Scott Benner 7/18/23 Scott Benner 7/18/23

#956 Diabetes Myths: Type 1 Diet Restrictions

A brand new series examining the myths surrounding diabetes.

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Scott Benner 0:00
Hello friends and welcome to episode 956 of the Juicebox Podcast

Jenny is back and we're gonna do another diabetes myth episode today's topic was sent in by listeners. And they say that people think that they have diet restrictions because they have type one diabetes. Jenny and I are going to talk all about it and read some listener feedback. While you're listening. Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your healthcare plan, or becoming bold with insulin. Save 10% off your first month of therapy@betterhelp.com forward slash juicebox. Get a free year's supply of vitamin D and five free travel packs with your first order at drink a G one.com forward slash juice box. And you will in fact save 40% off of your entire order. When you use the offer code juice box at checkout at cozy earth.com I actually use that offer code the other day and bought myself some clothes, cozy earth.com. If you're looking for the bold beginning series, the diabetes Pro Tip series, the type two Pro Tip series or any of those sorts of things, go to juicebox podcast.com. Look up in the menu or in the feature tab of the private Facebook group Juicebox Podcast type one diabetes. This episode of The Juicebox Podcast is sponsored by the Omni pod five, you can learn more and get started today at Omni pod.com. Forward slash juicebox doesn't matter if you prefer the Omni pod five, where the Omni pod dash, my link is the place to go. omnipod.com forward slash Juicebox Podcast is sponsored today by better help better help is the world's largest therapy service and is 100% online. With better help, you can tap into a network of over 25,000 licensed and experienced therapists who can help you with a wide range of issues. betterhelp.com forward slash juicebox to get started, you just answer a few questions about your needs and preferences in therapy. That way BetterHelp can match you with the right therapist from their network. And when you use my link, you'll save 10% On your first month of therapy. I was thinking that we could tackle the myth today that people with diabetes have diet restrictions. Sure seem fair. Okay, that seems fair. So I'm going to just go right to the first piece of feedback. Okay, this person said, people tell me that type ones can eat certain things. And I have a couple of family members that tell me about my type one, and oh, how he can't have this. And he can't have that. And, you know, maybe they should shy away from this. Like, like, it's a lot of that verbiage is being used, like, you know, so this person is trying to tell them, Listen, my kid can eat food. And here's how it gets handled. But people don't want to hear it. It seems to be the biggest problem. Next person says, everyone thinks I have to eat sugar free everything. That everything I eat has to be diet, but a lot of that stuff tastes gross to me and I don't want to eat it. So even that even that is interesting, right? Like the person does not want to eat the thing, but they're getting so much pressure from someone that they've tried it. They now know that they don't like it, but they still feel the pressure. Right? Yeah, absolutely. Does this happen to you?

Jennifer Smith, CDE 3:46
Ah, let's see. Recently, no. But in the past, in the past it has and I think and I think we met we talked about this in one of the other myth episodes as well is there's some old school thought to what's being told about what you can and can't right have. I mean, years ago, when I, the years after I was initially diagnosed, there were things that were just, I don't do them anymore, right. But they're also things that my family just, they just didn't do either. So it wasn't a my brother gets this but Jenny doesn't get this. My parents were like, No, it's going to be fair and clean. Everybody is just going to do it the way that Jenny does it right. At holiday kind of types of gatherings with friends or family my my favorite aunt actually, she would always make the vegetable tray right? Because those at that time were considered free food. And so Jenny could always have Have those items versus the other trays of things that were all of the cookies and treats and the bars and whatever, which did my parents let me have that occasionally? Sure. But they were definitely more of a, I'm not the greatest to have or indulgent or have four cookies at one gathering with friends just because I wanted them. Could I have had them? Absolutely. At that time, though, we didn't have the knowledge of how to take care of that. Today, we have the technology, we've got the information. And so I think it we have to transfer that old school thought into today, we've got insulin that works faster. We've got technology, we've got a visual on our glucose levels, we've got machines and pumps and things that they leap over that, yes and no food, and they allow people to absolutely eat what they want to

Scott Benner 6:01
eat. Yeah, it allows the separation between what should I have nutritionally? And what can I do without it impacting my diabetes poorly? Because you know what I mean by that, like the Cookies, cookies are a great example. No one, none of us should be eating four and five cookies at an event? No, no, but we. And I think these things get blurred together sometimes. But if you're going to eat them in your blood sugar is gonna go to 325 for four hours. Well, then that seems like a more imminent, you shouldn't do this. I think that's the two things to get blended. Right?

Jennifer Smith, CDE 6:37
Correct. Yes. Well, and I think you brought up a good a good point there. Like, nobody should eat four or five cookies at one time, you just shouldn't. And so there's a whole nother avenue of a discussion that is a little different than this, but it it kind of gets blended in because if all the kids or all the adults are doing something at a party or a gathering or a social event, or at a business meeting or whatever. Sure, you can follow suit. But in general, is it really good to do it all the time? Yeah, no, it's just not.

Scott Benner 7:18
And I see, you see where the resistance comes from, from the mother of a child, a father of a child or the adult living with? Because you don't want to be told what to do? Like, that's the that's the worst feeling in the world. Like, you can't I mean, you can't eat that as a statement, or a direction. Right has to be incredibly difficult to hear, right? And then you go, Yes, I can. And either you think, yes, I can, because I know how to cover it with insulin, or you think yes, I can, my blood sugar is gonna go up and I don't care. Like I'm not going to be stopped by this thing. Right? These things are, again, they're completely different. It's so interesting that you said about the plate of vegetables, because the next thing on the list says, I wish that people understood that candy is, you know, I'm told all the time that candy is the root of all evil, but somehow fruit is okay. And so she she gives an example. I'm not saying By the way, you should eat candy over fruit. This is her bigger point. A family member that meant very well made a beautiful tray of fruit for a holiday party, brought it put it down and came over and said, Hey, I made this because I know you can't eat the other stuff. You can't have desserts, right? Meanwhile, the impact from a fruit tray or the impact from a piece of cake is probably the same. Maybe worse. If it's the fruit like who knows, you know? So again, nutrition and blood sugar, two different ideas. Are you better off eating a plate full of fruit? Sure you are. Right, then then having a plate full of cake nutritionally, of course, that makes sense blood sugar, right? Maybe no difference.

Jennifer Smith, CDE 8:55
Maybe no difference and or, you know, maybe in fact, depending on the cake, or the cookie or whatever it was with cream cheese frosting. Maybe the cake actually doesn't hit you like the big plate of grapes and cherries that you're planning to eat instead. So it's a spike now versus a spike leader. So but they're absolutely it's a great point. I mean, it's sugar is sugar is sugar. Sometimes there's more complex sometimes there's a little bit slower, something that mixes up how that sugar impacts your blood sugar. But yeah, I mean, lovely that the person was like, Hey, I brought the fruit for you. You're thinking that's great. I'm still gonna have the key I got you

Scott Benner 9:36
covered. Don't worry. I know about I know all about your bees. I'm on top of wonderful. I don't know wait here go. My most recently my father said to me, oh, about my son. His blood sugar must be so well controlled because of the diet weed. And the person said it's not because of that at all. I know how to use insulin. And so by But that's not but that's not what the father sees. The father sees, oh, the kids not spiking all over the place, it's got to be this food that gets so interesting how people see ghosts and so many things, they think they see something, it's not really there. Now, sure, the other side of this would be if you ate a very low carb existence, and you had type one diabetes, you would require much less insulin, you'd have much less variability. And there is no doubt that from just that blood sugar perspective, things would be easier, very likely, right?

Jennifer Smith, CDE 10:32
Very likely abs, yes, 100%, the majority of people who really are following a very low carb, or what a lot of people call a ketogenic diet, right, there is a lot of stability following that. And if you're doing it the right way, nutritionally speaking, you're not necessarily doing all of the fancy stuff that's on the market, but you're actually just eating clean food, and getting in really low carb intake and high fat intake, to complete your caloric need, right, you're gonna get stability, you're probably going to get some weight modification, you're going to go down in insulin need, although your insulin needs will change in a different way you'll learn insulin effect, to work with that type of fueling plan, in a very different way than covering for carbohydrates. Yeah,

Scott Benner 11:30
I once had lunch with a type one who ate completely like, no carbs, all meat, this and 45 minutes later, they picked up their controller and gave themselves insulin to Bolus for the protein and the fat rise that they knew where it's gonna come. It was much less insulin, etc. I think again, the problem comes when this is a little different than the other thing, but in the diabetes community amongst the group of people together, who all have diabetes and have different experiences and have figured out different things. If you say, Hey, I don't know how to like, stop this spike, my kid went and had ice cream and this spike happen. You're gonna get somebody who is very low carb, keto, something like that. And they're gonna come in and say, oh, you know, don't eat carbs. And that won't happen. And you're like, well, that's not helpful. You know, like, like,

Jennifer Smith, CDE 12:24
Oh, that's not what, that's not what I want to do. Right? It's not the masking, right? That's not the question, right?

Scott Benner 12:30
Yeah, no, that that's, you know, it's not a Hey, Doc, it hurts when I do this. Don't do this anymore. Like, it's a decision you've made as a person eating that way, which I think is terrific. If anything, you figure out what works for you is amazing. You know, so but you can't just show up at somebody's door and say, you can't you can't eat carbs. That's the problem. You can eat carbs. I'm not going to bore you with it. But artists 24 hours, or just last 24 hours include a late night meal. I'm talking like 10 o'clock at night. Rice, steamed carrots and shrimp. Now, were there concessions made its basmati rice, not white rice like sure, right? Correct. All right. And there's not a bunch of there's no breading on the shrimp. It wasn't fried was sauteed like, okay, right, those things. But there, I gave her a bowl. I mean, between the rice and the carrots, and there had to be 45 carbs in there maybe like more maybe? Who knows?

Jennifer Smith, CDE 13:30
Let's not have been a very big bowl. It was pretty. It wasn't huge. I've been here. Okay,

Scott Benner 13:36
fair, a fair amount of rice, more carriage than rice, the shrimp except her blood sugar has not been under 70 or over 120 in the last 24 hours. So that it's doable. I saw her during the day, have a little chocolate thing where she ate a bunch of those little dove, like dark chocolate hearts. Sure, you know, like, I don't know, like, it's just do people with diabetes have a diet restriction? Yeah, no, but no,

Jennifer Smith, CDE 14:07
no and. Right. It's a little bit of both. Like somebody actually asked, I think this definitely fits here. Somebody asked me not long ago. Well, do you restrict yourself? No, but I also have certain preferences. I have many years of learning what I can do almost all the time, and I know it well enough to take care of it and handle it right. And then there are the things that are there not the 80 to 90% of quality food that makes up from a fuelling standpoint, from what I want to put in my body because it needs good nutrients, right. Those are the foods that I don't restrict them. But when I do the non typical foods I tend to do them when I know I can I say good got away with it. I don't. And I don't mean it in that way, but it's kind of the way that it works out. Like, if we're, if I've had a day that I've had just a lot of activity, or I've had a really good run or something like that, I have a sensitivity component that I can get away with. Now we're gonna go out for like the dinner,

Scott Benner 15:24
a lot more insulin, because you've got all that exercise on board. That's gonna correct,

Jennifer Smith, CDE 15:27
right. So I'm not restricting. I'm just, I guess I feel like I'm saving those types of things that I may want to do occasionally, for times, when I know that it's really going to work out to my advantage, and that I've figured out how to work it in.

Scott Benner 15:41
I feel like the word restricted stems from this idea that we should be able to just eat as much of anything that we want. So it's like, it's like an American freedom idea. It's like, you're not gonna study, right? We're gonna, I'm not going to make a pork chop for lunch, we're going to kill a whole pig. And you know, that kind of thing. Like, like abundance, like that whole, like, bigger is better. I mean, you go to some restaurants, and they give you food. And I think is this for all of us? Like, like, I but eventually you just eat it. You're like, Okay, I'll eat this. And then that like clean your plate mentality comes into your head. It's interesting how, in the 50s, it was clean your plate, right? So that's how our parents, my parents were definitely raised that way, like clean your plate. This foods expensive. I mean, if you grew up at my time, and somebody didn't tell you, there was a child starving in Africa. So you had to eat all this food, like I don't know, like that happened constantly. Well, and there

Jennifer Smith, CDE 16:39
were commercials for it on television. So wasn't just that you were hearing, or seeing these poor children.

Scott Benner 16:45
Oh, my parents knew they had television, right, like so this was the way people spoke. So now, we shift into a more kind of abundant lifestyle in more modern times, but we were raised with, like, eat all that food. Like if I think back to the amount of food my mom gave me versus the amount of food a restaurant makes, and then I start making for ourselves, those are significantly different portions.

Jennifer Smith, CDE 17:09
Yeah, I was actually going to ask comparatively, if you remember, what was the difference between what was put on your plate as an expectation, you will eat this, versus what we now have the ability to put on our plate, you know, if you have access, and enough to do it, it's probably at least double if not maybe triple. In some people's eyes,

Scott Benner 17:31
my simple example is this, my mom would buy five pounds of potatoes, and try to figure out a way to make them last until spuds started growing out of them. I open up a bag and I go, Oh, just make these five pounds of potatoes like this. As far as someone said they wanted mashed potatoes, obviously, five pounds is the way to go. And then. And then eventually they go into the refrigerator. And people kind of pick it them throughout the week. I'm not saying we'd five pounds at a sitting. But I do think you put more on the plate because it feels like generosity, it almost feels like love, like here have a bunch, you know, like that kind of thing. And so I think that again, these things get blended together. And that's where these conversations end up coming from. Yeah, absolutely. I realized, Jenny that the myth series was going to be more about psychology when we started it, by the way, but Oh, been fun so far.

Jennifer Smith, CDE 18:23
It has Yes. And I think that's another piece that as you talk about portion, I think it's a really big missing piece in education overall, it really is. Nobody, nobody these days gets educated about a real portion of meat or a real portion of vegetables or what a portion of fruit should look like or like your potatoes, like half your plate shouldn't be potatoes. I don't care if you like, half your plate doesn't need to be potatoes with three sticks of butter on it. So necessary.

Scott Benner 18:56
I just recorded with Jake leach yesterday from Dexcom. And that he discussed how they're going to present a sensor next year that's going to be for people with type two who don't use insulin. And my Oh, which is terrific. Right. And I immediately talked about how you know Arden moved from G seven from G six. And we had two sensors left and a transmitter. So I put it on my brother who has type two diabetes. And in 10 days, the light bulbs that turned on for him that hadn't been turned on in years of doctors yelling at him you don't eat right, like, you know, like, probably not trying hard enough. Like all that stuff. He suddenly was like, Oh, I see what happens now when I eat these foods. And it's so quick. It turned the light on for him. But people don't know about food. Like it's just so this is it. This is exactly what happens here. You get diagnosed, somebody tells you you can't do a thing. You brusque against that because you don't want to be told what to do. Somebody else who has no idea what they're talking about says something to you like let me read a quote here. Oh, I didn't know she could eat that. Or when this woman says her co Workers brought snacks pass them out to everybody skipped her

Unknown Speaker 20:03
except

Scott Benner 20:07
as she cruised by, I'm picturing a cubicle said I know you can't have this and rolled right past her. Right? So, or even when somebody here says they're trying to stop a little blood sugar with a pack of Smarties, and during the low blood sugar incident, someone a loved one looks at them, he goes, Do you really think you should eat all of them, you have diabetes. So, so when those things get blended together with just the misunderstanding about food to begin with, and this generational inclination to eat more, give more. It's what led me to say, when you and I did an episode about like ozempic, and things like that we did like a type two, it was part of the type two series, I had this kind of like whimsical idea while we were talking that I've not let go of yet, which was if you injected everyone right now with this stuff and took their hunger away, that in one generation, a whole new group of children would not eat as much food, because you would draft you would teach them to eat less by example. Absolutely. I'm saying we should like put it in the water or anything like that. But like, you know, it's not wrong. Like if everyone's parents used less food, more nutrition, it would literally take a generation for that to flip flop around. Right? Yeah, yeah. And I saw it just recently, because my son has been gone for seven months, he's been living on his own. He flew back to spend a couple of days around my birthday. And he had a couple days off from work. And while he's off on his own, he's cooking for himself, pre making his meals, he's trying to be very conscious about money. But also he realizes he's not as active as he used to be, like, all that stuff. And he came home, and he started eating more like he was a kid than the adults that he is off on his own. I noticed that in a couple of days.

