#1835 Bolus 4 - Ultra Processed Food
Scott and Jenny talk about how to bolus 4 ultra processed food.
Companies that Support Juicebox
Key Takeaways
- Ultra-processed foods (UPFs) are heavily altered with industrial ingredients, additives, and preservatives designed to maximize shelf life, palatability, and corporate profitability.
- Food engineering capitalizes on addiction cues: Manufacturers find the perfect blends of fat, sugar, and salt to trigger cravings, overriding natural satiety cues and promoting overconsumption.
- The absence of Amylin makes bolusing harder: In type 1 diabetes, the lack of the hormone Amylin leads to faster gastric emptying and weaker fullness signals, meaning blood sugar from processed foods rises rapidly.
- GLP-1 medications tackle "food noise": These drugs help control constant hunger and improve satiety, enabling weight management even when consuming highly processed foods.
- Refined ingredients spike blood sugars rapidly: Highly processed products, such as high fructose corn syrup and heavily refined seed oils, lack natural fiber and nutrients, making them particularly challenging to bolus for effectively.
Resources Mentioned
- Juicebox Podcast: juiceboxpodcast.com
- The Meal Bolt Framework: juiceboxpodcast.com/meal-bolt
- Omnipod 5: omnipod.com/juicebox
- Dexcom G7: dexcom.com/juicebox
- Wrong Way Recording: wrongwayrecording.com
- Juicebox Podcast Private Facebook Group & Diabetes Pro Tip Series (Episodes 1000-1025)
Introduction & The Meal Bolt Framework
Scott Benner Hello, friends, and welcome back to another episode of the Juice Box podcast. (0:15) 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. (0:23) Jenny and I are gonna follow a little bit of a road map called meal bolt. (0:28) 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. (0:39) Having said that, these episodes are gonna be very conversational and not incredibly technical.
Scott Benner 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. (0:52) So while you might not hear us say every letter of Miel Bolt in every episode, we will be thinking about it while we're talking. (1:00) If you wanna learn more, go to juiceboxpodcast.com/meal-bolt. (1:05) 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.
Scott Benner Always consult a physician before making any changes to your health care plan or becoming bold with insulin.
Scott Benner Today's episode is brought to you by Omnipod. (1:32) We talk a lot about ways to lower your a one c on this podcast. (1:36) Did you know that the Omnipod five was shown to lower a one c? (1:40) That's right.
Scott Benner Omnipod five is a tube free automated insulin delivery system, and it was shown to significantly improve a one c and time and range for people with type one diabetes when they switched from daily injections. (1:53) My daughter is about to turn 21 years old, and she has been wearing an Omnipod every day since she was four. (1:59) It has been a friend to our family, and I think it could be a friend to yours. (2:03) If you're ready to try Omnipod five for yourself or your family, use my link now to get started. (2:10) Omnipod.com/juicebox.
Scott Benner Get that free Omnipod five starter kit today. (2:15) Terms and conditions apply. (2:17) Eligibility may vary. (2:18) Full terms and conditions can be found at omnipod.com/juicebox. (2:23) Today's episode is also sponsored by the Dexcom g seven, the same CGM that my daughter wears.
Defining Ultra-Processed Foods
Scott Benner Check it out now at dexcom.com/juicebox. (2:34) Alright, Jenny. (2:35) I was thinking that today we would, for the bolus four series, instead of talking about how to bolus for something today, I thought we'd dig into what ultra processing means. (2:47) Oh. (2:48) So that we can figure out what foods are made out of.
Scott Benner Right? (2:52) Because now we've been talking about bolusing for a while, and, you know, I think people can hear that maybe simpler, more organic, natural foods don't seem like they need as much finagling when it comes to bolusing. (3:07) Right? (3:07) And then they've heard us talk about, like, bolusing for donuts and stuff like that. (3:11) And I thought maybe just taking a pause here in the middle of making bolas for episodes, we could talk more about why that is.
Scott Benner So Sure. (3:19) Alright. (3:20) Are you good with that?
Jenny Smith Yeah. (3:21) I know that's kind of fun.
Scott Benner Okay. (3:23) Well, I knew you'd find it kind of fun. (3:26) And I wanna be clear to everybody. (3:28) This is a fact finding mission for me because I mean, Jenny's got the background to talk about this. (3:33) I don't fundamentally understand all this.
Scott Benner I know I don't want processed foods, and I've heard the word ultra processed, and I'm gonna try to break up the difference. (3:42) So I do I just wanna start there, like, the difference between processed and ultra processed. (3:48) And I'm gonna ask you for yours, and then I'm gonna look online while you're talking and try to round up that question and then go to the next one.
Jenny Smith Sure. (3:55) Ultra processed foods compared to unprocessed or, for lack of better word, real food, right, is the ultra processed food, also often called UPFs, just a little acronym, are made from, like, industrial based ingredients. (4:16) They've got a lot of additives in, things that don't occur in nature, most often because of the taste profile. (4:25) Mhmm. (4:26) Most often in order to preserve the product and give it the crunch, the appeal, the taste after it's been sitting in the actual package for questionable amount of time on the shelf.
Jenny Smith So ultra processed is essentially, like, making something to eat in a factory. (4:45) That's kind of how I think about it.
Scott Benner Okay. (4:48) What it tells me is the difference is mostly about how much the original food has been changed.
Jenny Smith Yes.
Scott Benner Okay. (4:54) Processed foods are foods that have been altered from their original form usually to make them safer, last longer, or be easier to prepare. (5:02) The one thing I've noticed about this, because this is not the first time I've looked into this, is that sorry. (5:07) There's people working in my house today.
Jenny Smith I can't hear anything. (5:11) Well,
Scott Benner trust me. (5:13) It's gonna get on the recording. (5:14) I'm pretty sure. (5:15) So plain yogurts, canned beans, frozen vegetables, rolled oats, cheese, peanut butter with just peanuts and salt, whole grain bread with a short ingredients list is what they're talking about as processed food, ultra processed soda, packaged snack cakes, chips with flavor coatings, candy, instant noodles with seasoning packets, chicken nuggets made from reconstituted meat, sugary breakfast cereals, packaged cookies, many frozen microwave meals, and things that say cheese product on them.
Jenny Smith I think it's also you just said two different things about process.
Scott Benner Okay.
Jenny Smith Right? (5:52) You said ultra process
Scott Benner Mhmm.
Jenny Smith Which is more what I defined
Scott Benner Yep.
Jenny Smith And processed. (5:58) Because quite honestly, in today's world, we don't live like it's little house on the prairie times.
Scott Benner Right?
Jenny Smith So even something like yogurt, which I wouldn't consider a processed food, it is Mhmm. (6:14) Truly. (6:15) Because unless you're going to take the milk and make it and you've got a yogurt maker at home, blah blah blah, and take the time to do it, your yogurt has been processed in order to package it, keep it contained. (6:26) They use the word safe. (6:28) It does make it more safe because if they didn't do some of the stuff that they did, even a food that's been minimally processed is gonna go bad, and you're not gonna wanna eat it.
Scott Benner Okay.
Jenny Smith Right? (6:41) So I think it's great that you brought that in because there is a definition difference.
Scott Benner I also started to say and then didn't finish my thought that when you Google or chat GPT or however you get your information, this thing is gonna be leaning towards what the FDA said is okay, what the USDA says is okay. (7:01) If you press it a little more, it will, you know, like
Jenny Smith Give you more.
Scott Benner You'll see later when we get to oil and Mhmm. (7:08) And corn syrup and stuff like that. (7:09) But, anyway, so ultra processed foods are gonna have a lot of chemicals in them or Yes. (7:15) Preserve but more specifically, preservatives.
Jenny Smith But Typically yes.
Scott Benner Good. (7:20) Good.
Jenny Smith Preservatives, but also things like I think we've looked it up before. (7:24) Things that are anti caking agents. (7:27) They don't let the product get all crunchy and gross when it's supposed to be a powder Mhmm. (7:32) Or they help it to retain the crunch and not get soggy. (7:37) Again, all of these things that we've learned in industrializing our world
Scott Benner Mhmm.
Jenny Smith Have come about because lives have gotten busier. (7:48) We need something that's quick, easy, fast to actually do. (7:52) We don't have time to slice up the potato and put it in the food dehydrator or the air fryer to actually make our own potato chips. (8:00) We wanna buy them easy to crunch out of the bag.
The Engineering of Palatability
Scott Benner Yeah. (8:02) I've had this conversation already. (8:05) I'm having it again with you. (8:06) But I asked then, like, why should I care about this? (8:08) Mhmm.
Scott Benner And it was interesting because it didn't answer me the way I thought it was going to. (8:12) I thought it was gonna say, like, well, there's additives and preservatives and chemicals. (8:15) It said more about, like, that there's a it's just very low in nutritional value. (8:21) Yes. (8:21) And high intake is linked to chronic disease, but it's more about the the flavor and the salt, sugar, fat Fat.
Scott Benner Mix that that slurry they make then spread on your Doritos or wherever they wherever it goes. (8:38) Right? (8:39) Yes. (8:40) It's a perfect blend of the things that your body desires.
Jenny Smith 100%.
Scott Benner Right. (8:45) Right.
Jenny Smith They have hit it. (8:47) I can't remember the name of the book, but years ago, there was a gentleman who wrote a book all about this. (8:53) It was all about the food in quote, unquote, food industry learning to capitalize on fat, sugar, and salt, and how to combine them from a chemical structure that it hits your taste bud the way that people want it to, and then it hits the brain signals that say, take another. (9:15) Yes. (9:16) Take another.
Jenny Smith Keep coming back for it. (9:18) And they've they've figured it out. (9:20) I mean, they are absolute, like, chemical geniuses in terms of packing a whole bunch that no human body needs in it.
Scott Benner Mhmm. (9:28) So I kinda then I picked her around. (9:30) I was like, why would someone do this? (9:31) So I tried to like, I acted naive for a second. (9:34) Was like, why if I was making food, why would I do this?
Scott Benner The answer back was higher margin products, longer shelf life, less waste. (9:41) It creates repeat buying because it's hyperpalatable, and it's also very repeatable. (9:48) So you know that when you buy the chip, it's gonna taste the same time after time after time. (9:53) Like, it's there waiting for you, and you know what you're gonna get when you get it. (9:56) It talked a little bit about the addictiveness, not as much like drugs, but more about just, like, repeat consumption, like, the idea of and because I said, I was like, well, I must be able to eat some of this without it hurting me.
Scott Benner Like, can my body process canola oil? (10:09) And, you know, it's like, yeah, your body can process canola oil. (10:12) It can process Sure. (10:13) Yeah. (10:13) Yeah.
Scott Benner Then it becomes more about it's not about having a potato chip. (10:18) It's about having a bag of potato chips. (10:20) And it's not even about having a bag of potato chips. (10:22) It's about having 50 bags of potato chips. (10:24) Right?
Scott Benner Like Yeah. (10:25) Over a year or two. (10:27) Like, I don't even know how to quantify that. (10:28) Like, I wonder how many bags of potato chips a person eats in a year. (10:32) It could be probably more than I think.
Jenny Smith It could be a lot. (10:36) And I think that that also the consideration of I mean, the word addiction is correct to use here.
Scott Benner Okay.
Jenny Smith Not in the sense like alcohol or drugs or whatever, but honestly, if we imagine that the ultra processed foods are similar in effect over a long period of time on our internal health, on our vessels, on our nerves. (11:02) I quite honestly, right on every little cell in our body that's trying to make energy the right way
Scott Benner Mhmm.
Jenny Smith They become addictive. (11:10) And so, I mean, what's the is it Pringles? (11:13) It's once you pop, you can't stop.
Scott Benner Yeah.
Jenny Smith Right? (11:16) It's so salty. (11:16) It's salty. (11:18) It's crunchy. (11:18) It's got all of the hit points that you want, and you don't consider the calorie
Scott Benner Mhmm.
Jenny Smith That you end up taking in. (11:28) With a product that's mostly it's like air, and you eat it, and you take another one, and you take another one. (11:34) It's very easy to probably eat half a can of them without realizing, and then you've ended up with 600 calories worth of you're still hungry. (11:45) Yeah. (11:45) And then you go to something else.
Jenny Smith Whereas had you sat down to a 600 calorie meal that's truly real, mostly not high processed food. (11:56) Right? (11:56) Mhmm. (11:57) You are going to have a fullness, satiety factor in the aftermath of a meal. (12:01) You're gonna have a wealth of nutrients.
Jenny Smith You're gonna have all of the macronutrients. (12:06) You're just gonna have better for your body as well as that feeling of I ate a meal, and I am I'm full. (12:12) I'm satisfied.
Scott Benner So I asked the question next, and I have, you know, have this experience, so I know this is true. (12:19) And I almost I almost resist saying this out loud, but I've been on a GLP now for, like, three years. (12:26) Mhmm. (12:26) I can eat poorly for days at a time now and not gain weight. (12:32) So that's a little bit of gives with one hand, takes away with the other kind of a situation because you have to, like, thoughtfully anybody who's on a GLP who's trying to do what they're supposed to be doing is always telling themselves, I gotta take in a bunch of protein.
Scott Benner I gotta keep moving. (12:48) But, like, I need chicken. (12:50) I need beef. (12:50) I need I need protein protein eggs. (12:53) Like, I think about that all the time.
Scott Benner And by the way, that has not been easy lately as four steaks at Costco have gone from 40 to $90 in, the last, like, three months. (13:05) It's really crazy. (13:07) Wow. (13:08) So I'm trying to be aware of that while we're talking about this. (13:11) The food is getting, like, very expensive.
Scott Benner But yet so I said, like, why is that? (13:15) And I said, beyond like, at first, it was funny because at first, it ants I said, why would GLPs why would GLPs stop me from gaining weight from eating ultra when I eat ultra processed foods? (13:26) And the first answer that came back was like, oh, well, it you know, satiety. (13:29) It makes you not as hungry so you don't eat as much. (13:31) And I said, no.
Scott Benner That is not what's happening. (13:33) Like, I was like, I can eat as much as I I know how to eat through a GLP at this point. (13:36) Like, I understand how to, like, manipulate the whole thing. (13:40) Even if I eat that stuff and in excess even, why don't I gain weight? (13:44) And it started talking about insulin and slowing gastric emptying and kind of the ways my body's manipulating it.
Scott Benner And then I said, well, then are ultra processed foods the problem or the way my body works the problem? (13:58) It thought the ultra processed foods were the problem, by the way. (14:01) But Yeah. (14:02) I was just like, maybe we haven't maybe we haven't evolved enough yet. (14:06) I'm not a historian, but the way food's made now is obviously first about money.
Scott Benner This is the next thing that obviously is upsetting. (14:14) You look into all the companies that own all of the different things. (14:18) Pepsi and Coke, for example, own a ton of companies that make food.
Jenny Smith Right.
Scott Benner Okay. (14:23) They're trying to make money, but they're also trying to feed billions more people than used to be standing on the planet. (14:29) So I understand that even. (14:30) Right? (14:31) But I just it gives me the same feeling.
Scott Benner And I I'm I'll be brief here because I know I've probably said this before in the podcast. (14:38) But when I caught my little brother smoking when he was a teenager, I said, if I was you, I'd think about the eight rich guys sitting around a table laughing that you bought those cigarettes and that they're rich because of it. (14:51) And I bet you none of them smoke. (14:53) And, you know, so I I I do feel that way about a lot of this food sometimes.
