#1962 They Thought I Was on Heroin
They Thought I Was on Heroin
Cynthia was told she had type 2 and put on Ozempic. Three years later she was found barely conscious in a school parking lot and spent three days in the ICU with a blood sugar of 120.
Jump to a moment
- She was misdiagnosed as type 2 for roughly three years. Cynthia is a Chicago teacher, now 40, who had gestational diabetes with both pregnancies and was told at 37 she had type 2. The early signs she noticed weren't the classic ones — her thick hair started coming out in chunks, and she had a constant sweet taste in her mouth, like a piece of candy that never went away.
- The crash came at work, and people assumed the worst. She was found barely responsive in a school parking lot. She later learned colleagues and a passerby had assumed she was on drugs, and rumors ran through the school while she was in the hospital. She drove herself to the emergency room, where staff were waiting for her at the door.
- Her blood sugar was 120 and she was in DKA. Euglycemic DKA — near-normal glucose with acid levels dangerously high. She spent three days in the ICU and two more on the floor, describing breathing so labored she couldn't finish a sentence. Her sister, a nurse, initially told her she'd be fine because she was just a type 2.
- The GLP that helped her got taken away. Her endocrinologist attributed the DKA to Ozempic and refused to prescribe it again, telling her the weight loss was the drug's doing and that she simply needed more insulin. Cynthia pushed back that she thought she was insulin resistant and was told she wasn't — she just needed a different ratio. She is now on a different GLP and down considerably in weight. This is her experience with her own clinicians, not advice.
- Scott's longest on-air rant in a while sits at the center of this one. Around the 45-minute mark he stops the interview to address the ADA, endocrinologists, insurers and diabetes organizations directly, arguing that people keep arriving at his podcast having already paid professionals who failed them. Cynthia's response is the part worth hearing: the podcast helped her figure out what to ask her doctors for.
- Diabetes Pro Tip series — Episodes 1000-1025 — settings, insulin timing, and food impact.
- Mental wellness series with Erika Forsyth — For anyone, like Cynthia, looking for a therapist who already understands type 1.
- Bold Beginnings series — Scott and Jenny Smith for the newly diagnosed — or the newly correctly diagnosed.
- T1D Exchange registry — US residents 18+ with type 1 — take the survey and support research.
Every word of the conversation
Cold open & sponsors0:03
Friends, we're all back together for another episode of the juice box podcast. Hey. 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. Well, I got a nice surprise about how many of you have gone to the t one d exchange to fill out the survey.
Got that email today. Let me say bravo. Thank you very much. But it's not enough. I need more of you.
T1dexchange.org/juicebox. If you heard it and you didn't do it, others did. Don't let them beat you. T1dexchange.org/juicebox. 18.
Type one diabetes. Complete the survey. All questions you know the answers to. Your answers will help to move type one diabetes research forward. Please go do it as soon as this episode ends.
And speaking of this episode, check this out. This episode of the podcast is sponsored by MiniMed and the Kontoor Nextgen Blood Glucose Meter. MiniMed, of course, the innovators behind the MiniMed Flex system, a small, sleek, and discreet insulin automated delivery system controlled from an app. Nothing comes close to freedom you can feel. To learn more, visit minimed.com/juicebox.
There is one blood glucose meter in this house, the Contour Next Gen blood glucose meter. That meter is on my daughter's person right now and at all times. It is incredibly accurate and waiting for you at kontoornext.com/juicebox.
Diagnosed type 2 at thirty-seven1:37
Well, my name is Cynthia. I am, 40 years old, and I was diagnosed, at the age of 37 as a type one LADA, after being misdiagnosed as a type two for a couple of years.
How many is a couple?
Initially, I was started oh, I got diagnosed in 2000. Right? Right in, like, around COVID time.
Okay.
And so that's the initial, time, but I did have gestational with my two my my two pregnancies. My first one was back in, 2012. And so they just diagnosed me as gestational, but I didn't have to go on insulin. It was kinda diet controls because I think I missed it by, like, a one marker or something. So, they just had me do diet control at that time.
Cynthia, can I
But I think it started from back then, though?
Let me just double check something because I you I think you misspoke or I misunderstand one or the other. You were diagnosed during COVID in 2020?
Yeah.
Yeah. Not 2000.
Oh, it's I said 2000. Sorry.
'20 It's fine. Was like I was like, was I not around was I not around for that other COVID? Back back then, I think they called it, the flu or something else. Yes. Nevertheless.
Okay. So you've you're three years diagnosed, a couple years more than that, something going on, but nobody's really telling you what's up. Can you describe those first couple of years from 2020 on? Were you paying any attention to it? Was it having any impact on your life?
Yeah. Well, I started off during that time, we were, like, doing renovations. We had just bought a house. My son was my my little one was about a year old, and we had the crazy idea of, you know, doing an addition to the the house that we had just purchased. Of course, contractors and everything, that kinda when we took the roof off the house and it kinda stayed like that for months.
And then COVID hit, so we had no roof to our house. And so we had to move in with my parents until we could figure out how to fix this mess that we had started. And during that time, you know, my dad was sick. We were living with them, my two sons, my husband, myself, in their house with our three dogs, both my two dogs and my mom's dog. So three dogs at that point.
So it was kind of hectic. And it started I'm a teacher, so I, like, had just started the school year too. I had just come back from maternity leave. Here in Chicago, we had just had the with the we had the big strike that happened also. So it's like it was kind of all at one time.
Mhmm. So I started where like, the like, I had, like, a sweet taste in my mouth all the time. Not necessarily always wanting to drink water, but always had, like, the like like, if I had, like, a piece of candy in my mouth twenty four seven.
Hair in chunks, and a sweet taste4:40
You know, no one's ever put it that way before.
Yeah. And so I was I like, I felt off, and I was always tired. And then, initially, it was my hair. My hair was like I had had really thick, thick hair. Everyone would make fun of my hair when I was little because they they would say it looked like a wig.
Like, I had a Mary Tyler Moore kind of Mhmm. Hairstyle because it was so thick, and it was just falling out, like, in chunks. And I would, like, take showers, and I I would clog the, like, the the tub every single time because there's chunks of hair coming out.
Oh.
And so I was like, something's going on.
Was Mary Tyler Moore wearing a wig? Now you have me thinking.
No. But it was like, I was a little girl, and so think of Mary Tyler Moore's hairdo on a little girl. So, like, even, like, the length flipped out.
Yeah. Yeah. Just way too much hair. Right?
Yes. Just way too much hair. So it looked like a wig, but it was just my hair was super thick.
I almost wanna see a photo of that. But and that stayed with you through your adult life.
Yeah. So I I always had, like, the thick, thick, thick hair. And it was funny because my my dad's side of the family has curly hair. So, like, my sister, my grandmother, my aunt, they all have the curly hair, but I have the straight thick hair. So I was like it was something I I always like my hair was my thing.
And so I noticed, like, it's coming out in chunks, and it was getting thinner and thinner. And I'm like and my mom would say it looked like a I had, like, a rat's tail of how thin it was. Like, if I will put my hair in a ponytail, it was just like it looked like a little thin rat tail.
What's the length of time between the thick hair and getting to the rat tail?
I wanna say maybe so I didn't go into the doctor. So September, October I went into the doctor, like, in January, and it was around September, October that it started, like, coming out. Like
Okay. Five months maybe. Yeah. That's quick.
Mhmm.
Yeah. Yeah. Were you worried about anything else, or was the hair, like, the only thing you were noticing?
The hair was the only thing I was noticing, and then, like, that that candy taste in my mouth Mhmm. Was the next thing.
And once that came, that was 247?
Yeah. Once I came, it was 247. I didn't, like, have, like, the, like, immense thirst. I just had, like, that sweetness in my mouth.
Okay. Did people say your breath smelled differently?
No. I never no one really said anything.
Okay. Okay. And you're married at that point and everything. So Mhmm. So it's a thing
He never really said anything.
Yeah. And so it's a thing you're noticing, but maybe not a thing other people are noticing. Or Mhmm. Had you been married long enough that you hadn't kissed him in a couple of months?
I mean, that too.
Right? That's, for young people so you can feel sad about what's coming. That's all.
Well, we're high school sweethearts, so we have been together for a very long time at this point.
Cynthia's like, I used it up. Okay. It's okay. So these two things are going on. Do you do you decide to go to a doctor about it?
I do. Well, it ended up, because there was one night that I just felt really, really off. And my mom's a type two, so it was my dad. And so, my mom said, well, how about you just check your sugar if you feel like your that sweetness in your mouth is, like, not going away?
Mhmm.
And so I checked my sugar and it was, like, 300 and something.
Oopsie.
And she's like, oh, I think you have type two diabetes. It's it runs in the family. And so, of course, I'm I start crying. I'm like, I don't want this. And so finally, after I had checked my sugar, she gave she's like, which, of course, we should not do, but she's like, here.
Take a metformin. Take one of my metformin so it could bring your sugar down Mhmm. Until you get a chance to go to the doctor. So scheduled the doctor's appointment, and I went and I told them, like, you know, what was going on. And, of course, it was like the initial was just my hair is falling out.
It's coming out in chunks, and I have this sweetness. And I checked my sugar, and it was 300 and something. And so they checked my a one one c, and at that point, I was at, 14.5 a one c. Okay.
The Kontoor Next Gen blood glucose meter is sponsoring this episode of the Juice Box podcast, and it is entirely possible that it is less expensive in cash than you are 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, Meijer. You could be paying more right now through your insurance for your test strips and meter than you would pay through my link for the Contour Next Gen and Contour Next Test strips in cash. What am I saying?
My link may be cheaper out of your pocket than you are paying right now even with your insurance. And I don't know which meter you have on you 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.
Kontoornext.com/juicebox. And if you already have a contour meter and you're buying test strips, doing so through my link will help support the podcast. Let's be honest. Most of us would love to spend less time thinking about diabetes. That's exactly what MiniMed had in mind with the new MiniMed Flex system.
It's small and sleek, you can control it from an app, and it uses the trusted smart guard technology that automatically adjusts insulin every five minutes. Less juggling, less micromanaging, more freedom. That's the MiniMed Flex system available now at minimed.com/juicebox. There are links in the show notes and links at juiceboxpodcast.com to Contour, MiniMed, and to all the sponsors. When you click on my links, you're supporting the podcast and helping to keep it free and plentiful.
And when I went in, I think my sugar was close to, like, the four hundreds at that point, and that was, like, without eating anything because I was, like, first thing in the morning. Mhmm.
And and they just assume you're type two then?
Yes. Okay. Just because my parents are type two. I'm of Hispanic descent, so, of course, you know, it runs in our culture. Mhmm.
I was overweight, and so they're like, okay. Type two. And that was it. It was just like an a one c and, put me on metformin, and let's, and then he's figure out how to change your diet, and do a little bit more exercise.
You're making me can I cut you off for a second? I'm sorry. Yeah. You're making me, mad about something completely different. But I was talking to someone the other day about ways to help people with type one diabetes and whether or not doctors or, institutions would get behind this idea.
And the person was like, well, they're gonna want data. They're gonna want this. They're gonna want studies. They're gonna blah blah blah blah blah. And I was like, isn't it and it just made me think, like, isn't it funny that people who would say, oh, I can't tell anyone that.
I don't care if you say it works because I want studies and data are willing to look at you and go, oh, your parents have type two. You're overweight and you're Hispanic, so you have type two. Like like, there there nobody wanted to study there. Nobody want Yeah.
It was just, like, initial. Like, that's what it is. Yeah. Go for it.
Yeah. I I I academic people get on my nerves sometimes. This is one of those this is one of those times.
Oh, you'll you will we'll have many more Oh, oh, please. That would upset you as well. Go forward.
Thank you.
So yeah. So there's, like, change your diet. Change, do some more exercise. Lose weight, and you're gonna it's all correlated. So at this point, my my grandmother, my maternal grandmother, who I at this like, after listening to your podcast and listening to different stories, I think she probably had type one.
But, again, culturally, like, we're more known to have type two. And then it's, like I don't know if it's just my Hispanic family, but I feel like all Hispanic families are very hush-hush when it comes to, like, medical things. They don't tell, like, everybody, like, the actual things that are going on. So then, like, you know, assumptions and things happen. But I think she did have type one at that, but it was as far as the family knows, it's type two.
Okay. But she passed away. She was on insulin, and she ended up passing away, of a low blood sugar in the middle of the night.
Oh gosh. Oh, how which how old was she?
She was she was young. She was, like, in her seventies.
Oh, no kidding. Yeah. Oh, that's interesting. How long do you how long did she have a diagnosis?
As as far as I remember, like, all my life, she was always diagnosed. And I that's why I say I like, after listening to the podcast, I think she was type one because she, like, did, like, a I remember her having, like, a drastic weight loss and everyone being concerned, like, that she was so thin and then that she was on insulin. And then I remember, like, she actually passed away on 09:11. And I remember she they had told us that she had passed because she had taken insulin to go to sleep ahead and eat in anything and then passed in her sleep from a low blood sugar.
Losing weight and feeling worse14:22
Dear god. That's a lot. Mhmm. Oh my gosh. I'm I'm I'm so sorry.
I and now you're gonna wonder forever if, like
If that way if you if that was, you know, what she really had or not. Yeah.
Yeah. Okay.
So, like, as me being told, like, you're a diabetic, that was the first thing that came to my head, you know, like, oh my god. You're gonna die too.
Oh, did you say is that how you felt? Mhmm. Oh my gosh. That's how do you get through that? Like, how do you, like, push through the idea of somebody just told me I'm gonna die?
Honestly, I don't think I have.
No kidding.
Sorry. Oh, no.
I didn't I'm sorry. Didn't realize you were getting sad. I'm sorry. Take your time. If you're willing to answer, I'd love to hear more.
I I mean, I will. It just I don't think it has actually said it yet. Like, I still feel like that's a fear of mine.
That you that this is gonna take you? Yeah. Is there something going on that makes you feel that way?
I don't know. I think it's just the lack of knowledge. The lack of, you know, me I'm still trying to learn, trying to navigate things.
After three years, it still feels like that?
Yeah. After three years, it still feels that way. Okay. I mean, I've come a long way. I will say that.
But I'll still I still won't eat certain things just to avoid the high blood sugar or having to give myself insulin to the point where, like, maybe I miscount and then I drop. And then Yeah. So, like, going to sleep sometimes, it's like, oh, I have to look I, like, triple check my sugar before I go to sleep just to make sure I'm at a level where I'm I'm okay to go to sleep. Mhmm.
But if if you go to your physician, they tell you you're doing okay, or do they tell you like, and does that because my my thought here is that if every like, what's your a one c right now?
So I'm down to a 5.2.
Oh, wow. Jeez.
So yay.
Way to go. But but so as far as your physician's concerned, you're probably a model patient. There's nothing wrong and nothing you need.
And that's the thing, and I think that's where it kinda get worried because, again, like, it was like, do your diet, do your exercise, you'll you know, like, that's how you get over type b and type two. And I did. I I I was two hundred and ten pounds at the time of diagnosis, and I cut out, like, all carbs, all sugar. And, of course, it was COVID time, so it was so much easier for me to just, like, you know, go out and exercise and watch what I was eating because I was at home instead of being at work. So I did.
I I ended up losing, I was down to a hundred and sixty pounds, but my sugar was always high. Like, no matter what time I would check it, it was always, like, one eighty or higher. Mhmm. No matter what. And I could eat a I could eat a salad with just nothing on it, and I would just, like, spike.
But, again, I was a type two in their eyes. And I would tell them I would tell my doctor, and I'm like, why is it all like, why am I always so high? Why is it like, my hair's still falling out. Like, what am I doing wrong? And they're and from coming down from, like, the 14 a one c, I was down to, like, an eight a one c from just cutting out, like, certain foods and doing a lot of exercise.
Yeah.
But it was just like, well, see, you're doing everything good. You've lost this weight, and your a one c's down to an eight, and that's perfect. That's what you should be at.
Because you're moving in a positive direction. There's no need to give you more information. They think you're getting to it. Mhmm.
Okay. But It was just like, you're doing fine.
But you don't feel like that?
No. I felt crappy, crappy, crappy. And it wasn't until, I wanna say, it was maybe two years into being a type two that I kept telling them, like, something's wrong. Like, my sugar doesn't come down. It's always high.
I'm always tired, like, all this stuff. And so then my primary care is like, okay. Well, what about if we go on Ozempic? That would probably help you lose more weight, which would then bring down your a one c even more and then would help your sugars at the same time. And so that's what I got went on.
I went on the Ozempic, and it did. It helped me lose more weight. I was down to, like, a hundred and thirty pounds.
Mhmm. How tall
But, again
How tall are you?
I'm five four.
How much did you lose?
At that time, I was two hundred and ten pounds, got down to a hundred and thirty.
Seventy pounds? Mhmm. How long did that take?
Probably a good three years.
Yeah. It's awesome, isn't it?
Yeah. I mean, at the time, I was like, great. Now I'm losing all this weight. I was like, this is awesome, but my sugars are still not, like, where they should be.
Yeah. Thanks. Help.
Something's alright, but at the same time, I'm fitting in these size four pants.
So there's positive stuff with your weight. Nothing's changing with your blood sugars?
No. At that time, nothing.
Okay.
And I think, honestly, I think like, I went on that whole keto diet thing, and I was hardcore, like, hardcore with it for a long time. And I think that probably delayed going into DKA for a while because of the way I was eating. But, again, I was not eating any carbs, any sugar. Like, life was bland. Mhmm.
Found in the parking lot20:23
And it wasn't until that September of my of well, before I oh, when I was 37 that, my husband's job had a something, like a conference in Hawaii. And so I was like, oh, I'm definitely, you know, jumping along this conference.
And so he's like, I'm thin, and we're going to Hawaii. Let's
do it. Yeah. So we went to Hawaii. And from all these, like, past years of not eating, like, carbs and sugar, my husband's like, you're on vacation. We haven't been on vacation in forever, and we're in Hawaii.
You know? Like, live a little. So, you know, I I would eat a little sandwich here, a little carbs here, and just something, like, not over the top, but I was eating way more carbs than I had for years at this point. Yeah. And we were there for, like, five days.
And the night before we came, my husband started with, like, a stomach bug.
Mhmm.
And we came back home. He had the stomach bug. And then the next day, I, like, started throwing up. And I'm like, man. I'm like, you gave me whatever you have.
That stomach bug you have, you passed it on to me. And I got to the point where I remember going to work, and I just sat in the parking lot, and I couldn't get out of the car. Like, I was just, like, so tired, and I couldn't like, I fell asleep in the car. And then, like, a coworker passed by, he's like, you okay? And I was like, oh, yeah.
I'm fine. Got out, went into, like, my classroom, put my head down on my desk, and fell asleep again. And then, like, they the the bell rang and I woke up and I'm like, oh my god. Like, I fell asleep again. And I just couldn't stop throwing up.
Yeah. And so I asked my principal at the time, like, I can't. I I, like, I can't keep my eyes open. Like, I'm running to the bathroom twenty four seven at this point. I need to go home.
And so I asked for an early dismissal that I got coverage. I went home, and I just fell asleep. And, again, thinking I had a stomach bug. The next morning when I woke up, now I couldn't breathe. And so I called my doctor who was on vacation, and he's like, well, I can't see you.
But you know what? I think you should go to the emergency room. Just given your your sugars and everything, I think you should go to the emergency room. But I think he already knew what was going on because by the time I got to the emergency room, like, they just rushed me in.
He called us out?
I think he did. Because when I came in, he's out there, like, who's your doctor? And then I told them, and they're like, okay. You're so and so. And I'm like, yes.
And so they just rushed me in away.
You know that while you were going in the hospital, that guy that found you in the parking lot was on day two of telling people you're on heroin. You know that. Right?
Oh, yeah. Yeah. Pretty sure. Yes. Because even my principal, when I after I told him I was, like, in the ICU, he's like, oh, okay.
Yeah. Because, you know, everyone was talking about you falling asleep. There I'm sure rumors went rampant.
They were like, she was nodding. It was definitely fentanyl. I saw it. Yeah. Yeah.
I know they I saw her doing something in the parking lot.
People were already trying to get your job. It was happening.
I'm sure.
“Why are they waiting for me?”23:45
So you get to the hospital. Are does it hit you then how dire it is that they're waiting for you?
No. I was just like, why are they, like, waiting on like, wait. What? Like, something's up. Great service.
Throwing yeah. I was like, oh, this is awesome. Maybe I should come to this hospital more often. But then they started putting, like, an EKG machine on me, and then I guess I had, like, irregular whatever beats it does. And then they started throwing out DKA, and I'm like, what is that?
I don't know what DKA is. And at this point, I'm by myself because I just drove myself to the hospital.
Yeah.
And and then, they're like, okay. We're sending you to ICU. And I'm like, why am I going into the ICU? And barely like, I couldn't even catch my breath. I felt like I had just run a marathon, but I couldn't like, my breathing was so labored.
I couldn't, like, take enough breaths of air to, like, be able to talk.
Yeah. Cynthia, you're describing dying, in case you're wondering.
Yes. Yeah. Yeah. I was yeah. And I didn't know how bad it was until, like, I called my husband.
And I'm like, well, I'm here in the emergency room, and I'm going into the ICU. And he's like, why? I thought I was just a stomach bug. I'm like, they're saying something about DKA. I don't know what that is.
Hey, mister Live A Little. Could you get over here and help me out, please?
It was yeah. And then so then they send me up to, like, the ICU, and they started putting drips or whatever. But my sugar wasn't high, so I guess I was on u uglosimic TKA. So my sugar was, like, one twenty when I went in. Okay.
But, I guess, my acid levels were off the roof, which went into, like, the DKA.
A blood sugar of 120, and three days in ICU25:26
Yeah. How did it take them days to clear that for you?
Yeah. I was in ICU for three days. After that, then they took me out of the ICU into, like, the regular floor. And then I was in regular the regular floor for, like, another two days.
Are you pretty whacked in the ICU, or do you have time to think?
No. I was fine. Like, after they started, I guess, putting in whatever drips they were putting in, the next day, I was fine. Like, I wasn't as tired anymore, and my, like, breathing wasn't as bad. So I was able to actually, like, look up what DKA is, and I'm like, what is this?
