Scott Benner 6/3/24 Scott Benner 6/3/24

#1214 Queen of Pointless Stories

Johnna has type 1 diabetes.

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Scott Benner 0:00
Hello friends, welcome to episode 1214 of the Juicebox Podcast

today I'm going to be speaking with Gianna she's got like four kids, she made them all in like a very short amount of time. She has type one diabetes, and I don't know what to tell you this episodes about, but I did really like jhana please don't forget that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan or becoming bold with insulin. When you place your first order for ag one with my link, you'll get five free travel packs and a free year supply of vitamin D. Drink ag one.com/juicebox Want to help Of course you do T one D exchange.org/juicebox complete the survey. That's all I need from you. That's all the T one D exchange needs from you but they might give you a little bit more back than that. You're gonna have to go find out T one D exchange.org/juice. Box complete the survey. You need to be a US resident who has type one or is the caregiver of someone with type one. If you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes

Alright, I'm gonna have to pull back the fourth wall for a second on these ads. It's coming to my attention online that a lot of you think I don't know how to say FOMO and in the Omni pod ads I'm mispronouncing it. It's the fear of missing out on Omni pod. More O's mu right. So you don't go fo mu that sounds weird because it sounds like fo F a UX mu so you go full mu. I mean really like Don't come at me in the messages. Okay. This this episode of The Juicebox Podcast is sponsored by Omni pod Do you have FOMO fear of missing out on Omni pod? Well, you don't have to go to my link. Omni pod.com/juicebox Get rid of that. FOMO so many emails and messages. Scott, I just want to let you know I think you're you're mispronouncing FOMO. This episode of The Juicebox Podcast is sponsored by the only implantable sensor rated for long term wear up to six months. The ever since CGM ever since cgm.com/juicebox. Hello,

Johnna 2:37
my name is Jana sullair. I live in Chicago. I'm 42 years old and I have four kids and I'm a type one diabetic.

Scott Benner 2:44
Gianna, do you know that while your setup for audio was not the longest it's ever been for me with people? It was the most amusing. I'm very happy to hear that. Thank you. I really appreciate it like those little latter part. Those, what would you call this? They're not kerfuffles? Are they? No, no, those moments are more frequent than you would think. If you're listening to the podcast, and people get on and they're just like, I don't know how the machine works. Like like that happens sometimes. And sometimes it goes on forever and ever. But yours was different. Most people's go almost exactly the same. This was a first for me. So thank you very much.

Johnna 3:22
You know, the last time somebody they didn't thank me, but I had to say you're welcome that I remember was when, after my the birth of my first the resident was like, well, now I'm all wet and I have to change my scrubs, which I've wanted to do a couple hours ago. So thank you.

Scott Benner 3:42
It's not really a compliment and you didn't really help. Exactly. I just sorted that's pretty nice. Oh my God, what did you do that poor person?

Unknown Speaker 3:52
I was in a certain position.

Scott Benner 3:54
The wrong one apparently. My gosh. Well, he learned something too. Okay, so you have type one diabetes for how long? I

Johnna 4:02
am at what is this? 20 2311 years now? Wow.

Scott Benner 4:07
23 years? 11 years for you. So what do you do your math

Johnna 4:11
on this one?

Unknown Speaker 4:11
I got 32 Yeah,

Johnna 4:14
so I was diagnosed right before I turned 31. Okay, gotcha. The year I turned 31.

Scott Benner 4:20
Is there any diabetes in your family? There

Johnna 4:23
is not an actually in front of me. I got this out yesterday because I knew you would ask that. I'm adopted. Oh, and so I have very little background for my family. But I have these papers because it was a private adoption, closed adoption. And I have these papers from 1981 that talk about the medical background of my birth parents and the only thing on here it has for my birth father asthma. I believe in his father. It has for my mother epilepsy on her with her sister. Yeah,

Scott Benner 4:58
useless. Those things are once your pinkie. They come up to a person is giving their baby away and like, is there any medical trouble in your family and like the guy was probably like my grandpop don't breathe good. And you know, like,

Johnna 5:13
the hands like died of heart attack died of stroke. But yeah,

Scott Benner 5:18
what does that mean? Did they smoke all the time? Well, and

Johnna 5:21
here's the one that got me on my dad's side, it says mental retardation, rather than special ed classes for reversal problems. He sees things backwards. And I was like, wow, they call dyslexia mental retardation in 1981,

Scott Benner 5:36
and 81. And you see things backwards. Yep.

Johnna 5:40
which I would consider to be dyslexia, which, you know, now is so common. That's gotta

Scott Benner 5:44
be what that meant, right? Yeah. I don't know. I show him an eight. He sees an eight. Where do you know what state you were adopted out of? I

Johnna 5:55
don't want to make fun of people. Sorry. No, that's okay. In Illinois.

Unknown Speaker 5:58
Oh, is that a place where people don't know things?

Johnna 6:03
Depending on what zip code you're and I would say yes. And maybe even block

Speaker 1 6:07
the AES though. I guess you're right. Like Dick's dyslexia, get a designation. Dyslexia

Johnna 6:14
did not become big until I would say mid to late 90s. And then it kept growing. Yeah, cuz I was, I went to I, my undergrad, I did teaching and I started learning more about dyslexia. And like I didn't even learned until after. So it was in the 2000s. I learned there's like, at least three different types, if not more,

Scott Benner 6:37
I have to tell you that you just said that dyslexia didn't become big until is maybe the funniest thing anyone's gonna say to me today. You were like, do you remember when Van Halen really took off? Was that eruption solo, by the way my googling of dyslexia when it began only returned. A Omari isn't enthusiastic is enthusiastic about vegan cooking, and wants to dispel myths about the meat free food is bland and boring. The hell that has Oh, he's a young dyslexic vegan chef, someone, someone with no conscience named this blog post young dyslexic vegan chef in a vain attempt to get clicks and I'm insulted by it. That's all well, kids got a lot of juice on the internet. Good for you. Oh Mari she's He's everywhere. Somebody here back like this kids, like incredibly famous. I'm the only one that doesn't know who he is. Anyway. So you're you have no family background to speak of as far as what could be or what can be that make you ensure you have 1000 kids? So did that make you interested in like doing, like trial and error testing for them?

Johnna 7:51
No, it did not. But I don't know if I would want to do because I've been thinking about that. Because I'm already like, oh my gosh, you peed a couple times more than usual. Yeah. Is this going to continue? You know, I guess if we got negative results, I would be very excited. But if we had more factors, I would be like just waiting even more for the shoe to drop. I think today's

Scott Benner 8:17
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Johnna 9:42
I wanted a big family and I set out to meet that goal and met it will get you

Scott Benner 9:49
good just setting goals and breaking right through them. It's like the one goal in life that you would think that by the second time you start going yeah, it was I think

Johnna 10:01
My oldest was not old enough for me to own while neither of the two oldest were old enough for me to rethink that.

Scott Benner 10:07
Would you do them in two packages? Are they like kids and kids?

Johnna 10:10
They're just all about two years apart.

Unknown Speaker 10:12
Oh, wow. You're on a schedule. Yeah, yeah.

Scott Benner 10:16
Are you done now? Or is your husband set to have sex again? And nine months? What's going on?

Johnna 10:19
No, I plan to be done. He actually brought up vasectomy. So we'll see if he follows through on that and reaches that goal. But

Scott Benner 10:28
I bet you thought about that. While he was very tired at work one day.

Johnna 10:32
You know, like, oh, yeah, right. He sleeps through the night like nothing. You know, at three I was like, Yeah, you know, what's, what's one more guys, you know? And now that I have four, I'm like, you know, if we have a fifth, we have a fifth. Really? Hopefully we don't. Wow, I will actually work to not have a fifth.

Scott Benner 10:48
Just man you married. Is he super handsome or something? What's going on?

Johnna 10:52
We do make beautiful babies for you. Okay. gratulations.

Scott Benner 10:55
It's nice. I'd be sleeping with a bat next to my bed. If I was you. I'd feel the blankets move. And I'd be like, no, no, no, no, it's not happening.

Johnna 11:03
I'm hoping that with the more kids I have at least one that will take care of me as I get older. Oh,

Scott Benner 11:08
that's a valid plan, too. You think one of them could make a couple of bucks. And then you see that one being smart. And that's where you really lay the Mommy loves you thing. I got you. Daddy didn't want you I fought for you.

Unknown Speaker 11:24
Oh my god, that seems like so many kids to me.

Johnna 11:28
It's a lot of kids. It really is. When I had my third, I was consistently worried that I was going to leave one somewhere. Yeah, I can't imagine not. And at this point, I just don't care.

Scott Benner 11:38
I'm gonna say a thing. That's not anybody's business. But I grew up around a lot of baseball and softball, as a parent, right. So I know it's a weird thing to say I grew up around, but I became a parent. And my kids, my son played baseball since he was honestly just before it was four years old. And then, Artem began to play softball when she was five. So I've been around, like meeting families that you wouldn't otherwise meet, you know, for a long time. Some of them are just incredibly lovely. And honestly, most of them are except for a couple of the monsters and these lunatics that think their kids are going to play for the Yankees like other than that, like everybody's been really cool. This one lady who is as sweet as could possibly be, had four children. The youngest one, whose name I wish him the best nickname in the world that I can't share with you because it'll literally say Who exactly he is if somebody's listening, but he was the youngest. And I can remember being at like baseball fields, I don't mean once or twice, where someone says, Hey, where's blank? And she'd go? I don't? Did I bring him she wasn't joking. She wasn't certain if the child was in her physical presence at the baseball field or at home. This kid must have we thought he was feral. Like the way he just kind of moved around, you know, but if I'm being honest, I think he's the most solid of their four kids. And I don't know what that says about them. Exactly. But um, but this they never knew where he was. Oh, my goodness. Yeah, I've watched them look for him for 30 minutes, only to figure out that he was in another location with a different person. So that I don't think is an unfounded fear for you. I think that just it becomes a numbers game at some point. But what about the money and feeding them and putting clothes on them? Did you just wrap them in like brown paper bags? Or,

Johnna 13:31
you know, that's a good idea. No,

Scott Benner 13:35
you're actually buying them clothing. All right, well, you listen, you're independently wealthy. I didn't understand who I was talking to. But okay, I gotta go.

Johnna 13:42
Yeah, I wish and Well, the thing that works out is the oldest two are boy and girl so the younger two can just live in all the clothes they have. No so it's like we only have two kids you know? It's just the the food thing

Scott Benner 13:56
to kids that you care about and to kids that you just wrapping swaddles whatever they I got you, you know, hey, I want to just say to strong possibility that we call this episode young dyslexic vegan chef.

Speaker 2 14:12
Because I could use the clicker. It has the most clicks. I can use the clicks

Scott Benner 14:16
to Alright, anyway, can you imagine if that guy got back to me? And he was like, Hey, man, that's my thing, not yours. Get away from it. Alright. Okay, so you're you've but you were diagnosed as an how many kids did you have when you were diagnosed?

Johnna 14:29
Euro

Scott Benner 14:30
Wait a minute. You've had four children and 11 years? No,

Johnna 14:33
I had four children in six years.

Unknown Speaker 14:36
Six years. Oh my God. Are you okay?

Johnna 14:40
I don't know.

Speaker 1 14:42
You got arrested? Jesus. God didn't cry at the end. We did it. But you said the the the OB had to change. No, no. Wait, didn't you get the OB all wet when you gave birth? Oh, that

Johnna 15:00
was the first Resident so I go to a teaching hospital so it's completely different doctors every time I deliver, okay,

Scott Benner 15:05
I was just making a joke about Gotcha. The OB had to change

Johnna 15:09
like somebody else had to see me in general. change their clothes on

Scott Benner 15:14
the you ruin that joke that was set up. I know it was so good. You have no idea like it made. It made squeamish people upset but they're still like, I get what he's saying. And everyone else is cracking up and then you mess it up at the end. Okay, it's on your phone. Don't worry. We'll get past try not to do it again. We're gonna get past it. We're just gonna let it go. Oh, by the way, before we move on, let's tell people the problem when you were setting up the app is you needed to swipe one way and you were swiping the other way.

Johnna 15:42
Yes, swiping left and right is not my thing. I do not swipe. I'm

Scott Benner 15:45
like it says swipe, swipe left. Like that doesn't work. It doesn't work. But you were moving the thing. Oh my god. Anyway, let's not get over that onto that. But sometimes people move their finger one way. Think about them. Anyway. It's not important. All right. So your what's your oh my god, I've

Johnna 16:01
never been diagnosed as dyslexic so well, not yet.

Scott Benner 16:03
Oh, my God even put that together. Where am I on this? I'm giving you crap for not following it. I'm not following. It was all set up for me and I let it go. Okay, wow. So you were diagnosed with type one diabetes at 31 years old? How did it come on? Let's talk about the first couple of years. And then I want to hear about making all these babies with diabetes. This episode of The Juicebox Podcast is sponsored by Omni pod five. And this is for all of you who wrote to me. I'm just gonna say pho mood this time instead of foo, although I like FOMO. But whatever. A lot of people in my private Facebook group, talk about their love for Omni pod five. Have you ever seen those posts and thought, Oh, I wish I could have that experience with an insulin pump too. If you answered yes, you might be experiencing FOMO fear of missing out on Omni pod symptoms may include but are not limited to dreaming about walking past the doorknob without getting your tubing caught. fantasizing about jumping into a swimming pool without disconnecting from your insulin pump first, and wishing you could wear outfits without pockets. There's good news. You don't have to suffer from FOMO. any longer. You can see what you're missing by trying Omni pod fi for yourself. Just visit Omni pod.com/juice box to get started. Is everyone happy now?

Johnna 17:29
Oh my gosh. So this is the other thing. I was like, let me be on this podcast because I haven't heard the story. But then I fully realized I am late. I'm one to come to realizations later on. So I started listening to your podcast maybe a year ago. And I was like, Oh, he's got a lot. I haven't. And then more recently, I was like, I haven't heard any diagnostic stories like mine. Okay, let me you know, get on this. And then I'm like, wait, he's got like, over 1000 podcasts. Now. I

Scott Benner 17:59
may not have just heard that. Well, listen, I'm gonna tell you somebody said something to me yesterday, I had never heard before. And in 1100 G's probably 1200 times recording the podcast. No one's ever swiped the wrong way. And were absolutely sure that they weren't. So you know, new stuff happens all the time. Don't worry about so what's your story? Tell me.

Johnna 18:19
Okay. So I was in my doctorate level program, doing some not fellowship work, but something like fellowship work. We were doing stuff over the summer, we were preparing to do or maybe we were doing it, I think we were already doing it. I don't remember the line of events. I just specifically remember. It was the year my best friend and I, at the time in graduate school had created this preschool program. And so we were running that. And we had to get different clothes, or we didn't have to get different clothes. We just decided like, let's make ourselves wear this like uniform, which was yoga pants and a T shirt. You know, working with three year olds. So we did that. And I don't know if it was right before, right after. But I was an I had lots of dogs at the time. So no kids, lots of dogs. And I would take them for walks. And I'd be like, I'm so out of breath. And even we I would walk across the street to this like dog park lat thing. Just just an empty lot, not a true dog park and let them run around and just walking across the street. I was like, I'm so out of breath, what's going on? And then I started being thirsty and going the bathroom a lot. Nothing registered. Nothing clicked for me. And this was going on for a few weeks. I'm like, let me try drinking some different things. Let me try. I don't know why. But I remember eating licorice. Like red. Twizzlers? Yeah. I don't know why, you know, and looking back and like, Oh, I was drinking orange juice and Twizzlers that really helped. So I'm drinking water going in the bathroom like two The point where I'm like, Oh my gosh, I'm gonna pee my pants I did once. And then a couple times, I was like, I think I'm going to pass out. Well, before that I was also teaching online. So during graduate coursework, so I had to look at the screen and grade papers and things like that. And then one night, I was looking at the TV screen. And I'm like, the TV screen looks a little blurry. And then the next day, I get online to do my course. And I can't read it at all. And like, it's the I'm like, I cannot read, I have to go to the eye doctor, we have like this. Like, I thought I problems were gradual. I don't have any glasses, no context, no vision problems. In 30 years. I'm like, here it is. So I go to a LensCrafters.

Speaker 2 20:45
I don't know why it made me laugh. So I know, right?

Johnna 20:49
Like, go to a LensCrafters. The doctor walks in and examines my eyes. And he's like, here's your prescription. I also remember afterwards, reading all the things on the wall. One of them in particular was about how diabetes affects the eyes, he gives me a prescription for glasses. I go home with them. The next day, I don't need the glasses. My vision is back to normal. And

Scott Benner 21:14
yeah, you're like, oh, this are those self healing glasses. They're fantastic. So

Johnna 21:19
my vision keeps changing. And really soon after. I'm to the point where I'm like, I'm going to pass out. And my husband's like, I'm taking you to the hospital. I don't think you look great. And at the time, we were not married. We did not live together. But he lived in the same building. I did. And I'm just like, okay, so we go to the ER at, it's like, late at night. But we're in Chicago. And at the time, I didn't have health insurance. So I go to Cook County, sitting in the emergency room for hours. I think it's like five hours, and probably like one or two in the morning. Well, you couldn't

Scott Benner 21:59
see the clock. How do you know how long it was? Yeah,

Johnna 22:01
exactly. So I don't know if it was before they sent me to the waiting room, or I had to wait this long to, but I get to like the lady where she was like getting my info and stuff. And she pricks my finger. And as I was thinking about this to tell you, I don't know, if she was telling me like diagnosing me you're diabetic? Or asking, like, asking, like how long you've been diabetic, right? And so I think my blood sugar was somewhere around 800 G's. So that's, you know, I learned in the emergency room, and they're like, we're gonna put you in a bay and get your blood sugar down. And then you can come back and meet with the diabetes team. On what you know, next week, whenever it's

Scott Benner 22:49
fascinating when we went to the little kiosk at the emergency room where we took art, and I remember that we created that confusion unknowingly by saying, Our daughter has diabetes. And what we meant to say, Well, what we meant to say was we just figured out that our daughter has diabetes, and we're bringing her here. And there was like this moment of like, pause I remember pause and confusion, while the person behind the things like do it like that. So what about diabetes? And we were like, oh, no, wait a minute. You know, and then like we just figured out I have a couple of questions. The first one I don't want to sound disrespectful, but it's probably going to be

Johnna 23:24
that's okay, I'm not easily offended. We'll find out.

Scott Benner 23:28
What the hell did that story have to do with you wearing yoga pants?

Johnna 23:31
Oh, because I had lost like, over 20 pounds. And so the size of yoga pants was drastically different than what I like would have gone to buy like if I would have said hey, go get me like this size yoga pants. That's not what I needed. I needed like two sizes smaller. And it didn't dawn on me I'd lost all this

Scott Benner 23:52
weight. Did I not hear you say that? Are you setting up to say that and then never said it? I don't think I ever said it. Yeah, I was like baffled. So I literally just like the yoga pants have to be key important to this episode. By the way keep when I say key important. I'm making fun of Paula Abdul on the first season of American Idol. Anybody old enough to know that? Enjoy your laugh right now. But I thought this must be incredibly important. Like she's telling you like exactly what she was wearing. And then it never came back up again. I was like, it was upset. But my other thing is I think you're the first adult who's admitted to paying themselves before diagnosis. Yeah, so you were right. You wouldn't do anything new. Well, but not then you hadn't even had four kids by then. Don't try to like I saw it you just did there don't try to blame that.

Johnna 24:43
No, I'm like at this point. You know anything goes for me. Yeah,

Scott Benner 24:47
also, I might just call this episode busy decade so serious and

Johnna 24:52
awful. Like the first five years of my 30s my early 30s were like the worst in my life. Because

Scott Benner 24:57
of this diabetes diagnosis or other First, it

Johnna 25:00
started with that. And then I lost both my parents.

Scott Benner 25:03
Oh my god way to bring down podcasts. Okay, how did that happen? How do you lose both your parents in a short amount of time.

Johnna 25:09
So my dad had heart problems in general, he died of a heart attack unexpectedly, but expectedly like, we expected him to have a heart attack at some point, just not as when he did. And then three months later, my mom died of a heart attack. And they actually called it a broken heart. Because she literally had the syndrome where her heart gives out because she misses her husband.

Unknown Speaker 25:31
How old was she?

Johnna 25:32
She was born in 53 and died in 20s 60 370-393-2000 360

Speaker 1 25:37
something right? Yeah, I want to say something right now. This

Johnna 25:45
is 64.

Scott Benner 25:47
I know. We're only one generation removed from your parents. I better not die in my 60s. I better not. So, God, I'll be pissed. Like, I just I've been through so much. And I have fought so freakin hard. And I'm almost there. And I swear to God, oh, if I die in my 60s, I'm going to be I'm going to be so I hope if I die in my 60s, it happens so fast that I don't have a moment to go. You have to be kidding me. Like I just Oh, please, please, either let me live longer or a bus that I don't see one of the other. Oh my god, I'm so sorry. I'm sorry. I was also confused by the statement. We knew my dad was going to have a heart attack. Isn't that something we could have gotten ahead of? If we knew was happening?

Johnna 26:33
No. Like we tried. He it was just whatever the issues were with his heart. Like he was it. I don't know if he actually got diagnosed with congestive heart failure. But his heart was going to give out and there wasn't anything they could do. Like with his age and everything else. He was in Vietnam. Oh, oh, he smoked for so long. I don't think he would have ever made it to a donor list if that was even possible.

Scott Benner 27:00
Was he ever near the spring in Vietnam? I don't know. Do you ever talk to these people? Your parents?

Johnna 27:07
I don't know. My dad would not talk about anything related to Vietnam.

Unknown Speaker 27:12
Oh, no. Okay. Yeah.

Johnna 27:14
But I will tell you he he definitely had plenty of monologues, in his drunkenness as I grew up. So I did get a lot of information from him. Just not about his time in Vietnam. PTSD.

Scott Benner 27:27
Oh, yeah. Yeah, I'm sure the drinking was prevalent.

Johnna 27:31
Yeah, at least maybe maybe just trauma. I don't know if actual PTSD, possibly I don't diagnosis. So don't know all the criteria. The VA

Scott Benner 27:39
recognizes ischemic heart disease as being associated with exposure to Agent Orange.

Unknown Speaker 27:45
So yeah, maybe

Scott Benner 27:48
isn't crazy. Oh, my gosh. But your mom did she? How long were they together? They

Johnna 27:53
had celebrated their 25th anniversary. So they were married in 74. I think they got together maybe a couple years before that. So 7080 92,000. So 30 years? Yeah. I

Scott Benner 28:05
mean, I was born in 71. Well, I was Yeah.

Johnna 28:09
They had to be 30 years because my brother and I were both in our 30s is your brother 40 years? Yes. Yes, he is. His story is crazy. I'll try to make this short because I extend stories longer than I need to

Scott Benner 28:20
know. Just make sure you tell me what he was wearing. And then never tell me why it's important that I

Johnna 28:26
can do that. Although now he's got this trench coat. I think he finally got rid of it. Maybe your

Scott Benner 28:31
brother's a flasher? No,

Johnna 28:35
maybe, but you won't tell us about it. He so my aunt and uncle lived three hours away. My uncle worked as a manager at a grocery store. And one of the baggers said his girlfriend was pregnant. They didn't want to raise the kid because they didn't think they could give it a good life. And my uncle as the manager was like, I actually know people who are looking to adapt, and they worked it out. And that's how my parents got my brother.

Scott Benner 29:02
Well, ironically, if the Bagger would have bagged it, he wouldn't have gotten somebody pregnant. Thank you. I'm on a bad job roll today. Everyone enjoy it. By the way, when you told me that the grocery store was three hours away, I thought this better be pertinent to the conversation. And it wasn't no, no. Have you ever heard me tell the story about my uncle telling stories?

Johnna 29:31
No, do I want to he would ruin as bad as my telling stories. I don't want to

Scott Benner 29:35
know he would ruminate for minutes. But so first of all he could he owned a business. So he would capture us he's dead now. So I can do this without problems. He would capture us like during our break times. You couldn't do anything. He was the boss you know what I mean? So everybody was like Oh, here he comes. Hi. He you know when everybody's really like, please leave me the up. That's my 15 minutes like leave me alone. But he'd come over and hold court wasn't as good at it as he thought he was and would go into like telling a story about going for a ride. And the point of the story was where they ended up, but somehow would spend so much time on the ride and get caught up in what year the truck was that they were driving in. He couldn't quite remember he might go back and forth, he get to the end, and it had nothing to do with the truck. It had nothing to do with what year the truck was. And the voice in my head was sit there going, Oh my god. Why did we just spend 10 minutes on what year that truck was? I want to know, and there was never a reason and you're making me feel that way.

