Scott Benner 11/3/22 Scott Benner 11/3/22

#784 Bold Beginnings: Insurance

Scott Benner 11/2/22 Scott Benner 11/2/22

#783 Survey Says

David runs T1DExchange and he has type 1.

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Scott Benner 0:00
Hello friends, and welcome to episode 783 of the Juicebox Podcast.

David Walton is on the podcast today David is a type one who runs T one D exchange are always complaining. Things don't happen fast enough. Why don't they come up with a new adhesive quicker? Why don't they do this faster? How come they don't update that better? Alchemilla? Well, because you have to do research and it takes people to do research and people don't open themselves up to research. So David and I are going to talk about that today and discuss how you can help right from your sofa. I tell you, every, every episode like right here, I say, Hey, if you're a US resident who has type one diabetes, or you're a US resident, who is the caregiver type, you must have heard this by now. Go to T one D exchange.org. Forward slash juicebox. You join the registry, you complete the survey and you're finished. That's it. It takes like 10 minutes, and I say it and I say it and they say it. Okay, sorry about that. Nothing you hear that Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. Anyway, this is a good conversation I'm going to explain why this is so important to research and and I hope you guys check it out. Give it a try. This show is sponsored today by the glucagon that my daughter carries. G voc hypo Penn Find out more at G voc glucagon.com. Forward slash juicebox. Today's conversation is also sponsored by the Contour Next One blood glucose meter. This blood glucose meter is everything to me, it is the easiest to use easiest to carry most accurate blood glucose meter My daughter has ever held, used had in her purse. I've never seen one better is what I'm saying. Contour next one.com forward slash juicebox. There are links in the show notes of your podcast player and links at juicebox podcast.com. To contour G Vogue, T one D exchange and all the rest.

David Walton 2:19
Hi, this is Dave Walton. I'm the CEO of T windy exchange and have been in that role for the past three and a half years. I've worked at a number of device companies and diabetes since 2006. And in healthcare my entire career also have been living with type one since January 1996, while diagnosed while I was in graduate school, and have a 13 year old nephew with type one as well. So very focused and committed to working in the diabetes space and specifically trying to help improve the state of affairs for people living with type one.

Scott Benner 2:56
Well, thank you for coming back. i You were on episode Hold on a second. I will find it. I thought I had it. You were on a wow, Episode 330 April of 2020. This episode will be more like 800. So I've that I've been as busy as you have been, I think.

David Walton 3:16
Yeah. And that was right in the beginning of COVID when we spoke so it was definitely a unique time. And we're sure

Scott Benner 3:22
a lot a lot feels like it's changed since then. Well, you know, we'll give people a little bit of an overview of your of your life with type one. But I know we talked about it before. You said you were diagnosed in 96, which sticks in my head because that's the year I was married. And makes me feel like you've had diabetes a long time because I know I feel like I've been married a long time. Anyway, that I'm sure my wife won't hear that. diagnosed in grad school you said

David Walton 3:50
yes. After after one semester and I I literally had just begun dating my now wife. So we just hit 25 years so we've been almost the same trajectories you have. But literally it was within a week of us starting your relationship Yeah. that I got the symptoms first are presented themselves.

Scott Benner 4:16
So how did they hit your nation? Lucite

David Walton 4:20
telltale, yes, couldn't quench my thirst i i Actually chug this. At the time. I think there was the Magnum at 711 It was like at least 44 ounces of soda. And it was birch beer. I was so thirsty and I wasn't thinking that it was diabetes and sugar would we just exacerbate the issue. So that certainly wasn't wasn't helpful to my plight. But it was about a week of that going to the bathroom like 15 times a day just feeling totally different dropping 15 pounds, but when my vision got blurry in class, I couldn't read an overhead projector from sitting back in the in the room and I said Why doesn't the professor adjust this? And they said, What do you mean? It's perfectly fine? And I'm like, No, it's not like yes, it is. And that's, that's when I looked at someone else. Yeah, that or I better go to the Student Help and something's not right. Yeah.

Scott Benner 5:15
Well, you can't see things that Yeah. Although I interviewed somebody recently that said, They ignored their blurry vision for weeks. And I thought, Well, I must be a baby. If my vision I'd run right to the Yeah, wouldn't be

David Walton 5:29
day I walked in that afternoon after class to the student health because that blurry vision definitely threw me.

Scott Benner 5:34
Yeah. No, I imagine it would even mean you weren't that young. You were old enough to be able to think through your problem a little bit. I bet you if it would have happened when you were a freshman, you wouldn't know what to do. Maybe. Okay, so you've had diabetes quite a long time. I mean, that long. Did you start with regular an MPH? Yes, you did.

David Walton 5:55
As humans are the MPH I had a one touch or one touch to glucose meter was handed to me at the hot pen at that. At the at the hospital? And yeah, I was kind of off to the races. I was put on a dosing regimen that I realized years later wasn't necessarily the right one. And it was on that for probably 1213 years. Yeah. You think I was on that regimen for 10 years? Because I you know, I, I was doing okay, but not great. My agencies were always in the sevens, but I never could get below seven. And I'm like, Why? Why can I get bilobed And I wasn't testing a ton, maybe three to four times a day. And I started working at animus, the insulin pump company that j&j acquired and then later divested, or just exited the business. And I started reading about formulas for dosing and things for pumps, books and things to educate myself, because I've never worked in the industry of diabetes, I just had dealt with it myself. And I, you know, I learned about these rules, rule of 1800, the rule of 500, with your insulin to carb ratios, and all that, and I, I just realized, well, why am I on the ratios I'm at, they don't even come close to these formulas. So I just made the change that day at work. And so let's see what happens and my blood sugar instantly got better. And my next day when See, I came in, and I had a six, eight, or a six, nine and my endos. Like, what, Hey, what did you do? I said, I, I changed my dosing to one that matches the formulas. He just gave me this look

Scott Benner 7:51
like, Oh, those.

David Walton 7:55
But you know, I'd seen a couple different endocrinologist, one in a prominent center out west and other who worked for an insulin company, and neither of them brought it up. Yeah, nor third one. So this was like, my third endocrinologist that I because I've moved around. So it's, it was definitely a lesson in that, you know, there are certain reasons like if you're not creating, if you don't present certain problems or issues, an endocrinologist may not focus on something. And if I were having a lot of lows, or if I had a much higher rate when see, maybe they would have looked at that, but because I was like, Yeah, you're kind of doing okay, so I was in that little middle zone where it just, it wasn't really worth. Yeah, well, they, you know, because I have to believe that they were knowledgeable of these dosing rules, but who knows, maybe, maybe not. But one would think well, the

Scott Benner 8:49
story points out that, I mean, why research is so important, because basically, you read research that told you, oh, I could be doing this differently. And the research that was probably common at that time for what a good a one C was, was telling the doctors that you were okay. So you weren't somebody to fiddle with. Because the seven Wow, that's terrific. Why? Because the ADA says, that's good. And so that, you know, so they're kind of doctoring to these rules that comes from research, and now the research gets better and better and, right, the American diabetes Association lowers that target, you know, when I think that's what the doctors work off of, they, you know, whatever, whatever ADA says they're like, Okay, well, that's what we tell people.

David Walton 9:32
Yeah, no, I certainly the the ADA standards of care are that they update every year that they're extremely important and but I wasn't actually hitting the target. I was close, but I might agencies were ranging between seven two and eight. They were in like mid mid sevens kind of thing. So, but it wasn't, you know, a nine or a 10. So what and I wasn't having a lot of lows. So but you know, the The old dosing logic, you know, the one unit for 15 grams of carbs or one unit to correct 25 milligrams per deciliter. That's what they had me on that ratio, which apparently year many years ago was a common thing to start people on. I don't know if they often move them off of it, or what I haven't really looked into that. But I know, I've had educators, diabetes, care and education specialists, now we call them, you know, comment on how earlier in their career, that's what they dealt with a lot, they use that that ratio, but getting more data and research and people looking at these topics, they realized, and particularly with pumps, where you're gathering the information, you can track and analyze it that, that's, that's not right, and you can look at someone's total daily dose and, and their weight, their body weight, and, you know, there tend to be these averages and ranges that that work. And that's not what I was on. So again, I switched it to a one to 10 from one to 15. And I switched it to one to 35, from one to 20 where it was at one to 25 So I was constantly I was under dosing for my food, and then overcorrecting and I was just in this little yo yo thing, and it was, it was enough, it was keeping the, you know, getting the ultimately back to a point in between meals, or maybe I was getting closer to closer to where things should have been. But it wasn't ideal by any stretch. So that was that was, you know, definitely a big aha, because I just started using a pump the year before you you are collecting this data every day. So you can analyze it, or someone can analyze it and help figure that out. Well, especially if

Scott Benner 11:49
people can't see you, but you're, you're a big person to like you're tall and you're strong and like one to 15 seems, you know, I mean, Arden is a woman and you know, gets a period and has a bunch of hormones going on. But she would laugh at that if I if I covered art and one for 15 I might as well not give her insulin. And you could pick it up with her across the street is my point. So it's, it's just really, it's interesting how they're like, Well, this is the standard, give him that one. And then no one ever goes back and looks at it again. That's the fascinating part is that you turn it on, it's like turning the heat on the ad. And then everyone's always hot, and no one remembers to go back to the thermostat and go, Oh, we could probably adjust this. Here's just the it's common, honestly, through the years.

David Walton 12:35
But you know, situations like like that, you know, we t when the exchange, you know, we call ourselves a real world, you know, evidence organization, like we gather information from people in the real world, not not in kind of these artificial clinical study environments that just don't aren't the way people typically then lead live their lives on an ongoing basis. And, you know, we're trying to gain insights and understand things about what's happening when people use products out in the real world. We also help recruit for study clinical studies that people are doing, because we have to get these products out faster. I mean, it is amazing when you read how many times that study can't find people that way behind on enrollment. And I've actually had kind of strong discussions with companies like why do you accept this, if you work with some sites, some clinical sites that aren't recruiting fast enough, like we've got almost we've got 20,000 People who have registered with 20 exchange to be a part of research and to participate, we can help find people and send them to your site or, you know, go to a link virtually, like we can help speed these things up. And then so the faster the products get to market great. But then there's this whole second phase of learning and knowledge about then what happens when people use them in the real world and do the things they're going to do because they're also living life. And, you know, we're trying to get devices connected into our registry so we can see people CGM information and see how it relates to the others information they provide the surveys they respond to, and that kind of, I think there are a lot of things that can glean from that, you know, we did a big project with vertex which was presented at some medical meetings, which is why I'm naming them and talking about it. You know, they're working on this really interesting beta cell replacement therapy, which I think is our online community is thrilled to hear about and very excited about the prospects long term. You know, for that, that kind of a solution there are other companies working on it too, but you know, they wanted to understand severe hypo glycemia and impaired hypo awareness and, and how often is it happening? How often do people need assistance with their severe high bone what were the circumstances around it and We looked at CGM data for 1000 people on top of you know, a total of 2000 survey responses about different aspects of that. So we could really contextualize it and they had questions they wanted to understand because their product and the study that they're doing is for people who have this severe you know, hypo, an impaired hypo awareness. So it's, it's, you know, it's extremely important to get more people in to research it is going to slow we could absolutely get new products out faster. And I mean, I'm talking the entire industry, new new sensors, new pumps. You know, I, we have these conversations like every week with a company that's, you know, enrollment is slower than we'd like, you know, every time ticularly if they're recruiting children, as well.

Scott Benner 15:56
I have a quick ad break here and then we're gonna get right back to Dave G voc hypo pan has no visible needle, and is a pre mixed auto injector of glucagon for treatment of very low blood sugar. In adults and kids with diabetes ages two and above. Find out more go to G vo glucagon.com forward slash juicebox G voc shouldn't be used in patients with insulinoma or pheochromocytoma. Visit G voc glucagon.com/risk. I'm going to read you a review that comes right from contour next one.com forward slash juice box. Same product works well. And half the price of what I pay after insurance at the pharmacy will definitely buy again. Amazing deal cheaper for me than buying through insurance. I got 50 more strips for about the same price expiration dates were good. Plus they arrived very quickly. Very happy with this purchase. Contour next one.com forward slash juice box we're talking about the test strips that work in the Contour Next One blood glucose meter. Head over there now and find out what I'm talking about. Do you really know what your test strips cost you because it may be cheaper to buy contour next test strips over the counter without a prescription. Again, you could learn about this at contour next one.com forward slash juicebox here's why this is important. I don't care if you have the latest CGM Dexcom G six libre three Dexcom G seven, whatever you have. That's terrific and it's amazing. You still need a good accurate blood glucose meter. That's why I'm asking you to look into the Contour Next One. This episode might be sponsored by them. But my daughter's every day is supported by the Contour Next One blood glucose meter and is the one she carries and uses daily contour next one.com forward slash juice box it is small, easy to read, accurate and easy to carry. There is nothing more unique. This whole business about the test strips maybe being cheaper and everything that's a bonus look into that on your own but get the damn meter it's freaking terrific. Contour next.com forward slash juicebox G vo glucagon.com forward slash fuse box links in the show notes links at juicebox podcast.com. And even though they are not a sponsor of the program, I do benefit when you go to T one D exchange.org forward slash juice box. But I think you can hear in this episode, that I'm really just trying to get everybody behind. Behind the movement that helps bring where we are with diabetes forward. We need you. We need you to fill out the survey. That's it. Just Just keep listening and Dave explains it again. I give up it is so hard to get people to do stuff like this. I know it seems like it's a big deal, but it's not t one D exchange.org forward slash juicebox join the registry, fill out the survey and just like that you've helped you've helped move things forward. Alright, now let's get back to Dave and thank you for listening to the ads I really appreciate it please use my legs if you're gonna buy something

Yeah, well so it's it's to flip your life around and what you do for a living and kind of think about it from somebody else's perspective. When people say well, I don't understand like why is this only recommended for children six and older? It's because they couldn't do a study for children six and under. It takes longer. Well don't worry, we're getting to it. We're getting to under two we're getting it's because people don't do the studies and that's the only way this stuff happens. And I Dave I do my part on every one of my episodes when opens up, I'm like, go to T one day exchange.org forward slash juice, but I just keep putting, it's, I mean, a lot of people listen to this podcast. And still I don't push that many. Like, like, you get people to convert you, at least in my heart. I'm sure you guys are happy with how many people come through the podcast. But for me, I know the number you told me when we met, like, we'd like to add this many people. And it's a lot. And then you I don't know, I've become Ultra aware of how difficult the job is to get people involved in, in research. And I mean, I understand it from their perspective. But it's just I mean, you're not asking people to go to a site, you're not asking them to, you know, cut off a finger to see if it grows back like, right, you're like, take a survey, can you just take a survey? You know, let's