Hello, Google. Yes. And my sister's a nurse, and my aunt's a paramedic. And so, like, I messaged my sister. I'm like, hey.
I'm in the ICU. Apparently, I have DKA. And then she's still like, she did it. Like, I guess, even that, she's like, really? Why?
Mhmm. Like, it wasn't, like, clicking into nobody. Like, you'll be fine. You're just a type two.
Oh, everything's fine. That's what we do over here. Mhmm. I see. Yeah.
Yeah. Yeah. I I listen. I say this all the time, and I say it out of love and and concern. But, when nurses end up being the parents of type ones, they so frequently come on here, and they track as, like, maybe the worst prepared.
And and I think it's because that the the information they do get through nursing school and the jobs they have at the hospital, I think they they can believe that that's the entirety of what diabetes is.
Mhmm.
And and not understand the bigger picture. Because it's gotta be a letdown to, like, to text a a loved one who you think has, like, a background. They're like, ah. No. Like, no.
Seems pretty serious. And and they're like, nah. You'll be fine. Mom and dad
You'll be fine. It's okay. You'll you'll yeah. Like
We get it.
Mom, dad has it. You'll be fine.
Yeah.
They're probably wrong.
They don't call it the sugars in your in your culture. Right? Like, do down south in in, like, Georgia, Florida, that area.
They do. But they say, like, La Sukar. La Sukar.
Oh, it's nice. It sounds
So like the sugars.
It sounds nicer that way. Well, you but you understand at that point, not type two, or has any of that not been
said yet? It's still, like it's they were just like, oh, you're you're in DKA. But, again, still, like, in my brain, like, I'm type two and NDK. And I'm like, okay. I don't understand how that goes.
Mhmm. And it wasn't until, I guess, like, the diabetic nurse that comes and shows you how to, like you know, you're gonna insert insulin into yourself, and this is how you do it. That's when I was like, oh, okay. So I'm not a type two. Yeah.
And she's, like, showing me how to, like, you know, pull insulin out of the into the syringe and how to inject. And as as she's telling me this, like, it's going in one ear and out the other. And, again, going back to, like, my grandmother, like, the whole insulin thing scares the living
Mhmm.
Crap out of me. So then I start crying, like hysterical crying, and she's looking at me, she's like, you're fine. You're it's gonna be okay. And I'm, like, trying to tell her. I'm like, no.
I'm gonna die. Like, you don't understand. This is, a death sentence. And then there's, like, the doctor who was the endocrinologist. He's out in the hallway, and then they call him like, he sees me, like, having this hysterical meltdown, and they he comes in.
He's like, why is she crying? And then she's like, well, she's upset because of the insulin. And he's like, well, why? She'll be fine. And I'm like, over here, even more cry.
Like, he doesn't understand. This is, like, the end of me.
I got another, another guy over here with the, live a little. It's what that's a doctor?
Yeah.
Just what are you upset about? Oh, you're wrong to be upset?
Yeah. It was and that was even worse for me. Like
Yeah. Well, what is wrong with everybody? Do you think something? Do you you ever sit and wonder? Do you have you you're old enough that you don't worry about it anymore?
You just go, oh, no. I'm just gonna get to the end of my life. I I still wonder. I I still sit around and think, like, why would someone dismiss you like that in that setting from that position of power and not see that as not the thing they should be doing. You know what I mean?
And, again, it was and and it was just like, oh, you're a type one, and it was just, like, something that they threw out there. It wasn't like they explained anything to me. It was literally just, oh, you're not two. You're one. Now you're on insulin.
And, again, like, from my culture, like, type one is the bad diabetes. You know? And so, again, thinking, like, oh, it's the bad one. I mean, you're gonna die.
Also, you thought the good one was gonna kill you. So yeah. Yeah. Wait. I listen.
I'm not a professional, but just for everyone listening, in case you have a job that, you know, you might intersect another person and have the opportunity to ruin their life for them a little bit. When someone says, oh my god. I'm so upset. You say, oh, tell me why. Mhmm.
Not you shouldn't be. That's a funny thing you say to your wife when she's upset, and then you wanna have a fight on a Saturday. It's not a you go, oh, just calm down. Like like like, why would someone
do Like, you're making a big deal out of nothing.
Yeah. Yeah. Yeah. Yeah. What what don't worry.
Don't worry. Like, I'm worried. I don't know what to tell you. Like, I'm not calm. I can't just not I mean, if the world worked that way, everything would go much.
If you just had to look at somebody and go, be taller, be calmer, be the and go, oh, I didn't realize. I'll just do it. Like, that's just ask questions. When people tell you they're upset or they're worried, ask a follow-up question. Let them tell you how and then if you have some knowledge that will be valuable to them that they don't have, you just sprinkle it into the conversation as you're talking.
Learning it was LADA31:19
And I don't understand how people don't understand. I a doctor. You know what I mean? Like, I don't know, Cynthia. Oh, keep going.
Alright. So now you you alright. Now you know you don't have to be upset anymore because the guy told you. And and then where does it go from there?
So at that point, that's when I was like, I have no idea what's going on. I I don't know what what to do now. So then they sent me to, like, the regular floor. They put in, like, an insulin drip.
Mhmm.
And this is another, like, off the topic story. But in the as I'm in the bed with, like, you know, this insulin drip on my arm, I feel like liquid coming down my arm. And I'm like, oh my god. Like, now I'm squirting out liquid. Where why is why am I squirting out liquid?
But, again, I don't know why. So I call the the nurse, and I tell her, like, hey. There's, like, a bunch of water coming out of me. Is that supposed to happen? And she's like, oh, yeah.
I think one of your IVs is leaking. And then she walks out and never comes back. I'm like, okay. So this time, like, it's, like, 02:00 in the morning, and I'm messaging my sister. I'm like, hey.
I think I'm dying. There's water coming out of me, and she doesn't come back.
No one cares. Also, get when I look at my bill later, this bag of saline is gonna cost $5,000. It's running down my arm. Mhmm. And, really, I think your IV is leaking.
Never returns.
Nope. So then I'm over here trying to figure it out. I'm putting, like, blankets on the bed to, like, soak up all this little saline, like, whatever was coming out, and then, like, wrapping it around my, like, arm. And I'm like, yeah. I'll just, you know, die a slow death here.
Everybody needs to do better. I I really believe this. I I need you all to try a little harder. I need you to do I I listen. Fair is fair, Cynthia.
My job is not a real job. But I do a really good job of it, and I work really hard at it. And I feel attached to the idea that I should follow through and at least do the things I say I'm going to do or the things that someone's paying me to do or whatever. I I can't I really can't understand that. I I know it's listen.
I'm sure that a nurse would tell me, I'm sure that she was really busy. It wasn't emergent. She planned on coming back. Something else happened. I I could hear all the excuses right now, and maybe they're all legitimate.
But it doesn't matter to you, the person who's three days into this packing blankets around themselves going, I told you I was gonna die. This is it. In the middle in the middle of the night while your sister's like, leave me alone. It's very late. And yeah.
Oh my it's just not right. I I I don't know. Like, I I'm not a I'm not a, like, chicken soup for this whole person. You you know what I mean? But, like, we could all just do a little better.
It's not it doesn't take any extra to do a good job. I actually think it's easier to do a good job than this to do a bad job.
Too much effort into having to do a bad job.
Yeah. I I say this all the time, but it it's I see so many people so put so much time and so much effort into pretending they're working. I think I don't think it would have taken that much effort to actually just do the thing. And I don't know. I I give up.
They well, they didn't kill you. I mean
They didn't. No.
They tried, I guess, but it didn't work out. Didn't work out for in their favor. They were trying too hard. And you're online learning about diabetes, I imagine, in the hospital. You sound like you're motivated.
Yeah. So, I mean, I was I was trying to figure out. I was going through, like, Facebook pages and, like, trying to, like, oh, like, where do I go? Like, what do I do? And then I kept like, told my husband.
I'm like, hey. Like, I left my book bag in my car with my computer. Can you come and grab it and bring it to me so I could do more research? And he's like, dude, you're in the ICU for a reason. Let it be.
We'll figure it out. So he would not bring me my computer to do, like, more research than I could.
He was watching a ball he was watching a ballgame when you for sure. He's like, I I the kids. I got the kit. By the
The kids. I gotta take care
of them. You got kids. Right?
Yes. I have two.
Two. Yeah. He's like, oh, no. No. The kids meanwhile, the kids, he gave them a ho ho.
Sent them upstairs. It's a 100% watching a ballgame. And he's like, oh my god. Like, I'm sad that Cynthia's sick, but the house is so quiet. No one's bugged me about the dishes or the trash.
I'm just gonna sit here. I might call a buddy and smoke.
You have a cigar in the backyard.
Yeah. My god. What up? I I know this would be like a vacation for me. No.
But but but your instinct is I gotta learn more.
Yeah. And I I still couldn't because I still hadn't said, like, officially, like, what what it was. You know? It was just like you're in DKA, and, like, you were so close to dying. Like, you're lucky that you came to, like, the time you came because, you know, it could you got could have gone into a diabetic coma or you could have not woken up at all.
And I'm like, what what is this DKA they keep talking about?
Yeah. And isn't the liquid important?
Yeah.
Yeah. I swear to you. I could get lost in this moment. I this is this the I I I understand that in the in the in the moment, the nurse and nobody's thinking about it the way you can think about stuff when you break it down in hindsight and everything. But my like, my god.
You're really in a panic. You were just told you almost died. Somebody stuck this in your arm. You got to imagine because you need it, And now it's running down your arm and nobody's helping you. And then you're like, well, let me learn more about it to see if I should be panicked.
Your husband's like, you don't need that. And so and by the way, he's also not wrong. You're in the ICU. You're supposed to be sleeping.
Yeah. And that's what his, like like, his that's what his reasoning is. Yeah. No. He's right, by the way.
Yeah. According to according to him. I gotcha. But but, you know, he's being reasonable. Everyone's probably being reasonable.
No one is living in the situation you're in right now. Mhmm. Yeah. But then what I think the unintended consequence that people don't see is that three years later, when a stranger brings it up to you, you start to cry. You're still upset.
You know what I mean?
Yeah.
Yeah. I'm not gonna make you cry again, are you? I'm sorry. I didn't mean for you to do that. By the way, if you're gonna cry, do it out loud so people can hear it.
It's better for the market. Yeah. Yeah. Don't don't hold it in like that, Cynthia. That's just dead air.
Really if you wanna wail a little bit
That would work.
Throw your hands up, talk to Jesus, whatever you're gonna do. But but but seriously, so okay. You you wake up the next day, you get out of the ICU, etcetera. Like, when do you get ahold of your laptop?
So I I don't want until, like, a home pretty much. Mhmm. And then they give me the name of the an endocrinologist that the hospital recommends, you know, to follow-up with. I call, and they're like, oh, she's booked until next year. I was like, oh, great.
So in the meantime, what do I do? So I like, they've I I guess they gave me some I get their assistant, somebody else that was available. Regardless, she never really saw me. They were all virtual appointments.
Mhmm.
So, again, never really explained, like, what how is it that I went from a type two to now a type one. What is it that I like, how is it that I went into DKA? None of that. It was just you're type one. You're on insulin now.
We're gonna get you a pump, and, you're going oh, and a CGM. But in the meantime, I need you to schedule an appointment with our dietitian to figure out how you're going to do this. And I'm like, well, I don't need to any dietitian. Like, I've been, like, not eating carbs for how long. Like, I just need to know figure out, like, what's next.
Yeah. Cynthia's like, do you see me? I'm skint y. What's going on? Yeah.
Yeah. I don't need that. That part I got under control. Have you heard about Ozempic? Yeah.
Jeez. And by the way, a dietitian, that person doesn't help you with insulin. Right?
So the he did, like, the sense of, like, how telling me how to cut my carbs, which also didn't help because it's still like, that's still an area a gray area for me. But I keep telling him, like, well, I'm very low carb. I don't eat carbs. Like, what do I do with this insulin? How much do I give myself?
How much don't I give myself? And so they scheduled me to come in, and he like, the first thing was like, oh, why are you here? I'm like, I don't know. They told me to come see you. And they're like, oh, okay.
So it took him a while to, like, figure out why I was even there. And so I guess he scheduled me to get the the pump. So I got onto the Omnipod, and then I was on the CGM, the Dexcom.
Fighting to get back on a GLP40:08
Do you ever see the do ever see the movie Falling Down where Michael Douglas is on his way to work one day at his office job, and he just gets out of the car in traffic with a machine gun and just loses his shit.
Yeah. That was me probably.
I swear to you, if that dietitian would have said to me, why are you here? I would have been like, okay. I'm good now. I'm gonna I'm gonna go flip out somewhere. Why are you here?
Unbelievable. I swear to god. I anyway, Falling Down's a great old underrated movie, that you should that you should check out. And you'll think, oh my god. One day that man will marry Catherine Zeta Jones, which is odd.
And I know you don't know who Michael Douglas is. You're so young.
I do. I do.
Oh, you do. Okay. Thank god.
I'm an old soul.
You're an well, I swear to you. Like, I just I would feel like everyone is telling me I'm okay, and I'm not okay. And then when I I go to someone, it's not the person I want to talk to. And when I get there, they're not helpful either.
No. Not at all.
That's been your situation. That that's been your experience
so far? Yeah. This whole time. This whole time, it's been like that.
Okay. So the dietitian what did you mean you the, the carb counting is a gray area?
I still I mean, I count my carbs now, but I think it's also it's so they took me off of the Ozempic because, of course, they said Ozempic was what caused my DKA as well. So they took me took me off of it. But in taking me off of the Ozempic, like, my sugars were back to, like, being up and down in a sense.
I feel like I I can't take this. I'm gonna flip out. And while we're I'm gonna call this episode falling down in a second. Okay? I the one thing you had going for you, they were like, give that back.
Yeah. And then and that's one and so even and so she took me off of it. Like, the endocrinologist took me off of it because, like, of course, that's what caused my DKA, and that's why I was there. So I can tell you that. Probably kept you alive.
That was probably the only thing that was keeping me alive at that moment. Yep. Okay. Alright. Alright.
So I went down from, like so I was at a hundred and thirty pounds, when I got diagnosed. And then in a matter of months No.
No. No. No. Don't say it because I'm thin now. It makes me upset to say it out loud.
Don't say it. But go ahead say it.
How much I went up to, like, a hundred and eighty
pounds. No. No. No. No.
Well, that's healthier. You're you're fine. Everything's and did the endo go, oh god. I'm sorry. Take the Ozempic back?
Well, she goes, well, you know that the only reason why you were on, you were a hundred and thirty pounds was because of the Ozempic. Right?
Yeah. Thanks. Can I have it back now?
And so she would not give it back. She said no. And so, like, I like, my primary care, I like, bless his heart. Like, I love him. He's not and he's he'll tell you straight up.
I do not know anything about type ones. He's like, give me type twos. I know how to manage you. But when it comes to type ones, I'm not comfortable with it. And so I'm like, okay.
At least you're honest with me. Right? And so he's like, I I don't mind putting you back on Ozempic if the endocrinologist thinks that's a good idea for you. Again, I don't know how that works for a type one. And so I told her, and she goes, well, you know you're gonna have, you know, what is it, pancreatitis
or whatever. I wish you could see me right now. I my both of my fists are balled up, and I'm pressing them into my cheeks. And and I'm I let me say this real quick, Cynthia. Nothing you hear in the juice box pocket should be considered advice, medical or otherwise.
Always consult a physician before making any changes to your health care plan. Now that I've said that, just all listen to me. Okay? Or just Google something or or ask a hobo. I think you'd be better off.
I can't be I Cynthia, why is this making me so upset today? Why no. Because I had that conversation yesterday with the guy about how to help people. Everything we do is counterintuitive. Everything.
Everything institutions do until you find a good doctor, but they but you're gonna be crazy by the time you either figure this out for yourself, learn to ignore the doctor, do what you're gonna do, somebody into giving you the meds you need, blah blah blah. All the bullshit that goes on for the I'm gonna start cursing. I can feel it. And and, like, all the stuff that people have to go through and the hoops they have to jump through. Meanwhile, I look on LinkedIn, and I see a bunch of academics patting each other on the back.
They can't stop packing each other. We're helping people. We're helping people with diabetes. Oh, oh, we have a program. You're not helping anyone.
Scott has something to say44:39
I how come I talk to a new person every day that doesn't seem to be helped? And then I go online and see you all telling me how much you're helping everybody. Like, this is the this is the stuff you guys put into play. This is what happened to Cynthia. All the high minded shit that you you're gonna do, and we're gonna do this, then she'll see a dietitian and blah blah blah.
You hear me ADA? All the stuff you're doing leads to this over and over and over again. And then they come to me to find out how to take care. Is this gonna be the end of this story, Cynthia? Did I save you?
Just say it now.
Actually, I will say your podcast did help me. It'd be it helped me to figure out what it is I needed to tell my doctors. Like, here, do this. Check this. Give me this.
Yeah. That's my point. Is that, like, you went to professionals, paid them money. Insurance, by the way, hey. Are you listening to insurance?
This is what you're paying for. Okay? Mhmm. Then you're then then all this is going on. Everybody's trading money back and forth and pats on the back back and forth.
And in the end, people named Cynthia are walking around 40 for no reason with an a one c that's too high with blood sugars that are bouncing around for no reason because not one person that she's intersected knows a damn thing about how to help her. She has to go to her GP who who says, well, look, I I'm okay writing you the script, but not unless that person says okay. Everybody's passing the buck, throwing each other under the bus, and the and in the end, you die. Like, that's the end of all this. Mhmm.
Yeah. Yeah. Yeah. Everyone should be ashamed of themselves. There.
Okay, Cynthia. I'm sorry. The Endo said no to the Ozempic. What happened next? Must be mother each I'm sorry, Cynthia.
I told you I wasn't gonna curse at the beginning. Go ahead. Go ahead. I'm sorry.
No. No. You're good. You could MF everyone for me.
I well, unbelievable. Right? Like, really, I try so I I say it nicely on other episodes. I say things like, oh, if you went to get your tires changed, the guy didn't know how to use the impact gun. You'd think that was strange.
I'm trying to get people to pay attention to the fact that they have a job and that people count on them and that it's important and they do a terrible job mostly, except for the ones who are doing a good job who will get insulted when they hear this. Listen to me. I'm not talking to you. I'm talking to the rest of them, and you know who they are because you're sitting next to them in a cubicle right now. So don't act like you don't know and get all upset with me.
I didn't do this. Now go on. Now I'm sorry. I'm gonna stop. I'm gonna push the microphone away so you can talk.
Go ahead. Go ahead. I'm sorry. Jesus Christ.
“You just need more insulin”47:03
No. You're fine. Go ahead. But he it's all she told me that the reason I had lost that weight was because of Ozempic, but the Ozempic caused my DKA and that, all I needed to do was increase my insulin. And I told her, well, your insulin, I feel, is what's causing like, I don't think like, I feel like I'm insulin resistance.
This is, again, coming from one of the podcasts I was listening to. And so I said, I'm like, I think I'm insulin resistant. And she goes, No. No. No.
No. You're not insulin resistant. You just need to increase your insulin to carb ratio. I'm like, well, wouldn't that be what insulin resistant is?
Wouldn't that mean that I'm need more insulin and Mhmm. Insulin's
a Insulin.
Storage hormone and your nutritionist didn't and I'm not eating anything because you weren't eating anything. Right?
I was not. Like, I and that's why I was like, man, I should just eat the damn cheesecake if no no matter what.
If I'm gonna die, why am I not having cheesecake? That's the first thing. And can I ask a a detour question for a second? Mhmm. When you were heavier, were you still not eating a lot?
Like, was your diet okay, or did the diet change because of the Ozempic?
No. I was not like, I was trying to listen to what my doctor said and, like, lower my my, carb intake and do more exercise. And, also, I was I was miserable. I probably still am miserable because I still don't eat the cheesecake even though I've
but I still miserable as a t shirt, by the way. I would like to say to people listening, if any medical people have made it this far. If not, it's just for all of us to be angry together. But if any medical people are listening, some people's bodies don't work right. If GLPs have not taught you that in the last couple of years, you're fundamentally not paying attention.
I lost 14 pounds in seven days on my first injection of Ozempic on a nontherapeutic dose of Ozempic. My body doesn't work right. And on OGLP and let let me say this. I don't care about your studies. I don't care about whatever you wanna say that has to be done.
It doesn't matter. It works. Okay? It doesn't matter. If I I again, if I grow a horn out of my head because I take a Zepbound now, if my horn says Lily diabetes up the side of it or Lily on this, I will put lights on it and celebrate Okay?
Because it has changed that much for my because, well, we don't know what's gonna happen. I I definitely know what was gonna happen without the Zepbound. I was gonna have a heart attack and die. Maybe a stroke. Who knows exactly?
Right? But everything about my life is better now. I have more mental clarity to yell at you people. All the aches and pains in my body are gone. I've, lost 70.
I still eat exactly the same way I did before I started taking Zepbound. People like, oh, well, you don't eat as much anymore. I eat exact I eat the same stuff. Do I eat less of it? Yeah.
But not that much less of it, and it wasn't terrible stuff to begin with. You would have followed me around when I was heavy, watched me eat, and thought, this is the fattest guy that doesn't eat anything that I've ever seen in my life.
And that was me. That was me.
I know. Yeah. Because you and I have the same thing wrong with us. I I 100% know. I I knew as soon as you told me you lost all that weight on the Ozempic.
It's it's not it and I don't I don't have time. You don't have time for everyone else to figure it out. All these, like, academic people who are gonna sit around, they're gonna wanna see twenty twenty five studies. They're gonna want the ADA to say it's okay, and they're gonna want this to happen so they all can stop throwing each other under the bus. Well, if that one says it's okay, then I'll say it's okay.
Nobody's got the courage of anything. They're just spineless for the like, nobody wants to help you. What they want is for them not to get in trouble. And if you die in the process, then so be it. That's it.
I I'm so sick of this shit. I swear to God. I don't know why I'm so upset today. I have two meetings later with clients. I'm gonna have to calm down.
I I You're breaking. I'm just blaming Cynthia.
