Scott Benner 6/26/25 Scott Benner 6/26/25

#1560 Pump-Ready With Jordan

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Jordan Wagner has been to more pump trainings than he can count—and he’s seen it all.

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

Scott Benner 0:00
Hello friends and welcome back to another episode of The Juicebox Podcast.

Today's guest is Jordan Wagner, a nurse, a diabetes educator and a person living with type one diabetes, and today, Jordan and I are going to talk about getting you ready for your pump or CGM training, so that you can get the most out of it and get started on the right foot. If this is your first time listening to the Juicebox Podcast and you'd like to hear more, download Apple podcasts 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. Please don't forget that nothing you hear on the Juicebox Podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan or becoming bold with insulin. This episode is sponsored by the tandem mobi system, which is powered by tandems, newest algorithm control iq plus technology. Tandem Moby has a predictive algorithm that helps prevent highs and lows, and is now available for ages two and up. Learn more and get started today at tandem diabetes.com/juicebox this episode of The Juicebox Podcast is sponsored by us med. Us med.com/juicebox, or call 888-721-1514, get your supplies the same way we do from us. Med, All right, guys, Jordan's Back. We're in our second episode together. What are we going to talk about today? Jordan,

Jordan Wagner 1:56
yeah, so I wanted to kind of touch on a couple things here, but the big topic is just going to be getting an insulin pump, how to be successful for the training, leading up to the training, looking at the CGM that are compatible and being used with these pumps, and then realizing that sometimes there can be inaccuracy in CGM, and really How to address those inaccuracies. What could cause those inaccuracies? So just really looking to set someone up well for getting an insulin

Scott Benner 2:28
pump, there's more CGM now than there's there's ever been, right? Like, so absolutely,

Speaker 1 2:33
yeah. And then if you, if you think about things going on outside the US, there's even, there's even more CGM, more options.

Scott Benner 2:39
Give me an example of one that's outside of the US that you wish was inside the US.

Speaker 1 2:44
Yeah. So for example, you have the blanket on the name right now, but there's the new Medtronic CGM. They have it currently in the US, but it's only compatible with the in pen, whereas it sounds like it's going to be compatible with the Medtronic 780 G insulin pump, and it's, it's going to be a disposable sensor, as opposed to the Guardian sensors. Right now, you have to keep the transmitter. So it sounds like they're trying to get on board more with some of the other CGM brands where they've gone away from having to keep the transmitter or save a piece. It's all disposable now. So that's an example there. Yeah,

Scott Benner 3:20
the simplara, that's what it is. Yes. Thank you. Yes. And then that's been in Europe for a bit now, right?

Speaker 1 3:26
Yeah, I believe so, yeah. So they get the CE marks over there way sooner. The FDA in the US is usually a little bit slower to approve things. Okay, when it comes to diabetes tech, if you kind of want to know what's coming down the pipeline into the US, or perhaps other countries, looking at the European countries, that's going to be a good spot to start, yeah, because they can get the okay over there a little easier, a way easier, way sooner. Yeah, for the moment, there's still Dexcom, g6 Yes, and there's g7 and then Libre is up to what the libre three

Scott Benner 3:57
plus

Speaker 1 3:58
or libre three plus. And so the variation between the libre three and the three plus, you've added an extra day. So the three plus is 15 days. It's, it's the same size, but that one's going to be compatible, more friendly with with the insulin pumps. Okay,

Scott Benner 4:13
do they make it like with the people you help who are on liberty three plus as specifically, do they make it 15

Speaker 1 4:19
days? Usually? Yeah. I mean, I would, I would, it's hard to quantify that, but I would say maybe 60% of the people that I'm helping are making it the full the full time there. And I think one of the things, aside from sensor failures, is that, because it's so small, there's less tape area, whereas, like, if you think about the the Dexcom, and I really think that tape is very sticky with the Dexcom personally, but there's also an overtape that comes with the sensor, so it helps to keep it on a little bit better. There the libre three. Then three plus is the size of a penny, so it's a lot smaller taper. I think that contributes to it falling off more easily with some patients that I work with,

Scott Benner 4:59
Oh, I see. See by making it so much smaller, it also doesn't allow you as much tape, because it's not like it's a penny, is it really that small?

Speaker 1 5:10
Yeah, it's the size of two pennies stacked on top of each other. Wow. But

Scott Benner 5:14
then the area around it with the adhesive is not as much, and you think it's coming off because of that. Maybe, I think that's

Speaker 1 5:20
one of the reasons, too. Yeah, you know, I hear people say that, you know, they they bump their arm on the door and it fell off. And I know that can be said about all sensors, but that's just my theory. Is that by bringing the size down, while that's that is a nice thing to do, you've also got less tape surface area, okay? And so I always tell people the three or the three plus. You might consider getting an overtape for it. You might have to go to a third party place to get those, but it just helps to keep it in place longer.

Scott Benner 5:51
Do you have a preference between g7 and libre three plus?

Speaker 1 5:56
Yeah, so I mean, my personal preference is g7 and that's simply because I use the tandem pump, the TE Slim x2 with control iq plus, but the three plus is not currently compatible with tandem. You can use the FreeStyle Libre two plus that is compatible with tandem, but the three plus is not quite there yet. I've sampled the three plus, honestly, I think it picked up on low blood sugars a little sooner. One thing that I like about Dexcom over the Libre is that you can have the rising quickly or the falling quickly features on the Dexcom. So we think about Dexcom, you've got the the flat line, the steady line, there's diagonal, there's straight up or down, and then there's double arrow up or down, whereas the Libre is going to have all of those, but it's not going to have the double arrow up currently. And so I kind of liked knowing if, if I really messed up and I'm rapidly rising. There's that slight variation there with the Dexcom versus the libre,

Scott Benner 6:55
yeah, and that it's valuable to know like this is happening quicker than correct. And maybe I feel like it

Speaker 1 7:00
is, yeah, now I will say the Libre is nice in the sense that it it shows you're reading every minute compared to every five minutes. Oh, okay, I've talked to many Dexcom reps about that, and you know, hey, can we, can this be a feature in the future? Basically, when you look at the studies, there's no clinical there's no significant clinical difference when it comes to reading every five minutes versus every minute. So it comes down to a user preference, essentially. Oh, I see, but I don't think it's from Dexcom perspective. I'm I'm not speaking on their behalf, but I'm thinking it might not be financially worth it for them to to do that when there's no statistical significance

Scott Benner 7:38
to it. Yeah, because they have to. I mean, they have to remake the software, and then they have to put it back through the FDA again, correct? Yeah, I guess is that? Why that they don't make what seems to be the most obvious change, which would be rate of change. Like, having rate of change would be awesome, just like, plus five points, minus three points, like, on every reading. I think that's really helpful. But,

Speaker 1 8:00
yeah, no, that would be helpful. I mean, you have, you kind of have to guess a little bit, but like, the arrows do actually represent numerical values, yeah? Then again, you can't really know for sure, right? Because it's kind of giving you a range, you know, like two to three milligrams per deciliter, or or, like, four or five, or whatever it is. And then you kind of have to guess a little bit, like, oh, well, if it's every five minutes, and I do the math on this, maybe, maybe it's like 16, maybe it's 20, right? But it's not gonna exactly give that to you. I'm a fan of it. I like having it, so, oh, big time. Yeah. I get it through third party stuff, you know. So I see it on night Scout, I see it on sugar pixel, like, then it's, it's really helpful. I think, yeah, well, building off that, I mean real fast, just a side note here. You know, I worked with a patient the other day who was blind and he was only checking his blood sugars like once a week when a family member could come over. Didn't really know about CGM, so told him about that. But, like, I thought with with Dexcom, it'd be so cool if they had a feature that it audibly told you your blood sugar, like every 15 minutes, or every 30 minutes, whatever you programmed for it. I mean, I know they have the Siri feature, where you can have the you could say, like, hey Siri, what's my glucose at? Or whatever you programmed it, and it'll tell you, but to have the option where it automatically tells you, for people who are blind, I thought that'd be such a cool feature to have in the future. I

Scott Benner 9:23
think that, generally speaking, disabled people and elderly people are widely ignored by all of our devices. Yeah, that's for sure. Yeah. I mean, listen, I'm not running the company, and I can almost hear their arguments in my head. Against you want me to make a giant screen with numbers? Nobody else wants that like, in my mind, I think you just have to make space for that in your business plan, because these are people who have likely been customers of yours, patients for their whole life, and then for them to enjoy this, this stuff, and then get to a certain level where then all of a sudden it's like, well, I guess I don't get this anymore. You know, I don't like it. I don't like giving people something like that. Than taking it away from at some point, whether you're taking it from or they can't use it just one way or the other, right, right? Yeah, it would be nice if it was paid more attention to the other what's the other guard? The guardian for is, yes, is the one that's working in a US now for Medtronic,

Speaker 1 10:16
yeah, yeah. So you got the guardian for and that's nice, because you don't have to calibrate the sensor like some of their previous models, did you know, and the accuracy of it has gone up a lot there. So when you're looking at CGM accuracy, you want to look at something called the marred value, okay? And that stands for mean absolute, relative difference. The easiest way to understand that is to basically think, what is my glucose level in the blood right now, and how close can we get that on a device? So we want to be as accurate as possible. So when you're looking at a margin value, you want that number to be as low as possible. The lower the number, the more accurate the sensor is. And so you know, Medtronic sensor has improved drastically over the years. So have, you know, the libre and the and the Dexcom sensors, but, yeah, you want to be looking at that there. And so like the Guardian four has improved a lot in their in their values there, so it's a much more reliable sensor. Now. Do you have any patients using the ever since CGM, you know, I actually don't. No, yeah, okay, that's not as commonly seen. That's for sure. You know, I know Nico, sure she wouldn't mind. She's been posting all about it, but she's on the ever since now, had a chance to have coffee with her and Ryan, not that long ago. And really interesting to hear about that. Yeah, so I'll be, I'm really curious to hear about her experiences more with it.

Scott Benner 11:39
I am too, genuinely am, because, I mean, obviously there's, I mean, a lot of these companies are sponsors, so, but, like, but, you know, ever since is a sponsor, and I feel like my job is just to let people know about it, because, yes, because it's so new, you know, and it's different, it just is, like, at this point, you know, there's three CGM that go on the way they go on, and then there's one that's inserted, like, ever Since, and you're gonna wait to see if the if the public adopts the idea and goes with it or not. I can see that, I think, in a John right now, I don't use his full name, who's using it, and I see him in the group talking about the time that he loves it, yeah? Like, I just keep that. I mean, he's going out of his way to tell people that he how much he's enjoying it. So,

Speaker 1 12:18
yeah. And I think that's great, like, just the sharing of information. Like you know, my job as a diabetes educator is not to tell you what to do, it's to share the information you get, to take it and decide what you want to do with it. And so, like you said, I'm a big advocate for sharing about your own personal diabetes journeys with people or within the podcast group there, just so other people can see it, because it could just be a simple post that literally changes someone's life, and go, Hmm, maybe I should try this or do this differently, right?

Scott Benner 12:46
So, so tell me this. This just your, you know, your opinion, obviously. But any one of these four CGM, if you had a shot at having one, and you couldn't have any of the others, you're not losing, right? There's not one of them that you're just like, oh, I can't believe this is the one I got. Like, these are all like, life changing devices. Am I right?

Speaker 1 13:05
Absolutely right. Yes. Okay. And again, like that whole marred value system, these CGM have improved so much that you could look at the marred value on some of these CGM and compare it to, you know, a middle tier glucose meter, and it's actually going to be a higher margin value on the CGM than it would be the actual glucose meter, meaning that the CGM could literally be more accurate than actually poking your finger. Yeah. So that technology has improved so

Scott Benner 13:31
much, I say to people all the time when they're like, oh, this, this CGM is wrong again, I test it. I'm like, I've never seen that meter before in my life. Like, where, like, rock, did you get that under Exactly? And, you know, like, they have some janky, like, third party, like, you know, meter, and they're like, look, this says this, but my Dexcom says that. I'm like, I'd be more inclined to believe the Dexcom, like, absolutely, yeah, when

Speaker 1 13:52
you got the other consideration there too, with the the glucose meters, if you don't actually quality control, check your glucose meter, which most are not doing, then there's a good chance that it's not even right at all, even if the marred value on it is good. That is something you need to be checking. Like, for example, in the hospital setting, we have to do that every 24 hours to ensure that the meters are as accurate as possible.

Scott Benner 14:17
So, and nobody's doing that at home, like meters all used to come with that, yes, but they don't even come with it anymore, do they? This episode is sponsored by tandem Diabetes Care, and today I'm going to tell you about tandems, newest pump and algorithm, the tandem mobi system with control iq plus technology features auto Bolus, which can cover missed meal boluses and help prevent hyperglycemia. It has a dedicated sleep activity setting and is controlled from your personal iPhone. Tandem will help you to check your benefits today through my link, tandem diabetes.com/juicebox this is going to help you to get started with tandem, smallest pump yet that's powered by its best algorithm ever. You. Control iq plus technology helps to keep blood sugars in range by predicting glucose levels 30 minutes ahead, and it adjusts insulin accordingly. You can wear the tandem Moby in a number of ways. Wear it on body with a patch like adhesive sleeve that is sold separately. Clip it discreetly to your clothing or slip it into your pocket head. Now to my link, tandem diabetes.com/juicebox, to check out your benefits and get started today. I used to hate ordering my daughter's diabetes supplies. I never had a good experience, and it was frustrating. But it hasn't been that way for a while, actually, for about three years now, because that's how long we've been using us, med, us, med.com/juicebox, or call 888-721-1514, us, med is the number one distributor for FreeStyle Libre systems nationwide. They are the number one specialty distributor for Omnipod, the number one fastest growing tandem distributor nationwide, the number one rated distributor in Dexcom customer satisfaction surveys. They have served over 1 million people with diabetes since 1996 and they always provide 90 days worth of supplies and fast and free shipping us med carries everything from insulin pumps and diabetes testing supplies to the latest CGM like the libre three and Dexcom g7 they accept Medicare nationwide and over 800 private insurers find out why us med has an A plus rating with a better Business Bureau at usmed.com/juicebox, or just call them at 888-721-1514, get started right now, and you'll be getting your supplies the same way we do.

