Scott Benner 8/5/24 Scott Benner 8/5/24

#1271 Bold Beginnings: Using a CGM

Bold Beginnings will answer the questions that most people have after a type 1 diabetes diagnosis.

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

Scott Benner 0:00
Hello friends and welcome to episode 1271 of the Juicebox Podcast

Welcome back everybody today Jenny Smith and I are adding to the bold beginning series with this episode about using CGM. 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. If you are 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 CDC es 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. If you'd like to help with type one diabetes research right from your own home, and you're a US resident who either has type one or is the caregiver of someone with type one, go to T one D exchange.org/juicebox. and complete the survey. It's that simple to help. type one diabetes can happen at any age. Are you at risk, screen it like you mean it because if just one person in your family has type one, you're up to 15 times more likely to get it to screen it like you mean it. One blood test can help you spot it early. And the more you know, the more you can do. So don't wait. Talk to your doctor about screening. Tap now or visit screened for type one.com To get more info and screen it like you mean it. This episode of The Juicebox Podcast is sponsored by the Omni pod five, learn more and get started today at Omni pod.com/juice. box. Check it out. The episode you're about to listen to was sponsored today by ag one. You can drink ag one just like I do by going to drink ag one.com/juice box. Check it out. Jenny. Good morning. How are you?

Jennifer Smith, CDE 2:27
I'm well how are you?

Scott Benner 2:30
Good. Thank you. I'm excited to add to the bowl beginning series. Yay. I think that it is maybe the most popular series, certainly among newly diagnosed people. But in general people seem to really like it. It made me think a little bit. And by the way, this is a little tease about a way to kind of refresh the Pro Tip series, which Oh, yeah, when we're done here, I'll actually run my idea. I mean, make a note here to myself to tell you

Jennifer Smith, CDE 2:58
what I was talking about this a while ago just because of all of the new technology. And the algorithms that have really shown up compared to when we did majority of that.

Scott Benner 3:09
No, it was a handful years ago. Yeah, I think there's a nice way to refresh it. But the whole beginning series, we're just going to add to it today. I'd like to talk about basically wearing CGM, the accuracy best practices, that kind of stuff for people because I think you get diagnosed or you have a child who's diagnosed and all of a sudden you're wearing a device. This is obviously very new and different for somebody. Right? And then there's some quirks about wearing technology that aren't obvious in any mean and and ways to manage. That's a good way to say it, right?

Jennifer Smith, CDE 3:42
Yes, they are kind of, I guess quirks is a good? Yeah.

Scott Benner 3:46
So you know, I think no matter what you're talking about here libre ever since Dexcom. CGM is right. They're going to tell you Look, put them on. And it's going to tell you what your blood sugar is. And it will and they're great. They're absolutely fantastic. But you might then take your meter out, check your blood sugar and say, Oh, my meter says I'm 96. And my CGM says m 115. Which is it. So let's talk a little bit about how CGM work first versus how blood blood finger or excuse me about how BGM 's work. And then we'll, we'll lay it out for people so they understand give them some tips and tricks to get through and set up some expectations forums, that make good sense. Sure. Okay. So I'm gonna start by asking you some technical stuff that I don't understand as well as you do for certain. I use my, my blood sugar meter, and I check a drop of blood from my finger. And it says, I'm 96. Why is it possible that my CGM doesn't read the same? It's

Jennifer Smith, CDE 4:52
possible because your blood glucose meter is reading the glucose in your blood? which is, technically the more accurate it is the more real time right now. So your glucose then kind of shifts out, moves through our interstitial fluid that surrounds the tissues in the cells and everything in our body in order for the glucose to kind of move into cells. That's a very simplified explanation, right. But sensors, CGM EMS do not measure blood glucose, they measure the glucose that is in that interstitial fluid. And that's the reason that you can see a difference between a blood glucose and a CGM value, because they are not reading glucose in the same fluid in the body. And that glucose again from the blood has to kind of move out transport through the interstitial fluid. And so many people know the term or the thought of leg. In CGM data, a lot of people talk about that. And that data can leg then finger stick is here. CGM is higher than this or lower than this. The reason is because there's a lag in that glucose, sort of transport, if you will, into the interstitial fluid. And as we'll probably talk, it's another reason that hydration very important, really, really important.

Scott Benner 6:28
So very high level, not technically, someone one day said, Hey, there's glucose in your interstitial fluid. We can measure that and help people with diabetes using insulin. I'm going to read this interstitial fluid is the fluid that surrounds the cells in your tissues. It plays a crucial role in transporting nutrients and waste products between blood and cells. Yes, when you're using a continuous glucose monitor, it is important understand how the interstitial fluid relates to blood glucose monitoring. And Jenny's already brought up there's a lag, right? And that's lag could be five to 15 minutes from a finger stick. Okay? Correct. So somebody figured out, probably not that hard to figure out if you're like, you know, a scientist or you went to college or something, that there's glucose in there, we can measure it and we can help people not have to poke their fingers all the time and still get close enough to what's happening that it's really valuable for them. Okay, so interstitial fluid similar to blood plasma, it says, but without the high concentrations of proteins found in plasma contains water, electrolytes, glucose and other small molecules. Correct. So then, if you're dehydrated, then that fluid is not where it needs to be volume wise, I imagine. So Right. Why does that mess with the reading. I partnered with ag one because I needed a daily foundational nutritional supplement that supported my whole body health. I continue to drink ag one every day because it works for me. Ag one is my foundational nutritional supplement. It gives me comprehensive nutrition and it supports my whole body health, drink, ag one.com/juice box. When you use my link to place your first order, here's what you're gonna get a free welcome kit that includes a shaker scoop and canister, five free travel packs, a free year supply of vitamin D, and of course your ag one. So if you want to take ownership of your health, it starts with ag one. Try ag one and get a free one year supply of vitamin D and five free ag one travel packs with your first purchase. Go to drink ag one.com/juice box that's drink ag one.com/juice box. Check it out. My daughter is 20 years old, I can't even believe it. She was diagnosed with type one diabetes when she was two. And she put her first insulin pump on when she was four. That insulin pump was an omni pod. And it's been an omni pod every day since then. That's 16 straight years of wearing Omni pod. It's been a friend to us, and I believe it could be a friend to you, Omni pod.com/juicebox Whether you get the Omni pod dash or the automation that's available with the Omni pod five, you are going to enjoy tubeless insulin pumping, you're going to be able to jump into a shower or a pool or a bathtub without taking off your pump. That's right, you will not have to disconnect to bathe with an omni pod. You also won't have to disconnect to play a sport or to do anything where a regular tube pump has to come off. Arden has been wearing an omni pod for 16 years. She knows other people that were different pumps, and she has never once asked the question, should I be trying a different pump? Never once Omni pod.com/juice box, get a pump that you'll be happy with forever.

Jennifer Smith, CDE 9:50
Well tell me what happens when you have a really teeny tiny amount of water that you try to put a whole bunch of sugar in Does it stay fluid or what happens? Oh, it gets more viscous concentrated, right? It gets kind of sticky it gets. So not only are you impacting everything else that needs to be transported in your body in the right way, which, I mean, that's a whole just physiology discussion. But honestly, electrolytes play a big role in transport of even glucose and other sort of nutrients in the body. So when we're dehydrated, that concentration of all of these can kind of get slow in movement, as well as more concentrated, right. And so that can shift glucose readings. It's also the reason on the opposite, where people again know this term, it's like a compression low, right? Where you're laying on your sensor, what you're doing is compressing that sensor so much that all of that all but a good majority of that interstitial fluid gets shifted away from the sensor. And so what ends up happening is glucose levels drop. And not until you roll the child or the person over or they get up and kind of things get moving again, fluid comes back to normal, you know, levels that it should be at, then that glucose number jumps up, and is actually where it should be. So as you can see, hydration and proper hydration in the whole body can make a really big difference in

Scott Benner 11:22
so like a compression low as an example, almost like putting your foot in a puddle and you displace the water. So if you press hard on the sensor, you're displacing the interstitial fluid, which contains glucose, you're pushing that away from the sensor. And then that's why all of a sudden, you look low out of nowhere, because you technically push the glucose away from the sensor. And now suddenly, there's less there than actually exists in the body. Right? Interesting. Hey, here's a little side note that you'll probably pletely agree with. Only about 30 to 40% of adults meet the daily recommendation for water intake. And the remaining 60 to 70% may not be adequately hydrated with varying degrees of mild to moderate dehydration. So, my point bringing that up is is I think most people hear that and think I'm not dehydrated, but you very likely could be especially kids to who you know, correct.

Jennifer Smith, CDE 12:18
And honestly, you know, having worked with a good percentage of athletes in the past very heavily. Our biggest recommendation for hydration is that when your body finally gives you the signal that you're thirsty, you are definitely dehydrated,

Unknown Speaker 12:34
okay? You should not

Jennifer Smith, CDE 12:36
have thirst so to speak. That's like oh my gosh, I have to get a glass of water right now. You are not hydrated. Well, you're under hydrated at the point that your body is giving you signals right?

Scott Benner 12:51
I'm just gonna say here your urine like should be what? Oh, yeah, how do we measure our hydration by the color of our urine?

Jennifer Smith, CDE 12:58
Your urine should be like very light pale lemonade.

Scott Benner 13:03
Makes me want to sing lemonade. A cool refreshing drink. Clear or light yellow typically indicates good hydration, pale yellow. Also a sign of good hydration suggests that you're well hydrated but not overly so bright yellow can indicate mild dehydration and the presence of excess vitamins. Oh yeah, that's true too. If you take a multivitamin your your pee could get bright right and

Jennifer Smith, CDE 13:25
especially B vitamins. So I always recommend Do you know that you're really doing a good job of hydration and you've just taken like your multivitamin or a B complex or something like that. And your pee is like this golden color.

Scott Benner 13:39
dark yellow often indicates dehydration and that your body is currently conserving water. It's interesting and amber or Holly, honey colored, strong or sign of dehydration important to drink more water orange dye to people's Wait a minute. Orange can be the sign of severe dehydration and brown could indicate severe dehydration or the presence of certain medical conditions such as liver disease. pink or red is blood in the urine. Wait a minute, Jenny. This has nothing to do what we're talking about but blue or blue or green. unusual colors can result from certain medications or food dyes rare genetic conditions bacterial can and then cloudy or murky could indicate a urinary tract infection or kidney stone.

Jennifer Smith, CDE 14:21
Okay, but and from the color that even that pink it may not definitely be blood. If you have had a fair intake of bees recently. Beets or berries a fair you know an intake of those can definitely discolor the urine. Beets can also really discolor sort of poop. So just as an FYI.

Scott Benner 14:43
What color does beets make my poop? Kind

Jennifer Smith, CDE 14:47
of like? It's almost like a reddish color. Yeah, so there you go.

Scott Benner 14:52
Sorry. We go over it like this because being hydrated is super important for your CGM working by It's also very important for your insulin working as well. So we might as well talk about it here, because you're getting a double benefit. If you're wearing a CGM, you're gonna get more accurate readings. And if you're using insulin, which if you're listening to this, you're very likely are your insulin is going to work better. So can we take two seconds on that tell people why well hydrated body uses insulin more effectively?

Jennifer Smith, CDE 15:20
Absolutely. Again, it's a transport component, right, we're injecting or infusing insulin into what we call the sub q tissue. So the layer that sits like right underneath the skin, which is why your little cannulas or the even the insulin needles on your pens or your syringes, they don't really go in very far, they're not terribly long. The idea is that with proper hydration, and fluid movement in the body, that that insulin along with the chemicals that help it to get used in an appropriate timeline, it works along with the hydration of the body. And again, if you're under hydrated, things are not gonna be moving as easily I, I considered dehydration, especially like in circulation, it's kind of almost like molasses in winter, right, things move really slow. Once you get hydrated, things move and flow the appropriate way, your insulin, all of the nutrients, all of those things, they get moved to the right places in the body, in the timeframe that the body is meant to do it.