Johnna 30:37
I'm terribly sorry. Do

Scott Benner 30:39
this all the time? Or is this just since you gave away so much of your body to developing for human beings inside of it?

Johnna 30:45
No, I was labeled the queen of pointless stories in high school. Oh, and Queen.

Scott Benner 30:54
Pointless stories is definitely the title of your episode. Congratulations. Let's keep going.

Unknown Speaker 31:02
So this is an affliction you have

Speaker 1 31:05
currently, how many people do you think do this? I wonder? Is this a thing?

Johnna 31:11
I'm not sure. You wouldn't know better than me. You talk to more people. Yeah. So

Scott Benner 31:15
I'm gonna start keeping a checklist next to my next to my desk here. I am so purposeful. When I speak even though it doesn't sound like I am because I do this like, like sing songy back and forth, like Pulp Fiction timeline talking. But I don't waste words. I'm setting stuff up or getting ready or thinking about stuff all the time. But yeah, I don't know. I love you. This is great. Let me ask you another story. So I want to hear more. God, I want to hear more pointless stories. Let's go. So when you're diagnosed, back then what kind of technology do you get?

Johnna 31:49
I was doing vials of insulin and needles, vials and okay, I had no technology. Well, actually, they diagnosed me as type two. So I got pills. And then when I went, I think I went in for a follow up within like a week, because they wanted to see how I was doing. And the nurse was like, we think you might be type one. The doctor wants to do a blood culture or urine culture to check for whatever enzyme in your liver or something. And they're like, Yep, you're type one. So you're gonna need insulin. And then it was the needles, and then I did the pens. And then I switched, actually got a job in insurance and switched hospitals and doctors and then I went to a pump in 2015.

Scott Benner 32:39
John, are you are you? Are you purposely trying to only use words that are important to the story right now? Could you just slow Okay, cuz you slowed down when you were talking? I was like, Oh, I got in her head. I don't mean to do that. I'm sorry.

Johnna 32:49
No, I was trying to think. Okay, yeah, yeah. So. So I went to the pump and 2015 did not do a duck's calm. And then I've been trying to remember I'm like, did my doctor suggest this? And I refused. Like what happened? Because in a lot of your episodes, you guys talk about, you know, the fear being instilled in people. And I do not remember. And maybe it is just how I take things. But never once was I ever scared that I was going to die of giving myself too much insulin. And I remember them asking me every appointment. Do you have somebody that sleeps next to you? Do you? Do you live with somebody? And I'm like, Why? Why does that matter? And they would tell me because you know, at night, you could go low and this could happen. But I was never feared. I never feared that I would die.

Scott Benner 33:44
So you're you're with your husband, but not married to him at that point. Like how did you think of like it? Did you think you were were you living together? When

Johnna 33:52
I was diagnosed, we were not living together. And then we started living together. Maybe a year later. You guys,

Scott Benner 33:59
by the way are either really really in love or incredibly sexually compatible. I wish I knew which one it was. Am I right?

Johnna 34:07
I don't maybe both at some points. I don't know the if the incredibly in love continues every day. No,

Scott Benner 34:13
no, after a couple of years. Don't ruin it for the young people. You'll feel like this forever. Don't worry. You'll never walk into a room again. All right. No, no, I just I mean, like you were you guys waited into your 30s to get married?

Johnna 34:34
Well, we didn't need each other until we were almost 30 Is that because

Scott Benner 34:38
you were chasing the perfect person or a career? Both? Okay. And then I'm trying to say something without saying it. I shouldn't do that. But an adult who waited that long to get married who still marries a person who's diagnosed with a chronic illness. I figure either really loved you really love to have, you know what I mean? Like, so like I'm trying to think, because, yeah,

Johnna 35:05
he really loved me and loves any interaction with me, I would

Scott Benner 35:10
imagine. I just keep thinking you must look like a supermodel as we're talking. And not because people can't. Like, I want to be clear, I don't think people can't love people with chronic illnesses. I'm not saying that. I'm saying that this specific mixture of variables waited a long time older, more mature, maybe more likely to do the math on what this might cost, like, financially. Like, there's a lot of reasons why someone might have backed away, but but they didn't, which I feel like means you were with a really good match. And I'm just trying to figure out what that was. So

Johnna 35:43
I think it's lack of thinking things through.

Scott Benner 35:47
The two of you aren't paying attention. Yes, gotcha. I gotcha. Oh, he's like, No, this will be for kids. So then he did he not? Did he never understand the seriousness of the type one. In the beginning.

Johnna 36:01
It's hard. It's really hard for me to say I think he does. But it's just kind of like it is what it is. I think we have a similar attitude. And you know, this is serious, but we're going to deal with it.

Scott Benner 36:13
I'd say your personalities match up well. Yeah. And you never thought of anything of it. No matter how many times you're like, are you sleeping next to somebody? Are you going to be safe? That kind of stuff? It didn't, you didn't make the leap to wonder why they're asking me if I own a handgun basically.

Johnna 36:28
Well, I mean, they, they mentioned that and it wasn't also it wasn't immediately in the context of if you give yourself too much insulin, you could die, you know, especially during the day, but I just never, I think it was one of those things like, well, that's not going to happen. Yeah, I think it was a denial thing.

Scott Benner 36:46
Okay. Isn't it interesting to you, you kind of cruised over it for a second, but I wanted to go back to it. You said it's maybe in my personality, that I wasn't, like scared by it. I always that's one of the things I wonder about constantly is people's different reactions to the same information. Like what like how can you say something to one person, and it scarred them forever? And another person is just like, Wait, it might kill me. Alright, I'll be careful. And they just keep going. Like, that's fast. You know?

Johnna 37:15
Well, I definitely when they told me I, they wanted to check that I was type one, that type two. That definitely made me go full blown tears crying in the doctor's office, because I was like, what that means I'm going to lose my, my arm or my eyesight or you know, I'm going to be amputated. And you know, if it's type two, I can do better and this and that. And get rid of it. And they're like, no, no, no. Like, you know, and so then I learned more about everything because I knew very little about diabetes. Yeah.

Scott Benner 37:45
Are you the kind of person that watches the show called Chicago Med by any chance? I used to? Does anyone want to give me a minute? Right now? I don't know. You can't send me an award through the the internet. But I heard your reaction to that information and was able to surmise that you would watch Chicago Med. Everyone just wonder how that happened forever. I'm not going to tell you where my brain got that information from? Also, maybe we call this one bad jokes, and pointless stories. I'm still working on. Consider I'm workshopping that still. Oh my god. Okay. So when do you figure out that like type one? When do you How long does it take you to think I know what this is. I know what I'm doing. All these things. I wondered at the beginning. You know, some of them are valuable some of the more how long does it take you to get comfortable with it?

Johnna 38:32
I think it ebbed and flowed after, or right before I started having kids. And it's gotten progressively better since I started listening to your podcast. And how

Speaker 2 38:44
long ago is that than a year ago?

Johnna 38:47
Around there?

Scott Benner 38:47
You've been dumb luck in your way through this for a decade. Yep. Well, and

Johnna 38:51
let me tell you, I found your podcast because I was listening to a podcast, the vagina blog podcast, and you were on that I was there. And I started listening to your podcast. Oh,

Scott Benner 39:00
you must have really liked me if you like me on that podcast. I was very silly on that podcast.

Johnna 39:05
Yeah. Well, there you go.

Scott Benner 39:07
I have to ask you something you so you're already listening to a podcast called The vagina blog podcast, when they bring on a male not a doctor. Do you think why is this happening?

Johnna 39:20
No. Well, for me, I think it's perspective. Right? So I'm a type one diabetic. And that's what you were on there is to talk about type one diabetes and the menstrual cycle with your daughter. Yeah,

Scott Benner 39:29
you must have been the only person who wasn't wondering why am I listening to this? Don't you think though? Other ladies were probably like what's going on here? This is stupid. I don't ever like this guy. Like, he didn't know anything about our vaginas. I just knew about hormones. And yeah, so you found me on that podcast, and then came to this and now this is going to sound like I'm fishing for a compliment. I'm not. I'm asking the question because you literally lived 10 years with diabetes randomly and now It seems like you have it. Like, what's your situation now versus a few years from now? ago? I

Johnna 40:06
would say when I started my agency, I was able to look back at my charts. So 2013 I think my agency was around eight. And then I got the pump in 2015. It still stayed around eight, it might have come down a couple tenths of a point. And then it really came down when I started trying to conceive in 2017. Okay, and since then, it's been, I would say no higher than 6163. And sorry, there's my six week old

Speaker 2 40:37
lady that kids six weeks old. Yes.

Johnna 40:41
So, one of my pregnancies, my agency was 4.9.

Scott Benner 40:46
I love you. I just want to say that out loud right now. Are you gonna breastfeed that baby while we're making this podcast? Or what's going on here? Do you give that up? Uh, well, I got ready to eat for at least another half hour. No one's ever breastfed on the podcast, just saying I bet you know of. Well, I would hope if they were a good podcast guests, they would say, Hey, by the way on breastfeeding, so that I could say stupid stuff about it. And we can have fun. So well, wow, I didn't realize that your youngest was that young? Yeah. You are like a bag of surprises. Okay, hold on a second. First of all, I want to commiserate with you and everybody else this has ever happened to how upsetting is it to go from injections to a pump, and it doesn't move your a one se.

Johnna 41:32
So at the time, I was not even aware or caring about what my one C was? I was aware of it. I just didn't care. And like not to not because I was like lip balm compliant? Yeah. I just, I had no reason to like, you know, my doctors would just say like, oh, you know, you're doing great, blah, blah, blah. They weren't like honing in like, you need to bring your agency down. You need to bring these numbers down.

Scott Benner 41:57
You are a unemployed mother of three living in the United States of America with an eight something a one see, and no one was giving you any direction about that? Nope. I hope everyone's embarrassed. Okay. So, and you had had children with higher frequencies?

Johnna 42:17
No, by the time I started having children, I had brought it down to

Scott Benner 42:21
six. And that happened because the doctor said you have to have a lower one, see if you're going to be pregnant. So the focus has

Johnna 42:28
never and still is not on my agency. Like they take my agency every three months. But it's never like I have to ask what my agency was for them to tell me. You live in a like forest with my agency again.

Scott Benner 42:41
Especially what do you live in the forest? What's going on?

Johnna 42:45
Don't know. But it was the sole conception. You know, I read a few books and the doctors were like, We want your fasting blood sugar to be below 90. And your postprandial is to be you know, less than 120. And so I worked really hard to do that.

Speaker 1 43:01
Oh, they gave you a guideline. Okay, so they gave you God? Did they tell you why? To decrease

Johnna 43:07
birth defects? Risk factors?

Scott Benner 43:10
That's it. That's all somebody had to say to you was? And so why were you able to so effortlessly adjust from eight and a half to six?

Johnna 43:18
I was just paying attention to what I ate. I think better.

Scott Benner 43:21
That's it. It was about us around food. Not even around? Yeah. Yeah,

Johnna 43:25
definitely. Around the food.

Speaker 1 43:27
Are you eating? I don't mean it. Like, what was your diet? Like?

Johnna 43:31
I do not really, I the only thing I remember is, I ate a lot more spinach with my first and probably like, portion things out better. But I don't know that I really changed. Like what I was consuming

Scott Benner 43:47
a Europe for a party. I can tell.

Johnna 43:52
You know, I've, you know, as I've had the kids, I'm like, Well, let me just eat whatever. And now I'm more. It's more about the insulin and controlling things.

Unknown Speaker 44:01
Okay. Are you in my Facebook group?

Johnna 44:04
No. Oh, my

Scott Benner 44:05
God. I'm very upset by that. I definitely wanted to see you. I was just I wanted to go find out who exactly I'm talking to right now.

Johnna 44:12
That's fine. Back on the Facebook. I will join 44,000

Scott Benner 44:15
members 120 new posts today about diabetes. What would you do with that absolutely free by the way.

Johnna 44:23
I would never look at it because I have four kids. And I can only listen to podcasts. Yeah, no,

Scott Benner 44:29
I don't. I mean, quite obviously, you're doing two things with your life and neither of them involve your phone. i Well, maybe one of them does. Who knows? I don't know what you're doing over there. You did not answer me if your husband is incredibly handsome.

Johnna 44:42
I did not answer you.

Scott Benner 44:44
And you're still not going.

Oh, you know what? Don't answer me, John. Now I'm dying out. It'll fuel my entire day wondering if he's just really handsome and you didn't want to say anything? Or if you don't want him to hear that you don't think he's six Did I just let's leave it there? I just want that's what I wanted. That's where I want to live. There's no way my wife thinks to me is handsome, right? Like literally like 27 years we've been married. Now I looked the best I've ever looked right now, by the way,

Johnna 45:13
I think I I'm sure she thinks you're handsome. Oh, no,

Scott Benner 45:16
I think she's just happy that the kids look the same. I think that's why I got this day, actually, because I think she wanted an other kid. And she didn't want them to look oddly different. That was it. There was some time in there. When I was younger. I'm sure she was just like, I'll let this guy hang out a little longer. So the kids are the same. Like that's for sure what she was doing. Oh my gosh, now she's just like, getting pretty successful with that podcast. Maybe I'll see what see what he can buy me when I retire. Maybe that's what she's thinking now. Don't you think? Probably. Do you think young people are like, wait, what's happening? What's gonna happen to me? Oh, that's probably just. Yeah.

Johnna 45:51
I hope she's thinking that Yeah. Oh, randomly.

Scott Benner 45:54
It's probably just Gianna and Scott who have this experience. My experience will be different. Yeah, you're always gonna be an Instagram real Don't worry.

Johnna 46:03
Yes, exactly. Right.

Scott Benner 46:07
Suckers. Okay. Will be whatever you make it. Watch me watch me. prove the opposite point though. Gianna. Would you trade your husband for anything? Pancreas, I was gonna say such a long pause. I said didn't go the way I expected. She was I thought you were doing math. I thought you're going like, like, maybe $400,000.

Johnna 46:31
Oh, no, no, no, I would that? Of course not.

Scott Benner 46:35
But it doesn't make any of the other stuff untrue. Just so everyone listening is focused on what I'm trying to get at. It's gonna be a show, but not so much that you'd want to trade it for something else, which doesn't make any sense. But you'll figure out why

Johnna 46:48
later. Yep. Yeah. And you'll understand why, you know, after 1020 years,

Scott Benner 46:52
yeah, no. 100%. And here's why. In a nutshell, you bought so much stuff? How are you going to move it all out of here?

Johnna 46:59
Well, yeah, you know, unless you want to be the one to move

Scott Benner 47:02
out if you can't afford it. By the way, I think that I think that famous people divorce more frequently, because they can. But that's a really sad thing to say,

Johnna 47:14
Oh, 100% agree with that.

Scott Benner 47:18
Like, because they don't like like, when when t Swizzle moved into the Kelsey boy's house in Kansas City, or wherever the hell that just happened. My wife said, God, that was fast. I was like, she doesn't have to move the stuff. The cost of moving it is meaningless to her. She just said out loud, take some of my stuff that Kelsey is house, I'm gonna live there. And if it goes wrong, she'll just say out loud, Hey, everybody, go get my stuff out of that house and bring it back to here. Like she doesn't have any like, you know, speed bumps at all around that. And I think that allows people to follow their their like knee jerk reactions instead of like actually sitting around and like saying, like, well, let me be thoughtful about this relationship. They don't she doesn't have to be. I mean, God bless her off, but you don't you mean? Exactly. Yeah, I didn't think I'd say anything thoughtful while we were recording, but there it was. By the way, I got a haircut yesterday. And the head set feels so much different on my head. It's freaking me out.

Johnna 48:20
But I'm okay. Little things in life. I

Scott Benner 48:22
had a moment yesterday, I walked into the person who cuts my hair. I'm gonna just tell you. I do have my hair cut in a salon, but I have beautiful hair. So you should all know that. That's why I don't have like a guy's like, you can't just like, hit me with some scissors and everything's okay. I've like wavy curly hair. I need a lady that you

Johnna 48:40
have beautiful hair. You're not balding. But you host a podcast where nobody can see

Scott Benner 48:47
it. Nobody can see it. So it doesn't matter. Meanwhile, yesterday, she's running her new team you can brag about oh, yeah, no. And I have nice broad shoulders too. And again, you don't get to see that either. But I saw like, she's going through my hair. She goes My God. She goes, you have all your color. She's like, you still have so much curl. And you're so lucky. She's like, never complained about this. And I was like, I won't complain about it. She was okay with you and pay you for it. I don't know what she was thinking. I think she was going to eat me or like lock me in a basement hole or something. But I was like, I was like, She's lovely. By the way. She cut my hair for years. I sat down she was what are we doing today? After she told me like how lucky I was. I was like, I hate my hair. We have to get rid of it. So what's wrong? I said, Look how big my head is. So I do have a I do wear a bigger hat like a seven. I don't know, like seven eighths maybe like a bigger hat. Right? Okay, and my head is bigger than some people's heads. I really I hated saying that out loud because I think everybody who listens but hates me secretly is like, oh yeah, we know you have a big head like but that's fine. Like that's good pay. I'm talking about physically My head's a little bigger than it should be. And now that I'm skinny, or it's more noticeable and when my hair gets all fluffy and curly. I will locked in. I was like, Look at how big my goddamn head is. And she's like, I don't know what you're talking about. I was like, look at it. And she's like looking. And I think she thought I was kidding. I'm like, I'm not kidding. My head is huge. I turn and give her my profile. And I'm like, look from the tip of my chin to the top of the back of my head. That's too long. She's like, What are we talking about? And then she looked for me, and she goes, Oh, I see what you're saying. And I was like, right, right, right. And then she just, like, goes into her bag. And she goes, Can I go really tight on the back and the sides and I was like, I honestly don't care what you do. I was like, I'm so I woke up this morning. I was so irritated with how my hair looked. And so I made a last minute decision yesterday. Randori. And I was like, do this. I didn't even have an idea. I was like, just changed my haircut. So anyway,

Johnna 50:45
my head is now I love your haircut, and

Scott Benner 50:48
my head looks more normal. So I'm being my point is I'm vexed. I've got beautiful hair is gorgeous. I don't want to lie to you. It's absolutely fantastic. When it gets too long. I look like I don't know, I look like a dry Q tip that got stuck in your ear. Does that make sense? Is that a visual? Everyone understands. Oh, goodness. Alright, so anyway, my head is too big. And now I have to keep my hair short. Because I lost weight. I don't know. I don't know why I told you that.

Johnna 51:19
I don't know better keeping your hair short than gaining the weight back. Oh, yeah. Oh, listen,

Scott Benner 51:23
here's what I've learned. Nothing tastes as good as skinny feels. That's a real thing. Yeah, I don't I went. I told this story in a weego V diary. What will be like six months ago now. It actually made me cry. I'm going to tell you I literally like sitting by myself recording a five minute diary entry. I unexpectedly started crying. And that was really crazy. I'm not I don't feel like I'm going to cry now. But

Johnna 51:50
and you felt so good after, didn't you?

Scott Benner 51:52
Oh my god, I've made my whole day better actually. Yep. I've had a lot of stress about work recently, which I know sounds crazy because I make a podcast but I have. And. And so we went out this past weekend, Friday night. We're just gonna do I think we're just gonna go on like a little shopping jaunt. My daughter actually likes shopping for clothes and not even buying them. She just likes looking at clothing. And so I was like, I'll go with you. Like I've had a long day I need to get out of here. So my wife and myself and my daughter, we all went went to a mall where you're walking around. And I said, I need some new shirts. And Arden's like, well, let's go get you clothes. Then we went into a store and we started shopping and I've probably never shared on the podcast, but I hate clothes shopping. And it because it's because I grew up like a fat kid. And it just it brings back so many terrible memories. I hate the way I look in clothes. I don't like looking in the mirror about it. Like like a lot of like those feelings that people have. They probably don't tell other people about, but I have them like, you know, like my mom bought me jeans at Sears that had elastic waist bands. So that's a tough one. And like like that kind of stuff. But I looked good in the clothing and in colors and and patterns I would never have put on. And I was just so like, happy. I've never once enjoyed shopping for clothing. And I had such a good time. And I was so pleased when I left and and all that anyway, I start telling the story in the week OB diary. And it hits me of how horrible I was to my mom while we were clothes shopping all the time. And I started thinking oh, I wish my mom was alive. So I can apologize to her about this and explain it to her. And then she's not. And then I started crying. And I was like, diary about my weight loss. Like how did this happen? Anyway, I don't know what the hell we're talking about anymore. You got to pump. And you got to CGM making the babies brought your agency down. But what do you mean? Like you got your agency down to make the kids but what so you had three babies without me and one baby with me? Is that right? Yes.

Johnna 53:56
What was the difference? And the agency or in

Scott Benner 53:59
your experience? Your experience having a baby, pre and post podcast listener? It's

Johnna 54:05
hard to say because I think there's more factors. So I use a tandem pump, which has the control IQ technology. And it's not recommended for use in pregnant mothers, or pregnant women. So with my third I had it turned off. So it was just whatever settings I had, that's where I was running man. Most likely, if I remember correctly, I probably adjusted what I was eating, or we just adjusted my settings based on what I was eating. So when I'm pregnant, I messaged my doctors weekly and I'm like, here's my numbers, tell me what settings to change. And they always say, you know if this keeps happening, change it yourself. And then with this one, I had a new so it's always the doctor and then the nurse practitioner. And so it was a new nurse practitioner. Because my previous one who was amazing our first child, we each had our first kid. They have the same birthday And she had three kids, once she had her third, she stopped practicing. And I was so sad. And so all of our babies were born about the same time. So, in getting pregnant with my fourth, I had a new nurse practitioner that was following up with me, in addition to the doctor, and she was not as aggressive as the previous one. Okay, so I started making more adjustments on my own, and less paying attention to what I ate. I'm just like, Oh, I'm gonna make these adjustments. But I will say also, and the adjustments came, also due to listening to your podcast.

Scott Benner 55:29
Okay, so I gave you the courage to make adjustments to your settings.

Johnna 55:36
Is that it? More? Yeah, a lot more

Scott Benner 55:38
frequently than I was prior. And you were focused on it, because you knew it was important for the baby. Yes, for sure. Wow. You're a bright person. I'm so this is gonna sound wrong. I am so stunned that it took all those years for you to like, and then for those confluence of things to come together for you to like, pay attention to it. Like now that you're, you've given birth to what I'm going to assume is your last baby, but God knows. Are you going to keep your agency in the sixes Do you think?

Johnna 56:08
I would hope so. Yeah, that's my goal. What would stop you some other giant health thing? Well, I guess if it were me personally, and it was a health thing, I would then make sure my diabetes was kept in check, and a little agency to not affect that other health thing. But let's say one of my kids develops diabetes

Scott Benner 56:25
or something, it took your attention away, because like, Oh, what, but then maybe,

Johnna 56:29
maybe it would be easier for me to keep mine because then I'd be so focused on what they were eating to keep their agency and stuff. But, you know, management for myself. Unfortunately, I don't follow the aeroplane rules to put the mask on yourself before you put it on others. Yeah,

Scott Benner 56:43
I don't think anybody I don't think anybody does that. That's just the thing we say because it sounds by the way, most of advice in the world is centered around things that we all really know, but don't do. And then we hear somebody else tell us and we think, Oh, they must do it, I can do it, too. And I think that the only difference between a lot of people just talking crap and, and trying to get clicks and downloads and this podcast is like, I'm actually telling you what we do. And those things actually work. And so like, give me like, if you're a podcast listener, you know what I mean? Like, it's easy to turn, like, you know, like, get up every morning at five o'clock and run 20 miles and you'll look like me. Well, yeah. Okay, thanks for the input. I didn't know, I didn't know that being an ultra marathoner would make me in shape. But you've crystallized that for me with your explanation, like there's. So there's a lot of, there's a lot of self help out there. That doesn't actually help anybody. It preys on how you feel, and what you know, is wrong with what you're doing. And you listen to it, because you feel like well, if I listen to this, if I read this, I'll do it. But that's not how it works. And I'm really fascinated and thrilled, by the way that you're so honest, that you're not 100% Sure, if you're a one C will stay in the sixes. And you don't know why other than to say that this is your personality. It's how you deal with things. And it's how you interact with your life. That's pretty much it. Right? Yeah. Well, I

Johnna 58:04
think it will now that I'm, you know, just bolusing more and like, Oh, I'm trending up. So let me get myself a little Bolus. Did you

Scott Benner 58:13
not understand, years ago that an eight and a half a one C was going to contribute to poor health? Or did you know that?

