Scott Benner 12/10/20 Scott Benner 12/10/20

#418 Dexcom G7 Update

With Dexcom CEO Kevin Sayer

Kevin Sayer returns to talk about Dexcom. Learn more about the Dexcom G7 and find out how you can see video and pictures of the new G7 right now.

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

G7 Video and images - Watch Scott’s blood glue live

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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 0:07
Hello, everyone and welcome to Episode 418 of the Juicebox Podcast Today is a special episode for a number of reasons. I have Kevin Sayer back, and Kevin is the CEO of Dexcom. He's here to tell us about what's happening with Dexcom. It's giving me as much information about the g7 as he possibly can, and some of it is very exciting. We talked a little bit about how Dexcom is doing and where they're headed. I asked him as many of your questions as we had time for I only had Kevin for a half an hour Today's been really busy. But I got in as many of your questions as I could. And I'm already making plans to have somebody from Dexcom come back on and answer the rest. At the end of this podcast episode, I'm gonna give you two links. The first one is going to allow you to watch my blood sugar live online, so you can see how it working pancreas functions, and I'll talk about that with Kevin inside of the episode. At the end of the episode, I'm going to give you a link where you can go see pictures and video of the new Dexcom g7. Right now though, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, please always consult a physician before making any changes to your health care plan, or becoming bold with insulin. If this is your first time listening, hit subscribe in your podcast player don't have a podcast player, get one. This episode of The Juicebox Podcast is sponsored by the Omnipod tubeless insulin pump, you can get a free no obligation demo of the Omni pod sent directly to your door right now by going to my Omni pod.com Ford slash juice box. When you get there, you put in a tiny bit of information. And guess what? They'll send you an omni pod right to your house. It's nonfunctioning so you don't need to be scared of it. But you can wear it and see exactly what the process looks and feels like for you personally. And if you'd like to find out more about the Dexcom g six continuous glucose monitor, go to dexcom.com forward slash juicebox. dexcom is a longtime sponsor of the show. This ad is not just here because Kevin is on today. dexcom.com forward slash juice box my omnipod.com forward slash juice box and let's just throw this in for good measure. Checkout touched by type one at touched by type one.org absolutely fantastic Type One Diabetes organization. Okay, before we get started with Kevin, I recorded myself putting on a Dexcom g six just a couple of hours ago. And there's a special guest with me helping me out.

Okay, everybody. Hi, Scott. I'm gonna put on a Dexcom g sixth.

Unknown Speaker 2:52
Right now, actually.

Scott Benner 2:55
Where did I put the box? I see it. It's a Dexcom je six but on the box. It says hello Dexcom which is a new opportunity from Dexcom for people to test drive the Dexcom heaven say who is going to be on the show and just a little bit to tell you more about it. But I have one right here. And also if you're listening to this now, and it's December 10 2020. Let's see if it's between December 10 and December 20. My blood sugar will be live at Juicebox podcast.com forward slash CGM live. And I'm going to double check that to make sure I'm right about that. Yes, Juicebox podcast.com forward slash CGM live. When you go there, you will see my blood sugar in real time. And I'm going to be putting in the food that I'm eating. My goal here is to give you a reasonable look at what a functioning pancreas does. So that you can have an idea of what it is you're shooting for. As you're managing type one diabetes. Alright, so nice little box. It's like there's like a startup guide in there. You have to go to dexcom.com forward slash hello to activate it looks like and here's a sensor. One banging into the microphone and a transmitter. Okay. Let's see. I know how to do this to somebody else. But I don't have a lot of experience doing it for myself.

Wash and dry hands. I just got the shower, peel off adhesive backing, do not touch adhesive place applicator on skin, fold and break off safety guard. press button to insert sensor remove applicator from skin leaving patch and hold her on. I know how to do all that throw away applicator. Clean transmitter with alcohol wipe, insert transmitter tab first, snap into place. Rubber out the patch three times so far I know what I'm doing. And the rest is for after the sensor session ends, it's about how to get rid of it when you were done. Okay. Look into my startup guide.

guides nice it explains everything your smart devices, shows you what the applicator is shows you how what's interesting, it shows you how the transmitter excuse me, it shows you how the sensor bed is inside the applicator shows you what the transmitter is how it works to your phone, choose app receiver, both

of the other Dexcom receiver you can use the Hello Dexcom with it.

Unknown Speaker 6:11
Set up the app

Scott Benner 6:14
tells you how to set the app up. Alright, I'm gonna put this on. I kind of want to put this on my arm. I'm gonna try to get some help. Hold on one second. I'll be right back.

Okay, so I'm going to put this G six on, but I'm going to put it on the back of my arm so I enlisted a little help. And somebody here who you've never met before. Just say hello, hello. Get a little closer to the microphone.

Unknown Speaker 6:49
Hello. Okay, this

Scott Benner 6:50
is Arden. Arden is going to help me with the application. You know what you're doing? Open that up for me. I'll get the transmitter. So I'm going to put it What do you think? Should I put on my dominant arm or my arm? I don't use as much. You have no opinion about this whatsoever. All right, I'm gonna put it on my left arm. So want to put it let me take these headphones off. I want to put it

Unknown Speaker 7:28
like what do you think? Do you want to go this way? Or this way? What do you think? It's up to you.

Unknown Speaker 7:38
And I think it should be back here more. So like this. Do you want to go in this way? and have it go the other way? This way? Yeah. Like, where will that be when I'm standing? Here? Okay, let's do that. Okay, good to see ya. Take off the sticky.

Scott Benner 7:58
Wait, we should follow the directions. We do this all the time. Yeah, no, but this is like a different might be a little different. says when prompted enter your sensor code. All right. I guess we can stick it on now. Right. All right. You're on the microphone. Sorry. God. You put it you figure it out.

Unknown Speaker 8:25
Let's just figure

Unknown Speaker 8:26
it out. There,

Unknown Speaker 8:30
okay. Push it down real good. Okay, now you're gonna do the Take this. You're going to do this like pull away method with the pinch. No idea what that means. So pinch it, like give it a little tension.

Scott Benner 8:51
And then kind of pull slightly away from the direction it's gonna go in.

Unknown Speaker 8:56
Okay, can you turn this way? Yeah.

Unknown Speaker 9:00
What am I doing?

Scott Benner 9:04
As I push it, yeah, before you push it, hold it there. I'm ready. This feels wrong. Okay, just do it. Oh, I didn't even feel it. It's done. Yeah. Nice. Okay, push down on the stuff for me. Okay, clicking the transmitter. So put the shower cover on.

How's it look? Alright, do better than you do. What you did it better than me. Say hi to everybody. Just say hello. or didn't hear she's helping me put on the G sex transmitter. So we just put it on. And I'm going to set it up as an app on my phone as you do. And then I'm going to make it available for you to see online. So it's on it next. So as to take a picture of The transmitter box that says

Unknown Speaker 10:07
done.

Scott Benner 10:09
Enter the code from the sensor. It wants to pair already with it. Take a picture of the sensor code

Unknown Speaker 10:19
done.

Scott Benner 10:22
Next sensor has been in and start center. So I'm in the warm up. Thank you. Arden. Come here, come a little closer to the microphone. tell everybody what you're gonna do next year. Say it. Say it. Arden's gonna be on the podcast, aren't you say? Say, say, say? You are though, right? Yep. Yeah. Look how excited she is about it. tell people exactly how excited you ready to be on the podcast. bare minimum bare minimum excited. That's not bad. Right. Okay. Well, thank you very much. And here comes Kevin Sayer with some news about Dexcom. And then I'll give you details at the end about how to follow my blood sugar. And how to see video and images of the brand new Dexcom g7 coming in 2021.

I can't unmute you. That's because I'm not used to someone else starting a zoom call. I'm used to being the one in charge. Okay, well, this is perfect. I just, I have mine set up to come up. unmuted. Let me just check you on the recording.

Kevin Sayer, Dexcom CEO 11:35
I usually start on mute as well.

Scott Benner 11:37
Yeah. Let's see. All right, you're good. Well, how are you?

Unknown Speaker 11:44
Good.

Scott Benner 11:45
Yeah. I I see

Kevin Sayer, Dexcom CEO 11:47
Christmas boxes in the back. You're at least attempting to celebrate?

Scott Benner 11:51
Yes. Old St. Amazon comes every day here. It seems like it's just Yeah,

Kevin Sayer, Dexcom CEO 11:56
I know how

Scott Benner 11:58
that goes. That's awesome. Not exactly the most fun way to a holiday shop for people. But no,

Kevin Sayer, Dexcom CEO 12:04
especially when they see it dropped off and go. What did you get me?

Scott Benner 12:07
Someone checks there? The box like, Oh, this isn't for me. And I think the unspoken end of that sentence is and I know what I'm getting for Christmas. So it's we're doing our best. Not the worst thing.

Kevin Sayer, Dexcom CEO 12:18
Hi. We all we're all just doing our best.

Scott Benner 12:21
Yeah, I mean, maybe right. Maybe the vaccines will start to to get in use. And this time next year, this may be it'll be a little bit of a mess this

Kevin Sayer, Dexcom CEO 12:30
time next year. I think we could I think we could expect to be in a good place this time next year.

Scott Benner 12:35
Yeah. I know. My wife is downstairs killing herself working on one of the vaccines. So if she Yeah, she worked with. She works for Janssen. Okay, so she's working on Yeah,

Kevin Sayer, Dexcom CEO 12:48
here. And I've read very good things about about that

Scott Benner 12:52
vaccine. Everybody's got their fingers crossed, that's for sure. I if everyone's working half as hard as she is we should be okay. So awesome. Down there all day and night. So I have to say the last time we talked, I teased that I asked if anybody had any questions, and I sorted and get any. And I did it two hours ago, and I am up to 305 questions. So I might have jinxed myself. I

Kevin Sayer, Dexcom CEO 13:13
think we got I don't think we are talking 305. So

Scott Benner 13:16
a lot of them seem more Jake related. So I might have to maybe I'll hassle Jake to come on in the in the new year.

Kevin Sayer, Dexcom CEO 13:23
Well try me. And then if I can't do it, I'll do it in general terms, and you still ought to have Jake on anyway.

Scott Benner 13:29
Cool. That sounds great. All right. Yeah, he's been great. And these are a lot of technical, more technical stuff, like people ask him for things about apps and stuff like that. But anyway. So you had a, you had your revenue call yesterday, and I feels like you let some new information out into the world. And I thought I would get a piece of it here on the podcast.

Kevin Sayer, Dexcom CEO 13:49
Sure. We had our investor day yesterday we do. We've done two now we did one in 2018, where we told the world that we would be at $2 billion between two and two and a half billion dollars in revenue by 2023. And we gave him some profitability metrics as far as operating margins and such. And as we look at the end of the 2020, we're not quite to $2 billion, but 1.9. And we've exceeded the operating margins we gave them back then. So we felt it was important to reset the bar and give everybody a clearer vision because obviously the growth has been faster than we had projected at that time. We didn't project growing another 40% each of the last two years combined. Yeah, you know, and continuing that growth rate. And so we want to make sure everybody knew where we were coming from and and we said another five year target to four to four and a half billion out in 2025. We talked about our three pillars of growth. And then this is our base business in US type one intensive insulin management because that's the backbone of our company. That's where we come from. Those are our roots. We always want to be big in that market, then going moving to type two patients who aren't on insulin in the US to start but you know, elsewhere in the world on top of that, and then finally, geographical expansion more into our, our core type one business we we don't have near the revenue Oh us as we do in the US and we need to, you know, become more of a global company, we have plans to do that. And we laid some of that out. We talked a bit about our future product offerings. And, you know, just some of the things we see it was a good day, very well received by and large. Excellent.

Scott Benner 15:32
Now, you guys very recently, you're in is the g7 in Australia yet? It is right or no,

Kevin Sayer, Dexcom CEO 15:39
not quite. I think it's fair. There's just been one other administrative snag there close. There'll be there very soon.

Scott Benner 15:46
Yeah, I hear from Australia, a lot. People in New Zealand, Saudi Arabia as a country, I hear from listeners a lot, looking for Dexcom. It's interesting, where

Kevin Sayer, Dexcom CEO 15:55
I hear the same thing. And we were working on distribution arrangements in Saudi Arabia that I haven't yet been finalized. But I think they're very close to getting the right distribution partner. One of the things about a company like Dexcom, that's somewhat lost on people. When we decided to go to Saudi Arabia, we don't have anybody there. Whereas you take the larger conglomerates, the j&j, the Abbott, the midroc, whoever, well, they have other businesses in Saudi Arabia, they do business there, they have somebody to call, they have somewhere to go, we don't. And so we figured out from scratch was as led to some great experiences and some great learnings. But it's, it's just something that is kind of ignored, is a very complicated factor

Scott Benner 16:42
in growing a business, you literally have to start from the ground up, you have to build Dexcom in a new country. Well,

Kevin Sayer, Dexcom CEO 16:47
and I think, five, six years, six years ago, we had three or us employees. And now we have several 100 direct offices in the UK, Canada, Germany, our corporate headquarters, Ramya. In Scotland, we have our call center, Manila, started a manufacturing plant in Malaysia, and we're setting up another call center for our, our EMEA business, or you're a business owner in Lithuania. So literally, we are fulfilling that. But we have to build it all from the ground up. We don't have anything

Scott Benner 17:22
else to rely on. Do you share how many current users you have?

Kevin Sayer, Dexcom CEO 17:27
We did we shared 900,000 was the number we put out yesterday. And that's active users. It's not you know, a this one bought a receiver this one, but it's based very much on on actual data, who we sell centers to it cetera. So that's a good number. That number was in the 600,000. Last year. So obviously, we've grown a lot. And that's absolute growth in active users, not just users, we've really done a good job expanding technology. And we'll push it much harder. Even next year.

Scott Benner 18:00
I wonder how many people realize that companies will report like a million people downloaded our app, but only 10,000 of them ever opened it. But when they talk about they're like we have a million users. And

Kevin Sayer, Dexcom CEO 18:10
well, it's like, in the old days. We used to talk about going way back to 2008, nine months board member we based on how many receivers we sold. That's how many patients everybody thought we have. And that was it. I mean, that's how sophisticated it was. And if those receiver sales didn't meet the quota of the analysts, when everybody thought the world was ending, it's not that way anymore. It's but you know, you try and develop analytics and all this stuff you do the best you can. We have certain groups that are hard to track. I mean, for example, a tandem pumper who doesn't ever download their day to clarity and they buy their centers from from the pharmacy, we may never have visibility to that person. And their use cases. Patients use the receiver all the time we get visibility them if they downloaded clarity into their office, doctor's office, but otherwise we don't have as much bill visibility that so we have to come up with other metrics through groups like acute VA and pharmacies to to track and

Scott Benner 19:18
make sense. I happen to be wearing a Hello Dexcom I

Kevin Sayer, Dexcom CEO 19:23
just Oh, you got the highest so you're doing the Hello Dexcom experience

Scott Benner 19:27
I am I just put it on. It's not It's not even through the warm up yet. It's gonna be on for about another hour. And it got me excited right away because I don't talk about it usually, but my brother has type two diabetes. And he he should have a Dexcom he just should. And I don't know if I've ever been able to explain it to him in a way that you know, some people just don't hear it. So now I'm excited that he can just he can is that am I ready? You just go to his doctor and ask for it.

Kevin Sayer, Dexcom CEO 19:54
He can try it. He can get a prescription now then the tough part for your brother. If he's hot. on multiple daily injections or a pump, and he should qualify with most payers certainly with with, with Medicare and Medicaid programs. But yeah, he can get a prescription he can try it and he can learn. And we just, you know, patients have asked for that forever, we had to restructure our business. To do that we were there were certain federal laws that prohibited us from a sampling program. We've gotten out of the business activities that prevent us from doing that. So we we can, we just think the sampling program is very important to give people an idea of what they're going to experience. And and Scott, you know, this, if you go back in time, particularly two, three years ago, where we had very little pharmacy coverage and didn't have the commercial reach, we have now going through the paperwork to get a Dexcom. And then paying that copay, upfront, just to try it was something a lot of people really struggled with doing. Yeah, well, now we can give you an experience, okay? Where this right, we're confident you'll like it, we're confident you'll learn about your body, learn about what you eat, you'll learn about your workouts, you'll learn good things, and and we think it's going to be a great tool for clinicians and for patients, well, I'm

Scott Benner 21:11
going to use it. So the reason I asked for it was, I've actually, I've got it set up on my website. So when this goes live, anybody's gonna be able to watch my blood sugar while I'm wearing this sensor, okay, and, and oh, so I wanted

Kevin Sayer, Dexcom CEO 21:26
I tell you what not to eat.

Scott Benner 21:28
Well, I'm gonna go the opposite way, I'm gonna I want to show people who are using insulin, how a pancreas works, so that they don't freak out when they see a little bit of a rise sometimes and comes back down. You know, I think too many people are shooting for an absolutely stable line at 85 that never moves, and it makes them crazy sometimes. So I thought, let them see what it really looks like, if you don't have diabetes, maybe that'll make them feel a little more comfortable.

Kevin Sayer, Dexcom CEO 21:53
So it's interesting, you say that, because I showed my line to a leading endocrinologist and you know, I wear these a lot. And his response to me was your lines too flat, either you're not eating anything, or you produce too much insulin, and that's not healthy either. Wow. And, and, and physique wise, carrying too much weight in the middle, which I do, anybody who knows me can see that. That's a sign of over insulin production. So I, I watch that pretty closely. It's okay to have a spike, you're right, it is okay to have a spike. Now, the spikes that you create that are bad. I mean, I can give you a list of my top 10 worst foods pretty easily. The worst by far is chocolate covered raisins. Because you combine the rapid acting sugar in the chocolate, the rapid acting sugar in the raisins, and then you get another shot from the fat from the chocolate later, I can send myself into a glucose coma with that. And I learned that I said an investor conference back in the g4 days wearing a sensor and my glucose hadn't moved at all. I was in the airport and I got myself a cup of chocolate covered raisins and ate it and it's probably one of the two or three times I've broached the 200 mark, ever. And it wasn't a good thing. But that's that's probably my nine raisins are held that raising all those foods are fine for you. It's just moderation in them and understanding what to do so yeah. Well, people are going to have fun watching,

Scott Benner 23:23
I'm going to let everybody actually after they watch now that I figured out how to act, allow the data to be accessed. I'm actually going to let listeners who feel like they're really great at bolusing for certain foods, let them go live eat a meal and show people how they do it so that people can learn from each other about how they Bolus so I'm kind of great What a great service and community I think that's gonna be something Hey, are there any foods that you have learned that you just don't eat anymore? Or do you

Kevin Sayer, Dexcom CEO 23:51
worry about my laundry cars use anymore? And it wasn't great some requests for me but I loved it but that gives me a huge spike. Me personally, I think I've learned some things that aren't as bad pasta and white sauce is bad and I will occasionally have it because I I like it so much but boy I think twice about it. Yeah, some foods not as bad as I thought like for me a piece of chocolate cake is much worse than a bowl of ice cream. As far as a glucose spike for me and I would prefer the chocolate cake. But so you start looking at things and I obviously am not so physically fit that I've eliminated everything bad from from my diet but and you think twice about quite honestly about about bread you know, do I really need that rice. Rice is a and those sweet sauces with Chinese food are a killer. So if I you know there's a when I'm in the office, there's a barbecue place downstairs, a fresh grill place I get the veggies in the steak without the rice and My glucose doesn't move at the rice up. So I bet you'll learn things like that and sauces. Because I love a teriyaki sauce or something like that it, it makes everything significantly worse. My other biggest learning is just exercise. If I get a good workout in the morning, I have a glucose spike with a workout. But the entire rest of the day is 10 to 20%. better for me, well, no matter what I eat, because just getting your body to get things moving, I think does mean a tremendous amount

Scott Benner 25:34
of good helps your insulin be more effective. I got a bunch of questions. And I think this is something you guys must have spoken about yesterday. But a lot of questions about app updates are follow and are those apps being updated?

