#346 Dumpster Fire
Ally from has T1D and a PhD
Allyson Hughes, PhD works at T1D Exchange, has Type 1 diabetes and a great laugh. In this episode we talk about insulin prices, Ally's research, sh*tty people and more random topics that led too this episode being called 'Dumpster Fire'. Warning: some bleeped cursing.
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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:03
Hello, everyone, and welcome to Episode 346 of the Juicebox Podcast. Today, I'm going to speak with Ali who works at T one D exchange. Ali has type one diabetes. And she's responsible for some very cool work around type one that we do eventually get to talk about, actually, if you want to see alley study, it's on Juicebox Podcast comm on the page for her episode. The reason I say we eventually get to it is because I was having a particularly odd week when I recorded with Allie. And I was in a bit of a mood, I guess. And this went everywhere. I find it incredibly interesting. I think it's funny, I think you're gonna laugh, I think you're gonna learn things if you stay till the end, I'm gonna say some crazy stuff. But it's a really entertaining episode. I'm proud of it actually. It's, it's good entertainment wrapped around type one diabetes, and I call it dumpster fire. I almost called it here and now and later. But anyway, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan for becoming bold with insulin.
This episode of The Juicebox Podcast is sponsored by touched by type one, if you want to check out an organization doing wonderful things for people living with Type One Diabetes, all you have to do is go to touched by type one.org, you're going to get your fill of goodness. They just want you to know about them. And I want you to know how much I appreciate what they're doing. Touched by type one.org. Okay, buckle in, we're gonna get going. It's a longer episode very conversational, a lot of laughing some really good information, insight into things that I think and Alli thinks and stuff about the type one space in general, I think you're going to like this one. I had a lot of fun making it. And just now when I finished editing it, I thought I have never left so much sitting in editing a podcast before. So I hope you feel the same way. This is Ali. I maintain that if you told me this, you know the secret to life itself was at the end of a one hour podcast that I had to listen to. And the entire time I was listening, one of the people being interviewed was like clicking their lips together. So I'd be like, you know what, I don't need the whole secret to life. I'll be fine. Like, and so she'll say to me, sometimes you're up there editing for a while and I'm like, Yeah, the person and a lot. And so I i lovingly take the arms out. And not all of them. First of all, they make the person sound a little better. But yeah, but secondly, for the listener. And I don't know if it's just me like and you're from the northeast to like maybe you know, like the other day online, someone said, he talks so fast. And I thought, I know like 15 people that talk circles around me like you know, it's fine. And then you realize they're shorter from the south a little bit. And everybody's a little calmer and easier. But when I'm listening to something, pregnant pauses give my brain enough time to yell at me. So when when I'm listening and I hear silence my brains like shut off. This sucks. Yeah, yep. I just feel bad when I met I have no idea.
Allyson Hughes, PhD 3:41
Yeah, no, uh, I guess for me with like, my my background like I grew up in Ohio. I did my schooling like all my training in Texas. And then now I live in Boston for my job. And so like, I have these weird like accent things that I do where sometimes like Boston comes out. And sometimes Ohio or Texas comes out mostly road rage sort of thing, but can be anything but yeah, no, I really appreciate that.
Scott Benner 4:09
I mean, right now, there's just nowhere worse than Boston to dry. I mean, there's a few places Connecticut's a disaster.
Allyson Hughes, PhD 4:15
Yeah. Oh god, my husband drives for me. I'm gonna be real honest. He's like, he just like carts me around the city if I need it, because I just can't and I won't I think we moved here about a year ago and I think I've driven like eight times to see no joke, is
Scott Benner 4:29
he afraid you're gonna cost the family money? Like you're gonna murder somebody or get into it? Oh,
Allyson Hughes, PhD 4:34
yeah, he definitely has like control issues with driving and so they'll just get really anxious is like, Oh my God. And then you know, I've got it when I'm the passenger. I've got the death grip on the other. So yeah, we we should not ever be in the same vehicle together. We just make each other and
Scott Benner 4:49
I had to drive to Boston three times while my son was recruiting for God each time I dreaded it because it's not just a five and a half hour drive from where I live, but it's through Through Connecticut, where those people for some reason won't change a lane. And so they've been brainwashed their whole life growing up to think I just get in the lane and I stay there and I'm like, Alright, I'm not looking for you to be like, in a Formula One race car, but if you know, could you have a little bit you know, anyway, I probably shouldn't be allowed to drive either. Okay,
Allyson Hughes, PhD 5:18
no, yeah, I was just gonna say we drove to do the move we drove here from Texas. And, and I just was so angry at the end, you know, I was just ready to leave my husband and you know, and Indianapolis one of our stops, I was like, we're done.
Unknown Speaker 5:35
It's enough of you and the whole thing. The whole thing. So mistake, what do you mean the move?
Allyson Hughes, PhD 5:40
We've been together for like 11 years and I just was so angry at him, you know, cuz nobody in a relationship should ever be in that kind of situation. We It was
Scott Benner 5:47
so bad to our house down and rebuilt a house like we owe this tiny little junky house and with this goal of building a house, right. And as the construction started my, my, at the time, my, my son's kindergarten teacher, who he hadn't even had in years, you know, they mean just I bumped into her somewhere She goes, I see you're building a house, and I was like, she's got this long cigarette, and she's like, just old lady just drawing on this cigarette. Like she's seen life. 16 times. She's not afraid of cancer, nothing like that. She leans into miracle She goes, if you don't get divorced doing this, you'll be married forever. I was like, what she was one of the worst things. And then she just a drag on a cigarette and walked away from me. And I was like, you're the lady who taught my son kindergarten. How about that?
Unknown Speaker 6:41
Oh, god, that's terrifying. I was
Unknown Speaker 6:44
just like, Oh, great, because we already like got the loan. So
Unknown Speaker 6:48
Oh, my God, that's amazing.
Scott Benner 6:51
I love that she wasn't wrong. My wife and I had an argument about cabinets that I thought was gonna like end with the police arriving.
Unknown Speaker 6:57
Yeah, seriously. cabinets are a big thing.
Scott Benner 7:01
I didn't know at the time.
Unknown Speaker 7:05
Amazing.
Scott Benner 7:06
minutes little podcast now Please introduce yourself.
Allyson Hughes, PhD 7:10
So my name is Allie Hughes and I have had type one for 23 years. And by the time this airs, it's probably going to be 24 years.
Unknown Speaker 7:19
Is that a dig at me alley.
Allyson Hughes, PhD 7:22
I'm very close to my anniversary. It's in December. So we're filming in September. So
Scott Benner 7:28
I got I got I got, I got a lovely note from a guy the other day, and it was so nice. It just said, Hey, listen, if you've decided that my episode wasn't good, just let me know. And I typed it, I answered it back. I'm like, What are you talking about? Well, it's been months. And I was like, oh, and it's gonna be more months. So just, oh, it'll be a nice surprise for you when it comes out. You know, I just I have a very, I don't know if I've ever said on here. I'm sure I have at some point, but I'm not a well thought out person. And so I am soup. The minute I sold an ad on the podcast, I became like Uber responsible about it. And I thought I can't not have an episode ready. So I started recording ahead. And at this point, now, I probably could, I could probably stop recording right now. And the podcast could probably run for four more months. That's incredible. Yeah. And so I like that, because then I get it. Sometimes I'm like, Ooh, this episode. I was gonna put up three weeks from now. But it makes so much sense against the thing that came out last week. So I can sort of like play with it a little more I love. But the problem is it sucks for the people who record it. Then I'm like, hey, that'll be out in the spring. You know? The guy I told the other day, he's like, I'd like to come on the show. I'm like, I'm really interested in this. Do you have an ability to book in August? And he goes, it's September and I went, yeah, I mean, next year, can you book in August next year? So anyway,
Unknown Speaker 8:57
yeah.
Scott Benner 8:58
I felt what you were doing right there. So yeah, just screw you your episodes. I
Allyson Hughes, PhD 9:05
know, I talked to my mom before this. And she was like, Oh my gosh, when do I listen to it? I said 2020 the gas.
Scott Benner 9:15
So I played a couple things in life. Not most things. By the way. If you came up to me right now and wanted to buy a spaceship with me, I'd be like, Yeah, I would give that no thought whatsoever. I'm like, you think we could get a spaceship alley? That I wouldn't play it out at all. Anyway. All right. So you have what? How old? are you now? I'm 3131 diabetes for 24 years. Did you say? Yes. When you're seven years old? Yep. Okay. Seven years old. In Hold on a second. 2019 Now let's just call it 2020. For simplicity, was it around 96 it was 95. You were you were diagnosed the year before I was married.
Unknown Speaker 9:56
It's not incredible. No, it's mixed.
Scott Benner 10:00
This podcast is over. Never mind. I know you don't mind me that I'm old.
Allyson Hughes, PhD 10:04
No, I'm at the point Scott though when I talk about like old diabetes tech that I used to be on and used to use, I literally just start with I'm a dinosaur, and start giving examples of what I was using. It's, it's incredible to think how long it's been
Scott Benner 10:19
no. And you make a great point, honestly, because the other day someone asked me how long Arden has had type one. I said, Oh, just when she's two, she's 15. I was like, 13 years a little more. And that person whose kids only had diabetes for two years was Yeah, I was like, Oh my gosh, that's an incredible amount of time. And you just doubled Arden.
Unknown Speaker 10:37
Yeah, yeah. Yeah. What, um, what was your
Scott Benner 10:44
My biggest concern with having a kid that was diagnosed so young, I'll never forget when they were trying to be like, comforting at the hospital. They're like, hey, the long term effects of diabetes take 30 years to show up. And, and I was like, but she's too. Yeah. So you mean when she's 32? Like, and then that's stuck with me? Like, I thought, oh, when Arden's 32 she's gonna have problems. Uh huh. Right. And that, yeah, that was like, that wasn't nice to say to me, or was it? Or was it thoughtful? Like, I don't know. But did you ever worry about that?
Allyson Hughes, PhD 11:14
Honestly, I really didn't. There was kind of like this doom and gloom, like retinopathy message that was kind of pushed on me at different points. And really, like, I'm just like, growing up. I think my, my pediatric endo was he was more worried about scar tissue than any sort of complication, you know, because I was pumping.
Scott Benner 11:37
Yeah. So the here and now problems.
Allyson Hughes, PhD 11:39
Exactly, exactly. And I appreciated that because I didn't want to think about it either. You know,
Scott Benner 11:44
I have to be honest with you. I think that here and now takes care of later. Yeah, even like when I when people tell me like, Oh, it's I'm working so hard to get my UNC down. And, you know, I had somebody telling me yesterday on the phone, like, you know, I got it to this. Next thing I'm gonna do is get down, like, you have to stop thinking like that. I'm like, just use the tools. When you use the tools, your agency will just naturally come down. Yeah, right. Exactly. And I think yeah, I think long term, you know, problems are the same thing. Like, you know, some people are just going to have, you know, their bodies aren't going to handled as well as others. But for most of us, you know, most of us, I don't have diabetes, I now can hear Chris in my head. So Chris Snyder from tide pool tells me that when he tells me listen to the podcast, and I say something like, I have diabetes, he's like her, and like, suddenly, art and he like, he fills it in his head for me. So thank you, Chris. And for all the rest of you do that. And I don't mean it that way. I don't mean to assume but, but for everyone else, I'm just sort of I'm doing the Royal week, Chris, leave me alone. Okay. But for me, but for everyone else, you know, you do the right things, and it's going to work out probably so yeah. Yeah. not worry about I was just interested if you because you were I mean, when you were diagnosed the 2424 years ago, what? What are we talking about? Did you even have a meter?
Allyson Hughes, PhD 13:01
I have a meter I think I was lucky enough for it was like it was around the time that certain air quotes fast acting insulins had been introduced. And so I was I feel like I was kind of lucky at that to be diagnosed with that time, because it was right after kind of some of the Dark Ages sorts of things of doing much more guessing. Then I really, I really didn't have to worry about a lot of guessing. I mean, obviously now compared to what I do now, with with CGM and Lupin pumping, like, that's a lot. It's just a different game. But back then. I mean, it was, I think the biggest change was really like, the dietary restrictions. Like, I grew up in a really small community in Ohio. And so my parents, like, you know, it was before the diabetes online community, so it wasn't like, you know, searching on Facebook to find the best like endo. Like in Ohio Instead, it was like, who takes our insurance? And how fast can we get in, you know, sort of thing? How close are they? And so, when I went, it was like, it was like, I was on this like, awful, like exchange diet where I was really hungry. Like, all the time, it was a Greg good, it was just a lot of food restrictions. And, you know, not a lot of understanding of what your blood sugar should look like post meal, it was just kind of, I don't know, it was just kind of putting out fires as you went sort of approach instead of more planning. And it wasn't it wasn't my parents fault. They were doing the best they have with their resources and, and what was common at the time, I feel, you know, so looking back is just so much different than my approach now.
Scott Benner 14:40
No, of course. And so, when was the Let me ask you. I had an idea for a question. And then I had a different question popped in my head. Yeah, I don't know what to do. I'm gonna go with my gut. What juncture like what was the first big leap You're technology.
Allyson Hughes, PhD 15:02
So in high school, like freshman year, I got an insulin pump. And that was just like, this mind blowing thing. You know, I hate giving shots. You know, it's it's just one of those things that it just never works out for me. I just feel like, there's no precision, you know, it's like, oh, did I get the insulin? I don't know, I just always felt like me on long acting insulin is a nightmare. I just I was having like, severe lows. And, you know, just, it was like, right around the time that a specific fast acting was introduced, I don't want to drop names or anything. And the way it was marketed is that there would be no, like, peaks in dosing over the 24 hour period. But like, I ended up low, like, every morning because of it. And so yeah, it was just kind of, you know, when new influence were introduced, or when new tech was introduced, you know, how does this kind of like, okay, even though it's been approved by the FDA, it's like, you're still kind of a guinea pig, seeing what real world usage looks like. Yeah.
Scott Benner 16:07
So yeah, they can try it. And everybody exactly the same time that long ago, that was back when you could still take a sales rep to like, you know, Hawaii. Take a doctor to Hawaii. explain to them how well the insulin work. Oh, Dr. Jones, would you like to hear about our new insulin on Waikiki?
Unknown Speaker 16:27
It'd be
Allyson Hughes, PhD 16:29
the other dare one to get ahold of a sales rep. And let me tell you, I did not get a hold of one because I was like, Wait, are they being phased out of a specific company? I couldn't even get ahold of someone to start a conversation about a specific product. Yeah, I just I felt really old. I'm gonna be really honest. I'm imagining you like a young you
Scott Benner 16:49
and your doctor's office was like, hey, this works terrific. And you're like, Dr. Jones, that's an amazing tan you have and he's like, yes, yes. Just take the insulin.