Johnna 58:20
Actually, I don't know that I'd been told that. I don't remember ever really hearing any of my doctors or educators or anybody harping on or even discussing a onesies. You know, it's always about food and post granules and fasting blood sugars. So

Scott Benner 58:38
they're reading to you out of a book. Oh, I'm sure yeah, this is not coming from some personal experience or some like well thought out. Advice. This is absolutely no, I learned this in medical school. This is what I'm supposed to say to you. Wow. Yeah. That's crazy. Listen, I know it's not crazy. I've right. You know, I've been doing this a long time. I know it's almost expected. I Jenny and I are literally six episodes deeper, recording another one this afternoon into making a whole like series about talking to doctors about what they should be saying to people.

Johnna 59:09
And with being pregnant. A couple things that I had never heard the doctors never said, I somebody was on your on one of the podcasts and said at the beginning, the first trimester, your insulin needs go down. And I didn't know that. I also did not experience it with the first three kids. So no doctor has ever said that to me. It did not happen. My fourth it did happen to the point where I was working and they had to call the paramedics.

Scott Benner 59:39
So for three babies in a row, you didn't have that drop in insulin need first and second trimester. And then it bounced up in the third but it happened to you on the fourth kid. Correct? That's bonkers.

Johnna 59:52
And then another thing that I also mentioned to the nurse practitioner and she's like, Oh, as like she didn't know this In your third trimester, not even your third trimester, but like the last six weeks to a month, a month to six weeks of your pregnancy, your insulin needs also go down after drastically going up during the second trimester. Right? And ended the third ping

Scott Benner 1:00:14
pongs. Yeah, you have to really stay. And then did you have in any of those pregnancies, any of them in any of your myriad of pregnancies? Did you? Did you notice your needs? Jump right up after you delivered the placenta?

Unknown Speaker 1:00:30
No, no. Well,

Johnna 1:00:31
I will say the the recommendation was to change everything by 50%. So I did that. But with my second and third, will actually with all of them. I was like, Well, I still need to, you know, change things. And then with my fourth, I was like, I'm not going to do quite 50% Because I seem to be higher than I wanted to be.

Scott Benner 1:00:51
After the baby was interesting. It was so different for you. All right. Definitely the same father for the fourth one. I'm just kidding. Yeah, I would have would have nothing to do with it. But I just yeah. Wow, is that something? I will say this, you're not gonna have any mental health issues around your diabetes? Because you go with the flow? For sure. You really do. By the way, that's something we haven't dug into enough. You have four, four children, and have a job, right? You have a husband, a job for children. You listen to the podcast, you know, many people tell me I don't have time to listen. I'll say to them, like, Look, you don't have to be like to listen to every episode. But check out this bowl beginning stuff, or, you know, dive into the Pro Tip series. I think it'll really help you. And they'll say, I don't have time to do that. And I'm like, What do you like, running a small country by yourself? Like, what? And then you so why do you have time?

Johnna 1:01:44
I don't know, it became when I had two kids. Things were really easy. But you know, when whatever number of kids you have you think that's really the hardest thing ever. And then you have more kids, and you're like, Oh, one last was way easier than this one. So I will say when I had three kids, it was definitely hard. Now that I've got four, you know, he's only six weeks. It's about the same as having three. So what's one,

Scott Benner 1:02:06
you have perspective now that you didn't have before, but

Johnna 1:02:09
the with two I was listening to I would put the kids to bed and then go do the dishes. And I'm the dishwasher, we don't have a dishwasher. So that's when I would listen to podcasts. And then during any commutes my previous job, I used to travel a lot for work, so I could listen to podcasts and traveling. And now it's every once in a while. So when I take the kids to school, I can sometimes listen usually not. But then once I dropped them off, and I'm on my way to work, I can get about 20 minutes in and same thing when I leave

Scott Benner 1:02:41
the next time you feel your husband's hand sliding under the blanket, I want you to say out loud, not until I get a king dishwasher. That's exactly what I want you to say. Okay,

Johnna 1:02:51
well, I ready for one we've been I've been fighting with him on this for the fight. I didn't want one. I'm like our kitchen is too small. We're not you're not putting a dishwasher in here because he could do it himself. But now I'm like, yeah, let's get one.

Scott Benner 1:03:05
No, you say it in that setting. You'll have one the next day. That's the first thing I want to tell you and tell him to let me let me say this. You want a little extra money spent on a Bosch because they're silent. Okay. Okay. You don't care where he gets he better go rob a bank if he doesn't have it. Because a nobody coming on this side of the bed till I get a silent dishwasher. I will tell him that anyone listening, I've just given you the best advice you've ever gotten in your entire life. A silent dishwasher is a few $100 more and will change the next decade and a half of your life. And you're welcome. There. I've done that. This should be my podcast where I just say things you don't know. And they're like three minutes long. Yeah, can you imagine if you flipped on a podcast and the guy's like, Hey, welcome to the podcast. Today's advice. Get a silent dishwasher. Goodbye.

Johnna 1:03:57
You might get more listeners if they figured they could have time to listen.

Scott Benner 1:04:00
Yeah, don't worry. I actually already have a series of short episodes in the works we're working on right now. But seriously that I did it and it isn't done. And then here like a disco Clang, Clang, Clang, clang clang for an hour in your house, is you don't realize how much noise pollution is. I can't believe I just use the phrase noise pollution but it's absolutely true. And there are dishwashers that you cannot hear the inside while they're running.

Johnna 1:04:23
I'm telling you do it. Well. I have four kids. So it might be hard to hear a dishwasher in general

Scott Benner 1:04:27
those kids are going to leave. When they're gone that dishwashers

Johnna 1:04:32
gonna be playing in this house by the time they leave. Oh,

Scott Benner 1:04:35
well that's another thing you can say when you hear the hand move and you go whoa, give me a better house. You made the space problem. Fix it. Oh my god. I don't know what you're doing over there. If you have another baby, I'm gonna yell at you. I just want to say I don't know you've ever defined you and be like China. What are you doing?

Johnna 1:04:56
Well, you know I do have to go so I can catch my husband. On his lunch break, so we can try making that next day.

Scott Benner 1:05:02
Right now. All right, well, you obviously have to go feed that baby. But I have one last question. I'll let you go. We're over time because let's be honest, you couldn't figure out which way was left and right. Are you named after someone in your family? Like your name is literally Gianna? You

Johnna 1:05:18
are correct that I am literally named Gianna. I am not. So here's the story with my name. Nobody in my family is John. They wanted a J name. So both of my parents name started with A J. My older brother who was adopted, they named him his name starts with A J. But he's five years older than me. Six years school. Is that fine? Or no? Yes, six year school wise five, age wise. So when he was in school in kindergarten when they got me, and they realized there were like three other kids with the same name. And they're like, Oh, that's too common. We want our daughter to have a J name, but not common. And like Jennifer was really common at the time. And I don't know what else they were considering. And I guess they were asking around and somebody mentioned Gianna, and they went with it. I'm gonna

Scott Benner 1:06:05
tell you two things that I'm gonna let you first thing is this exact same thing happened to us. We chose Cole. And then when he got to kindergarten, there were like three or four holes. And that's how we got to Arden. We did the same thing. It was like maybe that we thought Cole was different, but I guess it isn't. The other thing is, and this is just, this is food for thought for you to take through your day. The detail about whether or not your brother how old he is more than you? Yes, completely not important to what you just told me. I had to throw it in there. But it doesn't matter. I'm just telling you. I don't think you're going to change and I'm not asking you to. You're pretty perfect the way you are. John, don't don't change. But no, seriously, but that's what I'm talking about. Like you dug into a detail with 10 or 12 words that had no impact on the story.

Johnna 1:06:52
I can't help myself.

Scott Benner 1:06:55
I really do. Love you. I just met you an hour and six minutes ago. You're my favorite person. Thank you so much for doing this. Can you hold on for one second for me? Yes.

Want to thank the ever since CGM for sponsoring this episode of The Juicebox Podcast. Learn more about its implantable sensor, smart transmitter and terrific mobile application at ever since cgm.com/juice. Box, get the only implantable sensor for long term wear get ever since if you're looking for an omni pod dash or Omni pod five, use my link Omni pod.com/juice box. If you click on the link, I'll say fo mu mu. It doesn't really matter to me, we're making up a word. So call it whatever you want. The diabetes variable series from the Juicebox Podcast goes over all the little things that affect your diabetes that you might not think about. Travel and exercise the hydration and even trampolines juicebox podcast.com Go up in the menu and click on diabetes variables. And don't forget, if you have type one diabetes, if you're the parent of someone with type one and you're a US resident, I implore you go help with T one D research by filling out the survey AT T one D exchange.org/juice. box you have to fill it out completely. And when you do you'll be helping me and people living with type one diabetes.

Unknown Speaker 1:08:23
Let me say this.

Scott Benner 1:08:25
It's not going to take you more than like 10 minutes. So the next time you think you know I'm gonna go take one of those Buzzfeed quiz. You don't even like a Buzzfeed quiz. Instead of doing that, go fill out the survey T one D exchange.org/juice. box you'll be helping out. And I mean, then you can take the Buzzfeed quiz. You're just sitting on the toilet anyway. If you were a loved one was just diagnosed with type one diabetes, and you're looking for some fresh perspective. The bold beginning series from the Juicebox Podcast is a terrific place to start. That series is with myself and Jenny Smith. Jenny is a CDC II s a registered dietitian and a type one for over 35 years. And in the bowl beginning series Jenny and I are going to answer the questions that most people have after a type one diabetes diagnosis. The series begins at episode 698. In your podcast player, where you can go to juicebox podcast.com and click on bold beginnings in the menu. Thank you so much for listening. I'll be back soon with another episode of The Juicebox Podcast. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com

#1213 Bad Reviews

Kelly has type 1 diabetes and a son with 2 antibodies.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends and welcome to episode 1213 of the Juicebox Podcast.

Kelly is a 30 year old type one she was diagnosed at 18 and she has a son who is three who has sporadically weird blood sugar tests and is positive for two type one diabetes antibodies. Nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. When you place your first order for ag one with my link, you'll get five free travel packs and a free year's supply of vitamin D. Drink ag one.com/juice box. If you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes, but everybody is welcome type one type two gestational loved ones. It doesn't matter to me. If you're impacted by diabetes, and you're looking for support, comfort or community check out Juicebox Podcast type one diabetes on Facebook. If you or a loved one has type one diabetes, please go to T one D exchange.org/juicebox. and complete the survey when you complete the survey you are helping to move type one diabetes research forward T one D exchange.org/juice box. This episode of The Juicebox Podcast is sponsored by us med U S med.com/juice box or call 888721151 for us med is where my daughter gets her diabetes supplies from and you could to use the link or number to get your free benefit check and get started today with us met. This show is sponsored today by the glucagon that my daughter carries G voc hypo Penn Find out more at G voc glucagon.com. Forward slash juicebox. My

Kelly 2:10
name is Kelly. I've been a type one for 18 years. And now I have a son who has sporadic blood sugars and two positive antibodies. But he's not on any insulin or anything yet. So we're just waiting to see what happens. Oh, wait, let

Scott Benner 2:26
me let me get my notes. Here you are, when I

Kelly 2:30
filled out your form, I was going like super fast that I was like I didn't want to miss the time slot, right. And so I just went super fast and didn't put a whole lot of information because I remembered hearing previously that you don't ever, like look at the form. So I was like, oh, whatever, we'll just we'll just figure it out.

Scott Benner 2:47
I I run my eyes over them before I turn the thing on. I don't read them ahead of time. And you are smart. Because you know, I'm not this is not me boasting. Although I'm not above that. I'm just saying this isn't what I'm doing right now. But I think twice a year, say to people, Hey, you can be on the show if you want to. And usually within two hours, I fill up six months of my year. I believe that it's crazy. And then I curse myself for the rest of the year. Because we're so busy. That Listen, it's nice to say I record the podcast pretty much every day of the week, Monday through Friday, a couple of times a year I slip somebody in on the weekends, if that's what they need. I don't mind that it's an hour and a half. I have like an invigorating conversation with somebody. It's no big deal, right? Like I know how to make that work with my life. It's when something comes up. Where I don't know a company comes out with something unexpectedly or someone sends me a message and they're like, here's my story. I'm like, Oh my God, I need to record with you right away. I literally start doubling and tripling up my days then because I don't leave myself any space that I have to do. But as I say that I didn't do it in 2024. And it's still 2023. So I have to plan ahead for 2025 not to have that happen to me. But I'm also not a great planner. So God knows that probably won't happen. I'm sorry. You've had type one for 18 years. Yes. I

Kelly 4:11
was diagnosed in 2005. Five holding, you know, I am all I'm 30 I have a birthday like next week. I

Scott Benner 4:19
am all 30 birthdays coming up. You're Oh wow. So you've had it for since you were like 11 1011 years old?

Kelly 4:27
I was 12. Yeah.

Scott Benner 4:30
And your son is how old?

Kelly 4:33
He is three. He'll be four next month.

Scott Benner 4:36
How did you know he has anybody's just

Kelly 4:39
kind of randomly tested him one day he had peed through his diaper the night before. And that was not typical of him. And I was like, let's just see. And it was right after he ate and he was like 250 or something around there. And I was like, oh, okay, well, that's weird. And so I had reached out to the pediatrician and he had reached out to the, the endocrinologist the pediatric endocrinologist, he did a few tests and then decided to run the antibody tests. I got a call a few days later. And I picked it up. And it was the doctor, it wasn't the nurse or the or the office staff. It was the doctor and I was like, Oh, crap, I know what that means. So he told me that two of his antibodies were positive. And then we entered into trial net. And so they're following him now to and we see the endocrinologist with him every few months, and we're just watching and waiting and seeing what happens. Telly,

Scott Benner 5:34
you know, I think that some people would hear you say, I tested his blood sugar was 250. And I thought, Oh, that's weird. And they think, and they think, oh, Kelly, you have type one diabetes, you thought, oh, he has diabetes. But I think this is a sign of the hopefulness of human beings. I really mean that. They you saw that and just was like, well, this could be potentially weird, but doesn't necessarily mean he has diabetes. And I honestly mean that I think I think that that hopeful nature, even in the face of things like that, I think that's how we persist. So I'm sorry, that happened. I can't imagine how upsetting it must have been. How long ago was that? That you had this experience?

Kelly 6:16
It was over a year ago? He was he was two at the time. I want to say it was like last summer?

Scott Benner 6:26
Do you look at him and think he has type one. Like when you if you were going to be honest with yourself, like when you think about him? In your mind, he has type one diabetes, or he doesn't, but he will or how do you think of it?

Kelly 6:38
Ah, it's kind of in between, like, I think of it like he kind of does like he's he does have a Dexcom. So we got that all situated. We got it all sorted out. We got insurance to approve it. So he wears a Dexcom. So I see that and that's like, seeing what his blood sugar's are doing regularly where he spikes to 300 but then sometimes they'll drop back down to 40. Right. So he's all over the place right now. And so I'm like, yeah, like he's for sure it got some stuff going on. But he's not. He's not being treated with anything yet. So I'm like, I know that he will. And he kind of does, but I mean, I don't I don't know that I have like a clear answer for that.

Scott Benner 7:19
Did you look at tz old?

Kelly 7:21
Um, yeah, but he's only three is too young for that. Right? Yeah. And also I kind of, I kind of hate the, the in between not knowing when it's gonna happen. And, to me, the TZ yield is gonna prolong that at this point. I'm like, can it just happen already so we can get a tackle on like, get start tackling it and then move on. Because it just it feels like this. This weight on the shoulders just waiting for a top and

Scott Benner 7:49
that's what I was gonna ask you about has the last year been difficult for you?

Kelly 7:53
It's gotten better. It was really hard at first because I see him spiking to 300 I know how crappy that feels. And I'm like, I want to do something about that. That does not feel good for him to be there. But you know the doctors I guess it's gonna come down eventually he's fine and I'm like, oh my god, he feels like crap like that's not okay.

Scott Benner 8:13
And giving him insulin would probably cause a low later is that what you're thinking? If you take insulin or sulfonylureas you are at risk for your blood sugar going too low. You need a safety net when it matters most. Be ready with G voc hypo pen. My daughter carries G voc hypo pen everywhere she goes because it's a ready to use rescue pen for treating very low blood sugar and people with diabetes ages two and above that I trust. Low blood sugar emergencies can happen unexpectedly and they demand quick action. Luckily, G voc hypo pen can be administered in two simple steps even by yourself in certain situations. Show those around you where you storage EVO Capo pen and how to use it. They need to know how to use Tchibo Capo pen before an emergency situation happens. Learn more about why G vo Capo pen is in Ardens diabetes toolkit at G voc glucagon.com/juicebox. G voc shouldn't be used if you have a tumor in the gland on the top of your kidneys called a pheochromocytoma. Or if you have a tumor in your pancreas called an insulinoma visit G voc glucagon.com/risk For safety information. diabetes comes with a lot of things to remember. So it's nice when someone takes something off of your plate. US med has done that for us. When it's time for art and supplies to be refreshed. We get an email rolls up in your inbox says hi Arden. This is your friendly reorder email from us med. You open up the email to big button that says click here to reorder and you're done. Finally, somebody's taking away a responsibility instead of adding one US med has done that. For us, an email arrives, we click on a link and the next thing you know, your products are at the front door. That simple. Us med.com/juice box or call 888-721-1514. I never have to wonder if Arden has enough supplies. I click on one link, I open up a box, I put the stuff in the drawer, and we're done. US med carries everything from insulin pumps, and diabetes testing supplies to the latest CGM like the libre three and the Dexcom G seven. They accept Medicare nationwide, over 800 private insurers. And all you have to do to get started is called 888-721-1514. Or go to my link us med.com/juicebox. Using that number or my link helps to support the production of the Juicebox Podcast.

Kelly 10:54
More than likely already he especially if he hits that 300 mark is body overcorrect and he drops to in the 40s. So I can't imagine I mean, I don't know my husband and I have been trying to brainstorm and figure out what there's got to be something that we can do. But I mean, at this point, overnight, he's writing in the 90s, you know, on his own, so

Scott Benner 11:21
does he not always spike with food? I

Kelly 11:24
mean, it depends highly what he eats. But he I mean, we aren't like we don't carb restrict or anything. He's He's three. And if I can get him to eat, I'm happy. So I mean, he'll eat like a bowl of ramen noodles, you know what I mean? And that'll spike him. But

Scott Benner 11:37
where my brain was going on that is, if you got ahead of a spike and stop it from ever happening. Would that not stop your body from trying to bring down a blood sugar? Right? So is it not just the timing? If you used insulin? I'm not saying you should. I'm just I'm wondering out loud. If you use insulin, using it after the numbers big. Now you're doubling up with what the body's like, oh, god, look, I can do something about this. But but if you did it before, and the number will never went up. Would the body react? Yeah. Where does the body still see the food and go, Oh, this is going to create a high blood sugar I need to put in something like I don't know how that would work? Actually.

Kelly 12:15
Yeah, I don't know either. And I've considered just trying it. So he did have my son did have a few days where he was writing. Like, the doctor has the note right now that he if he's over want to say 300 for more than three hours or something like that, like you can give him half a unit. And I'm like, okay, so we had picked up we had filled the human log prescription for him. And so I'm every so often I'm like, what if I just try it and see what happens. But I mean, to be very honest, the reason that I haven't is I'm like, if he has a low and we need help, we need to go to the emergency room, whatever. I don't want to get in trouble or get, you know, get my son taken away because I'm using this where I'm not supposed to.

Scott Benner 13:07
There's a lot of concerns there. Actually, even as I started talking through my idea, I thought, how would the body know that the blood sugar wasn't going to go up? The body is not reading a number, right? It's not reacting to a level. I don't even know now I'm wondering, she's gonna make myself a note how the hell does real insulin work? See ya. Yeah, let's find out about this is

Kelly 13:25
what I'm saying. I wish that his I wish that his antibodies would just take the rest of them and so that we could take over because I know how, you know, I know how injected insulin works. I can do that. But it's like this, this terrible in between that we're dealing with now. I'm like, I don't know how to do it.

Scott Benner 13:41
I don't know. It's crazy. It's terrible. Other children?

Kelly 13:44
I have three Yes. I have two girls. They are five and eight. And then my son is three.

Scott Benner 13:51
And how do you think your your husband's known you the whole time you've had diabetes? Right. So what was his reaction? did he expect this? Was he concerned about it?

Kelly 14:02
Like you mean concern that my? Yeah. Not uh, he was never openly concerned about it. Were you? Um, I mean, it's, it has always, you know, been on my mind, but I don't know that it was like a major concern. Like I just I just knew to you know, kind of watch out for things and that's kind of like what I said when he had peed through his diaper one night. I was like, oh, that's odd. Let's see what his blood sugar's

Scott Benner 14:29
doing. You're ending up other type one in your family. Nope, just

Kelly 14:34
me. I used to call myself the lucky one.

Scott Benner 14:37
Did that get boring? It did.

Kelly 14:39
It feels wrong. Now that like my son has that I'm like, I can't imagine ever saying something like that about him.

Scott Benner 14:45
Funny when it was about you, and that's mean we shouldn't say that. Exactly. Any other auto immune on either side, your husband or yours?

Kelly 14:54
I don't think there's really anything at all on my husband's side. Um, my side I think it's really just me honestly,

Scott Benner 15:05
Kelly, you're Irish?

Kelly 15:07
No, actually. I'm like, I'm like 50% Czech, and I don't know what the rest of it is.

Scott Benner 15:13
Okay, check, please. Can we call this one check? Please? Maybe? That's not a bad idea. Let's write that down. How about on your husband side? What's his background? I have no idea. You married that man. You don't know what he is?

Kelly 15:26
I mean, I know enough. But no, I don't.

Scott Benner 15:32
Really, you're such a lovely person. Okay, so there's no autoimmune on either side that you know of. You're the only one with type one. Got it? All right. I'm clear. What made you want to be on the podcast.

Kelly 15:46
I just I, I had to really listen to quite a bit. And I don't feel like I ever hear about, you know, really small kids are really young kids. And I also don't hear a lot about, you know, this kind of in between diagnosis that we've been talking about where it's like, kind of diagnosed but not really diagnosed and and how to handle it. I

Scott Benner 16:10
guess. I think you're handling it the way you're supposed to handle it. You try not to scream, and then you wait for diabetes to come. Are you prepared with glucagon for myself? In the house just in general? I mean, I have some for myself. Yes. Do you know how to use it on him if he needed it? I

Kelly 16:29
would I mean, yeah, well, it would just be the adult dose because I don't have his but yes, I do.

Scott Benner 16:34
And do you think he feels those lows when he goes to 40. Sometimes,

Kelly 16:38
some of them the other day, it was just a couple of weeks ago, he was low dropping, I have it set, I have his Dexcom alarms on my phone or the follow alarms set that I don't get any alarms until it's 55. Because the endocrinologist said, if his body is naturally creating these lows, don't treat them. And I'm like, okay, that really that's, that's really hard. And so I set it, so it doesn't give me any alarms until it's at 55. And I get this 55 And it's straight down and I'm like, oh boy, it dropped down into the 40s. And all of a sudden he crawls up on me next to the couch, just flat as a pancake and bawling his eyes out just scream crying and I'm like, Okay, I think you're feeling this one. I'm gonna treat it.

Scott Benner 17:27
Oh, God, I'm sorry to even ask this. But how does that make you feel?

Kelly 17:30
I mean, mostly frustrated that I'm not supposed to treat them. Yeah, you might you know what I mean? Like, I'm like, Come on, just give him like two marshmallows at 70 and call it good enough. Like,

Scott Benner 17:41
can I ask you why you wouldn't? I don't know. Because I was told not to. Lie, please. You married a guy without knowing his background. Why are you listening to this thing? Why are you making sense over here and not over there?