Midroll Sponsors: Dexcom G7 & Omnipod 5
Scott Benner The Dexcom g seven is sponsoring this episode of the juice box podcast, and it features a lightning fast thirty minute warm up time.
Scott Benner That's right. (15:09) From the time you put on the Dexcom g seven till the time you're getting readings, thirty minutes. (15:15) That's pretty great. (15:16) It also has a twelve hour grace period, so you can swap your sensor when it's convenient for you. (15:22) All that on top of it being small, accurate, incredibly wearable, and light, these things, in my opinion, make the Dexcom g seven a no brainer.
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Scott Benner Alerts and alarms that are customizable so that you can be alerted at the levels that make sense to you. (15:54) Dexcom.com/juicebox. (15:56) Links in the show notes. (15:57) Links at juiceboxpodcast.com to Dexcom and all the sponsors. (16:02) When you use my links, you're supporting the production of the podcast and helping to keep it free and plentiful.
Scott Benner Today's episode is brought to you by Omnipod. (16:12) We talk a lot about ways to lower your a one c on this podcast. (16:16) Did you know that the Omnipod five was shown to lower a one c? (16:20) That's right. (16:20) Omnipod five is a tube free automated insulin delivery system, and it was shown to significantly improve a one c end time and range for people with type one diabetes when they switched from daily injections.
Scott Benner My daughter is about to turn 21 years old, and she has been wearing an Omnipod every day since she was four. (16:39) It has been a friend to our family, and I think it could be a friend to yours. (16:43) If you're ready to try Omnipod five for yourself or your family, use my link now to get started. (16:49) Omnipod.com/juicebox. (16:52) Get that free Omnipod five starter kit today.
Scott Benner Terms and conditions apply. (16:56) Eligibility may vary. (16:58) Full terms and conditions can be found at omnipod dot com slash juice box.
Food Noise and Satiety
Jenny Smith And what goes along with it if you're thinking that way is if you can wrap your mind around that, you're probably the person that's gonna start to make changes. (17:13) You're the person, as you said before, how many bags of potato chips could somebody possibly eat? (17:19) And as somebody who has a mindset of occasional in their habits
Scott Benner Mhmm.
Jenny Smith It's much easier for them to say, even without a GLP or anything else that affects satiety, it's easier for them to say, I'm gonna take a handful, and that's what I have on my plate, and I don't need to go back for more. (17:37) There's something in kind of the the way that we end up learning and thinking about food intake over time that is also really hard to navigate. (17:49) Thus, an interesting reason that GLPs seem to work for a lot of people who had no ability to control before is it brings in you know, we've heard it many times called food noise. (18:04) It brings in the ability to control that food noise. (18:09) It almost brings recognition of how much you've eaten or what you've eaten.
Jenny Smith Even if it isn't an apple, you're still eating ultra high processed food. (18:18) It brings in a little bit more recognition of portion
Scott Benner Yeah.
Jenny Smith Than you may have otherwise had. (18:25) And then the idea of looking at all the foods in a store that come in a package and seeing the brand name on that package has come from, as you just said, a big corporation that has figured out fat, salt, and sugar. (18:40) Yeah. (18:40) Figured it out.
Scott Benner I would just tell you be insulted that somebody's taking advantage of you like that to take you take your money from you with no regard for what it's gonna do to your health.
Jenny Smith Right.
Scott Benner I do wonder as you were talking, I thought, I wonder if food because food noise is a is a trendy thing to say right now. (18:56) Right?
Jenny Smith It is.
Scott Benner But Mhmm. (18:57) Did it exist five hundred years ago?
Jenny Smith I I don't
Scott Benner Or did people just call that hunger? (19:02) Or, like, do know what I mean? (19:03) Or, like or has the processing of the food done something to us that makes it so that there's this, like, background noise of I don't know. (19:15) Or is it just a thing that, like, you know, people say nowadays? (19:18) Like, you know?
Jenny Smith I think it's a combination of those things. (19:22) We have if you take five hundred years ago
Scott Benner Mhmm.
Jenny Smith Okay. (19:27) And gosh, that was that was a long time ago. (19:30) Right?
Scott Benner That's six of my lives, hopefully, if I make it to 80, which by the way, I've been thinking about a lot lately. (19:36) I don't don't do that. (19:37) By the way, the actuarial table says I have, like, 1,400 weekends left. (19:41) So Oh. (19:42) Don't look into that.
Jenny Smith I won't be looking at that at all. (19:46) No. (19:47) As you say, like, it struck me something you said just before about, one, we have a lot of people on the planet to feed Mhmm. (19:54) Comparative to five hundred years ago. (19:58) The second piece of that is we are no longer the majority of people on the planet are no longer in a realm of understanding agriculture in order to actually support their family.
Scott Benner Mhmm.
Jenny Smith Right? (20:10) I I have mean, a lovely garden, but would it a 100% support our four person family? (20:18) No. (20:19) Yeah. (20:19) By no means.
Jenny Smith I I have to go to the grocery store. (20:22) Right?
Scott Benner Mhmm.
Jenny Smith And so therein food is widely available now comparative to five hundred years ago. (20:29) Yeah. (20:29) And it was much more the the true, again, hunter gatherer type of kind of idea. (20:36) I have to do something to get my food. (20:38) I'm gonna make the most out of the food that I get.
Jenny Smith I'm gonna preserve it. (20:41) I'm gonna pack it away. (20:42) I'm gonna do all of these things through the course of the year. (20:46) We also now have strawberries in December when they would not grow on the ground outside my house. (20:53) Right?
Jenny Smith So we have the advantage of a wealth of whatever type of food, unprocessed, processed. (21:01) Yeah. (21:02) And we've taken away the hunger cues in a way because it becomes so normal to just have food present at every every occasion that you end up coming to. (21:16) There is always who's gonna bring the donuts? (21:18) Who's gonna bring the muffins?
Jenny Smith Who's gonna bring the bars or whatever it's going to be? (21:23) Right?
Scott Benner My wife said to me last night, do you wanna go watch, TV before we go to bed? (21:28) And I said, sure. (21:29) It's like 09:30, 10:00. (21:31) And I thought, oh, I gotta get a drink to take with me. (21:33) And then I stopped and I went, why am I doing that?
Scott Benner I'm like, it's 09:30. (21:38) I'm good.
Jenny Smith Do I
Scott Benner need I've drank as much as I'm gonna drink today. (21:40) What am I drinking something for? (21:42) Like, like, I actually I actually thought that. (21:44) Was like, why am I gonna so I thought, well, I'll bring water with me just in case. (21:48) Mhmm.
Scott Benner But, like, I was thinking of, like, something else. (21:51) And then I was like, what what am I doing? (21:54) Let me say this about I don't again, I'm not a historian. (21:57) Right? (21:58) Isn't it interesting that people used to have way more kids?
Scott Benner Like, were pumping kids out forever. (22:03) And if you're and by the way, if you blew your lady up making kids, you'd grab another lady and start pumping them out with her too. (22:09) Like, so you're making know you know what happened? (22:10) Those ladies didn't they didn't live very long.
Jenny Smith Neither did men, honestly.
Scott Benner No. (22:14) Well, what you would do, Jen, I don't know if you know this, is your wife, you'd you'd you had her pregnant so many times, she'd just explode or something. (22:19) And then, like, then you'd go find I
Jenny Smith don't think so much.
Scott Benner Technically how it happens. (22:24) But then, like, then you go find some lady whose husband got run over by a horse and you're like, hey. (22:28) Come watch my kids and I'll pay for yours and why don't we make five more while we're at it? (22:32) And but then those people, they died more frequently. (22:35) They went hungry.
Scott Benner They got sick sooner. (22:38) Like, so many more people were being made back then, I bet, than are being made now, but we retain them so much better now. (22:44) Yes. (22:44) You know, like, not for and it is really kind of a I wanna say, it is kind of a miracle that people live as long as they do now. (22:51) And it's got a lot to do with the access to food and shelter and and etcetera.
Scott Benner But, man, we could be we could be doing it better. (22:57) Let me pivot here to people with type one diabetes for a second, unless you have something you wanna say.
The Role of Amylin in Type 1 Diabetes
Jenny Smith I wonder if you're gonna bring up the same thing I was gonna bring up, but go ahead.
Scott Benner This would be crazy if we do that. (23:06) I wanted to talk about Amylin. (23:08) Is that what you were because because if that was what were gonna say, then we should really get married because It have been crazy.
Jenny Smith In a way, not Amlan directly. (23:18) Okay. (23:18) My point was, as we were just talking about availability of food and what kind of boils down to is, like, hunger cues as you mentioned. (23:27) Right?
Scott Benner K.
Jenny Smith Eons ago, you did. (23:30) When you were hungry, your body was absolutely signaling to you. (23:34) It's time to take something in. (23:36) Or gosh, it's lunchtime. (23:38) Mom's calling us in from the field.
Jenny Smith It's time to actually eat something in between. (23:42) There was not something called a snack.
Scott Benner Yeah.
Jenny Smith Like, snack has become such a very, nowadays type of thing to I mean, snacks in the car for kids traveling ten minutes across the city because they can't stand it without a snack. (23:55) Like right? (23:56) So
Scott Benner No. (23:57) I mean, yeah, there's food there's literally food everywhere.
Jenny Smith Food every my point, though, for type one diabetes or diabetes in general is that I'm trying to think how to say it. (24:07) We all have a disordered way of thinking about food.
Scott Benner Okay.
Jenny Smith We are we don't all have eating disorders, but because of the nature, excuse me, of how we have to manage blood sugar Mhmm. (24:23) It includes the hormone insulin.
Scott Benner Yeah.
Jenny Smith Our body doesn't make it the right way in response to something happening that we take in. (24:32) So we have to cognitively pay attention to insulin, food intake, and we have now navigated food has to come in because I have to take my insulin. (24:46) Right? (24:46) Right. (24:47) And it has taken away for I don't know how many people over and over, I hear people comment.
Jenny Smith I'm not I don't feel hunger anymore. (24:54) I eat because I think it's time to eat, but I don't really have hunger cues most of the time. (24:59) And that's a disjointed way of considering why you should put food in your body as a basic need. (25:06) Are you saying
Scott Benner you hear that from a lot of people with type one diabetes?
Jenny Smith Absolutely. (25:11) A 100% that the food hunger cues are gone almost.
Scott Benner Arden, all the time, she's like, I'm I'm hungry. (25:21) I need to eat. (25:22) But she's like, I don't, like, I don't crave anything. (25:25) Or and that's with or without by there, it's Yeah.
Jenny Smith Yeah. (25:29) It's it's more it's not so much not being hungry. (25:34) It's almost like the hunger cues are they're not right. (25:38) It art you said Arden kind of just is I could nibble on something, like, all the time. (25:42) Mhmm.
Jenny Smith Right? (25:44) And that's that's not right. (25:46) Mhmm. (25:46) Like, our body, once we sit and eat something, should feel satisfied, and we shouldn't feel like we could grab something again from the cupboard. (25:55) So I just wanted to throw that in.
Scott Benner I would imagine too that in a in a previous, like, time line, you were eating to fuel literally to fuel yourself because you were gonna go keep doing something aggressively, probably active. (26:08) And then come like you said, come in from the field, eat again, then get the hell back out there and do it again. (26:13) And then come in and eat and then go to bed and then get the hell up and eat and do it again, like that kind of thing. (26:18) I I mean, my life is certainly
Jenny Smith We don't live like that.
Scott Benner I mean, you don't live like that. (26:22) You but you add exercise to it to take almost to, like I guess, you're you're pretending you're in a field by Yeah. (26:29) Running around and lifting things and stuff like that. (26:32) I I try very hard not to do that. (26:35) Back to amylin.
Scott Benner Make sure this is right. (26:37) In someone with type one diabetes, beta cells release insulin and amylin together at meals. (26:41) Amylin helps with three big things, slows gastric emptying, suppresses inappropriate post meal glucagon, and increases satiety through central signaling. (26:51) In type one, because the beta cells are damaged, amylin is also deficient, not just the insulin. (26:56) Is that correct?
Jenny Smith That is correct.
Scott Benner Okay. (26:59) So, practically, it says food may leave your stomach faster. (27:02) Fullness signals may be weaker. (27:04) Post meal glucose rises, may rise faster, and it can create a weird cycle of eat less and and less I'm satisfied less being satisfied signaling, so you still feel hungry and snack more.
Jenny Smith Right. (27:17) Which kind of goes along with my consideration of, again, listening to so many people over and over. (27:23) It's like, they don't really have the right hunger signaling
Scott Benner Mhmm.
Jenny Smith Because I mean, until Simlin, which is a created Amlan product, came out years ago and was never really
Scott Benner truly catch on.
Jenny Smith Well, it really never caught on. (27:41) And a big piece of the reason is because it did really require a good practitioner to help the person figure out how to use it well for them.
Scott Benner Mhmm.
Jenny Smith This is a finicky it's definitely a finicky
Scott Benner It wasn't easy to dose?
Jenny Smith Thing hormone. (27:58) It was not easy to use.
Scott Benner Okay.
Jenny Smith But it gives as you, you know, just gave the whole definition about it. (28:05) Absolutely gives the reasoning as to why we have such ineffective cues.
Scott Benner Yeah. (28:12) I just interviewed, like, a 23 year old girl the other day, and she's like, I just went down the rabbit hole of amylin, and, I didn't realize any of this. (28:21) And she's just you know, she's had diabetes, she was, like, 17 or 18. (28:24) And she's like, I am hungry constantly. (28:27) Like, you know, I'm just always hungry and never feel full and, like, the whole thing.
Scott Benner And she's like, I'm gaining weight now. (28:34) So they put her on a GL. (28:34) I mean, GLPs are gonna probably help a lot of people with type one with this, I would I would imagine.
How High Fructose Corn Syrup is Made
Scott Benner Pivoting back, I asked, some questions that I wanted the answers to. (28:45) Like, how does cornstarch get made? (28:47) Because I feel like understanding how it gets made, or, you know, and then how they use it to make high fructose corn syrup because I I'm like, I don't really know. (28:56) So do you know how high fructose corn syrup gets made?
Jenny Smith Well, I know that corn syrup and high fructose corn syrup are slightly different.
Scott Benner Mhmm.
Jenny Smith I know that they're derivatives of corn starch, which comes from corn. (29:13) Mhmm. (29:15) I don't know that I know the process of it. (29:19) I would expect that
Scott Benner they have to
Jenny Smith do some type of pulling of the starchy, sugary through some hydration process. (29:29) They probably use some type of enzyme to pull things out further. (29:34) I would expect, I'm just thinking like food science that I learned eons ago.
Scott Benner Love watching you do this because this reminds me of the time we tested out the bolus, estimator, and I was like, Jenny's getting this exactly right. (29:47) Yeah. (29:47) Yeah. (29:48) Hey. (29:48) Okay.
Scott Benner You start with corn. (29:49) Corn corn kernels are milled in to sep to separate out the starch from the protein, the fiber, and the oil. (29:57) Okay. (29:58) Then you turn the starch into glucose. (30:00) Corn starch is a long chain of glucose molecules.