Speaker 1 16:51
Most of them don't, yeah, so you might even have to go to the manufacturer's website. And maybe I'm incorrect, but it maybe some of them don't need to do that, but I was under the impression that you should still be doing that sometimes, well,

Scott Benner 17:03
one way or the other, having accurate numbers is obviously the most helpful thing that you could possibly do. I agree with you. Like CGM, I would say, get a CGM before a pump. If you can only have one thing, I think it makes a huge difference. Not that a pump wouldn't be awesome, but, like, if you could just get one thing, I get a CGM I think it would change your life. Oh,

Speaker 1 17:24
absolutely, yeah, it truly, truly will. And again, the accuracy of these has improved so much, and that's also helping to make these insulin pumps have these, you know, tighter controlled algorithms,

Scott Benner 17:35
right? Yeah, the better the CGMS get, then the more aggressive the pump companies could be with their algorithms, I imagine

Speaker 1 17:42
absolutely, yeah, because there's uncertainty, right? If the CGM is not as accurate as possible, the pumps not going to target a lower glucose level, because you have a margin of error. And if it's you know is going on the low side. They don't want people to be low all the time, because there's that huge risk for one, probably lawsuits as a pump company. But then two, you're harming patients, and so not what you're trying to do as the CGM get better. Yeah, they're gonna, they're gonna get tighter and tighter, for

Scott Benner 18:07
sure, what do you tell a person who comes to you and says, Listen, I want to get one of these algorithms. But, yeah, my CGM is not accurate all the time, and I don't want that thing making insulin decisions. When you know my CGM says I'm 220 but I'm really 170 or I'm 170 you know, but it says I'm 65 or, like, how do you answer that question? Because I've always struggled with that,

Speaker 1 18:29
so that's a great question. Yeah. So CGM, their accuracy, can be great under the right circumstances. So first I would be asking some questions to the to the person there. So for example, when did you put the CGM on? Because there's something called insertion trauma. And the first 12 to 24, hours of wearing a CGM, you are going to notice that there could be some variables in the accuracy there. And that's simply because, if you think about it, you've created a small hole in your skin that's going to cause inflammation. And when the body has inflammation, it's going to send an inflammatory response there, yeah, white blood cells, the whole, the whole thing, right, right? So that's going to naturally throw off the the CGM, potentially, because CGM are looking at, it's an enzymatic so enzymes, it's a reaction happening there. So if you have any other like micro things in your body going on there, it could throw off the sensor. So if they've put it on in the first 12 hours and they're telling me this, I would tell them not to really worry about it too much, because these CGM, you wear them for anywhere from, you know, seven to 15 days, depending on the brand

Scott Benner 19:36
you use. Yeah, that's not the question, though, like Jordan, the question is, isn't this thing going to give me too much insulin if it thinks my blood sugar is higher than it is? But I don't know how to explain that. Arden has been using some kind of an algorithm for years, and I don't imagine that her CGM is always spot on right, and it's never been a problem. Is that random luck, or is that you. Is that not is it? You know what I mean, like, I don't know how to quantify I'm you might not either. I don't know how to quantify it. All I tell people is, she's been wearing it for a really long time, and so far that hasn't been an issue.

Speaker 1 20:10
Yeah, I guess what I would say to that is, the algorithms are designed to reduce your basal rates if you're going too low. So for example, if you look at control IQ with tandem, they have a target range of 112.5 to 160 if you drop below that 112.5 or are predicted to in 30 minutes, your basal rates gonna slow down. So there's a pretty big gap there between a low blood sugar and that number there, because you could be 130 and dropping, and it's going to back off on the basal rate. So I would say, even if you're not actually 130 in that moment there, it's allowing for enough margin of error to where you're not actually actually at a low blood sugar for that basal rate to start slowing down there.

Scott Benner 21:00
What about if my blood sugar is 300 on the CGM, but it's really, I don't know, 180 and it's bolusing, and then the number doesn't move. I would describe Arden's experience with Dexcom as really good and even lucky to some point, like she wears them right out to, like, the 10 days plus 12 hours. She very infrequently gets one that just goes haywire. Yeah? And it's a thing I'm gonna ask you about, which is, like, personal body chemistry in a second, but like, like, so I'm saying, okay, like, it works really well for her, and I've still seen times when it tells me her blood sugar is 100 points higher than it really is, right? And the algorithm is bolusing during that. But yet, I'm not here also telling you that she got super low afterwards. But you know, also, I might be talking myself out of this. I also know how to look at that CGM and say something's not right, like, because I know what we've done and I know what should happen, and I've seen it so many times that when it doesn't happen, I think that number is lying to me. I know pretty soon, when it's happening like it doesn't take me, you know, I guess maybe that's the difference, if I'm looking for anyway, I'm sorry, there's a question

Speaker 1 22:06
in there. No, no, you're good. You're good. But so there's a couple things there, but to your point, right? You know how to look at the CGM graphs, and you can just look at it, and maybe it says it's stable, but you just know that it looks a little funky, right? Yeah. And so that that ties back into even, like in our first conversation, we talked about knowing your baseline and having plans, right? You have to know your baseline and what and what works right, because maybe you have a failed pump site or something, and that's why it's high and it's not coming down. But to that question, maybe I don't have the specific, specific answer to that, but like I would, I would be just going through a checklist, essentially, of saying, are you doing everything correctly to make sure that you have the most accurate readings on your CGM, right? Are you staying hydrated? Yeah. Like, if you're not, if you're not hydrated, you're going to have less interstitial fluid there, and that's not going to work out well for the readings of the CGM, right,

Scott Benner 23:00
right? So first of all, I asked you the question because I think in the end, I wanted you not to have an answer because, and I don't think I have a specific answer, because my answer is, this, is that, yeah, okay, maybe you found a flaw in the system, right? And, yeah, sure, it should be better than that, but at this point it's not, but it's still, even with that being a, you know, a weakness in the big picture, it's still so much better than anything you're going to do manually and absolutely, you know what I mean, like, I'm, for most people, you can still be half at this and get an A, 1c, under seven, like, Oh, definitely, definitely, just, it's just awesome. You can have a whole month where you're just like, I don't know, I wasn't really paying attention, and look down and be like, Oh, I have a six, six this month. Yeah. It's not crazy to think. And so I would say, I guess my real answer is, in a world of uncertainty, I prefer the uncertainty that comes with that than the uncertainty that comes with something

Speaker 1 23:57
else. Yeah, I think that's very fair. And then if you also look at, like, all of the CGM companies, I think they do account for this sometimes, because they will give you specific instructions when you're going through the setup process, that there are times that you should actually physically poke your finger, yeah, and see where you're at. So even though, even the companies themselves say, hey, like, you probably shouldn't, like, 100% of the time, just rely on this. Like, there are times where you do need to actually maybe confirm the reading a little

Scott Benner 24:25
bit. When I see people complain about I think, listen, everybody has their experience, and you should voice your opinion. I'm not saying don't pressure people to make their things better. But when I see somebody who's more newly diagnosed, like holding up a CGM and going, This thing doesn't work, I think to myself, someone ought to put your time machine and let you go live on regular and mph for a couple of days, totally. And you might come back and go, Oh, this thing is awesome. You know what I mean? Like, and I know that's just the fact of life. Like, you know, not everybody comes in at the same spot, and they don't all have the same perspective, but I wish they knew. Like, sometimes. When I see people doing that, I wish they knew. And I'll, you'll actually see very often online, older people with type one will send me notes and say, hey, somebody put up a post that their libre wasn't very accurate, or the Dexcom wasn't very accurate. And like, you should take that down. And I'm like, Well, I'm not, I'm not going to, but their points always the same thing. Like, you should not let people think that CGM aren't terrific. And I'm like, Well, I'm not into telling people what to say, but I get my point is that I get their greater point like they've been around long enough to know that a CGM, even with its foibles, is maybe the greatest thing you could have. It

Speaker 1 25:36
absolutely is. I mean, take my uncle for an example. He was diagnosed with diabetes in the 50s, right? And so he was having to boil his syringes before taking an insulin injection. Yeah, you know that to check glucose, you had to go pee and see what your urine had for glucose in it. And, I mean, that's like, two, three hours from what's even at. So, like, like you're saying a CGM is just, hands down, so much better. Even if there's a little bit of inaccuracy at times, it's just gonna be so much better for most

Scott Benner 26:08
people. I just interviewed a lady recently, and her thing's not out yet, but it'll be out soon enough. You know, she told a story of her mom diagnosed in like her, I think 11. She may be 11 or 12 years old. She was dead before she was 50 Wow. And the whole time just saying, No, I'm doing a great job. I'm doing a great job. And I thought while she was talking, if you could somehow go back, that means long time ago now, right? It's probably 50 years ago. This story is like when, when the woman was diagnosed, but you go back 50 Years and slap that Dexcom on that 11 year old, and she'd know she wasn't doing great, right? You know what I mean, and then she'd have a fighting chance to do something about it, at the very least. So I'm a big fan. I know I went way off the mark with what you were trying to talk about here. I apologize.

Speaker 1 26:50
No, it's okay. This is, I mean, that's, this is a super valuable conversation, like an understanding, yeah, I

Scott Benner 26:54
like talking more deeply about this kind of stuff, all right? So CGM get one if you can. I hope your insurance covers it. I can't say enough good things about it. But like you said, there's a lot of these CGM now that are supporting algorithm based systems. So yes, you were nice enough to put a list here together, so I don't have to do it off top my head. But right now we have Omnipod five, the beta bionics, eyelet pump tandem, which at this point is, what is the x2 Moby, and they might have a two. Are they working on? I shouldn't say it's out loud if I'm wrong. But is there a tubeless pump?

Unknown Speaker 27:25
Yeah,

Scott Benner 27:25
so there will be a tubeless pump in some point in the future. Again, I don't speak for the company, but they're working towards that. That's a goal for the future. Yes. And then medtronics Got that 780 G that people seem to love. And then there's a they're a brand new sponsor, actually twist their pumps, not even it's April 18. It's not out yet, but it's, it's coming very soon, from what I understand, very soon. Yep. And that pump is going to run a version of loop. It's good. They call it the what twist loop algorithm, yeah. And that's going to be a version of loop. So you've got a version of loop, you've got Omnipod five, you've got beta bionics, which says, Just tell me your meal is going to be average, smaller than average, larger than average, breakfast, lunch or dinner. Yep, the 780 G, which I started hearing about two years ago from people in Europe who were telling me that it was awesome, which I they there's, they don't use the 780 G in Europe, but it's the same pump with a different number on it. And I mean Omnipod five, which has been chugging along for a while now. And people seem to love the control IQ, and now they just upgraded it to control IQ, plus, yeah, these pumps all need your CGM data to work with. Can I ask you my first question is, if you have any idea, like, what the backroom scuttlebutt is like, how come some companies are like, hey, ours works with this one, but not that one, or that one, but not this one. Like, how does that happen? Like, how can you bring to market? Like, oh, it works with libre, but it doesn't work with Dexcom. Works with Dexcom, it doesn't work with libre. Like, do you know how that happens?

Speaker 1 28:49
I don't know exactly how that happens. I know it's a frustrating. It's frustrating. It's obviously a business negotiation thing. I don't know exactly, but there's also, yeah, good.

Scott Benner 28:59
You can say what you want to say, but I just don't understand from a like, if somebody's like, No, it's okay. We don't want to work with yours. I'm like, I don't like, or they can't I don't know, like, I guess I don't understand the back room of it, but it's frustrating for somebody to say like, either, oh, I really want to try that pump, but I don't, you know, I use this one, not that one. Or, you know, what's worse, I think sometimes is that people get stuck with things they don't want because it works with the thing that their insurance covers, or, I don't know, yeah, and

Speaker 1 29:27
I mean, there's also a lack of education from the prescribers themselves. How so well, it would be awesome if all the prescribers actually knew in depth about some of these insulin pumps. For example, you might have an older provider and all he's known for years and years is Medtronic so then every patient is going to go, I want an insulin pump. He goes, Okay, that means that you get a Medtronic pump. When that maybe that's great for that patient, but they don't know about the other options. It'd be great if the providers knew the options available, and could. Could speak to them.

Scott Benner 30:00
I listen. I can't talk about this with you. I will get very upset, but I can't wrap my head around that like that's your job and you don't have a weekend to figure out the five or six pumps that are available.

Speaker 1 30:11
Scott, listen this. So I just was in an endo office the other day looking at someone's schedule, and this endocrinologist had booked three appointments in the same 15 minute slot? Yeah, I guess not. So that's, I mean, if you're quick, you got five minutes with each patient.

Scott Benner 30:28
You get a day off eventually. Like, wouldn't the week get easier if you spent one Saturday understanding what all the pumps did? Or Can't you just ask a support staff to put together a one page on each one of them for you?

Speaker 1 30:39
Oh, you you should. I mean, you totally should, right? I mean, there's the other side of that too. It's like, maybe they do that, but maybe this person's only in the office once a week, or like that. That was literally the case at this particular office. It was that the person who would do any of the the pump trainings or putting anything together was only in house once a week. So you're working with all these

Scott Benner 31:02
conflicting schedules. I make a podcast. I work on the weekends, okay? And like, I hear you, it's not my point. Like, I think my bigger point is that if you were digging a ditch and your shovel broke, going to get a new shovel, even if it's a waste of time and you're supposed to be digging, is way more productive than digging with the broken shovel. Like, I don't understand not, it's insane to me that an endocrinologist could look at me and go, Oh, you want the tandem. I don't know anything about that one. You have to get the Omnipod, or vice versa, or whatever. Like, you don't know anything about it. Like, if you don't know who the knows, then, right? Seriously. Like, that's how it would that's how it feels to me every time somebody tells me something like this, like, Oh, my doctor said they couldn't support that one, or they didn't understand how that worked, or they wanted me to use I mean, look at Canada given their kids aren't, you know, mph and regular still, because they're like, well, there's no one at the school to give them an injection, injection. They're wearing rocket ships that give them insulin, right? What are you talking about?

Speaker 1 32:03
Yeah, no, I wholeheartedly agree with you. Like, but anyways, yeah, but yeah. I mean going into a pun training, like, if you want to be successful, do your homework, right? Because, as as we just discussed here, the provider might not know everything about the pumps, so it would serve you well to do your homework. Research different pumps, look at their websites, figure out which one you're thinking about, because maybe that takes you to go into the office and say, hey, I want tandem or, oh, I want Omnipod. So just research it beforehand, so that you're not stuck in a position where you might not have

Scott Benner 32:36
what you want. Let me ask you something. Do you have a one sheet for each pump?

