Scott Benner 10/29/24 Scott Benner 10/29/24

#1344 Screen For Type 1 with Dr. Blevins

Dr. Blevins discusses the importance of screening for type 1 diabetes.

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Scott Benner 0:00
Welcome back, friends. You are listening to the Juicebox Podcast.

Dr Blevins has been on the podcast a couple of times. He's talked about GLP medications, inhaled insulin, and today, he's going to share with us the importance of testing for type one diabetes. Please don't forget that nothing you hear on the Juicebox Podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your health care plan or becoming bold with insulin. Are you an adult living with type one where the caregiver of someone who is and a US resident, if you are, I'd love it if you would go to T 1d exchange.org/juicebox and take the survey. When you complete that survey, your answers are used to move type one diabetes research of all kinds. So if you'd like to help with type one research, but don't have time to go to a doctor or an investigation and you want to do something right there from your sofa, this is the way t 1d exchange.org/juice, box. It should not take you more than about 10 minutes. If you're looking for community around type one diabetes, check out the juice box podcast, private, Facebook group, Juicebox Podcast, type one diabetes.

This show is sponsored today by the glucagon that my daughter carries, gevok hypopin. Find out more at gvoke glucagon.com forward slash juice box. This episode of the juice box podcast is sponsored by the Dexcom g7 the same CGM that my daughter wears. Check it out now at dexcom.com/juice box. This episode of the juice box podcast is sponsored by us Med, us, med.com/juice, box. Or call 888-721-1514, get your supplies the same way we do from us. Med, all right. Dr Blevins, welcome back. I appreciate you coming back on the show again. How have you been? Hey,

Dr. Blevins 2:13
good Scott. It's good to be here. I've been I've been doing well, excellent,

Scott Benner 2:16
excellent. I asked you back today and you were interested in talking about screening for type one diabetes, which is kind of all the rage at the moment, and I was hoping that you could help me to understand why it's so important.

Dr. Blevins 2:29
Yeah, be happy to I think it's a really big deal that people start really moving toward the screening, because there's some really good reasons for it, and the reasons are getting better and better, and I think people need to be as educated as possible about about who may develop type one diabetes, and pick things up as early as possible. This is a concept in medicine in general, is pick up things early screen, find out risk. And I think it's the entering the the real world when it comes to type one diabetes. And I think everyone out there should be very, very very educated about this. Do

Scott Benner 3:03
you think that it matters if you have type one in your family line or not? Do you think everyone should be screened?

Dr. Blevins 3:12
You know, when it comes down to it, the people that have the highest risk are people who have diabetes in the family line, or they're called first degree relatives, which means, like brothers, sisters, children, parents, people, and even even probably second degree but that's the highest risk group. And I'll, I'll point out probably a little in a little bit, that that's certainly not going to get everyone, by any means, but that's a really good place to start. Okay, and people with diabetes are in the driver's seat. They can tell their family, hey, you need to get screened. They can get their kids screened. They can tell their brothers and sisters, and, you know, family members get screened and find

Scott Benner 3:53
out, yeah. So I guess the most obvious reason to know ahead of time is to not be in DK at the time. I was gonna say that hits the fan, but sort of when you know push comes to shove and diabetes is here, you can be ahead. I mean, do you see that as the as the first reason for knowing?

Dr. Blevins 4:10
Yeah, you should say when the ketones hit the fan. I think that might be more more okay, but the answer is yes. A few years ago, a study showed that 60% of people in this country were in DKA when they found out they had type one diabetes, and would sure like them to to know sooner than that. That's that's a traumatic event, and in the hospital, sick as they can be. I mean, sometimes ketoacidosis can even kill you and and so you don't want to wait until that time to find out you have type one. There's some studies around the world in which people were screened. Children were screened either because of risk, like family history, and there was, there was one study that just screened everybody, and The finding was that when people are are found to have the risk, that means the positive antibodies. And this is kind of a, know, your antibodies concept. Then they knew, and they could, they could check themselves, and when their sugar started going up, they got it treated. And it was insulin, of course, instead of just not knowing anything and suddenly having the symptoms, the weight loss, the frequent urination, the drinking a lot of water, you know, the typical ones that and then end up in the hospital. So, yeah, it makes a difference. I

Scott Benner 5:23
found that over the last year or so, I'm hearing more people talk about the stages of type one, and I have to admit that prior to us paying attention to screening, I never really heard people talk about that so much like, are you? You're in stage one, stage two, stage three. Can you break down for me what those are, yeah, sure, stages

Dr. Blevins 5:42
of type one diabetes. And, you know, we know about type one diabetes. We know about type two. We're not talking about that. We're talking about stages of type one. And this does lead to a level, I think, of complexity, because it requires that people kind of memorize some more numbers and some more characteristics, but you start staging things when you start finding ways to intervene and interact. So that's always a good thing. And so stages of type one. Now remember, each one of these stages technically would equal the diagnosis of type one. There's stage one. Stage one is also, or might be called pre symptomatic. Stage one is when the blood sugar is completely normal, but the person has greater than, or equal to two auto antibodies. So you have to have the antibody testing here to even diagnose stage one. So stage one, the sugar can be normal. It is normal, and you can still say the person has type one if they have greater than or equal to two antibodies. We'll talk about the antibodies here in a minute. And then there's stage two. Well, stage two is a progression from stage one, and these people have greater than or equal to two of those antibodies that we'll talk more about. And now they have blood sugar elevation, but they don't have the elevation you would normally associate with diabetes. They have an elevated fasting sugar and it typically is going to be between about 101 25 and you know that 126 and above equals diabetes. So these are people that are in this kind of like pre diabetes blood sugar range. They have the antibodies, so they're not they don't have normal glucoses. They don't have diabetes Range glucoses. Yet they have the antibodies, and they have this kind of pre diabetes picture. And if you do an oral glucose tolerance test, these people will have glucoses that fit into the we called impaired glucose tolerance range and and then stage three. So let me just summarize that one again, antibodies plus glucoses that are elevated, but not in the high range, not in the in the diabetes range. Stage three is now, okay, greater than, or equal to two antibodies, and now you have high blood sugars, and you could, you could be diagnosed having diabetes because the blood sugar, the fasting being over 126 could be diagnosed if the glucose is greater than 200 after a glucose tolerance test at two hours or just high, and the A 1c is typically elevated over or greater than equal to 6.5 that's stage three. And I'll back up a second say the a 1c in stage two is going to be in the pre diabetes range, which is going to be 5.6 up to about 6.4 Okay, greater than 5.6 up to 6.4 so those are the stages, and the bottom line is each stage requires, well, at least stage one and two. When you have stage three, the antibodies are helpful, but you have diabetes already, and So stage one and stage two do require antibodies to be measured. Does

Scott Benner 8:43
everyone who enter stage one make it to stage two? I have always disliked ordering diabetes supplies. I'm guessing you have as well. It hasn't been a problem for us for the last few years, though, because we began using us Med, you can too us med.com/juice, box or call 888-721-1514, to get your free benefits. Check us med has served over 1 million people living with diabetes since 1996 they carry everything you need, from CGM to insulin pumps and diabetes testing supplies and more. I'm talking about all the good ones, all your favorites, libre three, Dexcom, g7 and pumps like Omnipod five, Omnipod dash, tandem, and most recently, the I let pump from beta bionics, the stuff you're looking for, they have it at us. Med, 88887211514, or go to us. Med.com/juicebox, to get started now use my link to support the podcast. That's us. Med.com/juice box, or call 888-721-1514, you can manage diabetes confidently with the powerfully simple Dexcom g7 dexcom.com/ Juicebox. The Dexcom g7 is the CGM that my daughter is wearing. The g7 is a simple CGM system that delivers real time glucose numbers to your smartphone or smart watch. The g7 is made for all types of diabetes, type one and type two, but also people experiencing gestational diabetes, the Dexcom g7 can help you spend more time in range, which is proven to lower a 1c The more time you spend in range, the better and healthier you feel. And with the Dexcom clarity app, you can track your glucose trends, and the app will also provide you with a projected a 1c in as little as two weeks. If you're looking for clarity around your diabetes, you're looking for Dexcom, dexcom.com/juicebox,

Dr. Blevins 10:47
the answer is a very high percent. If you look at, if you look at like lifetime risk of developing diabetes going from stage one to stage two, and then stage two, stage three, it's it's up there if a person has greater than or equal to two auto antibodies, their risk of developing. And this is with just, this is a stage one and stage two. And some people say there's pre stage one with might be one antibody, but forget about that. We're talking stage one and stage two. Yeah, about 44% go on to have diabetes in five years, 70% in 10 years and lifetime risk. 100% if a person has greater than or equal to two auto antibodies, whatever stage they may be in. So some people ask me just what you ask? And they say, well, I might have an antibody or two, but I may have two antibodies, but Will I really go on to have diabetes? And the answer is, yeah, you will in some medical conditions, people can have antibodies, and they don't go on to have the the manifestation, but in this one, the data says you do. And

Scott Benner 11:49
so we're testing now because there's something that can be done about this to kind of slow down the progression.

Dr. Blevins 11:55
You know, we're testing now for that reason that you mentioned, and that is, yeah, Scott, you mentioned earlier about preventing DKA, which is a big deal. We're testing so that we can tell people, Hey, your sugar is going to get high. We can't tell you when, but you better watch out and start measuring it and be attentive to it, and that will help you prevent DKA. That's, that's, that's a big reason, right? The other reason is that there is a medicine currently that is available that is approved to delay diabetes in people who have stage two. So you have to have stage two, remember the antibodies and the kind of pre diabetes numbers to qualify for it. But it delays and it delays it for forever. No, we don't. We don't know that. We don't really know how long it delays it. We do know that if you look at time to progression to the next stage that is over diabetes, it was an on an average, four years, and people who were treated with that medicine, and it was, it was two years of people on placebo. So you know, nice prolongation, delay, nice delay. Did it prevent? We can't say that at all, and we don't even know the long term. Do we need to retreat people? It's a one time treatment, but now we have a medicine that can delay the onset of going on to have stage three or to have overt diabetes, and that's another reason to screen and there are quite a few studies going on currently, not as many as would all like, but a few that are testing other agents. And if people know they have antibodies stage one or two, then they might get into one of those studies if they elect not to take the delay treatment. So there's a lot of rumble in this space, and the pre kind of pre stage three diabetes type one. If a person knows their antibodies and knows their status, they they're in the driver's seat too, they get to kind of make a choice, yeah.

Scott Benner 13:50
So not only just quality of life in the short term, but if you're one of those people who has a very, very slow onset, and you're living with average blood sugars in the 120s but you aren't into the 126 I mean, you are degrading, right? You're doing damage to your body. Yeah, yeah, yeah. And just because you don't maybe feel it in the moment, like, maybe it's like, Oh, I'm tired a lot. Or, you know what I mean, like, something that you can write off for something else. It doesn't mean that as time collects, you're not going to wake up one day and either, of course, boom, have diabetes or have other issues that come from elevated blood sugars that don't qualify as diabetes in the moment?

Dr. Blevins 14:26
Yeah, I really agree with that. Yeah, not only just power. And I used to hear, Well, I don't want to know, because there's nothing I can do about it. Number one. Number two, I don't want to test my family member because that might make them, you know, upset. These are various reasons that people have given to say, not screen. I think all of those. I mean, I do understand those reasons, and people have their reasons and that they're they're in charge of themselves. Bottom line, though, really now there are reasons to know, and they're better and better reasons to know prevent. And I know this is kind of redundant, but certainly worth. Saying it over and over again, prevent DKA. Maybe get involved with the medicine that might delay, maybe get involved in study, or maybe just know, you don't have to do any of those things, you just know and prevent DKA. And, you know, get get ready, and get everything kind of organized and all that. Yeah,

Scott Benner 15:18
is there a reason I'm thinking of this one episodes that I that I've done in the past. This gentleman 50, I think he's 50 years old. He's diagnosed type one, and he uses insulin, you know, for six years, sure. And then one day, his doctor suggests maybe you should take Manjaro for your weight, and maybe it'll help you with some of your insulin resistance, right? And now he hasn't been on insulin for a couple of years. Now, he's got type one diabetes. He's got the he's got his antibodies, you know, yeah, yeah. And he fully expects that one day he's going to be back using insulin again. But now he's, he's got this moment in time where, you know, something else is helping him. And what I mean that's something else could be any number of things, because I think the idea is, I don't know how to say this, like, I don't want to, I don't want to seem like scary. But like, if you were driving in a car, Dr Blevins, that you were going to go off this cliff 60 years from now, and I could do something to make you go off the cliff 70 years from now. Like, let's do that thing. Sure. Yeah, right. Like that to me is, it's a lot. I'll say again, it's a lot about your quality of life in the moment, but it's also a lot about, you know, a long and healthy life as well. I love the idea of knowing, and I do take your point, and I agree. There are some people who might just say, for my own mental health, I can't, I don't think I could know this information right, right, personal decision for certain, yeah, but anyway, it's just kind of how I think about it, I guess, yeah, I think people still

Dr. Blevins 16:45
make that decision. They'll decide they don't want to know, but it's but I think it's important they they be educated to say, hey, you probably really ought to know, because just what you said, we can, no matter what we decide to do, it's good to know. And why not? And so I think, I think that that sort of not wanting to know is kind of a bit of a mindset, and it's kind of ingrained a little bit. But I think this is the time to get everybody off that, that center and say, hey, you need to know. And you need to screen everybody in your family so they can know, yeah. And you know, screening is not the screening also is not over at the at the first screen. You have to keep looking every so often because things change. This is truly the dawn of a new era. And I think everybody, once they kind of understand that, will get on board with that too. And I hope everybody becomes advocates, because it really, I'd like to a stone. You have to really push it hard and get it moving, and finally, get some momentum, and it starts rolling on its own a little bit. This is big, and it's a dawn of a new era. It's a whole nother angle. The current organizations like breakthrough type one diabetes totally behind this idea of screening and trying to delay and trying to discover other treatments that might delay and maybe someday, prevent, yeah,

Scott Benner 18:01
that'd be awesome. So what are the risks of developing Type one? If you have a first degree relative that has type one,

Dr. Blevins 18:07
yeah? And this is one of those, know, your numbers things, and you get to, get to decide which number you want to know. I would let me advise everyone to there's so many different numbers and drive you a little crazy. But you know, if a first degree relative has type one. The person's risk of having type one versus the general population is about 15 one five times normal. So that's one number. And to me, that's That's enough 15 times. And then another way to look at it is, what about certain family members? Well, we have data if a person's mother has type one, their risk is about 3% of course, the in the population of people who don't have relatives is like quite low at 0.4% the 3% may not seem like a high number, but relatively speaking, it is. And then if the father has type one, it's about 5% for some reason, if the father has type one, the risk of the offspring is a little higher, and then sibling is about 8% we can go on and on, but know your number. I like the 15 times. And there are other ways to look at this too. I could drive you a little batty. I

Scott Benner 19:12
have a question, though, based on my my experience talking to people, is there data for if both parents have an autoimmune issue, but not necessarily type one.

Dr. Blevins 19:21
You know, your points are really well taken, and that is that other autoimmune conditions other than diabetes also would signal increased risk of autoimmune glandular like diabetes. But do we have data on that? Not that I know of, but your point is so true that if family members so the so that you might say, the the straightforward screening group would be to screen the the offspring first degree relatives, or, you know, they might be offspring of people with diabetes. Screen them. That's where you get the biggest bang for your buck, in a way. But 90% of people with diabetes, type one do not have. Have a positive family history? Well, wow. So how do you find them? Well, you do what you said. You look at people who have other autoimmune conditions, like Hashimoto, thyroiditis, your thyroid, adrenal autoimmune even like celiac, things like that, even rheumatoid, yeah. And then if you have a lot of that in the family, then your risk you would, you know, logically, would be hired to even have another autoimmune condition like type one. Not much data on that, but clearly that's another group to go after and screen the offspring or first degree relatives of those people. People have those conditions, and still, there's a lot of randomness too. The only way to pick up everybody, and everybody who might be not developed type alone would be to screen the entire population. And that's not going to happen right now. And there are people talking about that doing screenings of children like every child right now. That's not happening. I mean, that's a really interesting thing to think about food for a lot of thought, but, but not food that we're going to eat today. So what you can do today is screen people who have family history. And you're right, people who have a history of other autoimmunity should be screened as well. How

Scott Benner 21:10
does ethnicity play into this? Yeah,

Dr. Blevins 21:12
ethnicity, you know, I think, I think people have the concept that the people with type one mainly are people who are Caucasian. And in fact, it is true that 72% of the type one population in this country, it would be considered non Hispanic, white. And interestingly, though, and this is where these these misconceptions, get busted, about 15.7% of the type one population is Hispanic. And then non Hispanic, Black, 9.3% and Asian, about 2.4 so, you know, there are lots of misconceptions, and that's one of them. And so think about type one, really any ethnic group, and the growth in the type one the greatest growth, when you talk about relative growth, is in the Hispanic and the non Hispanic black group.

