Scott Benner 3/10/23 Scott Benner 3/10/23

#866 Best of Juicebox: Diabetes Pro Tip Newly Diagnosed or Starting Over

First published on Feb 25, 2019. Diabetes Pro Tip: Newly Diagnosed or Starting Over is the first in the now 25 episode Pro Tip Series. Find them all at Juiceboxpodcast.com

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Scott Benner 0:00
Hello friends and welcome to episode 866 of the Juicebox Podcast

Hey everybody, welcome back. Today is another episode in the best of Juicebox Podcast series, and today we're going to revisit episode 210 diabetes pro tip newly diagnosed are starting over it originally aired on February 25 2019. In this episode, Jenny Smith and I begin the Pro Tip series that you now all know so well. By the way, if you're looking for that Pro Tip series, you can find it at juicebox podcast.com, where diabetes pro tip.com And of course, right here in your podcast player. While you're listening today, please remember that nothing you hear that 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. Are you a US resident who has type one or the caregiver of someone with type one, please go to T one D exchange.org. Forward slash juicebox. Join the registry complete the survey. When you complete that survey. You are helping type one diabetes research to move forward right from your sofa. You also might be helping out yourself and you're supporting the podcast T one D exchange.org. Forward slash juicebox. Today's episode doesn't have any sponsors. But I want to remind you that if you're looking for the Omni pod five or on the pod dash, you should go to Omni pod.com forward slash juicebox want to get that Dexcom G six or that brand new Dexcom G seven dexcom.com forward slash juice box. How about the brand new Contour next gen blood glucose meter contour next.com forward slash juice box. Start your day off the same way I do with a delicious scoop of ag one from athletic greens, athletic greens.com forward slash juice box. The T one D exchange is a fantastic organization that helps people with type one diabetes and I'm speaking at their next event. Check out their website T one D exchange.org. Forward slash juice box. You can get your diabetes supplies the same way my daughter does from us med us med.com forward slash juice box or call 888-721-1514 Would you like to use the same glucagon that my daughter carries? You can G vote glucagon.com forward slash juice box. Wow, there's a lot of advertisers. This is why I spread them out throughout the week cozy earth.com Sleeping on cozier sheets this sweatshirt is from cozy Earth super soft and comfortable. Everything at cozy earth.com is 35% off when you use the offer code juicebox at checkout and hold on. I can't tell you about that one. There's a new sponsor coming next week. But I'm not just talking about it yet. So you'll check back and find that. All right, thank you so much for listening to all that. Now let's jump into Episode 210 newly diagnosed or starting over from the Pro Tip series. This is Jenny Smith and I in 2019 Making the very first episode of the now very famous diabetes Pro Tip series from the Juicebox Podcast.

Welcome to the Juicebox Podcast I'm your host Scott Benner. I first interviewed Jenny Smith, the CDE from Integrated diabetes back in season one on episode 37. At that point, Jenny and I were just talking about different management ideas. But it was then that I realized how much we agreed about type one diabetes, and the management of the disease. I brought Jenny back on in Episode 105. And we really drilled down about a onesies what they were and what they weren't. After that second interview with Jenny, I decided that one day I would have her back on to discuss all of the diabetes management ideas that come up on the show. I wanted to break them down into small categories, something that was easily digestible, where we'd stay focused on just one idea. I wanted to create something that you could come back to hopefully learn from and if you found useful share with others simply and so with that in mind, I give you the first in this 10 part series, diabetes pro tip for the newly diagnosed Pro for those wanting to start over with Jenny Smith CDE

Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. And Always consult a physician before becoming bold with insulin or making any changes to your medical plan. If you're a newly diagnosed person with type one diabetes, or the parent of someone who's been newly diagnosed, what do you think the first things to understand are?

Jennifer Smith, CDE 5:29
The first things to understand beyond the glucose values are, what does insulin do? How does it work? I think that's it's a huge one. That is it's under, it's under emphasized, I guess is the best way to put it. Many people, especially adults who are diagnosed are kind of given a this is your insulin, this is the dose to take and kind of go experiment at home. I feel like that's kind of the way that it is. And I think insulin is a first most important thing to really understand. How does it work? What's What's the purpose of it? How is it supposed to kind of finish working? And what is the effect for you?

Scott Benner 6:17
Okay, and so what are some, like bare bones ways to come up with those understanding. So I think, obviously, if you have a CGM, it becomes different, right? If you have a CGM, you can get yourself at a stable spot where you haven't had insulin or food for a while. And just give yourself an amount of insulin and see how it moves you. Let's talk for a second about like old school, do you still teach people that they need to do Basal testing?

Jennifer Smith, CDE 6:43
In a general way? Yes, I think especially for pumping is helpful in the beginning, because it does in that basil only time period, it does give you a general idea of how things are being kept with the rate that's at play. I do think that basil testing needs to be more explained, let's say when we are talking about pumping insulin, though, because there are as you know, a lot of variables that could be at play in that barrel basil testing time period, especially like from from a woman's standpoint, it could very much be that it's not the right time of the month to be Basal testing. Right. Right, right. So all of these various are a kid or a teen who is a kid or a teen who is really athletic. Right, and there is consistent effect of activity level. And it may be different on different days, but there could be overlap from a data goal that you had for our practice or a tournament. I so Basal testing. As a general idea, yeah, it can be a really good place to start, especially if you think things are really off in a certain place of the day. But is it the end all be all of knowing where your insulin should be? Not 100% of the time, right

Scott Benner 8:07
and so, so what I ended up telling people when I speak with them, is that you know, if you're having an issue and that issue could be anything like you're spiking at a meal, or you're you know, drifting high all the time, or you're incredibly high all the time, you know, any of those things. You have to first look at your Basal insulin. It's it's absolutely far and away the first thing I have to apologize to you Arden's texting me and I believe she's trying to tell me, it's lunch. Okay, so lunch question mark. So Arden has been sick the last couple of days and pro already kind of resistant like this to her insulin a little bit. But we are ahead of it now. So she's 106 and stable now. But to give you an idea, she woke up at 110. By the time she was getting dressed, she was 120. Then there was this diagonal up, I Bolus a unit and doubled her Basal for an hour. And 30 minutes later had to Bolus two more units to get her back to this 106. Now she never got over about 150. But she sees that rise every morning like that, that little bit of a rise. But this morning I used I'm going to save three units more than I would normally use. Yeah, it's just because she's not feeling quite well.

Jennifer Smith, CDE 9:20
Again, another reason that basil testing things like this is not it's not purposeful. In fact, I think, you know, a lot of people try to overcome that morning time rise with a Basal adjustment. But what happens then when you wake up at a different time of the day, right or you have a variable schedule, so a lot of times I actually tell people, you know what, let's look at what the rise is. Don't correct it. Let's let's watch the rise. Let's figure out how much of a rise Are you consistently having, you know what we can offset it with a with a dose of it of Bolus. Sometimes that actually hits the mark better than trying to incrementally adjust a basil behind the scene that could actually change day to day.

Scott Benner 10:06
Right right. Okay, so now this is um this is really interesting to the waiter like tell you what just happened. So this is kind of hilarious but my wife is here. I'm gonna have to walk away for a second yeah back. Arden's pump only has 10 units left at it and, and just added her lunchtime Bolus is going to be 12 units. So I just had to do a smaller Bolus as a Pre-Bolus still, and I'm going to send my wife over to like swap. Oh, no, let me go out of my way. The Dexcom G six CGM is now FDA permitted for zero finger sticks. That's right, the continuous glucose monitor that Arden has been using forever, does not require calibration from a blood glucose meter any longer. But do you know what it does do? It allows you to see your blood sugar, speed and direction. Are you rising at two points a minute falling at three points a minute, the Dexcom CGM will let you know with customizable alerts. And if you're the caregiver, or someone who loves someone with type one diabetes, and you'd like to be able to see their blood sugar when they're not with you, that's possible too. Because Dexcom has a share and follow feature that is available for Apple and Android. My daughter is at school right now. We just gave her insulin for her lunch, and I can see her blood sugar, her blood sugar started to creep up on us a little bit. So I got an alert. And we added some insulin stopping a rise. The Dexcom G six features an applicator that is virtually painless. My daughter says she can't feel it at all. And it's completely automatic. One button push and the sensor bed has been applied. You snap in the transmitter and you're on your way. You can see your blood sugar's on your Apple watch or other smartwatches on your iPhone on your Android phone. You can share it with anyone in the world anywhere. I can tell you without hesitation that the Dexcom continuous glucose monitor is without a doubt one of the main reasons why we've been able to keep my daughter's a one C between 5.2 and 6.2 for five continuous years. To find out more go to dexcom.com forward slash juice box or the links in your podcast player show notes or at juicebox podcast.com. It's going to be the best decision that you ever made. So all is okay. Yeah, my wife's it's across the street. Yeah, my wife's gonna run over. She's working from home today. And it really does just go to show. I guess the fluidity that you have to keep around diabetes because okay, I'm lucky my wife's here today. If she wasn't, I would have to tell you, Hey, I gotta go. But in the end, there's no panic here. Arden's blood sugar's 107. I wanted, I wanted to do a Temp Basal increase of 50% for an hour and a half. And an extended 12 unit Bolus for lunch. But she only has 10 units. So instead, I had her set the Temp Basal still and do an eight unit extended Bolus. So she's still going to have four units going when my wife gets there, they're going to swap that pump real quick. And then she's going to head off the launch and be okay. Right. We'll be fine to get early lunch. Yeah, on every other day. It's a 1030. And then on the 30, like,

Unknown Speaker 13:23
what does he get up at five o'clock? Do breakfast? Really that

Scott Benner 13:27
sheets 1030 Every other day and the opposite day sheets at 1130? And she's out of school by two? Oh, wow. Okay, it's all kind of very quick. I don't know if she's learning anything. But so so I Yeah. So anyway, what I wanted to say about Basal is that, I'm sure just like you, I meet people who are having trouble, right? They're either on the roller coaster and they're going to 400. And they're going to 60 and up and down, or, you know, somewhere in that problem. They're high constantly, they're always 180, you know, they can't really seem to do anything about it. And when they get to you, they have all of these theories about why their blood sugar is too high, right? And I tell them, your blood sugar's too high because you don't have enough insulin, and it's not timed correctly. Now we're gonna start with your basil. And they'll inevitably say, Well, what about my insulin to carb like, that doesn't matter. I'm like, you can have a perfect insulin to carb ratio. If your Basal insulin is not right. None of this matters, right?

Jennifer Smith, CDE 14:24
That's right. That's why we call Basal insulin, the foundation of your management, it really is we, we actually tell people, it's like the foundation of a house. If you have a sound structure that you're building on top of everything you put on top of it will work. Even if the insulin, the carbon, the correction factor, and things are a little bit off. If the basil is off, those are going to also look like they're not working well.

Scott Benner 14:51
And it becomes impossible to diagnose what's happening, right. And so what I ended up saying is that you Try to imagine we use round numbers for examples. But try to imagine your basil is a unit an hour. That's what that's what it should be. But you have it at point five. And then you have you look at some food and you say, Oh, well, that food is two units. So you and let's say you're right about that. Let's say you're 100%, right that the food takes two units, you put your two units in, all you've done is now replaced the basil that you needed, right? You're so you're resistant, you're high, now you're replacing your Basal it's possible those two units will only go towards impacting the problems your Basal insulin has. And then your blood sugar shoots up and you go, I don't understand, I put in the right amount of insulin, I counted my carbs, right, I counted my carbs. I looked at the label, and I did everything the doctor told me why didn't this work. And in the end, and you know, through this series that you and I are going to do together, I'm going to repeat a couple of things over and over that I've found to be incredibly helpful. But in the end, if your blood sugar is high or low, you've mis timed miscalculated, or a combination of those ideas. And that's pretty much it, you know that I find that to be the core of it, it's not the first step to me, not being afraid of insulin is the first step. But we're going to talk about that in a different episode. But I think that it's it's timing and amount. And I think there's a million other things that can impact your life with diabetes. But that's the seed of the tree, right? And you could throw away all the leaves and all the branches and everything that comes off of that seed, if you'd have that seed timing and amount, you're well ahead of the game. Right?

Jennifer Smith, CDE 16:34
Right. Absolutely. And I would say the that those two pieces actually go very well together, as far as not fearing insulin, you know, and not being afraid of using it because I certainly work with many people who that is a major problem it is I just want to eat 200 Because I'm afraid to give the amount my pump is telling me to give or the amount that the doctor told me to give, you know, and I think understanding Insulin is the base of that understanding it and understanding the timing, and the action of the insulin and how it also individually works for you, helps to dissipate that fear,

Scott Benner 17:18
right? I think that I think that if you can keep your blood sugar stable at 200, then you can keep it stable at 180. And if you can do it any you can do it at 140. And believe it or not, if you can do it at 120, then you can do it at 75. And you know and so because the the tools that you use to to achieve that stability aren't different depending on what level your blood sugar's at. It's all the same. It's all the same stuff. Okay, so that's that is that's excellent. So we'll talk about fear in an upcoming episode as well. I'm newly diagnosed, I go into my doctor's office, now you are uniquely qualified to tell me this. What do people get told a diagnosis? And why do they only get told what is shared with them?

Jennifer Smith, CDE 18:04
I think it there's a wide range of what people are told, I certainly think that the younger the diagnosis, especially for type one, the younger the diagnosis, the more education there is, the more information is provided. adults that are diagnosed I think, unfortunately, get the least amount of education again, and it differs system to system and provider to provider. But in the beginning, you know, they're taught how to use a glucometer. They're taught how to give an injection, they're taught that you're going to be taught essentially the basics of that insulin action. And you're going to be taught carb counting. I mean, that is pretty much the gist of what you're going to be taught.

Scott Benner 18:51
Anyone who's been listening to this podcast for any amount of time will know that I call that do not die advice. That's the that's the advice you get so that you don't die. It doesn't keep you healthy. It doesn't help you understand anything. It just keeps you from going home and falling over.

Jennifer Smith, CDE 19:05
Well, and I think another piece of that, too, is very, very soon in that beginning is how to avoid hypoglycemia. How to avoid a low blood sugar because insulin causes low blood sugar. And unfortunately, that's where the fear starts.

Scott Benner 19:24
Exactly. And so that's where it starts where the fear starts, but try to understand that from the clinicians point of view, you are frazzled. I say this all the time being diagnosed with a disease that you cannot cure. It feels like someone just walked up to you with a shovel and smacked you square in the face with it and then started yelling, Basal insulin Bolus glucometer. This is a test strip and you're like, wait, wait, what? And so the doctor sees that on your face and can't in I guess in their minds, they don't want to overload you. But the unintended problem is just what you said that you start with Fear, then everything starts with fear. It would be a simple sentence, it would be, it would be Listen, we're going to teach this to you slowly. I know that seems counterproductive, but it's not. But there's no reason to be afraid. And that's what we're going to learn. Now, the question is, do doctors not teach that? Because they don't have the time? Or they don't have the knowledge? Like what like, because there are everyone's gonna walk into a different endos office, you're gonna get an 80 year old guy who's been doing this, since people have been boiling their urine, right? And he's just gonna think that if you count your carbs, and inject and go to 300, and come back to 100, that's amazing. And that's that, right? Right. And then you're gonna get a guy who's in his 50s, who's just starting to hear about like, this CGM stuff, and you're gonna get different advice from them, you're gonna get different advice from, you know, a woman who's been out of medical school for three years and has diabetes. How do you as the patient know what advice you're getting? When you don't know anything about diabetes?

Jennifer Smith, CDE 21:03
That's a very good question. Absolutely. And I think, you know, with today's technology, honestly, I, personally, as people have come to, to work with me, or to work with us that integrated, you know, it's people come because very soon, they realize they're not getting what they need. That's not quite, they're not sure what they're missing. But they know from researching and looking and Googling it, that the information that they've gotten is so just literally the tip of the iceberg, that they're missing so much more beyond and that, you know, that their doctor is saying, Well, you have to be in good control for a year to be able to start on a pump. And most parents or even adults are saying, that's not the case. Right? Doesn't it? That's that's not doesn't make sense. I want to know what I should be doing. I want to know, what is the best for my child or for myself? I want to know, and I think those are some of the things that as a as a newly diagnosed, asking more questions of your provider, even though you may not know exactly what you're asking, when you've Googled it, and you've researched and done some of your own searching, and even asked, you know, some people I think more and more people are, they're kind of they have acquaintances or whatnot, who might have diabetes. And so they, they will ask them, they'll say, Well, they're doing this, you know, maybe I should ask about this. And I tell all the people that I work with, you know, what, if your provider is not able to meet you or can't answer, even those basic questions in the beginning, it's, it's time unfortunately, to find a new provider. It really is.

Scott Benner 22:46
And based off of that idea, I want to say I want to say the same thing to two different segments. So if you're a clinician, and you're listening to this, or if you're a person who has diabetes, or is trying to care for someone who does, there's a space that a lot of people get into, they're not given enough information up front. And they're, they're paying attention, right, they want to do well, they're paying attention, and they see inconsistencies with what's been taught to them in the doctor's office. But because you're the doctor, or because you're looking at a doctrine, you were raised to listen to a police officer, your teachers and a doctor, you're raised to believe that a person in a white coat is infinitely more intelligent than you are, there's no reason to question them. And so when they give you these concrete laws of diabetes, you go home, put these laws into practice, and they don't give you decent results. This is for the doctors, it puts people into such a psychological bad place. It just wrenches their gut, they feel like they're killing themselves or their children. And they don't understand why. And even when common sense things about their diabetes show up. They can't bring themselves to make the leap, because you've told them, we're not told them anything about that idea. And I will give you a great example. And it's a very simple example.

Jennifer Smith, CDE 24:03
Or kind of before your example. You know, it's kind of a cut and dry too. As you know, kind of going with what the doctor said, the doctor said to do this, the doctor said I should take my my insulin and eat right away. Well, if that's not working, and you don't, if you don't know that and clinically, clinicians, I think, really do need more information about what really is the real life of diabetes. What's the real life use of insulin and mastering it's action and all of that because clinical book does not mean it meets what happens at home. And when your clients come to you and your patients with or people with diabetes come to you and they say this isn't working and following all of your rules. It's not working. Instead of saying well, you must be doing something wrong because that that happens often whether as a clinician you want that expression to come out or not. It does you Make them feel like they're not doing something right. And you don't give him a weight to, to help you don't explore with them and say, Okay, I hear what you're saying, I hear that you've tried everything I've thought would, excuse me would work. And it's not let's, let's see why it's not working, maybe something is variable for you.