A guy just ask me. In an extra room of his house with a podcast. First of all, shouldn't have 22,000,000 downloads. I have 22,000,000 downloads because you all don't know how to help these people. And, and my common sense is outweighing your well, we'll have to wait and see.
We'll we'll wait for a study. Double blind, maybe. And then I don't know. Five, ten years from now, maybe we'll have enough to go on and blah blah blah blah. We're all gonna be dead then.
Okay? Five, ten years from now, if I wait for those people, I'm 65 years old and seventy pounds overweight. You think I'm gonna make it much longer that way? The other day, I was in a room with people who were who were ten years younger than me. They looked fifteen years older than me.
And all I could think was, you ought to go on that GLP. Right? Tell them about the mental clarity. I haven't even asked you. I'm just gonna assume.
Tell them about it.
Oh, yeah. Like, every from as soon as they took me off the Ozempic, like, I felt, like, that fogginess, that brain fog just, like, completely consume me. Yeah. Not just, like, the brain fog, like, that comes with, like, you know, being newly diagnosed or anything, but I was I I was here, but I wasn't here. Like, my body was here and functioning, but I wasn't.
Yeah. You know that movie with Bradley Cooper where he takes something, he gets really super smart?
Mhmm.
It's called limit is it called limitless? Unlimitless?
Think, yeah, limitless.
Not really important. It was not a great movie. The premise was awesome, and he was good in it, but somehow it didn't pay off. That's between you, and I don't wanna do a movie review right now. But also Bradley Cooper's from Philly.
What's up, man? Go birds. And, but the but the this is not the point. The point is this. I am the real life version of that.
Like, I'm not obviously, like, for the movies. Like but I everything about me is clearer and sharper. I was just explaining to somebody yesterday on the podcast. When I get to the end of the day and I have to go to sleep, I'm disappointed. Like, I'm tired and I go to sleep.
Don't get me wrong. But I think, oh, no. I have so many I I my brain's still going. And not in, like, an ADHD, I can't go to sleep way. Like, I'm excited to be alive kinda way.
I don't if that makes sense. But but but if you're a doctor and you're listening to this and it doesn't make sense, stop worrying about whether it makes sense and just say, oh, it happened to Scott. It happened to Cynthia. It happened to the girl that Scott was talking to yesterday. I wonder if maybe I should get out of the way.
You know what
actually, like, help them.
Yeah. You're the you're the impediment at this point with her diabetes, with her weight. Like like, you're the impediment. Anybody who says, oh, I don't know or I'm not sure. What they mean is I don't wanna get in trouble.
Mhmm.
Yeah. Your health isn't worth my risk is what they mean. So either, like, nut up or get out of the way. Seriously. I'm so done with all this.
Cynthia, we're never gonna get through your story. Alright. I'm sorry. I swear to God. I'll stop talking.
Oh my god. How did you so you you did go online. I I by the way, I was not fishing for a compliment. I just assume if you're on this podcast, at some point, you're gonna tell me after this factocta story that, like, you got to the point where you're like, I gotta take care of this on my own.
Well, that's that's what happened because no matter how many doctor's appointments and, she never like, the endocrinologist never saw me in person. It was just, like, a virtual meeting and would never answer my questions, and it was always like, no. Just up your carb insulin to carb ratio. Mhmm. That should help.
And so I was like, no. Something's gotta give. Like, I don't I don't understand what's going on. I don't know. So I started going through Facebook, and there was, like, a diabetes, like, Facebook group.
And I've I forgot what the name of it is, but they recommended your Facebook group. And so I was like, okay.
Getting the pump, and getting it working55:02
Yeah. By the way, listen to what she just said. She went to a diabetes Facebook group, a diabetes Facebook group. And in that Facebook group, they were like, you know what you should do? Get the hell out of this Facebook group and go to the one for the juice box podcast.
What does that say to you? Like, if it doesn't say something to you, you're I I might have had enough of this. I might have to pivot. I I need another job. I I can't do this anymore.
I I mean, I'll figure it out. But, like, it's so unnecessarily damaging and frustrating. And if people listening aren't thinking, oh, I really have to do better, then I don't I don't know what to say. Like, I I I really like, if you're listening to this and you have control over someone's health and you're okay with all this, you really are as much of the part of the problem as the disease itself.
Mhmm.
So anyway, I'm sorry. You went to Facebook. They led you to my Facebook group. By the way, Juice Juice Box podcast type one diabetes on Facebook. Currently, 86,000 active members.
Go ahead.
And so I I did I, like, I found your the the podcast, and I just hit click play on the late the latest one. And I'm listening to it, and they're telling their story. And I'm like, great. You know, like, I'm over here crying with them and laughing at them. I'm like but I still don't know what to do with what's going on with me.
Right? Mhmm. So I went on the Facebook page, and they said, like, I have all these questions. How do I get these questions answered? And so that's when someone on the group sent me the list of the pro trip pro tip series.
Yeah.
And so I was like, oh, this is exactly what I need. So that's I started like, I went back and started, like, with each pro tip series on, like, explaining certain things. Because even, like like you said, I think you said in one of the podcast, like, MDI and bolus and like, all those words were, like, gibberish to me. Mhmm. Because even, like, the endo would, oh, you need to, like once she said, up your insulin to carb ratio.
I'm like, great. What does that even freaking mean? I don't even know what that is, and how do I even do it?
Yeah. I'll just do that. I'll supercalifragilist XPL, whatever the hell you just said. Right. Yeah.
I by the way, I, again, figured that out. I made the podcast. I made the content that I knew helped people. Then I made the the Facebook group. And then you notice when you ask a question in my Facebook group, you don't get told, don't worry.
You're okay. You get
in there. Not gonna die.
Yeah. Hey. Shut up. Okay? Let the thing drip down your arm.
We couldn't possibly care less. No. It's not that. We I've, I think there's 13 people that helped me with that Facebook group. All volunteers.
By the way, everything you've heard about free. Podcast is free. The pro tips are free. The Facebook group. Nobody charges you for anything.
And when and and still when you ask a question of a person who's not your physician, who is not being paid to help you, they make sure that you they understand your question, and then they move you in a direction that will be actually valuable for you.
Mhmm.
Yeah. They listen, they reflect, and they give back. Right? Like, that's it. A doctor could do that.
Which side note, my son who was in second grade, his teacher is a type two. And she was sick a couple days, not, like, sugar related. I think she was going through, like, you know, basic teacher and germs
Yeah.
Things. But he was concerned, and he thought, like, oh, I think it's her sugar. You know? Like, just like you, mom, I think it's her sugar. She's a diabetic too.
He doesn't know, like, a lot of the difference between one or two.
Yeah. But Well, could be a doctor then. Go ahead.
Well, he calls the next day she comes to to work, he he goes, you know, you really need to, like, work on your sugars. Maybe that's what's making you sick. You should go listen to the juice box podcast. My mom listens to it the time, and she's learned a lot.
What's that boy's what's that boy's name? What's that boy's name?
Xavier.
Xavier, thank you so much, buddy. You just you took all the anger out of me just now. Thank you. That's lovely.
But he told me, and then I was like, really? And I didn't like I'm like, he's probably just you know? He's just saying it. But then the teacher told me he's like he's like, yeah. He told me to listen to the podcast because I can learn a thing or two about it.
I'm like, oh, I'm like, oh, you do listen to me, Xavier. You do listen around.
I swear to god, that's the nicest thing I've heard in quite some time. Like, seriously, like, your son saw enough in another human being, and instead of telling them that they'd be okay to shut up, he said, you know, here's something I think might be valuable for you. Ain't that lovely? Alright. I get okay.
I'm back. I can I can I can I can do it a little longer? But I swear to you, I I'm saying this I I don't know. Cynthia, have you taken the survey yet? I have a survey on my website, juiceboxpodcast.com/survey.
And it's just to see how the podcast has either helped you or not helped you or whatever. It's a it's and you take the survey, and, in a week or two, I'm gonna be making the results, public. But, the results are are pretty staggering already from the first 150, 170 people who have responded. And I showed it to a person who's in this space, you know, who works in this space, a scientist. And he looked at the data and said, this is fantastic.
Like, nobody does this. Like, he's like, this is the like, what are you gonna do with this? And I was like, I don't know. And his suggestion was, you should show it to health care systems. They should probably be giving your podcast to people upon diagnosis.
If this is the outcomes, like, that people are having, then, you know, they're being it's free. There's no reason not to hand it out to people. And I and I thought, yeah, that's actually a really good idea. Yep. Just the pro tips of the bowl beginning series, like that kind of thing.
Yeah. Because, like, that's a two year your, you know, two year horn or whatever the saying is. But you did. Like, it it gave me the information I kept asking, and I wasn't getting the answers to for me to go back and be like, this is what I want. This is how I can kick this endocrinologist out the window and, like, find a new one because I did end up going I think in one of the podcasts, you guys had mentioned, like, going and looking at, you know, the list of doctors that, you know, the
Oh, another resource of mine for free. Juicejuiceboxdocs.com. Go ahead. Yeah.
So I did. I ended up finding one of the doctors that was on your list, switched over to her, from she's at Northwestern, and, like, she's been, like, one eighty completely different from what I had. Like, she actually sees me and touches me and, like, you know, spends, like, an hour, if not more, with me answering questions. And, like and before I leave, she's like, you sure? You don't have any more questions?
Like, I love you. You know? Like, thank you for answering them.
Seems like she'd be upset if you died, that kind of thing. Yeah. Yeah. Like, she seems human. Is that what you're saying?
Yes. Awesome. So she actually put me back on, Mounjaro.
Hey.
So I've been on Mounjaro for that one. Like, so she took me off of she's like, well, won't go with the Ozempic route because she did put me on Ozempic. So when we came back went with her, she put me on Ozempic, but it wasn't it was, like, really slow progressing. So she's like, let's try Mounjaro. I've heard that those Mounjaro might be a better fit for you.
Yeah. So she did. She put me on Mounjaro, and I finally started losing weight again. Still haven't eaten, like I'm still very low carb, which is, like, I think more of me being scared of food still.
Well, let's
So I still don't eat the damn cheesecake.
Yeah. Let's end on that, though. How do you how are we gonna get you past that part?
That, I don't know. That's where and I think that I do have to get over it because I think with because I'm at the highest dosage of Manjaro at this point Mhmm. Which
You're on fifteen?
Yes.
Okay.
But with the fifteen, that finally, like, hit the nudge where I started to lose the weight because I wasn't losing the weight, and my insulin absorption wasn't as much. Like, before, I was taking, like, two hundred units in my, Omnipod and, like, being done with the two hundred units in those three days. Now I'll if I put two hundred units in, I suppose probably still have, like, all of it at the end of, like, my change.
Yeah. Arden changed Arden changed the pump the other day, and she had a vial of insulin that was getting pretty low. And she drew it up, and she said, I don't there's not enough insulin here to fill the pod with. And then she just paused and said, I'm taking Mounjaro right now. That should I I I won't need all this insulin.
And then and then she put it in. That's really fantastic. May I just suggest I as a person who's been on Zepbound, which is Mounjaro for a long time, try eating more to see if you lose weight.
And I think that's what I think I need to do because I I'm not I don't eat like I probably should, which wasn't it's not so much Mounjaro thing. It's just like me and my brain thing because I wasn't doing it before. Yeah. But I think with the higher dosage, it's kind of making me sick. Like, I'll have, like, the headaches, and then, like, I have a headache once a week.
I'll throw up once a week at least, but I don't think I think it's more of the fact that I'm hungry.
What do you mean?
My body is like
Are you eating feed me. Yeah. Are you eating high fat items when you eat?
Yeah. Like, high protein stuff. So, like
That the protein can be harder. Actually, I would tell you to just have a slightly more balanced, like, diet. And, I mean, you're not afraid to bolus. Right?
No. I think I mean, I've gotten a little over the like, being afraid to bolus. Okay. Before, I was, like, super scared. But I've also started because I also with one of your episodes because I was always on the automatic, on my pod, but I've changed to manual so that I could extend my bolus because I've noticed that I would drop.
Where her numbers are now1:05:15
Mhmm. But I think because the Manchuros, like, making it, like, last longer in, like, the food, whatever I eat to, like, digest slower
Yeah.
I would drop and then go high. So at least with the extended bolus, I'm not dropping right away, and then it's and then I'm not spiking, like, two hours later.
Okay. And are you are you technically Lada? Are they calling you are. Yes. So do you have moments when you don't need as much insulin, your body's handling it?
I
don't know, to be honest. There are times where, like, no matter what I do, like, those times of the months where, like, my sugars be, like, crazy high. And then there's times where it's like, I'm okay, like, between I think the highest I'll go is, like, one twenty.
Okay. What what system are you using? You're Omnipod five?
Yes.
Yeah. But you're not on automation?
I I am and I'm not. So it depends. Like, if I'm gonna eat, I tend to, like, go in manual mode and extend it versus the automation. If I'm, like, not eating anything, I'll be just on automation.
Do you have any of the 100 target pods yet? No. No. How many do you have to use up before you end up with those?
I don't know, actually.
Yeah. Because I the new 100 target should be valuable for you. Okay. I'm seeing a lot of people online talking about how, it's been helpful.
Oh, okay. I'm looking to that one.
Because they just moved the target down to 100 from what one what was the lowest one twenty before? And and, anyway, people are changing the target and having success with it. Did you not see me in the commercial? We're yelling one hundred one hundred, like, all that stuff.
I I did see the commercial. I'm like, what is he talking about?
Yeah. Oh, they'll be they'll be thrilled to know you didn't know what they were what we were talking about. Actually, there's a person right now who I like very much who I know just heard you say that, and she's like, okay. I just got she's banging her head on a desk right now. Lovely lovely person.
I won't say her name. Yeah. Yeah. They moved the target down to 100. So, that that, you know, gives more insulin, makes it a little but there's also a couple of other adjustments they made to the algorithm.
I will also tell you that I think that Omnipod six will be out in not short order, but not that long from now. And I don't have any details about that or and I don't know anything that everybody else doesn't know. Nothing you can't figure out publicly. But from what I'm, like, gathering, it might be a real, like, leap for the for the device. So, hopefully, that'll be, something that would help you as well.
But I would just I would just tell you for now, if you're up on 15 of do you would do you get back to one thirty in your weight or no?
No. I'm down to one fifty four.
Okay. I if 15 of Mounjaro is not where what were you using? How much Ozempic were you using when she took you off it?
I wanna say not that much. I wanna say it was, like, the 2.5 or the five.
Yeah. So maybe some of it was high blood sugars too, like, helping you along. I would I I still I'd wanna I'd wanna go throw a brick through her window. I would I'd be I wouldn't do that, and I wouldn't suggest that anyone else does anything like that either. I it would make me upset.
Are you pissed that she took you off of that?
Oh, yeah. And the fact that she wouldn't, like, put me back on it, it was just like, really? Really?
Yeah. Did you call her the b word when you left the office?
Well, again, virtual. So when I left my virtual meeting, I was like, what the and then I walked into because we had a meeting at school that day. And so you could tell, like, everyone's like, are you okay? I'm like, no. I'm pissed.
Yeah. I is this where I should start? I I've I've started in a couple of episodes reciting the Hippocratic Oath after these conversations, but I won't do it today. Although I found it funny the first time I did it, but I might be the only one. People are like, oh, yeah.
I I fast forwarded through that. Well, I I I genuinely appreciate you sharing this with me. Is there anything that we haven't talked about or anything we missed that I should have asked you about?
No. One thing I do and then I don't know if you might know, if there's something on your, you know, wealth of knowledge of you on your website as far as, like, therapists. Because I've tried you know, like, I know I need to talk to a therapist. Okay. And I did.
Trying to find a therapist1:09:50
I tried, but it was more me explaining what type one was to the therapist, which I was like, yeah. This is not what I want. I want them to, like Awesome. Help me. Yeah.
I pay you $40 to educate you about type one diabetes? This would be awesome. What state are you in? Can you say? You're, like, in Chicagoland area.
Right? Yeah. Yeah. I I took do you wanna know how I figured all that out or no?
Mhmm. How?
Okay. Well, you're clearly, you're clearly, like, an upper middle class family. I can just tell by how you speak. I know that's strange to say. You your husband has an attitude that things are gonna be okay.
Your your accent a tiny little bit. Something you said about geography earlier, I forget. Oh, about the hospital, about Northwestern. But, like, you give off a whole vibe. Like, I I feel like I know who you are a little bit better, like, after we've talked for an hour.
Anyway, that's neither here nor there. I I I I threw that in because I failed to figure out, a girl was from Minnesota the other day or Detroit or something that she she she got on. She's like, at the end of this, I want you to guess where I'm from, and it put a lot of pressure on me. I felt that the entire time I was talking. Anyway, you I could kind of tell where you're from.
Did I get you right about your, like, your family structure and situation?
Yeah. I would say my upper middle class.
Yeah. Yeah. Yeah. No. You guys
Probably just middle class, not upper.
Listen. Middle class is upper middle class nowadays. Right? You're either a billionaire or you're that or you're broke. I don't think there's anything else.
There's just three. And so I don't think Erica, who's on the podcast, can do Chicago, or or Illinois, but I would send her a note and ask her if she knows somebody.
Somebody.
Yeah. Because I think she could probably help point you in the right direction because it is difficult. You need to find a therapist who I mean, I'll tell you. Like, Erica has type one. I think that gives her a great advantage when talking to people with type one.
Mhmm. So you gotta find a good therapist, but you also, like you said, don't wanna be explaining diabetes to them because now you're saying things to them that if you if you look at the general population, those are the same people who go, it's not that big of a deal. Right? Like, don't you just take a shot, or doesn't the pump do the whole thing? Like, so you don't wanna, like like, you're explaining your trials and tribulations.
You don't need the therapist sitting across from you thinking like, You know? Like, you wanna
That's how I felt. Like, the whole time, I'm like, okay. This is not I'm getting nowhere with you
Yeah.
Because I'm just explaining to you what it is.
Right. Right. Right. Yeah.
I mean again, then you have to, like, take out that, like, misconception of what type one is. Because, again, like, when I met her, she's like, oh, I thought that was only a childhood disease. I'm like, oh, great. This is this is going down. The drain is on that
one. Yeah. Yeah. The doctor in the hospital. You'll be alright.
Don't worry about it. See It's like the same the same exact thing. Like, you don't have heart you know, your heart didn't fall out. I'm like, why that doesn't help me? I still have my problems.
So, yeah, I mean, if she could help you, it's I think it's erica foresight dot com. She does like, I think she can practice virtually in, like, 10 states, but she's in California. But but I'm sure she would not be upset if you sent her an email and asked her. Just said I was on the podcast or I'm in the group, and I'm just wondering if you know anybody in this area. She could probably help you out.
Okay. I don't wanna Yeah. Because I know I know I need to talk to somebody.
Wait. Because of the the the the things that you talked about about the bolusing and the eating and stuff like that.
Yeah. The bolusing, the eating, like
The general sadness about having diabetes? Yeah.
Yeah.
Yeah. You don't wanna I mean, it would be nice to work your way through that for sure because otherwise, it's gonna stick to you forever. You know? Because you still feel that way you described in the beginning when you were crying and you're like, I don't want this.
Oh, yeah. Yeah. All the time. And even thinking, like, about my kids too, just like, I don't want that for them either.
Are you worried that they're gonna get type one?
Oh, yeah.
Other autoimmune in you or your husband's families? Hashimoto's, celiac, vitiligo?
So I think my on my husband's side, his mom has, again, the whole Hispanic thing. Like, you don't tell anybody your like, your medical stuff. But just, like, seeing her and, like, looking at the things that she does, I'm pretty sure she has some type of autoimmune. Mhmm. But then on my side, I'm the only one, like, with the type with type one besides, like, you know, the regular type twos.
And then my brother has, eczema, which I think is considered an autoimmune.
Yeah. Yeah. I think so too. Yeah. I mean, so will are you the kind will you do the trial net idea, or do you would you prefer not to know, or would you prefer to know?
I would prefer not to know because then I think knowing the type of person I am, like, if I know that that's gonna like, it's that, you know, one of them has it or will have it, then I would just probably dwell on it forever.
Do you have anxiety?
Not diagnosed anxiety, but I'm pretty sure I do.
Not diagnosed, but I'm diagnosing myself right now. Yeah. And for your for your whole life?
Yeah.
Yeah.
For sure.
The kids have it at all?
I wanna say they do. Yeah. Just looking at the certain things that they do. My older one, for sure.
Xavier's out there in second grade worrying about old people's health. So
Oh, yeah. And he's always he's, like, one of them that's always, like, sending people to, like, your podcast or, like, trying to save the world.
I should get that kid business cards to hand out. He's got a he's got a good he's got a good sniffer for diabetes. Like, hey. I could just see him just flipping that one of those out between his, you know, his index and his pointer and his middle finger. Just like, nope.
There you go. That's I
hear you. You need one.
Wait. Hold on. The pointer finger is the one you make the gun with. Then there's middle index is wait. Is index ring finger?
Yes. Your index is
ring pointer finger and middle finger. And then puts the card in there and just kinda, like, twirls it around a little 180 degrees, hands it to you, keeps moving. I get I get 20 or 30 him out in the world. We might really make this podcast jump.
Right.
So, okay. Alright. Well, listen. I I don't have somebody for that. I can tell you that I have considered asking people to add their therapists to the Juice Box docs page.
So Mhmm. You know, maybe
a good idea.
Yeah. I think that's not a bad idea at all. Okay. I I'll put that on my to do list. I feel like Sam Jackson in Jurassic Park some days.
That's gotta be a reference nobody gets. But he's like he says, like, we have all the problems of a zoo and of a theme park and we're not even open yet. Like, I feel like that some days. I'm like, oh, I should make a post about this or that or this. And I actually just did a thing this morning where I realized that I've added so much stuff to the website that's valuable, and I didn't even tell anybody.
I just I just put it up there. I was like, I don't find it. And I was like, you know, that's really not how that works. So I made a post about it to try to draw some attention to it, and then I realized these algorithms, they don't they don't want you to see they don't want you to see anything at this point. Like, here, I'll complain to you for a second and then I'll let you go.