Speaker 1 32:40
I do have a little one that I created for like, hospital use. Yeah,

Scott Benner 32:43
would you want to share it with a guy who makes a podcast to put on his website? Sure, no problem. Okay, thank you. All right, I'll do it if nobody else is going to do it. Yeah? I just, like, for the life of me, you know what I mean? Like, I listen, I have a ton of compassion for doctors. I know how hard their job is. I know. I know. Listen, I've been through it 16 different ways. I know all the problems, right, and I'm not unfeeling to the issue. But like, you can't be unfeeling to that the people are coming to you, like, whether it's fair or not, you're what's between them and success.

Speaker 1 33:13
Absolutely, yeah, you're that. You're supposed to be the expert. So like, in my mind, like, like, what you're saying, there's no excuse for a provider to, especially an endocrinologist to not know about the pumps.

Scott Benner 33:23
Yeah, right. So this is your wheelhouse. So tell me what the keys to pump training success are

Speaker 1 33:28
absolutely yeah. So like I said, be prepared. Know the pump that you wanna do, I would say also look at your insurance coverage. Okay, so before you start this whole process, you should have a general idea of what you're getting yourself into. So what I would recommend you do is you actually call your insurance company. They're not going to give you a specific number at that moment, but they might be able to tell you what percentage of coverage that you'll be able to have for each particular pump. You can even ask them, like, is this being run through pharmacy? Would this be run through DME? What are the differences there? That way you have a general idea of what to expect for payments and things like that. Now let's say you get an answer and you go, wow, this is ridiculous. This is too high. I can't I can't do this check with each of the pump manufacturers because they oftentimes will offer payment plans. And perhaps you have a payment plan, it's, maybe it's 50 bucks a month, or whatever it is, that would allow you to still get an insulin pump, otherwise that you wouldn't have been able to

Scott Benner 34:27
get it at all. Yeah, you don't want to fall in love with the convertible if you can't get the loan for it. Like, so, like, exactly, yeah, know what your purchasing power is like through your insurance or whatever. Like, what is it you're eligible for before you show up and fall in love with something and then find out you can't

Speaker 1 34:41
have it absolutely. Yeah. Now you're also going to want to know where, where are your supplies coming from? Okay? So a lot of people, I'll get them trained up, and that was maybe a question that was never brought up or asked, and now they don't know where their supplies are coming from for their next pump change, right? So they'll get, like, three months of supplies to start. I don't actually know where I'm gonna get my stuff, so make sure you know where it's coming from. Generally speaking, the pump companies will look at a supplier that's contracted with with your insurance. Yeah, right. So like, I know you talk about us Med, you know there's edge Park Byram. There's a bunch of them out there. Just make sure you know where it's coming from. Because you don't want to love the pump, be using it. And then you get to where you're like, oh, it's been three months, and I have no supplies, right? You want to know? You got to

Scott Benner 35:26
know that. Give me a second. Here. You can get your diabetes supplies the same way my daughter does from us, med, us, med.com/juicebox, or call eight. I don't know if I know the number of thought my, damn it. I don't think I know. It's so funny. No, they, I just wanted to bring up that they're, they're a sponsor, so, but, yeah, like, I'm a, I'm a huge fan of that, like, so my daughter's Dexcom comes from us. Med, her OmniPods come from there. We're on a, you know, actually, just was on the phone with them today because we switched insurances. And it's so interesting, because no matter which company this is, you see people mad at them all the time, like nobody's ever madder than somebody who sends medical supplies to you. And in fairness, I would say that they all feel like they should buy a new computer to me sometimes, but I know that's an oversimplification, but like it just feels, it feels like a process. It's a little outdated for you know where technology is. Having said that I woke up one day and I was like, Where the hell are Arden supplies? And then it hit me, oh, we changed insurance. That's my fault. Yeah. Like, you know what I mean? Like, oh, I never called them and said that I called them up. I just kept assuming, like, Oh, it'll show up. And this I called and I said, Hey, we switched insurance, and it's not a fun process. They've got to contact your doctor again because the new insurance company wants verification, and the whole thing is a rigmarole, like, it hurts, like, you know what I mean, but once it's set up, there's nothing like it. Because I don't know how some of these other companies work, but us Med, like, they call my house, I push a button on the phone, and the stuff comes and, like, you can't beat that with a stick. That's awesome, you know what I mean? Totally, totally,

Speaker 1 37:01
yeah. And that might not be everyone's experience with every single company. So just, you know, work with the companies, and if you don't really like them, I mean, you can, you can switch suppliers, sure? Yeah,

Scott Benner 37:12
absolutely. I've worked with Edge Park, I've worked with us Med, I've worked with other companies. I've worked with CVS, Caremark. Like, I don't know what it is about the process, but it always feels like, God, it shouldn't have this many steps, agreed. You know what I mean. But the thing I like about us Med, the best is that, once it's up and running, it is so automated, it's just, it's awesome. So, but, yeah, like, that's an interesting point, right? Because people are diagnosed and they like, your doctor gives you some supplies, maybe to get you set up, and then, or, you know, your first order comes with some stuff. And you probably just, like, you probably don't even think about it, like, Where does this come from, right? You know? And some people probably just think local pharmacy. But that's not always, you know. I mean, after, you know what, it is not bad, but after you've got this Albatross, I was gonna say Albatross, after you've had diabetes for a while, you don't want to be at the pharmacy all the time picking stuff up, you know? Yeah, no, I hear that, yeah. What else you got

Speaker 1 38:07
there? Yeah? So I'd say also, you need to know who your point person is. So the way it works is a lot of times you'll have an actual employee from the pump company who's doing a lot of the back end stuff, right? So they're they're working with a doctor to make sure that all the the orders and the prescriptions are correct, making sure settings are dialed in that employee there may not actually be the one who's going to train you on the pump, right? So you're going to want to know who is the actual pump trainer that's going to train train you. So like, as an example, I do pump trainings outside of working in a hospital as a contractor. And there's also endocrine clinics that have their own trainers there, and then sometimes there's trainers from the actual company. So you want to know who that person is, because they're going to be a really good contact point for you to while you're learning how to how to use the pump, or if you need help with the supplies and things like that. You gotta know who that is, and you need to communicate with that person. I would recommend don't leaving that person unread, like you wanna get things situated and scheduled up listen to their recommendations. Now that person there also is likely not gonna be able to come to your house. In the old days, you could go and do pump trainings at people's houses. But there's, there's definitely a safety issue that can come sometimes with that. And so most of the pump companies will say you need to do this at your doctor's office, like a coffee shop, a diner, a library, something like that, a public location where

Scott Benner 39:36
you can't be absconded with Jordan, where you don't end up in somebody's trunk. Is that what

Speaker 1 39:41
you're saying? That's exactly there. There's a few trainings that before these policies were really implemented. Let's just say I was like, I need to get out of here. You're

Scott Benner 39:50
like, this isn't going my way. I wish I remembered this guy's name, but this has got to be 10 years ago, a really long time ago. Arden was on, like, Chief. Four and we had some sort of, like a failure, and we didn't have any more supplies. And I called the company, just like anybody else, I didn't call. I wasn't like, Hey, I'm the guy from the thing. I wasn't the guy from the thing at that point. And I, you know, I got somebody on the phone, and they said, Well, your local rep may have samples. And they gave me my local reps number I called. She said, I'm sorry I don't, but, like, I know that the local rep in the next state over, like, I'm in New Jersey, she calls a guy in, like, Pennsylvania, and he says, I have stuff here, and I'm talking about, like, 90 minutes from my house, right? And he says, This is my home address. You come here. I'll give you one. And no VI, like, later that afternoon, I was standing in his dining room, and he was handing me a transmitter. Oh, that's amazing, yeah. Like, just a really, like, like, a genuinely nice thing that nobody had to do, you know. So I don't know if the world's gotten so big now that that stuff, that stuff like that happens anymore or not, but like, a long time ago, like, that was it just, you know, some local rep that has some stuff in his car. And he was like, happy to like, like, help me out with it.

Speaker 1 41:04
Yeah. I mean, I down here, because down here in Arizona, right, there's, it seems like to me, it's a pretty family friendly state for the most part. And like, the reps at all the companies kind of fit that description that you just said there. Yeah. I mean, I've had encounters before where you're like, This patient's really struggling, and one of them will be, I'm on my way. I'll be right there to drop off a sample, right? It's incredible,

Scott Benner 41:27
yeah, just very, very, very uplifting, actually, I guess, the way for sure, for

Speaker 1 41:31
sure, but yeah, I mean, when you're going through your training there, like you said, You'll coordinate with that person to figure out where you're going to be training. Just make sure, though, during the training, you come prepared to ask questions, and depending on the person's training style, they might try to do everything for you. I would say, go into that training. And if it's not made clear from them upfront, like you should be holding the pump, you should be doing everything yourself. You got to get that hands on experience. Otherwise it's it. You're going to get to your first actual site change or whatever, and no one's there, and you're not going to know what you're doing tactilely. It's not going to be memorable at all. You're not going to be exactly right. So like, if I do a training with someone, I say, Listen, from the get go, you are doing everything. I'm here to help coach you, but you're going to be entering all the basal rates. You're going to be putting the pump on yourself. You're loading it with insulin, you're doing it all. So, yeah, just, can

Scott Benner 42:23
I be cynical for a second, if a trainer is doing that? Is that just them trying to get out of there? Or do you think it just also could be just a style? Like, you know what I mean? Like, are they, like, let me just get this thing set up so I can get the hell out of here. Like, do you think that

Speaker 1 42:36
has I see? Yeah, there's a possibility that, definitely that could be a possibility. There are situations where maybe someone's getting really sidetracked and just really off topic. I got you, and you're like, Oh, hey, let me show you this real quick, and then you do it for them real fast.

Scott Benner 42:52
Are you? Are you asking me to remind people that that you're not there to hear someone's life story?

Speaker 1 42:58
That's for sure. Like, I think people should be personable and have good conversations, but you are there for a specific goal of getting someone going on a pump

Scott Benner 43:08
right? Listen. I'll tell you something. One of the reasons it's so easy to make this podcast is because no one likes to tell their story more than people with type one diabetes. They love this. Yeah, oh my God. They love it. Yeah? Like, yeah, I if I go speak at something and I try to walk across the room, I gotta put my head down and put a bag over my head if I want to make it to the other side. Because everyone who stops you, it's like, hey, it's, first of all, it's lovely. Like, don't get me wrong, but like, at some point they settle in, and if they feel like you're not moving still, boom, here's my diagnosis. Or they they start at a at the beginning, and you're like, Oh no, I gotta go.

Speaker 1 43:43
I know you don't want to sit there being rude or anything. But, oh man. And

Scott Benner 43:48
worse for me, Jordan, and you know, it like I'm really interested. So I'm like, oh no kidding. Before I know it, I'm making a podcast for them and me. You know, maybe, like, No, it wasn't. If no one else can hear this, I you know, can we record this at least? I think it's nice actually, that people are, you know, I honestly, I think it's a community thing. Like, once you get in front of somebody who, you know, understands, like, you're like, Well, this is my chance to, like, open up about this to a person who's not going to look back at me, like, blankly, you know, I get it like, it's awesome, but the trainer's got to go. They got a half an hour, and they got a lunch break too, and like, they got to keep moving get to the next

Speaker 1 44:24
person. Yeah, yeah. And again, this depending on the person, but I usually allow for up to two hours, or

Scott Benner 44:30
they call a mensch, that's nice, yeah. So

Speaker 1 44:36
that usually is plenty of time, like most of the pumps, you can get trained up in about an hour or so, give or take, and then that leaves about an hour to, you know, have some friendly conversation or ask questions and things like that.

Scott Benner 44:49
You have a list here of things to be prepared for. Can I Can I read the list? Yeah, go ahead and read the list, because I'm amused the pump. Have you shown up at trainings where the pump wasn't there? Absolutely. Absolutely okay. The charger. Have you shown up at locations where the pumps not charged? People who don't have their infusion sets or their pods with them? Yes, yes, they brought the pump, but not insulin correct? They have the pump, but they don't have their CGM, yep. Okay. They don't have the transmitter for the g6 but they have the sensor. Yes. So now, here's the here's one I'm interested in. Now, I know professionally, I think you have to say what you want to say, but I have other thoughts. Alcohol swabs, if you, oh, if, if you want to use them, you put it there. Okay, all right, yes, you are not carrying alcohol alcohol swabs with you. For them, not at all. Gotcha. And then, and this is a great tip, like, bring a notebook so you can write stuff. Now,

Speaker 1 45:41
yes, yes. Okay, so everything on that list that's all coming from experience. I've been doing pump trainings going on about five years now, professionally, and everything on that list has been forgotten, misplaced, or something like that, to where you either have to reschedule the training, or, you know, we're getting a delay where, while somebody drives home real quick to go get it. Listen, I don't want

Scott Benner 46:05
to be critical, as the person who has left my house 1000 times in my life and walked back in two minutes later going, I'm just gonna remember to take my wallet with me this time. Exactly this list hit me like, like Jordan, when my wife and I rented our first apartment after we were married, we were sitting down to sign the contract on the apartment, and there was, like, this highlighted, like something on the page had like, highlighter through it, so it drew your eye to it, and it said, No swimming in the pool with open wounds. I gestured to the rental person. I was like, this isn't just the thing a lawyer thinks of, like, what is this? She goes, Oh, you have no idea how many people try to get into the pool with open wounds. I was like, Oh, that's a problem. She goes, it's a massive problem. And I was like, oh, okay, that your list reminded me that I'm like, That's not just things people write down. Because why would you have to remind people to bring a pump to their pump training? But yeah, I

Speaker 1 46:55
can't tell you how many times they're like, Oh, I thought this was just an educational session. It is about the pump. Where's it at? Yeah, right. Okay, just a quick side story here, but I went to a training once, and this was for a tandem pump, and we get there, and this was also back when I went to people's houses. So I'm at this guy's house, way out, way out, far away, and we're talking and all that stuff. And then i All right, well, why don't you get the pump out? And he gets it out, and he's like, whoa. Like, what is this? My dad, that's your pump. He's like, No, I wanted that tubeless one. And I you mean, the Omnipod? Is like, Yeah, I thought I was getting Omnipod. I'm like, Dude, this is the tandem pump. And, like, when did you get this? He's like, it, well, it's been here for

Scott Benner 47:36
a month, yeah, in a box that says tandem on the front

Unknown Speaker 47:39
of it, right? Yeah.

