#256 Diabetes Pro Tip: Exercise
Diabetes Pro Tip: Exercise
Scott and Jenny Smith, CDE share insights on type 1 diabetes care
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Scott Benner 0:00
It's time for another pro tip episode with Jenny Smith. Hello everyone, and welcome to Episode 256 of the Juicebox Podcast sponsored by Omni pod Dexcom. And dancing for diabetes, you can go to dancing the number four diabetes.com dexcom.com, forward slash juicebox, or my omnipod.com forward slash juice box to find out more about the sponsors. Jenny is a certified diabetes educator. She's like a nutrition thing. Like she does a whole bunch of like technical stuff that she's got degrees for, she works at integrated diabetes, if you'd like to hire her for yourself, you know, have these conversations with her one on one, you go to integrated diabetes.com where you can go into the show notes of your podcast player where I have Jenny's email address, email her directly, all different ways to get hold of Jenny Smith. All these links, of course are at Juicebox podcast.com. If you get confused, and you need to find them somewhere, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. And to always consult a physician before making any changes to your medical plan or becoming bold with insulin. I liked your idea, a lot of beginning ideas around blood sugar management with exercise because I hear from people constantly. And I always think that my answer to them is incomplete. Because it's one of those things that I think I just know how to do. And I don't know why I know how to do it or why it works sometimes. You know, I everyone who listens knows that Arden played really competitive softball for years and years and years. Mm hmm. And that that means at this part of the country, that means being outside in incredible heat. weekend after weekend, sometimes from 8am till 5pm playing 234 softball games, you know,
Unknown Speaker 1:45
right?
Scott Benner 1:46
And I strive for a nice blood sugar around 90 or I don't change my goals because of what she's doing. Right. And I also am not much of a pre planner, but I do I have spoken to people who are like, Look, you know, I'm an adult, I'm going to go to the gym at five o'clock after work, I need my blood sugar not to fall at five o'clock when I start working out or later sooner. And how do I do that? And I have to tell you, I know it's around bazel insulin and pre, you know, basically like setting Basil's up ahead of time or afterwards to catch lows and stuff. But I'm so reactive. I don't think about it that way. So how do you talk to people about it?
Jennifer Smith, CDE 2:23
Yeah, you don't really have a I mean, as you've done for a long time, you're sort of like, you're surfing the wave of what's happening for art. And you're managing very well doing that, because you've intuitively learned how she reacts to things for the most part, right. But to teach people in a general sense, I think one, you said it correctly. I think it's around bazel. Well, you're right in that it's around insulin. Most people
I know I was waving at him too.
So the the insulin is really a big piece. And a lot of people again, they focus on a number when they're going into exercise, but they're not focused on what's what's the causative to that number, what's affecting that number and where it may directionally go. So we talked about, you know, your person here example wise, he's going to exercise every day at 5pm. Well, for them, that's kind of a nice timeframe of the day because the goal there in a simplified way would be, you know, active insulin onboard, so no bolus insulin, you know, and they, let's say, as an adult, they only eat lunch at noon or one o'clock, tected, by five o'clock that bowl is should for the most part, unless they're looping, that should be gone. Right. And it would mean then, you know, aiming to either not have an afternoon snack, or in which there's no Bolus that would be riding into the exercise. And then the Basal component, there is a lot of debate about Should I adjust my Basal for exercise? When should I do it? How much should I do it by and that's where it comes to be an individual nature of adjustment, because it takes you have to take into consideration the intensity and the duration of the planned activity. You know, if this example, you know, guy is gonna go for an hour and a half spin class, high low, it's sort of a high intensity interval sort of workout. And if he's only going in on bazel, he could shut his bazel down, not off, but lower has bazel incrementally enough, well, before he actually starts moving, so that he shouldn't technically need much of any food at all, to continue that let's say 90 minute spin class, for example, adjustment to bazel. Most people feel like they have an idea, I turn it off, you know, I turn it down or I turned it off 30 minutes before and I still went low or I continued I was low by the end, and then I continued to be low. And the problem is that as we've talked before circulating insulin level isn't lower or higher, until about 60 minutes post adjustment. And when you're really aiming to get into a specific target, for beginning exercise, your circulating insulin level should be low enough by that point, because, as is a kind of propelled intense, intense action of the insulin on a basal level that you have now circulating, and if you're normally at a 1.0 unit per hour basal rate, and you knock it down by 50%, that 50% reduction should be started at least 90 minutes, if not two hours prior to when you jump on that spin bike.
Scott Benner 5:46
I'm checking out dancing for diabetes.com right now went to their blog, there's a lot going on over there. It's like they had a fundraiser recently a game night in Orlando, group dance auditions are now open for their annual dancing for diabetes show. Others a follow up here from when they were at friends for life, are announcing new partners in their D box program. They have this box of like great stuff that they send out to newly diagnosed people, I some actually some Juicebox Podcast stuff in there as well. But they just added sugar, medical and trialnet You can find out all this yourself, you don't need me to read it to you dancing, the number four diabetes.com check out their blog.
Jennifer Smith, CDE 6:24
So this gentleman, you know, he should really reduce his bazel by 3pm. And he should reduce it for the intensity and the duration, at least by 50%. Again, these are kind of starting places, and you'll find what adjustment works specific to you. But it's a good starting place. Now if he was just going to go for a walk for 60 minutes at a moderate pace enough to kind of bring up his heart rate a little bit but not crazy. Maybe his adjustment is a 25% basal reduction, but it still needs to be taken back by at least 90 minutes to two hours before he takes that walk.
Scott Benner 6:59
It reminds me of a number of things. One, there was a I forget what it was called. Gosh. There is a thing that happened in in I can't think of what the name of the website is it's gone now. Manny Hernandez his website that's not Oh, two diabetes. They used to do that thing every year where they they kind of challenged you to get out and do exercise, right? And yeah, your blood sugar and see where it would fall.
Jennifer Smith, CDE 7:23
So that was in November for the diabetes bump. Diabetes awareness. Yeah, check your blood sugar. Now walk or do something fun for 15 minutes of movement and check again,
Scott Benner 7:32
and people would see that their blood sugar's would come down. Yeah. So it's the same idea except with lower lower numbers and tighter tolerances for exercise your blood sugar is going to fall or try to fall because of this exercise. What can you do prior to that, to not to keep the fall from happening. And I think that what ends up happening is there's two false narratives. Well, there's a false narrative that and a problem that people build around exercise and I think about going to sleep through with diabetes. The false narrative is, if I make my blood sugar this high, that when it drops, it won't get dangerously low. Correct. If you're thinking that you are completely missing the point, right, the point should be that your blood sugar doesn't need to drop like that. Let's let's find a way to live where it's not dropping out of nowhere. Correct. And so but I see how that's the fix, right? Like, I see how that's what occurs to people. I dropped 50 points. So, you know,
Jennifer Smith, CDE 8:32
let's start 50 points
Scott Benner 8:34
higher than I really ever want to be right because the guy stuck a pencil in his pocket. And then he brought up the bank. So the pencil cause the bank robbery, like just the falls, not the the falls, the falls. God what am I trying to say? Like, like the Fall is
Jennifer Smith, CDE 8:47
the fall can be offset. If you think ahead about how insulin works, it doesn't
Scott Benner 8:51
have to happen and right and so you shouldn't be planning to stop the fall, you should be planning for a fall to never happen to begin with.
Jennifer Smith, CDE 8:59
Correct or minimal enough that you really are not in danger because of the drop, right? I mean, exercise can even you know, even people who do plan ahead might see something like a 10 or 20 point change in blood sugar during or by the end of their exercise session. That's nothing you know, if you're starting with a blood sugar of 110, and you drop 10 points. Great. You're at 100 now awesome. Nothing, you know,
Scott Benner 9:27
my expectation isn't that you can set your blood sugar at nine while you're, you know, running a marathon, it's never going to move but there are things that play while you're running that you don't think about the you know, the anaerobic style of exercise is trying to bring your blood sugar down, but you've changed your basal rate which is trying to bring bring your blood sugar up also. Maybe you have adrenaline which is trying to bring your blood sugar up. So even people who have that stability, they don't 100% know why they have it like they don't really understand all the pieces that are affecting this number moving or not moving. Right. It's interesting that the other thing that you said that feels probably To me, because I hear so many people, like, every time I speak to someone, I'll tell them the same thing. Look, just start Pre-Bolus sing and your agency is going to go down like a point. And then they inevitably say, Well, I can't really remember to do that. And I'm like, Alright, well, then your blood sugar's gonna die. What do you want from it? Right? You have to Pre-Bolus like, this is how this is what you're gonna say, this exercise thing really is no different. Okay, they're still Pre-Bolus thing, they're just Pre-Bolus thing with their their pre bazeley adjustment with it with a reverse adjustments that have a more positive adjustment. So I wonder how many people fall into that category? When they say, Look, I know I'm going to be at the gym at five. But how in God's name, do I think about it at 330? Mm hmm. You know, in that situation.
Jennifer Smith, CDE 10:47
And so some of the strategies in pumps today, you know, there are alarms or reminders that you can set, you know, even in the PDM. For Omnipod, you can set up alerts and reminders for things, I used to have one set up for reminding me to Pre-Bolus, so that I had enough time between that and actually starting to eat my dinner. I also had a reminder to check my blood sugar at bedtime. Not that I needed the reminder. But it was there in case I had a really hectic night. And I did forget before I like climbed into bed, right? So for things like a reminder, if you are pretty strategic about popping in your exercise every day at 5pm, why not just set an alert or a reminder in your pump to go off or even on your phone? If your pump doesn't do it? Or you don't want to set it there, put it in your phone and call it exercise adjustment or whatever you know. So it is that physical visual reminder, you have to turn the alert off. Oh, why did I set the alert? Oh, that's right.
Scott Benner 11:45
suicides at five o'clock, just just two days ago, someone said my child will look does not seem to be remembering to Pre-Bolus at school. And I said, Oh yeah, Arden was terrible at that. And she said, Well, what did you do? I said, I just set up an alarm on her phone for when I wanted her to Pre-Bolus it would go off and it would pop up and say Pre-Bolus. And then she you know, send me a text and be like, do you want to do this now? And we built on that. And that was years ago. And last year? She says to me, I don't need the Pre-Bolus alarm anymore. And I said okay, okay, no problem. And sure enough, like it just, it happens so many times that now it just it's muscle,
Jennifer Smith, CDE 12:22
like brushing our teeth. It's just memory. Yeah, exactly
Scott Benner 12:26
what you guys are gonna have to do, whether this is about you know, an adult for exercise a kid for exercise, or a kid playing a sport. You can't just, I mean, it sucks, right that you can't just get up and run out the door and go do it. But it's going to take a little bit of pre planning and if your health that where you're, you know, you're, you know, if that means that much to what you're gonna have to do
Jennifer Smith, CDE 12:46
like, and I do think it helps. It's important. I mean, with that statement, you can't you can't just get up and run out the door. Well, you know, what, what if you ended up sleeping in because the alarms didn't go off the right way. And you had planned to get to your kids softball tournament at 9am. And oh my gosh, it's like eight o'clock, and we're like running out the door with like, food in our hand and we're running and trying to get there. It just didn't happen to be able to plan. Well, in that instance. I mean, there are strategic management, you know, ideas, you couldn't adjust the bazel there was no way to do it, right. So in that circumstance, then food becomes your offset to potential changes in blood sugar. You know, if you got up late to go for your normal six mile run first thing in the morning, and you always like to eat ahead of time, then the strategy may very well be okay. Maybe you don't Bolus if you're going to eat and head out the door in the next 30 to 60 minutes, and you're going to take a six mile run depending on how long that takes you, you may be able to take 25% of the recommended Bolus, you may be able to take none of the recommended Bolus. And strategically then manage blood sugar well, because you're feeding the activity you're feeding to avoid a drop in blood sugar, but you're not stacking insulin into a time that it's just gonna get active.