Scott Benner 25:23
And let's have more of a conversation and explain what's happening. So that so the doctor can glean more from what's going on. I'm at the point now, and I'm sure you're there, too. I can look at a 24 hour graph and make changes in five minutes that improve somebody's life. immeasurably in 24 hours. I don't know why a doctor can't do that. So I mean, I figured

Jennifer Smith, CDE 25:44
some can yes, some are. Some are awesome. But some are not know me

Scott Benner 25:48
well enough. Now to know that, you know, I'm not the wisest person in the world. And I can look at it and go, Okay, this is this like this. My example of, of how powerful the doctor's suggestion or non suggestion can be to people is that I was speaking with a woman in her 40s, who had had diabetes for 25 years. I looked at her graph, she was distraught. And I said, you just need more insulin? And she said, Well, no, no, because in the ocean, like I said, all these reasons why that wasn't the case. And I said, No, that doesn't make sense. And in a brief 32nd, Explanation, over a telephone call, I could literally hear the light bulb turn on in her head, and she went, Oh, my God, I just need more insulin. And I was like, right? That's it? I mean, can we go now or, you know, but but think about, think about that. A well intended, intelligent, educated person who goes to her doctor's visits, and in 20 years, can't figure out why their blood sugars are the way they are, and no one's ever helped her. So what I'm saying to people who are newly diagnosed, or people who have gotten to that point and want to start over, you have to sort of think different, you have to, you know, if you're, if you're in a situation where you're newly diagnosed, and you've gotten some real, like what I call like old timey information, you need to think differently. And if you've had diabetes for a long time, or been caring for someone forever, and it's not going the way you want, that's the first thing you have to do. You have to say to yourself, I must not be thinking like flip it upside down, look at it all the time, I have a friend who every decision they make is wrong. And I once said to them, How come when you have a reaction to something, you just don't wonder, what's the completely opposite of that, and then just do that. I was like, I was like, right, you're right, you're always wrong, you know, so like, and that's what happens every day, you get up and you do this thing with this insulin, and this pump and all this stuff. And it always goes wrong. But yet, there you are the next day,

Jennifer Smith, CDE 27:46
doing it over and over and over again, which is another reason that I you know, working especially with the women through pregnancy that I work with, that's a piece of the variability that I try to encourage them to sort of work on prior to pregnancy. You know, because if you can figure out it's why many people with diabetes, eat some of the same things over and over and over again, they have a standard breakfast, I know that it works. I know that I need this much insulin, I knew they need to use a temporary basil for this much or for you know, whatever extended Bolus, and it works for me, it's, that's the reason is once you figure it out, you're like, great, I like little magic because magic piece right here and I'm not gonna screw it up. Now.

Scott Benner 28:32
I'm gonna have this half a piece of wheat toast two eggs over easy and two tablespoons of avocado for the rest of my life. Right? Exactly. Every morning, if that's happening to you, if you're listening, and that's happening to you, I say this proudly, the there are some low carb people who will get upset and I want to tell them right now you can eat low carb your whole life. I don't care. I'm just saying that if you ended up there because you couldn't figure out insulin. You know, if you're if you're eating something you don't want to be eating there might be a way to manage this. But I tell people very proudly that at this point, my daughter is 14 years old when I'm recording this. She has had type one diabetes since she was two. And for the last five years her agency has been between five two and six two with absolutely no diet restrictions whatsoever. Anything you can think of Arden eats and eats frequently.

Jennifer Smith, CDE 29:25
And I bet her more important within that I think we talked about this in the E one Z discussion and podcasts but more important than even the a one C is her standard deviation the variability which I would estimate without even seeing her information, I would estimate that her standard deviation is very nice meaning she's got these juicy little gentle rolls through the course of the day rather than this major roller coaster because you could have anyone see a 5.4 Yes, but you can have a major you know, standard deviation

Scott Benner 29:56
and we will talk about that in coming episodes. You can't run around with your six a one C but be it 300 Half the day and 50 the other half of the day that you've just tricked the a one C test

Jennifer Smith, CDE 30:06
right? On the doctor. Yeah. Because, again that goes back to clinician. A onesie is certainly it's a starting place. It is not the end all be all there is more in depth that needs to be looked at with that a onesie. Yeah,

Scott Benner 30:19
we try very hard. Well, you know, as you go on and listen to these episodes, you'll realize I'm not trying that hard anymore. I figured it out to the point where it doesn't really take that much involvement from us. But Arden's low alarm on her Dexcom is set at 70. On my follow up, it's 120 for the high alarm on hers, it's 130. And so we'll talk about like bumping and nudging later on, but that's my concept is that smaller amounts of insulin as you try to leave a tight range, get you back into that range more quickly. And cause far fewer lows later. Yeah. Give me one second here, we'll take a pause. Okay. I'm gonna text Arden, she's now wearing a new pump. I need to know how much insulin delivered from the last Bolus. And then because it's a new pump, and she's literally gonna walk right into lunch. Excuse me, going to double her basil for I was only gonna do 50%. Now I'm just gonna double it for an hour and a half. And that way, if there's any slow start with that site absorbing and having action I'm just going to do, I'm going to do something that at some point during these you'll hear me talk about where I call it over Bolus Singh, like I just I imagined not just what her needs are now. But the momentum and higher number that I know is coming. In 2008, we made the decision to get my then four year old daughter and insulin pump, it's a decision that I wish we would have made years sooner. After seeing everything that was available, we easily settled on the on the pod that was back again in 2000 and ate. Today Arden is about to turn 15 years old, and she has been wearing it on the pod every day since then, every day. And as I mentioned in the other ad Ardens eight one C has been between 5.2 and 6.2 for five solid years. How do we do that? Well, we start by seeing an insulin pump is more than just a way to not have to take shots. The Omnipod gives you the ability to do temporary Basal rates, that's increases or decreases in your background insulin, extended boluses, which will help you spread out your insulin over the life of a meal. And so much more. The Omni pod has no tubing at all. The pod is self contained, you wear it on your body, and you control it with a wireless controller. So there's no tubes running through your clothing, and no pump that you have to jam in your bra or down your pants or wherever people have to put their pumps that just doesn't exist with the Omni pod but does exist is the ability to swim while you're getting your insulin bathe while you're getting your insulin and live life untethered. Beyond the party even features self insertion, just push a button. Now I want you to go to my Omni pod.com forward slash juice box. And when you get there, you'll get a free, no obligation demonstration pod sent directly to your house. Check it out and see what you think for yourself. I'm going to do something that at some point during these you'll hear me talk about what I call an over ball of saying like I imagined not just what her needs are now. But the momentum and higher number that I know is coming. Yep. So that's hard change

Jennifer Smith, CDE 33:49
was one thing that I was always in in. In the beginning, I was very thankful that I had noticed the difference with my animus pump change that I needed that site to just be like, just saturated with insulin to get absorption sooner. So and I was glad because when I started Omni pod in 2006, I started doing the same thing that I did with my other pump sites, you know, just Temp Basal ng up by almost 100%. For about it was usually about an hour to two hours depending on kind of where I was at that point. And if it was I was having to change that pod, especially if it was before a meal and I was going to need insulin for that meal with the new pod. I actually instead of doing it through the pod I gave an injection because I just found that a Bolus with that new pod site. It never went well. Whereas if I did a Temp Basal increase, I took a Bolus via injection for that food that I was going to eat and let the pot gets settled in. I didn't have any blood sugar issues.

Scott Benner 35:03
Okay. Yeah,

Jennifer Smith, CDE 35:04
yeah, it's everybody's strategy is different,

Scott Benner 35:06
right? But I'll tell you what it what it what that tells me is, again, this is going to be another sentence you hear over and over again, you have to trust that what you know is going to happen is going to happen. Yeah. So if you make a pod change and your blood sugar's 90, you still need to do that. Right? Right. It's okay, hold on. Yeah, good. 5.6 units. So I'm gonna do a Temp Basal increase 95% for an hour, and Bolus. seven units. All now go eat as soon as possible. So she's got 5.6 units in from 20 minutes ago or so she's still 102. And so I'm not scared of those seven units. She's going to be eating in five minutes. And look, the 5.6 units didn't do anything over the last 20 minutes. So I'm good. My goal here on this Bolus is 75. Diagonal down while she's about halfway through her meal. Anyway, that's again, stuff we'll talk about later. Yeah. Okay. So

Jennifer Smith, CDE 36:10
and comfort level with, you know, will happen?

Scott Benner 36:14
Yeah. Because, and by the way, and this, this, you have to, you have to have these experiences, like, I'm going to leave this in this episode, so that, you know, that things have to happen that you don't expect, because it's data, right? It's, it's, I did this and this happen next time, I'd like this to happen. So I'm gonna do sooner or later, more or less, whatever it is, I'm going to do, but you can't know that unless something goes wrong. Right, right. And so and so here's a great tip for somebody starting over or who is newly diagnosed. There are no mistakes. There are only experiences that build on for next time. That's it. Yep. see something happen. Instead, you can't get dramatic. You can't get upset. You can't cry. You can't go, Oh, my God, I'm killing her. You can't do it. Right. You say to yourself, Okay, bare bones, what just happened here, I put insulin in here. It went up to there. And then it came down and crashed. I bet you if I would have put that much insulin in sooner and spread it out a little bit like I could have created the resistance that that blood sugar needed. Right, right. But if you're busy running around, wringing your hands, and just you gave away an amazing opportunity, and, and I will use this as an example. This past weekend, I was helping a mother with a five year old four or five year old boy. And while I was talking to her, this kid's blood sugar went to 300 off of some Cheerios. And we talked for 20 years, that breakfast cereal. Oh my gosh, we're talking for 20 minutes or so. This poor kids blood sugar's at 300. It's not moving. And we're getting ready to get off the phone. She's like, he's hungry. I don't know what to do. And I was like, Are you? Would you like to do something that's going to sound insane? I'll help you. And she goes, I think I'm desperate enough to try something insane. I was like, great. How much insulin Do you think it'll take to bring a 300 to 90 and she says a unit? And I said How much do you think lunch is going to take and she said a unit and a half as a cool Bolus two and a half units right now. And she says she's like, what's going to happen? We're going to put his blood sugar into a freefall. And then we're going to add the lunch at exactly the right time. And then with a little bit of fast acting carbs if we need to, we'll bring it in for a landing. I said I'll never leave you will will text the whole time we'll talk again and we have to. So she does it. We get diagnosed down to 90 to 75 to 52 hours down to 50. She's texting. Oh my god. I'm like no, no perfect, like, a whole lot. I actually texted her a picture of the guys from Star Wars who are trying to blow up the Death Star. Right? Stay on target. Like just don't don't flinch. Like don't flinch to 52 down to 42 3200. I said, Okay, now's the time to start getting the lunch together. And she laughs She goes Oh, it's already it's just here on a plate. That was good. I said when we get the one at given the food. So 182 down kid gets the food 10 minutes later. Now isn't this interesting? We're dropping 10 points every five minutes on the CGM. Then he eats then all of a sudden the dropping stops the arrows are still there but now it takes longer to get the 170 took even longer to get the 160 and she gets the watch this happen 150 Still two down 140 Still two down. I said okay. It's not going to catch the arrows. Do me a favor, give him a few ounces of juice. She says we don't have juice in the house. And I thought to myself, Oh I just killed a kid over the phone. And goodbye, wrong number. She says we treat Lowe's with jelly beans because they hit him so hard. I said, that's great. But do you have any liquid in the house that has carbs in it? That's not soda. And she's like, Oh, we have lemonade. I said, that's great. I want you to give him four ounces. Eliminate. So she gives them I said, Don't go crazy measuring it. Just give him a little bit of lemonade, right? So she gives him the lemonade boom, goes to one arrow goes to diagonal down, the kid comes in, I swear to you 75 Nice and stable. It's foods been in for a half an hour. And when it was over, she's like, wow, that was nerve wracking. I said, Okay, I know that, clear your head, and then go back and look at the boluses. Look at the time you put the food in and look at the CGM and figure out how that insulin works in him. Because you just had a Master's class how insulin impacts blood sugar and how food impacts insulin.

Jennifer Smith, CDE 40:53
Absolutely, absolutely. And that's, that's the place that as you know, clinicians, they don't have the time to do that. And it's unfortunate is it's unfortunate in the stance that with somebody something like diabetes, type one diabetes, specifically, you need that hand holding, in an instance like that, you need the ability to be with somebody who can say, you're okay, write it out, you're okay, he's going to be fine. You've got jelly beans, you've got juice, you've got honey, you've got something in the house, you've got a mini glucagon that you could use if you need to, you're going to he's going to be okay, she's going to be you're going to be okay. It's, it'll be fine. But you do you have to use those learning pieces, I think it kind of goes along with a really good friend of mine. Who has had diabetes a bit longer than me, which is 30 plus years, hurt. Or her doctor actually gave her kind of a good little hint. For numbers, you know, we start to view numbers in diabetes as good and bad, right? And that comes with that feeling of frustration then, and oh my gosh, I'm like killing myself, I'm doing something bad or whatever. And he said, you know, the numbers are information to just like you said, it is okay, I'm here. Why am I here? You know, what can I learn from this? What can I do better next time. And maybe you analyze it, you know, three hours from now, maybe not in the instant. But it's information. And so he told her, you know, when the number is going to come up on the glucometer. You put this test strip in you put your blood on the strip, and you tell yourself, I am awesome. And here comes a number,

Scott Benner 42:38
right? Yeah, because I just didn't begin to tell me what to do next. And it can't be a judgment, you can't feel judged by it. You can't let you can't, you know, you can't look at it and say bad luck, you can say not what I wanted, not what I was shooting for. Right? What makes me what gets me to what I'm shooting for. And you know, it's funny as as you and I are pretty much wrapping up this first thought, right? I have so many people asked me when they're first diagnosed, what are the things I need to know? And I find around diabetes in general, everyone's looking for an amount or a number from you just once tell me how many minutes I should Pre-Bolus Please tell me how many units I should do if his budget is like this. And I tell them all the time, I don't know figure it out for yourself. And you will write like you have to but I can't give you no one can tell you that a 10 minute Pre-Bolus is going to be what's right for you. In any given situation, let alone all the time. I think it's insane that we think that just because we've set a Basal rate of you know, one and a half units at 2am that we think that that's what our body is going to need every day at 2am It's It's insanity to think that it's just the best we have with the technology we have at the moment. Exactly. And so if you listen to this thinking someone's going to tell me the rules about what I need to do when I'm starting with diabetes. We did we told you what to do it just isn't what you expected. Right? Right. And so I get that I understand that it's it's not a pill disease it's not take three of these a day and you have to have food with them like it's not that easy.

Jennifer Smith, CDE 44:12
And I think as a general to in the beginning of of learning that comfort level and learning you're learning what works for you by watching you also have to take into that the variables that can mean what you did figure out needs to change because of such an such variable right? So you know my breakfast in the morning if I don't get to go to the gym before or after my normal breakfast which I just I like it which is why I eat almost the same thing every single day and it works nicely blood sugar wise but I like it so and it's easy. So but I the variables that I had to figure out were pre eating it. Exercise, post eating it Exercise there, those are the variables, you know. And so what works in a morning, where I'm not exercising at all, is completely different than the mornings when I have exercise at such or such time,

Scott Benner 45:14
there's variables are forever changing, which is why you have to, interestingly, know what they are, and at the same time completely ignored them. And what I mean by that is that you're not a machine, right? So there's certain things that are going to make sense. Like you just said, I know if I exercise prior or post that this changes how this Bolus needs to be. But if you're walking around trying to decide constantly, am I anxious? Did I just banged my knee? Like, like, you know, like, am I going to get a client the thing I see people saying online all the time, like his blood sugar's gonna, he's gonna get sick three days from now I'm like, Oh, my God, just give him more insulin. Like, who cares if he gets sick three days from now, I so that's what I think of. When I say be fluid, I just that it's going to keep changing at such a rate that for you to try to apply static rules to it is insane.

Jennifer Smith, CDE 46:08
You've got that piece of, of life with diabetes that you can then bring into education, which is why people usually come to us because we understand it from the living it standpoint, not from the this is what the clinical book says should be happening. So do this.

Scott Benner 46:27
I'm incredibly proud to say that I've gotten to the point where if I can talk to somebody for about 45 minutes or an hour, they can have a major change in just a couple of days. That's that's communication. That's what that is. Right? Well, that's what I have in mind, Jenny for this series. Today we talked about being newly diagnosed or starting over. The next episode will be about multiple daily injections or MDI. We'll do an episode about insulin bolusing pumping CGM EMS, and on and on until you and I finished covering every aspect of the things that we talked about on the show. Please remember that the Juicebox Podcast wouldn't be possible without its sponsors for today's episode on the pod, and Dexcom Dexcom, the makers of the G six continuous glucose monitor, and of course on the pod is the tubeless insulin pump that Arden has been wearing for over a decade. You can go to my on the pod.com forward slash juice box get a free no obligation demo of the pump sent right to your house. We can go to dexcom.com Ford slash juice box to find out more about art and CGM hack you could do both.

Jennifer Smith has lived with type one diabetes since she was a child. And so she has first hand knowledge of day to day events that affect diabetes management. Jenny holds a bachelor's degree in Human Nutrition and biology from the University of Wisconsin. She's a registered and licensed dietitian, certified diabetes educator and a certified trainer of most makes and models of insulin pumps and glucose monitors. She's an active member of the American diabetes Association, the American Association of diabetes Educators, Jenny also co authored the book pregnancy with type one diabetes your month to month guide to blood sugar management. It's available on Amazon and there's a link in the show notes. All that aside, Jenny's just a nice person. And I like having her on the show. And I love the way she thinks about type one diabetes. I am incredibly lucky that she's doing this series with me. I initially shared my idea with Jenny about putting together a series of shorter podcast episodes that would help people transition from their starting point with type one diabetes, because there's just no good reason to struggle. All you need are the right tools and a knowledge of how to use them. And that's what we're hoping to bring you. So when you see the next episode, it's about multiple daily injections. Don't skip it because you're pumping. Listen, there's good information in each one. By the time you get to the end of my talks with Jenny, it's going to feel like you sat in a room with her and I and hashed out every possible angle that you're going to need to understand. Because of the nature of these podcasts, I want to mention again that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, to Always consult a physician before becoming bold with insulin or making any changes to your health care plan. If you found this podcast to be valuable, please go to iTunes and leave a rating and a review. And don't forget to tell a friend the podcast grows when you share it

I hope you enjoyed this episode of the Best of the Juicebox Podcast if you're interested in the rest of the diabetes Pro Tip series. Again, you can find it at juicebox podcast.com diabetes pro tip.com or by going in your podcast app and searching juicebox all one word and pro tip that's two words juicebox pro tip, they should all pop right up in front of you. There are 25 episodes in the Pro Tip series. This is episode 210 Of course, but episode 211 is all about MDI episode 212 all about insulin episode 217 pre Pre-Bolus Episode 218 Temp Basal to 19 Insulin pumping to 24 mastering a CGM to 25 Bump and nudge to 26. The perfect Bolus to 31 variables to 37 Setting your Basal insulin. Episode 256 is about exercise, Episode 263 fat and protein episode 287 illness injury and surgery 301 glucagon and low Beegees 307 Emergency Room protocols 311 long term health episode 350 Bump and nudge Part Two episode 364 pregnancy 371 explaining type one that's an episode that you can give to people and it will explain type one diabetes to them. Episode 391 glycemic index and load Don't skip that one 449 postpartum 470 weight loss 608 Honeymoon 612 female hormones and God knows they'll probably be more one day. Check them out. If you're enjoying the podcast please share it with someone who you think might also enjoy it. And don't forget to check out the private Facebook group Juicebox Podcast type one diabetes. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast

#865 Go Marry Your Sister

Denise is the parent of a child living with type 1 diabetes.

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Scott Benner 0:00
Hello friends, and welcome to episode 865 of the Juicebox Podcast.

Today, I'm going to be speaking with Denise, she is the parent of a child with type one diabetes. And for the life of me, I'm not certain what this episode is about, but it was fun. So that's all I can tell you for now. While you're listening, 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 are becoming bold with insulin. If you have type one diabetes, or are the caregiver of someone with type one, and you're a US resident, you are perfect, because you can take the survey AT T one D exchange.org. Forward slash juicebox. This whole effort will take you fewer than 10 minutes and you're going to help type one research immensely. You're going to support the podcast and you're going to help yourself you'll find out more at T one D exchange.org. Forward slash juicebox. Go fill out that survey. Don't forget to finish it. Finishing the survey is important. T one D exchange.org. Forward slash Juicebox. Podcast this episode of The Juicebox Podcast as to sponsors first sponsor, Omni pod five, Omni pod.com forward slash juice box automated insulin delivery with your Dexcom G six. All in that little tubeless thing I'm gonna do they call the on the pod five, you gotta go get it. Omni pod.com forward slash juicebox. Then next, the next and the next. Don't forget, by doing by Benga. Boom, bye, Papa. I'm sorry, I'm looking for a link. The next sponsor of the podcast is us med now us med is where we get Ardens Dexcom G seven and Omni pods from you can too. They also have libre three other pump, they got stuff. I'll tell you about it later in the show us med.com forward slash juice box to get your free benefits check or you can call 888-721-1514. Get your diabetes supplies the way we do from us med.

