Scott Benner 4/16/23 Scott Benner 4/16/23

#886 Yes Chef

Paul is an executive chef whose child has type 1 diabetes. We talk about Omnipod 5, clinical trials and raising a little one with T1D.

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

Scott Benner 0:00
Hello friends, welcome to episode 886 of the Juicebox Podcast.

Today I'll be speaking with Paul. He is the father of a young child with type one diabetes. Paul is an executive chef. His child has been on Omnipod, five done clinical trials. And we talk about all that plus what it's like to be married and raising a child with type one diabetes. While you're listening, please remember 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. Are you a US resident who has type one or a US resident who is the caregiver of someone with type one? Oh, if you are please go to T one D exchange.org. Forward slash juicebox. and complete the survey completing the survey helps type one diabetes research to move forward. It supports the Juicebox Podcast and it's just a nice thing to do. Plus, it doesn't take very much time. And you can do it from wherever you're sitting right now. T one D exchange.org forward slash juicebox.

This show is sponsored today by the glucagon that my daughter carries G voc hypo penne Find out more at G voc glucagon.com. Forward slash Juicebox. Podcast is also sponsored by Dexcom, makers of the Dexcom G six and G seven continuous glucose monitoring systems. You can learn more about the G six and the G seven and get started@dexcom.com forward slash juice box. See your blood sugar, the number, the speed and the direction all in one place on your smartphone or on your Dexcom receiver dexcom.com forward slash Juicebox Podcast is also sponsored today, by the contour next gen blood glucose meter, check out the contour next gen the Contour Next One and their entire line of blood glucose meters at contour next one.com forward slash juicebox get yourself an easy to handle easy to use an incredibly accurate meter, get a contour.

Paul 2:40
interested in sharing our story and our journey. So far, it's been interesting, I kind of got to participate some trials and Omnipod five now and we were on the tandem for you know, then two year old. So it's been a whirlwind and up and down. And we have some interesting interesting stuff to share and love to hear some of your feedback and what you think of the situation and also talk about you know, the kind of the strain and pressure that being a caregiver puts on on marriage and being in clinical trials and being a professional corporate executive chef, and my son eats five things. And it's a lot to talk about and a lot to share. So hopefully it'll be some good content for other listeners, other parents and caregivers and other T one DS

Scott Benner 3:32
Oh, I'm certain it will be. Why don't we start off by you introducing yourself any way that you want to be known?

Paul 3:39
Sure. My name is Paul. 46 years old. I have a three year old type one diabetic son named Justin. married to my wife Margarita. And we've been married since 2007. And Justin was diagnosed at 18 months, and he is now a little over three, three in May.

Scott Benner 4:00
Oh, wow. Okay, so Justin's had diabetes about as long as he didn't have it.

Paul 4:05
We just passed the halfway mark. So he has now been living with diabetes longer than without. Gotcha.

Scott Benner 4:11
And you've been married? Hold on. 16 1516 years?

Paul 4:16
Yes. Since July of 2007.

Scott Benner 4:19
Wow. Today is my 26th anniversary.

Paul 4:21
Wow. Congratulations. That's uh, you don't hear that too. So much nowadays. Do you not?

Scott Benner 4:27
I don't know. You don't know. All I don't talk to anybody. I don't know. I don't hear anything from anyone. I make this podcast and I sleep. So. Well. Well, thank you very much. I appreciate I just she hasn't opened them yet. But my wife has told me this story. Uh, probably a dozen times since I've known her and we've known each other. My gosh, since probably, well, we knew each other longer than we were dating. And so I don't know we've been married. For 26 years, I think I knew her when she was 16 and 17. Like, just like I, like, you know, to say like she walked past me and I recognized her. Sure, I think I started bugging her when she was 19. So, anyway, she's 48 now. And she's told me a handful a dozen times in her life, about getting these diamond studded earrings as a child. I don't know if it was wrapped around her Catholicism or if it was a gift or something. But she, um, I guess she took them out at some point. And I don't know why people do things like this, but left them by the sink or the windowsill near a sink or something. And adios. They're just gone. Yeah. So I don't know why it never occurred to me over the years. I've always felt so bad for that little girl. You don't I mean, like, I always wished I could have like swept in and been like, here. Here's two more earrings. It's fine. Don't tell anybody, you know. So I got my wife a pair of about nice diamond stud earrings for our anniversary today. They're downstairs on the table. And I had no better late than never Scott. Well, I wasn't there the day it happened. I just don't know, over the years. But I do know, Paul, over the years. In the beginning, I was like, I can't afford this, you know? Sure. And then today, I was like I could, you know, earlier this week, I said to art and I was like, come with me and help me pick out earrings for mom. So we did that and acted fancy in a jewelry store for a little while and then got right out of there because we didn't feel too fancy. But yep. But it's nice to know that 26 years feels like a long time. I have to admit it's it's different. Like, as everything is what you expect, and what you picture and what you imagine when you're younger. It's never what happens when you're older. And I don't mean like successes and failures and things like that. Just I think just what the union means is different than what you think it is when you're like 25, you know?

Paul 7:01
Yeah, I completely agree. And that also, it's also different. Being husband and wife and then being mommy and daddy as well. That's a change that no one really describes to you very well.

Scott Benner 7:17
Yeah, no, no, my, my son's going through a tough time right now, like transitioning out of college. And it's, it's he sort of I don't know, he's been kind of private about it, I guess. And it's, I don't know, Paul, my only job in the world feels like taking care of people. And then, you know, and I do that verbally. And so when that doesn't happen, then I get I'm the least anxious person in the world. And right now today. I'm is like twisted in a knot as I've been. I don't know, since Arden was diagnosed? Well, yeah, just because I can't I can't help the way I want to help, or the way I want to help. It's not helping or whatever. I don't know. But those are not things that you have to deal with if you don't have kids.

Paul 8:05
Yeah, I can't You can't look back and tell like a 19 year old, you that one day you're going to be faced with, you know, X. y&z just doesn't doesn't relate and you don't comprehend at that age. But, you know, just it's part of adulting in parenting, I guess.

Scott Benner 8:22
Everything's on the job training.

Paul 8:25
100% Yeah. With diabetes, diabetes, as well. It's a It's all real world experience. You can, you can only get lead from do not die information from your Endo, for so long before you have to start figuring stuff out yourself and acting in the moment. So this it pertains to a lot of different parts of life.

Scott Benner 8:47
Oh, I think so. What is there a something about a saying about building the plane while you're flying it?

Paul 8:54
Yeah, I don't know what it is, though. But I understand the analogy. Yeah.

Scott Benner 8:58
I couldn't explain it well, but I think it explains itself.

Paul 9:02
Some days feels like we're, you know, you're flying while you're building the plane. And it's you're bailing out water as the plane floods as well.

Scott Benner 9:10
Right. So isn't it isn't it? Isn't it exactly like that? It's because I'm imagining three years ago, you and your lovely wife are living. I mean, your body would just say you're an executive chef.

Paul 9:20
Yeah, I'm an executive chef. I work for a corporate dining company. So we do a lot of dining for, you know, like, corporate dining for Uber and Twitter and, you know, large bay area companies with 1000s of employees. So we do on site food service for some of the larger tech and.com companies.

Scott Benner 9:39
And that's a job you really enjoy a match. I don't think that's something you can do if you don't like it for some reason.

Paul 9:44
You know, there's, I guess in the culinary world, you can, you know, there's kind of two sides to it. One you can work in public restaurant. You know, like, sure you have a downtown area that has tons of restaurants, where you can, you know, work as a line cook or even a chef and your days are like when I was in my early 20s, you know, 1516 hour days, six, seven days a week, Thanksgiving, Christmas, all that you miss all the birthdays, all the holidays, you're in there from open to close every day, and the pay is substandard. When I got married, in 2007, I was working as a sous chef at a popular Mediterranean family style restaurant. And I would kiss Margarita on the cheek when I left for work in the morning at like 630 when she was asleep, and I would get home from work at 130 in the morning, kiss her on the cheek while she was asleep in bed. So I quickly explore my options to find out you know, before this marriage starts, how can I help it succeed by spending more time. So I've ventured into the world of corporate dining. So the world of corporate dining is Monday through Friday, get in about six I leave about 230 Every day. I'm off on all the bank holidays, regular holidays. And the pay is two three times three fold of what it would be in, I guess what you would say a regular restaurant.

Scott Benner 11:22
Let's see Paul. That's my point. You got everything together. And then life hoisted you up to 40,000 feet and said, Hey, your kid has diabetes. Figure it out before we crash?

Paul 11:32
Great pretty much. Yeah, yeah. In a nutshell. Yes.

Scott Benner 11:35
Absolutely. Well, what was it like when Justin was diagnosed?

Paul 11:42
Shocking, is I guess what stands out the most but the the story leading up to it, as you've probably heard a lot of times with the thirst and then excessive Bedwetting, and daycare. He was in daycare. And so you know, he's drinking a whole lot of water. And so it's okay. So a week later, you know, he's really drinking a lot, a lot of water like, you know, 10 times as much as the other kids. And so we message our primary is pediatrician. So yeah, it's fine, whatever, you know, don't don't worry about it and message him against him. He's wetting the bed every night and attitude. He's, you know, he's just been really, really cranky. And we got to take a bath, and he's just crying and crying. And so it finally took him to go into DKA for us to you know, I guess take him in, he was super lethargic, and breathing was, you know, concerning. So we took him to a respiratory clinic. And we thought, oh, maybe COVID. You know what, whatever it could be. They did a bunch of work at the respiratory clinic. And they couldn't really find anything. They were waiting for the bloodwork to come back. And they said, well, while we have them here, let's take some urine. So they took urine. They couldn't really give us a diagnosis. So they sent us over to the pediatric emergency. And while he was kind of going through the routine of being admitted there, the doctor called me from the respiratory clinic and said that they found sugar in his urine and your son has type one diabetes, you're going to be at the hospital for three or four days. The rest is Oh, my,

Scott Benner 13:27
I'm sorry. The respiratory clinic didn't recognize the small respirations. No. Well, geez, respiratory clinic respiratory. Okay. Yeah, it's okay. So you got Wow. So you tried to find out what was going on? And nobody was able to help you.

Paul 13:47
Yeah, we reached out to our primary care and now even some, some Google or some internet search results, but man, I guess that's if I have any gripe about the situation is that you know that and I don't know, I'm not I'm not a doctor. I didn't go to medical school, but seems like if you're emailing your, your primary care, and they don't recognize that excessive thirst and Bedwetting, you know, just the classic symptoms. Maybe something needs to change. There needs to be more education, but Yeah, seems like all the classic signs. But

Scott Benner 14:28
well, don't worry. Once you educate those people, they'll move on and get different jobs. And then there'll be a whole new group of people to educate and it'll just keep sweet. and over again, oh, my God. Yeah. Well, where are you in the hospital for that many days?

Paul 14:42
Yeah, well, the thing was when he was admitted it was only one parents in the hospital at a time because of COVID until he got admitted to pick you for the pediatric emergency ward. thing. And they tried to stop me from going in was the way I'll put it.

Scott Benner 15:07
It didn't work out for them. I'm on

Paul 15:09
like, six, seven to 50. So yeah, I mean, I, I didn't forcefully make my way in, but I was in there with him

Scott Benner 15:16
and my wife, Paul, you're six feet seven inches tall. Yeah. And we've got 250 Oh, my goodness.

Paul 15:23
That's not telling me no. So many words, I'm going in with my sons.

Scott Benner 15:27
That's crazy. Come from a tall family.

Paul 15:31
Yeah, my dad was a six to my mom is was average. But yeah, there's some pipes down the lineage.

Scott Benner 15:37
Wow. So after the diagnosis, what do you think struck you first, because you have a pretty, you have a pretty coherent list of things you want to talk about. So I'm wondering what got to your first.

Paul 15:54
The the first thing was, I guess, my understanding of how much I didn't know about diabetes. So because he, you know, he was in DKA, they were monitoring for brain swelling, which didn't happen. So, which we're grateful for. But I remember asking the doctor, okay, like, you know, when is that when is he cured? Or when does he not have it anymore, so we can go home. And our whole world kind of change over the next, you know, 24 hours as we started learning more information. So I just remember feeling like helpless, like I didn't know what to do, or how to help. And then not having the knowledge or information to, to help. So helpless was the first and a real emotion that I had. And then Then came the grief. But I will say that, you know, we spent three days in the hospital probably didn't sleep very much at all. And then before being discharged, had to go to a three hour kind of crash course in diabetes management from the on site, diabetes educators, which we retained 0% of the information from

Scott Benner 17:18
Yeah, it's hard to listen. Impossible. Yeah. And remember, it's it's very interesting that on the on the first day, that you were just under the impression that there was a medical problem that would be cleared up somehow.

Paul 17:32
Yep. Yeah. Wow, that's 100%.

Scott Benner 17:35
So while they're dumping all that information into you, you're just sitting there, grieving. Confused.

Paul 17:42
Yeah. I mean, Justin was 18 months old, crying the entire time. And, you know, he's just got poked and prodded and he hadn't slept. And it was just really, really emotionally draining. And then to hear some of the, you know, the stuff that they diabetes educators were sharing. As they share more and more information, you kind of in the moment are realizing how much everyone's life is going to change. And it's a lot to take in right after what we've just learned and all the previous 72 hours. How old are you, Paul? 4646.

Scott Benner 18:27
So you waited that children till a little bit? We did,

Paul 18:30
we went down the road of you know, let's, we can either be young and not afford it or be a little bit older and afford it. So.

Scott Benner 18:42
So he tried to do everything right. And

Paul 18:46
yep, still exactly. Yeah. Yeah.

Scott Benner 18:49
Still a life game for you. And you sound like a pretty emotionally mature person. Oh, thanks. Yeah. I mean, listen, we've only been talking for 15 minutes, you might be an idiot. But for now, I think you sound like a pretty emotionally mature person.

Paul 19:07
I will. We'll circle back at the end and let me know what you think. Well,

Scott Benner 19:12
also, I've heard crazy stories about people who work in restaurants that I'm not going to ask you about because we have serious conversations that here, but all true. Yeah, right. It's a big orgy. Isn't it Paul?

Paul 19:22
Tell 100% Yeah, everything you hear is is generally true.

Scott Benner 19:27
Yeah, okay. And in the chain restaurants, the food's all prepared. They just Soviet right, like it's frozen and then they just do a lot of places do that they're not really cooking for you.

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Paul 23:43
Yeah, I guess you look at it as if you're getting a full rack of ribs with a baked potato and some vegetables and a side salad and a general and a coke for 12 bucks. You know, no one's probably actually taken the time to prepare that foods probably coming from a factory right frozen or you know in bags and they're just reheating and serving.

Scott Benner 24:06
I know it Paul told me the sense. I've never worked right.

Paul 24:11
Opposite gun the opposite side if you you know went to a local place little barbecue joint that smokes or on brisket and does all their own sides. You're like well, you know, why is brisket $27 a pound?

Scott Benner 24:24
Yeah, that's because somebody actually made it for you. If somebody woke up

Paul 24:27
at midnight and smoked, I think for 16 hours

Scott Benner 24:30
if I only worked in a diner for like a week when I was I don't remember really young. And it was just such a hustle like clearing tables and washing dishes and everything. And then I quit for two reasons. One I was I made coleslaw in a trash can. Not a trial. It was not also used for trash, but not a point, right? Like it was basically like dump all these and then reach them with your arms and turn it over and turn it over until it's coleslaw, that flipped me out, and they would feed you, but then charge you full price for the foods. So by the end of the week, you really didn't make very much money. And I didn't realize I was like a kid. They're like, You want dinner? And I'm like, oh, yeah, great. It's just wonderful. Thank you. And then I was like, I'm not doing this. So I left.

Paul 25:22
Well, at least you spent a week.

Scott Benner 25:24
I did. I did. I stayed. And I was like, maybe I can tough this out. But he's just was this girl. It was really I mean, as a kid, but it was like grueling work. So he just never stopped. And the kitchen was always somewhere between like, like viciously on fire and somewhere humid near the dishes, and just none of it. None of it was pleasant. But so, so you get out of the hospital. I mean, I have all the empathy in the world for you. Arden was two years old when she was diagnosed. But none of the technology existed then. So did they start you with a CGM? Yeah, I would imagine. Yeah.

Paul 26:00
So yeah, we were. We got sent home with the CGM. And then we were on MDI for about a week and a half, two weeks, and then we started the Omnipod dash.

Scott Benner 26:20
Okay. MDI, and were you pushing for a pump? Or are they trying to give you one?

Paul 26:27
We pushed for every we weren't. We advocated as much as we could for every piece of technology and equipment that would preserve our son's health.

Scott Benner 26:40
Yeah. How did you find out about it so quickly?

Paul 26:44
We, so we left the when we left the hospital, one of the attending physicians told us about Brave Buddies. Are you familiar with

Scott Benner 26:58
I don't know. And I'm looking it up now.

Paul 27:00
So Brave Buddies is it's pretty much an online form. For for type one, diabetics, people will give away supplies or ask for help. It's, it's, but then lack of better term, it's like a Facebook page. But it's all through email through a server. So now if you're on vacation in Orlando, and you forgot your T slim infusion set, you can post the message up there and it gets emailed out to everybody and someone in the community will have one or you know, extra cents or whatnot. That's cool. So it was initially it was a way to connect with other families who had type one diabetic children, or were type one diabetic. So it was kind of offered as an emotional support, kind of reach out to other people. And I started reading the posts and people talking about all kinds of pumps. So I looked into it.

Scott Benner 27:54
Nice. And did you find that? I mean, I'm imagining you found it helpful, or, but how was it managing? Well, I guess the first question should be did Justin have a honeymoon?

Paul 28:10
Yes. To what extent or degree is that? I don't know. It's a lot of it is a blur. But look, looking back. Yeah, I mean, he was he was definitely dumping out, dumping out some insulin overnight. Yeah, before we got on the pump, there's a lot of overnight lows followed by too much juice and overnight highs and the pump really helped regulate that and got us some sleep. Nice.

Scott Benner 28:40
This Margarita work. She does. She does. So she has a full time job. And so do you. Correct. So baby was in daycare? So then what do you do with him? I mean, now, does somebody stop working or?

Paul 28:56
No. So we, when he was diagnosed, he was at a small family daycare. When he came back home, we tried to reach out to the daycare and speak to the owner about what caring for him would look like. So we got as much literature as we could. We translated the hospital translated all of the, I guess the binder that they send you home with into Spanish. And so we went to kind of sit down and meet with them and kind of go over protocols and procedures, which we looking back at the time, you know, really didn't have a big clue to what we were doing. But kind of the willingness and the communication just really wasn't there. And then COVID hit so we just pulled him completely out of daycare and cared for him at home. Oh Okay. I was, I never, neither of us ever lost our jobs. Both of our jobs paid us to kind of work from home, which as a chef kind of seems ridiculous. But I was creating a cooking classes and soothing and Thanksgiving turkeys and prime ribs and just filming them. And we were posting it for a bunch of people to see it at work who could log in? And?

Scott Benner 30:32
Well, that's Paulette, so your company, had you create food? And share it in video so that the employees might continue to eat well, during COVID? Correct? That's really nice.

Paul 30:44
Yeah, it was a it was a way to, you know, even though we're not physically there serving you food, we can still, you know, share recipes, show techniques. And, you know,

Scott Benner 30:55
that's great. Yeah,

Paul 30:57
that's fine. So we were both home for a while Margarita eventually went back to work. And then, you know, we were faced with the decision of, you know, we were both going to need to go back to work. What are we going to do for daycare options. So we found, and this is I can't say how grateful I am for this. But we found a daycare. That was like 20 minutes away from our house. That is run by a t one D mom, her daughter was diagnosed the same age as Justin. Her daughter is now 21. She did it for the technology in New York as a single parent with three other kids.

