#470 Diabetes Pro Tip: Weight Loss

Understanding how insulin works is the first step

Scott and Jenny Smith, CDE share insights on type 1 diabetes care

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

Scott Benner 0:00
Hello friends and welcome to Episode 470 of the Juicebox Podcast. Today, we're adding to the diabetes pro tip series with an episode that has been asked for by listeners forever. And for that reason in many others, I'm very excited to give it to you today.

The diabetes pro tip series from the Juicebox Podcast began almost two years ago now, when I decided to take the tools that were being spoken about in the podcast, and condense each one into its own episode. That was my original thought anyway, the pro tip series has become so popular that it's just you know, it's like watching a baby grow up and you just kind of go like oh my God, look what they're doing it. It's become more than I expected, and it continues to grow. And today is another another link in that chain, diabetes protip weight loss with Type One Diabetes. Please remember why 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. We're becoming bold with insulin. In just a second, I'm going to tell you a little bit about Jenny, a little bit about the sponsors and where you can find those other diabetes pro tip episodes. Then we're gonna jump right in

this episode of The Juicebox Podcast is sponsored by the Omni pod tubeless insulin pump, and you may be eligible for a free 30 day trial of the Omni pod dash right now. And you can find out if that so at Omni pod.com Ford slash juice box Get started today with the Dexcom g six continuous glucose monitor@dexcom.com Ford slash juice box. And if you're looking for those diabetes pro tip episodes, you'd like to start from the beginning, they started Episode 210 with an episode called diabetes pro tip newly diagnosed or starting over, he does a series it's made to be listened to in order. And it's of course available to you as a subscriber to the podcast. All you have to do is go back in that podcast player to Episode 210. And there it is. If you're having trouble finding the other episodes, you can look at Juicebox Podcast comm there's a tab at the top that says diabetes pro tip. If you don't want to go to all that trouble, go to diabetes pro tip.com, where you will find the pro tip episodes and the defining diabetes episodes, which I also am very fond of. In just a moment, Jenny and I are going to get started. But first I want you to know that Jenny Smith has been living with Type One Diabetes since she was a child. She holds a bachelor's degree in human nutrition and biology from the University of Wisconsin. She is a registered and licensed dietitian and certified diabetes educator and a certified trainer and most makes and models of insulin pumps and continuous glucose monitors. Jenny happens to be the bomb diggity. I love her. And in a couple of weeks, her 33rd diversity is coming up. So if you're in the private Facebook group for the podcast, please take a minute to go to the thread celebrating Jenny and leave her a little message. And I'll be passing those messages on to her on her diversity. Last thing I want to thank the listeners who sent in questions for this episode specifically, we get them about two thirds of the way into the episode. But first, Jenny and I are going to talk about ways to lose weight when you have type one diabetes. Every time I think there's nothing more to do for the protests, then somebody asks something and I think No, no, that that would work there too.

Jennifer Smith, CDE 4:01
Is the variables in life that I think will always bring in something to discuss in terms of what it could be in, in diabetes? Like management? Yeah,

Scott Benner 4:13
no, I'm really happy. I'm really happy to hear from people because I think that others perspectives can make me go Oh, yeah, wow. Just because that hasn't happened here. Doesn't mean that's not happening somewhere. And then if it gives you no good focus for what to do. So this is it. We're gonna talk about trying to lose weight, you have type one.

Jennifer Smith, CDE 4:32
As I mentioned, I think I texted back to you. I was like, this is a big topic. It's not just like five minutes of just go out and start running. I mean, it's it's kind of like a rabbit hole, honestly. I mean, there are many different like, little avenues to kind of talk about and you had a lot of really good questions that came in, or like comments about Gosh, I don't understand this or why isn't this quite right or whatever. So

Scott Benner 5:00
Yes, we actually knew three topics. So I'm gonna have very little to say here probably. And I apologize for that. I guess this is the time, the time we pretend like I just came on your zoom. And I'm like, hey, how do I help? And then you just talk. But what what's the I mean, where do you think we should start? Because to me, I think we should start at the idea that people correlate taking insulin with gaining weight. And then they don't think about calories and get that right. Go. Hi, Jenny. Oh,

Unknown Speaker 5:34
you help me please? Yes, well, maybe.

Jennifer Smith, CDE 5:39
I know, it's a good place to start in terms of like, one thing that everybody with diabetes specifically thinks about is that it's insulin. And I think a good place to even go with Why does that start is because it's often something that a practitioner will tell people, you know, using insulin, you may be likely to gain weight. I think that was one of one or a couple of like, the comments that came back about this topic, were specific to you know why I've been told that I'm going to gain weight or why, you know, why is this going to happen? or Why did I lose weight, and now I'm gaining all of this weight back like after diagnosis, right. So insulin itself, whether your body makes it or you take it with an injection or with a pump, it's a storage hormone, that's its job, it's supposed to move a certain quantity of carbs, sugar really out of your bloodstream and into places to either be used or stored, right. So in terms of management, insulin can make you gain weight. In terms of like initial diagnosis, a lot of people with type one specific have lost weight. Prior to diagnosis, maybe it was very rapid. Or maybe it was like a lingering loss that people were like, well, I could just keep eating the whole cake. And Gosh, I don't gain any weight, and I'm actually losing weight. And then they're like, wait, this is wrong, this is bad, that shouldn't be happening. So they go to the doctor, right, they get a diagnosis of diabetes, they've lost weight. And in terms of that loss, it's often relative, it's usually a relative to the fact that their blood sugars have been so high, that their body isn't storing those calories, right. So you're essentially paying them out, thus, decay, and all of those things that can come about, you know, around diagnosis time, but because you're losing all those calories, and your body's not packing them in, once you have back the piece of the puzzle that was supposed to help you use that food that you were taking in, your body's gonna start storing it.

Scott Benner 7:43
And so and so. And that is the one confusion you see from newly diagnosed people, like I don't understand, I lost all this weight, and they don't understand the function of it. So explaining the function of it, I think is great. I think boiling it down into one simple idea is that you were dying. And yeah, and your body is using itself up and not storing at the same time trying to stay alive. And then all of a sudden, everything's all right. Now, the more weight at Listen, if I'm if I'm talking about a school, here, you're stopped me. But if you've lost a lot of weight, before you get to this skinny, emaciated, those are my ribs, you probably had weight to lose to begin with, right? Because it was there to lose,

Jennifer Smith, CDE 8:22
likely and especially more as the adults who are diagnosed Yes. If you had weight to lose for whatever reason, you may have just thought, like I said, Oh, good, I'm actually able to take weight off. Now. I don't know why I'm still doing the same three mile walk every day. And now it seems to be working better. Great. But yeah, once you get to that, like, I shouldn't be able to see my lower ribs or Gosh, my face looks really sunken in when I look at old pictures. That's not what you want.

Scott Benner 8:52
And I think that, again, I this probably sounds I don't want it to sound like distasteful, but if you had weight to lose, you were probably it's likely that you were taking in calories that helps you stay at that weight. Meaning that when you start taking the insulin back in, there are calories there to be packed away to facilitate the weight gain again,

Jennifer Smith, CDE 9:14
and that's in any case, whether you could have lost weight, you know, and successfully hopefully helpful, you know, left it off. But the goal was starting insulin is in general to maintain a healthy weight then right to get Yes, you will come back from the weight loss, but you should also with the proper insulin dosing, you should be able to get back to a stable healthy weight. You know, if you lost 40 pounds when you were diagnosed and Hey 20 of that you could have definitely lost and the other 20 you really didn't need to great, we should gain back maybe 15 to 20 pounds and then we don't need the other

Scott Benner 9:56
what is the functionality of the proper insulin dosing It makes you gain too much or not enough

Jennifer Smith, CDE 10:03
in terms of insulin dosing, that's correct. The amount of food you put in to work with it, of course, is a piece of the puzzle there. But if your insulin is being balanced along with your use of the energy that it's working with, then you should be able to gain energy back to your body that gets stored, that keeps you at a healthy weight, and you shouldn't then continue to gain if the dosing is correct. And it's so it kind of goes back to, on a baseline initially, make sure your insulin doses are right for you. And a lot of people wonder, you know, they, I just leave it to my doctor. Yeah, it tells me how much more or less to take.

Scott Benner 10:43
And does that mean that if you're not using enough insulin that your blood sugars are left higher, so you're still having some of the action that you noticed before you were diagnosed? Right? Yes, you're a little You're too high, and your body's not storing the, the calories correctly, the glucose collect correctly, and so you're not gaining as much weight. So you could have unhealthy blood sugars, but feel like your weights good. And then you kind of come to that point, you're like, Oh, I'm good. And that really is the beginning idea of diabetes aimia to write, manipulating the insulin to keep your weight down, okay, so that's going the other way, if you're too low all the time, you'd have trouble putting on weight.

Jennifer Smith, CDE 11:26
If you're too low all the time. One, you've that's actually kind of an, it's an opposite of what you would think really, if you're low all the time. And that's a big reason, then when we start working with somebody, we analyze insulin to begin with, and the first thing we look for, even if there are highs, high highs, we first look for lows, because if weight management is another piece that they're really concerned about, then all of those lows that you're treating, you are feeding insulin, and you're feeding insulin, which ends up packing away the excess that you're taking in, and you maintain a weight that you don't want, or you keep gaining weight that you don't want.

Scott Benner 12:11
So this, this puts you in the position of having to look at carbohydrates as medicine, and being scared because you're low taking away more than you need. And then suddenly, you're back back up again. And maybe you've got enough insulin in there to handle the carbs for your blood sugar. But you've taken in way more calories than your breakfast once got it.

Jennifer Smith, CDE 12:31
Yeah. Yep. So that's, that's that insulin is, it's kind of the key place to start really. And you know, then a lot of people ask, Well, how much insulin? Should I really be on? How does this enough for me? Is that enough? For me? I know, we just talked about that kind of in depth in another episode, but really, you know, figuring out about how much insulin you need based on a wheat to begin with. That's kind of a starting place that you could go to, how much total daily insulin Are you using right now? What's your like current body weight, etc? Should you be using this much insulin? is it taking this much more insulin to counter things? Or are you using like a heck of a lot more like let's call it Bolus insulin, right? But you see that your Bolus insulin is for a lot of corrections. And when you're looking at your data, you can see that the corrections are following lows. There again, more insulin than you really need. And thus your body is going to pack away by allowing the insulin to use up the food.

Scott Benner 13:38
It's funny because I wasn't 100% sure what you were gonna say today. And yet I feel like we're into this situation, again, where the podcast should maybe be three minutes long. And it should say limit your variability use the right amount of insulin. And it kind of addresses so many things. I know this isn't weight loss specific. But let me just ask you one question. How many people you know what percentage of people do you think just a guess, are are getting to reasonable outcomes by mistake. Like their bolusing too much, but they're eating on time and their basil is too low and it works out or their basil is too high and they eat before they get low. And they don't have to Bolus too much in it like how many people are getting there the wrong way, but it seems like it's working and then have underlying issues that they don't recognize. Like I

Jennifer Smith, CDE 14:35
wouldn't say it's I wouldn't say it's anywhere near a majority of people. Honestly, I'd say it's a small percentage of people who have figured out insulin needs. Even though the dosing strategy that they're using might be wrong, like you said, maybe there's way too little basil, but they're offsetting it with boluses and maybe the little amount of basil they're using is right for their overnights and that's why it looks stable or, you know, Vice So whatever. But I don't think that's the majority of people, I think the majority of people who are having issues with blood sugar fluctuations that they don't want, and also likely are having some issues with weight management of some type. It's, it's a start of let's look at what the initial factor could be insulin. And then you move on further. And you know, lifestyle is a big part of it, obviously. So then we look at things like calorie intake. And I think some of the some of the questions that came in were kind of, you know, around that, well, you know, I've run a calorie deficit, and I've like, run myself ragged, going to the gym, or, you know, exercising 90 hours a week. And it's still not working. But I, you know, and then, you know, there's the fasting component, and all of these things that people try to put into the picture. But from the standpoint of calorie, your calorie needs should meet your baseline kind of need, in general. And then if you were working out on top of that, or you know, a training athlete or whatnot, then calorie needs go up. But at a minimum, there is kind of a minimum, on average, that needs to be there. It's about 1000 calories a day, give or take person to person. But when you start dipping below that oftentimes what ends up happening is your body conserves. Because you're not meeting a need. And then you wonder, Well, I'm at a deficit, why am I not losing? Because

Scott Benner 16:38
your mind thinks you're lost on a desert island, and it doesn't, it's trying to hold on to everything you put inside? Exactly. I had that problem where I've, by eating more food, I've lost weight and eating less. It didn't, it didn't impact me as a fact. In fact, it sort of made me go the wrong way. So okay, so if someone asks you, is it not as simple as Hey, I need to lose weight? Can you tell me where to start? Is it really person to person? Like, because what do you have to do first, like, think about if you were listening to this right now? And you could be any of the varied people who are listening? like where do people start?

Jennifer Smith, CDE 17:17
I would definitely say with Well, first might even be an analysis of Where are you? And where do you want to be? Or where have you been weight wise, right? What's your goal to get to? And how much more Are you above that, then you want to be and also in that timeframe, it goes back to insulin analysis. If you've gained weight, as many people have in this past year, if you have gained weight, but your insulin doses haven't really shifted, there in lies a piece of the puzzle to write usually, for about a 10% change to your baseline like Wait, you're probably going to expect a need to change your your basil and your Bolus ratio is by about 10% as well, to be more aggressive and to take, you know, take into consideration that gain now when people are looking for loss. They're like, Yeah, but I don't want to use more insulin, because that's not going to work

Scott Benner 18:20
anything. Insulin, put the weight on them. Correct. Okay, gotcha.

Jennifer Smith, CDE 18:25
But really, they need to first manage their blood sugars. And then they can start working on whittling away or wiggling back and some of that comes into, okay, let's look at the lifestyle things. Let's look at are you exercising? Are you active enough? Does your calorie intake meet what your actual need is? You know, where can we whittle away some things so that weight comes down and along with it, then as you do lose? The same thing happens with insulin, your insulin doses should be adjusted back based on loss.

Scott Benner 18:59
You're making me think so strongly about when somebody comes to me and says, Hey, I just got diabetes, and I play a sport or my kid, you know, is on the team and we're so worried about this and I very badly don't want to give them a band aid answer about how to get through the sport I want to tell them let's take the time now and get your insulin right so that during the activity there really isn't any issue and it's hard for people to believe that once they've seen it once they see cause and effect once they say I ran around and my blood sugar went down. They imagine that is going to happen no matter what all the time. And I Ardennes. I'm sure you're the same way. But Arden's insulin so well balanced at this point, like activity doesn't make her lower or higher. Really, it's not it doesn't really change too much.

Jennifer Smith, CDE 19:46
Yeah, it depends. I think that brings in, you know, the consistency of exercise or activity, right. The more attune your body is, let's say you go out for an hour every single single day to get some form of real exercise right Your body gets used to that. So initially, you might see that your insulin needs drop off within the hours of the active time, right, and maybe even stretching several hours later, depending on what you did. But over time, that impact is lessened, you will usually need to be less aggressive with insulin adjustment, or maybe not at all. I mean, I can typically take my kids to the park and not really worried too much about that, unless I know I'm really going to run around crazy with them, and I likely have insulin on board. Right. So then something needs to be you know, offset. But, um, so yeah, I mean, once you get to the point of like, lifestyle adjustments, and a base insulin that's working, your fluxes in insulin dose, then will be minimized. I think, oh, sorry, go ahead, we'll

Scott Benner 20:52
see I think people need to be certain to that, once they start exercising their body is going to use the insulin better. The answer then is not to feed the low, it's to adjust the insulin, you know, maybe the first time you have to feed it, but then you have to learn from there and make an adjustment so that you're not constantly battling yourself because that is what happens, right? They exercise they get low, they eat it out, though it out. It overpowers what they meant to accomplish, okay,

Jennifer Smith, CDE 21:18
and then they and then you end up getting frustrated too. Well, goodness, you know, I go to the gym, but I have to eat like a whole sandwich and a half a banana in order to go to the gym and not have a low blood sugar. What's the purpose of that when I'm trying to lose weight, and then

Scott Benner 21:30
I stopped doing it because

Jennifer Smith, CDE 21:31
and they stopped doing it right. Or on the other side of it, you know, someone who may actually, okay, I'm going to really focus in on my diet, I'm going to clean it up, I'm going to you know, cut my macros down and actually meet the caloric need that I'm at right now. And then what they end up with many times are lows, especially the cleaner the diet gets, and the more accurate intake of calorie value is for that person, your insulin needs will actually come down sooner. So to avoid lows and needing to treat in the time period where you're really trying to be Let's be good, let's say right, just take your insulin doses down by maybe even it's just your basil, take it down by maybe five to 10% across the board.

Scott Benner 22:17
Okay? So it's get your insulin, right. So it's understand diabetes first. And then it's the normal stuff, we all talk about it being active, getting your heart rate up. A sedentary lifestyle leads to more resistant blood sugars, which leads to more insulin, which probably leads to more lows, because you get out of balance, blood sugars, and what you just said, about clean eating. We don't really talk about it like we like if we were all out in a field, okay, let's say if it was 400 years ago, and somehow insulin existed, but we were still just farming and breakfast might be an apple you found on the ground, and maybe on Wednesday, if you're lucky. The guy up the street kills an elk. And we get a steak right? Like if we were still eating like that, and we had manmade insulin, people would not be using nearly as much as long as they use now, Jenny?

Jennifer Smith, CDE 23:14
Oh, no, not at all. I mean, if you were living on like, berries that you picked along the trail that you were tracking the elk on and then you stopped and you ate some of the watercress. Hey, get your vitamin C out of the like stream that floated by whatever. No, what No,

Unknown Speaker 23:33
you might not need as much insulin right?

Jennifer Smith, CDE 23:34
No, you wouldn't. You're also active level that I mean most like let's call them you know, cave dwellers or whatever at that point of life, right? activity was part of your day. They didn't have a gym that they went to. Their hunt for the bison man was like, act.

Scott Benner 23:53
I bet you're running from a mountain lion burns carbs. What do you think? What do you think? So I guess my point is, is that while I'm not telling anybody how to eat, and I'm not certainly telling you that my daughter's counting macros or anything like that. Processed foods, right? manmade foods, stuff that comes in bags, oils that don't belong in your body, all the stuff that we consume all the time that we're not aware of. It's making your variability greater and it's making it more difficult for you to use insulin

Jennifer Smith, CDE 24:24
true in fact, I've also kind of heard people and there's truth to it.

Scott Benner 24:39
Hey, let's not let's not waste any time shall we? just did it nice. How I said let's not waste any time it took me 10 seconds to say let's not waste any time then I went over it for 10 more seconds. I better jump in. Get yourself a Dexcom g six continuous glucose monitor why you'll be able to see trends, directions impacts of insulin on blood sugars, impacts of food on blood sugars, the impacts of life on type one diabetes, you'll see it all with your Dexcom g six continuous glucose monitor. And how does it do that? Well, it shows you your blood sugar in real time, not just the number, but the speed and direction of your blood sugar. Are you 184 and dropping or rising or stable? That's a big deal, isn't it? Because in each of those three situations, you might do something different. A rising blood sugar might get some insulin, falling blood sugar might warrant you paying attention to it, and say it's super stable, right where you want it, you know, you've done the right thing. The Dexcom g six gives that feedback in real time in ways that is so usable, you hear us talk about it all the time on the podcast. So check it out. dexcom.com, forward slash juicebox. Sure, there's alarms, you can set, those are a big deal, too. You can say, I'd like to know if I'm going below 80. Or if I'm going above 140. And it'll tell you don't want to know till you're 160, you can change that, that's up to you. The Dexcom g six is a vital tool. If you're using insulin, I'm talking about type one or type two, check it out, support the podcast when you do use the links in your show notes. Or type in dexcom.com forward slash juicebox. After that, you're gonna want an insulin pump. Right? Maybe you don't have one and you want one, I say check out the Omni pod, you have a different pump. And you're a little sick of the tubing. I say check out the Omni pod. You use an MDI giving yourself the shots and you're kind of sick of it. You know what I say? Check out the Omni pod, do that Omni pod.com forward slash juice box, you have two options when you get there. You can see if you're eligible for a free 30 day trial of the Omni pod dash system. And I mean 30 days is like a long time. And it's free. Or ask for a free no obligation demo pod where on the pod will just send you out one nonworking pod. So you can try it on and see what you think there's a lot of options when you get to that link. All of them are going to give you more information and help you make a good decision. On the pod.com forward slash juice box, use an insulin pump that doesn't have tubing that doesn't need to be taken off when you shower, or run or kick a ball. an insulin pump it doesn't have something on it along to from an infusion set back to a controller that can get caught on a doorknob or just kind of be a pain to carry around. When you like to carry nothing, just have that little pod on that talks wirelessly to a device where you give yourself insulin, not something that's tethered to you with tubing full of insulin. And they if you don't want it on the pod, whatever, do the trial, say you don't like it, don't like it. Nobody's holding you up, can do whatever you want, but at least then you'll have real data to make decisions with. As you know, I think data is very important. Okay, that's it on the pod.com forward slash juice box dexcom.com forward slash juice box links in the show notes links at Juicebox podcast.com. And again, if you're looking for these diabetes pro tip episodes, you can find them they started Episode 210 in your podcast player, where they're available at diabetes, pro tip calm and Juicebox Podcast comm

Jennifer Smith, CDE 28:38
many people have found that if they eat a true cart, let's say they eat an apple and they Bolus for it, they end up with the ratio that they're using for that simple, like very clean carb to go low. Okay, and then when they mix it up, and let's say they have potato chips or something along with the apple or they have something, you know, more processed along with it, their carb count ends up looking clean, like okay, it comes out I don't get low later. So what gives it really is that the body processes more natural food in a better way. There's there's less left over to kind of linger in impact. And a lot of people are basing their insulin to carb ratios, more specifically, around combination meals that are not quite as for lack of a better term clean,

Scott Benner 29:36
right. So your your heavier. Insulin ratios work better if you have the orange with the potato chips, but if you just eat the orange, the orange doesn't need as much insulin so the ratios you have or too heavy. Correct. I now Arden's ratios are heavier because she doesn't you know she eats a diet that has processed foods mixed into it, but she'll go on a kick around this time. If you're about oranges, where I have to buy like 10 pound bags of oranges to keep around the house, and she's like, I want an orange I want like now these are big like softball size oranges that I'm going to

Jennifer Smith, CDE 30:10
cara, Cara oranges. Those are my fav.