David Walton 20:46
take a 10 to 15 minute survey, right? And then from there, we will follow up with other opportunities. But that's, you know, if it doesn't fit, if you don't, you're too busy at the time, what have you, and it could just be another online survey? Or it could be, Hey, would you be willing to connect your Dexcom, your clarity account and just you connect the login information, we have a simple little couple of fields you enter in and then boom, it's done within a couple of minutes. And, you know, we're going to have, we're going to have another few 1000 People do that in the next six months. That's cool. Yeah. So, you know, research. And I've, I believe that most people just have this ambiguous view, and they hear research, they think I have to go drive somewhere and deal with hassle and fill up forms and give blood and do this and the other. And there are times where there might be a study that is fairly intensive with a new treatment, particularly if it's something being put inside your body. But there are other times where it's just it's not what you think it's not that big a lift, you know, and oftentimes, there's compensation to account for if you have to take time out and go travel or go do this or that. So, you know, it's we tried to spend a bit of time educating people that research can mean many things. But it can also it can be just what are your attitudes about doing something and so that these companies that are working on things understand, using your product may be more burdensome than you think or going to get screened for, or have your immediate relatives screen for auto antibodies. People don't really understand where to go or how to do it as an interesting program with T ones attack that certainly they should look into for that. But it is it is something that we spend a lot of time trying to de-mystify it and explain to people here is this is what research is, here's why it's important. And there is no doubt we can all pitch in and help make things happen faster. And your point about the six year olds or what have you. Yeah, you know that these companies start with the adults usually, and then they work their way down. You know, there are additional rules and safety measures when you're involving children in any kind of research. And so, you know, understandably so it's something that you have to be very have lots of safety data and really understand even before you then go to the official study to get the indication for that. And sometimes it happens because there are doctors out there that are willing from what they've understand of the research that exists. They're willing to try it out on some of the patients. And then you get that, you know, some of that volume of information builds, you know, just mean that happened with CGM and dosing. Right. It used to be adjunctive therapy, but so many people were dosing and not doing finger sticks and just going off their CGM. And some of that information that was gathered at 20 Exchange help with that years ago. Some of that information is what ultimately kind of led to the label change so that you are, you know, permitted to dose your insulin off of your CGM bacteria enough and yeah, so in that replace BG study they did. So

Scott Benner 24:11
it's so you're saying that in that exam, in that example, people had CGM, and they were like, well, I This thing's accurate. Most of the time, I'm just gonna, I don't feel like testing before I eat i dose and then enough people do that. And they gather enough information that it becomes its own study, the fact that it's not even on purpose, then suddenly they go, Look, this is what people are doing. And it's working. And then you are able to show that to the FDA and then move forward. And the company, by the way, who can say look our products doing what we expected it to do. This is amazing. I don't know. I mean, for me, I would I think I would take some pride if 10 years from now, I looked up and saw I don't know a two year old kid with diabetes wearing a the G 97 sensor, whatever. It'll be 10 years from now. Right. And and this kid is smiling and laughing and living his life and the mother doesn't look like she's about ready to pull her hair out of her head or, you know, the parents aren't arguing their lives are comfortable, I would think, well, I did that, like, you know, on some level, my participation helped us get to this place. And I do take. But I think when I think by I try to imagine why people wouldn't do this stuff. It is my inclination that it's what you said earlier is that they're, they're afraid that they're going to be asked to do something that they don't want to do. And I don't have enough time in a 32nd spot to explain to them like, Look, if you get an email, and you don't want to do it, just don't do it. Like the length team. Right? Yeah. Like, it's just, you know, absolutely,

David Walton 25:42
absolutely. And I got to do want to make the distinction of, you know, participating in research. And that's our goal, we want people to join the, the the to end exchange registry, and start that it's a very simple lift to be able to contribute. And, you know, the more people we have, then when unique situations come up, and someone says, We really, do you guys have people that have had transplants, we want to look at this particular issue, and it's hard to find these people. Well, yeah, we happen to have 78 people that have had either kidney or pancreas transplant, and oh, what about this, what about other transplants, and we can be the law of big numbers, just if it's a very small percentage, but we get our numbers up, we can find we have people that will, will meet some of those criteria. So we're able to help people, you know, and help recruit for some studies that are very difficult, but I do under and we should definitely I should emphasize, you know, their products are labeled or indicated for a specific purpose. And absolutely, people should, you know, we're positive stick to what that is, you know, but if their doctor is talking to them, or they're, they're looking at something that there's a lot of safety information out there, it's just not officially in the label, like, well, then, you know, there might be an opportunity to, you know, talk to a clinician about doing that, or what have you. I was working in industry, I was doing lots of testing of sensors and checking my blood sugar and looking at this data, and I knew how the sensor performed with me individually. Some people, the sensors can be much more inaccurate. Yeah. And earlier versions definitely were less accurate. So, you know, if people were hesitant to dose insulin until it was absolutely in the label, and their doctor said, Yes, I will absolutely understand that. But I was in the center of information gathering and seeing this and I, I knew a lot of other people that were and and then I was monitoring what was happening. And I was I was constantly vigilant, like, Oh, if I see my blood sugar dropping, and maybe maybe the sensor was reading higher than my blood sugar really was and then I gave it too much insulin. And so I was always focused on that. And you know that. So for me, it was something I was, you know, willing to do, because I felt like I understood those risks, and I could mitigate anything that happened. But

Scott Benner 27:59
I listen, I wouldn't do anything blindly because anybody said it was okay. Arden's been sick away at college this week. And we were fighting high blood sugars. And I said, I texted her and I said, Look, we're going to have to make like a big Bolus here. You got to test first. Like, I'm not just going to, I'm just not going to go off the CGM. Like I like I'd want I want some. You know, I want some I want other numbers. Like, let me let me say, so she tested CGM was mean, she was in the low too hot. She was like around 220 or so I think the CGM had her at like 224. And she tested at like 218 to 15. Something like that says like, Okay, let's do it. Like, let's go for it. But I don't know. Like the, the longer you have diabetes, the more you recognize the moments when you just want to like, let me just let me just check here. Like, you know, like, let me make sure I and your point about it just doesn't work for somebody, some people. CGM, a Dexcom, specifically works terrific for Arden. And I'll have people contact me and say I don't understand how you like how can you use an algorithm? My kids CGM has never anywhere close to what their blood sugar is. And, you know, you respond back you say, Look, do you have a an accurate meter, maybe you're checking with a meter. That's not accurate? Maybe the CGM is more accurate than the meter is maybe your kids not hydrated, maybe? Like I don't know. I can't tell you what the reasons are. But there are checklists you can go through to kind of get yourself better. And then at the end, I have met people were just like, it just doesn't work for me. And I've asked, I mean, I've asked people at Dexcom about and they'll say, Yeah, I mean, sometimes it just doesn't work for some people. We don't know why. You know, so you got to be careful and do what works for you. You can't just say, Oh, the box says it's okay. I'll do it. You know, I mean, I don't know.

David Walton 29:47
And the more I've worked in kind of the industry, I've worked for startups, CGM companies, where I was wearing SIX sensors at a time and then checking every 15 to 30 minutes on my fingers and all that and You realize the variability that exists both within one person, but more importantly, between people in the inter and intra variability, like it's people, there are just, there's a lot of different operating environments out there for the human, the human beings, and, you know, these, these products work really well, and a lot of people that, that, you know, there are some people that just some people they won't see reads lower for a certain average glucose than someone else's. And that's really come out a lot in the last several years where you can have these ranges in a onesie with the same average glucose, and just the way that hemoglobin and the way red blood cells work, and certain people, you know, you know, African Americans have an agency that's 3.3%, higher than whites would be with the same exact, you know, glucose on average. Really? Yeah, because of the way that, you know, that was all developed. And so, you know, that's another aspect that we, you know, we're focused more on now is, can we help with diversity in study recruiting, because people are slow with recruiting in general. And they tend to skew towards, you know, white and female, and a lot of different studies, I've seen NIH data for over 20 years, you know, our own registry, you know, historically, you've had more participation from from that group, and not as much, you know, from, you know, different groups of people of color. So, we're trying to work on what can we do to, to get the word out to more people to explain ourselves better, and what what they're really participating in, when they join us and work, you know, we've, we've been working with some great, you know, influencers out there on social media, who, you know, are good about getting the word out, and, and, you know, messaging in the right way, where it's relevant. So that's been, you know, positive, but we have, we have a lot of work to do. Still, we're still not where we want to be to be completely representative of the type one population in the US. Well,

Scott Benner 32:01
you mentioned the law of big numbers earlier. And I imagine that that's probably why this podcast does, well, driving people back to T one D exchange, because I have a larger group of people that I'm reaching to, I've learned, just getting people to click on things, you know, for anything for ads for my own site, you know, for content that I've made, that I know helps people, it feels like, you've got to reach 1000 people to get 100 people to look up and that gets 10 people to click, and that makes one person say yes, it's it's a, it's hard. It's hard work.

David Walton 32:35
Getting people to stop what they're doing and do what you want them to do, because there's a greater purpose you're solving for. Yeah, it's not easy. And I know, our marketing team is, you know, in our registry team are doing a good job. And part of it is working with people like you to get out to different audiences, and people who are credible and have a relationship with with a group of people. Like, that's important and important. That's very important, you know, kind of tactic for us to get more people to participate. It's been, it's been pretty successful. And we, you know, we add over 100 people a week into the registry. And that's, you know, because we've got, it's not just, you know, we're empowering, others are connecting with others who are able to reach out to all these other people. So that's definitely something

Scott Benner 33:23
well, I'll share something with you that it's a little backroom, but I don't mind people hearing it. I've learned using tea, Wendy exchange, specifically as an example. And maybe, maybe this bleeds into other stuff, but I can explain it. I can say, look, it's easy, you know, hey, here's some people have done it in the past. Like, I've gotten feedback from people, I've gotten photos, people like, Hey, I'm at the airport, I'm going to do this thing I'm on I'm on a Dexcom. I'm testing Dexcom adhesives, right? There's something people complain about all the time this girl is, is doing it, she's wearing a bunch of I saw a bunch of G sevens on her arm, and she was flying somewhere. And she was super excited. And they compensated or, and I share that with people thinking, well, there's something people are passionate about, like adhesives, and nothing but one. And it's interesting. I can say here, because there's no ad here. But I'm not allowed to tell them that. Like specifically, like I can't incentivize people to do a thing. Like, can you explain that? Like, why can't influencers like there's a law, but explain it to me so that they can understand it? Do you know what I'm talking about?

David Walton 34:30
Well, I mean, when you're involved in kind of, and I think there's a difference between the study versus there are different rules around a study and what you're allowed to compensate for, versus, you know, a product that's out there. And, you know, the whole notion of if a company is, you know, they have their own health care compliance rules about what do they believe based on laws is an acceptable way to compensate people who might be doing something and if you end up you're paying people to you As a product, that there are all kinds of rules that can come into that. It same thing like even with copay coverage and other things, there are all these rules and and rules, if someone's in a federal health insurance or you know, different Medicaid, you know, we would have these programs where Oh, you could, you could upgrade to the next pump, when I worked at anatomist always had these little asterisks with all of the little caveats. And if someone was with DOD, or the VA, or a state, Medicaid or Medicare, because the government has to get best price and this and that, and you're paying, you know, there are all these considerations like that, right? Companies need to be mindful of so they may, you know, I don't know if your example was around like a research study, versus actually, like, using a product,

Scott Benner 35:53
I had an idea. I know, you know, this, because we've talked about before, but I had an idea a year or so ago, when I came to, to, to Debbie, and Dave, and I said, I want to do a drawing, I said, I'm going to we'll pick a number, whatever a reasonable number is. And then when this many people get on the on the exchange, will, I will drop them all into a drawing, and I'm gonna go live with one of them for a week and help them with their diabetes. And your lawyers were like, no, no, you are not doing that. And so, but my bigger point was, is that when people learn, like, I have no trouble saying it, like, every time someone signs up to the registry, I make money. It's not like, you know, it's not like go buy a Ferrari money, but it's money. And so when people learn that, that drives them to sign up. And that is the thing that I started talking about that, that surprised the heck out of me, which was, they weren't even doing it. For all the great reasons that I laid out. They were trying to help me like they appreciated the podcast, and I call if Scott's gonna get Oh, good, we'll do it for Scott. And I thought, I mean, that just first of all, it floored me personally, I didn't expect it and it was lovely. But I thought, how are you supposed to get the average person who's not connected to a podcast host or you know, somebody on Instagram, they love that they they can make the leap in their head, you know, this must help him if I do this. I'll do it. It's I don't know, your job seems really difficult to me that that part of it is my point, honestly.

David Walton 37:24
Yeah. Well, I suspect the lawyers may have been more concerned about you living with someone for a week and like,

Scott Benner 37:33
listen, I was worried about that. But, but no, it's just, it's just interesting that you, you know, like, I'll say, like, Oh, can I say this? Can I say that? You know, trying to get people interested? Like, No, don't say that. Don't say that. And it's, and I've noticed that too, with other other relationships I have. Like, I'm getting ready to do a thing for xirrus. Right now I'm getting ready to do an episode Jenny and I are gonna do talking about how to use glucagon. And that's something that was my idea. I went to them. And I said, I don't think people understand how to use their glucagon. I don't think they understand when to use it. I think that we have an opportunity here to talk to a lot of people and help them. And so they agreed and they wanted to do it. But then once you do with the meetings, and the you know, you can't promise things to people, like there's so many laws, or it's very, it's it almost makes it hard just to talk like a person. So you can say to somebody, Hey, glucagon is important. Here's why. You know, it's tough, you know? Well,

David Walton 38:32
I mean, just watch the evening news or the morning news or any news and listen to a quote unquote, patient with rheumatoid arthritis say, you know, for my moderate to severe rheumatoid arthritis, I like to use x. Is that really how people talk really, that? They have to put that in? Because the indication is for moderate to severe rheumatoid arthritis? Probably not for me, you know, I don't know the classifications fully, but that obviously is like what their official indication is, there's characters categories and technical definitions there. So you know, I understand like, you have the FDA gives you you have claims and you have things you're able to say because there's, there's evidence for it. You've, you've provided substantiation, and so you have to stick to the script, you can't go and make claims that are off. I mean, we had some people tell us an animus someone made a presentation and they had Yoda wearing an insulin pump. And the regulatory was not happy with that at all. Because our pump isn't indicated for Yoda to wear. It's only when he met the age requirement, didn't they? Oh, wait, no, yeah, it's like literally, so someone had to take that off of their PowerPoint

Scott Benner 39:52
and internal an internal PowerPoint right. Not even like something that the public was seeing.

David Walton 39:57
Yeah, well, that I think this person They've been showing it to others.