Scott Benner 31:44
And she might know what she's doing.

Paul 31:47
She knows what she's there. Yeah. So he started there. He's currently still there. He's on summer vacation now. But yeah,

Scott Benner 32:00
that's, that's very lucky. And it just fortunate.

Paul 32:04
Yeah, it's, we're, we're so great. There's no not even words to express how grateful one person can be to have another person in their life that understands and gets it, especially when they're caring for your child.

Scott Benner 32:18
Okay, and I've stocked Margarita, she has a cool job. You don't have to say, you don't have to say she does. Yeah, but that's, that's pretty cool. So yeah, it is. Alright, so this isn't been long for you. This is, you know, 18 months to a year and a half. You're just Are you back at work cooking for people again? Yeah, we're back. Okay. And, and so this is all kind of chugging along now. And it seems like you're in a place where you're just looking for normal. I mean, cuz COVID was like, it was strange, wasn't it? Like, you know, it was somehow relaxing and anxiety ridden? Together? Yeah, I nailed it. I don't know how that happened. But, you know, it's, it's everybody's life was like the way you imagine it in a book. Like This must be how the Kardashians live. They just get exactly they get up at 10 o'clock. They make an egg.

Paul 33:15
Yeah, it's it's life right there. Right? Pretend make an egg. Yeah, lay by the pool.

Scott Benner 33:19
Go for a walk. Have a spritz. It's so like, you don't I mean that you start thinking about what are we going to do for lunch? If I screw lunch? We'll make a nice dinner. It doesn't even matter. Nothing matters. You want to vacuum? Yeah. All good, right? And then the other part of is like, I really think I'm gonna get sick and die any second now. In that, you know, in your head, and when am I gonna go back to work? And how is this all gonna go and everybody's life is on hold. Very weird. Just a very strange, we are still seeing we're still seeing the impacts of how it retarded people's progress students. You know, there's, there's a girl on here recently talked about meeting, meeting a guy and they started dating, and they started to become intimate and then couldn't see each other anymore. And then we're suddenly standing on a sidewalk talking to each other from six feet apart. And yeah, you know, just all the weird ways that the flow of life has been you know, impeded at that time. So you're probably I'm gonna guess mostly Lucky for you because you you got to deal with the diagnosis a little bit without being pressured about going to work etc.

Paul 34:30
Correct? No, there wasn't. There wasn't kind of that oh, shit moment. We had some time to process

Scott Benner 34:37
right and then then you get I am going to call it lucky, like Lucky meeting this person who runs this daycare is I mean, it's nice because can you imagine if that person didn't exist, and now you get thrust back into the world, the both of you were Where's Justin right now? You know?

Paul 34:53
I I can't I? It's hard to imagine. It's going to be even more difficult when We do the next transition into kindergarten. You know, we're we're pretty lucky right now that you know that someone else has his follow data and knows what to do with the information, you have

Scott Benner 35:13
two more years to tighten up your understanding of things too, and all that other stuff, which is great. But But you talked about in your note about a marital strain. Did that happen? Slowly? Was it very quick? Did one person try to take hold of like, take control and or how did it fall?

Paul 35:33
No, it's, you know, like most other things in our marriage, it's, it's equal participation. No one's taking ownership over anything, including diabetes management, it's always kind of been a, you know, a group decision. But, you know, there's, there's so many nuances and, and one offs and decisions to make. And sometimes you just don't know what the right thing to do is and that, you know, we, we started with the dash and then started a six month study, and he went on the tandem. And then Friday, we started the Omni pod five. So we've had some transitions, and a lot of times was transitioning from one device to another, you know, there's some kinks to work out,

Scott Benner 36:26
ya know, it's not easy. Just settings are different in the way the device acts some algorithms to not having an algorithm, it's, it's a lot. So when you say, so when you say strain do you mean? Do you just mean a loss of, of normalcy? Or do you mean actual, like, butting heads?

Paul 36:48
You know, butting heads is a strong term, but we've always been pretty free and easy in our relationship in our marriage. But there's, you know, there's never been an obstacle, you know, like diabetes or diabetes management. And it really puts a puts a test and a strain on the body, you know, not really the mind but you know, you being tired all the time doesn't doesn't help a lot in the decision making process for sure. But you know, if if he's a growing toddler, so if he's going to bed and he's getting this huge growth hormone spike, and he's shooting up to 250 and we're not think the pumps doing enough and do we Bolus Do we not Bolus and go I'm gonna Bolus well don't Bolus because it might auto Bolus. So still a lot of back and forth. And a lot of, you know, disagreements sometimes on on what to do for treatment, or, you know, he's at 76 trending down, do we give a crack? Or do we give juice? You know, a lot of it is just stressing. And yeah, it's a lot of sometimes it's not knowing what to do and thinking the other person has the answer. And you just kind of go back and forth until you're exhausted with it.

Scott Benner 38:03
For me, I find that either falls in the you really believe in what you're saying, and the other person disagrees. And that causes an issue, or you're sitting there thinking I need you to know because I don't know, their thing. Yeah, I need you to know, because I don't

Paul 38:18
it's definitely a lot. A lot of the you know, when somebody asked a question like, oh, you know, he's, he's training high. Should we give a correction and you're expecting the emergency? Yeah, probably a quarter unit should be good. And the other person goes, I don't know. And then you look back then and they go, I don't know. And you go. Okay, well, I guess we'll just stare at our Dexcom for another half hour and see what happened.

Scott Benner 38:39
Let's ask Justin what he thinks. Care. Hey, buddy, just grab this pinky. If, if you want to die now. It's, it's ridiculous. It's it's a lot of stress and not for nothing, you're in a specific situation. Meaning you, you waited till you were older. And it sounds like for the most part, your life was going pretty well. So yeah, not a ton of speed bumps. And then you get you know, then you get a I don't know, it's not just a speed bump, right. It's a it's a mountain. And you're and there's no input from anybody about how to do it. It's terrible. It. I don't know. I feel like I can't remember it anymore. Yeah, and yet, I feel like I understand exactly what you're talking about. Because we had all of those situations come up, like, Come on, just tell me what to do. What do you want to do? I don't I don't know. And the other thing is, my wife is such a bright girl, you know what I mean? And, and I calendar, so much like she's one of the few people like I really trust with her opinion, you know? And then all of a sudden you turn to her and I'm like, I need your opinions. Like I don't have an opinion.

Paul 39:49
Yeah, I feel the exact same way. Margarita has always been the, you know, more studious of the two and I've I guess more street smarts for lack of a better term, but together, you know, it's very cohesive and it works extremely well together. You know, where she's more analytical and more, you know, whatever, the quarter unit, whatever, it's fine. But together, you know, that kind of meshes together well, in everything that we do in life, not just not just diabetes.

Scott Benner 40:19
Yeah. Yeah, I got it. So tell me a little bit about this. You participated in a study already?

Paul 40:27
Yeah. So we participated. First of all, shout out to Dr. Bruce Buckingham at Stanford. Been doing diabetes research and education for over 4550 years now. He's a retired pediatric Endo. So we were in his study for FDA approval of the T slim and Justin's age group. So, six months, we were on the tandem. And it was, it was good. The the control IQ worked really well. It helped with overnights we probably went through, you know, months at a time where we slept through the night. Which is amazing that he Dr. Buckingham is the kind of person where he's taken zoom calls at 930 10 o'clock at night after Justin is asleep to review settings and data. And we had an issue the other night with Omni pod five. And even though he's no longer we're no longer in the study. He helped us transition over at a zoom call with him at like 130 in the morning. So he's just really committed and it was a really, really amazing experience. We're very, very grateful to have had access to that the tandem T slim for for his age group. Yeah. I will say it's been since it's Wednesday now. He's been on the Omnipod. Five since Friday. I do not miss the tubes, or fanny pack that you would have to wear with it at all. Yeah. I hear that. But the control was was fantastic. Right. I think for the last 90 days. It was like 86% in range. So you can't complain for a three year old?

Scott Benner 42:22
No, of course. What was the study for to get? Approval approval for lower ages?

Paul 42:28
Yeah, exactly.

Scott Benner 42:29
Okay. That's, that's great. Actually, do you know, do you know when they're did they ever tell you when they thought the study would be done? The study is done. It is done. So they have enough data to move forward. Right. Oh, that's cool. That's very good. Okay, hold on a second. You wrote here. This is interesting. You just wrote poop and bathing. And how it affects blood sugar's Oh, baby, I think I get but I want you to well start with bathing. What do you notice with your son?

Paul 43:04
What do we know? So by the way, poop and bathing, it's not Oh, one it's two separate occasions. Imagine in the bath? Yeah, yeah, I imagine. So bathing, if we bathe him. So generally, he'll have dinner 536 o'clock, then he has a bath about seven 730 in bed by 815. So if we give him a bath, he will generally say he's a 150 takes a bath. He may go up to 190 and then back down to like 130 After the bath. And we've you know, it's been explained to us and the waters hot and Slin surface of the skin and all that. But sometimes it doesn't happen. And sometimes it does happen. Sometimes. The finger sticks match and sometimes they don't match. So I'm just interested to hear other people's experiences as well.

Scott Benner 44:03
Yeah. Does it ever seem like he's like playing in the bathtub like excited? Could it be adrenaline?

Paul 44:10
It could be he's hot and cold when it comes to a bath. Some days. He's wants to take a bath for a half hour and some days. You drag him in there kicking and screaming to take a bath.

Scott Benner 44:22
Sounds like everybody I know. Exactly. Right? Well okay, well, I mean, listen, they the there are people who tell you that the hot water makes their blood, their blood sugar go up. There's people who tell you that the hot water makes your blood sugar go down. You know, I always think of it as maybe you get in the shower and relax and your blood sugar goes down. Right or maybe you get in the shower and I don't know. Think about the world and life and it upsets you and you know like I don't know like I don't. I do know that Jenny will talk specifically about like your blood. Like how How insulin works in your body, and, and the temperature that your body is at. But I mean, it seems crazy to me to think that in 10 minutes, something could change so drastically with the temperature of your body that your blood sugar goes like, like, like firing one way or the other. Like, it always seems to me like it's got to be something else. And then there's times that Arden will take a shower at the end of the day, and she'll get lower. And there are times that she takes a shower at the end of the day and her blood sugar goes up. And I so is the shower. Really part of the equation? You don't even need the mystery, right? Yeah, right? Or is it just, you know, one day she ate a larger meal that she didn't Bolus well forgot in the shower in her blood sugar went up in one day, she did a great job with her blood sugar. And she got in the shower and relaxed and her blood sugar went down like I don't know. I really don't. I'm not Yeah, we

Paul 45:55
we worked with Integrated diabetes. And we've met with Jenny a couple times. And it's, you know, everyone's experience is different. And I think it's just one of those. You know, like you said, what Jenny talked about what the hot water and even were in the study, we were talking to the endocrinologist and said, Yeah, you know, if you've recently Bolus and you know, insulin is still close to the surface of the skin that may have this effect and that effect, but at the end of the day, when, you know, he takes a bath, he's obviously when he was on the tandem, he's disconnected from the pump, so he's not getting any basil. So we will see, regardless of if the spikes are one way or the other during or after the bath, we do know that about a half hour later, he'll start to trend up because of missing basil. So we'll have to Bolus half hour of basil

Scott Benner 46:48
now that that, obviously, the first thing I should have said that I didn't. But yeah, you're you're on a two pump and you were disconnecting. So I don't know, man hit listen, here's what I'll tell you. It's diabetes isn't easy.

Paul 47:04
She said, right, that show about a show about it?

Scott Benner 47:09
I think you I think the key is, I mean, I guess the the key is to see what's going on, learn from it, try to anticipate it next time and stay a little bit ahead of it. I do really wish that. I don't know, there's part of me that thinks the podcast should be 20 minutes long, one episode, and it should say, hey, type one diabetes, it's difficult. Learn how to use insulin, stay flexible, you'll be alright. Like you don't even like there's because I think that applies to almost like at the beginning of the conversation where you were talking about, you know, the impact of one thing and you're like, I think you said like, well, it really is like that for everything in life. And I think that I think that's right, for diabetes, too. I think that in the end, it's about using insulin well. It's about timing and amount, and staying flexible enough that you don't get stuck in an idea to the point where you say, I have to know what what what is this that's happening? You know, instead just saying, look, it's going to happen. And here's how I fix it. If it goes one way, and here's how I fix it, if it goes another way. And until you can come up with a real answer, you know?

Paul 48:15
Yeah. And Margarita is very, you know, cynical in that way show. Where I, the way my brain works is, you know, I mean, I work in a kitchen. So my, my movements and my actions in the kitchen are very methodical. And when I do something, I expect a certain result. If you've braised beef 100 times, and it comes out wrong once I'm going to overanalyze the situation and find out what happened with diabetes, that doesn't work. You just need to correct and move on.

Scott Benner 48:48
Yeah, he's got another piece of meat and go again.

Paul 48:52
Yeah, well, what if you don't have any meat? So yeah, it's, it's, it's been a little bit more difficult for me to, you know, accept some of the, you know, high highs or low lows, and just, you know, correct and move on. I always find myself, you know, wandering and anticipating. Not so much so I can figure out, you know, what went wrong, but kind of just to be better prepared for the next time.

Scott Benner 49:22
Yeah. Well, listen, let's, you do have to do that as well. You know, you have to you have to take in the data and look at and step back and look at it. Do you ever come up with answers? Do you ever think oh, I know what happened.

Paul 49:35
Um, yeah. I mean, I think I think I do. And until something happens that disproves it, so yeah. Then we start from scratch again. But yeah, I mean, it's, it's, you know, it's a learning experience. And I do think that knowledge is power and, you know, just kind of recounting what happened, and trying to do better Next time,

Scott Benner 50:01
how is the diagnosis and the ensuing time? How's it been for you personally? Can you disconnect Justin from the conversation and talk about yourself? Rarely. I mean, do you ever get to think about how you feel about it?

Paul 50:17
Yeah, I mean, I mean, I've processed it. We're, we're talking to a therapist now that we meet with. But it's more for family therapy. But, you know, just as myself it's, it's hard to disconnect. You know, I'm, I'm still sad. That's for sure. Yeah, still, still heartbreaking. But, you know, I need to be strong for him and for my family. So a lot of times, you know, however, I'm feeling gets pushed aside, which is okay, I'm not, not a very selfish or self centered person have always had the giving and caretaker mentality in me. And I do it, you know, for living through food, feeding other people at work. So kind of second nature in that in that

Scott Benner 51:14
aspect. Yeah, I was gonna guess that. Yeah. Well, the family therapy sounds like a good idea.

Paul 51:21
It is. And a lot of it is, you know, centered around how to get Justin to do things. I never, in my adult life, had heard the term threenager before. Wait a minute, but guess what, Scott? Yeah. You don't know about threenager?

Scott Benner 51:41
Justin difficult. Are you telling me the kids kids hard to work with?

Paul 51:45
Yeah, a little bit rough around the edges. Yeah. So aside from the terrible twos, apparently, there's also a threenager. So it just kind of an extension, his twos weren't weren't that bad. But the threes are a lot of nose, obviously. But it's just everything is, everything's a challenge. Whether it's brushing your teeth, or taking a bath or going to bed or getting dressed, it's all it's all. What we've come down to find out is having him be his choice. So we worked with the therapist and say, you know, like, bath time, bath time was always a struggle. So she's like, Okay, well, you know, make it his choice. Let him choose. You know, what kind of toys he wants to play with blow bubbles, play music, have a dance party. And so you know, here we are. He's in the living room crying and we're dancing listening to Blippi in the bathroom. So

Scott Benner 52:45
46 years old, 672 150 pounds? Let's not.

Paul 52:49
Yeah, I'll send you a video. No, I don't want to say it.

Scott Benner 52:55
Yeah, you know, they're nice, like three times in the first 25 years.

Paul 53:00
Oh, three. So I got I got a few more to look forward. So you

Scott Benner 53:03
know, listen around. 678 that can be fun right there. You know, four years old, really cool. Boys, prior to puberty or fun 11 1011. And don't

Paul 53:22
get me wrong. I always like to use a sour patch analogy, you know, sour on the outside, sweet on the inside. He's an angel when he's in a great mood. And he's having fun is the greatest child on the planet Earth. But then the complete opposite is true

Scott Benner 53:38
as well. Does any of this correlate with his blood? Sugar's?

Paul 53:42
No? No. I mean, obviously. I mean, he's, he's, you know,

Scott Benner 53:46
really high. Yeah. Well, the Pro, I think,

Paul 53:49
I think it's a double edged sword. I mean, we've done we've put in a lot of work to make sure that, you know, he's in a good percentage, good amount of time and range. He rarely ever, you know, goes really high or very rarely goes really low. So, you know, he's used to having, you know, he's used to being in range. So, when he's high, it's, you know, for for a long, longer period of time, it's noticeable. Yeah. But he can be 100 Straight, take a bath and, you know, think the world's gonna end

Scott Benner 54:24
right. And I do not want to bum you out. And I'm sure that this isn't the case. But have you tested thyroid function?

Paul 54:30
Yeah, we can see thyroid and celiac recently.

Scott Benner 54:33
Okay, good. Would you get you remember the TSH for the thyroid? I do not know. Take a look at it if it's over two, but they told you it's in range. Go back to them. Okay, all right. Let's see. What else do we have here? Paul, you're a delight. I didn't realize this is gonna be so much fun. I never know how the guys are gonna go. Oh, really? Yeah, I love talking to guys about it. But sometimes People are like, they're still kind of closed off. They're like classically men, if that makes sense. And yeah, I understand. Yeah, you're more forward facing which is really, which is nice. But you're your wife so your wife's in the, in the in the podcast Facebook group, but you're not.

Paul 55:16
I am not I don't I don't care to partake in modern social media.

Scott Benner 55:23
I don't mean, actually. You wouldn't know it part of my job. So there's the I like the input from people. And I like I like seeing people help each other all all the good stuff about it. I love. Yeah, but you know, I'm 50. And exactly, you know, not like, if you if you put me on a desert island, you were like, Listen, you can have social media or I don't know, a television, we're only leaving one of them. I'd be like, Oh, just leave me the TV. I'll be.

Paul 55:54
Yeah, I mean, it has its you know, it has its it has its purposes, but you know, I'm not not interested.

Scott Benner 56:01
But does she come to you with things she's learned online? Oh, of course. Yeah, of course. And you've been helpful?

Paul 56:07
I do. I find it helpful. You know, sometimes the stories on there are heartbreaking. And, you know, I don't know if I want to read heartbreaking stories every single day. But you know, there's also successes on there. So couple people that we've connected with and had playdates that we've met through the group and whatnot. So I do see, you know, there is there is value to it. But with Well, I think with anything in social media, it's it's always more negativity than positivity. So I choose to stay away.

Scott Benner 56:39
Well, I think my Facebook group is more positive than negative. But other than that place, I completely agree with you. Of course, I met yours exclusive course, of course. And the the, so I get people's notes privately. Some of them are, are difficult, you know, I'm looking at one sitting here now like that I have to answer today. And it's just a person who wants to come on the podcast. And they said, like, I'd like to be a guest. My daughter has type one, and Down syndrome. She's 12 and has complex health conditions. And then, you know, I'm reading on, like, trying to pick in what this is, I'm already at the point where I'm like, okay, you know, she said, she dropped her a one C, you know, I'm like, great, like, she loves the podcast wants to come on and talk about what's going on. And I'm like, Alright, I got it. Right. Like, I want to say yes to this, but I'm going to keep reading the note because it just seems, I don't know, I it would seem wrong not to just read the entire note. And at the end, at the end, she says that she just had a stroke, and she's using a feeding tube now. And and you read that in like, okay, like, like, as that's so hard just to hear. But imagine living through it.