Scott Benner 47:41
Oh, my goodness. And for clarity, you mean you're out in the desert, is what you're trying to say, right, literally, out in the desert. You're like, oh, I don't want to get buried out here. So, like, so

Speaker 1 47:52
I was like, All right, well, I might have to either reschedule, or he ultimately, was like, I got to send this back. We're not, I can't do this training. I was

Scott Benner 47:59
wondering. I wondered, like, did he just, like, put the other pump on? But no, he sent it back and went and got the one he wanted. It's awesome story. I don't

Speaker 1 48:07
know how that actually worked out with his insurance. I kind of was like, All right, I'm gonna wash my hands of this

Scott Benner 48:11
one. Here I go. Now, goodbye. Yeah, he didn't ask if you want to stay behind and shoot cactus for a while or anything like

Speaker 1 48:18
that. No, he just asked if I wanted to stay for a couple of glasses of whiskey, but, oh, that's, that's lovely. It was very polite and kind. But I was like, you know, I've got to get home to my family. Thank

Scott Benner 48:27
you in one piece. Yeah, understand how a CGM works. Go ahead. What do you what do you want people to know?

Speaker 1 48:34
Yeah. So just just understanding, similar to, like, what we touched on a little bit up there earlier, but like, for example, CGM do not read blood glucose. They read interstitial glucose. And so if you're not aware of the difference, interstitial glucose is really the glucose just outside of the blood. So think about getting to that open wound discussion we had, if you scrape your knee and you clean off the blood and then it's kind of oozing a clear fluid that is interstitial fluid. And that fluid there contains glucose in it. It's going kind of back and forth a little bit through osmosis. Yeah. So anyways, it's just, it's just glucose outside the blood, the easy way to think about it, right? But because it's measuring that the changes of your actual glucose levels that are going to impact you are happening inside the blood. There can be a slight delay in that interstitial glucose there. Yeah. So as an example, let's say you look down at your CGM. It says that you are 150 with two arrows up. There's a good chance by that point there, maybe you're like 170 actually, if you pull out a glucose meter, a reliable glucose meter, and checked, because the CGM is going to lag behind when there's these rapid changes. So you just got to be aware of that, right? That's all I meant by that. Okay,

Scott Benner 49:54
I've tried to impress upon people forever, and I sometimes I feel weird about, I'm not going to lie like, because. You know, like, ever since Dexcom, they're sponsors, right? And then I see somebody online, they're like, This thing doesn't work, and blah, blah, blah. And I'm like, and you want to say, like, are you hydrated? Like, you know, is it this? Is it that? Like, I'm always afraid people are going to be like, he's over here apologizing for them. The fact that people aren't wowed that a little, tiny wire gets inserted under their skin, and then they know what their blood sugar is, which direction it's moving, and how fast it's going that direction. Yeah. Like, yeah. I don't know how you're not wowed by that constantly, but Okay, and how you don't see that like this, this static piece of metal and plastic, which is being run by like, an algorithm that's actually taking that measurement and then doing a bunch of gesenters that you and I do not understand, to come up with how much glucose is in this interstitial fluid, and how does that translate to how much we'd find in the blood right now if we did a finger stick like, that's magic, okay? It is magic, absolutely and not to understand that like you and your body or your kid's body, and that person's body, or that person's kid's body, are not the same. They're not in the same state, and that somehow this company has made this thing that still works for most people exactly like, that's beautiful, right? And yet, but we always act like, I don't know why this doesn't work, like it's not a doorknob, like it's not, like it doesn't just work or not work, like there's a lot going into it. And I find it valuable to remember that when you're using it Well

Speaker 1 51:31
absolutely. And I love the points that you brought up in other episodes where, like, if you really look down or look at like, what's going on a situation, I think you could probably dive down and get to the root cause of pretty much every issue with diabetes. It just seems like it's a mystery to some people, but if you actually took the time and looked into it, you'd find out, like, oh, that's why this happened, right? And so you can look at a CGM also, and like, you brought up the individual biochemistry of people, right? And so, like, think about, like, you could be taking even different medications than someone else, yeah. And that could, that could play a role into the into the CGM readings there. So it's not that the the CGM itself was not working. It just could be a different situation going on in that person's body. Again,

Scott Benner 52:15
it's a piece of plastic and metal and algorithm that, in 2025 is talking to a human body and coming back with this information. It's pretty awesome, and it's not going to be perfect for everybody. Like, you know, the same idea with the with adhesive. Like, one person will say, this thing falls off all the time. The next person will tell you, like, I can't get the damn thing off of me, right? Why don't they make it this stronger, weaker, better? Like, because it's they're trying to make it work for as many people as possible, right? Not specifically for you. So, like, if you have greasy skin and it falls off a lot, then you're a person who's like, I wish they'd make this stuff stickier. So they make it stickier. And people go, I can't get this thing off, right? People with dry skin are like, oh, and then, or like, you know, listen, I don't There's few things that break my heart, like medical adhesive rashes. Like, I just It breaks my heart to think that, like, you're already in this situation, you already need to wear this thing. And like, oh my god, now this is happening. You know what I mean? Like, and I take people's points, like, Well, why don't they make a hypoallergenic one, the one that like this, the one like, I'm like, because if they started doing that, they'd have to make 7000 of these things. And then, like, I don't know how they could do that, you know what I mean, or how would even figure out which ones for you, you know what I mean. But at the same time, like, I'm not again, I'm not unfeeling to people who put it on and four days later, they're like, oh, this thing doesn't work already, right? But at the same time, I'd like to be able to say to those people, could, could you drink a bunch of water and make sure it's working. You know, first, like, before you just announce it, the thing doesn't work anymore, right? Absolutely. Listen, it's tough for everybody, but like, you know, this is what it is. This is the best you have. So you know, understand what interstitial fluid is and how you can help to make sure that your CGM is working as best as possible, that's all. And we absolutely put out episodes about it. So it's out there, if you want to know, no,

Speaker 1 54:05
it's definitely out there. Yeah, I just, you know this is coming off my head. I just forgot to mention this. But like, back to where I talked about doing the research for the pumps. There's some things that your fingertips that you could do right now to look into pumps. There's there's simulator apps. Oh yeah, go ahead and take a look at the pumps. So go on the App Store the Google place or whatever, and type in simulator for whatever pump that you want to try out. And there's a good chance you'll be able to try it out on your phone there, just getting a feel of what it would be like to push the buttons and all that. No kidding, yeah. So there's some cool things

Scott Benner 54:38
I'm telling you. As you're talking I really feel like I'd like to reach out to every pump company and just say, like, look, you know, give me a web page worth of information that you'd like people to have and like, I'll put it on my website. Yeah, yeah. You don't need to be an advertiser for that. Like, I mean, the truth is, I haven't looked into it in a couple of years, but I get better traffic than the companies do. So like, yeah, my. My site does really well. Like, I'd be happy for that stuff to be there and to help somebody. I just, I'm a one man show. Like, I can't, you don't mean, like, if I did everything that I was thinking of doing, I'd never get done. So I just prioritize stuff as best I can. Absolutely, yeah, I would love to do that. Like, I mean, yeah, I don't know, like, I hopefully you could get somebody to do it, but it's hard, man, it's difficult because you don't realize, like, you think, like, oh, call the company. You're not calling the company. You're calling a person who works in, like, my connections are in like, media or PR, and right, they don't work on the medical side. Like, you know what I mean, like, so then they got to put you in touch with another person, and now I'm in touch with another person who doesn't know me anymore. I'm like, You know what you should do? You should give me your content to put on my website. They're like, who are you? Because they don't know me. The PR people know me. I don't know like you just it's hard to get things done. I guess is my is my statement?

Speaker 1 55:49
Yeah, no, it is. And like you said, you're a one man show, so it's, uh, that makes it harder to, yeah, there's,

Scott Benner 55:55
I'm out of time. Did we cover everything you want to cover? Yeah, we did. We did. And we had a nice conversation. I thought, too. Absolutely, yeah, I'm all jacked up. Jordan, I've You are my third recording today.

Unknown Speaker 56:06
Man, yeah, you gotta take a break after this shot out of a

Scott Benner 56:09
cannon. I'm running on adrenaline right now, but I really appreciate you doing this with me. It's been a lot of fun. You'll be back again, right? We're gonna do more.

Speaker 1 56:17
Absolutely, yeah, there's always topics there, like I'd said the previous one like, I want to at some point cover some things on nutrition, yeah, yeah, there's lots of things to talk about. So I'll be back. Awesome, excellent. All right, I'll talk to you soon. Sounds good.

Scott Benner 56:34
Thanks so much to Jordan for spending his time with us. If you're enjoying Jordan on the podcast and you'd like him to come back. Go find him on Instagram, the diabetic murse, and let him know how much you enjoyed him on the show us. Med sponsored this episode of The Juicebox Podcast. Check them out at us, med, Comm, slash Juicebox, or by calling 888-721-1514, get your free benefits check and get started today with us. Med, the podcast you just enjoyed was sponsored by tandem diabetes care. Learn more about tandems, newest automated insulin delivery system, tandem Moby, with control iq plus technology at tandem diabetes.com/juicebox there are links in the show notes and links at Juicebox podcast.com 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 podcast 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? Check out my algorithm pumping series to help you make sense of automated insulin delivery systems like Omnipod, five loop, Medtronic, 780, G twist, tandem control, IQ and much more. Each episode will dive into the setup, features and real world usage tips that can transform your daily type one diabetes management. We cut through the jargon, share personal experiences and show you how these algorithms can simplify and streamline your care. If you're curious about automated insulin pumping, go find the algorithm pumping series in the Juicebox Podcast. Easiest way. Juicebox podcast.com, and go up into the menu, click on series, and it'll be right there. Hey, what's up, everybody? If you've noticed that the podcast sounds better and you're thinking like, how does that happen, what you're hearing is Rob at wrong way, recording doing his magic to these files. So if you want him to do his magic to you, wrong way. Recording.com, you got a podcast. You want somebody to edit it. You want rob you?

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Scott Benner 6/25/25 Scott Benner 6/25/25

#1559 Side Quest

Jenna’s journey from burnout to educator shows how one nurse, one moment, can change everything about living with diabetes.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Here we are back together again, friends for another episode of The Juicebox Podcast.

Jenna 0:16
Hi Jenna, I was diagnosed with type one diabetes in 1997

Scott Benner 0:23
when I created the defining diabetes series, I pictured a dictionary in my mind to help you understand key terms that shape type one diabetes management. Along with Jenny Smith, who, of course, is an experienced diabetes educator, we break down concepts like basal, time and range, insulin on board and much more. This series must have 70 short episodes in it. We have to take the jargon out of the jargon so that you can focus on what really matters, living confidently and staying healthy. You can't do these things if you don't know what they mean. Go get your diabetes to find Juicebox podcast.com go up in the menu and click on series. Please don't forget that nothing you hear on the Juicebox Podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan or becoming bold with insulin. When you think of a CGM and all the good that it brings in your life, is the first thing you think about. I love that I have to change it all the time. I love the warm up period every time I have to change it. I love that when I bump into a door frame, sometimes it gets ripped off. I love that the adhesive kind of gets mushy sometimes when I sweat and falls off. No, these are not the things that you love about a CGM. Today's episode of The Juicebox Podcast is sponsored by the Eversense 365 the only CGM that you only have to put on once a year, and the only CGM that won't give you any of those problems. The Eversense 365 is the only one year CGM designed to minimize the vice frustration. It has exceptional accuracy for one year with almost no false alarms from compression lows while you're sleeping, you can manage your diabetes instead of your CGM with the ever since 365 learn more and get started today at ever since cgm.com/juicebox, one year one CGM. Summertime is right around the corner, and Omnipod five is the only tube free automated insulin delivery system in the United States, because it's tube free, it's also waterproof, and it goes wherever you go. Learn more at my link, omnipod.com/juicebox That's right. Omnipod is sponsoring this episode of the podcast, and at my link, you can get a free starter kit. Terms and Conditions apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox, this episode of The Juicebox Podcast is brought to you by my favorite diabetes organization, touched by type one. Please take a moment to learn more about them at touched by type one.org on Facebook and Instagram. Touched by type one.org, check out their many programs, their annual conference awareness campaign, their D box program, dancing for diabetes. They have a dance program for local kids, a golf night and so much more. Touched by type one.org. You're looking to help, or you want to see people helping people with type one. You want touched by type one.org?

Speaker 1 3:29
Hi, Jenna, I was diagnosed with type one diabetes in 1997 going on 28 years. So you do the math, and that's really it. I mean, I'm not just a person with diabetes. They have child, bonus kids, a husband, a career, home, all the good stuff that comes along with that, too,

Scott Benner 3:52
doing a whole thing. You know, you just said something. I was diagnosed in 97 so, you know, you do the math. And I was like, I was like, I was like, I don't think Jen understands how math works. Yeah. So no, I

Speaker 1 4:04
forgot the carb ratio. How old are you? I am turning 38 in August, and it will be my 28th anniversary in

Scott Benner 4:14
October. So were you like 11 when you were diagnosed about 10, I had just turned

Speaker 1 4:19
10, and then in August, and then in October, I was diagnosed. So fifth grade,

Scott Benner 4:25
that must have sucked, huh? Of

Speaker 1 4:26
course. Of course, diabetes sucks. There's no good or bad time. They all suck. Like I think back a lot, especially with my job. I'm a diabetes educator. I worked with a lot of newly diagnosed, or students, you know, going to school with diabetes. And it's like a full circle thing, you know, when, when it came about, and my mother brought me, you know, was brushing my teeth one morning, and grew up in the sink randomly. And, you know, I and after the after the fact, my parents had been in discussions in private, after I. In bed that I don't look good. I look really skinny. Something's going on. So my mom brought me to the doctor. You know, the I always used to try and play sick. So she'd be like, Well, if he's staying home, we're going to the doctor. And I'm like, okay, yes, finally one of us, yeah. And that's how she knew if I was actually sick or not. It's like, if we're going to see Dr G, like, then she's sick, and we're in the, you know, in the office. And because I was 10, I still have a very vivid memory of it. Like, I know Arden was really young when she was diagnosed, right? So, like, and my best friend was four. Like, there's no real, you know, all your memories are really from people telling you, sure, right? And then you make them in your head. But I vividly remember 10 is not a young age that you forget certain memories, you know, yeah, and the doctor did the strep test because I used to always have stress, and, you know, that goes into the well, is that? Why the autoimmune but whatever, there was nothing. Everything seemed fine, and they didn't do blood work in the office like that back, you know, back then. But my mom, all of a sudden, goes, actually, she's been drinking and peeing a lot, and the pediatrician, and we had been with this doctor, I'm the youngest of four, and my brother's nine years older than me, so for about 20 years, my mom's been bringing all of her children to this office, and she, like, slammed her hand down, turns around, looks at my mom, hands me a cup, and says, Go pee in this. And sure enough, ketones, you know, pipstick said over 500 over 600 and she's like, you know, comes back, yeah, tells my mom, and she's like, Do you know what that means? And I'm like, well, am I gonna die? And she was like, Well, if you manage it, because you can, you'll be fine. You will live a long, happy life. It doesn't need to stop you, but you're not leaving the office until I get an endocrinologist on the phone. So you know, we're waiting for a bunch of doctors to fall back. I just got really thrown into this world, and I wasn't fearful at first, and about a few months before, it was probably right before my birthday that year, my father's sister, my aunt, her husband and her two kids were visiting from Florida, and he had type one diabetes, so not a familial bloodline relation, but and I remember him sitting in my kitchen and taking a shot, and I'm like, wow. Like, that's crazy. I could, I could never do that. If I had to give myself it like shots all day, every day, like, I would never be able to do that. And he looked up at me. It was like, if you had to, you would. And he was right, you know, kind of like a, you know, self fulfilling

Scott Benner 7:37
prophecy. I don't know, did you start with MDI back then

Speaker 1 7:41
it was NPH and regular, twice a day. Don't eat

Scott Benner 7:44
sugar. That's it. That was it. Check

Unknown Speaker 7:47
your sugar before meals, or if you feel you know if you don't feel right.