Scott Benner 14:07
Right, I'm smiling so much because this is like the next level of thinking about all this about the manipulation of the insulin. When RM would run off the field like I and I'd have her I know what her blood sugar was. And she if she ran off i'd might say to her Hey, water, you know drink water now. And then maybe watch and then if I saw her blood sugar kind of dipping down the next time she came off the field I'd say switch to the sports drink and you know should switch to the sports drink and then I'd be like switch back to water. You know and it only happens a couple times maybe it maybe never to be perfectly honest with it. She's played softball games where a blood sugar's never moved, you've got her bazel right, your prep right going in or like you said you ate the right things before playing. And these things are sitting nice and stable in your stomach and kind of holding you know, holding the pressure back of of the activity to make your blood sugar lower. But you can reverse engineer all of these ideas like use food instead. Events like, you know, I say it here a, you know a lot and I don't know how clear it is because it's sometimes not 100% clear in my head, but we don't we always just think about how the insulin impacts the number your blood sugar, but we never think about how food impacts the insulin or how food impacts the number. There's so many different pieces to this. It's all not just a one way street, like, all right, things are affecting all these different things. And if you pick the right one, it can manipulate something, right? You ever thought was manipulatable. And it is, you know,
Jennifer Smith, CDE 15:31
and also understanding your variables and how they affect you maybe at certain times of the day is a piece of it as well. I mean, I can tell you from my, from my management, I guess toolbox. I've figured out that my morning runs, I can get up, I can Bolus for about 40 to 50%. of the normal recommended bolus, as long as I'm heading out the door within the next 30 to 60 minutes, that partial bolus for what I ate will help me keep my blood sugar nice and stable throughout. Now, in the afternoon, if I did that, my blood sugar within 1520 minutes would take it would entirely take I would need. I just know my sensitivity at times of day. And so again, on an individual level. Some of the things you know that we're talking about there a beginning piece there where to start, if you've had no strategy whatsoever, these are places to start with what you can try to, you know, I guess implement, but you're going to find that things need to be adjusted, personally for yourself. I raced a strategy knowing my like training run strategy by race day strategies completely different with the adrenaline of everything getting going on a race day morning. I mean, and I'm not a competitive like a pro runner. Right, I could only do four minute mile or something. No, I've just I'm out there, but it's a race day. And so I Bolus 100% for my breakfast on a race day morning. And if I don't my blood sugar is 300 by the time I start the race
Scott Benner 17:19
dexcom.com forward slash juicebox just got a facelift. Nice, it's fancy. Here's what it talks about zero finger sticks. That's right, the dexcom g six continuous glucose monitor is FDA permitted to allow for zero finger sticks. Of course, you can customize your alerts near alarms by setting the range and getting notified when you're heading higher low. There's smart device compatibility. What's that mean? You can see your glucose data in real time on your compatible smartphone, iOS and Android. Go check out which ones they support, sharing your data. Talking about this all the time, right being able to see a loved ones or someone's glucose levels, direction, rate of change all remotely. That could be your child at asleep over a friend that's alone for a couple of nights doesn't matter. Anybody who needs you know, someone to have their back. Dexcom even has Siri integration. I can't tell you about that right now. Or my phone will start talking to me, but you can check it out@dexcom.com Ford slash juicebox. To find out more. The CGM is also by the way indicated for use in children two years and older. It's amazing. Now to take the next step with Dexcom. Just go to my link, and fill in the tiniest bit of information patient's first name, last name, email, phone number, city state, you know, birthday, a little bit of information about what kind of diabetes you have in your insurance. You are on the way, you can do this through the links in the show notes. If your podcast that links at Juicebox podcast.com or by remembering dexcom.com forward slash juicebox. My daughter's results, of course are her own. Yours may vary. But I'm telling you that the dexcom g six is maybe the most important part of your life with Type One Diabetes, being able to see the direction and speed of your blood sugar is monumentally important.
Jennifer Smith, CDE 19:08
If I don't my blood sugar is 300 by the time I start the race, and again, it's experience it's experience of figuring it out. It kind of goes into the difference of what type of sport or what type of athlete Are you are you a an aerobic exerciser or you more the weight kind of the heavy lift or kind of you know anaerobic because those adjustments are different as well. Strategy there for many of the lifters that I work with the Find a need depending on their lifting plan, they find a need to potentially bolus to avoid a rise in blood sugar during a lifting session off at the potential rise that they see is slower with a Temp Basal increase. And again, in their standpoint, that Temp Basal increase needs to be started about an hour before they actually get to their lifting session. or it doesn't help enough and they get a major rise. So I think the biggest thing with exercise adjustment is what has happened. What have you seen? What is your problem? Right? Because if you start with the data that you've got, and you look at and you say, Okay, I just did this way. Totally didn't cut it, this did not work. Okay? adjust, look at your data and adjust and make you know, is it a timing component isn't an amount component, what do you need to change?
Scott Benner 20:33
It's funny because I see a through line from this to correcting a low so when, you know when people get when people's blood sugars get low, and they they eat because they need to, then this you know, uncertainty just allows them to they do nothing and their blood sugars come like crashing like back up again. Right now you're you've just crashed down now you're flying back up. I say all the time. Like you'll know you're like a ninja when you're bolusing. You know, after you've eaten for a low like, you know, your blood sugar is going down to 40 You're shaking, you're out of your mind. You're eating all the food. He stopped for a second go, okay. I'm okay, now I eat a
Unknown Speaker 21:11
lot of food.
Scott Benner 21:12
70 carbs worth of food. What do I do now? Well, the answer is I Bolus Now you know how much? I don't know you figure that out. But that's what I did. I mean, I the first time I did it with my daughter, I'm like I can I'm so scared. Boom, 350 blood sugar. Then next time, I was like, Okay, well maybe like for half of it and half of it didn't work. And so eventually, I could just I kind of eyeball it was usually about three quarters of the carbs. Like, right, and like when you stopped and really thought about it, you know, sure that 2025 carbs stopped the fall and got your level, the other 50 were just your body going eat more, eat more, eat more, eat more, right? If you could have stopped yourself after 25 or 30 carbs, you would have
Jennifer Smith, CDE 21:53
would need to bowl
Scott Benner 21:54
right wouldn't eat the balls. But you know, you can't stop yourself in that situation. And so it's happening. Now you got to do the next thing that makes sense. It's all really just about I hate I hate to I feel like I oversimplify sometimes. But all we're talking about in the last 10 minutes, all you really heard was right amount of insulin at the right time. You know, which is obviously overly simplified. But that's all we're talking about. the right amount might mean and I get scared to when people hear right amount that they that they think of on the positive or more like actually, the right amount might be less, it could be like bazel, right? It could be not bolusing at all, eating a banana going out the door for a run and thinking you know, this bananas, usually three units, but I know if I didn't bullish for this, my blood sugar is going to go up about 80 points because bananas Don't hit me that hard for some reason. Sure. And when I go out for a run, I fall 60 points. So boom, I'm gonna eat the banana. I'm gonna go and you've countered it. Yeah. Yep. All different ways to get in that fight. Mm hmm. I have a couple of notes. The other?
Jennifer Smith, CDE 22:57
Oh, yeah, Oh, please. Oh, I was gonna say kind of on this kind of on the same note there from the standpoint of not having enough time to adjust. Prior to, let's say, for a bazel adjustment truly, another component is you may actually have to, you may have to eat food to curb a potential drop. If you know the drop is coming, and you've only got 20 minutes before you're going to head out the door to go and exercise. And you may have to have 10 or 15 grams of carb in order to stop a potential drop from happening. And that's it's a, it's a hard thing to consider when you're also for the most part as an adult, especially considering exercise as a piece of like a weight management tool. Right? And if you feeling like, well, gosh, every time I exercise, I have to go and eat like three granola bars. And that's like, that's what's the purpose? What's the point of this? Right? I'm exercising but I'm not seeing any changes here. Well, again, some strategic planning can help. But if there's no ability to adjust anything ahead of time, because there's not enough time, you may actually have to quote unquote, eat something. And my my recommendation and most of the athletes that I work with, it's that the circumstance, simplify the carbs that you're eating, and eat in a butter jelly sandwich or a pro bar that's you know, like 300 calories, your body right before you get started moving needs the simplest form of carb you can get, it needs to get into the system to effect quickly and stop a potential drop because usually aerobic exercise drop happened within about the first 20 minutes or get started within about the first 20 minutes. So simpler. The carbs are one, you're not getting fat and protein calories. So you don't have this load of excess. And if you use something simple like the sport drinks, you know whether it's Gatorade, Powerade, vitamin water, whatever it is, make sure it's got some carbs in it and have about, you know, eight ounces which is Almost 15 grams of carb,
Scott Benner 25:02
that's a simple amount, your body is going to use it easily. It's going to help to stop an initial drop, you may need to bring it along and sip it along the way, as well. But at least it's getting used up. And it's not something that's packing away calories have a question, and I don't know the answer to it. So, which just as an indication to you guys, and sometimes I ask questions I know the answer to just so you can hear the answer. But in this situation, I don't know the answer to this question. So your body when you work out, uses up food as fuel, but that we're accustomed to putting that food in us and letting it be used up as a buoy for a blood sugar. So I don't know what my question is. But if I eat a banana, and I sit down, like because my blood sugar is 60 I eat a banana I sit down and expect this to bring my blood sugar back up to 130. And it does. But if I eat that same banana at 60, while I'm doing something that's causing my body, so is are my muscles stealing the banana that I need for the sugar? Does it still go in the blood and I use it and I get it any i do i get both benefits, or do I only get one. And all of this talk about exercise has me just super warm and fuzzy inside about the on the pod. You hear what we're talking about right? Jenny and I are discussing methods for increasing and decreasing your basal insulin in ways that will stop low blood sugars while you're exercising these tools work in a lot of other parts of life, not just for exercise. Now when you're exercising, you need your insulin, you don't need your insulin use a little more, you need a little less, you need to be able to manipulate your basal rates. If you're pumping right now and you're not using the Omni pod. This is not something you can do while you're exercising because you have to disconnect your tube pump to exercise but the Omni pod is a tubeless pump. And you can have it on not just while you're exercising. But while you're swimming or bathing, you never have to take it off. Now let's just take a second let that settle in. Right. The Omni pod is the only insulin pump that doesn't have to be the only insulin pump that you can wear while you're exercising. Because of that, it's the only insulin pump that allows you stewardship over your basal insulin during exercise a little more or a little less, a little sooner a little later. Now, here's the greatest thing about the Omni pod. And I mean this free, no obligation demo, it's a peck a pod experience kit, that on the pod is thrilled to send you an all you have to do is go to my Omni pod.com forward slash juice box for again, your free, no obligation demo pod. They'll send it to you and you can wear it, you can go out and exercise with an omni pod on and see if it's something you'd be happy and excited to do. And if you wouldn't be whatever, no harm, no foul, nobody's gonna hassle you. You don't have to get another pod if you don't want to. But the best way to find out if what I'm saying will work for you is to give it a try. There's links in your show notes at Juicebox podcast.com. Do I get both benefits? Or do I only get one
Jennifer Smith, CDE 27:52
depends where you are sort of in the exercise in early exercise, your body would get the benefit of the banana would actually bring your blood sugar up because your muscles have now are resting, you've stopped you're eating the banana you haven't been exercising for very long. So it should technically bring your blood sugar up maybe not as much as if you were just sitting and not doing anything and eating the banana and not taking insulin for it. But the longer amount of time you've been moving. And the more primed your muscles are to grab glucose and bring it into for for their benefit. right because they're trying to retain they're trying to energize essentially. And this is a really hard concept. I'm glad question wise you brought it up. Because athletes, endurance athletes, especially those who are doing long distance of anything triathletes, long distance cyclists, even kids or adults who are in long term like competition on a weekend like four or five like you said, you know, Arden might be have been in softball from 8am until 5pm. That's a long day of movement of asking your muscles to do something. And most people are like, ah, I've got my bazel dialed in. I totally I rocked it my blood sugar was nice and stable. But man, I felt like I couldn't move. My I just slogged through this whole four hour marathon and I didn't I my blood sugar was great, but I didn't feel the greatest. What's the problem? The problem is that even thinking about yourself as diabetes, a person with diabetes, right? You have to first think about yourself as an athlete. athletes, whether you have diabetes or not, you need energy of whatever source you're choosing to use, you know, even ketogenic endurance athletes use some form of fuel during long distance to maintain and be able to perform and you know, people who aren't ketogenic you need a carb source, and you need it put in strategically over that endurance time so that you can fuel your muscles, you can give it what is needed so the muscles can keep doing what you're asking them to do. Now, from a diabetes standpoint point, what you're putting into fuel your muscles also has to work well with punch for peace, right? They have to kind of balance each other out. But first and foremost, as an athlete, you have to think what am i muscles need to perform the way that I want them to perform, you're doing two different, very different thing. But they're both working on the same
Scott Benner 30:21
pool of food basically. So
Jennifer Smith, CDE 30:23
and, and thus, with insulin adjustment might be very different. I mean, when I am in training long distance like half marathon marathon, my training runs and the actual event, it's surprising, most people who've kind of dialed things in will find that their basal insulin adjustment doesn't go down a lot. For my marathons, I only reduce my bazel by 10%. And this was conventional pumping, right, I only adjusted my bazel down by 10% for the duration of time of the run, because what I expected then was the rest of the bazel to be able to encourage the food that I was taking into fuel along the way into my working muscle because insulin has to be there to propel some of that in the activity helps with the rest of it, it opens the doors on the muscle cells and lets the food in. So if I reduce my bazel too much and fueled along the way, I had these jumps in blood sugar that I didn't need. Whereas if I just kept my bazel a little bit lower, and I feel strategically, you know, every 20 minutes putting in a little bit of something along the course of time and hydration. Again, blood sugar stayed nice, but I also had energy to keep moving.