Scott Benner Manufacturers break that starch down with enzymes. (30:07) Oh. (30:07) So this typical sequence would be starch slurry. (30:10) By the way, every time I hear the word slurry, I think I should do better for myself. (30:14) Starch slurry is prepared.
Scott Benner Alpha amylase starts chopping the starch into shorter chains. (30:21) Go. (30:21) Here we go. (30:22) Gluca gluco amylase breaks those chains further into mostly glucose. (30:28) At this point, you basically have corn syrup, which is mostly glucose.
Scott Benner Then you have to convert some of the glucose into fructose. (30:35) So now here comes the high fructose part. (30:38) It says, the syrup is passed over an enzyme called glucose isomerase. (30:43) That enzyme rearranges some glucose molecules into fructose. (30:47) This does not convert all of it.
Scott Benner A common first product is at around 42% fructose. (30:53) The rest is still mostly glucose at that point. (30:56) That's often called HFCS 42 in Jesus. (31:01) If you need a higher level of fructose needed, the manufacturer wants it sweeter, for example, they can separate and concentrate the fructose rich portion often used processing like chromo topographic separation, and that can produce a much higher fructose stream such as HFCS 90. (31:19) Now we're almost done.
Scott Benner They blend the streams together to get a commercial product they want. (31:25) Common versions are HFCS 42, which is often used in baked goods, processed foods, and some beverages. (31:34) Then there's HFCS 55 common in soft drinks, and HFCS 90, usually not used directly much, mostly used to blend into other HFCS grades. (31:45) Then they filter it, purify it, adjust it for concentration, store, and ship it as liquid sweetener. (31:51) The liquid form is one reason the industry likes it because it's easy to pump, blend, and handle in large scale food production.
Scott Benner Why do they manufacture it this way? (31:59) It's cheap, stable, easy to transport in liquid systems, and sweet enough for beverages and packaged foods.
Jenny Smith Can I ask so the numbers behind those, is that the percentage
Scott Benner Looks like the of? (32:13) Oh, of the oh, yeah. (32:14) Because the first one is 42%. (32:16) They call it 42, 55, and 90. (32:19) Oh, look at you.
Scott Benner Look at you paying attention.
Jenny Smith It's you know?
Scott Benner I know. (32:22) Yeah. (32:23) But
Jenny Smith you would have never thought that.
Scott Benner What is that? (32:26) It's gotta
Jenny Smith be percentage of the amount, and that's the reason that it's better in one one product. (32:32) I won't even use the word food.
Scott Benner Yeah.
Jenny Smith It's better in one product compared to another. (32:37) And so if we if we break this down for anybody to understand, Quite honestly, the whole process that you just went through. (32:49) Mhmm. (32:50) That is that's so much chemical engineering.
Scott Benner And processing and and reprocessing and then want and heating.
Jenny Smith And just exceeding and processing and pulling it through and adding, like, adding all of these things that weren't meant to be. (33:06) Like, I pull an apple off of the tree, man, and that tree did everything that the universe was meant for the tree to do. (33:12) There was no engineering.
Scott Benner It says here, table sugar and HF's high fructose corn syrup wind up in pretty similar places chemically, but they start differently, are built differently, and are handled differently in manufacturing. (33:25) Mhmm. (33:25) Sucrose is a single molecule made of one glucose, one fructose. (33:29) These two sugars are bonded together. (33:31) They usually come from sugarcane or sugar beets.
Scott Benner Mhmm. (33:33) They crush the cane or slice the beets, extract the sugar rich juice, clean and filter it, evaporate off the water, crystallize the sucrose, separate crystals from syrup, dry and refine. (33:43) That's how they make that's how sugar is made.
The History of Coca-Cola and Seed Oils
Scott Benner I wonder if we can find out the original ingredients in Coke.
Jenny Smith Oh, that would be curious.
Scott Benner I wonder if we can find out what that is. (33:58) Because I'm gonna guess it's water, sugar, coloring, like like this probably would
Jenny Smith Would expect caramel coloring.
Scott Benner Cocaine, by the way, but that's not the point of this. (34:09) It's not working.
Jenny Smith Is that is that a myth that
Scott Benner I don't know.
Jenny Smith Used to have it in there? (34:14) I I feel like that's a myth. (34:16) But
Scott Benner The original Coca Cola was an 1886 thing soda foundation syrup created by John Pemberton. (34:23) Thanks, John. (34:24) The company does not publicly disclose the exact formula, but its own history confirms the early drink was a syrup mix with carbonated water named for the cocoa leaf and kola nut. (34:34) Oh. (34:35) Sugar, water, caramel for color.
Scott Benner That's what I couldn't think of. (34:38) Cocoa leaf extract, kola nut extract. (34:41) That's where the caffeine comes from. (34:42) Citric acid, lime juice, vanilla. (34:45) Flavored oils, spices often described in later reconstruction formulas as things like orange, lemon, cinnamon, coriander, nutmeg oils.
Scott Benner That doesn't seem so bad. (34:56) Oh, two important historical notes. (34:58) Yes. (34:58) The earliest Coca Cola did contain cocaine because cocoa leaf extract at the time still carried cocaine alkaloids that was later removed. (35:08) The company name still reflects the original cocoa and cola ingredients.
Scott Benner How about that? (35:13) Is that where cola came from? (35:15) Is that why because, like, in your part of the woods, what do they they call it pop. (35:19) Right? (35:20) Or am I wrong?
Jenny Smith Like That's more it's honestly pop is more like Illinois.
Scott Benner Yeah. (35:29) There are parts of the world where you order a pop, and then you have to tell them what one. (35:33) Like, you say, I just want a pop, and then they look at you you go Sprite. (35:36) Did you know that? (35:37) I didn't know that.
Scott Benner Yeah. (35:38) I would never say that. (35:40) I'd be like don't
Jenny Smith also We
Scott Benner call it
Jenny Smith we call it soda, but yeah. (35:42) I
Scott Benner Okay. (35:44) Alright. (35:44) Hold on. (35:45) Back to my list. (35:45) Do we have time?
Scott Benner Okay. (35:47) So we can't go into all the things I looked up, like how canola is produced, crushed seeds, heat, extract, oil, refined bleach, deodorized bleach. (35:58) Rape, the rapeseed oil, actually did start out as as a motor lubricant, and then they adjusted it so that you can eat it. (36:09) Lucky you. (36:11) But then, again, it I said, they healthy?
Scott Benner And they said they are safe in regulated amounts. (36:17) That doesn't seem like yes to me, by the way, when that's the answer. (36:21) They don't add health benefits at all. (36:25) You know? (36:25) So moderation's gonna be
Jenny Smith In fact, they're often often and maybe you said the the difference between the type of omegas that's present. (36:34) Right? (36:35) Most of the seed oils and things that we're talking about have a much higher percent of the omega six comparative to the omega threes, which are more from a cardiovascular benefit standpoint and anti inflammation and etcetera etcetera.
Scott Benner And as you said in the past, the the things get fortified all the time because when they process, they strip out all the nutrients, and they gotta throw something back into it so you're not just eating a filler. (36:58) I did, look a little bit into some of the list of ingredients. (37:04) You should look them up yourselves. (37:06) I looked into the companies that own other things. (37:11) I I don't wanna dig too far down a rabbit hole or feel political for people, but, like, Nestle, Pepsi, Coke Mhmm.
Scott Benner All are also invested in heavily by places like BlackRock, Vanguard, and, you know, the S and P five hundred in general. (37:27) So Right. (37:27) Yeah. (37:28) Money people need those things to make money and they need you to buy more and so on and so forth. (37:35) You know?
Jenny Smith And they have no interest in
Scott Benner Your health. (37:37) I don't believe. (37:38) Health. (37:38) Yeah. (37:39) Yeah.
Scott Benner No. (37:39) And even if they did, I would imagine they could just buy a couple of hospitals and then get your money on the back end too.
Jenny Smith There you go.
Scott Benner Yeah. (37:49) Yeah. (37:49) I'll take your money for the soda, and then I'll take your money for the, for the health the health things that happened to you afterwards. (37:56) They could get you coming and going as they say. (37:59) Anybody who's ever seen an eighties movie, just remember the first hit's always free.
Scott Benner And then, then after that, you're, you're on the corner. (38:08) I almost said paying with forget what I forget what I was saying about it. (38:12) I was gonna say you're paying with your accent at the end, but I guess it's probably that's how it gets you, Jenny. (38:17) Yeah. (38:17) Yeah.
Scott Benner It's pretty right.
Jenny Smith Trust go.
Final Thoughts
Scott Benner Anything I left out of this little chat that you'd like to add?
Jenny Smith Oh, it no. (38:23) We could go probably on for three more hours.
Scott Benner I honestly think so. (38:28) Yeah.
Jenny Smith Yeah.
Scott Benner I mean, you could dig into every listen. (38:32) I again, Jenny's, you know, got the background, but I honestly just so you know where this episode came from, this was something I was thinking about. (38:41) And I got up one morning and turned on my chat GPT and started talking to it. (38:47) I was like, explain this to me. (38:48) Explain that to me.
Scott Benner And I just kept asking a bunch of questions. (38:51) And then at the end, I said, hey. (38:52) Put all my questions in a list because I think I'm gonna use them to make a podcast.
Jenny Smith No. (38:56) It it is very much like a rabbit hole, quite honestly.
Scott Benner You can you can get lost really quickly.
Jenny Smith You can. (39:02) Yeah. (39:03) So
Scott Benner I mean, in the end, around diabetes, I let let's fold it up like this. (39:08) Right? (39:08) The more processed foods you're using, the more fillers, the more emulsifiers, the the more shelf stabilizing chemicals, the harder this stuff's gonna be to bolus for probably. (39:22) And because it's so broken down, your body's gonna grab that sugar out of it so quickly. (39:27) It's gonna shoot your blood sugar up so fast.
Scott Benner So if that's if you're wondering why cereal makes your blood sugar shoot up like that, like, this is this is kind of the basis of why.
Jenny Smith I Here you are.
Scott Benner Yeah. (39:37) I would say take your time, and if you're interested, you know, go look it up a little bit and read through it and find out where I was right and where I was wrong and what you care about.
Jenny Smith Then as, you know, kind of a end note Mhmm. (39:50) What you learn, take a look at take a look at your own intake, your own grocery list, and choose maybe one or two pieces that you can change, that you can look at differently and say, well, we could do this instead of doing this. (40:07) I could whole make that by using spices instead of using the packet in this product. (40:13) Right? (40:13) I mean, there are a lot of changes that are not with, again, the cost of food today being what it is.
Jenny Smith I understand entirely. (40:21) I have a family to feed as well, but there are some things that are honestly more cost effective when you really start breaking it down.
Scott Benner It becomes so much about time. (40:31) I've even see my my wife has come home and been like, I got this packet of sauce to put on chicken. (40:36) I'm like, why don't you just kill us all? (40:38) You know? (40:39) Like, that's wouldn't it be quicker to smother us with a pillow, Kelly?
Scott Benner A couple of things. (40:44) A, she's like, I liked it. (40:46) I had it once and it tasted good. (40:48) And I'm like, okay. (40:49) Well, they got her there, you know?
Scott Benner And then Right. (40:51) B, she's like, it's easy. (40:53) You fry up the chicken and then you dump it on and, you know, cook it for eight more minutes and it's finished. (40:59) And I'm working and you're working and blah blah blah. (41:01) And I it is I mean, it's not is the rest of it's not lost to me.
Scott Benner But a lot like talking about the diabetes, like, I think we can discuss the truth behind this Yes. (41:11) And not be insulting people at the same time. (41:14) Like Right. (41:15) You know, I I Yeah. (41:16) If you can't afford it or you don't have the time or I'm not shaming you about it, but you still should understand what's happening, you know?
Jenny Smith Right.
Scott Benner Yeah. (41:23) National estimates 55 of calories Americans consume come from ultra processed food. (41:29) 55% of your calories. (41:31) That's crazy. (41:32) Mhmm.
Scott Benner Yeah. (41:33) Yeah. (41:33) Alright. (41:34) This is gonna make me sad if we keep going. (41:35) I'm gonna stop now.
Scott Benner Thank you, Jenny. (41:36) Have a nice weekend.
Jenny Smith Yeah. (41:38) Of course. (41:38) You too. (41:38) Bye.
Outro & Resources
Scott Benner This episode of the Juice Box podcast is sponsored by Omnipod five. (41:51) Omnipod five is a tube free automated insulin delivery system that's been shown to significantly improve a one c and time and range for people with type one diabetes when they've switched from daily injections. (42:02) Learn more and get started today at omnipod.com/juicebox. (42:06) At my link, you can get a free starter kit right now. (42:09) Terms and conditions apply.
Scott Benner Eligibility may vary. (42:12) Full terms and conditions can be found at omnipod.com/juicebox. (42:19) Today's episode of the juice box podcast is sponsored by the Dexcom g seven, and the Dexcom g seven warms up in just thirty minutes. (42:27) Check it out now at dexcom.com/juicebox. (42:33) Okay.
Scott Benner Well, here we are at the end of the episode. (42:36) You're still with me? (42:37) Thank you. (42:37) I really do appreciate that. (42:39) What else could you do for me?
Scott Benner Why don't you tell a friend about the show or leave a five star review? (42:45) Maybe you could make sure you're following or subscribed in your podcast app, go to YouTube and follow me, or Instagram, TikTok. (42:54) Oh, gosh. (42:55) Here's one. (42:55) Make sure you're following the podcast in the private Facebook group as well as the public Facebook page.
Scott Benner You don't wanna miss please, do you not know about the private group? (43:05) You have to join the private group. (43:07) As of this recording, it has 74,000 members. (43:10) They're active talking about diabetes. (43:13) Whatever you need to know, there's a conversation happening in there right now.
Scott Benner And I'm there all the time. (43:18) Tag me. (43:19) I'll say hi. (43:26) 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. (43:35) 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.
Scott Benner 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. (43:55) 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. (44:06) Have a podcast? (44:07) Want it to sound fantastic? (44:09) Wrongwayrecording.com.
#1833 Stale Doughnuts
Kathy shares her late-in-life Type 1 diabetes misdiagnosis , navigating Graves' disease and Thyroid Eye Disease , the mental toll of visible symptoms , and the vital importance of medical self-advocacy.
Companies that Support Juicebox
Key Takeaways
- Adult-Onset Misdiagnosis is Common: Adults presenting with symptoms like rapid weight loss are frequently misdiagnosed with Type 2 diabetes, which can lead to life-threatening complications like DKA before the correct Type 1 diagnosis is made.
- Autoimmune Conditions Often Cluster: A Type 1 diagnosis can be accompanied by other autoimmune issues, such as Graves' disease and Thyroid Eye Disease, requiring you to actively monitor symptoms like racing heart rates and extreme fatigue.
- Hormones Must "Play Nice" Together: Insulin, cortisol, and thyroid hormones all interact. A disruption in one (like hyperthyroidism) can drastically alter your insulin needs and cardiovascular responses.
- Self-Advocacy in Hospitals is Critical: When undergoing surgery or hospital care, patients with Type 1 must vocalize their insulin needs, especially regarding suspended pumps and fasting, as institutional protocols are often inadequate for T1D management.
