twos do struggle with community. I mean, and and wanting to tell people they don't come out as much. I guess this type ones, though.

Justin 1:03:08
Yeah. Yeah, it appears as though like, type one, people are more bold about it, I guess it's a,

Scott Benner 1:03:15
you know, you get to say, I mean, think about it from a, from a human standpoint, if you have type one, you get to say, Hey, this is a genetic thing. I didn't do this. And people with type two are in the same situation. But they're really led to believe that they did it to themselves. And so it's an embarrassment, you don't want to say, oh, gosh, look what I did. I gave myself type two diabetes. Like, that's not something you want to run out and tell everybody you know, and some people have the clarity to talk about it, but most don't. It's just not. It's a very underserved group of people. It really is.

Justin 1:03:45
Well, it's one of those things, I've had it my whole life. So I don't know anything different. But I'm the people who get it at like 16 or something like that. I can just only imagine what they're thinking and inside their head about, did I do this to myself?

Scott Benner 1:04:02
Right, like, like the unfair which 100% is, yeah, everybody needs. I think you need like a super amount of support in the beginning. Whether it's you and your, you know, a little kid, maybe it's your parents or if it's an adult or you know, a 16 year old, you need you need to have people around you. Right, almost like bubble wrap to protect you from your, from your own thoughts until you can become adept. And I am assuming accepting, you know,

Justin 1:04:33
right, or if you're people like me and don't have people around you that that's where this podcast is coming great because that I mean, I didn't have anyone to talk to in my hometown growing up. There was one other person that I knew that had diabetes, so

Scott Benner 1:04:49
I appreciate you telling me that I really do because it's still it's strange to me still when I when I go speak somewhere and people come up to me and I They, they have a real feeling of like, I know you. And, you know, I'm I'm just, you know, it's it's, it's it's lovely, I really mean that. But it's not not so strange,

Justin 1:05:12
right? You change lives for people you really do. And I don't think you understand that really, you know, maybe it's just a diabetes podcast that you do you know, your daughter has it, so you talk about it. But for people like me, it's really altered my view of my disease and how I need to work at it to control it. So

Scott Benner 1:05:36
that makes me feel good. It really does. Thank you

Justin 1:05:38
know, I really do appreciate it. And I don't I don't think I can put it into words to have you understand fully, but, um, yeah, he changed my life. You really did. Thank you.

Scott Benner 1:05:49
I'm happy that it was here for you. I tried to say to my wife the other day, that I, I separate in my mind myself from the podcast, somehow, like the podcast is a thing. I me, and my wife's like, you're the podcast, and I was like, maybe, but it's weird. It's hard to think of it that way. You know, like, if I if I leave joking aside, which we do sometimes if I if I start feeling in my soul that I'm the reason that's a weird ego thing. You know, like, I don't I don't want that to feel that way. Like I know, intellectually, what you said is 100%. True. I just don't want to. I don't know. I don't want it to let

Justin 1:06:31
go. Just don't let it go to your head.

Scott Benner 1:06:32
Yeah, yeah. I mean, I don't want to affect who I am. So I don't know if I could listen, it's really it's wonderful. 100% you've said it to me in person. I've gotten three Instagram messages and three emails this morning already. And it's really not even one o'clock in the afternoon yet. And if I read every one of them gone. Look what I did again, here. You know what I mean? Like it would? It would just It's weird. So I don't know if it's, I don't know, I can't I take it to heart. And I believe you. I just don't know how to. I don't know how to respond other than to say, That's very nice of you. Thank you. You know what I mean?

Justin 1:07:09
Well, and from my perspective, I'm glad you you segregate those because then you don't let it go to your head. I mean, this podcast would be over in a year, if you let it get to your head, you know, just come

Scott Benner 1:07:21
on. Every week. I was like, hey, Scott's back again, to tell you the magic about diabetes. You're gonna hear it because I know what I'm talking about. And you don't like yeah, you don't think that we go over big? You know, well, I'm good. I'm sorry.

