#1558 Smart Bites: Fuel First, Feel Better

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

Macronutrients, Micronutrients, and the Mystery of Feeling “Off”

+ Click for EPISODE TRANSCRIPT

---

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

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

Welcome to my nutrition series with Jenny Smith. Jenny and I are going to in very clear and easy to understand. Ways walk you from basic through intermediate and into advanced. Nutritional ideas, we're going to tie it all together with type one diabetes, talk about processed foods and how you can share these simple concepts with the people in your life, whether it's your children, other adults or even seniors, besides being the person you've heard on the bold beginnings and Pro Tip series and so much more. Jennifer Smith is a person living with type one diabetes for over 35 years. She actually holds a bachelor's degree in Human Nutrition and biology from the University of Wisconsin. She's a registered and licensed dietitian, a certified diabetes educator. She's a trainer on all kinds of pumps and CGM. She's my friend, and I think you're going to enjoy her thoughts on better eating. If this is your first time listening to the Juicebox Podcast and you'd like to hear more, download Apple podcast or Spotify, really, any audio app at all, look for the Juicebox Podcast and follow or subscribe. We put out new content every day that you'll enjoy. Want to learn more about your diabetes management. Go to Juicebox podcast.com up in the menu and look for bold Beginnings The Diabetes Pro Tip series and much more. This podcast is full of collections and series of information that will help you to live better with insulin. 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. This episode of The Juicebox Podcast is sponsored by the Dexcom g7 the same CGM that my daughter wears. Check it out now at dexcom.com/juicebox, the episode you're about to listen to is sponsored by tandem Moby, the impressively small insulin pump. Tandem Moby features tandems newest algorithm control, iq plus technology. It's designed for greater discretion, more freedom and improved time and range. Learn more and get started today at tandem diabetes.com/juicebox Jenny and I are back to add to the nutrition series, but we've been talking about personal stuff for a while, so I just told Jenny, I'm all warmed up. I might speak too quickly, so keep an eye out, Jenny, if i i start babbling too quickly, I will fix it. Thank you. Yeah, you just slow me down. You go, Hey, slow down, buddy. So far, we've done the first three modules, and today we're looking at number four, advanced nutrition. And you have this marked for 18 and older health professionals and those wanting in depth understanding. So what are we going to talk about today?

Jennifer Smith, CDE 2:59
Yeah, so we've talked a lot about the some of the basics, right? Even, I think last time, we talked a lot more about how more processed types of foods impact overall health in a lot of different categories. And the reason for this more advanced Nutrition has to do with understanding how much your body needs, and it really is based on things like your sex and what weight you want to be at, how active you are, and then even moving into the diabetes realm, which is, again, the big piece of your podcast is, why is It then important to focus on the wealth of nutrients coming from all of those food groups that we've talked about already? Right? All the macronutrients boils down to the micronutrients. At what level do those micronutrients have a role in overall diabetes management, whether it's type one or type two, there are numbers of things. And I think a big, you know, a big piece is that people in general have been very focused on carbohydrates. And in the end, what I see is there's no understanding of how much to have in your intake on a day to day basis, okay, and especially, I see that for adults, kiddos, many times, will have a meeting with a registered dietitian, especially first at, you know, initial diagnosis to establish where are they on their growth curve. Are they growing well, have they kind of fallen off because of loss around the diagnosis time? How to get them back on their curve. And then what does your child do? Are they athletic? Are they more sedentary? But in all, whatever age you're at, it's understanding how much do you need, that's from a caloric level. And then again, those micronutrients, how much do you need of that? There are, you know, host of places that you can kind of chart things. There's things like lose it in my fitness pal and I spark people and places to put in weights and goals and that kind of thing, and get a feedback of this is your overall nutrient goal based on your parameters you've entered. But working with somebody to really establish that is valuable, because if you're really just focused on covering the food you eat with insulin, you could 100% have an overage, or you could be undercutting what you need in one category, and then your overall health can suffer.

Scott Benner 5:35
Do you find that people just think of eating as addressing hunger a lot of times. And not so much about fueling, right? 100% Yeah? Because it's funny, because you say macronutrients. And even I was like, macronutrients, like, is that a thing? I don't understand. So I went over to like, a web portal, and I was like, give me some examples of macronutrients, in case I don't know what I'm talking about. And all it said was, carbohydrates, proteins, fats and water, yeah, but you need a mix of chicken breast, rice, oats, like, you know, that kind of stuff. Yep, I get afraid that people are like, Mac nu. What is that like? But I gotta take a supplement. Like, you know what I mean? Like, no, you just have to eat a reasonable balance of quality foods when you're hungry,

Jennifer Smith, CDE 6:18
right? And you can, let's say you are the healthiest in choosing your they're all organic, and don't do anything that's processed and whatever. But if you don't know how much food you actually need, you could have the loveliest looking blood sugars. But you're wondering, well, why can't I get rid of this excess 10 pounds or whatever? Why

Scott Benner 6:37
won't my muscle build up because I Yeah, right, yeah, because I eat chicken. But actually, Jenny, you put me to this, like, while I've been losing weight, because I said, I told Jenny, I'm like, I'm taking in protein I'm doing this and this, she goes, Are you eating enough? And I was like, Oh, I don't know. What's enough, yeah, you know, I didn't realize. Like, so I'm putting all this effort and eating chicken and not eating enough of it. And I was like, Oh, you got to be kidding me. I added a protein powder, yeah, yeah. Because I was scared, I was like, I'm on a GLP. I don't want to not have enough protein. No, okay, and we

Jennifer Smith, CDE 7:07
lose muscle mass as we get older. I think it's after about the age of 30 or 35 if I remember correctly, you no longer really gain a heck of a lot, and it takes a lot more effort to maintain and then build that muscle structure, right? So anytime you're doing more of the resistance training and whatnot, you're really kind of tearing muscle fibers apart, yeah, in like, layman's terms, explanation, right? And then you have to rebuild that. The way that you rebuild that is putting back the right grouping of macronutrients. And also then the reason we eat the big food groups for their caloric value, which comes from the macros we get all of the micros, which, again, we've kind of talked about the micronutrients being non caloric, but they do provide the vitamins, the minerals, little antioxidants, and those pieces that we have to have from a very Small structure in our body. Our cell structure requires those,

Scott Benner 8:03
yeah, and these things exist in the right foods, but they don't exist in some things. I know it's so hard to think about, like, yes, a manufacturer makes a potato chip and then they add something into it, because it has to rise to some level to even be considered to be food, right? So they'll sprinkle something on it. But this is not where you should be getting your vitamin B from, or something like that, right?

Jennifer Smith, CDE 8:25
I'm imagining them at the food man. They're like, let's sprinkle this. How much do I have to sprinkle

Scott Benner 8:29
on that? We can feed this to humans, right? Right? Like, and because it's all flavor and nothing else, really, it really is, right, yeah, where do people like, trip, like, how come they don't add butter or avocado when they're looking for fat or something like that. Like, how come, or is it always just too much or not enough? Like, where do people, like, fall short when they're not getting their macros? Let's talk about the tandem Moby insulin pump from today's sponsor tandem diabetes care, their newest algorithm control, iq plus technology and the new tandem Moby pump offer you unique opportunities to have better control. It's the only system with auto Bolus that helps with missed meals and preventing hyperglycemia, the only system with a dedicated sleep setting, and the only system with off or on body wear options. Tandem Moby gives you more discretion, freedom and options for how to manage your diabetes. This is their best algorithm ever, and they'd like you to check it out at tandem diabetes.com/juicebox when you get to my link, you're going to see integrations with Dexcom sensors and a ton of other information that's going to help you learn about tandems, tiny pump that's big on control tandem diabetes.com/juicebox, the tandem Moby system is available for people ages two and up who want an automated delivery system to help them sleep better, wake up in range and address high. Blood sugars with auto Bolus, you can manage diabetes confidently with the powerfully simple Dexcom g7 dexcom.com/juicebox the Dexcom g7 is the CGM that my daughter is wearing. The g7 is a simple CGM system that delivers real time glucose numbers to your smartphone or smart watch. The g7 is made for all types of diabetes, type one and type two, but also people experiencing gestational diabetes. The Dexcom g7 can help you spend more time in range, which is proven to lower a 1c The more time you spend in range, the better and healthier you feel. And with the Dexcom clarity app, you can track your glucose trends, and the app will also provide you with a projected a 1c in as little as two weeks. If you're looking for clarity around your diabetes, you're looking for Dexcom, dexcom.com/juicebox when you use my link, you're supporting the podcast, dexcom.com/juicebox head over there. Now

Jennifer Smith, CDE 11:04
we fall short entirely in our education system. That's where we start to fall short is nobody learns these things unless one you've gone to school to understand them, like I have right, or you've done your homework and said I don't feel right. Or I'm trying to do this in terms of, like sports performance, and I'm not quite getting there. What am I doing wrong? And thankfully, now, you know, we don't have to go to like, Encyclopedia Britannica to look things up at the library. We can Google it or use AI systems or whatever to look up information. But unless you're really willing to do that, we fall short in the fact that we haven't been taught how much do we need? Why do we need it? And that's kind of the basis of this. Is the build of understanding, so that, you know, as kids, kids get what they get in a good way from their parents, what their parents understand and bring into the house has value as they then grow up and start to make sense of well, gosh, I was a runner. Right in high school. I got better at running, but thought I could probably do better. I went into college as a runner, but really didn't know why I was failing and not progressing. Had they learned some of the things about what goes in to build their body and to build that piece, they probably could do better. So in understanding these basic ideas, the goal is essentially to build a platform for parents to educate better. That's why this is more advanced, right? People, I said, probably over about the age of 18, so that they can really incorporate this idea in starting with how much do I need? It's based on where you are in your life, who you are, what your workout plan is kind of like. And then a piece behind it that even goes a little bit deeper is we're all made up genetically a bit differently, right? We have genes that have come down through our own heritage, that do impact our own body's metabolism, right, how we store and burn those macronutrients that we essentially take in. And I think a great way to boil it down is, you know, we talk about diet plans earlier, we've listed a whole bunch of them, right? And the piece here to figure out is people end up really do their homework. They end up finding some type of fueling plan that feels the best for them and gives them eventually the results that they want, and then they stick with it. But there is no one plan. There is nothing that will fit every single human on this planet. And the reason has to boil down to our genetics. We are all a bit different. You have to do your homework. You have to know a little bit about, well, you know, my grandma, my dad's mom, she was probably the tiniest person in our family. She was very healthy. She just died in old age, right? A better portion of the other part of my family, my mom's side, all definitely have some type of metabolic issue. They are much bigger people. They had there's a lot of cancer, obesity and all of that kind of stuff. And so if you know enough family history and enough history in terms of family health history, we can work against genetics.