Scott Benner 31:38
I I should say that at the the other side of Arden's long tournament days. You know no problems like you just said with the blood sugar's throughout the tournament into the evening, their regular bolusing at dinnertime, but around late evening, 910 o'clock going into falling asleep time, all the food was free at that point, like she could eat without insulin like s and by the end when she goes to sleep. I know people see like one way or the other usually Arden's eyes closed blood sugar falls person, like so if something's not right with her insulin, when she goes to sleep, her blood sugar tries to go down. And so even if you gave her a juice at midnight, and turned her bazel off, that still couldn't catch a low after a full day of activity, you had to give her something to eat. That was substantial that would really stick with her in her system while she was sleeping. And even in the morning, even in the morning waking up like getting through the night, okay, and I've done it well and I've done it poorly and poorly would be like you know, three juice boxes to get through the night and a banana or something like that. I would call that poorly. And I've done it well where I've gotten her through with like a you know, something at the end of the day that stuck with her overnight some tamping down with bazel, stuff like that. But even that next morning when she woke up, her blood sugar's were like terrific. They were low, you needed the be of the mind, whatever the base amount of insulin was for the meal, like you know, sometimes you're like, this is two units, then the next day you're like, oh, how come it was more like four today? Whatever the right most minor amount was, but always the day after a softball tournament is all you need her insulin needs? Yep, very low. But that was, gosh, if that didn't kick in nine hours after she got done playing and lasted probably for nine hours after that. It's really it's really
Jennifer Smith, CDE 33:32
Yep. And that's what we call a Gary actually has coined the term dope, like Homer Simpson don't dough is d do Ah, delayed onset hypoglycemia essentially is what that is, right. And it is, again, this is where visually looking and seeing, you know, it was about nine to 10 hours later, that she started having a drop in insulin need. And it lasted for another good, let's say 10 hours. That's experience, you looked at our data, and you said over and over, this is what I see. So that's kind of where you have to go back and you have to look and see, well, gosh, after I have like a three hour run in the afternoon, or you know, a four hour softball tournament in the morning, I ended up being low from dinnertime all the way through the next morning. If that's the case, you can set temp adjustments down again in bazel at a strategic time, so you don't end up having to do a juice box and a bazel off for a certain amount of time because really there you're missing the boat. Right? Your that was your treating now when ahead of time had the bazel been adjusted down enough. The treatment shouldn't have been needed or less of it right? Yeah.
Scott Benner 34:45
No, I I made sure to characterize it that way. Like in the beginning like I didn't do a good job of it all. And you were just the whole evening was just like here, stay alive. Eat this here stay like this. Hey, why don't we just shut your bezel off for a while and see if that helps. That's all Call 911 stuff like that. That's not like, Oh, I'm really, really great job. You know, later, right later a great job was knowing that after dinner throughout the evening, she needed less bazel. Yeah, and that she should eat something reasonably substantial, like a little before bed, like that kind of stuff. But oh my gosh, the first couple times, you know, I did it once in a hotel room, where Oh, my god, it was just embarrassing. You're banging into thing, he'll know where everything is. And it's dark, you know? And I'm just like, what is happening? And then, you know, her alarm goes off. She's like, we have another game. And I'm like, Yeah, that's great. Because I've been up all night. You know? And then the next day, all the parents, all the parents, like, You look tired. I'm like, Uh huh. Yeah, you guys are all drinking all night. I was trying to fix this blood sugar thing. Not that all parents at sporting events are drunks, but most of them are and not a drinker. So I wasn't involved to begin with but they all were like they come down in the morning, like all hung over and I they must have thought I was just like, quietly privately drinking by myself, you know, I looked worse than they did some days. But no, but there's just so much so. So
Jennifer Smith, CDE 36:13
I kind of on the same on the same note not to interrupt but the aftermath sometimes to of exercise can happen right after the lower needs and insulin can be for several hours after weightlifters to may have that rise during but then the impact of lifting and their muscles sort of building repairing restructuring. And the insulin sensitivity sensitization that they get from working their muscles out, can have impact into, you know, for six, eight hours after where they actually need less insulin now.
Scott Benner 36:47
Yeah. I had that. I had that on my notes, like, What does muscle breakdown and rebuild, do? And what you know what to dehydration. I'm reminded about this again the other day, because I said this to a person. And it was like no one had ever said it to them their whole life. And they're like, you know, sometimes my insulin doesn't work as well. In the morning. I was like, you know, have you tried waking up and just banging down the glass of water? And they said, No, why? And I said, well, insulin doesn't get through your cells as well, if the cells are dehydrated, because then the insulin can't travel through, you know, like 10 it and as I'm singing, I'm like, God, you've never heard this before. You know, like three years with diabetes. Like I had never heard that before. It's like, I just Okay, that sounds great. I'll try that. When horns at school. Whenever her blood sugar gets sticky. The first thing I say to her is like, hey, drink some water. Let's see if, you know, we can find a simple, you know, answer to this question. So
Jennifer Smith, CDE 37:38
well, it's kind of like things just move slowly through your system. It's like your blood gets when you're dehydrated, your blood gets like sludge, or like molasses in winter, essentially, it doesn't move, nothing moves through the system very well. Nutrients don't get where they're supposed to go. Everything that's traveling there is slow. Whereas when you're well hydrated, and everything is nice and plump with water, it can move fast. It's like a freely flowing river, right?
Scott Benner 38:03
Yeah, that so. So I have to stay hydrated when I'm being active no matter what. But it is also helping me get a smooth baseline for what I expect out of my hands on and then at least when I see one way or the other, I know is real. And not because I'm dehydrated and or something. What does he eat? How does he impact blood sugars? Because you know, people in the warm weather states always report problems with their blood sugar's as soon as the as the summer comes, but I'm wondering, right, you heat yourself up when you're working out too. Is that similar? Or no?
Unknown Speaker 38:43
Um,
Jennifer Smith, CDE 38:44
you know, that's a good question about the workout. I guess I never thought about it that way. It's probably pretty similar. I'm in exercise, of course, your muscles are just uptaking glucose more efficiently, the doors are opening even with less insulin being there, they're just opening more efficiently exercises like free insulin, really. I mean, unfortunately, we can't live on exercise to use insulin, but it does help. But in the case of overall warm if you think about when you're warm, your vessels move closer to the surface of the skin or right and you sweat and you that's a cooling effect, right. It's your body's sort of way so that your you don't overheat. Well, when that happens, get more circulating. You get more circulation around the actual insulin pumped or injected site. So you allow that insulin to get absorbed faster. I guess is the easiest, most simple way to say it so in warm weather or worse when warm weather comes in. Many people do see an object a friend of mine, once April hits, she's always like my baseline Just need to go down, it's warmer outside, I know that I need an adjustment, nothing else has changed, my weight hasn't changed my in my food hasn't changed, and I am just outside more, it's warmer, she needs less insulin, and then it might go up again in fall and or winter. And exercise, obviously that heats you, you get a lot faster circulation, I mean, that's the benefit to your heart, your you know, circulatory system is exercise does your heart good, makes it pump harder. So with that, and the fact that you're getting warmer, you just get a faster circulation of insulin essentially. And we we
Scott Benner 40:35
haven't really said this here, either, but you have type one diabetes, or the person we're talking about does exercise is very important to you. So this is a piece you have to figure out, you can't just say, I can't figure out exercise you you need exercise, you know, everyone does, but you know, people with diabetes needed maybe a little extra because you're trying to keep your body healthy. While it's trying. While it's trying to, you know, that's trying to beat you up, you need to you need to take away as much power from that as you possibly can.
Jennifer Smith, CDE 41:03
And as a weight management strategy, sort of in the same realm of it needs to be something that happens every day. And many people with diabetes are really struggling and really trying to keep a healthy weight. If you can strategically plan your exercise in the aftermath of a meal. As I said before, you could potentially use less insulin then because you're planning the exercise in a timeframe of after insulin has been injected to influence going to work better, you're also going to enable your body to burn more of that fuel off. Right. So it's a good strategy to just all around, then workout, eat and then workout. Again, ability to reduce the amount of insulin again, prevention of lows, but also just burning calories and not having to take as much insulin. So
Scott Benner 41:57
doing what you what you wanted to what you what you intended to do. When you when you decided to get up and go exercise. I want to look right very quickly, too, because Chris Rutan was on the podcast and we talked a lot about we talked a lot about this kind of stuff, too. And I just want to be able to tell people what episode that was. Be nice if I could figure it out. I am the guy with the podcast you would think I wouldn't know. But well, there are so many of them. Well, that we are getting to that spot, aren't we? I can't figure out what should people like what episode Am I don't know any more. Let's see Where's All right, I'll have to figure it out and plug it in. Jenny's got her own life. She's got to get back though. I will figure it out. And you'll hear it edited. And right here. Chris Rutan was on episode 201. Jenny, is there any anything else that you think we should talk about here?
Jennifer Smith, CDE 42:52
We could probably go on and on with more like advanced stuff. But overall, I think those are the good basics to start with.
Scott Benner 43:00
Yeah, I think this is what we're looking for a basic invoke, we'll hit more advanced things in another episode. Let this awesome. Cool. All right. Well, thank you very much. Thank you. Some quick stuff. There's just a couple days left to enter my giveaway. It's the end of August 2019. If it's past August 2019, forget it. But right now there's a huge giveaway going on, go to Juicebox Podcast calm. There are a ton of great prizes for this giveaway. But among them is a free 30 minutes of talking with Jenny Smith. So if you love talking to Jenny here on the podcast, you know where she's talking and you're talking back to her in your car. Imagine if she could actually hear you. There's nothing to do to enter give it a shot you might want. Thank you so much to Dexcom on the pod and dancing for diabetes, for sponsoring the Juicebox Podcast. These people have been with me for a very long time. And they help keep the podcast free. So give them a shout write check them out of their links or, you know, just find a way to support them. Like for instance, dancing for diabetes has instagramming now, so does Omnipod and Dexcom. Follow them. Do something like that. When you see them online, be like Yo, thanks so much for sponsoring the Juicebox Podcast, whatever you're gonna do. Give them a little Hey, hey, you know, so let me thank you here for all the great reviews. The merchandise are buying the T shirts, I'm starting to see pictures of you guys out in your real lives. We're in shirts that say like stop the arrows and be bold. Very, very cool. All right, there'll be a new defining diabetes this Friday. And then we're going to get into the fall, run, run. My next episode with Jenny Smith will be up in a month. It's going to be about fats and proteins and how to Bolus for them. The month after that. The next episode with Jenny is called Ask Jenny. It's gonna be the first episode where your questions are what I asked Jenny
Please support the sponsors
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#255 Defining Diabetes: Glycemic Index and Glycemic Load
Defining Diabetes: Glycemic Index and Glycemic Load
Scott and Jenny Smith, CDE define the terms at the center of your type 1 diabetes care
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Pandora - Spotify - Amazon Alexa - Google Play/Android - iHeart Radio - Radio Public or their favorite podcast app.
+ Click for EPISODE TRANSCRIPT
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
Defining diabetes is made possible by Dexcom on the pod and dancing for diabetes, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before becoming bold with insulin or making any changes to your medical plan.
Jenny, what is the glycemic index?
Jennifer Smith, CDE 0:24
How do we explain Oh, glycaemic index, that's a excellent one. So it's essentially a number from zero to 10. That's assigned to a food with pure glucose being represented as 100. Right. And it represents the relative rise in glucose level within two hours after eating or taking that food in. And the index being from zero to 100, or 100, being pure glucose, the higher the foods number, like watermelon, watermelon has a GI or glycemic index of 72. So it's close to 100, it's considered a high gi food, the higher the number, the faster and more more profound, the impact is going to be on blood sugar. The lower the glycemic index, you know, down in like, you know, less than 55 is considered low glycemic index. Those should have slower lower impact on blood sugar in the aftermath of eating.
Scott Benner 1:25
Other Are there any foods with carbs that have no impact? Where is that person to person? Because you just ironically said watermelon, which doesn't touch Arden at all?
Jennifer Smith, CDE 1:37
Well, that may be another definition. It might be glycemic load. That's the difference there.
Scott Benner 1:43
Right? Why don't we combine the two of them go ahead glycemic load, keep going?
Jennifer Smith, CDE 1:46
Okay. So glycemic load is essentially, it takes glycaemic index one step further, glycemic load talks about the amount of food eaten at a time. So let's say you had, you know, a half a cup of watermelon, despite it having a high glycemic index, the half a cup load amount that you're eating might be very low. And so the impact in the aftermath of eating is also going to be very low, it's the same thing. Like if you eat a bucket of white rice versus a half a cup of white rice, the glycemic index is the same. But your the impact it has on your blood sugar should be lower and less dramatic, because you're not eating this gigantic portion of it.
Scott Benner 2:32
So load is more about amount.
Jennifer Smith, CDE 2:35
load is more about amount. So you know, in terms of like carb impact, carbs are not the enemy. Most of what the problem is timing of insulin, and then also the amount that people choose to eat. Right.
Scott Benner 2:54
In moderation, I guess. Right? Correct. are manageable. Okay, so I have to try to go through this in my head, because I want to make sure I understand because this is this is one that's beyond me a little bit. glycemic index is like literally a scoring system. And there are certain foods that fall into certain ranges of index high, I guess there, is there a medium and a low? Is that how it is
Unknown Speaker 3:16
moderate? and low?
Scott Benner 3:17
Yep. And so that is, first of all, I guess, where do they find that? Is that like, Is there like a magic Genie that's in charge of the glycemic index? Is that something the government does? Where's that?