Kelly 17:54
I'm just a rule follower. I

Scott Benner 17:55
don't know. I'll give you a new rule. Don't let them get to 40 There's a rule now you can take care of it. Perfect. That's exactly what I needed. Welcome. It's all done now. I mean, in my opinion, anything that's causing him that much distress? I'd want to avoid?

Kelly 18:11
Yeah, usually it's not like that. Most of the time. I don't see the lows. Really at all. It's it's rare that I do see any sometimes I'll just get real cranky with a low and it's not. I mean, I don't who knows if it is or not, he's three. He's kind of a jerk. But

Scott Benner 18:31
he never turns into like a drunk baby kind of video that you'd be like delighted by on Tik Tok or something like that. He's never like dancing with a hat on or something. It's

Kelly 18:40
I don't watch the video. I

Scott Benner 18:42
don't know what you're talking about. Um, and babies that crazy? I don't mean they're really drunk people. First of all, let me be clear, do not let your babies drink if that's what you thought you heard just now, but like when babies like her, you know, like all like goofy and somebody takes a video of him and it's funny like it's never like that. It's either he's crying and screaming or he's low and you don't really notice it.

Kelly 19:01
Yeah, yeah, he definitely doesn't get the goofy lows. Okay.

Scott Benner 19:04
So this is interesting, right? Because you have a firsthand knowledge of what a low feels like for you what a high blood sugar feels like for you. And so most parents when their children go through something medical they don't know what's actually happening so it's easier I would think just to like tell the doctor said this like it's fine but when you really know what a low feels like, that's why you have that Pang inside of you. That's like, I should not be letting this happen. Yeah, I think so. Yeah. Well, that makes sense completely. This has nothing to do with your kid. But I thought you find this interesting. This person has not been on the show yet but I'm in contact with them. I'm just gonna stay vague. A girl around 1314 years old, has had type one diabetes for three years. And about I don't know now nine months ago started taking a week go V for weight loss, and is now from something Like 16 units of basil plus meal insulin down to two units of basil a day and nothing else. No way that crazy. So I don't know what to make of that. Exactly. But her mom sends me graphs. Weekly. I look at them, she shows me where the food is. It's It's insane. I can't that's wild. I can't make sense of it.

Kelly 20:22
I wish I could get my insurance to approve that for you. Yeah, for me.

Scott Benner 20:27
Interesting question. Would you want to GLP for weight for insulin, but would you be what were your well? Okay, well, then you can?

Kelly 20:34
I can't.

Scott Benner 20:35
Why have you got crappy insurance?

Kelly 20:38
I have great insurance, but it's TRICARE. So they're really strict about trying to get through drugs that are not on their formulary.

Scott Benner 20:48
Oh, it's not it's not on there. Well, that could change. Listen, I'm no soothsayer, I am also may not even be a person who can pronounce soothsayer exactly right. But I think that these formularies you're gonna have a hard time keeping GRPs off in the near future. I

Kelly 21:05
did just recently start trulicity like, three weeks ago.

Scott Benner 21:09
Okay. That's a pill, right? No, it's

Kelly 21:12
a

Scott Benner 21:13
that's an injection to? Yeah, I mean, is it working for you? Did you notice anything, I

Kelly 21:19
get full faster. But as far as, like insulin adjustments for the first like two days of the very first dose, I was taking, like maybe 50%. Like, typically, my total daily insulin is like 100 units 220. For those first two days, it was at like 56 to 62, like half like it had. But after those two days, it's really gone back to normal. And back on my normal Basal settings, and my normal normal Bolus settings. Everything is, I don't know, I'll

Scott Benner 21:56
share this with you. Although I don't have enough information about it to be thoughtful yet. But I do have the experience of the last two and a half weeks art and began using a GLP. One, she's done three injections so far. And her last injection was like four days ago. So she's two and a half weeks into it. Maybe her Basal has gone from 1.1 during the day 2.8. And her insulin sensitivity has gone from 42. That's one unit moves her 42 to one unit moves her 68. Like that's a huge, a huge reduction in insulin sensitivity. Yeah, it really was a big number. And on top of that, and again, it's anecdotal at this point, but she just had her first period with it. And her acne breakout was, I'd say 90% less than it usually is. Really? Yeah. And she's lost like eight pounds. Oh, interesting. Wow. So that's two weeks on the lowest dose? And those are the those are the impacts we've seen so far. So did she lose the weight? Because she's not using as much insulin? Maybe? Is she losing the weight? Because she's not eating as much? Probably? Is it hard? Because the adjustment period is difficult. It is like it's not easy. You know, there was, I think, a day and a half when she had her period on top of the the injection where she was just like, I don't think she ate for like a day and a half. And now she's getting back into it again. So she's adjusting to the medication, which takes time. I don't know, it's not for everybody. There's people, you know, their stories all over the place. I don't know. You never know all the information behind the stories like some people tell you like, Oh, I got like, an intestinal blockage. And I'm like, Oh, that's terrible. Like, did you already have an intestinal blockage? Like, you know, like, I don't know, like, what the medication does doesn't do to people like what the side effects are? I've been on we go V which is ozempic for like, since March, March, April, May, June, July, August, September, October 10 months, I've lost 40 pounds. It's fundamentally changed my life. And other things have happened for me to I don't know how to put into words. I have not made an emergency visit to a restroom in like, a year. So I have not been in the situation where like, oh my gosh, I have to go to the bathroom. And if I don't get there, there's going to be a problem. That was the thing that would occur in my life before it does not happen anymore. I used to have really bad acid reflux. It's gone. Like little things like that, that I can't really explain. Anyway, the point about Orton is, is that she's not even on what they would consider a therapeutic dose yet. She's using point two, five and she's having all these like experiences already. So that's amazing. I can't see how it doesn't end up being something but type ones are prescribed in the future.

Kelly 24:49
I really hope that's the case. i I can only imagine how beneficial it's got to be mean. I had great success for the first two days that I took it And I, it's very possible that they'll have to increase the dose and then I'll start seeing that across the board. If it can lessen the load of the, you know, the amount of insulin that a person has to take, that would be incredible.

Scott Benner 25:13
Yeah, or spikes or your time and range or, you know, a number of other things. Yeah, my

Kelly 25:16
spikes have definitely been a lot more gradual. Yeah,

Scott Benner 25:21
right. That's a big deal. And, you know, geez, now, what's gonna end up happening is that people are gonna say, doctors are gonna, like, freak out, they're gonna be like, Oh, your insulin needs are going away, right. And we can't do that, because I don't know how to adjust your insulin. Like, it's been a thing that I've had to pay attention to, like, We purposely did it while she was home from school. Because I don't know that, like, while she was away, I don't know if she could have handled it, to be honest. Like, because it was it was a really quick like, hey, we need to move this basil, we need to move this, like, you know, she was getting a low for like, two nights in a row. And I'm like, Okay, that's it. I'm calling this thing. I'm changing your settings. And now we're back to good again. But still, like, she had a little bit of a rise the other day, like a 120, or something that stuck for a while. And I watched the algorithm push at it. And she got low, like three hours later, and the algorithm wasn't able to stop it. So that means I don't know exactly yet. Like that is one of those things where like, I don't really know what dial to turn to stop that from happening. So I'm still figuring the whole thing out. But anyway, I wish people luck. It's, I'm not saying it's for everybody. And, you know, I'm sure you can google and find out that, you know, there's like a fifth of what's the one article that somebody tried to point to the other day, when people were arguing about this online, there's been a 15 100% increase in calls to poison control because of ozempic. And I was like, let me look at this. It took me eight seconds of googling to find the story. There has been a 15 100% increase, but it's because people are odd on it, not because it hurts them because they use it like the person tried to make it sound like oh, if you put this in you're in trouble. You have to call poison control. But that's not what's happening. People are either Miss dialing the the insulin giving themselves way too much and slowing their motility down their gut motility down so much. They think they've been poisoned. So do you see what I'm saying? So like, ah, yeah. So what we really do is we have a problem with people who don't know how to use pens and or doctors who don't know how to direct their patients, or maybe people who are just like, if point two five made me lose a pound. I wonder how much three would do. Right, right. Like, I don't know, you'll have that. You know what happens? But it's anecdotal information that people point to and then go Oh, see, there's a problem. Like, I don't know if you know all the facts. I don't either, but I'm not sure you do. Anyway. So you got him a CGM, that your insurance company was like, no problem. Your kid who doesn't have diabetes can have a CGM.

Kelly 27:46
We had to fight for it. The endo had requested it once. With TRICARE, it's easier to fill Dexcom through DME, they submitted it for prescription and they were like, yeah, absolutely not. So they had declined it. And then I think I had asked on your Facebook page, and Samantha was able to help me write a letter and formulate a letter and send it in and say like, Hey, listen, this is something that is really, really needed, we want to watch, make sure that he we catch any, you know, problems before this becomes DKA and hospitalization, and that's gonna cost you all this money, right? And so we were able to submit that and are you with insurance and they were able to, we were able to get it approved. Finally, is Sam not magical? He's amazing.

Scott Benner 28:45
He knows how to write those letters, right? It's not her profession, but it easily could be. It should be honestly, like, she's so good. Yeah, the problem is Kelly is like, Where would who pays you if that's your job? That's true. That's the problem. Because the insurance company, of course, they don't want those letters to work. They wouldn't care. I won some years ago. I don't ever remember what happened to it. But I was like, why don't you work for a company? Like those companies need people to get on their products? And insurance companies stand in the way and these letters get get them through? Like, wouldn't it make sense for the company to have somebody on staff that helped people write these letters? And I don't know, whatever happened to that? I mean, I don't know if it was a good idea or not, but it's just the thing I said out loud when I first met her. Sounds good to me. Sounds like a good idea. Yeah. But she's brilliant at that. And she just really understands or is very good at picking through the documentation. Yes, at the insurance company side. I

Kelly 29:41
know when I told her that we had TRICARE she was like, oh, no, we might not be able to make that happen. But she's really good. She's amazing.

Scott Benner 29:50
I didn't know that's what you did. But that's that's really cool. And another example of why that Facebook group is fantastic. And what really lovely person in there who spent by the way, how much time with you do you think until Oh,

Kelly 30:00
you know, it's been a year and a half. I'm not sure. The phone were

Scott Benner 30:04
you going back and forth and writing? Yeah, we were just messaging. And then did she actually write the letter for you? Did she tell you how to write it?

Kelly 30:11
She sent me what I am assuming is more like a template. And then we kind of work together to fill in the details.

Scott Benner 30:18
That's a stranger doing that with you who you didn't pay. That's amazing. Yeah, that's really cool. Anyway, you guys should check out the private Facebook group. There's people like that in there and a lot more. There's also crazy people. But very few, so don't worry. Right, Kelly, the ratio of lovely to crazy in my Facebook group is very slanted towards lovely. Oh, for sure. Most, most are great. Most are great. That's perfect. But a t shirt most third grade? A few make you question your sadly. Fantastic. So you just want diabetes to come? Because of this weird way of putting it. But yeah, you're like, Please get here. I think this is a very common feeling for people who are in a honeymoon situation, which is technically what you are. I mean, your does your son technically have lotto right now?

Kelly 31:06
That's what I feel like I would call it but I mean, he's three. So yeah,

Scott Benner 31:11
well, we should call it something latent autoimmune. diabetes in little babies. It's, well, I can tell you this, I raised the kid from two years old Till so far, almost 20 who had diabetes, she weighed 17 pounds the day she was diagnosed, there was no Dexcom there was no, I love a pen dorso pumping. Like, I didn't have any of that stuff. And it's okay. I look tired. So, don't expect your like 50 year old photos to look fantastic. Maybe. But, um, but it's doable, you know? And do you work full time?

Kelly 31:51
You don't I stay home. I homeschool my my two older kids at the moment. So you know

Scott Benner 31:57
what? Good? Because, you know, I'm sure this fluctuates constantly.

Kelly 32:06
For sure. It's actually helped me a lot to listen through the podcasts and kind of your story and your recall of you know how it was to raise a type one toddler. And it's very different than when I was diagnosed at 12. Oh, for sure. You know, I mean, it's a whole it's the same disease. And yet somehow there's almost no similarities between me at 12 and him with the exact same thing. At three.

Scott Benner 32:31
Is it frustrating that your experiences aren't valuable right now? Kind of Yeah, you think I have all this like knowledge? And it's like, it's almost right for this, but not quite. Yeah, exactly. There's a great episode that went up yesterday, I think it's just called Anonymous guest. And that person talks about how their father's diabetes kind of poorly impacted their diabetes, because the father had it such a long time ago that like, you know, he would say things to her, like, as long as your blood sugar isn't over 250 You know, and now, you know, she has issues like moving forward, but he thought he was giving state of the art cutting edge information, right, all those years ago. I wonder too, he is not alive. But I did wonder like, if you could say that to him, like you were you thought you were giving great advice, and you weren't. Right. Not that you're not you're stuff that you know, right now, because you're moving with it. Right? Like, yeah,

Kelly 33:25
for sure. Things have changed a lot. I mean, I think what Arden was diagnosed 2006 2006 i It was around the same time I was diagnosed in 2005. Okay, so it's been it's it's been just absolutely wild to see the progression. You know, of course, we're all told, you know, when you're diagnosed like, oh, the cure is coming. Right. And so you get that hope for a little while. But it, you know, that fizzles out eventually. And it's been really, really amazing to watch the technology and just kind of the way that diabetes is cared for the way that that is all changed 18 years, like just in my lifetime alone. Yeah,

Scott Benner 34:10
it's been very quick. I mean, I'm sure if we could look back over other 18 year chunks, and put them in context. They'd all feel like they were moving quickly. But this one with the addition of these technologies, and now like some of these drugs, like it's really leaping and leaping forward very, very quickly. Yeah, it's huge. Before Dexcom figured out that if they had people working in Washington to help understand the process of getting stuff through the system, things did not move quickly. And as a matter of fact, it would take sometimes three years for a meter company just to put out a new meter. And you when it came out, you realize that wasn't really any more accurate. Yeah,

Kelly 34:51
it was no different than the last except for maybe the shape and the color. Yeah, they changed

Scott Benner 34:55
the shape and the color had a light now and they were like look, it's brand new and we were all like, Oh my God, look at this, it's happening. They basically put handles on doors and we were like your recap as you come up with this, you know, like, this is the best thing that's ever happened. But Dexcom stepped up, and they were like, okay, you know, we're making advancements, we need to get this stuff through FDA. And then they, you know, I don't want to make it sound sinister. Like it's not like every pharma drug company has people who understand the the FDA process, and therefore the submission process and, and the, you know, resubmissions that happen, sometimes all that stuff, you have to have somebody on site that understands that those things go smoothly. I think Dexcom was the first diabetes device company to take that seriously. I don't know, I'm guessing, but they probably went to the pharma world and picked out a couple of people who understood device regulation, and brought them over. And now the whole thing just moves so much quicker, just that one of those, like decisions that none of us will really ever know about. That made everything kind of leap. And now, it's to the point where people are online. Dexcom puts out a G six. And I say, hey, Dexcom is coming on to talk about G six. What are your questions? Inevitably someone says, What's this? When will the g7 be out? Like as they're still launching the six, you know? And then the seven comes out, I say to anybody have questions for Dexcom, about g7 wins the g8 coming up, like now people have that like cell phone expectation about it, which is pretty crazy, you know, especially given that Arden had a little meter. Oh, I didn't mean to curse, although I did that nice conversation. She had this little like meter that I had kept for so long. I just threw it away the other day. Like, and it was just this tiny little, probably not accurate thing that look, junkie, and I just tossed in the garbage. I was like, oh my god, I left that in the bottom drawer for 15 years. So sentimental. I don't know what a weird thing to be sentimental about. Right. But anyway, so things have changed. You've moved with them? What's your agency right now? And what how do you manage

Kelly 37:07
6.0? Well, it was my last day once a just a few weeks ago, I use the Dexcom J six, and I have the tandem, I don't know, x two, or whatever they

Scott Benner 37:20
call it. That's control like you. Yeah, with tandem,

Kelly 37:23
I was using central IQ for a few years, I've actually turned it off recently, because,

Scott Benner 37:31
well,

Kelly 37:32
I was having trouble where I'm I know that one of my settings has to be off. But it would suspend, you know, it would say you're going to be able to 70 so it would suspend. And then it would suspend for so long that eventually I would shoot up to like, you know, 160, which is not that high. But then you know, the the algorithm was not aggressive enough to bring it back down. And that was usually happening overnight. And so I would wake up at 160. And I might want to start my day in a really crappy place. And I feel like, you know, I want to wake up at like, 90, that'd be great. And so I just I fiddled with it for weeks. And finally I just turned it off. Because without it suspending I can ride 70 overnight, and it's fine. And I gather I know that it wants to leave you you know, 112 and a half or whatever it is. But it's missing the mark. Okay, and it's not getting me I would be fine waking up at 112. But it's missing that and I'm waking up at 160. And I know that something is wrong, and I can't find what it is.

Scott Benner 38:41
So can I ask you prior to your son's issues? Would you have done more than fiddle with it and then shut it off?

Kelly 38:50
I wouldn't have fiddled with it at all.

Scott Benner 38:53
Oh,

Kelly 38:54
wait a minute, I would have been like Oh 160 Cool, whatever. Oh,

Scott Benner 38:59
are you trying to figure out diabetes better for him?

Kelly 39:03
Probably that's when I started listening to the podcast is after he was well I don't know he technically doesn't have a diagnosis. But after we kind of learned all this about him is when I started listening and I mean it has given me a lot of knowledge that you know, at 12 They give you I wasn't hospitalized when I was diagnosed. So I was at my like the family doctor. It was i They checked my sugar it was like 470 something and essentially the the doctor came in was like hey, you're type one diabetic sent me home. And again you'll go to Children's Hospital in the morning. They sent me for the entire day and then sent me home like they just sent me to do you know the the learning the teaching, like you know they teach you everything and they send you home and tell you to deal

Scott Benner 39:55
with it. What a great hospital they were able to teach you everything about type one diabetes and just today Did I

Kelly 40:00
mean we were fine? We were fine. I never died. That was everything that you really know. And you know, I feel like once you're taught things or or you go to a new doctor, right, and they just assume that the doctor before taught you, and so you don't ever learn more things like you kind of learn everything right at that moment. And yeah, the podcast itself has helped just really teach me some of that in between stuff like, like you said, they they taught me everything they know in one day, and then you never really get more information and more knowledge more, like, just stop there. Fine tuning

Scott Benner 40:40
and listen to you, and art. And we're, like you said, diagnosed around the same time. So it's counting carbs. It's insulin to carb ratio. It's will set your Basal and then you'll go back to the doctor if it has to be changed. And this is how you put an injection in a banana. and launch it get out of here. You're silly kids. Like, yeah, right. That's, that was that's what we got. The first time one of the questions pops up into your head. You know, when you the first time you think about a little broader you go, I don't have enough knowledge to make this next decision. Yeah. And then kind of I called the night Arden came home from the hospital. I called the endocrinologist at four o'clock in the morning and woke her up. No. And she's like, You can call me if you need I bet you should meet at four in the morning. But anyway, I woke her up. And I was like, this is Arden's blood sugar, and I want to give her this much insulin. Is that okay? And she was like, Yeah, I guess it sounds right. Oh, my God, this is the level of help. And that's a woman who was willing to give her personal phone number to me. That was still the level of help that she presented. Yesterday me mean, like, it wasn't any grand breakdown of the situation, or like an understanding of bigger ideas. And I don't think that's her fault either. I think the advent of CGM has really opened people's eyes in general to what blood sugars are doing. I know that we like to think that years ago, doctors just weren't telling you everything because they didn't think you could handle it or you didn't have the tools. I don't think they knew either. Yeah, yeah. I think the first time somebody said Oh, it went up to 300 and came back down. You didn't get low. That's fine. I think they meant that. Yeah. You know, and I was one of the you know, I was the person that would said, How do we stop it from getting highlight that, like, couldn't we do that? And they were like, No, bitch, I could. And then honestly, if you've really listened to the podcast, it's not until Arden's nurse practitioner tells us about Dexcom for the first time by telling us a story about another person. They put the CGM on the kid, he was like a 16, or 17 year old kid, I think. And the kid was like, Oh, I'm going to be able to eat my favorite candy again now, because I'll figure I'll figure out how to do this with this data. So it was that kid's mind. Having that thought, telling the nurse practitioner about it. She used it as a story to try to sell Dexcom to people because she thought she was saying you could eat candy. Like she wasn't being like high minded about it. You know what I mean? And then I heard that and thought, Oh, I understand what that kid is saying. What if we just put that on everything? And not just a snack. And then we start talking about it. Nine years later, you, Kelly, have the news about your child, find the podcast, and you're going to be really ready for him. And it sounds like you're doing better for yourself. So I I kind of wrongly assumed that you've been listening for a while. And you're just now here in your here telling me about your son, but you started listening because of him. So go back five years ago, what was your one C then

Kelly 43:47
five years ago? Let's see I have a five year old. So you gotta go back further. Before I had my first kid. I know you talked about it all the time. Right? Like, Oh, you did it because for another person. When I got pregnant with my first my agency was like, 10.1 I think? How old were

Scott Benner 44:07
you then? 2121. Did the math earlier when you said you're an eight year old? So. So you're 21 your agency's in the 10s and you didn't get pregnant on purpose?

Kelly 44:19
No.

Scott Benner 44:23
Sorry, I don't does anybody get pregnant on purpose? Are there just levels of like, I'm not going to try to stop this from happening. Okay, so that happens and you've you go to the doctor who probably flips out I'm imagining.

Kelly 44:40
Yeah, so I went to the OB I was only like six or seven weeks pregnant like very, very early on. My husband. Well, he was not my husband at the time. Yeah, he was out of town. I take my mom with me or

Scott Benner 44:56
she must have been thrilled.

Kelly 44:59
Is If we don't get along, let's put it that way. We're talking to the doctor and she for whatever reason, tells them like, oh, yeah, she hit over, you know, on the I didn't have a Dexcom at the time. So she tells me or she is talking, I had checked my blood sugar on a meter. And it had said, Hi. So it was over 600 which happened in later pregnancies as well just not at 600. But just ridiculous spikes really early on for me. And so she says that in the middle of the appointment in front of the doctor, and they admitted me to the hospital right away. Like all we got to figure this out, this is not okay. And I'm like, well, you're you're right. It's not okay. But like, I'm not 600 right now. Like, it was at like, 95. Right. I was like, I don't need to be admitted last. That's an

Scott Benner 45:49
average. But thank you. Great average, but it's not Yeah, that was my blood sugar's right now, way to tell me you don't know anything about what you're talking about? Yeah.

Kelly 46:00
I did not stick with that doctor's office.

Scott Benner 46:03
But but so you're so you're smacked immediately with that? Oh, wow, I have to bring my agency down by four points to have a healthy pregnancy. Hmm. How quickly did you do that? And how did you do that?

Kelly 46:16
It was really fast. When I say that, like that weekend that they had it. It made me that a hospital it was down to nine point something already. And by the end of the pregnancy, I was at 5.7.

Scott Benner 46:31
What did you do to lower it.

Kelly 46:32
So the maternal fetal doctor that I ended up going to his wife was type one. And so he actually you would go, I would go in about once a week. And he basically became my endocrinologist. He went through my pump settings, and he would adjust every little thing for me. And he kind of did it all for me at that time.

Scott Benner 46:57
So you met somebody who had some expanded knowledge who looked at you, and were like, you're not getting this done on your own? Basically. Yeah. And so was your higher agency mostly because of settings? No, no. Was it food settings not Bolus thing is it that is like the trifecta.

Kelly 47:15
I would say, and I don't know if this has to do with like age at diagnosis, or just my own mindset from probably age 1421 When I was pregnant, like, I didn't really test my blood sugar, like, maybe once or twice a day would just like, if I felt low, I might check. Sometimes I would just treat. And I mean, I would still take, you know, a Bolus or whatever, just to cover the food, but I wasn't really do ever doing corrections.

Scott Benner 47:53
Were you in the situation where you were diagnosed old enough that your parents are like Kelly's a good girl, she can take care of it. And they left you to your own devices? Yeah. Okay. Something like that. And when you said earlier, you don't get along with your mom really? Well, is that because you don't feel like she looked out for you as a child?

Kelly 48:10
Probably. But I mean, I'm sure there's more.