Justin 1:07:38
But then you'd be like, Well, here's the Omni pie commercial.

Scott Benner 1:07:40
Yeah. Buy yourself an insulin pump and get out of here. Your silly kids? No, I, um, I think that that doesn't work. Because it wouldn't resonate with anybody, but also wouldn't work because it wouldn't genuinely be how I feel. You know, they mean, like, I don't feel like a huckster who talked you into using insulin. I'm just talking about what we do and, and that I realized one day that it's not just diabetes, and this will really work for most people. So

Justin 1:08:08
you know, well, and you let everybody in on your life, you and your daughter's life, you know, And that, to me is big. Because it's not just something you do and talk about, because this is what you know about or what you've been trained to do. This is something you're doing, because it's part of your lifestyle. So I think that's where it shines to is because these are real world scenarios, real people, and this is really working for your daughter. So that to me is great. Thank you.

Scott Benner 1:08:39
Yeah, I listened. I'll feel good all day from talking to you. So you've done you said, You've done as much for me as I've done for you. Seriously, I really read all the people listening. I it might sound weird, but I've said it a million times this podcast helps me in a bunch of ways, probably more so than it helps the people listening. So I'm, I'm chatty, it gives me a chance to chat. I like that. It helps me think about diabetes, so that I can help so that I can come up with new ideas for my daughter. It lets me get out sometimes anxiety and stress. I did an email or an episode The other day and like I I cried while I was saying something, and that's got to be good for you. You know, just get like that out. All right.

Justin 1:09:25
And you know, it touches your emotions like that you're drawing the audience to to believe and trust you as well. And it takes a lot for diabetes to be able to trust somebody else. So

Scott Benner 1:09:36
Justin, tell us what you're doing. I hear the smacking in the background.

Justin 1:09:39
Oh, I've got a little plastic egg that I was playing with. Are you nervous? No. I just always keep active gotcha. Excellent. I in my desk at work. I stand all day. So

Scott Benner 1:09:53
my desk goes up and down. I've still done the podcast a couple of times. I can't like you know, you have to stay Near the microphone. So sometimes you'll hear episodes where I'm I started having too good of a time. And then all of a sudden my voice goes over here, like this thing comes back again. So, but it's hard to know what to look at. Because I'm trying in like you're telling me your thing, right? But I'm listening to your thing, and then also thinking about how to direct the show. And so sure if something catches my eye, and I miss 10 words, I'm in trouble. You know what I mean? So I tried my best to take my attention away.

Justin 1:10:28
Well, in that, I mean, the little egg thing for me is kind of funny, because I remember the podcast where your dog was in the background making noises. And it just made me laugh. I mean,

Scott Benner 1:10:39
I moved the set up. I couldn't like I was like, I can't keep this. And by the way, for the same reason, like I'd hear the dog, and then I think, oh, they're gonna hear that on the recording. And I think I don't want that to be on the recording. And then before you know it, you've said eight more words, and I don't know what the heck you said. And I was like, I have to go somewhere where I can, I can concentrate a little better is as you can tell from this episode, I don't even know when my kids are at school. So many little bright light, I'll probably just catch my attention. Anyway, Justin, I got it. I'm sorry.

Justin 1:11:11
No, I just like sometimes I mean,

diversion of attention. It's gonna happen. So

Scott Benner 1:11:19
no, I listen. I'm not trying to be perfect here. I think that's obvious. I want to thank you. We've been talking for over an hour. I really appreciate the fact that you came on.

Justin 1:11:29
Oh, wow. It has been an hour. So cool. Yeah. Appreciate it.

Unknown Speaker 1:11:33
Good. You have a good time.

Justin 1:11:35
Yes, it was great. Thank you. It's

Scott Benner 1:11:37
not I I really, I swear, I'm very appreciative what you said. And I'm glad that there's somebody in Wyoming who knows about this. Now who might tell somebody else one day like, I mean, I don't know, you probably only see a human being every couple of days, but eventually you'll bump into one that has diabetes.