Jennifer Smith, CDE 3:30
That's interesting. So and then one point of I guess, reference, we talk about glycemic index is the fact that glycemic index was established for foods in a digest alone setting, right, so when they took apples or watermelon, or grapes, or whatever they were, it was looked at as impact only be being digested as that one food, it wasn't like grapes on top of meat lovers cheese pizza, right? You know that that kind of takes it as a one point in time. This is what the impact and low and this is what the impact should be. This is what you should expect from this food fast, moderate or slow. So
Scott Benner 4:12
so when I tell you the people, some foods like hit, they punch above their weight, like that's what I'm talking about. I'm talking about work index, like it's okay. So I guess that you have, like, I guess there's a way that you would look at a food and maybe apply something to it that you think is true, that might not be true, but there's actually a scoring system somewhere called the glycemic index, maybe I'll try to find a link and put it in here for people, and they can see what these foods are supposed to, you know how they're supposed to hit. And then from there, glycemic load is the idea of how much of this food you eat, and how for how big of an impact for how long it's gonna have. Correct right. So like, in a very simplistic way, I used to say to my wife Never forget the first time like we gave Arden a lollipop and we like bolused for it, and then realize that she didn't really need the insulin for the lollipop because the sugar like hit her really fast, but then it sort of just went away again. I realized Now look, I realize now looking back, it didn't go away. She was MDI, and she was probably at too much basal insulin. So sure, so we were feeding the bazel with the lollipop because it felt like it went in and went away. But now I realized that in a perfectly balanced system, where ardens bazel is right, that lollipop does have an impact on her,
Jennifer Smith, CDE 5:32
and would need insulin to cover it and we need insulin to
Scott Benner 5:35
cover it. Jenny Smith is not just a delightful voice you hear on the Juicebox Podcast. She's also a real live person with a job and she works at integrated diabetes. If you'd like Jenny to help you in your personal journey with Type One Diabetes, go to integrated diabetes comm find Jenny's profile and send her an email. There's also links right here in the show notes about you know how you can do that. I think there's actually even a link there to her email. And there's a brief description of her you know, Bona Fie days, why it is you might want to give Jenny a ring. Thanks so much to the sponsors Dexcom. On the pod and dancing for diabetes, there are links in your show notes at Juicebox podcast.com, where you can find out more about the Dexcom g six continuous glucose monitor, figure out what's going on at dancing for diabetes.com. and order a free no obligation pod experience get That's right, a free no obligation demo of the Omni pod. Before I go, I just want to thank everyone who downloaded and shared the show because the other day it reached 1 million downloads. Absolutely amazing. took a couple years to get there. But one of the exciting part because of you guys and how you share the show. I'm pretty certain that 2 million downloads will be here this time next year. Is that amazing? Your good words and sharing or how the show grows. So thank you very much from the bottom of my heart. Go out spend the rest of your weekend being bold. Do it with your insulin, do it in your personal life do in your professional life. Just be bold. If you can't remember to be bold, go to Juicebox podcast.com. Scroll down the merchandise you can buy a shirt right there. That'll remind you just look in the mirror. You're like oh yeah, I'm supposed to be bold. Alright, well, that was weird, but please buy a shirt.
About Jenny Smith
Jennifer holds a Bachelor’s Degree in Human Nutrition and Biology from the University of Wisconsin. She is a Registered (and Licensed) Dietitian, Certified Diabetes Educator, and Certified Trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. You can reach Jenny at jennifer@integrateddiabetes.com
Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!
#254 Will Exercise for Cookies
Caroline was diagnosed with type 1 diabetes at 16 months old…
Today she is a college student... this is her story.
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Pandora - Spotify - Amazon Alexa - Google Play/Android - iHeart Radio - Radio Public or their favorite podcast app.
+ Click for EPISODE TRANSCRIPT
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.
+ Click for EPISODE TRANSCRIPT
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 everyone and welcome to Episode 254 of the Juicebox Podcast. In today's episode, I will be speaking with 19 year old Caroline, who has had Type One Diabetes since she was 16 months old. This girl is absolutely one of a kind. The episode you're listening to today is sponsored by Omnipod Dexcom. In dancing for diabetes, you can go to my omnipod.com forward slash juice box dexcom.com forward slash juice box or dancing the number four diabetes.com for more information. There are also links in your show notes and at Juicebox podcast.com.
I don't want to give anything away from this episode, so there's no lead up to a lot just get in there and listen. While you're doing that, 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 medical plan or becoming bold with insulin.
Carolyn Willard 1:19
My name is Carolyn Willard I've been diabetic since I was 16 months old. I'm now 19 years old and I'm a freshman at Ruskin college. I have been using the Omni pod since I was 12. And I've had a service dog for the past two years.
Scott Benner 1:34
And I'm seeing the service dog in your picture. What's Is it him or her?
Carolyn Willard 1:39
His name is Teddy Teddy.
Scott Benner 1:40
Is he a golden retriever?
Carolyn Willard 1:42
He's a yellow lab.
Scott Benner 1:43
Oh, yellow lab. Very nice. My picture is fuzzy. Where my understanding of dogs is fuzzy. It's one of the
Unknown Speaker 2:00
pictures really small now it's made Trust me.
Scott Benner 2:03
Kelly's 16 months old. That's why he crazy. So hold on. You're a freshman in college. I'm gonna make you 19 in my head. So I'm gonna say you were like a year and a half old when you were diagnosed. Right? Look at me.
Carolyn Willard 2:16
Yes. Today is actually my 18th diversionary
Unknown Speaker 2:19
girl here.
Unknown Speaker 2:20
Yeah,
Scott Benner 2:21
we've never done this before. There should be a sound effect. There's no sound effect callin I'm sorry. But but so this is literally the date, the date? Wow, wait a minute. I don't know what to do about that. And so let me figure out the date. March 6. Yes, we're recording this in 2019. And you were diagnosed what year
Unknown Speaker 2:39
- Wow.
Scott Benner 2:41
That's crazy. Well, congratulations. Yeah, I don't I never know what to say about that. congratulating you seems like saying, Hey, good job. Not like, you know, falling apart.
Unknown Speaker 2:52
Yeah, I feel alive. Right.
Scott Benner 2:55
And there's party that wants to go Oh, I'm so sorry. It's been that long. And you don't really know how to answer something like that. But you're a person who celebrates the anniversary.
Carolyn Willard 3:03
Time. I've had friends who've been like, Oh, we should celebrate. I never started until I was in high school. And it's just been like, Oh, yay. But nothing like I don't throw a party or anything like that. I hear you. I don't
Scott Benner 3:15
100% know, the day Arden was diagnosed. And sometimes my wife will bring it up and I say is that today? And she's like, yes. Like I remember it being like in August or something. So well, good for you. That's that's really amazing. I want to go back to that time a little bit. And find out are you from a two parent household?
Carolyn Willard 3:34
Oh, yes, I'm, I'm an identical twin. And my older sisters are identical twins and I also have an older brother. Well, nobody else has it.
Scott Benner 3:43
Okay, well, that's See you in the right to the diabetes part. Here's the part I want to know. The first time your parents tried to make a baby did one baby come out or two babies come out? Why would they ever do it again? Do you think?
Carolyn Willard 3:56
Oh, my mom really loves children.
Scott Benner 4:00
No kidding. Now here we go. The second time your mom dad had a baby. One baby came out have two babies.
Carolyn Willard 4:05
One, but they thought it might be twins.
Scott Benner 4:07
Do you think they were like let down when they found that? It wasn't twins?
Carolyn Willard 4:11
I don't think so. It was my it was the boy and he's he's a handful. So
Scott Benner 4:16
probably a good thing. Okay, so then they like we're gonna do this one more time. Yes. Which I mean, at this point, though, hold on a second. Are you the first set of twins in the last set of twins? last set of twins. So if they weren't like amorous and hard working you you really would have been the end because trust me If I was your parents, you wouldn't exist. After the first time I'd be like, Hey, listen, we've obviously made a mistake. And let's stop this but but this is very cool. So you have it they have they get pregnant a third time. I have another set of twins. It's you and your sister. And you both you're both sets of twins. Your family are identical. Yeah. That's crazy. Does your dad work like 29 hours a day
Carolyn Willard 5:00
He will probably tell you that Yes.
Scott Benner 5:03
Does he do that to make money to send you off to college or to avoid being around the house for their five children?
Carolyn Willard 5:08
It's probably probably a bit of both. Honestly. No, he's,
Scott Benner 5:13
I'm sure he's a delightful man. If he's sorry, you sound like your guy. So your first set, how much older is the first set than you?
Carolyn Willard 5:21
They're 11 years older than we are. Oh, my
Scott Benner 5:23
God, your parents are Catholic. No. Are you Mormon? I don't understand. You're not Mormon or you know, we're
Unknown Speaker 5:31
Presbyterian.
Scott Benner 5:32
Nigerians do this too. Unbelievable. I had no idea. So excellent. For the record, I've assumed Presbyterians also have children. But But that's not what I'm saying. Okay, so Well, let me wrap my head around this. So you're, you're a freshman. In college, I'm assuming it's possible that your older set of twin siblings have children of their own? No, they do not good for them. They learned their lesson growing up and you're thinking, okay, but they could they old enough that they could have
Carolyn Willard 6:05
all three of my older siblings are married. My older sisters are 32.
Scott Benner 6:09
Nice. Well, listen, it sounds like they're putting me first which is something I wish I would have done in my life. So okay. All right. So you're, you're diagnosed, there's no other diabetes out of the five of you, or your parents or extended family anywhere, right?
Carolyn Willard 6:22
No, no, buddy.
Scott Benner 6:24
You're really are just lucky, huh? By the way, do you know the odds of being an identical twin?
Carolyn Willard 6:30
No, I do not. I know they're not
Scott Benner 6:32
not very big. Here's what I'm gonna find out. And I will plug the information in later. And I never give myself work on the podcast. But today, I'm going to write it down because of my bad memory. odds of being twins identical odds of having type one diabetes. You might be like the ultimate bad lottery winner cow.
Carolyn Willard 6:54
I actually I go to a diabetes camp every summer and you would not imagine how many twins there are that are identical. And one of them's diabetic. And the other one's not super interesting.
Scott Benner 7:06
Google tells me that for the average American the chance of developing type one diabetes by age 70 is one in 100 or 1%. In the general population, identical twin pregnancies occur point four or 5% of the time or once in every 250 births. Now, my common sense tells me that visiting dancing for diabetes.com 100% of the time makes you happy finding them on Facebook or Instagram doubles that response. Do you think you're and I won't ask you to put yourself in your sister's head too much. But do you think that she's feels guilty that you haven't and she doesn't, or do you think she's like secretly like who I like dodging, they're like, do you guys
Carolyn Willard 7:49
I don't know. We never really talked about it. I hope she doesn't feel guilty that kind of stink. And I mean, I'd hoped she wouldn't be gloating about it, but
Scott Benner 7:58
like, Oh my god, I dodged such a bullet. Well, you know, like, I do wonder how much of that the idea of survivor's guilt might like? Well, we'll figure that out later.
Carolyn Willard 8:09
I'm very happy that I'm the one who got it. Like, I wouldn't want anybody else in my family to have it. Like, I'm glad it was me and not them. So
Scott Benner 8:16
why are you so nice? How are you brought up? What happened?
Unknown Speaker 8:19
Oh, no, no, I have a great mom.
Scott Benner 8:21
No kidding. Wow. I mean, I guess she's got to be a great mom since your dad never home because he's so No, but seriously, that's a really a really wonderful thing to say that, you know, you're glad it's not them. Yeah. I don't know how kind I would have been at your age, if something like this was going on my life. And someone's like, Do you wish it was your brother? I might be like, yeah, I mean, you know, one of them not the other one, but I would never say which one?
Carolyn Willard 8:47
No, she said um, she's actually collegiate athlete. So I would not wish that on her.
Scott Benner 8:53
No kidding. What sport?
Carolyn Willard 8:55
I'm cross country and track.
Scott Benner 8:57
Wow, that's a lot of running. I don't have the running gene. I start running and I'm immediately reminded I shouldn't be running.
Carolyn Willard 9:05
Yeah, I ran throughout middle school in high school, but I did not pursue that politically.
Scott Benner 9:10
What are you going to school for?
Carolyn Willard 9:12
I'm, I'm a biology and history major. But I'm going for an want to be a doctor. I want to be a neonatologist.
Scott Benner 9:19
Well, I feel like we're gonna learn a lot here, Caroline. Okay, let's, let's get started. Which parent had the? The energy to take care of you when you're dying? The question
Carolyn Willard 9:32
Who does one? My mom she's a stay at she was a stay at home mom. So
Scott Benner 9:36
she took care of me. Okay. And do you remember? What's your first memory of diabetes? How old are you do you think?
Carolyn Willard 9:44
Um, I don't think I have a specific memory but I our kitchen is like semi connected to my parents bedroom. And so I would always run and jump on the bed and stick out my leg and she would give me the shot right before dinner and then we walk in and have dinner. That's kind of like my earliest diabetes memory, I'm going to have them range from like, kindergarten. Um, when I was diagnosed, I went on, like the ratio to where I had 45 carbs at breakfast 45 at lunch 45 at dinner, and that was it and had two shots a day. So I had like that regimen thing. And so I couldn't share my food. And I would always want to because I like sharing things because I'm a twin, so I had to share everything. Um, and so I always had that you at certain times, and it wasn't the same time that my class ate. So my mom would come to the classroom and bring me my lunch and make sure I didn't share it
Scott Benner 10:38
at all, I actually have to stop you from being kind to other people.