Allyson Hughes, PhD 16:57
Just take it. Just take it. Yeah, that's, that's, you know, I think that's definitely sometimes what happens. And, I mean, it's definitely, you know, not a great situation. But, you know,
Scott Benner 17:08
listen, everything has, I don't mean to joke, I'm a fan of, I'm gonna, I don't know if people will be upset at me, but I liked it. pharmaceutical companies make things that save lives, you know, I'm happy if they, if they really try, okay, when they take their insulin and change the molecule molecule just enough so they can keep it on patent that I don't particularly enjoy. Okay, but when, when when they're really trying and they're doing things? I mean, listen, you know, without a lot of different things, forget insulin for a second your life, your life would be terrible. Yeah, you know, so I would my daughter would be boiling her urine if somebody didn't say to themselves,
Unknown Speaker 17:45
what imagine?
Scott Benner 17:46
Yeah, I wonder if we can make these meters better? I wonder if you know, and now that we did that, how are we going to make money off? It will overcharge for the test strips? And? No, I mean, listen, yeah, there's a balance, obviously. I don't think it's been struck incredibly well, right now, but at the same time, everybody has a part and everybody's doing something that's helpful. And you know, and people get to make money. And I mean, I'm for that I'd like to see you make a living. And I'd like to make one. Exactly. Right. So um, I don't think you should price gouge to the, to the tune of hundreds of percent over but
Unknown Speaker 18:23
yes, I also
Scott Benner 18:24
may, I'm sorry, I didn't know this was gonna go this way. But what are your like? Do you have thoughts on that? Like, because I think it's a slippery slope idea, right? Like, so I have a medication, and I make it. And I've decided this medication costs $5. For me to make and $10 for me to get to you and Mike, out of pocket after my r&d is, I don't know. $30 for this medication, but I charge you $300 for it.
Unknown Speaker 18:51
Yeah, so
Scott Benner 18:54
I'm just I'm sorry. I was like, I really was fumbling for my next thought. But that's an unfair amount of money for you, let's say right, or just in people in general. Yeah. Right. But it keeps you alive. So it should be I hear people say all the time, it should be free. And I think, well, if Okay, I hear that. Well, what else should be free then? Should my heart medication be free? Which I don't take? What if I did? How about my cholesterol? Like, where do we draw the line on what doesn't save someone's life? And then if everything's free, because it makes sense that you shouldn't have to pay for things that keep you alive? Then how does the company stay in business to make more of it for you? Uh, huh. Right, like and yeah. And what about all the people that work for the company and blah, blah, and like getting their families and like, oh, like there's a, I don't know, like, I find it such a strange conversation.
Allyson Hughes, PhD 19:44
Yeah, so yeah, so I guess like is a two part comment on that. So like, the first part is that when you see graphs that show like that 1200 percent increase, like from, you know, 2425 years ago to now that's literally when I started mining journey, I remember picking up insulin at the pharmacy, and that was around the time it was like 25 bucks a bottle. And it's, I'm on the same insulin now, as I was saving. Yeah, I look at that I know what works. And I'm a dinosaur and I do what I want. And so, um, you know, it's one of those things where like that graph, to me, it has a personal relevance, and it's really it reflects my journey on this, you know, diabetes journey, it's the price has gone up. But at the same time, I want to say as a second comment, I actually work with researchers at Eli Lilly, that's part of my collaborations that I do in my current role as a research scientist is I work with their researchers, and we, you know, work on projects involving fear of hypoglycemia and, and things of that nature and the cost of type one diabetes, not just financial, but really focusing on like psychosocial, like diabetes, distress and diabetes burden. And so like, I know, like, many people from that company that are really good people. And so I think it's a little, it's a little discouraging to me when I'm not going to name names, but when sometimes people come forward and really go after an attack, you know, insulin producing companies, it's like, they're good people, they're and they're doing really good research, and they're trying really hard and it's not their fault, you know, that the insulin price is so high. You know,
Scott Benner 21:28
I like to say that, you know, there, I'm sure there are a few people at the top who really, you know, report to shareholders, and they probably they're the ones in charge of making final decisions on stuff. Yeah, there are plenty of people at the middle and the bottom who are doing incredibly hard, I have to say, my wife is not involved, my wife is in the safety part of pharmaceuticals. So she does the stuff that you know, you would want people to be doing, making sure reports, get to the FDA make sure things are looked into properly, that things are set up properly. She oversees the idea of your safe. And I she worked from home yesterday, I watched her walk out of our bedroom at seven in the morning. And last night, no lie at 930. I said to her, don't you think you should stop? Wow. Right. And so she sat almost perfectly still for an entire day and to you know, 12 or 14 hours, working really hard to make sure things are safe for people. And then to hear someone come along and say, Well, you know, there's here's a way of pharmaceutical, if somebody could save some money, what if they, you know, just got rid of people? And I you know, like I'm like, Yeah, okay, well, you got to be careful which ones you want to get rid of, you know, yeah. And it's, there's some people out there doing really good work for you. There's no answer. It's Yeah, it's obviously we're not talking about benefit managers, and right, the politics and the insurance and all that stuff. And there's all these things that are artificially inflating prices so that everybody can get their piece of this money, which I you know, I think Moreover, so what's going on? But it's just, it's a strange thing. And it's interesting that you've got to see it all the way through because you actually have a memory of like, Oh, this is $5 or $25. And that was $400. Yeah. And I looked while you were talking, the median income in America has only gone up $6,000 from 95. Until now, there you go. Right. Yeah. So yeah, it definitely it's not like it's not like back in 95. Everybody was making $54,000 yours, a household, another making 3 million, and their insurance, more expensive or whatever. It's both Well, anyway, I'm so sorry. I don't know how we got all the way down this row.
Allyson Hughes, PhD 23:36
No, I just like one. One final thing is like, I think when it comes to co pays to like, you know, because of course my co pays have changed from the type of insurance and of course the price of insulin going up. But either way that, that I think right now I pay 80 bucks for three months of insulin. So like that 80 bucks could be like, I don't know, somewhat nice dinner in the Boston area for me and my husband, you know, and so I'd rather obviously spend it on that or, you know, some anything else really been a copay? You know,
Scott Benner 24:07
it's because it's medical. Like, yeah, like you and me. Yeah, there's a real feeling like, wow, like, my life shouldn't cost me money like that. Exactly. It should be exactly my dinner with it or whatever. Yeah, I hear you. Okay. Well, why did you come on the podcast? I forget.
Allyson Hughes, PhD 24:23
Ah, honestly, maybe I forget to I just thought it would be. I really liked the podcast, like I'm a big fan. And I just one day, be on the podcast and talk to you. So here we are. Let's dig
Scott Benner 24:34
in. Are you one of those kids who grew up around doctors and thought I'd like to help people like me?
Allyson Hughes, PhD 24:41
Oh, yeah, I did. Um, I kind of went through this whole thing where I was like, you know, I've really wanted to help people with diabetes. And first I was like, Oh, I should go into health care. And, you know, from some perspective, maybe as a nurse You know, kind of go through that whole thing. And then I was like, You know what, I really tried nursing and I really hated it, to be honest. Like, it just wasn't. I just, you know, it's I, you know, I know love nurses, I think they're fantastic. I don't, I just, it just didn't make me happy. Like, I've always been a person where I'm like, whatever I'm dedicating, you know, any hours of my day to I want it to bring me joy, and it just didn't bring me joy. So then I was like, Okay, I'm gonna go ahead and try a few other things. And in the middle of that, I took a bunch of psychology courses as an undergrad, and I loved it. And so that just led to like, a Bachelor's in psychology, where I started doing like, grant funded research, and then a clinical psychology Master's. And then I didn't stop there, because that would make sense. I just was like, I'm gonna keep going. Yes. PhD in health psychology last year. So yeah, I just was like, I'm gonna go, I'm gonna go for it. And it was really, I just, I really fell in love with like, data, and not only my own data, but just like, being able to harness other people's data, which is why I love tide pool. You know why? You know, we can just use this data that we're already generating to make a big difference. Um, yeah.
Scott Benner 26:23
Let me ask you, are you like a school geek? Like if I if there were more degrees, and you didn't have bills, would you just stay in school?
Allyson Hughes, PhD 26:30
Oh, and my husband and I have this agreement where I'm not allowed to get any more degree. He said, he's done with the PhD. He's like, this is it? This has to be done.
Scott Benner 26:42
Looks like it. Let's do what you'll do after you. Maybe ignore him. Okay. Now, if he didn't exist for a second seriously, and there was like, yeah, would you keep going,
Allyson Hughes, PhD 26:53
um, I think I'd probably think about some certifications, like, additional certifications, but I wouldn't get any more degrees. I just, I'm done. My brain is done.
Scott Benner 27:03
My wife, my wife loves being in school.
Allyson Hughes, PhD 27:07
It's so much fun. But at the same time, it's so draining for a while there I was, I was on a very large grant. And part of the grant was teaching like professional development courses. And like, I had a stats boot camp I taught, it was awful, where it was just like, and these pork this poor students, but come straight out of high school, and then it's like that Monday, following graduation, they had a week long boot camp with me learning statistics. And you know, so I, it was it was intense. And so like, you do that, and then you're supposed to be doing your coursework and your research and having a life. I mean, it's a very draining experience.
Scott Benner 27:50
My son is so good at math, and freaks me out, because he's also not a person who enjoys being a student. He's interesting. He's a blend of my wife and I, he's really good at being a student and doesn't like it. So I didn't like it. And she was good at it. But he's taking some time, what's the degree he said, He's, he's like, I'm gonna declare this year. And I'm like, all right. And I'm like, what do you what do you what do you think? And he goes, quantitative economics. Oh, wow. I was like, what does that mean? I say, you know what, never mind. I'll just keep sending the checks. You go ahead and take the quantitative economics course. But he's like one of those people, like you put math in front of them, and he's getting real joy out of it. But he just, he's good at it. And I so I think it's interesting to watch because I had to work so hard, like understanding everything I never enjoyed, like you just spoke about going to school, you said it was so much fun. I didn't have so much fun at school once. Maybe Maybe once I saw three things at school, that that delighted me over 12 years, and one of them was a girl fight. Oh, wasn't anything academic. It's funny, not to go too far off the rails. But I think there we were. We were out the other night with my daughter and a bunch of her friends and they said all they saw these girls get into a fight. And they just scribe It was like, You call that fight was like a world done to you people. One day after a long day of high school, I was sitting on the bus, exhausted in my face, plastered against the dirty window hoping to get 20 minutes of sleep on the way home before I had to go to work. You know, I hear all this screaming and yelling and I look out the window is a beautiful piece of grass around the bus. That's all really old, hundreds of year old trees like you know, you couldn't get your arms even halfway around them. And I look installa one girl with a handful of other girls here bashing her face off of the tree. And I was like and that's how people fought in the 80s. So I just like they're like, somebody slaps somebody in it. Everybody got really upset and they stopped and I was like, Oh, you guys would not have made it when I was growing up. Someone would have murdered you. But it was just anyway. So you are doing are you? So I guess let's ask like, are you? This is interesting because you said you had a grant for a while. And it's interesting to get somebody to kind of like bankroll you while you're doing stuff. Right until you get a job. Yeah, sort of the idea.
Allyson Hughes, PhD 30:21
Yeah. So yeah, basically, like what happens is like, in grad school, like, you'll have like a mentor who's often like an assistant professor or a tenured professor who's really like put their time in and they already have a grant, were there only one person, so they need to hire like students to carry some of the workload. And so that's what happens is a lot of people end up working part time or full time under grants. And that's just, that's how you pay the bills. You know, I mean, they don't pay that much. I'll tell you, it's laughable how much you get paid in most grad programs. But it's, I mean, it's still, it's still money, so it works out.
Scott Benner 31:06
Take a pause here for a second. I'm gonna do our lunch Bolus weather. Yeah, go for it. blood sugar. 70. I've asked her if she's hungry. She says don't want the sandwich. I say okay. So we are going to Bolus hold on a second what's in there, there's a pepper, and ranch dressing. Grapes. Let's call that 15. Chips. Let's go 30. I remember to cookies. I don't know how many carbs are in those. So now we're up to 45. And let's call the whole thing. 55 carbs. 20 carbs. This might not make sense for a second two hours. And what I say 55. Thank you. 35.
All right. Yeah, yes. All right. Come on, I can't really describe why I did that yet. But 2020 carbs, two hours, and 35 carbs over three hours. And I'm sorry, if I'm not able to explain that. But maybe by the time I edit this and put it out, I will be able to explain it. And then I'll just pause here and future Scott will come in and explain it to you. Hey, present day Scott here. Arden is using the loop, which is a DIY closed loop system. And I was spacing out her boluses to keep bazel insulin on. Now that's even changed since then, when this was recorded, we used a version of the loop algorithm that would kind of take too much bazel away for us during boluses. And so I would pick different absorption times telling the loop that some carbs would have an impact over two hours, while some carbs would have an impact over three hours, which would keep it it kind of folded into keeping her bazelon a little longer. The newest version of the loop, I don't have to do that as much, I usually just pick about three hours, three to four hours for the food, and it kind of keeps up on its own. If you're interested in finding out more, just go to Juicebox podcast.com to get a list of algorithm based episodes. So as you scroll down, what you'll see first is recent episodes. And then you'll see a little banner for diabetes pro tip.com. You'll see the sponsors. then underneath that algorithm pumping, that's a grouping of podcasts that are just about Arden's loop experience and other people's loop experiences. If you keep scrolling, you'll find the defining diabetes series adult topics for after dark. It's really kind of nice to check out the website sometime. I put a little bit of effort into it. I mean, I'm not like you know, I don't know JavaScript or anything like that, but I do okay. All right. Let's get back to the conversation. Anyway, Arden's getting 55 carbs for her lunch. And I and I wait a minute. I didn't send a sandwich.
Unknown Speaker 34:10
I sent
Scott Benner 34:14
sporky I sent a bit
Unknown Speaker 34:17
right. She didn't open the bag. No lunch.
Scott Benner 34:21
No, please. Are you kidding? She's still. She's still in class.
Allyson Hughes, PhD 34:24
Okay, okay. Wait a second. It's early. I was like, Okay, that makes more sense.
Scott Benner 34:30
Yeah, we, um, we we bolus like ninjas. She's probably like in in math right now. Uh huh. So I'll have a little that's not a help. Helpful statement at all. Is it? Um, okay, so Okay. Go with Bolus cheese. Wow, it's fine. It took a couple of seconds rollover. But now she's typing something yesterday was daughter's day you see on Facebook, everybody was their daughter's. Yep. By the end of the night I was sending art in the worst photos I had of her I was texting her my Can I put this up on Facebook, like her face, her eyes are closed, or it looks like she got punched in the mouth like it's up in between picture. She's like, No, no, I'm like, I really want a bad picture of you to put up on Facebook. So she's like, you can use these. We negotiated for hours. And we finally came, we settled on one silly picture, which wasn't really that silly. She had passed out on a countertop doing her homework, and I took it. And then two photos that she thought she looked terrific. And wow, I put them on my Facebook and I said, I don't know why the Russians want all of these pictures of our daughters. But here's ours.
Unknown Speaker 35:45
Amazing.
Scott Benner 35:47
And then she just passed out in one of the photos and my wife's like people have texted me this morning. Is she mad about that? I'm like, No, no, she picked that one. There are far, far worse options.