Jennifer Smith, CDE 22:00
It's because mom and dad's house has more up here,

Scott Benner 22:03
because we have more money, because we make more money than he does. And so there's extra stuff here. And he's like, Oh, I haven't had these in a while, which was I didn't want to pay for these. But then his stomach started hurting. And I was like, Yeah, you're eating better on your own because you're eating less food. It's for you. It's because you don't have as much money. But who cares why the truth is he's making clean meals for himself. And I don't know, it just it's all so freakin obvious.

Jennifer Smith, CDE 22:34
And the interesting thing is that he's learned that almost on his own, it's not like you gave him a big a big sit down lecture before he left the house to be like, You know what, you really have to think about all and maybe you did, maybe you talked about some things in terms of budgeting, or he just saw that while he was growing up or whatever. But he's kind of taken this on, on his own, which is, it's really adults, like good for him.

Scott Benner 23:01
That's fantastic. I'm excited for him the extent of what I mean, listen, we're careful with money in our house. And that stems from me. You know, while we're talking about where everything comes from, I grew up broke. It's not hard to figure out right? And so, but on the food side, I've told them throughout their life growing up when they were old enough to understand, I grew up like a monster with food, like everyone, for the most part did unless you had a nice granola mom like Jenny who's like was going to be like, hey, I'll grow some stuff in the backyard. Like the rest of us. The rest of us grew up eating like Kentucky Fried Chicken and drinking orange drink and thinking it was juice and like anything you juice was good for you, etc, and so on. And like so I figured it out as I became a young adult.

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And I did my best to change the course of the ship. But it wasn't that easy. So, you know, so I told I would tell them along the way, we've done our best to give you a better view of food. But the truth is, you do not have a completely correct view of it. Like it's better than what I had. And I'm moving in that direction again. But and they took that seriously. So, you know, I got lucky there, basically, yeah.

Jennifer Smith, CDE 26:40
I know. I mean, we've tried to do the same. You know, with our kids, we have a garden, we teach them where food comes from, we've taken them to farms, they know what a chicken looks like, they know what a cow looks like they know where food comes from. And a lot of people just don't have the opportunity or understand that that's an important thing to teach. I mean, we've teach we teach portion, like my kids know how to read a food label. Not many kids their age, without diabetes, know how to read a food label, you know. So, you know, these are again, they're things that aren't being taught. And we need to remember to teach them I would say that people with diabetes are probably a step ahead in terms of understanding compared to the general public, which isn't a bad thing. Yeah.

Scott Benner 27:25
So I've so that's my public service announcement, you should eat better, you should eat whole foods and limit sugar intake and like you shouldn't, you know, your day shouldn't be 600 carbs or something like that, you know, like, like, all that's aside. Now, having said all that, if you can't accomplish that, for some reason, the answer isn't give away your diabetes health on top of it. Like right, that's it. So maybe you'll get the eating thing together, and you'll figure it out. But in the meantime, we don't just go Oh, sugar makes my blood sugar go up, and I don't do anything about it. And I can't stop eating ice cream. So I guess I'm gonna die. Like like that's, that's what the at the core of what I think this podcast is about, I think it's about taking the correct amount of insulin for what you're eating.

Jennifer Smith, CDE 28:08
Correct. And that goes right along with not having to think about the word restriction, right? It's learning how to use this medication that we have to have in order for the food that we choose to put in to actually work well and keep our body healthy. Long term. Yeah,

Scott Benner 28:27
I choose to take a bigger, holistic view of the whole thing. I don't I think that it's obvious where we all are as a society. I don't think that you just changed that with a light switch because someone told you you have type two or type one diabetes. So we're going to take care of our health, learn how to manage that. And then hopefully over time, you will come to a better understanding about your food. And if you don't, at least your blood sugar's have been under your control threshold. And by the way, at least, amazing, you know, right? That's always been my, my perspective. Like if I step back a little bit from like two people having a conversation and talk to you like the person who makes the podcast, it was my expectation that we didn't you can't make everyone do the right thing. So they should have as many tools as they have to apply to whatever their thing is correct. Yeah. And I don't have any trouble with it like to say that. I don't want people to hear that and go, Oh, he says Bolus for whatever but he's at home eating quinoa. I've never had chemo on my life. I couldn't identify. And I had three chocolate chip cookies last weekend. But, but what happens again, like Jenny, our pediatrician diagnosed us and the first thing I thought is I can't bake anymore. I love baking. You know like so that's that's how that hid a person who didn't know anything about diabetes five minutes before. People think I have to bring or drink something special because they don't provide drinks for me when I come to fat family gatherings. This is a big one. And isn't it? diet drinks? There's a divide in the world. There's people who don't worry about their blood sugar who say, I don't eat that aspartame, it makes mice go crazy or whatever they say. And then there's people like I, I can't have a drink with sugar and it'll make my blood sugar go up to 400 That's that one happens constantly, doesn't it?

Jennifer Smith, CDE 30:22
It does happen and I'm, you know, I'm in a different sort of lane altogether. I don't expect somebody to have something for me for a beverage. I always bring my beverage along. If I want something outside of water, which, these days most people have bottled water or something available for people to drink. Great. I'll have that. If not, I will bring my own stuff along that I know what's in it. I know that it's not you know, whatever color such and such. That's going to turn my eyeballs green.

Scott Benner 30:54
Well, Jenny, now that I jacked up on the Wii govi I'm bringing, I'm bringing my own drinks places. Not that I would, I would never drink a sugary drink. Like I just was beyond like my I can't even tell you what it tastes like if I drink something like that.

Jennifer Smith, CDE 31:11
Did you? Did you grow up with sugary drinks? Or did you not because I I also don't prefer sugary or sweetie types of drinks. But we didn't grow up. We did even before I was diagnosed. It was not in the house because my that was just it was either milk or water. That was what

Scott Benner 31:28
we drank cut rate soda. So whatever like the you remember the Did everyone have a grocery store that the bags didn't have printing on it. So they were cheaper. And the labels were all white is like poor people grocery store, you might not have had one I had one. And that's where we used to go. So like off brand soda juice, like in, you know, giant tubs of sugary crystals that you dissolved in water. Like that's all we drank. But I as I got older, I was like, That's stupid. I'm not going to do that. And, you know, and so I changed that. I think I went to diet soda first. And then I lost my flavor for it. Like now I can't like I was in a restaurant in Atlanta visiting with my son. And they had Mexican coke. So like real cane sugar, Coca Cola, and I was like, give me one of those please. I would like to try that. It was like a 12 ounce bottle. I was halfway through it. I'm assuming that's what meth feels like. Like, holy hell. I was like, I can't keep doing this. So I just I stopped. I was like, Does anyone else want to try this? I can't completely drink this gel on my stomach. It felt weird in my head. It tasted horrible. Like as far as I could tell. But no, I grew up with it. I just changed my palate. On that one. Yeah.

Jennifer Smith, CDE 32:50
So I think the last sip of like real soda actually had was we went on a trip to Peru with some friends who were Peruvian. And they insisted we had to try this, like neon yellow soda from the bodega down the street. Like, okay, like there's no label on it. This is a total like, swig of sugar, or whatever.

Scott Benner 33:16
I guess I'll see what happens. I don't even know where this came from.

Jennifer Smith, CDE 33:19
I don't know what the flavor was. I have nothing to compare it to. But I could not believe that this was the like it was the beverage. Yeah, it was like the thing did

Scott Benner 33:30
you know what also changed my palate is that I grew up with like legit sugar. Like my example here is if you eat Fruity Pebbles, or Apple Jacks, if you're a person who's doing that right now, in real time, you are eating a terrible version of Fruity Pebbles and Apple Jacks because they were so much better in the 80s that I don't know why I have no idea why. But they changed the food that I grew up with. And so I was like this. I don't even like this anymore. It's not good anymore. It got me away from it too. I can't tell you how many here are just like my son. They they told me my son can't have cake. My daughter has dietary restrictions. This goes on and on. Here's one though. I hate that people think my child cannot eat sugary foods or junk foods even because he has type one, or that his diet somehow caused this type one. a teaching assistant at school tried to deny my eight year old non type one son ice cream because his brother has diabetes. So that lady turned to the sibling and when you people you're prone to this you can't have no ice cream. Like that's that's something

Jennifer Smith, CDE 34:40
I also am what I'm astounded about in this whole line of like discussion is how somebody who has not lived it is taking it upon themselves to make a decision for somebody who clearly is living with it. Right like where where do you get one Sorry, where do not make my decisions for me, if I want to down those five cookies, I'm gonna down the five cookies and I'm gonna figure it out and take care of it. And it's, it's not on you. It. So don't worry about me, please,

Scott Benner 35:14
this might be a dangerous part of the conversation for me. I'm fascinated by all the things people think they're qualified to do some way your life is is a dumpster fire this year. Sure about like, fascinating, you know, absolutely fascinating to me. You know, that's a different conversation. That's the conversation, Jenny, I'll have them private when we see each other. On the podcast, maybe. Let's see, people brought meals to our house after my daughter was diagnosed and asked, or told us they didn't bring desserts because they didn't want her to get worse. There you go, Oh, or to keep having diabetes. That was another thing they got. I understand their intentions were pure, but I just kept saying, Oh, she can eat anything. diabetes isn't going to go away. It's a lifelong autoimmune condition. And sometimes sugar saves her life even. She said the looks that she got made made made her feel like they were looking at her like she didn't know what she was talking about. So same thing. And she throws in something else here that has nothing to do with this topic. So I'm going to jump over the I mean, what I'm getting is that people hear constantly Oh, you're diabetic bla bla bla. But here's one, an endo ask them. I was once asked by an endo should you should should you be eating that? Like not their endo and endo in a in a social setting? Wow. What are you gonna do there? I don't know.

Jennifer Smith, CDE 36:44
Maybe that was an endo. who clearly doesn't see a lot of people with diabetes in their practice. Maybe they focus on like hormone regulation, or? I don't know, I'm trying to give them I'm trying to give them some reason for being silly. And what their what they said to that person.

Scott Benner 37:00
You want a funny one? A friend of mine told me I shouldn't eat onions because they're just pure sugar. Think that goes back to your other. Your other statement of like, how do people talk about things that they don't know about? Right? That's it. He's more fruit and vegetables. My gosh, there's so many things here, way back, a school principal asked my mom, if she could wean me off of the snacks. We, oh, that's a quote wean me off of the snacks. And she's saying these were the snacks I use to bring my blood sugar's back up when they got low.

Jennifer Smith, CDE 37:41
I'm curious how it probably isn't in the post. But like that, that sounds almost like when I was younger in school, I did have snack times that were very specific because of the type of insulin I had and the way that it worked. So they were timed. And it almost sounds like this person has had diabetes a long time and remembers that being asked, without the understanding that there was probably something in effect there that the snacks were necessary for not necessarily just for low blood sugars. But maybe that was just the way that it was because that was the way her insulin was working right? And again, we'll weaning you off. Like, when are we going to get to the point that you don't have to send the snacks to school with your child? Well, when the pancreas starts making some more insulin,

Scott Benner 38:35
where are they thinking? Well, the snacks are the problem like one or the other. It doesn't matter. It's it doesn't matter. I'm gonna skip through the your feet will fall off comments. There are a lot of them. But here's the one I was once treating my low blood sugar with Smarties, my husband's grandpa regaled me with a story about how his mother's feet at age 90 lost. She lost a toe and he said you shouldn't eat that. That's how my mom lost a toe. So by the way, that might be how his mom wants to tell. Like maybe she had untreated type two diabetes for most of her life. And like, I have no idea by the way it 90 If the worst thing that happens to be at 90 Is someone takes one of my toes. I'm gonna be like I'm killing it here. But

Jennifer Smith, CDE 39:17
I didn't need it anyway.

Scott Benner 39:19
No kidding, though, Jenny. I'm scrolling past a page of comments about people who have been told about feeds or feet. Yes. People who love to say, oh, that's diabetes on a plate, or that's diabetes in a cup, that that sort of thing. She says I hate that. And I hate it when comedians use it as a joke. This one's interesting. My family was shocked when I explained to them that we actually have more juice and candy in the house now that my child has diabetes than we did before they did. And this one's interesting. This person was told that you can't do intermittent fasting as a type one. I'm going to tell you right now that's not true. That's definitely not true. Arden's I mean listen Arden's on a, on an algorithm. So in fairness, like there's a thing trying to stop her from getting low, but it's very successful. And she is definitely a person who eats at a window. Like I would, I would bet that in a 24 hour period, Arden probably only eats for eight or 10 hours of that. And she's not running around low constantly. Right? Yeah. That's it. That is the end of the diabetes myth. For that we have diet restrictions you have anything to add to it?

Jennifer Smith, CDE 40:34
I don't think so. Not about the diet restriction stuff. Do we have more myths to deal with? Oh,

Scott Benner 40:39
my God. Yeah,

Jennifer Smith, CDE 40:40
don't we, I was gonna like we had 52 pages, there have to be more

Scott Benner 40:44
complications are inevitable that there is a cure, that there are strict rules to follow like strict do's and don'ts. And insulin pump will fix everything. These are all episodes, you will still hear coming in this that you have the bad type of diabetes. Type ones can't be overweight type twos are definitely overweight. Type Two can become type one, vice versa. i You should see. Oh, that this isn't a myth. This is just people who don't understand insulin is what you get when your blood sugar's low. Oh, yes. Insulin pumps are bad for diabetics.

Unknown Speaker 41:27
Huh? Yeah. Really?

Scott Benner 41:30
Yeah. How about that you're doing drugs?

Jennifer Smith, CDE 41:35
Yeah. I mean, that was that's a funny one. I mean, it is and it isn't, I can understand from one perspective that clearly it looks very weird. From one angle to some outsider who just doesn't know. I mean, my friends. I mean, I did not have a pump until I got married. So I was MDI for a very long time. And all of my friends, they love to hang out. Jenny's got a shoot up, it's time to eat. Like they thought it was hilarious. And I did as well. I mean, I was not bothered by that. I'm, I let a lot of things just sort of roll. I'm like, Ah, doesn't, that doesn't hurt me. So whatever. It's kind of funny. So listen, it's

Scott Benner 42:13
one of the all this falls under that category to some if you think it's funny, it's funny. Like, right. Arden does not care if you joke about diabetes. Yeah, she goes so far as to say I don't understand why people are upset by that. So it's just her personality. It doesn't bother her. But there are plenty of people in this document are like comedians that make jokes a diabetes infuriate me. So it's just it's personality. That's all. Alright. Well, I appreciate you doing this with me. Thank you very much. It was fun.