Denise 2:36
So my name is Denise and I have a son who is nine years old. And he was diagnosed about a year and eight months ago with type one. At the time, he had an A one C of 16 and a blood sugar of 910. Which is just mind blowing to me still. And the funny thing is that at the time, we saw pediatrician the week prior for well baby on the base, actually. And I had mentioned my concerns to him. And of course he missed it just like every other pediatrician. Unfortunately, I don't want to give them a bad rap. But it seems like a lot of pediatricians don't seem to detect this early enough. And then kids end up in the ICUs.

Scott Benner 3:27
What What were your concerns that you went to the doctor with?

Denise 3:30
So he he was really thin. But he was also growing in height. But we were concerned because it just seemed like too much. And we would be eating dinner and finish up the meal and the minute we would like clean up the plates or whatever he was in the pantry grabbing snacks. And I actually was getting mad at him because I was like, Dude, we just ate and if you were that hunger, you should have had like seconds of the meal and not plan to go binge in a cabinet. You know. So I was like getting really mad at him, you know, and I feel terrible still thinking about that. You know, little did I know he was like wasting away. But at the time, I thought it was a growth spurt like every other parent. And obviously now when you look back on those pictures during that timeframe, he was like, Somalian style. Like I could see all his ribs. It was it was terrible. So

Scott Benner 4:27
when you saw it a little then you just didn't see it for what it was.

Denise 4:32
I feel like when you live with somebody, you don't Yeah, you don't see it to the degree that it actually is, like you said I knew he was thinner, but I also knew he was growing and so I was like well, he's stretching out so that's probably why he looks thinner. And you know he grew in height so I expect here soon he will also put on some weight, you know?

Scott Benner 4:55
No, I mean makes sense. How long do you think that was going on for?

Denise 4:58
I mean with Send a one C like that, I would guess a good chunk of time. I can tell you this, I knew something was wrong. My husband and I both did, we were both concerned about his weight. But it was also during the time of homeschooling. And so we also were nervous about his emotional like outbursts. But we attributed it to, you know, learning from home and his, his, he didn't really like it at all, so, but he would just sit there and cry about having to do homework and stuff. And we would get really frustrated because nobody liked it. But we expected he would do the work and kind of suck it up a little bit more, you know, but he would just like sit there and pout and cry and whatever. And we would get frustrated because we needed him to do what he needed to do for school because we had no alternative, you know. So we knew he was more emotional, we knew he was super thin. We knew he was eating a lot. And that was pretty much it. And when I took him to the pediatrician, told him he was really thin. And we were concerned, but that he had also grown in height and he he never even lifted up his shirt to see like and do a thorough assessment. So at the time, I just took his word for it. And I was like, okay, pediatrician says it's a growth spurt, we're good. So when I got home, I still was worried about it. And so I was, you know, investigating things. But the thing that really clued me into the fact that it was type one was that we so we were getting ready to move to Virginia because we're military and my husband needed to do training for us to move to Slovakia. So before we moved from Vegas, I was like, I'm gonna get everybody set up with all their health appointments. That way, when we get to Virginia, we're up to date. So we went to the pediatrician, and then shortly thereafter, we had eye doctor appointments for all three of the kids. We lived in Vegas, of course, it was really hot. But on the way to the eye doctor, my son was like, Mom, I'm so thirsty. Do you have water? And I was like, No, I actually forgot a water bottle. for you guys today, unfortunately, which I never did, you know? And he was like, Oh, I'm so thirsty. And I'm like, Ben, I have no water bottle. I'm gonna need you to kind of suck it up a little, you know. And so we drove to the eye doctor, and we were waiting. My son's appointment was like the second one. So my daughter was like, in the chair with the optometrist or whatever. And he was like, Mom, I'm so thirsty. Like, can you ask them? If they have water fountain or anything? So I'm like, Hey, I'm so sorry. Because I'm like, embarrassed about the urgency of this. Because we weren't going to be out long. I was like, you could be fine. It's not really that big of an issue. Made it longer without water, you know? So I asked them, I said, Do you guys have a water fountain or anything? And they said, No, and they gave me know your standard plastic bottle of water and he slurped that whole thing down and like one breath. One goal. And so I was like, wow, you were really thirsty, and I apologized. And so then everybody, you know, had their eye doctor appointment. And I was like, you know, while we're all in the car together, we should just go get breakfast because it was like, you know, it was like the middle of Coronavirus, but we had been locked up for so long. I was like, let's just go get some breakfast. It was like the first time we had gone out in Muncie. And so we sat down to breakfast. And you know, the kids all had those standard sized OJ cups, you know, like diner style. And he again, drank that and like one gold. And then the girls, my daughters still had some orange juice left. And he asked for theirs at the end of the meal and gold those down. And so then this is after the pediatrician appointment, I was told nothing was wrong. So you know, the whole time I was freaked out about this, trying to figure things out. But I do have a nursing background. I'm an RN, and I also have an occupational therapy license. So I had some medical knowledge. And I knew things were wrong. But of course, you live with someone and you're like, Oh, he's fine, but I know something's a little off. So at that point in time, I started getting into his medical records, you know, because the base you can access all of your electronic medical records. So I went through all that. And the funny thing was at Nellis Air Force Base, they were switching from one database to another. So it was like TRICARE online, switched over to MHS Genesis, which I know no one cares about. But they were like literally literally right in the transition of the two. And so what I think happened was that the provider didn't actually look at the growth charts because when I went in there, I noticed he was gaining and height but losing weight, which is not the normal trajectory of a you know, kiddo, and it's not what's supposed to happen they're supposed to gain weight and increase in height. So that to me I was like, Oh my gosh, something is seriously wrong. And then I put two and two together. And I was like, You know what, I'm just gonna go out and get a glucometer. Because these seem like symptoms of type one. So I told my son and my husband, I said, I'm going to Walgreens, I'm going to get a glucometer. It's just a little test, it was a weekend, and we live 45 minutes from the base so that I could get my masters out there in Vegas. I didn't want to drive all the way to the base, because I was like, if this is nothing, I'm wasting all of our time. And I'm going to feel like the biggest idiot. So I'll just take matters into my own hands, spend the 20 bucks, and then I'll have peace of mind as we go through this weekend. So I did that. And I took my own blood sugar first, so I could show my kid what it was about and that he'd be okay. And then I took his, and of course, it read high, which I think is already 600 plus. So I said to Ben, I said, Hey, I'm gonna need you to go pack your stuff. We're going to the hospital. And we're probably going to be there for a little bit. And I tried to explain in a kid friendly way, like what diabetes was and how I was 99.99% Positive. That was what was going on. And of course, he was like, super angry with me. Because as a seven year old, you're like, it's your fault you picked up on it. Like, if you hadn't figured this out, I wouldn't have ever had this disease. You know, that was kind of the approach he was taking with me just crying and screaming like the whole way to the hospital, which made me feel like the biggest piece of crap, you know, well, but I knew it wasn't my fault. You know,

Scott Benner 11:34
let me jump in for a second. So, I mean, you alluded earlier but didn't really like follow up on it. Like he was having a lot of outbursts and having a lot of trouble with his, with his composure, too, right. And so you thought that was because like, everybody was like, Oh, we're gonna lock these kids up and make them learn online. That's gonna make them crazy. And you were like, oh, what's happening to my kid? Great. That's what you thought. Right? Exactly. Yeah. All right. And so I mean, God, a 16. So seriously, I asked you this earlier, and you said a big chunk of time. But but think on this again? How many weeks or months Do you can you look back and see the skinniness? Or whatever? Like, how long do you think it's possible this was happening for?

Denise 12:18
I don't even know. I mean, and a one C measures the blood glucose over the last three months? So I don't know, probably like six to eight months prior, maybe I don't even know.

Scott Benner 12:32
Maybe it was okay. What about the outbursts stuff? How long was that going on? For before diagnosis? Pretty much

Denise 12:39
since the beginning of the kids learning from home.

Scott Benner 12:44
How much time is that?

Denise 12:48
It was probably like four months or so by that point.

Scott Benner 12:51
All right. I just wanted to try to put some sort of reference. Okay. I appreciate it. I know you're it's, and I'm racking my brain. Basically, what I'm saying to you is Hey, Denise, how long were you not noticing the kid was dying?

Denise 13:05
Yeah, but that's the funny thing is well, go ahead.

Scott Benner 13:11
No, no, no, that's not the point. Like, you know, I'm not I'm obviously not saying that. I just wanted to apply some context to it, because then they won't save 16 is huge. So when they get him in there. What's the process? And how long does it take them to start bringing his blood sugar down?

Denise 13:27
So I show up and I'm like, Oh, hey, by the way, no one was in the pediatric er at the time, which was awesome. But I was like, Hey, I'm a nurse. I bought a glucometer. I checked his blood sugar it read Hi. I know that he has type one. Or at least diabetes at the time, you know, but he's been and we have a healthy lifestyle. So I assumed it was type one. So anyway, and they took him back right away. And then they were really surprised that he was doing so well with a blood sugar and a one C So hi, he's

Scott Benner 14:06
a little closer, a little closer to the microphone. Okay,

Denise 14:09
better. Yep. Okay, so they were super surprised that he was functioning so well with such a high blood sugar and a one C, because most individuals with the same numbers are typically like in a coma or in an ICU, at least, you know. So at that point in time, they were telling me I was like, it's type one, right? And I'm assuming because in your head, you're, I know this is wrong, but in my head, I was like, well, we eat well, and we're not fat people. And I know that's really wrong. But that was like what I thought at the time, because you know, my dad had type two, he didn't take care of himself. He ended up dying really young. And so I know the trajectory of a lot of people with type two in general, I've seen the complications associated. I know that a lot of the people that do have type two tend to not actually manage your blood sugar appropriately and, and then they end up with tons of complications. So in my head, I was like, It's not tied to like, tell me it's not type two, I want to know that

Scott Benner 15:13
type two didn't do anything wrong. Yeah, so type two seems worse to you.

Denise 15:17
Yes. And I know that's wrong. It was just like, as a parent, and unfortunately, I tend to be a perfectionist and a lot of ways I needed to know as a parent that I wasn't the reason that I screwed my kid up. This was what I told myself in my head, you know, and I don't mean to offend anybody that has type two, but this is like, what I processed at the time, you

Scott Benner 15:40
know, I appreciate you being honest. Yeah. So because it's just, it's, it's, it's such a human thing, right. You know, like, even in the middle of that situation, where you're like, there's something really wrong with my kid. There's still a portion of your brain that's thinking like you did. Don't worry, you didn't do it. It's okay. Like, yeah, it's exactly in there. What's that? I said, you have a cheerleader inside. They're trying to try to help you not like fall apart, basically.

Denise 16:11
Right? Yeah, exactly. Yeah, I needed to know, it wasn't my fault, too. You know, like, I feel like with type two, I know, kiddos, get it. But I do also know that it's a lot of times related to the types of foods they're eating and their sedentary behaviors, you know. And I just needed to know, that wasn't us, even though I already knew that in my heart, you know,

Scott Benner 16:35
did it? Did you ever think about it later? That like, because what I mean, how does it it doesn't matter. In the end, like, right, you have this emergent problem. But in the end, did you have a one someone told you? That's definitely type one. Did you have a letdown? I was relieved.

Denise 16:52
Yeah. And even the doctors though when we were in the ER, they're like, we can't guarantee it's type one. Because normally type one kiddos with these numbers are, you know, they've Crumped and they're in the ICU, or they're in a coma. So the fact that he had compensated so well, for so long and had such high numbers, they, they could not like guarantee me that that was what was going on. And obviously they had to check the antibodies and everything anyway, but but they were not sure. And they were totally surprised when he came back as a type one. And I like you said I was relieved, because I needed to know that it wasn't my fault as a parent.

Scott Benner 17:32
So are there any autoimmune issues in your, on your side of the family?

Denise 17:37
My mom and my dad both type two. And then my brother has colitis. And actually my sister just got diagnosed with colitis. So yeah, unfortunately, a lot of my side, my husband side, also colitis. But no type one.

Scott Benner 17:58
I'm, I never say this, but I always think it and I'm gonna just say it here, because you seem like you can take it. Was it okay? I'm, I'm I'm never not fascinated when I asked people about auto immune in their family. And they skip over that I asked them about autoimmune, and they just start listing health ailments. And how many people say, Well, my dad has typed too, and I always liked it. There's this little guy, right? Yeah, there's this little part of me that always wants to go.

Denise 18:29
Hi, no, I'm sorry.

Scott Benner 18:31
You don't need to be sorry. It's such a common thing that happens. I think that it's an association thing. I think, yeah. First thing they think of is diabetes, diabetes. So hey, no, there's no type one but there is type two, and and colitis is very well, autoimmune. Yeah. Right. And then I'm sorry. You said on your husband side.

Denise 18:52
He also has the colitis thing is his brother. Yeah, you're right. I just, I assume you can make the connection that clearly the Type Two is not the type one and therefore it's not out. Oh,

Scott Benner 19:04
no, no, no, of course I can. And you know, you know, I'm just right. It's just happened so many hundreds of times that I was just like, funny point. I have to point this out. So here we are, Denise. I pointed it out on your ass. Sorry, the mold

Denise 19:17
of the people you interview. Oh, that's

Scott Benner 19:21
how long did it take for him in the hospital to get down and how long do they have in the hospital for?

Denise 19:28
So we were in the hospital for days. And we actually averted an ICU admission they had to get like it was his sodium down. And so they were pumping him with fluids. And they said if they couldn't normalize it while we were in the ER that he would go to the ICU, but luckily they were able to get it back on track. And so we ended up going to a standard pediatric unit. And all of the pediatricians that we saw during that four day stay, they were all floored that he ended To up on a normal pediatric floor and then I had caught it in time, because they said like 99% of the kiddos they see with new diagnosis. Do new diagnoses end up in the ICU?

Scott Benner 20:12
Yeah. Was he doing the panting what does that called?

Denise 20:18
No. Oh, he was totally normal. No. He had no symptoms other than eating a crazy amount. He was emotional, but I didn't I didn't recognize that I thought he was just being an annoying seven year old and he was said you know that was it? He was totally normal every other way. Interesting. Kussmaul respiration respirations Yeah, no,

Scott Benner 20:43
but okay, so Alright, so now you're so you're I'm trying to track it because your military move on this was happening in Vegas right? I guess Yep. He gets out of the hospital what what kind of gear do you start with?

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Denise 24:14
we did not have a Dexcom. I begged. I begged them, and they would not do it. They said you have to wait till your endo appointment. I was so pissed. This wasn't even the military hospital. This was sunrise children's. They would not do it. Because at the time when you have four days on your hands, all you're doing is researching and actually I'm pretty sure I found you during that hospital stay because you know I'm like batshit crazy when it affects my camera. I spent all nights and days just researching all the things and I found out about Dexcom and I found out about you because nobody told me about you or your page.

Scott Benner 24:51
So you just found that on your own. Yeah.

Denise 24:55
So I beg them for Dexcom they wouldn't give it to me. And so we left with a a glucometer and MDI setup

Scott Benner 25:04
and how did his his overall behavior change as his blood sugar's came down,

Denise 25:12
he was still really angry with me for a while he, he just couldn't internalize the fact that he was going to have it whether I had found it or not. And so I remember him like telling me how mad he was with me. Because we shared a bed, you know, I had the option for like a pullout couch. But I didn't want to be on that we, we laid in the same hospital bed together. But at night, one night, he he told me how mad he was. And, you know, he was still very angry and emotional at the time. So I remember just laying next to him. We were both just crying. It was it was hard. But yeah, over time, things definitely improved.

Scott Benner 25:53
Such a human Denisa isn't it? You need people and you want to be around people, but really, they just try to kill you. Yeah. Yeah.

Denise 26:03
Especially your kid telling you that they they're so mad at you. And it's all your fault. Like, imagine that, like, in your heart. You're like, I did what's right, I saved my kid. Everybody else tried to screw him over. And he hates me now. How do you not lose yours? In that moment? You know,

Scott Benner 26:21
it's a it's not great. I mean, I would I trade my children. No, but you know, it's tough. It's just a really

Denise 26:29
that out of the mouths of babes moment.

Scott Benner 26:33
It's such an interesting thing that, um, the I mean, there's so many cliches, but like, you know, you heard the ones you love the most like all that stuff, even and not that he's trying to do that. He's expressing how he feels. And he's got a limited perspective on the world and understanding what's happening. So I mean, I don't not understand it. But on your side. That's an academic exercise explaining to yourself it still feels the way it feels. You know, that's just it's that sucks. I feel free there. That's a that's not pleasant. Over time. Has that gotten better? Are you still the Oh, yeah.

Denise 27:05
Yeah, I actually asked him so I was like, trying to think about what I would want to talk about today. And I asked him how he felt about the whole situation and, and if there were any positives, or whatever. And he said, The drawbacks are, how annoying it is that I make him dos all the time, and how annoying it is for him to wait for food. And then the positives. He said, I get delicious snacks and yummy stuff when no one else gets like so we just moved to Slovakia. And there's like this really awesome Italian market with like legit Italian cannolis and cheese and all this delicious stuff. And so we had a box of like delicious Italian cannolis in our fridge and my husband in the middle of the night. He was low and he actually ran him up a freaking cannoli. So my son was like, Yeah, like that other time when I had the cannoli, daddy woke me up and give me a cannoli to raise my blood sugar. I was like, Yes, pretty friggin lucky did

Scott Benner 28:12
bakery delivery at 2:30am, right?

Denise 28:15
I know, I would not do that. I was like, Dude, you're gonna get a couple of glucose tabs in night. My husband, the way

Scott Benner 28:22
you're thinking there are times where I feel like, I feel like I'm standing in a dark room talking to Arden. And we're, we're negotiating over what, you know, sounds good for her to eat. And you know that you have like a span of time before she gets so low that it doesn't matter. It's just gonna be juice, right? And you're standing there, you're like you sure because there are times she doesn't care. Like she just wants to bring her blood sugar back up. It's not a big deal. But sometimes she wakes up and she's hungry. And she'll go, No, you know what I want? That's exactly what happens. He's like,

Denise 28:56
can I get up later? Yeah, could

Scott Benner 28:59
I get this and you know, you're walking through the house, the dogs look up, like, Why are you awake? And like, It's not my fault. It'll like, go back upstairs with a handful of stuff. And like, what about this? What about this? But anyway,

Denise 29:12
that makes the parent of the year and those moments?

Scott Benner 29:14
Well, you would think but the award has never arrived. Denise no one's actually set it out.

Denise 29:19
Yeah. Yeah. And that's the thing. When I was talking to my son today, I was like it realized I don't, I don't want to annoy you for fun. Like, it's not fun for me to annoy you. You know, I said, my main goal is to keep you healthy and strong so that you can live a normal, healthy, happy life. You know, I said I would annoy you till the cows come home just so that you can have a normal happy life, you know,

Scott Benner 29:43
so true. So it's quite a it's quite a balanced, that's for sure. And you're saying now he has Dexcom and does the pumper Does he still do? Yeah,

Denise 29:52
he isn't too slim. Yeah.

