#1728 ADA Standards of Care for 2026

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Scott and Jenny review the newly released 2026 ADA Standards of Care, praising key updates like hospital safety protocols while critiquing the "slow drift" of official guidance compared to real-world management.

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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 (0:0) Welcome back, friends, to another episode of the Juice Box podcast. (0:14) If you're new to type one diabetes, begin with the bold beginnings series from the podcast. (0:18) Don't take my word for it. (0:20) Listen to what reviewers have said. (0:22) Bold beginnings is the best first step.

Scott Benner (0:24) I learned more in those episodes than anywhere else. (0:27) This is when everything finally clicked. (0:29) People say it takes the stress out of their early days and replaces it with clarity. (0:33) They tell me this should come with the diagnosis packet that I got at the hospital. (0:38) And after they listen, they recommend it to everyone who's struggling.

Scott Benner (0:41) It's straightforward, practical, and easy to listen to. (0:44) Bold Beginnings gives you the basics in a way that actually makes sense. (0:50) If you're looking for community around type one diabetes, check out the Juice Box Podcast private Facebook group. (0:57) Juice Box Podcast, type one diabetes. (1:00) But everybody is welcome.

Scott Benner (1:01) Type one, type two, gestational, loved ones, it doesn't matter to me. (1:06) If you're impacted by diabetes and you're looking for support, comfort, or community, check out Juice Box Podcast, type one diabetes on Facebook. (1:16) Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. (1:20) Always consult a physician before making any changes to your health care plan. (1:29) Jenny, I'm gonna spring this on you while we're recording.

Jenny Smith (1:33) Yay. (1:34) Which is not odd.

Scott Benner (1:35) No. (1:35) It's not odd at all. (1:36) But, you know, this one's a little out of left field. (1:38) We're gonna take a break this week from making bolus four episodes, which I have to tell you people are really enjoying. (1:43) So

Jenny Smith (1:43) we're gonna Awesome.

Scott Benner (1:44) We're gonna be making more of them. (1:45) I saw the ADA guidance came out the other day.

Jenny Smith (1:48) Yeah. (1:48) Right? (1:49) The 2026?

Scott Benner (1:50) 2026 guidance came out. (1:51) And I have to admit, like, the past, I've always been like, whatever. (1:55) Like, I don't really look at it too closely. (1:57) But this year, I thought, like, you know, everybody gets excited. (2:01) This marketing, this excitement or whatever?

Scott Benner (2:03) So I kinda dug into it a little bit. (2:05) And it is a lot it is a it's a it feels like a lot of nothing to me. (2:09) And I realized that it's something that probably moves on very slowly, but I thought it would be interesting to look at it and to kinda look backwards a little If bit you don't mind, like, I'm gonna scroll back to 2022.

Jenny Smith (2:22) Okay.

Scott Benner (2:22) Where the let's see how how I broke it down here.

Jenny Smith (2:26) Why 2022? (2:28) I'm just curious. (2:28) It's only four years ago. (2:29) It's not, like, a round five number. (2:32) So why that number?

Scott Benner (2:34) I wanna see if there's anything happening that just feels I guess what I wanna do is I I wanna show

Jenny Smith (2:38) people Significant enough indifference?

Scott Benner (2:40) Yeah. (2:40) And I'd like to show people that something that came up in 2022, 2023 is slowly being adjusted going forward. (2:47) It's not like, how do I mean this?

Jenny Smith (2:50) Okay. (2:50) A couple of

Scott Benner (2:51) go ahead.

Jenny Smith (2:52) No. (2:52) I was gonna say I I have one that I I know that we'll probably get into in terms of reviewing the current guidance that, again, just came out.

Scott Benner (3:01) Mhmm.

Jenny Smith (3:01) And that slow progression to something finally being in a standardized guideline

Scott Benner (3:08) Yeah.

Jenny Smith (3:09) That technically, I feel like has already been standard in the crowd of people I tend to work with or that you tend to speak to in terms of who listens. (3:21) Right?

Scott Benner (3:22) This is what throws me off about this. (3:23) Yeah. (3:24) I was prompted by I'm not trying to out anybody. (3:27) I was prompted by an email I got from a fairly big diabetes organization recently where they were like, oh my gosh. (3:35) Look at how exciting this is.

Scott Benner (3:37) And they their news I don't wanna say even what it was because I don't want people to know what it was like. (3:40) Like this Sure. (3:41) Amazing thing that's happening, blah blah blah. (3:42) And I thought, I've been talking about that for three years.

Jenny Smith (3:45) Right.

Scott Benner (3:45) Like, the mass of people see it like that. (3:48) Even, like, going back to 2022. (3:50) Right? (3:51) ADA is like screening is gonna be very important. (3:53) Screening.

Scott Benner (3:54) Screening. (3:55) Screening. (3:56) They've been talking about it now for, you know, a handful of years. (4:01) And in my opinion, where we're at is, you know, we're trying to screen to see if people are, you know, eligible for t zeal, but the process of screening them is just, it's insane. (4:12) Yeah.

Scott Benner (4:13) They're gonna get people who have not been diagnosed with type one yet early enough that they're eligible for t zealed. (4:19) And then if you find them, the answer is thirteen infusions over thirteen days. (4:24) You might have to fly somewhere and live in a hotel to do it. (4:27) And if we're lucky, this might stave off diabetes for a year or so. (4:30) Like, wow.

Scott Benner (4:31) Like, why does so much effort go into something like that? (4:34) Do you know what I mean?

Jenny Smith (4:35) Yeah. (4:36) I mean, I think in in terms of these standards, right, they are I don't know, honestly. (4:44) It's a really good question. (4:45) My thought is that from an organizational standpoint, it's almost like they're waiting to see enough momentum to be able to actually put it in there as a a trusted, valuable standard that they can suggest to the greater these standards are usually not even something people with diabetes look at.

Scott Benner (5:05) Right.

Jenny Smith (5:06) They really are from a clinical standpoint of what should we as clinicians be looking at now as this is what we should talk to people about diabetes about, or this is what we should try to move to as the new guidance rule or the new medication and why it holds value when all the data has been building to that statement, but it's already been happening.

Scott Benner (5:34) Yeah. (5:35) I don't say that people should run forward with their hair on fire and try everything that, like, randomly pops up in front of them. (5:41) I think the screening thing going back this many years because if you have any social media or you're around any contact with diabetes at all, you're gonna hear, like, screening rhetoric being pushed at you. (5:53) Right? (5:54) Like so what that to me means is that the machine thinks it's important.

Scott Benner (5:58) If the ADA thinks it's important, then I gotta think whoever supporting the ADA thinks it's important. (6:03) I don't know anything about anything, but Sanofi paid a lot of money for that drug. (6:07) So I gotta figure there's some, you know Some push. (6:10) Some push from that. (6:11) Yeah.

Scott Benner (6:11) I understand I understand all this. (6:14) But if that's how that works, then I want you to wonder about things like, I don't know, CGMs and GLP medications and micro dosing stuff and thinking differently in general about things that you see in your life working, but then go out and say, the machine is not telling me that this is important.

Jenny Smith (6:36) Right.

Scott Benner (6:36) I just think that it's it's 2026. (6:39) What's the guidance on a one c right now?

Jenny Smith (6:42) The guidance on a one c? (6:43) You tell me. (6:44) I know you're looking at it.

Scott Benner (6:45) 7.5 for kids. (6:46) Right? (6:47) And what is it for adults? (6:49) Seven?

Jenny Smith (6:49) Under seven.

Scott Benner (6:50) Under seven.

Jenny Smith (6:51) Mhmm.

Scott Benner (6:52) Okay.

Jenny Smith (6:52) I mean, it's and that has that has not changed at all. (6:56) And then that's a standard. (6:58) Right? (6:59) We all have the knowledge as well that it's it's kind of a standard that's not a hard box standard. (7:05) It's a there are wavy lines to it.

Jenny Smith (7:07) If you have this type of situation going on, we might expand that. (7:14) If you have, you know, hypoglycemia unawareness, if you are over the age of such and such or under the age of, you know, whatever

Scott Benner (7:21) Mhmm.

Jenny Smith (7:22) Then that gets a little bit wavy, but it's still they have to have a hard set value to put into something like this. (7:29) Again, from a medical from a medical liability standpoint, there has to be something that medical clinicians are using as their as their standard. (7:41) It's their starting point. (7:43) Right? (7:43) I do think that the standards and I've I actually looked at them when they came out for a couple of reasons.

Jenny Smith (7:50) I think some of the new things on the list are important because they've again been things that clinically that I've seen have been pushed to the background. (8:02) And so I think that standards like this putting them more to the front ground and saying, hey. (8:09) This is really important to pay attention to. (8:12) And this is why we know this now about this particular medication. (8:17) It can impact this condition, which got kind of a second or a third notice comparative to just a one c.

Jenny Smith (8:24) Mhmm. (8:24) Right? (8:25) So the newer the newer guidelines have things around I I think a big highlight is absolutely the GLP ones. (8:31) Yeah. (8:32) There's a huge highlighted piece of that, which most people with diabetes, especially with type one diabetes, have been hitting on and pounding their fist into the ground about being noticed

Scott Benner (8:46) Mhmm.

Jenny Smith (8:47) For a while already. (8:48) And yay. (8:49) Now the standards say, yes. (8:52) There's value to these medications.

Scott Benner (8:55) Let me be cynical for a second. (8:56) Sure. (8:56) Isn't it possible, Jenny, that I'm not a genius and that three years ago when I was like, gonna give my kid a little bit of this GLP and see what happens. (9:05) That maybe what was really going on when they were busy telling us, no. (9:07) No.

Scott Benner (9:08) No. (9:08) It's not for type ones. (9:09) It's only for type twos. (9:10) What they meant was is we don't have production ramped up yet. (9:13) So let's not everybody be dipping their toe into this pond yet.

Scott Benner (9:17) Like, I think that's the kind of I am not a conspiracy person. (9:20) I just think that this is very, like, realistic to look at. (9:23) Right? (9:24) Like and the reason I I dislike it so much is because not only is that three years of people not getting support maybe that would have been valuable for them

Jenny Smith (9:32) True.

Scott Benner (9:33) But it's three years of telling people, oh, no. (9:36) This thing is not for you. (9:38) And those people will never think about it again. (9:41) Right? (9:42) Like, that's the part I hate.

Scott Benner (9:43) Like, I hate when they tell me like, if you tell a parent a seven five a one c is a good target for your kid, I understand big picture. (9:54) Everyone hears this. (9:56) Everyone has different technology, ability to, like, use tools, access the tools, and we want everybody to be safe. (10:02) I don't not want everybody to be safe.

Jenny Smith (10:04) Of course.

Scott Benner (10:05) I'm worried about all the people that heard the number and will move forward for the rest of their life going seven Five's okay.

Jenny Smith (10:11) That that's the standard.

Scott Benner (10:12) Yeah.

Jenny Smith (10:13) Correct. (10:13) And partially because nobody then clears it up. (10:17) And once you've established that as your standard.

Scott Benner (10:20) Then that's it forever and ever.

Jenny Smith (10:22) Then that's it forever and ever unless you're the type of person or personality that says, I'm going to do more research. (10:30) Like, I was given that like, I think there there are several personalities within the scope of diabetes management. (10:37) Yeah. (10:37) Some who are given a standard like that to begin with Mhmm. (10:40) And and go off and say, okay.

Jenny Smith (10:42) Yes. (10:43) This is just it for life. (10:44) I was told 7.5 or under that is really great. (10:46) Fantastic. (10:47) And they never ask more questions, but I think their doctors are also not providing enough either

Scott Benner (10:55) Yeah.

Jenny Smith (10:55) To make them think that there are additional things that could be done. (10:58) And then there's the other avenue of people who absolutely take that as maybe this was the starting place because it was safe to begin with.

Scott Benner (11:06) Mhmm.

Jenny Smith (11:07) But I know, and I think especially because we have such a broad diabetes community in an online way that I did not have growing up. (11:16) There was nowhere else to look. (11:18) Right? (11:18) Books that were on it, you had to go to the library or had to, like, order them from someplace. (11:23) And there was not the Internet nor the online communication that we have today to see that there is better, there can be better.

Jenny Smith (11:32) And gosh, I should be asking more questions to my doctor about why did you give me this and why haven't we adjusted this now as things are changing?

Scott Benner (11:42) I'm gonna tell you a sad story that I don't know that I've ever told you before, and I'm sorry. (11:46) But Oh. (11:47) I it fits here. (11:49) And Okay. (11:49) I've been thinking about it a lot lately.

Scott Benner (11:51) So it pops in my head initially because Dexcom moves to the fifteen day sensor.

Jenny Smith (11:58) Yes.

Scott Benner (11:58) And Mhmm. (11:58) Everyone's like, mine doesn't even last ten days. (12:01) Now you're gonna tell me it goes fifteen, you know, blah blah blah. (12:03) And everybody's complaining. (12:04) Right?

Scott Benner (12:05) And then you're you know, you try to parse it in your head, like, really the Internet is where people come to complain. (12:10) My daughter wears an Omnipod right out or excuse me, a Dexcom right out ten days, twelve hours, almost every time. (12:17) Right?

Jenny Smith (12:17) Which is awesome.

Scott Benner (12:18) It's lucky. (12:19) I understand that. (12:20) But at the same time, like, the Internet's not full of people who show up to go, hey. (12:23) I just wanted to come by and say that my CGM lasts ten days all the time. (12:26) Right?

Scott Benner (12:27) So you get this feeling, you know, oh gosh. (12:30) It must not a thing must not work. (12:32) And then I saw somebody say something that really stuck to me, and it was more about the way they said it. (12:38) And I and I felt for them because I understand they're obviously either scared or having a bad experience or whatever, but, you know, why don't they fix the problems it has before they shove this down my throat? (12:49) And shove this down my throat is what stuck to me, and here's why.

Scott Benner (12:53) When I was getting ready to graduate high school, my best friend got diagnosed with type one diabetes. (12:58) Mhmm. (12:59) His name is Mike. (13:00) Mhmm. (13:00) Well, his name was Mike.

Scott Benner (13:02) And he was given regular an Miles per hour and that was it. (13:06) Mhmm. (13:07) And my entire life knowing and loving and being with Mike as a as a great friend, I thought of him as a person with kind of a strange temperament. (13:15) He was lovely and sweet, but sometimes he'd get angry out of nowhere. (13:19) I never understood that.

Scott Benner (13:20) Right? (13:20) And later at night, there was always a rule we didn't let Mike drive because he'd swerve and he wasn't like a great driver and we just thought Mike couldn't drive. (13:28) And, you know, that was just how we went along. (13:31) And Mike went along and he got up in the morning and he did his like, probably about this much injection and then we'd go eat breakfast and I'd see him do it again in the afternoon. (13:40) We never talked about his diabetes and it turns out that Mike didn't know much about his diabetes either and neither did his doctor.

Scott Benner (13:47) And Mhmm. (13:48) One day, we're adults and we're married and moved on. (13:51) Mike says to me, hey, I think my kidneys are failing And I I I'm gonna go to the doctor today. (13:58) And the next thing I know, Mike's on dialysis. (14:00) And then Mike loses his job because he's always on dialysis.

Scott Benner (14:04) And then his doctor says to him, I'm not kidding, and this is only about six years ago. (14:09) We should really try carb counting. (14:11) That's when they moved Mike to NovoLog and Atlantis. (14:17) Yeah. (14:17) Wow.

Scott Benner (14:18) And he's a bright guy. (14:19) He was lovely. (14:20) He had all kinds of interests. (14:22) He would have been a real great addition to this world moving forward. (14:26) And instead, he started having seizures because he didn't know how to use his his NovoLog.

Scott Benner (14:31) He crashed his car because he tried to bolt like he was at a comic bookstore picking up his books and injected before he went to the diner like he does all the time except he used to inject a much slower acting insulin before. (14:44) Onlooker said that my friend's car went down a private street between eighty and ninety miles an hour. (14:50) It went into a cul de sac spun in a circle before it crashed into a mailbox in somebody's house. (14:56) Mike was lucky he didn't get hurt. (14:58) A couple of months later, he fell out of bed having a seizure and broke his arm.

Scott Benner (15:03) And two years later, he was talking with his wife about what to have for dinner. (15:06) They decided on what to have. (15:08) He stood up out of his chair to go make it and fell forward on his face when his heart failed. (15:13) Right? (15:13) Yeah.

Scott Benner (15:14) And I always think sad that the EMTs came and they saved him. (15:20) And then three days later, I sat in a hotel room with my cell phone playing Mike's favorite music from when we were in high school and he died the next day.

Jenny Smith (15:27) I'm sorry.

Scott Benner (15:28) And I see that story as completely connected to this. (15:32) Because at some point at in Mike's life, someone said, this is how you take care of your diabetes. (15:38) And he believed them, and then he moved forward. (15:40) And all this crazy stuff that happened to him, we were all completely unaware of Sure. (15:44) As was he.

Scott Benner (15:46) Mike didn't think like, oh, I yell at people because my blood sugar's been high for three days.

Jenny Smith (15:50) Right. (15:51) He didn't make an association.

Scott Benner (15:52) No one knew. (15:54) And I guess I'm asking everybody to say, what do you think might be happening to you right now that you're not aware of? (16:00) Right? (16:01) While we're slow walking, telling people CGMs are important. (16:05) I'm I'm scrolling back now to 2018.

Scott Benner (16:07) CGMs for adults. (16:09) Expand CGM recommendations to all adults 18 and over. (16:12) Expand. (16:13) Like, my last thought here is, and then I really wanna hear what you think about all this, is that, it's been about a year or so now. (16:20) This very well respected doctor, in the diabetes space was I'm gonna make an announcement.