Scott Benner 7:53
Do you remember how long you managed that way?

Speaker 1 7:55
Probably till about 12 or 13. So I started that way. That was 10. I went to diabetes camp. I think when I was turning 12, okay, I went to Camp magenta. Love that place. Met my diabetes there still so 20 something years later, we still are, you know, in each other's lives, very much so. And saw some kid at at camp with a Medtronic 507 C and I got home and was like, we're getting me a pump. So I didn't even go to pens until after my first pump experience. I was syringes with two insulin and then heart

Scott Benner 8:33
count right to it. Oh, wow, yeah. I heard your New York there for the first time. Oh

Unknown Speaker 8:38
yeah, Brooklyn, born and raised

Scott Benner 8:41
you said soul. And I was like, oh, okay, yeah, that happened. That's okay. Let me kind of dig through a little bit. So when you were doing the regular mph, was your mom involved? Like, because it sounds like you're the youngest and I am her three other ones are much older. Like, were you the like, Oh, she'll be okay. I don't really need to do much. Baby that turned into, wow. This kid needs a lot

Speaker 1 9:04
No, no. Who is. So I have a sister two years older than me, sister six years older than me, and my brother's nine years older than me. So it wasn't a huge gap, but I was resilient because of being the youngest of four. You know, back in the day, there was, you know, your siblings watched you, and it was okay, and you wanted to run around and tag along after them. But I think when I was so crazy enough, I the endocrinologist called back. We set an appointment for, you know, either the next day, it might have been a Friday, you know, within the next few days, with the explicit instructions, if she starts vomiting again or at all, go right to the ER, okay, cool. So we go home at the, you know, our first endo appointment, and it was right around the same time my brother was in boot camp in the Marines. And it was literally. Leading up to it was diagnosed October 7, and within the next few weeks, we were supposed to go to South Carolina for his within the next week for his graduation, for boot camp. Okay, so it was like, admit her and miss our son graduating boot camp. And I wanted to go to me and my my brother was like, my idol, yeah, you know, my big brother. And I guess I can't remember if he did a finger stick like he should have went through the whole thing, you know, all that education, but it turned out that it was like, I guess my ketones really weren't elevated. I don't know. But he was like, Alright, go on the trip. No insulin, nothing. You're the meter. Check your blood glucose, if she gets sick, Bernard or the closest CR when you get back from your trip, we'll admit her and get her on insulin. Interesting, yeah, so, and I don't know now, it's almost 30 years ago, so I don't know what the specifics were at the time, but that's what happened. We went, took Amtrak, but it was like, avoid sugar. So instead of my snapples or my nest tea, it was diet nest tea, tic tac, orange tic tac, because they were carb free, you know, like they were sugar free. You

Scott Benner 11:06
just freaked me out. Snapple was around 28 years ago.

Speaker 1 11:10
Apple, it wasn't and I, in my head, I'm like, No, it was nest tea. So they had a diet lemon nest date, like it was an ice tea. And right before diagnosis, it would be like, I would go to the corner store and get a 20 ounce soda, right? And I'd guzzle it, and I'd fill that with ice tea, you know, 4c mix, you know, iced tea in the fridge. Fill the bottle up with that, guzzle it. Fill up a bottle of water for the sake, guzzle it. And that's when my mom, like, said to the doctor, like, that's a lot of liquid and a lot of urinating, you know, but that was okay, diet and st now, and they had, you know, I remember it was like the long, thin bottle and orange tic tac very sugar free. So it was like, all of these. I was the amount of orange Tic Tacs I ate in that first year of diagnosis, because it was like, just free, you know, sugar free. Because, again, we weren't counting carbs. It was just sugar free sugar

Scott Benner 12:03
that was your sweet thing that didn't hit your blood sugar too much. Yeah, yes.

Speaker 1 12:07
And it probably was because I think it's one car per tic tac and how many in there? Like it probably was,

Scott Benner 12:14
I know, right, you're like, there's only one carb in each of these. I'll just eat all 55 of them. Well,

Speaker 1 12:19
we weren't even counting carbs. It said no sugar on it. It said, or zero, or whatever it was. It was, you know, sugar free, you know, labeled that way. We know better. Now, probably still gonna have an effect, aside from whatever crap is in it, right? So we go to the graduation. We get, luckily, no incidences of vomiting or needing to go to the ER, you know, not even really feeling that ill. And knowing what I know now is because my body was probably used to feeling that way.

Scott Benner 12:49
You know, I have to tell you that I looked Jenna because I was really interested, and I was way off on this and anyway, Snapple was founded in 1972 in Valley Stream, Long Island, New

Speaker 1 13:00
York, which is about a neighborhood over from me, right? It

Scott Benner 13:03
started as a natural juice company called unadulterated food products. It was created by Leonard Marsh Hyman golden and Arnold Greenberg. The name Snapple emerged in the early 80s, derived from a carbonated Apple soda product called snappy apple, and it was among their initial offerings. I only began to know about Snapple and Jenna. I don't know if you were too young for this or not, but they put a PR campaign together that only went through the Howard Stern Show, and that, that's how I found out about Snapple.

Speaker 1 13:33
Absolutely, Howard. Yes. My, my, my dad did construction, and when he got to his new when I was serious, act when it was just XM, or just serious, like when he originally signed on. My dad and his construction crew were the ones that built his office in

Scott Benner 13:50
the city. Oh, no kidding. Yeah, that's really cool. So

Speaker 1 13:54
I mean, I remember the glass bottle Snapple, yeah, but I only remember them as like, a T, like, and like you're saying, like Snapple. It wasn't as popular, no, I don't think it was as widely distributed.

Scott Benner 14:07
Well, it was incredibly local. I thought, like, northeast, yeah,

Speaker 1 14:10
right. But I think it was more on like I live in, in Nassau County, now very close to Valley Stream. But in like, I grew up in Brooklyn, so it was more like Arizona, you know, Arizona cans are, like the little grenade juices or, you know, those are the things we saw in, like our bodegas or our grocery stores, you know, yeah. But then Snapple came out when I and it was all glass bottles. It was like, really, one of the only options other than, like, Martin's apple juice, Martin Ellie that came out, you know that had glass bottles. Yeah. Do

Scott Benner 14:41
you remember feeling like, if it was in a glass bottle, it was somehow healthy or better? Yeah,

Speaker 1 14:45
it was all natural, and it was because it's not plastic, and that's before, yeah, you but you're drinking for a plastic truck. But I used to love, um, hitting the bottom of the bottle, because it used to do that snap. Oh, yeah. But if you snap. The top, you like, potentially could blow out the

Scott Benner 15:04
bottom. All I know is that Snapple doesn't taste the way it used to

Speaker 1 15:06
taste, not in a plastic bottle. I agree with you 100% and I my, my go to, like, my guilty pleasure, because I try to stay away from the aspartame, but like, I'm not trying that hard because, like, I I want to enjoy things and that tastes good, yeah, so, you know, but diet, peach and Apple is my guilty pleasure, and in my brain, it's healthier than diet. So

Scott Benner 15:29
tell me a little bit so you it's helpful after the you know, I want to know about, like, management when you were younger, was your mom involved? Like, were you just doing it yourself? Today's episode is brought to you by Omnipod. It might sound crazy to say, but Summertime is right around the corner. That means more swimming, sports, activities, vacations, and you know what's a great feeling, being able to stay connected to automated in some delivery while doing it all. Omnipod five is the only tube free automated insulin delivery system in the US, and because it's tube free and waterproof, it goes everywhere you do, in the pool, in the ocean or on the soccer field. Unlike traditional insulin pumps, you never have to disconnect from Omnipod five for daily activities, which means you never have to take a break from automated insulin delivery, ready to go tube free. Request your free Omnipod five Starter Kit today at omnipod.com/juicebox Terms and Conditions apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox type that link into your browser or go to Juicebox podcast.com and click on the image of Omnipod right at the bottom. There's also a link right in the show notes of your podcast player. When you think of a CGM and all the good that it brings in your life, is the first thing you think about. I love that I have to change it all the time. I love the warm up period every time I have to change it. I love that when I bump into a door frame. Sometimes it gets ripped off. I love that the adhesive kind of gets mushy. Sometimes when I sweat and falls off. No, these are not the things that you love about a CGM. Today's episode of The Juicebox Podcast is sponsored by the ever since 365 the only CGM that you only have to put on once a year, and the only CGM that won't give you any of those problems. The Eversense 365 is the only one year CGM designed to minimize device frustration. It has exceptional accuracy for one year with almost no false alarms from compression lows while you're sleeping, you can manage your diabetes instead of your CGM with the Eversense 365 learn more and get started today at ever since cgm.com/juicebox, one year, one CGM.

Speaker 1 17:49
So when we got back and we were admitted, I had this wonderful diabetes educator, you know, a nurse educator. It was probably day four or five, and my parents had given me, you know, the shots now, and I was finger sticking like a pro after the first time they did it to me, I was like, Can I do that? You know? Like, I want to try a very like, Well, okay, I could do that. That seems simple enough, you know, but I hadn't given my own injection. So we're nearing the end of the week. I want to go home. I'm done now, you know, like, get me out of here. And the diabetes educator was like, well, have, I haven't watched you give your own shot yet. Oh, and I was like, Well, what do you mean? She's like, your mom and dad aren't always going to be there with you. What if you want to go a friend's house? What if you want to go, you know, like, you have to be able to do it too. And I was like, and then I could go home. She's like, Yeah, I'm like, give

Scott Benner 18:37
me the syringe and the vibe. I didn't know that's what we were waiting for. I would have done this. Yeah, I

Speaker 1 18:41
didn't know that was it. I could have been old for days. And, you know, we are near to cloudy always, you know, put the the air in the in the NPH first, put the air in the regular, flip it pull up the regular, then pull up the mph, you know, and gave myself the injection, and did the line, you know, drew it up the plunder and everything. It was more so like my mom would give me the shot if I wanted to use my arm, you know, because I hadn't figured that technique out yet on how to inject myself in my arm. And then the first few months, she was probably definitely double checking my syringe. I'd pull up the regular she'd make sure I pulled it to six and, you know, math, so if I need 10 regular totals gotta be 10 mph, totals gotta be 16. And she would double check that there were, I remember, like, walking into the living room being like, Can I check my sugar? And they're like, Well, do you feel off like it was after dinner? And I'm like, Nah, I just want to know what it is like, because it was cool. Like that was cool to me. I can take my blood and figure out my electric level like that was just awesome to me. And my family still teases me. I'm like, the nerdiest, a new meter comes out, a new pump, a new sensor, new apps. Like, I'm a tech nerd when it comes to diabetes management, I'm like, if this is my. Silver lining, leave me alone. This makes the decisions less and easier. I'll take it.

Scott Benner 20:06
Was that a thing like that you would have been interested in, like, I mean, is that how your mind worked as a kid? Like you were like, Oh, look at this. Like, the blood inside of me tells a thing that's awesome.

Speaker 1 20:16
I used to take apart, like the TV remote control, just to see what was inside. Can never get them to back together to work. Used to try, like, anything I could take apart I would so, yes, very interested in things like that. And I come from a long line of nurses. So even before I was diagnosed, like I was pretty certain that I wanted to be a nurse. And then after being diagnosed and returning to school with that. I saw the school nurse every day, you know, so, but, you know, like, yeah, the tech thing, the interested thing, this is cool, yeah, I was that, you know, I wasn't like, Yeah, I had my Barbies and stuff like that, but I was like, in the dirt, digging up, you know, worms or getting dirty, you know, like, just always trying to figure something out, yeah, something cool, that would work.

Scott Benner 21:03
So you, you get done High School, you, you go off to college.