Scott Benner 29:54
Are you using the control IQ?

Denise 29:56
Nope, we're in sleep mode. 20 470 Wait

Scott Benner 29:59
control like you're using the algorithm?

Denise 30:03
Well, so technically you have to turn control IQ off for sleep mode to run. Okay. So basically with sleep mode on, the Basal itself just increases or decreases, pending his blood sugar.

Scott Benner 30:19
So sleep mode sort of turns into Basal IQ.

Denise 30:22
I guess I don't know anything about Basal IQ. It is the Basal rate. So I guess that makes sense. So interesting.

Scott Benner 30:27
How long have you been using it?

Denise 30:31
A pump itself or

Scott Benner 30:32
the pump?

Denise 30:35
We got it in Virginia. Once we moved our endo in Vegas, she was great. But she was like you guys are moving. So you might as well just wait. So you get set up in Virginia. And then we got it. So I think we got it maybe about March of this year. So no, last year previous? Yeah. Maybe we've been using it about 1415 months.

Scott Benner 30:59
It's interesting. You you measure all your time. With landmarks.

Denise 31:05
Assignments? Yeah, totally.

Scott Benner 31:07
It's it's very, it's very interesting. So you went from Vegas to Virginia, and brain year for a year, but now recently, you moved overseas?

Denise 31:16
Yeah, we're in Slovakia. We're in Bratislava, the capital.

Scott Benner 31:19
How long do you think you'll be there?

Denise 31:22
Three to four years? Definitely three at least. Is

Scott Benner 31:26
that a longer assignment than normal?

Denise 31:28
No, about right. Yeah.

Scott Benner 31:31
How did the kids go to school.

Denise 31:35
So they're not in school yet. When we got here, they had like two weeks left of their school. So I didn't want to put them through that at the very end of the school year. So I figured I would keep them out until they start again, which they will start August 25. And so my husband's affiliated with the embassy out here. And the embassy pays for them to go to a British International School. So they will be going there. Come August 25th.

Scott Benner 32:06
And that's that's an English speaking school.

Denise 32:08
Yeah. You know how much money it is? If I had to pay out of pocket? If you'll tell me I want to know 20,000 euro per kid per year,

Scott Benner 32:18
20,000 euros per kid, even like

Denise 32:20
Fathom without would be like,

Scott Benner 32:25
I can look it up right now.

Denise 32:27
Can you imagine? Like, I can't even I mean, I feel really grateful for my kids to have this opportunity. Holy cow.

Scott Benner 32:35
20 grand a year for each card?

Denise 32:38
Yeah. And then it's more for meals, which I don't even know what we're gonna do about that. Is there like, legit like home cooked type stuff over in Europe? Because it's not like cafeteria nasty food, like the states. And so I'm nervous about that already thinking about how many kids will actually bring lunch from home? And will my son want to do that? And if he does, like, what does that look like for me? You know, is the website even going to have nutrition facts on it for me to try and figure out a carb? Or a number of units prior to a meal? You know,

Scott Benner 33:14
are the meals extra money? Or does it come for the 20?

Denise 33:17
There extra money, we do have to pay for that. But they also have a bus that can pick up our kids from the door. And that is like 15 euro per day. But we don't have to pay for that, thankfully. Can you imagine you're already paying 20,000 euro per year, and you're also having to pay for transportation for your kid like,

Scott Benner 33:40
what the heck, but they get a nice fillet at lunch? Yeah,

Denise 33:44
I don't know, we'll see. But you have to pay for the meals, I will have to pay for that. I mean, the people have been really nice. Hopefully, there's no diabetic mothers or fathers that follow your podcast. So I won't have friends anytime soon. If so,

Scott Benner 33:58
you know, in my lifetime, when I was a kid growing up, my grandmother made school lunches at an American school. And she would get up every morning. Like, you know, five o'clock in the morning, she'd go to that school and prep and make by hand 1000s of sandwiches. Like, you know, real ingredients, like, you know, that kind of stuff. She'd finished those sandwiches up, and then she'd go home. It's all she did was make sandwiches every day for those people. And in just 10 years after she was doing that, and I was in high school, you know, 1015 years after, you know, I was I grown up knowing her doing that. They were down to like frozen pizza and like here, you know, like, so sad. It's really disappointing. You know, Arden said this year at school, and they blamed COVID But they didn't have any they just didn't open the cafeteria. So it's all packaged right by packs of chips. Yeah, that kind of stuff, but they didn't. And yeah, it's

Denise 35:05
disheartening because a lot of kids don't have parents that can provide them healthy meals at home, either. You know,

Scott Benner 35:11
I've had a half days where she was home by noon 1230. So she could kind of go in and come out. But if she got hungry while she was there, she was stocked with potato chips. That's all they had. And $15 a day to feed to transport your kids. Probably another 15 to feed them. 30 Yeah, it's nice how they pay for the school, but don't don't pay for you to feed them while they're there. Yeah, right.

Denise 35:36
I think we'll be packing lunch anyway, though, to have control.

Scott Benner 35:42
You know, you've used that word about six times that he's Do you want to tell us about your mental disorder.

Denise 35:48
I will curse you out right now. But I'm going to try and keep this clean. twice already. But I would throw an F bomb in there for you right now.

Scott Benner 35:56
Tell me about a little bit like what? Why? Like, what about it? Do you feel like you're too soon into diabetes to start eating like food that's being prepared somebody else somewhere else with? It isn't yours.

Denise 36:08
So with him, I think with the Pre-Bolus aspect. And even their schedule, I'm not sure how it works. I don't know if they go out to play and then eat or if they eat and then go out to play. I know they have a one hour lunch break. And I don't know, I don't know what the food looks like. And I don't know anything about the delicacies here and what the carb count might even look like. I think I never let him by when we were in Vegas, or Virginia just because I don't know. I like to have control over what they're eating. I don't know. I feel like the food is usually crappy, obviously, in the States, and so we just didn't bother there. But here the food will probably be a lot better. But how do I dose for that when I don't even know what it looks like, you know?

Scott Benner 37:10
So is this. So how long have you been there?

Denise 37:14
We just got here. I think we're here like almost a month now. Okay.

Scott Benner 37:17
All right. So yeah. Have you gone out for a meal? Have you eaten? Oh,

Denise 37:21
yeah. Yeah. I would need to see the menu to see if I even know what these meals are. I can tell you the top meal in the areas brings over a Hulu ski, which is like almost like little dumplings with sheep cheese. My kids really like it. They say it's like like Slovak mac and cheese. What's it called? pretty yummy. Britain's obey Hallelu ski. Our Y and DZOV and then Hulu ski is Ha L Yes.

Scott Benner 37:59
Ky. The Internet right here. Do

Denise 38:02
you find it out?

Scott Benner 38:02
Yeah. I want to understand what we're looking at here. super yummy.

Denise 38:06
It's almost like a new key concept.

Scott Benner 38:08
Bacon potatoes cream soft cheese flour. Yeah, you just said yeah, like it's pretty good. To medium potatoes, a cup of flour, a teaspoon of salt. 150 grams of smoked a regular bacon, half a tablespoon of vegetable oil. 125 grams. Britain the or other soft cheese like feta goat or cottage cheese. 50 milliliters of cream that are optional. Hold on a second. Are you gonna make it? I mean, I'm looking at it now trying to figure and it looks like

Denise 38:44
I don't know what's going on. Okay, almost.

Scott Benner 38:47
What I'm looking at is a plate that looks like lumpy white stuff with hunks of bacon.

Denise 38:53
Yeah, basically. Yeah. Hopefully we're not offending anyone.

Scott Benner 38:58
I'm not a fan. I'm describing it very accurately. So

Denise 39:03
here's what's objective data.

Scott Benner 39:05
Here's a here's a recipe that has six stars. Hey, somebody likes it.

Denise 39:12
Finally Great. Try it and report back to me. Oh, I

Scott Benner 39:16
have to hold on a second. Well, I mean, it's just it sounds like alright, I can't believe I'm doing this finally great to potato into a bowl keeping the juice out of flour, egg and salt. Stir with a wooden spoon at water stir until lumps are smoothed out though is not too runny at flour. If too thick add water. Large pot bring water to a boil add salt transfer potato dough into boiling water by using spatzle maker or push the dough through a large grater or colander. Thank you gently boil for seven to eight minutes until it floats I was it's like it's like it's like okay almost like me while me off by the big toe crest. I think the cubes strain It sprinkle the bacon on top and pour the rendered bacon fat all over it. Salt. I got a salted afterwards bacon that's not going to handle.

Denise 40:09
It's very healthy. Yeah.

Scott Benner 40:11
So what this sounds like is flour and a potato and bacon. And cheese. That's hard to go wrong.

Denise 40:18
Yeah, right. All the best things rolled into one so

Scott Benner 40:22
interesting. Denise, that you said you don't want your kids to have any junky food.

Denise 40:29
They have plenty of junky food, it's just I need to know how to control his blood sugar at school. Dude, we've had so much ice cream since we moved here, you would be floored

Scott Benner 40:40
because because you know how to Bolus for ice cream?

Denise 40:43
No, it's everywhere. And it's delicious. I mean, and really have become a real slacker with like, counting carbs. I just like eyeball it. I don't know if this makes me a good mom or a bad mom for diabetes, but I just eyeball it. And I'm like, You know what, let's just get two units on board right now. And then I think this is going to hit hard. So but we have the protein, it's not going to hit too hard. But once it does, it's gonna go real high. So we'll just like reconvene in like an hour. And then once I start seeing it rise, I'm like, Okay, let's hit it again with another three. And that's kind of how I do diabetes. Now I'm like, I don't know if that's a good thing or a bad thing. But it's kind of fun.

Scott Benner 41:27
It's just sort of how I do it. So really, like, do

Denise 41:30
you ever like say, just looks to be about 50 grams of carbs?

Scott Benner 41:34
I mean, you do that? In a sense. Yeah, every time but not, but not in the way that you're imagining? I don't I don't look at it and think, Oh, that's a cup of this. And I end on the bag, right says this match? You know, I look at the plate. And I'm like, it seems like this much, you know, and if what, you know, if, if I think it looks like 60 carbs, and when she enters 60 carbs into you know, the algorithm. If the suggested amount of insulin is about as much insulin as I think that plate needs, then I go okay, well, that's it. All right. And then I just then you just watch it. And if it goes up, then you go after it again. Yep. And very infrequently. Is it too much. Although we used too much at a lunch yesterday, sort of how long did she go? She had to she had to do something like three hours later, she needed to like she had to take in carbs, like three hours later to stop. Like a drifting 60 ish blood sugar. It was a salad. Just the salad had stuff on it. And I was like, you know, that looks like this many carbs. We were in a restaurant and have to admit, I gave her a number that assumed that she was going to take a couple of bites of what I was eating. And then she just never did. And then it held so well for the first two hours that we kind of were like, Oh, we might have had this. Like we're I guess we're okay. And then in the like, two hours, 30 minutes time started getting a drift. And then we had to we had to jump in and do something then. Gotcha. But you know, still it was a salad, like a big salad in a restaurant. And we Bolus like 30 carbs for it. Wow. So we were almost right. So I would think that salad needed more like, it was probably more like 2022 Maybe carbs. And had she just had a couple of bites while I was eating we would have definitely been right, but tried. So you wrote maybe the most expansive note to me of anybody in the last two years asking really? I guess you put so much information there. I want to be that bad? No, I just want to be clear with you that I did not read it. So

Denise 44:07
I don't even remember what I wrote. So it's cool,

Scott Benner 44:09
small novel, I wouldn't even know. Yeah, it's a small like, you know, like, you know, not a, it's not a full novel. It's not a full book. But you know, Ben Franklin used to put together those little readers for people. He'd be like, here's common sense. Like it's sort of on that, that that level. Um,

Denise 44:25
that's really funny that you read it.

Scott Benner 44:27
You You know.

Denise 44:31
Now I know for next time

Scott Benner 44:34
how presumptuousness.

Denise 44:37
Know what all right if I ever come on again, and it'll be the F bomb, and then you

Scott Benner 44:43
fill in this jackass you don't even read this.

Denise 44:47
Go blank yourself. Yeah.

Scott Benner 44:50
I've, I've run my eyes over it before we started. But I don't want to. I don't want to know I don't want to put myself in a situation where we're just reading from a list. Yeah, no.

Denise 44:59
I appreciate that.

Scott Benner 45:00
But it's interesting because, yeah, but it's interesting because you wrote this probably six months ago, I'm guessing. And you're worried about your son's health when you make the move to where you are now? And you're still worried about it, aren't you?

Denise 45:17
Oh, yeah. That's like my life, unfortunately. Yeah. What it weighs heavily on you?

Scott Benner 45:24
What's going to take that worry away?

Denise 45:27
Um, nothing.

Scott Benner 45:30
Is it a real concern? Or is it honestly, is it? Is

Denise 45:33
it? No, I mean, we function fine. But I can tell you, there's always in the back of my mind, I really hope that I can send him off to college, if that's what he chooses, after graduation, knowing that I've done the best for him, and he will have zero complications at that point in time in his life that are associated with my and my husband's, you know, dosing, and treatment of his diabetes.

Scott Benner 46:02
Can we talk for real for a second, like we're friends? Yeah, I know you're at

Denise 46:08
D Nice.

Scott Benner 46:13
Last night, I'm going to deviate for a second I'm gonna go back to my last night, a person in the Facebook group was asking people questions, and people were giving a lot of good answers, but they seem to still be discombobulated. And I was up late editing a show. And I thought, well, let me see if I can't, like, be valuable here. And I asked, I asked to see a graph and they put a graph up, but then they were pretty clear that this was not a standard graph. And you know, that other people had been involved in the Bolus thing and that they were getting back involved in it. And, and I said, Okay, well, the graphs, like a little scattershot, I thought to myself, and if they're telling me this isn't the norm, then that's fair, like, so I answered back. And I said, Well, you know, why don't you, you know, get back in the game and send me a graph in a couple of days and just tag me at all. I'll take a look again, if I can. And in the meantime, I gave some, like high level ideas of what I thought I would concentrate on based on the graph I'm looking at, well, this this person did not like they did not think that my, my, my response was thorough enough. valuable, and they began to like, in 15 years of doing this for people bashes. I've never, I've never been spoken to like that before. Oh, and and I immediately thought, this person isn't a isn't a bad situation. They turned on me in, in it splits. It was like, it was like, defensive, it was like petting your favorite dog, and it biting you after it knowing you forever. I was like, I was stunned. I was like, You know what I mean? Like, like, I went back to, to have a back and forth. And the response was, so just, it was just so out of bounds for what was happening. You know what I mean? Like, there was no even like, slowly I turned, it was just like zero to 100 miles an hour. And I tried to respond and to, you know, I was like, Look, I think maybe we're just having a communication issue here. Because I know you what you're receiving right now is definitely not my intention. And I'm I'm very willing to believe that what I'm receiving from you is not your intention. Let's just start over and then they just deleted the whole thread.

Denise 48:26
Hmm. So they stay on the page? Or did

Scott Benner 48:30
they just stay on the page? I wouldn't, I wouldn't block them. I would have been happy for the person to continue to tell me how they felt like, yeah, you know, like, it just seemed like they were overwhelmed. And I could be wrong. Maybe I'm just okay. But I know what I said. And I'd be hard pressed to think that anybody would read it and think you're just being a jerk. I was not I was trying to help. Yeah, I just did not offer what they wanted. And I think I think there's

Denise 48:57
something deeper going on at that point, you know? Yeah, I think it's a perfectionism thing, probably to like, I don't want you to see my flaws. You know? I don't know. Yeah. Because I think people internalize the numbers a lot. I know that I do. Like, I feel like the biggest piece of when my son has a bad day. And I know, that's not a healthy way to live, but I can't help it because I know 90% of the day, I'm the I'm the one responsible, like, my husband helps at night and stuff. But right now he's in a vault, you know, he can't even take his cell phone. And so it's me, you know, when you have those days that are really crappy. Like, it's really hard to separate the fact that this is not you, you're not a bad mom, you know, like those kinds of things that go through your head.

Scott Benner 49:45
So I brought that situation up because over the last hour, aside from the first 10 minutes where you couldn't make any of your stuff work, which oh, by the way, I will I'm going to put at the end for people to hear just I wanted to make that clear here. So hang on a second. You're gonna hear Denise tried to make her headphones work. But no one will listen. Don't worry, Denise,

Denise 50:08
they'll probably let well, people I know that are going to be listening to laugh.

Scott Benner 50:12
Everyone's gonna hear they're like, oh, yeah, I do want to hear her fun for, but I brought it up because you're, you use you've used language for the last hour. That is over and over again, telling me that if he's not okay, you're not going to be okay. And and I mean, on a psychological level, but you seem aware of it?

Denise 50:40
I am. I know. I'm all about it. I mean, I have anxiety for sure. And I know I have perfectionistic tendencies. So I'm aware, I just don't know how to make it better. You know, I don't know how to separate the two like right now I feel that I am the type one diabetic, almost, you know. But it's worse, because it's my kid, you know, and I'm 100% responsible for his well being right now. Like he is not making these decisions. He and I work together. He has as much opinion on it as he wants. And I'm not going to overwhelm him by giving him more than he wants right now. But with that being said, it's me. And it's my husband, my husband's awesome and he helps when he can but he's not always home. And he, like I said doesn't have a cell phone on him. So doesn't know what his numbers are half the day, you know?

Scott Benner 51:33
Oh, yeah. Did you ask me not want a cell phone?

Denise 51:37
He's not allowed. He he has a, you know, secretive kind of job. Oh, I see. Yeah, you can't bring any technology. I'm with him when he's at work. Duty is not like Fred Flintstone.

Scott Benner 51:52
Would that make him a Luddite? If he didn't want to use technology? I have to find out if I'm right. This might be me showing off and I know what Luddite means. Or it might be me proving rare a person opposed to the new technology or ways of working a lot. I think. Speaking of big words, are you martyring yourself at all?

Denise 52:16
No, I don't think so.

Scott Benner 52:17
You don't think you will just be like, it's on me. It's all me. I might as well have diabetes. He's involved. He's

Denise 52:25
a he's a baby. You know, that's the thing. Like, he's not a baby, but he's not obviously making the decisions that affect his life from here on out, you know, and working as a nurse and seeing tons of type one, or type two complications. My dad was on dialysis when he died. Actually, he wasn't on it. When he died. My mom donated a kidney to him. Because he was on dialysis. Like, I don't know that I can let those things go. I've seen too much. I've seen amputees. I've worked with amputees. Yeah.

Scott Benner 53:00
Yeah. You have a bigger perspective. Your mom has a two as well, right?

Denise 53:06
Yes, but she didn't at the time. My dad had type two since I was like in third grade.

Scott Benner 53:12
And she No, I have a bigger one. Now. I don't even care about you or your kids. They were a perfect match. I was gonna say your mind blowing. How long were they married when she donated that kidney? Like how old was she

Denise 53:22
God a long time. I think my dad was diagnosed when he was 40. He died when he was 60. So that was maybe when he was 50. Something. They were married a long time they got married when my mom was 18. And she's 70. Now

Scott Benner 53:38
so Okay, so they married when they were 19 in his 50s. So 30 years later, your mom gave him a kidney? Mm hmm. I have been married since 96. Let me do the quick math on that. 2006 16 Hold on a second then forced 20 That's 24 That too. I've been married like 26 years. I'm not 100% certain that Kelly would cross the street to save my life. And you're telling me your mom gave him a kid? Did she love him? Or was she scared which wasn't?