Kevin Sayer, Dexcom CEO 25:49
Well, I can walk through it. g seven will obviously have a brand new, we said to show. So we'll have a brand new app, completely different experience than what we have with G six. And our goal here is again, to create something more engaging, we certainly are going to get rid of our the the arrow and the you know the up and down thing or we think our glass has kind of a trademark for us and graphs. But adding some of the retrospective data from clarity into the app to give you a direct time in range computation, for example, and things like that at right in the app rather than going to another one we think will be very helpful to patients. So we've got a new app coming for g7, we announced that we are going to launch a couple of other products with different user experiences we didn't get into the details. But those are coming we are working on on a follow upgrade. And that's when you'd have to talk to Jake more about because you know follows not a product that we charge for. It comes with the system, but we you know, ever since the outage that we were talking about a year ago at this time, and I still wake up in a cold sweat with nightmares about for the patients not for me. Yeah, you know, I, I, we've done nothing but work on that platform to make it more robust. And we continue to invest in it because I think ultimately this data is going to be critical to our future success. So we are making big investments or you'll see a new follow up. Okay, but I can't really give you a time frame of that. I know they've been working on it for quite some time here.

Scott Benner 27:19
androids in that working to

Kevin Sayer, Dexcom CEO 27:22
Android is working out for follow, I'm sure they'll do both we we do have a an upgrade to the Android app coming. And we couldn't override the mute button with Android. And we've had discussions with FDA about trying to get to the same place we got to with iOS on the mute button, we are working towards that. We did announce there is a new there's improvement to the algorithm that just got approved, it will not be out immediately. They'll be out soon. We have to since we embed our firmware on the transmitter, we have to go through the transmitters we have an inventory now that what that algorithm does really those sensor failures where data shuts off, we eliminate a lot of those with this upgrade. And so with the with the new algorithm, the team has worked very hard to make the product better and and you know, we want to deliver the experience we promise. And and that's why we've been a bit you know, people asked a bunch of questions. Last earnings call, why are you doing g seven, you know, for 10 days to start? And the answer is very simple. We want to deliver 10 days like we promised it's taken us a while to get g six to the 10 day delivery point that it is now but instead a very good place. These can be better with that algorithm, we can do the same thing with G seven. The accuracy of the product 15 days is not the problem. It performs very well we show to display a chart in the presentation show how well it worked. It's just as he said, we got to make sure we have the right adhesive that they don't fall off and number two to meet I CGM standards. And as we as we do this, we do turn the sensors off. And if appears there, they're not going away. It should be in anticipation of that rather than give a patient that data. We don't want to be turning a bunch of sensors off at 12 or 13 days. And our reliability data. You know right now it's a 15 day we showed in chart was around 71%. That's not good enough for us. We need that number to be higher. We don't want to say hey, you get a 15 day sensor but you can call us 12 days every time and get a new AI now think of the business model what what are we accomplishing with that so we'll get there. Right? But it's just a it's a question of time but those are the things we talked about on the technology side we showed more pictures of g7 how easy it is to use, how easy it is to put on. We showed some real about the automated factory everything is automated all the steps to it so we think we can scale very quickly as we Get Real Estate, replicate one manufacturing line from the next and get going, we've got the first few in and we'll have several of them up and running before the end of the year. So I'm good on that future technology side.

Scott Benner 30:12
So you think not holding you down anything but this time next year you and I'll be talking about g sevens on the leash

Kevin Sayer, Dexcom CEO 30:20
I what we've said, and I go back into our statements, we said we'd launched it in 2021. Okay, it's now going to be a function of how quickly we can execute our clinical studies, prepare submission and get it filed. all at the same time while scaling up, we will launch it in 2021. And we've said geographies, which means certainly there's some international element to this, we've finished this study that we just filed on clinical trials.gov for up to 150 patients, we finished that. And in November, we're analyzing that data, we have more studies that start that'll be included in submissions in January. And we'll update people more as we go. A lot of it's gonna depend on how we how well we execute or confident in a product's performance. These ice jam standards, the FDA is set Well, there's part of me that will sit in bitch about how hard they are to me, I'm gonna tell you something, if a product can meet those standards, what the FDA did is they said you got to be good. If you're going to do this, you have to be really good. And and and that's what makes it tough. We have to make sure we're really good. And you've got to get low glucose into steady high glucose points across the board. I mean, they really addressed all the problems that happened with CGM, when they hit those standards and to fit in those buckets, you got to be pretty well. And we want to fit in those buckets to whereby we did announce our warm up will be an hour or less. That a lot out of town what we seen the clinical study faster, warm up is good for us. But when we're done with warm up, we want to be done. That you can rely on the data immediately not wait for 12 hours before you can make an insulin decision like others have done or have to calibrate it four or five times or we're not going there. We know what our patients want. And we need to deliver it then those are the decisions that

Scott Benner 32:08
we're making. And that one hour warm up that'll be for g7. It's not

Kevin Sayer, Dexcom CEO 32:12
Yeah, I said I said one hour or less. I haven't given you the we have place that we have it we have a we have I have my aspirations, the team has their aspiration. And then we have the our on the upper bound. So we'll see where we land, Kevin's aspiration is always turn it on and go and they aren't to my aspiration yet. So we'll see. Ironically, I don't know. It's really interesting to study sensor data and learn about that. It does take a while to warm up. But that's very much a function of into into individual physiology as well. There's some people you can put these in and they go immediately there's some people you put them in and it takes a while. I'm starting

Scott Benner 32:49
to learn that with Arden it it's um, depends on some of our hormones. Actually, I get a different reaction certain times of the month. Wow. Wow, I

Kevin Sayer, Dexcom CEO 32:57
did not know that he or she I haven't I've had I've been I've had other parents tell me that.

Scott Benner 33:02
Yeah, it's interesting. I got a question about COVID assistance you guys offered it is there any chance it's going to be extended?

Kevin Sayer, Dexcom CEO 33:09
We'll continue to offer COVID assistance to Dexcom patients who lose their insurance. And that program is relatively robust as far as, as patients, it's, you know, for our patients, and there's a process they go through. We do have an outside party, administer, administer it. But yeah, we will continue with that program. And we'll analyze it and look at it and see if there's other things we should do as well. I can't commit to anything, but I have asked the team to look at some other things we could do. But if you're on Dexcom last year insurance and come to us, we absolutely can get you in that program.

Scott Benner 33:46
Okay. A couple other quick ones. A lot of people just wanted me to convey that they love Dexcom that happens all the time and how great it is. But almost equal number of people asked me to ask you if you could make some green considerations about packaging, who was that they just they liked to see less cardboard and stuff like that. So I thought I would tell g7

Kevin Sayer, Dexcom CEO 34:06
is maybe half the size of G six. As far as the insertion device. The box is much much smaller. With respect to the cardboard and the packaging. It's interesting. We've had long writing discussions with the FDA about how much we have to publish and put in a box on the green factor. Couldn't we do this all electronically but it's a medical device. FDA relies on labeling and they believe patients read all the labeling and may not go to online to read them all. I think you'll see a lot of that stuff change. We are looking at Green options for the future of other changes, we can make less class less plastic, obviously 15 days versus 10 is less plastic. But at the same time, 15 days if it doesn't work 15 days in and being more plastic. So we're we consider all that III agree with everybody on that one I think we need and we are better, we will be better. Ironically, as big as the G six applicator looks, it really was no more plastic than the G five

Scott Benner 35:10
What was I realized? While I was looking at people's questions today that I'm steeped in this 24 hours a day for years. So when they ask questions, I'm like, we've answered that question before, but I realized they're new to it, and they don't, they don't see it, you know,

Kevin Sayer, Dexcom CEO 35:23
everybody's a different place. And I'm happy to address those.

Scott Benner 35:27
I appreciate it. Somebody asked me to ask, you know how you you guys are free with your data for like, third party apps? Is there any changes coming to that? Or is that gonna stay the way it is?

Kevin Sayer, Dexcom CEO 35:37
They'll stay the way it is. Okay.

Scott Benner 35:39
So apparently, there was a rumor floating around that that was gonna change. And it got to a person who third

Kevin Sayer, Dexcom CEO 35:44
party apps. Now the question becomes, or where this becomes difficult over time is those who who use the data in their own ad systems and things like, you know, patient choose our data and our things for a number of varieties of activities, does this become a an activity that Dexcom cuts off for everybody else, and we monitor it closely we watch. We've had discussions with the FDA, we've we've, you know, we've been tried to be helpful with the patient community, there may, there may come a day when we can't, I would love the opportunity or the ability to be able to figure out a way to do this in a structured manner. But so far, it's been tough, but now we're not we're not shutting out third party apps at all, if anything I want, I want more of them. And and maybe someday, you know, again, you asked me like to the future, maybe there's a day where we say, you know, but your app doesn't do anything for us. It's okay not to go there. I don't, I haven't seen that yet. But but we'll see. There might be some. But right now, we've been pretty open with that.

Scott Benner 36:53
When you when you do upgrade to another sensor, when g seven comes out, is all the other. The pumps that now are incorporating g seven in their algorithms like on the pot horizon or control like you, that's all taken care of.

Kevin Sayer, Dexcom CEO 37:09
So here's how this, this will work. g they're all up there, all with G six, right now, with G seven having an ICBM level, they will integrate with G seven, but we have changed the electronics in the interface of G seven from g7. For example, we've added heightened cybersecurity to the g7 chip, because it's available now. And that's a very big concern of everybody out there. And so they will have to do some more work to integrate, they won't have to run a study. But we'll work with our partners. In fact, we're working with them now giving them access to g7. Saying, here, let's start building this today. So there will be some lag, I hope it's not more than six months, but put a look at a six month window because they will have to file and just say, Hey, we're working with this and get approval, no additional clinical studies if we're an IC jam. And I think that's where the FDA has been very helpful. And we've tried to be cognizant, I mean, and I go back in time, the way our transmitter works with the phone and sends you the number, it doesn't send you just a bunch of electronic goopy goop that you figure out some glucose value. This is very easy to integrate. And we we built it for that integration was one of the primary considerations we had when we went from the g4 to the G five platform. So it we're trying to ensure this, we know how to do it, we've worked with several partners. Now we don't have all the offerings that we'd like to have, but we're gonna do and I think and there's other ways to do it as well. app to app can work, which is one way that people are doing it. I like it best when the data is embedded together. But over time, you'll see a number of different options here.

Scott Benner 38:53
Yeah, I think the fear gets in people. And I don't even know why because I Arden has you know, we have an integrated system that Arden's using, and it's terrific with G six, I hope it will be even better with G seven. But if you if you drop g seven today and said here it is, and I had to wait six months for it, it wouldn't okay. Yeah, I don't think much would change for us to be perfectly honest. That's the fear

Kevin Sayer, Dexcom CEO 39:16
and and you know, it really doesn't. And it's in the past, it was a big deal. Because, again, that hardware those receivers in those transmitters people spend so much money on them when you dropped a new sensor and they didn't want to give it up. And I'll be honest with you, we still have some we shut g five down earlier this year, we still have some g five patients who send us letters saying how could you possibly

Unknown Speaker 39:41
take this from G five?

Kevin Sayer, Dexcom CEO 39:43
So yes, but g six is going to be around for a while to support the integrations and and geographically we while we want to have a lot of capacity on the go, we can flip the entire switch and we have capacity to build 10s of millions of G sixes. There's no need to we'll make unavailable for some period of time. But what the beauty of G seven is you don't have to buy another transmitter, you'll be able to switch over the day is compatible because the transmitters built in and go pick up a couple sensors and go

Scott Benner 40:12
that opens you up to the question that you answer all the time. But I just for people who are listening new, direct to watch Apple Watch connectivity, that's going to wait till g7, right? That's

Kevin Sayer, Dexcom CEO 40:24
it is in the electronics configuration and g7 is just much better suited for this. It's better suited to communicate with multiple devices. You know, if you think about, about the devices that you have that have Bluetooth, how many of them talk to four or five things at the same time? Well, that's what people want us to do. And we've engineered it to talk to multiple, multiple devices at the same time. But that's hard, you know, your earphones, talk to one, your phone talks in your car, but you might lose something else. I mean, Bluetooth is evolving and becoming more sophisticated. But it's just it's something that we're very cognizant of, I think more cognizant than anybody else in the marketplace? Well,

Scott Benner 41:04
I have to say that people's misunderstanding about how the technology works, was never more evident than today. When somebody and I won't use their name, obviously, I don't want to embarrass them asked if you could add a Bluetooth extender to it. And I was like, how would that even work? Would you bolt it to like what I wear it on my shoulder? Would it be a little antenna off my ear and it's just somebody who just desperately wants the Bluetooth range to be longer, you know?

Kevin Sayer, Dexcom CEO 41:25
Well, and hopefully we'll have great range with the g7 and I I do have my next call Scott. It's always a pleasure to talk to Jake about all the technical things have him back on the show.

Scott Benner 41:35
He'll be great. All right, Kevin, thanks so much for being here. Hey,

Kevin Sayer, Dexcom CEO 41:38
it's great to have a great holiday

Scott Benner 41:39
YouTube. Merry Christmas.

Kevin Sayer, Dexcom CEO 41:40
Merry Christmas.

Unknown Speaker 41:42
Oh by

Scott Benner 41:44
a huge thanks to Kevin and Dexcom for coming back on the show. Thanks also to Omni pod for being a sponsor. You can find out more about the Omni pod tubeless insulin pump and even get yourself a free no obligation demo pod sent right to you by going to my Omni pod comm forward slash juice box. Learn more about the Dexcom je six and get started@dexcom.com forward slash juicebox. And of course touched by type one can be found at Facebook, Instagram, and it touched by type one.org. If you're interested in watching my blood sugar, and it's between December 10 and December 20 2020, head over to Juicebox podcast.com forward slash CGM live. And if it's not in between those dates, check it out anyway, you might catch someone else sharing their blood sugars. At the very least there'll be an announcement of when the next blood sugar is going to be

Unknown Speaker 42:44
live

Scott Benner 42:46
Juicebox podcast.com forward slash CGM live. And if you'd like to see video and pictures of the Dexcom g7 the videos really cool. Go to Juicebox podcast.com. forward slash Dexcom g seven d x c o m g and then number seven Juicebox podcast.com. forward slash Dexcom g7 to see those pictures and video, grab them up, take them for yourself, make them into a wallpaper that you can stare at until the Dexcom g7 comes out. Thanks so much for listening to the Juicebox Podcast. If you're enjoying the show, please tell a friend show them how to subscribe. And if you're not subscribed, what are you doing? Hit the subscribe button. If you're listening online, you know there are podcast apps everywhere. They're very free. It's easy to get this show. There are links all over Juicebox Podcast comm to get yourself a podcast player that is free and compatible with your phone. And if you're here just for Kevin, there's a lot going on in this show. As a matter of fact, if you have type one diabetes, I implore you to check out my diabetes pro tip series that begin at Episode 210 diabetes pro tip newly diagnosed, we're starting over I think it would add a ton of clarity to your life. And if this is your first time listening to a podcast, you can also find those episodes at diabetes pro tip.com. Thank you very much for listening, for subscribing, for sharing. I'll be back very soon with the next episode of the Juicebox Podcast. Actually, somebody from NASA is gonna be here next time. What do you think of that?

#417 Fossil Friends

From OK to AU

Skylar is an adult living with type 1 diabetes who enjoys searching for fossils.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
There's a way for you to support Type One Diabetes Research and the Juicebox Podcast. And you can do that through the T one D exchange. The T one D exchange is looking for type one adults and type one caregivers who are us residents to participate in a quick survey. As a parent of a child with Type One Diabetes, I've taken the survey, and it only takes a few minutes to complete. And the questions are not deeply probing, or overly personal. They're pretty basic questions about living with type one. The process is 100% anonymous, completely HIPAA compliant, and does not require you to ever see a doctor or go to a remote site with the data that the E one D exchange collects. They've helped to bring increased coverage for test strips, Medicare coverage for CGM, and they've helped to implement changes in the ADA guidelines for pediatric a one segals. I find it really exciting to imagine what my participation may lead to, but they need help. They need people data, they're looking for up to 6000 respondents. So just my data alone is not going to be enough. Every time someone completes the process. If you use my link, T one d exchange.org. forward slash Juicebox. Podcast will benefit. So if you're looking for a way to help type on research, and the podcast, this is a simple way to do both. And it's really valuable. So get involved, go to T one d exchange.org. forward slash juicebox. There's links right there in the show notes of your podcast player. We're at Juicebox podcast.com. When you get there, click on join our registry now. And after that simply complete the survey. I want to thank you for your help and get the show going.

Hello friends and welcome to Episode 417 of the Juicebox Podcast. On today's show. We have Skyler scholars and adult living with Type One Diabetes who's living in Australia, but he's from Oklahoma. And that makes for a very interesting accent and Skyler makes for a really great episode of the Juicebox Podcast. Please remember while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, please always consult a physician before making changes to your healthcare plan or becoming bold with insulin. I have a little time here. So I'd like to remind you that if you have a great doctor, or need one, check out juicebox docs.com send me your favorite diabetes practitioner, and we'll add it to the evergrowing list from all around the world. That way when people need a great doctor, they know where to look juicebox Doc's calm. And if you're looking for those diabetes pro tip episodes, they begin at Episode 210 right there in your podcast player, where you can find a list of them and even listen online at diabetes pro tip.com. Alright, here we go. This is it. You're coming Skyler.

Unknown Speaker 3:11
Hello.

Unknown Speaker 3:14
Can you hear me? Yep.

Scott Benner 3:16
Hi. Good morning.

Unknown Speaker 3:20
I just turn you up a little bit.

Scott Benner 3:21
Is this better?

Unknown Speaker 3:23
Yeah, that's better.

Scott Benner 3:24
There you go. I have this just one setting. And no matter how many times I put it to where I want it. It puts itself back. So I I stopped arguing with it a while ago and I just go do it myself.

Skylar Cox 3:40
Yeah, technology is great when it works. Yeah.

Scott Benner 3:43
Yeah. I felt that way about my uncle. A little weird. Anyway. Uh, hi. Good morning. What time is it? Where are you at?

Skylar Cox 3:54
Um, I'm in Queensland, Australia. So it's 11pm here. Wow.

Scott Benner 4:00
Well, good evening to you then.

Unknown Speaker 4:03
Yes.

Scott Benner 4:04
I'll tell you what we're going to do. I'm sorry. Good.

Skylar Cox 4:08
I was just gonna say good morning to you.

Scott Benner 4:10
Thank you. I have to tell you, this is my second Australian interview in like the last five days. Really? The podcast is oddly popular in Australia.

Unknown Speaker 4:23
Yeah, yeah.

Skylar Cox 4:26
I was actually recommended to me by an Australian Facebook groups.

Scott Benner 4:31
No kidding. That's lovely. There was a person who once tried to bring me to Australia but we couldn't quite raise the funds to ship my carcass on an airplane. And it was one of those weird things where I was like, Am I gonna fly 20 hours to talk to people for three hours then fly back. I was like, that doesn't seem to make sense. No, yeah. You know, so we were not

Skylar Cox 4:52
that those flights are terrible.

Scott Benner 4:54
See, that's what I thought

Skylar Cox 4:58
they are you do not think You know that your bomb can hurt sitting, but it can.

Scott Benner 5:07
I just seemed like a bad idea. Like, logistically, it seemed like a bad idea. The idea itself was lovely. And I was excited to try to do it. But that's just crazy. I would have to, I would have to build some sort of a vacation around the idea. And then

Skylar Cox 5:23
yes, yes, definitely. And

Scott Benner 5:25
then do that while I was there. And if I did that I told the person to I was like, let's just do like days of it. Like, let's not just do a couple of hours, let's bring people together and, like, do giant Q and A's and workshop and stuff like that. And I can't just come down there and be like, here's what I think and then leave us like I could, I could do that over zoom for you, you know, that? That'd be easy. I've done it before for Japan, and a couple of other places where you just jump online for a couple of hours. And, you know, yeah, that seems nuts. Oh,

Skylar Cox 5:56
I think it'd be, you know, I think there'd be a lot of interest in it. If you were to come over here and do workshops, and the like, I believe that too. I

Scott Benner 6:05
just don't know. Like I said, one day, I'll, I have to be first of all, when I record all this, so you know, if you go crazy, like understand that, I'll take it out. But in a minute, we'll you'll just introduce yourself Anyway, you want to be known. And we'll start talking. So I was gonna say why don't we do that now so that we don't, we don't waste any good conversation.

Unknown Speaker 6:30
Oh, good.

Skylar Cox 6:34
Okay, just let me know when

Scott Benner 6:36
it's okay. Sorry. It's funny. Some people want to try to do it. And some people are like, wait for the go and it amuses me to figure out. Like you can go whatever you want.