Hey, isn't it nice to have Jenny back. Thank you so much, Jenny. If you'd like to, you can hire Jenny. She works at integrated diabetes.com Thanks so much to Omni pod for sponsoring this episode of The Juicebox Podcast. Don't forget Omni pod.com forward slash juicebox Get started today with the Omni pod five, where the Omni pod dash and everything check your eligibility. Take a Test Drive. It's all there Omni pod.com forward slash juicebox. If you're looking for community, check out the Juicebox Podcast private Facebook group, which now has 40,000 members in it and adding more every day. Check it out. There's something there for you. Juicebox Podcast type one diabetes. Thank you so much for listening. I'll be back soon with another episode of The Juicebox Podcast. Hey, everybody, better help as a sponsor of the podcast, and they're offering my listeners 10% off their first month of therapy. It's a great deal. I hope you can check it out. Better help.com forward slash juicebox. Now better help is the world's largest therapy service. That is 100%. Online. They have over 25,000 licensed and experienced therapists, they can help you with a wide range of issues. All you have to do to get started is hit my link. answer a few questions about your needs and preferences and therapy. And that way better help will be able to match you with the right therapist from their network. Better help.com forward slash juicebox you're gonna get the same professionalism and quality as you expect from in office therapy. And if for any reason your therapist isn't right for you, you can switch to a new one at no additional charge. Do therapy on your terms, text chat, phone video call and you can even message your therapist at any time and then schedule a live session when it's more convenient. So if you're looking for someone to talk to check out better help

#955 Hindsight is 20/20

Sami has type 1 diabetes, is unsighted and has some other issues.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello Friends Hello friends Hello friends Hello Hello Hello Hello friends and what? Hello friends and welcome to episode nine I don't like the way that sounds Hello friends Hello Friends Friends Hello people of Earth Hello friends and welcome to episode 955 of no no not okay you guys hearing that? Am I gonna leave all this? I'm? Probably not hold on all right Hello friends and welcome to episode 955 of the Juicebox Podcast nailed it

Sam is with me today she has type one diabetes and is blind. She also has some other issues she's had a transplant. There's a lot going on here. This is a very, very, very, very, very interesting and honest interview. While you're listening to it. Please remember that nothing you hear on the Juicebox Podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your health care plan for becoming bold with insulin, drink a G one.com forward slash juice box that's my link to get started with a G one. When you use the link you'll get five free travel packs in a year supply of vitamin D with your first order. My cozy Earth offer code now gets you 40% off everything at cozy earth.com that offer code juice box. I'm talking about super comfortable luxurious bedding, clothing and towels. Cozy earth.com use the offer code juice box at checkout to save 40% off your entire order. All right, I hope you enjoy Sammy as much as I did. I'll see you on the other side

today's episode of The Juicebox Podcast is sponsored by Dexcom Dexcom of course makes the Dexcom G six and Dexcom G seven continuous glucose monitors dexcom.com forward slash Juicebox Podcast is also sponsored by touched by type one, they've got their big event coming up soon. I'm going to be there speaking you should come touched by type one.org. The event is free and open to everybody whose lives are touched by type one diabetes.

Sami 2:41
Hi, I'm Sammy, and I am a diabetic. who is blind from type one diabetes.

Scott Benner 2:51
Okay, Sammy, you were how old were you got type 117 How old are you now? 4817 48. Okay. And was there other type one in your family or other autoimmune diseases?

Sami 3:05
No, no one on either side. It was it was new. I didn't even in high school. I didn't I never even heard of the word diabetes. Never heard of the disease. So it was all new to me and my family.

Scott Benner 3:20
And just 17 years old bang, here it is. That's 31 years ago. Is that right? No? Yeah, no. Okay, so in the early 90s,

Sami 3:30
yep, 90 to the end of my junior year. So this is

Scott Benner 3:35
right around the time. People are transitioning to faster insulins away from maybe starting to get away from regular an MPH did you start? What did you start with?

Sami 3:52
I just remember it was a violent syringe. I honestly don't remember what I started with. At that time I was sighted. And over a two week period is when I kind of experienced the symptoms of weight loss and having to urinate all the time. Dry mouth. I didn't really think anything of it. My brother had mentioned something and so went to the doctor and tested my blood sugar and is over 600

Scott Benner 4:24
Wow, your brother mentioned that you look like you lost weight.

Sami 4:27
Yeah, yeah.

Scott Benner 4:32
Interesting age. So you're 17 does this lead to your parents saying sent me we're gonna help you with this? Or does it lead them to say, well, this is your thing. You have to take care of it or how does that go?

Sami 4:46
Like I said it was it was new to all of us. So we were learning. We were learning together. And at that time back in the 90s I kind of had a older doctor who was kind of by the book we're no sugar, you know? None of that good stuff. And I'm like, I'm a teenager, I live off of sugar. I live off a mountain dew and Snickers. And so that was a big, a big step to try to change. But I didn't I just thought the doctor was thinking no not being I'm a teenager, nothing's gonna happen to me. I'm invincible. I know better.

Scott Benner 5:20
So, so you're met with change your diet? And do you say no, I'm not gonna do that.

Sami 5:26
No, I didn't. I didn't say because I was still in that kind of fear mode. What is happening to me? And don't know what, what it's going to bring to my future, you know? So I just kind of did it on the slide. Underneath, kind of underneath my parents knows when they were trying to help me eat right and stuff. But when you're at school vending machines, that's was my that was my go to lunch.

Scott Benner 5:57
How were you doing the insulin? Was it? Do you remember? were you shooting it twice a day? Were you shooting it at meals? How were you? How was the management setup?

Sami 6:06
It was supposed to be with meals. But oftentimes I skipped because I was in between the in between classes and stuff. Didn't check my blood sugar at my locker trying to be really discreet. And so oftentimes, I just skipped it and kind of guessed on what I ate and what my blood sugar was, and kind of went from there. And over 12 years, that kind of habit. lead to losing my sight.

Scott Benner 6:34
Well, how long did that take to happen?

Sami 6:40
Happening Oh, four. So there was a more he was gradually over eight months, I noticed. Ironically, I was working at a deaf and blind school. And I woke up one morning and my eyes were swollen. And my vision was blurry. And it took half a day for my vision to return. So then I decided to go to see an eye doctor. And they said, My, both my retinas were detaching, and I would need surgery. And then at that time, I was working part time, no insurance. And back in the 90s. If you didn't do college or anything, you weren't under your parent's insurance. So after 18 I was on my own. So no insurance, paying out of pocket for meds when I really couldn't afford using syringes, twice, sometimes three times just to save money. So it was a lot, a lot of mistakes, for sure.

Scott Benner 7:40
So that onset of that issue is about 12 years after your diagnosis. Yeah, okay. And for those 12 years, I want to try to give people a picture and by the way, you're very kind to come on and talk about all this. What what did you not do for 12 years? That I think that's what I want to know about like, and were you not doing it? Because you didn't know better? Or you're not doing it because you just thought oh, it's not going to happen to me like what was your whole mindset around it?

Sami 8:14
Like it's going to interfere with my mind because my sports again, nothing's going to happen to me, you know, going into my early 20s very active in sports and taking the time like in between games, especially on the weekends competitive softball there was no you know, you didn't really have time so just skipped like I said skipped eight meals skipped my insulin sugar was skyrocketing high would take it just for their blood sugar the correction and then it would drop with the sports so it was a it was a roller coaster up and down all the time. But more so on the high side than the low side. We're talking three hundreds for hundreds back then I would wouldn't feel sick like some people do. This more of the dry mouth that I would experience and everyday go yep, I no time to try to save on test strips because those are expensive too. So guessing what my blood sugar was based off how I felt. So a lot of them misbehaving I guess I'm like, again, I couldn't afford to go to the doctor. So I try to do everything on my own. And at that time, I'm still new to it. So a lot a lot of guessing of what I should do a lot of bad guessing.

Scott Benner 9:40
Do you recall getting information from doctors that was valuable that you were ignoring or, or misunderstanding or was it not even coming?

Sami 9:51
It was probably there. I mean, back then there was no internet nothing. So it was it was paper and I'm like I don't have time to sit here and read this you know but it wasn't. I don't even think I even met with a nutritionist back then too. It was just strictly the doctor. And like I said, she was kind of older and old fashion. And I didn't like her. My parents didn't like her. But that's, that's who I had as a doctor. So, again, trying to avoid that going to see her was my biggest thing. And then she retired and got a new doctor, which was younger, who I liked a lot. But again, still couldn't afford the appointments, couldn't afford the insulin, the syringes, the test strips, so a lot of

Scott Benner 10:36
your parents school, your parents couldn't afford to help you either.

Sami 10:39
No one had four brothers shows. It was tight.

Scott Benner 10:44
Was there ever any conversation about what the consequence would be of that?

Sami 10:50
Um, probably, I don't remember. But probably I know, over the years, doctors who have kind of warned me and like, Hey, you don't know nothing. You know, this is my health my life. I'm okay. But I did notice a few years and before I lost my vision, and Oh, for that my vision would get blurry. And I just thought, Well, I'm working nights. I'm tired. My eyes are tired. But I never got my honest because I couldn't afford it either. So there were signs that I just ignored.

Scott Benner 11:23
Now I understand. What does it mean that you lost your sight? But what is the level of are you citation?

Sami 11:31
There's no vision, nothing whatsoever.

Scott Benner 11:34
Okay, so things are like, as you and I are talking right now? How do you describe what you what you take in? Is it black blackness?

Sami 11:44
Yeah, like, if you were, if you were in a dark room, that's like you don't see anything? Or if you close your eyes, there's nothing there.

Scott Benner 11:50
Right? Is it helpful in your day to day life that you recited for a while? Or does it not matter?

Sami 12:01
It's yeah, I definitely miss it. I miss my brothers growing up. And I have nephews that I've never seen, or last time I seen them was two years old. And they're 28 and 23. Now, so that's the last image I have, in my mind is last time I saw them, my two younger brothers were elementary and middle school. So there's a lot of things that I've, I miss, for sure I miss driving. For sure. Uber and Lyft is great, but it's expensive. And so not being able to get in the car and go whenever I want to, wherever I want to. I simply I, I really miss. But on the flip side of that is, I've met so many nice people as a blind person. And I tell people that I've been more blessed as a blind person than I was as a sighted person. And kind of what I mean by that is, as for me as a sighted person, more superficial than those who maybe were prettier than me, or more athletic than me just to try to fit in. And now I don't I don't you know, I don't see skin color. And I see personality, I see what comes from the heart. And that makes a big difference as to who is in my life now. And before?

Scott Benner 13:34
What our day to day, day to day. Are there things that you can accomplish that you miss? Or do you just adapt?

Sami 13:41
You adapt. There's lots of technology out there, like the Apple has what's called VoiceOver. And Apple specifically created that for blind and visually blind and visually impaired people. So that's been helpful. I've been able to use a cell phone, my laptop has what's called JAWS, which is Job Access with speech. So it's what's called a screen reader so it can read it, what's on my screen, anything that I type, same thing with the phone. So that's been helpful. There's talking looking meters, there's talking skills, just just a lot of technology out there that I didn't really have when I first lost my vision. And now it's like, you know, I don't need to learn braille, but I couldn't read it because I had neuropathy and in my hands and my fingertips and neuropathy in my feet. So Braille was really no use to me. So the technology has been, for me a good blessing because I'm able to do things on my own. It's very rare that I asked for help. Whether it's finding something or do See my phone's acting up and I can't scan the barcode to get the nutritional information for my carbs and serving size and stuff like that. That's when I rely on family and friends. But for the most part, I can live on my own.

Scott Benner 15:16
What do you think you're a one sees where for those 12 years,

Sami 15:21
double digits for sure. In my early 20s, as a type one diabetic, I was drinking a 12 pack of Mountain Dew a day. And now I just drink strictly water, a more plant based than anything. And that's helped my blood sugar's quite a bit, especially with say, chronic kidney disease, which led to end stage renal disease, which now leads to dialysis. So that's coming from uncontrolled diabetes.

Scott Benner 15:54
Have you How long have you been on dialysis?

Sami 15:57
Couple months,

Scott Benner 15:59
couple months? And what what's the prognosis? What are you hoping to have happen? Are you waiting for a transplant?

Sami 16:05
Yeah, my older brother is a match. I had my first transplant was in oh six, my dad gave me one of his kidneys. In oh seven, I had a pancreas transplant, which was great, because no more No more diabetes. That field unexpectedly, two and a half years later. So in 2010, I believe back to being a type one diabetic 2013 had another pancreas transplant, which lasted five years. And that failed unexpectedly as well. So back to being a diabetic again. And now I am into the July 10, I will go to one of the hospitals where I'm at and get evaluated for a transplant, my older brother is a match. So that's good. I don't have to wait years to find somebody, especially with three transplants, the antibodies are are harder to match. And so But thankfully, he's he's a match. And then once he does his evaluation, I do my evaluation, we get our testing completed, we can put something on the calendar for a transplant.

Scott Benner 17:20
Can you tell me what it's like to approach a person and ask them a question like that?

Sami 17:25
Oh, hey, family, does anybody want to donate one of your kidneys? My older, I have four brothers. My two younger brothers have kids, I didn't want to approach them. My second brother is single. And he he wanted to donate. But I know he's little he's nervous to do so my older brother, he's got two older sons in their 20s. So he felt comfortable enough to get tested.

Scott Benner 18:02
It seems like a really difficult thing to ask somebody.

Sami 18:06
It is. There's a lot I mean, the typical risk involved, and but there's no even though my older brother's a match, there's no guarantee that my body's gonna accept it, even with the rejection that so there's that chance of going through this whole process going through the surgery, and then my body says no, no, thank you. And then it's dialysis for the rest of my life.

Scott Benner 18:30
Yeah. So any chance to grab another pancreas while they're in there? Or?

Sami 18:34
No, they say because it has to be on the right side. And so the the vessels, arteries that are used or have been used already twice, I should say three times because I still have my original pancreas for the, for the digestive enzymes. And the transplanted pancreas is more for the insulin. So that's, I was hoping but that's out of the question. So the kidney Can is transplanted in the front. Kind of Viva hip bones. The first one from my dad is on the right side. So for my brother's gonna be the left side. So this is probably going to be the final one. And I'm hoping it'll last

Scott Benner 19:15
yeah, I hope so too. You're in a unique position to answer a question. So you've already said, you know, it's not going to happen to me. I'm young, like that kind of thing. Like that's how everybody thinks. And when they're faced with the idea of what could happen. Everybody just they dismiss it somehow, right? They're like, Oh, that won't happen. Bah, bah, bah, but when it actually happens, and there's no rewind button. Can you explain how that feels internally?

Sami 19:54
loss here My life is over. I, I, when my when I was losing my vision over the, the months, both of my retinas had detached by then my optic nerves were dead. And little vessels were growing out to try to get oxygen. But the high doctor that was going to was, was lasering them to shut that down. And every time he did that my vision got worse. So knowing that from full vision, and it gets smaller and smaller, kind of like tunnel vision, and then you wake up one day, and there's nothing, absolutely nothing is terrifying. How am I gonna live my life? Am I gonna have to live at home forever? You know, I mean, when I worked at the deaf and blind school, I had seen the deaf students travel quite a bit, you know, I'm very way younger than I was, and like, they can do it. But you know, now I'm in my 20s going to 30 How is it even possible for me. But you learn, like, you learn to adapt. And it's always easier, you're always kind of in survival mode, because it is a world of the sighted. So it's hard to thrive. In a society that kind of looks down on people with disabilities, you're always out there trying to prove yourself. And it's difficult to have been looked at as a liability instead of asset because people with type with disabilities tend to work harder, because they know how hard it is to get a job and wants to get a job. They want to stick with it. So they tend to work harder, and are more dedicated and able bodied people

Scott Benner 21:48
was there. Was there self reflection as the vision was waning? Like, did you say, Oh, my God would like do I can't believe I did. This was did you? But did any of that happen? And am I my my follow up? Question is that is? Are you the same person? Now you were when you were 27? Or are you a completely different person?

