#902 Jessie Inchauspé is a Glucose Goddess

Jessie Inchauspé shares her glucose hacks.

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

Scott Benner 0:00
Hello friends and welcome to episode 902 of the Juicebox Podcast

I just got back from a weekend long speaking event and we do not want to waste this deepness in my voice from the soreness I'm having in my throat. Let's use it right here, shall we? On today's episode of The Juicebox Podcast. Today I'll be speaking with Jessie she goes by glucose goddess on Instagram and other places. Jessie is the author of the book glucose revolution and her brand new book which comes out today may 2, glucose goddess method a four week guide to cutting cravings getting your energy back and feeling amazing. While you're listening today. Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your healthcare plan or becoming bold with insulin. If you have type one diabetes, or are the caregiver of type one and are a US resident, please take a few moments to go to T one D exchange.org. Forward slash juicebox and complete their survey. When you complete that survey. You were supporting type one research. You're helping yourself and you're supporting the Juicebox Podcast T one D exchange.org. Forward slash juicebox I wish you could all hear how deep my voice sounds in these headphones. Juicebox Podcast T one D exchange the glucose goddess echoing in my ears. This episode of The Juicebox Podcast is sponsored by ag one from athletic greens. You can have ag one just like I do every morning. A little bit of water. A delicious scoop of ag one and you're on your way. Athletic greens.com forward slash juice box get a free year supply of vitamin D and five free travel packs at my link when you make your first order. today's podcast is also sponsored by the Omni pod five tubeless algorithm based pumping with the Omni pod five. It's insane. Listen how deep I go get it Omni pod five I commend you Omni pod.com forward slash juice box don't want an algorithm get the Omni pod dash same link Omni pod.com forward slash juice box My daughter has been wearing an omni pod every day. Since she was four years old, she will be 19 this summer tubeless insulin pumping with Omni pod cannot be beat Omni pod.com forward slash juice box links in the show notes links at juicebox podcast.com, to Athletic Greens on the pod and all the sponsors will use my legs. You're supporting the show.

Jessie Inchauspé 2:46
Hi, Scott. My name is Jessie interest B. I'm a biochemist by trade. And I became somewhat of a scientific vulgar riser in the world of glucose science. So now I spend my days teaching as many people as possible about glucose, how it affects our body or mind. And then easy tips that are all science backed so that everybody can learn to manage it better.

Scott Benner 3:13
Okay. What did you go to? I know what you just said you did. But what did you go to school for? Like, how did you get to this?

Jessie Inchauspé 3:21
So I started by studying mathematics after high school because I had no idea what I wanted to do with my life. Like I had no passions and nothing. So my stepdad told me, give me a really good piece of advice. He said, If you don't know what to do, do the hardest thing you can. So I thought the hardest thing is math. So I went to study math in undergrad. And I hated it. But it was it was actually a really good move. Because then a few years later, when I discovered I wanted to, you know, be in this space of in the field of health, I could then go and do it. You know, if I had studied history and then been like, Oh my God, I want to be a biochemist, that transition would have been much harder.

Scott Benner 3:57
Well, I you know, my son just graduated from his undergrad about a year ago. Oh, thank you. And it was the same thing as he left for school. We're like, what do you want to do? And he said, play baseball. And we're like, is there anything else? Because you know, and he's just very math minded. So he got a quantitative econ degree, which I don't think he enjoyed any moment of and but it came most naturally to him. I think so. I take your point. And so you were with this mathematics background you were able to work go to grad school.

Jessie Inchauspé 4:29
Yes. So in my in my second year of math, I have an accident. I break my back jumping off a waterfall. So that just completely changed my life. I started suffering like crazy physically, but mostly mentally and like my mental health went really really dark. And I was 19 and at that point I just realized okay, like I need to understand how my body and my mind work. I need to understand this machine otherwise like you Living is getting really difficult. So I thought to myself, Hey, I'm gonna go studying the body, I'm gonna go study how this machine works this machine that had become sort of a black box to me. So that's when I decided I'm gonna go to grad school. And I'm going to study biochemistry. So I moved to the US, I was in London at the time, and go to Georgetown to do grad school for biochemistry. And then I wanted to go even deeper into health and what was at the forefront at the time. So I moved to San Francisco. And I work in the field of genetics for five years understanding our DNA, etc. But you know, I mean, that was very interesting. But I was a little bit disappointed because I thought that DNA was going to be much more helpful. To me, I thought that if I understood my DNA, I was going to be able to figure out precisely what I need to do every day to feel good, and to get my mental health back. But that wasn't the case. But while I was there, that's when I discovered glucose. And that's when things really started changing for me.

Scott Benner 5:59
So what's the first thing that you notice back then that makes you think this is worth focusing on?

Jessie Inchauspé 6:06
So, you know, in Silicon Valley, people are always testing technologies, just trying to test everything out there. And so a pilot study was put in place at the company I was working at, and this pilot study was offering five employees to wear a CGM animatronic CGM, as people without diabetes, to sort of like test the technology and see the applications that were happening, you know, in athletes in personalized nutrition, etc. So I raised my hand, I don't know why I just felt very drawn to it. And I raised my hand and starts a big, big deep dive into this data this world. And I start realizing, Scott that the days I have the most spikes, and the most, you know, variable, glucose, the worst my mental health is, and I see a very clear pattern, you know, me as a person without diabetes, who never thought for one second, that I would, you know, that this was appropriate for me or useful, I started really learning a lot about my body and myself, and it truly helped me start the healing process. And because I'm a scientist, you know, I dove into all the scientific papers I could find on the topic. And I found that I wasn't alone, that even in people who don't have diabetes, you know, you can still be experiencing spikes that can still have consequences and need to symptoms, and impact your physical and mental health. So then I went super deep dive. And now it's all I talked about all day,

Scott Benner 7:33
we talk about mental health impacts from a blood sugar spike, for example, you mean just from like, what is the range from moodiness to short temper to like is that what you expect to see with a higher blood sugar?

Jessie Inchauspé 7:46
Yeah, so the more spikes and drops you have, the lower your tyrosine levels in your brain are going to be and tyrosine is something that regulates your mood. And so you might see more moodiness, more anger, some studies are showing that the more variable your glucose is, the more you're going to snap towards, you know, people in your family, your partner, the more you're going to want to punish people around you. And then, you know, I mean, the more spikes you have, even without diabetes, the more you're going to experience symptoms of anxiety and depression, if you're prone to that. And this is all from the scientific studies, right? I'm not inventing anything, this is what I saw in the papers. And then long term, brain fog is a very common symptom of a lot of glucose spikes. Because your neurons, you know, the more spikes there are, the more inflammation there is, and then you feel it as brain fog. And then super long term, we're now starting to see a lot of connections between glucose and dementia. So I was like, Whoa, the brain is really connected to what I'm eating through this variable of glucose. And it was like, it was a real revelation for me, you know, because for 10 years, I had been in a state where I didn't understand at all, how to make my mental health better. I was like, completely clueless about why I was having these episodes of feeling like I left my body and feeling super anxious. And now I started to find a clue. And that really fascinated me.

Scott Benner 9:09
Well, it's interesting to hear somebody who doesn't who has a functioning pancreas right to say that fluctuations help because I mean, what's the fluctuation when you for you? I mean, what would a high blood sugar have been like 151 60

Jessie Inchauspé 9:23
the highest I've ever been was like, 190. But after eating, like a whole box of cookies, right, like that was that was the highest I ever got. But I heard from a lot of people who have diabetes, that they were quite surprised that somebody with a functioning pancreas could even get that high. Right, like so. We're discovering that. Glucose is you know, very variable. And depending on your body, depending on what's going on, you can see readings that are technically, you know, that we used to think that people with a diabetes could not touch so yeah, 190 I got

Scott Benner 9:56
to I wear a CGM, like two years ago. and this one night, I just went online, I said to people like, alright, like, I actually I made my chart available live to people Oh, nice. And I was like, Alright, tell me what the, you know, and I ordered a pizza. And a slice of pizza didn't really touch me two slices crept up at three slices, I got into the 150s 160s. And then I started throwing, like, sugared candy on top of it. And it held on for hours before it would go away. But then I was interested with some things like breakfast cereal, which is I mean, I don't even think it's really food, right. But if you have type one diabetes, or type two, and you're using insulin, and you have a meter, you see how hard it hits you, right. And I was surprised that I couldn't eat enough breakfast cereal to get my blood sugar to go up, really, but I still felt the same way I felt when I ate the pizza. Like sort of just like, you know, like, like, Why did I do that, like, you know, that feeling of like, that could

Jessie Inchauspé 10:54
be the dopamine crash, right? It could be like, the sugar releases dopamine in your brain. And then you know, an hour later, you start getting withdrawals, basically from the dopamine, and that can make you feel really, really bad.

Scott Benner 11:05
Okay, so you. So first of all, you mentioned tyrosine, which I don't understand it's an amino acid.

Jessie Inchauspé 11:12
Yeah, it's also it's, it's used in the brain, essentially, to regulate mood. And this is one of the theories that scientists have to connect variable glucose levels and mood, they think, oh, maybe it's because the more variable your blood sugar is, the more tyrosine is being impacted. And they think that maybe that's then why it affects your mood.

Scott Benner 11:31
Okay. And then you mentioned dementia, later on, is that sort of why they call Alzheimer's, diabetes type? Or do they call it diabetes? Type three,

Jessie Inchauspé 11:40
right? It is. So for a long time, we thought Alzheimer's is, you know, based on this plaque, this plaque thing, and now we're starting to see actually, it might be the case that Alzheimer's is actually just the cells in your brain experiencing insulin resistance. So experiencing type two diabetes, but in the brain, right, of like your cells not being able to get energy into them anymore. And of increased inflammation. And glycation that happens, the more glucose spikes you have. So now, it's seems that Alzheimer's is actually very linked to glucose into your food into your lifestyle, right? I think actually, last week, I can't remember, I think the first person somebody got diagnosed with Alzheimer's disease, and they were 19 years old. And this was like, you know, the first ever 19 year old with Alzheimer's a bit like back in the day when we thought type two diabetes was adult onset diabetes, and now we can see it even in children. So the more our food landscape is evolving, and the less we really know how to eat, to keep our body thriving, the more of these symptoms and conditions are becoming prevalent. And what I try to do Scott is really just teach people about like, Okay, how, what happens when you eat? How do different types of food impact your glucose levels, and then easy things you can do to really manage that and avoid harming your health too much long term?

Scott Benner 13:06
What is the what is the action that happens? So like, you know, this is a, I wouldn't call this common sense, but I think everyone knows they took a bunch of food, and I don't feel good afterwards. You do it again. Right? So is there a is there a function internally that makes us because we all talk about like, oh, eat sugar, you want more sugary carbs, you want more carbs? What does that? How does that actually work?

Jessie Inchauspé 13:29
So there's this molecule in your brain called dopamine, and it's called also the pleasure molecule. And it's the same molecule you, you get dopamine in your brain, your brain releases dopamine when you eat something sweet. And that molecule of pleasure. Dopamine also gets released when you have sex when you play like the casino when you do illegal drugs, like that substance is highly addictive to the brain. And that's why sugar is addicted. And that's why when you don't feel good, maybe you're having, you know, a difficult day, a difficult week, like if you're tired, you feel like Oh, I'm gonna have something sweet because that's going to make me feel better. What you're after is that dopamine feeling, but a lot of people got confused that feeling with energy. They think, oh, you know, this, this, this cookie is giving me energy because you kind of feel a bit perked up. You're like, whoa, your brain gets, you feel like your brain is waking up. That's just pleasure. That's just dopamine. That's not actually energy. And when we eat something sweet, we're actually hurting our cells ability to make energy effectively. And so there's this big you know, myth around sugar in the morning for breakfast is going to give you energy for the day. That's just not the case. It gives you pleasure for a little bit, but actually hurts your body's ability to make energy on the inside. So over the years, you're having cereal for breakfast with orange juice, yet you feel more and more tired. You know, playing with your kids is exhausting. Carrying the groceries up the stairs is exhausting, but you keep Eating this sugar. And it's because on the inside all that sugar and all those glucose spikes are harming your mitochondria. The mitochondria are the powerhouses of your cells responsible for turning glucose into energy. The when we when we eat too much sugar, and we give too much glucose to these little mitochondria, they kind of break down. So over time eating a lot of sugar equals chronic fatigue, which is counterintuitive.

Scott Benner 15:24
You're also oddly describing every addiction to right yeah, like you've you, you have a feeling that's a baseline, you're going for something that feels bigger, and then suddenly, your body can't sustain that. So your artificial input has to get bigger and bigger and bigger to get a lesser and lesser return. And eventually, your body just kind of gives up.

Jessie Inchauspé 15:45
Yeah, you become accustomed to it. Right? You become resistance like coffee, right? Like when I first started drinking coffee, I would have a half an espresso. And that'd be wired for 12 hours. And now I you know, I need a couple of cups of coffee to really feel an effect because my body has gotten used to it. And so your body is very good at getting used to things but then that can have negative side effects,

Scott Benner 16:06
right? I've never had coffee ever in your life. Everybody who listens knows but I've never had coffee. I my parents drank it so much when I was growing up like the smell of it's disgusting to me. And I also commingle it in my head with cigarettes because my dad smoked.

Jessie Inchauspé 16:20
But now it's a thing like you can never ever drink coffee in your life, it

Scott Benner 16:24
would never occur to me to try it. Wow, it's very, it is very strange. There's a couple of things I've never done that throw me off. And you like chocolate. I will use I hope everybody heard me say us. I buy a certain brand of chocolate chips. And I buy some milk chocolate and some dark chocolate. I mixed them together in a container. And when I need something sweet, I take a few of them. But I don't to say that I like chocolate is not fair. Like I like chocolate. Sure, but I don't eat it because I'm like, oh chocolate, I eat it because it's I know it's a kick and I don't get stuck snacking on it. Whereas if I if I wanted like a sweet kick and I went to a hard candy. Yeah, I would just keep eating them. Interesting. So I know that about myself. So I try to you know

Jessie Inchauspé 17:15
that chocolate is a safer place to get some dopamine because it's somehow less addictive to you. Yes, dopamine from candy.

Scott Benner 17:21
That is what I have figured out. Because if I like bought a bottle, let me just I'll let you into my mind if I stopped at a gas station and bought a box of red hots, or something like that. That's just pure sugar. In 20 minutes, the whole box would be gone.

Jessie Inchauspé 17:34
Do you think chocolate kind of makes you a little bit nauseous at the same time. So you don't want to eat too much of it? Or like there's something about it that you don't really like?

Scott Benner 17:41
I don't I don't enjoy the This is so weird. I don't enjoy the thickness that my saliva gets when I eat chocolate. So I don't want to keep eating it because of that. Interesting. Yeah. So I stopped my so I it's basically I've basically found heroin that I can't stand doing, you know what I mean? So it stops me at some point. Amazing. I also have trouble like digesting food. I've recently in the last year added a digestive enzyme to my maintenance and a magnesium oxide. So I learned this through my daughter who has type one, she's almost 19 Now, but she was not eliminating on a regular schedule. And her stomach would hurt very badly. And you know, we did all the kind of I want to say like normal doctoring things you would do about something like this. We, you know, we went to all the doctors we were supposed to. And we ended up at a gastro who just told us that she had gastroparesis. But that's, of course, a very scary word to someone who has diabetes versus if off the street. I just said, Hey, you digest food slowly. So luckily, there's a CD that comes on the show a lot. And she's had diabetes for 30 years. And she and I were talking privately and she's like, you know, I'm not a doctor, but Arden doesn't have gastroparesis, like, something's going on. And we tried an elimination diet that did not help her at all. And we finally I just sort of like took over one day. And I said, I'm going to have you take these digestive enzymes at every meal. And she started taking them in her stomach stopped hurting when she ate, but she still wasn't going to the bathroom. So we added the magnesium oxide, which got everything moving. And then once she had a cycle that was happening every day, we started putting in a probiotic. And she's in a completely different world now. Wow. It's clearly finding that yeah, it cleared her acne it. Her stomach doesn't hurt. She goes to the bathroom, she eliminates every day. And then I realized and like, but I've struggled with that my whole life like I thought of it for her because she has type one I figured maybe her pancreas wasn't helping with the digestion. But then I'm like, I have the same problem. I have trouble digesting protein. Like I can't take in oils. It took me my whole adult life to figure out not to eat oil. And then when I eliminated all that, like things would get better and better, but I would never ascend to a place where I thought like, Oh, this is good still, you know, like I was having to add fiber to my meals and things like that. And the magnesium and the enzyme together have like, have, like, changed my life, too. It's very interesting. Yeah. Anyway, so this is kind of cool. So what do you tell, like, I know, we're gonna get to the part where we're going to try to figure we're going to try to apply what you talked about the people who are using insulin. But for now, like when you talk about this, when you stand in front of a group, or you get on a podcast, what are the things you want people to know?

Jessie Inchauspé 20:39
I want people to know that learning about their glucose levels, whoever they are, and learning to manage it can help them regardless of you know, their life, maybe they have type one, maybe they have type two, maybe they have difficult mental health, maybe they don't sleep well, maybe they have fertility issues, which is very linked to glucose. Maybe they have psoriasis, eczema, difficult menopause symptoms, like we now know from the scientific studies that essentially, if your glucose levels are very variable, it can lead to many different symptoms in your body. And learning these easy hacks to manage it can really make a difference. And so that's the first place I start. And then I teach people all the hacks that scientists across the world have discovered a lot of the times by studying people by studying people with type one first and find that these hacks are working. And so I talked about the hacks, let me go into the hacks because that's really the meat of it all I want to hear. Okay, so first hack.

Scott Benner 21:43
On the pod is an insulin pump. It is a tubeless insulin pump. And there are two of them to choose from, you can get yourself the Omni pod dash, which is an absolutely terrific pump, where you put in your settings, and then make all of your decisions. And then there's the on the pod five, where you put in your settings, and then the algorithm makes decisions for you. You tell it how much you've eaten, it handles the insulin, your blood sugar tries to go down, it handles the insulin, your blood sugar tries to go up, it handles the insulin, it's based on an algorithm called Smart adjust technology. Omni pod.com forward slash juicebox. So maybe you want the Omni pod dash, use my link to get started. You have a G six and you want to try the Omni pod five, use my link to get started. Use my link to learn more. Use my link to reach out to Omni pod and say hey, I'm thinking about doing this they'll get back to you, you can start a dialogue, figure out what's best for you. Omni pod.com forward slash juice box. When you get to that link, you're gonna be met by a photo of me but don't let that deter you. At least you'll know you're in the right place. Then you can just scroll down a little bit. Do your reading and your learning. You can check on your coverage, you can click to talk to a nominee pod specialist. trust me this is this the place you want to be if you're looking for Omni pod. What's next, athletic greens make something called ag one. That's what you're looking for ag one from athletic greens. I'm going to tell you about my experience with it. I had a lot of trouble with all of the other green drinks that I tried before eg one treble meaning I hated the way they tasted and I couldn't get them down. But I have absolutely no trouble drinking athletic greens. I don't just mean I don't have trouble. I mean, it's a pleasurable, easy experience. I begin every morning with a scoop of athletic greens. In some water actually, they send you a nice little shaker that you can shake it up in and drink it down. And my day is on its way I take athletic greens for vitamins and nutrition that I don't think I'm otherwise getting in my diet. You may have another reason I can feel a crispness in my step. What does that skip in my step? I don't know exactly what I feel. I feel better when I drink athletic greens every day I think is what I'm trying to tell you. Athletic greens.com forward slash juice box Get started today with ag one using my link and you'll also receive a year supply of vitamin D and five free travel packs with your first order. Ag one contains less than one gram of sugar no GMOs. No nasty chemicals or artificial anything. That's why it tastes so good. It supports better sleep quality and recovery, mental clarity and alertness. And like I said, I just feel crisper when I'm using it. I don't exactly know what that means. But there's a crispness to me. Tons of people taking some kind of multivitamins every day. It's important to choose one that has high quality ingredients stuff that your body will actually absorb. Athletic greens.com forward slash juicebox Get started today get that free vitamin D By the travel packs, you won't be sorry. There are links in the show notes of the audio app you're listening in right now. And links at juicebox podcast.com. If you can't remember, Omni pod.com, forward slash juice box, and athletic greens.com forward slash juice box. Alright, let's get to Jesse's tips and the rest of our conversation, you can find her on Instagram, by the way, I'll put the information at the end

Jessie Inchauspé 25:42
first hack, have a savory instead of a sweet breakfast. So we just talked about dopamine and energy, right? The myth that sugar in the morning is going to give you energy is just it's not true. If you have a breakfast, that's just something sweet or something starchy, which most of us have, right, whether it's like bread with jam, maybe it's fruit juice, maybe it's breakfast cereal, maybe it's oats with some honey, a banana. If you're just having sweet and starchy foods for breakfast, you're going to create a big glucose spike in your body. And we want to kind of avoid the big spike in the morning, because then, even in people without diabetes, it will deregulate your glucose for the rest of the day. So instead, you want to switch to your breakfast that is built around protein, what I call a savory breakfast. So protein, some fats and fiber if you can. And if you want something sweet have like a piece of whole fruit for taste, right. But in the morning, it's really important to have a savory breakfast, to set your glucose up for the day. So that's Hack number one. And it's really kind of like a pillar of study glucose levels. If you don't have that, it's gonna be really hard to study things.

Scott Benner 26:51
Before we move on. Can you tell people what the difference is between eating a piece of fruit and having jelly on their toast?

Jessie Inchauspé 27:00
Absolutely. So first of all, I want people to know something very important about fruit. So the fruit that you see today in supermarkets like you might think, oh, it's natural, it's good. For me, it comes from plants. The thing is, the fruit that we see today in supermarkets has been actually bred for centuries by humans to be extra sweet and extra juicy, to give us more of that dopamine hit. So a little bit like humans bred gray wolves into shiawase. They've bred ancestral bananas into the banana. As you see today, if you look at how fruit was a million years ago, it was not sweet at all, very difficult to eat very fibrous, very, you know, dense and difficult to chew. So all this to say that the fruit you see today in supermarkets has been manufactured. That being said, Scott, in a piece of fruit, yes, there is some sugar. But there's also a very, very, very, very important substance called fiber. And fiber is what you find in most fruits and vegetables. And fiber, as you probably know, when we digest it, it doesn't turn to glucose, it doesn't increase your glucose levels, actually, it's very protective. Fiber makes a mesh in your upper intestine, sort of like protective shields, and it stays there for a couple of hours. And then it prevents your body from absorbing too much glucose, it's very, very important to eat enough fiber when you're having also sugar to prevent that glucose spike. So all this to say that if you want to eat something sweet, a piece of whole fruit is always going to be the best thing to eat because it has that protective fiber. Now the issue arises when we denature a piece of fruit, when we do sit, for example, and we get rid of the fiber, when we turn it into Jam, which is also getting rid of the fiber, concentrating the sugar, maybe adding some table sugar on top of that. Or when we dry fruit, you know, when we drive mango, we're actually reducing the amount of water in the mango. So we're concentrating again, the sugar concentrating that dopamine hits. So whole fruit is fine. But any sort of derivative product, fruit juice for jam, fruit puree, all that stuff, we should consider that dessert. Right? It's really it's a dessert. It's like having a piece of cake or some chocolate. It's really not something that is health promoting. Right, it gives us dopamine, but it's not helpful to our health. So that's really, really key. Because for a long time, you know, I thought as long as it comes from fruit, it's good for my body.

Scott Benner 29:37
Right? No, I know I Jenny is a person I do a lot of episodes with. And she's always saying like don't drink juice. Like don't don't drink fruit juice. And it's just terrible in the glycemic hit from it is insane. And it's devoid of anything valuable at that point. Right. Exactly. Yeah.

Jessie Inchauspé 29:55
And another hack I have is like Okay, so in the morning you want to avoid eating sweet foods and you want to make a breakfast that's built around protein. And in my book, I have lots of cool recipes. But also, I want to teach people how to eat sugar in a way that's less impactful on their glucose levels. So how do you eat sugar in a way that creates a smaller spike? Because I want a pleasure. I don't want to stop eating chocolate. I love chocolate, right? How do we eat it in a way that doesn't cause too many side effects on our glucose and on our body. So another hack is, when you eat something sweet, make sure it's never on an empty stomach. Instead, make sure it's after a meal as dessert, right. So if you if you want to have your favorite cookie, don't have it first thing in the morning or between meals, have it after your lunch or after dinner. That way you get all the pleasure from it with less of an impact on your glucose levels.

Scott Benner 30:47
I'm going to write down no cookies for breakfast. And that's because your stomach is why what's the value in that?

Jessie Inchauspé 30:56
Because when so let's take the states where there's nothing in your stomach. So maybe you just woke up in the morning, right? Your body is really empty, your stomach is empty, your intestines are really empty. So if you eat something that's high in sugar, well that let's say a cookie, it's going to go really quickly from your mouth, to your stomach to your intestine, to then your bloodstream, nothing is slowing down, nothing is stopping it, it just goes straight through like a roof. And then big increase in glucose levels in your blood very quickly. On the contrary, if you have something sweet after you've had already a meal, let's say I don't know, like some chicken, some broccoli, some rice like a full meal, that meal is sitting in your stomach, right, and that meal is gonna slow down how quickly the cookie is going to arrive into your intestine and into your bloodstream. And one important thing as well that I think a lot of people can relate to is, the more spikes you have, the more you're going to have these very intense hunger moments. You know, if you don't have even if you don't have diabetes, you're going to feel a lot of cravings from a glucose crash. And by eating sugar. After a meal instead of on an empty stomach, you can really reduce those cravings that come on a couple of hours after a meal, and cravings

Scott Benner 32:07
are the dopamine dwindling and your body going. Let's do that again. Right.