Unknown Speaker 35:56
But there's always worse. Yeah, obviously.
Scott Benner 35:58
Okay, so you are doing so sorry. This one's This one's bipolar this episode. But so this one is to you're doing. Who do you work for right now? You have a job now, right?
Allyson Hughes, PhD 36:11
Yeah, yeah, I have a job. So I work for the TMD exchange. And I've been here I've been working for the company for I think about 16 months. I worked remotely while completing my dissertation in Texas and then made the move here. And
Scott Benner 36:31
how are the winters in Boston compared to Texas?
Allyson Hughes, PhD 36:34
I was told this last one was a mild one. But at one point it was negative 15 I mean, like I had to buy my dog sweaters. It's very I had to buy a coat just to come interview here. I didn't have a coat Scott like I didn't have I didn't have anything winter ready. And so when I came to interview here, I had to go to like Burlington Coat Factory in Texas and I found a giant coat on clearance and you know, packed it in my bag because it was like 20 degrees here at the time and I
Scott Benner 37:08
have a jacket I have never worn I took my son to see a school in Vermont in January yes so Exactly. ended up going to but I do on the jacket so I it's off putting the Boston's too close to the ocean. That's what yeah, that's what's wrong with it.
Allyson Hughes, PhD 37:26
Yeah, yeah, we just have like tourist season, which was a nightmare. It was just so many people. I'm not a big fan of you know, crowded transportation and and just like, you know, just you have no room on the sidewalk. I'm like, I'm just trying to walk to work. Please move, you know, is the thing.
Scott Benner 37:45
Stop looking for Fenway Park and get up? Yeah,
Allyson Hughes, PhD 37:48
yes, exactly. You're going the wrong direction. Get out of here.
Scott Benner 37:52
become quite a little healthcare pharma hub? Oh, yes. number of years there's they're poaching farm of people out of New Jersey pretty soon. We're just we're New Jersey is gonna lose its pharma capital of the world status. Oh, my God. Yeah. So you can have it? It's fun. Yeah. What do you do for a tea Wendy exchange.
Allyson Hughes, PhD 38:13
So I'm a research scientist. So that means anything from, like I said, collaborating on projects with companies like Eli Lilly with their researchers to doing like internally funded projects through the company. So sometimes, I'm just writing all day like today, once we're done here, I'm just going to be writing the rest of the day manuscripts with writing up our data to get it out so clinicians can read it, and people with diabetes can read it. Other times, it's it's a lot of project management, just like, you know, making sure everything's running smoothly. We have a longitudinal project right now with the new york marathon runners from the beyond type one team. And so we're getting their CGM data, we're getting like monthly surveys sold out by them. And so it's just it's a lot of moving parts that you have to always keep an eye on and make sure everything's running smoothly. So
Scott Benner 39:09
two things you would do, my wife would love each other, because her technical writing is so good. And she can explain really complicated things in really proper ways where my writing is more flowery and things like that. And too, that's why you love the podcast, isn't it? Yeah, yeah. Yeah. Because of how I talk about diabetes.
Allyson Hughes, PhD 39:30
I like that's like a major, a major part of it, like I, you know, with my psych background, and of course, my diabetes background. It's just like I love hearing about the experience of other people like someone who was diagnosed in the same year as me and maybe was even on the same devices is going to have a completely different time, a completely different outcome. And I just think that's so fascinating. That's that's part of why I got involved like I just, you know, I want to improve quality of life. I want to impact the devices that are coming out. And, you know, I just I think I'm in a really good position to be doing that. That's cool.
Scott Benner 40:07
Do you agree or disagree with me when I say that diabetes really isn't that variable between person to person?
Allyson Hughes, PhD 40:15
I think part of it's just really a mindset. I know so many people with diabetes now at this point where it's like, you know, I know genuinely like, what work my my cousin got diagnosed two years ago. And so he's nine. And so I know what works for him, definitely does not work for me, and vice versa. And so I think it's all the like, the lifestyle variable surrounding it. I'm really not answering your question, Scott. I'm kind of like,
Scott Benner 40:46
my secondary backup question. And I have a joke about your I have a joke about your cousin taking your thing in the family. So I'm going either direction when you're done.
Allyson Hughes, PhD 40:55
But like, it's, you know, it's the lifestyle factors. And so I really see it as you know, it's, it's the mindset, it's, some days with diabetes are gonna be awful. You know, where you're sick, and you're just like, Oh, god, what do I do now? I haven't been sick for a year, like anytime I get sick. It's always been a year since the last time I'm like, Oh, I don't I don't remember what how much insulin Do I need to take? You know, and just kind of winging it. So okay, I'm reading for your
Unknown Speaker 41:21
follow up question. If
Scott Benner 41:22
I scrub if I scrub the humanity out of my question, right. Ah, and, and just take it down to using insulin properly in all of those varied situations. There are, it's hard to say right, but there are a lot of right and wrong decisions in every mode. Yeah. And some people make the right decisions. And some people don't and some people get lucky. And some people, you know, No, you don't. I'm saying like there is not so what i what i brusque at, is it brusque? I don't know, I should not do it. I don't know I should, with the dumb words that I'm good with. But I'm brusque. I will look. Yeah, you really, thank you. Yeah, we're gonna go with brass for now. But what I what makes me upset is when somebody says, you know, oh, I ate this in my blood sugar shot up, but there's nothing you can do about it. And I think Well, no, there is there is something you could have done. Exactly. not know what that something is, which is fine. Yeah. But but it doesn't, it doesn't not exist. And yeah, and that part makes me upset because then it puts expectations in people's minds. That a 300 blood sugar, for example, is something that has to happen, it has to happen, because that's just diabetes. And that's the power of your podcast is like, you're doing what I'm doing just on a different level where it's, it's about science communication for me. And for you, it's more health communication, and you're giving people techniques. And so whether they're burnout or not, you know, you can move some of those factors, like, it doesn't matter where they're coming from, like they're hearing those techniques, and they can employ them if they want to, because I wonder about burnout, like the idea of being burned out on something. Yeah. Diabetes on anything, right. So like, I wonder if me maker make a broad statement. Okay. I can't believe I just said broad statement. And then the example that popped into my head was if the perfect woman to me showed up and wanted to have sex with me every day, and I would I burn out on that eventually. And then there's the part of me thinks, no, how would that happen? And then there's another part of me that thinks, well, but somebody divorced Farrah Fawcett majors in the 70s. And so like, right, so yeah, somebody got sick of her Jennifer Aniston is really cute. And guys leave her constantly. So like, like, so maybe, and vice versa. By the way, I think Angelina Jolie, like put Brad Pitt in a tin can and kicked him out of her house. And I'm straight as an arrow. And I at least hold Brad Pitt's hand and see what he had to offer. Like, you know what I mean? Like you're really handsome man. So I guess you can burn out on anything, but at the same time, do you burn out faster when there's things in the background that are making it difficult or always fighting? And she like me? Maybe Brad's a jackass, right? And so Angelina just couldn't take it anymore. Or maybe she was just really tired because she's so thin and she has um, a lot of energy. I don't know what it is. But but like so. But like, so there are other things that make it worse, like, like the what, but when the wheels are greased? How come some people don't burn out? Do you know what I mean? Like is that is that their psychology is the way their brains build? Is that their outlook? Is it a little conglomeration of all that, or did they just make all the right decisions, so they never bumped into the problems and without the problems? It was a pain in the ass, but it wasn't. It wasn't enough to grind them to a halt and make them Oh, yeah, I find all that fascinating.
Unknown Speaker 44:46
Yeah, I do too. Yeah,
Scott Benner 44:48
I really do. Like Yeah, how do you we said the same thing I should say. kinks. But I would love to so it's my best guess because I do not have it in need to go to 19 different colleges and can, you know, get degrees and do dissertations and things like that? It's easier for me to just narcissistically believe that I've come up with an answer and blurt it out. And then hopefully it helps most people that it runs into. I don't want to make you feel bad about all the school you went to you probably could have just done this tomorrow. But can you imagine? Like, it turns out, I could have gotten a podcast. No waste of my life. I don't think that I think you're I think what you're doing is amazing.
Unknown Speaker 45:29
But save me a lot of money. But um, yeah,
Scott Benner 45:32
yeah, no kidding. You would have had to buy a microphone. It's expensive. So. But, but so it's my my inclination is, the earlier you pick up the information, the less likely you are to have something grinds to a halt. Like, I just see it too often. Now. I can use examples from literally from yesterday and today because I now have so much contact with people with diabetes that I am never without a brand new observation. Yesterday, I spoke to a mom of a newly newly diagnosed child who found the podcast right away. And contacted me privately to say she's having a real problem. And she needed to speak with me. And I was like, Well, I do have laundry to fold today. So I can talk to you on the phone while I'm folding laundry. So she calls me and the irony, of course is that she's got the kids a one seat down to like 6.1. But she really wants it to be more like 5.60. See this graph here, this horrible problem here? I looked at it. I was like I said, this is the nicest graph I've ever seen in my life. Like great. Like, we're like, what are you upset about you? What do you see here where it went down to 68 for 15 minutes, and it came out? Oh my gosh, no, but but she wasn't crazy. She was just so far ahead. So soon, she was down to the fine tuning stuff already.
Unknown Speaker 46:51
Uh huh. Uh huh.
Scott Benner 46:52
Right. And I thought, oh my gosh. I didn't think it like this. But I thought because everyone's gonna take this wrong. But I thought, wow, the podcast got to her. And she's gonna skip over all the stuff. Like, we're all the bait, like, she's not gonna cry in the shower like I did. She'll get the cry in the shower for reasons other people cry in the shower. Not because they think they're gonna kill their kid with insulin. She'll get the cry in the shower, because she hates the guy she married or doesn't like her car, or whatever other people cry about, because the guy who won big brother shouldn't have won like that stuff we should be crying about, you know what I mean? Like, this is so cool. She's fast forwarded. And she's not the first person I've spoken to nearly this has happened to at the at the same time. I saw online this morning and interacted with people who are blaming their insulin pump for their blood, their blood sugar's Oh, and when you look at what happened, they went from MDI, to an insulin pump. And they don't have their insulin setup correctly in their pump. Mm hmm. And they leaped over the idea. All the things that make sense about what could be going wrong, and they just like this pump doesn't work. Uh huh. And I thought, Oh, my gosh, it's what the barrister said in the episode, like last year, when he said, Some people put a pencil in their pocket guy puts on his pocket, robs a bank. And some people look and say pencils, cause bank robbery. And then factly just saw what was like blatantly right in front of them. So I went back in and I said, Look, I'd love to explain this to you right now. But uh, here's an episode of the podcast you can listen to, it'll explain the whole thing. I have to go record with Allie. And, and I thought this will help them. And how do you? How do you get to people so that they have the information they need earlier? And because this is now my sticking point, we have now turned your episode into my episode? Because?
Allyson Hughes, PhD 48:47
Because I can just interview it's fine. Well, well, so my,
Scott Benner 48:51
my, the problem I'm having right now, Allie, is that I know what this podcast does. I know how it works. And I am slowly infiltrating the adult world with it, I guess is the best way to say like, yeah, I tried really hard to get through to a D and tell them how important it was. And they kind of listened to me for a little bit and then didn't, and I think we'll do I have to go to AD myself and set and do I have to pay for a stand and stand and talk to doctors and tell them this. But what happens is like maybe that's what I have to do. I have a children's hospital who's considering having me up to train their staff on how I talk to people about diabetes, that would be a big leap for me. But I can't I come almost 48 You know, I'm saying like my dumb jokes, people are gonna get sick of eventually, and I'm going to run out of things about diabetes to talk about probably the next few years. And so how do I how do I keep helping people? were more importantly, how do you get to them so they don't need this podcast anymore?
Allyson Hughes, PhD 49:58
Yeah, I think I think that's a major problem with with the devices with, you know, the other existing education that's out there is like, the people that, you know, we need to engage with whether it's as clinicians, as researchers, as a speakers, you know what, whatever hat you're wearing, it's like, those are not the people that are coming to AD. And those are not the people that are even getting online to go into the fold with insolent Facebook group, it's like, those are just people that it's just really hard to even make a connection with, because you have to really be face to face with them. And so that's something I struggle with, with my research. And with what I do as well, it's like, how can I get this message out properly? How can I have the most meaningful impact? It's like, I have a lot to say, and I want to tell everyone about these findings. But it's like, you know, I recently had a paper published where I was talking about research that I had showing how detrimental it is, for people on Medicare to be using insulin pumps, because the Medicare policies are just really delaying them getting their sites on time, and they end up in the doctor's office very, very often to get forms filled out, it's a pain for the doc, it's a pain for the person. And I was like, I am like, do I have to go to CMS headquarters? You know, do I have to go to DC, wherever they're located, and just deliver this to them? Like, I feel the same with him with my research. It's like, how can we get the message out there? And what's best practice? And of course, best use for your time, Scott, as used for my time. It's like, I think that's always the struggle. And I don't think there's a good answer. I wish I had that answer. I think maybe you and I would be millionaires, then if we could figure out the best way to market. You know, what we do and, and your message with Arden and your podcasts, because people out there like, there are some that just will continue to be like, this is diabetes at or this is my pumps problem, or this is an insulin problem. And I I just they just don't want to tweak what they're doing. You know,
Scott Benner 52:01
I do see that. You know, when I go speak somewhere, it's interesting, because, and I, you know, stand in front of 300 400 500 600 people, and some people hear it right away. And they're like, oh, my god, yes. Right, because they're in the right spot. So they're ready to hear it. And and those are the people you get a note from two weeks later, who started talking about like, my clarity report says my agency's dropping like a point and a half like those think they heard it, it made sense when they brushed on some people, I'm assuming it goes right over their head. And that never comes back to them. But I see a lot of people who come back around, and you hear from them six months later, like I heard you speak somewhere in November, and you're like, wow, summer now you know. And it's making sense. I started listening to podcasts and look what's happening to me. So I think if you can speak to them, it can make sense. But what happens to the people who get all that sort of scared information up front? And then they hear the right thing once they think that's the wrong thing. You know, do you mean Yeah, and so on. And so that means you have to reach the doctors. And I'm going to do something here I don't normally do. I'm going to tell a story from I, there's a private Facebook group for Juicebox Podcast listeners where people talk and it's like 1000 people in there now. So woman told a story today, I'm actually going to have her daughter on the show, because her 16 year old daughter went to their appointment with this insane a one say it's like 5.6 or something like that. And the doctor doctor just comes into the room and begins to admonish her over her below. She's having a and so the girls like, like in her mind thinking. I don't know what he's talking about. I don't have lows. Mm hmm. He's actually just saw the ANC number and began to yell at her over it not using canned responses that he expected from the ANC number. And so he starts opening up a reports and then slowly, it hits him. And then he looks up doesn't apologize, but says you're not low. How are you doing this? Yeah, so she starts telling him about bumping and nudging and Pre-Bolus Singh and the Juicebox Podcast and explains this whole thing to him and hidden his, you know, to his credit, and we'll hear her story at some point really longer. I'm gonna be up before yours, so I can kind of talk about Okay, is that um, he said, okay, explain this to me, and then said, Hey, with your next appointment, you're supposed to see this, you know, the practitioner next time, but you come back to me, I want you to do that. Also, would you be considered helping other people in the practice? We have a mentor program, like this guy saw it right away. Wow. Right. But But will he walked into the next room and say 15 carbs. 15 minutes to somebody? Right, right. Right. Right. Right. Because I think you will. I think he's happy that it worked out for that girl but still believes that it won't work for most people, where what I'm seeing is, it actually just works for anybody who hears the word Information and once it? Uh huh. Right. So, I don't know, I think what you're doing is so cool. And at the same time, I can see the sadness in it. Like, I feel like, like, what do you do when you have that information? When you can say to the Medicare Look, if you just made these changes to your system, you'd make people so much healthier? Yeah. Yeah, I think just drink. I mean, how do you hear?
