#1137 Teach a Man to Fish

Natalie has type 1 diabetes and uses Omnipod 5.

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

Scott Benner 0:00
Hello friends, and welcome to episode 1137 of the Juicebox Podcast.

Natalie is 50 years old she's using the Omni pod five, but she was originally diagnosed as a type two in 2012. After having gestational diabetes, she just got her type one diagnosis three years ago. Today Natalie and I are gonna talk a lot about Omni pod five and how it's helped her. She has hypothyroidism she says just a little bit, and Natalie is actually a returning guest. She was originally in an episode called cattle drive, which aired on September 14 2022. It's episode 754. 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. Don't forget to save 40% off of your entire order at cozy earth.com. All you have to do is use the offer code juice box at checkout. That's juice box at checkout to save 40% at cosy earth.com. When you place your first order for ag one with my link, you'll get five free travel packs and a free year's supply of vitamin D. Drink ag one.com/juice box. This episode of The Juicebox Podcast is sponsored by the continuous glucose monitor that my daughter wears the Dexcom G seven Dex comm.com/juice box Get started today using this link. And you'll not only be doing something great for yourself, you'll be supporting the Juicebox Podcast.

Natalie 1:51
Hi, I'm Natalie, and I've been using the Omnipod. Five for about a year now.

Scott Benner 1:56
Natalie, how old are you?

Natalie 1:58
I am 50 years old soon to be 51.

Scott Benner 2:02
That's the M means I'm really 51? Basically, no,

Natalie 2:07
well, almost I mean, it's this month my birthday. So I might as well say that I'm 51. And my husband likes to remind me that I'm an entire four months older than he is. So there's that. Well,

Scott Benner 2:17
happy birthday. It's very nice. How old were you when you're diagnosed? Well,

Natalie 2:21
it's kind of tricky. I had gestational when I was pregnant, which was now 20. Some years ago, I was diagnosed as a type two, back in 2012 or so. And then recently, they don't know if I'm type one or what they call a typical diabetes. Somebody that's type one without antibodies. And that came to light a couple of years ago, so I don't know. 15 years, something like that.

Scott Benner 2:51
So you've been treating yourself as a type one for about 15 years? No,

Natalie 2:55
I've been treating myself as a type one for only about three years.

Scott Benner 2:59
Okay. 15 years total three years as a type one. Got it? Yeah. All right. I'm going to ask you a question here that maybe I'll just edit out, depending on how you answer it. Are we telling people you've been on the podcast before? No. Okay, well, if you don't want to, we'll just chop this part out. And I'll keep going. Well, we can tell them I'm fine with that. Okay. All right. So your episode was what seven? My

Natalie 3:23
episode was the cattle drive episode. And you'll have to forgive me, I don't remember what number it was. And in that episode, I was still pretty early in my journey to try to figure out what type of diabetes I have. And I talked a little bit about the study I was in to try to help figure that out, which ultimately, after a boatload of tests and a day spent in a clinical trial wing of a hospital. They still don't know exactly what I am. My my pancreas acts like it's a type one. But I don't show insulin resistance or some of the other typical hallmarks of type two. Right?

Scott Benner 3:58
I have a question. And if you have an answer for it, I'm interested. Is there any, like you've heard your episode? So why did I call it what I called it?

Natalie 4:09
Um, that's a good question. We talked a little bit about how with type two diabetes, it's a lot of driving people to an end. And sometimes there are outliers along the way that doctors don't know really what to do with

Scott Benner 4:26
and I called your episode cattle drive. Okay. I wasn't sure. Like, if you were gonna say, I work on a steer farm, or if it's gonna be something.

Natalie 4:34
You've been watching a lot of Yellowstone at that time, Scott, it's um, I think cattle drive was pretty high up there in your mental.

Scott Benner 4:43
You're probably onto something right there. Yeah. Okay. So, so you're back on the show more specifically to talk about being on Omnipod five. So,

Natalie 4:51
a while back, you had asked for people especially like different people across the whole spectrum of folks that might be using the Omnipod to speak to their experience. I'm pretty sure I was my endos first patient on the Omnipod. Five. And so I've been having a decent amount of success with it and just wanted to try to add my perspective. So

Scott Benner 5:13
a tiny bit of context. And so for three years as a type one, how were you managing prior to Omnipod? Five,

Natalie 5:20
I was managing with injections for about six months to a year once I finally relented and agreed to go on what I call mealtime insulin or full time and insulin. I've been using a long acting for a little while prior to that, so about six months with injections, but I knew once I started injections that I wanted to go to a pump as soon as possible. So I started the dash fairly quickly after starting insulin. And then I was on that for about a year before I could get my hands on Omnipod five, oh, I've had it for about a year now a little over.

Scott Benner 5:53
Alright, great. So let's talk about when you transition from MDI, to dash originally, that's probably like a weird time because you're just starting to use insulin more like, traditionally, I guess, how long did it take you to find a rhythm pumping with Dash,

Natalie 6:10
I'd have been pretty quick. But I also have to give you credit for that, because I found the podcast about a month or so before I actually started my Omni pod. I think that just starting to listen to the podcasts and some of the concepts about insulin and how it how it works. And hey, it's okay for me to want to take charge of my own health with it and not necessarily rely on the endo to tell me every little thing I need to do that made a huge difference in in my mindset, which I think then affected the way that it worked for me. So I went into insulin at about a nine a one C. Once I started insulin, I was down in the sevens. But after I started the dash and started listening to your podcast, I was down in the low sixes. And I haven't been above six in about 18 months. Good for

Scott Benner 7:03
you. Congratulations. That's wonderful. Yeah, no, of course. Okay, so what made you go from dash to Omnipod five, honestly,

Natalie 7:11
I wanted an algorithm. The idea I was doing a lot of interventions with the dash all the time, all day long, I had my nighttime Basal fairly well tweaked down, but I was still waking up in the middle of the night, multiple times a week, sometimes multiple times a day to either correct a hi or fix Hello. And during the day, I was doing a lot of extended basals a lot of temp basals just to try to keep my my numbers in the tight range that I was liking to keep them in. And so the idea that I could go to an algorithm that would kind of take a little bit of that burden off of me was definitely appealing. I didn't really consider tube pumps very well. And probably just because being diagnosed as an adult, it's hard enough to conceptualize having a another device stuck to you. And especially at that time, I don't know that I'd be that worried about it now. But the idea of having tubing connected when I'm a klutz I run into things all the time, I can just imagine the number of times I'd pull the tubing out or the dogs would grab it or whatever. I really looked at the Omnipod five and I thought about looping but I haven't been brave enough to to go down that road yet.

Scott Benner 8:25
The Dexcom g7 is sponsoring this episode of The Juicebox Podcast and it features a lightning fast 30 minute warmup time, that's right from the time you put on the Dexcom g7 Till the time you're getting readings, 30 minutes, that's pretty great. It also has a 12 hour grace period, so you can swap your sensor when it's convenient for you. All that on top of it being small, accurate, incredibly wearable and light. These things in my opinion, make the Dexcom g7. a no brainer. The Dexcom g7 comes with way more than just this. Up to 10. People can follow you, you can use it with type one, type two, or gestational diabetes, it's covered by all sorts of insurances. And this might be the best part, it might be the best part alerts and alarms that are customizable, so that you can be alerted at the levels that makes sense to you. dexcom.com/juicebox links in the show notes links at juicebox podcast.com to Dexcom. And all the sponsors, when you use my links, you're supporting the production of the podcast and helping to keep it free and plentiful. So you are having success without an algorithm but it's causing you to be involved more than you want to be involved. Yeah,

Natalie 9:42
I constantly had the controller in my hand. I did a lot of numbers watching too, right? Because with what you can only set your alarms so many times, right. You can't set a Hey, pay attention here alarm versus a hey, the world is ending alarm. And so you know I I do a lot of watching to try to keep it from getting to the point where the alarms would go off. It was a lot mentally, and that definitely is one of the biggest things. That's benefited me going to the five I sleep at night now, regularly. Yeah, I still have a nights where something didn't go quite as planned.

Scott Benner 10:19
But if you're making, like, if you're bumping and nudging, basically, before the algorithm is that mostly with, like corrections with food, like, where we use your intervention needed? Both,

Natalie 10:32
um, it would be like, Okay, I've been a little more active than I expected. And so I'm drifting lower than I want. And maybe I'm getting ready to get in the car, and I don't want to have to deal with it, dropping the low 70s. So I would if I was watching my numbers, and maybe I was a slow drift. And maybe I was getting ready to get in the car and drive. And I didn't want to have to worry about what would happen if I dropped below 70. While I was trying to drive, a lot of that kind of thing. Honestly, I think it was a lot more using temp basals up to catch a rise, and then maybe not cutting it off quickly enough. And then I would drift low later and have to correct it. You

Scott Benner 11:13
had a Basal rate set up that worked ish, but maybe wasn't strong enough. And so then you would come by push back on it cause a low later eat food drift up like were you kind of caught in that loop a little bit?

Natalie 11:27
A little bit. Yeah. And I think I was also using a higher Basal to offset meals without realizing that that's what I was doing. Because now that I've been on the five, my Basal rate is

Scott Benner 11:38
a lot lower is a lot lower. So then my question is, how did that work? When you started on the pod five, like where you're setting so messed up? Because you were intervening that it didn't allow the algorithm to work? Well, when started? Or how did the transition go into the algorithm? It actually

Natalie 11:53
went pretty smooth, because I had listened to all the things I could listen to your podcasts about. The five came out after I started, but I tried to do as much research as I could. And I knew that it was starting with a 5050 assumption. Yeah. And so I did a lot of research into gluco to see. Okay, what am I what kind of insulin Am I really using at this stage? How much insulin Am I using here? What's my usual Bolus to Basal ratio. And I calculated up my total daily and created a program for my basil, that was pretty close to what my dash would use, but it was more in line with what half of my total daily would be. And then once I got on the five, if I started drifting up, I would go ahead and correct pretty quickly. And that I think, helped the algorithm learn how much total insulin I was truly using a day rather than just what I told it I was using.

Scott Benner 12:55
Okay. So, you know, it's funny, Arden used AMI pod fire for a while, those episodes came out before she started. And I thought the same thing. Like I was like, Oh, I wish I would have made these episodes before she started trying to use this. Because there's so much information in them that leads to a good transition. But okay, so now you're using it. And it's good, like so I just want to say for people like contextually, you kind of said like the 5050 assumption, when you're setting up Omni pod hives, specifically, they want the algorithm to have some autonomy, I guess like like, you know, like, and they wanted to have like the autonomy is the wrong word. Like they wanted to have the flexibility to make decisions. If you were in a situation where let's say your basil should have been a unit an hour. But you were for some reason how to add half a unit an hour, but we're constantly making adjustments and adding insulin somewhere else. And then you go back and tell the algorithm my basil definitely point five an hour, well, then it's going to be way off of what you need. And so the assumption is that a lot of people probably just don't really know why their settings work, but that their total daily insulin is probably pretty accurate. So start with total daily insulin, give half of it to the to the basil give half of it to the Bolus during the setup process. And that gives the algorithm a chance at making good decisions. So it's so based on total daily insulin, really, those episodes are terrific. I should put the names of them in here somewhere. Maybe I'll put them at the end. Yeah, you know, so for when people are starting, it really does help. I also found a lot of people who did the same thing started before they had the information and went back and reset the algorithm and started over again. I got a lot of luck out of it that way the second time because the settings are really the whole thing. I've

Natalie 14:42
recently received a new controller from them because of the whole situation and I haven't set it up yet because I'm a chicken. But I think I mean knowing now what I know that I didn't know then I expect it to go pretty smooth. It's just been a little hack. Jake and I haven't done it yet. Yeah.

Scott Benner 15:01
Okay. All right. So I want to know about actual day to day use of it. I want to know how you handle meals, how you handle high blood sugars, like the whole thing. So can you tell me, like maybe take me through a day you get up in the morning is your blood sugar where you expected to be when you wake up, for example,

Natalie 15:20
I would say probably 75% of the time, my blood sugar is in a range that I'm comfortable with which I try to keep my numbers between 70 and 150. I don't freak out, usually it is 65. But if it gets much lower than that, especially if it's a trend down, I'll I'll take care of it. I do intermittent fasting. And so I usually don't eat breakfast, and I rely on my basil to hold me steady throughout the morning. And it does a really good job. I'm usually around 100 to 110. The exception is sometimes i I seem to have a fairly strong Dawn phenomenon. And I think lately, the algorithms been struggling a little bit to manage that the way I would like. So I might be waking up at like 130 instead of 100. So I've just been correcting in the morning to try to address that. And it usually drifts back down then about where I want it. But I will find that regardless of then the activity that I do in the morning, which might be going into the office, it might be chasing dogs, it might be what you know, going for a walk whatever, it does a pretty good job of keeping me pretty steady between 90 and 110. Good. That's

Scott Benner 16:37
amazing. What about overnight, like so is it? Like you go to bed at a stability and it stays there? Do you like what's your, what do you see when you look back over the next? It

Natalie 16:49
probably doesn't drift more than 10 or 15 points during the night. Unless I've done something crazy, like have pizza late at night before we go to bed or some sort of food that's going to have a really long impact, like sushi or something like that. It seems that sometimes the algorithm doesn't handle the rises for that as aggressively as I would like. But it still handles it. It's just I don't like looking at a number above you know, 150. And so yeah, I a little impatient to get it to come back down.

Scott Benner 17:25
So do you do intervene when you see that? Yes, usually.

Natalie 17:29
But what I have learned is that for me, I will tell the pod that, hey, I want a correction. And I'll use the CGM button to see what it's recommending I have. I've learned not to override that and give myself more, even though my head will tell me. Oh, no, you need way more than that. Because what I found is that that those will be the times that I end up going low later. And the one thing for me, I don't know if this is true for everybody else. But for me, I found that my loads are much less frequent. But sometimes it seemed like they take a lot more carbs to bring back up than what they did before when

Scott Benner 18:08
they do happen. Yeah, not necessarily when you overcorrect though,

Natalie 18:13
correct. If I don't overcorrect, then I don't end up having that low later.

Scott Benner 18:20
But if a low comes without correction, they're harder to bring back up.

Natalie 18:24
Correct?

Scott Benner 18:26
Is there any correlation between that way you've eaten before do you think

Natalie 18:29
could be, could be, it could also be that perhaps I was a little more aggressive with my meal rise then then what I had or maybe I overestimated my carbs. And so then later, if I dropped low then instead of needing one glucose tabs, clot, one glucose tab, maybe I need three.

Scott Benner 18:50
Okay, nothing. That's still not crazy. Like, no, no, of course,

Natalie 18:55
no, I'm not eating the kitchen. I'm not going nuts with juice boxes. Usually 15 grams will more than take care of it.

Scott Benner 19:06
Okay, I gotcha. What What's your eating style, like?

Natalie 19:10
I try to stick to a diet heavy in fruits and vegetables, lean protein. But I like carbs. And I firmly believe that. If you're out, celebrating with family for something that you should feel free to have a bite of a celebratory food if that's what you want to have. That being said, I find myself choosing lower carb options A lot of times just simply because I don't feel like fighting with blood sugars later. I know how to dose for just about everything, but sometimes I know that it's going to be a lot of work. And sometimes I just don't feel like putting in that work. The food itself isn't worth it. I often have a big salad for lunch with probably chickpeas for protein for dinner. err, I do a lot of, you know, some sort of protein and then a veggie and aside, I do have kids that are still at home, I do have a full time job. So some days are crazy. And if we all end up having to eat out, I want to be able to eat out without worrying myself sick about what my choices are. Okay.

Scott Benner 20:20
Yeah, I mean, I think that makes sense to me. So what do you think your total carbs a day are?

Natalie 20:24
It's usually under 150. Usually somewhere between 101 25. Some days might be more than that. Some days are less than that. But, but

Scott Benner 20:35
that's not a low carb lifestyle. It's just it sounds like a me honestly, just sounds like you're making very targeted choices about your food.

Natalie 20:43
Yeah, I tried to avoid processed carbs, you know, the white bread and the flowers and stuff like that. But like, if my stomach's upset rice is my comfort foods. So that was one of the things that I forced myself to learn to dose for. Because if I don't feel good, I want to have something like that. And it's easier for my tummy to digest. And so it works for me.

Scott Benner 21:11
Nice. That's excellent. I'm just trying to figure out like, where the lows come from when you have them. Do you think their activity?

Natalie 21:17
Yeah, sometimes, I think what I've noticed is that sometimes my sensitivity seems like it changes and so things that I would do, and dose accordingly and not have any trouble with maybe another day, I do the exact same thing the exact same way. But my result is a little different. And I know that it's probably due to different time of day or changing sensitivity or something like that,

Scott Benner 21:42
or hormones still an issue for you. Yes.

Natalie 21:45
So that could be part of it, too.

Scott Benner 21:48
Mostly I had foot or excuse me, I'm looking at one thing and saying another literally sorry, Natalie, I had a I had a foot surgery recently. I need to put my foot up. So hold on a second. Oh, go right ahead. I'm gonna make some noise. Just now happen on two episodes. I am all full of myself. Like it'll happen. I'll be fine. And then like, about a half an hour into it. I'm like, I gotta get my foot up.

Natalie 22:13
Yeah, it starts to throb or really hurt.

Scott Benner 22:15
What happened was what, what had happened was they told me the doctor, he's like, I'm just gonna make like this, like pinhole incision, I was like, okay, then he gets in there and decides, he's got to cut it open. Oh, and, you know, for the first number of days, like, I don't really know what that meant, because it's all covered. And you're like, Don't uncover it. Like, I like how they say, don't take this dress. For two weeks, don't take the dressing. I'm like, This dress is gonna last 48 hours, and I'm gonna have to cover it back up myself. So when I finally opened it up the incisions like four inches long. I was like, Oh, my goodness, like, oh, that's where all the pains coming from, like, really hurts. But I kept thinking like, it's whatever he had done inside of the foot, right. But that's not where the discomfort is coming from. It's the healing from the, like Frankenstein incision you put on my foot. So this the take your bone chip out? Well, it turned out to be more than that. So yeah, like so they the guy tells me, you know, gives me my inspection. I guess they call that an appointment. And he, he's like, Oh, that's gonna be a bone spur and arthritis, we'll clean out the arthritis. I'll take off the bone spur. I'm like, great. And then later, he's like, yeah, it was cartilage. It was torn, where we wasn't that much arthritis. And I'm like, Okay. He's like, I didn't take off the growth with the growth. Like, he called it a bone spur before, which made me feel old. Then he called it a growth and I was like, geez, we just stick with the same words, please. And, and he's like, yeah, it's gonna, he's like, I had to do microfracture surgery on your towel. And I'm like, What do you see, I made a bunch of little holes in the bone to try to get cartilage to regrow. And I go, Wait a minute, like, cartilage can regrow. And he goes, Well, no. And I'm like, Well, what? Then? He goes, it's more like fibrous cartilage. And I'm like, right? He goes, so it's not really cartilage, but like, hopefully, it'll support the toe. And any kind of like, whines up and I'm like, hopefully. Yeah. And I was like, I'm like, What, are you not telling me? Yes, I Well, you know, this is still a problem. And a couple of months, we might have to talk about fusing the bone in your toe. And I was like, No, I don't want to do that. I don't think that's a good idea. That was like, no, please. So now I find myself like hoping that fiber is Cartlidge grows in my toe. Anyway, that's where I'm at. But I got my foot up. So now I'm okay. Now I'm in a incredibly awkward position with a microphone on my face. But at least my foots not throbbing. Okay, so. So, I mean, what you hear people most say about algorithms in general, you've already said which is, man, it gives you your sleep back like that. It really is something. So can you talk about that for a little bit like what the impact that's been on your life of just sleeping through the night? To

Natalie 25:07
be honest, I think sleep and the lack of sleep is something that you don't notice how much it's affecting you until you actually sleep at night. I know when I worked night shift, and I had broken sleep all the time. I felt like garbage all the time. And I didn't realize until after I started sleeping at night that oh my gosh, this is what sleep slumps feels like this is what it feels like to wake up refreshed. And I kind of feel that way with the with the Omnipod five two is that I didn't realize how much I was getting up in the middle of the night on a regular basis until I wasn't anymore. And it just for me it it affects every part of me, I'm not so impatient, I'm in a better mood, I'm able to get more done in the mornings. Just because I've actually slept during the night instead of being woken up every, you know, two to four hours.

Scott Benner 26:04
It's such a slow drain on you when it happens. The diminishment happens so slowly, that once you're there, you don't know you're there. And definitely Yeah, and it's it really does suck like because you are having a significantly less desirable life honestly, and interactions with people. And it's, you know, just really, it screws you up. Now, like you said, you get it back, like oh my god, I remember feeling like this. I didn't know I didn't feel like this anymore. You know? Yeah, no, it's amazing. How often you said once in a while at night, but how often do you think you have to wake up

Natalie 26:41
and give yourself something? Probably less than once every two weeks?

Scott Benner 26:45
I was gonna say like, twice a month, maybe yeah, maybe once a month, maybe once

Natalie 26:49
or twice a month, depending on what's going on. And like I said, if if it's been a really active day, or if I've had a lot of activity during the day and didn't really realize it then sometimes that night, because again, I'm a little more sensitive than than what I planned, I might drift a little low. But I go back in the morning and I look at my, my numbers, and you'll see where the where it was taking insulin away from me during the night. So that I didn't get too low.

Scott Benner 27:19
Yeah, isn't that fascinating? When you look to see, like, wow, if this thing wasn't working, and didn't take my basil away for an hour here in an hour there, I would have had an hour whatever, like what's your Basal rate? Right

Natalie 27:34
now it's about a between a half unit an hour and about point eight minutes an hour, the idea

Scott Benner 27:41
that like to like one to two extra units would have been in you through basil. And then you definitely would have had a low and you would have been feeding that insulin, those two units of insulin, you wouldn't have known why. But the algorithm is just like no, no, just take it away. And then you don't get that extra. And even when you're drifting low. When you're drifting low, and the algorithm has been trying to stop you unless you've made some horrible mistake in the past. Even the low is not as like frightening because it happens slower. It's not falling. It's really it's, it's just change, I would

Natalie 28:15
definitely agree with that. There's very few times where I see an straight arrow down, or double arrows are even more rare. And it so usually catches the drift. And then I just need a little bit to bump it back up. It's in those cases where I've usually me screwing something up where I've been too aggressive or Bolus and then forgot to eat or you know, something like that that. Do you

Scott Benner 28:44
have a couple of questions around food? Do you have to Pre-Bolus still?