Jessie Inchauspé 32:12
Good question. Yes, actually is multifactorial. So scientists have discovered that when your glucose levels are low, the craving center in your brain activates. And this is a part of their brain that is in charge of cravings. And when your glucose levels are low, that part activates and tells you like Scott, you gotta find something sweet to eat, right. And that system, it's really hard to fight against it. So if you're somebody who has cravings, they're probably not your fault, it might be just your brains reaction to glucose levels that are too low, that are going too low. And that's really just, you know, an evolutionary ancestor reaction of that particular creating center of your brain. Of course, when your glucose is low, that's not the only thing that happens. But that's one of the consequences. So if you avoid the spikes, you then avoid such a strong drop that can lead to more cravings. I've heard

Scott Benner 33:03
adults say that, and people who don't have diabetes, so they're not using manmade insulin. They'll say, I feel like my blood sugar is low, but then you test them and they're not. Is that the craving Do you think?

Jessie Inchauspé 33:15
Yeah, so that's another thing. There's so many things. So that's probably so you know, when you have diabetes, you're familiar with the concept of reactive hypoglycemia, right? So like, you spike, and then when your goes drops below baseline, and even in people without diabetes, that can actually happen, of course, to a lesser extent, but you can still feel that drop and that craving, but it can also lead to things like nausea, sweats, palpitations, you know, even with people without diabetes. So yeah, it's a combination of so many things. And when people say I have low blood sugar, actually, what they don't know is that this is not a condition they were born with, right? Where they don't know is that actually, those symptoms are probably caused by just a very short lived crash after a spike.

Scott Benner 33:58
It is two things. It's funny you use the phrasing because my daughter when she was younger, the only way she could describe she would say I could feel the fall. So she would know that she was going to be low before any testing actually indicated that she was slow. And she would say I could feel it falling. But what you just said not to jump around, but what you just said made me wonder, is this why when you hear people and I've done it to forget people, like go on a very low carb like high protein, high fat diet and you suddenly you're like, I feel so much better. But is that just because your your glucose is very stable like that?

Jessie Inchauspé 34:36
It's a very it's a it's probably one of the main reasons Yeah, because a lot of symptoms are caused by being a new glucose rollercoaster. The studies show us that 80% of people without diabetes can still be experiencing this roller coaster on a daily basis right and those leads to many symptoms. So one, it's because you're not having the roller coaster anymore so you don't get all these crazy symptoms and to your body's just functioning better, because with with fewer spikes, your mitochondria are just like, you know, humming along really well. They're able to make energy efficiently. A lot of things fall into place when you're able to study your glucose levels a bit more than they were before.

Scott Benner 35:14
Is there any value to the idea that when you don't overtax one part of your system that there's more to go around for the other parts for your other systems as well, like you don't I mean, like, when you're sitting in, I don't know, convalescing after you have an injury or something like that, like your body's trying, it's putting a lot of effort towards one thing. I don't know, I'm reaching a little bit, but like, I also think that I've eaten, like I said, I've eaten low carb before, and sort of just aches and pains go away. Yeah, like mission,

Jessie Inchauspé 35:42
inflammation reduces. So many, so many symptoms get better when we don't give such you know, violent influxes of glucose to the way that we're eating. Okay, so, so many things, aging also slows down fewer spikes you have the slower your aging, like there's just the consequences are coming by the dozen. So yeah, it doesn't surprise me at all, that somebody who's on the low carb diets, and who's learning to manage their glucose levels that they would see so many symptoms get better. But also like, I'm not necessarily a proponent of going super low carb and not eating any starches and sugars anymore. I just don't think that's really realistic. And for a lot of people that is for me, like, that's not really what I want to do.

Scott Benner 36:29
You and I get along great, because my next question was going to be, but all that doesn't sound very realistic to me. So how do we

Jessie Inchauspé 36:37
be realistic? And of course, you know, in some instances, it makes a lot of sense, like for sure, if you want to do it, and if it works for you, like go for it, but it's just difficult. And then it's a bit of a like, 01 approach to it all. Like, either I don't eat any carbs, or I'm not on the diet, like what about we learned some principles that allow us to eat whatever we want, in a way that's better for our glucose and our health. And so that's, that's where all the hacks come in. So we talked about savory breakfast, super important, that'll really sought you out for the day. And then if you'd love your sweet breakfast foods and sweet foods, it's totally fine. You can have them but remember, as dessert, after lunch, or after dinner, not first thing in the morning when you're fasted, because that way, you're not going to create such a big glucose spike that's going to stay with you all day.

Scott Benner 37:24
Is that more breakfast question? Yeah. So so if a person that because I went onto my Facebook group before you and I came on, I should find this for you. And, and I said, hey, everybody real quick. Tell me all the meals that you have trouble bolusing for. Okay. And let me say it was an hour and a half ago, let me see where we're at now. Because I'm thinking of one that I saw specifically, where the person said that their child eats a fairly savory breakfast except puts potatoes with it. And then their blood sugar stays high, all day long, and they have trouble getting it down. So they're eating bacon, or eggs or something to that effect, but then also some potato along with it. So you can't just what it's making me think back on is the first time that I found the Atkins diet, like I'm old, you know what I mean? So years ago, and it was in your head that if you ate very low carb, you'd go into ketosis, not the ketosis, like diabetic ketoacidosis. But ketosis, and but it's, but you could eat that way, all day long. And you had this feeling like, well, any of the fat that I'm taking in is going to just pass through me, so it's okay. And then you make one slip up during the day. And I would think, well, one slip up equals ruining this whole day for me, and I would kind of consider it that way. And I'm wondering if adding the potatoes to the Breakfast isn't the same idea, like, overwhelmingly, the breakfast is gonna put you off on the right foot. But once you grab a couple of these potatoes your shot, is that kind of the feeling or no?

Jessie Inchauspé 39:02
I would say no, I think it's more about like balance, right? So what about you kind of like, have one less potato and one more egg and kind of find that balance until you're able to still have some starchy foods that you like, but you might actually use another hack, which could solve this problem. The other hack is eating your food in the right order. So that's very powerful. So if this person is starting the breakfast by eating the potatoes, that will cause a much bigger spike than if they had the potatoes last, okay, you can eat the exact same food, the exact same meal. But if you have this is what the science what science has found. If you have fiber, proteins and fats at the beginning, and starches and sugars at the end, you can reduce the spike of that meal by up to 75% without changing The meal you're eating like without changing the actual foods.

Scott Benner 40:02
Yeah, and I know we've been clear, but I'll say again, this is a study done with people who have a functioning pancreas. Right. Yeah. But still the the, the lesson from it should be very valuable, I would think.

Jessie Inchauspé 40:14
Absolutely, yeah. And by the way, so all the hacks I share, some studies have been done in people with a functioning pancreas. Some studies have been done in type one and type two, like there's actually a lot of replication going on. And the food order study has been studied in type two, I can't recall off the top of my head if it's been done in type one, but I'll look it up for you. Well, but the principles stay the same.

Scott Benner 40:36
Yeah. What I can tell you is that through the years being in the space for the years, and hearing people talk, whether it's a study that's been done or not, it is passed around like campfire folklore, like eat it in this order, your blood sugar won't. I've heard people say that for a decade, they didn't have any science behind it, other than their own trial and error. But I've been hearing people talk like that for a long time.

Jessie Inchauspé 40:58
And that's so interesting, because a lot of the stuff that we're now sort of understanding more deeply with the scientific studies that have been knowledge that's been around for a long time, whether it's cultural, like, for example, another hack we can talk about is vinegar, and how when you have vinegar at the beginning of a meal, it helps reduce the spike of that meal. So many cultures have been having vinegar for centuries. And now we kind of understand why it's so helpful, specifically on your glucose levels.

Scott Benner 41:27
It's interesting, I imagine you must find yourself in the position of over explaining, because some of the things I feel I don't I'm trying to, I'm trying to figure out like a word that will mean something to you culturally, but it feels crunchy, a little granola you don't even like like, oh, just drink finger, everything will be fine.

Jessie Inchauspé 41:50
I don't find it to be overextending. Like, my job is I'm, you know, I teach stuff. I share science. So I will explain everything as deeply as you want to go. And I find it really fun and fascinating. Well then wanting to dive into why would that help something I was just waiting for you to ask I was setting you up perfectly. So you can be like, Why does vinegar work? Okay, so vinegar contains a molecule called acetic acid. Acetic acid is very cool. Acetic acid does a few things to your glucose levels. So number one, when you have some vinegar before a meal, the acetic acid in the vinegar is going to hang around in your stomach. And there it's going to slow down how quickly starches break down to glucose. So if you have a little bit of vinegar and some water, before some pasta, for example, that pasta is going to break down into glucose more slowly. So it's going to arrive in your bloodstream more slowly. So it's going to be less of a sharp increase and more of a sort of steadier rise. So that's quite interesting. Number two acetic acid goes to your muscles, and it tells your muscles to soak up more glucose than they usually would. So as a result, you have these two things going on, of glucose arriving in the bloodstream more slowly, and your muscles soaking it up more quickly. So it's pretty, you know, it's pretty amazing in the studies, you see really the impact of that has on the glucose spike of a meal. Super powerful, quite easy to try out. And cheap. And you don't have to change what you're eating. So that's that's a nice a nice one to try out.

Scott Benner 43:31
Have you ever heard this is one that goes through the diabetes community I wonder if you've ever heard about it, cook past the eat it hot. Hit your blood sugar, very hard cook pasta, refrigerate it reheat it does not hit you as hard. Why is this true?

Jessie Inchauspé 43:43
It's because when you cook starches, so it can be bread, pasta, rice, potatoes, and then you call them down some of the starch in that food is going to transform into something called resistant starch, which essentially is like fiber. So it's like it's as if you're increasing how much fiber there is in that pasta or in that potato by cooking it and cooling all the way down. And then once it's done that only does that once. You can then reheat it cool it down as many times as you want. You can eat it however you want. That transformation will be locked in. Yeah, so it's very awesome. I love that one Sunday

Scott Benner 44:21
night. My wife said Wouldn't you love pasta with turkey meatballs for dinner, which I took to mean you should make pasta and turkey meatballs for dinner. And so I did that. And for simplicity just for description. We use a brand dreamfields pasta because we've just learned over time that it hits my daughter's blood sugar easier, right? So we already have what I'm calling a lower glycemic pasta. The sauce is just be taking whole tomatoes and throwing in some garlic right there's not much to it. And the turkey meatballs are just ground turkey. Two hours after we ate My stomach was uneasy. I expect that the digestive enzymes helped me from having I can't believe. I don't know why I started the podcast just so I could tell people things I don't want anybody to know. But the digestive enzymes kept me from having a bathroom emergency, which I would have had if I just ate it straight. But I was still a little uneasy. But I'm also cheap, and I made a lot of pasta. So every day, this week, I've had some pasta with a meal, I have not felt uneasy in the ensuing days, just on the first day.

Jessie Inchauspé 45:33
Amazing, I love that that's resistance starts working for you. Another thing you might try. And this is another hack, and it's probably one of my favorite is at the beginning of a meal, start your meal with a little plate of vegetables, I call this the veggie starter. So it can be you know, any kind of veggie like maybe it's a few cherry tomatoes from the fridge, because that's what you have, maybe it's some leftover roasted, I don't know, cauliflower, maybe it's a bit of spinach. Like when you have vegetables first at the beginning of a meal. And this goes back to the food order thing. The fiber in those veggies, is going to coat your digestive system and really protect you and help you not absorb glucose too quickly afterwards. So that might be another one that helps you if the resistant starch helps you as well. I love the veggie starter one, like it's a non negotiable for me anymore.

Scott Benner 46:19
It feels like a natural way of doing what you know, 15 years ago, there was a big push. Do you remember this Olestra there was going to be a drug that kept fat from being digested, and it would pass through you what, which just made very, like, explosive, oily stools for people. But but it was it's what popped into my I'm older. So it's what popped into my head was the idea of like, coating your system so that some things don't get Yeah, yeah. But in this case,

Jessie Inchauspé 46:49
you know, we're not talking about drought, we're talking about something that all of us should always have, like, we should always have that mesh that's protecting our intestines, but most of us don't, because we just eat so differently nowadays. And so by adding that veggie starter and you're kind of working hand in hand with your body to prepare your body for that meal. It's a it's a really lovely one.

Scott Benner 47:09
So I'm gonna ask you a question, but first, I'm going to tell you something. So you know why I'm asking. Don't judge me, okay. I don't eat vegetables. Is there anything I can do? supplementally To help that?

Jessie Inchauspé 47:22
Yes. So there are a few supplements that can help. You can take some actually right now the best thing you can do is take some fiber supplements, really? Or you can make yourself a little like, Would you drink a little bit of water with like some ground flax seeds in it?

Scott Benner 47:39
Maybe I do a green drink in the morning. I don't want to say the brand because they're a sponsor. Yeah, but I do. And by the way, you said something earlier that really struck me. When I started doing the green drink right away in the morning. Not only did I first I thought I was just feeling hydrated because I'm bad at remembering to drink water. So at least I'm taking like the 16 ounces of water right away in the morning. I thought maybe I'm just feeling the hydration. But I have to tell you like I missed the green drink on some days. And I noticed I didn't have it. And I can't say why bright I just know that I feel I'm going to use a weird word crisper, like a little more brightness a bit sharper. Yeah. Right. And so but okay, so I could do like a, I'm sorry, like a fiber like right before the meal. Yep. Could I do like a tablet of like, like a capsule, or would I want to do it mixed up in a water,

Jessie Inchauspé 48:36
you could do both really, you could do you could do a little capsule of like psyllium husk or like some pretty standard like little fiber supplements you could do a little you could create a little your own little Scott fiber cocktail with some like, you know ground flax seeds, ground chia seeds, that can actually help quite a bit. And then if you don't really want to do any of those things, you can also just start your meal by a little bit of protein and fats. So like half an egg or you know something to just coat your stomach before you're going to take in, for example, pasta or any other starches, you really want to think about preparing your body so that the impact of the meal you're going to have is going to be a bit dampened. And the best way to do that is with fiber from veggies. But even if you want to do it with some proteins from fats, that's still going to help. Okay, rather than doing nothing

Scott Benner 49:29
I just realized we're having too good of a time. Are you stuck to an hour or can we keep going?

Jessie Inchauspé 49:33
Oh, no, we can keep going. Okay, great.

Scott Benner 49:34
All right. So let's get me through more of your hacks you just did the veggies first. I got savory breakfast veggies first.

Jessie Inchauspé 49:43
Breakfast vinegar us we talked about if you want to eat something sweet habit, meal, not an empty stomach. That's super important. Now let's talk about your muscles. So another hack is after meal. Use your muscles for 10 minutes so that can be walking for 10 minutes that that can be my new favorite thing, which is okay, do it with me, Scott. So your feet are on the ground, and you're going to lift your, I can't even explain this, you're going to do like a calf raise. Okay, so you're going on to your tippy toes and your calves are working, and you're up and down and up and down. That's a calf raise. Yeah, yeah. And so your calf has this really cool muscle in it called the soleus muscle, which is very good at uptaking. glucose from the bloodstream is very hungry for glucose. And so when you do these calf raises like this, you're going to be pulling glucose out of the circulation into that calf muscle, and it's going to reduce the spike that you're experiencing from a meal. Super easy. You can do it at work sitting down. Nobody needs to know that any kind of movement after a meal is going to help lower that blood sugar. Because your muscles when they contract, they need glucose for energy.

Scott Benner 50:51
How long would I do these catchphrases for?

Jessie Inchauspé 50:53
So in this studies, I think we do them for three hours, which I don't recommend. 10 minutes is good. Okay, right. So just kind of like, put a little timer on your phone or whatever, and you don't have to be super crazy about them. Right? You can just think, Okay, I'm doing a few like maybe 10 You know, catchphrases per minute for like, 10 minutes, right? But even if you just do one, that's better than not doing any. Okay, so it's really up to you. I think 10 minutes is really good amount to see a big difference. But even just one is already cause for celebration.

Scott Benner 51:26
Oh, wow. Okay, so I so I don't have type one, but I'm still going to try it. Do you think I'm gonna listen just for like, I'm just gonna say giggles I don't know if that's a French term that would like get to you or not, but, but just for fun. Next time my daughter finds herself with a sticky blood sugar. I'm going to say just for fun, do 10 minutes a catchphrase is sitting down, I want to see what happens I'm going to be interested to see.

Jessie Inchauspé 51:50
And walking is also very powerful, of course, very, very powerful. You know that. But it requires a whole organization and somewhere to walk. So cafes is a really good, the study is very interesting. It's

Scott Benner 52:00
crazy. There was a decade ago, a gentleman that did something in the type one community where he just wanted to promote exercise. So we had people record their glucose, go for a walk, come back recorded again. And people saw 50 Point drops in their blood sugars and stuff like that. So we're always telling people, even just the idea of that, that's kind of two prong for a type one, by the way, the way you're describing is just creating a situation where the muscle pulls the glucose in, which is part of what you get out of exercise. But the secondary thing you get when you have type one is the distribution of the insulin through your system. When you're sedentary, you need more insulin, because it just doesn't work as effectively, effectively. So you get people up and you get them moving. And sometimes they'll say exercise makes me drop. But really what they should be thinking maybe a little bit is that exercise makes my insulin work better. I see you know, so it's a it's an interesting hair to split, you know, makes sense? Yeah. Okay. All right. So calf raises. I mean, yeah, you give more or because calf raises seems like that would be the crazy one at the end. But go ahead.

Jessie Inchauspé 53:05
Let's do one last one. Okay, this one is called put some clothing on your carbs. So don't eat any carbs naked. So what I mean by this is, so carbs are starchy foods, so like bread, pasta, rice, potatoes, or sweet foods. So that can be anything from a piece of fruit to like candy to the chocolate things that you like. And again, those are carbs. If we eat them naked, the glucose and carbs contain glucose, that's really important, right? Carbs break down to glucose when we digest them. So if we have them on their own, which is what I call naked, then boom, as I explained, the glucose goes really quickly through your digestive system and into your bloodstream and big spike, what we want to do instead is learn to put some clothing on them. So clothing, our proteins, fats, or fiber. When you add some clothes, I'm going to give you some examples. And when you add some clothes to your carbs, you reduce the spike that they create. So for example, let's say you want to have a piece of toast, you have two options. You can have the toast naked, which is going to create a bigger spike than adding, let's say, a slice of ham to the toast or half a mashed avocado, which is fat to the toast, right? So think about dressing your carbs, and not letting them run around naked. Another good example would be you're at a birthday party, you want to have a slice of cake, the cake on its own, that's just naked carbs. Add to it. A few spoonfuls of Greek yogurt, or add to it maybe like a handful of nuts, right. Do you want to have some pasta for dinner? Add to it's a little bit of spinach and I don't eat vegetables, but for people who eat vegetables, like a little bit of spinach, some leftover roasted broccoli, a bit of chicken, you know, so meatballs, like think about not letting your carbs get into your body naked that'll help study your glucose levels.

Scott Benner 54:58
So to put context to this for people listening Have type one. If your blood sugar starts to get low, and you need a quick infusion of glucose, you eat simple sugars, right stuff that your body can absorb very quickly. And you'll find after a while, as matter of fact, emergency like gel, you just rub in the lining of your cheeks, because it's so easy to pull glucose in through your cheeks, right? You would not, you would not get into a panic situation where your blood sugar was changing rapidly going down and say, Oh, I'm gonna eat peanut butter does fix it like that won't work. You want juice, you want simple sugars that get pulled up quickly. And so you just sort of reverse engineer that idea, right? Don't allow your body to just have those simple sugars and you won't see the big spike, even though you've taken in the same thing. So you really do believe there's a way to eat what people want to eat without getting into a situation where your body craves it in an overindulgent way. And it's not impacting your blood sugar's in a way that is damaging the way you described earlier. That's doable.

Jessie Inchauspé 56:01
Absolutely. And I think that's why, you know, my message and my work has been so popular is because this is not about cutting out food groups. This is about learning to eat things you love in a way that still helps your body do its best. And that's just how I want to live my own life. You know, I don't, when I learned that glucose spikes, were triggering these mental health episodes in me, my first thought was like, I can't ever eat glucose ever again. You know, but then I was like, No, I don't want to live like that. Let me figure out how I can eat everything I love with less impact on my body. So yes, I do believe it's possible. And I have actually a lot of readers who have type one, who by using the hacks have been able to learn so much about how their body responds to food, you have been able to incorporate what they love in a different way.

Scott Benner 56:48
Well, I think it's very important. It's why I reached out to you. And you and I don't know each other well, but I think that's why my podcast is popular too. Because I looked at this problem. And I said, How do I keep my daughter's life not feeling restricted at all, and yet not give away your health over it. And so I focused on how to use insulin, and then figured it out, and then figured out a way to simply explain it to other people. And then these people are having these these things too. And then those people give me the gift of finding you and then saying, Hey, you have to go find this girl, Jesse. And I was like, okay, so I went and I thought, Oh, this is great. And just the idea like you and I are doing the same thing from two different perspectives. We're thinking about where the impacts are coming from and how we can hit them off. That really is it right?

Jessie Inchauspé 57:39
Yes, and how we can minimize you know, harm in a way. For me, it's really important to, you know, in in the world of people with a functioning pancreas, something you often might see is like people going on extreme diets, and people feeling really upset at their body or feeling a lot of guilt around cravings and just these relationships to food that become distorted. And I tried to teach people how food actually scientifically biochemically impacts their body. And teaching them these hacks, shows them that they can eat whatever they love, and still help their health at the same time. And I really such a strong believer in that message of like, you can have both, you just need the right information to be able to do it. And this would

Scott Benner 58:21
likely not be valuable to people with type two diabetes, right?

Jessie Inchauspé 58:25
Absolutely. Because type two diabetes in most cases, you can put it into remission, in most cases, and you can reverse pre diabetes, type two diabetes can get better. If you have type one, your numbers can get better when you learn more about how food impacts your glucose levels, right? Like you. There are things you can, as you know very well, there are hacks and solutions and strategies you can put in place to help your body. And yeah, I see many people who reverse type two diabetes in remission after reading my book and applying the science that I share, I have

Scott Benner 58:57
to say how grateful I am for the podcast format. Because this is a thing that once it's, you know, you let it breathe, and you have a long conversation. And you think okay, well, that makes sense. You just said something like how could I as a person? If I'm a person with type one diabetes? How could I do some of these things that might help my blood sugar spikes, and therefore make my day less variable? I might feel better, all these things will come with it. And the problem is, if you don't have like a slow, easy conversation about this, it turns into I saw somebody on Instagram and they said if I drink vinegar, I don't know. I think they said it cures my diabetes, then that makes people angry because obviously that's not true. And then we get caught in this sort of like social media storm, instead of just listening and saying, what would it hurt for me to try a couple of these things to see if it helps. You're not here saying like, drink vinegar, and I'm gonna get taller and magically and I'll be prettier and my blood sugar will be perfect. You're like, here's the function of this. Give it a shot. See if it helps you. Yeah, yeah,

Jessie Inchauspé 59:59
I'm He's trying to communicate this science because when I first started diving into the science of glucose, I was like, wow, there's all these amazing papers and discoveries. And nobody knows about this stuff. Nobody, I mean, not enough, you know. And so I just wanted to give, essentially, the scientific discoveries, more of a voice. And I agree with you that Instagram and social media format is really not good enough. And that's why I wrote books, you know, and that's why I love doing podcasts. Because I feel like that's a much better way to teach and to learn. And for me to Instagram is more like the trailer. And then if you want to see the movie, you have to you have to dive deeper. You know, I try to give as much information as I count on every single Instagram post. But you can never add all the nuance in the context, it's important to have other platforms where you can really get into it.

Scott Benner 1:00:44
Yeah, I have a similar feeling where I think at least I know if I put it down like this, the people who made it through it, they at least heard everything I wanted them to hear. I like on a post or something. I don't know if they read that, or they understood it. Or if it was a scroll, and like, Oh, I like Scott taptap. You don't even like that kind of thing. And so I appreciate you do this. I have many more questions, but but I want you to first talk about because I think this is a good opportunity to stop some outrage that isn't necessary. Can you explain to people how valuable it is to have a continuous glucose monitor to help figure these things out, even if you don't have diabetes.

Jessie Inchauspé 1:01:26
So I would just, you know, caution that by saying I don't tell everybody to work, because monitoring, I don't think it's necessary. I think it's a medical device. And it's, you know, if you're not, if you don't have a care system around you or a doctor to talk to, it can be really confusing to understand the numbers, what I think is very valuable is for everybody to learn how food impacts glucose, and learn these hacks to manage it, even if they don't have diabetes. I think the most pressing thing that's going on right now is that more and more females are experiencing infertility, polycystic ovarian syndrome, you know, a lot of issues around the hormonal systems. Even if you don't have diabetes, I think it's now one in eight females have polycystic ovarian syndrome, which is a complete dysregulation of your sex hormones. And that's very linked to glucose and to insulin. And so that's why when you learn to study your glucose levels, if you have PCOS, your symptoms usually get much better. And that's why I hear stories, you know, every week of women who had been told they would never be able to get pregnant naturally, who, after using the hacks get their period back are able to conceive like this is important that we're talking about Yeah. And then even if you don't have type one, type two is a growing epidemic. There's a billion people in the world who have pre diabetes or type two. And so preventing that needs to be a top priority for everybody. And in order to prevent that you have to learn about your glucose levels and how they work. And then, as you mentioned, you know, Alzheimer's, mental health, brain fog, energy levels, like 80% of the population who doesn't have type one diabetes, is still probably experiencing glucose spikes. That's what the studies show so we can all benefits and we all have glucose in our bodies. And it you know, learning how to manage it is just such a foundational piece of being able to thrive. And so I just, I think it's so important that everybody knows about this, right?