Allyson Hughes, PhD 55:22
Um, honestly, you know, having a glass of wine now, and again, definitely helps. Um, but, you know, it's, it's really, I have a great support system at work. My team is fantastic. You know, I really believe in just like, work life balance. I've just been like, okay, I, I can't, I can't focus on this all the time. You know, I can't always be charging around trying to, you know, improve, you know, oh, my God, government policy, you know, I have to take a step back and catch my breath. And, and, you know, right now that specific papers been out since like, March, and I'm at the point where I'm, like, you know, how can I keep promoting that paper? And is it time to, you know, I've put it down for a couple months, and I'm like, maybe it's time to pick it up again, and start pushing a little harder with it. You know, it's really about balance and really taking care of your own mental health. Because, you know, I can't I can't just be on call all the time to to try to fix these problems. Do you
Scott Benner 56:20
own it? Because my SEO on my blog is really strong. I'll put it up for if you want to see when people Google Medicare and insulin pumps, they'll get they'll end up on my my site if they do it. Yeah, yeah, I'm not lying. My SEO is like, I'm, like Jedi level. That's awesome. And you don't know why it is. Why? Because the listener of this podcast, who reached out to me once and said, I think you saved my life. I don't know how to do something for you. But if you give me the keys to your website, an SEO person, I can turn it up.
Unknown Speaker 56:52
Oh, wow. That's amazing. He said,
Scott Benner 56:54
Sure. Here's my password. It's not also my Mac card pin, I promise. And it's, but
Allyson Hughes, PhD 57:02
here's my social Yeah.
Scott Benner 57:04
They were like this. I'm sorry. I can't do more for you that she said in here. And she, she judged up my my website for me. All the all the graphics that you see me using now that are all nicer and everything. Yeah, it's from the mom of a 16 year old boy who's a graphic designer who wanted to find a way to give back to the podcast.
Unknown Speaker 57:21
That's amazing. So
Scott Benner 57:22
what we need is somebody who works in the government who can take your gun and walk it up to somebody and say, and by the way, at this point, I believe someone listening has that power. So
Unknown Speaker 57:31
Oh, I'm sure
Scott Benner 57:32
it's a it's that because that sort of thing is insane. Like that's just process like just changing process. And people's lives just genuinely get easier. And you know, it's no one's fault. When they set it up. Initially, they started with whatever the rules were at the time, and they built onto them the best they could. And this is the mess that it came to. Yeah, I mean, it's Yeah, you just need somebody to scrub it clean and start over again.
Allyson Hughes, PhD 57:58
Yeah, yeah, exactly. It's totally best of intentions. And on paper, it looks fine. But when you think about just everything that it that it impacts, it's just it's not worth it. So it definitely needs to be overhauled.
Scott Benner 58:12
Do you offer a fix? In the paper?
Allyson Hughes, PhD 58:15
I kind of dance around that a little bit. I gave a few suggestions. But if you want I can I can send the paper to you. And I'd love to get your opinion on it. And
Scott Benner 58:27
I would love to have my wife read it and explain it to me. Yeah.
Allyson Hughes, PhD 58:33
I can just imagine that like storytime at your house.
Scott Benner 58:36
This is this is the kind of stuff like I'm like, Hey, could you read this and it should like sit down for 15 minutes and explain the whole thing to me. She She hates her job is I watch her read things. As she's reading them. I'm like, Oh my god, this is why you're good at your job. And she's like, why I'm like, because who else would want to do this? There's other people who could be good if they're just smart enough not to do this for a living I think like like this massive amounts of information that I see her take in. And then she has to make sense of it and clarify it for people. Yeah. And it's very, it's very cool that she can do it. Trust me, all of you who use medication or devices or anything like that in the world. You want a lot more people like my wife and like Allie out there fighting for you. It's a It's not easy what they do. Do you have a couple minutes to stick with me? I know we were only supposed to go to 11. But yeah, of course I've got time because I I'm not even sure what we did for the first 20 minutes. So
Allyson Hughes, PhD 59:30
I think we were just chit chatting. And then I was like, Oh my god, we're recording.
Scott Benner 59:36
That's it. That's the goal. That's why people are hired this great conversation with this girl named Allie today on the Juicebox Podcast. It's like she didn't know she was being recorded for a while so it's fine.
Unknown Speaker 59:46
Oh, Daddy. Yeah, I do. I'm ready. Now. I might
Scott Benner 59:50
even leave in the part about your road rage and the driving and everything.
Unknown Speaker 59:53
Oh, geez. That's fine. I don't care.
Unknown Speaker 59:57
I have no shame. There was a moment
Scott Benner 59:59
there was A moment when I was like, I wonder if I could get her to admit she doesn't like her husband or something like now let that go. I'll tell you what I, one of the questions to get into the private group is, what's your favorite episode? And people are varied in what they respond, but so many people love when that one girl through her family under the bus. Oh, yeah. We're just like, I love when that girl was like, I'm the favorite. That has nothing to do with diabetes, like I know. But isn't it great? The way she did it? She was just like, I know, my siblings aren't my parents favorite? I was like, This is great. Anyway,
Allyson Hughes, PhD 1:00:33
and that's why the podcast is great is because and that's why you're great is because you can get people to really open up and, and she says something that maybe she wouldn't tell anybody else, you know, but like, she just, she was real. And I think that's why this is so valuable, is it's real people. I honestly think it's
Scott Benner 1:00:53
one of my only, like, pure superpowers is that people get incredibly comfortable around me for some reason and start up, they absolutely shouldn't say, so I caused a major fight between my mother and father in law one Christmas night. Oh, my God, it wasn't my fault. I was just talking about how I felt about the holidays. And I started so long ago, it doesn't matter, and they're not gonna listen to us. And so I it was Christmas night at Christmas was over. And I had like a young son and I was in my, like, maybe early 30 ish, like, and I said to my father in law at the end of the night. You know, I hate to say it, but Christmas just didn't feel magical to me this year. I'm like, I guess this is just what happens, you know, as you get older, and I felt like I was going through the motions of Christmas. And he started talking about how he felt, which is not very common in my wife's family. And it got to something that I think rubbed my mother in law the wrong way. And then they started arguing, and I stepped back and I was like, they're having a private moment. My wife looked at me, he's like, Can we just walk out in the middle of this? And I was like, I don't know. And when it ended, and he got pinned down by his wife and didn't know how to answer, he blamed me. Like, he turned to me. And he's like, this is your fault. I'm like, Yo, I just said how I felt about Christmas. And he's like, well, I don't like and you could see on his face he was like, I don't know why I started saying that. And I thought I know I man cuz you got trapped by my soup. You opened up, only doesn't work on my wife works on everyone else in the world. But I do. I listen, I don't want to get I was about to say I don't want to give the secret away. Because I like doing this podcast. I don't want somebody to do it better than me. But no one's gonna do it better than me. So I can just say what I want to say. I think that this can't be school. Right? It has to be not because Nope, there aren't enough people like you who are just like, please tell me more things. I don't know. Like, like, you know, like, most people are just like a medicine. I hate Yeah. It's what it tastes like. Right? So, you know, some people are like, I don't understand why the podcast episodes. You know, I always joke about I don't name them anything. But the truth is, I don't name them anything, because they're about so much. Yeah. And if I pigeonhole an episode within title, and somebody comes along, as Oh, I already understand that they're gonna miss out on the other things that happen in that episode. Exactly. So now, you all know for 300 episodes, I've been joking and saying, I just make up silly names. But the truth is, I want you to listen to the episode because I know what's in it.
Allyson Hughes, PhD 1:03:28
Yeah, right. It works. Obviously, I also
Scott Benner 1:03:31
do a thing where I trick you into listening to the end by picking something that said towards the end of the episode to put in the title so that you'll listen to find out what it is. I'm a diabolical podcast, maniacal genius. No place. But But the truth is, and I'm not kidding, is that I think that even your episode right now, which as we're recording, it feels like a dumpster fire that's not about anything isn't. Right, right? Because it feels like we were like kinetically going all over the place.
Unknown Speaker 1:03:59
I know,
Scott Benner 1:04:00
there's so much in here. And if I pick what I think is the main focus of what you said, like imagine if I said, magic, the title of this episode is Allie thinks Medicare could be reformed for users, you know, who would listen to it? Maybe, maybe not even you, right? Like, you might be like, boring not doing that.
Allyson Hughes, PhD 1:04:22
No, just name it dumpster fire, and that will just make my life that would be hysterical. And people will listen because they're like, oh, I'll use a dumpster.
Scott Benner 1:04:32
dumpster fire. Very possibly could be the episode title. I was gonna say Ellie had road rage. But you admitted to that too early in the episode, so it might not keep people's attention the entire time.
Allyson Hughes, PhD 1:04:42
Yeah, we can't give all the secrets away right away. I've given them all away. Now. By
Scott Benner 1:04:45
the way. Let me just say this alley. I've never said this out loud, but I'm in the right mood for it today. All of you who have a podcast who keep ripping my ideas off you keep going. I have better ideas six months ahead of when you're ripping me I'll change this whole format before you can even Fs rip off what I'm doing. So go ahead and try, go get your broke ass CD and to talk about insulin ain't gonna be as good as Jenny Smith. And I already did it. So suck it. There. That's, that's gonna be one big beep when the podcast comes out just so you know. Yeah,
Unknown Speaker 1:05:19
but that's it.
Scott Benner 1:05:20
alley. Now you. You are the only one who knows how I feel about that.
Unknown Speaker 1:05:25
I can appreciate that. I come
Scott Benner 1:05:27
up with this thing. I help people with it and someone else comes along goes, Hey, that guy's getting ads on his podcast. Let's take what he's doing and do it here. And by the way, time honored tradition and blogging, ripping people off and everything I get it, but have your own idea. Like and be to be again to go back and forth between humor and seriousness. Maybe your idea would be better than mine. And or maybe it would be different and you could help a different group of people. Like stop just taking what I do and doing it again. That doesn't help. Like that doesn't help anybody. I do this podcast to help people I know that probably is hard to believe because I probably seem like an idiot to most people or at least a jackass, right? I only do this because I don't want people to feel the way I felt like I that that to me, it's not necessary. And it impacts your life poorly in ways you don't even think about. And I don't think you should have to feel like that. And if there's a way not to, I would like you to know it. And so I'm doing it the best way I can do but when you come along and go I have a podcast too. And I wish more people listened to it. Like they listen to his I'll just do what he's doing or steal his guests or whatever else you think is going to help you. I've already done it. Like they don't do you know what I mean? Like like like like, what the other day like this stand up special. Dave Chappelle stand up special came out? Yeah, I watched it. If you go do Dave Chappelle stand up special. And rerecord every word of it. I don't need to watch yours. I already saw it done. Go. But you might have brilliance and you go find it. I hate that. It's not that they rip me. It's nice that they think the podcast is good. And I know I mean, like people will come back and be like, oh, flattery form of compliment like, whatever. Just, I work hard at this. Have your own goddamn idea. That's all I'm saying alley. I don't know. Let's
Allyson Hughes, PhD 1:07:14
call it let's just call it Scott's podcast rage and like that what it just like Don't even mention that I'm in the episode just like this is just
Scott Benner 1:07:24
like this girl's talking about Medicare. I'd never even heard though, Scott. I know. I don't know what happened. And I'm not even you know what the truth is? I'm not even. I'm not even upset. Like I'm trying. Yeah, I'm even just trying to be entertaining here. And upset in the way you think of like the listener. The way they might define my anger is not how I feel the way I feel it is as disappointment. Yeah, no, you know, like, I really wish you have this voice. You have found a an audience. And if your audience is different than mine, don't give them what I'm doing. Give them what you're doing. And by the way, if you think you're just trying to steal my audience, I don't think that works. Like do you mean like blackish has an audience you can't you can't go get a different black family and think, oh, I'll steal blackish his audience is too late. People are in for blackish they're you know, they're they're bought and sold. Now they're, they're ready for it. You're not going to steal one of my podcast listeners by having on somebody who I've already interviewed. Like, doesn't that make sense? Like why would I look at your podcast and go oh, you have on that person Scott head on? I've already heard that person on Scott. So why would I What do you think the person has something new to say? They don't. Ollie has said 19 things on this podcast. She could never say to another person. And Allie tell people why that is.
Unknown Speaker 1:08:41
Oh, I what you just said it
Scott Benner 1:08:44
might be helpful for god sakes.
Allyson Hughes, PhD 1:08:48
I can't stop you just have this whole like, diatribe thing that you just did. You just went off on your little manifesto here. And then like, I'm just laughing my face hurts from smiling. Like it's I mean, your
Scott Benner 1:08:59
words for you that now like Allie said what she said because I made her say it. I'm the puppet master. That's if you have Allie on your podcast. It's gonna be some research girl talking about Medicaid. No one's gonna listen. Just Just turn your podcasts off. I want already
Unknown Speaker 1:09:16
let it go. Oh my god. I love
Scott Benner 1:09:19
it. Oh my god. Now Now I can't wait for the review. Scott is an egomaniac. He has an incredible hunger inside of him. One guy said once he said he was adopted that's obviously because he wasn't loved as a child. That one was my favorite one. By the way. Whichever one of you said that. Brilliant. I'll bleep out later. Yeah. Somebody said but by the way, brilliant armchair psychology like right? I LOVE IT guy mentioned he was adopted one time that's where this sickness comes from. Okay. And then the one that hurts is the narcissism one because you you There's gonna be so many beliefs This was but whatever mother's called me narcissistic, okay. You like want to come watch my life for a week and see how much of my free time goes to the idea of other people's health? Yeah, I swear I'm not like I feel like I'm saying now Hey, I make donations to charities, I want you to all know who they are. Because I don't want you to know that. But you call me a narcissist. You come here, you'd apologize. Because I put a ton of who I am into making sure other people are okay. And that and they, when it's over. They say thank you. And I am as uncomfortable with that. Thank you as you could possibly imagine, because I don't even think they should have to say thank you for it. So I just I'm like, no, it's my pleasure. Like, if you ever see me respond to people online, I just put blue hearts on things. People are yours.