Denise 54:09
Probably combo. She loved him. They had a really good relationship overall. That's really we have we have pictures of the two of them and hospital but it's like being wheeled back at the same time stuff is mind blowing. Lovely. Pretty beautiful and sad all at the same time. Listen, if

Scott Benner 54:29
Kelly ever listens to this just tell you like you better not need an organ. Don't ask me

Denise 54:34
because I don't know what my choice is going to be. I don't want to be put in

Scott Benner 54:37
that situation. You know what I mean?

Denise 54:40
Oh my god, I think you need to have her watch or listen now.

Scott Benner 54:43
All right, well, I don't want to have to shine a light on this. See where I'm gonna when

Denise 54:48
I feel like I need to like tag her. Is she on your page by the way? I think you need to let me know. I don't think that's important when it when it airs. I would be like, Oh Hey Kelly, this episode. You really want to listen to it.

Scott Benner 54:59
Don't worry, please Just last week when I talk about and I'll say, Oh, I just talked about how I don't want to give you an Oregon.

Denise 55:06
You better keep your blood sugar in check. You don't need I

Scott Benner 55:09
don't need any kidneys. I'm not giving them.

Denise 55:12
But yeah, there's not a lot of organs you can do it in anyway,

Scott Benner 55:15
I just found it really nice that people who were together that long would do something like that for each other. I usually imagine when people are together for that long, they're just they're out of convenience. Yeah,

Denise 55:25
they hate each other. Like,

Scott Benner 55:27
I don't want to go through selling this sofa.

Denise 55:30
Right. Right, or I need his medical benefits.

Scott Benner 55:34
Yeah, you mean the guy with the money? He's okay. He gets there. But not that that's really that's a I mean, it's a real indication of something. Giving somebody giving somebody a kidney? Yes, for sure. No. How long did it by him?

Denise 55:48
Oh, gosh, probably four or five years. Maybe I'd love to ask him. He thought he had COPD. And she gave him a yeah, he was in the Navy. He smoked like a chimney. We my sister and I used to like break his cigarette, his cigarettes. And we eventually got him to quit. But you know, the damage was done. So he was on oxygen and everything. And yeah, it wasn't dialysis at that point.

Scott Benner 56:20
snap decision, your husband needs a kidney. You given it to him?

Denise 56:25
Don't do this to me. I think as long as I don't know, you know, my situation is different. Got to know. I mean, with two parents with type two.

Scott Benner 56:39
Do you think you're getting? So I

Denise 56:41
don't know. Because I feel like I'm screwed. I'm gonna end up with type two, regardless of my lifestyle choices.

Scott Benner 56:48
I see your point, but I don't know. Like,

Denise 56:51
I think I would. I think I would. And then I'd also be concerned at the same time for my own future with the potential for myself to Andover type to see it's

Scott Benner 57:01
interesting. I thought you were gonna say I'm saying if I was gonna give anyone a kidney, I would give it to my son. So I want to hold on to him. I never

Denise 57:09
even thought about that. But yeah, absolutely. But who knows if you're even a match. That's the other thing. You know? I can't believe still to this day that my mom and dad, you know, we're a match. That maybe they were brother and sister. But I turned out damn good.

Scott Benner 57:27
You don't have a tail or anything like that?

Denise 57:33
Oh, god, that's gross to think about.

Scott Benner 57:35
Which part you having a tail or your parents being brothers?

Denise 57:38
My parents seems siblings.

Scott Benner 57:42
Definitely holding on to that excuse for oh my god, I'm saving it in case it needs it. I'm sorry.

Denise 57:47
Go see. That's a really good excuse.

Scott Benner 57:50
It's such a leap. Like when people donate organs. I mean, I find it to be one of the like, really major kindnesses. You know, it just it's just a big leap. You know? Yeah. I mean, it's not like you're letting your neighbor use your other weedwacker like, I got this one stole it's crazy. It's a crazy thing to do. I mean, a lot of respect for people who do that. I

Denise 58:14
really selfless. Yeah, for sure. Yeah.

Scott Benner 58:17
Okay, so I want to go back to your anxiety whole life.

Denise 58:22
You know, I think so. And I don't think I recognized it until my adult.

Scott Benner 58:29
Just thought you're on top of stuff.

Denise 58:32
Yeah, I mean, my childhood was a little rough. So. So I think that kind of makes you a little more anxious. And then like, I distinctly remember my sister and I, we were both camp counselors. And she was a camp counselor like the year before, when we were in high school or whatever. She and I are three years apart. And then I had just, I just got in my car. And I was like a brand new driver. And my sister and I were both driving separate cars to the camp but I'd never been there before. In this was like before the time of GPS or whatever. And so I was falling behind her. And she I think was trying to show off and so she passed this car in front of me. And I was so nervous about getting lost that I to pass the car without looking in the other direction and seeing this 18 Wheeler coming towards me. So I distinctly remember him like laying on the horn because we almost had a head on collision. Well, I almost had a head on collision with like an 18 Wheeler. And when we arrived my sister's like, I can't believe you pass that car. I should have never passed the card and think you were gonna follow me and I was like, Well, I was so nervous about you know, getting lost. I don't know my way around here and yeah, so I think that was a you know, first indicator where I realized But I probably needed to chill out.

Scott Benner 1:00:02
So your anxiety was so overwhelming that you were willing to put yourself into a harmful situation just to not have the feeling of oh, I might get lost falling apart. Yeah.

Denise 1:00:11
Yep. Yeah, that feeling of being out of control it couldn't handle. Yeah.

Scott Benner 1:00:17
And so what do you do you do anything for it.

Denise 1:00:21
I mean, I've talked to therapists and stuff, I do meditation, when I'm exercising, I'm in a better place, I think overall, but have kind of come to accept that this is my norm. And I really don't think diabetes has helped it at all. I think it's made it worse. I think, if you have perfectionistic tendencies and anxiety, diabetes is like the worst condition for you to have to deal with in my eyes. Because there's so many numbers, you know, there's so much objective data, you go in every three months, and you get an A onesie and time and range, you know, and, and that's a reflection on, you know, how well you're managing. And so even if it's three months later, and your agency and time range go down, just by a point, you're like, Gosh, I really screwed up, at least for me. And of course, it's not my disease, but it feels like it right now. Because I'm the one managing my head. Do you have any

Scott Benner 1:01:17
idea of what age or what situation you'll want him to be in when you start giving him some aspects of a responsibility?

Denise 1:01:27
I mean, he has responsibility. I have him like, pull things out for a meal and, and figure out how much to dose for instead, but not when he's away from me, you know, and he plugs everything into his pump by himself. I just do and he feels comfortable with but he gets really annoyed by having to do too much, you know, he doesn't like to be interrupted while he's playing or whatever. And that's, that's the real disservice with the T Slim is. I can't just take the PDM because there is no PDM it's the pump, which he wears, you know, so I have to be nagging him, or I take it out of his belt and do it for him. You know, so does this and I know T Slim is coming out with the update, but it's not out yet. And I really look forward to that to reduce some of the pain in the ass burden for him, especially on nights. And we have like a tricky meal, you know,

Scott Benner 1:02:25
do you. So what you're describing to me makes sense, because he's nine, and I hear everything you're saying. And at the same time, I imagined that there are people listening who have had type one diabetes for 30 years who are thinking like, yeah, let that kid do more like that kind of stuff. Like, are you worried that there's a tipping point somewhere where he could go so far in the direction he's in now that you can't get him back? When it's time for him to take over? And do like, feed it a little out like what I used to do in Arlen was little. And we still do it now to some degrees, we kind of played that game where food would come out like like, how many carbs do you think that is? Or how much insulin Do you think that is? And or I do that? Or when our when our blood sugar starts going up, I asked her leading questions to teach her know, like, hey, was there any fried food in your lunch? Even now, today? I still do that. And it makes her think and then she'll go, Yeah, I had French fries. And I'll say, oh, we should Bolus for the fact that and you know where she says no, when I go, Okay, well, what did you eat? And so I'm teaching her without? Well, I mean, Denise, if I'm being honest, I'm doing to her what I'm doing to all of you, but I just I'm teaching her without letting her know she's being taught.

Denise 1:03:40
That's a good idea, actually. I mean, I do mention what I think happened in that moment, but I don't ask his opinion on those things. I mean, there have been times where he's like, I'm gonna take another tab too, because I'm starting to not feel good or whatever, you know. And we do talk about what I think is happening, when it's happening, and why it happened, and how I messed up or how we messed up. Well, really how I like, yeah, I should ask his opinion. For more. I like that idea, actually, like, just make it a game and not have him feel like I'm grilling him, you know, because I don't want to make it a burden. And based on what I've read in the beginning, I, I didn't, I just wanted to take his lead on things because I don't want him to have burnout when he goes off to college and be belligerent and not care at all and end up in the ICU or something. You know, you

Scott Benner 1:04:39
also don't want him to not know what he's doing.

Denise 1:04:41
Yeah, I know, like, how do you find that balance? So, you know, I

Scott Benner 1:04:45
just told you what I thought so

Denise 1:04:48
probably, I will implement ASAP.

Scott Benner 1:04:51
So like yesterday, we were coming home from lunch, and we had like a nice 20 minute ride and I said, Hey, I'm going to explain how your algorithm works to you She knows what and I was like, I like the background of it. I'm going to talk you through it a little bit. And she's like, Oh, that sounds so boring. And I said is going to be very boring. I was like, but just let me go. I was like, we're driving. And I'm talking like, you understand. I'm saying she's like, Yeah, and I looked over it again. She goes, I'm getting tired. This is so boring. I said, we'll just let me you know, fill in a couple more blanks for you. I've been doing that for years. Like I remember, I remember the first time we had a real conversation was after an endo appointment. And she showed some interest. She said, What could I do to bring my agency down? And I thought about it. I said, if I could ask you to do just one thing, until Daddy can figure things out a little better. Could we stop eating cereal for breakfast? That would be terrific. And she's like, if that'll help, I'll do that. And so she did that, which gave me more time to figure out things like this was many, many years ago. And, and ironically, of course, she doesn't even eat cereal anymore. But you know, there was enough time where I actually could figure things out back before I was good at polishing for things. And then I was able to take what I learned and then reapply it to cereal. And that's what I need. Hold on a second. This is unconscionable. My wife has one job in the world. To actually that's not true. She has three jobs. I'll tell you what they are. Make money. Tell me reasons why we can't have sex. And keep that dog quiet while I'm recording. The three things, three things

Denise 1:06:38
bring the dog in and I'll whisper sweet nothings in its ear. She's

Scott Benner 1:06:42
good at the other two things. Why can't she do this?

Denise 1:06:46
Probably because there's someone out your door or something. I

Scott Benner 1:06:48
don't care. There should be an urgency, a snap in her step. She should that dogs should bark and she should think Scott is recording that podcast is a very, very popular podcast. It cannot have dogs barking in the background. Let me leap to

Denise 1:07:01
know what people like to hear that you're like a normal human.

Scott Benner 1:07:05
Like, I don't know how normal I am.

Denise 1:07:07
Because I Googled earlier, right? You're not normal, actually. But

Scott Benner 1:07:11
I have a chart in front of me right now in case we want to play a game where we get to guess what US state it's legal to marry your cousin. And that's just based off of what you like, philosophize about your mom. Nice. Mostly. By the way, the answer is way more states than you think.

Denise 1:07:27
Well, there's so many Utah.

Scott Benner 1:07:32
I don't know what you just said because I love people in Utah, but I'm gonna look right now and give you us Hall. It's gotta be Utah. Yeah, only if both parties are 65 years or older, or both are 55 or older with a district court finding of infertility of either party.

Denise 1:07:49
Wow, my so old,

Scott Benner 1:07:52
cuz they're like, Please don't make babies when you're with your first cousin. I guess it makes Are you allowed to have sexual relations or cohabitation? If your cousin's in Utah? No. But there are plenty of states where you are legally allowed to

Denise 1:08:08
do it. Like where appears Don't tell me it's New York

Scott Benner 1:08:12
there's an interesting one in Wyoming you can't get married. But you can do the sexy part

Denise 1:08:21
Oh, wow. Is there an age limit?

Scott Benner 1:08:24
Not on not in Utah there's an age they're not in Wyoming there's an age limit in Utah. There's an age limit in Indiana you have to be over 65 in Illinois both over 50 were one is in fertile so you can be 35 if one of you can't have a baby. Arizona

Denise 1:08:44
How do you prove that you have to go to the doctor and prove that you're infertile?

Scott Benner 1:08:47
Have sex with your cousin nobody gets pregnant I don't know like it's the whole thing. When I googled that and there was a chart I was like

Denise 1:08:56
get out of here you know people are looking it up if that chart exists oh

Scott Benner 1:08:59
my goodness you have no idea i all i all i googled was married to your sister.

Denise 1:09:06
And you're gonna get like all kinds of all kinds of weird ads face to face.

Scott Benner 1:09:11
You brought this

Denise 1:09:14
I want to know like I need you to screenshot those and send them to me like what kind of ads you're getting on Facebook. Now it

Scott Benner 1:09:20
was your brain that brought this up. It has nothing to do.

Denise 1:09:24
You're gonna get like polygamy to polygamy, ads and

Scott Benner 1:09:28
there is just so like, what is it called when you date your sibling? While cousin marriage is legal in most countries. And a functional at marriage is legal in many sexual relations between siblings are considered incestuous almost universally Yeah. Okay, well, good. Oh, my goodness. I don't know how you made me think about these things. But you did. You're talking.

Denise 1:09:53
You gotta keep it fun around here, right?

Scott Benner 1:09:55
I don't know that. I'm not calling that fun. In case you're wondering where I draw the line for fun

Denise 1:10:00
Yeah, it's it's awkward and disgust I'm

Scott Benner 1:10:03
adopted. I can't even think of my cousin that way. And I've literally they they're not related to me in any way shape or form for real. It's just we grew up together.

Denise 1:10:11
Yeah. Hey, have you ever found like your birth mother and father know if you want to answer well, I mean,

Scott Benner 1:10:19
not have no. Suddenly we're on your podcast and he's been okay. Sorry. So when Arden was born, Kelly pressured me. And I'm using the word pressure to accurately pressured me to find out about my, about my natural parents. She wants to know for she said back then health reasons which never really panned out at all. We found we were able to find my birth mother who was already passed. And that was, I mean, when Arden was little so like, I don't know, 1718 years ago, and she had died in her 40s. We learned that she had a big family. And we contacted somehow contacted the family I think, an attorney that it for me, and then one person said they'd be open to speaking on the phone. I spoke to her one of her sisters. She described that my natural my birth mother was depressed her whole life. Because she gave me all the way she made it sound like it wasn't really her idea completely. Like sound like a lot of family pressure, maybe. Young. Yeah. And young guests, not really young, but younger. And she died. So I guess the depression turned into obesity. And she died having surgery trying to have like, like a stomach stapling or gastric bypass or something like that. She had a heart attack, I think in her 40s. And that said, obviously, I have no real emotional connection to the story. Right? So it's just the person then they had no, no idea who the father was, at least that they would say to me. Then later as the conversation went on, she described if you hear from your uncle this don't answer the phone. If you do this, don't answer the phone. Don't talk to that. And I was like, I'm out. And I never. I never ever watched him again. Yeah, too much drama. Yeah, so it turns out if it wasn't for adoption, I would have grown up in the mountains in the south somewhere.

Denise 1:12:35
Oh, dang. Yeah. southern twang

Scott Benner 1:12:39
Can you imagine? What if I had all these thoughts? And I was like, you know, living in a pickup truck in the woods. People would not be there but yeah, I don't think about it ever. I like the idea I've said here before I like the idea that I felt like as I was growing up, I felt like I was a new country and I got to make up my own walls. I always thought that was

Denise 1:13:02
so that was cool. Anyway,

Scott Benner 1:13:05
and I still live by those rules now the nice

Denise 1:13:08
nice I marry your sister

Scott Benner 1:13:14
are you trying to name this episode Denise?

Denise 1:13:19
Oh, ah you know what I always get a kick out of figuring out why you name the things you do this

Scott Benner 1:13:26
go marry your sister's a strong contender for this one.

Denise 1:13:29
Okay, what are the other options? I

Scott Benner 1:13:31
don't know whatever that food was called and friends of a Hiller ski Denise's anxiety one of the other I don't know.

Denise 1:13:39
No, leave that one out. You know, I know how to say I need help in Slovak. Oh yeah. Go ahead. It's put rebel Yeah. Promotes do people on the street but I will put caribou EMA promotes

Scott Benner 1:13:57
and people on the street don't speak English.

Denise 1:14:01
Young people do I'm actually taking Slovak lessons and I have been talking with her about learning more medical Slovak in case my kid gets admitted here. I pray he does not.

Scott Benner 1:14:15
Do you think you're going to get come along at all learning the language or is it hard?

Denise 1:14:21
Yeah, I mean, I know some stuff. I know how to order. I know how to say. Here you go. I know how to say good morning. Good day. You know? I'm sorry. I know some basic stuff.

Scott Benner 1:14:36
Are you obviously American? Oh, yeah.

Denise 1:14:39
I mean, I try to dress like I'm not but I stumble when I'm trying to use Slovak. You know, it's hard

Scott Benner 1:14:47
about visually. Like, can I look at you in that setting and think you don't know I'm here.

Denise 1:14:52
No, I don't I don't. I think everybody kind of looks a little different. I mean, everybody's white here. Okay. But I'm also white case you're wondering. Yeah, but people have all different hair colors and stuff. Yeah, I was just wondering, look like

Scott Benner 1:15:12
anything. I didn't know if there was an aesthetic that you don't fit somehow or No,

Denise 1:15:17
no, I don't think so I think you could blend in as long as you could speak and dress properly.

Scott Benner 1:15:22
Gotcha. How is it getting your medical supplies? It's all is that all through the military? Yeah,

Denise 1:15:26
I want them to talk to you about that, actually. So

Scott Benner 1:15:29
why did you bring a possibility of your parents being related? And not just

Denise 1:15:34
I mean, it was kind of a fun thought I thought it better not be true. I know. It's sad, but it's pretty funny to think about. So I can tell you this. So before we even got this assignment, we knew it was on the radar, because the whole reason we moved from Vegas to Virginia was so my husband could take Slovak classes and learn how to do his job in Slovakia. And so we were approved prematurely because they had to go through an approval process before they moved us to Virginia, because there's no point in taking these classes if we weren't going to be approved for the assignment to Slovakia. So then he goes through all these classes, and we knew we would have another medical board that had to meet again, Denise

Scott Benner 1:16:20
microphone again. Oh,

Denise 1:16:24
okay. Can you hear me now?

Scott Benner 1:16:25
Yeah. Where'd you go? What are you walking away from the computer?

Denise 1:16:28
No, I just sat up a little bit. Is this good though? Just get up. I'm in the most uncomfortable,

Scott Benner 1:16:34
I don't care. That's your problem, not mine.