Okay? Everybody listen. Don't tune out. Okay? I'm telling you something about how your life's being manipulated.
I can tell you that on Instagram turn this down. On Instagram, I've made a post in the last couple of days that would help you with your diabetes, that could help you with a lot of other things that would be very health related. I assume you're following me. I've made a post to celebrate a gentleman's life who was an advocate for type one diabetes who passed away. And none of my posts have done as well as me standing in front of a pack and play in the parking lot of my grocery store.
I was about to ask you if you found out who that pack and play belongs to.
I didn't I ain't got that kind of time, Cynthia. I just I just looked at it. I took the picture and I left. But point being is that, I I so I look. I was getting in my car.
There was a pack and play in the middle of the parking spots. Clearly, happened is someone took the pack and play out to put the groceries in, never put the pack and play back in and left. Okay?
So I You know that some wife is yelling at some husband right now for forgetting.
Is that interesting? You think it's a guy that did it. I see. Okay. And I write on the just on the picture, I'm like, parenting is hard.
I saw this at the grocery store parking lot trying to imagine the moment when someone says, hey. Where the hell is the pack and play? So and it's and it's just a static image. Right? With actually jelly roll over top of it singing in a in a in a loop.
I am not okay. Like that. The point is is that that's been served to people tens of thousands of times. And my post that it's like, hey. I have this thing on the website that'll help you.
I can barely get it to show it to a thousand people.
So because I don't think I think I saw the old pack and play for sure.
Oh, no. Of course you did. Because it But
I didn't see I don't think I saw whichever one about those those things on here.
Right. Because these algorithms are just serving you both that doesn't help you at all. And then I put the this is this I I'm gonna look down. I know it's gonna break my heart. Let me just let me just pull it up.
So I put the post up, and I'm like, hey. There's four things on the website you might not know about. First of all, I put up a transcript library because the people who read, like, each episode has its own transcript, but I put them all for the management stuff in one place. It's really fantastic and easy to get through. I put up the listener survey, which is really gonna help me explain to people how to, you know, how how the podcast is being helpful so that maybe other clinicians will will, know, send it around.
There's this great, twenty one day, it's it's sort of like short readings, one little idea thing you notice, a thing to practice, like to help you go through the small sip series, is kind of like a primer for the pro tip series. I piloted it with 50 people. They had amazing outcomes listening to it. And I made a juice a jukebox where there's, like, songs that are literally made from episodes of the podcast that'll help you either understand your diabetes management, help little kids understand it, or for adults, a lot of the kind of, like, social or mental health stuff. And they're they're some of them are goddamn snappy.
And and and right. And that post has been served to 1,200 of the 86,000 active members in the group. But my photo I put up the other day of something completely innocuous and stupid was shown to, like, 50,000 people. So this is just how this all works. So you it is if you think it's on you to figure out what to do because your doctor's not gonna tell you, I'm gonna tell you that even after you find me, it's still on you.
So hard.
Yeah. You still have to dig. No one is gonna hand this to you. Like, it just it no one's incentivized to hand it to you. The doctors don't seem to be incentivized.
The algorithms don't be incentivized. Trust me. You've seen some diabetes influencer act like a fool 20 times this week, but you've not seen any of the stuff that I put out.
That's true.
Until the one time I said something stupid. Then it was like, oh, here. Here's Scott standing in a parking lot with a pack and play. You must be interested in this. So, anyway, good luck to all of you.
Okay? It's a it's I don't know what you're gonna do. Oh oh oh, here's one my posts where somebody yelled at me. That got more likes. Yeah.
Alright. I gotta go, Cynthia. I'm gonna have a stroke from you. Okay? Alright.
Hold on one second. Uh-huh. Something new just arrived from MiniMed. It's the MiniMed Flex system. Think about everything people love about MiniMed technology, designed for great outcomes, helping keep you in range, and made to be easy to use.
Now in a pump, it's the size of two stacked vials of insulin. MiniMed Flex is fully controlled from an app, designed to stay tucked away, empowered by the proven automation that helps over six hundred thousand people manage diabetes day and night. Order today, minimed.com/juicebox. Having an easy to use and accurate blood glucose meter is just one click away. Contournext.com/juicebox.
That's right. Today's episode was sponsored by the Contour next gen blood glucose meter. It's the meter my daughter uses. She has it on her right now, and you're one click away from having it too. And don't forget using juice box podcast links helps support the show.
Friends, 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 am joined by Jenny Smith, who is a diabetes educator with over thirty five years of personal experience, and we break down the 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 in the menu. If this is your first time listening to the juice box podcast and you'd like to hear more, download Apple podcast or Spotify, really any audio app at all.
Look for the Juicebox podcast and follow or subscribe. We put out new content every day that you'll enjoy. Are you tired of scrolling past clips that last five seconds? Are you an adult? Would you like to have a long conversation?
Juicebox podcast is the place to be. Follow and subscribe. I'll be here tomorrow with another episode. I hope to see you again.
Read the full disclaimer
© 2007–2026 Juicebox Podcast. All rights reserved.
#1961 Terrible People Live Forever
Terrible People Live Forever
An emergency room nurse was married to a man with type 1 for seven years and still didn't understand it. Then her daughter was diagnosed. She speaks anonymously about learning it late and managing it across two houses.
Jump to a moment
- She is an emergency room nurse who didn't understand type 1. Asked to rate her knowledge during her marriage on a scale of 0 to 100, she says 25. Her explanation is worth hearing: nursing school covers type 2 at length — insulin resistance, chronic disease acquired later in life — and touches type 1 only enough to say it's the insulin-dependent kind. In the emergency room, she says, some of what she absorbed turned out not to be correct.
- Seven years married to someone with type 1 still wasn't enough. He handled it himself and didn't ask her for help, which she now distinguishes carefully from handling it well. She knew to watch for lows and that illness ran him high, and not much beyond that — a gap that only became visible once she had to learn it properly for her own child.
- The diagnosis came through a urinary tract infection visit. Her daughter was complaining of irritation, so she took her in to be checked. There was glucose in the urine. Even then, she says candidly, she didn't register how significant that was — and when the physician asked whether the child had symptoms, she answered no, because she wasn't looking for the right ones.
- Managing it across two households is its own problem. The children are with her most of the time, so she carries most of the work, and when they're with their father she coaches by text — telling her daughter when a correction is needed. Her daughter can enter one herself, and guesses when she isn't sure. Nine years post-divorce, the two of them are still negotiating how this gets done.
- Her endocrinologist gives out a cell phone number. She credits a specific doctor who trusts her to adjust settings and says to call with questions — and notes that a different physician in the same practice would likely not have appreciated changes made without a call first. Scott's observation is that it takes very little to make an enormous difference to a patient. Nothing here is medical advice.
- Diabetes Pro Tip series — Episodes 1000-1025 — settings, insulin timing, and food impact.
- Bold Beginnings series — Scott and Jenny Smith for the newly diagnosed.
- Juicebox Podcast Facebook group — The private community she credits with getting her started.
- Juice Cruise 2027 — The third annual Juicebox community cruise, on sale now.
Every word of the conversation
Cold open & sponsors0:03
Hello, friends. Welcome back to the Juice Box podcast. Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan or becoming bold with insulin. Are you looking for a vacay?
Of course, you are. Juice Cruise 2027 is on sale right now. Go cruising with a bunch of people who either have type one diabetes or live with it. We're talking about parents, loved ones, adults. It's a great eclectic mix of juice box podcast listeners getting together, enjoying each other, fun, sun, and a little getaway.
Juice Cruise twenty twenty seven is available right now at juiceboxpodcast.com/juicecruise. We're already selling slots. It is I don't wanna say it's filling up, but it's coming together. So hustle, hustle. Today's episode is sponsored by Tandem Diabetes Care, the Eversense three sixty five, and touched by type one.
There are links in the show notes and at juiceboxpodcast.com to all the sponsors. When you use those links, you are supporting the Juice Box podcast and helping to keep it free. The Eversense three sixty five is a one year wear CGM. That's one insertion a year. That's it.
And here's a little bonus for you. How about that there's no limit on how many friends and family you can share your data with with the Eversense Now app, ever since cgm.com/juicebox. Now let's talk about Tandem Mobi, the impressively small insulin pump. Tandem Mobi features Tandem's newest algorithm, Control IQ Plus technology. It's designed for greater discretion, more freedom, and improved time and range.
Learn more and get started today at tandem diabetes dot com slash juice box. Touched by Type one is my favorite diabetes organization, and they're sponsoring this episode of the Juice Box podcast. Please take a moment to learn more about them at touchedbytype1.org. Also, follow them on Facebook or Instagram. When you get to touchedbytype1.org, check out their many programs, their annual conference, the d box, dancing for diabetes.
They have a golf night. Gosh. They have a dance program for local kids. Go check them out at touchedbytype1.org and see what they're up to. Alright.
Why we're using an alias2:28
So normally, the person I'm speaking to would introduce themselves. And but instead today, I wanna let you all know that we are going to be using an alias for today's guest. So, I mean, we can pick a name together if you want, or we could just call you Jennifer Garner since she starred in the television show alias that I watched through the two thousands. What do you wanna do?
That's fine. Let's use that one.
You're gonna call you Jennifer?
Yeah. Sure.
Awesome. You know Jennifer Gardner's good friend, Victor Garber, has type one diabetes?
I did not know that.
Oh, now you know. I don't know what you're gonna do with that information. It's Jennifer, but we'll find out. Also, we'll probably never call you Jennifer again.
Right.
A nurse who didn't know type one3:12
So what brings you here today?
Well, I just thought my story was a little bit interesting. My daughter was diagnosed almost two years ago now with type one. Mhmm. And I work as a nurse. And even as a nurse, I knew very little about type one.
And I was married to a type one diabetic for almost seven years and still didn't know what I needed to know about type one diabetes.
Okay.
But after meeting with some friends on Facebook and starting to listen to the podcast, I quickly figured it out. But what I have learned in the process is there is a lot that goes into it, especially when dealing with a co parent and ex husband, you know, stuff like that.
Yeah. I wanna hear about that. But first, I have to understand, how are you married to a type one and don't understand type one?
For the longest time, he like, I knew type one was insulin dependent diabetic diabetic. You know? Like, I knew he had to have insulin all the time. I didn't really understand what basal insulin was and what you know, like, obviously, fast acting insulin, I know what that is, but he did not take the best care of himself. He did not have health insurance for the longest time before we got married.
I knew, obviously, to be prepared for if he had lows or something like that. I knew when he was sick, he would get high. But for the most part, he took care of it. He didn't rely on me for much, and there just it there wasn't a whole lot that I had to do.
Okay. So he took care of it with air quotes means he didn't ask you to help with it. Doesn't necessarily mean he was taking good care of himself.
Correct.
Okay. And vaguely speaking, what kind of nurse are you?
Well, I started out as an emergency room nurse, and I am now an emergency nurse.
But just but to say that you understood diabetes like, if if the understanding of diabetes was a spectrum that went from zero to a 100 while you were married, what do you think your understanding of it was?
Probably 25.
Okay. And
before Of type one diabetes.
Right. Right. And before you were married, was it about the same?
Probably.
Can you explain to people listening who are confused? I understand because I've been doing this a while. But explain to them in your words how you can be a nurse and not understand that kind of stuff.
What nursing school actually teaches5:44
Honestly, I think in nursing school, they teach more about type two diabetes. You learn about insulin resistance. You learn that most of, I mean, really, the majority of the diabetics that you're going to see are type two diabetics. Mhmm. You learn about diseases that people acquire later in life, chronic diseases, you know, with but they don't they teach you.
They touch upon what type one diabetes is. They tell you there's a difference. There's insulin dependent diabetes, and then there's this other kind of diabetes. And you really don't learn the specific of the of type one diabetes.
Sort of the extent of your educational. Then Right. Then what happens when you come across the person with type one? How does the how does your knowledge not grow? Is it just your time touching them isn't long enough, or is it that it gets dumbed down so much you don't think about it?
It probably just gets dumbed down so much you don't think about it. I mean, it's just really, after listening to the podcast, some of the things I learned working in the emergency room weren't really correct. But it was like, well, if you see a diabetic who has an insulin pump, I'll immediately drop it off. You know? Mhmm.
If they come in with I I I'm seeing my fair share of patients in DKA. I've seen a lot of them, actually. I've hung insulin drips quite a bit, but you don't really there's just certain things they don't teach you or you don't have to know, I guess, in an emergency room setting.
Do you think it's as simple as one day somebody with a pump on came in, their blood sugar got super low because the pump kept giving them insulin. They didn't need it. You know? They were unconscious or something. They got low, and then the rule became, hey.
When someone comes in with a pump, shut it off.
Right.
Probably. Yeah. Yeah. Like, it's just there's it's sort of this nonsensical, we saw this, so now we always do this thing. And then people say that out loud, and it gets what what?
It gets repeated and repeated. And when you hear it eventually, it just seems like a rule.
Yeah. Correct.
That's how all bad communication works. Exactly. Yeah. Yeah. So okay.
So you have little knowledge of it through your schooling, through your work Mhmm. Even though people some people might assume that seems crazy, but I I think it's I think it's reasonable to say that it's not, honestly. I Mhmm. I I just don't think people are I don't think humans have the capacity to remember everything they need to know about medicine and everything they might bump into along the way. And
That's true.
Yeah. But from the outside you don't have this experience because you've probably been a nurse for a long time. But if the outside, it is really confusing. You know what I mean?
Like Yeah. Yeah.
I don't know.
It is.
It Yeah. Sorry.
I mean, like I said, the majority of of diabetics the majority of things we learn in nursing school is about type two diabetes. Mhmm. My family has a history of type two diabetes. I had never really run into any type one diabetics. Mhmm.
And like I said, even knowing my husband was a type one diabetic, there was very little I had to do for him.
So so you meet a guy. He has type one. This doesn't put you off. You date and get married, obviously. You're thrown in with him.
Mhmm. What do you think you're getting involved in? This episode is sponsored by Tandem Diabetes Care. And today, I'm gonna tell you about Tandem's newest pump and algorithm, the Tandem Mobi system with Control IQ plus technology, featuring auto bolus, which can cover missed meal boluses and help prevent hypoglycemia. It is a dedicated sleep activity setting and is controlled from your personal iPhone.
Tandem will help you to check your benefits today through my link, tandemdiabetes.com/juicebox. This is gonna help you to get started with Tandem's smallest pump yet that's powered by its best algorithm ever. Control IQ plus technology helps to keep blood sugars in range by predicting glucose levels thirty minutes ahead, and it adjusts insulin accordingly. You can wear the Tandem Mobi in a number of ways. Wear it on body with a patch like adhesive sleeve that is sold separately, clip it discreetly to your clothing, or slip it into your pocket.
Head now to my link, tandem diabetes dot com slash juice box to check out your benefits and get started today. Juice Box is also sponsored today by the Eversense three sixty five, and just as the name says, it lasts for a full year. Imagine for a second a CGM with just one sensor placement and one warm up period every year. Imagine a sensor that has exceptional accuracy over that year and is actually the most accurate CGM in the low range that you can get. What if I told you that this sensor had no risk of falling off or being knocked off?
That may seem too good to be true, but I'm not even done telling you about it yet. The Eversense three sixty five has essentially no compression lows. It features incredibly gentle adhesive for its transmitter. You can take the transmitter off when you don't want to wear your CGM and put it right back on without having to waste the sensor or go through another warm up period. The app works with iOS and Android, even Apple Watch.
You can manage your diabetes instead of your CGM with the Eversense three sixty five. Learn more and get started today at evercentcgm.com/juicebox. One year, one CGM.
I really didn't know. I didn't know about the long term complications. I didn't know, about the difficulty with insurances and even, like, getting being able to get on to my life insurance. He couldn't even get life insurance through my work because of his history. Mhmm.
He I I mean, really, I thought, oh, okay. Yeah. I mean, he has to take insulin. He has a bag with supplies that he needs, so I knew that he had to have that bag with him. For the most part, he never he never really got low, that I really had to take care of much.
I probably saw my mom, a type two diabetic on insulin, get low more than I saw my ex husband have a low blood sugar.
Interesting. How long did you date before you got married?
Two years or maybe something like that.
So your total time together is nine, ten years right there?
Mhmm.
Okay. And you're do have a child with him?
I have two children with him.
And which one has type one?
The younger one. She is 11 now. She was nine at diagnosis.
How long have you not been married?
Nine years.
Okay. So you were together ten. You've almost been apart as long as you were together.
Correct.
Gotcha. And in the last couple of years of your marriage, you had your daughter?
Yes. I have
that math all correct? Okay. So okay. So is she diagnosed while you're married? No.
Oh, okay. Now that she's diagnosed and you have a different understanding of diabetes, what do you think his understanding of diabetes was?
I I don't I don't appreciate his understanding of diabetes. After learning about it myself and really looking into what my daughter needs and what I can do to help her, I don't appreciate the way he handles his care. I don't appreciate the way he handles her care. I don't know that he knows how to count carbs. I think he probably guesses doses.
Like and and and I've heard you say that you look at a plate and you see units, not carbs
Mhmm.
Which it may be what he does. And to be fair to him, I think when he got diagnosed, it was you're allowed to have this many carbs and this much protein and this much whatever per meal, and this is how much insulin you take Mhmm. I think. And that rule has since changed. Now you just dose for however many carbs you're gonna be eating.
But I'm pretty sure when he was diagnosed, that was how they did it. You know?
Had he had it for a long time since he was a kid?
He was 18 when he got diagnosed.
Oh, that's a tough time too. Okay. Well, do you know what his a one c's were like when you were together?
Finding out after the fact, I think they were tens.
Oh god.
Nines, tens.
Was he in the medical field as well?
He was an EMT basic for a while.
Okay. You people love to stick together in the matter.
He he wore many hats while we were together. That was part of it. He's very full
with it. Heard you say he couldn't keep a job.
That maybe.
Oh my gosh. Sorry. Do you think any of his issues came from his high blood sugars?
Yes.
Do you think he knew that?
Maybe he's putting it together now, but I I still think when we talk to him, he probably thinks he got the short end of the stick.
Meaning, this isn't the life I bargained for, so I'm just gonna sort of kick rocks and make For
me, I have the worst luck. Everything bad always happens to me.
Okay.
Yeah.
Do you see with with a lot of brain fog?
What?
Did he have brain fog, like, kinda confusion or, like, slow thinking with high blood sugars?
I I don't know. I mean, I was probably just so used to seeing him with high blood sugar. And for the longest time now I did know this. He always told me, I feel better when my blood sugar's in the two hundreds than I do when it's in the one hundreds. He always told me that.
Because And in my
Go ahead. Go ahead. I'm sorry.
Well and in my thinking, I always told him, if you kept it in the one hundreds, you would feel better in the one hundreds. But that was the most of my knowledge of at that point.
Like, was that was all I knew, but I still I got that right. What's interesting, it'd be it's like if I said to you, like, I'm much more comfortable when my pants are on fire. And you said, but yeah. But, Scott, eventually, you're gonna burn down into a crisp and die. I go, but I'm very comfortable like this.
It's a it's a a weird thing to like like like, well, I'm more comfortable in the two hundreds. It mean, I I don't know how to, like, exactly, like, wrap my confusion around something like that. You you know? Like, I don't I really don't know how to, like, articulate it. It's something horrible is happening to you.
And instead of saying, wanna remove myself from something horrible and put myself somewhere good, I'm just gonna say, well, I like it better here.
Mhmm.
That's very, very weird in human. But at the same time, if his blood sugars are elevated forever and ever, then maybe he's not the best arbiter of decision making and what's what's right for him. So then my question here and you've been divorced long enough that I don't think I'm gonna make you cry and, like, you know, up you know, change your life and everything. But Right. When you started to understand diabetes for your daughter, did you ever have a moment where quietly you thought, oh, that poor guy?
Like, I like, did you ever have that I wish I would have known? Like or he needed help and he couldn't do it himself. Did you ever, like, have a compassionate thought about that?
Actually, I I think we were probably too far divorced and in a bad spot when that came about.
Okay.
Okay. I did send him I remember listening to your specific episode where you talked about diabetes complications and picturing, like, the sugar on the table and it's granular and, you know, how it can destroy your blood vessels and stuff like that. I wanted him to listen to that, not only for himself, but for our daughter Yeah. And he never knew.
Because did did he give you a reason, or do you not have enough of a relationship, though?
At first, I thought he didn't listen to podcasts. And then I found out he does, but maybe not as fun.
That's one of my favorite things when people go, I I can't. I don't listen to podcasts. I'm like, I don't even know what that means.
Right.
It'd be like it'd be like if I said, hey. The secret to life is on a billboard over there, you went, I'm sorry. I don't look at billboards. Right. Why don't you just make an exception today and look over there?
Just a couple of episodes.
That's, like, I promise. You know what? What you need to know in about ten or fifteen o'clock.
We have people we really are a mess, aren't we? This is fast it's fascinating. Hey. I think there's something really important for you to do. Oh, I'm sorry.
Is it in a podcast? I can't do it. Had you sent me an audiobook, I would have definitely been able to listen. And everybody's stupid. Okay.
And and okay. I don't need to understand. We're not here to talk about your your marriage. Are you remarried now? No.
Smart. I mean okay. Can I ask you? How did you are you older when
you 43.
Were you were you older when you got married?
I was in my late twenties.
That's not older. What happened? Was he fun? Was he like, what how do you
He I've actually heard many, many people say this about their ex husbands or boyfriends or whatever, but he actually was the classic narcissist. So he was really fun and outgoing and charismatic and just confident, and he had all these qualities that were just fun to be around. And then they slowly started to disappear.
Was he handsome?
To me, personality makes someone more attractive.
My god.
So I thought he was attractive attractive then because he was so outgoing and funny and, you know, all the things. And now I look at him, and I am not at all attractive.
Can you imagine how dorky guys with good personalities and no look feel when they hear something like that? Like, you went with a like, you chose a guy who's not that attractive because he had a good personality, and then this is what happened. Great. We're over here.
People would some people would probably look at him and say he's attractive, especially in his younger days. He probably was attractive considered attractive.
I think what you're saying.