Speaker 1 21:08
I went off to college. I dormed first so my high school, I didn't go through my, like, burnout, denial until college. Really, okay, like, I made it through high school, and it's funny, like, going through, like, the way that school, that diabetes is managed in school settings now is so wonderfully different than it was then. You know, I couldn't finger stick in the classroom, even though I was independent in blood glucose monitoring from day one. Yeah, I knew what to do based on the number. I knew how to get that like that was never questioned about my skill level there. But I couldn't do it in the classroom because it's sharp, okay, you know, couldn't eat in the classroom I needed because of mph and regular I couldn't wait to have, you know, taking it at eight o'clock in the morning, 730 in the morning. I gotta eat by like, 1011 lunch wasn't till one, but I couldn't eat a half a sandwich in social studies. I had to go and eat the Deans off for 15 minutes and miss that part of that class, right? You know, even though, like, I don't know,

Scott Benner 22:09
like, I feel like we're arguing something, it's probably over already, if we talk about

Speaker 1 22:15
this, absolutely had a lawsuit back in the day. I could have absolutely,

Scott Benner 22:19
just, like, common sense, like, couldn't somebody, like, pull someone aside and go listen. Why is she missing class? Because she has to eat this half a sandwich. They just let her eat it. Why is she leaving for this and that? Like, I know it's so much different now, but well,

Speaker 1 22:29
don't get me wrong, I pulled the diabetes card. You're like, I gotta live with it. I might as well to be I might as well use the card. Everyone's

Scott Benner 22:37
I'm dizzy. I gotta go. Yeah, I

Speaker 1 22:41
don't feel good. I was the first student diagnosed in the school, like diabetes was known, and it was in some schools, but I was the first one in that school, who I've ever been in that school with diabetes. And the policies at that time, and even state laws at that time, like, even non licensed personnel couldn't administer glucose, yeah, you know, only nursing nurses could like. So it was, it was laws that have changed since, that are really in regards to that too. And I think it was more so like, because I had to finger stick before I eat. So either way, I had to miss five minutes of that class, yeah, because I wasn't allowed to do that in the classroom. So instead of walk, you know, and this was middle school, instead of walking downstairs to the nurse, my Dean, who was literally right up the hall from my classroom, would let me eat during that time period. He made sure that was his office hours Monday through Friday, so that I could be there during that period. So there were accommodations

Scott Benner 23:37
that happened. Yeah, listen to there was a time I forget exactly. Arden was pretty young, and our governor signed into law that diabetes could use their like their needles and their pumps and stuff like that in the classroom, and they could test in the classroom. I'm forgetting the exact details around this, but it was a big deal for us, like those of you who are listening, who are like, Oh my god, like, I fell in love with this podcast on episode four, when he's talking about how he's texting with his daughter like that actually came to be because, because they changed the law, and it was all of a sudden possible. I wish I remembered when that was. I remember thinking like, I can't believe this is such a big deal in our lives, but yeah, but it was, it was huge. So and

Speaker 1 24:15
but you also have to remember when I was first diagnosed, in those first two years, really. So figure, fifth and sixth grade. I wasn't even on insulin in school. It was just blood glucose monitoring. I did it in the morning, before school, and I did it before dinner. You know, it was two shots a day. And I have a few students that are like that, that, you know, whether it's they're just starting out, so they're only on a long acting, you know, newly diagnosed things like that, and as they progress. But I think everyone was just scared. But I will say this, and why my life changed, why my I didn't just want to be a nurse anymore. I wanted to be a school nurse. Is when I was out that week, you know, being admitted and learning what my life would be like, my school nurse without any you know, didn't act my. Mom, which I think now I'm, like, some parents would lose it because of HIPAA and privacy and this and that she bought the bringing diabetes to school, you know, book. I read it to my fifth grade

Scott Benner 25:12
class to try to bring everybody up to speed on what was happening to you. Yeah, like,

Speaker 1 25:16
why isn't Jenna here for a week, you know? And I got back and I had, you know, or maybe they brought it to me in the hospital, but I think it was when I got back, they were like, the door of the classroom was decorated, welcome back, and all the kids, and, you know, all my classmates had, like, written notes, and they were like, on the classroom door. And, you know, I had my select few friends who would walk me down to the nurse if I was low. What were they gonna do if I passed out like there weren't paraprofessionals? I remember it was like parents on the PTA that volunteered to, like, do, like, hallway duty, you know, like there wasn't, there wasn't Paris that would have been assigned to me. So I had an adult escort, if need be. Yeah, it was students.

Scott Benner 25:58
What would they do? They'd be like they'd run and get help,

Speaker 1 26:02
what they know, or would they sit there and scream like I had some really great friends growing up, you know, at that time period, and I feel like it made such a difference that I didn't have to go in and explain it myself. Okay, they had the basics. So they had questions, and I pretty much knew most of the answer. It's pretty basic questions. We were 10, you know, we're not going into the biology and science of it, just the pancreas this that you know basics, but they already have those answers, and what my normal day in school might look like, because the nurse took it upon herself to teach them and educate them, right? And it wasn't until years later, and now I am was a school nurse, and now I have my position. I have that. I'm like, that was amazing. It was a big deal for you, but not until years later, reflecting back, okay,

Scott Benner 26:50
that you think that your your little cadre of friends who was, you know, surrounding you the hallway probably look like a soprano as you guys walk into the nurse's office. You know what's hilarious. Yes, I just like that. You think that if you passed out, they would have stood around you, like, stand by me, just staring at the body, going like, I don't know what to

Speaker 1 27:05
do. No, they wouldn't have. They wouldn't have. But in certain grade levels, that would the ones that I would pick to escort me to the nurse. Would I knew what I was doing? Yeah, I knew which kids in the class wouldn't know what to do and would absolutely panic. But, like, I had my still, like, you, you know, buddies that walked me down

Scott Benner 27:24
was that, like, a, like, a power move, like, like, you could absolutely, yeah, you could choose kids who could leave class, right,

Speaker 1 27:32
absolutely. And it was like, John, can I call you the nurse today? I'm like, I don't know you pissed me off yesterday. It was usually my best friend at the time, Jessica, and even after, like, over the next few years, like that was the only place I was allowed to sleep over at her house, yeah, and it was, you know, 15 minutes away from my house, like my mother could easily get there in a blink of an eye. And at that point in time, I did, she did. My mother did trust me to draw up, you know, my insulin and administer it and make sure I ate. And she trusted the, you know, Jessica's mom, she trusted her.

Scott Benner 28:10
How about once you got the pump on? Was it? Was it the same? Or did you have problems?

Speaker 1 28:15
Oh, my goodness, I went nuts. My uncle was like, even at one point, was like, you're an addict. I'm like, What do you mean? He's like, just eat whatever you want. Pump yourself up like you're just No, he we had his not like that. He's it wasn't in a bad way. It was more in a because I was just eating everything. I'd eat a donut just for the donut. I did it. I wasn't doing it the right way. I thought in my head. I can do that now, because I'll just give myself more insulin. I can do that. You can manage that way. It's not the best way for anybody. Nobody should eat a dozen donuts, whether they have diabetes or not, you know, like, it just wasn't healthy, even if I didn't have diet the way I was eating. You know, I see

Scott Benner 28:56
what you're saying. So you got into that, you got into that situation. This is pretty common. Like, it's like, Well, I figured out, even though you probably didn't exactly figure out how to Bolus for it, but it felt like it right? Like you were like, I know what to do. Like, it's no more needles. Like the freedom of needles is gone, so all I have to do is, I want to eat, I push the button and that's it. It's all good. Like, see how easy it

Speaker 1 29:17
was, a little bit harder than that, because back in the day, we didn't have all this brain in our in our pump, it gave you your basal, and you had to calculate your correction if needed, and your car coverage, total it, and then tell the pump, okay, okay, so it didn't do the math for you, no,

Scott Benner 29:34
but it gave you the feeling that it was free and easy, right?

Speaker 1 29:37
Yes, it was. I didn't have to draw up a syringe because, remember, I didn't even really know about pen yet, because I went right from syringes to a pump. So, like, I wasn't as familiar with I could have done the same thing with a long acting and a short acting. I had really only been introduced to this rapid acting. Now, I had had the intermediate and the short now, this is a rapid act. The insulin works right away, which

Scott Benner 30:04
works a lot faster than that regular mph did.

Speaker 1 30:06
That's I wasn't, I wasn't, I wasn't forced to eat anymore. So like Saturday mornings, when my parents used to wake me up to take my insulin and I had to eat at least two hours later,

Scott Benner 30:16
right? And that didn't sleep

Speaker 1 30:18
in on a Saturday morning. Pretty awesome. So yeah,

Scott Benner 30:21
what were your a one sees like, on that pump? Do you remember? I cannot remember for the life of me. Do you remember overall, like, what the vibe was around your your general health? Did people feel like we're doing a good job? That they feel like we're not like, was there? Was there always a panic in one way or the other?

Speaker 1 30:36
In the beginning, I feel like we were just managing. We were just doing what? Because I feel like it wasn't, it wasn't as information, as much information to obtain. Like we didn't have, I didn't have a sensor, yeah, so I only knew what my blood glucose was, you know, when I checked it, you know, four or five times a day,

Scott Benner 30:54
diabetes was more like the instructions you get now for taking a pill, like somebody told you, like, take it at breakfast and at dinner and make sure you don't take it with this, and you just did that, and you're like, that's it. I'm doing it. There's no real bigger thoughts about like, I wonder if this is going well or not, because you're not seeing data frequently enough to make any sense of it to begin with.

Speaker 1 31:13
That's how I remember it. Okay. I have no idea how it was for my parents and my older siblings. I'm sure they probably panic a hell of a lot more than I did, yeah, but, like, I also vividly remember, like, ordering, you know, dinner from one of the restaurants and covering for it. And this was later on when I did switch back to, you know, I wanted to be off a pump. I wanted to try, you know, Lantus. I think Lantus had, like, just come out. There was probably another one or whatever, but it was a new long acting insulin. And I was like, I want to try that. And my doctor was like, Okay, well, here's the thing. And he was, he was amazing even about a 1c after being he was, like, an A 1c is just an average. You can have great numbers for like, two and a half months, and then be sick for a week and a half, and it's going to skew your a 1c and this is even pre sensors, like, you know, and I used to fill in my log book all the way to the doctor and make up numbers, because I wasn't always checking but, and then, like, even when I wanted to get off the pump, and I was like, I remember, I was one of his first patients to get on a pump, you know. And I pushed for it. My mother, how I and he was the same way. He was like, it's your diabetes. At the end of the day, you go home with it, right? Yeah, as long as you manage the way we plan to manage, as long as you're doing the thing, taking the insulin, doing eating the what, you know, counting the carbs, taking the insulin, I'll help you manage any way you want, but you got to do the work too. Like, we're not going to switch it back to pens, and then you're not going to you going to take them, you know, you have to inject yourself each time. That was the big concern, yeah, because I was probably around 1516, so that's the age group, you know, I was in that age group where the burnout and the denial or the ignoring can occur, you know, puberty and hormones and this, that and the

Scott Benner 33:03
other thing, did it happen? Because you said you burned out at some point. But when was it

Speaker 1 33:07
not so, like college, how much did all the things? I mean, there were times I'm sure that I didn't check my my finger stick as much as I should have, you know, and being having the experience professionally now that I do, we're so lucky to die so

Unknown Speaker 33:24
many times. You think so,

Speaker 1 33:25
like, I would, yeah, because there could have been times I was like, low and covering for a meal and gave myself more insulin. You know, like there were times I would give myself insulin without knowing what my blood glucose is. I feel high. I'll give myself, like, a unit, no blog or something, you know, like, there were a lot of risky things that I put up potentially went very, very badly, and I'm very glad they did it. And even now, meeting with the students in that age group that I do, and I'm like, Listen all these things. You think you're CR you're making up. Like, ways to manage this. I did them, they don't work. I went through that. It's not good. It's actually a little bit easier to pay a little bit of attention. Yeah, no, I know it completely.

Scott Benner 34:11
Did you ever have like an emergent situation in during that time?

Speaker 1 34:15
So when we ordered dinner that night, so I gave myself, we figured it usually only takes like 20 minutes to get delivered. And so I'm like, All right, I'll take it now, you know, give it a little bit of time. I think my sugar is probably high, and you're ordering, like, pasta, pizza and stuff, you know. And I gave myself my insulin, and the delivery wound up taking like, an hour day, okay, my parents were calling, where are you? My daughter? And then I worked in pizzeria, and you get the phone call from the customer, like, where's my pizza? I'm diabetic. I took my insulin. I'm like, Well, you probably should have waited until it was there knowing, because this is happening.

Scott Benner 34:50
Listen, we just make the pizza, okay, and we bring you the pizza. And I want you to know, yeah, that the guy who's bringing the pizza to you is not. He doesn't have a master's degree, okay? Like, it's, he's we're just happy he's here. And we think he stops once in a while to do crack cocaine, but he will bring the pizza to you.

Speaker 1 35:09
Maybe smoke a joint. Maybe smoke a joint. It's probably

Scott Benner 35:14
that. All I'm saying is, like, it's not the well oiled machine that you think it is over here,

Speaker 1 35:19
or it's busy. Yeah, you're not the only one busy. Three drivers, and they each have five deliveries. They're out on, yeah, and the fourth guy that's supposed to come in his his tire blue. So, like, my husband owns a pizzeria. So I know both times as being the customer and that, you know, not easy. But I remember my parents like calling them, like, where is it? Where is it? And I vividly remember like, sliding down the doorway between my mom, my mom's hallway in the kitchen, like, because they kept trying, like John and just eat, like a little something. And I'm like, No, I want a week for dinner. Like, I was so psyched for like, my spaghetti meal, whatever. And I remember like, sliding down the wall and then nothing I don't remember between that and like sitting at the table eating, okay, I didn't pass out. I didn't lose consciousness, but I blacked out, yeah, because I don't remember the next parts could just be it being retold to me that I remember, you know, like I remember, but they had given me juice. I drank it. I sat at the table and I spent they were like, you know, blank eyes like it just I like my eyes just were not focused. Should not focus on one things, learning words sounded like a little jumper, you know. And at 1011, years old, however, you know, I was at the time. I was like, not, I wasn't normal. Nothing was wrong. And I think that was the first really low that probably scared the shit out of my family.

Scott Benner 36:45
How about you? Did it scare you? Or do you not have enough recollection? All

Speaker 1 36:49
right, I got food now, yeah, I was very like, it blew until I became like a nurse and started this, you know, being more involved in diabetes management, I feel like, I mean, there's days that I want to put my pump through a wall, like I'm done. I want to rip everything off my body. I want to ignore it, but for the most part, it's more I kind of, like, if I just pay the attention, yeah, it's stressful and annoying, a painless but like, I feel better when I do

Scott Benner 37:17
that. A little bit of work up front saves a lot of problem on the back. So I made

Speaker 1 37:21
it through high school. And, like, high school, I think I was both on pens and pumps through those four years, and, like, the nurse was right off the cafeteria. And I probably used my diabetes card then more than any other time in my schooling, just to, like, get out of class, like, I'm not feeling good, you know, and I'd go to the school nurse. It was another wonderful school nurse, but, well, I was, and I wasn't supposed to be giving myself injections in the cafeteria, but I was, you were doing it like I was going to the nurse when I didn't need to be, per policy. You know, I would get my food and sit down, and my friends would, like, turn a little so that the cafeteria ladies, who were like a bunch of older Italian women cooking us meals in the kitchen. It was great. We had the best school food, popcorn, chicken, oh, the best. And I would just give inject right at the table, like, and it wasn't a big deal at all with anybody else around me. It was like, if anything, they were interested. It was never like anybody you know, you can't do that here or something like that. Never like that.