Scott Benner 16:24
I was going to mention that extreme temperatures can affect the rate in which glucose diffuses into your interstitial fluid. So that is a potential impact for your CGM, right things are also different, like blood flow. So like sedentary versus exercise again, increases. Yep. Right. So some best practices, first of all, be aware of lag time. Right? And that's an interesting one, because here's a real world example. Arden's blood sugar will, you know, dip down to 63? And I'll send her a text and I'll say, Hey, did you do something about this? And she'll say, Yeah, I'm good. I did, you know, I drank this, or I ate this or whatever. And then five minutes later, the CGM will still say 63. Or it'll go down again. And then I get the tap, tap, tap. It's my wife. She's low. And I'm like, no, no, I know. But she's already had something. Well, this thing still beeping at me. Right. And I'm like, Yeah, I know. But I think we did enough. Like, I think we did enough. It's gonna come back. You gotta wait. I find sometimes you need to wait 10 minutes? At least Yeah, to see. Yeah. And if you go, go ahead. Well,

Jennifer Smith, CDE 17:29
I was gonna say, and it could also be longer depending on what you've used to treat that with, right. Thus, the reason that we really recommend dextrose are really simple sugar, something that's going to get in get moving fairly quickly. Because if you don't, then not only is the CGM potentially lagging, but it might be also even behind further because of what you ate not being fast enough to reliably start bringing that blood sugar

Scott Benner 17:58
up. But in a case when you have done that, when you've taken in that simple sugar, and it's bounced like, say you're 63 and CGM says 63. You wait a couple of minutes after you drink your juice, and you test and you get a 75 test. And you think, Okay, this hit, it's coming, right? The CGM is not suddenly going to say 6075. As a matter of fact, that next time it it reads, you could end up being 1520 points higher than the last time, right. And so I just want to say here, you really still need a really accurate blood glucose meter, and you should use it. I know. And listen. Dexcom is a sponsor ever since as a sponsor, I think CGM are fantastic. I don't know what I would do without them. You still need a really good meter, and you should test your blood sugar. That's

Jennifer Smith, CDE 18:45
100%. Yeah, I 100% disagree. And I Oh,

Scott Benner 18:50
you just said I 100%. Disagree.

Jennifer Smith, CDE 18:52
I 100%. Agree. I 100%. Agree I was what I was gonna say. In terms of, you know, like disagreement is, I disagree with the fact that people are really heavily relying on only their CGM. And that they're really only waiting to do a fingerstick when their own body symptoms are telling them something that seems off compared to the CGM value. I mean, I think if I were the one setting up any of the sensor systems, my recommendation doesn't get into calibration because there's a whole strategy with calibration and that kind of stuff as well if it's needed, but my best practice is doing a finger stick when I get up in the morning. Yeah, just to see because just to see it because it gives me a visual of the CGM has been here all night. I have no food in my system. I have no excess of insulin from boluses or anything that could really be impacting right now. I do a few You're sick before I get out of bed. So I don't have that quick shift in blood sugar that could happen for many people, right that foot on the floor. And they compare. And if it's off with, you know, within this set comparison, I may calibrate, but 99% of my mornings I'm not calibrating. I'm just comparing and saying, yeah, it looks great, fabulous, even

Scott Benner 20:24
like, but what you don't want is to get out of bed with a blood sugar of 140. And your CGM is like, Oh, you're 95. And then rack, then the whole day just 45 Points off everything that you do that the first Bolus you make, you know, leads to probably arise, you know, because you didn't have enough insulin. And this just doesn't, this doesn't stop. And even if the CGM comes back in line eventually great, but it just throws it. I'm just a big fan of testing once a day, at the very least,

Unknown Speaker 20:56
yeah, yes.

Scott Benner 20:59
Getting older means a world of change. But some things still stay the same, like being at risk for type one diabetes. Because type one can happen at any age. So screen it like you mean it. If just one person in your family has type one, you're up to 15 times more likely to get it too. And 50% of type one diagnosis is happen after the age of 18. So screen it like you mean it. type one diabetes starts long before you need insulin. And one blood tests could help you spot it early and lower the risk of serious complications like diabetic ketoacidosis, known as the Ka. So don't get caught by surprise. Screen it like you mean it. Because getting answers now can help you get prepared, the more you know, the more you can do. So don't wait, talk to a doctor about how to get screened. Tap now or visit screen for type one.com. To learn more. Again, that's screen for type one.com. And screen it like you mean it.

Jennifer Smith, CDE 22:01
You know we have Dexcom Hello, and I know the other systems have something else but Dexcom has clarity reports, right? And so clarity reports will give you an estimated what they it's not an agency but an estimated average, right? They call it a GMI. A glucose management indicator and that gives you a value close to what a one C would represent from an actual blood draw. And in comparison, some people get really frustrated. Well, my agency came back at this but my GMI according to clarity was telling me that I should be here or here. And it's frustrating. My first recommendation is or a question is, are you doing finger sticks,

Scott Benner 22:46
right?

Jennifer Smith, CDE 22:47
If you're not doing finger sticks, let's start doing several finger sticks a day. Because I would almost say that in the majority of those cases, the CGM is what's off. The CGM is not on with the finger stick enough. And so your GMI is then reporting an average. That's not actually what's really represented in your blood. Yeah, right. So I think they're in the case of things being really different. It's just a good strategy to do even more than one test a day for even if it's just a week, if

Scott Benner 23:24
I'm listening to this, and I'm more newly diagnosed, what I would want you to take away from this is, this is maybe some of the best technology that's ever existed for people with diabetes, agreed that and algorithm pumps are going to change people's lives with type one. And you should not walk around bemoaning, oh my gosh, I'm 95 and it says 110. That's astounding, be very happy. Okay, right. But the next thing they're going to think, is, well, if I'm really 95, and it says I'm 110, and I'm on an automated system, is it not going to give me insulin based on 110? And, you know, like, should I be fearful that I've never come up with a better answer other than to say that my daughter has been on different algorithms for a long time. This has never been an issue. And I know that is not a comforting statement. Right? To me, it's the same question. It's the same answer as back in the day when somebody would have, you know, four different meters. And they would like take pictures they'd like they test their blood sugar with one meter. Then with the next one that would the next one, the next one, they get four wildly different numbers. And they say great, now which one of these should I use? Right? I'd pick the most accurate one. You know, like, go look online, see which one of them they have is most accurate and go with that. But at some point, do you don't remember that moment? Probably because you were a kid when you were diagnosed, but I remember the moment of like swallowing hard and going, this is the meter. I don't know if it's right or not, but I gotta go with it because I gotta go with something. Like I'm not in the hospital. She doesn't have we're not using a $10,000 blood glucose meter. and I really mean like, this is the one I have. And if you know what I'm saying like it's a real big leap to make

Jennifer Smith, CDE 25:05
it is and unless you really know, as you already said, you can look up accuracy online, right? There are charts and in diabetes daily, there are a whole bunch of different places that have accuracy chart by different brands even have the off brands right that are on there for an evaluation. I always say choose the one that is not only on your insurance plan coverage wise, but also choose the one that's on that list that is the highest accuracy according to this chart.

Scott Benner 25:36
Yeah, there's like three meters at the top of the chart, listen to contour next gen is a longtime sponsor of the podcast, and it's the one we use, it's a very well ranked and rated meter and

Jennifer Smith, CDE 25:47
and they've rated top of the charts for years. Yeah, particular meter I kind of right up there with it is, I wish I could use that one. My insurance doesn't cover that one. It prefers accucheck brands. So I use the guide or the guide me that one has very similar to the contour accuracy readings. So again, look, because that also translates into if you're going to be calibrating as you brought up, I checked one this meter and then I checked on this meter, and I checked on this meter, and I have three varying results. And this day, you're using this particular brand and this day you're using this particular brand at work to calibrate your CGM. Don't Don't do that. Pick one, pick a meter and use that one to always calibrate just

Scott Benner 26:32
freaks you out in the beginning. Like it just does. Like you know, you're fairly newly diagnosed. You're like, well, this meter says my blood sugar's one thing. The CGM says another thing, then you start going well, which is it? And right, I always tell people I'm like, I don't know. Is it a $4 meter and an A Dexcom? I'd probably trust the Dexcom more, but like I don't think it's a more or less it's an understanding of once you have as accurate as you can blood glucose meter CGM. Then understand the lag time really seriously. Look at your hydration. You know, you know, are you in an extreme temperature situation? I listen, I'm wearing a CGM. Today. I got in the shower and my blood sugar went up 45 points. I have a working pancreas. Do you really think my blood sugar went up? 45 points. Right, right. So there's that stuff to remember it also, when you put it on is really important. So going back to CGM Jenny, I talked about this before we started. Again, I want to say again, I don't want to scare anyone away. Definitely get a CGM. Okay, but the first day ain't as good as the second day. Ain't as good as the third day. And then all of a sudden, when you get to the end of the sensor, it could trail away again, some people have great luck. Some people's physiology works great with them. And some old time Oh, my God, yep, just boom, all good. Yep, I saw Arden had a g7 go bad in the last three hours last week. And other than that I've seen they go right, she wears them right out to the end every time. And the longer she's wearing them, the better they look for her, like accuracy wise. So but keep that in mind, too. If you're in a 10 day window or a 14 day window, it's boring. But there's that little sensor is under your skin. And it's in there. And it takes a little time to what's the word people use marinate,

Jennifer Smith, CDE 28:13
marinate,

Scott Benner 28:14
again, yes, right? Like get set, who cares what's actually technically happening. Dexcom added what to the g7. It's a like a grace period.

Jennifer Smith, CDE 28:25
There is so after the 10 days, you have a 12 hour grace period that the sensor will continue to work before it's fully expired. And in that grace period, it will continue giving alerts and alarms and all of the regular stuff. They've just given, you know a period of sometimes life is what it is, and you planned to be home at 2pm to change it and your train got stuck or you're just stuck in traffic or you had to go pick up your dog or whatever happened. And now you're either without a sensor because it has fully expired or now with g7, you've got 12 hours beyond that 2pm that it's still going to help you until you can really get home.

Scott Benner 29:07
And so I'll tell you what I tried to get Arden to do and she fights me all the time about it. But you know, I'm always like, look, put a new one on now while the old ones still working. And just let that thing sit in there for a while and get accustomed to its surroundings. And you know, because if it if it doesn't work as well, in the first couple of hours of the first day for some people, then let's try to buy some more time there and then we'll swap it back on the end by taking the free 12 hours on the backside if we can, right that makes sense to me. So people call that like marinade era needing a new sensor right you just you all you do is you open up the g7 pop it on and then you don't do anything else. You don't start it up often hold on to the box hold on to the sensor then when it's time to switch you scan that one and jump to the other one. And you might very well see better numbers coming back from it the longer it's been in. We try to do it for a couple of hours at least but she's just He's just tough. She's young. You don't I mean, I'm like, I'm like, it

Jennifer Smith, CDE 30:02
doesn't mean a million other things. Yeah, it's

Scott Benner 30:04
hard for to get but it's a great, it's a great tip. Is that something you can do with libre? Do you know? That's

Jennifer Smith, CDE 30:10
a really good question.

Scott Benner 30:12
No, if you can, I don't think so.

Jennifer Smith, CDE 30:15
I don't know. Okay, I would honestly because Libre is similar in that the device also is like G seven that it just pops on. There's no additional transmitter to pop in, or it's like a one and done kind of habit on it. I think it could be possible because you still have to enable that CGM to get started with the app. I would expect but I don't know for sure. I. Honestly, the majority of people that I get the opportunity to work with are either Dexcom or you know the small number who get really good accuracy with Medtronic Guardian system, which is nice.

Scott Benner 30:53
How do you find the predictive alerts work for CGM? Like the ones who tell you you're going to be low in a while? Do you notice that they are helpful?

Jennifer Smith, CDE 31:03
I think that they can be helpful what I've seen the best though, and it goes back to hydration. It really goes back to the reliability of your fluids moving the way that they're supposed to through the body. And that data that then gets transmitted from blood into the interstitial fluid, it's going to register a shift that's going to trigger however, you've had that predictive alarm set. Either you get you have it set really conservative or really aggressive to alert your alert you sooner or later to that drop happening that could predispose you to the low. Where

Scott Benner 31:40
are you at on calibration? Do you calibrate?

