Scott Benner 4/27/25 Scott Benner 4/27/25

#1505 Best Of Juicebox: Bump and Nudge II

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

Diabetes Pro Tip: Bump & Nudge II was originally published on June 29, 2020 and is part of the Diabetes Pro Tip series.

+ Click for EPISODE TRANSCRIPT

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.

COMING SOON

Please support the sponsors

The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!

Donate

Scott Benner 4/26/25 Scott Benner 4/26/25

#1504 Best Of Juicebox: Fear of Insulin

Bold Beginnings: Fear of Insulin was originally published on Jul 08, 2022 and is part of the Bold Beginnings series.

+ Click for EPISODE TRANSCRIPT

COMING SOON

Please support the sponsors

Donate

Scott Benner 4/25/25 Scott Benner 4/25/25

#1503 Fox in the Loop House: Part 7

Ken demystifies the Loop algorithm—how that squiggly prediction line works, when it cuts basal, and when it adds insulin. With clear talk on correction ranges and timing, he ends the confusion over why Loop acts when it does.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Welcome back, friends to another episode of The Juicebox Podcast.

Kenny is back, and don't forget that you can find Kenny at Fox in the loophouse.com today, he and I are going to talk about some details around how the loop algorithm works. We're going to talk about correction ranges and overall, this is just a nice episode to make you even more comfortable with how the loop algorithm functions. 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. A g1 is offering my listeners a free $76 gift. When you sign up, you'll get a welcome kit, a bottle of d3, k2, and five free travel packs in your first box. So make sure you check out drink a G one.com/juice box. To get this offer, 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 Juicebox at checkout. That's Juicebox at checkout to save 40% at cozy earth.com my grand rounds series was designed by listeners to tell doctors what they need, and it also helps you to understand what to ask for. There's a mental wellness series that addresses the emotional side of diabetes and practical ways to stay balanced. And when we talk about GLP medications, well, we'll break down what they are, how they may help you, and if they fit into your diabetes management plan. What do these three things have in common? They're all available at Juicebox, podcast.com, up in the menu. I know it can be hard to find these things in a podcast app, so we've collected them all for you at Juicebox podcast.com Today's episode is sponsored by the tandem Moby system with control iq plus technology. If you're looking for the only system with auto Bolus, multiple wear options and full control from your personal iPhone you're looking for tandems, newest pump and algorithm. Use my link to support the podcast tandem diabetes.com/juicebox, check it out. The show you're about to listen to is sponsored by the ever since 365 the ever since 365 has exceptional accuracy over one year and is the most accurate CGM in the low range that you can get ever since cgm.com/juicebox, have you heard me talk about how I I don't even know how I accomplished getting Victor Garber on the podcast and like, the first two years of the show, right?

Kenny Fox 2:36
Oh, yeah, yeah. And then you only recorded one side, or something like that. My side.

Scott Benner 2:39
I just recorded me. It was horrifying. And he was nice, of course, he came back and did it again, but, yeah, I got like, you know, like, the first, like, genuinely famous person who has type one diabetes to come on the podcast, and super excited. And he's like, you know, doing it in between shooting a TV show and something else he's doing. And, you know, right, I have somehow his home phone number, like, this whole thing has been very kind, and the whole thing recorded, and I get done, and I'm like, Oh, God. Like, oh, it's like, his voice isn't there. I didn't know what to do, so I actually called the number I had for him and said, I'm so sorry. I just wanted to let you know this is, you know, a huge mistake on my part, but, you know, and I explained it to him, and he goes, Oh, he goes, we'll just do it again. And I was like, Oh, thank you. Just so nice.

Kenny Fox 3:23
Just really trying to nail down any other like celebs or athletes or anything.

Scott Benner 3:27
No, I haven't, I have to tell you. And by the way, Kenny, we're being recorded. I might leave this in. I don't find that episodes with famous people are any more or less popular than episodes with people who, you know, just want to be on the podcast. So it's a lot of work and effort to get people on, and then sometimes they don't know the first damn thing about their diabetes. They just happen to have it. And then people get frustrated by that, and I also think it can put them in a bad light, and I think that's unfair to them as well. So and some of the other famous people that people want to have on I've been around, and some of them are just boring, like, and then they they're so, like, guarded, and they don't want to say anything. So it just ends up being not good. I loved there are some people with a measure of fame who I thought had been great on the show. Charlotte Drury was awesome. And the girl from the TV show with the witches, Jennifer stone, she was awesome on the show. She was on Wizards of Waverly Place. Oh yeah, she was really I thought she was terrific. I'd have her on like, every week if I could. I don't think she would want to do that. But anyway, Kenny pack for Episode Four. What are we talking about? Today? We're

Kenny Fox 4:49
going to talk through a little bit of detail around the algorithm, how it performs. I want to talk about kind of the basics that make up that crazy line people see that is the the future. Answer that loop predicts, and then how and when loop adjusts, how, when it can take away basal, and how and when it it gives insulin extra insulin. And that will basically talk about correction ranges. Is all this will be a good episode for just some of the mechanics of how it works and what to expect. Kind of bullet expectations around when loops going to do stuff, and can help explain why people get confused. Okay,

Scott Benner 5:22
you dive in. I think we're gonna keep doing this the way we've been doing it. Obviously, the bulk of the information is coming from you. We're working from your notes, and I will say things that I find useful along the way.

Kenny Fox 5:34
All right, sounds good. Other the basic prediction elements people can find this if they tap on that graph on the same like the home screen of loop, that blue one gives them four pieces they can toggle on and off. It doesn't actually turn anything off. It's just letting you see what each piece is, how it's influencing the prediction. That's probably the easiest place to see it and loop docs, it's covered a fair amount, but we've talked about insulin, and people mostly understand how insulin works. It's, you know, got kind of a peak around 90 minutes and fades over six hours. So that's kind of understood, and we've talked about that. We talked about the food in episode two, about how loop just assumes that your food impact is going to be spread out over a certain time window based on the absorption time that you enter, with most of that impact being expected up in the front part of the meal. So those two pieces, most people know pretty easily, and usually when you toggle those on or off in your prediction, you'll see pretty dramatic changes, because those are kind of the main things and influencing where your blood sugar is going, whether you're using loop or not, food and insulin. And the last two pieces are the ones that I'd like to take a couple minutes just to cover real fast. And it's we have the retrospective correction, which is a big, fancy word that basically just means we're looking back at the last, I think it's 60 minutes or so, and looking at what happened versus what loops thought what happened at a high level. It's just saying, hey, in the last 60 minutes, How often have I been right versus what actually happened? And based on that difference, let's say you end up higher than loop predicted, then it'll say, Okay, let's raise the prediction up a little bit higher to make up for the fact that that didn't, it wasn't what loop expected. And so it's not a huge modification. It does just kind of bump the prediction up, but usually a couple points. Nothing crazy.