Carolyn Willard 10:41
Yeah, I can. I can be that time. You can do that.
Scott Benner 10:44
You know what I'm interested about the design of your house, it makes me feel like your parents realize that your mom was either going to be hungry from sex or from being pregnant, so they put it near their bedroom. And you find out about that for me and get back to me later if that was a design movie. Yeah, thank you. Maybe you're like no, but I'm already writing doing this podcast.
Carolyn Willard 11:05
I am home alone. So I cannot ask them right now. That's very cool.
Scott Benner 11:10
Okay, so you want to be a doctor? I that's amazing. Yeah. So what do you manage with nowadays? So you were doing ratios back then then for people who are listening to this whose kids were diagnosed five minutes ago, or? They were not there like ratios? They used to give people you know, like, regular Is that what you're on regular an MPH? Um, yes, yeah, they get this older insulin that was sort of like a, I don't know how to put it exactly. But it just sort of gave you like a blanket of insulin all day. And so if you inject it at a certain time, at a certain time ate a certain amount of food, that was pretty much the protocol. When did you stop doing that? Do you know?
Carolyn Willard 11:47
I was 12. I was on the same ratio from when I was 16 months to 12.
Scott Benner 11:53
Oh my god, at any point. Did you become murderous and angry?
Carolyn Willard 11:58
No, I really didn't. I was fine with it. And the only reason I went into the pump was because I was starting cross country. That didn't bother me. That was just how my life was. I was hungry a lot. I had a lot of celery.
Scott Benner 12:14
Well, Carolyn, way to get the title of the episode right away. ate a lot of celery. Carolyn, I very frequently find myself interviewing people that I think these people are better than my kids. I wish I could watch them. So you as hungry as you were didn't rebel. You weren't like sneaking food. You just went with the program?
Carolyn Willard 12:38
Yeah, I did. I would run laps around the house. My mom is a an amazing Baker. And she would bake cookies all the time. And so one of her chocolate chip cookies is 15 carbs. And I ran like five laps around the house. And then I could eat a cookie. Or I would run up and down the steps. And we got a mini trampoline for me. And if my blood sugar was high, I could jump on the trampoline. And I would do that if I wanted to cook your something too.
Scott Benner 13:01
So no joke, you would go jump on a trampoline run around the house something to that effect and then we'll go to your mom be like hey, I've done my jumping. Where are the cookies? Yeah, anyway, and that would keep everything within reason Now, I do want to know if if you know you might not what is in reason mean? Like what were your a one sees? Like, you know, did you
Carolyn Willard 13:21
um, I've never had an A one c above seven, eight. My entire life.
Scott Benner 13:27
Um, you know about your variability because I'm sure you're more aware of that now than you were then.
Carolyn Willard 13:31
Yes. So I know when I was little and my mom was completely in control of me. I had a one season the five and my doctor told my mom that she was being too title mean that I should live my life a little bit. Um, so
Scott Benner 13:45
I am not was that just his his or her assumption?
Carolyn Willard 13:49
assumption. Um, I love that doctor. I met he moved to the Maine or something when I ride around the time I got my pump. But yeah, he was funny. I loved him a bit. So I i loosened up a little bit. Around the time I hit puberty, I went I had been in the sixes constantly. And I jumped up to around the seven, mid seven. And then I've been anywhere between seven six and six nine for the past five years or so. I don't
Scott Benner 14:21
want to be the one to break this to you. But if that doctor moved to Maine he's either frozen to death or been killed by a caribou by now so
Carolyn Willard 14:28
I'll be right him I do right since I know he's not Verizon,
Scott Benner 14:31
Caroline. Are you trying to be the best most nicest person ever come on this podcast? Because you're so we're not even 15 minutes into this. I mean, by the time I had put the ads and there'll be 15 minutes but we're 15 minutes into this and you you are Hold on. Did not buck a system of food consumption did not sound fun. Had the exercise eat a cookie which by the way, I'm thinking we should all exercise to eat a cookie but just the point. I'm actually thinking now I had to cook yesterday probably would have been good To run up and down the steps once or twice before you write your endo. You know, I'm not done listing your stuff yet, hold on a second. You would you're happy that you have diabetes and not the other people in your family. And, and you've never have you ever murdered anybody and this is your repentance like this, like what have you done? Name The worst thing you've ever done right now that you're like,
Carolyn Willard 15:24
Oh, I have no idea. I'm
Scott Benner 15:28
53 things just popped in my head that I've done. I was like, I wouldn't even know where to begin to start. I once made a Hollywood cry in high school. That's, and that's like the least of the things I've done. Just there's not one thing. Are you sure?
Carolyn Willard 15:41
I'm sure my siblings could tell you something.
Scott Benner 15:44
That would be their complaints about you. I'm saying something that you've done and that was over. You're like, wow, I regret that.
Unknown Speaker 15:51
I really don't know, Caroline,
Unknown Speaker 15:53
you're perfect.
Scott Benner 15:57
Do you know that about yourself? Or is this Where do you live? Can you tell me like the state
Carolyn Willard 16:01
panda in South Carolina?
Scott Benner 16:03
The southern thing I get it, okay. All right. extra nice. All right. All right. I don't know what to do with any of this information. You Fried my mind. So we're gonna have to go back to the diabetes stuff. Okay, geez, seriously, so you want to pump the run cross country? Yeah, you made me dizzy. How am I gonna name this episode, I ate celery a lot. If you're gonna end up like, I'm gonna give me a second, I'm gonna put in that we use the Dexcom g six continuous glucose monitor this house. And it's not just to stop a low, right, I don't just see it as an alarm. The next column is really for us more to understand how the insulins working in our body and finding the exact right time and amount that she needs to keep blood sugars from spiking. Falling too far, the information we get from Dexcom helps us stop meals from overpowering her insulin. It's really so much more than just the alarm that goes off when your blood sugar gets too low. What I'm about to share with you our personal results, and yours may vary. But my daughter's a one C has been between 5.2 and 6.2 for over five years now, with absolutely no food restrictions. In my mind, a lot of the credit for that goes to the dexcom g six continuous glucose monitor the trends that I'm able to see, being able to decipher the impact insulin is having on some meals over others this stuff is where the decision making really happens. So yes, I love that the Dexcom will tell me if my daughter's blood sugar is getting too low or getting too high. I love that I can see her blood sugar while she's at school or with a friend. That's all terrific. But there's more there. You can use it for just those things, those surface ideas, which are still pretty amazing, where you can dig deeper, and find some of the answers to the things that have been confusing you about type one diabetes. Hey, here's some exciting news for Walgreens customers. Dexcom is now in a partnership with Walgreens. So if you use the Walgreens find care or the care Connect programs, you'll be able to get information right there about Dexcom CGM. And in order for him, of course, I'd prefer if you went to dexcom.com forward slash juicebox. But you know, whatever is easier for you. It's 12 years old. At 12 years old, you switch to a pump to run cross country what made that seem necessary.
Carolyn Willard 18:29
Um, I just really I went, like I said, I went to diabetes camp earlier and I fell in love with how the Omni pod worked. It looked like a lot of freedom. And I had a senior member on the cross country team who was on a Medtronic and I saw how much easier it was in shots to handle but I also saw that she had to disconnect before races and things and I didn't want to be without insulin for a race because I get adrenaline rushes so I knew I'd be Hi,
Scott Benner 18:57
Charlie, my favorite person this is so catchy even doing the exercise right? Look at you. Okay, so you say you saw the on the pod at a camp like a camper was wearing it or there was somebody there Hawking it which was it I'm
Carolyn Willard 19:09
paying for was wearing it. And we had people there who we I actually like to do a trial on the pot at hand.
Scott Benner 19:17
Oh, okay. Like you were the demo pod.
Carolyn Willard 19:19
Yes. I
Scott Benner 19:20
the way they're not calling it the demo pot anymore.
Unknown Speaker 19:23
What are they calling it a second?
Unknown Speaker 19:26
Ready hold on my
Scott Benner 19:30
juice plugs. This is not an ad. I really want to know what this is. They're calling it the
Unknown Speaker 19:38
something.
Unknown Speaker 19:41
The P e k the
Scott Benner 19:45
experience pod experience kit is interesting. It's much more fancy of a box. Yes, the box has a picture of the dash on it now not have a PD. Okay, so the pot so now that you were a demo pod, let's just get It's tough, like old timey army badass. Yeah. And just then in there, you're like, this is good. I like this.
Carolyn Willard 20:06
Yeah. So I'm really big on pro cons list. My dad's an engineer. And so he's very practical. So I make pros and cons charts for everything I do. So I made one for the Omni pod. And so it wasn't like been in there after camp that I started. It was a couple years later. And like I said, I was starting cross country. And that was a big pro on that one. So
Scott Benner 20:26
I would love to see your parents pro con list on the third time they had a con no more money. Con have to find energy to have sex again, because we have three kids. I'm sorry if this is making you uncomfortable. So you have a service dog. How long have you had a service though? About two years? And he is for your blood sugar? Yeah. Hmm. Interesting. How do you find that?
Carolyn Willard 20:54
I'm very interesting. I thought I knew what I was getting into. I really didn't at all. Having a dog with you. 24. Seven is really fun, but it's a lot of work as well. But I got him right before I went to college so that my parents are that peace of mind with me like sleeping. And because I tend to drop a lot in my sleep, and I don't wake up to it. Because I've had diabetes for 18 years. That just kind of becomes normalized with the symptoms and stuff. And I can't tell as much when I dropped below. What's your sleep? Yeah. I used to be able to wake myself up No problem, and I can't really do that anymore. So what are your superpowers is going away?
Unknown Speaker 21:35
Caroline? How's it feel to be mortal? Hmm. Oh,
Carolyn Willard 21:38
I know. Um, so Teddy will wake me up in my sleep now.
Scott Benner 21:42
That is and how frequently does that happen?
Carolyn Willard 21:45
I'm not as frequently anymore. I've kind of quit teet tweaked my bazel rate a lot at night to where I don't drop as low. But it's happened a good bit of times. He pushed me out of bed one morning because I didn't get up because I didn't want to wake I knew my alarm is going off in 10 minutes. And I was like, I'm sleeping for 10 minutes. Like my blood sugar can wait and he pushed me out of my bed. Okay, I'll check.
Scott Benner 22:12
My dogs does that but it's because he's threatening to crap on the floor. Take him outside. It's not over anything medical or altruistic like that. How was that having a dog in it? Are you in a dorm?
Carolyn Willard 22:25
I am I am. I have a roommate.
Unknown Speaker 22:28
Okay.
Carolyn Willard 22:29
Yes, it's um, it's interesting. Our I we have a bigger dorm. We have a corner room like right by the kitchen because it's Teddy. We got priority on like the bigger size dorms. It's still quite small. But it's it's really, I don't think anything much different than living with another person.
Unknown Speaker 22:48
You roommates pretty cool with it. Oh, yeah. She
Carolyn Willard 22:50
loves Teddy. There's so many pictures of like him sitting in her lap and things like that.
Scott Benner 22:56
Because she got a bigger room. You think she likes him? Or you think she likes him? Because Because of him?
Carolyn Willard 23:02
Probably because of him. He's very fun loving. Okay,
Scott Benner 23:05
okay, so I'm sorry, I'm looking at Arden's blood sugar. It's 1122 here, it's about an hour since we bolused for her for her lunch. And there's part of me that thinks it needs gonna need a little bump at a second and part of me that wants to go with it. So we had um, let me try to suss this out for you around 8:45am This is her early lunch die. She eats it like we bolus at like 1020 I think but anyway, around 11 around 845. She was like drifting lower and I'm like this is gonna get low. So we killed her bazel for a half an hour, which held her blood sugar at like 89 for like from like nine o'clock 10 o'clock into going into like 1020 when we bolused but I could see her starting to drift back again the other way. I did a Temp Basal increase of 40% for an hour and a half. And I think we Bolus 12 and a half units. But instead of I needed to extend it a little bit but instead of the way I normally would if my blood sugar was at nine I would normally put in like half and then do the other half over an hour or something like that, you know something like that. But instead I only put in 30% but then I put the rest in over a half an hour because I thought with the deficit of the bazel from 845 to 945 I thought the food might end up getting a jump on her she's got like she's got a banana. A half of a peanut butter and jelly sandwich a few chips. Grapes, a hard boiled egg. Something else maybe a molano cookie or something like that in there are some peaches. I don't know exact I can't I can't remember anymore. But I remember feeling like it was going to hit a pretty hard fast. So anyway, at the moment we're 106 Yeah, yeah, it's been an hour. I think 106 is good but if there's going to be a drift in my experience, the drift is gonna happen very soon. Okay, just Teddy tell you when you're just when you're low or does he tell you when you're hot as well?
Carolyn Willard 25:06
He does high he does trend mainly. So he doesn't do they kind of does his ranges 80 to 120. So he'll alert any time out of that range. But he'll also if I'm dropping really quick or rising really quick, he'll alert me to that.