Jennifer Smith, CDE 31:44
I calibrate if necessary? Yes. The majority of my centers, I've had really, really good luck, if you will, with my Dexcom. For a long time,

Scott Benner 31:58
I'll have ordered and calibrate once in a while doesn't come up that often. I think you really have to pick through what works best for you. Like some people will say, look, I put that thing on six hours into it. It says I'm 65. And I'm 90. And I calibrate. And some people will tell you like don't calibrate on the first day. And you know, in Dexcom, all the CGM companies, they don't really talk about how to best do that. So I would say this,

Jennifer Smith, CDE 32:21
they do tell you that you can calibrate. And most of them, if you've read the fine print in their owner's manual, there is a defined strategy to what they recommend for calibration. And how far outside of that could actually create sort of a setup or where the sensor is just going to fail itself. Because you have over given it information. And the algorithm that's changing that sensed goes to a number to tell you what it is, it gets all messed, you could just

Scott Benner 32:54
confuse it. You could confuse it you find sensor placement because you know, there's the places where they've tested the sensors. So they can say you can wear it here, but people move them all over the place. Do you find that you have better sights some than others for accuracy?

Jennifer Smith, CDE 33:08
I do. You know, again, leg sight isn't technically approved. I don't wear it. I also don't wear my pumps on my thighs either. Neither of them work ever for me. But people find special places that do definitely work. Many times. They're the approved sites. And the majority of the time. They are not technically approved sites. My recommendation is tested. This is another opportune time to use your glucose meter. And make sure that it is actually really serving you. Well there. And then if it is great, keep using it. I mean, we all have limited real estate on our body. Yeah,

Scott Benner 33:50
I don't know that Arden has ever worn a Dexcom on our arm. Seven gees. Oh, nice. You bring them on or like size for hips or budget, upper body kind of thing. Yeah, like there. So let's talk a little bit about the quality of your management is also going to add to the quality of your CGM accuracy. So if your blood sugars are not constantly bouncing up and down or super high or super low, you are going to see, I think more stable accurate readings back from a CGM, correct. Yeah, yes. Okay.

Jennifer Smith, CDE 34:21
Absolutely. And with the difference between those coming again speaking Dexcom, specifically, those coming from G six to G seven, where there is no longer smoothing of the data. Right. That balance could get worse, visibly in the data points with somebody who has a lot more Rise Fall happening looking a lot more like a roller coaster. Those numbers again, data points on the CGM graph, they could look a lot more jagged and up and down even as the glucose is going up and down compared to somebody who has a lot smoother trends. addition from data point to data point.

Scott Benner 35:01
Yeah, that and then my point is that if you do simple things, like we talked about in the diabetes Pro Tip series, like Pre-Bolus, your meals, you know, have your settings closer, you're not going to see as much variability. And you're going to see more accuracy out of your CGM as well also do not calibrate while your blood sugar's moving. So correct. If you're rising very quickly falling very quickly. That is not a good time to calibrate. No, this thyroid have impact on CGM accuracy at all? Or do you think it just has impact? Because right, like, as I looked into it a tiny bit like, so you can have like, an overactive thyroid, right, which would maybe speed up your metabolism as an example? Like, would that maybe move glucose through you differently? You know, it's an interesting, I just, I don't know if it's right or not it just like it popped into my head. I'm like, I wonder what medications people are taking that might have an impact on this as well? Well,

Jennifer Smith, CDE 35:54
I do you know, obviously, and most people who are Dexcom users know about acetaminophen. And in fact, while they cleared that push to avoid acetaminophen, I think it was once G six came out, they still will ask you, if you are trying to return a failed sensor, if you had used acetaminophen, my expectation is that they're looking potentially maybe for a dose, that's more likely going to fail a sensor comparative to just using you know, 500 milligrams of something once a day, and you had no effect whatsoever. I know Vitamin C is another one, you know, higher doses of vitamin C can certainly affect the accuracy. I think it's a FreeStyle Libre, too, for vitamin C, and you know, a lot of people might not even realize that they're using a large amount of that. If they're, if they're taking some type of a powder that includes a high amount of vitamin C, they're not technically just taking a chewable or a daily might vitamin, they may not think that they're really going to have a problem. They may not realize it's in something else that they're eating. Okay, those are the two things I definitely have impact. So with

Scott Benner 37:10
overactive underactive thyroid, I'm just kind of picking through some of the notes I made earlier. It's gonna more change like, like underactive thyroid, slower metabolic rate could delay glucose uptake into cells, which could affect how quickly changes in your blood glucose are affected. All I'm saying is that if you have hypo hyperthyroidism, it's not crazy to think that you might see Genki readings from your CGM. Or maybe it's a little different for you than it is for other people. Maybe listen, if I'm wrong, that's fine. You have to imagine there are other things impacting this, it's not as easy as I put the thing on and the thing don't work. You don't mean like it right. And that's what I think always happens with people's they just kind of don't see the bigger picture. And I understand why. Right? Because you don't buy tires, and think, oh, they were out faster. But I drive faster than other people like you just think I bought more than other more or like the roads are worse or whatever. Like you just think like I bought the thing they said 30,000 Miles 60 It didn't last, like you know, there's reasons why things happen. I don't know what they are sometimes. Yeah, you just need to think bigger when you're trying to decide how to make this thing work the best because this is going to be a very important part of your life with diabetes until they come up with something different. And I don't know if there's something different to come up with. A CGM might be the greatest advancement for people using insulin, you know, in the last 20 years.

Jennifer Smith, CDE 38:34
Absolutely. Yeah. Yeah, absolutely. In terms of that accuracy to, you know, and calibration and whatnot. There are strategies, like I said, in the fine print of the books to if it's this far off, this is one to add a calibration. I know in the realm of people with diabetes, there are so many conversations about when to calibrate how to calibrate how many calibrations to put in, should I change the number from this to this to make it closer to the actual to put into the system so that I don't confuse it. I mean, there's so many different things. My first recommendation is always go by what the system is telling you as allowable for a calibration and try that

Scott Benner 39:15
first. Right. Follow the advice from the company about how to handle it.

Jennifer Smith, CDE 39:19
Correct. Exactly. And then, you know, Bob on the corner who has his own proven strategy? You know, what, if you've tried the strategy, they don't seem to be working, maybe try Bob strategies, but I, I wouldn't necessarily rely on them. 100%

Scott Benner 39:35
working for you, you have a second over adhesive stuff. Sure. Okay. So some people are going to have adhesive allergies. And it's not crazy to say that everyone sort of while some of you are going to have significant adhesive allergies must be no big surprise. You have autoimmune issues and your body tends to overreact to things. So skin preparation, doctors, so it's tough, right? Because they're going to tell you to clean your skin The alcohol. Yes, and for some people may be a person with very oily skin that might be really important. But for some people who have more sensitive skin taking out those oils could lead to, you know, dry skin, that kind of stuff. We are more like light soap and water, pet dry people. We don't use alcohol to clean the sights. In that idea somewhere might be something for you. So if you're noticing your skin getting very dry, bumpy, scaly, I the first thing I would do is I'd get away from alcohol, if you're using it to see what happens, not a doctor not advice, etc, and so on. It's what worked well. For us. There are skin barriers. There are skin tag, Tara DERM. What's the other one IV?

Jennifer Smith, CDE 40:43
Well, there are a couple that help with stickiness. So if you're having a problem on the end of things not staying stuck, okay, there's some things that are patches for that, or perhaps IV prep, all those kinds of things that actually help at here. But then there are more patches, IV 3000. And those types of barriers that are hypoallergenic, they're typically clear, they come in multiple different sizes. And essentially, you would clean your skin with whatever method you're going to do, let it dry with that on the skin, creating a thin barrier. Upon which then you're going to apply the sensor you're gonna pop the sittin sensor on over so the sensor adhesive is not technically touching your skin, right.

Scott Benner 41:31
So you're just trying to create a barrier between you and that adhesive because some people, some people are never going to be bothered by it. Some people are terrible, they can't wear it, you feel horrible for them. Some people can't get it to stay on, some people can't get the tip come off. And you're gonna you're gonna, you're gonna hear people online like well, I don't know why they don't make it more like this or they're trying to make it down the middle. So everybody helps most people. And you might have to make some, some adjustments. hypo allergenic tapes, adhesives are a way to get around sensitive skin. There's these holders like some 3d printed like holders I've seen people use Yep.

Jennifer Smith, CDE 42:10
And that's actually for the people who really can't do an adhesive. So what happens is they'll put a dressing on, the adhesive will essentially not be on their skin. And in order to hold especially like the pad or in the infusion set, or even the sensor on the skin. That sort of 3d printed is almost like a it's like a cage that sits on top. Yeah. And then there's a band that goes around to actually hold that in place

Scott Benner 42:41
where you can use different adhesive that doesn't come on your device that maybe you can deal with. Yep, keep moving your sites, if you're having reactions is can be helpful. hydrocortisone creams and histamine, stuff like that. Like if it gets to that point for you. You know, there are ways to manage it. And for those of you who can't, I mean, I'd say if you absolutely can't figure it out, like if your skin just doesn't work then I think you got to look at ever since for the implantable CGM right because they have their transmitter is on a silicone based I think I'm saying that right silicone based adhesive, which I don't think causes much. dermatologist. dermatological. Is that dermatological? Is that right? issues. If not make up a word. A good

Jennifer Smith, CDE 43:27
word. A great works for me. Yeah, good.

Scott Benner 43:31
Okay, so anything we're not talking about here that you can think of anything we must. I think

Jennifer Smith, CDE 43:37
the only thing that I would say in the same line of thought that we're just talking about would be really make sure that after you remove any adhesive, whether it's a CGM or a pump soldering, you really clean that site. Well, they seal a lot of times just a basic like, clean over it with like, again, like an alcohol or something to kind of get the sticky stuff off, but you never really completely getting off all of that residue. And there are some really good residue removers there even some that are more like essential oil type, you know, or homeopathic that work really well that are just good for the skin. I also think keeping skin really, overall, people with diabetes can tend to have drier skin, and so making sure that you're overall really well moisturized as well. But does that sound

Scott Benner 44:31
weird? Either on the cocoa butter or whatever. Yeah, coconut

Jennifer Smith, CDE 44:35
oil actually. I mean, it's great for a million wonderful things and it is you know, it's a wonderful

Scott Benner 44:44
kid, you know, you can refinish leather products with coconut oil. I did not know that. It did it with an ottoman once it worked very well. Treat yourself like an ottoman Jenny is saying and moisturize your skin

Jennifer Smith, CDE 44:56
and moisturize your skin and especially those sites that get used and used and used, really make sure that they get nicely cleaned and hydrated. How about from

Scott Benner 45:06
your perspective, nutrition or vitamins that would help with that? Anything that pops the mind? That's an outside of the box question, but because I'll point out that hypothyroidism could lead to dry skin as well. So if you're under medicating your thyroid and you're experiencing dry skin, that would not be crazy if your TSH was if you're one of those people walking around with a four and a half TSH, your doctors like it's fine, which probably isn't you probably want to push it under 2.1. But like that could be a thing. But I mean, are there like when people take multivitamins? Are there foods that help with with skin? Health? Or am I just making that up? Um,

Jennifer Smith, CDE 45:48
well, I'm quite sure I'd have to go to my skin health kind of guide. But I mean, there are certainly things that are very good overall, even in the in terms of aging, which is not what we're really talking about, but it kind of goes right along with keeping your skin healthier, more stretchy and keeping things more elastic. Rather than getting paper thin kind of skin. There are definitely nutrients and food in terms of supplemental, I'm always wanting to save try to eat it in food as much as possible. Rather than pulling out a whole bunch of expensive stuff that you may not actually be in need of. Jenny,

Scott Benner 46:30
I asked our chat GPT overlords. They said that benefits of vitamin A produces cell production helps repair vitamin C boosts collagen production. Yep, vitamin E acts as an antioxidant. omega three fatty acids reduces inflammation keeps skin moisturize supports skin barriers, function. Zinc can add in skin repair and reduce reduction of inflammation. Bio 10 B seven supports healthy skin by improving the skin's hydration collagen, protein essential for repair. Vitamin D plays a role in skin cell growth and repair. So yeah, I mean, eat well. Always a good advice, but you know, all these things could be valuable for you.