Scott Benner 14:30
It's hard. You know, how I prove that out in my head is I'm actually thinking of this one person who has type one diabetes. She's, I can't think of her name. She's probably listening like, great, she's Canadian and she's a bodybuilder, right? Okay, I see her online. She pops up in my feed all the time. And I think there's a person who perfectly figured out what nutrients their body needs, right? Because you don't build to that size by mistake. Like, look, no, I'm doing resistance training. Every day, right? And when I'm done, I'm like, Oh, if I look like this all day, this would be awesome, right then, but, like, but I wake up the next day and I don't look like that anymore. But if I take enough protein and I eat the right way, I actually hold that the next day, right? Like, so she's figured that out, like, blown up in a big way. I'm not asking all of you to do that, but I'm saying this, like, if you're not using the right building blocks every day, not only are you gonna have lesser outcomes, right? You brought food in anyway. You might as well bring in the right food, you're gonna have lesser outcomes day to day. But what Jenny's saying is, like, it could really impact you 10 and 20 years from now as well. And I think maybe, just to highlight the idea, before we started recording, I told Jenny I missed my GLP medication for a day, and I woke up that following day two pounds heavier, and it's just water weight, right? It goes away. But like to Jenny's point about us all being different, it doesn't make any sense that my body would retain two pounds of liquid just because I'm not taking that GLP for a day. Like, there's something wrong with how my body's built,

Jennifer Smith, CDE 16:05
and it's making up for it with using it for why? Why does it work that way for you and for other people? Exactly, it

Scott Benner 16:12
doesn't Right, right? Like, how come, like, some people take that medication? I've heard people say, like, I've been on it for three months, I haven't lost any weight. I lost 14 pounds in the first week, right? Whatever happened, my body was like, Oh, we've been looking for that. And like, you know? And boom, and all that water weight came out of me. Why? It doesn't make any sense. I didn't change how I ate. I didn't, didn't, I didn't even know I was on the medication. Like, I didn't feel any differently. So tell me if I'm right about this. Because sure, like, I told you I went I just said, like, Hey, tell me what my macronutrients are and it breaks them down into carbs. But it also says what carbs do is that it gives you quick access for fuel for your brain and your muscles. Gives you some examples, oats, rice, pasta, potatoes, fruits, beans, table sugar, honey, and it says protein building blocks for muscles, enzymes, hormones and immune cells like chicken, breast, eggs, Greek yogurt, tofu, lentils, salmon, peanut butter. So I'll make sense to you, okay, Jenny's like, great. Good thing I went to college because now any dumb ass can ask this thing. But

Jennifer Smith, CDE 17:11
like, well, it's a good thing you can read. So there you go.

Scott Benner 17:15
Fats, long term energy. Cell membrane structure helps absorb fat soluble vitamins like A, D, E and K. You can get that from avocados, olive oil, nuts and seeds, butter, cheese, fatty fish like salmon. And then it lists water right? And it says that this is often listed separately, but the way it thinks of it is solvent for biochemical reactions, temperature control, nutrition, transport, and so you can get water by drinking it or by eating things like cucumbers, watermelon, broth, stuff like that. So that's what you're talking about. You're talking about, like a good blend of these kinds of items. How long if I'm sitting here now listening and I'm like, I don't feel right, my body's not where it should be. I know something's wrong. How long do you think a person eats like that before they sit, stand up and go? I do seem like, I think I feel better now. Like, how long do you think that has to happen for?

Jennifer Smith, CDE 18:11
It would be a pure guess. Honestly, if I put a number out there, days, weeks, whatever I think it does depend on how, for lack of a better word, how messed up their system is, right? It's gonna take some cleansing, if you will, of a system, especially if there's a lot of packed in issues in the arteries and the vessels and that kind of stuff, there's a lot of cleanup that the body has to work on. And one of the big pieces in our body that really is driving our sort of burn, our metabolic everything, is our mitochondria. There are a host of really good books all about mitochondria out there. It's really, you know, what we call the powerhouse of the cell, right? And then how we generate energy comes from how well our cells work, how well they clean themselves up, how well they kill themselves off, how well they regenerate. And so again, how long would it take? I think it doesn't take long to determine a fueling plan that you know doesn't feel right, okay, right? Because I can definitely say I'm somebody that I know how to do, for lack of a better you know, use is I can do the ketogenic diet. I have very flat looking blood sugars. I can do it to a T, but I do not feel the way that I know that I should feel on it okay. It doesn't work that way for me metabolically. So I know what works for me. I know what I've found works for me, gives me energy, allows me to be active the way that I need to, allows me to think through the course of the day without brain fog, etc, etc. So I think how long it's going to take might also. To take some experimentation and say, well, especially with diabetes, this doesn't seem to be working for me. I've tried everything in and out with Bolus timing or insulin timing and everything. Maybe I need to clean this up. Maybe I need to cut this back a bit, add a bit more of this, and it may not be a specific named diet, so to speak, but you will end up finding things that make you feel well and also, in the realm of diabetes, help you manage your blood sugars as well as you possibly can, along with also letting your body respond to insulin the way that it's supposed to

Scott Benner 20:33
respond. Yeah, and I don't want to sound like a hippie here, but like I think also when you start eating differently, I've had this experience, it takes a little while for your again. I even saying this out loud makes me feel stupid, but like, I know that this is true. Like, your gut microbiome, like, it takes a while for it to shift again. It's been breaking down whatever the dust is that they put over the thing to like, like, that's got to get out of you. Like, right? And it's not so much. It's got to get out of you is that it's like, it's that your body has to learn how to deal with something. Like, you've put your body in a situation where it is pretty reasonably processing a ho, ho or whatever, like thing, like, right? Like, it's nothing Jenny would not eat if you put a gun to her head. So, like, your body's learned how to get that through you, and now you're putting in good stuff it doesn't have what it needs to break down chicken and, like, it's, it's a different mix in there, and so you have to kind of make it through that, maybe take a probiotic at first to try to help you along. Because I hear, I hear all the time people say, like, oh, I made a shift, but my stomach was uneasy, or, like, I just couldn't do it anymore. And I'm like, Yeah, I think that's because your body was so used to doing it this way. It's got to adjust it this way.

Jennifer Smith, CDE 21:41
It has to clean it up Absolutely. And so that's why I don't think that there's a time frame to really put on, how long until you start to feel better. And again, with diabetes in the mix, you do have, you have a piece to watch that other people without diabetes don't have. We have a CGM or a glucometer to be able to use and say, Well, I'm not quite feeling better yet, but I do see that my blood sugars look better when I do this.

Scott Benner 22:06
Yeah. Do you find, generally speaking, that people with type one end up oversimplifying their nutrition, because it is a lot about like, if I can cover this with insulin, without spiking, without getting low, I have a success at this meal.

Jennifer Smith, CDE 22:20
Some people can oversimplify again, this is where personality comes into the mix, right? Some personalities do really, really well with the same thing over and over, because it's what they've figured out works and they don't veer from it. And if they're okay with that, there's nothing wrong with it, as long as they're meeting all of their micronutrient needs, if they're getting a host of everything they need. There is some limit to eating that way too.

Scott Benner 22:45
Yeah, no, at some point it can't just be about I know how to keep it from causing a spike, right? So, right, yeah, exactly. It's got to be food.

Jennifer Smith, CDE 22:53
It's got to be food. And in our world today, you know, as we've said before, we have so much that inter that's social about food intake. And can you be social without food? Absolutely, you certainly can. But it food has worked its way into the majority of settings in which we interact with other people, yeah, and so you have to work your way around it. Maybe you establish, I think everybody with diabetes, whether there's a name for it or not, we end up having some type of rule around how we do things, okay, around how we navigate food. We all end up with some some level of disordered eating, truly. You know, when you think about it, you may end up eating less of this, because you know that eating This amount could keep things under control better, or you shy away from this or that. And again, we don't define it by a true eating disorder, name of which there are within the realm of diabetes, but I think we all have these rules that we've established in how we navigate our day to day, to keep our control, so to speak, where we want it to be.

Scott Benner 24:06
I take your point. I mean, when food is medicine, it's tough. Like, you know, you mean, like, Dan, I don't mean like, listen, food could be medicine for all of you if you ate off that list. But like, I'm saying, like, when you know, you're like, oh, I have to eat something now. It needs to work in the next five minutes, or I'm going to get dizzy, or I'm going to pass out, or this is going to happen like it really does change. It's just, it seems like an oversimplification to say, but like, type one, I guess type two diabetes changes how you think about food in a way that I don't think is good. You know, I was just interviewing a woman who had Lada as an adult, and I'm not gonna, like, retell her story, but the myriad of psychological impact she had from not knowing, can I eat this? How much of this should I eat? What is this going to do? Like she was frozen, like she almost couldn't eat at all. Right? It's not fair, but I think what we're saying here is, if you take foods in that you. Find that jive well with your body that bring in micro and macronutrients. You might find diabetes to be easier to manage as well. You know, you

Jennifer Smith, CDE 25:09
may Absolutely and you know, as I as when we kind of started, it was, how much do you need? What you figured out does work? Then what's the portion of everything that you kind of need so just that you've found out, great, I do really well with broccoli, but I don't do super great with peas, fabulous. But that doesn't mean you should eat, like, six buckets of broccoli every single you know. And it boils down to then figuring out, how much nutrient do we need in our day to day intake. And we have, you know, two things. Really we've got our Do you know what BMR is,

Scott Benner 25:44
body mass? No, I don't know.

Jennifer Smith, CDE 25:48
That's my best guess. No, that's that's okay. I when we talk about, like, caloric intake, we talk about need versus need being what our body needs at base, and then overall, what do we need? Because we've added other variables into the day, like exercise, right? So BMR is our basal metabolic rate. Okay, that really speaks to the number of calories. And again, everybody's is a bit different. It's a base for breathing, thinking cells to develop all the essential functions that would go into maintaining your body, even if just sat on the couch all day long, you still need calories for that. Yeah, and it's a fair amount of calories, quite honestly, to keep your head up, to keep your head up, right? So essentially, then we add on to that. What do we need in total? When we add in our what we're called like activities of, you know, normal daily life, like walking around work, at at our job, or exercise that we do, or, you know, whatever it is, there's an extra amount of calories into that that we want to take into consideration. For those who are working on weight management, how do you know, well how much I need, but I really want to lose weight, so how much deficit then do I need in order to lose a certain amount of weight? So, you know, in terms of that, you may find the fueling plan, but then how much on that fueling plan do you need becomes the next thing to pay

Scott Benner 27:15
attention to, right? And I mean, how do you figure that out? There are

Jennifer Smith, CDE 27:19
formulas. And again, one of the easiest places to go. You can do it free or paid versions. I always think of like my fitness pal, is you can put in your parameters, and it'll give you a baseline of your your needs. And then, when you say, but I'm going to be moderately active six days a week, then it builds into that base an amount also. Then with the goal of, let's say I want to lose 12 pounds. Great. You've told me you want to be at this weight. You're active this amount, your baseline needs are here. So it kind of does all the math for you.

Scott Benner 27:50
Yeah, I hate to say it, but, like, I probably just go to any AI model and ask it, you could probably get the answer. Sure that AI could probably do it. I know people are going to give me crap, but you know, I was interviewing somebody last week who told me, you know, Scott, you talked about how you used AI for something, and I picked it up and tried it. And I've always had trouble talking to my doctors, so now I have the conversation with the AI first, and then ask the AI how to approach my doctor with it. And she's like, and then I email that to them, and I find that it's more concise than when I write it out. That's great. I ask it to be a little more technical so the doctor can understand it better. And she's like, and now I'm having a much better time talking to my physicians about my health. And I was like, Awesome. Cool. That is, you know, hey, I'm this old, I'm this tall, I weigh this much, you know, here's what I usually eat, but I'm hoping to eat somewhere like this. Can you tell me how much of it to achieve whatever I'm trying to achieve.

Jennifer Smith, CDE 28:43
And many of the platforms will even break it down, even I'm assuming AI would do it too. The more questions you ask or the more things that you want it to delve into. You can say, Hey, I'd really like the breakdown of my carbs, proteins and fats to be this percent, this percent, this percent. And I'm sure that it would break it down and say, great, you want to focus on this many grams from this group, and this many grams from this group to give you the overall, you know, breakdown in 3030, whatever.

Scott Benner 29:08
That's awesome. I think that anything that makes people's path easier is helpful, like, you know, because maybe people are embarrassed to go to a doctor and say, also, by the way, this is a group of people who've lived with, you know, autoimmune issues. There are doctors more often than not, and a lot of them have experiences of going to a physician asking a question and not getting an answer correct. It's a hard one to jump over, which is, I got to go to a doctor, set up an appointment, sit there and go, I don't like my weight or my health or like, so now you're embarrassed to begin with, can you tell me what they're doing? The guy goes, like, get more exercise. Like, awesome, great. I'm glad I took a day off from work for this. You know what I mean? Like, I need a real answer so

Jennifer Smith, CDE 29:44
well, and I think that is the the unfortunate thing people expect that their doctors are the person to go to for any health consideration. And that's just not the case. It's the reason that we have many different clinical places. Places to ask questions, right? I mean, you wouldn't ask your dentist about the fungus on your toe. He'd be like, I don't know.