Scott Benner 7:23
Is that there to help with? If it's the third day of a site versus the second day of a site like that kind of stuff is like, because it looks back and it says, What? Like, I thought you'd be 160 by now, but you're 170 I'll be a little more aggressive. Or you're lower than I expected, I'll be a little less aggressive. Is that really what it's doing this episode of The Juicebox Podcast is sponsored by Eversense 365 and just as the name says, it lasts for a full year, imagine for a second a CGM with just one sensor placement and one warm up period every year. Imagine a sensor that has exceptional accuracy over that year and is actually the most accurate CGM in the low range that you can get. What if I told you that this sensor had no risk of falling off or being knocked off? That may seem too good to be true, but I'm not even done telling you about it yet. The ever since 365 has essentially no compression lows. It features incredibly gentle adhesive for its transmitter. You can take the transmitter off when you don't want to wear your CGM and put it right back on without having to waste the sensor or go through another warm up period. The app works with iOS and Android, even Apple Watch. You can manage your diabetes instead of your CGM with the ever since 365 learn more and get started today at Eversense cgm.com/juicebox, one year, one CGM. Let's talk about the tandem Moby insulin pump from today's sponsor tandem diabetes care, their newest algorithm control iq plus technology and the new tandem Moby pump offer you unique opportunities to have better control. It's the only system with auto Bolus that helps with missed meals and preventing hyperglycemia, the only system with a dedicated sleep setting, and the only system with off or on body wear options. Tandem mobi gives you more discretion, freedom and options for how to manage your diabetes. This is their best algorithm ever, and they'd like you to check it out at tandem diabetes.com/juicebox when you get to my link, you're going to see integrations with Dexcom sensors and a ton of other information that's going to help you learn about tandems, tiny pump that's big on control tandem diabetes.com/juicebox the tandem Moby system is available for people ages two and up who want an automated delivery system to help them sleep better, wake up in range and address high blood sugars with auto Bolus. It's really

Kenny Fox 9:59
just in the. Last hour. It's just saying, hey, stuff didn't go quite the way we expected, and so we should probably add or subtract some points based on that. Okay, so it's not anything bigger for the bulk of the day. I mean, it will help throughout the day. So even if you end up going lower and loop thinks you're going to go higher, it does kind of temper its rise prediction based on the fact that you are a little bit lower than loop expected, or maybe a lot lower than loop expected. That's really all it's doing. It's nothing super fancy in the code. You can some people played around with extending the window of time. It looks, I think, actually, retrospective correction is looking back the last 30 minutes, and it pushes the influence over the next 60 minutes. So it's a very mild like bump in blood sugar over the next 60 minutes of the prediction. So nothing too big, but there is an option that's available in the current version of loop called integral retrospective correction. It's basically just using slightly more aggressive calculation to say, hey, you were higher than expected or lower than expected. Let's move your blood sugar a few more points than we did with the regular version. It does help a little bit more. It can be more aggressive when my daughter was six, seven years old. This feature has been around for quite a few years, but it just got added to the main branch as an algorithm experiment, just so people know where to find it in the settings. But when I had it on when she was younger, I felt like the spikes up from, you know, just being a little kid eating food and jumping up real easy would make loop over correct when I had that feature on and ended up causing a low that wouldn't have been there if I used regular retrospective correction. So just be careful with turning it on, and try not to mess with too many other things at once. And run it for a day or two and see how it goes. But for the most part, people appreciate the change, because the biggest issue is when you're stuck high or stuck low, and so making this system be adjust more aggressively based on, hey, you were really low instead of high, or you've been high instead of going low, is helpful just to turn that up a little bit. So

Scott Benner 11:55
when you talk about that, like, how many people do you expect are actually digging around in the code and making changes, versus the people who just kind of use it out of the out of the box, as it were, oh yeah,

Kenny Fox 12:04
changing the code. Very, very few people. That's why it's nice that the integral retrospective correction feature was added as an option to turn on in loop. So people can, if they want to play around with it, they can. They don't have to do any extra coding to add it all in. So

Scott Benner 12:19
is there a setup that you prefer for people to start with? Like, you know, we talk about like, you can turn this on or you can turn that on. Do you have like, in your mind, a checklist of like, yes, this on, no, that not on. Like, when you set it up for someone? That's a

Kenny Fox 12:33
good question. So if we're talking about added features, would be one thing we can look at where they kind of called Code customizations, the new build scripts that have been out for a while now add the option to say, Hey, I just want this customization by either typing in a series of numbers in your X code build, or adding a couple of phrases to your browser build, I really like the bulk of the ones that are available in the loop and learn script. And there's actually a bunch on the loop and learn.org page under code customization that tells you, like, hey, copy and paste this block of text into the browser. Build to get you started, and you kind of tweak the ones from there, the ones that come to mind as the ones I find the most useful is allowing you to enter carbs further into the future. There was a restriction added a few years ago to limit insuring carb entries more than one hour in the future, because some people had some problems where they put a large carb entry way out, and the system just kept dosing and dosing and dosing every time their blood sugar would go up. So I understand the safety, but we talked about in episode two about fat and protein, and that impact is showing up around 90 minutes two hours. So it's really helpful to be able to put fat and protein entries out a couple hours from now, so you don't have to think about it later. And so there's a customization for that that kind of reverses that safety constraint. I think that's one of the biggest ones. There's a few others. If people eat large meals, if they're always eating more than a regular eating more than 100 grams, then you can there's a warning that shows up in loop that says, hey, you're entering a large meal. Are you sure about this? And it could be bothersome, I guess, if you ate low carb or high carb, and you were or were not getting those warnings. So you can add a warning that says, hey, 50 grams is a large meal. Double check if this is right. The default is 100 and the one you can change to you is 150 and then the other one that I really like is the changing the lollipop, the fast entry time from what is currently the default of 30 minutes. I think it set the two hours. And the customization I like to do 90 minutes. But if you're not going to mess with the code, you just want to click a button, then the two hour absorption time for the fast entry I find more useful just because there are things like fruit and other stuff like that. That's I think it fits better. The idea behind the 30 minute absorption time was that it was a safe way for people to enter low treatments. If they made a really short absorption time loop, would expect a rise, and then that rise would have. Because you treated with something really quick. And this actually goes into the retrospective correction. The idea was in retrospective correction wouldn't kick in and try to over correct because it expects you to kind of jump up real fast from like a glucose tab or juice or something. But with a 30 minute absorption, it would fade super fast. So even if you took a bunch of carbs, loop, wouldn't really have a long enough time window to see all those carbs and try to dose for them, but at least it would say, Hey, you're going to bump up real quick, and that's okay. I expect that, no problem, and it wouldn't be any retrospective correction coming in, which so I appreciate the idea. I really just think loop needs a dedicated low treatment button that does that because there's too many other use cases for fruit and maybe really quick acting candy or drinking juice, just on its own, just because you want to a better fit, is the two hour time frame. So those are the main ones I'd say are a big deal

Scott Benner 15:50
in that scenario. The treating a low blood sugar, I would set like overrides. Instead of it correcting and targeting. I don't know what whatever I had at targeting 85 or 90, I would set the target to more like 150 or 160 because it's the worst thing in the world. It's like, you get low. Finally, you get our blood sugar to come back up. And you know that a lot of that number is probably going to get eaten up by the insulin that caused the low. At least, you want some time to wait and see if that's what's going to happen or not. And then you're just like, oh, we fixed it. And then all of a sudden, you're like, why is it Bolus thing? Why? Like, no, not yet.

