#1855 Murder at the Subway
Thirty-two-year type 1 veteran Lars discusses his screening trial diagnosis in New Zealand , moving to Canada , and why current transplant trials shouldn't be called a cure yet.
Key Takeaways
- Early Screening Benefits: Lars’s type 1 diabetes was caught before the onset of clinical symptoms through an early 1990s pediatric antibody screening trial in New Zealand led by Professor Bob Elliott.
- Retinopathy Remission: Proactive management, a stable A1C (currently 5.9), and targeted anti-VEGF eye injections successfully stopped the progression of Lars's diabetic retinopathy, leaving him treatment-free for over 18 months.
- Altitude & Hypoglycemia Awareness: Moving to a significantly higher elevation (such as Calgary, Canada) can temporarily blunt or mask typical physiological low blood sugar warning signs, requiring heightened vigilance and device reliance during acclimatization.
- The Clickbait Clinical Reality: Lars shares a grounded perspective on modern stem cell and islet transplant trials, cautioning against media clickbait that labels functional management alternatives as a full "cure" while anti-rejection therapies remain necessary.
- Community Mentorship: Navigating more than three decades of type 1 diabetes across multiple continents highlights the value of long-term veterans volunteering in peer support spaces to guide newly diagnosed families.
Resources Mentioned
Introduction and Sponsor Messages
Scott Benner Hello, friends, and welcome back to another episode of the Juice Box podcast.
Lars Hi. My name's Lars. I'm a type one diabetic, have been for about thirty two years.
Scott Benner My grand rounds series was designed by listeners to tell doctors what they need, and it also helps you to understand what to ask for. There's a mental wellness series that addresses the emotional side of diabetes and practical ways to stay balanced. And when we talk about GLP medications, well, we'll break down what they are, how they may help you, and if they fit into your diabetes management plan. What do these three things have in common? They're all available at juiceboxpodcast.com up in the menu.
Scott Benner I know it can be hard to find these things in a podcast app, so we've collected them all for you at juiceboxpodcast.com. If you're looking for community around type one diabetes, check out the Juice Box Podcast private Facebook group. Juice Box Podcast, type one diabetes. But everybody is welcome. Type one, type two, gestational, loved ones, it doesn't matter to me. If you're impacted by diabetes and you're looking for support, comfort, or community, check out Juice Box podcast, type one diabetes on Facebook.
Scott Benner Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan. This episode of the juice box podcast is brought to you by my favorite diabetes organization, touched by Type one. Please take a moment to learn more about them at touchedbytype1.org on Facebook and Instagram.
Scott Benner Touched by type one dot 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. Touchedbytype1.org. You're looking to help or you wanna see people helping people with typeone, you want touchedbytype1.org.
Scott Benner Today's episode is also sponsored by Eversense three sixty five, the only one year wear CGM. That's one insertion and one CGM a year. One CGM, one year. Not every ten or fourteen days. Ever since cgm.com/juicebox. The podcast is also sponsored today by System, which is powered by Tandem's newest algorithm, Control IQ Plus Technology. Tandem Mobi 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 tandemdiabetes.com/juicebox.
A Unique Diagnosis: The New Zealand Screening Trials
Lars Hi. My name is Lars. I'm a type one diabetic, have been for about thirty two years.
Scott Benner How old are you, Lars?
Lars I'm 45 this year.
Scott Benner 45. You were 13 when you were diagnosed?
Lars Yes.
Scott Benner Okay. And...
Lars But I bet you all the money in the world, you've never heard my diagnosis story.
Scott Benner Oh, I can't wait to find out. I just wanted to find out real quickly. Are you married? Do you have kids? Are you single? What's your...
Lars I'm married, and I have a daughter.
Scott Benner How old?
Lars She's 17.
Scott Benner Oh my gosh. Look at you. Alright. Well, what do you mean? What happened? Don't you feel like it's possible I've heard every version of someone's diagnosis story?
Lars Potentially. I mean, you've been doing this for a while, so potentially. But my one is very different.
Scott Benner Alright. Surprise me. Let's do it.
Lars So in the early nineties, a famous professor in New Zealand, he was knighted as well, he pioneered and it's actually relevant to to trials going on now. He pioneered use of encapsulated pig islet cells. Okay. So way back in the early nineties and stuff, and so he got approval in New Zealand, which is where I'm from originally, to test all the five year olds in the country at the time for islet cell antibodies. So with 10 being a borderline count, and obviously the ethics said if there were any one of the five year olds had, like, a count of 10, then they would test the entire family. Mom and dad got tested. There's was, like, one or two, which was normal, so they weren't worried about but my count came back at, like, 324.
Scott Benner Oh, okay. 10 being borderline. Wait. What was the doctor's name?
Lars Professor Bob Elliott.
Scott Benner Bob Elliott. Okay. Yes. And his idea...
Lars So he was trying to see if a form of vitamin d, pretty sure it was vitamin d, called nicotinamide, would hold off the onset of developing type one diabetes.
Scott Benner Okay. So he wanted to test everybody, get a baseline, and on top of that, hit some kids with vitamin d if they had certain markers?
Lars Yes. An islet cell count. And so because my sister was 10, which was the borderline, I'm not sure how they worked that out, but they did. And so mine they pulled me in to test me. My islet cell antibody count came up at 324 or something insanely large. Okay. So they started me off with these nicotinamide tablets, literally horse tranquilizer pills, twice the size of a Tylenol. And so I I was nine, nine and a half, trying to swallow these, so I had to learn to swallow these huge tablets. And then part of the trial was I went in for a yearly glucose tolerance test. I was fine for the first two and a half, three years going into my first year of high school because obviously schooling's a bit different to in New Zealand to North America. And about April, just before Easter, so great time. And they got the results back for the glucose tolerance test, called me in, and gave me Protivane and Actrapid or whatever. Yeah. I think that's what it was. And he said, you're diabetic now.
Scott Benner Did they think that the vitamin d had any impact on it? Like, do you know what the result of his study was?
Lars They think it held the onset off for about three and a half years. No kidding. Yeah. The last I heard, there was still some people who and this was about ten to fifteen years ago who were still taking it and hadn't developed it. So there's something in that vitamin d combination that looks like it held it off, but yeah. Sorry.
Scott Benner No kidding. If it worked for you, it worked for you for about three years. And then how old were you when you were finally diagnosed? 13.
Lars A month into my first year at high school, so I was yeah, 13 or 14. Did it come on very quickly when it came on, or was it slow?
Lars I had no symptoms. Nothing. I just went in for the yearly glucose tolerance test Oh, I did as part of the research, and they diagnosed me that way.
Scott Benner Oh, wow.
Lars Obviously, my glucose tolerance was very bad, so it's like, here you go. Here's your insulin. You're diabetic now. And by that time, my parents and sisters had dropped off to zero. So I was the lucky one, and none of the rest of my family have it either. So...
Scott Benner Here's what I was able to find online. For type one diabetes risk and prevention, the overall evidence has been weak or inconsistent. 2021 Mendelian randomized study found that lower vitamin d levels did not appear to have a substantial impact on type one diabetes risk in population study, which argues against the vitamin d being a major cause lever. Yeah. I don't know. There's a lot here about it. If people are interested in reading, like you know, if you could look into into Bob Elliott's work, he passed away a few years ago, it looks like.
Lars In 2020. Yes. My gosh. And did your sister ever end up getting diabetes? Nope. I'm the only one in my entire family. The lucky one.
Growing Up in the 1990s & The Subway Video
Scott Benner Do you have any other autoimmune issues?
Lars Thyroid.
Scott Benner Hypo? Yeah. Yeah. Okay.
Lars My mom had her thyroid, so she had a she took the other one. So she had the...
Scott Benner Your mom was hyper? Yes. Bulging eyes, goiter, stuff like that?
Lars No. Not quite that bad. She was on the medication. But...
Scott Benner Okay. I'm sorry. When you were diagnosed, you were in New Zealand at that point still?
Lars Yes, I was.
Scott Benner What was it like growing up there with it?
Lars I mean, it was in nineties, so we didn't have all the great insulins we have now and no pumps or anything. So I was different, obviously, and you don't want to be different as a teenager starting your first year of high school. Right? So but I had a pretty I suppose you can call it normal teenage life. Like, I just had friends and everything, still played sports Mhmm. Everything. So...
Scott Benner Nothing remarkable to you about growing up with it?
Lars No. Okay. Not really. I do have a video of me having a bad low when I worked at the subway though, which is a public video on YouTube. If you ever wanna have a look at that.
Scott Benner You made a video when you were really low?
Lars Yeah. So the security camera in the subway recorded me having a quite a bad low, and I'm literally throwing the knife around and almost cutting the person working next to me. But...
Scott Benner Well, how old were you when that happened?
Lars That would have been in my twenties.
Scott Benner In your twenties. Were you working there or no?
Lars I was working there. Yes.
Scott Benner Okay. And you just kinda got really low at did you feel it coming on? Do you remember?
Lars No. I didn't. Not at that stage.
Scott Benner No CGMs back then for you?
Lars No. No CGMs.
Scott Benner How about now?
Lars Yes. Omnipod dash and, g six.
Scott Benner Have you come close to knifing anybody since then?
Lars No. No. Why did you have a knife, Lars?
Lars Because I was making someone sabotage in the subway.
Scott Benner Oh, you were you were it didn't have mayonnaise on...
Lars No. I was I I was just cutting the bread and you've obviously been to Subway, you see how bad the bread is and their sandwiches. It was like quarter of the size.
Scott Benner I wanna admit to being confused for a second. I thought you were working down in the Subway, and then I imagined you and then I thought, is there a subway in New Zealand? That was gonna be my next step. And then I heard about the sandwich, I started picking through a little more. So you were literally making a subway sandwich for somebody when it happened.
Lars Yes. You had that little...
Lars That's correct.
Scott Benner Knife with that little flexible blade they used to cut the bread with. Yep. That's the wrong knife to cut bread, by the way. I don't I never understood why they have those at Subway.
Lars I don't know.
Scott Benner Is it true, Lars, that all of the meat is the same? It's just flavored differently, and they call it different stuff.
Lars I don't know about here. I haven't heard that, but I do know that it was actual ham and turkey.
Scott Benner Well, that's good to hear. I wanna say I have no actual knowledge of that. It's just a story that I used to hear going around that it was all kind of the same, like, meat like based thing that was flavored differently. But I'm glad to hear it wasn't. How did you get the video?
Lars I asked for it because I've never seen myself have a low before. So and the bosses were nice and said, yeah. Sure. And grabbed it for me.
Scott Benner What was it like to see yourself like that?
Lars It was interesting because obviously, I'd never seen it because you don't see yourself going low as a diabetic. Right? You just have the low and then other people see it. So...
Scott Benner Did it make you manage any differently? Did it make you be more careful or look into different technology or anything?
Lars No. No. Yeah. Like Because in New Zealand, we were limited to the government funded for most of the medications, but obviously a small population, not everything can be funded.
Scott Benner So Okay. So you get what you get. Do you know what your a one c's and your outcomes were like growing up with diabetes?
Lars They were in the sevens and eights. Okay. And what was your expectation for yourself? Was that what they were telling you to do?
Lars Yeah. I mean, obviously, we can't we can monitor it as well as we can now. So I tried the best I could because the insulin, it was like the Protovane, which was, what, six hours as the long acting Mhmm. Which isn't really a long acting, but that's all we could get, really. And so and then the Actrapid, both made by Novo. And so it was, like, really, as best as you could do without wanting to test, like, 25 times a day. Yeah. But, obviously, you don't want I had dozen team. You don't wanna prick your finger and do any of that, so I tried my best.
Scott Benner Sounds like you did alright, actually.
Lars Yeah. Were you low a lot or not really?
Lars No. Not really. That's awesome. Do you feel lucky when you look back on it?
Lars Well, considering the couple of lows I've had since I moved to Canada, yeah, I'm surprised I didn't have anything worse.
Moving to Canada: Elevation Changes and a Stolen Phone
Scott Benner Okay. How long have you been in Canada?
Lars Since 2014, so twelve years. Twelve years. And did your management change when you got to Canada because the coverage changed, or did you stay with what you were doing?
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Lars It did change because, obviously, I was able to access more and better stuff, but I had a couple of issues moving here, like, a month after moving here, June. I was looking for work, was at one of the LRT stations, like the light rail transit stations in Calgary, and hadn't acclimatized because, obviously, Calgary's a bit higher elevation than all of New Zealand pretty much, or where I lived in New Zealand anyway at sea level. So when I moved, I hadn't acclimatized yet and didn't recognize I was going low because of the higher elevation and had a bad low that EMS had to be called by someone else for, and someone stole my phone because it spilled out of my hand. So...
Scott Benner Can you imagine seeing somebody having a seizure and stealing their phone? With that happening, can I thought Canadians were nice? No?
Lars I did too.
Scott Benner What had you moved there? Was it for a lady?
Lars For my daughter. She moved with her mom.
Scott Benner Oh, okay. And you followed along?
Lars Yes.
Scott Benner Okay. I see. So you kinda wanted to be closer to her. Wanted to old. I see. So you're divorced?
Lars No. We weren't. Never married to begin with. I gotcha. No. Well, look at you being a good dad. Yeah. Did how did that work out for you, like, in hindsight? Obviously, following your daughter, I imagine, was great, but leaving a country where you grew up and going somewhere else, was it a a reasonable experience?
Lars Yeah. It was it was fine. I mean, I didn't know what to expect. I'd visited once, and it seemed nice. But I moved knowing literally nobody apart from my daughter and her mom, and obviously, we're together at that stage with her mum. But and then I navigated my way round, found an endo, found how to get the insulin, because obviously I could only bring a certain amount, and then went to went on bitter insulin than I had in New Zealand, like, Lantus, and then moved to the pump, the Omnipod. And so...
Scott Benner I'm gonna find out more about that in a second, but I wanna go back to this before it becomes too late. Sure. I I did a little more research about Bob Elliott because I didn't wanna leave anybody with I mean, it's a long time ago, but still wanted it to be clear. So, like, a simple breakdown was that Bob noticed that type one diabetes rates were different in different places and populations, and he started asking what changed in the environment. One idea he had was sunlight vitamin d or maybe kids getting less sun made the immune system more likely to misfire and attack the insulin making cells. But even people close to the work later described vitamin d as, at best, a possible contributing factor, not a full explanation. From there, Elliott's attention seemed to have shifted more towards diet, especially cow's milk exposure, and later the a one beta casein hypothesis. The rough logic there was if migration or lifestyle change raise type one risk, maybe something newly introduced in the diet was part of the trigger. That line of thinking became much more associated with him than the vitamin d did. So his idea really wasn't that vitamin d kinda cures type one diabetes, like, in quotes. You know? It was more like maybe environmental triggers made susceptible kids and vitamin d deficiencies might be a clue. Then as he kept digging, he seems to have concluded that diet was a stronger lead than vitamin d alone. A look back from today, that's about where the evidence still leaves that vitamin d is biologically interesting, but it never turned into a clean, proven explanation for why type one happens. So it sounds like he had some theories, and perfectly honest, like, none of them panned out. But it caught your diabetes early enough that you do not have go into DKA or get sick or anything like that.
Lars That's correct. Yeah. But he was also I don't know if you wanna look up the diabetes cell. So it was, encapsulated pig islet cells that were transplanted.
Scott Benner He got involved in that at some point?
Lars Yeah. He pioneered the use of that.
Scott Benner Wow. Something about that popped up. It says here he was major figure in child health and diabetes related research in New Zealand helped found what became Cure Kids and was associated with the work. Yeah. That's interesting. Oh, wow. Look at that. Lifetime of effort. Hopefully, helps somebody.
Lars Yeah. Hopefully. Yeah. Yeah. Okay. When do you switch your management from sorry. Give me the rough date from shots to a pump.
Lars In about what are we about 2015. Okay. About ten years ago. Big difference for you? Yes. Tell me about the experience.
Lars Well, I mean, I the pumps are funded in Alberta, so I'm it was like, cool. I've by this time, I'd met my now wife. I'm I had a low where she had to call EMS, and I just woke up to two ambulance officers standing over me in bed. Those are always the fun ones, aren't they? And then she said, have you ever considered a pump? I hadn't. I'd heard about them. I thought I was managing it okay without one, but I said, yeah. Okay. Let's have a look. So I applied to the Alberta pump program, and we actually went through and did it got approved. And at that stage, was the Eros, not the Omnipod before the dash. Yeah. And because I'd heard horror stories about people pulling their tubing out of their pumps, and I didn't wanna deal with that because I was working and working with computers. I didn't wanna be under a desk and accidentally catch something That sort of thing. So it's like, I'll just go on Omnipod, it'll be fine. And it has been my a one c's come down. My last one was actually 5.9.
Reviewing the Subway Video & Public Advocacy
Scott Benner Wow. Good for you. Congratulations. They didn't let you be around knives anymore after the last incident you had to switch shops?
Lars No. I mean, I that was a temporary role just to...
Scott Benner I imagine. Did your wife let you use the knife in the house? Have you ever showed her the video?
Lars I have. Yes. So it's a public video on YouTube. So, I mean, if anyone wants to see it, they can look for Diabetic Goes Low at Subway.
Scott Benner How many views does it have?
Lars Well, we've we've got it posted from two different channels, so it's got about it's got a couple of 100 views, but, I mean, it could have a few more now. So Diabetic goes low at Subway. Is that what it's called?
Lars Yeah. I shared the link in the chat here if that's easier for you.
Scott Benner Let me see.
Lars There's no sound. So if you ask because there was no sound and the security cameras are there.
Scott Benner I see it here. I'm gonna watch. I'm just gonna watch it. Alright. So there's a guy in a blue shirt. Looks like...
Lars I'm the one in the black behind the counter.
Scott Benner Yep. You're behind the counters. But alright. Lars is putting on his plastic, those little plastic terrible gloves that Subway gives to people. I don't know why they can't have a better glove than that. He's got his hands up. He's fighting with the gloves a little bit. It looks like you've never seen plastic gloves before in your entire life. There's a girl working with you. She's reaching in. Looks like she's getting the sandwich ready too. She's pulling the meat out. I guess you're supposed to get the bread. This is interesting. It's in like stop like a little bit of stop motiony. Yeah. Like it moves and clicks and clicks. And okay. Here comes the bread. Lars is pointing the tray out, picks a loaf.
Scott Benner Oh, he's going for the little wobbly he got the paper down, the loaf's on top. He's got the little wobbly knife, fixes his glove one more time, starts the weird cutting process they must teach you in subway school about how to cut bread. That's gotta be two days worth of training, I would imagine. You're picking at it. Okay. Your arm's flailing a little bit. There's another woman coming into the oh my gosh. Yeah. It's hard to imagine. It's hard to like, the guy you're trying to help is laughing a little.
Lars He's a regular customer. So...
Scott Benner Did he think you were screwing around, I wonder?
Lars He didn't realize.
Scott Benner Your arms get weird to scarecrow you over your head a couple of times. Yep. I do. Like, you reach in a really strange if you told me I was watching a video of somebody with CP trying to cut bread, like, I would probably believe that. Like, you are fumbling with this thing. Like right now, you kinda, like, stop for a second. You're you're grabbing the counter, and the girl tries to help you. You're on the floor now. Okay. Now the people who are being helped are like, oh my god. Why didn't I go to Burger King? And they're they're wait. What's going on? Does she keep making the sandwich?
Lars Customer asked for a new piece of bread, and then the girl who pulled me away made him a fresh sandwich.
Scott Benner But what was happening to you at that point?