Sami 22:11
Yes, self reflection, even now self reflection, I mean, going on 19 years later, still self reflection, self reflection all the time. Because I'm missing out on stuff. My family is so used to me moving around the house. Without my without my white cane that they tend to forget that I'm flying. And same thing with friends. So hey, it's over there, you know, it's over there, while whereas over there. So stuff like that really kind of hurts in a way that they're, I mean, in a way, it's it's nice that they're forgetting that I'm blind, that they're not treating me any differently. But on the other hand, it's like, you know, you can't, you can't put a sharp knife in the sink. And that in that tells me you know, a little stuff like that. Or if you're gonna move stuff, taking the heads up, I've broken my toes. From objects being in, in the walkway, you know, my path. So forgetting to tell me and I go off to too late another broken toe. But I'd say the second part of that for sure. I've am a different person, for sure. In so in good ways and bad ways. And I have a lot of irritation, get irritable, quite a bit of people trying to be my voice and trying to do things that they think I need or want to do. And a lot of times, we may not need help or want help. So the best thing is to ask instead of assume. So you try. I mean, I try to be patient. It's always a teaching lesson and a learning lesson for others as well as tech because a lot of them a lot of people have never interacted with a person with a disability. So I tried to take that moment to teach and have learned something new instead of kind of being Oh, you're such a jerk. You're so ignorant, you know? I mean, it might go through my mind. Hey, if I put on the Uber app, hey, I'm blind need assistance. And this, you know, they pull up and don't say anything to me. And I'm like, Asus, my car is not my car. So thank you.

Scott Benner 24:38
Yeah, no, you initiate and it's not an Uber, but it's somebody with ill intentions. They'll be like, Yeah, this is the Uber good end.

Sami 24:45
Yeah, yeah. And I've done that where I've tried to get in a different car because I thought it was the Uber or Lyft and it's not. And it's not because the driver doesn't say anything or they don't hop on the car and say Hey, can you send me you know, and so on. stuff like that. It's kind of frustrating, for sure. But do you try to take an Australian try to show patients for sure. Like I said, a lot of people, they see people with disabilities, but never have really interacted with them. And we're just the same as everybody else. We bleed red, just like you we have a heartbeat. We have a mind we have a voice. But we're not treated like that. Which is,

Scott Benner 25:25
which is really hard. I can't imagine honestly, do you? Do you ever have like, one to one feelings? Like, I traded my site for Mountain Dew? Like, like, do you really mean like, you ever think of it that way? Like, well, I did these things. And somebody told me not to, but I did it anyway, I was sure I was gonna be okay, I was really wrong. And I don't even have nothing to do. And I mean, it's not like you. It's not like you ended up with something for your trouble that was positive. And I guess I'm asking you, Sammy, because it just in general, like about food, like, Forget diabetes for a second and your blindness and all that, like, every day people make decisions like that. And we say it, but I don't think anybody thinks that, like, you know, a cigarette takes a certain amount of moments off your life, a decision, you know, blah, blah, kills a brain cell, like that kind of thing. Like I'm gonna run into something I play football and you know, blah, blah, blah. Like there's, there's trade offs you're making, and you're paying with the end of your life. And, and I just don't think that anybody sees it that way. And I'm, I am almost desperately asking you to put into words like what what would you not give to go back?

Go to your browser type in touched by type one.org. The one is the numeral one. When you get there, you can check around look at the site, it's delightful. Or go right to that Programs tab and see what touched by type one does for people with type one diabetes, after you've poked around a little bit, go right to that annual conference. That's where you're gonna see that on September 16 2023. I Scott Well, I don't think my name is there yet. But trust me, I'll be there. I am going to be at touched by type ones annual conference, giving a number of different talks. And I hope you can be there with me. Touched by type one.org. registration opens on August 1, we're getting close. But go check out the venue and and see if you can't get your ducks in a row to come. Come see me. We'll say hi, take some pictures, smile or smile. You don't have to if you don't want to. You want to try to look serious in the photo. It's fine with me. But I'm going to smile touched by type one.org. Today's podcast is sponsored also by Dexcom dexcom.com. Forward slash juicebox. I just typed it in. Oh, look at this. They've updated my page. It's very lovely and colorful, cool people wearing Dexcom G sevens. The new Dexcom G seven it says the most accurate CGM system manage diabetes confidently with a powerfully simple Dexcom G seven that could be you. I won't read the site to you when you get there. But once you get there and read past those words, you're gonna see a button that says Get Started. You can click on that or you can scroll down and look a little bit at that and look more at the bit of a bit of them. Well, that was technical. Let me start over again. You can click on get started and fill out the data and what's wrong with me feel like I hit my head dexcom.com forward slash juice box click on get started I'm lost what am I am I have Hold on Alright, I got this dexcom.com forward slash use box click on get started and you'll be taken to and you'll be taken and you'll be taken yeah taken and you'll be the mother of click on get started and you'll get taken down to the new patient form where you can get started with the Dexcom CGM fill out a little bit of information Dexcom is gonna get right back to you. But you can also look around the page and learn more. Learn more about the connected pumps that work with Dexcom G six. You can learn about getting started with Dexcom G seven. Take a look at the receivers how it might work with your Apple Watch what the device looks like on different people. And you can read about how you can share your data with up to 10 followers there's so much information on this page. Don't Don't worry about the fact that I'm something seems to be wrong with me. The page Just terrific g7 For Medicare costs and coverage information, how it works an overview of the product Dexcom G six, everything is that my link dexcom.com forward slash juicebox. I am now going to go make sure that I'm okay. Because I think it's possible I've banged my head and I'm not aware of it. Anyway, I'm going to leave all that in, you should know that there are times where I just I can't talk. Today was one of those times don't take that out on Dexcom though. dexcom.com forward slash juicebox touched by type one.org links in the show notes, links at juicebox podcast.com. Oh, look at that. Now I'm rolling now it's over, right.

Sami 30:47
I mean, I'd give up everything to have. So even even if it's for one day, really, I think I think about that a lot of there are times where I give up my life just just to have a mission for 24 hours just to see my family just to see my nephews.

Scott Benner 31:06
No, I mean, that's what I appreciate you saying that.

Sami 31:11
It's, it's to me, it's, I know it's going to be for because I do my 2004 I lost my vision and over the years, because my eyes are not getting oxygen, they started to change color. Um, I got cataracts and glaucoma and was treated for that, but so that my, the whites of my eyes kind of turned yellowish, and my pupils were constantly dilated, and they started to shrink. So I can feel people staring at my eyes all the time. So I made the decision to get prosthetics in 2012. Okay. And now that you people can't, people don't even know the difference. They don't know that I have prosthetics unless I tell them or unless one of my eyes is looking the other way. You know, sometimes that happens when I rub my eyes and forget about it. But other than that, you know, back in the day, I guess, kind of like marble types where you they would put it in the eye socket. So what they did for mine is they put like a tiny, a tiny rubber ball in my eyes, I can only stretch the muscle over it. And then the doctor hand handmade my eyes and hand painted my eyes. Which is kind of cool. Because I could choose a color I used to have blue and now I have gray. So it's kind of cool that I could change my colors with with a Medicare, I can change my eyes every five years so I can get a new color. Every five years, I've had my original blue, I've had green and now I have gray. But you know, that moment of there goes my eyes, there's no chance of in the future. Being able to see again,

Scott Benner 33:09
yeah, it feels so similar to when my son left for college. And I told him I'm like, there just a couple of things in life, you can't. If you do them, you can't go backwards. And that they'll that they'll stay with you forever. And and you're not going to know that those things aren't going to be as impactful as they are. So I listed them out as I saw them for him. And it's funny, because as you're talking, I almost picture you in a jail cell because you murdered somebody sitting there every day having to think about it and and saying I wouldn't do this again. Like if you could let me do this again, I would do it differently.

Sami 33:52
We put it into words. That's exactly what it feels like.

Scott Benner 33:56
So sorry. I mean, not not especially but because even when you were diagnosed, like they really weren't giving great advice at that point. And the technology was specious. And you know, and you're just being told don't eat sugar that's not valuable. Like you know, just to tell somebody hey, just change everything, you know, you just had this diagnosis. You're 17 Now just go ahead and change everything about your life on top of that. And you have one year to figure it out, by the way before you lose your insurance with your parents. I mean, you weren't you weren't given a level playing field that's for certain you know, I mean, I don't see this as your fault like you and I hope that's clear. I don't I don't see it as fault I just see it as very just bad luck circumstances. But at the same time I don't know how you could possibly not put it on yourself internally I think I would I guess is what I'm so yeah, for sure.

Sami 34:51
I blame myself all the time thirds in my vision. It's my fault for not taking care of my blood sugar's for not doing the insulin like I should have found that listening to it. Yeah, there's always a blame. It's it's a heavyweight that I carry on my shoulders and I don't think will ever be removed.

Scott Benner 35:08
Yeah, but and isn't isn't the gift we're gonna have to say fault like it. Yeah, I mean, okay letter the law you did it right. But I mean, did you really know you were doing it while you were doing I mean honestly, it's not like pulling the trigger on a gun like I if I point a gun at you and I pull the trigger, I have an expectation that the person I shoot is gonna die. You didn't think that's what you were doing to yourself though?

Sami 35:31
No, absolutely not. I figured, well, you know, as long as I can get my sugar's back down, everything is going to be okay. You know, I can make up for it. There was. And the reason I had reached out because there was a podcast, with a mother who had talked about her teenage son, who kind of was doing the same thing that I did back then, of catching up kind of catching up. And that's what made me want to come on the podcast. And say, I, you know, I was in your shoes that you are in now, don't continue down that path. Because look what's going to happen? Yeah. And it's, it's, yeah, and like I said, it's fearful, it's terrifying, to be able to go from 2020 vision to absolutely zero vision.

Scott Benner 36:19
And at the level of at the level that you are managing at for those 12 years. I think that's about what I hear from people because there are other people who have come on with other kidney issues or sight issues, etc. This like 10 year thing, like 1012 years like, of really not paying attention and not doing the things that you need to do. It seems to be about as long as your body can take it. You know, for a lot of people. Were you thought you were taking some insulin, but what were you doing like running background insulin, not really injecting for food all the time, stuff like that.

Sami 36:56
It was more just for food and not for correction. Because again, the test strips didn't always test to see what my sugars were. So okay, so I didn't really understand the whole carb issue as well. So I'm like, Oh, well, I'm gonna guess I know, it's one over six, one for every six. But I'm not sure what these carbs are because I didn't look at the label. They really quite still understand that because again, no nutritionist no education. Just whatever the doctor said, Here, you Here you go. This is what you're supposed to do. I'm like, Okay, well, I

Scott Benner 37:34
don't imagine that even people right now, like 2023, somebody who's 1520 30 and 2530 years old, even when we could believe that but it's true. Like when we were growing up, Sammy, when we were growing up, no one discussed that any food was better or worse for you than any other food. That was not a consideration. Like soda was like, soda was a thing from like Happy Days, like from the 50s like a treat that happened at a diner for example. And it was and it was tasty and different than soda. Like, you know, like no one. No one thought about it as a bad thing. My parents drank copious amounts of coffee, no one said, Hey, you probably shouldn't drink 10 pots of coffee a day, my dad smoked two and three packs of cigarettes a day. No one ever said to him like, hey, that's gonna kill you until time went forward. And, and society started talking about it differently. And that's the first time my dad was like, oh, people say this is gonna kill me. Like my dad would go into coughing fits. That were, I mean, maybe beyond description. And it ended and everybody was just like, Ha ha like that happens to Ben. Like the only means really? Nobody if you did that. Now, if you coughed in public the way my father coughed 10 times a day, someone would have taken you to a hospital. And back then it just wasn't like that. And diabetes was was that personified? Like, like, I wonder if that doctor didn't wasn't saying to you look, do this stuff. Don't eat sugar. Did they ever tell you you're not gonna live long?

Sami 39:21
I don't remember. Yeah, I

Scott Benner 39:23
don't. It's right on the cusp of when it started getting think thought about differently. I mean, there are people older than you are not older than you but who have had diabetes longer than you who have who I've I've spoken to were told, just like, I had a woman told leave college, it's not going to be worth it. You're not going to live that long anyway. And I mean, when that's the expectation, then a How are you supposed to live like that's not going to happen and be What are you expecting from doctors, you think you're gonna die anyway? You know, and you were just on that cusp, right there of when we were starting to figure it out. little bit. It's so terrible. I am very sorry. I know that's not. I don't know if that's something that you care to hear or not. But I mean, it does just seem to me that your situation, even if you're going to blame yourself for it, like, it just seems random to me.

Sami 40:17
Yeah, yeah. Just the information that I know that I mean, it's, again, diabetes is is a moving target. It doesn't stay still, you know, you could, for me, I've had lots of changes, even within days of the doctor setting my correction scale and my carb ratio. I'm like, Okay, this is not working. I'm having month lows. I'm having lots of highs. It's, it's, it's constant. You know, it's constantly moving. And sometimes it's frustrating, because my mind is set on this dose, but Oh, darn it, I forgot I have to do this dose now. And in that sense, it's kind of frustrating because it's always changing. And now we have this new medicine. Oh, now we have this and this Miss. And it's like, Well, which one is which one is best? For me? I've been on this Novolog for a long time, that seems to work.

Scott Benner 41:08
A different one or something like that.

Sami 41:10
Yeah. And now Now I take three insolence. So I have my Nov along with the meals and then I take NPH in the morning with my transplant meds because I take prednisone every day. And no other doctor has ever mentioned the how prednisone could affect my sugars ever. To this recent doctor,

Scott Benner 41:32
that fascinating. So you're taking a medication that you have to take that's driving and holding your blood sugar up. And no one's ever put those two and two together and said, hey, you know what, why don't we go back, reach back to this mph stuff. And so you have a nice background of of, you know, trying to push down on this number.

Sami 41:50
isn't crazy.

Scott Benner 41:52
I mean, I wish I have to tell you something I wish it was and I don't think it is. Yeah, wow. That's something else. What is how are your outcomes? Now? Where's your agency? What's your variability? Like? What are your goals?

Sami 42:10
Last time I checked, I believe my A once he was a 6.9 which came down from last year I believe was 11. So I focused more on especially going into end stage renal disease of hey, I really need to pay attention. And there are days where I'm like, You know what, I don't care. I really don't care. Because of dialysis. It just makes you weary all the time. You're so tired all the time that I don't I don't feel like eating but I know I have to eat I know I have to take my insulin. I know I have to take my transplant meds and that's what kind of keeps me me going is these half twos. I wish they weren't but they are.

Scott Benner 42:57
Can I Can I ask a question? Did the blindness not move you on the diabetes stuff? Was it the was it the kidney stuff that got you to do differently? Or it was like the kidney stuff? Yeah. Wow. Can you walk me through that a little bit? How did losing your sight not kick you into gear?

Sami 43:18
Oh four, I had to I had to. I had to move back with my parents again. Because I was working at deaf and blind school couldn't drive anymore. So they had to come drive an hour and a half to come pick me up and all of my stuff move back home. I don't know. I mean, it's, it's when I lost my sight. I was so fearful of getting out of bed. I slept for 20 hours a day, my parents had to force me to get up to eat to take my insulin. They did all of that for me. Until about six years. deep dark depression. My life is over. I can't live as a blind person. Of course thoughts of of suicide go through my head. But then I'm like, you know, it goes kids. And this is what kind of changed the tide of working at the school. There was a student who was blind and he was on the wrestling team. And I was coaching assistant coach to the basketball team. And I would just watch him travel the halls of the gym, out on the campus back to the dorms all by himself. Like oh, she can do it and I know he's yet a lot younger than me. I should be able to do that too. And before that I only had one interaction with a student who was blind in middle school, he had a locker next to mine and he would travel this, the school hallways and so those two memories came back to me like, if they can do it, I can, I can definitely do it. So it took a lot of training, I went to, like a blind Training Center to refresh my memory of how to cook how to clean with different techniques and methods. But yeah, I mean, I don't know what I mean, no blindness was, was already going to be permanent. And there's nothing I could do to change it. But then with the chronic kidney disease, and we'll even know why that struck more of a chord with me. Because maybe, maybe, because I could I could lose my life with the kidney disease versus blindness.