Kenny Fox 16:23
So yeah, we'll get we'll get to that here in a sec, but actually we'll break down why that works, and when you'd use it, which activity is a great time? Or treating a low is a great time to use a higher direction range or target override. That's really going to be probably the core of what we're going to talk about here. But before we leave the customization. Since you brought it up, I'm checking here, and I'd say some people really find the profile save and load feature. If you miss having be able to load profiles of different basal rates and carb ratios. I don't use that one, but I know a lot of people do. That's a big one. The other stuff is, is all fun? There's a live activity. It's a geeky iOS feature that's existed for the last two versions. Or you can create, like, a widget that you put on your home screen on your iPhone that pulls in loop data more frequently, so you don't actually have to open the app and kind of see what it's doing. So you can turn that on in the customization. That's more of a new feature that I think people are are liking. I i added it just the other day for my daughter, and she thinks it's kind of fun to look at so well, thank all right, I may get her to look at her numbers. I guess that's great, right? So

Scott Benner 17:23
Kenny, living through the time where that's still fun, that's awesome for you.

Kenny Fox 17:29
Yeah, we'll see it's but I'm it's changing already. So, yeah, retrospective, correction, just again, just trying to make adjustments for what really happened versus what loop thought would happen. The last piece of the prediction element is, oh, momentum. That's right. So momentum is kind of what it sounds like. It's the idea that if your blood sugar is moving up quickly or moving down quickly, it's probably not going to really slow down a whole lot. It's going to keep doing that for at least a little while. So this piece is really influential, sometimes more influential than I would like, where, if you start going up quickly, it makes sense that the whole prediction would kind of like slide up, would aim up a little higher, because you're accelerating from, like a steady number to a more faster rise number ends that would often, not always, but often result in loop dosing a little bit extra, which is great, right? You're going to eat food, you go up a little faster than expected, and loop should add a little bit of insulin. And if you drop relatively quickly, you start picking up speed. As your blood sugar is dropping, it's going to shift the whole prediction down a lot lower. And so it's loop is far more likely to turn off the basal, which, again, is something we really want. If you're dropping relatively quickly, you'd like the system, even if it's just one reading, you want the system to think, oh, maybe we should turn off the basal. And so I think that's, it's a really big deal. It's influential in the system. It tweaks the first like, I think it's 30 minutes or so of the prediction fairly aggressively, depending on how fast you're moving, and if you're steady, it's not really going to change the prediction elements a whole lot, because it's going to say, Okay, we'll just keep going flat for a while. So that's a big piece. And I think some people need to realize that that isn't always a setting problem. If they end up going a little bit higher, a little bit low because of the momentum. Sometimes momentum is very influential. If you have a sensor that's kind of jumpy, or if you were exercising, or you had something like juice, or something that hits kind of fast, so sometimes you don't have to, like, panic about, oh, I need to change all my settings because I went a little low or went a little high. Sometimes it's just because loop over corrected or under corrected based on the speed of your blood sugar, and they just influence the prediction a lot. So don't panic. Don't basically what I like to tell people, how

Scott Benner 19:34
many times do you want to see something go unlike you expected before you start thinking about settings?

Kenny Fox 19:40
Good question. I mean, I still think there's a lot of trust. What you know is going to happen, is going to happen right layered into this like last night, Tessa is is fighting an illness, a stomach bug, so she's needed a lot less insulin for her food, and her basal is dropped a little bit, and I'm expecting it to go back up now that she's eating more and feeling better. At her. She got a little sticky last night, she got high, kind of Rose of, she went to sleep, kind of went up to like 171 80, and I gave significant boluses, enough that I should have expected it to start coming down within an hour or hour and a half, and it didn't. And I because I even got impatient and gave more in less than an hour, and it just leveled off, and then kind of started to go back up again to, like, 190 so at that point, it's either going to be, in my mind, it's either I totally miscounted the food, which she had a really light dinner, so that probably shouldn't be it, or it's going to be bad pod site or basal. And the site's relatively new. She didn't do anything physical yesterday that would have, like, nudged it or bumped it and tweaked it. So I went with, I don't know it's probably the basal. Now, normally I would wait, normally I would Bolus a bunch more, wait for it to settle, and then look at her iob, like we talked about in the first episode, and adjust basal based on that. But I was tired, I wanted to go to bed, so I threw on I increased her basal a couple clicks and Bolus a little bit more, and then I set an override, which we'll talk about here, in a second of slightly higher correction range, in case I increase the basal too much. So for me, I only waited a couple of hours, maybe three or four hours, but I would say, in general, usually at least a whole day, if not a second day, is fine as a guide. But I'm getting to the point where I can usually make adjustments within the same day, within a few hours or half a day goes by and suspect there probably needs to be something to change. And I'd say 80, 90% of the time, I'm right. There's still times when I change a setting, it's like, oh, well, I didn't need to do that. Some of it, you just have to make sure, as a caregiver, especially, that you're getting all the information. So my go to when we're running higher, for example, or even lower, actually, is fine. I just double check, Hey, what did you actually eat? You didn't send me a picture of it. What have you what kind of activity were you doing? Were you moving around? I didn't know about it. And just try to eliminate those obvious variables. And then if nothing crazy comes up, then we might make a change, especially if it's like known meals we talked about before, then I'll make adjustments very quickly. We have a certain set of food Tesla tends to eat on Sunday, so if Sunday morning doesn't go well by lunchtime or before, we're changing settings where I'm checking the pod or whatever, because it's very mild food, it's like a smoothie, basically. It's very easy to for us to dose for and it doesn't cause a problem. So if there is a problem, we know we need to change something. So definitely dependent. Is that a fair answer? Yeah,

Scott Benner 22:30
it is. I mean, that there's no, like, rock solid, like, it's this many hours. I also think that it's important, you know, to kind of reiterate something you said a little while ago, that if it's just a thing that's happening in one scenario, if you're always in that scenario, then fair enough. Maybe your settings need to be changed. But if that scenario only pops up every four days, there's still consistency there. But maybe you have to make a physical adjustment to your approach instead of an adjustment to settings. If that's not a thing that's happening at every meal. Yeah,

Kenny Fox 23:02
and food. Food is the single largest variable, right? And we're gonna get it wrong. Get it right, it changes that. So it's you always kind of want to blame the food, you know, check the basal, check the pod site, then blame the food first. And if it's not reasonable to blame the food, then you can move on to settings. But usually that's where most of our adjustments stop. Right? Was basal. Right? Is the pod site looking okay? And where do we mess up in the food? And that's kind of the end of the conversation, right? Make an adjustment and move on.