Scott Benner (16:26) I'm making an announcement. (16:27) I'm putting up a video. (16:28) I'm making an announcement. (16:29) You should all be there. (16:30) I went and looked, and he said they've been doing research for ten years now.

Scott Benner (16:34) And he is confident and and excited to tell us all that, you know, if you lower your alarm on your CGM, you'll have better outcomes. (16:44) They figured that out, Jenny. (16:45) Only took them about ten years. (16:47) So Yeah. (16:49) Yeah.

Scott Benner (16:50) I'm saying this is great. (16:52) I got nothing against the ADA. (16:53) I got nothing the way the machine works. (16:55) I understand slow, steady, make sure everybody's safe. (16:58) But for the everyone else, pay attention.

Scott Benner (17:00) Like, follow your common sense a little more.

Jenny Smith (17:02) Right. (17:03) Well, I think it also what it highlights for me is also that and I don't know what kind of doctor your friend Mike was going to.

Scott Benner (17:12) I'm sure he didn't either, by the way.

Jenny Smith (17:13) If it right. (17:14) He may not maybe it was a primary care. (17:16) And, unfortunately, primary care is like the jack of all trades. (17:20) Right? (17:21) They really know a little bit about a lot of things, but they are not they've not gone to schooling for a specialty.

Jenny Smith (17:27) That's where endocrinology does shine. (17:31) Whether you believe your endocrinologist is a great one or not, they still have a specialty in a lot of endocrine, not just diabetes either. (17:43) So those are the doctors that I believe, really hope, I guess, are looking at more than just these standards.

Scott Benner (17:57) Yeah.

Jenny Smith (17:58) It's the primary cares and the ones in the general public that I I truly think should be the ones getting these standards and having to check it off almost like a continuing education that they have looked at it, that they now acknowledge the value to these things because they do see the larger portion of people with diabetes, not endocrinology. (18:24) And again, for your friend Mike, my expectation is that he was probably going to a primary care or just a really bad endocrinologist who didn't know what they were doing with diabetes.

Scott Benner (18:36) Yeah.

Jenny Smith (18:37) Right? (18:37) Because that endo six years ago I mean, I've been using a CGM since 2005.

Scott Benner (18:47) Mhmm. (18:48) Yeah. (18:48) I looked the other I think, if if I got the if I it's now it's in the back of my head, but I think there's been, like, over 10 iterations of, like, Dexcom CGMs over, like, nineteen years or something.

Jenny Smith (19:00) Yes. (19:00) I didn't even start on Dexcom. (19:02) Yeah. (19:02) I started on Abbott's Navigator Mhmm. (19:05) Which was a phenomenal CGM.

Scott Benner (19:08) Kenny's like, why did they take that Navigator from this?

Jenny Smith (19:10) Loved it. (19:10) It was awesome. (19:12) But, you know, and then got kind of moved into Dexcom mainly because Navigator was leaving The US, and they were no longer gonna have it. (19:20) So I have had almost all of the iterations of Dexcom and can say that it is an enormous reason that I no longer set an alarm overnight to check my blood sugar.

Scott Benner (19:35) Yeah.

Jenny Smith (19:35) Prior to that, even my husband will tell you, like, the 2AM alarm, it went off every night. (19:40) And after a while, like, he didn't even pay attention to it anymore because it was just the norm. (19:44) Right? (19:45) Yeah. (19:45) Once I got a CGM, my goodness.

Jenny Smith (19:48) The value there and the value that it could have had for your friend, Mike, I think that he probably could have even started making associations on his own. (19:59) Even if no doctor told him anything about how to look at the data, he sounds like he was smart enough to probably start making associations of, gosh, my blood sugar is here, and I start acting like a jerk. (20:14) You know what I mean?

Scott Benner (20:14) That a lot, honestly. (20:16) Because, like, I where where didn't where did someone fail him? (20:21) And where did he not say, I gotta take care of this? (20:26) But I don't I just don't know. (20:27) Like, you know, we talk about how blood sugars affect your personality and your ability to think and fogging.

Scott Benner (20:32) I I just don't know where he was. (20:34) You you know what I mean? (20:34) And and that's the that's why it's why we made the grand rounds series. (20:38) Like, because I want people to start with a good knowledge. (20:40) Like, I it's why I talk about all this all the time.

Scott Benner (20:43) I I mean, honestly, you guys probably don't realize it, but a lot of the reason why I come at this the way I do is because of Mike. (20:49) I just don't talk about it because it seems distasteful. (20:51) But Mhmm. (20:53) His is an exploded example of what could happen. (20:57) I'm saying, like, you don't have to end up, you know, with heart failure and and kidney failure for this to be impactful on your life.

Scott Benner (21:04) You can have other small impacts along the way that you might not notice. (21:08) And and if you're counting on if you're counting on guidance to get you there, I'm saying, I I don't think I would do that. (21:16) Like, I because it's gonna lag behind. (21:19) Know? (21:19) Yes.

Scott Benner (21:19) Here look. (21:20) How does that guidance impact something like insurance coverage? (21:24) It defines medical necessity for technology. (21:27) It sets prior authorization criteria. (21:30) It justifies coverage for off label use, preventative screening at zero cost.

Scott Benner (21:35) Lag time, commercial lag. (21:36) It typically takes one to three years for a new ADA recommendation to be written into insurance medical policies. (21:43) Correct. (21:43) Yeah. (21:43) Everything takes too much time.

Jenny Smith (21:46) Too much time.

Scott Benner (21:46) Life is this long. (21:48) That's a big picture thing, and we should be doing that. (21:50) The idea is thank god. (21:52) Right? (21:53) But, like, for you personally, inside of your life, you don't have the 300 years that they're mapping this out over.

Scott Benner (22:00) You know? (22:01) You you've got this time right now, and I'm arguing you don't even have that much time because you're gonna get set into some sort of a comfortable rhythm that you won't look up from, and then it'll just be ten years later.

Jenny Smith (22:14) I I mean, the gist of it all is that it's too slow. (22:17) These standard recommendations, they wait, they gather data, they gather more data, they gather more data. (22:23) And finally, there's enough information for them to say, yes. (22:28) We can now state that this is of value and a needed, you know, discussion or a needed reference or a needed medication. (22:36) Even the I mean, if you look at the new and this is the first time, if I'm remembering correctly, this is the first time that they're acknowledging the AID systems inclusive and their value, inclusive of the open source DIY systems.

Jenny Smith (22:54) Right. (22:55) The first time. (22:56) How long have I been using an open source system? (23:01) I've been using one since early twenty seventeen.

Scott Benner (23:04) Yes.

Jenny Smith (23:04) That is a long time. (23:07) Right. (23:07) I have worked with person after person after person. (23:10) I have talked to doctors. (23:12) I did a presentation eons ago Mhmm.

Jenny Smith (23:17) At a ADCES conference about specifically the DIY open source AID systems, and what are you afraid of? (23:28) Get your head out of the sand. (23:30) Yeah. (23:30) Why are you not acknowledging this? (23:32) And a lot of the problems at that time were that came from the audience, it was there are no standards around using them.

Jenny Smith (23:40) We have not been educated on using them, and we are liable if we recommend them in office. (23:48) Those were the baselines. (23:50) So until a standard comes out that brings it to the forefront within the medical community, there is a liability issue to a lot of this.

Scott Benner (24:00) Right. (24:00) So you're not gonna until this until this guidance says, hey. (24:04) Do this. (24:05) Then doctors won't feel comfortable even if they know. (24:08) That's why by the way, this is partly why the podcast is so popular because this is why you guys get grabbed in a hallway on the way out of an appointment.

Scott Benner (24:15) Somebody just whispers in your ear, just try the Juice Box podcast. (24:18) They shove you out the door. (24:19) Yeah. (24:19) Have you tried did you read this book? (24:20) Did you do this?

Scott Benner (24:21) Like, get out of here. (24:21) Hurry up. (24:22) Don't let anybody hear me saying this to you. (24:24) My god. (24:24) If you don't go do this, you're gonna live like this forever.

Scott Benner (24:27) Jenny, if I And

Jenny Smith (24:28) there oh, go ahead. (24:29) No. (24:29) No. (24:29) Go ahead. (24:30) I was gonna say there are there are good doctors.

Jenny Smith (24:33) There are good endos. (24:34) There are good high risk doctors, you know, in the whole realm of pregnancy with diabetes. (24:39) They are they're too few and far between because the the good doctors are willing to step outside of the box and say, while this is not the recommendation, there is value in trying this because I can see I can see how this medication, for example, works. (24:59) I can see how this system works. (25:00) They're the ones that at at night at home, they're not sitting down and reading the next romance novel.

Jenny Smith (25:06) They're actually online reading about open source. (25:09) They're online reading about medications expanding the use and how could this actually work in the type one population despite it being a type two medication. (25:19) Mhmm. (25:19) But there aren't enough of them.

Scott Benner (25:21) No. (25:21) The ones I meet are special and Yes. (25:24) You know, they deserve a a medal. (25:25) If the guidance is there, then the insurance isn't gonna cover it. (25:29) If the insurance isn't gonna cover it, then the device manufacturers aren't gonna push for it.

Jenny Smith (25:33) Right.

Scott Benner (25:33) Right? (25:34) Like, so you're going to get slower, what, forward motion with technology, with with ideas because there's there's no pressure to do it. (25:43) If the guidance was there, then one company would stand up and go, oh, we're gonna do this, which would make the rest of them go, oh, hell, we gotta do this now too. (25:51) And then, you know, and then you'd get your stuff more quickly. (25:54) And it would and I'm telling you, I think it would it would value it would add value to your life.

Scott Benner (25:58) I wish I could find I can't even remember her name right now. (26:01) I feel bad. (26:02) One listener who reached out to me and was like, yo, your daughter should try a loop. (26:07) And, like, I thought she was here right now. (26:08) I'd kiss her on the mouth and buy her a car.

Scott Benner (26:10) Like like, I think I'd be dead, like, without that because of what you mentioned earlier. (26:15) Like, I wasn't sleeping. (26:17) Like like yeah. (26:17) Like, Arden was super healthy. (26:19) I was awake nineteen and a half hours a day.

Scott Benner (26:21) And and, like, so they and there's that thing. (26:24) Just poof. (26:25) All good. (26:26) Here we go. (26:27) And it works.

Scott Benner (26:28) And then you walk out in the world, and all you hear is, oh, I don't know. (26:31) I don't know. (26:31) I don't know. (26:32) Yeah. (26:33) And it's forever.

Scott Benner (26:34) And they're gonna I don't know you to death

Jenny Smith (26:37) To death.

Scott Benner (26:37) Is is what I think. (26:38) And Mhmm. (26:39) It just so I'm not picking on the ADA or the guidance. (26:43) I'm just trying to show you how slow it is. (26:45) Like, why did I go back, like, just a handful of years?

Scott Benner (26:49) Because if you go back a handful of years, what you see is not a lot of motion.

Jenny Smith (26:52) Much change. (26:54) You know, I think the other really good thing that could come from the standards and I said before, in general, I think these standards are really more for the medical community truly. (27:05) Right? (27:06) But I do think that as a person with diabetes, it behooves you to also take a look at what they are on the continuum every single year when they come out. (27:17) Mainly because if there are things that you have been trying to address and bring up with your doctor, they may pop into the standards.

Jenny Smith (27:27) And if the doctor's still giving you pushback, you can bring it and kinda say, hey. (27:31) Look.

Scott Benner (27:31) Yeah. (27:31) It's okay.

Jenny Smith (27:32) This is part of the standards. (27:33) Why are we not discussing this? (27:35) I've brought it up for two years already.

Scott Benner (27:36) Yeah. (27:36) That thing where you tell me the GLP is gonna make me go into DKA, we can stop saying that now.

Jenny Smith (27:41) Right.

Scott Benner (27:41) The paper says you don't have to say it to me anymore.

Jenny Smith (27:43) And look at the other benefits that are coming out of it. (27:45) The more research, the more information, the fact that, yes, gosh, it is very beneficial for those with type one diabetes. (27:52) And, yes, even the micro dosing was of those was something that was also not done in the typical endocrine practice. (28:01) It was a this is the dose. (28:03) This is the standard starting dose.

Jenny Smith (28:05) We titrate it this way up, up, up, and see how you tolerate things. (28:09) And again, the sort of the gray area thinkers in the medical community were like, well, type one's very likely, and we can now see they do need a different dosing strategy than most type twos using these meds. (28:23) But it doesn't mean we shouldn't use them. (28:24) It means that we should figure out how to dose it better.

Scott Benner (28:27) It's the crazy leap that I never understand. (28:29) Right? (28:29) Like, it's oh, well, it's there's a label warning for type ones because they go into DKA with and so I said to somebody, I'm like, wait. (28:36) So GLPs cause DKA in type ones? (28:39) And they go, well, no.

Scott Benner (28:40) And I'm like, well, what's the problem then? (28:42) Well, GLPs make it so that some type ones need so little insulin, they don't take enough insulin, and they go into DKA because they're not eating. (28:51) And I went, oh, well, that's not the same thing. (28:54) Like like, you're

Jenny Smith (28:55) There's a big difference.

Scott Benner (28:56) Yeah. (28:56) You're fixing the problem in an unnecessary way. (29:00) Like Entirely. (29:01) Yeah. (29:01) And so it's it's the baby with the bathwater thing.

Scott Benner (29:04) Like, I just don't throw the whole thing away because you bumped into the first problem. (29:08) Like, you you know what I mean? (29:08) Like, oh, no. (29:09) You know, we gave GL because these are studies. (29:11) We gave GLP to people with type ones.

Scott Benner (29:13) Some of them went to DK. (29:15) So there now there's a label warning about it. (29:18) That's a big leap, you know, because the GLP lowers my daughter's insulin needs by, like, 30%.

Jenny Smith (29:24) Yes.

Scott Benner (29:24) Yeah. (29:25) She not in DK. (29:27) She's good.

Jenny Smith (29:28) She's good. (29:28) Right. (29:29) Because you've also you also know enough about titrating insulin. (29:32) Right? (29:33) I mean, you look at

Scott Benner (29:34) the fixable problem, not the you know, I'm sorry. (29:36) Cut you off. (29:37) Go ahead.

Jenny Smith (29:37) Oh, no. (29:37) No. (29:38) No. (29:38) I was actually just gonna compare it to it's a major problem because if you compare it even to all of the pharmaceutical ads, which I would a 100% be the one that's like, we gotta get them off the television. (29:50) Right?

Jenny Smith (29:51) But, like, if you look at any of them, at the end, there's always a host of it could cause this, call your toe cause your toe to turn purple and fall off, But that's just a potential side effect. (30:02) Right? (30:03) But they have to list side effects.

Scott Benner (30:04) Yes.

Jenny Smith (30:05) But if you look at that from a medical perspective, doctors are still prescribing these for the value of what they're prescribing them for, and often, they don't even talk about the side effects. (30:16) But when it comes to something like diabetes and the value and the very low chance of any of the side effects and if doctors were actually reading the research the correct way, they'd actually see that things like DKA with type one and the GLP ones, there's a there's a path to that happening. (30:34) Yeah. (30:34) And if you educate your patient the right way, that's it's not gonna happen, and it isn't a 100%. (30:40) It's it's utterly ridiculous.

Scott Benner (30:43) And it here's what it leads to. (30:44) It leads to me or somebody like me, you know, stepping like, Jenny, I've said this a thousand different ways, but, the way that it it sticks to me the most is that when I started talking about GLP medications, some parts of the Internet came after me with a hot poker and tried to shove it right up my, Okay?

Jenny Smith (31:01) I'm sure

Scott Benner (31:01) they did. (31:02) And I was like, no. (31:02) You guys are like, you're missing the boat, but how does that happen? (31:05) Because the ad says, you know, be careful blah blah blah blah blah blah. (31:09) And then somebody hears that, and then you say online, like, hey.

Scott Benner (31:12) You know, I was I've been doing this. (31:13) It's really working. (31:14) Look into it if you want to. (31:16) You're gonna kill people. (31:17) That makes this happen.

Scott Benner (31:19) I know a person who was in the hospital and their guts were turned into a knot and but, like, okay. (31:24) Give I'm not saying that it doesn't happen to some people, but there's also millions of people it's not happening to.

Jenny Smith (31:30) Like Correct.

Scott Benner (31:31) It's fascinating, and it and it goes back to you're not gonna remember this, but, like, when we recorded that pro tip series in, like, 2020, you didn't even know me that well then. (31:42) And I was like, Jenny, listen. (31:43) I'm like, I'm tired of, like, common denominator teaching for people. (31:47) Like, I know there's 20 kids in the class and two of them are really having trouble, but why are we teaching to them all the time? (31:53) Like, can't we teach to everybody else and protect them at the same time?

Jenny Smith (31:58) Right.

Scott Benner (31:58) Humanity doesn't work there. (31:59) They go, nope. (32:00) Sorry. (32:00) We can't. (32:01) We'll all just pretend that that's the level that we're all working with and the rest of it, we'll just sit around and pretend it doesn't happen and it doesn't exist.

Scott Benner (32:08) I'm not down for that anymore. (32:10) So No. (32:11) Yeah.

Jenny Smith (32:11) Are there many if I was writing the standards

Scott Benner (32:15) Mhmm.