Scott Benner 1:03:22
Well, it's, you know, I only brought it up because people get upset when they see somebody using a CGM, because they feel like it's taking one from somebody who's using manmade insulin. And I, I'm not not, I understand where that feeling comes from. And but I like what I heard you say is like, Okay, so maybe if I were one once I could see how things impact me, if I don't have diabetes, I don't need to keep learning, I now have that information. And now I can just use these hacks to try to impact those things.

Jessie Inchauspé 1:03:48
Yeah, for sure. And like I understand, you know, at the beginning of my work, I was posting a lot of selfies of myself with a glucose monitor. Like, I didn't understand that that was triggering. And then I had some amazing people with type one reach out to me and be like, hey, Jessie, like, I don't know you. But I just want you to know, like, for community, this does not feel good. Can you please change what you're doing? And I was like, Yeah, of course. And then I had other type ones come to me and say, Oh, my God, now that I see you wearing a good monitor, and you don't even have type one, I feel less, like, you know, embarrassed about wearing because monitor for some people, that's a feeling as well. So, so many things are true. And I think I've found a line where I use a glucose monitor to create the graphs that illustrates the scientific studies. I use it because monitor to be able to create these visuals that are so key in teaching people about how their bodies work. And if you go to my Instagram, glucose goddess, you'll see what I mean like those graphs are fundamental to the education of it'll listen, I'm always learning.

Scott Benner 1:04:47
Yeah, those glad I'm gonna tell you just, you know, I used to be very good at managing insulin. And then glucose monitors came and I got really, really good at it. And then algorithm Just came along, which are making decisions about insulin back and forth and watching them work up my game again, just seeing the different impacts and seeing where the insulin comes in and seeing where the where the spike or the low happens. I sent my daughter a text last night, she's in college. She's not. She's 700 miles from here. And I'm getting in bed last night. And I look at her blood sugar before I go to bed. And I sent her a text and I said, if you were to eat two gummy bears right now, her blood sugar was 110. I said, you're going to avoid a low and about 45 minutes. And she of course is 18 and doing her homework and she ignores me, which I understand. And about 45 minutes to an hour later, her blood sugar dipped under 70. And I sent a text and I said I don't know if you saw my last text. But and, and I'm not teasing her. I'm hoping that she pulls up the graph and thinks what did this old man see an hour ago about this graph that made him know this was gonna happen? I just wanted to learn kind of slowly, you know, I'm gonna I'm gonna say something to you. Now. I can't wait to see the look on your face. Because part of me thinks if you know about this, you're gonna be like, Oh, my God, I can't believe you know this to my daughter began to take over assets Hall last year, which has in a city hall and it is oh, SAP Oh, well. Okay, okay. And is it did not say it for me. I don't know how you say it. Actually, I will between us. It's and I own

Jessie Inchauspé 1:06:27
French. But I don't know the American English version of it. So

Scott Benner 1:06:31
my daughter starts to get her period. And it's incredibly heavy. It is happening too long, sometimes 11 days. And sometimes she only gets a two or three day gap before it starts up again. Once a month, she gets a nosebleed one time. Horrible for a couple of minutes. This happens to her for years, so much so that her her iron drops so low, we have to get her iron infusions. Like she's, like just dripping in a pile on a puddle. You know, a number of years ago, we started using an integrative endo from around here to help out him with her. She also has a thyroid issue. So she's hypothyroid. And that person helped her get her thyroid all balanced out. And then we just kept talking and kept seeing her. And one day she said, I really think like we've looked at so many things. I think a lot of the things your daughter is experiencing are hormonal. And try this. So now she takes like a heaping scoop of this and dissolves it and water once a day. Normal periods. Not too heavy, not too long. No more nosebleed. Crazy, right? That's why she comes home from college for a break. kind of loses track of her. Her schedule for a couple of weeks. Data don't feel good. My periods too heavy. Boom, she gets a nosebleed. I'm like, Have you been taking the basketball every day. And she goes now starts to back up again. A month later. She's okay. Again. Fascinating, like really sad. Like, I think we saved her life with it too. Like she was in a desert. And it's it's, it's again, it's one of those things that I think if you just bumped into it somewhere, he'd be like, some hippie told me about a thing I put in water and it makes my period better. You know what I mean? Like, it's hard to like, I would have been that person 20 years ago, like, honestly, if you would have come to me and said, I don't know, Scott put the vegetables before this. I'd be like, Oh, but now I hear it. And I think God damn, that all makes sense to me. You know, sounds

Jessie Inchauspé 1:08:31
so fascinating. All the things that you come across in your life, right? And then you just want to share those and maybe in 10 years inositol everybody will know about it. And I hope also the veggie thing. Everybody will be like, Oh yeah, we know that you've written juice first, like Jesse like, shut up. And I hope I don't have a job anymore. I just hope all this stuff becomes super common knowledge.

Scott Benner 1:08:48
I have that thought sometimes, like I tell people that. I think that the goal of the podcast is that you don't have to listen to it anymore. Yeah,

Jessie Inchauspé 1:08:57
you want to become irrelevant. Yeah, I mean, yeah.

Scott Benner 1:08:59
I keep thinking like, like, I don't want this to be your life. This should be a pitstop. Not the whole thing. You know, that kind of idea. Alright, so Alright, so now, I think we've laid out pretty clearly the stuff that you talk about, right? I am. And I'm going to ask about we're going to try to talk through maybe maybe we can go for 20 more minutes, talk through how it might work for people with diabetes. But first tell me you said you had a book, you have more than one, right?

Jessie Inchauspé 1:09:23
Yeah, so my first book came out last year. It's called glucose revolution. And in it, I talk about all the basics of the science and the hacks and how it impacts I have stories of people in it, who have type one who don't have type one. There's lots of cool stuff in it. And I have a new book that's out now that's called the glucose goddess method. And that's basically a four week guide to actually doing some of these glucose hacks that I've been talking about. It's like a fast track to turning the hacks to habits and it has a bunch of recipes. And it has a whole week about veggie starter recipes, Scott. So you You could actually maybe find a veggie starter recipe that you actually like,

Scott Benner 1:10:05
in an I just recorded a net. So Jenny and I are making a type two series right now. And so we're in the middle of recording it, it hasn't been out, it's not out yet. And in the middle of it, I was like, You have to imagine I, I have a real relationship with this person, you know, and I, in the middle of it, I'm like, Oh, God, Jenny, I don't need vegetables. She's like, wait, what I'm like I don't. And I, by the way, I went into it there. It's not important here. But I grew up poorly. And, you know, I was I grew up in one of those situations, like, eat these and they were like crappy French green beans out of a can. I didn't want them. I didn't like the way they felt my mouth. I'm very tactile about food. That's not a thing. Anyone understood in the 70s. I'll tell you that right now. And then my parents would be like, you're eating data, you're not eating anything else. And I just, like the idea of eating vegetables now is probably a psychological problem is anything else for me?

Jessie Inchauspé 1:10:57
The coffee thing is psychological, too, right? Yeah,

Scott Benner 1:11:00
I don't I my, my parents drank so much coffee that the house smelled like it. And then it was this again, 70s and 80s. Like, we we lived in an apartment, my dad smoked three packs of cigarettes a day. I'm surprised I'm alive. You know? And those are just things I don't, I don't want because of that. Yeah, it's interesting. So okay, so I'm going to tell you something, and then we're gonna see if we can't build a conversation off of it. So many people with type one diabetes often have a lot of trouble bolusing for pizza. So they'll count the cart, the initial mistake is they count up all the carbs, they put in all the insulin, and then they get very low. And then of course, then they treat the low with something fast acting, then they spike up and then they keep spiking up and it stays that way for hours. Before they understand that what happened was that the pizza has cheese on it. And so you, I can't wait to say this to you to see if you agree. So you eat the pizza, your body kind of the digestion gets slowed by the cheese or any meat that might be on it. And so the dough of the pizza sort of gets pushed off to the side for a little bit. Right? Basically, what

Jessie Inchauspé 1:12:09
you're doing is you're putting clothes on that dough,

Scott Benner 1:12:14
right? And ending it from being absorbed. Yeah, exactly.

Jessie Inchauspé 1:12:17
You're slowing down digestion, you're slowing down how quickly food goes from stomach to intestine, then from intestine to bloodstream. If you ate just the dough of the pizza, with nothing else on it, you would get a much faster spike, because then you would just have carbs. But when you add stuff like the fats from the cheese and the proteins, you're putting clothing on that naked carbs, so you're slowing down how quickly the glucose is making its way to the bloodstream

Scott Benner 1:12:43
and type one situation, you've put in a significant amount of insulin for what could be I mean, a slice of pizza is going to be somewhere around 30 carbs, right 20 Or 30 carbs. And now you eat two, you've put in, I don't know, say you're one for 10, you know, a unit for 10. Now you've got six units of insulin going for these two slices. And then the digestion doesn't happen. You crash. You don't Oh, no, eat a bunch of sugar spike up. And then as the spikes going up, then the digestion hits. And now your blood sugar's high for hours afterwards. So the simple fix is for some people. And by the way, here's the interesting thing. Domino's Pizza, or a hand tossed pizza from a place up the street, where a pizza I make it home all have different impacts. Right. So it's not just pizza's pizzas, pizza, but once you figure out where the insulin goes in, so that the so that the the way I talk about it is that you want to match up the action of the insulin with the impact of the carbs. And that manmade insulin doesn't work. It's not a, it's not a light switch, right, you don't put it in, it's just working, you put it in, it starts to work slowly over time, it picks up speed. And then there's an intense part where it's really working hard. And you just have to adjust when the Bolus goes in. So that it matches up with that that food impact. Yeah, and that's if

Jessie Inchauspé 1:14:03
you're slowing down the spike of some carbs. Right, you also need to slow down how quickly insulin is arriving into your bloodstream. So let's take another example, if you're doing like, a piece of cake on its own versus cake in Greek yogurt, right? It is the same number of carbs in both of those instances, but in the plus yogurt part, you're also adding fat and protein. So the glucose is going to arrive more slowly into your bloodstream. So maybe you would need a different strategy, insulin wise.

Scott Benner 1:14:36
Yeah, no, and that's exactly what you end up doing is you just like most, most food takes what what would be colloquially called a Pre-Bolus. Like putting the insulin in a little before you eat so you can find that matchup, not all foods, not all people. And there's also another level of a problem where insulin. Thinking about how it's been made insulin work is it's sort of like thinking about like A time travel movie. Like it's sort of like what we do now impacts us later. Whereas people want to think what's happening now is somehow impacted by now, which it very infrequently is. So you, you kind of get the idea of people like, Look, you got to get the insulin working a little bit, so that it's got a little power when the carbs are trying to drive you up Nansel trying to drive you down. I tell them that, you know, on a glucose monitor, for example, when you see a stable line, when there's food and insulin there, what you're really seeing is the food trying very hard to push up while the insolence for trying very hard to push down. And these are two things caught in a battle that neither can win. And because one can't go up and one can't go down every time he every five minutes, you see your blood sugar just doesn't seem to move, right, it doesn't mean that the reaction is not happening inside. So so this is it, right. So if if, if somebody is seeing a certain spike from a meal, you think it might be as easy as them reordering their food and that spike might change. And then they're going to need to pay attention to that, because they might be making heavy boluses for what they think is going to be a larger spike that might not end up being. So this is very similar to when my daughter started taking the digestive enzymes. Some meals that were requiring a ton of insulin, were suddenly not requiring as much because it was passing through her system more quickly, and not getting stuck in the stomach where it was being leached. Right.

Jessie Inchauspé 1:16:33
Essentially, it's not just about like, what you eat, it's about how you eat it, in which which order which combination with vinegar before, not like, it's not just about the number of carbs in the food or in a meal, you can you really have lots of other levers that you can activate to impact how that food is gonna impact your glucose levels. So like, if you have type one, and you're using insulin, like it's really important to if you're going to try any of these hacks, to be super aware that you might need to adapt things, maybe talk to your doctor to make sure you're doing it all properly. Because the changes can be very drastic, like if you switch the order of the foods in your meal, and you have the veggies first and the carbs last, the impact in your glucose will be vastly different.

Scott Benner 1:17:18
Wow, I'm excited to try it. Yeah, don't worry, at the beginning of the episode, you're going to hear me in a very deep voice say that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, then I say some other stuff. So we're all good. But um, do you have anything that like, is there anything I haven't asked you about that I should have, like roads that you'd like to go down that I didn't get you to?

Jessie Inchauspé 1:17:43
know No, I don't think so. I mean, you know so much about this topic that you know, it's, it's like you're teaching me stuff really? So no, you asked everything. And I think what I want to say is like, in my first book, My intention was really just to explain to people how food works, and what glucose impacts in our body and just kind of give you like, a very easy, very fun masterclass, and just glucose and what the heck it is and how it impacts us and how we can impact and return. And so it's it just, I just want people to know that my intention is really to teach as much as I possibly can on this topic, because it's so important, whether you have type one or you don't. And also you're doing a fantastic job. So I'm just happy that we had this chat.

Scott Benner 1:18:27
I'm glad we met it is really because of a listener of the podcast who came to me privately and they're like, you really should look at this. And I was like, Okay, I will. And then you were kind enough to answer and it's lovely. Let me Can I go back and ask you something more personal. Yeah. You alluded to but didn't deep dive deep into your mental health earlier. And then it got better. Can you describe where you were and where you are?

Jessie Inchauspé 1:18:52
Oh, for sure. I mean, trigger warning, but so after I broke my back, you know, physically, I was fine in a matter of a few months. But then I started getting these really weird feelings of being in a dream or being in a movie and like everything around me was two dimensional. When I looked at my hands, I was like, whose hands are these? When I looked in the mirror it would give me panic attacks because it was like who is that person? Like I was fully not okay. And you know, I found these different terms like depersonalization felt like it fit quite well what I was experiencing some dissociation, a lot of anxiety, depression, and I was just like, I cannot live this way. I felt so broken to my core felt like my brain was so broken. I couldn't be alone at all. Like I could just couldn't take the bus by myself. Like it was impossible. I had to always either be distracting myself with a video game on my phone or be with somebody else. I was terrified and I was not okay for you know, the better part of a decade like I was really not okay. But you know, I just kind of kept going, kept at it. But deep down there was something really not okay with with my brain. And seeing that these spikes were triggering some of these episodes really. It completely changed my life. And I'm so thankful that I've felt that I wanted to raise my hand and say, Yeah, I'll try this CGM for this, you know, experiment thing. Like it just, it gave me so much hope back. I can't imagine if that hadn't happened. Yeah, that's where I would be now. Like, yeah. And then you layer so then I fixed my glucose. And then I layered on top of that, you know, amazing therapy EMDR that really helped me Eye Movement Desensitization and Reprocessing, like that really helped me a lot. And today, I'm actually okay, like, I actually I can be alone. I can challenge myself, which, you know, for most people is like, whatever. But for me, like just being able to be in a hotel room by myself for one night is like, I'm like, so grateful that I can do that. Because I was so not okay, well, but ask me any question you want. Like, I'm an open book. Oh, that's fascinating.

Scott Benner 1:21:05
So how do you think the injured Do you think the injury led that to that? Or did you have any of that prior to the injury?

Jessie Inchauspé 1:21:14
Nothing, nothing prior, I think what happened is that during the accident, and then the very intense three weeks pre surgery, and then the surgery where I thought I was gonna die, a lot of stress got stuck in my body. And nobody taught me how to process it, how to move it, you know, I was just like, I was living in London, like, nobody talked about healing from traumatic experiences or like, nervous system, like, just those weren't in my consciousness. So I think my body just held on to so much stress and anxiety and fear. And then, if small things happened around me, it would just go full blown into panic mode. So I found out that the spikes were one of the things that pushed me over and made me go into full blown panic mode. It's as if my baseline was like, super broken. And then any other extra little stress could put me in a horrible, horrible state.

Scott Benner 1:22:07
It's interesting, because I've been making this podcast, this is the ninth year I've made I'm making this podcast. And I appreciate that. But I have not heard the, in the first six years, I didn't hear the word anxiety as much as I have heard it in the last three. But I think people always want to like right off to like, oh, it was COVID. Or it was this or something. But I don't know. Like, I don't like I'm having deeper conversations with people. They're being more honest. And that's part of the reason why I think I'm hearing it. But it just makes me wonder about, you know, the podcast has listeners, because most people have a lot of trouble rakia regulating their blood sugars when they're using insulin right type twos and type ones and even type twos that don't use insulin, they have trouble with this regulation. And I'm just wondering, like, like, after a while, like you start talking to people with autoimmune issues, like you don't know this, but autoimmune issues where maybe you do kind of run in families, and they, they kind of run in groups, like if you have one, you're more likely to have to etc. The amount of people that come on here and are like, I have Raynaud's and type one, and hypothyroidism, and this and that. And the next thing, you know, they've listed seven issues that they have that are diagnosed, that they can feel the impacts from the amount of people who say that they have a bipolar person in the family and a lot of autoimmune stuff. It just like, I I'm fascinated by how many people tell me, I'm anxious, or I get easily triggered by things or you know, like, you know, sometimes when you're in a bubble, you feel like this is the world but I leave this bubble sometimes. And most people don't talk about stuff like this. And it all feels like it just comes back to I mean for me and be clear all that school you went to I barely got through high school, but it all comes back to me to like it's inflammation, right? Like it just that's what it seems like it is that people have autoimmune issues, their immune systems going wild, and they have inflammation, and it's impacting everything from mitochondria in the cells to their wrists hurt, you know, or whatever.

Jessie Inchauspé 1:24:22
Yes, well, I think what's going on is that most of us have bodies that are just in a state of stress, right? Maybe it's biological stress, it's inflammation, stress, it's, it's stress from the food from the environment from just real stress, and the stress causes more stress. And so you get into this cycle where a lot of things can go wrong. And you can get a lot of various different symptoms. I don't know you know why more people are experiencing this. But if you just look, for example, the type two numbers, I mean, they're going up and up and up and up and up and up a billion people in the world. I mean, that's wild and type two is a disease that's caused by food and our food environment. So I mean, it's crazy. But also I feel very hopeful. I'm like, I don't want people to be in the situation that I was in for a decade completely clueless about how I could help myself. Well, yeah, now.

Scott Benner 1:25:15
Yeah, I was gonna say, that's why I was, I was excited by the things you were saying? Because it's the other part of it, right? Like, it's not lost on me, there are a lot of people on the planet, we have to feed them all. We've come up with ways to do it. Obviously, some of them are not valuable, like, but they're still producing food in bulk for people. You can't tell people that foods the problem, they don't know where to go get more, what are they going to do start a farm, you don't eat meat, like, like, what am I doing, I'm gonna I'm gonna start I'm gonna get again acre, I know you're gonna cow and the plants I'm not, I'm going to keep going to the grocery store and keep buying the stock that's available to me. And so giving them the idea that there's at least maybe a way to lessen the impact of of these things that they're eating, you know, because I can

Jessie Inchauspé 1:26:02
also to not fall prey to marketing messages. Because often we make food decisions based on what something says on packaging, or, you know, advertising etc, we have to remember, a lot of food products are driven by profit. So we need objective scientific information, which is hard to come by, that helps you understand what's noise and what's real. And that's what I'm trying to do. I'm trying to Okay, guys, like, I know, the package says, like, good for your heart or low in this and good for that. But like, actually, here's how your body actually works. This is what the food turns into. And this, how it impacts you. And then you have the information you're empowered. And then you can start making decisions on the go that you understand why you're making them, you're not just making them because of what something says on a box.

Scott Benner 1:26:47
When I try to make that point to people, I usually use the example of shaved ice like Italian ice, and they're always assigned at an Italian ice place that says fat free. Yeah. And I like I'm like, that's hilarious, because my body is gonna turn that sugar into fat in about an hour or so. Right? But they're not lying. What's in the cup right now? Doesn't have any fat in it. Yeah, yeah, absolutely. So

Jessie Inchauspé 1:27:10
there's just so there's a lot of misleading marketing. And in my first book, I also go through like, all the things that you might see at the grocery store that are trying to make you buy foods that are actually things you should ignore, like, this is organic, this is gluten free, this is fat free, this is no sugar added, like all that stuff can be abused. What you really need to know is, what the molecules are, what molecules the food contains. And that's what I try to teach people and then you're empowered for life. And that's really freaking cool. Because I don't want just scientists to know this stuff. Like everybody needs to know this stuff. Because we need to be able to operate and navigate in this crazy food landscape that we live in. Like we need to know all of this.

Scott Benner 1:27:49
Yeah, it doesn't say on the package ever. We know some people can't eat gluten. So we've created gluten free cupcakes, but they're so Ultra processed. They're really they have a ton of carbs in them, and they're not going to be good for you at all, but there won't be any gluten in them. So yeah, you know, and it's

Jessie Inchauspé 1:28:06
not people's fault. Like, I mean, you're everybody's just trying to be healthy and be happy and do what's best for them and their family. Like my God. We're bombarded with messages. We don't know what's real than not. It's really intense and difficult. So I really empathize with that. That just despair of like, what am I supposed to eat? Yeah,

Scott Benner 1:28:24
this keeps coming up. When when we've been like I told you, I think I'm like five episodes deep into recording this type two series. And it keeps coming up in conversation where I keep thinking, it's no one's fault. Like it's easy to say eat better exercise more. Great. Like, what am I supposed to do about that? My I got a vague, so unhelpful. And I got a family of four and I make $35,000 a year, but you want me to go get a steak and some asparagus like where am I getting that from? You? Me? I gotta feed all these people. And this is what's it just anyway, that made this whole thing feel uplifting, would you? I hate to do this to you, but at the end here, would you mind like in a sentence run through each of the hacks again? Oh, of course.

Jessie Inchauspé 1:29:05
Of course. Let's do it. Okay, savory breakfast instead of a sweet one. Very important. If you're going to eat something sweet to have it as dessert after a meal, never on an empty stomach. After you eat, use your muscles for 10 minutes to maybe you go for a walk. Maybe you do some magical calf raises at your desk. Before at the beginning of a meal, start the meal with vegetables. That's called the veggie starter. And if you can finish the meal with the carbs, vinegar, one tablespoon of vinegar and a big glass of water before a meal helps reduce the spike of that meal. And finally, clothes on carbs. So never eat your carbs naked always put some protein fat or fiber on them. If you want to see the million visual examples of this to actually help you like grasp all these hacks, go to my Instagram glucose goddess or pick up my new book The Ghost goddess method full of amazing read recipes that will help you actually fast track to turning those hacks into habits. And I'm going to send you a copy, Scott,

Scott Benner 1:30:05
Jesse, I feel like we're friends. Thank you, you know, I really like I don't like a lot of people come on, you know, and sometimes they're just like, I'm telling you, I'm amazing. No, no, I just, you know what it was that it felt like, it felt like you and I are on opposite sides of mirror saying the same thing, just for two different perspectives. Like I'm just talking about it around diabetes. And you should and so. Wow, it's just it's so interesting, because this whole sounds like this. I don't know how the system but I'm not blowing my own horn. But I figured this all out by myself. Yeah. And and I only figured it out, trust me, because it was for my daughter. Yep. And then once I had it, I used to write a blog. And the blog was popular. But then people stopped reading and I don't know what happened to all of you, but you don't like to read anymore. And so I was like, Well, how do I do this? I almost stopped. In 2014. I almost stopped writing my blog and just gave up. But I knew I was helping people. But they weren't reading anymore. And to tell you have weird story. I wrote a book about being a stay at home dad. And I found myself on a soundstage in New York being interviewed by Katie Couric. And when it was over, she grabbed me as I was walking away. And trust me, I was just excited to be there. Like I had had a car home. And I was like, Oh, I was so excited. And I'm just walking away. I'm a little jacked up. And she grabbed me by the shoulder and turned me around. And she said, You're very good at this. And I said, I don't know what you're talking about. And she said, talking to people she had there were like, 500 people here. There were other guests. She's like, you didn't feel it when the others were talking. They were just thinking, let that guy talk again. And and I said, Oh, I didn't know I said, I did feel that I had him one time I said something funny. And I watched everybody, like go like this. And it's a weird feeling. Like I felt like a magician for a second. And I said, Okay, thank you. I didn't know what to do with that. But about a year and a half later, when I started thinking like this blog is not going anywhere anymore. I thought, Oh, I wonder if I like Katie Couric did say I was good at talking to people. I was like, maybe I'll start a podcast. And then I got lucky. It was just the first diabetes podcast. So then I kind of was able to build on it. I learned to treat it like a business, not like a hobby. And only by that I mean, like, a lot of time, a lot of effort, a lot of content, no fluff, like that kind of stuff. And, and now like, I used to get like one or two letters a month from people. And they were like, Hey, your blog helps me. And now I get about like 20 or 30 a day. Oh, super cool. Like, and I think you might be like, in a position where you're doing the same thing? Yeah. Yeah.