Allyson Hughes, PhD 1:10:48
You're so nice online. But
Scott Benner 1:10:51
I'm nice in person. But my point my point is, even when you listen, again, someone will twist this around. But it's weird to have someone tell you that you save their life. Yeah, when you don't feel like you did. Do you know what I mean? So it, it's and it happens a lot. And I try not to become callous to it. I want to feel it from each person, because it's their experience. And the moment it's happening to them. And I don't like imagine if it happened to you. But you were like the 5,000th person, they would send me the thing. And I was like, Yeah, whatever. That's great. Good luck, you know, like, I don't, so I don't want to become so I end up feeling it. So I allow myself to feel it. But then I also feel the people who are struggling. And when I tell you I woke up this morning at 3am to give Arden a little bit of insulin. And I got back to bed and I saw a message just on the screen of my phone. And I knew who it was from it was from one of you listening one of you ruined two hours of my sleep. Okay. And I'm just kidding. I mean, they did. But it's not that I don't want them to feel bad about it. And they and I just I knew the problem they were having. And when I saw their name, I started thinking about how to help them. And then I couldn't go back to sleep. Yeah, because somewhere there's a person with a blood sugar that is way too high and variable and doesn't need to be that way. And I had not figured out a way to say what needed to be said to this person yet. And I know, I know, I can say something to them. Or somebody could say something to them that would help them. So anyway, when that's the life you lead, you know, and then you see online somewhere that someone took your goddamn gas, stealing your makes me upset. Okay, and just for a second because then my narcissism kicks in I go doesn't matter, I'll do it way better than they will. And everybody will just realize that my podcast is better anyway. They're really just helping me. But anyway, there's a moment in there where you're like, You got to be kidding me. Like imagine, you show up at a dance and a dress and three other girls are wearing it. That's what it feels like for a second because they saw it on your Instagram three weeks ago.
Allyson Hughes, PhD 1:12:54
It happens in research, believe it or not, where you'll have a full, you'll have a full research project, you're writing up the manuscript to get published in a very, it can be very difficult to be published. Sometimes it takes people years to get one paper published. And you'll write everything up. And then all of a sudden, you've realized someone's already done your project. And they've already published it.
Scott Benner 1:13:17
Because they knew you were doing and they got ahead of you.
Allyson Hughes, PhD 1:13:20
That can be part of it. That's that can happen at conferences, research conferences. I've been plagiarized before.
Scott Benner 1:13:25
I'm going to tell you right now I know. I know, people whose blogs get ripped off word for word. And it's hard. They put so much effort into them. I was at a thing one time where I thought I was with contemporaries. And everybody was talking about what they were getting ready to do next. And this was like two years ago, and I started talking about my plan to have Jenny on and to break down the the tenants of the podcast. Yeah, Jenny. Yep. And then somebody did it on their podcast first with Oh, and and I just did it better and crushed them. So I can picture your face right now in that room actually took my idea. I can't even use social media anymore to look for guests. Is anyone surprised? Yep. Anyway, reach two will show up on another podcast. Yeah, just have your own idea. It's not that hard. And if it's that hard, you shouldn't be doing it, by the way. Yeah, you know, I mean, but but the world's like this. Like it's not. It's not uncommon, like you just said like, it's in your wallets in everyone's world. Like there's, there are some people who innovate things. And there are some people were like, Oh, I didn't know I can make money doing that. And, I mean, think about that, that shows Shark Tank, right? Where, yes, I'm gonna come on with a great idea. And someone will say, Hey, I love your idea, but I can't invest in it because we're not going to be able to protect it. Someone's going to knock it off. Right? And you're just like, oh, that's that's a thing. Okay. You know, like, that sucks. Like, this guy had this great idea. It's so revolutionary, and now and now someone else is just going to come along and steal it from him. You know, and I'm just so good. I'm sorry.
Allyson Hughes, PhD 1:14:59
No, I was just gonna say I think in the the fields that we're in, like I said, like communication, you know, on some level, we're trying to get the word out there. And I think that's just naturally what you want to do is communicate. Right? And you can even do that because someone could take it.
Scott Benner 1:15:15
Yeah, neither. There's, I've said things on this podcast that were not said on record on the internet prior to me saying it. I know that like you can you can, you can, you know, empirically tell these things. And someone will come along, say it a year later, and then I'll hear from the grapevine like, oh, Scott's got my idea. And I'm, like, Scott said that thing a year before you said it. Wow. Like, are you kidding me. And so they'll even take your idea, and then try to end around you on it and make it seem like it was there. So it's like, just awful in the end, like, if you're helping people just go help them. And I guess in the end, if I'm being serious for a second, the part of me the nice part of me that puts blue hearts up on things that is very thrilled for your success. If someone else, I guess, can take my idea and reach someone that I can't reach with it, and do as good of a job as I'm doing with it, then I'm happy. I'm happy that it's reaching someone else. And I genuinely mean that I can't reach everybody. I'm not a maniacal lunatic. I don't think that everyone with diabetes on the planet should be listening to that. Wait a minute, let me take that back. I'm not a maniacal lunatic period. I probably do think most people with type one diabetes should be listening to this podcast, but I don't imagine that they will. Or that, you know, I'm everyone's cup of tea. There are plenty of people who will listen to me and think, you know, I don't like this guy's delivery. Or, you know, his jokes aren't funny to me, or I hate his voice, whatever. I mean, that's understandable. I'm not for everybody. Nobody's for everybody.
Allyson Hughes, PhD 1:16:41
I mean, the thing is, it's I was gonna say this earlier, when you were, like I said, on your tirade, but I think something to think about his like, even if they reach one additional person, and it's not just, if it's just one additional person, is it worth it, then is it okay? Not really. But it's one person that they're at least making a difference. And even though it's your ideas, I don't know, I'm just that's the way I think about it. You're still having an impact? Yeah.
Scott Benner 1:17:09
Yeah. Great. Well, listen, and I would have to say, I have recently heard someone take something I did and redo it, it would have been nice at the beginning, if they said, you know, where I got this idea from, from Scott on the Juicebox Podcast, and then I would say, okay, that's attribution. that I that I don't I wouldn't have an issue with that. If you said, Look, I heard this idea on another show. And I think it's great. And I want to share it with you guys. To me, that's attribution. And then it's fine. But to say what I say word for word, and then not say where you heard it from, that I don't particularly enjoy.
Allyson Hughes, PhD 1:17:44
I can't believe that it's word for word.
Scott Benner 1:17:46
That's what kills me if it's like an interpretation that this Wow, just there. It's, it's again, it's fine. And maybe that. You know what, let's be liberal for a second, because I just heard you be liberal and say, like, I don't know why I feel that way. I know why you feel that way. You're bleeding heart liberal, like, Oh, yeah. And so it's fine. And so I and I feel that way, too. It would be great if one more person, right? Like I've said it on here before, it's completely inappropriate as a an explanation. But in my mind, when I don't, when I get a note from someone, I think, Oh, God, I wish it was 10 more notes or 100. More notes, not because I want the notes, but because it would mean it would reach more people. When it absolutely feels to me like the last scene of Schindler's List where Oscar Schindler realizes he still has a cufflink that he owns and he could see him think like, if I could have sold this, I could have saved more people. And I know that's not an apples to apples comparison. But I feel that badly. Like is what I'm trying to tell you. Like when I feel it. I feel that badly. I feel like how is it not possible that I can't be better at this podcasting thing to reach more people. So more 16 year old girls are in their endos offices with 5.681, CS schooling, an endo who's been doing it for 30 years. Like, like, I want more people to have that experience. And I don't care how they have it. But then the other problem is, too is how much of what I do here is me. Like, I don't know that I'm not. I can't make that determination. But right. Is it possible that the message without the messenger isn't the same? Like I don't know?
Allyson Hughes, PhD 1:19:25
Why, I mean, you bring such a unique perspective to this, you know, it's, it's gonna be different than hearing it for me for sure.
Scott Benner 1:19:34
I think the one thing that helps is the idea of like, stripping out um, I don't know what the word is, but you have type one diabetes. So there are pressures and anxieties and unpleasantries about diabetes that I don't feel. Yeah, so I can say things in a more nuts and bolts way because I'm not burdened with how I feel about them when they happen. Yeah, if that makes sense, and I think one a person with because you know, the first One of the interesting things that people always assume about the podcast when I, when I talked to them outside of it, where people are talking about like maybe buying an ad or something, and they go, who you just talking to parents of kids, right? And I was like, No, no, not at all. You know, like, there's just as many adults living with type one who listen to this, and somebody said, Well, why would they listened to you? And I said, Well, I mean, at this point, I've got a track record, it works, you know. And so if an adult comes up to another adult and says, Hey, you should try out this podcast, it's going to be weird, because it's going to be a guy who doesn't have type one diabetes, giving you rock solid information about how to take care of your type one diabetes. That's a an endorsement and a half. Yeah, you know, but it is the assumption right away that, that I'm only talking to people who have who are parents, but because I'm a parent, but I don't know like, right. I don't know, like this is turned into a therapy session. Really?
Unknown Speaker 1:20:52
That's fine. I apologize. I'll send you my bill.
Scott Benner 1:20:56
It's fine. You know, what we learned is you're good at making people say things they don't want to say either, because I hold in that stuff about what other people offer me all the time. It did pile up this week, though. It happened three times this week. And on the third time, I was cooking dinner and my wife saw something in front of my face, and I went, why would you show me that? I'm making dinner. And then and then we just I was like, ah, all right. I felt so defeated for a second. I was just like, what am I gonna let him do it? Whatever. You know what I mean? let her rip me off. Just do whatever. It's fine. Like, but it's let me just say this to the people who rip me off.
And ready, ready? Mm hmm. I know. Okay.
Fat farts Never making it the podcast. Yeah, like,
Unknown Speaker 1:21:56
but it might be it might be. It might be interesting to hear. Let me say this to be.
Scott Benner 1:22:01
But yeah, so anyway, Ellie, you now know everything I've never told anyone else. NATO. And they should be wondering right now how I know that. You want to know how I know that. Because the people are giving like you that much. I want just kidding. All this is
Allyson Hughes, PhD 1:22:24
your evil genius. laughs Yeah.
Oh my God, that's amazing. I was gonna say there's like that thing. And like, I mean, take from it what you will with like imitation is the sincerest form of flattery. And it's like, yeah, maybe, you know, but even then it's like they're getting paid to do your work. They
Scott Benner 1:22:42
aren't they aren't. They aren't taking money for a lot of them. Yeah, they're trying. I say it's sometimes out here. And I know it sounds like I'm, I'm, I'm angry. And now at this point, there'd be no way for me to think that I am. But there are a lot of people in the diabetes space who purport to be doing things because they're trying to help people. And yeah, they are just doing it for money. I know a person who does something really well. who wishes to God, they didn't have to do it. They hate doing it. And they only do it for money. Wow. Right? They hate doing it. They don't take any joy in it. They don't. They just they don't care anymore. They don't want to be away from it. And they can't because it pays their bills. Uh huh. So I don't feel like the one thing I always hope people can take from the fact that my wife is in the pharmaceutical industry. And we, you know, we're not, we're not wealthy people, but we are not scraping by Okay, wait, is that I don't, this is nice for me. And it, it definitely helps the money I make helps. But it is not a necessity in our life. I am doing this. This takes a lot of my time and a lot of my effort. And I am not compensated dollar for dollar for my hours. So so you know, as long as I'm here, I care. Because
Allyson Hughes, PhD 1:23:56
Yeah. And it's evident on my end, like I see how much hard work you're doing. Like I see it on Facebook. Like, I see that you're always connected. And I know you're a team of one, you know, like this is all you and and so I think the people that are closer to it and have been listening for a long time. I think they get that and I think they appreciate that. I hope so
Scott Benner 1:24:17
I know people don't there are a lot of people who listen, who don't realize that everything that happens on this podcast is me. Like I don't have another person helping me. But yeah, sometimes I'll get a note and the note is so interesting. It's it's written, it's like, Hi. I don't know if the guy I don't know if the host knows this. And I'm like, Wait, do you think you're writing a different person than the host? I was like, that's, that's fascinating. It's like, it's just me, like, like, I can't even get Arden to do an ad for me like, Hey, could you sit down and say this and she's like, leave me alone. And I'm like, Oh my god, I can't get anything. But I appreciate that. I really do. You're very you're very nice to listen to me rant and rave. I You caught me in a bad week. Like I said I
Unknown Speaker 1:24:57
anytime Yeah, fine.
Scott Benner 1:24:59
I made it. through the first two is the third one that got me. I was like, you've got to be kidding me. Yeah, I just can't Oh,
Unknown Speaker 1:25:07
my gosh. Anyway,
Allyson Hughes, PhD 1:25:09
that's really hard though. That's really really hard. A lot of time in.
Scott Benner 1:25:12
See, this is how I know you and I aren't married. You've heard me. I've heard me complain, and you're still being nice to meet you. We're ready to leave your husband because you drove across the country with me. You're like, this guy's been bitching for 15 minutes. I have compassion for him. Oh, yeah. uproot his life for you. And you're like, get out of the car.
Allyson Hughes, PhD 1:25:33
He's such a good person. I really don't deserve him. I mean, what can I say?
Unknown Speaker 1:25:40
He knows the problem.
Scott Benner 1:25:43
That's great. I just as I'm airing all my laundry here to let me get this thing out. Those of you who backstab me and think you don't know that I know, I know. I'm just too nice to say anything. Okay?
Unknown Speaker 1:25:55
Like, that's all
Scott Benner 1:25:56
you had. Ellie, you would be mesmerized by what goes on.
Allyson Hughes, PhD 1:26:00
People are awful. I, the online can. I mean, there's so much that's good about the diabetes online community and just online communities in general. But it can get very, very ugly. Everyone thinks they have to say their opinion. And everyone thinks that their nasty opinion is valued. And, you know, it just it just gives another type of media for backbiting sorts of things. It's awful. So all the
Scott Benner 1:26:24
people who wish I would come out and speak in their area, there are two places in the country that I will not be speaking that I was going to be speaking, because somebody who wanted that slot, took it from me, ah, by using their friends Endor money and influence to get me moved out of them. Because they wanted them instead of me. And it wasn't that they wanted a spot. They wanted my spot. Wow. So I'll be back. I'll just come the following year, and I'll smile, you'll never know what happened to me. But those people do that and think that no one knows. And they don't realize that I know.
Allyson Hughes, PhD 1:27:01
Yeah, it's, um, we say this all the time at work. It's like diabetes is a small community. And research is a small community. And you're always it's like any field, you're always running into the same people. You know, you get very close over the years, and it's like, Don't burn any bridges. Don't do anything that you that you shouldn't be doing. That's so frustrating. Sorry, Scott.