Natalie 28:47
I do? Well, half two is. The other day I didn't I was eating McDonald's and I didn't Pre-Bolus that. And I don't think I ended up going over 150. So Wow, that's great. There was that. But generally I find that a 15 minute Pre-Bolus to 30 minute, which is actually shorter than what I used to do MDI, really, it that seems to work pretty well with MDI. I saw that it would usually have to be 30 minutes

Scott Benner 29:15
to Brilli Well, you were also under you were under Basal too, right. Yeah. So you know, that makes sense as well, because now that that Bolus has to go in and has to overwhelm a lot just to get you moving. And then you've got us. Yeah, then you have to start falling so that when the food goes in, you don't see a crazy spike in the other direction. Yeah, yeah. Yeah, I try. I tried so many different ways to explain that a podcast over the years. But the best way I think I found is just imagine if your Basal should be a unit an hour, and instead it's point eight, like in that seems like well, it's not that big of a difference, but over 24 hours, it's point to an hour you're deficient. Right. So point 2.2 point 2.2 All this hadn't four hours have gone by, and four or five hours have gone by you're down a unit. So 510 1520, you're almost five units deficient a day of basil. If you're up, if you're a point eight basil when you should be a one. And that's, that's a significant amount, then you come along and have a meal. And you think the meals, only two units or three units, but you're also deficient the Basal all day as well, you started throwing in insulin, it starts making up for the Basal but doesn't impact the food, you spike up and you're like, I don't know what happened. I count the carbs, I did the thing. And it's everything settings, like, like, the algorithms are making it more obvious now two people, but I've been screaming about it forever. Like if your settings are wrong, like just nothing's gonna work, right. And basil has to be right. And people never pay attention to basil. So that's, I think that's the simplicity of why some people have issues. You know, you're right. Yeah,

Natalie 30:52
I was gonna say on that point, I firmly agree with you there. To that point, I will occasionally run in Manual for 24 hours, just so that I can be sure that my Basal settings are still spot on. Because I always worry, you know, what, what, if something were to happen, I need to know how much I really need, you know, that kind of thing. So I'll do that. Occasionally, you

Scott Benner 31:16
will, especially if something's changed, right? Like you come in with a one Basal into the algorithm. And over time, a month, a month go by and your needs changed. Like, let's say you gained weight, or you what if you had hypothyroidism and your medication was off. And you're, you know, you were a little more hypo than you usually are, that can even impact your insulin needs, like little stuff like these, right? So anytime I

Natalie 31:41
explain that, so because I also am a little hypothyroid. So.

Scott Benner 31:46
So I think that what you'll hear most people say is that when their TSH is high, they might end up using more insulin. And so the lower and more normal that you can get your TSH, you might end up using less insulin or, or your sensitivity might be a little better.

Natalie 32:04
Well, that's something I also have to thank you in the podcast for I doubt that I would have been as aggressive with my thyroid. With my Endo, had I not had all of the thyroid episodes to listen to mine was one of those that considered in range. But the symptoms I was having, were definitely not fun stuff to work with. My hair was falling out, my skin was dry, it's cold all the time. So I convinced my Endo, probably about six months ago now, to start me on some medication. And it's helped a lot. My numbers have come down. And I just had my visit yesterday, actually. And we're going to up the dose just a little bit. Because again, my numbers are still in range, but I'm starting to see some of those symptoms come back. And so just try it out.

Scott Benner 32:53
Since you just went yesterday, tell people what was your TSH?

Natalie 32:56
When I started treatment, my TSH was 2.8. Okay. And then after starting the medication, it got down to 1.02, I think. And then it had come back up to 1.8. So 1.8 is still below two, it's still well below four. But when I explained the types of symptoms that I was starting to see, she's like, No, let's try it. Good.

Scott Benner 33:21
That's great. Good for you. Yeah, I mean, you, I can say I should probably just print it on my forehead, but you don't treat the number you treat your symptoms. Yeah, and that's that's how you handle that.

Natalie 33:32
And I was just so glad to find an endo that was willing to work with some of them are very much insistent on the number so

Scott Benner 33:40
Oh, please, there are people walking around right now with three and a half TSH is and there and they have every hypothyroid symptom in the world, the doctors like you're fine. And that's it. It must be something else go for a walk, get some air, like you know, like stupid, and they should just use the medication to bring the number down to where the symptoms disappear. It just it's so simple. Natalie, it's such a struggle being the smart to understand.

Natalie 34:06
Here I am adding to your struggles. Right. Thank you. So

Scott Benner 34:09
there we go. Yes, yeah, it's just making me feel terrible for being so smart. I guess I'm joking, of course, because it's such common sense. And yet you watch people just ignore it constantly. And the idea of it was in range. So freezes some people, like I've had private conversations. I spoke with a woman who's was in the hospital once and I'm like you're describing a high TSH and hypothyroidism. And she's like, Well, the doctor said it's in range. I'm like, but you just listed all your symptoms. They're all hypothyroid symptoms. Like what would it hurt to try the medication and she was resistant? She's like, No, no, it's in range, like in range was like a speed bump for that was like 10 miles high. She couldn't get over. And then finally, you know, it goes six months goes by, and an email comes Oh, I finally did that thing. I feel So much better. I mean, I could

Natalie 35:02
have told you that, not

Scott Benner 35:03
only could I have told you that, I was telling you that, and it just, and you ignored it, it's just and then it'll happen to their kid. And they'll go, and they'll start the whole process over again, instead of just assuming, like what I learned the first time, you know, maybe I should put the practice here, it starts over again, well, they're having symptoms, but their bubble is high. And I'm like, Oh, my God, we're gonna do it again, I'm gonna go, okay. But anyway, I'm gonna do so anyway, with all these variables that are possible, see, if I can find my original thought. Imagine you go on the algorithm, and you're, you're rolling along. But then something's changed, you've gained weight, you've become less active, maybe you had a job where you used to walk a lot, now you don't walk anywhere, that is not a thing you would think about, right. And so if you weren't on an algorithm, and you stopped all the walking, you might start seeing higher blood sugars. And you might start giving yourself more in sample, the algorithm just sees the higher blood sugars and starts to give you more insulin. But to your point, you don't even know that's happening, really. Because you just, you don't even you just you're not going to know, right. And so then if you have to go back to manual for some reason, or, you know, I don't know what happens, your shipment doesn't come or you're suddenly MDI, and you're over here with your one unit of basil, because I know, this was what it was like before, and everything's still working, and you forget to factor in those other variables, then all of a sudden, you're not gonna have enough insulin. And by the way, the other way too, what if you got a more active job, and now the algorithms giving you less insulin, and you flip over to manual, and all of a sudden, you're getting low and you go, I don't understand, like, like, it's, it's that kind of stuff that I liked. What I'm saying is, I like that you go into manual once a while and test your settings, basically. Yeah.

Natalie 36:45
And like, when I was having trouble with the dawn phenomenon, and rising every morning, the first thing I did was, I went manual, so that I could adjust it and see how much I really need to come in to the number that I like, I like to float around at at night, if I can. And so once I did that, then I let the algorithm try, it still wasn't catching it. So I went back and adjusted my insulin seven sensitivity during the early morning hours, so that it would give me more insulin during those early morning hours. And that seemed to really help. And so I might be at the point where I might need to make a little tweak there. If I still continue to see that morning rise that's a little higher than I want, but

Scott Benner 37:31
I love it. Well, you've just said something that made me think of something. And then I looked at myself and thought, I can't believe my foots in front of me while I'm talking. And then I lost my train of thought.

Natalie 37:40
I can't see your foot. Nobody needs to know you're not

Scott Benner 37:43
distracted by but I'm staring at it. It's out in front of me. Oh my god, what were you just saying? Hello, I'll get back to it. Oh, I'll go to my other question till I get back to it. What do you do for fat or protein rises?

Natalie 37:57
I really don't. And I think that's the two factors. Number one, it's probably a factor the algorithm, I think it it catches it. Number two, I don't usually have low carb meals that are high in fat and protein. And I know that sometimes people see the protein rise a lot more if they're lower carb. But if if I've got a rise happening, that's outside of what I would expect, or it seems like it's lasting longer than the food should be sticking around. I'll go ahead and just do a correction then. But typically, I will stick with what the algorithm is recommending. Unless I feel like I know something that the algorithm does it like, Okay, I've been snacking on something and the algorithm doesn't know that. And so I'll do a more aggressive correction.

Scott Benner 38:48
Yeah, okay. Do you ever have like a french fries situation where you have like a burger and fries and you get like that 90 minute later rise.

Natalie 38:57
Um, sometimes what I'll do with those is I will Bolus for the carbs that I'm pretty sure I'm having an O I also usually don't Bolus more than five units at a time. So whatever my carb ratio is, that gets me to five units. If it's going to take me over five minutes, I'll break it up. So I'll do a partial Bolus. And then 30 minutes later, I'll do another Bolus because for me my body tends to reject big Bolus. Excellent. Yeah, it doesn't like big Bolus has no matter where I put the pod. And so I'll just break it up like that. And so if I'm having something like french fries, or something like sushi that I know is going to stick around. I'll set a timer on my phone for either 30 minutes or an hour depending on the kind of food and then I will just do another Bolus of a part like usually like, I don't know 50% or 20% of whatever it was that I ate. So that that controls that later rise that's going to happen. Okay,

Scott Benner 39:55
okay, good. I like that. What do you think you were seeing tunneling you know, It is when I say that. Yeah,

Natalie 40:00
yeah, that's exactly what was happening. It just seemed like there's too much insulin going on that my body could absorb at one time. And so then it would just like sneak up back out the hole and leak around the the edge of the cannula there. Yeah, once I stopped trying to do bigger boluses. And then also I, if, if I put it on my thighs, it seems like the pod gets bumped more there. And so I will usually go ahead and put an over patch that has a strap on it over the pod to keep it from rocking back and forth.

Scott Benner 40:35
Yeah, kind of bringing their cattle out a little bit. I think that's just for do you think it's getting bumped? Do you think it's just from walking?

Natalie 40:42
For me, it's probably a bit of both. I tend to bump into things, my dogs will hit it. I don't seem to gauge the wideness of doors very well. And so I when I first got my Dexcom I was constantly ripping them off on doorframes. You know,

Scott Benner 40:59
I find us talking about this sometimes hold on a second. About I think it's an actual thing. Hold on. Awareness. Yeah. I walk into doorframes homeless people seem to think that's an ADHD thing.

Natalie 41:15
You might not be wrong. My son was recently diagnosed with ADHD. And we've actually had to fight for a long time to get him diagnosed for a variety of reasons. But as I learned more about it and researched more about it, I'm, I'm pretty sure I'm an undiagnosed adult with ADHD. But I've been able to find coping mechanisms to deal with it. I'm, you know, I work in a professional job I get by, I'm getting by,

Scott Benner 41:43
like, I'm 51. But I'm almost finished.

Natalie 41:49
I just I don't know the point of being diagnosed at this point. Right? If I've made it this far, but I'm pretty sure. Yeah,

Scott Benner 41:57
the only other thing, there could be like a visual problem. But I mean, I think it's called vertical. Oh, God, hold on a second. I'll find it. Vertical header theory? Oh, I don't know. I'm just saying that the bumping into a doorframe is actually could be a sign of other things. I also used to be what I called a close Walker. And, and I stopped myself from doing it, which I've said on the podcast before, like, I used to turn corners and like catch the edges of walls and things like that. And then one day, I said to myself, I'm not going to do that anymore. I'm going to like purposefully not do that. And I stopped doing it. So it's not ADHD, because I was able to like, make yourself stop and make myself stop doing it. Right.

Natalie 42:42
Yeah, I think for me, once I got used to wearing either the Dexcom or the pod, that part of it's gotten a lot better. But I'm still a klutz. I still bump into stuff.

Scott Benner 42:56
That's why I just wanted to bring it up because it comes up. It's like that. That rapid eye movement, Rapid Eye Movement Desensitization like thing that people do with therapists, the amount of times that comes up on the podcast is fascinating. So just yeah, it's just an the bumping into things thing. So I like to like, shut out for a second, just to this, because like, right now someone's like, Oh, God, I probably do have ADHD. And I walk into things all the time. Like, I just I don't know, he didn't use this me to think someone's in their car right now thinking that. That this is where they figured that out at. But anyway, yeah, cuz

Natalie 43:33
you know, it makes so much sense to get so much medical advice from a dude you listen to on a podcast. Yeah.

Scott Benner 43:39
Badly. None of this is medical advice. I just want to say that right now. But

Natalie 43:43
yeah, that used to really floored me that I was learning so much from the podcast, but tell

Scott Benner 43:50
me about it. What like when you were first because I it makes sense to me. But tell me about the feeling?

Natalie 43:55
Well, you know, you always hear, you always know not always here. But the whole thing about, you know, you can't trust everything you see on the internet, or you can't trust all that you read on the internet. And oh, you're gonna let Dr. Google diagnose you and this kind of thing. And so then I start listening to a podcast that's put on by a gentleman that doesn't have diabetes, and isn't a doctor. But yet through his life experience and through the things that he's he's learned, the things he's saying makes sense. And then, you know, you brought Jenny on to and she was agreeing with the things you were saying. And it was just such a different way of thinking about things than what had been presented to me through the medical community. Yeah. I like devoured your podcast when I first started listening to it to the point where my kids are teasing me. Mom, are you listening to your doctor podcast again? Yes.

Scott Benner 44:52
Well, I guess he's to say, you know, like when, when one of you says that you like the podcast, you listen to it, I get it. For my wife, or my kids or stuff like that all the time, and I agree, listen, as as crazy as it might sound for me to be saying it, I agree with you, I don't think you should be listening to me either.

Natalie 45:13
Know how we ended up here,

Scott Benner 45:14
it just is, um, you know, when I speak in public, I'll stand up in front of a crowd of people, and sometimes their big crowds, you know, hundreds of people. And I'm like, Look, I'm going to talk about diabetes in a way that's probably going to sound almost foreign to you. And it's going to some of it's going to be shocking. And, you know, if you really, if you already know about it, or you've listened to the podcast, it's not shocking at all. But to hear somebody say, I want you to consider Pre-Bolus In your meals, or don't stare and look at a high blood sugar for three hours, because it's not stalking if you needed. Like those things. When you're told that by doctors, when you hear them somewhere else, you think, oh, that's crazy. Like, I can't do that. And then I mean, I do take your point. Like, it's a It's the strangest thing. It's like you're taking like, it's like somebody's telling you how to change a tire and they've never driven a car. I don't have diabetes, like so I don't really like I don't know what it's like to live with it. I know what it's like to manage it. And I know what it's like to care about somebody who has it. But still, like you said something earlier in the episode that really like struck me. You said, when my stomach's upset, I like to have rice. So rice is something I had to force myself to learn how to Bolus for. And when you said that, that makes me feel like, like, oh my god, there are things people won't put in their mouths, because they're scared of the Bolus. Oh, absolutely. Yeah. And that's prevalent for people. And that's the thing I don't know firsthand, I know that from listening to you guys and talking to

Natalie 46:50
you know, and sometimes it's because it's not worth it. And sometimes it's because oh my gosh, I would have to have X amount of insulin to to have this food. And that's so much more than what I normally take. And I'm afraid of taking that much. For me it was more, figuring out the strategy of making sure that it doesn't continue to hit me for, you know, four or five hours after I eat it. But I'm, I don't know, I'm pretty flexible in my eating style. I don't think I've weighed a food my entire life, even after having diabetes. Yeah, I definitely estimate carbs a lot more than I scientifically calculate them. I know, I would not have the control that I have. If I hadn't been learning from the podcast and the people on your podcast.

Scott Benner 47:39
That's excellent. I'm very happy to hear that. And it's kind of you to say, so I appreciate it very much.

Natalie 47:46
What I went to the endo yesterday, when you hear it, she said, I mean, I

Scott Benner 47:49
thought we were gonna do a monkey impression. Is that what that was? I was like, I don't have a monkey impression. But okay, yeah, you're really excited. I'm so excited to be here with you.

Natalie 48:00
My, my AMC is 5.4. And that might be the lowest I've ever had. And then she also, after going through all my data and looking at the things and asking me about the lows. She's like, Natalie, I wouldn't change a thing. You're doing great. You look like you're really on top of it. And you know, like, it looks like you know what you're doing? And I wanted to laugh at that part. But

Scott Benner 48:25
I said, Thank you. Why did you want to laugh at that part? Because you never feel like

Natalie 48:29
you really know what you're doing. Right? Right. Especially if, like this week, I went to the state fair, and my Dexcom decided to do take a break. When I got to the state fair. Luckily, I had a meter with me. And so I just had to do finger sticks throughout the day. But Oh, am I going to know what to do in this situation? What about this situation? That kind of thing?

Scott Benner 48:53
You went to the state fair without an extra Dexcom? I did. Yeah. That's because you're an adult art and just went out? Like Brian is ready to you and I were getting on art and left to go out with someone. And I was like, Hey, you're going kind of far from home? Are you taking stuff with you? And she goes, now I checked my pod, it has plenty of insulin. I was like, What about just extra stuff? In case she was now I'm like, okay, by the way, nine times out of 10 It's gonna be fine. And, but but the one time you're at the State Fair, like, I should probably keep one of those sensors with me. Like, you know,

Natalie 49:25
and it's so well, and I thought about going home to get one right. But I was like, you know, it's a two hour warmup anyway. And I'm an hour from home, and I would have to drive back up here to pick up my kid later. So I've got my meter. I've got my strips. We're just gonna go in manual. Pump. Yeah. And then I'll just fingerstick and I ate food that I wanted to eat. I had an era corn and I had I shared some videos with my daughter. Nice and it was a great day,

Scott Benner 50:00
I would have done it. Listen, in that scenario, I would have done exactly the same thing. In my mind. I think like I'm thinking ahead all the time. So to me, I think, Okay, well, the CGM takes a crap at a bad time, I'd swap it now do exactly what you did. But at least two hours from now, I'd be back again. Like, that's how I think about it. Like, then we're back. And but also, you didn't do anything wrong. I'm just saying, if you were if you were a kid, if your kid had diabetes, and you were me, I bet you would have had stuff with you when you went to the fair.

Natalie 50:31
Probably would have had a spare Dexcom. Yeah, yeah. And typically, like if I'm going somewhere around home, I don't carry extra decks comes usually I will carry extra pods, extra insulin and a pen, and usually a meter. But I usually don't necessarily carry extra decks comms. Now, if I'm traveling, or going far away from home, then I packed like, I'm going to be gone for three months, even if it's only a week. Yeah. And there's been times that I've needed the extra supplies. And then there's a lot of times that I bring everything home, but to your point, it's the one time that you don't have it that you really need it that you prepare for. I'll

Scott Benner 51:12
tell you to In fairness, CGM are one of those things like they either go on time, or they were they go, and you can usually see them going. It's not usually a thing that just happens. It's almost like you know what I mean, you get choppy data from it or something like that happens, you start having connection issues or something like that. You can kind of see it coming. Usually,

Natalie 51:33
I should post the picture of when it happened on the website, I think. Okay, so I know that spray sunscreen affects the pods. Does it also affect the Dexcom? Because it was within five minutes of me putting sunscreen on that the Dexcom decided to take a break. The

Scott Benner 51:49
only thing I know about spray sunscreen is that if you get it on an AMI PATA could crack the shell of the Omni pod, right? Yeah, I don't I mean,

Natalie 51:58
I've never heard of anybody having trouble with the Dexcom. But it was just so coincidental that within just a couple of minutes, it decided it was not happy. Yeah, I

Scott Benner 52:07
think that's just Murphy's Law. I think that's really what that is. Because it

Natalie 52:11
normally I last 10 days, usually. And this one was only on day like four.

Scott Benner 52:16
Oh, yeah, something was definitely off. I you know, that's actually difficult for me when people try to talk about Dexcom not lasting for them. It last so consistently for Arden, like I did, it's just like, it's just good luck, you know, but 10 days, and now the g7 has a grace period, she goes into the grace period, no problem. Like it's she's always had really good success with XCOM. So

Natalie 52:40
I'm sure most people loved it. Yeah, it's, it's been so informative. And it's really changed how I manage. And I started using it when they thought I was still a type two. And so that was very helpful. Especially once I started insulin. It's just been great.

Scott Benner 52:57
Cool. So I'm gonna ask you, do you have anything else about Omnipod? Five, you want to say before I ask you my next question. No,

Natalie 53:03
I mean, I think even though it's got a target of 110. I mean, I'm able to as an adult, have a, a one see that's, I think spot on an average of 110 or 106, something like that. And so don't let the target dissuade you from trying it. Yeah. Well, no,

Scott Benner 53:21
it's terrific. It's terrific. And this is this is it like the in my mind like these, this is the year of like algorithms, I can't wait to see what happens to them as we move forward. Like it's very, very exciting. So my last question is before we started talking, wow, that's not fair. Also, it's not accurate. Before we started recording, you were talking about the other episode that you did, and that you wish it would have gone differently. And like all this other stuff, so I wanted to like chat through that with you if you're comfortable chatting about that. Okay, do that. So, go ahead, tell me what you said first.

Natalie 53:56
So I just said that I, I reminded you that I'd been on the show before. And that I really wasn't very happy with my episode, I felt like I didn't sound like myself, that I really wasn't very engaging. And it could have gone a lot better if maybe I'd let you do more of the leading on the episode rather than having like a specific list of things that I really wanted to get across than it. It stemmed from the fact that I was so passionate and still am very passionate about helping all people with diabetes, but especially those that have been misdiagnosed as type two, or maybe they even do have type two and they're getting a lot of, of shame or grief or not support from the medical community that it can get better. And there's there's things that can help.

Scott Benner 54:51
So your goal was to help people so you came on and you had a list with you? Yes, and then I probably drag you around. Not letting you get to your list. Is that fair?

Natalie 55:01
I mean, yes, a little bit, but I think you did. Let me get to the list. But I think that if I had just let the conversation flow flow a little bit more rather than having prepared, not poorly prepared, but you might be surprised at how much I practiced because I really just really wanted it to go really well. In the end, I wasn't super satisfied with how it went just because I didn't feel like very many people would. Wait,

Scott Benner 55:29
wait, wait, how do you practice? How do you practice to be on a podcast? You

Natalie 55:33
practice your your list of topics and like, what questions do you think the host might ask you? And how would you answer that then?

Scott Benner 55:42
Oh, that's nice. Thank you. Well, let me tell you something. Your episode has been up for less than a year. And it has well over 20,000 downloads. Oh, wow. So it's doing good. And yeah, and if you're worried that it's not helping people still, it is downloaded on an average of 30 times a day. Oh, my gosh, that's a long time after it initially. Yeah.

Natalie 56:10
So in the in the Facebook group, I occasionally will see one of the one of your helpers, reference. My episode. Isabel is really great about Isabel and Nico. Both are really great about helping somebody that's, especially if they're type two, or they don't know what they are. Or if they've got something weird like I do, where they don't have antibodies. Yeah, they'll refer them to my episode, which I really appreciate. Because ultimately, if it can lead to more people being in that study that I was in, we might get more answers for folks like me.

Scott Benner 56:42
So you had an expectation of how it was going to sound or how it was going to go or what you were going to say, and then you didn't hear that back? Is that right?

Natalie 56:49
I heard the words, I didn't hear the excitement, or the tone or the flavor. So

Scott Benner 56:56
you have a very specific way of speaking. You know that you speak in a very specific way, like so you're somebody from the Midwest, you're not monotone. But you don't vacillate very high or very low while you're talking. Right? And so you're not, you're not purposely engaging people with the sound of your voice, you're speaking you have a lovely speaking voice, it's fine. You speak a little slowly. And that throws me off a little bit. So because but not me, personally, and not you specifically, when people speak slowly, there's a clock in my head. And I want there to be talking. And I want there to be shifts in conversation. And that's me, like producing the show while I'm making it. So I have to go back and listen to yours to find out if, like you talking more slowly made me be more like made me try to like make up for that. Because that happens. Sometimes

Natalie 58:00
you're probably on to something there because I, I often have to speak in my job. And by nature, I speak very quickly, especially when I'm excited. And so I've had to have years of practice of slowing myself down, especially in situations where I might be nervous, and I was definitely nervous. So I very likely could have been speaking much more slowly.

Scott Benner 58:25
Well, and by the way, if Isabel is suggesting your episode to people, then it's good. Because I don't know that you see, you're saying thank you, but I'm giving you an insight Isabel that other people don't. So like if she didn't like the episode, she wouldn't share it with people. Oh, that's funny. Yeah, you're good. Trust me. I'm always just amused like i. So this is what I told you before we started recording. And this stays completely true. If I let people be involved in the process after they recorded the episode, I don't think any of the episodes we get on the air. Because everybody has either an idea of what they're supposed to sound like or what they were supposed to say or what this was supposed to accomplish, instead of just trusting that I know how to build the podcast, so it helps people and and they all have like the site. A lot of people have an idea of what how it should go. And if I gave them any editing power, then people wouldn't get the shot. Like if I gave you your episode, it wouldn't exist because you'd be like, no, no, it's bad. I didn't do what I meant, or blah, blah, blah. And But meanwhile, it's being given out by group experts in the Facebook group as something to listen to. So who's right? I mean, I'm right to go ahead and say, Man,

Natalie 59:34
you're Isabel's. Right. Let's put it that way. Right.