Jessie Inchauspé 1:32:53
And you know, it's interesting, because neither of us have diabetes. Yet, we became really fascinated by this topic for different reasons. And I think whatever we can do to help people understand their bodies more is just so incredible. And so I'm so happy that you were able to turn it into business. So you can actually keep doing it. And I'm so happy that and I get paid to do this and write books. So I can keep doing it too. Because it's so important. It's the

Scott Benner 1:33:17
part that sometimes people don't realize is that if I always tell them, like, Look, if the if the podcast didn't have ads, what you wouldn't have as a podcast, because I'd be working somewhere else to pay my bills. And so it's a real, it's just a real great moment in time, where there's actually access to technology that reaches people and a way that to make it viable for you to be a thing you do. You know, it's really lucky. I actually think it's going to push humanity forward and a lot of ways, much quicker than we could before people could pull their phone out of their pocket and listen to something amazing

Jessie Inchauspé 1:33:50
what we can learn these days yet most of us just look at cat videos on the internet, not me.

Scott Benner 1:33:57
I hear I'll tell you something. I opened up Tik Tok this morning to check up to put a post up and I just have my daughter's roommates in college, make videos for the podcast. And then I put them up, right. And I went to put one up, and I don't know what happened, what came up in front of me. But 15 minutes later, I found myself saying Scott, what are you doing? Like put the video up and get out of this app, like, you know,

Jessie Inchauspé 1:34:22
just pulls you in? It's so it's so good. So powerful. And so it's scary.

Scott Benner 1:34:26
It's funny, right? Because you either get something, it's like gambling. It's like a slot machine. It's like either get something you want, or you get something and you think oh, the next one will be better.

Jessie Inchauspé 1:34:36
Hey, and what's that molecule that happens? Dopamine. Yeah, brought

Scott Benner 1:34:40
it back around. Don't worry. I completed the circle. All right. You were really lovely. Thank you so much. Thank you Scott.

First, I'm going to thank ag one athletic greens.com forward slash juice box get a green drink that you can actually drink And of course, I'm the pod makers of the Omni pod dash, and the Omni pod five, get started find out more, all the things you need to do are doable at Omni pod.com forward slash juice box. When you use my links, you are supporting the production of the show and keeping it free and plentiful. And last but not least, I want to thank Jessie, check out her new book, The glucose goddess method available right now on Amazon, or wherever you get your books. And Jesse is on the Instagram if you're looking for you want me to tell you where you would think I would have had this information prior to making this recording, but I did not. Instagram Jessie is at glucose goddess. It's that simple. Thank you so much for listening. I'll be back very soon with another episode of my award winning podcast. It's not really an award winning podcast. You know why it's not an award winning podcast? Actually, this just came up the other day. You have a second? I mean, of course you do. Right? You just couldn't move to another podcast or clean the house or something. Go for a walk. You've got a minute. Somebody said to me recently, this podcast talking about different podcasts. They say it's an award winning podcast. And I said well, yeah, all you have to do to win an award is enter into some sort of contest and win it and there are many contests that no one enter into. So say you're the only Aardvark pruning, they prune aardvarks. No, let's try something else. Let's say you're the only sheep shearing podcast in the world. And you submit your sheep sharing podcast that no one else does. Then you win. And you're at our award winning podcast just like that. I don't need to win an award. I've already won my award. Do you know what it is? It's all of you. It's the great way that you embrace the show. Listen, download and share it with others. That's all the award I need. If you ever see that this is an award winning podcast. I got really desperate are really bored one day. Anyway, thanks again for listening. I'll be back very soon with another episode of The Juicebox Podcast. By the way, I wrote a book a long time ago it won an award. Do you know how it won an award? I publisher sent it out for Awards and won an award. I think it's like the mug here. This is embarrassing. Hold on. I'll find that for a second. Life is short. Laundry is eternal. Not a bad title. Award. Here it is. It won the hilarious but what it does, I don't want to give away the farm but it does that puts a big gold seal on the cover online. It's an award winning book, you know, assault both the 2013 Mom's Choice Award winner. Life is short laundry is eternal Confessions of a stay at home dad by Scott Benner an award winning book award winning podcast at the theater

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#901 Out and About and Full of Doubt

Amanda’s son has type 1 diabetes and she has rheumatic health issues and some other stuff going on.

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

Scott Benner 0:00
Hello friends and welcome to episode 901 of the Juicebox Podcast

Welcome back, everybody today on the podcast I'll be speaking with Amanda. She is the mother of a child with type one diabetes. And I love the title of this episode. While you're listening to our conversation today, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your healthcare plan or becoming bold with insulin. If you have type one diabetes and are a US resident, or are the caregiver of someone with type one, completing the survey AT T one D exchange.org. Forward slash juicebox is incredibly valuable. T one D exchange.org. Forward slash juicebox. Maybe take your 10 minutes to complete the survey. You're going to help diabetes Research type one diabetes research to move forward. Simple questions, simple answers, HIPAA compliant, absolutely anonymous. It will only take you 10 minutes. I think you're basically just sitting on your sofa right now anyway, touched by type one.org. Do me a favor, please complete the survey.

This episode of The Juicebox Podcast is sponsored by cozy Earth, you can get the most comfortable and delightful sheets, towels, joggers, and more at cozy earth.com. And when you use the offer code juicebox at checkout, you will in fact save 35% on your entire order. Cozy earth.com juicebox at checkout, you're all done. The podcast is also sponsored today by Dexcom Dexcom, makers of the Dexcom G seven and G six continuous glucose monitoring systems. My daughter just got her first delivery of the g7. And just about to embark on her new journey with her smaller, lighter, very accurate, continuous glucose monitor from Dexcom. You can to dexcom.com forward slash juice box.

Amanda 2:25
So I'm Amanda and I live in the east coast of Canada. And I have a son Boyd who was diagnosed July 9 last year.

Scott Benner 2:36
Okay, so let me make sure I understand Boyd is how old nine.

Amanda 2:41
Yes. So he he was just about to turn eight when he was diagnosed.

Scott Benner 2:46
Okay, urine a month ago, 13 months ago, you already said a bit. So that's great. You don't know you did it. But I appreciate your about that was very Canadian. And we're well on our way. Okay. So you have a lot to talk about. I think

Amanda 3:03
I have a very lengthy story. Do you

Scott Benner 3:07
want to? Do you want to start with your story? Or do you want to talk for a little bit and get to your story?

Amanda 3:12
Whichever, wherever you want me to start? Interesting. Okay. Well,

Scott Benner 3:15
let me make sure I understand the backing of the story. So any other kids?

Amanda 3:22
Yeah, I have a daughter, Nora, and she just turned 14. Okay, married, not married. Married my husband Ryan. Okay.

Scott Benner 3:32
Daughter's 14. Any other autoimmune stuff? Oh, yeah, we

Unknown Speaker 3:38
have a lot.

Scott Benner 3:40
At ease with the kids.

Amanda 3:43
I know. This is the first with the kids, but I've battled with different things since I was probably 15 years old. Okay, how old are you know? I am 42.

Scott Benner 3:55
All right. What was your first thing? Well, when

Amanda 3:58
I was about 15, I started with joint pain. And it just got worse and worse. And they diagnosed me with juvenile arthritis. Okay. And I was medicated for that. And it was pretty bad. I had to stop school for a semester. And we did get into remission and I didn't really have a lot of problems until I had Nora on my daughter. And then it was about a year after I had her that I had started having symptoms and stuff again.

Scott Benner 4:40
So the joint pain came back after you gave birth. Yeah.

Amanda 4:43
And they say that that can happen with rheumatoid arthritis. That it causes like a flare up after you have children's so I did go back to my doctor that because I wasn't on any medication or anything for years. And it did take them a while to get me in. And eventually, I did get into a rheumatologist again, and they started me on Plaquenil is what I was taking. Are you Yeah, after

Scott Benner 5:14
her birth? Can I? Yeah, back when you were a kid, what did they give you?

Amanda 5:19
It was the same thing. Plaquenil and then just

Unknown Speaker 5:23
pay like,

Amanda 5:26
went away. And then I stopped taking the medication. I was good through my 20s and stuff.

Scott Benner 5:32
Okay, so you took that? I'm sorry, I think you might have like, flipped out for a second. So you took the plaque when I was a kid for how long?

Amanda 5:42
It was probably about maybe a year or so.

Scott Benner 5:46
And then you stopped taking it because the pain disappeared?

Amanda 5:49
Yeah, I just I thought I first tried to go off it and, and it did come back. And so I stayed on it for I can't even remember how much longer and then went off it again. Months later, maybe? And then it didn't bother me again, like, in my 20s at all, really?

Scott Benner 6:12
And is that your diagnosis of Ra.

Amanda 6:15
Um, they did. When I went back to the doctor, they did more testing, I didn't have a lot of, they've always told me I don't have a lot of inflammation markers. But I did test positive for anti CCP, which is a big marker for rheumatoid arthritis. So that's basically what they diagnosed me with. And then it did go on to like chronic fatigue. And I also got a diagnosis of fibromyalgia as well.

Scott Benner 6:50
Are those is that the, the full host of your issues? Or is there more?

Amanda 6:56
Well, ADHD and anxiety, a little bit of that as well.

Scott Benner 7:00
Okay, so and then I did make a list now. ADHD, I'm going to get out of my anxiety, ra, Fibro. And you said something else, fatigue,

Amanda 7:15
chronic fatigue. Now, when after I had, I did get in pretty good health before I had my son, so there's five years between the two of them. And I was off all medication had my son and then it started up within a few months, I started having joint pain again. And until he was probably I think it was three, like I had a lot of pain issues and back and headaches and stuff. And I ended up for I had my son, I started with a lot of pain and stuff again, within a couple of months. And it just got worse and worse until he was about three and I had a lot of back pain and headaches and like pain down my legs and joint pain. And I my mom was talking to somebody, a relative who had Lyme disease. And she thought, Wow, this sounds a lot like Amanda. So she had told me about it. And then I got in touch with like our local support group. And they put me in touch with a doctor in Maine and he had blood work done on me and I did have some markers that showed that I had exposure to Lyme bacteria. But it's very, like things are very different in Canada. They don't do a lot of testing for it. And a lot of doctors are skeptical about Lyme disease. But I did end up going to him in Maine so I traveled down every three months or so and see him and he gave well he he's probably the only doctor that really actually helped me because at the point when I went to visit him I couldn't even sit in the car like it was it was like four hour drive and I would have so much pain by the time I got there like just my back and the back of my head and stuff and I was in pretty rough shape.

Scott Benner 9:34
So he What do you do for you?

Amanda 9:37
Well, he he treated me for a lot of different things the symptoms like he said so he he's the only doctor that really actually helped me like I remember spending at least four or five hours in the office with him just talking about like the different symptoms and he tested for so many different things that they wouldn't test here in my city. So he thought that I probably had exposure to the Lyme bacteria when I was a teenager. And that's what cause the flare that I had so and then it just kind of goes into remission. But then when your body gets exhausted and tired or stressed, it can flare up and trigger other things to happen. So, I mean, he treated me with some of the same medications and some let me think like any depressants like that for pain as well. And I did do some rounds of antibiotics. And, and that was like injectable antibiotics. And it seems I don't know if it's just a fluke or

Speaker 3 10:59
what, but after that, I did start to get better.

Amanda 11:04
And I was probably at the best I had ever been, just before my son got diagnosed,

Scott Benner 11:11
did his diabetes, the stress of his diagnosis, put you back into an issue, are you okay? Now? You're pretty tired. I might just be diabetes, but I hear what you're saying. So. So diabetes is no secret, not easy to deal with. But Dexcom makes it much, much easier. Being able to see your blood sugar or a loved one's blood sugar in real time is a gift that I don't know that I can quantify. But right now I can see my daughter's blood sugar, and she is 700 miles away from me. I can see the number. I can see the direction it's moving if it's moving, and I can see how fast it's moving. Arden just had a meal. Her blood sugar's elevated right now around 150. And I'm watching it come down. It's happening the way I expected to happen. This is just the greatest comfort to us. And a huge help for her while she's away at college, and managing her own blood sugar. This can be the same for you as an adult, or as the caregiver of someone my daughter's age, or even younger. The speed direction and number at your fingertips right on your iPhone or your Android phone. It's just me, you should just get it dexcom.com forward slash juicebox. It's hard to sell something that, in my opinion is so obvious, right? It doesn't need a sale. I think you just need the PE dexcom.com forward slash juice box, go get it if you can. It's amazing. Seriously, seriously. I don't know. It doesn't require selling, it requires education. Just understanding what it can do for you like seeing in real time right in front of your face in a way that's understandable and easy to digest. I ate something or my kid ate something and I'm watching the blood sugar. I see what happens. I see what happens when I put the insulin in here versus when I put it in over here. I see it and then I can make decisions about it. I can fix it or do it better. dexcom.com forward slash juicebox please take my advice and check it out. While you're out buying things, get yourself some super comfy cozy sheets or towels or sweatpants or scrunchies or so much socks cozy Earth has it all cozy earth.com Premium stuff. I'm not kidding you. Super soft, super like washable and resilient. You're going to love it. I have the sheets in the viscose bamboo. I have some joggers, a sweatshirt and the viscose bamboo. I've got some towels coming. You can't go wrong with quality. And you can't go wrong with comfort. I mean, especially coming out of the shower, like all your bits are available. Should be nice to them. You don't I mean, and when you're sleeping. Oh my goodness, what are you gonna be hot and sweaty while you're sleeping? No, no one wants that cozy earth.com Now here's the thing. You go there, you get whatever you want. You put it in the cart. And then when you check out juice box is the offer code that saves you 35% On your order. I'm telling you 35% That's a lot. That leaves you only paying for 65% of it. Which is that right? 65 Dammit. I might have got that wrong. Give me a second 6535 and I take the five and the five and make it a zero then I put a one over here. So I get a zero, a six three and a one six plus three is nine was 110 Yep, that's right. Cozy earth.com use the offer code checkout to save 35% off your entire order. My math is rock solid

Amanda 15:24
Oh, I'm pretty tired.

Scott Benner 15:26
It's hard. I might just be diabetes, but I hear what you're saying. So yeah, so So for all your stuff. Basically, they gave you kind of high impact antibiotics. They gave you an SSRI for the pain.

Amanda 15:44
Yeah, and I was on neuropathy medication as well, because I had a lot of like, just weird sensations and tingling and pains in my legs and arms. But the doctors Hiro is just stuck with like, it's the rheumatoid arthritis, but they never did. Like I love my doctors here. And they're great, but they just never seem like they really listened. And I always felt like I almost like they thought I was making things up, which happens

Scott Benner 16:15
a lot. Did they tell you just to go have a Molson and take a brisk walk? And you'd be okay. Pretty much. Yeah. Amanda, if you can just get through this a little longer. Yeah, I appreciate you're about still they're really coming fast and furiously. I'm enjoying them very much. It's a good time. Okay, so you, that all happen to you. That's terrible. So in your heart, do you think you have autoimmune stuff? Or do you think you have autoimmune stuff that was kind of kicked into gear by a tick bite? Or do you not even know how to think about it?

Amanda 16:51
I don't even really know. I'm not sure if I have rheumatoid arthritis. I've said that to my doctor. And she's like, No, you're you were positive for the anti CCP. And that's America. And but I don't know if maybe lupus or because that's in my family as well.

Scott Benner 17:13
You have people in your family line that have lupus.

Amanda 17:16
Yeah, yeah, I do. And I do have an aunt on my dad's side who she experienced joint pain and like when she was younger as well, kind of kind of the same thing as me. But I have like on my mom's side, there's a couple of them that had lupus as well. And my sister my niece, they have different joint issues and problems too. But I also have thyroid issues in the family as well.

Scott Benner 17:47
Does any do any of your issues impact your digestion?

Amanda 17:53
My stomach bothers me some I did. That's one of the things that the doctor in Maine helped me with I get on like a gluten free. So I do I eat gluten some just more like if we're out somewheres but and I don't eat dairy. And I eat lower sugar. Unless I'm having treats.

Scott Benner 18:19
Okay. All right. So before we move on, just can you say Out and About for me? Out and About. Thank you. That's so amazing. Thank you so much. Because you don't know what you sound like when you say it. But it's delightful to me. Oh, great. You'd like out and about that fantastic. Thank you made my whole day. Okay, so your son's diagnosed with type one. Is there any other type one in your family line?

Amanda 18:50
Yes, my dad actually was type.

Scott Benner 18:55
Campbell believe you broke up again. Damn it.

Amanda 18:59
And also two adult children. They're adults now. But they would be my cousin's kids. So they're in the same generation line as my son were diagnosed when they were about the same age nine. I think

Scott Benner 19:15
I'm gonna stop you for a second because you started telling me that your dad had type one. I lost you again. So here's what I'm gonna do.

Hey, hi. Hi. Good. All right. Let's cross our fingers that that did something.

Amanda 19:33
Okay, you're way louder now because I got my husband's headset.

Scott Benner 19:37
Oh, you sound much better too, by the way. Yeah.

Amanda 19:40
It's playstation one so.

Scott Benner 19:43
Well, okay, so we're back. We did a little bit of updating to some software. And I asked you if there was any type one in your family and you said yes, my dad and then I

Amanda 19:53
lost you. Okay. Do you want to know but my dad,

Scott Benner 19:57
I want to know about everything you were saying when I couldn't hear you. Okay, yes. So

Amanda 20:01
my dad was diagnosed as an adult, probably in his 30s, I think. And he also are my cousins. on his side of the families. There's two children in the same generation line as my son Boyd. And they were also diagnosed when they were about the same age.

Scott Benner 20:24
Okay. So your father and two other relatives on your dad's side who are your son's age? Yeah. Okay. So that's for now. All right, and you said there's thyroid in the family, too? Who's got that?

Amanda 20:41
Um, I believe that I probably do. I did. That's one thing that I was tested for when I was in the States, and they haven't done any testing here, but I did take like a low dose dose of the Synthroid. For some time. I have my bloodwork stuff out, in case you ask,

Scott Benner 21:04
Are you not taking it now?

Amanda 21:06
No, I'm not.

Scott Benner 21:08
I didn't Well, you're tired.

Amanda 21:10
I'm not sure. I wanted them to test me again here. Before I tried it again. But I did. I don't know if it was too much. Because I was like, sweaty a lot. And just like, I felt like it was too much.

Scott Benner 21:27
Or taking too much. Probably. Yeah, yeah. So you how much do you remember how much you were taking?

Amanda 21:34
It was only 25. Okay, milligrams. Yeah.

Scott Benner 21:38
Were you losing weight?

Amanda 21:40
Uh, no, I was quite heavy at that time. Just because I was also taking something else that was making me gain weight.

Scott Benner 21:49
I wasn't sure if you were hyper maybe like, if you had hyper, if you had taken so much Synthroid that you were too low. Your TSH was too low. That's what I was trying to figure out.

Amanda 21:58
Something like that might, uh, went on, I was looking at my blood work. And the last one that was 2021. My TSH was low. And my T four was

Scott Benner 22:13
up. What was your TSH?

Amanda 22:17
Do they measure it different between Canada? And

Scott Benner 22:20
I don't know you're about to find out. It should be like about like a one to 10 scale.

Amanda 22:24
Yeah. Now secure. You're gonna hear my papers probably.

So point

Scott Benner 22:40
two, six. Yeah. So little high.

Amanda 22:44
And then at that time, because that was in April 21. Oh,

Scott Benner 22:48
wait, two? Not two. Point. 6.26. Yeah, that's what it says. Alright, so

Amanda 22:55
then my T four was 15.9.

Scott Benner 23:03
So your idea now is to go get more blood work done. But are you having trouble getting someone to do it for you?

Amanda 23:09
No, I could probably my family doctor would probably do it. I procrastinate a lot, because I'm so busy with everybody else's issues.

Scott Benner 23:20
Well, take a day and do that for yourself.

Amanda 23:22
Yeah, my grandmother. She has like my mom's mom. She's always had thyroid issues.

Scott Benner 23:29
Okay. So do they medicate for it? Yeah, she takes them through it as well. Your mom's mom's alive, though. Yeah, she's

Amanda 23:37

97. Jesus.

Scott Benner 23:40
That's really old. Yeah, she's

Amanda 23:43
a happy little one now.

Scott Benner 23:46
Probably the cold keeps her going. Yeah, probably. Yeah. Okay. Well, what was Pope was the What led you to believing that your son needed to go to the doctor before his diagnosis?

Amanda 24:04
Well, I always like it's funny, because I always had like this thought like, Oh, what if one of my kids have diabetes, like my dad did. And so I always had it in the back of my mind, and I always watched for it, but I never realized how much I didn't know about it and like, not know what to look for. Now, Boyd has always been a very fussy little guy ever since he was a baby. And I always felt like something was off with him. Like, even when he was an infant, like he had like, sores in his mouth. And I took him to the doctor. I took them to like our dentist, they sent him to an oral surgeon to have a look in his mouth at these sores, canker sores, and they never ever could give me any answer. And I kept saying like They come and they go, and they come and they go. And then eventually, when he was probably over one, we didn't really see many of them. But he was always tired, and just irritable and could never keep up with the other kids. And, and I, one thing why I wanted to be on the show is because I, when I first found the podcast, I listened to some ladies, I tried to find the episode that it was and it was about someone who had a lot of regret and stuff about not seeing the signs and stuff like that. So that's one reason why I wanted to come on because I, I really didn't see what was right in front of me. And I could have took him to the doctor. And I had, I had a hard time with the doctors because I was wrong with me or the kids. So I put it off. And at the end of his, I guess 2021 school year, he was drinking a lot of water. And we just thought that maybe it was hot out and stuff like that. And he was very irritable for a couple of weeks, and I reached out to his old kindergarten teacher. Because I had, I had urine analysis test strips that I had for myself, and I just got him to pee in a cup one day and the glucose on it was like at the highest it could be on the test strip, and the ketones were on the highest as well. So I reached out to her because I knew her son was diabetic. And I just had this weird feeling that something was going on with him and and when I did the urinalysis test strips,

did you get that part? Yeah. That they were at the highest

marker on them, right. So I went and got a meter at the drugstore. And did a test on him without him knowing because he's pretty high anxiety. So he would never let me prick his finger anything. And it said 33 over 33 Actually it said. So she encouraged me like to take them to the hospital. And I was still questioning like, should I take them up there? It's like, during the middle of COVID. Maybe it's not really this and I guess I just it was hard to believe that it could possibly be diabetes, like my dad,

Scott Benner 27:47
even though that's something you worried about? Yeah. Which is funny.

Amanda 27:50
So. So we ended up taking him and it was it was late at night he had fallen asleep. And we took him and he I mean again he couldn't they couldn't even read his blood glucose. It was so high. It just said high on the meter. And they admitted him like right away and started on IVs. And they had to give him Ativan to calm him down because he was so hysterical. And yeah, so he was in DKA. His a one C at that time was I think it was 12.7. So he was a sick little

Scott Benner 28:36
boy. Yeah. Well, I'm glad to talk him, obviously.

Amanda 28:39
Me too. And I thank her like, every day I send her updates all the time. Because she basically, she saved him because I would I think I would have kept doubting that. I don't know why. Because I'm usually very, like, notice everything that's going on. But maybe I was in denial that it could actually be something serious.

Scott Benner 29:06
No, I understand. And so now you're kind of torturing yourself over that still a year later.

Unknown Speaker 29:12
Yeah, I still do. I

Amanda 29:15
I think about it a lot. But I can I remind myself that, like I didn't really know. And he's okay, so yeah, it's still hard. No, I

Scott Benner 29:27
understand. But there was really no way to know. I also think I might name this episode out and about full of doubt.

Amanda 29:35
That's awesome. I'm definitely full of doubt all the time.

Scott Benner 29:42
Well, I mean, you're you're past that now, though. I mean, I don't know what you do to let go of it. All I can tell you is that most of the people I've spoken to in your situation, feel it in the beginning and it lessens over time.

Amanda 29:55
Yeah, and I know I remember. I don't even know how I stumbled upon the podcast, I just seen something and then went to it and started listening. And I just remember standing like crying, because I couldn't believe that there were other parents that felt the same way. Like I thought I was the only one that felt like that.

Scott Benner 30:16
Do you have a real like, conscious thought? Like I'm alone in this? Or is it just a feeling like when somebody says, I found community, I realized other people felt like me, I thought I was the only one who felt like this. Did you? Did you really think that? Did you really have like a conscious thought? Like, I'm by myself? No one else knows how I feel? Or is it just a? Is it just a feeling? Or an Express?

Amanda 30:43
No, I really did. I did. I guess I I didn't know that. So many people would feel the guilt that I felt for not seeing and letting it go on for so long. Kind of thing.

Scott Benner 31:00
Sort of this expectation that everybody's better at something than you are? Yeah, I probably think like that a lot. Yeah, that's probably not true, by the way.

Amanda 31:10
But I I know, I'm good at this. It's taken a while but like, I've surprised myself in like his management. I know I can be really good at it. And I'm learning a lot and I've put everything into it. But I probably wouldn't be where I was if it wasn't for you in the podcast and the whole

Unknown Speaker 31:35
Facebook group.

Scott Benner 31:37
Yeah. You got into that very quickly after diagnosis into the Facebook group. Yeah,

Amanda 31:40
it was September. So and I asked a lot of questions. I was like, Oh, my word people are gonna be so annoyed with me. But there were so many people like strangers that were willing to help out and give advice. Like, I probably sometimes put on three questions a day just to get this support and see what other people were thinking and, and know that I was kind of like on the right track.

Scott Benner 32:09
I'm scrolling through your posts right now.

Amanda 32:13
Oh, no.

Scott Benner 32:14
I'm just like scrolling. They're, they're limitless. I feel like I feel like my fingers gonna get a cramp. If I keep scrolling. You probably will. I don't know if I should be happy. I mean, Amanda. Yes. Sorry. You disappeared again. But sorry, I have no idea what's going on. It's like the last couple of days this is happening. It's not my setup, but might be the internet. Maybe everybody's home from school using the internet and they should stop and go back to what they're supposed to be doing. So I can make my podcast plus your what do you do probably like on like, the tip of an iceberg or something like that. Wherever you live, right? Sorta, yeah. Are you really know? Maybe like, right in the middle of Toronto or so?