Scott Benner 30:07
I'd go with my theory about the grocery store. Follow the fit people around, see what they're eating. Your doctor sitting there. Look like he's had seven packs of cigarettes today. Like, Hey, can I can I ask you a question about my health? He's probably like, Sure,

Jennifer Smith, CDE 30:21
right? Even, you know, even lab work, then, is another place, sure the doctor can order it. You can get the lab work. You can get the lab work back. And let's say, you know, taking this topic kind of further into not macro, but those micronutrients that we want, the reason we want to eat everything, it boils down to, well, maybe we're deficient in something. Maybe we don't have enough, you know, of magnesium or whatever it is, and there are quite a number that's specific to diabetes, play a pretty important role in helping manage background, how your body navigates life with diabetes. It helps with insulin use. It helps with glucose metabolism. A lot of different pieces in the mix, right? So we've got things like some of the fat soluble vitamins, vitamins A and D and E, that could actually be more deficient in those who have especially type one diabetes, you know, and the role of those quite valuable, you know, Vitamin D plays a big role in terms of sort of glucose metabolism, how your body uses insulin. On the cellular level, it has an important role, you know, in terms of overall, how our body sees and interacts with the food and then uses it up, yeah, you know. And then other things like magnesium and selenium and zinc and you know, their pieces B, 12 is a common one that's lower levels, and people who have type one, so if you're going to get those analyzed, great, but then know who to go to to talk about, what to do about it, right? Because I guarantee your primary care is not the person who's going to know the baseline. They're going to say, well, take a take a supplement. You might be have, you might have really expensive PE then,

Scott Benner 32:14
yeah, yeah. Now you're at the grocery store picking up some garbage, gummy or something like that, and spending $50 a month on it. It's not doing anything for you. Also, I'm not going to give any more details here, because I don't want to muddy the water, but you just gave me a great idea for a series for the podcast. So, oh, thank you. Awesome. Sure. Yay. Where are we at on our list? I want to make sure we're I

Jennifer Smith, CDE 32:32
want to definitely talk about micronutrients, which I just mentioned, kind of the big ones, essentially, that are often deficient, not always, but often. Vitamin D, I think, is top of the hit list there, quite honestly, how the body metabolizes different nutrients. We've kind of talked about that you brought up your nice AI of those macronutrients, what your body does with them and why they're important overall disease prevention, kind of more therapeutic nutrition, I think it's a it's definitely a piece that's beneficial to know about, because most people with diabetes may not have a second condition right now, but many people do. Yeah. Many people already have some type of what's called digestive disorder. Many people are always already having some type of heart disease or nerve problem or another autoimmune condition. We tend to in medicine, unfortunately, compartmentalize conditions. Take care of this one, and then we do this for this one over here, when really they all have an impact on each other. So we need to start looking at the whole of the person and what they're living with, whether it's one chronic thing like type one or a host of things like celiac and type one and thyroid and whatever. And we have to see how, from a nutrition standpoint, how are the things that we're doing interacting as a whole? Are there pieces missing? Do we need to start adding something that will benefit the whole, rather than picking them apart and only treating to one thing. Yeah.

Scott Benner 34:05
Okay, so I have to tell you, like, it's because we've been talking about this. I've approached Erica about talking about an idea too, that I think will help with this. And so okay, we'll bring it in later. But I think there's kind of the idea of, there's what we want and what we want to want. It's easy to talk about all this, but, and you can say, like, you know, I want to want this, like, I really do, but what I want is, yeah, you know, pizza rolls, course, yes. So we have to figure out a way. Like you just said, like you can't, you can't keep breaking things up into little like, we'll do this, then we'll do that, then we'll do this. Because if you keep saying like, you like, I'm going to address how I eat, but your brain's telling you not to do these things, you're not going to make it long. You know, there's that piece too. So I'm going to talk to Erica about how to logical. You know, you don't want to go down a rabbit hole, but a lot of this food probably has a hold on you in one way or another. Yeah, and making you want more like little drug dealers running around

Jennifer Smith, CDE 35:04
those people, you know, no that, and that's a great topic to bring up with her, because there truly are, I think we even talked about it before, you know, many different kind of cultural groups and or the way that you grew up eating. It becomes a piece of your family structure. And if you're the one that changes, and now you're doing this, and you're the only one eating the items that you brought, and everybody else is the wealth of the rest of the table, there's a big psychological piece to that, and you almost start feeling like the outsider then. So that's a great topic to bring up.

Scott Benner 35:39
Yeah, I just think that there's things that just get burned into your circuit boards, you know. Like, I'll tell you, you take my wife to a movie, she's buying popcorn. It doesn't matter if she wants it or not. Sometimes she'll have, like, four fingers full of it, and then she puts it down. I'm like, I think we just bought $75 worth of popcorn for you to have a handful of popcorn. I'm like, You didn't even want this. And she goes, No, I know, but it's hard to go to a movie without popcorn. I'm like, what? Like, it's something from her childhood. You know what? I mean, like, it just sticks to her. She goes into a movie theater, she buys popcorn. You want that? I mean, I don't know, but we're at a movie like, okay, let's just imagine all the other things that you're doing throughout the day that you don't realize. So

Jennifer Smith, CDE 36:20
absolutely, I there a host of things. Again, that's why, from this age, this more advanced piece, it's a I hope that more you know, parents, adults who have influence on the younger can start to understand it and even bring in some of the concepts in an easy way into family structure. Because it's what I've tried to do with our kids to help

Scott Benner 36:45
them. I've said this before in probably my weight loss series and other places, but you're gonna hear me cheerlead for glps, because I think some people are in such a generational pickle that they it's not, honestly, you can go to all the therapy you want. I don't think you're breaking free of it. Breaking free of it. If you can stop your brain from wanting to eat and stop your stomach from telling you you're hungry long enough for you to eat these macro and micronutrients have I mean, Jenny, look, it's two years now, I look like a completely different person. Now, yeah, I'm just gonna be honest with you, I don't think there's any world where I would have done this on my own. I could have accomplished it on my own. I forget that me even trying. I've been trying my whole life. I don't think I was getting it done. If you want to sit here and say that, you know, you go back and my dad grew up on a farm, and they ate, like, way too much food, and my mom was all about, like, make more, make more. And it was never good food, but there was always a ton of it. Or, you know, I think I shared with you recently that I'd eat grilled cheese constantly, but it was just wonder bread, butter and Velveeta. Yeah. I mean, I've probably eaten a truckload of that in my life, I'm sure, like, and so now I'm an adult, and I'm like, Oh, I can eat better now. I don't even know what that means, and my brain's wired from the sugar and the carbs and all the other stuff. Like, I was never somebody threw me in a hole so deep that even with a flashlight and a pair of spikes and a ladder, I wasn't getting out of it, right? Sure, this GLP came in, and it was like, here, you having trouble not thinking about food. Boom, done. You having trouble feeling full? Boom, done. And it's also wasn't magical. It wasn't a month or six weeks later, like it's two years later, yeah, but, but two years later, and I walked into the post office the other day. We have a very quaint little post office in my town, right? Like, it's literally, it's like five by five, and the same woman's been running it for years, and I only go there once a year to mail my taxes, because I like to see them put the I want to make sure it's dated correctly, right? Went in. I'm like, is this a my fault? If it doesn't go well, right? So I didn't see her last year. I saw the other guy that works there, and I walked in this year, so I hadn't seen her in two tax seasons. I walked through the door, we made eye contact. She lit up because she saw it was me, and I'm delightful, you know. And so, and she goes, Hey, how are you? Oh, are you okay?

Unknown Speaker 39:03
Because you look like you're a smaller human.

Scott Benner 39:05
Now it's been two years. I've looked like this now for eight months. I don't register what she's talking about, and so I'm frozen, and I'm looking her in the face. I'm like, What is she asking? Am I okay? And I can I just put it? Went, Oh, you think I have cancer? And she goes, Yeah, do you? And I'm like, No, I just I've lost a lot of weight, and we haven't seen each other in a while. She goes, oh, good for you. And then she started telling me about her husband and cancer and stuff like this. But what I realized is, is that, like, you know, had I seen her three months into this, she wouldn't have noticed. She wouldn't have noticed six months into it, she might have started seeing in a year. So if you're going to make these changes for yourself. It's not going to be right away, and if you need help, then you need help, right? I hate turning on another podcast or a TV show or something online and seeing some jacked up person tell me like you just don't want it enough. Like I want it plenty. Like I. Don't have your genetics, I don't have your job, I don't have your money. I don't have a lot of things like, right? Like my mom grew up giving me Velveeta cheese. I'm in a hole here. So anyway,

Jennifer Smith, CDE 40:09
well, I think the other thing, from a help standpoint, help from one angle, maybe it is some type of medication that helps you clear up that that food piece. But then I've seen enough people as well who may do fine using it in terms of what med does, but they still don't know the basics of what we've been building. You have to put it all together. Yeah, yeah, yeah. Have to find and if you don't know how to do that, and you want the wealth of benefit, if you are deciding to use something like this, then work with somebody who can truly help you get in quality. Because, again, there are a lot of pieces to using this medication that do focus around the quality of the food and those macronutrients and which ones are more heavily important.

Scott Benner 40:56
I am certainly not saying Just jab yourself once a week and eat your Doritos and like, and meld away. That's not valuable. Like, look, maybe it would be valuable on some level, but it's not. It's not what you're trying to do. But I'm just telling you, like, I have a personal story from this week in a meeting, and I can't give you any of the details. Like, somebody was in a meeting with somebody and said, I've lost over 100 pounds on a GLP medication, and in that room, someone treated them like they cheated. Oh, well, yeah, I guess if you don't have the stick to itiveness to do it on your own, yeah. And that person, by the way, was significantly overweight, and I was like, What is wrong with all of us? You want the same thing they have? Like you're mad at them for taking a shortcut, like it's not a shortcut. They weren't getting there, like it's not I know these people. They're not out there. They're not out there eating Crisco with both hands. It's not the world like, you know what I mean. So I'm not saying just take the Med and don't do anything else. I'm saying that if you can do all these things without that medication, then you should, and I think that's great if there's other things in the way I don't want to see you spend 10 years talking to a therapist to figure out why you want Cheetos on Thursday afternoons, because your mom used to come home and yell at you, like, I don't we ain't got time for all that. Jenny, right, life is short. Yeah, that's all I'm saying. Look, I got all upset at the end. All right, sorry.

Jennifer Smith, CDE 42:16
Oh, good. You didn't talk. You didn't talk too fast. Though they're all They're all warmed up, and I

Scott Benner 42:22
wrote myself a note before we started that. Just said, slow down.

Jennifer Smith, CDE 42:27
I did a great job. All right. Thank you. Thank you. Hold on a second.

Scott Benner 42:36
Today's episode of The Juicebox Podcast is sponsored by the Dexcom g7 and the Dexcom g7 warms up in just 30 minutes. Check it out now at dexcom.com/juicebox head now to tandem diabetes.com/juice box and check out today's sponsor, tandem diabetes care. I think you're going to find exactly what you're looking for at that link, including a way to sign up and get started with the tandem Moby system. Hey, thanks for listening all the way to the end. I really appreciate your loyalty and listenership. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. You

my diabetes Pro Tip series is about cutting through the clutter of diabetes management to give you the straightforward, practical insights that truly make a difference, this series is all about mastering the fundamentals, whether it's the basics of insulin dosing adjustments or everyday management strategies that will empower you to take control. I'm joined by Jenny Smith, who is a diabetes educator with over 35 years of personal experience. And we break down complex concepts into simple, actionable tips. The Diabetes Pro Tip series runs between Episode 1001 1025 in your podcast player, where you can listen to it at Juicebox podcast.com by going up into the menu, the episode you just heard was professionally edited by wrong way recording, wrong wayrecording.com you.