Lars I was in the back drinking pop.
Scott Benner Oh, okay. You weren't having a seizure or anything like that?
Lars No. I was still loose a dish. Enough to drink a soda anyway. So That was insane. I mean, that was that was really interesting. Oh my gosh. That girl must be super successful somewhere right now. She's like she watched, like, the craziest thing happen in front of her. She's like, listen. Let me, like, cut up another roll and keep this thing moving. She went right back to it. I was lost. Do you know her Do you remember her name?
Lars No. I don't. It was as you can see from the time, it was a few years ago now. Yeah. A of date in the bottom corner. So...
Scott Benner Yeah. No. It look I mean, it looks like it could have been twenty years ago. Right? Okay. So what makes you come on the podcast? What interests you in being on?
Lars Well, I mean, I've had diabetes more than probably eighty percent of my life. So, I mean, if I can help educate people and help them with my story, why not?
Scott Benner Just wanted to add to it. When you think about things you wish people with diabetes knew, what pops to mind? Like, what do you think are universal truths of it?
Lars That's it's not the be all and the end all. You can have a pretty or a very normal life. My biggest thing is the education of non diabetics as well, because it's still, as we know, it's still misunderstood in movies and in TV series. Doctors, actors will still they're low, so give them insulin. It's like, yeah, that will kill them, but sure. Okay. Like, just the education around it where it can help people have longer fulfilled lives.
Scott Benner Do you wonder what else you're watching on TV that's not correct? Ever think of it that way? You know what I mean?
Lars Yeah. I know. A lot of it is. You know, the one thing you're aware of isn't right. I wonder what the 25 things you're not aware of or how accurate they might be. Yeah. Yeah. So why does that bother you, or or why do you feel like that's important?
Lars Because I mean, I you know, I've had some complications as of people with this condition have for thirty odd years. So I mean but if kids and people can live a pretty normal life with the technology we have now, I can help with that in any way. I want to, like, I've I work in IT, so I like helping people. It's what I do, so...
Scott Benner Yeah. Go back for a second to, like, television and movies and etcetera. Like Yep. Why does it matter if they I mean, I'm sure I have an answer too, but to you, why does it matter that it be correctly portrayed?
Lars Because it means that people will more understand, I suppose, like, diabetics will more understand that if they do see it in the real world and someone's on the ground, they don't go, oh, look for the insulin to give that to them. Like, if it's portrayed correctly, then if people need to help a diabetic in the real world, then they'll know and they may have watched the show they've got it correct, then maybe they'll know how to actually help the person correctly and not potentially...
Scott Benner Not do the opposite thing of what they need?
Lars Yes.
Scott Benner What is your experience with large with people ever getting anything right? I don't understand. What what do you think's gonna what do you think is gonna happen here? I understand what you're saying, and I I have the same feeling. So it would be great if everybody understood. I don't know that they remember the wrong thing any more than they would remember the correct thing if it was on TV.
Lars No. I know. Yeah. It's tough.
Scott Benner I mean, but you've uniquely have been in a situation where you've counted on a stranger to kind of know something. But did they ever? I mean, the girl yanked you away from the thing, but she she abandoned you pretty quickly. If she understood diabetes, she would have went in the back with you, don't you think?
Lars I think there was someone else in the back, and the bosses had just stepped out, so they came back pretty soon after. But, like, I think I was probably in the twos bigger than millimoles, I assume, because the I was able to hold a drink enough to actually drink it myself without someone else helping.
Scott Benner Yeah. So Hey. Did you go back to work afterwards?
Lars Yeah.
Scott Benner Kept work?
Lars Once I was back up, I went straight back to work. Yeah. And then the customer the one the male customer came in, and he's saying, I asked if I was okay, and I asked what happened. So And He ate one of those sandwiches every day, that guy?
Lars Yeah. I think so. Or every second day.
Scott Benner He's on that Subway diet? Thought he could lose some weight that way? I wonder.
Lars I didn't talk to him that much, but, I mean, he was a really killer customer, so he was a nice guy. So...
Scott Benner I hope this means something to you. My daughter's friend is a a huge Subway aficionado, and she has a what I would call a rather deep relationship with the guy that makes her sandwich. Like to know them. Yeah. Yes. I feel like he'll be at her wedding one day with the way she talks about him.
Lars Well, the funny thing is you like, when you find a doctor or when you find a dentist or when you find whatever other professional and, you know, like plumber, electrician, if you find one you like, you stick with them because they make things the way you like them. So that's why they're technically called sandwich artists at Subway. They make it in a particular way, and yeah. I had regular customers who liked the way I made their sandwiches, and they didn't want anyone else but me to make them.
Fundraising and the Clinical Definition of a "Cure"
Scott Benner That makes sense, honestly. That really does really make sense. Okay. So you'd like people to be better informed in the public? Yes. What else? Do you have feelings when you see younger people coming up with diabetes or parents with newly diagnosed kids? Like, do you ever have things where you wanna just kinda say, oh, gosh. I wish you knew this?
Lars Yeah. And, I mean, Diabetes Canada's doing a modelling event across the country at the moment. And so from Halifax through to Vancouver, numerous cities in between, and so we're getting to walk down a runway and model our pumps and everything, which is a pretty cool idea. And there's kids from, like, three up to I think, yesterday, we had a like, last year, sorry, we had an 80 year old who was modeling.
Scott Benner Have you been a part of this?
Lars This week, the third year I've done it.
Scott Benner beggars code. Okay. So you just, like, walk a runway at an event? Yes. Yeah. And what kind of crowd is there? Supporters, or do they find a way to get uninitiated in there? How do they do that?
Lars But we find like, we I know there's a couple of people who are like, we didn't have people who like, volunteers who will do, like, the introductions and highs and everything. A lot of people are friends and family of the models themselves. Mhmm. But, like, the tickets are open to anyone who wants to purchase them. So and it's not just in Calgary where I am. It's in, like, Vancouver, Toronto, Halifax, Saskatchewan.
Scott Benner So a fundraiser? Yeah.
Lars It's a fundraiser.
Scott Benner Right. Right.
Lars And the idea behind it is to send kids to diabetes camps, which means that that gives the parents a break and often helps to give the kids a bit more independence, often give the first shot or the first basal bolus themselves.
Scott Benner Meet other people with diabetes. What keeps you involved? Like, you don't have kids with diabetes, so what keeps you involved at this later age? Why do you feel like supporting this is valuable?
Lars Well, I mean, I've had it for thirty years. If I can be, like, an older person and be taken newly diagnosed people can ask me questions, I'm always happy to because I've seen multiple pretty much all the more recent technology anyway, like, physical needles through to the insulin pump. So the technology has advanced us a lot more. I wish I had kind of had the insulin pump and CGM back when I was diagnosed. Blood sugar probably would have been better then, but we probably couldn't have miniaturized enough to be able to do it back in the nineties.
Scott Benner So You said you have some complications now. What are they?
Lars I've had a couple of issues with my eyes, so blood vessels in my eyes and that sort of stuff.
Scott Benner So Have you had had any treatment to it?
Lars Yep. Injections in the eyes. The worst the worst needle ever. Like, I hated those because they don't they don't knock you out. They freeze your eyeball and then jab a needle in the eyeball while you're awake. So all you see is this thing and your peripheral vision coming into your eyeball. It's not fun.
Scott Benner How many times did you have to have the the injection?
Lars I've had it about five or six times.
Scott Benner Did it work?
Lars Yes.
Scott Benner So a reversal of your problem, or, did it just stop it?
Lars It stopped it. Yeah. And since my blood sugar and my a one c's come down to a pretty much nondiabetic a one c now, it's, means that I haven't needed anything for the last, like, eighteen months.
Scott Benner Is it just the technology that helped, or have you been able to use, like, a lifetime of experience to apply it on the top of the technology?
Lars I think it's a lifetime of experience, but it's also like, being able to see your blood sugar in real time or close enough to real time anyway on a phone or a mobile device. It means that you can go, okay. This is what my blood sugar is doing. I'm fine for now.
Scott Benner Help you plan better being able to see us, I would imagine. Right? Yep. And you're using Omnipod five now though?
Lars No. I'm still using the Dash.
Scott Benner You're still using the Dash. You're making your own decisions, making changes and everything. How did you find the podcast?
Lars I've heard about it. I'm in a group. I try and give people education from my experience, and someone said, oh, you should apply to be on the podcast.
Scott Benner But Okay. Where were you telling it that somebody saw that?
Lars On Facebook or somewhere.
Scott Benner Do you know what Facebook group?
Lars I've been in so many diabetes ones. I don't remember, to be honest.
Scott Benner Are you in mine?
Lars I'm sorry.
Scott Benner Don't be sorry. Are you in my group?
Lars The Juice Box podcast? Yeah. Yes.
Scott Benner You are. Okay. Yes.
Scott Benner So you find Facebook pretty valuable then?
Lars Yes.
Scott Benner Okay. Tell me about that. Why are you in so many different Facebook groups, and what is that doing for you?
Lars Well, it helps me like, if people have questions who are newly diagnosed and I have some experience what they're dealing with, which usually I do, it means that I can provide a bit more experience for them and help them succeed with their control and learning how to be a diabetic looking after themselves with this condition that we all have as diabetics.
Scott Benner Did you have anybody helping you when you were growing up with it?
Lars Mom and dad, kind of. I mean, because I was 13, I pretty much made all the decisions. Mum and dad, obviously, we started to carb count and everything. But after a few years, I once I left high school, I pretty much just did it all myself.
Scott Benner On your own? So if you were having, a seven or eight a one c, back then, that was considered reasonable and good. Right? Like, people would tell you you're doing a good job. Right? Yes. At what point does it become obvious to you that better is is it tied to the technology? Like, does the idea that your a one c could be lower or more stable not arrive in the world until the technology arrives? Was there ever anyone telling you, I know we're just injecting here and this and this, but, you know, you could, I don't know, change your diet or increase your exercise or, you know, give yourself more insulin. Does any of that ever get spoken about?
Lars It does a bit. Yeah. It's just because I mean, there's only so much you can do with some of the older insulins because, obviously, of the length of time they last. They're still running around in your body, delivering the insulin as they need to, but, I mean, it's it was a lot more difficult to actually get good control because we what was it? The ACTRAPID started working, I think it was within half an hour, it was gone within six. I found it difficult anyway to actually work out a good way of managing it because of that. Right? So it proved difficult. And no no CGM, so you didn't know what your blood sugar was doing unless you've done a finger prick. And so it's like, well and I didn't want to be doing that, like trying to learn at school. I don't wanna look different. People knew I was, but didn't wanna be different, so I just tried to do my best so I could without being too different as a teen, so...
Scott Benner What do you think would have changed most drastically about your upbringing if all that technology existed twenty years ago?
Lars I would probably manage it a bit better and be able to keep it more stable, the big high and low swings, which I'm sure I had. I just didn't know I had them because I didn't have a CGM to see them. Right? So...
Scenery, New Zealand Biology, and Living Options
Scott Benner Does it freak you out that lizards that are running all over New Zealand are commonly kept pets in America and other places?
Lars What do you mean, Lizardans?
Scott Benner Like, bearded dragons, for example, aren't they from New Zealand?
Lars No. No.
Scott Benner Are bearded dragons not from New Zealand? Or what about blue tongue skink? Not also not from New Zealand?
Lars I don't know about the blue tongue skink. I know there are skinks in New Zealand, like native ones. Yeah. But remember, New Zealand split off from Gondwanaland so early that both of the birds have gone, okay. There's no predators. Cool. We'll just stop flying.
Scott Benner What kind of pets did you have growing up? Did you have anything?
Lars A cat.
Scott Benner A cat. I just always wonder, like, what it's like to go outside, see something running around in your lawn, and then look into another part of the world and see that people are, like, fanatically keeping them as pets. It would be like if I woke up one day and found out that people in New Zealand were keeping squirrels. I'd be like, that's a weird decision. They're everywhere here. But anyway, sorry. I thought I had something there. I missed. For everyone listening, I apologize. I get it wrong sometimes.
Lars It's all good. Yeah. I mean, if you want to go, New Zealand does have some very beautiful scenery and very different birds to what North America has. So like the kakapo is going which is one of the I think there's about 251 of them left in the world.
Scott Benner Really?
Lars They are going through a baby boom right now. So they don't breed every year. They only breed when a particular tree has a lot of fruit on it or berries on it, and then they produce a lot of chicks.
Scott Benner No kidding. Oh, so their production is attached to when their food is available?
Lars Yes.
Scott Benner That's very cool. I I had somebody on once, I think. I'm trying to decide if I have an episode that's named after that bird. Is that possible? I'll have to figure that out later. Okay. When you move so far from home, are your parents older at that point? How is that separating from your sister and your parents?
Lars I was in my early thirties, so my parents were a bit older than I mean, I felt I needed to be in my daughter's life, like I said, and made the decision. I knew my parents would try and talk me out of it, so I didn't tell them until after I'd booked the tickets, had the visa, had everything done and then told them.
Scott Benner Well, that's interesting. I would have made the same decision. I was just wondering how you handle it. It's a pretty far way to move. So Yes. Yeah.
Lars It is. I was confident to be able to find all the medication and the diabetes stuff I needed, so it's like, well, okay. We'll throw caution to the wind and go. So...
Scott Benner That was kind of the rest of my question there was, do you leave with enough to keep you going for a while, or do you plan ahead for how to get signed up to get medication when you get there? Like, how did you make that leap?
Lars I had no plan. I literally the only plan I had was I needed to be close to my daughter. So I lived with 23 kilos of clothes. Sorry. I can't do that conversion, my head to pounds, but that's the standard international flight.
Scott Benner Yeah. About 46, 50 pounds, something like that. Right?
Lars Yep. Yep. And that's that's pretty much all I bought to Canada. So...
Scott Benner Wow. If I asked my wife to leave this house with one suitcase full of clothing and never come back, I don't even know what would happen. We can't seem to go away for four days with one of those suitcases without it being overweight.
Lars Yeah. And then I I had enough insurance to last me I think it was about three or four months.
Scott Benner Okay. And what did you do to, like do you go to, like, an office, a doctor's office to the government? How do you get set up once you get to Canada?
Lars Pretty much had the idea about moving well, at least a year and a half before I actually did. And by that time, I met some Facebook groups and Canadians who were actually able to give me a bit of advice on how to find a doctor and that sort of thing. And so I followed their advice, actually found one, and then I got referred to an endocrinologist and was able to get all the medication.
Scott Benner Isn't that terrific? Seriously, the Internet and being able to just reach out to a group of people and say, I need help. I don't know what to do. Get some advice and pick through it then and and make a decision. It's really fantastic.
Lars Yeah. Hold on a second.
Scott Benner It is. Excuse me. Sorry. Came up here without my drink today. Messing me up. How are we doing? What were your expectations like for this, and how do you feel like this is going so far? And, you know, are we missing anything?
Lars I don't think we're missing anything. I mean, I I've come out of my shell a bit more since moving here, so I've been able to I was probably very introverted in New Zealand since I moved here. I've become a lot more extroverted and well, hence, doing the modeling. I've spoken at a conference, which I never thought I'd do back in New Zealand. So, I mean, I have no issues with how we're doing. So...
Scott Benner Good. Good. What do you think just the experience of being out on your own kinda opened you up?
Lars And and the support from my wife.
Scott Benner Yeah. Since you've been and how long have you been married?
Lars Ten years.
Scott Benner Ten years. Okay. And just the one child from the previous relationship?
Lars Yes.
Scott Benner Do you worry about your child getting diabetes?
Lars No. She hasn't had any any potential symptoms or anything. Like, I do a little bit in the back of my mind, but, I mean, I'm literally the only one in my family. No cousins, no aunts, uncles, and I have a big family. I've probably got probably 30 cousins on both mom and dad's side. So...
Scott Benner Yeah. How about that thyroid thing? Is that a problem throughout your family?
Lars No.
Scott Benner No. Just you and your mom? Yes. Do you have symptoms from that, or do you feel like that's pretty well managed?
Lars I feel it's pretty well managed. I'm under the lowest possible dose I can be. So...
Scott Benner Do you ever have, like, brittle nails, lose hair, uneven temper?
Lars A little bit of an uneven temper sometimes. But...
Scott Benner Do you know what your TSH level is when they test your thyroid?
Lars The last one, I just got it done with my a one c. It was well within the normal range.
Scott Benner Do you know what that means though for the number? Because the range is pretty wide. That's why I asked.
Lars I think it was, like, four or something. I'd have to look up the range.
Scott Benner In your own time, obviously, I'm not asking you to do it now. I would tell you to check out episode four thirteen of the podcast, and then see if maybe you don't wish that maybe somebody could manage that number under two.
Lars Two seems low.
Scott Benner Why is that? What do you know about that?
Lars Well, I mean and, yes, I don't know how it is in The US, but I think here in Canada, I think two would be too low. So...
Scott Benner I would ask you to listen to episode four thirteen and see if you didn't change your mind about that.
Lars Okay.
Scott Benner Yeah. So to go over it just briefly, the scale goes from, like, zero to 10 on the the testing, and the green part, you know, is pretty far in the middle. I would tell you that if you have symptoms of hypothyroidism, you know, or any kind of impacts from it and your TSH is above two, it probably indicates that you could use a little more medication. I can pull up a couple of symptoms for you. See if you have any of them. So we went over a couple a second ago, but I'm just gonna go through a list so I don't miss anything. So I'm clicking on stuff. Alright. Tired or low energy?
Lars Yeah. Sometimes.
Scott Benner Feeling cold more than usual? No. Weight gain? No. Dry skin?
Scott Benner Sometimes. Constipation? No pooping? No. Nope.
Scott Benner Hair thinning or hair loss?
Lars Not that I've noticed. So...
Scott Benner You'd see it in the drain. Depression or low mood?
Lars Maybe sometimes. But then, I mean, well, you're dealing with diabetes, so that's kind of common, isn't it? So...
Scott Benner Yeah. Slower thinking, memory trouble, brain fog?
Lars Sometimes, I think.
Scott Benner Muscle aches, weakness, joint stiffness?
Lars No. I don't think so.
Scott Benner You ever have heavy or irregular periods? I'm just kidding, Lars. But no. There's others. Listen. What I would tell you is I talk to a lot of people. And if you're having a few of those symptoms, I would tell you to consider a four TSH as being too high. And then go ahead and take a look at what might happen if they just put that dose up a tiny bit, got you down a little lower.
Lars Sorry. Okay. I was completely wrong.
Scott Benner Okay.
Lars Mine's point eight four.
Scott Benner Oh, Jesus. Well, then we just wasted a lot of time. Yours is fine. You're just a little large. That's okay.
Lars Yeah. I'm...
Scott Benner Sorry. No different than anybody else. So that's fine. Don't be sorry. I'm glad you looked.
Lars Yeah. Well, it's awesome. Well, then well, still other people listening might have heard and and gotten the idea. What do you look forward to with diabetes management? Are you looking forward to trying an algorithm or anything of the sort?
Lars Well, I'm excited about the, like, the stem and islet cell transplant trials happening at the moment. I think they're being and this is just my personal opinion, obviously. I think calling them a queer is too soon to do that Mhmm. Because we don't know what's gonna happen in five years. But, yeah, calling them cures too soon, and I don't think we're going to have a cure for diabetes until we know what causes it.
Scott Benner What would you consider a cure to be? Like, what would the outcome have to be for you to consider yourself cured?
Lars Not have to have anything. Like, no anti rejection drugs. No...
Scott Benner Somebody finds a switch inside and shuts it off, that kind of thing. It's just over.