Scott Benner 45:41
Is that also a view? Because you've worked through the Depression part of it too?

Sami 45:46
Could be I mean, there's still some depression there, of course, but it's not as as drastic as it was back in 2004. To 2010.

Scott Benner 45:56
Back then, did you have a plan?

Sami 45:59
Back? No, no, I was just going to be in bed the rest of my life, what my parents do everything, I was afraid to take my dishes to the sink to walk 10 steps from the table to the sink, I was afraid to do that, that I dropped. And so I didn't do that. I didn't do that for the longest time. And then I saw how somebody had to be home with me all the time. Because again, violence syringe, so they had to measure up my insulin. So they would kind of take turns between their jobs and stuff. Someone would be home with me all the time. I just, I just kind of felt inhibited in their voice of how exhausted they were.

Scott Benner 46:40
That's the second time you said that. So the first time you said that you could feel people looking at your eyes. And I wanted to ask him about that is it? Is it like, you know, when you're in a room, you can feel there's another person there. But you don't, you don't have to see them to know like, it's almost like the air pressure is different, or the pauses are different or something is that there's nothing you're reading when you're like, I know they're looking at my eyes right now.

Sami 47:05
Yes, you can kind of feel that, you know, sometimes when you feel someone staring at you, you know, you know, someone's looking at you. And that's kind of how it is. Again, there's an everybody has an aura so it can feel that. And like you said that the pressure in the room changes. Like when I'm walking, I can feel like the tree overhead like the branches overhead. I can feel that. I can feel if there's a car next to me, I don't know how big it is. But I know there's something there. And

Scott Benner 47:37
so the same thing with when you're living alone with your parents like you feel that is it. Can you feel that they're burdened by this that that they wish it wasn't happening? I'm sure nobody said it to you. But did you have that feeling?

Sami 47:53
Yeah, their energy had changed for sure. That's what I mean. Yeah, yeah. Yeah. Still kind of that. That way, too. They're older now. They're in their 70s. And that's kind of where I'm helping to take care of them now. My mom is deaf and my dad's hard of hearing. So thankfully, growing up, I knew sign language. If I had lost my vision without knowing sign language that would have been difficult to communicate with my mom, but we make it work. We do tactile signing, where she can send it to my hands or use my body as part of the sign and I signed to her. Yeah, just anything. So we we make it work.

Scott Benner 48:36
Is there any lightheartedness about it at all? Anyone ever said, Hey, what a pair we make or something like that?

Sami 48:42
Oh, yeah, yeah. When my mom and I are out shopping, she's my eyes and her ears and people come up and comment on that all the time. Oh, you guys would make a great pair. Yeah,

Scott Benner 48:54
how about? Again, this happened to you. 2029 years old. Am I right about that? Yeah. Okay. Were you in a relationship at that point? had had you had relationships prior?

Sami 49:11
Nope. Nope. Never, never. I mean, I've dated but never been in a relationship. And I feel too, and I was back then I was all about sports. That was my that was my thing. I don't have time. I don't have time to date men. I don't have time. You know, it was all about me and my sports. And then now losing my vision outdated, but a lot of times I find and I've done almost don't tell my pants icon on those stadiums. Those dating sites. And they're not always accessible, but I found a way to make them work like Bumble. And I start talking with a guy and in my profile, I would say I'm blind, you know, but they'd still reach out to me and And then when I bring it up again, they just think ghost. It's like really?

Scott Benner 50:04
Like they didn't see it at first. And then they were like, oh, geez, yeah. Or some

Sami 50:08
of them are like, hey, yeah, it's great. I'm cool with that. But it's like, Hey, you want to meet and then they're gone.

Scott Benner 50:15
Sammy, you just said, Don't tell my parents like you were 15. That was really interesting. They're not gonna listen to this podcast on their hands. Yeah, I mean, they're a part of hearing and deaf. They're not listening to the podcast, for sure. Yeah. Are you okay? With like, humor around about this stuff like it? So if you're with a person you trust you hear about or, you know, well, it's talked about make no differently than, I don't know, break balls with a friend about something.

Sami 50:46
Yeah. And I A lot of times, I use my blindness as an icebreaker. Because a lot of people are like, I don't know how to act around her. I don't know how to treat her. And so I'll use my blindness as an icebreaker and, and I'll laugh about and be like, Okay, well, that's cool. You know, she's cool about it. I'm cool about it.

Scott Benner 51:05
Yeah. I thought for sure. When you told me when you're on Bumble, and they found out I was blind, they still tried to send you a picture. That was exactly where I thought guys are so wanting to do that, even if they don't even think you can say it.

Sami 51:23
Well, I want to say it probably I want to say one guy did and I'm like, really? I think I got to the point of texting. And so he had said he's like, send me pictures of your wife. How am I supposed to do that?

Scott Benner 51:40
You should have you should have sent a picture of half your face and the armbar. Hilarious. But, but he still did it. I still was like, here. Let me show you.

Sami 51:51
Yeah. And I'm like, Okay, well, that doesn't help. Were fascinating

Scott Benner 51:55
people, men generally. That really made my point. And by the way, most people heard me say that and think oh my god, Scott, You're ridiculous. But see, it happened. I know people. Okay, so. Do you ever Can Can I ask you a really uncomfortable question. Ever? Consider getting like, I don't know what it's called. I guess it's a prostitute, right? If you're like, Yeah, have you ever thought of doing that?

Sami 52:30
As long as I don't share this with my family. Yes, I have. But it makes me fearful because being taken advantage of.

Scott Benner 52:39
Yeah, you need a third party. You gotta have a real good friend. Be your your reverse pimp somehow, like somebody's gonna be there for you for safety.

Sami 52:49
Yeah, I've talked with one of my good friends. And she's helped me with stuff like that before, but it's always the it's always the vulnerability that stops me.

Scott Benner 53:00
Sure. No, I would have a hard time imagining how you could get over it. But I still think you would think about it.

Sami 53:08
Oh, yeah, I mean, even even going out for a walk. You know, I really can't enjoy the sun. I can't enjoy hearing the birds. I have to pay attention to where I'm going what's around me and all the noises around me to make sure that I stay safe.

Scott Benner 53:23
Yeah, because in a world where a guy would send a pic to a blind woman on Bumble you need to watch out for yourself. Yes, yeah. 100% No. 1,000,000% like I definitely get that. Oh my gosh, yeah. It Do you have any other autoimmune issues? No one else has ever come up.

Sami 53:42
No, thyroid has always been normal. And I've heard you talk about that. My mom and her mom has had thyroid issues, but thankfully mine has always been normal and I haven't had any issues with that

Scott Benner 53:52
suit. No celiac or anything like that digestion stuff.

Sami 53:56
I ended up getting gastroparesis in 2010 I had no idea what it was lots of vomiting after meals and stuff and then finally diagnosed so I was on medication for the longest time. And and I went to a chiropractor because I was having back issues and after a couple adjustments my gastroparesis went away. Relative to not I could do not Yep.

Scott Benner 54:24
Listen, I don't know if there's any cause there but good for you and congratulations.

Sami 54:30
But now with dialysis, it's kind of returned back. Yes. So that's kind of it's it's it's frustrating.

Scott Benner 54:38
Are you going to a dialysis center or are they doing it at home?

Sami 54:41
Center? That's for me it's it's more conducive to do a center than try to figure out do

Scott Benner 54:48
I kind of imagined but I just wanted to check and are you wiped out afterwards? Does it kick your ass?

Sami 54:55
Yes, it does. Even on my off days. It's like I'm recuperating, right It's the weariness that is the biggest thing. The first week. It was awful leg cramps all the time. Hard to break shortness of breath, heart palpitations, but I guess that's kind of normal when you first started and then after a while your body gets used to it. But the weariness always stays. So usually I take a nap in the afternoon exam in the morning from seven to 11, three, four hours a day, three to three times a week. And then afternoon, so I usually take a nap and then on my days off, sometimes I'll take a nap twice a day. It's just very, I can't work. It's hard to really do anything. Chores are a chore.

Scott Benner 55:48
My my friend went through dialysis and I know it was it was really difficult. Hades switch to Diet Mountain Dew.

Sami 55:58
No, I don't drink. The only thing I drink is water I strictly water.

Scott Benner 56:04
Diet Mountain Dew is not that bad. I mean, if you're gonna drink Mountain Dew, get it. I mean, it's funny too, because I remember it from when I'm your age, like I'm three years older than you. But you guys, like you don't know, like, when Mountain Dew came out, it was so good. And like so different from anything I'd ever had before in my life. And I don't know, like it just, I just it's such an interesting time in our history where we were, we were able to make all these like so called foods and yet we never really considered what if anything, they might be doing.

Sami 56:40
Very, very addicting and paper that what sugar does is makes you want more. So, one one bite of a of candy or potato chips. You know, I mean, just keep going like that, Oh, I gotta have another one little pieces or two pieces. You know?

Scott Benner 57:01
Yeah, it's like gambling almost. Like, I'll just I'll just bet $1 And then before you know it, you're like, I lost 500 bucks. And, you know, it's that same sort of slippery slope thing. What am I not asking you that I should be but what don't I know about your life that's interesting or, or might be valuable for people to know.

Sami 57:24
Intention. Pay attention to your diabetes, for sure. And it's, it's, it's not a game. It's definitely not a game. No matter how frustrating it can be, or burdensome it can be you need to pay attention all the time. Even, you know, when your sugars are high, it adds up it does damage. And over years of that, it's it's gonna hit you out of the blue, you know, and if you get married, have kids, and you miss out on that. It's gonna hit you hard.

Scott Benner 58:00
I can't even I genuinely can't imagine what's what you're going through. Do you have a Do you have a dog? Do you have a seeing eye dog?

Sami 58:07
I do not know. You have to be to have seen I dog you have to travel quite a bit out and about quite a bit. And I'm not more of a homebody, so that wouldn't work. But we have a dog here we have a cat here. I have a visually impaired cat. My younger brother thought it was cool. I had a Blind Cat first blind sister. So yeah, thinking a little good.

Scott Benner 58:32
Let's see, well, your younger brother's got a it's got a good vibe about him. And I would imagine that helped you. You know, my brother has a one eyed cat. And he said he they went to a they went to a shelter. And they were looking at animals. And he's like, I saw one that had just one eye. And I thought well, this is the one I'm gonna help. That's it. And he and he took it. So I mean, it's nice to help people that need help. And it's nice to help animals that need help.

Sami 59:05
You can sense that just like people only making sense when something's wrong with you, you know, they sense that you're sick. And so a lot of dogs tend to gravitate towards me because they know, they know I'm sick. All of my brothers dogs. They gravitate towards me. So in a way, it's kind of cool that I get their attention and their love

Scott Benner 59:26
100% Wow. Well, I mean is is your attitude. I mean, I'm gonna end on this for you. Okay, so is your attitude. A function of your new perspective, like I always say that, like, the more you experience in life, the more broadly your perspective grows, right? And then the the more you can kind of look at things and say wow, that's not important. Like things that you would hold as very important in the past you know, aren't things that you would ignore you know, are are important, like that kind of stuff, you almost get the perspective of a person who's lost that I mean a life almost, but you're still alive. And instead, so instead you're like, Wow, I'm still here. And this is what what it is like, you're, you seem very kind, do you think you're a kind person?

Sami 1:00:16
Yeah, I give more than I receive, I don't like receiving gifts, I feel people have pity on me. So they give me this, or that I can't afford it. So I give more. Because there's always somebody who's the least of you, if that makes sense. So somebody who's worse off than you. So I, I find for me giving to others is it helps, helps me. Attitude wise, still kind of cynical. At the world. I mean, I know things are, are slightly changing. But it's, I feel like it's always going to be anybody with a disability is always going to be at the bottom of the totem pole, no matter what, we're always going to be shoved down there. And when we try to climb up, you know, we're pushed back to. So trying to be an advocate and, and fight for that and fight for rights. And, you know, there's laws that protect us, but they're not always followed, which is, which is frustrating, too.

Scott Benner 1:01:27
I really believe in helping people as a way to help yourself at times. And I hadn't planned on talking about this to me, but I do do you listen to the podcast with any regularity?

Sami 1:01:41
Sometimes it depends on what your what your subject is. Okay,

Scott Benner 1:01:44
that's fair. My mom's health is in a sharp decline. And as a matter of fact, talking to you today is maybe the best thing I've done today. And I actually appreciate the the opportunity to not think about things for a little while. But I, oh, God, I don't think I don't think my mom's gonna live much longer. And like, we might be talking about days. And my wife's like, why don't you cancel this recording this afternoon? And I said, no, like, you know, I just, I like it. I like helping people. And I like, making this recording. So it helps other people. And I felt like I was doing something today, and I'm in a position where I can't help my mom any longer. And I just thought, Well, I'll try to help other people. And I find it really rewarding, honestly, in ways that are hard to maybe to understand if you're not. If you don't find yourself in this situation, I guess.

Sami 1:02:45
It's like you're, you're helping your mom or connecting with your mom by helping other people.

Scott Benner 1:02:52
Yeah, no, it definitely feels like I'm also very much a problem solver. And I think I'm a caregiver. And sometime about an hour before you and I got on, I think I made the last decision for my mom that I can make. And so it's very, it's a very lonely feeling to not be able to do something for and, and believe it or not the way my brain works, asking you that question about whether or not you thought about like getting an escort? I actually felt good about that question. I thought that's a really honest thing that people in your situation must go through. And I bet nobody asks them about it. Nope.

Sami 1:03:36
It's, it's one of those questions like, you know, can be too personal. But I heard I mean, that listen to other podcasts where, you know, whatever their disability is they do they, they go that direction, because that's the only way they feel they can get connection and love from somebody else. And sometimes I feel that way too. It's from strangers versus family or friends. Again, it's that vulnerability and afraid of being taken advantage of that. Definitely held me back.

Scott Benner 1:04:11
Just get yourself up. Get yourself some muscle and a little body guard action, you'll be okay. What about other stuff? Like, you know, I mean, what happens if you like because the other thing I'm hearing from you, to me the most restrictive part of your situation is not being able to immediately get up and do something like that actually, is the thing that hit me like, What if I want to go somewhere? I can't What if I want to do this? Like I got to ask another person like that. That thing? I know is not must not be fun. But what happens if you get it in your head? Like I want to smoke weed? Like how do you make How do you make things like that happen?

Sami 1:04:51
No good question. Find somebody find a friend who does it and ask hey, can you introduce me?

Scott Benner 1:04:58
Later for things I don't just mean what I mean, like anything like you need a facilitator for some of that stuff. That's not. That's not the stuff we say out loud.

Sami 1:05:05
Right? Absolutely, yeah. Yeah. Because, again, a lot of websites are not accessible and not easy to navigate. Here, link, link, link, link link. Well, what is this link for? Or blank? Blank, blank, blank? Well, what's going on here? So, I mean, there is a law in ADA law, that website is supposed to be accessible, but a lot of a lot of that is ignored. And it's hard to, you know, there's just so much out there that you can't find every single one. But yeah, I have to depend on friends for that kind of get a feeler out there of if they're comfortable, if they're not comfortable, you know? If I think of a friend that all ask her, well, now she doesn't, you know, the topic is ignored.