- The Mental Toll of Visible Symptoms: Managing public lows and dealing with visible physical changes (like proptosis from Thyroid Eye Disease) can cause severe self-consciousness, compounding the daily mental burden of chronic illness.
Resources Mentioned
Welcome & Introductions
Scott BennerHere we are back together again, friends, for another episode of the Juice Box podcast.
CathyHi. I'm Kathy. I have type one diabetes diagnosed at a later age, thyroid disease, specifically Graves' disease, and thyroid eye disease.
Scott BennerMy grand rounds series was designed by listeners to tell doctors what they need, and it also helps you to understand what to ask for. There's a mental wellness series that addresses the emotional side of diabetes and practical ways to stay balanced. And when we talk about GLP medications, well, we'll break down what they are, how they may help you, and if they fit into your diabetes management plan. What do these three things have in common? They're all available at juiceboxpodcast.com up in the menu.
Scott BennerI know it can be hard to find these things in a podcast app, so we've collected them all for you at juiceboxpodcast.com. While you're listening, please remember that nothing you hear on the juice box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan or becoming bold with insulin.
Scott BennerToday's podcast is sponsored by US Med, usmed.com/juicebox. You can get your diabetes supplies from the same place that we do, and I'm talking about Dexcom, Libre, Omnipod, Tandem, and so much more. Usmed.com/juicebox or call (888) 721-1514. Today's episode is also sponsored by Medtronic Diabetes, who is making life with diabetes easier with the MiniMed seven eighty g system and their new sensor options, which include the Instinct sensor made by Abbott.
Scott BennerWould you like to unleash the full potential of the MiniMed seven eighty g system? You can do that at my link, medtronicdiabetes.com/juicebox. The podcast is also sponsored today by the Eversense three sixty five. The Eversense three sixty five has exceptional accuracy over one year and is the most accurate CGM in the low range that you can get. Ever since cgm.com/juicebox.
A Misdiagnosed Adult-Onset Type 1
CathyHi. I'm Kathy. I have type one diabetes diagnosed at a later age. Thyroid disease, specifically Graves' disease, and thyroid eye disease. I guess I am identifying myself by my diagnosis, but lots of other fun, cool things too.
Scott BennerYou were diagnosed later in life. How old?
CathyI was diagnosed at about 50 years old.
Scott BennerHow old would you tell me how old you are now?
CathyI am 62 now.
Scott BennerOkay. So you've had it for a dozen years. What was the diagnosis like? Do you recall?
CathyOh, yeah. I sure do. I was the classic misdiagnosed type two. I had recently taken a new job and moved three states away, of course, so no family, no support in the area. Had all the classic things. I lost, like, 80 pounds in, I don't know, two or three months.
CathyJust all those things. And, of course, in moving a lot, seeing a bunch of different doctors, I didn't have any consistency there and on and off with insulin. And with changing jobs, my insurance changed as well. I kinda had a perfect storm in my diagnosis story that I thought I was type two taking metformin and didn't know about deductibles. The insurance I had previously was not an issue.
CathyI would, you know, go to the pharmacy, get insulin, everything's fine, but didn't realize I was being reimbursed for insulin. So I'd go in and spend, you know, at that time, $1,200 for a month's insulin supply.
Scott BennerOh.
CathySo I thought, well, I'll stop taking insulin for now. Just do the metformin and, you know, eat very low carb.
Scott BennerThat didn't seem problematic to you because you thought you had type two diabetes.
CathyRight. Right. And that that's doable and ended up in the emergency room, crawling to the emergency room in ICU in a state two states away. I was in ICU for a week. The doctor told me he was very sick, I had heart issues, and it was a pretty serious situation, but it wasn't even that I was diagnosed as type one at that point.
Scott BennerWell, we're gonna wait. Crawling to the ER didn't get you a diagnosis? Yeah. Oh my gosh. Really? Okay. Alright. So let me make sure I understand. Like, as you're moving away, your doctors are are getting kinda split up, you're just seeing people to see people. So there's no consistency.
Scott BennerYou get the wrong diagnosis. The 80 pound weight loss, I have to ask you, that didn't freak you out or did it? And you just like, how did you reconcile that in your mind when it was happening to you?
CathyI thought it was pretty cool.
Scott BennerKathy's like, what are you talking about?
CathyI'm just trying I I think that's pretty common thing that yeah. Look at me. You know, I'm wearing a size two and, you know, I know that's just just wrong. But
Scott BennerI'd like to say out loud probably, if your body is rapidly changing drastically, matter which direction it's going in, you should probably wonder why that's happening. That's for everybody, not just for you, Cathay. There should be a reasoning behind it that you understand. You're in the hospital, but not getting a diagnosis still.
CathyRight. Seeing a diabetic educator, and mine was slow coming. You know, I didn't immediately need lots of insulin or for a long time. You know, I could manage that. Finally, I went to my doctor and said, you know, hey.
CathyI'm doing everything. I'm doing low carb. I can't get a a one c under seven. You know? And he's he looked at me, he's like, has anybody ever tested for type one?
CathyLike, yeah. Okay. Right? So we did that.
Scott BennerHow long into the journey was where somebody finally asked it to test you?
CathyI think it was at least a couple years.
Scott BennerNo kidding. Okay.
CathyLike I said, I was slow onset using insulin on and off. It just came to a crisis. I kinda had a a perfect storm, came into a crisis, and, of course, I ended up in the hospital. And then I went started to ask questions then. But I I really didn't know. You know? I thought I was moving along fine and a lot of stressors in my life. You know? New job, moving out to a different state, not a lot of people around me that could see, you know, hey. What's what's going on with you, Kathy?
CathyYeah. You know?
Scott BennerYeah. People you didn't look different to people because you just met them.
Graves' Disease & Heart Concerns
Scott BennerWhat about your heart, Kathy? Like, you said they said heart problems at first. Did that actually end up being true?
CathyWell, actually, at in DKA in the hospital in Indiana, they did a stress test. I remember a couple of times, you know, there's nurses in the hallway, and I'm setting off the beepers in the machines. They did a stress test or a chemical stress test, and I failed that. Okay. So went to a heart hospital after I got out of ICU, and they did the not remembering the name right now, but when they stick a tube down your vein to check things
Scott BennerOh, terrible.
CathyPast that. They didn't they didn't see any blockages, and there was no ongoing issues there.
Scott BennerOh, they give you, like, a heart catheter?
CathyRight. That's it.
Scott BennerAnd then looked around, and they didn't see any. Okay. Good. So so that the heart that they saw in that moment, that was from the DKA, you think?
CathyI think so.
Scott BennerOkay. So it's not an ongoing issue?
CathyNo. It it hasn't. Well, moving up, I have, another my kind of song and dance right now is I have Graves' disease hyperthyroid. Mhmm. And that ended up in another emergency room visit.
Scott BennerHow far into your type one diabetes does the Graves come up? How far into your initial diagnosis? So when you first thought you had type two twelve years ago, how much longer was it after that until you got the Graves' diagnosis?
CathyTwo years.
Scott BennerTwo years. Okay. So right around the time you're getting the type one diagnosis, you're getting the Graves' as well.
CathyWhat about years ago. 2024.
Scott BennerOh, two years ago. I'm sorry. Okay.
CathyRight. Yes. Sorry. A little trouble hearing everything.
Scott BennerOh, I'm so sorry. I'll I'll, I'll yell.
CathyWon't be the last time somebody's gonna yell at me today. So that's
Scott BennerOh, I'm sorry. Why? What do you do for a living?
CathyOh, I just have some meetings today. I, work for the Chamber of Commerce area development type of things, lots of small town politics and and whatnot.
Scott BennerKathy's like, my whole day is people yelling at me. It's fine. Tell me about the graves. Go ahead.
CathyYeah. That came again in a movie, and I guess I need to stay put. The company I work for was sold, and so I decided to move back to my home state because, you know, couple years from retirement, I'll just take the paying the bills type of job and and get to retirement. All is good. But I was just really, the moving process, just really tired and stressed out and heart racing.
CathyThe heart rate, like, you know, over a 100 and blood pressure, you know, one ninety over something something. I don't remember at this point, but just always exhausted. I could barely walk across the room without needing to sit down. Know? And, of course, you go to the doctors for that, and they think, well, you're diabetic so that, you know, that's the answer for everything.
CathySo didn't really get in a read on that until with Graves, for me, lost a little bit of weight and couldn't eat. I literally would go days without eating, and I was on a pump at that point, so it wasn't you know, my my insulin would suspend all day because I literally wasn't eating or drinking anything. So ended up on the move halfway to my new place, ended up in the emergency room, DKA, mild DKA. Luckily, there was a resident there that was pretty persistent, and and I asked too, you know, what what's the deal with the heart rate? You know, why why is that so hard?
CathyAnd they did some testing with the antibiotic testing, figured out I had Graves' disease as well, and that was, what was causing the heart issues again.
Scott BennerAll those symptoms go away how quickly when you get medicated? Like, how long does it take for the medication to pull you back to a better place?
CathyI went to primary initially because, of course, you know, like everywhere, an endocrinologist can be kinda hard to get to. And, of course, I'm moving from one state to another, so out of that. But they prescribed beta blocker metoprolol
Scott BennerMhmm.
CathyRight away, and that helped tremendously.
Scott BennerOkay.
CathySo got to an endocrinologist and put on methimazole. And I would say within a couple months, I was in much better shape. The weakness and the fatigue lasted a while, but pretty quickly, I could I could function again.
Scott BennerOkay.
CathyAnd that's kind of where I ended up in. I live real close to research hospital for an hour and a half away, so got into clinical trial for another drug that's a treatment for or possible treatment for Grave is impossible treatment for thyroid eye disease as well and feeling better pretty quickly. My doctor is pretty conservative with adjustments to medication, but I did find out on that journey too that type one diabetes, the thyroid issues, and, at one point was concerned about cortisol as well that they need to play nice together. And it's kind of hard to manage all this that I went through a period when we're concerned about cortisol that I dropped my insulin use dramatically, and my heart rate would go down to, like, 80 over 40.
Scott BennerDo you speak to other people in my Facebook group who have similar issues to you? Because I I there's, like, a little group of them talking about, like, cortisol and Graves' and stuff like that. But have you found those people?
CathyI have found those people and talking back and forth and yes. I think it was a comment I saw on the Facebook page that somebody described it as bumper bowling. I can't think of the exact word, but you've got insulin hormone over here, cortisol hormone, and thyroid hormones that kinda gotta get that ball all the way down and bump off each other. I didn't realize until talking to people like that, and that's that's the huge value of that that it all kinda has to work together.
Thyroid Eye Disease & Double Vision
Scott BennerYeah. Thyroid eye disease, do you get that diagnosis at the same time as the Graves', or does that come more recently?
CathyNo. And that's that's really a word I wanna put out. That was the clinical trial I was in as well that
Scott BennerFigured that out.
CathyIn a blind study at first and was a nonresponder to that. Then I put an extension trial where it was open label that I knew I was taking the drug and not responding. In fact, the, with the thyroid eye disease, what they look at to judge is some clinical signs, eye redness, dry eyes, and actually, take a measurement of how much your eyes are, can't think of the medical term, but, bulging. Mhmm. Mine was pretty significant.
CathyA normal white woman average, that measurement's gonna be not over 20. Mine was 28 and 29, so it's fairly significant.
Scott BennerIs it called proptosis?
CathyThat's it. Exactly. Yes.
Scott BennerAnd so your measurement was greater, and I am interested, though. So you got into this study. How valuable has the study been for you?
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CathyAs far as taking the drug, it didn't didn't help, but it got me the right connections. The research hospital I go to, they're very into collaboration
Scott BennerMhmm.
CathyThat the endocrinologist is talking to the ophthalmologist, is talking to the surgeon. I ended up well, let me back up just a minute with a just try that steady drug, and then there's, TEPEZZA that they offered me to try. And I I had some concerns about that. I'm I'm not bashing the drug or anything. It's just for me, it didn't sound like it would be a good idea.
CathySo I ended up mid December getting bilateral orbital decompression surgery. It ended up being a ten hour surgery. Mhmm. There's a team of surgeons that will go through your sinus and another team that will remove the fat and move the muscles around your eye. Okay.
CathyIt was fairly intensive, but decided to go not with more drugs and backing up again too. It's a hard thing to diagnose. What they were having trouble with in the trial is that they wanted people that have been less than a year diagnosed with thyroid eye disease, and doctors didn't wreck don't recognize it. They you know, you go to your eye doctor and well, you have dry eyes.
Scott BennerMhmm.
CathySo You don't necessarily get the thyroid eye disease diagnosis. Just they'll say, oh, you have dry eyes. You have redness. Use drops, stuff like that.
Scott BennerSo we can go undiagnosed for quite some time.
CathyRight.
Scott BennerYeah. Do you think that happened to you?
CathyI, of course, get diabetic eye exams every year and went to that doctor first because my it was very red above my eyes and swollen. And they, of course, sit well, they said dry eyes, you know, you're fine. So there's there's no test that I'm aware of. It's just really clinical. And if you have Graves, I think it's forty percent.
CathyMaybe I'm just grabbing a number out of my my head, but a lot of people with Graves' is pretty directly related to that.
Scott BennerI see. Do you have any of the serious side effects of it? Do you have damage or vision loss, anything like that?
CathyWell, right now, after surgery, I have double vision pretty badly and maybe looking at it in a few months, once kind of the healing has died down, looking at some muscle surgery, and that's not as intense at all, but to be able to move around my eyes. It's fairly rare with thyroid eye disease, vision loss. In fact, my vision is twenty twenty, twenty thirty. But the danger is is it starts messing with your optic nerve, which I'm good with so far, knock on wood, with that. But with the dry eye and physically not being able to shut your eyelid, you can get really bad dry eyes.
CathyAnd I have some signs of that that you know, some spotting on my eyes that they can see the dry eyes, and that's the danger with, vision loss.
Scott BennerOkay.
CathyIt can literally burn your cornea because you can't close your eyes.
Scott BennerWhat do you do for that? Do you, like, physically have to remember I'm I'm gonna say something silly, but do you do it with your hands, or do you, like, put drops in, or how do you manage that?
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CathyI use drops. I use gels at night, and there are people that I don't have to do it, but will literally tape their eyes shut at night. Next month, I'm back to an ophthalmologist looking at maybe plugs in my tear ducts so the the tears stay on my eyes.
The Mental Toll & Stale Donuts
Scott BennerOkay. My gosh. Kathy, are you alone? Do you live by yourself?
CathyYeah. Yeah. I am.
Scott BennerIs this I mean, I I'm sorry to ask, but is this all very frightening? How do you find the kinda mental side of your process to be?
CathyYou know what was hard about thyroid eye disease? I had very significant the bulging on my eyes didn't bother me that much. It didn't. But above my eyes, on that eyelid were very pronounced. So like I said, you know, I have a very public job, and I'm out and out and about all day.
CathyYou know, we have in in the boardroom, there's there's mirror a mirrored section on the boardroom, you know, having a great meeting and turn around and and look at my eyes that are look swollen and, you know, something's wrong with something's wrong with her. And it's it it does take a toll, and I find that too. I just had a you know, with a type one, I I wear a pump, but well, I've had a few low situations recently where, you know, I'm sitting in the grocery store eating stale doughnuts that I haven't paid for, and I'm not concerned so much that I'm having a low it's like, are people watching me and and thinking, you know, what's what's wrong with her?