Scott Benner 25:20
Nice. He's got rise and fall or it's like the Dexcom Yes, nice. Do
Carolyn Willard 25:24
you have a CGM? No, um, my pro con list was for a dog or for decks common dog one out because the dog was cute. Cute. Does that really happen? Yep. The dog was less expensive. He I thought he would be more reliable, more long lasting. Honestly, I went to camp and I was not impressed with sex calm. So but I've heard great things. I honestly kind of think it's like in north south thing, because all the Northerners that I've talked to love it all the southerners don't. So I don't know what's up with that. But that's just the trend. I've noticed. I'm gonna
Scott Benner 26:02
keep track of something like that. So yeah, so let's break it down for a second people that you've met from the north.
Carolyn Willard 26:09
Mainly have better work better like
Scott Benner 26:13
results with the with the CGM right with Dexcom right or CGM. And and in the south, they have less better books. I'm sure there's English involved in there somewhere that I could have used worse results with the CGM. Now, that doesn't make any sense. So let's try to put up notice.
Carolyn Willard 26:30
I don't know if it's a temperature thing. Or something like that. But I that's just all I've noticed, which is interesting.
Scott Benner 26:38
I liked listening to you talk about Teddy like he wasn't alive for a second. You're like I thought he had more longevity possibilities. That's really funny. Do you feel any sadness at all that you've made Teddy your slave? Oh, just kidding.
Unknown Speaker 26:55
No.
Scott Benner 26:57
Does he ever look at you and go, I don't want to pay attention to your blood sugar today. Carlin, please let go.
Carolyn Willard 27:02
And now that he's sleep, I do not feel bad at all. In my classroom, she just curled up under my desk and sleeps the whole day. I i he's he's got at me. I think it's tennis balls and sleep for him. So
Scott Benner 27:16
how many years have you been with him?
Unknown Speaker 27:17
To?
Scott Benner 27:19
how sustainable Do you think it is through a lifetime?
Carolyn Willard 27:24
Um, I don't know. I haven't seen any changes in him so far. And the people that I do know that I'm like, from his company that had them for a while. There's, it's, it's good. This sounds like really morbid, but he has a 10 year warranty. That sounds awful. Every time I say it, I
Scott Benner 27:46
don't want to say it. What you're saying. But that's Yeah, but ration out. I appreciate that.
Carolyn Willard 27:51
Yes. So he should be working for 10 years. It's his sense of smell. And that can go with age. I would say 10 years.
Scott Benner 28:04
Now, what about your lifetime? What do you think about that? Like, do you see yourself 3040 5060 years old with a service dog? Yeah. Okay,
Unknown Speaker 28:13
what do you think change?
Carolyn Willard 28:15
Um, hopefully technology is I've been hoping for Kira, since I was like 16 months. I remember in elementary school, I was told that it was 2008. And I remember they said in four years, there'll be a cure. And I was like, Yes, 2012. Like, I won't be a teenager and diabetic. And so that didn't work out, obviously. And so I'm hoping that in the next decade, technology will have advanced enough to where I will be able to trust a CGM more or there'll be an like a bionic pancreas or something like that.
Scott Benner 28:50
Okay, so that's all that is really interesting. So I'll tell you that, you know, I hope it'll bump people out. But I don't live like there's gonna be a cure. I, I hope for one, and I genuinely hope for one. But my, my, kind of in the moment, desire is for technology to continue to improve for insulin to improve that.
Carolyn Willard 29:12
Yeah, I I don't go day to day like, oh, there's gonna be a carrot like i don't i don't really do that.
Scott Benner 29:17
Don't think about it day to day. daily basis. Do you think your mom does?
Carolyn Willard 29:21
Um, I don't know. I remember my first endocrinologist that I was talking about. I remember him telling my mom that there won't be a cure in her lifetime, but there might be in mind.
Scott Benner 29:32
Yeah, I seem you know, I it's funny. I was having this conversation with somebody last night through messaging. And I don't remember them off the top of my head. But as us as a race as a society, human beings haven't really cured many diseases. And so we've eradicated some things through vaccines. But we haven't you know, to date yet we haven't been like, oh, remember, you know, remember cancer. That old chestnut, that's gone. Like, like not only do do people not die from it anymore, they don't even get it like that would be a cure. Right? If no one ever got cancer again, we have cured cancer somehow. Right? Same thing in, you know, with diabetes, if you're saying you're going to cure it with, you know, what does that mean to you? Does that mean that if you're diagnosed with it, that someone gives you the diabetes pill, and it goes away? Again, doesn't mean that people don't get diabetes anymore? Like, which? What does a cure mean? Right? I guess that probably means different things for different people.
Unknown Speaker 30:31
For Oh, good. Go ahead.
Scott Benner 30:33
No, I was just gonna say that I'm in my heart. I know how Arden's health is using a glucose monitor. Right. And so if the marriage of you know, Arden zombie pod with her Dexcom, which appears to be coming in the next year, somehow, right, I'm hoping I'm thinking through tide pool first before before Omni pod even gets out there horizon system, is my sort of hope. If that marriage keeps her blood sugar from getting dangerously low, overnight, creates a world where we can sleep a little more soundly for longer, and her a one c stays in a in a reasonable range. I'm gonna take that as a win for now. Yeah, you know, and so, but it sounds like you want that to but at the same time, you were dissuaded from it. But were you only dissuaded from it because people you know from warm weather places don't like it as much
Carolyn Willard 31:31
as I have trusted us with technology a little bit. The first time I got on the pod like the first couple years, it wasn't many yet. And the old one had several quirks. And I just I have their helpline memorized since their phone number, just because calling so much with problems, and I just
Scott Benner 31:53
didn't really from the old pods, the bigger ones.
Carolyn Willard 31:56
Mm hmm. And I still have problems with the many ones not as many, but
Scott Benner 32:00
we'll have to call them what kind of problems because I have problems with insulin pumps once in a while too. And with CGM, too, I expect that to be part of the game. It sounds like yeah, that's the part of the game. You don't want to be involved.
Carolyn Willard 32:11
I don't want to be involved with that, oh, they would just stop working. Like I would just get alarms that they would stop working. It would just say pot expired. Like on day one. It was really strange. I've had fun with the many, like with sweaters that are worn to static electricity has killed them. Yeah,
Scott Benner 32:29
I see that. My best guess is once or twice a year, like you can get like a static pool. Right. Right. And so
Carolyn Willard 32:37
yeah, I had one week, it happened twice. And I was just like, this is enough. Um, but yeah, I just don't like that I would, if I'm using the technology, I'd appreciate it to work a lot of the time, and it works most of the time. And I would definitely prefer Omni pod than anything else.
Scott Benner 32:57
So now I would say and I don't feel hold, I'm gonna tell her in the Bolus. She's one. She's 112. Now people are like, Oh, shut up. Six to 112. And you're like balls, but I'm seeing there's an I have an inclination and something's happening here. So I'm just going to look at although I said six, so she'll be dead in a minute. While I send another one that says politics. Yeah, six and she's she'll be gone in about now. She's saying what Bolus point six? Because I said Bolus six Bolus points sex. And then her her what that what is so it cuts right through me when it comes through text messages. I, I in first so much anger into what? Which is unrealistic. By the way, she probably just means Wait, what are you talking about? What But anyway, so I would tell you that what Omnipod would tell you and they've told me and other people is that if you were around too much static electricity, and that pod shut off. That is the pod working correctly. because something happened to affect its internal circuitry, and it doesn't want to make a mistake giving you insulin. So it says Look, I've been compromised. We're gonna stop this now. But what you mean, if I can, if I can speak for you for a second, and you'll tell me if you're if I'm wrong, is you want technology that seamless. And you just, and you want it to work and you Vic, I think that about most of the technology in my life, there are things I will not move up to, until it just works. I don't want to spend time diagnosing things and that sort of thing. It is only with the diabetes technology where I sort of add a little bit of air and I say to myself, okay, the good outweighs the bad for me. But for you the it didn't in the idea of getting a glucose monitor. So it's very important for people to do what is going to be I mean, I think the best for them as far as their day to day life. Yeah. Now if you were if you and Teddy were like rolling along and what's your agency now what you tell me
Unknown Speaker 35:00
70 I believe, cool. That's amazing.
Scott Benner 35:03
And so but if you and Teddy were rolling along and your agency was 10, two, would you? Geez, maybe I gotta put up with technology. Yes, absolutely. Okay. So it's that you're finding success, that that you're like, I don't need this thing right now. I'm doing fine without it. That's amazing. Yeah, that's absolutely fantastic. Do you have any idea about your there's this thing that, you know, people who use glucose monitors talk about standard deviation all the time, like how much? You know, how much difference is between my highs and my lows? Am I steady all day? Like if you have a 7.2? What does that mean? Like your blood? If your blood sugar was constantly stable, I guess it would be stable around 135 or 140. Right. But, but it's probably not like that.
Carolyn Willard 35:47
No. I know a bit about Tinder deviation. I have an app called my sugar, I believe. And I think it's my sugar. I don't use it religiously. Just because I'm, I'm honestly not technologically savvy, I can't handle too much technology in one day. So I do know a little bit about standard deviation of the blood sugars and stuff. I tend to go low quite a bit. And if I am low, it's kind of like, if Teddy doesn't catch it, it'll be quite severe. I know, I've been in the 20s three or four times since I've been in college, which is not not good. Um, but I don't day to day, like, my average days, I'd probably say between 70 and 180. I don't think there's like too much between every day's but there's been like an outlier days sort of thing. Kind of scary. Would you be interested in picking through that for a minute with me? Or do you want to wear do not care? Like about the lows? And guess what? Okay,
Scott Benner 36:54
so here's what I would say, if you are experiencing lows that are happening after meals. But But your blood sugar's not going much over? 180 then my question would be to you, how soon before you eat, do you Pre-Bolus or do you not?
Carolyn Willard 37:14
I don't generally Pre-Bolus I've tried to incorporate that. I just don't eat on a reliable schedule. enough to do that. And I, I don't decide to eat until I'm eating generally. Um, and those episodes that I was talking about, weren't really after meals is cut. Yeah, it was kind of like, late at night, studying that I just bottomed out. Probably stress more than anything else affecting that,
Scott Benner 37:47
you know, so that's incredibly interesting, because, because I was just, I was messaging with another person last night, whose blood sugar was going up while they were studying in college. So um, so is it possible that when you're really sitting down and hunker down and studying for long periods of time that you forget to eat while you're doing that?
Unknown Speaker 38:07
Oh, certainly. Right. And then you
Scott Benner 38:10
should forget about diabetes. Yeah, I guess, right.
Carolyn Willard 38:14
Yeah. And I will tell you that I'm quite the opposite every time like, like when people get sick, they usually go high. I always drop low. No matter what, I'm always low when I'm sick. So when I'm stressed out like I really low and I've talked to other people who said they always go high. So that's something
Scott Benner 38:33
guys and but you were saying that when you've got adrenaline when you were running your blood sugar would go up, right? Yes. Yeah, you're just a conundrum. Arden when Arden is sick, not like I get sick in general, she doesn't get ill that often. But when she does her blood sugar definitely stays on the lower side during that time, so you don't feel like free food days. Yeah, of course, the joke is you're not that hungry. Cuz you're saying yeah, you know? Okay, so because what I would you know, what I would say is that any really kind of crazy lows that you can, that you can't figure out, right? Like, you know, be you seem like you figured out what those lows came from, there's extended amounts of time where you just kind of stopped thinking about diabetes probably didn't eat as often. Bang, you start getting low, and you don't have you're not wearing a glucose monitor. So if you're drifting low, that's not going to make Teddy say something right? Like if you're going down like two points every 20 minutes.
Carolyn Willard 39:29
He won't relate to that. He's not going to learn to that and
Scott Benner 39:32
then all of a sudden, you're going to hit an actual low and maybe then start falling and then he's gonna be like, Hey, lady, and by then you're where you're at. I always think of it as most times like you said, not all the time. But as an unbalancing of insulin, like at some point, you have insulin that's active, then there's nothing whether it's food, carbs or body function to hold up that, you know, to combat that insulin. I guess the last Have a better word. So what I thought was if you're probably if you're not Pre-Bolus thing, but you're not spiking crazy, right, then you're putting enough insulin up front to stop that spike. But it's then becomes unbalanced when later the foods through your system doesn't need the insulin anymore, but your insulin still behind, it still remains. Right? And then you get, you know, all that's left is the insulin in your body, right. So by putting it in a little sooner, you not only stop the spike, but you create a balance where the insulin is not so leftover by itself at the end. So even if you could put in the tiniest bit of insulin a couple minutes sooner, like it takes away from how much you have to use the moment. Yeah, but anyway,
Carolyn Willard 40:52
good times that I've tried the Pre-Bolus thing I've done partial Bolus as to where I knew I was gonna eat at least 35 carbs. So I put in like a unit or two.