Scott Benner 48:14
Also crack. No, I'm just kidding. I'm sure your mom did do crack. And I didn't mean to say she did. I was just so that I mean, it's very common story. Like it's it's a mistake a lot of parents make. Yeah. But like that kids old enough for this, because they don't really even understand it. And they can come to the conclusion of like, well, we taught them to give the injections. They know how to do that. So that will just tell them to do it. And they'll do it. Exactly. Yeah. But that's listen, if you're thinking about right now, as a parent, I'll come out and say this, you're lying to yourself, or you're an idiot. That's one of the two.

Kelly 48:51
And it was it was really challenging. I mean, a lot of it is on them. Like they should have taken the reins and dealt with it. But I was also 12 I didn't want them to help me with anything. I wanted to handle it on my own. Like I was like, Oh, well, I know just as much as you do. We sat through the same classes together. Like I got this meaning

Scott Benner 49:11
list to me, Kelly, okay. I know, I've been a parent a long ass time. The amount of things I have to say to my kids that I know they don't want to hear from me is uncomfortable. I know why people don't want to do it. But that doesn't mean you get to skip it. I hate to say something to Arden yesterday, as I was saying it I was like she's gonna be pissed when I say that I was like, but it's my job to say it. Right? So what am I gonna do? Now? If she disregards me, she gets older and older and older, and, you know, sets herself on fire and explodes on I tried, but I can't go oh, she's not gonna like it if I say this to me, or she wants to do it on our own. So like, you have to find a way to communicate

Kelly 49:52
definitely like not pointing.

Scott Benner 49:57
And I'm not saying Listen communication, probably the root of most problem seems like people are poor communicators overall. Like I get that it's not specific to your mom or you know anybody else and I struggle with it. And I, I mean, you can make an argument that I communicate for a living now and still in my private life. I'm like, I'm gonna do this wrong. I know I'm gonna do this. You know, like, it still happens. But Jesus, you were a 10 when you were 21? Yeah, yeah. Yeah, you look back. Now, what does that? How does that make you feel?

Kelly 50:27
It just makes me like upset that I wasn't paying attention to it at all. I feel like at that age, you really feel invincible, like nothing's ever gonna happen, like you hear about. You hear about the complications that can happen. And you're like, Whatever, I'm fine. And I mean, I still am for now. But for now.

Scott Benner 50:51
You got to it in time, you know, it means you're pretty young. And hopefully, maybe you're talking about seven years in there, right? With like a double digit day one, say,

Kelly 51:01
when I still lived at home, I think a one sees were seven, maybe eight and a half.

Scott Benner 51:08
And that's a function of your mom being like, Did you test and stuff like that? Probably

Kelly 51:13
not. I mean, maybe I truly don't have a lot of memory of that time. You're

Scott Benner 51:19
probably not cut every mother so deep just now. Because you didn't say, oh, that lady. No, she didn't help me. Kelly, that was something. I took a lot out of those two words. I think I'm right, by the way. Okay, so just maybe because you were in that setting, it was more controlled. Maybe it was just you were following some of your own rules that you knew you had.

Kelly 51:46
Yeah, I mean, even when I am sure. I know that they used to ask me, you know, did you test what's your number? I to this day, I'm very uncomfortable, like I will show you but for whatever for some reason, telling you like saying the words I am you know, 170 Physically pained me at the time. So they would ask and I would probably either lie or just like, throw the meter on the table near them and be like, here, look at yourself. Oh, he's up my ass. Tell me I'm wrong. To bring Steve. I mean, in my head I was but outwardly

Scott Benner 52:33
to go put a second coating of black nail polish on now. Leave me alone. I'm afraid you'll see the whites of my nails if I don't. I hear you listen, it ain't easy. Like right. Like it's not easy to raise a kid who doesn't have anything medical going on? So let's say then this guy knocking you off pretty much saved your life.

Kelly 52:53
I mean, I don't know if you want to give him that much credit. But no, he's he's great. I love him.

Scott Benner 53:01
He's amazing. Yeah. Listen, how can you me you've set your parents at a pretty low bar. So you're I don't know. Honestly, Scott. I don't know if he's great. Or if it's just that he's here and he looks at me. Oh, you're making me reevaluate this. He might be terrible. It's might just be a perspective thing. No, I

Kelly 53:21
will say I have a great relationship with my dad. I love him. He's amazing. And my husband reminds me a lot of my father.

Scott Benner 53:27
Okay, lovely. I'm worried that I just made a bunch of women right now go Oh, my God, I have accepted so much less than I deserve because of how my parents were. Don't all go getting divorced. I'm sure you can fix them.

Kelly 53:38
It's not uncommon for people to

Scott Benner 53:41
Oh, you don't think that's uncommon? Every time you hear somebody say that if one generation of parents just took their jobs super seriously, and they were selfless. It would change the entire world. It's completely true and will never happen. So just too many people. But Bilasa bomber sorry, everybody. So your agency comes down to because you you want to be there for your your first daughter works and then you keep it down or she comes out and you're like, ooh, here I come. 10 What do you do afterwards? No,

Kelly 54:16
it's really stayed down. All of my kids have birthdays in January. So only

Scott Benner 54:21
horny once a year, apparently.

Kelly 54:27
I really enjoy April.

Scott Benner 54:31
I love Easter, Scott. I don't know what to tell you. Alright, sorry. That was inappropriate. I apologize for saying that. Anyway, what were you gonna say? Oh, my kids reporting January what?

Kelly 54:48
I was gonna say it's been nine years since I probably had that 5.7 When I was pregnant with her and I would say the highest that I have seen since then was probably I'm guessing I saw like a 7.8 right after she was born. Okay. And other than that, it's been mostly fives.

Scott Benner 55:14
Wow, good for you. That's really wonderful. I happen to know because you're in the group, but did your thyroid pop after the baby's or did you have a thyroid issue before? No,

Kelly 55:23
I actually got diagnosed with hypo thyroid. The same time I was diagnosed with type one. Oh, well, the same lab work

Scott Benner 55:32
you mind if I quote one of your tweets or one of your posts? Sure. Go ahead. My most recent TSH was 10 ish. Geez. I added site a mil so somebody's not managing your thyroid. Well, either. Yeah. What backwards state are you in? By the way?

Kelly 55:49
Um, we live in Florida right now. I'm

Scott Benner 55:52
sorry. I didn't mean that. I'm huge in Florida. I'm not insulting any of you. I love you guys. So how are you? How long is your TSH been that high?

Unknown Speaker 56:00
This is the only

Kelly 56:02
Well the last time I got bloodwork done was a year ago and it was two or so little under two.

Scott Benner 56:09
Kelly, are you not going for bloodwork every year for your thyroid?

Kelly 56:13
CoreSite? Yeah, what a question.

Scott Benner 56:15
How are you? Um,

Kelly 56:17
I shouldn't be doing it every six months. I usually go once a year.

Scott Benner 56:21
Okay. So you just had a big spike in TSH? It's not that it wasn't well managed before.

Kelly 56:25
Yeah, I've never felt particularly great. They did add the T three, the site ml. And so far, I think it's helping but I also. I mean, who knows? I might just think it's helping. So I don't know, the last time.

Scott Benner 56:43
I love the way you talk. You're like, oh, no, I've never really felt great. You know, when people talk about happy, I don't exactly know what they're talking about.

Kelly 56:57
The last time before now that my T three was checked, and I don't know how accurate like T three bloodwork is. But the last time that I had the T three checked was in 2017. Okay, so they've been checking T four TSH, and I don't know what else, whatever else. But the last time the T three was checked was 2017.

Scott Benner 57:22
They gave you site ml this time. Yeah, that helped anything? I think so more energy.

Kelly 57:29
I do have more energy.

Scott Benner 57:31
You feel more well rested? Yeah, yeah. Yeah. Okay. I love it. I have to say I love it. GLP for you, can we get that? How does that happen? Let's get you out of that insurance.

Kelly 57:44
You know what my husband's getting out of the military in September. I'm so excited.

Scott Benner 57:49
Oh, you see, maybe there's a chance here. There might

Kelly 57:52
be in like, you know, nine Marma.

Scott Benner 57:54
You have a job lined up? No, not yet. I mean, so far, the job of getting you pregnant on a consistent basis. Seems like he's good at that. Because, yeah,

Kelly 58:02
maybe he'll find a job in May.

Scott Benner 58:05
Yeah, when he's all happy. And later. By the way, for everyone wondering, I know, you've heard me say over the years, like, you know, I don't I only let out like a small portion of my sense of humor, because I think if I let it all out, it would just like you guys would all run away. Because I could be clear with you as far as stupid, childish humor goes, not not me as a whole person. But anyway, that that happened to me too quick, like I was already giggling. So my inhibitions were gone. And then you said April, and my, my brain goes Easter. And then it says, say something stupid. That's all that all comes out. Just so you know how it works? In my little head. I'm not apologizing for it. I actually think it was hilarious. But

Kelly 58:49
no, that's all how to present my sense of humor. Like,

Scott Benner 58:52
yeah, I imagine you would have hung up if it was like, and that's where the interview ended. And by the way, if that happened, I would have played it just like that. It just wouldn't come to a dead stop. I would have like in a very serious voice like months from now been like, Kelly left the call and never returned. I don't know what happened.

Kelly 59:12
For some reason we're posting a short episode this Yeah. I

Scott Benner 59:16
don't know what she just I mean, she's no sense of humor on that girl. Anyway, yeah. Okay. I don't know what to do. Now. I'm lost at this point. In case you're wondering. I've lost my way. And I have to record with Erica in an hour. So I'm like, trying to like I stacked my recordings up today before I have to leave. So here's what's happening. I'm leaving. Today. I should say this in the podcast. I am leaving today to go retrieve my son from Atlanta who has now been there for just two weeks shy of a full year. His contract is up on his job. He could have resigned it but he did not want to resign a year long lease. He thinks that he has learned everything he can learn from this position. And that now he is basically just poor forming a task, which there'd be nothing wrong with if that was the job he really wanted. But he was down there to get experience. And he's coming home now to start looking for another job and gain a different experience. He's also considering a master's degree. But anyway, I get to go get my kid. And so when I get done with you, I eat an egg. I record with Erica, I probably get rid of the egg, then I get my car. to Now my afternoon is gonna go I assume I'm gonna go to the bathroom around 1pm. And then I'm gonna head off to Atlanta, and help my son move home. So pretty excited. Anyway, that's my day. Kelly case you. Also, do you think we should apologize to rob for all the cutting he's had to do for the cursing and that other reference and stuff like that? We're sorry, Rob. You

Kelly 1:00:44
know, when I was like mentally preparing for this, I assumed there would be a lot of editing, did you?

Scott Benner 1:00:48
Because you know yourself or because you thought you and I together this would happen at some point.

Kelly 1:00:53
Oh, both. I actually figured I would let some fly too. But I've been I've been preserved.

Scott Benner 1:00:59
Isn't it insane? That the same person who helped you understand diabetes is the same person who said That's stupid. But he's actually find that amazing. There are times when you'll like, here's an example. I was at a gas station once, when a woman walked up to me and was waving her hand frantically in my face. And I put my window down. I was like, Hey, what's up? She goes, podcast. And I was like, Hold on one second. So I put the window back up. And then I finished what I was doing. And I got out of the car. And I was like, Hey, how are you? And she goes, good. I love your podcast. And I was like, Oh, thank you. And I was like, how do you? How did you know me? Like, I'm sitting in a car, you know? And she goes, I saw you out at the traffic light pulling in here. And I was like, Oh my God. That's Scott from the Juicebox Podcast. And I'm like, did you follow me in here? And she's, oh, yeah, maybe. And I was like, that she like, whips her kid out from behind her like, like a Russian nesting doll. She's like, this is my daughter. I was like, holy shit that person come from. She's like, she has diabetes, she starts talking about everything. And it was lovely. By the way, it was a wonderful interaction. And then I got back in my car. And I thought, How am I the person that that's happened to just now? Like, I really I have such stupid thoughts about so many other things. Like how am I that person? It's so weird.

Kelly 1:02:23
I wonder if that's why it's effective. So I feel like so often, like we go to the doctor, and we see them as this person, like up on a pedestal and they're so like, cut and dry. That it's hard, at least for me, like it's hard for me to like really absorb that. And so just being able to like, listen to you as somebody that I would get along with and be able to listen to you and like also have the stories tied into it. It's really effective style of I don't know learning for me, I

Scott Benner 1:02:52
guess you don't think I should over whiten my teeth and talk like a local weather person.

Kelly 1:02:58
Maybe you shouldn't give it a try for one episode.

Scott Benner 1:03:01
Such a headache. If I did that by the time it was over. Yeah, yeah. I mean, I don't put any effort into pretending to be nice or like to shine myself up or anything like that. So I take your point, it's, listen, I know. I mean, there's a person that's popping into my head right now who I won't disrespect by mentioning them. But they're, they're diabetes infos good. They're just not likable. I look at them. And I think, Oh, you're just not a person I'd want to hang out with that sucks because your info was rock solid. But it's that last piece of it in this digital age. It's not enough to just, it's not enough to be right. And you can't pretend to be likable. And by the way, not everyone likes me either. Like there are plenty of people who really don't like that I could read you a couple of reviews right now of people who do not do and that are not going to like the Easter reference either. The same people that left that review call me but will you read some of them? Do you want me to?

Kelly 1:03:57
I really

Scott Benner 1:03:58
do you want me to Alright, so this is how we're going to end Kelly I'm going to read I gotta find them. I didn't know we were gonna do this. Oh God, this is gonna be embarrassing. I've never done this before. One lady I think flat out call me a misogynist. Which by the way I do not agree with how do I get to? You would think I would know. Being the person who does this. I just burped? Could you hear it?

Kelly 1:04:23
I didn't. What a great

Scott Benner 1:04:25
microphone. Mic is amazing. I sometimes cracked my knuckles while I'm doing it. I don't think people can hear that either.

Kelly 1:04:31
I've been popping a I'm holding a highlighter in my hand. I've been popping the cap and I do that

Scott Benner 1:04:36
all day with

Kelly 1:04:37
my I'm hoping that it's not a lot of editing for your editor and he can't

Scott Benner 1:04:41
actually hear it. Okay, I'm scrolling back. Oh, okay. Here's the first one. I'm just gonna Oh, Jesus Christ. I'm just gonna read it. Okay. One star hosts needs to let guests speak. Yeah, okay. We know. I am. Wait, am I the only one that notices how he's talking the majority of the time. I had to unsubscribe, I couldn't take it anymore. He cuts them off all the time. And on more than one occasion he'll make cringe comments that I'm sure. I don't know what she's talking about. He makes cringe comments that I'm sure makes the guests uncomfortable. Were you uncomfortable today, Kelly?

Kelly 1:05:22
No, I'm so much enjoyment. Okay. Well, I'm

Scott Benner 1:05:25
shocked how not enough people have commented on this. Now, interesting enough, this person who left this review about three months ago, I think if you asked me to step out of this, I would tell you that this person has had an experience in their life where joking around things that may be sexual in nature, make her very uncomfortable. And God bless if that's how it makes her feel. I don't certainly don't want her to listen either. I don't know how a person doesn't look at 1300 reviews that are all except for hers and a handful of others five star and say things like my fear and anxiety has subsided. This is a literal lifesaver. This is an excellent podcast. Heavenly best. Like this has been a huge help to me. Like I don't know how you don't look at the other reviews and go i Why am I the outlier here. But now an outlier. Sure but TMI as a diabetic, one star by the way, I by the way, you can't give zero stars where I assume they would. I used to love this podcast as it gave me so many mi two moments of connections with other diabetics out there. But recently, the interviews are peppered with inappropriate content for a podcast about diabetes. Be still a she didn't say be still I said that the poor woman being interviewed must endure jokes about their bodies in their personal and intimate relationships indoor, okay, I can feel the awkward CRINGE CRINGE toys of the guests. If it were me, I might just hang up. Unfortunately, the content has gone downhill. Now. This podcast is nine years old. It's going into its 10th year, it is the largest diabetes podcast in the world. And it is downloaded at the same level as other high level health and fitness podcast, things that are put out by major corporations that have giant businesses behind them. The contents not going downhill. It's not, but it did for her, which is fine. And but by the way, she's actually it's interesting. She's referencing one specific episode, where I know that that this is what this is. And I went back to the person who I interviewed to make sure that I didn't miss something. So here's the here's the layout for how this, this review happens. I'm talking to a girl who's now 22 years old or something like that. And during the course of the conversation, she's telling me how her I think our parents have like a lot of children, right? And her dad works like a bunch of jobs. And I said, Well, yeah, he has to like work a bunch of jobs. He's he's got all these kids, he must have never been home. I'm paraphrasing now, Kelly. But I did say something specifically, like, you must have only known your dad is the guy who came home, swatted your mom on the s in the kitchen, and then went to sleep. And I said that because I thought, jeez, you must be like a real sexualized person have seven kids and only be around each other. Like, it's a lot of kids get up and leg like and I was like, they must just like he's never home. They must either be like, being intimate or sleeping. Like, you know, anyway, the girl laughs and everything. And I think oh, gosh, was she laughing to be polite? So I'm going to make the effort. Because of this review, I was going to make the effort to go contact this person to make sure I didn't make them feel uncomfortable. So I searched my email for them. And what do I find, but an email from a couple of days after we did the interview. And again, I don't know the exact words, but here's the gist of it. Oh my god, I had so much fun doing this with you. I hope that the people listening had as much fun as I did. So this person who left this review, I will say to you as well, your reaction probably has more to do with your personal situation that it does. The person you're listening to on the pious you're making a lot of you taking a lot of leaps here deciding how that poor woman must have felt because that poor woman had a great time and loved being on this podcast. So you know, it's fine with me so I get that that's gonna happen now let's get to the others hold on a second. We're scrolling scrolling. Here's another one about that specific interview said it was creepy. Couldn't you tell she was uncomfortable? She wasn't you just thought she was oh, this ruffled a lot of feathers? Well, that one that one comment about somebody coming in the house and slapping their wife on the button.

Kelly 1:09:53
By the way, do you think it's because you were talking about like her parents and not about her her like her? So

Scott Benner 1:10:00
I think it's because she was in her early 20s. And I talked about her parents, and they probably, I'm gonna guess their parents didn't have a great relationship, or they were watching their parents, like get along in the living room or something like something weird had to happen. You know what I mean? Like they walked in one too many times, while their mom was in weird garter belts or something. Something had to happen. This next one. This one is, I'm sorry, I think this one's funny. One star chauvinist. This is a quote, my wife has two jobs, keep the dog quiet. And think of excuses why not to have sex with me. That is something I said on the podcast that it says safe to say I won't be listening to this podcast again. Now.

Kelly 1:10:48
I don't. But to be fair, just imagine that's like the first episode.

Scott Benner 1:10:53
I'm like, there are times when I say something, I think God if this is someone's first episode, they're not coming back. But so usually, I say, my wife has two jobs, not know when the trash goes out and come up with excuses to have sex with me. But this was a reference inside of an episode, there was a dog, but my dog was barking. And I and I said to the person I was interviewing, I'm so sorry. This is this is my wife's job. She only has two jobs. And I was trying to be funny. By the way, my wife has an incredibly high level job where she helps a lot of people and she's the brightest person I've ever met in my life. But these other two things are also true. So anyway, that person did not like me, either. scrolling, scrolling. Here's one that gave me four stars, and talks glowingly about the podcast. But then says I talk too much. To which I would say to her, this is a podcast. Imagine how it would be if I didn't talk. That's true. And people came on and weren't good at carrying the conversation, which by the way everyone thinks they are, but most people aren't. So this one by the way, the last one that was bad. The call me chauvinist was from Great Britain. This one's also from Great Britain, maybe I don't know well liked. Well, I have I, I have a lot of downloads in the GB but okay.

Kelly 1:12:20
They're just telling all their friends about how bad it is.

Scott Benner 1:12:24
The chauvinist guy talking about diabetes, this one again, one star, I don't think we're at this one. This one doesn't hurt but self centered is the title of this review. I searched out glycemic index on podcasts in an effort to educate myself. Let me say I am not diabetic nor thankfully, are any of my family. Okay? I do however, like to be informed. Like imagine you wake up tomorrow, and you're like, I just really want to understand the glycemic load. Anyway, God bless. I have to say I found Scott irritating and very self centered as he spoke over, this is going to go up, Jenny. While she was trying to make a point, Jenny and I have recorded together about 200 times, we are insanely good friends. And privately that woman has told me that she thinks I'm single handedly saving people with diabetes. This is not in any way reflective of Jenny and my relationship. So I must have just spoken over Jenny mistakenly. And this is what happened when the person heard that. Furthermore, he seemed to boast how when wearing a glucose monitor, he couldn't get his sugar to spike, even though he gorged himself eating two slices of cake. So yes, I wasn't first of all, it wasn't boasting. It was making the point that a person with a functioning pancreas can have two slices of cake and their blood sugar doesn't spike. I'm I'm you understand, well, you have diabetes, you understand? But like she she obviously understand. I left the podcast early. I won't be listening again. 45 minutes of my life, I won't ever get back. And she put a sad face. She's I don't know what to say to that person. You just you you fundamentally misunderstood everything you heard. But in one listening of a podcast felt compelled to go leave a horrible review of it. That part freaks me out. Like I've heard things and seeing things in my life I didn't enjoy. It's never occurred to me to be like, I have to now go tell everybody not to do. That throws me a little bit if I'm being honest, Kelly, are you having fun with this or should we stop? Yeah, I'm good. I'll see if I can find it.

Kelly 1:14:35
Was it my kids aren't here I never have this time.

Scott Benner 1:14:39
By the way, I'm scrolling past I'm not kidding you hundreds of glowing five star reviews to get to these for them. Sort them. What do you think the internet is made for use? Like

Kelly 1:14:49
click on the like, you know at the top like on Amazon or target. It'll say like five stars. 4321 you can click on one it'll give you all the one star reviews.

Scott Benner 1:14:58
I'm the creator. I don't see the internet The same way you do hold on a second, I get, oh, I'm reading. Oh, this person thinks I'm only positive towards paid sponsors products. I don't think that's true. I'm scrolling. This one. I love how matter of fact, this one is two stars helpful information, brilliant information and great tips offered on the podcast. I've gained insight on management, which has resulted in better control of my type one diabetes. And Jenny Smith adds credibility to the material provided. What a great review, right? The host Scott talks too much and cuts people off two stars, hey, how about this brilliant information and great tips offered on the podcast have gained insight on my management which results in better control Jenny Smith adds credibility. Thank you. What about that? Thank you. You know, the

Kelly 1:15:56
guy runs a podcast which he much talk on,

Scott Benner 1:15:59
motherfucker. Just can say thank you and be done with it. Like, oh, you know, this guy. He spends his whole life making a podcast where he takes the breath of his information from the last blah blah blah years have written badminton. And it's helped me immensely I don't love his speaking pattern though. He should go himself you're out of your mind. What a horrible thing. That's all persons this way. Isn't

Kelly 1:16:25
that kind of what you were saying earlier about the other one though, like great information sucks to listen to

Scott Benner 1:16:30
I can't get to the I can't I haven't found the one yet that AI is my absolute favorite one. It's just like I love this podcast. I hate that guy. Can be too much focused on him at times three stars host talks a lot about himself versus interviewing the guests but he can have great content. Pick one you can idiot I'm making the great content you motherfuckers I'm Do you know I interview Kelly. You've been lovely today and most people are but I've interviewed people who are the the entertainment equivalent of dry mud in your Okay. And you don't know that because I made them interesting. You'll never know that they're lovely. You'll never know you won't go back and listen to go this person was not good. I sussed out in three seconds. They weren't going to be good at it and I peppered in more conversation to draw them along. Like you again. Just say thank you. Hold on a second. Scrolling scrolling five stars. Five stars five stars. This one these pisses me off more than anything. This is a glowing review that they they only clicked on three stars. It really bothers me Kelly, I don't know why. Kelly, are you there? Did you die?

Kelly 1:17:42
I'm here.

Scott Benner 1:17:43
Can you hear me? Yeah, no, I can. Well, it's like it

Kelly 1:17:46
doesn't give you what's your like a war overall rating? Like 4.8? Yeah, I'm

Scott Benner 1:17:51
like 4.8 isn't really Yeah, yeah, I'm great. Well, it's a good good. Yeah. This person doesn't like the ads. That's interesting to me. If you don't want the ads, then you're not getting the podcast. So I gotta live to did

Kelly 1:18:05
you get up and running? I thought I had seen in your Facebook group that you are going to be starting a like a subscription one.