Skylar Cox 6:47
Okay, so my name is Skylar Cox. And I live in Australia. And I use MDI, manual daily injections to manage my diabetes.

Scott Benner 7:02
That's interesting. You call it manual? Daily injections?

Unknown Speaker 7:06
I yeah. Yeah.

Skylar Cox 7:08
I know, some people call it many daily injections. But

Scott Benner 7:11
this is what I've heard.

Skylar Cox 7:14
Yeah, yeah, I've heard multiple as well. I think they're interchangeable.

Scott Benner 7:19
When you said when you said it the way you did, I thought, oh, that works too.

Skylar Cox 7:24
Yep, yep. I think I've heard both interchangeably here.

Scott Benner 7:29
I think many is. seems more ominous. multiple, multiple, just makes it feel like there's gonna be more than too many is just like, you want to keep your blood sugar down, you're gonna inject, man,

Skylar Cox 7:43
I guess it depends on the mood you're in for the day.

Scott Benner 7:46
That's great. I didn't realize you're gonna get off to such an auspicious start. Thank you. So you said as we were kind of warming up, you said that you found out about the podcast in a Facebook group.

Skylar Cox 7:59
Right? Yeah. So I think it was Australians living with Type One Diabetes, or type one diabetes support group Australia. Those are the two main two main ones that I know about.

Scott Benner 8:10
Right. That's a That's very nice. I had, I once had this long conversation with a person from from Australia while I was watering, newly planted trees in my heart. I remember having had headphones on my phone. And we couldn't seem to figure out how to speak because I guess it's not as easy to call internationally for some people as it is for others to I was under the impression that at this point, we were all just allowed to call wherever we wanted, but it ended up being really difficult. And I don't know, we may have actually used Facebook audio to talk to each other. Which is, is that something pretty common for you guys?

Unknown Speaker 8:54
I

Skylar Cox 8:55
yeah, I have personally found that it is a lot better to use Facebook messenger to call people overseas than it is to actually use the phone. For whatever odd reason.

Scott Benner 9:08
Yeah, well, that's what we did. And I got on the phone with this person. And they had been a fairly, I believe, lifelong diabetic. And we're having really like terrible outcomes. And it's always interesting when someone reaches out to you and they're sort of persistent. Like I really wish we could talk and I was like, Alright, well you know, if you don't mind the sound of spraying water. I'm happy to you know, have this conversation. And you get on the phone and or even sometimes on the podcast. I mean, you guys maybe can tell sometimes in the episodes like sometimes someone starts speaking and I think, ooh, this is more than I bargained for. And and at that point, you know, you're you're in And anyway, that person ended up doing really well. And it was exciting because, like I said, there had been a long distance of time with a lot of trouble. And it was it was, it was nice to be able to help. So maybe that one good deed got all the way around Australia? I don't know.

Skylar Cox 10:11
Yeah, well, it's it's likely it is likely.

Scott Benner 10:16
You guys have like a real thing a telephone going on there where you just one person says something and tells another person. And I mean, in my mind Australia's like as big as what?

Skylar Cox 10:26
I don't know. Well, it's actually approximately the size of America. Actually, a lot of people don't realize that

Scott Benner 10:34
is that the map thing with a map is drawn in a weird way for navigation. Have you ever heard that the world map is? This is like the second time I'm bringing this up now. And don't know anything about it. But I was joking, I'll show you is huge. And it's a it's interest. But on the world map, it doesn't, in any way seem so.

Unknown Speaker 10:57
Yeah, yeah.

Skylar Cox 10:58
I think I actually learned in human geography a few years ago that depending on what kind of dimensional map you use, or whatever, some countries are a bit more squished look smaller. And generally, Australia does tend to get the brunt end that makes it a lot smaller than what it actually is. I

Scott Benner 11:17
feel like there's another country near you, that sometimes gets left off of maps to remember hearing about it. Anyway, this is not a typography podcast, if it wasn't. People would be like, wow. And they don't see anything about maps. Anyway, I'll show you really big place. I'm gonna reference back for a second to a recording that I just did that no one's heard yet, with another person from Australia, who sort of outlined a fairly bleak view for me of how a lot of people their diabetes is managed. Are there are the haves and have nots? health care wise? Pretty obvious there?

Skylar Cox 12:04
Yes, and no, I'd say Australia is really, really blessed in with the public health care system when it comes to being a diabetic. But at the same time, we don't have access to up to date technology. So, for example, insulin for a script of insulin 25 300 mil pins cost you $41 flat out to anybody. But in saying that, we may not have access to all the insulins available, such as tresiba. You know, and test strips are subsidized. So they're $15 flat rate for 100 strips, for a personal on a health care card. But, you know, your CGM devices actually aren't subsidized for people who are basically working enough to not be on a healthcare card. And they're over the age of 21. And it's not covered by private health insurance here either. So you're having to cover the brunt of that out of pocket.

Scott Benner 13:16
Is health care card a way of saying government assisted?

Skylar Cox 13:20
Yes. It's kind of the equivalent to the Medicare card in America. Yeah. Yep. So I think the Danny foundation is a big advocate group over here. Trying to raise awareness to the government as to why CGM devices need to be subsidized for every type one diabetic. And that's actually how I currently have my CGM. It's a scholarship through them.

Scott Benner 13:50
Interesting. Wow. And you're younger. Am I right? How old are you?

Skylar Cox 13:56
I am 22 years old. See, that

Scott Benner 13:58
sounds younger. And to me like with numbers, but you have a more mature voice. So if you told me you were 35, I would have just been like, Alright, okay.

Unknown Speaker 14:07
I'm 35.

Scott Benner 14:09
Would you Really? I would too, just in case you're wondering. Yeah. No, I just you mentioned a course a moment ago, and I would think that anyone who heard you say I learned in a course. But heard your voice would think, Oh, this lady's gone back to school. That's lovely. She's probably trying to better herself, but you're definitely younger. So what were you studying in school?

Skylar Cox 14:31
Yes, I am. I'm currently enrolled in uni. Actually, my last test is tomorrow. It opens up online at 2:30pm has to be online because of all the Coronavirus.

Unknown Speaker 14:44
Are you going to cheat? No.

Skylar Cox 14:46
No, it is open book. It is open book now.

Scott Benner 14:50
I'm just gonna say everything is okay. Let me ask you a serious question for a minute, Scott. If you're going to cheat, would you tell me

Unknown Speaker 14:57
Yeah,

Scott Benner 14:57
no kidding. Good for you. I think that one, I've watched two kids, one go completely through high school and one now halfway through high school and a, you know, a Corona a couple of months. And I think that we're teaching our children how to collectively come up with answers. unintentionally. So I'm seeing a lot of a lot of kids, they just they talk to each other they have, they have text chains going, they have all kinds of messaging, they're talking about their homework in the class, they're not talking about the learning. Interestingly, and it's not a good thing. But they are talking about the problem solving aspect of it. And so while I don't believe that a lot of American children are going to know who William Barr was, I do think they're going to know how to pull together six of their brightest friends and conquer anything. So it's a, I think it's a very unintended thing. I used to think of it as we were teaching our children to cheat. But now I don't see it that way any longer. Now, I, you know, it looks like it looks like really good adult tools to have but you know, the way people can communicate so quickly. You know, like, if you had to, if you were taking your, I don't know, you're doing something in school, remembering back when you were even younger, and you couldn't get the answer, and you had to get on your bike and ride to a friend's home to, you know, find out the answer, you wouldn't do that. You'd be like, I'll figure it out. But when you can text somebody and be like, hey, real quick, you know, answer seven, what is that? People do that all the time. So anyway, I would cheat if my test was online, just to you know, want to be very clear about that. I was about the worst student ever. And I would have, I would have taken the easiest way out possible, which, ironically, looking back now at this podcast, this whole podcast exists, because I wanted the easy way out of diabetes. So, you know,

Skylar Cox 16:58
yeah, I never really had that issue. Growing up, because my family was a bit slow to get up to date with your technology. So I, you know, my household didn't actually have a computer until I was just entering high school. I didn't have a phone available to me until my junior year, consistently anyways, so, and I was socially awkward on top of that, so I wasn't really connected enough to be able to get away with that. I

Scott Benner 17:36
want to know how you were socially awkward. But before you tell me, I want to point out that you paused right. After you said slow, you said my family was a little slow. And there was this pause. And I thought, is she going to tell me that her parents are stupid, or that they didn't get the technology quickly? Like I couldn't tell where you were going to go? And you said you'd be honest about cheating. So I was like, Oh, my God, this is gonna take a dark turn. But it didn't. How were you socially awkward? How does that manifest in your life? Um,

Skylar Cox 18:05
I'd say that I was just never really concerned with talking about superfluous things. You know, I didn't really care about who was dating whom, or you know, the latest trend or whatever. I was more interested in talking about more pertinent subjects. And nobody really wanted to engage in that kind of depth of conversation.

Scott Benner 18:32
Can I ask, do you find yourself at gatherings? I don't know, if you remember, gatherings. It used to be, people would go and get together in the same place and talk with each other and eat food and things like that. But back when that happened, did you? Do you feel like Do you ever have that feeling like, Oh, I don't want to be here, because the conversations aren't where you want them to be? And when you try to take them to where you want them to be, it turns everyone else off. Has that ever happened to you? Um,

Skylar Cox 19:02
not really. Because nobody ever really talked to me. Just to be honest, I was just always kind of on the outskirts of those gatherings, you know, prom nights or whatever. I only went because my mother wanted to do my makeup and put me out there and yeah, so I just kind of wander around the tables and sort of eat some of the kinky

Scott Benner 19:27
your mom was pimping you out so she could practice makeup.

Unknown Speaker 19:30
She's like, Oh, yeah, I

Scott Benner 19:32
don't want to do that mommy can figure out this eyeshadow.

Skylar Cox 19:36
Oh, yes. Oh, yeah. It even got to the point where, you know, she was bound determined that I was not going to wear my glasses to my high school prom. And so because I can't wear eye contacts, I went without my glasses, so I could not see anything. So neither Let's just say I ended it about 30 minutes in.

Scott Benner 20:02
Was that so that you'd find a boy? Is that what she was thinking?

Skylar Cox 20:08
Well, yeah, my my mother. Really? Yeah. She She tried to hook me up a few times.

Scott Benner 20:16
Would your mother say bloke if she was talking about a tea or is that not Australian?

Skylar Cox 20:21
Well, I'm actually American. Living in Australia. You

Scott Benner 20:25
ruined the whole pot, and I'm just kidding. That's fine. Where were you born?

Unknown Speaker 20:29
Oklahoma,

Scott Benner 20:31
where the wind comes whistling down the lane. sweeping down, sweeping dammit. God dammit. Can we do that again? where the wind comes sweeping down the lane? Is that the place? You're talking about Schuyler?

Skylar Cox 20:40
No, no, no, no, no sweeping down the plane.

Scott Benner 20:43
Hold on. Third try. Is that the place where the wind comes sweeping down the plains?

Unknown Speaker 20:49
Yes. Oh, I

Unknown Speaker 20:49
thought so.

Scott Benner 20:51
Well, I do know that the waving weed smells sweet. So I've got you there. But so how old were you when you moved to Australia?

Unknown Speaker 20:58
I'm

Unknown Speaker 21:00

Oh, well, that

Scott Benner 21:02
wasn't that long ago.

Skylar Cox 21:04
Well, not terribly much my entire independent adult life.

Scott Benner 21:10
So you're not there with your family? Your family's in Oklahoma? Yep. Oh, this is interesting. Okay, let's get into this. What makes you leave Oklahoma and go to Australia? Is it that your mom would dress you up like a hooker and send you outside to find a boy?

Skylar Cox 21:31
No, I found my own boy. And he happened to be in Australia.

Unknown Speaker 21:35
Ah, gotcha.

Skylar Cox 21:37
But there were a few other things because it The decision was he either moved to America or I moved to Australia. So there were a couple other deciding factors in that.

Scott Benner 21:50
And he talks to you even though you wear glasses. Yes. What a progressive guy.

Skylar Cox 21:56
Oh, he actually prefers me with my glasses. He finds it weird without the mom

Scott Benner 22:00
who is joking. I think calling him progressive seemed ridiculous to me. So you meet Okay, hold on. How do you meet a boy from Australia? In Oklahoma?

Unknown Speaker 22:11
Oh, well,

Skylar Cox 22:12
we had a shared interest in pre history. So fossils.

Scott Benner 22:16
Ah, that's right. You like the bones of things that have been dead for quite some time they get stuck in rocks.

Unknown Speaker 22:24
And that is one way to put it.

Scott Benner 22:26
Thank you. I like to, as you know, from listening the podcast, I'm very good at boiling things down to almost simple. And by simple I think we know I mean, you know, really, really, really simple terms. I don't know enough big words to say anything another way. But you so you had this interest together. But he wasn't in Australia, you meet online?

Skylar Cox 22:50
I yes. Yeah. But not through a dating website. It was actually through the fossil forum. So it's actually a pretty well meaning forum. The people are very respectful. You have a lot of scientists on there a lot of avocational paleontologists that have contributed a lot to science and such. And yeah, it just kind of fell in place from there.

Scott Benner 23:21
It'd be great if they change the fossil forum slash dating app. Because where else are you gonna meet other people who enjoy fossils? That's not something you can bring up on your own?

Skylar Cox 23:33
No, we actually have another mate. He's looking for a girl. And you know, we always joke Well, you need to go to the fossil forum because he's also interested in fossils.

Scott Benner 23:44
I think it's a reasonable decision to be perfectly honest with you. Okay, so you guys meet on the fossil forum, which we're getting very close to calling this episode fossil forum. I don't know if you've noticed or not. But that's only because your parents didn't end up being stupid when the simple thing came up earlier. And so he's in Australia, you're in Oklahoma, Oklahoma is not a bad place to what would you call it when you're looking for fossils? There's a word for it right.

Skylar Cox 24:11
Not really is just called fossil hunting or fossil collecting. Okay. And that is

Scott Benner 24:15
that something you did as a child like in high school?

Skylar Cox 24:19
Yep. Yep. I used to go to Black Cat mountain in Oklahoma to look for trilobites.

Scott Benner 24:26
You say that again? Cuz I don't know what the hell you're talking about that look for what?

Skylar Cox 24:30
So trilobites? They're kind of like these pill bug looking things that used to live before the dinosaurs in the oceans.

Scott Benner 24:40
And the fossils look swirly. Is that what I think?

Skylar Cox 24:45
Oh, sorry. pillbugs rolling police. Oh, okay.

Scott Benner 24:50
I found it. Don't worry. I can't believe that. I can't believe that based on what I just typed Google knew I was trying to say trial. Fascinating. Now that algorithm works amazing because I was pretty far off. Okay, so these things are weird. And so you'd go out looking for these. Did you actually find these?

Skylar Cox 25:13
Yeah, quite a few. Wow.

Scott Benner 25:15
That's pretty cool. How old are they? And how to get

Skylar Cox 25:20
cheese? I think the black cat mountain site has been dated to like around 405 million years

Unknown Speaker 25:27
old. Wow. That's really kind of cool.

Skylar Cox 25:31
I think around that anyways, before the dinosaurs came into play,

Scott Benner 25:36
that's amazing. I'm just Anyway, I'm a little lost than in what you're showing me here. That's really cool. How old were you when you were diagnosed with type one?

Unknown Speaker 25:44
Um,

Skylar Cox 25:45
well see that but bits a bit confounding to my doctors. I have been showing symptoms for probably about two or so years before I was actually diagnosed. And they reckoned that those two years may have been the honeymoon ending before I actually got diagnosed. And when that ended, that's when I finally went in and got properly diagnosed. So I was officially diagnosed August 13 of last year. But blood tests back in January show that I was clearly diabetic, but that was missed. And yeah, it's and I've had symptoms since before that. So the idea is, is I was in my honeymoon before I was actually diagnosed. And at the end of that is when it actually got bad enough that I had to go in. And yeah, get properly diagnosed. Gotcha.

Scott Benner 26:47
I have a lot of questions about that. But first, I thought this will stick in my head if I don't ask this. You said I reckon is that that's from okhla. homo, right. Not from Australia, using the word reckon. Do you know

Skylar Cox 27:03
you know, I'm not I'm not sure.

Scott Benner 27:05
That's not a colloquialism from Australia. And from

Skylar Cox 27:08
I mean, I have colloquial is, colloquialisms that aren't really from either place. It's just from reading a lot to gotcha. I thought

Scott Benner 27:19
you're gonna say from being in the desert by yourself. But we're in the mountains myself, but you make up words, Scott, after you're out there for a while. So I so I have a ton of questions. So first of all, you were diagnosed about a year ago, so around the time you were 21. And you had been in Australia for, obviously, about three years, and you still shacked up with this guy, or have you gotten rid of him? Is he still in the picture?

Skylar Cox 27:42
No, he's still in the picture.

Scott Benner 27:44
Yeah, very nice. So you guys are together doing your thing? He about your age?

Skylar Cox 27:48
He's a bit milder.

Scott Benner 27:52
Do you want to tell me about that? Or are we gonna leave that out?

Skylar Cox 27:56
Oh, he's six years my older. I know some people like to preliminarily judge against that. Yeah. A few people

Scott Benner 28:08
don't know how so cuz I was thinking Good for you. Cuz he's probably already got it.

Skylar Cox 28:14
But yeah, well, yeah, that that did help me moving over? Well, a lot of people think, you know, that is too big of an age gap. And to be fair, it is with the mentality of some people. Especially, you know, across different generations. But we were born in the same generation. And, you know, being from different countries. Anyways, we had some differences we had to work through. We dated long distance exclusively for three years, yet three years. So we kind of got through a lot of those differences. And also, my father, for example, knew that I was always going to go for somebody older than myself, due to just my mentality, I guess,

Scott Benner 29:09
what I would think if you're looking for a conversation, you're, you might be hard to find it. 22 years old with another 22 year old I was, I kind of half brought up earlier. I'm not good at some get togethers. If I don't like having I'm not good at just basic conversation. Like I can't just sit around and talk about cars. Were boobs with guys. I can't do that. Yeah. And and so when I try to speak about the stuff that I'm interested in, I see most people's faces glaze over and I'm like, okay, no one cares about this, but me, that's fine. You know, and then you can get into another space where you are with like minded people. And it's it's obviously a much different conversation. But in a lot of those situations, I just find myself like sitting there thinking like, Oh, I wonder what I can get out of here. Because nobody cares, and I can't I just can't do it. Like,

Skylar Cox 30:05
I guess I share that sentiment.

Scott Benner 30:06
Yeah, I try, but I can't and it comes off, I will come off as judgmental. If I get into those conversations. If I don't stop myself, or if I'm not aware of it and stop myself. Just like I'm like, how long can we possibly talk about this? You know, the Sixers are doing great. Let's move on. I don't see why we need to break this down. Like I don't work. I don't work at ESPN. I don't no one cares what I think about this guy's work ethic? How is this what we're talking about? So the world's falling apart around us? Maybe? No? Okay. All right, let's talk about Joellen bead for 10 more minutes. Anyway, point is, don't love it. And, and I get it like I get wanting to be with, I can see how it would shake out to age. With me, Kelly is just, she's so much smarter than I am that like she she grades out as an older person. So even though she's a little younger than I am, you know, I could talk to her. I'll tell you right now, when people ask like, what are you looking for in a person? Even when I was in my early 20s. And I don't even know where I got off believing someone would like make a baby with me at that point. But I thought I really do want somebody who I think will be a solid parent. That seemed very important to me. And I wanted someone I could talk to. Okay, really, I know that sounds like I don't know, like I'm making that up. But it wasn't to me like I want to be able to say something deep to someone and have them pause, consider and respond, not stare through me. So I guess

Skylar Cox 31:43
exactly that that's the key thing, I think to a relationship is finding somebody that you can communicate to, you know, on your deepest passions, you know, interests and everything and have them communicate effectively back with you. And that's really where my husband, Troy and I come in, you know, fossils bind us together. But we also have a love for nature and history and

Scott Benner 32:12
the like. That's beautiful. Exactly. Yeah, I didn't, his age didn't interest me as much like in a salacious way as it did in the idea that I, that made sense to me, because how could you relocate from Oklahoma to Australia, if you didn't have some sort of stability when you reached Australia? And I don't know how 20 you know, three years or four years, I don't know how like a 17, or 18, or 19 year old person could offer you stability to move across the world. So I wasn't and you didn't seem like a person who was just gonna be like, Whoa, let's do it and just see what happened.