Scott Benner 30:12
Yeah, I think they are and they're really good, right? And but I bet you I've never looked, but I bet you that the carb count on them's got to be more like 25 or something like that, like he could be more, right. But I only give her enough insulin for like 11 carbs. And and she does a little 130 rise and comes back again. Because I you know, because I know her ratio is higher to handle other things, which is why you look at plates and go Okay, tonight, I don't need as much, you know, for right. But this is not this is not going to be a satisfying, you know, people just want to hear like, please just tell me what to do. And I'll do it right. So work, but nobody wants to hear. I guess this? I know, I don't like it. You know what I mean? I don't have diabetes, and I'm listening. I was like, Oh, this is how I would lose weight. So you know, it's, um, it's just, do you think that we've just spent so much time as a society looking for marketable sellable ideas about how to get around? The idea of being in shape? There's no, it's, it's exercise and calories. Right.

Jennifer Smith, CDE 31:21
And I think that's the reason that there are so many, I mean, if you look at around the first of the year, there, I can't remember which publication it is. But they come out with an analysis of I think, like the top most, or maybe it's the 25, top most like us call them diets, right, in the past year, and what's kind of proven true to what it promotes and what really isn't, it's kind of like flimsy, right? Um, and some of the top ones are things like the Mediterranean diet. And you know, by no means am I promoting that, or whatever. I'm just saying that that ends up being taught from a lot of different health parameters. And it's also a clean way of eating. Most people think Mediterranean and they think well, lots of breads and lots of starchy things. And that's actually not true. A lot of it is plants, especially the really good non starchy vegetable types of plants. And then if there are grains that are hardier grains, right? I mean, it doesn't tell you to eat your carbs as a bag of Doritos. It tells you to go and eat some keen Wah On your salad with, you know, an orange on the side. Right. But I think it brings in diets. Yeah, this idea that there is the perfect thing out there.

Scott Benner 32:43
Right, right, and that it's going to be doable for somebody because maybe, listen, maybe macro counting, maybe there's a biologist somewhere that could give you the perfect diet for your body. But where am I getting that from? And where are most people getting that I have to tell you that a couple of weeks ago, I started getting an ad, right. And then I looked in the mirror and I was like, My face looks puffy. And I went to the Costco and I bought two little roaster, chickens, and four steaks. I spoke them all, slice them up, put them in the refrigerator, and I've been eating those and salads and some of those oranges because they're around the house. for about the past eight or nine days, I'm easily 10 pounds lighter than I was. And I know that I know, I'm a fluctuating person. Like I know I jumped around like because what'll happen is at some point, someone's going to give me a piece of bread and I'm going to pick Oh my god, bread does everyone remember Fred? And then I'm going to eat a lot of bread for a week and I'm going to go Oh, now my back's deaf. And I feel like I gained five pounds and all that stuff. But just if I explained to you that most of my meals have been like a couple of eggs in the morning, and a couple of tiny slices off of that steak and then at lunch, some some of the chicken and some of the steak with a salad. And I've I feel great and I know it's true, because I've been through it enough now now to talk my stupid childish inside into like just continuing on that way that I don't know if I'm ever gonna get to do but I do know it's honest. And it works for me. And I've seen it work for other people too. Like you take out processed food and carbs. And your your you're better off like I don't know, it just seems obvious. But

Jennifer Smith, CDE 34:16
it's, it's you know, like you said you're not focusing on like macros. You're not focusing on how many do I need in a day? You're what we end up finding and I think this is the premise behind a lot of the like, the Palio kind of diet and the keto type of diet, right. It's, if you're following the rules of those plans pretty well. They can be very clean eating plan. They can. There can also just like being vegetarian can be or vegan can be very healthy way of eating, but they're also like the complete like backside of that where you're eating a lot of processed vegan or like the key You know, like kinds of things that are like the treats and whatnot, you're focusing your intake on a lot of that kind of stuff, you're lacking in quality. And then your macros may very well without you realizing it be completely out of order. And I think that's why a lot of like plans like this end up failing, you know, I followed keto. And it was supposed to be this magic, like weight loss, and I also have diabetes, and it was really supposed to help with my blood sugar management and whatnot, well, I haven't lost any weight, well, maybe there are some things then to evaluate within it, you know, the keto diet is a way to get your body to start utilizing fat instead of carbs. So if you haven't really analyzed how you've broken that down to make sure that you are one maintaining ketosis in the right way. And that the kinds of like carbs that you're eating are really not offsetting, then it may not work well for you,

Scott Benner 36:03
don't you find that you have to be in tune with what your what satisfies your body? Like Not, not what satisfies your brain, right? But what satisfies your body. And I've absolutely, I've seen myself go either way, like where you're just eating for taste and flavor and comfort. And that's never usually good for your body. And then there's a way where you're just sort of never hungry. It's it's that's where I am this week, I have not been hungry this week. And if I had any like inkling towards a sweet, I've been specifically careful to take just like dark chocolate, like just a little bit of dark chocolate like this will this will get me through, like, what I'm assuming is basically withdrawals from flour and sugar and stuff like that, you know? So I don't know, like, are you telling? He's telling me that all these questions aren't even worth looking at? Or should we ask them? No, I

Jennifer Smith, CDE 36:53
think they're very worth looking at, because I think some of them may relate to what we've kind of already gotten into. And then some of them, I think, are really good questions in terms of the why it wouldn't be working. Right what's or why it might actually work. So yeah, let's

Scott Benner 37:12
pick a favorite or should I just pick, you just pick right? Well, so Jennifer's asking about her son, she says any any advice on how to balance all this high carb gluten free food from my growing always hungry, 14 year old T one D with celiac. So she has a son who seems to need blending down and at the same time. She's giving him a lot of carb heavy stuff, because it's like it's some of this. For the celiac diet, it seems like right? The gluten stuff,

Jennifer Smith, CDE 37:43
right? And that's it. I mean, celiac is a hard addition. It definitely is because while we now have a plethora of gluten free, very tasty products on the market, most of them are made with very, very processed very high glycaemic, I mean higher glycaemic than even your wheat based bread, you know, type of pasta, whatever it might be. So when you start processing things, like rice into a flower, or, you know, potato into a flower, you have a quicker digestive component to that, and it raises the blood sugar faster, its glycemic index is just high comparatively. So when you have to do these types of things, especially if you have a teen who is growing, is active, but also could maybe use some slimming down, or maybe needs to gain a bit of weight. One, it's may be sitting down honestly, with a dietitian to see what are my child's growing nutrition needs right now? Are we you know, keeping kind of a log a couple of days of what are they really in taking? And then looking at what their nutrition needs should be for the point in life where they are, you know, are they moderately active? Are they heavily active? Are they kind of couch potato video gamers? What is it and what do they need? And then looking at the kind of food that you put into their caloric need, right, again, I mean, parents are typically the purchasers of the food in the house. Yeah,

Unknown Speaker 39:27
give or take. You don't think this 14 year olds got a credit card?

Jennifer Smith, CDE 39:30
Yeah, no, I mean, and my kids, gosh, I mean, if we walk down the aisles in a grocery store, and they see like, the pretty packages and you know, like, I never got we don't eat cereal, so I don't go down the cereal aisle, but they'll always have something on like an end cap, you know, at the grocery, especially my eight year old, like, boy, that looks really good mom. I'm like yeah, and not really good for your body.

Scott Benner 39:56
That's why they have to make the picture. So nice. Right? There's no fun here, stop it.

Jennifer Smith, CDE 40:04
Well, so I think, you know, from from that standpoint, you have to look at what is the child in need of? Are you meeting it? are you creating access? And then potentially from a gluten free standpoint? Yeah, finding substitutions that can be fit in to meet his tastes, because all kids and teens are different, you know, as much as you want them to eat asparagus, they might not. Yeah, so you know,

Scott Benner 40:29
right. So, so you have to be, it's Listen, I know, if you've been listening for a while, you know that I took me a while to diagnose my low iron thing years ago. And during that a doctor made me eat like, gluten free for a month, and I gained a lot of weight because I went out and bought all these gluten free items. And somehow in my mind, I was like gluten free equals health. That's how it felt to me. So I was like, oh, it felt like zero calorie stuff when I was going in. And man, it was just not. I think if this was me, if Jennifer was me, and I didn't know what I was doing, I think I'd introduce, like, lower carb, more meat friendly, like meals, like that's what would occur to me first, right? Make some chicken, make some steak, put it with a salad or a vegetable, and maybe cut down on carbs. But then you got to remember, like we spoke about earlier, not to dose it as harshly as you would some of this gluten free stuff, or you're just going to create a low and you're and then have what you did buy with them. Right?

Jennifer Smith, CDE 41:27
And I think you know, when we look at, you know, going back to just that, like clean eating idea, quite honestly, you can be gluten free. If you're choosing to not buy as much processed food pretty easily. Yeah, I mean, you know, things like qinhuai, or, like a wild rice, or even like a brown rice, or what, that's 100% gluten free.

Scott Benner 41:52
It's the fun stuff where it causes your problem,

Jennifer Smith, CDE 41:55
right, it's not taking it out of the diet, it's just that you know, and I know the struggle with kids, I work with plenty kids and teens to know that what they get at home, under mom and dad influence because this is what you're eating turns around, it changes considerably once they start to do things with their friends, you know, now gluten free in the picture. If the child is paying attention to that, and knows that they just can't have gluten, they may already then have limitations, even compared to what their friends are eating, because they know that they just can't do it, or they're not going to feel good, right? But in that circumstance, then it kind of takes sitting down and figuring out well what that what will possibly be there that you could have, um, knowing that it's still more of like a process Trini kind of thing, but also that, you know, we're not going to do this at home. But you could have it when you're out.

Scott Benner 42:54
Okay. Laura has a question. It says, Is it true that insulin on board prevents the body from breaking down fat? Meaning that in order to burn fat, you need to have stretches of time with only your Basal insulin and no insulin on board? That's interesting. I've never heard that.

Jennifer Smith, CDE 43:11
Yeah, it is, I guess it's an interesting way to frame it. I mean, we know that in the we know that in the overnight time period, without any food on board. And on basil, only. Our body does get into more of that, like fasting state, right, of actually transitioning to some fat burn, etc. Because you're on a low level of insulin.

Unknown Speaker 43:34
I see what you're saying. Okay.

Jennifer Smith, CDE 43:36
But when you have insulin on board, technically, there's a reason for the insulin on board. Right? Right. You're dosing for food, so that insulin on board should be covering food that is there. So yes, your body's processing carbohydrates. And your body is not at that point then going to be in fat burn mode. It's kind of correct in a way of stating it. Yes. I mean, the same thing for a high blood sugar that you've corrected. Now you've got iob. And the high blood sugar indicates that there's excessive sugar there, and your body needs to process it. And as such, it's using the insulin to process it and break it down and get it in the right places. So again, technically, as long as there's not an insulin deficit in that high blood sugar scenario, and insulin is working to get it down then your body isn't also breaking down fats either. Then is that a vote for intermittent fasting for type ones? It could be and can intermittent fasting work, right? It can. But again, a blanket statement is to stay that any plan that you choose. No longer term that you can continue this, right? The problem with the diets that are out there isn't the diet itself. In fact, there's a lot of research around a lot of the diets that proves long term, these people have had this success in weight management and cardiovascular benefit, etc, etc. But they've stuck with it. Yeah, it is the Oh, I'm going to do intermittent fasting, oh, I'm going to do the keto diet, oh, I'm going to do the, you know, cabbage soup diet for the next month. And once it starts kind of showing benefit, I'm like, I can do I can kind of step outside of the rules, parameters, which are often for diets very black and white. Yes, do this, this and this, but don't do this. And as soon as you do that, don't do this. You've broken the piece of that plan. That was getting you to your goal,

Scott Benner 45:52
right. I found intermittent fasting, the easiest to stick with, because to me what it was was as long as I don't eat, like don't eat after ate, and don't eat before noon. That is basically how I did it. And I have to admit, it's very effective. Now, I realized while I was doing it, that Arden basically does that already, without the late night thing. But she's so young, I don't think it matters, right. But she gets up in the morning and is not normally hungry in the morning. And so I've had to over time thoughtfully balance out how her insulin works in the morning, right? How do I come out of sleep into feet on the floor, off to school without a rise that needs a bunch of insulin so that I don't create a low because she really doesn't want to eat until she's done with school or till lunchtime, right? Sure. So basically, Arden does intermittent fast, except she doesn't do 16 is it 16 wait 1819 2016 eight, that was embarrassing. A lot of people would edit that out, but I'm not going to. She doesn't do 16 eight and as much as she probably does, like, maybe 1410 something like that. But also she's 16 so she can write you know, she can like we over Bolus her meal last night for dinner. We had stuffed peppers, like Turkey stuffed peppers, and, and a salad. And my wife, my wife, like swung at it really hard. And about a half hour after she ate I was like, Hey, your blood sugar is like stuck at seven. I was like I This doesn't look okay to me. Like I think this is gonna go the wrong way. You know. And so as it started to trend away, Arden got a little light in her eye and she goes cinnamon toast crunch, please. So she knew she had basically Pre-Bolus cereals. So she was like, let's do it. And she had some of that have my wife go on. I'm gonna guess 10 or 15 carbs less on the Bolus. She hit it right on she was so close. But But you know, that's a young kid. And Arden's also helped by other things that I think are worth mentioning here too. Because those of you listening have type one diabetes, or love somebody who does, you really have to get your thyroid levels checked. Like you could be fighting against a borderline thyroid problem that's making weight loss impossible. You know, and you if you're going to do that you really need to go back and listen to the thyroid episode with Dr. Benito because the range that your doctor is gonna say your thyroid your TSH levels, okay, and a real badass endocrinologist will not accept you know, they mean they will not like if you're over a two Doctor beanitos giving you thyroid hormone like and there are people right now we're listening. You're like oh, my TSH is a five my doctor said it's okay. I'm borderline. Yeah, yeah, right. But I but my hair does fall out a little bit or I'm having trouble losing weight or I'm a little nasty sometimes or whatever the other things come. But I'm just telling you if your thyroids moving the wrong way, deal with it, because it makes a lot of life easier.

Jennifer Smith, CDE 48:56
And it's a lot within this whole topic of weight management. Absolutely. If you've the Hashi moto is which is very common autoimmune. Once you've got you know, type one, it's good to get tested thyroid levels at least once a year if not every six months, especially if you've got other family who has a thyroid disorder known already. But that's huge in terms of metabolic

Scott Benner 49:20
Yeah, but you have to you have to advocate for yourself. You can't say oh my god, Scott, you're right. I am tired all the time and I can't lose weight and blah blah blah, and then go to the doctor and the doctor say Oh your TSH is four you're fine your TSH just for you are not fine. That's the equivalent That to me is the thyroid equivalent of in diabetes. When somebody says yeah, your blood sugar, your average blood sugar is 180 You're doing great. Right? Right. You might you know you're not dying, but you you're not living at a healthy level. And that has other impacts on your life. This thyroid thing is it is crazy. It is like the equivalent you trust me at this point. I've seen everyone in my family except for me deal with it. It's like taking a long metal like paper. clip and just touching it on a computer circuit board. It just messes with stuff, you know what I mean? Yeah, but,

Jennifer Smith, CDE 50:06
and with with Ardennes doses, have you noticed that when things get out of order, do you notice a shift in her insulin need, because that's very common right away that, you know, metabolically, she's feeling more sluggish, sluggish and fatigued. And insulin is just not working, like it was supposed to work. And if there's a timeframe in terms of adjustment, or even just starting on a thyroid medication, where you will then start to notice a shift back to normal insulin dosing. See, again, that insulin manipulation in terms of the weight management piece with thyroid in the picture, you have to be very kind of eyes on right to make sure that you're adjusting then where you had bumped everything up in terms of insulin need, you're going to need to start bumping down. And if there's weight loss in the picture at the same time, definite need to bump down or you're gonna just run lows. Yeah,

Scott Benner 51:01
I there's something I use, I think I should even have a flowchart for myself like If This Then That kind of chart because you're right. If the thyroid level starts to get away, then her insulin needs go up. And then we adjusted, it doesn't happen right away, and our insulin needs start coming back down again, the same thing with she had to start a birth control pill to regulate her periods. Hall. I lost three months of my life to figuring that out. Like it was just first they gave her a pill with not enough estrogen in it. So it was basically just two wasted months. She was exhausted all the time because she was bleeding constantly. So I had to get her through those pills. Those aren't the right pills put her on the right pill that started working the bleeding, regulated. Yay. Now she's lost so much blood, I had to go get her an iron infusion. Got her the iron infusion. Now we're waiting for that to come back up. When the iron infusion comes on board, her insulin needs are gonna change again. Yeah, vitamin D levels seem to impact insulin knee. Yes.

I just,

Jennifer Smith, CDE 52:05
in fact, many people for vitamin D that you bring it up. That's another like piece. And I think in terms of like, like, again, going down the rabbit hole of discussion and weight management, the we're kind of on the track of like medications, and medications in terms of thyroid, as well as things like iron. But vitamin D, you know, your lab will tell you optimal is between or standard is 30 to 100 optimal according to the female specific physician that I'd worked with years ago, before I had my first son, she was like, you know, optimal range is really 50 to 70. For vitamin D, she's like, and if it is not in there, you need to be being supplemented, because otherwise, especially with diabetes, vitamin D works on the cellular level. And it allows insulin to be seen correctly, it for lack of a better term by the cells. And so it lets insulin actually work the way that it's meant to have one of the many things that can so if your vitamin D level is off, supplement, I mean, in general, someone with type one, adult wise, should be supplementing at least 2000 I use a day. And if your levels are not optimized at least 4000 a day. And if they're really on the low end, you need to be doing like the hyper significant doses of vitamin D for a short period of time, if you

Scott Benner 53:30
like. And then for 50,000, I use and you take one once a week or something like

Jennifer Smith, CDE 53:34
once a week, or I've even seen some doctors do like 110 1000 iu a day for you know, a couple of weeks and then retest. But vitamin D is huge.

Scott Benner 53:43
And I'm not a doctor, but there's something about vitamin D deficiency and autoimmune that go hand in hand. So just look

Jennifer Smith, CDE 53:50
at the studies out of Finland,

Scott Benner 53:52
right? I listen, I take 5000 a day. And I take 5000 a day of vitamin D, I take a zinc tablet, I taken a sorbic acid with iron and a B 12. And that's that's what I do every day. And that's what you know, my kids do and and everyone here is doing because when the D levels drop again, problems with insulin, I'll tell you right now too, because Jenny mentioned ranges that you need to be in versus what lab values will tell you, Dr. Benito back on the thyroid things that if you were a woman of childbearing years, anything under 74, your ferritin is too low. And they're not going to tell you you're low till 20. So she's like if you are having a period, he gotta be above 70. And so there's a lot of things. And then all of these things also impact your body's ability to work correctly, which is in part and parcel of losing weight or

Jennifer Smith, CDE 54:50
losing weight, right. There was one in here that does go along with medications that I think is a really important question. This woman has a son on a medication that is more for like attention. And it's specific to using it versus not using it school year versus spring date break or summer time and what ends up happening in terms of insulin needs. And I think it's an important one, because I've seen a lot of kids who are using a DD ADHD kinds of meds. And a very, very common thing with those is that it decreases appetite. Okay. And if they're using it in their school day, and they're also the brain uses carbs. And so the more thinking that's going on, and the potential that they're really not hungry, they may not even finish the lunch that you packed for them, they may pick at the lunch that comes from the school lunch, because their brain is just saying, I'm not hungry enough to eat, you may end up having to have two types of basil profiles, maybe one for like a spring break, time off another one for school days. And again, as kids get more into the teen years, that becomes really beneficial in terms of growth and the potential for weight gain in the wrong direction. Because if you're constantly feeding loads again, or constantly adjusting insulin up and down, but it's kind of willy nilly and not quite right on with need. It's a medication adjustment kind of thing that goes along with adjusting insulin

Scott Benner 56:31
again. We're right up on it. But there's enough questions in here that all circle around menopause. Do you have any feelings about what happens at that time? And

Unknown Speaker 56:41
yeah,

Unknown Speaker 56:42
that's a fun one.

Jennifer Smith, CDE 56:45
I mean, in general menopause in and of itself. I mean, perimenopause really is the start of kind of that time period in a woman's life where your cycles might start to get less evenly spaced, right, let's say you were the typical, like, 29 days, and you was right on spot. And now like, Huh, now it's like 26 days and next month, and might be 32 days, and that may be 29 days. And, you know, periods can get a little bit more aggressive, or kind of look more spotty. But that perimenopause kind of leading into menopause, which is really, a woman has not had a cycle in a 12 month time period. Right. So insulin needs can look very jumpy, you might even find that, again, as we get older. And these things come into the picture from a female perspective, our metabolism does slow down, we oftentimes start to need a little bit more insulin, or it takes a little bit more activity to maintain or burn off what we were able to do when we were 30. That doesn't work anymore when you're 45 or 50. So a menopause, perimenopause, it brings in a whole circle of hormone impact, right, that may more aggressively change your insulin needs, especially around your cycle times.