Scott BennerYeah.
CathyYou know, that's that's the mental toll for me that
Scott BennerFeeling self conscious is what gets you.
CathyYeah.
Scott BennerYeah.
CathyYeah. And, of course, when, you know, into a low, your your brain's not functioning, and I've literally stood in grocery lines look deciding which flavor of juice, you know, I'd like and and dropping below 50 and yeah.
Scott BennerYeah. Well, I have to tell you, I'm definitely calling your episode stale doughnuts. A million percent.
CathyI'm glad I could help you with that. I I
Scott BennerYou were worried?
CathyI was worried what it was gonna be. Yeah.
Scott BennerThere are times I get done, and I leave a voice note for myself and for Rob at the end, and I just I'm just babbling into the note. I'm like, I don't know what to call this. This nothing came up during this one. I don't know what to say. But no.
Scott BennerThis if only you would have said you were sitting on the floor eating stale donuts, I would have called it stale floor donuts. But we're just gonna go with stale donuts. And then I just wanted to ask because, you know, you moved a few times and you did a really good job explaining how that feels. You were very descriptive in just a couple of words, like being in a meeting, doing your job, knowing you're doing a great job, and then looking over, seeing yourself, and then having that moment where you think, oh, gosh. Is everyone looking at me and thinking what's wrong with her?
Scott BennerAnd even at your I mean, you're 62, and that doesn't go away, I guess. You know? Mhmm. Do you talk to anybody about it? Your friends or people you can chat with?
Scott BennerDo you see a therapist? Anything like that?
CathyNo. I haven't. I don't know. With this whole process, I'm I'm kind of always hoping, well, this will resolve. This thing will get better.
CathyYou know what I mean? That that next doctor appointment, that's that's gonna be the answer, and this will get better. And I don't with that clinical drop trial when they were offering me different drugs when the first didn't work, You know, that was part of my decision making process too that the TEPEZZA is is an eight month process.
Scott BennerMhmm.
CathyThat you know, surgery choice was pretty pretty radical, but I I couldn't hope for eight more months that this was gonna resolve because it's it's it's pretty traumatic. I mean, it's not just that you have a medical problem. It's yeah.
Scott BennerKeep keep talking. It's not just they have a medical problem. It's what?
CathyI mean, it it becomes your whole being. That's you know, I like to push things push things aside. You know? Love my insulin pump. I rarely have to think about it.
CathyYou know? I'm I'm not good at confronting it. I just assume it not be there. And just my dad used to, tease me that I was just like my mom, and I'm fine.
Scott BennerOh, you just be like, everything's fine. Everything's fine. Everything and
CathyI'm fine. I'm fine. Don't don't worry about me.
Scott BennerDo you think it's that you don't want people to worry about you, or do you think that you're trying to just ignore things and hope they they that you get back to some semblance of normalcy that you're looking for?
CathyI would say I don't want people to work worry about me, but I also I just wanna live a normal life. I think about times where I do a lot of event planning in my work, and I love live music, go out to concerts. I remember a situation where I was at a concert and kinda scouting out all the food trucks, you know, where what do I gotta time my insulin and and get food and get back? And and I started to drop low, and I'm sitting in the middle of a crowd. Just my my pump's alarming, and I'm like, why?
CathyYeah. Why can't I just be normal? You know? Go about the day, go to the food truck just and not worry about it.
Scott BennerDo you feel like why me or just
CathyI don't know if I feel so much why me, but I wanna live my life the way I wanna live my life, and it doesn't always doesn't always jive.
Scott BennerYeah. I didn't think we were gonna have such a deep conversation at 8AM. It's making me upset. I'm getting I'm getting sad. I
Cathyknow. People are gonna be in my office in about forty five minutes, and if I'm in tears
Scott BennerYeah. She'd be like, why is she crying? She's like, she was on a podcast. I don't know. She said something about the guy.
Scott BennerHe asked about her feelings. I mean, I'm trying to think through your life and, you know, the best I can from this position. And when you have situations like that that are not resolvable or something that like like you said, like the pump. Like, you know, hey. I have type one diabetes, but this pump thing kinda takes care of it most of the times.
Scott BennerLike, you know, I can kinda not think about that as much. But the Graves' thing is is tough, and I don't know that people, you know, would understand that if you if you didn't spend the time right now talking about it. So I really appreciate it.
CathyGraves' has kinda become my my standout. When I see other people posting about things, I'm like, get your thyroid checked to get your I looked back at my medical records, and I've had an endocrinologist for, you know, how many years and how many times I've actually had a thyroid checked. Zip.
Scott BennerYeah. I feel like that's my secondary cause with the podcast. Like, I I try to ask everybody when they have symptoms like that. Like, have you had your thyroid checked? You know?
Scott BennerAnd then everyone always says, oh, yeah. It was fine. I say, well, you know, can you get the TSH number? Because it you know, there's a possibility that the doctor saw a number that they think of as in range, but, you know, might be indicative of of your thyroid having an issue no matter whether it's in range or not. You give that whole explanation.
Scott BennerI feel like I've said it a million times, but I feel like sometimes when I say it to people who listen are probably like, oh my god. He's talking about their thyroid again. But it just gets missed for so many people, and it has really serious impacts on your life. And, you know, one little pill once a day. You know what I mean?
Scott BennerAnd it just I just wish people knew about it more and more. So I appreciate you talking about it bringing it up.
Navigating Surgery & Hospital Care
Scott BennerHow did how's the diabetes going? Like, so once you got the diagnosis and, you know, they told you you had type one, was it injections? Like, did they give you a pens?
Scott BennerDid you get on a pump right away? What was that process like?
CathyI was no. Not not a pump for years later. Started out MDI and had a CGM. That was amazing to me even to have a CGM because I my blood sugar was just all over the place. So I was didn't have any awareness of that and how often I was going low because I was just randomly taking insulin.
CathyYou know? Oh.
Scott BennerWhat was random about it? Why did you not have a plan?
CathyI think the doctor didn't have a plan. Started out sliding scale and, of course, you know, they're thinking I was type two, so maybe the insulin wasn't a wasn't a big deal. There didn't need to be a plan to just take a little when you're eating, you know, nothing about pre bolusing, you know, up and down with that. Then went to ended up with a a much better diabetic educator, so got on board once I got the type one diagnosis. Went to a pump three years ago, so it hasn't been terribly long.
Scott BennerOkay.
CathyBut my doctors push technology. She had a rep in the office there, so it was pretty easy. And, she was she was all about Medtronic, So that's what we went with.
Scott BennerAre you on the seven eighty g?
CathyYes.
Scott BennerYou are. And How do you like that?
CathyI like it a lot. Recently did the update to get the instinct sensors. Those are being shipped. So the switching over to that, there was, when I had the eye surgery, my the anesthesiologist, I talked to him about it. I'm like, well, I've got a pump on, and he's like, no big deal.
CathyAnd I looked at the records afterwards, and it was like a perfect line. So that did really well for me.
Scott BennerHow long was the surgery?
CathyTen hours.
Scott BennerTen you were in a ten hour surgery. Seven eighty g kept you stable the entire time in there.
CathyYes. I had one slight low, but otherwise, it was, one thirty four the entire time.
Scott BennerA 134 the entire time at ten hour surgery. What was the slight low? What did it go down to?
CathyThere was a bleep, and I'm kind of wondering it's a known thing with the seven eighty g with Tylenol.
Scott BennerOkay.
CathyIf something but it was, you know, it it was dealt with. I'm not sure. It was kinda mid surgery why it went low. But the anesthesiologist, was very comfortable with. He seemed very knowledgeable of my history.
CathyAnd
Scott BennerWell, that's awesome.
CathySo yeah. But I did figure out after surgery, I see a lot of when I'm kinda browsing the the Facebook, people talk about, you know, being able to use their pump during surgery and, you know, what that looks like and how to convince people. My message to folks is that take a look at what your aftercare looks like. I couldn't after surgery, I mean, my eyes were just very swollen. I couldn't even see a pump.
CathyMhmm. And the ENT surgeon was kinda imagining the aftercare rather than endocrinology to my awareness. You know, I haven't dig deep into it. Who knows what goes on behind the scenes? But he was like, well, you can you know, it was 07:00 on a Friday night when I got out of surgery, and they're gonna send me to the hotel.
CathyI'm like, no. That's not safe. So even even in that situation, I'm comfortable advocating for myself that we're we're not doing this. Yeah. But, yeah, I had a kind of a weird situation with that surgery.
CathyMy support person got COVID, so switched it up fast so that wasn't somebody that was really familiar with how to how to manage that. But, yeah, in hospital situations before, they're very diligent about, you know, not leaving until we you could show us, you know, how to use that pump.
Scott BennerRight. Right.
CathyBut that
Scott BennerKathy, a second. You had a support person set up for after the surgery who understood your pump and everything because you just had eye surgery, and then that person got COVID?
CathyCorrect.
Scott BennerOh my gosh. Did you come on. That had to that had to kick you in. Right? Were you like, come on.
Scott BennerReally?
CathyOh, absolutely.
Scott BennerI'm like No kidding.
CathyIt was my sister, and she called, and she was so apologetic. And I'm like, it's okay. The deal is is like I said, it was a research hospital, so those surgeons were, like, top of the top. You know? You don't wanna lose that appointment unless absolutely necessary.
CathyI'd never get back in.
Scott BennerYeah.
CathyI took it. But yeah. That's crazy. My fault or partially responsible not asking more questions about what aftercare was gonna look like.
Scott BennerYeah. I understand. Hey. You said you're getting the Instinct sensor. What sensor were you using previously?
Scott BennerThe one that has to recharge?
CathyYes.
Scott BennerOh, and so you're making the leap to the new more modern one with your Medtronic. Are you excited about that?
CathyI am. Because I used to, I used the Libre or CGM the first time, and I really like that. I like that you know, I'm always on the go, like, to travel. Mhmm. Like to be able to just pop it on rather than having to replace a transmitter, charge it up for two hours.
CathyAnd, yeah, I'm very excited about that. Hearing good things.
Scott BennerGood. Yeah. No. I am I am as well. I'm I'm interested to know, how it's going.
Scott BennerSpeaking of sensors, I think Arden's laying on hers right now because I'm seeing what looks like a, a compression low. People just asked me the other day if she's gonna try the fifteen day sensor. And I said, oh, she's an adult. Like, I don't even know if she knows it exists. I said, hey.
Scott BennerDexcom just went to a fifteen day sensor. Do you wanna try it? And she's, like, sitting in bed doing her homework. We just gotten done talking about, like, possibilities for grad school. You know what I mean?
Scott BennerAnd she goes, I don't know, dad. What do you think?
CathyIt's dramatic to have to switch. I started on on Omni
Scott BennerMhmm.
CathyAnd had a lot of problems with the adhesives.
Scott BennerIt wasn't good for you. Was it not sticking or sticking too much for you, or did you get a rash from it?
CathyIt was terrible terrible rashes and tunneling and yeah.
Scott BennerOkay. Just didn't work right for you?
CathyRight. Yeah. Fair enough. No. I I didn't have any problem with accuracy or anything like that.
CathyIt was just the adhesive didn't work for me. And my doctor did say something about as I'm getting older, Medtronic is kind of easier to get through Medicare.
Scott BennerSo Medicare likes Medtronic?
CathyI think so. That's what she said anyway.
Scott BennerWell, listen. Whatever whatever's free and whatever works. That sounds about right to me. What's your management like now today? Like, do you I mean, if you just only had a pump for a couple of years and you're you know, you pretty I mean, they brought you on pretty slow.
Scott BennerYou said you started sliding scale even though it was ten years ago. So, I mean, how do you describe your management now? Where does your a one c sit? Do your successes look like what you're, you know, what you're working towards? Does the Graves interfere?
CathyMy last a one c was 6.5.
Scott BennerGood for you.
CathyAnd I'm I'm comfortable with that. I because with the with the med tri, I can get the target down to a 100, and that's what I have it set at. But I I, yeah, I feel pretty comfortable with how things are going. It seems like when I go off track, I go off track hard, and it takes it a while to come back. And I'm not but I figured out every once in a while, I do need to calibrate and put in a blood glucose reading, or it will suspend too long.
CathyWhen I did the update for instinct, it was suspending too long and causing a problem there. So, you know, of course, bump high and but little things like that to figure out. And with the stale donuts, I figured out that's Tylenol that I was taking for after the surgery. And that's that's a known issue with that, but I was going severely low. In fact, I was at my endocrinologist office getting labs, and they're real good about that.
CathyBut and waiting for that, my blood glucose started dropping, so I'm eating jelly beans that I could find out of my bag at my endocrinologist office. And, they called me at 10:00 that night. I had a blood glucose of 34 sitting at the endocrinologist.
Scott BennerWait. Are you are you telling me that I wanna make sure I understand. Like, acetaminophen messes up the sensor, and so you were low and didn't know it. Is that the context?
CathyNo. With the it's it reads too high, so it delivers too much insulin is my understanding.
Scott BennerOh, so yeah. Then the okay. So the the sensor gets messed up by the acetaminophen. It gave you a high blood sugar. You were getting insulin for it, but you didn't need the insulin.
CathyRight.
Scott BennerMade you low. Okay. Alright. Yeah. I I felt like I was that's what you're saying, but I wanted to make sure that that's what we were getting at.
Aging with Type 1 Diabetes
Scott BennerHow do you think about, like, the rest of your life with diabetes? Do you spend a lot of time wondering how you're gonna manage as you get older? Are you making plans for it?
CathyYes. I do. And I I guess I'm not even sure how to begin to plan for that because my mom is 92 years old. Bless her heart.
Scott BennerOh my gosh.
CathyYeah. But she's in memory care, so I, you know, I hear things walking by the nurses and the medical assistants and and that type of thing. You know, comments like, well, I haven't given their noon insulin yet and saw somebody being called in to change a sensor. I'm assuming it was a sensor. I'm like, I don't know.
CathyI don't know how you change those protocols because, you know, I need that pre bolus.
Scott BennerYeah.
CathyOr if you don't feed me and I'm just sitting there, my insulin is being suspended that you know, that's a a bad problem for me too.
Scott BennerI have to tell you, Kathy, I find myself when I'm talking to older people who are thinking about this, what strikes me the most is that at the moment, they're trying to plan for the future. And they are people who pre bolus for their meals and take themselves very seriously, and they're really on top of their health. And they're trying to imagine how to do it out into the future. And all they're hearing, you know, from, you know, stories and and whatnot is that, like, you're gonna get into a home one day, and that's all gonna go out the window. And when I talk to people who who work in those facilities, they talk about it differently.
Scott BennerThey talk about it like, well, they're older now. They're not gonna live much longer. It's not that big of a deal if their a one c is seven. Like, you you realize that their focus and your focus are not the same thing. And then that realization that comes that you'll get older and you probably won't you won't be able to fight back or you might be in a position where you can't argue or stick up for yourself or advocate.
Scott BennerAnd even if you could, they wouldn't have the the infrastructure in place to handle it for you. Like, it's such a I find these conversations to be very, I don't know, sullen.