Scott Benner 1:18:12
I got it set up. But I hate the idea of it still. It's got right now it has all the pro tips in it with no ads.

Kelly 1:18:20
And I was thinking you're gonna do after dark and it's still

Scott Benner 1:18:24
I decided to do something else this year first.

Kelly 1:18:25
Well, I love the after dark.

Scott Benner 1:18:28
Can I tell you what I'm going to do though? Because by now it'll be out for years, or four months, I'm doing a series called cold wind. And I'm having healthcare professionals on and other people around the healthcare industry. They're speaking anonymously and having their voices changed and they're telling me about their jobs.

Kelly 1:18:45
Okay, just so like endos or just across the board. Anyone

Scott Benner 1:18:50
nurses have an HR professional who talks about how they've been doing how many times they fired somebody over 25 years for having a health issue. Okay, okay, directed by the CEO, stuff like that. This one's funny. There is occasionally some interesting stories or nice tips, but it's pretty much an hour plus long commercial for Omnipod and Dexcom. Omnipod index some of the stuff my daughter wears, so that's probably why that feels that way to you. Because of the words I say

Kelly 1:19:20
Dexcom is also the best there is. I mean, I can't speak on Omnipod I've never used it but Dexcom I just remember ah, it was probably like 2006 or 2007 I was wearing what Medtronic had put out some kind of awful, awful, awful awful sensor. It was not accurate but also like

Unknown Speaker 1:19:45
hard to use and

Kelly 1:19:46
painful. It hurts so bad and then like the you know the transmitter part you would click in it didn't secure in any way except right at the click in part so it would just like flap around. Oh,

Scott Benner 1:19:57
in fairness to them. I've heard really good thing about their new system and their new CGM. So

Kelly 1:20:02
that's great. It was really bad like 15 years.

Scott Benner 1:20:04
I've definitely heard that speaking of like, a long time ago, I've now had to scroll back like four years to get to this bad one. But here is an example of a review that is about you, not me. Okay? Mixed emotions two stars. Overall, I have nothing bad to say about this show, as it does a very good job educating diabetics about new technology and experiences surrounding the type one diabetes life. However, what continues to get under my skin is how much the host continues to talk about it. By the way, I don't like it when people use the same word twice in one sentence, but you don't see me writing can review about it. However, what continues to get under my skin is how much the host continues to talk about his daughter to the point of interrupting, and one upping their experiences. This has at times caused me to become frustrated and turn the show off, as it makes the conversations disjointed and pulled off topic. The show isn't about art, and it's about type one diabetes. I suppose if he wants to be about his child, angle it that way. But as it is right now, it feels arrogant and self focused. Oh, so I will say this. I've seen a number of people in this space do this thing where they're talking about raising a child with something, right? They overwhelmingly make it about their kid all the time. It's it's basically like, here's a pretty picture of my kid, give me clicks give me likes, oh, by the way, and

Kelly 1:21:27
there's also only so much you can say about your own kid. Yeah. Also, like no matter how great they may be, I don't

Scott Benner 1:21:32
do that. I would I would venture to guess that 99% of the people listening this don't know what my daughter looks like. Yeah, yeah, I use my experience of helping her to come up with the ideas that I liked that I talked about, and I and I'm really sharing with you what worked for us, I can't share with you what worked for us without sharing how we did it. And so But moreover, this person just does not like my kid being they think my kids being used to make this thing. And she has nothing to do with this and almost no knowledge of it, to be perfectly honest with

Kelly 1:22:08
you. Speaking of though, are you gonna get her back on because I really enjoy those. Yeah,

Scott Benner 1:22:12
I'll harangue her to doing it once before she goes back to school. Okay,

Kelly 1:22:15
I remember seeing on the Facebook page like somebody will I don't know if it was the last day she's been on twice right? Yeah. I don't know if it was the last time or the time before but they had posted like oh, I cried so much listen to her tell this story while yada yada and I was like I laughed through the entire thing that did not make me the least bit emotional at all. Like

Scott Benner 1:22:42
she's hilarious really love her perspective. That was great. She's pretty cool. This one's like five years old. I once had a guy named Adam Brown on and I was like shot out of a cannon one day and I talked too much like I absolutely did so I can't like I said it later in another episode or even in that episode God I spoke way too much today I'm super sorry like that kind of thing. But this person says this is a one star review disturbing symbiotic relationship through his daughter's type one disturbing use those again set disturbing twice, they really want to make sure that you knew they were disturbed. It is concerning to me that he speaks as if he were the actual type one and not his daughter. That actually I have to be honest with you. It's just a that's a function of speech. Like when you say I when you're trying to make a point or or us or we or that kind of thing. I've actually been over the years very cognizant to try to break that it's not me thinking I have diabetes. It's just I'm trying to get stories out quickly. This is unhealthy in my opinion. It is also disturbing by the way she is now used to serving three times I get at the source it is also disturbing I struggled to block him out and here the guest and info presented this person wants me to go podcast starting go ahead and talk Kelly hobby back in an hour.

Kelly 1:23:57
That would be I would never have requested to be on Yeah,

Scott Benner 1:24:00
guess what you would have done you would have been like I'm Kelly my kid I don't know what to do. So I'm a long term very educated type one I can tell by how many times you use the word disturbing. I am always searching for the most current information he has great knowledge await he has great knowledgeable guests that I want to hear from but he won't stop talking about himself as the type one not as though I am not talking about myself as I've had diabetes. I have never done that. I don't do that. That is the thing. I think again might be a little more about their sensitivity than about what I did but that's fine.

Kelly 1:24:36
But I think that is very personal though because there are some times I'll see whether it's in a Facebook group or I'll just hear people talking and they'll say like, I don't remember like oh yeah, we we took a shot and I'm like no we didn't take a shot. No

Scott Benner 1:24:50
100% Like I know completely understand that but again, that's your sensitivity because you have diabetes you know everything that comes along with it like if I said you we went to KMart, you wouldn't be like no Oh, she went you sent your credit card like like you don't even like, yeah, if I bought something at Kmart, is Kmart even a thing anymore? Who knows? But I

Kelly 1:25:08
don't think it is. But I went when one of them was going out of sale or out of business I got so many good things on sale.

Scott Benner 1:25:15
I gotta tell you something a sporting goods store went out of business when I was in Georgia with my son playing baseball and I got a $70 Golf umbrella for $5 it's still like one of the best things that's ever happened

Kelly 1:25:25
to me. I like golf umbrellas are $70 Not

Scott Benner 1:25:29
when you pay five bucks for me to go in on a business sale. They're not. By the way, here's the end of this review. He even admits his ego gets in the way when interviewing Adam Brown. So if I joked and said something about like, I know, I'm just my ego got in the way. She's like, see? Proof? Yeah, I'm right. Lady to you. And by the way, I know it's one because of the name in the review. Not because I just assumed that only a woman would complain to me, because I'm not sure. But to her I say I don't care what you think. I am gonna give you one more. And then I'm gonna go because I have to I have to go. And we're actually gonna have to end up calling this interview like bad reviews or something like that.

Kelly 1:26:23
No, it's the very end. Well, what

Scott Benner 1:26:25
was the other one? Check? What do I say? Yeah, you said check. Please check. Please check me bad reviews all figured out.

Kelly 1:26:33
Checkmate for bad reviews. Like that's not bad.

Scott Benner 1:26:37
Good info, but bad host lots of good information, but the host never shuts up about himself and and is a complete egomaniac. You guys might not understand sarcasm. He is also an insufferable, elitist, and elitist. Kind of the best and the worst of most resources. So great information, great information, don't like that guy at all. By the way, I want to just say to this person, I love that you had to listen to me and you didn't like me because it just tickles me inside. But this guy's like my guinea one sees five and a half that I really hate this son of a bitch. Alright, I am not an elitist. There are some times I'm like, Oh, I can be judgy about things. And I complete egomaniac. I think that it's possible that I have a lot of self confidence. And I joke around around it. And that those things can get blended and come off that way. And that's fine. Like I it's fine for me the guy again, you know, I could scroll this thing. And just push stop and just go game changing five stars can't say enough about the game changing strategy Scott shares to help lower your or your loved ones no one sees like I can scroll, hit stop. I've been a type one diabetic for 32 years. And I've learned more from this podcast and for many doctors. So thank you very much. They are also from Canada, Russia, America, like Australia. These These reviews are from everywhere. overwhelmingly people like the podcast and I could find up I could easily find reviews of people who say this is not just my favorite diabetes podcast. This is my favorite podcast. I'm incredibly entertained by the show, but there's plenty of those too. I didn't read them. They're not as much fun because that would be egotistical. The other thing I just did is the opposite of egotistical, but I'm sure someone will find a way to say that I did this on purpose to prove I wasn't an egomaniac. So I look forward to that review. And then I will not pay attention to that one either. So good luck. Kelly, you were terrific. I was fantastic. I spoke way more than you did. And I'm sure that'll piss somebody off. But again, I'm not sure what to do. This is how it went. You know what I mean? You okay, Kelly? Everything's alright. I'm good. I'm just laughing the whole time while you were quiet just you quietly laughing under your breath? Yes. Because people are gonna think here's what somebody will say. See, he asked if she was good and she wasn't but she couldn't even bring herself to say

never left

snowflakes Okay, um, by the way, I don't mean that like a political way. I mean that in a way where I'm Judging You

You should all come to the northeast and and get a good dose of sarcasm so you could live your life in a more fun way. Kelly, thank you very much for doing this. I really appreciate Thank you. Yeah, good luck with your son Arden has been getting her diabetes supplies from us med for three years. You can as well, US med.com/juice box or call 888-721-1514 My thanks to us med for sponsoring this episode. And for being longtime sponsors of the Juicebox Podcast. There are links in the show notes and links at juicebox podcast.com. To us Med and all the sponsors. A huge thank you to one of today's sponsors, G voc glucagon, find out more about Chivo Capo pen at G Vogue glucagon.com forward slash juicebox. you spell that GVOKEGL You see ag o n.com. Forward slash Juicebox. Podcast lots of people with autoimmune seem to have trouble with their thyroid. And that's why I've made the defining thyroid series juicebox podcast.com. Click on defining thyroid the menu to find out more. A diabetes diagnosis comes with a lot of new terms, and you're not going to understand most of them. That's why we made the finding diabetes, go to juicebox podcast.com up into the menu and click on defining diabetes to find the series that will tell you what all of those words mean. Short, fun and informative. That's the finding diabetes. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com

#1212 Dr. Tom Blevins on GLP Medications

Dr. Tom Blevins discusses GLP medications.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends and welcome to episode 1212 of the Juicebox Podcast.

Tom Blevins is an endocrinologist that Texas diabetes and Endocrinology in Austin Texas today Tom is going to come on and share his expertise so that we can better understand GLP medications I'm talking about we go V I'm talking about ozempic, zap bound, mon Jarno and more. Please remember while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan or becoming bold with insulin. You can find out more about Dr. Blevins at Texas diabetes.com If you are a loved one has type one diabetes and you'd like to be involved in research. All you need to be as a US resident and you can head to T one D exchange.org/juicebox. When you complete their survey you are helping with type one diabetes research. You're also be supporting yourself and this podcast T one D exchange.org/juice box. When you place your first order for ag one with my link you'll get five free travel packs and a free year supply of vitamin D. Drink ag one.com/juice box don't forget to check out the private Facebook group Juicebox Podcast type one diabetes with over 50,000 members. This episode of The Juicebox Podcast is sponsored by Omni pod five Omni pod.com/juice box if you have FUBU the fear of missing out on Omni bod. You don't have to have that any longer. Just go to my link Omni pod.com/juicebox This episode of The Juicebox Podcast is sponsored by the only implantable sensor rated for long term wear up to six months. The ever since CGM ever since cgm.com/juicebox.

Dr. Blevins 2:04
Hello, everyone. My name is Tom Blevins. I'm an endocrinologist at Texas diabetes and Endocrinology in Austin, Texas. I work at a clinic where there are about 12 endocrinologist and we have about 12 to 15 advanced practice providers and we see a large number of people with diabetes, especially type one. And we also see a lot of people with type two diabetes. Of course we treat people with pumps and technology and, and even just regular injections. Happy to be here. Oh,

Scott Benner 2:35
I appreciate that very much. Thank you. How long have you been an endo?

Dr. Blevins 2:39
I've been an endocrinologist since about 1986. I finished training and went to Baylor College of Medicine in Houston and got boarded in internal medicine then Endocrinology and Metabolism ultimately got boarded and lipid ology as well. So I've been in practice for about that long. I think that adds up to be about 38 years.

Scott Benner 2:58
What drew you to it initially? And is that the same thing that you do today. Of

Dr. Blevins 3:03
course, back in the 80s, when I was in training, endocrinology was kind of a different space, a lot of diabetes, a lot of thyroid, I really was fascinated by the conditions. And I saw a big potential to help people. You know, interestingly, I really liked the people I worked with who were endocrinologist and, and that attracted me. Now over time, of course, things have changed a huge amount, which is really fortunate for everyone. And diabeetus has evolved from the days of mph and ultra linty. And all that the huge fingerstick devices, which if you've seen it those made, you're probably too young to have seen those but the old iTunes and the the evolution of technology has been just incredible. And then the evolution of the therapeutic agents as well.

Scott Benner 3:52
And that's why you're here, Tom. So can I call you Tom or would you prefer to be called Dr. Blevins or Thomas? Good Thomas. Good. Okay. So you you mentioned something else though you got boarded in Lippa chronology is that right?

Dr. Blevins 4:06
Lipid ology technology. You know, like lipids, interestingly, you talk to people about cholesterol, and their LDL, the good and the bad and all that and that sounds very basic, but really, there's a huge world underneath that there's a board Believe it or not, it's that's when you study for and there's a society of lipid ology, and I'm a fellow of that group. And there was a lot of work done in Houston and that's where I trained with people like to Debakey was there the the surgeon, and the cardiovascular surgeon, then a guy named Tony Gato came in to be the person that did the lipids to help prevent some of that heart disease that they were treating, then a few other people, very smart people came in and I was fortunate to be able to train alongside them. So lipids, part of Endocrinology, really, that's metabolism.

Scott Benner 4:53
Is there any intersection between that and why you and I are talking today your understanding of lipids? No, no and how you came to, like pay attention to GLP is

Dr. Blevins 5:04
not exactly it's another aspect of metabolism. Yes, and that is what endocrinology is about by specialty the board has actually Endocrinology and Metabolism, then there's not a tight link between glucagon like peptide, one mil. It's a GLP. One meds and lipids are somewhat of a loose link, we could talk about that anytime people lose weight, of course, their lipids get better. And the GOP one meds can can help people do that.

Scott Benner 5:27
I see. So let me tell people a little bit about how I found you. For the people listening to podcast, they probably know that for about the last 13 months, I've been taking a GLP medication strictly for weight loss, I don't have diabetes. And I've lost I think 46 pounds at the moment. Since then I started on we go V I moved on from weego V to zap bound maybe a handful of months ago now. Anyway, I think not this similarly to how most people end up doing things. I was about six or eight months into this. And I thought maybe I should understand better what it is I'm injecting into myself once a week. I mean, it's working fantastically. I feel better, everything about my life seems to be better. But I'd like to learn more about it. And I'm starting to see people with type one speaking openly about the successes they're having. So that led me of course, to where any good research would lead a person to YouTube, where I found you, Tom just doing a sit down talking head describing GLP to people and I just thought you were masterful at it. And I reached out and I'm really grateful that you reach back because I think this is a great topic for people living with diabetes.

Dr. Blevins 6:35
Yeah. Glad to be here. Good. Thank you. Nice to work on the on the weight change. Weight loss.

Scott Benner 6:39
Oh, thank you. I appreciate it. The just about three weeks ago, I went to my Endo, who's the one who manages my weight. She was doing my vitals and she kept like mumbling half under her breath and half of my ear like a kid like a kid. These are great. You know about my BP my blood pressure, like just yeah, just just so much stuff that she's like, wow, this is it's incredible. I look like a completely different person. It's my aches and pains are gone and everything else that you would expect to come with weight loss. But then there's also been other benefits. One being that for my entirety of my adult life, without knowing it, I was running around with an incredibly low ferritin level, I was not absorbing iron, and my digestion was always poor and kind of off. And I guess just the slowing of the digestion. My last Burton was 170. And I'm telling you, I've been in the hospital like in the ER with a nine ferritin where I was like almost passing out. And no matter how I supplemented it, I couldn't cut it to come up without iron infusions. It literally is changing my life in ways I don't even think I know yet. Anyway, I sent off a massive list of questions from listeners to you. And you've kind of boiled it down to what you want to talk about here in our first recording. And I think if you enjoy yourself, we're going to do more. So I'm going to try really hard to make you enjoy yourself. But why don't we start right at the top like GLP one. Of course we go V and ozempic GLP one with a GI P that'd be Manjaro. And zap bound. There's others but these are just the ones that are out in the zeitgeist right now. So let's start real basically with what is a GLP?

Dr. Blevins 8:14
Yeah, GLP one that stands for glucagon like peptide one. And, and the gap that you mentioned, Scott is and let me just recommend everybody stick with the gap abbreviation it's glucose dependent insulinotropic polypeptide. Now, okay, stick with gap and actually stick with GLP. One, if you say GLP, I know what you're talking about. Actually, interestingly, people make these hormones in their body, and they make them in the small intestine, and GLP. One is made in cells called the L cells in the small intestine. And when a person eats, carb stimulates the production of GLP one. And gi P has made in the case cells in the small intestine, and in it to is produced after carb, and maybe protein can stimulate it as well. But those normally do is the GLP. One actually goes to the pancreas and can stimulate insulin production. So that's what they do. Normally, this is natural. This is what your body does all the time. So GLP, one stimulates insulin, it also can affect another cell in the pancreas called the Alpha cell. alpha cells make another hormone called glucagon. And glucagon stimulates glucose release from the liver, and actually GLP one that suppresses the alpha cells, it makes them less glucagon the Alpha cell does, and there's less release of sugar from the liver. And so that's those are two things that GLP one does. Now, I'll tell you, I'm going to skip to tip a minute. Tip stimulates insulin production from the beta cell in the pancreas. That's what it does. That's his main role. And we'll talk more about Then a bit, because there's some other things that GeoIP mimicking medicines can do. Like you mentioned mount Jarrow has GeoIP. And of course mount Jaren is up bound to the same thing GLP one does two more things, though, we talked about the insulin to glucagon all that that's good. But what it also does is slows gastric emptying. Meaning this slows your stomach down when you eat. And it slows the emptying of the carb and everything else into the small intestine. Therefore, the carb can't get in as quickly, that lowers the amount of carb that gets in lowers the sugar after you eat is what it does. And what else happens if your stomach slows down. And Scott, you've experienced this, it makes you get full fast and easily, you don't want to eat as much. And so that's one way by which a GLP one time Ed can lower calorie intake, but also it probably has a direct effect on the hypothalamic area that reduces appetite. And gap can reduce appetite a bit as well. And I'm just gonna go ahead and say GeoIP, and meds, that's the amount jarred can also seems that they increase sensitivity to insulin, which is really interesting. And so these meds, do some really good things. It turns out that people with diabetes, type two, make plenty of this stuff. And as far as we know, people with type one, make these two. But the effect in type two is, is reduced of these two hormones. And so therefore, giving people a medicine that mimics that kind of a hormone can really kind of improve things. Of course, people with type one don't make insulin, so you're not going to get that effect. A person with type one would get the lower glucagon, the gastric emptying effect and the appetite effect. I want to just step right in front and say these medicines are not approved to be used in people with type one diabetes at this point, right? They're approved for type two.

Scott Benner 11:59
This episode of The Juicebox Podcast is sponsored by the only CGM you can take off to get into the shower. The ever since CGM ever since cgm.com/juice. Box. Well, I mean, sure, you could take the other ones off, but then you'd waste the sensor and have to start over again. But not with ever since ever since is a six month were implantable CGM. So if you want to take a shower without anything hanging on, you pop off the transmitter jump in the shower, when you get back out, put it back on, and you're right back to where you started. Come to think of it. You could do that whenever you wanted to. Maybe it was your prom night or your wedding day. Maybe you just don't want the thing on for a little while. But you don't want to go through the hassle of taking it off and having to restart it and you know, starting back over with like wonky numbers and having you know all that that goes with it when you take off the CGM and put it back on Oh, but you don't have to do that with the Eversense CGM. Because ever since is the only long term CGM with six months of real time glucose readings. This gives you more confidence, more convenience and flexibility. The Eversense CGM is there for you when you want discretion, a break. Or maybe just a little adult time. Ever since cgm.com/juicebox. Podcast transmitter off, pop it back on, you're right back where you started without any wasted devices, or time. A lot of people in my private Facebook group talk about their love for Omni pod five. Have you ever seen those posts and thought? I wish I could have that experience with an insulin pump too? Well, if you've answered yes, you might be experiencing Fuu fear of missing out on Omni pod. symptoms may include but are not limited to wishing you could wear outfits without pockets. Dreaming about walking past doorknobs without getting your tubing caught her fantasizing about jumping into a swimming pool without disconnecting from your insulin pump first. Well, there's good news. You don't have to suffer from flu any longer. You can see what you're missing. And try on the pod five for yourself. Just visit Omni pod.com/juice box that's Omni pod.com/juice box, check it out. And is that because I don't want to go off our path too much. But is that because at this point it hasn't been studied. And if you slow down the stomach, and you eat less than you're very possibly going to need less insulin and people aren't going to pivot quickly enough and then you're going to see hypoglycemia and people aren't gonna know how to get out of it. Is that the fear? You

Dr. Blevins 14:41
know, the answer is these. Well, to your second question was a good way to enter back into the first part of the question your first part of the question. That is a concern with slowed emptying and suppressed glucagon. And of course glucagon and people type one your alpha cells do make glucagon and go God can help when you get low, of course, and that's what you get by injection, you know, the glucagon injections. And your your alpha cells make that and they help regulate your sugar. So if your sugar gets low, your cells kick out glucagon. Well, if you suppress glucagon, it could increase your risk of low number one. Number two, what you said is right, if the stomach emptying slow down that could increase your risk of of low also. Now back to the first part of your question. These agents have been studied in people with type one. And I'll just briefly tell you, there were two studies a few years ago, we participated in one of them here, we do quite a bit of clinical research here. One thing I didn't mention when I introduce you should have but we do quite a bit of clinical research. And we were really excited about these studies using it was liraglutide, which you know, as Victoza. And that was being studied people type one and there's large studies. And sure enough, in people with type one diabetes, who were treated with, I'm gonna say Victoza because people know this is Victoza. liraglutide is one of the GLP one meds, it's the one you had to give every day, once a day. Yeah, short duration, you have to give it once a day. And we were very excited about this people's agency did drop, you know, around point 3.4. And, and the body weight dropped five kilos or so that's good. But also and the insulin dose reduced, no surprise, but also those people had more hypoglycemia. And also, there was a little bit of an increase in ketoacidosis diabetes related ketoacidosis. And, you know, that kind of caused everybody to pause. And and these big studies were done, and the drug did not get approved for type one. If you look back into those studies, I will tell you this, just just to let you know, the ketoacidosis episodes occurred for typical reasons, it wasn't they didn't look as mysterious when I looked at the studies. And the hypoglycemia was a bit increased. But I think, you know, it's very possible that could have been mitigated with increased change in doses and things like that. Nonetheless, though, those two studies kind of stopped the whole approval process for type one in its tracks.

Scott Benner 17:21
Do you think it needs to be looked at again?

Dr. Blevins 17:23
I do. I really do. And I'll also tell you that another analysis of this whole area, kind of a pooled analysis of, of a number of studies with GLP, one meds and type one showed, certainly there was more gi side effects, we know that's going to be true. And anybody that takes these medicines are competing nausea, vomiting, diarrhea, constipation. I always tell my patients, you know, with these meds, you could get diarrhea, constipation, nausea, vomiting, and usually gets better I tell people you don't get to choose. One of those might have some of those might happen. But if the this pooled analysis showed no differences in ketoacidosis, severe hypoglycemia between the people treated with the Met or the placebo, so yeah, I think it needs to be studied more. I think, anyone that listens to this should, you know, rattle the cage of somebody and say, Hey, we need to study this again and get this so it's approved. Right? That's my opinion. And you know, we're very cautious about this when people talk why and we'll talk about that more.