Scott Benner 22:06
You know, I want to go backwards just for a second, but we talked about, hey, maybe if either thyroid or other autoimmune in your line. But does that open you up to be eligible for screening? Like, who do they say no to at the moment, do you know what I mean? Like, what I mean? Like, what do you have to have on your on your chart for someone to say you're eligible to be screened if you take insulin or so faucinyas, you are at risk for your blood sugar going too low. You need a safety net when it matters most, be ready with G vo hypo pen. My daughter carries G vo hypo pen everywhere she goes, because it's a ready to use rescue pen for treating very low blood sugar in people with diabetes ages two and above that. I trust low blood sugar emergencies can happen unexpectedly and they demand quick action. Luckily, jivo hypo pen can be administered in two simple steps, even by yourself in certain situations. Show those around you where you store GEVO kypo pen and how to use it. They need to know how to use jivo kypo pen before an emergency situation happens. Learn more about why GEVO kypo Pen is in Arden's diabetes toolkit at gevok, glucagon.com/juicebox, gvoke shouldn't be used if you have a tumor in the gland on the top of your kidneys called a pheochromocytoma, or if you have a tumor in your pancreas called an insulin OMA, visit gvoke. Glucagon.com/risk. For safety information,

Dr. Blevins 23:38
yeah, you know something we by the way, we're still learning what that answer is. Okay for the most part, the diagnosis of family history of diabetes or auto immune disease or endocrine disease is probably the best diagnosis code to use. And because you're screening the person who doesn't have a condition and you're trying to find out if they do and what you said is so true, we're learning. We know what to do. We know what tests to do. How do we get those covered for people so that they can do them without great difficulty? That's another, another challenge that's been worked on. And I'll mention something here in a minute, anytime you want me to about particular effort that looks like it's fairly cost, effective and relatively inexpensive that would allow large numbers of people, even if they don't have coverage, to get covered. We are still making our way through that one. Number one, there's a cost certainly, to the antibodies. And number two, we'd like to get them covered. We want to know. We don't want cost to get in the way. I'm just talking about the collective we in the medical world and the people who have diabetes, we don't want costs to get in the way of having people do what they should do. And so we're still learning about that.

Scott Benner 24:50
Okay, I want to know about the antibodies. There's five. Is that right? Or six? There are five? Oh, no, wait, five.

Dr. Blevins 24:56
Okay, well, there are four good ones, and they're five. And. And I'll kind of give you a bit of a coverage of those. There's the the anti insulin antibody, and that's a good one. There's a gad antibody, Glutamic acid decarboxylase. That's a really good one, too. And then there's the antibody called the insulinoma associated antibody, and that's a good one. And then there's a zinc transporter, all these strange names. So gad antibody, insulin OMA associated antibody to insulin, anti insulin, antibody, zinc transporter. Those are the best four. Then there's one called the islet cell antibody, and we do that one, but it's probably the least accurate of the whole group. Okay, and so do the more antibodies you do, the better clarity you get. And the there are different panels that are run by different groups. And in our own office here, we run the four that I mentioned, but not the islet cell, because those are, we think, the most accurate. And that's kind of what the literature would say. There's a group called trial net, and they're around the country, and they'll do antibodies too, because they're looking for people. They're really looking for people that have this stage two. And they're also, you know, enrolling people in studies, and they do the GAD and the and the anti insulin antibody. And then there, there are various groups. The Barbara Davis group in Colorado will provide a screening kit to people, and they do all of the four antibodies that I mentioned. They too exclude the islet cell antibody. And then there are various groups that that offer screening. If you want to do screening, you know, what do you do? We can talk about that whenever you'd like to know. I

Scott Benner 26:46
would like to know more. I also want to say that currently, as we record this screen for type one.com, is a sponsor of the podcast. I just want to be, I want to be, Oh, good, like clear about that, so that people, okay, yeah, that

Dr. Blevins 26:57
is excellent. Because I was about to say, if people want to go learn more about screening, they can say they could go to, I have it written down right in front. We screen for type one, and the musician, a very well known musician, has jumped in to help increase awareness. And that would be Usher. Usher is there, you know, go on that site and take a look, and it'll also let people kind of sign up for a screening kit and tell them what the cost would be based on their insurance. I mean, I can't go into great detail about that. You really have to go on the side to figure that out, but, but I've give that even more AirPlay screen or type one.com. That's the site. I believe

Scott Benner 27:38
that that is it. Yeah, they've been with me for a bit now. And good,

Dr. Blevins 27:42
yeah, I didn't know that. Yeah, that's good to hear. Because, you know, when it comes down to it, we're talking about screening, and how do you do it? You know, if I see a patient in my office who has type one, I'm gonna say you should get your kids screened. You know, do it? Can I order it? I don't see their children. I don't, I can't do that. I can't order it, but I can recommend it. Some people I see have relatives who have type one, and I'll say, Hey, I'm going to do a screening on you. Or I see a person who has an elevated blood sugar, and I decide you're going to get screened. But they're not, they're not diabetes range yet, but, and maybe they are, but I'm going to, I'm going to screen them, if they're my patient, I can do that, and I can write the diagnosis code that that I find to be the most useful, but I can't order screening and people that are family members. So what do I do? Well, I have a little sign on the back of one of my doors, and it says, Here, the antibodies you should get done talk to your doctor. But another way to go about that is to go to that site, screen for type one com. That kind of a site is going to help us all get people screened and really kick up the gain. And there'll be other ways to do it in the future, and everybody's struggling. This is a kind of a new site. Don't have a new era. New things have to be learned and have to be developed.

Scott Benner 28:57
How often do I get so if I say I don't know, I have my my child's screen, they don't have any antibodies. Do I do it again? Or is once enough?

Dr. Blevins 29:08
That is a really, really important point. And the answer is, if they're negative, or you might ask yourself, are you home free? And the answer is, no. Do we really know? The final answer is that, how often someone should be screened, not really, but the current, current suggestion is re screened in a few years and and keep, keep looking, because these antibodies can crop up at different times. And also, what about people who have antibodies positive and they don't have type full, full blown stage three? There's a consensus guidance that's been recently published, this whole science is starting to grow, and essentially says, well, re check their glucoses routinely see if there's any sign of progression. They might want to get into the treatment that we talked about. They might want to get into a study, and it goes through this whole list of kind of follow up, because, no, you're not home free once you have. A negative test, and that's an important bit of information, yet you want to keep checking. We do the final answer to all this is not totally clear.

Scott Benner 30:08
You know, if a person screened, they're found to have these auto antibodies, then they're going to go forward with the medication, like, what's available right now the

Dr. Blevins 30:16
medicine? There's exactly one medicine that's available that is approved to delay type one diabetes, and it is the medicine to please a map and it's all the brand name is the T sealed Med, so that's the one that I mentioned earlier. Was was shown to delay the time of progression to stage three about on average, four years, and the group of people treated versus two years in the people who were on placebo, remember, these are people with essentially stage two. They don't have diabetes yet, but we know they're going to progress on so the people that were treated median time, that is more or less the name time without progression, four years versus two four years, two more years on average of no diabetes, no progression to stage three.

Scott Benner 31:04
Does science know how it works? Or is it just one of those things we know works, and we're not sure why

Dr. Blevins 31:11
science thinks it knows. Actually, this drug, teflizumab, is an anti CD three monoclonal antibody, and let me just explain that a little bit, T cells in your body identify beta cells that make insulin as being foreign, as a mistake, and then they attack them, and they attack them and they attack them until they knock them out. And that's why it takes time. It takes time. There are millions and millions of beta cells, but they have to be knocked out for the most part, to per person they have high blood sugar. This drug is an anti CD three antibody. What it does is it interacts with a component like a one of the regulators of the T cell. Now, T cells are in your body, they help you. I mean, they protect you from foreign things and things you don't want in your body. But they're making a mistake here, and they're attacking one of your own cells. Not good but, but it's what happens. Well, if you go in and and have an antibody that sort of goes against one of the regulators of the T cell, the CD three, then you can deactivate those T cells, and you can cause them to be sort of exhausted and and that's what T cell does. It interacts with the CD three part of the T cells, inactivating them, not all of them, of course, but knocks them down. That kind of slows that process way down against the beta cell, and allows the beta cells to hang on longer, and and so that's what it does. Okay,

Scott Benner 32:49
that's awesome. That's and you say there's other drugs too that are under investigation at this point? Or No,

Dr. Blevins 32:56
yeah, there are other drugs, and there are other drugs that are being investigated. And I can, I can tell you that the breakthrough type one diabetes group you know, which is, of course, you all know, was the JDRF, and they renamed, right? Is looking at another drug called beracitinib. It's a it inhibits a different component, but same idea and and so there are other drugs that are being studied. And I can tell you that, though I know nothing about this there, I know there are other other ones following behind. Also they're going to be looked at. So

Scott Benner 33:30
if a person's in stage two, they qualify for T sealed and then it's, I guess, you know, that game of going through insurance and whatnot. But then once, once they're you're okay for the drug. What's the process of of getting

Dr. Blevins 33:44
it? Yeah, you have to have just the right criteria number one. So you're talking about, how do you get the drug? It's not straightforward. It's actually, the process is straightforward, but it's a fairly expensive med. It costs, like, I think, about $200,000 per treatment. And I'll tell you more about the treatment in a minute, too. But so you have to go very carefully through the approval process, and then the company has, you know, some things they can do, and insurance companies look at it very carefully. It's a brand new it's not brand new as much as it's just very still low usage, and they're going to spend a lot of time. We've treated one person here, and I have another person who's hopefully in the wings to be treated soon. And it's a slow process. And when, when people are waiting, I tell them, hey, check your blood sugar. Keep me informed. But, but it's, it's, it's something that has to be approved by the insurance. It takes time. Then this is a treatment that's an IV administrated medicine 14 days in a row. You have to have a place that can can treat people on Saturday and Sunday for at least a couple couple times, couple weekends. And that's that's very doable here, but it's not doable everywhere. And so there are certainly factors. Yeah. And then the medicine does have potential side effects, and those have to be monitored for. So it's a process, yeah?

Scott Benner 35:07
And so what? What are the common are there common side effects? Or no? Yeah,

Dr. Blevins 35:11
there actually are one side effect that I'll mention that is occurs in about 2% of people, which is the low percent, but still happens is cytokine release syndrome. That's just simply, when you give a medicine like this, you get the release of a lot of kind of inflammatory substances from the T cells and from the immune system. And that can lead to like fever, rash, nausea, vomiting, and can be disturbing. It also could lead to elevation of liver tests and things like that. This medicine could with the cytokine release syndrome. So these things all have to be monitored for. They're kind of ex they're not like expected, like, where it's going to happen is 2% of people, but it's not a it's not an allergy, it's it's a reaction to the medicine. So with treatment, we're going to monitor the liver test, and if they go up a certain amount, we're going to stop the medicine. We watch the white blood cell count. They can drop. We watch the lymphocytes, in particular, because they can drop. And if they dropped a certain level, then we would stop the medication. There's a somewhat of an increased risk of infection when people are getting the medication. And the good news is that lymphocytes tend to rebound. And those are, those are symptoms that are manageable. We give people anti diuretics, you know, like acetaminophen, for example, or non steroidals too. And we give people anti nauseals. Those are ways to mitigate the symptoms. So the top four adverse reactions are going to be lymphopenia. That happens. That's the lymphocytes, the white cells, and then they do fight infection. So we don't want them to go too low lymphopenia. About three quarters of people rash can happen in about 35 36% and leukopenia, that means low white blood cell count, 21% or so in a headache too. And so those are all things that we we know can happen. It doesn't mean there's an allergy. It's a reaction to the medicine. That's that's kind of expected, and we just have to, kind of get people through that. You have

Scott Benner 37:19
one person, you said, who's been through the process, and one person you're trying to get set up for does anything about the possible side effects stop you from suggesting it to patients. You

Dr. Blevins 37:28
know, I'm an endocrinologist, and I'm not really all that used to using immunologics, although some of the medicines we use are monoclonal antibodies. Like to treat osteoporosis, for example. And when I first looked at this, I thought, gosh, those are some side effects I want to be really careful about. But the truth is, with proper monitoring and with the right place to give the infusion that is a an infusion, we use an infusion center here in Austin, and it's been doable. We know that there are certain, certain side effects that are potential, and so we're prepared. And the, you know, there, I guess there could be surprises, but we're always ready for that. But, but this is outpatient. People walk in, get the infusion, they go home, and they go back the next day. They do it for two weeks. It's an infusion for two weeks. You know, the pause that I had initially is kind of his past, okay? And I educate the people very carefully. The person that's waiting right now, talk to her very often about the potential side effects, and she's very aware, yeah, you're a proponent,

Unknown Speaker 38:32
absolutely. Yeah, yes, I

Scott Benner 38:34
listen. I used to have to get iron infusions. And you know, the first time somebody says it to you, you're like, Well, it sounds frightening, but then it's, it's not, you know, I don't, actually, I don't have to get them anymore, since I've been on a GLP med. But that's a different thing, yeah, but, but nevertheless, it's just, it's not as, not as scary as you think it is. Is like, I guess my point, I

Dr. Blevins 38:55
know what you're saying. Iron is different than this. This is a immunologic and a CD three antibody. But you read through the side effects of iron infusions, you saw that it could cause probably a reaction at the at the infusion site, it could cause a diffuse reaction. There are things that these infusions can do, and I think it's really important for the person who's being considered for this to be really assertive about finding out all the potential side effects and be ready, sure, and that that's really, really important. Yeah,

Scott Benner 39:25
I'm not comparing the two. I just even met. The idea of going to an infusion center seems kind of like off putting, you know, yeah, yeah, no, I understand, yeah, but it's not, it's just, it's not bad at all. And you have this great thing of being in a place where these people do the same thing over and over again. They're very at least in my experience, they're good at it. They know what they're doing. It runs well, like that kind of stuff. They are, yeah, they

Dr. Blevins 39:46
are. And that we're really happy with the infusion center that we use, because they that's what they do. They do infusions, and they infuse all kinds of different things. So they are quite ready. I think some practitioners might end up doing their infusions in their office. Us, and that's okay, too, as long as you monitor people and check blood pressure, check temperature and essentially walk in and walk out. So different offices are going to come up with different ways of doing it. Some people may do it in the outpatient facility at a hospital, which is essentially the same thing as an infusion room, and there are different ways that this will be administered, and the

Scott Benner 40:22
possible side effects, they exist during the infusion, but once the infusion time is over, are they there's no side effects? Left? Is that right?

Dr. Blevins 40:30
Well, that is true, although you could still see some white count changes later on. The rash could even continue on well past the time of of the administration liver test elevations could occur later too and continue and so we continue to monitor people for a few weeks. Most. For the most part, any of that effect is going to be gone after two to four weeks. But it is important to not only monitor during the infusion process, but also after for a few weeks. Gotcha?

Scott Benner 41:01
Okay? Yeah. Dr Blevins, is there anything we haven't talked about that we should have?