CathyI come from a very loving family. I have supportive friends, but yeah, that I mean, that is in my thought process that I I live alone, that who's who's gonna advocate for me because even to back up a little bit when I had that surgery, very fine hospital. And I was, you know, at 07:00 on a Friday night, and I just got out of ten hours of surgery. My eyes are practically swollen shut, and I was talking to the medical assistant. I'm like, I'm I'm not comfortable just Yeah.
CathyBeing kicked out here. I don't I don't feel like that's safe, she said. And I I'm not gonna name names here. And she said, well, you could go to the emergency room and see if you can be embedded that way.
Scott BennerThat's terrible. Yeah. Yeah.
CathySo the my support person had had walked away. I don't know. Bathroom break or something. And when they came back, all of a sudden, was going to the hospital. She he's like, what did you do?
CathyI've learned how to be an advocate for myself even even in this situation that and they said, well, we'll we'll check your blood sugar. And I look back at records overnight there. It was, like, one test in the morning before I left, and I'm like, no. Really. You know, I haven't I haven't eaten in at least twelve hours.
Scott BennerRight.
CathyIn twenty probably closer to 20, and I I can be in just as much trouble when I don't have insulin going in because the pump is suspending as I need to be able to manage that, and they didn't get that. And that's my concern between type one and two. I'm not I understand the issues with type two. I was misdiagnosed that way for a long time, but I need people to understand that I have no insulin going in, and I can be in just as much trouble with nothing as
Scott BennerMhmm. That's that's too much. Well, isn't that really the point, though, is that institutionally, the understanding is low. I mean, look. You got done with that surgery, and they were like, well, we can't help you.
Scott BennerYou gotta get out of here. And so even if you would've went to a hospital, who knows how good of a job they would've done for you? And then thinking about long term care as as an elder person, you're gonna be lucky to even be in a situation that good with as far as people's understanding
CathyRight.
Scott BennerAnd and desire to be, you know, desire to to be proactive in a way that lends to health when they're looking at you and your you know, the actuarial table says you're not gonna be here for much longer. So they're not thinking about you the same way anymore. It's like, you know, type one diabetes is like a lifetime of, like, I gotta take a good care of this because I wanna live and I wanna be healthy. What happens when you get to the end and there is no there are just not that many years left? You know?
Scott BennerLike, I don't I'm I'm so sorry. I don't wanna be a bummer, but, like, it doesn't get talked about enough. And I wonder when I'm talking to people who are in the service side of that industry, you know, and and it really is it really is a business taking care of older people. You think about how they think about it, and then you think about how you, the person, thinks about themselves, and that you still have the same desire at 70 and 75 and 80 about your type one diabetes that you had when you were, you know, 50 and 60 and some people for their whole lives. Like, how are you supposed to just give that away and say, oh, yeah.
Scott BennerI I guess I'm probably not gonna live much longer, so this is okay if my a one c is seven or if I don't get my insulin right away? Like, how do you make yourself right with the fact that that's how the system looks at you? And I I don't I really don't know the answer to that at all.
CathyThat's a good point that I hadn't kind of thought about it that way. You know? I kinda take it from my perspective. But, yeah, it is a it is a business, and I I do see that. Yeah.
CathyI feel like my mom is in a very good place. But yeah.
Scott BennerThey're not gonna you're not getting the round the clock attention. I mean, look at yourself as an adult now. Right? You've been taking care of your diabetes for a decade. Think about all the effort and time you put into it.
Scott BennerLike, how could they possibly do that for everybody in the building? Like, you could barely get your doctor to understand your diabetes. You're gonna get you know, every six hours, a new person, you know, streams through your room to take care of you. They're all gonna understand it like that, and you're gonna be older and maybe not in the same I don't know. Maybe you're not gonna be in the same situation where you can actually be directive about it at that point and tell them what to do.
Scott BennerI think in the end, it's just an incredibly unfair fact of life if you have type one and you live a long time. Like, it just sucks, and I don't know if there's much you're gonna be able to do about it. Maybe the automated systems by then will be so much so that, you know, it'll be like a slap it on pump, they'll be comfortable doing it because they won't have to understand how it, you know, quote, unquote, understand how it works because it's just gonna do the thing. You you know, maybe maybe that's maybe that'll end up being the key for older people. It would be nice because I think if you're waiting for the the staff or the institution to get the desire to take care of people on that level, that's never gonna happen.
Scott BennerYou know, they couldn't keep my mom free of a UTI. They're gonna take care of diabetes type one. You know what mean? And do a great job of it. I I don't see it happening.
Scott BennerBut, yeah, maybe the maybe the automation is the answer.
CathyMhmm.
Scott BennerYeah. I'm sorry. Did I completely ruin your day? Kathy's like, it's nine in the morning. Will you calm down?
CathyNo. I'm I'm pretty resilient type of person. I I I go with the flow.
Scott BennerWell, that's obvious.
CathyI just wanna live a full life.
Scott BennerYeah. It's awesome. And you're doing I mean, listen. From what I'm hearing from you, you are putting a ton of effort and time and focus into your health. I wish more people put this kind of effort into themselves.
Scott BennerYou were really trying, it sounds to me.
CathyMhmm.
Scott BennerYeah. You feel like you're doing everything you can?
CathyYou know, sometimes I I feel like I need to let it go too. Mhmm. Let those automatic like, you know, like we talk they let those automatic systems roll. And I'm I get all excited about things, and we'll do 20 things at once, and then we're gonna fix this. We're gonna fix that.
CathyYou know, kinda like New Year's resolutions that, oh, we'll do this all at once. And then three months down the line, it was like, I'm tired of doctors. Cancel that appointment. We're not going there. We're not doing that.
Scott BennerYeah. You did say something earlier that I didn't dig into. You said something about, like, when it goes off the rails, it really goes. Does that mean, like, when you lose your focus on care, you let it go for a while until you decide to pick it back up again, or did you mean something different?
CathyI don't feel like burnout is an issue for me, but in, like I said, very active, you know, meetings all day long out in the public that I won't take the I've got a sensor going bad or, you know, a fusion set needs changed, then it's have a terrible problem if my infusion set. I've got a bad site and, you know, here I'm up to 400 and don't take the time to say, you know, hey. I need to I need to take care of myself, I think. Maybe it even goes back to that I don't don't want other people to see this.
Scott BennerYeah. Do you think I've actually just had more conversations with people recently where, you know, they were trying to tell me what was it? Like, Omnipod five has been such a big deal for them. And I'm, like, picking through all the reasons, I think. And they're like, no.
Scott BennerNo. It's just it's the phone. And I'm like, what? And they said, you know, I can pull my phone out and give myself insulin without anybody knowing. And I said, oh, were you not giving yourself insulin when you needed to because you didn't wanna pull out a controller?
Scott BennerAnd they were like, yeah. Absolutely. So that's a problem for some people. Yeah. Yeah.
Scott BennerJust not wanting people to see.
CathyI kinda I had a situation where, you know, during COVID, worked in an office where we had cubicles and plexiglass up over everybody, and I think I was just diagnosed formally with type one and and well, it would have been a little after. But, you know, if you have the conversation with everybody, if you hear the alarm going off, just, you know, I'm probably okay. Just don't worry about it. But that was a time where I was having a lot of alarms. So so I'm sitting in a plexiglass cubicle, and my alarm's going off, and nobody responded at all.
CathyThat was a poignant moment for me. It's like, okay. Maybe we need to find a middle ground here that maybe sometime, you know, I need some help, and it's a
Scott BennerYeah. Also, it would kinda tell you, like, nobody's really looking. Like, that's sort of that part's in your head. Like, know, if all that beeping is going and no one's coming, you're just like, oh, I guess nobody gives a crap. You know?
Scott BennerLike, I nobody's really paying attention to all this maybe. Whatever I I'm gonna assume that the thing that my brain's missing where I don't really seem to care what other people know about me, I'm gonna tell you in about a month, there's gonna be an episode of the podcast out where I have a doctor on who did, like, an embolization surgery on me for, like, internal hemorrhoids, and I had, like, this crazy bleeding and everything.
CathyYeah. I remember reading about that.
Scott BennerWhile I'm on the the episode recording with the doctor, it actually occurred to me halfway through. I'm like, what is wrong with me that I don't mind talking about this? There should be a mechanism in my brain that stops me from saying this out loud. Right? I wonder if in my regular life I actually from having all these conversations and from having a daughter with type one, I often wonder if I had diabetes, if especially type one, would I walk the walk or would this all just be academic and it would go out the window?
Scott BennerLike, do you know what I mean? Like, I wonder if I wouldn't be in the same exact situation as that person I was talking to. It's like, well, I didn't wanna pull out that controller and let people know I needed insulin. Like, I wonder if that would happen to me. Or, you know, Arden had a bunch of stuff at college yesterday.
Scott BennerShe had to go to a bunch of kinda lectures and stuff, about her you know, what she wants to do in grad school. So she was at these events and people were talking. And you know how they always, you know, say, like, everything happens on the worst day. Right? So her GLP medication kinda waned in the last day or so, and she hasn't injected it again yet.
Scott BennerSo her settings that work great for while the GLP's running were certainly starting not to work. So they're starting not to work. She's real busy all day, probably eating at, like, buffet tables at these these events and everything. And I must have and I haven't done this in a long time. I must have texted her three times yesterday.
Scott BennerArden, you've really simple, but, like, hey. The GLP is gone. You need to, like, put in more manual insulin today. Hey, Arden. Please bolus here.
Scott BennerArden, would you put a temp basal in for an hour? Like, blah blah blah. Like and I haven't talked to her about, that in a long time. And so she comes home last night. We're sitting together.
Scott BennerActually, we were sitting with my phone looking at old videos of, like, when she was a baby. It was a really nice hour. I just turned to her and I was like, why did you not bolus yesterday when I asked you to? And she goes, I was busy. And I was like and it wasn't like I'm ignoring it or I don't care.
Scott BennerShe's just like there was a lot going on. And I I wish I could dig more into that with her, but because of you know, it's a father son relationship, I can't. You know? There's only so far I can push. And so I but it was interesting to hear her her perspective.
Scott BennerAnd then I kinda take her perspective back, I blend it in with other conversations about having other people. I basically try to figure out what's going on with Arden through talking to all you guys. I don't know if that's obvious yet or not, but that's my path. Anyway and I wonder if I had type one diabetes, would I be as bold as I say when I'm speaking, you know, without actually having to deal with it? I I don't know.
CathyI totally get that. And I grew up in a family, you know, we we don't talk about that. You know, I'm I'm fine. We don't talk about that. And even yeah.
Scott BennerThe stuff we talk about here, I think, would shock people. And my wife did not grow up that way. Like, it took years to drag her over to our side. I don't seem to care what other people think, and I really don't and I but but I do in, like, other like, in other ways. Like, I'm know, you I wouldn't want anybody to think of me as being coarse in my real life or, like, you know, I wouldn't I don't wanna make people unhappy.
Scott BennerLike, I'm I'm very concerned about what other people think in situations that make sense, you know, structurally with my relationships. But in this other stuff, like, I really don't care. Like, you are gonna listen to an episode where I'm just describing, like, laying on a floor bleeding from my and I realized, like, I I know how many people are gonna hear that, and it really doesn't I don't care. It's kind of fascinating. I don't know if the Internet fixed that for some people, like, knowing that when you have a a, like, a wider audience, like, it's just it is what it is, and it doesn't really matter.
Scott BennerBecause maybe I learned the same lesson you learned sitting in the cubicle when it was beeping, which is nobody really cares all that much. Yeah. You know? So and it really is about you. I think it all really goes back to that story that I've told in the podcast a number of times about taking my son to a diner when he was a kid after a baseball game and the and then putting us in a in a table that was in the middle of the floor surrounded by all these different booths.
Scott BennerAnd I could tell he felt uncomfortable sitting there because he felt like people were looking at us, and I just said, nobody cares. They're eating. No one's looking at us. And, like, when he looked around and realized they really don't see us, and it it was just a it was a great moment for him where he's like, oh, I I don't need to be everyone's not looking at me all the time. I don't I just don't know where I got that from because I grew up, like like, happy.
Scott BennerI was a fat kid growing up. Like, I know how you feel. Like, god, are people looking at my eyes? Is this happening? What are people thinking about me?
Scott BennerI don't know if maybe it's just maybe it's a defense mechanism I built up over being a kid. I'm not I'm not even sure. I don't know. I'm I'm in my fifties. I don't have time to figure all that out.
Scott BennerI just know I feel better not caring. So, anyway, don't worry about what other people think. You know? Did we, miss anything? Did we not talk about anything that you wanted to bring up?
Every Cure & AI Medical Research
Scott BennerTake your time because I have one more question for you. So tell me, make sure we didn't miss anything here.
CathyNo. I I think I've covered what I other than, I am involved in I've been to Philadelphia for the last five years in a rare disease community, and they are working on it's interesting. I I mean, it's not my work, but they're using AI to find drugs that are already being used or off label for other things and finding drugs that they don't have to be developed, for orphan diseases. So that's pretty cool. I'm actually
Scott BennerKathy, explain that to me. So what do they do? They load the the data about the molecule in and then ask them AI model. Is there something that it's not being used for that it could be valuable with?
CathyThey collect data, and it it's beyond my scope. But to find, hey, doctor. And and this is my understanding. Doctor in Montana used aspirin for rheumatoid arthritis, and that worked, you know, getting results. Pretty high level AI.
CathyThey've getting some grants. But, anyway, he's a doctor that, wrote a book, Chasing My Career, doctor Fagenbaum. I don't know if you've heard of him out in the Philadelphia area. He's at Penn.
Scott BennerIs he running this program?
CathyWhat's that?
Scott BennerIs he running the program that's looking into, like
CathyIt's two different things. What I got involved with is I have Castleman disease. It's a enlarged lymph node, and this was about ten years ago. But the subtype I have of that is fine. They removed it.
CathyI'm I'm fine. But got involved with it because, you know, you go Google this disease. It's like, holy crap. This is bad. And other subtypes are are really very serious.
CathySo I got involved with this online group, and what they they have some different ideas about medical research, and they actually crowdsource with actual patients. And I've, you know, filled out surveys and what I think the research direction should be and, you know, how I'm doing, and they have every scrap of my medical records possible. But, anyway, he cured himself. He was, given last rites, like, five times, and he found the drug that would cure him. And it's it's pretty cool.
CathyThey fly us out or a group of us to Philadelphia every year, and we have have a summit and participate in Zoom calls. And and with the crowdsourcing, they wrote a paper on there, actually listed as a collaborator on that paper, and they they spelled my name wrong.
Scott BennerIt's called ever Every Cure. Is that right?
CathyEvery Every Cure. And that's the other part of it. He's kinda bounced to working on that.
Scott BennerMhmm. I'm gonna reach out to them and see if he'll come on and talk about it. That's really interesting.
CathyIf you need some connections, like I said, I'm pretty well connected, and I would be happy to get you some connections if you want.
Scott BennerWell, then, Leah, let's make that easier. Would you please tell me somebody I can contact? Because I'd love to have someone come on and explain what this is.
CathyGoing to have to get into my email for those those names, but I'd I'd be happy to do that.
Scott BennerNo. Yeah. Send it to me later. That would be great. Okay.