Skylar Cox 32:46
No, there was a lot of paperwork, and the like that I had to go through.

Scott Benner 32:53
Yeah. Okay, so do you do fossil collection, which I guess is called anthropology. Am I right? Did I get that alien

Unknown Speaker 33:02
knowledge?

Scott Benner 33:04
When the wind comes sweeping down the plane? I hear it. So paleontology, is that a is that a hobby? Or is it a profession? Or is it a future profession? Like how do you see all that?

Unknown Speaker 33:15
We

Skylar Cox 33:16
like to call it avocational? So we're a bit more invested than your hobbyists, but not to the point where we're professionals. So we're friends with the Queensland museum curator, and we kind of work in tangent with him to identify our funds and to eventually work on allocating our collection to the Queensland museum when we're ready to pass it on.

Scott Benner 33:42
Okay. Is your studies at University are they focused on paleontology? Or what are you studying?

Skylar Cox 33:49
Nope, I'm actually studying nursing.

Scott Benner 33:52
Perfect. That makes total sense. Okay, so there, I was being sarcastic. How did you so you found your way into a nursing track before you had type one?

Skylar Cox 34:08
Um, no, I actually decided to change after my diagnosis.

Scott Benner 34:14
Gotcha. What were you doing prior to that?

Skylar Cox 34:17
biochemistry.

Scott Benner 34:19
Wow, that sounds incredibly difficult. So I Oh, I'm sorry. I just got the chills thinking about taking a biochemistry class. So your your C are you close to being a nurse? You getting there? This? Is that what this last test is for? Are you gonna be a nurse after today?

Skylar Cox 34:38
No, no, unfortunately, I still have two and a half years.

Scott Benner 34:42
Okay. So so you get in like a basic like an undergrad, and then you're gonna go to nursing school? Is that how that works?

Skylar Cox 34:49
I know, two and a half years and I'll be a nurse.

Scott Benner 34:51
Ah, okay. All right. I'm trying to dig out the Why does it take six years to be a nurse or is it because you spent the first couple of years on a different track and then Switch. Yeah,

Skylar Cox 35:01
yeah, pretty much. So I started University in America right after high school. I had a year under my belt, studying biochemistry. And then I decided to move here to Australia. Partly because uni is a lot cheaper here. It's 8000 a year versus 40,000 a year. Um,

Scott Benner 35:23
while you were getting college for 40 it's a good deal.

Skylar Cox 35:26
Yeah, yeah. I'm always Yeah, forking over 40 grand a year. Wow. And anyway, so I moved over here. And then I went to go through and finished biochemistry, I had about two years left on then got diagnosed and realized that I didn't have any particular direction. With that degree, and I felt nursing afforded me a more direct pathway.

Scott Benner 35:56
Good for you. That's wonderful. So when you're, I guess there's two ideas, I want understand. So you're on your, you're doing MDI, we ended did we meet? Because in the in the Facebook group, I was asking for people who are doing really well on MDI. Yep, that's how that happened. Right? So tell, talk to me a little bit about that, like, how do you? What do you What's your management style? And what does that mean that it's working out really well. This is super simple and super quick. I'm just stopping back to remind you about the T one D exchange, please go to T one d exchange.org. forward slash juicebox. Fill out their survey. And when you do, you're supporting Type One Diabetes Research, and the podcast. Super simple way to do good things for people living with type one and help out yours truly keep this podcast going. T one d exchange.org. forward slash juicebox. took me about seven minutes to fill out the survey. It's 100% HIPAA compliant. It's 1,000,000%. Anonymous. And it's definitely going to do good things for people living with type one.

T one d exchange.org. forward slash juicebox.

Skylar Cox 37:19
I am typically between 92 and 98%. Time and range. I don't really have any highs above 8.5. I try and keep it under 7.2 millimoles. So what is that

Scott Benner 37:37
that got you here? 8.5 would be around 150 ish, little more. 7.2 is about 130. So your your highs are about between 130 and 160. ish.

Unknown Speaker 37:50
Yeah,

Skylar Cox 37:51
I consider 130 a high. Okay, I will actually act at 6.5, which I think is 117. So I'll actually act at that point. And then my lows I consider 70. That's my action point anyways.

Unknown Speaker 38:10
Okay. Okay.

Skylar Cox 38:11
I like that. 70. Yeah. 70 to 130. But I act on 117. And whatever. 4.4 millimole is 4.4 80. Yep. So I'll start kind of eyeing it off around the 80. Mark. You know if it's dropping or not, but if it's just leveling out, then I'll just kind of let it sit there. If it's not like a pressing concern,

Scott Benner 38:38
are you using a glucose monitor of any kind?

Skylar Cox 38:42
Yep, I'm using the CGM provided to me by the Danny foundation. It's the Medtronic one.

Scott Benner 38:51
Very common. That's the common commonly available CGM. And in Australia, isn't it?

Skylar Cox 38:59
No, I'd say Dexcom is actually more prevalent. Um, but in saying that I have tried the Dexcom. And the Dexcom wasn't as accurate for me. Now given that's on the older versions, we still don't have the G six out here yet.

Scott Benner 39:19
Yeah. Where we're using like the g4.

Skylar Cox 39:22
Yep, yep. Gotcha. Yeah. So

Scott Benner 39:26
Well, yeah, we're almost a seven, honestly. So.

Skylar Cox 39:29
Yeah. Which is just crazy. It really is.

Scott Benner 39:33
I'm wearing something right now. Actually, this is my last few hours with it. I'm wearing the Dexcom Pro right now.

Skylar Cox 39:40
Which Yeah, I heard about that. It sounds like it'd be a good diagnostic tool.

Scott Benner 39:44
It is and it's been it's been an interesting an interesting 10 days seeing my blood sugar excuse me and and how, how my body reacts to different scenarios and it's it's fast enough. get really as the things that move my blood sugar around that I would have never imagined away from food. So even though

Skylar Cox 40:08
you have no idea how tempted I am to put one on my husband to see his because each time I pricked his finger, he's at a perfect 100

Scott Benner 40:16
just constantly 100

Skylar Cox 40:18
Oh, yeah, just just constantly, you know, either 4.8 or what's 4.8? Like, 85?

Scott Benner 40:26
I didn't know we were gonna do that again. It's about 87 ish, like, right in there.

Skylar Cox 40:31
Yeah, yeah. So he's just constantly always in there, it's like, Okay, well, I kind of want to see what's going on behind the scenes, you want to be my guinea pig.

Scott Benner 40:40
I, I'll tell you the one thing that that fascinated me more than anything is it when I go outside in the heat and work, my blood sugar tends to go up with or without food doesn't matter and not go up a ton, you know, not, not the way people would type one think of going up if you would go up like 1015 points. But when I was really active or working outside, especially in the heat, my blood sugar would go up a little bit.

Skylar Cox 41:04
That makes sense. Because your body would be utilizing more glucose, I'd be Yeah,

Scott Benner 41:10
elevating. I'm assuming there's like a little control guy inside of me that's like, Oh, this fat ass is gonna try to do something strenuous, he needs help. And they just, you know, hand over a little bit of glucose to make it happen. But I tried eating well beyond my desire to be full, to see what happens. And it still my blood sugar won't go over like 140 something. And I mean,

Skylar Cox 41:36
yeah, I am do see with doing I'm gay, I have tried pushing myself and basically subjecting myself to my own experiments. You know, so I will sit there and you know, I'll have my relatively healthy food days, and then I'll have my days where it's like, I will just gorge out on carbs to see how much I can push myself with this. You know, so it's, while I empty your perfect sugar levels, at the same time, I find it engaging to be able to experiment with my own because they actually do fluctuate a little,

Scott Benner 42:18
I do actually have to do the process of elimination to figure out what's actually causing what I think it's, I think it's amazing to do that. I think it's how you come to bigger answers and how you can then eventually take care of food in a way that you want. That could be problematic, because if you know what the problem is going to be, then you know how to, you know, act on it before it becomes an issue. And

Skylar Cox 42:44
exactly, I just call me crazy, but I actually find it. You know, diabetes is the one chronic illness that you can actually sort of play around with and see your results in lifetime. So I actually in some morbid way find it fun.

Scott Benner 43:03
Well, you like digging around in rocks looking for things that have been dead for a long time, so I'm not judging. Yeah,

Unknown Speaker 43:08
yeah, well, I

Skylar Cox 43:10
don't make sense anyway. So well, to one

Scott Benner 43:12
guy he did. That's good enough. I keep flashing back and thinking like what did your dad expect painting up his daughter and sending her out to the world was going to happen?

Unknown Speaker 43:24
Yeah,

Scott Benner 43:26
that's so funny.

Skylar Cox 43:28
He was a bit uneasy, but he trusted my instincts, my instincts, he knew that I was very cautious reasonable. I was going to say from the outset, with any relationships, my motto has always been go for character, not beauty, because beauty fades character remains. So yeah, that's always been sort of my prerogative when looking at a relationship. And, um, yeah, so I didn't really,

Scott Benner 44:04
yeah, in fairness, I only know one thing about Oklahoma. Those people are incredibly scared to drive in any kind of inclement weather. And it was a huge letdown. When I found out I was in Oklahoma, and given a talk. And I thought, this is like, I'm gonna meet a bunch of cowboys. Like that's how I felt about it. I was like, everyone's gonna ride up on a horse, they're going to probably have like a steer like like lassoed and like slung over their shoulder, they're gonna cook it for dinner. These are the people I'm going to meet giant pickup trucks that and the weather got in climate for an hour and people were like, We can't come I was like, wait, why? Just like it's it's and I was like, wait, it looked outside and like, You're kidding. Like, this is gonna stop you thought you were cowboys. But turns out rough and tumble people in less any kind of precipitation falls out of the sky. And they're like, why you Is that exactly if you have any idea?

Skylar Cox 45:03
Well, it depends. Where did you hold that workshop?

Scott Benner 45:06
You're asking me to remember where I was. Exactly.

Skylar Cox 45:09
I said Oklahoma City, Tulsa

Scott Benner 45:12
felt more north. I don't know what that means. Anyway, I don't remember. I feel bad for the people who were there. Like words,

Skylar Cox 45:22
names, your big city, people are a bit more trepidatious about that sort of thing. When it comes to ice and the sort, I'd say we're a bit more cautious, but that's more so because a lot of Oklahomans do drive big pickup trucks. I

Unknown Speaker 45:41
thought that I was like, this is your time. Like,

Skylar Cox 45:43
yeah, but see, the issue with that is trucks like to fishtail. And unfortunately, Oklahoma doesn't get so much snow is what it does ice. And ice can be pretty scary to pick up driver. Because you're fishtailing all over the place. No way back secure. Yeah, exactly. Understand. And because Oklahoma has crazy weather. We also you know, we actually call her bipolar. Nobody expects to constantly have a weight in the back of their pickup truck to prepare for a sudden you know, bout of ice. You know,

Scott Benner 46:17
just thinking if anyone ever says to anyone that, hey, it looks like you've gained some weight in your your back part. You can just say I'm trying to get ready for the ice. I don't want my essence sliding out from under me. Oh my gosh. Anyway, so when I'm interested in about, you know, what are you using is your slow acting insulin.

Unknown Speaker 46:39
So I use Lantus.

Scott Benner 46:41
Okay, and your fast acting is probably novo rapid, I'm guessing.

Unknown Speaker 46:44
No, it's humalog.

Scott Benner 46:45
jemalloc. Okay, humalog and Lantus. You're injecting? How frequently? Do you find yourself in inhospitable places? digging around for fossils? And how long? Are you out there? When you're doing that? How do you manage through that situation?

Skylar Cox 47:04
Okay, so usually about anywhere towards the end of June into late August, October is what we call the fossil season, it kind of depends on the wet season prior. So see, Australia doesn't really have intermittent rain in our area, it just kind of dumps everything in the beginning of the year in one week, and then you're left to deal with what you got for the rest of the year. So during that wet season, we can't really go look. But during the dry season, we can. And so what is there's like anywhere between six and eight months timeframe. And during those six to eight months, Troy and I will go out every weekend. And, you know, anywhere between four and eight hours, we'll just be trekking along, looking for fossils.

Scott Benner 48:05
And so you're pretty removed, I would imagine from amenities during that time. Yes. Okay. Yep.

Skylar Cox 48:11
Yeah, um, we're kind of, we're in areas of very patchy reception. We're well away from where emergency services can get to us quite readily.

Scott Benner 48:29
What do you bring with you then to be ready for that? Do you ever spend the night?

Skylar Cox 48:34
No, no. Because our fossil areas are pretty close to us. So you know, we can just drive, you know, about an hour or so away and come back the same day.

Scott Benner 48:50
Gotcha. Gotcha. I'm gonna ask a question. You don't have to answer. Have you ever found something that it was so exciting that you had sexy time out in the middle of nowhere? No. May I suggest that because it seems like that would be nice. Not that you need to take my suggestion.

Skylar Cox 49:07
Yeah. Yeah. Well, it's it's been brought up before but just the habit ties in Isn't that nice? It's pretty.

Scott Benner 49:17
Everything I gotcha. And by it's been brought up before you mean, Troy brought up and by Troy brought up, you mean every time you're out there, he brings it up? Is that what you're saying?

Unknown Speaker 49:27
No, no, not.

Scott Benner 49:32
He probably has a calendar. And at least like I said it last time, I'll skip this time. For clarity, I would say it every time to I just be like, Hey, you know, we haven't done yet while we were out looking for fun. There's so many simple jokes here that people are filling it in their own head.

Unknown Speaker 49:53
Yeah, but

Scott Benner 49:54
I tried to keep it friendly. But anyway, I can

Skylar Cox 49:59
only imagine What the listeners are thinking of right now?

Scott Benner 50:02
I can't even say what I'm thinking. That's that's where we're at right now.

Unknown Speaker 50:06
Yeah, yeah.

Scott Benner 50:08
But, but no, I just, it just seems very secluded, I guess was my my overall point. Yeah. And so you're right. So you're by yourself. What do you bring with you as far as like, food to sustain yourself? And do you ever do you pack for the idea of like, what if we became stranded, have a car broke down or something like that? Um,

Unknown Speaker 50:31
let's see, well,

Skylar Cox 50:32
I usually have a pack. My pack usually includes like, you know, jelly beans, it's got, you know, your glucagon cha it has insulin. What else is there, we usually pack like a fiber one brownie, because they're like 15 grams, some nut bars, which are like 12 grams, that's protein. You know, and just, every couple hours or so we'll just find a spot a shade, we'll pull over, you know, drink some water? I'll check my sugar levels on them, we'll proceed accordingly.

Scott Benner 51:13
Does the process of looking bring your blood sugar down? Is it is it, I'm assuming it's like a lot of manual labor, right?

Skylar Cox 51:22
Um, it's mostly walking. Because you're looking in areas of erosion. So you're kind of wanting to let nature do the work for you. Because I mean, the chances of you just picking a spot and digging in, the chances of you actually finding something are quite low. But if you kind of let nature do it for you, and you just cover a lot of ground, you're more likely to pick something up. So there is that. And usually, when we go collecting, it's interesting that no matter what my blood sugar levels are, they will drop down to about 4.6. And they will just stay steady around that point the entire time.

Scott Benner 52:13
Do you feel like you just have your basal insulin really well?

Unknown Speaker 52:16
Yep, like, yep, figured out. Yeah, I

Skylar Cox 52:19
do frequent Basal tests. Not, not necessarily test, but I will do continual checkups, like I'll do a lot of examinations of my blood sugar levels to make sure that it is in tune. Because if my base was not said, Nothing is said, I will get, you know, correction doses off, I'll get insulin rebounds and everything. So as soon as my blood sugar levels start going wonky, the first thing I look at is my Basal.

Scott Benner 52:55
I just I'm sure you've heard me say but I think that the Basal is the base and B if it's not right, nothing else works. And just makes sense. I mean that you're out wandering around like this for hours at a time. And holding a blood sugar around 85 is it's amazing. It's well done work. And so how often do you have to adjust your basal insulin like a little more, a little less? Do you find yourself doing that?

Skylar Cox 53:25
I usually only have to do a major change about maybe once every three, four months. But you know, there will be some weeks where it's like, Okay, I'm a little stressed from this, I might need an extra unit or two on and I'll see how that goes. Or Ah, you know, like this last week, I suddenly, you know, I went through one of my major changes. And so I actually went from 24 units down to 15.

Scott Benner 53:55
Well, what was what precipitated that?

Unknown Speaker 53:59
I'm not honest.

Skylar Cox 54:01
I mean, is there really any ever clear cut answer with diabetes?

Scott Benner 54:04
No, no, I was just wondering if maybe, like, you know, you, I don't know threw away like your head. And then you were like either body or something like that. Like that's a it's a big jumps.

Skylar Cox 54:14
It's interesting, because it actually came at a time where I am more stressed. Because, you know, at the end of the semester, you have exams, I recently changed jobs. You know, so there's a lot of crazy things going on right now. And yet, you know, my basal insulin, just just, you know, my body just decided to be more sensitive to it.

Scott Benner 54:37
That's interesting. It's cool. And how long did it take you to figure it out? What do you have some lows and you're like, what is happening?

Unknown Speaker 54:43
Um,

Skylar Cox 54:44
actually, no, I was having a lot of weird highs. So usually, I actually have my insulin to carb ratio and insulin sensitivity factor pinned down in so much that I can do a quick calculation. And I can tell you exactly where one unit of insulin will bring me approximately within point two millimole. Or you know, how many grams carbs will raise me millimole wise, you know, I actually have a graph for conversion factors. That works really well. Basically, based on a variety of scenarios, just simple math, simple algebra, conversion factors. But once you nail down your insulin to carb ratio and your insulin sensitivity factor, it makes it really easy. It's basically kind of like doing the Bolus calculator, you know, your Bolus calculator on your insulin pumps, I'm just doing it manually, you know, adding in a few others, a lot of reading. So, I read a lot of scientific reports, I read about the equation of dividing 460 by your total daily dose to get your insulin to carb ratio. And then 130 divided by your total daily dose to get your insulin sensitivity factor. And then, you know, I never necessarily liked algebra or chemistry, but I was proficient in them. enough that I put two and two together, and I was like, Hey, you know, this is actually really simple algebra and conversion factors. In fact, in chemistry, there's a graph showing how to easily figure out your conversions from like millimoles, to particles, to units of measurements or whatever. And basically, I just took that concept, and I plugged it in with diabetes. So my graph shows millimole units, insulin units, and grams of carbs. And in between those conversion factors, you have your insulin to carb ratio and insulin sensitivity factor, and you use one of the two or a combination of the two to get from one to the other, depending on your situation.

Scott Benner 57:15
Wow. So Geez, that's fascinating. And you figured this all out in the last year?

Skylar Cox 57:22
Yeah, yeah.

Scott Benner 57:26
I told you, you were more like 35. That's why you were so like, I would take that. In the beginning. You're like 35? sounds right. For me, I think that's really uncommon for people to figure out on their own to begin with, and I think at your age, it's really, it makes it a little more uncommon. Do your, does your period change things for you? I'm

Skylar Cox 57:49
not really, because I actually have the implant. Um, so that actually keeps my hormone levels pretty darn stable, thankfully,

Scott Benner 58:00
is that the ring? The my thinking of the right thing?

Skylar Cox 58:03
No, I have the implant on.

Scott Benner 58:06
Oh, the one thing that that literally goes in your arm?

Skylar Cox 58:09
Yep, yep. Yep. And it works really well. For me, the only thing I noticed is before my diagnosis, I had the next one on, which is like the same thing, just different brand. And I found that at the end of like, after a certain amount of time, it starts scaling back on how much of whatever units it gives you. Um, and so interestingly, when I had to go in for my implant on renewal, I noticed I did the calculations because I noticed that my insulin needs increased by a fair bit, and funnily enough, they doubled which accounts for like, the difference between the two because it was a fresh implant, so it was putting out more units or whatever chemical or hormone it puts out in you. So yeah, once I figured that out, I was like, Okay, well, maybe I need to double my insulin does because this is doubled the dose of

Scott Benner 59:15
hormones, whatever I was on, but it becomes consistent and stable.