Jenny Smith (32:15) Again, this is where nobody would live in Jenny's world. (32:18) But, I mean, there were

Scott Benner (32:19) I'm try before you say that, I'm trying to imagine a world where you have a child with type one diabetes and someone tells you to keep their a one c at 7.5. (32:27) And it was a and they'd be like, oh, you're doing great. (32:29) You're almost at 7.5. (32:30) Yeah. (32:30) That would happen, wouldn't it?

Jenny Smith (32:32) No. (32:32) No. (32:32) No. (32:33) No. (32:33) In fact, I'd have many words.

Jenny Smith (32:36) Many words as well as I mean, you know me. (32:38) You see me all the time when we when we do this. (32:40) Right? (32:41) You know that I have literally no poker face. (32:43) Like, I do not play cards.

Jenny Smith (32:45) I have no ability to hide. (32:47) It just shows on my face. (32:49) And I'm quite sure the doctor would be like, what do you what? (32:52) Really? (32:53) You don't believe me?

Jenny Smith (32:54) Like, I have no problem voicing my opinion there.

Scott Benner (32:57) By the way, there's a drift that happens. (32:59) If you tell somebody 7.5, then 8.2 doesn't seem that far from 7.5. (33:04) And then next week, you know, or next month or three months from now, we come back again and it all went to eight five. (33:10) You know, it's not bad. (33:11) It only went up point 2.3.

Scott Benner (33:13) You're doing great. (33:14) We'll try again. (33:15) Like, you know, and you just zoom.

Jenny Smith (33:17) And what you're bringing in is also a slower drift. (33:20) Right?

Scott Benner (33:20) Yeah.

Jenny Smith (33:21) Most people have ups and downs in their life. (33:24) Variables that impacting and let's say 7.5 has been your gold standard because that's what you've been told, and now you're at 7.6 or 7.7. (33:34) Again, the drift is so small that you you have just a concept with those numbers

Scott Benner (33:40) Mhmm.

Jenny Smith (33:40) That that's not a big change. (33:42) Like, whole number value is going from 7.5 to 8.5, I think, is a very visible larger jump that somebody would probably acknowledge and say, well, gosh. (33:51) Absolutely. (33:52) Something major has changed. (33:53) But anytime there's a little decimal drift, we don't really acknowledge it.

Jenny Smith (33:59) And, I mean, point 1.2. (34:01) Again, it really that

Scott Benner (34:02) blood sugar if your a one c moves around a little bit. (34:04) I'm saying that you get lulled into, like, complacency.

Jenny Smith (34:07) Entirely. (34:08) And so then 7.8 becomes 7.9 Yeah. (34:11) Becomes 8.1, becomes 8.4. (34:14) And that drift continues, but because it's so slow Mhmm. (34:18) You don't acknowledge where you started and how much you've drifted over a time period when the drift didn't have to happen if you knew what to do.

Scott Benner (34:27) It works the same way in your mind as gaining weight, not cutting the weeds around your house or something. (34:32) You just accept more and more of something that on day one you weren't excited to accept.

Jenny Smith (34:36) Absolutely. (34:37) Right.

Scott Benner (34:37) Now listen. (34:38) This year, there's some I think they made some really nice improvements this year. (34:42) Mhmm. (34:42) First time GLP receptor agonists are explicitly listed as recommended treatments or options for obesity in people with type one. (34:49) That's a great step for you.

Jenny Smith (34:50) Hundred percent.

Scott Benner (34:51) Awesome. (34:51) Great step. (34:52) New recommendations state that there should be no requirement for c peptide levels present of antibodies or duration of insulin use before initiating an insulin pump or an AID system. (35:02) That's a really good one.

Jenny Smith (35:04) It is huge. (35:04) Yeah. (35:05) Yeah. (35:05) Yeah. (35:05) Absolutely.

Scott Benner (35:06) This one's nice. (35:06) Workplace advocacy. (35:07) New, guidance explicitly states that adults using diabetes technology like pumps or CGM should receive reasonable accommodations in the workplace. (35:14) Now that's nice, but it took us till 2026 to say that? (35:18) Like, that one one we could have slipped in ten years ago?

Scott Benner (35:21) You know what I mean? (35:22) Like, here's a great one. (35:23) Percent. (35:24) Hospital safety. (35:25) A new safety standard mandates that hospital policies must ensure basal insulin is never held for people with type one diabetes.

Scott Benner (35:31) That's a great one. (35:32) I clap for that one.

Jenny Smith (35:33) 100%. (35:34) And that should be something that in bold type red when somebody comes into the emergency department. (35:40) Right? (35:40) And they acknowledge type one diabetes, highlighted in red blinking lights as soon as they acknowledge that or it comes up in the system is another statement. (35:50) Don't hold insulin.

Scott Benner (35:51) Yeah. (35:52) It's just it's insane. (35:53) My point over, I would say to whoever added that this year, congratulations. (35:57) Where the hell was that before? (35:59) Like, you're in charge of what the hospitals think about when so when you when people say all the time, I just had doctor Beachcham on a while ago.

Jenny Smith (36:06) Yeah. (36:06) I love her.

Scott Benner (36:07) She was lovely. (36:08) Right?

Jenny Smith (36:08) She's great.

Scott Benner (36:08) Yeah. (36:09) As I'm talking to her, like, she says this one thing that, like, strikes me. (36:12) It's like like, look. (36:13) We we follow the like, there's guidelines. (36:15) We we have protocols.

Scott Benner (36:17) Those protocols come from stuff like this. (36:19) So you're telling me that you could have added this ten years ago, and then for the last ten years, the people went to the hospital with type one diabetes wouldn't have their pumps taken from them or have their blood sugar shot way up and treated like they were type two and just on vacation. (36:31) Like, because that is really what kinda happens. (36:33) Right? (36:33) I go back to 2025, like, here I mean, it's more about screening, teplizumab, but sleep, cannabis warnings.

Scott Benner (36:42) What are you making cannabis warning? (36:43) A new specific recommendation to avoid cannabis use in people at risk for DKA to the risk of cannabis hypermysis syndrome. (36:52) Oh, come on. (36:53) Kidding me. (36:56) Whole world's high.

Scott Benner (36:57) Jesus. (37:00) You ever walk outside? (37:01) What is that I smell? (37:02) It's weed, Jenny. (37:03) It's everywhere.

Scott Benner (37:04) Okay? (37:04) No. (37:07) No. (37:08) Not for type ones. (37:09) You guys can't have weed.

Jenny Smith (37:10) You can't have it.

Scott Benner (37:11) No. (37:11) It's gonna make No. (37:12) Cannabis hyper mysis. (37:14) I don't know what the fuck that says. (37:15) And, like like, it just that's

Jenny Smith (37:17) good job trying to read it.

Scott Benner (37:18) This one here

Jenny Smith (37:19) think Go go

Scott Benner (37:20) ahead. (37:20) No. (37:20) No. (37:20) No. (37:20) You go.

Jenny Smith (37:21) I think some of the the newer things that are in this, you already mentioned in terms of just GLP one, that takes a heavy hit of explanation in many different categories, things like kidney health and heart health, cardiovascular. (37:39) GLP ones are mentioned in many different places Mhmm. (37:44) Which is thankfully, again, slow, but it is continuing to highlight the value of what they're finding. (37:53) And as we all know, research takes a long time to put together enough sort of quantifiable information that suggests to the positive before any broad statement can be made. (38:06) Right?

Scott Benner (38:07) Yeah. (38:07) It just I I I I was I didn't interview the other day with a guy who makes a GLP one podcast. (38:13) And he was talking about all the things that, you know, they know it's helping with and all the things that they're wondering if it's helping with and testing to see. (38:21) It looks like it is if you look at the population. (38:23) And he got done, I joked about it.

Scott Benner (38:25) But I said, feel like what you just told me is I'm gonna live forever. (38:27) And, like and I know that's not so it's not what it's not really true. (38:31) But if all these little things are happening behind the scenes in your body and now they're happening at a lesser degree and it's gonna it's gonna increase your longevity. (38:41) And but back to the original point, we've demonized GLPs for so many years now that there's now gonna be a whole generation of people who will never try them because they have an idea in their head or it's that oh, that's the thing you cheat with to lose weight or you do. (38:58) No.

Scott Benner (38:58) How about that's the thing that'll make my kidneys work better or my fatty liver go away? (39:03) Right? (39:03) Right. (39:04) How about my cytokines are going down? (39:06) How about that?

Scott Benner (39:07) Yeah.

Jenny Smith (39:07) Look at two big words.

Scott Benner (39:09) I know a couple of words, Jenny. (39:11) I used apoplectic in an episode the other day. (39:14) Just so you know. (39:15) Yeah. (39:15) Damn right.

Scott Benner (39:16) I've heard words before.

Jenny Smith (39:19) You're funny.

Scott Benner (39:20) Yeah. (39:20) No, please. (39:21) I guess that I would ask you. (39:23) I'm gonna put I'm gonna put that crown back on here for a second. (39:26) Right?

Scott Benner (39:27) Oh. (39:28) If you were in charge, what do you want people doing, looking at, thinking about, how do you want them measuring? (39:35) Like like, what's a big picture way people should be thinking about this for themselves? (39:40) It's a big question, but I think you can answer it.

Jenny Smith (39:44) The big question about how they should be looking at the standards for themselves

Scott Benner (39:48) Is that is that? (39:49) Like, how should they running their lives? (39:50) Like, what did they get up in the morning and say to themselves, like, this is what I should be trying for? (39:55) Like, I'm not saying you're gonna get it every day, but, like, let me rephrase it. (39:59) In a world where this amount of insulin Mhmm.

Scott Benner (40:03) Keeps my a one c at this level and a greater amount of insulin would keep it lower Right. (40:10) And we know that the only fear is that people are like, oh, you're gonna get low. (40:13) That's it. (40:14) Like, what do you think people should be I I'm telling like, look, I'm I'm gonna cover your ass for you before you start talking.

Jenny Smith (40:19) Oh, no.

Scott Benner (40:20) I know some of you don't wanna pump, some of you don't want a CGM, some of you can't afford of it. (40:23) I'm not saying that. (40:25) I'm talking about perfect world.

Jenny Smith (40:26) Sure. (40:27) In a perfect world, it would be an option for all people to have access. (40:34) Right? (40:34) Mhmm. (40:35) So that they could have enough information to say this is where I am.

Jenny Smith (40:40) So the starting point of, okay. (40:42) I've been told the 7.5. (40:43) I've I've recently learned I should technically be lower than that. (40:47) It is a a lot about insulin knowledge. (40:51) And so my, I guess, standard would be teaching people enough about knowing their insulin and how it works for them so that as they're looking at their numbers, whether it's just a finger stick or their CGM, they can say, okay.

Jenny Smith (41:05) Well, this is my base as you were getting at. (41:07) Like, this amount of insulin is keeping me here. (41:09) But if I'm really aiming here now, how do I get there? (41:15) It is about sometimes lifestyle stuff, but it is also about insulin. (41:20) And, gosh, I've got a base that's holding me here.

Jenny Smith (41:23) I wanna be 20 to 30 points lower. (41:26) What if I just add a little bit more insulin? (41:30) And, again, I always encourage you to talk to your medical provider. (41:33) Don't just dial things up by 30 extra units, but even little titrations. (41:38) Let's say a meal is consistently sending you high and you're using three and a half units.

Jenny Smith (41:42) Well, goodness. (41:43) Three and a half up to four. (41:45) If you're on three units already for a meal is

Scott Benner (41:48) Yeah.

Jenny Smith (41:48) Half a unit is not really gonna but it is gonna help to move you forward. (41:52) So I think standards should go in the direction of teaching people how to move where they want to get to if they even know. (42:03) Mhmm. (42:04) You know, the broader population of people again think doesn't know enough, and that makes me sad.

Scott Benner (42:12) Yeah. (42:13) No. (42:13) I'm with you.

Jenny Smith (42:14) So if you have standards, I think it's it's the people who are already looking for more that are going to look for these standards as again, a way to bring into their doctor to say, hey, look at this. (42:27) Like, we've never talked about this. (42:28) I've been talking about it. (42:30) It's now a standard. (42:31) But other people are hoping that their clinician who has the white coat in on and has gone to school for eight, ten, twelve years that they should know these things Mhmm.

Jenny Smith (42:41) And that they're bringing it into the practice and helping them.

Scott Benner (42:45) But those people are waiting for the the the buttonless pumps, which I think are probably coming, but they're not gonna come as quickly as you hope. (42:52) You you know?

Jenny Smith (42:53) And there are years until that point of which there's stuff going on in your body that I mean, we've talked about it before, like the incremental little things that end up happening aren't like, gosh, I have diabetes and three days later I have heart disease. (43:08) That's not how this

Scott Benner (43:09) works. (43:10) Right.

Jenny Smith (43:11) It's incremental and it's it's unfelt. (43:14) You don't feel nor do you see the internal stuff that is going on until you get to the point of I mean, again, I you brought up Mike.

Scott Benner (43:25) You stand up to make dinner. (43:26) Yeah.

Jenny Smith (43:27) You stand up to make dinner or the doctor says, hey. (43:29) You know, your urine sample shows that you're spilling such and such. (43:33) I think you've got kidney disease. (43:34) Mike didn't feel anything going on.

Scott Benner (43:36) Nope. (43:36) He had no idea. (43:38) He really didn't. (43:38) Diabetes is not a cross we'll cross that bridge when we come to it situation. (43:43) Like, need to be you need to be thinking about it every day.

Scott Benner (43:46) And and I even take that not everybody's going to, and that's fine. (43:50) But I I just I really do wanna repeat again to anybody listening who makes a decision. (43:54) If the island's on fire and there's only so many boats, we still tell people the island's on fire so they have a chance to get away. (44:02) Correct. (44:02) Right?

Scott Benner (44:02) You don't get to make the decision about whether or not I die in the island fire. (44:07) Right? (44:07) Like, so

Jenny Smith (44:08) I I'd be looking for the largest branch to float on. (44:10) If the boats were full, man, I'd be looking for the door or whatever.

Scott Benner (44:14) You gotta give people a fighting chance.

Jenny Smith (44:16) You do.

Scott Benner (44:17) If your argument is, well, everyone's not gonna understand. (44:19) Everyone's not gonna have the bandwidth. (44:21) Everyone's not gonna have access, So we just won't tell anybody. (44:25) That's a terrible perspective to have. (44:27) Right?

Jenny Smith (44:28) It's also judging somebody from what you think you gathered out of a ten or fifteen minute office conversation with someone.

Scott Benner (44:36) Which isn't that funny considering that when I scroll back through this document, the ADA is always worried about people being treated properly.

Jenny Smith (44:45) 100%. (44:45) It's in the it's in these. (44:47) It's one of the things that treating people with individualization and empathy and and all the wordage that they can possibly use, but let's put it into a fact.

Scott Benner (44:57) Yeah. (44:57) Let's not then tell them a seven five's okay. (45:00) That's hilarious. (45:01) Like Right. (45:02) Everyone deserves to be treated well.

Scott Benner (45:04) Blah blah blah. (45:04) And now you know you know what it takes me back to? (45:07) I was at a blogging conference one time, and I got caught in an elevator with a person who

Jenny Smith (45:12) conference.

Scott Benner (45:13) I was. (45:14) There was a blocking conference for people with type one diabetes. (45:16) I don't know what to tell you. (45:17) They used to exist. (45:18) I got into an elevator with a person who I was like, oh my gosh.

Scott Benner (45:21) This person was like like one of the gold standard people in the space. (45:24) And I had gotten to over a couple of days watched them, And I was like, this person really knows what they're doing with their diabetes. (45:32) But public facing, it was a lot of like, woe is me and isn't this hard and blah blah blah. (45:38) And I was like, oh, you understand this one way, but you talk about it another way. (45:43) Another way.

Scott Benner (45:44) And I did at some point say to them, like, why don't you talk about it more like this? (45:47) And so I'm not getting involved in that. (45:50) Oh, yeah. (45:51) And those same people told me, I can't do what I'm doing. (45:55) Mhmm.

Scott Benner (45:55) And I I've complained about it enough. (45:57) I don't wanna complain about it again. (45:59) But when I started doing this, I got pulled aside by people who were like, you can't tell people how you manage your daughter's diabetes. (46:06) And I was like, why not? (46:07) I was like, it's just what we do.

Scott Benner (46:08) And they're like, yeah. (46:08) You're gonna hurt someone.

Jenny Smith (46:09) It's like having conversation with somebody you run into at the coffee shop, right, who wants to tell you about how they manage the exterior of their vehicle. (46:19) Well, you know what? (46:19) If you hold

Scott Benner (46:20) them Jenny, they can't see the big picture. (46:22) I'm just telling you. (46:22) Okay?

Jenny Smith (46:23) Yeah. (46:23) Yeah. (46:24) I don't And, you know, and and what you were talking about as well, I think you were seeing somebody as the front face of of, like, what they were spilling out into the community, but you also saw behind the scenes the fact that they were doing something different on a personal level. (46:44) Yeah. (46:44) When I went into this field specifically, I thought about eons ago when my parents got married, my dad was a smoker.

Jenny Smith (46:54) Mhmm. (46:56) My dad went to his primary care doctor, and his doctor told him to stop smoking, that it was going to be detrimental. (47:05) This was obviously at the point that that was coming to be

Scott Benner (47:08) Breaking news.

Jenny Smith (47:09) Breaking news. (47:10) And so, you know, it goes home thinking about this blah blah blah whatever. (47:14) And out in public, my dad sees his doctor smoking. (47:19) And he's like, what the and I remember that story. (47:23) Yeah.

Jenny Smith (47:23) Because when I went into doing something that is so it has become very visible now, especially. (47:31) Mhmm. (47:32) I don't want to tell someone one thing and not do it in my own life. (47:38) I don't think that's fair.