Scott Benner 40:02
Okay, but isn't that that's, that's a great. That's a great example of where common sense intersects those rules because there's no one who looks at that and thinks, oh, well, Yoda is real, and obviously has diabetes and wears an insulin pump. But it's, it's fascinating. But I guess that could be an enticement to Right. Like, that's how it could be looked at, like if a child saw that they could be enticed to want to use that. I mean, who knows who's thinking that way? But that's, anyway, all these angles

David Walton 40:32
that I appreciate I'm, I feel fortunate that I spent as much time in industry as I did, you know, I was at j&j. 11 years, and then a number of smaller companies, device companies agamatrix. And understanding the realities of what rules have to be followed what constraints they have, I had to operate under, it does give me an appreciation for like why industry does certain things. It doesn't mean I, I think everything they do is right, and I agree with it all. But I certainly understand this is, this is probably why they're doing it because I remember the conversations I had with quality with regulatory with legal medical affairs. So it's, there are a number of things that you need to get, I'd love to see improved. But I also understand some of the realities, that can't just happen overnight. But the one of the areas we can is gather this information about what is actually happening out there in the real world and gather the information, conduct research, and we have research and data scientists on staff with PhDs who are very good at what they do. And we're able to do a lot of that, those type of things. But we also just literally, forward study opportunities to our, our registered participants, and try to encourage them to participate. And everyone else is doing all the heavy lifting on the study, we help get as many people to look at that opportunity and try to sign up for it. So you know, you mentioned adhesive, we've done a couple of things. For a research organization, looking at adhesives for a CGM company, we've got another company now that wants to do a survey of people who use a certain patch palm to understand how, how satisfied are people with their adhesive. Because this other company wants to use that adhesive as the litmus test of like, maybe we should be targeting that. So there's a lot of things we can do. Because we have 1000s of people who use this, you know, hundreds of people that use that, and we're able to go target them and get a certain percentage to respond. And, you know, we there's often some, some compensation to participate in, in that type of thing. Because you know, it's people's time and we understand like, you have to, yeah, there's a fair market value, you have to pay people for their time, you should pay people for their time, if you you want to get as much participation as possible. Not everyone, you know, continues to stop doing what they're doing to go help you out because you need something. And that's, that's a mantra that, you know,

Scott Benner 43:10
we've tried to live by. Yeah, to support the people who are supporting the work. Yeah, yeah. Well, it's, it's so you could do this with a clinical study. This could be industry and this could be academic, right? Like you support all those three ideas.

David Walton 43:26
Yeah, we've had researchers out at a university say, hey, we like during COVID I want to do a survey on telemedicine users and see kind of what's, what their experiences have they done it and what type of visit did they do it with? But this was back in like, late 2020. So we did and we were able, very reasonably to recruit. Had it was it was maybe a couple 1000 people to who completed this information for this Dr. Krause and at UC Davis. And I think she just published on that work recently. But you know, sometimes it could be literally a five minute survey for on behalf of someone, some researcher who has who's really trying to nail down something and understand what's going on, or gain insights in a particular topic. So we'll work with companies. You know, we will work with an academic center that isn't recruiting as many people as they want from their patient pool. So we'll say Well, here's how many people we have in within an hour driving distance of your location, we could send out something to those people. And we did that for someone who had like a novel biologic for newly diagnosed to try and help preserve whatever beta cell function was left by halting the immune reaction. The goal really is to move before the symptoms present move earlier when people are kind of in those stage one and stage two of of type one like before the symptom is present themselves, but you are having that, you know, you're going down that path. And so that's something that we're definitely getting more involved with. But they're in their accompanies, and, you know, prevention bio may get approval here in four weeks for their their product. And something

Scott Benner 45:20
must be happening with that, Dave, because they're on my schedule pretty soon, so they must be pretty hopeful. Yeah.

David Walton 45:26
You know, the FDA has a date where they have their, quote, unquote, required to give a decision. I think it's November 17. Yeah, literally, it's, it's four weeks from yesterday. I think that it's my maths, right. Yeah, that's that there's, that's when the producer date they call it where they should be hearing about whether or not you know, they obtained the regulatory clearance to market that tip lism AB.

Scott Benner 45:57
They've been on before. And it was just, like, mind blowing, like what they were trying to accomplish in just the even the thinking outside of the box, because my daughter was diagnosed after getting hand Foot Mouth. And the way he was talking about maybe we could slow down like, like, put aside what we're doing here for a second. Like, what if we just inoculated people against Coxsackie virus? And it because if Coxsackie starting that many people down the road of type one, I thought, My gosh, like, is it possible that my two year old got Coxsackie? Which, of course, you know, she obviously had markers for type one, and it kicked the whole thing off. But could she have lived 10 more years without getting sick? And that way or 20 more years? Or like, you know, really?

David Walton 46:47
Yeah, who knows? Like I, a couple of months before I was diagnosed, I had a nasty stomach bug. I don't know exactly what it was, I just I was green. And like, is the only day of school I missed because of sickness and two years in grad school. And, you know, I thought it was bad Taco Bell I had the night before and in West Philadelphia. And that's what I just thought. And then as I started working in the diabetes field, I started reading about, you know, enterovirus coxsackievirus. That the how often it's associated with it, and and even some of the research more lately, where they're saying like, they're seeing it in the pancreas is of 70 or 80% of the people who have type one, when they've looked at tissues. So it's at diagnosis. So it's, I think, it seems like there's growing evidence about that relationship. And you could see very different approaches to public health, you know, because of something like that. Yeah. Well, and yeah,

Scott Benner 47:52
I'll tell you, the reason I brought it up, just to be transparent is because they obviously can't, there's some companies, you're not naming by name on purpose, and I hear you kind of like talking around it artfully. But anyone who's listening who's aware of the diabetes, space, all the big things that are happening, and all the things that you want to end exchanges in is generally speaking involved in. So take the damn survey, like that's just go it seriously. 10 minutes, I took the survey for Arden back when she was a minor. And then she takes she had to take it as a, you know, when she went over 18, she took it again, first job and yeah, yeah. And it's just it's not difficult. I did not run into one question where I thought, Oh, I don't know the answer to this. And they're like, now my data is helping somebody. And it's and moving us towards all these things that everybody wants. And you know, you were really passionate about it in the beginning talking about that things could happen faster, and they could happen probably better. You just, you know, this is the process. And we don't have enough people to do the studies.

David Walton 48:55
Yeah. And where, you know, where I've had this kind of, I would say puzzling discussions with a couple of companies where they're then telling their sites, hey, we want you to work with T Wendy exchange. And some of the sites say yes, and then there are a couple of sites that say, Well, no, we like to work with our own patients. We don't want outside patients coming into our clinical study, they want to deal with patients that have been going to see them they know who they are, they have their information in the electronic medical record. They know there'll be a good study subject. And I'm like, this is the problem, right? If we keep doing things the same way, we're gonna get the same results that and those results aren't great. Right? JDRF had some stat about, you know, how many studies fail because they can't recruit enough subjects or in fast enough time? Because every day, you know, it costs money to put on a study and you're, it's just, it's an expensive proposition. And then if you're, you know, you're just dragging that on. It's then there's competition. It's just very difficult. So I said, Why do you allow that? You're developing a product you're trying to get in the hands of patients, the patients want it. And you're going to allow someone's attitude of, no, I don't want to have outside patients I need to have, like, the people that are in our registry, are people with type one who have an interest in research, you've already gotten an enriched pool. So one of the companies we're talking to absolutely agrees with that. And so they're circling back talking to some of these sites, and they're going to be a little more insistent. And if I were in their shoes, that's exactly what I would do. What Why are we tolerating this, let's move forward, let's get things out faster. And then once products get out faster, it's out when they're out in the real world, then you learn new things and new opportunities. When I worked in pharmaceuticals at j&j, that was like, the number one mantra was, it's impossible to forecast how well a product will do in the market. With a certain amount of accuracy, there's just way too many variables. So we would do have all this like science and approaches and analogues. And we had a product that ended up being like three or $4 billion, that they had forecasted to be 50 million. Because once they got out there, then some doctors started using it for something else. And they realized, Oh, my God, look at this, this actually helps it. So and that spawns something else. And just when you get something in the hands of people, and clinicians using it and recommending it, you may learn something, even just how to use it more effectively, that can then reinforce the whole thing. So it's,

Scott Benner 51:32
I think, also that data coming back to the companies, once they have something on the market helps them understand how it's being used, or where it's falling short. And it allows them to, to put more resources towards bettering it or fixing it or updating it, like you're going on Twitter and being like this don't work that I mean, the company is gonna be like, alright, like, you know, like, what am I gonna do with that? You know, it's,

David Walton 51:53
it's one of the benefits of actually all these products now being connected products with Bluetooth, or what have you, and then sending data up to the cloud. Now the companies are getting to see a more direct line of sight about what's happening with some aspect of the patient and their data that, you know, it may be blinded, but they know that they can see things happening up there, like, wow, look, we pull all this data together, we can see XYZ is occurring. And, you know, there's some really powerful information that the companies now are seeing for their own people. We're trying to get all connected products like trying to link that data. And so we can do comparisons and look at a broader kind of representative look about how people are faring out in the real world. And yeah, that's one of my things is I still I marveled at the fact, like, why we don't have more people using a connected Bluetooth glucose meter. If you're not going to use CGM, there are affordable, BGM products out there that you can you can get a 50 counted test strips for like $9 or $10. And, and test with a Bluetooth glucose meter. And that data, you know, can be then available to a clinician or a family member or what have you just like we have Dexcom and the follow, and, you know, a lot of a lot of these products now. That's something that I think for those who use BGM. But you know, it would be great if we had more of that occurring. Because, you know, it's very hard for a doctor to get insight on things if they don't understand the date, they don't see what's actually going on.

Scott Benner 53:42
Yeah. And I'm assuming too. I mean, I know a little unfairly, I know that far fewer people than you might imagine of the however many people have type one diabetes in America, far fewer of them than you might imagine using insulin pump. And I'm assuming that far fewer of them have CGM than you think to everyone's got a meter. Like everyone just has a meter. And so I guess there'd be I would imagine you'd get data back that in the beginning, you wouldn't even know where the value was until you actually dug into it to to figure it out.

David Walton 54:15
Yeah, yeah. No, I would say our best estimates right now. You know, that CGM usage for people with type one it's over 40% Now really, because last couple years it's really Yeah. You know, having Abbott and Dexcom just working hard upping their game and Medtronic getting improving you know, now that they're better sensors is on the the CUSP here within their system. You know, you're gonna have three good options. You know what, when when that finally gets out? You a lot of work in our quality improvement with all of the diabetes centers, 50 of them around the US right now. We're one of our big thrusts is trying to drive CGM usage, because the evidence is there that people do better when they're on CGM. So. But it's still not in our collaborative, which are a lot of leading larger academic medical centers, it's still it's maybe at 5051 52%, something like that. But we know across all of the US yet, you've got other segments of people where it's much less so I think it's in like the low 40s. So you know, that means exclusively there are 50, some percent are using CGM. And of those, how many are using a connected one versus just a regular one where you have to download it in and someone has to look at it and and gluco or some other download program and then make sense of the pattern? You know, it's it's that things could be done a little bit.

Scott Benner 55:51
But back in the day, I Arden center didn't have the cable for her PDM. So we never downloaded her data ever once. And you know, they were just like, here. Oh, you have that one. We don't have the cable for that. going on for years like that. Yeah. When you're when you're counting on, when you're counting on stuff like that, you're not going to make big leaps. And, you know, I mean, for people who have been around diabetes, you know, less time than you are. Or if you don't recognize that just a decade ago, you'd get a new meter, it wasn't even more accurate. And you're excited. You're like, oh, somebody made a new meter. You know, it things have leapt forward, insanely over the last I mean, decade, right, like,

David Walton 56:32
Oh, absolutely, absolutely. I mean, I, I left animus 10 years ago, you know, but at that point, we, you know, the CGM is we're just getting more accurate like, to where you're getting close to 10, this 10% numbers, there's this accuracy measure that they look at the difference between it and like a lab value blood glucose, and that was like the threshold to look at and, and they were like, 13%, you know, and they started off at 20%, which was bad. So the first versions were bad. That was like 2006. From 2006 2012, they dropped that down from like, the 20% 19 20%, down to like, 13%. And then you got into the, like, 10% 11% 10%. And that now you're down in the 8%, eight to nine. It's plenty accurate. That's very worked with that, that's for sure. Yeah. And you're right, the, the, when I left, you know, the, on the blood glucose meter side, it was like, Oh, we've got a color screen or a backlight, or some new tagging feature, a tag post meal. It wasn't. But But Bluetooth was just getting thought about. I mean, I remember when we were at, we were talking to Dexcom, about their G four, and wasn't going to have Bluetooth or ant was some other radio communication technology that I didn't really understand. And so I remember they made the decision to go to Bluetooth, which was a smart decision. But like 15 years ago, that wasn't, my understanding, was going to be the prevailing standard or not. And then it there was a lot of variability in how people implemented it. And then things got standardized and better in a more stable technology. And it's been the mainstay for the last 10 years. But those five years before it, it was up in the air as to what was going to have

Scott Benner 58:29
tandem held on just for having a color screen. Right, like they were, they were, I mean, I don't know how true this story is. But I've heard that they were getting ready to pack up and just go overseas and sell the the pump. And they just held on and held on a little longer. And people there was a day when, if you talked about a tandem pump, all you would hear was like, Oh, it has like a color touchscreen. And then and that was enough to make people interested in now you say tandem and you hear people go control IQ. So look where we got to, because they were able to hang on a little longer, you know, so, I mean, we need competition, that's for sure. The idea that Medtronic and Abbott and Dexcom make sensors is is good for people living with diabetes. It will keep everybody innovating and moving and that part of it is is that transcends psionics

David Walton 59:19
we should we should point out ever sells right? Much, much, much smaller amount but absolutely competition. And I've said this to people, both companies just Dexcom an Abbott on the TV commercial side, like you know, habit came in and made some waves and then they both had to kind of fight and be competitive to training. You know, many people's they could and it ended up now there's a lot more awareness amongst people and clinicians and what have you because of all the direct to consumer advertising this taking place and just both you know, I having bigger companies competing? Yeah, you know, if one company can just do it all, you know, they're not, they don't have to put in as much effort to go get the people.

Scott Benner 1:00:11
If you were, if you were watching a Padres game, the other night you saw a homerun, go right over a Dexcom sign in the outfield. That's, that's insane. To me. Like, that's a diabetes device. You know, on the wall in the outfield of a Major League Baseball Stadium, like I, that is just not something you would have seen in the past. And, you know, I hear people sometimes, like these companies, they make so much money. I was like, good. I was like, that's how they're going to do this. Companies that don't have money, don't do things like that. They don't they don't invest in

David Walton 1:00:43
innovation, right? You don't invest in innovation unless you're making money on it. So I understand like, look, these things aren't cheap. There's no doubt about it. You know, and then there are things that can be done. And I think, to lower the cost of making them and part of it is, the bigger they get, the lower the individual cost of each item will be because they have these economies of scale that they'll get so you want them to be big to lower the

Scott Benner 1:01:09
cost. Yeah. Because eventually my expectation is my expectation always is that one day Dexcom will call me and be like, Hey, we don't need these ads anymore. And that will mean to me that a greater percentage of people have them and it's become commonplace, like getting a glucose meter would have been 20 years ago, you get diagnosed with it, you said it and you're storing a diagnosis of diabetes and give me insulin and a meter here, boom, and there'll be a day you'll get diagnosed with diabetes, and they'll be like, here's the CGM right away. And then you would hope when the price starts to fall on them, and they don't have to do all the other stuff now.