Paul 57:59
Yeah, I mean, yeah. I mean, I hear things like that my heart goes out to her and her family, right? That, you know, makes what what I'm doing seem almost easy, in a way. And so it's like, it's it's all about perspective.

Scott Benner 58:15
Yeah. And so that's exactly it. Like, obviously, I want to speak to this person, why not to hear not to hear a terrible story about her child's health. But because it's very possible that this woman has a perspective on life that the rest of us don't 100% And I want to hear that. But then hearing the story in our mingled in it is, it's difficult, you know, it's, you have to tell the story, so that people understand where their perspective comes from. You can't just have her on and say, Look, trust me, this lady's life is harder than yours. Let's listen to what she has to say. Now, it just doesn't work that way. So you lay out the story. So now I've read the email. And I'm like, I'm also a real person, Paul, you know, and so not that it matters. But this has not been the easiest time of my life right now. And so like, I'm dealing with my own personal stuff. I have family, too. You know, people in my life are sick. There are people in my life who are, you know, everything, all the things you can think of, I'm I love somebody that has all those things, too. Or I have them. And then you get this note, you're like, wow, so I understand you not wanting to see it. And I don't think I don't know if it sounds harsh, but if if I didn't have this podcast, I don't know if I'd want to see this email either. You know, so,

Paul 59:36
yeah, I mean, yeah, that's, I will listen to the episode and I will take something away from it. But I don't I don't want to be exposed to something every day. Yeah,

Scott Benner 59:52
it's to me. Well, I think the one here might have talked myself out of listeners here if I'm not but I think the I do think the one thing that a modern like this modern life allows, is it gives you access to so many people's stories, and so much access to news and things like that, that I don't know that our brains are meant to know what's happening in, you know, the trucker strike in Canada and a shooting in Kentucky and, you know, a warlord and someplace killing a group of people. And I don't think we're supposed to, like, consider all that stuff. Seems like a little bit much. Yeah. You know, because especially when you have no agency over and like you talked earlier, one of the first things that hit you when your son was diagnosed is a feeling of helplessness. So what stops me from hearing about people being treated poorly in I don't, Australia, and now I on some level feel helpless about that. It's just, you know, I mean, I don't want to live in the middle of the woods for I don't know what's going on anywhere. But we're exposing ourselves to so much stuff. And everything feels like it carries the same wait for some reason, like from like, like, I my social media this week. I'm not gonna lie, my social media this week. What is this guy's name? Give me a second. I'm gonna figure it out. It's completely ridiculous. I could just say. Okay. I am in a I am at a point now where I've been made to feel bad for the Cubs catcher. He's had a tough couple of weeks, Paul, because, yeah, Wilson Contreras. It's had a tough couple of weeks. Everybody kept saying that he was gonna get traded, and it was stressful. And then he didn't get traded. It's been hard on him. And I've read like three blurbs about how hard it has been for him. And like so like, don't get me wrong. Like I'm not walking around my house like punching holes in the wall going so unfair how Wilson Contreras this beach? Not him. Poor guy. This guy. I don't know. What is he? He probably only makes I should look just to make the story fun here.

Paul 1:02:15
I wonder how much he makes?

Scott Benner 1:02:17
Let's find out for a second. Well, listen, see, here it is. He's a young guy. Wait, he's 30 years old. But he isn't making enough money.

Paul 1:02:27
I think the league minimum is like 350,000.

Scott Benner 1:02:30
Yeah, I can't believe him about the same. He's only making a half a million a year. So the guy is being treated a little poorly or guy. But but but but you know, like, here he is the guy making a half million dollars here. He plays baseball. And my social media set me up to feel badly about it. Yeah, and I was like, now did I take the bait? I gotta be a little bit. It's in me somewhere because I'm aware of it. Like when I reached for an idea, it popped into my mind. I'm not walking around. Like, you know, I'm not I'm not getting ready to overthrow governments so that Wilson gets paid correctly and depends on where he belongs and all. But um, it's still it's it's in the back of your head. Like it's it's like a pile of dirty laundry. Like a for everybody's woe is a sock. You don't I mean, like, eventually it goes up to the ceiling. And it's overwhelming. I'm like, I can't do all this laundry. I can't. I don't know how to help Wilson. You know what I mean? My son just graduated from college, he's having trouble transitioning. I don't know how to help him. My daughter is getting ready to go away to college. I'm assuming she's, you know, putting on a brave face. And she's excited for a number of reasons. I also imagine she's nervous for a bunch of reasons. You know, like, at this point, it's my 26th wedding anniversary. I just left my wife's gift on the table downstairs because I couldn't find five seconds to talk to her yet today. So yeah, you don't I mean, like it's, uh, I don't know, I don't think it's important for me to know everything is happening in the world. True story, that's all anyway, went a long way for that. But now we know about poor Wilson.

Paul 1:03:58
We do struggle is real. Yeah, by the way, here,

Scott Benner 1:04:00
here. Let me tell you what Yahoo Sports says. Okay, the club's handling of Wilson is a Contreras, at deadline is shameful. Can you imagine it's shameful. I almost want to click on this link to find out why it's shameful.

Paul 1:04:17
Well, if you click on it, then that means that you're interested in SEO get more on your feed now. So

Scott Benner 1:04:21
I know and I know I've done it. I've already done to myself. But But I mean, I mean, honestly, shameful. Is that not a pretty harsh word? Like I use the term butting heads earlier. And you were like, That's too harsh. Yeah, it's too aggressive. I mean, I don't know. I just I don't know. And I'm not making fun of athletes. He's a person too. And I'm sure it was difficult for him actually, like, let me take that back. I'm gonna take the whole thing back. I'm sure it's been difficult for Wilson Contreras and not know where he's going to be when he wakes up on Wednesday morning. I bet you that is not pleasant, and I don't think it matters how much money you make.

Paul 1:04:59
I mean, Worst case scenario, he has to get on a first class flight somewhere,

Scott Benner 1:05:03
it's going to be bad. Like the, the guy that I don't know, usually carries his bag probably won't be there. So, but I'm just saying that I don't need to know about it, that's all great. But there are some things that you learned that are helpful. So I don't know where the line is, I don't know if we're gonna mature. And, like, you know what I mean, like, I don't know, if like one more generation removed, we'll know how to ignore the parts of all this, that that aren't important. Or if this is just going to be a thing that people aren't built for. And it and it it. It weighs heavy on us for a long time. I have no idea.

Paul 1:05:43
But there's there's just, there's just too much. Too much information everywhere. Yeah. And you know, you're almost in a position where you have to pick and choose what you want to care about.

Scott Benner 1:05:57
Right? Yeah, no, I even like politics is such a great example. When you're younger. No one cares. You don't care when you're younger than No, but when you're younger, you don't care at all, then you hit an age where you do care. And then you hit an age where you go, Listen, I don't know how many times I'm gonna hear the same story. It's just changing. Like, like, the the nature of people hasn't changed in my lifetime. I'm going to ignore this again. It's, um, you go through seasons for certain. Alright, so what is your what's your favorite thing to make? Well,

Paul 1:06:30
we're in California. So I have the luxury of using what seasonal so there's not really one particular favorite thing to make. It's just working with what seasonal and it looks and tastes the best. So we're kind of spoiled, where it's a pretty, pretty good climate here in the Bay Area in California. So we have hundreds of farms within 150 miles of the kitchen. So

Scott Benner 1:07:00
let's get like an eclectic mix of things that you can work with.

Paul 1:07:03
We do I recently started a smoker program so we we feature something smoked every week, whether it's brisket or Tri Tip or St. Louis ribs. So yeah, we talked to work into buying a $5,000 Yoder Smoker. So I get to play with that at work.

Scott Benner 1:07:25
Is that pellets? Or is that would know what wood fired? wood fired? How hard is that to figure out how to learn how to do?

Paul 1:07:36
How hard is it?

Scott Benner 1:07:39
Like how long does it take you to figure out how to get the fire burning? Right?

Paul 1:07:42
Oh, no, three years? There? Yeah. Yeah. It's it's, it's a process like anything, you know, you have to learn it and understand it and you think you're doing everything right. But then you have the wrong kind of wood because the woods wet. So then you got to find better wood and you finally get the wood but then the beef you got it's not that great. So on and so on. So it's like anything in life, you know, you have your your trials and errors.

Scott Benner 1:08:08
I only have a pellet grill, which I bought during COVID. Because I was like, What am I going to do? Because boredom? Yes, I'm like, I'm gonna cheat. I'll learn how to do this. And I basically, I guess I use it for some, like basic ideas, but it's amazing how well it works like from like, you know, like a pork but just for pulled pork. I mean, amazing. Not difficult. I buy. Usually I grab a couple of steaks, and soak them and then just slice them up. As I as I eat them. Like I don't even like eat, I don't even make the steak and then just bring it inside needed. Like I have a little bit of it and like that was good. And then I put it away and then I'll yank it out every day. And maybe just take a couple of slices off it throw a little like, I don't know, pink salt overtop of it and eat it with something else. It's amazing. Once you understand how important the time it's just time and temperature. Yep, yeah,

Paul 1:09:00
it's it's really all it is. And the only difference that my preference is to use an offset smoker. So pellet smoker. You just don't get as much of a pronounced smoke flavor. It's fairly light. Yeah, with a wood burning offset smoker, you can get that that deep smoky taste. We've been trying a lot to imitate Texas barbecue, so just kosher salt and 16 mesh black pepper on your on your protein and then it's all about time and temperature.

Scott Benner 1:09:31
Yeah, really is love. I didn't have somebody with deep pockets that I could snuck her into buying me a smoker, so I had to buy it myself like a true story. Yeah, I'm sorry. Don't be sorry. I mean, I'm proud of how you've accomplished this. I can't believe you got your boss to buy anything that seems seems like a heavy lift no matter what.

Paul 1:09:49
Yeah, I mean, it's. It was I've been working on this purchase for quite a while and the general manager who was Leaving, kind of pushed it through before he left. And so

Scott Benner 1:10:07
I say he's like, Well, this won't fall on me because I'll be gone. So sure take your smoker. I would take that that sounds right. All right, I. So I'm gonna let you go. But I want to check first, if we've talked about everything you want to talk about, then I want to ask you one other thing.

Paul 1:10:25
Um I think that the kind of the only obstacle kind of new thing in our life is starting the Omni pod five. And seems like for anyone else who's just started, I just like to share a little bit of feedback if it's okay, no, please. So we started Friday, today's Wednesday, the first pod failed. The first pod failed Saturday night. We thought that it was the algorithm learning but by the time he hit 300, we pulled off the pod, gave him a manual injection, and then started a new second pod. He did throw up twice, so we were in close contact with his Endo. But we decided to manage it home he had 2.9, where his ketones via blood. An hour later, they were 1.9. And by the next morning, they were point six. So I mean, we were able to manage it at home. But the algorithm is better on the second pod. It is learning. I think I will say that with any automated insulin delivery system, I haven't found and this is our third different from pump from dash to tandem to T slim to Omnipod. Five. So we haven't found any of them that can handle hormone rise and a three year old. So there's been mean from going to 86 89% in range to you know, hitting the lower 70s. Now, because he's high for four or five hours overnight, as our algorithm is, you know, learning. So to other people or parents out there that may be experiencing kind of the same thing. The algorithm did better on the second pod, and we're hoping to see improvements as it as it goes, we changed the next pod. Yeah,

Scott Benner 1:12:34
yeah, this, your episode will come out long after this happens. But I have three episodes that I just recorded with a CDE. And we put together a list of things to talk about, I got the list from the people in the Facebook page. And then the the list was given to on the pod. And they went over it and made great sense of it for me. And then we went back and I had the conversation with the CD, it's going to come out in three parts. But I think the takeaway from the pod five for me after hearing the conversation was settings are very important. Entering in with basil and Bolus, it's near 5050. A day is very important when you're starting the pod on the first one.

Paul 1:13:22
The first pod was like 3070, basil to to Bolus and then the second pod day one was like 5347. And then yesterday, it was like 4951. So yes.

Scott Benner 1:13:38
And what I meant was that the your initial settings that you put into the pod is where the pod begins to learn. But then it stops, listen, it stops taking your settings into account very quickly. But if you but if you're a person who, for instance, is under basil and over bolusing or over basil and under bolusing, or something like that, that's going to throw off the amount of time it takes the algorithm to learn things. I think the other thing I learned was that you still that you still have to manage insulin Well, like I think people have an expectation like that this thing's automated. I think they think this about all the automated systems, but it's automated. It'll just do it. And that's still not the case. You know, you have to Pre-Bolus your meals, you have to you have to get your carbs counted. Pretty right. You have to understand if there's going to be a fat rise 90 minutes from now that the algorithm doesn't know that. You know, that that kind of stuff. And, and you have to understand that it's not it's not super aggressive. So when you see a rise that comes out of nowhere, it's going to treat it like it would treat anything else. And then if suddenly, hormones is a great example, hormones are hitting like food. So imagine if you ate and didn't tell it you ate. The same thing happens when the hormones come

Paul 1:14:59
in Yeah, and that's exactly what it looks like. Yeah. You know, when he's, he's an avid milk drinker. So if we Pre-Bolus, you know, 1520 minutes, because we know when he drinks six ounce, the milk is probably going to go up 100 110 points, even with the Pre-Bolus. Even if strong, you know, like, almost a two unit Pre-Bolus for, you know, 30 carbs and 11 to that is milk, right? You know, it's really hard to avoid that spike. So unless you split the milk, but then when he goes asleep, you see that kind of similar like, plus 11 plus 12. You know, as he falls into that deep sleep as his hormones are kicking in.

Scott Benner 1:15:40
Yeah, wait, oh, wait, oh, what happened here last night, happens to you. It's, uh, somebody grabbed soft pretzels yesterday, and they just sitting in the house. And it must have been like, 11 o'clock or so. And I said to Arden, Hey, your blood sugar's drifting. And I was like, There's something about the angle of this line that tells me it's not stopping. And I know you're only 100 now, but I think this is gonna go 195 90 Like, I think I think in a half an hour, you're gonna be 65. Like, I just don't think, you know, I don't think the algorithms gonna catch it. Like, it's the, it's what I'm saying right now. And she's like, Oh, yeah. So she of course, waits too long to have like a small snack. And then, you know, she grabs some stability, but she grabs it at like, 70 instead of, you know, 90 where it could have been, and she just didn't flow. Yeah, had she just eaten it 20 minutes sooner, she would have grabbed stability at 90 and maybe gotten to 70. Instead, she held at 70 and was gonna get lower again. She starts getting lower. And she's I hear so I got it. I was like, okay, she eats an entire soft pretzel. Bolus for like, pretty aggressively, like she didn't do bad. And, like an hour later, like I was, I went to bed. I was like, I'm good. And Kelly was still up working. And she's like, Hey, I need you to wake up. She's like, I've been trying to help art and but like it's not working. And artists blood sugar went to like, 250 off of that soft pretzel.

Paul 1:17:15
Yeah, and pretzels are impacts just in the same way. They are hard and fast. Right? Right.

Scott Benner 1:17:19
So I just, I had her change some settings, and you know, with sleep, and when I woke up this morning, she was 90. So it all worked out. But you know, it's tough. And just imagine if it was something else adrenaline, pain, hormones, like these kinds of things. I think what people need to understand is that right now 2022, you can get tandem control IQ, you can get on the pod five, you can get the Medtronic device, you can get, you know, do it yourself loop, and the three, the three retail devices are going to be less aggressive, I guess, then you because you can make the loop be more aggressive, right, because it's more, it's more user definable, you can tell it to start correcting it a lower number, you can tell it to auto Bolus 10% 2030 4050 60% of what the it thinks, you know, you're a little more, a little more control over those settings. Whereas in the other ones, they they work the way they work, and they work amazing. There are for the most part going to keep you from getting low. And, you know, they're going to do a pretty good job with meals as long as you understand meals. And as long as you understand when the algorithm just I don't know what the word is, but it's beyond its ability at that point, you're gonna handle it, you're gonna have to jump in and do something. And, you know, once you learn that, I think you're good. I just I don't I desperately don't want people to think that. These things are just like, oh, you put it on and everything's like fine. Your blood sugar will be 93 the whole time. You don't I mean,

Paul 1:19:04
by no means is it a set it and forget it kind of thing. It's a drastic improvement from 10 years ago, but it's that that still needs to be managed. And I mean, I think since we've started the Omni pod five, on Friday, I've probably been up till 12 One o'clock in the morning just trying to see how aggressive it is and how much insulin it's giving at what rate because I want to understand it and know what it's doing. So if I go to make a decision and override to Bolus that I understand what it's doing and how it's working, yeah, so yeah, I mean, there is a learning curve to it. Don't let me all the algorithm has its learning curve while it's learning. You know, I'm trying to learn as well so I can manage manage as best I can to

Scott Benner 1:19:54
and from what I hear from people weeks from now, it'll be better than it is today for you

Paul 1:20:00
I think the five week mark is the kind of buzz that I'm hearing

Scott Benner 1:20:04
from people. Yeah. Now, I've heard all kinds of different stuff, but and so even what you're learning might change. But the truth is, and people, you're going to hear me say this a million times over the next year, for the vast majority of people using insulin, you put an omni pod five on them, and their life is going to just improve. But 100% Yeah. So, you know, I also believe that it's, I did it for the first couple of days that aren't used on the pod five, I was like, Well, this is, you know, I started comparing it to loop. And then I just realized I was like, they're not the same thing. Yeah, it's different. Yeah. So I'm, I let go of that very quickly. They're not the same thing. They shouldn't be compared to each other. If you want that, like, you know, if you if you're looking for that, like drill down type control like that, then you you need to look at that, do it yourself product. And if not, then, you know, this is what these things do. And I imagine they'll get better over time. Of course, all of them. So anyway, right. I think it's a, I think they're amazing. I think I think if you can afford them, you should try them. That's for sure. Agreed. All right, Paul. I kept you too long. So I can't ask you about the restaurant orgies in the massive drinking and drugs that I'm assuming you've seen through your 20s and 30s. working in restaurants but

Paul 1:21:22
ruin but invite me back for an after dark episode we're talking about if you had

Scott Benner 1:21:25
diabetes, you'd be right there. See where you're getting let down by not having diabetes, you cannot come back on. And my son said to me recently, she's like, Are you always going to just interview people with type one? I was like, people with type one have regular lives too. It's plenty interesting. Don't worry.

Paul 1:21:41
Don't worry. Yeah,

Scott Benner 1:21:42
don't worry. It is anyway. All right. Well, thank you so much. I appreciate you doing this.

Paul 1:21:46
Thanks, God, thanks for everything that you do. We're appreciative. And I didn't mention in the beginning of about a week after diagnosis, we found your podcast. And I think two weeks after that, we started with Integrated diabetes. And it really changed our kind of our philosophy and our, our way of managing diabetes. So thank you very much.

Scott Benner 1:22:11
It's my pleasure. I'm so happy you found it. A huge thank you to one of today's sponsors, G voc glucagon, find out more about Chivo Capo pen at G Vogue glucagon.com forward slash juicebox. you spell that GVOKEGL. You see ag o n.com. Forward slash Juicebox. Podcast want to thank Dexcom and remind you to go to dexcom.com forward slash juice box start with that G six or G seven, sensor. And of course contour next.com forward slash juice box get yourself an accurate meter. It's easy to hold easy to use, and has Second Chance test strips contour next gen at contour next.com forward slash juicebox. I'll just remind you also to check out the private Facebook group Juicebox Podcast type one diabetes on Facebook. Although there are people in there with so many different kinds of diabetes, I should probably change the name. It's for everybody. Juicebox Podcast, type one diabetes on Facebook. If you're new to the show, please subscribe or follow in Apple podcasts, Spotify or anywhere you get audio. And if you've been listening for a long time, Please share the show with someone who you think might also be interested. Oh, and if you're really loving it, leave a five star rating and a beautiful review. Wherever you listen. Sharing the show is how it grows. So whether it's through a review, or personal conversation where you say, Hey, I think you should check this out. Tell your doctor about it. Anything, anything to help the podcast grow. I very much appreciate and of course supporting the sponsors is why the show is free and plentiful. And also why the Facebook group is also free and well managed. You guys are making that happen with your really kind support. So thank you very much. I hope you enjoyed this episode. I'll be back very soon with another

#885 Type 2 Diabetes Pro Tip: GLP1, Metformin and Insulin

A series for people with pre and Type 2 diabetes.