Scott Benner (47:40) Yeah.

Jenny Smith (47:40) I think that if you put something out there, then you should absolutely hold that as something that's also important for the value of your own life. (47:51) And I think that it's just being truthful in my opinion.

Scott Benner (47:55) I've said a thousand times. (47:57) I don't know how I was supposed to know all this and then just not tell anybody about it.

Jenny Smith (48:03) Pretend.

Scott Benner (48:03) Yeah. (48:04) Ridiculous. (48:04) It was ridiculous. (48:05) That person was having great outcomes and was, you know, really on the ball. (48:10) Then when they talked to people, was always like, oh, I know it's hard.

Scott Benner (48:13) It's okay. (48:14) And Mhmm. (48:14) Go two fifty. (48:15) You're fine. (48:16) Like, I'm not saying your blood sugar might not go to two fifty once in a while.

Scott Benner (48:19) I'm saying don't set that in people's minds as expectation. (48:22) Like, it's okay to say this is gonna go wrong sometimes, but here's our goal. (48:28) Like, there's and if you don't make the goal, it's not a failure. (48:31) It's just like, don't act like that's not the standard we're looking

Jenny Smith (48:36) that the goal can shift.

Scott Benner (48:37) Sure. (48:38) Right?

Jenny Smith (48:39) Yeah. (48:39) You you have somebody who starts with an a one c of 8.5, and you say, well, the initial goal is 7.5. (48:46) But this is a moving goal. (48:47) Eventually, we wanna get down here, and, eventually, we wanna have an average more around this. (48:52) Eventually, we don't want your your numbers to look like a, you know, the Rocky Mountains.

Jenny Smith (48:57) We want it to be a little smoother. (48:59) Eventually, eventually, and they're they are. (49:01) They're baby steps for some people. (49:03) Other people, no. (49:04) Not at all.

Jenny Smith (49:05) And some people gather all the information you want, and they apply it, and they go home, and they change everything.

Scott Benner (49:09) I get those notes. (49:10) They're those notes are crazy. (49:12) Great. (49:12) Yeah.

Jenny Smith (49:12) Yeah. (49:13) Fantastic. (49:14) But you have to have also from a clinical standpoint, you have to have the vision of where could somebody get to if I just give them this little nibble of information that could help right now.

Scott Benner (49:24) Right. (49:25) But I've spoken to clinicians who will tell you that there are people that come into their office that they don't even try to talk to because they've decided ahead of time they're not gonna figure it out. (49:34) I think I've had a conversation with somebody with an IQ from, like, 80 up to a 170. (49:39) And they all have the same concerns. (49:41) They all have the same roadblocks to understanding.

Scott Benner (49:45) And there's and by the way, I use the same language to get them all to a place where they can figure it out. (49:50) I I I have an example right now that I'm incredibly proud of, but I won't like, I don't wanna embarrass anybody. (49:56) But there's a person listening to this podcast right now that really is limited, and they're still doing well for themselves. (50:03) And so so everyone gets to know what happens when the island burns down. (50:08) It's up to them what they do with it.

Scott Benner (50:09) It's not up to you as to whether or not they die without ever having fought for themselves. (50:14) That's how

Jenny Smith (50:15) I what they can use.

Scott Benner (50:17) Right? (50:17) Right. (50:18) Don't stop them from I can't get a c peptide test until what was it? (50:22) You know? (50:22) And so I can't have a pump or I can't like, that's insurance bullshit.

Scott Benner (50:26) Like, don't

Jenny Smith (50:26) A 100%.

Scott Benner (50:27) Yeah. (50:27) Yeah. (50:27) Yeah. (50:27) Don't, I mean, don't try to pretend like that's some sort of rule. (50:30) There are so many rules around life and diabetes more specifically that have nothing to do with anything, and I try so hard.

Scott Benner (50:38) Like, you know, I like, I'll I'll be like, oh, it's the pot roast story about the short pan. (50:43) I'm try just trying to get you to think like, oh, maybe there's no reason I have to do this.

Jenny Smith (50:47) Right. (50:49) My pan is big enough. (50:50) I don't have to cut the ends off anymore.

Scott Benner (50:52) Get a bigger pan? (50:53) Like, how about I do something for my like, there's no I and listen. (50:57) Some of you are rule followers, and god bless you. (50:59) I don't know your what your illness is. (51:00) Okay.

Scott Benner (51:01) I was like, but, like, I'm not some crazy podcast. (51:04) You guys have been listening to me long enough now. (51:06) This just seems like common sense to me. (51:08) I'm not saying you all need to be on a GLP. (51:11) I'm not saying you all need to be doing anything.

Scott Benner (51:13) I'm saying, like, don't limit yourself. (51:15) To me, I've been having the same conversation about thyroid for eight years. (51:19) The amount of people who are not medicated well for their thyroids and how horrible it's impacting their lives is inconstionable. (51:26) Like, it's so simple to figure out. (51:29) And still, like, I talked to a woman the other day.

Scott Benner (51:31) Jenny, I said, list all your issues. (51:32) She listed them. (51:33) She got done. (51:34) I went, you have Graves'. (51:35) She goes, well, no.

Scott Benner (51:36) They said that, my test is, like, point one or something on the wrong I'm like, no. (51:41) You have Graves'.

Jenny Smith (51:42) Please find a good clinician who can actually

Scott Benner (51:44) pops out of the side of her head or her eyes fly forward, they'll go, she might have Graves. (51:49) Great. (51:50) Alright. (51:50) Listen. (51:51) Go fight for yourselves.

Scott Benner (51:52) Stop it, Jenny. (51:53) Thank you.

Jenny Smith (51:54) Yeah. (51:54) Of course.

Scott Benner (51:55) I I'm all upset now. (52:03) My diabetes pro tip series is about cutting through the clutter of diabetes management to give you the straightforward practical insights that truly make a difference. (52:12) This series is all about mastering the fundamentals, whether it's the basics of insulin, dosing adjustments, or everyday management strategies that will empower you to take control. (52:22) I'm joined by Jenny Smith, who is a diabetes educator with over thirty five years of personal experience, and we break down complex concepts into simple, actionable tips. (52:32) The diabetes pro tip series runs between episode one thousand and one thousand twenty five in your podcast player, or you can listen to it at juiceboxpodcast.com by going up into the menu.

Scott Benner (52:43) Okay. (52:43) Well, here we are at the end of the episode. (52:45) You're still with me? (52:46) Thank you. (52:46) I really do appreciate that.

Scott Benner (52:48) What else could you do for me? (52:50) Why don't you tell a friend about the show or leave a five star review? (52:54) Maybe you could make sure you're following or subscribe in your podcast app, go to YouTube and follow me or Instagram, TikTok. (53:03) Oh, gosh. (53:03) Here's one.

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#1727 Bolus 4 - Applesauce

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Scott and Jenny discuss how to bolus for applesauce.

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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 back to another episode of the Juice Box podcast. (0:14) In every episode of bolus four, Jenny Smith and I are gonna take a few minutes to talk through how to bolus for a single item of food. (0:21) Jenny and I are gonna follow a little bit of a road map called meal bolt. (0:26) Measure the meal. (0:28) Evaluate yourself.

Scott Benner (0:29) Add the base units. (0:30) Layer a correction. (0:32) Build the bolus shape. (0:33) Offset the timing. (0:34) Look at the CGM.

Scott Benner (0:36) Tweak for next time. (0:37) Having said that, these episodes are gonna be very conversational and not incredibly technical. (0:44) We want you to hear how we think about it, but we also would like you to know that this is kind of the pathway we're considering while we're talking about it. (0:51) So while you might not hear us say every letter of Miele Bolt in every episode, we will be thinking about it while we're talking. (0:58) If you wanna learn more, go to juiceboxpodcast.com/meal-bolt.

Scott Benner (1:04) But for now, we'll find out how to bowl us for today's subject. (1:10) While you're listening, please remember that nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. (1:18) Always consult a physician before making any changes to your health care plan or becoming bold with insulin. (1:29) Applesauce.

Jenny Smith (1:31) I brought a whole bunch of applesauce to Florida.

Scott Benner (1:34) You brought applesauce to Florida?

Jenny Smith (1:35) Well, I shouldn't say we brought it to Florida. (1:37) So we, as I've told you before, we like, if we're gonna be on vacation to save money and just be more economical

Scott Benner (1:45) Yeah.

Jenny Smith (1:45) Especially at parks, which are just expensive. (1:48) Right? (1:48) We order in from Amazon Right. (1:50) Whatever cart or whatever it's called fresh. (1:53) And so one of the things we order was applesauce because it's easy for both me in terms of carrying it around as well as for the boys.

Jenny Smith (2:02) They love applesauce.

Scott Benner (2:03) Nice. (2:03) So I'm gonna guess it wasn't Mott's applesauce, though, which is the one I'm looking at.

Jenny Smith (2:07) It wasn't. (2:08) It was an organic unsweetened

Scott Benner (2:12) Organic, unsweetened applesauce. (2:14) You're ruining applesauce, Jenny. (2:16) Well, why doesn't it have to

Jenny Smith (2:17) be sweetened? (2:17) It's got natural it's got natural sugar. (2:19) It's just like eating an apple that's been pureed. (2:21) So would you do you put do you put sugar on your bites of apple slices? (2:26) No.

Jenny Smith (2:26) I'm sure there are some people that do. (2:28) I've got a friend who actually put sugar on her watermelon. (2:30) So you know?

Scott Benner (2:31) Wait. (2:31) You have a friend who sugars their watermelon?

Jenny Smith (2:33) Yeah. (2:34) Don't ask.

Scott Benner (2:35) Isn't watermelon just sugar?

Jenny Smith (2:37) She doesn't have diabetes.

Scott Benner (2:38) Well, obviously not. (2:40) No. (2:41) Okay. (2:41) Well, what's your organic applesauce called? (2:43) Because you're gonna do one off the shelf one and one Jenny one.

Jenny Smith (2:46) Yeah. (2:47) The organic one, I'd have to look run upstairs to look at

Scott Benner (2:51) apple sauce. (2:52) Maybe I can find it. (2:53) I don't need you to run around. (2:54) Is it Thrive? (2:56) Is it

Jenny Smith (2:57) not Thrive. (2:58) It is Nature So if I get it well, one, if I get it at, like, Costco has just a plain applesauce that's organic, which is usually what I get for, like, lunch boxes and stuff for the boys.

Scott Benner (3:09) I'll find out.

Jenny Smith (3:09) But the one that I usually get is it's a brand name, and it's not Mott's. (3:15) It's like a green they usually have, like, the Gogo. (3:19) I think it's the Gogo brand.

Scott Benner (3:20) Well, I mean, I'm looking at the one from

Jenny Smith (3:23) Yeah. (3:23) The Gogo Squeeze.

Scott Benner (3:24) Oh, Gogo Squeeze?

Jenny Smith (3:26) The Gogo Squeeze organic applesauce packets. (3:28) Yes.

Scott Benner (3:29) Well, I have to say this. (3:30) That's an awesome name for a product.

Jenny Smith (3:33) There you go.

Scott Benner (3:34) Go Go Squeeze.

Jenny Smith (3:35) Yeah. (3:36) And some of them come with applesauce that has spinach in it or applesauce that's blended with, like, peaches and kale and or cinnamon or, you know, that kind of stuff so you can kinda be sneaky Really? (3:49) With your kids and sneak a little bit of extra something in that they don't know is there.

Scott Benner (3:54) I wouldn't have thought that.

Jenny Smith (3:56) But in general, I expect unless the mozz is sweetened that you're looking at, I'd expect similar impact from whatever brand of organic fancy pants, you know, with apple pie.

Scott Benner (4:10) Fancy pants. (4:11) Well, I'm gonna start with the mozz. (4:12) Right?

Jenny Smith (4:13) Cool.

Scott Benner (4:13) Okay. (4:14) So I'm gonna measure this meal up. (4:15) Total fat, none. (4:16) This, of course, always, amuses me because sugar gets stored as fat later. (4:22) And I I love when high sugar things are like, there's no fat in it.

Scott Benner (4:25) Awesome. (4:25) Thanks.

Jenny Smith (4:26) But if you eat the whole carton?

Scott Benner (4:27) You'll find some eventually. (4:28) No sodium. (4:29) That's good that they didn't think to have to put salt into applesauce. (4:33) Carbs, now this is a it's a pouch. (4:35) So we're sticking with

Jenny Smith (4:36) this Is it, like, three ounce pouch?

Scott Benner (4:39) 90 grams. (4:40) How many ounces is that?

Jenny Smith (4:43) Granny grams, I think that's three ish ounces if I remember because I think that's the average size pouch of apple sauce is three ounces, I think, 90 grams.

Scott Benner (4:51) Okay. (4:52) Yeah. (4:52) Because the the GoGo Squeeze is 3.1 or no. (4:57) The Kirkland. (4:58) Hold on a second.

Scott Benner (4:59) So, yeah, I'll get to that in a second. (5:01) Dietary fiber, one gram. (5:02) Total sugars, 14 grams. (5:04) Added sugar, Jenny, seven grams. (5:06) So, yes, they did sugar the apples.

Jenny Smith (5:08) The moths has added sugar besides the natural apple sugar?

Scott Benner (5:12) Yes. (5:12) They've got the moths, and they've got seven grams of sugar. (5:15) Potassium, seventy milligrams. (5:17) Vitamin c, nine milligrams. (5:19) So this is a great one.

Scott Benner (5:21) Right? (5:21) Because Mhmm. (5:22) These are this is a grab and go treat, I would imagine, for kids. (5:25) They probably and they probably don't just grab it. (5:26) They grab it and they, like

Jenny Smith (5:28) Squeeze it down. (5:29) I mean, it's in in it's in within not even fifteen seconds. (5:33) It's sucked down. (5:34) Yes.

Scott Benner (5:34) Okay. (5:35) Alright. (5:35) So, yes, three point one seven ounces in the pouch. (5:39) Do you use applesauce for Lowe's?

Jenny Smith (5:41) Applesauce, I like for Lowe's.

Scott Benner (5:43) Yeah.

Jenny Smith (5:44) I do.

Scott Benner (5:45) On the go or all the time?

Jenny Smith (5:46) No. (5:47) They're more of an on the go. (5:48) They're things that I like, when I had a stroller for children, just a while ago, they were easy to keep in the zip because they didn't have to be refrigerated. (5:58) They could sit there, you know, for a week or two without getting gross. (6:02) They don't have unless you've opened it.

Jenny Smith (6:04) Right? (6:05) And then I usually keep it in, like, my backpack if we go biking or something like that because it is an easy thing to use, and it's not quite as fast as some of the more fuel, like, gels and goos and that kind of thing. (6:18) Mhmm. (6:19) But, again, in exercise, applesauce helps me to catch without a really quick hit. (6:25) So it's not as quick as dextrose or glucose or candy by far.

Jenny Smith (6:31) But if you're just trying to stop a slide down, applesauce can work pretty well.

Scott Benner (6:36) Yeah. (6:36) You I know, just realized how many things I don't understand because I don't understand why applesauce doesn't need to be refrigerated.

Jenny Smith (6:43) The packaged pouches don't have to be refrigerated because of the way that the apples are processed. (6:49) They're they're cooked essentially to make them into applesauce. (6:52) Right?

Scott Benner (6:52) Right.

Jenny Smith (6:53) And then it's it's almost like the pouches are a they're a contained bacteria free environment until you actually open it.

Scott Benner (7:02) I wonder if

Jenny Smith (7:03) they Once opened, then they would have to be refrigerated.

Scott Benner (7:05) I wonder if they pasteurize applesauce.

Jenny Smith (7:08) I would guess they probably do. (7:11) I mean, they're not really canning it. (7:14) Like, my mom used to, when I was little, make canned applesauce. (7:18) She canned everything. (7:19) She still does.

Jenny Smith (7:21) Dill pickles. (7:22) I don't get store bought dill pickles because my mother still makes canned pickle.

Scott Benner (7:26) What so your mom grows the cucumbers. (7:28) This is getting away from applesauce. (7:29) Grows the cucumbers, brings them in, and cans them, and then turns them into pickles?

Jenny Smith (7:34) Oh, yes. (7:35) Yes. (7:35) She doesn't grow most. (7:36) I mean, most of them, she buys actually at the farmer's market, or she knows farmers around the area, and so she gets the the canning pickles.

Scott Benner (7:43) Okay.

Jenny Smith (7:44) I mean, my mom doesn't can, like, two two jars of pickles.

Scott Benner (7:47) How old is your mom?

Jenny Smith (7:49) She's in her seventies.

Scott Benner (7:50) She's in her seventies? (7:52) Alright. (7:52) I like it. (7:53) Jenny's mom is pickled.

Jenny Smith (7:55) And sauerkraut. (7:56) Oh my god.

Scott Benner (7:57) That's probably good.

Jenny Smith (7:59) Sour my mom's sauerkraut. (8:01) Everybody wants my mom's sauerkraut. (8:03) It is fantastic.

Scott Benner (8:04) I actually I I love sauerkraut.

Jenny Smith (8:06) So anyway

Scott Benner (8:06) Only one in the house. (8:07) That's not the point. (8:08) By the

Jenny Smith (8:08) way only one in the house.

Scott Benner (8:09) Yeah. (8:09) Nobody else will eat it. (8:10) Also, applesauce is pasteurized. (8:13) But let's get back to bolusing for this pouch. (8:16) So Yes.

Scott Benner (8:17) Here we go.

Jenny Smith (8:18) And, we're bolusing for it in an environment of just eating the applesauce. (8:23) Correct?