Dr. Blevins 41:05
I think one thing that I found that's important for people to realize too, is that we talk about screening and and some people have the idea, well, people over the age of 20, they can't get diabetes. We don't need to bother screening them. And that's totally, totally not true. What's interesting, and even surprises me, when I see the numbers that 59% of the people diagnosed with type one are over the age of 20. You think it's like kids and teenagers and adolescents and all, but so it's a pretty large population, so that's never too late to screen. I guess you might say I think that's the other thing I wanted to talk about, and just to let people know that, you know, if a person has risk, then type one can happen at any, any age. Yeah, I have,

Scott Benner 41:53
I'd have to go back to check to be 100% sure. But I believe that I have interviewed someone who has, personally or their child has been diagnosed at every age, from one up into the 60s. So yeah,

Speaker 1 42:05
yeah, I've got it covered pretty much, I think so,

Scott Benner 42:09
yeah. Well, I appreciate you doing this. I really do. I know this is not a, probably not an exciting topic for people, but I think it's very important, and I appreciate that you, that you thought so too and wanted to come on and do it.

Dr. Blevins 42:21
Yeah, no. Thank you so much for having Thank you. This is really enjoyable. And I really like talking about this subject. Because when I went into for one thing, when I went into endocrinology years ago, there was no delay. It was a lot of talk, but there was really nothing. And we would like, you know, we would all like a cure and some kind of way to just give some cells and it's all over with. That's certainly making its way along. I think the pace is picked up there. But this is a totally important angle that is to delay or eventually, hopefully pick up. People who have this, these antibodies, who are going to go to diabetes Always have, always have, in the past, and say, just alter the course of the disease and delay it or prevent it. So I think this is something everybody should know about and really be talking to their the family about and so get screened and go look at that, that website. I think that's actually a pretty, very informative website, right?

Scott Benner 43:21
Yeah. Listen, as exciting as the idea is to be able to delay the onset of type one, the other excitement is, what are they going to learn from this, right? And where does it go from here? And exactly, is there going to be a time in the future where you're screened, you have that auto antibody, they give you something, and you don't develop type one? And that would be, I mean, that would be crazy. And for all the people living with type one, you know, I agree. Just think about that for a second. Yeah,

Dr. Blevins 43:47
everybody jump up and help push that rock I talked about earlier forward and get some momentum and keep it rolling. Yeah,

Scott Benner 43:54
no, I appreciate that very much. Okay. Dr Blevins, if you'll hold on for a second, I have a question for you, but not for a while ago recording, thanks again,

Unknown Speaker 44:01
we'll do Thank you, Scott, thank you.

Scott Benner 44:10
A huge thank you to one of today's sponsors, G VO, glucagon. Find out more about G vo hypo pen at G VO, glucagon.com, forward slash juice box. You spell that, G, V, O, k, e, g, l, U, C, A, G, o, n.com, forward slash juice box, us. Med sponsored this episode of the juice box podcast. Check them out at us, med.com/juice, box, or by calling 888-721-1514, get your free benefits check and get started today with us Med, you can use the same continuous glucose monitor that Arden uses. All you have to do is go to dexcom.com/juice, box and get started today. Okay, that's right. The Dexcom g7 is sponsoring this episode of The Juicebox Podcast. From the very beginning, your kids mean everything to you. That means you do anything for them, especially if they're at risk. So when it comes to type one diabetes screen, it like you mean it now up to 90% of type one diagnosis have no family history, but if you have a family history, you are up to 15 times more likely to develop type one screen it like you mean it, because type one diabetes can develop at any age, and once you get results, you can get prepared for your child's future. So screen it like you mean it type one starts long before there are symptoms, but one blood test could help you spot it early before they need insulin, and could lower the risk of serious complications like diabetic ketoacidosis or DKA. Talk to your doctor about how to screen for type one diabetes, because the more you know, the more you can do. So don't wait, tap now or visit screened for type one.com to learn more. Again, that's screened for type one.com and screen it like you mean it if you or a loved one was just diagnosed with type one diabetes, and you're looking for some fresh perspective. The bold beginning series from the Juicebox Podcast is a terrific place to start. That series is with myself and Jenny Smith. Jenny is a CD CES, a registered dietitian and a type one for over 35 years, and in the bowl beginning series, Jenny and I are going to answer the questions that most people have after a type one diabetes diagnosis. The series begins at episode 698, in your podcast player, or you can go to Juicebox podcast.com and click on bold beginnings in the menu. I can't thank you enough for listening. Please make sure you're subscribed or following in your audio app. I'll be back tomorrow with another episode of The Juicebox Podcast. Hey, what's up, everybody? If you've noticed that the podcast sounds better and you're thinking like, how does that happen? What you're hearing is Rob at wrong way. Recording, doing his magic to these files. So if you want him to do his magic to you, wrong way. Recording.com, you got a podcast. You want somebody to edit it. You want rob you.

#1343 Mini Scott

Adalia and Scott's brains work exactly the same.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Welcome back friends to another episode of The juicebox podcast.

My guest today is 18 years old. Was diagnosed with type one diabetes when she was 15. Adalia wanted to be an astronaut before her diagnosis, and she and I think, oddly alike, this is her story. Nothing you hear on the juicebox podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan. Are you an adult living with type one or the caregiver of someone who is and a US resident, if you are, I'd love it if you would go to T 1d exchange.org/juicebox and take the survey. When you complete that survey, your answers are used to move type one diabetes research of all kinds. So if you'd like to help with type one research, but don't have time to go to a doctor or an investigation and you want to do something right there from your sofa. This is the way t 1d exchange.org/juice box. It should not take you more than about 10 minutes. Don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code juicebox at checkout. That's juicebox at checkout to save 40 percent@cozyearth.com

the episode you're about to listen to was sponsored by touched by type one. Go check them out right now on Facebook, Instagram, and of course, at touched by type one.org. Check out that Programs tab when you get to the website to see all the great things that they're doing for people living with type one diabetes touched by type one.org. This episode of The juicebox podcast is sponsored by the Eversense 365 that's a CGM that lasts a full year, ever since cgm.com/juicebox. One, year one CGM. My

Adalia 2:05
name is Adalia. I'm from Ontario Canada, and I am 18 years old, and have been diagnosed with type one diabetes since I was 1515. Three

Scott Benner 2:13
years, right? Yeah. 1518, Adalia. Adalia, yes, your parents make that up. Were they drunk? Tell me more.

Adalia 2:24
They founded a baby book supposedly, yeah, I don't know. It just kind of was something that they found interesting. And then I don't know if they made up their own pronunciation for it, or if, like, it actually said a pronunciation in the book or whatnot. But yeah, I've never met anyone with the same name as me, so I

Scott Benner 2:42
also don't think you're going to you have any brothers or sisters, like the Rio Grande day or anything like that.

Adalia 2:49
Yeah, I've got an older sister who's married, and then two brothers, one older, one younger. So I'm the third of four,

Scott Benner 2:56
and you're 18 now. Yes,

Unknown Speaker 2:58
do they? You

Scott Benner 2:59
don't need to tell me your your siblings names, but are they all very unique, or is it like, yeah, okay, it's not like, Mike, John, Pat and Adalia.

Adalia 3:09
No, we've all got pretty unique names. You

Scott Benner 3:11
don't need to tell me their names, but if you rate them one to four, where's yours on the hippie cookie scale? Oh, probably like two, okay, somebody else, somebody else has one that's wilder than yours?

Adalia 3:26
Yeah, a little bit. My sister's name starts with A J, but it's pronounced as a y.

Scott Benner 3:32
So are your parents? I don't know how to ask this. All right, you're 18, right? Yeah, okay. Are your parents weed smokers?

Adalia 3:38
No,

Scott Benner 3:39
they're not they drink alarm,

Adalia 3:41
nope, no.

Scott Benner 3:42
All right, I'm okay. Do any of those siblings have type one diabetes or other autoimmune issues? No, none

Adalia 3:51
of my siblings have any autoimmune, anaphylactic allergies and a heart condition. But like, that's kind of it. Other than that, I'm the one with the most of the medical stuff.

Scott Benner 4:02
So how about your parents or grandparents down the line, stuff like that. So

Adalia 4:07
there's nowhere we can trace type one to but we do have, like, other autoimmune like some thyroid things, some like celiac and like different stuff like that. But like, no one in our family has type one. I think there might be one, like Great aunt, great uncle, or something that has type two. But, yeah, all right,

Scott Benner 4:27
well, that's not interesting. Then this was pretty surprising for you.

Adalia 4:31
It was, yeah, it was quite surprising. We were not expecting it. Yeah, it was just, it did kind of come out of the blue. And when we went in and I got diagnosed, like, my mom had thought, like, oh, maybe, like, you have mono or something. Like, at first we're like, covid or strep, because it was like, mid pandemic 2021, and then got tested for those, it was all negative. And then finally, my mom was like, Well, this is clearly not getting better, so we'll go into the ER. And she was like, you might have mono, because we had some. She's with a chronic mono with my younger brother, and then, surprise, it was type one. So I said,

Scott Benner 5:04
like, a little menagerie of issues. Do your parents have issues that aren't autoimmune,

Adalia 5:09
not really a little bit so like, my mom has had, like, a couple different things, like she had thyroid cancer, so she doesn't have a thyroid and had that removed. So she's on thyroid medication, but because she just doesn't have one. And then she also is kind of self diagnosed heliac, because she didn't want to go through the testing of eating gluten to figure out if that was the issue. So she eats gluten free and dairy free, because our body just doesn't respond to foods like that very well. She just figured

Scott Benner 5:39
that out. She's wandered outside one day, yelled to your father on the snowmobile, zebedia, I think I can't eat milk or like something like that.

Unknown Speaker 5:48
Oh, sure, yeah, yeah, yeah.

Scott Benner 5:50
It happened exactly like that, right? That's what I figured, too. How come you don't have, like, a real Canadian accent? Do I not is it gonna come is it gonna come out? I don't really wait a minute. This is messing me up. Can you give me an oh yeah,

Adalia 6:03
oh yeah,

Scott Benner 6:04
that's a little better. Okay. I mean, what a bummer. Sound like you're from, like, I don't know, the middle of America, you're screwing with me. I mean, there's, I know. I mean, listen, I accept your apology, I guess. Okay, that's fine. You're

Adalia 6:22
welcome. Was that Canadian for you? The story? No,

Scott Benner 6:24
you gotta go. Oh, sorry. It's Sorry, sorry. Do you not know how you're supposed to speak? Not really. No, I think the pronunciation of your name has messed up your Canadian accent,

Adalia 6:37
probably, yeah, so

Scott Benner 6:38
how does it sound when your mom says your name,

Adalia 6:40
like, Adalia, I don't know. Oh, Jesus, really so boring.

Scott Benner 6:44
Oh, my God, never mind. Don't you live, like, near a strip club in the Yukon or anything like that. Usually, my Canadians have good stuff. What's going on?

Adalia 6:53
No, we don't really live anywhere. Like, super exciting we so I live, I will say I live in Ottawa, which is the capital of Canada, but everyone doesn't realize that it's the capital of Canada. Is that West kind of just boring? No, it's east. It's like, Central East.

Scott Benner 7:08
Okay? And you're supposed to say Odawa, like, I don't understand you. Like, it's like, you don't even live there.

Adalia 7:15
Well, oh my god, you said Toronto. Like, I don't pronounce the T in Toronto. You're supposed

Scott Benner 7:19
to say Toronto. Listen, I've been learning a lot about Canada over the years. It's Toronto, odo, oh yeah. And now you're just like, it's Toronto. Like, oh my God. All right, that's fine. We're gonna skip the Canadian part. You obviously don't own a penguin so

Adalia 7:32
well, I don't know who you're learning Canadian from, but I don't think it's right. Everyone that comes on the podcast, it's Toronto. You don't pronounce you don't pronounce it. It's not Toronto. God, I

Scott Benner 7:42
just want to put this out here. If you speak like you're from Idaho and you live in Canada, don't bother trying to come on the podcast. It's a freaking bummer and a half. So all right, we're just gonna get past it, I guess, and talking about your life. But jeez, Way to ruin things. Why would you settle for changing your CGM every few weeks when you can have 365 days of reliable glucose data. Today's episode is sponsored by the Eversense 365 it is the only CGM with a tiny sensor that lasts a full year sitting comfortably under your skin with no more frequent sensor changes and essentially no compression lows. For one year, you'll get your CGM data in real time on your phone, smartwatch, Android or iOS, even an Apple Watch, predictive high and low alerts let you know where your glucose is headed before it gets there. So there's no surprises, just confidence, and you can instantly share that data with your healthcare provider or your family, you're going to get one year of reliable data without all those sensor changes. That's the Eversense 365, gentle on your skin, strong for your life. One sensor a year that gives you one less thing to worry about, head now to Eversense, cgm.com/juicebox, to get started. What do you remember about your diagnosis? How did it come on? I

Adalia 9:03
remember a decent bit. So I was, it was February, so it's cold, and I remember in like, January, I had gone in to get a medical exam because I was working towards getting my pilot's license. So I had to get, like, it's called a Canadian aviation medical exam, and in it, they do test urine for ketones and sugars and stuff. And so I remember getting this, this test and being like, oh, like, that's kind of a silly thing for them to be testing for. Like, there's no way I had that, like, whatever at the time in January, I didn't, but then a month later, I'd gotten pretty sick. Yeah, we weren't really sure it was going on. I kind of, like, I'm the type of person where, if I'm not feeling well, kind of just tough through it, I'm like, it'll be gone in a bit. Like, it's fine. So I was, like, going to school and like, doing all these things, but I was just so tired, so thirsty all the time. Like, I remember being at my job and, like, literally, like, had forgotten my water. Bottle, and just was searching everywhere I could for like, something to drink, like I was so thirsty, and like, sometimes getting up in the night to, like, go to the bathroom and whatever, kind of all the typical signs that kind of point towards type one. Yeah, so kind of just like, not really sure what's going on. There's always like, there's always the fear, like, oh, it could be covid. Because whatever, we weren't really right. We weren't sure. So

Scott Benner 10:23
everything was almost covid, by the way, during covid, exactly, yeah, right,

Adalia 10:29
yeah. We just, like, had no idea. And obviously, with no type one in the family, we weren't like, that wasn't on our radar at all. And so finally got to a point where my mom was like, okay, like, something's not right, if you're still not feeling well, and you're actually coming to me and complaining about it, because I usually am just, like, whatever, like, I'm fine. And so she's like, we'll go get you covid tested and get a strep test, which I'd get within like, five minutes of each other, which I don't recommend. That was very

Scott Benner 10:57
awful. Wait, what's the strep test? I forget that. What that is they stick it

Adalia 11:01
into your like, tonsils and like, swab your like, swab your like, uvular you're taught, like, back of your throat, and

Scott Benner 11:09
it's just Oh, and then, and then the covid was up the nose at that point, right? Yeah.

Adalia 11:14
So, oh man, I just felt, I felt very violated, if I'm being honest. I was like, Oh, I don't like this, yeah. So at that point I was just like, I wasn't really. I kind of stopped being, like, having enough energy to go to school. So I was kind of like, whatever. And then we got the results back from those tests, and they were both negatives. We're like, Oh, this is like, something else going on. My mom's like, we'll wait a little bit and see. And then it came to that, like, weekend, and I think it was like, Friday night and I went to my mom's room. I was like, Mom, like, I'm not well. Like, I don't feel well. I think she's told me now that, like, that night, she was, like, very, very concerned. She's like, something's not right. But we didn't go in that night. We waited till the next morning and went into the Children's Hospital because I was still young enough to do, to go there. I mean, it was a pretty short wait, like, we went in, obviously, like I said earlier, thinking that I might have mono or just anything except type one was on our minds, right? Yeah, we go in and got triaged pretty quickly, and then we're waiting in a room for a while, and I remember falling asleep in like, one of kind of, like the still, the ER, like, rooms, but we're at least not in, like, the waiting room. And I'd fallen asleep because I was just so tired and and then they came in to take my to do blood tests and start an IV, because they're like, we're gonna get you some fluids and whatever. And they could not get a line in. I was so dehydrated that my veins just were not, like, there at all. And so they grabbed, like they had a special kind of, like ultrasound machine for your veins to, like, try to find them, I guess. And so they grabbed that they had, like, two, three people working on me trying to get a line in. And it was just like I was a little Pincushion. I was just lying there. Like, okay, like, please just get something in. I'd

Scott Benner 13:04
like to go back to the swab in my nose, please. Yeah, yeah, yeah.