Scott Benner 1:27:22
I'll tell you what, we're gonna do this. Really, this will absolutely make all the listeners upset. I'm gonna stop the recording, and then tell you the story of why I won't be in some of those places. Oh, can't wait. Well, we get to know. Ladies and gentlemen, this was ali ali does really good work at t Wendy exchange. You wouldn't know that from this podcast. But what's the web address versus they check out? It's strange that is it work? Or? Yes, it's org. Yeah. All right. So I'll put it in the show notes. And you should go check out what they're doing because they're taking diabetes data and doing really cool things with it and trying to help you and everyone else. I will say goodbye. I'm pushing stop. Huge thanks to Alli for coming on the show and putting up with my shenanigans. Thanks also, to who? Well me, I'm just getting touched by type one.org. Please, please, please check out touched by type one.org. Wonderful, wonderful organization, helping people with type one diabetes, you need to know about them. And of course, T one B exchange is where Ali works. And double Of course, if you're interested in alley study, go to Juicebox podcast.com. Find her episode, Episode 346. I think I said at the beginning, and you'll be able to check out Ali's hard work. It's really impressive. I want to share this one last little thing with you two things, actually. First of all, I know I said a lot of stuff at the end of the podcast. 99% of the people I've met in this space are not like that. Honestly, 99.9% of them probably are just wonderful people, but the ones who aren't. They're a special breed. Anyway, what was the other thing I want to say to you? Oh my gosh. I'm sitting outside of my dentist office one day having just had my teeth cleaned. And I received a text from Allie has panicked. I didn't do a very good job on the podcast. She says we need to re record it. And I of course, told Allie and she's hearing this for the first time right now. She did a fantastic job and it was terrific. Everybody thinks they didn't do a good enough job when they were finished. But here's the truth. It had been long enough since Sally and I recorded that I didn't remember any of what we said. As a matter of fact, as I edited the show today and heard everything that went on I was like, Huh, I don't remember any of this was really good. I'm glad I didn't let her re record it. Because this is excellent. She's doing good work. You know about it now. People talked about how they feel about things. It's an honest conversation. I think that's all we can ask for. So hope everybody's well have a great week. I'm gonna put out a defining diabetes in a couple of days. So look for that. And thanks so much for listening. The podcast is about to have a monumental month and it's very exciting and humbling and I really appreciate it. I will talk to you all soon.
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#345 Dexcom CEO Returns
Kevin Sayer is here!
Dexcom CEO Kevin Sayer returns for his seventh appearance on the Juicebox podcast. Today's topics; Patient Assistance Programs (Covid-19), CGM in hospitals, G6 Pro, G6 anniversary, Hybrid closed loop, Medicare and more!
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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Hello, everybody, welcome to Episode 345, the Juicebox Podcast. That didn't feel like enough energy. Let's try it again. Hello, everybody. Welcome to Episode 345 of the Juicebox Podcast. And that was too much. I'm going to shoot right for the middle. Give me a second. Go. Hello, everybody. Welcome to Episode 345 of the Juicebox Podcast on today's show, the CEO of Dexcom Kevin Sayer is here to discuss with me what's been going on with your favorite continuous glucose monitoring company. And there's a lot here short show lots of information. And this is very uncommon, recorded on the day it was dropped. That doesn't usually happen. So this information is up to date, June 15 2020. The Juicebox Podcast is sponsored by the Omni pod. You know what that is, is a tubeless insulin pump. My daughter's actually been wearing it since she was four years old, and she's about to turn 16. The Omni pod tubeless insulin pump is a Marvel and the company who makes it offers an absolutely free, no obligation demo. So they'll send it right to your home, you can try it to see if it's something you're interested in before you move forward. That's of course at my Omni pod.com forward slash juice box, and Dexcom, makers of the G six continuous glucose monitor and the company who does all the stuff you're about to hear about. You can find out more about the dexcom@dexcom.com forward slash juice box. The episode is also sponsored by the Contour Next One blood glucose meter. Of course, everything you need to know about that exists at Contour Next one.com. Just head over there, you can find out all sorts of things about the greatest meter I've ever used, including, if it's possible that you may be eligible for an absolutely free meter. Links to all of these sponsors are available at Juicebox podcast.com. Or right there in the show notes of your podcast player. I am joined today by Kevin Sayer, the CEO of Dexcom. This is Kevin's seventh appearance on the podcast. Kevin took a little time out today from the American Diabetes associations ADF Scientific Sessions. I don't know if you know what that is. But it happens every year. It's this very big event that usually happens in person this year because of COVID-19. Of course, it's happening virtually. And so anyway, Kevin took a little time out to talk to me about what's going on at Dexcom. At some point in this half an hour, we're going to talk about the patient Assistance Program. CGM use in hospitals around COVID-19, the two year anniversary of G six, the G six Pro, which I'm wearing hybrid closed loop partnerships with Omni pod and tandem Medicare, some new things happening in the EU. And the rest. You know, when they did that Gilligan's Island thing they were like in the first couple seasons, they were like there's so many people here we don't know if everybody cares about Marianne yet, so we'll just say and the rest. Trust me, they ended up caring about Marianne, and you're gonna care about everything that Kevin talks about here on the show. I have to do disclaimer very quickly. Nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, please always consult a physician before making any changes to your health care plan or becoming bold with insulin. Oh, yeah. How are you finding Ada being online?
Kevin Sayer, Dexcom CEO 3:39
I miss being there. I miss talking to healthcare professionals I've known for a long time I miss going actually to sit tomorrow the scientific sessions and hearing the buzz, it's on the floor. I still think a lot of data is getting presented. And I still think we're learning that we are doing much better with diabetes from done in the past. And in all fairness, Dexcom appears to be in the middle of all this.
Scott Benner 4:02
So that's all good. You really have a head things covered on all fronts. It gets to the point sometimes where I think people get confused and think that companies are one in the same because you know you've got Well, I mean, you've got a relationship with with tandem. And I can't find anybody to say anything bad about control like you that's for certain.
Kevin Sayer, Dexcom CEO 4:23
Great product.
Scott Benner 4:24
Yeah. And what's going on with did on the purchase chain is it's on the pod five is going to be the loop,
Kevin Sayer, Dexcom CEO 4:32
then I don't know their product names. I just know they've restarted they're pivotal and they're get everybody re enrolled and they're pushing to get this thing done. So we can get the horizon system out there. I don't know what they're gonna call it. I just, you know, the presentation, the patients really had a very good experience from a user interface perspective and the time and range data was it was strong comparable to the others. Yeah. So we're looking forward to another integrated system and more For our patients, do you feel
Scott Benner 5:01
like a proud parent, sometimes when you watch these things happen, like recognizing they couldn't happen without XCOM?
Kevin Sayer, Dexcom CEO 5:07
You know, I feel an integral part of it. And I do feel very proud and Oh, my, in all fairness, humbled to be here, because this is so important. Yeah, I would tell you what happens. And the people that work for me tell you the same holiday happens is when these good things happen. I just turned a pressure up to the next one, I am not very good at celebrating. I there's just so much to do.
Scott Benner 5:29
Well, then you're exactly in the right position, I have to say, I look today, because I found myself wondering, and you've been doing this podcast since 2015. This is your seventh or seventh time on. And just looking back to what we were talking about in 2015, and 16, and 17. There's never been a pause. And this will sound like I'm, I'm kissing your butt a little bit. But I'm not. I've been in the space long enough to see that innovation doesn't normally happen this quickly around things with diabetes for people. So it's incredibly exciting.
Kevin Sayer, Dexcom CEO 6:00
No, it is, in fact, we're celebrating our second anniversary of GE six right now. We lost his two years ago, okay. And we're still learning how good it is. We are learning the subtle things we can do to improve it. We are learning how important it is and everybody's lives. And just look forward to to the next wave of innovation. We Oh, yeah. Yeah. And we have moved very quickly. And in a very planned, well executed manner.
Scott Benner 6:30
What are you learning from that two years of data, because you've been on in the past and talked about, like, kind of pie in the sky stuff and always sound like like, you know, we'll be able to see enough data one day that it'll be able to tell you, Hey, don't you think you should Bolus here or something like that? Or is that stuff really, in the works?
Kevin Sayer, Dexcom CEO 6:45
You know why it hasn't happened yet. And it's still conceptually being thought of, I would tell you, if I could look back from when we talked about that two years ago, I'd love to have made more investments on that front. But in all fairness, we made the investments we need to get the technology that affects people right now in their daily lives on the market. Yeah, and and when g six and all fairness, our biggest investment in the past few years is trying to get enough manufacturing scale and get enough product to take care of our patients, right. And we've made some pretty bold promises, we said, we double our capacity by the end of 19. From the start of 19, which we did, we made a promise again, to double capacity by the first of July of this year from the end of last year, which we will achieve that as well. So we'll have the ability to build a lot of G six sensors to take this technology to a lot of places and to a lot more people. So we've kind of been catching up on the physical aspects. And I think now we can turn a bit inward and start looking at this science, this data, these integrations, all these other things and invest a little more time there. On top of going through all the same process. We went through G six, yeah, to get a G seven product out the door to
Scott Benner 7:57
he's not that I'm not in a hurry. g six works great for us. But is there a timeframe for seven?
Kevin Sayer, Dexcom CEO 8:03
We're not where we are we always we're always trying to be quick. But effective. We don't have a launch date for G seven yet. We have disclosed that the trials been delayed because of everything with COVID. Yeah, the centers aren't doing the studies, once we know that study timeframe, and how long it will take us to execute that study then that will give more dates, but like you said, g six has been a great product, it remains a great product. It's well integrated, we'll have more integrations and and we'll continue to improve it and make it better over the next several months anyway, we're not going to abandon all right, right, Mr. g seven come in yet still Well, our patient choose. So we'll continue to to make g six better while we move to to G seven get ready for that, too.
Scott Benner 8:52
So speaking of COVID-19, I guess I wanted to understand a little bit more about the patient Assistance Program. What did you guys put into place when all this happened?
Kevin Sayer, Dexcom CEO 9:02
Yeah, and we've designed a patient Assistance Program, it has not gone live yet it will go live, hopefully, first in July, maybe a little bit before that. We looked at the economy and everything going on. The one thing that was very important to us is to make sure current Dexcom users get taken care of. And Dexcom users may in fact lose their insurance or their jobs during this point in time. And we unfortunately don't have Medicaid coverage in every state and even some of the states where you do have Medicaid coverage, it takes quite a while to qualify. Okay, so we put a program in place for Dexcom patients that literally for $90. Over a six month period patients will get enough sensors and a couple of transmitters to get them through this time. And we will we've had some patients sign up not a lot. I think once we roll it out live, we'll see more that we really wanted to take care of the Dexcom family and doing that.
Scott Benner 9:54
So they're actually able to sign up now getting ready for when it launches. Yes. Cool. I'll put a link to that. In case anybody's and this is going to be for people who lost their insurance, like directly, how do you? How do you figure out who that is?
Kevin Sayer, Dexcom CEO 10:09
What we did is we went to an outside service that has the systems to do all those types of checks and go through and you know, where was your last? I don't know what the process that goes through. We knew we didn't have the systems to do that ourselves. And we did find a company that that is administered types of programs like this for pharmaceutical companies, right? So apply the same type of program to Dexcom. And and go from there.
Scott Benner 10:34
Do you know much about what you guys are learning from the Dexcom being used in hospitals around COVID-19? Rick was on a few weeks ago and was telling me about it. And I don't know if you've learned anything since then.
Kevin Sayer, Dexcom CEO 10:45
You know, we've learned a lot. I haven't listened to Rick's comments, but I can tell you, the first thing we learned is just hospitals operate a little differently than we do. And we've had to learn how to get the product and how to get the cell phones, that it's going to receive the data safe and through the IT systems in the hospital. And we've learned a lot about education. You know, we're used to training patients with diabetes and endocrinologist, we had a new audience. And we had to hear our training towards them. And they understand it, obviously that and we start thinking everybody knows everything about this, and everybody doesn't always know everything about it. We've learned that the the benefits from it are everything we'd hoped they'd be a human action and PP, patients are getting out of the hospital faster if they're putting on insulin drip, that insulin drip is much more well controlled, because you have a CGM data, again, leading to earlier discharge. The biggest benefit quite honestly, for anything in the hospital is when you can improve workflow and make the lives of the people who interact with the patient's better and more effective. And while we're hearing from, you know, from healthcare professionals, we put this on we get them up on Sharon follow, we can monitor them from the hall. And when we get an alert, we're going to deal with it rather than sticking their finger some places every half an hour. Yeah, 40 finger six a day in a hospital bed costs a fortune in nursing and caretaker time. So we've learned that we've learned essential performance the way it does with our regular patients. So we've not seen any abnormalities as far as what these patients are getting as far as compounds interfering with central membranes, which is something we have had many discussions with the FDA about, excuse me. And so
Scott Benner 12:32
that'll all be good. I think we'll gather as much of this data as we can. We made a commitment to the FDA, we'd present it to them. Before we run any further with this, and then talking about what we need to do more to be in a hospital full time. I'm excited for that after Rick came on, I get so many notes from people who are like, Is there gonna be a study, we want to hear about this thing. I was like, it'll happen Hold on a second. So when it happens, I'd love to know about it. Actually, the thing that I kind of got most excited about all the stuff you just said about what's happening is great. But I like the idea of this sort of reverse education is going to happen back to the nursing staff and the doctors so that they can see things about insulin use that I don't believe they thought about in the past. You know, when people are hospitalized, they have a tough time with type one. And I'm excited for what this might do.
Kevin Sayer, Dexcom CEO 13:19
They have a tough time with type twos as well. I remember, many years ago, my mother went to hospital for valve replacement. My mom had type two diabetes, they had a harder time getting her glucose in control than they did, getting her healed up and ready to come home from a heart valve replacement because of the stress that that surgery put on her system. And just the way her body was wired. I think one of the learnings from all this is there's no one size fits all. Yeah. Where people have different physiologies and different ways their bodies and systems react to things and CGM gives you a view? Yeah,
Scott Benner 13:54
I think I really believe that Dexcom in a hospital setting, beyond COVID-19 would be amazing for anybody who uses insulin, because they just don't get they don't always get the care that they need. And actually talking about everybody being different. You guys were very kind and sent me a Dexcom Pro, which I'm about
Unknown Speaker 14:13
a pro I
Scott Benner 14:14
heard How's it going? Well, I'm in my last few hours and I melancholy that it's gonna shut off soon, honestly, because of what I'm, I know that sounds crazy. But as I looked at came up, and it said, 24 hours left in 24 hours felt hopeful. But when it got to six hours, as I call this thing's almost done, you know, and I really felt badly about it, because I'm making slightly different decisions about food based on what I'm seeing. But some of the crazy things that I've seen, I never expected I you know, I'm kind of held up in my home like everybody else. I had to go out and get food the other day. So I jumped in my car, it's hot out, I opened the windows, I'm going to go for a ride by myself. I'm kind of excited I turn on some very loud music, and my blood sugar went up while I was driving to the grocery store and I thought that's just an anomaly, right? But I get out of the car, it goes right back down and settles in. And I come out, get back in the car, turn the music back up and watch my blood sugar go up a little bit. Now not a lot, you know, it's obviously different thing then. But it was a little bit of an adrenaline rush. But there was an adrenaline rush. I was like, wow, I'm excited to go to the grocery store, by the way that felt as sad as it did experience.