Scott Benner 59:35
Like, exactly. And so you're you're wrong about it. And so you are the worst judge of an episode about yourself. So here's the question. I usually ask people when they get into your situation. Do you like the podcast? I love the podcast. Does it help you? Absolutely. Then you should trust me that I thought your episode would do the same for other people.

Natalie 59:59
And I will do You bet. Yeah.

Scott Benner 1:00:00
Let's see that long pause you made after I said that. I was thinking about it, you're while you're thinking about it, my brain is yelling, oh my god, Natalie faster. Let's go

Natalie 1:00:12
on with it. You don't think that has anything to do with you'd be an east coast you.

Scott Benner 1:00:16
So I don't know, because I've lived here my whole life, I couldn't judge that. What I can tell you is that from a listening standpoint, I am a fan of audio entertainment. And I know what I don't like. So I don't like pausing. I don't like I don't mind if people think. And every once in a while, like a long pause, I'll cry during some people's pauses, because you can feel the emotion hitting them in the silence. But when people just have a slower way of speaking, I think it's it doesn't engage the listener. And I want people to stay engaged because you said something, 45 minutes into this that was really impactful. But I don't want people to get 10 minutes into it and be like, Oh, she talks slow, and then not make it to the 45. And by the way, people don't have that conscious feeling. Like, oh, she's speaking slowly, I'm not going to listen, it just it hits you wrong. And so you need something to kind of pull you in, I don't know, like a total world and just keep spinning you like so you're you're stuck to the outside wall and can't get away. You're like I have to stay here and ride this ride. And that's that's it. And it also it's it's an unfair thing to expect the people. So making the podcast has taught me to be more patient, because there's nothing wrong with it. It's just not 100% right for me. So, I will tell you, I will never tell you what it is. But there is an episode of the podcast that went up this year. It was the first time it ever happened to me. I put up an episode and I didn't like it. I was like This sucks. And oh, I can't believe I'm doing this. It's so bad. I hated the way the person spoke. I hated that. I hated what they talked about. It just ate it. I hated it. And oh my god, do people like that episode. I was like, son of a bitch. And like I got emails about it like, Oh, I love this episode with this person. I was like that one. Are you kidding me? I was like, oh my god, her voice is so annoying. No, like, but it just turned out what I learned from it is it wasn't for me. It didn't make it not for other people. And I have gotten good enough at this now that I was actually able to moderate the conversation. Even though I wasn't enjoying it, it was still a good conversation for somebody. And that was a big learning moment. For me. Real it really was honestly, like even talking to you today. If you if I would have spoken to you. Two years ago, I would have talked over you a lot. Like because I know what you're going to say in those pauses. And there's a part of me that's like, just say yes, like, let's go. And I've learned to like, like, just wait, I'm getting better. The podcast is making me a better person. Honestly, if I'm being honest. So well,

Natalie 1:03:06
I will say when I first started listening to you, I was like, Well, this guy just shut up and let the guest talk please.

Scott Benner 1:03:12
Now, I know what I know what needs to be said now, like, I don't need them. But even that, like back then I needed the thing to do a thing. Like I don't know if that makes sense or not like I know you think of it as your personal story. But the way I think of it is it's a slice of life a look at something from a certain perspective, and people want to hear it so they can draw from it what they need and move on. Like nobody is. I'm sure there are a couple of episodes like this. But for the most part, people who listen to the show religiously, don't know everything that happened in every episode, but they know what they took from it. And you know what I mean? And so that's the, to me the important part. And I'm like, you know, I've slowed down over the years, right?

Natalie 1:03:57
Yeah, I would say that for sure. Because

Scott Benner 1:04:01
I'm like, I don't know. But also keep in mind, there was like long stretches of time where my iron was really low, and I was still making the podcast. So I don't even take responsibility for any of that. What do you think?

Natalie 1:04:13
It's all done under different circumstances. Yeah, I

Scott Benner 1:04:16
was a completely different person. Listen, I gotta I gotta review the other day where someone just didn't like that. I talked, I spoke to somebody personally about like, their personal life. And the person's like, this is supposed to be about diabetes. I'm like, well, first of all, it's supposed to be about whatever I think it's supposed to be about. That's why it's my podcast. You know, like, so if you want it to be about what you want to be about, go make your own diabetes podcast. Good luck. You know, like, that's fine. That's where the conversation took me. Like, am I always right? I'm not, like, am I always exactly like, do I speak exactly the way I should? I don't, but if I start measuring my words and practicing for the podcast, you guys aren't going to you're going to hate it. It's gonna suck. And that's part of the reason why I don't let people do it who Come on. Because it seems it seems like practice, like, imagine if you would have last time been like, Oh, I remember practicing this part in the mirror, and then you did it again, it would sound, it would sound rehearsed, you know. So anyway, that's one

Natalie 1:05:17
of the things that I love about the podcast is that you've got so many different elements, right, you've got the management episodes, management from all kinds of different perspectives, you've got, the how we eat, you've got the defining diabetes, the bold beginnings, all of that, you've also branched into the type two stuff now to help folks on that part of their journey. But then you also have the personal stories, and I, I love listening to the personal stories. In the beginning, the management side of it is what really brought me in because I needed it. But the personal stories, I think, help on a different level. And they they help you appreciate both where you are, and they give you ideas of where you could go. Yeah, some of them have been really, really inspirational. And you know, we I find myself crying along with them.

Scott Benner 1:06:10
Yeah, trust me, I am. So that's the key to this whole thing, right? Like, you could get on here and read a list and say, Here do these things. You're a one seal by this, but no one's gonna listen to it. They just aren't like, so you have to like I've told people privately, I've probably said it on here, I'm not scared to say it on here. I partly see my job is I'm tricking you into paying attention to something that's boring, so that you can take better care of your health. And I'm doing that by giving you like conversations with people that are like the ones you just described, you know, and, you know, again, there's no shortage of entities, Ada, for example, who has all this information written down. And I defy you to know where it is or what it says. Because just because you make good information available to people, doesn't mean they're going to find it, it doesn't mean that if they find it, they're going to absorb it, it doesn't mean that they're going to take the time to listen to it you still see online? I mean, how often does someone come to me and say, I don't know what to do. And you'll hear me and I'll respond back or I'll you know, the people who helped me in the group will respond back and say, Here, listen to the bold beginning series. I don't have time for that. Can you just tell me what to do? I'm like, why? Like, I know, because that's not a valuable use. I can't tell each person individually what to do. Like, that's why I made this thing. Even if

Natalie 1:07:33
you could tell them what to do. There's a difference between somebody telling you what to do and you working through it on your own. There's part of the learning process in there to Scott that, that people have to take responsibility for their own learning in their own care through it

Scott Benner 1:07:49
only are you trying to name the episode on your own? Are you trying to name the episode Teach a man to fish? Is that what you're trying to do? Because that's, that's what you're saying? And you're 100%? Right? 1,000,000%, right. I can't if I come and do it for you, you won't be able to do it again the next time. Like just listen to the stupid I did it. I gave you all the Listen, you mentioned Isabel earlier, she texted me this morning because she's doing something that's going to put a variable into her life. And she goes, Hey, I'm doing this and this, should I do this? And this like as an example with my insulin? And I answered her back. And she goes, yes, yes, I know that from the podcast, and I would do well. Everything I know is in the podcast. Like, I'm not gonna, I don't have like a magic extra thing. I didn't I didn't say out loud at this point.

Natalie 1:08:32
magic bag of secret. Yeah, no.

Scott Benner 1:08:35
Here's what I don't tell anybody. Right, like so. But that feeling that people are like, just tell it to me. Like I understand it. I genuinely understand it. They're probably overwhelmed and scared and they just want it to be right. But the truth is, you have to live through this. You have to go through it. You have to learn. And the podcasts will make it easier for you. But you still have to I don't want to say do the work, but you have to experience the experiences. You have to react, watch it happen, watch it work or not work, learn from it, do it again. And that's just, it's just that's the truth of all this. Absolutely. There's no shortcut to it. But there is the podcast is the shortcut. But it's still not. It's still not five minutes

Natalie 1:09:22
doesn't prevent you from having to do it yourself. You still have to do it. It's 1,000,000%.

Scott Benner 1:09:26
Right? Like yeah, and I don't know, like, I do my best. Like I do my best to get it to people. I do my best to make it interesting. I avoid like the plague all the people who do who do the rounds, the diabetes rounds. Like you don't I mean, they're saying the same crap over and over again in 16 different places. They've been on every blog, you know, you see them like talking 16 Instagram accounts are all saying the same crap. And you know, they're there. I don't know what they're looking for clicks maybe like I have no idea But the content to me is not. It's not accessible. And I don't usually like talking like that. Like, I'm like saying out of the box and accessible and meet people where they are and like that. Oh, that's

Natalie 1:10:09
all the jargon. Yeah. Let's see. Oh, now see, they're all fallen out of my head. But yeah, sorry. No,

Scott Benner 1:10:18
no, no, please. All that anything you've heard on a meeting at work? I'm not going to say, we're

Natalie 1:10:24
not going to boil the ocean here today. Is that what you're telling me?

Scott Benner 1:10:28
It's a way that people talk to say nothing. Yep. And so there's these I just had someone explain this to me yesterday, he hears this, he's gonna be like, I can't believe my thoughts are on the podcast. But we were we were talking about somebody I do business with. And I said, I don't understand why more companies don't have me speak at events. And by the way, I don't even know if I would say yes, but I don't understand why they would. And he said, well, because everyone sticks with safe and what they know. And so it's this narrowcast information that is neither incredibly helpful, or incredibly, not helpful. It's banal, okay, like, and they will feed you that banal information until the end of time. Companies, Instagram accounts, influencers, are all going to say the same crap. Because it doesn't take any thought. It's not going to offend anybody. It's not really going to help anybody, but it's not going to hurt you either. And then it's just down the middle. It doesn't, you don't have to infer from it. You don't have to learn. You don't have to do anything. You can be a passive passenger on their content Express. And they get clicks. And then they sell those numbers, those clicks for ads. Right? And you might think, Well, yeah, Scott, you're doing the same thing. But I'm not. I consciously decided to say what people need to hear. So that that will help them so that they will share it was someone else, and then that creates the clicks. And then full disclosure, I sell those clicks, for ads,

Natalie 1:12:13
which is what why we continue to keep getting the podcast. That's

Scott Benner 1:12:17
why on a Friday afternoon, at three o'clock, I can sit here chatting with you recording it, and then putting it up for people to hear. Because there's going to be two ads on this episode, those people will pay me money for those ads. And that provides me an income so I can make the episode the podcast, which by the way, is not I don't think like that's surprising to anybody. But the difference is, is that the content is valuable. And, and it's not just valuable, but it's entertaining or engaging. And that's the other thing, because I'm not the only person. Listen, between you and me, Natalie, a couple of people try to rip me off every year. Like there's content out there. That just sounds like they listened to Jenny and I on the on the Pro Tip series. And they repurposed it, but they don't have whatever it is that makes this work. And I don't even know how to quantify that, to be perfectly honest with you. I don't know why it's working. I can't take credit for it. I couldn't probably reproduce it. If you asked me to, like whatever happened here. Like whatever made you say the kind things you said earlier about the podcast. I didn't do them on purpose. I just made the podcast and that was your experience. They're out there. I don't know. Bad voice bad timing. Maybe they're just not likable. Like who knows? I'm not likable to some people are damn sure. You know what I mean. But I also don't like I don't vanilla myself up so that I don't offend anybody. Like I just like, like I said, I got an I got a review the other day and I'm like, That person doesn't like me, but it's not terrible. And I'm like, perfect. I'm right on that line. And that's kind of where I want to be. You know. So anyway, I have a lot of big thoughts about this, that I'm sure are boring to people. But there's a way to get this information to people and to not waste their time. And I mean, honestly, if you don't agree with me, please say but aside to diabetes. This is a good podcast, right? Yeah.

Natalie 1:14:23
I mean, there's definitely episodes that I've listened to just for the pure entertainment value of the episode. I still listen multiple times a week to the podcast because I find that that I enjoy the information and I know that it has helped me so much that I like hearing how it's helped other people as well.

Scott Benner 1:14:46
Do you think I could do it if it wasn't about diabetes? Do you think if I left the niche, like people would listen to me interview people about other stuff. You

Natalie 1:14:53
you have a way of pulling things out of people that's really entertaining. Now, you know So in my case when I first started listening to you, and I would get irritated with you for one reason or another, but I kept listening because the info was good. If it wasn't something that that the info was good, then I don't know that I would have listened to it as long as what I did.

Scott Benner 1:15:15
So I grew on you like a fungus you're saying? Absolutely.

Natalie 1:15:19
Right. Yeah, your mushroom. Oh,

Scott Benner 1:15:21
I love that. I think that's terrific. Like the way content is delivered. Nowadays, right? Like the face the forward face of content. I'm not the mold for that. Like, I didn't say mold like fungus. Although that would have been amazing. If I did. That would have been really Yeah. But I'm not the most like, I'm not young. I'm not pretty. I don't just like say things that are, you know, it just vanilla so nobody can disagree with it. And, you know, I'm I'm kind of like somebody told me recently that I'm like, my, I have aggressive opinions. And I was like, Oh, I don't know that about myself. It's like, really? And they're like, yeah, like, she's like, you're like unapologetically you. And she's like, I like it. She goes, but I could see why we're might scare somebody. And I was like, Oh, I was like, I don't know that about myself. Like this is just how I am like, I'm not out here acting like a thing. You know what I mean? Yeah, you're just being you, man. But anyway, like, so that is part of my plan, by the way was to put out information that was so good that even people who didn't like me would kind of be forced, you've heard me say on the podcast, who are my favorite review, basically says, I hate that guy. But my a one C is so good that I listen to this podcast. Like, that's my I swear to you, that's my favorite review.

Natalie 1:16:39
Well, and every time I hear you talk about that review, I giggle to myself, because I will tell you the first couple episodes that I listened to, I was like, Who is this guy think he is? Why is he talking over these people? And and then you went through the phase where you actually started looking at how much you talked versus how much they talked. And so I think you made some adjustments there. But you know, you said it earlier, you've grown you've evolved. And I think the interviews now are really entertaining to listen to. I'm so glad. Like we said the info was so good that, that I kept listening.

Scott Benner 1:17:11
I hooked you. I kept you here, I guess basically against your will. And then yeah, yeah. You've basically been human traffic is what you're saying.

Natalie 1:17:23
Your traffic. I've had to listen to

Scott Benner 1:17:25
you. By the way, there's a great example of something most people wouldn't say. And, and even as I'm here, I'm like, Yeah, I like, I don't think I shouldn't have said it. I just think it's not something I don't even know what I meant by it, to be perfectly honest with like, You got hijacked basically, like, and I just don't have. I want to say that I don't care. But that's not true. I just think that the ends. I don't think that's right, either. I was gonna say the ends justify the means. But I don't think that's right, either. I guess what I believe is, is that this has to be enticing some way or another. Because it's information about diabetes, and who in the hell wants to listen to that? Like, that's just what I think of it. ever see the movie private parts? You know what that movie is? Okay. Private Parts is like a. It's like a movie about the Howard Stern's career. And there's this

Natalie 1:18:21
okay. I probably did watch it. But it's been a long time. Okay. And

Scott Benner 1:18:25
so there's this, there's this scene. I don't know if it's real, or it's not. But he goes into a different market. They're having these reactions to him. And they're doing the, you know, the people who he works for are looking at the data. And they're looking at the feedback from people. And they're talking about how long people who like Howard Stern listen to him. They say oh, like the average listener who says that they like the I don't know, the whole quote, but like, who says they like him? Listen for this long. When asked why they listen, answer most oftenly given is I want to hear what they'll say next. And then they say the people who don't like him, they actually listen longer than the people who do like him. And when they're asked why they said, I want to hear what he's going to say next. Next thing. And part of that is what I'm doing here, whether you know it or not, so

Natalie 1:19:19
but so we want to hear what you say next. That's

Scott Benner 1:19:22
all like he just like, is he gonna say something stupid? Let me let me find out like is this going to be like valuable? Is it going to be like a tear jerker? I mean, honestly, like, some of the episodes are me people say that. There are times that while people are talking, I'm thinking, Are you sure you want to say this? You know, like, and we'll get to the end and we're not being recorded anymore. And I'll go like, Hey, you said some fairly personal stuff back there. You okay with that? For sure. Like we're not being recorded anymore. Like now's the time. Just go. I shouldn't have said that. And they're like, no, no, I want it to help other people. And everyone always comes from that person. back there. And I think that's part of why it works is because now the people who are coming on the show are saying, this show helped me. I've got some odd stuff in my life that I didn't think would have happened to anybody else. But it turns out, I might be wrong about that this crazy stuff happens to everybody. And let me go tell my story. So somebody else can feel like how I felt. So I can't thank those people. I know, you're so

Natalie 1:20:23
authentic Scott. And then you bring your guests on, and you allow them to be authentic to and I would have never guessed in a million years that I would reach out to you and say, Hey, I think I need to be on your podcast. But it was in that that interest of helping people and telling what's happened to me so that maybe other people can identify with it as well. And it hopefully will help them.

Scott Benner 1:20:46
Yeah, that's a great place to stop. Okay, thank you, Natalie. I really appreciate you taking the time. Thanks, Scott. Yeah, hold on a second.

You can use the same continuous glucose monitor that Arden uses. All you have to do is go to dexcom.com/juice box and get started today. That's right, the Dexcom g7 is sponsoring this episode of The Juicebox Podcast. If you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes, but everybody is welcome. Type one type two gestational loved ones. It doesn't matter to me. If you're impacted by diabetes, and you're looking for support, comfort or community, check out Juicebox Podcast type one diabetes on Facebook. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com

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#1136 Fifteen Year Old Type 1 Using a GLP

My anonymous guest is the mother of a 15 year old type 1 who uses Wegovy. We discuss the impact GLP meds have made to her insulin use. Crazy results!

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

+ Click for EPISODE TRANSCRIPT

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

Scott Benner 0:00
Hello friends, welcome to episode 1136 of the Juicebox Podcast.

Today's guest is going to remain anonymous. She is the mother of a daughter who was diagnosed with type one diabetes at 13 years old. Today her daughter is 15 still has type one, but began using a GLP medication six months before this recording. When you hear what happened to her daughter's insulin needs on the GLP medication, your head is going to explode. Please don't forget 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. When you place your first order for ag one with my link, you'll get five free travel packs and a free year supply of vitamin D. Drink ag one.com/juice box. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode.

This episode of The Juicebox Podcast is sponsored by cozy earth.com Cozy Earth is where I get my clothing, linens and towels from they are incredibly comfortable and temperate. I love them. I really do love them. And I love that I can give you an offer code that will save you 40% off of your entire order. Just use the offer code juice box at checkout and you will save 40% at cosy earth.com This episode of The Juicebox Podcast is sponsored by us med U S med.com/juice box or call 888721151 for us med is where my daughter gets her diabetes supplies from and you could to use the link or number to get your free benefit check and get started today with us met. This episode of The Juicebox Podcast is sponsored by touched by type one touched by type one.org. And find them on Facebook and Instagram touched by type one is an organization dedicated to helping people living with type one diabetes. And they have so many different programs that are doing just that. Check them out at touched by type one.org. Okay, you're being recorded, you can introduce yourself when you're ready.

Anonymous Female Speaker 2:52
Okay. I'm the mom of a type one teenager, she is currently 15 years old.

Scott Benner 3:00
Okay, so you're gonna stay anonymous, and therefore, just gonna get everybody ready for that idea. So they're not like Why won't they say her name? She want to get from you people online. That's why. So your daughter is 15. Now how old was she? When she was diagnosed?

Anonymous Female Speaker 3:21
She was had just turned 13 when she was diagnosed.

Scott Benner 3:25
How long ago? Did she start using weego V. She

Anonymous Female Speaker 3:28
started using the Gobi in August of 2023. So it's been what is September, October, five, six months down through let's

Scott Benner 3:36
call it six months on the go v. And she's been using insulin the whole time. She's had diabetes the whole two years. Correct?

Anonymous Female Speaker 3:45
Yeah, she started right out the gate with insulin she was when she was diagnosed her fasting blood sugar was 319. And our agency was over 14.

Scott Benner 3:54
Do you think she went through a honeymoon?

Anonymous Female Speaker 3:57
I do not think she went through a honeymoon. I mean, they started as right out of the gate on like 1819 units of basil, you know, so there was no, no easing into it. And there was never a day where she didn't need insulin for food. We didn't even get the free snacks right out of the gate. We tried the 15 gram carb snacks that were supposed to be free and they would spike her every time. And so I think it was after about the first week that we literally were doing insulin for everything that went into

Scott Benner 4:24
her mouth. How did she manage in the beginning with an MDI. She was

Anonymous Female Speaker 4:29
MDI for the first six months because that's the endos preference. So yeah, she did MDI for six months and then transitioned to Omni pod. She did the arrows for a couple of months and then we got coverage for dash and upgraded and then hopped right on Omni pod five as soon as it was released, and lasted a few months there and ultimately transitioned to DIY loop. And that's how she she managed primarily at that point.

Scott Benner 4:56
Okay, don't tell me what she's doing right now. We're gonna get to that in our story. Okay, I'm gonna jump over to you. medical concerns for you anything auto immune? Yeah,

Anonymous Female Speaker 5:05
so I have Hashimotos and PCOS P

Scott Benner 5:09
ce o. 's. Now we're getting to it right away. How about your daughter anything besides the type one?

Anonymous Female Speaker 5:17
At the moment just type one we are watching for potential PCOS diagnosis. There's a couple of things that lead us to believe that she's probably going to end up there. But not not quite ready to make that call yet. Tell

Scott Benner 5:32
people about your PCOS. How does it when did it start? What's it like etc.

Anonymous Female Speaker 5:37
is horrible. I've had it ever since I can remember it. I just remember having really, really really horrific periods, horrific period pain, but also in between period pain was never regular and periods were always just ridiculously heavy from early on. And so I also had endometriosis which kind of played into it a little bit too. But finally found a empathetic OB GYN here a couple years ago and was very blessed with a full hysterectomy. And so life has been wonderful. Post hysterectomy for me but yeah PCOS was was everything that everybody says that it is right horrible periods, horrible period pain, weight issues. Just everything that comes with crazy hormones, right and the acting. I did have pretty terrible acne. Yeah.