Adalia 13:08
So I just, oh, man, it was quite painful. And eventually they did get one in my arm. And so they'd taken some blood out, and then started a line of fluids. And then, like, I think I'd fallen asleep again or something. And then they came back. And when they came back, that was when they were like, okay, yeah, like, it's type one. And I had no idea what that meant. My mom's a nurse, so she had, like, somewhat of an idea, but like a textbook idea, right where it's like, don't know really what it means, but you kind of are like, okay, like, got, like, pancreas, insulin, all this stuff. And so I was kind of like, just a little stunned. And then, like, anyway, then eventually we did. I did get admitted, and I remember lying in that room, and then my line had burst in my arm, and so my arm just flew, like, filled up with fluid. And that was like, oh man. But then that meant that they had to go in again to try to get something else in.

Scott Benner 14:01
Did they did the vein burst or the no where they put them? Just like, came out. Oh, okay. And it pumped your and it pumped your arm full of fluid, yeah? Oh, good times, okay, yeah.

Adalia 14:12
Great times. I had a balloon arm, and I, like, couldn't lift it and, like, whatever. And I just, I had people coming in and out of the room, kind of like explaining different things to me and whatever, like a lot of that, I don't really remember what people said, but I do remember like people are coming in and out, and then eventually, not like current endocrinologist, but the endocrinologist that I had, basically, up until I turned 18, came into the room and we chatted. And at the time I had, I'd been really hoping to go get my pilot's license, and end goal was become an astronaut. And I remember sitting that lying in that bed, and the endocrinologist came in, and she was like, oh, like, just like, making conversation, and we were chatting, and she's like, so there's very few people, very few things that, like type ones, can't do. And then she asked me what I wanted to do. And I was like. I want to be an astronaut. And she's like, Oh, well, that's one of the things. And so that was just a really, like, devastating, like, having to process that at the same time is like, oh, like, I now have this, like, lifelong yeah thing,

Scott Benner 15:13
hey, and so Natalie, if it makes you feel better, I don't think Canada has spaceships. You're fine. You weren't ever, you weren't ever going to be able to do that anyway. No. I mean, listen, because everything there is made out of ice, and so when the rocket went off, it would melt. So you could never do that. But that's a nice dream to have. And if you came here to America, we have spaceships and stuff, but you don't have it, so it's

Adalia 15:37
okay. I would have fit in, though, right? Like with my accent,

Scott Benner 15:39
no one would have known you would have what they call pass. You know, pass, yeah, yeah. Wait, was it surprising to you at any point that your mom, who was a nurse, didn't seem to know much about it? And did that make you worried? It

Adalia 15:50
didn't make me super worried, because she didn't, she didn't present that she didn't really know a lot about it, like she was pretty good about like she would ask questions, like for me, which I appreciated, because I obviously was, like, I'm not mistake to, like, ask any questions, or, like, whatever. I was kind of just trying to process everything, okay, but like, I think she did have like, a decent knowledge of it, but like, there's just, like, I think when it came to the management of it, like, She obviously didn't know, like, had no context for that. But yeah, like, it didn't really freak me out that she didn't know, because I didn't realize that she didn't know. Okay, okay. But anyway, so sitting in sitting

Scott Benner 16:28
they broke your dreams about being an astronaut. Then what happened? I'm sorry if I'm

Adalia 16:33
being honest, I don't really remember a whole lot. I got moved at some point. They were still taking blood and stuff out. They eventually got another line in over the night. Though, like, I remember, like, sleeping, not Well, obviously, but the nurse that was doing all my night draws for my blood was just it was so painful. I don't know what it was, but, like, I just remember waking up every single time, and it was not a pleasant experience. And then finally, came to the morning, and they decided to scrap those lines. And then, because my arms were so, like, prodded at, they ended up taking my final blood draw out of my leg, because they're just, like, we can't get any other, like, good real estate, really, right? They'd like, tried everything. Like, they'd put wet, warm diapers on my hands to try to, like, I don't know, like, make you warm up the veins. Oh, okay, so no, like to get the veins going. So there's a picture of me with like, these diapers wrapped around my hands that they look like boxing gloves. Who took

Scott Benner 17:35
that picture of you? My mom did. A person who does not care about you. That's what that is, yeah. Okay, 50 and you're 15 years old. Yeah. All right, after they get you stable and they get your blood sugar to come down, how long does it take them to do that? Not

Adalia 17:51
too long. So by the morning, I was pretty stable, and I was off, like the IV like, fluids and insulin and stuff. And then for breakfast, I got my first insulin injection, okay, which was like, I think the nurse, like the actual nurse was like, a little like, okay. But my mom was like, no, like, I'll do it, which I was kind of glad for, like, it made me a little more comfortable. Yeah. So breakfast, I had my first insulin injection. And then after breakfast, had educators come into the room and, like, teach about, like carb counting and pre bolusing and like, all these, like, all the kind of, like basics I got, like, a binder with all this information they gave me my like insulin pens and information about, like, CGMS and stuff like that. Were

Scott Benner 18:43
your siblings, maple, Timbit and ulu there? Or were they, like, did the Oh, you couldn't. It was covid, right? I

Adalia 18:50
didn't have them in there. So my dad ended up coming that morning for all that education stuff. So my dad was able to come in, but my siblings weren't okay, yeah, nobody was really allowed to, like, visit, but I was only there for one night

Scott Benner 19:03
trying to get you out of there because of covid too. Yeah, yeah. So

Adalia 19:07
I was in for one night, and then I left at lunchtime the next day. So we went in, like, morning of Saturday, and then I was out by Sunday at lunchtime. So okay,

Scott Benner 19:19
and off on your new adventure. Yep, was this during and so school wasn't happening either. So you were, like, you were was

Adalia 19:27
for me. So I went to a smaller a smaller school a little bit further from where we live. And so we, like, stuck to, like, semesters. We didn't switch to quad masters or anything during the pandemic. And for at that point, we were in person, I think, and so I had missed about a week before, and then the next week I when I was home, we then had a bunch of zoom education meetings. So we met with, like, nurse educators, nutrition, all these different like my endocrinologist, like every. One. We basically had meetings every single day to, like, be taught how to manage and different things like that. So

Scott Benner 20:05
what insulin did they start you on? I was on Nova rapid and Lantis. What do you use now?

Adalia 20:11
Right now, I use Nova rapid in OmniPod. OmniPod dash in

Scott Benner 20:16
a dash, okay, and you have a CGM or No, I

Adalia 20:19
do so at diagnosis, I got a FreeStyle Libre, okay? And partially because we didn't have insurance, we didn't have medical coverage. And so that was the one covered by the Canadian government at the time. Yeah, so I was on the FreeStyle Libre, like the one, and then when the two came out, I got put on that, which I was grateful for, just to have some more alarms. And so I was on that, actually, just up until two months ago, when I switched to the Dexcom g6

Scott Benner 20:46
okay, this, uh, Ottawa. What province is it in Ontario? Ontario, right? So that's where you want to go get diagnosed everybody, because she got a CGM and modern insulin in Canada. That's pretty impressive. Yes, yeah. Okay. Do you think that was because of your age or because of the province and what they do? I

Adalia 21:05
think it's a province of what we do. Like, I haven't heard of anyone

Scott Benner 21:09
like, regular mph or anything like that. Okay,

Adalia 21:12
I've never heard of anyone be put on that.

Scott Benner 21:14
So my next question is this, we're gonna fast forward, jump around a little bit, okay? I am generally baffled when a person your age wants to come on the podcast, really, yeah. So how did you find it? Why did you find it? Why did you want to come on?

Adalia 21:30
My mom actually found it, and she sent me the episode you recorded with April Blackwell, the NASA engineer. Ah, that makes sense, yeah. So she sent me that probably, like, two, three days after being home. I listened to it, and I was like, oh my goodness, this is, like, incredible. Like, it was just really great to, like, hear stories from, like, people who, obviously, I was like, I didn't know anyone who also had type one. And so just to hear stories from other people, and also, like, learn how to better manage it. Like I, I love information. I love information seeking. And so I was like, Okay, perfect. Like, new strategies, different ways to, like, do things. And so at the time, I was working for a beekeeper, and so I was one of his, like, only employees, and would just work. Thank

Scott Benner 22:19
you. For finally saying something Canadian. I appreciate that. Go ahead. Keep going.

Adalia 22:26
Yeah. So I basically, I would just then stick my earbuds in and listen to the podcast while I worked, because I was the only one who I was the only one there, and so I didn't have to worry about, like, other people, like having to talk with other people. So I could just stick my earbuds in and I just listened to, like, a bunch of episodes of podcast. I would seek out the ones with people my age, because I don't know, it was just something different to have people who also were kind of in a similar stage of life. Like, it's one thing to hear from, like someone who has type one themselves and is, like, 30 or whatever, but then to hear from, like a parent, then it's like, okay, like, okay. Like, it gives me a little bit of perspective on, like, maybe how my parents feel. But like, then to hear someone like, my age, who has gone through it, then I'm like, okay, like, this is really, like, feels very personable. And so that's kind of why I wanted to come on. Because I was like, Well, nice. I loved hearing other people's stories, and so I'd love to share mine. Not that it's, like, super exciting, but like, at least there's maybe a bit more of a young adult presence in the podcast and whatever. So if you

Scott Benner 23:26
think it would make you more like relaxed, I could like, play the sound of buzzing bees in the background while you and I are speaking. Oh, it's okay. Please just tell me for a second, what does a beekeeper need to hire help for? What do you do for them? So

Adalia 23:39
I did a lot of his production. So I would, you squeeze

Scott Benner 23:42
the bees till the honey comes. I don't understand. What does that mean? Yeah,

Adalia 23:46
so the honey would already be extracted. We made like different flavors of honey, so we'd add different things to it, like lemon or cinnamon or like chocolate, like we'd make different flavors. So I made that, and then I would we also made like beeswax candles. So I'd make a lot of his beeswax candles, and then he would sell his products at farmers markets. So I would go and work at the farmers markets and stuff. So how about

Scott Benner 24:07
that? That's a living. You can, like, stay alive, doing that, pay bills somewhat. Yeah. I

Adalia 24:12
mean, I was 15, so my high school job, I

Scott Benner 24:15
meant him, but he, yeah, yeah. He was actually, it's

Adalia 24:19
kind of beekeeping becomes more of a like, retired people's hobby, I see. And so that he was like, 86 and so his like,

Scott Benner 24:28
yeah, geez, I'm gonna try cinnamon honey, 86 that's not bad, Yep, yeah. Okay, all right, so you were doing that. That's nice. Do they pay you in loonies? Or how do you get paid? Yeah, loonies and two knees only. That's what I would figure because of the silly names, yeah, damn, yeah. And then how do you get to the job?

Adalia 24:48
He's our neighbor down the road, so you could walk, yeah, yeah.

Scott Benner 24:52
Do you wear snow shoes to get there? Or is that not necessary? I

Adalia 24:55
mean, it depends on the time of year, but Ah, see, no. It was usually. Own

Scott Benner 25:00
snowshoes. We do own snowshoes. Yep, people think I'm kidding, but I know what's happening. Yep, snowshoes. We

Adalia 25:06
don't use them on our street, necessarily. We do live in a suburb, but yeah,

Scott Benner 25:10
where the roads get plowed? Are you making the little quote fingers when you say suburb? Like, what does that mean? Like, there's a tree near you? Or what are you saying a suburb,

Adalia 25:21
I'll tell you my my view right now is a tree. I know a house. Oh, our car, our garbage bins. It's garbage day. I don't know

Scott Benner 25:30
cars, a tractor, though, right? Be honest, it's not a real car. It's a like a pickup from the 70s. Yeah, sure. You know fun at all. Okay, that's fine. Whatever. So upsetting. Like, you started off with the name, and I'm like, Oh, this is going to be great. And then nothing else was weird. Now, one other thing was weird, you're like, Oh, I had a nice after school job working for a beekeeper. I'm like, yeah, just casually, yeah, it's fine. You know, I went to school for math, millionly. What are you going to do in what they call University? Undecided.

Adalia 26:03
So I've just come out of a gap year where I was in New Zealand for six months, and then I'm going into another gap year.

Scott Benner 26:17
All right there. What do people call you like, add or add a or like, give a nickname.

Adalia 26:23
I don't actually, okay, all right. I do kind of just make people call me my full name. Nobody

Scott Benner 26:28
calls you. Leah, nope. What would happen if it happened? Would you be pissed? You think maybe a little bit. You correct them. Okay, all right, okay, I hear you. It doesn't matter. Um, it makes me think of that song, Cecilia, okay, you know that song? I

Adalia 26:43
don't think I know the song, but a lot of people do reference Cecilia and Adelaide when I tell them my name, yeah, because of

Scott Benner 26:49
it's the song. It's not the name. It's, first of all, it's Simon and Garfunkel. Do you have any idea who that is? I do know who that is. Okay, okay, so Cecilia and then it's Adelie. I think it just, it's musical like that. I can't sing, so it's hard for me to replicate it, but you get what I'm saying. Isn't it weird that I have, like, such a nice, deep voice, but I can't sing. That's a little disappointing. It is. I've been disappointed by it in the past. Oh no, I can't skip to this because I have to ask you, what do you mean? You took a gap year and you went to New Zealand,

Adalia 27:18
kind of just that. So I, I I left in September, end of September, I did go to I went to Australia for two weeks and visited some friends that I knew. And then I went to New Zealand for a three month like outdoor Ed adventure experiential learning program. Was supposed to come home after that, and then decided not, I'm going to stay so I went back to Australia for Christmas, stayed with my friends there, and then came back to New Zealand, and kind of just like lived and existed in New Zealand for three months, and then I came home at the beginning of April.

Scott Benner 27:50
Listen, are your parents rich, or was somebody grooming you to human traffic? You what was going on? Exactly, no, I

Adalia 27:57
actually paid for all of it myself with the B money. Yeah. I mean, I also lifeguarded, so I had two jobs. Were you stealing from

Scott Benner 28:04
that old man? Be honest? Is that what? You know, how much is it? How much this is not in my business. But, I mean, that's ridiculous. It's a podcast. I ask people things constantly that are none of my business. How much does it cost to go on a trip for a gap year? Like, how much did you spend the whole time? So, like, say it in real money, so we understand, like, American dollars. Go ahead, I don't

Adalia 28:24
know American dollars, American Canadian dollars aren't that different. But my plane tickets were about 2000 each way, so that's already like four grand. And then the tuition at the school was, like, pretty typical to like, a, like, university tuition. So it was like seven grand. How many second beans

Scott Benner 28:45
did that guy have? What were you doing? For Jesus, yo, he wasn't taking pictures of your feet or something while you were doing this work, right? Nothing. Okay, all right, okay. Wow, you're like, you're a little like, adult,

Adalia 29:00
yeah, I tried it.

Scott Benner 29:01
No kidding. You're like, you know, I just took my $900,000 that I saved, like helping the bees and went on a world tour. Like, do you curse Adalia? Do I? Yeah,

Adalia 29:14
I don't know, but

Scott Benner 29:16
what you're the worst Canadian? Have you ever stabbed anybody? No. Oh my God. What a mess. Okay, all right, hold on a second. You people run into someone if I snowboard, but heck, yeah. Okay, that just sounds like a I don't know what generation you're from. I don't, I don't keep track of that. What is your generation called? You know, I have no idea. I was gonna say you don't know. You're busy off scrolling away, 30,000 loonies or whatever. The hell. Holy, seriously. Okay, you're freaking me out. Okay, so you see, you did this whole thing. What did you do? It for personal enrichment to get away because you didn't know what to do in university. Like, what was the onus personal

Adalia 29:53
enrichment? I think New Zealand's always been like a bucket list destination, and then this program was kind of like exactly what I was. Looking for because I was like, I don't know what I want to do for university. And then, at first, it appealed to me because it was only a semester long. So I was like, Okay, perfect. I can do a semester in New Zealand, come home and then work for another semester. Spoiler alert, I ended up doing, like, seven months there, but it was like, it was personal enrichment. And then I stayed because I met really awesome people and had great opportunities to just do a bunch of volunteering. I had an older couple that I'd met offer for me to live with them. So I lived with an older couple. I

Scott Benner 30:27
see what happened? You became a concubine. Sure you don't even know what that means. You do. What is it? Wait a minute. I don't understand. Let's go backwards for a second. What's your IQ?