Scott Benner 23:29
So I hear, okay, well, speaking of that, go ahead and move on. So that's the basic elements

Kenny Fox 23:33
of the prediction. And now we can talk about when loop makes adjustments. There's a section called Automated adjustments in the loop docs. I have a video on loop and learn about this as well. I think it's called something like, how does the loop algorithm work? And it's one of my videos where I step through this section of loop docs. I'm just going to cover it briefly, because a lot of it would be visual, and graphs are super helpful. But the four basic changes loop can make is it can decrease the insulin it gives which, by and large, is kind of intuitive. Is if your prediction says you're going to end up lower than your range, that you've defined the correction range that you set in the system says, Hey, I kind of want to be in this range. We'll talk more about what that means in a minute. But you're oftentimes, people are picking, kind of, you know, 100 to 115 or 120 or like an 80 to 85 to 100 or 90 to 100 sort of numbers for this sort of range. And so if your prediction says, in six hours, you're going to going to end up a little bit lower than your correction range, then it makes sense. The only way to get your blood sugar up is to turn down the amount of insulin you're getting. So it turns down your basal pretty obvious. The next one is increasing your basal rate. If you're using Temp Basal mode, or if it's auto Bolus, we're going to give insulin automatically. The initial description of that is an oversimplified version, is if your blood sugar is current, blood sugar is higher than your correction range, and your prediction is all. Higher than your correction range, and you're going to end up higher than your correction range. It's all high. Then obviously loop says you should have insulin, and so it will dose that for you that's allowed to do that, and we've talked about it before, where there's automatic Bolus, which does 40% of whatever that recommended amount is to get you from where you're predicted to be to where your correction range is. And then there's the glucose based partial application, gbpa. Fancy version of Audible is it just says, Hey, if you're really high, if you're higher than your correction range substantially, then we're going to increase the percentage that's going to get you to your correction range faster. That's all. It's just how much it's going to give so again, loop says you might need a unit to move you from where you were predicted to be to where you want to be, and it's only going to give, you know, a little less than half of that 40% so just on its own. And then in next five minutes, it'll do it again and again and again. But if you were to check the Bolus button, that orange double arrow in lube, you'd see the full amount and say, hey, yeah, you can give a unit and it will, you know, let you dose it. Otherwise, automatically, it's just going to do a portion of that. So pretty simple, the zero basal rate, or turning off basal altogether, is the third option, and that's if any part of your prediction, whether it's the end or like the near term, or somewhere in the middle, if the prediction line goes under your glucose safety limit. That's kind of like a like a hard stop, the hard ceiling for your blood sugar. So if you're predicted at any point to go below that line, that number, then the system just says, All right, we're going to turn off the basal altogether. That's the most we can do to put the brakes on this thing and it turns it off. So that can be a little frustrating for some people, when they're using these long absorption times and doing fat and protein like we discussed, where you start to kind of dip down a little bit, and that momentum kind of makes a lower inflection point in the prediction where it's dipping down low, and so then it turns off the basal but that's also a really cool feature, because you the fat and protein impact of these longer meals, or pasta or something like that. It's spread out and can be a little unpredictable. So sometimes any movement down can force the basal off, and that's okay, just know that's that's happening, and no big deal. So those three are pretty easy to understand. When you're high, you need more insulin wants to give you more. When you're a little bit low, we're gonna end up a little bit lower than desired. It'll pull back your basal. And when you're going to go lower than your glucose safety limit, then it just turns it off. The more useful example that you see in loop Docs is something called resume basal rate. When does loop decide to just leave the basal rate on and run life as normal? And some of these you only see more frequently at night. But if you're the oversimplified version is, if your blood sugar and the whole prediction are all kind of hanging out inside your correction range, let's say 100 to 110 then Luke just says, okay, like we're good. We're going to land in the safe zone. And our whole predictions in the safe zone. So cool. We'll just turn on the basal and, you know, just run do nothing, which is great. Sometimes it seems like that doesn't happen very often, but that's what it's going to do. But the other interesting part about when loop chooses to just turn on the basal rate and essentially do nothing is a situation where your blood sugar might be in or maybe slightly above your correction range, but your prediction goes below your correction range. So let's say you're starting at like 120 your correction range is 100 to 110 and you're like, we entered fat and protein and stuff, so you're going to see a dip in your prediction value. Just say, Oh well, the prediction is going to dip down to like 80. Nothing crazy. Not going to turn it off or anything. But then it very quickly rises back up again because it's waiting for the rest of that fat and protein to show up. And so let's say your eventual blood sugar is like 150 so you you do need some insulin to avoid going high later. And in that situation, you might even check the Bolus button and loop and it'll say, Yeah, sure. You need, like, a unit. That's cool. You could deliver it if you wanted to. It'll give you a warning on the Bolus screen that says, hey, like, you could give this unit, but your prediction says you're going to go below your your range. You said you wanted to kind of stay in just heads up, like, be careful. But that also means that same warning means that automatically, loop won't choose to give that insulin. So even though your prediction loops even recommending a Bolus, the system won't give the insulin for you. It's just going to say, Cool, yeah, you you could use a unit, and it wouldn't send you below your safety limit. But I the system are not going to be responsible for create, making this prediction come true and pushing you below your safety your range you want to be in. So it won't give any insulin. Those are situations where people can sometimes get frustrated and be like, Why does loop predict or recommend a Bolus, but it's not giving anything. And that's kind of that, that thing where the system is going to air on the side of caution, but if you checked for a Bolus and you really wanted to give it, you can go ahead and give it.