Scott Benner (8:23) The applesauce. (8:23) Yeah. (8:24) Okay. (8:24) But we'll talk about it in a second in another way. (8:26) But so you measure the meal.

Scott Benner (8:28) We've got 16 carbs. (8:30) Evaluate yourself. (8:31) I mean, let's say the kid's getting ready to, I don't know, just running through the house. (8:36) Right? (8:36) Like, mom, I'm hungry.

Scott Benner (8:37) You're like, and they grab an applesauce thing. (8:39) Blood sugar's where it is, one twenty. (8:41) We're gonna add up the the carbs. (8:42) Right?

Jenny Smith (8:43) Right.

Scott Benner (8:44) We're gonna do our base units, figure out what we need. (8:46) One if we're one to 10, it's 1.6 for the applesauce.

Jenny Smith (8:50) Right.

Scott Benner (8:51) And, I mean, this one I find interesting because I think of it as a grab and go in this situation. (8:57) So you're not gonna get a pre bolus out of anybody. (9:00) No one's gonna grab their applesauce pouch and then be like, I'll wait fifteen minutes for this. (9:06) It's just not happening. (9:07) Right?

Scott Benner (9:07) What do you do? (9:08) You just pop it in there and hope for the best, or would you over bolus it a little bit?

Jenny Smith (9:13) Well, you know, the interesting thing is that apples turned into applesauce

Scott Benner (9:18) Mhmm.

Jenny Smith (9:19) Without sweetener don't actually have a very high glycemic index.

Scott Benner (9:25) Not much of a kick to it.

Jenny Smith (9:26) So there's technically not much of a kick. (9:29) But, again, eating it in its own space and not really prebolising, you're gonna get a little bit of a hit from it compared to having some time for prebolus. (9:42) But it's going to be gentle compared to sitting down to, as I said before, like watermelon or pineapple or any of the tropical fruits have a much higher glycemic index.

Scott Benner (9:52) Mhmm.

Jenny Smith (9:52) So applesauce, you can probably get away with a little bit less of that concern about a really big huge spike. (9:59) And, if your insulin dose is correct, meaning your ratio is correct, then, sure, your blood sugar might go up, but it's going to come back down. (10:08) It's gonna respond pretty quickly. (10:10) You're not eating anything else with it, so you're gonna get an up and a down and then even it out.

Scott Benner (10:15) I think Mott's applesauce, if I'm seeing this correctly, might have high fructose corn syrup in it.

Jenny Smith (10:22) I was gonna ask about the added because you said there are added sugars, seven grams of added sugar.

Scott Benner (10:28) Yeah. (10:28) They're not very forthcoming on the website.

Jenny Smith (10:31) And if that's the case, then this type of applesauce would likely have a faster hit because it's got added sugar, not just natural apple sugar in it.

Scott Benner (10:42) They do have a real apple promise on the website.

Jenny Smith (10:45) Oh.

Scott Benner (10:46) Yeah. (10:46) That's nice. (10:47) But but they're not gonna make it easy for you to find out what's in that applesauce. (10:51) Hold on a second. (10:52) That's interesting.

Jenny Smith (10:53) Well, that's gotta be on the back of the box.

Scott Benner (10:55) Mott's applesauce ingredients, very rare product, but the classic variety typically includes oh, yeah. (11:00) I'm we're gonna have to do the Amazon thing again because their their websites this is pretty common, by the way, I'm finding while we're doing this.

Jenny Smith (11:07) Are hard to find the actual?

Scott Benner (11:09) Yeah. (11:09) On purpose, it seems like. (11:11) So it it really does feel like they don't want you to be able to find too easily what's going on, but Amazon gives you the back of the box usually. (11:20) There it is. (11:23) Apples, high fructose corn syrup.

Jenny Smith (11:25) Good call.

Scott Benner (11:26) Water, ascorbic acid, vitamin c processed under the authority of Motz LLP. (11:33) Boy. (11:34) Yeah. (11:34) It's just

Jenny Smith (11:35) The second ingredient is high fructose corn syrup.

Scott Benner (11:37) Yeah. (11:38) Yeah. (11:38) They get right into it. (11:39) The Kirkland brand that you brought up

Jenny Smith (11:43) is The organic one. (11:44) Yeah.

Scott Benner (11:44) It's the Oui. (11:45) Yeah. (11:45) Same size, 3.17. (11:47) Who knew there was an exact amount that squeezable applesauce came in? (11:51) I can't believe I'm so happy you said that because I was like, oh, that's crazy.

Scott Benner (11:54) Kirkland puts the thing right the thing the nutritional facts right on here. (11:58) Organic apples, ascorbic acid to protect color. (12:02) That's it. (12:02) There's apple.

Jenny Smith (12:03) What ascorbic acid is. (12:05) Right? (12:05) No. (12:06) Vitamin c.

Scott Benner (12:07) It's oh, yeah. (12:07) I do know that. (12:08) Why did I say no? (12:09) That's ridiculous.

Jenny Smith (12:09) Like, usually it's actually I mean, you can do the same thing in terms of protecting the color as well as more of a preservative

Scott Benner (12:16) Mhmm.

Jenny Smith (12:17) With just adding, like, lemon juice. (12:19) A lot of people who canned fruits will add lemon juice because it adds an acidic. (12:23) Ascorbic acid is acidic.

Scott Benner (12:25) I didn't know it did that.

Jenny Smith (12:25) And so it yeah. (12:26) It adds preserves it from turning gross. (12:29) Okay.

Scott Benner (12:29) Here's something interesting for you who care. (12:32) The Mott's applesauce pouch has 90 calories in it. (12:36) The Kirkland organic has 45 calories. (12:38) So you're doubling the calories, doubling the sugar for the most part. (12:42) There's no

Jenny Smith (12:42) And changing the glycemic impact without adding sugars, your again, glycemic index of just applesauce is probably somewhere in the thirties.

Scott Benner (12:51) Yeah.

Jenny Smith (12:52) I as like, maybe. (12:53) But with the ones that have added sugars like corn syrup, you're definitely gonna get a faster hit because almost is it, like, 50%? (13:04) Is it 16 total grams in the Motts?

Scott Benner (13:06) Yeah. (13:07) Well, it's 16 in the Motts, 10 in the Kirkland. (13:09) God, this is making me irritated. (13:12) Because I just remember growing up, like, it was just one of the things that I thought was sweet and healthy, and now I realize it wasn't.

Jenny Smith (13:18) Like, oh, darn. (13:19) I thought I was eating apples when I had that mozz.

Scott Benner (13:21) You mean, I was hoping total carbs in the Kirkland 10, no fiber, eight sugars, no added sugar. (13:29) So this Kirkland's gonna hit completely different than the mozz will.

Jenny Smith (13:31) Mhmm. (13:32) Correct.

Scott Benner (13:33) Okay.

Jenny Smith (13:33) So, again, from an aspect of getting something that you want some nutrition from without a big hit, you're gonna look for the unsweetened applesauce packets rather than the typical Mott's. (13:49) And I don't even know if Mott's has an unsweetened one. (13:52) I I don't know. (13:53) They might. (13:53) I just know the brands that I typically go for, and that's what is on my list.

Scott Benner (13:57) So Mott's no sugar app added applesauce. (14:00) Oh. (14:01) Okay. (14:03) It it lines up with everything. (14:05) Guess, how would it not line up with everything else?

Scott Benner (14:07) It's just freaking apples.

Jenny Smith (14:08) So Right.

Scott Benner (14:09) Yeah. (14:10) It they have a no Motts has a no sugar added. (14:13) They do not add any sugar to it. (14:16) Let's see if I can find it here to see if they've snuck something else into it or maybe not. (14:23) Maybe we're maligning them for no reason.

Scott Benner (14:26) Well, I am. (14:26) You haven't really said anything. (14:28) Cruel.

Jenny Smith (14:29) What's that?

Scott Benner (14:29) I said maybe I'm maligning them for no reason. (14:32) Oh. (14:32) No sugar added applesauce, 50 calories. (14:39) Yeah. (14:39) Well, the carbs are still a little higher.

Scott Benner (14:42) It's interesting. (14:43) And it's still hard to find the ingredients.

Jenny Smith (14:46) The actual ingredient?

Scott Benner (14:47) Isn't that interesting? (14:49) I wonder why they oh, here it is.

Jenny Smith (14:52) Now everybody is going to be in the applesauce aisle.

Scott Benner (14:56) I hope so.

Jenny Smith (14:57) Beaverishly looking at the labels.

Scott Benner (14:59) Hey. (14:59) Which one? (15:00) Apples, water, ascorbic acid. (15:02) So okay. (15:03) So mods does it that way too.

Scott Benner (15:05) And the go go squeeze just for people because we brought it up, 15 total carbs. (15:09) This has fiber in it though.

Jenny Smith (15:11) Mhmm.

Scott Benner (15:11) Three grams of fiber, 12 sugars 12 grams of sugar, no added sugar. (15:18) So, also, I like how I love it when they say things that are obvious. (15:23) Like, it's gluten free. (15:24) I'm like, thanks.

Jenny Smith (15:25) I I know. (15:26) Thank you.

Scott Benner (15:26) Like, taking credit for stuff that's obvious. (15:28) You know what I mean?

Jenny Smith (15:29) Well, and it used to I they don't I don't think they do it as much anymore, but even products like this used to say cholesterol free. (15:35) Yes. (15:35) It it should be cholesterol free. (15:37) There was there was no organ system whatsoever in that apple.

Scott Benner (15:41) Putting grease in there, are you? (15:43) Even kosher. (15:45) Although BPA free, that's interesting for the go go squeeze.

Jenny Smith (15:48) For the in the lining of the product. (15:50) Yeah.

Scott Benner (15:50) Spending a little money on the more money on the package, maybe. (15:53) Does oh, I gotta tell you, Costco, same thing. (15:56) BPA free. (15:58) Whiskap, organic applesauce, 24%

Jenny Smith (16:02) of the One of the reasons I like the the Kirkland is because it's the lowest of any in carbs that I've found Yeah. (16:09) On the market at only 10 grams per packet.

Scott Benner (16:11) I'm gonna grab it next time I'm there and try it. (16:14) Can I just be old for a second and complain about something before we're done? (16:17) Because we're clearly done without Although, the wait. (16:19) Before I get old, what about when I put it on a plate, the way my mom gave it to me? (16:23) A pork chop, mashed potatoes, and applesauce.

Scott Benner (16:26) Green bean.

Jenny Smith (16:27) Pork chops and applesauce. (16:28) Come on. (16:29) You know the Brady Bunch episode.

Scott Benner (16:30) Don't you I'd say that's how we got it. (16:32) It's probably where my mom came up here. (16:33) Yeah.

Jenny Smith (16:34) Pork chops and applesauce.

Scott Benner (16:36) Now I've got the the potatoes are a tough sell on the digestin. (16:40) Putting in the protein in there. (16:42) It's gonna take a little time to break down. (16:43) And then I'm gonna put this high fructose corn syrup applesauce on me, and that changes things. (16:50) Right?

Scott Benner (16:50) Like, that's gonna give

Jenny Smith (16:51) Yes.

Scott Benner (16:51) Yeah. (16:52) So just keep that in mind, I guess. (16:54) Like, you guys have been listening to this long enough. (16:55) You'll be able to figure it out. (16:56) But, like, keep in mind that there's a world where you probably don't think you're putting sugar on something, and you are.

Scott Benner (17:03) And then

Jenny Smith (17:04) And you might be. (17:04) You wonder percent.

Scott Benner (17:05) Yeah. (17:05) You wonder later why. (17:07) Okay. (17:07) Here's my complaint. (17:08) The Kirkland applesauce.

Jenny Smith (17:12) Yes.

Scott Benner (17:12) 3.17 ounces, 24 count, $13. (17:16) I gotta pay $2 for a pouch of applesauce? (17:20) No. (17:21) A doc wait. (17:22) No.

Scott Benner (17:22) 50¢.

Jenny Smith (17:22) They're not that because they're how many are in the package? (17:24) I think it's twenty twenty four in there.

Scott Benner (17:26) Okay. (17:26) Right? (17:27) Yeah. (17:27) I have my number. (17:28) I was thinking it was $24 for for 12 of them, but no.

Scott Benner (17:31) Okay. (17:31) Sorry. (17:31) Okay. (17:32) So that's better. (17:33) I just I'm starting to get mad about what everything costs, I guess.

Jenny Smith (17:36) I know. (17:37) It does. (17:37) It's it's very expensive. (17:39) That's the reason we do a cart, and we have it sent to a hotel room. (17:43) And we pack our peanut butter sandwiches, and we take them into the park or wherever we're traversing on vacation because it's expensive.

Scott Benner (17:51) Right. (17:51) Also, I imagine a half an hour after your kids eat, they're not like, hey. (17:54) Where's the bathroom? (17:55) That cheeseburger is not set one well on me. (17:57) Yeah.

Scott Benner (17:57) Yeah. (17:58) Yeah. (17:58) I hear you. (17:59) Okay. (17:59) Alright.

Scott Benner (17:59) I'm okay with 50¢ for a squeeze bag of applesauce. (18:02) Seems Thank you.

Jenny Smith (18:03) Yay.

Scott Benner (18:13) In each episode of the bolus four series, Jenny, Smith, and I are gonna pick one food and talk through the bolus thing for that food. (18:21) We hope you find it valuable. (18:23) Generally speaking, we're gonna follow a bit of a formula, the meal bolt formula, m e a l b o l t. (18:32) You can learn more about it at juiceboxpodcast.com/meal-bulk. (18:37) But here's what it is.

Scott Benner (18:38) Step one, m, measure the meal, e, evaluate yourself, a, add the base units, l, layer a correction, b, build the bolus shape, o, offset the timing, l, look at the CGM, and t, tweak for next time. (19:01) In a nutshell, we measure our meal, total carbohydrates, protein, fat, consider the glycemic index and the glycemic load, and then we evaluate yourself. (19:12) What's your current blood sugar? (19:13) How much insulin's on board? (19:15) And what kind of activity are you gonna be involved in or not involved in?

Scott Benner (19:18) Do have any stress, hormones, illness? (19:21) What's going on with you? (19:23) Then a, we add the base units. (19:25) Your carbs divided by insulin to carb ratio, just a simple bolus. (19:30) L, layer of correction.

Scott Benner (19:32) Right? (19:33) Do you have to add or subtract insulin based on your current blood sugar? (19:36) Build the bolus shape. (19:38) Are we gonna give it all upfront, a 100% for a fast digesting meal, or is there gonna be like a combo or a square wave bolus? (19:45) Does it have to be extended?

Scott Benner (19:47) Offset the timing. (19:49) This is about pre bolusing. (19:50) Does it take a couple of minutes this meal or maybe twenty minutes? (19:54) Are we gonna have to again consider combo square wave boluses and meals? (19:59) Figure out the timing of that meal.

Scott Benner (20:01) And then l, look at the CGM. (20:04) An hour later, was there a fast spike? (20:06) Three hours later, was there a delayed rise? (20:08) Five hours later, is there any lingering effect from fat and protein? (20:13) Tweak.

Scott Benner (20:14) Tweak for next time, t. (20:16) What did you eat? (20:17) How much insulin and when? (20:19) What did your blood sugar curve look like? (20:22) What would you do next time?

Scott Benner (20:24) This is what we're gonna talk about in every episode of bolus four. (20:29) Measure the meal, evaluate yourself, add the base units, layer a correction, build the bolus shape, offset the timing, look at the CGM, tweak for next time. (20:38) But it's not gonna be that confusing, and we're not gonna ask you to remember all of that stuff. (20:43) But that's the pathway that Jenny and I are gonna use to speak about each bolus. (20:52) The Juice Box podcast is edited by Wrong Way Recording.

Scott Benner (20:57) Wrongwayrecording.com. (20:59) If you'd like your podcast to sound as good as mine, check out Rob at wrongwayrecording.com.

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#1726 Cinderella Story - Part 1

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.

Diagnosed at 16 months while her parents were on a cruise, Olivia reveals how diabetes became her anchor through divorce, depression, and a chaotic family life.

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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 back to another episode of the Juice Box podcast.

Olivia (0:14) Hi. (0:15) My name is Olivia. (0:16) I'm 29 years old. (0:18) I've lived with type one diabetes since the age of 16, and I'm here to talk about t one d and my life and very excited to be on the show today.

Scott Benner (0:31) Alright. (0:32) Let's get down to it. (0:33) You want the management stuff from the podcast. (0:35) You don't care about all this chitting and chatting with other people. (0:38) Juiceboxpodcast.com/lists.

Scott Benner (0:41) They are downloadable, easy to read, every series, every episode. (0:47) They're all numbered. (0:48) Makes it super simple for you to go right into that search feature. (0:51) In your audio app, type juice box one seven nine five to find episode one seven nine five. (0:57) Juiceboxpodcast.com/lists.

Scott Benner (1:05) While you're listening, please remember that nothing you hear on the juice box podcast should be considered advice, medical or otherwise. (1:13) Always consult a physician before making any changes to your health care plan or becoming bold with insulin. (1:29) The episode you're about to listen to was sponsored by Touched by Type One. (1:33) Go check them out right now on Facebook, Instagram, and, of course, at touchedbytype1.org. (1:40) Check out that programs tab when you get to the website to see all the great things that they're doing for people living with type one diabetes.

Scott Benner (1:47) Touchedbytype1.org. (1:49) Today's episode is also sponsored by the Eversense three sixty five, the one year wear CGM. (1:56) That's one insertion a year. (1:58) That's it. (1:59) And here's a little bonus for you.