But, I mean, I'm
really like, this is obviously not about you, but I'm just trying to understand bigger picture. Plus, I have a young daughter. Like, you know what I mean? Like, what makes you guys, like, just be like, oh, that one. He's a but whatever.
Yeah. Like, I don't that's fascinating to me. Were you just in, like were you I I were you thinking, like, you wouldn't have a baby?
No. No? It wasn't for
baby fever?
At the time, I didn't even have children. When I look at even dating now, I it's not that one can fix him type of thing, but you try to give somebody the benefit of the doubt. Okay. But why He has this, but I think he's a good guy. Are we missing something?
Did Jennifer, did he have good Coke? What are we talking about right now? What was really going on? Please tell me.
I can't tell you. I think it was just his charisma. I really think that's what it is.
No kidding, guys. There you go. Get a wrap and head out there. Some poor lady will throw her life away on you if you want. Jesus.
You feel better now, though, that you're divorced?
Yes.
Good.
Yes. Yeah. Best decision in my life.
Don't even know what to say about that. I'm so sorry. I'm so sorry.
It's okay.
Oh my god. If my wife would leave, I definitely think that's what she would say. Oh my gosh. Okay. So your daughter's diagnosed.
Glucose in the urine21:09
Do you know like, do you see symptoms coming, or is it does it come on you?
I I didn't see symptoms. Looking back, I may have saw a few. But at the time, I did not see symptoms. She was having some, I don't know, possibly, like, yeast infection type of just itching, complaining of things bothering her down there. Mhmm.
So I
really just went in to get to see if she had a a urinary tract infection, and she had glucose in her urine.
Okay. And that was not quick.
Even then. This is embarrassing to Even then, I did not realize that glucose in the urine was that bad.
When you heard the word glucose, you didn't think, oh, that guy who I wasted a decade with, he we talked about glucose a lot. That that didn't strike you?
No. Okay. I mean, it okay. So the physician even said to me, okay. She has glucose in her urine.
“Is she having any symptoms?”22:06
It's not very much. And I was like, okay. And he goes, is there any diabetes in the family? And I said, yes. Her dad is diabetic.
And he said, okay. He goes, well, is she having any symptoms? And I said, no. She's not having any symptoms.
You should have said yes. This yeast infection.
Well, I mean, that and all I didn't know that was a a symptom. I didn't know. And he honest he let us leave. He was fine. He was like, okay.
I stop that for second?
Let me stop you for a second. There's a life lesson in here for everybody. I don't care if it's medicine, your finances, the guy trying to put a roof on your house, whatever. Please please hear me and take this forward in your life. No one knows what the fuck they're talking about.
Everyone is pretending to get a paycheck to get through. Think about yourself. You know you're in your job. Half making it up all the time. And then you go out into the world and see somebody else and go, well, they must know.
You know what I mean? What a weird you're a nurse. I'm not I'm not being hard on you. You're a nurse. That was a doctor.
You were like, my daughter, whose whose father has type one diabetes, has a yeast infection and glucose in her urine. That's probably nothing.
Well and I even think her pediatrician probably should have been checking her urine every year at her physical and never did.
Well, I mean, there's a lot of things that probably should have been happening. Correct. My point is when you get out in the world, you just see other people and you think you you just think they know what they're talking about all the time. Mhmm. You know, I sat down with somebody recently who's a like a I mean, they they work with money.
And they're they're they're just a friend. And I was chatting with them, and I asked them a question about, like, you know, markets and how things work and trying to figure out a way I can retire one day and all this stuff. And the answer back was almost like, no. I don't know really. Like, it was I'm like, hey.
You've doing this for twenty years successfully, and it's all just like, well, you know, it's a little bit of hoping and a little bit of maybe going in the story. I I just don't think there's a lot of situations in the world where you have to absolutely listen to somebody and say, well, they know. They're the principal of the school. They know. They're the school nurse.
They know. No one knows. The school nurse is at home doing heroin. Okay? Like or or what she's a regular person is my point.
This is what our doctors did to us, and I listened to you, and I think, my gosh. This guy figured it out on on his own.
And I'm an idiot. You know? You probably thought that. You're probably like, this moron. Jesus.
How bad did you feel when you realized I knew? You're like, oh god. What was I doing?
What I was begging for.
No. You're very nice. Go ahead. I'm sorry.
No. That's I mean, it it's true, though. It is. Like, we trust that these people know what they're talking about. Mhmm.
And he let us leave. We left. Fascinating. Yeah. When she was probably you know, she had diabetes.
At that point, we left.
Did it get worse after that, or did you were you able to, like, come back around on it quickly?
So it was probably a week's time. And the I wanna say the girls probably told their dad something about it. And I'll give him credit for this. He was like, oh, she's got diabetes. Uh-huh.
And I was like, she you thought your other two he had two children from previous marriage. I said, you thought they have diabetes. They don't she doesn't have diabetes.
Like, they I'm gonna be right eventually.
He he was was right. And so I did I got some strips, and I tested her at home when it was probably a week's time. Oh, yes. A week after that appointment.
Yeah.
I mean And she had large amounts of glucose in her urine. Very large amounts.
In fairness to him, he knows what poorly controlled diabetes looks like. So he was probably like, that really reminds me of my life, what you just said there. So Yeah. Wow.
Oh, I think tells me he thinks she was being alive. He thought she was drinking a lot. I didn't see it. I did not see those at all. Don't think so.
Even looking now, looking at it, I do not see those. She was very, very, very, very skinny. She didn't lose weight, but she was very, very skinny.
Okay. Are you hey. Was he older than you?
By, like, three years.
Yeah. And he already had a couple of kids with another lady when you met him? Girls, again, the these simple the rules are simple. Okay? They're very simple.
If if someone else in the sisterhood couldn't take it, why do you think you're gonna be able to take don't understand.
Well, you get those stories about how terrible his ex wife was and what she did to him and how it wasn't fair. And
I bet you tell some stories about you.
I know. I am now a greedy, and I am okay with that. I'm not
laughing at you or anybody else. It's just the whole human condition is ridiculous. Mhmm. Because he could have just you know? I don't know.
You could just be nice to people and try to make your life work. It's not hard. Yeah. Okay. Right.
Wow. Okay. So, yeah, a week later, you he figures it out or, you know, pushes. You go back. Do you end up in the hospital, or what's the the beginning?
I I called the doctor's office. I got her scheduled for labs first thing in the morning. We went in and got fasting lab work, and then we met at the doctor's office for an appointment. And as we're, like, in the waiting room getting ready to go back, her a one c comes back, and it's eleven point two. And I was like, oh, crap.
Mhmm. So, I mean, I knew it. I you know, at that point, I knew it. But so we go back to the doctor's office, and, obviously, they they were like, okay. Well, let's let's stick her finger again, and let's see what her sugar is after you let her eat.
Let's see what you know, obviously, it was high. It was in the three hundreds. And like I said, her a one c was 11.2. And Yeah. And she goes, what do you wanna do?
Do you wanna get admitted to the hospital? Do you want me to just call endocrine and just see if they can fit you in? Like, what do we do? And I was like, I at this point, I don't care as long as we get her taken care of. Mhmm.
If you need to admit us, you can admit us. But she sent us home. She said she'll call Endocrine, and I before we even got home, I got a phone call that said, if you can get there now, just turn around and drive to their office, and they'll see you right now.
Is that a professional courtesy, do you think?
I don't know. Okay.
So okay. So now here it is. He's gone. She's diagnosed. You don't have any comfort that he understands what he's doing.
You now recognize, holy, you don't understand what you're doing. And then where where are next steps? Do you just, like, lean into what the doctors tell you and just hope for the best? Or like, I'm I'm really interested how you, like, psychologically pick through those first months.
So the very first month, I probably was leaning on his knowledge because I too was afraid of what happens if she gets low more so than what happens if she gets high. Mhmm. Because I didn't know. I didn't know how bad it was if she got high. You know?
So and they teach you a little bit about counting carbs, and they teach you I mean, we were in that office for probably four hours before we came home, and I still left there feeling like I did not know anything. You know? But I got you know, you they go downstairs to the pharmacy and fill all of these things, and then the pharmacist is like, this is glucagon in case she passes out. And I was like, then I'm balling in a pharmacy in front of a stranger. You know?
Why would she pass out? Like, yeah. Like, what what wait. What no one mentioned that. Yeah.
Just
There's this thing you don't think about. You know? So in probably in that first month, I was more afraid of low than high. And I did like, he he would come over, and he would say, okay. This is, you know, this is what she's having for supper.
Learning it from scratch30:02
This is what we need to, you know, dose her, and he was trying to make her feel more comfortable. And he did let me know of a few, like, apps that you can count carbs with. And I felt comfortable having her in his care because I knew that he wasn't gonna let her get too low. But then after that, I started doing my own education and getting more comfortable with it myself and and finding out these things. And then I was like, oh, okay.
What what makes you, like, let go of what you're told in the beginning and the comfort of, well, he won't let her get low, and you don't really know the the, I guess, the weight of the outcomes that he's been having his whole life. So what makes you look for more? Do you see something, or is it a somebody say something to you? What what what opens up the door for you?
Originally, my dad was telling me about a child in our hometown that has type one diabetes. And he's like, I'd like you to talk to her. You can talk to her. I'm sorry. What's her name?
Did you? Yes.
Oh, okay. Take that out.
Talk to her. Mhmm. And, you know, you can talk to the mom. And so I met her at one of the basketball games for our hometown basketball game. And I did speak to her a little bit, and she got my phone number, she texted me.
And she said, I follow this group on Facebook. It's moms of type one diabetics. So I started following that group on Facebook, and that is what got me started thinking, okay. There is so much more to this Mhmm. That I need to know and I need to understand.
Well, god bless your dad for realizing that you married a dummy and that you are now listening to him about the god the granddaughter. And he was like, listen. If if she wants to ruin her life with him, I guess I can't do anything about it, but I gotta stick up for the kid. That's what your dad's doing. Right?
Right. Yeah. Yeah.
See how how ain't that nice your dad was still looking out for you?
Yes. Absolutely. He does. He is I should've married a man lying in my desk.
Well, I don't wanna ask you why you didn't, but I'm assuming there's a reason. But but no. I mean, seriously, like, that's lovely. Like, there there's your dad kinda stepping back and going, okay. You know, I haven't said I'm sure he said stuff over the years, but he he stays out of it.
You're divorced now. Whatever. But now that he sees you're gonna lean on the husband, the ex, for the care of the of your daughter, he's like, no. No. No.
We're not we're not doing this. Wow. Look at that. Did you ever thank him?
Oh, yeah.
Yeah. That's awesome. Very cool.
And and from there, then I get, you know, introduced to the Juicebox podcast. And I I think probably at the time right before I got introduced to that woman from my hometown, I was probably more recognizing, like, hey. She shouldn't be this high all the time. Mhmm. We should probably be, you know, giving more insulin for some of these things, or, you know, there are definitely things that I was looking at before, probably, I got in touch with her, but that really solidified it.
Can I ask you a quick
I don't wanna, like, denigrate anybody because I don't mean for this I hope this isn't how it comes off? But I do not freak frequent's the wrong word. I do not go into other Facebook groups. So I've just a long time I mean, you know, when I was a parent, I was, you know, members of a couple of them. But once I started doing my own thing, I thought, like, they don't want me in there.
Like, it feels predatory. Like, you know, he's trying to drag people to his group or whatever. So I I never wanted the the the appearance of that, so I just I don't I don't get involved. But how how is it that inside of a a group for people with type one diabetes or parents of or whatever the group is, like, how come my thing still gets suggested? How come the answer doesn't live in there?
I think sometimes the answer lives in there. There are a lot of knowledgeable people in there.
I imagine. Yeah.
But but your stuff get your stuff is very popular in the type one diabetes world, and it gets mentioned. I think probably the answers some of the answers are in that group because some of the members in that group have listened to your podcast.
Okay.
Have
okay.
I I think it some of it overlaps. Probably not all of it. There might be people in that group that don't listen to the podcast, and there might be people that you know, I I think but maybe a lot of people just get their answers from experience and stuff the way you got your answers, but I think a lot of people listen to it as well.
I see. I'm I'm outside of that. I really do live, like, in a bubble around all this on purpose. Because every time I try to, like, be out in the world, like, somebody yells at me. So I'm like, okay.
I don't need this. I yelled at the other day by somebody I like, and I was like, you know, who I thought I was like, what is happening? I I just I'm trying to help. Okay. But I just didn't under like, it just occurred to me.
Like, you don't take your car to a mechanic, and the mechanic looks at it and goes, okay. Great. We're just gonna take this to a different garage.
We're gonna
get it all set up. And, you know, like so Well, okay. I I'm I'm just gonna accept your your compliment and say thank you. I just wasn't sure why that that struck me as strange. But
Legitimately, in this community, there are people that just want you to be helped. They want to help you. And the if the best way to help you is to send you over to your Facebook page with your podcast and your information, then that's what you do.
Yeah. No. I feel the same way. When people suggest other stuff inside of my Facebook group, I'm like, yeah. I mean, if it's helping you, tell somebody about it.
Mhmm. It is hard. Like, in the very, very beginning, I can see the the feeling of, like, oh, I built this thing. I believe the answers are here, and now you're telling somebody to go somewhere else. It it's hard to swallow at first, but you realize that if you're really in it to help people, it doesn't matter.
And they all you know, people are you know, just because I say something, maybe they wouldn't understand me or like me or whatever. Let them go find it somewhere else. Why why would you stand in the way of that? So okay.
Two houses, two approaches36:04
No. Even so, I bet they probably wouldn't completely abandon yours for a different one. I bet they would probably still listen to both or do both.
You know? Why is that? What's it about that Facebook group that I made that's like, what what's attractive of are you in it? I imagine you are.
Yes. Oh, yeah.
In Is what's attractive about it, though?
Just the the knowledge base, the the people that and if you ask a question, they can tell you exactly what episode it's on. Mhmm. Or, you know, it just yeah. It
It really
does an incredible resource.
Yeah. Well, thank you. Mhmm. That's nice to know. Mhmm.
Okay. So you start figuring out that this ain't right. And then you tell your ex, and he's so happy that you're taking good care of your daughter. And not only that, but he wants to transform his own health and happily ever after. Is that
what happened? Something not quite like that.
Okay. Go ahead.
I he doesn't appreciate the way I manage her diabetes. He thinks I let her sit too low. He thinks like, I I even measure out, like, here's a little baggie, and I put six Skittles in it because this is how many Skittles you need to bring your blood sugar up from a low blood sugar. Okay? Like, you don't need 70 Skittles.
You don't need 30 Skittles. You need about six. You know? And he's telling me, you don't know what it feels like. You don't understand what it feels like to have a low blood sugar.
You'll never understand. You know, I know what it feels like. And I'm like, why? I I probably, at some point, have had a low blood sugar in my life, but maybe like, you're right. I do not understand these severe hypo episodes.
But I also can promise you it probably doesn't feel good to go from 60 to two forty in a matter of twenty minutes because you overdosed for a low blood sugar.
It's also not gonna feel good in twenty years when your heart pops or something else horrible happens.
Correct.
Yeah. Yeah.
So Correct. She had an a one c of five point four, and she was so excited. And she comes home, and she calls her dad, and he said, that's too tight of control. And I asked, can you just be happy that your daughter's healthy?
Or go to
school, maybe?
I would maybe see a therapist.
Right.
Well, jeez. You can pick them. Is that why you don't date anymore? Did you think I was I'm just gonna just gonna pick another one like this?
Just are not good options out there.
Did you did you try for a little bit? Yeah. I
mean, I do try.
Oh, you still do?
I dated someone after that for two and a half years, and that just didn't work out either. But maybe it's me.
Listen. I had a guy come on the other day, and he's like he's been on before. He we went all through it. So you guys probably if you're listening to this now, you probably just heard it recently. And if you didn't, please just listen to the podcast.
I work really hard on it. But he comes on because he'd been on before to talk about, I was on this pump. That pump sucks. So I went to this pump, and this pump sucks. So I went to this pump, and I'm really happy now.
Then he wanted to come back on to talk about how that third pump sucked, but then he tried a fourth pump, and that one sucked me. I was on a fifth one. He doesn't think it's right. And he starts talking, I went, hey. Hey.
Hey. Hey. It possible you're the problem? And then we had a lovely conversation where he was like, oh god. It is me.
And I was like, yeah. Yeah. Yeah. No. It's definitely you.
Yeah. I don't it's so funny. Actually, you know what? Go ahead.
That pop is only as good as its settings, I think. But
Yeah. Right. Exactly. I'm like, I don't think they all kinda work about the thing. Yeah.
No. Listen. I've been married this summer. I'll be married thirty years.
And
and my wife is, like, very smart and, you know, thoughtful and has a ton of, you you know just she's very she's just a very smart girl. Like and and you know? But she's also, like, very opinionated and pushy and, like, all those other things that Right. I'll joke about all the time and say, like, oh, like, I'll joke and say, next time, I'm just gonna get somebody that nods and just go, you know, okay. Is that what we're doing?
And, like, you and but because that's never happened to me once in my entire life, and I do wonder what it would feel like for someone just to look at me and go, good idea, Scott. I like you. Like so
but having I mean, I
Go ahead.
I no. I think it's nice sometimes to to meet a guy or a person that that knows what they want and to make decisions so you don't have to make all the decisions.
Yeah. Yeah.
Because being the primary decision maker isn't all that fun.
I definitely know girls don't wanna decide stuff, especially food
and things like that.
But Right. But I'm telling you, if my wife disappeared tomorrow and I started dating, I'd go find another girl like her. I don't know what's wrong with me. Like, well, I don't know why I wanna be treated this way. It
must mean you picked it right the first time.
I don't know. It's like it's like three times a year, she'll be like, I love you. And I'm like, oh my god. Are we doing that today? I was I didn't know we were gonna be feeling today.
She's gonna I'm sorry. I'm painting her in such a bad picture. I'm just saying that, like, she there's a type. She she has she is a type. And as much as, like, I sit around and go like, oh, no.
I don't know. Like, it would be nice to see what the other side was like, When I really start to think about it, I don't I think that would make me crazy. Like, if a girl ran around behind me agreeing with me all the time, I think I'd be like, oh, why are you doing that? Stop. You know, like, have your own thoughts.
And I'm Right. I'm interested in what you think. But, you know, so I can it's fun to complain about, but then you get back into it. I know I do the same thing yet. Anyway, that's my point with you.
And so you're just gonna end up with that guy again and again and again. So therapy for everybody.
Yeah. Right.
Yeah. Exactly. Go for because you're still young.
Reasonably so?
No. I mean, listen. They told me that AI and GLPs are gonna keep me alive, but I'm, like, a 110. You're gonna be going for a while now. There you go.
You're gonna need a guy to cut the lawn at some point.
That's true. I it does get tiring cutting it myself.
I was gonna say, aren't you sick of that?
I am. Tired of getting a single lawn grass. But I like the way I do it too, so I might have a hard time working with somebody else.
For years, my wife told me I was cutting the lawn wrong when we were first married. I'm like, what are you basing this on? And she's like, oh, the way my dad cut it. I was like, I don't know. Your dad doesn't seem that great.
I was like, I think I could
It's true. I have to load the dishwasher a certain way because my dad had to load the dishwasher a certain way.
That's what I'm saying. It's all ridiculous. Yeah. Then mostly, the dishes will come out clean unless you're one of those horrible people that lies them flat and doesn't understand anything. Yeah.
But I I had I was I've never said this on here before. It's been long enough. It was Thanksgiving, and we were at our house. And it was you know, everybody helps with the dishes a little bit afterwards. And so I'm rinsing dishes off and then putting them in the in the dishwasher.
And my sister-in-law was baffled by that. And I was like, what well, I don't understand what's going on right now. She's like, why are you washing them to put them in the dishwasher? I'm like, well, there's, like, chunks of food on them. It's not a magic box.
It's a Exactly. It's a box with a hose inside of it
that's that's, like, going Food's gonna go somewhere probably at the bottom of your dishwasher.
Yeah. I was like, wait. What are you okay. Then And I was just she was baffled by that. I thought, oh, world's interesting.
Anyway, so and she's a lovely girl. Just saw it the other night. It's her her birthday. So okay. So now the kid's moving.
Nine years later, still negotiating43:36
You're understanding better. What's the difference like? Like, you're you you have her lower stable. You've gone through the personality problems of him, like, giving her crap about her lower a one c, all that stuff. Like but where are you now?
How did you get to where you are now through all of that?
We're I'm not at a great place with him. We're still dealing with stuff, me and him. And even, you know, nine years divorced, we're still dealing with stuff. But, the children spend most of the time with
me. Exactly.
So it's easier for me.
Yeah.
I'm I'm the one in charge of most of it. During his times with them, he is the you know, he has to manage it, but I can text her and be like, hey. He needs to take a correction. That sugar is way too high. He needs to bring that down.
And and she can. You know? She knows how to do that kind of stuff, and she'll type in a correction. And if she doesn't know, she guesses.
That's that sounds exhausting to still be involved with somebody who divorced and nine years later and be fighting still. Could you guys have just gone on a family cruise and he fallen? Wouldn't that have been okay?
That might have been okay. But I've decided terrible people will probably live forever.
It's what he's saying about you right now. It's just something. He's like, this one won't leave me alone. Yes.
Correct.
So so, okay. So you still have difficulties. And by difficulties, you mean, like, as easy as, like, please don't let her overtreat her low. You know? Like, let's not leave her blood sugar so high.
And then isn't that confusing for her? Because isn't she managing one specific way with you, and then she goes to him, and then it goes out the window? Like, how does she
She came home one time, and she said to me I said, oh my gosh. It it kinda got high there for a little while. What happened? Oh, the crumple takes it. And I said, oh, no.
We don't say those things. Like, I know it will eventually, but there's no reason to sit there with a high blood sugar for hours and hours and hours. You're just hurting your your, you know, poor little blood vessels and stuff. And there's only so much she understands, but in her mind, she wants to be healthy. She doesn't want to die, and I'm not trying to, like, you know, scare her into you're gonna die if you don't take care of yourself.
But she wants to live a long and healthy life, and she wants more than anything to be a mom. And I said to her, you have to take care of these things if you wanna be a mom. Because if you wanna get pregnant and have babies, that's how we have to do it, is we have to take control of these things. And That's good that you brought that up with
her so early. That's that's why I we were just talking about that we. I just said we. I think I'm talking about my AI box. Sorry.