Scott Benner 58:10
So not unlike, well, I guess, more aggressive but not unlike having your period and seeing right hormone fluctuations throughout the month,

Jennifer Smith, CDE 58:19
right. And then once you're in menopause, oftentimes, you know, outwards of a year or two post no longer having a cycle. Many times, then insulin levels should get more stable, because you don't have that hormone flux. And as we age men and women have less and less and less growth hormone cycling anyway. And so we end up especially women passed about the age of 65, or people passed about the age of 65. Oftentimes, their baseline Basal needs definitely go down. And the reason there is because their hormone cycling has kind of started dropping off. Okay.

Scott Benner 59:01
All right. Did we do this justice in an hour? Because I feel like we did, but I don't know much.

Jennifer Smith, CDE 59:06
I think that we did as much as we could get it in an hour. I mean, if we really wanted to focus in again, dig really deep into that information hole. There's a whole bunch about meds that are very specific to like weight loss, and you know, things like the GLP ones and things like the stlt tos and what despite them being type two meds, they are getting a lot more. They're kind of climbing on the ladder of benefit for those with type one and who are just insulin users. And they do have promise in terms of weight management, if use the correct way.

Unknown Speaker 59:51
Okay, so

Scott Benner 59:53
do you feel comfortable talking about that? Because maybe you say here that if you like this episode, look for that one coming in? Yeah. Okay. Great, thank you. Yeah, Jenny, you have to do all the talking. I was at some points. uncomfortable. Not for because he was like, Huh, there's not a lot for me to do here. I was just checking. I was just saving files and checking rates and looking at questions I

Jennifer Smith, CDE 1:00:18
was like, so like, I should have just gone and gotten an extra cup of tea.

Scott Benner 1:00:21
kind of nice. I should have just said, Jenny, tell me about weight loss. I'll be back.

Jennifer Smith, CDE 1:00:26
Really is I was looking at all the questions. I mean, there are a lot of really good questions, but I think a lot of them honestly. Go back to insulin. Yeah. dosing it the right way for what you're kind of taking in. And then also, secondly, looking at what are you taking in,

Scott Benner 1:00:45
right? And obviously, in my mind, these questions all are, they're similar, they're tied together, whether it's vitamins, or your thyroid level, or your calories or, or whatever it ends up being, there is a balance that optimizes your body, it's not going to be the same for everybody, some people's vitamin D level can be crashy load to the floor, and they'll never notice it, and it won't matter to them. But for some people it does. And when you get those things in the right balance, then you feel better and feeling better. To me, as you feel stronger, you're more rested, like all this stuff happens. You're clear in your mind. But how. But some of these things nobody would even know to look into. No, you know, even vitamin D like I can remember 10 years ago, my ardens nurse practitioner gone, we're gonna start checking vitamin D was almost like a mandate came down from a mountain, you know what I mean?

Jennifer Smith, CDE 1:01:35
Yeah, actually, I don't even know when that would have been. But if it wasn't, I remember when I was working in DC, and the endo practice I worked with within the, our director was very, like high up within the whole, like, diabetes management, like realm of information. And his he was like, we are testing vitamin D levels for every person with diabetes. And at that point, it was really just, if the thought was it was relevant more to type two. But as we started testing, then I went to my own end to when I was like, you know, I run I'm outside all the time. I have, like, you know, like brown skin from being outside. Like, I don't take my, I'm like, I'm sure it's fine. In fact, my vitamin D level came back and my doctor himself called me, not his nurse. He was like, this is really weird. But he's like, I want you to go and get it tested again. He's like, this can't be right. And my level was 18. Yeah. 18. And so when it got to test again, nope, it was 18. Again, he was like he did he that was the one time a week the 50,000 I use, I came back in eight weeks, it had moved to 21. And he was like, Huh, so I he sent me to see like a naturopath, who was also a physician who knew a little bit more in that realm. And she actually had me started, she started me on oral drops, okay, and the drops get absorbed through your oral mucosa rather than having to go through your gut. And because we know there's a lot in terms of gut and absorption in autoimmune disorders, she's like, I guarantee your body's not absorbing it. She said that's the problem. And is within about I think it was 10 weeks after that I got it retested and was already up in the high 40s. Yeah,

Scott Benner 1:03:25
you know, I have to, I thought I was gonna have to live getting iron infusions my whole life, because I couldn't absorb it through my gut. And I do probably have some like weird stuff going on down there. And instead, I mix it. So first of all, I use a really pure like supplement from a company that you know, you can do your own research and find one that you like for yourself, but I researched out found a really pure supplement. And I have to take the iron within a sorbic acid at the same time. I do that it absorbs great if I take just the iron tablet without the sorbic acid won't won't work. Yeah, that's it. There's a over the counter when called via Tron or by Tron D or something like that. It's it's iron that comes with it. C, Vitamin C. Okay, gather that helps that too. But yeah, these are the kinds of things no one's going to tell you about. Or they're just gonna blurt out. We're testing for vitamin D Now, then you come back, quote, unquote, in range, and they don't give you one anyway. And you're like, wow, this was a lot of fun. So anyway, everybody balanced your body, balance your insulin. things should get better. That makes sense. All right. Thank you, Jenny.

Jennifer Smith, CDE 1:04:30
Yeah, you're welcome. Absolutely.

Scott Benner 1:04:38
Let me thank Dexcom and Omni pod for sponsoring this episode of the Juicebox Podcast. I'd also of course like to thank Jenny, you know, Jenny works for integrated diabetes. So if you want to learn more about what she does for a living, you could even hire her. You go to integrated diabetes comm I think there's even a link in the show notes to email Jenny, but I don't remember I haven't looked in a while. You'll find out, just go route around, see what you can say? Would you like to see if you're eligible for a free 30 day trial of the Omni pod dash, go to Omni pod.com forward slash juice box. And of course, to learn more about the Dexcom g six and to get started, it's dexcom.com forward slash juice box there are links in your show notes, links at Juicebox Podcast comm or you can just type those right into a browser. Since we're at the end, and you're still here, let me tell you a little more about the diabetes pro tip series. First, I'm going to read you a couple of reviews, all from Apple podcasts, this podcast that changed my life, I had a desire to lower my agency and manage my blood sugar's better, but was going at it blindly finding this podcast put everything into a tangible and practical management approach that is taken my agency from 8.3 to 6.3 in less than six months. And that's just right now, it's going to keep coming down. Thank you, Scott, I'll be quoting you forever. My son was diagnosed with type one about five months ago. And I've learned so much from just the pro tip shows and we'll be listening to all of the episodes. This podcast is amazing both for the information and for the shared experiences from Scott and his guests that make you feel less like you just got hit in the face with a shovel. And more like you can find ways of keeping your loved ones happy and healthy. And finally, I saw I mentioned this podcast and one of the Dexcom g six groups on Facebook. The pro tip series is filled with such great information. Thank you. For someone who has been living with diabetes for 30 plus years. I wish I had been more proactive in finding the information sooner. I'm going to recommend this to my endocrinologist. So that's a little bit about the diabetes pro tip series and the podcast from other people. You can just subscribe right now in a podcast player just hit subscribe if you're there, and you can listen to the podcast every week, three new episodes every week. If you don't know how to find a podcast player, there's tons of links to free ones at Juicebox Podcast comm where if you want to start with those diabetes pro tip episodes, or in my opinion, I like seeing you start with the defining diabetes episodes which are much shorter, and give you a good basis for all the terminology means and how to use it. All that information is at diabetes pro tip comm you can get there just by typing that into a browser. Or if you go to Juicebox Podcast comm there are links to the top one of those links as diabetes pro tip. start listening. I mean, wouldn't you love to send a review and that says my agency went from eight three to six three in less than six months would be amazing. So I hope you keep listening. I hope you enjoy the podcast. Thank you so much for checking out this episode. Please share the podcast with a friend. And don't forget to subscribe. Thank you so much. I'll be back soon with more episodes of the Juicebox Podcast.

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#469 Week 19

Lisa discusses her son’s life with type 1 diabetes.

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

+ Click for EPISODE TRANSCRIPT

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

Scott Benner 0:00
Hello friends and welcome to Episode 469 of the Juicebox Podcast.

On today's show, Lisa is going to visit us all the way from Sweden and tell us a rather remarkable story about her son, who among other things, has type one diabetes.

While you're listening today, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan, or becoming bold with insulin.

If you're here looking for the diabetes pro tip episodes, they begin at Episode 210 and are also listed at Juicebox Podcast comm you just go to the top and click on diabetes pro tip or you can go to diabetes pro tip.com. But I wouldn't do that until after you hear this conversation with Lisa, because I think you're going to love it.

This episode of The Juicebox Podcast is sponsored today by the Omnipod tubeless insulin pump. By the Dexcom g six continuous glucose monitor and touched by type one you can find touched by type one on Facebook or Instagram were touched by type one.org. You can learn more about the possibility of a free 30 day trial of the Omni pod dash tubeless insulin pump at Omni pod comm forward slash juice box. And you can get started today with the Dexcom g six continuous glucose monitor@dexcom.com forward slash juicebox. There are links in the show notes of your podcast player and links at Juicebox podcast.com.

Lisa 2:16
My name is Lisa and I live in Sweden. And I probably don't sound so Swedish. And that's because I was raised in Northern California.

Scott Benner 2:25
I was gonna say your middle name, which I'm assuming is your maiden name. Is that is that your is?

Unknown Speaker 2:31
Oh, that's that's a long story.

Unknown Speaker 2:34
Like we don't have time for that, buddy.

Lisa 2:37
We don't have time for that one. But you're correct. My my. My second name is the name in Sweden, right? My Swedish married name correct. And I am I've lived in Sweden since 1988. I came here with a tech company and I have two boys and a husband and boy dogs. So maybe four boys and I am the mother to a 15 year old who was diagnosed with Type One Diabetes 11 months ago.

Scott Benner 3:09
Okay, so within this year, correct, gotcha. Okay, so within a calendar year, your 15 year old was diagnosed. Was that out of the blue? is there other? It was okay. You've I have some background here on you, which I you know, I'm just happy to tell people that I'm looking at and I think we should probably just pick slowly through everything I'm seeing here is your type one's life. Right? Correct. Okay, so did the issues begin? Before he was even born? How did that? Yes.

Lisa 3:44
So the second ultrasound week 19 showed a fluid filled cysts in the abdomen of the baby I was carrying. And so that's when it all started was week 19 of the pregnancy and it was some quite severe damage to the intestinal area, primarily the liver and the intestine. So they took him out early and did nine hours of surgery actually. The surgeons actually said they had to lay him on the table and call Japan to get some help so so he's kind of a miracle. And it's just kind of been a long story since then. I want to start off by saying he's a great joy and I call him my sunshine. He's very happy and great young, young person. But he has medical issues in his abdomen, so that would include liver intestines, and now even kidneys. He has we did some investigations. I didn't really know what was happening. And I did suspect maybe behavioral disorder autism spectrum, but it turned out to be a severe hearing loss and then also a mild to moderate cognitive disability, which the two together kind of mimic, he didn't hear what we were saying and didn't know what to do about it. And then some motors, motor impairment, and then 11 months ago with diabetes diagnosis from nowhere, do you. Okay,

Scott Benner 5:33
I have a couple of questions. Yeah. One of them's just gonna sound silly. And I don't mean to, but after the surgery, they don't put them back, right. You know, when you're making a cake, sometimes you need some work, and then you put it back in. But it wasn't like that, right? No, no. So he,

Lisa 5:52
they did they did this is arion, five weeks early. So we tried to manage it in utero. And I had really great medical care. Of course, again, I'm living in Sweden, and living near the capital of Stockholm, right outside, actually. And so really the highest quality medical universities and kind of in Northern Europe and maybe around the world, or 10 minutes from my house with both pediatric care and even like the diabetes care now and all the specialists and even when I was pregnant with him, so yeah, so I was really fortunate to live where I live, what's happening.

Scott Benner 6:35
So he, they perform this nine hour surgery, he's in an incubator for a while, I imagine.

Lisa 6:41
Um, yeah. He was in intensive care for a while. And then we that did the hospital for we came home to visit for the first time after about five weeks. And my father had come over from California to stay in our home with our older child who was turning four at the time.

Scott Benner 7:09
Gotcha. See, Lisa, if you're gonna know what I'm going to ask you before I asked you, then you can just get I get, I'm gonna go have breakfast.

Unknown Speaker 7:15
And you can tell me,

Scott Benner 7:16
I'm just getting ready to be like, How old were your other kids? And were they Yeah. But but so you lived in the hospital for weeks upon weeks? And then he came home eventually with you? Or you will when he's

Lisa 7:28
a kid? No, no, they never separate parents and children here, so and so we were put up there, they have parent apartments and in the Children's Hospital here, so we lived there. And we came home with him briefly for a visit just he was maybe five or six weeks after his birth, and then kind of back and forth. And then he got really sick at home. Another long story. Another long story, but he he got something called necrotizing enterocolitis. You guys call it neck NAC which is basically it can cause sepsis in the body. And so we had to go back in the hospital for quite a long time to try to see if he could repair that through not eating. So he was on IV foods for a while. So we were we were in and out with multiple surgeries and, and and attention for the first you know, year. And then he was Yeah, and then he was going blue at home. So I was given a mouth to mouth when we came home. So again, it's a lot of life and death early on. For us with him.

Scott Benner 8:43
Yeah, what is? Do you feel like you're a completely different person now than you were a year ago? Did you know so many things that you didn't know, prior? Like, how does it impact you? I guess.

Lisa 8:56
So I think that for me personally, you know, sometimes when you go through traumas, and you know heartbreaks and challenges in your life, or, you know, you you're impacted by them, and I had worked really hard to heal from some of those. I mean, I've had a lot of support through our medical system here with therapy. And I think when, when, when we get hit with the diabetes diagnosis, it sure didn't take much to crack the egg, if you know what I mean it I think I don't know whether I took it harder or easier than somebody who had never had a trauma before with a child. But we had gone through so much and we had worked so hard to you know, to get him healthy and to adjust our life and to give him all the tools and resources. I mean, even for the cognitive side and the hearing side and special schools and we really we're getting somewhere and then to have this hit us the last the last 11 has, I think in some ways tougher than the first time we went through the medical challenges? Well, you've listed a number of things, I think any of which, on their own would be

Scott Benner 10:14
a significant hill to climb, you know, and then there's just one on top of it. Other ones have another do each of these. And I'm assuming, like, each of these things, when they need attention from a physician, it's a, it's a separate visit somewhere, like is much of your time spent. Seeing doctors.

Lisa 10:35
Yeah, that's a really astute kind of understanding that you get that I don't think a lot of people do understand is that when you have so many very rare issues to deal with, and such a number of them, and there's no known profile, then yeah, they're there. Everything's pretty separate. I mean, and and what it does on top of it is that a lot it, it makes the responsibility for keeping it all together on me and on our family. So I'll give me an example. And I might be getting ahead of this. But we had for the first time ever, an infection at a pump site last week. And I, of course, who do you contact for an infection in the pump site, and I sort through all these Facebook groups and internet forums, and I think, okay, it's our primary doctor. So I contacted our primary family doctor, and and she said, Well, maybe you should contact the diabetes nursery or doctor, and then if they think it's okay, all right out the antibiotic. And then I remembered, oh, gosh, antibiotics deliver specialists, they don't want us to give them these three antibiotics. But this one's okay. And in the end, I had to take the responsibility to tell our doctor, I want you to write out the prescription and the weekends coming, it was actually just a few days ago. And if it gets worse, I'm going to give it to them. But if not, I'm not going to so a lot of the responsibility ends up being here at home with us. Yeah,

Scott Benner 12:12
I would imagine that each of these things is sort of like diabetes, in that they give you some information, and then you have to make on the fly adjustments with it. And I just was thinking about the, you know, I mean, we're trying to manage our way through things with Arden that are obviously not nearly as significant or severe as what you're talking about, in many cases here. But it's one doctor over here, you know, and one doctor over here, and then the third one in the middle, and they don't really talk to each other, they'll send like their notes to each other. But you know, I don't know what that means. Exactly. And then, you know, at some point, like they give you some kind of marching orders. And then the rest of it, it's inferred. It never gets said out loud. But it's always like, okay, you take care of this, figure out what you're seeing and report back to me. And then we'll take the next step, which which heartbreakingly is often not the step that gets you to where you want to be. It's, it's like, I don't know, it's like, you're absolutely in the dark, and someone throws a flashlight on the floor, and you're just feeling around one hand printed at a time trying to figure out where the flashlight is, and and then you find it, the batteries don't work is to

Lisa 13:26
figure out what's causing what's causing the symptom or what's causing this not to work the way it should work. And, and it's, it's like a medical mystery every day. And then, you know, you said something smart about, it might be like diabetes. And I would say that diabetes is today's management of diabetes and how we're managing diabetes with the CGM and the pump and the data and, and the knowledge. It's actually quite unique. I would say the other conditions that we deal with are maybe like how diabetes was managed. Before CGM. So we're kind of blind as to how is this medicine helping the health of his liver? Like I can't I can't track that every five minutes at home. So. So diabetes is somewhat unique with with what we have now.

Scott Benner 14:16
There's so many like user tools that don't exist with other issues. Yeah, right. Do you see a lot of ghosts meaning while you're trying to figure things out, you find yourself I find sometimes that I spend three, four or five weeks chasing down a thing and you get to the end, you're like, oh, that was nothing. And you're just like, Oh, my God. And then I do this. I here's something I end up doing, and I'll ask you about it. Sometimes I just reset for a minute. Me personally, I stopped thinking about it, even though we haven't found the answer. And then that makes me feel guilty.

Unknown Speaker 14:55
Yeah,

Lisa 14:56
yeah. I am so honored. On top of the diabetes management that I ended up in, in the cardiac intensive three weeks after his diagnosis, so I'm chasing, I thought I could control an uncontrollable disease because I was used to being able to control math. And I work in in medical technology products. And so I put myself in the hospital with no underlying cardiac conditions. So I, you know, at a pretty young age in pretty good shape and, and so now, what you say is, as I'm chasing what's going on, I am getting better right now is 11 months in, I am sometimes saying, screw it, I'm going to bed now. Like, I'm going to live with that value. For now, you know, I just like so I'm getting better kind of saying, you just also have to live through this.

Scott Benner 15:57
We say your special kind of type A, aren't you?

Lisa 16:01
When it comes to math? Yeah. I mean, when it comes when it comes to algorithms, and I mean, that's, that's my background. And so watching trends and seeing curves, and, you know, the sugar surfing protocols, and all those types of things. And that's really interesting to me if it wasn't my kid that's like, this is like my dream job is being an artificial pancreas.

Scott Benner 16:23
Yeah, until it's for your kids. And it's not my kid. Yeah. No, I You should hear me talk to people privately. I'm so loose. I'm just like, do that. Try this. Why don't you do that? Why just think that they're like, what I'm like, No, there's part of me, that's just trying to imply that you have to chill out a little bit, you know, because it just isn't going to come together as quickly as you want it to end when you get so tight. And I think to micro you know, with your vision, then you miss other things that are happening that are valuable, you're always kind of hitting yourself hard saying, Oh, I messed this up, or I didn't figure something out or something happened again, that went wrong. It's too much for a person to take. You really, you really can't do you can't sustain it. I mean, you didn't make it three months, it sounds like

Lisa 17:13
no three weeks, I ended up in the hospital three and a half weeks after the diagnosis. And it's called the takotsubo. It's a stress induced heart failure. So there's so many the adrenaline and the cortisone and they're called catecholamines. In the body, it was a surge of stress hormones, and it basically paralyzed my left ventricle. And it's a rare condition. And you know, typically it happens people that have been married for 60 years, and they're both on their deathbed holding each other hands and one passes away, and then the other passes away, like 10 minutes later, right? That's generally when a takotsubo happens. That's in general, when people get them,

Scott Benner 17:55
we start to tell people not to marry men from Sweden, is this.

Lisa 18:01
What I want to go back to you said about you telling people like, try this and try that. And I, I think that's really what made a difference for me, Scott, is I that that I want to go back to that because I want to tell you what your podcast and that attitude did for me. But before I do, so, do you think we start out like that, because the medical professionals scare us into not daring to take take testing. And to like, try out things? Do you? Have you thought about that? I mean,

Scott Benner 18:36
have I thought about it? I've thought about it a lot. I I find myself wondering if it isn't just the nature of people to want to follow a rule or to be on a team. You know, I'm team low carb I'm team you know, keto, I do vegan. I you know, we love the I pump pumping is very important. Oh, no. MDI, like, everyone's got it. They want to be on a team, right? Like having a jersey on makes you feel good, because then there's other people, and you're not alone, this whole thing. But then there's the rules. The rules are the rules. People want there to be rules. And if you really step back and really look at society in general, there aren't many rules beyond a couple, right? Like, you know, you don't treat people poorly, you don't kill people hurt people steal things. You know, that's pretty much it right? The rest of it's just common sense and calm. And when you think your life is moving the way that it's supposed to you stay calm. And you follow these couple of basic rules. And for the most part, things work out about the way you expect. And that's what people seem to be able to handle and you throw them into this. This medical situation where nothing they're seeing is making sense and they want the rules. so badly. So then the doctors give you the rules.

Lisa 20:02
And the doctor in this society is not to be questioned often by people or they feel that they don't have the knowledge necessary to question the doctor. Whereas we're the ones that know our children and ourselves the best. And that's what I learned through all the other challenges all the other medical challenges over the past 1516 years is, I have always questioned what the doctor says.

Scott Benner 20:29
And when people do find time to challenge like they, they kind of get the nerve to challenge something very frequently, at least in this space. As far as I can tell, they pick the wrong hills to die on, they challenge the wrong things, they, because they're seeing, they're seeing so many ghosts in their diabetes care, they can't make sense of everything.

Lisa 20:51
I want to give you an example.

Scott Benner 20:53
I had one, but I want to hear you.