+ Click for EPISODE TRANSCRIPT

00:00:28 GLP ones can be beneficial.
00:09:44 Insulin and metformin for type 2 diabetes.
00:14:45 Metformin can help with weight loss and may have longevity benefits.
00:18:25 Consult physician before starting medication.
00:27:06 GLP1s can aid in weight loss.
00:34:18 Lifestyle change and satiation matter.
00:39:30 Mindless eating and constant access.
00:43:05 GLP1s can be beneficial for diabetes and weight loss.
00:50:23 Medication can help improve health.
00:55:02 Weight loss medications can have positive impacts on healthcare.
01:00:11 Weight loss lifestyle requires commitment.

Scott Benner 0:00
Hello friends, welcome to episode 885 of the Juicebox Podcast.

Jenny Smith is back today and we're going to do another in the Type Two diabetes Pro Tip series. Today we're going to talk about medications like GLP ones, insulin Metformin, and we're going to touch on a few others, this may end up being a part one of two, because we get pretty far into the conversation about the GLP ones. Now if you don't know what those are, those are ozempic but Jarno, these are once weekly injectables made for type two diabetes. While you're listening today, please remember 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. You can get 10% off your first month of therapy@betterhelp.com forward slash juicebox. And you can save 35% on your entire order at cozy earth.com. When you use the offer code choose box at checkout because the Earth is towels sheets. Oh my gosh, Sweatshirts, sweatpants really great stuff cozy earth.com use the offer code juice box at checkout to save 35% off your entire order. This episode of The Juicebox Podcast is sponsored by Dexcom, makers of the Dexcom G six and Dexcom G seven continuous glucose monitoring systems. Whether you have type one diabetes, or type two diabetes, seeing your blood sugar in real time is a game changer. dexcom.com forward slash juicebox. Jenny Hello. Hi, we are back. And we have a number of episodes in our type two Pro Tip series already up and being consumed by people just terrific. Today we're going to talk about medications that people with type two might find themselves using. So I struggled there

Jennifer Smith, CDE 2:21
are so many yes medication.

Scott Benner 2:24
I struggled to ask you if we should begin with what's hot right now in the news, which is like GLP ones or if we should just start with insulin and end with GLP ones. So I think insulin,

Jennifer Smith, CDE 2:38
start with insulin, I

Scott Benner 2:39
think so I want them to understand how it works. And then we can tell you later how these other things might help them as well.

Jennifer Smith, CDE 2:45
Okay, because it's not I would. And that's great, because I think I think I'm the mind of a lot of people with type two is that insulin is going to be in the picture at some point. So I think answering what is insulin? How does it work? What is it supposed to do? etc? is good to start with? I think in terms of where people might start, once they're diagnosed, may not necessarily be insulin, in fact, that may be very far down the road, or maybe not at all. You know, but I think there are lots to discuss. So we can start with insulin because we know insulin right? Yeah,

Scott Benner 3:25
we can talk about that. And we can talk about that. And I do think that, from what I'm learning these GLP ones really could be a situation where if you are in a pre diabetes situation, type two even, it's possible that you could get out of being in that category with the GLP ones at some point. Do you think that's true? Do you think they could keep people at bay for even a lifetime?

Jennifer Smith, CDE 3:52
In fact, in terms of you know, like the GLP ones, and the other ones that we'll discuss and talk about? They should actually from a lot of the new standards that are done by the ADEA. Right, the standards of diabetes care, not only should we be individualizing, management person to person, right? It used to be a chart that was followed start with this go to this move to this but we really do need to and the standards of care suggests to personalize to really in depth talk to the person that you're working with from the clinical standpoint and say, hey, you know, what are your lifestyle factors? Where are your glucose levels, what lifestyle changes have been put into place? Let's look at the meds that one we could use that would be beneficial. And oftentimes the GLP ones and that these newer kinds should actually be more of a front line rather than insulin honestly. And because they have they have a lot more protective. And we'll talk a little bit more about it. Obviously, there are a lot more protective components to some of these newer meds as well. And they're protective in many of the things that we talk about in terms of diabetes complications. So why wouldn't we want to start with some medications that can prove very beneficial in many avenues of type to management, weight management, nutrition intake, glucose management, all of that stuff? Why wouldn't we start with them versus something that might be old school and doesn't fit their need? Really? Yeah.

Scott Benner 5:37
And that makes me think, too of metformin, which is taken in a pill. But that's a drug it's been around with since the 50s. Maybe?

Jennifer Smith, CDE 5:45
For me, yeah. And I think, oh, my gosh, Metformin. I'd, it was like one of the it's like the first, if I remember,

Scott Benner 5:55
there is as much research about Metformin, and insulin and diabetes and weight as there is about longevity. Like there is a ton of metformin research around longevity as well. Yes. Yes, I think we can, that'll seep into the conversation as we go. But let's just start with insulin because, sure, because what if somebody with type two finding themselves here and they're already on insulin? Yes. So I mean, what is it? You need to know? Really? If you have type two, are they going to put you on a Basal insulin?

Jennifer Smith, CDE 6:31
Yeah, yes. Is anything possible with insulin with type two? Yes, absolutely. They could potentially see that when they're looking at glucose levels, especially if you have a CGM, or if you're just doing finger sticks, your fasting glucose level is not meeting target, right under 100 is what we're aiming for. Then, they may start you on just a Basal insulin, with the goal being of overall lowering that background glucose level to get you waking at a fasting target level. Yeah. Right. So yes, Basil could be a first start. If we're talking just insulin in use, and Basal insulin. It's the foundation of kind of management, it's, it's kind of what keeps things stable. If you were to live in a world without food, and without stress, and without anything else, those variables that impact blood sugar, your Basal insulin should hold things stable.

Scott Benner 7:35
Yeah. So in type two, if my average blood sugar is like 120, all day long, for example, and I might inject the Basal insulin once a day, and then I might see my average blood sugar sit lower, hopefully, you know, and, and maybe I see spikes at meals, but they come back pretty quickly on their own. And so just the Basal might help but if that's not the case, then I also might get a mealtime insulin as well to inject to compensate for food.

Jennifer Smith, CDE 8:05
Correct rapid acting insulin Yes. And, and rapid being that mean rapid. We hate the word rapid when we talk about insulin because it's it's not as fast as like instantaneous action. It takes, you know, 2030 minutes for it to really get going and get moving. But its action profile is really short where Basal insulin you may take once a day, and it has about a 24 hour effect. Rapid insulin is much shorter, it goes in and out. So it clears within about three to five hours is the average right?

Scott Benner 8:41
Yeah. So you you might find yourself just using a Basal insulin which is a once a day background insulin, you might find yourself using a meal insulin along with it. Is there a world where they would give you mealtime insulin but not Basal? No,

Jennifer Smith, CDE 8:57
that's not where there might be. But that's not something that I've seen. Lately, and there are other meds obviously we're going to talk about a lot of the meds. There might be some other meds that are in use and maybe maybe the mealtime management is not going as well. The other meds are helping in one way. But the mealtime navigation, it just needs it needs some insulin to assist, right? That might be a scenario where there is some rapid acting insulin added to kind of assist in that picture. But typically not if you're not using a basil. You wouldn't really only be using a rapid insulin without a beat. So

Scott Benner 9:38
the progression might be basil. If that doesn't help then mealtime. Do people do basil and metformin? Yes, yes. Okay. I'm trying to think of what I would wonder if I had type two diabetes that's that's where my brain is like skipping around to right now.

Jennifer Smith, CDE 9:54
Well, and a big reason as you just mentioned, might you do Basal insulin and like a Metformin I And remember that Metformin is not one that really increases the risk of hypoglycemia or low blood sugar. Whereas insulins job, I mean, it's its main job is to bring your blood sugar levels down, right? Your pancreas has really good management of all of that, it's just part of what your body should naturally be able to do. So your body doesn't naturally drop your blood sugar too low. But when we take an injectable form of insulin, it's dose management. Okay? So it's, it's really, we have to be very careful in adding oral medications, if there is insulin in the picture, that those oral medications are also dosed appropriately taking at the right time, and that they're also not potentially going to be something that's going to increase the risk of low blood sugars because somebody's already taking insulin, right? So Metformin is a very safe one, so to speak. Because obviously, its job isn't to really help release extra insulin from your pancreas, it does help your body to use insulin better, it's an insulin sensitizer to some degree, helps your body to release less glucose, essentially, from your liver. And that helps to keep the glucose levels more stable. Right. So but again, it doesn't help your body make more insulin. Okay. All right. So,

Scott Benner 11:32
so can we should we talk a little bit about Metformin here? Sure. Okay. So I don't know anything about this. Hey, Jenny, Metformin, go,

Jennifer Smith, CDE 11:43
Metformin? Yes. I mean, there's, you know, gluco, fysh, is as another kind of name for Metformin, right, you can take various forms and extended release, which many times people will actually tolerate better, the extended release, it's slower, it doesn't have as, like quick upfront action, Metformin, the nice thing about it is that its side effects are very minimal. Upon starting it, the most common side effect is going to be a little bit of like nausea, or sometimes stomach upset, sometimes a little bit of softer stool. But honestly, those symptoms typically go away. Within about a week or two, after starting it, we also start Metformin at a really low dose to begin with to evaluate tolerance. Many times you may not see much impact from that starting low dose. And so then as tolerance is there, we can increase to more therapeutic doses. And that's done along with the doctors kind of assisting you to titrate that to

Scott Benner 12:54
do a lot of people see a Metformin given by a doctor prior to insulin, right. That's sort of their first step. Usually,

Jennifer Smith, CDE 13:01
that used to be yes, I think with again, some of the newer meds that we'll talk about, sometimes Now, if you've got a really good doctor who is following a lot of the standards of care again, Metformin might be started, but it might also be started again, along with one of these newer meds. The goal being containment of blood sugar sooner than later. Yeah, to really get things as protected for some of those other complications that, you know, we want to try to avoid.

Scott Benner 13:31
Why why do we let me see if you know the answer to this, why do we see what's the phrase I don't want to use it? It's not pejorative for me, but bro science like, why do you see those guys using Metformin in general like they like so what does Metformin do besides, besides help you with your blood sugar, it's also impacting other things, right?

Jennifer Smith, CDE 13:54
Sure, Metformin is one of one of the few oral meds that has been shown in research to have a minor effect on weight, meaning it doesn't, it doesn't increase the risk of gaining weight. If anything, people will lose a slight amount of weight or at least be able to maintain weight. Some of the other medications because of the way that they work can actually not be as beneficial in terms of weight loss, along with lifestyle changes and everything else that somebody with diabetes needs to be making. Metformin is one that can help you to lose a little bit of weight. It's not going to be astounding weight loss, like 1020 30 pounds, but anything taken off can be beneficial. So that's one one positive side effect, I guess, of using the medication.

Scott Benner 14:50
I googled Metformin, longevity. And I hit A Harvard study that says preliminary studies suggest that Metformin may actually slow aging and increase Life expectancy by improving the body's responsive responsiveness to insulin, anti oxidant effects and improving blood vessel health. So I don't know how right or wrong that is. But I do know there's a ton of research about Metformin,

Jennifer Smith, CDE 15:18
longevity, longevity. Well, and when you also, longevity also speaks to me in terms of ability to use long term to not just in terms of the body, but also in terms of safety, safety, right? Because medications, as we know, outside of insulin insolence got a job, it does its job, it gets cleared, you take more of it. It's not like it really does other things in that, like it doesn't impact like your eyeballs and make them grow green spots. Right. We are I hope, not.

Scott Benner 15:55
Wondering why your imagination jumped to that. But okay,

Jennifer Smith, CDE 15:57
yeah, I don't know. Yes. Well, I have kids, you know, they've, they're all about monsters and dragons and weird things. So you know, but a lot of medications in many areas, not just diabetes, they have impact. And thus, all the commercials on television, you hear if you have any of these side effects, or you notice any of this and sometimes those commercials, I'm like, Man, I think I'd rather live with this. See the side effects, you know, but Metformin is one that is truly mostly gi side effects. And are there some people that the GI side effects are so much that they don't go away? They get worse, and they actually can't continue on it? Absolutely. It's not as many people but there are some people that it just isn't tolerated. Is there

Scott Benner 16:43
any way to know what that's tied to when they can't tolerate it? Is it people trying to like continue their dieting from prior, like their fueling plan hasn't changed? There's no connection that you can think of?

Jennifer Smith, CDE 16:55
Okay, no, I mean, I'm sure that maybe there are some studies that I've not read or looked at in terms of why some people have symptoms, or that those symptoms are so bad that they just can't even tolerate it going above the starting dose.

Scott Benner 17:10
But yeah, I think when you're sick, or that it's not an answer, for sure.

Jennifer Smith, CDE 17:13
Yeah. And with you know, Metformin that kind of brings up when should you take it, we most often recommend on starting people take it with their meals, right? So on starting, we usually say start taking it with your breakfast meal, or with extended release, usually recommend taking that with your evening meal, right? Because there's a long term action profile of it. Taking it with a meal decreases the chance of that stomach upset. And I even often tell people take it in the middle of the meal, like sandwiches, eat a little bit, take the Med, eat the rest of your meals, it's kind of like plopped between. Right.

Scott Benner 17:51
The break up in your stomach without hitting harshly somewhere.

Jennifer Smith, CDE 17:55
Yes, exactly. I mean, there are some some, certainly some kind of cautions, obviously, with liver or some kidney problems. Those are some reasons that consideration for not using or paying attention to tests for liver and kidney function would be important if it was a med that was started. But those are some of the things that again, your doctor would be able to pay attention to, and know whether or not they should even prescribe it. Yeah,

Scott Benner 18:29
I mean, I think it goes beyond saying but consult your physician, pay close attention, be in contact, you know, do your own research those things. Yes, exactly. You mentioned when to take it. So I'll just add this. It's kind of one of those things. That seems simple, but you might not think of it. If you're gonna start a medication like this. Do it on the weekend. Or when you're not working, you know, if you have off Tuesday and Wednesday, started on Tuesday, right? Yeah,

Jennifer Smith, CDE 18:58
absolutely. Because then you have a visual to any potential side effect that's going to be negative. And you've got time to deal with it before having to go you know, you take it in the morning, you have this big board meeting presentation and your stomach is going wrong. is probably not the best thing.

Scott Benner 19:18
You don't want to be at work going. I think I'm gonna have loose stools.

Jennifer Smith, CDE 19:21
No, not a good idea.

Scott Benner 19:24
At home on Saturdays what I'm saying? Yes, that's all be

Jennifer Smith, CDE 19:29
close to your own toilet. Yes.

Scott Benner 19:30
So we're not going to see like huge effects from Metformin, we will see. I mean, you will see huge effects from insulin. If you make it to insulin like you are going to notice a significant change in your agency, because you're going to be covering what your body can't cover for the Basal side for that long acting insulin and you're going to be yes hitting your meals with a mealtime insulin, you're going to see a significant change on insulin.

Jennifer Smith, CDE 19:57
Insulin is like immediate efficacy. You You are, it's going to work. Here we are, right? I mean here. And, again, I should backtrack and say if your blood sugars have also been significantly high, you may see impact, but it's not like it's going to be so dramatic that you're going from a blood sugar of 300 down to 50. Right? You may have to increase dose slowly, which is actually much more optimal. You don't want major shifts down. If you've been stable at really high blood sugars for a while. You don't want to all of a sudden be sitting at 80. That's, that's not good for your body. So this slow titration even of insulin, yes, you're going to see impact of it. But it may not be as quick as Gosh, I'm floating at Target now.

Scott Benner 20:44
Yeah. Okay. All right, Jay, let's spend the rest of this time talking about Hilah monsters.

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you're ready? Do you know why I said that?

Jennifer Smith, CDE 22:44
I know why you said it. You tell me since All right. Sounds like sounds like you know you studied

Scott Benner 22:50
so there's a Canadian researcher who studied Hila monsters? Is it it's Gila monster healing doesn't matter big lizard right? And I think that I think the story goes that initially he noticed that they don't eat very much and then started to try to figure out why and found GLP one in the in their saliva. Is that right? Am I getting this right okay. And that was a while ago by the way like I know a long time Yeah, yeah, I know we we get wrapped up in like, you know what's going on in social media and you know, famous people are using GLP ones lose weight. No, we can't, you know, whatever. All that that's all just noise. This has been going on for quite some time. I can remember. It's got to be 15 years ago, a doctor tried to give my wife Victoza for weight loss. And it made her very it didn't didn't it didn't work well. Well with her. Yeah. But since then, others have come along so let's see if I can get these GLP ones ozempic trulicity Victoza by EDAA Where's more? I don't know there's one that starts with an A. I'll find it hold on.

Jennifer Smith, CDE 24:18
Those are I would say that those are

Scott Benner 24:21
the Go ahead. Well, they're all GLP ones though. Right? Like with semaglutide Some of them are so GLP ones are some already Jenny you gotta help me here. GLP ones are semaglutide Is that correct?

Jennifer Smith, CDE 24:35
GLP one you tell me you're listening.

Scott Benner 24:39
I don't know if I trust the list because Victoza for an example is often listed as GLP one but isn't it have a different main component?

Jennifer Smith, CDE 24:49
So Victoza and by Edo were the oldest Okay, right. By Yetta was, if I remember correctly, the first on the market in the very early two To 1000s, and it was dosed twice a day. Right? And then everybody was like, oh, but what if we could just take this once a day and they're there came to be Victoza, which was once a day, and then things like trulicity Trulicity is once a week, similar to ozempic, which is once a week, and which just increases the potential. I mean, and you're right semaglutide or however you were saying it whatever is GLP one,

Scott Benner 25:32
so it's a magnetite. I hear some people say semaglutide I don't think that's correct at all.

Jennifer Smith, CDE 25:37
It might I say some magnetite it might be semaglutide. i There are so many ways to say these, these names of things that as long as you know that category and what it's supposed to be doing in your body. Great. So

Scott Benner 25:51
I pointed out that Victoza is liraglutide. So it's not exactly the newer drugs, and I think it is good.

Jennifer Smith, CDE 26:00
It's all formulation. Yeah. Okay. Right. I mean, it's kind of its formulation, I think that's the easiest way. I mean, they have in terms of action, their action profiles are all similar enough. But some are taken, like I said more on a daily basis. And some are taken more on a long term, sort of basis, which I think for some people makes it a lot easier that they don't have to remember something every single day. But in general, these GLP ones, their action profile is to really increase insulin secretion. And to help, again, kind of like Metformin, decrease glucose release, sort of from the liver, specifically in the after meal time period. Yeah. And then they also help to delay sort of stomach emptying and like the glucose kind of break down and whatnot, which helps to increase satiety, which is a huge reason that GLP ones are beneficial for weight loss.

Scott Benner 27:06
So if so, for me, if this was me going into a doctor's office, and I saw I was like, Look, I I have prediabetes or I have you know, I have type two, I'd be pointing to, I'd like to try it was epic, or I'd like to try Manjaro. That's where I would be focused based on what my research is telling me. Do you see a reason why others would be?