Skylar Cox 59:20
Yeah, exactly. Exactly. Um, you know, it only took like the first week of fluctuations. And then after that, you know, like, Okay, this is a new implant, it's putting out you know, twice the amount or whatever, of the former implant because when I was diagnosed, I was at the end of the life of the last implant. So once I did that calculation, I was like, Okay, well, my insulin needs probably doubled, and I increased it And sure enough, it matched. Wow, that's

Scott Benner 59:51
really cool. I actually just I looked it up here, because I knew what you're talking about. It's um, do you use there's only two of them right. Then next blomidon or there's next put on next next point on is that is that the one you use?

Skylar Cox 1:00:06
It's the first one I had I currently have the infant on, I think they're the same thing. They're just different brand names.

Scott Benner 1:00:13
Gotcha. And this just this little, how long does it like, I can't tell.

Skylar Cox 1:00:20
Don't know, it's like an inch and a half long. Okay.

Scott Benner 1:00:23
And it's just inserted, is it injected? Or is it inserted surgically? Or how do they do it?

Skylar Cox 1:00:29
Yeah, it's sort of insert, like, they make a small incision, and then it like, injects itself in.

Scott Benner 1:00:35
Hmm. That's crazy. And and it lasts for years, right? Yeah, it

Skylar Cox 1:00:40
lasts for three years. Wow.

Scott Benner 1:00:41
So it's funny, you brought that up? Because I've been looking for a birth control for it not because I, because somebody brought it up to me the other day. I just don't want to get pregnant. I think at my age, it would be it would be difficult. But somebody brought it up the other day and said, Hey, when your daughter gets older, I got a lot of stability in my blood sugar by using an IUD. It was a note i got i get the strangest notes, by the way. And that was one of them. Which I was really grateful to hear about. And it just made sense. instantly. It's like, yeah, this just, you know, give us it. You know, I don't have I forget how this this implant, or this thing? It's probably not an IUD. I'm probably using the wrong words. But it's another it's like a ring or something like that. That has, I guess, hormones on it. Right arena? Yeah. Listen, if something like that, like it again, a lot of emails and I'm standing and I'm like, this one's super interesting. Like a person has taken the time to write me just say, this might help your daughter when she gets older. And I was like, oh, I'll keep that in my head. But then you just brought it up to and it's just, it makes total sense that you take that information away it gets easier to manage your blood sugar's that's very, very interesting. cisely

Skylar Cox 1:01:53
Yes, I see. The only caveat with that is each birth control, you know, each person reacts differently. So the implant on works perfectly for me. But it may not for other people. I know other people have had issues.

Scott Benner 1:02:11
Like they grew like a third arm or something like that, or

Skylar Cox 1:02:15
no, I think the most common issue is inconsistent bleeding. where, you know, some people control Yep, weight gain. But you know, side effects are to be expected when you're changing the chemistry of your body.

Scott Benner 1:02:32
Yeah, you would think I yeah, I guess it's it becomes a trade off at some point. If you decide, yeah,

Skylar Cox 1:02:38
it really does. When you're taking any sort of medication, you have to outweigh you know, you have to weigh the benefits versus the side effects.

Scott Benner 1:02:45
Okay. Hmm. All right. So, how much of your stability is based around your diet? Do you think?

Skylar Cox 1:02:58
None at all. You know, there'll be some weeks where, you know, I'm a star pupil, while not even some weeks, even some days where I'm a star pupil, and I'll just sit there and only eat my meat and my veggies or whatever. And then there's other days, like the other day, I had. Don't judge me. I had doughnuts for breakfast. Um, what did I have for lunch? I had a beasting for lunch, which is like some sort of pastry with cream. And then I had carbonara for dinner. All terrible, terrible, carby thing,

Scott Benner 1:03:35
all the same day. Just went? Yeah.

Skylar Cox 1:03:38
But I never once went above 6.8.

Scott Benner 1:03:42
Wow. That's and that's just with your management of insulin.

Skylar Cox 1:03:47
Yeah, so, um, I do have like some markers. So I try to aim for non diabetic levels, because I know a lot of diabetes educators, endocrinologist, doctors, caution against it, because, you know, they think that's too low for you. But my thinking is, okay, well, if non-diabetics can achieve that, and as long as there, you know, as long as I'm stable and not really dropping below those numbers, then why wouldn't I want to try and aim for non diabetic levels?

Scott Benner 1:04:27
I listen, that's what I do here. So you know, so

Skylar Cox 1:04:31
yeah, so my range is between 70 and 130. And from here, I don't know the conversions. But I think what is it a normal non diabetic is between five and 7.21 hour after eating. And then 3.8 to 6.12 hours after eating. So I try and match those patterns, myself recently.

Scott Benner 1:04:59
So you're saying between 90 and 135, five and 7.2, I have to admit, and I'm gonna do a, I'm gonna do an episode with Johnny about this, at some point, when, when I first began doing the things that I do the things that I talked about on the podcast, and etc, I was able to have even tighter tolerances, like the idea of like any kind of spiking, I mean, not that you could really call 130, a spike, but a blip, right? I just was like, I can keep them all out. But once Arden became a full fledged card carrying lady, that that was not as easy to accomplish. And I've really come to believe that there are people doing amazing things for young kids. But you know, as with timing of insulin, but I don't know that that's a lifelong possibility, all the time of that super steady, you know, 85, blood sugar all day long. It's a, it's a, it's a ton of work that goes into it. And I don't know, like, what I'm not sure of is the love of a parent who can think of a way to do that. And to actually keep up with it. People don't generally feel the same way about themselves when they get older as parents feel about you. Like you don't realize it when you're young, but nobody cares about you more than your mom, and maybe your dad. And and you know, and so once you become an adult, like to keep your blood sugar at 85, constantly, I think you would have to have a fairly strict restriction of carbohydrates to accomplish that. But I agree with you, I don't know that there's anything wrong with a blood sugar going to 130 for a little while and coming back and having a couple of gentle rolling hills throughout the day. That seems very reasonable to me. And it's very doable. I have a question is, did your concepts lead you to liking the podcast? Or did the podcast lead to the concepts?

Skylar Cox 1:06:57
admittedly, my concepts led to the podcast, but I would think yeah, it was my I love learning as much as I can to incorporate my own sort of, say, My way of handling diabetes is knowing it is being able to battle

Unknown Speaker 1:07:17
it.

Skylar Cox 1:07:19
So I decided, you know, as soon as I was diagnosed, I realized, Hey, I don't have to feel achy anymore, I actually have tools within my grasp and knowledge that can be obtained to reverse this around and leave lead a completely normal life. So I just dove ahead in to anything and everything, I could research papers and everything, to formulate my own concepts. And then, you know, as I said, Before, I subjected myself to my own experiments. So now I sort of have like guidelines by which to direct myself as to when to act when to you know, ease up, you know, for a more holistic view of my health. And then, you know, just in all of that, you know, it was just inevitable finding through Facebook, you know, tips from fellow diabetics, and then, you know, of course, the podcast was mentioned. And that's really how I came across it.

Scott Benner 1:08:29
That's what I mean, from talking to you for the last hour. I didn't think you were gonna say, Oh, I was lost until I found you. I thought you were gonna say, I found you because it was a like minded idea to what I was already doing. Yep. Yeah. That's excellent. That's very exciting. And you found all that on your own just like reading research and figuring things out. That's your to be that's really, like I would applaud for you. But that seems weird because it's a podcast if I started clapping right now people like there's a weird noise at the end of the show. I don't know what it was. But seriously, if somebody should stand up and clap, because that's really well done. Good. Now, you handle everything like this. Are you a bit of a mess in other ways, but um,

Skylar Cox 1:09:11
yeah, it's pretty much how I tackle life if I can't stand. Well, I I admit that there are always going to be some things that can't be known. But those things that can be known I want them to be known so I can figure out how to deal with them. That's

Scott Benner 1:09:29
really cool. And by the way, for anyone listening, jump back a couple times to hear Oklahoma come right out of scholars mouth. She said I can't. It just literally went like that for a second. I thought I thought you were gonna get the vapors and start fanning yourself. I was like, Oh my god, we're going right into. We jumped right back into the dialect from Oklahoma. You have a really interesting accent. It's a It's a neat blend. really is. Do you think you'll stay in Australia or do you think you'll finish up uni and drag Troy to go Go home again. You know,

Skylar Cox 1:10:02
yeah, um, to be honest, I'd be happy visiting America, but I think I'm really happy with the way Australia deals with diabetes over here. And you know, because diabetes is obviously a big part of my life. Um, I wouldn't say it dictates it, but it definitely you know, I think Australia better supports it.

Scott Benner 1:10:28
That's really cool. That's amazing, actually, that you found that he only had to fly. You know, like a whole day to get there. Do you come home ever? Like how do you see your parents? Is it like video stuff?

Skylar Cox 1:10:39
I, yeah, I pretty much voice message them. They came over and visited last year. But otherwise, I haven't been back to the States since July 29. of 2017.

Scott Benner 1:10:53
Wow. Did your dad try to shoot a wallaby while he was there something because you know, America?

Unknown Speaker 1:10:59
No, no.

Skylar Cox 1:11:01
He was more keen to try and pet one.

Scott Benner 1:11:04
Gotcha. I have to be honest. Right now. If you showed me pictures of three different animals. I am not 100% sure I could pick a wallaby out. So know why the lobby

Skylar Cox 1:11:14
kind of looks like a smaller kangaroo. Oh,

Scott Benner 1:11:17
hold on a second. This is this is how we're gonna end this episode with me trying to figure out what a wallaby looks like. Alright, so I figured out the spelling. So we're halfway there. Somebody wants to know if you can have them as a pet. That seems like a poor idea. Sir, it's very cool. Oh, wow. If you just told me it was a kangaroo short. I'd be like, Oh, if you told me this is a baby kangaroo. I wouldn't know the difference. Are you sure it's not? Maybe you guys are just used?

Unknown Speaker 1:11:47
Yeah, yeah.

Scott Benner 1:11:48
Do you think I figured out that Wallabies are actually just baby kangaroos? And no one else knows. I think that's

Unknown Speaker 1:11:54
not i i'd

Skylar Cox 1:11:56
say you know, it is pretty it is a pretty reasonable assumption.

Scott Benner 1:12:01
Skyler I like you. You have not let me get away with any bullshit whatsoever. While we're talking for the entire hour.

Skylar Cox 1:12:07
I'm sorry, I am. I am terrible. When it comes to sarcasm like I can even understand. You know, when I can pick up that somebody being sarcastic to me, I will still give them an honest direct response in relation to the thing they're trying not to.

Scott Benner 1:12:25
You were you were terrific. I I wasn't saying it in a bad way. I was just like, you'd never like, I was like, oh god, I'm married to this girl. That's how it felt to me. Exactly. Because you were just like, you were not letting anything go. And I was like, here we go. I already I already have women in my life who treat me this way. Skylar, I don't know. Oh, my goodness,

Unknown Speaker 1:12:44
it is it is

Skylar Cox 1:12:47
it has been such a struggle. That's been one of my biggest struggles here in Australia is everybody is sarcastic here. And their tone of voice doesn't give it away, like we do in America. So in America, where, you know, we kind of, um, you know, exaggerate our head movements, or, you know, exaggerate our tone of voice to indicate that we're being sarcastic. And over here, they just, they don't give any indication whatsoever. And, you know,

Scott Benner 1:13:17
I have to tell you that away from this podcast, I am proud of how dry my sarcasm is. I I'm only happy when no one understands what I'm joking about. That is my happiest place ever. It's not great in personal relationships, in case you're wondering. But, but you should I am never happier than when I say something I completely don't mean and everyone believes it. I really appreciate you doing this. Is there anything we didn't talk about that you were hoping to get to?

Skylar Cox 1:13:45
No, not really. I was a little surprised. You didn't ask about corrections. But I mean, that's sort of a touchy subject in and of itself.

Scott Benner 1:13:52
Well, hold on a second. Let's get to that. I don't I'm not Can you go a couple more minutes?

Unknown Speaker 1:13:59
Yeah,

Skylar Cox 1:14:00
I am usually up to like two or three in the morning anyway, so it is no big deal for me, to me. And you go.

Unknown Speaker 1:14:08
Um, well, um,

Skylar Cox 1:14:11
I just noticed a lot of people have issues with corrections. And I probably do a bit I'm a bit more daring in my approach. So again, I'd say I probably do what you do with the insulin pump with iron, but I do it the best way I can with manual daily injections or multiple daily injections. So when multiple daily injections we don't have the option of stopping insulin, or you know, delaying it or extending it or any of that are two options are. Give yourself a correction or give yourself more food. Right. That's the only two weapons in your arsenal. So with corrections, to be able to stay within my target range, I kind of go off of how quickly I'm rising.

Unknown Speaker 1:15:11
So

Skylar Cox 1:15:14
I'll just walk you through one of my concepts that I arrived to. So, um, this is the way I think insulin takes about 10 to 15 minutes to work. Food absorbs in about 40 minutes, depending on what type of food you have, this is just an average, obviously, you would see, you know, whether or not you have fat and protein or not. But generally food peaks in about an hour. So that's why you Pre-Bolus about 15 minutes or so 10 minutes for me, I have found if i Pre-Bolus, 15 minutes, I started dipping, and then rising a lot because that insulin, you know, didn't actually cover the carbs, it dipped me a bit. So basically, if I am still trending up between 45 and 50 minutes after eating, so I'll have like, says sly arrow up. And I'm around the 6.5 millimoles per liter mark, you know, just before I hit my 7.2 Mark, one hour after eating, because I want to try and stay under that mark, I will go ahead and give an additional small bolus. Depending on how heavy the meal was or not, you know, if it was just, you know, quick in and out carbs, I might scale it back some if it's just your standard carbs, I'll give the standard amount. And that additional Bolus actually usually kicks in immediately for whatever reason, and starts fighting those additional carbs to bring me back down. To say I'm like going slightly up 4550 minutes after eating. So 6.5 millimoles. Around that time, I usually give like 20%, or whatever my initial dose was, or if I'm like rising rapidly double arrows up or whatever, 30 to 40%. And then, yeah, I will be prepared, generally, to kind of lay down a small blanket of carbs to slow down that drop, if I start seeing myself drop, so I kind of like do the reverse. You know, I can take that 20% of the initial dose, you know, if I have like straight arrows down and go like,

Unknown Speaker 1:17:41
okay,

Skylar Cox 1:17:42
I might, you know, take some carbs to kind of cushion my landing or whatever. But I know most endocrinol address doctors, what not, they don't want you to do a correction until like two hours after a meal. But at that time, you're already suffering from a higher low. Yeah. So, you know, you're generally speaking, if the arrows going up or straight up, that means that my initial bolus or timing was wrong. And more often than not, I can rule out the timing. Um, and, you know, I go, yeah, I configure, yep, I can figure out that it's the amount. So I will go ahead and give that additional amount that I should have probably taken.

Scott Benner 1:18:34
And then it's not stalking if you need it. And that's

Unknown Speaker 1:18:37
exactly,

Skylar Cox 1:18:38
exactly. And you know, it, I hardly ever have any issues with it. Like, you know, because it takes about four to five hours completely to leave the system. If it does drop me, it's usually not that very, very tail end, where it's just starting to really slow down, and I can really see that and it's like, okay, throw in, like, three or so carbs, and that'll raise me half a unit and then you know, I'm sitting easy the rest of the day,

Scott Benner 1:19:09
how often do you find yourself in that situation where you have to bump a little bit after a meal?

Unknown Speaker 1:19:15
Um,

Skylar Cox 1:19:15
hardly ever, actually.

Scott Benner 1:19:18
I bet you that doesn't happen to you much. Because you probably once you see it happen a couple of times you adjust your ratio for the meal then.

Skylar Cox 1:19:25
Yeah, yeah, exactly. And I think I would say it's very similar to what you do on a pump. I just do it manually, and I keep a close eye on it as you would, regardless of MDI or not. Yeah, and yeah, so And I'll just cushion my landing with carbs if needed, but more often than not, it's it's not needed, because that's insulin I needed anyways. You were

Scott Benner 1:19:48
the right person to be listening to this show, that's for sure. That's excellent. I couldn't agree with what you said anymore. I just don't. I don't watch you know, I've boiled it down to ideas like Don't watch a high, you know, do something about it, catch it with food later if you have to make an adjustment if it keeps happening. That stuff all to me just makes sense. It's, you know, if you ever considered, I'm not pushing you. I'm wondering, because of how you talked about it seems odd that you don't have a pump

Skylar Cox 1:20:21
that don't have a pump. Yeah. Yeah. Um, well, at some point, I may try a pump. Just because I want to be able to subject myself to everything and say, you know, I've tried everything. But at the moment, I am happy.

Scott Benner 1:20:44
There's nothing wrong with it. I was just yeah, it just seems like you would have fun manipulating bazelon I just see you at home going, Oh, my God, the greatest thing happened today. I did a Temp Basal decrease.

Skylar Cox 1:20:57
See, with my chances, I'd probably hit the pump with a hammer.

Scott Benner 1:21:02
While you were while you're out there looking for, you know, bones in the ground? Yep. Gotcha.

Skylar Cox 1:21:09
I can't even begin to tell you like you damaged things that you don't even think would be damaged. Like I had to go and work out like $800 for a new set of glasses. Because in digging for bones, I didn't realize that the dust, you know, the dirt was kicking back in my glasses and scratching them. So you know, we're prepping your fossils particularly. So yeah, that that would just be my, my luck. Again, this

Scott Benner 1:21:39
dust is causing problems. More than what I've pointed out earlier. I hear what's happening. I gotcha.

Skylar Cox 1:21:44
But I mean, the reason I brought the corrections up is because it just it amazes me with a lot of people with manual daily injections, you know, that have issues with that. And it's like, Okay, well, if the pump, you know, a lot of people say the pump mimics the pancreas best. Well, if that's the case, then why don't you do the manual version of what the pump does?

Scott Benner 1:22:13
Do you know you think they're just trying to avoid injections, though?

Skylar Cox 1:22:18
Yeah, but initially, I would say yes. But after a bit of time, you hear a lot of people say that injections no longer bother them.

Scott Benner 1:22:29
So why not just

Skylar Cox 1:22:30
Oh, I can't Yeah, so why not just do it?

Scott Benner 1:22:33
I think it doesn't occur to them. I think that I think that they get stuck. It's it, they get stuck in that idea of like, Listen, I count my carbs. I put in the insulin, I wait three hours I test and then I look and I correct if I have to? That's what I've been told do. I'm still alive? Exactly. You know what I mean? So likely, I hear

Skylar Cox 1:22:51
because they were told to do it. And that's the biggest issue I have with that is because diabetes is I think I forget which doctor was maybe Val Wilson or something like that. basically said that diabetes is the only chronic illness where the patient has to do the majority of their health care decisions on a day to day basis. You know, it is impossible to think that an endocrinologist or diabetes educator can make half the decisions that we make during that day. So why, you know, would you it just amazes me that you know, why you would listen,

Scott Benner 1:23:42
watch a bad outcome and then do it. Yeah, yeah, exactly,

Skylar Cox 1:23:44
you know, precisely and it's like madness heating it and not change it. Right.

Scott Benner 1:23:50
Um, well, everybody isn't in the same boat. With their curiosity. Yeah, intellect. me like ability to figure it out. Thank you. You described reading some things and some simple math. And I guarantee you that there were plenty of people listen that it was I did not think that was simple what she said. And it's just because people's some people's minds just don't work that way. mind doesn't. Like this whole podcast exists, because I understand that.

Skylar Cox 1:24:17
Yeah. Yeah, yeah. I think just trying to think of what I'm wanting to say it's, it's not saying anything against, you know, their willingness or not to engage in that I think.

Unknown Speaker 1:24:40
No, you do.

Skylar Cox 1:24:42
Yeah. yet. You do. And I think there's a lot of stigmatism that oh, you know, you can't disagree with the doctor or anything. You can't take diabetes management into your own Hands. That's not what you're supposed to do. You're only supposed to listen to the textbook or whatever, right? You know, but I think I think what I'm trying to say is that diabetes, because of the very nature of what it is, it demands a more dynamic management system, you need to

Unknown Speaker 1:25:23
be active,

Skylar Cox 1:25:24
if, if you want to do well with it, then you have to be willing to

Unknown Speaker 1:25:29
be involved, you know,

Skylar Cox 1:25:31
be involved. Exactly. And that doesn't mean, you know, completely fine in the face of what your doctor saying, or did you know any of that, but by no means I'm saying find a doctor that has a concept, you know, has the concept that you know, diabetes is unique, it's very dynamic, it's going to require dynamic managing methods. And you know, to be there to support you to basically to enable you to manage it on your own, not make the decisions that you need to make. To manage yourself. Well.