David Walton 1:01:43
And we see that happening in certain places. I think Stanford starts people on CGM right away, but sometimes depending on their insurance, it can end up that something doesn't get covered. Right away the CGM. So they happen to have a grant that helps cover that until they can get things squared away or what have you. So that's one of the ways that they're able to just make it a rule and say, Oh, you're diagnosed. You're gonna start with CGM. Huh.

Scott Benner 1:02:12
Stanford has GAP Insurance. You're saying for CGM. It's basically

David Walton 1:02:16
like, yes. As I understand it, that that's the whole

Scott Benner 1:02:20
Yeah. That's amazing. Well, is there anything we haven't thought of or talked about that you wanted to?

David Walton 1:02:40
know? I just want to remind people T one D registry.org. Is the T Wendy exchange registry? Location. But I know you have your

Scott Benner 1:02:49
your they can't use that link. Don't use though. Use my link, forward slash given given the link Scott in the link T one D exchange.org. Forward slash juicebox. Right. And that'll get you to where you were talking about, right?

David Walton 1:03:03
Yeah, that way, we can keep track at least where people are coming from to join us. So I should have

Scott Benner 1:03:10
I should have used the I'm joking with you. Anyway, they get there is terrific for me.

David Walton 1:03:14
But that's you know what we've like I said, we hit the 20,000. Mark, we added over 100 people each week, but it gets harder and harder every week. Like because we've hit so many people, we have to keep trying to find new groups of people. So you know, we're constantly trying to think of new ways to find pockets of people who you know, have type one and are not participating yet. And to try to make the case, hey, it's very simple join and then we're doing the work to try to find studies that might be of interest, there might be some new thing that Yeah, you don't care about these other ones. But this one new one that we said that might be something of interest, you'd want to be a part of. We have a woman who works for us who is on who got to us on the pod five, because she was in the clinical study before she joined us really? Yeah. And that's the way she had access to use that technology and to have it covered. You know, as part of that, that's amazing. Yeah. Yeah, sometimes sometimes those things can happen. Other times, it could just be getting your opinion on something. And that's just you know, that's important too. But we encourage everyone to please give us a

Scott Benner 1:04:15
call. I appreciate you coming on and going over all this. I just never feel like that I can accurately. I don't know, like I say I do it in 3060 seconds at a time. And I'm like, I know I'm not telling these people everything that they would like to know about this. So I appreciate you taking the time to go over everything with me.

David Walton 1:04:32
Yeah, well, no, I appreciate you having us on and and, you know, you, you've been a great, you know, kind of advocate for us. So we appreciate you getting the word out to all the people who like to listen to you on all the topics and the speakers that you bring on. So it's my pleasure.

Scott Benner 1:04:49
It really is. I think it's a big deal. I don't know a way to magically get more people to want to be involved in research. So this is my this is my little bit of meat. trying to get people to do it. So it's really a pleasure. Thank you so much. Right?

David Walton 1:05:04
Thank you that

Scott Benner 1:05:13
a huge thank you to one of today's sponsors, GE voc glucagon, find out more about Chivo Capo pen at G Vogue glucagon.com, forward slash juicebox. you spell that GVOKEGLUC AG o n.com. Forward slash juicebox. I'd also like to thank the Contour Next One blood glucose meter. And to remind you about all the great information that is available at contour next one.com forward slash juicebox. And of course, if you're a US resident who has type one diabetes, or is the caregiver of someone with type one, t one D exchange.org, forward slash juicebox. complete the survey. That's it. Thank you. I'm still getting over COVID. So I have no energy to do all the things I'm supposed to do here. I'm supposed to remind you to go to the private Facebook group and become a member to my I got a little bit of the brain fog. You know what I mean? It's not terrible, but like today, I'm super tired yesterday, I thought, Oh, I'm better. COVID is gone. Here Here. Cheers. Cheers. Take a drink. I can't believe what what to do that my drink is gone. And today, woof feels like somebody pulled the plug, you know what I mean? But it's only day 11. So what do I expect? Anyway, if you're joining the podcast, please share it with a friend. Share it online, tell people about it. Download old episodes, definitely head to the private Facebook group or to juicebox podcast.com to get lists of all the series that are involved. involved. It's not the right word. But again, I'm really tired all the series that are available inside of the podcast like defining diabetes, diabetes, pro tip, diabetes variables, defining thyroid, mental health stuff. I mean, there's just so much I can't even if I had all my faculties right now, I couldn't remember all of them to tell you. Anyway, find them at juicebox podcast.com. In your podcast app or in the featured section of the private Facebook group. I really hope you take the time to fill out the survey at the end exchange or at least that you appreciate how hard it is to to do research and and to move these things forward. After hearing this conversation. I really have to go now completely winded and this might kill me. T one D exchange.org. Forward slash juicebox

#782 Dexcom G7 User

Emily's son has type 1 diabetes and he uses the Dexcom G7!

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, and welcome to episode 782 of the Juicebox Podcast.

As you know the show is international and because of that, we have listeners from all over the globe, listeners from places like Germany, where Dexcom G seven is already available. So I'm able to bring you an interview today with Emily. She is the mother of a 12 year old son named Henry. Henry has had type one diabetes since he was eight years old. And Henry has been using Dexcom g7 for a few weeks. So we got Emily on to talk about it. And at the end, Henry will jump on and visit with us for a couple moments as well. How about that? Nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan or becoming bold with insulin. If you're a US resident who has type one or is the caregiver of someone with type one, please visit T one D exchange.org. Forward slash juicebox. Join the registry. Take the survey. The whole thing takes you about 10 minutes you help yourself you help other people with type one, you help the podcast T one D exchange.org forward slash juicebox.

Today's episode of The Juicebox Podcast is sponsored by us med. US med is dedicated to bringing you better service and better care. Where else would you want to get your diabetes supplies other than us med that's where we get Rs Dexcom and Omni pod to get started with us med get your free benefits check at us med.com forward slash juice box or by calling 888-721-1514 us med has the brand new libre three, go check them out. The podcast is also sponsored today by Dexcom, makers of the Dexcom G six continuous glucose monitor and the forthcoming Dexcom G seven, which we're going to hear about today with our guest, Emily. So Dexcom g7 is not quite ready yet for the US market. But it is available in a number of countries. And you can find out more about it. And the Dexcom g six@dexcom.com. Forward slash juicebox when you're looking at index comm whether it's G six or g7 whether you have type one or type two diabetes, whether you live in Germany, America or somewhere else, please use my link dexcom.com forward slash juicebox. There are links in the show notes of the podcast player you're listening in now. And links at juicebox podcast.com. When you click the links, you're supporting the podcast.

Emily 2:59
My name is Emily, I am a mom to a my type one son Henry. I guess that sounds terrible to say it that way. One of my sons Henry has type one and I'm his mom. I have one other son. And he has let's see my son Henry is 12. And we're coming up on his four year anniversary of his diagnosis. He was eight years old when he was diagnosed.

Scott Benner 3:23
Alright, and you have one other child younger you said, I have an older son. Okay, who doesn't get to get talked about because it's at diabetes?

Emily 3:31
No, he doesn't get to get talked about. He just knows the look that I get my if he gets up to go to the bathroom when too many times.

Scott Benner 3:39
No one's allowed to eat too much in this house. You know, I just try it. As you just said, Henry is 12. He was diagnosed four years ago when he was eight, I guess. Right? But please hold on a second. I'm like, we're already off track on 90 seconds. And but let me just let me know it's my fault. I wrote 12. And then I wrote slash for almost like a date and then slash eight. And I thought, why don't I do that every time? Why don't I teach myself that it's age, length of time. And then age diagnosed? Why don't really make a shorthand for myself. I literally write it out. On a whiteboard in front of me. Every time someone says it. It took me 100 episodes to realize I could have made it easier.

Emily 4:23
And I'm picturing in my mind going okay, what could go wrong with this system, but it does seem like a dead white night.

Scott Benner 4:30
I'm just saying Emily. I mean, I'm like, oh, no, no, I'm a moron. And I just realized that just I was like, why am I not like coming up with a system that makes this easier for myself? Unbelievable. Okay. All right, so I really feel dumb. Anyway, so you live where? Right now?

Emily 4:50
We live in Bonn, Germany. It's on the western side of Germany.

Scott Benner 4:53
But you're an American. I am hearing your voice.

Emily 4:56
I am American. Yes, my husband is active duty military. Are you but we are not stationed at a US military installation.

Scott Benner 5:03
That sounds fancy for some reason.

Emily 5:07
I use all the fancy words. He he's about to retire, actually. So we've spent much of our time at bases and forks, things like that in the US military installations. Most people who are familiar with anyone who is American military, living in Germany probably will assume we are associated with the Ramstein Air Force Base, or I don't even know the other ones anymore. Kaiserslautern, something like that. And we're actually just geographically separated. He's actually working with the German military. Oh, here in Germany. Oh,

Scott Benner 5:42
I see. So he's, he's even he's installed somewhere where there's no housing. So you get to not

Emily 5:49
exactly correct, yes. And that and that affects us as a type one family as well, because it affects our we don't we're not going to a giant US hospital on a base somewhere for our medical either.

Scott Benner 6:02
Oh, so you have to go local for your health care? That's correct. Yes. Does that pose a problem? Or is it workable?

Emily 6:09
It has not my rabbit trail backwards here. My son was diagnosed when we were living in London, actually. And it was a similar scenario where my husband was working with the UK military. And so we're actually using the NHS for our health insurance. And so that was an absolutely lovely experience that I wish everyone could have. And so that's kind of how we started off. And then we were nine months in the States for my husband to take a language course. And so we were back in kind of the regular military system at Walter Reed. And then we moved here. And my so my husband took the language course. And he and I previously have learned some German in school, which when we were in school, they didn't treat languages as if it was going to be important to you. In the United States. It was as if it was like an art class or baking or something. It was do you want to take French or whatever is that we took we had we happen to take German and we've actually used it. The clinic where my son is seen. They do speak some English, the doctor speaks English, but the rest of the people around the staff speak German, the forms we fill out are German. So in the training I recently had for the g7 was in German, so it's definitely not for everybody, but we make it work pretty well. I think.

Scott Benner 7:43
I don't know if you know this, but when you translate diabetes from English to German, it's diabetes.

Emily 7:47
Yes.

Scott Benner 7:49
Is this why you had such an easy time learning learning German?

Emily 7:53
as possible? Yes, some of some of the words are definitely very similar. That sounds challenging,

Scott Benner 7:58
though, honestly, filling out medical forms with so you had like a nine month class. I love that they took you away from Germany back to America to teach you a different life.

Emily 8:10
Yeah, so we were in London and had to move during the pandemic, to the United States, for my husband just be at home to do a virtual course the whole time. And there was definitely some times where I was especially when I was sick with COVID going. So glad we did this.

Scott Benner 8:25
Could we have just sat? By the way, couldn't we have just sat in the UK and learn German?

Emily 8:30
The timezone might have been a little easier.

Scott Benner 8:33
Okay, so you. That's interesting. So you and he both do a brush up course to the kids have to learn German? Or do you do that to try to help them.

Emily 8:44
So during the nine months that we were in the states of schools, were just in kind of a little bit of chaos, I guess, you could say. And so I thought rather than worrying about going back to school, not going back to school, virtual or whatever, I decided to just homeschool my two kids. For those nine months, they had been in a pretty competitive school in London. And so I thought the worst that would happen was that they just had a little bit of catching up to do when we got to Germany. And then also, we have been out of the United States for most of our kids lives. We lived in Belgium before we lived in London. And so they actually haven't had things like US history taught to them in school. So I thought, Oh, this nine month window, I can't mess them up too badly. And we'll get some stuff like US history and before they go to Germany, and I also went ahead and taught them some German basics so that they're at least competitive at I don't not competitive, they're they're doing okay, where their peers are in school and that their school that they're in, they are it's an English language. It's a primarily an English language school. And they also teach German but my kids They're not behind on the German I guess

Scott Benner 10:01
when you're in Belgium. Are you in the French? Are you?

Emily 10:06
Yes, we were in Wallonia we are in the French speaking. So Henry, actually, that's where he was first in school. And so he spoke some beautiful French for a long time, and now has forgotten all of it.

Scott Benner 10:19
Isn't that disappointing? Really, that sucks. You're like, Oh, here's gonna be the happy part of the story. Your son speaks German and French and English, you're like, No, yeah, it's not.

Emily 10:31
The only thing I get out of it is that they don't think it's weird, or different or special that we speak more than one language. Because over here, it's so normal. Okay. So I don't get any kudos for that at

Scott Benner 10:43
all. When your husband retires? Will you go home? Or will you?

Emily 10:49
The plan would be if we if possible to stay overseas.

Scott Benner 10:53
Yeah, you found the place you live.

Emily 10:56
We like I think when we were first married, and he was in the Air Force we, for we did live in Germany for three years. And we just really, really, really loved it. And it's always been something that we've tried to get back to. And so when we did get back to it, when we went to Belgium, it felt right when we just really liked it. And then after Henry's diagnosis, we have found the healthcare systems overseas to be so much easier to navigate. And it just feels like he has more options. In the future. If we were to stay here and secure that kind of health insurance for him. Is the

Scott Benner 11:41
healthcare your main reason for staying? Or?

Emily 11:45
No, I would not say it's the main reason, but I would say it would. It's definitely a huge plus.

Scott Benner 11:52
Okay. All right. Well listen to anybody who has contact with militaries on both sides, and says to me, I want to live in Germany, I make a note, maybe I should be moving to Germany. I don't know what your husband knows that. I don't know. But honestly, assuming it's something. Anyway, I'm on my way. I didn't I didn't know. I didn't know I was supposed to be getting out. But okay.

Emily 12:18
Camera, we're not sending the evacuation signal.

Scott Benner 12:23
When I see the flare, I'll be on my way. That's right. You'll know. Okay, so Henry has had diabetes now for four years. Yeah, he started in the UK, what technology did he have a diagnosis.