Lars Pretty much.
Scott Benner Yeah. But would you take the alternative? I mean, I guess you're referring to that Eladon trial right now, the one out of Chicago?
Lars Yes.
Scott Benner Yeah. And so if somebody could inject some stem cells into your liver and give you a fusion every twenty one days, you wouldn't call that cured? What would you call it?
Lars Positive.
Scott Benner Positive? Because yes. Yeah.
Lars Because, to me, it's not a cure because you're still they're still taking anti rejection drugs.
Scott Benner Okay. But you don't have type one diabetes anymore. Well, you do, but you don't have to take insulin anymore.
Lars Yes. But see, is it really a cure though? Because you're still taking the anti rejection drugs. If you stop those, what happens? Not that they're probably going to.
Scott Benner I I understand what you're saying. I'm asking you why do you care? Like, what's the difference? If you don't have to take the insulin anymore, you don't have any of the impacts of high and low blood sugars. I mean, obviously, you've traded one kind of management system for another, but, I mean, would you do it, I guess, is my question. If somebody came up to you and said, hey. Here you go. You can do it. Would you?
Lars Probably not at the moment. Not until there's been further research done.
Scott Benner Because you'd wanna see if it was okay long term. Yes. Let me say this. Pretend that it is. It works fine. It's not gonna hurt you. Blah blah blah. Would you do that? And would you consider that, like, a good outcome, or do you think you'd be irritated that you just were having to do something else?
Lars Potentially, I would do it. I mean, it would make it make life easier, obviously. Mhmm. But, I mean, right now, anyway, with the technology I have, it's pretty easy to manage for me anyway. I'm not having a huge amount of insulin.
Scott Benner Okay. It's interesting to listen to you try to pick through it in your own head because, you know, obviously, I understand what you mean by a cure. Cure would be like, snap your fingers. It doesn't exist anymore. I'm cured. That's that.
Lars Yes.
Scott Benner Alright. I don't think that's happening anytime soon either. And so Yeah. If having some cells injected into your liver and then right now it's an infusion every 21, I don't know if they'll be able to change how that works or not. I'm actually interviewing the doctor, the lead researcher on this in about a week.
Lars Okay.
Scott Benner There you go. Like, once a month, you go into a doctor's office, and they put you on an infusion. And an hour later, walk out. And there's no change. You don't get sick afterwards. You don't feel weird or anything like that. And for the next month, you just do not have to take insulin. You can eat. Everything works the way you expect it to work. And then, I don't know, five years from now, they figure out how to turn that into a an at home injection or a pill or something like that. I'm trying to figure out if that would feel positive to you.
Lars It would. Like, yeah. The whole thing is positive because it's from my way of thinking, it's probably the precursor to a full blown cure. Like, if they keep working along these lines, then I'm sure at some stage we will be able to have a cure.
Scott Benner Something else will come. You won't though. Let's just pretend you get this one and you're done. You don't get another one. So, like, I mean, is that a good way to make it through the rest of your life, do you think? 12 infusions a year, no diabetes? It's just interesting to listen to people after they've lived with it for a while because what I hear from you is that you're like, listen. It's not that big of a deal to have diabetes.
Lars Sometimes it's not. Sometimes it is. Yeah. If you have bad lows and everything. But, I mean, with the technology we have now, and yes, obviously, it's different here than it is in Canada with insurance, and we won't get into all that. But I've been I all myself's funded, so I don't have to worry about the costs of it. Like, everything's covered, I'm on, and so I'm sitting here talking to you with my phone on the desk and looking at my blood sugar and going, okay. It's good. I don't have to worry about it. I can just talk and not not have any of the issues.
Scott Benner Okay. No. I mean, listen. I don't have an opinion one way or the other. I'm just wondering how you feel about it. Okay. You brought that up because you think, what, the people are running around maybe being a little too, what, blase about calling it a cure and stuff like that?
Lars Well, I think it's too soon to call it a cure. Yeah. Yeah. It's a positive step towards one in my opinion, but potentially not. Yeah. Depending on your definition of cure.
Scott Benner Of course.
Lars To me, it's not cure.
Scott Benner Yeah. No. No. No. I hear what you're saying. I would tell you that where it creates a little bit of worry for me would be the idea that people could hear that and think, oh, they're gonna have it cured pretty soon, so I don't really have to take as good care of myself. Yeah. I get a little worried about that. Like, oh, you know, my blood sugar is one eighty five. I'd push it down, but next year, I'm gonna be getting those stem cells, so it'll all be okay. That part gets me. I also would tell you, I don't like the way it feels like it's being used as clickbait by diabetes influencers. I don't like that very much. No. Doing. If you need clicks, I understand. If it's the way you make a living or you're trying to turn it into something, I understand. But by telling people, like, oh my god, I'm cured, or there's a lady that's cured over here, a guy over here that's cured, he has a he. Like, you know, there's ten, twelve of them at this point who are in this study. I'm sure they'll be adding more If they haven't already, But and I don't that's, you know, under 20 people having this experience of, you know, what, 2,000,000 people who have it. So it's not like bubble gum. Can't just get it anywhere. And then getting people excited, and I just think it's I don't know. Like, I don't know if I'm doing a good job explaining what I don't like about it, but...
Lars No. I I yeah. I totally agree because it's still too early in the research into it to say, yes. It's a cure. Because like you said, there's only been ten to twelve people who've had this infusion done. Right. So it's like, well Yeah. And it's positive for them that they've not on insulin anymore and that their body is producing it, but it's like it's still way, way, way, in my opinion, way, way too early to call it anywhere close to a cure because it's they've just come off ejected insulin.
Scott Benner Yeah. Also, if you just take the word cure out of the conversation, it's also not even a prescribed treatment yet.
Lars Exactly.
Scott Benner Yeah. It's a trial. You're not even saying to everybody, forget curing you, but I can shut off your need to take man made insulin for a while. I'll call it that for a second. You know, come on over to the office and grab some. That isn't a day away. You know? I I don't know how far away it is. I'm gonna find out when I talk to the person. But, I mean, my guess would be that if the trial was branded a full on success and the FDA said, absolutely, go ahead and do this, that in itself is gonna take years. And then after that, what? Then years more to get it set up. So, you know, are you telling me maybe ten years from now it'll be okay? You know, if this all works out like that, I pointed out and would continue to point out that I had one of the people on who's had the experience of being through the trial. All sound very positive to me, but, you know, they had only had this process in place for six weeks at that point. And I don't know. I just I'm glad for them, and I think they should tell their story a million percent. I think people should hear it. I really do get worried about that idea of, like, it's happening right now. You know? It's just not the case. No. It's not happening right now.
Lars And we all know how long like, research takes a while. Like, it does. Yeah. That's why it's research. It's not like, oh, look. We can flick a switch, like, light switch, and and here we go. Everyone in the world is is available to them.
Scott Benner There's also an intake questionnaire and a lot of testing that gets done before you even get put in the trial. So my indication there would be that there might have been plenty of people who said, I'd love to be in the trial who got told, well, you're not right for the trial. So...
Lars Exactly. Yeah.
Scott Benner They're trying to keep it very specific to people I think that they imagine it's going to work with, which makes sense to me. When you got this sorted by Advil, Lars, you don't have to take a a questionnaire first and run the risk of the the Advil not being for you. You know what I mean? Right. Yeah. So let's get it to the point where, oh, no. I have diabetes. I call the guy, and then, you know, they set me up, bring me in for the I don't know whatever they're gonna do, and then I don't have it anymore. Then that's functional to me. So Yes. Anyway, what else you got here, man? Anything we missed? Anything we didn't talk about? Something I didn't ask you about anything at all?
Lars No. I don't think so.
Scott Benner We did okay? Yeah. We did okay. Your first podcast?
Lars Hopefully, mine was okay. Yeah. Mine first.
Scott Benner Were you nervous at all?
Lars No. Good. Like I said, I've spoken at a conference last year and just spoke off the cuff and was able to speak well. So...
Scott Benner Yeah. No. You're doing a great job. It's not a...
Scott Benner Yeah. It it's just interesting. I don't often get people who don't, like, listen to the podcast, to be on it, which is really nice for me, and I appreciate it. I wish more people would do that. I don't know how to it's hard to get in touch with people who don't know about the podcast. So...
Lars I know about it. I just haven't Yeah. You're busy. Chance to...
Scott Benner You're busy. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. I am.
Lars So...
Scott Benner You got a 17 year old. Is it a daughter? Your 17 year old?
Lars A daughter.
Scott Benner That's a lot of work right there. And, the boys become more work just slightly after that. And, and you're married, and there's a lady who's the mom of your daughter. There's a lot of things going on with you. I would imagine you got a job. You got diabetes, stuff happened. I understand. What do you do for, like, entertainment? Do you have a lot of in your ear entertainment in being in IT or no, you're not able to?
Lars Yeah. I do. I just have to try and keep up with all the advances in IT and AI and quantum computing and everything. So...
Scott Benner What kind of job do you have? What do you what do you do?
Lars I'm a system admin.
Scott Benner Are you using AI very much yet?
Lars For some things, yes. Like, it's not the it still gets it wrong, so don't put all your eggs in the basket and say, yes. AI is perfect. It's not. It will still make mistakes. So Yeah. So just double check it is my advice.
Scott Benner You found some uses for it?
Lars Yes. I found some uses for it. So Very nice. It's good for if you're, like, doing research into a trip and stuff, it's good to just say, hey. If I've done this research, can you confirm that this is good? And there's a yep. Takes a look for it. Yeah. Yeah. Quick answers to questions you have and that sort of thing. So...
Scott Benner I do like asking it to, like, quality check something or, you know, can you fact check this for me? Give me some some backup that I can read and see if I agree with the fact checking, that kind of stuff. I it helps me a lot with my website. I'll say that. And Yeah. You know, that kind of stuff. Like, things I could never have I would have not known how to code on my own. I can make now much easier. Yes. You know, it's been helping me with transcripts and stuff like that. It's been been pretty valuable, honestly. So Yeah. Okay. Alright. Well, Lars, I appreciate you doing this with me very much.
Lars Thank you for the time.
Scott Benner No. It's my pleasure. Do you think you'll ever move back to New Zealand, or do you think you're a Canadian now?
Lars Potentially. Like, I would ideally love to just have endless summers, but because of New Zealand's smaller population, and so I still keep in touch with some of the people I knew in New Zealand. Mhmm. And the insulin here that I'm using, I can't get down there, so I would have to go to a older generation, which I'm not so fond of. So interested in doing oh, that's interesting. Do you think your wife would move?
Lars Yeah. I mean, we would love an endless summers. So...
Scott Benner I would too. Yeah. I hate the cold. I'm done with it. Perfectly honest with you. What part of Canada are you in?
Lars Alberta. So we get minus 40.
Scott Benner Yeah. I know. You gotta leave. That seems wrong to me. Times. Yeah. Yeah. Yeah. Yeah. So Well, I just but get a bunch of insulin, take it with you. See how see how long you make it last. Yeah. Lars, thank you. I really appreciate this, man. It's it's been good talking to you.
Lars No worries. Thanks, Scott.
Scott Benner Yep. Hold on one second for me. Okay? Sure.
Scott Benner This episode was sponsored by Touched by Type one. I want you to go find them on Facebook, Instagram, and give them a follow, and then head to touchedbytype1.org where you're gonna learn all about their programs and resources for people with type one diabetes. I'd like to thank the Eversense three sixty five for sponsoring this episode of the Juice Box podcast and remind you that if you want the only sensor that gets inserted once a year and not every fourteen days, you want the Eversense CGM. Eversensecgm.com/juicebox. One year, one c g m.
Scott Benner The podcast you just enjoyed was sponsored by Tandem Diabetes Care. Learn more about Tandem's newest automated insulin delivery system, Tandem Mobi with Control IQ plus technology at tandemdiabetes.com/juicebox. There are links in the show notes and links at juiceboxpodcast.com. Thank you so much for listening. I'll be back very soon with another episode of the juice box podcast. If you're not already subscribed or following the podcast in your favorite audio app, like Spotify or Apple podcasts, please do that now. Seriously, just to hit follow or subscribe will really help the show. If you go a little further in Apple Podcasts and set it up so that it downloads all new episodes, I'll be your best friend. And if you leave a five star review, oh, I'll probably send you a Christmas card. Would you like a Christmas card?
Scott Benner Alright. Let's get down to it. You want the management stuff from the podcast. You don't care about all this chitting and chatting with other people. Juiceboxpodcast.com/lists. They are downloadable, easy to read. Every series, every episode, they're all numbered. Makes it super simple for you to go right into that search feature. In your audio app, type juice box one seven nine five to find episode one seven nine five. Juiceboxpodcast.com/lists. If you have a podcast and you need a fantastic editor, you want Rob from Wrong Way Recording. Listen. Truth be told, I'm, like, 20% smarter when Rob edits me. He takes out all the, like, gaps of time and when I go, and stuff like that. And it just I don't know, man. Like, I listen back and I'm like, why do I sound smarter? And then I remember because I did one smart thing. I hired Rob at wrongwayrecording.com.
#1854 Heavy Feet, Clear Eyes
Thirty-four-year T1D veteran and engineer Arnie discusses offering free diabetes coaching on Instagram , while Scott uncovers the algorithm mechanics behind the "social media casino".
Key Takeaways
- Early Positive Frameworks: Arnie emphasizes how his pediatric doctor set a resilient mindset at his 1992 diagnosis by demanding he play in a scheduled soccer game the day after discharge, establishing that diabetes wouldn't hold him back.
- The Free Coaching Disconnect: Driven by empathy for the daily financial struggle families face to afford insulin, Arnie chose to open his Instagram DMs for entirely free peer coaching instead of adopting standard industry packages that run up to $3,000.
- The Engineering Lens: Arnie leverages his chemical and process systems engineering background to interpret trends systematically, looking at how insulin moves and operates in the body like a logical flowchart.
- Somatic Awareness vs. Hard Data: To help children establish physical intuition for their glucose levels, Arnie introduces a symptom game called "Blood Sugar Ninja." Scott cautions that while guessing can build helpful internal context, it should never entirely replace hard device data.
- Unmasking the "Social Media Casino": Scott pulls back the curtain on tech algorithms, detailing how major networks like Meta and TikTok function as attention-trapping ecosystems that throttle educational reach and deliberately suppress external links to keep users browsing.
Resources Mentioned
Introduction and Sponsor Spotlight
Scott Benner Welcome back, friends. You are listening to the Juice Box podcast.
Arnie I'm Arnie. I've been type one diabetic since 1992, so I'm going on thirty three, thirty four years now. I am, to my knowledge, the only free diabetes coach, available.
Scott Benner If this is your first time listening to the Juice Box podcast and you'd like to hear more, download Apple Podcasts or Spotify, really any audio app at all. Look for the Juice Box podcast and follow or subscribe. We put out new content every day that you'll enjoy. Wanna learn more about your diabetes management? Go to juiceboxpodcast.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. If you're looking for community around type one diabetes, check out the Juice Box Podcast private Facebook group. Juice Box Podcast, type one diabetes. But everybody is welcome. Type one, type two, gestational, loved ones, it doesn't matter to me. If you're impacted by diabetes and you're looking for support, comfort, or community, check out Juice Box podcast, type one diabetes on Facebook.
Scott Benner Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan. Today's episode of the JuiceBox podcast is sponsored by the Kontoor Next Gen blood glucose meter. This is the meter that my daughter has on her person right now. It is incredibly accurate and waiting for you at kontoornext.com/juicebox.
Scott Benner Today's episode is also sponsored by Able Now, tax advantaged savings accounts for eligible individuals with disabilities. If you or your child lives with diabetes, you may qualify for an ABLE account because of ongoing medical needs, and many people in the diabetes community do. With Able Now, you can save for future expenses without affecting eligibility for certain disability benefits such as Medicaid. Learn more and check your eligibility at ablenow.com. You spell that ablenow.com.
Scott Benner The podcast is also sponsored today by Medtronic Diabetes, who is making life with diabetes easier with the MiniMed seven eighty g system and their new sensor options, which include the Instinct sensor made by Abbott. Would you like to unleash the full potential of the MiniMed seven eighty g system? You can do that at my link, medtronicdiabetes.com/juicebox.
The Concept of Free Coaching
Arnie I'm Arnie. I've been type one diabetic since 1992, so I'm going on 33, thirty four years now. I am, to my knowledge, the only free diabetes coach, available.
Scott Benner You're a free diabetes coach?
Arnie Yeah. That's a terrible profit idea. Right? No. I went through the I hit my midlife crisis. Right? I'm 38 years old.
Scott Benner Yeah.
Arnie Diagnosed at five. I went through my midlife I'm in the process of going through my midlife crisis. And I was like, you know, I need to get involved in the diabetes community, but I'm an engineer. For me to get to be a CDE or to to have those certifications, like, I'm not going back to med school. Like, I can't stop what I'm doing. I have two daughters and a wife to provide for. So I see that these diabetes coaches, like, you go through this health and wellness coaching certification process. So I did that. And then I went to try to go figure out how I was gonna, like, price my services.
Scott Benner Mhmm.
Arnie And I could not make myself, like, do it.
Scott Benner Okay. Hey, Arnie. Real quick. You're tapping or or moving a chair or something while you're talking. So just...
Arnie I'm sorry.
Scott Benner Don't be sorry. Just sit a little still. Keep telling your story. I'm enjoying it.
Arnie Okay. Yeah. No. So went through the coaching certification process, got certified, took my test, got my piece of paper. I've got the letters after my name now. I'm making a website. And then and then I started comparing, like, what other coaches were charging.
Scott Benner Yeah.
Arnie And I I know that people struggle to pay for insulin, like, every day. How can I expect them or ask them to pay the people that need the help to pay $3,000 for twelve one hour sessions?
Scott Benner Is that what they're charging?
Arnie I mean, it it's it's crazy, Scott. Like, it really is.
Scott Benner Also, Ernie, when I asked you to be a little quieter, did you then go to a construction site? What just happened?
Arnie No. That's probably you probably hear my girls. So they're in spring break.
Scott Benner Oh, yeah. That is definitely what I hear. Okay. There's...
Arnie There's probably a fight going on upstairs that my wife's trying to referee.
Scott Benner You wanna become a parenting coach and get up there and try to...
Arnie No. I'm staying locked in the bay I'm gonna lock this door to my to my office down there. I'm not going up there and getting involved. Alright. I get hurt.
Growing Up with Diabetes in 1992
Scott Benner Alright. Let me pick through this a little bit. Okay?
Arnie Yeah. Go for it.
Scott Benner Okay. So you've had diabetes since, what'd you say, '92?
Arnie 1992. Yes, sir.
Scott Benner How old were you then?
Arnie I was five.
Scott Benner Oh, okay. Do you remember what it was like growing up with type one and, you know, what your experiences were like?
Arnie You know, we were very fortunate that we had very positive experience in the hospital. So I went into DKA, and that was on, like, a Friday of Labor Day in '92. And we went in, and I was in the ICU for a couple days. And before we got discharged from the hospital, the doctor was basically like... my parents are sitting there, and they're talking back and forth. And, you know, I'm five. Right? I was getting ready to start kindergarten, but then we decided to hold me back a year to get the diabetes stuff under our belt.
Scott Benner Mhmm.
Arnie And mom and dad are like, well, he's got a soccer game on Saturday, and I think we're gonna pull him out and not let him play just so we can, you know, get home and get settled. And then the doctor, like, stepped in and was like, no. No. You're not. He is going to play on Saturday, and you're gonna bring him off the field. When it's time for him to come off the field, you're gonna check his blood. You're gonna give him something to eat if he needs something to eat, and you're gonna give him insulin if he needs insulin. Okay. You are going to figure this out. And that's really how it's been since then.