Kevin Sayer, Dexcom CEO 15:19
Oh, but the things you learn and the things that people will learn from gee six Pro, particularly like somebody's pre diabetes, or type two diabetes, who hasn't had the type of interaction, you know, type one patients, their bread and butter, and that's the business we're in today. But as we look forward to the future, if you have type two diabetes, what these patients have been told for years is eat less, exercise more and take your meds. But there's nothing that shows them the effect of that. Yeah, when you put g six pro on or G six on and you see the effect of that, you kind of sit back and go, Okay, I can now do something I can now learn.
Scott Benner 16:00
It's really good. It's massive. Because if I told you that I made pizza yesterday from scratch, and that didn't impact my blood sugar as much as a navel orange, I ate the day before. That wouldn't make any sense to somebody like if you if you just said to somebody Look, there's this guy's got type two diabetes, what do you want him to have? This slice of pizza? Or this orange? What do you think's gonna spike his blood sugar less? I don't think anybody would pick the orange over the pizza. But it's really just it's fascinating to watch. And it's fascinating to see how quickly your body. And the reason I asked for it initially was because I talked to so many people about how they use it so and I really wanted to see firsthand how, how it worked like how does the pancreas really work because all I have is what I've kind of gleaned from my daughter all these years, you know, like what should be happening and what gets you back to flat again. And to see that when I eat more sugary foods, my body comes in harder and more aggressive than it does when I eat more complex carbohydrates. That was fascinating to me to see, because I don't get pushed very low. Unless I eat sugar if I have a bunch of sugar, which I don't normally do. But I've been this has been quite a little fun thing for me, I guess I've been experimenting. And so I had a piece of cake with a lot of frosting. And then I was full and would have never done more and did more. And I just washed my blood sugar shoot up and then it pushed it back down to 80. But if I eat pizza, I don't get pushed back down to 80 not nearly that fast. It was it was really fascinating and continues to be
Kevin Sayer, Dexcom CEO 17:30
how the learnings for all of us when you are in this technology are it's really fascinating. The the effect of exercise, effective timing of meals right is dramatic. Yeah. For me, in particular, if I eat that piece of cake you talked about at 10 o'clock at night, that will affect at least till two o'clock the next afternoon for me, no kid, I'll be too high. It takes a long time to my system. And then then I have the big crash like you're talking about. Right work on much lower. And so trying to run on an even keel is quite a challenge. Wow, really sings
Scott Benner 18:06
the cake took me to like 146 and as soon as I got up that high, I got yawn I started yawning I felt tired. Like it was you know, people talk about Oh, it's after lunch. It's it's maybe it's not after lunch, if you don't eat the wrong things, you know, is which is what I took from it. Just so how is this going to get used? Or what's your goal for how it's going to get used in a doctor setting you want them? Well,
Kevin Sayer, Dexcom CEO 18:28
we have you know, we have always had a lot of goals, we still are going to be focused on our intensive insulin world. And we'll design our product and our base technology for that. And it will it will be there and it will be continually offered to those patients over time our next market would be the type two non intensive patient that those patients on other compounds. So they can literally delay if not eliminate the need forever migrating to insulin if they can manage themselves appropriately. And we've learned the effectiveness of some of these drugs. For some of these patients possibly earlier intervention in pre diabetes. I spoke with one physician who's not under chronologist but in a field where there's a lot of diabetes, and she told me she puts all of her patients who have anyone see above a certain level on index comm to see what's going on and then she'll prescribe jardiance or some other type to drug before they hit diabetes to see if she can prevent it from coming.
Unknown Speaker 19:25
Wow. Well if we
Kevin Sayer, Dexcom CEO 19:26
can prevent those costs and keep people healthy like that through CGM use it it's a huge benefit to the system and to people's lives and if you've seen with your G six Pro, it really doesn't bother me much it's it's pretty easy to wear and the data is is very fascinating. Yeah, we would start there I think over time there's fitness uses and health and wellness and giant uses for this. You know a lot of very high powered technology people have warranty six as an experiment and have suggested things to me. Like, every time you eat a meal, you measure the height of the spike and the width is spike and you have a bunch of analytics and graphs that can become literally industry standard type measures for people as they want to give themselves more healthy from a nutrition perspective. I think we can go there, I and then I think over time, what we would like to do with dexcom is then see what other type of analytes and experiences are required for this total health picture. You know, and we probably talked about ketones and lactic acid, as analytes, which is what others have talked about as well. But what other things can we make, it would be important to this world and really become as you look out 10 years, a healthcare sensor company rather than just glucose, right? And then so as we look to the future, though, because we've learned a lot, we've learned a lot, you know, on the electronics and the algorithms and all of these mechanical features that make our system so good, can we apply those technologies to measuring other things, and, and really create a business around around other things. But that being said, there are several hundred million people around the world with diabetes. And we have a market to go after there that is just massive, and they'll continue to do that.
Scott Benner 21:13
Well, I believe him, obviously, both both goals. And after wearing it for 10 days, I just, I been doing intermittent fasting, and I was just at the end of thinking, I don't know if this is something I want to keep doing or not. But after seeing my blood sugar during those intermittent times, I'm like, I'm gonna keep doing this.
Kevin Sayer, Dexcom CEO 21:28
It's no, it is a great thing. Yeah, it absolutely shows that time you spend on eating set you up for a better day.
Scott Benner 21:35
It's crazy. I'm I am fully just amazed with what happens. So with everything, you know, with Ada being right now, what are you guys presenting? What are you sharing with everybody? Is it just everything we're talking about? Or is there more
Kevin Sayer, Dexcom CEO 21:47
no our presentations that we've had some type q presentations, showing that there's benefit there. And some of our partners like on duo presenting really good data, showing you CGM and talk to patients leads to significant agency reductions. We've also presented with our partners tanam control IQ presenting more pediatric data and other day with their system. And the data is extremely compelling that that system is working very well insolate present some horizon data with what they have gone so far. And that data was very compelling, particularly respect to user experience, and how the patients engage with the system. And you know, the time both those systems have tremendous time with the algorithm running, certainly over 95%, which is a big change from systems have been on the market before. So those efforts are advancing. I think, you know, the other thing is continuously the ADA, everything revolves around what the CGM says, There isn't. There are many studies done where CGM is not an outcome anymore. That timing range doesn't become the indicator that everybody's looking for. And what is the timing range of cheap with this drug or this therapy or this? Whatever? I and I think you'll see that move to time and range being more important measure over and over again, to add on day one, see if not being is certainly a more meaningful interpretation of agency than what we have today.
Scott Benner 23:14
Yeah, we had john Welch on recently from from Dexcom. And he was talking about he was really generous, he brought his own data up on the screen while we were recording, and it's pretty awesome. He was I'll tell you, I, when I reached out, I said that I'd like to have somebody on the can really explain standard deviation, that that stuff and and do it at a detailed level because it never gets spoken about. And I have to admit, when I asked, I think everybody was like, you really want to talk about that. I was like, no, it's gonna be great. And people's response to him being on absolutely spectacular because he had it in a way that I mean, you know, he had it in a different better way. And he explained it well. And he went over also how coefficient of variation can be a good telltale for Lowe's. He said, If you keep that number, and I think he said 36% you'll have far fewer lows. I was like, Wow, that's amazing that that kind of information comes from this, you know, and you know, my daughter's life is, is is just on measurably better because of you guys, so I'm just a huge fan, obviously.
Kevin Sayer, Dexcom CEO 24:18
Is that fun talking to somebody like john that's why I love working at Dexcom I can before when we all get back to work someday, right? I can walk down the hall and find somebody like john and say, Okay, tell me something I don't know. And I promise I leave the office with some I don't
Scott Benner 24:36
know every time Oh, I left that conversation very humble and you're
Kevin Sayer, Dexcom CEO 24:40
it's just it's kind of overwhelming sometimes you go well i i guess i do run the place but boy there's a lot to learn No
Scott Benner 24:48
kidding and and your to your other point. I had him for an hour and an hour and 20 minutes into it had I not moved to screen to see something I had to apologize let him go. I had no idea how much time went by. It was Just really, it was riveting. I had such a great time. A couple of things, you're starting to make some advancements in the European Union to what what's happening there.
Kevin Sayer, Dexcom CEO 25:11
We are, you know, Europe is our second biggest market and there are many cat we are in many countries here, we two recent approvals, we think that will be very helpful. One of them is we have a back of the army indication. So it is now labeled to be one in the back of the army, which many patients did off label anyway. But we think that indication is really important for us for a number of fronts, and it ties directly into our second approval. And that's an official designation that we can be used in pregnancy. Our Pregnant Patients have never quit using our product. If they have diabetes, they've been using it. But the back of the arm medication for Pregnant Patients is really important. Because there's one pregnant patient said to me, I've run out of abdomen space, what am I going to do. So having the back of the arm is a is a good thing. There, we are working on both those indications in the US. And we need to figure out what our data plan is there. But ultimately, we'll get that for G six over here. And then the G seven product, we're running a study on the arm, on the abdomen, and for Pete's on the products as well. So we'll have three labeled indications where patients can wear it with that right out of the gate or not gonna
Scott Benner 26:27
wear us again, is that one of the benefits of having the longevity that the company has that you can start looking at those other indications and spending time doing those studies so that you can get more and more on the label.
Kevin Sayer, Dexcom CEO 26:39
Yeah, it is. And it is, as you understand it, and also, as you listen, you know, one of our core values is to listen to patients, and we've heard from numerous patients get us an arm label indication, please. And the pregnancy data that we got from women who've worn this certain pregnancy, the pictures of babies and stuff. We really need an indication for pregnancy where it says hey, and not necessarily a diabetic patient with a gestational diabetic patient, right. I have a twin grandbabies from a daughter law had gestational diabetes, and she's a nurse and was told, keep your blood sugar's under 125. While four finger six a day, you have no idea how many hours you've spent about 125, right? She put a CGM on and man, she knew everything. And when she showed it to her ob gyn, the OB tear, why and says I don't know why Ray doesn't have this. So we need to get to that market for that product.
Scott Benner 27:37
It's important to keep these kids safe. Let me tell you this, and I ask you a question. And then I'll let you go. But I did a series with a person who was pregnant wearing Dexcom. So I talked to her three months in six months in right before she had the baby. And it is it's not for the faint of heart making a baby to begin with. But making one with diabetes is a it's another game altogether. Oh, yeah, we appreciate that. No kidding. Um, Medicare. I didn't ask you about Medicare today.
Kevin Sayer, Dexcom CEO 28:06
Oh, yeah. But I'm happy to talk about Okay, cuz there's a couple things that we've learned. You know, I talked about capacity earlier, and we did not have capacity supply our Medicare patients last year, and we that switch, and we've nearly got almost all of them converted from G five to G six. And so that's been a very good thing. They don't have calibrations. Also, our G six minute care pricing is actually lower for our patients. Because as CMS looked at it, since there are no fingertips required, they dropped what patients would have been paying for finger six before, to Dexcom. So it's the lowest priced offering on the market for Medicare patient right now, on top of that, as you look at our times of uncertainty, where people can't be in the clinic, and where were the highest risk population is probably our senior citizens with diabetes, we offered a tremendous telemedicine opportunity for these patients to be able to have visits with their doctors, and make sure their diabetes is under control. So our Medicare patient population has been extremely served over the past, well served over the past several months. And we look forward to continue to expand there. And we're really happy that we have been able to make this switch have the capacity to do so,
Scott Benner 29:20
you know, I would have to say I'm assuming you don't talk about clarity. Like it's a real diagnostic device. But a lot of people would you do you because I think what I'm seeing is a lot of doctors are like, Look, you can't get in here. But can you tell me on this clarity like what is this? What is this? What is this? It's a it's a great way when you can't move people into a doctor's office especially to take a blood test to help them you know,
Kevin Sayer, Dexcom CEO 29:43
and clarity, you know, and we used to have a three hour delay we dropped that three hours away. It's closer to real time there may be a little bit of time that missed that. But the average be 30 minutes would be all but we dropped that three hour place. Clarity can be used on a much more real Timing decisions for these visits. Yeah,
Scott Benner 30:02
I did it with my daughter, looking right through the same screen that her whole thing and, and it was really amazing. The only thing I didn't go over was that, you know, the company is looking very, very strong financially congratulations. I'm assuming that's probably because the ads on the podcast, you probably don't want to embarrass yourself by thanking me like in while we're being recorded, but
Kevin Sayer, Dexcom CEO 30:22
I love our sources and where we get our patients. I think some of the greatest stories we hear are where people hear about us. And and while Listen, we were running commercials on television now. emails, hey, saw your ad today. And we're we certainly have our direct digital media but I all the places we we run a report to us if somebody's listening to your podcast, I gotta guess our hit rate is pretty high on that patient.
Scott Benner 30:48
Yeah, I well listen to it. If they're listening to what's happening in my house and they're excited for it, then they would at least want to look into it. I would think it's a we're six years now. 5226281 see, oh, sheets, whatever she wants. She's, you know, getting ready to get her driver's license, you know, strong like Healthy Kids. So.
Kevin Sayer, Dexcom CEO 31:07
So when you want when you want advice from me having raised five teenagers, non diabetes related, you can give me a call. I had a daughter. I have been through five teenagers and good luck.
Scott Benner 31:18
Well, I'm just gonna say that. That's quite an accomplishment. Kevin, thanks so much for coming on. I really appreciate
Unknown Speaker 31:23
the time. Of course, we appreciate it. Thank you.