Please support the sponsors

---

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

Donate

#1557 Remy's Ma

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

When 18-month-old Remy started soaking through diapers and guzzling water, Kara had a hunch.

+ Click for EPISODE TRANSCRIPT

---

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

Scott Benner 0:00
Welcome back, friends. You are listening to the Juicebox Podcast.

Kara 0:13
Hi, my name is Kara. I'm in my early 30s.

Scott Benner 0:20
The podcast contains so many different series and collections of information that it can be difficult to find them in your traditional podcast app. Sometimes. That's why they're also collected at Juicebox podcast.com go up to the top, there's a menu right there. Click on series defining diabetes. Bold beginnings, the Pro Tip series, small sips, Omnipod, five ask Scott and Jenny, mental wellness, fat and protein, defining, thyroid, after dark, diabetes, variables, Grand Rounds, cold, wind, pregnancy, type two, diabetes, GLP, meds, the math behind diabetes, diabetes myths and so much more, you have to go check it out. It's all there and waiting for you, and it's absolutely free. Juicebox podcast.com, nothing you hear on the Juicebox Podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan. Today's podcast is sponsored by us Med, US med.com/juicebox, you can get your diabetes supplies from the same place that we do. And I'm talking about Dexcom, libre, Omnipod, tandem, and so much more us, med.com/juicebox, or call 888-721-1514, this episode of The Juicebox Podcast is sponsored by Omnipod five. Omnipod five is a tube, free, automated insulin delivery system that's been shown to significantly improve a 1c and time and range for people with type one diabetes when they've switched from daily injections, learn more and get started today at omnipod.com/juicebox of my link, you can get a free starter kit right now. Terms and Conditions apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox, today's episode of The Juicebox Podcast is sponsored by the ever since 365 the one year where CGM that's one insertion a year. That's it. And here's a little bonus for you. How about there's no limit on how many friends and family you can share your data with, with the ever since now. App, no limits. Ever since. Hi, my name is Kara, Kara. How would Kara be spelled?

Speaker 1 2:33
So I see it spelled the same way that I spell my name, C, A, R, A, and so what I do is I tell people it rhymes with Sarah, and that tends to help. It really is based on like, if they knew someone who pronounced it Kara, that's kind of what stuck in their head. If they are familiar with pronouncing it as Kara, that's easier for

Scott Benner 2:50
them. I see So Kara it is. I can do it all right. I care a lot about you being happy Kara, so I make sure I do that correctly.

Speaker 1 3:00
There you go. You have type one. I do not my son. Does your son? Does you look incredibly young? Oh, I, I'm in my early 30s. No,

Scott Benner 3:09
that's crazy. I honestly thought, like I I saw the description for who I was talking to today, and then you popped on camera while we were working out your technical issues. And I thought, Oh, I might have this wrong. Good for you. Oh, thanks. Do people think you look young? Generally, I

Speaker 1 3:27
don't know. I don't know if I've heard that in a while. Okay, maybe the lighting is doing something for me

Scott Benner 3:33
today. Whatever it's doing, take it home with you. Just walk around. Say to people when you want to visit me, we do it right here. This is where I look amazing. Anyway, all right, so how many kids do you have? Just

Unknown Speaker 3:47
one,

Unknown Speaker 3:48
awesome. How old he is? Almost five.

Scott Benner 3:51
Five. Wow. And how old was he when he was diagnosed? Remy Rennie. Oh, like, like, Rennie Harlan, like, the director, like,

Speaker 1 3:59
like, like, some people ask the short for Remington, but R, E, M, y, Remy,

Scott Benner 4:06
like the rat in that movie?

Speaker 1 4:07
Yes, I get that question sometimes like, oh, you named him after the rat in Ratatouille? No, we did not.

Scott Benner 4:13
Oh, Kara, Kara. I would never think you named your kid after a rat in a Pixar

Speaker 1 4:22
film? It depends. It depends on who I'm talking to. Like I was talking to some college students, and they're like, wait after ratatouille. And I was like, Absolutely not. But I

Scott Benner 4:30
appreciate the question. My wife says to me this morning, she goes, Hey, I got put on a committee to help name a drug. And I was like, Hey, hold on a second. I walked over to her. I was super serious. I said, Is there any chance we could call it Scotty b She, she goes, I don't think I'm gonna have that kind of pull on the committee. And I was like, gotcha worth a try. Yeah. I mean, I don't even know. Like, can you imagine, what if it ended up being bad? Like, and I was, and it was on the news, they're like, Scotty Billy kills it. There 50,000 people today. All right, so Remy yes is diagnosed at what age? 18 months old. Oh, gosh, you got me beat there. Yeah, he was little. Wow. How did you figure it out?

Speaker 1 5:13
Okay, yeah. So that fall, he was sick, you know, as babies sometimes are when they're in daycare, and he had different viruses, including pneumonia. And then I, like, noticed that he was really thirsty, he was peeing through diapers. And I was like, Huh? I think that has something to do with diabetes. And so, you know, I Google, and I'm like, okay, he has a Well Child appointment coming up soon. Like, I'll just ask his doctor at that appointment. And so this was, like, December 2021 went to the appointment. My spouse, Remy, his dad, was also there, and the pediatrician was like, Oh, he's just fighting another virus. I'm like, Okay, I'm not gonna panic like he I'm gonna trust what the doctor is is telling us, like, we'll just see how this goes. So then a couple weeks later, he got really sick. We take him to the ER, he gets diagnosed with COVID, and they test for, like, other things too. They give him a steroid, they send us home. They're like, okay, he should be so you should be seeing improvement, like, in the next 12 hours or so. Cool, we go home the next day, he is definitely not better. I'm thinking that he's worse. So we bring him back to the ER, and then he is diagnosed with type one

Scott Benner 6:25
Carrie. You break up once in a while. So I'm just gonna, like, I'm gonna live through it, and the editor is gonna seam it back together. Because we're not losing any of your words. There's just a gap sometimes. So, oh, okay, good to know. So if you pause at the end of a thought, and I'm not there right away, give me a second. Okay, gotcha. Okay, all right. Wow. So you figured out, how did you know, like, what do you do for a living? Or are there people in your family with diabetes that you were just like, oh, that sounds like diabetes to me. Yeah,

Speaker 1 6:51
great question. I don't know exactly. Okay, so I'm a social worker, but not like in the medical field, and I do have some family members with diabetes, but it wasn't like I didn't, I don't feel like I was super educated on diabetes prior to my son's diagnosis. It was just kind of like, somewhere, you know that, like, knowledge is in your brain. You're like, read something once, and you're like, oh, okay, I think these are, like, connected symptoms. And, you know, I googled and was like, Yeah, this. Like, this could be a

Scott Benner 7:16
possibility. That's crazy. You were just like, Oh, I think I know this. Yeah, I don't. I

Speaker 1 7:21
like to read a lot, so I don't know, like, you know where that thought came from? Yeah,

Scott Benner 7:24
hey. Last odd question about Remy his name, do people since you're Remy his mom, Do people ever call you Remy Ma? No, they really should, don't you think?

Speaker 1 7:35
No, well, like his classmates call me Remy his mom because they see me at drop off. But not

Scott Benner 7:40
like adults. Adults don't do that. No, huh,

Unknown Speaker 7:44
no, not to my face. Anyway,

Scott Benner 7:46
she got eight years for shooting somebody. Oh, this was in 2008 I guess she's out by now. Grammy nominated rapper Remy Ma was sentenced to eight years in prison on Tuesday for shooting and wounding an acquaintance after discovering money was missing from her purse. Hey, you know what? Don't take money from people. Lesson learned, yeah, they might shoot you with a handgun they have in their purse. Think a little bit full generation of people, Kara, that aren't aren't properly scared. You know what? I mean, what a shame. We've nerfed the whole world for everybody now they think they can just steal Remy took care of it. She's like, bang, no, that's my money. Give it back eight years. I wonder how much money it was. I bet you not eight years worth of money. Probably not. Anyway, you're a Remy Ma from now on, and we're gonna move forward. I was just like, oh my god, this is gonna be a great episode title.

Unknown Speaker 8:36
It will be. I can't wait to see what you come up with.

Scott Benner 8:39
Yeah, I'm piecing it together already. Well, okay, all right, so you pulled diabetes out of your let's

Speaker 1 8:43
say, I mean, kind of but no one believed me right away. So

Speaker 2 8:47
oh yeah, oh people were like, Oh no, no, no, yeah. So his pediatrician

Speaker 1 8:51
was like, Nope. It's, you know, it's just a virus, you know, we took him to the yard. So I think the fact that, like, when he got really sick and we took him to the yard that first time, I think the COVID diagnosis, like, I think those symptoms were masking, you know, the dka, because he was in DKA, he was in really, really bad shape, wow. So I think, I think that made that tricky for them, you know, the first ER visit,

Scott Benner 9:12
did he come close to a real, like, significant medical issue, not that this isn't, yeah,

Speaker 1 9:17
I think so, right, yeah. So they were, they were pretty concerned about, like, his mental state. They're like, Oh, mom, like, good instincts, like, good thing that you brought him back. I'm like, Yeah, I think he was dying, and he kind of was, they were talking about, like, intubating him. They were really closely monitoring, like, I said, his mental status, like the COVID and the DPA, like, you know, His breathing was really tricky. Thankfully, they didn't have to intubate him. Like, you know, he pulled through. Here we are, yeah, and we were released from the hospital on Christmas eve of December 2021

Scott Benner 9:48
Oh, Merry Christmas too. Yeah, it was, it was a

Unknown Speaker 9:50
rough Christmas, for sure.

Scott Benner 9:52
Nothing good for you in this like your husband said, No, it's not that. And then later, you were like, Oh, I told you I was right about that. Any Did you get any of that at all? Yeah. Hmm,

Speaker 1 10:00
no, not my husband. I mean, we, we don't see that pediatrician any longer. We weren't really a fan of him to begin with. We didn't feel like he was a good listener even before the diabetes thing. So we did switch to a different pediatrician, and we really like her. We also love our like and he, you've actually interviewed him. He has type one himself. And are the educator we saw the CDE, her son has diabetes, and so, like, the care we received in the children's hospital was excellent, even if getting to that diagnosis was like a rough process in some ways.

Scott Benner 10:37
Shout your PD, your endo out. I had him on. It. He was awesome. I thought,

Speaker 1 10:41
yeah. Nadia Kasim Nader, I always say his name incorrectly. Sorry,

Unknown Speaker 10:46
really, really,

Scott Benner 10:52
oh, you say people's names wrong. Do you Cara, Cara, whatever,

Unknown Speaker 10:58
sometimes I do give big

Scott Benner 10:59
opinions about your name being pronounced correctly.

Speaker 1 11:02
No, I really don't. I feel like I offer people a lot of grace. I just try to, you know, give people a heads up if they if they care about pronouncing it

Scott Benner 11:09
correctly. Oh, you were so lovely, actually, before you started, you were like, I just want to, want you to know. And you're like, I won't even if you say it wrong, I'll never even bring it up. And I was like, No, bring it up if I say it wrong. Well, Dr Kazem was awesome. Like, his episode is really, really wicked good. Like, and I'm not even from Boston, and I just said that. So, you know, you said you had a pediatrician who didn't really listen. You had one that that does. Now, what do you think that that brings to you? I

Speaker 1 11:34
think it's so critical for healthcare providers and anyone in the helping profession like profession, to make sure their patients are heard. Yeah, I think that's just really important in general. Like, I know from personal experience, like, right? People want to be heard.