Scott Benner 38:21
No one cared. But the rules, the rules cared that you were doing it, but nobody else

Speaker 1 38:24
cared. Yeah, yeah. Like, my pre, yeah, no, and I, yeah. I don't think anybody would have really

Scott Benner 38:30
been anything, yeah, when you're in college and you experience the burnout, like, Are you focused on being a nurse at that point?

Speaker 1 38:38
So I was enrolled in a nursing but it was also my first time away from home, and I didn't go far away. It was kind of like I could go home on the weekends and do laundry if I wanted to, like, it was a drive. I was in the Bronx, lived in Brooklyn, like it was an hour at you know, if there was no traffic, it was 45 minutes, okay, you know. But I was not living in in my house. Now I'm 18 way College, and smoke a lot of weed, like a lot of alcohol, and I just, you know, took my Lantus. I have some insulin in me. Sometimes I gave myself, you know, boluses for eating. Did miserable, like with Miss class, because of all the other extracurricular things I was doing. You know, I'm sure I have a diabetes played a role as well. And my my GPA that first semester was like a 1.9 so in order to start nursing, you know, by junior year, you had to have a cumulative GPA of three point up.

Scott Benner 39:33
You had to be trying, yeah,

Speaker 1 39:35
yeah, right. 1.9 was like, I went, right. But the rest of my semesters, I had 3.5 3.6 and then come junior year, when they're like, letting us know if we're going to start clinicals, I had a 2.98 and they wouldn't let me. They wouldn't let me. So I wound up switching my major, and I went to nursing school after getting my bachelor's, I did the opposite. Went for my bachelor's and then got my Associates in

Scott Benner 40:02
nursing after school. That's interesting. Well, okay, but,

Speaker 1 40:06
but in that college, I went into DKA quite a few times.

Scott Benner 40:10
Are you telling me that you just shot your basal and nothing else sometimes sounds like

Speaker 1 40:15
in my brain that I know is incorrect. I would be like, as long as I take my Lantus every day. I'll be all right, I probably won't, yeah, and that's where my head was.

Scott Benner 40:27
Do you have any, like, backward looking knowledge, like, what happened?

Speaker 1 40:30
It was such a fool. It was being out of my home, you know, wanting to just be a college kid. Okay? You know, I will say that I did teach my roommates how to give glucagon. And we're talking conventional, standard glucagon, the red box, like I if you ever can't wake me up, this is what you do. Okay, so I did do that at 18 years old. I was teaching my other 18 year old, 19 year old roommates how to inject me with glucagon if they couldn't wake me up. But

Scott Benner 40:59
at the same time, weren't you high most of the time anyway?

Speaker 1 41:02
Yeah, but it wasn't finger sticking. So it was like, no idea. It doesn't matter.

Scott Benner 41:07
So you get to college, whether it's conscious or not, your thought here is, I'm going to stop having diabetes now instead, I'm going to be college. Jenna, instead of, it

Speaker 1 41:17
was a subconscious thought, yeah, yeah, right. It wasn't like an actor, and then like, and reflecting back on it after that, I was losing weight, obviously, yeah, and was getting complimented a lot. Okay, Johnny, you look great.

Scott Benner 41:33
Yes, I'm in DKA, almost, yeah. And I never,

Speaker 1 41:36
and I didn't at the time, because all I knew about was, like, my diet, I didn't know, like, all the other things that can come along with it, just like the complications they are. You can lose a foot, you know? I had a teacher and freaking my husband had a diet. My husband had diabetes and he had to have his foot amputated like that. Is not what you tell a 10 year

Scott Benner 41:55
old, yeah. But Janice, so you didn't know any of that by the time you were 18.

Speaker 1 41:59
I did. Oh, but I did, but it wasn't in the forefront of my brain, because at 18 years old, I'm a selfish human. It's me, whatever's right in front of me, yeah, is what's going on, out of sight, out of mind. So if I didn't check my sugar, it wasn't high, you know? And and think again now, like I there, things could have gone so terribly wrong so many times, right? You know, because then I'm drinking too, and if I did happen to take my insulin, I could have went low, like I know so much more now, not that I didn't know it, but I consider it and use it and include it in my thinking process. How

Scott Benner 42:35
old were you when your brain started helping you take care of yourself?

Speaker 1 42:39
I think it was senior year, or maybe right after senior year, I was still, like, working up there, and one of my friends had an apartment. I had already been in TK a few times, like I would have my friend drive into the ER, because I was growing up in a cut stop. And, you know, it maybe happened two or three times while, you know, through freshman senior year. And then there was the last time that I was at my friend's apartment. I was alone. She was working. Her roommate was somewhere else or away for the weekend. I was staying there until she got home, and it didn't feel good. My sugar was high. I was giving myself insulin to try and bring me down, and then I threw up. And from my history of having bkas, if I throw up once it's happened, yeah, and then I'll throw up every hour, literally on the hour. If I throw up at 1101, at 1201 I'm in the bathroom again, throwing up. Okay? I throw up. I call my mom, and she's like, John, ambulance. I'm like, okay, goal, the ambulance I get in and attack all their occasions when I've had to go in as long as, as soon as I'm in the ER, I'll fall asleep, not coma or unconsciousness, but like my body, the adrenaline keeping me awake to save myself is done. I'm in medical professional hands. I'm going to sleep now. I'm tired, so they had admitted me for that one, and the next morning, I wake up, and my mom's sitting in the chair next to me, and she like, looks at me, and she's like, I'm just so tired. And I was like, You know what mom I am, too. I was tired of my mom having to drive from Brooklyn to the Bronx to find her daughter in a hospital because she almost died, yeah, because it wasn't the first time, and it was not fair to her, like she, you know, and again, out of sight, out of mind. I wouldn't call her for days because I'm at school. Like, of course, I'm alive, but I have diabetes, so my mom's at home going, maybe, maybe, yeah, did her friends wake did she wake up this morning? Did her friends wake her up? Did she eat? Did she not eat? That, you know, as a parent now I'm like, wow, I am such a dick. I really am such a dick. She's sitting worrying all the time, yeah, and then finding me at a hospital,

Scott Benner 44:48
yeah? So she's trying to tell you, like, Jenna, I need you to take care of yourself. It's killing me, yeah? And it's probably killing you too, yeah? But does she say that

Speaker 1 44:57
my mom is such a strong freaking wife? Mean, like, it's just insanity, the things this woman has done and continues to do at for her children or grandchildren, things faces, challenges she faced, just She's awesome. And I could just tell, like, just the way she said it, because she never asked, really, for anything, okay, and she never says she's tired, and never said, you know, like, it was always just, mom, would, you know, Mom handled that. Mom dealt with it. Mom, you know, sure, there was a lot of behind the scenes, I didn't know, but just the look in her face.

Scott Benner 45:30
So, like, Listen, before we started it, because we have about, we have about 15 minutes left, like, before we started, you were like, hey, look, I have ADHD, yeah, and you're like, and I'm gonna go all over the place you listen to the podcast, right? So, yeah, I love a conversation like this once in a while. I actually, I have no trouble with it all, but I'm very worried we're not going to get to the part where you're a school nurse, okay, yeah, like, so we're gonna fast forward, like, we're just gonna go and now, like you're out of school, you decided to keep yourself alive.

Speaker 1 45:59
Well, there were other things involved too. Instead of being really high, I was still drinking and going really low. But we'll cover those, and I'll come back.

Scott Benner 46:06
Oh, my God, how is that? Yeah, like, I don't know how people

Speaker 1 46:10
out the side quest, right? I became a nurse in 2012 did a lot of private duty, dabbled in pharmaceuticals, you know, as a pharmaceutical rep, hated it, went and worked as a medical assistant for a pediatrician, because I need that bedside, became a home health care nurse, and then got knocked up and had a baby. And when it's like postpartum anxiety, I just couldn't be I put it not that I didn't want to work. I just that job. It was like I spent more time documenting than I did, actually, with the patients, and it just was not good for me, and had a breakdown, and my husband's like, well, quit like, it's more important for me, for you to be happy and healthy and sane or harsan, than to work like we were. We're lucky enough that he, you know, it would have been tight, but it's okay. If that paycheck wasn't coming in from my end, we would have been, you know, it wouldn't have put us, you know, out on the street. And I'm like, All right, but I don't feel good about not having a lineup. So I had called my brother's friend's mom, who I had interviewed with right out of school. Was like, Hey, I gotta quit my job, because then got, you know, gave her the rundown. I'm like, Are you guys hiring? And she's like, funny enough, we have a hiring event going on tomorrow. Print out your resume and come on in. And I did, and I interviewed, and I got the job to be a school nurse. How long ago is this now? 2019 so I got into my assigned school in October. 2019 spent five months and then went home like everybody else.

Scott Benner 47:44
I'm really loving this job. I'm gonna go sit in my living room now for a year and a half. Well,

Speaker 1 47:50
yeah, well, I, because we're, you know, I was, I worked for a large agency, government agency. I was assigned to answer phone calls for OC, I mean, the Office of Medical Examiner,

Scott Benner 48:07
oh, so they found a job

Speaker 1 48:08
for I was literally answer, yeah, because I had, I had put in for accommodations, because at that time, it was like, if you have

Scott Benner 48:15
diabetes and get COVID, you're gonna die. Yeah, right, right. You're like, oh, I don't want that, yeah, not,

Speaker 1 48:19
you know, after further research, it's like, if it's uncontrolled, if it's mismanaged, you have read higher risk and, you know, complications and things

Scott Benner 48:27
like that. On day one, you were like, I need a job. No one's like, you're gonna die if you have died. Yeah, I need a job, and I don't want to die. Yeah, right, right. So they gave

Speaker 1 48:35
me accommodations to work from home, whereas a lot of other staff went and did testing areas hospital backup, you know, they sorted out. I couldn't go in the field, so I got this accommodation, but I was answering phones for people, looking for their family members. They had been in the hospital. They passed. They're not there in the morgue. They're where are they? Because there was so much

Scott Benner 48:59
chaos. I was trying to be a school nurse, not this.

Speaker 1 49:01
Oh. It was crazy. It was crazy at that time, sad. It really messed with me mentally. They're, you know, yeah, you know, calling, they get the date of birth and my they're my age, yeah.

Scott Benner 49:16
You have to tell people on the phone, like, Hey, I found your aunt or whatever. She died in this hospital.

Speaker 1 49:20
This is where they were sent to. And then there was, like, scandals with, you know, ventilator stuff, not being No, not being handled correctly, their bodies, oh, and like, and we were, like, sent a man's email. If you get a phone call regarding this, you know, one parlor, take their information and let the supervisor know. Because, again, we don't work for them. We don't know the usual drill. We have like a script, yeah, sure to do. But if a poll for this place comes in, do not say a word because of everything that was going on. So it really slipped my head a lot at that time, especially with everything else. Going on. Fast forward September, we go back into the school, and then December, this job posting comes up for diabetes nurse educator to basically help case manage students with diabetes in school. Help, you know, train school staff members, train nurses. And I applied, and I got it, and it's like a full circle job. I can meet newly diagnosed students and their families, and a lot of the parents I was saying, like, just want to make sure somebody has already told you, like, there's nothing you did or didn't do that caused this, right? And I've had parents go, Yeah, I worked through that already, and then I've had parents just completely break down, yeah? Like nobody told them that, yet they're still sitting there with the guilt that they caused their child to have diabetes. And it's like, No, you didn't stop their mouth with spoonfuls of sugar that wouldn't have caused it anyway. No, you didn't. And we're in there, and look, I'm an adult with a beautiful career and a family and a home, and I manage my diabetes. It sucks, and it's hard. And it's not that it gets easier. It just becomes like breathing, like in nature, you know. And I get to share that with them and say, like, Hey, your little kid is going to still grow up and be a living adult with a light like, it's gonna be okay in the flash. Look Hi. I'm a little crazy, but I was that way before,

Scott Benner 51:25
yeah, and you didn't do this to them. Is a big relief for them.

Speaker 1 51:29
Yeah, yeah, absolutely. And even, like, finding you, like, I had heard about the podcast, you know, from just things I read and online so it's probably two years ago, a student was newly diagnosed. They went for the 504 meeting and did that with mom. And was like, Mom, you know, it's not she's like, No, I know I've heard that, but, like, it was a lot, because now this is whole world is different. And think of an eye, your whole world and everything you knew is like, funny, here's diabetes. Good luck. And we hit it off. And I think the next time we got together or for a school visit, we were she was like, on top of things, like we had discussed pump options and, and I'm biased. I use the Moby. I love tandem all day, but I see the usefulness of OmniPods for wanting tubeless. And you can get great results with Omnipod. I tried it didn't work. I have better control with tea slim, but I see people with better a ones, you know, yeah, yeah. I hate the A, 1c, but better time and range than I am on an Omnipod. I'm like, great. It works for you, yeah? And gave her everything I know about each one here. Look up this one, look up this one, look up this one. And she was like, Have you, have you listened to the Juicebox? Yes. And I'm like, I haven't. I've heard of it. I like, I haven't really gotten into it. She was like, there's a Facebook group, so that's where it started. And I joined the Facebook group. So when I told her I was going to be on she was like, she would tell me all the time. She's like, you and Scott would be so hilarious

Scott Benner 52:59
together. You didn't let me talk. But I think I would have been funny for sure. Yeah, absolutely,

Speaker 1 53:06
I could go on for hours. So, and that's, you know, I get to bring that too and, and even school staff members, like, you know, I treating you in glucagon, helping them, you know, students specific. Because, yeah, diabetes is textbook in in the textbook, but once it's out of the textbook, it's individual, like your symptoms may not be mine, my time. You know, when insulin works, everything is individual. And then for that individual can change by in 24 hours. Yeah, you know. So being able to teach that and and educate is like full circle, because the very first person was the nurse that taught

Scott Benner 53:45
my classmate, yeah, yeah, you feel really good about what you're doing. You had to go through a number of jobs to get to to something that you enjoyed, but that's awesome. Oh, I love it. I love it. How many people do you think you talk to in the course of a week?