Emily 12:36
So when we left the hospital, they gave him a Libra to us when we left the hospital. I was very fortunate in our diagnosis. So during a difficult time, I was actually very, very fortunate. I have a very good friend of mine. Lindsey, whose son Jacoby was diagnosed two years before Henry. And she hit the ground running with education and making sure everyone knew what she knew about diabetes. And so I had somebody I could immediately reach out to you. And so one of the first things she said to me was you need to get a duck's comp. And so we talked about it at the hospital and the NHS was not covering Dexcom they would cover the Libra. And then we so we talked about doing the labor, which was definitely better than nothing, right. And it gave us as first time. diabetes, Beatty's parents, something to kind of ease our mind. So we would be sneaking in in the middle of the night. And instead of doing a finger poke, we're just doing a scan on his arm with the Libra. It was very nice. Yeah.

Scott Benner 13:49
I think first of all, you use her full name. So I'll bleep it out for you later. But oh, I'm so sorry. Sorry. But I recognize her name. Somehow. Are you both in my Facebook group?

Emily 14:02
We are yes,

Scott Benner 14:03
I actually recognize. I know that must be. I was stunned by it. Because there's like 30 houses on there now, but I'm like, I know that somehow. Why does

Emily 14:12
that mean? Yeah, that's fantastic. Yeah, and I'm also friends with, you'll have to bleep this out too. But Michelle. Oh, okay. So she, I met her after I joined the group and we had a mutual friend in common. And then we kind of had a post in Juicebox Podcast in common and became friends that way. And she was actually she helps me out when we were in the States for the nine month period. And she is amazing. I love

Scott Benner 14:39
her 100% I don't know she's been around forever, too. So you're saying I'm making friendships for people?

Emily 14:47
I don't I mean, I think you know that.

Scott Benner 14:49
I mean, I don't know anything. You should I just live a life. You know what I mean? Like while you're over here, imagining something going on. I just got up and took the dog out and took a shower and you know, like, I don't know anything special? I wish I know.

Emily 15:02
But I think you're aware that the Facebook page especially is a lot about people connecting with other people. And it's a big deal. I think when we can find somebody to talk to in the middle of the night, I

Scott Benner 15:15
know for certain, and Michelle really has been around forever. I feel like okay. All right. So you start with Libra A, and I don't even know if it's Libra or Libra. I'm gonna care and I don't know. And Libra shots, or pumping. How does that go?

Emily 15:34
No, she was immediately on the shots.

Scott Benner 15:39
Okay. With a pen. Did they give you a syringes?

Emily 15:44
They gave us a pen.

Scott Benner 15:45
Okay, how are you still using pens?

Emily 15:48
He is still using pens. Yes.

Scott Benner 15:51
You guys like it? He likes it. What's the reasoning?

Emily 15:55
He likes it he. So and this is something I have gotten from other people. So it's by no means original. But for us. The CGM is kind of like a seatbelt. It's not that he doesn't have a choice about it. But that is the kind of that's what makes the car ride safer. So if he's not going to be finger poking all the time, there's got to be a CGM. So he doesn't really, he has choice about it. But he doesn't have a lot of choice about it, because he's not going to pick finger pokes over the CGM. But it's his body. And apparently, we taught him really well about body autonomy. Because he, when we first started talking about pumps during the first few months, he just told me, he said he didn't want something else on his body. And I said, Oh, okay. And every once in a while we revisit it. We've gone to some classes that the NHS had while we were still in London. So he could see what it was about. Maybe see another kid wearing it, maybe see someone his age, just talking about how what they liked about it. And he just at this point, is still happy to be MDI. So we taught we revisit it all the time. I mean, he's had three new endos in four years. So we definitely have talked about it. And those always want to know if he wants to go on a pump. But nobody is pushing it because his blood sugar is very good. So it's not a it's not an immediate concern. It's definitely his preference. And for now, his preference is the MDI,

Scott Benner 17:30
is He? Is he hit puberty yet? Yes, yeah.

Emily 17:37
This last year, I guess, for boys that might be one that might be a definitely is different. Because when you're in the middle of it, you're kind of going, Oh, my God, what is going on with the insulin and everything else? And then I look back at pictures from a year ago, and I go, Oh, well, yeah, he, he grew like a foot. And you know, he's got to watch like hair when I'm putting a Dexcom on and things like that. So yeah, he's definitely in the midst of that. Yes.

Scott Benner 18:04
Well, it's cool that you're able to keep it's that you're able to keep your goals and with the MDI, that's terrific. is, Is he real? Is he persistent about his diabetes? Or are you the one that's like, Hey, your blood sugar's going up?

Emily 18:22
No, he's really good about he, I mean, we try to set his alarms at a wider range than we have our our alarm set, so that I get an alert, usually before he gets an alert, but he will often kind of be he'll, he will glance at it and let me know, hey, this is what's happening. This is the trend. I'm just saying, you know, I'm this and I'm going down, but it's I'm not shaky, or he does, he does keep in good eye on it usually, actually.

Scott Benner 18:56
Okay, cool. All right. Um, but if, if I'm hearing correctly, that if you were somehow magically in charge, and he didn't have an opinion, you'd get a pump?

Emily 19:06
I would. I would, I think just because, from what I've been able to hear from other people about it, it takes a lot of the I mean, obviously, there's a lot of initial decision making to your algorithm and to get all those kinds of stuff, fine tuned. But after that, it would be very nice to you know, turn off the Basal for sports or to use that so that, you know, the Basal IQ kind of thing for nighttime lows, that kind of thing, I think would be really nice. And I think he would enjoy that. But I think he's enjoying being successful with this right now. And he understands it. And so maybe that's a factor in why he does not want to change.

Scott Benner 19:52
Yeah, I don't I don't think he should. I just think that I was just wondering what your opinion was.

Emily 19:57
Oh, no, it is. It's a funny thing too, because I think a lot A lot of people I know when he was first diagnosed, I had some people say, Oh, he'll get on a pump, and it'll be fine. And I always laugh now, because I see people in the group talking about their pumps. And I'm like, Oh, my God, I know that once you get things set up, it's probably not that complicated. But it's not uncomplicated, and all these people who are just like, Oh, you'll get on a pump, and I'll be fine. And I kind of laugh because I'm like, well, it's not the solution. You think it is. It's still there's still a user. That is, you know,

Scott Benner 20:29
there's a new learning Grammy music. Yeah. And there's, there's the new learning curve. Your settings are, of course, incredibly important. But you don't realize but you, you probably do realize, but you have settings with MDI, too. They're just yeah, you know, they're, they're amounts and numbers that you use that work. And so you've good settings now. And when you move to a pump, there might be some adjustment times where you're getting the settings right there, too. There's definitely a, you're definitely starting over to some to some degree.

Emily 21:00
Yeah, it's not a magical answer to anything. And I think that he'll go to a pump, he won't go to a pump, but, you know, whatever. He'll always have this knowledge, I guess, to fall back on if he wants it. No,

Scott Benner 21:13
I completely agree with you. Okay. So here, you're in Germany, where you want to be, which is exciting. He's now using Dexcom G six, I think, right?

Emily 21:24
Yes. So we got the G six, about two months into his diagnosis. We got we talked to our insurance, and got it through our insurance.

Scott Benner 21:34
Okay. So the better part of of the four years he's been using Dexcom? Yes. How long ago? Did you realize that G seven was released in parts?

Emily 21:47
So in September, he went to go see his endocrinologist for his regular quarterly appointment. And she just casually mentioned that Oh, as of next, oh, no. Sorry, in in August. So yeah, in August, he went to go see her for his regular appointment. And she just kind of casually mentioned that Oh, yeah. Starting next month, if we want. She could write a prescription for the g7. Just letting us know.

Scott Benner 22:15
It'd be that easy. Don't worry, just Yeah. And it was

Emily 22:20
it did end up being that easy. My husband who is kind of I'm kind of the glass half empty, look for problems before they happen. And he's my counterbalance of everything will be fine, no matter what. He right away was like, yeah, let's get this prescription. And I was going, Oh, we still have, you know, so much time left on our G six prescription, surely the insurance is not going to approve this until we are out of RG six. And that was kind of my base of like, oh, I don't think they will. And then we thought, well, we'll get the prescription at any rate, and we can, you know, the worst that can happen is they say no. Right. And so we got that prescription. And we we have a company here in Germany that acts as the kind of medical equipment procure, which I know is very common in the United States as well. And the lady we talked to there said, Okay, I could definitely get it for you guys. But just so you know, with your insurance, a might get hung up on the fact that the FDA has not approved it because it's an American Insurance. And so we said, okay, let's so we submitted it to our insurance to see if it would be approved. And they actually pretty quickly approved it much were surprised. No

Scott Benner 23:34
problem. Yeah. So yeah, I remember. I remember when it happened here. So you kind of have to like, my life is slightly different than yours in this. Right. So I start getting emails from people that are like, hey, we need to do agree to an NDA. And I'm like, I already agreed to an NDA. I agree to a lot of MBAs, by the way, right? Like now, this is new information, just respond back that you understand that there's a I forget what they call it. I don't pay close attention. But I'm like, whatever. They're, you know, they're about to say something, and you can't talk about it yet. And I'm like, okay, so I have to agree. And then once I agree, then they send me the information. And the email comes and it's like, Dexcom g7. Like, holy hell, like, this is great. Dexcom G seven is coming. And I keep reading and I'm like, UK, Ireland, Germany, Austria, Hong Kong. I'm like, I don't live in those places. Hold on a second. I started going, Oh, wow. It's going to come out first. overseas before it comes out here. And now we're you and I are recording on Halloween. And by the way, you and I were supposed to record the other day, but we were both so sick. We just couldn't do it. Yes. By the way, when you cancelled I was like, thank God.

Emily 24:54
I felt so bad. I was like, I will drag myself out of bed if I have to, but I don't think you'll be able to hear what I did. stages, my voice is just gone. I was

Scott Benner 25:01
so dizzy on that day. I was like, that's fine. I'm just It's okay. Let's move it. But yes, so it's not. I mean, I don't know, I don't want to say it's not common or uncommon, but in the past, I don't remember Dexcom coming out in Europe before it came out in America. Am I wrong about that?

Emily 25:20
So someone told me, they said, oh, when we were living in Germany, everyone, we got the gadgets first in Germany, it was awesome. They loved it. So I don't know if it came out first or not. But I was honestly, just from what I know about regulations and agencies and departmental government kind of stuff. I was just honestly surprised that Europe or the UK would get it before the US because of those kinds of things. Because whenever anybody kind of bemoans the FDA, I think, Oh, well, it's like, in Europe, it's like the FDA times a million. It's not a fast process at all. So and then, because I know there's been hangups with the apps, and I thought, oh, there'd be more likely to be hanging up here with the apps because they are more into the privacy and consent on all the different websites and apps and things like that. So the fact that it came out here first was a complete surprise to me, who knows nothing. But I was surprised. Well, I

Scott Benner 26:21
was stunned to I got through the email. I was like, huh, this is interesting, because and, you know, and then the public relations around it was clearly I mean, I don't think it's surprised anybody, like they don't start working on how to tell you about the day before it comes out. Right? Like it's a process. There's months and years of work that goes into things to launch products and stuff like that. But I was like, wow, they have a real, there's a big launch here set up. And I thought, I mean, I have no idea. I am genuinely, I'm being genuine, like, I don't know anything. But you have felt like, they must have thought that the US was going to kind of roll at the same time, because I don't know, the marketing material looks to me like they were ready for it, I guess. And so I don't know what happened in the US, they gotta kick back one more time at the FDA. But now you're hearing people talk about early 2023. You know, that kind of stuff I had one person told me, you know, it would definitely be a Christmas miracle if it happened at the end of 2022. And I was like, Okay, so I'm like, you know, kind of like picking through what I'm hearing and trying to figure things out. It gets pretty obviously coming very soon to the US, hopefully. But you guys got it first. So this is you know, so I'm like, Well, how do I interview somebody about g7? Like, how do I and then you were just like, I have it? And like Oh, yeah.

Emily 27:42
I was so excited to share it. Because it has been such a point of gossip almost of like, Oh, what have you heard? What have you heard? What have you heard? Yeah, and oh, I've heard this about it. And I've heard this about the launch and all the details. And so it has just been such a boiling. And of course, since we've only had the diagnosis for almost four years now, unlike so many people we came in with the G six, like I said, We've been really fortunate. So this is the first kind of leap in technology that we've experienced. And so it's so I feel like as far back as my son's diagnosis, people have been talking about this though. So it's a slow boil, build of gossip about it. And I thought I like I shared it with like my people I care about but like they still don't really get how big of a deal. So I thought I'll just put it on the Juicebox Podcast page, and then it kind of blew up more than I thought it was. Which I don't know why I thought people wouldn't be about it, because it's so exciting.

Scott Benner 28:41
Well, I definitely expected it once I saw your post. But let's like I really want to dig into it. So you just said it was a big leap. Was it a big leap because it's the first time you guys have experienced a leap in technology or is the g7 actually that much different than the G six Arden has been getting her diabetes supplies from us bed for quite some time. And here are just a few reasons why us met accepts Medicare nationwide and over 800 private insurers. They have an A plus rating with the Better Business Bureau and they carry everything from your insulin pumps to your diabetes testing supplies. The latest CGM is like libre three from freestyle and the Dexcom G six. US met is the number one distributor for FreeStyle Libre systems nationwide. The number one specialty distributor from the pod dash, the fastest growing tandem distributor and they're also the number one rated distributor index. com customer satisfaction surveys with over 1 million diabetes customer service since 1996. US med is offering you better service and better care, not to mention, always, always giving you 90 days worth of supplies and fast and free shipping. Sounds pretty easy right? Oh 888-721-1514 You can call them at that number, or go to us med.com forward slash juicebox. And don't forget us Matt has the libre three. If that's what you're looking for, they've got it. Check them out. So in just a moment, we're going to get back to Emily. And she's going to talk all about Dexcom g7. But for the moment, I'm here to tell you about the GS six and Dexcom. In general. What are you getting when you have a continuous glucose monitor? With the Dexcom G six, you're seeing the speed direction and number of your blood sugar. I can pull my phone up right now. Arden's in class, it's an evening time, I can see that her blood sugar is 107. And it is rising. Looks like she had a little bit of a lower blood sugar. But I can see what's going on here. Actually, I don't have to act like I don't know. Looks like she had a little bit of a low as she was getting ready to go to class. She must have drank a juice for that. Yeah, I'm gonna say yes. And then came back up. And her blood sugar is leveling off. In that cool, I can see that on my phone. Actually, up to 10 people can follow your blood sugar with Dexcom. myself. I'm watching right now my wife is falling on her phone. And actually Arden's roommate follows a college. Anybody you want can follow your CGM. It's up to you. They can also see rates of speed, direction changes, arrows, get alarms. That's the kind of stuff like you know, I said Arden had a little bit of a low before she went to class. She was actually taking a nap. She's a college, I saw the falling blood sugar. I called her on the phone. I said, Hey, where are you at? She was I'm sleeping. And I said, Well, your blood sugar is falling. So do something that she said, Okay. And that was we talked about like 20 seconds just like that. You can do that stuff to dexcom.com forward slash juicebox. Make knowledge your superpower with the Dexcom GS six. Just get started today. There's a button right there. It says get started with Dexcom GS six, you click on it, boom. And before you know it, you've filled in a tiny bit of information. And you're on your way. I don't know if it does on every browser. But if you're on my page, and then you try to leave like you try to close the browser window. But you haven't done anything yet. It says Hey, before you go, are you interested in our free Dexcom G six sample question mark? Well, maybe I am. Our 10 day trial empowers you to make more informed decisions and delivers a new level of diabetes management request the sample, who knew I mean, I know. But now you know, to dexcom.com forward slash juice box head over get your sample. Get started. Do whatever you want to do. Just do it with my link, please.