Scott Benner 18:27
Yeah, no, I appreciate you being candid. I mean, listen, I think people who listen, no, I am getting, I mean, our endocrinologist is giving my daughter GLP. Actually, she's using Manjaro at the moment, which seems to go Jive better with her. I don't know a better way of saying that. Yeah, the decrease in insulin use is insane. Yep. Yeah, I genuinely believe my daughter will use 16,000 fewer units of insulin in the next calendar year, because she's injecting five milligrams of Manjaro a week. Yeah, it's fascinating. And her her excursions, her glucose excursions are flatter. I don't. And now in fairness, she's also wearing a DIY algorithm she's using Iaps. I don't see any more instances of hypoglycemia. As a matter of fact, without the excursions high we're getting fewer Bolus is to bring her back down, I actually think it might be making less hyperglycemia than before, which isn't to say that she had a lot. I've also told you a story and sent you an episode of 15 year old girl who's gone from 70 units a day down to now, seven units a day of total insulin, a type one, my 47 year old brother went from a seven a one C with type two diabetes down into a five a one C without really even changing how he eats and he lost 35 pounds. I mean, I know there are people who are going to have results that aren't like that or that You know, they have some sort of a reason why they have to stop it. But my gosh, like everything I'm seeing just it screams for us to pay attention to this. Yeah, yeah,

Dr. Blevins 20:09
I agree I do, I do want to emphasize that, since it's not approved for people type one, where I don't want to talk about the information for type two interchangeably, it would be using these medicines and a person with type one diabetes, unless they fit certain weight criteria. And we'll talk about that more in a bit. But is off label meaning it's not approved, right. And, you know, insurance, insurance coverage is highly variable, not guaranteed, in fact, likely won't be covered. And so the doctors, your, your treating prescribing doctor can use a medicine off label if, if that doctor or provider feels like it's appropriate, and some will, and some won't. And everybody wants to be very careful, I'm very cautious, for good reason. And these are some great stories like your brother well, and you know, some people do great with these meds, and some people simply can't take them and they can't tolerate them. And I've had a person in this morning to the office who said, you know, I tried a couple of these. And I simply, she simply could not tolerate, and we can we can adjust the dose sometimes and make it work. And we can use a little bit under even recommended dosing to make it work. But they're not for everybody. Yeah, they really are, are wonderful meds for for many, many people. Right?

Scott Benner 21:25
I do wonder if in the future we won't see at boils down to be micro dosing for people with type one sometimes. Because if you're not looking for the weight loss aspect of it, or the hunger aspect of it, although, you know, when you have type one, a lot of people with type one have trouble regulating their hunger and have digestion issues. It's not uncommon, right? But you know, I want to go back before we go forward, you just said, you know, early on, one of the mechanisms of this is the fullness you feel full, go over again, the part where your brain just doesn't tell you you're hungry, because I have both implications. So yes, I get fuller, faster, right, right. That's slower digestion, that's lovely. You can eat through it, by the way, you have to you have to mindfully stop when you feel it. I can eat through it. I should say, I'm sure some people would vomit, or I've heard those stories, right. Yeah, but the part where your brain, like I have to remind myself to eat, I don't get hungry very often. And if I do get hungry, it's almost always in the last two days of the injection when I think the halflife is waning,

Dr. Blevins 22:32
right? Yeah, you know, there's a lot to learn here. We don't know all the answers. But there does seem to be a central effect of GLP. One agonists we'll call them agonist because that's what these meds are they, they stimulate that GLP, one receptor in various places, there does seem to be an appetite suppressant effect, and GeoIP probably does that too. So those two together work well together when it comes to the appetite part. So appetite could be partly regulated by feedback from the GI tract. That may be and so that could be part of it could still be linked to the to the gastric emptying, issue, or change. But also there's a seems to be a central effect. And when I tell people is, you know, you're taking the appetite, I call it Daymond you're putting into a cave, and you're kind of putting a rock in front of the cave, so won't come back out. Because appetite. Everybody has appetite. And, and I'm sure over time, appetite has been a really good thing to keep people eating. And when there's food eat. And when you're not, you're not getting enough calories eat, you know, but appetite these days, kind of throws people into high calorie intake and high carb high anything intake. And so these meds do seem to have an effect a central effect on appetite. Yeah,

Scott Benner 23:48
that's fascinating. I mean, I think not like most people, I felt impacted by it immediately. And my wife's like, Oh, it's a placebo, but I lost four pounds in the first four days. Yeah, recently, I had to go up in my dose, like I was writing the 7.5 milligram dose as long as I could with the Zep pound. And my doctor, I said, Hey, I put a couple of pounds on but I'm not doing anything differently. And she said, Well, I'm gonna move you to 10. Actually, 10 and 12 is where I see the most weight loss. She goes, I just wanted to see how much you could get out of the 7.5. And all of the little things like I was starting to have more sugar cravings. I was hungrier, all that stuff. I swear to you, I shot the 10. Four or five hours later, I said to my wife, oh, I have that feeling of like when I started the first time in my stomach, my body regulated to it. I've been using it for 13 months. So you know, in a day, I felt better. And now it's been four days since I did that. And I've already lost four pounds. Yeah, and I have not I swear to everybody listening. I haven't changed my activity. I haven't changed my hydration. I haven't eaten any differently. I just I'm losing weight now. Oh, it's absolutely fantastic. And to watch it work on my daughter's blood sugar is is magical. She I couldn't get her she's away at college. And so I, as I was switching her to Manjaro, because she was using ozempic. In fairness, we're getting this through a Canadian pharmacy. So everybody understands how it's happening. I had to ship it to her, and it was late to getting to her. And in five days past her injection day, her blood sugar's got completely wonky, we had to make all kinds of adjustments to her Basal or insulin to carb ratio to her insulin sensitivity factor just to get her through the four days. And then she injected it. And I talked to her last night and I said, Listen to me right now put all of your settings back. And we are going to be looking for lows over the next 36 hours just in case now the algorithms getting ahead of it. But as soon as the medication hit her, her blood sugar's all like flattened out and stabilized. Again, it's, it's really, it's crazy.

Dr. Blevins 25:54
That's really interesting, you said a few things are really important. One is it's not approved, so it's not going to get covered, you're getting it from Canada, which which, of course, I as a prescribing Doc, I can't write scripts, and send them to Canada, they have to be, I can write a script that you could take anywhere you want. But and that's one thing. And the other thing is, it's definitely want to be cautious because the you're right, hypoglycemia is possible, and then you treat it with oral carb, and it may not get absorbed quickly. So you know, the stomach slow down. So you got to be really cautious about that. And if a person has had diabetes for a long time, they might have gastroparesis. And that is slowed down empty, and because of some nerve involvement from the diabeetus, and then they definitely would get doubled to slower in and that would be a person who wouldn't want to take it. So we have to be very, the stories are great. And and the results can be really interesting when you're using it. And off label again, I'll say that repeatedly. Because I want everybody to know that's it as a story right now, with type one and vicious I'd be very careful about it and select people properly and can be careful about the and understand the drug itself may make it a little difficult to treat hypose And could create hypose

Scott Benner 27:08
Yeah, and it's going to be such a case by case situation not that everything about diabetes isn't right. But at the same time, like when this becomes more accepted or covered by insurance or everything, it's going to take some real overseeing by people who understand what's going on, because your transition so important. If somebody wouldn't have told me in the very beginning, hey, it feels like your food stops halfway down your chest for the first couple of weeks, you know, which is how I would describe we go via when I first started taking it. I might have panicked if somebody wouldn't have said to me like do not eat crazy. I don't anyway, but but do not eat crazy, fatty or greasy foods you might throw up, I had help moving into it. I had good direction. It's why I was able to navigate it. Because the truth is there's a lot there to navigate. I you know, people ask like what are your implications, and I had diarrhea in the beginning. But I said to myself, I know that when my body regulates this, I have a good chance of this stopping. So I'm going to try to make it through. Because I want the other side of this because Tom, I thought I was gonna have a heart attack. I'm always carrying all my weight and my stomach. I've classically ready to have heart attack, you know? Yeah, yeah. So anyway, we're gonna go back and forth here. But let's talk about the the half life and the dosing. Right. So I don't I'm sure everybody doesn't know what half life means. But you can explain it to them and tell them why it's important with us. Yeah, thank

Dr. Blevins 28:29
you for asking Half Life is you can look at it two different ways. One is the time it takes when you give a medicine for it when you stop it, the time it takes to reach half the level of the dosing. In other words, look at it as the time that it takes to reach the steady state as you give them medicine. So if the half life is a day, that means that takes about a day for the drug when you give a dose to reach 50% of the metabolized, excreted whatever. And, and so it tells you a lot about the duration of the medicine and the body. And then when you're creating dosing frequency, it tells you how often you have to give the dose I mean, if I gave it a medicine that had a half life of a day, would I want to wait two days to give the next dose? No, because you want to give it every day to maintain the level of the Med and we could go on and on about various meds. But the relevance here is that some of these medicines have very long half lives, meaning they can be dosed infrequently, and some of them have shorter half lives they have to dose more often. And for example ozempic would go v semaglutide. And that rebelliousness is the pill version of that that drug has a half life of a week. So it can be given once a week because it stays around for a long time. The medicine like the mount Jarrah And that's also observed bound. Okay, yeah, as you pointed out earlier, that one has a half life of five days. So it can be given once a week to. And we could go on and on about that Victoza has a half life of about 13 hours. So you really have to give that every day to maintain that level. So the beauty of these new meds that we're talking about the ozempic will go V set bound mount Jarrow, those meds can be given once a week, which is very convenient, really in relative to other meds. And so that that makes a difference.

Scott Benner 30:34
It's fantastic. And I know I think Novo is working on a pill, a once daily pill I got, it'll probably be 10 years before you see it. But I think that people are people by people. I mean, researchers, pharma companies, they obviously see what's going on at this point. Like, it's the amount of people who use this don't have side effects that don't stop them and are having insane kinds of, you know, transformations, both health and visually. Yeah, it's gonna be a focus. But you know, it brings me to this point that you put on your list here, like what is overweight and obesity. And I really do want to hear from you. Because what you're seeing right now, in the zeitgeist, right? The way people talk about this is you'll either find somebody who says, well, whatever works for you, that's fantastic. Good for you, which is how I think about it, or you'll hear somebody say, well, work harder, eat better. And sometimes for those people, I say, Okay, fair enough, there are plenty of people who are not getting movement and are not eating well. And they, they're overweight. But I can tell you that from my perspective, I was not eating poorly, right? My entire life. This has been my situation, I used to joke with people. If I ate like you did, I'd gained five pounds. I retain water, like a pregnant lady, I would tell people, right? Like, if you and I went out to dinner and had a normal meal, I'd be three pounds five pounds heavier. The next day, I couldn't tell you why I didn't eat differently than you did. And so can we talk about this a little bit like, you know, just weight and obesity? How you think about it in relation to these medications?

Dr. Blevins 32:07
Yes, you know, there's a lot of data that shows that as people gain weight, certain things happen. And if there wasn't some risk to gaining weight, we wouldn't care. You might not like the way it looks. But it has medical consequences. And that's where a lot of the treatment sort of motivations come from. And it turns out that as people gain weight over their usual ideal weight, then you start seeing things like high blood pressure, high cholesterol, type two diabetes, insulin resistance. And you know, it's well known that people with type two diabetes have insulin resistance, some of that's genetic, some of its acquired, like when people gain weight. And so, you know, it's kind of arbitrary, when you set a cut point to say over a certain amount of weight over ideal, it is a problem because sometimes people would gain five or 10 pounds and things go to pot when it comes to metabolic things like I talked about. But a commonly accepted standard for overweight, that could cause medical issues is a BMI of 27. Now BMI, what is BMI? Everybody, I think when you go to your get a checkup, you get your weight, your height, and those two can be put together into a formula. And his body mass index, BMI, his body mass index, it's an index that takes into account height and weight. So a person who's like, you know, 610 ways to 10, that's probably okay. A person who's five, two that has a weight of up to 10. That's way over. So you takes into account height and weight, BMI. We could go on and on about that, but I'll just tell you the currently accepted standard is a 27. Plus on the BMI over 27, is overweight, and that person is at high risk for things like all those things. I've talked about high blood pressure, high cholesterol, type two diabetes, insulin resistance, and over a BMI of 30 is called obese. And there are other cuts that are higher than that too. But those are the two classics. Again, BMI is calculated by height and weight. If you wonder what yours is, you could go to a table online, when you go see your medical person and you can say what's my BMI because the EMRs calculated pretty much automatically these days. That's an adult's. I do want to talk a little bit about pediatrics a little different. There are various standards for defining obesity in pediatrics. The most accepted one here in this country is obesity and pediatrics is a weight that's over the 95th percentile. So you get out of BMI. You could use BMI a little bit but you get out of BMI. In up we're looking at percentiles that is comparing people to other people their age. There's so much dynamic changes that occur in the pediatric population. So they get older, the height changes, weight changes all that. So obesity and pediatrics is defined as a weight. That's over 95/95 percentile of other comparable people they like age matched. And those that that goes from the ages of two to 19.

Scott Benner 35:18
Is there an increase over decades in young people being overweight? Absolutely. Is that in your opinion? Like, I mean, is it a little bit of everything? Is it movement? Is it what's in our food? Is that how we eat? Is it how often we eat is? It's an amalgam of these things.

Dr. Blevins 35:39
Yes. I mean, I could expound on that. But you nailed it. Okay. It's, it's the diet, its nature, for sure. Genetics determined things, determined metabolic rate. And you can see overweight and families. But it's also nurture, it's the environment we live in. And activity changes over time. And, and what you know, everybody knows what's going on. But it were glued to the computer, or to the phone or something like that sitting still a lot. In the old days, that didn't happen. And we could talk on and on. But you're exactly right about that. Scott.

Scott Benner 36:18
So is the clinician, how do you think about it? Meaning? Maybe I should back up and ask this question. How many times in your career have you told somebody to lose weight? And they've actually done it?

Dr. Blevins 36:28
I'll answer that is many, many times, I think people understand the concepts of calories and calories in calories out. And you know, I'll say, exercise is always important. You mentioned exercise earlier, and your own particular experience. And 20% of weight loss is related to exercise, unless somebody's an elite athlete, or a very athletic and exercises all the time most people don't. So exercise is important. And reducing calories is important. But I'll tell you, I think people respond and are successful, many times, the problem is the long term part of it, people are successful frequently for a while, and on average, they tend to gain it back, we're all busy, we're exposed to calories all the time. Activity is challenging, sometimes because of scheduling or, or just understanding about the amount that you need. So I think people really handle this way on their own. And so people can lose weight on their own to keep it off and do really well then understand the medical part of it. But for the most part, it's really challenging. A lot of it has to do with the environment that we live in. My

Scott Benner 37:36
take on that is in a world where I can't impact the environment, right? I can't just it's nice to say like, I love turning on a podcast or TV show, you hear a rich person say get out and move around. I'm like, Well, you have $9 million in the bank. That's great. You know what I mean? Like, I've got to get up and sit back down and make this podcast all day or I don't get to pay my electric bill. And that's how this works. Right? Right. When that's the environment? Do you have any moral qualms with giving people medication just to lose weight?

Dr. Blevins 38:06
The answer is no. That's the answer. But you know, when I have a medicine that I think is safe, and, and effective, and I understand, then I'm much more comfortable prescribing, we've gone through all kinds of medicines over time. And some of them, we still have, I mean, GLP ones are not the only medicines approved for weight loss. Right. And, and some of them, I feel comfortable with others. I don't like the side effects. And I don't like the idea of long term, I have increasingly come to think and No, and I think most people in this area are similar, that any medicine we use is going to need to be long term. Right? And for example, I mean, let's just go look at other like type one diabetes, it's not like you can take the insulin for a while and and get off of it. And and, you know, various medicines, thyroid hormone, it's not like you can take thyroid hormone for a month or two and then get off and everything's okay. It's a it's a continuing need for treatment, then people call it chronic, chronic condition. So I think the weight loss medicine is going to have to be that way too. Because like you pointed, as you pointed out, you get toward the end of the cycle of these very effective meds and the appetite comes back and tries to come out from the appetite demon tries to come back. Yeah. And you just have to keep it where it is. And so I think chronic treatment is is is the way to go. With this type med.

Scott Benner 39:31
I've heard people describe a food noise in their head that goes away. My wife got a got hypothyroidism and it took us seven years to talk a doctor into giving her medication for it. And in that time, she gained a significant amount of weight which she's almost completely all lost on we go vino. And she describes and I'm going to have her on at some point to tell it in her words, but she describes it she would open her eyes in the morning and be thinking about food before she was even conscious and Then, as she was making breakfast, she'd start wondering what she was going to have for lunch. And she said, It's all gone. It just doesn't happen anymore, which makes it much, much easier. And then her you know, then it impacts the insulin, and that your body's using, keeping in mind, she doesn't have diabetes, right. And then the weight starts coming off, and then the metabolic stuff gets better. And that's in there. I think to me, for me personally, the most significant part is the way I ended up describing it as my body works better with the GLP. I don't really care what that means. And I by the way, I am now more active than I was before, because a I lost weight b I have more energy, my joints don't hurt like I am more active now than I was prior, it was easier to get going, it was easy to pick up weights and go, Hey, I'm gonna lift these now. It's a nice say, go ahead and lift some weights and go for a walk, etc. Except every time I tried to do something, I ended up getting a knee surgery or something like that. Because in fairness, my body was too big. And every time I tried to use it, I'm older and it would break. And so if we can all basically agree that there's stuff in the food we shouldn't be eating, and maybe stuff we're spraying on the food that we shouldn't be eating. And we're microwaving and plastic. And there's 90,000 Different kinds of oils, three of them apparently could be her one of them could apparently be an Industrial Lubricant, the way it's graded out, right. And we're eating this stuff all the time. And over time, people don't even understand what good food and bad food is anymore. In many situations, to say to people, I threw you in the cesspool, and I could pull you out, but at you should climb out. I don't understand that. Like I really don't like what is it? You're saying to people, if you're fighting against this idea now, is this ideal? It's not. But until GLP is make food come out of the ground tasted like candy and being good for you like lettuce. I don't know what else we're gonna do. Because this is where we are now. That's my opinion of it. Yeah, it's nice to hear other people wanting to be helpful for those who are are stuck in that. Also, there are plenty of thin people who are not healthy either. So you know, they're eating the same crappy food to their bodies just aren't reacting the same way as mine did, if that makes sense. Yeah, I think

Dr. Blevins 42:13
that makes sense. Yeah, your body, it was built for a certain amount of weight, your chassis, your skeleton was built for a certain amount of weight, your internal metabolics worked better with a certain amount of weight. And when we load the body with more things happen to the metabolics. And they also you pointed out, you pointed out they happen to the structural part to the knees. Cancers are higher in frequency. You know, I don't have a study that tells you when you lose weight, your cancer risk goes down. I would think that's probably true. But nonetheless, we know that overweight is related correlated to all kinds of things cardiovascular answer, all of that. And then losing weight is actually really important for some people losing 40 pounds is was needed. Some people lose 10. And they do a lot better. Yeah,

Scott Benner 42:59
time. Listen, I didn't even go to college. I have no background in medical whatsoever. I'm better off now than I was last year. Yeah, that my common sense tells me right? I've joked with people if I grow horn out of the middle of my head, and it literally says Manjaro up it. I'll go at least I'm not going to die of a heart attack. You'd have to show me some really tough health concerns about using this for me to think about. I'd be better off 40 pounds heavier. Yeah, yeah. So here's the thing like that. We don't talk about enough. Maybe you could do these medications. They started being researched in the 80s. I might is that story about the heal a monster in the Canadian researcher. Is that true? That's

Dr. Blevins 43:38
pretty true. Yeah. Yeah, they were started. The research started many, many years ago. And there was something in the heel of monster spirit that was kind of similar. And the one of the one of the early medicines that you probably remember was by Ada, which is exemplified, we don't really use it much anymore. He had a very short half life and had to get given twice a day. It was effective. It caused lots of side effects. It had peaks and valleys and peaks and valleys because they had to be given so often. And yeah, these are not brand new. You nailed it. I mean, epic has been out since 2017. Yeah, by eight it was approved long before that. And then we had a long acting by Ada kind of thing. I extended it that was by durian, you probably remember and one or two came and went because they just didn't have enough uniqueness to actually be used very much. And then along came Victoza. And we use that quite a bit that eventually got approved as the drug saxenda that the same thing for weight loss. And then you know, started people start observing, Oh, these are good for diabetes, but they also cause weight loss. And most of the drugs before that we use for diabetes, including the insulin would be associated with weight gain. And we'd say, Oh, that's good weight gain because your sugars are better, but nobody that I know Who is listening? And there's no weight gains good. Yeah, yeah, they've been around for a while.

Scott Benner 45:06
Yeah, it's tough because you lose weight when you're diagnosed with type one very frequently because you're, you know, drifting away from life and you don't realize it at first and then you reintroduce the insulin. And then you get back to the caloric intake that is normal for you, which for some people is more calories than they needed. And then they start gaining weight. And then they say, Oh, the the insolence making me gain weight. And I always try to tell people like, generally speaking, it's the calories you're taking in that help you gain weight. Now, the the insolence putting it, you know, is storing it for you. And do you agree with that generally? Or is there more to it than that? I

Dr. Blevins 45:40
agree with that. Okay, everybody, you know, people, everyone's different. And everyone, not everyone, but in general, it's still safe to say it's a good concept. Everyone has a different metabolic rate. And they deal with calories differently, frankly, calorie burn his genetic appetite is partly genetic attitudes about food are acquired. But, you know, we grew up in our families and in certain attitudes about food and amount of food. People are told, eat three meals a day, and you know, have a dessert. Yeah, we live life in real time. And we eat and so the calories, it would be kind of interesting if everybody had a custom calorie for their particular body. And that can be calculated. But But still, the environment we live in is so easy to get calories one on but you know, a handful of us has lots of calories, go look that up. I use, I use the net. And as many people do in Siri, I just say, Hey, Siri, how many calories in a handful of walnuts or something and you know, it's like, wow. And I still remember when I was in training, we were asked to have a dietician sit down with us. And I would go over to the hospital every day, and grab lunch. Lunch was, you know, an event. And, and we got time off to do it. And I was having a chili dog with french fries and a regular drink. And the dietitian calculated calories for that. And I thought, oh, it's gonna be like 450. But it was like 1000. And I will tell you that kind of feedback was a reality check. And I never had a chili dog again, I'll tell you because I just it just floored me. So if you look at what you actually eat everyone, you've done this, you do this, then you'll you'll find some interesting things.

Scott Benner 47:21
I'll tell you that I had an experience last week where I started eating something I hadn't eaten in a while. And I enjoyed it, and I ate it. And then I injected the 10 milligrams up from the 7.5. And I reached for it on the counter one day. And I actually thought to myself, Oh, I don't want this, right. Like the idea of it nauseated me. Yeah. And I was like, but But five days prior without two and a half more milligrams of this medication. I was like, Oh, this is good. I like this. It's it's it really is fascinating.

Dr. Blevins 47:52
changes your attitudes. And you know, something, there's nothing wrong with that. That's good. I mean, people, do you ask the question earlier? Is that really? Okay? And the answer is, you know, if it works, and it's, it's safe, and you tolerate it, go for it, it's what you should be doing

Scott Benner 48:06
is overweight and obesity, an issue in the type one community more so than in the regular community?

Dr. Blevins 48:11
You know, I've had people tell me, oh, overweight, it's not a problem. The type one is type two. And I look at them and go, No, that's not true. I know that because of the people I see in my office, people with type one diabetes have the same struggles with appetite, and maybe sometimes more. So as the people with type two and struggles with weight. If you look at stats, I can say, Is it 2050 or 80% of people with type one who are overweight or obese based on that definition I gave you earlier. And most people probably say 20%, I think most of the people in the medical world right now would say 50 or more. It's not at all mean, but if 50% of people with type one are overweight or obese, and I'll just say this type two diabetes, people with type two, have not cornered the market on overweight or obesity. And they haven't cornered the market on insulin resistance. People with type one can have genetics that are insulin resistant. And when you gain weight, you get more insulin resistant, whether you have type one or type two. Yeah, so it's a real it's a common issue. It's talked about more and more. And yes, we really do need some good studies, with I hope, this kind of medicine, looking at people with type one, and I'm going to tell you more about I can tell you now and there's a study that's going on, but we need more studies that look at this and people with type one, we need to find ways to mitigate risk. And we can do it. When

Scott Benner 49:34
you say we need studies. Where does that have to come from? Is it a pharma company that has to say, hey, I want to sell to these people. So I have to prove it works? Is it researchers like Who are we looking for to jump in and carry this load for us?