Scott Benner 6:33
Terrible periods in length in a mouth. Oh,

Anonymous Female Speaker 6:38
all of the above. All of the above, they would last 567 days super heavy flow to the point that I was anemic. My iron levels were dangerously low. And so then I was blessed to get iron infusions fairly frequently to try to get me pumped back up again. Guys

Scott Benner 6:58
cozy Earth just sent me a new shirt and pajama pants. I got the bamboo Raglan T is it Raglin What's it matter? That thing is so comfortable. I don't care what you call it. Cozy earth.com. Now, the pajama pants. Again, fantastic. They're so comfortable. I don't even know how to describe this material other than to say heavenly, not too hot. Not too cold. Incredibly. My gosh, what's the word? It's comfortable, very comfortable and it feels premium to the touch. That's whether I'm touching it with my hands or wearing it. It just feels like I'm wearing quality clothing cozy earth.com Now if you use the offer code juice box at checkout, you will save 40% off of your entire order. But if you want a shortcut to that, the link in the show notes of your podcast player will take you right to my page at cozier a.com And that automatically gives you the 40% off of whatever you select. We also got my wife's and cozy Earth pajamas. She hasn't worn them yet, but they're right at the side of the bed ready to go into action. I can't I just can't tell you enough how much I enjoy all everything that I've bought from cozy Earth towels, sheets, joggers, T shirts. Now pajamas. Nothing has been a letdown cosy earth.com. use the offer code juice box at checkout to save 40% or click on the link in the show notes. diabetes comes with a lot of things to remember. So it's nice when someone takes something off of your plate. US med has done that for us. When it's time for art and supplies to be refreshed. We get an email rolls up in your inbox says hi Arden. This is your friendly reorder email from us med. You open up the email. It's a big button that says click here to reorder and you're done. Finally, somebody's taking away a responsibility instead of adding one. US med has done that for us. An email arrives we click on a link and the next thing you know your products are at the front door. That simple. Us med.com/juice box or call 888-721-1514 I never have to wonder if Arden has enough supplies. I click on one link. I open up a box. I put the stuff in the drawer and we're done. US med carries everything from insulin pumps, and diabetes testing supplies to the latest CGM like the libre three and the Dexcom G seven. They accept Medicare nationwide, over 800 private insurers and all you have to do to get started is called 888-721-1514 or go to my link us med.com/juicebox using that number or my link helps to support the production of the Juicebox Podcast. How old were you when you when you had to get your first iron infusion?

Anonymous Female Speaker 9:53
I was in my 20s

Scott Benner 9:57
and just for reference now you're

Anonymous Female Speaker 9:59
44

Scott Benner 9:59
gratulations somebody made fun of me for being old and I was like, I'm alive. That's the only measurement. I

Anonymous Female Speaker 10:08
know every day is waking up on the right side of the dirt. So if I was

Scott Benner 10:11
younger, I wouldn't be here to hear your crap. Because I'd be dead already. Now anemic volatile How has your daughter ever shown anemia problems?

Anonymous Female Speaker 10:20
She has not all of her labs have been beautiful minus the sugar. glucose.

Scott Benner 10:27
When did her lady time start? What age

Anonymous Female Speaker 10:30
four teen. So she's a little bit late.

Scott Benner 10:34
And you think she might have PCOS? Do

Anonymous Female Speaker 10:37
just in that, you know, she's been cycling long enough that we should be seeing some regularity. And we're not and her periods are superduper heavy. And she gets the wonderful you know, horrible terrible cramps and, and all of that. So yeah, so I think we may be headed in that direction, but just not quite ready to to go there yet.

Scott Benner 10:57
When you speak to a gynecologist about it. What do they say? We've

Anonymous Female Speaker 11:01
not gone to gynecologist for her yet. So we've been talking about it just her endo and with her primary care. And they've given us some options of things to try right. The obvious birth control, which she's not interested in, and I don't blame her. But really, we're just trying to give it just a little bit more time not necessarily because I'm expecting it to change. But more giving her more time just to be comfortable with the next step of going to the gynecologist

Scott Benner 11:25
did the gynecologist ever suggest to you to go on the pill to help? Yes.

Anonymous Female Speaker 11:30
Oh yeah, I tried all the different birth control methods, pills, rings, IUDs all of them. And they just made everything so much worse for me. I just had terrible reactions to them. Okay, and so so I was better off on nothing.

Scott Benner 11:45
Did you have I'm so sorry to ask you this. But you're you're anonymous. Okay. Any unwanted thick or unpleasant or fast growing hair for you? Oh,

Anonymous Female Speaker 11:55
yeah. Okay, I started having to shave everything very early age. So and laser hair removal y'all it's a wonderful thing

Scott Benner 12:06
that that took it away and kept away it didn't necessarily

Anonymous Female Speaker 12:09
take it away completely but it made it much less noticeable. No

Scott Benner 12:14
kidding. All right. Interesting. Your daughter have any of their little

Anonymous Female Speaker 12:19
bit she does? She does.

Scott Benner 12:22
How was your weight through your life though?

Anonymous Female Speaker 12:24
You know, I was super duper active and so my weight was really great until about 30 and and then I really started to struggle where it it seemed like no matter how well I ate no matter how clean I ate no matter how low of a calorie diet I took in and how much I exercised. I was just turning into a human puffer fish

Scott Benner 12:48
what is PCOS belly? Common symptoms include insulin resistance, diabetes, reproductive hormone imbalance, missed periods and fertility overweight and obesity. PCOS belly is one symptom of the widespread syndrome. Yes.

Anonymous Female Speaker 13:01
And insulin resistance is real. And so all of my labs always showed really high insulin levels, really, really high off the chart C peptide, which just tells me that my body was trying really hard to keep things in check and was failing miserably, fighting an uphill battle, right? Yeah, fighting an uphill battle. And so that, you know, that explains why no matter how good I was, and how much I exercise, there was just nothing I was going to be able to do on my own. So GLP ones have been wonderful for me.

Scott Benner 13:33
So let's start. Who used it first, you or your daughter?

Anonymous Female Speaker 13:39
Me, actually, I jumped on the ozempic train early on,

Scott Benner 13:44
how long have you been using it?

Anonymous Female Speaker 13:46
So I was on ozempic for about two years before my insurance decided that I didn't need it anymore because I wasn't diabetic. And it wasn't wonderful. I got my weight down was able to maintain it was no longer what I call the human puffer fish. You know, it used to be anything that I ate, I would just bloat like nobody's business. But it was epic. That didn't happen anymore. So I was on it for about two years. And then insurance said, Wait, wait, wait, you're not type two diabetic. We're not going to cover this for you anymore. So I had to go off of it. And I had to let nature take its course right, I had to let my weight get back up high enough that I could get approved for Wigo v. And so now I am on Wigo V and have only been on it for about five weeks at this point. But I'm starting to notice it reversing the bloating and the scale is no longer moving up every time I jump on it. So that's great. And I look forward to you know, as I increase my dosages, getting my weight back under control and feeling as great as I feel

Scott Benner 14:50
all the time. Would you tell me what your weight was prior to us? Empik prior to ozempic

Anonymous Female Speaker 14:54
Oh, I was pushing like 160 And for reference I'm four foot 11 In,

Scott Benner 15:00
okay, four foot 11 You can't even you can't even say five. You can't get away with telling people your

Anonymous Female Speaker 15:05
driver's license says five feet. So I feel like I can get away with it. But technically, I'm four foot 11 my calculation purposes 160

Scott Benner 15:14
pounds on your frame was was a lot. Yeah, it was a lot. Yeah. And how long did it take for you to get down to the weight? That you were like, Oh, I'm, I'm good here.

Anonymous Female Speaker 15:24
I know them back. I would say it was probably a good nine months, nine months. And

Scott Benner 15:29
then what did you get to?

Anonymous Female Speaker 15:30
I got down to 119 did not not all in that nine months. But in that nine months, I was I was making very steady progress where I felt like I was finally moving in the right direction.

Scott Benner 15:44
Two years 41 pounds. Yeah. Okay.

Anonymous Female Speaker 15:47
And then in the in the I was off of it about five a month and got back up to 150. Before I started going in,

Scott Benner 15:57
okay, in two years, it was fast. It took you two years to get the 119. And then five months to get back up, get 150 in those five months here dispel the rumors for people and those five months. Were you double fisting cheeseburgers because the ozempic wasn't telling you you weren't hungry anymore? Or no, I

Anonymous Female Speaker 16:14
absolutely changed nothing. And I feel like it was even more diligent about what I ate and how much I exercised, because I knew I didn't have the ozempic to help me. Right. And I needed to prove that this wasn't because I wasn't making the right choices, right. Like I needed to prove to the doctor that this was this was not me. I had zero control over my body packing the pounds on. And so I maintained a diet of no more than 1200 calories a day. I protein, low carb, low fat, and tons of exercise

Scott Benner 16:50
and you gained 30 pounds in five months in five

Anonymous Female Speaker 16:53
months. Yeah. Okay. It was beautiful. And so right then my doctor was like, Yeah, okay, I get it. You know, I mean, I heard what you were saying. It's not that I didn't believe you, but

Scott Benner 17:02
I didn't believe you. And that's not what the label says. And bla bla, actually.

Anonymous Female Speaker 17:05
And so it was not and honestly, when I started the ozempic and when I started the Wigo v, because I had been so strict with my eating habits, it didn't really change my eating habits for me. I didn't experience the you know, I mean, yeah, I do have to think a little bit more about like, Okay, it's time to eat. Like, I don't get hungry. But in terms of the amount of food that I could eat in a setting, that didn't really change. I've never been a big eater.

Scott Benner 17:33
Okay. Yeah. So you weren't, you weren't shoveling it in to begin with? And so now, so what were the impacts of ozempic for you? Like, I think of them as physical. And we know about the weight loss, but physical and mental. What did you learn from it?

Anonymous Female Speaker 17:47
I mean, physically obvious impacts, I was losing weight, I was not bloating with every bite of food. So that was huge. I mean, I felt like I walked around looking like I was pregnant for 30 years, you know? Yeah. And that wasn't happening anymore. And what that did, from the mental health perspective for me, was I finally felt good, right, a lot of the PCOS symptoms were relieved. And I just felt better. And so that snowballed into being more fun to be around and enjoying life in general. And then obviously, notice to the reverse of that when I went off of it, and my body started taking control and I was no longer in the driver's seat. It has a huge mental health impact on you. So

Scott Benner 18:36
I started using weego V in March of 2023. It's January 2024. Now and about three weeks ago, I switched from weego V where I had plateaued onto Zep bound, which is, you know, for people who are not keeping up we go V is ozempic. Zep bound is Manjaro. And it's not just, like, similar. It's the exact same thing, same thing. Yeah. Like the dosing strategy is different, and that's only so they can build it through insurance differently. I know it's weird, but it's the delivery system that they patent. So the way you deliver we go V start at point two, five, do it for four weeks go 2.5 like that, that's all like kind of proprietary I guess. And that's what makes it for weight loss. With ozempic. You and your doctor decide how much was Empik you need there's a ramp up but after that you have a pen and you can dial it up to what you need. And anyway same molecule, same drug is that bound is Manjaro. We go V is ozempic. So I start we go V for weight loss. And I should probably like I only usually talk about this in my weight in my go V diary, but I'll talk about it here. Let me get my phone out. To give people a little bit of context. I just weighed myself this morning. I am the lowest I've been since I started today. Today I weighed 188.6 pounds. Now I'm four foot four Nah, I'm fine. I'm five, nine, I weighed 188.6 pounds. When I started we go V in March, I weighed 233.4 pounds. I have lost 44.8 pounds. Yeah, it's amazing. Yeah, my body fat, my BMI, that free. Everything is better. My subcutaneous fat is better. My visceral fat is better my muscle mass is going up, my body water index goes up, my protein goes up, like my bone mass is going up. My, my metabolic age isn't moving. But so here's the thing. When you discuss what PCOS was to you, I find myself sitting here thinking, men can't get PCOS. I know that's not there's no way because they don't have all those bits and pieces inside them. But you're describing my life. Doesn't matter what I eat, or what I do, or how much I exercise or how much I don't exercise. I eat food again. Wait. That's it. I'm always bloated. If I ate like a normal person, I've been restricting my food my entire adult life. If I eat like a normal person, I swell up like I'm nine months pregnant, and I've been wearing tennis shoes in the summer. Like miserable.

Anonymous Female Speaker 21:14
You're just you feel like junk, unpleasant

Scott Benner 21:18
to begin with. And more so with this, and so people are like, you seem so nice. I'm not that nice. And so I you know, so this is my whole life. I couldn't if I ate a piece of bread. I was gonna wake up two pounds heavier. I'm not kidding. Right. Like, I'm not joking. My bathroom habits were tenuous at best. You know, the amount of times that I need something. I'd be like, I gotta get to the bathroom. Like that happened a lot, right? Oh, yeah. Oh, yeah. Yeah. So that's you

Anonymous Female Speaker 21:47
knew certain things. If you were gonna go eat a certain meal. You knew that you had to come home right after Oh, or at least for me. That's how I was like, I knew if I was gonna go eat at this particular restaurant and eat this particular meal that I love. I was going to have to come immediately. Dallas table prompt with the bill. You know, like, I will have to get home from milk on the way home. Yeah, no, no, stop it. Like if the server doesn't have the bill turned around the minute I put my fork down on my plate. You know, we're gonna have a problem.

Scott Benner 22:19
I've had the thought, oh my god, I'm done with it already. The credit card company doesn't even know I bought it yet.

Anonymous Female Speaker 22:26
Exactly. point point

Scott Benner 22:28
being also poor for my nutrition. Right? Like I'm not I have had low ferritin and anemia and had to have iron infusions, too, because my body not absorbing nutrients. Because what it does now seem to absorb nutrients. Fine. I haven't had an iron infusion in a year.

Anonymous Female Speaker 22:45
And don't you feel so good? Oh, unbelievable.

Scott Benner 22:49
I think most people here we go the ozempic Manjaro No, GLP one, they go, Oh, you just can't control yourself. And

Anonymous Female Speaker 22:58
I mean, I wish and I had that bad fight with my doctor, right for a very long time before she agreed to put me on ozempic Even in the first place. You know, she's like, you just need to not ever splurge. And you just need to cut your calories and you need to focus on high protein. And so I finally started journaling. Everything that I put in my mouth, like to the point that I was weighing everything on the scale, right? So you can hand it to the doctor. Yeah. And then I put it in front of her and I'm like, Okay, here we are. Another month has passed. I've gained 11 more pounds. Here's everything that I've eaten the last month. You look at this and tell me where I went wrong. Yeah. And she looked at it. And she was like, Oh my God. You're not kidding. When you say you've been trying? I'm like, Yeah, I eat chicken and green beans every day for breakfast, lunch and dinner, chicken and green beans.

Scott Benner 23:50
Chicken to save time. That's

Anonymous Female Speaker 23:53
I mean, it's like,

Scott Benner 23:54
what do you want me to do your Hashimotos as well like controlled, what's your TSH? So

Anonymous Female Speaker 23:58
my last few years, TSH was 1.9. That was just a couple months ago. It was not well controlled for a very long time. And then I finally got medicated, and then got over medicated and actually went extreme hyperthyroid where my TSH was 0.001. It was really, really, really bad. Or whatever it was, it was, it was super wrong. It was not supposed to be what it was. And I actually started having heart issues because of it. And so that was about three years ago, three and a half years ago now. And so I went off of all of my thyroid medication, and I'm still not on any thyroid medication. So we're just kind of riding the wave for however long it lasts. My

Scott Benner 24:47
point is, you weren't gaining weight because your TSH was four six or something like yeah, no. So okay, so now we have a good background about that. And this obviously what it did for you also your story now uncommon, I see a lot of people online say, they took this medication from me because my, listen, there's a couple reasons it's happening. One, the insurance companies like cheese, a lot of people are using this, it's costing us money. So you know, they were willing to give it to anybody with a doctor's order, right? You know, at one point, like, it's, you know, we made it for type two diabetes, but here, go ahead, we don't care. Then when everybody wanted it, they were like, Oh, if you don't have really good insurance, then you weren't gonna get it, then all of a sudden, if you didn't have type two, you weren't getting those epic. And I've had people go in and say, Look, you know, my BMI is this, you know, I want you know, I want to get my a one C is right on the verge of being type two. And that and I've heard people be told by their insurance company, well, when you're a one C goes up a little more, we'll give it to you. Or, you know, the other one, you lost weight, you don't need it anymore. And then they have your story. And I've over and over again. There's a one woman my wife found online, I don't know where I apologize. But she said, I lost it. My my insurance, I lost my week over because of insurance. But I thought it's okay, I know how to eat now. Like, you know, she was a person who wasn't eating well. But she but she went back to, you know, she didn't change, same exercise. Same food as when she was on we go, he put all the way back on in six months. Just just all of it like didn't matter what she did just started ballooning up. I'm telling you, I'm not a doctor, I barely got out of high school. Some people have GLP deficiencies or something to that effect, because my body just works better now. Yeah, like, it's easy to say, oh, Scott lost weight. It's not that my body works better. Now, I don't run to the bathroom anymore. Right doesn't happen to me anymore. My energy is much better. I'm absorbing all of my nutrients. I used to take fistfuls of vitamins. I was like, this is not doing anything. Now I take a reasonable amount of vitamins. And guess what? I'm okay. My skin looks better. Like my face looks better. The dark circles under my eyes are going away. Like it's insane. From from GLP. Now, my weight leveled out. And I got to the point where I just I said to my doctor, I'm like, this was epic. Like, it only goes to like it's 2.4. Or we go V I'm sorry, I think we go The only goes up to 2.4 when you're on it for weight loss. And I said this isn't enough. And because I'm shooting it, and for four days starting to lose weight. And then the last three days of the week, my weights going back up again back on. So I was losing no like gaining and losing the same two and a half pounds. For months. I was like, Oh my god. So I went to my doctor and I was like, What are we gonna do? She goes, we'll put you on zap bound. I was like, let's do that. So now I've injected zap down three times. I'm using five milligrams because the measurement systems different from one to the other. And I've lost. I just told somebody today, but I forget already. I've lost seven pounds this month, in 2026 days. I haven't done anything different than I was doing the month before On we go V an end I've lost seven more pounds. Yeah, like and by the way, I want to I want to be very clear, I am still fat. Like I there's fat on my body that is not healthy. It is not just a visual thing. I'm not just like, oh, I want to look perfect or something like that. I'm still in heart attack range for my belly,

Anonymous Female Speaker 28:34
right? And that's it. Like I'm not I'm not in this to like get skinny. I just want to be alive. You know, I need to be in that healthy range

Scott Benner 28:41
and be one of those fancy people who finishes up dinner at a restaurant and then goes for a stroll.

Anonymous Female Speaker 28:47
That too would be nice, right? Yeah.

Scott Benner 28:51
But anyway, I'm a proponent. Obviously. Now I hear the arguments. Oh, it gives some people I guess your presets they were in the last budget. Okay, it wasn't right for them. Like parent Fair enough. I don't think it's going to work for every person on the planet. But absolutely turn your TV on. There ain't one fat famous person anymore. Okay. There's not one famous person has eight extra ounces in their face anymore. It works for a lot of people not gonna work for everybody. If it doesn't work for you, you certainly shouldn't use it. I'm not saying that. I'm saying it's

Anonymous Female Speaker 29:24
not gonna work for everybody and not everybody is good at following directions.

Scott Benner 29:29
Well, I do wonder that sometimes they know maybe

Anonymous Female Speaker 29:33
the way that you're told to and you have problems you know, like it just maybe everybody follows instructions well,

Scott Benner 29:42
so how do I know who's who when I'm getting feedback? That's my point to like, I think there are plenty of people who follow the instructions perfectly well and it made them sick or they you know, they got an intestinal blockage even right on it wasn't good for you. And I'm sorry that happened to you. But how many people thought oh, the magic juices me now I can eat whatever I want, and started eating a bunch of fatty foods or really slow digesting stuff, and it just got them really sick,

Anonymous Female Speaker 30:07
right? Or who decided they didn't want to do that point two, five dose for a whole month before they moved up, right? Yeah, I'll just jump right on ozempic When you can dial up the pen to whatever dosage you want, right? People

Scott Benner 30:19
are like, more is better, right, which is not gotta be patient.

Anonymous Female Speaker 30:23
Yeah, you want to use as little as you have to, to get the result that you're looking for, you know,

Scott Benner 30:29
patience is a key. And it's taught me to be patient, etc. But all of this is incredibly interesting. And I'm having a very good time talking to you. But it is not why you're on the podcast, right? Why you're on the podcast and why you're on a diabetes podcast is this. Your daughter, who was diagnosed with type one diabetes at 13, who we established did not experience a honeymoon period and was using insulin starts using we go V and tell people what happened.

Anonymous Female Speaker 30:57
Yeah, so it's been crazy. So I felt like it's important to discuss why she started using will go v. And, and it was to help her get to a healthy weight. You know, she was experiencing a lot of the similar things that I was experiencing that it didn't matter how good we were with our meals, she was putting the weight on and especially, you know, she had lost a fair amount prior to diagnosis, which was not a red flag to me. Because we were trying to lose weight, right? We were working with a pediatrician to get her, you know, at a healthier out a healthier way not to be skinny, but to be healthy. So I thought we were doing a great job, right. And then she got diagnosed with type one. And I was like, oh, and so once we got her, her insulin, you know, worked out and figured out and started controlling her blood sugar better the weight just came back with a vengeance. And so we had to do jump through the same hoops, you know, that I had to jump through, we had to talk to the doctor and the doctor would say, you know, we'll high protein, low carb, you know, no sweets, try to eat better get more exercise. And we did as well as you can do with a teenager. You know, it's hard. You can't monitor every bite they put in their mouth. But she's a really good kid. She's a really obedient kid. And so it's not like she was going off the rails, you know, like, she was really trying. She wasn't super successful with the exercise. But what teenager is honestly, and so finally, you know, the doctor realized after several months that yeah, okay, you know, they're really trying, but she's still gaining. So let's give this a shot and see if insurance will approve it. And so insurance approved the Wigo v. And she started on that back in August, about six months ago. And when she started the would go V prior to go the her average total daily insulin was now 4045 units. We were dry looping at that time. So it fluctuated but 4045 units, her carb ratio was 10 ish. Her correction factor was like 30. But she was doing great, you know, but when she started with go V, I started noticing,

Scott Benner 33:05
hey, stop for a second. Let's let it absorb in because it's gonna hit everybody right in the face. And you say this total daily insulin 45 units?

Anonymous Female Speaker 33:14
Yeah. 4045. Somewhere in there. Depending on the correction factor.

Scott Benner 33:17
One unit moves her 30 points. Ish. Yeah, yep. Carb ratio, one unit covers 10 carbs. Okay, go ahead.

Anonymous Female Speaker 33:28
So we she started the Wigo V, and I started noticing we were having a whole lot more lows than we usually had, you know, we I felt like we had it pretty dialed in where we didn't have to treat Lowe's very often. But we were treating Lowe's, you know, daily, if not multiple times a day. And so I started obviously reducing her insulin intake, which is super easy to do on DIY loop, you just throw on an override and say only give her 80% of what you think she needs, you know, so thank God for loop through this process. But in August get this at the end of the month, I pulled her numbers. Her average total daily insulin for the month of August. Our first month on movie was 27.7 Yuan

Scott Benner 34:14
month on me, which means she was using point two five a week. Correct or what they consider to not be a therapeutic dose of it. Correct. Point two, five,

Speaker 1 34:24
tell me the total daily insulin again. 27.7

Scott Benner 34:28
can I do math with everybody hold on a second, I'll do it with you. 27 they count up to 15. So that's eight and you carry along? You move out over there to make that 15 Then that makes this a three two. That's eight teen fewer units a day. 18 Does anybody know what 18 times here? Hold on a second. Yeah, I love this. Wait. I knew I was right. So every once in a while I'm right about something. A how many days are in a year? 365? Yes, that's 6500 and 70 fewer units of insulin in a calendar year. Yeah, keep talking. And so

Anonymous Female Speaker 35:05
her carb ratios we had to you know, start doing breakfast lunch and dinner a little bit differently, but her carb ratio is is now you know 2025 depending on the time of day

Scott Benner 35:17
one unit covers 20 to 25 not 10 Right.

Anonymous Female Speaker 35:21
This is where the fun is really fine is her correction factor now is no longer 30 Her correction factor during the day now let's do night first because nights funner because she needs more at night, her correction factor for nighttime is now 85. And her correction for daytime is 110.