Emily 33:04
Think you're right. It's it's definitely a perspective as far as for us. It's the big leap that we've had. So we don't pump we don't do any of that stuff. So we don't loop. So we've gone from the G six to the g7. It's for us it's a big leap for other people, I definitely can see people thinking it's different, but it's not huge. Honestly, though, the warmup time alone feels like I am somehow light years in the future from where I was a couple of weeks ago.

Scott Benner 33:40
Okay. All right. So let's let's kind of make a list of things that are changed, and then we'll go through them one at a time. So the warm up, the warm up time has significantly decreased. Yes. Okay.

Emily 33:55
So what was two hours before, and now it is 30 minutes, and we have found the two so we changed it last night, for the first time. And the first time we put one on when we looked when we started everything. The app gave us a 24 minute warmup time. And yesterday, it was a 25 minute warmup time, so it wasn't even 30 minutes.

Scott Benner 34:18
Okay. And like, I'm gonna keep jumping ahead for a minute, then we'll come back to warm up. So warm up the saw the size is obviously different, right? Like, and it's disposable now. So size, disposable. The inserters different.

Emily 34:38
Yes. And I think the grace period is a big deal too.

Scott Benner 34:42
And there's a grace period, which Yeah, we're gonna hold up to last because that is a big deal. Is that it warm up? sighs disposability. inserter.

Emily 34:53
No, um, and then the app has changed.

Scott Benner 34:56
Okay. All right. Okay, All right, Emily. I'm actually excited. Like, there's, I know people probably think I get product before other people, but I don't.

Emily 35:08
And so, you know, Yeah, cuz you can't on this one. Yeah.

Scott Benner 35:12
Well, not only that, it just doesn't. There are so many rules about how these companies can, like, do stuff like this, like marketing or even like testing like, it's you have no idea. Like, even when we got on the pod five, it had to go through our insurance. And if our, if our insurance wouldn't cover it, then art and couldn't get it was like that easy, you know? So? Yeah, you don't you don't there's no ways around these things. Anyway, so Okay, so warmup time right now, Dexcom, G six, you take off your sensor bed, pop out your transmitter, clean off your transmitter, put on a new sensor bed, put in the new transmitter, connect it to the app, and then two hours later, it comes online. But that's not how this works anymore. So

Emily 36:01
no, so we go, let's see, we go in and on my son's app, he uses a phone for his he does not use the receiver uses his phone. And you just say I think I think it's changed sensor. He's not with me. So he's phone is with him. So it's like, it's like end session or change sensor or something like that. There's two different options. And so we go to let let's see, we went to change the sensor. The applicator is really easy. And there's a huge instructional with pictures as well, that comes with it that is easy to follow, just in case you get a little mixed up about what you're supposed to do. Yeah, of course, the wash our hands, we wipe the sensor site we and you don't have to take, it's not going to send data from both to his phone at the same time, of course, because he's got a Bluetooth with one of them or not the other but you don't have to take off the other one before you put on the new one because they're not sharing a transmitter anymore.

Scott Benner 37:11
Okay, hold on a sec. So I'm a little over work. Sorry, no, I'm sorry. I translated the word confused. And I tried to slip it in in German, but I must have not done a good job. I am a little confused. I want to make sure I understand. Henry Henry is wearing a g7. It's the day to switch. His g7 is giving information to his phone, we can see his blood sugar. You put on a new one. It's got a warm up time. But during the warm up time, you're still seeing the old one.

Emily 37:43
No, as soon as I because it still requires the warmup time. But I don't have to take off the other one before it put the other one on because I'm not sharing any components between the two.

Scott Benner 37:53
I see. So it's not like you have to take off the old one disconnected shut it down or it confuses the process.

Emily 37:59
Exactly. It just wants to the only thing it wants to do is connect new Bluetooth to the new sensor.

Scott Benner 38:06
So what is the reasoning why I would put the new one on but not take the old one off?

Emily 38:11
I don't know. There's no There's no I don't think there's a reason to and honestly at first I was wondering if we would not have a lapse of numbers because of there's no transmitter to share. But I guess it's just I don't know why you would not take off the other one. But just in case you were like Oh, I'm in a hurry and I just need to pop this one on so the warm up can go or whatever. See

Scott Benner 38:37
what's your sir? Yeah. Okay. All right.

Emily 38:38
Have to take the other one off.

Scott Benner 38:41
I Emily, I thought you were getting to some sort of exciting announcement and then that turns

Emily 38:45
No, no, we wondered, we wondered, that's that was our big experiment last night was like, Can we do this? Because it kind of seems like you might be able to, but No,

Scott Benner 38:56
all right. So the warmup time is is listed as 30 minutes but you are getting shorter times like it's almost like a calculates it once it's on.

Emily 39:06
We put it on we go through the screens where you have to verify the site you use that kind of thing. And once we say start censoring put in the number it the first time it immediately told us 24 minutes remaining and the second time yesterday that we put in the new sensor it said 25 minutes remaining,

Scott Benner 39:26
okay? And is everything still kind of scanner based if you're using your phone, like there's a box with a code on it, you scan it with your phone, like that kind of stuff.

Emily 39:34
So this time it's the applicator that has the scan code, or the number and or the number of both of them on there. So it's a QR code. And it also has the number in pretty big font, and it's actually on the applicator that you can find that sensor number

Scott Benner 39:54
Okay, and the applicator sort of looks like I don't know how to describe it. So it's like a little cup almost right ate

Emily 40:00
like, I was yeah, like a small yogurt cup or something.

Scott Benner 40:03
Okay, around that size? And then what do you do you pull off the adhesive.

Emily 40:08
So there is a screw top on the front of it. So pardon me,

Scott Benner 40:15
don't worry, you're fine. I appreciate you doing.

Emily 40:19
So you just screw the top off of it. So if it was like some sort of a single serve yogurt, like you had this screw top on, you screw the top off. It's very, I found it very easy to screw the top off of. And it's just kind of right there in mechanism that deploys

Scott Benner 40:39
it is it already exposed the adhesive when you screw off the top? No, you're fine.

Emily 40:48
Yeah, but it's it's kind of within the canister a little bit. So it doesn't seem it's not. There's nothing pressing about it. Sorry,

Scott Benner 41:00
no, no, no, we want to get the story out of you before you die. The one thing I do you want to stop and drink something?

Emily 41:08
I did. Thank you. Okay. Let me take another one here.

Scott Benner 41:12
Yeah, you straighten yourself out, because I'm trying to understand something. And I think I do, but I want to make sure.

Emily 41:19
So

Scott Benner 41:21
So what let me say this with G six right now, right? I take the sensor, you know, and it's got the applicator, it looks like that spaceship from Star Wars, that is great. And you you pull off the tabs, there's two tabs that expose the adhesive, you touch it to your skin, and then you push the button. But now you're saying I have this kind of small thing, maybe the size of a small yogurt cup, and then I screw the end off of it. And when I do the adhesive is exposed already or I have to still pull off paper from it.

Emily 41:51
You don't have to pull anything off of it, you there is a part of basically where the cup would touch your arm that needs to be depressed against your arm. And so if you're not doing that, so if you're if you unscrew the cap and look inside, you can see the sensor and everything inside, but it's down further inside the IC. So there's there's no worry that oh, I'm going to touch the adhesive and mess things up or anything like that. But there's nothing to peel off. You unscrew it, there's a seal on the screw part. So you know, it's sealed at some point in you break that seal when you unscrew it. And then like I said, you can look inside of it. And you can see everything, it's just a little bit deeper inside the cup. So that there's no worry that I'm going to, like I said, touch it, maybe screw up the adhesive or do something weird, right?

Scott Benner 42:42
So I'm, I'm not an engineer, but I'm starting to imagine because at first when you said screw top, I was like, why is it a screw top, but it's probably reasonably airtight. So the adhesive doesn't dry out. Maybe that's what the screw was about, like makes a seal.

Emily 42:56
It's possible. I think it is a nice tight seal when you're when you're first opening it. But I also think it's somebody actually mentioned this in the group and I hadn't thought about it it. I feel like that if you had any sort of mobility or joint issues, unscrewing the cap would not be a problem

Scott Benner 43:17
comes off very simply. Yes, yeah. Seal is you don't have to

Emily 43:21
have. Yeah, so there's just a little tiny seal on it. I think just you know, the peace of mind that no one's touched anything inside. I guess it's sealed up. But it's not like it's hard to break the seal or anything like that. It's very easy to unscrew.

Scott Benner 43:36
That's really amazing. And you made me think of the singer SEAL who also is in great shape. He's also a nice tight seal. If you think about it. You don't I mean, I'm keeping it tight. I mean, he really is. So he's an older man, he looks terrific. So

Emily 43:48
I would never think of him as an older man. So he's definitely keeping it tight. Want

Scott Benner 43:52
to know how old he is? Hold on a second.

Emily 43:54
No. Let me keep my the 90s just happened 10 years

Scott Benner 43:59
ago, Emily seal is 59 years old. No, that makes you old, doesn't it? Well, no, my my wife. I had a conversation last night where I said we are right at the age where people are going to start dying from our childhood and it's going to shock you. And I'm like, I'm not you know what I mean? Like it's gonna be like a frontman from your famous you're like the best band you loved when you were in high school or something like that. And you're gonna be like, Oh, God,

Emily 44:29
oh, because it's already happening where they report somebody died and they report the age and I'm like, Oh, they weren't very old. And it's like they were in their 60s, which is not very old. And I'm going oh, that's not that old. Like that's not old. Yeah. And now they're gonna like you said it's going to be people that are beloved from our childhoods, and they're not going to talk about it being like, tragic. They're just going to talk about people dying. You lived

Scott Benner 44:51
a good long time. Like, let's think Alright, hold on, who's the singer of Aerosmith. Oh my god.

Emily 45:01
Tyler Perry.

Scott Benner 45:03
No. Tyler Perry's director God. Tyler, Steven Tyler, Tyler, Steven. How old Steven Tyler is.

Emily 45:17
This is hard focus. He's looked old for forever.

Scott Benner 45:20
I don't care. I want you to guess. As he's 7874 Mick Jagger is 79. And Ozzy still alive. I don't even know how that happened. Yeah, but just he's probably pickled, but that's not the point. Alright, so Okay, so now we've got this, right. Sorry. People are like, could you talk about the g7? You all

Emily 45:44
know, damn, it doesn't matter. Things

Scott Benner 45:47
got important. You said tight seal that made me think. good shape. And now we know that Ozzy 73 Just be happy and entertained. You'll find out about the g7 as we go, did you not hear Emily coughing? I had to help her. Okay, so we screw the cup off. You touch it to your skin? I guess you hold it still. And then when does it

Emily 46:11
pay to have you have to press it in a little bit. So there's kind of this plastic rim around the outside that's exposed when to take the screw cap off. And it goes, it can be pressed in and out like it's on a spring. And it has to be like compressed in order for the button to work to

Scott Benner 46:30
during during that compression. Emily, are you sticking the adhesive on or No? No. Okay. So you compress it down a little bit, then you just push a button.

Emily 46:40
You push a button, it's much quieter I find than the G six. So I don't know if anyone has any sensory issues around that button. I know my kid would always flinch for that, which I totally get. But this one, it's a lot quieter when you hit the button. And it won't. If you're not compressing it properly. It won't let you hit it will look you're hitting the button it will not deploy.

Scott Benner 47:08
Okay. And so has your son described whether or not it's feel similar to a G six going in.

Emily 47:17
He said he didn't feel it. So sometimes he feels sometimes he says that about the GS six. Sometimes he gives us uh oh, it hurt more than normal. Or, you know, it's he always kind of gives us the review of the Yelp review right away afterwards.

Scott Benner 47:34
Every time this one wasn't this one. That hurt.

Emily 47:38
Like, as I'm doing the three times around going Oh, I'm glad or Oh, I'm sorry. So I totally just did that as if you can see me.

Scott Benner 47:49
You were talking times around your finger around the adhesive. G six, hold it down. So when arting when Arden's on the pod goes on, if it hits a spot where like stuns are getting, I mean like I used to like kind of tickle her skin a little bit. And then around it and she got to an age where one day she just reached out move my hand and she's like, do not do that. And I was like, Oh, okay.

Emily 48:12
Yeah, yeah, we

Scott Benner 48:14
grew out of that. Okay. So okay, so you're, you're so used to like, push down the adhesive for him on the GSX. And then you would get his review. But is there even anything that pushed down now do you still do that with the g7

Emily 48:30
Or is so once you click the button it, it does the adhesive and everything, it puts the sensor and the adhesive in you pulled a cup away, and it's all there, the adhesive is there, everything is just there looks very similar to what's the Libra looked like from my memory. And you are there is a very thin adhesive that goes around it still. And so they do still ask that you do the three times around,

Scott Benner 48:57
pushing on hang.

Emily 48:59
Yeah, and each each box does also come with an overlay. So now you don't have to ask them for overlays. Each box comes with its own overlay. So I guess if it looks a little funky right from the beginning, you could throw the overlay on over it right away or as time goes on, you

Scott Benner 49:20
can see is Henry using it the overlay so

Emily 49:24
the first time we used it last week, I since I was doing a video of it because I was so excited. I was doing it one handed so I did not it was not my best application. And so I went ahead and put the overlay on for the first sensor that we used. And on his on the back of his arms. He tends to have with the G six even with the overlay stuff would start to come up and we'd have to put another overlay on. So even with my kind of not so great application of it with the overlay and everything It actually seemed are really really well, the first time.

Scott Benner 50:03
Yeah. The weight is lesser right.

Emily 50:06
I in sign I know that you had I talked about this in a previous podcast with what they call the Z height. Yes, I think that makes a huge difference. It's not getting caught on anything. Okay, and so nothing is snagging it. And I think that makes kind of a big difference on the overlays,

Scott Benner 50:27
effectiveness and the adhesive in the adhesive in general being able to work better because it's not, if it's, the farther away from the body it is, the more I'm imagining, like drag there is you know, and you can get caught, caught on more things. And even just, I don't know what the word is because I didn't pay attention in school. But you know what I mean? Like, just the, you know, the, I don't know, like thinking about holding a broom out at its end, like the farther you know, the the closer to the middle, you're holding the broom, the more control you have over it. So exactly, I guess the same thing is happening there.