Lisa 20:55
Because I so I learned to be aggressive and bold with insulin, you know, through the podcast tonight. And I and I back it up with math. And so I feel, you know, quite confident in what I'm trying to do. And I generally take like a concrete situation. And I'll like back it up, for example, in the evenings when our son falls asleep, we fight rises, and I've come to determine it's a combination of growth hormones, and also late digestion of dinner. He's a huge eater. I mean, he he eats massive amounts of food every day. And so I was trying to adjust, you know, that from 9pm to midnight type timeframe and am I don't ask for much help from the Diabetes Center. And but I really wanted to get aggressive and I thought, Oh, can I really do that? Like I wanted to almost like double his basil, you know, those three hours and, and I called the nurse. And I literally shocked her because I said, I think I want to double his basil rate for three hours. And she says, Oh, well, we we recommend only doing 10% changes at a time and then waiting three days. And I was like, Thank you Bye, click.

Scott Benner 22:05
So the thing that I most frequently say to people that that they just can't wrap their head around is here's the scenario right? There, Basil is too low, they don't know it. And they miss on their meal insulin, so their blood sugar shoot up. So they have a lot of spikes a lot of highs then later they crash low. And then they put in food and they spike and they're on this, you know, it's never ending. It's a roller coaster. And so I'll get ahold of somebody and say, there's like we haven't, we're having a lot of lows, what would you do here? And I say you need more basil. And so now I've said more insulin, right? And they're like, No, no, like, it can't possibly be more insulin because the blood sugar keeps getting low. And that would indicate too much insulin. I'm like, no, that indicates poorly timed insulin. And that now your three steps into this situation. And I haven't said this on the podcast a lot. But you get much more past three levels of thinking. And you begin to lose people. There's there's a lot of balls up in the air. And you have to remember how they're all impacting each other. And I'm not saying that you could put me into a different scenario. And I'd be some great thinker. I'm just telling you that around diabetes, I can see all the balls up in the air like diabetes, to me feels like the end of the matrix. When Kiana figures out how to slow the bullets down.

Lisa 23:33
Yeah, and your daughter is very fortunate to have someone who gets that and I feel the same way about our son. But what I often feel is I feel so bad for those kids who have parents that don't understand the all of these complex factors together and they're getting this very traditional direction from their diabetes, you know, resources on I just, I see these curves. I know I've heard you before Scott, you're like, oh, man, I just couldn't not say anything. Like when you see something and you're, you're like, I just couldn't not say anything. And I don't ever say anything to anybody because I don't have the energy to spare beyond brushing my teeth right now.

Scott Benner 24:21
Are you sure you would get the tacos to be again, or whatever it's called?

Unknown Speaker 24:25
Yeah.

Lisa 24:27
Do you know that's the Japanese name for a device they use in Japan for catching octopuses. It's the shape of this almost like a it's like a vase. It's like a it's an octopus catcher. It's called a takotsubo. And it's the shape that the heart gets when it has this left ventricle failure.

Scott Benner 24:46
Okay, so at some point, a doctor saw this on an image and thought that it looks like the thing that catches the octopus.

Lisa 24:52
I mean, whoever that was, must have been catching some octopus.

Scott Benner 24:57
So I don't want to get away from what you're saying. And I have something I want to get by as well, but first of all it a long time ago, I came, you know, to the conclusion, as we all probably should, that you cannot just go out into the world and fix everybody or help everybody and is really sad to see someone struggling and walk away. And I will tell you that for me, it feels like, it feels like I came up on a car accident. And I could get them out. But I just decide not to. And I leave. And so when I say you

Lisa 25:30
wait for the paramedics to get there, and then you leave

Scott Benner 25:32
well, but but the point is, is that I wouldn't leave a car accident, but at some point, with my life being intersected with social media, which by the way, I don't particularly enjoy. And and somebody new comes every five minutes, and I look and I think I could fix that. And I don't have time. And and

Lisa 25:53
around the corner last night and there was this old man in a wheelchair outside and he and he was like trying to push himself up a hill. And I said to my husband, oh, I want to get out and push him. And he looked at me like I was crazy. I said, I want to get out and push him and he said Lisa, you know, you can't get out and push every single person that goes by in a wheelchair.

Scott Benner 26:12
Yeah, your life, your life would literally become about constantly about other people. And, and so listen to me this podcast, if I'm wrong, I'm wrong. But I think if you listen to this podcast, you'll understand how to take care of diabetes when it's over.

Lisa 26:26
I totally agree with you, Scott. And if you can actually take it in, I mean, sure. But yeah, I agree. And it changed it for me too. You know, it did, I had I had read in the hospital, we were only in the hospital two days with the diagnosis and I had already read through the whole sugar surfing, you know, website and I had ordered things like a pancreas and pumping insulin. And then I just met, you know, just child through all of that ended up in the hospital and started listening to the podcast. And, and as I was afraid this, you know, around three, four or five months into it, when I had this horrible fear. You really changed it I you know, I you really made me feel bold. So thanks.

Scott Benner 27:20
If you're interested in the insulin pump that my daughter has been wearing for ever since she was four years old, or the glucose monitor that she's been wearing for ever, since she was six, maybe a long time, then you're gonna want to know about the Omnipod tubeless insulin pump, and the Dexcom g six continuous glucose monitor. Let's start with the Dexcom. The Dexcom g six is a glucose monitor that gives you readings and data in real time. You can get them on a receiver or right there on your iPhone or Android phone. This is beyond exciting. And if you're not excited by it, then you don't understand what it does. Try to imagine seeing your or a loved one's blood sugar in real time. And not just the number not just she's 89 or 53 or 120. But what direction is that blood sugar moving? Or is it stable? And if it's moving in a direction? How quickly is it moving? That's the kind of information that is next level. That's how you make ninja level decisions about using insulin and type one diabetes. At least that's how I do it. And I think you could check it out@dexcom.com forward slash juice box. You can get started right there or just getting more information but one way or the other. You need to start looking. I just opened my phone. My daughter's blood sugar is 104. There's a little boy named Dominic. I'm watching his blood sugar today. This is 106 both are stable. not crazy. You could do that too. You could do it for a husband and a wife, a friend, mother, a daughter, a son, anybody you care about. Think about the possibilities. A school nurse could watch if you want it or not. It's completely up to you. And how do we give my daughter the insulin that made that 104 blood sugar? Well, we do it through the Omni pod tubeless insulin pump. It is tube less. I know that might be like if you don't have a pump right now like does that matter? But it does. Other pumps have tubing. So there's an infusion set on other pumps that goes into your skin followed by a long tube that has to snake through your clothing or whatever and then goes to a controller where the insulin is and where the buttons are. With on the pod. Everything is in one small pot. You put it on and then you tell the pod what to do from a wireless tubeless controller. It is very small, sort of like a cell phone. The great news here is that some of you will be eligible for a free 30 day trial of the Omni pod dash and that is available at Omni pod dot COMM forward slash juice box, go and check it out free 30 days of using an insulin pump with no strings attached and no tubing attached, but you don't have to buy it. If you do the thing in I mean, you could do the 30 days and be like I don't want it. That's not a problem. There's other stuff at that site too. You could also get a free no obligation demo pod, which would just be one nonfunctioning pod for try on and where just see if you dig it or not. So maybe you'll start slow with a nonfunctioning demo, and then move up to the on the pod dash trial. Who knows, there's only one way to find out on the pod.com, forward slash juicebox. And please don't forget, touched by type one.org. and define touch by type one on Instagram and Facebook. They do amazing things for people living with Type One Diabetes, they're a great org. And I hope you check them out. There are links to these and all the sponsors in the show notes of your podcast player, or at Juicebox. Podcast calm, please remember, when you click on the links, you're supporting the show. So I'm not saying just click on them. But if you're looking for a pumper CGM, or to help an org or glucagon that comes in a hypo pen, or the most accurate blood glucose meter I've ever seen in my life, I'd appreciate it if you did it through my links. Thank you very much. Let's get back to Lisa.

You're very welcome. And I'm super happy about that. I have to tell you, you named a number of things that I know people really like. Think Like a pancreas, that book is incredibly popular. Pumping insulin. I know some people really love sugar surfing, I've had Dr. ponder on the show. Yeah, I know. I've listened to it. But I've never read any of those books. And if I read those books, not those books, forget those books for a second. If I read a book, I just know how my brain works. If you told me Hey, the answer to diabetes is in these books, I would think oh, well, I'm never gonna figure this out. I'm just not it doesn't work that way for me. And I don't think this podcast is for everyone. I think there are plenty of people who can and will read think like a pancreas. And they'll just be like, Oh, that's it. Great. You know, but I think that the thing about the podcast is that it's alive. You know? And so when people ask me, can you write a book about diabetes, which people ask me constantly about, I'm like, that's a waste of time. The podcast is the right way to do it. Like conversations with the right way to do it. hearing things, explained multiple ways by different people. Until the thing that gets to you gets to you. And you're like, Oh, that's it. I understand. Now, this to me is the way but once you write something down, it's static. And then something changes, you start wrote

Lisa 32:32
down, if you wrote down the things that are being said in this podcast, you probably get sued.

Scott Benner 32:39
Well, you know, hey, not for nothing, too. I'm not a doctor. All three of those books are written by people with degrees. Yeah. And so you know, and not even just that, I think, but if I wrote it all down, it would either be a million pages of text, or it would be too, because there's part of me is like, really believes when I tell you like this is all timing and amount. That's it, you just have to use the right amount of insulin at the right time. There's no nothing else to it. There's Don't get me wrong, there's a bazillion other variables. But as you start experiencing them, them, you eventually just figure out Oh, this is potato chips. I get this now. And this is when they're playing ice hockey, I understand now. And you just you grow into it. I would tell you that if it wasn't for this podcast, I don't think I would. I don't think the word diabetes would come into my head maybe once a day. Because it's just easy at this point.

Lisa 33:39
And I think you guys are looping still, right? You're still

Scott Benner 33:42
Yeah, it but I felt that way prior to that as well. And, and the loop just kind of tightened everything down a little more takes out some of the, you know, you know, when you're just looking at a 97 blood sugar, you're like, this is great. And then all of a sudden, it's 130. And you're like, Huh, what happened? Like those, those kind of moments go away. You know, I

Lisa 34:04
ordered I ordered them rightly links from the US that have arrived and I was gonna build and I decided to postpone it now because number one, our son who has you know, a learning disability and, and all the other issues and he's actually getting pretty good at like, using the PDM 80 style PDM you know, on the old on the old Omnipod. Now, the people around him during the day are also you know, understanding when I tell them I mean I'm managing diabetes by SMS to adults that that are around him and he is gaining some self I wouldn't say not self care, but but he's able to understand like, Oh, this is what I'm supposed to do when she says you know, put a tent Bissau lawn and so I decided to postpone it primarily because of that, but also because I I feel like I've got such tight control right now that I'm going to have to go through a period of relearning and re testing all of the factors. And so I haven't done it yet.

Scott Benner 35:09
Yeah, you don't seem like the kind of person who should pick up a hobby. You know, I'm gonna try woodworking, or you know, and I'm looking at our graph, and it's great, you obviously know what you're doing. And it Listen, honestly, had one person not badgered me so harshly to try this algorithm, I had no reason to do it, I was never going to do it. And it just was, she said, like, I really think that people in general would benefit if you understood how to use this. And I agree

Lisa 35:42
with that. And I and I had planned to do it. And then I chose to at least postpone for for different reasons. And, but I do manage his diabetes quite a bit like Luke does, I am using temp bisol, you know, a lot. And I use that a lot as a big tool, kind of as loop is adjusting the bisol a lot. So. So I do I,

Scott Benner 36:05
I was I was an algorithm for many years on my own. And it just helped me, it helped me understand like, it's now like, when I when people ask me, like, how do you excuse me, when you you see a high blood sugar with loop? Like, how do you get it back down? Because the the algorithm does not want to come down quickly. Right?

Unknown Speaker 36:27
I know you open it, don't you?

Scott Benner 36:28
Yeah. So I basically tell the loop. Okay, you go away now. And then I

Unknown Speaker 36:32
carb sign I

Scott Benner 36:32
do. I don't even fake carb. I just put in a bunch of insulin. And I and I know where in the drop to close the loop. So that levels off? Yep. And if you think that's something magical, it's not I just did it a bunch of times till I figured it out. And people are like, Well, you know, they would ask them, well let what number do you turn it back on? I think it would be different for every person. What I'm saying is, is that I did it. I watched the graph. Yep. And one day, I was like, Okay, here. And when I say here, again, I'm not saying a number. It's a visual. Like I look at the line.

Lisa 37:08
That is so interesting, because that's exactly what I'm looking at every, every moment with, with the diabetes management. It's not about the number for me, like I've never had, like, I don't like have a number goal. What I have is I want it to be as little variation is possible.

Scott Benner 37:26
Yeah, you're just flying an airplane, and you want it to be smooth. You want it to go up smoothly and level out smoothly and come down smoothly and level out smoothly. Excuse me, let me take a drink for a second. At one point, Dexcom sort of changed their graphics on the follow up. And I had them on one day and I was like, don't do that. Like don't make it look different. I know what this looks like. And I was in a panic for a second. But you know what? I see it the way it is now too. They could change as much as they want. I could keep figuring it out. It doesn't matter.

Lisa 38:00
I don't use follow a nearly at all.

Scott Benner 38:03
Are you using sugar mate? Sugar, mate? Okay, yeah, and I have that as well. And I don't look at that as I need. I like Dexcom follow for the line. I like sugar mate for kind of the information that's on the front page of it a lot. I'm actually getting ready to do something that I think I might be, I might be doing something with sugar mate coming up. Which will probably happen before they put this out. So I'll tell you, I'm going to wear a G six and broadcast my blood sugar's live on my blog. And then I'm going to tell people when I'm eating and what I'm eating so they can see how a pancreas handles the different situations. Because I think that information will help them understand their kids and themselves.

Lisa 38:51
Do you know we use we use candy called Mentos if if if we have to treat kind of an aggressive following blood glucose, we don't have lows, but but essentially physical activity and then you know, trending down and we don't use. We don't use glucose tablets. So Mentos has glucose in it. That's the Skittles, what have you and and so I decided we came home from summer vacation and there was a half a package of this Mentos candy left. And I was kind of I don't usually eat candy, but I just thought well, I like to have those and I so I ate half of a role. And then I was just I had this like epiphany. So I went and I got the band tested my blood sugar. And I mean, I was super high. I was like what's that in? 8.8 times eight.

Scott Benner 39:39
I have my finger right here. So you were 8.8 by 8.8. This is a team Xbox 160 Yep, I have it at 158 there's a beautiful I don't know if you saw it but a listener built this. This calculator that does a one C and blood glucose. So like I I'm on. How do you say it? Is it mimeo? How do you guys say MMO? l do millimole millimoles. Okay, so I just put in 8.8, it immediately told me that that's in America 158. And it tells me that if your average blood sugar is a point A, it will come to an A one C of 7.1. And that was

Lisa 40:22
after a half, half a package, like maybe about double what I would use to treat it, you know, drop with him,

Scott Benner 40:28
right. And your functioning pancreas is in there fighting off those Mentos. Right,

Lisa 40:33
I test 5.1 Exactly. All the time. Like, whenever I test, I'm just at 5.1, whenever I see, well, is 91.8.

Scott Benner 40:44
And that gives you in that situation, I'm assuming gave you a real idea of Oh, that's why Mentos stopped drops so well. Like they're really fighting

Unknown Speaker 40:55
rocket fuel, fuel.

Scott Benner 40:57
It's funny how everybody just thinks of it differently like, but in my mind, it's sort of just like these opposing forces. It feels like a cartoon to me like fire like a flame thrower on one side and a flame thrower on the other side, and they're just blasting at each other. And they kind of meet in the middle and dissolve and like, that's how I think of the sugar coming in to press against the insulin that's pushing down, and then it pushes back up until they kind of you know, they both go off. And hopefully you're left about where you mean to be. I don't know. I can't imagine. There's What do I want to say there are not many other places in my life where the way my weird brain works about things, or people are like, Oh, this is very interesting. And I should listen, I can't believe it worked out for diabetes, of all the bizarre things I honestly can tell you that that this is my podcast still confounds me. Like, it doesn't seem like I should be the person doing this to me even. But

Lisa 41:51
thank you revisit, you're a visual learner and are like a picture learner. And I am a person who I have to draw when I have to circle and move. I just recently went to law school, you know, it's free here to go to university. So I'm an engineer, but I just went to law school right before this, this diagnosis and all the young kids, you know, they're like typing in a computer. And I hand wrote on paper, because that's the way I learned and your way of learning and communicating works really well in this kind of visual interpretation of the blood glucose trends and levels on so I get it. I'm also very visual. And I think that's why it works well for me, too.

Scott Benner 42:30
Yeah, it's crazy. You know, every time you mentioned Sweden, I think of the chef from the Muppets. I'm like,

Unknown Speaker 42:34
Oh, that's funny.

Scott Benner 42:35
I'm like a seven year old, like, I can hear it in the back of my head doing like, I'm trying to keep up with our conversation and overwhelmed, doing be doing in that's going on. And

Unknown Speaker 42:46
I don't even love The Muppets.

Unknown Speaker 42:49
Anyway, back

Lisa 42:50
to Sweden, I was thinking, when I was preparing, just kind of where I'm at with diabetes management, I thought to myself, because I had to relive this a bit just kind of thinking about talking to you. And I thought, wow, I couldn't imagine going through what we've been going through the past 11 months and having on top of it the financial pressure of insurance questions and insulin costs and things like that. I I really thought hard about that today that I couldn't imagine feeling any worse than I felt going through this, this first, you know, adaptation to life with a child with diabetes and, and just the thought of people, you know, not taking insulin they need or not having access to the medical technology they need, or being afraid of losing your job. First, in the first hand, in the second hand, you lose your insurance on top of it during these times. And it's like it's inhuman. I mean, we it doesn't cost anything, nothing related to our son's medical care. And especially with diabetes. I mean, nothing is a cost for us straight out of the pocket. So I don't have to pull insulin out of a pump that goes bad or there's no insurance.

Scott Benner 44:14
You'd have to fight comm or anything like that.

Lisa 44:17
Oh, no. I have the G six on him two weeks after diagnosis in the Omni pod about seven weeks after diagnosis. Terrific.

Scott Benner 44:25
It really is. What kind of insulin does he use?

Lisa 44:29
He uses he uses what would you guys call it as it called Nova log. It's nobody there.

Scott Benner 44:38
So it's no is it? No volin there or novo novo? No, you call it something completely different? Yeah.

Lisa 44:44
He in the beginning he had you know the when he was on MDI, he had I think you call it a basketball or we call it a basketball. So we had basaglar and novolog. And now he just has of course no vlog.

Scott Benner 44:57
Yeah, that's amazing.

Well, how is I don't want to make you upset, I guess. Are you okay? Like, how did you? How did you get to okay?

Lisa 45:14
What's a lot of support? I so, you know, I think the first few weeks for the first month was I can control this, I can handle this, just like I've handled everything else that's come our way. And I was somewhat, you know, like magical about it about reading and I wanted to know everything there was about diabetes, everything there was to learn. And that was my, that was my mode, that put me into the hospital. And then I was forced to chill out and ask for help. And then I ended up referring myself to psychiatry care. over the phone, I call them said, I'm concerned about my mental health. And I got help. So I a combination of just having, you know, therapist contact me twice a week, and some medication and some help asleep. And then with time, so they tied mostly with something called adjustment disorder, like and I remember the doctor saying that the psychiatric doctor saying, Okay, well, Lisa, you're going to feel better in about nine months, you just like the body has a great ability to adjust again, and we're gonna do all these things to get you there. But you will feel better. And I, I could, I never thought I would. But I did, we did have summer vacation. And I think just going from diagnosis to putting him into an environment with other people that didn't understand what was happening, and then trying to manage his diabetes remotely. And he goes to a special school in another area of the city. He rides in a taxi three times a day to special schools and care programs. And so I was having to, like take care of him, but I couldn't see him and I couldn't touch him. And I couldn't see the food I had to. I had to like use the pictures they were sending me and the weights they were sending me. And so that was just like this intense demand on me both workload wise, emotionally brain capacity. And then once he was on summer vacation, and I kept saying, why don't you just stay home with us when school was out? No, I want to go to my after school program, he wants to go and be with, you know, friends and, and with these, these mentors that lead them and when he got home, and when I got six weeks with him 24 hours a day. I just think I just healed me. I just got to share with him some more. And when I sent him back to school, when school started the end of August, I just I felt calmer. And he understood a bit more from his time with me and with us. together and I just so far. So, so far, it's only been what, five or six weeks since school started in this kind of like, energy. I got refilled during the summer. I mean, it's still lasting. So I'm feeling better. But it was it was touching go there for a while. I was concerned about myself. I was shaking, most of the time.

Scott Benner 48:21
Yeah. I told my son recently that with us all kind of living on top of each other because of COVID. And him being here instead of being a college, I said, Look, I realize how much you're missing. And I'm sorry that this is your experience right now with college. He's now in his bedroom, taking classes. But I said I'm going to look back over this time and be so thrilled to have this extra time with you. And and I I feel better when he's here. Yeah, I don't really know another way to say it. Like I just eat seems right that he's here. Now I'm

Lisa 48:57
going to start crying our older son just left for the university, just

Unknown Speaker 49:03
trying to learn things.

Lisa 49:05
No, I mean, he he just left and moved to the other side of Sweden to a university. And so this is the first time our older son has ever really lived someplace else for a period of time. So so now that your son's home, our oldest son left no,

Scott Benner 49:21
he'll be going again soon. He'll be out of here pretty soon there. He was talking to his coach the other day and he's like, I think you guys will be back in the spring and you know, so I feel like after the holidays he'll he'll be out of here. But how far did your did your child go to?

Lisa 49:37
Let's see Sweden is the same size as California length and width. And so if you imagine we live on the very east, east side of Sweden, and he moved to the very west side so that distance from you know one edge of the California State to the other edge, it's it's about five hours by fast train, or car, I think Yeah.