Scott Benner (2:01) How about there's no limit on how many friends and family you can share your data with with the Eversense Now app? (2:07) No limits. (2:08) Eversense. (2:09) The podcast is also sponsored today by the Tandem Mobi system, which is powered by Tandem's newest algorithm, Control IQ Plus technology. (2:18) Tandem Mobi has a predictive algorithm that helps prevent highs and lows and is now available for ages two and up.

Scott Benner (2:25) Learn more and get started today at tandemdiabetes.com/juicebox.

Olivia (2:31) Hi. (2:31) My name is Olivia. (2:32) I'm 29 years old. (2:34) I've lived with type one diabetes since the age of 16, and I'm here to talk about t one d and my life and very excited to be on the show today.

Scott Benner (2:44) I'm excited to talk to you, Olivia. (2:45) Thank you for doing this.

Olivia (2:47) Of course.

Scott Benner (2:48) 16.

Olivia (2:50) Yes. (2:50) Sixteen months.

Scott Benner (2:51) How many children did your parents have, and where did you fall in that order?

Olivia (2:55) So I am the youngest of two. (2:57) I have an older brother who is two years older than me. (3:00) Pretty small family.

Scott Benner (3:02) Mhmm. (3:02) Youngest of two because after you got diabetes, they stopped having kids?

Olivia (3:07) Well, not necessarily because of my t one d, but more so because my mom had a very rough delivery with me. (3:15) So I think originally, she was planning on having four. (3:20) Then my brother came along. (3:21) She said, okay. (3:23) Let's make it three.

Olivia (3:24) Then I came, and she said, I'm done.

Scott Benner (3:26) Would you, like, hold onto her spleen on the way out? (3:28) What were you doing?

Olivia (3:30) I mean, I have no idea what I was doing. (3:32) All I know is that it came very fast, and my mom had no kind of, epidural or anything. (3:39) And I was I was a larger baby. (3:41) So, yeah, it was from the sound of it, it was just really rough on her.

Scott Benner (3:47) Oh, I'm so well, I'm sorry for her, but, fun story. (3:49) Like, you know, so you're slip and slide now, what, at, like, nine pounds three ounces or something like that?

Olivia (3:54) Like, nine pounds six ounces, I think.

Scott Benner (3:56) No kidding. (3:57) Oh, wow. (3:57) You were big.

Olivia (3:58) Yeah.

Scott Benner (3:59) So did she have gestational with you?

Olivia (4:01) I I'm not a 100% sure. (4:03) I think I recall her saying before that she might have had gestational with me, which would explain why it was a larger baby, but I'm not really sure. (4:12) She hasn't really, like, talked in detail about it with me. (4:16) Interesting. (4:16) So, yeah, I don't really know.

Scott Benner (4:18) Okay. (4:19) No. (4:19) It's interesting because I think I think you would think that eventually I could remember these things, but I feel like I I feel like people have spoken on here before about gestational, like, making the possibility of your baby having type two later in life greater. (4:35) You should probably look into that, before I say it out loud, but I never I've never heard it, like, connected to type one. (4:40) Doesn't mean it's not.

Scott Benner (4:42) Also, makes me wonder if is your mom, like, a not a very what do I mean? (4:47) Like, not a very open person with stuff like that, or is it just you know what I mean?

Olivia (4:52) It's a good question because I think I don't know. (4:58) Like, I think when it comes to things like that involving her health, she isn't maybe the most open about certain topics. (5:06) And, again, I'm not really sure why, but that's kind of the way that she's been.

Scott Benner (5:10) Yeah. (5:11) So No. (5:11) I mean, I'm not trying to, like I'm not saying anything about her, Jane. (5:14) I'm just trying to figure out like, in my mind's eye, I'm thinking, like, oh, she has a baby. (5:19) Sixteen months later, has type one.

Scott Benner (5:21) You know? (5:22) A year and a half before that, somebody said to her gestational diabetes, you know, blah blah blah. (5:26) Maybe she feels maybe she just feels, I don't know, at fault and doesn't wanna talk about it even though that would be silly if that's not the case. (5:34) You know what I mean?

Olivia (5:35) Yeah. (5:35) I've I've never really thought about it that way, but now it kinda gets me wondering if there is some kind of connection between gestational and t one d. (5:44) Again, I'm I don't really know, but I am interested in finding out more.

Scott Benner (5:47) Right now. (5:48) Don't worry about it. (5:49) I don't

Olivia (5:49) Awesome.

Scott Benner (5:50) Yeah. (5:50) So, yeah, I don't think that's the case. (5:53) And gestational diabetes does not directly cause type one diabetes. (5:55) And to him, no. (5:56) I didn't say caused.

Scott Benner (5:57) I said increased likelihood. (6:00) If our overlord's not gonna pay attention, then what's gonna happen here? (6:05) You're asking gestational diabetes, likelihood not cause of type one diabetes in child. (6:09) The main drivers of type one are genetic. (6:11) Yeah.

Scott Benner (6:11) Thank you. (6:11) Gestational diabetes by itself does not significantly increase the likelihood of type one. (6:15) I didn't think so. (6:17) Large studies show no strong link between maternal gestational, and later type one diabetes. (6:24) Where the impact is clear, children exposed to gestational diabetes in utero have a higher likelihood of obesity, insulin resistance, and type two later in life.

Olivia (6:33) Okay. (6:34) That's interesting.

Scott Benner (6:35) Do you have any insulin resistance?

Olivia (6:37) No. (6:38) I in fact, like, a week or two ago, I noticed that my insulin sensitivity did a sudden jump, I was like, oh my goodness. (6:46) I'm having so many low blood sugars. (6:48) I need to back off on how much insulin I'm taking. (6:51) So it it it's kind of a blessing in disguise, I guess.

Scott Benner (6:54) Well, I for sure it is. (6:56) Let me let's move forward from my pretend supposition that possibly your mom had gestational diabetes. (7:01) Sure. (7:02) So we don't because that would be a weird road to continue down. (7:05) Anyway, I think maybe away from the the more technical parts of that conversation, it just struck me.

Scott Benner (7:14) I wonder if somebody said diabetes to her, and then you got diabetes, she got, like, just, I don't know, sensitive to it maybe.

Olivia (7:23) But I I don't know.

Scott Benner (7:24) That's me guessing still. (7:25) So

Olivia (7:26) Yeah. (7:26) I don't know. (7:27) But, but the the circumstances surrounding my diagnosis were pretty chaotic, actually, from what I've heard my mom share with me.

Scott Benner (7:37) Yeah. (7:37) Tell me what they've told you.

Olivia (7:39) Yeah. (7:40) So, of course, I don't remember anything because I was so young, but this would have happened around Memorial Day when I was a year old. (7:50) And leading up to Memorial Day, both my brother and I were sick with the flu. (7:56) My brother was recovering at a pretty normal rate, and I was taking more time to recover, kinda dragging my feet in recovery. (8:05) Mhmm.

Olivia (8:05) And around that time, my mom and dad were planning to go on a cruise to The Caribbean, and, they were going to leave my brother and me with my grandparents. (8:16) And so leading up to their trip, my mom was pretty worried about leaving me sick with the flu with my grandparents, but they were like, no. (8:24) Go ahead. (8:25) Like, go have fun. (8:26) We'll take care of the kids.

Olivia (8:27) We'll be fine. (8:28) So they left, and they were down in the Caribbean Sea. (8:33) And for context, they live in Michigan, so very, very far away. (8:37) So based on what I understand, I was exhibiting a lot of the classic t one d symptoms, peeing a lot. (8:47) Apparently, I was wearing, like, the strongest absorbency of diapers that you can wear, and I was peeing through those.

Olivia (8:53) I was drinking lots and lots of liquids. (8:57) And so I think I and, again, based on what I have heard, what ended up happening was one night, I woke up in the middle of the night. (9:07) I was asking my grandparents for something to drink. (9:10) And so they got me Kool Aid, which is probably one of the worst things that you can give a non diagnosed type one diabetic to drink, but I was excited about it because it was like, yay, like, more liquids. (9:23) Mhmm.

Olivia (9:23) I can satiate my thirst. (9:26) And after giving me that Kool Aid, I immediately threw it up. (9:29) So

Scott Benner (9:30) I thought you were gonna say you ran through a wall because that would have been awesome.

Olivia (9:34) That would have been hilarious. (9:35) Of course.

Scott Benner (9:36) Like a little baby Yeah. (9:37) Like a little baby sized, you know, hole through the drywall. (9:40) That would have

Olivia (9:40) been great. (9:41) Yeah. (9:42) That would have been amazing. (9:43) But Like, obviously, they, you know, they could tell that something's wrong. (9:47) From what I understand, one of my aunts who works in the medical field was also there, and she was observing what was going on.

Olivia (9:54) So she said to my grandparents, let's take her to I'm assuming they took me to urgent care first.

Scott Benner (10:01) Think there was urgent care thirty years ago.

Olivia (10:04) I think Sorry. (10:05) What was that? (10:05) You said, do

Scott Benner (10:05) you think urgent cares existed thirty years ago?

Olivia (10:10) I did they not?

Scott Benner (10:12) I don't know. (10:15) That seems to me like a am I just so old? (10:19) Oh, yeah. (10:20) Apparently, in the nineteen seventies. (10:21) Oh, how about that?

Olivia (10:23) Well Oh, wow. (10:24) Okay.

Scott Benner (10:24) Sorry, guys. (10:25) My dog's in here today if you're hearing him licking his paw. (10:27) Stop licking your paw. (10:29) The first recognized urgent care centers were started by emergency medicine doctors in 7071

Olivia (10:36) Wow.

Scott Benner (10:37) In Phoenix, Arizona. (10:38) Later in the Midwest and early hubs by the mid seventies urgent care became a defined industry which chains and organizations formed to expand the model. (10:46) In the eighties and nineties, urgent care centers spread widely filling a niche between primary care and today, there are more than 10,000 urgent care centers across The US. (10:55) Okay. (10:55) I'm so sorry.

Scott Benner (10:56) You're the middle of trying to tell me how you got diabetes, and I'm like, wait. (10:59) Did urgent cares exist? (11:00) I'm I it really did strike me that way. (11:02) Anyway, they took you somewhere. (11:04) Right?

Scott Benner (11:04) Because your aunt is a fancy lady, and she went to college, and she knew something. (11:08) Right now,

Olivia (11:08) what happens?

Scott Benner (11:09) Yeah. (11:09) Yeah. (11:09) Good.

Olivia (11:10) Yep. (11:10) So they took they took me to some medical facility, whether if that was an urgent care or a hospital, but, ultimately, whoever we saw first said, you gotta take her right away to the emergency room. (11:23) So they took me to the emergency room, checked my blood sugar. (11:27) It was over 600. (11:29) So I was diagnosed on the spot with type one diabetes.

Olivia (11:33) And meanwhile, both of my parents are thousands of miles away in the Caribbean Sea.

Scott Benner (11:38) Yeah. (11:38) Trying to enjoy a Mai Tai.

Olivia (11:41) And Yeah.

Scott Benner (11:42) You can't just tell the boat to go home because my kid's sick. (11:45) Right?

Olivia (11:46) No. (11:46) So from my parents' perspective, what ended up happening when they're on the ship is so back, you know, almost thirty years ago, there were you know, there was no Wi Fi, no cell service, or anything like that. (12:00) So they put a slip underneath their cabin door saying, call this phone number using the landline. (12:08) And I think it was a slip with some information from the hospital describing what happened. (12:15) Oh.

Olivia (12:15) And when when they got the slip, they were out at sea on that day. (12:20) So, like, long story short, my mom was incredibly shaken up and my my dad too, and they had to wait until the next day when they were in port to get an airplane to fly back to The United States.

Scott Benner (12:34) Oh, I bet you they felt terrible.

Olivia (12:37) Oh, yeah. (12:37) I I'm pretty sure that they did. (12:40) I I don't know how else they would feel.

Scott Benner (12:42) Although, I I wouldn't I should've married a lady like your mom, though, because in a million years, I couldn't have got Kelly to go on that cruise. (12:49) She'd be like the babysitter. (12:50) We're not going anywhere. (12:51) Don't even think she would have left without you. (12:52) As a matter of fact, and this is not a judgment about your parents, but I had friends growing up who once in a while would get left at our house for a week while their parents went on vacation.

Scott Benner (13:02) And I always thought that was strange. (13:06) But I guess that but I learned as I got older, it's pretty it was a pretty common thing that parents don't always take their kids on vacation with them. (13:13) And it's not a thing I knew

Olivia (13:14) about. (13:14) Yeah.

Scott Benner (13:15) Isn't that crazy? (13:16) Because by the way, I didn't go on vacation. (13:17) We were so broke. (13:18) We didn't go we didn't go anywhere. (13:19) We were always together.

Olivia (13:21) Oh. (13:21) Yeah.

Scott Benner (13:22) Yeah. (13:22) It's okay. (13:22) Don't worry. (13:23) Everything worked out. (13:24) So they fly home.

Olivia (13:26) And Yeah. (13:26) They fly home. (13:27) Yeah. (13:28) There was actually a delay in them getting home because so they were flying, I think, from Saint Thomas to Florida Mhmm. (13:35) Where they had, boarded the cruise ship.

Olivia (13:39) On the day that they're flying into Florida, there was a tornado by the airport. (13:42) So there was a delay in that landing, and then they had to get another plane from Florida back up to Michigan. (13:48) So I think it took probably a day or two before they got to me. (13:52) And my mom, when she entered the hospital, she described described it as I was laying in a bed. (14:00) I had an IV in each arm, one with insulin and one supposedly with glucose, I think.

Olivia (14:07) Like, probably a dual insulin glucose strip.

Scott Benner (14:10) Yeah.

Olivia (14:10) And, like, she she was devastated. (14:12) My my dad was too. (14:14) So, yeah, that's that's the story.

Scott Benner (14:17) Olivia, thank god this all happened before cell phone cameras because otherwise, there'd be an incredibly odd photo of your mother super tan with her hair braided holding a very sick 16 year old 16 old baby. (14:28) And it would just Yeah. (14:29) Because people listen. (14:31) Again, I'm not throwing shade on anybody, but, like, I don't get why people take pictures of weird stuff like that all the time. (14:36) Like, but I like, you know what I mean?

Olivia (14:38) People let me get a either.

Scott Benner (14:40) I'm like, I'm in the hospital. (14:41) I don't need a photo. (14:42) I'm good. (14:42) Thanks. (14:43) But Yeah.

Scott Benner (14:44) But but nevertheless, like, oh my gosh. (14:46) That I feel badly for them. (14:48) That's a terrible, like, amount of time to have to spend not knowing, feeling terrible like that, like, you know, trying to travel while your grandparents who, you know, are are trying to stand in for them.

Olivia (15:02) Oh, absolutely.

Scott Benner (15:03) Is that aunt your mom's sister or your dad's?

Olivia (15:05) That's my dad's sister. (15:07) Okay. (15:07) My grandparents are also my dad's parents.

Scott Benner (15:10) Oh, it's even worse for your mom. (15:11) You the baby Yeah. (15:13) The baby was with with his parents while it was happening. (15:16) Oh my gosh. (15:18) If you're married, you know what I'm saying.

Scott Benner (15:20) Anyway, well, okay. (15:21) You lived through it. (15:22) That's awesome. (15:23) Yep. (15:23) What is your earliest obviously, you don't remember much from being 16 old.

Scott Benner (15:27) If you did, would think you were lying. (15:30) You're like, let me tell you what happened, Scott. (15:31) I remember the whole thing. (15:33) But what are your what are your earlier remembrances of having type one? (15:39) Let's talk about the Tandem Mobi insulin pump from today's sponsor, Tandem Diabetes Care.

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Olivia (17:51) Yeah. (17:52) So my earliest memories probably are from when I was three years old, and I remember from the time I was diagnosed all the way up until I was seven, my parents were giving me multiple daily injections. (18:07) And so, like, I I don't remember a whole lot of those instances, but I remember there was one evening where, they were giving me probably Lantus. (18:20) They're giving me a Lantus shot, and, I remember just laying on the floor and saying, like, you know, dad, this hurts. (18:29) And and he said, like, you know, in a joking voice, like, maybe it won't hurt so much if, you know, I chop your leg off.

Olivia (18:37) Like, he was trying to make a joke out of it. (18:39) Awesome.

Scott Benner (18:40) Funny guy. (18:40) And I

Olivia (18:40) was like, oh my goodness.

Scott Benner (18:43) Listen. (18:44) I I'm gonna guess that your dad is, an older school guy. (18:47) My if I would have said something hurt, my dad would have said, why don't I punch you in the arm so you don't feel it anymore? (18:51) I don't know where that common sense came from from that generation, but there it was. (18:56) So Yeah.

Scott Benner (18:56) I'm I'm I'm guessing he was going for one of those jokes.

Olivia (19:00) I I guess so. (19:01) Like a I don't know. (19:02) Maybe a traditional dad type joke.

Scott Benner (19:05) Just not a good one. (19:06) That's all.

Olivia (19:07) Not a good one. (19:08) No. (19:08) Well,

Scott Benner (19:09) your note is very interesting, Olivia, because you kind of laid out something that you wanted to talk about. (19:14) And Mhmm. (19:15) And I I'd like to dig into it a little bit because you're telling me that that having diabetes was a source of strength for you and that it be it came in handy because a number of times through your adolescence and growing up, some rocky things happen. (19:30) So I'd like to first understand how do you characterize a strength that comes from diabetes?