Hold on a second.
That's ridiculous. I just I just did a thing with my grand round series and pulled out, like, a bunch of lessons from it. And I'm just turning it into social media. And one of the things I can't believe I said we. And one of the things that that it pulled out about pregnancy was talking about like, it it was obviously in a conversation I had already.
And it was talking about about we we were talking about, you know, telling young girls early on, like, give them the expectation, like, so that it's not something they're trying to figure out, you know, when they find themselves pregnant or the minute they decide, like, oh, I'm gonna get pregnant now. Like, they they understand that this is a goal for the future. It's interesting to hear that you actually did that, you know, in your own life. Mhmm. Mhmm.
How'd you end up being such a good parent? Jesus.
It's hard. I also I I don't you know, obviously, I don't wanna sit here and talk crap about their father. But I have said things like, I know, like, I know he cries sometimes. And in all fairness, when when he was diagnosed, they did things a different way.
Sure.
So he doesn't necessarily understand this or this or this. But, you know, your daddy's had a lot of heart catheterizations, and your daddy has had poor wound healing from his surgery, and and your daddy is pretty much on the verge of, like, kidney failure. Like, there are things that we don't wanna do the way daddy did it because we don't wanna end up that sick.
How does he defend his opinion versus his outcomes?
I don't I don't know that he correlates all of it together.
Really? Is he is he what they call?
I mean, I think, again, it goes back to that poor me. Like, I just had the crappiest luck. Can you believe?
Oh, this is what my surgery?
And and now I have to have surgery again. Because it didn't heal right.
So it's not my decisions that leave me with poor healing. It's
Mhmm.
It's woe is me. This this stuff keeps happening to me. Right. Oh, and he and and you've at some point I mean, you sound angry at him. So at some point, you've blurted out to him that this is his fault.
Right? Like and so he doesn't yeah. No. I know you did for sure. I've been married for a long time.
I my wife likes me, and she would do that to me. So I assume I assume that you did it already. But but when there's no, like, come to Jesus moment for him there? He doesn't pause or nothing.
I mean, he tells me that he's gotten better. He went back. He got insurance. He got a pump. He got or he was on a pump for a long time, but he got CDM finally to talk to his pump.
No. No. I'm going all the time, and I'm getting my a one c down. I'm getting my a one c down. And then I think it has kind of lapsed again.
I think he got tired of it. And maybe he ran out of money to buy some GMs.
Can I tell you if I talk to him, I bet you I'd I would have it's fun? You know, listen. It's fun through your perspective. But, like, if I if I had a conversation with him and never met you, I bet you there's a a real story in there that would break your heart. Mhmm.
You know?
Probably.
Yeah. Even if, like, even if he's made bad decisions along the way. Like, still, like Mhmm. I I take I I would take his point. He was diagnosed a long time ago.
The ideas were different. He was diagnosed at 18. Doesn't sound he didn't go to college. Right?
Right.
Right. So he jumped right into the working world. Like, it sounds I bet you his parents didn't help him much with it. If they did, they probably didn't know what they were talking about because nobody did at that point. Things changed over the years.
What her daughter can do herself50:05
He didn't pivot with it. He starts having bad out poor outcomes. You gotta start protecting your psycho your psyche eventually because when you start realizing it's your fault, that's a that's a tough pill to swallow. You you know what I mean?
Oh, yeah. I can't need the insurance. I mean, insulin is expensive.
And These are the reasons
are expensive. And I mean yeah. Like, that's that's my fault. It's
right. Yeah. Yeah. Yeah. And by the way, a lot of that could be completely realistic.
And yeah. It's just it's just a terrible situation to be in. But It is. But for you, from your perspective, your main concern now is that this doesn't bleed over into your daughter's life and become her her situation too. Yeah.
Correct.
So so I guess then because I heard you say you don't wanna speak poorly of them, and and and I appreciate that because, you know, my parents were divorced too, and it's not fun when they
Yeah. I mean, I probably was very bitter in the beginning.
Oh, sure.
For part of your life. Wait. Take this with your life. Will admit that it is hard to sense yourself in front of the children. So Well,
yeah. You probably also don't want her ended up with a guy like him. Correct. Which she's probably gonna do because it's her dad. You know what I mean?
Although it didn't happen to you. You ran you said it, Your daughter's gonna end up with a jerk, and you ran away from a nice guy. We're all screwed. How do you think of that? But Right.
But so that is the real goal there, right, is that, you know, she grows up understanding without overwhelming her, you know, the the realities of what's going on, that you're gonna have to get her through, like, her teen years and through, like, her college age and and somehow be a a good partner to her till she ends up in her twenties because, obviously, you could've used somebody in your mid twenties telling you what to do. And Exactly. Trust me. I I should've I so I needed somebody too. And and then and then you have to, like you know, you have to you you you find a way to be involved without overwhelming them or being too involved.
And it's very, very difficult. Like, it's very difficult. If you think this thing is about, like, is about, you know, oh, I figured out diabetes, and we know how to bolus now, and my kid's eight, and it's going along, and that's great, you're out of your mind. Because then your kid's gonna turn 12 or 13, and there's gonna be a rebellion age in there, and hormones are gonna come, and that's gonna be another thing. And then just when you think that's over, they're probably gonna wanna smoke cigarettes or vapes or whatever these freaking kids do now.
Definitely gonna be weed if they've seen what's going on. And then you're gonna have to make yourself through that. Then they're gonna start to drink or not and then have sex or not and then go to college or not and then meet some dickhead or a nice per who knows? And then blah blah blah. And then the and if you get the girls, they're gonna wanna have babies at some point.
I mean, you think this is stopping, and you're wrong. Right. You know? Like, it's it's about it's about being flexible, seeing the problem in front of you, and trying as hard as you can to be as good as you can about it. And then just keep, you know, keep being there for people and showing up.
I hate to say stuff like that, but you gotta keep showing up for people. You gotta find a way to forgive each other, you know, to be kind even when you don't wanna be, and, you know, just shoot for the best every day. And some days go incredibly bad, like, poorly. And you gotta be able to, like, shirk that off and keep moving. And, you
know Exactly.
And if you can't, then some of these things are what happened. So I don't know. And then you're involved with other people, and they get to make their own decisions. And that they're not exactly on board with, like, doing the thing or, you know, being happy or, you know, they're not as enlightened as you are or vice versa. I don't know what you're supposed to do.
You should've just I don't know. Maybe they should make sex maybe they should make sex robots. You know?
Yeah. I I mean, I've had conversations with her. I mean, we still talk about it. I told her I'll be here for her as long as she needs me to be managing what I can manage from my end. But, yes, eventually, she's gonna have to to do it.
You know, she's gonna have to make decisions. She's gonna have to, you know Yeah. Hopefully, I'm around for a while.
What do you think about her personality? Do you think she's think she's wired right for this? Because, you know, I I've come to look like, imagine after talking to so many people that also some of this is just it's not within your control. Meaning, like, you are the kind of person you are, generally speaking. Mhmm.
Some people are just more you know?
Yeah. She's a very spunky child. She always has been my spunky, outgoing like, she went to school and loved it because it was social out of her. And then, oh, by the way, we're I think we're learning in the background. You know what I mean?
Like, she loved interacting with, you know, people and and all that. She was my very spunky child. Since diagnosis, she has dealt with a lot of anxiety problems, getting made fun of. I mean, the school is not as fun for her anymore. There are a lot of things that are very, very hard for her, and she gets very nervous doing.
But I think that she has a very strong personality, and she is I I she's very strong. She is a very strong girl, and I think she will get there.
Yeah.
She's just young, she wants to have fun. It's hard to have fun when you have this, you know, that that you have to deal with in the background.
Yeah. And then and then being kids on top of that.
Right.
How old is she again around?
She's 11.
Yeah. Oh, it's probably not gonna get better right right away.
Yeah. Some
some sometimes these girls are very mean to each other. Mhmm. These boys
are mean to each other.
Yeah.
Boys. Mean.
Boys just hit each other usually. That's better, honestly, because that ends, you know, pretty quickly. And then you just have resentment, and it's quiet in the background. Jeez. No.
No. I've seen some I've seen some mean kid stuff with, you know, my kids, their friends over the years. And and you're right. If you keep going, it all does sort of work itself out. You know?
It's not it's not like it's I mean, unless some of you were out there still living through middle school and high school as adults, and then I I would tell you that's a different problem. But
Yeah.
Yeah. Wow. What pump does she use?
She's on the same Moby.
The Moby. And you like it?
We love it.
Okay.
Good. Good.
What is her A 1C, did you say?
Well, her last one was 6Point2. But since diagnosis, we haven't been above a seven since her follow-up. She's had 6Point2, 6.3, 5.7, 5.4. Just kinda we're there in the, you know, five, sixes low sixes now.
Oh, good for you. That's awesome. Mhmm. What what's the key? Like, what what where what do you think like, if you had to boil down your daily regimen to, you know, the the small things that keep you in that situation, what do you think they are?
Settings, and being trusted to change them57:07
Pre bolus in breakfast, especially, is our big one. Breakfast pre bolus is huge. She doesn't necessarily have time at lunch and school, which we need to figure out certain things that way, but she's still insulin resistant in the mornings. Pre bolus thing for breakfast is huge. And then we correct a high.
We don't sit on a high blood sugar. Mhmm. If I see it climbing, I'm gonna grab it before it goes high. I'm you know, I I don't sit on it and say the pump will fix it. The pump will bring it down, and we'll give her a correction.
I I you know, and I have her pump set to alarm her at school. I can't necessarily see it. I can follow, you know, what her numbers are, but she can't I can't get ahold of her unless I call the school, and then school calls the classroom, and then she gets all embarrassed and whatever. So I told her, said, your alarm is gonna go off. Your alarm goes off because you've been high for however many minutes, you need to take a correction.
And she does.
Cool. You're not allowed to text her?
I am not allowed to text her. No. Just
happened, and then nobody knew.
Yeah. We've been working on her accommodation plan. It's a private school. There's you know, we don't do five zero fours. I'm still having I'm still finding that now with the five zero four.
But there's no school nurse. There's, you know, there are things that and they they have snacks or something in the middle of the day, and she's not allowed to call me from her phone to find out, you know, how many carbs are in it. And I was like, you planned that snack, she can call me. Well, she can call you from the office. She's not walking all the way down to the office and just not on the party because you planned a snack and didn't tell us.
What's the difference about where she calls you from?
It's not gonna be her kids if she has a cell phone.
Oh, boohoo.
You wanna talk about fair?
Yeah. Tell those kids, get an incurable autoimmune disease, and then they can have a phone too and use it whenever they want. Perfect. Exactly. Yeah.
Makes total sense to me. I love it when people don't make sense. It's my favorite thing.
Even older older kids look at her and say, oh, that's not fair. She can just carry a dog. I was like,
what? Douchebag. Hanging around there. You're children are assholes. Just wanted everybody.
I just want you to know. You're out there just being little douchebags every which way. Can you imagine caring about somebody else's cell phone revolving around their ability to take care of their their health.
And it's not like she's on Snapchat or any social media or doing anything fun with it throughout the day. It is there for her blood sugar.
I don't know how quickly humans' IQs are rising, but I'd like to go to sleep and wake back up when they go up about 30 more points.
Jesus. Yeah.
Exactly. Oh my god. Alright. Well, this is depressing. I mean, I appreciate you sharing this with me.
Can we call this do you think we can call this episode daddy issues?
That'd be fine.
K. I mean, I'm definitely doing that. Tell me what else we should have been talking about that I didn't because I know I took you in a way you didn't expect. So what what did you
from here. I I appreciate that you have a way that you that you take things. They're just just a way of managing Finding out you know, I didn't know for the longest time that I could have been getting Dexcom cheaper through a DME company than I was through a pharmacy. And, you know, being the insurance holder, you know, I I you know, all of these things, like, having insurance, first of all, I should not have to pay as much as I do for insulin or Dexcoms or any of it. You know?
And then, yeah, again, dealing with cost sharing and stuff like that with a co parent that doesn't doesn't like to lend a lot of help in those directions either. I mean, it's it's a lot. You know? And, yeah, I just I wish I would've known from the beginning. Hey.
I need to call the insurance company right now and find out what is the best way to be getting this or this, or how do I handle I mean, I don't know. Maybe I could be getting insulin cheaper if I didn't use my insurance. I don't even know. You know? It's it's crazy.
It really is.
Yeah. Well, what what happened? You're just talking to somebody one day online, and you're like, oh, wait. What what is this now? Is that how you figured it out?
Well, they they said something about it being covered through DME. And I was like, what is DME? Mhmm. And they're like, oh, it's durable medical equipment. I was like, okay.
And then again, I'm still picking up these Dexcoms from a pharmacy. And I was like, okay. But I thought these were supposed to be covered better. Well, they're covered under DME. Somebody tell me what that means.
You know? And then I finally had to realize there are, you know, durable medical equipment companies, and then I had to call them. And even the insurance company will say to you, yeah, that's covered under DME at 18%. But they won't tell you, you're getting them out of pharmacy. You need to call this company that we work with, and this company will get them to you cheaper.
Yeah. You just have to start looking around.
Yeah. No. It's a lot to have to do when all this other stuff is also stuff that you have to do. Mhmm. Yeah.
I mean, there's only so many hours in a day at at some point. You you know? Correct. What are gonna do? I listen.
I just picked up I just picked up Synthroid for my wife at the at the Walgreens, and Mhmm. It was way too expensive. And I know we can get it mail order cheaper. And I left there, and I thought, let me let's go home and, like, set that back up again. Because we had it set up, then my wife changed jobs.
My wife is the responsible adult in our relationship. She has, like, a job with insurance and stuff like that. And she doesn't make a podcast.
But I'm sure your contributions are quite quite a bit.
We're doing okay. But still, like, it's just it's you know, she's like the or she's like a real adult. And and so she switched jobs, and we, you know, we just kind of they switched, you know, mail order pharmacies. And we just never switched it back. And I thought, oh, I'll do it.
I'll do it. I'll do it. Now I realize she's had this new job for, like, four years. I've probably paid I'm not even kidding. I've probably paid hundreds of dollars in Synthroid that I haven't had to pay over the last couple of years just because, like, I just haven't been able to sit down and do I have to listen.
Today, I gotta get my kids have to get new doctors today. Arden needs a new endocrinologist because ours has a life, apparently. And I tried to explain to her that that wasn't okay. She didn't listen. I really did.
I said to her, hey. You've been married a long time. You've probably had enough of that guy. Why don't you just let him go and you stay here and be our doctor? She laughed and said, no.
I think I'm gonna go with him. And I was like, I mean, to each their own. You you know? Right. Can I can I tell you that that our that Arden's doctor who, you know, helps my whole family, who's who's doctor Benito from episode four thirteen about the thyroid stuff?
She is such a lovely person that that her practice is holding a going away party for her that's being attended by hundreds of people. It's a surprise party. She doesn't know. And hundreds of people have RSVP'd to come say goodbye to her at this party. It it just it just kinda goes to show, like, what could happen if you just put people first and like, she's a successful happy lady.
And, you know, like and I I watch her, and all she seems to do is care about the people she's helping and put an honest effort into it. You know? Stays up to date on things, isn't afraid to try to help, will talk to you. You know, like, you know, talking about your your freaking kid's school that won't let her call from one phone but can call from another phone because we don't want people to be upset. So, lady, if I texted her and said, hey.
I got a problem. She text me right back. She never told me it was okay to text her. You you know what I mean? Like, she's a she's a person who who at one point when Arden was getting started on on GLP meds, it was back before, like, you know, we weren't gonna get it covered.
She's like, I have samples. You can come get them. And Oh, wow. And then I said, oh, okay. Well, on Monday, I'll come down.
She's say, to my house and get it. It's fine. And then just texted me her phone number. You know? Like
That's amazing.
Yeah. Like, just a good person.
An endocrinologist who gives out her number1:05:14
And Yeah. I I love our endocrinologist, and she she makes me happy because she she trusts in some of the changes that I make on her pump and on all her settings. And she's like, oh, yeah. You know, you change them. If you have a question, can call me.
If not, you know, I I trust that you're gonna, you know, figure out what you need to know on that. I think if I would have gotten one of the other doctors in that practice, he might not have appreciated some of the changes I made without calling him first. Mhmm. We really do have wonderful endocrinologists that we see. But I haven't had doctors in the past.
I'm just like, oh, you shouldn't have waited to call through the office. You had a problem on the weekend? Here. Here's my cell phone number. Yeah.
Like, those those people are wonderful. They're fantastic.
It's super simple to make a to make an impact on people. And, I mean Mhmm. You know, just the other day, I I had a person ask me the other day, how did you like, how do you keep this podcast going so long? Podcasts don't last this long is what was what somebody said to me. And I was like, oh, I'm like, it's simple.
Like, I get up every day, and I think about, like, I wonder what would help everybody. And then I just try to do that. And sometimes it works out great, and sometimes it doesn't. When it doesn't, I don't feel badly about it. I just pivot and try something else and, you know, continue to wake up with the idea that I think maybe this is helping somebody and then, you know, try again.
It's it's really not hard to, you know it's not hard to do a good thing and the right thing at the same time. And Right. And Go ahead.
In an ever changing world where technology is always changing and treatments for things are always changing, I mean, there's so much more to to touch upon that you can just you can just keep going. There's always new technologies or new ways that you you know? You're talking about GLPs. You're talking about changes in in insulin pumps. You're talking about, you know, certain like, the just certain CGMs that you wouldn't expect them to do the things that they do.
Like, there's always ways to keep going. Yeah. Some of your new series on the podcast are just so interesting.
Thank you. Well
Because there's always more to touch upon.
But not just that too. And you've now you're a part of it too. But, like, you know, think about seriously about a 26 year old girl with type one who's listening to this today and going, oh god, and starts recognizing stuff about a guy she's with that you just said. And maybe maybe she'll stop for a second before she throws in with him, makes two kids, and spends the next nine years figuring out this wasn't the right thing to do. Like, seriously.
You know what mean? Like, that's a real value to somebody. And, you know, and everywhere in between. I I mean, you have no idea how many people have sent me private messages about their reptiles, which is just the thing that, like, I offhandedly talk about, like, once in a while. And there's a lot of people out there listening.
They're like, oh, I have one of those, or I do that, or I really like it. I find it com like, I get, like, really nice notes from them about that.
Mhmm. I
got one recently where somebody said they didn't realize they were keeping one of their pets incorrectly and learned it by listening to me and then fix it, the pet seems happier. I was like, Yeah. Didn't expect that one
when I started doing this. Interesting. Mhmm.
Why she talks back to the podcast1:08:17
Yeah. It's just it's just a great way to it's just a great way to talk to people. It it really is. I will
find myself I listen to your podcast. I did it a lot when I was driving, but now I do it when I'm on my walks in the morning. And I will find myself responding. Don't tell people that way. Yeah.
I think he can hear me.
Listen. I do that sometimes. I'm listening to people's podcast, and they hear somebody say something. I go, oh, what don't say that. And then it comes out.
It feels like you're in a movie. You're like, oh, no. Don't go in that door. No. But that's but that's a great fee that's a it's a really nice feeling to feel comfortable in a setting that you weren't gonna get invited into otherwise.
So, like, it's easy to say, like, find community. Where am I supposed to find that at exactly? You you know, like, again, there's only so many hours in the day. Listen. If if I'm if I started a podcast right now with four guys in their forties who all grew up with diabetes, and they got, you know, a bad start because the technology and the and the medicine wasn't there yet, and they had trouble pivoting to it.
And they all sat around and bitched about it and then let their feelings out while they were doing it. Your husband will listen to that. Your ex husband will listen to that, and it would help him. Like, I can't make a podcast for everybody. Like, do know mean?
But,
like Right.
The truth is is that that that would be him going, oh, here's a group of people who understand my situation. I don't have to actually stand up, raise my hand, and say I need help so I can privately look into it. And at the same time, get some feedback that resonates with me, start to make little decisions, and then before you know it, you pop out the other side, and you've changed. Like, it's just it really does work. But to keep it going for so long in an ecosystem that is fighting with me constantly like, you have no idea.
I I really don't wanna sound like I'm complaining. I'm sure I do. But to keep something going in a social media, like, digital world for twelve years is a sheer act of will. Like Yeah. That this this ecosystem is trying to get rid of me every day, and it's trying not to get rid of me.
It's trying to get rid of everybody. All it wants is for new people to start making content constantly, and it wants to throw away the old people. Mhmm. That's what it wants. Right?
It because it doesn't I think they would argue that they want democratization, but what I think is that they don't want anybody to be more powerful than the whole. So, like, it used to be YouTube, for example, would make some people really, really famous. But now it's not doing that the same way anymore. Mhmm. It's it's and and that feels on purpose to me.
Because I think when that happens, then the channel gets the ad money instead of the platform. That makes sense? Yeah. Yeah. So if I make a if you make a YouTube video and it gets, you know, a couple tens of thousands, couple 100,000, like, views, that's great.
It drag a 100,000 people into YouTube, and then YouTube serves those people ads. But when you get big enough that somebody offers you an ad on your YouTube channel, now suddenly YouTube's not getting that anymore. You're getting that. Mhmm. And so I don't think they want anybody to be bigger than the than the machine.
No. That's probably true. I never thought about that.
You wouldn't have to because you don't have a dumb job like mine. But and god bless you for not having to do it. Facebook you know, all I am to Facebook is I'm a carrot on a stick. Like, so I wanna create a Facebook group for all the reasons you discussed an hour ago because I know what
Mhmm.
A great thing it can be for people. And what they want is people to stay in Facebook so they can serve the mats. So anytime I try to share content with you that has a link in it, or now that AI is so good, anytime I try to share content with you that even intimates in its text that I'm asking you to leave Facebook, it it makes sure that nobody sees my post. So I can't say to you, hey. Today on the podcast, we had, I don't know, Katie Beth Hand on who, you know, is in the Elodon trial and
Right.
Free events. Right. Go click on this link to listen to more. If I say that, 84,000 people in my in my private group, incredible activity in there, like, as far as people online and in the group. If I make that post, it will not show it to even 500 of you.