Scott Benner 35:46
I was gonna guess 110 Okay, I should have guessed it would have been more fun if I guess. Okay, next time follow my heart. Yeah. And how long has she been on it now? a month. This is her first this is the first month still.

Anonymous Female Speaker 35:57
This is our first met her time in range, using you know the the standard 70 to 180. Her time and range is 97.9%. Her average? blood sugar's 99, or standard deviation is 20.8.

Scott Benner 36:13
Hello. What's your a one C?

Anonymous Female Speaker 36:15
I don't know. Because our endo only does a one C once a year. That's okay. So I don't have an updated a one C for August that comes what

Scott Benner 36:23
was there for the the govi before we

Anonymous Female Speaker 36:27
go, so her entire time of diagnosis. Once we got things, once we figured out how to use insulin, once we got things figured out. Our agency has fluctuated between 4.9 and five.

Scott Benner 36:40
Point 2.5 Yeah, I was gonna say a 99. And average 99 blood sugar is a five one a one say? Yeah.

Anonymous Female Speaker 36:47
And so our agency has always been great. And I credit that fully too. So I got introduced to the Juicebox Podcast, the very first night that we were in the hospital at diagnosis, I posted on a local mom's Facebook page and said, you know, hey, we're at the hospital, my daughter just got diagnosed with type one. I have no idea what I'm walking into anybody else in the hood, familiar with this? And this one very, very kind mom sent me the longest Facebook message ever. And I typically don't open messages from people that I don't know. But I opened hers. And she said, Hey, sorry to hear about this. My daughter's same thing. This is what you need to ask for before you leave. She's like, make sure you get a Dexcom you know, make sure you get all of your ratios and correction factors and start listening to the Juicebox Podcast.

Scott Benner 37:40
Okay, she didn't like pictures of your feet. So you thought I could trust this? Yeah,

Anonymous Female Speaker 37:45
like you know, okay, and so here I am, you know, awake at 3am at the hospital, and just reeling in. I am a data nerd. And so I just needed to start doing some research right about this type one diabetes thing, and found the podcast in and listened to defining diabetes the entire thing, like without stopping. And so we got a handle on the diabetes thing. Pretty quick. I felt like her by her three month appointment. Her agency was down in the sixes so so her agency has always been pretty good.

Scott Benner 38:22
Yeah, things were in bonkers. You were doing Whoa, just her. We were doing well.

Anonymous Female Speaker 38:27
Yeah. So like go back to December before she started, you know, six months before she started would go V O or even the month before she started would go V her time and range was 98%. Her average blood sugar was 108. And her standard deviation was 22. So it's not like we all of the sudden figured out

Scott Benner 38:44
you were doing a great job with but you were using a lot more insulin to do it. We

Anonymous Female Speaker 38:49
were doing a great job using a whole lot more insulin. Yeah. So yeah, so I was like, Okay, this is crazy. And so I texted the endocrinologist because we have a direct care endocrinologist, like a concierge endocrinologist. And so I have their cell phone number and can call and text and whatever. 24/7. And so I texted the endo and I was like, Hey, I'm noticing this, is this just random? Or is this a thing? Right? Like, she needs a whole lot less insulin? And she's like, oh, yeah, it's gonna impact her insulin resistance and all of that. And yeah, she's gonna need less insulin. And I was like, ah, yeah, the data nerd that I am like, I would have loved it have a little warning, but it's fine. I can handle it. I pay attention to her numbers. 24/7. So like, I got this. I know how to make adjustments. I'm good. But I got on Dr. Google. Right. And I was like, some magnitude impacts or semaglutide. however you say it, whatever the long word is for the drug impacts on type one diabetes. And an article popped up about an endocrinologist up in Buffalo that had done a very small All study with 10 newly diagnosed adult type ones. And he put them on ozempic Right out of the gate. And and as I read along, you know, I'm like, oh, yeah, it impacted their insulin needs to. And some of those folks even came off of insulin altogether as long as they stayed on their ozempic. And I was like, wow, that's really impressive. And what I read that it does is that it preserves beta cell function. So, you know, when you're newly diagnosed, and you're experiencing that honeymoon, it's because your beta cells are still, some of them are still working, right, your body is still producing some insulin. And so I was very curious. I was like, But wait a second. Here we are, you know, two and a half years into diagnosis, never had a honeymoon, I was like, so how is how is this possible? You know, how is this possible is impacting my daughter the way that it is? Yeah. And so then I jumped into her lab tests, right. And I just wanted to see and I was like, oh, okay, well, at diagnosis, her C peptide was still in the normal range. And a year after diagnosis, her C peptide was still the exact same. And two years after diagnosis, or C peptide was still the exact same. And so I was like, oh, we should have had a honeymoon. We never did. Apparently, insulin resistance is a thing, right? But I was like, so that's how this would go V is making this much of an impact. But I was like, but surely, you know, this is as good as it's gonna get right. Which was great. I was happy to be using, you know, almost half the amount of insulin in

Scott Benner 41:40
the first month, but you have these reductions in insulin, how much weight how much weight was reduced? You

Anonymous Female Speaker 41:45
know, I wish I had kept track of that. But we don't, with my daughter, I'm very careful about putting her on the scale. Because they don't want this to turn into an obsessive disorder to a number with her weight. Number. We really have been focusing all this time on being healthy, good and feeling good in our body. I can tell you that as of about two weeks ago, she's down about 20 pounds from

Scott Benner 42:18
for how long? She started. And that's how long ago? Six months, six months? So 20 pounds? And yeah, would you mind telling me you know, she's going to be your anonymous, so nobody will know what was her starting weight?

Anonymous Female Speaker 42:30
You know, that's a super fantastic question that I would have to look at her medical records to tell you because I honestly don't even know. I want to say that it was up around 150 ish. Okay. And she's like, 5354 She's growing. So.

Scott Benner 42:48
Okay. And so, but she's lost 20 pounds. Is it? Beyond noticeable or just noticed?

Anonymous Female Speaker 42:54
Oh, my, it is beyond notice the ball. She's so excited. So she does performing arts and they have uniforms that they wear for their performances. And she's gone down just the school year, right? So we're not far into it. She's now on her third dress. For Performing Arts. That's a smaller size. Like she's gone down three dress sizes.

Scott Benner 43:18
I started in a 2x T shirt. Right?

Anonymous Female Speaker 43:21
Oh, I started in like, she started in like a 14. And then she went to a 12. And then she went to a 10. And now she's in an eight. So she's like, over the moon excited and people I laugh because my parents will come down, you know, for performances and whatever. And my mom is like, I can't find her. Where is she? And I'm like, she's right there. She's like, that's not her. Like yeah, yeah, it is. And so it's like my parents didn't even recognize her in a crowd after not seeing her for like a month. You know, I

Scott Benner 43:52
walk past Kelly in the store recently. Yeah, she didn't even notice. You know, I didn't notice her. She's using weego V as well. Oh, exciting. My wife is probably elicit my daughter probably has PCOS. Yeah, my wife has Hashimotos or, you know, hypothyroidism. I don't think she's ever gotten tested for antibodies. And, you know, went through a significant weight gain after she had a heart and when her thyroid blew up, right. So she's lost so much weight. And like, I literally I walked right past her. I took two more steps. I was like, Oh, that was her. And I turned around and went back. I didn't tell her but that is amazing, though. I

Anonymous Female Speaker 44:27
mean, it's just, I've

Scott Benner 44:28
known her by the way. I've been married for 27 years.

Anonymous Female Speaker 44:33
I'm telling you, these medications are so beneficial for so many different types of situations that I think that we've only scratched the surface right? Like I really feel like I mean, like with my daughter's story. I mean, it just gets better. I mean, obviously that first month I was like holy cow this is amazing. Right? And so then you know upper dosage go to the next month. Get this September so now she's she's still on what I call Baby dose right the point five, her average total daily insulin for September 14 units. Yeah, her carb ratio 35 or daytime correction factor 180 Oh my god, it's getting it's getting to the point where it's really hard. Like, I've never struggled so much with diabetes management in the whole process like not even at first month when she was diagnosed, that was a walk in the park compared to what this is right. And I'm so so so, so thankful for DIY loop, because I'm, you know, throwing overrides on of like, only give her 40% of the insulin that you gave her last week or whatever, you know what I have programmed in

Scott Benner 45:46
your moving settings and still having to tell it do less? Yeah, because it's

Anonymous Female Speaker 45:51
like, you know, the whole time three will go the managing diabetes was like you you moved things, but you didn't move them? Quickly. Right, right. Like you're talking you Okay, let's raise Basal by a unit a day, you know, or 10%. You know, this is like, if you compare August to September, she's using 50% less insulin in September than she was in August. That's

Scott Benner 46:14
huge. What happened in October, in

Anonymous Female Speaker 46:17
October, again, is just lows after lows after lows after lows. And I didn't even write October down because I was so frustrated of like, you know, things were just crazy. And so I finally in November, I was like, alright, Doc, here's what I'm thinking. I'm thinking, we're just going to cut all of her fast acting and just do basil. Like, let's just forget bolusing for food. And let's just forget correcting a high blood sugar. Like, let's just let's just try this and see what happens. And our endo was like, if it were anybody other than you, I would say absolutely not. She said, but I know that you're paying attention. And I know that you know how to react appropriately. She said, so go for it. And I was like, Okay, so we're DIY looping. And I go in and I open the loop, meaning like, people will understand that as being manual mode, right? I'm turning off the algorithm and I'm just letting it run basil. Still through, you know, still through her pod. So it's still technically fast acting, but it's her Basal delivery. So we're not Bolus paying for food or meals, or anything. And I'm still treating lows. I'm like, okay, so clearly, her Basil is too much, right? If I'm not bolusing for food, and I'm still catching lows, especially in the nighttime, right? Her Basil is too high. So I'm dropping her basil. And, and I get her basil down like things are great, right? And we're rockin and rollin. No mealtime Bolus is no corrections. You know, kid can eat whatever, whenever, however, don't have to tell me just have fun. And she even said to me, she's like, Mom, it's like, I don't even have diabetes anymore. And that just like, hit my heart. You know, it was like, she did so great with diagnosis, and overcoming her fear of needles, because that was huge. And she did great embracing technology and learning how to use it and learning how to carb count and make good choices. Like she did fabulously with all of that. But then when she said to me, it feels like I don't even have diabetes anymore. I was like, this really did impact her. You know, like she she played it very well. And so, so then she was sitting on the couch, and she was like, it was hot change night. They were still using our pods because we're still running basil through loop. She's like, mom, she's like, we have any long acting. And I was like, yeah, we've got some pens in the fridge. And she's like, Can I take a pod break? And I was like, Are you sure? Like, you know, really, you really want to? I love the flexibility of the Basal being delivered through loop, right? Because I could adjust it at any time. Right? And so I was terrified that going back MDI and doing that Basal injection meant a I had to figure out how much to give her and that once it was in, it was in right there was no pausing basil or suspending basil for a couple hours to help us overcome, right, a mistake. You know, I was terrified. And so I texted the Endo. You know, it's eight o'clock at night, whatever. And I'm like, so she wants to take a pod break. We've got, you know, some basil in the fridge. What do I do? And she she asked me, you know, well, what's her Average basil on the pod right now in loop. And at that point, our average basil was like nine units a day.

Scott Benner 50:07
Okay, down from

Anonymous Female Speaker 50:08
down from I mean, that's total daily insulin at this point not just based Oh, he's not all wishing

Scott Benner 50:13
yes sir total daily insulin started at 49

Anonymous Female Speaker 50:21
Nine, how long ago was this now? Um, this was in November. So it was what, August, September, October, so four months in the end of that fourth month, you know, she's right in about nine. And so the endo was like, Okay, well then give her nine of, you know, of whatever we're using, I think it's receba give her nine and give it a few days, you know, she's like, that one's a little bit longer than a 24 hour deal. So don't go changing everything the next night, you know, give it a few days and, and see what happens and, and the endo was following along, right, she had access to our Nightscout. So she was seeing, you know, numbers and everything in real time and was real good about checking in. And, you know, the perks of paying out of pocket for a direct care, endocrinologist. So we did it and she took up a pump break upon break and started just doing that one Basal injection every day or every night. And then just her one will go via injection. She did it on Saturdays, you know, every Saturday. And I thought, you know, this is this is like early November, actually, it's like the week before Thanksgiving. So mid November, and I'm like, There's no way we're gonna get through Thanksgiving without needing some fast acting insulin, right? Because like, we're not eating clean for Thanksgiving. We're eating. We love Thanksgiving. We love the Thanksgiving foods. We're not cutting back. We don't I mean, that was from day one. We holidays were holidays, you know, and we didn't do anything differently. And so I was very skeptical that we were going to survive Thanksgiving. But she survived Thanksgiving without bolusing for food, and without needing to do corrections. And I was like, holy cow. This is bananas. And not only did she survive, we ended up having to kind of cut back a little bit on her basil.

Scott Benner 52:05
Thanksgiving, turkey stuffing, gravy, stuffing mashed potatoes, gravy,

Anonymous Female Speaker 52:10
pies, cakes, cookies, like, and did she spike it all? I mean, she did. But they came right back down. You know, like it was it was literal. Like, I know, the goal is those gentle rolling hills, right? That she had mountain peaks. But they came to a point and then came just as fast back down as they went back up. Oh, hi. Not anything crazy. She might have hit 200 A little bit here and there. But for the most part, her spikes were 180 or under. And the endo told me that that was okay. And I went with it. You know, I was like, okay, because I'm like hyperventilating, you know, like, Oh, my God, she's at, you know, 190 Aren't you

Scott Benner 52:50
imagining her blood sugar is gonna be 400 in a minute. But yeah, like,

Anonymous Female Speaker 52:54
as fast as it was going up. I was like, you know, because my alarm starts going off at 120, you know, and I'm like, Okay, let's just watch. And then it hits 140. And then it hits 160. And I'm like, drink water. They'll walk around the block, you know, like, I'm panicking. And she's like, Mom, relax, you know, and I'm like, but I can't.

Scott Benner 53:14
How long do you think from this? The start of the spike till the end of it. And when it was back down, how long do you think that was?

Anonymous Female Speaker 53:20
Like an hour? Oh, yeah. Like it was stupid fast. And so then it's like when I would see it turn at the top and start to come back down. And then she would be straight arrow down, which like, we never were right. Before. You know, like the the goal was always diagonals. I didn't like straight arrows up or down. And so then I would panic, and then she would be double arrows down and I'm like, holy lip. You know, what, what do I do? Because I can't take insulin away. She's MTI. Right. And we've not put any fast acting in. So I'm like, How do I fix this? Because I'm not bolusing for food anymore. So the thought of using food or juice to bring up a blood sugar doesn't make sense because I'm not Bolus thing for it. Right? Yeah. So throwing extra carbs at her is not fixing this issue. You know, and so I would panic and it took me time to get past that of it took me time to get past feeling like I needed to take care of the high as it was going up. And it took me even longer to get past the feeling of needing to catch the low. Yeah,

Scott Benner 54:28
I want to say two things. I think that there are going to be some people listening to this like, Well, yeah, well, she lost 20 pounds. So obviously she needs less insulin, but that's not what this is.

Anonymous Female Speaker 54:37
No, I mean, she needs like I don't want to say no insulin because she's still on basil. Very little. But very little. Yeah,

Scott Benner 54:46
I was gonna say now it's two months since Thanksgiving. Yeah.

Anonymous Female Speaker 54:50
Two months since Thanksgiving. She's still MDI, right. She's still on basil. Currently, she's on I mean, it fluctuates based on time. Mobile payments, you know, we still do see those fluctuations. She's anywhere between seven and nine units of basil right now just kind of depending. She did get sick a couple of weeks ago, and I did give her some fast acting corrections. Because her highs were not coming down back. She would go high and stay there. But those corrections were terrifying because I'm using pens. And they're one unit pens and I'm like, holy, you know, do I really need to give her this unit? But I would and it was okay. Her body. Her body catches the lows for her. But she had to be high enough, you know, like like she had to be right 181 80 Before I was willing to you know do a fast living

Scott Benner 55:47
like a type two. Yeah, well on with Basal and then right. Yeah, and then some injections for higher things are anomalies. Yeah, but

Anonymous Female Speaker 55:56
it's those those injections for for fast acting are few and far between now

Scott Benner 56:03
to come for people. She definitely has type one diabetes.

Anonymous Female Speaker 56:06
She definitely has type one diabetes. She tested positive for Islip cell and God autoantibodies just trying to think of all the things. You type one. Yeah, that was my question, too. I was like, are we sure? And so the endo even repeated her antibodies. And she did test positive for to

Scott Benner 56:24
not listen these the GLP is they're not brand new, by the way. They're just in the last year. You've heard about them or they've been around a little longer than than that. Yeah. But the doctors are still probably just like it's a medication like, oh, that's for type two diabetes. You can't you hear it all the time type ones can't take that. It's for type twos. It's labeled for type twos, like you know what I mean? Meanwhile, people write me all the time. Hey, I went on we go V for weight loss, and I'm using a lot less insulin balaban like this, by the way, have her periods become more stable on it or not? That hasn't changed that at

Anonymous Female Speaker 56:58
all. That hasn't changed that. It has helped her appetite. Okay. You know, because she she likes to eat she loves food. She's a foodie, and loves to eat and loves to eat in large quantities. And we'll go via has impacted that.

Scott Benner 57:11
How about any does she have acne prior? Did it help that

Anonymous Female Speaker 57:15
she did have acne prior she still does have acne. I've not really noticed a difference here.

Scott Benner 57:21
Now I'm asking because my daughter has been shooting point two five of the week OB for about seven or eight weeks now. And I don't know her weight loss. But it is. I mean, on her frame significant. She looks different. And her Arden's correction factor was one unit moves her 42 points. And now it's one unit moves or 83 points. Yeah, exactly. Yeah. And her insulin to carb ratio was was at one unit for for carbs. And now I think we have it at one to eight now.

Anonymous Female Speaker 58:00
Yeah, see, suppose there's half and a half the amount of insulin but

Scott Benner 58:04
it also put a big dent in her acne. And I haven't talked to her about her periods yet because she's off at school. Right? But I'll tell you what, it's having enough of an impact on her who she's actually a person with a fairly terrible needle phobia. She's overcome it enough to give herself the injections of ozempic.

Anonymous Female Speaker 58:24
That was huge for for my daughter. Initially, those injections were, for whatever reason, extremely intimidating. Yeah. You know, at that point, she had been on the pod for, you know, two years, and said, been a really long time since you've done an injection of any kind. And that was really, I mean, it would take her a couple of hours to work up the courage to do those injections for like the first load. Yeah. I mean, it was it. There were tears there were, you know, pinner in a corner. I hate to say it, but like, I mean, I would sit on her, you know, like to get her to overcome that fear, right? Or

Scott Benner 59:04
didn't had the Kung Fu hands as you came at her. She'd be like, no, no, no, no. And she'd be like swatting at you with both hands. Yes, yeah. Yeah.

Anonymous Female Speaker 59:10
And and it wasn't a fair fight. Because you know, I'm for 11

Scott Benner 59:15
holding the needle, I'm like, I'm like, be careful. Yes.

Anonymous Female Speaker 59:18
I don't want like she was bigger than me and taller than me and like, could do some serious damage. You know, it wasn't a fair fight. She'll complain about it when she gets it out of the fridge, you know, does your injection or do I have to and I'm like, no, like, you want to quit and she's she looks at me. No, mom. Okay, well then do it, you know?

Scott Benner 59:36
Oh, no, please. I once watched Arden as she was defending herself from the needle. She's laughing and crying at the same time. She's hysterical laughing because she knows how ridiculous it is that she is almost unconsciously swatting at me. Yeah. And at the same time she's crying from the fear about the needle like literally to say Fanta it's passing she's getting better and better.

Anonymous Female Speaker 59:57
It was horrible to witness but but Now she's you know, like because I, I very much want her to feel like she has some control over these choices right even though she's, you know, getting ready to be 16. She's still a kid by all rights and purposes, but I want I didn't ever want her to feel like I was forcing something on her. Like the the pump was her choice, you know? Which one do you want? When do you want to start it? That was her choice. The CGM was never her choice and will never be her choice. But the Wigo V was like, you know, we, I had a conversation with her about it before she started it and was like, you know, here's what it could potentially do for you. That's good. Here's what it could potentially do for you. That might not be so pleasant. Do you want to try? Yeah. And she made the choice, you know, yeah, I want to try. And I felt like that's so so important, you know, not giving her full control. You know, she ever made a decision that I disagreed with her. Yeah, it's gonna hurt her, then, you know, mom, mom would make the call. But I just feel like I get further with her if she feels like it's her choice right now. And especially as a teenager, you know, and so we'll go, he's always been her choice. And it was really, really hard that first month, like I laid it down, and I was like, you know, she wanted to quit by like, week two. And I was like, No, you got to three months, you got to give it three months, and then three months. If you still hate it, then you know, we'll have another conversation. And so now I do still ask, Are you sure you still want to do this? Oh, mom? Yes, mom, you know, it was like, I can't believe you even asked me that. Because she sees the benefit, that it's given her both from the you know, being able to eat as she pleases without having to do an injection or count carbs, which has been really nice. But also from the just being healthier perspective, she can see the changes in her body. And she recognizes that that's good in the long run. Yeah. And so I think that's important. And it's not, it's not this miracle drug. Right. Like you said, it doesn't work for everybody. It definitely has its place, and it definitely has its purpose. But I mean, we're living it and I feel like there's a whole lot of untapped potential. There. Oh, yeah. And I really hope that we start hearing more about it being a an option for treatment. type one or type while it's

Scott Benner 1:02:26
chi Beatty. Yeah, you gotta get past the insurance thing and everything but they're, they're doing the studies.

Anonymous Female Speaker 1:02:30
You know, there's case studies out there are endo intends to write a case study on my daughter, you know, once once she's been doing this for about a year, you know, just kind of see, because, you know, we're at the point where things are still changing with her basil. And so there may potentially be more reductions in insulin use for her. I mean, she's been down as low as four units on basil. She popped back up when she was sick, and we just haven't seen the need to cut it back again. But, you know, is there the potential that that she goes off of insulin altogether? I mean, yeah. Could happen. I guess it just kind of all depends on on, you know, her weight loss and and how her body holds up, you know, we want to repeat lab work in about six more months and see what her see peptide is, right. Has it remained stable? Has it increased as it decreased? You know, like, like, what is her body doing in response to this medication?

Scott Benner 1:03:32
There's a lot of uncharted territory here, too. Yeah. I mean, I don't think you were saying and I don't think anyone is saying that, you know, we go V. shores type one diabetes, you don't

Anonymous Female Speaker 1:03:44
know very much a type one diabetic. Yeah, but her

Scott Benner 1:03:46
insulin needs are just significantly lower. Right?

Anonymous Female Speaker 1:03:50
Insulin needs are significantly lower. Her body's playing nice.

Scott Benner 1:03:54
Yeah, this isn't everybody, by the way, either. I know. Jenny's told me about, like, people she works with privately who are like, you know, their insulin needs are down like 20%. And that's great. You know, like, it's, it's been a real benefit for them. They're losing weight, or they're right.