Jennifer Smith, CDE 47:15
And interesting, a very valuable thing about all the rest of those is that they are highly recommended and people with diabetes anyway. Yeah.

Scott Benner 47:23
If you're taking care of yourself, you might be taking care of your skin by mistake already. Right. Cool. Yep. All right. Well, I want to thank you, I'm gonna let you go. But then I'm going to tell everybody to hang on for a second because I'm going to go over some things that I have in my notes that I'm not sure if we hit or not so fabulous. There'll be more right after this. Okay, thank you. Alright, guys, Jenny's gone she had to get going. But I put together so much like stuff to talk about in this episode that I just wanted to kind of roll through it very quickly. And make sure that it's all highlighted for you. So very, I'm gonna go through very fast. These are things you should be researching maybe on your own. Super simple stuff, right. Sensor insertion, clean the site, use proper placement. Rotate your sites, calibrations, like Jenny said, Follow the manufacturer's guidelines for calibrations, and try very hard only calibrate during stable glucose levels. Do your best to keep the sensor dry. I know you can be in and out of water with them. But you know, the better you keep them, maybe the better the adhesives going to stay, you know won't be moving around that could end up helping you stay on top of when the sensor expires, right? You want to know when it's going to shut off? Are you noticing janky readings and you're more towards the end? Maybe that's why take a look at maybe swapping it out a little sooner. If you don't know what's happening, all the company ask questions go online, find Facebook groups, go to the Juicebox Podcast Facebook group, ask other people who are users, you might get some great information from them. Skin Health hydration superduper important a balanced diet. Now just not just a balanced diet for your skin but a balanced diet so that your blood sugars aren't bouncing all over the place. You're monitoring your blood sugar with the CGM, which just works better. If your blood sugar is not super variable. You're always going to need adequate sleep. Keep your stress down, get mental health support. Remember that alcohol consumption moves your blood sugar around CGM is going to bounce around with it. Now you're a little loaded and the things jumping around might be harder to pay attention to. I'm not saying that alcohol changes its ability to work. I'm saying alcohol can have impacts on your blood sugar. And now you are trying to decide what you're seeing on your CGM when you're inebriated, and it's bouncing around a little more. Scrolling down super important. I know we went over it probably felt boring to you but understanding how interstitial fluid works, what it is and how the CGM is monitoring it really important especially for understanding lag time. And that's impact on what your readings might be versus your blood glucose meter. I can't suggest enough a quality blood glucose meter contour next.com/juicebox Great, great, accurate meters. There are other medications impacting your readings Jenny mentioned acetaminophen, also beta blockers could have an impact. Check into that with your doctor or online. So regular monitoring consistent medication use regular endocrinology visits. Some other stuff to keep in mind the Dexcom G seven has a shorter warmup time of just 30 minutes, you can plan your sensor changes to give yourself some marinating time very helpful. Between me and you. I don't care what the company says about never needing a calibration. You need your meter, you should be checking your blood sugar and seeing if there are drastic differences. Just so you know. Okay. And then you can make a decision about calibrating but you want to make sure that you understand what's going on. That's libre three Dexcom all of them adhesive skin prep barrier methods, hypoallergenic adhesives, rotating your sights, making sure you get all the adhesive off, and managing reactions if you have them. Finding a health care provider to help you with this may be necessary. If you're having significant allergies to adhesive. You can consult a dermatologist, look for barrier creams, non adhesive alternatives, medical grade silicone tapes, all these things might be possible. This would be a time to get online find other people who have this issue and see what's working for them. That's it.

Did you know if just one person in your family has type one diabetes, you're up to 15 times more likely to get it to screen it like you mean it. One blood test can spot type one diabetes early tap now talk to a doctor or visit screened for type one.com. For more info. The conversation you just enjoyed was sponsored by Omni pod five. You want to get an omni pod five you can you wanted to make me happy, do it with my link, Omni pod.com/juice box. I'd like to thank ag one for sponsoring this episode of The Juicebox Podcast and remind you that with your first order, you're going to get a free welcome kit, five free travel packs and a year supply of vitamin D. That's at AG one.com/juicebox. Are you starting to see patterns but you can't quite make sense of them. You're like, Oh, if I Bolus here this happens, but I don't know what to do. Should I put in a little less a little more? If you're starting to have those thoughts? You're starting to think this isn't going the way the doctor said it would I think I see something here but I can't be sure. Once you're having those thoughts. You're ready for the diabetes Pro Tip series from the Juicebox Podcast. It begins at episode 1000. You can also find that at juicebox podcast.com up in the menu and you can find a list in the private Facebook group. Just check right under the feature tab at the top it'll show you lists of a ton of stuff including the Pro Tip series, which runs from Episode 1000 to 1025. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com

#1270 Weekly News 7/29/24

For the week of July 29, 20024

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
OmniPod. Hello friends and welcome to Episode 1270 of the juice well. Did you hear them? 1270 of the juicebox Podcast.

Today I'm going to go over the news stories around diabetes that jumped out at me for the week of July, 29 2004 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. Don't forget, if you use my link drink AG, one.com/juicebox, you'll get a free year supply of vitamin D and five free travel packs with your first order. And if you go to cozyearth.com and use the offer code juicebox to check out, you're going to save 40% off of your entire order. The juicebox podcast is full of so many series that you want and need after dark, ask Scott and Jenny algorithm pumping bold beginnings, defining diabetes, defining thyroid, the diabetes Pro Tip series for type one, the diabetes variables series, mental wellness, type two diabetes pro tip, how we eat? Oh, my goodness, there so much at juicebox podcast.com head up into that menu and pick around. And if you're in the private Facebook group, just go to the feature tab for lists upon lists of all the series. Always free. Always helpful. What's up? Everyone? This is the news that caught my eye for the week of July, 29 2024 let's get started. So there's a recent trial investigating the use of ozempic to manage kidney disease in individuals with type one diabetes. The study aims to determine if ozempic can reduce insulin needs and improve blood glucose control in people with in people newly diagnosed with type one diabetes. I can only talk from my perspective here with my daughter, but I don't think we need to study for this one. The answer is yes. Study Details participants and dosage. The trial involved 10 adults aged 21 to 39 who started taking semaglutide With three months of within three months of their diagnosis, they began with a weekly dose of point 125, milligrams, which was gradually increased to a maximum of point five per week. The mealtime insulin doses were reduced based on continuous glucose monitoring data, key findings, it says, After three months, participants no longer required mealtime insulin. And after six months, seven out of 10 participants no longer needed basal insulin. Additionally, there was a significant improvement in glycemic control, with a 1c levels dropping from an average of 11.7 at diagnosis to 5.9 at the six month mark, and 5.7 in one year, most participants achieved a time and range of 89% some participants experienced mild hypoglycemia. Sounds like they gave them too much insulin while the semiclutide dose was being increased, but no severe side effects like diabetic ketoacidosis were reported once the dose stabilized. I'm just going to jump in here and say all the people who came to me and said, You can't share stories of people who are using less insulin on glps, because type ones will get confused and think they don't need insulin. First of all, I don't think type ones are easily confused like that. I still know you need insulin if you have type one diabetes, but to all you people who mercilessly, mercilessly, mercifully, mercifullessly Ram your hot poker up my ass for spreading news that is absolutely legitimate. Let me just go say to you now yourself. In addition to these findings, a separate trial starting in March 2020, will investigate the use of karadia for preventing kidney disease progression, adults with type one. This study, known as the fine one trial, will enroll 2220 participants, and compare the effects of finaroni. I mean, how do they F, I N, E, R, E, N, O N, E, against the placebo. Over six months, if successful, finaron could become the first new medication for managing kidney disease in type ones in 30 years. That's very cool. I got this information from a number of different places, but one of them I really enjoy is diatribe. The rest was kind of cold over the internet and I asked, of course, our chatgpt overlords, the carodemia trial for preventing kidney disease is actually accepting participants. It must be 18 years old, diagnosed with type one diabetes, have an A 1c of less than 10% diagnosed with chronic kidney disease, meeting specific criteria for estimated Glomar, really. I mean, why do they these words? Fill? Rate, EGFR and urinary albumin. I know this one, albumin, creatine ratio, UA, CR, I don't talk so good. Sometimes must be on a stable dose of an ACE inhibitor or an angiotension receptor broker for CKD exclusions. Individuals with type two or those taking SGL t2 inhibitors or GLP one receptor agonist, they're not eligible for more information or express interest in the participant. You can contact the study directly, 888-842-2937, and to add some clarity to what I was poo pooing a minute ago. I've had two conversations so far with type ones who have used the GLP and their insulin needs have significantly decreased. Episode 1136 is called 15 year old type one using GLP. You should check it out. Episode 1230 is called off insulin with Manjaro. That's an adult with type one. Listen, does he have Lada? Probably, but he's not using insulin right now. Go listen to his story. Jenny and I talk about glps as part of the diabetes pro tip for type two series. That's episode 885, actually, that whole series is terrific if you have type two diabetes, or know somebody who does or even has pre diabetes. It's great for them to know what's about to happen to them, so that they can tackle it well. But in the end, today's story is about kidney disease and looking at glps and how it might help. It's a big deal. I hope you check it out. Looks like I've received an email from OmniPod today, most of you have probably received it as well. I'm just going to read it to you. Hey, Arden, you insert your name there. We're excited to share the latest information on the OmniPod five integration with Dexcom g7 launch and limited market release of OmniPod five app for iPhone with Dexcom g6 sounds like things are moving. OmniPod five, Dexcom g7 you will receive a free over the air update to complete on your controller starting July 30. That's today. OmniPod five app version 3.0, point one will add the option to pair your system with Dexcom g7 you can choose to install the update immediately, or delay it until a time that is convenient to you. It's important to know that the software update requires 15% battery level and should only take a few minutes, depending on the strength of your WiFi connection. During the update, you will not be able to navigate with the OmniPod five app, including the ability to bolus Bazel insulin will continue to be delivered in the background. There's a link here for where you can find out more, but I am not going to be giving you that link so you can do some Googling. Let's see here there's more. The new pod. Oh, the new pods compatible with Dexcom, g6 slash g7 may be at your current pharmacy as early as August, with full availability expected in the fall continue using your Dexcom g6 supplies until you see this is going to be written right on the box, the words compatible with Dexcom g7 right in the top right corner of the face of the box. It'll say that you don't need a new pod prescription. Oh, this is nice, but a new Dexcom g7 CGM prescription will be required if you decide to change your CGM, which I think makes sense. If you have g6 and you want to go to g7 you're going to need a script to go to the g7 that's got nothing to do with OmniPod now iPhone control with Dexcom g6 the limited market release of OmniPod five app for iPhone with Dexcom g6 is underway. The first version of the app will integrate with the Dexcom g6 only if you prefer. And so ends the part of the show where Scott reads you his email. This last thing here. I mean, it's not news, but I keep seeing people talking about it in the Facebook group, so I thought I'd go over it with you real quickly. You can get a free lifetime national park pass if you have diabetes. I don't know if you knew this or not. Eligibility US citizens or permanent residents with diabetes qualify as it is considered a disability by the ADA. The pass, called an Access Pass, grants free entry to over 2000 federal recreation sites. Apply in person for free, online for $10 or by mail for $10 you have to provide evidence, a physician statement or document from federal or state agencies are needed. I don't love reading URLs, but www.nps.gov/sub, s.gov/subjects/accessibility/interagency-access-pass.htm

There you go. Have fun with that. One tickets for the 2025 juice crews are limited. I'm not just saying that they actually are. Limited. We have a certain window to sell them in, and then that's it. Juicebox podcast.com, scroll down to the juice cruise banner. Click on it. Find a cabin that works for you and register right now. You are absolutely limited by time on this one, I'm so sorry to say that. It sounds pushy, but it's the absolute truth. Juice cruise 2025 I hope to see you there. We're gonna get a tan, talk about diabetes and meet a ton of great people who are living with diabetes. It's kind of gonna be like floating diabetes camp, but you won't have to sleep in a log cabin. You'll get a tan. And it's not just for adults or kids. It's for everybody. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode.