Olivia (19:37) Yeah. (19:38) So I I think a lot of times, I hear that having type one diabetes is just, like, one of the most awful things in the world. (19:47) It and it it it's tough. (19:49) Like, it you know, I think every person living with type one diabetes has better days and other times really rough days. (19:57) Mhmm.

Olivia (19:59) For me being diagnosed at the age of 16, I don't know any better. (20:03) I don't know what it's like to not live with this. (20:06) Yeah. (20:06) So it's always been a sense of normal for me. (20:09) But I think throughout my life, and as I start digging into some of the messier stuff that I've endured, having type one diabetes has always been, like, a source of stability and a constant in my life.

Olivia (20:25) It's been something that I've been able to really take the reins on and do my best managing in the midst of a lot of instability and uncertainty throughout my adolescence and early adulthood.

Scott Benner (20:41) That's interesting. (20:42) So the diabetes is is knowable once you figure it out. (20:47) It's pretty consistent with meaning that it needs you every day, and you feel like that's interesting. (20:56) So you feel like compared to other things that happen in life, you're pretty much in control of how you handle the diabetes?

Olivia (21:02) I like to say that, and I think a large part of that is actually due in part to listening to the diabetes pro tip series. (21:10) I've learned so much just listening through all of those podcast episodes. (21:15) And even though I still have rough days here and there, I think the rough days in general have dropped in quantity, and the good days have increased. (21:27) So

Scott Benner (21:27) That makes me happy. (21:29) Thank you for saying that. (21:30) As you didn't Yeah. (21:30) Absolutely. (21:31) You didn't have to, but that was that was lovely.

Scott Benner (21:33) You made me feel emotional. (21:34) I appreciate that. (21:34) Oh. (21:35) Well, it's early. (21:36) It's good.

Scott Benner (21:37) And I had a I didn't get as much sleep as I wanted last night, so I'm gonna be a little more set so because oh, by the way, because Arden's CGM stopped barking at 5AM.

Olivia (21:46) So Oh my goodness.

Scott Benner (21:47) You know, and I get a text, are there CGMs up here? (21:50) And I'm like, I don't know. (21:53) So I popped up and I I grabbed one and and I tossed it into a room like a hand grenade. (21:58) I was like, here. (21:59) But she was like, wait.

Scott Benner (22:00) Turn the light on. (22:01) And I was like, okay. (22:02) Now I'm involved.

Olivia (22:02) Oh, that's so rough. (22:04) I actually had that happened to me the other night where I had a sensor fail on me at, like, 3AM, and I was laying in bed thinking, okay. (22:12) Do I get up and change it, or do I just go back to sleep and change it in the morning? (22:17) And it was causing me just enough anxiety where I was like, alright. (22:21) Fine.

Olivia (22:21) I'll get out of bed. (22:22) I'll change it and then go back to sleep.

Scott Benner (22:25) Well, I wanna say in fairness to the CGM, I think it might have been Arden were right till the last second and thought it was gonna make it till morning, and it didn't.

Olivia (22:33) Oh, no. (22:34) And then

Scott Benner (22:34) it was making that, I don't know if you do which one you wear, but the g seven makes that like, like, it's a really loud noise. (22:41) I think that's why she was changing it.

Olivia (22:43) Oh my goodness.

Scott Benner (22:44) But the last thing she said is the light went off and she laid back down. (22:47) She I just heard her go, why at 05:00? (22:50) And that was like, and I'm assuming she was asleep before I got back to my bed, but I gotten back in bed, and I did not I wasn't able to fall back asleep right away. (22:58) So Ugh. (22:58) Yeah.

Scott Benner (22:58) It's fine. (22:59) That's rough. (23:00) Yeah. (23:00) Anyway, that makes me more emotional when I'm tired. (23:02) I don't know if that's a thing that happens to everybody or not.

Olivia (23:04) I yeah. (23:05) I would say, you know, when I don't get a lot of sleep, I tend to be more emotional too. (23:09) I I think it's pretty common.

Scott Benner (23:11) Yeah. (23:11) Yeah. (23:11) Here here's a marriage tip for anybody. (23:13) Do not have important conversations later at night.

Olivia (23:16) Oh, yes. (23:17) Absolutely.

Scott Benner (23:18) Do just do not. (23:19) Worst idea in the world. (23:21) Nevertheless, so to keep going with this Mhmm. (23:24) Diabetes is a is a constant for you even though it's not super consistent. (23:28) Right?

Scott Benner (23:28) I I assume it's like the the ocean a little bit. (23:31) Like, sometimes the ocean's calm, sometimes it's choppy, but it's always deep and you can drown in it. (23:36) So it's there's some consistency to it. (23:38) And Yeah. (23:39) Other things in your life have not been as reliable.

Scott Benner (23:43) Is that right?

Olivia (23:44) That's right. (23:45) Yeah. (23:45) Mhmm.

Scott Benner (23:46) What's the first thing that came for you, do you think?

Olivia (23:49) So I think so the first major thing that happened during my life was my parents getting divorced when I was 10 years old. (23:59) But before even that, there was a lot of a lot of moments of tension that I could sense between my mom and dad. (24:06) They didn't really have a happy and intimate marriage with one another. (24:13) Mhmm. (24:13) I remember being a young girl, and my mom would be raising her voice and screaming at my dad for who knows what reasons.

Olivia (24:22) And whenever I heard my mom's voice starting to rise like that, I knew, like, okay. (24:29) It's time to hide either in my bedroom or the basement. (24:32) Time to get out of here and just hide until the storm rolls over. (24:38) So I think a lot of the instability started even before my parents' divorce. (24:44) And I remember several months ago, my mom even sharing an anecdote with me where she told me when I was, like, too young to remember, maybe two years old, she screamed at me so harshly that I vomited.

Olivia (25:01) And so although I don't remember that, I'm pretty sure that my nervous system has Has remembered

Scott Benner (25:07) it? (25:07) Yeah.

Olivia (25:08) Yeah. (25:08) Yeah.

Scott Benner (25:08) What's, what's up with your mom? (25:10) She got, anything going on?

Olivia (25:12) Honestly, I don't really know. (25:15) I think I'm not a 100% sure.

Scott Benner (25:19) Have a guess, Olivia?

Olivia (25:21) Sorry. (25:22) What was that?

Scott Benner (25:22) Do you have a guess?

Olivia (25:24) Well so I've there's been issues between my mom and I over the past few months

Scott Benner (25:31) Oh, I'm sorry.

Olivia (25:32) Where, yeah, where she and I haven't been speaking to one another since mid June. (25:39) And that's a whole other story to unpack probably later on as we carry on with this, but sorry. (25:46) Go ahead.

Scott Benner (25:47) No. (25:47) I don't wanna like, I'm not trying to pick through your life too much. (25:49) I'm trying to figure out is she, you know, undiagnosed thyroid? (25:54) Is she is she, you know, depressed? (25:58) Is she borderline?

Scott Benner (25:59) Does she have, like, some sort of a mental health issue?

Olivia (26:02) So my mom hasn't been diagnosed with any of those. (26:06) Though, over the past few months, I have come to an increasing hunch that my mom could be borderline. (26:15) Mhmm. (26:15) And she seems to exhibit a lot of the DSM criteria for it. (26:20) But, again, I I don't wanna go around just diagnosing her because I'm not a mental health expert.

Scott Benner (26:26) No. (26:26) Yeah. (26:26) Leave that to podcasters. (26:28) You don't wanna do that.

Olivia (26:29) Yeah.

Scott Benner (26:30) No. (26:31) I understand. (26:31) I I I mean, listen. (26:32) It's you know, from a young age, you you remember your mom, like, screaming at your dad. (26:37) You you know, eventually, they got divorced.

Scott Benner (26:39) You know? (26:40) It's a little I I mean, there's some strange stuff in there, like, like, enough for make me wonder. (26:46) You know what I mean? (26:46) So oh, okay.

Olivia (26:47) Yeah. (26:48) Absolutely.

Scott Benner (26:49) But but you're what the the crux of that story is is that a as a child, somebody yelled at you and you vomited from it.

Olivia (26:57) Mhmm.

Scott Benner (26:57) Like, that's pretty drastic. (26:58) Like, either the yelling was drastic or the, you know, the response or maybe the combination of them, I guess.

Olivia (27:04) Yeah. (27:05) And and the crazy thing is that, like, I I don't have any memory of this happening. (27:10) I take my mom's word for it. (27:11) I trust that what she told me is true, but it's yeah. (27:16) I don't know.

Olivia (27:16) It it's weird to think that this happened, I have no recollection whatsoever.

Scott Benner (27:21) You're so nice. (27:22) How old is she?

Olivia (27:23) She is 61. (27:25) Oh, She's 61 years old.

Scott Benner (27:26) That's older than when when people start saying, like, I don't know. (27:29) My mom makes stuff up. (27:30) I don't trust her anymore. (27:32) I

Olivia (27:34) I think my mom is still with it. (27:37) Oh. (27:37) I think she's still very much with it.

Scott Benner (27:39) Yeah. (27:39) No. (27:39) I don't

Olivia (27:40) She might forget things.

Scott Benner (27:41) I don't know if people are always forgetting when they make stuff up. (27:44) I think sometimes it's a little bit of, you know, trying to shine up history a little bit or, you know, it's it's I'm I've I've seen it with other people. (27:52) So Mhmm. (27:53) Yeah. (27:53) Anyway okay.

Scott Benner (27:54) So okay. (27:55) Your mom screamed at you and made you vomit, and your parents and your parents got divorced, but that's probably not the end of it. (28:01) What happened next?

Olivia (28:02) No. (28:02) In fact, I would say that the divorce was really the beginning of a lot of stuff. (28:07) So when my parents got divorced, I was 10. (28:11) And when they drew up their divorce papers, they agreed to share split custody of my brother and I. (28:18) So the way that that looked was we would go stay with my mom for one week, and then we'd go stay with my dad for one week, and then back to mom for a week, back to dad for a week.

Olivia (28:30) And this repeated until I was 16. (28:34) So six years of going from one house to the other. (28:38) Horrible. (28:38) One house to the And it was I I think that living situation so at first, being 10 years old, I was innocent, and I thought, great. (28:49) I get to see mom and dad for the same amount of time versus, like, my mom or dad taking full custody of us.

Olivia (28:56) So at first, was happy about it, but as time went on and my brother and I were going back and forth constantly between each house, I started I think, like, around the age of 12, I started developing some form of depression. (29:15) I I remember back during that time having some subtle suicidal thoughts. (29:21) Like, you know, I wish I wasn't here. (29:23) I never acted on any of these, though.

Scott Benner (29:25) Did you ever have a plan did you ever have a plan?

Olivia (29:28) I never had a plan. (29:30) I never really thought about carrying out anything.

Scott Benner (29:34) Right.

Olivia (29:35) But I just remember thinking, like, I wish I was dead.

Scott Benner (29:39) Well, the

Olivia (29:40) back of 12.

Scott Benner (29:41) I mean, listen. (29:42) From my perspective, the it it feels to me like for six years, you lived in a hotel because it's you pack up, go somewhere, stay there for a few days, leave. (29:51) I I that feels unsettling to me.

Olivia (29:54) Yeah. (29:54) That's a really good way of looking at it. (29:56) And what you said about packing up belongings and leaving, that's exactly how it felt. (30:03) Every Friday, my brother and I would go to the other house. (30:08) And so Thursday night, we'd be packing up, you know, our, like, cell phone chargers and

Scott Benner (30:15) Yeah.

Olivia (30:16) Video game systems and all of that to carry to the other parent's house.

Scott Benner (30:20) By the way So the other house, what a humble brag. (30:23) Two houses. (30:24) Yeah. (30:25) Look at you look at you guys. (30:26) Yeah.

Olivia (30:28) It's like living in two houses. (30:29) It it was I remember being a a teenager, though, and it it would just be confusing to me because I remember making friends in middle school and high school. (30:39) And when I would go hang out with them at their parents' house, they'd say, yeah. (30:44) I live at this address. (30:46) But on the other hand, whenever I would invite my friends over, I would have to specify, okay.

Olivia (30:52) This week, I'm at my mom's house or this week, I'm at my dad's house. (30:55) So it never really felt like I had a true address, like a true home.

Scott Benner (31:00) Yeah. (31:01) You're settled.

Olivia (31:02) Exactly. (31:03) Yeah.

Scott Benner (31:04) Am I I mean, were the houses very close to each other, or or you spend a whole week with friends and then be like, hey. (31:09) We should hang out on Saturday, but you're going across town or somewhere else?

Olivia (31:13) Fortunately, the the good news is that they lived only about ten minutes away. (31:17) Okay. (31:18) And I was going to the same high school in the midst of all of this too. (31:21) So that was another point of stability Yeah. (31:24) In the midst of this, chaotic sea.

Scott Benner (31:26) So they tried to keep it I mean, it it is a good try from them. (31:31) But, I mean, I'm just thinking if all you would just, like, tough it out and stay together, we wouldn't have a housing crisis. (31:36) That's all I'm saying.

Olivia (31:37) Yeah. (31:38) Yeah. (31:39) It so I remember during those

Scott Benner (31:42) Sorry. (31:42) Sorry, Olivia. (31:43) I'm I'm I'm I'm I'm characterizing being married as tough it out.

Olivia (31:49) Well, I mean, like, marriage isn't all, you know, rainbows and kittens all the time. (31:54) Yeah. (31:55) Like, it it's great if it's that way most of the time, but Yeah. (31:58) You know, marriages are, you know, like any other relationship. (32:02) You'll run into Of course.

Olivia (32:03) Times where there's a bit more friction and you have to work it out.

Scott Benner (32:07) But You ever feel like that? (32:08) You know, I don't get to talk to a lot of adults who come from divorce. (32:11) Like, it doesn't come up as much as you would think. (32:13) You ever mad at them? (32:15) Did you have a parent that you blamed as a child?

Scott Benner (32:18) Did that hold true as an adult?

Olivia (32:20) Yeah. (32:21) I so from what I understand, it was my mom who initiated the divorce, so I don't think it was mutual. (32:31) Well, it it ended being a mutual decision on both of their parts because they went through with it, but my mom was the one who initiated it. (32:38) I don't think my dad wanted the divorce to happen. (32:41) Yeah.

Olivia (32:42) So I remember

Scott Benner (32:43) Olivia, I don't think you get to stay if if if you want to and the other one tells you to go, though. (32:48) So it's you know what I mean? (32:50) Like, if she if she says, don't wanna be married anymore, he goes, well, I do. (32:54) That's not that she doesn't have you know, she doesn't get to go, oh, well, then never mind. (32:58) Like, so maybe Right.

Scott Benner (32:59) Yeah. (32:59) Maybe it wasn't. (33:00) It also reminds me of that great scene in the the Santa Claus movie, gosh, with, Vince Vaughn. (33:09) Do you know this this movie?

Olivia (33:10) Oh, yeah.

Scott Benner (33:10) Where his brother is Santa Claus?

Olivia (33:13) Yes.

Scott Benner (33:13) And he's he's dating this girl, and she breaks up with him at from I know I've talked about this before. (33:19) It is, like, it is an incredibly funny scene and not a very good movie. (33:23) But but she's yelling down to him from the apartment. (33:27) She's like, I'm done. (33:28) He's like, I'm not done.

Scott Benner (33:29) I'm not done. (33:29) And there's I I can't do it justice, but go watch it. (33:32) It's hilarious.

Olivia (33:33) Yeah. (33:34) Oh, I totally gotta watch that just as Christmas season is coming up too.

Scott Benner (33:38) You know what? (33:38) While you're talking, I'll find the actual name of it for you. (33:40) Oh, it's Fred Claus. (33:41) I know what it's called. (33:42) It's called Fred Claus.

Olivia (33:43) Okay.

Scott Benner (33:43) Yeah. (33:44) Yeah.

Olivia (33:44) Fred Claus. (33:45) Yeah. (33:45) I I've watched I've watched, like, the first two Santa Claus movies with, Tim Allen, but I haven't watched Fred Claus yet. (33:52) So I'll have to add that one to my list.

Scott Benner (33:53) Well, I don't know how good it is, but that one scene make if you if you're trying to understand my sense of humor at all, that scene makes me cackle just so so everybody knows.

Olivia (34:02) I'll totally have to get give that a a listen Thank you. (34:05) And a watch.

Scott Benner (34:06) Thank you. (34:06) Thank you. (34:06) I'm sorry. (34:07) Go ahead. (34:07) So continue.

Scott Benner (34:08) I apologize.

Olivia (34:09) Yeah. (34:10) So I remember so during these six years of living under split custody between both of my parents, I I remember so there was that feeling of feeling very, very unsettled and not having a a true place to call home. (34:27) And my my mom and dad are very, very different people with different expectations. (34:32) And so over time, I, so during these six years, there was also pretty regular conflicts between my mom and dad, so there wasn't really even much peace between them after the divorce. (34:47) And so, like, I'm sitting there thinking, like, okay.

Olivia (34:50) Like, I want some kind of peace. (34:52) What can I do to achieve that peace? (34:55) I'm going to be the person my mom wants to be when I'm with her. (34:59) And then when I'm with my dad, I'm going to be the person that he wants me to be. (35:04) So I was a massive people pleaser with both my mom and dad.

Olivia (35:10) And since my mom and dad are very different people, personality wise and expectation wise, I in a sense, I developed two different personalities living with each of them, and I really didn't know who I truly was for a long, long time.

Scott Benner (35:30) Did you consciously turn them on and off?

Olivia (35:34) I that's a good question.

Scott Benner (35:37) Yeah. (35:38) Like, did it become a mental health issue, or was it conscious?