Scott Benner 1:26:08
Well, I agree with you, 100%. And I very much appreciate you coming on and doing this and taking this extra time at the end to go over what you said, I think it's important, you know, people you got to do you got to be involved. You have to you can't just watch numbers and and hope it's, you know, you have to do something. And if you don't know what to do, you have to step back and figure out what it is that's happening. And if that's not clear to you, then find somebody that can help you. But don't just stare at it and spend the rest of your life thinking, you know, my blood sugar just goes to 250. That's what it does. You know, I get 400 once in a while it happens. I yeah, I cannot even begin to tell you that I sorry. 422.20. Yeah, probably I don't

Skylar Cox 1:26:57
think I've ever had that recorded. yet.

Scott Benner 1:27:01
It'll happen at some point. But you're all well, so it's not like you have a site that can go bad on your pump or something like that. So there's some stuff like that. But I'm just going to tell you that the last time Arden's blood sugar was that high. I don't know when that was, that is not something that just randomly happens to us. And it's not luck. And it's not magic. It's on purpose. I stopped that from happening. And so could everyone else. So exactly, just need to have a couple of tools and then know when to use them. That's pretty much it.

Unknown Speaker 1:27:30
Exactly. I

Skylar Cox 1:27:30
think diabetes management needs to lean away from you know, stagnant. Hey, okay, do this and do this. adjust this. See in six months, I think it needs to be okay. You need to look out for this. And do this when you start seeing this. Maybe try out this? You know, they might be? Yes, exactly. I think for me, my three main concepts, and I think this has mentioned on your podcast is diabetes problems, blood sugar level wise, are usually either due to miscalculation of an insulin dose, miscalculation at the timing, or miscalculation on the carb count. And, you know, obviously, if you didn't get the results you want, then you need to eliminate go through the process of elimination to figure out which one did you end? Yep, it's timing, or amount or combination of both. That's just how I think of it like it CDs, the right amount, the wrong time,

Scott Benner 1:28:36
the wrong amount, the right time, that's not gonna work. It's got to be the right amount at the right time. That's it. And it sounds super simple, and it's not, but it is, and once you figure it out, it's one of those things that you'll think I can never believe I struggled with this. I just have it now. But in the run up to just getting it is can be painful. So

Skylar Cox 1:28:55
yep, I could not think to succinctly sum it up more aptly. You should

Scott Benner 1:28:59
have a podcast and then you would figure out how to say a whole bunch of words in three words, because if you don't do that, nobody can remember it. And I know that because I couldn't remember it. Trust me. I I I dumped this stuff down for me first not not for you guys. And and then after I could follow it, I was like, well, I bet you somebody else could understand it this way. So Skyler, thank you very much. I'm going to go I have another recording and a little bit so I need to get ready for that. Fair enough. But thank you so much. Huge thanks to Skyler for coming on the show and sharing her story. Also, I'd like to remind you that if you find yourself listening to stuff like this going, Oh, I wish I knew how many five millimoles where you're going to Juicebox podcast.com. Right up there at the top, you can click on a one C and blood glucose calculator. There's a quick conversion calculator there. That will also help you see what your average blood sugar means. In a one. See, it's very cool. Like I'm here now. So if I type in the my average button was 123, it tells me that instant Scott, that's an average agency of 5.9. And that cool. Let's say your agency was 6.6. That would mean that your average blood sugar is 145, or 8.1. It does all those calculations in an instant, thanks to a very lovely listener who built this beautiful calculator for me. Again, it's at Juicebox podcast.com. And at the top, you just click on a one cm blood glucose calculator. If you're considering going to the T one D exchange to fill out the survey, I want to personally thank you. It's very valuable for people living with Type One Diabetes. And it's incredibly helpful for the show when you do so T one d exchange.org, forward slash Juicebox Podcast diabetes pro tips or diabetes pro tip.com, or right there in your podcast player beginning of Episode 210. Lastly, I'd love to thank you for listening and of course, for sharing the show with other people. And let you know that in Episode 418, I'll be leaving a link that you can go to to watch my blood sugar in real time. So I'm going to wear a Dexcom g six for as long as I can. So that you can see what a working pancreas looks like, while it's working. So thanks to sugar made, I want to thank Josh, the owner of sugar made for helping me do this, you'll be able to see my blood sugar live at Juicebox podcast.com. But there's a specific link you're going to need. So you'll get that in Episode 418. My idea here is that if you can see how a pancreas handles things, it might help you to understand what you're shooting for. That makes sense, as a person using insulin. I know there can be this pressure to just you know, keep the line completely flat all the time. But I thought maybe if you could see that sometimes someone's blood sugar goes to 131 40 and then comes back down again. I thought that would be really helpful and kind of comforting. So I've set this up. I'm going to thank Dexcom for giving me the gear that I needed. And of course Josh from sugar mate for helping me put it online. And I'm excited to share with you so that information will be in Episode 418. Then after that, I'm going to show you the blood sugar of someone who is pre diabetic, has some insulin resistance. And then I'm going to be looking for people who are really great at bolusing for certain meals to put their blood sugars live online during the Bolus, so we can watch them Bolus for these meals, you'll be able to see pictures of the food. And when the insulin goes in and how everything reacts. I think that'll be really cool. And I'm going to be doing the same thing. By the way, when I put my food in, you'll see a photograph of what I ate. It'll correspond with when I ate. Anyway, I think it's a really great idea. I'm super excited for it. That information will be in Episode 418 which is coming in just a day or so. Thanks so much for listening to the Juicebox Podcast. We'll be back soon. Talk to you later.

#416 From Cloudy to Clear

Guess, Check, Jab, See

Lachlan is an adult living with type 1 diabetes, a father and a teacher.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
This show is sponsored today by the glucagon that my daughter carries. g Volk, hypo Penn. Find out more at Gvokeglucagon.com forward slash juice box. I'd also like to thank the Contour Next One blood glucose meter for sponsoring Episode 416 of the Juicebox Podcast. You can learn more about that Contour Next One blood glucose meter at ContourNextone.com forward slash juicebox. And of course, learn more about touched by type one on their Facebook page on Instagram. We're touched by type one org

Hello friends and welcome to the show. On today's episode, I'm gonna be speaking with Lachlan Collins from Australia, and he has type one diabetes. He also has a bunch of kids and a wife. And he's a teacher. Laughlin got Type One Diabetes A long time ago. So he was using like that cloudy insulin and just eating on schedules and stuff like that. And he's gonna talk a lot about that today, and about his transition into newer ways of managing. I really enjoyed this conversation. I hope you will too. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. or becoming bold with insulin. I just got out of bed honestly. So hold on a second. Good morning. It turned out to be one of those days where where everybody was like, I don't really have to start till nine. My daughter's like school doesn't start till nine. I'm gonna get up at 845. And I'm like, Okay, my wife's like I canceled my seven o'clock meeting. I was like, Oh, all right. So anyway, all the people usually get up, and then wake me up. Because they don't want to take care of the dogs. They'll slip it Sorry, I opened my eyes like it's 840 I gotta move anyway. But yeah, we can leave it on if you want. I just thought it's dark in here. I don't have a whole lot of light.

Lachlan 2:09
Now whatever you want, I'm fine. It's fine. I've been doing this for the last last few months with with teaching kids and stuff. So

Scott Benner 2:17
have your eye

Lachlan 2:19
on or off doesn't matter. The kids. Kids Wi Fi at home Don't isn't normally really good. So normally just talking to a blank screen anyway.

Scott Benner 2:27
I can't believe we all have to think about this stuff now. But like how to talk to each other this way. I'll leave it on. Let's see how it rolls. It seems pretty stable so far. I'm recording your audio already. So before you introduce yourself, let me just finish my thought. What kind of teacher?

Lachlan 2:45
primary school? So I think you guys caught Elementary. Yeah, I'll teach five sixes which is age 1112 year olds.

Unknown Speaker 2:57
Right before they go crazy.

Lachlan 3:00
Or towards the end of this year, they start going crazy. But

Scott Benner 3:05
it's interesting, isn't it? You really do have them right to the spot where they they're just leaving one error. And another one. transitioning into a lunatic is what happens if I remember myself being that age? What do you teach them anything? Do you have them all in one class all day? Or do you have just one subject? How do you guys handle it?

Lachlan 3:27
Yeah, so we're with generalist teachers so that they'll have a couple hours out. Give us time to do some planning couple hours out to do say music or art. Yeah, we'll teach him English and Maths and everything. My name's lucky I tell a father to Yeah, I'm a teacher, as I said, and I'm a top one diabetic.

Scott Benner 3:53
How old were you when you were diagnosed?

Lachlan 3:57
I was 10 years old. Now back in 1997 97,007 17.

Scott Benner 4:01
Just got to you now your whole it's 2017. You're 30. And then 2018. You're 31 1932? You're 33 years old?

Lachlan 4:13
Yes, at the end of the year, you probably

Scott Benner 4:15
be probably like oh my god, those kids I teacher are way better at that than he is but I did some multiplication and a little bit of counting. And then I did addition really it was a lot of my a lot of my grammar school tools were thrown right together there.

Lachlan 4:29
Well, I knew I needed to do something like that. So I had to I had to work out how old I was.

Scott Benner 4:34
I just need to know how old you are. And I find it incredibly boring to ask how old you are for some reason. So okay, so you're 33 now you're diagnosed when you're 10 you were 10 it was 9797 exactly wasn't exactly the golden era of type one diabetes. And you live in Australia, which appears to be a place where American technology doesn't make it very quickly nears, I can tell

Lachlan 5:00
Yeah, it takes takes a while. I think I started off. I think you guys call it regular or something I remember it was a purple vial. And yeah, a couple injections a day with the cloudy and a clean mixture. And now I was on that for Aurukun three or four years before I got any of that. The rapid acting stuff, so, you know, okay, in the early 2000s, yeah.

Scott Benner 5:27
What he is you listen to the show. So is being diagnosed in Australia much different than being diagnosed anywhere else or mean.

Lachlan 5:38
I don't think so. I think like listening, listening, obviously, to you, too, over the last 1218 months, probably the whole podcast resonated with me with the fact that there's so many stories that I'm just like, sitting back listening or, or golf or walking on. Yeah, that that's exactly what happened to me, or that's, you know, that seems what was happening to my mom or, or that, you know, just kind of like, you know, it doesn't matter where you are? I don't think it kind of it does. Yeah,

Scott Benner 6:09
I agree. Do you find it comforting? Or?

Unknown Speaker 6:15
Were Yeah.

Lachlan 6:18
Initially, when I started listening, I didn't I don't know exactly what I was listening, while I started to listen to your Skype, but what it was, you know, started hearing some of these stories, where to start, you know, some of the some of the things that I've heard before or things have happened to me, I was like, I did start to feel a little bit of a connection with, with total strangers, I suppose. And that's, you know, I suppose what kept, you know, kept me hooked throughout Alaska last year. So

Scott Benner 6:47
excellent. I just think that there are some people who very much want to believe that, you know, we're all individuals in a way that nobody's the same and, I mean, everybody has their individual things, but for the most part, you know, I mean, we all live in a society, you know, there's doctors that are fairly similar. And I didn't know if that is I don't have diabetes. I didn't know if that made it comfortable, or if it was angering to not feel like your situation was unique. And but it's nice to know that it feels, you know, like it draws you in and makes you feel comforted. So that's excellent. Oh, cool. Mom, Dad, Mom, just who'd you have gone when you're diagnosed?

Lachlan 7:31
Well, I'd mom and dad at home that mom mom helped with? With everything. I think, right from the start, she was she went through with with me to the hospital and things like that. But yeah, pretty much at the hospital, I wouldn't, I wouldn't let anybody jabbed me, I wouldn't let a nurse or a doctor or if my mom give me an injection, so 10 years old, I was straight on, not on, on doing this on, on taking control of this and, and run with it. So mum was there, you know, that was pretty much made from the

Scott Benner 8:10
from the get go. But in those first number of years, using the cloudy you're just really getting up in the morning, giving yourself some insulin, and making sure you eat at certain times was that about the extent of it?

Lachlan 8:25
That's pretty much it. And I reckon that's pretty much my life. And until two years ago, not I wasn't, I wasn't using that insulin, but just just giving a few jabs. And, and not worrying about not not checking, you know, I might do one one test a day. If I if I was lucky, you know, didn't even really know what a carb ratio was, until a couple years ago, just look at a plate and go around, I'll do six or seven, eight units, just guessing if I went low or went low. If not, I was just, you know, just winging it. You know, I'm not sure exactly what the what the education was with, was with mom or anything like that. But, you know, it was just just guessing, checking. jabbing. See

Scott Benner 9:12
what, I grew up with a friend who had diabetes. So I think, you know, in those first couple years for you, that sounds, it mirrors his experience. Exactly. I can remember him thinking that little things like we're going to be more active today. So we'd give himself like a little less, or, you know, we were going to sit, we're gonna go to a movie, so it'd be a little more, but that was the extent of his consideration about it. And his meter was like, you know, it was like half the size of a shoe box, and it never left his house. So and he never used it and he never went to the doctor, like there was not like a I want to make sure I'm being clear. He wasn't. He wasn't not going to the doctor. It was just like the idea of having an endocrinologist just for your diabetes sort of didn't exist for him is Yeah, his general practitioner took care of it. And I don't know what took care of it means it must have meant making sure he had supplies and insulin. And that was pretty much it. But you unlike my friend, you transitioned into fast acting insulin in a couple of years. So you're saying that when you move to what do you guys call it Nova rapid there? Yeah. Okay. Yep. When you move to that, you're only like, it's so funny, right? I can't believe how things work out. Sometimes you're about 13 years old. We were just talking about that when it started, you know? Not the not the not exactly the greatest time for boys,

Unknown Speaker 10:37
for

Scott Benner 10:38
sure. And so did you treat the novo rapid? Like it wasn't much different than the cloudy just that it got injected at meals instead of it set times?

Lachlan 10:49
Yeah, pretty much what when, when I was introduced to that I was actually, I was one of the first I think I was the second kid that we traveled, or hours to get to the Children's Hospital in Melbourne. And when we got down there one time, the doctor was talking about lantis and how it was gone through a trial stage at that point wasn't actually, you know, freely available and stuff like that. So I was like the second kid or something in that in his office that day, and he was just like, yep, you're gonna be the second kid on the trial, or introduced Lantus. And while you're there, you're gonna be using this Nova rapid stuff as well. So you know, learnt learning how to how to get that Lantus dose, right. And then, yeah, the Nova rapid was just, it was more of a sign, you know, just look at the plight and trying to go Yeah. Yeah, I'll just have a guess it's much looking back. Do

Scott Benner 11:51
you have the feeling that you and the doctor were learning about this at the same time?

Lachlan 11:58
I think so. Yeah. Yeah.

Scott Benner 12:00
Yeah. as it moved in. I have to tell you, I'm sorry. This is gonna derail us for a second. But if you all want to look into my mind, you said I traveled four hours to get to my endocrinologist. Immediately, I see your mother on a zebra, you have little tan shorts on and boots and a hat. You're riding on the back of a kangaroo. And I know that's not what Australia is. But just so you know, you're telling this story. And like, in my mind, are these cartoon characters making their way across I don't know what the landscape was in my head. But it was a trek. Honestly, you had to stop at a watering hole is really something.

Lachlan 12:38
Every time you talk to somebody from overseas, when we have been traveling, that is suck, you say kangaroos regularly like you

Scott Benner 12:45
know, Yeah, you do. Like squirrels here. They're just everywhere.

Unknown Speaker 12:50
Yeah, they're there.

Unknown Speaker 12:51
When you have you been to the US?

Lachlan 12:55
Not the US. No. Okay, perfect. When you imagine

Scott Benner 12:57
the US is it just New York City.

Lachlan 13:03
Just Just finished watching something I'm telling you about. To bring bring down the mood map mass school shootings, and all this type of stuff. So now I think of cities and everyone in America has got a gun. That's what we just said.

Scott Benner 13:19
We're just all walking around with go see the Wild West. super interesting, because I have a, you know, well, I have a record realization of, of Australia, that's not real at all. And yours is pretty damn accurate. We don't want to so you know, it's an I think it is a little regional here. And by regional I don't mean state to state, although it is it might be county to county, or, you know, like, whatever. I probably shouldn't say this out loud, because people, I think some people figure it out who I am by now. But I've never held or shot a gun in my life. I have no interest in doing it. It isn't because of my politics. I just, you know, but but I would be lying to you if I didn't think sometimes. How am I going to like, you know, defend this house. If somebody comes barreling in here? Is it just gonna be me in a bat? And maybe that's better off like, I don't know. It just, you know, I don't know. I really don't I know some people that have 10 guns, to be perfectly honest with you, and I can't for the life of me imagine what they're doing. To me, it would be like if I had 10 computers, if I had 10 computers, I'd want you to call a doctor and say, Hey, I got this friend. He said, can you help computers? But that's super, that's very interesting. Okay, so you're so you just made a statement. I mean, I'm 33 years old. You get this novo wrap it around the time you're 13. So for 18 of the last 20 years, you're doing what you described, you're looking at your plate and Going I don't know about this much. And saying that I'll either get low or I won't. Did you first of all give any consideration to what would happen if you didn't use enough insulin? Was that ever part of your thought process?

Lachlan 15:12
No, no, not really. I was never. I was never afraid of being low. that that wasn't an issue with me. So I would always kind of go if I looked at a plate and thought six or six units, I might go seven units. You know, it would, wouldn't wear me out. Yeah, I remember being being young and dumb, and, and being low and, and not even eating just like just saying how far I can push it. When I was in my early teens and stuff and just sit on the couch and shake and sweat and have some jelly beans next to me. And, you know, I've never been afraid of it. So I've always kind of been probably lower than higher.

Scott Benner 15:50
Where you consciously in those moments, just thinking, I wonder how long I can hold out till I pass out. Was that a game? Or were you incapable of getting to food or what's that

Lachlan 16:01
about? Yeah, probably. Yeah. Like I said, I was just young and, and Domine. At some. Yeah, probably. Sometimes just coming home from school and just thought, I feel a little bit low. I wonder how shaky I could get. Oh, I've never never been unconscious or anything like that. So I'll probably be a bit chicken or lose.

Scott Benner 16:22
Once you'd be like, you know what, why don't I eat something?

Lachlan 16:24
Yeah. What a stupid thing to do. Yeah.

Scott Benner 16:28
Although I probably just scared the hell out of every mother of a boy that has. They're probably like, Wait, you mean that idiot stuff he does is gonna translate.

Lachlan 16:39
Yeah, I'm not an idiot now. But yeah.

Scott Benner 16:42
Oh, congratulations. I stopped being an idiot a year or two ago myself. Well, okay, well, that's it. I mean, it's good to know, though. It's, it's not that everybody's the same. But, you know, I mean, you're just describing how I handled cutting the lawn when my dad was like, cut lawns. Like, I'll get to it, you know. And he'd get angrier and angrier. And eventually, he looked like he was gonna kill me. And that's probably about when you were shaking. I was just testing out the waters, I guess. But you know what I was thinking when you said that was as much as you didn't have a system? You did. Because you were aggressive, and not scared to get up to sweating and shaking. So you probably were looking at food, giving yourself insulin, not getting shaky, and thinking, Oh, I could have done more. And then going more getting shaky and backing off a little bit. I bet you had some sort of a system even if you weren't maybe even completely aware of it. You know what I mean by that?

Lachlan 17:45
Yeah, I probably would have I would have been remembering how much I've given you an update and not? Yeah, for sure.

Scott Benner 17:50
Yeah, it's not. I mean, listen, that's not a good system. You're not going to build a podcast around that or something like, imagine ISIS Laughlin, I have a podcast about diabetes, what you do is you give yourself insulin, if you don't get shaky and sweaty next time you do more. That's not a good plan. But, but for a kid. Now. Why? And I'm not this is not a condemnation, obviously, because I'm trying to just figure out how it happens. Was your mom just not involved? Did she not know you were getting sweaty and shaky? Or was that just kind of thought of is part of the game how it goes?