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. You.

#1269 Multiplicative

Christi has four kids all with different auto immune issues. Her youngest son has type 1 diabetes.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends and welcome to episode 1269 of the Juicebox Podcast

so Christie has four kids, they all have different autoimmune issues. Looks like her youngest son has type one. Her husband and herself have other autoimmune. We talk we talk about a lot of stuff in this episode, you're gonna love this. 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. When you place your first order for ag one with my link, you'll get five free travel packs and a free year's supply of vitamin D. Drink ag one.com/juice box. Hey, you like we're uncomfortable stuff sleeping uncomfortable sheets drying off with beautiful towels. If you're that kind of person. Cozy earth.com use the offer code juice box at checkout save 40% off of your entire order. If you've taken a quiz to find out what Gossip Girl you are or what Hogwarts house you belong in, and you haven't gone to T one D exchange.org/juice. Box include the survey. You're personally hurting my feelings. You have questions? Scott and Jenny have answers. There are now 19 ask Scott and Jenny episodes. That's where Jenny Smith and I answer questions from the audience. If you'd like to see a list of them, go to juicebox podcast.com up into the menu and click on Ask Scott and Jenny. Today's episode is sponsored by Medtronic diabetes, a company that's bringing together people who are redefining what it means to live with diabetes. Later in this episode, I'll be speaking with Mark he was diagnosed with type one diabetes at 28. He's 47. Now he's going to tell you a little bit about his story. And then at the very end of the episode, you can hear my entire mini interview with Mark. To hear more stories from the Medtronic champion community or to share your own story. Visit Medtronic diabetes.com/juice box and check out the Medtronic champion hashtag on social media. This episode of The Juicebox 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 this show is sponsored today by the glucagon that my daughter carries. G voc hypo penne Find out more at G voc glucagon.com. Forward slash juicebox

Christi 2:37
Hi, my name is Christie and my son Silas is 11 years old. He is a type one diabetic. diagnosed two years ago tomorrow. Two years ago tomorrow

Scott Benner 2:49
February of 2024. How old is he?

Christi 2:53
He's 11. He was nine. Yeah,

Scott Benner 2:57
he was diagnosed.

Christi 2:57
I started off math. So

Scott Benner 2:59
two years if I can't do the math on two years I'm in trouble. Silas that's an interesting name. Is that a family name? No. Where'd you get it?

Christi 3:07
It's not the Bible.

Scott Benner 3:08
Oh, nice. Yeah. Which one? The older the new one? I don't really new

Christi 3:12
one. The new one? Mm hmm. Yeah, he was Paul's buddy. Missionary.

Scott Benner 3:19
Hold on. Sorry. I used a lot of words just there. Like I actually just thought, can I call this episode Paul's buddy? Maybe?

Christi 3:26
Possibly. Yeah.

Scott Benner 3:27
But you mentioned it's so early on. It's you know, I don't like doing so by the way. Not for nothing. Christie. You then said Paul's buddy and missionary all the same time. And then I was like, I don't want to say anything inappropriate. So I kind of I stopped thinking about okay, okay. Sorry. Do you have any other kids?

Christi 3:47
Yes. He's our youngest. We have four. Wow. Okay.

Scott Benner 3:52
Your youngest is 11. How old are you?

Unknown Speaker 3:56
I'm 44.

Scott Benner 3:58
Are you done with the kiddie making?

Christi 4:00
Oh, my gosh. Yes.

Scott Benner 4:01
I will say

Speaker 1 4:04
she's 18. Wow. In high school,

Scott Benner 4:07
any other autoimmune with the kids?

Christi 4:10
Well, now that I've learned a lot about autoimmune stuff, the answer is everybody has something. Our 16 year old. He he's the first one who had anything he's had asthma like just not bad, but like, you know, when he would get sick since he was little. And then right around when Silas was diagnosed with type one. Our daughter who's 18 She's our only girl. She started getting hives. Horribly, horrible, horrible hives, was diagnosed with chronic hives a few months later, she's on Zoeller injections. I can't figure out what you know what it is, but we're guessing it's auto immune. I mean, that makes most sense. And then back in our 13 year old, he has to auto antibodies and is last August they said he was into Stage two, that I've just been doing fasting blood sugars, and they've all been really like in the 70s and 80s. So he'll redo that in May, because they want him to do a clinical trial. Right. So they'll redo that in May and I, I'm kind of doubting that he's eligible.

Scott Benner 5:16
They thought he was but for like, tz old or something like that?

Christi 5:19
No, it's a new one. Oh, gosh, I shouldn't under organizing this. It is through trial net. And it is. It's a it's some drug that they give to kidney transplant patients. Okay. I can't remember

Scott Benner 5:34
what it's called. I'll see if I can figure that out while I bring up something else. Okay, have you on a second? Let's do this first trial that I was going to try to type and talk about something different. I'm like, I don't think my intelligence goes that far. I tried try on that and kidney to see if I could get something ATG onset. Yep. Yeah. That's it. Okay. trauma.org If you want to learn more, but I want to go to your daughter for a second. Sure. So my son, Arden was diagnosed when she was two, and colts about, you know, I don't know how old he is five years older than her. I don't know how old he is. I just had to do I just had to remember how old my kids were. So Arden's diagnosed when she's too cold, five years older. And we don't know anything about autoimmune issues as we're raising a young family. Although if I look back now, my wife's grandmother has celiac. Some people with like, irritable bowel and her life, there's a person with bipolar distance away, you know, some depression, like, you know, like stuff that as you hear people talking more and more, you hear kind of clustered together around people with autoimmune issues. Anyway, my son, Doring, COVID, was going to school at home. That was fun. By the way, any of you who have ever sent money to a college and then watched your kids zoom, you're like, I got my money back, please. He's getting through that season. And he says, As soon as I'm done these last tests, I'm going to start working out again. And you know, we started talking about stuff he was going to do for baseball. And he finished up all this testing. It was definitely a stressful time, he disappeared into the basement to start working out. And a couple of days later comes running up the stairs covered in hives. And we couldn't figure out what was going on. So you do all the things that you think you know, at first, it feels like a thing. It's just not going to happen again. And then you see it happen again, he's working out again, he breaks out again, you go to a dermatologist, because that seems to be the way to go. They treat for all the things they know how to do. You probably went all through this, they probably gave her a cocktail of like over the counter, and histamine and stuff like that, right? It didn't do anything. And then we started talking about Xolair and injections and oh my god, he's got a chronic hive issue, etc. And then one night I was up late online trying to figure out what was wrong with them. And I hit on this NIH article that mentioned that a very uncommon thing that you see with people with hypothyroidism is hives. And so we contacted our endocrinologist who put him on tiersen, which is like Synthroid but a different brand, because Arden already used tiersen and his hives went away, and he's been fine ever since. A nice

Christi 8:28
thing about our allergist is that she is with our endocrinologist, so they knew all of styluses history. So they tested her, her thyroid, I asked him test her for celiac. Yeah, and everything came back normal and thankfully, because I've been listening to you, I knew what normal was right. So yeah, I wish I don't know. I mean, do I wish she had thyroid now? But her Oh, that's normal. Her

Scott Benner 8:51
TSH is under two even.

Unknown Speaker 8:53
Yeah, I'm

Scott Benner 8:54
so sorry. I wish it was an easy answer. How long has she been taking the injectable about

Christi 8:59
a year and a half? Does it work? So with she also takes an Anna histamine and Zantac with the cocktail of all three of those. It works that their their desire was that she would be able to wean herself off of the oral meds and just do the injections. And that has not happened.

Scott Benner 9:25
So she needs the injection and the oral over the counter. But oral medication too.

Christi 9:30
Yeah, it was I mean, if you saw it was horrific. I could not believe the Porvorim thing. The Hives were so so so bad. Yeah, so that's been a little bit more, you know, type one at least is pretty cut and dry. You know, they go in and it is you know, then you start treating it but the hives have been a bit of a challenge.

Scott Benner 9:49
If you take insulin or sulfonylureas you are at risk for your blood sugar going too low. You need a safety net when it matters most. Be right Edie with G voc hypo Penn my daughter carries G voc hypo pen everywhere she goes because it's a ready to use rescue pen for treating very low blood sugar and people with diabetes ages two and above that I trust. Low blood sugar emergencies can happen unexpectedly and they demand quick action. Luckily G vo Capo pen can be administered in two simple steps even by yourself and certain situations. Show those around you where you storage evoke hypo pen and how to use it. They need to know how to use G vo Capo pen before an emergency situation happens. Learn more about why G vo Capo pen is in Ardens diabetes toolkit at G voc glucagon.com/juicebox. G voc 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 insulinoma. Visit je voc glucagon.com/risk For safety information. You've probably heard me talk about us Med and how simple it is to reorder with us med using their email system. But did you know that if you don't see the email and you're set up for this, you have to set up they don't just randomly call you but I'm set up to be called if I don't respond to the email because I don't trust myself. 100% So one time I didn't respond to the email, and the phone rings the house that's like ring. You know how it works. And I picked it up I was like Hello. And it was just the recording was like us med doesn't actually sound like that. But you know what I'm saying? It said hey, you're I don't remember exactly what it says. But it's basically like hey, your orders ready? You want us to send it. Push this button if you want us to send it or if you'd like to wait I think it lets you put it off like a couple of weeks or push this button for that. That's pretty much it. I push the button to send it and a few days later box right at my door. That's it us med.com/juice box or call 888-721-1514 Get your free benefits check now and get started with us med Dex comm Omni pod tandem freestyle, they've got all your favorites, even that new eyelet pomp check them out now at us med.com/juicebox Or by calling 888-721-1514 There are links in the show notes of your podcast player and links at juicebox podcast.com. To us Med and to all the sponsors. Yeah, no, I as we were considering them as the possibility that something my son was going to live with. I found it much more overwhelming than diabetes to think about. And it's maybe weird to think but like because it seems so if your blood sugar gets high or low, you know why? You know what I mean? But like the hives, they appear to come out of nowhere and for no reason that you can discern. So, so scary.

Christi 12:49
Well, they tell her they're like they could go away at anytime. Like Great. Well, that'd be nice. If that happened, that's

Scott Benner 12:55
the other thing or you find some poor kid online on YouTube is like I've been living in this bed for three years because of my you know my breakouts and stuff like that. My son couldn't his trigger was getting warm. So yeah, for people who haven't heard me say it before he he spent like months in his bedroom with the windows open in the middle of winter trying to keep his body temperature down. He couldn't like exercise or get moving or like even get excited or laugh. They all these things would make them break. That was really crazy. Yeah,

Christi 13:24
that's the weird part is that when she was little, she would get high. It's like a heatwave, just like a heat rash. And then anytime she got a virus, she would get hives at the end of it, which is also pretty normal. So when it first came up, we were like, Oh, you must have just like had a virus, you know, or something like that. But they just didn't go away this time. So I think she's always been prone to them. They also did the allergy testing on her back. And everything, including the saline. She was allergic to the saline. She was alert. Yeah, they just said that she's got some hyper reactive skin. So every single I mean, you know, so I said, Well, should we change detergent? And they said, well, it doesn't really matter.

Scott Benner 14:06
Okay, well, my son has our like some allergies to like, you know, pets, hay fever, stuff like that he can be real susceptible to. And I had terrible allergies as a child that just kind of went away at one point in my life. Yeah, that's what my husband is. Yeah, I can't I could never explain it. But I was a person. I couldn't go outside during the summer sometimes. And then one day in my like late teens, it just stopped. was really crazy. That's great. Yeah. Anyway, that's not why you're here. I don't know why you're here. But that's not why we take a look here. I can look TrialNet advocating managing super active kids Oh, with Omnipod five being a foster parent, in the mindset of type one diagnosis. 23 and me, maybe I don't want to talk about that assess. Okay, so whatever you want well at that cocktail, these children and some of them are foster kids.