Justin 1:11:52
Well, there's been, there's been more than I can count now. People that I've diabetics that I've told to check out your podcast, so I appreciate that. There's gonna be more of us, Wyoming and people listening to you.

Scott Benner 1:12:06
Thank you. Eventually, I'll get all 50 of you. I'm just

Unknown Speaker 1:12:11
joking. But

Justin 1:12:12
hey, there's more pronghorn antelope in Wyoming than there are people. So

Scott Benner 1:12:17
I didn't even know that was a real thing. No, it's true. Wait a minute. Now you're not getting away prong. horned antelope. Google agrees that exists on a second.

Justin 1:12:30
There's, there's more people in Denver than there are in Wyoming. It's interesting.

Scott Benner 1:12:35
It looks like a furry deer. But it's taller. Yeah. Yeah. Wow. It's huge. Do they hunt those?

Justin 1:12:44
Oh, yeah, there's a hunting season out here for them.

Scott Benner 1:12:46
Before they before they overtake you guys. I guess you'd

Justin 1:12:51
well and every year they do the pronghorn antelope hunt. So you'll get all the celebrities that come in and pay high prices for out of state tags and licenses and stuff. So maybe

Scott Benner 1:13:01
Yeah, name a celebrity and hunted a pronghorn antelope to your knowledge.

Justin 1:13:07
Oh, gosh, you had to ask me that question. Don't put this on the podcast because I don't know.

Scott Benner 1:13:13
antlers dealership beautiful.

Justin 1:13:16
I'm glad like when they're fully developed, they almost look like a heart.

Scott Benner 1:13:21
Yeah, I'm looking at that. But that's really Oh, come together at the top. The left to the right.

Justin 1:13:28
Yep. All right. Well, let's have a look at it. They go over the back of it looks like a heart almost when they're fully developed.

Scott Benner 1:13:34
So go support the sponsors and then go check out a pronghorn antelope they're really kind of beautiful. Exactly Yeah, but not before you order your no obligation please do that first. So I keep doing the podcast

Justin 1:13:48
on new pods index cards and I

Scott Benner 1:13:51
also also touched by type one.org Contour Next one.com listen the ads the ads are a good sign it means that you guys are listening and and that people know you're here so that's a that's really great actually I swear I could not do it without the ads I my wife would look at me and say go get a job buddy right now

Justin 1:14:15
it's time for you to leave the house for one

Scott Benner 1:14:17
yeah either move out or make money i think is what is another way the podcast helps me I get to stay I get to do my my stay at home dad thing more often, you know because I don't have to have your house to work so I appreciate you guys a ton I there's probably no way for me to to adequately, adequately say that but um but I

Justin 1:14:37
really do. We appreciate you as well. I just

Scott Benner 1:14:40
and that's enough of you saying nice stuff to me. It's making me uncomfortable. You know, build a teepee or whatever it is you're going to do and I will. I will go downstairs and make sure Arden's not mad at me. First things first, let's thank Justin for being terrific on the show. Secondly, Thank you to the Contour Next One blood glucose meter, which you can find out more about at Contour Next One com forward slash juice box. Thirdly, touched by type one.org. Fourthly, T one d exchange.com. forward slash juice box. And fifthly. Justin said the most adorable thing when the recording stuff, and I'm so sorry the rest of you didn't hear it. He's like, how will I know if this is gonna be on? Like if it'll make it to air? I think he was worried that it wouldn't be good enough. Justin, I've never made a bad podcast in my life. My been been bing, bing, boom, boom, boom, boom, boom, boom, boom, juicebox docs.com diabetes pro tip.com. These are just some offerings from the podcast that you can have for the free. Check it out by the by the private Facebook group, just for Juicebox Podcast listeners has skyrocketed to like well over 5000 members, and it is still as homey and kind and lovely as a place as it was with 1000 members. it very well may be the nicest place on Facebook. I'm not making that up. The page adds 40 new members a day. I'd love it if you were one of them. Okay, that's it for today. Kids. hope you had a good time on the podcast. There's gonna be more coming up, don't you worry.