Scott Benner 11:49
Yeah, no. I just wondered if you had, like, an actual like, hey, this happened before, and now we're talking to somebody who's a little more locked in. And, I mean, is it your comfort? Like, do you just you feel more heard, and what does that bring to you when you have that feeling, you know what I

Speaker 1 12:06
mean? Yeah. I mean, so, like, our current, I mean, pre nutrition, she's great. And it's not that she's really involved in Ronnie's, like, diabetes care, yeah, I don't know if I have, like, much more to say about just the importance of being heard it, I think it makes for better relationships in general, but especially with a healthcare provider, right? You're in a vulnerable position. You want to feel like your voice matters and that you have something to add to the conversation, and instead of being, you know, talked over or dismissed,

Scott Benner 12:36
yeah, no, I hear okay, all right. What makes you like I don't know, pick up a keyboard and say I'd like to be on a podcast. Today's episode is sponsored by a long term CGM that's going to help you to stay on top of your glucose readings the ever since 365 I'm talking, of course, about the world's first and only CGM that lasts for one year, one year, one CGM. Are you tired of those other CGM, the ones that give you all those problems that you didn't expect, knocking them off, false alerts not lasting as long as they're supposed to. If you're tired of those constant frustrations, use my link ever since cgm.com/juicebox, to learn more about the ever since 365 some of you may be able to experience the ever since 365 for as low as $199 for a full year. At my link, you'll find those details and can learn about eligibility ever since cgm.com/juicebox check it out. Today's episode is brought to you by Omnipod. We talk a lot about ways to lower your a 1c on this podcast, did you know that the Omnipod five was shown to lower a 1c that's right. Omnipod five is a tube, free automated insulin delivery system, and it was shown to significantly improve a 1c and time and range for people with type one diabetes when they switched from daily injections. My daughter is about to turn 21 years old, and she has been wearing an Omnipod every day since she was four. It has been a friend to our family, and I think it could be a friend to yours. If you're ready to try Omnipod five for yourself or your family, use my link now to get started omnipod.com/juicebox get that free. Omnipod five star kit today. Terms and Conditions apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox,

Speaker 1 14:33
and listening, you know, for a while, like, we found out about you pretty early on our CDE, let us know about the podcast when we're in the hospital, and I joined the Facebook group, I think, like, while we were maybe still in the hospital, or soon after, and then you had posted something in the group about, like, I don't understand. And I had listened to, maybe, I think I listened to a few of those episodes. But anyway, and so my question was, I don't understand why doctors. Don't do a finger poke when patients are presenting with symptoms of type one, especially when there's a family history, like there is in my family, so that I am someone who really cares a lot about prevention, and so that I know the answer to this question, but I also still feel like we can do better in general, for our kids and for adults.

Scott Benner 15:21
So this is a thing that that I find newly diagnosed parents seem to feel very, very strongly about this, okay, like, why doesn't everybody just do a finger pick? You know, at every, every doctor's appointment, when something like this comes up, and I wonder if that comes from, like, you just having the experience where you're like, you realize now, like, oh, we were in there, somebody would have just done this, then the rest of that time, that gap wouldn't have been there, I guess. Like, what was the gap of time between that first visit and when you actually got a diagnosis? And, you know, first, how long was that?

Speaker 1 15:58
Yeah, so, you know that, well, child appointment, and then the actual like, diagnosis in the emergency department wasn't that long. It was probably only about a month. But like, you know, looking back at pictures and looking at how he was, you know, he was so sick that fall, so I don't know exactly, I can't tell you exactly, like, when his symptoms started, so it was an incredibly long period of time, but I do feel like it would have been maybe possible to avoid DKA I had at that well child appointment, the doctor or whoever did that finger poke. And so it's not like, you know, the diagnosis still would have been there, but we would have avoided conversations about intubating our 18 month old child, you know, right before Christmas Eve, which

Scott Benner 16:42
is a thing you probably still think about

Unknown Speaker 16:44
now, yeah, sometimes. I

Scott Benner 16:45
mean, clearly I'm talking about it right now. Yeah, no, but I mean, seriously, like, that's a it's your first kid, right? You don't even know what you're it's 18 months. You're just, you don't even know what you're doing yet. You know what I mean. And then this pops up exactly, yeah, you said you had diabetes in your family. Where is that?

Speaker 1 17:01
Yes, so technically, it's on both sides. So on my husband's side, his maternal grandfather had type one. I never met him. He died before we were together, so I don't know much about that, but on my side, so my dad has type two currently in remission. So his brother, my uncle, who has since deceased, probably had type one or Lata, and he died due to diabetes complications. And my grandfather, so my dad's dad and my uncle's dad, he also probably had type one, or, you know, Lata, he died due to multiple health complications, including diabetes. So, yeah, it definitely runs in the

Scott Benner 17:46
family. Jeez, it does. How about other autoimmune issues, like thyroid or celiac or anything like that?

Speaker 1 17:51
No, not that I know of. Yeah, no, I have an autoimmune disease, but that was diagnosed like in the last year ish, what is yours? It's this kind of random kidney thing. It's called AGI nephropathy. It's more common in like, young men, and they don't really understand why I have it. There's not a lot of information about it. So technically, I'm in stage one

Scott Benner 18:14
of kidney disease. What's I was gonna say? What's the impact on your life right now?

Speaker 1 18:17
None, right now. So I had, you know, I was on a steroid treatment and lots of other medication, which took care of the problem pretty quickly. And so I'm also, I'm technically in remission, so it's something that I follow up with my kidney doctor, my nephrologist, on yearly basis.

Scott Benner 18:33
Is there a thought that you can manage it and it won't become more of an issue?

Speaker 1 18:37
Yes, that is the thoughts and the hope, you know, on the one end of the spectrum, like, you know, severe would be needing dialysis one day, but I've responded really well to treatment, and the hope is to keep in remission. And, you know, if symptoms come back, to just continue, like treating it, and hopefully it continues to respond. Well,

Scott Benner 18:54
it's awesome that they found How did they find it? I was having a lot of

Speaker 1 18:57
swelling, which wasn't going away, and so I asked my primary care doctor about it, and she listened right away and got on it. And had, I had some testing done, they found, you know, protein in my urine, referred me to a nephrologist right away and had more lab work. I had a kidney biopsy, yeah, geez. And so that's then when I got the actual, like, diagnosis.

Scott Benner 19:20
Are you guys thinking, I've had other kids or no? 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 Arden supplies to be refreshed, we get an email rolls up and in your inbox says, Hi, Arden. This is your friendly reorder email from us. Med. You open up the email, it's a big button that says, Click here to reorder, and you're done. Finally, somebody 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. You. That simple, us, med.com/juicebox, 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 g7 they accept Medicare nationwide over 800 private insurers, and all you have to do to get started is call 888-721-1514. Or go to my link, usmed.com/juicebox, using that number or my link helps to support the production of the Juicebox Podcast.

Speaker 1 20:48
That is a great question. Um, yes, I would like to my partner needs some more time to consider.

Scott Benner 20:55
Is everyone on board? Yeah, I

Speaker 1 20:57
don't know if that's something we want to spend a lot of time talking

Scott Benner 21:00
about, because there's a guy holding half the cards in this deck. And, yeah,

Speaker 1 21:04
that's how it works. And, you know, and friend Remy was initially diagnosed, both he and I were like, oh, like, I think we're one and done, but some time has passed and I am more open to expanding our family.

Unknown Speaker 21:14
Yeah,

Scott Benner 21:16
interesting. What do you think, without digging too deep, just high level is the hold up on the other side, the diabetes and the health stuff,

Speaker 1 21:25
yeah, that is, that is part of it, for sure, okay? And just in general, like, you know, Parenting is hard, so, oh yeah, lots of factors. Can I just tell you,

Scott Benner 21:35
it was maybe three nights ago now, Saturday, whenever Saturday was Tuesday, already, I feel like it's like Three nights ago, I gave my wife a hug in the kitchen, and I whispered in her very gently. If I would have known all this, I never would have spoken to you. I just would have stared through you and kept going. I didn't know all this was gonna happen. You know what I mean? I do. I do know what you mean. Yes, it's like, I was like, I I just had this moment a couple of days before where I was talking. I was, you know, we still talk, but we've been married for a while, so it's not necessary all the time. But we were talking, and I said, I don't feel this is going to sound crazy, because I'm a pretty hard worker. I was like, I don't feel like I'm working hard enough. And she's like, What are you talking about? It's like, I don't have a lot of ideas and things I want to do when I just don't feel like I'm doing them quickly enough, and I'd like to do that. I feel like I see a space here to do something like that, and I'm really going to get to it. And the next like, it couldn't have been four hours later, like, our son comes home and says something, and I was like, oh, here goes the next five months of my life, there you go. And then it's not like, 48 hours later, Arden wakes up in the morning. She goes, I'm sick. I'm like, oh, okay, all right.

Unknown Speaker 22:50
Like, okay, there's always something. It never

Scott Benner 22:53
stops. It's never and that people keep saying, like, I heard somebody told me today. They're like, oh. They say when they go away, like when they get married, it gets easier. I'm like, Well, how old am I going to be at that point? First of all? But I don't think it will. I just think it'll change.

Speaker 1 23:06
It just changes. Yeah, I've heard someone say, you know, when they're little, like their problems are little or, you know, like we're trying to feed them and learn ABCs and things. And then as they grow, their problems become more complicated and more expensive and sometimes work time consuming. So, yeah, even when they're adults, if you're still involved in their life, like that, takes time. This is

Scott Benner 23:27
my point. I just, I actually, I was like, I don't even think we should be trying to save for like, retirement at this point. I was like, we should just, like, light everything on fire, go out and blaze the glory and be done, right? Yeah, just enjoy ourselves while we can. I really, because I don't see how I'm going to live to ad to begin with

Speaker 1 23:42
that. Yeah. I told some students the other day that aging is a privilege, you know, in some ways, and they were like, what? Like,

Scott Benner 23:50
yeah, it just means you didn't die. It's awesome. Yeah, you said a social worker in what setting?

Speaker 1 23:56
Yeah, so that's, that's a good question. I am a macro social worker, which means, like, I don't practice therapy, I don't do direct work. I used to, I've done direct services in the past, but I work for a nonprofit that provides. Well, I work, I work on the prevention team. So primarily, what Children's Advocacy centers do is they help kids who have been sexually abused. That's the clinical side of things. I'm on the prevention side, so I provide education in the community to both children about body safety and to adults like recognizing signs, but also like having good policies and procedures and their organizations and knowing how to report something if they have a concern.

Scott Benner 24:37
Wow, that's awesome work. How'd you get involved in that.

Speaker 1 24:41
So prior to doing this, so I started off, like, right out of grad school, I was a foster care worker, and that was not the job for me. So I, like I said, I'm very passionate about prevention. That's always been something I've been interested in. And so I learned about this prevention position at the Children's Advocacy Center, and that felt like a great fit. So I've been doing that. About five years.

Scott Benner 25:01
That's awesome. Good for you. Is this a more prevalent problem than I would imagine it

Speaker 1 25:07
is? We could, Scott, we could dedicate a whole podcast episode to that, but I know that's not why I'm here, so I won't use this opportunity for my soapbox. But it is, yeah, it's much more prevalent. The kind of like National statistic is one in 10 happens a lot more than I get it. That's a stigmatized topic, and so that's kind of what I'm passionate about, is de stigmatizing conversations around it, so that people can get the help that they need, rather than not telling and then not getting help.

Scott Benner 25:34
One in 10, somebody they know, a lot of people. Yeah. Is it somebody they know, generally somebody they don't know. Does it happen in all kinds of communities, like even ones where you'd think like, oh, white picket fence, everything's good here.

Speaker 1 25:48
Yes. So it happens in every community, and it's often someone they know, because that's someone that has maybe built some rapport with them. So it could be someone in their family, or it could be someone close to the family, or, you know, someone else in the community who, again, like it's not that only the child has trusted this person, but also the family or caregivers have as well, and then that person gets access to the child.