Dr. Blevins 49:46
Yeah. You know, it's the pharma companies. And there were these studies early on that there was a lot of optimism and we all assumed it was all going to be approved and it wasn't they have to go to the FDA and have to show the adverse events associated with medicines, and everybody has to come to an agreement, it just didn't happen. So the pharma company typically would have to put together a sizable enough study, which is very expensive, and then show effect, and then show, you know, manageable side effects. To get it through the FDA. Currently, there are some studies going on. In fact, I'll just jump in a minute and tell you about one, there's been reluctance to proceed. Of course, most people with diabetes have type two. And then there's just people who are overweight, who don't have diabetes at all. And then there are people with overweight who have pre diabetes. And that's where the numbers are. And that's where they're going for. A big part of me says, We want to go on something, and you have type one diabetes, go to the JDRF, and say, hey, please lobby for this because they have an organization. And they know how to do that. And they're really good at that. If I went to a company, and I said, I want to put 50 People with type one on this medicine, and that I probably could get funding to do the study. That's not nearly enough people, though, to get it by the FDA. So it really has to be a large study. Question is what about these weekly meds? That that's those two studies I told you about? That had the ketoacidosis and the hyperglycemia. Were in the once a day drug alert. liraglutide Victoza? What about the weekly meds we don't know, we need studies. Now there is a study going on right now. And I'll just jump in and say something about it's called car mod c AR mot that's just the name of the study. And accompany is studying a medicine such as we're talking about, specifically, in people with type one diabetes, who are either overweight or obese. This is a phase two study meaning it's going to turn into hopefully, if things look good, into a bigger study phase three. Now that's the kind of study that needs to be done. And that is ongoing. That's not from Novar. Lilly, it's a different company. And we are involved in that study, here. And in fact, if anyone is in the Austin, Texas region that wants to be with type one diabetes, who could be categorized as overweight or obese, we're looking for people for that study. So these studies, please, I've encourage everyone to volunteer for some of these studies, as you have in the past. Every medicine that's approved for type one, type two, anything, has people who volunteered to study jump on in there and help those things get approved, or at least at least get them study. They may not get approved. You never know.

Scott Benner 52:34
Yeah, Tom, I'll I'll get some information from you afterwards, I could probably funnel some people towards you that would help with that. And also, let's take a moment to chide Lilly and Novo who both in their charters say that they're around to help people with type one diabetes. So here's your opportunity, spend a little money and help them you know, the big problem here is there's not enough people to sell it to afterwards. That's the bigger problem. Yeah, there's not enough type ones. For them to think of it as a splash. But my gosh, like you're looking at really impacting people's lives. Because, listen, I think you can hear through the raindrops when Tom's talking. If he was in charge, if you were the Wizard of Oz, you'd give this to people, right? You do the study, come up with the protocol and give it to people with type one. Is that fair to say?

Dr. Blevins 53:19
And the answer is yes, I would. Yeah, I would be very, very careful. I would talk about all the things we talked about with the little part of my head saying, you know, there was a study that showed increased ketoacidosis. But then another larger kind of analysis said, probably not, it doesn't make a lot of sense to me that it would cause that I can I can come up with mechanisms. When you look at the studies, you come up with your own impressions. Yeah. And it looks like those people might have developed it anyway. But and then hypoglycemia, that one, I get that one I really do understand. And I know how to mitigate. And what you said earlier, you're you're looping your your daughter's loop. And I mean, and and even the automated insulin delivery devices from all of the manufacturers, since hypoglycemia, or since the progression towards it, and they back off the insulin. So with those devices that lots of people with type one are using, would there be an issue at all with Hypo? The answer is I don't know it needs to be studied. We

Scott Benner 54:18
live in a world where generally speaking, people with type one diabetes don't know how to accurately adjust their insulin to begin with. And often they see doctors who are not much more help it so then to say that we will I'll inject something in you that's going to lower your insulin needs. Who's going to adjust the insulin, like the user doesn't know how to do it, the doctor doesn't know how to do it, you know, like it's, that's where the rubber is gonna hit the road right there you have, you're gonna have to tell people look, we're gonna enjoy when Arden gave herself the first injection of ozempic We spent the next three days changing her settings. It was that significant and that real quick, and then after we got them right, it was fine. And that was it. So you know, anyway, Yeah, sorry, can I say about the DK thing? Yes, I bet you could have gathered all those people up and just check them for DK and came up with similar numbers without the GLP. But that's my guess based on nothing other than talking to people for years about diabetes?

Dr. Blevins 55:15
Well, I will say in those studies, there was a group on placebo and the group on treatment and the people on placebo, that is the comparison and a scientific study where you actually have people who aren't on and who are on and the people who weren't on didn't have the ketoacidosis. I can't say that interesting. And why did it cluster in that particular group? It on treatment, it tended to be the higher dose, so maybe the nausea from the higher dose sort of covered nausea from something else going on, like ketoacidosis. And people were kind of misled. It's possible that the lower insulin dose needed, made people more prone to have keto ketosis because they had less insulin going in. I don't know.

Scott Benner 55:59
And they were still eating regularly because they weren't being slowed down from eating. I wonder there's a lot in there. Yeah, there's, like you said, I think further study might prove out that that's not something to be overly concerned about?

Dr. Blevins 56:11
Well, it's something to be very careful, definitely. And what you said, is, is very important about adjusting for the first three days, the studies studies that are the one that we're talking about the karma study that we're doing, yeah, we have a very clear kind of direction as to how to adjust insulin right off the bat to be very cautious. And so we don't know if person is going to go on the real thing or not. And we adjust the insulin in a certain way. And so these studies should look not only and they are this one study, looking at not not only the effect, and the side effects, was also looking at a treatment kind of algorithm approach to reducing the insulin.

Scott Benner 56:55
Yeah. Do you have any patients of yours type one who you've given them a scrip? And they're paying cash?

Dr. Blevins 57:02
And I'll say I do? Yeah, yeah, you know, I'm writing it off, it's off label. And what I tell people is, I tell them about all the side effects, I say it's not approved by the FDA. And if you look at the approvals, many times, it says specifically not approved for type one. And, and I tell them that and give them a prescription of I think is appropriate, we we start low, we always start low, and then we increase the dose as as appropriate. It is off label. And I'm gonna say that so many times, and and I tell them, it could bring out some major gi problems, and you may really not like it, and you may not be able to take it, you may have to discontinue it. And we're really cautious. But I do have people who are overweight with type one, and I will point out and we can talk more about this later, that actually there are instances in which it could be covered in people with type one. And that would be the obesity overweight obesity indication. And and that would be the main one actually. Yeah. So if somebody and then also with what GAVI there is an indication for using if a person is overweight, or obese, and if they have a cardiovascular disease, so someone has a history of SEO, and a heart attack or stents or bypass or whatever. And if they're overweight, then there's a really, really interesting study that showed a reduction in major cardiovascular events. And people given them a govi. It wasn't that people type one. But there were a few people type one of the studies, it turns out, and they still fit that indication. I hope that made sense. Does

Scott Benner 58:41
Do you think we'll see an approval one day or a study one day for PCOS? Have you seen the people talking about that the the mass amount of women in these Facebook groups who are getting pregnant before they're losing weight on GRPs?

Dr. Blevins 58:54
Yeah, yeah. People with PCO, you know, weight loss can improve fertility and people with PCOS and without, and there are studies that have that are done small studies, there are ongoing studies. Are we going to see an approval? I don't know. I don't see a big study being done. And people PCO at this point, I may not be aware of one that's been done possible, but I think it's really an interesting thought.

Scott Benner 59:21
I think a lot of women suffer with it quietly. Yeah. And it's not looked at and it's

Dr. Blevins 59:26
highly connected to overweight. You said it right. It's highly connected to overweight and insulin resistance. And if you lose weight, the insulin sensitivity improves. Ovulation improves. Really interesting. I

Scott Benner 59:36
am going to share a story that I can't tell you who the person is, but I know them very well. And 20 mid 20s female, not you know, growing up heavy than not heavy, mostly not as an adult through college, and then suddenly in the last year, just gained 60 pounds. They're working out crazy eating as clean as they can gaining weight through the whole Then doctor says you have PCOS. We told her, go back to the doctor, see if they'll give you a week. Ovie something like that. We go, here's that bound doctor gave her we go V. She shot it on Saturday morning, over FaceTime with me because she couldn't bring herself to do it. I had to talk her through it. And she got it in and sent me a text 36 hours later that said, I've lost five pounds. I don't know what that means, or how to measure that. But that's insane. Like is that's not water weight. Do you know what he means? Like, it is probably some of it. But she stopped eating in the past for 36 hours and nothing's happened. And she's eating super clean to begin with. And she's active and everything else. Like, I don't think we have the answer yet. But you can't tell me that there's not something happening here. That's not commensurate to the idea of thyroid stimulating hormone, right? Like you My body's making it but it's not using it correctly. Like, there's gotta be something there making those those GLP receptors light up, that's changing people on a metabolic level like it maybe I'll be wrong one day, but in the moment, this is how I'm thinking about it. Yeah, yeah. Well,

Dr. Blevins 1:01:10
I mean, I'll say 36 hours, five pounds. There's a lot of water there. I think I mean, that or something? Or maybe there was a big blowout, diarrhea, I don't know. But, you know, usually on any diet when a person lowers calories. Typically the first week or two, you lose a lot of water weight for various reasons, part of its decreased salt intake and, and part of it is kind of the ketone formation thing and the less calorie in and all that type. I agree

Scott Benner 1:01:41
with you totally, but she was already doing that. Yeah, there was never a moment whether it was either a Gary has just exploded, and she just that diary, like or whatever it was, that still didn't happen to her when she was eating clean, exercising, and, and etc, and so on. Who knows? Like, I have no idea, I can tell you my daughter's acne is almost completely gone. And she was not overweight to begin with.

Dr. Blevins 1:02:04
Yeah, you know, we have a lot. Well, I will, I will say we have lots to learn. And I will emphasize to the audience, these are anecdotal, please, of course, examples of effect, not that everyone's going to get anything like that. And some people are really not going to tolerate it. And I have some people who simply can't take it as too bad. Can we talk about that people don't have and yet some people don't have as much weight loss as we're talking about either. So life is a bell shaped curve in response to a medicine is to Yeah, and we like to we tend to talk about the real yet exceptional examples. But remember, not everyone gets that that result.

Scott Benner 1:02:42
Talk to me about the not tolerating it when you don't tolerate it, what does that look like?

Dr. Blevins 1:02:46
You know, the main thing is Gi, and it's typically just what we talked about that gastric emptying, change, and maybe even some central effect can induce nausea, vomiting, it tends to get better over time, we always start with the low dose and we titrate or increase the dose very gradually, we if we increase the dose, and then a person gets side effects, we back off. And that's very doable. You have to work with your health care person when it comes to that. And, and so diarrhea, and constipation, the medicines typically slow down the GI tract all the way down, but some people can get diarrhea as well. Commonly, those those effects are tolerable or get better. I had a gentleman in this morning who told me he's taking one of the meds and that at the highest dose, he gets really tight in his abdomen and very uncomfortable. And he's backed it off, backed it off, backed off and I encouraged him to continue to and try to find a happy medium because the GI tract is in the balance here. Some people can't take it and if you look at studies for up to 8% of people on these meds discontinue because of the GI side effects. Now they're those effects can be matched with medicine. I don't like to treat the side effects of one medicine with another but it's sometimes temporary use of like anti nausea pills can help. And you can use medicines or anti diarrheal 's to same concept but that typically are temporary but not always. And so people need to be aware of that. It just happens it's not your fault if that happens. I will say this if you have nausea and maybe Anyway remember that high fat slows the stomach down to so if you add fat plus a GOP one, your chance of nausea it goes right up. So one thing to do is cut the fat back about

Scott Benner 1:04:40
Yeah, no I don't eat high fat to begin with. I don't use any oils almost at all in my life. But I was very careful about that. I also if I don't see myself going to the bathroom I add a little magnesium oxide to my supplementing Yeah, I knew how important it was to keep the process rolling once I started this, like, if I don't see myself going, going every day on this, I hydrate, I take the magnesium like I keep things moving. I know there are some, you know, people love to yell in the media about stuff like this, but have people been injured permanently from it at all that you know of like, I mean, and is that got something to do with who they were before they started? And? Or could it because I think the fear is like randomly you're just not going to be able to like, I don't know, digest food anymore. Like you mean like people get when they hear about it, and you hear them panic about it, they say kind of bombastic things like that, is there a call for concern,

Dr. Blevins 1:05:37
you can ask something, when we talked about half life earlier, I mentioned that, that, you know, the week Half Life means that it takes a week to reach 50%, I'll tell the audience, it typically takes five half lives for a medicine to get totally out of your body. So if a medicine has a long half life, it's gonna take a while for it to get out. So if you have a symptom that you don't like, and you're gonna stop the medicine, it's not like you stop it. And that just goes away with this type of medicine because of the long half life. The symptoms of like the slowed gastric emptying are gonna go on for a while, and maybe they'll go longer than that. But there's really no clear evidence that those go on forever. And some people have underlined gastroparesis, and we don't know. And, and we might bring it out, make it worse. And then after they get off the Med, they may they may get diagnosed. And I may say maybe think Well, I have this now because the answer is I think they probably had it before. And there's still a lot to learn, but there's no clear evidence out of studies that there's there's a permanent impairment. Right. Okay. And, you know, there are other side effects too, we could talk about that. That's, I think the main one that people talk about,

Scott Benner 1:06:48
I would, I would never minimize anybody's experience. But either, yeah, but I want to say this, and I want to leave with that. I've interviewed 1000s of people. And I have access to my Facebook group that has 50,000 active people in it. And so when my daughter at 18 years old, was told by a GI doctor, she had gastro precess, even though her a one C had been in the fives and the low sixes for most of her life. I didn't accept that. And we went and looked at other ideas, and added a digestive enzyme to her process of eating, which made all of her stomach pain go away. I shared that on the podcast. And I have to tell you that the amount of people with type one who I hear back from who just said to me, I thought my stomach was gonna hurt the rest of my life. I thought there was something wrong with me, my body was broken, etc, and so on. Now, I've added this, and it's all gone. It just cleared up. So we don't talk enough about when you get type one diabetes, some people get digestive problems, right. I mean, you know, they used to give Amazon out like it was like candy to type ones. But now if suddenly we don't do that anymore, so we, we ignore the possible digestive implications of having type one diabetes. And then when people talk about stomach issues, they send them right to a GI doc, who just jumps right to you have slow gastric emptying, you have gastroparesis. And I wonder if there's not, it wouldn't be helpful if people were better educated about that and spoke more about that to their patients. Do you find yourself seeing those things? Yeah,

Dr. Blevins 1:08:27
I think it was a really good point. And I think gastroparesis should be diagnosed based on you know, commonly some testing to document what's going on. And I think if anyone goes to their GI doc, please, if you're on a GLP one, tell them about that. Because everyone, you know, we we in the endocrine world, diabetes world, we're, we're all up on it. But not everyone is. And I can't tell you how many people now the GI Doc's I work with are really sharp. And they picked up on this very quickly. But I got some calls early on, from people saying, Hey, I just did an endoscopy on somebody who's on that medicine and they're still fluid in their stomach and they haven't eaten anything since last night. We've learned a lot, we've learned that that can happen. Slow gastric emptying can leave contents there for a while. And you need to be aware of that. If you're a GI doctor, and then this thing about symptoms too. I've had people go through major gi workups. And, and they're told Finally, well, everything's okay. Take these medicines, and it might help. And then they come back to my office, I go, Oh, you're on this medicine that probably cause all those symptoms. And Did y'all talk about that? And the answer is, there's been a lot learned and things have gotten a lot clearer. But But these medicines if you slow the stomach down, what happens? Well, you slow the stomach down, you could get fuller. And, and like my patient said earlier, it felt like his stomach was tight. Yeah, and that's no surprise. You can also have that gastric to juice be kind of pushed up the esophagus because there's more pressure and you could get some a soft vaginas. So it's important to kind of understand the implications of that gastric emptying thing.

Scott Benner 1:10:11
I have to tell you my acid reflux has completely gone away on a GLP. Right? Yeah, good. Is that in common?

Dr. Blevins 1:10:18
All things are possible there. They could get worse. I mean, you said it's got better for you. Yeah. And so the various things can happen. Okay. Most people really don't have any don't have an increase in reflex. Some do. And I can understand how it could get better, too. So there you go. And, and a lot of variability from person to person.

Scott Benner 1:10:39
I think we're coming up on our time. Is that right? We could go a little bit longer the longer Can I ask you about? So two things? So first of all, availability? Are you seeing it get better? I know there was a flood somewhere that slowed it down for a little bit? Like do you think that they just can't keep up with this? Do you think that so many people are using it? What Why are we seeing this? Do you think it'll clear up at some point?

Dr. Blevins 1:10:59
Yeah, availability has been a big deal. And I think part of it is related to some manufacturing difficulties. Part of it, the most of it, I think, is due just as pure demand. I mean, these these medicines are in high demand. And we almost need a pipeline, you know, there's so much that is needed and needs to be distributed. And we've seen those Olympic supply became very challenging, and it's improved a little bit in my experience will go the challenging, and maybe getting better, I keep hearing next month is going to be better. And then the next month comes in, it's not better June next month. And then now now, you know mount Jarrow has had some tight supply zapped bound as well. And of course, we as treatment people, like I want I want my people with diabetes, to have availability to the medicines they need. Right. And I like people losing weight, that's great. And so, you know, people that don't have diabetes, and you lose weight, that's important people with diabetes, big deal. So, you know, there's this this kind of back and forth about, you know, people who really needed aren't getting it really needed, what the definition of that, but that would be, you know, I think most people think those people with diabetes, again, we're talking type two, because remember, these are not approved? Yes. In general, for type one.

Scott Benner 1:12:24
I mean, listen, I, they've got to, they want to make money, right, they've got to figure out a way to get on top of it. I think one of them literally just bought a new place and down south somewhere, or they bought they bought somebody else's building and they're they're manufacturing, they're trying to get set up for it. I don't think it's because they're not trying. To me it lends to the idea of doing studies in other populations, because if it's this popular now, and you're not going to be able to stop taking it. And we have no shortage of people who could use it for diabetes and or weight, or hunger or PCOS or whatever we end up using it for like moving forward, find more people to give it to so you can make excuses to build more buildings and hire more people and produce more. I've heard of people getting it through China, like through China through a Canadian pharmacy into that was happening like that for a while. It's insane.

Dr. Blevins 1:13:13
Your your points well taken? Yeah. I think the demand surprised everyone, the potential the benefit has been embraced. And there's a shortage, which I think will cure in the next few months. Of course, I said that three or four months ago, too.

Scott Benner 1:13:29
Do you think that the demand was surprising is an indication that it works?

Dr. Blevins 1:13:33
I do? Yeah, I do. And I think that, that people understand that people with diabetes, that have the under the indication, benefit, a great deal from it. And that's really a big deal, because lowering the agency reduces risk of complications of diabetes, and helps all the metabolic issues that occur with diabeetus. And we know now that at least a few of these are approved for reducing cardiovascular risk. This studies were done in people with known heart disease, of course, but we know that too, there there are benefits all the way around. And but I think that people who don't have those, the diabeetus. And those risks still want it because weight loss is something people want. And for good reason. I can't blame them at all.

Scott Benner 1:14:19
Can I give you my my big theory? Yes. I think that after a generation of people using GLP medications, and basically learning to eat less and eat better, because they're being chemically kind of directed like that, that we might raise a new generation of people who don't eat poorly. I know that's a big idea. It's a generational idea. But how do your kids end up eating poorly? It's because you eat poorly and you maybe don't even know it. I use this example all the time. My mom who's passed now was told she was pre diabetic a few years ago, and she called me and said Scott i They Say I have prediabetes I'm gonna film to change up my diet completely. So that's great mom. And then I visited her a week later, and I opened up a refrigerator and everything she bought, couldn't have been a worse decision. Because she just didn't know the right things to eat, right. And that's the lady who taught me how to eat, right. And then I taught my kids how to eat except I got lucky, at some point and said to myself, we're doing this wrong, my wife and I were like, we both grew up very blue collar very simply, nobody understood, you know, nutrition at all. And what we consider to be good food was just the stuff we couldn't afford, that we got once in a while is a treat. And that made it good food is really interesting, like how we think about what's actually good for us. So that's my big idea. My big idea is if we take a generation of parents, and write their thinking that they might raise a generation of kids who don't get, I can see in three generations, this completely flipping the other way and forcing Agra to move with it. Because if we're not buying it, they're not going to make it. That's kind of how I feel about it.

Dr. Blevins 1:16:05
I like your idea there. I think starting early, with pretty much anything when it comes to kids is going to have long term consequences. And I think dietary, you know, approaches that early ages that are good, make make things happen. I've actually know some your young children who eat nothing but vegetables and all that all day, it seems. And they really, they do like ice cream and that but they don't. It's a treat, it's not a common, it's not something they expect, but they don't like some of the things that are really what we'd consider it to be high fat. And they're just because their tastebuds are there, they're acclimated to things that are different and, and they're healthy. And I do think you start early, whether it comes to when it comes to food or various things, like Stay away from drugs and cigarettes and all that I think you start early and you teach the kids how to how to go, it

Scott Benner 1:17:00
just becomes kind of second nature. Yeah, I do a Pro Tip series about diabetes with a with a CD or excuse me with a nude, a woman who's got type one diabetes, and is a nutritionist and her children eat fantastically, but So does she. Yeah, and that I think it just is what Liz also, I have to tell you, Tom, if you're willing to do this a few more times, I think you and I are gonna have a Pro Tip series on GLP is together because this is fantastic. I can't thank you enough for spending the time and we still have we didn't even get to the listener questions yet.

Dr. Blevins 1:17:30
So there's a lot to talk about. No, I'd love to. Okay, we'd love to. That's

Scott Benner 1:17:33
great. Kate, listen, do you accept new patients at the practice? Or would it not benefit you for us to share your information like that? I

Dr. Blevins 1:17:41
really don't see new patients. I do supervise a lot of people with advanced practice providers. We have excellent group here, who are really experts on diabeetus. But we have we're a single specialty. We have 12 doctors and three offices here. So though, I don't see any patients. The we as a practice, we see new patients all the time. Okay. In the Austin area, people come from various and we do diabeetus all endocrine so, you know, some listing that would include the practice predominantly

Scott Benner 1:18:14
and no, I Well, for sure. What would tell me the website? Yeah,

Dr. Blevins 1:18:19
it's Texas. diabetes.com. Okay. Yeah,

Scott Benner 1:18:24
I'll put it in the show notes as well. And I'm not kidding you. When you get done. You send me the study information that I can share online. I'll put it in a place where a lot of people say it for you. Okay, I'll

Dr. Blevins 1:18:33
do it. Yeah, we'll do that. Thank you. Yeah, I appreciate that. Oh, my God, let's let's put off the Frezza a little bit, because, first of all, we'll probably want to do more GLP. One first, because there are quite a few things we didn't get to your right. And we need to like the muscle mass change all that stuff. Preparing for surgery, all that very practical, that the impressive thing, American diabetes is late June, and there's going to be I know there's going to be a study presented that will make that discussion more useful. Okay. And I can't talk about the results before them. So anyway, when that's okay,

Scott Benner 1:19:08
can I leave this part in you talking about it? Like that? Yes. Okay. Because what I see here on I'm going to keep recording. You're back with me in two weeks. I think we need that one and one more to get through. GLP. Okay, and, and then do a fourth one on a friends. I think that would be terrific.

Dr. Blevins 1:19:25
That'd be great. Okay, cool. Very good. All right.

Scott Benner 1:19:27
Use that link I gave you and grab a couple more recording dates. I'll do okay. All right, Tom. This has been fantastic. No, you're amazing. Thank you. Bye. It's

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