Adalia 30:39
I have no idea. You've

Scott Benner 30:40
never had your ID test this. No, you have the emotional intelligence of a 97 year old woman who has 53 kids. That's all so okay, you're never going to college. Well, no, I think I will when you're going to take another gap year. Where are you going now? Greenland, what's happening?

Adalia 30:59
I have no idea. It'll be interesting, because when this, like, releases, I'll probably be like, I don't know, in Europe or something working, or whatever. I have no idea. Wait,

Scott Benner 31:07
like, the astronaut things make it more sense now, because before, I just thought you were like a kid who was like your parents, like, what do you want to do Atala? And you're like, I want to go to space. But it's not like that. Like you have like, that wanderers, lost, yeah. Oh, yeah, oh, okay. All right. Oh, do you have a boyfriend? You don't. Do you? I don't, yeah, because they would just hold you back. Big, dumb boy everywhere you're trying to go, right? Yeah, exactly. You know, I'm seeing it now. Okay, all right, I get what's going on here. I'd like to set you up with my son's too old for you. We'll find somebody I care about and get you set up. Oh, you're perfect. I didn't realize. How did you become a perfect person? This is why God gave you diabetes. Because you were so perfect, they had to, like, make you dinged a little. Yeah, okay, no, no. How did you actually,

Adalia 31:54
like, thought that though? Because I'm like, I had no issues growing up. I literally, like, nothing.

Scott Benner 31:59
I just want to say when I say stupid, and people are like, That's ridiculous. I know what I'm talking about. I knew you thought that. Okay, all right, so we slow down. I'm too excited. Now hold on, give me a second. I'm figuring you out. It took me a half an hour to figure out, but it's because it's early in the morning, by the way, if it wasn't so early, I'd have figured this out 12 minutes ago. I just want everybody to know. Okay, so, all right, so you're, you have wanderlust, and you don't know what you want to do in college, because none of it seems attractive to you. Yes, okay, and you figured out you can make money, so you don't have any pressure to make money. Yeah, I

Adalia 32:36
mean, a little bit, but not really. Also, you're from

Scott Benner 32:38
Canada, so, like, how much do you need to live in Canada? Really? Like, got it, you know what? I mean, not a lot. It's well, well, you could just go to Saskatchewan if you needed to, and live there for like, I don't know whatever it costs to live there. I don't know anything about Canada. I want to be clear about that. I really don't know a goddamn thing about Canada. Well, the first time I realized there weren't penguins in Canada. I just played it off like I was being sarcastic.

Adalia 33:05
There are polar bears, I promise. Oh, I

Scott Benner 33:07
know there are. Don't you worry. I'm aware of everything that's happening. Do you know about the houses hippo? House hippo? Yeah. Oh, wait, let me try to think it through. Is that a muskrat? No, all right, I

Adalia 33:19
don't know what that is. It's a pet hippo. We just call them house hippos. Wait,

Scott Benner 33:22
people have hippopotamus in Canada. Are they like pygmies?

Adalia 33:27
They're like little mini, like little mini hippos.

Scott Benner 33:30
What is wrong with Canadians? This is ridiculous. The House hippo is a fictional creature from Canadian public service announcements that aired in the late 1990s look at you lying to me. You know, I believe that, right? Yeah, I don't care. God damn it, has become a beloved and memorable part of Canadian pop culture, and the PSA remains a nostalgic place for many Canadians. Well, I hope you know Adalia that you just named your episode house hippo. So good job. Okay, so you don't have a plan. Your plan is, what grab life by the balls and see where it goes. Yeah, kinda Okay. Well, it's gonna run. If you squeeze hard enough, it'll run around. So there you go. Oh yeah, you'll be all set. Wow, okay, and your parents are cool with this. Yep, yeah.

Adalia 34:15
I mean, like it was actually so I, I have dual citizenship, so I have a Dutch passport, so it's very easy for it would be very easy for me to, like, go over to Europe and work without having to, like, apply for visas, right? And it's actually like my dad who suggested that. And I was like, Oh, I thought you wanted me home now, since I've been gone for so long, yeah, he's like,

Scott Benner 34:36
You got to get the hell out of here. Your mom and I have been having way more sex than you left. So get the out of here. How do you get dual citizenship? Three

Adalia 34:44
of my four grandparents are immigrants from Holland, and because my dad's mom had kept hers, he was able to get his. And then you only need one parent to have theirs in order for you to get you. Ours. Okay? So then me and my two older siblings, we all have ours. Have you been there?

Scott Benner 35:04
I haven't. I've actually never been interesting. Do you own wood shoes? We do, yes. Have you ever worn the wood shoes on the snow shoes in Canada? I can't say I've done that. No. Then how adventurous, very uncomfortable. You're not as adventurous as I thought you were, then never mind. Okay, so now it makes sense why you're on the podcast. Because basically you're like 36 in your head, sure. Well, now do you not think that? Don't agree with me if I'm wrong.

Adalia 35:32
No, I do. I just think it's funny that other people think that sometimes

Scott Benner 35:36
you understand sarcasm, which is a very un Canadian thing, really? Yeah, what do you mean? Really? Do you not live near Canadians?

Adalia 35:45
I do, but I've been away for so long, I don't know. And you're

Scott Benner 35:49
just gonna go again, and you don't even know where, and that's not even important. It's just that you're going that's important. Yeah. Okay, so now I have to listen to all the people who I can hear screaming in my ear who are listening to this. I'm like, Scott, talk about how she manages her diabetes while she's obviously really well. First of all, where's your a 1c, what's your variability? Like, tell me about that.

Adalia 36:08
Yeah, so I was on MDI for a year and a half after my diagnosis. Because of where I was, you have to wait a year before you can go on a pump, and then the pump waiting list is really long. So after a year and a half, I got put on the OmniPod. And while I was on MDI, my ANC was 5.1 okay, like between 5.1 5.4 and then I got put on the OmniPod in June of 2022, and was on that for a year and a bit. And my ANC, I think it hopped up to, like, the high fives, just because I wasn't actually really using it in terms of, like, entering carbs and, like, having all my carb ratios. I just was like, this looks like it's five units. This looks like it's three units. This looks like it's 2.5 units. So that I was kind of using it the same way I used MDI. And so it was great to have more basal control. But my ANC did hop up a little bit to, like the high fives, low sixes. And then when I went to New Zealand, I actually switched back to MDI, and you're doing a five

Scott Benner 37:16
on MDI. Yeah, you have an eating style that's specific.

Adalia 37:21
No, not really eat whatever.

Scott Benner 37:25
Oh, my God, wait a minute. Is this the moment? Did I teach you how to do this? Yeah? Oh, I didn't know this was gonna happen. Oh, excellent. Oh, oh, hold on. A second. Give me a second. I feel good about this. I've allowed you to travel the world and keep a five, a, 1c, yeah. Oh, my fucking hero. Oh, okay. All right. All right. This is good. Okay, okay. All right. How did I teach you that? What did you learn that in the podcast that helped you do that?

Adalia 37:50
A lot of it, like, I don't think there's anything like specific it was just like hearing how other people did it, like, like the Pro Tip series and all that incredible. And I listened to a few of them. But like, when I was just thrown with, like, all this information, I was like, okay, like, this is great, but, like, how do I do it? I would just pick and choose different things from different people's like interviews and like, someone would say, Oh, I do this, or oh I do this, or oh I do this. And I'd just be like, Oh, let me try that. Let me try that. And so I kind of just pick and chose from all the different, like strategies that different people used, and then it ended up working. Like, granted, I was taking like, maybe, like 12 injections a day. It was like kind of crazy, like they recommend what, like one per meal, plus like one in between. But I was probably taking like 12 to 14 injections a day. Oh,

Scott Benner 38:37
my God, I know why you like the podcast, why you and I think similarly, right? I yeah, I think so, oh, my God, you're like my daughter, except like, from Canada, and not really from Canada, more like the Netherlands. But you understand what I'm saying. Okay, all right. Oh, this is super interesting. You don't want to go to college. Well, I

Adalia 38:58
think I do. Though. I just like, I don't know what for. I don't know I had applied, like, last fall. I'd applied to go for like, this September, but you're not doing it. No, I'm not. I didn't know what I wanted to do, so I applied to like, six different programs. Like, I had no clue what I wanted to study.

Scott Benner 39:15
Finish this sentence, I would choose a college direction. But I'm afraid that if I picked one, then I'd be locked in. Yeah, when I think about doing the same thing every day for the rest of my life, it sounds like torture. Oh, my God, you and I are the same person. Oh, this is so crazy. Okay, all right, hold on a second. You would have never made it through the astronaut thing. No, no, no, it would have been too specific, yeah. Oh, your IQ is in the 130s you should get it tested. Okay. Oh, no, no, seriously, I got you. Oh, okay, hold on a second. I'm not telling anybody my IQ, but I. Ah, but here's yours. No, I'm not telling you mine. It would embarrass me, because I don't understand anything, so it makes it seem like I'm lying, like I don't, like, you know algebra, yeah, I don't. Oh, my god, yeah. Oh, you have the thing. Are you thinking all the time? Yeah, right. Do you have like, these great ideas when you're in the shower sometimes? Okay, most of the podcast I dream up while I'm taking a hot shower. I Yeah, that's fair. Do you need to write anything down, or do you just work out of your head? I

Adalia 40:35
used to work out of my head, but now I need to write things down. I can't just, like, I'll remember something, and then be like, oh, I need to write that down. And then 10 minutes later, be like, What did I say? I need to write down. Like, okay, I there's just now so much in my head that I'm like, Okay, I do have to write things down. When

Scott Benner 40:52
you decided you were going to New Zealand, did you do much like, I mean, you knew where you were going and you were gonna stay with friends and everything, but did you think about it much past that?

Adalia 41:00
No, I was like, I'll just go, like, yeah, yeah. I like, thought out all the details. I was like, Okay, well, I'll make sure I know, like, how I'm gonna get here, and like, all these, like, book a bus and, like, do all that stuff, like, all the like, logistical things, like, okay, making sure that I'm not, like, stranded on the side of the road. Other than that. I was like, well, let's just see where it takes me.

Scott Benner 41:18
The things that you understand, do you have to methodically go through them, or do they just make sense to you? Things that

Adalia 41:24
I understand, I think I they kind of just make sense. But there are things where I do have to, like, kind of methodically. I'm a very like, I like it. It makes sense, but then I'm like, Hey, but then why does it make sense? Like, that's the question I asked.

Scott Benner 41:35
You do care about that? You care about? Why? Why you think? But that's because you're young. You're still doubting yourself. Sure? Yeah, people call it narcissism when I do it, but I'm like, Yeah, I'm just, I'm just really sure I don't need people laughing while they're listening to the pie. Like I'm imagining some, like, 16 year old girl listening right now, and there's bees flying around her head, and she's like, No, man, I think you're probably narcissist. But like, you know, um, I really don't have like, classic narcissistic like, tendencies. I just really believe in myself. Do you believe in yourself? I do, yeah, but for no real reason to right, because you're 18?

Adalia 42:11
No, yeah, no, literally, I'm like, I'm just a girl. I don't really know what I'm doing, but, like, whatever,

Scott Benner 42:19
can I just say that if your parents are to die tragically, and I hope that doesn't happen, and if Ziba pop bang, and your other brothers and sisters can't help you, I'd be happy to help you a little bit. Okay, okay, sounds great. So follow your heart. That's all you do, right? Hi, deaf, yeah. If I were to ask you, like, how do you take such good care of yourself while you're traveling, you'd go, I don't know, I just, I just do it.

Adalia 42:43
Yeah, I was trying to think, like, I was, like, I was lying in bed last night. I was like, hmm, like, how am I gonna explain this? And I really have no good explanation. I'm like, it kind of just, I kind of just did, like, it was a little tricky at first, like, transitioning back to MDI after being on the pump for like, so long. But then also, like, flipping time zones really messed up, like, my blood sugars for a little while, okay, like, after that, like, once I got it, like, once I figured out, okay, like, my basal rate, and, like, all of that stuff again. Like, it was just like, I don't know, muscle memory, and I kind of just went with it. And I was like, well, like, yeah, you're

Scott Benner 43:18
my greatest accomplishment. This is fantastic. Okay, is there any chance now? There's no chance. If you get older and make a baby, you're not going to call it Scott, you're going to call it like, zippity doodah or something like that. Like, so, yeah, like, so that's not going to happen, okay? And you, plus you don't need boys. They're dragging you down. Yeah, I

Adalia 43:38
don't really want kids either, so I don't want to get

Scott Benner 43:40
you in trouble with the mob, but do you fit in with people your age? There's no way, right?

Adalia 43:45
Not really, but yes. Like, I think I, like, let myself fit in. I don't know. Like, what?

Scott Benner 43:50
You have no anxiety? No, no. You have no anxiety, right? No, yeah, okay, and you don't drink. No, you've never smoked weed. No, you don't even plan to. No, if someone asked you to, you'd just get up and leave. Yeah, I know exactly who you are. This is fantastic. Oh my gosh. Are there others of us out there? Ring a bell, see if more come

Adalia 44:18
there are some others, like, I don't know. Like, maybe I don't know.

Scott Benner 44:22
Oh my god, seriously, my daughter is so much like me. Arden is so much like me, and I think you're more like me. This is very weird. Never tell her. No one let Arden listen to this episode. Okay, I love you too, Arden, but I also love Adalia. She said she's fantastic. Oh my god, your parents must be thrilled with you. Yeah, yeah. No, no, no, you were probably the the least of their problems, even with the diabetes. Oh yeah, yeah. Are the other ones among are there monsters or the other brothers and sisters? I can't say that. No, listen to this, but are they moonshining and doing stuff like that? No,

Adalia 44:58
no, but like. I mean, well, so my older sister's married, and so she's great, but I think there was, like, some periods of time where, like, definitely, like, a bit of a problem, yeah, and like, same with my older brother, and then my younger brother's 14, so he's just started high school.

Scott Benner 45:14
Oh, we don't know what's happened to him yet. Yeah. So who knows, in high school, you weren't a great student, right? I was. You were like, A's, or is that how they marked them in the Canada A's, um, we

Adalia 45:27
usually do percentage marks, but like, I, I mean, I finished with, let me see what, um, look

Scott Benner 45:34
at how it matters to you. If the numbers right, just you did well, is that? Is that right? You're like, let me get my report cards. Hold on, I finished.

Adalia 45:43
I finished high school with an A average. Okay,

Scott Benner 45:45
okay, so you have, oh, my god, maybe it's because you're a girl, because I can't overcome the feeling that I don't want to be tied down by anything. Like, I can't overcome that. Like, if you try to tie me down to something, I'll, I'll say, I don't see the value in that. And then I walk away from it. I don't want to be and people are like, that's ADHD. It's not ADHD. I I am not wasting my time with something I know I can't do. Oh my god. Arden just started talking to me about school last night. She said all this to me. Oh my god, am I gonna have to let her do what she wants to do? I already paid so much money though, I don't know. Um, okay, all right, I'll have to think about that. Oh, my God, this is so interesting. Did you know this about yourself? Did you know we were like, like, brothers from another mother when you came on? Or did you not really,

Adalia 46:35
like, I think, like, I knew maybe that, like, we kind of thought, like, similarly. But then I'm like, okay, but then I'm like, okay, but do I just do that? Because I'm like, have I've just become a minion to the podcast.

Scott Benner 46:44
Hey, listen. If that's what's going on, I gotta say I'm down for building an army. You know what I mean? Like, yeah, yeah. Because I might transition this whole thing into a cold at the end if I need to pull some money together. You know what I mean, fair enough.

Adalia 46:58
Yeah, so. But no, I don't think I really, I don't think I really knew. Like, there were things that I was like, okay, like, this is a little interesting about myself, but, like, maybe I just didn't really have a way to describe it. Yeah, I don't know.