Lachlan 18:27
Now I just would have been mom could have been anywhere at that at that point in time in the house. And I could have just been sitting watching Telly. And nobody would know that no, no technology, those days with CGM with alarms and stuff like that. So she could have been walking past and not even taking a second look at me. She didn't have to probably listen to this and be horrified. Now, I don't know if I've ever told her that but she'll find out but sure.

Scott Benner 18:54
She'll find out. How much of that do you think comes from those first few years of the of the cloudy? Like of just like this? Did it set up the expectation that this is what diabetes was? Were you waylaid a bit by the fact that the doctor did not step in and say hey, here's how you use this stuff. It's, it's markedly different than what we're doing now. Because I don't think that your experience leaving older insulin and coming into faster acting insulin is any different than most people who lived in that space. I also don't think it's different that you took so long to figure it out. I think it's a fairly common story. But do you have a feeling for what lulls you into like just feeling like that was okay.

Lachlan 19:37
Probably probably the fact that I'm only now realizing and hearing about, you know, the how different insulin works is, is that that clarity stuff that makes sure it takes a long time to work so you get lower later on, if you do nothing if you're not eating at the right time, so I'll be having lows anyway and I'm on even be thinking, I don't know why I'm feeling like this, because I've been on so long ago. So, you know, maybe it was just the fact that, you know, that's just diabetes you get you get low, sometimes you get shaky sometimes, you know? Yeah. Don't worry, you know,

Scott Benner 20:16
isn't it interesting that just the lack of a couple of tools really made that that statement, which you've heard me rail about on the podcast, you know, don't just say that's just diabetes. It's not you don't understand how to use insulin, but in that exact timeframe in history, that really was just diabetes. And the lack of a small portable meter was really the difference in your life. Like, that's fascinating. That's not good over here.

Lachlan 20:45
No, that's me. Two beeps.

Scott Benner 20:46
What does that put you? Are you high?

Lachlan 20:49
7.1 I just had a, I just had a couple of days. Ah, I'm gonna wide up lakes trails, I'll see watch them telling how to be

Scott Benner 21:00
with time isn't there, by the way?

Lachlan 21:03
live in 2018.

Scott Benner 21:04
I'm sorry for that. But thank you very much. I'm gonna do that. I gotta find my conversion chart.

Lachlan 21:12
Oh, sorry. I got it. Thanks, 128 120.

Scott Benner 21:15
Oh, so where's your high alarm set?

Lachlan 21:20
It's set at 7.0 rs. 126.

Scott Benner 21:24
Is that because of the podcast? Because if it is, I'm very proud of you.

Lachlan 21:29
Yeah, yeah. And the fact that now I've got a CGM. And I can I can actually,

Scott Benner 21:34
well, that was something I just heard beeping from a Dexcom. has had somebody from Australia on pretty recently. But obviously, it was recorded a couple of months prior where she was talking about not being able to get to it. But has that become different recently,

Lachlan 21:50
for you guys? Alfa summit has. So I think if the new runs if you're over 60 years old, and if you're under 18, or if you're on a healthcare card, so if you're a low, low income earner, you get the library or the Dexcom, I think, fully funded, but I'm working, working teacher, like I said before, so I earned too much money and have to pay for and pocket

Scott Benner 22:21
Well, in fairness, I can see your home. And it's obvious that you have opulent wealth, and your health should be tied to that for certain COVID I'm not making fun of locks on this house, it's just you know, there are no gold toilets behind him as near as I can see. So

Lachlan 22:41
I spent all my money on Dexcom since

Scott Benner 22:44
we dispersed this room up, but I'm trying to keep my blood sugar under 120. Well, you know, it's interesting, I don't know that there's a perfect health care system anywhere, obviously. And it always does come back to money somewhere, there's not an endless supply of money, or you're in a more capitalist society, where people are like, Hey, you could totally be healthy, if you can afford it. You know, so not for nothing. But that's, I mean, it's great that you got it, how long have you had it?

Lachlan 23:13
The Dexcom have been on since November, I tried to the library for about nine months. And that was that was awesome. That was a bit cheaper. But then I decided that I wanted to take another step and get a pump as well. So I thought I'm gonna get something that kind of integrates with that. And listening to you talk about Dexcom ching ching, it's meant to mention your sponsors, but

Scott Benner 23:43
I saw a Dexcom in Australia, as easy as I can sell it in Missouri, just so you know. Dexcom The price is probably going up next year.

Lachlan 23:53
Yeah, so I thought I'll give that a crack, you know, a lot to the, you know, the idea of having those alarms, I wouldn't have known I was seven. That was 120. Then Yeah. alarm went off. So

Scott Benner 24:05
well. What's the car? Is it all out of pocket for you? Do you pay cash for them? Or some of its subsidized?

Lachlan 24:12
Yes. So I got it's $250. So I don't know what that's American. But $250 for for sensors. Okay. And $250 for a transmitter that I've got onto people on social media that that can race reset, a re battery the transmitters. So, pay 50 bucks for a better transmitter instead?

Scott Benner 24:38
Well, I have to say only because of the sponsorship. I'm very much against that. And I think that's wrong, and you shouldn't do that. That's just what I would say real quick about that.

Lachlan 24:48
And also restart the census. That's horrible too, but that's what I've got to do.

Scott Benner 24:53
No, no, no, I am. Listen. I think you gotta do what you got to do. I was just looking to that. About the money exchanged looks like one of your dollars is like 70. So 70% of ours is one of yours. I am now very embarrassed to tell you that I went through 12 years of school and I realized there's probably some very simple mathematical equation that would tell me what that amount is. And I don't know what

Lachlan 25:18
it is is 100 $190.

Scott Benner 25:20
So I would take, I would find out what 30% what I would do here is take your cost, let's make it round numbers, just say I said $300. And I would find out what 30% of that is. And then that's what it would cost here. And so I would multiply point three, get 90 and subtract it or is that completely wrong? That's wrong. That's a third. Dammit. Hold on. Let's do it again.

Lachlan 25:45
Three, subtract that from 300. Don't talk.

Scott Benner 25:49
Don't just wait. I'm embarrassing myself. I have to stop my I never once in mathematics through my entire learning system that I come up with the correct answer in the right way. And back then, as a dumb kid, I thought, what does it matter? I'm being tested, I have the answer. And now I realize it's a lot about how you apply it when you need it. It would be like if I stopped a car by throwing a rock out the window attached to a rope, and then got into a real situation, right? It's not very quickly and thought, Boy, I bet you it would have been better if I knew how to use the braking system on this car. So when I need math, I'm, I'm lost. You probably none of you should probably be listening to this podcast, just so you know. But But okay, so you're so you're doing that, I think it's great. It's tough, because I imagine teachers aren't, you know, any more better paid in Australia than they are in in America. It's not like you're, you know, just probably walking out of the building every week, waving to the children. Goodbye, kids. I'll see you later, my money falling out of your pockets. I don't know what I'm going to do with all this money I got today for teaching you. So it sucks. But I love that you're doing it. I have to tell you. This hasn't come up on an episode yet. But I'm wearing index calm right now. I'm getting to where one for 10 days, right. And it's fascinating in a way that I can't believe I'm saying it as if I've never seen it before. And obviously, I've been looking at my daughter's data and other people's data forever and ever, but to watch it work in a person whose pancreas is doing what you expect. It's it's really eye opening. And I think I'm going to learn a lot so that I can talk to other people, which is was my goal when I asked for it. And it but it was hard at first and and the reason I bring it up is because as I as I was about to put it on the first time, I thought, am I about to find out something about my health? I don't know. Like, do you need me like am I about 48 years old? Am I about to slap this on to find out I have pre diabetes, about this, slap this on and find out that my favorite meal is something I probably should never eat again, you know, you know, like these that it was it was very, it was very interesting. And I'll tell you two things that have really kind of like, been super interesting about it. One is, and this is not what we would call humble brag. This is just what's happening. Arden's blood sugar and mine are following very similar patterns and heights. When we eat the same meals together, which was incredibly comforting. Do you really mean like when I see her blood sugar go to I don't know, you know, 120 after a meal, and then it comes back down again? Yeah, see mine do the same thing. took away a lot of anxiety for me, because I think that when we use insulin, least if you're listening to this podcast, you're trying to stay ahead of a potential mess up, right? And the idea of 120 diagonal up, you still don't know as much data as that is you still don't know. Is that about to be 170 diagonal up? Or is it going to level and come back again. And then I think that fear makes me concerned that any rise is bad. And then I realized there are some meals that we're handling better with insulin than my body could handle. Again, I'm not I'm not like Arnold Schwarzenegger at 48 over here, but you know, at the same time I'm, I'm not dripping out of my chair, you know, so I'm doing okay, that that part's been really kind of comforting. And the other thing is I find myself very This is gonna make you laugh, I hope because either that or again, you might want to call somebody and say Scott needs help. I find myself irritated at how slow my body takes care of my blood sugar. I look I think I wish I could give myself insulin here. Or, yeah, I would love to have Pre-Bolus this. Yeah. It's been just

Lachlan 30:09
telling you just tell the pancreas that I'm about to eight months, well not so it's not working.

Scott Benner 30:15
You'll apparently you'll probably hear this on the podcast before you hear yourself on it. But eventually I'm going to talk to Jenny about the entire experience. And I was telling her that I was texting her, I was like, I want to Pre-Bolus. I said, No, that sounds stupid. And she goes, your body sort of does. And I said, How? And she said, and I will have to dig into it more. But she said, when you smell food, your body starts to give you insulin. And I was like, get out of here. Did you make that up? I'm texting her back. I'm like, you made that up. Like, you just mess it with me, you know. But yeah, I'm gonna dig into that more and figure that out, too. But I have so trained myself to not want to see that graph. Bell at all, that when it happens, it makes me uncomfortable, even though I know for certain my blood sugar is gonna come back down again.

Lachlan 31:06
Yeah, it's, it's interesting, when when I got the, when I got finally got the Dexcom, I still had one of the Libras leftover. And I very persuasively talk my wife into wearing it for the two weeks as well, because I wanted the same type of data. And the thing I got from it was, how low she went when she was fasting, is she was comfortably sitting, sitting around, you know, 3.8 to 4.0. I got it ran 668 to 7070 all night without any issues and that type of thing. That's normal. So, you know, I would, you know, be a little bit more comfortable sitting at, you know, in the 70s. Overnight, rather than thinking or I'm sitting at that hour, but I have a little snack before I go to bed. Because, you know, it's normal, nothing bad's gonna happen.

Scott Benner 31:57
Yeah, there's an old episode called Terry lives on a boat. And he was the first person that ever said that to me years and years ago. He's like, you know, there are people without diabetes whose blood sugar's go to 60 and sit there for a while they're not scared of it. First of all, they don't know it. But secondly, they're not scared of it because their their body's not gonna pull them lower than that. And it's not like they have you know, man made insulin them running wild because they use too much of it. And I thought, okay, that's comforting. You know, like I took a lot from that actually just recently recorded a second episode with with him and it's gonna go up in a little bit. I just very much enjoyed him. I reached out into the listeners, I was like, I said real quick. Whoever says it wins first, like, name an episode you really loved and somebody came back right away. It might have been a woman named Jamie and she said, Terry lives on a boat. I love that episode. I got so much from that when I was like done, I'm gonna record retiree again, sorry, I got him back. And it was really it was really, really interesting. The guy who pays attention, so Okay, so you you go about your life for these 18 years, living the way you described what happens that makes you pay closer attention. Je Volk hypo pan has no visible needle, and it's the first premixed auto injector of glucagon for very low blood sugar and adults and kids with diabetes ages two and above. Not only is chivo hypo penned simple to administer, but it's simple to learn more about, all you have to do is go to G Vogue glucagon.com forward slash juicebox g vo shouldn't be used in patients with insulinoma or pheochromocytoma. Visit je Vogue glucagon.com slash risk. You know, sometimes you're just banging around the internet looking for something to understand, learn, see or look at checkout touched by type one.org. While you're doing that, and if you're not such an internet person, and so much as you don't like the www, you can also look on Instagram, and Facebook. Touch by type one is my favorite diabetes organization. And I really hope you check into them. While you're out there, don't you deserve a state of the art accurate blood glucose meter? I can answer for you. You do you do deserve that. And it's not as far away as you think. You might be thinking I have a blood glucose meter. It's right here. It works fine. Does it? Is it one of the more accurate ones available? How do you know? Well luckily for you, well, I know that the Contour Next One blood glucose meter ranks at the very top ranks up there with the very best of blood glucose meters. It's super accurate, easy to use as a bright light for nighttime tracking and a second chance test trip. So you don't have to waste the strip. If you touch the blood but don't get it off and you still get an accurate reading when you go back in for that. next little bit of blood. Contour Next one.com forward slash juicebox learn about their meter. Learn about their journey. Your program, and you may even be eligible for a free Contour Next One meter. Not only that, I know you're like Scott, that's a lot already, but there's a little more. Many people may find that paying cash for the Contour. Next One and the test strips is cheaper than getting your current meter through insurance, it's worth looking into Contour Next one.com forward slash juicebox touch by type one.org g vo glucagon.com, forward slash juicebox. There are links in the show notes or links at Juicebox Podcast Comm. And of course, you can always type them right into a web browser. Let's get back to Laughlin who's about to answer a question. What happens that makes you pay closer attention?

Lachlan 35:48
Probably the birth of my second son, I just I just started thinking a little bit more about the diabetes and the fact that you know, I suppose runs in the family to some extent I was a bit you know, of paternal instincts. I don't know what it is, but started wiring about my boys getting it before they actually get it. So I was like, Well, if if it does happen that, you know, one of my sons do get it one day, I kind of wanted to know, I wanted to know something because it turns out I knew kind of nothing. I was just making it up as I was going. So from there, I just I started educating myself, I started reading books, and I asked to ask the doctor that I was saying, you know about CGM. And he knew nothing. He was just like, is the name of an educator, go to go to this lady. And because I've never been to a diabetic educator either. And she was just like, yeah, these This is, uh, this is what they are, this is how you get them, you know, you're gonna have to pay out of pocket for them. And then, you know, from then when I strapped one of those on, and you know, like I said, I was reading books and that that educated kind of said to get online and start talking to people on a bit of community because I never knew I never knew diabetic from when I was growing up, right?

Scott Benner 37:14
None of the kangaroos have diabetes.

Lachlan 37:17
Yeah, they might have, but they don't say much. So

Scott Benner 37:21
that's gonna be a problem there. No, you can't form a community with a bunch of kangaroos that won't talk to you. That's for certain? Well, so a couple of things. You said there are interesting, the one that really sticks out to me is that even when you went to a doctor and like I have to do better at this, they said, Here, we'll take this technology, and then go online and find somebody who can help you like it. Was there any part of you that was looking, I'm like, you're the person you're supposed to be?

Lachlan 37:47
Well, first, I went to my doctor and asked him about it. And he was he gave me to somebody else who, you know, who was supposed to know, and she didn't know, things about it, it was just the fact that you know, to get more information that you want, you know, from I only had my short, short appointment time, you know, get online and start talking people and find things out. So

Scott Benner 38:10
those poor doctors must have PTSD. By the end of the day, in the week, just 20 people asked me for help. And I said, I don't know, you know, we only have 10 minutes together. Have you tried online Goodbye, like, you know, I feel terrible. Sometimes when it's over. When you put on? You said you went with the library first, when you put that on? What did you learn?

Lachlan 38:33
sparks sparks? Or is that just how high I went? After reading, and then not not panicking, but just kind of go I didn't realize that maybe I didn't give him enough insulin and then I'll give more insulin. And then the insulin that I gave to start with would catch up and then I'll get really low lighter. So is the fact that I was Miss Tommy is the old adage of Pre-Bolus times and which I didn't know anything about at that at that period. So I was having lots of spikes going up to 1414 or 13. To 60 to 70. Yeah, and then come back down and and, and that type of stuff.

Scott Benner 39:17
So how low Are you getting?

Lachlan 39:20
Ah, I could get well into the twos into the 40s. Yeah, regularly.

Scott Benner 39:26
So even some of your eight one c Do you remember what your agency was in that time?

Lachlan 39:31
Oh, yeah. Every time went to the doctor, and I still went every three months, six months ever since I was diagnosed. I've never, never didn't go always in mid sevens.

Scott Benner 39:45
So you're in the mid sevens. And you're but your blood sugar's are regularly 40 and regular 200 regularly 280. So your deviations so far off that the lncs sort of meaningless.

Lachlan 39:57
Yeah, so the doctors always said you you're doing okay, you don't find He's just scripts Off you go. So and I just took him as much as right now I'm doing fine. I don't know anything what I'm doing, but what I'm doing is fine.

Scott Benner 40:09
Well, you may or may not enjoy the episode I put up last night. So I had a doctor who works for Dexcom His name is john Welsh, and I so the way it started was, is I reached out to there's a person I used to schedule my stuff with Dexcom. Right. So I reached to that person. And I said, I would love to get someone on who can really pick apart standard deviation as it relates to diabetes, and how these these graphs are built, and how we talked about because, you know, a one C was, you know, the only measurement for a long time, but now, you know, standard deviation people are telling you is maybe more important. And he came on and told me beyond that, that. And here comes my lack of school, again, co coefficient coefficients of all odds are made with it, you're like, no, the kids I teach are not that old. I don't know, either. One second, Oh, my gosh. Anyway, john comes on. And while I'm looking, and he is much smarter than me, and I could tell immediately, when he started speaking, I was like, Oh, so I picked a spot on my desk for an hour and a half, and stared at it. And listen to him like this, when he was talking, like trying to keep up it was it was it was like being sent into, it felt like I was being sent to an algebra class for the first time. And I only had an hour to learn it. And because I had to ask him follow up questions that were reasonable. So So while we're talking, he's like, Scott, I think standard deviation, coefficient of variation, time and range, a one see these things together are the story, you know, not just the a one C, which, you know, you hear people say a lot over the last couple of years, or I hear them say it a lot, but it never followed with context. So I wanted more context for it. Even I would tell people I I'd say kind of just like, you know, like James Bond asking for a drink, I'd be like, Well, you know, anyone sees not everything, your standard deviations, very important. And then, you know, just sort of fell off because I don't know what the hell else to say after that. You know, I didn't know what else. And I wanted to know. Well, I know now. Interview Listen, you'll know to, but you're going to need to listen through some, you know, which I'm assuming to math people was probably like coloring, you know, like me. While I'm just like, oh, that guy's telling me calculus was, but but but he did his best and I and I, you know, to make it, you know, digestible. But in the end, it was very interesting. an hour, I was supposed to have him for an hour and an hour and 20 minutes into it, because he was sharing his screen with me. I couldn't see my clock. And I just suddenly thought, oh, like, what time is it? You know, so I looked down. I was like, I'm keeping you you have to go and and it the time flew by, like, the description of it probably sounds so dry, and boring. But I really enjoyed, like having the conversation and I hope other people enjoy listening to it. Honestly, because I think he's right, like he talked about, there's this number in your clarity, coefficient of variation. He said, If you keep that number under 36%, you greatly decrease your chance of low blood sugars. And I was like, Are you serious? Like all these numbers mean something. So that was just really interesting. But But nevertheless, to go back a little farther. Hopefully your children will never hear this. Why did the birth of your first child not make you want to be a better parent?

Lachlan 43:55
No, I would have thought about it. For sure. Actually, I just gave him a blood prick tonight, because he was drinking a little bit too much and gone toward a bit too much tonight the first job, but I know just I don't know, maybe I was thinking the first one I just came, you know a bit more than that. So

Scott Benner 44:11
I was like, I was like, God, I hope he doesn't say, you know, to be honest, the first one's kind of a prick. So I really, you know, I mean, if I'm not around for him, whatever. But the second one I really like that's a good question. What a good What a good kid, you know. But I understand how old were you when you had your first?