Scott Benner 1:05:59
Like, what if you drop the hint, you're like, Hey, Mom was looking for some weed, and then they just kind of ignore you. And you're like, Oh, I said it, nothing happened. Like that kind of thing. Or even like, I mean, boy, that's you really would have to have a good friend to say, Look, I know, this is crazy, but I'm looking for an escort. And I don't feel safe. And I need to I need, I need some help. Because if you if we were friends, and you asked me that, I'd be like, All right, like, let's I mean, because now we're probably involved in something illegal to some degree or another. But maybe we can work it out online a little bit somewhere. And, and then I don't know, it's like, maybe it would feel exciting, like a James Bond situation. Yeah, yeah. I think you should go for it, Sammy.

Sami 1:06:44
If I do, I'll give you an update. Oh,

Scott Benner 1:06:46
my God, listen to me. Thank you. If you do that, honestly, I should be the person you call the next day. You will get right back on here. And we will talk all about that. For 100%. Sure. It really is. I mean, it's a it's just a very interesting look, you just gave us into into a life that I don't think many people can understand. And I think you've also, you know, left a great message for people listening without trying to be scary. Like you're not, you're not yelling Buddha them. Like you're saying, Look, I I did the things, here they are here was the outcome. If you think it's not going to happen to you, you know, you're wrong. And I've used this example before. And I think it works here. You know, my father would, his whole life would say I went to the doctor, I said they can't even tell I smoke bottle, and I was like, whatever. And then you know, he died from, you know, heart failure from smoking. And, you know, and, but his whole life, he was like, this isn't getting me like as he was as it was killing him. He thought it wasn't getting him. You know, and he Luckily, he lived into his 70s. But, you know, it's not how it goes with this, this. This blood sugar thing is woefully misunderstood by a great many people. And incredibly impactful on your entire body. Not just one part of it, like you have blindness and your kidneys, blah, blah, blah. But that doesn't mean that I mean, Saint me, I wouldn't say this unless I unless I was very comfortable that you're a bright person. And you know this already. There's no saying there's no damage in your heart, or that there won't be one day or any, that's, there's no such thing. This is the end of this even. And yeah, and it's not something that people talk about. And they should and it's not people it's not something people understand widely and they should so

Sami 1:08:51
yeah, it's it's blindness is survivable. It's doable for sure. Testament a testament to that. But it's not something that I would wish on anybody or even myself you know, I mean if I could go again talking prior if I can go back I would, I would. I would go bankrupt to make sure my blood sugars were the way they were supposed to be. I was taking insulin like I should have been and I was taking care of myself I would absolutely go back

Scott Benner 1:09:25
I fully expect that if I ever turn on the television and see Elon Musk saying he made a time machine I'm gonna see you bum rushing him on the stage

Sami 1:09:35
wagon with my cane Linnaean there

Scott Benner 1:09:37
we're going Elon right now let's show all these people you know, I can't I mean again just very kind of you to talk about all this and let me be the way I am. What we're talking about it I don't even know even know how to describe myself sometimes. But it just to me seems like like if we're going to talk about this, then let's really do it. You know?

Sami 1:09:59
Yeah, and And I appreciate you. Let me come on because again, it's not, it's not a topic that's talked about, you know. And it's important that that everybody knows, parents, teenagers, or, you know, whatever it may be that, hey, you know, you may have to be a helicopter parent, or a nagging parent, but it's extremely important that your child or yourself, take the time to pay attention.

Scott Benner 1:10:32
You have to find a way, you have to find a way to be a parent. And you have to believe that it's not always going to be like a great story. We're like, oh, I told them this, and they really accepted it, and everything's fine. They might not accept it, but it's still when it's over. If they're alive, and their kidneys work, and their eyes work, then you did it. You know, not not saying it has to be a battle, but it's for some of you, it will be like, for some of you, you're gonna I mean, listen, Sammy, between you and me. You sounded difficult when you were younger. What, but but if but if I was your dad, I would have kept after you because I know better because I live in this time your father didn't know. Right, fair enough. But he even would have got an inkling and said, Oh, no, this isn't okay. And he would have rode you. You'd be in a better situation right now. Even if you had a you didn't like your dad because of how he treated but you were healthy. Yeah, I would have thanked him.

Sami 1:11:27
Right. As you get older, you're like, oh, looking back? Oh, you know, that's why my parents said that. That's what my parent did that or prevented me from doing that. You know, I mean, when we're younger, we don't think about that. It's all about me and having fun and whatnot. And you don't think about the cost points of yourself or to other people, and how that might affect them or yourself. And then when it happens, it's like, oh, yeah, I get it, then it's too late.

Scott Benner 1:11:52
If you expect to get paid right now, for being a parent, you're out of your mind. You have to live long enough for your kids to get old not for them to go, oh, wow, that was great. What they did for me, and then they still might not say it to you. So it's not a job. If you're looking to get paid to be apparent, like it's, it's not really how it works. So alright, Sammy, I appreciate this very much. Can you hold on one second for me? Yeah. Thank you.

How about Sammy? Hmm, just That's terrific. Really terrific. Thank you so much, Sammy. Thank you. And thanks. So I still can't talk. And thanks. Can I be honest with you guys, I got like three hours of sleep last night. And it's like, nine o'clock at night. And I realized I gotta go to bed. So I want to thank Sammy, I want to thank you for listening. I want to thank Dexcom for sponsoring this episode of the podcast, and remind you to go to dexcom.com forward slash juice box to get started today with the G six or the G seven whatever your preference is. They have it at my link, also to remind you to go to touch by type one.org and look through that tab, Programs tab. See all the great stuff they're doing there and find them on Facebook and Instagram. I'm just gonna cut my losses here and say thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast but I promise I'll sleep before I put the next episode together for you. Thanks, guys. Have a good day.

#954 Dexcom COO Jake Leach: G7, G6, Type 2 and your Questions

Dexcom COO Jake Leach is here to talk about G7, G6, Type 2 and answer listener questions.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, welcome to episode 954 of the Juicebox Podcast.

Today, we welcome back a guest. That's been here quite a few times. Jake Leach. Jake is the Executive Vice President and Chief Operating Officer at Dexcom. He's going to answer your questions, a bunch of questions sent in by listeners, my questions, talk about a new product, a few other things that are on the horizon, and we're gonna find out if that Dexcom is ever going to go to your Apple Watch. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan are becoming bold with insulin. Big news kids that cozy Earth offer code juice box at checkout now saves you 40% On your entire purchase. Go to cozy earth.com Enter the offer code juice box at checkout and save 40% off your entire purchase. You'll get a free year's supply of vitamin D and five free travel packs with your first order at drink ag one.com forward slash juice box get a green drink drink it with me in the morning like virtually because I'm drinking it if you're drinking it, we're kind of doing it together. But I'll tell you about the advertisers and then we're getting right to Jake this episode of The Juicebox Podcast is sponsored by the contour next gen blood glucose meter contour next.com forward slash juicebox. Check out the meters, the second chance test strips and everything else happening at contour next.com forward slash Juicebox Podcast is also sponsored today by us med us med.com forward slash juicebox. Now us med is the place where Arden gets her diabetes supplies from actually her Omni pod dash comes from there and her Dexcom g7. Yours good to you can get your free benefits check right now by calling 888-721-1514 or by going to my link us med.com forward slash juice box, type those links into a browser or click on them in the show notes of your podcast player or at juicebox podcast.com. When you use my links, you are supporting the production of this show. And keeping it free and plentiful for everybody. So you can get more stuff like this with Jake. Jake, how are you?

Unknown Speaker 2:37
I'm doing great. How are you doing?

Scott Benner 2:38
I'm well, thank you. It's nice to see you again.

Unknown Speaker 2:41
You too, man. It's been a little while. Yeah, well,

Scott Benner 2:43
there's a good, there's a good reason to get back together. So I'm excited. Yeah,

Jake Leach 2:47
yeah. g7 approval, I think was last time we chatted. Yeah,

Scott Benner 2:51
right. Right around that time. I have a couple of g7 questions for you. I'll hold off till later. Okay, cool. But I did want to find out what was going on. So it sounds like you guys are bringing some new products to light. And I wanted to hear about those.

Jake Leach 3:05
Yeah, yeah, we are. Absolutely. Yeah, we recently announced a exciting new product where we're looking at CGM for people who have diabetes, but not on insulin. So really, really focused on the needs of those users, which are different than, you know, many of the needs of folks who are taking insulin. You know, it's basically trying to build a product that's for, you know, there's about 25 million people in the US that have type two that aren't on insulin and don't have, you know, severe hypoglycemia events. So that there's really, you know, they could, they could use a CGM, like G six, or G seven. But we're really this idea here is let's design a product that really meets their needs. And it's something that, you know, they can really get engaged with.

Scott Benner 3:52
What is that a? Is that an easy timeline? Is it yours? Because the reason I'm asking my brother has typed too, he was just here visiting. And I may or may not have slipped him an old GE six transmitter and two sensors and put one on him while he was here. And inside of the first 10 days, he was already understanding what food was doing, that he never understood before, no matter how much a doctor tried to explain to him or I tried to help him. It wasn't until he saw it that it started to make sense. And then the next text I got from him was, do I put this next sensor on now? Or do I wait? Or like he already had that feeling of like, oh, no, I want this thing. So is this going to be like a long process FDA like that whole thing or? No? We have

Jake Leach 4:37
to get it approved by the FDA. But it's so a product we plan to launch next year? That's great. Yeah, so it's short term. It's built on the g7 hardware platform, and it has a totally different mobile app that goes with it.

Scott Benner 4:53
Okay. And you think insurance companies are gonna get behind it?

Jake Leach 4:57
You know, ultimately we have to show you But to generate enough evidence in this population of users to show the benefits, I mean, one of the most exciting things that ADA that just happened last month was there was quite a bit of data around use of CGM in this, this population that's not taking insulin, and looking at outcomes that can be generated there. And just like you mentioned, by your brother, it's like, that type of insight that you can get from wearing a CGM, it's, there's no, there's nothing, there's another tool that can give you that. And so that's why I really think this is something that it will be highly engaging for this group, it's something that they'll really find helpful.

Scott Benner 5:39
I would say not just the Insight either. But it provided a motivation for him that he couldn't find us anywhere else. And just he you know, he would call and say, Oh, eight this thing. And I saw what it did to my blood sugar. And that was the first context he had for it. He's like, I'm not gonna eat that anymore. And it of course, it's frustrating for me, because in my head, I don't know how many years ago I was talking to God, it might have been Kevin, and he said, I was wearing a sensor. And there's a couple of foods I've cut out of my diet because of that now, and it's just really valuable. Do you see it as something they would need forever? Or do you think it would be to help them adjust their lifestyle? Or do you think it might be different for different people?

Jake Leach 6:18
You know, I think it's gonna be different for different people. I mean, we did you know, there was a study that we saw, you know, greater than 90% utilization of CGM in this population, we basically looked at a group of about 7200. People, they're using G six, and in that population that was greater than 90%. Were so that was a strong signal to us. It says, Okay, I think people are gonna like this. I, you know, it's the real time feedback. That's the key. Like you mentioned, the motivation factor, it's hard to get motivated when you get an A one see every six months. But when you get that live feedback right away that says, This is how, you know, either that food choice or, you know, activity, stress. did sleep a lot. You can see how that impacts you.

Scott Benner 7:01
Yeah. 100%. Okay. So that you're shooting for for next year? Yes, absolutely. All right. Anything else coming?

Jake Leach 7:10
We got We got lots government, I mean, even just the g7 platform, you know, we just launched it last year, we've got lots of things going into that we've had, if you've noticed, but there's been a pretty steady cadence of app releases, as we've after we launched G seven. Some of that's, you know, small bug fixes, but all bunch of it was pretty significant functionality, you can now verify an account or get lost passwords using a text message code instead of going into the email. So that, you know, much faster we enabled silence all sound saw wasn't in the original g7 is now in there. And then we just released some updates for the widget on iOS to to make that update more frequently and be more functional for users. So it's been been about five releases. Since we launched in, there's a bunch more coming. One thing that we talked about, recently, around the time, VDA is the director watch is finally coming. And so we're very excited to put that into the product. We're shooting for getting it in by the end of this year.

Scott Benner 8:14
Wow. Okay, so you're gonna, you think, Well, let me ask my question a different way. I feel like I've noticed, because I've been around for a number of different releases, that when the device first comes out, it comes out as is. And then there are things I feel like I'm seeing in its functionality, like not just stuff you can see, right, but like, you know, a screen or something like that. But I feel like things like connectivity, even you know how accuracy works. I feel like you guys are tweaking that in the background. Is that happening? And does that happen with all new stuff?

Jake Leach 8:50
It does, we're always looking to improve the product, we get lots of feedback, right? That's one of the number one things we do is listen to feedback from users, about new products, but also about current products. And so you know, working on Bluetooth connectivity, further enhancing that adhesives, you know, the performance is all of those pieces we're always working on in terms of improvement. We did it with G six, right over the number of years that it's been out there, we've continued to improve it. We're gonna keep doing that with G seven for all of our current and future customers.

Scott Benner 9:23
Some people are asking me, Is there a difference in Bluetooth distance for G six for NG seven from the phone to the device?

Jake Leach 9:31
Not so when we did all of our testing? We haven't seen that. But we have had certain users that have run into that. They say, hey, look, my G six worked a little bit stronger than my G seven. So we've been analyzing that and take determining if there's anything more we can do to further enhance the Bluetooth. One thing we do know is that as we looked at the every time a new phone model comes out, we do quite a bit of work on the analyzing the way that the phone connects to our on our device we get, but we get very consistent performance with our receivers and our pump users. But on the mobile app, sometimes there is, you know, phone will come out. And we do make changes, to ensure the product connects better to different phones. And so we're always kind of doing that in the background. And so you know, anybody's having that type of an experience with GS seven, I'd say definitely call us and see, we've got lots of tips and tricks to help ensure that you get good connectivity. But we're also making improvements along the way here.

Scott Benner 10:29
It's confusing for me when people ask because Arden has been using it now, G seven, I don't know for a number of months. And I haven't seen like a disconnection of data more than more, more or less than I saw it before. But she's also 19. And I'm assuming her phone is like, glued to her somehow. So I don't know if that's the case. Because I mean, fair enough. I've seen her walk from one room to another, stay out there and come back. Now what I'll say is that when she does come back into the room, I see it pick it back up much faster than G six, like, that's my, you know, but my, my experience at least. But how much of it has to do with people's phones? Like, I mean, is it newer phones, stronger Bluetooth in some phones and other phones? Is that Is

Jake Leach 11:16
it you know, all each case is different. But what does happen? Sometimes it's just basically how people have their phones configured. I've even had experiences where, you know, I have like rock solid connectivity, and all sudden, I'm starting reading some issues. And I'll cycle the Bluetooth but also cycle the Wi Fi. And what I found is, you know, a lot of our mobile phones, the Wi Fi radio on the Bluetooth radio, often the same silicon the same chipset. And so sometimes, you know, if something gets hung, there's tons of software in our in our phones, right? And so, you know, there's always that, turn it off and turn back on to help connectivity. But I think, you know, it's it's can be unique to, I don't think it's necessarily the full models. It's more around just how phones are set up and how they're used. But, you know, like with any new product, we're going to keep learning. We you know, all of the data that we get back, we analyze for performance of the phones and Bluetooth and sensors and everything else. We do make enhancements based on that feedback.