Jennifer Smith, CDE 27:29
I've actually, and again, I've been out of specific, we've got a number of type twos, but I've been out of the type twos specific, like prescriptive component for a while, by Yetta. And Victoza were very, very big when I was working more heavily with the type two population. But we didn't have things like trulicity or ozempic, or any of those meds to choose from. Yeah, I think now, the benefit of something like ozempic, especially is that they have clearance for some of those other risk factors that we're trying to decrease, right, especially cardiovascular benefit. So if you're looking for the most bang, let's say, in a medication, and you're potentially high risk for heart disease, or you've heard already had some type of cardiovascular event happen, or you have a strong family history of then you're looking more towards these newer GLP one because of what they've proven in some studies.

Scott Benner 28:39
Now Manjaro Manjaro is a GLP one and also a G I P. In that drug. This is what my, my my thinking and my reading has told me. So apparently a GI p is a gastric inhibitory polypeptide. Jenny's just impressed, I said polypeptide correctly. She was looking at me, she goes, watch him mess this up. And I got it. So they are like their studies. Basically the Manjaro people, I don't know who makes it as it Lily. Is it? I don't know. Let's figure it out. I guess I'll scroll. Lilly Lilly makes Manjaro they're saying that people on average on Manjaro are losing like over 20% of their body weight. Is that right? I

Jennifer Smith, CDE 29:29
think I think the one study I read said like 23% Yeah, that's crazy. It was an enormous amount of weight. Absolutely. Yes.

Scott Benner 29:39
And it's not in an insane amount of time either. Six it is not it's under a year, you know. And so but then ozempic I don't know what their their studies say. But it's something more like is it like 16 or

Jennifer Smith, CDE 29:54
it's less than that? But it's it's substantial. Again, when we're comparing it to something that's The older, like even the bio data and the Victoza and definitely much more beneficial than Metformin in weight loss. It's in the it's in the teens area in terms of percent loss.

Scott Benner 30:13
I have here, New England Journal of Medicine semaglutide group, approximately 70% of participants achieved a weight loss of at least 10%. And approximately when we get the rest of it, and approximately 50% of the people are that go. achieved a weight loss of at least 15%. Furthermore, 1/3 1/3 of participants treated with semaglutide lost at least 20% of their baseline weight. Wow.

Jennifer Smith, CDE 30:41
Which is it's huge, you know, if that is, if that one has been a struggle for a really, really long time for you, and now you kind of are slapped with another now you have type two diabetes as well, right? God, I've already been working on this, and I'm not getting anywhere. And now you tell me I have this to work on as well. It's like, how much more can you load on right? And while lifestyle change is the four front of what we would try to encourage, sometimes people have already done some things, lifestyle wise, and it's helped, but it hasn't helped to the degree of 20%.

Scott Benner 31:24
Right? It goes on to say that these are results that approach those of like three years after bariatric surgery. So you know, people getting their stomach stapled, or whatever they call it. And it's three years later to lose 20%. I'm talking about like, click, click, live my life, I'm losing weight. And I we've touched on this before I and I'm going to do it again. i If I could close my eyes and imagine a world we'd all be out jogging after work and eating a half a piece of chicken with a little bit of broccoli on it and go, Oh, I'll take some sparkling water. That's not happening. So like, as long as that's not happening as long as people are are, in some situation stuck eating processed foods that are just beating the hell out of their bodies, right? Yeah, yeah. We all shouldn't just go okay, well, I guess I'm, I guess I'll die. You know, like, this is, this is crazy how well this works. And it is because it got into the weight loss market. It's got a light shined on it now, because I've been hearing people tell me around diabetes for years whispering in my ear, maybe GLP ones, maybe a GLP. One for type ones, like and it doesn't catch any traction. But I'll tell you what, a couple of people lose 50 pounds on tick tock, and everybody goes, Hey, what the hell? What's happened to her?

Jennifer Smith, CDE 32:47
And how did they do it? And gosh, they didn't have to just sit and eat green beans.

Scott Benner 32:52
Right? Because I work because because they make me choke because my parents. It doesn't matter. Like for whatever reason, like I keep trying to make this point. I don't think you should be embarrassed if you have type two diabetes. I don't think no embarrassed if you're something's going on. I don't believe that a large amount of people are just sitting at home with their hand and one bag of Doritos in their hand and something else and going I don't care if I die. Like I just don't think that's true. Is it true for somebody? Yeah, maybe. But also that person deserves a life too. And I'm not saying you should use the drug and then just eat poorly. I'm totally not saying that. But I'm saying that if this helps, then why not? And my point is, why did it jump into the weight loss category. So for example, right now, Manjaro is only available for type two diabetes, but there's no doubt in my mind that they are very busy right now making, you know, something, something that's going to be for weight loss because those Empik is for diabetes, type two, and they made we go V. Now, you'll hear people say ozempic And we go V are exactly the same thing. They they are right, like at the molecule they are it's just the dose, it's just the dose that they change. So there's a different dosing for diabetes than there is for weight loss. Now what they're learning and what they're seeing is the satiation that you're talking about, like just not being hungry. If you go into any weight loss Facebook group or pay attention online, we go over users as an example are like I am not hungry, like I'm reminding myself to eat right? Yeah. And as a matter of fact, their doctors are telling them when you start taking this, you have to keep eating. Correct. And that might not be easy to do. I talking to somebody personally right now, who describes they're using weego V for weight loss, but this person is prediabetes as well, right? So sure. And And they talk about their entire life. While they're making breakfast. They're thinking about what they're going to eat for lunch. Like, like, and it's not like a softness, this isn't a weak person, you know, seemingly, she's just their mind just, they're always hungry, shall have hunger in a way that you can not like, I don't understand when it's described to me. Like, like, What do you mean? Like we just ate? Or did they? Or they'll make three things at a meal, like, any of those things would be a full meal. And they're like, Well, I'm at this with this and this. And as soon as I get that, Enos, I'm going to be hungry again. I don't care if we found a way to say that's a disease or not, that's a disease. You know, like, if your brains not shutting off, you're that correct? Yeah.

Jennifer Smith, CDE 35:46
And I think in today's I mean, I, it begs to actually, it's a rabbit hole. But honestly, we've lost a lot of connection with our brain, to our stomach and what our body actually needs. And when it needs it. We have we've lost a lot of that because we are bombarded with food on a day to day basis, not only with the commercials, but also with social interactions. Yep. Everywhere we go. Availability, something social. includes food, you can't go to a board meeting that doesn't include some type of probably pastry, along with coffee or tea, right? You can't go to meet a friend at a park and just sit. It's let's go grab something to eat and talk over the food. Right? So I

Scott Benner 36:41
I've never drank coffee in my entire life, right? Cold coffee, calories. Oh my

Jennifer Smith, CDE 36:49
goodness, if you're truly just getting a plain old Cold coffee, nothing in it. It's like hot coffee that you've just cooled down. Okay? It's not caloric, right? Our, our cold coffee culture today? Well, that was a lot of C's. Sorry, see, I have little I have little children. But it is it's it's an entire, you don't just get coffee, you get some type of sweet something in it. And you get Frappuccino wised or you get you know, something to it. That makes it not taste like coffee. But it's a sweet treat.

Scott Benner 37:30
And all of a sudden, it's 300 calories in a glass. Absolutely. Yeah. And that's just, I'm saying, imagine a world where you were you've just got caught in this cycle. Like you said, like you we've been eating like this for years. If you go back to the 50s and the 60s and the 70s. There's scarcity of food, right? And people eat your plate, like because we you know, but they were still just eating. I don't know, some potatoes and beef and beans. It wasn't like but they

Jennifer Smith, CDE 37:58
were eating regular meals at fairly regular times. Now. Life has also gotten very busy, very different in today, comparative to the 50s. Right, right. And the structure of our day has changed very dramatically. We don't have a typical breakfast together, a lunch and a dinner time everybody is home. And you know, somebody's reading the paper at the dinner table. That's that's, I mean, now it's I was just talking to somebody at my kids taekwondo last night, and she's like, sometimes I'm shoving peanut butter and jelly in their mouth and being like, we have to be there in five minutes. And that's what they get for dinner is peanut butter and jelly. And I'm thinking to myself, I understand. But I have so much I could say to you about this, but you're not asking so I'm not going to elaborate.

Scott Benner 38:44
Exactly. So but if people's lives are in I mean, look the us up. I remember, I was 12 years old. And my grandmother and I were driving down the street in the town. She lived in her whole life. And she pointed I swear to you, she pointed at a corner where there was construction. And she said they're putting a 711 there. That's the end of this town. That's what she's holding. And I'll be damned that old lady was right. Because now, Wawa 711, any kind of convenience store that you can think of along the way. They're not one in a town. They're at every corner. And so you just think oh, I'll stop and get and then money's more people have money in their pockets in a way that they didn't before. You know, and it's just it's a terrible cycle. So my point is, I think our brains to your point have been they've been I don't know what the word is. But now you're hungry constantly and you have access to food constantly and is generally speaking not good food

Jennifer Smith, CDE 39:43
and it's an it's a miss I think there's a disconnect between what is hunger feel like and oh, I could grab something quick because I'm not like your brain is thinking further. I'm not quite sure when I'm gonna get to some thing else. So I might as well grab something now because hey, that you know, little place to grab up, you know, a coffee and whatever is here, or this little place to grab a sandwich from is here. And it's not truly remembering to connect with your hunger level. It's a, it's almost just a brain notification of grab it. It's here,

Scott Benner 40:20
I had a situation recently where I knew 45 minutes from now, there was going to be food, but I was hungry. And I almost ate to not be hungry. But I still would have eaten 45 minutes later, because I was gonna be there and I just I stopped myself as like, that's insane. Just be hungry for 45 minutes and then eat. But I don't have that. I don't have that push the way some other people do. Correct. And then the other side of it is the so GLP ones, they're going to tell you the side effects may be nausea, vomiting, or diarrhea. Those are the three that they post when they're telling you, right? Correct. The nausea, I don't understand. But the vomiting is from trying to eat food that your body can no longer kind of process, right because it slows gastric emptying. It's

Jennifer Smith, CDE 41:10
correct. In fact, there are you know, if you are utilizing insulin along with some of these medications, it's really important to pay attention to, to the what the meds can do in terms of satiety. Very important because if you are someone who is using insulin and dosing for the food that you're eating, or you have what we call as a set dose, based on meal time, you know, you always take five units of insulin with your lunchtime, and then you eat your lunch while starting on these meds now, you may not be hungry enough for that five units. Yeah, right. So there's, there's some caution to be put into the mix here. Along with use of these because they do impact your desire for food.

Scott Benner 42:01
Right? So there's a desire, the lose the desire, which is good news, if you're if you're eating too much, but you're going to have to remind yourself to eat but eat the right things within reason. If you know, do people vomit on it? It's not from what I can tell it's not something that happens constantly. But it could be that if you're eating fatty, or foods or greasy stuff that you might have a bad reaction with it.

Jennifer Smith, CDE 42:26
It could be that and honestly, it's more the digestive like, I haven't heard as much complaint about the vomiting piece. It's much more Justice background like queasiness on starting the Med and getting used to it. And then a fullness factor that I think a lot of people may not, again, with that brain not really connecting that way. It may be a fullness that their body's not used to feeling. So it may be uncomfortable. Yeah. So

Scott Benner 43:03
to wrap back around GLP ones if I have pre diabetes, if I have type two diabetes, if I maybe just have weight to lose them in the I think right now for I think right now for insurance reasons, you have to be technically obese to get like we go V.

Jennifer Smith, CDE 43:21
There are BMI standards that they have to essentially follow in terms of prescription. Not that they can't prescribe. But in terms of coverage. For that medication. You have to meet a certain BMI. Yes,

Scott Benner 43:36
yeah. Okay. But again, I think doctors who are looking out for your health and can think outside of the box can find a way to get you these things. But these GLP ones, I'm gonna tell you right now, I'm pushing someone very close to me pretty hard. Who has type two diabetes? To start it? Yeah, I mean, just try to imagine the that you have type two, and you have weight, that's x in excess of what you should be carrying. And that a year from now, you could lose 1015 22% of your body weight and be helped supporting the insulin production. And what's it doing the liver again, it clears something with glucagon. And it helps to decrease

Jennifer Smith, CDE 44:19
your glucose outlet right from your liver. And so the benefit of that, obviously, is, I mean, your liver and your pancreas. They're what these wonderful organs that are supposed to work together really well. Right? They're supposed to. But when you've got too much being released and your body isn't responding the right way and or your body's not making insulin in the right way. You don't need this assistive piece. That's supposed to be this beautiful, like management strategy that your body would naturally do and it's not happening.

Scott Benner 44:56
Not only that, but you know you hear about a lot now that you just never heard about before. fatty liver disease. But like, right, so if there's a non alcoholic, fatty liver disease and an alcoholic fatty liver, I'm talking about non alcoholic fatty liver disease that stops your liver from working the way it should. And these medications are seemed to be helping with that as well. So there's a lot of good here that comes from this. And

Jennifer Smith, CDE 45:23
there are Yeah, there are an enormous I mean, I think, I think, again, with standards of care being changed, as they have been, especially with the increase in these types of medications that are being shown to be more beneficial. It's, it's really talking, again, advocating for yourself, if you don't have a practitioner who has brought any of this up, and you're hearing this, and you're doing a little bit of your own research, and you're saying, Well, I don't know why nobody talked to me about this, right? I don't know why we're starting with this. It doesn't I've been doing the things that I've been told to do, along with the medication doesn't seem to be helping, why can't we consider this? Right? And that's when you might need to go to your doctor and bring it up. And maybe you can teach them a little bit of something, right?

Scott Benner 46:21
And for those of you who are gonna say like, well, GLP ones, they're brand new I, you know, I just heard they can't even make them fast enough, because the famous people are using them to lose weight discovery of GLP. One was first identified in the early 80s. So there you go. It's been, that's 43 years ago. Yeah.

Jennifer Smith, CDE 46:40
And what's interesting is that our zoo, we have a healer monster at our zoo, and they actually have the information about the saliva, and that there is now a medication that helps people with diabetes. They don't name the medication, but they just note that from the saliva was formed this medication, which I

Scott Benner 47:01
think is the gentleman's name is Drucker and inductee into the Canadian Medical Hall of Fame and winner of the Canadian gardener international award is most well known for his contributions to the discovery of glucagon like peptide GLP, one and GLB to gut hormones that help control insulin and balanced blood sugars. That's, I mean, it just it makes sense. Like, it really, really makes sense. You know, we have a couple of minutes left. Before we started recording, you told me you have you have type one clients who are using GLP ones.

Jennifer Smith, CDE 47:35
I have, I have one client who had tried trulicity, I have another one, who has had very good success with ozempic.

Scott Benner 47:47
Yeah, so and a reduction in insulin use significant 25% a day

Jennifer Smith, CDE 47:53
a reduction in insulin use, I have to go back to their specific charts to see how much we reduced by but it's it's a fair amount, I mean, the person using ozempic, now for several weeks has come down in insulin use by about 10 units overall, and has lost weight as well, which is very significant. And beneficial. Obviously, when you are an insulin user, we have this, we have this management that we have to do in order to make sure we're using the amount of insulin that keeps our blood sugar in the right place, but that we're not getting an overage that then insulin is a storage hormone that allows our body to store more than we actually are using up. So it's it's a fine balance. And I mean, you know, in terms of these other GLP ones, I think the newer ones, again, are more the way to honestly go especially as I mentioned briefly before with the benefit towards cardiovascular benefit and whatnot. We really want to look at that in type two diabetes because again, many people who are diagnosed with type two have actually had mismanaged blood sugars for a number of years before they're formally diagnosed.

Scott Benner 49:11
And here, Mayo Clinic along with helping to control blood sugar and boost weight loss, GLP ones and SGL two, two inhibitors seem to have other major benefits. Researchers found that some drugs in these groups may lower the risk of heart disease, such as heart failure, stroke, and kidney disease. Kidney Yep, kidney disease. Yeah. So you have your damage being done that you're not aware of type two, because you're slow to be diagnosed. And this isn't going to reverse these problems. Right? But it will,

Jennifer Smith, CDE 49:45
it's not going to reverse them. But in a side note there again, our body is it's a self healing machine. Your body does as much as they possibly can to get over all the damage that you're putting into it or on it right At some point, it can only do so much. So while these meds aren't necessarily healing, what they are doing is with navigating your glucose levels, getting your weight more under control, maybe now you can actually feel good enough to start moving more. That's going to be preventative. And then it allows your body to do some of the self healing that it can. Yeah,

Scott Benner 50:23
if two things are the one, you just said something that really kind of lit me up. Like, I don't think people know how much they're being held down by their health issues. Like I think they get accustomed to feeling tired or weak or whatever. And you just think this is life. And if you can lift that veil, a little, almost like an antidepressant, if you can lift that veil, little you might be able to see up, you know, you might Yeah, and the other thing you talked about about it doesn't, it's not a cure. But you know, think of it this way, if you stand next to the wall and bang your head on the wall, right, and your heads gonna get sore. If you stop banging your head on the wall, your head will stop being sore, it'll end it will go back to the way it used to be tried to think of the sugar as the wall. And instead of it your head, it's your heart or your kidneys or something and you just keep abusing it, it can't rebound. So you gotta give it a shot to rebound. Jenny,

Jennifer Smith, CDE 51:15
that was that's funny that that was actually a really like was a common joke in our house, my dad, we'd go to him with like a complaint like My knee hurts. Well, when does it hurt? Well, when I do this, my dad be like, Well, don't do that anymore. Like it was just it was a joke. Right? But you brought up the exact the exact? Absolutely, yeah,

Scott Benner 51:34
I mean, listen, you said earlier about somebody sticking peanut butter sandwiches in their kid to run off to a thing to run off to a sport, right? Like think about like, when you're four and five, and you're playing soccer or baseball or doing some peewee thing, everyone's reasonably athletic, like they're not all stars, but they can go out and run around and get exercise. And then what happened and

Jennifer Smith, CDE 51:55
their metabolism is much higher than you as an adult, right?

Scott Benner 51:59
And then But then you sit in school for 12 years. And then some of you sit in college for four or 567 years. And all of a sudden you're like, Oh, I gained 20 pounds, I gained 15 pounds. I did this, you know, like your your life changes. So you're eating more like, you know, at the corner kinds of foods. And then you say, Oh, God, I'm 40 pounds heavier than I was in college. I tried and nothing happened.

Jennifer Smith, CDE 52:22
Right? Yeah. Right. I know. And that's like, your head against the wall. It's this it is. And I think in today's society, the I'm not, I don't love medication. Like I try really hard to avoid medicine, I don't have to use like, if I can do something about it, to fix it. I will write even for a headache, like I drink the water. I take a meditate for a little bit. Whatever I try hard. But I think in today's world, some of these meds are they're the best that we can honestly do in order to get around some of the things that you're trying to work on. But you're never gonna get 100% benefit.

Scott Benner 53:10
Yeah. Oh, Jenny froze. This has never happened before. Jenny, you froze for a second? Oh, never gonna get 100%. I did.

Jennifer Smith, CDE 53:18
Oh, that was the first Oh, yeah, you're never gonna get 100% benefit, as you just said, so many things have changed since a kid was being very active. And now as an adult, they look at and they're like, gosh, I used to do all these things. And now I'm 40 4050 pounds heavier. And I'm slow. And I, you know, I can't run the bases around the T ball field with my kid anymore, because I just so that's where these meds, especially from a lot of the protective features that they're proving and research coming along with them. There is a benefit to using them just just remember

Scott Benner 53:53
that hundreds and hundreds of years ago, one of the signs of wealth was being heavy, because it meant you could afford food. And that sort of mindset has just moved in the wrong direction over hundreds of generations. It just has. And I'm sitting here imagining I'm imagining everybody in the world who who can who could and should for health reasons be 3040 50 pounds lighter, right? 2030 4050 pounds lighter, and it's not happening. Like imagine if the whole world used the GLP, one for a year. And we woke up a year from now and everyone in that situations weighed was 15 or 20%. Lower, the world would change and everyone's mind would be rewired. And you wouldn't be like oh I'm going to stop at Wawa and get a pretzel. You'd be like I'm gonna go home and eat my dinner and it right it's just I'm with you on the mat. I wish like I'm sitting here wishing that this wasn't necessary but I yeah situation we're in.