Wow.
Yeah. And but if I rewrite it and it doesn't indicate that I'm asking you to leave, then it'll leave it up. And the and then what happens is people come to me, and they go, I don't understand. Why wouldn't you put a link in here so I can go listen
to this?
And I'm like, oh,
well Yeah.
You you know? And it just it goes like that. It it's just over and over and over. And
You see that on so many apps. Like, even TikTok will be like, oh, but follow me on the you know? And they have to give you a a another term for it because you can't say, you
know Yeah.
Instagram or you can't say you know?
And it doesn't work. I've tried I spent last year 2025 was last year, I spent $5,000 of my own money to open up another group on a different platform that doesn't control people, and getting people to it was completely impossible. So Facebook does have a a stranglehold on on the population. So it's okay. So it didn't work, and it was worth a shot.
It would have really helped you guys, but, like, it's just not how people think about it. So I just pivoted away from it. I like, okay. Well, then that didn't work. And, actually, it was my money, but I got a company to cover it.
So they paid me the money to do the thing, and then I paid the taxes on the money, and then I had to pay the thing. So it actually cost me money when it was all said and done. And but it still felt worthwhile to me because I thought it would be more valuable for you all, but it just didn't it didn't pan out. Like, people it's not what people wanted to do. So so right on.
Like, I I'm not fighting against what people wanna do, but I'm telling you, like, it it is a constant struggle. Even Apple Podcasts, like, they retune that that's where most of my listeners are at in Apple. Mhmm.
Right.
But they retune their algorithm all the time. Mhmm. So what they and they're doing the same thing is that they just don't want anybody to be too big. It's it's I don't understand the
Right. The cycle. Even things as simple as you would listen to one episode, and then it would automatically push you into the next one. Now it pushes you to a different podcast.
Yes. Yeah. That's by the way, if anyone from Apple is listening, fuck you. So, I mean I mean, really, like, difficult because I also pride myself in putting out a lot of good content. And so, like, it's I just the way I think of it is, you know, I've been I've said it before, but, like, I grew up listening to radio.
What she'd want another parent to know1:15:05
And, you know, Howard Stern didn't come on on Monday and then come back next Monday. He was on Monday to Friday, and you didn't get to listen to all of it. But it was always there, you knew it was there. Right?
Right.
But there was also nowhere else to go. If you wanted to listen to something like that, people talking, then that's you would go back and tune into that. I I can't even accomplish that now. So at some point, like, it it really is like, it it's a it's a it's a hump. Like, it really just is difficult.
But yet this is the best way to accomplish it still.
Sammy, it really is. And and the fact that you're still doing it after your daughter is older and in college and, you know, it's it's like you've done your job at home almost, you know, but you still have so many people that you're helping.
I like doing it too. Like, it it is nice. Like, I'm obviously very chatty. I don't know what would happen if I didn't get to talk at least once a day. Yeah.
I'm sure at some point, would just lose my mind, run around outside. But, no, I appreciate that. It it well, there's more to learn, and there's more to go. This just because I'm not as hands on with her every day doesn't mean that also over the last twelve years, I didn't learn from the countless 22, 23, 24, 25, 26 year old people that I spoke to that they still have trouble too. And that and that, by the way, if they don't handle that trouble, then it follows them into their thirties, and it follows them through their pregnancies.
And they one day end up being the divorced ex husband of a lovely woman who used to be a nerd or who's a nurse because who knows why? Because they have Mhmm. Weird attachments to whatever. They're not good with their they're not great with their their own health. It's causing them other problems.
Now those people are, like, you know, having heart catheterizations, but then telling their daughter who now suddenly has type one diabetes, it's okay. Don't worry about it. The pump will get it. Mhmm. Like, I'm trying to help break all those different cycles that we've uncovered over the years of doing this.
Like like I said to an advertiser recently, and they asked me how much longer I thought I was gonna do this because I am I shouldn't say me. The podcast is a big part of some people's advertising, like, ideas. Like right? Mhmm. And so they don't want me to just, like, you know, catch fire, flutter off, and go.
And I was like I said, look. I think I can do it for another decade, and I think that would be valuable for people through there. Like, into Arden maybe having her own children. Like, I think that's maybe when I'm I'm gonna run out of insight. And and I said, and I think that that'll be, like, the extent of, like, you know, being helpful for people.
I think I can do that. I said, but you guys gotta you know, everyone's gotta stick with me here because
Right.
It's you know, I I'm still young, and I have bills. And I'm not ready to retire yet, like, age wise. I'm also not ready to retire yet, like, financially. I can't just stop working. Like so if I can't do this for a living, then I don't do this.
And then I think you lose whatever whatever this ecosystem is that I've put together, it'll disappear. Like, I think it needs it needs to stay so that it can unearth other things and unearth other conversations and hopefully lead to other people's success. Or
I agree.
That's my goal. Nevertheless, if Facebook would just leave me alone for five minutes, I would be on if, like, literally I'm being serious. If just Facebook would calm down, then this podcast would be the biggest thing in the world because then 84,000 people would absolutely know when something was coming out, and they might go check it out. And then, you know, then you don't know what that would do for people with type one. Because if it got that big that it spread out that much, then just try to imagine try to imagine your situation specifically.
Right? And one day you get good information. Now look at the success your daughter's having her her health success.
Mhmm.
And there's two million people living with type one diabetes or whatever the the number is, like, in America. And and I'm only I'm reaching more of them than anyone else and still not reaching a big fraction of them. Right. Right? Just imagine that if every just forget me and my dumb talking and all that stuff.
Just imagine if everybody woke up tomorrow who had type one diabetes, made their way through the pro tip series, and then never came back to me ever again. And they learned to knock down high blood sugars and to pre bolus their meals and how fat impacted them and how to stick up for themselves at a doctor's office. Maybe that's all they took from it. Just imagine how much better everybody's situation would get if they just had that information. Exactly.
Yeah. So if you work at Facebook and you're listening and you have type one diabetes, maybe turn that dial the other way on me that I hear you guys have because I know it's there and you're controlling how much I'm allowed to talk to people. So may maybe just leave me alone for an hour and see if I can, you know, change the world in a more meaningful way. Anyway, now I'm complaining. Alright.
Jennifer Garner was with us again. Star of alias. Once married to Ben Affleck. We never said his name today, but, obviously, Ben Affleck, terrible person with type one diabetes who doesn't take care of his family. That was all facetious.
Your name is not Jennifer Garner. But it did occur to me while we were talking because we called you Jennifer Garner in the beginning as you were talking about your ex. People are probably like, oh, poor Ben Affleck has really taken it today. By the way, I like Ben Affleck a lot. I I Right.
I'm a fan is what I'm saying. Yeah. And you people should be ashamed for mocking him while he was dealing with alcoholism. Seriously. Stronk with the Internet.
Guy's trying to take his kid to school. Anyway alright. Anything else? Anything I missed?
No. No. I don't I don't think so.
I appreciate your time. Hold on for me one second.
Okay? Okay.
Today's show is sponsored by Tandem Diabetes Care, the Eversense three sixty five, and Touched by Type one, who you can learn more about on Facebook, Instagram, and at touchedbytype1.org. Head now to tandemdiabetes.com/juicebox and check out today's sponsor, Tandem Diabetes Care. I think you're gonna find exactly what you're looking for at that link, including a way to sign up and get started with the Tandem MOBI system. I'd like to thank the Eversense three sixty five for sponsoring this episode of the Juice Box podcast. And remind you, 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. If you or a loved one is newly diagnosed with type one diabetes and you're seeking a clear practical perspective, check out the bold beginnings series on the juice box podcast. It's hosted by myself and Jenny Smith, an experienced diabetes educator with over thirty five years personal insight into type one. Our series cuts through the medical jargon and delivers straightforward answers to your most pressing questions.
You'll gain insight from real patients and caregivers and find practical advice to help you confidently navigate life with type one. You can start your journey informed and empowered with the juice box podcast. The bold beginning series and all of the collections of the juice box podcast are available in your audio app and at juiceboxpodcast.com up in the menu. Thank you so much for listening. If you're not already subscribed or following the podcast in your favorite audio app like Spotify or Apple Podcasts, please do that now.
Just hitting follow or subscribe really helps the show. And if you'd like to go a little further and leave a review in Apple Podcasts, that would be fantastic. But most of all, sharing the Juice Box podcast with someone you know or someone you think can be helped by it, that's the biggest thing you can do for the show. I'll be back very soon with the next episode, so don't forget to check your apps.
Read the full disclaimer
© 2007–2026 Juicebox Podcast. All rights reserved.
#1959 Dr. Joanna Mitri from twiist
Dr. Joanna Mitri from twiist
Dr. Joanna Mitri is an endocrinologist and Sequel's chief medical officer. Scott brings her a list of questions from the audience about twiist — coverage, cost, sensors, tubeless, and what's next.
Jump to a moment
- She came to fix diabetes care, and stayed to build the tool. Dr. Mitri trained in endocrinology in Lebanon, where she describes care as fragmented and access difficult, and came to the United States intending to learn integrated care and go back. Instead she spent years overseeing Joslyn affiliates — going into clinics in the US and abroad to repair their diabetes care models.
- Her diagnosis of the real problem: we build the model and make people fit it. Every clinic she visited had a different obstacle — staffing, electronic records, whether they had a diabetes educator at all. Her conclusion was that excellent technology existed and simply wasn't being offered, because it was seen as too complex or didn't fit the workflow. Joining Sequel was, in her framing, a chance to build technology around people instead.
- The number they brought to ADA. She reports that real-world data on people using twiist in daily life — not in a study — showed almost seven out of ten meeting recommended glucose goals. Scott presses on whether that's people who were already doing well; her answer and the surrounding detail are in the episode. These are the company's own reported figures.
- Coverage runs through the pharmacy, not durable medical equipment. twiist is cleared for ages six and up. Her description of the path: see a provider, get a prescription, fill it at the pharmacy — which removes a common barrier. On cost, she says commercial insurance means $0 the first month and no more than $50 a month after, covering the kit, the cassettes and the infusion sets. Medicare depends on the specific Part D plan, and she recommends checking with Sequel directly rather than guessing.
- On tubeless, and on sensors that misbehave. Asked the audience's most common question — will there be a tubeless twiist — she doesn't commit, but says they hear it and want the system to meet people where they are. On unreliable sensors, she notes twiist works with two sensor options, and that because the algorithm re-decides every five minutes rather than learning over time, a bad reading doesn't set a lasting course. Nothing here is medical advice.
- twiist — The twiist AID system from Sequel, powered by Tidepool — targetable to a glucose level as low as 87.
- Diabetes Pro Tip series — Episodes 1000-1025 — settings, insulin timing, and food impact.
- T1D Exchange registry — US residents 18+ with type 1 — take the survey and support research.
twiist™ is for T1D ages 6+. RX ONLY. US ONLY. Important Safety Info: twiist.com/safety.
The twiist™ Savings Program offers U.S. residents with commercial insurance a $0 Starter Kit and Refill Kits for $50 or less (may be higher with high-deductible plans). The maximum benefit is $200 per Refill Kit. Call 1-877-489-4478 or your insurer to verify coverage.
The Eversense 365® Continuous Glucose Monitoring (CGM) System is indicated for continually measuring glucose levels for up to one year in people (18 years and older) with diabetes. For important safety information, see bit.ly/eversensesafety.
Every word of the conversation
Cold open & sponsors0:07
Hello, friends, and welcome back to the juice box podcast. If you don't love today's episode, you can have your money back. You should not, in any way, shape, or form, take anything you hear on the juice box podcast. As medical advice, I'm talking about medical advice, regular advice, any kind of advice. This is a podcast.
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. I cannot stress that enough. Spend a few minutes today making the world of type one diabetes a better place by completing the survey at t1dexchange.org/juicebox. They're looking for US residents 18 or older who have type one diabetes.
T1dexchange.org/juicebox. Links are in the show notes. This episode of the podcast is sponsored by the Twist AID system powered by Tidepool that features the Twist loop algorithm, which you can target to a glucose level as low as 87. Wanna learn more? Go to visit .twist.com/juicebox.
That's visit.twist.com/juicebox, and Twist has two i's. Understand? Twiist.com. Visit .twist.com/juicebox.
Hi, Scott. Thanks for having me today. Tell you a little bit about myself. I'm Joanne Amitri, an endocrinologist by training, and I'm the chief medical officer here at Sequel.
Oh, you guys make the twist pump.
We do.
I am excited to talk to you. I have a list of questions sent in by the audience, and I'm sure you have some things you wanna share too. Can can I just ask you a little bit about yourself before we jump into the questions?
Yeah. Of course.
From Lebanon to Joslyn to Sequel1:57
Tell me what happens to you in your early life that makes you want to be a physician, and then once you decide to be a physician, what makes you pick endocrinology?
Yeah. No. It's it's it's a good question. It's actually a long story, but I'll make it short. I really started out with a plan.
At that time, I think it was a clear plan. I and, you know, I was interested actually in food, to be honest, like how food shape, like, our health, how it leads to growth and aging. And that's what really led me to do diabetes and endocrinology in the first place. But where I grew up is in Lebanon. It's a country where, like, diabetes care was is very fragmented
Mhmm.
Scattered. And I'm sure you, Scott, and many people here would would would identify with something like that where, like, access sometimes is difficult. Things are not coordinated. So I came to The US because I wanted to know, like, how, like, integrated care works. So I thought I'd come here, and I'll go back, and I'll build everything in one place.
But that didn't happen. So instead, I actually ended up working here in The United States on care models for diabetes. What kept what I can tell you yeah. Go ahead.
I cut you off. I apologize. But what what kept you? Was it a was it a job that you loved? You meet a boy?
What what what made you not
want? What happened? Great. All of the above, but no. No.
What I say is that, so I it's funny because I really wanted to go back and build that center in Lebanon. Mhmm. But I was lucky because what I couldn't do in Lebanon, I was able to do it here in The US for many places. I was overseeing what we call the Joslyn affiliates, which means we go to centers in The US who needed to help fix their diabetes care model, and we would help them. We also did it internationally in different countries in the world.
Wow. So I felt like I couldn't accomplish my mission in Lebanon, but I I did it here for other people who needed it. And I can tell you that every everywhere I went, whether here it's in The United States or outside, I felt that, we tend to build model or technology and fit people inside and not the other way around. Mhmm. So when SQL, came up and the opportunity came up, I felt like this will be an opportunity for me just to to be part of a technology that actually work in people's life and not the other way around.
So this is how I ended up at Sequel.
It's interesting that you bring this up because I was just having a conversation with a friend of mine who is a CDCS and a a lifelong type type one. And we were talking about how the academic side of diabetes tends to say, oh, this will fix it, but they don't often, do a great job of wondering if that's what people need or finding a way to translate it to regular everyday life. Can you tell me, when you were doing that work, what are a couple of things that still stick out in your head now that you identified when you looked into clinics that needed to be, like, straightened up, fixed, I don't know, collected in a way that could be used over and over again and be valuable?
Why good technology never reaches people5:26
Yeah. This is really great. I mean, honestly, like, this is where I found most of the challenges. First of all, every that's the thing. Every clinic had a different problem.
Not all clinics are the same. It really depend on resources, how much people and staff they had, what electronic health record they used. Do they have diabetes educators? Not all of them had diabetes educators available to teach about new technology all the time. Mhmm.
So I felt like there's a lot of technology out there. There's a lot of new devices, new tools, amazing technology, and but it wasn't being used, because it was felt that it's either too complex, or there wasn't enough enough staff or models to incorporate it into their workflow and to offer it to people with diabetes. So at the end of the day, many people were actually left out. They were not even offered what's existing out there.
I I find that I think of it as the this, like, cycle that keeps everybody trapped. So is the is it's like a chicken or the egg. Right? Do you spend your time educating people so they can make better decisions, or do you put technology on them that will limit their need to make decisions? And then somebody eventually says, oh, well, if they don't know how to use the technology, that might be dangerous.
But they're also in a dangerous situation now. So it's almost like, you almost have to pick one and go with it. And what I found is that there are some people who are eager to be educated, to be able to make better decisions, and they're able to take that that in. But there's also some people where that's not a good fit for them, and that I don't think that means that they should be left out of a healthy lifestyle. So what did you land on?
If you could only if you magic wand people and it had to go over the whole society, you can only decide one thing, would you lean education, or would you lean technology that does it for them?
Yeah. First of all, it's it's it's it's really a great question. And you're talking specifically, Scott, about people with diabetes. Right? Do you educate them or you give them the tool?
Right.
I I think what what in my in my opinion, the ideal thing to do to give people with diabetes is to let them determine the goal they want and then give them the tool that lets them get where they want Mhmm. In my opinion. So I think, yes, you wanna educate them, but you wanna give in my the priority would be give them the tool that will help them get there. Let them decide what goal they want, and the technology will help them get there.
Yeah. I'm with you. I I have to say that if I take a pill that takes care of a thing, I don't care how the pill works. I just know it works. And, you know, as long as I have it, I'm okay.
Because I'll hear people make the argument, well, they need to know how to do it with a with a needle and, you know, and a meter. And I don't I don't disagree that that would be valuable, but some of this technology and I guess we should just jump in and talk about it. Some of this technology is so advanced and just continuing to to advance that I I just think it's sort of a shame not to give it to people. I I that that's my opinion. I wouldn't be I wouldn't be worried, oh, they can't figure it out.
I think they'll figure it out way sooner than they're gonna figure out that a meal with 40 grams of fat in it isn't gonna hit them the same way as a meal with 10 grams of fat in it. That's a that's a heavier lift for a lot of people. So can you start off by telling me what Sequel and Twist talked about at ADA? Like, what was your big, your your big reveal at ADA?
What Sequel brought to ADA8:54
We're a company. We're really focused on improving how, people living with diabetes, improve how we can improve their lives. So we have the Twist system, and, we launched it back in July of last year. And, it it was really great to be at ADA. It was a big moment for us, which happened at in June of this year.
And what I was really most excited about, I would say, is to bring what we were able to bring this year, which is really a big batch of real world data that we've looked at on people using Twist in their everyday lives. Mhmm. And not not really in a study, just like using it on a daily basis. And we shared that data with the diabetes community, with health care providers to to tell them how how really Twist has been performing in real life.
What what was exciting about that data? What did you what did what's your take what should people's takeaways be about using Twist?
Yeah. I think the headline, I would say, for me was that the data we show we shared showed that almost seven out of ten people using Twist were able to hit their recommended glucose goals.
Seven out of ten hitting their goals10:11
And are these people who previously struggled to meet that goal, or they were already doing well and discontinued to do well for them? Who who I guess everybody would benefit if if if the answer is both, but I'm just wondering because sometimes this data gets skewed a little bit. Right? Like, we gave, we we gave, lollipops to 10 people that don't eat lollipops. None of them ate them.
You know, that that kind of thing. Like, what what did you guys do? How did you put this together?
Yeah. And I love this question, and and the answer is quite simple. We actually didn't filter anything out. These are people who made their own decisions to go on Twist, and they come from different backgrounds, from different prior therapies. Some people were on AID systems, and some other people were even using the DIY, and others were coming from injections, multiple injections per day.
So we've had people coming from all those backgrounds, and this is the result compiled for all of them without, like, leaving every filtering or leaving every anybody out.
Filtering mean you didn't take any data that you didn't like and pull it
Gotcha. We just all of them looked at all of them.
Well, what's unique about the algorithm that's running on Twist? Why don't you tell people where you guys got it from and why you think it's it's a good choice?
Yeah. So we got it from the DIY community. I don't know. I can tell you a little bit about that, or I can jump into the algorithm uniqueness.
No. You know what I would say? I would say let's talk about that a little bit because I think that the DIY online, like, the people just listening, not people who are involved in it or really understand it, but I think it had a season. And I don't think it gets talked about as much as it should anymore, that there's a an awesome group of people who have been working on some of these algorithms, you know, privately in their own time for a long time. And Loop, I guess, is, you know, is one of them.
So tell tell me how Loop goes from being a thing that people online are making for themselves and sharing amongst each other, and how does it end up on a on a retail pump?
Yeah. I wanna say awesome is the correct word about this community who developed, this algorithm. So, yes, the twist loop algorithm is actually based on that, diabetes community driven type pull loop. And so I'll tell you a little bit more about it because the people who built it, these are the people who are we call them like, they built a movement called the we are not waiting community movement.
Sure.
And we really value everything they did and they brought to the community because those are people with diabetes who didn't want to wait based on the needs that they felt their their loved ones needed to have.
Why does it well, let me say this before I ask my question. I I just like to share this from my personal perspective. I think not only is the work that has been done over the years by all those people too numerous to mention important, I actually believe it's what drives the space. I think that most companies are out there trying with their algorithms because this thing got started. I think there's an argument to be made that if if the we are not waiting movement didn't happen, then a lot of people would've waited.
So I I I just I wanna applaud everybody. I think I think we're where we are now because of those people. Don't have you don't have to answer if you don't want to, but that that's my opinion.
Well, I have to say that it's because of this community and because at SQL, we share the same values, and we wanted to bring in an algorithm that was built by people who really like I said, rather than designing system and trying to fit people in Mhmm. We wanted to we wanted to include a system that was built by community for people and instead offering that so it can fit in their real lives.
Targeting as low as 8714:14
Yeah. There's a lot of smart people out there. So so okay. So you get this you know? So, I guess, so that people can understand a little bit, Tidepool did the lift, right, of getting looped through the FDA.
And then
We took it and embedded it on we did some we call it mathematical equivalence and embedded it on our pumps.
Could another company could I do that? Could I say, hey. I have an insulin pump. I wanna embed it on there. It's already been cleared.
Would it work that way?
Well, the code is in the is is is in the open source, so people people can access it, obviously. But I think to get it on a pump, there's a lot of work that needs to be happened to integrate it so it can be part of, like, a closed loop system.
Yeah. I I don't worry about I'm not starting a juice box pump. I just want I just want although it's not the worst idea in the world. But, no, I just wondered if it somebody else could pick it up and use it. So okay.