Emily 51:00
It's it's slightly lighter, it's smaller. It's like there's just less drag around it. I guess if

Scott Benner 51:07
he was racecar less wind resistance, that'll be more miles per gallon out of them.

Emily 51:15
But right now is would be really nice.

Scott Benner 51:18
Okay, so now it's on the size is? I mean, has he mentioned the size like this is easier better? I mean, it doesn't stick out of your clothing anymore, I would guess right? Like how far off the skin? Does it feel like it is? It is? So

Emily 51:33
I don't I feel kind of bad for Dexcom? Because I know everybody's seen him compared to like, I don't know, what was it like a quarter or something like that? It doesn't do it justice, how small it is. And I think it really, it ends up being that Z height. Because the G six transmitter is not just sitting on the skin, it's sitting on top of like the sensor kind of carrier thing on top of the skin. And the Dexcom G seven is really just this quarter sized sensor transmitter sitting right on top of the skin.

Scott Benner 52:11
How about so good, I'm sorry.

Emily 52:14
It's also so it's not just that it's the distance from the skin to the top of the sensor is so slim. I think it's also there's, there's like no real 90 degree angles either. And it just it's almost shocking how much smaller it seems even though when I put the Tran like if I put the G six transmitter next to it, it doesn't seem crazy smaller. But there's just something about it on his skin where I'm like, it's so much smaller and right away. He just said he couldn't, he couldn't feel it. And I thought he was giving me another review on the insertion. Which it is a different insertion because instead of the needle going in at an angle, like it does off of the G six spaceship, it does go straight in and I don't know if that makes a huge difference on how it feels going in. But

Scott Benner 53:02
I'm just gonna bring that up like now it's a 90 degree insert and it used to be more Yeah, 45 right, I guess.

Emily 53:09
Yeah. So I don't know if that is part of what's making it better for him so far, but he so far is just kind of laughing. Oh, yeah, I didn't feel that at all. So

Scott Benner 53:18
that's excellent. Hey, did did Henry have compression lows ever with G six?

Emily 53:22
He did a lot.

Scott Benner 53:25
Are you seeing them with your seven?

Emily 53:28
We have not seen any with the g7

Scott Benner 53:31
See, this is my if you listen to the podcast, you know like two years ago when I was interviewing someone with Dex from Dexcom I was like hey, is this gonna cut down on compression lows feels like this would kind of cut down on the compression loads and like well we can't say that you can't say anything. It didn't test it. You know what I mean? But it just makes sense. So

Emily 53:49
if you just because even if he's laying right on it he's never going to be laying on it and an angle I think that

Scott Benner 53:56
puts pressure on it.

Emily 53:58
Yeah, so yeah, we haven't had we hadn't none No no, no compression laws at all. That's

Scott Benner 54:06
great. How many warrants so far do you think?

Emily 54:09
Oh, the G six is

Scott Benner 54:12
now the Gol G six for four years but how many G sevens Have you been through so far?

Emily 54:15
So this is the second g7 Wow, you

Scott Benner 54:18
guys are so new to it. Oh, this is so cool. Okay, all right. So when the first one came off now different than G six g six you take off you're like oh don't lose the transmitter. This one you rip off? It goes right the trash, right? Yes, exactly.

Emily 54:31
Which still feels really weird. Like there's part of me that's like should we keep it just in case?

Scott Benner 54:37
Something that did so much for you? Right like for 10 days and then you're like you're done that's how people feel when they get divorced.

Emily 54:49
Obviously goes in the trash, but we bought a house to get okay.

Scott Benner 54:55
I guess I'm done. Thank you. So right in the garbage but you have that feeling still Whoa, I shouldn't be throwing this out. That'll go away. Oh, I'm

Emily 55:03
sure. Yeah.

Scott Benner 55:05
He must be. Gosh, I don't know. Is he around? Well, I guess it's talked to him at some point. Yes, yes. All right, cool. Let's keep talking. But I'm gonna I want to grab them up. I want to get his feeling about it. So we've talked about the inserter. The inserter. Is, is it recycling or garbage when you're done with it?

Emily 55:22
So, I don't know. When I yeah, when I look at it, I feel like the top part could possibly be recycled. But the cup part? I think not. There's too much still going on inside of it. Okay. All right. So you could potentially grab stuff out of there if you really wanted to, but then the part where the button is, is more of a rubbery kind of material. So I don't even know if that would be

Scott Benner 55:52
a thing. Gotcha. Do you find the inserter? The the, the yogurt cup, which now the internet is going to call it a yogurt cup? And that'll be your fault, Emily, but it's the yogurt cup inserter? Is it feel like it's material wise? Is it commensurate to the old inserter? Or is it does look like they were able to use less material? What do you think?

Emily 56:18
I think it. So I have I actually kept one of the old ones just like you kind of look and give you a better idea. It looks so much. It's obviously a different shape. But it definitely looks smaller, less materials than the old one.

Scott Benner 56:34
Okay. Oh, cool. Well, I hope that's true. Now, what about I think

Emily 56:37
she the packaging is less as well.

Scott Benner 56:40
The box is much smaller.

Emily 56:43
And it's not so and how they. So they're all in their own box. But the there's no like plastic packaging.

Scott Benner 56:53
Okay, so this little cue box, I'm imagining, I opened up the inserter comes right out. It's not wrapped in anything or anything like that. So that's just the yogurt cup. Cup comes out of the box. And then you can press the spring and push the button and it's on. Yep. Nice. Alright. We talked about the app. So you said the app on your son's phone is now different. Is that right? Yes. Okay. Did he have to update the app he had? Or did you have to delete the app and put on a new one?

Emily 57:27
We did not have to delete the GSX. It just is not working anymore. But so we had to get a new the g7 app on the App Store new

Scott Benner 57:35
app? And what do you think of it? Is it uh, I haven't seen it yet.

Emily 57:42
So I really like it, I am sure that there are people who will not like it. Obviously, people are people in that regard. And like I said, we don't pump. So there might be things that other people are wishing we're on it that aren't on it that we don't even notice. But I really like the way the app is organized. And I think so we were in the States, we were using sugar mate to follow his numbers more easily. And when, when that kind of went wonky, we went back to Dexcom here. And I feel like they take not everything. But they've taken in a lot of consideration of what people like about some of the other apps besides Dexcom that they use. And they've incorporated some of those things into the new G seven app. So I think the number one thing people would probably want that they did not incorporate is the rate of

Scott Benner 58:41
change. Yes, I know I saw.

Emily 58:45
But they do have NIF different alarms that you can now set for if it's falling at a certain rate or rising at a certain rate, which is better than the last step.

Scott Benner 58:56
Okay, good. So there's more functionality with the alarms. Yes. And then there's kind of like tabs across the bottom right like glucose, then history. There's,

Emily 59:05
there's glucose, history, connections and profile, and they each have their own little icon that you can go to. On the glucose, tab page, whatever it is, you can see you can see what you're used to seeing from Dexcom on that page, which is the chart with this with the numbers and the dots. There's a plus sign and if you go to the plus sign, you can go right from that plus sign to add meals, carbs, exercise, long acting insulin, quick acting insulin,

Scott Benner 59:43
putting notes, putting notes into Yes, things you've done. Yeah.

Emily 59:46
So you can do that just right from that page. You can also do that from the history page so you can see what you've had in there. And you can also add things in from the history page. Okay. And then on the glucose app, I think something But I didn't fully realize until we had the app going, was that you literally just scroll further on that page, and it gives you your clarity information. Okay. And that I think for some people, that's going to be maybe a nightmare of too much information that they don't want to see.

Scott Benner 1:00:20
But it's not, it's not something you have to see though, right? Like the, like crawl. Yeah, like cards, right? Like, that's how they were talking about it when they were on like, so one screen or a card is your graph. And then you can go to history to see a different card with information, what is connections?

Emily 1:00:39
So the connections is just, I really think that's just like the followers, basically. Okay,

Scott Benner 1:00:47
that makes sense, following people who are following, and then your profiles, probably just a little bit of information about your account, you can get a profile,

Emily 1:00:54
it gives you a countdown of how many days you have left on the sensor. And it's done in a much more friendly way for my 12 year old. Instead of going into the settings and kind of giving me the date readout of exactly what time it's going to end it has a system of kind of like blocks that are there's 10 blocks and then one comes off of it for every day. And it gives you It also tells you this many days remaining makes

Scott Benner 1:01:20
it very visual. Yeah, it's a good idea.

Emily 1:01:23
It's nice just to glance at and it also from that tab will allow you to connect to Apple first. So we have iPhones, it allows you to connect to Apple Health if you would like to. And we have not done that so far on his but I will be looking into it when I have more than a couple of seconds to rub together.

Scott Benner 1:01:44
I have Arden's attached to Apple Health. And it's it's helpful, honestly, yeah. And so on that graph, still three 612 24 hours, I can see that it does it's it still goes landscape or portrait. What are the um, I found a picture of it now while you're looking at it. So across the top three 612 24 hours, then there's three dots to the right, have it? What is that four? Do you know? It's a menu. Right.

Emily 1:02:12
Let me let me call my son in here for a second. See. Or I'll text him because that's the way we all communicate.

Scott Benner 1:02:22
My father would be bellowing right now, Scott.

Emily 1:02:27
Normally I would

Scott Benner 1:02:30
come into the room going like oh god, did I do something wrong? Or like, how's this gonna go?

Emily 1:02:36
I was usually in trouble when it was me as a kid. Yeah, I we like to do that to our kids every once in a while just to keep them on their toes.

Scott Benner 1:02:42
Yeah. Hey, listen, that's a great idea.

Emily 1:02:46
You get the bellow get out here.

Scott Benner 1:02:49
What do you offer job today? You did it. You didn't piss me off too much.

Emily 1:02:58
It's not going through. Alright, so now I'm gonna bello for Andre. Could you come here please? Yes.

Scott Benner 1:03:11
What makes me think of Goodfellows Is it good Phil Hendry, Hendry? What was that? That was a little guy. God, I can't think of anybody's name. I'm so old at this point. Pachi Pachi Pachi Hendry.

Emily 1:03:30
Okay, so Okay, so the three little dots is basically a really quick way to get into all your different alerts if you want to change them from that page as well.

Scott Benner 1:03:43
Okay, cool. That's excellent. And now, what about your app? Did your follow up change at all? Or no,

Emily 1:03:49
not yet. No, it is the same, which honestly, was a little bit of a relief because I didn't, it was just it was easier the first time we were doing everything to go okay, it's working great. So it went perfectly with our follow ups. But we don't have a new follow up yet, which I know from previous podcasts, you've done that that's I'm sure something they're working on. But for now, it's the same follow up it's just his app that's different.

Scott Benner 1:04:18
My last question about the graph is you know how you look at the graph and you kind of infer things from it like the pitch of the line tells you stuff none of that's changed graphically.

Emily 1:04:28
No, it's still the same I think we have a different layout for us that is it's it's like a different background. Basically it's it's brighter than it was

Scott Benner 1:04:41
color schemes a little different but but the color schemes

Emily 1:04:45
a little different but otherwise, and now I'm looking at his phone and is it not let you do landscape? So his on his app, it's not letting him do the

Scott Benner 1:04:55
landscaping Android or iPhone. iPhone. Is it there? There's a landscape lock in the main screen, he might have it, he might have the whole phone locked.

Emily 1:05:05
Okay. I'll have to look into

Scott Benner 1:05:09
figure that out. But yeah,

Emily 1:05:09
so so it looks, it basically looks the same with the dots and everything else. Okay. And the arrow, the arrow I think is slightly different than it was. So where it actually tells you your number and gives you the arrow, though the design of it is slightly different, but it's basically the same. It

Scott Benner 1:05:27
looks updated, but similar. Yeah. Okay, so I have one more question for you that I'm going to grab Henry, if that's okay. Okay, that's fine. I want to understand the grace period, how that works. Okay, so what does that even mean? Because they're pushing it. And then I started listening. And I was like, that makes sense to me that that's a big deal. So what does it explain to me how it works functionally for you.

Emily 1:05:51
So you start getting the same messages of you know, your sensor is going to expire in 24 hours, 12 hours, six hours, three hours. And then once it actually expires, it just doesn't stop it says new basically says you now have 12 hours to change it. So if you wanted to change it before, you could, of course, but then it's just it's basically it's extended for 12 hours no matter what. So it's interesting to me, because there's definitely been times where sensor has been failing, or something's been wrong with it. And so we've had to change it early. And we know that the time that we're changing, it is not a good time. So it's normally a time that he'd be at school, or it's the morning or something like that. And so we have to think ahead with the GSX. To go okay, well, the next time we change, we're gonna have to change it the night before, or you know, earlier than we planned on changing it. So we're not getting the full 10 day use out of it. And so, for this, it's definitely that 12 hours, it's a it's a big deal. It's hard to explain to somebody, I guess he doesn't use these, what a big deal that is to be able to say, we'll you know, it will change it in the morning, or we're gonna go out to dinner right now. And it's, you know, let's just wait till after dinner.

Scott Benner 1:07:17
You basically get the freedom of the entire 24 hour clock to decide when it happens. Instead,

Emily 1:07:22
because 12 hours is such a huge Yeah, no,

Scott Benner 1:07:25
yeah, I listen, I think this agenda and an episode recently, but we had two months before Arden left for college. We were like, Hey, we've got to get your CGM on a better set on a better what am I looking for? You know, a better, like schedule schedule. I got Emily, thank you a better schedule. Schedule. I couldn't come up with the word schedule. So the COVID still has me a little bit Emily. But that's okay. Because it just happened that one time, right, like you got this, this sensor that just it just went off before you expected it to we last one at like 1112 o'clock at night one time. And then every time we changed it, we'd say to ourselves, let's set an alarm for nine days from now. And we'll just change it in the evening. We'll get ahead of this. And we kept I swear to you, we kept screwing it up and screwing it up to the point where he started writing it on stickies around the house because I didn't want Arden to have to change her CGM at midnight. Yeah, you know, when she was a college, because then all that comes with it. Forget it just being not pleasant to do when it's it's late at night. But now you had but with G six a two hour warm up window? Yes. And then, you know, you also are like you're a little like in the first couple hours. You don't I mean, you're not sure what you're getting as far as readings go. And, and so it just took us forever. But now basically, we could have just done it whenever we wanted to. Yeah.

Emily 1:08:53
It's interesting, too, because the 12 hour grace period is so nice. Of course, it's makes so much sense. But also, my husband and I kind of had to laugh a little bit because we were kind of going well with the 30 minute warmup. I don't know when is not a good time to change it.

Scott Benner 1:09:12
So quick. Yeah. Well, you gave your game that too. Now, I guess my last question for you is, what about accuracy? Are you noticing? What are you saying?