Scott Benner 50:06
Do you feel like you'll be able to visit him at all? When he's there is that is there a reason to?

Lisa 50:11
Well, my husband, you know, helped move him and his, his girlfriend there. But with, with how life is right now here with our younger son, I haven't been there to visit yet I just basically got brave enough to start kind of being in other environments with our son that has diabetes that it took me this summer, it took me about a half a year for me to actually grab up all my diabetes supplies that I have pretty good control of at home, and take them to what we call our summer house, which is another home that we own. It took me about a half a year just to just to do that.

Scott Benner 50:59
So I want to dig into this if you could, yeah, so here's why. Because I couldn't get in my car and drive to the store for the first year. Because I was like, What if something happens while we're in the car? You know, and that's kind of where I'm at. But it's funny to hear you say it. Because for 14 years, you've been in charge of all of these special needs. Right. And and obviously your son's, you know, going to school and taking taxis and he has friends and all that's going as I would I don't want to say as well as can be expected. It sounds like it's going really, really great considering

Lisa 51:34
absolutely doing he's doing really well. But I did feel like that also in the beginning. Yeah. When things happened, and know when different things happen.

Scott Benner 51:43
So did your experience with all of the stuff that happened at birth, it wasn't able to inform you enough for you to ignore similar feelings around diabetes. Sorry, I

Lisa 51:57
think I think it's actually opposite of what you just said. I think it made it more catastrophic that when your body goes into like, like, with a post trauma diagnosis, what happens is like you're living kind of always the flight or fight mode is what you're trying to reason yourself through, right? And when the body just consistently is like, do I fight? Or do I take flight? Or how do I handle this, this emergency that's happening? You know, you're on standby, you're on high alert. And it takes a lot of work. And I had done a lot of work to try to not overreact to things that weren't life threatening. But when the diabetes happened, my body biologically just hopped really fast, right back into that, that's why I landed in the hospital.

Scott Benner 52:51
So instead of my hope or assertion that being through something terrible, makes you ready for it the next time, all I did was show you the path to terrible quick,

Lisa 53:03
logically, I think I think it's and I think logically, I was calmer than maybe a lot of people would have been that, that the doctors in the hospital when we had the diagnosis, like they saw me as someone who was really on it really competent, already reading everything totally at ease, like adjusting well. So on the outside, I was logically well suited to fight, but on the inside, I was weak. I was like weakened from all that I've

Scott Benner 53:32
already cuz you know what it feels like to be punched in the face. And so you're, you know, it's coming, that kind of a feeling.

Lisa 53:38
It's just the body's response mechanism. I mean, it's it's just, it's innate in us. So you're saying it's happened fast? You know,

Scott Benner 53:48
your statement? Is that it to me the definitive answer on this podcast about whether or not you should tell people Oh, you're the right person for this to happen. Right? Yeah. No one, no one's the right person for this to happen.

Lisa 54:00
And I used to always say, before this happened, you know, my people that know enough about us and that have seen some of my doctor, doctor friends. I mean, I'm surrounded by some brilliant, empathetic, lovely, especially women in my life here in Sweden, that and you know, really fabulous people, and some of them understand what we've gone through. And, you know, I'll say to them, they'll say, Wow, I'm so sorry to complain about this, because you guys have it so much worse. And I said, you know, we're all kind of dealing with a mean person that has a child with a fever and a cough and it can't get to see a doctor. I mean, they're stressing over it. It's not just because I've had more severe experiences doesn't mean that they feel any better than me when they're dealing with, you know, issues. But I think the thing with diabetes, I think, where I'm at right now, again, 11 months in I'm almost getting upset because I, I feel that people have this misperception really smart people have this misperception that they say, oh, but he has a pump now. Why? Why are you Why aren't you sleeping at night? Right?

Scott Benner 55:16
Yeah, the pump. But no,

Unknown Speaker 55:19
I mean,

Lisa 55:20
no one I literally I'm a person who was very rarely angry. I really don't feel anger on, you know, at all very much. But I really wanted like punch somebody in the face with a say that because they don't get it and I don't want them to have to get it. But it's like, diabetes is the most I'm thinking of the Swedish word for it. See, but what is that? It's the most unpredictable but it he knows all these factors and what what works today with that food and that time, tomorrow at the same time, and the same food is not going to work and be one day when he has physical education class. Maybe he doesn't drop the next day the same. Maybe he drops. It's just like it's so it's such a constant. constantly moving target.

Unknown Speaker 56:14
Yeah. What was the Swedish word? You were thinking?

Unknown Speaker 56:17
Oh, no, I don't need to.

Unknown Speaker 56:21
Do you don't want to say

Lisa 56:23
I don't want Swedes to hear me say no, I was speaking Swedish in my head.

Unknown Speaker 56:27
Don't say I hear you don't want people to hear you're terrible. Like, like,

Lisa 56:32
Swedish. Yeah, no, I'm still in Swedish. I just I just took a law degree in Swedish.

Scott Benner 56:37
I understood why you won't say it out loud. I don't care if you don't tell me why.

Lisa 56:41
Damn. And I said, all we're for rootsy bar. It was just a word that was non predictable. And it was just sometimes I think in different languages in my head and I don't know which

Scott Benner 56:53
I'm asking you to spell because I'm very possibly putting that in the title of the episode is

Unknown Speaker 57:00
unpredictable.

Unknown Speaker 57:03
What what? Can you spell it? Do you know it? Yeah. Oh,

Lisa 57:06
my gosh, I have to spell it with the sweet but the English pronunciation of the Swedish

Scott Benner 57:10
I'm googling just give it to me.

Lisa 57:12
Yeah. Oh, F. Oh, four. c? CFR. It's a it's a Swedish letter with two dots over it. I'll have to send it to you.

Scott Benner 57:25
Okay, perfect. Seriously, it's totally ending up in the title of this episode. So I just I heard you slip into your like, into like the back of your voice and you were like working through a word to another language. And I was like, This is amazing. Well, you know, I guess that as we're looking here, I'm looking in front of me. You know, your son's born he has all these different operations like right out of the womb, issues with his liver, his intestines, all this gastrointestinal stuff. hearing disability, I'm interested, does he wear something to help him? Yeah, he

Lisa 58:00
has a severe hearing loss. So he wears hearing aids.

Scott Benner 58:04
Do you sign with them at all? Or is that not? Yes,

Lisa 58:06
he went, he went to a sign language school up until fifth grade. Okay, so he's essentially Deaf when he when he doesn't have them on. So there's an issue like when he's sleeping? He can't hear a pump alarm? Sure. So I've had to go buy another baby monitor so I can hear pump alarms in the night from his bedroom. And so if he you know, showers or is in the hot tub or what have you and takes out his hearing aids, then we use sinus support. Yeah, so we had him in assigning school.

Scott Benner 58:34
So then I guess I, it's you told me he has an intellectual disability as well. But I'm, it's funny how my brain stops me from believing that because you understand sign language. But I know, it's just it's a you don't I mean, like, it's a weird, like,

Lisa 58:50
let me let me translate the disability, very concrete is that he'll never he can't, he'll never be able to rack the call. He drove to he'll never be able to calculate carbohydrates will never be able to, he doesn't really understand numbers. And if you ask him, you know, a basic question about x plus y he he's guessing. He doesn't know. So, but he's a super social. He's got great. You know, he's a super social open person who?

Unknown Speaker 59:27
Yeah, yeah,

Unknown Speaker 59:29
well, what and you also Yeah, good. No, no, no,

Scott Benner 59:31
don't be I'm wondering what's your what's your hope like, for his life? And does he think about that? Or is it just still with you? I mean, my 15 year old doesn't didn't think about what they're expecting for the life I'm not sure.

Lisa 59:46
Generally speaking, the lower the intelligence level kind of the more here and now you are so you don't worry as much and that's interesting with diabetes. You know, people talk about the dawn effect and the feet on the floor syndrome. I've heard you know, people talk About that, and his his ex, and that's because people wake up and they get stressed out about what's going to happen during the day, right? Like that's kind of like I woke up now all of a sudden my adrenaline's going, Correct, yeah. He's opposite. He doesn't worry. He wakes up and he starts moving around so his blood sugar actually drops. He doesn't have any feet on the floor effect at all.

Scott Benner 1:00:21
So what Lisa just told all of you, if you calmed down enough, your blood sugar will not go. How calm Do you think they need to get Lisa, do you think everybody needs to wake up stoned or what?

Unknown Speaker 1:00:34
Probably Yeah. Probably.

Unknown Speaker 1:00:37
Right now, I got a lot of cortisol going on over here in America. Just so you know.

Lisa 1:00:41
I do. I don't. It's not being American overseas. I can tell you is it is a it's a show. Sorry. I can't say that on this show. We can

Unknown Speaker 1:00:49
probably bout it's fine. You

Lisa 1:00:51
can see it now. So that's all I can say it to you and I just voted Oh, I just voted from here. So yeah, I'm not we're not going to go down that rabbit hole right now.

Scott Benner 1:01:01
No, there's nothing about diabetes in that. I'm just saying that I'm at a heightened sense.

Unknown Speaker 1:01:06
I know. I know. Me too. Me too.

Scott Benner 1:01:08
I'm not accustomed to talking about this stuff every day.

Lisa 1:01:11
Now. I don't I don't like to talk about all this stuff anymore.

Unknown Speaker 1:01:16
Unless I'm happy that your son doesn't think about it. I seriously.

Lisa 1:01:19
You know what you asked about what my hope is for his future? Yeah, if you forgot what you asked me. And I can tell you that that's probably been the number one one of probably the number one reason why I haven't felt well. It wasn't because I couldn't handle the diet, the management of diabetes, that the problem is what happens when I'm not managing it.

Scott Benner 1:01:45
What does happen?

Lisa 1:01:47
You know what happens, like who's going to who's going to keep his blood sugar healthy, like, Who's How is he's never, he doesn't have the motor skills to put on a pump himself. He doesn't have the motor skills to inject himself. And there's all sorts of help available here for home health. They, like elderly people who have diabetes here in Sweden, I mean, they don't move into facilities, they have home care that comes eight times every day. So someone comes to your home here, as part of you know, the community service and they make your food and they give you your medicines. And so there is that kind of base level of care here that you wouldn't maybe have access to in the US, but they're certainly not going to employ the methodologies that I do. And they're not going to be on hand. 24. Seven to, you know, I mean, I'm up at night and giving him a Korean What do you guys call it when you're correct? the correct direction? Not good. Not a court hearing you guys

Scott Benner 1:02:46
from California, Lisa? Good.

Lisa 1:02:48
I know. Like, like, I start my evening, I start giving him corrections. Once he hits about 7.5. That's once he hits about 135. After he's gone to bed, I start smashing it. And, you know, because I know, I know that once he starts rising, and it's just going to get harder to keep them there. So then they're not going to do that. There's nobody else is going to do that for him. When if I'm not around. So. So, you know, I, it's that's what that's what's hurting me.

Scott Benner 1:03:20
Actually, while I'm on, it sounds like you get to live forever. So that's perfect. Right? Yeah.

Lisa 1:03:25
Can you arrange that? Scott?

Scott Benner 1:03:26
I'll work on it. I'll call the podcast Council and put my powers before us here. Excuse me? Oh, sorry. I'm sorry. I just I don't know what happened. I was just talking. And suddenly, I didn't have a voice.

Lisa 1:03:42
live forever. You know, one of my, one of the other parents in some of the groups I'm with, I'm on the board of an association for people with intellectual disabilities. And she the parents are older, they're in their 70s. And she wrote this book, and she said, and the title of the book, which has been really hard for me is I hope I die first. I hope she dies. First was the name of the book. I was like, wow. Sorry, that was wrong. That they hoped that their child died before them because they weren't going to be around to take care of them. So it is it's hard. You know, it's hard. Like, I mean, your daughter's gonna be able to manage her diabetes on her own as she's an adult and our son won't. And so that's, that's what's hard.

Scott Benner 1:04:30
I can't tell you that. I understand that I understand it intellectually what you just said, but on a feeling level. I don't I don't know how to wrap my head around that other than I mean, either other than to say I can understand the sentiment and because I mean, I don't I'm not trying to make you upset, but there You're right. No one's gonna care the way you know. No, yeah.

Lisa 1:04:50
And maybe but now I'm trying to say well, maybe if I get him maybe if I take good care of myself and I get him to, you know, 15 if I get him to 50 or 60 with really Excellent, you know, diabetes management, maybe we've avoided you know, that the a lot of the damage that can happen and then six, you know, 5060 plus with just kind of like the old style static diabetes management, maybe he'll be okay. I mean, you know, people, you know people manage like that. So the other

Scott Benner 1:05:17
side of that thought is that 35 years from now, I would imagine, I would imagine things are much different than they are right now

Unknown Speaker 1:05:23
in 10 years. I

Unknown Speaker 1:05:24
agree with you,

Lisa 1:05:25
I agree with you. We'll have commercial systems that'll that'll loop. And that'll do good enough, right. It'll be good enough, even if the highs take longer to bring down on a on a loop system, and they're not as aggressive. It'll be good enough.

Scott Benner 1:05:39
Yeah, I think Well, listen, artists, we tried fasp different insulin.

Unknown Speaker 1:05:44
Yeah, I saw that I

Lisa 1:05:45
haven't, I haven't seen what you thought after just the initial,

Scott Benner 1:05:49
I don't imagine we're going to be able to keep up and keep using it not it's working terrific. But it burns every time she gets it. And so it's irritating to just to wear the pump because it's always in the same spot. And she's always getting basil. She's got this background irritation that she says is not pleasant. We're trying to get through to vials to see if it if our body somehow builds a, you know, a way to help it. But I'm afraid if the body builds a resistance to the burning, it's also going to build a resistance to how the insulin works. I'm not I'm not I'm not sure. But she's toughing it out to try it. But we had to give her like a 15 unit Bolus the other day. And the entire time the Bolus went and she just held her arm and she was like this is not good. And so she's really being a trooper to get through it. Having said that, it works more quickly. And she has fewer lows, and she wasn't having that many lows to begin with. So it works really well. And at the same time, I don't know that we're going to be able to keep doing it. Which is

Lisa 1:06:51
nice. It's nice. She lets you use her as her personal Guinea guinea pig.

Scott Benner 1:06:54
I told her I was like this is you know, it's the real reason we tried first was because she has these muscle aches and joint pain sometimes. Right? And I just we're down to like what we were talking about the beginning of the episode, we're down to like picking through the minutiae, trying to find something that helps her. And so I just said, Look, there's probably preservatives in a pizza that don't exist in fiasco. Why don't we try and see what happens. And it hasn't really helped her in that vein at all. Which is why we're trying to wait a little longer. I the blood sugar control aspect was a bonus. We weren't, I love a feature and how feature works. So I wasn't switching away from it because of the insulin. So we'll say, but I imagine she'll be switching back with our next pump, actually. But I don't I mean, you were really nice to come on and do this. And I didn't we didn't talk much about diabetes. Do you have a couple extra minutes?

Unknown Speaker 1:07:52
Yeah, of course. Cool.

Scott Benner 1:07:55
So what's your I mean, obviously, you're texting with adults. So you have this ability to, like I do, and a lot of other people who like I always think of it as like tech support for computer. Like I don't need to be in front of the computer to fix it. And, and so I can kind of see diabetes in my head, and the numbers and just my understanding of what she's been doing. And even now, to be honest with Dexcom follow, I don't even need to know what she's doing. I can infer from the, you know, from the what's happening get

Lisa 1:08:25
crazy when I when I when I write and I say Hey, are you guys out taking a walk or something? And they're like, yeah, and I'm like, okay, just wanted to make sure that was why it was dropping, you know, for sure. See everything they do freak out a little doesn't graph.

Scott Benner 1:08:38
We have a, I have a thermostat in my bedroom and has a motion sensor on it. But I never told anybody. So my wife and I went to a baseball game with my son one day, and we were gone for, you know, a while and I texted Arden and I was like, Are you awake? And she goes, Yeah, I just woke up. I said, Are you in my bedroom? And she was freaked out for like hours. She's like, No, I'm like, I just had a feeling. And I teased her for a while about it, you know, and she couldn't figure it out. But I imagined something similar. Yeah, I just saw I see it. And I infer and I know what's going on. So you're doing that when he's away from you. But the one thing

Lisa 1:09:18
and even with him a little bit even when he's in the same house as us I'm trying to practice with him so that I'm acting like I'm you know that I'm not in the same house with him. So when he gets home and I'm preparing dinner, and he's in his up in his room, instead of me doing all like text him and so I'm trying to teach him that way too.

Scott Benner 1:09:39
I'm a huge fan of that. I really think it what what better time to practice distance care than when if something goes wrong. You can just walk into another room and go Okay, well I mess that up. Yeah, essentially

Lisa 1:09:49
I did that all summer and it's made a big difference in me feeling like he he understands a little bit more than what he did before. So it's just Kind of that's really important for me to try to help him and that we also implemented for that. We always do a split Bolus. So this was before this a long story, but I wanted to implement a routine that would, that would work for him most of the time, because I wanted to Pre-Bolus the lunch at school. And we didn't know what he would be eating or how much and so we started at school with doing just a standard amount every time as a Pre-Bolus. And as I saw it working, we just did that for every meal. And so every time is going to eat, we do the same Pre-Bolus amount against 50 grams of carbohydrates. He eats like 400 grams of carbohydrates a day, healthy carbs, if there's such thing but and so we Pre-Bolus for 50 grams of carbohydrates before every meal, breakfast, lunch and dinner. And that's really helped us actually to avoid kind of like the spikes and the dips. And I don't even use the extended Bolus function on the pump because I love the split Bolus demand a manual split Bolus. So you're

Scott Benner 1:11:01
doing basically when you hear me say, just get some going get some insulin on your side. That's what you're doing.

Lisa 1:11:07
Yeah, every time before, it's, we always give him that and then, and then he can take what he wants. And we don't have to like measure everything out, given the incident before you can eat it. He takes the Pre-Bolus for 50 grams of carbohydrates and then under under the meal at some point, we'll you know, figure it all out. And then we'll give them what's left. And if he didn't eat 50, which isn't very often then we'll supplement it with the you know, something else.

Scott Benner 1:11:32
That's amazing. That's brilliant. actually good for you, I think works really well for us. Yeah, that's excellent. I listen, I think that, again, the way that you use insulin is the whole game, like I just pulled up Arden's blood sugar to look at it. And I'm following other people too. So right now it's 10am, where all these people are all these, these, there's an 18 year old in here and a 16 to 16 year olds, right. Two of them are girls, I happen to know they both have their periods. And I got blood sugars here. 9994 95 are Arden's at school, the other girls still asleep, this, the kids at work, and they all have the exact same three hour graph. And it's just because it's just because I have

Lisa 1:12:21
the right amount of insulin at the right

Unknown Speaker 1:12:23
time. That's it. That's it.

Lisa 1:12:24
That's all it is, you know, you know, his our son's graph, when you don't introduce food into the picture, it's just flat. It's just, you know, once my only issue in the evening is to is to smash that rise, and not smash it hard enough to where I you know, push them too low. And I get you know, I rage Bolus, like you've talked about I definitely rage Bolus. And I've you know, I've upped his insulin sensitivity factor from one to six to one to two for three hours, because I was just kind of like reverse in reality, so I'm just giving him like, like massive amounts of insulin, I just need to make sure I don't push them too low. But once I have them stable, then I know he's gonna ride there. And he can wait to eat until like, 10 in the morning. It doesn't matter what seven or 10 he just writes flat. Okay. The whole time.

Scott Benner 1:13:12
Yeah. Beautiful. All right, listen, you got it, you figured the whole thing out? You're doing I mean, with the amount of carbs you said, well, seriously with the amount of carbs that you said he uses? Yeah. And and where his range is and where you're keeping him and how you're doing it with you know, being aggressive and thoughtful at the same time with insulin. I'm sure you'll get things you know, honed over time, but you're doing incredibly well. Aside of all the other stuff for being 11 months into diabetes. Seriously, you you leapt forward very quickly.

Lisa 1:13:49
Yeah, no, I know. And I mean, I that's I thank you for you know, for saying that.

Scott Benner 1:13:54
Well, it's true if he wasn't sure I would have said something different there.

Unknown Speaker 1:13:57
No, no, no, no.

Lisa 1:13:57
I mean, I know that. I mean, and that's not really like I'm, that's like, that wasn't ever my concern. My you know, like I said, my concerns are other things. And I just, I wish I wish them every parent kind of like got it like this and was able to help their child you know, stay calm what their blood glucose and and it's, I feel good, because I don't want it you know, his other organs are already damaged. He is sorry, was that mine or something was mine. And, you know, his, his livers already damaged his kidneys already damaged is you know, I mean, there's other his heart I mean, there's his other organs are already impacted by other diseases. And so, um, you know, the least I can do is try not to get them more damaged. And, you know, he hasn't had I mean, and this other part, you know, I'm terrified of lows because he doesn't feel anything and so I'm, it's, it's my next challenge. As you know, I hold him between five and seven, four and six is Correct. So five and seven, five would be 90 and seven would be 126. So I don't let him get down to four. I don't let him get down to 70. And I start treating him like bump him up a touch already, when he starts going down there, and he hasn't had a single blood value under for under 70. Ever, ever. Yeah, well,

Scott Benner 1:15:28
he's got so many cards, he's got so many carbs in them too, that it's probably seriously it's probably a little easier to manage. you're managing up instead of managing down the insulin. Is that the way I mean that?