Speaker 1 53:57
I mean, over spring break, I was already I was notified, and I had been working remotely, working on a training for 504, coordinators, so that they can better, have a better understanding of the template we use for for students with diabetes, because it's just there's a gap, so we try and fill those gaps, for sure. I got like, two or three emails of newly diagnosed in the area, you know, in the territory that cover, wow. And I'm like, just in this one week, I had three different notifications, and it's, you know, it's been a crazy, crazy number of newly diagnosed, but in a week, I don't know, it really does depend on the week, because it's not just the student, the families, it's the nurses. Oh, there's an addendum to the orders or newly diagnosed came in. I need you know this staff, this staff, you know, five or four coordinators. I work from top to bottom. I work with providers. If there's, you know, a trend going on at school for a kid, I'll assist the nurse in reaching out to the provider to say, hey, look, every Wednesday, they have lunch before they have gym before. Lunch, and they're still dropping after

Scott Benner 55:03
lunch. So it's a big job that's both administrative and people oriented, and you're doing a lot of different things. Like, it's not just talking to people, it's not just pushing paperwork, like you're you're setting up processes, right, right? It's a lot there. Do you find that fulfilling, being able to do a bunch of different things.

Speaker 1 55:21
Yeah, I get the, you know, I am a data person too, though. So, like, I love Excel spreadsheets, and I love the forms and trying my best to be organized, but I have like, five different ways to be organized, and none of them work together. So it's like trying to figure that out. But I like that data, and I plan to go in for like that, like a masters for, you know, data informatics, because I like that aspect, that tech area of it. But I still get that bedside. I still get to meet kids. I like, you know, all bribe kids they don't want to wear a sensor. And I'm like, Okay, I will buy you a new phone case. If you wear the sensor for 10 days or

Scott Benner 55:55
one month, check it out to see how much it can help you.

Speaker 1 55:58
Just to see just and I'm like, and just once a month wear it so that when you go to the doctor, they can at least see the behind the scenes. Like, it's usually for the MDI kids, like, we gotta make sure your Lancet. We gotta make sure that your car breachers are right. We need to see what's going on outside those finger sticks. So, like, I'll pay you. Just wear it for 10 days once a month. Like, every 10 day, a 10 day period, once a month,

Scott Benner 56:22
are you seeing like, is there a big swing between kids whose families are supporting them and giving them good information and kids who aren't? And do you find yourself having to help one more than the other? Where does that? Yeah, oh,

Speaker 1 56:36
not, not help more. Like, there's, you know, it's a big swing. Okay? Bipolar, you could either be like, you have the helicopter parents, where it's like, Dude, you gotta, you gotta stop, take a breath. You know what we're doing? Your kid's Okay, your beard, like, let loosen the reins a little bit. You know, mom, dad, like, let us sleep. We're good here. And then there's a parents where you can't even get them on the phone to get the parents signature so that you could actually give their pen insulin as well? Yeah, I hear you, you know, and or the doctor saying we can't fill out those forms because we haven't seen them in a year and a half. So those take more time, and sometimes escalations, you know. And I hate that, because it sucks, you know, for the student, for the family, but there's both sides both require a little bit more finesse and a different finesse. But, yeah, it's the there's a lot of under privileged areas. And it doesn't just have to be MDI, or if they're insurance, you know, if they're, you know, on state insurance that you know, sometimes it's like, you have to pick this pump or this insulin, or that you know, and they don't even know that information. Yeah, just because you go to the doctor and you have like, 30 minutes, that's all you

Scott Benner 57:51
get. When you finally talk to those parents, what's your takeaway from how it got to the point where they're not being supportive and they don't understand how, how important all this is, like, like, I mean, I'm sure it's a lot of different ideas, but like, I'm trying to put myself in your shoes. Like, once you've met that person, because you have kids, right? Like, so you're not ignoring your children. And you know how tough diabetes is. So when you meet a person who's who's literally, probably, you know, hurting their own kid with their lack of whatever involvement or understanding or whatever, like, what is your finding about who they are? Do you understand what the question

Speaker 1 58:26
is? Right? Yes, I do. And and you're right. It is usually like, there's, there's so many different variables depending on the situation. But when it's sometimes it's they, they know everything and the way that they're doing it is right and don't want to hear

Scott Benner 58:42
you. So even though it's the kids, you know, not doing well medically, if they're not talking to the doctor everything, the answer is, I know what I'm doing. Leave me alone,

Speaker 1 58:50
right? I don't need the doctor. I only need the doctor to fill prescriptions. Well, clearly not see once he was, like, at 9.2

Scott Benner 58:59
and it's an unfair question, but, like, I'm trying

Speaker 1 59:02
to figure out working with providers, trying to meet them at their level and and I get a kick out of some and I have to do it because, like, that work Jenna and outside Jenna are two very different fucking individuals, and my family, like, I usually curse like a sailor. It's been very good during this conversation, yeah. And they're like, how do you not get fired? I'm like, because that's work, Jeff. I save all my cursing for you. Get a little out here, um, and that's it's the same thing with, you know, dealing with certain you have to know your audience, yeah. And so, you know, if there's someone that's that narcissistic that they know everything, but there's their kids only have diabetes for two years. I'm like, I've been doing this for 20 without all the technology you have. So I might know some stuff. Do

Scott Benner 59:48
you ever have, like, a win? Do you ever, like, start with a person who's like, I know what I'm doing. You don't understand and like, and you get them to a point where they go, Oh, I didn't realize all this, and they do better,

Speaker 1 59:56
yeah, that a few times. And a lot of it is, Hey, listen. To this episode on juice. Oh no kidding. Oh yeah, anything for myself? Like, I know the Pre Bolus thing. I know. I get it. I get why Pre Bolus thing is important. But you made a statement on one of the pro tips. Like, I want to see like, Arden at like, 86 or 72 like, but hours down, and then let her start eating. And in my head, I'm like, so many people panic at 72 I don't, but so many people panic. At 72 with an arrow down, it's like, oh, I'm like, but you're about to eat. Yeah, you're gonna you're gonna correct that. And I'm like, and I started doing that, and my time and range increased, but like 90% 95% I'm like, Oh, didn't win, and it's not I knew the information, but I wasn't utilizing it correctly. So listening to you and Jenny talk about

Scott Benner 1:00:42
it. That's nice. I love knowing that. Yeah. I mean, I don't even think that number is important, like, there's, it's and maybe it's hard to put into words all the time, right? But there's a place where the insulin is working at the right speed that when the food peaks, it just can't take it over, and then they just end up in, like, a battle, and the number doesn't move.

Speaker 1 1:00:59
Yeah? And I see it a lot with the little kids, like, they, they're, they're gonna, you know, they're really diagnosed, MDI, and they're getting Bolus after meals because they're picky. And I'm like, okay, I get it, but there's gotta be a number where you want that correction

Scott Benner 1:01:15
before you keep right there. So there's gotta be a small amount you can so I'll

Speaker 1 1:01:19
communicate with the providers and the parents, like, hey, if they're over 250 before lunch, let's at least give them a correction. How's your kid with needles? They're okay, all right. So we can give them the two injection, you know, or at least covered. They always eat at least 10 cars. So, like, that's a good one when they're on pumps. Like, all right, do the correction. They're picky eaters, but they always eat at least this part. This the fruit of the meat. They may not eat the rest, but they always so at least cover that Right, right? And then come back and get the rest for anything else they eat. But you gotta have that insulin before, like, if you start eating at 250 and you're not getting a correction or carb cover until after, like, you're gonna they're eating, and you start rising. It's like the arrow knows, and it just starts going up. As soon as the food hits your mouth. They're coming back to you for that correction, that pre meal, you know, correction, because we'll take that pre meal number and these cards, and it's like, like, it's the insulin is just chasing the glucose, and it's never gonna

Scott Benner 1:02:15
Okay. And are you finding, like, sometimes you give somebody an episode of the podcast, and they actually, they figure it out from that.

Speaker 1 1:02:21
I can't think of anything directly, but I, you know, I'm told, like, like, like, Oh, they're they're great, like that. I've listened to it. I'm like, if you don't, if you're not a podcast person, because some people aren't, like, Sure, I've really only listened to the pro tips, or, personally, not even for like, to get people out. I but the Facebook group alone, the information and help. And like, oh, I never thought about that from others in the group. And I'm like, That makes so much sense, like, the way that they put it, you know? And then, like, to swag, like, What the hell is that? And I like, scientific, wild guess. I'm like, that is so amazing. That's what it is. That's what it is. And like, I told my whole team, and they're like, that's hilarious. That's, you know, like, and being it's so great working. I've had some jobs that suck with managers or supervisors that don't get the diabetes. They think I'm using it as an excuse, but I'll, like, text my teams and team and be like, hey, guys taking the day off. Like, what's Kyle died, had a bent cannula, woke up at 400 this morning. Like, feeling like, they're like, do a correction. Make sure you change your site. Did you check your ketone? Like, so supportive. And know the information that they're saying at me. I'm like, Yes, I did it. Yes, we're good. And they'll check in on me through the day. How you feeling? Don't forget water, you know. And it's so awesome. Like, I don't have to explain to them. They don't because they're educators too.

Scott Benner 1:03:43
That is really great. Like, I love that. It works that way for people. That's it really is wonderful. I

Speaker 1 1:03:47
had a manager one time, like, leave me a voicemail. I had, like, a really bad low in the morning I get and it didn't show up to work, which rightly so. That's, that's a move as an employee. But the voicemail was like, You better get your together. I don't know what you think you're doing, but this isn't like, I quit, like, later that week, like, handed to my resignation. But like, you know, I have diabetes. Like, there wasn't a norm for me to do, right? You know, like, instead of like, hey, checking in, you're supposed to be here. Are you okay? Yeah, right. It's like, you got to get your together. I was like,

Unknown Speaker 1:04:26
you should try living with this.

Unknown Speaker 1:04:28
Yeah, exactly. All

Scott Benner 1:04:30
right. Well, John, listen, I should have been recording you in the beginning when you were like, I have ADHD. I'm gonna jump all over the place. You did not let me down. I was gonna say. So what I was gonna tell you at the beginning was, sometimes people say that and then that that's not what happens, but you were consistent, so good for you.

Speaker 1 1:04:50
My brain opens like 15 tabs during a conversation. Jump

Scott Benner 1:04:53
between them. Does that make the job harder? Are you able to like like? Are you able to not jump around when you're talking? Into somebody, or do you find that this part of your personality is something that people kind

Speaker 1 1:05:04
of relate well to? I tell almost everybody, like, I get a lot of phone calls while I'm driving, like, between schools, and if a nurse calls me a parent, I'm like, Yes, I'm like, I could talk right now. When we get off the phone, you got to shoot me an email. You need something from me. Yo, yeah. I'm like, by the time I get to where I'm going, I'm totally gonna, so shoot me that email because you're in front of a deck. And I'll, I'll do, I'll send you that form when I get there, but by the time I get there, I will not remember. If you don't send me that out the out in one ear, out the other. And everyone's like, Okay, I'm like, I have ADHD, I will not remember. I'm honest with it, because it, it's a lesser strength. It's not flaw, it's a lesser strength. I'm constantly working on. I interrupt people. I, you know, I have trouble controlling the volume on my voice. I get really excited about certain things and hyper fixate I know all these things, and I work on them constantly, actively in my brain, like while interacting with people, and sometimes that's really hard. So I found it's easier to just be like, Listen, this is how my brain works. So if I'm off track and like, you need me to keep me on focus, I'm not going to get mad. If you're like, hey, let's get back to that. Like, hey, we were talking about that, you

Scott Benner 1:06:15
know. If people understand, so that they don't, while they're talking to you, they're not always like, what is happening? Like, you know, so they, yeah, they know what's going on, huh? That's a good idea, yeah. And

Speaker 1 1:06:26
it works. And I, you know, if I'm having a conversation or, you know, in a meeting, and something pops into my head, instead of carrying it out, I write it down. You know, it's a lesser strength that I work here.

Scott Benner 1:06:38
It's awesome. Now, listen, whatever works, right? Do you have any other autoimmune issues? I meant to ask you,

Speaker 1 1:06:43
I don't. Okay, well, yeah, because ADHD isn't autoimmune,

Scott Benner 1:06:47
it's not but no, there's a lot of people with type one to tell me about it. This

Speaker 1 1:06:51
is the type one, and also has celiac and and thyroid. Your niece does. So my niece, yeah, she was diagnosed years after I was I actually finger stuck her Okay, and she wasn't even in DK yet. But if we're done, that's okay.

Scott Benner 1:07:10
I could go on a whole other but anything with your kids at all. So I had two

Speaker 1 1:07:14
bonus kids. They came fully grown. Oh, I are 28 and 22 and then I have a six and a half year old with their dad, okay? And so far, knock on wood, we're good. The six and a half year old's doing well, yeah, I mean, he's a lunatic, but that's

Scott Benner 1:07:33
besides, I'm sure he's not a lunatic, or maybe he

Speaker 1 1:07:36
is. He's a space phrase, lunatic. If you ask this kid anything about space, he probably knows the actual right answer. Like, he'll say things and I'll Google it. And I'm like,

Unknown Speaker 1:07:47
did you know how did you know that? Yeah,

Speaker 1 1:07:49
people are like, Did you teach in that? I'm like, No, that, you know, targeted screen time, yeah. Like, we go to sleep watching how the universe works on Discovery. Like, that's our nighttime show. That

Scott Benner 1:07:59
is really, really awesome. It just absorbs I don't think that's what that means, but I appreciate that. All right, listen, you were terrific. I thank you very much. I am going to say goodbye and then hold on one second for me, so I can tell you a couple of things and then I will. I'm going to spend the rest of my day making podcast stuff, but hold on one second for me. Okay, thank you again. Very much.

Unknown Speaker 1:08:23
Got it. It was my pleasure. Scott.

Scott Benner 1:08:30
Touched by type one sponsored this episode of The Juicebox Podcast. Check them out at touched by type one.org on Instagram and Facebook. Give them a follow. Go check out what they're doing. They are helping people with type one diabetes in ways you just can't imagine. I'd like to thank the ever since 365 for sponsoring this episode of The Juicebox Podcast, and remind you that if you want the only sensor that gets inserted once a year and not every 14 days, you want the ever since CGM, ever since cgm.com/juicebox, one year one CGM, summertime is right around the corner, and Omnipod five is the only tube free automated insulin delivery system in the United States, because it's tube free, it's also waterproof, and it goes wherever you go. Learn more at my link, omnipod.com/juicebox, that's right. Omnipod is sponsoring this episode of the podcast, and at my link, you can get a free starter kit. Terms and Conditions apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox, i

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 if. Is your first time listening to the Juicebox Podcast, and you'd like to hear more, download Apple podcasts 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. The episode you just heard was professionally edited by wrong way recording, wrong wayrecording.com, you.

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Scott Benner 6/24/25 Scott Benner 6/24/25

#1558 Smart Bites: Fuel First, Feel Better

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

+ Click for EPISODE TRANSCRIPT

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.

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