Scott Benner Yeah. I was gonna say that he started them off on a good foot.
Arnie For sure. Incredibly blessed early on in my diabetes journey.
Scott Benner '92. You taking injections? Like, do you remember when you got a pump if you got a pump ever? Like, how old you were when that happened?
Arnie Yeah. My first pump was 1999. We did injections until then. I remember getting an insulin pen and thinking that it was, like, the greatest thing ever. Right? Like, oh, we don't have to carry a bunch of syringes around and a vial of insulin everywhere. Yeah. No. Pens were a huge upgrade.
Scott Benner Yeah.
Arnie Yeah. But we were doing NPH and r early on, and then ultralente for long acting when it came out before they pulled it off the market. And then my first pump was in '99, MiniMed five zero seven c, that sexy blue. And I still remember going through the training. And, yeah, it that changed my life for sure.
Scott Benner It's fun talking to people who've had diabetes for a long time, and they talk about just they had a pump that was a certain color in there. That was so exciting. You could pick, like, different colors or...
Arnie Yeah.
Scott Benner You know, yeah, just happy not to have to inject anymore, like, that kind of stuff, the kind of simplicity of it. Now everybody wants to know, can it do it by itself? Do I even have to tell it I'm eating?
Arnie Yeah. Exactly.
Scott Benner Yeah. I and really, but it's not that long, you know, like, in between you just being like, it was blue. Now people are like... I mean, I saw this morning, islet's still working on that dual hormone pump with, you know, glucagon and insulin in it. Like so I don't know where all this is headed. Yeah. But, it's super interesting. So you didn't have, like, trouble having type one embarrassment or trouble with other kids, or have we just not got to that part yet?
Arnie No. I never really had any kind of trouble or issues. I was pretty athletic, so I was involved in sports. My dad was in the air force. We moved around a lot. So I got really good at making friends fast to try to have strong friendships.
Scott Benner Yeah.
Arnie I just put myself out there pretty quickly.
Scott Benner Nice.
Arnie Yeah. No. I never really had any run ins or issues or no bullying or any of that. Pretty fortunate, honestly.
The Engineering Mindset
Scott Benner And then you said you're an engineer. What kind of engineer are you?
Arnie By education, chemical. By actual work and practice, more mechanical a little electrical, but more mechanical and process systems type engineering.
Scott Benner Your brain works that way? That's not a thing you have to force on yourself?
Arnie No. I I definitely don't. That that's just how my brain works, which comes in handy with diabetes because I think it frames my view of what I do on a daily basis and what the insulin's doing and all that so I can think through that.
Scott Benner Yeah. I had an experience recently. I think I've mentioned it once, but my son basically codes things and, you know, has that kind of, like, math brain, like, in that direction. And I was having a problem with something with the podcast, and he just kinda walked into the office. And he's like, what's wrong? And I was like, oh, I'm trying to figure this whole thing out. And I don't even think there was a pause, and he started talking. And he laid out, like, what felt to me, like, directions that you would give a computer to fix a problem. And as soon as he got done, I was like, oh, that's right. That's exactly what I should do. And I think I probably would have spent the better part of an hour, like, dreaming through, like, artistically how to and I would have got there, but, like, it wouldn't... it was just so interesting to see how his brain ordered it so quickly.
Arnie Yeah. That's a gift.
Scott Benner Yeah. You have that experience, though.
Arnie Maybe not to that extreme, but yeah. No. I logical and systematic thinking comes fairly naturally to me.
Scott Benner Okay. Alright. Listen. I want you to have success because I want you to be able to put carpets on the floor upstairs so when the girls are running around, it's not so loud for you in the basement.
Arnie Yeah. I appreciate that.
Scott Benner So you're doing like, are you still an engineer today? Like, do you still have that job?
Arnie Yes. My full time job is being a dad to these knuckleheads upstairs running around. But, yeah. No. I'm an engineer full time. And then a couple years ago, started this diabetes coaching journey that I'm on.
The Side Hustle Journey
Scott Benner Why did that happen? So, like, I know you started to talk about it, but, I mean, I'm imagining you make a reasonable living doing what you're doing. Right? Like so it wasn't like bread got real expensive, I gotta get a side hustle. It didn't feel like that. Like, what kind of moved you to want to do it at first?
Arnie It all started maybe when my girls were born, and that was in 2017 time frame. I was never really involved in the diabetes community before. I was just kinda out on my own, and that's probably a product of me having moved around so much. But I kept having these experiences where someone would come up to me. They'd see my CGM or they could see my pump, and they would just divulge, like, their entire life story, like, on me. And it happened several times over a period of a couple months, and I was like, you know, I probably should do something about this. And then I would forget about it, and it would go away, and then it would come back. But when we moved back to Tennessee in 2022, it happened, like, right when we got here, like, three or four different times within a week. And I was like, okay. I definitely need to do something about this. Like, this is obviously some sort of sign that I need to get involved in the diabetes community. And and then I ignored it again because I feel like we do. You know, something hits you in the face five or six times before you actually need to do something about it. Right. So in November '23, I decided I was gonna run a marathon, and I wanted to raise a bunch of money for diabetes. So I ran that twenty twenty four and 2025 New York City Marathons with beyond type one. That was a lot of fun. But as part of trying to get on the marathon team, I was like, I need to get some sort of social media platform going because I didn't have any social media at that time.
Scott Benner Yeah. Which was great. I'm not convinced I need social media.
Arnie Yeah. So the net positive maybe, but maybe not by a lot. You know, it's hard to say right now. I'm sure in fifty years when we're looking back, we'll look at it through clear lenses. But so I created an Instagram account, started trying to get out there and just get involved in the diabetes community, and diabetes Instagram, woof. Like, I did not like what I was seeing and what I was hearing and just a lot of, you know...
Scott Benner Let me stop you there. So I'm sorry. I almost laughed. One time, they went down the hallway so heavy footed. You were talking, and I almost laughed over top of you. I'm so sorry.
Arnie I tell them all the time. I'm like, are you guys mad at the ground? Like, you walking that hard in tension?
Scott Benner How old are they?
Arnie They're eight and four.
Scott Benner No. That's Yeah. Hilarious. I mean, Boom. Boom. I'm gonna take this moment to implore everybody, like, just to hang on. You're gonna you're just gonna hear all these kids running around, like, during this one. Because I don't think we're putting a... because I imagine he's texted six times already and been like, please keep the girls quiet, and it's not working.
Arnie So they're kinda like me. They don't take direction very well. So they come by that completely honestly.
Scott Benner I by now, I would have texted my wife. I would have been like, tie those kids to something.
Arnie Yeah. Outside, outside now.
Scott Benner But I'm interested. A person who's not on social media, who's had diabetes for a long time, decides to throw themselves into Instagram as an example. Like, what are your expectations for it? What is it you actually find, and what is it that you didn't like, and what did you like? Unlike other systems that will wait until your blood sugar is a 180 before delivering corrections, the MiniMed seven eighty g system is the only system with meal detection technology that automatically detects rising sugar levels and delivers more insulin as needed to help keep your sugar levels in range, even if you're not a perfect carb counter.
Scott Benner Today's episode of the Juice Box podcast is sponsored by Medtronic Diabetes and their MiniMed seven eighty g system, which gives you real choices because the MiniMed seven eighty g system works with the Instinct sensor made by Avid, as well as the Simplera Sync and Guardian Force sensors, giving you options. The Instinct Sensor is the longest wear sensor yet, lasting fifteen days and designed exclusively for the MiniMed seven eighty g. And don't forget, Medtronic Diabetes makes technology accessible for you with comprehensive insurance support, programs to help you with your out of pocket costs, or switching from other pump and CGM systems. Learn more and get started today with my link, medtronicdiabetes.com/juicebox.
Scott Benner The Kontoor Next Gen blood glucose meter is sponsoring this episode of the juice box podcast, and it's entirely possible that it is less expensive in cash than you're paying right now for your meter through your insurance company. That's right. If you go to my link, contournext.com/juicebox, you're gonna find links to Walmart, Amazon, Walgreens, CVS, Rite Aid, Kroger, and Meijer. You could be paying more right now through your insurance for your test strips and meter than you would pay through MyLink for the Contour Next Gen and Contour Next test strips in cash. What am I saying? MyLink may be cheaper out of your pocket than you're paying right now even with your insurance.
Scott Benner And I don't know what meter you have right now. I can't say that. But what I can say for sure is that the Kontoor Next Gen meter is accurate. It is reliable, and it is the meter that we've been using for years. Contournext.com/juicebox. And if you already have a contour meter and you're buying test strips, doing so through the juice box podcast link will help to support the show.
Critiquing "Diabetes Instagram"
Arnie I don't really know that I had any expectations, to be honest. I think I just got out there and started posting stuff. It really just about, like, diabetes and running. This is how I take care of my butcher while I run. I'm already... I've had diabetes since 1992, yada yada yada. And what did I see? I saw a lot of... I'm not a, like, feel sorry for myself person, and I still see a lot of, like, woe is me. Diabetes is the bad guy. And I think a lot of that is self defeating, and that drives me nuts.
Scott Benner So this will be an interesting question for you. Do you think that those people in general are trying to share their lives with diabetes, or do you think they're all trying to build up a thing so they could do something? Like, because you were there admittedly because you're like, oh, I'll be a diabetes coach, but how am I gonna find people? I'll get on Instagram. And so, like, I'm starting to wonder how many of those people are just like, oh, I hope that my blog, podcast, YouTube channel, coaching service... like, this is how I'm gonna... I have to tell everyone who's listening, it's not gonna work. But, like, good luck and, you know, God bless. But, like, social media doesn't work like that anymore.
Arnie Yeah.
Scott Benner And there's so many of you, it doesn't matter. I'm gonna be this guy for half a second right now. Like, I'll have you crying by the time it's over, but I'm gonna tell you a story. A couple of summers ago... this is gonna sound roundabout for a second. Doshi was very famous for a while. And then a couple of her songs came out. I was liking them. My son turned me onto it. I listened to her album a little bit. And then one day, I'm in TikTok, like, doing something with my account, which is, like, one of those things that I'm just like, god, I don't even have this. And I open up TikTok, and there apparently is some, like, you know, dance trend going on with a Doce song. And there's this girl that pops up in front me. I've never seen her before in my entire life, but she's got very curly, bouncy hair. And I realized quickly her whole shtick isn't that she's super curvy or super pretty or anything. She's just got really bouncy, curly hair, and it's just mesmerizing while she's doing this stupid TikTok dance. Right? And I must have stayed on it a half a second too long. Oh. And then the next time I opened it up, the girl with the bouncy hair was there again. She was always there. And before I knew it, I was like, I think I'm a person who wants to watch people's hair bounce while they're doing TikTok challenges. Like, so I guess I am. Right? But I also then tried to look at it more forensically because of what I do. And then before I knew it, in the next six months, girls with curly bouncy hair was a thing on TikTok. Like, she got popular, and I mean, like, really popular. Like, has millions of views on her videos. And then people looked up and went, oh, I guess if my hair was curly while I did these, it would help. And then there was countless of them. And it went from watching her be the one to it being so many of them that the algorithm stopped serving her to me. I don't know her name. Like, I couldn't even know... I wasn't following her. Like, I couldn't go find her right now if you paid me money. Do you know what I mean? Like, and so somebody did something. It got popular, and then people swarmed in to try to get a piece of it. And then all they did was ruin the whole thing. I've been talking a lot about this this week, so I apologize for people who listen real chronologically. But this happened in diabetes blogging. There were four or five people writing these really great diabetes blogs, and then you woke up six, seven years later, and there were 4,000 people writing diabetes blogs. And, like, that's a literal number. And then inside of four more years after that, blogging completely disappeared in the diabetes space to the point where the person who I would mark as probably being having been the most successful at it, she stopped doing it. Like, she stopped doing it. And when she stopped doing it, I was like, oh my god. There must be no audience at all if she can't draw an audience for it. And then I went off. I pivoted before other people, and I started making the podcast. So I have, you know, what I think business people would, you know, term, like, first movers advantage.
Arnie Sure.
Scott Benner Yeah. Like, I was out in front. And, I mean, I'm pretty diligent, you know, etcetera. Like, I treat it very seriously and whatnot. But the only thing that's saving me is that I built such a lead that I live in a slightly different category from everyone else because then they started coming like locusts after that. And I would tell you that I used to have a compulsion to pay attention to it, which I have not had for many, many years. But in the beginning, when I was more in the mindset that I was in a foot race and I was only a couple of steps ahead and I kept looking over my shoulder, I would pay attention to diabetes podcasts when they would pop up. And before I knew it, it had gotten to a 150 that had started and failed. And they all fail within a couple of months to a year, usually. And one or two hang on, sometimes three or four hang on. I can tell you that now, I don't know how many there are that are actively producing, but maybe three of them actually pop up on a top two fifty chart once in a while, or they'll jump up and then fall out again like that. But even at that level in a subcategory, it's not a lot of listens. Do you know what I mean?
Arnie Mhmm.
Scott Benner And so, you know, when I see somebody pop on to something and they're like, oh, I just wanna share. I wanna do this. What I think is you were trying to set up to make a business. And I think maybe somebody will come along and do a great job of it, but I don't know that the space allows it anymore. Like, my point is is that if I started over today, I think I'd fail in about four months. It's easy to think, oh, no, Scott, everybody listens and, like, it's so popular and they would find you again. I don't think that's true. I think the algorithms and the social media, TikTok, Instagram, Facebook, they don't dole out the access like they used to. And if they give you too much of it, they'll take it away pretty quickly too. So people get popular. I just was interviewing... do you know the Boggs family?
Arnie Yeah. Type one. Yeah. Yeah.
Scott Benner I was interviewing her yesterday. And she's like, at this point, it feels to me like TikTok's purposefully not serving my videos to people anymore. And, like, in some situations, it it... and we talked a lot about... it's weird that you came on today because we talked a lot about being on a platform that you have no control over. It would be like if I said to you, hey, build a house, but build it on this piece of wood, and I might come along and pull the wood out from under you, and you have no rhyme or reason for why I may or may not do that. I don't know. I guess what I'm saying is is that I worry that social media is just a bunch of people trying to do something and not necessarily a bunch of people sharing for other people. I wonder if they're not just talking to themselves and each other is what it... I wonder sometimes. And maybe I'm wrong or pompous. I don't know exactly. But when you get there, you see a lot of, like, woe is me. Is that the phrasing you used?
Scott Benner As I told you earlier, Able Now is sponsoring this episode. Able Now, of course, tax advantaged Able accounts for eligible individuals with disabilities. If you or your child lives with diabetes, you may qualify for an Able account because of ongoing medical needs. Many people in the diabetes community do. With ABLE now, you can save for future expenses without affecting eligibility for certain disability benefits such as Medicaid. And thanks to updates to federal law, ABLE accounts are now available to more people than ever before. That means more individuals and families can use ABLE now to save and invest. Funds in an ABLE now account can be used for a wide range of everyday needs, including education, transportation, health care, assistive technology, and more. There's no enrollment fee, and you can open an Able Now account with a small initial contribution and build from there. Learn more and check your eligibility at ablenow.com. That's ablenow.com, ablenow.com.
Arnie Yeah. Kinda woe is me. Yeah. Kinda like, not a lot of positive, I'll say, diabetes content. Like, hey. You can actually go and do stuff and live a normal life. And, I mean, there's content, right, where, you know, people are feeling site changes and and things like that.
Scott Benner Mhmm.
Arnie But not a lot of, like, positive I don't wanna sound like a motivational speaker, but, you know, just positive outlook on life with diabetes.
Scott Benner Do you know why that is?
Arnie Probably because it's not popular.
Scott Benner Yeah. Nobody cares a lot.
Arnie Which is insane to me.
Scott Benner Yeah. The algorithm supports how people's brains work, and people's brains either want woe is me or they don't wanna be involved. They want complaining. They want you know, they like that. That's why political news is so popular. Right? Like, because it's just arguing. And listen. I put out a lot of positive stuff. It never gets traction. I just put up a post the other day. This is a good example. I put up a post the other day saying that Juicebox docs has been completely revamped. So if you're looking for an endocrinologist or a nurse practitioner or somebody who a listener has said has been really good, You know, I have a pretty extensive, beautifully searchable web page where you can go look for those people. It's free. It doesn't cost anything. I put up a post about it. People don't see it. They don't click on it. You're not blaming them. The algorithm is not showing it to them. And so then the next day for fun just to make myself feel bad, I put up a picture of gummy bears that has 25,000 views.
Arnie Right. Perfect. Yep.
Scott Benner And so a meaningless post about nothing with gummy bears that taste nice and are bling up your blood sugar. You know, you could try to build that up and then slip in some good stuff again. It won't work. So when people get on originally and they're like, hey. You know, I'm Arnie, and I this is really great information. I'm a runner. I have type one diabetes. I'm I'm pretty good at managing it. I know that's hard for people. Here's how I do it. Doesn't matter. It's not gonna take off in that system. People, the algorithm, the world, like, it doesn't care about that. It's sad, and I don't like it either. But it's partly why my thing is still able to work because I was able to build an ecosystem that is not those others. But then you have to wait for people with that interest to find it and come to it, And then you have to hope it's valuable enough to them that they tell somebody else about it, and then you've gotta wait for them to tell somebody else who's actually looking for that kind of information. It is a very slow burn to build something like this. If you wanted me to complain about Instagram around diabetes specifically, I hate that people with diabetes felt like they had to lean into trends to get views. And then on a completely separate note, I cannot explain to you nor can anybody else I know who works in this space or pays a lot of attention to it explain to you why site changes are so interesting to people.
Arnie Yeah. It's fascinating why that is, but that's a lot of the content.
Scott Benner But it's because it's the only thing... it's the only thing that gets views. Even the tech stuff is starting to die. Like, oh, the new CGMs come that... like, that kind of stuff, like, you know, exciting tech news, that's almost done too. You even watched it happen with cell phones and computers. Like, that used to be a big space in social media. Like, you know, the new computers out, the new... like, people got tired of it. They don't care anymore. Like, it's interesting how things ebb and flow. What's his name? The... oh, god. I wish I could remember his name. There's a guy who lives in Jersey who does tech stuff. He's huge, but I'm watching his views go down. Car stuff was huge for a while. That's going down. I used the example the other day that during COVID, reptile YouTubers were huge, and now they're almost completely collapsed. And I think talking about diabetes technology, no disrespect to anybody, like, I think it might follow this trend too. Like, it ain't getting that much better anymore. Like, I think that's the idea. Like, before, it was like, hey, people had, like, the... you know. Right? But you just said it. It was so exciting to go to a pen.
Arnie Right.
Scott Benner Like, right? Like, and then meters came out. I used to be able to get 50,000 clicks, like, putting up a picture of a of a new meter and saying, hey, there's a new meter out if you wanna check it out. It would it would draw people in. If I put up a picture of a meter now, nobody would look at it.
Arnie Unless you complain about that meter using our complaining logic.