Lisa 1:15:40
Yeah. I think I've listened to you before and and I, you know, you've said something to the fact that if you can hold them steady at 120, you can hold them steady at 90. And then you've said something to that before. And I know, I know that I can if I can hold him study at 100 or 110. I can hold him study at 80. But I'm too afraid to do it because he's not near me. And I'm not. So I tend to err on the higher side I my favorite number. If somebody said to me now, you know when you're a kid, they say what's your favorite number? At least I'd have all these different numbers. My favorite number 6.3. When he's 6.3 6.3 and when he's 113. I can I just I relax. It doesn't matter. Like in sleep like that. To me. That's like nothing bad can happen because I can catch it. If he's low and I can catch it. If he starts going up.

Scott Benner 1:16:32
We say your math is really tight before I could type that into the calculator you have the answer. Like all find out for Well, listen, then do those. If you want to try to go lower, just do it when he's with you on weekends or days. We do we try it right?

Lisa 1:16:49
We do. I just also don't want to give him I think you asked me earlier just now on the podcast, you know, is he worried and I gave you this feed on the floor analogy. But it's interesting because he he looked very thoughtful at dinner two nights ago. And I asked him what was wrong. I said, you know, what are you thinking about and a lot of stuff happened about a year ago at this time, we had several losses in our family and then of course the diabetes happened and and he didn't tell me and and he's not allowed to have Facebook and stuff. But he does have an Instagram post with with seven female followers. He only likes women. He only likes girls. He likes women. More so than girls.

Unknown Speaker 1:17:28
He's right. Yeah, no that way. I'm

Lisa 1:17:31
funny. Like all of my girlfriends is our his like, anyway, he posted a picture of himself two nights ago and I'm gonna do this translation direct from Swedish picture of himself in the mirror and he writes your attic. Lord, I am happy. In my new life. I have had a young big, I've had a I've had a job big, hard. I've had a hard year, the last year. It's been very tough the last year, but now I'm very happy in my new life. I hope you understand that. And he put that on Instagram. Whereas he's never been able to really express to us that I'm worried about diabetes or that I feel bad. And I mean, when we discovered diabetes had a blood sugar of he was outside working in the yard for eight hours with my husband like raking leaves and outside in the rain. And he and I took a Jacuzzi outside and not we walked in I just had this epiphany and I said, Oh, crap. He has diabetes, because he had like, peed the bed and was really thirsty. And he had a blood glucose of let's see, it was 30 he had a blood glucose of 540. And literally I'd asked him all day long. Are you okay? Are you feeling sick? And he's like, Nope, I'm going back out to work again. So he never complains he never like tells you that he's unhappy. Yeah. But I think he does feel the stress and I don't want to add to it by panicking when I see him dip and under under 79

Unknown Speaker 1:19:05
smile. I

Lisa 1:19:06
just want him to feel like hey, we've got all the time in the world. Hey, you want to eat three Skittles? You know, I mean, you notice these micro micro adjustments. But I'll get there someday.

Scott Benner 1:19:18
I know if needed. I think there's pretty damn close now to be perfectly honest. So I don't see what you could be doing that that would be that much better. I understand that. There's always better I'm not saying that. I'm just you're doing so well. I think if you're not if you're not really proud of yourself and somewhat satisfied.

Unknown Speaker 1:19:39
I am Yeah. Yeah.

Lisa 1:19:42
I'm worried about I worry about him. I love him a lot. So I yeah, just trying to, you know, melted in with with, you know, with what, what else we're dealing with and I just, you know, I want to keep them safe and healthy. That's really all I want.

Scott Benner 1:20:01
It really sounds like you're going through? Well, let me let me tell you this. And I actually, I have to go in a minute. But I talked to a lot of people like this. And I talked to many people privately. And I can tell when they're going to be okay. And I kind of boiled it down to desire and concern. And when people have the desire, and they have a reason to want to get to a place, they most often do. Yeah, you know, I don't see why you would be any different, you're obviously bright enough. And you're, you're paying attention to it, you're seeing aspects of it 11 months in, that I spend hundreds of hours trying to artfully beat into people's heads. And so you're, you know, you're, you've got it, and I don't see how there's anywhere to go but up, honestly, you know, yep,

Lisa 1:20:56
I just need to moderate, you know, the attention to it as well. And like you, like you've said a few times, or more than a few times, you've said, I don't think that much about diabetes in the day. And I can tell you like that's kind of all I think about and that'll be my next goal is to think about other things.

Scott Benner 1:21:12
Yep, you set those alarms, and you just wait for them to beep. And if they're not beeping, you don't think about them, you just trust that what you know is going to happen is going to happen.

Unknown Speaker 1:21:21
That's it. Yep.

Unknown Speaker 1:21:23
I really appreciate you doing this. Thank you so much,

Lisa 1:21:25
Scott, no great talking to you. I feel you know, really enjoy just chatting with you. And you're doing a great service for for this community. And you know, I, it needs more of this. The community, the parents, and the people need to have access to more modern thinking on how you do this, and I, you know, advocate for that

Scott Benner 1:21:52
all the time. I appreciate that. And let me just have hardly say, and with a little bit of just in my voice. They don't really need more podcasts. They just need to hear this one. I don't want I don't need What are you trying to do? Give me a bunch of competition. Somebody's gonna hear this and think I should start a podcast. You people don't need a podcast.

Unknown Speaker 1:22:06
I have one. Only one pod. Yeah,

Scott Benner 1:22:09
go do something else. You're fine. Find a hobby.

Unknown Speaker 1:22:12
I was actually thinking more in the hospitals. I was thinking more newly diagnosed. No, listen, I, I

Scott Benner 1:22:20
I'm sorry, you faded away for saying I couldn't hear you. But

Lisa 1:22:22
it's a pity, it's a pity that people aren't getting access to more knowledge earlier on. And they have to go find this on their own.

Scott Benner 1:22:29
I don't know how I think about this quite a lot. And I don't know how you're gonna make me upset. Because the way you feel about your son getting older, I feel about myself getting older. Because I'm my, my last goal is to do something that persists beyond me, for people with type one. And I'm I, to this point, do not know how you can take all of this and squeeze it down and tell it to somebody while they or their child is being diagnosed in a hospital. I don't know if you can maybe maybe that's why they don't maybe it's just impossible. I'm not sure.

Lisa 1:23:11
I think you and I should talk offline about

Scott Benner 1:23:14
that idea. Yeah, well, listen, what we need here, Helmsley, we just need some people to throw some some, some support behind some things. Because I do think that there are a dozen 20 or so episodes of this podcast that could be handed to you on a thumb drive. And that would really would zoom you right along. So I agree. There's definitely ways but again, if you're looking, here's the conundrum before we go, right. People have had diabetes for a very, very long time. And there are people who are good at speaking about that aren't me, I'm not saying that. I'm the only one I'm certainly not saying that. But for whatever reason, the mix of my experiences, and my the way I talk to people resonates with a lot of people who hear it, but I don't have any medical degree. So it doesn't matter if this podcast was 100% going to help everyone who heard it, let's just say somehow that was true. They still wouldn't hand it to you. Because I'm not a doctor. liability. Yeah. So it just wouldn't happen. And that

Lisa 1:24:21
we just then we just need to spread your podcast crazily and trying

Scott Benner 1:24:25
to tell people this and it's by the way, it's spreading so

Lisa 1:24:30
modulations Yeah, great, great metrics, Scott,

Scott Benner 1:24:32
people doing this really everybody who helps by telling someone else is helping beyond and I didn't mean to sound all like, I don't know how that sounded just now. But I, I, I worry about the day I can't make the podcast anymore. Like I get too old or, you know, whatever happens. I don't want this information to disappear and I don't want you know, because, think about it. Your son's diagnosed, you find the podcast, you're okay. 11 months later, the podcast does They exist. I don't know where you are right now. And I don't know where all of those other people are either. And I don't want to be a band aid in the world. Do you know what I mean? Like, I don't just want there to be a swath of time where I was valuable, where this information was valuable. And then suddenly it's gone. Like it needs to persist. And, and that's what I'm trying to figure out. So I appreciate you coming on and helping me add to the add to the lore of the show, and somebody is going to hear stuff that you said today, it's going to help them so I appreciate

Lisa 1:25:30
that. Thanks for having me. And thanks for thanks for the podcast.

Scott Benner 1:25:33
Have a great, it's really it's my pleasure. What time is it there, as I'm saying

Lisa 1:25:37
is almost 430 in the afternoon.

Scott Benner 1:25:40
Very nice. I am going to go hit a baseball with my son for a while and try to have a nice day. I hope you do as well stay

Lisa 1:25:47
safe and stay sane.

Scott Benner 1:25:49
I wear a mask. wearing masks, although I have to tell you last night 8pm not tired. completely out of things to do. I actually thought maybe I should just restart the next workday now. like should I sit down and just edit a show? I was out of things to do. And that doesn't normally happen. But apparently if you lock me in my house long enough I run out of stuff to do Yeah,

Lisa 1:26:13
yeah, I was gonna say I don't really wear a mask cuz I don't meet anybody.

Unknown Speaker 1:26:19
Away from people

Scott Benner 1:26:20
be in the house here. No, I it really is an odd, odd time. Just like there's nothing to do I couldn't I in a normal situation I would. You know, I've got a list of things I'd like to do that not the least of which is you know, go visit my mother and other things like that. Yeah. But instead, I'm just standing here going. It'll be time to go to sleep soon. I guess. You know,

Lisa 1:26:44
I lost my father a lot of COVID this spring. Oh, I'm so sorry. Yeah, I know. It's sorry. It's strange times.

Scott Benner 1:26:55
First, I'd like to thank the Dexcom g six continuous glucose monitor the Omnipod tubeless insulin pump, and touched by type one for supporting the show today. Touched by type one.org for Facebook and Instagram. The Dexcom g six is dexcom.com forward slash juicebox. And you can learn more about those free trials that you may be eligible for. And the demo pod that you're definitely eligible for@omnipod.com forward slash juicebox. And of course, I want to thank Lisa, for the really fun, thoughtful, emotional, and entertaining conversation that we had. I'm working on a pretty cool giveaway for you and if everything works out, I'll be able to tell you about it very soon. Keep listening. Please subscribe in your podcast players. Tell somebody else about the show. If you love the show, leave an amazing review wherever you listen. And of course, thank you. Thank you very much for listening. I'll be back very soon with another episode.

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#468 Two for One

Megan is the mother of two children living with type 1 diabetes.

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

+ Click for EPISODE TRANSCRIPT

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

Scott Benner 0:00
Hello, everybody. Hold on. Hello, everybody and welcome to Episode 468 of the Juicebox Podcast. I don't know why my voice got that high. Sorry about that. Today, let me tell you about the show Megan's on. She's the mom of two kids with Type One Diabetes. She's gonna tell you a story. It's going to be delightful. That's how this is gonna go.

This one doesn't need a big preamble. It's a great conversation with Megan. Like I said earlier, she's got a couple of kids with type one. I really enjoyed speaking with her. While you listen to me speak to Megan, I need you to remember that nothing that you hear Megan or I say 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. A

couple of quick things, check out the Facebook group for the podcast. It's Juicebox Podcast type one diabetes, it's a private group just have to prove that you're a real person. And then you can get in and talk about type one with over 10,000 other listeners. If you're looking for the diabetes, pro tip, or defining diabetes episodes there in your podcast player, right, you can find them there or you can find them at Juicebox podcast.com. Or more specifically, at diabetes pro tip.com. There'll be a tiny bit more music. We'll thank the sponsors and get started.

This show is sponsored today by the glucagon that my daughter carries g vo hypo Penn. Find out more at G Vogue glucagon.com forward slash juicebox. This episode is also sponsored by the Contour Next One blood glucose meter. You can find out more at Contour Next one.com forward slash juicebox. Check out the meter art and uses it is the most accurate and easy to use meter that I've ever seen. honest, I'm holding up my hand like you do before a court hearing where you're like I swear to tell the truth, the whole truth and nothing but the truth. That's exactly what I'm doing right now. Because that meter rocks Contour Next One comm forward slash juicebox just introduce yourself.

Unknown Speaker 2:31
Guess as much pressure. Okay, so hold on, hold

Scott Benner 2:34
on. I'm gonna stop you. Does it really feel like pressure because there's this? Everyone like stops for a minute. I'm like, just just introduce yourself and then we'll start talking and they go out and some people get very formal. They're like, Hi, I'm Scott Benner. I've, you know, this, it's like, it's like, it's like their their x, their exit interview with a job. And then there's the HR guy and like, Oh, we've never met before. I'm Scott Benner leaving the company today. And I want to leave you some parting thoughts about, you know, my time here. And some people are just like, Hey, I'm Megan. My kids got diabetes, and they're done. I'm like, I never know what anyone's gonna say. Are you nervous?

Megan 3:13
The small little synopsis? I'm a little nervous.

Scott Benner 3:15
Are you really? It's just a podcast right?

Unknown Speaker 3:18
Now.

Unknown Speaker 3:18
This isn't. I know, I'm

Megan 3:20
gonna hear my voice later and be like, Oh, that sounds horrible.

Scott Benner 3:24
Well, I will tell you the same thing. I tell everyone else that says that no one knows what you sound like. So you sound to them, like however you sound and they'll have no thoughts about it at all.

Unknown Speaker 3:34
All right, well, I'll

Unknown Speaker 3:35
give it a go. So

Megan 3:36
hi, my name is Megan. My husband and I have three boys. And our oldest two both have type one diabetes. They were diagnosed at the same time. And they're diagnosed about 19 months ago. So currently, they are now seven, four. And then our youngest is three, the one without diabetes.

Scott Benner 4:00
So the two that first of all, the youngest one who doesn't have diabetes. I'm sorry for him because this is probably the last time we're gonna mention him. And the other two, when you said they were both diagnosed at the same time it my heart right away goes, Oh, they're twins, but they're not even close in age. Nope. You just Yeah. Are you like sitting on top of a diabetes bomb or something like that? Like me?

Megan 4:24
Yeah. Then we're a first for the doctor and all the nurses in the clinic. Everyone's like we've had siblings, but never two at the same time. And they're always really thrown off by the fact that they're three years apart in age and the and there was no you know, clear onset. They're like, were they both sick at the same time? Nope, not at all. They were very healthy that entire winter. So okay, I have no idea why the timing was like that. I'm sure we you know, we were looking back at it and we're like, I'm sure they didn't start with it at the same time. We just saw the symptoms at the same time. Okay.

Scott Benner 4:57
I want to pick into this for a second because that's what I was gonna May I ask So, okay, so seven and four, is that right? Correct. Okay, and how long ago were they diagnosed?

Megan 5:07
That was February of 2019.

Scott Benner 5:10
That tells me that they were six and three at the time.

Megan 5:13
Yeah, our oldest was just a little bit shy of his sixth birthday. Oh, five.

Scott Benner 5:18
Okay. So which. So first of all, do you have any inclination about what diabetes is? Like? What was your first thing that?

Unknown Speaker 5:24
Yeah, so

Megan 5:25
we we have type one in our family. On my husband's side, he has two half siblings that have type one diabetes, one was diagnosed, I think he was about 11. But then his sister only was diagnosed a couple years ago in her 20s. have siblings on his father's side?

Scott Benner 5:44
Yes. Don't know why characters, just double check. I

Megan 5:46
don't know. Does that matter? Is there research that goes with that? That'd be interesting. Just imagine if I didn't, on his father's side. And then it's very distant in my family. But my mom has two first cousins who are siblings that both have it, but it's pretty distant.

Unknown Speaker 6:03
That third four years look nervous. Is he just walking around going hard? Can I see where this is headed?

Megan 6:11
No, I, you know, honestly, I don't think was ever on our radar that our kids would ever have it. Especially since you know, I think when we had our, actually, when we had all of our children, there was just the one family member, his half brother. And his sister got diagnosed later, just probably about a year before our children really. So it wasn't really something we thought of much. And then actually, by coincidence, I'm not blood related. But my brother's wife is also a type one diabetic. So we're pretty familiar. As much as anyone could be familiar when they're not living with it day to day. I also work in health care. I'm a speech therapist at an acute care hospital. So I am more educated on type two diabetes, because I work a lot with stroke populations. So I know the symptoms, you know, I know that I know what normal blood sugars are. So there's just a day where it suddenly clicked with me. And I just knew it.

Scott Benner 7:05
Which which kids? Did you see it in first? Or did you see it at the same time?

Megan 7:08
So our middle son, he had just turned three. And I think what was hard for us for a while is since both the two oldest, you know, our youngest at the time was only 18 months. So like, you know, he he's still eating and behaving more like a baby. The other ones, they were doing the same thing. So it was easy to just kind of ignore it and be like, Oh, that's normal child behavior. They're always drinking water. They always want more water, they are always saying they're hungry. They want another snack. You know, that's just what our kids are doing. I guess they're growing boys. Right? So we explained it away for quite a while. But then our middle. There was one day in particular, I was at work and my mom had sent me a message saying like, he is like begging for water. I was like, Okay, well, we have the pediatrician. His three year appointment is next week, you know, I'll bring it up and everything. And then that evening, you know, he was still, you know, talking about water all evening and everything. And then all of a sudden, it just clicked with me. I had remembered that a little bit after his birthday party. He came up to me in the morning. And he said Where's pull ups at night. And I remember saying, You smell so sweet. It must be all those brownies you ate at the party or something. And then all of a sudden, it clicked with me that evening. I was like, Oh my gosh, when he smelled sweet to me, that was sweet smelling urine. And I just we were about to put the kids to bed and I told my husband I was like I just I don't feel right. He shouldn't go to bed. I think he has diabetes and bring him to urgent care. So I go to urgent care with my super happy, delightful sweet kid. And they I'm sure rolled their eyes at me when I was like, I think he has type one diabetes like sure lady, whatever.

Unknown Speaker 8:42
Like get some sleep drink.

Scott Benner 8:46
Like they're probably like, get some sleep and stop drinking after dinner. You know, like calm down a little bit.

Unknown Speaker 8:53
I wasn't sure they thought I was

Scott Benner 8:54
nuts. I wonder how often it happens. That there's nothing wrong that it starts to seep into people's minds that people overreact. Does that make sense? Like I wonder how Yeah, how many times they have to look at people and go, Oh my god, there's nothing wrong with you get out of here. And then until they start thinking that that way, by the way, I just want to take a detour for a half a second. Anyone who doesn't have children yet? Who wants a good reason not to have them Megan just told you that she smelled urine and thought Oh, that's nice, my baby. That could be your life too. If you make a baby or could just you know put some effort in yourself and get a condo. So anyway, if you want to think if you think urine is gonna be a big part of your happiness later. It's going to be if if Anyway, I'm sorry, Megan. So there you are. You are rolling to the Roland to Urgent Care lady. What and what what do they do there? They just did they do like a urine dip.

Megan 9:52
Um, they did a finger prick and he was 530 something I think 535 so we instantly knew I guess even at that point, I guess I still thought because I knew he wasn't like acutely sick that he wasn't NDK. Like, there was no signs of that. So I just thought we were would be going home, and we'd be following up with the pediatrician or whatever, you know, get referred on, I guess I didn't really think this was gonna turn into a whole hospitalization and everything. So the next thing I know, we're in an ambulance to my hospital that I work at, which is not a pediatric hospital. So that annoyed me because I knew they were just going to, you know, do stuff there and then send us out to the pediatric hospital. So we took two ambulance rides that night. So by my other son, so I went to school the next day, and when he got home from school, I was talking with my parents were like, you know, saw the same symptoms as a Can you bring him to the pediatrician and have him checked right now. Right? So they went and checked him. And then Luckily, that one was just a direct admit from the pediatrician to the hospital. So he was there. In less than 24 hours from when we were admitted with our middle

Scott Benner 10:57
you remember his blood sugar?

Megan 10:59
His was for something

Scott Benner 11:01
pikeur Okay,

Megan 11:02
I just remember being on the phone when my dad gave me the call and my the nurses standing there, and I just start sobbing. And that nurse was so sweet. She had no idea what was going on. It was like my other sons coming here now.

Unknown Speaker 11:13
Like, what are you talking?

Megan 11:15
She was wonderful. So yeah, we kind of took over the floor for a while.

Scott Benner 11:18
You didn't consider asking your dad, like just put all the kids in the garage in the car, and I'll be home in a second. We're gonna get I mean, that's crazy. Like, no, no kidding. that's legit nuts.

Unknown Speaker 11:29
That just it was very nice.

Unknown Speaker 11:30
Oh my god. It's like getting hit by a car and standing up in a plane crashing and be

Unknown Speaker 11:37
like that analogy. I

Unknown Speaker 11:38
felt.

Scott Benner 11:40
Just like I can't believe I live to this car accident. I feel very dizzy. And I think my arms falling off, but I'm alive. And then. And then as you're dying on the ground, pinned onto the plane, a raccoon starts eating your feet, and you're aware of it. That's all this is picking your toes. At first. It's like, Oh,

Megan 11:58
yeah, I guess that's kind of how we felt we were waiting for the third way we kept on being so worried about our youngest son. So you know, a couple weeks later, is when we start doing the trialnet testing and all that for him. And so far, everything's fine. But like, that's still how we feel. We're like, well, When is that going to happen? Oh, it does. But it's always what we're kind of just waiting for.

Scott Benner 12:16
You must have PTSD. Seriously, right. Like, you just must walk around. Like, I seriously I'm like thinking like if someone breaks into your home that the rest of your life you walk around the house thinking like someone's gonna come through the windows, I'm just gonna come like you just probably can't shake it, you know? Wow, that's and there's no reason like, not that anybody would know. But no one's offered an idea or just, it's just random that they both. Got it. Alright, so hindsight, hold on a

Megan 12:45
second. Yeah, in hindsight, I think our oldest his son, his symptoms were always a lot more mild than our middle so i can i can trace it back over a longer period of time when I saw that. So I'm thinking he probably actually had it a lot longer and it just wasn't as significant. You know, he was honeymooning a lot longer. Because even now I'm like through the whole honeymoon period. He honeymooned way longer than our middle. And even now, he still I'd have to double check it. But I still think he uses less insulin mostly on a daily basis than our middle does. So okay, something I don't know. Somehow it just like attacked our middle a little bit harder, I guess. So I think his symptoms just came on. So suddenly, and were much more significant. So we noticed it. But I don't I highly doubt they got it at the same time.