Denise 1:16:36
I'm glad it's working out for you. So anyway, so we knew we'd have to undergo another medical board prior to actually leaving Virginia and moving to Slovakia. And so that second Medical Board, we were actually denied because of my son's type one, because the military doesn't typically move type one families overseas. And if they do, they're gonna go to a base that has a larger military medical facility like Lakenheath in England or, you know, launched or Germany has a big, like the biggest military medical hospital so they have more of the resources to manage it easier. So the board that met they were not keen on the idea of sending us out here, because Slovakia is not a first world country medical system is very different. They were concerned that we wouldn't be able to find a English speaking endocrinologist for him. So there was a myriad of reasons why they didn't want us to come here. But obviously, people out here have type one and type two, and there are providers. And there are ways to get supplies. And there is a Facebook page for military families that are stationed overseas with type ones. So I did a ton of research to make this happen, because it's like my husband's dream job. And I wanted it to work out for him. But I also obviously wanted to keep my kids safe in the process. But I knew if we did the research, we could be just fine. So anyway, so we had to do like a rebuttal. But my husband in the interim was like crushed, because we thought that that was going to be the end. And you know, we were going to submit the rebuttal. But chances are that we weren't gonna be able to come here. Which would mean he did all of that Slovak language learning for nothing, all of those other classes for nothing like that whole year of his life was a complete waste and all that hard work that he put in, you know, so we submitted the rebuttal, and then we were approved. So with that being said, by that point in time, we had already researched endocrinologist and the supplies and everything because we had to submit that and we you know, I'm very well prepared on that kind of stuff. So I had reached out to a foreigners in Bratislava Facebook page and asked if there were any other type one mothers. And if they had a pediatric endocrinologist that they could recommend, and there was one person who I believe is on this page now, because I actually told her about it at the time. She reached out to me and said she had a 13 year old type one, and that her daughter saw this one provider, but she didn't love that provider. However, she knew that the other provider in the office was much better. And she recommended that provider. So we reached out to her and she was like, incredible about getting back to us like I love Europe in the sense that there's no gatekeeper like there's no nurse sitting at the desk preventing you from speaking with a provider. Like she wrote us back that day. We were like, these are all our concerns. Are these going to be able to be managed? You know, like, is there a hospital that can see him in the event of ketoacidosis? Like, do you have glucagon? How would we get her insulin? Is it possible that he can use a T slim blah blah. So she's asked So in Bratislava, initially, we were planning to just go to Austria because Vienna is like an hour away, and their medical system is really great. But Vienna like Austria itself, they don't have the ability to write scripts for the T slim because it's not approved in Austria. So in Bratislava, the T Slim is approved, so we had to find a provider in Bratislava. So she was awesome from the get go really responsive. And when we got here, we were supposed to just meet with her so that she could just write scripts for her for us. And then we had an appointment with her like, a week or two later, but she was so awesome. Like, the hospital is sketchy as you know what looks, it looks like something you would find in a scary movie. At like a psych hospital with like some Red Rum going on. When we pulled up, I was like, oh my god, this is our life. And I know this is really wrong. And I'm not trying to offend anyone in Slovakia, you guys are great people. I just need a preface with that. But it is not aesthetically pleasing at all. It does not look like an American hospital at all. But the provider was incredible super kind. We wanted her because she has type one herself. She's probably late 30s, maybe super nice, really kind to my son wrote all the scripts we needed. We've received insulin here from one of the local pharmacies, the scripts that she wrote for the Dexcom and the T slim, we actually submit them to CBR medical who's out of Germany, and they actually have our first shipment on our way to us. Which is cool because they give us a six month ship and at once which is really nice because dealing with advanced diabetes, I had to you know, message them or whatever call them every three months, which was a big pain in the ass. So yeah, so far things are going well. TRICARE our insurance didn't want to pay for her. They had one other provider in Brighton in Bratislava, that apparently was TRICARE approved. So when I reached out to them, because I was already adamant about seeing this other provider because she was so good to us. And we had established rapport by the time we got here. TRICARE was like we will authorize two visits. But we need you to see the other provider because she's in network. And so I called her to try and make an appointment with them. And she's like, she's booked up and she doesn't even take insurance, you'd have to pay out of pocket. I'm like, What's TRICARE talking about? So then I told TRICARE. A, I couldn't even speak with a woman B, she's booked out for like months and see, she's not even taking insurance. So I don't know what you're talking. Like, if that's the case, you might as well play it pay for the provider that we want, you know? Yeah. So they've approved her, thankfully. So,

Scott Benner 1:22:53
Denise, your connection is getting noisy. So this is an opportune time to say thank you. It's okay. Don't worry. We got through as best as we can. And if people want to hang on for the next 10 minutes, and let us know how hard it was to get you on they can. But it was, it was really nice to talk to you. I hope we thank you. I hope we talked about everything within reason that you wanted to. And did you did you have a good time?

Denise 1:23:17
I did. Yeah. You're fun to talk to. It'd be fun.

Scott Benner 1:23:21
That's true. No, I'm just saying Oh, thank you. I mean, no, I really do appreciate. Can you hold on for one second for me? Yeah, thanks.

A huge thank you to neat. Hey, first, I'd like to thank Denise for coming on the show and sharing her story. And I'm going to thank all the above makers of the AMI pod five and the Omni pod dash and remind you to go to Omni pod.com forward slash juice box links in the show notes, links at juicebox podcast.com. And of course, U S med.com. Forward slash juice box or call 888-721-1514. Listen, switching is not fun. Looking into new things isn't fun, but some quality stuff here for you to think about on the pod, US Med and the rest of the sponsors. And if you hold on for just a second, I'm going to play you the 10 minutes of Denise not being able to get her I was going to curse not being able to get her computer setup. Here we go. Oh, before I do that, let me say thank you so much for listening.

Denise 1:24:31
Hey, everyone, my name is Denise and I am the mother of a nine year old type one diabetic child. He's been diagnosed I actually did the math before I came on a year and eight months ago. And at the time he had an A one C of 16 and a blood sugar of 910

Scott Benner 1:24:53
days. Do you remember before we started recording that you said I turned up the volume? Yeah, can you turn it back down a little bit? Yeah, let me hear that.

Denise 1:25:02
Can you hear me? How's that?

Scott Benner 1:25:05
I'm gonna need you to speak another sentence. So he was diagnosed what was his a one, two?

Denise 1:25:10
It was 16 actually.

Scott Benner 1:25:13
Okay. All right. I don't know if like, it turns out a little more. Okay. Am I like super loud sound like Darth Vader

Denise 1:25:22
is that? Oh, cool.

Scott Benner 1:25:26
That might be better. We'll try again. Okay, wow. So a year eight months ago, how old is he now? He is nine. Nine was the seven or eight when he was diagnosed. He was seven.

Denise 1:25:37
October 24 will make two years for us.

Scott Benner 1:25:42
You're up on two years. Okay. Any other kids?

Denise 1:25:47
I have two others. He's a middle guy or only boy. And we have an 11 year old and a seven year old.

Scott Benner 1:25:55
Denise Denise, Denise, Denise, I gotta figure out what to do about your microphone shoot. So you're talking and then behind your words, or? It sounds like it's okay. I think it's just the mic.

Denise 1:26:09
I go down lower. I don't know. Can I test it?

Scott Benner 1:26:12
I mean, if you've if you've been turning down the volume on your end, I don't hear any difference on my end. Really? Yeah. Well, crap, do you have like Apple headphones, just the white wire ones?

Denise 1:26:26
I do, but I can't find them. We moved and I seem to have like misplaced them.

Scott Benner 1:26:32
Is there? Are you using a Mac or PC?

Denise 1:26:37
A Mac? Is there a way to like test your settings and fix them? I'm like kind of computer illiterate unfortunately.

Scott Benner 1:26:44
Are you using the zoom app? Or are you using? Like just a portable app? Alright, so why don't we try this? Or you're on a laptop? Okay, so why don't we try it on my phone? Maybe? Well, I think it's the headset mic. Okay, there's my is my estimation. So if you click on Zoom, and then go to the top left corner where it says zoom.us of the screen all the way up to the top left.

Denise 1:27:14
My screen is like, minimize. Okay, here we go. Top left. What does it say? So it's not aimed at us.

Scott Benner 1:27:22
Okay, you see that? And when you click on that, you go to Preferences. It's the second choice down. Yep. And then audio. Okay, okay. So right now the microphone. What is it set at?

Denise 1:27:38
The input volume, is that what you want?

Scott Benner 1:27:40
There should be after you've clicked on audio on the left, on the right side of the screen, it should say speaker than test speaker and then next to test Speaker It tells you it's like a drop down box. It tells you what Speaker you're using. That should that's probably the headphones.

Denise 1:27:57
Okay, so yeah, it's like in the middle ish. A little further. Now you're

Scott Benner 1:28:02
answering the wrong there's no there's no numbers. Scott. Denise. No, I'm not asking for a number you need you're not listening to. So there's a drop down box next to the word the button that says test speaker next to it on the right is a drop down. What is this Denise's be solo. Great. Now when you move down to microphone, it says test mic and then what's that set toe? That also says the same thing. What are your other options when you click on it?

Denise 1:28:29
built in microphone try that. Is that better? There we go. Can you hear me?

Scott Benner 1:28:38
Yes, that's better. All right. So can you still hear me in your headphones? Can you hear me? Hello? Denise Denise, can you hear me?

Denise 1:28:53
Yeah, so I put on the built in microphone under microphone. Should I? I couldn't hear you at all when I did that. Should I do built in output on the speaker thing instead?

Scott Benner 1:29:05
No. I was hoping for you to use your headphones as the speaker and the microphone on the laptop as the microphone.

Denise 1:29:12
Okay, I couldn't hear you.

Scott Benner 1:29:15
When you did that. You couldn't hear me in the headphones anymore. Now. When you change the microphone, then you couldn't do you have any other headphones

Denise 1:29:26
my kids do.

Scott Benner 1:29:27
So that's what we need because the mic on their laptops. Great. Yeah. And so

Denise 1:29:33
let me see if my daughter can grab some real quick. Take your time. You know what, though? I think they have a wire. I don't know if she has wireless.

Scott Benner 1:29:42
Why? Why do you have these wires? Is that better? Or it's probably better

seriously, take your time.

Denise 1:29:54
Do you have headphones? Can you grab them real quick please? This is gonna be my best setup. So

Scott Benner 1:30:04
first of all, don't be sorry, because we're going to start over. Okay? But I'm putting all of this at the end of the episode so people can listen to it. I've been I've been thinking about doing this for a while now.

Denise 1:30:15
Sure. I would like to curse but I'll be nice

Scott Benner 1:30:20
because I'll bleep it out later.

Denise 1:30:22
Okay. All right. So I have these wired headphones

Scott Benner 1:30:28
now. Okay, so I think you have to turn off disconnect. Yeah, just literally power them off

Denise 1:30:43
Okay, how about now?

Scott Benner 1:30:45
Well, I'm always gonna be able to hear you because you're using the mic on the laptop. Can you hear me in the headphones?

Denise 1:30:51
I can just slow How about can you talk again?

Scott Benner 1:30:53
Hello, testing. Hello. Hello.

Denise 1:30:56
That's better. My voice better now or am I still Darth Vader?

Scott Benner 1:30:59
No, you're good because that you're not using those horrible Beats headphones. They're like frickin expensive. Our horrible. Bluetooth Bluetooth sucks. That's why

Denise 1:31:10
Oh, yeah. Well, that makes me want to like, write them a nasty gram.

Scott Benner 1:31:14
Well, now you're now you're all staticky. though. What are you doing?

Denise 1:31:18
Well, I was moving for a second. Hang on. Just get in position. All right. Can you hear me?

Scott Benner 1:31:25
I can. So if the laptop is on the desk in front of you, or something like that, I imagine.

Denise 1:31:30
It is actually sitting in my bed with a laptop on top of the pillow. Is that a bad situation? Should I put it on the dresser?

Scott Benner 1:31:40
I'm just wondering, I can't wait for people to hear all this. I'm just wondering if you couldn't bring the laptop microphone closer to your face?

Denise 1:31:50
Where is the microphone?

Scott Benner 1:31:52
It's on a laptop. Just bring the laptop close to the knees have you? Better about now, it's pretty good. Just keep your face in one orientation. You know? I mean, like, don't start looking into other corners of the room while you're talking and stuff like that. Okay, all right, because I will be frozen in place because the mic is in this in the central location. Okay, so now I have the last thing I have to figure out is the staticky thing. I'm not sure what that is. Which it didn't. It is.

Denise 1:32:22
Don't mean to relocate to a different parts of the house.

Scott Benner 1:32:26
I mean, are you moving around right now? No, no. Interesting. Unplug the headphones for a second

Can you hear me through the laptop?

Denise 1:32:42
Now,

Scott Benner 1:32:43
can you hear me through the laptop?

Denise 1:32:46
I can hear through my headphones. Plugged you and then I couldn't hear you at all.

Scott Benner 1:32:50
Okay, so I'm in your headphones now. There's something there's a lot of noise. I don't know what it is. You're not moving or scraping or moving blankets or something like that? Nope. Okay. And the Bluetooth or the bluetooth headphones definitely off. Yep. Okay. What was that? What were you just doing just now?

Denise 1:33:16
I was just moving. Okay. I'm not moving right now.

Scott Benner 1:33:21
A Sure. Yes. Like, like, just now like you're not moving at all. Like you're not rustling something?

Denise 1:33:29
Oh, I was laughing. So now. Theater.

Scott Benner 1:33:33
So wait, so the computer is moving when you're laughing? Well, it's

Denise 1:33:37
on my chest. Yeah, we

Scott Benner 1:33:39
don't want to be in that situation. That's

Denise 1:33:43
when we put it on the dresser. We'll see if that defies problem. I'm gonna be in like a padded room by the time we're done here. I'll put it on the floor. I don't

Scott Benner 1:33:55
want to give you pressure here. But this better be a good interview.

Denise 1:33:59
Right? Okay. How is this?

Scott Benner 1:34:04
I mean, you don't have to, like speak a sentence. How about the rain falls? No. How's this? That's better. Really? Yeah. Okay, well, now it's right. You're Are you farther from the laptop now than you used to be?

Denise 1:34:20
No, I'm like right up on top of it in the most uncomfortable position known to man

Scott Benner 1:34:24
back up a little bit because it's not loud. About now Hey, there, don't know now. 20 minutes later, if I took the last 27 recordings I've done and adds up all the difficulties someone's had getting set up. They don't they don't best to you right now.

Denise 1:34:51
Good. Makes me feel better. We're gonna get you.

Scott Benner 1:34:53
Yeah, we're gonna get you. I don't know. Some sort of a website where people can send you headphones. All right, so you hear me through your ears in like in your headphones or you through my

Denise 1:35:05
ears. Excellent. Okay, so my headphones, I am in position and ready to go. Nice let's Shall we freakin begin.

Scott Benner 1:35:19
We absolutely should go ahead and introduce yourself again.

Denise 1:35:22
Okay. All right.

Scott Benner 1:35:26
Hope you enjoy that if you're still here, you should check out the private Facebook group a fantastic place for community. Right now someone is saying something that you need to hear. Or they're asking you a question that you can answer Juicebox Podcast type one diabetes on Facebook private group, absolutely free 35,000 members. It's a really terrific. Alright, that's long enough. I'm gonna let you go. Have a great day. I'll talk to you soon.

#864 Type 2 Diabetes Pro Tip: Guilt and Shame

A series for people with pre and Type 2 diabetes.

+ Click for EPISODE TRANSCRIPT

00:06:12 Addressing guilt and shame.
00:09:00 Stigma around Type 2 diabetes.
00:16:14 Lifestyle and genetics contribute to type 2 diabetes.
00:17:53 Emotional response to diabetes diagnosis.
00:24:17 Education is crucial for managing type two diabetes.
00:29:24 Misdiagnosis and stigma in diabetes.
00:35:57 Education is vital for diabetes management.
00:40:10 Type one and type two diabetes are related.
00:45:37 Take action for someone else.
00:53:00 Take care of your health.
00:59:57 Empowerment through education and action.
01:00:55 Successful type two community is possible.

Scott Benner 0:00
Hello friends, and welcome to episode 864 of the Juicebox Podcast

Welcome back to the Type Two diabetes Pro Tip series from the Juicebox Podcast today is the next episode in that series, and Jenny Smith and I will be discussing shame and guilt, and how those things may be tricking you into not taking care of yourself. 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. This is the spot in other episodes where I remind type ones to go to the T one D exchange and take the survey but instead because this is a type two centric podcast, I want to say this to the type ones that are listening. You love the podcast, you subscribe. That's why you got this episode. I bet you also know people in your life with type two diabetes that need help. Please pass these episodes on to those people. And if you're new to the podcast, and you have prayer, type two diabetes. Welcome. I hope you'll love this. I really think it's going to help you.

This episode of The Juicebox Podcast is sponsored by the contour next gen blood glucose meter. Learn more at contour next one.com forward slash juicebox. That's right, the contour next gen. What do you think the Gen stands for next generation, whether you have type one, or type two diabetes, or pre diabetes, and you need to check your blood sugar, the contour next gen is for you. Contour next one.com forward slash juice box. I'll tell you a little bit more about that meter later on in the program. But if you're looking for accurate blood glucose meter results, contour next gen is the way to go. Hey, Jenny, how are you?

Jennifer Smith, CDE 2:16
I'm great. How are you? Scott?

Scott Benner 2:18
Jenny's not great. Her dog ran away and she's trying to be

Jennifer Smith, CDE 2:24
doing this while my husband is

Scott Benner 2:26
out looking for the dog. Sure the dogs gonna be fine.

Jennifer Smith, CDE 2:30
You got a caller? He's got a number on it. You know, it's all?

Scott Benner 2:33
Yes. Let's just say the people just missed a nice five minute conversation about the responsibility of dog ownership.

Jennifer Smith, CDE 2:40
If you're going to own a dog, be prepared to take care of it like you prepare to take care of a child

Scott Benner 2:45
exactly, essentially. Yes. So we hit record here because I'm in slightly unsteady water for what we're trying to do here. So I think everybody who listens to the podcast knows that it is overwhelmingly it's a type one diabetes podcast, right? It's I think it helps adults and caregivers pretty equally, but it's mainly about type one. And then over the last few years, I've been thinking about, as I mentioned, in the first episode of this series, I wanted to figure out how to help type twos. And then I started seeing type twos come into the Facebook group and listen to the podcast. And then they were making these kind of really amazing, like improvements in their life. So we we asked the listeners of the podcast, you know, what would you like to know about type two diabetes. And it's going to be a little strange talking about it, because my conversation is going to come from kind of some anecdotal stuff and kind of my reflections of what I've seen people talk about you, of course, Jenny are not just the CDE. But you have a degree in nutrition. Yes. So you're going to be a great help here and Jenny, in a former life, why don't you tell people what you used to do?

Jennifer Smith, CDE 4:00
Yeah, so within the realm of diabetes education, and while I was working as a dietitian within a hospital care system, I was also helping to teach the type to accredited classes within the hospital that I worked at. And I was working with a nurse educator who was head of the education, the diabetes education department, and we coordinated the classes together on the angle of, you know, all things diabetes, in terms of the medications and monitoring and the nutrition part and the activity part. I mean, all the things that go into managing, so that is what I did, and it actually helped me as well. A crew, enough hours to sit what was the CDE exam certified diabetes educator exam, which now we are CDC, e ss, right? Everybody's still calls us CDs. shots. All right?

Scott Benner 5:03
Well, I so here's what I've been thinking forever. And I mentioned a little bit in the first episode, but I'll just say it here again, if you see behind the scenes, the diabetes space, people, companies, organizations, institutions are always trying to figure out why type ones are such a close knit group of people online. Like there's a real type one diabetes community online, as Yeah, it's just the reasons why I mean, you can all guess for yourself, but it just exists. It's a helpful community, it's a vocal community, they're not afraid to share what's going on with themselves. And anyway, these organizations, these companies, they've all they all use kind of behind the scenes about I wish we could, you know, build a community for type twos. And we tried, and it didn't work. And we tried this, and it didn't work. And, and I've had conversations in meetings where I've given my opinion about why I think it didn't work and how it could and people didn't take my advice. So now I'm just going to do it myself. And I'm going to do it here with this. And I thought I thought the way to start off was by addressing guilt and shame. So there were a number of different categories that people brought up medications, doctors, you know, die diets, which we're not going to call diets, Jenny, we're going to call fueling plan fueling plans, I'm gonna have to leave that written in front of me for a couple of weeks, the way I speak. But, to me, if we're going to start this conversation, I think we have to start it with why if you have type two diabetes, is it difficult to step up and say, I have type two diabetes, I don't understand it. I don't know what I'm supposed to be doing. I think it's killing me. And I'm not really sure how to stop it. You know, like, that's the insecurity I see with a lot of people with type two, like this thing is happening to them. And they, they don't seem to know what to do about it.