Christi 15:01
Not anymore. So

Scott Benner 15:04
are you, you did a rent to buy house? What are we talking about?

Christi 15:08
So we, before styluses diagnosis, we've been involved for a long time with foster care or like foster care adoption organization, and helped with just supporting families who had foster children like bringing meals and helping with one another. we ever did child care, but mostly helping with food because feeding a lot of kids is very hard. Then a sibling set of four came up that needed help. My husband and I both felt like they were supposed to come to us. So we started that it wasn't it was all through, it wasn't through like the state or anything was just through relationships. And this, basically, their aunt had taken them in because their situation was really bad. Neglect, mostly neglect. And then it had just become a lot for her for some different reasons. And we stepped in. But in the midst of all of it, Silas gets diagnosed with type one, which was mild. So we still he was, we started the process in December. And he got diagnosed in February. And then we ended up taking them in May. And we had them for eight months. And then they went back to there. And she was at a better spot to care for them. But now they're back with their mom, which is not great. But the court was never involved. So her rights were never removed. She just abandoned them basically, that because it wasn't I mean, the courts were involved in like we had guardianship of them, but she was never, you know, like detox was never involved, I should say. So or whatever you call it. And you know, every state is different. Anyway, so we're in the Atlanta suburbs, that the children are now back with her in Portland, Oregon, which is hard. So they're really far away now. But But yeah, it was the hardest. I mean, 22 is just really hard. Really hard.

Scott Benner 17:09
You're in the middle of trying to do something really kind and then the diabetes comes at you. And it's it's a lot. Jeez, you know? I mean, it would have been a lot. It would have been a lot to take on for children if you didn't have children.

Christi 17:23
Seriously, yeah. Oh, oh, my gosh, it. It was, yeah, I really had a hard time deciding what to do. After styluses diagnosis that we thought, well, we'll just give it a shot. We didn't know very much. I mean, we really didn't know anything. Your podcast was an absolute godsend. Because I literally knew nothing, then I knew we had all this potentially happening. And so I knew the priority was his health, like that has been the priority from the very beginning. I'm like, I'm, you know, I'll do everything. I want to do everything. I can have my kids out with me, you know, and, and I want him to be able to do all the things. He's an incredible human, and he loves to go out live 100% Every single thing he does, so I didn't want any of that to stop. So it's like, how are we going to do all this? And then what ended up happening is he did great. I mean, his his agency has been under six since its original diagnosis. I mean, he's been just, he has not slowed down a bit. But then we added these four children who he actually loved. I mean, he, they were right around his age, he had a blast with them. But I because I also have some like autoimmune stuff. And so I've been basically in remission for the last 13 years. And I could feel that I know what I have to do to keep myself healthy. And I could just feel things like my pinky swelling up randomly and myself, you know, just I could feel things happening to me because I couldn't take care

Scott Benner 18:53
of myself. Yeah. Do you have lupus or so I

Christi 18:57
have it's a nonspecific connective tissue disorder that they think probably is the beginning of lupus that just never got like I have mild kidney disease. And then I did have like joint issues dry mouth dry, which I still have, but those are just annoying, you know, because I do. And I was on Plaquenil for like, two years, I guess. And then we wanted to have another child it was after it was during my second pregnancy that it all happened. And then we wanted to have another child. So we didn't know did all the consoles and everything and all the doctors were like I think you're fine do it. So I went off the clock well and that pregnancy. I mean, something happened and everything just kind of turned around and after that, like I haven't been taken steroid haven't been on Plaquenil I haven't done anything other than just diet exercise, get enough sleep, you know, try to alleviate stress and that of course is very challenging when you have eight children, one of them being diabetic and four of them being we

Scott Benner 19:56
get the hive start by the way, was the hives after this was the hives before or after the lead time of thinking about taking on for more kids or my daughter. Yeah.

Christi 20:05
They really started when Silas got diagnosed. So it was right in the middle of

Scott Benner 20:10
everything. So her stress went up. And then she had this. Oh, for sure.

Christi 20:14
Yeah, her stress. It was definitely stress related. That is like the trigger. For sure, huh?

Scott Benner 20:19
All right. What made you want to be on the podcast? Well,

Christi 20:24
primarily, just to say thank you. Yeah, you're

Scott Benner 20:28
receiving reason to turn the podcast the receiving line, that'd be nice. Right now, we're going to hear from a member of the Medtronic champion community. This episode of The Juicebox Podcast is sponsored by Medtronic diabetes. And this is Mark. I

David 20:45
use injections for about six months. And then my endocrinologist and a navy recommended a

Scott Benner 20:50
pump. How long had you been in the Navy? Eight years up to that point? I've interviewed a number of people who have been diagnosed during service and most of the time they're discharged. What happened to you?

David 21:00
I was medically discharged. Yeah, six months after my diagnosis. Was

Scott Benner 21:04
it your goal to stay in the Navy for your whole life? Your career? It was?

David 21:08
Yeah, yeah. In fact, I think a few months before my diagnosis, my wife and I had that discussion about, you know, staying in for the long term. And, you know, we've made the decision, despite all the hardships and time away from home, that was what we loved the most, was the Navy, like a lifetime goal of yours? lifetime goal. I mean, as my earliest childhood memories, were flying, being a fighter pilot,

Scott Benner 21:30
how did your diagnosis impact your lifelong dream?

David 21:33
It was devastating. Everything I had done in life, everything I'd worked up to up to that point was just taken away in an instant, I was not prepared for that at all. What does your support system look like? friends, your family caregivers, you know, for me to Medtronic, champions, community, you know, all those resources that are out there to help guide away but then help keep abreast on you know, the new things that are coming down the pike, and to give you hope for eventually, that we can find a cure. And

Scott Benner 21:59
you can hear more stories from Medtronic champions, and share your own story at Medtronic diabetes.com/juicebox.

Christi 22:10
And because what I found is that because of everything, because I had the outlet of being able to listen to the podcast, like in all the pockets is nice, because you don't have to really change anything. And I mean, I didn't have to take a bunch of time to like, this sounds bad. I like to read, but didn't have to take a bunch of time to like, sit down and read a book, or follow the doctor's office constantly. I just listened as I drove and learned. And in this season that was so busy and so overwhelming, that like I was continuing to expand my understanding of how to manage Silas his care. And there is this like, I mean, everybody experiences this, but I had such mom guilt when he was diagnosed. And listening to the podcast, and having so many people tell the same story helped me just free myself from that, because I was like, Oh, this is kind of what happens. When they're kids diagnosed, it's all it's all the same story. And I think you giving people the space to share that really helped us let go of those feelings. Oh, I'm so

Scott Benner 23:17
happy. That's excellent. It's interesting, because everybody's story is so similar at its core, you know, and then you let them kind of blow it up and tell the rest of it and you go, that's a detail. And that makes it entertaining enough to carry a podcast. You know what I mean? Because if we just had somebody come on once a week and was like, I had to pee a lot. And then this happened. And they like, you know, you'd be like, Oh, my I've heard this already. You know, like so. Trying to keep it fresh by letting people tell bigger stories and and get more down into the details and stuff like that, I think is has been valuable, but I'm glad it helped you. I really am. Where did you find it?

Christi 23:54
So Abby, she was on a roll and episode she was on episode 573. Wow, that adoption? Oh, yeah. Yeah, she so my husband used to direct a family care like a summer family camp. And she and her family were campers. So and then, when Silas was diagnosed, she reached out to us over Facebook and because I posted something I think right after he was diagnosed and she responded and said, You have to listen to this podcast start with the newly diagnosed are starting over. So she just sent me right in the right direction. So I think I mean, I right from day one.

Scott Benner 24:31
She's a curly redhead. Yes. Look at my memory. Hey. Let's take a minute. That's pretty impressive. All right. I've interviewed that was back in November of 2021. And I don't know why did we do it over video maybe that's why I remember what she looks like. Ah, that's interesting. Like I don't listen, Christie don't let anybody take this the wrong way. Okay. But I make this podcast like Fast and Furious like so. You If you said to me, Hey, Scott, what were last week's episodes about? I honestly off top my head don't bow. But they were also recorded like six months prior to that. And so like you don't I mean, like, I'm like so far ahead of the podcast that I don't really remember it sometimes. So I'm sometimes the worst person to ask about it, though. Like, you know what episodes about this? And like, I have no idea. I was just very pleased with myself that I remember that. So anyway, I'm glad she shared it. hello to her if she's listening. So basically, this is through the adoption thing that you found this. I

Christi 25:28
mean, she just does happen did happen to adopt but no, they can't. My husband directed was just for any family. Oh, anybody? Okay. This family's? It's like a resore It's It's nice. It's not like what you think

Scott Benner 25:43
it's a camp like camping, or is it? glamping? So yeah,

Christi 25:47
it's a little different. But it's, it's a great.

Scott Benner 25:53
What's it called Pine Cove? panco.

Christi 25:54
Chimney point is the camp we ran right there in Texas and in like, the Georgia, South Carolina border.

Scott Benner 26:01
Nice. Are you from Atlanta originally?

Christi 26:04
I'm from Oklahoma.

Scott Benner 26:06
I was gonna say you don't sound like you're from there. So I was trying to figure out what was going on. Did he drag you there? Or did you just move there? Have you on for a while.

Christi 26:12
He's from Illinois, actually. So we met working at a different camp in Missouri. Like halfway between both of our homes. Matt was there for a little bit. And then we ended up in Atlanta for a job and just never left.

Scott Benner 26:27
Very nice. My son just left Atlanta, saying and I'm not directly quoting, but I hate it here. I have to go.

Christi 26:38
Yeah, I mean, we live in the suburbs. It's It's definitely different out here. But I, I we lived in Texas before we lived here. And that's kind of my that's what feels the most like home to me.

Scott Benner 26:48
Really? That's interesting. Whereabouts in Texas. Like what part? Fort Worth? Okay. That's interesting. I don't know. I liked it where he was it seems safe and everything, but he's like, I don't think he's a city person. You know what I mean? So yeah,

Christi 27:03
I totally, and it's a monster in the tropics are atrocious, and you know, yes. Yeah. Good trouble. No, good. It's public transportation. So it's, I

Scott Benner 27:14
know when people complain about traffic in places, they're like, Oh, the traffic's bad everywhere. But Atlanta has its own different animal. Yes. Especial really something. Yeah. Anyway. Okay. So you come on to say thank you. And I do that, by the way, say your Well, and, and to share our story a little bit. So what about this year with managing an active child with Omnipod? Five. So how long has Silas had Omnipod? Five?

Christi 27:35
Since July of 2022? Oh, well, you

Scott Benner 27:39
got to pretty close to the beginning. Oh, yeah, I

Christi 27:42
was just all over that. Okay, like we're, we're getting all the stuff as soon as we can. And he's been on it

Scott Benner 27:48
before just tell me before that. Just MDI or pens or what was he done?

Christi 27:53
So he started on parents, you know, right from the hospital. And then he is a he does not use as much insulin I think is like they expected or what kids his age do because of his activity level. And I don't know why from the hospital, they gave us the one unit pins, which that's silly. Just didn't give me he needed a half unit. So we struggled with that for a little bit. Finally got the end pin, which was better. I knew I wanted to put them on on the pod just for listening to the podcast. And understanding that he we could do a lot with his Basal rates because of his activity level has basil is it just changes constantly. Also, he had a really bad reaction to that basic or is that a great fan? I think he started

Scott Benner 28:36
the Basal insulin. He had a problem with

Christi 28:38
Yeah, okay. Yes, he would get this big red welt around the injection site. Yeah. So really quickly. I mean, within two months, he was on the dash. And we did that. So in April, he started on the dash. And then I just kept bugging them until they would they let him get on the five. But I want to alter on the pod. I hear people say like their doctor had problems with their doctors giving them a prescription and you know, don't my recommendation would be go through Omni pod and let them advocate for you let them bug the doctor. Let them deal with insurance because they want people on the device. So they will they'll they were such a partner with me as far as getting him as fast as possible on on the devices and doing all the training. So I didn't have to wait for the doctor's office to

Scott Benner 29:22
Yeah, yeah, sometimes everybody's dragging their feet, but the people who are selling it, they're very motivated.