Amanda 32:59
No, no, definitely not. Oh, yeah. Those people who? Um, braid on the river,

Scott Benner 33:04
so nice. Well, anyway, so you posted a ton. And as you're thinking, like, Oh, I hope people aren't bothered by this. What I privately think is, this is terrific. Because your questions, got conversations moving.

Amanda 33:25
Yeah. And I did notice that like, and some, they would lead to different conversations between other people in the threads. And then I was able to learn more just from them changing the topic to something a little bit different.

Scott Benner 33:43
Yeah, I had a person one time put a post up. It only happened once. They said, this group is full of information, you should do a search and stop asking questions over and over again. I message that person I was like, Hey, stop it. Like was like you fundamentally misunderstand what this group is. It's not a encyclopedia. Like like people who think that Facebook groups are already have all the answers. So just go find them. That's a quick way to kill a Facebook group.

Amanda 34:13
Yeah, it's, I mean, every day there's a different topic and different people's lives, like what they're going through. And it's you pick something from it. Yeah. And I was really embarrassed at first to share because I'm not like, like, my Facebook page is just like silent. There's nothing on there. But like to open up and share and ask the questions was like, like, I was really nervous about that. But at one point, I was like, You know what, it's for my son. I'm gonna do this and, and it's helped like so much. So I always post whenever there's people like new people always say like, listen to the all the episodes and ask questions.

Scott Benner 35:00
Yeah, it's very, very helpful. It's not just helpful for them. It's helpful for the, for the group to, like, I can't if if I made it my life's work to just manage that Facebook group. Just me. I'd never do anything else. No, probably not. Yeah, average of, I think it's right now 80 to 110 posts a day. That's crazy.

Amanda 35:22
Yeah. And 75 of them are probably mine.

Scott Benner 35:28
And I don't, I'm not even aware that groups at the point now if people tag me, it's even a crapshoot of I'll see it.

Amanda 35:38
But you're there, you're involved. And it's like, really something to see. Like, you comment to things like, because you're taking your time to do that. And you don't see that and a lot of groups and stuff. I'll tell

Scott Benner 35:51
you, there are moments. Like last night, I was sitting here, headphones on editing a show. So listening to a show with with a mouse and a keyboard to my left in case I needed to do something to that. On my right. I was building a web page for content that's gonna go up in a couple of days. And I was talking to people on Facebook saying,

Amanda 36:17
Oh, my goodness, I was like,

Scott Benner 36:20
and then if you go downstairs and ask my wife, oh, don't talk to him while he's doing something. He can't do two things at once. And I'm always like, Yeah, okay. But anyway, it's important, like the group is important. What it does for people is important, and the way it works. Is, is is valuable. If you come on, you don't know, you ask a question. Somebody hopefully steps in and says, Well, let me ask you another question. See if we can get to your problem, or some people will come in with advice. And every once in a while, they're still, you know, there's something happened the other day where I just felt like, there was a moment where I was like, there's like, 20 crazy people in here. If I could just make them leave, this would be better. But yeah, but at the same time, I'm like, It's okay. Like, they were in their own thread. Being crazy. And I was like, yeah, good for them. Like get any like somebody, like, you know, people can report posts. Yes, someone reported it. And it caused me to go read through it. And I thought, Oh, this doesn't matter. Like, let them let them be get an amen. Like they're, they're having their own conversation about something like do I think they're right? I don't do I think they have conspiracy theory issues and should speak to somebody? I do. But it didn't bleed out into the rest of the group. And that just means that there's 109 other posts that day that somebody else can do. And I know it can sound overwhelming, like, wow, there's that many. But it doesn't work that way, the algorithm does a surprisingly good job of pushing down posts that don't find engagement. Oh, really? Yeah. And it's not that people don't get their questions answered. They just don't end up in posts that are like 30 Answers long. If somebody comes in says, you know, asks a question. Next person's like, oh, yeah, this this, this, the other person says, Thank you, and it kind of dies. You know what I mean? But that person still got their, their question answered. So I don't see a better way to do it at this point in time, but the way technology is set up right now, I can't believe I'm saying it. But Facebook groups are perfect for this. So yeah, it's great.

Amanda 38:37
It's, it's my go to for everything. If I have any questions, I'm like, Ah, I'm gonna ask my group. And then they all laugh at me and then gets funny.

Scott Benner 38:47
Well, do you get your answers? Yes, I do. Perfect. Yeah, absolutely. Perfect. And look how you threw yourself into all this for your son. And you really did. So tell people a little bit about like, what the journey has been like, for the first year understanding diabetes?

Amanda 39:02
Um, well, when they told me that he had type one. Like, I was like, Oh my gosh, what? Like, what am I gonna do? He's a picky eater. Like, he doesn't he only has like, 10 things he likes to eat. And just I had even though my dad was type one, I had no idea what it was actually. Like. And we just, I don't even know I just came home and and his blood sugar's were I mean, crazy. In the beginning, I have a book that I looked back and that first little while was just like, above 10 all the time. And, and you can see when I pull up my clarity and stuff, when I started listening to you, and learning more, and there was at some point that I just like I wasn't getting anything for In our local clinic, the group and the podcast was where it was going to learn everything I needed to know. Now Boyd does have a lot of anxiety over pretty much everything. So that was really hard for him. He liked the injections. It was just like crying. Every time he would avoid treats like, because he didn't want to have any more injections than he needed to have. And through the group, I did find one lady had mentioned to me about the Medtronic. They i Poor report. Yeah. Have you ever seen one of those little things? See the picture of it? Yeah. Yeah. So I was like, I'm gonna order that and try it out. So I put them on. Oh, he everything he has on him all his devices we do when he's sleeping. Because he wants nothing to do with it when he's awake. So the decks calm. Whenever we have our Dexcom change night we do it once he falls asleep. He never wakes up sleeps through the whole thing. We do. We did the eye ports that way as well. And he he had said that we made this video one time, I think I sent it to you. I don't know if you've seen it. But we were just sitting at the table. And he was he was like, Can I have a chocolate bar from his Halloween treats. And I was like, Sure, we could just give you the extra insulin for and he had his eye port. So as we were sitting there, he said, you know, my eye port almost makes my life like normal again. Because he didn't have to experience the pain of having the injections. So anything that I could do to make it easier for him. I'm gonna do it. And I'm gonna find a way if there's a way he doesn't like things or bothers him, I'm gonna find a better way to make it more comfortable for him and the eye ports. I highly recommend those. Anyway, great.

Scott Benner 42:04
Is he still using MBR? Now?

Amanda 42:08
No, we're on Omni pod now. Oh, okay. He's been on that since early May.

Scott Benner 42:16
And he's okay with insertion. But it has to happen when he's asleep.

Amanda 42:20
Well, see, I he started with the Omni pod asleep. And we told him you know, it does fail sometimes. So you'll have to do it in the day. The first ones in the clinic, he did do it. And he said it wasn't too bad. But he preferred it when he was sleeping. But the last probably two months, we've had to do Dexcom in the day. And he's doing it awake. He prefers that, like when he's sleeping. But he does do it. And the Omni pod if we need to do that earlier, something he'll do that when he's awake too. So I feel like that I just gave him his own time to get used to, you know, this big

Scott Benner 43:04
life change. And he's making progress now. Yeah, he is he's doing

Amanda 43:08
it all on his own. And

Scott Benner 43:12
that's excellent. Good for him. That's really great. Plus, I mean, how you can't keep that going forever with the sleeping thing. Also, I'm impressed that he can sleep through.

Amanda 43:22
He doesn't but jumped on you if there was some nights we would have to do like Dexcom and Omni pod it would fall on the same night. And we do both of them and he'd stay sound asleep. The whole time.

Scott Benner 43:35
I was making myself laugh while you're talking. I was thinking like what happens if at four in the afternoon, you need to change something? Does he run over on the sofa? Lay down and go to sleep real quick. So

Amanda 43:43
no.

Scott Benner 43:46
But that's really great. I mean, that's terrific. It's in his time you took care of it? Do you really think it was the people say anxiety a lot, especially lately? But do you think it will it's real, like clinical anxiety? Just think it was a nine year old kid was like I really prefer if you didn't stick that needle in me?

Amanda 44:03
No, I think I mean, he's had a history of it with before diabetes, he's just always been anxious and afraid of things and, and scared of new things. And just it's just like that form but it's all once we've get over this hump of like this big life change because you know, he now he used to say like he hated his life and diabetes ruined his life and and you might as well die. He would say he has to have diabetes, and I can't even remember the last time he said that. Like, like he's happy now and he he'll joke about it some and I love insulin. I don't take it all die also. But like he's happy because I think it's because I let him adjust to the new lifestyle on his own. Yeah,

Scott Benner 45:02
no, it sounds like he did a really good job, honestly. And you're understanding the diabetes on top of that, like, what's his agency now?

Amanda 45:10
Well, we haven't had an official lab, a one C done. Because of COVID. It was

Scott Benner 45:17
an iceberg. Just stick with the Joe command. Right. And it's too hard to you know, get the dogs together and go all the way to Maine to get your blood test. So okay, now that my sledding dog right, of course, so and what are you going to feed them? They're hungry, and if you they run, they need more food and exactly busy. So but But what are you getting off of clarity?

Amanda 45:42
Yeah, and I did have one done, you can do the meter when like at the drugstores so at his six months, he was five, nine. Wow. And we're actually next week, he's gonna have the lab a one C DME, but still on Claire.

Scott Benner 46:02
We were doing so good. And say it again on clarity he was.

Amanda 46:09
He's still five nine on clarity. Wow. But it was it was up to. But did you ever notice that in? When you look at the summary unclarity of the A one C and then you look in the AGP. Part of it, it's different.

Scott Benner 46:26
Can I be honest? That's what this is. Right? I don't look at those apps very much anymore. Artists, a one C is about where I expect it to be. If we're doing great, it's 56789. If we're doing terrible, it's 6123. Like in there? Well, not three, usually six to eight. And I just don't I just trust that it's going to work out the way I expect it to because it just does.

Amanda 46:57
Yeah. And I honestly, I'm kind of like that as well. They won't see doesn't really, like it means something to me. But it doesn't because I see what happens every day for him. And I see like, I like looking at the standard deviation. If I can keep that tighter that he's not bouncing up and down all over the place. I'm more happy with that. Yeah. Now with the clarity, like, I kind of lost control after we started on the Omni pods. So maybe a little bit before that. And it did say 6.5. But I've noticed, like, in the last months, like I'm getting more control. And I've also find when like there's, I mean, there's your way of management. And then there's the doctors way of management, right. So every time I go, it's like, I get a lot of fear. They put a lot of fear in me of lows, and and I feel like I'm doing something wrong by trying to keep him in such tight control. But when he is in better control, when at better numbers, I can see that he feels better, right? Yeah, I'm not gonna, I just can't do that. I feel like it's my job as mother, right? So I'm not just gonna let him bounce all around. So I kind of get afraid of the insulin for a little while. And I feel like I'm back on track now. And I'm being more aggressive and things are, like doing a lot better. Just in the last month. When you

Scott Benner 48:43
move from MDI, you had you had a way of doing things. You move to a pump, you had to adjust. And now you're figuring that out. Right?

Amanda 48:50
Yeah. And I'm in a good place. And I'm actually I've built the loop app. Okay. So I'm dabbling in that now. But again, it's something new, so it makes me nervous. But I really want to do it. And I've built the app, and I am just waiting for my orange link because I got an emo link and it was It wasn't really working. Right. So I've had to send that back to Robert. And he's gonna look at it for me.

Scott Benner 49:26
I just bought I just bought another orange like the other day.

Amanda 49:29
Yeah. And I was like, I need to anyway, so I'm gonna get the orange link and try that and it should arrive tomorrow or the next day. But it was amazing. Like the little bit I did try it to see what it could do for him. So right now I've been kind of acting like the algorithm myself just from seeing it for only a few days.

Scott Benner 49:51
Isn't it watching watching the algorithm works. You're like, Okay, I see. Like I see or you see I see where more is needed and where less is needed and How much yeah, it is to make decisions when you've, when you've seen it happen when you've seen that algorithm do stuff. You're like, oh, I never would have thought to put insulin here. That's a great Yeah,

Amanda 50:08
yeah. And take it away. I've been doing like Temp Basal Slyke off and stuff. And I've stopped lows. Like, when I knew it was gonna keep going down. Oh, for sure. And it's worked really good. But my my problem is, well, the basil, I'm always questioning the basil, I can't seem to figure that out. And I know I heard you say once that Arden has more basil in the daytime. So I'm wondering if Boyd needs that because I can, like he's only at point two right now. For basil like his, his insulin needs are very low. Like, it's usually be at between 10 and I think 14 units a day. But that's just because we've been having summer treats and extra food. Yeah. So I can leave him if he's gaming, and sometimes till 11 In the morning, but I'll just leave him alone. And he can stay up point to that whole morning and not need anything and be like in the low fives. And then yeah, and but then as soon as he has breakfast. And then Breakfast has been really good lately. Like I think I he only went up to he didn't even really have he went to 6.9 at breakfast, and then stayed up there for a bit and I had to give him a little more. But then lunchtime. And then after lunchtime till bedtime is like the big problem. He just he stays up.

Scott Benner 52:03
Lunchtime. And what happens if you get more aggressive with it? Well, oh, later.

Amanda 52:08
Yeah. But I can't figure it's really hard. What I find to figure out is all the variables that you have to deal with with a child, especially with the activity, because if I don't give them enough insulin, which I've increased or decreased, I guess his his carb ratio, and it will work. But as soon as he starts playing and stuff, he drops right down.

Scott Benner 52:34
Right? So so that is strong enough. If he's, if he's sitting around, it's perfect. And once he becomes active, there's too much insulin there.

Amanda 52:43
Yeah. So which way do I go? Like, I just, I find it very confusing to figure out that like, but in the last week or so I have been, I've been trying the stronger like insulin at lunch. And it's almost like he is taking double the amount if he just sits around, he needs double the amount of insulin. And he, like he'll stay pretty good, like the breakfast there. And I'll keep it at the strongest or stronger insulin. And then if he's gonna do activity or play with a friend, I will judge it on that and take it away. Is that what people usually do? Do you know what I mean? Yeah,

Scott Benner 53:32
yeah, sure. You do like a Temp Basal decrease over, you know, before the activity and maybe during the first two thirds of it or something like that.

Amanda 53:40
So what because I asked a question in the group there just the other day about, like, when is your carb ratio supposed to work? Is it supposed to work? If they're just sitting still? Is that?

Scott Benner 53:58
The answer is that if they're just sitting still, then maybe there's one ratio. And if they're moving around, there's another? And you just have to maybe be aware of that or shoot the middle? Yeah. And, you know, make up for it on either side. Deal with a with more or less, depending on?

Amanda 54:16
Yeah, and I think that's kind of just clicked recently that maybe I should be more aggressive. And work back like that if I need to.

Scott Benner 54:25
Well, 13 months in Amanda. You're doing great. So thank you. Yeah, I wouldn't I wouldn't beat yourself up about it. Just I mean, it's a what do they say? It's a marathon, not a sprint. Right. So,

Amanda 54:38
oh, it's so much more like I'd never realized what my dad went through or anyone that has type one or a child with type one and a lot of people they, they just they don't understand that it just never stops. Like it's every minute every time Everything he does if he games if he gets upset if he walks the dog, like, every little thing affects his blood sugar.

Scott Benner 55:08
Yeah, it's funny. It's you know what it is, it's um, everything in life is that way, except there are things you can ignore. And or put off till later, right? And diabetes ends up not being one of those things that you can just say like, ah, you know what, I won't pay, like, you know, you get into a fight with like your neighbor, and you walk back in the house you go, I'm not gonna think about that anymore. I mean, they still hate you. And, but it doesn't really impact you in the moment, because you're back in your house. But, you know, when you're doing diabetes, you know, ignoring it, it's funny, right? Because the The goal is not to be paying attention to it constantly. Yeah, the goal is to find stability that exists on its own doesn't need your input a ton. But if you do ignore it, people ignore it on the high side, because they don't want to get low. And then before you know it, you've been in your house for six months, you haven't talked to your neighbor, and you're a one sees eight and a half or nine. And, you know, you've you've done a real disservice to your health at that point. So

Amanda 56:12
yeah, and I'm probably I fear that a lot because my dad isn't with us anymore. He, my dad was great. He was a great dad fun. But he did live, like quite a hard life. He was a truck driver, and he drank and smoked. And and that doesn't really work. Well, type one. So he did have a heart attack and asleep when he was humbled was a 51. Wow, that Moore's around there. But now, the more I have learned, like, I know that it wasn't just the heart attack. I know it was the complications from poor management,

Scott Benner 57:04
and diabetes probably caused the heart attack.

Amanda 57:07
It did. And nobody knew that. And I didn't realize that till I learned so much more like about it, because I know, there was lots of times that we thought that he was just like, on the couch sleeping, but he was probably near diabetic coma or something like he just was all over the place. Yeah. No, it was in their 80s and 90s. So I mean, you didn't? He didn't know in a small town and

Scott Benner 57:39
plus Canada. You know, I'm saying, yeah, no, you have to go all the way to Maine to find out if you have Lyme. Come on Canada do better. Terrible, really bad. You know, I don't want to share somebody's details. But I know a Canadian who's having trouble getting some simple health care right now. It makes me angry. So now

Amanda 57:58
it's different. Yes.

Scott Benner 57:59
Yeah. Well, there's a triage system. Yes, yeah. You call your doctor, you're like, hey, I cut my finger off. Oh, come right in. That's fine. You call your doctor and you say, my finger really hurts. I think it's gonna fall off again. It's fine. You come in about four months? Yeah. So it's and I don't think that the person with a cut off fingers shouldn't get quick treatment. I don't understand why everybody else keeps getting, like why does the system not account for the fact that there are some people in emergency situations, and some people were trying to improve their lives? And we could see them all at the same time? I don't. But I'm right about that. Right. Like, that's how it goes. You kind of get pushed off if your stuffs not as serious. Yeah. You don't want to speak bad about the motherland. I hear what you're doing right now. But it's okay. I'll do it for you. You don't have to say look, there's plenty of problems with the American healthcare system. So but if you have insurance, or cash getting seen isn't one of the problems.

Amanda 59:02
Yeah, exactly. Yeah. No, it isn't.

Scott Benner 59:05
So I gotcha. All right. Let's see. I was gonna make a big point that I lost it when I got annoyed at Canada. Shoot, shoot. owe you I think you mentioned in your note that you weren't really aware of what can happen when diabetes isn't well managed. That the podcast helped you understand that and I appreciate you telling me that because that was a big moment for me. When I decided like let's just be honest about the whole thing. And not just like the parts that are easier to deal with. Like it's unfair. I just I'm not okay with the idea. What do I want to say here Amanda? I'm aware that there are things happening in my life right now. Physically, emotionally, my my. My communication share with other people. Like, I know there are things that are happening that I'm not aware of. Right. But I think you want to be aware of, of as much of it as possible so that you can make conscious decisions for yourself. Like, I can't imagine your poor father 51 years old, the heart attack took him at 51. Is that right? Yes, 51 years old, and he's dying in his, you know, in his bed for something that didn't have to kill him. Not as though you know, and he doesn't get the opportunity to think like pause his heart attack and go, Oh, gosh, I wish I would have known more about how to manage my blood sugar. But it's, you can't just ignore things like this. You can't ignore anything, it's eventually going to blow up on you. But there's a difference between losing a friend, you know, in a relationship to bad communication and losing your life. Because you don't understand that you need insulin and how it works. It's not okay to me. Yeah, you know. So anyway, so you say it out loud. And then some people are like, well, you make people upset when you say that I was like, you know, when they're going to be more upset, when they're 51 Grabbing their chest, in their bed, that you know, then they're going to be more upset, like, tell them now give them the opportunity to help themselves. So I think of it,

Amanda 1:01:19
it really doesn't like it just It boggles my mind. Like I just can't believe the lack of education for diabetes. Like it's like, I really don't know where we would be without, you know,

Scott Benner 1:01:38
you don't have to say thank you so great.

Amanda 1:01:39
Like, I talked about you all the time. Like, everybody makes fun of me, my family.

Scott Benner 1:01:44
Oh, tell them to shut up.

Amanda 1:01:47
But you know what, now my husband, I got him on the group now. So I'd be like, do you Did you see this and he'll like, finish my sentence, because now he's into looking through it, and seeing all the stories and he'll ask me, Did you see this? And so it's really great. I got

Scott Benner 1:02:04
freaked out. When we get in bed. My wife says, Did you see a post in your group that I'm like, You're in my group. Stay out of there. I was like, What are you doing? She's American banks around. But no, I think that's terrific that your husband's looking at that really fantastic.

Amanda 1:02:17
Yeah, yeah. He listens to like all tell him the episodes to listen to. And it really got him on board with what I wanted to do with Boyd and how I wanted to, you know, keep things tighter for him. Yeah. And, like, we work so good together. Like, we're like a plus team. I think

Scott Benner 1:02:41
for you. That's excellent. Well, alright, so is there anything we haven't talked about that you want to I don't want to miss anything.

Amanda 1:02:48
I didn't want to I wanted to know, like, with Arden and stuff, like a lot of people push, like, oh, they have to be independent and do this on their own. And I get a lot of that from my son's doctors and the teachers at the school. And like, I believe in that. But to me when I look at how you like you push hard and to be independent, but I feel like, am I wrong that you take on most of it? Like just so she can still be a kid? Like when she was younger and stuff. I wanted to talk about

Scott Benner 1:03:32
I was talking to somebody in my private life about this yesterday. Yeah, because there are moments even at 18 years old, where I'll say something to Arden and she puts it off or she's like, Yeah, I will. I will. I will. And there's part of you that wants to say like, come on, like you're 18 Just do it. You don't I mean, and there's part of me that says, Oh, she's only 18. And people, generally speaking, don't have to live with problems like this, you know what I mean? Unless they have an issue, like diabetes and other things. So there's a balance in there in my mind. And the goal is to protect their psyche and their experience. And at the same time, be doing things in the open so they can see them and learn from them. And then the next. It's not a problem, but the next step is to transfer it to them. And I see that transfer is a slow process.

Speaker 4 1:04:35
Yeah, that's what I feel too, right. And it's not

Scott Benner 1:04:39
like you're gonna like you can pull your son aside when he's 12 and go alright, guess what, Boyd you're 12 years old. Now. Here's how you Bolus for fat and protein you better not forget because you eat french fries. You know what I mean? And your blood jolly eats Yeah, and your blood sugar is gonna go to 250 If you don't know how to do this, and it's gonna stay there for three hours or a once he's gonna go to seven and blah blah, blah. My dad had a heart attack, like you don't mean like, you're gonna like you're gonna, it's too much. So it's little bits, little bits, little bits, and then you kind of have to step back and do an assessment once in a while, like, are they coming along the way I expect? I think they are. And then once in a while, you have to realize that they're kids, and they're gonna use that as protection. Like, I don't want to do that, you know? Or it's sometimes it's little stuff like, I got a text from Arne last night. Can you bring me my blah, blah, blah? And I'm like, okay, sure must be a problem, right? So I leave where I'm at, I go to where she is. And I give it to her. And I'm like, you couldn't have got this she was I just didn't feel like getting up. And I'm like, Alright, like, let her have that a little longer. She's leaving for college and four weeks, no one's gonna ever do this for again, you know what I mean? And so art is a one see right now, it's probably around six to actually I looked on the app earlier, it is around six, though. And it's because she's been doing more of the stuff recently. And she's learning Yeah. And she's, she's having her own experiences and learning things. And I'm doing that purposely now, before she leaves for school hoping that when she gets to school, it'll empower you to make good decisions, not just not just try something and go, Oh, hell, that didn't work. You know, we found out yesterday that her her first semester classes are pretty much as far away from her living situation as possible. Oh, really? Yeah. And now there's a bus that runs through the, so the campus is kind of spread out through a town. So there's a busing system that she's going to have to use. But still, it's like a 26, block walk to one of her classes. Oh, wow. So she's obviously not going to walk it. Right. And then your first thought is, oh, I guess we got to find the money and buy her a car. You know, because she doesn't have her own car. She uses Kelly's car, which drives around here. And then I'm like, I'll just let her take the damn bus. Like, she'll be alright. You don't I mean, like, it's only a couple months, the first time she's going to be away. I'm like, let her take the bus. And and figure that out. Because it's another learning experience. Exactly. Yeah. And so I get when people say it, they need to understand it for themselves. And I get when older type ones say it, because I think what they're saying is I didn't understand my care. And then look what happened to me. I think they mean that a little bit. And at the same time, I don't understand why you'd have to give it all to them on day one, or because I've also spoken to people who've had that happen to them. And it has not gone well either. Like, yeah, you're you're talking about extremes. You know, and and I don't know why everybody, I don't understand, like, you ask the question. And you get, you know, a group of people feels like they're holding the flag yelling, it's their disease, they have to understand it, give it to them, blah, blah, blah, like you don't help them. And then the other side, it's like, well, they're just kids. Like, like, where's the middle? Like, how did we lose the middle? Amanda? You don't need me? When did the? I think it happened for me? You're Canadian. So I don't know about your politics are different. But when I was growing up, politicians tried to make the middle seem like you didn't have an opinion. And I don't see the middle is not having an opinion. I see the middle is a blend of both sides. Yes. So that's how I think about this. Like, I mean, and just you just can't let it get away from you. You can't let them take advantage of you, too. Yeah. That's hilarious. Amanda. And, hello. Hey,

Amanda 1:08:52
and not think about the diabetes for just, you know, my knees playing?