Anonymous Female Speaker 1:04:08
And I think it has to do too, with like, where you're at in your journey. You know, is your body still helping a little bit? Or is your body done? Right, right. You know, I think that's a big factor too. In, in what you see from from results. Yeah. Well, your daughter

Scott Benner 1:04:24
absolutely could go into a situation where you're back to 20 or 30 units a day. They absolutely,

Anonymous Female Speaker 1:04:30
absolutely like I mean, if her C peptide dives, then she's gonna need more insulin. You know, I'm not in the camp that thinks that this is fixing her right. It's this is just part of our journey. It's where we're at at the moment. It's very encouraging. I mean, she's not had any undesirable side effects from it, even when you're new to even when she started she the very first injection She was remarkably tired that week. But the second one did not impact her in that way. And she she recovered, Arden

Scott Benner 1:05:09
had some nausea. She couldn't eat the first week very much. And she's

Anonymous Female Speaker 1:05:14
not we've not had any, any of that she does get to the point. And it's really funny when we're eating because you can see it on her face, where she gets to the oh my god, if I take one more bite, I'm going to vomit, you know, like, and it just hits her like a like a break. He had no and you can see it all over her face. And like, all right, she's just hit her full point. That's new for her. You know, she she never really had experienced that before. But that that's really been the only I don't want to even call it an undesirable side effect. She doesn't like it when she feels that way. But it also is giving her the signal that she needs to quit eating. I

Scott Benner 1:05:51
opened up a little Mango Sorbet the other day. I took two teaspoons full, but I went oh, that is sweet. And that tastes nice. And I look back down and I was like, that's good. And I put the lid back on. I put it back. Yeah. Like okay, I'm telling you right now, I could have eaten a pint of that a year ago. Yeah. Oh, yeah. I think of it as I mean, I guess it's going to be somewhat different for everybody. But I have my brain does not tell me I'm hungry any longer. Yeah. And my stomach does not get that like rally feeling right? It gets empty, but not in a way. Like I actually that's not true. On we go via didn't get empty on zap bound. I can feel my stomach empty. Oh, wow. But it's not but it's not a weird or bad feeling. And it's not a hunger pain. Yeah, it's just I'm just like, I know, there's like nothing in here. Like, I can hear it.

Anonymous Female Speaker 1:06:37
I don't get hungry anymore. doesn't really get hungry anymore. But I we both still think about food a lot. I didn't realize that we liked food. Yeah, I've like if we're if we're getting ready to go somewhere, you know, and we know, the different foods that are going to be available. Wherever we're going. Let's say we're going into town because we need to pick up toilet paper at Costco, you know, then we'll be like, oh, there's a Cheesecake Factory right there. You know, like, let's go there for lunch. You know, we still do think about food. But we also have had to reframe how we enjoy food because we know that I take as much of it and that we can't Yeah, we can't get as much as we would have before before we hit that point. So we make sure when we're eating our meal, you know, at the Cheesecake Factory and I get that barbecue ranch chicken salad thing that's the size of your head. But I know that I want the pineapple upside down cheesecake. I have to pace myself with that salad and be like, you know, could I continue eating this salad? Yes, but if I do, I might only get to enjoy one bite of that cheesecake. You know,

Scott Benner 1:07:45
we took my wife out for her 50th the other day and went to a steak place. I had a steak. I had I have steak. I had shrimp. I had other sides. Had a little bit of this a little bit of that. I got it all in. And at the end they brought out. I don't know, like I guess we made a reservation online. So they said is there any special occasion? My wife's like, it's my birthday week. I don't think she thought it was any they brought this giant Sunday out there were four of us at the table. So everybody kind of went after it. And I was like, Oh, I eat some ice cream. And I had a little bit of like a cone in the cones good. And like, um, and then that was it. But I swear to you, I know I could have eaten the whole thing a year ago. Yeah, like by myself. I could have like fended off the other three of them with one hand and eaten the entire Sunday with my other hand if I needed to. And so you could say oh, yeah, see, Scott, you're eating less. That's why you're losing weight. I could have done that. I wouldn't have found that. Like yeah, yeah, but I could you

Anonymous Female Speaker 1:08:42
didn't you didn't stop because you you couldn't eat anymore. You stopped because you knew better than to continue. Yeah,

Scott Benner 1:08:48
but now my flavor for food is a little different. I don't I don't mind it. Honestly, like I like the steaks still tasted great and everything. But it does cut a little bit of the highs out for me the the real sweet taste is kind of going out of things. Yep. And like savory is still there, but it's not as much you know, I decided yesterday I was like oh, I want to like try to lose a little more. I'm going to kick this little weight thing at the end of the week here because I'm my injections tomorrow. And so I'm like yesterday I'm like I'm just going to eat like completely like no carbs yesterday had like chicken wings and like all kinds of like low carb stuff yesterday Right? I never ran to the bathroom even though I had like wings sauce on the wings and everything and that stuff. I was all fine. I got up this morning I did what I did and I got on the scale and I lost like a pound since yesterday. Nice like it's just it's insane it's insane. Yeah, like you know, like it really is crazy.

Anonymous Female Speaker 1:09:39
I mean it's a helpful tool it will I feel like it's more helpful if we play smart yeah for sure easily if we're there's ways to help all the time. It's not going to be you know, yeah as as good of a result but

Scott Benner 1:09:51
I don't think I could like greasy is really was hard for me before but it's much harder for me now. Oh

Anonymous Female Speaker 1:09:57
yeah, for sure. Yeah. And I do find myself, if I'm not being smart with what I'm eating, I find myself needing Tums.

Unknown Speaker 1:10:06
Okay, so now Hey, funny thing

Anonymous Female Speaker 1:10:07
like things are giving me heartburn a little bit easier than they were before.

Scott Benner 1:10:11
I had pretty bad heartburn prior to this. And then it got better on Weibo V but never completely went away. And that's one of the reasons my doctor switch me because she's like I hear the doctor was like I hear like Manjaro no like southbound. You don't? Yeah, the heartburn, it helps with heartburn too, so I don't have any heartburn now. Nice. It's crazy how well it's working for I would literally, I wouldn't kill a stranger to get this F mount. But I dig in with my car a little bit if you like if you said like, you can't have it unless you ding this guy with your drive. Like, he's not gonna die. Right? Let's try.

Anonymous Female Speaker 1:10:47
We tried to get that bound for me. And my insurance didn't play nice. Okay, but I was just happy to get whatever they would give me really at that point. It was like, you know, not having anything is not an option. Yeah, obviously for the kiddo that will go v is the only thing that's approved for

Scott Benner 1:11:03
for the weight kids, or do you think they're gonna yank it away from her when she loses gets to a certain way?

Anonymous Female Speaker 1:11:07
Yeah, so that was a concern that I had. Because when she initially went on it, the insurance, the pre authorization was for three months. And I was like, Okay, well, I understood it, right. If it doesn't work, then no big deal. But we went back for that three month, you know, to renew their pre authorization. And by that point, I had seen the impact on her insulin needs. And realize that this was something that we we wanted to continue Very much so. And I was really super concerned about it. And so I dove into the research, right, jumped on the bulgogi website to look at like the dosing guidelines and everything. And everything that I read talked about a maintenance dose, right, like once your goals have been achieved, and you'll continue a maintenance dose. And so I was like, okay, it doesn't sound like this is something that's intended to be just for like a short period of time. Sounds like this is something that's like long term. And then I talked to her endo about it. And she was like, it's all in how I submit the paperwork, right of like, it was initially approved for obesity, BMI was, you know, XYZ, and BMI is, you know, this or whatever. And so we're seeing success. But to continue, she, she gave me this whole spiel about like, it's all in how you submit the paperwork. And so when she submitted for the renewal insurance, renewed it for a full year. And so I feel fairly confident, you know, that was just in December that it was renewed. And so I feel fairly confident that come next December, the pre authorization may not even be a thing anymore. I'm hopeful. I'm hopeful. I'm optimistic, in general about life. But I'm very optimistic that over the course of this year, the industry is going to see,

Scott Benner 1:12:53
I'm gonna assume because the pharma companies are making money too. So they're gonna they're gonna pressure insurance to cover it too. Right? I always laugh when people are like, well, what if you have to take it forever? I'm like, I don't care.

Anonymous Female Speaker 1:13:04
I mean, I feel bound by me. Yeah, I

Scott Benner 1:13:05
think I mean, it's, it's a, you know, it's a peptide like it's not. And now I'm getting GMP and GLP. With was that bound, which is obviously helping me with, you know, the stomach acid too. So when people are like, what do you have taken forever? My, what a weird thing. It's worked out.

Anonymous Female Speaker 1:13:22
And it's, I mean, at this point, it's a little bit like, I'm still a little bit weary of having to be on anything like this long term. Because there's just not a lot that you can find about people that have been on it.

Scott Benner 1:13:36
You want some data, I'm sitting at a 90 degree angle on a chair, and I can see the hinge of my hip. When I look down. I didn't even know that was there.

Anonymous Female Speaker 1:13:47
So like, I don't know that I'm ready to say that I'm, I'm okay. With the thought that this is a forever kind of thing, based on what I know today about how I feel off of it versus on it. And the same thing for my daughter. It's a risk I'm willing to take. Yeah, at this point in time, like pending more information, right. I'm always open to changing my mind. If something comes up, right. Sure. something pops up and like, oh, I need to, you know, need to not do that anymore, then we won't do that anymore. And we'll figure it out. But yeah, but based on what I know, today, I'm okay with that.

Scott Benner 1:14:26
I agree. Yeah. If somebody comes along and says, Hey, here's data, you're gonna get foot cancer, I'd be like, Oh, God, I gotta get fat again. Okay. Like Like, yeah, like or

Anonymous Female Speaker 1:14:33
it's like, do I want to feel good every day and not have a foot just one I know that sounds crazy. I don't know. Honestly. I would probably choose to lose the foot at that point. You don't

Scott Benner 1:14:50
know what it's like to feel bloated like that. And it's

Anonymous Female Speaker 1:14:55
and what it did mentally to me, right? Like it's not just about the food As a goal, but but it impacted my happiness and my well being. And it impacted my family because I wasn't fun to be around impacted my co workers because I just wasn't nice. You know. And so I would have to think long and hard about that if it came down to, you know, stay on the GLP one or lose a foot like I probably could do okay, without the foot like, as long as it was just one of them. You don't want to talk on both of them.

Scott Benner 1:15:26
If you want to hear me be emotional about losing weight, go listen to that we go V Dyer I've been making because I've, yeah, I've had a couple of journeys. Yeah, well, yeah. But nevertheless, listen, I want to be clear about this to our insurance does not cover ozempic. For Arden, I am buying it through a Canadian pharmacy, I'm paying cash for it. And it's not a thing we could afford. If she had to shoot it the way it's the way it's the way it is for a type two, like like, like, you know, bunch of units or whatever. However, it's, she's taking the point two, five, that's all she's taking. So we can get a pen through Canada, one

Anonymous Female Speaker 1:16:06
of those one ml pens, and it lasts for freaking ever. Yeah.

Scott Benner 1:16:09
We're getting like months out of it. So like, it's, you know, it's it's still it's, it's an expense, right. But it's an expense that, you know, I'm going to tell you if it was if it was just an acne medication, I'd pay it for Yeah, if it was just helping her with her periods, I'd pay it for if it was just helping with her insulin needs, I'd pay it for like, we're getting, she's getting all of these things out of it. Yeah, yeah.

Anonymous Female Speaker 1:16:37
I mean, I would I, I'm a single parent, I don't know that I even threw that in there. You know, initially, I'm a single parent, she is my only child. So finances are not, you know, we don't have a lot to spare. But if it came down to it, and insurance quit covering it, I would absolutely get a second job if I had to.

Scott Benner 1:16:54
No, I feel I feel the same way that I do. Also, you know, and I'll let you go. But like your to your point about we don't really know what this is doing yet. Go ahead and Google things like ozempic babies, like women who have not been able to get pregnant, their whole lives are on ozempic and getting pregnant. Right? Like, and I'm not saying it like boosts your fertility. It's I don't think it has anything to do with that. No,

Anonymous Female Speaker 1:17:18
but if it's helping to regulate your body, like if you're a PCOS sufferer, and it's helping to regulate your your system, then absolutely, that's going to contribute to Oh, you're

Scott Benner 1:17:27
gonna see this die. This is going to be like they're already studying it about things like impulse control, right? Like for like gambling and drinking and like, I don't know what they're gonna find there. But I'm telling you, if women who like have been infertile for so long that they just don't even bother using birth control anymore. And then they get on a start on us and then boom, baby time. Like that's getting, by the way that's already being looked into. So it's Wait, it's it's impulse control. It's insulin resistance. It might be the ability to have a baby it might be the ability to like fend off these horrible things that women go through with their their uterus isn't like this PCOS and like Jesus Christ, it's terrible. If it makes a dent in that for somebody, like, let's go, you don't I mean, like, what else is it going to do?

Anonymous Female Speaker 1:18:16
Right?

Scott Benner 1:18:16
I haven't gotten taller. But you know,

Anonymous Female Speaker 1:18:18
I wish I would pay good money for something that really hit me. Smart.

Scott Benner 1:18:23
Yeah, you wouldn't. You would definitely I would.

Anonymous Female Speaker 1:18:26
Yeah, I feel like it. We're just at the tip of the iceberg. With this. Yeah. It's gonna be really exciting to see what, what this does for people, you know, I mean, it just, I feel like it's given my kid her life back in a sense, you know, of being able to just eat the pizza, you know, or just haphazardly decide to go be active without having to remember that she's got insulin onboard from dinner. Yeah, or even even taking showers. Right, like pre would go V. She couldn't shower with insulin onboard because she would crash and burn. And so we would have to be like, Oh, you need to shower today. Do that before dinner. You know,

Scott Benner 1:19:11
and health both just health like I I'll share this here, then I'll let you go. Right. I think we've covered everything, don't you?

Anonymous Female Speaker 1:19:19
I feel confident.

Scott Benner 1:19:22
Yeah. You know, people tell me all the time, like, oh, Scott, you gotta make social media videos to support your podcast, and he's like, Oh, I don't want to or that's silly, but I what I was thinking is I don't look good. And I don't mean just like I look fat. I mean, like, I don't look good. I look unhealthy, you know, and like, I'm not like when I wasn't one of those people who was like carrying around 40 extra pounds. I looked like Ashley Graham. Like you know, do you mean like, like, I wasn't like all beautiful and smooth skinned and just happened to way more like I didn't look healthy, right? Like I was definitely not taking in nutrients that I am now taking in like now I like I jump in front of that camera. I'm like, Hey, there's an episode of the podcast coming up. I don't even look at myself. Like before that I would have had that thing at a certain angle, it would have been up on the ceiling pointing down from my head. Like the only mean like, I would have only done it certain times a day. I couldn't have done it if I wasn't shaving because I would have looked like I was on a bender. But I

Anonymous Female Speaker 1:20:13
wasn't. And I feel like I can say this to you because we've all got no, but it just it. Do you looked like you might be coming down with something. Yeah. Yeah. You look like you might not feel super fantastic. Right? And it wasn't I never thought of it as anything more than that. But I was like, Oh, he's got a cold coming on or something.

Scott Benner 1:20:36
Oh, my dentist once told me he's like, you gotta have type two diabetes. Look at yourself. And I went I don't I wasn't even anywhere near to Mike my one seat. It wasn't up at all. Like, you know what I mean? He's like, you don't look good, man. Check into type two. And like, and I was good, wasn't that and it just, and you're so used to it after years? You don't even fight against anymore? You just like I guess this is how I'm supposed to feel. But right now turns out no. I know.

Anonymous Female Speaker 1:21:01
Right? It is possible to feel good about things and to feel good in general. And

Scott Benner 1:21:07
skinny Scott loves fashion. We learned by the way. I don't know if you know that. Scott likes to dress nicely. I didn't know I did. I thought I was like I'm happy and sweatpants. I happy and sweatpants. I was dying. It was in a puddle. Anyway,

Anonymous Female Speaker 1:21:20
I'm still in my happy and sweat pants phase. But I'm very much looking forward to being able to expand my wardrobe.

Scott Benner 1:21:27
Actually, though, my sweatpants are much nicer now. I get them at cozy Arthur. Very

Anonymous Female Speaker 1:21:30
nice. Yes, I you know, I've got a pair coming that I am very, very, very excited about.

Scott Benner 1:21:35
I just want to say, Save 40% with the juice box at checkout. But that's not even a joke. They're really nice. Do

Anonymous Female Speaker 1:21:41
they? I'm so excited. I've heard you talk about them so much that I'm like, Okay, I'm splurging one beer,

Scott Benner 1:21:47
I hope you like them, I really do. I really do appreciate you doing this. Again, no one is saying like GLP medications are not a cure for type one diabetes, like, but you're gonna hear more and more stories from people with type one who are using less insulin, and maybe getting other benefits to my

Anonymous Female Speaker 1:22:04
disclaimer that I had kind of thought of was like, you know, please, please, please, if you find yourself blessed enough, to be able to try one of these medications, please do it. Only if you feel like you're really good at making adjustments to your insulin and to your settings. And that you have that kind of relationship with your prescribing physician that they will be an asset to you in the journey. Because I just I think about how quick the impacts were. And if I wasn't at the comfort level that I was at, with making adjustments to run overload sensitivity factors, it could have been very, very bad.

Scott Benner 1:22:51
Yeah. Because you had to make you had to make some big adjustments taking insulin away, and people would have thought to do

Anonymous Female Speaker 1:22:59
huge, huge adjustments. And in reaction of like, you know, we've all caught a low, right, we've all had a scary low, but it was happening three, four or five times a day. And in you just have to have the capacity to deal with that. Right? Don't start on it, and then send the kiddo off to camp for the week, you know, or if you don't have that great relationship with the school nurse, where they'll listen to you make adjustments on the fly, you know, like, I just feel like we can't overstate the importance of being knowledgeable and comfortable. in caring for yourself, if you're the type one and going on this journey, or caring for your child or your spouse.

Scott Benner 1:23:52
Well, that's in the lives, it's in the labor, don't ya jump

Anonymous Female Speaker 1:23:57
into this without any thought preparedness and preparation and a game plan. Because, you know, we jumped into it not knowing that these impacts were going to happen. It was profound. And we were in a really good place. And I feel like, I don't want to brag, I want to be humble, but I knew what I was doing with my daughter's insulin and diabetes care. And I panicked, you know, and so, I just want people to hear that if nothing else, you know, don't don't hear this and think that it's a miracle fix and I'm just gonna do it. Please. Make sure you have the support that you need. You're gonna listen to it's gonna be a lot I don't want to hear a very, very, very sad story because somebody jumped into it without those resources.

Scott Benner 1:24:55
I actually think the the label for about type one is on these medications says like, you know, we go we, you know are one of those GRPs will cause low blood sugar, but you have to think of it the right way. It's not causing low blood sugar, it's causing your insulin needs to be significantly less. And you're, now you're suddenly using too much insulin, and that's causing low blood sugar. But yes, the mechanism is you had a certain amount of insulin in there, you put in this GLP, and then boom, you know, you're and

Anonymous Female Speaker 1:25:23
now all of a sudden, what you use to to take care of that low blood sugar is not going to take care of that low blood sugar anymore, right? That that four gram glucose tab is no longer going to cut it, you know, you're not gonna see that make a dent in that low that's resulting. And so just that that's my one thing is, this is a very happy story. We're very happy with our journey. But I don't want somebody story to be the opposite, because they didn't have the support or the knowledge going into it. That this, this is a big thing. And it changes things. It has the potential to change things in a big way. Yeah. And just just know that right, just to be smart about it, use your head. You know,

Scott Benner 1:26:10
we're also early on in this right now. Like, you'll look back on this episode a year or two from now. And you'll be like, oh, yeah, we all know that now now everybody's getting this you know, like that. That kind of a thing. And like, wait, wait, do you see because I've, I mean, you you mentioned the University of Buffalo right? at Buffalo. Yeah, they

Anonymous Female Speaker 1:26:28
got their dandona up there doing doing fun studies. Yeah,

Scott Benner 1:26:32
yeah, you should check it out. So okay, well, thank you so much for doing this. I got to ask you a couple of questions before I let you go, but I'm gonna stop the recording right now. Thank you great.

Arden has been getting her diabetes supplies from us med for three years, you can as well, US med.com/juice box or call 888-721-1514. My thanks to us med for sponsoring this episode. And for being longtime sponsors of the Juicebox Podcast. There are links in the show notes and links at juicebox podcast.com. To us Med and all of the sponsors. I'd like to thank cozy Earth for sponsoring this episode of The Juicebox Podcast and remind you that using my offer code juice box at checkout will save you 40% off of your entire order at cozy earth.com where you can just click on the link in the show notes. A huge thanks to touched by type one for sponsoring this episode of The Juicebox Podcast. Check them out on their website touched by type one.org or on Facebook and Instagram. If you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes, but everybody is welcome type one type two gestational loved ones. It doesn't matter to me. If you're impacted by diabetes, and you're looking for support, comfort or community check out Juicebox Podcast type one diabetes on Facebook. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com

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#1135 Cold Wind: Healthcare Whistleblower Adult NP, GLPs and more

"Kat" is an anonymous Nurse Practitioner who provides insight on working at an adult endocrinologist office. Discussion of GLP meds and more. Her voice and name have been changed to protect her identity. 

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

+ Click for EPISODE TRANSCRIPT

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

Scott Benner 0:00
Hello friends, and welcome to episode 1135 of the Juicebox Podcast

welcome back to another episode of cold wind. Today we're going to be speaking with a person we're calling Cat. Cat is a nurse practitioner in adult endos office, and she also trains people in nursing. Today we talk about type two GLP is type one. And in the end of the episode, we go over what you might expect in an ER. If you have type one diabetes. Hint, it's you shouldn't expect much. While you're listening today, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan or becoming bold with insulin. The cold wind series is looking for more guests. Do you work in healthcare? Does your job let you see what's happening in healthcare? Do you want to tell us all about it? While you're staying anonymous. Go to juicebox podcast.com and send me an email and we'll start to talk and see if we can't get your chilling story on cold wind

a huge thanks to Omni pod not just my longest sponsor, but my first one Omni pod.com/juice box if you love the podcast, and you love tubeless insulin pumps, this link is for you omnipod.com/juice box. This show is sponsored today by the glucagon that my daughter carries. G voc hypo Penn. Find out more at G voc glucagon.com. Forward slash juicebox Hello and welcome to the cold wind series from the Juicebox Podcast. These episodes will feature physicians, nurses and other professionals who agreed to come on the show anonymously to share what they see in the healthcare profession. I've altered the voices of each guest so that they can remain anonymous and feel comfortable telling us what really goes on at their job. Just listen to how well the voice altering works.

Speaker 1 2:19
My name is Beth and my oldest child has type one diabetes diagnosed in October 2020. My name is Beth and my oldest child has type one diabetes diagnosed in October 2020.

Scott Benner 2:32
If you work in health care and have a chilling story to tell about your experiences in the healthcare field, contact me today. I'll get you right on the show. Your story does not need to be specific to diabetes. So today we're speaking with someone anonymously. And before this person introduces themselves, they get to pick their own anonymous name. So go ahead. What do you want to be called?

"Kat" 2:58
Okay, I'm gonna go with Cat, Cat. Cat KT cat,

Scott Benner 3:03
as unreasonable as it sounds, I'm just gonna say do you prefer that with the C or Okay?

"Kat" 3:07
Actually, okay,

Scott Benner 3:09
okay, we're doing it with a K Cat, cat with a K. Cat. Tell me what you do for a living.

"Kat" 3:15
I'm a nurse practitioner. I work at a hospital system, one hospital system. Full time as a nurse practitioner and endocrinology practice. And then for my side hustle. I go to a different hospital system in a different in a different role as a nursing instructor. Okay.

Scott Benner 3:35
Oh, that's interesting. All right. So you're in a, an NP for an endo for an adult, endo or adult. Okay. How long have you been doing that?

Unknown Speaker 3:47
10 years.

Scott Benner 3:49
Do you have any personal attachment to diabetes? Do you have it or know somebody who does?