Scott Benner 13:40
Yeah, I'm not saying that someone threw a switch on the side of your house and gave everybody

Megan 13:45
but it did. I mean, those thoughts went through our head as we start researching where it came from, or like, Is there something environmental in our home or like, you know, all that stuff comes to you like, oh, should we be moving out of our house? And like, you know, some diabetes trigger, but it's I mean, I think it's all just a crazy coincidence.

Scott Benner 13:59
Yeah. Well, yeah, I think you you outlined it pretty pretty well there. Your your middle son symptoms came on more rapidly, you notice them, and then while it was fresh in your head, you were like, Oh, God, the other kids been doing that too, but not exactly drastically. And so it might have taken him. I wonder how long it might have taken him had your middle son not been diagnosed? How long until you would have figured out your your older son had it?

Megan 14:22
Yeah, I think that's what was emotional about it for me, too. Is he at this, you know, and around the same time, he was having more, you know, like, meltdowns, just like, you know, Qmr behavior problems and changes. And so I think so much of like, what was happening, we just kind of attributed to that, like, Oh, that's just him being dramatic or him Do you know, and like, then I felt horrible being like, Oh, my gosh, those are medical symptoms, too. Yeah. For a while, probably,

Scott Benner 14:51
I'll tell you, for people who don't have children, it's maybe difficult to understand, but I can give you an example. That's once You would think we'd be on such a smaller scale, but almost hit me exactly the same way. When my son was just a few years old, we noticed, you know, over months and months and months that he seemed a little hard of hearing, you know, and he was just sort of like, you'd always repeat yourself to Him, and it wasn't ever drastic. And just one day, I said to Kelly, I'm like, I'm gonna take him to the doctor and have his hearing check, because it's kind of crazy, you know, and the doctor looks in his ear. My friend, Adam looks in his ear, and he goes, his ears completely blocked with wax. And I'm like, really? Like, that's a thing. Okay. You know, like, I just had my first kid, I didn't know, you know, we were still like, figuring out how to, like, pay the bills on time. And, you know, stuff like that. And so we were pretty young. And he says, I like to have the nurses do this, because I don't like the kids to hate me. And I'm like, Wait, what? So he leaves the room. And the nurse comes in. And you know, she takes this lavosh it's just this water the Jets through this tiny little nozzle so that it makes like this, you know, like laser thin line of water. And I guess she's basically drilling a hole through this wax to fill his ear behind it to throw the plug of wax out of his ear. Anyway, I didn't need to describe all that. But the, although it is kind of fascinating, isn't it? And into the wax comes flopping out on to like a little towel. And she dabs off his ear. And somebody says, hey, how's that coal? And we start talking, and he stops us and says, Why is everybody shouting? Yeah. And then it made me cry. Because of exactly what you just said. I thought how do I not help him sooner? Yeah, you know,

Megan 16:38
oh, we went through the same thing with my oldest two, he had tubes put in his ear as he's had wax problems for years. So same thing, like we thought we were past it. You know, he had all that when he was really young, kindergarten comes around. And actually, this was a few months after he got diagnosed with Type One Diabetes. The school nurse is like, oh, by the way, he also failed his hearing screening. And I was like, Sure, I was so distracted by all this. I kind of forgot about his ears. Like, we haven't been to the end and a while. And sure enough, I look and he's got like, you know, he's got impacted earwax. Again. I was like, Oh, great. So I let your hearing go. Because we're so distracted by diabetes. You know, I'm gonna feel horrible. Yeah, parenting is just, like a whole big game of guilt.

Scott Benner 17:22
It's terrible. And listen, I'm gonna say something after I say this, but I'm gonna take interviewing credit for bringing up the your thing, because it brought out your story, even though I had no way to know, but I'm still taking credit for it. But you know, it's just listen, the truth is, it feels like a cliche, right. But you know, from the minute you're born, you're dying. You know, like, it's just you're on some sort of a slow path to deterioration, it's hard to think about, but it's, it's true. And when you have something kind of chronic come up or something that's, you know, quote, unquote, outside the norm. It feels so crazy, like, Oh, my gosh, my kid has this and this and this, and I stop and think about the things that are wrong with me and my wife, and then everyone I know. And then you come to realize that this no one escapes this. You don't mean like this, something like this is happening to everyone constantly. You don't know. You know what it is, but it's happening to somebody. And, and it could be something that's real obvious or something that makes your pancreas stop working, or like I have plantar fasciitis, like I walk around, like some days of the month, and it just feels like someone's constantly stabbing me in the heel. You know, I don't tell anybody about it. But it sucks, and my life would definitely be better if it didn't happen. You know, so, but everyone's dealing with something the person who is born and dies 95 warm in their bed without ever being sick probably doesn't exist, you know? But isn't it what you think's gonna happen when you make a baby? Yeah,

Unknown Speaker 18:52
he wish Yeah,

Scott Benner 18:53
right. Everybody thinks that like, Oh, it's gonna be great. isn't gonna be great. It's gonna suck.

Megan 19:00
Especially when you've been home for months on end and doing e learning. Oh, yeah.

Scott Benner 19:04
You're learning English. At the foot of your parents bed on a tiny sofa that we drag into our bedroom so that Arden could do her, you know, be closer to the Wi Fi signal. Like that's what High School is. And my son's getting a degree down the hall in his bedroom. It's all going really great, you know? But But no, seriously, it's just it shouldn't be a bummer. It really should be enlightening. Like, something's going to happen for most people, you know, varying levels. And I think that a lot of people have something go wrong. And then they think oh, luck. See, now life's not perfect the way it's supposed to be. Except I think life's not supposed to be perfect. I think it's supposed to be the other way. Just

Unknown Speaker 19:43
Exactly.

Megan 19:44
Yeah, I think that's one thing that's helped me through all this is my professional experience and helping people overcome stroke and brain injury and various health crisis sees that they don't see coming and it comes out of nowhere and you have to deal with your new life. If you're new normal afterwards, and you don't choose it, but it's choose to make the best of it. And, you know, so I think in running and I used to run support groups for them and everything. So having that experience has helped me get through this. And like, this is just our obstacle, this is what we need to do we have no choice, we can dwell over it and you know, just kind of feel sorry. Or we can just move on and say, Okay, how are we going to get this, you know, life out of this and everything and make it work for everybody. So that's what we do. So

Scott Benner 20:33
best time in the history of mankind to be alive. If this was happening to you, while you're on a wagon, going out west trying to find California, when they went around a little curve on a hill or a mountain or something, they just would have pushed you off the wagon, you know, they mean, that's all they would have been like, hey, grandma doesn't hear well anymore. clunk. She fell. That's the end of it. Like nobody, they leave you in the desert sleeping, and everybody just kind of goes away quietly, and you freeze to death in a coyote. That's that used to be the world.

Unknown Speaker 21:01
That's just so sad.

Megan 21:03
I've been reading the book, I'm totally what's it called breakthrough, or I can't remember, it's called the book about like, the history of insulin, okay. And it's just fascinating. And then you just oh my gosh, your heart just breaks like reading and thinking about how these parents dealt with his with these kids before insulin. It's just, it's just horrific. So Oh, my gosh, I think every day that we have

Scott Benner 21:26
all the tools that we have, it's amazing. I try to remind myself all the time that prior to you know, 1920, or whatever it was, my daughter would have died when she was two. That's all and then she's in the other room. I think learning English. So you know, it's amazing. I it's the same thing that when you hear people like complain about their technology around diabetes, I always think like, really, like, it's not perfect. It's like two years old. Like they just thought it up like five seconds ago. You know, like it's, look what it's doing for you. And I know it Listen, we should always push towards better. But you know, I don't know what is made perfectly the first time and you know, when so? Just take the little. Everything's got pros and cons. You know what I mean? So, you got to take the cons in stride. Because if not, like, what are you doing? You know, you're gonna

Megan 22:17
play I agree to having, you know, I'd rather have the stuff out to me faster and have a few glitches happen, and have to be waiting for it to be perfect.

Scott Benner 22:27
Because by the time they get it, you know, somewhere near perfect, they'll come up with a different idea. And then they'll start trying to get that thing to be perfect. And you'll never see any of this stuff. And again, you could be just shoved off a hill in 1850. Billy looks tired. He's always asking for water. Whoops. You don't like like what do you

Unknown Speaker 22:47
think happened? wanted to go around?

Scott Benner 22:48
Yeah, we let him play with the wolves. That's all fine now. It just like you know, it's things are so great right now. Now listen, not to not to minimize the fact that two of your three children got diabetes on the same day, because that and I've just bleep this out later is terrible. It's really, really, really horrendous. And I'm sorry for you. But how are you guys doing with it all?

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Unknown Speaker 24:00
You use a blood glucose meter every day, every day, and you count on it.

Scott Benner 24:08
But have you ever wondered if the meter you're counting on is accurate? Two pretty important question, right? Well, I can point you towards an accurate blood glucose meter. And it's not just accurate, it's easy to use and it has some other stuff about it that I love. I'll tell you about it in a second. But for now, let me just tell you the name the Contour Next One blood glucose meter. This thing is accuracy personified. So good. It's in fact the most accurate meter Arden has ever used as we come up on her Oh my gosh. 15th year of diabetes maybe I don't know if she got it when she was two and she's gonna be 17 Yeah, 15 years. Best meter I've ever seen. It's easy to carry, easy to use has a nice bright light, a nice bright screen and it has Second Chance test strips meaning you can go in hit the blood not get enough, go back, get more without changing the accuracy of the test and you don't waste the test trip. Contour Next one.com forward slash juice box head over. It is a website full of information, you know, when you go to a website, like there's nothing here, there's so much at Contour Next one.com forward slash juicebox that if I start listing it all here, it's gonna boggle your mind. So I just have to leave you with this great meter, you can find out more about the website, they also have a test trip program, and you may be eligible for a free Contour Next One blood glucose meter, that should be enough to get you over there to check it out. Please use the links in your podcast player or the links at Juicebox Podcast comm if you can't remember the URL, the URL, the contour next comm forward slash juicebox I'm going to quickly remind you to visit T one d exchange.org. forward slash juice box fill out that survey help other people living with Type One Diabetes. While you benefit the podcast must be a United States citizen who has type one diabetes, or is the caregiver of someone with type one.

Megan 26:21
Oh, I think we're doing pretty good. You know, I literally the very first night in the hospital is when I found your podcasts. I've been a listener for a long time. I'm a big podcast listener to begin with. So one of the first things I did is I'm up all night and can't sleep is what kind of resources can I find online? What Facebook groups can I join I had an I had actually stopped using Facebook for a while because I hate Facebook. But those groups are so helpful. So I I joined again to get back into those groups. I joined some of those I started looking for podcasts about type one diabetes. And so I just started immediately learning as much as I possibly could. And we went home from the hospital already on Dexcom. And we had pumps within a few weeks. And that's where we've been. Yeah, that's cool.

Scott Benner 27:03
So you're proactiveness really got you like leapt you forward quickly.

Megan 27:08
I think I think so yeah, I think we kind of dove right in. And our entire family is incredibly supportive and wants to learn and we had the support of my my sister in law coming and helping us right away coming in organizing the cabinet full of diabetes things and we color coded everything in the beginning just so we wouldn't mix things up. And everyone kind of helped us and we got hit the ground running.

Scott Benner 27:32
I'm gonna ask about that in a second. But I want to just ask like, like, do they both use the same meter or the same glucose monitor that kind of stuff? Yes, currently,

Megan 27:40
we're using everything the same. Currently, they both have Omni pod and Dexcom. And we're looping on auto Bolus. So we're doing all everything's the same. Right now we have had a few times where we've done things differently for a while, like my middle we tried. We used to be on Medtronic, and we tried auto mode for him. And we tried the Medtronic CGM for him do the auto mode. So for a while they run different setups, which wasn't too bad. But we try as best we can to keep it the same. As long as it's working for them. And it's not drastically, you know, obviously, if one child really needed something different we change it. Otherwise, we since get good results. We're trying to keep it easy on all the caregivers

Scott Benner 28:22
read it for like simplicity sake, right?

Unknown Speaker 28:24
Oh, yeah. Yeah, for my

Megan 28:25
own sanity,

Scott Benner 28:27
giant ordering and

Megan 28:28
the organizing and the replacing. And I just it's it's a lot

Scott Benner 28:32
to imagine if Arden supplies came double. I don't even know where I would put them.

Megan 28:36
We have a big cabinet.

Scott Benner 28:39
drawer, but a drawer would not wouldn't do it for two kids. That's great. Oh, that's really interesting. How did they handle it? And are they Is there like a kinship between them over it or not? Really?

Megan 28:51
Yeah. So they're they handled it really well. Our oldest is very mature about it, and he loves, like math and everything. So I think he took to it pretty quickly. He started bolusing for himself. You know, he was diagnosed at the end of kindergarten. So he didn't he didn't it was half day. So he didn't eat at school. So we never had to worry about that in kindergarten. But by first grade he was doing his totally independent at lunchtime, he would Bolus his own meals. He's learned you know a lot about percentages and fractions because of how much food he ate and you know, different percent overrides and all that so he learned a lot that way and he just thought it was interesting. So I think that's how we engaged him in diabetes. And I think he kind of liked showing his brother that it was okay that you know like this is how I stay calm during my pod changes and things like that. So they share kind of little tips on this is you know how I make it better. And like my our middle he already doesn't remember life before diabetes I asked him about and like you really don't remember like even being in the hospital. He doesn't remember any of it anymore, because he had just turned three. So I think this is all he really knows. And because this is so much of our life, like even our youngest, like, he knows everything he knows how to fingerprint he'll set everything up and you know, to fingerprint his brother and he eyes whole asked for, you know, the same like a tape covering, you know, on his arm so you can look like his brothers. And he knows, like, the alarms will be like, oh, sounds I was low, and, you know, so that it's just kind of part of our everyday life. So I don't know. It's just,

Scott Benner 30:35
that's amazing. I mean, it's, it's, it's what you would hope to hear, right? Are they ever? Like, like, is every one of them ever just like competitive with the other one? Like, oh, my number or anything like that? They? Is there any of that going on? Any brotherly jiving? I guess? Little ones? Probably little No,

Megan 30:52
actually, I don't think that really comes up very much. No,

Scott Benner 30:55
that's cool. I want to understand a little more about your older one. And the the math are you? Did he learn these kind of concepts through doing? What did you actually sit down

Megan 31:05
with? I mean, he just he loves, loves, loves math, like he is in second grade. And he asked me for algebra problems. He's got a math brain. But I think just early on, it would be like, Okay, well, you're, you only ate half of the sandwich. And so you know, we talked about the his carb ratio, and how much then he should get. And, you know, we kind of just introduced it that way. So, I don't know, it's just I think it was just a really real life way for him to engage in something he was already interested in. So he just I feel like he just accelerated really fast. That's lucky because of that.

Scott Benner 31:44
That's just incredibly lucky, right? That it's it hit him in his wheelhouse for the lack of exactly.

Megan 31:50
He's always liked being able to control the pump and do things on it. He thinks it's really interesting. And now he's kind of starting to learn about we talk about the different absorption times for different foods. So he's been learning a little bit about that and try some, he memorizes he knows more carb numbers, and I do I'll be like, enter what's the snack again? And he'll be like, Oh, yeah. You know, so we'll bring up certain things that like we already we forget it, like something he hasn't had in three months. And I'll remember how much it was. I'm like, Alright, I'll trust you

Scott Benner 32:22
Arden's more aggressive than I am sometimes. Oh, yeah, I'll be like, how many carbs? You think that is, right? Your how much insulin you want to use here. And she's always a little stronger than I am. And I'm always like, I try that, then. You know, like, I don't know how other people think about it. But I used to take the Omni pod PDM. And, you know, there's, if when you're really trying to, like roll up insulin, like because I wasn't, you know, when I counted carbs, let me think about how to put this. So people who have a pump and you push a button up in the, you know, the numbers going 123, I would just push the button and look at the plate and think five 710 1525 38 and I look over and I stopped at like, you know, 48 and I'm like, that's fine. And just, like, get it going. Because I realized I was every time I tried to be specific about it. I was always too light. So I just thought like, Alright, more, you know, like Moore's fine, more works. And I didn't, I wasn't thinking back then about, you know, the different impacts that food has, I wasn't thinking oh, well, the glycemic load of this food is probably greater than the carb count. Like I think about that now, a little bit, but back then I was just like, stop it. You know, it was like, it was like, literally, like I was on the prices right? And came within $10. I was like, Good enough. I'm gonna stick with that. Bob, let's go with 48. And it's it's really interesting to hear that somebody can think of it so much more specifically, and still have really good luck. Are they both having good success?

Megan 34:01
Yeah, you know, the getting on loop has been a huge learning curve. I think it's gotten much better in the last couple weeks, and we're definitely going to stick with it. But it's been a big learning curve. So we've had a lot more highs recently than normal. But I mean, even even with that a month ago, or maybe five weeks ago, our middle happened to have an A one c done just because he was having other labs done. And he was 6.0. I do think there were probably a few more lows mixed in there too. So I don't know if that was the best indicator because, you know, some of the other stats aren't exactly where we want them to be. But in general, we've always been between probably like 6.0 and 6.7 on a one sees the whole time since diagnosis pretty much Um, so I think our goals are like, our goal is just more stability, like a lower standard deviation. You know, less, less intervention needed from us and the other caregivers. So that's kind of our goal with loop. And we're just still trying to learn exactly how to get there. But we're making strides each time. So yeah, I know, we're still fighting that like, rise, right? When they fall asleep, we're still fighting it like crazy. We do like everything. So that's a big one we're working on?

Scott Benner 35:19
Well, I have to say, I agree with you. And I think of it in a very similar way. I don't think about obtaining an A one C, I think about stability, stability, and a lower number Pre-Bolus, saying, you know, doing the things that I know, lead to success, and then the a one c number just sort of, is a byproduct of that. You know, like, like, if you do these things, you're a one c turns out to be in this spot. If you do the more aggressively it ends up being lower. You know, if you do it too much, you end up with a problem. So you just kind of stay fluid and bring it back again, I think that's an incredibly healthy way of thinking about it. Instead of just thinking about the numbers. Think about doing the thing. Yeah, I don't. Yeah,

Megan 36:04
I don't really yeah, the number of course, we want good numbers, but I really just want them more stable. And I feel like once we see more stability and more predictability, then we can kind of lower our target a little bit from there. Yeah. Right now, it's like, part of our problem is not just learning loop and all that. It's, it's that like, we get these wild card days, I feel like they're thrown in there. And it's like, oh, well, this are the pods, just currently, this one's not working. And we have a lot of those problems with our middle, like, we have to change every two days. And sometimes even that the second day, it's like it's hardly working. You're just like pouring more insulin in and it's like not doing anything. So I feel like there's a lot more variants with him a lot more like, I wonder, Is this a pod? Is it something else? Is he suddenly growing? Like there's, we're constantly trying to figure out? What is the big change because everything will be exactly the same, and love drastically different numbers. So we're trying to figure that out. So sometimes, so

Scott Benner 37:00
does that work better than others?

Unknown Speaker 37:03
Does he have sites? Or sites that

Scott Benner 37:05
work better than Yeah.

Megan 37:08
I wanted to say yes, but I feel like there's still not even really a good pattern to that. Right now we're we seem to be getting the best success on his arms. He is so thin. All my kids are just Third thing. So we don't have a lot of fatty spots to put things.

Scott Benner 37:24
I'm just hard to keep them hydrated with just water.

Megan 37:28
Not really, they drink water throughout the day. And a lot they actually drink a lot when they go to bed for some reason. Everyone likes to drink water while they're listening stories. Yeah, I think everyone stays hydrated pretty well in the family.

Scott Benner 37:41
That's cool. I mean, you know, just trying to think through different reasons why insulin would do what you want it to do or not, is really how I think about it. I just think about, you know, is the water do it. Excuse me, I just got a text from Arden that took my mind off of what I was saying. I asked her to Bolus 10 carbs, and I didn't get a response. So I just put like a little like exclamation on it. You know, you can do that too with accent and then I got oh my god stop in return. And if later I tried to explain to her that if I didn't do that she wouldn't see it. Then she'll just stop listening to me while I'm explaining it to her. So anyway,

Megan 38:15
I did it. We we have the same kind of situation just like you know, if I'm at work, and I'm trying to look and be like, Did somebody do this? Like I want to be like a nag to whoever's with the kids. I'm like, Did you do this or not? So I you know, I just learned how in nightscout you could put different notes and everything. So I'm gonna teach everybody like, here's how you can enter like, extra information so that I can see it and then I won't have to like nag you and be like, was that john? Because I don't want to sound like a nag. I'd rather be able to just look at the info and be like, Oh, great. They just did a finger prick. That's good. Oh, great. They just Bolus extra here. And you know,

Scott Benner 38:44
I don't think I would nag. I don't think of it even as nagging. But I think the thing that bothers me and I think might resonate with people, is that when I text you, Hey, is the house on fire the entire time between after I hit Send and when you respond to me as to whether or not the house is on fire. I'm standing perfectly still, like wasting my life. That's how I feel about it right there. I feel like I'm like I'm standing here waiting for someone to respond to me. I'm not talking to Megan, I'm not doing what I'm supposed to be doing. Sometimes you're in a grocery store, standing perfectly still waiting for someone to respond to you or you're you know, you get in your car and you go to drive away. You're like, hey, real quick, can you Bolus to half the unit, and then they don't respond. Now I'm sitting in a dry like in a parking lot in my car, waiting for someone to respond. I just I've explained to her a million times. I'm like, Look, I'm not bothering you. But try to put yourself in my shoes. You've put my life in status. I just paused. You know, like I'm paused waiting to hear back from you. And I was like and after 30 seconds it starts feeling like what am I doing? With my time you know, like I'm standing here waiting for someone to respond to me. And so I'm not trying to bug her. I just want to make sure she sees it and you know at Anyway, I'm sure every parent in the world had has had that thought at some point. I just that's the part of it that bothers me. It's the, it's the wasted time. I'm just sitting there going. Okay. And then by the way, what if she didn't say it?