Scott Benner 29:51
I think my most frequent text sent during high blood sugars is suggested. That's all it says, just Yeah. But. Ever suggest that just do it? Yes, yeah. And, I mean, listen, I understand why the it's not just Luke, by the way, I recall on Omnipod five the same thing, you know, and I'm sure on others as well. So I get it, but that's where you have to come in and say, I mean, I've lived through this before. I know what's gonna happen here, like this thing thinks it's coming down, it's not coming down. There's not enough basal to make it come down, one way or the other. I need to get this insulin in somehow. I would also say that in some of those stuck situations, I'm a fan of pushing, just pushing the basal and but there are times that I look at all the insulin on board, and I factor in how long the food's been in, or you know what it's doing, and there's no basal, and I think to myself, I know, if I just put the basal back on here, with all these other things happening, blood sugar is going to start falling immediately. When it happens, it almost feels like it happens too quickly. It feels like you're balancing on a line, and you're never gonna fall, unless somebody blows on you, and then, like, for sin, you tumble right off. You put that basal on, and you get a diagonal down arrow in, like, 510, minutes. Just crazy, yeah, but I don't know. Like, there are times I think, like, Am I seeing what I'm seeing, or have I just waited so long that this was about to fall anyway? And now it feels I can never tell, but, yeah,

Kenny Fox 31:26
that would peak is hitting or something, but it always feels like, you know, you're you did something, and all of a sudden it changes in five or 10 minutes or 15 minutes, I

Scott Benner 31:33
swear to you, I don't know. I don't know if it's like, I'm like, is it the thing I just did, or was this gonna happen anyway? And you know, she doesn't get low afterwards, so I guess whatever. But yeah,

Kenny Fox 31:43
it works out. I have another scenario to talk through. But I think if we take a look at this discussion here, where you know you're gonna probably not, you could be high, or you could just be, like, a little higher than your range, and your prediction drops in the middle somewhere. It's a good time to talk about something you could do if you knew this was going to happen if you knew the rides can become a little more soon, a little sooner than than loop expected, you could do one of two things, right? You could take the recommendation which is a good place to start if you want to kind of be hands off a little bit more, you could set an override. So we'll talk about overrides for a second. Overrides allow you to temporarily change the sort of settings that loop is using. And the main thing I use overrides for is just simply it says, In the override screen, when you set one up in the heart icon in the main screen, it calls it target, but the target is the same thing as correction range. I don't know why the text is inconsistent, but if I use the word target or correction range, they're interchangeable. But essentially, what we'll do is we'll create an override that maybe has a lower target, like a target, say test says gluco safety limit is 70. I have one called Target 71 just remember what it does and all it does that slides that correction range down to 71 for like an hour. What that does, in the case we described where, like, you're just dipping down to like 80 and coming back up, is it says it moves that that line, it moves the correction range. Now your entire blood sugar prediction is above this correction range, and so now it's in a situation that we talked about earlier, which is, oh, I can give insulin automatically. It's, it's cool, everything's above the range. I can go ahead and dose automatically, but less aggressively than I would if I just hit the Bolus button and gave it. So I'll do that for certain meals. I'll do a going into a meal. In case the loop aims a little bit lower and and if she's kind of coming down into a meal, it can be more aggressive in giving insulin sooner. So she pops if She slides down, she has PE before she eats lunch. And so if she's diving down, the momentum of her blood sugar drop will usually tell loop not to give any insulin, or maybe give less when she at times she gets the cafeteria. So if I if I just pop on the target 71 for an hour, when I happen to notice it, it's the nice thing about running it for an hour is if I notice it while she's dropping, or I notice it right around lunchtime, I can put it on or she can do it. I'm trying to teach Tessa to do this too. Is that if she does dip down, and then once she starts eating, starts to level out edge. Let's see she levels out at 75 Well, her normal correction range is like 85 or 87 so loop wouldn't be allowed to give any insulin automatically, and Tessa's not going to check for a Bolus after she's eating and talking with her friends and doing her thing. So if we put on an override that bumps the range all the way down to like 71 once she hits 75 and levels out, at least loop can start giving some of the insulin lower numbers sooner. And it's totally appropriate, because loops being safe, saying no, she's dropping into this meal. So I don't want to give anything, but I know she's walking across campus and in line and getting her food, she's not running anymore in PE by time she slows down then eats, the system can start to deliver at a lower number as she starts to come up, so at least we're not totally late to giving insulin sooner. So that's a really neat tool. When you think about when loop is allowed to give insulin automatically, versus not the other. Your scenario would be, let's say you start at this like lower number, like Tesla was at 71 and you're going to go, your prediction is set to go higher than your correction range, but you're starting under your correction range. So loop might suggest some insulin, but in most cases, it won't suggest a whole lot. And automatically, the system is not allowed to give anything until your blood sugar gets up into your range. Well, that could be 1520 minutes after your maybe 30 minutes after you've already entered the food. And so now you're really late to the game getting insulin, and you're the food's got a head start, like too big of a head start, so you start shooting up well past your correction range, and the loop starts finally dosing. So that's why it's nice to be able to lower that number and but conversely, like we discussed a little bit ago, and when you're treating a low or going to be active or something like that, you kind of create your own activity mode, if you will, in loop. And I create a couple of target based overrides to just change the correction range to, like 150 I ended up just recently creating a 180 and, like a 220 which initially was like, I don't want Tesla's blood sugar to be that high, but it is serving a purpose, where I put those on the essentially, what you're telling loop is, even if you predict a rise loop, even if you say you're going to go to, like, 250 your only thing you can do is turn on the basal. That's the most help you can give. And it can't dose until blood sugar gets to and the prediction, but I can't the current blood sugar has to get to or above that number. So if I set it at 150 if she hits 145 and the prediction says she's going to go to 300 the most loops doing is turning on the basal. It's not dosing at all, which may be going into activity or treating a low during activity. That's really what you want, because she might level out real quick and kind of not need any extra insulin, even though loop thinks that she does. So we're kind of moving the line. Say, Luke, when can you engage fully? When can you actually add insulin? Is super helpful. And then the other reason why I created a higher one like the 220 recently, is if that eventual number, that Prediction number, sometimes I don't want the basal on at all, and I can't, I don't want to bother Tessa to say, turn your basal off. So if I set a really high number, higher than that six hour prediction is currently set, then loop will say, Oh, not only can I not give insulin until I hit like 220 but the prediction is and then, you know, we're going to end up at 120 but now the target's being changed at 220 well now I need to turn off the basal. The only way I can get from 120 to 220 is just to turn it off. And so I had to create a couple of really high ones this year just to make sure that I get the basal off before PE, when she's entering PE, before lunch, because sometimes I loop would just leave the basal on, which is great. It's not adding any more insulin, but I need it off off. So we got to have a higher target range for, like, two hours. So those that's why I'm using, that's how I'm using the overheads. Mostly it's just target based. We're moving or moving the line. I