Scott Benner Exactly. And that's even not working as well as it used to. Complaining about CGMs not lasting, it's not as attractive social media wise as it used to be. So I don't really talk like this very much, but I'm trying to help people. And at the same time, I don't wanna be doing the stuff that just hijacks the part of you that loves to complain or be mad or whatever. I'm not into that. I'm not gonna do that. And so I'm always looking at where people are trying to imagine how I could offset that with better content. Like, Jenny and I'll do a series later this year that's based on what people say they struggle with. But instead of complaining about the struggles, we're just gonna say, hey, look. Do you struggle with this? Because, you know, a recent thing we did, seven hundred and sixty five people said they struggle with this specific thing around type one diabetes. Here's content about how to help you not struggle with it instead of leaning into the struggle. I hate the woe is me stuff. I'm insulted by it.
Arnie Yeah. Understood. Yeah.
The Pricing Disconnect of Coaching
Scott Benner Yeah. And now, of course, I found a way to talk while your girls were quiet. But tell me, when you get there, you have that experience, you're thinking, I'm gonna start a coaching service. I got a coaching certification. And then what do you mean you didn't have the heart? What were you, first of all, learning people were charging for it?
Arnie I was looking at other coaches, other diabetes coaches, and I realized that the diabetes coaching... I'm gonna use the word industry, it's like a side industry. Like, there's this niche in the market where people don't wanna go to their endo or their endo isn't helpful or whatever. We've all had those experiences. So these diabetes coaching services started popping up. I mean, there's a lot of them.
Scott Benner Yeah.
Arnie But they charge, like, crazy amounts. We talked a minute ago. I make I make a comfortable living. Like, I'm not doing this to try to get out of my golden handcuffs job. Right? Mhmm. So I was like, you know what I'm gonna do? I'm gonna open my DMs on Instagram, and I'm gonna start advertising that. You DM me whatever you wanna and we'll talk about whatever you wanna talk about. Do you have a question? We can talk for a month. We can talk for a day. Whatever you wanna talk about, I'm a free diabetes coach. Because I I kept going back to these same people who are charging what they charge would then turn around and be like, insulin should be free. Like, the incredible hypocrisy I I felt like I was seeing, and I'm a hypocrite too. Insulin should be free, but you should pay me $3,000 for twelve one hour sessions of of my time.
Scott Benner Well, if we're gonna be completely honest, Arnie, it's a business that's focused pretty much on people from a certain background through a certain age range with a certain income.
Arnie Sure. Right. Like yeah. Totally agree.
Scott Benner You're selling something to somebody that can afford that. And by the way, I don't think there's anything wrong with it. If you wanna sell a $3,000 service to somebody and they can afford it, and when it's over, they're gonna have a better outcome, then you know what? Maybe that's worth it to them and that's awesome. I come from the perspective with the podcast. The reason there's advertising on the podcast is because I thought, like, I don't think people should have to pay for this.
Arnie Right.
Scott Benner And I think diabetes coaching or maybe a lot of different life coaching, yeah, I think it all kind of falls into the same bucket, which is to say that, like, life's not as hard as you think it is when you're struggling with it. You just don't know the answer. You don't have the pathway laid out in front of you. You know, you can use people's finances as an example. You know, I just helped a person very close to me, a young person that in their mid twenties had gotten themselves into $25,000 worth of debt already, and it was completely ruining their life. And not just that, like, not just day to day. Like, they were working to pay credit card bills at this point. Sitting in their house, eating ramen noodles, you know, gaining weight, paying off credit card bills that weren't gonna be paid off for about fourteen years if they didn't buy another damn thing ever, which wasn't happening because they couldn't afford anything to begin with. Right? They were already stuck in that cycle. They asked me about it one day, and we started talking. And I said, I can put you on a plan to be out of this in eighteen months. Like, eighteen months, you'll be clear, and you'll probably have $5,000 saved. And they were like, I'll do that. And so I laid out for them how to do it to their credit. They did the things I said. They're six, eight months into it now. Everything's going exactly the way I said it was going to. But my... the secret here is I'm not some financial genius. I am just a person with common sense.
Arnie Right.
Scott Benner And when I talk about diabetes, it's the same thing. I am not like some, like, diabetes guru. Diabetes is as simple at its core. And if you follow the steps, generally, it works out about the way you expect it to. And then you can learn from that, build on it, and make your own thing. It's very simple. Your basal has to be right. You have to pre bolus meals. You have to understand the impacts of your food, you know, fat, protein, makeup of the food, that kind of stuff. Your insulin to carb ratio has to be right. Your insulin sensitivity has to be right. You have to have good settings. You have to have good settings and time the insulin well and understand the impact of the food. It's the whole damn thing. Shut the podcast off right now. You don't have to listen to it. Yeah. Okay?
Arnie That's right.
Scott Benner That's it. So if there are coaches out there helping people, except for the people who have really difficult situations, there's a ton of variables around it. Maybe that's where the coaching is most helpful. Like, that's actually what I like about Jenny is that, like, after she sets you up and gets you going, where her value with you is is that, like, she talks to you every week and talks to the variables that are impacting. Like, you've got the stuff set now, but other things still aren't going right. That's great. If you can get somebody to coach you through that, if you can get somebody to say to you, do this with your money, do this, put this here, blah blah blah, because you don't know any better because nobody ever taught you, then there's a ton of value in that. But, also, if you can't bring yourself to take that money from them, you personally, I understand you feeling that way because I have ads because in the end, I didn't wanna charge people to tell them that they should pre bolus because that just seems silly to me.
Arnie Right. Underplaced.
Scott Benner Yeah. And I didn't need the money that bad. But I'll tell you, there's... I've seen coaches out there. I don't know what they charge, but I've seen them celebrate their ten thousandth customer. And if you're telling me $3,000, I can do 10,000 times 3,000. Gotta tell you, that sounds like $3,000,000 to me. So maybe I'm wrong. Maybe it's more than that. You know? Like, maybe my math is terrible. Hold on a second. Let's do it together. You might change your mind before this is over. You might say, you know what? So you're like, hey, Scott. You know what? Hold on. But, no, if if I had 10,000 customers over a handful of years and charge each of them $3,000... I'm sorry. Would I have $30,000,000? Is that right? Can that pot...
Arnie See, 3 thousand's got three zeros in it and 10,000 has four?
Scott Benner Is that right?
Arnie I think that's right.
Scott Benner See, there's a thing that sounds insane. Hold on a second. This is crazy. I know I'm right, but hey, ChatGPT. What's up?
Speaker 3 Hey, Scott. Not much. Just here to help you out or bounce ideas if you need. What's on your mind? Something about bling right.
Scott Benner Yeah. No. I just did some math, and it seemed crazy to me. So I just wanted to back it up here. If I charge 10,000 people $3,000, would I have $30,000,000 when it was over?
Speaker 3 Yeah. That math is right on the nose. 10,000 people each paying $3,000 would indeed get you to $30,000,000. It sounds huge when you say it, but the numbers don't lie.
Scott Benner Well, thank you. Hey. Listen. I'm recording a podcast right now. Is there anything you wanna say to the people listening to the Juice Box podcast before I say goodbye to you?
Speaker 3 Well, hello, Juice Box podcast listeners. Just a reminder, whatever big idea you're dreaming of, do the math, and then go for it. And keep listening to Scott. He's got good stuff for you.
Arnie That was a great sales pitch. Yeah.
Scott Benner Jeez.
Arnie For Chat GPT and for you.
Scott Benner I should have her do the ads. Yeah. For sure. Done. Wow. I maybe I'm gonna change my mind. Y'all gotta pay me. Wait. Wait. What the hell?
Arnie So I think what you're seeing there is I mean, you have a platform that you could you could probably make that leap and get to those numbers. Right? I don't know. I think my my thing with diabetes coaching in general is that, yeah, I I just struggle with the people that need the help. How do you get them the help that they need? Or and then they have to be coachable. Right? That's the other piece, which isn't up to me. It's up to them.
Scott Benner Yeah. No. I mean, listen. Also to say that it's not worth the money, there are some people that are... they're difficult to help. It's a slog. So they come to you and they say they want help, and then you start helping them, and then they fight with you the whole time. And at that point, the 3,000 probably doesn't seem like enough. Also yeah. Could you all just send me $5? Like, would that work? I think I could just retire if that happened.
Arnie Yeah. I mean Yeah. You'd be you'd be moving in no time.
Scott Benner Moving. Yeah. Oh, wait. Oh, wait. I told Arne before we started recording, I was thinking of moving. Listen. I still feel the same way. I mean, do I want $30,000,000? Yeah. But, like, no. At the same time, because that's not really... you said, Scott, I'm sure you have a big platform. You can do that. I couldn't. Because you'll very quickly find out who's willing to part with a dollar and who's not, and most people just aren't. For me, part of keeping it free, this thing for you guys and keeping this thing free for you guys, part of it is this, very, very simply. I worked in a credit union when I was a kid in the marketing department. And we were in this meeting one day trying to figure out how to get people to come into a branch to do something. I forget what the hell we were doing. And I said, why don't we just put dog shit in a bag and write free dog shit on it? And everybody looked at me and I said, I think my point is is that, like, people like to get free stuff. Why don't we just put a gift out? And I think you'll draw people in. People are unwilling generally to pay for things. Like, yes, somebody found thousands of people to pay them a couple of thousand dollars apiece. That's fine. But that's not that many people still. For a business, it's insane. 10,000 customers a couple thousand dollars. That's an insane business. Right? But 10,000 people, there are... I mean, what are there? 2,000,000 Americans living with type one at this point? Or 2,000,000 people across the world? Or I don't know how many people have...
Arnie I think it's 2,000,000 in the US. Yeah. That sounds good.
Scott Benner Point being, 10,000 of them is not a meaningful percentage. It's a great percentage for that business. It's not great for people living with diabetes. And so what I chose to focus on was reaching as many people as I could with the idea that, like, get your settings right, pre bolus your meals, you know, understand, you know, how fat and protein impact later, that kind of stuff. And then I've tried to add a lot to it since then, but I thought, like, I don't wanna help five people. I wanna try to help as many as possible. That's been my goal.
Arnie No. I appreciate that. I've I have personally benefited from some of the episodes on the podcast, so I hope to pay it forward today or tomorrow or whenever somebody sends me a free DM on on Instagram asking me.
Scott Benner Is that working? Are people reaching out to you?
Arnie So you'd be amazed at how many messages I've received. You know? So I've been doing this since I opened up my DMs in, like, June '24, so we'll call it two years.
Scott Benner Mhmm.
Arnie I mean, I have people message me. I have three or four messages a day.
Scott Benner Yeah. That doesn't surprise me at all. But there's no part of you that says, like, if I got three or four messages a day, why don't I drop the price to $500? Like, if I'm doing it anyway, why don't I collect some money from it? Like, you're not feeling that way?
Arnie Not yet anyway. I kinda have the same mentality. Like, I told my wife this maybe nine months ago that, ultimately, what would be fantastic is to have paid ads on my page. I don't know how I would do that, but to continue to provide free coaching services, but have paid ads to try to make money that way. And I'm still so new to all this...
Scott Benner Yeah.
Arnie ...social media and all of it. I I don't know how any of that works, to be completely honest.
Scott Benner And I wanna say in fairness to people listening, I have no idea if you're any good at it or if you know what you're talking about even. That's that's neither here nor there. Also, I just want people to understand, like, Arnie being here today, like, I didn't know this is what we were talking about. Like, I really do not pay attention to what people are coming from the podcast for. And so, like, I just I'm interested that this popped up. And in a week where I'm always weirded out by how this happens, like, there's been so much of this conversation this week, you know, with different people that I've been recording with. Maybe it's something in the water months ago when we when everybody sets up or whatever. I have no idea. In fairness, like, I'm not pimping Arnie. I don't know. He might kill you. I have no idea. Yeah. I don't know. He might show up at your house and dismember your body and throw it in a river. I absolutely do not know Arnie at all. But I like this conversation about, like, you got into that thing thinking, oh, I'll make a business. And then can I ask, is it religion? Is it that you make enough money? Like, where was the pang that hit you in the heart that slowed you down from your initial idea of, like, I'll start a coaching business?
Arnie I don't know that I ever thought about... I never came in with the intention of of making a business. First off, I was just trying to get my name out there to help me get on the marathon team.
Scott Benner Really?
Arnie Because yeah. Because in 2023, late twenty three, when I decided to get on the marathon team or to try to apply, one of the things they ask for is, like, your handles so that they can see because they want you to try to generate, you know, some some buzz around the marathon and try to get people applying all that.
Scott Benner Yeah.
Arnie And I didn't have any of that. And I was like, well, I have to have this, or I'm not gonna get... you know, they're not even gonna look at my application to be on the marathon team. And that's when I was exposed to diabetes coaching. Like, I got ads for for diabetes coaching, and I was like, what in the world? These people are charging what they're charging. Like, I can do that today. Yeah. And that's kinda how the the process started.
Scott Benner I've heard all kinds of stories from people who have used different coaching services. Some of them say, like, it was a feel good, like, cheerleader experience. Yeah. But I don't think I know anything more about diabetes than I did before I started.
Arnie Which would be infuriating to me as a customer thinking I'm going to get diabetes coaching, I'm getting, like, a...
Scott Benner A pat on the ass.
Arnie Pat on the back. Yeah. Get out there, kid. You can do it.
Scott Benner By the way, I'll do that for free for you right now. You guys can do it. I promise. Go ahead.
Arnie Yeah. I mean, my advice is free, and sometimes it's worth what you pay it. Sometimes it's not. But, I mean, it depends on if you come with a problem that I, like, I can't do anything about, I can talk to you about it, and I can try to listen to you. And I get some of that. You know? And some of it's very specific questions. I mean, I've been around the block long enough that I think I can handle and address most people's concerns. I have some frequent flyers feel they come to me once, two, three, four times a week. I'm like, hey. You know?
Somatic Awareness and the "Blood Sugar Ninja" Game
Scott Benner Well, can I ask you a question? What if it got so popular that it took up all your time? Because, like, I went out to lunch with Arden yesterday, and I was working, like, sitting there, like, from my phone. Right. Because there's something I had to do. I mean, this podcast and the surrounding community around it encompasses most of my waking hours. And, like, I don't know what you all were doing last night at 01:00 in the morning, but I was sitting up fixing code on a web page. And you know what I mean? Like, when it turns into that and your wife is like, hey, you don't talk to us anymore because you're coaching people for free online, that's gonna be a a loggerhead for you.
Arnie We've had some of those conversations already. Not that I've spent a sufficient amount of time to, like, curl a warrant. Like, hey, dummy. Like, we're still married, you have kids. Like, you need to let me take care of...
Scott Benner By the way, I don't know how long you've been married, but I assume the hey, dummy part every time my wife opens her mouth even if she doesn't say that.
Arnie Yes, sir. 1100%. It's there. Upset or unsaid, it is there. I feel I feel it.
Scott Benner I'm so sorry. Go ahead.
Arnie No. You're... you're exactly right. But we've had some of those conversations. Like, what would it take to have to leave work? Does this become a full time thing? Like, I can't do it... you know, I can't do two full time jobs and be a full time dad.
Scott Benner Mhmm.
Arnie So we've had some of those conversations way too prematurely. Right? Because I don't have any idea what I'm doing with trying to build this. I'm literally just making this up as I go. I think that's part of the fun, honestly.
Scott Benner Yeah. The scaling is near impossible. You know, Kenny Fox has been on here a number of times. He's really great with Loop, and he has a service like this. It's a pay service. And I was just talking to him last week about it. And, you know, he again, people come. They meet him. They like what he does. They have success and everything. But how do you meet the next person? Like, it's a difficult process. Right. Like, you have to be... it's almost like it feels like, you know, you either have to be out in front or you have to be relentless, like a real like like a business mind and really, like, business it up to get it to where it's going and have a little bit of that social media, like, swagger at the same time. It takes a lot to to draw in enough people where you know? Because by the way, you use the number 3,000. I really don't know what any of it cost. But, like, if you have two customers, well, you might be able to go make $6,000 a lot easier at a job. Do you know what I mean? Like, that that that... and especially when one of them leaves, and now suddenly your income's $3,000. And then you lose the next one, and you can't find the next one again. Like, that's different. I mean... but, you know, basic math, and this is, you know, this is how people make money online at this point. Like right? Like, you don't need all of the customers. You just need enough of them to make a living. You know, that is a business model that's all over America and and maybe the globe at this point. Right? Like, you know, think about it. 10 people paying you $3,000 over twelve weeks, you made $30,000 in three months. You made $10,000 a month. Just like that. That's more than a fair living. And if you do it well and you can scale it to 20 people, then now you make $20,000 a month. And, you know, if you can... then now you gotta get 20 people for this twelve weeks, 20 people for that twelve weeks, and that's when the panic comes in. And that's when it turns into social media. In that same feeling that those people have, like, put up a video and the video's got 5,000 views, and I need to get to 10,000 views, and I gotta get to 20 because I gotta get to 50 because I gotta get to one. Like, that's when you're gonna be in that mad rush of chasing. There are not many people that are built for that. It's unrelenting. It really is. And you have to be able to give it away at some point, and you can only give it away if you're having success. Like, when people are like, oh, you used to worry more about how the podcast was doing. Like, I did when I was building it. I'd worry about it all the time. Now that it's what it is, I don't have to worry about it as much. Not about the content. That's stuff I actually have more time to think about now. But, like, oh my god, this is gonna fail any second feeling. I lived with that for eleven years. It's not fun thinking like this thing I built is a house of cards and it's just gonna blow away. So I don't know. Like, it's not for the faint of heart and that you're gonna see a lot of people trying to do it only if you are gonna succeed. Maybe even fewer than that are gonna be valuable for the people. And then it's up to all you out there to go find it. I will say this, like, Arne, you being here is very uncommon because I have a very simple rules, like, in my Facebook group, and one of them is no coaches. Like, no health coaches allowed in that group. You can't pimp yourself in there. You can't do that. Like, I just don't let that happen because who knows who's who. And, you know, I don't wanna be on the hook for saying this guy's good or this guy's bad. This is why, you know, in maybe unfair to you, but that's why your conversation's gone this way because, like, I'm not here to say you're great or people need health coaches. I'm saying, you know, this is an interesting story about the back way of of how kinda how it works. I hope you're okay with that. Like, you seem like you are.
Arnie Yeah. No. No. Yeah. Yeah. It's been an interesting journey so far, and I'm looking forward to seeing where it's going. You know, we've talked about a lot of different things. I had a couple bullet points that, like, I thought I was gonna try to go through today, and I think we've touched like, I'm Arnie, which has been fantastic because the conversation has flowed.
Scott Benner No. Tell me what we have time left. What else is on your list?
Arnie I'm a parent of two kids. I see parents who I'm gonna use the word, like, paralyzed by not trusting the tech. Right? Because we we wanna trust the tech. We rely on the tech because the kids don't know their, you know, their blood sugar symptoms just yet. I had such trust with my parents when I was young because I learned my symptoms very early. And I could tell them, like, hey. I'm high or low or in the middle. Right? When Arden was growing up, you probably said, hey. What do you think you are before you checked her her profile?
Scott Benner All the time.
Arnie All the time. Right? Yeah. So we did that too, and the whole family would guess. I had to guess first, right...
Scott Benner Mhmm.
Arnie ...to give the family a frame of reference. Right? Like, I can't be, like, you know, mislead them. You know? So you had to play honest. But I've turned that into, just in the last couple weeks, more of like a game. I call it blood sugar ninja. And you have to don't look at your CGM. We don't trust the tech. Right? That's a big complaint out there right now. Don't trust your CGM. Don't look at it. Guess what your blood sugar is, and then check on the meter. And then report your results is something that I'm trying to push right now really hard to try to teach kids through their parents teaching them, like, to know what their blood sugar symptoms are. And you you can start out by saying, do you think you're high, low, or in the middle? Right? Because back in the day, we didn't have CGM. So anytime I was checking, I was going to either give insulin for a meal or something was wrong, and I needed to correct either be a high or a low.