Scott Benner 1:08:56
Yeah, I mean, I have to stop you. I spoke for six solid minutes. Then you opened your mouth and we lost your thing. So just start over what you just said. I'll fix it later.

Amanda 1:09:07
Now, I can't remember.

Scott Benner 1:09:10
I said you can't manage. Have you? Oh, and

Amanda 1:09:13
I said that. I don't remember. You're gonna cut that out. Right? Please.

Scott Benner 1:09:24
Oh, maybe who knows. But anyway, I'm sorry. I went online like that and answered your question. Oh,

Amanda 1:09:33
I love listening to you.

Scott Benner 1:09:34
Do you really? I'm so sorry. Yes. Hello. Have I tricked you into liking this podcast? What happened?

Amanda 1:09:40
I don't think so. Okay, just great.

Scott Benner 1:09:42
Oh, stop it. I'm gonna go downstairs and live with people who don't think I'm great in a couple of minutes. And then what am I going to do there like I to me, I love listening

Amanda 1:09:52
to about your bantering back and forth. With your family. It sounds like mine. We're always picking out each gather in teasing and going on?

Scott Benner 1:10:02
Well, I don't know, I think when you're around people all the time, no matter what the situation, you know, you don't. You don't see the whole thing I started, I started to share something with Arden and Kelly yesterday. You know, everyone's talking about this thing. This subject right there talking about God, what were we talking about? We were talking about just oh, how our brains work. Right. So about, like, some people have inner monologues and some people don't? Yes. And so we're talking about it. And I don't have an inner monologue. Like, I don't have a disembodied voice that isn't my voice that, you know, that's, that's directing me. I'm saying this wrong. But Arden does, like artists had when she reads the voice in her head, says the words to her. It's, it's how she describes reading, right? Yes. And she's like, What happens when you read? And I'm like, I don't know, I just know the words. She's like, you're not hearing them in your head? And I was like, No, I don't think so. Like, or maybe who knows, like, maybe her description or my descriptions are exactly the same. And because I'm looking like here, I'm looking at a different computer screen right now. Somebody's talking about blood sugars. And it says here, the algorithm has specific things it learns from, it won't learn from what But now, if I go back and look at it again and read it in my head. I don't hear the words in my head. Right. But Arlen does. And yeah, and so we're talking about that. And then we started talking about how we understand things. And she said that she has trouble watching television with closed captioning on because she hears the actor's voice. And then the voice in her head says the words when she reads them. And I was like, Oh, I could see how that would be confusing. And, and then I joked with her, and I was like, hey, what else do the voices in your head saying? She goes, they're not voices in my head. It's how I hear things when I read, like, like, okay,

Amanda 1:12:06
that's too funny. Yeah.

Scott Benner 1:12:08
And then I and then she started talking about how she didn't enjoy taking the SATs, because her brain doesn't work that way. And I would not be good at standardized testing, either. But my son, my son, and my wife would be anyway, this is a long way of saying, then I said, Hey, I'm doing this thing. So I can't tell you what this is exactly. But I'm doing a business thing, right. And I'm working, and I'm working with some people. And it turned out really well. But I'm kind of the one that that told them how to do it. Like, they had pages of notes and ideas. And I got on I got on a call with them with nothing written in front of me. I was like, no, no, do it like this, do this. And this, and this, put this here, this is what's going to work. And they're like, that's great. And I just thought like, I don't know why my brain does that. Like, why did I not need to write it down or go over it or think about it before it happened? And and so people's brains just work differently. Anyway, as I'm telling them that my wife and my daughter start mocking me. Oh, I'm so good at this. I'm like, That is not what I'm saying. They're just they love to tease me. It's unpleasant. Amanda. I don't deserve to funny was literally literally trying to like, expand a conversation we were having at the middle. I talked about my own perspective for a second. They're like, Oh, look who's here. It's the guy with the podcast. I'm like, oh my god, you guys are assholes. So they stopped. And they laughed at me and I stopped talking to him. I was like, Well, now you've enjoyed our conversation. Congratulations.

Amanda 1:13:42
I'm excited. Like, I don't want my kids to grow up. But I'm excited for them to be teenagers like that.

Scott Benner 1:13:48
Yeah. I would like, Tell me more. Why?

Amanda 1:13:54
No, I was just gonna say I like to keep them young and save them.

Scott Benner 1:13:58
I know you feel I've been thinking lately about what it's going to be like to drop bharden off at school. And then take a long ride home. I figure I'll just like devolve into a pool of tears and you probably will swim in. Yeah. Right. Because like, I kept thinking like, how am I gonna leave her there? Like, my son was two and a half hours alive by car. And I could like, I could get up in the morning and think and on a Saturday and say like, I'm gonna go see his baseball game today. I could just I could do it. You know what I mean? get my work done during the week and go do it. I could do that. But Arden is going to be at Best Buy car 13 hours away. Oh, she is Yeah. So that means I'm gonna have to leave her there. And I'm pretty sure I can't do that. So I don't know how to explain to her that when I leave I'm gonna suffer back in the car. Back Oh,

Amanda 1:14:54
yeah, I'd be the same way. Yeah,

Scott Benner 1:14:57
but at the same time I take your point, right. Like I want them to get on older, and I want, it's not like we're going to stop it right. And I want them to have experiences and be happy and sad and do all the things that happen. The thing that bothers me the most Amanda about them getting older. It's the medical stuff. Yeah, I was. I was looking at Arden last night before bed. And I thought I let her down. Like I really did, like, I thought I failed. Like I didn't. I didn't figure out everything that that else or before she left. And then I realized I'm like, Oh, God, is that how I've seen like the last 18 years of her life? That's just trying to get her to a place before she left. You know what I mean? Like to a level or something like that. But I know I didn't do it. Like I tried. And like you said earlier like I everything I tried everything I could think of and we got her pretty far in a lot of places her diabetes is definitely not a not a big concern. Or thyroid stuff is not a big concern. But there's other things that we just didn't come up with answers about. And I hate to say that listening to you earlier about like, stuff like joint pain, even your like it just kind of went away after a while, like I reached

Amanda 1:16:18
a certain certain have joint pain, though. Did you say that one time?

Scott Benner 1:16:21
She does sometimes. Yeah, she gets like her kneel hurt or hip. It seems to fluctuate around her hormones, but you can't really tell, you know, stiff necks, which cracks her neck a lot. She'll get headaches once in a while. You know, just like, I'll see her rubbing her hands, like things like that. And we've had her tested for just everything, you know, to the point to the point where I feel bad even taking her to a doctor sometimes to get out, like, you know, like, because they're gonna want a blood test. And then she's like, this isn't gonna do anything. And she ends up being right most of the time.

Amanda 1:17:00
Yeah. You know, that's, that's, that's just like how I am. Yeah. Well, I say to my husband sometimes. Does your feet hurt like this? Or does your back hurt like this all the time? Like, is this just what it is to be normal? But I don't feel like it is. And that's one of the reasons why I don't think, like, I don't feel like I have RA but apparently that's what they say I do. But it just bounces around and just things a Yeah,

Scott Benner 1:17:30
I wish I know. I don't know how to fit like my back. My lower back is hurt for ever. Like, I like it's just my whole mindset. And, and recently, I had to take a steroid pack for something. And I took it in for 10 days on this steroid pack my back loose as a goose. It was amazing. Yeah. And little things like my digestion works off and on. Well, and for 10 days, perfect. My back didn't hurt. I was eating and using the bathroom the way I imagined a person, you know, exists. I was it going on long enough that I was like, oh my god, this is amazing. It's a real turn. And I stopped taking that steroid pack. And immediately my back started hurting again. You know, and I was like, okay, my back's gonna hurt. I guess that's just what happens to me. Do I have some inflammation? And that, you know, maybe, like, that makes sense. You know? Like, I You have no idea. I do not. Oh, are you talking about it? And yeah, and I've had a stomach since I was like, I don't know. 13. But it doesn't make any sense. Yeah. Luckily, it doesn't make any sense at all. So I have no idea. I assume I'll just fall over one day, and somebody else will take my place on the planet and hopefully their back won't hurt. We'll keep going.

Amanda 1:19:05
I think you'll be around for a while.

Scott Benner 1:19:07
Yes. I don't know. You know what I did the other day, so bummed me out. I contacted homeless. My mom is trying to call me. Give me a second. Mom. Let me call you back in a few minutes. Okay. All right. Her doctor is not doing a good job of managing her blood pressure.

Amanda 1:19:30
Well, is she doing better?

Scott Benner 1:19:32
She is my mom had her cancer removed. Yes. When all through chemotherapy, she got remission. Good designation, and now we are getting ready to move her to where she wants to go live. So Oh, that's good. Yeah, unless her heart explodes because her blood pressure is really high. Trying to try to get people to stop that from happening. Oh my gosh. What was I gonna say? Oh, shoot. Right before she called What was I gonna say?

Unknown Speaker 1:20:05
I forget. Amanda, you are

Scott Benner 1:20:07
no help with us.

Amanda 1:20:09
Ever No, I

Scott Benner 1:20:10
I forget a lot. Forget what you said to Oh my gosh.

Amanda 1:20:16
Oh, what you were gonna do? You were doing something, weren't you?

Scott Benner 1:20:20
I was gonna do four. Oh, yes. Thank you Good job well done. Yeah, I contacted the company that hosts this podcast the other day. And I said, I have a slightly morbid question. I'm sorry. And there's no reason I'm asking this. So please don't worry. It's not like a health thing. I've just found myself wondering. I said, I have a podcast that helps people with their health. And what happens if I die? How do I keep it online? Right, so I'm gonna put this, so I'm gonna put this in here, Amanda. So everyone knows. Okay, you contact the company that hosts my podcast for me. It's called Libsyn. And you tell them, hey, the host of my podcast that I love dropped dead. And he said, you would continue to host it for free after his passing. So somebody has to remember to do that when I die.

Amanda 1:21:15
Okay, but I don't like talking about this kind of stuff.

Scott Benner 1:21:19
Amanda talking about dying doesn't make people die. Don't worry about you're fine. If the way people spoke about things made it so you'd be living on an iceberg. And your son would be riding a beaver to school? Because that's where that's what happens to you. So yeah, no. Anyway, I thought that was really nice. Yeah. Like, we'll just host it. The it will host it for as long as we're in business for free. Wow, the guys like don't die. I was like, alright, well, thank

Amanda 1:21:47
you. Yes, don't die. So.

Scott Benner 1:21:49
But anyway, I thought that was good. And I don't know when this like, when this thing stops being helpful to people, like I'm sure at some point in the future technology or insulin will shift. And a lot of what we talked about here won't be as I don't know it valuable, probably. But for now. No,

Amanda 1:22:07
Scott, I think it always will be. Because it's the truth you like you've lived it's nobody gets taught this way of how to really live with diabetes.

Scott Benner 1:22:22
I hope so. I mean, we've put a lot of time into it by now. Hopefully, it's not just, it's not throw away, you know?

Amanda 1:22:29
Oh, it's good. I started. I was trying to find the episodes that I one of the first ones I listened to this morning, but I went and I was listening to the fear of insulin. One like, that was one of the early ones. But then it reminded me how much I really liked that episode. And just and how much it like reminded me too, yeah, don't be afraid to use insulin. So now I'm going to go back through because I listened to a lot of the same ones over and over. But I'm gonna go back to those early ones. And that one, and what was the other one? Great after I just started?

Scott Benner 1:23:11
Oh, there's the ones on the Quickstart list. Maybe the roller coaster?

Amanda 1:23:15
Yeah, stop the roller coasters, something like that. And just, whenever I think I made a comment one time about, like listening to them. It feels like you're like speaking to me. Like I'm always saying like, how did he know that? How did he know to post that episode?

Scott Benner 1:23:34
You know, I have to tell you, that although I think you just I have to tell you that. Um, I get that comments so much from people. Do you? Yeah. How did they like how did he put up an episode today that was so specific to what I'm going through? And I think really, it's just an indication that you're all going through similar things. Yeah. You know, but I know how it feels like it does feel like like, because it happens to me every day. You always hear me say somebody asks a question. I go, Oh, we were just talking about this the other day, you know, and it's not like, it's not like, I'm not making it up. But it's just, it's the world you live in. You know, I can't wait to for Arden to go away to college and to find out. What I'm going to learn next because of our situation changing because we're clearly going to you know, we're clearly not going to stop talking. Oh, yeah. And she's going to have to get through a situation. You know, where she can say to me like, look, I'm good, and I don't think she feels that way yet. Yeah, I listened. Can I be honest, I don't feel that way. I'm pretty good at diabetes. And there's still days where I'm like, What is like, why is this happening?

Amanda 1:24:48
She, she needs you and I actually somebody said to me like, oh, it won't always be like this. You won't be stressed out like he's gonna be looking after it. Like he'll know what to do some day. And I was thinking like, so all this stress and everything, I'm just going to hand over to him. And now this is going to be like his problem to deal with. Like, it's always going to be the ups and downs and downs and dealing with. Yeah, The Rise and Falls, like, I'm not happy about handing that over, I'm always gonna be there to help him. And I'll always educate myself, as long as he wants me to.

Scott Benner 1:25:28
I feel the same way. I don't, I don't want to feel like that. I'm shouldering all this in one day, I'm just gonna look at it and go, hey, guess what happened? You turned 25 years old. Here's all the crap I've been worried about for the last 25 years. Good luck. You know, like, yeah, although I do think there will be an age that I hit, where, like, I watched my mom. And she just doesn't have the bandwidth to like, touch talk about all like, you know, when you're 40 and 30. And you know, your cousin does something weird. And you talk to your sister about it. You know about your sister's problem with her husband, and you know about your brother's problem, boss, like it's all in your head like that. You do get to an age where you just like, I can't, I can't worry about all this. And I don't think it's a conscious decision. I think it just happens because there are things that my mom used to be interested in and concerned with that she just does not talk about anymore. Oh, no. Yeah, so maybe, maybe. So that's the good news. Amanda. Maybe at the end, when you have to lean on something with wheels to get to the bathroom. You won't have to worry about diabetes anymore.

Amanda 1:26:35
That might be soon with me, though.

Scott Benner 1:26:39
Well, I hope that I made I really appreciate you doing this with me. Thank you so much.

Amanda 1:26:44
It's awesome. I'm so it's so exciting. Good.

Scott Benner 1:26:48
You had a good time.

Unknown Speaker 1:26:48
Yes, absolutely. Can

Amanda 1:26:50
we talk once a week now?

Scott Benner 1:26:52
No, we can't. I mean, I'm very busy. Do you know I have to answer an email right now from a person who wants me to call their friend on their birthday and wish them happy birthday. That's funny. Yeah, I can't do that. Amanda. That's a thing. Like I actually at one point, she's like, can you record a video message for my friend? And I was like, no, no, I can't do that. Well, that I get more than you think. But you guys can see. The world of cameo must give. Give people that idea. I'm like, I don't have like I'm working and I have a life and everything. I can't stop and make videos for people. And I said, I really can't do that. I said, I said, Look, why don't you just tell me figure out a way I can talk to her for two minutes on the phone her birthday. And I'll say and then she sends me the date and it's literally in the middle of Arden's moving to college. So I obviously can't Can you imagine if I walked out of Arden's dorm room or like hey, I'll be right back. I have to say hello to somebody for their birthday. My but they wouldn't even let me back in the room. If not, yeah. So now I have to send this email and say I'm very sorry, I can't do this. So I feel bad. But it is not the only it is not the only call. I got like that. Anyway, all right. Well, it was great to talk to you. Thank you so much. Yeah, hold on one second. Sure.

Well, I'm embarrassed to say I did end up making that phone call and saying happy birthday to somebody, I just felt so bad. I couldn't not do it. Anyway, let's thank Amanda for coming on the show and sharing such a terrific and open story with us. And of course, we're going to thank Dexcom makers of the Dexcom G six and G seven continuous glucose monitors. dexcom.com forward slash juicebox. Get over there. Get started. Let's do it. Speaking of doing it, you can get really comfortable luxury sheets for your bed at cozy earth.com. And then do whatever you want to do them. use the offer code juice box at checkout to save 35% on those sheets, the joggers and so much more cozy Earth. Thank you so much for listening. Thank you so much for supporting the sponsors. I couldn't do this without you. I'll be back very soon with another episode of The Juicebox Podcast. Keep listening, sharing. And of course please subscribe and your favorite audio app. If you're not subscribed, but you're listening, subscribe. Just hit follow like in the Apple podcast app or, I don't know, Spotify, wherever you get audio

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#900 Best of Juicebox: Omnipod 5 Pro Tip: Overview

Omnipod 5 Pro Tips: Overview was first published on Aug 15 2022

This episode is available at JuiceboxPodcast.com/omnipod5

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

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

Scott Benner 0:00
Hello friends, and welcome to episode 895 of the Juicebox Podcast

welcome back to another episode of the Best, the Juicebox Podcast. Today we're revisiting Episode 431, which originally aired on January 22 2001. This episode includes community feedback on the topic of switching from MDI to pumping. It's very informative. So if you're thinking of switching, check it out. While you're listening today, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your healthcare plan or becoming bold with insulin. Are you a US resident who has type one are the caregiver of someone with type one, please go to T one D exchange.org. Forward slash juice box join the registry complete the Scott Benner 0:00
Hello friends, welcome to episode 900 of the Juicebox Podcast

Welcome back to the best of the Juicebox Podcast. Today's episode was originally today's episode originally aired on August 15 2022. It's episode 736. It's called Omni pod five pro tip overview. It is the first of my three part series about how to begin on the Omni pod five. While you're listening today, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your healthcare plan or becoming bold with insulin. As I said, this is the first part of a three part series. They're available to you at juicebox podcast.com forward slash Omni pod five or, of course, right in your podcast player. If you're a US citizen who has type one or is the caregiver of someone with type one, please take the time to complete the survey AT T one D exchange.org. Forward slash juicebox you really will be helping type one research when you complete that survey T one D exchange.org forward slash juicebox.

This episode of The Juicebox Podcast is sponsored by ag one from athletic greens. I start every day with ag one and you can as well athletic greens.com forward slash juice box if you head over there now and get started. You get five free travel packs plus a year supply of vitamin D along with your first order athletic greens.com forward slash juice box best green drink I've ever had. The podcast is also sponsored today. By the contour next gen blood glucose meter. You can learn more or grab one at contour next one.com forward slash juice box you owe it to yourself to get an accurate meter and the contour next gen is just what you're looking for. Hello friends and welcome to part one of my Omni pod five series with Carrie Birgit.

Before we get started today with part one of this three part series, I'd like to tell you that insolate has paid the host of this podcast that's me Scott Benner and my guest Carrie Bergerac a fee to create this content. Kerry is an omni pod ambassador with an ongoing commercial relationship with insolate. This podcast provides general information discussions about health and related subjects. This information the other content provided in this podcast or in any length materials are not intended and should not be construed as medical advice. Nor is the information a substitute for professional medical expertise or treatment. Never disregard professional medical advice or delay seeking it because of something that you've heard in this podcast or read in any length materials. The opinions and views expressed on this podcast and website have no relation to those of any academic hospital, health practice or other institution. Please speak with your health care team if you or any person has a medical concern. And before making any changes to your diabetes management, you can always consult the Omni pod five automated insulin delivery system User Guide for more information. In short, nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your healthcare plan. You are about to listen to on the pod five pro tip overview. The second episode is on the pod five pro tip settings. And the third episode is on the pod five pro tip connectivity. Please listen to them in order as I think that is how they'll best serve you. If you're listening in an audio app, these three episodes went up at the same time so there'll be right next to each other or you can find them at juicebox podcast.com forward slash Omni pod five.

Cari Berget, MPH, RN, CDE 4:22
My name is Carrie forget I am a nurse and specialty nurse and diabetes care. I work at the Barbara Davis Center which is in a diabetes Center in Aurora, Colorado. It's part of the University of Colorado Anschutz Medical Campus. And I love my job I love working with families who have kids with type one diabetes, because I get to help them figure out how to make the most of their lives and still have a great life even though they're having to deal with type one diabetes, which can be really challenging.

Scott Benner 4:54
Don't have type one, is that correct? That is true. I do not have type one. How did you make it to this kind? of work.

Cari Berget, MPH, RN, CDE 5:00
My background as a nurse actually did not bring, like prepare me at all for type one diabetes care. But when I first I've been a nurse for 17 years, and when I first started nursing, I worked in the hospital and I didn't love it because it was, I didn't get to know people enough I was it was too much just put a bandaid on things and not really get to know or help or be a part of anybody's life. And so then I started working as a public health nurse where it would do the home visiting program for young mothers. And so I would go into their homes and support them throughout their pregnancy with health education, and I got to work with them until their child was two years old. So I did that for about seven years. And while I really loved that, too, I was kind of like, well, I think I want something that's a little bit more clinical, but not back in the hospital. And I had a friend from nursing school who had type one diabetes. And I learned a lot about it from her and was just amazed at how, how smart she was and how hard she had to work to manage her diabetes, but also how much self care and commitment it took. And so then when I was looking for another career, the Barbara Davis Center came up and, and I was like, you know, I think I think this is, this is the place for me because, you know, I don't want a job where I'm the, quote, nurse who's, you know, in charge, and I just tell people what to do know, like, I want I want, I wanted a place where I could connect with people and come alongside them and support them and be a team to help

Scott Benner 6:39
him because he you get to make a real tangible difference in someone's life, right? It's not, it's not like emergent care where you just kind of run in and do what you got to do with leave. But you get to know people and see where their struggles and their strengths are. And then and then and lift them up a little bit, which I think is what we're going to be able to do here with these episodes. So I appreciate you very much taking the time to let us know about yourself. We basically have our topics broken down into a couple of headlines. Right. So the first one we have here is what do we need to know before we get started with the Omnipod? Five? And I want to ask you first, how many families have you been involved with so far with Omnipod? Five?

Cari Berget, MPH, RN, CDE 7:19
Well, I've been working with Omnipod, five for over two years now, because I got to work on the clinical trial, which was the study that you do before the device is commercially approved. So I had about 30 families that were in the child from our center, and I was the primary nurse for that study. So I got to train them on the device and teach them how to use it. And then we got to work together to figure out how to use it best. So that's been for the last two years. And then now that the device is commercially available, we're rolling it out in our clinical practice as well. And we've had over 250 new prescriptions for it. And just these last couple months, and then over 80 have started the system. So there's been a lot of a lot of kids and families that I've worked with on the system. That's perfect.

Scott Benner 8:07
So you've got to we've got a couple of years worth of knowledge that we can pull from here, it's going to be terrific. We're going to start simply getting things laid out right. And person wants to start with Omni pod five. What do they need? They need on the pod five? That's pretty obvious. But they're also going to need a Dexcom G six CGM. Is that correct?

Cari Berget, MPH, RN, CDE 8:27
That is true. Yep, the Omni pod five works with the Dexcom G six, and you do need that Dexcom G six in order to use the system. In the automated mode.

Scott Benner 8:37
It's important to remember that these are separate items. You don't get a Omni pod five prescription that ends up bringing you a Dexcom. So if you have the G six, all you need is the Omni pod five. If you have neither, then you're going to need to talk to your healthcare provider about getting a prescription for each.

Cari Berget, MPH, RN, CDE 8:54
Yes, very important point. Okay. The other important point about that is that the Dexcom G six is it really is a separate device in the fact that you need to use it on your own cell phone with the G six mobile app, there is no way to download the G six mobile app on the Omnipod five controller. So that's also an important piece to to understand and that you can't use the Dexcom receiver either if you're using Omnipod five,

Scott Benner 9:22
right. So if you're already a Dexcom G six user, and you're using Dex comms receiver, you're going to need to move your Dexcom on to an app on your phone before you can use on the pod five with it.

Cari Berget, MPH, RN, CDE 9:34
Yes, that's correct. The G six mobile app to be specific. Yeah,

Scott Benner 9:37
thank you. Now you could use on the pod five, right without the G six but you would just be using it as a just a regular insulin pump. It wouldn't be an automated system. That is correct. Yes. Having said that, Carrie. I think if you're gonna do this, like get all the stuff because, you know, right?

Cari Berget, MPH, RN, CDE 9:58
Yes, absolutely not. If you're going to get Omnipod, five, use it in automated mode, that will definitely be the best way to go.

Scott Benner 10:05
Yeah. Okay. So does that mean that you can't use Omnipod? Five if you don't have a smartphone? Well?

Cari Berget, MPH, RN, CDE 10:12
Well, the short answer is yes. But let me give you the more complicated trail have that. So you do need to have the Dexcom G six mobile app in order to operate the Dexcom G SIX sensor. And as I mentioned before, you cannot use automated mode without the sensor. But if you had the G six mobile app on one smartphone, and the sensor was all up and running, and you had already connected it to your controller, the active sensor session, if you already have the Dexcom transmitter in the Omnipod, five, app, either on the controller or your own phone, then once that's up and going, you don't need the G six mobile app within range in order for the pod five to operate in automated mode,

Scott Benner 11:01
right? Well, yeah, we're gonna go over that probably a number of times. So one of the one of the great things about the system is that it's it's self contained within the things that are on your body. So the GS six will talk to the Omni pod five, without the controller for the, for the, for the on the pod five there or without your cell phone, those things could be nowhere near you. And the algorithm can run because the algorithm actually lives, like right on the circuit board inside of the on the pod five.