Emily 1:09:22
So for us, the G six within the first 24 hours was always we tend to be the kind of people who we since we are on the MDI and not the pump. We basically believe Dexcom unless we have reason to not believe Dexcom. So unless he's feeling a certain way or something doesn't seem right with the number to us, we basically go that's probably right. And whenever we've had to do a finger poke, it's generally been okay. With the G six. I know in the first 24 hours we just get used to okay the numbers kind of are a little crazy at first you end up Doing a few finger pokes in the first 24 hours just to kind of see how far off it is. Yeah. And with this, we did some finger pokes. And it was, like, just right from the beginning it was on. Oh, that's great. And we never really had you get the kind of scattered. I don't know how to describe that first 24 hours where sometimes you get that kind of scattered shot, kind of look to your graph. That still happens. But it's more, it's like tighter.

Scott Benner 1:10:33
So not much of a bit. So listen, I have to say, just for clarity, like, generally speaking, Dexcom works really well for Arden. And will either EPS as well, yeah, on G six, I'll either see, like the last one she put on was good to go. Like, I don't even know how to describe it to you. Like she had a lot of for two hours. I was like, hey, just test that. Make sure that number is right spot on. Super smooth graph always fine. The one prior to that the first couple of hours, I think four or five hours that it was on. I kept saying to her, like, hey, Don't doze off that number. Like check it, you know, like, but and they were they weren't wildly off. But then all of a sudden one time it was like, your blood sugar's you know this. Now suddenly, it's at points higher. And five minutes later, it wasn't again, I was like, Whoa, you know, like, I'm like, this one's not settled in yet. Which is usually how I ended up thinking of it, you know?

Emily 1:11:24
Yes, yes. This one hasn't settled.

Scott Benner 1:11:27
Exactly. term. It hasn't it hasn't settled in yet. But that is, I mean, I, I don't know that I can remember the last time I've had to say to her take that off. That one doesn't work. I mean, it's maybe happened like two or three times and all these years, you know what I mean? So,

Emily 1:11:44
yes, for us, even when one is not great. Right away, it eventually comes around and sooner rather than later for us as well. We've been very lucky. We've had a few where they've just been terrible. And we all laugh about it. But it's been mostly wonderful for us. So we definitely don't have any complaints that way. But it did. It felt different in the first 24 hours. So even being somebody who, who likes the G six and who found it to be good, I still found a difference, a better difference in the first 24 hours of the g7. And then throughout the 10 days. We, with the GS six, there will be times where you know if it goes too low or too high. There's just times where it's like the we're gonna take just feels like the sensor is going to take break for a few for a little bit. And you're kind of going yeah, it was an extreme number. So I get it. And that just it didn't happen at all with the g7. We didn't have, we had some slight disruptions where it would tell him that, oh, it's the they he basically been too far from his phone even if he had not, but it came back on right away. So the disruptions were just minimal to nothing. It's great.

Scott Benner 1:13:00
I do find myself wondering how long it'll be until the integration happens. Like you know, G seven to control IQ, G seven on the pod five, you know, how long till the DIY community figures out how to do GCF and like, all that stuff. But it's super, I mean, listen, from my, from my perspective, as a person has been using this stuff for a long time with his daughter. The size change alone is a big deal. The warmup time is huge. I mean, that it's not going to get caught on stuff. Give me that you won't have the same ability to compress it while you're laying down. Seems like a big deal to me. Like I don't see any. I don't see any back steps here. So how about you? Do you see anything where you're like, Oh, God, they shouldn't change that?

Emily 1:13:52
No, I for us, because we came into this with G six, we haven't had the hard time that a lot of other people have had. And we've been really, really grateful for the G six and it's been wonderful, but this I had to pinch myself. I felt like I was dreaming. It's just a really good product in my opinion.

Scott Benner 1:14:14
That's good to hear. Okay, well, thank you, Emily, for doing this for me. I'm gonna say goodbye to you now, just in case. You know, Henry, and I really hit it off and this is the end of you. So do you stick those air pods in his ears?

Yes, I can. Here he is. Hey, Henry, how are you? I'm Scott.

Henry 1:14:39
I'm good. Good. How are you today?

Scott Benner 1:14:46
Oh, I'm getting over COVID Thank you. So oh, I'm better than I was yesterday. Your mom can't hear us. It's just you and me. I think so. Yes. Still there though. Yes, she's still there. Yeah, let let us let her think we're talking about her for a second. It'll make her uncomfortable. It'll be fun. How was she is a mom decent good or not? Okay.

Henry 1:15:11
Pretty good. Pretty

Scott Benner 1:15:12
good. Yeah, that's excellent. She doesn't hate you

Henry 1:15:17
know? Okay.

Scott Benner 1:15:19
I mean, if you if you need help, you'll tell me. Yeah. She seems she seems lovely. You have an older brother. Is that right? Yeah. And do you remember being diagnosed with type one?

Henry 1:15:33
Oh, yes. I don't remember too clearly, which probably fits better, but I do still remember it.

Scott Benner 1:15:45
Okay, Henry, your voice is so deep. It's like you're 70 years old. But your, your your are you? 12?

Henry 1:15:53
I'm 12. Yeah,

Scott Benner 1:15:54
you have a very nice deep voice. Thank you. Yeah, that'll come in handy for you as you're getting older. Your mom was telling me you don't want to pump? Can you tell me about that?

Henry 1:16:05
So yeah, I, when we were first introduced to it, it sounded like a good idea. But I didn't like the idea of changing something every three days, because it seemed very, very inconvenient. As well as it does like situation where do like have something connected to you, and you'd be connected to monitor device thing? And then you'd have to keep that somewhere? It seemed very, as again, inconvenient. And so I felt like the my situation with the G six felt like, the way he was going felt very good. So that I would just stick with that.

Scott Benner 1:16:52
Okay, that makes sense. Well, I wasn't, you know, I'm not pressuring you. I was just wondering what you were thinking, when you said that? Did you look at a tube pump or tubeless? Pump? Or did you look at all of them?

Henry 1:17:04
We look at right now it was probably a tubeless. But, um, yeah. The the three days situation was not good for me.

Scott Benner 1:17:22
You just did not want to be switching it every three days. Yeah, I gotcha. And you make out okay with carrying a pen with you. And you don't have any trouble with with obviously injecting? Are you good with injecting a lot if you have to, like if you eat something that's very heavy carbs in your budget or starts going up, you're not bothered by injecting and re injecting again.

Henry 1:17:44
I mean, I get irritated because a when I get high, I usually stay high for a bit, but I still get irritated. But I I will do multiple injections easily.

Scott Benner 1:18:00
Okay. If if the pumps got to the point where the algorithms were working so well, that it would take away a lot of that. Do you think that would be a good enough? I don't know. Do you think that would be enough of a reason for you to change? If you knew that, suddenly, if your blood sugar was trying to go up that a pump would see that and keep giving you more insulin? You wouldn't have to think about it as much, for example.

Henry 1:18:23
Oh, yeah, I do think that would be nice.

Scott Benner 1:18:29
Yeah, okay. All right. Well, well, it gets you see what the future brings. So let me just ask you a couple of questions about g7. Before I let you go. Okay, you weren't G six for a number of years obviously was was switching to G seven. A change for you that was positive, negative. How did you feel about it?

Henry 1:18:49
Oh, I think it was very positive because I'm the G The G Flex. I can't remember when we started using it. We use like the Libra thing for a bit. But then we switched to it. It just kind of happened. I can't really remember when it happened. But then the g7 felt very like like it happened like there it feels like not much has changed but it still feels like something's different. Yeah, it makes sense.

Scott Benner 1:19:34
The only does so I totally understand what you're saying. The so the g7 functionally feels a lot like wearing G six, because of the process that you go through is is changed but still similar. But is the big change for you. Just the size of the device. Has that been a benefit?

Henry 1:19:54
Oh yeah, it is because I can I can barely notice it at Um, and even when I am like trying to like, like, see where it is? I can, it's hard for me to find it because of how small it is. As for the G six, it was like, three times a day that I would accidentally notice it because of how like clunky and big it was not Kong. Not big but it was like it. It was kind of large.

Scott Benner 1:20:25
Well compared to this one. Right. It's it's a lot bigger. Yeah. So how about sleeping with it? Have you noticed the improvement there?

Henry 1:20:34
Yeah, definitely. When I usually I don't stay still in my sleep as I like to move around as and so with the smaller sensor, it's easier for me to kind of sleep on a side that I'm comfortable but comfortable on but also, like situate my arm so that it's possible to still sleep on that side. Just not like in a mess up the sensor. Yeah,

Scott Benner 1:21:15
yeah. So you were getting compression loads before your mom was telling me? Yeah, it's nice not to get that and get woken up by an alarm. That's not necessary. This is really, how about the I know you're only on your second one but has your mom put both of them on for your Have you done it yet? With the with the inserter?

Henry 1:21:35
Um, my mom did it the first time and then I think my dad did it the second time. Yeah, my dad did it the second time.

Scott Benner 1:21:47
Previously with G six. Were you doing it? Or were they helping you still?

Henry 1:21:52
They were helping me still because for a while I was doing it on my, my. My I was doing it in the the upper but until like, until like last year when I started using my arm about um, and so but I still can't really do it on my own.

Scott Benner 1:22:23
Right? Because of reach and where it's at. It's a little difficult. Yeah, yeah, you'll figure it out. My daughter was like, here help me with this helped me do this. Then she had to go to college. And she's like, I can do this. And she's she just started doing it. So apparently, a necessity is the mother of invention. Hey, your mom told me that when you were little you could speak like other languages, but you lost it. You don't could use Do you have any now?

Henry 1:22:49
Well, so I used to speak really good, really, really good French. Because we lived in Belgium. And that's when I started going to school so and it was like the only you can only the only time it was necessary to speak English was like talking to your friends. And so when you when you had to communicate teacher, it was usually French and so I learned it. And I learned pretty well because there wasn't a distinct French class. It was just everything was in French and I kind of got the hang of it. But then after we moved to London, I heard God basically all of it and because now that's London and in French is just a subject that you we I was I got I lost my fluency in French and now that we're here in Germany, I'm much better at German than I was at French. I think. But yeah, well, the only

Scott Benner 1:23:59
Oh, I was gonna say the UK. In London, Germany now you've been in America, Belgium. Do you have a favorite spot? These are one of those places you wish you lived?

Henry 1:24:12
Um, because they're all nice. I mean, I definitely have I definitely have a preference but I can't think with all the top ones. I mean, my my favorites have been Germany and London. But I can't think between them because in London the community was really nice and like the cut the stuff we could do like there was this bookstore and we lived around it as in Germany, this schools really nice. There's not much to do around our area. There's like we can go to other part except Germany, but I'd say that London has pretty much been my favorite place so far.

Scott Benner 1:25:08
Nice. That's excellent. So if I I'm gonna let you go on a second. And I appreciate you doing this, Henry. But if I asked you to say, I don't know, my name is Henry and I have diabetes in German, you can just spit that out.

Henry 1:25:22
Ah, no, I, I can say my name is Henry Haifa, Henry, but I don't I don't know the words for type one diabetes. My, one of my friends with this project were like helping each other with subjects. He gave me some flashcards on like, diabetes stuff in German. And so I'm thinking to like, look over those sometimes. Got it.

Scott Benner 1:25:50
So you speak better with the everyday words that are necessary.

Henry 1:25:56
Ah, yeah, I'm, I'm better with like, if I, if I've lost my way. So it's good.

Scott Benner 1:26:08
Please help me get home stuff like that. That's excellent. All right. Well, Henry, I really appreciate you taking the time to do this. And I hope you're enjoying the g7 It sounds like you are. It sounds like you're doing terrific. And I don't I just I appreciate your time. If you give me back to your mom, I'll say goodbye to her before I go. Okay, thank you. Amen. Thank you. Thank you. Hello, hey, Emily, I just wanted to tell you before you went, he was delightful. Good job, kid and everything. Early in the, in the episode, you talked about that you put up a post in the in the Juicebox Podcast Facebook group, the private group, I actually found it. And, you know, there's, I don't know if people don't care about this. But there's like 30,000 members in the group. And posts are, like, you know, I can see tracking on them. Like, how often do people see them, your post reached 21,000 of the 30,000 people in there. Which is insane. Because that's incredible. If I get up there, and I'm like, hey, it's the guy from the podcast, I don't reach that. And people are pretty excited. Usually when I show up, and they're like, Oh, the guy from the podcast is here. You know. And so this is just to me an indication of how much people are interested in this. I mean, that's out.

Emily 1:27:36
People have been talking about it and thinking about it and speculating about it for so long. It's just such a big deal.

Scott Benner 1:27:43
Yeah, I mean, it's a stunning percentage of I like I couldn't believe it when it scrolled up. I was like, That's stunning that it hit that many impressions. And, and had a big conversation, 350 comments, and, you know, 1000s of likes and stuff like that really, really terrific. So anyway, I appreciate you sharing it with everybody there. I really appreciate you coming on and doing this. I know you're not feeling well, was a big deal.

Emily 1:28:07
No, I appreciate it. I've had so much help from people in the community. I appreciate the opportunity to give back even in a small way. So thank you.

Scott Benner 1:28:15
Well, this should keep their whistles wet until it until it until it makes it to the US. But thank you so hopefully

Emily 1:28:24
sooner rather than later. I know people were very gracious in congratulating us about it. And I appreciate that as well.

Scott Benner 1:28:30
Yeah, so we'll cross our fingers for a Christmas miracle. But we'll keep in mind probably the beginning of 2023.

Emily 1:28:37
Hopefully Christmas miracle but yes, it'd be nice.

Scott Benner 1:28:44
First, I want to thank Henry and Emily for coming on the show today and sharing their experiences with the Dexcom g7. I'm going to thank the sponsors as well. dexcom.com forward slash juice box get started with Dexcom today use my link dexcom.com forward slash juice box type in your browser. Click on it somewhere, please. Who else? We're going to thank us med That's right. Go to us. med.com forward slash juice box. Were called 888-721-1514. Get your diabetes supplies the way we do from us med. Listen, I'm still sick. So I'm just gonna say thanks so much for listening. I'll be back very soon with another episode of The Juicebox Podcast because I can't talk much longer. i You have no idea. I'm out of breath.

#784 Bold Beginnings: Insurance

Test your knowledge of episode 784

1. Why is it important to build a support network for diabetes management?

2. How can staying active benefit diabetes management?

3. Why is it important to understand your medications?

4. Why should you stay informed about new treatments?

5. How can customizing your meal plan help in managing diabetes?

6. Why should you monitor your blood sugar regularly?

7. Why should you prepare for emergencies?

8. Why is staying positive important for managing diabetes?

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#783 Survey Says

David runs T1DExchange and he has type 1.

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#782 Dexcom G7 User

Emily's son has type 1 diabetes and he uses the Dexcom G7!

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