Lachlan 44:34
29

Scott Benner 44:34
Yes, yeah, I have to tell you. I don't really think this is I don't, you know, I don't want women to take too much of a wind from this. But I don't think I was really a human being until my early 30s to be perfectly honest. I mean, like I was just in my 20s after I got married, I was just like a machine of doing things that I thought my wife needed or wanted. Like didn't mean like building a life. That kind of feeling I don't think I got to the point where I was like, I wonder, you know, who I am, you know, like, that didn't hit me until 3132 33. I was like, I wonder if I could maybe pay attention a little more. But I hear what you're saying. And I and I think the same thing. Through this pandemic, I, I purposefully, I recognize when the COVID-19 thing came, and they were like, everybody get in your house, I was like, Oh, I'm gonna get fat. Like, my first thought I was like, I'm gonna weigh 50 pounds more than this when this is over. And I thought I can't let that happen. And so I did some simple stuff that obviously I could have done forever. I went to intermittent fasting schedule of eating, you know, cut out a couple of items, not much took some oils, like processed away a lot of my life, like simple stuff that obviously I should have been doing forever and wasn't brain surgery. And I lost I've lost 11 pounds so far, during this whole thing. But it wasn't Thank you. It wasn't from. I never once thought I wish I looked better. I don't know how this will sound but I don't think of myself as how I look. Like I think of myself as like, what's going on in my head, if that makes any sense. And my thoughts are me, in my opinion. But I really did start thinking about, you know, my kids are gonna have to go on for a while. And I don't know, I had something going on. I talked to my mom, my mom's 76. And I thought this was valuable. Like, I learned something talking to my mom today. I want to be available for my kids to talk to me, you know, hopefully, hopefully, they're just not that guy's a prick. Nevermind. I don't mean, you know, the way you think of your children, but

Lachlan 46:46
just one.

Scott Benner 46:47
Well, in fairness, the other one's terrific. You know, so I was kind of doing the same thing. And I really hope I can keep doing it. I think I found something that's very workable for me. So I don't, I don't see how I'll have trouble sticking to it. But I understand what you mean. So. So once you decided you wanted to be there for your second child. And you got this advice from the doctor to go into the community. You said you found some books, what books did you find?

Lachlan 47:16
I read things like a pancreas, which is Gary Schneider's. I

Scott Benner 47:21
think you've interviewed him before I've never had Barry on but Jenny works for Gary.

Lachlan 47:25
Oh, that's right. Yeah, that's what I've heard. Yeah. That bright bright spots and landmines book who have interviewed Adam,

Scott Benner 47:33
did they help

Lachlan 47:35
those books? Yeah, they did. They did. I don't do a lot of reading for my own site for my for myself. For the work I do, but I did. I did learn a lot there. Like, like I said, at the beginning, I didn't even know what to carb ratio was like I was I was basically, I kind of thought of myself as just being diagnosed all over again. I was getting all this information. And because I was interested in wanting to learn about it, it was it was sticking in the head, right. And then, you know, from there, it was, you know, trying to listen to people online and everybody else's opinions and things and stuff. And it just kind of got too much people just conflicting things that say, Oh, that was the other book. The burns Bernstein's dark Swan, whatever, that one Oh,

Scott Benner 48:27
you thought about maybe doing low carb at some point?

Lachlan 48:29
Well, it's just another book that I read. And and I, you know, I tried it for a little while, and it was great. But, you know, I enjoy beer too often or too, too often. So it was just like it just, it worked. out for me

Scott Benner 48:46
for dinner. It's a ribeye steak again. He bought a whole cow he stuck in a freezer, he's chipping a piece off every night. biking, hiking, biking. Please don't yell at me. Low Carb people I know there are other foods that are low carb but I i understand. And I think by now people who really listen like if you stumbled on this show on this episode, and heard me say that you'd be like there's another person saying, I don't think low carb is not a good option. I think that whatever people like are comfortable with that works for them is a good idea. I'm not a nutritionist. I couldn't tell you if one thing is better for you than the other. I mean, you heard me try to do percentage of 300 the other man I still don't have the answer. It's so good. But what I what I always really think and I hold dear is that you need to understand how insulin works so that whatever eating system you come up with, you can you can stay ahead of your meals, you know, like you just need to understand how insulin works and then do whatever you want after that. I honestly don't care. But so you took all this information in and what do you think the first like adjustment you ended up making was like What got you on like, what is your agency now?

Lachlan 49:57
As of three weeks ago, it was five point Non Wow. And that was on. That was MDI, I was because I've only got the pump for about two weeks now. So yeah, my educator, my educator said, when I got the pump and told her that, she said, What are you getting on a pump for? You're not going to do better than that. So

Unknown Speaker 50:17
I said, Well,

Lachlan 50:17
I said, Just wait, just wait and say,

Scott Benner 50:20
lady, I got a podcast and I'm just gonna tell you right now,

Unknown Speaker 50:23
I'm gonna get out of Scott,

Scott Benner 50:26
five, five, you just hold on to yourself a little bit longer. That's that's very, I mean, first of all, five, nine on empty eyes is terrific. And the books I can't, you know, I can't say a bad thing about any of the books that you found. But let's be honest, it was the podcast that really fixed it for you, right?

Lachlan 50:45
Oh, absolutely. Yeah. Yo, man. Yeah, it just got to the point where it's like, I might have a little bit of information, but I don't really know how to apply everything. And I suppose you know, a lot of your analogies and things you tug of war one gets me every time you mention it.

Unknown Speaker 51:04
I'm glad

Lachlan 51:05
when I heard that the first time it just just clicked. And it was just, you know, I've just got to give it a bit of time and a bit of bit of a head start. And, you know, I would have those thoughts. And I don't know, which is correct. Do you

Scott Benner 51:17
know, have I ever said how that where that tug of war? Like, thing came from? Oh, I mean, I was. So a lot of what I know, a lot of what I understand about the podcast was made more, I enriched it by talking to people privately. So I had these ideas. And I would write them on the blog, and then the podcast, you know, when the podcast started, even, and I still do it now. But it's almost like an exercise for me at this point. But back then I would do, I would have a lot of conversations with people, what would happen is like through social media, someone would probably be in the same exact situation, you found yourself in online, desperately trying to figure out what's going on and someone else who had read a blog, or, or something would say, Hey, you know, this guy, Scott will help you if you message him. And so when people message, they start sending, if you've ever tried to message diabetes management back and forth, but it's just it's too much and too much gets lost in writing. And so I would tell these people, why don't you just call me, because we can, you know, we can bang this out in 45 minutes, I genuinely believe that if you're motivated in about 45 minutes, I could probably fix everyone say, you know, like, it's not like, it's not that because I've I've kept honing it, like getting that conversation down shorter and shorter and shorter. There might be people listening now that were like, Oh, my God, my call with Scotland like, you know, an hour and 15 minutes. That was before I got really good at it. So it's so it ended up being practice for me. Like, I know, I wasn't practicing on people. Like I wasn't saying stuff that I didn't know. But like the way I would say it would, would get refined. And one day I was speaking with this very young mother of a child with diabetes. And the woman, because she was so young, it's almost hard for me to call her a woman because I can I can I know about, you know who my daughter is, at 16 years old. She was young, she had dropped out of high school to raise her child. The kid gets diabetes. And she finds her way to me. And I explained to her how to Pre-Bolus in a way that I thought was crystal clear. And I was just like, I've done it, this girl understands we're gonna get off the phone. Now. There's this little pause, and she says, I'm sorry, I don't understand what you're saying. And I felt really defeated. I was like, I'm gonna have to get off the phone with her and she's not gonna have an answer. And then that made me feel terrible. So I just literally said to her Hold on a second. I'll think of another way to say it to you. And I just got quiet for a minute. And I was like, okay, okay. Okay, here it is. And I used to talk about, like, I used to tell people, like, imagine scales of justice, but there's little holes in either side of them, and you're pouring in insulin and carbs on either side, but they keep draining out the bottom. So you have to put in a little more carbs, a little more insulin to keep the scales balanced. And it was the way I used to think about it. But when I said it to her, she was just like, I don't know what you're talking about. So I said, Imagine a tug of war. And I started talking. And now, you know, when there's been times where Jenny's like, that's like the greatest way to explain it to anybody I've ever heard in my life. And she's like, I do it. Personally, that really touches me because Jenny is incredibly good at talking to people about their diabetes was much better at it than I am, I think. But, but I just it resonates. It's very cool to hear you say all the way across the world that that it was valuable for you to I'm really glad about that. In the end, I just figured you've got to distill these ideas down So far that they're unmistakable when people hear them. Yeah, you know, because it's not an academic endeavor your life with diabetes, it's happening to you, you know, you need to be able to like, how do I Pre-Bolus this? How do I take care of this on the move while you're raising your children, and, you know, just

Lachlan 55:17
not a mathematical equation you get from some of those books that just like,

Scott Benner 55:21
right, it works when it works.

Lachlan 55:24
But it's not. That's not life.

Scott Benner 55:26
It's not the way you do that. That's very cool. So you've been at this now, the better part of a couple years, you're a one season to five, what kind of pump? Are you getting? Or got?

Lachlan 55:39
I got t slim. No. omnipods in a in Australia. So that was the next best best option. And yet, john? Good. Yeah.

Scott Benner 55:52
That's excellent. It's a good it's a really good pop. Are you going to use um, do they? Are they offering you the algorithms?

Lachlan 56:03
Yeah. So I've because we're, we're still on a j five here in Australia. I think the J six is due for August. I think I read somewhere recently. So obviously, we can't do the algorithm stuff until we get that but I was thinking I probably would give it a go. But, you know, I'm doing alright, without it. So you

Scott Benner 56:27
certainly are,

Lachlan 56:29
will say Oh, yeah, you

Scott Benner 56:30
really, really are actually. So you mentioned this earlier. Do you have a fear that your kids are going to get diabetes?

Lachlan 56:40
Yeah, yeah, I suppose. Yeah. It's it's an end. You shouldn't you shouldn't because it's, it's not the end of the world. No, it's not the worst thing they could have. It's it's manageable, obviously. So but but just having, you know, like I said before, I pricked my four year olds finger tonight and you know, he doesn't see his blood too often. And you know, he'll some tears and tantrums because of that. So you know, having to do that regularly. You know, I don't know, I've heard heard parents and stuff come on your podcast before and I don't envy the situation is a lot easier managing yourself than I can imagine having to manage someone else.

Unknown Speaker 57:19
I think so

Scott Benner 57:19
too. I've I've laid over top of Arden's legs, so she can't get away and I can hold the lance in the meter. At the same time when she was little Mike stays still.

Lachlan 57:29
If it happens, I'm gonna have to find a whole whole different podcast or something that's gonna tell me how to manage a five year old

Scott Benner 57:38
hole, bury him up to his chest, he won't be able to. I mean, that's off top of my head. It's no tug of war analogy, but it's gonna work. I'm just telling you. I think the government will come take your children, by the way if you do that, but they'll be like, that's enough. You can't have them anymore. We saw what you did. No, I listen. The truth is, is that it? I mean, nobody in their right mind wants to poke a hole in their finger and make it bleed. And you know, but at some point, just like everything else it becomes. Yeah, I mean, you're never gonna love it. It's it. I don't think anyone ever picks up a lens and goes, I've been doing this for 20 years. Boom, I love it. They'll do it. They'll tolerate it. It doesn't bother them. But they're not. They're not in love with the idea. I don't think yeah. I have to say when I put this Dexcom on, it really didn't hurt. Like, I always had to take my daughter's, you know, description of it when I talked about it. But it was so funny. I used to do art. And I was like, why don't you do it? Like you can stick it on for me like fair's fair, like, you know what I mean? We'll go ahead. And she got real funny. She's like, what do I do next? I was like, What do you mean? What do you do? So like, you know what to do, just like it's different from this side. I was like, Okay, if we got already and I said, just, you know, give me a little pinch up, and, and push the button. And she's like, I can't push the button. I just pushed the button and started making me nervous. Because I was like, wait, why not? And she pushed it. I went, huh. I was, like, really fasting, like, to even call it a pinch would be excessive. And then there was a tingle, or I wouldn't call it a burn for a minute or two afterwards, just kind of like it's settled in and the skin got used to it and then I just didn't know is there anymore.

Lachlan 59:25
Yeah. And well, I get I get my wife to have to put my decks on because I put on the back of the hip and I can't really reach around and like I said, you know, I've always done my own jobs and taking care of myself completely. So, you know, letting somebody else put something like that on for me over the last six or nine months. You know, it's not that it doesn't hurt it's just I think it's just that anxiousness of waiting for somebody else to do it because it doesn't happen exactly when you push it or anything it's gonna happen. I think that I anxious thing more than anything else.

Scott Benner 59:55
I definitely see that with her and she's still like I talked about all the time, but like on the Pipe clicks as it's it's like ratcheting. It's making tension so that it can fight it fires a needle in and retracts and leaves the candle behind it happens probably, you know, in the beat of a butterfly wing or something like that. But as it's making that tension, it's like, click, click, and you can see her she's just like, tensing. By the time it's done. her shoulders are above her ears. I was like, can you relax? And she and we talked about all the times. I know, like Arden's gonna be 16 in a few weeks, she's been wearing it on the pod since she was four. Now that math I can do, okay, so if it's every three days, that's 10 a month, 120 a year 120 times? That's a lot of out of the box. And she's still, it's just like, it's clicking? And I'm like, I know, like it did three days ago. Does it hurt? She's like, not really. So it's interesting, you know, it's just, it's human nature, it's hard to, it's hard to avoid? Well, did we not talk about anything that you wanted to talk about? Because I'm not good at, you know, linear thought.

Lachlan 1:01:13
process, probably just the fact that, you know, for 20 odd years, or whatever I did, wasn't really taking great care of it. Just the fact that, and you don't talk about it a lot, is the fact you're talking about the long term. The Long long term issues with high blood sugars and things like that, but probably from what I've realized, and learned over the last couple of years is is some short term problems with high blood sugars is enough, because I've only just learned about it in last few years is the fact that, you know, then the mood swings, I think, having high blood sugars, and then low blood sugars, and then being high for for, you know, a period of time. Probably all grown up and, you know, even into my 20s, people probably thought I was grumpy or moody or angry at them at different times. You know, even people in my family have said it a different times, you know, learning about it, you know, the last couple of years that it could well, and it is now a lot to do with high blood sugars, because you just irritable and just don't want to be around people and things like that. And, you know, just if people understand that high blood sugars are good in the short term, not then obviously not good for the long term. But, you know, your personality can change when when you get high. Nowadays, I don't get above, I don't get above 10 I don't get above 180 it just doesn't happen very often. So I just feel a lot happier and, and easygoing and relaxed. And I don't feel like that. Right, grumpy, moody type person that a lot of people that I've grown up with,

Scott Benner 1:03:06
think of us

Lachlan 1:03:07
and think of Yeah, and I do, they've said things are, you know, like, he's just grumpy. Don't, you know, don't mess with him now or whatever like that. But no, it's,

Scott Benner 1:03:17
and you don't feel like that kind of a person. So obviously, I have to tell you that you just hit on a number of things. But one thing that I really identify with is that um, when I'm when I feel misunderstood, it I find it heartbreaking. Like Like, there's a person I am and if I'm, you know, if I care about you, and I'm interacting with you, and I'm not coming off the way I intend, I'm like, Oh, that's not how I feel like I can't believe they don't see how I feel. And I'm more in tune with that because of almost exactly what you just said, although I don't have diabetes, I turns out I was living for a long time with an incredibly low ferritin level. So we're learning more now but it's very possible that my body does not retain ferritin like other people's do, and as my blood as as that value drops in my blood. It's very similar to what you're talking about, like you can get irritated for no reason things seem worse. You know, you're you're more short tempered, tired, cloudy, that kind of stuff. And you know, once I figured it out, then I got it straight. There's my very first thought outside of my own health was oh my god, like all these people around me think that's how I am. Yeah, I just I was terrible feeling you know? It turns out you were the prick. But kids are mine. I just and so is it has it changed. like have you and your wife discussed it?

Lachlan 1:04:53
I have talked. Yeah, I have talked about it. And I don't know. I suppose she married me so she must have The best to me at some point anyway, so

Scott Benner 1:05:02
small island man, she was probably just like a decent guy. And I mean, what am I gonna do? not marrying that kangaroo that's for sure. Well, I think everybody's got it figured out. Now you're getting laid more because of the podcast and you're just have your wife jamming something into your hip.

Lachlan 1:05:25
Is this an off the dock special?

Scott Benner 1:05:27
Yeah, but I made a couple more minutes. And we'd have to cut out the references to your children because that would just be creepy. But no, I mean, I listen. And I do. It's funny. You say I don't talk about it much. I talk about it when I speak live to people. Yeah, I am. I tell them all the time there is a person you are, you know, at your core. And when your blood sugar's are swinging around or high all the time, you're not getting to be yourself. And that's unfair to you, you deserve to be yourself, you have to figure out how to be you. And that's made even more difficult. by the sheer fact that those things are happening, you're low, then you're high, then you swing high, and you feel cloudy. And while that's happening to you, day after day, week after week, you're telling me that with no input from a doctor, nothing, even the stuff that's written down feels too academic. While that's happening to you, you're supposed to figure out how to stop it. But it's senseless, like how are you going to do that? Yeah, that'd be like if I put you out in the desert without any water. And you started hallucinating. If I said to you, you know, if you drink water, you'll stop hallucinating. Go take care of that. Well, I'm in the desert. How am I gonna handle that? Exactly. There's no water here. And I'm already hallucinating. Oh, it's up to you fix it. You know? I'm really happy to hear that. That's That's wonderful. It seriously is. I'm keeping you up very late. And don't you have to get up tomorrow. And I'm sorry, teach children through

Lachlan 1:06:54
that first day back in the classroom. Tomorrow, the kids are back where we're at a lockdown. Australia doing real good. So on it's two months, two months of remote teaching, and the kids are back to the end of the term. So

Scott Benner 1:07:08
you're going you're going into school tomorrow?

Lachlan 1:07:11
Yes. I'm only working part time this year. Just to be a stay at home dad for a couple of days a week and yes, I'm starting on a Wednesday.

Scott Benner 1:07:21
Well, congratulations. That's That's great to hear. It's exciting because there's part of me who listens to all this and I'm like I'm never leaving my house again apparently. And you know, or I'm gonna be wearing this do you guys cover your face when you go in public?

Lachlan 1:07:35
in the inner city? A few a few do but now it's not that it's not that bad. I think 400 in the whole country. That active case isn't minute. Yeah, we've we've done pretty good.

Scott Benner 1:07:46
That's amazing. I think I heard recently that really threw me was that Italy says that they're pretty much been eradicated like it's almost like it burnt through the population and it just everyone

Lachlan 1:07:58
got it. Yeah,

Scott Benner 1:07:59
I hate I really do hate to say it like that. But it sounds like it sounds like the people who got it and lived lived and the ones who died died and it's over you know, which is a terrible way to think of it but it does sound like that's what happened. Yeah, I said been a very strange time

Lachlan 1:08:15
has been weird for certain

Scott Benner 1:08:17
well luckily your blood sugar's not bouncing all over the place anymore because locked in your house for two months. Been a pain in the ass probably would have got your shot. I'm thinking, you know, there's a lot of guns right now. Right? Well, yeah, that's funny. I used that as a metaphor that I didn't even mean shot necessarily. I just met your wife would be upset at you. I don't know what she would do in Australia hit you with a didgeridoo or something like that. Alright, man, this was really terrific. I appreciate you doing this very much.

Lachlan 1:08:48
Now our thanks for having me. Now. Of course.

Scott Benner 1:08:51
This episode was recorded in the middle of June 2020. It is being edited on December 7 2020 because we brought up COVID I wanted to give you some updated totals, googling the words Australia current COVID cases. I learned that total cases in Australia 27,009 72 total recovered 25 446 deaths 908. And because Italy came up I will do the same cases 1.7 4 million recovered 933,000 deaths 60,660. And Italy began to they were pretty flat in June. July stayed flat August it started to creep up September more into the 1000s of cases October began a jumping into two and a half 1000 by the end of October. It was at 25,000 they're currently back down to more around 21,000 but they were up in the 22 30,000 range there, maybe till mid November. I'll look at the same for Australia. Australia is interesting, very flat when I recorded. He wasn't off either about 20 cases when I recorded with him, but it began to jump at the beginning of July. They hit a peak in mid July, August of about 600. danced around around three 400 and then steadily came back down back into the double digits in September and remains there today. There are seven cases in Australia on December 7, so I just thought that could use some clarity. Because what we thought we knew about COVID in June, turned out maybe not to be right.

A huge thank you to one of today's sponsors. g Vogue glucagon. Find out more about chivo Kibo pen at G Vogue glucagon.com forward slash juicebox you spell that GVOKEGL Uc ag o n.com. forward slash choose bot. Further thanks are due to the Contour Next One blood glucose meter which you can learn more about at Contour Next one.com forward slash juicebox and of course, touched by type one.org. Check them out right there on their website on Facebook or Instagram.