Christi 29:28
Right, exactly. Go through them.

Scott Benner 29:32
You want attention, go to the people who are getting paid. They'll hustle, right? Yeah. That goes for everything, by the way. Not just Yeah. All right. Yeah, for sure. Find someone who has a stake in it that will help you. So you wanted to use Omnipod five? Is it an interesting tool with the all the different kinds of like, I don't know, allergies that might be kind of streaming through your family. The Basal guard was was tough for him. Yeah, but it hasn't any trouble with any he's though, I

Christi 30:00
mean, his skin's not great. He's always had dry skin, but he's never really had like, you know, eczema, psoriasis or anything. So the winters are hard when I take off a pod, it's usually pretty inflamed. But he doesn't, he can tolerate it. The problem becomes like he's really lean, and he only likes to wear him on his, like, upper back and on his thighs. So getting him to it's the challenge is finding new, you know, clean spot. So we off on the aquifer, we're just putting lots of aquifer on. You

Scott Benner 30:34
and your husband are quite a little played a little auto immune mix here. You guys. Yeah, we

Christi 30:39
Yeah. A special, special. Yeah. But all that's his uncle had type one. His brother has graves. And then I might have, yeah, I've got lots of stuff on my side. But we didn't really know, you know, you get married and you're like, I don't even think half the stuff had been diagnosed. And it was uncle had died from diabetes, but I just assumed as type two because I felt like that's so much more common.

Scott Benner 30:58
For sure people don't pay attention to stuff like this even like 20 years ago, like nobody's like it was just like, you're itchy. That guy's got dry skin. He can't go outside. And when the weather like you know, whatever. I mean, look at me like I'm, I have terrible allergies as a child. My wife has hypothyroidism. My kid has type one diabetes. It's not always like just the cut and dry like diagnoseable thing that has a name like I just I sneeze a lot around grass. I have, you know, my bodies. I have I carry inflammation in ways that I don't even think I completely understand. So, you know, I think that all blends together. So

Christi 31:35
funny story when my husband and I got married. His mom, hands me this typed out from like, 1983 probably typed out on this yellowed old, you know, paper, a list of everything that he's allergic to.

Scott Benner 31:52
Is this after you said I do?

Christi 31:55
Yeah. It was so strange.

Scott Benner 31:57
Did she say, hey, what do I do? She say, hey, here you go, sucker. Like you just bought some swamp land from her. And that was the deed.

Unknown Speaker 32:12
Good luck for nature. Yeah.

Scott Benner 32:13
Good luck. Watch out for the Gators say yeah. Did you ever talk to her about that?

Unknown Speaker 32:22
No,

Scott Benner 32:22
I'd love to hear me. She's probably like, I was so thrilled to offload this kids care to somebody else.

Christi 32:27
She and I are complete and polar opposites. So

Scott Benner 32:31
your sounds like she was worried about him. And she just wanted to make sure that like he was safe. But at the same time, maybe she was like, yeah, here's what you're in for.

Christi 32:38
He's like, I don't have any of that anymore. None of it. Okay,

Scott Benner 32:45
is there anything embarrassing on the list?

Christi 32:47
No, it's all it's every tree and it's everything outside. You could basically just write outdoors. Yeah. And then be done with it.

Scott Benner 32:54
Have you ever seen the movie with John Travolta where the boy lives in the bubble? This is probably your best bet. Yeah. hermetically seal your house run an air conditioner constantly. Don't let him outside. Good luck. He didn't tell you you're gonna get a kid with hives, asthma, type one diabetes. Did you just gonna say to her mom hand something to your husband? Like, she's got some what we're going to call on specific connective tissue disorder. The key would be like, hey, that didn't come up during dating. Oh my gosh. Well, none

Christi 33:30
of that was there yet. Nobody you know, later. Yes. I have always had stomach issues. So we shouldn't when something goes wrong.

Scott Benner 33:37
Oh, the digestion part. That's the first sign Don't you think? Yeah. Oh,

Christi 33:42
for sure. Oh, for sure. It was like my constant struggle my entire childhood Christy. I

Scott Benner 33:47
always imagine people who are finding the podcast in the beginning and they just pick up an episode and they're they're right here and they're just in their house gone. Least a digestion bipod somebody mentioned bipolar disorder without making notes furiously calling their mom. Hey, Jim have bipolar. Does doesn't yet know it. Like. It's better to know than not to know Christie. What's up? That's all. I think. That's what I decided. Yeah, yeah, knowing is better. You can be ready. And at least Gird your loins a little, you know, so I haven't used that as a episode title ever. But I'm dying for it to fit in somewhere. I love that phrase. Also, you know, I don't want to out myself as liking girls movies too much. What's the one with Devil Wears Prada? Do you know that movie?

Christi 34:38
I do. I forget movies immediately after I watch

Scott Benner 34:41
them. I've seen Devil Wears Prada like a dozen times.

Christi 34:46
You blamed that on your daughter and the fashion

Scott Benner 34:48
stuff some of that's hard. I'm not gonna lie. I don't think I've ever sat down and been like finally two hours to myself. What will I do? Devil Wears Prada. That doesn't happen. But there's a great line in it where Stanley Tucci who of course is a national treasure? Says Gird your loins. Um, one day, it's going to be an episode title. Not today, sadly, but one day, because I'm gonna run out of other stuff at some point, too. Yeah. I'm at the point now where I name an episode and I go, I should check to make sure that hasn't been used before. And I've never once. I don't know how that happens, like, there's like 1100 episodes. That is really impressive. I've never once been like, oh, call it like purple bananas and then like gone. Oh, I did that three years ago. Like it hasn't happened yet. I'm pretty impressed. So anyway, people who are new to the show must be like he mentioned Omni pod 515 minutes ago. Then this lady has given her a list of stuff for the husband and now we're talking about Gird your loins. I heard Stanley Tucci in there somewhere, is going on. Well,

Christi 35:46
I completely forgot what we were talking about. Don't worry. I

Scott Benner 35:49
got the whole thing I had. We're doing it. So activity I know from before we started recording your son plays soccer. And what else does he do? He

Christi 35:58
plays basketball. He is He does theater as of right now he's kind of I don't know if that will keep going but he's also just you know, there's kids who just go like there's just something in them that is it's like he's wound he just have to go all the time. So like at recess he's not one of those kids at recess who's like swinging on the swing or you know, playing I don't know something quietly he's running full bore all recess. They play football or soccer every day and he I mean the car ride home is usually about what happened during that game and if he got a you know, a got passed to or who he you know, interesting intercepted or what yeah, he's just I feel bad time that there's competition. He is

Scott Benner 36:41
just go go go. I feel bad for you, Christy because I've watched my son explained sporting events to my wife and just she tries so hard not to glaze over. And you know, she's, she's like, that was what inning and then you're saying who hit the ball? And you did what you caught it. And she's just trying to like, you know, try not to lie and I have, I have three of those. Oh, three boys that have like that gogo energy. Well,

Christi 37:09
three boys who play sports and two of them have that gogo energy one of them would prefer to just, you know,

Scott Benner 37:15
stop these four sports, because everyone else is doing it. Don't worry who grew up to hate you. Daughter active? No, no. Did you say what you just said that Chrissy was very telling, you know,

Christi 37:34
trying to get her to good. I'm just trying. Yeah, I would like for her to just get into some type of rhythm where she felt. I think that exercise is if you don't build it into just your normal life, then you won't do it when you're older. I would love for her to be a little bit more she's she'll go run occasionally. She did. I mean, she she danced and then she ran track and but now

Scott Benner 38:00
yeah, the girls sports that are more like softball and like stuff that's more like kill something with something. You know what I mean? That's that's a purse. That's it's specific personality. I don't think I've ever met one girl who played softball for Arden played softball forever, who was very meek. Like they all even if they were quietly so even if they were quietly so they still were like, I don't know, like little murderers inside like cats. You know what I mean? How you think if your cat was bigger, it would probably take out your eyes and eat them as an order of like, like that kind of like that energy behind them. Yeah, you know what I mean? Maybe she just doesn't have she doesn't have that going on. Right? She doesn't

Christi 38:37
she's I mean, she's a very strong personality. She's really tenacious, but she's more like she's editor in chief of this school yearbook. Okay, so she loves to be in charge. She loves to she's very creative. But she doesn't like

Scott Benner 38:51
Christie. You said she loves to be in charge. Oh, yeah. I heard you told me she was a girl earlier. You didn't have to repeat yourself.

Christi 38:59
And the oldest and has three brothers three little brother.

Scott Benner 39:02
I got what's going on. Also, I can't wait for the one interview that calls me a misogynist now for joking like that. But whatever. People have no free it's too much free time. So you're looking for something for her. That's more like more exercising and less activity, right? Because she's not like into like that. Yeah. So

Christi 39:20
she goes to college and they have the, you know, they have the gym rec center or whatever. Yeah, I think she'll do that. I've just been encouraging her. She like me

Scott Benner 39:27
to tell you the story of six months ago when art and FaceTime me all read her face. And I was like, What are you doing? She goes, she goes, Kaylee and I went to the gym. And I was like, Yeah, I was like, How was she just really nice to get a lot of good equipment. And she's like huffing and puffing and walking back to her room and everything. And I said, What do you guys gonna go on the schedule? Because I think that's the last time we're gonna do it.

It was a lot. And I was like, gotcha, because I'm so out of shape. You know, she was like, she said to me, I don't think I could go play softball right now. And I was like, Yeah, you don't look like it. Yeah, so Anyway, you keep hoping. Yeah, go to college. Take up a sport. How about you guys? Do you? Are you active people, you and your husband? Yes. Okay, so you're hoping to lead by example, maybe?

Christi 40:14
Yeah, I do, like a sort of CrossFit type thing. It's not as hardcore as CrossFit that nobody does that with me, that they've seen me go every day. And I think that, just having that or they know that, that's my habit. And then my husband played every sport under the sun, and he coaches, our boys and basketball. And he goes, he played more like, I mean, you know, things are starting to get out. But

Scott Benner 40:38
I love your hopeful nature, like they see me go do it. There's, there's a case study, by the way, where you walk out of the house, and the rest of them get together in a kitchen and go, she's out of her mind. Are you burning?

Christi 40:51
Do you think? Oh, well, I

Scott Benner 40:52
know, please, are you? Are you burning off some of that? Like, I mean, there's a lot going on around you, like a lot of health stuff, a lot of things to keep track of, you're trying to stay kind of Zen about it for your own health reasons? Is that what the exercise is for you, you just get offloading that, that anxiety there.

Christi 41:10
I think for sure, I'm not a very introspective person. So I don't feel a lot of anxiety like, or I know I shouldn't, I don't think like in my brain, a lot of anxiety, it ends up coming out in physical symptoms. So I do think that the exercise, so I was active through like college, say, and then I started having a lot of health issues. So I really stopped until I was in like my late 30s. And I saw a picture of myself and I was like, Oh, my arms, oh my gosh. And then at some of my friends had bought this gym, just like perfect timing. So I've been at my husband, I both started going there. And at the same time, my parents were going through anyway, they were kind of a hot mess. So I needed a place to get out some anger in a healthy way. And that's when I started going. And I just haven't stopped. So yeah, all this has happened since you know, I've been there since for the last six years, I think. Yeah. And, and a lot of life has happened since then. But it's a great and I have like that's a lot of my community is there. And I love it. I love my I love. Yeah,

Scott Benner 42:17
that's excellent. So I'm hearing that in the attempt to not push your parents off a cliff, you start working out. Is that what I heard?