Jennifer Smith, CDE 54:55
It is and I think if we look at it even deeper level Will, Will medications like this if they're used not only for type two, but some of them are being found in terms of just weight loss avenues, right. So if that's the case, we know the stress on our healthcare system already, with a lot of the conditions that we have, that are utilizing a lot of medications that aren't having positive side effects, right. So if meds like this are being brought in and utilize to the extent that it's decreasing, some of the issues, people are coming in with cardiovascular, kidney, whatever, then, at some point, I would like to be able to see that we've decreased the impact on our healthcare system.

Scott Benner 55:49
And there's no reason that things couldn't switch back in a generation or two as well. Like, if every adult right now whose mind is wired to like, stop and grab food and eat this, before I eat that and all that other stuff. If we all rewired our minds, then our kids would grow up in a different situation and a generation from now you could be going in a completely different direction. So here's what I'm gonna say. If you have type two diabetes, or prediabetes, go to a doctor and say I want to use epic or Manjaro. They're not advertisers of the show. As a matter of fact, I don't know insulin, or drug manufacturers ever tried to advertise on the show? I'm not even kidding. Anybody here, right? I'm saying I'm saying this is a fairly simple thing to do. That has a good chance of leading to a benefit for you. I think it's worth a shot.

Jennifer Smith, CDE 56:37
I think the only caveat to it and is very visible, and your doctor may bring it up as well is coverage, right? That it coverage may be a limiting factor, depending on what your in insurance carrier is, or you know, who you're going through for your medical care. So that is it, we talk about all of the highlights and the things and Hey, go and ask about this. It is a certain consideration that you have to make sure that you have coverage because these meds out of pocket are expensive. Yeah,

Scott Benner 57:09
I'm even wondering big picture for the world, if people who have decent coverage that will cover it or can afford it in cash, which I know it sucks extensively expensive and cash like $1,000. But like if your insurance covers it, and it's 25 $50 a month for you or something like that, maybe just the people who can afford it using it, and then the benefit becoming obvious. Maybe then that moves the insurance coverage along and the medical community along and people that are in a position to push and say, Look, we have to cover these things for people look what it's doing. Right?

Jennifer Smith, CDE 57:43
Absolutely. I mean, if they're not having to end result pay for all of these major procedures and things that are very, I mean, I've ever looked at the cost of like a heart procedure not covered. They're enormous. Just I can't even imagine paying for that out of pocket, but add some end result being that somebody now doesn't have to have that done on our whole insurance sort of industry. It's a rock that once it gets rolling the right way, hopefully it does gather the right kind of grasp.

Scott Benner 58:17
They'll just make money on something else is like, hey, we'll do this instead. And it'll actually help you. I honestly think that what people are complaining about now about all the like social media, people using it and everything, I think that's gonna end up being a good thing. You know, I get that it pisses people off, because they're like, oh, there was a shortage of the drug. And there are people who have diabetes that can't get it now. And I mean, I don't know how true that is that that's actually happening, or if it's just a news story. But what I think is that it normalizes it. And I think that's the one thing around weight that we really lack is somebody being willing to stand up in front of a camera and go, Hey, look at me, I weighed 300 pounds, and I'm gonna stick this on my side. And I'm going to come back every week and show you again and watch that person. You know, shrink down is it's

Jennifer Smith, CDE 59:01
sure. I mean, the you know, the one show that I can't remember what is it the biggest loser right? I don't even know if that's still on anymore. But that was kind of what what this is it was a weight loss, lifestyle weight loss, that really did have major turnaround impact. It did. But they had coaches, they were like, stuck in this place with like, you will exercise this much you will eat all this food, you will make these changes, like, you know, people don't have that in their own home, though.

Scott Benner 59:36
Many of those people reverted when they got away from that that situation too, which is hard to keep up with, right? Because there's no that somebody's yelling at you every 20 seconds do this, do that and you're like, Um, how about I just go to work instead? You know, but but it was I thought that show was a great example of like, wow, you could actually extra small size yourself out of like significant.

Jennifer Smith, CDE 59:54
Absolutely. You can but you can also see the work that it takes and when Again, busy life's life that we have now, you can see the work that that takes and what you would have to do with the other things in your life to get it going the right way.

Scott Benner 1:00:12
Well, and I want to say to for weight loss, there's no one saying that you just stick this drug in and you don't do anything like you still need correct, move and do all the things that you're supposed to do, but you're gonna get an incredible boost from it. And I think the last thing that I want to say is, like I just talked about, like watching like weight loss people like be influencers online, I'd love to see somebody with type two, like, forget the shrinking of your body. Like I'd love to see someone with type to stand up with a camera go, Look, I'm going to inject this and watch my a one C go down, watch my variability, get tighter, like watch my health improve over and over again. I think that would be really, really

Jennifer Smith, CDE 1:00:48
would be. Yeah, absolutely. I I agree.

Scott Benner 1:00:51
Absolutely. Johnny, thank you. We've done

Jennifer Smith, CDE 1:00:55
I know we've and we've only really touched like the tip of the mountain of like, you know, there's so many other medications. So I don't know if we'll want to do anything brief later at some point about the other meds because there are other medications and I know that they are still being used. And I think some minimal explanation might be helpful,

Scott Benner 1:01:15
run through them, and we'll go back and hit them again. But tell people what we're going to hit when we do it again.

Jennifer Smith, CDE 1:01:19
Yeah, I mean, we didn't really hit on like the DPP fours. I mean, we commented, but there are the DPP four inhibitors. Let's see the SDLT twos, we didn't really get into talking about them. We did mention them, right. And there's a host of oral combination meds that are often in combination with metformin. I, they work all different kinds of ways. But honestly, the main categories are the DPP, fours, the stLt twos, we've also got some that are, I think, less use. Now, the TZ D is some that I haven't seen used in a really long time. They're called Alpha glucan. Alpha glucosidase inhibitors, if they're like starch blockers, essentially.

Scott Benner 1:02:06
Are these things gonna go by the wayside though, as the these GLP ones become more prevalent? Do you think? Maybe, no,

Jennifer Smith, CDE 1:02:15
maybe? I mean, honestly, in terms of in terms of use, they are still out there. How much use they're getting along with these newer meds? I don't, I don't know. I'd have to look honestly and do some research to be able to tell how much these newer ones are really taking

Scott Benner 1:02:34
over? Yeah. Well, listen, Jenny. I've never seen anyone and Tiktok say, Hey, I took a DPP four and look at me now. Well, that's an indication but you know,

Jennifer Smith, CDE 1:02:46
no, and there they are. I mean, the DPP fours are usually used in some type of combination with other things, too. So they're not just taken alone. But I think definitely, at least the DPP fours in the stLt twos would be good to chat about Yeah, okay. I

Scott Benner 1:03:05
just want to point out that he'll monsters are very dangerous and don't try to kiss wanting to get their saliva. That's all Yes.

Jennifer Smith, CDE 1:03:09
Don't don't have one as a pet, although I'm sure people do have.

Scott Benner 1:03:13
I saw one eat a goat. While I was looking this up online. I was like, oh my god, so just please, I don't know. Yeah, stay away.

Jennifer Smith, CDE 1:03:23
Leave the lizards in the desert. All right, Jamie. Okay, bye.

Scott Benner 1:03:33
Thank you so much for listening today. thank Jenny. Jenny can be reached at integrated diabetes.com. She does great work for people living with diabetes. Check her out. And thanks to Dexcom for sponsoring this episode of The Juicebox Podcast dexcom.com forward slash juice box, check out the G six the g7 Find out if you're eligible for a free 30 day trial of the G six all on my link dexcom.com Ford slash juice box when you click on the links. You're supporting the show. Alright, thanks so much for listening. I really hope you're enjoying the Type Two diabetes Pro Tip series. If you are, please share it with someone who you think might also benefit or enjoy it. I'll be back very soon with another episode of The Juicebox Podcast.

#884 Talking Online

Scott talks too much about the Internet and Erika is delightful.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, welcome to episode 884 of the Juicebox Podcast

Erica Forsythe is back today and she's gonna say talking with me, but this conversation took a turn somewhere and I got very passionate, so I'm not sure how much Erica spoke. Anyway, we're talking about how people speak to each other online and some other online eccentricities. Like complaining about seeing other people wearing CGM or using GLP ones and stuff like that. Anyway, it's a spirited conversation. I invite you to listen. While you're listening. Please remember 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. We're becoming bold with insulin. If you have type one, or the caregiver of type one and a US resident, well, then I need you to go to T one D exchange.org. Forward slash juicebox and complete the survey. That's it t one D exchange.org. Forward slash juicebox. complete the survey. It helps people living with type one, it'll help you it'll help me.

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 podcast is also brought to you by touched by type one now this is a fantastic organization helping people with type one diabetes, it's an org. And they just want you to check out what they're doing. Hit him up on Facebook, Instagram, and of course, at touched by type one.org. I'll be speaking at one of their huge events later this year. Go check it out touched by type one.org. The podcast is also sponsored today by Omni pod. Now Omni pod makes the Omni pod dash and the Omni pod five. So there is a tubeless insulin pump for whatever you desire. The dash puts you in charge, it's completely manual, you make the decisions. But that only pod five, its automated runs off an algorithm with the Dexcom G six. It's going to make a lot of the decisions for you. Check them out Get started today at Omni pod.com forward slash juicebox. There are links to all of the sponsors in the shownotes have the audio player you're listening in right now. And at juicebox podcast.com. But you can always just type them into a browser. Hey, ARCA. How are you?

Erika Forsyth, MFT, LMFT 2:53
I'm doing well. Thanks. Good to see you. Good to be here.

Scott Benner 2:57
I am. I think we'll jump right in because you're on the schedule for today. But we just decided last night what to talk about. I think we're going to kind of commingle two ideas together. I think I don't know where to start. Which Which of the two things do you think we start with?

Erika Forsyth, MFT, LMFT 3:15
Let's start with on you know how to communicate. online. Online. Okay. Yes. All right. effectively and appropriately and compassionately communicate?

Scott Benner 3:31
Yes. I have no training about how to talk to people. I, all I have is that back when blogs weren't a thing, I had a blog. So I was learning to communicate with people I couldn't see. And you can say it's Oh, it's not. It's not that deep. But it kind of is like you have to learn how to talk to people in a way that they can receive it. Right? Like so no matter what you're saying. You're not You're not sugarcoating it, and you're not holding back. But you're saying it in a way that doesn't just light them on fire before you present them with the topic, right. And I'm sure as we're talking, we're going to come up with a lot of examples of that. But I learned how to do that the blog was pretty darn popular. So I'm people must have accepted my writing pretty well. When I went to the podcast, it's the same thing. Like you're I'm talking to a wall most of the time, or I'm talking to a person I don't even see. And you're developing a conversation that people can hear from the outside and not brusque, up against not be like, oh, you know, right. You know, I'm upset by this part of what you said or that part of what you said that's on purpose for me. Like real Scott in real life. Isn't this nice? I don't mean to other people, mainly to my family. I mean, but like, but I don't because I don't think about when I'm interacting in my purse. My life, I don't think about, oh, I want to make sure this is accessible to everybody. I'm more about, like, let me get out my thoughts and my feelings and how this impacts me and that kind of stuff. Anyway, it wasn't really until I launched the Facebook group that I really started seeing it. Some people don't know how to talk. They just don't know how to get their point across without making somebody angry. And there's a difference between doing it on purpose. Like some people run into a thread, and they're like, hey, and then they run out because they want to see the they want to see the fight, right. But that's not often what happens. Often what happens is people just see the world from a very like, me centric perspective. And I don't know if they put much thought into, how is this going to resonate with the person who's hearing it? And then it starts weird fights, that it's interesting where they go. So I want to start with how to talk to people. And there's probably nobody better to ask than you like, how how, and I'm sure this what we're going to talk about is going to be beyond the internet and work in people's real lives as well.

Erika Forsyth, MFT, LMFT 6:15
Yeah, so I think, you know, in grad school, we learn a lot about communication in marriage and family therapy. And oftentimes when people land in my office is around communication. And one of the things that we learn is this image of there's a sender, as when you're communicating with someone, there's the sender, and then there's the receiver of information. And so envisioning yourself, if you are the sender, you are communicating like as if in a letter and you you've written your message, you're sending it in a letter, and you're not always sure how the receiver is going to receive that message. Is, is the receiver of your letter, so to speak. Has anybody had a horrible day? Have they had an incredible morning? Did they have sleep? Have they eaten, right? So you're delivering a message as a sender? Not knowing how it's going to land? And that is often what causes conflict? Yeah. In verbal and you know, in person verbal communication.

Scott Benner 7:18
And I think there's a way I think what some people hear, like, the more I don't know, I don't know what to say, there are gonna be some people that hear that and go, Oh, well, you're just, you're just saying what you don't mean. So it doesn't upset anybody. I'm not talking about that. I'm saying you can get your point across without everybody hating each other, and yelling and screaming and everything just coming up, like, like, octaves up. And I just think that that's I don't know why it's not a consideration. Like, why is it so important for me to say what I think that I don't care how you feel? That's a fascinating aspect of this to me. So I guess on some level, you have to be concerned with your audience, and how they're going to feel.

Erika Forsyth, MFT, LMFT 8:10
Yes, and I agree, I'm not talking about the inauthentic with how you're feeling? Because that you can read through that. So yes, it is we are, we do want to encourage authentic, honest communication. But if you are not thinking about how your messaging is going to land, then it may never land. The point that you're trying to address. Or the point you're trying to make may never land. Well, if you're not thinking about the tone, the audience, how where are you in your emotional spin physical space? Are you tired, hungry, exhausted, stressed?

Scott Benner 8:49
Oh, you have no idea how many people I see start a post, and they're ranting and raving. But there'll be like, you know, at the end of like, I'm sorry, I had a bad day. I'm like, Well, then why are you doing this? Like what is like, if you need to get it out, go scream into a pillow? Why are you screaming on the internet? Like, like, just so they even know, Erica, they know they're like, I already know that my perspective is skewed because I've had a bad day. So I'm just still going to come in here and shut on the floor and light it on fire and watch all of you tried to deal with it. Because Because because that's what happens. That is there are some that everybody's personalities come out. Right. There are people who want to pick apart your point. Take the opposite side, play devil's advocate, there are people who get mad and just launch back with anger. There are some people who are and I'm assuming their parent, their parents were alcoholics. They want very badly to stop the fight. Right, like and so there's like all of that. And all these voices come together. And it's fascinating to watch none of them understand where the other came from. And, and, and it's fascinating to watch each one of them not care how it lands because it goes on both ways. You can see if you step back If you can see what people mean, you just, it's not what they said. And that's interesting, you know, and then when you try to reframe it can sound what's the word I want? You have to be able to try to reframe without insulting them, or making them think that you're going Oh, okay. But have you thought of it this way? Like, that's not the way to go? Obviously, this is going to be all over the place. I'm sorry. Yes. I've seen a lot of this.

Erika Forsyth, MFT, LMFT 10:31
So Well, I think what one of the couple things that are lost in online and we're talking about maybe some of these longer threads right on in the Facebook community, or anywhere online, that's what's lost is you can't pick up the tone necessarily, although sometimes you can. You can't read the other person's facial expression, body language. And so you're, you're posting how you're feeling in the moment. And I think, just like what I would advise in person, if you're, you know, you're coming in hot and bothered and tired, all the things, step away, even right, write that post, write it down, don't click Post yet, take you know, walk away, take some deep breaths, go eat, go take a walk, and then come back and see, reread it. Yeah. And so is that really what I wanted to post

Scott Benner 11:20
because to your point earlier, if you're putting all this effort into saying something to someone, or writing something down, showing it to them, then you must want to get them to a level of your understanding, right, you're trying to impart how you see something. If you're, if you're gonna run it again, if you're gonna run to the room and light the whole thing on fire, no one's gonna take your point. And so if it's really important to you, then deliver it in a way that that will be actionable for them that they can actually stop and go, Oh, that's not a bad idea. You know, like, that does make sense. You can, you can deliver it that way. By the way, these things help you having 504 conversations with your kids schools, like these things help a lot, you know, they're not just for this kind of communication. It's it's every kind of human interaction, where you're just trying to get across how you feel. And I think that's why the fights happen. I think that when you try to say something, and someone else doesn't understand it, there's a level of frustration that comes up inside of you that's difficult to deal with, because you don't feel heard. And then depending on how you grew up, that might hit you really poorly. And then you kind of get lit up like a firecracker a little bit too like not being heard is is a trigger I don't use the word trigger not being heard as a trigger for for many people.

Je voc hypo penne has no visible needle, and is a premixed 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. My daughter has been wearing and using an omni pod tubeless insulin pump since she was four years old. And she's a freshman in college now about to be 19 this summer. So that's a long time, right? I don't want to do the math, but roughly it's over 15 years. And Arden has been wearing a nominee pod every second of every day for the last 15 years. It is a friend in this journey. It is dependable and valuable and easy to use. And it is not a detriment. I mean, it's not in your way. There's no tubing, you can wear it when you swim, you can wear it when you're working out in the shower. You don't have to take it off or anything. It really is absolutely fantastic. Now on the pod has two different versions that you can check into right they have the Omni pod dash if you want to just put your settings in and make all your decisions yourself. Fantastic, fantastic pod. And they have the Omni pod five, the Omni pod five is an algorithm right? It's making decisions about basil. It's making decisions about corrections. It's really something else. It's next level on the pod five or on the five dash whatever you're looking for. If it's tubeless if it's easy, it's on the pod Omni pod.com forward slash juice box you head over there right now and check it out. You may actually be eligible for a free 30 day trial the Omni pod dash you should ask and and see unless you want the Omni pod five and then I wouldn't do the dash trial. But anyway, you know what I'm saying? Omni pod dot com forward slash juice box, get the insulin pump that my daughter has been wearing every day, for 15 years. For full safety risk information and free trial terms and conditions, you can visit omnipod.com forward slash juice box. If you're like me and you like Erica, you can check her out at Erica forsythe.com, or call her at 626-344-2266. Erica is a licensed Marriage and Family Therapist. She's got a brick and mortar store in California, I don't think therapists call their place the store. But she can also help you online. If you're in California, Utah, Oregon or Florida. She is really terrific. She has had type one for 30 years helps a lot of people with type one diabetes, Erica forsyth.com. You know,

Erika Forsyth, MFT, LMFT 15:54
yes. In in, in, in person communication, you're able to do reflective listening and say, I think this is what you're saying? I'm let me let me double check. Or you know, are you saying are you saying it this way? You're saying it that way? And then you have an opportunity to to confirm or disagree? Yeah, right. And then on line, it's a little bit more challenging to communicate that way. But I do see people do that sometimes say, is this what you're trying to say? And that's such a beautiful way to say hey, I'm, I'm reading I hear you I see you is this what you're trying to say? And that can often interrupt, you know, intervene and interrupt the conflict and the spiraling of attacks that happen,

Scott Benner 16:36
though some of those are very good interviewing techniques to, like, my wife will joke she'll say, and I don't know how much she's joking. She'll be like, sometimes I walk past that room. And I think who's that lovely man interviewing that person who seems to be very understanding and want to know more? Because, because that's what I'm doing for an hour, when I'm talking to somebody a guy I'm trying to get how they feel. And when there are times where I'm motivated to tell them how I feel, or to offer up a parable. It's like, hey, well, what about this, you know, but in your regular life, it's difficult. And I, the longer I make this podcast, the better I get at being a real person away from this microphone, because you have to be interested in what the other person is saying. And it can't be judgmental. Like you can't be judging people while they're talking. Because when you do, all that's happening is you're coming up with argumentative responses to while they're talking. They say something like, well, that's wrong. I'll tell you, I know what's right here. I'm gonna say this, it's not a fight, you're not trying to win. You don't I mean, you're you think something, they think something, you all say it, nothing has to change. You know, like, and I think that's one of the one of the misconceptions is that every one of these interactions somehow needs to end with the other person changing their mind. And that's not how things work, you're offering up an idea, it'll get planted in their head as a seed and may or may not grow. And that's all you can do. Like, you know, you can't you can't run around changing people's minds, good information, give them give them your best information and see, you know, if they don't pick some of it up. Makes sense.