Scott Benner 47:10
Wow, you got rid of the hippo title. Good job. Now this episode's called mini Scott, or maybe mini Canadian Scott, Canadian mini we'll figure it out. This is lovely. Are you like your parents? I think so. Your dad has it a little bit, right?

Adalia 47:29
Yeah, my dad does. But like so my family's also riddled with ADHD, so it's

Scott Benner 47:36
like he said that you said that like you had mold in the bathroom, and we all know it's too cold in Canada for you to have mold. So, like, so what do you mean? Like,

Adalia 47:47
okay, so my dad and then my two older siblings all have, like, some sort of add ADHD. My dad is a very like. He is a very like. Think it through logical, like, methodical person. He does like software, programming and stuff and so, like, all of but then, like, he really likes the, like formulas and when it all works, and like, all of that stuff. And he's very smart. And then my mom is, like, a very, like, academic kind of person, like, so she had gotten a master's degree, had four kids, went back for nursing school, and then now is also getting a second master's degree. And so she just, like, she's never stopped learning, like she's always, like, trying to, like, gain new information. Your

Scott Benner 48:32
parents are methodical thinkers, yeah, but are you? I can be, but it's not your default, no, not really. If I describe to you that thinking about something to me was just telling myself a story in my head till my brain gave me the answer. Does that sound like something you understand? Yeah, so my son was explaining to me about being like a methodical thinker and going through things like line by line, almost like writing or reading code, right? But when I think about big ideas, I just think about the question until the answer arrives, but I don't step through it with any words or solid thoughts, yeah, I never know how to explain that to people. Like, I end up saying something flippant, like, No, I just know what the right answer is. But I don't really just know what the right answer is. I just think that while I'm thinking about it, the words aren't available to me. The answer is, yeah, this sounds ridiculous to people. Don't you think?

Adalia 49:34
I think it would like, it sounds ridiculous a little bit, but then I'm like, wait, but that's the exact same way that, like, I think as well sometimes where I'm like, well, it's clear. It's clearly not ridiculous, if we both think that way, like, so

Scott Benner 49:47
if you really listen hard to the podcast, I like that. It's just because you and I agree you're like, obviously it makes sense. If you really listen hard to the podcast, I make the most sense when I get revved up and I get going, yes, because. Words. I don't know where the words come from. Like you think, like you might think. Scott knows all this stuff. It's all written down in his mind. He's pulling from it because he knows that today he's gonna get on a an episode with Erica and talk about resilience. And he must know a bunch about resilience. I don't know anything about resilience. I don't know anything about people, how their brains work. I know none of it, but when you get my brain warm, and I literally mean warm, I warm up while I'm making the podcast, my body gets hot when I heat up and I start going, I don't know what I'm about to say next, and I always make sense, and I'm freaked out by it. If I'm being honest with you, I don't know how it happens, or where you can't just call it intelligence or like, people do that. They're like, Oh, it's a it's IQ, it's emotional intelligence is, I don't know what the fuck it is. I have absolutely no idea. I can't even quantify it. I just know that if you get me going, I will be entertaining, and I will make sense, and when I'm done, you'll go, That guy seems to know something. And I don't know where any of it comes from. But you know what I'm talking about, don't you?

Adalia 51:03
I do my issue. I think you have an advantage where, like, all your conversations are recorded, whereas, like, I have found, like, I'll be like, I do it when I'm driving. I'll like, start getting, like, really excited about a topic, or, like, my friends will bring something up, and I'll just start talking like, and I'll just, like, continue. And I'm like, I don't even know where these things are coming, where these ideas are coming from. Like, what? Like, whatever. But then at the end of the conversation, like, dang, I wish I could remember what I just said. Like,

Scott Benner 51:27
I have no idea what I've ever said. Like, that's like, that's why, like, I'll have there are people who help me, like, wonderful people who are like, group experts in the Facebook group and and Isabel, who's very, very like, if you enjoyed the last two years of the bowl beginning series, that's pretty much Isabelle. Was like, You need to have an episode about this and this and this, because this is what people are talking about. I'm like, okay, like, I never would have thought of it like that. I would have just That's why even, like, the Pro Tip series, I made it up, like I said, I sat down one day and I was like, what's important about diabetes? And I made a list, and then I sent the list to Jenny, and I go, Hey, I want to make a series about this. And she goes, Okay, would you mind if I put it in a better order? And I was like, I don't care. And she's like, she moves stuff around. She goes, that's the order. And I went, all right, whatever. That's fine with me. Like, like, that's and I was like, Okay. And then, have you listened to the Pro Tip series? I've listened

Adalia 52:19
to some of them. I can't say I've listened to all of it all the way through, but I've listened to bits and pieces, but it's

Scott Benner 52:24
helped you. Yeah, yeah, with of what you've listened to, of it, did it feel like haphazard or thrown together? Not at all. No. Do you know that every episode of that series started with me getting Jenny on, like I got you on, and saying, Hey Jenny, today I think I want to talk about this one. And she goes, Okay, and then I just start talking about it.

Adalia 52:45
Yeah, I did know that partially because maybe just mentioned it a couple times. I mentioned

Scott Benner 52:48
it because I'm freaked out by it. Even when I do public speaking, I don't know what I'm going to talk about. Yeah, I put slides up because the people who invite me out to speak seem to think it's important that I bring slides, but I don't need those good slides. I'm like, I'm like, I don't like, like, I just stand up there and I go, all right, diabetes. And I look at people, and I go, what do they need to know? And then I tell them. But if you ask me five seconds before that, what do people need to know about diabetes, I'd be like, I don't know. I gotta start talking about it to get it out. Oh, my God, I'm so upset. I'm upset for you, because you're gonna live your whole life like I had to, like, not knowing why you know something. Yeah, it's I really it does bother me. Sometimes Me

Adalia 53:31
too I yeah, I find sometimes I'm just, like, I really do wish I knew where this was coming from, or, like, what? Like, yeah, I don't know. Even in conversation with my parents sometimes, like, I was talking to my dad the other day about something, and then he's like, you're holding yourself better in this conversation and about this topic than, like, a lot of adults that I've talked to, and I'm like, it's not that difficult. Like, I feel bad for saying it, but like, it doesn't seem that difficult. People aren't going

Scott Benner 53:55
to believe this, but I feel bad for saying it too, like I really do because, because I don't feel like it's something I can actually take credit for. Yeah, it's not like I had to sit down and learn about a topic or something like that. Like, that's when I talk about common sense. I'm like, well, that's just obvious. And then I finally had somebody say to me one time, like, Scott, it's not obvious to everybody. And I went, Oh, okay. Like, I'm not mad at people for not having common sense, like having the answer's not like popping into their head or something like that, but I'm also older than you significantly. Like, I'm like, I'm 30 years older than you, aren't I 32 years older than you? 34 years Hold on a second, 2838 48 and then 4950 I am. I am 34 years older than you. I can look back and tell you that the things I decide to do, generally speaking, go, Well, yeah, that's all I know. People in my life come to me for advice all the time, and it's been happening since I was in my 20s. Like people will come to me and say, What would you do in this situation? And I go do this, and they're like, Okay. Okay, and then they just do it, like the tug of war thing, about the pre bolus thing. I made that up on the spot. I had never thought of it once in my life, and it just popped into my head. And then I just said it out loud. And then the girl was like, Okay, I understand. Thank you. And I was like, Okay. And then I said on the podcast, and then Jenny came to me one day and goes, that's the clearest explanation of pre bolusing I've ever heard in my life. And I was like, Really, I made it up on a phone call. Yeah?

Adalia 55:23
Well, it's because you didn't think about it. I feel like when you do think about those kinds of things, sometimes it just becomes so jumbled and like, so many words are used. And it's like, really, when you don't think about something like it comes out in the simplest form for you and me.

Scott Benner 55:37
Yeah, right. Because I don't know. Why isn't that interesting? Very interesting. This has been a lovely self reflection conversation so far. Okay, see, because I got I figured out, like, 25 minutes ago, if I asked you about your diabetes management, you're not going to know what to tell me. Yes, yeah, no. Arden's the same way, like people are like, have Arden come on to talk about she takes care of her diabetes. I'm like, she doesn't know. She just does what makes sense to her after what I told her was important. Yeah, I don't know, because my endocrinologist

Adalia 56:08
hate it, maybe, but it's okay. Yeah, we don't care what they think.

Scott Benner 56:15
Can you imagine you have an A, 1c, in the fives, and your endocrinologist has anything bad to say about you at all? You'd be like, listen, they couldn't do better for you. No, no, not at all. Do you have any plans on having children? No, I didn't think so. Okay. Do you date, like, casually? No, bump into guys in bars and you know what I mean, like, just that

Adalia 56:39
kind of thing I did. Like, I dated a guy for like, a year and a half, but like, I haven't since. It's

Scott Benner 56:45
insight time tell everybody why you don't date him anymore. There's a lot of reasons I know I want to hear what they are, because they're your reasons, and they're going to be very specific, and unlike other people's reasons. So go ahead.

Adalia 56:58
I just, I mean, one, I was not like me leaving was a reason, but I was just like, I couldn't predict, or like, I didn't know what to expect for when I went away. And then I was like, well, then clearly this isn't a secure relationship. And so, like, that's not good. Well, I mean other things,

Scott Benner 57:16
because the answer is, if my brain told me to keep dating him, I would be, yeah, but the reasons aren't important. You just knew it wasn't the right thing to do. Yeah, and you're happy. I'm very happy. I know I can hear it in your voice. That's crazy. When you got diabetes, did it phase you? No, not really. Did you have a plan? Or your brain just did the same thing. It just did the Well, now it's time to do this. Yeah, my

Adalia 57:43
brain was just like, Okay, well, perfect. Like, this is just something else I have to do. But, like, not in a negative like, oh, there's something else I have to do. It was just like, Okay, well, like, this is just another part of life now, like, relearn how to do it and then just move on.

Scott Benner 57:56
I thought I felt that way because I grew up hard. I thought it was, Oh, that's so interesting. Maybe it's just because, if I have you heard me describe that I wake up every day hopeful, like the whole world's reset.

Adalia 58:08
I don't think I've heard that. No, do

Scott Benner 58:10
you feel that way? Sometimes, I

Adalia 58:12
don't know if I've ever thought about it like that, but do you wake up

Scott Benner 58:14
in the morning and feel burdened by what happened yesterday? Or do you feel like new day start over Groundhog Day? Sometimes

Adalia 58:20
feel burdened, but I A lot of times just like,

Scott Benner 58:23
No, it's interesting. The worst thing in the world could happen to me, and I don't wake up the next day thinking about it, yeah, because I've already thought about it. I know what I know about it already. I don't need to think about it again. Yeah,

Adalia 58:37
it's not worth the brain space or energy. Sometimes,

Scott Benner 58:40
do you ever think about something to the end of your understanding of it and then spend time wondering what exists beyond your understanding? Yeah? Oh, God, really.

Unknown Speaker 58:54
Okay.

Adalia 58:56
Sometimes scary though. Yeah, to do that,

Scott Benner 58:59
I explain that to people, and they're like, I don't know what you're saying. That's saying. And I'm like, There's something beyond what I understand. What is it? And they're like, if you don't know what it is thinking about, it's not going to help you. And I was like, I know, but the but just by the way, a very accurate description of why it's a waste of time. But like, it's the wondering, what's there I'm waiting for my brain to fill it in. And sometimes it does, yeah,

Adalia 59:26
and sometimes there's like, well, though, like, the question of like, well, if I know up to this part, like, why don't I just know that much more,

Unknown Speaker 59:33
right? What's

Scott Benner 59:34
out there that I don't that's why you wanted to be an astronaut, yeah? Oh, boy, is this interesting. I'm so sorry. It took me a half an hour to figure all this out about you. But okay, I also want to say, let's be honest, there's very few people who would have drawn any of this out of you in one hour. I am. I'm almost amazing. Yeah, I'm quite impressed. Oh, you should be, everyone listening should be you should, right now, be going like I don't do enough to. Spread the word of this podcast to other people, like, if you're listening right now, you're letting me down. Just so you know, even if you're trying really hard, you're not trying hard enough. Because these are the kinds of, I'm just being sarcastic, but these are the kinds of, these are the conversations. La, when I get up in the morning and I think, why is my podcast not more popular? It's this episode, and episodes like this, where I think this has nothing to do with diabetes and everything to do with diabetes, and everyone should be listening to this. When I put out the after dark episode about the woman who went to prison, did you hear that?

Adalia 1:00:31
Oh, I It's on my list. I literally was gonna listen to it on my drive. I have to drive back to I'm working at camp right now, and I have to drive back to camp. It's like two hours. So I was literally gonna listen to it

Scott Benner 1:00:42
right after this. It's gonna shrink your balls to the size of raisins. Do you understand what I'm saying? Like, it's getting it's gonna throw you for a loop. But when it, when I actually listened back to it, because some I got so many notes the day it came out, I was like, Man, I should go listen to that. So, like, I put it on listen to myself, which is weird. I understand, yeah, but I got done, and I was like, that's a good podcast. Like, forget diabetes. That was a good podcast. And I got stuff out of that lady. Like, Wait, do you see and do you know the other night? Like, literally, it might have been two nights ago, she emailed me and she said, yeah, yeah. Hold on a second. Let me find it. Let me find it, everybody. Hold on a second. Chill out. If you're driving, keep looking at the road, stuff like that. If you're at the grocery store, now might be the time to figure out what kind of peanut butter you're gonna get. Hey, thank you again, Scott, for giving me the opportunity to share my story with you. It meant the world to me after we got done. This is a private note. I'm probably not supposed to be sharing this on anybody after we got done. I assume people know if they share something with me could end up online, right? Yeah, surely, yeah. Okay. After we got done, I cried happy tears. I felt like a part of my inner child was healed after years and years of negativity, given the chance to speak, to share my voice to so many living with a condition was not only an amazing experience, but healed so much inner trauma. I hope my story touches the lives of others, and I will continue to support your podcast. I talk about it all the time with my family and friends. If you ever want another jail story, don't hesitate. I've got plenty. How great is that? That's incredible, yeah? Like, I'm done for the rest of the day. I've already added to the world. If I don't do anything else today, I'm good, yeah? And after I had that recording with her, like I didn't know I did all that for her, like I didn't know the experience did that for her. And you can be like, Oh, Scott, you didn't do it. She just wanted to voice her. I made the thing where she could do it, like I did do it. The whole thing's my idea, but it's not really my idea. It's my brain's idea. And I'm not joking about that. When I was writing a blog and people stopped reading, I thought, I don't want to lose the ability to talk to people. And then my brain actually said to me, this is a quote from my brain. Katie Kirk said, You were good to talk. You were good at talking to people. You should start a podcast. Wow. And I only knew what a podcast was because of Kevin Smith. You must know Kevin's Jay and Silent Bob. I think so. Okay, so Kevin Smith had a, I don't know if he still runs. He had this great podcast called smodcast, and I loved it. I loved like, the way he he almost felt like he was rambling, but everything made sense, and there was no beginning, middle or end to what he was talking about. I enjoyed that, right? So I, I knew about podcasts because of Kevin Smith. I know about talking to people because of Howard Stern. Like, because I know these are names that mean nothing to you, but like, I like, I like morning radio, okay, like, so I like getting up in the morning and listening to people talk to each other, people who I feel like I know somewhat their story and who I like, the way they talk or think or feel or whatever, the way they the way they communicate, generally speaking. And so I was like, Oh, I'm gonna start a podcast. That was 10 years ago. And for years I made that podcast to nobody, like, seriously, like, three years in, it took me a year to get the amount of downloads I got this month. And, like, so I was doing it because I was like, this makes sense. Like, this is going to work. It's going to get bigger if I just do this, if I just do that. And like, people in my life will be like, you're too focused on this. And I'm like, no, the answer is out there somewhere about how to make this more valuable for people, how to make it so that more people can find it, and more people like this, person who sent me this email can have this feeling, I don't know the steps. And if you go to like the internet, or, you know, you go to chatgpt, and you ask it like, how do I make a successful podcast? Everything it tells you is useless. I believe that it's it's just the banal stuff that people say when you ask them questions about that. But none of it's real. It's not actually how you grow something like this. But if you ask me how to grow it, I have no idea. You wait. You wait till your brain tells you the right thing to do. Then you, does it sound like I'm boasting? I don't think so. No, because I don't mean it that way. Yeah, yeah. There's plenty of things I suck at. Yeah. Like, if

Adalia 1:05:15
someone didn't know that you didn't mean it in a boastful way, then maybe they could interpret it that way. But like, I don't know. I think you're it to me, it just sounds like you're kind of just explaining.