Unknown Speaker 40:11
exact so

Scott Benner 40:12
now I'm like, then I text again. Hey, and then she'll say, Oh my god, like, or I didn't see the first one. It's good thing you sent me the next one. Oh my gosh. Yeah, it's a it's a harsh show. But yeah, I don't like standing there. It just makes me it just bothers me. You know, for the the wasted time and just the pausing. It's just

Megan 40:33
like, yeah, I feel bad. So um, my husband sleeps through absolutely every alarm and alarm will never ever wake him up. So you know, I'm the one that wakes up to the alarm. So as a backup just in case, my dad still has like the urgent low alarm on his. So anytime there's like any sort of urgent low or anything at night. My dad is just sends a an email, like, Is he okay? And I have to respond back like, yeah, I'm on am awake, you know, otherwise. So like, the plan is like, if I don't respond within like 30 seconds or a minute he calls me. Today, I think of my poor dad, I guess quickly. Like, I think even before I go do any treatment, I'm just like, yes, I'm up. I'm up. It's okay. Like, I always just try to make sure because I know you must be sitting there in the middle of the night being like terrified. He doesn't know what's going on, you

Scott Benner 41:18
know, that compassion that you have for your father is really all I'm asking for. And by the way, you said he emails you is does he not have his fax machine handy? No, I

Megan 41:31
think they i don't i guess i don't know why we don't text I think originally Well, part of is because like, he doesn't know for sure if I'm, if it's still my husband's duty time, or if it's my duty time, like so a text message wakes me up like it has a, you know, I have an auditory sound, audible sound, where's my email? I don't. So I think he's trying to make sure he doesn't wake me up. If I don't need to be woken up. If my husband's in charge at that time, you know, so it's just don't respond to me, then we get a phone call. So it's more just like to make sure I'm sleeping.

Scott Benner 42:04
It's a very weird bounce. Also not to give your husband life advice, but never let your father in law complete something for you. It's not good. Just makes her feel like our dad is better at this than you are. So just, you know, I know what to do. And that's never like Kelly's father be the knight in shining armor anymore. That's it. I gotta, you gotta fix that.

Megan 42:24
And I think he's happy to take over some of that my dad's a retired engineer. So you know, he has a mind for looking at diabetes graphs and everything too. So I think he's happy to be like, okay, the more good eyes on this, the better.

Scott Benner 42:37
Sounds like you might have given that to your son to

Unknown Speaker 42:40
that. Yeah, that's my math mindset.

Scott Benner 42:43
Yeah, it's very cool. Well, I'm going back to do you want to talk about the loop for a little bit? Or do you have something else you want to talk about? Yeah.

Unknown Speaker 42:52
I'll talk about anything.

Scott Benner 42:53
So what's like, whatever I'm here now. I mean, I stopped my kid from learning for this. So we might as

Megan 43:00
what happened, I don't know. I'm trusting that he's another room learning who knows.

Scott Benner 43:04
He's not

Megan 43:07
Luckily, he goes in person on Monday. So I'm like, we just got to get through a few more days of this.

Scott Benner 43:11
It's interesting to me that they go some days but not other days. I don't mind

Megan 43:15
this is a we've been all virtual. And then we're going all in person starting Monday, so we'll see. Yeah,

Scott Benner 43:21
well, you my brother's kids schools just you know, they were like we're going it's fine. And then yesterday, he texted me He's like, yeah, they're all home now.

Megan 43:30
Oh, yeah, I'm just waiting for that that email on Friday afternoon saying nevermind, but

Scott Benner 43:35
Coronavirus is a little bit like being in a fistfight. And let me explain my thought here. And I'm not saying that everyone should go back to school or shouldn't I'm not a, you know, I'm not a specialist on how germs spread and how disease proliferates. I'm just saying. Don't hit me if you don't want to get your face knocked in. And so like unless you're willing to stand and fight to the death don't start. And so like I don't understand sending a whole group of people back to school and then the minute someone gets Coronavirus, sending them all home again. Meaning Did you not know that wasn't gonna happen? Exactly.

Megan 44:10
Yeah. will be some cases. Yes.

Scott Benner 44:13
And didn't you say like, did you say to yourself, Well, if it happens, we're gonna send everyone home was this just like, Well, I hope it doesn't happen. It was that like, Is that what you were doing? Where you're five years old going? Maybe it won't be us lets everyone cross our fingers. Either. either send them all in there and give everybody Coronavirus because that's what's gonna happen eventually. Or don't go back but like, though, the whole hoping that germs aren't going to spread in a school doesn't seem like a plan to me. Yeah, either do it or don't. But, you know, once you start swinging hands, you can't stop in the middle and go please stop beating me. I want to give up now. That's not how a fight works. So anyway, I don't know it just it seems like a ridiculous notion to me either do it or don't do it but you know, don't do it. imagining that like you know, the laws of Physics and science aren't going to apply to your situation. Very strange. I'm just gonna jump out of this plane without a parachute. If I feel like I'm not stopping, I'll just call do over. I guess it's not gonna. I don't know, I think it's a fascinating way I understand people wanting to go back to school and their lives and everything else. But either, you know, I don't know. It's just it seems like a lack of pre planning domain or common sense. One of the other. So you said some days on loop, there's good days and bad days. So are you is that wrapped around types of food sometimes is it when you don't Pre-Bolus is that we win the loop gets away really

Megan 45:39
tricky. So I even have like one of them an amazing, one of the loop mentors from the group and everything helping me out. And there are days where we are just scratching our heads, I think because I, we can do the exact same food exact same quantity of the food at the exact same time with the exact same level of activity for a couple days in a row and still see big differences, like big differences. So I don't know. No, and at some point, I just have to be like, I can't understand it all. Let's just look at the head. Now. Let's look at the trends as best we can and go from there and just assume that some days are going to be just really confusing. And we have no idea what the differences

Scott Benner 46:22
are put in more. I don't even know.

Megan 46:25
Yeah, I don't know. So sometimes when people talk about all this, like stability, or like, Oh, well, I'm sick, I just do 110% override, and then I'm fine. I'm like, I just like that doesn't make any sense in my world at all. There's no, there's we've never had that much consistency ever. I don't think you ever have one week is totally different from the next week and day to day is totally different. It's like I don't know if it's just the growing children or what and definitely our middle is more variable than our oldest. But

Scott Benner 46:52
yeah, I have to tell you try your best. rides never worked for me. Yeah, like that idea of like, you know, there's, I mean, for people who don't use loop, there's basically a slider that's just like, more, like, turn everything up. 10% 20% 50% like everything down, you know, 30, whatever, you just slide it. And it's, it's in my understanding impacts like basil, and insulin sensitivity. And you know, and all this stuff, and I just don't see it. It doesn't work like a Bolus marks, in my opinion. And I would say that when when loop becomes untenable to me, I just treat it like a tantruming child, and it sits on the sofa for a while. So I just open the loop. And then I act like I normally act and I put it back to where I want it and then close the loop up again. That's it, I have given up on trying to make everything perfect all the time.

Megan 47:45
That's exactly what we've done on the days where we just have like these highs that aren't coming down and loops, not, you know, getting them down.

Scott Benner 47:52
I'm just like, we give up, we are opening the loop, we're bringing it down, and then eventually we'll close it back up. Because it's just it's not worth it. Because in my opinion, if your settings are working for days in a row and then suddenly don't work. I mean, it seems like madness to me to try to pin down why it didn't work on Thursday. And to and even if you could figure it out, how are you going to make a change for that because like you said, there's variability that you you can't figure out, you don't know what the variability is. So when variability hits and causes, you know, the need for more insulin, I always just say just meet the need, just give yourself the insulin your body's asking for I know that becomes difficult for people because they say then how much because they're scared to do too much. But I you know, I'm always just like, I'd rather do too much than too little. So I'm always just sort of on the aggressive side of that. But

Megan 48:41
we try to do to like, especially those early night. Hold on one second. Thanks. Sorry.

Scott Benner 48:52
One of the kids. Yeah,

Megan 48:54
you know, my husband has he's actually still in the house. He hadn't left yet for work. So I was like, Oh, go take care of this. One kids dropping just a little bit. But um, yeah, we definitely are more of the mindset of, I'd rather give a bigger Bolus and catch it on the you know, if we overdid it, catch it as they're falling. Yeah. And then waiting it out.

Scott Benner 49:17
Well, you would definitely think that because you found the podcast on day one. So I must be like, in your ear. When you're thinking about it. It's

Megan 49:24
not totally I know, when people are like, Oh, well, it totally changed my life. I'm like, well, it did change my life. Except this is all I like knew. I never I never had those months of bad advice. You know, I'm very fortunately, we got good advice from day one kind of things. I can like unlearn stuff.

Scott Benner 49:39
Yeah, we can't take the podcast knowledge from your first few months of that you can really appreciate it. Although I really believe that, that finding it early is a big deal because I'm helping. I've helped two different people in the last number of weeks, right. And the one person's kid, excuse me, I got a little dry there. The one person's kid had Diabetes for years, and they get built up fears and misconceptions. And so telling them the right thing to do was hard for them to accept. But then I started with another person who hasn't had diabetes very long at all, and they're just willing to listen. And it's so much easier to get them to a good place than it is to get somebody who's got preconceived notions of things into a good place takes those people longer to break bad habits, I guess, or, or give up on the ideas that they thought were true. And that ended up not being true. You know what I mean? Like I love people are like, my, no, my basil has to be lower right here. Oh, I get low every night at 1130. And I'm like, Yeah, I don't think that's right. You know, I think you're getting low at 1130. Because you're super bad at dinner. And you know, like, like, I, I'm looking at your graph, and you, you screw dinner up every time and then it, then you correct it, and then it makes you low at 1130. And then you've got your Basal super low, and then you correct and there's nothing to stop the correction, you should back up again, like, you know, it's very often has nothing to do with what you're looking at in the moment. And a newly diagnosed person will hear that and go, okay. And somebody who's had diabetes for seven years has been living with for seven years, like, No, no, you're wrong. I get every day at this time. My basil has to be lower right here, like, okay, so it's a hard, it's a hard sell to tell somebody to turn their basil up to stop below. You know what I mean? Which is around about

Megan 51:28
at some point, I mean, you're just so nice to do all that I would be like, then why are you coming to me for help? If you're really frustrated me, I'd be like, well, then just keep doing it your way.

Scott Benner 51:39
I am more direct than that. But especially in person I did. I did say to somebody recently, I was like, Look, you know, do whatever you want, but it's gonna go wrong. And when it goes wrong, I don't have enough time to talk to you about it the rest of the afternoon. And so they did it and it went wrong. And then the next time I spoke to the person I was like, so, you know, like, I can unfollow now if you don't want to do this? And they're like, No, no, I'm sorry. I'm like, Don't be sorry, just you know, and it's fine for them to have to go through their process. I'm not trying to push anybody. You don't I mean, like, the worst thing you could do is? Well, I don't know, I was gonna say the worst thing you could do is make them do something they don't want to do. But I mean, if it works, then you'd think they would accept that, but I've actually seen people watch it work, and still reject it. And that's how bad the fear can be sometimes. You know, they're like, no, that they actually think that when it went right, it went right by mistake. Like, no, we did this. We made this happen. You know, like I had somebody say to me that they're gonna rise now after the meal. I'm like, No, they're not. This is what they always rise after the meal. I'm like, yeah, that was when you were doing it. I'm like, when I'm doing it, they're not going to rise after the meal. And trust that and for the next three hours, they just, they're on pins and needles. You know, and then you'll get a tax like, I can't believe you didn't go up. And I'm like, I haven't thought about it once. Just so you know. I, I saw the Bolus work two hours ago. I haven't thought about it since then. But then they get to it, which is really gratifying and nice. And in honesty, Megan helping other people sharpens my skills for talking about on the podcast, too. So I get something out of it, too. You know, it's good. Yeah. It's not completely altruistic. Oh, my gosh, but yeah, it sounds like you It sounds like you're very fluid. I like I really like that.

Unknown Speaker 53:23
Okay, yeah, I try to be

Scott Benner 53:25
what do you ever? Is it always one or the other? Or do they ever both work? Well, at the same time?

Megan 53:32
Oh, gosh, I don't know, there's a few days where we have like, really good days. They're just like, you're like afraid to even look at the numbers. Like, if I look at them, something's gonna go wrong. But yeah, you know, it's been, like I said, in 19 months, and up until maybe two months ago, I think I had probably had maybe five full nights of sleep. Um, you know, because there's always something with one of them, you know, when you have two of them, you're just up all the time, just even between the blood sugar issues, but then the technology issues like, we went through long periods of times where we just had so many signal losses on Dexcom. And things like that are all the compression loads. Something's always keeping you up. And now I have been getting much better sleep since sleep although again, we're we are higher than where I want to be at night. But I'm right now our goal is again to get a little bit more stable, even if it's a little bit higher, and then bring it back down. So I'll take it for now. And we'll get there. Then I feel really guilty on the days where I'm like, Oh my gosh, I slept all night and then I look I'm like oh it's because they say hi or shoot because I feel kind of bad. But I'm like you know I need that sleep or I can't look at these graphs and make any sense amongst my brain won't work.

Scott Benner 54:50
Yeah, no. Are you so when you're trying to bring this stability to a lower number? Are you doing it with insulin sensitivity? Are you making the insulin sensitivity more powerful?

Megan 55:00
Most of what we've been playing with at night has been Yeah, the sensitivity.

Scott Benner 55:05
Yeah, well, I so Arden, you know, because Arden's older, and she has a period, she's basically three different people every month. And with loop, I've figured out that it's a small increase, or decrease of basil, in conjunction with a small increase or decrease of insulin sensitivity. So whatever way it's moving, if she's needs more insulin, then I make the sensitivity stronger, and turn the basil up a little bit. And that seems to do it. And then you know, when she's super stable, there's that week where she's terrific. And then you just turn it down to the lower edge of, you know, basically this range that I have. And for everybody listening who's like, say, the range, what percent, it doesn't matter what I do for my kid, I'm just, you know, like, you're gonna have to find the range for yourself. But it's just, I found, I basically figured her out three different ways. This is who she is, in week two, this is who she is. And week three, and it's who she is. And week four. And then as we roll through week, the week, as soon as you see the telltale signs of it, you just make the change in the settings and everything's fine again. It's really, it's about stepping back, in my opinion, and not looking too micro at everything. You gotta have to see the bigger picture sometimes, you know,

Megan 56:22
and that's where like, when we see these big differences that will last for a few days at a time, I just can't help but think there has to be something with them being growing children, that is a hormone based change, too. And so that's why I wish that was like a pattern. I wish it was like, oh, for this week, they're like this, and for this week, they're like this, because I feel like we're just guessing every time there's a new change, like oh, okay, well just go with the swing. And yeah, figure out like, why they suddenly swung high, or, you know,

Scott Benner 56:55
I don't care about the y as much like, I would just feel like like, this is my stronger settings. And this is my weaker settings. And yeah, when they start getting higher, I just flipped right into the stronger settings. And then I

Megan 57:05
used to have that when we first switched to Omni pod, I had different basil settings, and they did work pretty well for a while. And it would be like, I had my, they were labeled weak, strong and stronger, or something where my my basil profiles based on like, what they seemed like they needed that day nice. And they actually worked pretty well. But it's kind of funny when like the endosome. She's like, so, which is you like looking at the names of trying to make sense of it. Like, um, she's like, we I look at this now and you're you're stronger is actually weaker than you're, you're weak or something. I was like, Yeah, I know, over time they've morphed. The names don't make any sense anymore. But it makes sense to

Scott Benner 57:46
stop looking for clarity.

Megan 57:48
If I should have named them that way.

Scott Benner 57:51
One, two, and three, guide it. I think that also, as they morph and you start changing, changing, changing, there is a time where you have to just there bastardize too much, you almost have to throw them away and start over again. Now, if that makes sense or not. But that's what we did. That's why we were like, well

Megan 58:11
just go to loop insert.

Scott Benner 58:13
So many dials so many times that you've lost the thread of common sense. And you just have to start over and I do that and then I'll just I pick one basil rate and I start over again. And then I adjust the off of it. And I'm going to tell you that the other day Arden switch to fiasco, we're trying something we really like a Peter, but we're we're just trying to be asked for you know, doesn't matter why right now. But we're trying it. And I have her switched successfully from one insulin to another in six hours. And I hear people are like, Oh my god, it's gonna take forever again, will it? Or will I just turn this a little bit and then this a little bit and then it'll all work again. In the end? I've come to think of these the insulin doing what I mean for it to do, or is it not? Like, I don't think about the rest of it. I'm just like, is it doing what I want? I put the insulin in here. Here's my expectation did that not happen? If it didn't happen? It's not enough, or it's too much, or I didn't do it for long enough for short enough. It's just I wanted to do what I wanted to do. And when it doesn't, I try something different. I just don't stare and I don't you know, I don't whip it around, like you know, 100 100% higher. But I also don't move so incrementally slow that it takes days to get to it. You know what I mean? By then then something changes by that and you're like, then you don't know what happened again. You need to be in that like in that space. Like when I talk about I'd rather see you do something first. So the next thing happens, you know you have made happen so that you can change it, you know, like so you can see Oh, I did this and then that happened. I should have done a little more, a little less, a little sooner, a little later. But once you do something at eight o'clock and then try to figure out the next day at 9am what happened like There's no cause and effect left. You can't make decisions about stuff like that. So it's micro for some things macro for other things. And all I can say is you get good at it at some point. Or at least I did, and a lot of people who follow the show do so I think it's

Unknown Speaker 1:00:16
helping

Megan 1:00:17
me so much. Better. Just not I wouldn't say.

Unknown Speaker 1:00:20
Yeah, I also,

Megan 1:00:22
can I just take a break for like two minutes. The youngest has been running around the house stealing Mommy, mommy.

Scott Benner 1:00:28
No, listen, we can just we're almost at an hour. We can stop here. Like, let's not have the kid out there. Thinking you abandoned him.

Unknown Speaker 1:00:34
I feel like that's gonna be in the background.

Scott Benner 1:00:37
In the background, I let it go because it's fun. Is he younger? Is he the littlest one?

Megan 1:00:41
Yeah, so he's three now he

Scott Benner 1:00:43
can handle himself. Now. Just kidding.

Megan 1:00:46
I thought maybe, you know, it's only been a whole 10 minutes. He's been alone where my husband is left for work, but somehow you still out there be like, oh

Unknown Speaker 1:00:53
my gosh.

Unknown Speaker 1:00:55
They left this. They left us. This is it.

Megan 1:00:59
We had a long talk beforehand. Mommy's gonna be in the office.

Unknown Speaker 1:01:03
A little bit of time.

Scott Benner 1:01:05
Just telling your oldest right now. I hope you know how to use the stove man. Cuz I can't drive. We're dead man. We're dead. They're gone.

Megan 1:01:13
We could do that. Like he comes down. He he's stealing food from like the highest shelf and all time. That's why we're always like, oh, gosh, please don't ever get diabetes. Because if you do, like I don't. Can't stop you from eating this good. Just as is stealing food. This was me. He's here now.

Scott Benner 1:01:27
Yeah. Hey, what's it? We don't wanna say anybody's name. That's all right. But yeah, like that's, it's totally cool. Listen, there's a really nice conversation. I don't know if we talked about anything, but I had a good time. I felt like we did. So that's good enough.

Megan 1:01:38
Thanks for having me. It's really fun.

Scott Benner 1:01:40
I'm glad. That's excellent. I appreciate wanting to do this.

Unknown Speaker 1:01:42
Yeah. Thanks for having me.

Scott Benner 1:01:49
A huge thank you to one of today's sponsors. Je Vogue glucagon. Find out more about chivo Kibo pen at G Vogue glucagon.com Ford slash juice box, you spell that GVOKEGL Uc ag o n.com. forward slash juice box. Thanks also to the Contour Next One blood glucose meter, you can find that meter at Contour Next one.com forward slash juice box. Also look into the test trip saving program and the possibility that you may be eligible for a free meter contour next comm forward slash juice box. I have a couple more seconds for you after this.

I want to thank Megan for coming on and sharing her story. And I want to leave you with the couple of minutes that happened right before we started recording because they made me laugh.

Unknown Speaker 1:02:46
Let's see. I could turn the volume down a little bit to

Scott Benner 1:02:49
sound pretty good like that. All right, actually, there's something in the background of television or something like that. That's coming through loud and clear.

Megan 1:02:57
Hmm. All right. Let me go see that might be my kid on his elearning out in the

Scott Benner 1:03:01
home. There's no school today. Okay, let's

Unknown Speaker 1:03:03
go move them to another.

Unknown Speaker 1:03:06
Alright, hold on one sec.

Scott Benner 1:03:26
people's kids are such a trouble. Children always want things neat things always making noise. need to go to school.

Unknown Speaker 1:03:39
School of all things.

Unknown Speaker 1:03:49
Okay, I'm back. You didn't

Scott Benner 1:03:50
have to hit him. I'm just kidding. If you're still here, I appreciate you listening to the end, please support the sponsors using the links and don't forget the T one D exchange. Super simple to do to help people with type one diabetes. It also supports the show T one d exchange.org. Ford slash juice box fill out the survey. It only takes a few minutes. It's 100% HIPAA compliant. 1,000,000% anonymous, and you're definitely going to help people with type one diabetes. If you take the time to answer the questions. And those questions are not that difficult. They're not hard. They're easy. You know the answers to them already. They're not overtly personal. It's just the kind of data that they use to help people with type one. Thanks so much. I'll talk to you soon.

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