Erika Forsyth, MFT, LMFT 18:16
Yes. And it will. And I think that, you know, we're we are passionate, particularly and you know, how we live our lives, the choices we make, how we choose to manage not only diabetes, but our our lifestyles. And if it's working for you, I enjoy it, I see and hear the passion in the comments, right? And you're wondering, this is how it's working for me, and I want you to be able to see it and feel it and live it this way, too. So I think oftentimes, the intent, and the motivation behind some of the stronger comments is because it's, you're passionate, and it's working for you. And you want other people to, you know, quote, see the light. But oftentimes, people aren't ready to hear that. And if you weren't recognizing that, maybe the tone is too strong. It's just gonna land flat. Yeah.

Scott Benner 19:04
And what you lack I'll tell you what, like banking podcast, all I'm doing is sharing how we're managing my daughter's diabetes, right? And I mean, it's gotten bigger than that, but at its core, that's what it is. I don't get I don't hear back from people. Like I say my thing and I go, Alright, listen, here's what I think. You don't need to think it. If you don't, I don't care. You know, like, but here's what I think. You can't do that in a in a face to face or screen to screen conversation because you say something, and then they fire back in. Everyone's always trying to be either you're in a good conversation where everybody's being like, light and supportive, and thoughtful, or you're in a crappy conversation where everyone's trying to win. Get a dig in. You know, be funny. That's the other thing. A lot of you are not as funny as you think you are like me, God bless you. I'm probably not as funny as I think I am but a lot of fun. A lot of you, and so like, but there's levels, there's levels of of that too, like, were that your humor doesn't land, or how hard it is to write sarcasm. You know, there's so many things, but I really do take your point about the passion. Because I think that's at the core of the of any low carb argument I've ever seen in my life is just people are like, I found this thing that really helps me trying to tell you about it. You're not listening, you're killing yourself, I know. And then somebody else will come in and say, Well, I found a way to manage with insulin perfectly fine. And my uncle and yours are exactly the same. And so you don't understand, you're telling me I'm wrong. Nobody wants to be told they're wrong. Nobody wants to be told that they're doing something wrong or thinking about something incorrectly. And there are only certain trusted voices that get away with pointing that stuff out. And for the most part, it's not a thing we can just willy nilly do between strangers or even sometimes? I don't know, even sometimes people you know, really well, I actually think that's harder. I always think about, you know, I grew up watching my son play baseball. And if your kids pitching, and they're struggling, you don't send the father out to talk to them on the mound, you send somebody else, somebody else who doesn't have a lot of history with them. And, you know, isn't quietly angry about something that happened a week and a half ago in the house and stuff like that. So anyway, I don't know. What do you think about all this?

Erika Forsyth, MFT, LMFT 21:32
Well, I think that oftentimes, it might feel easier to express our, our passionate opinion, online. I mean, we talked to our children, our teenagers about, you know, being aware of online bullying and trolling. And I think one of the things that I constantly tell children is, you know, what, would you say this? Would you write this out? What you want to write online? Would you say that in person to that, that, that friend? Would you write that post? Would you write that comment if that person was standing right in front of you. And I think when we're in the heat of the moment, and we're on our phone, and we're wandering around, and we're reading the thread, and we're just want to put our two cents in. I think it's so easy to get caught up in the moment. But just to think, okay, these are a bunch of people I may have never met before. But if they were all standing in my living room, would I be say this, you know, saying when I say this in this way, and that's a hard thing to remember, in the moment, I totally understand.

Scott Benner 22:33
I just got back from a trip where I was gone for like, 11 days, this is like, the one time this year I didn't make the podcast for a week. And other people helped me with the Facebook group more than they usually do. And I wasn't looking at it as much. But I posted before I left, I was like, I'm leaving. I'm going away at my family hold all your crazy inside till I get back, please. Read. And time. In this is such an interesting thing to break down a person made a post, it was a meme about Plan B. And it you know, plan B the pill, like, you know, the the day after, oh, and for the life of me. I don't even know why it was funny. Like, but people told me it was I was like, alright, so I but when they put it up, it's easy to think, Oh, well, this is to stir up the pot, you know, but it wasn't that you really just thought this is funny. And here. And then it was diabetes related. Somehow I forget how. And I saw it go up. Because one of the moderators reported it so I could see it just so I could see it. And now I see it. I'm like, well, this isn't gonna go well. And my first thought is like, how does the poster not know that? How does the person who puts it up not know, at some point, this is going to go poorly, this is going to turn into an abortion conversation online, right? And then, but I always take the fact of like, let them be adult like they can. They're adults, let them do what they want, you know, as long as nobody's mean or blah, blah, blah. But man, it just went exactly like you thought, you know, four out of five people got the got the joke, and they were okay with it and weren't put off by it. And some people took it as an opportunity to say, oh, no, I have feelings about this. I'm going to share them with you now. And then other people come back in and share the opposite side. And then here we go. And the I think two things as the person who runs a large group, I think, how did you not know this was gonna happen? Because I don't think the person had that intention. And my other thing is, this group takes in 300 new members a week. Like, wow, okay, so 4050 people a day come in. I don't want them seeing you ranting and raving about Plan B on day one, because they're going to think that's what this is about. And the truth is, that's not not true at all like that one post is meaningless on a group that size That group gets 110 new posts a day on average. Wow. Okay. And so most people aren't even going to see the stupid posts. But the algorithm sees people going back and forth and says, aha, people care about this and start pushing it towards other people's posts. And now suddenly, in my mind, everyone who's been there knows Scott takes care of this stuff. This bush doesn't go on here. I'm not worried about it. But those new people might think, Oh, where am I? What? What asylum Am I in right now? You know, right? Because I don't think people understand no matter what side of an argument you're on. Yes. Sound crazy.

Erika Forsyth, MFT, LMFT 25:42
And it just, it just feels like that meant that's probably not the place to have that type of conversation. Yeah. But I understand how and why it happens. And, and perhaps, you know, the person who posted it is a quick witted, funny person sarcastic, and thought this would be a funny, you know, response to your posts. And then here we go. But didn't pause to think about how is this going to land? And that's how it does happen. But obviously, not probably ill intent. It don't originally,

Scott Benner 26:11
I'm thinking back now on I think there was like candy, the plan B pill and something else. And the idea was, like, be prepared. And like so I think they thought like the candy like low blood sugars and like they the Okay, yeah. But still, you're just like, oh, dear Lord, like this is like, if you had to write what I thought was, if you had to run this page for a day, you would never do that. And not because I don't want the place to be fun or free, free minded. I absolutely, you should see this stuff i i Don't get involved in because I really do think people are adults, and they should do what they want. But like, I don't know, like, when you go back to a regular conversation, that big kind of blown up idea. It's the same thing when you're talking to your sister, and you're trying to get something across, it's not a good place to bring up something that happened 10 years ago, unless you're trying to be in an argument with your sister, right? And in that case, I say just be more honest, just look at her and go, I'm so mad at you for the thing that happened 10 years ago, let's talk because that might actually get you somewhere. I don't know. I don't understand why. You know, I keep hearing it broken down as people are, like, tribal or on teams. And I don't even think it's that. Like, I just think that people have a collection of thoughts. And they defend them, like very vociferously, like they defend their thoughts, because I think they think their thoughts are them. But your thoughts, like your ideas about? I don't know, politics, that's not really who you are. That's your thoughts about politics. And I think it gets commingled and then you feel like you're defending yourself all the sudden, you know,

Erika Forsyth, MFT, LMFT 27:58
yes, and, and I hear people who respond there, when there's been other, you know, controversial topics that have come up within the Facebook group. And people can say, well, you can choose not to read them or not to participate. Turn off your phone, you know, and I think those are all if you are finding that you are reading some of the posts and having a visceral response or, you know, feeling offended, check in with yourself of how you're feeling and is it appropriate to respond back? Online? Do you need to go take care of yourself in another way? And just to be mindful of that, like, maybe you're feeling your your it is does feel personal? And and maybe you need to process that. And it might not be the best way to process it online. But again, those are I know, these are really hard steps to take. It's kind of your automatic thought and action is to respond back,

Scott Benner 28:49
right? Yeah, this just might not be a setting that's right for you in this moment. And I mean, from the outside, I swear I'm trying to have this conversation because there's two reactions. There's the like, flippant, like, human reaction, like Just leave if you don't like if it bothers you, but you're not putting yourself in their position, where they're like, you've now just let off every synopsis in the wrong word, like you're firing their brain up, you're like, Oh, my God, this is promoting something that I think is wholly wrong. Or, you know, I have to say something now I'm now I'm the defender of everyone who they imagine is going to see it. And even that's a funny thing about the internet. Everyone's not seeing what you think they're seeing. There was this thing years ago, when the diabetes space moved into Twitter at first, I think it's been long enough now I can make fun of people for this. So there were diabetes, people that got on Twitter, and they would have these like, like interactions online. Then later, they would report back. My tweet got 1.3 million impressions. And I'm like, why? 1.3 million people read your tweet, you've got 2000 followers, what are we talking about? You know, and then you realize that they take the 2000 number, I have 2000 followers. And each one of those followers has the amount of followers they have. So we'll assume that their followers saw it, too. So my tweet could have been seen by 1.3 million people. And then they'd run around espousing that that was the reach. And I think people believe that. Now I as a person who puts content in the world can tell you that if it was that easy to reach 1.3 million people, I'd be sitting on a gold chair in a gold room right now. And I am not, okay. So it's not that easy to reach people, you are not talking to as many people as you think you are. And when you post something that gets 100 likes on it, I want you to know, 100 is a very small number. There are billions of people on the planet, you in your in a group with 40,000 people, and you got confirmation from 100 of them, you have statistically reached none of them. And but people have this feeling online, like my voice is carrying. And I'm impacting people, and I don't think people realize they're not they're not, I have a huge reach online, and I am not impacting as many people as you think I am. So you on your private Facebook group, we're talking to yourself and your old neighbor, some guy from high school. So good luck.

Erika Forsyth, MFT, LMFT 31:35
Yeah, I feel like if, if that maybe people do find, you know, we know that people find value in numbers. And are they impart that they're valuable based on how many likes how many repos? How many shares? And if that is where you find value, that's okay. But also, conversely, you are valuable, I would say, you notice that you're valuable, even without all of those likes, and perhaps maybe kind of reevaluate. Why, what are you saying and why? And what are you getting out of it?

Scott Benner 32:16
Yeah, I don't mean to say that they're wrong. I mean, by say that they're not changing the world the way they think they are. We have a whole generation of kids who think they're advocates, because they have an Instagram, like, You're not helping anyone get nice try, like, like your your post that reached 500 people is not going to change a company. I know you think it's going to it isn't going to, but it doesn't mean your thoughts are wrong, or that you shouldn't live your life that way. Teach your children that way. Speak to people that way, where that are that what you're saying is not incredibly valuable? Like you're just I mean, think of all the good things in the world that we can all agree with. Clean water is a great example, right? We all know that. Okay. How come it doesn't happen? I mean, you all have an Instagram, have you not said something about it? How come how come the people in Flint, Michigan aren't swimming and great? Well, it's because that's not how this works. And, but people get stuck in the idea, especially now that social media is in everybody's hand that like I have real power here. And you just you do your power within your own life, you know, and you can I hate to say this, like, act locally, and maybe that will grow. But I don't know, you're not. There was that one moment in social media, where you could scare a company in two seconds. You could have a bad a bad vacation or something. And you could get on Twitter and go, Hey, you guys, you know, baba, baba, bah. And the company would literally like find you and call you and be like, we're so sorry. If you take that tweet down. We will be like this. Now nobody even they don't even do that anymore. Like, I don't know how to tell you like most companies. The way most companies handle, people who are upset with them online is just ignored away. They don't really do anything about it. And how was that? How was that what happens? That's what happens because what they learned is your tweet, your Facebook thing, your Instagram thing, it really doesn't. It doesn't hit hard enough to make a problem for them.

Erika Forsyth, MFT, LMFT 34:19
So the ripple effect isn't as significant as you think it is.

Scott Benner 34:23
And so while you're busy online, or in your own family ranting and raving about something, you've really just kind of solid the relationship you have with these very Pete these close people who are with these 50 people who saw your post or the seven or eight people in a room with you. You're not You're not doing what you think you're doing. But you could be and that's what we talked about earlier. You absolutely could be impacting people differently if you found a better way to deliver what you were saying. And I just I hope people think about that, like the delivery person, you know,

Erika Forsyth, MFT, LMFT 34:58
and I think in that day livery. And I see people do this in the threads as well is remind if it gets kind of out of hand and out of control. Someone will come in, you know, either the peacemaker or the reminder of like, well, let's go back to the topic. That's the the first post, because it's really easy to get caught up in the discussion. And it's law, you know, the very first point or question or comment is lost. And so that would be maybe something helpful to do as well. If you're wanting to engage in a conversation or comment, go back to the original post to see, you know, what, what was this person asking? And I think we've talked about this before, as well as when you are the first poster in a comment. Or asking for to be very clear with what you're needing as well, because sometimes it is venting, sometimes it is seeking, you know, clarification or seeking questions. And you can even lead with that, like, just looking for some validation, or really looking for some new ideas on how to treat lows in this specific area of my child's life. You know,

Scott Benner 36:06
it's all very doable as well, like, you have to be patient and listen, take it from me. I, my Facebook group is one of the largest groups for diabetes in Facebook, and it is it easily one of the most active if not the most active one. And it's also what most people describe as a nice situation to be yes, I did that on purpose. I built that that way on purpose. And then I introduced other things, I have blended together, people who eat all different kinds of ways. In one diabetes Facebook group, not seen anywhere else. There's low carb, there's vegetarian face diet, but not me. I'm like you got diabetes, forget type one or type two, you come on in here, I don't give a crap how you eat, you're allowed to talk in here. I brought type twos together with type ones. And nobody's done that. I've been around this space for 20 years, you people wouldn't say type one and type two diabetes in the same sentence level in the same paragraph. Because what what were they afraid of? Type ones would say, Well, I don't want to be categorized as type two, because those people did it to themselves, which isn't even true. And yeah, and then. And then the type twos would be like, Well, I don't want to be about them. They use insulin, they're really sick. That's the bad kind. The like, then they started using words like the bad kind of diabetes for this one. Like, in sadly the worst kind. Yeah, that was prevalent, and still is not my space. Because I set it up not to be that way I set expectations. People follow those expectations. When people fall outside of the line of them. I don't ban their account. I don't like I write in public. I respond back, I don't DM anybody, you try to DM me, you're not hearing back from me. I'm not getting involved in your crazy yelling and screaming. But online, I'll say listen, here's here's what I'm seeing. You seem like you are very passionate about this. And I think this might be why is that right? And but can you also see that this person seems very passionate about it, too. And I think they have their own reasons. And you guys can share information with each other without yelling at each other without telling each other, you're wrong. Because you're both right. And this conversation is important that people come by and say what are you going to delete it, not going to delete it, it's valuable. And the other thing you don't realize is that the 10 or 20, or 50, people that are commenting in a post are again, the very small minority of people who are actually seeing it. And most people, it's sort of like talking about politics. We focus on the right and the left, and we ignore everybody in the middle who basically agrees. And that happens online to like the people who you know, not don't think of it just right and left but from, you know, polar opposite perspectives. And mostly everybody's like, Oh, that lady makes a good point. But she's a little weird. And that guy makes a good point. But I don't like the way he said it. And by the way, that's also very much something I've noticed too is that men can be taken as harsh when they're not being harsh. And I'm I'm, I used to be a current I used to communicate and current language, but not current embed just short and factual and to the point, and you can read it as it and guess what I did? And how rude. Yeah, guess what I did? I stopped writing like that. Because I wanted people to hear what I was saying. I knew I didn't mean anything bad by it. And there'd be other men that would come in and say no, you're misunderstanding. He's saying this. And they like Well, that's not how it makes me feel. And I'll tell you, that's a frustrating thing to hear. than to hear that you've said something in a very to you is a very clear and concise way. But then another person heard it and it made them up said, I'm upset by that, like, oh my god, I made you upset. Like, I'm just trying to, like lay this out factually, and get out of here because I don't have a lot of time to sit and like, I'm the I'm the guy making the pocket. I'm kind of busy. And it's like, so like, I'm trying to come in and say a thing. And I don't, I don't know, like, so what I learned was, I'm not writing to communicate exactly what I think when my brain says the words, I'm writing to communicate what I feel, and what I'm trying to impart and the bigger picture, it just you turn into a teacher, when you're, when you're communicating that way, I guess.

Erika Forsyth, MFT, LMFT 40:35
And over time, you have learned in practice that right you have developed that skill, it's it is it is a skill to communicate authentically, to a broader audience who can understand what you're saying and receive it, it is a learned skill,

Scott Benner 40:50
it took me a long time to build up to where it is, and I'm not, I'm still not great, like amazing at it. But I'm much much better at the when I started. It also like you probably seem like once or twice a year, somebody will get out of hand, I get angry about certain things I don't like companies selling their crap to people. And that kind of stuff. And people trying to slip in and slip in links to things and if I get upset about that, and I will like be more authoritative when I come back. But I'm between you, me and everybody who's listening. That's the razor's edge of my anger. Like, if I let my whole anger out, you'd be like, Oh, my God. And I'm articulate and know how to write and how to communicate, like I could be. I could be piercing if I wanted to be like, I could knock you over out of your chair, if I wanted to be, I don't want to do that. If that's not my intention, or my desire, or my thought, but I don't know that intention, desire and thought gets involved, when people are arguing, I think they just reached down as far into their bag of horrors, they can pull out a handful of it and throw it forward. And I guess that's a different consideration, right? Like, when you when you aren't actually interested in communicating, you actually are interested in hurting somebody when you see that, just ignore it. And yeah, I'll tell you to, from from, from a lot of experience, those people, they come around eventually, some of them but most of them disappear before they come around. And just just telling your Facebook feed, like I don't want to see from that person might be a good idea. You know, yeah, so

Erika Forsyth, MFT, LMFT 42:29
you can set obviously emotional and physical boundaries around people in your life like that, and and on mine. And I will say, you know, conversely, going back to the point the community that you have created, from when I do read lots of threads. The majority are kind and supportive. Yeah. And and, and will advocate an intervene when it feels like things are spiraling, you know, other other members.

Scott Benner 42:55
Oh, I see them. I'm like, Yeah, manage the threads

Erika Forsyth, MFT, LMFT 42:59
self managed. Exactly. And I think that's why it has been such a success. And when people do feel safe, and supported and go there for support, ideas, interventions,

Scott Benner 43:11
I wouldn't want to give the impression that it's like, it's like the Wild West, like, I mean, I don't know the exact number. But overwhelmingly, 99.9% of that group is just lovely people helping each other. But every once in a while someone's like, Hey, you shouldn't eat this. And I'm like, Ah, and even that I've quelled. It took me two years to get out the like, we do not tell people how to eat, when, like, if you do not tell people how to eat in this group, it took me two years, and I'm telling you, it's good now, like we've fixed it, like it's, it runs smoothly.