Cari Berget, MPH, RN, CDE 11:29
Right, the algorithm is directly inside the pod. So the pod itself that is on your body, each one of those pods has the automated insulin delivery algorithm on it. So the Dexcom actually sends the glucose data directly to the pod. And then that pod uses that CGM information from the Dexcom directly to calculate how much insulin to give. So yes, you do not have to have the controller, the Omnipod five controller nearby, in order for the automated insulin delivery to occur,

Scott Benner 12:02
okay, so we have our stuff we got, we got our gadgets and gizmos on our websites, and we know what we're doing. And we got to get started, right. So some people are going to train in person with a CDE or a nurse practitioner, whatever they have available to them. Even I guess, I'm guessing through people that on the pod provides. Is that true?

Cari Berget, MPH, RN, CDE 12:21
Yeah, there. I mean, it depends on your clinic, there's a variety of ways that clinics might go about training their patients on insulin pumps in general, a lot of clinics do use the industry trainers, so they'll have a trainer from Omni pod that covers their clinic, and that would be the trainer that they would Gotcha. They would work with Yeah.

Scott Benner 12:40
Now there's also like an elearning situation, right? Where you can go online and take no walkthrough. Isn't that great, I don't have a job, carry, I don't have a job. So I don't get to do things the way other people do. But I hear a lot of people train online and stuff. But that, but I did take the online training from the pod five, and I'm assuming that's available to other people as well.

Cari Berget, MPH, RN, CDE 13:01
Yeah, it's available to everyone who's a current Omni Potter. The way it's designed actually, is that if you are current on new Potter, and your specific healthcare provider has like, given the stamp of approval that they're good with their patients self starting, then when you get your intro kit from the pharmacy, inside that kit includes a QR code. And it's just not very complicated, just Omni pod.com backslash setup, you go there, and it'll walk you through the steps of setting up the controller. And then from there, you can access the elearning modules, which will walk you through how the system works, how to program it. And, you know, walk you through the steps of starting it up. Right.

Scott Benner 13:43
So let's talk about that a little bit. The, I think, a couple of the key words, you and I are going to hit over and over again. One of them's going to be settings, whether this means your Basal profile, your insulin to carb ratio for your meals, your correction ratio, insulin sensitivity, all these things that I mean, if we're being honest, I guess a number of people don't even understand they go with whatever set up for them. And then whatever happens happens. But on this automated system, I think the easiest way to consider this is that if your settings aren't good, it's going to be like sending, I don't know, five basketball players out to play a baseball game, right? Like, you know, you've kind of got the tools there. You got some athletic people, but they've never held a bat before. They don't know how to throw a ball overhand. And and she you've got these things, it's close to what you need. It's not exactly what you need. So having your settings correct, is I think, in my opinion, by far the most important step of getting going. Now, how does how do you do that? When you might be in a situation? I guess what I'm what I'm thinking about is what happens if someone sees automated system while an automated insulin delivery system? I'm out of this, but it's not just going to magically work. You're gonna have to give it a good starting point.

Cari Berget, MPH, RN, CDE 15:02
Yeah, that's all true. So programming the settings, the initial settings that you have, it's, I wouldn't recommend just just blindly programming whatever you have in your current insulin pump, when you go to start on the pod five, it's important that, you know, to get off to the best start, you really should have your Basal program representing about 40 to 50% of your total daily insulin needs. And the reason for this is because the algorithm is it's using this assumption that that's typically what people require. And so you'll, it'll estimate your total daily insulin best, when you first start the system. If you have about 40 to 50% of your total daily insulin coming from that Basal program, or at least that's what you have programmed in the system. So that's what it what it assumes. And that's, that's pretty physiologically accurate. I mean, that is what you would expect, you know, we have these two types of insulin delivery, when you think about it, for intensive therapy, you've got Basal insulin, you know, which is like your background, it's what's supposed to help stabilize your glucose levels and manage, you know, the livers role and storing and dumping glucose into the bloodstream. And then you've got the Bolus insulin, which is larger doses all at once that, you know, are For if the blood sugar gets high, or if you're eating. And this is basically how the, the body works with insulin delivery. So this is trying to simulate those same type of, of structure, right, so look at what your current settings are, and then see how close or far that is. So you can always start from, what is the total amount of insulin that I receive in a day. And then how much of that is coming from Basal quote from the pump, and how much of that is coming from boluses. And you know, people with diabetes, they're really smart, and they figure out how to make things work best for them. And on a manual pump, you might be getting some of what might be considered Basal through giving extra boluses and things. So that's where if if those splits are way off of that, I think that's a time to go to your health care provider, and try and reevaluate what they really should be to get off to the best start and then start from there.

Scott Benner 17:20
Yeah, Carrie, and I've kind of put that into layman's terms for people. And this is something I've learned baking the podcast over the years, there are times that people using insulin arrive at the right destination, but they don't quite get there the correct way. And just a general understanding of what that might mean is, let's say you should be using, I don't know, 24 units of basil a day, I'm obviously doing that. So it's easy for us to remember one unit an hour. But for some reason, your Basal program is set at point five, and you end up making up that other insulin through manual corrections. Or maybe you've figured out a way where your your meal ratio is really heavy, but it works because the basil is light, or vice versa. Maybe your basil is too heavy and you are eating on a schedule and feeding the the insulin like there are a lot of different ways that unbalanced settings can still look okay at the end. But this system is going to learn more quickly. If those settings are as close to write as possible, it can still learn if you if you begin with bad settings, but it will add to the amount of time is that right?

Cari Berget, MPH, RN, CDE 18:25
Yes, I'm sitting here like nodding my head, but you can't see that. So yes, that's absolutely right. And it's going back to your analogy of the, you know, baseball players trying to play basketball, or maybe it was vice versa. If you, if you teach those baseball players how to play basketball, they'll probably learn it eventually. So it's a similar concept that if it's not perfect at the beginning, or at least not optimal, it will eventually get there, it just is going to take a little bit longer to figure that out. And I think the other point I would make is that this system really operates off of total daily insulin, that is what it uses to base a lot of its automation decisions on not all of them because it's also taking your current glucose level. It's making these you know, decisions about how much to give every five minutes, but kind of the big picture factor that plays a huge role in that is your total daily insulin.

Scott Benner 19:21
Okay, and would that be the same for somebody coming from MDI?

Cari Berget, MPH, RN, CDE 19:27
Yeah, I mean, it would be the same as somebody coming from MDI, generally with MDI, you would look at, you know, what's your, what's your total long acting insulin dose, and that would typically, you know, be what you would use to figure out Basal settings and a pump. So you just would take that total Basal dose if it represents about 50% of your total daily insulin, and then you would divide that by 24 to get a starting rate. Okay, so Carrie, I'm

Scott Benner 19:57
gonna give you a little more anecdotal from my end, which is I see people frequently going from MDI, to any kind of pumping. And having a similar issue, where settings don't look the same, you know, and they, they'll, they run into it in all kinds of different ways. But, but kind of think of it like that. So you know, sometimes people from MDI go to pumping, and it takes them a while to get their setting straight, and find your you're on your way to doing that. But that pumps not trying to learn anything from what the settings are that you've told them. So have your settings really, really close before you start. And in the next part, we're going to talk about that a little bit more, but I just wanted to, to make sure to be clear about that. So So let's, let's imagine, here we are, we've done our learning, we've talked to our doctor, we have our settings straight, and we're sitting together, it's our on the pod five, we have our on the pod five controller, our Dexcom or Dexcom is on our phone, we're ready to go. Now you need to have the controller with you right to start up, you have to get it going. And earlier we talked about that the system works without being near anything. But there are of course, some things you need the controller for, for instance, you need it to give yourself a tell it how many carbs you're going to eat, right? You need it to hear alarms and alerts. There are things that if you walk completely away from it, you won't get alarms and alerts are a big part of it. The ability to control the, the system, as far as entering carbs is another one. If you happen to be in manual mode, you know, you have access to a few more settings, then you do an automated. So those things need to be nearby when you're making changes, or when you need to hear alarms and alerts. And the truth is right, you need to hear your alarms and work.

Cari Berget, MPH, RN, CDE 21:41
Yeah, the other thing is, if you want to see anything, you need to have the controller nearby. So you know, if you're gonna go swimming, just leave it on the on the chair. And you don't need to worry that it's not going to be able to deliver insulin. But generally speaking, you're going to want the controller nearby the unless you just want to be completely blind and not know what's happening. But a couple other just clarifying things there. They're calling it a controller now. So very fancy, no more PDM. But controller, that might be the lingo you hear when you like get your intro kit box and stuff. And then also, as far as alarms and alerts, I did want to clarify. Another reason for having the Dexcom G six app near you is that you cannot program any of the Dexcom CGM alerts on the Omnipod five controller. So that's another thing to keep in mind. If you want to be getting those Dexcom alerts, you have to have the G six app within range and get it through that app. There's a couple exceptions. There's a one LOW Alert on the Omnipod five, four if it predicts your glucose dropping below 55. And then there's some like pump related alarms and alerts. But I did want to make sure it was clear because this is a common question that I get that there are no CGM related alerts other than that 55 In the Omnipod five app,

Scott Benner 23:00
right so there so you have two devices that are speaking to each other but they're giving you their information on their their own separate platforms.

Cari Berget, MPH, RN, CDE 23:08
Exactly.

Scott Benner 23:15
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So let's I guess dig in a little bit into this algorithm and what we can expect it to do and what it's going to do. I feel like I want to ask you, and because I can, we've used the Omnipod five and I know a great deal about it. But I think you have a lot more than me, as far as knowledge goes. So there's a predictive control algorithm, right. And it's called Smart adjust technology. And we know how it's going to communicate back and forth with the G six that happens every five minutes to predict where your glucose is going to go. 60 minutes from now, it increases or decreases or pauses insulin, trying to get you to that level that you actually get the program right. So unlike other automated insulin delivery systems, I guess on the pod five has a 110 target, but it also has other targets.

Cari Berget, MPH, RN, CDE 27:05
Yeah, you can program the target anywhere from 110 to 150. In 10, and 10 milligram per deciliter increments. So 110 121 3141 50. And yeah, that is the only automated insulin delivery system where you can customize the target to what you want it to be. And then additionally, you can also set that target, you can have a different target for different times of day. So if you wanted to run 110 of the rent 110 target, you know, all day, but you wanted the 130 target overnight, you

Scott Benner 27:40
can do that as well. It does not go lower than 110. No, it does

Cari Berget, MPH, RN, CDE 27:45
not you cannot program a target lower than 110. Okay, that doesn't mean your blood sugar will never go lower than 110. But the the target that you program can't be lower than 110. Yeah. So

Scott Benner 27:56
that's as good a place as I need to talk about that. So your blood sugar could get lower, and then it's going to take away insulin trying to get back to the one time.

Cari Berget, MPH, RN, CDE 28:06
Yeah, that is correct. But I think

Scott Benner 28:09
that's important for people to hear that it doesn't happen instantaneously. If you were to, I guess there's a lot of different things right, you could you could make a Bolus for a meal that's too large for what you ate. And then you might get lower than that. And then this, the algorithm is going to just try as hard as they can to take away insulin, take insulin to create a new balance, but you could be lower while it's doing that. So there are times where you might have to step in and fix a lower blood sugar. There's it that seems accurate to you.

Cari Berget, MPH, RN, CDE 28:37
Oh, yeah, absolutely. I mean, you know, what we see with these systems is they, they do a really good job at helping prevent hypoglycemia, but they don't eliminate it altogether, usually. So you may still have a few, you know, situations that the example you gave is, is a really good one. Because if you do over Bolus for a meal, for example, once that Bolus insulin goes in the body, you can't take it out, you know it's there. So if you can't remove it, all the algorithm can do is just stop the automated delivery in the background. Yeah, so it should help. It should help kind of like cushion the fall if it's too much Bolus, but it may not always be able to 100% prevent the the low blood sugar entirely. Yeah,

Scott Benner 29:23
it comes from a personal experience I had with it because when we first got it, I was like, I bet you I could get this to keep a lower number. And I did it. And Arden's blood sugar was like 85 for like two and a half hours. I was like see, I trick the outcome. And then it didn't it tricked me because because it took away so much of her basil that her you know, once that act of insulin I used in the meal was gone. Then she just started going up and up because I had basically, you know, I had I had put the algorithm in a situation where it took away the basil for so long that the only thing that was going to happen later was arised. Like that's the only thing that could happen eventually I basically trade Did my meal insulin for basil? And it said, Well, we're going to, we're going to get you back up to 110. And then that rise happened. So I just, you know, I, it's not this stuff's all really very new to people, you know, and everybody's kind of had a way they've done things and there's going to be a different, you know, a slightly different way to do things. And these are the things that are gonna get you there. So, alright, so Carrie, we thrown on this, we got our first pot on, right? What happened? Yes, five minutes. 10 minutes later, my blood sugar's perfect.

Cari Berget, MPH, RN, CDE 30:30
So I wish Sunday. But so you put your first pot on, right, what'll happen is the with your very first pod, the system, you can go right into automated mode. So that's another cool thing about this is, even though the system operates off of total daily insulin, you can still go in automated mode with the very first pod, even though there is no insulin history. If you think about it, you might be wondering, wait, you just told me this algorithm operates off total daily insulin. But this is my very first pod. So how would the system even know you don't program your total daily insulin anywhere in the pot, it's based on the insulin you actually receive. So that goes back to what I was saying before that it estimates your total daily insulin. And it uses that to determine what they call an adaptive Basal rate. And so I would think of that as like a baseline, it's your baseline Basal rate that this system thinks you have. And then in then it adjusts up and down from that rate, based on the current glucose trend, recent insulin history, delivery history, all with the goal of trying to reach that 110 target. So the 110 is the brain's that's the number it's using when it's making these calculations every five minutes. And then, so you go along, and you give your meal boluses. Because that's really important. On a system like this. For one, if you want the best blood sugar control around meals, you should Bolus, you know 10 To 15 minutes before you eat, to get the best control around meals, but also to make sure that the total daily insulin that you need is actually accurate. Because if you miss the boluses, two things will happen. Your your meal control won't be as good, you're gonna go high, the system will increase to try and help you so still be better than missing a Bolus if you are on a standard pump. But the total daily insulin will start to be underestimated, then because you're not giving the Bolus and the automation can only do so much for you.

Scott Benner 32:26
So so if I, if and again, this is a great example of it's not, you know, it's not just like set it and forget it and walk away, you do still have to do the things you need to do Pre-Bolus In a meal is have you know, I think it's a basic concept. And and so what you just said makes sure I understand if I don't Pre-Bolus a meal, then we're going to see a big shoot up 2030 minutes after I've eaten my blood sugar is gone from wherever it was, you know, 100 and now it's it's 180 and on my CGM is telling me I got two hours up. And then all of a sudden, I remember to tell the, the Omnipod five, hey, by the way, I ate 45 carbs. So you're by doing that by not letting it know that food is happening when it's happening. It just thought you shot up out of nowhere, and it tries to stop it. And now you're putting the food in and telling it Oh, no, there was food here. But you're telling it that there's food at seven o'clock at night when really the food existed at 630. And then that kind of throws things off is that I understand that correctly?

Cari Berget, MPH, RN, CDE 33:24
Yeah, yeah. Yeah, the only thing I would add to that is, it's just that the time it's the time doesn't really matter. So like the algorithm doesn't really care when you like to eat breakfast, lunch or dinner, like it's not going to learn that it's not going to learn, oh, Scott always eats lunch it at seven, or dinner at seven, you know, yeah. But if you, like you said though, if you don't eat him, if you don't Bolus for a meal, your blood sugar will rise. And the algorithm will respond, you know, it will respond and try and increase the insulin delivery, the automated delivery, right? But the other but what happens if you put the 45 grams in an hour later, you've got a bunch of insulin on board now from this automated delivery, then you put in the 45 grams, it's just going to calculate, you know, based on your carb ratio, which is going to be too much because now you already had this other insulin in there. So it does create this yo yo effect because if you come in with the meal Bolus after, it's going to likely be too much. And then you're going to you're going to crash down and then you're going to treat that low and then you're going to rise up. So that's where it goes back again to the pre meal Bolus is is really important. Yeah, because but what I what I was saying before, it was actually more than if you just miss the Bolus altogether, the total daily insulin calculation will start to be be off to okay, it doesn't you don't give those boluses it's not going to know that you require the amount of insulin that you require.

Scott Benner 34:55
See, that's a bigger picture idea that's important. It needs to understand like I guess in this same breath. If you were a really high carb person for three days, and then decided to eat very low carb for three days, the system isn't going to magically know that you stopped eating 150 carbs a day versus now you're having 50 or something like that. Right?

Cari Berget, MPH, RN, CDE 35:15
Right? No, it won't. But it will update your total daily insulin every time you change your pod. So this is a very important point, because, you know, especially with kids, which is what you know, I work in pediatrics. And so kids grow and their insulin needs change all the time, constantly. And that's expected. And so a lot of people will ask, well, how, if it's based on total daily insulin, like how does it adjust as my kid grows, or, you know, needs more insulin, and it does that by updating the total daily insulin with each and every pot. So every pod, it's going to change the adaptive Basal rate based on the more recent total daily insulin, so it will adapt over time to changing insulin needs.

Scott Benner 35:59
Okay, so this first pod is on and it's collecting data, it doesn't know anything except the settings that we've given it. And it's just living with you. And it's seeing what you're doing. And it's seeing what's happening. After that first pod is done, you move to the next one. And that's where you really start seeing the system working a little more, right, that very, very first pod is a is a collection day, or days Excuse me.

Cari Berget, MPH, RN, CDE 36:24
Yeah, and it's, it's operating more conservatively, conservatively with the first pod, because it's only estimating your tea, it's guessing your total daily insulin. And then in so because of that, it's just more conservative, it's a little more constrained on how, how high the adaptive Basal can go how much it can increase the insulin. But then when you change, and you go to the second pod, it starts using your actual total daily insulin, and then those constraints aren't, aren't there anymore. So I see.

Scott Benner 36:55
Carry, I've been told something by my my little birds. And I want to know, if you see any value to it at all, they say, that first pod instead of going the full 72 hours, they say change it after 48, because it's learned everything it's going to learn and you want the next pot to get moving to have you heard that at all?

Cari Berget, MPH, RN, CDE 37:14
I haven't directly heard that. But my guess is that comes from the fact that you know, what's required for the system to start using your actual TDI instead of the estimated TDI after the first pod is at least 48 hours of insulin delivery and A pod change. Okay, so that might be where that comes from. But in my opinion, I don't, I don't know that I would worry too much about that. You certainly could change it after 48 hours and like, make it start using your actual TDI. But there's also concerns of like, do you, you know, do you really want to change your pod earlier than you need to you only get a certain amount of supplies. So I don't think it's essential, or will make a huge difference. But certainly could.

Scott Benner 37:55
I just wanted to get that in there because the internet always thinks it knows. And so I wanted to see what you thought. Thank you very much. All right, I have some questions here. Actually, I want to thank existing podcast listeners, they sent out a ton of questions for this. This person says, I've read that the first pot operates at a reduced Basal rate. Is that that true?

Cari Berget, MPH, RN, CDE 38:17
I mean, reduce from what I don't, and I'm not sure that that's actually true. I mean, what I would say is the first pod operates off of more conservatively than it will in subsequent pods. And I would say that the maximum delivery is more constrained. But I wouldn't say that it is operating off of a reduced Basal rate, because the adaptive Basal rate it determines is based on the total daily insulin it estimates. So a lot of that is based on what you have initially programmed for your Basal program,

Scott Benner 38:50
in a perfect situation, you're gonna put this first pot on, and you're gonna let it do its thing, you're gonna live your life and let it learn. Is that correct? Yes, yeah. What if you get into a situation where your settings were way off when you got started? So you're seeing a high blood sugar that you're just not okay with? Do you come in and correct it?

Cari Berget, MPH, RN, CDE 39:08
Yes. And I would encourage, especially in the first couple of weeks, as it's getting, you know, adapting and adjusting to your total insulin needs. If your glucose is high, give, give a correction Bolus, it all it can do is help because it does two things, one should help bring your blood sugar down. But then too, it's it's adding more insulin in to the total daily insulin. And so you know, that's going to increase the total daily insulin and then with the next pod, you're going to have a higher baseline adaptive rate, and it's all just going to balance out from there. So the principle of giving correction boluses really, really helps. But can I add one more thing about correction bonuses at this point? You're

Scott Benner 39:50
the only one here really, I'm just okay, if you don't, we're pretty dumb. You know what I mean? Yeah.

Cari Berget, MPH, RN, CDE 39:56
So, okay. And this gets to what you were saying before, a little bit. In that, you know, people who live with diabetes really figured out how to make their insulin delivery work for them. And there's a lot of different ways to get there. As you mentioned, when you're using a manual pump therapy, and the difference with an automated system is that you now have insulin delivery going on that you aren't in charge of anymore. And so my best advice for giving correction boluses is to follow the Bolus calculator recommendation. And I know that's really hard for for many people, because you know how much you need. But with an automated system, you can have a lot of insulin on board from the adaptive Basal increasing that you just may not be acutely aware of. Yeah, so what what's great about the system is if you're using the Bolus calculator, any insulin delivery that is above the baseline, so this baseline I told you, the system calculates for you, it will factor that into the insulin onboard. Point being you can see how much insulin onboard is active. And that includes the automated Basal, which is also different from standard pumps where typically Basal insulin is not incorporated into the insulin onboard calculation. And it is now if it's, you know, being given to deal with hyperglycemia. So, you can follow the recommendation and just be advised that the the correction dose may seem smaller, you know, a lot of people will say to me, oh, my gosh, this thing thought said, I needed point five and I, on my other pump, I would have given two units for this. And I have to tell them well, on your other pump, your basil was stupid, it wasn't helping you like it was stupidly delivering point five units an hour, no matter what your CGM was doing. So just keep that in mind and try to work with with the system and not against it. And that will really help with frustration, but also with getting better outcomes to

Scott Benner 42:00
carry Listen, may I make a mean, let me just be honest here for a second, I fought it. In the beginning, I was like, that's not what I would do. Or that's not what I need to have happen. Or and it really did just eventually occurred to me, I was like, this thing is gonna do stuff. I'm not going to understand it all. And if it works great, why do I even you know, you know, why am I fighting. And I was just applying what I knew prior to what was happening now. And it really did take me longer than it should have to say to myself, This is not an apples to apples situation here. I am not doing manual pumping the way I used to. That's not what this is. This isn't even another automated insulin delivery system, right? Think because they all work differently. I mean, there's a number of them that are available, and not one of them is accomplishing what they're accomplishing in the same way. And so I did find myself having to put away some of my old tools that I thought worked really well. And and look at on the pod five more and try to find the tools that I thought worked better with it. Yeah, you

Cari Berget, MPH, RN, CDE 43:03
may need to find some new tools, you know, and you will, but I think that that's, that's really, that's really the key, I think. And in admit it, I mean, that's hard to do. I mean, you know, when you've been spending years and years and years, taking care of diabetes, and then sometimes you'll you'll have to let those things go. But that can be in that can be hard to let those things go. So I usually tell people, you know, the system needs time to adapt to total daily insulin as far as thinking about expectations of like, you know, how long is this going to take to get used to this? Most people are asking, like, how long is it gonna take for the algorithm to figure out how much insulin I need? And while that's true, there's another piece, it's how long do I give myself to get used to a new type of insulin delivery. So that's another piece of it is it's you know, you as the user, you have to figure out where you need to let go and let the system do its thing. And then where you need to give insulin and do your part in how to find this, like, beautiful harmony, where the two of you work together the system and you you know, to get the best out of it. Yeah,

Scott Benner 44:11
I think we'll jump into that. We'll do a settings episode where we'll talk more about how to make those adjustments and even how to talk to your healthcare provider about making those adjustments. I'm just, I'm glad you brought it up. Because I feel like what I need to know like if I'm going to recap here is that I'm going to come in with as good a settings as possible. And could that even mean that I start on the pod five in manual mode for a couple of days, say I'm not coming from on the pod dash, maybe I'm coming from MDI or something else, right. If I start in manual mode for a little bit, I'm looking for that stability, right? It's my basil at a good place where I'm held. I mean, the way I talked about on the podcast is Bezos job is to hold you at a number, right and that number is, you know, it can be whatever you you think it is, but if your basil is set correctly, it will hold you away from food and active insulin. Add a number at 90 at 100, you could use a little more basil and have it lower, you could use less basil and have it higher. But stability is the important part. If you don't have stability, then your basil is not close to being correct away from food and away from an act of Bolus, you know, your blood sugar shouldn't be dropping very harshly, you're jumping up and down your basil. I mean, Basil is everything. I think it's the it's the bedrock of diabetes. And it's the way to, it's the way to have success is no matter what you're using. So maybe I even start on the pod five, in in manual mode for a little bit, it's still seeing if my basil is working, it's still seeing my bonuses and my corrections. And it seemed my total daily insulin, that would work as well. Right?

Cari Berget, MPH, RN, CDE 45:42
Yeah, I mean, you could do absolutely necessary, right, right, it's not necessary. And the only other caution I would give you is that, you know, the system isn't using the Basal rates themselves. So testing it, that'll give you a really great Bayes Basal profile for if you're using it in manual mode, right. But what's more important for getting the best start in automated mode is really just the total insulin. And so, you know, if your settings are just have gotten off over the years, like, let's say, you know, per your programmed settings, you only get 25% of your insulin from the Basal rate, I wouldn't recommend starting Omnipod five, with it like that, you could go into manual mode, tweak it all up, you know, test it out, if you want it to, but you could also just talk, look at what your actual total insulin is. Because if you have, you know, relatively, you know, good control that you're happy with overall, you have a total amount of insulin that you're receiving. And that seems to be working as far as the amount. So you could just re estimate what that basil really should be based on the total insulin, can I

Scott Benner 46:56
pick your brain a little more here on that? Yeah, so if my total daily insulin is whatever it is, but my average blood sugar is 180, then my total daily insulin might not be enough.