Scott Benner 41:02
Right? And that works out. I'm a big fan of that. Actually. I love that idea. Okay, all right. So 38 minutes and 55 seconds later, I forget why you wanted to be on the podcast. Can you tell me please? Before I get into the Omni pod ad proper, let me tell you that if you're using the Omni pod dash, Omni pod has just released companion apps for the dash. That's right on the pod display. And on the pod view apps are now available for iOS in the App Store, go check them out. The rest of this ad, of course, is for the rest of you who are still considering getting an omni pod, I absolutely maintain that the best way to decide if on the pod is right for you is to try a pod experience kit, let them send you a free, no obligation demo of the Omni pod. This way you can wear it, or put it on your child and see what you think. After that, it's a simple process to continue on and get your Omni pod if you decide you like it. And if you don't want to, it's no big deal on the pod, it's not gonna bug you or pressure you, it's completely up to you. What you want to do is go to my Omni pod.com forward slash juice box, fill in the tiniest bit of information. And this is going to get the process started for you. It's very simple. Again, there's no cost and no obligation, there really is nothing to lose. Once you get it on the pod and you start wearing it, I think you're going to find that the freeing nature of no tubing and not having to carry a device on you is going to be amazing. Additionally, those of you coming from MDI are going to find incredible freedom in being able to Temp Basal extend your boluses and just do all the other terrific things that on the pod allows. It would be hard for me to quantify the impact that on the pod has had on my daughter's life, but it is immense. And I think it could help you to don't wait another second, Miami pod.com forward slash juicebox with links in your show notes. And at Juicebox podcast.com.
Carolyn Willard 43:05
I started listening to you and I I just really loved what you were doing and I wanted to be a part of it.
Scott Benner 43:12
So nice. And so are you do you fall more on the side, I find that people either really enjoy the podcast because of the management stuff, where they really enjoy the community aspect or they just love hearing other people who have diabetes, because they don't have that what part of it really kind of grabbed you.
Carolyn Willard 43:30
I love being a part of the diabetes community. There's, I don't know very many diabetics in my, like real life, I guess you'd say. Um, so I love being a part of the online community and things like that. How
Scott Benner 43:43
do you do that? Is it on Instagram?
Carolyn Willard 43:45
I do a lot on Instagram. Yes.
Scott Benner 43:48
Well, you got the cute dog and you're young. So I guess Instagram?
Carolyn Willard 43:51
Well, I i've mainly look unfollow people, I don't really do much land.
Scott Benner 43:57
Oh, no kidding. So you're, you're more of a that's great. And so you just sort of get your I guess information or inspiration from the other people who are sharing but you you're not out there creating your content. Right? And and Is this your first try into the like, in defining community online or heavy things in the past?
Carolyn Willard 44:17
This is the first time I've ever been active myself like with talking with you. Um, I've read a lot of stuff on Instagram and Facebook and things like that for quite a while.
Scott Benner 44:28
This is the first time right now the thing we're doing now where I'm making fun of your parents are having so much sex and be fired and all this stuff. This is the first thing you've done. Yeah, I'm so sorry. I would have been nicer Had I known. So funny. And you just wanted to do that because you enjoyed the podcast and you wanted to add to it. I'm very touched by that. Thank you. I'm a little less touched by it because you're so incredibly nice. That it seems to me like obvious that you were going to do something nice after you had this experience but I'm very tired. No, no I'm being my ne sarcasm isn't allowing it to come through. But, but I really, I really mean that, like, that's wonderful to think that something impacted you that way that took you from a spot of like inactivity about you know, sharing, to actually wanting to share, do you have something specific you wish the world knew? Um,
Carolyn Willard 45:28
not really, I just I'd like to encourage parents just, I mean, your kids will be okay. Um, my mom raised me in tight control of my diabetes, and I don't hate her. I love her for it. So just, there's right ways around things, right ways and wrong ways to do things like my mom never told me. No. When I asked, like when I asked for a cookie, she didn't tell me no, she'd say yes, you can have one just go run five laps around the house. So
Scott Benner 45:54
I'd say sometimes I say to Arden, like just Pre-Bolus. And then she's like, oh, like Shut up. By the time you get the food and get back to where you're sitting and do all that stuff. Like just push the buttons now. And but I think your messages is incredibly important, because I will do that too. I probably don't seem like from this podcast, somebody who would do that. But I would if I was having trouble with Arden's blood sugar, you know if it was stuck somewhere 161 80 and I couldn't get it to move. But she said she was hungry. I wouldn't stop her from eating. Yeah, it might bolus like, you know, a bazookas worth of insulin. But I I'm very frightened to cause a food issue with Arden. Yeah, I very much don't want to do that I'd rather see her blood sugar be higher than I want it to be, then for her to have an adversarial relationship with food, or with her diabetes to be perfectly right for her to think of this diabetes. As you know, the reason why she can't eat I'm now an extension of that. If I'm the one saying no, now I'm hurting our relationship. I'm hurting how she feels about you know, diabetes, which is going to be with her for you know, forever. Yeah. And, and then she hates food. Now I've got an angry, non compliant, which I know everybody hates that word. But now I'm gonna one day I'll have an angry non compliant kid with an eating disorder. Right, like, right, because I just couldn't be like, Alright, fine. Let your blood sugar be high. This one? Yeah, right. Oh, no, I think that's amazing. Also, your mother was raising an incredibly kind person. So which i think i don't i don't think you can give her complete. Is your mother this nice? Oh, yes. Yeah. So maybe it is her? Maybe this isn't genetic. Maybe you're just like the anomaly about anybody else. Any of the siblings? Yeah, they're pretty much at the middle ones a problem, right?
Carolyn Willard 47:46
He's just a hand. He has a lot of energy. He's very funny. But he's very well behaved and very, very kind hearted as well.
Scott Benner 47:53
So Carolyn, I just realized this I said that your expectation of what a handful would be compared to mine. Like I was thinking once he steal cars or something like that a little bit of energy.
Carolyn Willard 48:07
Literally, the clerk of archers, you know.
Scott Benner 48:10
So not a car thief yourself.
Unknown Speaker 48:12
Not McCarthy
Unknown Speaker 48:13
that you know of? Oh, well.
Scott Benner 48:17
I mean, if he was a car thief, would he be running around telling people?
Unknown Speaker 48:20
Probably not?
Scott Benner 48:20
I don't think so. either. I think you're onto something the kids. Okay. Listen, let me just be clear, you're not afraid of something right. Like the church hasn't, like, threatened you with like an eternal damnation or anything like that. No one's forcing you to tell you this. That's correct. You're not good. These are your own thoughts. Ryan thought, Yeah, no kidding. I should be in South Carolina, except for the humidity is terrible, right?
Carolyn Willard 48:49
Well, that's something you can deal with. There's always nice people.
Scott Benner 48:54
How do you deal with humidity?
Carolyn Willard 48:57
You just tie your hair back. You don't wear it down a lot, which probably is not a problem for you. But for the girls, you just tie your hair back. Everybody's dealing with it, though.
Scott Benner 49:05
You don't even hide inside. Like there's no like, No two month period where you just never get out of your house or anything.
Carolyn Willard 49:11
No, that's when that's when you're in the pool. So it's just like, you're in the pool and you don't really worry about the humidity. You're already wet.
Scott Benner 49:20
The humidity doesn't matter if you're in the pool, right? Correct. That's genius. I want to know I I'm going to jump around a little bit here. But how do you plan on being a doctor if you don't particularly like technology?
Carolyn Willard 49:31
Well, I just don't like it for myself. I can do it with other people.
Scott Benner 49:36
Okay. Okay. So you don't have a problem. Like, if you're using like something in a hospital, and it's working, you're not gonna be like, Ah, forget this, we'll get a seeing healthy dog instead. Like and but those words, all, all the words that I needed to say what I wanted to say, left my brain at the same
Carolyn Willard 50:00
No, I can work with technology. Um, I just for myself, I would rather trust not technology. No,
Scott Benner 50:07
I hear you. I really do. I, I you know, I say here a lot, but I I feel I feel very much the same way. Like I want something to come out of the box, do what it says it's gonna do. Yes, I'm not looking to make an adjustment to it. I don't want to download something. I don't want to have to learn something. I just want to push the button and make the magic. That's that's what I'm looking for. But if I said to you, Carolyn, go ahead and get a CGM. It's gonna be fine. Would you believe me? I'm not saying you have to. I'm just saying Would you believe me?
Carolyn Willard 50:41
I might. Um, I listening to your podcast. If I would have listened to it two years ago, before I got Teddy. I probably would have had more pros on my list for the CGM. And like I said, I don't, I don't picture myself with a dog. And I don't picture myself with another dog after him. So it might be a CGM, for me. First warranty expires. Yeah.
Scott Benner 51:08
Which is now how I'm going to start talking about older people in my life. When their warranty expires, I wonder what we're going to do. So do you think it'll be an open casket warranty expiring? Or maybe a cremation warranty expiring? That's such a nicer way of saying it. But it's not really It's horrible. It's a horrible thing. I can't believe all the nice things you've said here. You've said warranty expiring. I know in relationship to your beautiful dog when he really is gorgeous. He has a face that is like talking to me.
Unknown Speaker 51:39
It is he's so sweet. Yeah.
Scott Benner 51:41
And nobody, I'm at school. Nothing. Nobody's ever looked at you and been like, Look, you with this dog? Come on. It's no push back.
Carolyn Willard 51:52
In college. No. in high school. Yes. I did not have a great senior year with Teddy.
Scott Benner 52:00
Because the school was uncomfortable, or the kids weren't
Carolyn Willard 52:03
people, like the faculty and I just had a problem with maybe a handful of kids who are like, just bullies. So people,
Scott Benner 52:13
you know, it's easy to say people suck. It's not true. But a lot of them are pretty soon, but not
Carolyn Willard 52:21
at a wonderful school district. Like for most of my education in my, my second and third grade years were not great. People didn't want to cooperate with my five a four. But after that, I mean, my high school school nurse was amazing. But just a handful of bad apples.
Scott Benner 52:40
How do you deal how did you deal with that when somebody was giving you? I don't know what to say when people were being like bullying towards you about about Teddy in high school? Like how do you handle that on a personal level, like a psychological Do you just what do you do?
Carolyn Willard 52:59
Oh, well, a cup. Some people just it would be like one or two comments and they were done. But this one person in particular, just it was relentless. And I was best friends with the nurse and the SRO, which is like the Student Resource Officer. And so I told them about it. And he had to go to bully counseling, which sounds like really awful. But um, yeah, and so it kind of stopped after that.
Scott Benner 53:23
So you personally you didn't feel bad about yourself? Or like you didn't know what was me thing or the stupid diabetes acquitted. Put me through, you didn't have any of those feelings.
Carolyn Willard 53:32
A little bit. Um, but not any lingering feelings. I tend to look on the bright side of things.
Scott Benner 53:40
I'm going to steal your blood while you're sleeping and put it in me and see if it makes me worry about things because you might have the secret life in there somewhere. being serious. Really? Yeah, we're gonna come to your room and take your blood. Like, are you at school right now? Please give us your address. I don't know.
Carolyn Willard 53:56
I'm I'm on spring break. I'm not at school. That's exciting.
Scott Benner 54:01
Yeah. What are your plans? Are you doing anything? Are you just home?
Carolyn Willard 54:04
Um, well, I actually a part of the core leaders, which is the choir at my school, and we went to Disney World this weekend. And then I went from Florida to Earth skin in do west, south carolina, which is absolutely in the middle of nowhere. And then went to my home. And then we went to Charlotte. And we're leaving Charlotte today to go to Charleston. So she to travel.
Scott Benner 54:33
I'm headed to Florida in a couple of days myself. My son's going on his spring break for college and he's on the baseball team. So we're going to go watch him play baseball where it's warm, because right now it's like 23 degrees where I'm at. Yeah, yeah, it's really warm in Florida. It was very nice. I will take some of that Eve and there'll be no humidity because it's March isn't March, January, February, March. I'm not good with the month. But I was always saying to my wife the other night like we have to move somewhere. Like it needs to be warm but not humid. Which then popped into my head to me like northern Texas. Right? Like, am I right? I don't know about that. I've never been there. I'm just willing to move there. If it's warm, doesn't get too cold the winter and doesn't get humid
Carolyn Willard 55:14
for South Carolina doesn't get too cold in the winter, but just spend your summers in the pool and you don't worry about humidity. Don't you get hit with like, like, Hurricane sometimes, um, sometimes more recently in the past couple years, but I my childhood I didn't ever remember anything like that. So I
Scott Benner 55:31
have never made a pro and con list in my life. But if I were to make one I'm gonna put hurricanes on the con side. And
Carolyn Willard 55:39
they generally talk them up more than they are. It just looks wet.
Scott Benner 55:43
I'm not gonna lie. Like windy and wet. I'm already out. Now Texas like I don't know like are there gonna be like giant spiders like the wind or like Saudi Arabia there? I don't know. You can tell I don't get away from home very often. So okay,
Unknown Speaker 55:57
North Carolina. Yeah.
Scott Benner 56:01
Sound have seen it snow there sometimes. Yeah, I never want to see snow again. That's my goal.