Scott Benner 31:27
Well, Kevin went over so much that I'm going to provide links at Juicebox podcast.com. So there's episode page for this episode, you'll see it go to Juicebox podcast.com. And then everything we talked about, there'll be links to I'll put them in the show notes of the podcast player as well. But just in case you have trouble accessing them there. There'll be right there at Juicebox Podcast comm huge thanks to Kevin for coming on the show and taking some time during this very busy week. While we're thanking people, let me thank you for listening to the Juicebox Podcast and for sharing the show. We had again, a huge month last month and this month is looking to be bigger. So that is because you are sharing and listening. And I appreciate it very much. If you appreciate the show, you can stay on for just a couple more minutes. Because this is how I pay the bills. This episode of the Juicebox Podcast was sponsored by Omni pod, you can get a free no obligation demo of the Omni pod tubeless insulin pump sent directly to your door today by going to my Omni pod.com forward slash juice box. When you do that, and then provide the tiniest amount of information on the pod is going to send a pod right to your home. You can put it on and wear it to see what you think. Is it gonna bother me? Is it bigger than I thought it was? All that stuff? What would it be like to work out with it or take a shower or you know, take a tumble, all that stuff? Those are the kind of things you want to know before you buy. And only pod knows that. I think that's fair. So they're gonna send up demo to your house and let you make the decision. Like I said, I'm wearing the Dexcom Pro right now. And it's one of the things that took me by surprise, I'd never wanted Dexcom before, and I thought I was going to be bothered by it's just existence on me and I have not, I have not even noticed that. It's been terrific. Now Dexcom Pro, that's for physicians, if you're not a physician, this is not what you're interested in. But if you're a physician, check the show notes get in line like Kevin was saying they're gonna start this program very soon. no reason you can't get one for your practice. Everyone else, you're going to want the dexcom g six continuous glucose monitor, go to dexcom.com Ford slash juice box to get started today. So that's simple, high and low alerts. Right. Arden's are set at 70 and 120 we actually get a little beep lets us know if our blood sugars leaving range. And then we just gently guide it back in again. It gets rid of a ton of the highs and lows that come with Type One Diabetes gives you more time back. It also brings a real security knowing not just what your blood sugar is but how fast it's moving and being able to share it with a loved one up to 10 of them actually on an Android or iPhone dexcom.com forward slash juice box and lastly but not leastly the Contour Next One blood glucose meter I've been using hardens all week actually. Because I've been wearing the glucose monitor I've been wanting to match my results. meters terrific. I've used it on Arden for a long time you know when she's sleeping it's you know my job, but I've never used it on myself until just recently. Absolutely everything I say it is and all the other ads goes double now for me Contour Next One small, easy to use, easy to hold. Test trips that you can hit blood miss it once and go back again without ruining it. Nice, bright light for nighttime, fantastic, takes a pretty small blood drop. I didn't have any trouble with it all. Find out about all the sponsors, there's links in the show notes of your podcast player and at Juicebox podcast.com. And don't forget that all the stuff Kevin talked about today that I have links for will be in those exact same places. Little music left. So let me thank you again for your listenership. And for your desire to share the podcast when you're finished with it. I'm seeing really incredible growth over the last couple of months, even when podcasts were affected by the covid 19 crisis, this podcast kept going. So thank you, thank you, thank you. It's a really big deal. And I will continue to do a good job for you best I can appreciate that you share that you listen and that you enjoy.
Seriously, I was really proud while other podcasts stopped putting out content during I guess, April, was a big month for everybody. It's just like, no one's listening to podcasts or we're not putting out and then they slowly kind of put some back. I'm seeing it with a lot of shows. I didn't have to do that. And that was really heartwarming to believe that people cared so much about the show that even when their lives were turned upside down, they still went to it. That really means a lot to me, and I appreciate it. Let me remind you that if you want the pro tip episodes of the podcast, you can go to diabetes pro tip.com. You can of course listen to your podcast app, but for new listeners, or someone who's trying to share just the pro tip episodes, diabetes pro tip.com no es pro tip and juice box docs. It's JU ice bo xdocs.com. I am building a list of listener approved physicians, CDs, that kind of stuff. Check it out if you need one. And if you have one, use that link to send it to me and I'll add your favorite doc. I think that's it right. It's got a big Alright, I'm out. See you guys
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The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!
#344 Defining Diabetes: Feeding Insulin
Scott and Jenny Smith define diabetes terms
Defining Diabetes: Feeding Insulin. Scott and Jenny Smith, CDE define the terms that are at the center of your type 1 diabetes care.
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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
This episode of defining diabetes is brought to you by Dexcom Omni pod. The Contour Next One blood glucose meter and touched by type one. Please visit touched by type one.org dexcom.com forward slash juicebox. My omnipod.com forward slash juice box or Contour Next one.com. To find out more about the sponsors. In this episode of defining diabetes, Jenny Smith and I will be defining feeding insulin. Now, you know Jenny, she's in all the pro tip episodes and defining diabetes and ask Scott and Jenny. She's also a person who's been living with Type One Diabetes for over 30 years. Jenny holds a bachelor's degree in human nutrition and biology from the University of Wisconsin. She is a registered and licensed dietitian, a certified diabetes educator and a certified trainer on most makes and models of insulin pumps, and continuous glucose monitoring system. Jenny services are for hire, check her out at integrated diabetes.com.
We're gonna get started in just a moment. But before we do, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical more. Otherwise, please always consult a physician before making any changes to your health care plan. or becoming bold with insulin.
There are people and I am not bothered by it. I'm just telling you there are people who come into the podcast as new listeners who if they hit the right episodes, once they get through an episode where you're not on it. They're like, Where's the woman go? No, no, I'm like, No, I understand. And like she's on these and these knees. And they're like, Okay, I get it. Like I got a note one time, please. Like, I don't understand where did Jenny go?
Jennifer Smith, CDE 2:01
Still here, I was like, Jenny,
Scott Benner 2:02
Jenny records podcasts like, like, she's tanning. Like, she's canning vegetables, he just makes a bunch of them, and then brings them out when she needs them.
Jennifer Smith, CDE 2:11
I feel like people think that I like live in your closet.
Scott Benner 2:15
Let me get Jenny Hold on a second.
Jennifer Smith, CDE 2:18
There she is right over here.
Scott Benner 2:19
There you go. Ask me your question.
I use this phrase. And in my mind, it paints a tapestry of idea. And I hear back from people and they'll say like, I don't understand what you mean. So. So I use this a lot. I say feeding insulin. So you know, I'm like, oh, you're feeding the insulin. And that apparently doesn't make sense to some people. So when I use that phrase with you, what does it make you think of?
Jennifer Smith, CDE 2:56
Yeah, feeding insulin means that you're having to actually, I guess on a negative side of feeding insulin, it means that you're putting in food to compensate for there being an excessive insulin that shouldn't be there. Right. So whenever you're feeding insulin, especially, and that's something it's a term I use when I'm talking to people about weight management. Because if you're constantly adding extra food, because insulin is driving your blood sugar down, then there's a problem. there's a there's a balance that's off, you're getting too much insulin from somewhere, whether it's bazel, or too much bolus or whatever, and you're constantly having to put food in to avoid drops. I'm now on the positive of feeding insulin. I mean, that's what we do. We we feed insulin with the carbs that we put in, but hopefully there's a balance there when we're feeding insulin that way. So and if you find yourself feeding insulin too much, you can you'll have weight issues. Yeah, that wrap around that too. And we talked about that a lot. The idea that because you have type one diabetes, and you're using manmade insulin, food seems like medicine. And so you stop thinking about it as calories where you know, sometimes, I mean, don't get me wrong, you know, in the moment, when you're falling, don't don't hold up Skittles and go, No, you know,
Scott Benner 4:12
a moment on the lips, a lifetime on the hips, don't think that think oh, I want to stay alive and eat the Skittles. But right, the idea is to not have to feed that insulin. So if you want to get a look into my mind for a second, there's gonna be an old reference, I guess. But if Pac Man is insulin, and the dots are glucose, you don't want Pac Man to have energy when the dots are gone, because he's gonna turn on you and bite your face. Right? Exactly. And he needs to have more dots until until he's done. And so, but there's ways to reverse engineer that idea as well. And I don't think that people would think about it this way. But I think I just created that situation with Arden just now. So by way of an example, she gets up in the morning, she still goes Going into school at home. And it's the end of the school year, she has to return her books to school. So she she leaves the house, Kelly takes her. And I don't know if she was excited or not, I don't know. But her blood sugar was sitting around 110. I was recording a podcast earlier today. And I told her, I'll make you breakfast when I'm done. So she left the house and the 110 went diagonal up and it went 115 120. You know, it kept going her auto bolus started bolusing at it from the loop and it leveled off at 140. Then she gets home and she's hungry. And so we bolused for the 40 points plus her meal. And we're going to create a fall that happens. And we're going to in essence, feed the insulin to stop the fall at a level number. And so there's, that's there's a positive way to think about it. I think when I use the term in public, or in my mind, I don't think of what I just did is feeding the instant I think of it as Pre-Bolus saying and timing the food instead of timing the insulin. Does that make sense? Okay, yeah,
Jennifer Smith, CDE 6:11
absolutely.
Scott Benner 6:13
Absolutely. But when I generally save, you know, you're feeding the insulin, my intent of that is to say, hey, it's possible, your bazel is too high. Because I you see, you find yourself feeding your insulin I when when people show me a graph, and it bounces. My first question is always, are you stopping highs with insulin on this graph a lot or stopping lows with food a lot? Right? And that moves me towards too much bazel or not enough? bazel? It's my first question. So anyway, when I say feeding insulin, or when you hear somebody saying that, I think that is a complete explanation of what I mean by that. Do you
Jennifer Smith, CDE 6:50
know, absolutely. And I think you know, when you talk about it in terms to have, like that weight management piece of it, I was just, I just worked with somebody who she said, You know, I feel like I'm eating more normally now. And I don't feel like I'm eating as much. And I'm actually feeling more. She called it real appetite. And I said, That's right, when we adjust your, your baseline levels of insulin the right way, technically, and she's not using loop. She's just normal conventional pumping, right? So um, you know, when she gets hungry for a meal now, she knows that she's really hungry. That it's not because her insulin is telling her, Hey, there's too much of me here, like your Pac Man example. Yeah, I need more food. Please put more in. So now she has more real understanding of what appetite feels like, rather than just insulin appetite.
Scott Benner 7:50
So I realize I'm just asking you, and it's your personal experience. But is hunger? Because you're low? Does it feel different than hunger? Because you're hungry? Where is it the same feeling?
Jennifer Smith, CDE 8:02
To me, there is a definite difference, like from my personal experience, and I think everybody might be different, but I can tell the difference. When I have hunger from being low. It's more, it's much more ravenous. It's, I need food now. And it's definitely like, I don't want to sit down and eat a nice salmon fillet and a salad hunger. It's, I would like to eat the whole entire, like container of glucose tablets, which we know it doesn't taste very nice. Yeah, right. So it's, I would say it's definitely more of you need something now. Whereas if I've, like skipped a meal, because I've been out in the yard gardening through like lunch hour or something. I can tell by the time I get to like the mid afternoon, even if my blood sugar has stayed normal, you know, hopefully has stayed normal through that time. I am. I'm hungry, right? Like I can tell the pit of the stomach kind of hunger difference from a low blood sugar. It's an it's a more now craving.
Scott Benner 9:06
I figured that out first. It was a time of day thing when Ottomans say she was hungry at like 930 at night. I'm like, she's not hungry. What is that? And then inevitably, in the next 20 minutes, her blood sugar would start to fall and I was like, Oh wow, she's feeling the drop before it's happening. And it registers this hunger for anyway, I think it's funny. It's the two small words but I think feeding insulin It teaches you a lot about how to use it you it is not your goal to be doing that. And and if you find yourself doing it too frequently, it is very possible that either your basal insulin is too strong or you're over bolusing it meals and creating Lowe's later you should not I know that seems obvious, but I don't think it is that people once they get caught in the in that little Have, I'm always low and I'm feeding, they get to that feeling of like, this is just what my diabetes is. But it doesn't have to be that way.
Jennifer Smith, CDE 10:06
Right? Especially with today's very smart, smart technology that we have to use, you know, years ago, when I was diagnosed, you did actually feed the insulin, because that's how the insulin works. And you know, your, your intermediate cloudy insulin, it peaked at a certain time. So you had to eat a meal and a snack at a certain time in order to coincide with when it's action kind of was there. Today's insulin, even though it's not as rapid as we want it to be.
Scott Benner 10:34
That's not as necessary.
Jennifer Smith, CDE 10:35
It's not as necessary. Yeah. So
Scott Benner 10:38
I, I hear that. Okay, thank you. Hey, here's some quick contact information for the sponsors. If you're interested, to get the dexcom g six continuous glucose monitor, you're gonna want to go to dexcom.com forward slash juice box, and hit the button that says get started with Dexcom JSX. It's just that simple. If you get there and you want to read a little bit, definitely check into it. Zero finger sticks, customizable alarms, and alerts, smart device compatibility with Android and iPhone, the ability to share data, or data, this depends on where you live in the country or the world. Although right now, some people are like it's data, or data, you're fighting with each other, but you're just fighting with the voice in your head. So don't do that. You can any anyway, no matter how you say you can share that data with up to 10. People, it's amazing, right? Your kid could be at school being tracked by their mother, father, grandmother, school nurse, or just a friendly guy, you met up the street, you're like, Hey, you want to watch my kids blood sugar. I mean, if you're, you know, if you're a hippie, you might do that, although do hippies have cell phones, I don't know, it's not for me to judge. Anyway, dexcom.com forward slash juice box, you're also going to want an omni pod tubeless insulin pump, that you're going to get my Omni pod.com forward slash juice box. And on the pod has quite a little deal where they'll send you a free, no obligation demo of the AMI pod to your home so that you can wear it and check it out. I've worn it on the pod demo before. It's astonishing how quickly you forget you're wearing something. And you'll really get a feeling for what it's gonna be like to have a tubeless insulin pump, right, just this little device that's with you, and nothing else to clip to your belt or stuff in your bra or do anything like that with and there's no obligation. So I mean, if it doesn't cost anything, and they're not holding you to it, you might as well give it a try my omnipod.com forward slash juice box. And of course, if you go to Contour Next one.com there's a button at the top of the page to see if you're eligible for an absolutely free blood glucose meter. And I have to tell you a little more context now because at the moment, I'm wearing a Dexcom Pro to get the feeling for it. You'll hear me talk about that later. But because I'm doing that I'm testing a lot. So not just with Arden, but I'm testing myself to get a feeling for you know where the CGM sitting with accuracy. And all that stuff that I've been telling you has been my experience about using the meter with my daughter goes double for me. Small, convenient, accurate. pocket size. It's great, the light works great at night. And trust me My eyes are you know what I mean? And I what they used to be Contour Next one.com and of course, touched by type one, please, please please go to touched by type one.org to check out the good work that these amazing people are doing. For children living with type one diabetes, and people with type one diabetes in general. They raise money to support a cure. They put on all these kinds of great programs to support the community. You can be part of it touched by type one.org. We're just gonna tell you one more thing before I go short episode today. So today we defined feeding insulin. But there are many other defining diabetes episodes. It starts way back in Episode 236. And some of you are going to say Look, I know what Bolus says Scott, I don't need that episode. But you'd be surprised about how many new people with type one diabetes don't. So Episode 236 is Bolus 241 honeymooning 245 time and range 247 standard deviation 249 extended Bolus 251 algorithm 253 non compliant 255 glycemic index and glycemic load 258 Pre-Bolus 260 Trust will happen to 69 low before high to 84 brittle diabetes 286 stop the arrows 288 ketones, 295 insulin resistance and overall singing Of course today Episode 344 Feeding insulin. And there are many more on the way that was all very confusing to you, you can go to Juicebox podcast.com and scroll down. All of the episodes are there. Actually the Ask Scott and Jenny episodes are there as well. And the diabetes pro tips and of course, all this is condensed way down at diabetes pro tip comm if you want to check out the pro tips, we're share them with somebody. That's diabetes pro tip.com.
The point is at the end of tip, see what i'm saying diabetes pro tip, there's no s. No s at the end of tip. It's just tip, and then the dot and then the calm. That's my tip for you today about how to spell diabetes. Perfect. Thank you very much to Jenny Smith for coming on the show as she always does to help us understand terms and ideas. bigger, more vexing Type One Diabetes issues. She really is the best Asus there is an S at the end of best assist, but not at the end of diabetes pro tip calm. I mean the English language is funny punctuation right
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!