Scott Benner Arne, is that actually a a valid way to figure out what your blood sugar is? You people can get accustomed to higher blood sugars and not feel it anymore. Like, you know, there's... hey. Listen. I'll I'll tell you, like, I appreciate the idea because I've done it as well. Like, hey. What do you think you are trying to get her to feel, like, whatever she feels right now and give her context for it? But I also told my daughter, if how you felt was a valuable measure, we wouldn't need this meter or this CGM. How do you balance that?
Arnie I think that's why you you check. You feel what you think you are, and you check. You don't rely on completely on what you feel. Just like you don't completely rely on the tech. Like, people will say, my CGM's telling me I'm this, and I definitely know that I'm not. It's a similar vein of that. Right? And I'm not saying that you should get rid of your CGM. I'm not saying you should get rid of your tech. But I think going through the, hey. What do you think you are? Or playing what I call blood sugar ninja.
Scott Benner Yeah.
Arnie And you're you're exactly right about people being accustomed to being higher. Right? So, ideally, your blood sugar's in range, you begin to feel how you're supposed to feel. You feel normal when you're in your normal range. Right?
The Illusion of Online Grievances
Scott Benner Let me go back to something we talked about earlier and maybe, like, warn against something a little bit. So you said I see people online that say they don't trust their technology. You see it a lot. Right? But we also said that people just like to complain online because that's the only thing that gets views. And when people are newer at things and don't understand how stuff works as much, they are more apt to run to the Internet to tell the Internet how bad this thing is.
Arnie Agreed. Yeah.
Scott Benner And I would just warn against this. We said earlier, if there's two million people living with diabetes and you see fifty of them online complaining about the Libre, you know, that means there's a lot more of them out there who are not complaining about it. It's easy to see people online complaining and thinking that's how things are going. It's hard to remember that most people aren't even online, and that online is a thing that drags people to wanna complain, to want to look for sameness in that complaint, to do the woe is me thing with other people because it feels easy and good and it feels comforting.
Scott Benner Contextually, I started writing a blog in February. I started making this podcast twenty fifteen January. This podcast has 1,800 episodes, like 21 and a half million downloads. It's, you know...
Arnie It's incredible.
Scott Benner It's in the top 30 of the medicine category in The US for, like, eight years and in, like, 45 other countries. It charts. And I see a lot of people and a lot of conversations. And what I can tell you is that when you get past the beginning part and get to the rest of it and go talk to those people again, they don't talk about it the same way anymore. So you have to be careful that you're not listening to the uninitiated or the recently initiated when they complain. Now I'm not saying that all the technology is perfect or that it doesn't need to be improved. I'm certainly not saying this. As a matter of fact, I'm spending a lot of my time over the last couple of weeks and then in the coming months doing a, like, a consulting kind of a thing with Dexcom to tell them all the things that I see people talking about that, you know, they're doing a lot of fact finding and wanna make sure they're doing the right stuff.
Arnie Thank you for doing that.
Scott Benner Oh, no. Please. I'm being paid for that. So don't worry.
Arnie But still, companies need feedback. So I appreciate you doing that.
Scott Benner Yeah. No. No. It's big chunks of time, like, when they do it. But, whatever. Like, you just make space in the calendar and and do it. Right? But, like so that's important. The other thing you learn when you sit down with a bunch of people who really know what they're talking about and are using the devices that they've figured out a lot of ways to not have those problems, or you start realizing the things that other people might be doing incorrectly that lead to some of the problem. Like, there's a lot more to it than just the thing is supposed to be perfect and the thing didn't perfect. And I'll tell you something. I hope it doesn't sound out of context and, like, pompous. I think I've used that word, like, three times today. But but I will tell you that I think that part of my job is to ignore what people think they need and give them what they actually need. I don't know if that makes sense or not.
Arnie It does completely. Yeah. Makes complete sense.
Scott Benner If you knew what you were doing, sometimes you wouldn't be asking the questions you're asking. And so when I sat down with that person to help them with their money, everything they were saying was wrong. You could tell how they got in that situation. And then they started offering ideas like, well, I tried this and I tried that and I tried this. I'm like, yeah. None of those things were gonna work. You don't know that because you don't have the context for it. Nobody educated you about it. Your parents didn't raise you well with this information. Right? Whatever. Switching that over to diabetes, when you hear people complaining, they are sometimes just complaining because contextually, they're lost or they don't have the right education or they don't understand something. And taking the cue from them about where to go next is only gonna keep you on their path. So anyway, that's a long long way of saying, like, be careful of how you judge the value of what's needed based on what you see people arguing about or complaining about on the Internet because they are the minority. They often don't know what they're talking about. And if they did, these aren't the things they'd be asking for help with. Does that make sense?
Arnie No. It does. And I appreciate that advice.
Scott Benner Yeah. No. Seriously. I you're gonna help people. You gotta help them, not just hold their hand while they're saying the wrong thing and go, yeah. Yeah. Yeah. Yeah. Yeah. Yeah. I know how much this sucks. Because you can tell them how much it sucks, but then you gotta get them to pivot from the thing they wanna do or the thing they're inclined to do to the thing that's actually gonna help them. And some people are gonna hear that and think, oh, that's just a person who's a little farther ahead on the path looking back and helping people behind. And there are some people who are gonna feel lost, hear that, and think I'm an asshole for saying it. Like, you don't understand me. You don't understand my life. Yeah. I hear you. But I bet, yeah, I could sit with you for a couple of days and make five or six little tweaks to ideas you have or things you do and put you in a different position, and you might think differently about this a week or two from now.
Arnie It's fantastic to watch people, like, human psychology, like, of those two responses. You think you're talking to someone about what you think they need and not what they're telling you they need, but they can't get to that path yet because that path hasn't been laid in their brain quite yet. It's it's fascinating to watch.
Scott Benner Believe what they see. Yeah. And there's no reason for them not to. Like, right, like, people don't make poor decisions. Forget diabetes. Like, people don't make poor decisions because they get up in the morning, go, I'm gonna make a bunch of decisions that six months from now will put me $10,000 in debt, and then two years from now will put me $25,000 in debt. Let's get moving on that. Every step along the way, this person I'm talking about was doing what they thought was right. They were trying. They just didn't have all the facts. And they were in a system that was, you know, hedged against them. They were already set up to lose. You know, you can't... and finances for people who don't have a lot of money and can't just buy their way out of a problem is very simple. Like, once you get behind, you're screwed. When you hear me talk about insulin, what do I say? Get ahead. Stay ahead. Right? Like, it's all the same stuff. Like, I try to say this over and over again. Like, I don't think about diabetes any differently than I think about everything else in the world. Like, you know, get ahead, stay ahead, have a good foundation, know the next thing that's gonna happen, trust yourself, trust what you know you see something happen, trust it. And it's hard advice to take, and sometimes it's hard to do in the moment, But that's why you go to someone else and say, I'm struggling. And then when you get to them, you tell them, no. You're wrong. Like, I don't help people one on one privately at all, and but I used to a long time ago before I had the podcast. Like, I was one of those people that somebody'd be like, you should ask that guy. He might be able to help you. And I've talked to a lot of people, but, like, at some point, your time becomes valuable. More people are reaching out to you. And I used to start these conversations by saying, listen. I'm sure you feel like you wanna explain to me everything that's happened to you for the last year, you know, and why you're in this situation. But with absolute respect, I'm gonna tell you, if you knew what you were talking about, you wouldn't be on the phone with me right now. So why don't we just start with what I think, and let's see where that gets you? And, like, I let people talk it out on the podcast because it's valuable when you're listening to hear their thought process and how it misled them because then, you know, you can say, oh, well, wow. I am... I'm doing that too. Like, you know what I mean? Like, there's a value for having that conversation that way. But when you're one on one with somebody, maybe other people are better than I am, but I don't have the fortitude to listen to your crazy path of bad decisions. Like, you you know what I mean? Like, I didn't let the person tell me, like, all the things they did wrong to get them in the debt. I was just like, yeah. Well, you don't know what you're talking about. Try this. And...
Arnie How does those past decisions affect your advice to them now? Yeah. It doesn't. It doesn't matter. No.
Arnie It's meaningless. You've sailed to the new world, and you burnt the ships. Like, we're at the new world. Like, let's go.
Scott Benner Yeah. Yeah. Yeah. Don't tell me how we got here. I know how we got here. Again, not because you were not trying.
Arnie Intentionally.
Scott Benner Yeah. Nothing intentional about it. Like, you just don't have good... it's the same thing with everything. Like, people don't parent poorly because they mean to parent poorly. Like, people aren't bad friends. Nobody's brain works that way. Maybe some people in government. But other than that, most people's brains don't work that way. And so, like, I just assumed they have good intentions, and now we're talking, which means they're motivated. And I don't wanna spend a lot of time hearing what went wrong. Now after you start talking a little bit and they get a little context, then sometimes it is interesting to hear how they made those decisions because you can help them not make future decisions with the same thought processes. I'm saying on day one when you're getting set up, I don't need to know what you think because what you think got us here. Why don't you try what I think for a second and see? And maybe I'm wrong too. God bless. I'm not saying I'm right about everything, but at least now you have a different perspective and you can sit back and try to absorb it and see if you think it's valuable. I've tried to help people with money in the past who have not taken my advice, and those people are still broke. But, like... and and still struggling. But this... I'm using this one person as an example who had the lack of ego to say, tell me what you think. I'm gonna try that. And then actually calls me every once in a while to say, hey, I'm doing great. This is where we're at. I'm up to this part. I almost got this paid off. No small stuff, man. Like, I made that person move back home with their parents. And by made, I mean, like I said, this is your only option. Right. You know what I mean? I was like, I'm I I didn't actually force them. But, like, you know, I said to, like, look. Here's what you need to do. I'm like, right now, you know, you're way out over your skis. You owe more than you're ever gonna make. Like, this will literally haunt you for the rest of your adult life. $25,000 is gonna ruin the rest of your adult financial life. You're never gonna get out from under this. And I was like, I think you need a clean start, and you need to think about how you spend your money differently. And so I talked to her about how to spend money differently, put her in a couple of different situations, got her out of a car that was messing her up. I called her parents and said, listen. You gotta let her move back home for eighteen months. You know, this is how this is gonna work. This is how this is gonna work. I basically told the parents, you need to take out a home equity loan, pay off her debt. She's gonna give you back this much money every month, and you're gonna have all your money back plus the equity loan will be paid off in eighteen months. She'll pay the interest as well for you. Then you need to let her stay a little longer to put away a little bit more money before she leaves. And then I took her, and I was like, you have to do these things. You are taking money from your parents. You cannot screw this up. Like, you absolutely have to do what you say you're gonna do. They need their money back in this frame of time, or you're gonna put them and you in a bad situation. So they're almost done now. They almost have their money back. She's, you know, almost to the point where she's saving money and getting going. She's in a car she can afford. She makes much different decisions with her money month to month. And I don't know. She might be back in this situation three years from now, but at least I know if it happens to her again, it's a decision she made, not a path she was set on before she knew what the hell she was talking about. And I don't know. Like, I don't think this diabetes thing is any different than that big picture thought wise. I don't think anything's different than that, really. Anyway, I'm sorry. So what are you gonna do? Let's say this comes out and, you know, five people get ahold of you.
Arnie Sure.
Scott Benner And you're like, I could charge some of them $500. Where's the courage of your convictions on this free thing? How long is this gonna go for?
Arnie I don't... I'll probably keep it going until I can't sustain it as free. The time becomes valuable so that free is not an option anymore...
Scott Benner Mhmm.
Arnie ...if I have enough demand. But even then, I don't know. Taking all this this day by day, and, you know, it it's been very interesting to see how my social media presence has changed. I started doing running dedication videos. I was dedicating training runs to kids. I put out, like, a basically, hey, if you want me to dedicate a run to your diabetic kid, I'll send in a little message and and share it on my story.
Scott Benner Mhmm.
Arnie And doing positive things like that, I think, has helped. Now do I get a ton of clicks on that? I don't know. I don't care. I've tried to maintain that views and clicks don't matter and that I'm not trying to make money off of this and that the person that I'm talking to is gonna see this when they need to see it.
The Mechanics of Tech Platforms
Scott Benner Yeah. They don't matter in your life. In the real world, they don't matter. They do matter if you're trying to build that thing up. I mentioned this the other day, so I feel weird saying it again. But, like, yeah, I saw a fairly big organization the other day put out this really great, like, well conceived, like, thoughtful social media content, it had two likes on it after, like, four days. I was like, oh my god. They must be, like, apoplectic over there looking at this. Like, I can't imagine all the money and time and people's effort that went into making this series of posts they put up that no one saw. Like, it's gotta be incredibly... I mean, gotta be. It's frustrating. But it was all good information. None of it was sad or, like, you know, what's that one thing they what do they call it? Like, like, sadness porn or something like that. Like... oh, yeah. It wasn't... it wasn't anything like that. Nobody saw it. I saw a big organization, a pump company do a live the other day. 13 people were watching it. And I'm pretty sure that the two people on the live count as part of the 13. When I laid on it, I was now part of the 13, and you gotta think that four or five people from the company were watching at the same time, like, a lawyer, stuff like that. And I'm like, oh my god. No one's watching this. So, like, I got super interested in it. I went back and checked it, like, a day or two later because I thought, well, you know, fine. Nobody watched it live, but it'll maybe it'll get views later. I mean, it was up to 490 views, like, days later. I was like, oh, god. I was like, all the effort and time. Like, there was a person on there. I know they paid that person to be in this video. And I'm like, 490 people. You could've walked outside and screamed, hey, does anybody have type one diabetes? You know what I mean? And then walked up to him and said, here's a pamphlet for our pump. Like, I mean, it might have been a better use of your time and a hell of a lot cheaper. It's just a weird world, and the algorithms don't want you to win. They want you to try. Like so listen. For anybody who's trying to do this, who wants the advice of a person who's been doing this way too long, Facebook, Instagram, TikTok, those kinds of places, they don't want you to be successful because you being successful means that you took their users and redirected them to a different link. And they don't want their users to leave their platform. They want them to live there constantly as long as they can so they can feed them as many ads as they possibly can. To Facebook, you are... it's the matrix. You're in a bubble and they're pumping ads at you. That's what TikTok's doing. That's what Instagram's doing. Instagram's owned by Meta. Meta owns Facebook. Like, these are, like, big companies making countless, countless dollars off of ad revenue. They can't serve you ad revenue if you're not in their system. So what they do is is they carry you, Arnie, and they carry me. They go, look. If you come here, you can build an audience, and you can build a life off of that audience. That's what they're saying to people. And then they get you in there, and you do all the work. You make the content for them. You draw in the people. You build the fan base up. You get people interested in what you're saying. You draw in more people from them. So they are using you as the magnet to bring in people that they can serve ads to. So the last thing in the world they're gonna let you do is redirect those people out once they get you in there. And then they're gonna give you a little success every once in a while so that you think, oh, it's getting ready to work. I just have to try a little longer.
Arnie I'm in control. I have control.
Scott Benner Yeah. It's like a slot machine. You're like, oh my god. Like, I'm losing. I'm losing. I'm losing. Then all of a sudden, some money falls out and you go, oh, I'm gonna put in another $100. Like, this is gonna pay me again. Then it does and it does and it doesn't. Then it gives you a little bit... it's like having sex when you're married. And then they give you a little bit again, and then you go, oh, I'll pull on this lever. I'm gonna get back into it again. Like, it's gonna happen again. It's gonna happen again. You're not set up to win. They're the house. You're going to lose. But in that time, you're gonna draw in... listen. I have 85,000 people in my private Facebook group. Right? Like, if I put up a link to something completely valuable to them, that algorithm will squelch it immediately. It will not let people see it. So if I'm like, hey, there's a list of doctors that could help you here... anything I might say, they're not gonna let you say it. They don't want you to leave. They want you there. So that is what you're all fighting against or that's what's being done to you if you're on the other side of it. It's not winnable. And they did a good job in the beginning of getting people like me, like, OG people like me to think, this was how it worked. Because I used to write a blog post and put it on Facebook, and, like, a 100,000 people would see it, like, twenty four, forty eight hours. It was insane. It's almost like they made some people big enough to make everybody else believe that it was doable. Do you know what I mean?
Arnie Right. Yeah. To get hooks in. Yeah. To for others. This is... this is appetizing. Yeah.
Scott Benner Listen. Like, I'm a fan of the mister beast videos. I like them, and I'm sure he's got a lot of good ideas. And I've heard him talk before about, like, a thumbnail needs to look exactly like this and this. Like like, it worked for him and you're not arguing about it, but, like, it's not rocket science what he's saying out loud. Like, he just did it. The algorithm rewarded him. He built on it. Now, I mean, he's clearly got a lot of business sense to, like, to propel it the way he has. But my point is is that if you took that all away and made that go away right now and let him start over today, if that algorithm doesn't decide that he's the one, then it just doesn't happen. Right. You know?
Arnie It's the casino. It's this... I refer to it as a social media casino. It's funny you said the slot machine. Yeah. That's what... that's what I call it.
Scott Benner It's exactly what it... and listen. I had a a lovely person that works at Facebook. It was nice enough to get on the phone with me one time. I was trying to figure out what I was doing, and I used everybody listening to the podcast. And I reached out, and I said, does anybody know anybody who works at Meta? And got ahold of somebody. Inside of five seconds on the conversation, the person said to me, I wish we would have had this conversation like a year and a half ago. I could have helped you. And I was like, what do you mean? And they said, oh, just recently, they took away our ability to turn up people's volume. And I was like, what are you saying? And she's like, basically, a year and a half ago, I could have just decided to make your podcast more popular on Facebook.
Arnie They control the throttle. Isn't that insane?
Scott Benner She said employees were allowed to kinda, like, pick and choose and amplify people when they wanted to. And I guess what was happening was that people were starting to sell it, so they stopped it from happening. Oh. But that's not the point. The point of it is I'm working my ass off trying to get good information out to people. And what you're telling me is is there's an invisible hand holding my top of my head where it is. And it can push my head down if they want to, or they can let it rise up if they want to. It's not my effort or the quality of what I'm doing that keeps me where I am. It's an unseen electronic force that says this is as popular as you're allowed to be.
Arnie Which sounds un-American.
Scott Benner Do you know, like, once a year, Facebook lets me have more followers for about six or eight weeks, and then it pushes me back down to the amount that I get. So, like, my group adds about a 150 new people about every three days. At certain times, it gets fewer, and then there's a gap of time where it jumps up so much that you realize that something else is controlling it. Because you don't go to, like... by the way, a 150 people every three days isn't a massive amount of people to add to a Facebook group. It's already a huge number. But once in a while, the throttle comes off, and I'll get, like, three, five hundred people every forty eight hours. And it'll go on for a while. And then it's almost like somebody notices it and just goes, oh, how did this switch get flipped? And then puts it back again. Downloads for the podcast work the same way. I do the same downloads day after day after day after day after day after day. Same unique people within a few 100. Like, it's pretty close. Right? And then a new iOS comes out for Apple, and it's clear they just didn't tune it exactly the way they want. And all of a sudden, thousands and thousands more people heard the podcast that day. And then they put out a patch to the iOS, and it goes back to where it was. It's really interesting. Like, you are not in any kind of control of this stuff at all. And that's my point of saying what I said earlier. It's like, you're trying to build a business on the back of that platform, you are setting yourself up to put a lot of effort and time and maybe money, blood, sweat, equity into something that literally somebody could just go like, oh, why is this switch like this? And then it's over. But everyone thinks that the switch is gonna get flipped the other way and they're gonna be mister beast when it's done. And I'm telling you, he's the guy. They're not gonna let that happen to other people.