Scott Benner 1:05:24
I am just trying to explain how my brain works. Yeah, yeah. And literally, I don't feel like I can take credit for it. And there are plenty of things I'm absolutely terrible at, so if you'd like me to tell you about those, you'll see that I'm not boasting. Okay, the interesting thing here is, is that you're gonna, you're about to live a whole life like this. Yeah, is that exciting to you, or is it scary?

Adalia 1:05:43
It's a little scary, yeah, I don't know. I think, like, already, like, realizing, like, all, like, the, I don't know, like, the typical path, like, whatever it was, like, that's not for me. I don't think it's for very many people, actually, unfortunately, yeah, I don't know. After realizing, like, life could be just kind of whatever I make it to be is exciting and scary, because then it's like, Well, I actually, like, the not knowing. I think used to be really scary for me, but then now I'm like, Oh, whatever. Like, that's just great. Like, I why stress about something I don't know about. It's also there are times where, like, I would love to just be able to, like, maybe have somewhat of an idea, but, yeah, I don't know it's a bit of both. So stability, you're worried about stability, maybe, yeah.

Scott Benner 1:06:29
What about like, diabetes supplies?

Adalia 1:06:31
Yeah. So that is one thing where I just am, like, unfortunately, it is like, Okay, well, I know that I have to set myself up well, in that I either have a high enough paying job that I can, like, afford diabetes supplies, or one that has enough coverage. It is something that is always kind of the back of my head where I'm like, Okay, well, I do kind of have to go and do something a little bit more but, yeah, I don't, I don't know. Like, I what that looks like. I have no clue.

Scott Benner 1:06:58
Yeah, there's no way you're never gonna know. It's so interesting. Do you ever work on something, start doing something, and get to a point where you say to yourself, my brain's not wired this way. I can't do this. Do you just bail on it and go in a different direction? No,

Adalia 1:07:13
I wouldn't necessarily bail on it. I definitely like to see things through, whether I enjoy it or not, like I hate to leave things unfinished.

Scott Benner 1:07:21
Okay, does it cause you, uh, disappointment? If you do sometimes,

Adalia 1:07:26
yeah, I feel like, even with like, within myself, disappointment, but also like, then it's like, well, now I'm like, making someone else have to do it. And so then I'm like, Oh, well, I hate to do that. So Okay, all right, what

Scott Benner 1:07:39
if it's just a personal thing, if dropping it doesn't hurt anybody else, but it's like, you, I don't know if you got up one day and you're like, This is what I'm gonna do for the rest of my life. And you're like, six months into it, you're like, I don't like, jive with this well, like, could you just pivot away from it, or would you hammer through it? Do you think?

Adalia 1:07:55
No, I think I could pick. I would pivot away from it. I would not like, if it was something to that extent, like where it was, like my life, and maybe, like what I was doing, or like the job I had, like, whatever, if I, if I didn't jive with it, I would, nah, I wouldn't stay, okay. It's

Scott Benner 1:08:11
interesting. Would it cause you pain to stay, like, actual, like, mental anguish? Possibly, yeah,

Adalia 1:08:19
yeah. I don't know. Like, I I'm trying to think of different things, but like, I've lived such a short life, but like, I don't know there's nothing I can think of right now where I'm like, oh, like, I did leave that or like, I stayed in this too long. Like, I don't I try to not stay in things that aren't right for me. Too long. Yeah,

Scott Benner 1:08:38
I forgot that you were 18 a while ago. So you even know that your life's been short. Most people your age think they've been living forever. Nah. It's also interesting. And you're Canadian, but you're not really, yeah, yeah. I didn't know people from Canada thought like me, yeah, I thought, I just thought you guys drank beer, like, worked in like an oil rig and stab people in a bar like I didn't really know anything else happened there, but apparently, there's other things going on. I'm learning

Adalia 1:09:06
there are other things going on. Yeah, I've

Scott Benner 1:09:09
never been to the Netherlands either. Yeah, me neither. Well, yeah, no, my son came to us the other day, and he goes, I've been talking to somebody about the possibility of working in the Netherlands, and I went, really, I don't think it's gonna happen. I was like, okay, like, I never had a conversation like that in my entire life. Yeah, super interesting. So if I told you my son and my wife are very, like, methodical thinkers, like, does that isn't that weird.

Adalia 1:09:36
It's weird, but it's not at the same time. Like, I think that, like, I don't think people who aren't methodical thinking thinkers could like, if I was thinking about marrying someone, I would not think about marrying someone who thinks the same way as me. Oh yeah, we'd

Scott Benner 1:09:49
be dead if I always say people, if I met someone like me and we got married, we would just die. Yeah, one day we'd be like, Oh no, where's the food, but yeah. But once I. Yeah, with security, I can take very good care of myself, but if you left it to me at 18 to find a way to make a living, I would have been in trouble. And was what's wrong? Okay, are you being abducted? No, oh, I thought I heard you talking to somebody. I heard I thought you were sorry. I said, interesting. Oh, okay, sorry. How did I put it to my wife? Like, so my wife saved me. Like, my wife went to college and got a, like a, like an adult job, and that gave me time to follow. Oh, God, I am gonna have to let Arden do the thing. She said, okay, all right, so that gave me time to follow my head and, like, let it see where it took me. And in the beginning, I just pointed it at my kids. I was a stay at home dad, so I was able to, like, very like, seamlessly raise my I'm like, Can I be honest, a fantastic father. Oh, I believe it, but it's only because it's like, all the stuff is obvious. Like, you know, like, if it had been raining for four days, and then I woke up on Thursday and the sun was out and it was warm and I had plans, or I had to do the laundry or go shopping, I would just go, Oh, that's not important. We'll move that over and let's go take advantage of the of the weather. And I didn't have any probably didn't sit around all day thinking, Oh, God, I was supposed to do this. So I was like, I'll just take care of that another time. Like, Oh, do you do the reordering your to do list thing? Oh, yes. Oh, and it's, it's effortless, right? It doesn't matter. Like the most important thing becomes the fourth most important thing. Who cares? It gets pushed down. It

Adalia 1:11:32
gets done when, when it really needs to get done. And, yeah, my wife

Scott Benner 1:11:36
yells at me for that. Her brain can't make sense of it like she put stuff in order. I hate to do lists in general. I just, I hate it when she hands me a list. Do you know, if she gives me a list for the grocery store, she has less chance of getting what's on the list, and if she just tells me what to get? Really Yes, because when I walk around the store, I do it with no purpose. I don't think, Oh, my God, I'm sorry. I wish you were older, so we could be friends, but you don't want to be friends with a 52 year old guy from New Jersey. So I don't like that's gonna happen. That's I mean, how bad does that sound? I don't know. I'm friends with my dad. So are you? Yeah, why do tell me about you and your father's relationship? Oh, we

Adalia 1:12:22
just my dad. It was always when we were kids, like, very intentional about, like, doing things that we were all interested in and so and, like, even if we were doing something and he didn't know much about it, he would learn about it. And so I don't know it always like, yeah, there's just like, little like quirky things too, where, like, we've bonded over random things. Like, I think back to like, in the pandemic, when we were both like, like, I was doing school from home, and he was, he's always been working from home, like, he's worked from home since, like, before the pandemic. But we just, like, would always, like, grab like, we bonded over like, potato chips. It was probably really bad for us, but it was just like, I don't like little things like that, where, yeah, I don't know. Like, I can have a conversation with him and not feel like I'm being always being told what to do or how to do things, or like, whatever. Like, it's actually like, I'm treated like a person, and so I'm like, well, we can, like, I have no issues telling my parents things, like, I'm I'll just I don't know. I don't really. I not that. I don't hide things, but like, I don't, like, I'm not, like, afraid to tell them things, because I'm like, well, like,

Scott Benner 1:13:27
Yeah, they'll accept it, right? Yeah. Wait, were you making the potato chips, or did you go out and buy a bunch of different brands and just

Adalia 1:13:33
get them and try a bunch of different flavors and, like, whatever. What's

Scott Benner 1:13:36
the best potato chip? Oh,

Adalia 1:13:39
there's one. Well, I really like lime and black

Scott Benner 1:13:43
pepper. Lime and black pepper. Yeah, is that, like, is that a company that makes it, or it doesn't matter? It

Adalia 1:13:49
doesn't matter. I think there's a couple different ones that make it. And it's tasty, spiced, spicy ketchup chips. But you guys don't have ketchup chips, so I think

Scott Benner 1:13:58
we do. Do you? Yeah? I think so. I mean, it's America. We have everything true, yeah, and if we didn't make it, we'll get it, or we'll just take it. We'll just take it from you. Doesn't matter. Yeah, you probably did take the ketchup chips. Yeah, we'd be happy to just come up there and take your ketchup chips and be like, shut up. We're taking that. Yeah, yeah, no, we can do that. We've been doing it for like, hundreds of years. Don't worry about it. How do you think of America? I

Adalia 1:14:22
don't know. I don't really think of it as, like, sometimes I think of it as, like, a super far away country, and then I realize I'm literally, like, two hours from the border or but then, like, other times, like, it just seems like the same, like, very similar, at least,

Scott Benner 1:14:37
like, warmer Canada, yeah, yeah. When you think of Canada, do you think of it as, like, the greatest place in the planet? No, no. When you think of other places, do you think I don't want to go there because it won't be as good as here? Yeah, that you do think, okay, yeah, was, did New Zealand hold up? Or was there like a jumping spider in your bed? And you're like, why am I? Here,

Adalia 1:15:00
no New Zealand was incredible. There's New Zealand is the one that doesn't have, like, any predators. Like, they don't have any dangerous animals, really. They like, maybe, like, two species of, like, poisonous spiders, but, like, yeah? Like, they just have a bunch of birds, birds.

Scott Benner 1:15:16
Yeah, that's because there's nothing to eat the birds, right? Yeah, yeah. Oh, that's

Adalia 1:15:21
interesting. So, yeah, no, New Zealand was incredible. And, I mean, I stayed twice as long as I was supposed to already, and so it was just,

Scott Benner 1:15:30
where are you right now,

Adalia 1:15:32
I'm at home, but I'm working at camp for four months. So I've been at Camp since the end of April. What kind of camp? And I'll be there a summer camp, like a place

Scott Benner 1:15:41
where Canadians drop their kids when they're sick of them after school. Yeah, yeah, I get what you say. You said sure. Do you mean no, or do you mean yes? You got that exactly right, and it's kind of that okay, but

Adalia 1:15:54
yeah. So I worked there, so I got home from New Zealand, I had three weeks at home, and then I moved to camp, but I'm at home right now, and then I'm driving up to camp after we're done here. What's

Scott Benner 1:16:06
the scam at camp? Did they tip you at the end of the season? The parents?

Adalia 1:16:09
No, I actually don't get paid that much. Oh, my God, then why are you doing it, my friends, and it's a great experience, and it's just really fun, like I so I'm a lifeguard, and so I'd much rather be lifeguarding at the beach than to be lifeguarding in a inside a pool during the summer.

Scott Benner 1:16:25
Why are you lying and saying there's a beach in Canada, we have lakes. Oh, okay, that's not real. But okay, I hear what you're saying. Okay, so

Adalia 1:16:34
yeah, and I get to do canoe trips. So I love to go out and do, like, extended, like, week long canoe trips where, like, we're out in the wild and, like, no, like, completely isolated. And so I get to do that through camp as well. Listen,

Scott Benner 1:16:49
I don't mind that there's a hole in Canada that filled up with water. It's fine. And I like that you're there, but don't call it a beach. It's ridiculous. The Beach leads to the ocean where the sharks are. That's that, yeah, do something for me. Okay, you said your friends at camp. So you have other friends who are working the camp too. Yes. What do you guys do for fun?

Adalia 1:17:09
It kind of depends. As a group, we'll kind of like, sometimes we'll go for hikes. Sometimes we'll kind of just like, walk and walk around and talk like, I don't know, like we kind of board games. Some of my friends don't like board games, but I do, by

Scott Benner 1:17:26
the way, I thought this was your answer. Like, you guys just hang out and talk about the world sometimes and your lives. Yeah? And you find that very fulfilling, yeah, yeah. And when you meet people who would prefer to be, like, at a bar or screwing around or something like that. Like, there's, you can't find any value in that, right? No, not really. Yeah, all of your friends, do they have direction? Are you the only kind of rudderless one? Or are there, like, are you all very similar in personality? No,

Adalia 1:17:58
I'm kind of, I'm kind of the odd one a little bit.

Scott Benner 1:18:02
You're the hippie in the group, yeah? Okay, the rest put it that way, yeah. The rest of them are like, in university, they have a plan, yeah, yeah. I wonder if you'll end up being the most successful one of the group. Can you keep up with them for 20 years? And then get back to me before I lose my mind and tell me, because I want to know,

Adalia 1:18:19
I'll do my best. I would love to keep these friends around. So, yeah, excellent.

Scott Benner 1:18:23
Oh, my God, your parents must be so proud of you. I think so. Yeah, seriously, and have your sister for pulling it together. You think I remember that, but I remember, yeah, well, she's

Adalia 1:18:38
the one who now lives far away. So, oh, oh, on purpose. Like, she's

Scott Benner 1:18:41
like, I gotta get out of here. Yeah, well, she followed a boy to school. Uh, you can't do that, girls. You can follow a boy somewhere, because, well, what? Tell everybody, why? Well,

Adalia 1:18:51
sometimes, well, then you get you're stuck. If something wrong go something goes wrong, then you're just stuck in this place that you don't actually have any interest in because you followed someone else there,

Scott Benner 1:19:03
right? And boys are limited, right? They can only do so much. Yeah, can't only do so much Exactly. You're 100% right, by the way, oh my god, yeah. There's like, moments where I'm like, I don't know. I'm just, I don't know I'm a boy. I don't think about that at all. I had this great conversation yesterday with this returning guest, and we talked a lot about, like, kind of culture, and we got down this rabbit hole about talking about how people apologize before they share something about themselves, which I find very woke, I guess, in the bad sense of the word woke. I think there's good senses of the word too, like, but that idea of like, you know, you're about to say, like, I don't know how much you pay for insulin, and then, but first you have to spend 15 minutes going, I understand. I have been very privileged to have insurance and be able to afford my co pay and, you know, like, I'm housed and like, you know, you have to do all that before you say out loud, like. You know, I own a pair of shoes. And then, because, if you don't, you know, as soon as you go, hey, check out my shoes, somebody's gonna run up and be like, you know, there are people who don't have, like, Oh my God. Like, I know. Like, I don't know what that has to do with my shoes. So we were having that conversation, she's also, like, a very anxious person, and we got to the end where she was like, I don't know. I feel very bad for people with anxiety, like, I wish I knew how to help them. Like, it seems torturous, and she's like, I wish I could just take yours somehow, like, your confidence. And she's like, because I know when I'm anxious. I know it all doesn't make sense, and I can't not feel that way. Anyway, it was just this really interesting conversation, and then today's conversation is so completely different, because you, like, you just went to New Zealand. Yeah, yeah, I would do that. I know I would. The other day, this woman contacted me, and she's like, I'm a travel agent, and I think that you have, well, she's a travel agent who has type one diabetes, and she listens to the podcast. And she's like, you know, we do these things where, like, people, like you, who are, like, oddly famous, but not really, do these cruises so people who, like, can get together. And, you know, she explained, I obviously went through all the details, but like, my brain was like, Okay, that'll work. Like, I just knew, I was like, this will work, and if it doesn't work, I said, Is there a refund period? Like, I don't want to screw people, like, you know, I don't want them to have a bad time. I don't want them to be, you know, on some, like, rickety boat, like, you know, like, that kind of thing. Like, it needs to be, like, a big cruise line, like, that whole thing, and they have to have a good time. It can't cost too much money. And if, for some reason, you're wrong, and I don't have the the motivated people that you're saying, I do. I want to be able to give their money back, you know? And she goes, Okay, none of that is a problem. And I was like, Okay. And then I went through it in my head, and I was like, Okay, well, let's do it. And I was talking to my brother, and he goes, You think that's gonna be all right? I was like, No, it'll work out. And he goes, How do you know? And I'm like, I'm not sure. It just it'll be okay. It just will Yeah, yeah. I know it's gonna be fine. And he goes, where does the cruise go out of I'm like, Galveston. He goes Texas. And I was like, Yeah, I don't worry it'll be alright. And he was like, Okay. I was like, oh, like, a lot of cruises go out of there. And he goes, they do. And I'm like, yeah, the lady told me, anyway, I made, like, that giant decision. I know it's gonna be okay. Yeah, I'm not worried about it at all. And a lot of other people in my life are like, Oh my God. Like, this is nerve wracking. I was like, No, it's not. It's fine, but I know nerve wracking things, but even those things don't make me feel anxious. They just they somehow, like, slide onto another list in my head of like, things that might not go right. Does that make sense to you? Yep,

Adalia 1:22:42
yeah, it does.