Scott Benner 12:14
That's great. Okay, can I jump to some questions? Let's do it. Yeah, absolutely. I'm gonna, I'm going to, I'm going to hit some miscellaneous ones first and then go to stuff that's kind of grouped together. Can you help me dispel the myth that a G SIX sensor with the code 9117 is somehow not as good as a sensor with another code on it? I love a CGM just like the next fella. But you also need a really accurate blood glucose meter contour next.com forward slash juicebox. You will love the line of meters from contour Arden is using the Contour Next One, the contour next gen is brand new, they are all incredibly accurate. They featured Second Chance test strips, meaning that if you for some reason don't get the right amount of blood the first time you can go right back, get more and it will not affect the accuracy of the test or ruin the strip in our lovely. So you don't have to be perfect to get a great result. Contour next one.com forward slash juicebox. It is possible, it's incredibly possible that the meters and test strips may cost less in cash than you are paying right now. For a possibly inferior product through your insurance. Isn't that crazy? Go to the link contour next.com forward slash juice box when you get there. Hit the button that says buy now you understand I'm typing into the browser right now the browser that's how the kids talk I say browse by now big orange button you click on it. What it'll show you is that you can get these supplies@walmart.com Amazon Walgreens CVS Pharmacy online, Meijer, Kroger target Rite Aid, these are all online links clicky Clicky. Right there you're buying. Go take a look. Why don't you you can save time and money by buying contour next products from the convenience of your home with my link contour next one.com forward slash juicebox. And if you want to dig down deep into your data, dig down deep into your data. Wow, there's a lot of these. If you want to do that, use the free app that comes with the contour meter, put it on your phone, bing, bang, boom, all of a sudden you're keeping track of things stuff makes more sense. You can make better decisions. Check it out, get started today. Use the link. It's in the show notes of the podcast player that you're looking at right now. Or it's at juicebox podcast.com. And of course you can just type it into a browser. Here's something else you could type into the browser. Us med.com forward slash juice box and A plus rating with the Better Business Bureau. They accept Medicare news nationwide and abroad, broad swath over 800 In fact, big big bunch of private insurers What am I saying your insurance is probably accepted by us med give them a call and find out or go on the link 888-721-1514 or us med.com forward slash juice box. Now Scott What am I gonna get us Matt how about this US med carries everything from insulin pumps, and diabetes testing supplies the latest and CGM. They've got the libre two and the libre three they ever got the Dexcom G six and the Dexcom g7 Omnipod five Omnipod dash t slim baby. They got it over there. In fact, the number one fastest growing tandem distributor nationwide. And how about this? Because we're talking about Dexcom today, how about the number one rated distributor in Dexcom customer satisfaction surveys art and gets her supplies from us Med and you could to get your free benefits check today and see what US med means when they say they want to give you white glove treatment, better service and better care. That's what US med is offering you us med.com forward slash juicebox 8887 to 11514. Hey, I appreciate all you guys listen to the ads, I do my best to make them fun and jazzy and informative. Now let's get back to Jake and find out the answer to my question about the code 91170. No, not the 9117.

That a G SIX sensor with the code 9117 is somehow not as good as a sensor with another code on it.

Jake Leach 16:52
So that is a very common code. It's one of the more common codes towards the center of the distribution. So it's no that just I think it's a more common code. It the other thing I've noticed too, is when people do have issues, you always trying to find something to associate it with whether it's sometimes it's just the difference between new products and an old product. Or maybe it's that they've seen that code frequently. That is one of the more frequent sensor codes because it's in the middle of our calibration distribution.

Scott Benner 17:19
I just wanted somebody besides me to say it. So yeah, sure, I get tired.

Jake Leach 17:24
I'll tell you a funny story. In the old days when we were read in sensors, and before we had the the calibration stuff all figured out. I would just type in 999117 was my normal code that I type in that it would take. So

Scott Benner 17:37
are you guys working on getting approval for in hospital use of a Dexcom? Yeah, actually, we are.

Jake Leach 17:45
Yeah, yeah, the, you know, the current CGM CGM aren't basically approved for use in the hospital. But one of the things that we during COVID was there was an emergency authorization that the FDA gave us to allow us to allow Basal hospitals to use our product, and they could buy it from us. And so we had many hospitals come and ask for the product. They put it on patients, you know, during the time when they had a lot of patients COVID And it helped them, you know, they weren't utilizing as much of the protective gear because they weren't having to go fingerstick the patients often they could put it on someone, they were worried about glucose excursions on that. So they could basically I mean, G six, this was G six timeframe, it was a great product, it's a great product. But you know, for a hospital workflow, they basically had the phones like sitting outside the room, or sometimes they use receivers, some set up their own follow networks, to be able to follow the data. So you know, they were kind of using it, it was a super beneficial tool to help them manage blood sugars during during while people were in the hospital. But what we're doing now is taking the product, taking the substance sensor technology and designing a product that specific ly designed to fit into the workflow in the hospital. Think like connectivity data data display. That's a big part of the product development. The other thing we're doing is we're running clinical studies that show the performance of a subcutaneous sensor in the hospital, basically showing we're seeing really good performance from these studies. But they're a little bit longer because you have to enrolled people who are actually in the hospital. The FDA wants to see the sensor in that intended use environment just because it's such a critical place to make sure your sensors performing well, drugs, your parents is all that stuff that can happen in a hospital is what we're basically doing the study to show that the sensors are great there

Scott Benner 19:36
is the idea of sort of, when you're done with it, a nurse would be able to look up the same place where the blood pressure is and see the blood glucose.

Jake Leach 19:44
That's the That's the vision. It's the you know, glucose, the fifth vital sign so that's really important. You know what, you know, we've worked in the hospital for many years. In the past we had a program that we were focused on more of a intravenous sensor but the thing that I took away from that was that I spent a lot of time in ICUs and in the hospital environment and just saw the the teams there need better tools to manage people's diabetes or blood sugar's even a lot of people have blood sugar issues from stress, stress induced hyperglycemia. That's not they don't even have diabetes, but they're just the tools are not good. The finger stick is so you know, to get actual frequent measurements, you go in and prick and someone's finger every hour was the kind of the protocols that I saw in the ICU. So yeah, a continuous monitor makes perfect sense for that environment.

Scott Benner 20:32
I think anybody who has been through it knows that makes sense. Obviously, the work has to happen with the FDA, but Arden had an exploratory surgery once I explained the loop to them in in the pre op, and the doctor was like here, put that in a bag, leave that under the table. He wanted her algorithm to run during a surgery. And I only heard about it 30 minutes before and he was like, Yeah, we're good with that. So yeah, yeah, hopefully, hopefully

Jake Leach 20:54
that works out. Alright, one less thing to worry about. Yeah, exactly.

Scott Benner 20:58
All right, here's the scary one, you made a new thing. So everybody's worried you're gonna stop supporting the old thing. So Oh, yeah, G six is that

Jake Leach 21:08
it's we're gonna so we're building G six now. And serving all the customers ng six particular AI D users. Quite a few of our customers use automated insulin delivery systems. And those are still working on their G seven integrations. So now we're not taking g six away. We are encouraging people, though, to upgrade to G seven. So you continue to get the latest updates and technology. But we'll support GE six for quite a while until everybody's got got the upgrade. You know, upgrade timing is different for everybody. So we got to work through that. But yeah, G 16 is running great, super happy with the output that we're seeing. So yeah, the other point that I'd like to make too, is that, you know, we are, you know, we've got our g7 we've got this new product for non insulin users. But we're still very focused on innovating in the ad space and in the sensor space, and you know, automated insulin delivery, MDI, multiple daily injection, we're focused on continuing to innovate there, we've been the innovation leaders there, and we are going to remain that. So just because we are launching new products that benefit more people. We're not taking off our current customers.

Scott Benner 22:17
Yeah, I mean, is the company. I mean, you guys, are you sticking fingers out in a lot of directions? Is the company growing? Are you taking more staff on? Or is this something that you're able to do with your, your current workforce?

Jake Leach 22:27
We know we do we, we grow our r&d, Greg, kind of team and all the folks that work on product development that that has grown over time, it's actually been an exciting, fun kind of process of going from developing just one thing right now developing multiple different products that utilize the core CGM technology, but you'll have different embodiments of the of the physical product. And so the team has grown. We continue to, you know, grow revenue and the customer base. We're also kind of we don't grow our expenses at the same rate, as we bring on new customers. So we are we find efficiencies and how we work. But yeah, we make really healthy r&d investment. And that's a really important part of our growth story. And also ensuring that as many people can benefit from CGM, there's still you know, hundreds of millions of people out there that could benefit that don't have access to the product you know, they either can't afford it. They don't have an insurance coverage. It's not available in their country. There's there's all those things that we got to get after.

Scott Benner 23:27
Yeah. Oh, please. The bottom my list here, India, Australia, Japan, those are the three people are like, When can I get g7 is so that's not lost on me at all, that there's stuff to do still, you know, you you hear from people all the time, especially now the world's opened up, people are more aware of what they don't have, and the benefits of it. And I think it's hard to hear about the benefit of something like that and then not be able to put your hands on it. I mean, really frustrating, especially around health, you know, and I made myself laugh and you said you're growing and bringing in new customers with I forget exactly how you said it because when I thought my head was the ads on the podcast are very affordable. I was giving myself credit and my love it. No

Jake Leach 24:12
awareness. You know, awareness for CGM is so much greater now than it was even a year or two ago. But there's still people I meet that have never that have diabetes that ever heard of the CGM. So? Yeah, well, you know, actually, I was at South by Southwest doing a panel, and we actually asked the audience, you know, it's about 2000 people who here knows someone with diabetes, almost every hand raises. Then I asked him, Okay, who knows what a continuous glucose monitor is, and it was a very small fraction less way less than 10% raise their hands. So it's like there is, you know, awareness around technology that can benefit that we started to work

Scott Benner 24:47
on I did a talk in front of 200 couples, adult couples, at least one person in the couple had type one. And I started a, an uproar when I asked about if everyone had glucagon in their home and It was fascinating how few people knew what glucagon was, or understood how dangerous insulin could be. And these were not like newly diagnosed people, for the most part, it was really, like fascinating, kind of stunning, actually. So I think the work is always there to try to get the word out to people. Yeah, a 12 year old boy wants to know if they'll ever be a poke free sensor.

Jake Leach 25:24
Well, I, in the time period that I've been doing this, which is, well, north of 20 years, I've never seen a technology that works non invasively, meaning you don't have any sensor. But what I would say is, if you looked at what, you know, she, she she for, and some of the previous generations started with that manual applicator, which you're familiar with Scott, and now where we are with G seven, with a much smaller sensor, very quick insertion. Most most of the time, you don't even feel it. So that's, that's our focus is on making, you know, sensing technology that is as minimally invasive as possible.

Scott Benner 25:59
I have to tell you that every time I see somebody put up one of those like, I don't know, a picture of a watch, and they say it's going to tell you a glucose, I think that's not gonna work. I mean, I'm not an engineer. But that seems like that's not going to work, not with current technology, right? Like, it's not to say that in the future, we don't figure something out. But at the moment, you what you do is is the best way to do it at this point.

Jake Leach 26:21
Yeah, basically, there hasn't been a technology, you know, there's a lot of light, you know, infrared light, radio frequencies, all kinds of different techniques have been tried to send a signal into the body and then get a signal back that somehow represents glucose, it just, glucose is a particularly challenging molecule to measure. It's not like oxygen, right, where you can put a pulse ox on somebody's finger, and get their oxygen level in their blood, from a light shining through their their skin, it's just It doesn't work that way for glucose. And so having the sensor probe actually in contact with the glucose in your body is one of the ways that we make the sensors as accurate as they are

Scott Benner 26:56
number of times that I've spoken with different people from Dexcom. It's been brought up that the data that you guys are able to see that maybe one day it would help people make decisions about insulin. Is that still something you think about? And are you working on it?

Jake Leach 27:11
Yeah, 100% in a couple of different avenues, right, one of the avenues we're working on is, you know, we use data to tune our automated insulin delivery algorithms. So you know, our first generation we algorithm we launched with tandem and their control IQ, we have another generation algorithm that we're working on, that we talked a little bit about at attd. This this year, and it was really around full automated control. So actually doing boluses and controlling correction Bolus isn't everything, Basal everything with just an algorithm. And so we in that we've used quite a bit of the kind of glucose dynamics that we see in our in our data, to to help develop that algorithm. We also see kind of you think about Basal insulin users, you think about MDI users, there's a lot of things we can do, to provide further insight to help them you know, make make the disease easier to manage. And so they'll they'll be predicted, as we've started to kind of build out our software capabilities, you're seeing g7, we're launching more more frequent releases to the mobile app, you're gonna see some more stuff there in the future on insulin as well.

Scott Benner 28:25
So I have a couple of questions here about in pen and why it's not real time, like it used to be. But my my guess is, it's because Medtronic bought in pen, and they probably would prefer if their users use their sensor. Is that is that the reason? Or what is the reason that happens?

Jake Leach 28:41
No. So so the in pen is, you know, it was purchased by Medtronic, but we still support connectivity to it. And we're working with Medtronic to continue to provide that support and maybe even expand it will see, but no, I think, you know, for my perspective, is that, you know, Medtronic, you know, it's a great pen for people who are using it, and we make a fantastic sensor and why why shouldn't those two go together?

Scott Benner 29:06
That's great. Because it is a it's a really important device. And even people who only use it for a time before they go to a pump, talk about how valuable what they learned is from it, so Okay, well, I'm glad to hear that I just that was me, I was being cynical. I just assumed they were like,

Jake Leach 29:19
well, you know, it's I mean, thinking about you, technically, competitors were working together, but it happens all over and definitely something that we're comfortable with.

Scott Benner 29:27
Okay, cool. g7 questions specific? What's the difference between entering a blood glucose versus calibrating? Like, why would I enter one but not use it as a calibration?

Jake Leach 29:38
Maybe you want it to show up in your data reports, but you don't want to use it as calibration. It was it was I don't know how many users actually use that. But it was definitely something that came back in user feedback where they wanted to be able to track glucose but not with a finger stick meter but not always use it to calibrate okay.

Scott Benner 29:56
I also saw this question enough that I want to ask it of you. I don't have any personal no experience with it. People say they're traveling internationally and having trouble restarting new sensors because it feels like the app is like geo locked or something like that. Is that real? Or is that?

Jake Leach 30:10
Well, there's, well, there is there is basically an important component here. But it can get confusing, so I'll explain it. So yeah, I think users, what happens is, the important thing to know is that every country that you go to, and you set up your phone in that country, they all have different app stores. So if I take my US phone, and I leave it is, you know, it's my account, my my, you know, I'm an Android user. But for the Apple account to when I traveled to the UK, and I looked at the App Store, I'm still looking at the US App Store, even though I'm physically in the UK, I'm looking at the US App Store, I can download a US App. One of the things that happens though, is if you start using a UK phone that UK based, like you picked up a phone at a store, there's something that phone will go to unless you like entering all your us information, it's gonna go to the UK App Store, and download the UK app, which is different functionality than what you have in the US. And so when you basically are traveling, you need to use the phone that you you know, your normal phone and your normal account, and everything should work just fine. Okay, the sensors aren't different. They're not the sensors don't function different. But there is differences in the in, you can't take a US account and say, I'm in I'm in the UK now. And unless you want to call tech support, we can actually correct that on the back end. But the idea there is that, because we have one global app that configures itself to the functionality of each of the countries of which you purchase your sensors and reside. So it's basically locked into your account and where you live normally,

Scott Benner 31:46
but it wouldn't be necessary for like, like when I have to call my credit union and tell them I might want to use my ATM card in another country. I don't have to call.

Jake Leach 31:54
You'll be fine. Yeah, yeah. And it's still the follow network in the share network. It's actually one of the interesting things where we've got a US person and someone owe us wants to follow them. That owe us person has to download the US follow up. The Oh us follow up won't connect to a USF data privacy, all kinds of, you know, back end stuff there.

Scott Benner 32:13
So I don't know how specific you can be about this. But I'll just go in order that it's written here. g7 compatibility with I let any idea how long that will take.