Unknown Speaker 56:07
Oh, I'd love to snow. Yeah,
Scott Benner 56:08
I mean, it's nice enough, but I'm done. I walked outside today, just before you and I got on a second. Let me take the dogs out first. And they can be nice and comfortable while I'm talking account. And, and then they just didn't feel like coming back in right away. And I had to walk six feet out my door to get them in, thought I was gonna die. So I was just standing in the frigid cold had a code on begging the dogs. I look at them. And I think I know you don't speak English. Because I say one of the dog's names. And they both look. Now, if they really knew their names, wouldn't one of them not look up when they heard the name is my contention. Right? So now I'm like, Guys, come on. You got Come on. Come on. Come on. And by the time it's overcoming this is me. I'm gonna come again. Come again. Please. You kill it. Now. I'm yelling in my backyard. You're killing me. Why are you trying to kill me get in the house, please get please, please. Then one of them looks up and goes, Oh, look at that poor guy. I'll go in, and he starts wandering. And then I think oh, the other one will like see that happening and fall down. That doesn't happen. Then the begging starts over for the other one. And you're like, please, please, please, please. Then they get in the house. And I stand there for a couple of seconds. And I take a deep breath. And I remember the happiest day of my life. It was the day right before we got dogs. And I have to take them outside in the freezing cold. Now if it was warm outside, I wouldn't have felt like that. Mm hmm. So I'm thinking northern Texas.
Carolyn Willard 57:33
Yeah, my largest experience with snow It was like maybe three inches on the ground. So
Scott Benner 57:39
So you've never seen snow.
Carolyn Willard 57:40
I want to know, three inches of
Scott Benner 57:43
snow never really seen snow until you looked outside and thought if I shovel this once an hour for 24 hours, maybe we'll be able to get out of this house. That's the that and that happens sometimes where you're just like, you go outside clear off an entire like pathway, your driveway, whatever it is. And by the time you get inside and can feel like the tips of your toes again. It's time to shovel again.
Unknown Speaker 58:08
No.
Scott Benner 58:10
Have you ever looked up and wind hit you in the face and you're not able to breathe?
Carolyn Willard 58:16
I can't see what I have. Yeah,
Scott Benner 58:18
so I don't really think we need your input on this though thing. Okay. I think we found something where we think maybe you don't know what you're talking about. So the cold socks callin Okay, and anybody who can live in the snow is weird or has been brainwashed in there. Okay, so a few people up in the northeast, like even higher than me or like I live in Minnesota. Shut up. Okay, we all wish we live somewhere warmer, Don't lie. And that's my contention. I'm sticking to it right now. Okay, so you go answer a couple questions for me when you're away college? How often? Do you see the endocrinologist just when you come home? or do something there?
Unknown Speaker 58:54
Um, every three months? Do
Scott Benner 58:57
you have to come home to do that? Or do you accomplish that at school? You?
Carolyn Willard 59:00
Um, I have to go home for that. It's only it's about three hours.
Scott Benner 59:04
Okay. Okay, so you actually you you make, like a lot for that you drive home see the end? No. Do you have? Do you actually go in and say, Hey, here's what's going on in my life. Can you help me make adjustments or were you at after this many years with diabetes?
Carolyn Willard 59:20
So I just got kicked out of my pediatric endocrinology office and it it was really sad. Um, so I've only seen my adult endocrinologist one, actually. Um, and I saw her over Christmas break. And so I was really nervous going into that because I've not heard good things about adult Enders. Just because they're mainly type two focused and other things and aren't really concerned about juvenile diabetes. So I went in and I didn't even get a physical exam and that was really off putting for me. And it just she was impressed like, she asked me to change a basal rate and I changed it in like, five seconds. And she was waiting for me to hand my pump over to her. And I was like, No, ma'am, I can do this myself. And she was like, Oh, well, I'm so impressed. Like how adept you are with that now, like, are we in the right office? Like, what is this? So? Um, yeah, I haven't really been too impressed with them. So far, I was expecting a lot more than I got.
Scott Benner 1:00:18
So I would think that it's very telling about the state of how doctors, some doctors, talk to people, that the ability to take your pump and change your basal rate was like, life changing for her. I think it's possible that everyone who goes and sees her is in trouble. Is that really and by the way, unless you're five minutes into this, if you don't know how to change your basal rates by No, please, please go over the manual and figure out how to do it. You know, you should have a little more control. You shouldn't be waiting every three months to hand your pump back to somebody and go oh, you know, Great and Powerful oz. Can you please show me how to make my Basal lower or higher or something like that? Right? Yeah,
Unknown Speaker 1:01:01
yeah, I
Scott Benner 1:01:02
get you. That's not good. Plus, now you have to write to endocrinologists, which is more of your free time.
Unknown Speaker 1:01:07
All right. Oh, excellent.
Unknown Speaker 1:01:10
I've only seen one. What about the one you just left with the pediatric one?
Carolyn Willard 1:01:13
Oh, yeah, I don't know her address. She was I really liked her as well,
Scott Benner 1:01:17
but not enough to write.
Carolyn Willard 1:01:20
I don't know her at she moved to Charlotte. And I'm in Charlotte, maybe I could track her down. I don't know
Scott Benner 1:01:24
about the window until somebody arrested. Or maybe there's a crazy person yelling their doctor's name. And then once they find you, and they realize you just wanted to find our address that you
Carolyn Willard 1:01:37
need to the doctor, they might think it's a psychologist or something.
Scott Benner 1:01:41
Right? So okay, so when you finish this schooling up in three years, you're gonna have to go into medical school. Right? Do you have goals for what place that is? Or you're gonna go with whoever takes you in? Or
Carolyn Willard 1:01:54
realistically, whoever takes me in my, like, ultimate dream would be Oxford. I don't think that's very attainable. But I do have a picture tape of Oxford to my of Oxford taped to my wall just because it's gorgeous there. And I love London, and Europe.
Scott Benner 1:02:11
a darn good goal to have to and I think, I think you know, it's funny. It's funny, you said that as we're approaching an hour, I just got done saying to my daughter and one of her friends the other night, that you'd be surprised that just one thing something. And working towards it is most of it. You know, it's most of getting to it. I mean, I say I think I said all the time, like don't get me wrong, like you can't just you know, want to be a brain surgeon. You know, it's not like, you know, you can't have your vision wall and not know algebra. And I'm gonna, I'm really I'm gonna be a brain surgeon. I swear to God, if I three pictures taped up on my wall about it, but I mean, things that fit you and are obtainable. Getting to those things is mostly just the decision to do it. You know, it really is like, I can sit around and Josh around about, you know, wanting to live in North Texas, which I don't know if I want to or don't. But make no mistake. I could put my house up on the market, find a job and move. But we could do that. You know, so I just I'm a big fan of, of going after things. I don't think you can't go to Oxford. I don't I don't see why that would be unless you're dumb.
Unknown Speaker 1:03:28
Oh, I hope I hope
Scott Benner 1:03:32
you really don't seem like you are. I don't think you're hanging on by a thread your biology majors what I'm saying?
Carolyn Willard 1:03:38
I graduated top 16 of my high school class.
Scott Benner 1:03:43
That's amazing. Congratulations. I was glad that my high school did not rate us because I was afraid. No, they were like, I didn't know. Or maybe I just ignored it. Because I was scared to find out. I forget it was a really long time ago. But I I got to I got a diploma like everybody else. So I'm just the smartest, the smartest person there. My mom told me it's fine.
Carolyn Willard 1:04:09
That was a big deal at our high school what your ranking was. I think I was 14.
Scott Benner 1:04:13
Wow. That's pretty great. How many kids were there? 915. Right. Or more?
Carolyn Willard 1:04:19
Around 200, I believe.
Scott Benner 1:04:22
Wow, that is really impressive.
Carolyn Willard 1:04:24
My sister was like six runing as impressive. Well, she
Scott Benner 1:04:28
didn't have diabetes. Oh, no, there's a lot she didn't have to do. And plus, nobody was given her. You know, a problem about her dog and her senior year to you were clearly deserved. 10 points. Just for the other things you have to Kelly, you are absolutely delightful. I am incredibly happy that you decided to make this podcast your first kind of foray into sharing with the world.
Carolyn Willard 1:04:54
I'm very glad you had me.
Scott Benner 1:04:56
Are you kidding me? How could I I don't even know all the amazing things about you and you still seemed amazing when we were talking. I'm writing on this. Have we forgotten? Is there anything you want to say that I haven't thought to ask you about?
Carolyn Willard 1:05:11
Um, just to get aside before for your kid if you don't have one? Like for schooling and stuff before is a very important, I relied on that heavily.
Scott Benner 1:05:21
Yep, I agree, I think I think that having it in writing is important. But I think what's more important is the overall feeling that the school has, once it's in writing, that they have to do what's in there. It doesn't have to be an adversarial conversation, you don't have to be a fight. But it is helpful for them to feel like, we have to do this. Because I'm telling you the otherwise, it falls out of people's heads, they don't do what they're supposed to do. When you actually really need something badly. They have a lot of leeway to tell, you know, if you don't have a 504 plan, so yeah, if you don't know the 504 plan is figured out an episode about it in the podcast, there's my rs 504 is available to download on my blog. But yeah, take it from somebody who knows. Caroline knows having a good having a good 504 plan make your life a lot easier. Do you have one? So college?
Carolyn Willard 1:06:17
It's not cost effective for it's called academic accommodations. And they're a little bit different. It's not you don't get as much, but I do have them.
Scott Benner 1:06:28
Cool. I mean, it gets you like a bigger room for your dog. Right? That kind of
Carolyn Willard 1:06:32
that was just that was just clap for the dog. Yeah, I can. I was friends, not friends that I've talked with the resident director over the summer and things like that. So
Scott Benner 1:06:44
putting a little extra effort in to make sure that things were gonna go your way? Yes. Boy, there's a lesson in that too. Don't just sit back and hope. Right? Yeah, right. Yeah, seriously, a lot of people don't let this work out. That doesn't work. You believe this?
Carolyn Willard 1:06:58
And you got to put effort into that. Yeah,
Scott Benner 1:07:00
I saw somebody complaining online the other day, they're like, I think they ordered pump supplies or CGM supplies or something like that. And they're like, I've been waiting for a month and they didn't show up. So finally, I called and I said, Where's my stuff and they said, Oh, we had to cancel that order. And this person's like, ranting and raving about the company. This is so on Baba. But they didn't get the prescription done correctly. So the person got a prescription sent it to the company, it wasn't the correct prescription, the company probably should have gotten back to them sooner and said, Hey, by the way, prescription is not right. But just you know, sat around, didn't do anything about it. And then once they ran out of their supplies, were like, this is your fault. I'm like, Yeah, I mean, we gotta be a little involved, don't you? You know, like a like a little bit. Yeah. And so I like that idea. I like the idea of you like getting out ahead of it and trying to say, Look, I'm gonna need a bigger space. And who do I talk to to make that happen? You are way mature. Seriously, all right. Well tell your parents I said Good job. Because it's yours. Seriously, even if your other four brothers and sisters are just complete losers. You are so you're such a win that I mean, I think they still want do you think? Any I'm gonna ask this question before we go? And I think I know what you're gonna say. But are you your parents favorite? Or do they have a favorite?
Carolyn Willard 1:08:19
They? Okay, that's that's the question. That's the question. Um, so they do not claim to have favorites. But all of my sisters have decided that it's my brother.
Scott Benner 1:08:29
The one in the middle. Yes. for not being a twin. They feel bad for him. Yeah.
Carolyn Willard 1:08:35
Yeah. I mean, you. Everybody loves him. Like when you meet him, you just immediately love him. So it's like understandable.
Scott Benner 1:08:43
I don't like this. I think that I think this is unfair. I think you're obviously should be the favorite. I mean, I've spoken to the other four. Yeah. You're my odds on bad.
Carolyn Willard 1:08:54
I'm here there. Jim. I'll tell you their gym.
Scott Benner 1:08:57
Oh, please. You You had me back when you said you would eat celery. I was any kid who was like I'm hungry. But you know, my blood sugar. So salary and and didn't complain. We're gonna need a signed affidavit from your mother, saying that you didn't complain about the salary.
Unknown Speaker 1:09:14
I will get that for
Scott Benner 1:09:14
you. Thank you very much. I really I really appreciate you coming on and doing this. Thank you so much.
Unknown Speaker 1:09:20
Thank you.
Scott Benner 1:09:23
Thanks so much, Caroline for coming on the show and sharing your life with Type One Diabetes with everyone. Thank you also to on the pod dex comet dancing for diabetes for being sponsors. Again, go to my omnipod.com forward slash juice box dexcom.com forward slash juice box or dancing the number four diabetes.com to find out more. I've also put links right in the player right in your podcast player there in the show notes and at Juicebox podcast.com.
It seems like the first of you who ordered news Juicebox Podcast merchandise have started to receive it. I'm starting to see pictures online. Thank you very much for doing it. Anyone else who's interested can go to Juicebox Podcast calm and just scroll down to merge. Lots of lots of good stuff to choose from. Last thing the giveaway celebrating 1 million downloads of the podcast is still going on, you can still enter absolutely for free with nothing to do you just click the ENTER. It's again at Juicebox podcast.com. Just scroll down till you see the giveaway banner and click on it. There's over 1500 entries right now. You can enter up until August 31 8:59pm pacific time It looks like no way Eastern Time. Ah, that would be midnight eastern time. Okay. Okay, August 31 2019 and 11:59pm Eastern Time is the last time you can enter. There's some really good stuff here a bunch of swag and giveaway stuff. One great item from myabetic.com submit bold with insulin t shirts. There's a lot go check the whole thing out you'll see what's there.
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