Jennifer Smith, CDE 7:02
There's absolute negative, there's a negative piece to having type two diabetes. From an from an understanding perspective, but I think that, that it lacks information. And I think that that's where it comes from, in a lot of a lot of that negative attitude can be because the majority of people who don't have diabetes of any type, type two, specifically here, there, there's a lot of missing information. And so there are there are silly statements that are made that are completely not true. And you never know, when you're seeing something that might be just an off the, you know, off the cuff, kind of like, Haha, joke, whatever you don't know if somebody that you're sitting around, has type two diabetes, and then that's taken, it's taken in or you

Scott Benner 8:11
internalize, no, and then you realize I need to keep this quiet, or I'm going to take, I'm going to take this from other people, or I'm

Jennifer Smith, CDE 8:17
going to be the brunt of the jokes, or I'm going to be the brunt of, Hey, did you know this could help you? Or hey, did you know you know, I've got this friend who's talking to this person? And don't you know, that this could really help you or, you know, we'll talk about all the supplements and all the funny things that people get offered help from. And I think that brings a lot of it in it's like, I'd rather maybe be quiet about it. And just

Scott Benner 8:41
Well, I think we always end up in this situation where we sort of talk around it because, I mean, obviously you and I don't want to insult anybody. And we don't have oh, we don't have those feelings. But it's I think it's worth, like just vocalizing right now that other people do that. And that's hard to hear. And you don't want to hear that. And I understand not wanting to hear that.

Jennifer Smith, CDE 9:03
Right. And I think a lot of it too comes from the people who may be making con comments or may be thinking what they know about type two diabetes, but it's completely false. It's it's from this idea. People have that it is self induced. Yes,

Scott Benner 9:19
exactly. Right. I did that to myself. I did

Jennifer Smith, CDE 9:22
something I have it or God there, they must have totally just not paid attention. Or they must have done something that created this problem for them. Yeah, right. Look

Scott Benner 9:34
at you, your body is whatever. That's obviously because you don't take care of yourself. And so you deserve somehow this thing that's happened to you. And that's I think that's the that's the path that minds can follow when they say stupid things like that. And it lets them off the hook to they get to say well, I'm, I'm okay being horrible to this person because look, they did it to themselves. And and then whether that's true or not, and we're going to talk about why it's not. But whether it's true or not. That's how you feel it. If you're on if you're on the receiving end of that, that's how you felt it. And now someone picks up and says, Hey, I've started a diabetes group that might help you understand your diabetes better. Or why don't you talk to your friends who have it and see if nobody, nobody's gonna want to do that then. Right? Yeah.

Jennifer Smith, CDE 10:21
Right. Absolutely. And I think, as you said earlier, the the type one world has a lot of has a lot of connection, they've, it's a very big community. That's like getting a big hug whenever you reach out for something, right. And people are very willing and open to talk about it. But it's the minimal percent of people who have diabetes as a whole. The bigger community has type two diabetes,

Scott Benner 10:55
by leaps and bounds numbers wise, right? Absolutely.

Jennifer Smith, CDE 10:58
And even now, and I think it's unfortunate, but now even includes children and teens, with type two diabetes, not type one. And thinking of that, and how they will grow. If they don't get the right information and the right way to feel about how to navigate this, they will get that same image that maybe their parent with type two has, or maybe their grandmother with type two has, and a lot of the older information, unfortunately, is kind of clouding what those with type two in the past 10 or even 20 years, could be doing differently, if they just got around that mindset of I clearly must have done something wrong. Well,

Scott Benner 11:45
in regards to being open about it, I guess, type ones are sort of protected, right? Because, and here's how I've seen it like that. Again, this is anecdotal from watching people talk about it for so long. But because it's an autoimmune issue, and your pancreas, you know, was attacked by your own body and doesn't make insulin anymore, you get to say, I didn't do this to myself, I don't you don't make an autoimmune issue. So you can you can shed, you would think you could be able to shed some of that, the guilt and the shame that could come along with it. So I guess we should first talk about what are the ways that people get type two diabetes? Like if you if you have an autoimmune disease that gives you type one? Can you eat your way into type two diabetes? Or is that? Is that just a misnomer? Is that the quality of the food? Is it like what? What's the real honesty of it?

Jennifer Smith, CDE 12:51
That's a deep rabbit hole.

Scott Benner 12:53
I don't want Listen, I don't wanna get anybody in trouble, because I know. But I mean, let we can't start talking about it if we're going to lie to people in the first 10 minutes. So you know what you mean.

Jennifer Smith, CDE 13:03
Right. So to be quite honest, in terms of lifestyle, absolutely, lifestyle does play a part in terms of the potential for somebody to have type two diabetes, you're more likely to develop it if you are overweight, or what you know, is categorized as being obese, which is a certain BMI level above being just overweight. extra weight can cause what we know is called insulin resistance, or the inability for for the body to utilize the insulin that is being produced by the beta cells in your pancreas. And initially, somebody with some dysregulation of insulin production in the body. In terms of potential for having type two diabetes diagnose, some of that comes from the resistance factor. The location of where the weight on the body is distributed, can make a big difference. activity level can make a big difference. Can food make a big difference? Absolutely. It can. Is it? You said quality? Could the quality of food make a difference? Yes, if you're thinking on the on the edge of preservatives and more processed versus more real food, let's call it right. Sure. There is a big difference. I mean, that's it's kind of a question that's in the air, regardless of what condition you have heart disease and all of those kinds of things. Could it be worse or could I have brought it on because I'm eating more of this processed, less real food than real real food? Sure, but those are some of the big pieces from a metabolic standpoint that somebody is more likely to have type two diabetes is does it mean that every person who might be overweight is going to have type two? No, it does not. Family history or genetics, we know play, it plays a very big part as well, in terms of the potential. So if you have a strong family history of type two diabetes, then some lifestyle things that you put into action for yourself. may very well be preventative. Yeah,

Scott Benner 15:28
I would say this too. I don't think I mean, yes, if you're an adult, you're in charge of what you're eating, right. But there are, there are other factors at play, like financial implications about the foods you can afford to begin with, how you grew up, what somebody put in front of you, when you were a child, and told you this is good food, this is not or in. And by the way, no one may have said to you, this is good, or this is bad. They may have just, maybe it's just giving you food, you remember, like, oh, like when I was a kid, we used to eat this. And so you become an adult and you make that, you know, like, it's, it's not, it's not, I don't think it's a malevolent issue. Like, I don't think that somebody's parents three generations ago, were like, I'm going to eat unhealthy, you know, and it's gonna cause all kinds of medical issues, and I will teach my children to eat unhealthy and they'll teach their children like, it's not like that. It's just you do what you do. And but to not understand that that's what's happening. I think that's the crime, right? Like, if and to not know how to get out of it, if there are actually ways and it turns out, there are a number of ways that you can help yourself, then, you know, that's a crime too. So we're not going to pretend like I mean, listen, this is straight from the ADEA. Type Two diabetes is generally caused by a combination of lifestyle and genetic factors, lifestyle factors, including being overweight or obese, eating a high, eating a diet high in carbohydrates, sugars, and fats and physical inactivity. Um, that's a, you know, that's directly from their website. And it's dated just last year. So, but that's all but the point is, is that that's, that's all both. Now, you've got type two diabetes, like, who cares how we got here, right? See what we can do now. But that becomes an issue because guilt and shame are real things. They are real things and they burden people. So I want to read you a couple of a couple of things. And I'm not going to tell you who they're from, until, until we're done. But I asked a group of people, if you struggle with guilt, or shame, and he found a way past it, can you please share your experiences here. And I told him that their experiences might be used anonymously on the podcast. So you know, everybody's first person just says, I went to therapy. And other person said, I connected with other people who were in the same boat and hearing their stories helped me, giving myself grace, being patient, focusing on my family, prayer, therapy, connecting with others. This goes on and on. My neurologist put me on an antidepressant for migraines, but that ended up helping me with my anxiety. You know, like that stuff. I was embarrassed. And I felt guilty for adult. Now, here's where the, here's where the secret comes in Jenny, because I think I've read enough now that anybody with type two diabetes is listening and said, Okay, I have felt like that, you know, here at the beginning of the onset, it was the realization that I'm often part of strategies, I went through a bunch of grief, you know, I, I went through the stages of grief, I had to get educated the education empowered me, I felt a lot of guilt. I felt like I brought it on myself. These are just over and over again, there are dozens of responses here, right? So if you're a type two, and you're saying yourself these sound like things, I have thought for myself, these are all responses from people with type one diabetes, type one or type two, type one. Because in the end, it doesn't matter how you got here, it feels the same once you're there. You know, like, how did this happen to me? Bargaining people talked about bargaining with God, I'll do something different. Please take it away, you know, and this person of course, said they'd bargain that they would eat better if their pancreas would start working again. And these are real real responses from real people who live with type one diabetes, but yet their responses I imagine mimic how anyone else would feel type one or type two.

Jennifer Smith, CDE 19:30
I would agree especially within the like I said, I I taught classes for type two diabetes and many of the people that initially came into our classes, which was like a four part series.

Scott Benner 19:48
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Jennifer Smith, CDE 22:31
Many of them appeared to just come because it was something their doctor required them to do or really requested for them to do or felt like they had enough questions to their doctor that they needed to go somewhere to get them answered. And I would say that many people didn't appear to really want to be in that first class. Yeah, they. And that was just my perception. Right? What I could see. But once once we got rolling, and they could see that information, the tidbits that would make sense in their life. This bit of information, that bit of information. Well, gosh, what? How many questions or how many times I heard, why didn't nobody tell me this? I've had this for you know, our classes were people who had had type two for a number of years, or who were newly diagnosed as everybody all together. And eventually in class those with type two for a longer period would bring in to the people that they'd get connected with the people who are newly diagnosed, I've tried this or Oh yeah, I was on that medicine, and ever worked for me, you know, kind of thing. So there was a sense of bringing people together that they felt comfortable to talk with others who had type two. And then by the end of class, the questions and the things, and they they would leave class, feeling like whatever portion of education or information they got, from what we gave them. There was a way to put it into action. Yeah, there was something that made sense. As their this is why I this is why I can try this, or this is why I can go back to my doctor and say, Well, I learned all this stuff. And I've been trying this and this isn't working. So I might need a medicine change. Would you talk with me about the other options? So in terms of education point for type two, that's one piece. I would definitely say if nobody's ever told you, you can have education. You can Yeah. And you should ask about it. If nobody's ever told you to go and see somebody. The classes for type two, I think are enormously beneficial. And if you can find one within your area, like I said, getting to be in class with others who also have type two, it brings in a sense of community that many People who've lived with type two for a number of years already have not ever had.

Scott Benner 25:04
What would you say that people lack the most? Like, what do they lack? That they're there to learn about? Is it basic understandings of nutrition? And that because I find, I find there are times that people say to me, I didn't realize that this food had this impact on a body forget my body on a body, I just didn't know. And then somebody told them, they're like, Okay, well, then I won't do that anymore. You know, and it's the, it's the feeling. To me, I think that the the implication from others can be that, again, you're doing it to yourself, but I just think that we're just doing what occurs to us. It's not like we're making a bad decision on purpose all the time. I'm sure there's some people are, but that's not my, that's not my point that overall, I find that people don't run around doing things to hurt themselves on purpose. Correct, you know what I'm saying, and so you just need to understand enough to get you going. And then you get a little momentum and you see a little, maybe you feel a little better, or, you know, maybe you lose a couple of pounds, and you'll have a little more energy and you start having a little more focus. And you think, Okay, well, I made this small change. Maybe I'll add a walk, you know, go for a walk now. And you know, if you can't walk outside, walk around your house, like work on your apartment, like, I don't care, like do something, you know, and then incrementally, you'll see change. And that change should draw you in that other direction. And but again, it seems like the problem is, I should go to a class to learn, but I'm embarrassed. I feel ashamed. Listen, the guilt and shame of not noticing made me sick. My initial gut reaction when my PCP told me that I had diabetes, was of shame. But people use the word shame constantly over and over again. And this is a very, I'm not a therapist, okay. But I have, I have a therapist that comes on. And this is a big thing that she talks about all the time that people just can, the feeling of shame and guilt are not exactly the same, and I'm not qualified to talk about it. But I do know that it holds you down. And it stops you from doing things you want to do. Because you don't want to feel it anymore. And then that is not a tenable situation like it's not going to you're not I mean, you're not going to pretend your way through this, basically,

Jennifer Smith, CDE 27:35
no, you're not. And in fact, if you if you feel that way, forgetting will, will will make it worse. Whether nobody again, as you said sets out for that to happen. But it's almost a will, if I just put it to the side, and I just take the meds that the doctor told me to take, that should take care of like, it's almost a convincing of yourself that they do this bare minimum thing. Yeah. And, again, I go back in terms of education. At diagnosis, it shouldn't be this rip off scrip of, well, this is what you have. And there's no education about even what Type Two diabetes means, like, physiologically, what's happening in the body? Why do I all of a sudden have this or, quite honestly, type two diabetes has been a progressive state, where initially your body tries to handle the glucose levels that are not contained in the normal range without diabetes. And so you know, your body needs more insulin to essentially get the glucose levels down, and to help that glucose get into the cells, right. So at first in type two, your pancreas actually kicks in, it's like I have to make more I have to keep up I have to give, give, give, give, give and eventually over time, at that point, many several years later, that's when you actually find out a diagnosis of type two after your body has already not been handling things well enough

Scott Benner 29:24
to tell me the the other side of it so it's a combination of lifestyle and genetic factors. So you could be I mean, people say it all the time on the on the podcast, right? I was I was diagnosed with type one as an adult, but I was first misdiagnosed as a type two, because they looked at my body style and they just assumed I had type two diabetes, but that can happen in the reverse for people too. You can be you know, I always use the example of when I was growing up. My neighbor's husband was tall and lean and fit, but he died of a heart attack. act really young. And when he passed, everybody was like, that doesn't make sense to them. That doesn't make sense. He's not fat, right? Like, because back in the day, I mean guy was the 70s and the 80s. Like, that's what we understood. You know what I mean? Like, heavier people have heart attacks, you know? Yeah, trust me, we didn't know a whole lot. And my best toy was like a stretchy doll. World was not as advanced. But, but he's a good example. This man is a good example. He didn't fit the bill visually. And so nobody paid attention to his heart. And right, and people in diabetes get kind of yanked around like this all the time. Oh, you're heavier, you have type two, they won't even test you. Like I've heard people tell stories. Like, look, I'm in the doctor's office, I tell them, my mom has type one diabetes. My grandmother has type one diabetes, I have diabetes, test me Give me a C peptide test. I think I have type one. No, no, we're not doing that. You're overweight. It's type two. Like, That's just insane. And so when that kind of stuff also exists, and you're already embarrassed, or you feel ashamed or guilty? How are you supposed to stand up in that moment and tell the doctor, I need help? Like, you're not explaining this to me? I obviously don't know. And I think, look, I can't speak for every doctor, obviously. But it wouldn't have gotten this far. If there wasn't a preconceived notion, hey, you have diabetes now. And now we're gonna write you off, like you're a lost cause we move you over to the other side of the ledger. And I really think that happens to people. And it doesn't need to be like that. But the doctors probably bump into so much what they consider to be God, that word. I don't even want to say, I want to talk around it. Okay, I assume they mean, I assume they bump into patients that they think, have no interest in getting better. But the doctors are going to call them non compliant. They're gonna say, they're gonna say, I gave them a diet. And I told him an exercise routine. And six months later, he came back, and he hadn't lost weight. And there was no difference. So I take you and I slide you right off here. And then that happens enough times that Dr. And my assumption is that they just begin to believe that people aren't going to try to change, or to do the things that they, you know, whatever. But it's never that easy. It just isn't like I, for some people, like your body's built the way it's built, like you ever see a real muscular person and you're like, I would like to be like that. But my body doesn't. It's not built that way. You know what I mean? Like, everybody's not gonna, I'm not saying people shouldn't get more exercise and eat better. Everyone should be doing that. That's just, I think that's obvious to all of us. But correct. But just changing something if you don't really understand what to change. Like, I watched it with my mom. My mom got type two diabetes should not have been a surprise. Your father had it. His father had it. This is not her brother has it? Like you don't I mean, like, everybody's got it. And my mom says to me, I have to start eating more healthy. That's what she said. That's what the doctor told me be more healthy. My poor mom in her 70s trying to decide what that is. I said, well make a list of foods you think of as healthy we'll sit down look at them together. There was not one valuable food on that for Lauren, her blood sugar. Not one. I'm sure oh my god, it was I wasn't mad at her. Like I was like, I'm like mom, like, like, Honey, listen, like, here's what we're gonna do. You don't eat meat. And I got her into a slightly lower carb situation. set her up with some like, my mom just thought a vegetable was a vegetable. You know, like, so I said, Mom, these are the vegetables that are actually lower in carbs. Your vegetables

Jennifer Smith, CDE 33:44
were corn and peas. Because she comes from that she comes from that era. Yeah, it does. Yeah, great. Well,

Scott Benner 33:49
we'll throw a potato in. It'll be lovely. Man, we're not gonna have a potato for a while. Okay. And so it was just very interesting. That when given the task of why don't you write down things that you think would be less impactful on your blood sugar? She couldn't she couldn't for the life of her think of any of them?

Jennifer Smith, CDE 34:11
No, I'm sure she couldn't. And again, I bring in Oh, my dog is back. By the way not to interrupt. Oh, no,

Scott Benner 34:17
that's a good thing to say. Everybody's probably been worried.

Jennifer Smith, CDE 34:20
Yeah, sure. They're not. Yeah.

Scott Benner 34:23
You have no idea. I'm gonna get emails about your dog. I'm glad you said this.