Olivia (35:43) I don't know if it ever truly became a mental health issue per se. (35:47) I think it was more a situation where if I knew I was going to my dad's house, for example, I would say to myself, okay. (35:56) Like, since my dad is, you know, quieter and more stoic, I'm going to be quieter and more stoic with him. (36:04) Mhmm. (36:05) And then whenever I would go to my mom's house, she's a lot more expressive.

Olivia (36:10) Yeah. (36:10) Like, a lot more expressive.

Scott Benner (36:12) You kinda locked up than around

Olivia (36:13) her. (36:14) Yeah.

Scott Benner (36:14) Was your dad quiet, or was your dad beaten down?

Olivia (36:19) That's a good question. (36:21) So

Scott Benner (36:23) You don't know. (36:23) You're so young. (36:25) You know?

Olivia (36:25) Yeah. (36:25) I I honestly don't know, but I think so I think if my suspicions about my mom having borderline are true, I think my dad probably was beaten down quite a bit by my mom. (36:38) Right. (36:39) And I think, generally speaking, he is a quiet person. (36:42) He's more introverted.

Olivia (36:44) Yeah. (36:44) But I I think my dad was just beaten down by my mom's barrages when they would happen.

Scott Benner (36:51) It's tough. (36:52) Is she a is she a physically opposing person?

Olivia (36:55) What do you mean by that?

Scott Benner (36:56) Is she is she tall? (36:57) Is she strong, or is she small and slight? (37:00) Like, what's her build?

Olivia (37:01) She's pretty small. (37:03) She's strong. (37:04) She's less than five feet tall.

Scott Benner (37:06) Okay. (37:06) Because it's a little She's

Olivia (37:07) pretty small.

Scott Benner (37:08) Yeah. (37:08) You know what I mean? (37:08) Like, it's a little less scary for a lady who's four eleven to be yelling at you than if she was five nine and, you know, give Right. (37:14) Yeah. (37:15) I I mean, honestly, like, if somebody's ranting and raving at you like that, like, it's there's a physical component to it as well.

Olivia (37:22) Yeah. (37:22) Absolutely.

Scott Benner (37:23) Are you a smaller person? (37:24) Are you built like her?

Olivia (37:25) I'm built more like her. (37:27) I'm a few inches taller than her, which isn't really saying much. (37:30) I'm barely, you know, just scraping above five feet. (37:33) Yeah. (37:33) Yeah.

Scott Benner (37:35) I don't know. (37:36) Do you ever see yourself in her or vice versa? (37:39) Does that worry you?

Olivia (37:41) So now that I like, so now in adulthood, now that I have a much better picture about who I am as a person, and I'm still actually I feel like I'm still trying to piece that together fully.

Scott Benner (37:54) Yeah.

Olivia (37:56) So my mom, I would say, is very extroverted. (38:00) I'm definitely more of an introverted person, more of a quiet soul, I would say. (38:06) Yeah. (38:06) When it comes to expressing emotions, she's a lot more expressive. (38:11) Me, on the other hand, I'm not quite as expressive, though I feel things deeply, if that makes any sense.

Scott Benner (38:18) Sure.

Olivia (38:18) So personality wise, I don't see a whole lot of her in myself. (38:25) Yeah. (38:26) Appearance wise, though, I take after her quite a lot.

Scott Benner (38:29) Gotcha. (38:30) Now do you find yourself because of what you shared a moment ago, do you find yourself wondering if this is your personality or if it's the one you chose? (38:37) Do you know what I mean? (38:38) Mhmm. (38:38) Like, because if you because I imagine when you were with your dad, you didn't become another person.

Scott Benner (38:42) You probably just leaned harder into the quiet part of yourself. (38:45) And when you were with your mom Sure. (38:46) You know what mean? (38:47) You leaned harder into that part. (38:48) But then it sounds like you chose one, but I won't but I don't know.

Scott Benner (38:53) This is just me. (38:54) Like, I would wonder. (38:55) I'm not trying to mess you up. (38:56) Like, you know what I mean? (38:57) Like, I would I would I would wonder, like, is this who I am, or is this who I settled on?

Scott Benner (39:03) Does that make sense?

Olivia (39:04) I see what you mean. (39:05) Yeah. (39:06) Yeah. (39:06) That I think that's a good question too. (39:08) I so I think maybe there were certain elements of my personality that I chose just in you know, I saw things in both of my parents, and I said to myself, don't wanna be like them in these different ways.

Olivia (39:25) I think also the times that I was at school so, like, again, kind of that common one point of stability when I was going back and forth between houses. (39:35) I think the way that I was at school gave me some hints as to who my true self was. (39:42) And, at school, I was generally a a pretty quiet girl

Scott Benner (39:46) Okay.

Olivia (39:46) A bookworm, a a band geek, all of those types of things. (39:51) Like, I never really was, like, super bubbly or going up to random people, striking up conversations.

Scott Benner (40:00) Yeah. (40:01) Clarinet? (40:01) What'd you play?

Olivia (40:03) Yeah. (40:03) I played clarinet.

Scott Benner (40:04) Did I get it? (40:04) Yeah. (40:05) Goddamn. (40:05) Yeah. (40:06) Hold on, Olivia.

Scott Benner (40:06) Take a second. (40:07) Hold on. (40:07) Just take one second. (40:09) Everybody just give me some credit, like, virtually through the airwaves right now. (40:14) I how do I do these things?

Scott Benner (40:16) This is not a great skill, Olivia, but it is my skill, and I'm gonna celebrate it for a second. (40:21) How did I do that? (40:22) What do you think I knew about you that I came up with clarinet? (40:25) Oh, we'll never know.

Olivia (40:27) That was amazing.

Scott Benner (40:28) Thank you. (40:29) I'm basically a genius at things that don't matter.

Olivia (40:34) Seriously, that was brilliant. (40:35) Can't wait to tell my husband about this later.

Scott Benner (40:38) Thank you. (40:39) Thank you. (40:39) So I wish there was an audience here right now. (40:41) I would take a curtain call on that. (40:44) Really lovely.

Scott Benner (40:45) Okay. (40:45) Oh, wow. (40:46) Alright. (40:47) I'm sorry.

Olivia (40:49) Let me refocus. (40:50) Good.

Scott Benner (40:50) I was about to ask you something really serious, and it just hit me. (40:53) I'm like, I know for sure this was a clarinet. (40:55) Let me say it out loud. (40:56) But then there was a lot of risk because I could have been wrong. (40:58) You know?

Scott Benner (40:59) You said you didn't wanna be like either of them, but, like, so far in the story, your dad's a good guy. (41:04) Does that change?

Olivia (41:06) It does. (41:06) Oh. (41:07) So, like, there's nothing in my story yet that I would say is completely black and white. (41:13) So my dad, when it comes to him, I should actually back up to the time I was 16 when the split custody thing ended. (41:23) It ended when I came to a decision to live at my mom's house all the time because because of a variety of factors, but one of the primary factors was that I just needed stability.

Olivia (41:39) I couldn't take it anymore. (41:41) And in deciding between whether to live with my mom or my dad, I remember a lot of times being at my dad's house and just sitting in my bedroom pretty much the whole time unless if I was sharing a family meal or going to school. (41:57) Mhmm. (41:58) But I felt very lonely. (41:59) And my dad and my stepmom, his wife, didn't really check on me a whole lot when I was spending time in my bedroom.

Olivia (42:10) So it I remember back during those days thinking that my bedroom was like a prison cell, and I was starving of love.

Scott Benner (42:17) Oh my gosh. (42:19) That's crazy.

Olivia (42:20) Yeah.

Scott Benner (42:21) Did they have kids of their own, the two of them?

Olivia (42:24) Yeah. (42:25) They when I was 13, they started having kids of their own. (42:31) They have, four daughters together.

Scott Benner (42:33) Jeez.

Olivia (42:34) Yeah.

Scott Benner (42:36) Wow. (42:37) I think like, that's I mean, you're already 13, and they're having four they have four other kids?

Olivia (42:42) Yep. (42:43) My, for context, my it's kind of weird. (42:47) My stepmom is fourteen years younger than my dad, and she's also fourteen years older than me. (42:53) So she's, like, right in the middle

Scott Benner (42:55) Oh my gosh.

Olivia (42:56) Between my dad and I. (42:57) But, yeah, they they popped out four girls. (43:00) I suspect they were probably trying for a boy, but then gave up after the fourth daughter was born. (43:06) Not really sure.

Scott Benner (43:07) I have so many theories in here about, like, your dad being domineered by your mom and then him probably going after a younger person who is more amenable the next time. (43:16) But am I right?

Olivia (43:19) Maybe to an extent. (43:20) I think I think and, again, based on what I remember back during my adolescence, I think my stepmom definitely wore between the two of them. (43:30) Think he was being domineered by her.

Scott Benner (43:33) Yeah. (43:34) Wow. (43:34) Your dad's a a he's got a type.

Olivia (43:38) Yeah. (43:40) Yeah. (43:40) Just I don't know. (43:41) Like, compliant. (43:42) I'm not really sure if compliance is the right word.

Scott Benner (43:44) See, I was I'm I was a 100% as right as I was about the clarinet thing, I was very wrong about that. (43:48) Like, what I thought was is he went after somebody younger because maybe they wouldn't know themselves as well and maybe would not, like, stick up and you know what I mean? (43:56) Like, maybe he was tired of being told what to do and was looking to tell somebody what to do, but that doesn't sound like the vibe.

Olivia (44:02) So No. (44:03) No. (44:04) I I think I think, ultimately, the dynamics that were at work in his marriage to my mom are pretty similar to the dynamics he shares with his, with his new wife in that

Scott Benner (44:16) In the I'm sorry. (44:17) In that

Olivia (44:18) in that, my both my mom and my stepmom are more domineering types, and my dad is more of the passive type.

Scott Benner (44:25) Mhmm. (44:26) What do the kids call that? (44:27) A simp? (44:28) Is that what they call it?

Olivia (44:28) I

Scott Benner (44:29) I don't know the Internet that much. (44:30) Yeah. (44:30) Yeah. (44:31) Yeah.

Olivia (44:31) I'm I'm not really familiar with a lot of the common lingo these days. (44:34) Like, simp sounds right, but I I could be totally wrong too.

Scott Benner (44:37) I love that you said common lingo. (44:39) I love you, Olivia. (44:40) You're awesome. (44:40) I don't know. (44:41) Listen.

Scott Benner (44:41) I don't know why.

Olivia (44:42) Too, Scott.

Scott Benner (44:42) Oh, thank you. (44:43) I don't know why your parents were ignoring you. (44:44) You seem cool. (44:46) So

Olivia (44:46) I I appreciate that. (44:48) Seriously. (44:48) I do. (44:49) Seriously.

Scott Benner (44:49) Also, I wanna take a half a sidebar here for a second before we because I have a question about why you picked your mom. (44:54) But I just found myself thinking, like, when you're out in public or at work, you know, or you're around a bunch of people, whether you're related to them or just around them a lot, like, when you listen to people's stories like Olivia's and other people that come on the podcast, does it not make you look around the room and wonder, like, what are all of these other people's stories? (45:13) Because this is such a complicated, you know, rich, sad, you know, story that you're telling. (45:21) And that's a thing you carry around with you every day. (45:23) Like, your building blocks are this story.

Scott Benner (45:25) Right? (45:26) And when you're at work or church or wherever you go at the grocery store, everything you do and think and react come from from this, like, this this origin story of yours. (45:39) You you know? (45:40) And and everyone has one. (45:42) And it's so simple, I think, to, you know, sit in a room with 20 people that you work with and just be like, oh, you know, he's a asshole and she's a bitch and that one's you know, wants to tell us what to do all the time and that one doesn't listen and but and to oversimplify people.

Scott Benner (45:58) But and I really think if people got to know each other better, they'd work better together. (46:03) You know? (46:03) I don't know how reasonable it is at work for you to tell stories like this, but it just occurs to me we should know each other if we really expect to, exist well. (46:11) So, anyway

Olivia (46:13) Yeah. (46:13) Definitely. (46:14) I I agree with that because every person is unique. (46:17) Every person has a unique story that they are carrying around. (46:23) They have different sets of circumstances that have led them to the point where they are now in the present moment.

Olivia (46:29) And I think that it's so easy to just kind of go along our own way, not really give a second thought to what other people are going through.

Scott Benner (46:37) Yeah. (46:37) Yeah. (46:37) You've overcome a lot. (46:39) Like, I would like, if you were on my team at work, I would think, like, hey. (46:42) Let's get Olivia involved in this.

Scott Benner (46:44) Like, she doesn't give up. (46:45) You you know, like, she gets stuff done. (46:47) She follows through. (46:48) She doesn't, you know, she doesn't just put up her hands and go, oh, no. (46:50) You know?

Scott Benner (46:51) Well, dad stuck me in the in the love prison and my mom's screaming. (46:55) I mean, like, this is my next question. (46:56) It's like, how do you choose her? (46:58) Like, that's, like, that's that's all. (47:00) I mean, that's really, like that's like a reverse Sophie's choice, isn't it?

Scott Benner (47:09) This episode was too good to cut anything out of, but too long to make just one episode. (47:15) So this is part one. (47:16) Make sure you go find part two right now. (47:18) It's gonna be the next episode in your feed. (47:23) Touched by Type one sponsored this episode of the Juice Box podcast.

Scott Benner (47:27) Check them out at touchedbytype1.org on Instagram and Facebook. (47:32) Give them a follow. (47:33) Go check out what they're doing. (47:35) They are helping people with type one diabetes in ways you just can't imagine. (47:41) Today's episode of the juice box podcast was sponsored by the new Tandem Mobi system and Control IQ plus technology.

Scott Benner (47:49) Learn more and get started today at tandemdiabetes.com/juicebox. (47:54) Check it out. (47:57) The podcast episode that you just enjoyed was sponsored by Eversense CGM. (48:02) They make the Eversense three sixty five. (48:05) That thing lasts a whole year.

Scott Benner (48:07) One insertion. (48:08) Every year? (48:09) Come on. (48:10) You probably feel like I'm messing with you, but I'm not. (48:12) Eversensecgm.com/juicebox.

Scott Benner (48:17) Thank you so much for listening. (48:19) I'll be back very soon with another episode of the juice box podcast. (48:22) If you're not already subscribed or following the podcast in your favorite audio app, like Spotify or Apple podcasts, please do that now. (48:30) Seriously, just to hit follow or subscribe will really help the show. (48:34) If you go a little further in Apple Podcasts and set it up so that it downloads all new episodes, I'll be your best friend.

Scott Benner (48:41) And if you leave a five star review, oh, I'll probably send you a Christmas card. (48:46) Would you like a Christmas card? (48:52) Hey, kids. (48:53) Listen up. (48:53) You've made it to the end of the podcast.

Scott Benner (48:55) You must have enjoyed it. (48:56) You know what else you might enjoy? (48:57) The private Facebook group for the Juice Box podcast. (49:01) I know you're thinking, Facebook, Scott, please. (49:04) But no.

Scott Benner (49:04) Beautiful group, wonderful people, a fantastic community. (49:08) Juice Box podcast, type one diabetes on Facebook. (49:11) Of course, if you have type two, are you touched by diabetes in any way? (49:15) You're absolutely welcome. (49:17) It's a private group, so you'll have to answer a couple of questions before you come in.

Scott Benner (49:20) We'll make sure you're not a bot or an evil doer, then you're on your way. (49:24) You'll be part of the family. (49:27) Oh my, did I get lucky. (49:29) The Celebrity Cruise Line reached out to me and said, how would you like to come on a cruise before your juice cruise so you can get a real good look at the Celebrity Beyond cruise ship and share some video with your listeners. (49:43) I said, thank you.

Scott Benner (49:45) So that's where I might be right now. (49:47) If it's December, let me actually find a date for you. (49:50) I'm not a 100% sure. (49:52) I think I'm going in December right before Christmas. (49:56) Like, you know, like, I don't know, like, the third or fourth week of December.

Scott Benner (49:59) I'm sorry. (49:59) Know this isn't much of a that. (50:00) But if you wanna see video from me on the cruise ship, my wife and I are gonna head out and really check it out to see what it's all about to grab some great video for you. (50:09) Get it up on TikTok, Instagram, and Facebook so you can see what you'd be getting if you came along on Juice Cruise 2026, which, of course, leaves from Miami on 06/21/2026. (50:21) We're gonna be going to CocoCay in The Bahamas, San Juan, Puerto Rico, Saint Kitts And Nevis.

Scott Benner (50:26) Do not miss it. (50:27) It's a great opportunity to meet other people living with type one diabetes to form friendships, to learn things, and just swap stories. (50:34) It's a relaxing vacation with a bunch of people who get what your life is like. (50:39) And trust me, there's a lot of value in that. (50:41) Juiceboxpodcast.com/juicecruise.

Scott Benner (50:45) Come check it out and go find my socials to see what that ship looks like. (50:49) There's also a video at my link that's, kind of a ship tour for the celebrity beyond. (50:54) And let me tell you something. (50:55) If this ship is a tenth as nice as this video is, I am in for a great time, and so are you. (51:02) Juiceboxpodcast.com/juicecruise.

Scott Benner (51:05) Come along. (51:08) If you have a podcast and you need a fantastic editor, you want Rob from Wrong Way Recording. (51:14) Listen. (51:15) Truth be told, I'm, like, 20% smarter when Rob edits me. (51:18) He takes out all the, like, gaps of time and when I go, and stuff like that.

Scott Benner (51:23) And it just I don't know, man. (51:25) Like, I listen back and I'm like, why do I sound smarter? (51:28) And then I remember because I did one smart thing. (51:31) I hired Rob at wrongwayrecording.com.

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