Scott Benner 37:49
think those overrides are awesome. I don't know if everybody uses them. And actually, even while you're talking, I'm wondering, I mean, the people that are here to, like, find out more about how to use it, obviously they're thrilled to hear it, but I worry for the people who are like I just thought this thing worked better, and I didn't really want to get into all this. They might worry that it's too in need of adjustment. But I don't find it to be that way. I think if you have good settings, and you understand the impacts of your food, and you you know, you pre bullish your meals, I think loop works like, you know, out of the box, you know really well, but these overrides once you start seeing repeating issues, right? Or things where, like, you know, this happens here, you know, off top of my head, like, you know, periods is a great example, right? You hear people talk all the time about, like, oh, well, can the algorithm? Either talk about all different kinds of algorithms, like, I have shifts in my activity, like, I'm very active during the week, and then suddenly I'm sedentary, or vice versa, and they just want the algorithm just magically, no, and it just never going to work that way, not anytime soon, at the very least. So, you know, awesome to be able to say, I know insulin needs have just gone down. I'm just going to set an override. I'm going to set a different target and a different, you know, whatever basal, you know, settings, and I'm gonna let that override run for a while during an illness or during the next two days or the next three hours, or it's awesome. I think it's a fantastic feature set inside of loop. I also, you know, wanted to ask you not to pivot too hard. But do you use the pre meal button in loop ever? I

Kenny Fox 39:19
don't like it at all. Actually, the downside is, when we change used to be used to enter the number into most of the settings, like the pre meal, and they changed it so that it's just like a scroll wheel to pick the numbers you want. So there's no way to clear it out if you set it. So every time I've actually done this where I actually deleted loop altogether and started from scratch just because I wanted the pre meal to not work. So when we set up, when I walk someone through setting up loop, I say, just don't, like, skip that screen, don't enter anything in pre meal, and move on. And what will happen is that pre meal button will stay gray and disabled, so you can't turn it on. And the reason why, well, here's how it functions. It's a 60 minute run time, and it's supposed to be some kind of lower target range. And so it will. Help in the situation. And we discuss, or should we turn it on? It'll start to dose at a lower number. The annoying part is that it turns off once you enter food. It's the idea, I think was like, Oh, it was like a little tiny Pre Bolus, you know, like, aim a little bit lower as I approach a meal. But that's just going to give you, like, tiny amounts of insulin to nudge your blood sugar down from prediction of 100 to prediction of 75 not a big adjustment. So it's really not effective for that use case, in my opinion. But as soon as you enter food, it turns off. It's like, oh, well, now you're eating. So now we turn off where? Whereas the 60 minute target, lower target ice set runs for 60 minutes no matter what, if you use the pre meal button after you enter food, then it would do the same thing you could enter the food, hit the pre meal button, and then it would stay on for 60 minutes. And that would effectively be the same, same thing, but I just avoid using it. It is a convenient button. I really wish it wasn't like you could set whatever override you wanted to that pre meal icon would be cool and it behave however you wanted. But I just, I try not to enter it at all, and don't use it. But it does work well if you're going to do it after you eat your food, not as a pre meal, but as a post meal.

Scott Benner 41:03
Your answer really is interesting to me, because I had a similar I thought, where I was like, this is going to be awesome, and then it didn't end up being awesome. So yeah,

Kenny Fox 41:11
yeah, if the pre meal button Bolus, the set amount of insulin or something, you know, that would be cool. But the other thing is that it's so easily bumped, it can turn off any existing overrides. So if I have a target 71 on for Tessa, and she bumps it on her watch, or bumps it in the app, it turns off whatever overrides running, and it runs that, which is, again, super annoying. I've had it happen on the watch a few times, and that's the reason. Main reason I don't use it is I'd set like a some kind of different override, and all of a sudden I see it's off because she bumped the pre meal on her watch. You know, there's

Scott Benner 41:39
a use in there, just, I don't know, it just needs to happen differently. I think, yeah, I agree. I see the idea of, like, let's be more aggressive now. We're gonna eat in 20 minutes. We're gonna eat an hour. Like, I'm 120 I'd love to be a drifting 80 when I get to the food, or something like that. But it just didn't, didn't end up doing that. But anyway,

Kenny Fox 41:58
yeah, I encourage people sometimes to pre meal like or Pre Bolus like you would with any other system, is you can just give insulin approaching a meal without entering carbs, especially if you kind of generally have an idea of how much you'll need, and you can just give it loop will predict you're going to go super low, because it's like, well, you don't have any food here to hold up all this insulin, but you know you're going to enter it eventually. And so I think people freak out and say, What? Loop won't let me Bolus. I was like, well, just, just throw in a couple units, and you know, then when you get to the food, you can answer it, and loop will give you, it'll adjust what it thinks based on how much insulin is left from that Bolus and the food you're answering. So I like to give people permission to defy the system a little bit and give too much. I hope people on the podcast don't, aren't too shy to doing that, like you have to do that on new pod five or random or whatever occasionally as well. So yeah, but you can Pre Bolus. It's no big deal

Scott Benner 42:49
right now. There's definitely times when the system breaches its limits and your needs are still there. So

Kenny Fox 42:55
yeah, you know stuff that the system doesn't. So yeah, right. It's limits.

Scott Benner 42:59
About making a decision is what I was gonna is what I meant. But yeah, it just it gets to the point where it's like, look, I think I'm doing the right thing, so I'm not gonna do anything else. If you know something that I don't know, and we don't have function to explain it to the system, like, then you're gonna have to make an adjustment on your

Kenny Fox 43:17
own, right? Yeah, and sometimes that means being creative on how you express that. We'll talk about exercise in a later episode, and that's where you can kind of tell loop what's going to happen if you feel like it. Otherwise, you can just use these overrides to get around it. The other thing overrides do is you can use percentage changes. The percentage changes are it modifies all of your insulin needs by a certain percentage. So if you do 110% then I'll give you 10% more basal, 10% more aggressive ISF, and 10% more aggressive carb ratio. And those can be helpful. You just have to be real careful with those. I think I've come to avoiding using those during the day, because what happens is, at least for most people, I see is the scale doesn't always work out, like sometimes it does, but sometimes 10% more aggressive carb ratio is way too much than just a 10% nudge in basal, for example, for like a little kid, I find it not super helpful. Like the balance doesn't work out. And when you go back and change your carb ratios, or go back and change your basal, Luke's gonna say that one segment where you ran 110% for a little while also adjust. So let's say you're changing your carb ratio from 15 to 12. Well, at that point of the day, loops. Gonna say, Well, when you enter this food, it was 10% stronger than 15. Now it's 10% stronger than 12. So you can't go back and fiddle with your settings and try to find the right setting, because you had an override on for part of the day. So I don't like percentage based overrides very often. I will use them most commonly when Tessa is asleep and she's across the house or she's not with me. Maybe she's sleeping somewhere else at a friend's house, or whatever, and I can see her basal needs have changed either up or down. So I'll take a guess at how much. Need to dial basal back or increase basal using a percentage based override. But I try to make sure it ends by the time she wakes up, so that she's not entering food with those changes. And then I'll text her and say, Hey, I need you to change your basal to whatever. Sometimes, if I'm sleeping in the same house and she's just too far, I don't want to get out of bed and put my feet on the cold floor. I'll grab my phone and do a remote override for a percentage change. So that's that's how I try to use them. You can use percentage based overrides during the day. It just gets a little tricky. Let me