Scott Benner 26:13
So for every 50 people I know, how many of them are psychopaths, what do you

Speaker 1 26:16
think? Oh, man, I am not qualified to talk about that. No, you're

Scott Benner 26:21
not qualified to talk about it, but you might think about it, right, and just get the help I need, right? Yeah, no, but I'm seriously though, when you see this side of the world, when you see that side of the world, is it difficult not to look into a crowd of people and think there's a terrible person in this group? Like, statistically speaking,

Speaker 1 26:38
a great question. So, yeah, once you're, I think, in the field of social work, and especially like the side of child welfare and the work that I do, you definitely see the world differently. I don't like think about terms, like, of bad people, but I think about, like, you know, everyone has probably faced something hard, and not everyone's talking about the hard things they have faced. So it definitely, I think, makes you just more empathetic and aware and just not afraid to talk about hard topics like this

Scott Benner 27:05
I can imagine. All right, so this, yeah, poor Remy, 18 months old. I mean, honestly, Arden was two years old, and I thought, Oh, how you know, but 18 months how much did he even weigh at that point? Oh,

Speaker 1 27:17
man, well, so he definitely had lost some weight with the undiagnosed diabetes at the time, I don't remember, I'd have to look, but he didn't walk for two weeks afterwards. That's something that, like, sticks out in our minds sometimes, like something I don't think about very often. But, you know, he was so ill, so like, he had COVID and this diabetes diagnosis at the same time. So he was really, really sick, really tired. He was little. He was still nursing at the time too. I remember, like, Finally they let me, you know, he had, like, less tubes connected to him, and so I, like, climbed up into his hospital bed, and the nurse walks in, and we're nursing, and she's like, Oh my gosh, I don't what are we supposed to do about that? Like, how do we dose? Oh, the nurse didn't know. I don't know. Like, it's not his primary source of nutrition. But anyway, so it's not something that we,

Scott Benner 27:59
like, worried about. Take a look at this thing. How many carbs you think are in it? I don't know. It's not a thing you've been thinking about ever in your life, either. Oh, no. How long did it take you to figure out a plan and a pattern for all that, for, like, nursing or, like, I mean, just in general, having an 18 month old, newly diagnosed kid. Like, I mean, is there a let's start at the beginning. Do you get a CGM? Do you get a pump? Like, how do you figure out, like, carb counting for nursing? Like, the whole thing,

Speaker 1 28:26
yeah, yeah. So I didn't, I didn't worry about carb counting for nursing, just because, like, it wasn't really, like, I don't think he was getting very much, like, it wasn't pumping anymore, so more for comfort. So I really did not worry about that. But I know other people who you know early on diagnoses were trying to figure that stuff out. But yeah, so he we did get a CGM in the hospital, which I'm very grateful for. Walked out, you know, with the Dexcom on his body. We started out MDI, but we were told in the hospital, but because of, I think, his age, we were, you know, they were pushing for us to get an automated insulin pump pretty quickly, which we did. It only took us, like, a couple of months of being MDI before we're able to get the Omnipod dash. He's now in the five so, yeah, pretty early on.

Scott Benner 29:08
And so you were dosing from a pump really early. What did a Bolus look like for a meal? How much insulin?

Speaker 1 29:13
Oh, man. I mean, it was, it was small, for sure. And we were more strict on carbs, I think, in the beginning, than we are now. So yeah, getting really little amounts, and that was kind of part of the push for the pump, was that you could do smaller amounts more easily, right? Than trying to draw up a Bolus with a needle. It could be more precise. So yeah, he was having pretty small amounts of insulin.

Scott Benner 29:39
What do you mean? Careful about carbs. What were you how were you managing it? Yeah, we were

Speaker 1 29:43
so, you know, we were doing, like, carb free snacks, as they recommended. He was going to daycare, and so he did. He didn't go back right away. I think it was like, a couple weeks later he went back. And we were, you know, still learning ourselves, but trained them how to drop inside. In and we would send this little, like, rich sheet. And we still do that currently, we send a little written sheet with the carb counts for his snacks and meals. I don't remember the original question. Oh, careful with carbs. Yeah, we were trying to, I mean, we were still feeding him like bread and pasta, but I think we were just trying to be more mindful about having a balanced diet, you know, having like, protein and veggies at the same time.

Scott Benner 30:23
Has that changed now? Or did it just get easier when you learned how to bowl, a seat, better,

Speaker 1 30:29
a little bit of both? So he was only going to daycare a couple days a week, and they provided food, which is really cool, like that was included in the cost. So we would look at the menu ahead of time and kind of say like, Oh, they're serving cereal. He will not be eating cereal, you know, that kind of stuff. And now this year, especially, he is in preschool full time, and meals are also provided. So he eats the same meal as everyone else. If he wants it, I tell him what the menu is. He loves pizza, but then crust. So when they serve deep, deep dish pizza at school, he opts to not have that, which is fine by us, but he eats all the other I mean, you know, like, there's like 90 carbs in a meal, sometimes for lunch, so like, he's having that along with his classmates. Now we do send his own snacks, because, again, the snacks they serve are cereal. I love cereal, like, it's a great snack, right? It's not full of nutrition. He also doesn't like cereal, but anyway, so we do send his own snacks, just to keep it a little easier, stay more stable blood sugars. But he's eating lunch along with his classmates.

Scott Benner 31:30
Yeah? You're like, listen, I know it's not good for me, but who doesn't love a handful of apple juice? Yeah?

Unknown Speaker 31:35
Classic cereal. It's like comfort food.

Scott Benner 31:39
Yeah? You know, I just, you just made me realize something you said that there was this year that I I beat the school over the head until they made carb and calorie and all kinds of nutritional information available for everything that they served in the cafeteria. They still do it to this day at the school like I'm telling you, I made that happen, and then I never looked at it once. They because, you know, when I went on my crusade, I didn't know what I was doing yet, and by the time I figured out how to Bolus for things without knowing exactly what was in it all the time, I got the whole thing worked out with the school. So by the time was available, I don't think I ever looked at it once, yeah, but other people have it now, so I'm happy about that. But right, yeah, I just realized that the the poor woman who was like, shackled to me to get this accomplished, realized she'd probably come over here and hit me with a stick or something. My god, that's like, because she's like, we don't want to do like, they did not want to do it. Oh, I'm sure they did. No, they they weren't looking to be involved in this. But they got one day, got tired of me calling and going, how many cars been in today's lunch? And they'd be like, I'll put you through to the lady in the kitchen. I'm like, Okay. And then one day they were just like, maybe we could put this on the menu. I was like, that'd be awesome, yeah. And it wasn't that easy for some reason. My goodness, what have you seen from Remy growing up that would say to you that diabetes has made an impact and changed his life from where you thought his life was going to be, and where are there spots where you can't believe Nothing's different?

Speaker 1 33:14
Yeah, I think early on so like when you know we're in the hospital and they tell us a diagnosis, like I remember, and this is, like, my memory of it, right? So I'm not saying this is how the doctor was, but I remember one of the doctors being almost excited and probably more relieved that they figured out what was going on, right? Because he was in such bad shape. And so I remember being, like, kind of devastated, because I had a little bit of an understanding of what this diagnosis meant, because of my family members, like knowing, like the longevity of it is what was really hard for me to swallow at the beginning. This is something he would have forever. I'm over that now, I think for the most part,

Scott Benner 33:50
you had a situation where he was celebrating a thing that you thought killed your uncle, right?

Speaker 1 33:55
Right? Uncle is still alive at the time, but yes, and doing knowing the devastating consequences that, you know, improperly managed diabetes and have on one's

Scott Benner 34:04
body. And your uncle passed recently, in the last couple of years? Yeah, oh my gosh. How old was he? Like, in his 60s? Jeez, gosh, yeah, yeah. Well, I mean, guess maybe another story, yeah, no, I'm just saying, I'm, you know, I'm sorry he's gone, but probably good for you that it wasn't you know, before, because it would have hit you much harder. I would imagine. Yeah, I think so, yeah. Well, so, okay, so is there anything you can look at like, I see people worried all the time that this is going to change my kid's life, right? They're just not going to have the life that they that we expected, or we wanted or whatever, like that. But are you having that like, is that your experience is, Has it changed things drastically? Or do you think,

Speaker 1 34:44
no, I don't think so. You know, at first, like, yeah, just the longevity of it was something that was like, Oh, this is so sad that this is this burden that he will carry with him his whole life. But we, you know, since then, and his doctor did a good job too. So we live in a beach town. Yeah. And we love going to the beach and spending our time outside. And he was like, hey, these, the technology they have is waterproof, like this is not going to prevent him from living his life. And so, yeah, we haven't, you know, let that really impede his activities. I think it has made us think more critically. I mean, it has impacted like, babysitters, right? Like we don't have, we don't just choose anyone to be a babysitter. There's some extra training involved, as parents, know, and that's fine. That's something that we are fine to manage. Yeah, I don't think we're concerned about, like, stopping him, you know, from living a full, it's awesome, happy life. He does. He's really interested in outer space, and so he talks about wanting to be an astronaut. So I have not, you know, explained to him that, like, I'm not sure if that is an option for someone type one but hey, who knows? Maybe that will be fine one day to go to space with type one diabetes. They stuck

Scott Benner 35:49
those two people in that space station for they were they tell them they're gonna be up there for three days and nine months later, they're like, we'll come maybe, I think we got a guy we can send. Yeah, I don't think you can. Yeah, hopefully he won't want to be

Speaker 1 36:01
an astronaut. Yeah, I'm not, not worried about that. But he did

Scott Benner 36:05
mask. I know this is like, premature, because he's five, but, yeah, there's an episode of the podcast with the person who wanted to be an astronaut has type one couldn't be but she flies the space station.

Speaker 1 36:15
I think I heard, I think I heard that one, yeah, and I do think about that too, like there's so many other ways he could be involved, if that really is his true passion. So, yeah, he talks about wanting to be a doctor when he grows up. He really does well, you know, but I think, as probably some other type ones do too, they're used to the pokes and the fraud, so he's pretty interested at any kind of, like, medical appointment. It's

Scott Benner 36:38
awesome. Oh yes, no kidding. Like, you know it's, it's interesting. The kids at such a young age have thoughts like that. Like, I wonder how often they it actually bears out. Like, you know what? I mean, I wonder how many five year olds are like, I want to be a blah, and it actually happens, right? I'd be super interesting. There's no way for us to know, by the way, but I would be super interested. It's a great

Speaker 1 36:58
question. Well, especially because his endo also has type one, so I think that's like, a cool role model for him that you might not see represented everywhere.

Scott Benner 37:07
Do you find that helpful? Like, I mean, you don't have another experience, I guess. But I would imagine, like, I mean, listen, Dr Kasim, he's obviously really thoughtful about diabetes. Like, from my perspective, but still, like, does it bring you a comfort when the person who's giving the information is living it as well? It

Speaker 1 37:27
does, yeah, especially early on. You know, when you're going through that training that, first of all, I have a lot of questions and critiques of the training they provided us, but that's like, kind of a separate conversation anyway, when they're telling you, like, all the complications, I think that was like the final training went through, like, all the, all the complications that can happen with diabetes. And so I remember early on some appointments my husband and I, and my husband in particular, being like, Okay, tell me, like, kind of like asking for reassurance, right? Like, he's diagnosed so young, does that, you know, increase his chance of having complications? And just he, our endo was so reassuring about like, you know, we have great technology. We've got more data now, more studies to show, like, you know, looking at this time and range, looking at agencies, that the risk for complication, you know, decreases. So that that was reassuring.

Scott Benner 38:15
You know, how I feel, because you've probably heard me say it, but also because I we've shared the experience. I've had that experience too, where they're like, Oh, don't worry. Like, I actually had somebody say to me, the complications, they won't come for like, 30 years. And I was like, she's two, right? Like, so you tell me when she's 32 she's gonna have diabetes complications. Like, that's not comforting. I don't know if you thought it was maybe, but yeah. And having said that, I don't expect Arden to have diabetes complications in our early 30s. But I think that's because we figured out what we figured out too, like, dig in more. What did you mean? You didn't like the initial education?