"Kat" 3:54
I do not have diabetes. I do not have type one diabetes, okay. 100% of my patients in my practice have diabetes. And it's kind of typical for nurse practitioners in an intercalary practice to focus on diabetes. Okay, I'm going to nurse nurse for 30 years nurse practitioner for 10. And I fell in love with diabetes. When someone said, Hey, we're starting a diabetes program. What do you know about diabetes? I said absolutely nothing. I worked in ICU for 20 years. So I learned from the ground up.

Scott Benner 4:27
How long ago was that? About 20? About 20 years into your career, I guess. Yes, yes. So does the practice do mostly type one or type two? Mostly type two, type two. Okay. And the practice does other endocrine things, but you're specific to the diabetes side.

"Kat" 4:44
Yeah, I like to say chronologist do all the fun stuff that thyroid, parathyroid, thyroid cancers, you know, everything else. endocrinology related,

Scott Benner 4:54
right? Just vaguely what's the percentage split type twos, the type ones that you see

"Kat" 4:59
Probably at 515. Okay.

Scott Benner 5:04
All right. So let's start with my question about type twos. What's the biggest roadblock for you in helping people with type two diabetes? Well,

"Kat" 5:17
I work. I do, too. I unfortunate in my early career in diabetes was in a in a clinic. And when I people use the word clinic two different ways. When I say clinic, I mean, uninsured, not documenting, meaning people who will never have a chance to have insurance. So I was dealing with a lot of, you know, no access to health care, well, we were the access to health care in a truly clinic setting, they had no money. A lot of, you know, it's kind of a buzzword now. But social determinants of health, or social drivers of health where they truly didn't know where their next meal was coming from, didn't have stable housing, English was not their first language. So I felt truly blessed that I worked in an inner city place. And I still do, so that, you know, type two diabetes, along with access to medications was because I had I could use metformin and you know, stuff on arrays, and, you know, Walmart from insulin, insulin from Walmart for about three years in my career. And then I go into a private practice, where about 35% of my patients have Medicaid, which, you know, I love Medicaid, getting Medicaid, you have no co pays. So I know, you can afford your medicine, and you come to see me for free, it just the barrier would be transportation, but now we do zoom calls. So a lot of that barriers be taken away. But you do have some access to food issues and health issues and housing issues I still deal with. But now I have, you know, the other 70% of the population who have commercial insurance, which we all know co pays suck, but every say, those are the people who coupons on me for so please go online and get coupons for your medication. So the barriers to type two diabetes are kind of betting on which population I think I think of my truly, you know, office patients has more to do with, I'm not beating around the bush and tried to

Scott Benner 7:13
say, oh, no, you're doing you're doing a good job. Yeah, no, but

"Kat" 7:18
you know, it's, it's what we eat. And a lot of the patients and you know, including myself, you know, deal with depression and things like that, who gain weight. I just may feel when I talk to someone, it's never, not never a lot of the times and yes, I know we have stressors in our life, and we don't make eating a priority and exercising priority. And I still say it's at 28% weight to understand exercise. When someone says and I see people every three, four months, and I see and you have to change something, you can't do the same thing and expect to see a change. So I think we tell like I hear a lot that we're we made a change. But you know, when you really get down to it, they didn't. And again, I'm doing a little self reflecting here myself. Right think of people, but I didn't put people on Adobe or ozempic or Manjaro, the news found that's coming out next week or in two weeks whenever they're not magic bullets. Yes, they do help. But you really see people get results when they make the lifestyle changes. So I think if you're really honest with yourself, we we aren't doing what we're saving a lot of times we're not doing what we say we're doing and we have the best intentions.

Scott Benner 8:35
So what would you say that the biggest? So there's two populations that you've dealt with professionally. There are people who are don't even like you said to have a place to live. They have a they have a completely different roadblock. Right, right. But yeah, yeah, but in a professional see those patients? Yeah, but in a professional setting where people are insured, and come in, you know, they're almost trying to be proactive, or they've been sent there by their general practitioner for a problem. You think the biggest problem that you see is follow through? Is that you you give people information, and they go home and don't do it?

"Kat" 9:13
Yeah, yeah. I'm not labeling because because I, I know, you know, there's so much more than their life and diabetes and with everything else that goes on with life, and it's not, okay, I just, I can't call the biggest barrier. I'll just say one of the

Scott Benner 9:33
Well, we'll find the rest of it. But let's, let's go through that thought a little more though. So they go home with marching orders of some kind, but they're probably immediately met with the fact that their house is full of food that might not be beneficial to them or their lifestyle is set up in a way where they can't they don't have time to get moving or they don't even know how to exercise or how to begin to exercise or maybe they're already in firm some way and it makes it feel difficult. The first time to get a pay You go while wait for this to stop hurting my knee before I keep going. But you know, like that sort of stuff. So the food that's there, I'll tell you right now I think the first thing that happens to people is they get home and they're like, look, I already paid for this food. I'm not throwing all this, thrown all this out. So let me eat through all this. And then next month, I'll start, except you go to the grocery store and you don't buy things differently. You don't suddenly go, Oh, I'll have a carrot. And you know, like, you're like, Oh, I love I love to read us. And so like, that's the problem is the shift plus, the bigger problem might be that the processed foods, and really kind of like high carb, high sugar foods. I think they have a hold on people. You know,

"Kat" 10:44
120% agree with that. They're super addicting. Absolutely, they do. They truly, truly do.

Scott Benner 10:51
My wife bought these little candies last year, right. And she can eat them, like once every light blue moon. But if I see them and have one on my, oh, I'm gonna have three of those. And I don't even think and I just reach out and I take three. I'm like, these are tasty. And then I'll have three today and then three tomorrow. And then the next day, I'll be like, Oh, I might have six of those. I got three in the morning and three in the and I don't think about it. It's just it's in like what she sees as a decorative jar, that she might take four years to go through. And I'm like, if you leave that where I can see it, I guarantee I'm gonna eat all of those in a month.

"Kat" 11:28
And it's funny. Yeah. And I and I in the same way, it just can't be in the house. I struggle with telling someone Oh, in moderation versus nothing at all. Because then people say, Oh, I'm going to just crave it and go get it. You know, you hear I guess my, my own practice of doing this for 10 years, I'm not sure what way works the best, you know, totally eliminate from your diet and just have it as a treat. Or some people say, I wonder I teach in my love. She says get a shot glass and put your chocolate chips in there that you treat for the night. So you're not depriving yourself. So yeah, I get it. People are one way or the other there. And I find that there's, there's little gray on that with people that I know myself. I can't do the moderation thing. It's got to be out of sight. So

Scott Benner 12:19
yeah. So the people you meet, you feel like they they lean one way or the other either just throw it all away, settle on fire, get it away from me, or, you know, I can do moderation, but but some people can.

"Kat" 12:33
Yeah, and I truly you're fighting I? I can't I can't say that. Well,

Scott Benner 12:40
I can't say that. Nobody knows who you are. Okay,

"Kat" 12:43
no. So this is not the first time you when I met. You actually you actually said to me when I said I'm a nurse practitioner practices in the cloud, blah, blah, blah. You said, Are you good at what you do? Do you remember saying I

Scott Benner 12:57
don't know I'm I'm always making a podcast, even if we're by ourselves. I'm just probably just asking questions. So you, so we met in person somewhere. And and you identified yourself and I said, Are you good at was that what I said? I'm an asshole, aren't I? That's terrible.

"Kat" 13:16
I said I should yeah, I'm absolutely I said I'm very good at what I do. And you can judge that by, you know, different avenues, you know, but one of the ways that the organization where I work encourages that is those patient comments that, you know, you're graded by those and Press Ganey scores, and, you know, you get rated by your patients. So I, you know, we get a lot of patient feedback, you know, with the patient, all I hear you get when you leave the doctor, you get a survey, you can fill out the five stars, but then there are those people that take a little bit further and they actually write comments. So, what's consistent about the comments that I get is that I listen, and I make sure that they participate in their care and I explain things, they know that they know the why behind what they do. And it's something like that. So I, I do pride myself on that, like, I don't just say I'm, you're going on with OB and this is why, you know, I make sure they understand how Ruby works or why the SPLC to me, you know, why recommends protect your heart and your kidneys. Oh, by the way helps diabetes to so

Scott Benner 14:26
like a full explanation. So it's not just take take this Yeah, they get to know why they're doing, what they're doing, how they're going to do it and what the expectation is from it. Today's episode of The Juicebox Podcast is sponsored by Omni pod. And before I tell you about Omni pod, the device, I'd like to tell you about Omni pod, the company I approached Omni pod in 2015 and asked them to buy an ad on a podcast that I hadn't even begun to make yet because the podcast didn't have any listeners on All I could promise them was that I was going to try to help people living with type one diabetes. And that was enough for Omni pod. They bought their first ad. And I use that money to support myself while I was growing the Juicebox Podcast. You might even say that Omni pod is the firm foundation of the Juicebox Podcast and it's actually the firm foundation of how my daughter manages her type one diabetes every day. Omni pod.com/juicebox whether you want the Omni pod five, or the Omni pod dash using my link, lets Omni pod know what a good decision they made in 2015 and continue to make to this day. Omni pod is easy to use, easy to fill, easy to wear. And I know that because my daughter has been wearing one every day since she was four years old and she will be 20 this year. There is not enough time in an ad for me to tell you everything that I know about Omni pod but please take a look. Omni pod.com/juice box I think Omni pod could be a good friend to you. Just like it has been to my daughter and my family. If you take insulin or sulfonylureas you are at risk for your blood sugar going too low. You need a safety net when it matters most. Be ready with G voc hypo pen. My daughter carries G voc hypo pen everywhere she goes because it's a ready to use rescue pen for treating very low blood sugar and people with diabetes ages two and above that I trust. Low blood sugar emergencies can happen unexpectedly and they demand quick action. Luckily jeuveau Capo pen can be administered in two simple steps even by yourself in certain situations. Show those around you where you storage evoke hypo pen and how to use it. They need to know how to use Chivo Capo pen before an emergency situation happens. Learn more about why G voc hypo pen is in Ardens diabetes toolkit at G voc glucagon.com/juicebox. G voc shouldn't be used if you have a tumor in the gland on the top of your kidneys called a pheochromocytoma. Or if you have a tumor in your pancreas called an insulinoma. Visit G voc glucagon.com/risk For safety information.

"Kat" 17:21
I do yeah. Or they'll come to me their primary care doctor put him on you know the shuttle to just you know Tuesday Jordans for Sega don't want to be out of sugar. But your agency was telling you that he's infection after UTI of yeast infection. Like he I wouldn't have done that with the reader servers in the 250s. Yeah, I can tell you why that he's infection takes me two seconds. Well, now they're like, Well, I don't want to take any more time. But we'll stop it for now. But let's try something else. And I will put you back on it later. Yeah, we'll talk about it. But so yeah, getting back to that roundabout question is Yeah, I do try to explain, you know, things and right. Yeah. And listen, bla bla bla. So

Scott Benner 17:59
sticking with type two is a little longer here. If I since you're going to be anonymous, you can just say what you think, okay, if if people who came in with type two diabetes, whether it was genetic or lifestyle, or mixture, any any number of ways that they've made it to having type two diabetes, if you could literally control their intake and their exercise? Could you help everyone? Or are there some people who even if they ate well and exercise, they'd still have type two diabetes?

"Kat" 18:29
small percentage, I wouldn't say yes, we still have type two diabetes, but you

Scott Benner 18:33
think it's mostly those ideas? It's movement and food. Okay. Food, food first. And people you find is true, that some people think they're eating well, when they're not. Absolutely.

"Kat" 18:47
Okay. So here's the best example. We check them out, you're gonna come through the door, and it will be high. And also, you know, during the intake process, that nursing assistant will say, you know, when's the last time you ate? What did you eat? I had blah, blah, blah. I stopped at McDonald's on my way. And, you know, but I don't normally eat that. Well, you don't normally eat that. But you had it you just happened to have the day you came to. I just find that funny.

Scott Benner 19:14
Beyond funny beyond funny cat, you find it a lie. Is that correct? Yes, yes. You think they're lying? Like Like, like your your thought is? Why would you go to McDonald's only once this year, and it'd be the day before the the hour before somebody's checking your blood sugar in a medical situation?

"Kat" 19:34
Correct? Yeah. And here's the deal. I live with a man who takes hasn't lost any weight and I can tell you why. It's not the

Scott Benner 19:44
drug. So So okay, so you have personal experience with a person on Weibo V. Are they how far into the process are they? What's their? What's the dose they're getting right now?

"Kat" 19:55
2.40 that's

Scott Benner 19:57
the full dose. They've been on it for a while. Yep. And he's eating through it. Is that your contention? Absolutely. type of food he's eating through? It is is it's still not good. It wasn't good food before. It's still not good food now, or is it is the bulk of food? Both. Okay, now I can tell you when you met me in person I probably had. Do you remember what month that was my experience? August? Was it really though? Okay, so I've lost 40 pounds, probably 30 of them since I saw you. March, April, May, June. Actually, that's not fair, maybe 20 More since I've seen you. So I've lost 40 pounds on Weibo v. And I was not a poor eater to begin with. Like, I didn't take in a ton of calories. Even though I you know, talking about candy, like I don't eat candy every day all day long. My intake is pretty reasonable. I just have always maintained there's something wrong with my body, it just doesn't work. Well. I believe that to be true, even more. So after beginning to take we go V because even on a non therapeutic dose, I was losing weight. Like right away, I lost weight in the first week. On we go. Yeah, you know, now that I'm down 40 pounds, the weight loss is slower, I don't have a lot more to go, I don't think maybe 15, maybe 20 pounds, I don't know exactly. But it's very mean and see, like at this point now fully dressed standing in front of you, you would not go that person needs to lose weight, I look significantly different. I think that I have a deficiency of some sort that the GLP medication is covering for but you think there are some people who don't have that deficiency, they just have the they eat a lot. And that medical.

"Kat" 21:48
They don't have the deficiency. There's lots of reasons why the IDI binge eating disorder, you know, there's reasons why people continue to eat. But the flip side of that is yes, so I do have patients who come in not losing weight on these medications. But that I do see the people like you who are doing phenomenal, absolutely phenomenal on these medications. And I just I just praise them when they come in. It's just a life changing. You know, it's just so life changing for them. And they change the way everyone in their house eats they're so they're making future generations healthier. They're they're teenagers are now eating healthy. It's just amazing. It's just so inspiring to see that.

Scott Benner 22:34
Yeah, no, I believe I believe what you're saying I actually think that the GLP is might change an entire generation of the country and how it needs but

"Kat" 22:41
did GRPs. And now you've got release coming out with the third one, the GRP GLP. One. And I forget what the third hormone is going to be. Yeah, it's helped me out much. But

Scott Benner 22:53
I don't want to skip over the binge eating thing, because I have input on this. I know what you're talking about. Because for me, we go, we can make your stomach feel fuller, right being that does that by slowing digestion. But it also tells your brain you're not hungry. Right? So like, I have to remind myself to eat. But when I when I remind myself like is this a good example, it's 1030 in the morning, I haven't eaten yet. And I had a long weekend. So I decided to sleep in a little bit, get up, record the podcast and I'll eat after, when I'm done talking to you, I still won't be hungry, my brain won't be hungry, and my stomach won't be hungry. But I will eat because I know I need to eat. But I could over eat. If I wanted to. I could I could absolutely make a conscious decision to eat food and just eat it. Which is which is fascinating because it sounds like it can sound like to the person on the outside or the medication stopping and breathing. It's telling him his brain. He's not hungry. It's telling his stomach. He's not hungry. It's all true for me. But if I just said to you right now I'm gonna go downstairs and eat as much as I can. I could do it. I wouldn't feel good when it was over, etc. But if I had that psychological component of it about the eating, which really does, I think go to prove that that somebody in that situation is not being ruled by anything except psychology in that situation. Do you agree with that?

"Kat" 24:21
I agree. I agree. Yeah.

Scott Benner 24:23
So there is that there is a person that could be in that scenario too. So the person you know, they should be seeing a therapist, you think they're not going to know it's you. So go ahead. You can say whatever you want.

"Kat" 24:36
Yeah, yes, yes. Yeah. And there's better medications. That's why, you know, people can take, you know, wiggly and beyond phentermine, I mean, not to phentermine treats, binging disorder, right and stars, but there are people who do need both. So it's not uncommon for me to prescribe some local tribal phentermine or other medications that also help

Scott Benner 24:59
Did you Just say that Vyvanse helps for binge eating disorder. Yeah,

"Kat" 25:04
it's FDA approved for that. That's also

Scott Benner 25:07
that's that. I just wanted to make sure I heard you because you spoke kind of quickly, and I wasn't certain you said that. Oh,

"Kat" 25:12
yeah. It's also it's the only medication for ADHD.

Scott Benner 25:20
Okay. And that helps with that, too. That's crazy or can help with it. And that's something Well, yeah, so Okay, so, Alright, so now we've, we've kind of learned a lot, but we learned about one of the ideas that stops people from being helped with type two, it's not as easy as information, you can inform them, but they're not necessarily going to follow through for a number of different reasons could be financial, could be what they think of is good food could be that they're being pushed by psychology, it could be that they're being pushed by physiology, like all kinds of different possibilities. Yes. And then what happens to them if they don't see gains, if they don't see improvement, it becomes like, I guess demoralizing, and then they stop. When they

"Kat" 26:07
say the medication doesn't work. It's, you know, that's basically it's the medication squat.

Scott Benner 26:14
Okay, I can tell you this, I have an incredibly long view now of my health, more so than I ever have in my entire life. My wife and I were talking about this yesterday in the car, and I said, I, I now don't care if it's a half a pound a week, like, it's fine. It's fine with me, if I reach my goal weight two years from now, like that, like, but in the past without the weego V, because I wasn't seeing any improvement. If I didn't see like a drop in weight constantly. And it didn't seem significant. It was hard to keep going. And you know, don't I mean, you're like, I'm never gonna get there. This isn't gonna work. I one thing yesterday shouldn't happen again, two pounds, like this is like this is just where I'm at. But because I'm seeing improvement, I can afford to be patient, if that makes sense.

"Kat" 27:02
I absolutely. And you should be any pound. Anytime that enemy. You know, also, there's non scale victories, like you know, about I don't, I just don't really look at a scale, there's so many things wrong with the scale. But anyway, time that scale goes down, and I can show a patient Well, I saw you three months ago, or six, you know, six months ago, you've lost 10 pounds in center, like that's 10 pounds. Before we started, you know, talking, that scale was going up and up and up. So it is progress and maybe some progress. I think people see, you know, I can't stand saying this. But you know, celebrities, whoever losing tons of weight on this, I'm like, No, really, your scale is going in the right direction. But let's see what we can do to, you know, make make the document a little faster.

Scott Benner 27:49
Another reason not to compare yourself to somebody online, is that they show you their first picture, when they're when they're at one weight. And then that's not even if they're showing that you're used to seeing them like that. Correct. And next time you see them, they've lost 40 pounds. And you're like, Oh my God, look how quickly that happened. Like didn't have probably didn't happen quickly at all. It probably took them a year. But they were hiding for a year while they were they weren't taking any new pictures during that time. Right. So you didn't see the process of it happen. Yeah, I started making videos online when I started doing weego V. Because after I lost the first 10 or 15 pounds, I was actually comfortable pointing the camera at myself. And then I realized that this will be a good, like visual diary of over time. So I kept doing it. Because even I was like, the first time I made a video. I'm like, oh my god, I look better than I've feel like I've ever looked. And then a month later, I was like, Oh, I looked terrible a month ago. Like look at me, you know? And so I thought, well, I'll keep doing that. Because then people can see the progress instead of just showing them like the finished product and being like oh look, because then it feels magical. And it's not magical. It's it's I mean, I've been doing this since March. It's November now, March, April, May, June, July, August, September, October, it's I'm nine months into this. And there are weeks where I lose a half a pound. And I just have learned to say that's amazing. And I keep going. It's

"Kat" 29:07
yeah, that's exactly. That's amazing. And that's slow. You know, it's, you know, all the cliches that you can think of, it's not a marathon, it's a marathon. You want that to be slow. And I just feel my one of my favorites is when the tide rises, all boats rise, like you feel better and just when people say, Oh, you recruit and just to keep it going keep the momentum going to keep you motivated to put in the effort. So I'll tell you right now, you know, patients come in and say oh, so sick on it. i Since I've been around, you know these medications as young people that have been in the market since don't quote me 2005 With Victoza and I remember when I first started I'm like yeah, let me try that. I don't have any weight to lose with the drug but it was fine. The drug reps like, Hey, you want to try this? And like I said, I was new to new to diabetes. So I had to learn how Metformin worked. Yeah. So I'm like, Yeah, sure. Let me try that. I throw up left and right. Even on the lowest dose. Well, the first week I tried it, I lost four pounds. I was like, Oh, my God, I am not hungry. I feel great. Yeah, we to still on the point six through.

Scott Benner 30:27
Were you eating through it? I know. That's a weird term. But were you just pushing? No,

"Kat" 30:32
no, I just, I had it partially if I drive,

Scott Benner 30:36
so not good for you? Yeah.

"Kat" 30:39
I say sick if the wind changes directions, but then like, Tanzeem came on the market, then you had by Dorian, it was on again, we tried to answer him the weakest one ever tire on the market anymore. Threw up. So then like I would try low dose Manjaro. The 2.5 People say they tolerate a lot better than people do. In my, in my anecdotal evidence, people tend to tolerate low dose Manjaro better than it was epic. So again, you know, I got access to all this crap. I'm again to try Manjaro threw up on it. So not

Scott Benner 31:14
for you. Yeah, I mean, does that make sense? For me? Yeah. No, it makes sense. Um, look, I I've had people ask me like, Are there side effects. And I'm like, I'm like, I don't know that I've had like a bowel movement that I've been super excited about, you know, in a while, but I, but here's, here's my response to that I have a flippant response and a serious response, my flippant response is, I don't dislike a loose stool. More than I dislike being heavy. So like that, that to me is like, Okay, this is what this is, I also think that I have a perspective of my body is reshaping itself. And I think there's a lot of like, this is a very non technical way to say this, but I think there's a lot of badness inside of me, and it's coming out. And I don't think that that's going to be a smooth process. So like, I mean, I'm losing a lot of fat, a lot of fat. And I don't like and you know, if you eat a high fat, if you ate a low carb, high fat diet, you'd have loose stool, like that would be a thing that would happen. Right? Right. So I'm expelling a lot of fat. And that makes sense to me that my body is not perfectly balanced at the moment, but so many other things that have been unbalanced, our balance. So my expectation is, is that at some point, I'm going to have to get on a medication where I can vary the dose a little more. And that perhaps what I'm taking right now is maybe too much or not enough for like I won't know, but like that, I haven't found the answer yet. I also think there are likely other things unbalanced in my body that I'm not aware of. I'm also trying to look into those things as I go along. Great, yeah, but it's just it's to me, it's just, it's a science experiment. It's time you get to keep going. But then that's the problem, right is that I'm a person who a had access to the medication, it was paid for by my insurance, I have the access to food, I have a job where I can actually say to myself, like, alright, well, here's how I'll eat because I don't I'm not up at 6am. And running out the door. I you know, I don't get 30 minutes in the middle of the day to eat, like I have, like, my life is different. You know, and I think those things all impact them. And I think that those same stressors, impact people trying to change their diabetes as well. Absolutely, you know, so I think that our lifestyles, and I don't mean, like around food, I mean, our lifestyles, the way Americans lives work, and the food, the food that we have access to, and the time that we have to prepare it, I think those are the three issues.