CathyIt's very interesting work. I get to go out there and hear about the new studies and yeah. I mean, it's very top level, but, you know, I don't understand everything. But the to go there and just see those researchers and what they're doing. You know, these young kids at Penn are just really excited about what they're doing and and helping people.
CathyYou know, I see examples of that every day that like I said, I have the type that's not, you know, not an issue. They took it out, and I'm fine. But there's it can cause very serious disease, and to see the work they're doing is is fabulous.
Scott BennerNo. This is really, really cool. I'm so glad I asked you if there's anything else I didn't bring up because I'm gonna reach out to them with your contact and try to get somebody on. I'd like to get him on if I could. This is really interesting.
Scott BennerOkay. Oh, well, can I ask my last question?
CathyYes.
Scott BennerWhy are you buying stale donuts? Why don't you buy the fresh ones?
CathyYou know, I still walk by there in the grocery store. Like, those are really terrible. What's the expiration date on these? But I was sitting in the pharmacy, and it it took I must have been significantly low. But it because it said under 50, and it took a whole package of doughnuts.
CathyIt's sitting in the pharmacy because that's the only place in the grocery store that has a chair. So, you know, of course, nobody's helping me then, and nobody's asking. Hey, lady.
Scott BennerThere is a woman sitting in the pharmacy just scarfing down doughnuts. It it's and no one says anything to you. Like, that isn't that well, I get it. So are you talking about, like, the sale table at the front where they're trying to push out the older food and then there's, like, an orange tag on it that's making it cheaper?
CathyNo. It's a it's it was a whole pallet full of donuts. Think they've tried it.
Scott BennerI just think they should sell fresh donuts is all I'm saying. I don't know why they have to sell stale ones.
CathyI'm a former retailer. Oh, excuse me. I I get this. They were yeah. They were trying to offload the donuts, and I was helping them.
Scott BennerThere's a little cooler at the front of my grocery store, and it's just full of prepared foods. So prepackaged, like, meals that you just warm up, Right? That they you know, I think they make there at the store. But they just have big orange labels on them, and they are just at the end of, like, their usefulness. Like, you need to eat them today or tomorrow or they're just gonna get tossed.
Scott BennerAnd, man, people buy out of that cooler constantly. Like, they really like, people do. Like, I see them stop every time and look at it, they're like, oh, okay. And, like, I don't know. I just I've never looked in there.
Scott BennerI I guess that's maybe I just I'm lucky I don't need to save 75¢ on a piece of meatloaf. At the same time, like, I'm personally fascinated by how frequently people go to and there's a baked there's a table in front of it with baked goods in the same situation, like stuff that's coming out to the end of its date. I thought for sure that's what you were talking about. Anyway, Kathy, you're delightful. I really do appreciate you doing this with me.
Closing Thoughts
Scott BennerAnd I don't know how you got me to do this at 8AM, but I think it's just because I've known your name for a really long time and I was like, I like Kathy. So, I appreciate you coming on and adding your story to the to the podcast. I was just telling somebody this morning. They asked me what my favorite episode of the podcast was, and I said I I genuinely amassed that a lot. I don't know how to answer it.
Scott BennerThere's 1,800 episodes now. I really see the podcast more like a diary, And it's just sort of instead of my story on every page, I feel like it's just everyone else's story sort of through my lens maybe, you know, because I'm the one that kinda generally directs the conversations based on my interest and, you know, what pops up in my mind. So I said, don't know how to tell you. I they're all like, the whole thing is my favorite thing. I love the collection of what it is.
Scott BennerSo I just really appreciate you putting your your story into it. Thank you very much.
CathyMhmm.
Scott BennerIt's a pleasure talking.
CathyI will get that get that information to you.
Scott BennerKathy, you're lovely. Hold on one second for me. Okay? I'd like to remind you again about the MiniMed seven eighty g automated insulin delivery system, which of course anticipates, adjusts, and corrects every five minutes twenty four seven. It works around the clock so you can focus on what matters.
Scott BennerThe juice box community knows the importance of using technology to simplify managing diabetes. To learn more about how you can spend less time and effort managing your diabetes, visit my link, medtronicdiabetes.com/juicebox. The podcast episode that you just enjoyed was sponsored by Eversense CGM. They make the Eversense three sixty five. That thing lasts a whole year.
Scott BennerOne insertion every year? Come on. You probably feel like I'm messing with you, but I'm not. Ever since cgm.com/juicebox. This episode of the Juice Box podcast was sponsored by US Med.
Scott BennerU smed.com/juicebox, or call (888) 721-1514. Get started today with US Med. Links in the show notes. Links at juiceboxpodcast.com. Thank you so much for listening.
Scott BennerI'll be back very soon with another episode of the juice box podcast. If you're not already subscribed or following the podcast in your favorite audio app, like Spotify or Apple podcasts, please do that now. Seriously, just to hit follow or subscribe will really help the show. 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. And if you leave a five star review, oh, I'll probably send you a Christmas card.
Scott BennerWould you like a Christmas card? If you're looking for community around type one diabetes, check out the Juice Box podcast private Facebook group. Juice Box podcast, type one diabetes. But everybody is welcome. Type one, type two, gestational, loved ones, it doesn't matter to me.
Scott BennerIf you're impacted by diabetes and you're looking for support, comfort, or community, check out Juice Box podcast, type one diabetes on Facebook. If you have a podcast and you need a fantastic editor, you want Rob from Wrong Way Recording. Listen. Truth be told, I'm, like, 20% smarter when Rob edits me. He takes out all the, like, gaps of time and when I go, and stuff like that.
Scott BennerAnd it just I don't know, man. Like, I listen back and I'm like, why do I sound smarter? And then I remember because I did one smart thing. I hired Rob at wrongwayrecording.com.
#1832 Ninja Training, Mom Guilt, and Pop-Tarts
Bethany shares her daughter's recent diagnosis , overcoming the mom guilt of ignoring early symptoms , and how she translates the podcast to her stay-at-home husband.
Companies that Support Juicebox
Key Takeaways
- Bethany Googled her daughter's symptoms eight months before diagnosis but dismissed diabetes because she only knew about type 2 - highlighting how lack of type 1 awareness delays diagnosis even when parents notice something is wrong.
- Family autoimmune history matters more than you think - Bethany discovered her "hypochondriac" family actually had multiple undiagnosed autoimmune conditions (celiac, hypothyroidism, rheumatoid arthritis) that she had dismissed for years.
- The podcast's influence creates ripple effects: a diabetes educator who improved her own T1D management now teaches those methods to families, and previous T1D families at Jordan's school had already implemented 504 plan advocacy, making the transition easier.
- Dramatic improvement is possible quickly - Bethany went from 24% time in range to 83% in just two weeks after a "ninja training" class that condensed podcast concepts, followed by listening to the fat and protein series.
- Thyroid guidance for caregivers: if TSH is over 2.1 with symptoms, push for medication even if it's "in range"; ferritin under 70 can cause fatigue even when in range; silent celiac is worth investigating if you have iron issues.
Resources Mentioned
- Omnipod 5 - Free starter kit available, no four-year DME lock-in through pharmacy
- US Med - Diabetes supply delivery with automatic reorder reminders (888-721-1514)
- Juice Cruise 2026 - Listener cruise with stops in Puerto Rico
- Episode 413 - Deep dive on thyroid issues and management
- Fat and Protein Series - Understanding extended bolusing for complex meals
- Pro Tip Series - Condensed practical diabetes management strategies
- Small Sips Series - Curated takeaways voted most helpful by listeners
- 504 Plan Templates - School accommodation resources at juiceboxpodcast.com
Introduction
Scott BennerWelcome back, friends. You are listening to the Juice Box podcast.
BethanyMy name is Bethany. I am the mom of two, a 13 and 10 year old. And my 10 year old has type one diabetes, and she was diagnosed in June 2025, so just this year.
Scott BennerThe podcast contains so many different series and collections of information that it can be difficult to find them in your traditional podcast app sometimes. That's why they're also collected at juiceboxpodcast.com. Go up to the top. There's a menu right there. Click on series, defining diabetes, bold beginnings, the pro tip series, small sips, Omnipod five, ask Scott and Jenny, mental wellness, fat and protein, defining thyroid, after dark, diabetes variables, grand rounds, cold win, pregnancy, type two diabetes, GLP meds, the math behind diabetes, diabetes myths, and so much more. You have to go check it out. It's all there and waiting for you, and it's absolutely free. Juiceboxpodcast.com. While you're listening, please remember that nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan or becoming bold with insulin.
Sponsor Messages
Scott BennerA huge thanks to my longest sponsor, Omnipod. Check out the Omnipod five now with my link, omnipod.com/juicebox. You may be eligible for a free starter kit, a free Omnipod five starter kit at my link. Go check it out. Omnipod.com/juicebox. Terms and conditions apply. Full terms and conditions can be found at omnipod.com/juicebox. Today's episode is also sponsored by US Med, usmed.com/juicebox, or call 888-721-1514. Get your supplies the same way we do from US Med.
Bethany's Story Begins
BethanyMy name is Bethany. I am the mom of two, a 13 and 10 year old. And my 10 year old has type one diabetes, and she was diagnosed in June 2025. So just this year.
Scott BennerOh, goodness. Very, very recently.
BethanyYes.
Scott BennerHow about that? Was this a surprise, or was it a thing you saw coming?
BethanyI did not necessarily see it coming. I mean, I think I know you talk about, like, mom guilt a lot, and I think the guilt that I have is that I started googling some of her symptoms eight months, like, almost a year before she actually got diagnosed in DKA, and I didn't, like, take the next step. That's one, I think, positive benefit I've gotten from listening to the podcast is that you have some amazing people who are really good at advocating for themselves in the health care system, and I was not very good at that. And I kind of considered myself a little bit of a hypochondriac. So I would say for about eight months, I knew something was up. I had googled that it could be stress hormones or diabetes, and I honestly didn't know anything about type one diabetes. Mhmm. I only knew type two, and I was like, well, this kid clearly doesn't have type two. So I would say for, like, about a month or two before we finally got her diagnosed, I was pretty sure she had a blood sugar issue of some kind, but didn't know exactly what it was. But we don't have anyone else in our family with type one, so it wasn't necessarily on my mind.
Scott BennerYou know, it's funny. You and I chatted for just a couple of minutes before we started, and you came off as so, bold to me, but you're not. No. Oh, well, that's interesting. But you're such a good speaker. Did I misread that for that maybe? Do you have a job where you speak a lot?
BethanyI do. Yeah. I'm the president of a sales organization, so I'm pretty good at speaking usually. Maybe not today. We'll find out.
The Juice Cruise Story
Scott BennerNo. No. K. You're right. It's like, watch me set myself up here. I'll just bump right through everything. I just was on a cruise, and we did a couple of stops. And just a tiny bit of context, I'm taking a bunch of listeners on another cruise in June. It's called, Juice Cruise 2026. You should click on the link and go learn more about it. If you're a cruiser, I think you'll really enjoy it. One of the, stops for the Juice Cruise is Puerto Rico. So my wife and I just went on a cruise last week. Basically, it was like a taste test. So I was allowed to go on to get a vibe for the boat, make social media videos to share with people, stuff like that. And thanks so much to Celebrity for inviting me, and it was very nice. Now I feel like I have to say this. I had to pay my taxes on the trip. I had to fly myself there, put myself up. The cost of the cruise was taken care of by Celebrity. So thank you very much. We got off at Puerto Rico, and my wife and I decided to do a walking tour of the island. But it was a guided walking tour. And this 19 year old kid comes up, introduces himself. His name was Diego. And he set about maybe giving us the most complete, lovely, well thought out formulated breakdown of the history of the island and the people and what we should know and what we should care about and how things got to be. He was just excellent. What a great speaker. And we get to the end, and he walks us back to the ship, and we're, the last people there because a lot of people went and still went around the island. My wife and I were like, okay. That's enough walking for today. We're going back. I was giving him a tip, you know, financial tip, and I said, can I tell you something real quick before you go? I said, you were awesome. And my wife was very effusive and explained to him how well she thought he did. He wants to be a teacher. He was really great. And I said, but you have a a connecting word and it breaks the flow of your conversation. And I was like, do you wanna know what it is or would you prefer not to know? And he thought about it for a second. He goes, no. Tell me. And then I just, you know, I just said, look. When you get done with a thought, you say okay. But you say you're checking with us. And I said, and you've done such a good job of explaining what you're saying. You have such authority, clarity. Don't end your thought with, okay, like that. Yeah. Because it takes away all your power and it breaks the flow of your conversation. I was like, just pause quietly and then move on. And he was like, thank you so much. I'm like, I'm gonna remember that. And he's like, why did you hear that? And I said, oh, I make a podcast and I have like a thousand connecting words that I use that I I write down on sticky notes and try to stop myself from saying some with more success than others. But, anyway, I didn't wanna set you up to be like like, I'm great. I speak for a living, and then you're just all, like, tripping over yourself and everything.
Bethany100% what would happen. Yes.
Family Autoimmune History
BethanyI definitely have an authority that you have to carry at work that does not always transition, especially over to whatever reason, like, authority. I think I have just, like, a sense of authority. So, like, you know, police officers and people at the school and doctors, nurses. Like, I think I didn't realize how much you have to push within the medical system. And I have a lot of family history of autoimmune, and autoimmune is kind of hard to prove or hard to get diagnosis is on. So I really grew up with a family that I was like, man, you guys are all a bunch of hypochondriacs. And so it was hard for me to really push past that, especially with Jordan getting diagnosed to say, hey. If you think something's wrong, there probably is something wrong, and you really have to push to get that answer. I usually think, like, this person went to school. They've studied all these years. They know. And this whole experience has really taught me that, like, they can't know everything, and they don't know all the details.
Scott BennerYou've uncovered a lot of interesting things here. First, let's give me credit for pimping the cruise and highlighting the difference between being a confident speaker in some situations than others and opening up this other thing about you growing up. I really have done a masterful job right here. Let's move on. Juiceboxpodcast.com/juicecruise. Now, Bethany, what do you mean? You're growing up with a group of people who all had autoimmune stuff that they were having trouble getting diagnosis for, and you saw your family and your extended family members as a bunch of complainers?
BethanyYeah. Absolutely.
Scott BennerTell me more.
BethanyI think when we were in the hospital with Jordan and they're going through family history and they start asking about, do you have a history of any of these things? And I'm like, yes. Yes. Yes. Yes. This person has all of these problems.
Scott BennerBut I thought they were making them up.
BethanyI thought yes. Honestly. Like, my husband was even like, yep. Are any of these actually diagnosed? I'm like, well, if one person is celiac and three others have gluten sensitivities or wheat allergies, it would tell you that there is something going on there. So, yes, I did honestly believe a lot of times that they were just complaining and that they didn't have diagnosis for these things. So it's like, do you really have what you think you have? And then, you know, the doctor looked at me, she was like, okay. So it's it's from you. I was like, oh oh, I guess, yeah, I guess it is.
Scott BennerWell, can't we dig into his life a little more? There might be something there.