Cari Berget, MPH, RN, CDE 47:10
Right? Right. And that is a excellent point. Because, and especially I mean, I see this all the time, it's, I think this is very, very common in youth, even, especially, most kids are not getting enough overall insulin. And so I will sometimes when, because what I do at my clinic right now in prep for everybody starting up the system is I review, I try anyway, to review everybody's current pump settings, and suggest different settings for them, and work with them to you know, what they should programming Omnipod five, and if I see that somebody's, you know, got an average blood sugar of 200. And their last time in range was, you know, 45%, then I'll look at what their their Basal is. And if it's, if they're over Bayes alized on paper, as in like, Oh, they're getting 60 70%. But really, that represents more of an expected TDI, total daily insulin, then I probably just keep it. So that is an excellent point that just because on paper, the split might look off, it's all relative to whether the total daily insulin that you're getting is actually the amount that you need. Yeah, it

Scott Benner 48:25
just occurred to me that you might be, you know, doing great, you know, and thinking I'm doing fantastic. You know, my blood, my a one sees a seven and a half, and this is my average, you know, insulin intake, and then all of a sudden you put on this, you know, the Omnipod, five, and you put on target of 110. But you give it settings that led to a 170 or 180, those two things are in Congress at best. So, yeah, so that makes, there's going to be an adjustment period is what I keep thinking to say.

Cari Berget, MPH, RN, CDE 48:55
Right? Yeah. And it all starts with, I think, if you just remember that it really all starts with what's your total daily insulin? either? What is it that you're getting? Or? Or how much is it? Would you really expect that you would need? Because, yes, it is different for everybody. But it's not a complete mystery. Like there are ways to estimate how much you really should be expected to be getting based on just simply based on weight. So like, if you're really not sure that the amount you get, whether it's really close to optimal or not, you know, talk with your with your doctor. And it'd be like, what, how much should I probably actually begin, you know, and go from there.

Scott Benner 49:36
So, a minute ago, I talked about being in manual mode. And I just wanted to point out that even if you're in manual mode, the algorithm is paying attention to your total daily insulin there. But in manual mode, there's no algorithm to stop you from getting low. It's just you're using an insulin pump just like a regular old insulin pump then, and I didn't I didn't I didn't say that clearly enough. So I wanted to we ever A couple of things here, a person who started on the pod five, and they had, you know, they were like, well, I wanted to be more aggressive. And so they get to their fourth pod, and they start making all these changes to their settings, thinking, this is going to make it more aggressive, I'm going to increase my Basal the carb ratio, the insulin sensitivity factor, etc, on and on, right. Except that's not how this works. Like after that first pod, you put that first pod on the algorithm is learning. And it's adjusting those things. So if you made a change to one of those settings, that change would only be concrete if you were in manual. That's correct, right?

Cari Berget, MPH, RN, CDE 50:41
Partially, I mean, if so when you're in automated mode, I cannot stress enough that it does not care what Basal rates you have programmed. Even if it's the first pot, it doesn't care about the actual Basal rates, the profile itself, it's concerned about the total only to help it estimate your total daily insulin. So I just want to make sure that's really clear that even with the first pod, the actual rates themselves and the different ones you put at different times of day, it does not use those in any way. So no changing, no changing Basal rates at all, when you're using automated mode. Those would only be used if you were in manual mode. Okay. But for boluses, if you change your insulin to carb ratio, if you change your correction factor, that will change the amount of insulin that's recommended for your Bolus doses. And that can actually make a really big difference in your overall glycemic control. Really fine tuning those Bolus doses, because that's what you have the control over, it's your job to give those boluses for meals. And so focusing on those actually, I would highly recommend because it can make a huge difference in your overall blood sugar control.

Scott Benner 52:02
Okay. All right, thank you. I just, I'm trying to put myself in the position of somebody who just comes at it new and doesn't, doesn't quite understand what's going on. You want to do one more question? Or do you want to move on? Let's see.

Cari Berget, MPH, RN, CDE 52:17
Do you have questions? It's good for ya. It's like sending a man you know, then they want them answered. I think it's, that's good.

Scott Benner 52:23
I love you. You're very nice. I'm having a good time. It's our first time recording together. And I feel like we're doing well. What do you think give some credit for Yeah,

Cari Berget, MPH, RN, CDE 52:32
we're feeling great. I'm feeling more and more normal. And the more we go,

Scott Benner 52:36
you're not as nervous any longer. Cool.

Cari Berget, MPH, RN, CDE 52:39
Okay. Settling in.

Scott Benner 52:42
I'm oddly calm, just so you know,

Cari Berget, MPH, RN, CDE 52:46
you do seem very calm. I'm like waiting for the I don't know, waiting for you to yell at me about something.

Scott Benner 52:55
Okay, so carry, like, let's just kind of dig in. Before we move forward, let's add a little more clarity to total daily insulin in manual mode. So, okay, do you? Do you feel like we've covered it all? Or do you think there's more there? Like, I don't know, what to add to what you've said. So maybe you did.

Cari Berget, MPH, RN, CDE 53:16
I mean, I think the point you made of just making it clear that Omni pod five, it the pod tracks total daily insulin, whether you're using manual mode or automated mode, it's always tracking that. So if you went out of automated mode into manual mode, for whatever reason, for you know, a week, two weeks, a month, a year, it's still tracking it. So then if you switch back to automated mode, it's it's just going to pick up with that total daily insulin, maybe is the point there.

Scott Benner 53:49
Carrie, I believe that was a perfect explanation. Thank you very much. All right. So let's roll through a couple of questions that I have pretty simple answers. person asked, Will it be possible to decrease to decrease the target blood glucose level from the current built in minimum values? Now I know the answer to this one. So no,

Cari Berget, MPH, RN, CDE 54:07
no. No, the target is 110.

Scott Benner 54:13
Yes, yeah. And you can go higher if you so desire, up to 150. I think we've said already, all the way up to 150. If you want to target a 90 it, it's not going to do that.

Cari Berget, MPH, RN, CDE 54:25
It will not okay. All right. But can I just have one thing about that, please? Because I have stuff to say to go. Yeah, the target thing is fascinating. For me, because I work with a lot of automated systems, not just Omnipod five, and this is something that comes up with every single one. I would just realize that this target is the brains, it's the brains of the algorithm. It is not i It's not saying that your blood sugar is going to be at 110 all the time, and that it's never going to be under 110 or that you couldn't possibly ever be under 110 it's just every time The algorithm makes a dosing decision, it's doing it trying to reach 110. That doesn't mean you're always reach 110 Or never go below it. Does that make sense? So I would focus, when I think about adjusting the target, since this is the first system where you can do that, look at it more from the bigger picture. Like, if you're running high overnight, and your target set at 130, drop it, because then the insulin is gonna give more in the algorithms gonna give more insulin. So think of it more as like, if you want to try and make the algorithm more aggressive, because you're running high, overnight, drop the target, if you're running lower than you want to be, I don't even wherever that might be, like, I just worked with someone the other day who was running at five overnight, which some people would love, he, they did not love that. And so we bumped up the target, you know, so in it, it helped bring them up a little higher. So, think of it more pragmatically like that, like, it's a way for you to influence what it does and less focus on what the actual specific number, it's

Scott Benner 56:07
sorry, listen, I think if people listen to this podcast, they'll understand this. And if they're new to it, and they're finding it because of the only pod five episodes, and this might be a little lost on them for a moment. But there are so many variables that go into how insulin works for you. So if you're a person who does a set amount of exercise every day, your insulin will probably be more effective. If you're hydrated, well, it will probably be more effective than if you're not hydrated. Well, if you're experiencing a fluctuation of hormones, say, at one point, but you aren't at another point, the insulin is going to have different impacts. And so it's a lot about your behavior, as far as what you know about that, and what you and what you ask of the system. My point being, if you go along, eating, you know, a house salad for three days, and then on the fourth day, decide, I'm going to have a half a pizza, well go for it, except, just understand that if you are a person who has been eating how salads for a year, your your insulin to carb ratio, for example, is probably more tied into that style of eating. So if you're gonna slide into a completely different style of eating, all of a sudden, that insulin to carb ratio might not be the same for pizza, as it is for something else. And I'm getting a little outside of you know, I'm not a health care provider and etc. But you do need to understand how insulin works, I guess, is what I'm saying. And if you don't, you're gonna run into problems. And you could turn to, you know, and think it's, you know, you could, I don't know, you could chase ghosts around, you could think you see what's happening, but you might not be.

Cari Berget, MPH, RN, CDE 57:46
Yeah, and then I would just end that statement with I mean, I think that people give more concern to the target than I think is necessary. That it's not as big of a deal that sometimes it can be beat out to be. And so I try to encourage people not to worry too much about that back to what you were saying, just focus on doing what you can to get get the best control that you can, and the target is not really the most important factor here.

Scott Benner 58:16
Well, yeah, my only point was, is that if you're if you're targeting 110, and you know, your blood sugar's rising, and the system says, Oh, it's coming, you know, that's happening, I'll do what I did yesterday. And that'll work except that you've made some, yeah, here's, here's a better way to think of it maybe, if you are getting low overnight, for example, and the algorithm is stopping that low by taking away basil, you may have had less basil than your body really needs, you know, four or five o'clock, six o'clock in the morning, because of, I don't know, a bed Bolus, she made it about three o'clock, who knows. But when you wake up in the morning, the algorithm doesn't know to you know, that your toast is going to hit you extra hard now, because you really haven't had your full Basal for the last three hours. Like you kind of have to know that. And yeah, you know what I mean?

Cari Berget, MPH, RN, CDE 59:08
Right? That's a really good example, because it does show the interaction between, you know, things that the algorithm doesn't, and that's a perfect example of, of that kind of perspective. And that, oh, what's the word like, kind of the vision the that you see that that insight of, oh, look, I'm about to eat breakfast, I see that the system has suspended my basil for the last hour. And if I when I eat this toast, it's going to have a huge impact because I've got very little if any insulin currently working in the system. So in those cases, you know, Pre-Bolus saying as far ahead as possible, makes a really big difference because, you know, you get you make sure you have some insulin starting to work before you, you know, eat get those carbs in the system

Scott Benner 59:59
x One. I feel like care. Tell me something. I feel like we've done a good job here. Do you not agree?

Cari Berget, MPH, RN, CDE 1:00:07
I do.

Scott Benner 1:00:10
You're looking at the same notes I'm looking at. And I feel like we covered so much of it. Without getting to it in the notes, does that makes sense to you? Sure.

Cari Berget, MPH, RN, CDE 1:00:18
I, I haven't even looked at the notes. So I mean, I'm glad that you think we're covering it

Scott Benner 1:00:23
carry on me.

Cari Berget, MPH, RN, CDE 1:00:27
I mean, I've looked at the notes, but I didn't want to make a bunch of noise there right here. But I, yeah, I've seen them before. Yes, we're doing we're we're doing great.

Scott Benner 1:00:35
Okay. So I just wanted to sit down for a second and go through a couple of ideas about just making sure people understand what the adaptive Basal rate is. But I feel like we've done that. No, I'm just gonna run through them. And you tell me if you think we've done it, adaptive Basal rate is a baseline for automated insulin delivery. It is the insulin delivery calculated in units per hour than the smart adjust technology continues to change over time as only part five is used. And this is all of course, based on your total daily insulin. Yes, okay. Adaptive Basal rate is based on the total amount of Basal and Bolus insulin delivered in a 24 hour day or the total daily insulin again, updates with each pod change based on the previous insulin history to best match the user's needs.

Cari Berget, MPH, RN, CDE 1:01:21
That is true. I'd like to add one thing, this is a very common question. Can you what how do you know what your adaptive Basal rate is? The short answer is you don't? And there's no way to know you can't find it out. So we should probably get that out of the way.

Scott Benner 1:01:37
Yeah. Okay. And if for some reason, and I know, it's not a not fun to think of, but if for some reason your controller explodes, like you drop it in the pool, or you throw it across the street for some, I don't know what you might do to make it break apart. But if that happens, you are starting over again, when that next pod goes on. Yes, yes. Yeah. So I want to point out, always know, what you're like, know, your settings as best you can, right? Right. Like whatever you put to that thing, the first time write them down somewhere, don't just, you know, don't just go I don't know, know what your total daily insulin is like that, I think is incredibly important, right? Because then at the very least, even if you're just like, I don't know, any of these settings anymore, you can at least look at the total daily insulin, you could say to yourself, Okay, let me just take 50% of this and make it or break it up over 24 hours and make that the Basal. And I'll take the rest of this, and I'll look at some of my carbs, and I'll figure out my insulin to carb ratio. And these would be good restarting settings. That's a very basic way to think about it. But but at least you'd be getting that total daily insulin set in there. Does that make sense to you?

Cari Berget, MPH, RN, CDE 1:02:43
Yeah, no, it does end. But the only thing I would add to that is, you know, your insulin needs can change over time. So depending on how long it's been, since you started, before you broke your controller, I mean, if it's been a year, and your manual mode, Basal rates haven't been changed at all, they might be slightly off, if your total daily insulin has actually gone up any

Scott Benner 1:03:08
number of 1000s, changed your activity, a few pounds, lost a few pounds, etc, etc.

Cari Berget, MPH, RN, CDE 1:03:13
So the best way to really keep track of that information is to have your Omnipod five linked to gluco. Because this is one of my favorite things as a healthcare professional, because if you link your Omnipod, five to gluco, which is a data management system that you can summarize, you can get reports that summarize your insulin delivery and glucose control, then you can just log if you break your controller, you can log into gluco. And you can see what the settings were, and how much and you can see how much what your average total daily insulin has been okay, and so, and that it'll walk you through doing that when you go to the setup screens. So I highly recommend doing that and not skipping that part. Because it's, it's really cool. And then once you're set up, it will automatically upload the pump to gluco via the cloud without you having to do anything, you don't have to manually upload it. And then when you show up to see your your doctor, the data is already there, and everyone is so happy.

Scott Benner 1:04:15
I like not having to do anything that makes sense. So so keep track on your own use paper. If you still have a pencil on your house or use your computer or your phone. Most people just use their phones, right Carrie I sound very old now when I send someone to use their phones. Yeah. So keep track of all your settings and and utilize glucose. Glucose is free, right?

Cari Berget, MPH, RN, CDE 1:04:36
Yeah. And when you go through the setup, it will it'll walk you through pairing it and if you don't have a Google account, it will walk you through like creating one and everything.

Scott Benner 1:04:44
Okay. What can I see? So you've had a lot of experience with with the system and with the controller. So what can I see as a user day to day like what do I have access to?

Cari Berget, MPH, RN, CDE 1:04:57
On the controller? Yeah, like Can the app itself?

Scott Benner 1:05:01
Yeah, like, like, do I just see oh, it made a Bolus or do I see, you know how much it used?

Cari Berget, MPH, RN, CDE 1:05:07
Yeah, so what you can see on the main screen is you can see this current CGM glucose value and trend arrow. Because you've, you've paired the transmitter into your Omni pod five, so it can, the pod will send that duck that information to the PDM. So you can see the CGM data on the Omni pod five app. So you can see the CGM value and current trend arrow, you can see how much insulin on board you have. And you can see your last Bolus, it's very similar appearance to the dash interface very, very similar. So you can see the last bullet you gave and how much that was. And then there is a way that you can expand the CGM graph, you can, you can see the last three hours of the CGM values and on that graph, you can also see the insulin on board and the current CGM value as well. And then you can get a visual representation of the automated delivery. So at the bottom of the CGM graph, you can see if you're in automated delivery, or manual delivery, and then you can also see visually if the algorithm is at maximum delivery, or suspension. So you can see things categorically, but it won't show you the exact amounts. Okay. However, you could go to the history, if you want to see each five minute, you know, micro delivery that, you know, or adaptive Basal delivery, if you are so inclined. I mean,

Scott Benner 1:06:41
I think it's, it's pretty obvious, right, that the system is set up to try to take away your burden, and so that you're not constantly worried and looking and, you know, overwhelmed. I mean, I think, you know, I'm going to put my, my personal opinion in here, I think Omnipod five, for most people is going to be an incredible improvement for them. You know, like just an incredible improvement and, and getting it set up and getting it rolling is the crux of the whole thing, right? It's just why we're talking about it, because what's beyond this should very well be some fairly smooth sailing, where the algorithms learning and keeping up with you and making adjustments where it's necessary. And even you're learning as you go along. How to how to Bolus for your meals better, or how to think about things as far as the way the system works. And, and hopefully you're, you know, you're you're, you're feeling a weight lifted at some point.

Cari Berget, MPH, RN, CDE 1:07:31
Yeah, I think so. I mean, I think there's a lot of potential here for a lot of people to get much better blood sugar control than what they've been able to, you know, to get on a manual pump, as well as more stability. Because the other thing I think we often don't talk about is glycemic variability, just the ups and the downs. So sometimes the average looks fine. But when you really go and look at it, you know, yeah, you're spending 50% of your time high and 50% your time low. So this helps you kind of find the balance and be more stable with less big fluctuations. Yeah. And sleep. That's the thing,

Scott Benner 1:08:08
you still might think, oh, go ahead. Go ahead.

Cari Berget, MPH, RN, CDE 1:08:11
I was gonna say that's, that's the thing, especially for for parents. And you know, I worked in pediatrics, I always want to give that disclaimer, I don't really know much about adults. But for parents getting to sleep at night is the constant theme that that I hear, because not only is the blood sugar improved overnight, it's the stability that you just get to sleep the whole night. And that's just not something many parents and kids really experience so

Scott Benner 1:08:40
I have never slept so well, as I have, since some automated insulin delivery has become a reality. So and it sounds

Cari Berget, MPH, RN, CDE 1:08:49
overnight, it's really very exciting. If you think about it, it's half of your day. So I mean, it's, it's also super encouraging that, you know, the nighttime tends to be relatively, like, really reliable, like you can really rely that for almost everybody, like it's just it is gonna help overnight

Scott Benner 1:09:07
for sure. I think also, he had kids that go on sleepovers, or, you know, adult who's got a real heavy sleeper or no, you know, next to them or nobody next to them, they're on the road. I always think that being an adult with type one and living by yourself has got to add an extra amount of anxiety to your life. You got kids going away to college, all these things. It's just, it's, listen, I'm a huge fan of the stuff I have been saying on this podcast for years, that you do not want to get stuck in how it's done. Because, you know, people are gonna make advancements and you don't want to be back with like, Oh, I'm still peeing on this test strip. Is that not the way we're doing it anymore? You know? And so this is, it's a big deal. It really is. I can't I don't think I can quite say enough. What a big deal. Yeah,

Cari Berget, MPH, RN, CDE 1:09:53
it's a really exciting time, you know, and it's only gonna get more and more exciting as we go. I think I think we're just at the beginning. Okay,

Scott Benner 1:09:59
we're gonna hammer through couple of questions here. And then we're gonna we're gonna button this up, try to keep it around an hour, right? Okay. Realistically, how long should I expect it to take for the system to adapt, optimize the insulin delivery, do its thing, what did you see during the, during your time with it,

Cari Berget, MPH, RN, CDE 1:10:17
I think a couple of weeks is a is a good expectation to set for yourself that you've got to give it a couple of weeks, you know, three or four pods for it to really get some time to adapt. And then the other thing is that it's not even just the adaptive basil and figuring out the total, you know, giving the algorithm time to figure out the total daily insulin. That's obviously a huge part of it. But it is very, very common. And this has been true with every automated insulin delivery system I've worked with, you almost always need stronger carb ratios on an automated system compared to a manual system. And again, like, work with your doctor and look at this stuff, and talk about what your carb ratio should be. But if you're running high after meals, don't hesitate to reach out because there is something that can be done. Oftentimes, you just need to strengthen the carb ratios. And it's not a bad thing, it doesn't mean the system's not working. It's expected it's it's a dynamic Basal delivery, that's totally different than a manual pump, where it's just statically delivering. So because it's dynamic, you're going to have periods where it's turning off and then turning back on. And oftentimes leading up to a meal, you have less insulin on board, because there's been suspensions, because you're getting back to that target. And so, because of that, naturally, you're going to need a stronger carb ratio than maybe you used before. So keep that in the back of your mind. Because after those couple of weeks, if you're still running high, or higher than you'd like or high after meals, specifically, reach out to your doctor and in fine tune those carb ratios because it can make a huge difference.

Scott Benner 1:11:58
Well, it really does depend, I guess, on the person or its individual, how long it's going to take days, weeks, plus all the other stuff that we just spoke about.

Cari Berget, MPH, RN, CDE 1:12:06
Yeah, I would agree with that. I mean, everything's individualized. But I would say, you know, give it a couple of weeks. And if you're not where you want to be, you know, reach out to your health care provider to help you because there's probably, you know, some Bolus settings that can be adjusted to really help you get where you want to go.

Scott Benner 1:12:23
Let me ask you a question. Because you've seen so many people on it attached to this idea. Is there something I can be looking for that shows that we're moving in the right direction? Like, when's the when's the part where I go? Ooh, maybe I will call my doctor here. I think we're, we're at a point where maybe we've plateaued?

Cari Berget, MPH, RN, CDE 1:12:41
Yeah, that's a great question. Ooh, that's a hard question. Um, I mean, I'm a big, big picture person. I think time and range is the most important thing. And so if your timing range is not getting to where, you know, you want it to be, and you should be able to get it, you know, above 70%, and meet those targets. You know, reach out and, and help have your doctor help you get there.

Scott Benner 1:13:07
Okay, I guess in in the end, you can paint that picture to your doctor as well. And let them help you make the decision. If you can't decide if you're seeing Yeah, man or not. Carrie, I find that thinking about insulin is like a time travel movie, right? Like insulin I use now is for later. But really insulin that's happening now was from before, and it always helps to have another person to talk about that with. So you don't get a little lost. You know what I mean? Like, it's great to talk to your healthcare provider, your nurse practitioner, whoever it is that you're making those decisions with, because it's nice to just have another person to bounce it off of sometimes because, you know, like, at some point, you're sitting in the theater, and you're like, I don't understand how to slow those down. Like, you know, like, you need somebody else to chat with about it and, and make good sense of it. You sound like you would be a good person to do it. With.

Cari Berget, MPH, RN, CDE 1:13:56
Oh, well, thank you. I really enjoy it. And I do it a lot. So love working with people to get those carb ratios. Right,

Scott Benner 1:14:03
right. So if I even if I start the pod, and I'm like, Oh, God, I used all the wrong settings. I just might have to wait a little longer for it to figure it out.

Cari Berget, MPH, RN, CDE 1:14:11
Yeah, exactly. Yeah, you might just have to wait a little longer, but it will get there. It will all be okay.

Scott Benner 1:14:17
Okay, so time settings. bolusing. You know, the way you need to Bolus whether that means amount or timing, timing and amount, such a big deal. And then just let Omnipod five do its thing.

Cari Berget, MPH, RN, CDE 1:14:32
Yeah. And can I make one more comment about that? So the other thing is, like I already told you like, I highly recommend following the Bolus calculator for correction doses so that you can work with the system and not against it. But if you find that it's always recommending zero, and you're still running high, again, you don't have to just sit there it could be that your correction factor is two Hi, it needs to be stronger. I find that correction factor is like the forgotten about setting often. In pump therapy, you know, we're all in manual therapy, we're always tweaking the basals. And we often change the carb ratios, and we hardly ever do anything with the correction factor. And so I see this, you know, 15 year old and they have the same correction factor from when they were six

Scott Benner 1:15:22
was 350 points. Yeah, it's like, I don't think

Cari Berget, MPH, RN, CDE 1:15:25
that one unit is going to drop the 300 points anymore, you know, so the correction factor, yeah, it needs some attention to sometimes, you know, yeah.

Scott Benner 1:15:34
And I know it's, you know, it's, it sounds super simple. But the idea of, you know, if your correction factor is one unit moves you 50 points, but you haven't looked at it since you were five years old back when it was one unit moved to 350. Now you're trying to adjust the high blood sugar, and you have no hope of that working. And on top of that, you've told the algorithm this should work. And you've given a bad information.

Cari Berget, MPH, RN, CDE 1:15:59
Yeah, isn't the Bolus calculator is just going to use whatever is programmed in there to as part of his calculation, so Right, yeah, it makes a big difference.

Scott Benner 1:16:06
Okay. Well, I think this is a great time to break and say that we hope we see you in part two, where we're going to do a deeper dive on settings.

I'd like to thank Carrie Birgit for being on the show today and sharing her knowledge about the Omni pod five with us. And a huge thanks to the listeners of the podcasts who shared questions and comments that led to the building of these three episodes. If you're interested in getting started with the Omni pod five, we're learning more about it, go to Omni pod.com forward slash juicebox. And don't forget that these episodes will be available in your audio app forever. But you can also find them at juicebox podcast.com forward slash Omni pod five. This episode was just part one of a three part series, you still have Omni pod five pro tip settings and Omni pod five pro tip connectivity to listen to. If you found this episode helpful, and you're new to the podcast, be sure to subscribe or follow in your audio app for more diabetes and on the pod five content. Thanks so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. A huge thanks to athletic greens and contour for sponsoring this episode of the Best of the Juicebox Podcast. Get started today with that green drink ag one from athletic greens, athletic greens.com forward slash juice box you and I could be doing the same thing every morning together except not really together. But I mean, we you know what I mean? And of course, you want you need you deserve an accurate blood glucose meter contour, next gen at contour next.com forward slash juicebox. When you click on the links, you're supporting the podcast and I appreciate it very much. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

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