Erika Forsyth, MFT, LMFT 43:47
It's been it's been normalized that, you know, you can eat the way you want to eat, but you don't have to, you know, inform and advocate others to do to say, Yeah, you

Scott Benner 43:55
don't have to, and by the way, because there's no good way to do it. Like, what are you gonna say to somebody you don't think they know, you know, your genius is gonna, like turn the light on over their head. They know, they got a hand in the burrito bag, they're upset with themselves, they already know. They're like, I shouldn't be doing this. And here, it isn't happening anyway, you coming along and telling them how you went low carb and look at me and pulling up your shirt and showing your abs and stuff like that, hey, helping anybody. I've also changed the flow of how people think about succeed, about celebrating successes with their diabetes. That used to be a very frowned upon thing in the group. I've always maintained that people's success should act as hope and guidance, and that you need them to come up and say, hey, look what I did. I used to be a seven and a half. I'm a 5.2. Now, I think you should see that and think I might be able to do that too. I don't just think you should think that I offer you episodes to listen to so that you can go try to accomplish that on your own. And I don't know how many people who would have have accepted unhealthy lives are now living better because of that. And that is the thing that the diabetes community in general stood firmly behind not doing for years. Never tell people if you're doing well, don't show them a good graph, don't show them a good number, you're gonna make them feel bad. And I thought, why can't we make them feel hopeful?

Erika Forsyth, MFT, LMFT 45:22
So yes, I want I love that reframe so that if you are listening to this now, and you're seeing somebody say, my agency went from, you know, a nine to a six, or whatever it is, that if you see that and feel either ashamed, or hopeless, that's also feedback to say, what do you need to do? Do you need help managing the diabetes, you need help with your thoughts and emotions and how you're seeing that data. But that is the motivation behind sharing that is hope and not to shame.

Scott Benner 45:56
That's why I asked people to, to leave reviews of the podcast, because then I can use them in social media. Like when you come along, you say, I'm 53 years old, I've had diabetes for 25 years. And I started listening this podcast last year. And this this and this has happened now. That's amazing. Like, I'm reading a note right before you and I got on from a type two, who was like, Thank you for making this type two Pro Tip series. I've been up all night listening to this. And you have exactly encapsulated how I feel and all the guilt and the shame that I have from this. And I'm going to do about it like that kind of stuff. Like that's big stuff. And, but you'll notice I didn't do it by getting online and going who rose the boat, you roll a boat, go for a run. You're on? Yeah, like I noticed this the other day, I just time or am I going to take you? Yes. Okay, now we're good. We're good. Okay. It occurred to me the other day, in the last five or six years, podcasts from very healthy fit, often, like military guys have become incredibly popular, like they are very, very popular. And I am not saying by any stretch of the imagination that exercising is not what you should be doing. We should all be exercising, and probably a lot of us more than we are. My point is, with the popularity of all this stuff. How come I don't see people getting thinner? Why don't I see people healthier? Why am I see more guys running around 10 miles a day? Like, yes, it's interesting to listen to. And it might feel very motivational. But if a year and a half later, you still have 30 pounds to lose, then the guy screaming and yelling at you and the podcast didn't help you made you feel better for a little while, because you're like, Oh, I'm gonna do this. Except he can do it because it's his job. And you work at IBM, and you're sitting on your ass for nine hours. And you can't go outside at four in the morning and go for a 20 mile run. Right, like so. I understand why they're popular. But I don't know why we don't stop back and look and go. Yeah, but they're not really helping that many people. And, or else, I mean, that popularity should have shifted into mass change. And it didn't, they're reaching millions of people. And yet every time I turn on the TV, that's not the case of what's going on, right? I've always taken that perspective with the podcast, which is it needs to help you not like that was one of my first founding thoughts about this. Like when I was writing a blog, I was like, it doesn't matter. Like, like, Yes, I can write a blog post and say, hey, my daughter's blood sugar was low tomorrow morning. And that sucked. And here's how I feel. And then other people see that and they go, Oh, that happens to me too. And I know there's value in that, like I absolutely do. But I just kept thinking like, Wouldn't it be better if you weren't low at 2am? Like, why don't we get to that part? Why don't we start talking to people about how to actually not what they should be doing, or what the right thing to do would be, but a thing that would actually move them towards a better place. And that maybe they could then make their own motivation and their own. Force that in so you don't need somebody yelling at you to get up at? I don't know,

Erika Forsyth, MFT, LMFT 49:03
do whatever. And that might work for some people, but not most. Yeah.

Scott Benner 49:06
And listen, I'm not I am also saying I'm sure it's helped some people and God bless. Terrific. But you know, I know me. And like and, and I think that there's a way again, you're not just getting on and saying do this. Like here I am again today to tell you these are the right things. If you do these things, you'll be okay blah, blah, I tell a story, this the story of this lady and how it happened to her. And here's the guy that happened him and a little kid and a mom and a 50 year old and a 14 until you can hear so many stories that you think I could be one of those people. I probably have one of those people like what is this? They're doing that I'm not doing this so my my point again about talking to people is communication is not for telling people how to think communication is for sharing things, and then you hope that people take something from it. Whether it's in a one on one conversation guy with a podcast or a Facebook group, any people I got this all figured out if you just listen to me, you'd be okay.

Unknown Speaker 50:13
You got all the tools? Sure.

Scott Benner 50:15
It's just about how you talk to people. Now, if we have time, I'm going to transition into something else. Okay, it's gonna come right out and say it. Okay, all y'all who seem to get off online saying, I met people using a CGM who don't have diabetes, or you can't use a GLP. One to lose weight, because it's a type two medication, and then you get all upset about it. I gotta say, you should stop. You know, like, it's just, it doesn't make any sense to me at all. If if a person needs to lose weight, and they need a medication to lose weight, and it makes their life better, what do you care if somebody wants to see their blood sugar so that they know the impact that grapes are having on them so that they can talk themselves into not eating grapes anymore? What do you care? Like? Like, I know, everybody's like, well, there'll be a shortage, like, stop it. There's not going to be a shortage. Pharma companies know how to make stuff that makes them money. There'll be okay, okay, maybe there was a moment where, you know, GLP TLP ones came became like, you know, in the Tiktok world and stuff like that, and the company got caught off guard, they're not gonna get caught off guard again, they want to sell the drug to people who need it, that's their business. There's not going to be a shortage, there's not going to be a shortage of insulin, there's not going to be a shortage of Dex coms or li braze. Because Dex calm and Abbott sell CGM. And if you want to buy more CGM, they want to sell you more. Okay, like, like, there might be a moment where there's an ebb or a flow but but if you've been listening to this podcast for years, the CEO of Dexcom has been on here saying like, we want to, we started with type ones. And then we want to get Medicare and Medicaid because that's a pathway to insurance understanding what it does for people. And then once they understand what it does for people, we want to get it for type twos. And then they're going to want to pre diabetes. And then guess what, now you help eliminate this illness for so many people. Like why would you get online and rant and rave at somebody? Because they have a CGM? Is it because you can't afford it?

Erika Forsyth, MFT, LMFT 52:25
They I feel like most of the time is maybe fear, fear of what scares not scarcity of this of the product, which, you know, that was there for a little bit for one of the drugs. But I do agree that these companies want to make money and so they will figure out a way to prevent that from happening again. But I think it's often fear when we lash out and criticize other people's choices. It's often because we are we're scared. We're not we're not certain of how their actions are. They're going to affect me personally down the line. And, and maybe you really have a personal opinion and feel like that's it's the use is an improper or ineffective. But I'm not sure going back to you know, is is online communication, the best forum for that probably probably not

Scott Benner 53:23
also, you scare people into stopping, saying saying their story. Like, I think, you know, we just Jenny and I just recorded a type two episode this morning about GLP ones and other medications you will use for type two. And I said, I get why people are like, I hear you. I know that some people have like a famine mentality. And they think, oh my god, it's going to be gone. Like I mean, one of the most popular conversations online is like, what, what, what if the zombies come? Where am I getting insulin from? You're not. But but the zombies aren't coming? You're okay. You know, they're gonna keep making it. And so I said to Jenny, I'm behind people getting on tick tock and saying, like, hey, look, I stuck this thing in my leg. And I started doing it last year, and I'm 70 pounds lighter, and my life is better and I am healthier, because then other people who feel stigmatized will go Alright, well, that lady put a video up of herself. I would never have let somebody see me like this. But look at her now. Like, this is terrific. You know, like, I think I may have come out and said, I think everybody that needs to lose 40 pounds to get this drug like imagine where the world would be a year from now. If everybody who had 40 pounds to lose had lost it and felt better about themselves and was healthier and didn't need heart

Erika Forsyth, MFT, LMFT 54:41
replaced on the side.

Scott Benner 54:43
Yeah, I mean, just forget financially. How about happiness? What if those people all their hunger was all satiated for whatever reason? Like yeah, maybe some of them had crap parents and maybe some of their brains just tell them to eat like anywhere in between. But if if an entire generation shouldn't people could let that go, then their kids would grow up with a better understanding of how to fuel their bodies, then maybe this wouldn't. So stop being so scared of everything all the time. And I said, I hope type twos start jumping up and going, Hey, here's my mom, Jericho or my ozempic. And instead of showing me their weight loss, show me your a one C coming down and your stability happening and like, you know, back to your life and that kind of stuff. Like, I don't think hiding, we're forcing people to stop talking is the right way to do this. And you don't know what's gonna happen, or what good might come from some personal trainer wearing a CGM, or, you know, my brother wearing it or because he's got type two and, and in his doctor says, Well, you know, it's not covered for this yet, or like, your insurance won't cover it or something like that, like, you want to normalize this stuff to help people you have no idea what good places it might go. And instead, it's right back to I'm the whole set. I'm the world. I'm the center of this conversation. There's a person who has the thing I don't have, it's not fair. It's not right. And I need it, and therefore they shouldn't have it. Those two things are not connected to each other, like, like your lack of financial ability, or the deficit you have with your health insurance, if you have health insurance, or that you don't have health insurance or whatever. It doesn't have anything to do with that person. It's not like if they don't buy it, the company is gonna mail it to you for free. That's not happening. I get the feeling. I understand the anger. I understand the I understand all of it.

Erika Forsyth, MFT, LMFT 56:40
And the pain, right like I want that, but I can't afford it. I want that for my whole family to experience CGM. But how do we do that mean? It's they're experiencing pain, right? In those moments

Scott Benner 56:51
percent. It's, it's a hard like, and I'm not, I'm not saying it's not. I'm saying going online and railing against that person. They're not going to stop using the CGM or the GLP. One or whatever you think whatever you're yelling about. They're just going to stop talking about it. And then, and then imagine, I guess, imagine if I didn't start telling people how we manage my daughter's blood sugars. Like they're like, do that. Okay. Okay. Imagine that I, which, by the way, happened to me, but I pushed through it. Imagine I started speaking up about how we managed Arden's insulin. And someone was to have said to me, maybe this is a direct quote, you can't tell people how you manage your daughter's insulin because it's dangerous. And I went, I don't agree with you shut up. And then I didn't listen to that person. But what if I did? What if I just went Oh, yeah, okay. The show's got over 11 million downloads. now. It's getting a half a million a month. Right? Like, it's touching places, like you just can't imagine. And it's and the notes come constantly about my agency, my variability, back to running, I had a baby, if any idea how many people call me to tell me, I am the reason they had a baby. I don't get any of America, but they call me okay. And I'm just saying, like, don't stop some middle aged person on Tiktok, from showing you how their weight loss is going. Because it really you don't know where this is going to go. And I don't see why it's a bad thing. Like, listen, I told Jenny, I'll say to you, too. I understand the diet, you know, fueling better fueling exercise, like this is the key. But I don't know how long a person's got to live, where that's not helping. And then, and then society ends up telling you, oh, they're their last cause. And so we write them off, and we'll just get the next generation. But that doesn't happen. Because now I'm hearing that kids are getting type two diabetes. And you know, and obesity in children is going up. It's it's a weird thing to look at people like products coming off an assembly line and going oh, that one didn't work. Throw it away. The next one will be Oh, no, that one's worse. Throw it away. No one ever goes back and looks at the assembly line. They're just they're just like, oh, yeah, just keep throwing, we'll keep the good ones. Get rid of the bad ones. Keep the good ones get rid of the bad ones. There are people for Christ's sake there. You know, I mean, they're not they're not Cadbury eggs, like they're, they're people. Just you know, by the way, you could still eat a Cadbury egg if it had like a split out of it, but and I don't know that people see it that way. But I do. You yell and scream at somebody shouldn't be wearing a CGM. You are silencing them, and you are stopping a potential benefit from coming for other people. And maybe, and this would be terrible. Maybe you shame them out of using it. And that would be horrible. So I understand why you feel that way. But I mean, from my perspective, you sound you said On silly when you're saying it, you just do you know, the your argument is not the argument. If you can't afford it, that's an argument. Should it be cheaper? That's an argument. Yeah. Should insurance companies cover it? That's an argument. Other people shouldn't get it that I don't understand, like, so. I don't know. Maybe there's a reason I don't get but I just think, shine a light on everything and let the good stuff rise to the top. And let's see what happens. I'm sorry. I thought Wait.

Erika Forsyth, MFT, LMFT 1:00:27
Yes. No, I Well, I think it just Yeah, going back to why why do we make comments about certain things, going back to just the beginning of either we're passionate, we want to convince others about our opinion. We feel threatened or scared or excited. And we want to share, and I think just constantly trying to apply that, you know, the filter or the lens of how is this going to land with the viewer or the reader? And just try to check yourself again? No, it's just just check yourself sounds so easy. But just constantly applying the filter. And I think we can, it'll be in even, it's already a safe place, the community, the Facebook community that you've created, but it could be even safer during that practice, which I think would be awesome.

Scott Benner 1:01:17
Well, that's terrific. And while I'm busy saying things that people aren't gonna like, let me just add this. When you argue that they have type two, and I have type one, we're not the same and they can't be here. That sounds the same to me. It sounds it sounds absolutely ridiculous to me, I've had that said to me, I've received emails and said, I see you're doing type two content. Stop it. You keep this podcast type one. I don't know what that means. Like, uh, you know, meanwhile, a lady with type two wrote me the other day and said, You know, I asked for a C peptide test. And the doctor said, I don't understand like, what's, how would your management change? If you're using insulin? We think your type two which you're using is on how would your management change? If you knew you were type one. And that person said, well, then I would think it wasn't my fault. And I and so I see, I see that. But at the same time, type two type one, it's still not your fault. Like we can dig into it. But foods been going wrong for about seven decades now. And we and we've been pushed into more processed higher carb, higher sugar stuff that tells your brain you're hungry, you're hungry, you're hungry. And then somebody ends up with insulin resistance and pre diabetes. When we go, oh, they did it themselves. You're out of your mind. Like, like, everybody who talks like that is foolish. That's there's five people who actually have to go out and buy spinach and make it with a half a piece of chicken and don't put any oil on it, and then go for a 10 mile run and the rest of you are foolish. Okay, like so. That's that. And I, again, I think it's one of those like, Well, they did it to themselves. It's not about them. It's about you not wanting to wonder how it happened to you. Right? Like, I'm, I don't see a difference between that argument. And when somebody tried to tell me 10 years ago, that Hurricane Katrina, people who were trapped by Hurricane Katrina, they just didn't work hard enough. And that's why they couldn't get away from it. I'm like, You're out of your mind. Like, you don't understand generational poverty, if you're talking like that. That's right. Yeah. And so anyway, I feel

Erika Forsyth, MFT, LMFT 1:03:32
like that that's, we could talk about this, you know, the topic between type one and type two, and the shame involved in that and how, you know, even 32 years ago, when I was almost 33, when I was diagnosed, it was very, it was juvenile versus adult onset. And then it became more type one and type two. And even in my generation as a little girl, I remember being told, Well, you don't you don't have type to this and then that became my narrative like, oh, that's type one. It's not the kind that I brought on myself. But that that line and I still do hear that because there's either if there's fear, there's shame. But that doesn't help either community have type one or type two right in that mindset, and that neither group or subset within the type one let's talk about the lotta you know, there's so many different groups within the diabetes umbrella that none of us want it and there and we still don't really even know why we all have it, but no one did it to themselves.

Scott Benner 1:04:34
I tend to that I say, the people you got to think bigger, like, like you really you got to think bigger, like stop looking at things. So like micro like, Oh, this is this and I got the bad and you got the good like, that's crazy. Like, you know, type ones. There are some type ones who are starting to use those GLP one medications, and they're helping them and Jenny told me about somebody who's Using 10 units a day less insulin on a GLP one and insulin it so they're looping with a GLP. One, okay? And 10 almost like 15 or 20% of their daily insulin has gone down. And, and they're losing weight. And and by the way, that drug was for type twos. So say thank you like, like, like what do I always say when people give me crap on it I'm like I would prefer if you just said thank you and went away. But this is fun too. But, you know you My point is, you don't know what's going to come up with these things. And they might end up helping you. And I'll tell you right now if it becomes the common practice, that type ones do a once a week injection and insulin, there a one sees are all magically in the fives and they're eat more of the foods they want. And they're not gaining weight and blah, blah, because they're not eating a ton of stuff for Lowe's all the time to correct Yeah. Oh, my goodness, well, then I want am I going to hear a bunch of apologies? I don't think so.

Unknown Speaker 1:06:05
That all sounds pretty amazing. Is the lady

Scott Benner 1:06:07
wrote me going? Don't let these type twos in here. Is she gonna go? Oh, my fault, like no, like, so. You sound silly, is what I'm saying. Like just just just in a sentence. Just want for everybody else, what you want for yourself. That's all just want everybody to be okay, or better or happy or whatever is going to do it for them. And why don't they? Why do you care how they get to it? That's the part I don't understand. Like, just Why do you have an opinion about this? And not for nothing. You can take that sentence and apply it to basically everything that people argue about. And you'd be okay. Everybody's gonna have a reason. Like, oh, I'm defending this, or I'm defending that, or God told me or whatever the hell they're gonna say. But in the end. It's not you like it's not your life? Just, you know? I don't know. Let it be. It's a good song. You should go listen to it. I mean, my God. All right. What did I not do say? What'd I do? Wrong guy told me now?

Erika Forsyth, MFT, LMFT 1:07:14
No, I think I think we covered it. I think in essence, I think our goal was to Yeah, just want one everyone to get along. Just you know, I think communicate effectively, communicate authentically and communicate with compassion. And, and living that way, you'll feel better about yourself too, and the way you communicate with others.

Scott Benner 1:07:39
And I'll tell you to not having a victim mentality is pretty helpful too. Because often the conversation you find yourself in is as much you're doing as it is someone else's. And instead of saying this person did this, or they said that or they made me upset, you might want to look at why that is. Because there are plenty of people who can hear things and go on without, you know, without crumbling and screaming and everything else and it's not always someone else's fault. Like I'm not saying you can't run into somebody who's an absolute prick, and like, just be like, Wow, what the hell, you know, but we've gotten to the point now where people are like you did this to me like, I don't know. Like, come on. Anyway, this will be fun. I can't wait to lose a bunch listeners over this one. Thank you.

Erika Forsyth, MFT, LMFT 1:08:24
All right, bye bye.

Scott Benner 1:08:31
A huge thank you to one of today's sponsors, G voc glucagon, find out more about Chico Capo pen at G voc glucagon.com. Forward slash juicebox you spell that GVOKEGLUC AG o n.com. Forward slash juicebox. Also want to thank Omni pod and remind you that you can learn all about it and get started at Omni pod.com forward slash juice box check out the dash checkout the Omni pod five Omni pod.com forward slash juice box. And of course Erica is that Erica forsythe.com. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.