Jennifer Smith, CDE 34:28
So anyway, there you go. Okay. All dogs back. But in general, you know, my dad also had type two diabetes. And were it not for the fact that I had had and lived with type one diabetes prior to his diagnosis, and I think he was diagnosed when I was in like the end of high school probably like my senior year in high school. And I had, you know, been living with type one for a number of years already. And so my mom had, she had learned because of me. Yeah. However, had she not my mom being the primary like cook in the house. And my mom having grown up on a dairy farm, she would have continued to cook the very typical, I call it the meat and potato type of fair. Yeah, right. That would have been what she did. And we also wouldn't have known the things that we knew from learning from my experience. So my dad had a very different start with type two diabetes than somebody else, but he was of the same age as kind of your mom, who, well, goodness, what's wrong with like corn and peas? Right. And, in general, they're better than sitting down to a bag of Cheetos. Absolutely, from a nutrition, like, nutrient standpoint, they are. But from a blood sugar management standpoint, they're different. And that's where, like I said, I keep going back to education. But quite honestly, from a type two perspective, I think, some of some of the stigma some of the feelings of Gosh, I've got this thing now. And I don't know where to turn, or even know who to talk to. And maybe my, you know, my grandma had it, my dad had it. So I was gonna get it anyway, I saw how they navigated it was never really talked about. So I guess I'm just gonna go about and maybe I'll eat a salad every day, because that that's better, right? I mean, that's better, the doctor said to try to eat better. And there's there's not enough information. And that kind of boils down to the fact that majority of people with type two, they're being navigated in management, by primary care. Yeah. And thank goodness for health care, thank goodness for physicians, for general practitioners for PCP, thank goodness for them. However, type two diabetes is definitely it's a metabolic, right, it's much more metabolic. You can hear all the things we're talking about that are lifestyle that many people, they don't really think about too much, until Oh, my goodness, I have type two diabetes, and primary cares, or they are not. They're not educated, for lack of a better word. In terms of teaching the things that are needed for type two management, they are not, they should be referring for people to learn more, you've got this major thing that's going to be there 24/7 For someone now, you have to give them more tools than telling them to just eat better, and to get exercise. That is that's like speaking Greek. You need it to somebody

Scott Benner 38:06
you need a chance to you know, it's interesting. You told your story. And I told my story. Your father and my mother both had the same thing. Yes, they had the benefit of someone else's experience. It's exactly what they had. My mom was helped by me because I have a daughter with type one diabetes. And this podcast and I was like, I know how to. I have seen every food go in my daughter's mouth. And I've watched it on her CGM. And I was like, Mom, I don't know anything about nutrition, but eat these things. These things don't hit his heart. And that's it. I know you want a piece of bread. We'll get your bread. We're gonna make sure it doesn't have high fructose corn syrup in it. We're gonna make sure it does this. We're gonna do like little things, right? Yeah. Your father had a woman cooking for him who had to cook. Right? Because that was a long time ago. Your dad probably made a meal in his life. And

Jennifer Smith, CDE 38:51
oh, no, he was actually he was he was a he was a good cook. It was just that my mom. You know, they grew up the way that they grew up. And it was just that my mom. She was the cook and she was a really good cook. But yeah, my dad could. He could in fact, we have a hot dish. I don't know that. No, anybody even knows what hot dishes. It's like a casserole. Okay. He had a hot dish that on the nights that my mom had my mom was a teacher. And so on the nights that she had, like teacher, you know, teacher, he would make the dinners and that kind of stuff he had we still call it dad's hot dish. Now I make it with like, better thing. But it was essentially ground meat. And then they always did these canned jars of like was peppers and onions and tomatoes from the garden and my mom did all the canning and it was like a hot dish seasoned kind of thing that you'd put over elbow noodles and ground meat or ground beef. And it was mixed together. So

Scott Benner 39:51
why my dish is different because when I would get in a corner I would just take ground meat and then melt cheese over and I would put on a plate and my son was like What does it sound like? It's cheeseburger surprise. So what's the surprise? I'm like, It's not on a roll. I'm stuck. I guess all dads do something silly like that. But they do. But the point of it is, is that whether you're a person who has type two diabetes, who I've witnessed in the Facebook group, or come on the podcast and been nice enough to tell their stories, they all have the benefit of listening to someone else. And I know we want to stand around and like, some people want to argue that type one diabetes and type two diabetes like I don't want there, they don't have anything to do with each other. Okay? They're different diseases. And that's 100%. True. I'm not arguing that point. But both of them are about blood sugar management in Yes. And that's what they're about and the and the things that you can learn from watching a type one manage their blood sugar's whether it's about how you're fueling plan, or it's about using medication, or insulin, or exercise, or all of the other things that impact blood sugars, those same things are going to impact blood sugars, for type twos. So as I'm sitting around, trying to figure out how do I talk, type twos into creating their own community, what I realized was, they don't need their own community, this one's already here. It helps your dad, it helped my mom, it helped those people, it can help them as well. And they can deal with the guilt and the shame and the embarrassment in their own time and still listen to this. Because if you have to go to a therapist, and spend three years getting over the shame, just so you can walk out and go to a class. Well, that's too much. That's too long, it's too long to wait. So here's this thing, you can listen to it completely anonymously. And, and I at first I thought, Well, how am I ever going to get it into these people's hands? But there it is, right? People with type one diabetes, they all know people who have type two diabetes. And they already believe in the podcast, and they'll have no trouble sharing the series with them. And I thought this is this is it. Like, this is going to work?

Jennifer Smith, CDE 42:03
And I, you I think you bring in some things sort of behind the scenes here that, like jogged my brain, it's people with type one diabetes are very vocal. They are they they are very big advocates for themselves, or the person that they're caring for with type one. If somebody says something to them about, oh, hey, did you try this? Or, you know, if you did this more with your kid, you probably, they step in? And they're like, No, you are wrong, but they educate the person, they don't just blather a bunch of offensive words to the person because they're angry, they educate the person and they say, This is why you're wrong. This is what we do. This is how we do it. And maybe in broad sense, or maybe in a couple of sentences. And I think, in that respect, one, somebody with type two has enough information that they can spit back. That doesn't work, I will tell you why. But at this point, a good majority of the population with type two, unless they've done their own research, and, you know, people have they don't feel set with something to come back with.

Scott Benner 43:21
Yeah, how are they going to argue something when they think maybe they did it to themselves too, right? And type ones that this was my point earlier, at least what type ones have is they can they can stand up and go, I didn't do this to myself, right? I'm gonna argue, and they won't get hit with Well, you did it because they can go No, I didn't. And but a person with type two might actually, by the way, a lot of people think this, you could be a person who thinks this too, and then get type two diabetes. And now you, you believe you did it to yourself, because that's what you thought five minutes before it happened to you. Right. And this is just a, this is a unique opportunity to take something that already exists. Just adjust that a little tiny bit and make it work for a whole new group of people. And you don't have to get over I want you to get over the shame and the guilt because you don't deserve it. And it's it's misplaced, if you feel that way about type two diabetes, but in the but I think maybe the process of understanding how to help yourself might actually help you also get rid of some of those things. Like I don't think you all have to go to a therapist to get past that. Do you know what I mean? Right?

Jennifer Smith, CDE 44:26
And eventually may also help again, if it because of the large or the heavy genetic component to type two, you will impact somebody in your family's future. Yeah,

Scott Benner 44:40
I was gonna say, yeah, you will help

Jennifer Smith, CDE 44:42
if you're, you know, brother has type two now as well. Well, what you've learned, you can get them going in the right way. Right.

Scott Benner 44:53
So no, no, I mean, I the way I was thinking about it was much more ham fisted. But, I mean, if you've gotten your is off to a point where you think I'm never going to be able to get this back again, like, alright, I respect that maybe that would be difficult to do. Also, trying doesn't hurt anything, but at least you could put the people in your family on a better path. Like I mean, everybody talks about breaking circles all the time, there's an easy circle to break, you know, you feed your kid, the way you got fed, they're going to eat that way when they get older. And that's just

Jennifer Smith, CDE 45:25
and they may not, maybe that's enough lifestyle change from a genetic standpoint, that you've impacted enough that they won't have type two diabetes. Exactly

Scott Benner 45:35
right. And so, so this is gonna sound strange, if you don't have a podcast listener, this is your second episode, because somebody shared this with you. But what I've noticed, overwhelmingly after, after she's interviewing, like 1000 people is that it is a very common human trait, to not be able to do something for yourself, but to be able to do it for somebody else is a lot easier. So if it's not for you, if you have feelings of like inadequacy, or you feel beaten already, to do it for someone else, like do it for a kid or a loved one, or somebody who will benefit, you know, and you'll, and listen, you're gonna get the benefit, too. And you'll see six months from now a year from now, that, you know, wow, this is helping me as well, like, there's no secret here. Like, just, you know, there really isn't you, right is hiding

Jennifer Smith, CDE 46:21
something from you, you're just not getting the right information to start with.

Scott Benner 46:26
And my bigger point is that it doesn't matter how we all got here, I hope I'm being clear about that. It doesn't matter if I have an autoimmune disease, and my pancreas stops making insulin, and I'm a type one diabetic. It doesn't matter if I ate myself into this, and I have type two diabetes, it doesn't matter if my genetic predisposition put me into this type two diabetes, none of it matters. We're all here now. Time to do something, right. And so that I think ends up being it's why I wanted to talk about this as we were going into it, the impediment in those other people's minds about starting community for type twos and how to help people have type two diabetes, it's because they always get stuck on this piece, the like, well, how are we going to get them out of that mindset. And what I'm saying is, you don't have to get out of that mindset. Just we'll work on that over time, right now, let's do some simple things. And by the way, if one of those things ends up being insulin, not a failure, if it's an injectable, not a failure, we're going to Jenny and I are gonna go over all those different medications in another episode, if you need help getting out of your situation. There's just no shame in that whatsoever, you know, right? Like, you need to do what you need to do. I mean, for type twos we talked about with type ones, a lot of type ones will um, they'll feel badly if they're using quote unquote, too much insulin, they think the amount they're using is too much. Right? We have episode after episode, you need the amount of insulin when you're a type one that you need. And, and when you're a type two, if you've gotten to a point where your body just can't, it can't shoulder it anymore, then help it don't just go down with the ship and say, I got the sugars. I guess I'm done. You don't? I mean, like you're not, there's so many good things you can do.

Jennifer Smith, CDE 48:07
Right? Your ship still has lifeboats, yes, utilize one,

Scott Benner 48:11
there's things to do, and we're gonna, we're gonna and you'll be surprised how quickly you can get to them as well on how once you change those insulin issues, or metabolic issues, that things like weight loss can come along, like, it's very interesting. And a lot of these medications that will help you with your type two will actually help you with weight loss to begin with. So, my gosh, and to Jenny's point earlier, your doctor probably doesn't know. So. So we got to figure out what to do for ourselves. So that's going to be an interesting portion of this journey is that type ones are at their core, very independent in their care. And they're very accustomed, because the the one thing I wanted to mention that I haven't mentioned so far is that I think the benefit that you have, this is gonna sound strange. When you get type one diabetes, this is gonna sound really strange. So give me a second to get through it. I think the benefit that you have is that if you don't do something right away, it'll kill you. It forces you to do something, it forces you to learn about it, it forces you to it forces you to get in the game. When you get type two, the feeling is Ah, well. I got time. Yeah, you know,

Jennifer Smith, CDE 49:26
time. That's, that's a good word use because I think from a physiology standpoint, there is not there's a big difference in terms of one versus two. Right? And time is a big reason that, as we already know, with type one regardless of how you're managing, you don't get a complication on on day eight on day two of diagnosis. Right. And these are things that until there's enough issue long term. Finally, there might be some symptoms of something, right. But for both type one and type two, then diabetes, it is not a visible condition to live with. In either regard type one, you're right, if you don't do something about this right now, meaning take your insulin, you will have a very quick impact of that, a very quick visual impact. Whereas with type two, if you forget to take your oral medication of whatever kind it is, or even maybe your insulin, one, maybe you don't have enough test strips to monitor. Or maybe you don't know what the numbers mean, or where you were before. So who knows what difference this made. Maybe you don't have a CGM. So again, you're completely blind. And until you're really paying attention to how your body feels when you are in those target ranges where you should be. You may be able to, as you said, get away with

Scott Benner 51:01
Yeah, well, it's the strength in the immediacy of the implications. If they're not too strong and not too quick, then you can procrastinate because yes, because in your mind, you're like, Yeah, well, I've been okay, this long. Like, so what if I let me just get through one more Christmas season? Right? Yes. Oh, but to have cornbread stuffing one more time, LA, like, you know, like, who knows what the thought in your head is. But I'm saying that people the way people's minds work, it's like, oh, I have time I can I can do something about it. It doesn't mean they start necessarily doing something about it, it means they have time to do something about it. Like I think, oddly type two diabetes and the way I see people, even in my own life, decide or not decide to, I think the same attitude that put them in that situation is the same attitude that got my powder room needing a paint job three days, three years ago, because I was like, ah, nobody sees it that much. And I can get to it eventually, like the problem is, is then once it's too late, it's really, it's really good. And it becomes a real issue like act now, like do it when it's only a little touch up, I should have done that when I just needed a couple of touch ups in one hole filled in, I could have got it all done in a couple of hours. And now I'm looking at ripping out a vanity and doing the whole thing again. You know, anyway, I don't know if that makes sense or not.

Jennifer Smith, CDE 52:21
No, it doesn't. It also brings into as I said earlier, with type two, it's almost an accumulation over time. Right. And for some people who haven't, maybe you haven't really kept up with health care, because other than the average yearly cold that you have, or whatever it may be, you've been feeling fine. And so you skip your yearly visit with your doctor and you never get lab work done. So there are many things that can sneak up then if you haven't been at least going in yearly for a checkup. Those are mean they're important. Even I go in yearly to my primary care. I just write it's part of my checklist of things to get done. Not that my primary care for me, but I'm glad that she is there if and when needed. And if I've got questions to bring up in that visit, so you know, a checkpoint is just start going to your doctor yearly, at least. And if there are things that you're kind of, hey, I've got a history of type two diabetes in my family. If the doctor doesn't recommend checking, you know, an average glucose or even Hey, asked for an E one C, right? I get it checked if it's this range to this range. Well, goodness, Doctor, could you send me in for you know, some additional questions, I'd like to ask somebody about this. I think as adults, we get away from taking care of ourselves. Because there are so many things get loaded on as an adult. That until, until you're hobbling into the doctor. Clearly your leg hurts so bad. You're like, oh, well, it started hurting about six months ago. But now I can't walk on it. Well, oh, you know, it's too

Scott Benner 54:06
late now. Now it's broken. We got to do a whole thing. I we just we live in a different time. Like when do you know if you listen, I wasn't alive in the 50s. But my expectation is that if I got a Coca Cola in the 50s, it was a special thing that happened for me every once in a while. Yes. And now if I go to the grocery store, and I'm willing to buy 10 bottles, I can get them for $10 because they're $1 a bottle if I buy 10 bottles, and so I listen, I'm I want to say I'm not a judgmental person on this on this front. I'm not because I do believe and I do think the way I said earlier I think people just end up being carbon copies of what happened before them right? Sure. But I will walk down that aisle to get a sparkling water for myself. And I look in people's carts and I'm like you are leaving here with more soda than I will drink in the next 10 years of my life and you're going to be back here next week to buy more of it. Like that's not a thing your body's supposed to process. Right? Oh, I mean, I eat a burrito once in a while, but you shouldn't. And there's just there's there's food process. I know people hear this and they must be bored by it. Process food is difficult for your body to process. So. And it's not food, no. And it's everything everybody eats. Like, there's

Jennifer Smith, CDE 55:28
just it is, it's something with calories. It is not food, right?

Scott Benner 55:33
You'd be surprised how much better you feel when you get away from that stuff. And again, it's a financial thing. I understand. But, I mean, and now we're all like, I mean, we're gonna end up talking about as we go on, like, maybe people are thinking right now like, I can't break this cycle. I'm, I'm addicted to that food. Like, I absolutely know people who are addicted to food. Yeah, so it's, I understand all of that. But we'll talk about some things like maybe we'll talk about, you know, trying a intermittent fasting to help break some cycles, the foods that you're stuck to, or things like that feature,

Jennifer Smith, CDE 56:06
or budget. And you know, budget eating, honestly, is another thing to bring in. Because, unfortunately, type two diabetes doesn't care what you bring in monetarily. It doesn't. And it can be a major strain on many people, especially adults with families to take care of. And often as you know, as a parent, you're very willing to take care of outside of your own cell. Yeah,

Scott Benner 56:32
that's hard to write yourself. Yeah. No, I know, as soon as my it wasn't, as soon as my kids, my son went, got his own job. And my daughter went back to college. And the first thing I did was make a doctor's appointment. I was like, oh, and I wonder when the last time I did this was, you know, so I know how I know what how I know what happens. And I know how you feel. And I know that it can feel like between the guilt and the shame and the uncertainty about how to deal with things, and not really understanding nutrition, as well, as we all think we do. All that stuff together can feel like it's too much, but it's not. And I'll end with this. And then you can say whatever you want. At the end, I have now interviewed three people with type two diabetes, who have significantly changed their life through listening to this podcast. And they're really good. I left I've listened to them. Yeah. And we're going to put them back into like, circulation with these episodes too. Awesome. But But it's so doable. And these people like, I wait, I want to be clear. They're not like superheroes. Like, they're not a person you'd look at and go, Oh, well, yeah, of course, they can do it. Look at them. These are these are people just like you and me. You know, and, and they did it. They figured out what was going on. They made some adjustments, some of them added medication. And they came out the other side better off. And I think that's possible for everybody. So anyway,

Jennifer Smith, CDE 57:52
I agree. No, that's excellent.

Scott Benner 57:54
Thank you. I thought you were gonna say something thoughtful at the end, but just goodbye.

Jennifer Smith, CDE 58:01
I just Well, actually, what I was gonna say is that I think this was a really good place to start. Because I think it's a big piece specific to type two, despite the comments that you had from the type ones and how they felt and kind of that background. You know, that background piece of, I don't know, feeling bad about like, Why did I do something wrong that I have this? I think it's really important to address some of the reason that type two hasn't been well navigated in terms of helping people know how to do better for themselves, there

Scott Benner 58:44
is some disconnect between between the machine and the people. And the people don't believe in the machine, the machine doesn't believe in the people. And that's how it looks. To me, it looks like nobody thinks anybody can be helpful. And I think maybe, maybe they can't be helpful, but I do think there's help that's available, that would be beneficial and create a big change in your life. I'm just tired of watching. I'm tired of watching people say like, oh, I we really do care about this population. And I'm like, well, we should make some content for them. My we don't have a budget for that. Okay, thanks. Great. So you know, so it's just it's everybody, it nobody wants to they want, they want them to be there. If you're listening type twos, they want you to be there right because they want to market to you and they want to tell you what you need and everything. They don't know how to get you all together. And turns out I don't want to get you all together. I want you to go live your life and be happy. I'm not looking to make a pile of people with type two diabetes who we can sell something to write, write, write. I'm not that's not my thing. Like so I want to make content that helps them and I want them is I have the same feeling about type juices I have about type ones. I love People listen to the podcast. And I think that's amazing. But I want them to get to a point where they don't need it anymore. And they can go on and just live their life. This should be a pitstop in your life, not the story of your life.

Jennifer Smith, CDE 1:00:11
Right? You know, and it should be a place to that you get enough information in digestible. Yeah. In a digestible way that you can take action from just listening for 20 minutes about something that was very specific, like you know, your Med, here it is, I'm gonna listen to this one, because this is what I'm on. And you're like, well, darn, it's supposed to be doing this. And it totally isn't. Maybe I could just go back to my doctor and talk about this, right? You know, it's those pieces that are really important, because they're empowering, right? They're, they're a way to say, Gosh, I get this now. And I want this to work. But it's not. So I have to try something different.

Scott Benner 1:00:53
My hope is that when this is over, people will understand how food impacts them, how medications can impact them, how exercise will help them, and then they can go do these things on their own. Like it's just it to me, it's it's not as difficult as people have made it out to be. But I do, I do believe that the reason that somebody hasn't successfully put together a large type to community is because of, of the stuff that we talked about here. And that's why I just wanted to dispense with it and just get it out of the way right away. Like, let this go. Let's get to the part where we we do something positive. So Right. That's great. All right. Excellent. Awesome. Thank you very much, Scott. Yep.

Jennifer Smith, CDE 1:01:30
Thank you. Okay, bye, bye.

Scott Benner 1:01:36
I hope you're enjoying this. So far. The next three episodes are going to be about your medical team, your fueling plan, and technology that might help you with type two, or pre diabetes. Keep coming back. This series is going to be terrific. Thank you so much to Jenny, and of course to you for listening. And to all the people who shared this with you. I also want to thank the contour next gen blood glucose meter and remind you that if you're testing your blood sugar, you want to get a good, accurate number. And you can do that with the contour next gen contour next.com forward slash juicebox. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

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