Jake Leach 32:25
That's a really up to beta bionics. You know, I think they're just getting going with the eyelid ng six, which has been super exciting. So Ada saw a couple of people wearing it saw some great time and range numbers from those folks. And so, you know, it's a great product, and we're ready to support them on g7 as fast as they can move, but

Scott Benner 32:46
you know, they're just brand new coming to the market. So I don't actually know the specific timing. Okay, but I would assume there's a window in your head to where g six is going to be gone? Even if it's Yeah, even if it's a couple of years from now. So it's got to be at least in that window. Yeah, you got it. What about on the pod five?

Jake Leach 33:05
So they're, they're working hard. I mean, it's been a while I've seen quite a few, you know, open systems up and running on the development side. So I they haven't made public comments about when, when their timing is, but you know, I know they're working hard on it, and we're ready to support him when it comes out.

Scott Benner 33:20
I'm sorry, I'm gonna just ask for about tandem to say they all about the same answer or because Play Doh

Jake Leach 33:26
no tandems actually tandem said publicly that they're planning to launch a around quarter three of this year. So that's pretty soon, right. We're already in cute quarter three with the July. So you know, in that timeframe there. And, you know, I had to I mean, reasonably, they're not on track.

Scott Benner 33:45
So I have to I have two questions about watches. The first one is, you mentioned, you mentioned the Apple Watch, but we didn't talk about other, like watches the integration for other kinds of wearables to

Jake Leach 33:55
Yeah, so right now we support the same things. We did ng six, with the Android Wear platform. And we also support the iOS, the Apple Watch, when we go, excuse me, we go to direct to watch. The initial foray there is on the Apple Watch. That's what we spent quite a bit of time working through making an Apple watch a full functional receiver, because that's what we have to do to ensure that you get the right alerts, and alarms and all the things that are really important from a safety perspective, that those are always reliable on the watch platform. And that was basically what we've been working on for a number of years with our team and also the team at Apple on the watch OS to ensure that you can reliably get those alerts because that's the you know, if you think about you know CGM it's one of the most important things it does is give you alerts when you're out of range,

Scott Benner 34:47
the first time that it's available for the Apple Watch, I'm going to find out where you are and send you flowers because I'm going to be super excited that we're never going to talk about this. Like

Jake Leach 34:57
there's a there's a large team that's very excited that this is finally coming to fruition. They've been working on it for a long time. Yeah.

Scott Benner 35:04
Somebody told me that the Apple Watch question with XCOM is like asking Elon Musk when the cars are gonna drive themselves. Like, oh, it's happening next month, don't worry.

Jake Leach 35:15
I like I like that analogy. It's one of those like, it's gonna happen as fast as it can, yeah, put a finger on it. But yeah, we're feeling really good about where it is now.

Scott Benner 35:22
Nice. So I'm going to just say, for me, personally, of all the things that I wanted you to do, that didn't happen? I am probably most disappointed, I guess I'll say about there not being Delta. I knew you're gonna say that. That would that would make me a little snippy. I got a little sad when I saw it, wasn't there? Is there a reason it didn't happen? Or is it coming in the future?

Jake Leach 35:48
It's one of the things on the on the priority list. I don't exactly know where it ranks, but I know it's on there. So like I said, with the faster app releases for G seven, you know, we we've already, you know, released more functionality into G seven, within a short period time has been available than we do with G six last year. And so you'll see more and more app releases, we're kind of targeting the teams, we're targeting almost one and one every six weeks. So new functionality each time

Scott Benner 36:14
I saw the app, and I thought I hold no sway at all, I Dexcom.

Jake Leach 36:19
I wouldn't say that. I didn't

Scott Benner 36:21
think I did. But I was I was like, Oh, I definitely don't. People are asking about the graph looking jumpier I don't know another word to use, is there something you can explain about that?

Jake Leach 36:33
So it is that so there's there's less smoothing in g7 than what was ng six. And a lot of that has to do with trying to heighten the performance of the sensor. And its ability to detect glucose, and what kind of changes and turnaround and rapid rates of change and all those things. And so with the performance of the sensor being better than G six, we turn down the filtering. And so you're gonna see a little bit more jitter there's no reason to think that it's less, it's actually, you know, we know G seven, we studied it, it's more accurate than G six. But the perception of the I've had multiple people ask me, Hey, my lines, kind of, you know, it's not as smooth as it was on G six, is that a problem? And it's like, no, no, it's actually measuring glucose quite accurately.

Scott Benner 37:16
Okay. Speaking of accuracy, before I go back to my next question, is there are we at the ceiling? Or is there more? Do you there's more to go? There's more to go?

Jake Leach 37:25
There's more to go? Yeah, I mean, I want to continue to tackle, you know, sensors that, you know, every so often you'll get a wonky sensor, right. And it there's a lot that cause can cause different things to happen. But my goal is every sensor works 100% of time, I think there's still improvements can be made on the first day of where, right, sometimes first days is more variable than the rest of the where, and also on those latter days, you know, as we continue to extend the life of the sensor, you know, ensuring that you've got good performance all the way to that last day is there. There's plenty more to innovate there. From both the sensor technology as well as the algorithm that powers it.

Scott Benner 38:06
Arden got up yesterday morning. It was my birthday yesterday. So we had a whole big day planned. My son was home and we were all doing stuff together, right? And she got up and she said, hey, my Dexcom is going to expire in like eight or nine hours. And I was like, oh, put a new one on now. And you know, like, so she's just home from college. She's like, is this the thing you were trying to tell me in college? I'm like, yeah, like, I'm like, put the new one on now. And then she wore it for, I don't know, five, six hours. And then when there was a lull, I said, Okay, now, you know, disconnect the other one and put the new one on. And I'll tell you, man, it just popped back on it read exactly where the other one was. And I was like, This is amazing. Like, I love it. Everyone should be trying to accomplish that if they can. Really fantastic. More on g7. Is there a right and wrong way to do the insertion? And people want to know, why is it only cleared for arms?

Jake Leach 38:57
Okay, yeah, so two great questions. You know, I know that there's no right or wrong way to insert it, you basically just have to push it down hard enough so that the little safety guard is you know, ensures is pressed up against your skin and the press the button you know, when I've worked way where sensors, I wear them farther on the back of my arm than on the side because you know on the side sometimes you'd run into things, you see belts, whatever so I like kind of like it on the back. I find it's more protective back there. And then from arm in wherever it is abdomen where basically when we did this study that we saw the best performance in the arm and so that's what we got cleared by the FDA but if you look outside the US our labeling has both arm and abdomen in the US based on the way the study went in the way we wanted to get the product approved through the regulatory course and also the performance we just we settled on let's let's go with arm

Scott Benner 39:48
I'm going to save 30 seconds at the end of this to tell you a funny story that I don't think I can record but I'm gonna make myself a note. It's about something Arden said that cracked me up.

Jake Leach 39:56
I can't wait to hear. Happy birthday by the way. Oh, thank

Scott Benner 40:00
you. I'm 52. So I'm feeling pretty old. But my hairs stand dark. So I feel like I'm ahead of something. Also,

Jake Leach 40:08
you're ahead of me for sure. Check that out. Check your handsome man. And

Scott Benner 40:11
there's no reason for you to say that. I, I found that we go via about four months ago, so my life is getting much better. It's crazy. I swear, I just got nothing to do with our conversation, but 25 pounds in four months.

Jake Leach 40:25
Congratulations. But it's it's a fantastic therapy. Yeah, it

Scott Benner 40:29
really is. And I'm starting to see people use it with type one and watching their insulin resistance, or not just resistance maybe, but their insulin needs are dropping, which is really fantastic. I really feel like you're gonna see the the semaglutide maybe get okayed for type ones in the next couple of years. Anyway, I'm sorry, I got off track there. Okay, here's some half like, conspiracy theory stuff. Did you start using but I don't even know what I'm saying here. Did you start using less dielectric grease on the g7 than you did on the G six? Because I'm seeing something wonky when I take a shower.

Jake Leach 41:07
Oh, interesting. No, the, that's interesting. That's a person who's into the details on the on the ceiling system. The ceiling system for G seven is totally different than G six. So it doesn't use that those same components. So it you know, G seven is, you know, from a waterproof perspective, you know, meets the same standards G six very waterproof. So when taking a shower, if they're seeing something wonky, the only thing I've seen is like really hot temperatures sometimes can make a little bobble in the signal, but it depends on what they're seeing. I don't know what what they're experiencing. But know it the waterproofness is great. You can swim with it and go underwater, reconstruct koozie Yeah, all good.

Scott Benner 41:49
I mean, Arden's blood sugar jumps naturally, when she gets in the shower, and some people's fall, I didn't know if maybe they're just, I don't know, seeing that I couldn't tell. But I was like, well, some engineer, that anyway, I thought I would could help quell your internet rumors. So there was one for that. I know this is never going to end, but you guys made a change to the adhesive. I think it works terrific. I'm not seeing any trouble with art. And she is wearing the little over patch that she sent. If I can give a personal bit of feedback, it would be nice if they were a little stiffer, because I end up sticking them to themselves a lot. I agree. I totally agree. IVs, big X square fingers. And my hands are huge and are just like leave it alone. Like you're gonna, it's stuck to itself. And I'm like, I know, I'm sorry. But anyway, that's that. Some people are saying, could the patch be larger that comes with a Dexcom? Is that something you're evaluating? Are you happy with where it is?

Jake Leach 42:42
No, no, we're evaluating I mean, we're always looking at new patch technologies. And there's quite a bit going on in that space with the different patch manufacturers. And so now we're always looking at making it you're better with the balance of ensuring it doesn't cause skin reactions, right? We we made a number of enhancements to G six over time that reduced some people have sensitivities to medical grade adhesive. And so we made a bunch of changes over time to G six to improve that those changes are you know, that learning went into G seven. And so but now we're still we're always looking at how do you improve it, that it's I think it's gonna be less about the size of the patch and more about this specific materials that are in there. But yeah, you'll you'll see enhancements come out over time on G seven for the patch.

Scott Benner 43:29
Art was it removed? The countdown on the on the caregivers side? But that's not different. Is it? Because I don't

Jake Leach 43:38
know. I don't think so. I don't I don't even on the follow side.

Scott Benner 43:42
Yeah. Let's see. Is there any plans to add a time since updated? clock on the g7? Mobile App? Okay, so

Jake Leach 43:49
Oh, I don't know. Yeah, no, I get it to get because we have that on the follow up, right? I don't think so. But I can I can double check and look,

Scott Benner 43:59
in that same vein, a number of people asked if why they can't ping the sensor. Why do they have to wait the full five minutes if they I think it's a lot of parents who are like, stand here for two minutes until I see what this does. And then you can like go away? Is there? I mean,

Jake Leach 44:16
yeah, the current design community, it only communicates every five minutes. So depending on where you catch it, right, it could be as short as a minute. But it's basically five minutes in between the communication cycles. But that's another thing that we're looking at in terms of for reliability, and ensuring you get the connection back faster. Enhance hands there.

Scott Benner 44:38
A lot of people are asking for a lot of the management stuff that you can see in your your app if you're the user, but on the on the follow side, time to expiration like things that really helped with management. And I know we've talked about the app a number of times it feels like you're working towards it, but we are

Jake Leach 44:56
you know, we spent a lot of effort the sovereignty He was super focused on getting g7 out and getting it internationalized across all these different countries. And we're still continuing to launch new countries around the globe with g7. But we also, we built a lot of software capacity to do that. And we also do one, the Dexcom, one product that's available outside the US same thing, added a bunch more software resources to drive software development forward. And the teams do kind of inter interchange, we don't use, it's not like there's a dedicated g7 team that's totally separate from Dexcom. One, there's a lot of common software. And so follow, I'm excited to bring follow into that fold and start making more enhancements to follow. Because it's, you know, it's time we do that we haven't we've ensured it stayed compatible and made some small changes, but it's time to make some of those changes that users are asking for because it follows a really important part of the system. And we need to put more attention into it. Yeah.

Scott Benner 45:53
I'm glad to hear you say that. I have a question I hope doesn't seem difficult, but I feel like I've known you for long enough. When do you hit enough scale that you can bring the price down? For for cash options? Like did you know what I mean? Like the idea in business like we can sell a few expensive things? Or a lot of inexpensive things? Like is there a tipping point where that can happen? So that so that instead of you and I having this conversation, and a lot of nice, middle class people hearing it like when can everybody use one of these that needs it?

Jake Leach 46:26
Yeah, I think so. You know, the price of CGM has come down quite a bit over the over the period of time that it's been available. The average selling price of CGM is quite a bit less than it was even four years ago. But there's still more room to go and I there, there is a time period where we're getting to a point where it's, it's very affordable for people to access it. Now, different products, maybe a different price points based on functionality. You know, you think about it from the perspective of like an automated some delivery system, and all of the functionality that's required there, that may be a different price point than someone you know, who doesn't use automated insulin, they're not using insulin, they don't have the alerts alarms, not using ShareFile. So I mean, there's there's different feature sets for users. But you know, I think we're it's one of our focuses is always to innovate on the cost side of the product. G seven was a big step for us, in terms of, you know, continuing to reduce the cost, it takes us to manufacture now we're not there, because your G seven volumes aren't, you know, completely, it's not the whole base hasn't shifted over and all the new customers that are coming in, but as the g7, volume ramps, and we just, you know, our factory in Malaysia just just started up at the beginning of the month of June. And so we're really excited to have that factory now running. And that's a big part of our cost to serve and being able to reduce the overall cost of the product.

Scott Benner 47:50
Is it possible that the business on the non insulin using type two side could help to buoy the other side at some point,

Jake Leach 47:57
volume volume, in all cases helps, right. And there are a lot of common components to the systems. And so you know what the nice thing about having, you know, kind of the product built around a particular hardware platform like G seven is that as scale continues to grow, and your volumes grow, you can take advantage of that. And so absolutely the more volumes that we grow in all the different patient segments, the better. Okay,

Scott Benner 48:19
here's my last question. And it's very Nishi. I think four people are going to understand it when I say it. Is John Welsh, still with the company? And can I interview him again, because people loved him.

Jake Leach 48:29
John Wells has tested absolutely still with the company. He actually is one of our main medical writers and has published a lot of recent data. Actually, that's some of the data I was talking about. With the type two users that aren't on insulin, some of the outcome data we saw there. That was all, John was one of the authors. So yeah, he still is

Scott Benner 48:48
he's maybe without a doubt in the top five. I don't know if you call it gi here. Dorcy diabetes, people who have been on people love the I mean, we talked at length about standard deviation and things that I just think most people might not even understand or care about. And man, people loved it. It was. So I'm glad to hear that I'm gonna reach back out and get them on the show again. Which is on the lock screen that's still there for g7

Jake Leach 49:13
Yeah, I believe so. Yeah, we actually just yeah, we just made a bunch of updates for the widget in the last version. So if if it wasn't that I'm assuming it's there now. Okay, great. Jake,

Scott Benner 49:23
I appreciate this very much. And I am cutting it two minutes short, because I'm going to tell you this very silly story. So I'm gonna say goodbye to you. I'm gonna hit stop. So you know, you're not being recorded anymore. I appreciate you being here.

Jake Leach 49:31
Awesome. Pleasure.

Scott Benner 49:37
A huge thanks to Jake leech and Dexcom for coming on the show and answering all of your questions. And thanks to you guys, of course, for sending in those questions. Check out us med at us med.com forward slash juicebox or call 888721151 for better service and better care. That's what you're gonna get hate us med. The podcast was is also sponsored today by the contour next gen blood glucose meter. And I'd like to remind you to head over to contour next one.com forward slash juice box to learn more, and maybe buy yourself one. If you're looking for community around diabetes, please check out the private Facebook group Juicebox Podcast type one diabetes, if you have type one, type two pre diabetes, gestational, everyone's welcome. It's a private group with over 40,000 members. There's a conversation happening there right now that you would be interested in. Or let me say this, maybe you'd have something to add to that conversation. Maybe you just want to work doesn't matter to us. Come on over. Everyone's welcome. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.