Scott Benner 45:27
say that I the place I've run into trouble with that is like, say, you try to use a very aggressive temp override to break a high blood sugar, and then somebody eats. And you told the thing, like, Let's go 150% of your normal power, and then all of a sudden, you Bolus for carbs, and it's giving you 150% of your carb ratio. That's that's the problem? Yeah, yeah. That's not great. The remote thing through night Scout to change this stuff. Awesome. Like, just super

Kenny Fox 45:55
helpful. Yeah, yeah. I just, but you can also get yourself in trouble in that same scenario where it's like, oh, we'll just need to, just need a little more basal right now, maybe we missed on the fat and protein. I don't want to bug test it ends from our carbs. And so the thought would be, hey, let's put on like, 120 130 150% override for like an hour. But then she does something like, oh, eat something and and now you're, you're really like, coming down with a vengeance. So I'm

Scott Benner 46:19
a much bigger fan of the remote overrides when, like you said, when it's not possible that something else is going to happen in that time, like, you know, overnight, like, all the time. I'm, I'm like, Look, I love her blood sugar here, but she's just riding a little too low. So I just want to take a little bit of the basal away, for example, like, just so it kind of rises up a little bit awesome for that. You know, 110 blood sugar, super sticky. I wish it was 90. A little aggressive. There, she's asleep. Nothing's gonna happen. She's not gonna be bolusing. It's awesome. There. I do hear people, by the way, say, especially adults will hear this and think, you cannot go touching somebody's insulin without them knowing. I agree. But Kenny's point is he made earlier too. Is like, sometimes kids just don't look again. So even if you text and say, hey, look, I've made your basal more aggressive, or I've done this, like, be careful, it kind of falls out of their head sometimes. So that's not a great protection either. In the end, they need to get what they expect is going to happen. You know, you can't go changing the game and telling them and not telling them, that's not cool, right? And adults seem to know that adults living with type one diabetes seem to reactionarily, know that, maybe more intrinsically than a parents who are helping kids with diabetes. And I know this has nothing to do with loop, but I'll add this here because I think it's important. I've talked to enough adults with type one. They'll tell you, like, when somebody goes to touch their settings, like, you know, like, I've had adults say, like, look, I was the doctor's office. And Jenny said it to me recently. She's like, if the doctor ever said to me, give me your controller, I'll change your settings. She goes, I wouldn't let that happen. She's like, that's me. And she started to explain that, and I and her explanation, I don't want to bastardize here. There's a thing that happens with people with type one like that insulin is affecting them in a way. You shouldn't get to say what's going to happen to it, unless they agree to it. And anyway, sometimes the remote stuff can make that a little tricky. I think,

Kenny Fox 48:16
yeah, definitely. And that's why I like starting with just target base changes. It's you're not modifying settings really. You're just kind of changing when the system is going to respond. In case you made the wrong decision, it's easy to back out of the other thing, we'll use targets for that I find, especially parents. If you're not confident in your basal settings, like last night, I increased test is basal a fair amount, point one, five, all at once, and I wasn't sure it was going to be wasn't going to be too much, so I set an override that ran for the whole night. It changed her correction range from 87 to whatever, just like 95 to 100 to 110 just a little bit higher than normal, just in case I was wrong. Case I put too much basal on and I didn't know. So if your confidence is shaky and you're worried about lows, and just nudging the correction range up just 1015 points can make a really big difference. Because if she if I did increase the basal too much, she probably would have been running under that number of 100 she probably would have been in the 80s or 90s, whereas, if I left it as a correction range in the 80s, she might have been in the 70s, or maybe even a little bit lower if I went to overboard. So that's helpful. And the first time I created that slightly higher correction range was when she had her first sleepover while she was looping with my sister. I was like, you know, I like, everything is probably fine, but let's just, let's give a little more room for loop to catch a low and I'm comfortable with her running at 110 Right? Or if she's running a little bit higher because her basal is off, she'll be at like 120 but not like 150 so using a slightly higher correction range when you're less confident in your settings is a good thing to use, and it's great for sleepovers or just for anything that you just are not confident in. You want to let the system play around. I really encourage. Rich people to do that. When they start looping the first day they first night, they run it. I think it works best if they just run closed loop and set a correction range that's fairly wide, like maybe 100 to 130 or something like that, or 140 somewhere in that range. Or it's not super high, but they can let the system play and move and adjust, but give them room in case they have their basal too high or something like that. So correction ranges are pretty powerful tools.

Scott Benner 50:26
Is Tesla's range wide? Or is it very tight, like, is her range 89 to 89

Kenny Fox 50:32
Yeah, perfect. I don't like the one number or really tight ranges, because I feel like not. You know, the predictions are just models of what should happen, and they move enough that if the prediction kind of moves to 90 now, loop wants to, like, maybe add some insulin. If it moves to 87 it wants to take some away. I feel like loop is, like, gyrating too much. It's making too small an adjustment. Plus or minus, you don't really get a good sense of your settings. It's trying to hit this, like magical one number. It's really difficult to do. So I like to create at least a range of some kind. So at night, sometimes down as low as a five point range, but typically like kind of a five to seven or eight point range. And then during the day, it's more like a 15 point range. So right now it's like 87 to 93 or 95 I think, at night, and then during the day, she's running an 87 to 100 or some people, I'll suggest, like a 90 to 110 or something like that. So when there's more variability in the day, I like to give a little bit more range the system to play with, and not overreact either direction. That's kind of the way I approach it. And then along those lines, is because the correction range effects of that prediction interacts with the correction range for the full six hours of that prediction. I find it's really tricky to get the system to do what you want it to do. If you set a bunch of correction ranges, people like to set, oh, I'm going to set, you know, a correction range that's higher right a PE time or whatever, it doesn't really do what you want it to do, because loop is is looking six hours ahead and starts aiming for the correction range at six hours ahead of right now. So that means six hours before PE loop is aiming for the 150 which, you know, in theory, is kind of nice, but ends up not really doing what you want. I tend to tell people once you just start with either one or two ranges. I like to do, if you want a tighter range at night, create a night range that starts at midnight. That means that starting at 6pm so starting at dinner, it's sort of aiming at this lower number and then have it run until 12 one, two o'clock, somewhere in there, because six hours before, let's say two o'clock is 8am from basically 6pm the night before, all the way through to 8am loop is aiming at that lower range for Tessa, and starting at 8am It starts aiming at the higher range that we have set. Now it does change how the system reacts, like we discussed about what, what number the system can automatically dose if your prediction is dipping and those kinds of things. It does mean that she's the system slightly more responsive. It's reacting at like a lower blood sugar number from like breakfast until like lunchtime, yeah, which I find useful. Most people struggle with breakfast, but then by the time lunch comes around, we're still aiming for the higher numbers. So just pick one to two ranges, midnight to noon, one two somewhere in there, and then starting from there to midnight, and that will usually get you kind of a nighttime slash mildly more aggressive day, morning to kind of a nicer, wider range in the afternoon, until about dinner time, it tends to work out pretty well. So figure out where you want to be. Some people just like to have a higher nighttime. That's fine. Then adjust it up. It won't make a big difference. Try not to make them radically different. But, uh, yeah, one range or two ranges is enough. And then use overrides for more specific times, like PE, it just gets you. The override takes over the entire correction ranges. Oh, okay, well now I'm not looking six hours ahead. I'm looking right now. What are we doing right now with this override? Well, it's on So