Scott Benner 1:22:43
Oh, my God. All right. What? What have you not said that you want to say anything at all. Let

Adalia 1:22:47
me see I did make you have a list, but it wasn't you made a list, yeah, but it wasn't like anything crazy. I can't even remember what I emailed you about. Like you want

Scott Benner 1:22:59
me to find it Sure. All right, hold on a second. It won't be hard to find your name. All right, here we go. Yeah, it's so interesting. It's also, like, it's a short note, which is what I would have done, too, my name, my name. You want me to read it? Sure you can. I don't remember what I said. All right, hold on a second. It says, Oh, hey, Scott. It says, My name is adelaya, and I am an 18 year old Canadian living with type one. I found your podcast almost immediately after my diagnosis in 2021 and I went searching for the episodes with people around my age. There were a few, and the ones that I listened to were incredibly inspiring, as I recognized those were people who were living with the same day to day struggles that I had just begun experiencing. I've had a lot of things change in my life post diagnosis, not necessarily because of diabetes, if I'm being honest, the diabetes has become a bit of a blessing. I am currently traveling around Australia, New Zealand, on my own while taking a bit of a break from school. Adventuring is one of my favorite things to do, and I haven't let my diabetes diagnosis change that I would love to share my story with you so that other teenagers and young adults can feel related to when it comes to type one. Thanks for the opportunity. I'm looking forward to hearing from you. Okay, why has it been a blessing?

Adalia 1:24:22
I think part of it, like we kind of talked about it earlier, where I just, like, realized that, like the astronaut thing would have was not for me, and it was like, needed, like, something outside to like, because I gotten really stuck in it, I think because it became something that other people expected of me. So I was like, Well, I just have to do this now and then. It kind of gave me an out, like, I was like, oh, like, I don't have to do this. It led me to working at camp. It led me to being able to canoe trips, which I now have done, like, pretty much every summer since my diagnosis, yeah, just like, it's let me discover more of my interests and things that I love to do, instead of feeling. Like, bogged down by like, this, like, unreasonable expectation for myself that I didn't even have anymore, but I felt like other people had for me, and

Scott Benner 1:25:08
because you said you were gonna do it, yeah? And now you're like, I don't want to do that anymore, but I don't want to let people down. Yeah? So interesting. Wow, I can't believe that you and I are having this conversation. Like, 12 hours after Arden and I spoke about what we talked about last night, which I can't tell you about, because it's none of your business, but now it's not, and it's not you. I would tell you there's a lot of people listening to us have this conversation which you don't even give a shit about. Do you it doesn't bother you at all, really? Yeah, I know people say all the time, like, how do you talk in front of all those people? I'm like, I don't know. I just stand up there and I talk like, and they're like, it's not nerve wracking. Like, I don't care. It's like, I really, like, I really don't like. It doesn't matter to me how many people are there, like, few or many? Like, although I would tell you that if I showed up to speak at something and there was like, nobody there, I'd be embarrassed, yeah, yeah. But because I've seen it happen to people, and watching them try to pretend that they're not embarrassed by it makes me uncomfortable. It sucks. Like you fly across the country to speak at something, and they give you, like, an hour, right? And you're like, Oh, I'm speaking from 10 to 11, and then, like, I'm walking around because I'm not speaking from 10 to 11, and you walk past a room that this room is set up to hold 200 people, and there are like, four people in the front row, and it's like they're having a private conversation. And, you know those persons like, oh my god, I flew here for this, yeah, and no one came. Like, it's got to be devastating. I would I pretend to be sick? If I walked in that room and I saw four people, I'd be I gotta go. I don't want someone taking a picture of me talking to four people at this event. Do you ever notice how they do it on social media? They they find one table with people in it, and then they get somebody to take a picture of them on stage from that angle, with the heads in the front that so that it looks like the room's full. It's my favorite it's my favorite thing they do. That's why I always take the camera, I turn around, I take the picture of the room behind me, over my shoulder. I'm like, check it out. Not a empty seat in here. That's just me being petty. But I have to have things, you know what? I mean. Yeah, everyone does Aliya, you're fantastic. You know this though, so I'm not gonna bother telling you. I appreciate you doing this very much. You had a good time. I talked too much, but you really got me, like, worked up. Yeah, that's okay. Also, you're 18. When I let you talk, you've like, pissed out pretty quickly. Do you know that? Do

Adalia 1:27:34
you know that? Yeah, I do realize that sometimes it's

Scott Benner 1:27:38
a limitation to talking to younger people. That's why I feel I so what will happen later is people will be like, he talked too much. He didn't let her talk. I let her say every You said everything you want to say, right? Yeah, yeah, absolutely. I know. I know how to do this. Is what I'm saying, Yeah, especially with the little kids. So like, he didn't let him talk. I'm like, what if you think he was gonna say? He's nine, he's got four thoughts. He's out of the market. Yeah? No, yeah. What are you gonna launch into what you think of the conflict somewhere like you don't give a All right, you're terrific. Hold on a second, okay?

The conversation you just heard was sponsored by touched by type one. Check them out please. At touched by type one.org, on Instagram and Facebook, you're gonna love them. I love them. They're helping so many people. At touched by type one.org, I'd like to thank the Eversense 365 for sponsoring this episode of The juicebox podcast and remind you that if you want the only sensor that gets inserted once a year and not every 14 days, you want The Eversense CGM, Eversense cgm.com/juicebox, one year, one CGM, you

Unknown Speaker 1:29:00
OmniPod.

Scott Benner 1:29:04
I can't thank you enough for listening. Please make sure you're subscribed, you're following in your audio app. I'll be back tomorrow with another episode of The juicebox podcast. The episode you just heard was professionally edited by wrong way recording, wrongway recording.com, you.

#1342 Community Spotlight: T1D Exchange

Talking about places and people who help.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Welcome back, friends. You are listening to the Juicebox Podcast.

I'm always hearing stories about people and entities that are out there in the world doing great stuff for people living with diabetes. Today, in this short episode, I'll spotlight one of them. Perhaps their efforts can help you. Maybe they're happening near you, or maybe it's something you'd like to get involved in one way or the other. We're gonna throw a light onto all the good work that's being done out there. I hope you enjoy hearing about it, and I hope that it helps to lift you up and make you feel you know, like you're not alone. 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. If you're looking for community around type one diabetes, check out the Juicebox podcast. Private Facebook group. Juice box podcast, type one diabetes, but everybody is welcome type one type two gestational loved ones. It doesn't matter to me if you're impacted by diabetes and you're looking for support, comfort or community, check out Juicebox podcast, type one diabetes on Facebook you I'm

going to start today with the T 1d exchange. This is probably something you hear about in the bumpers of every episode that you listen to, but the T 1d exchange is a non profit organization that's focused on improving the lives of people with type one diabetes through research. Right? They are involved in how do I explain to you what they do? You go to T 1d exchange.org/juicebox, and you join their registry and fill out a survey. That's all you do. This whole process might take you 10 minutes. They take your answers right and then they I don't know how to it's data. Then when I don't know companies or when institutions or anybody who's doing research for diabetes, when they need data to make sense of you know, what's important or what they need to do. Like, I'm obviously not the right one to tell you about this, but, but I'll read you a couple of things in a second. But my point is, is that they need to know from huge swaths of people the answers to these questions. It actually helps research move forward. It actually helps things get done, like CGM, for example. So you give up about 10 minutes of your life. You do it from your house, you do it from your tablet or, you know, your computer or your phone. You could probably do it while you're, you know, sitting on the sofa. This is not like a heavy lift, is my point, right? The answers to your questions are not things you're gonna have to think about. They're gonna ask you questions about diabetes that you know the answers to. They're looking for caregivers, of people with type one and adults living with type one. They need you to be a US resident, but that's pretty much the only couple of things you need to be they would love it if more men would do it. More people of color would get involved. But they're looking for everybody caregivers, type ones to jump on, join the registry, take the survey and help. Super simple. I hope you do it. But here's a couple of things, T 1d exchange supports numerous advancements in type one diabetes research, care and technology focusing on improving patient outcomes and quality of life. They do patient and clinical registries, right? So the T, 1d exchanges, large scale patient and clinical registries have gathered invaluable data on various aspects of living with type one diabetes. These registries have been essential in identifying trends and challenges in type one diabetes management, from glycemic control patterns to health care disparities. They use real world evidence to help with these things, right? So their data has been in instrumental in evaluating the use, adoption and effectiveness and effectiveness of diabetes devices like continuous glucose monitors and insulin pumps. This information has helped drive innovation in diabetes tech, making devices more user friendly and effective. So this is my point. You go answer a few questions, and I don't know, two years from now, you get a better device that's a big deal like it really is. They need your answers to these simple questions. It is genuinely a situation that is just, it's no skin off your ass. You know what I mean? Like, you are not going to be put out by answering these, these questions or joining the registry. Jump on, sign up, answer the questions. They actually send out follow ups once a year to continue. You know, they don't bug you. They're actually really good about that. And sometimes there's opportunities for you to be involved in other stuff. You. Get an email and be like, Oh, maybe I will do this. Like, I've known people who have been in CGM studies, for example, listeners to the podcast and actually got paid a little something to do it, and had this experience and were able to help more. But if you just want to help from your couch, that's absolutely crazy good too. Let's see, during COVID 19, telemedicine research was done the T 1d exchange supported research on the effectiveness of telemedicine in diabetes care. This has highlighted the benefits of remote care for people with type one diabetes, which has been essential in advocating for the long term integration of telehealth and diabetes management. That's another thing that the T 1d exchange did. They published significant findings on disparities in diabetes care and outcomes, particularly around racial and socio economic factors that impact access to technology and glycemic control. Their research has informed initiatives aimed at improving access to care and technology for underrepresented groups. Let's talk about insulin affordability. T 1d exchange has been a leading voice and understanding and addressing insulin affordability challenges through surveys and data collection, they have provided insights into the financial burden of insulin cost, which has fueled advocacy efforts for better pricing regulations and support systems. What else? They've conducted research on glycemic management in children and adolescents with type one diabetes, emphasizing the need for age specific strategies and the importance of early and consistent use of diabetes technology for better outcomes. I can go on and on if you want, but T 1d exchange.org/juicebox, go there. Join the registry, fill out the survey. If a look, you guys. Don't know how many people listen, but it's a lot more than you think. If 1000 of you just did this today, that registry would be that much more rich and valuable. It would just be fuller of good information. It would be fuller of ideas waiting to be mined by researchers, waiting to help you. It's, I mean, how often do you get to do something that helps other people, that will actually help you or your family as well? All right, couple more things, let's see the organization's quality improvement. Collaborative engages over 50 clinics improving care standards through shared data and evidence based best practices. They focused on disparities in care, showing that CGM users generally have better glycemic control than those using self monitoring methods, which has implications for device adoption and access advocacy. Oh, look at this. The T 1d exchange has been at the forefront of studying off label GLP one use among people with type one diabetes, particularly its relationship to cardiovascular help, despite glps recognized benefits in type two, its role in type one is less understood, and this research is helping establish new care pathways for patients with type one who may benefit from GLP one therapies. So this is something that could end up helping you down the line in I mean, imagine, imagine that they help prove that GLP ones have significant impacts for cardiovascular health, for type ones and 40 or 50 years from now, not to be too heavy handed, but you don't have a heart attack because of something that got figured out today, because you signed up for the registry and filled out the questionnaire like that's helping, right in ways that you almost can't imagine. T, 1d exchange.org/juicebox, is there more here? Let's see. All right, I'll wrap it up with this. T, 1d exchange, collaborative program with over 50 us clinics works to improve care through real world data sharing, the program has enhanced best practices across type one diabetes care, allowing clinics to identify and act on areas needing improvement, which has scaled successful practices across participating clinics. They provided data showing that continuous glucose monitors generally achieve better glycemic control and fewer severe hypoglycemic events compared to those using traditional monitoring. This research supports advocacy for broader CGM access across the more diverse patient demographic they investigated, like we said, GLP one finding that the findings indicate limited use of GLP one, despite potential benefits for patients with obesity and cardiovascular conditions, paving the way for additional research on the effectiveness for it with type one management. I'm telling you you want that research done so you've been listening to this for nine minutes, just 10 more minutes, and it's over, and you've done something awesome. T 1d, exchange.org/juicebox, I'm going to put the link in the show notes right at the top, you can click on it and fill it out. They'll know you came from me, which helps support the show. But that's not why I'm telling you about this. I've been telling you guys about the T 1d exchange for a long, long time, years and years and years, because this is a simple and effective way for you to help with type one diabetes research, and you don't need to leave your. House. I hope you do it. Do it now. Don't wait. T 1d exchange.org/juicebox, now the music's going to play, and if you're interested in hearing about the juice cruise and some other stuff we have going on, you can listen for another couple seconds. But this is pretty much the end. I'm going to keep coming back and doing this. I need a name for this, if it's like community highlight, or, you know, spotlight, or something like that, but, but I like this, we're going to do more and more. And actually, there is, I started a Facebook post about this, and people are just piling in organizations and other people who have been doing great stuff for people with type one so I'm gonna have no shortage of great works to tell you about in these short episodes. So look forward to another one next week.

If you or a loved one was just diagnosed with type one diabetes, and you're looking for some fresh perspective the bowl beginning series from the Juicebox podcast is a terrific place to start. That series is with myself and Jenny Smith. Jenny is a CD CES, a registered dietitian and a type one for over 35 years, and in the bowl beginning series, Jenny and I are going to answer the questions that most people have after a type one diabetes diagnosis. The series begins at episode 698, in your podcast player. Or you can go to Juicebox podcast.com and click on bold beginnings in the menu.

I was looking for a way that we could all get nice and tan and meet each other and spend some time talking about diabetes. How are we going to do that on a juice cruise, juice cruise 2025 departs Galveston, Texas on Monday, June, 23 2025 it's a five night trip through the Western Caribbean, visiting, of course, Galveston, Costa, Maya and cosmel, I'm going to be there. Erica is going to be there, and we're working on some other special guests. Now. Why do we need to be there? Because during the days at sea, we're going to be holding conferences, you can get involved in these talks around type one diabetes, and they're going to be Q and A's plenty of time for everyone to get to talk, ask their questions and get their questions answered. So if you're looking for a nice adult or family vacation, you want to meet your favorite podcast host, but you can't figure out where Jason Bateman lives, so you'll settle for me. If you want to talk about diabetes, or you know what, maybe you want to meet some people living with type one, or just get a tan with a bunch of cool people. You can do that on juice cruise 2025. Space is limited. Head now to Juicebox podcast.com and click on that banner, you can find out all about the different cabins that are available to you. And register today. Links the show notes. Links at Juicebox podcast.com I hope to see you on board. I can't thank you enough for listening. Please make sure you're subscribed or following in your audio app. I'll be back tomorrow with another episode of The Juicebox podcast. You.