Arnie Yeah. He... he escaped the asylum. Yeah. He's the one that... that got away.
Scott Benner He is it now. Yeah. They're beholden to him at this point. You know what I mean? Like, the lunatics took over the asylum is an exact right way to say, like... not that he's a lunatic, but, like, he got... you know, he broke out, and there's nothing they can do about it at this point. So, but that's not gonna happen. It's the same thing. I use this example so much, but my son used to play baseball with this kid. He was so nice, but he was so small. And his parents were really tiny, and they were just so sure, like, he was gonna play professional baseball. And he was so talented. Like, he was just tiny. You know? And his dad told me one day, he's like, oh, you know Dustin Pedroia? He points to, like, you know, the second baseman for the Red Sox back then. He was this little guy. And I was like, yeah. That's him. He got that. The league's not gonna fill up with five-five second baseman. That's not gonna happen. Then they go, well, Jose Altuve. And I went, okay. Well, there's two. I... you know, I'm like, yeah, I'm like, your kid's not gonna be the third one. There's not gonna be 50. I'm like, this is a random thing that happens to random people for random reasons. Not a thing you should plan for. Your five-six kids should not be planning to be a professional baseball player.
Arnie You don't plan to win the lottery. Yeah.
Closing and Community Links
Scott Benner Well, yeah. Exactly. I'm sorry. I talk so much during this, Arne. I almost feel bad.
Arnie No. You're good.
Scott Benner So I'll button this up for you here. How do people find you on Instagram or wherever you're gonna be? I hope this helps you. I don't know that it will, but, like, give people your socials.
Arnie If it does help me, so be it. And if it doesn't, so be it. That's kind of the great thing. Me being free, I don't lose or gain anything. I get incredible satisfaction from people who come back to me and go, hey, I did what you told me to, and and I'm feeling a lot better. I've... I've... I've improved. So I...
Scott Benner Feels good. Doesn't it?
Arnie Where my payment is. Oh, it's...
Scott Benner ...so good. Yeah. Don't that feel great when people are succeeding? Wonderful.
Arnie So my socials are at type underscore run underscore diabetic. Type run diabetic on Instagram. I'm not on TikTok. As a 38 year old man, I can only manage one and a quarter... I could say the quarter... I'm on Facebook as well. I can only manage one and a quarter social media platforms at a time.
Scott Benner It's a lot of work. And the worst kind of work, Arne. The kind of work that as you're doing it, you're like, I know I'm wasting my life right now. I...
Arnie Well, it's funny. I get to do it, and I'll... I'll finally think, like, I think I know what I'm doing, and then I don't. I get just... it's like the rug gets pulled out from under me. And not that I have, like, incredible content, but it's like, oh, I did a much better job editing that reel. You know? Oh, yeah. I forgot I still don't know what I'm doing.
Scott Benner And meaningless. And it doesn't matter. And it's gone. Yeah. No. What I've learned is is just hold the camera in front of your face and talk and don't even edit it. It's really not worth the effort of the time.
Arnie What I've learned is that me not being in my content is my best content. I have a post where I have a trunk full of diet soda. I went to the grocery store for two cans of green beans, and they were having buy three, get three free 12 packs of diet soda. So I bought, like, six different kinds and and took a picture of of all that in my trunk with the two cans of green beans that I meant to go there for. I posted, this is without a doubt the best time in history to be living as a diabetic. Yeah. And I do believe that sincerely whether we talk about Diet Coke or all the tech we have available, and it's almost at a million views.
Scott Benner Isn't that funny? Like, what?
Scott Benner Can I tell you I've never done anything that's gone viral ever?
Arnie I find that hard to believe.
Scott Benner Never. Never. Never. Never. My most popular blog post is a picture of a a guy with type one who's in such good shape that he's got, like, no body fat, and he's wearing his pod on his chest. And the idea was, like, hey. Listen. If this guy can wear an Omnipod, I don't wanna hear from your, "my kid's too lean."
Arnie Right.
Scott Benner And the other one was I took a picture of myself one time. I was exhausted. I put arrows all over it to, like, the bags under my eyes and all the stuff that was going wrong with me, and I was like, this is how you can tell your kid has type one diabetes. That's maybe the most popular thing I've ever done. And I think the ProTip series alone has well over, like, a half a million downloads, And the Omnipod five series has a lot, hundreds and hundreds of thousands. What I mean is, like, I've never, like, held my camera up, took a picture, and then suddenly been like, there's a million views on this. Like, I've... Right. Never once happened. I don't imagine it ever would. I don't even know what I would do if it did. Like, don't... I think it would matter. I saw this great video the other day of this girl's, like, making content, and, you know, it's pretty popular to tell people how much money you make, like, making content.
Arnie No. I didn't know that.
Scott Benner Yeah. There's a content level of just content creators showing other people how much money you can make making content. I hate that. I also hate the one where people tell you how to be successful. Yeah. Like, "I'm successful. You can be too." And I'm like, no. No one can...
Arnie If you have to say "I'm successful"...
Scott Benner Well, they are. They have a lot of views, but all they're selling is hope. They're just selling hope.
Arnie Yeah. Right.
Scott Benner All they're saying is, like, "Do you wanna get where I am? I know you do. Like, this is what I did to get here." And by the way, if you go to ChatGPT, which I know people have done and say, how do I make my stuff more popular? Everything it gives you back will not be valuable. It will be right. It's the only thing you can do, but it won't actually work. Like, all those, like, clip services, like, give us your content. We'll clip it up for you. None of that's going to work. None of this works the way you expect. So, anyway, I forget what I was saying even. We gotta go.
Arnie We were in the process of buttoning.
Scott Benner I was buttoning? What was I? Buttoning?
Arnie We were buttoning up.
Scott Benner No. Yeah. Well, we're done then. Arnie, I appreciate you doing this. I don't imagine this went the way you thought it was going to. I didn't know what we were gonna talk about before we started, and you maybe had the misfortune of coming on on a week where I've already been complaining about social media a lot with my recordings. But, like, I do really appreciate the conversation, and I hope you find a way to help people for free, and and I hope you're so valuable to them that it turns into a real business for you, and it's valuable. You know what I mean? So...
Arnie Yes, sir. I appreciate that, Scott. Absolutely. For having me on.
Scott Benner Oh, of course. Hold on one second. A huge thanks to today's sponsor, AbleNow. AbleNow offers tax advantaged able accounts for eligible individuals with disabilities. If you or your child lives with diabetes, you may qualify because of ongoing medical needs. With ABLE now, you can save for a wide range of disability related expenses without affecting eligibility for certain disability benefits such as Medicaid. And thanks to recent federal law updates, more people are eligible than ever before. Learn more and check your eligibility at ablenow.com. You spell that ablenow.com. There's links in the show notes and links at juiceboxpodcast.com.
Scott Benner I'd like to remind you again about the MiniMed seven eighty g automated insulin delivery system, which of course anticipates, adjusts, and corrects every five minutes twenty four seven. It works around the clock so you can focus on what matters. The juice box community knows the importance of using technology to simplify managing diabetes. To learn more about how you can spend less time and effort managing your diabetes, visit my link, medtronicdiabetes.com/juicebox.
Scott Benner I'd like to thank the blood glucose meter that my daughter carries, the Kontoor Next Gen blood glucose meter. Learn more and get started today at Kontoor Next dot com slash juice box. And don't forget, you may be paying more through your insurance right now for the meter you have than you would pay for the contour next gen in cash. There are links in the show notes of the audio app you're listening in right now and links at juiceboxpodcast.com to Contour and all of the sponsors.
Scott Benner If you've listened to any number of podcasts or maybe watched a YouTube video, you're very accustomed to listening to the creator of that content ask you and sometimes just outright beg you without any feeling of self respect for you to follow, subscribe, share an episode. The reason that happens in podcasting specifically is because podcast players don't have a sophisticated recommendation engine like YouTube or TikTok does. They can't watch listener behavior and then give you content that you might like. Word-of-mouth skips that line completely. It's an instantly expanding reach engine and really the only thing I've ever found that helps to keep the Juice Box podcast growing. So subscribe and follow because that the algorithm understands. Set up automatic downloads, listen to the show, but share it with somebody else. Leave a five star review. Make it a thoughtful review that the algorithm can understand. I really appreciate the time it takes you to do those things. And I hate that I have to say this to you because I feel like an idiot. But subscribe and follow, tell a friend, please and thank you.
Scott Benner If you're new to type one diabetes, begin with the bold beginnings series from the podcast. Don't take my word for it. Listen to what reviewers have said. Bold beginnings is the best first step. I learned more in those episodes than anywhere else. This is when everything finally clicked. People say it takes the stress out of the early days and replaces it with clarity. They tell me this should come with the diagnosis packet that I got at the hospital. And after they listen, they recommend it to everyone who's struggling. It's straightforward, practical, and easy to listen to. Full Beginnings gives you the basics in a way that actually makes sense. Have a podcast? Want it to sound fantastic? Wrongwayrecording.com.
#1853 Bolus 4 Sushi
This Bolus 4 episode details insulin strategies for sushi, breaking down hidden rice sugars, the glycemic stretch effect of cold starches, and tracking fats, proteins, and dipping sauces.
Key Takeaways
- The Meal Bolt Roadmap: Scott and Jenny utilize the "Meal Bolt" framework (Measure, Evaluate, Base units, Layer correction, Bolus shape, Offset timing, Look at CGM, Tweak) as a foundational pathway to map out insulin requirements for tricky foods.
- Hidden Sushi Carbs: Sushi rice is a short-grain, highly starchy rice. Its carbohydrate impact is further amplified by the traditional preparation process, which involves mixing the rice with a hidden sugar and vinegar blend to make it sticky.
- The Cold Rice Stretch Effect: Because sushi is served cold, the cooled starches digest differently, dragging out the glycemic impact over several hours. This unique physical property makes split bolusing and accurate timing critical.
- The Fat and Protein Factor: Popular specialty rolls feature significant amounts of protein (fish) and fat (mayonnaise-based spicy sauces, avocado, or fried components). Omitting these macros from calculations will trigger a massive, prolonged blood sugar spike hours later.
- Hidden Condiment Values: Dipping a roll into a "slurry" of soy sauce, wasabi, and pickled ginger introduces sneaky, uncounted carbohydrates and protein akin to ketchup, which can instantly disrupt an otherwise well-calculated bolus.
Resources Mentioned
Introduction and the Meal Bolt Roadmap
Scott Benner Here we are back together again, friends, for another episode of the juice box podcast. In every episode of bolus four, Jenny Smith and I are gonna take a few minutes to talk through how to bolus for a single item of food. Jenny and I are gonna follow a little bit of a road map called meal bolt. Measure the meal, evaluate yourself, add the base units, layer a correction, build the bolus shape, offset the timing, look at the CGM, tweak for next time. Having said that, these episodes are gonna be very conversational and not incredibly technical.
Scott Benner We want you to hear how we think about it, but we also would like you to know that this is kind of the pathway we're considering while we're talking about it. So while you might not hear us say every letter of Miele Bolt in every episode, we will be thinking about it while we're talking. If you wanna learn more, go to juiceboxpodcast.com/meal-bolt. But for now, we'll find out how to bowl us for today's subject. While you're listening, please remember that nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise.
Scott Benner Always consult a physician before making any changes to your health care plan or becoming bold with insulin. The episode you're about to enjoy was brought to you by Dexcom, the Dexcom g seven, the same CGM that my daughter wears. You can learn more and get started today at my link, dexcom.com/juicebox. Today's episode is also sponsored by the Omnipod five. And at my link, omnipod.com/juicebox, you can get yourself a free, what I just say?
Scott Benner A free Omnipod five starter kit. Free? Get out of here. Go click on that link. Omnipod.com/juicebox. Check it out. Terms and conditions apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox. Links in the show notes. Links at juiceboxpodcast.com. Jenny, hello. We are hey. Hello. Hello. Hello. Hello.
Scott Benner Hello. Alright. We're gonna talk about a food today for bolus four that I've never eaten. Well, that's not true. I had one piece one time, but I have never had beyond that sushi in my entire life.
Jenny Smith Missing out. That's what my boys if we have something special Mhmm. A birthday, a celebration, something, which by the way, Oscar just got his black belt. He tested last Saturday and was out of 20 some testers. There were only three who actually were passed all of the pieces through, like, a four and a half hour test.
Scott Benner What a nice accomplishment.
Jenny Smith It is. So he again, getting back to sushi. You know, we were like, well, we'll go out and we'll celebrate. Right? What would you like? And I already knew. Like, he's like, the sushi place.
Scott Benner Yeah. That's awesome. That's really
Jenny Smith Sushi is the thing.
Breaking Down Sushi Macros: Rolls and Rice
Scott Benner Well, I have a specific order here lined up for us to try to work through. Spice Spicy tuna to tuna. Spicy tuna roll. It says specifically dunked in soy sauce, wasabi and ginger slurry. No idea what that means. Macchi, nigiri, sashimi. Boy, this is gonna be fun for everybody to listen to. Tamakia, impact of sushi rolls rolls, California rolls, dynamite rolls. That's that's what they're looking for. So I'm gonna let you go because I don't I mean, how do you break this stuff apart?
Scott Benner I I let you know, for context for everybody, I asked Gemini to break down the nutritional value of these things. So I have something in front of me, but I'm I'd be much more interested to hear what you think about it.
Jenny Smith Yeah. So in general, rolls rolls is the whole entire roll that you get. Mhmm. Right? You may get in a roll depending on the location somewhere between six to eight pieces in a roll. The rolls can be considered small, meaning it's the diameter. Mhmm. Medium or the large are usually more like the specialty rolls. They've got a lot more sauces. They might have crispy onions on the top or that kind.
Jenny Smith So they're much larger and they're stuffed with a lot more usually like ingredients, not necessarily a lot more rice. But as you can see, wise, as that diameter gets larger, each piece is going to be more carbohydrate.
Scott Benner Mhmm.
Jenny Smith Right? So when you talk about something like a spicy tuna roll, essentially, you've got rice, you've got the tuna, and you've got usually usually, the spicy part also has fat. It's usually mayonnaise with some type of spice to it.
Scott Benner Okay.
Jenny Smith And the interesting thing about sushi rice is that one, it's a really it's like a short grain rice, so it's much starchier. It's also the way that they make the sushi rice that increases the carbohydrate content of it.
Scott Benner Yes. Because I read a little bit about that. Like, they like, to make the rice sticky, there's like a sugar mixture Yeah. Vinegar kind of mixture or something like that. Right? Okay.
Jenny Smith Absolutely. So again, not just rice, but you've got something increasing the carbohydrate content. Mhmm. So when you look at just like a spicy tuna roll in general, let's say it's eight pieces in the roll, you're probably looking at about four grams of carb per piece.
Scott Benner Okay.
Jenny Smith Okay. So eight pieces times four grams of carb a piece is what? About, let's call it 32. That's kind of on the lower end, honestly. Okay. For a spicy tuna roll, I'll tell you what I count. I count 38 because I figured that's I figured out what works.
Scott Benner It's like that's my number.
Jenny Smith And I do it often enough that and it's also, again, based on the place that I've gone over and over, kind of the content I've I've figured out. The lower thirties were too little, and it is this is the case where it truly is. It's an estimation. It's your best estimation. Yeah. Even if you fed a picture of what was on your plate to something like an AI, this is where you could get very varying results.
Scott Benner Wildly different, probably.
Jenny Smith They could be very wildly different. Mhmm. But in general, even if you just said, okay, a roll 35 grams of of carb in something like this. Again, the middle part is all protein, and the fat is the spicy kind of mayo sauce. And then you also have the carbohydrates that essentially come from the rice.
Scott Benner Okay.
Jenny Smith Protein becomes the secondary question. Not only carbs, but it's not a little amount of protein that they're putting in an entire roll. It looks little piece by piece. Mhmm. But if you consider how much probably goes in the entire roll, you're probably looking at a couple of ounces.
Scott Benner It's funny that because the breakdown I got online, which I have no idea if it's right or not, is and it's why this conversation is so interesting around this food specifically. It's almost a one to one carbs to protein for the roll. I don't know if that's accurate or not, but they that's how Interesting. That's how it broke it down.
Jenny Smith I would expect the protein to be less grams in a roll.
Scott Benner Okay.
Jenny Smith And again, this is based on facility. Right? The restaurant.
Scott Benner This one's gonna be your point about it all being different every I mean, this is really gonna be one. You are gonna get to eat a lot of sushi while you figure out how to handle this. Right? Yes. Yeah.
Jenny Smith Absolutely. My estimate would be that a sushi roll, again, spicy tuna specifically for this one, is probably three ounces of protein.
Scott Benner Okay. For the whole roll? Six to eight?
Jenny Smith For the whole entire roll. Which is about six to eight pieces is a typical roll. Mhmm. And so, you know, with seven grams of per protein per ounce, if we're looking at three ounces, that's around 20 ish grams of protein for the entire thing. Whereas the carbs really are more. Again, if you're estimating on the lower end 35 grams
Scott Benner Mhmm.
Jenny Smith It definitely does outweigh the protein.
Scott Benner And then there's fat in that as well. But
Jenny Smith And then the fat would be again on top of the roll typically or sometimes mixed within depending on how they make estimate is usually somewhere around 10 to 15 grams because again, it's mayonnaise.
Scott Benner Okay. This thing said 11. I'm going with you with 15. And so that whole roll then you're thinking maybe 35 carbs, maybe 15 fat, maybe 20 protein.
Bolusing Strategy and the Stretch Effect
Jenny Smith Mhmm.
Scott Benner Ice you know, when we do these, I keep insulin to carb ratio at 10, sensitivity at 50, targeting a 90 blood sugar. It's saying 3.5 up front and another one point o seven, one point one over four hours. I don't know if you agree with the four hour stretch or not, but basically, the theoretical requirement here is, like, almost 4.6 units for that.
Jenny Smith Mhmm.
Scott Benner Today's episode is brought to you by Omnipod. Did you know that the majority of Omnipod five users pay less than $30 per month at the pharmacy? That's less than $1 a day for tube free automated insulin delivery. And a third of Omnipod five users pay $0 per month. You heard that right. 0. That's less than your daily coffee for all of the benefits of tubeless, waterproof, automated insulin delivery. My daughter has been wearing an Omnipod every day since she was four years old, She's about to be 21. My family relies on Omnipod, and I think you'll love it. And you can try it for free right now by requesting your free starter kit today at my link, omnipod.com/juicebox.
Scott Benner Omnipod has been an advertiser for a decade. But even if they weren't, I would tell you proudly, my daughter wears an omnipod. Omnipod.com/juicebox. Terms and conditions apply. Eligibility may vary. Why don't you get yourself that free starter kit? Full terms and conditions can be found at omnipod.com/juicebox. You can manage diabetes confidently with the powerfully simple Dexcom g seven. Dexcom.com/juicebox. The Dexcom g seven is the CGM that my daughter is wearing.
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Jenny Smith I do agree with the four hour in terms of, like, that extended part, mainly because sushi is interesting. If you look at it just from a rice perspective, it's a pretty quick high glycemic index. Mhmm. It could be a quick hit. So pre bolusing becomes really important here. But there's a stretch effect to sushi and how it ends up digesting. I mean, you don't eat sushi warm.