So you guys, you integrated together and start selling them last year. People are having good outcomes on them. Are we seeing, like, measurable a one c drops? Are we seeing more time in range? Do we see there are people reporting less distress, fewer lows?
What's the feedback so far?
We put it out there, like I said, in July, and people decided to go on those who decided to go on twist. We looked at the first batch of data, and we've seen that overall without taking anybody out, those who started high or low or those who had any if anybody had any issue, all of them actually, together achieved a time and range of 74.4. And like I mentioned, almost 70% of those users achieved their targets.
What's is that range fixed for everybody? The the the low high range that you're that you're saying time and range for?
That's so people can achieve their own. Like, they could say what they what they wanna be at. Mhmm. But the American Diabetes Association, there's a consensus on people need to achieve a certain amount of glucose between between the time and range that it's recommended, and that's the one that I'm referring to.
What is that range?
70 to one eighty.
70 to one eighty. Okay. And loop Lupin Twist allows you to target like, what's the lowest blood sugar you can target with it?
And that's one of the uniqueness about Twist. So in most others current existence systems before Twist, like, you could set it up as low as a 100, the lowest. And with Twist, you can you have a range, and you can set it up as low as 87. Mhmm. And you can go as high in one eighty.
So you really have this, vary or this large correction range.
Yeah. A target number that the that the device is shooting for when it's giving you insulin.
Exactly. So it goes as low as 87, and it goes at as high as one eighty. You can select any number in between to meet your own goals.
Mhmm. Was it what's it like doing your job at a company that is you know? I mean, you're sort of a software company. You're sort of a hardware company. Right?
Like, you're you've got a pump now. I have a a question here from people, about your site. When do non Clio sites options arrive? So, like, is there an auto insert coming? They have a lot of questions, I guess, about how the pump goes on to them.
Here's what makes Twist different. It measures the volume of insulin delivered with every dose using Soundwave technology. That gives it the ability to recognize a blockage quickly, allowing you to step in and deal with it before things potentially get out of range. It is also the only automated insulin delivery system that can be controlled from an Apple Watch. So you can discreetly check-in, enter carbs, or deliver insulin right from your wrist.
You can also set your glucose target anywhere from 87 to 180 milligrams per deciliter and adjust it for different times of day. So if mornings, workouts, school work, or bedtime all need a little different approach, Twist can flex with that. And here's a real life example. You enter carbs then something changes and you do not actually eat what you planned. With Twist, you can go back and correct or remove the carb entry and the system adjusts based on the new information because diabetes doesn't always follow the plan and your tech probably should not expect you to either.
If you'd like to learn more, go to visit.twist.com/juicebox. That's visit.twist.com/juicebox. Don't forget, Twist has two i's.
Yeah. First of all, I'll tell them we hear you, and we're we're always trying to improve on things we have. And you're correct. And we have taken some steps to enhance the experience. And now ICU Medical has modified some of that on the inserter adhesive pad to to help maintain the adhesions performance.
And we, on the other hand, we are working at SQL on our proprietary infusion set because we want to be able to give users more options.
K. Do you have a time frame for that? Do you have any idea when it might be available?
I I can't share a timeline, but I can tell you that, we got it cleared, and, we're just right now have to work through some logistics, some testing, and then putting it out there.
Oh, that's exciting. Well, so that's a a hardware question. People also said, why why did temp so temp bazel, did it get removed from your version of loop? It isn't available when loop mode is running, and they wanna know if you're gonna give it back or not.
How the algorithm actually behaves20:07
Yeah. So I can tell you a little bit on the temp bazel just to I do wanna clarify first that we do have temp Basel in two ways. The first way is that if if people wanna use manual mode, they could set a temporary Basel. But when in your in loop mode, which is when you're in a closed loop, the you the system does the adjustment for you. So they it does this what we it it is a temporary basal because it adjusts your basal every five minutes and put it in another state to make sure it it's accounting for the glucose and where you are, where you're going to be, and how much you ate how how your carbs is being absorbed.
So it sets up its own temporary basal to while you're looping. Mhmm. But I think what the community probably wants to hear is that we're there are more features coming up. And I think if there's more features like those, the DIY would call them, like, presets, there's more feature we're continuously evolving, to include, features that exist and people love in the DIY, and those are things we're listening to and try we will be bringing at some point.
I have a question that comes right from me. So I don't know how long ago my daughter started to use Loop, But, god, it feels like it was maybe six years ago, I'm guessing. And when I started, I feel like I started on a version similar to the one that you guys are using now, but then eventually moved to one that instead of trying to address higher blood sugars with, like, a basal increase, it started to do a bolus. They called it auto bolus back then. And I'm wondering how how does this system address higher blood sugars, and do you have an eye on on changing that, or do you like where it sits now?
Yeah. It's it's a good question. But, Scott, I'll I'll tell you. So if your glucose is high, you get insulin. You can get it whether you get it in a bolus or in a basal, insulin at the end is insulin.
Right? So some people gives it different type of names, on how it adjusts for the glucose. And in the current version of the twist, loop, algorithm, the adjustment for when your glucose is predicted to be high happens through what we call basal modulation, which means the basal was will go up so it can adjust for the, predicted high glucose taken into account, obviously, other factors as well.
Mhmm. And do you think yours will ever will you look at the auto bolus version? Do you see a reason to do it, or do you do you think that what you have is is is great and doesn't need to be adjusted? I guess I'm wondering about when you get the algorithm from, you know, the DIY community and it comes into the company, do you start thinking about how to make improvements to it in house, or do you think about going back out to DIY and because then don't you have to then put that back through the FDA if you did that again? Like, I I don't under like, it gets intricate and hard for me to understand right there.
Yeah. I can explain a little bit more. So first of all, we we do listen to people like you, who who express on what they need. So we're listening right now and trying to see if people wants those additional features. Be like I said, we know that there are features that people love and want, and they're feature that some people love but others may not want.
So what we do is that once we hear all the feedback, and this is what we're actually doing, is that we take that and work with Tidepool, to to kind of source those codes and upgrade it on the pump and work with the FDA to, update the next version of the algorithm.
I like that. That's a good answer. Thank you. Is Twist compatible with Dexcom right now?
It is not. But we know that for us, providing people with diabetes with choice is at the core is the core of what we do every day, and that includes CGM choice. So we don't have a public timeline on that, but our work is ongoing. But in the meantime, I'll say, Scott, that, our CGM road map is really actively expanding. We we are integrated with Eversense three sixty five, the Freestyle Libre three, and we are working to finalize the the Libre Duo integration as well.
Awesome. Thank you. How about for Android devices?
So, Android is this, I wanna say, is kind of, on the same page that, we we know that some people have different preferences on what they use. And, and if you're on Android and you're interested in Twist, I could say that you can't use it yet, but I don't I don't wanna brush pass past that. So, it's something our team is actively working on, and it is coming. I just don't have a date on it today.
Okay. That sounds more promising than a Dexcom answer, so that's good. Multiple profiles. People say multiple basal insulin to carb ratio, insulin sensitivity profiles for exercise stress, menstrual cycles, etcetera. They wanna know if those would be available.
So I guess set up a profile that's like, this one's when I'm active. This one's when I'm sedentary. This one's for when I'm sick, that kind of stuff.
Profiles, presets, and variability25:42
I think it's an important things to be able to have like, wanting to to have different profile if that's what works for people because they have variability. But but what I could say is that currently, Twist have tools right now in place to allow to flex for that variability. Mhmm. Because we have things like activity pre exercise preset. But for those who obviously likes to completely change profile for a certain period of time, those are things we're also working on based on feedback, some of the feedback we've heard.
Yeah.
Yeah. But but what I could say, maybe, Scott, just to add is that our algorithm, because it doesn't learn, so, it adapts, which means that if you're right now go through, let's say, exercise or hormonal changes
Yeah. To what's happening now. It's not
Exactly.
I'm jumping around a little bit here, but I'm enjoying the way we're doing this. Are you okay so far? Are you feeling good?
I'm feeling very good.
Awesome. Awesome. So there's a question here from the audience. I have to tell you, a lot of people ask me questions and I generally have answers, but this one I never quite know how to answer. How am I supposed to use, they wanna know, an automated system that relies on the data coming from my CGM when my CGM feels like it's never accurate or sometimes says I'm 400 when I'm 60 or says I'm 60 when I'm 300, like that kind of stuff.
“What if my sensor is never right?”27:14
And and all I can like, you know, when I when I'm asked the question, I say, look. All I know is that Arden has used Omnipod five. She's used Loop. She's used Trio. It's never been a problem.
And I don't but that's also my daughter also does not have a lot of issues with sensors. Right? So her sensors tend to work well, not get choppy, last the entire time. But I I never do know what to say to those people. Do you have you this is a thing you thought about or that you talk about internally?
So first of all, the if they have issues with one sensor, the good thing about our system is that it's compatible with two sensor Mhmm. Right now. And we're we're con like I said, we want to provide people with more choices. So if a sensor doesn't work for them to to select another sensor. But the other thing is that so there are some guidelines.
Right? If the sensor is completely off by a good amount, you're talking here over 50 or, like, really off, then, obviously, you you you're gonna the the the algorithm will make a decision, but to say how much insulin to give. But the uniqueness about Twist is that that decision will change in five minutes if that was if something was wrong and the sensor let's say, you change sensor or you fixed or things don't go in the right direction, the algorithm will reset again every five minutes and make the decision based on new information. Mhmm. Now if the sensor is off the whole time for like, you check and it's not really you're not able to there are sensor you can calibrate, sensor you cannot calibrate, then, you just basically, you can't you have to change the sensor.
Yeah. Okay. Let me ask you a a quick question about access and coverage. So people wanna know about how to get started. Is it covered by private insurance?
Coverage, prescriptions, and the pharmacy29:13
Does Medicare cover it? And then they actually, some of them specifically asked about certain health health care coverage. I'm not gonna ask you names, but I'm I do appreciate everybody sending the questions. And is there any plans for your indication to go under six years old?
Yeah. Right now, we are Twist is cleared for those age six and up. And in terms of access, right now, the path is very clear for us. If somebody wants to go on Twist, they'll speak to health care provider. They get a prescription.
It comes through the pharmacy. There's nothing that go through durable medical equipment, which sometimes may take longer and more things to navigate. So that removes one of the barrier. Now on cost wise, I think the the way it's designed that the first month, it's go if you have an insurance, the cost will be $0, but then it will not be more than $50 a month afterward for for refills. I'll say that when we launched or as we launched, we had a strong commercial coverage.
Now there may be specific plans you have called out maybe. I would say the most reliable way to get a real answer is to reach to your SQL team because, coverage can be different between one one and another, and I don't want to just make a guess here.
Sure. Sure. Of course. Oh, I appreciate that. So I'm I wanna make sure I understood what you said, though.
So if it's covered, it's nothing the first month and then no more than 50 moving forward. That's private insurance?
If you have a commercial insurance, the first month is $0, and then it would be no more than $50 per month, afterward.
Oh, wow. So what do you you're getting the device itself and then infusion sets. Is that right?
You would get the whole kit, the device, the infusion set, and, yes.
Okay. So the 50 a month would be for infusion sets mainly?
Well, the pump has two parts. It has the cassette, nonreusable part, and you have the reusable Okay. So you get in your package.
Yeah. I didn't mean to talk over you. The cassettes are disposable along with the infusion sets. That's the the supplies you're gonna need month to month. I got it.
You would be getting this on a monthly basis.
Zero the first month, fifty after31:37
That's a really fair price, actually. Is that a thing, like, that you guys set out to do? Is that was that part of the the idea when you got going? Like, let's do something that won't cost a bunch of money, or, I mean, is that just how it worked out?
This was really very important to us. It's one of the things that our CEO is very passionate about. Arlen Lodwin is our CEO, and and the first thing that he really told everybody and told us that he wanted to make sure that those system are accessible, and they are at a price that people can afford. Obviously, I know not everybody can afford, but I think we wanted to make sure that that we can work with payers to give it at at a at a rate that may work for many.
Yeah. How about I I did I miss did I not hear? But did you say, is it covered by Medicare?
So right now, it it depends. So we we the the way it works with Medicare, I think, depending on the specific plan that people may have.
Okay. Alright. So they should check with Medicare to see if it's covered?
Well, if they are on Medicare Part d and they have a specific coverage, that's what I meant. They may have coverage through the pharmacy.
I see. I see. Oh, through pharmacy. I'm sorry.
Correct.
I'm gonna ask you for a second a little bit about what you guys are looking into for type two, but I don't wanna I don't wanna make people wait any longer for what I think might have been the biggest question that I got asked when when I went to the community and asked. And here it is. Will Twist ever have a tubeless option?
Will there ever be a tubeless twiist?33:16
So it's very important for us. Like I said, this question and many others, when people we we we want to be able to meet people where they are. We want to listen to what, really matters for them. And, we know that tubeless is something people are asking about. Some people may think that they want tubeless because they want something maybe easy to use.
So we listen to all of that, and the idea for us is to make sure we we make Twist is continue to be able to be personalized to everybody and meet them where they are.
Is there anything I haven't asked you that that I should have stuff that would have led to information you want people to have about the device or the company? Did I leave anything out? I am gonna ask about the type two stuff, but I wanna know, like, did I leave anything out? Because in my listen. Here's how I'll put it.
I feel like I know a lot about loop. And not as much as some, but a a fair amount. And I know how fantastic it is. My daughter used it for years. And I would tell anybody if you wanted to use a DIY loop and you couldn't figure out how to do it, I would a million percent look into Twist.
I would also say this is probably a good time for me to say that you guys are on again, off again advertisers on the podcast. And I think at this at this juncture, we are actually in the middle of a a contract. So just so people know that. But I'm telling you, if if you wanna try Loop, definitely look at Twist, especially if you're afraid to build it yourself. But I wanna make sure that I didn't, like, skip anything or miss anything that you're sitting here thinking, oh, no.
They should really know about this part, and it didn't come out.
Yeah. Maybe if there's, like, one last thing I wanted to leave people with is that that the the belief that we we build around because I've heard few questions and that we believe that technology should adapt to the person, not the other way around. Mhmm. So we listen to feedback, and we're committed as ever to the community that we're serving today, the type one community. And I know you've had questions on others, and we're trying to make sure we're putting a lot of energy to making their their experience better, but also expanding access to others.
Now our Twist algorithm has what is unique about it is that you're you're able to really customize it according to to your target and to your needs, but also the the health care provider who's helping you have some levers to will have some levers to use if they wanna be more aggressive or less aggressive. They have those tools that we are we are teaching them about
Type 2, and who else this could serve36:03
Yeah.
To make sure they're comfortable adjusting their their settings for the patient sitting in front of them.
You're telling me that other systems some other systems work the way they work, and that's that. And you you can actually go into into Twist, into Loop, and make finer adjustments maybe to insulin sensitivity, carb ratios, things like that.
Yeah. So if people I mean, I'm a health care provider, and sometimes it's hard to to know which because there's things that you can't change. And with Loops, you have the option to change things if you want to be, more aggressive or if you want to account for a few things. And and the last thing I would say about our algorithm is that it has also some uniqueness that it does adjust for how your carbohydrate is predicted to be absorbed. You know that not all foods are absorbed in the same way.
Right? So some things may be absorbed quickly. Something may be absorbed more slowly. So the algorithm, when it makes the adjustment for insulin every five minutes, it takes into account the the meals that the patient or the person with diabetes would have entered.
Yeah. Is that still done by touching pictures of food, like lollipop and stuff like that, or did you guys make an adjustment to how that works on on this system?
It is done by selecting an emoji. Yeah. And for those who don't wanna select an emoji, it will select it will default, sorry, to the three to the three hours absorption Mhmm. Which is probably the majority of the meal.
It's a fantastic algorithm. It really is. It's just whoever thought it all up and did it, yeah, kudos to them. And and for you guys for bringing it out into the world, I mean, I've I've always said I'm very candid on the podcast. I've always said, I think the DIY community is fantastic, and the algorithms they build are amazing.
But, I mean, how many people are we really reaching with them? Like, it's people who are comfortable building an algorithm and uploading it onto their own phone, and it's just it's a leap for a lot of people. It's wonderful to bring it to the masses like this. It just it genuinely it's a it's a great thing for people living with diabetes. So notice I didn't say people with type one because you guys did a a trial for type two.
I'm guessing you're just starting to get into it, but what what led to wanting to do this investigational trial for type two, and and what are you guys thinking about over there?
Yeah. So we do want to improve we want to make technology accessible to everybody who would benefit from it. And right now, we are cleared for use in type one only, age six and older, but we want we're doing a lot of work to get us to get this technology cleared for other populations as well.
Yeah. And do you have a timeline for that? Are you something you're hoping for, or is it even too soon? Did you get data back that made you think, okay. That's good.
We'll keep going. This looks like a good idea.
Yeah. I can't share a timeline, but I can tell you that, yes, we completed our, trial, which is an important step, to get us, to get this tool or this technology to people with diabetes.
Mhmm.
And then we shared that data at the American Diabetes Association.
Okay. And, can where can people find it? It's on your website, I imagine.
So we did issue a press release, that tells, that tells about, the completion of the trial and, the data that was shared at the at the ADA.
That's cool. Did you include people, using a GLP in the trial?
We did include people coming from, different backgrounds and different therapies. GLP one, SGLT two, different age groups, different, race and ethnicities, different, insulin regimen coming in.
Joanna, can I share with you this is not a thing I need you to comment on? This is all completely from me. But I think the future of even for type ones is going to be a combination of an algorithm and a low level of GLP to kinda cut into insulin resistance. My daughter does it that way, and the outcomes are just spectacular. So I I think it's gonna be a a couple tools in the toolbox over the next few years.
And then my hope is that you and other people like you continue to work on these algorithms and get us to a point where maybe we don't have to announce meals. I think that would be a really big deal for people with type one diabetes. And then, you know, who knows from there? But in my mind, if you put me in charge, those are the things I'd be that I think I've seen be most valuable for people and that I'd be shooting for. So that's my 2¢.
GLPs, phenotypes, and a time capsule41:02
Of course,
I make a of all.
I make a podcast, you're a doctor. So, you know, you take it with a grain of salt.
No. I've I I wanna thank you for sharing your experience with your daughter. People have different needs. Right? So GLP one may help with, glucose after a certain after a certain meal.
It may help a little bit with the weight, help with insulin resistance. And, if that's what people need, to use with their AID system, then that's that's what they need to get to the goals that they want for themselves.
Yeah. Hey. Listen. I just said it here so that, like, years from now, I can use this as a time capsule and look back and say, yeah. I was right about that.
And and and it doesn't have to be and what I would add to it so we can both look at it back in time, the future Okay. Is that it doesn't have to be one or the other. Right? Sometimes it it it it has so you're right. Like, it may be that it's a combination of things to to get people where they wanna be.
Oh, yeah. No. I don't think it's for everybody. I mean, my just looking at people right now and having conversations, I think there are some type ones that have type one diabetes and have some insulin resistance almost as if if they didn't have type one, they might still have insulin resistance. And I'd also I'd also look out for the the appropriate bodies to start I think they're gonna say that a dual diagnosis is, like, a a legitimate thing in the in the future too.
I would I would imagine that's coming as well.
Anyway, like people working on different phenotypes. Right? Like, the diabetes, not all the same. Not all type one are the same. Yeah.
So you are correct in that regard.
Do you do you know doctor Hamdi?
Yeah. I worked very closely with him. I did work very closely with him, and him and I always get into that discussion. We're both very I would say, personally too, I'm passionate about those different phenotypes in diabetes because I believe that we can't only just think of them as type one or type two. People have different profile, different needs, and and I like different classification too.
I interviewed him last year. He's one of my favorite doctor interviews I've done in a while, and passion was the right the right word. I think he's one of the people who will move it all forward for people. Anyway, let me just say this. If any of this made you guys excited, I'd personally appreciate it if you went to twist.com/juicebox to learn more about it.
Twistwith2i's.com/juicebox. We'll probably put your ads on this episode so people can hear it too. But thank you very much for doing this. This was wonderful. It was great to meet you.
You and I hadn't met pre previous to this, and this was really lovely. It took us a while to get you on here. You canceled on me a bunch of times, I just wanna say.
You must be busy. Thanks so much for having me. I did enjoy. Obviously, I did enjoy. It was a great conversation.
Oh, I'm I'm glad you think so. Well, thanks again for coming. I appreciate it. To learn more and see if you might be able to get Twist from the pharmacy and try it for free, head to visit.twist.com/juicebox. That's visit.twist.com/juicebox, or give them a call at 18774.
That's +1 (877) 489-4478 and tell them Scott sent you. TWIST requires a prescription and is indicated for people with type one diabetes six and older. Let's face it. Diabetes is tough, but it's easier when you have a community around you. So if you're looking for a great community around type one diabetes, check out the juice box podcast private Facebook group.
Juice box podcast type one diabetes, but everyone's 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 the juice box podcast private Facebook group. Juice box podcast, type one diabetes on Facebook. I promise you it is the most unfacebook like experience that you'll ever ever find.
What a great group of people. I don't like saying this usually because it dates the ad, but right now, there are 86,000 active members. 86,000 people in there who might have your experience, know what to say, or just be a great shoulder to lean on. Don't be too proud to find a community. It really does help, and it's completely free.
Juicebox podcast, type one diabetes on Facebook. I just wanna say thank you so much for listening. I'll be back very soon with another episode of the juice box podcast. If you're not subscribed, please subscribe in a podcast app. It really helps Apple Podcasts, Spotify, or whatever your favorite audio app is.
Like and subscribe. You know what the kids say on the YouTube, like and subscribe. It really does help. If you or a loved one was just diagnosed with type one diabetes and you're looking for some fresh perspective, the bold beginning series from the Juice Box podcast is a terrific place to start. That series is with myself and Jenny Smith.
Jenny is a CDCES, a registered dietitian, and a type one for over thirty five years. And in the bowl beginning series, Jenny and I are gonna answer the questions that most people have after a type one diabetes diagnosis. The series begins at episode six ninety eight in your podcast player, or you can go to juiceboxpodcast.com and click on bold beginnings in the menu. Thank you so much for listening. I'll be back soon with another episode.
Read the full disclaimer
© 2007–2026 Juicebox Podcast. All rights reserved.