Scott Benner 53:50
Ken, I'm gonna go back in a series Full of the thoughtful things that you said. I'm gonna go back and listen to this part again myself, because I think you might have just like opened up my mind a little bit on the correction range thing that was really awesome. Thank you.

Kenny Fox 54:05
Yeah, it's more influential than I tend to think. And it was kind of hard to wrap your head around for a while, especially because you have to think about it in kind of six hour chunks. You can check out, I'm gonna do that that that's really awesome. Listen to it. Check out the loop, docs page on automated adjustments, or you can watch video, you know, keep an eye on my my website, YouTube channel, Fox and the loop house. I'll probably try to do some smaller or updated segments on this topic, because it's really useful for people to right. Just know how to apply the overrides. And then the last thing I'll leave you with, as I think about it, is sometimes, because you have remote access to this stuff, I find some parents tend to obsess over looking at the numbers. And it might set, you know, a target six, a millimolar, or target seven millimolar, or target, you know, 121, 3141, 50. And they're constantly changing because you're like, Oh, I think loops gonna gonna do this, and I don't want it to or they're gonna come up on PE and do that, try to. Not let this it gives you the opportunity to drive yourself crazy and just set an override and let it run, and if you need to cancel it, cancel it. But try not to play around with setting so many overrides that you start driving yourself crazy. But you also need to make sure you have a few of these overrides pre built that way. If you're going to be setting things remotely as a parent, they're available in your list if you don't make the override, if I don't set create a one target, 150 and a target 180 they're not there for me to pick remotely. I could they'll test it and make one up. But again, we're trying to do this to minimize diabetes interactions, so it just needs to be made. So go ahead and make all the overrides you think you might need. Put them in the order, like the target based ones on the top, so you don't accidentally bump the percentage changes, and then you're going to go

Scott Benner 55:42
stop setting up an impossible parlay. Is what you're talking Yes, yes,

Kenny Fox 55:46
yeah. It's been a couple of clients of mine. We've had to work on that where it's like, okay, you're setting overrides every like, 15 minutes or so. Like, just pick one and let it go for a while and try not to look at the numbers for a little while. Like, it's it's good, but you can the remote accessibility makes it so that you can obsess over the wrong things, right?

Scott Benner 56:04
So Kenny, tell people again where to find you. Box in

Kenny Fox 56:07
the loop, house.com, I'll also be on Facebook, YouTube, Instagram. Try to do more educational videos. If you want to see some of the video content that's already been created, hop over to loop and learn. Org and the YouTube page that goes with that. There's a series on there that has has me listed as well. But yeah, if you want to come check me out and see what the courses or classes I'm offering, I'm going to open those up a couple times a year. You can find all the updates to that on my website, and love to see you there. Awesome.

Scott Benner 56:34
And we're going to do more of these together. Is that right? Yeah,

Kenny Fox 56:37
we'll have probably another series of three or four. We can go over, maybe a Q and A episode, if people have questions after these ones come out, awesome. See where it goes. Listen,

Scott Benner 56:44
you know, because my camera's on that I look super handsome today, and I have, I really do, this is my best day this week, and I have an event, so I'm gonna go, because I don't want to get sleepy and then people not see me in my glory, because I think I'm really like, I'm popping today. Kenny, I don't know if you look fantastic. I can tell. Yeah, thank you. I didn't want to take want to take this away you. You as well, look awesome. But I'm just, I'm looking at myself, and I'm thinking, if this angle is how the whole world saw me, I could probably be a model take a picture. It just, it's unfair, because if I start turning my head one way or the other, it all goes away. I've been looking at you and me for the last hour, and like five times I thought this is a good day for me, because I don't have that many of them. Ken,

Kenny Fox 57:25
I just want to be clear about that. I want to say it didn't want to distract from, yeah, you

Scott Benner 57:29
know, you didn't want to you don't want to come off like you're hitting on me. I understand. Okay, well, thank you so much for doing this, man. I really do

Kenny Fox 57:35
appreciate it. You got it? You

Scott Benner 57:44
head now to tandem diabetes.com/juicebox and check out today's sponsor tandem diabetes care. I think you're going to find exactly what you're looking for at that link, including a way to sign up and get started with the tandem Moby system. I'd like to thank the ever since 365 for sponsoring this episode of The Juicebox Podcast, and remind you that if you want the only sensor that gets inserted once a year and not every 14 days, you want the ever since CGM, ever since cgm.com/juice, box, one year, one CGM. Okay. Well, here we are at the end of the episode, you're still with me. Thank you. I really do appreciate that. What else could you do for me? Uh, why don't you tell a friend about the show or leave a five star review? Maybe you could make sure you're following or subscribed in your podcast app, go to YouTube and follow me or Instagram. Tik Tok. Oh gosh, here's one. Make sure you're following the podcast in the private Facebook group, as well as the public Facebook page you don't want to miss. Please do not know about the private group. You have to join the private group as of this recording, it has 51,000 members in it. They're active, talking about diabetes, whatever you need to know, there's a conversation happening in there right now, and I'm there all the time. Tag me. I'll say hi. The podcast contains so many different series and collections of information that it can be difficult to find them in your traditional podcast app. Sometimes. That's why they're also collected at Juicebox podcast.com go up to the top. There's a menu right there. Click on series, defining diabetes. Bold beginnings, the Pro Tip series, small sips, Omnipod, five ask Scott and Jenny, mental wellness, fat and protein, defining thyroid, after dark, diabetes. Variables, Grand Rounds, cold, wind, pregnancy, type two, diabetes, GLP, meds, the math behind diabetes, diabetes myths and so much more. You have to go check it out. It's all there and waiting for you, and it's absolutely free. Juicebox podcast.com, Hey, what's up? Everybody? If you've noticed that the podcast sounds better and you're thinking like, how does that happen? What you're hearing is Rob at wrong way recording, we're. Doing his magic to these files. So if you want him to do his magic to you wrong way recording.com, you got a podcast. You want somebody to edit it? You want rob you?

Please support the sponsors

Donate