Scott Benner No. Okay.
Jenny Smith Right? Alright. So we eat sushi cold, rice, like many starchy foods, and I'm sure you've heard about the noodle idea.
Scott Benner Yep.
Jenny Smith Right? You cook the noodles, you cool them down, you reheat them, or you even eat them cold, and it reduces the glycemic hit.
Scott Benner Mhmm.
Jenny Smith But it can also stretch out the glycemic hit. Sushi is kind of similar along with the fact that it's full of protein depending on what else you're eating with this spicy tuna roll. Yeah. So you're looking at a stretch effect that can be several hours. And that's where I think it it kind of trips up a lot of people thinking, well, gosh, it's it's rice.
Scott Benner It's also so small. I know that's It's small. It sounds crazy, but it's not that big of an amount of food. Yeah. Actually, to your point, the bolus estimator that is at juiceboxpodcast.com/bolusfour, bolus, the number four, it's saying pre bolus time, and I have this set up as the current blood sugar. I didn't even put it in, but I I I just put the the BG trend as stable. It says Uh-huh. It says nine minutes would be a pre bolus.
Jenny Smith Starting place.
Scott Benner Yeah. Yeah. Yeah. If I Could
Jenny Smith could be a good
Scott Benner If I put in a a current blood sugar of one twenty, it stretches it out to, you know, twelve minutes. But it's to your point of, like, food get you know, let's put a reasonable pre bolus on here.
Jenny Smith Right.
Scott Benner But not, you know, but at the same time, not too long because this is gonna get going here.
Jenny Smith And my my sushi strategy, again, my n of one personal experience has been with many, many sushi eating experiences.
Scott Benner Many, many, many.
Jenny Smith The best of which by far was in Lima, Peru, which is very weird. It was the best sushi that I've ever ever had.
Scott Benner Didn't expect that?
Jenny Smith It was amazing. But my sushi experience has taught me that I can bolus knowing what I've ordered as soon as our order gets placed Mhmm. And knowing now about how much sushi I eat, I pre bolus. It's fifteen minutes as long as my blood sugar is in target. And even if my blood sugar is just slightly trending down, I still do the same pre bolus.
Jenny Smith Mhmm. But I don't pre bolus all of the carbs. Okay. Instead, I pre bolus about 40% of the carbs that I expect I'm going to eat of the rolls that we've ordered.
Scott Benner Mhmm.
Jenny Smith And when the meal arrives, I enter the rest of it.
Scott Benner You put the rest in. Use the classic how to pre bolus for a little kid trick on
Jenny Smith It is kind of Yeah. That exactly.
Scott Benner Yeah. Little bit going.
Jenny Smith It's more based on what I know the extensive reach of sushi for me looks like. So for you. Bowl is all upfront, I'm gonna hit a low before it starts kicking in.
Scott Benner Right.
Jenny Smith So I pre bolus enough that I catch the first digestive, if you will Mhmm. Of the initial. And then because I bolus for the rest at the beginning of starting to eat.
Accounting for Protein, Fat, and "Slurries"
Scott Benner Then you have a heavier blanket on the second burst, basically. Yes. Yeah. Yeah. Yeah. Mhmm. It's interesting. Just so people can track along, I think this why this estimator is really helpful to kinda learn from, 3.5 up front, one point o seven on the back end for those four hours. If you just take the protein out, so I don't count protein on this meal, it keeps the initial bolus at 3.5, but the the Warsaw wave now goes to three hours and comes down by, like, point four, like a half a unit. So if you're gonna get a big push later, not only have you not stretched it out long enough now just by not considering the protein, but you also, you know, you also are not, having enough insulin.
Scott Benner Again, same idea. If you don't think about the fat, if you just go like this sushi roll is 35 carbs, this goes down to a 3.5 bolus with no consideration for later, and that must be what people are seeing. Right? They're not treating they should be treating this food almost like a burger and fries as far as, like, that secondary hit.
Jenny Smith And the fancier the rolls get, again, those specialty rolls, they tend to have sometimes they have a fried component to them because the shrimp inside might be fried or you might actually have fried, like, squid or eel. Like, there might be a fried fish component that's inside as well as the mayonnaise based types of sauces or the avocado that might be inside of your, you know, California roll, for example
Scott Benner Okay.
Jenny Smith Depending on how much you're eating. And then what you might also be eating it with. Like, I know we always before our sushi even comes
Scott Benner Mhmm.
Jenny Smith We really like the edamame. Have you ever done the edamame? You probably
Scott Benner Arden loves edamame. Yeah.
Jenny Smith Yeah. So much fun to eat. Like, my boys could each eat their own bowl Mhmm. Of salty, hot edamame. So we usually share some of that ahead of time, which is actually great because it adds a fiber coating component, a protein component before the sushi actually also kinda gets digesting and rolling.
Scott Benner Right.
Jenny Smith So think about what you're doing before you eat the rolls.
Scott Benner Well, let's talk it through a little bit. So soy sauce has carbs and protein in it that I didn't expect even. Not a lot.
Jenny Smith It's more minor.
Scott Benner Yeah. A tiny little bit, but, you know, two tablespoons, two carbs, two proteins. The pickled ginger doesn't have any.
Jenny Smith Oh, the pickled ginger is so good.
Scott Benner Wasabi paste has carbs in it. Again, teaspoon of wasabi paste looks like about three grams of carbs. So that slurry you're talking about, you know, when it it's all put together and by the way, whoever said slurry, like, thought they were making that word up, it's obviously a real thing. But it's, 10 carbs, two proteins. So it's one of those things. It's it's almost like ketchup. Like, it's really easy to be like, oh, I didn't I didn't really account for that. But we go back down to this meal. If you're, you know, if you're putting I don't know what you do with that slurry, but all of a sudden, you know, there's two more proteins, 22, and there's 10 more carbs. So now it's the the roll and the slurry. It it boom. You know what I mean? Like, here we go again. It's, it's now four units up front. That went up by a half unit, and the worst all weight kinda stayed similar. But now we're up to over five units just with with that Right. That that add You
Jenny Smith You add on a good component in looking at a lot of meals that have these little saucy kinds of things with them. Right? Mhmm. I mean, ketchup is a huge offender.
Scott Benner Yeah. Oh, no. Yeah. All the time.
Jenny Smith Nobody ketchup. Right?
Scott Benner Sugar, you know, basically.
Jenny Smith It is. And then in this example, with your insulin to carb ratio standard at one to 10 for ease in calculation, if this little slurry
Scott Benner Mhmm.
Jenny Smith Great word. This little 10 grams of carb, That's a unit of insulin that you miss.
Scott Benner Yeah. Yeah. Yeah. Yeah. And that can definitely make a difference. I mean, that's a 50 if if your insulin to carbon, your correction factor are truly well calculated Yeah. Then one unit of missed insulin can also create 50 more point rise than you would expect. Just like that. Right? Would a person eat a spicy tuna roll and a California roll, or is that too much food? Oh,
Jenny Smith no. Oh, okay. Like, if you were my children, oh, the more rolls, the better.
Scott Benner Well, then I'm telling you here, I'm looking at California roll, and the again, the spicy tuna roll estimate that I'm looking at was under your estimate. It says California roll, nine protein, 38 carbs, dynamite roll, 12 protein, 45 carbs, standard maki, 15
Jenny Smith The maki is just simple.
Scott Benner Yeah. But still, it's 15 it says 15 grams of protein, 25 carbs. Like, you know, sashimi has a lot of protein in it.
Jenny Smith It is. It's really sashimi is just it's without rice entirely. It's pretty much protein though. But again, if you are the person who goes and let's say you get the steamed edamame, maybe you get the oh, what is their soup called that they have? I really like it. Now it escapes me the name of the soup. Miso soup. Okay. There we go.
Scott Benner Right.
Jenny Smith I I mean, again, pretty pretty negligible. But if you are truly just doing a big plate of sashimi, you've got a lot of protein there that you're you should be expecting a hit down the road.
Scott Benner Three to four and a half ounces of thick slices, 22 to 25 grams of protein.
Jenny Smith Right. So in a and again, then they're pieces. They're not rolls.
Scott Benner Mhmm.
Jenny Smith So per piece, usually somewhere I usually say somewhere around five to seven grams per piece
Scott Benner Okay.
Jenny Smith In general.
Real-Life Meal Simulations & Learning Tools
Scott Benner Listen. I I'm gonna tell you right now. I think this conversation will help wrap your head around it, but this is just this is just Gemini. It's just Google Gemini. I didn't do it in Chad GPT. I didn't do it in Claude. I don't know if it would come up with different things or not. Yeah. But at least it's a starting point. Like, you're telling me that this one's a science experiment for sure.
Scott Benner Mhmm. And so at least start at a a reasonable guess. And all I did was took someone's order. It's a it's a listener who sent this to me. Yeah. Spicy tuna roll dunked in soy sauce, wasabi and ginger slurry, maki read it to you already. Right? I put it in and I said, I need a nutritional breakdown for all. Be complete. Be accurate. I need fat, protein, and carbs. And it just spit it back at me. I don't know if it's right or not. I mean, what the hell does right even mean? Like, you know, if each restaurant's gonna be different and each person's gonna feel impacted differently by it and maybe your settings are right and maybe they're not, but still, like, you gotta start somewhere.
Jenny Smith Yeah. And it
Scott Benner could be fun to be perfectly honest with you. Like, sit down at the table.
Jenny Smith Absolutely.
Scott Benner Yeah. Whip open your app. Ask your ask your ask your, you know, your world dominating minion in your pocket what it what it thinks. And then
Jenny Smith more you feed it, you know, this little helpful minion as it's like that consideration, truly. As you feed it the information, you can say, okay. I'm having a California roll. It is eight pieces. Each piece looks like it's about an inch in diameter. Yeah. So the more information you can give this type of system, it doesn't have parameters for distinct rules. Right? You have to feed it the information to get back the best cumulative that it's pulling from from all sources that it's looking at. Right?
Scott Benner Yeah. And this isn't a I mean, listen, this isn't an AI conversation, but as long as it got brought up I'm using Claude now mostly.
Jenny Smith Uh-huh.
Scott Benner And they recently added, like, some memory to it. Like, you can build in skills and and Oh. So, like, you could build a I don't know what you would call it. I don't know if it's a skill if it's, it it's not important. Again, this is not a this is not a Claude lesson, but you can basically teach it things about yourself. So you could say, you know, give me the the starting points for this meal and then get down to the point where you realize, like, well, this is what it actually took. I mean, you could easily add on to this and say, is my carb ratio. These are my settings. Here's what I tried this time. Here was my end result.
Scott Benner What should we try next time? And then say you figured out, and it's it ends up being like, this meal is this many carbs and this much fat, shush out over this much time. I've added in the protein, blah blah blah. You got it worked out. You go ahead and tell it, like, that's what worked for me. Right? Yeah. So now the next time you ask it for something, it'll probably be able to, like, say, oh, you know, I know the carbs say this, but, know, the last time that happened, it ended up being more like this for you. Maybe try this. And I'm telling you, like, that's not that difficult to figure out. So especially for these sorts of things. I mean, the reason sushi comes up is because everybody seems to struggle bolusing for sushi. Like, you know what I mean? When I'm seeing people online
Jenny Smith A 100%. Unless you test it and fiddle with it and expect that it's this is, again, not specific to sushi, but this is where you make a decision to try something and you say to yourself, this is entirely an experiment. I'm gonna use all the information I have from similar foods that I've learned to navigate well, and I'm gonna put in these strategies, and I'm going to see how it hits. Yeah. And then you end up making a change.
Scott Benner Right. But it but this is so much more focused and I think simple by starting with at least a better jumping in point, really, on on the numbers. Instead of just sitting down one day and going like, I don't know. I'll try this. Eating it, having your outcome going, I'm gonna go back next Friday night give it a whirl again. Like, although, you know, I'm sure you come to the same conclusion eventually.
Jenny Smith No? Yeah. Right. Correct. So, I mean, in a real world, like you said, would you eat just one roll?
Jenny Smith Yeah. Oh. Oh, no.
Scott Benner No. No.
Jenny Smith Yeah. Like, no. No. So let's I mean, let's put together a real life scenario. Right? Right. Let's say I mean, this person fed you a whole bunch of different things, but if we did what people tend to do, maybe especially if you're eating out for lunch on your own.
Scott Benner Mhmm. Let's say we take something like two spicy tuna rolls. We'll take some of the things from what you did. Two spicy tuna rolls, and we take, we like the salmon. So how about, like the salmon nigiri or nigiri? I never know how to say it exactly right. And we say, we're gonna have, let's see, four pieces of that. Okay. Okay. So as a cumulative then, what are we looking at in terms of macros? Like, our carb count goes up considerably from one roll.
Scott Benner I've been tracking you. I got what you were saying. The two rolls and the and the fish, 76 carbs, 30 fat, 44 protein.
Jenny Smith And that's on the light side.
Scott Benner Okay.
Jenny Smith That really would be on the light side. I mean, if you're looking at the nigiri nigiri, I mean, in pieces, you're probably looking at 35 grams ish from a carbo standpoint.
Scott Benner Of that.
Jenny Smith Yeah. Yeah. Yeah. Yeah. I mean, from, two spicy tuna rolls, again, if you use average 35 for a spicy tuna roll, but two of them, that's 70 grams of carb.
Scott Benner Yeah.
Jenny Smith Like, we're looking at a large amount carb.
Scott Benner And five in that at that point.
Jenny Smith At least. Yeah. Right? And then the protein. Right? Protein for what did we count for the sushi rolls? I think it was like 30. Mhmm. 25 or 30. Right? So that's again adding up how much protein in each of the rolls. If we go on the low end twenty, twenty five per roll, that could be 40 to 50.
Scott Benner I'll put in 50. And what do you think about fat?
Jenny Smith And then fat, again, spicy tuna. Each roll being, I think, I said somewhere between ten and fifteen. So probably somewhere between 20 to 30 grams of fat. Mhmm. And then you're looking at the other, right, the other salmon containing. Salmon's a little bit of a fattier fish. It probably has more fat. It doesn't have a sauce on top of it, but you're looking at carbs, protein probably similar to this the tuna rolls.
Scott Benner Mhmm.
Jenny Smith And you're also looking at fat less for that. I would say probably 10 to 15 again, total fat for those pieces. Okay. But So you've got you've got huge macro hits here.
Scott Benner Yeah. So if you if just following along with what you're saying, a 105 carbs, 45 grams of fat, 50 grams of protein. Fat in the protein, not something most of you are counting to begin with. I'm going with a stable trend on your, you know, and let's just say you started at a 90 blood sugar, which let's you're probably not. Okay? But, like, like, let's just say that you are. That's 10 and a half units. This is a one to 10, right, with a Mhmm. Insulin sensitivity of 50. So it's 10 and a half units up front, three units over it's now saying eight hours.
Scott Benner Like like, you know, so three units stretched out over eight hours still with, a nine minute pre bolus. It's 13 and a half units for sushi.
Jenny Smith It's a a lot of insulin.
Scott Benner Yeah. Yeah. Yeah. Yeah. And, again, we're not this is not a judgment. Right? Of course. You just have to consider though that if this is your meal, you have to also from a mindset standpoint, maybe your meals are usually more like six or seven units. And you're looking at this mouth thinking, my goodness. That's gotta be wrong. Something's gotta be wrong.
Scott Benner But but are you having that meal with your six or seven units in and then going up to 300 and staying there for five hours? Like, they this is your answer, really. You know? And again, just to make the point to everybody, if I just took 10 and a half up front, three over eight hours, if I just take out the 50 protein, it changes the back end, but it doesn't change the it doesn't change the front end very much. Right. If I take out the fat and no one's teaching you to bolus for fat, the complexity of this extended bolus is completely gone.
Scott Benner Now it's just telling you this is 10 and a half units for the meal. And we just said it might be not only 10 and a half, but my god, you know, another three units and stretched out over eight hours afterwards. That's a three unit impact. You're not getting it all with the amount of insulin, right, because you're not using it. Right. And you're not addressing the timeline after the food at all either. You're just looking at your regular old Yeah. Basal or, you know, if you're injected, it's just basal. If you're on a a a, you know, a regular old pump, it's just basal. If you're on an automated system, not only is it not there, but the automated system's probably taking the basal away.
Jenny Smith It might be.
Scott Benner Right. Right. And now you have now not only do you not have the three over the time, you you also have no basal either.
Jenny Smith No basal either.
Scott Benner No basal either. You could be diff yeah. You could be different deficient significantly, and you're seeing this crazy rise. And then you get on the phone to the pump company, you go, damn, pump don't work. Yes.
Jenny Smith Something's wrong. Something's wrong. It took all my insulin away, and I was sitting high. Well, you have to understand how the algorithms work.
Scott Benner Yeah. Yeah. And you have to understand these these impacts. I'm telling you right now, this estimator is a great way to learn this. I like just throwing in numbers and seeing, like, how does not accounting for this or not accounting for that or accounting for that correctly? How does that change the amount of insulin, the time that that insulin needs to be active? I think it's a really great learning tool. I really did build it as a learning tool. Yeah. You know, if you wanna use it otherwise, I probably can't stop you, but you are gonna answer a couple of, disclaimers on the way through. Ask your doctor about it. I would I would open this up at my doctor's appointment and say, like, hey.
Jenny Smith What do you think?
Closing and Community Resources
Scott Benner How come nobody ever mentioned fat to me? Can we talk about how to do this better? Mhmm. And if you're really, like, technically interested, keep scrolling down. It explains to you how the whole page works and the Mhmm. The estimator works and everything. Really just letting yourself know about that is, is probably the the the secret to the success a lot more. I'll even under I I might even say, it might even be even more valuable than understanding exactly how many carbs and fat and protein are in the in the sushi that you're eating. So thank you for doing this. I I really do appreciate it.
Jenny Smith No. It was super fun. A a a definitely type of food that I I I really like. We don't do very often, but I really like it. So thanks.
Scott Benner Well, the next time we get together, we're gonna do Mexican and Chinese. You're gonna love it.
Jenny Smith Oh, that's fun too. Bye. Bye.
Scott Benner This episode of the Juice Box podcast is sponsored by the Omnipod five. And at my link, omnipod.com/juicebox, you can get yourself a free what'd I just say? A free Omnipod five starter kit. Free? Get out of here. Go click on that link. Omnipod.com/juicebox. Check it out. Terms and conditions apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox. Links in the show notes. Links at juiceboxpodcast.com. Dexcom sponsored this episode of the juice box podcast. Learn more about the Dexcom g seven at my link, dexcom.com/juicebox.
Scott Benner Okay. Well, here we are at the end of the episode. You're still with me? Thank you. I really do appreciate that. What else could you do for me? Why don't you tell a friend about the show or leave a five star review? Maybe you could make sure you're following or subscribe in your podcast app, go to YouTube and follow me or Instagram, TikTok. Oh, gosh. Here's one. Make sure you're following the podcast in the private Facebook group as well as the public Facebook page. You don't wanna miss please, do you not know about the private group? You have to join the private group. As of this recording, it has 74,000 members. They're active talking about diabetes. Whatever you need to know, there's a conversation happening in there right now. And I'm there all the time. Tag me. I'll say hi.
Scott Benner 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 thirty five years of personal experience, and we break down complex concepts into simple, actionable tips. The diabetes pro tip series runs between episode one thousand and one thousand twenty five in your podcast player, or you can listen to it at juiceboxpodcast.com by going up into the menu. Have a podcast? Want it to sound fantastic? Wrongwayrecording.com.