BethanyRight? I was like, nothing? Like, are you sure he had no contributing factors? But it was pretty much me. I found out a lot about my family after that diagnosis. They're like, oh, yeah. Hypothyroidism, and I have low blood sugar issues, and I have, you know, celiac, and just all these things came out. Your grandma had rheumatoid arthritis and just finding out that they were all related. So it gave me a little bit more respect maybe for my family members and an internal apology that I issued for thinking that they were all kind of, full of it sometimes and also just an understanding of how all of that is interconnected.
Thyroid Testing Advice
Scott BennerAnybody anemic, low iron, low energy?
BethanyNot that I know of. Although, I get tested for low iron and anemia probably every five years. Some doctor will be like, maybe you're tired because you're anemic, and I get a test done. And it's always negative. So I think that probably is in the back of my mind too a lot of times, but not anemia.
Scott BennerYou ever get your thyroid checked?
BethanyI actually just did. Through all of this, we've realized we need to be a little bit more proactive about our health care. So I actually just had a test ran last week, and I'm getting the results next
Scott BennerOkay. Let me tell you a couple things real quick. Yeah. On the anemia thing, if your ferritin is 70 or under, they're gonna tell you it's in range. I'm gonna tell you it could be the reason why you're tired. Mhmm. Okay? And iron infusion. Don't let them be like, take an iron tablet. It'll go back it'll go back nine years from now. You'll eat a whole field full of cows before your iron will go back up. So an iron infusion, you're especially if your insurance will cover it, is a quick way. Also, it's possible that you might have something called silent celiac if you have an iron issue. Look into that. And your TSH, if you have thyroid symptoms and your TSH is over, like, 2.1, say it's, like, 2.5, they're gonna be like, oh, it's in range. It's not that. But if you have thyroid symptoms and you have an elevated TSH over, like, two, two point one, you would probably benefit from the medication.
BethanyOkay.
Scott BennerDon't let them strong-arm you out of it because they don't understand the difference between green on the test and actual therapeutic needs.
BethanyOkay.
Scott BennerOkay.
BethanyI'll keep that in mind. I'm super fortunate. I think that's, like, one of the things that I said when I first reached out to you is just, like, I think we're so fortunate to have good people in our corner, and our general practitioner is one of the first people that when I told them what was happening with Jordan was like, you have to get in, like, today. Mhmm. Like, this is not a joke. You gotta get in. And has helped, you know, get testing done for my other daughter and, you know, is running these tests. So I think I'm pretty fortunate, but I am still gonna write these down because Yeah. I would get strong armed out of it.
Symptoms Before Diagnosis
Scott BennerOkay. So eight months, you're googling things. And what stops you from putting together what you googled and what you're seeing, is it that a, you just said, oh, that kid clearly doesn't have type two diabetes, so I'll stop thinking diabetes, or was it your nervousness to find out the truth?
BethanyIt just kept saying diabetes, and I only knew about type two. So, like, I truly did not know anything about type one. Yeah. So I think that was a piece of it. And I think, like, looking back on it, I think that she was going through honeymoon phases where she'd have issues for a little bit. She, you know, would have issues with wetting the bed or and things that just this kid had never had. And then it would go away, and she'd be good for a couple months or, you know, a month. And then it was little things that didn't really tie together until it got to a point where it was so obvious something was wrong. I think also I have a niece who has bladder issues, and my husband's family would say, like, bladder issues run-in their family, especially with kids. And so I was kinda like, well, maybe that is what it is, and that is what the problem appears to be. It also talked a lot about, like, hormones and stress when I googled it, and we were in the process of moving. We had family moving into town. She was going through, like, what I would consider hormonal type changes. And so I thought, okay. That's that seems more realistic and probable than diabetes until, like, the last months before we actually took her in. I started to see, like, very direct relationships to her food and how she was acting beyond hangry if we had a plan for food and then the plan didn't happen or having a slushie that day and then not feeling good that night. And that's when I started to realize there's a direct relationship between these two things happening. And then, you know, as they got worse, I was like, we have to get this figured out. But it took a while for me to get there.
Diagnosis Day
Scott BennerSo you get her to the hospital, but in DKA. So what are those last hours like?
BethanyYeah. So I had reached out to our general practitioner, said I think she might have a UTI. Here's all the symptoms. She's drinking a ton of water. She's going to the bathroom all the time. I just need to get her checked. You know, they responded back that afternoon, and I didn't see the message. They called me, and they said, hey. Can you get her in first thing in the morning? And that didn't really ring any bells to me that they were being that urgent about it. But my husband was taking her golfing. He's a stay at home dad, so they were going golfing that morning. And, you know, they're both irritated that I'm delaying their tea time. It was funny that morning, I had offered her a Pop Tart. Really just because I wanted to eat the other Pop Tart. And she was like, no.
Scott BennerBethany, you were like, I want a Pop Tart, but I'm an adult.
BethanyA 100%.
Scott BennerIf I can get this kid to eat one, then I'll be able to go I can
Bethanyhave the other one.
Scott BennerIt's open. I should just eat this.
BethanyYeah. She was like, no.
Scott BennerPlease tell me how old you are.
Bethany38.
Scott BennerThat's awesome. Keep going. I'm sorry.
BethanySo I'm 38. I'm offering this nine year old a pop tart. I'm like, no. Seriously. Eat it. She's like, no. I really think I have to start eating better. And I was like, let's start on Monday. Like, let's start the diet Monday. We don't need to do that today. So I forced her to take the Pop Tart and
Scott BennerYou forced her to you can't just eat this thing so I can have one.
BethanyAlright. The golf course. You're gonna get hungry. Like, you get hungry when you golf. So, you know, I gotta call an hour later. Hey. You know, the doctor says she has type one diabetes. I have no idea what's going on. They told us to go to children, and, you know, do you want us to come pick you up? And that kinda started the whole process. She was just kinda barely in DKA, so they said we caught it. They said, like, within three days, we would have been in the ICU no matter what.
Scott BennerI see.
BethanyAnd so we have a satellite children's hospital in our area, but it's not a very big area. They don't have overnight care in the endocrinology unit. So they flew us down to Little Rock. So we had to take a Life Flight that day to get down there, and we spent the next three days in the hospital just learning how to manage all of this.
Stay-at-Home Dad Discussion
Scott BennerBy the way, respect to him tricking you into paying his bills. I did it to a a lovely woman too.
BethanyHe always says he knows when to invest because we got married when we were 18. So he's like, I knew early. I invested early.
Scott BennerOh my god. My wife was in college. I was like, this girl's gonna make money. I was like, I can't I could tell right away. It's like, she's smart, hardworking, smart. She's pretty. What am I doing here?
BethanyRight. You gotta take your chance.
Scott BennerI ain't letting her talk to anybody else. Take your shot. He got you when you were 18.
BethanyYeah. We were still in high school.
Scott BennerHe did trick you.
BethanyYeah. Yeah.
Scott BennerYeah. Yeah. How do you do it? Is he super handsome?
BethanyYeah. I think he's pretty good looking. He's a hard worker, good guy. He's got a good personality.
Scott BennerHard worker. I've been a stay at home dad. Let's not oversell that. So
BethanyI mean, he would probably agree. He would probably say the same thing. He says he's living the dream.
Scott BennerOh, it's awesome. I swear to you, there was a time in my life where if someone would've made me go back to work, I would've cried. I would've just stood up and just burst into tears. I've been like, no. I love my life.
The Podcast's Impact
BethanyBut that made us think of an impact because you have, Scott. And I think that's, one of the reasons why I reached out to you is because, to be fair, I also told you our story was boring. But, you know, it's because I really have felt the impact of the work that you've done and how it got to our area before we had this diagnosis. And we've definitely had the benefit of people taking the work that you're doing and, like, moving it forward. So
Scott BennerCan you explain that to me? Yeah. I'm sorry. Thank you. That was very nice. I appreciate that. But but explain that part to me. Like, I'm not dismissive. I just I don't wanna sit and make it feel like you're saying nice stuff to me. And I'm trying to find out what you meant by that. Like, people took it and did what? What is that piece?
BethanyOh, I mean, I think the first month of after diagnosis, we got the do not die, you know, education in the hospital and the one you know, the three inch binder of information. And, that first month for us was super rough. Like, we didn't know about goals. We were just kinda told to stay higher because coming down fast is dangerous. Had been told to pre bolus. We had an average blood glucose of, like, over 200 that first month. And then we had a follow-up four hour education meeting. And our second diabetes educator is amazing. She has type one, but she gave us what she called ninja training. And that was basically, like, if you took the pro tip series and condensed it to, like, a four hour in person class, that's what it was.
Scott BennerMhmm.
BethanyAnd she talked about your podcast quite a bit, and she had all of the episode lists printed out at that time on the table. And it was like, you can call me anytime you want. If you start listening to these, they're gonna get you through all of this. Oh. So I had that. And then my daughter's school has two other kids that have type one, and those parents really, like, took your advice and lists, and they, like, implemented it. So we walked into a school where every single teacher and employee has already had emergency diabetes training every single year. The nurses knew what to do, and, you know, there are specific teachers who had already taught these kids. And so they had really gone through all the hard work of, like, advocating, getting processes put in place. You know? So we were able to get a huge benefit from that, I think.
Scott BennerCan I ask you a couple of questions? Yeah. First of all, I realized I'm so relaxed and happy since my vacation, juiceboxpodcast.com/juicecruise. My emotions are very, like, raw right now. I'm not all like I would normally be a couple days before Christmas. I don't feel harried or crazy. I can't believe this is the first time I've ever gone on vacation right before Christmas. What a great thing to do. Leave your anxiety behind and do that, people. It's awesome. Make sure I'm I'm understanding you correctly. I'm not trying to take credit from anybody, but the hospital setting, when you're getting your training, there's a person talking to you, and now you've listened to the podcast since then. Right? Yeah. Is that person and I'm not trying to take anything away from them. Are they talking to you through a lens of having listened to this podcast, or are they a person who really understands the whole thing and offered you the podcast as a way to take that idea home with you? And I'm not trying to take credit for their knowledge, but if it is a thing that came from the podcast, I am interested to know that.
BethanyI don't know for sure. Mhmm. But she did say that she hadn't been taking care of her type one diabetes up until a few years ago and that she had listened to your podcast and then went and got like, she is obviously, like, in the endocrine system. I mean, she has the knowledge now, and I think that that's a piece of it. Like, she truly understands it. But she definitely told us, like, you need to go listen to this to take this home with you so you can keep getting the education that you need.
Scott BennerTwo thoughts. Mhmm. If that person is listening, please come on the podcast and tell me that story.
BethanyI will tell her too.
Scott BennerPlease. And my second thought is and please, I hope this doesn't sound self serving because I don't mean it this way. When you were saying that, I thought very quietly in my head, I thought, oh, I did it. Yeah. Like, I accomplished the thing I tried to do. I felt so accomplished at that moment. Like, you're telling me that I found a person with type one diabetes who is also a diabetes educator, and the thing that I gave them elevated their own health, and then they passed it on to you.
BethanyHonestly, 100%. Like, that is the main reason I reached out with to you is just to, like, thank you and tell you that. Like, it can be frustrating to think, like, you're not having the impact that you think you you should be having. I think I had seen a post where you had said something like that. And here I am sitting here, like, knowing that the thing that you are talking about, at least in my area, it's happening and working. And, I mean, we went into that class 24% in range. And in the two weeks after that, we were eighty three percent range. God. And that was the first time I had listened to the podcast. I kind of get OCD. Like, I dive into things, I really dive into them. So I had actually tried not to go online and get all the answers right away. I was like, let me just figure out what this thing is per the book. But after that, I started listening that day. I listened to the fat and protein series that day, and it just got us got us going.
The School Preparation
BethanyYeah. Like, I met a couple of the people, and and multiple people have told me, like, these people went and advocated at that school. Like, they are known for the work that they did in getting that school on the track. And I would say, like, I appreciate it a lot more, especially these last two weeks because our school nurse went on vacation, and we had the fill in nurse. And my daughter came home, and she was like, yeah. This lady's not in it day to day. You could just tell. She's not in diabetes the way our normal school nurse is.
Scott BennerShe's just trying to get through this week and get her checked.
BethanyOh, I'm telling you. My husband got the schools, like, put in lockdown last week because they freaked out. I mean, like, we've we've experienced what I'm sure other people do every day, and it's been super frustrating. But prior to that, I mean, seriously, we told the schools, you know, hey. Jordan was diagnosed this summer. This is a new thing in our life. Yeah. I had your five zero four plan, are in sixth grade five zero four plan, and it was like, all people in the school have to have this education. And, like, it was like checking off going down the list. It was all already done from this other family who had done all the advocacy work, and she said that she listened to the podcast. That was one of the first things that she asked me when I met her. Like, do you listen to the podcast?
Scott BennerWow. I'm so happy. I don't really know another thing to say. I can't decide if this is giving me the energy to make a decades more, podcast or if I just wanna now ask all of you to just send me a dollar so I so I can so I can so I can retire.
BethanyI think you're gonna have to keep working.
Scott BennerI've done it, everyone. If you all just sent me $1, I could get out of this, I think. But, you have no idea. Like, I'd miss it in two seconds.
Closing
Scott BennerThat's it.
BethanyI appreciate that.
Scott BennerYeah. Thank you. Yeah. I appreciate you asking me even though I'm an egotistical lunatic who, is condescending to people all the time.
BethanyI mean, really, what was I thinking? But I
Scott Bennermean, you're an idiot, obviously.
BethanyRight. I'm the problem.
Scott BennerDid you hear he called her an idiot? She laughed. She felt a lot of pressure. Was very cringey.
BethanyVery demeaning.
Scott BennerThank you. Yeah. Here we are. Thanks very much. Hold on one second for me.
Sponsors and Closing
Scott BennerA huge thanks to my longest sponsor, Omnipod. Check out the Omnipod five now with my link, omnipod.com/juicebox. You may be eligible for a free starter kit, a free Omnipod five starter kit at my link. Go check it out. Omnipod.com/juicebox. Terms and conditions apply. Full terms and conditions can be found at omnipod.com/juicebox. This episode of the Juice Box podcast was sponsored by US Med. Usmed.com/juicebox or call 888-721-1514. Get started today with US Med. Links in the show notes. Links at juiceboxpodcast.com. Okay. Well, here we are at the end of the episode. You're still with me? Thank you. I really do appreciate that. What else could you do for me? Why don't you tell a friend about the show or leave a five star review? Maybe you could make sure you're following or subscribe in your podcast app, go to YouTube and follow me, or Instagram, TikTok. Oh, gosh. Here's one. Make sure you're following the podcast in the private Facebook group as well as the public Facebook page. You don't wanna miss please, do you not know about the private group? You have to join the private group. As of this recording, it has 74,000 members. They're active talking about diabetes. Whatever you need to know, there's a conversation happening in there right now. And I'm there all the time. Tag me. I'll say hi.
Scott BennerHave you tried the small sip series? They're curated takeaways from the Juice Box podcast, voted on by listeners as the most helpful insights for managing their diabetes. These bite sized pieces of wisdom cover essential topics like insulin timing, carb management, and balancing highs and lows, making it easier for you to incorporate real life strategies into your daily routine. Dive deep, take a sip, and discover what our community finds most valuable on the journey to better diabetes management. For more information on small sips, go to juiceboxpodcast.com. Click on the word series in the menu. Have a podcast? Want it to sound fantastic? Wrongwayrecording.com.