Speaker 1 38:49
Yeah. So I felt like so much of it was it was too general. And I get that they're trying to reach a lot of people right in different times in their lives. There it was not just for kids. It was for adults, it was for people across like the diabetes, you know, Spectrum wasn't just toddlers with type one, and so I felt like so much of the information they were giving us like, you're so overwhelmed at the beginning, right? You're eager to learn, but also it's this, it can be this shocking diagnosis, and there's so much to take in, and you want to get it right, and you want to do it well, trying to do your best for your child. And so much of the information they were telling us. Like they felt like they were so focused on like, okay, when they're playing sports as high schoolers, this is what you need to do. And I was like, Listen, I have an 18 month old, like, I am not thinking about him playing sports. Like I needed to talk to me about how when he says he wants a snack, and then I do some for that snack, and then he doesn't want that and want something else. And they're like, Oh, well, it's different for toddlers, like I kept asking questions that I thought were relevant and important to our lives, and they're like, oh, sorry, this doesn't apply to you. Oh, sorry, you'll have to talk to your endo about that. And I was like, why am I wasting my fucking time with these trainings if you're not going to give me the information that I'm asking for and that I feel like I need so that that's my critique

Scott Benner 39:57
of those trainings. Awesome. Hey, a little bit of your Remy monkey. Him out there. Oh

Speaker 1 40:01
yeah, oh yeah. There's more. Where that comes from. Trying to behave myself. They're lucky

Scott Benner 40:05
you didn't have your purse with you.

Unknown Speaker 40:08
They're lucky they were virtual. I can't

Scott Benner 40:10
figure out what part of the country you're from. Like, I feel like I want to say California.

Speaker 1 40:13
No, well, I am from Michigan. Oh,

Scott Benner 40:18
oh, you Oh, beach. You mean a lake? Beach, not a not a lake, yeah, it's your voice is so clear, clean, I would put it like it doesn't have a ton of accent,

Speaker 1 40:28
that Midwest accent, yeah, I think that's because I've lived in different parts of the state, maybe travel a little bit, I don't know. But thank

Scott Benner 40:35
you. Thank you like because you know some of you guys sound like you're Canadian, yes, yeah, there's some bastardized version of it, at least. Right, right? Yeah, exactly. But then you cursed. I was like, there's a whole layer to you. I don't understand.

Unknown Speaker 40:47
Yeah, that's the east side of me in there. Yeah, no

Scott Benner 40:50
kidding, because, like, you're like, Oh, I went to the library to record this. I'm like, library. I didn't even know there were libraries. That's awesome. Love libraries, yeah, and you're helping people. And I thought this is just a nice lady, but just not you're a thug. I get it. I hear it in your voice now. I got it. I see what? You're hiding in there. You're hiding in there. Yeah, that's why you didn't want to talk about your husband's not being sure about having other kids, because you were going to go while murder assault. And you're like, let me tell you what I really think about this mother. Hold on a second. I let this guy be with me and look how he's treating me now.

Speaker 1 41:26
No, he, he is wonderful. He, you know, I feel when I see people talk about their spouses, their partners, not being kind of like equal partners in diabetes care for whatever the reason. Like, I feel so sad for them, because that is not the case in our household. No, that's awesome. My husband is so involved and is just incredible. So I am so grateful for that. That's

Scott Benner 41:45
very good news. I feel for every person who comes on here and says that, you know, I can't get my spouse or to be even interested in this, it must feel I don't extra alone in that situation. You know, wow. Okay, so you're, you have a little list here. You said, I believe other people can have a less traumatic experience. Was that just you saying, I wish everybody would finger prick at a at a doctor's appointment. Do you have more thoughts about

Speaker 1 42:09
that? Yeah, kind of well. So like looking, you know, there's some information out there, some studies that looks at the percent of children who are in DK when they're diagnosed, and it to me, it feels like it's too high. So like, yes, our experience, but I know that we're not alone. So I'm seeing a pattern of parents, yeah, not being believed, maybe the first time around, or really having to, like, push and advocate for more testing to get this diagnosis, and then their kids in really rough shape. And DKA is not anything that anyone wants, right? So if we could avoid at least that, like, at a minimum. Can we avoid kids going into DKA? I think that would be a win, or it could be decrease, because right now, it's at about what, like 30 to 40% of kids are in DKA when they're diagnosed, and that feels too high to me. Can we get that down to like, 10 or 20% that's where I'm coming from

Scott Benner 42:58
with that. It's a very simple, solid answer to a problem that doesn't seem to ever get any traction. And I've said this before, but I've seen pretty big organizations try to make it happen, and they just can't seem to make get it off the ground for some reason, I guess. Yeah, everything's so splintered and fractured around the country, it's hard to hard to get a rule up and running for everything, but I take your point,

Speaker 1 43:20
right? Yeah, it's a symptom of a bigger problem of our healthcare system and how it operates. And I don't blame, like our pediatrician, necessarily, do. I wish he would have listened better, sure, but I know that we're not alone in that experience, and so I don't see him as the problem it's I do see it as, like a systemic issue, but I'm sure that there's, you know, folks with other diagnoses who are like, advocating, you know, probably for similar things, like, you know, pay attention, please. But like at the same time finger poke feels so non invasive. I mean, they do regular blood draws of children, or at least at certain points in their lives, right? Testing for lead, testing for different things. And so this, to me, feels like kind of a lighter or an easier ask to incorporate. But there's, we're just going up against a lot of things in our healthcare

Scott Benner 44:06
system, right? And maybe every kid who has flu, like symptoms, doesn't need their blood sugar check. But if you maybe you could make a short checklist. If you you know, five things, do you hit? Yeah, maybe then go to that screener, yeah. How hard could it be? Is that's the horrible part. Is, when you're thinking about it, it feels like this shouldn't be that

Speaker 1 44:22
difficult. Shouldn't be that difficult. Yes, yeah, that's not how the world works, not

Scott Benner 44:26
so far. But I've only been alive for 53 years, so maybe it's coming. It's not maybe, by the way, it's not give up now, I don't know.

Speaker 1 44:34
I agree, like, you know, I'm sure. I know we've come a long way, right? And like our healthcare providers do, I think most of them truly care and like want to do the best they can for their patients and but I do also think it's okay for us to ask for them to be better.

Scott Benner 44:48
Yeah, no, I think it's imperative that we continue to ask everybody, politicians and doctors and anybody who's out there helping people to do their best. It's, I don't know if it's gonna make them but I don't think you should stop asking them to. So I agree, yeah, if you get complacent, then you have a real problem as a society. I think, honestly, you start accepting crap, you're going to get that plus some,

Speaker 1 45:11
I agree, and we see that it's possible. You know, in other nations, there does seem to be some traction for this. And I know I understand that the US sometimes lags behind some other countries in this area, but I do have hope that, you know, we can make things

Scott Benner 45:27
better. Good for you. I like that. You're hopeful. You're still in your 30s, and you've got a young kid. You're hopeful, yeah, yeah. Give you 10 years, she'll be like, listen, Scott, here's what I've learned. Nothing's getting better. I started smoking meth. You Yeah, I want to be fair to everyone. She said, I'm not there yet before I said the math thing.

Unknown Speaker 45:48
Thank you. Thank you for that clarification. You're very welcome.

Scott Benner 45:54
Oh, my God, so sorry. There's a tiniest bit of lag in your signal. I think it's what caused that. Just out. I just was like, Oh, let me be clear about that. Also, the library needs to apologize to rob, who's gonna later yell at me for all the edits he had to do in this

Speaker 1 46:07
episode. Yes, I was trying to avoid this issue by being like, plugged in at the library. I thought it'd be a more, a better internet connection than at home. But apparently, when

Scott Benner 46:17
I say this, Rob, leave that last one in where, where it gapped, where she said, avoid this issue, so that people can hear what we're talking about and then let everybody know that what Rob just left in where it said, avoid it's happened maybe like 30 times since you've been talking. Watch how you'll never know, because Rob's a genius, and he fixed it, and you should go to wrong way recordings and and hire him. Thank you, Rob. Yeah, Rob, wrong. Everybody wrong. Let me give it to you. Wrong way recording.com head over there. Now he's mastering an album this week. He told me for a band, and he does a great job on my podcast. And if one of you had a podcast that made some money and could afford to hire Rob, it would probably offset his life in a way that would let him, you know, charge me less, so I need to get Rob more work so that he can, he can make more money and be nicer. By the way, Rob's such a fair guy. His pricing is so fair. You're gonna love it when you talk to him, but I'm just teasing. Nevertheless, he does awesome work. Now back to your list. Oh, he's, he's opened my life up. A lot of the things here, we'll say one more thing. You know, you hear people say all the time, what's more valuable than time, right? A lot of the offerings you're getting back from the podcast about, like, online community stuff and more written content, stuff like that, it's all because Rob's editing and it actually gives me time to, like, pick my head up and do something. So my life for years was record the podcast, edit the podcast, sleep now. I'm not kidding either. So he might have saved the podcast, honestly, because I could have, like, I don't want to give him too big of a head, but like, I'm not 100% sure how long they could have done this for at the pace I was going. Nevertheless, your list says one last thing that I'm interested in spending time. We're grateful for meeting and spending time with other families with type one. How did you meet them? What did the time bring to you? What do you think? Why do you think that's

Speaker 1 48:11
been important? Yeah, so our our clinic, actually was able to connect us. So we, early on, we met some other families who also have boys the same age, diagnosed with type one, which is pretty incredible. We were meeting more regularly at the beginning, like about every month or so, but as people get busy, that's I think happened maybe like every other month or so, or like quarterly. And it's just it's so wonderful to be able to connect and, you know, empathize with each other and understand where we're coming from. And I'm happy to talk about diabetes with the general population, so to speak like and educate people if they have questions, it's not something that, you know, we feel like, ashamed or like need to hide. And I think because Remy was diagnosed so young, like he doesn't know any differently. And so I just, I'm trying to, like, kind of normalize that for him, and for it to not be a secret. And I like that he's in let people see it, I guess. Yeah, and, like I said, I'm happy to talk about it, but at the same time, it's also important to have that community where you don't have to be explaining things to and they just get it. And it's nice, I think, for kids to see other kids wearing little pods on their bodies and CGM and having to, you know, respond to the alarms going off when we're at the park or playground or where we are, and we just get it, yeah, it's just been really valuable community for us, and we're very grateful to have that.

Scott Benner 49:31
Listen, I know that I talk about everything, so it doesn't really bother me, but so many people articulate to me that they are not interested in explaining their lives over and over again to people, and that you need to have those conversations, but you don't want to go through the rigmarole of explaining the whole thing, and it's just such a big deal. I can't say enough how much I think community does for people. Community can mean a lot of different things. It could be online, it could be in. Person, but in the end, I think it's exactly what you're saying is somebody who understands and is living the same situation, so that you don't have to do all the unsaid things that go on in most conversations, because all of a sudden you're explaining the subtext, and it sucks. Yes, yeah. No kidding. In fairness to me, I love talking, so no way. So I don't really care. I think I said on the podcast recently, like somebody was talking about that, like, I don't want to share this. And I thought, Oh, my God, everybody in my family knows everything about me. And I said, and I said to the point where I said, probably, they probably know more than they want to know. And so then I later went and said that to my family. They're all clicked together. They all looked at me like, yes, yes. We all know way more about you than we want to know. I was like, oh, oh, gosh, that's hurt my feelings. But okay, oh, that's

Unknown Speaker 50:49
so funny. They're like, Yeah, of course, dad. Like, this is not news to us.