"Kat" 33:49
That makes sense. Actually, your patients, you know, leave of absence from work. And they come back and you know, it was just wonderful. And, you know, I'm thinking of one of my patients type one on a pump. He's like, I ate well, I exercise, I didn't have the stress of my job. And, you know, I feel amazing, and my blood work shows it. He's like, Well, I gotta go back to work now. You know? Yeah,

Scott Benner 34:13
like she's all over maybe. Yeah. Yeah. You know, it's funny. I was wondering if you've seen this, before we move on. Let me ask you this question. My wife had an interaction with a person who's on ozempic or we go probably we go via I think it was just for weight loss. So we go v, right. And this person said that they lost like all this weight over like year and a half. And they were almost like down to a maintenance weight. Like they were at that back close to their goal. And they had also made changes she said, you know, that being on the medication had taught taught her how to eat better and like kinds of foods, amounts of foods, etc, exercise. And then suddenly, one day woom insurance calls and says, we're not covering this for you anymore. And so the person said, Well, I'm not going to panic. I am going to keep eating the way I eat, exercising the way I exercise I'm gonna keep doing the things that I've been doing, you know, all the lifestyle stuff. And she said that no lie, absolutely no lie. She started to gain weight slowly. And she's like, I did not eat anything different. I didn't do anything differently. My exercise my intake, everything was exactly the same. And my body just started to put weight on again. And that's how I feel like I am. That's who I feel like I am in this scenario, like this medication is doing something for me. I don't exactly know what it is. But it is filling a gap that I have that my body can't do by itself. That's what I see happening for me. So you see that with others is what was going to be my question.

"Kat" 35:42
I see it, I do. One thing about these medications is you people say I'm on this rest of my life. I'm like, yeah, it's some way shape or form, whether we lower the dose or maintenance dose, take it every 10 days instead of every seven days. Some people take it every two weeks, I have one of my co workers who lost weight on one Coby and she was happy about her weight, and she just stopped it. And then lo and behold, she comes work the other day, really throwing up all over the place. So what did you do? So I took a movie, I said, how she changed. She said, Oh, my, you know, 2.4? I said, What was last time you told me? She said June? I said, Oh God, you can't do that. You literally have to start back over from zero. If you give your body that much of a break. It's your girl. Yeah, so you should be told your practitioner, you know, should we telling you that these are considered lifelong medications even

Scott Benner 36:38
working there, she didn't know that, that you have to because you titrate Up we go visit example, you titrate up when you start taking you it's it's like a quarter of a was it point two, five milligrams to start, right. And then and then you it's four weeks of that and four weeks a point, five 4.7 5.6 Or one one to fight like it goes on forever to get to 2.4 is like a six month like March really to get to it. And so now 2.4 is the highest I will tell you, I don't think 2.4 is enough for me. Because I lose weight in the first four and a half days of the week. And then I put some of it back on in day 567. That's why I'm so all I lose three pounds every week. But my net loss is only point five. I'm

"Kat" 37:26
sure there will be worse clinical trials go with higher doses. It's just it just makes sense.

Scott Benner 37:32
Yeah. So it's just it's all of it's incredibly interesting. Also, I think it points to first of all, I don't mind talking about the GLP is I think it's a good conversation. But at the same time, I think that the plight of a person with a GLP deficiency if there is one, you know, pointing nine out? I don't think yeah, I don't think it's much different than a person who has type two diabetes, the struggle is my point. I think the struggle is very similar. Yeah, absolutely. My gosh, so then what's it like managing a type? Like? So this is a great example, because Jenny says all the time on the podcast, like she's like, you know, most adult endos don't see many type ones. So you said maybe at 515? Is your is your breakdown? So do you know a lot more about type two than you know about type one? Of course, yeah. Are type ones in the same sort of boat as type twos, meaning that they might lack education, access and or desire or ability to follow through?

"Kat" 38:31
Yeah, absolutely. I just in a funny story. You know, the reason what you put out the, the the reason I came was to talk about what happened, she come to the hospital with type one diabetes. I

Scott Benner 38:48
have two thoughts. And then I do want to go over to talking about hospital intake for type ones. Do you think type ones and type twos at a basic level are kind of suffering with the same problems like access, desire, ability, education, that kind of stuff?

"Kat" 39:05
So yes, but, and I talk, I don't want this to come out wrong, but my heart actually breaks for the type ones living where I live with for many, many years, there wasn't an endocrinologist in the city. So now I have people who are in their early 20s who have type one diabetes and did not have good care. So the long term complications, they have the blindness, luckily, and actually blindness, and the neuropathy, the gastric creases, and diabetes distress, the depression is which still there, it's there aren't great therapists or people who are trained to deal with diabetes distress. So that just breaks my heart. So to me It's just to a whole nother, to a whole nother level cat. Do

Scott Benner 40:03
you see those things with frequency at at younger ages where you're at?

"Kat" 40:08
All the time? Okay. potations through the roof through the roof people

Scott Benner 40:12
in their 20s who are blinded by their type one? Yes. And this is because they, so they have insulin. Is that right? Yeah. Okay. They don't know how to use it? No,

"Kat" 40:26
they don't know, I've had, you know, someone diagnosed at age five and just doesn't know the basics of diabetes rate basically hanging on by a thread that they don't, they aren't in DKA because they'll take full, full take for Basal insulin, but they haven't taken human log in a long time. Or they'll take it once every three, four days. You know, so just, you know, we live in an area we live in, in between Philly, New York. Yes, there's children's chop in Philly and New Brunswick and hospitals all we were back, you know, not having the parental support they may need not just, it's it was rough growing up in the city, and not having an endocrinologist not having someone to go to but yeah,

Scott Benner 41:12
yeah. So in that setting, the setting that you're that you're local to, there's not a lot of parental support, which leads to people growing up not knowing what they're doing, which leads to a really advanced diabetes Complications early in life. Yes, yeah, absolutely. How do you, if I gave you a magic wand and said, go ahead and help these people? What do you think would help them? Now they're in their 20s? They have all these problems? I know, they're in a different situation. But what would have stopped them from being in this situation? Should have been my question?

"Kat" 41:45
Well, I mean, it goes back to all the social determinants of health, you know, with the food, you know, access to food, just the education piece not being local and not being able to follow up. And again, unit technology, so much better now. But just not having just not knowing how important it is to know what your blood sugar is. Or they just don't know the complications, diabetes, erectile dysfunction, and somebody who's 26 years old, you know, is something I see is I talked about erectile dysfunction all day long, basically.

Scott Benner 42:21
To try to scare them into thinking if I take care of myself, I can keep having sex. Sure, yeah. That makes sense to me. But okay, yeah.

"Kat" 42:30
They're going to urologist and each one exists. But anyway, it's just the complications. Let's

Scott Benner 42:33
think deeper. I get what stops them. Right. I get their problems. I know, I heard what their problems are, I understand what they are. Let's say they still have those problems, is there a way to help them like it because you can't fix their problems, right? You can't pull them out of poverty, you can't give them a you can't give them a smarter brain. You can't give them a parent that cares about them. You can't give them all those things. You're talking around some stuff, but I hear what you're saying. Like, so you can't do those things for those people. Are they lost causes? Or is there something we could do for them? Like, is there something they could be told? Is there something they could be shown? That would like alright, yeah, they're gonna go to McDonald's before they go to the doctor. We can't stop them from doing that. But could we teach them how to Bolus for the McDonald's? Oh, absolutely.

"Kat" 43:19
Absolutely. And that's where I'm just gonna get at the CGM. Knowing what their shares I know, I just think, yes, I work with a team of people. I work with wonderful diabetes educators. We had to have tons of resources in our office, I love where I work. I love what we do. Just the education. And once you, you know, once they're engaged, they come and once they see progress, you know it, they're excited. So yeah, I don't think they're nervous because I just, I'm just so I just love the fact that that part of my job where I get to help and if they take one thing away from an appointment, hey, you're on a pump. Now, you know, I have aggressive the other day she was diagnosed at age five. She's never been on pumps. You know, I did what she knew even when a pump was how they worked. And she's been on one for a couple months now. And I just pulled up her CGM and her pump report and like, well, look what happens when you Bolus before you eat. Wow, I didn't have spikes and she doesn't have blood sugar in the 400 you know that she may peak to 250. But that's pretty freakin amazing when you lived in the 402 50s

Scott Benner 44:26
not great, but you're not going to be blind when you're 26 to 50 either like so you know, maybe it buys them more time to have an epiphany or to mature or to meet another person that can help them with their like it buys your time to do better. Well, it changed your

"Kat" 44:43
life because her stomach your gastric resists, like she couldn't eat she spent the first six hours she was awake, try not to throw up but now that her blood sugars are coming down and do much more steady. For some it feels better. So she sees it. It's that instant gratification that instant instant, but you know, she feels it now. Already, she feels better.

Scott Benner 45:06
Can I ask you a question? And this was not my intention when you came on. But is there a world where the hospital you work at would let me come give a talk to people in that situation to help them understand how to use insulin? Where would they never let a person in? Who doesn't have credentials? No, I

"Kat" 45:22
think you're open to it. I think they would be. Do you

Scott Benner 45:25
think that would help? Like, if we just did that like high level, this is insulin, this is how it works thing, here's why it's important. Like, give them an hour and a half of late and then let them ask questions and then send them back on their way is that is that because there's a part of me inside that thinks that the podcast is successful about management stuff, because it is very clear about when and how to use insulin, and why changes need to be made. Sometimes, depending on food, I'm saying this thing. I think one, if you're going to be amazed by how the podcast helps people, it's that I'm not having a two way conversation with the people are listening. So I'm able to like dispense the information in a way that they can pick and choose from and help themselves without being able to re ask a question. And without me knowing their specific situation. And I think that having figured out a way to do that, maybe that would translate to people who are in the situation that you've spoken about, like maybe that makes sense. I don't know if that made sense or not. But I mean, I'm I'm also not, I don't know, I'm sure that I'm sure you could do it, I'm sure there are plenty people that could do it. But I think that what they might need is for someone to like, instead of doing an a, you know, an appointment, if you did a large group, collection of people, if you just if you just said look like, you know, come out on Saturday at one o'clock, you know, there's going to be this there'll be food, like, you know, like make it enticing, like make it a thing. And you know, while you're here, someone's going to explain, you know, Pre-Bolus and your meals to you, or getting your carb ratio set or stuff like that, like real simple, basic stuff that they could maybe and then maybe have nurses and doctors there to actually help them get their settings, right, like on site and stuff like that. Like, it seems to me that if you did a health care, like a three hour health fair like that, you could make a pretty big impact. And then maybe you could start that process that I've started hear on the podcast, which is if you can get a core group of people to buy into the thing that's happening, they actually go tell other people about it. Because they're they're super excited because their life has changed. And then they meet another person with diabetes. They go you know what, I used to have this this, this is my problems, but I don't anymore, because I learned how to do this. It wasn't that hard. You know, like that. That kind of stuff? I don't know. Like maybe I'm being Pollyanna. Maybe there are some people who are just never going to be okay. I don't know, but it seems there are some

"Kat" 47:52
people are never gonna be okay. That is that is a yes, that is an accurate statement. Like,

Scott Benner 47:57
it's a harsh truth, right? You're just you're not reaching every little. Right? Like, they got a bad roll, and they're not gonna be able to rebound from it. Oh, yeah. And there's some people get a bad roll. And they find their way through it. There are some people who like stand up immediately and say, I'm not letting this happen to me. There's different versions of responses when somebody gets diabetes, for example. And a lot of that is contingent on things that outside people can't help. Is that fair?

"Kat" 48:22
Yeah. And it's also learned responses. Yeah.

Scott Benner 48:26
meaning they've, they've grown up with the idea that their life sucks, and that it's gonna go poorly, and so that when it does they just go okay, well, here's more of that. Yeah. Right. Now, that's upsetting, but I understand what you're saying. And I appreciate you being so direct about it, too. Thank you. Let's take the last little bit of this time and go over this, this piece here, right. So people type ones. I guess we should do both right. Type ones are type twos, they come into the hospital for something emergent. They should not expect anyone to really understand their diabetes. Let's start with type ones. They shouldn't really expect anybody to understand that their type one diabetes in the ER, is that right?

"Kat" 49:07
Absolutely correct. Okay. You are giving staff members way too much credit. I read all the posts in the comments. And no, please don't expect that you have to be your own advocate as a lot of people have mentioned. Do not take your pump off. Beg plead. Stand up for yourself, do not take your pump off. Unless there's an you are in DKA or have a severe hypoglycemic event. Or you know, obviously test some tests. But there is really, very few reasons why you would need to take your pump off. That is I when I were I'd work with a very so the two hospitals where I work. The one hospital is very robust. We have a diabetes test for force we meet once a month. We have inpatient diabetes educators. Who are amazing, which you do not find that in hospitals anymore when budget cuts happen, that is the one of the first positions that go it's a full RN salary. You know, asked around how many hospitals have inpatient diabetes educators and I will tell you, not many. I can think of 10 hospitals in the area. And where I work is the only hospital that has inpatient IVs educators. So nurses who will who will go see with the bedside, you have a CGM, when you have a form bond that you meet with you, they mature everything is, you know, per hospital policy, which means we know you're wearing it and everything's okay. Very, very few places have that tooting our horn a little bit further. When our nurses get oriented our dogs educators do in servicing to everyone that walks through the door. We do quarterly in services to our residents and interns. Having said all that, it's like whenever I have to say the nurses have a little bit more knowledge than nurses who don't receive our, our education, but there's so much more to be done. From the time that Scott that you posted about this topic. I could list so many stories to doing yesterday between that time and today. A week. You know, someone was under our care in the hospital like DKA How does that happen? It happens. Someone was in the ER came in by ambulance with a blood sugar 600 from a doctor's office seen by the doctor but the nurse didn't get to the patient patient didn't feel like waiting. Went home three hours later came came back the next morning and full blown DKA backup less than five super super sick. What happened someone the patient comes in on some pump hounds that ER staff come on insulin pump. Okay. Communication gets lost. The first provider on the hospitalist sees the patient document in the chart, insulin pump was removed. They gave the patient you know 3040 units Lantus. I remember the dose. A couple hours later, they're hypoglycemic. The nurse says oh look, no, they're they've got their insulin pump on it wasn't a pump. It was a CGM. Remember it's not disturbed. But anyway, the patient had the pump on gotta dosa Lantus. And the staff had no clue what that piece of technology was. This. This isn't a week.

Scott Benner 52:34
This isn't a week art. It was in the ER for something not diabetes related. And she had to go back once it was while she was at school people are going to hear me say this a lot because it's so crazy, but I'm gonna keep saying it here. So she was in the ER 12 hours one day, one day off 12 hours the next day, and in 24 hours of care over two visits. You should guess how many times they checked her blood sugar? Just pick a number how many things in 212 hour visits? How many times do you think they would have checked her blood sugar? Never. They never once checked her blood? No. Oh, Jesus, never. They never paid attention to the fact that she had type one diabetes the whole time she was there. And they put her on morphine when she got there. So she was not able to handle herself. Didn't check on her blood sugar. Trust me, they didn't know she was on an algorithm that's like fine tuned with an inch of its life or that I was managing it remotely through one of her roommates who was in the room. They didn't know any of that. They just never checked on her again. That was it was all just left up to chance. So and she came in, I have type one diabetes. This is my insulin pump. This is my continuous glucose monitor. These are my things. You would think that that would put her on a protocol where they would check on her but never they never even came in and said Hey, what's that CGM say your blood sugar is? Well never ever give those people that education but it doesn't stick to them. No.

"Kat" 53:56
Some. So when you get oriented to hospital, you're bombarded with speaker after speaker after speaker presentation presentation. That's what I'm talking it up to because the information was you know, was reviewed. It's simple. It's this is this the pump. This is a CGM. Please know what it looks like. We're here to help call us. So I'm losing. It's not better. But it's not great. It's not great at all. And again, we have these resources. I can tell you, there's other hospitals that don't even address this stuff. And we review every hypoglycemic event that happens in the hospital. We review every DKA event, you know, we review this stuff, we talk about it so we have root cause analysis. We haven't, you know, updated and improved and provided education. We know these things happen and they continue to happen.

Scott Benner 54:56
Can I ask a scary question and maybe we can As you do you do Nurse Education. So you're gonna have the, you might have the pulse on this one, put diabetes out of the out of the picture for a second. How many other things did the nurses not understand? Just so many. So our expectations of nurses is is incorrect. Correct? Yeah, yes. And then when you get to the doctor level, the doctor doesn't really see the patient that much. And is it also not true that the nurses can sometimes depending on the doctors, be afraid to go back and speak to the doctors?

"Kat" 55:32
Oh, absolutely. That mean that I have to admit, over 30 years of doing this, that culture has changed. I still say I do get a practitioner. I'm a provider. But I do get up if I see a doctor comment if there's no seat. And if somewhere else I can go I mean, yes, I get I still do that. It's I know That's old school have made but now the culture is you're not penalized for making an error. So it's we want you to know you're encouraged to speak up, they call them good catches. One hospital boy, where is you know, you report a good catch maybe the patient's date of birth, when the name brand name band didn't match up with what it should have been, like, you actually get recognized for that. They'll say, Hey, good job, your name gets put in a raffle, you get chosen, you get eight hours PTO time, like it's that culture is changed. And it's a whole read back and verify type thing. If I say to you get eight units. We're not allowed to give verbal orders anymore. By the way, it's got to go into the computer. But the nurse is supposed to dismiss a question everything and I, we do want to texting, you know, secure message. Hey, you said to give 14 to human world sounds like a really high dose. Is that? Is that what you want? I'm like, yes, thank you for clarifying. You know, so the nurses, it's a different culture these days, they are supposed to ask questions and not just accept something they think is wrong.

Scott Benner 57:03
I'm following up, though, on something another person said to me on one of these episodes, so is it not possible that some doctors are terrific, but some of them are kind of ego driven? And if I'm the patient, I'm like, Look, I need insulin. And the nurses wife talk to the doctor about it. And I said, well go talk to the doctor about it that the nurse may not be in the situation with like, I don't want to go talk to that guy. Because he is he's an asshole. And like, this isn't going to go well. And he doesn't want to be told what to do by the patient, let alone by me. And I know that's not going to happen. So I'll slow walk through this and try to forget about it. That's that stuff not happened to

"Kat" 57:35
us. But that's how nurse like look at your, you gotta look at yourself, okay, in that situation? And I'm saying, yeah, there's there's lots of nurses out there, there's nurse residency programs, where brand new nurses are hooked up with a mentor, and they have a nice year long orientation. But you know, at our hospital, there's 80 nurses in that residency program right now. And you combine that with 100. medical interns, you tell me, you know, who's leaving who here

Scott Benner 58:05
and people come through so quickly, so eat. So even if we like, even if we choose type one diabetes as an example, and say, Look, we're going to teach them, we're gonna give them a crash course on type one, it doesn't stick to them. It also leaves open about 1000 Other things that they don't understand that they you don't have time to give them a crash course on. So then emergency medicine really is just, we're going to ignore everything else about you. And the thing that's got you here trying to die we're going to try to get in front of Sure. Yeah, that's it. But is there a better way, honestly, or is that what it has to be? I

"Kat" 58:36
don't know if there's a better way, it's what it has to be right now. They will tell you it's because they're short staffed, you know, there's the throughput is slow, meaning patients are hanging out longer in the ER than they should. It's called they're holding in the ER er hold, we got 20 year holds. So now the ER nurses are taking care of the ER holder and they really should be taking care of the ER, true ER patients who have been triaged yet the patient's just aren't moving. Yeah,

Scott Benner 59:03
why are the holds not taken upstairs?

"Kat" 59:05
There's no room for him upstairs. Therefore, there's no nurses to care for him upstairs more. So it's because there's no, not room upstairs. There's just no beds available

Scott Benner 59:15
to space and staffing is a problem as well.

"Kat" 59:17
Absolutely. And it will, it will continue to grow. Yeah.

Scott Benner 59:21
Because there's more sick people than there is hospitals. Yeah, it's

"Kat" 59:25
seasonal. You know, we're, you know, it's that time of year where things are ramping up again, but yeah, better

Scott Benner 59:32
to get sick in the spring than in the winter.

"Kat" 59:36
Yeah, yeah. And some hospitals because of the staffing shortages. It may be a 200 bed hospital, but they're only staffed for 125 beds. So you can hold 125 patients, despite the fact you know, the hospitals went broke paying for agency nurses spent, you know, I can't even tell you the numbers the amount of money per month that they spent there. recouping from that. So they, they do what they had to do like close units to using the staff, they have staff beds that they can.

Scott Benner 1:00:08
So no different than when I go to a restaurant and there's tables, but they don't see me because they don't have waitstaff. Perfect.

"Kat" 1:00:15
Perfect. Yeah. Yeah.

Scott Benner 1:00:17
I say, Well, you've painted a lovely picture for us. Thank you so much. I'm so sorry. Sorry, no, this is what these what these episodes are gonna be the people in the medical field coming on telling the honest truth about what they say at work. So I appreciate you doing this very much. I really do.

"Kat" 1:00:34
You're welcome. I have wasted wasted.

Scott Benner 1:00:37
Oh, we did. We did fantastic. You were great. I liked the mix of of talking about, you know, in the hospital talking about, you know, in the office, talking about significantly underserved people at the same time. And you were really honest about a lot of stuff. I'll tell you the one thing that bothers me is that when we talk to people, we say like, well, what would fix this? And you say, Well, the problem is that they don't have this and they don't have that, and this isn't the way they grew up. And I'm like, Okay, what then? Then there's no answer after that, like you, people are incredibly good at pointing out why things are going wrong. Not very good at stopping them from going wrong. Or, or saying, Look, we can't stop them from going wrong. But here's what we could do next. We seem very good as a society at saying, Well, you know, that person, they this is what happened to them. So but nothing we can do. You know, like and that is where we get to we get to nothing we can do. And maybe that's true. And maybe it's not. That's kind of what I'm trying to get at. I'm trying to find out if there's something more that can be done. Or if really it is just sometimes life is just luck of the draw. Yeah, so anyway, this is a bummer. I'm gonna go hold on for me once. Sure.

If you'd like to wear the same insulin pump that Arden does, all you have to do is go to Omni pod.com/juice box. That's it. Head over now and get started today. And you'll be wearing the same tubeless insulin pump that Arden has been wearing since she was four years old. A huge thank you to one of today's sponsors, G voc glucagon, find out more about Tchibo Capo pen at G Vogue glucagon.com Ford slash juicebox. you spell that GVOKEGLUC AG o n.com Ford slash Juicebox. Podcast. Once there was a time when I just told people if you want a low and stable a one C, just listen to the Juicebox Podcast. But as the years went on, and the podcast episodes grew, it became more and more difficult for people to listen to everyone. So I made the diabetes Pro Tip series. This series is with me and Jenny Smith. Jenny is a Certified diabetes Care and Education Specialist. She's also a registered and licensed dietitian and a type one herself for over 30 years and I of course, am the father of a child who was diagnosed at age two in 2006. The Pro Tip series begins at episode 210 with an episode called newly diagnosed are starting over and from there all about MDI Pre-Bolus Singh insulin pumping, pumping and nudging variables exercise illness, injury surgeries glucagon long term health bumping and nudging how to explain type one to your family. Postpartum honeymoon transitioning all about insulin Temp, Basal. These are all different episodes, setting your Basal insulin, fat and protein pregnancy, the glycemic index and load and so much more like female hormones and weight loss. Head now to juicebox podcast.com. Go up in the menu at the top and click on diabetes pro tip. Or if you're in the private Facebook group, there's a list of these episodes right in the feature tab. Find out how I help keep my daughter's a one C between five two and six two for the last 10 years without diet restrictions juicebox podcast.com Start listening today. It's absolutely free. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com

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