Scott Benner 50:52
Yeah, yeah. Like, sometimes I'm saying something, and Kelly's like, oh. And I'm like, you know, people online love this. You know, she always, like, says the same thing in return. She's like, they don't have to live with you. And I was like, No, I hear what you what you're saying. Yeah. She's like, good for them. Or sometimes, like, the way I talk about things, I'm like, you know, on the podcast, this is really helpful, because I speak kind of like long form, and it helps people understand and they can follow better. And she goes, this is not a podcast. I don't need an explanation. This is our family. But here's the thing that I can't help, right? And it's a little unfair to me. I just want to stick up for myself for a second. Go for it. I don't talk like this because it's a podcast. I just happen to have a podcast, and this is how I speak. So I do talk in pictures, yeah? And I I over explain things and stuff like that. So, like, it's not like, I'm like, I'm not on here. Like, oh, you know what the people want. I'll give them that. Like, this is just who I am. It just happens to work out for this. But in your regular life, like, it's not lost on me that I tell a story. I'm like, three minutes into it. They're like, when does this story start? I'm like, all this backstory is very necessary. Yes,

Speaker 1 51:58
it is. Yeah, my stories can be long and winding. And I'm like, Hold on, let me get back to where I was. But like, I need to share this one thing that's not really relevant. But like, I think it's relevant

Scott Benner 52:07
that you have this, yeah, no, it feels like a episode of The Dukes of Hazzard when I was a kid. Come on, in the voice would first be like, first, it's important for you to know, and then, like, and I feel like that. I feel like, look, there's a whole part of this you need to know, and then I can tell you the rest of it, because it's going to bring it all together for you. And sometimes it seems necessary. Sometimes it's not. Sometimes people like, you know, we could have figured out the second part without the first part. And I was like, Oh, I didn't know that's part of the process. I also want to say how angry I am at racism for killing the Dukes of Hazzard. Like you can't even watch it in reruns now, and probably for good reasons. But what a fun TV show. When I was, like, they just made cars fly through the air. It was awesome. Yeah,

Speaker 1 52:48
I never watched it, so I can't really, like, empathize with your point of view on that. But well,

Scott Benner 52:52
it's a giant car with a confederate flag on the top of it. I see where some people might be touchy about it. I'm not saying otherwise. I'm just saying, like, it was so great. Like, they just, like, cars just flew through the air, and people said stupid things, and they raced around on dirt streets, and that's all I really remember about. It's like the A team. But for hillbillies, no offense to hillbillies, by the way, had I not been, I don't know if I've ever been honest about this in the podcast or not, but had I not been adopted, I would have been raised in the mountains of the Carolinas.

Speaker 1 53:21
Yeah, I have some I have some family roots I can trace back to that as well. I definitely have some hillbilly in me. I mean

Scott Benner 53:27
it in a loving way, because apparently I am one, at least with the stuff they built me with. What do they call that? Genetics, right? Genetics? Yeah, or biology, I swear to you, one time I spoke to somebody in my what would have been my family like, my wife was like, she was like, I want to know about health stuff for the kids. So I'm like, All right, so we went to an attorney, paid an attorney to look into it, like they had to open up their records, like I had to, like, it's how we found out that my birth mother had passed away already, and that nobody, there's no birth record for a father, and this whole thing, like this, the whole problem, right? And I get somebody on the phone, and an hour later, I come out of there, and my wife's like, How'd it go? And I was like, Do you think you'll talk again? And I went, I don't think so. No. I was like, my wife's like, what's your takeaway? I said, I lived my whole life thinking that my mom was a princess who got whisked away to live in a castle and couldn't take me. I'm like, I don't think that's what happened. Better not to know. It's hard to know. It's hard to know. Yeah, also recently, I might have gotten because of one of these online I didn't think I was gonna say this on the podcast. I think I got, I've never on like, 23andme been like, that close to somebody like, you know. And so this person pops up, and we are really closely related. And I was like, All right, so we, like, started messaging back and forth, and, like, going back and forth. And like, I think my he's, like, said something like, I think my father could be your brother, or something like that. And then he like, and if he's listening, I'm sorry, but like, I gotta be honest, because I make a podcast. Is my whole stupid job. But, like, I clicked on a couple links, and I was like, Yeah, I'm okay, yeah, I think half brother actually. But still, I was like, I'm alright, yeah, I'll just be alone. There's nothing wrong with that. Nevertheless, no offense, yeah, no offense to anyone. But, you know, I think maybe I just, I'm not that interested. You get to choose your family. Well, I definitely do get to choose. And if I'm choosing, I'm saying no to that one. That's all I'm saying. So the rest of you who aren't adopted are like, yeah, man, we're all related to people who were like, Oh, I can't believe he's coming to Easter like, but I've never been in that situation before, right? It's not the same. Yeah, every family event I'm at, I'm not like, if you're like, a wacko, I'm like, not really related to you. I can be like, Wow, you're an idiot, but I have no ties to you whatsoever. I get to pretend that I'm better, but I'm not. But hey, it's an illusion. I get to hold up at least once in a while. Anyway, what have we not talked about? Like, you have I skipped over anything or not gotten through things that you wanted to say, like, make sure you get everything

Speaker 1 56:08
out. Thanks. So no, I think, like, the only thing, it's not really important that we talk about this. But when you asked me earlier, like, did his diagnosis, like change, kind of the vision we had for his life? Like, do we feel like it's stopping him from doing anything, and no, the diabetes diagnosis is not But interestingly, at the same time, he was diagnosed with diabetes. So you know, one of the things they do to check for brain swelling, they did a scan of his brain, and they're like, Hey, we found this really large

Scott Benner 56:34
mass in his brain. What? We

Speaker 1 56:39
don't know what it is, so we're gonna refer you or neurology, yeah, so they found it by accident, right? And we're like, oh, okay, so he has type one, and he might also have brain cancer. He does not have brain cancer, let me just say that. But like, at the time, we didn't know, and so we couldn't get into neurology for, I think, like, a couple months, for, like, a follow up scan. And so thankfully, what they found is benign. It's called an arachnoid cyst. It's very large, like the doctors are impressed every time about how large it is, that it's not affecting his development, or, you know, impeding him in any way. So they do kind of recommend against roller coasters and contact sports because of the increased risk of, like, a brain bleed that might then require some kind of intervention. So we did learn that kind of by accident, so they've been monitoring that, but it seems like he's gonna be okay and can just live with this huge cyst on his brain.

Scott Benner 57:24
Wow. But that must have, Jesus, that's unfair. That must have freaked you out, and probably still does to some degree, even though they're telling you it's okay Justin, it's still like, mess with you a little bit,

Speaker 1 57:35
not really. It's something I really don't think about very often, except them when they like, give us that call, like, Oh yeah, it's time to schedule, like, his yearly schedule. Yearly scan. We're like, Oh yeah, okay. You know the experience for him the second time. So the first time he was, like, sedated, so he didn't know what was going on. So, like, that was a pretty peaceful experience. But the next time he wasn't sedated, and they had to, like, you know, we couldn't be in the room with them, they had to, like, strap him down. So that was traumatizing, because we could hear him, you know, screaming and crying for us in the 30 seconds he was away from the room. From the room, so that was hard. So then we prepped him better next time around. But honestly, no, it's something I do not worry about,

Scott Benner 58:08
really at all. Good for you. Why are you so healthy? Oh, I'm not, but

Unknown Speaker 58:13
that is not what

Unknown Speaker 58:14
I'm here to talk about today.

Scott Benner 58:19
You're like, why you got that one way, wrong, buddy.

Speaker 3 58:21
I mean, I do my best, but hold this whole

Scott Benner 58:25
thing together with spit and bailing wire

Unknown Speaker 58:30
pretty much one day at a time. Are you from

Scott Benner 58:32
that part of Michigan that people talk

Unknown Speaker 58:35
about? Sorry, which part you

Scott Benner 58:37
know which part I'm talking about? Come

Unknown Speaker 58:38
on. Well,

Speaker 1 58:40
so depends. So I was born in the UK. Um, that's not where I grew up. I grew up in the middle of the states, but I don't, I don't live there any longer, yeah,

Scott Benner 58:47
my favorite disparaging thing I've ever heard someone say about where they were born was not said on this podcast, but it's a friend of a friend who said to me, once I'm from the lower, slower part of Delaware, and I went, Wow, is that a thing? People say, Oh, wow, I've never heard that before, but isn't there like, a bit of the, like, I own a little bit of land, and I don't see people that often, part of Michigan?

Speaker 1 59:09
Well, yeah, there's quite a bit of that part of Michigan. I would say

Scott Benner 59:13
anyway, the lower, slower part of Delaware was said to me 35 years ago, and it still sticks in my head, because I was like, that's a hilarious thing that only somebody from a place would know to say nevertheless. And who even knows if that's true. You might be in southern Delaware right now and say, No, I'm fine, and I'm sure you are. I'm sure you are. Who am I to judge? Nobody. I would like to stop this recording, though, and let me then and have you tell me your top two craziest family stories, because I feel like you've got a couple. Oh, man, okay, yeah, get one in your head. Then we'll stop the recording, if you can tell me, okay,

Unknown Speaker 59:48
okay, I for sure have one kind of two.

Scott Benner 59:51
Yeah, okay, all right. Is it going to beat the girl who told me that her parents got divorced and she was very upset she was still living in her. Home, she was young, she didn't know what to do, and she went to her older sister who was no longer living at home, and said, Hey, I'm very upset about mom and dad getting divorced, and I don't know what to do. When the older sister said, Try meth. Oh, no, I don't I don't have a story. Story that good. Okay? That poor woman, by the way, if I'm not sure if her episodes been up yet or not, okay, she was hooked most of her adult like she had just gotten off at a couple years before she recorded with me, like it stuck to her for decades. It's just, yeah, one bad piece of advice from one lunatic in your life. You know what I mean? Like, I don't know anyway, you must see stuff like that all day long

Speaker 1 1:00:34
with your job. Yeah, addiction. Addiction is really hard, for sure. I feel, I feel terrible, okay, all right. I'm glad I don't, yeah, work in that field. I

Scott Benner 1:00:42
just gonna say I feel lucky that it's not a thing that has attached itself to me. And, you know, I do see those addictions as health issues. And you know, I think you're just lucky if you don't have it to be perfect. Yeah, I agree. But do you have something else to say you want recorded? No, okay. All right, we're done. Thank you so much for doing this. Hold on one second.

Are you tired of getting a rash from your CGM adhesive? Give the ever since 365 a try. Ever since cgm.com/juicebox beautiful silicon that they use it changes every day. Keeps it fresh. Not only that, you only have to change the sensor once a year. So, I mean, that's better. The conversation you just enjoyed was brought to you by us, med, us, med.com/juicebox, or call 888-721-1514, get started today and get your supplies from us. Med. This episode of The Juicebox Podcast is sponsored by Omnipod five. Omnipod five is a tube, free, automated insulin delivery system that's been shown to significantly improve a 1c and time and range for people with type one diabetes when they've switched from daily injections, learn more and get started today at omnipod.com/juicebox of my link, you can get a free starter kit right now. Terms and Conditions apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. If you're not already subscribed or following the podcast in your favorite audio app, like Spotify or Apple podcasts, please do that now. Seriously, just to hit follow or subscribe will really help the show. If you go a little further in Apple podcasts and set it up so that it downloads all new episodes, I'll be your best friend, and if you leave a five star review, ooh, I'll probably send you a Christmas card. Would you like a Christmas card? Hey, kids, listen up. You've made it to the end of the podcast. You must have enjoyed it. You know what else you might enjoy? The private Facebook group for the Juicebox Podcast. I know you're thinking, Oh, Facebook, Scott, please. But no. Beautiful group, wonderful people, a fantastic community, Juicebox Podcast, type one diabetes on Facebook. Of course, if you have type two, are you touched by diabetes in any way? You're absolutely welcome. It's a private group, so you'll have to answer a couple of questions before you come in. We make sure you're not a bot or an evildoer, then you're on your way. You'll be part of the family. The episode you just heard was professionally edited by wrong way recording, wrongway recording.com, you.

Please support the sponsors

---

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

Donate

#1556 Weight Loss Diary: Eighteen

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

Eighteenth installment of my GLP journey

+ Click for EPISODE TRANSCRIPT

---

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

COMING SOON

Please support the sponsors

---

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

Donate