Christi 42:24
Yeah, that's basically right.

Scott Benner 42:26
They still together? Yeah. Ah, gotcha. Yeah. Had the same tone as is your daughter active? No. By the way, yeah, possibly one of the most honest things anybody's ever said unprompted on here is I'm not a very introspective person. Well, I'll be honest, thank you kids, like murder a puppy and just get past that no problem are like, What do you mean? Like, how much interest? What are we talking about? Exactly?

Christi 42:54
I think it's usually good. Yeah, I'm

Scott Benner 42:57
not saying it's good or bad. I'm just interested in what you mean by it.

Christi 43:00
I don't spend a lot of time trying to figure out how I'm feeling. I think that on purpose. No, it's just how I am. But if someone asks me, I can figure it out. It just isn't something like I can just, you know, immediately tell you. And I, I think that a lot of people, and I don't think this is a cambium may get stereotyped as a male female thing, because it's probably more women than men. But I think that a lot of times, women specifically, but it can also be men to not just have a lot of thoughts. Like there's just a lot happening in their brain. And then we'll kind of say, well, men don't do that. But I'm probably more like that side where I don't, I don't necessarily have like a ton of things running through my brain all the time. It's

Scott Benner 43:51
interesting. I was out the other day with Kelly. And we were talking about this because there were some people with some very far away looks on their face. You know what I mean? And like, maybe they weren't thinking about anything. And I remarked to Kelly, I was like, Look how relaxed that guy looks. I said, I said, I'm thinking about seven different things right now, while we're walking through this store as crazy to believe that that's not how everybody brain works. I mean, I know it's not but still, for me, like I was literally walking around thinking about something I had to do for the podcast. Arden needs an apartment for college, we're looking for some certain foods, there's things I can't say in the grocery store, because they get me in trouble with my wife. And I have to stop myself. Because I mean, it's only been 30 years, but I have not yet shown an ability to just not say it. And you know, like so like I'm doing all these different things and having all these different thoughts. And I like having a conversation while we're walking around and everything. And then I just looked over at somebody that looked like they were like, just a half a second away from drooling on themselves. And I thought God that looks nice. You don't I mean, like there's no way that that guy right now is worried about what's going to be on the podcast three weeks from now. I understand I think I know what you're saying like so you're not unaware of how you feel. You don't spend a lot of time mulling it over. If I asked you about it, you could tell me. So you're more of a person that you consider yourself sort of like a head down, get things done person?

Christi 45:21
No, no. Okay. No, I really don't know. I'm not very No, My poor husband. He's loved that. That

Scott Benner 45:29
was more. Do you have a job? You work? Yes. Well, we

Christi 45:31
have a couple of businesses. Oh, so I'm more of like a future thinker, big idea. person.

Scott Benner 45:40
I'm an ideas man, Scott. So what does that mean? Where we're going on vacation next year? Like that kind of thing? Or?

Christi 45:48
I mean, yes, planning it, I would rather someone else plan it for me. Because I don't really care about the details. That's one thing that's been a challenge with diabetes is that it's so in the weeds, it feels like that's been probably the most draining part. I love problem solving. Like, I think that they give me a problem. I like to help think of I like finding a solution that to me is like, enjoyable,

Scott Benner 46:12
but not the day to day stuff. The day to day

Christi 46:15
stuff can be Yeah, it's very, it can be very draining. At the same time, I'm just so committed to the big picture, I think I'm just looking for, you know, I'm looking forward and saying, if we figure this out, well, now then, when he's 20, and on his, you know, in college, he's just learned to expect to have, you know, low variation, and to have a good a one C and he feels good at a lower blood sugar. And, you know, like, all these things. So I'm just always kind of balancing this, I'm here now, doing the like, nitty gritty of making sure that his blood sugar is, is stable, and that he's has every opportunity here, but I'm also thinking, I just want that to be his expectation. So when he's taking care of himself, that's what

Scott Benner 47:07
he's doing. No, I think it's a great idea to to set up expectations so that they become norms. That's really terrific. I just, I'm just literally laughing to myself, because again, you've been an incredibly on a show, like, Look, I'll have the ideas, but I don't want to facilitate them. Like I don't Yeah, it's interesting. Have you always been like that?

Christi 47:24
Yes. Interesting. Yeah, like my rent was always a mess growing up, and I don't, yeah, we've always our entire marriage, we've had to have separate closets because my husband's very tidy and very organized and very, like, he's the doer. And I'm the one who has like, like, we always buy fixer upper houses is one of these things we do. The house we're in now we're in the middle of working on and I'll have you know, I'm usually the one who's like, this is what I want it to look like. And he wants more, more details and more information. And then he's the one who actually does the work. Ah,

Scott Benner 47:57
that's interesting. Yeah, no, I understand. Again, I think pretty honest. Cuz you're just like, I don't really do that much. So I do know you do? Yeah, but not the stuff that nobody wants to do. Yeah, I've really tried to stay away from that. Yeah. Because Christy that's the truth of it is is that I don't think anybody wants to do those things. I just something I think some people see it and do it. And I think some people see it and go, Oh, God, I hope somebody else does that.

Christi 48:23
Well, some people get more satisfaction out of it being done. That's the thing

Scott Benner 48:27
you tell yourself to make yourself feel better, I think because maybe anyway, tries that on me all the time. She goes, Do you enjoy cutting the lawn? Like Oh, no.

Speaker 2 48:38
What are you talking about? She goes, You don't like being alone? I was like, No, I like being alone. She goes here for an hour every week. You have to be alone. I'm a kid. That part's great. Because the light coming on. I'm like, No, I could be alone somewhere else. I don't like cutting the lawn. Like I for years. I think she thought I liked that. But then I really looked as like she doesn't think I like that she just wants to tell herself. He's out there having a good time. So she didn't have to feel bad about it. And just for clarity, I am not having a good time.

Scott Benner 49:07
It's hot and sticky and dirty. And like, Yeah, I mean, I come back inside. I'm like, Oh, don't touch me. I have to get immediately into the shower. I'm covered in dust and dirt. And she's like, did you have fun? Are you talking about?

Christi 49:23
Well, that's what I tell my kids all the time. They're like, Oh, I don't want to do this work or I don't want to you know, do anything fun today. And like, yeah, that's why I like you think I like doing the dishes three times a day or I don't really like thinking about what we have to have for dinner every night. You guys are hungry constantly. Yeah. I'm constantly having to think of somebody to feed you. stuff that we do. Because I love you and I want you to have

Scott Benner 49:47
Yeah, yeah, but I'm not making I'm not making dinner for fun. I used to tell my kids I'm like, Look, if it wasn't for you. I wouldn't even eat tonight. I have to be completely honest. I'm like, I just had my own self preservation. I would skip this meal just so had some time to do anything. I don't think time is such a. It's so valuable. And like I got up this morning and I was up pretty early. I had a meeting this morning with a new sponsor who by the time this comes out, you'll know ever since CGM says a new sponsor of the podcast, oh, very lovely. I'm having a meeting getting, figuring out their messaging and how to talk about their products and stuff like that. And you know, I had a little meal. And then I was standing there cooking, and I was gonna get on with you. And I was like, Oh, God, by the time I get off with her, it's gonna be 130 I got so much more work to do. It just, it's crazy. How at noon, I already feel like I'm running out of time. You know? Yeah, that's really something. I gotta get a wife like you who doesn't do anything, but give me more stuff to do. I'm just teasing. I know you do things. I'm just teasing. What I wanted to know is around that idea. How does that relate to diabetes, though? Like, like, is it? Are you the one who's like, Hey, you got to change your pump on time? Are you the one actually pulling it out of the drawer going? Hey, come here. Silas, we got to do this now. Yeah,

Christi 50:59
no, I do it. Sometimes I forget, though. And he'll be the one who's like, Hey, Mom, I need to change my pod. I mean, I put everything in my calendar. So I don't, you know, forget all the dates that we have to change all the things that the pod is the one that will give me his CGM is hard to it's hard to get it to last a full 10 days. So I'm usually right on top of that, because I can see it's like, you know, failing or there's scissors. No, he's still only with the G six because you know, Omnipod, five, G seven. So there's no grace period. So it's like, well, when it's over, it's over. He doesn't like to go.

Scott Benner 51:33
Actually, right now. It's in a limited market released g7 With Omnipod? Five. So yeah, so it's coming pretty quick, I

Christi 51:41
think. Okay, good. Because,

Scott Benner 51:43
I mean, if it's in an LMR, then they think it works. And they're trying it in a small population. That's gotta be close.

Christi 51:50
Yeah, I'll be great. Because but

Scott Benner 51:52
what are you saying with the GS six? Like, are you saying when the adhesive starts to fail, or when the when the readings aren't good anymore? Readings

Christi 52:01
just start to drop, like I can tell when it's getting a little wonky, you know, it'll like, his line will look a certain way. And then it'll just drop down like, you know, 15 by 15. And then it'll pop back up. Yeah. So I'm, like, drink a bunch of water and let people get this to last the rest of the day, or, you know, yeah,

Scott Benner 52:19
it actually because with all the talk of allergies, and your family like that doesn't surprise me because it makes, because the way I feel about that is that that sensor wire obviously looks like a foreign object to your body. And if your body's already on a heightened alert for things like that, doesn't it like attack with like white blood cells? And like, do you mean like, that makes sense that you'd have more trouble? Yes. Makes sense. Yeah. I think that's like, what we don't talk about a lot is that these, these devices are all very contingent on your body chemistry, and gear, because some people will say things like, I'd never have any trouble with it. And you know, Arden's on a g7. It she wears that into its grace period every week. Like, I mean, the amount of times I've heard her say, this has to come off this thing isn't working. It's like once in the last seven months, so it's she just doesn't have that trouble. That's great. Yeah, but it's random. Whether you know, other people will have trouble with stuff like that.

Christi 53:12
But yeah, I think has has a lot to do with hydration. realize he's a little boy. Yeah, he's a little boy and he forgetting. I'm, like, I'm when my kids grow up. They're gonna say, What's the most annoying thing your mom said to you? One of them is going to be? Do you have your water,

Scott Benner 53:29
drink more. But listen, I'm not a little, I'm not a little boy. And I'm holding the water that I gave myself four hours ago, it looks like I've taken three sips out of it. So I'm right there with him.

Christi 53:41
Let's just stay hydrated, please, it'll help so much with all the things, you have

Scott Benner 53:45
no idea how quickly it changes. So I'm very in tune to now with my much more paying attention to my body. I think now that I'm using a GLP medication, if that makes sense. And so, last week, this has got to do with hydration. But last week, I decided I'm going to make potato chips like from scratch for the Super Bowl. So I wake up on Saturday morning, and I take five pounds of russet potatoes and I mandolin them down into these little thin slices and then I leach out all the I don't know if people have heard of this pre soak them in cold water and rinse them till they run clean. You pat them dry and then actually like kind of squeeze them out dry so that they'll fry right and fry them and salt them put them in a bag, Baba. And so this is not a thing I do very often. And obviously there's a lot of salt involved that normally isn't involved with my life. I probably ate a handful of chips in the five hours and people are like Did it take five hours to make potato chips it did. I probably had a handful of chips and like the five hours took me to make the chips. And then because they were there I had a couple of dinner and I had them the next day during the Super Bowl. And not a lot of them. Now I woke up Monday morning, over two pounds heavier than I was on Saturday morning when I got up and just the salt. And so like as soon as I realized that I start like over Were hydrating myself and watch the weight just pour off of me again, like in those two pounds, even a tiny bit of dehydration, or you know, too much salt, or little things like that really can throw your body off. It's fascinating. If you're not paying attention to it, you would notice I don't look any different Monday than it looked on Saturday. You know, but I can tell what was going on because I'm tracking my weight more specifically. Anyway, it was kind of interesting. The nobodies hydrated the way they should be it honestly.

Christi 55:29
Okay, that made me think of something. Do I worry, this is another tangent. But when you have been listening to her, we go the episodes. And when you cried, and then we go the episode. And then later you apologize for crying. And I just wanted to say, I don't think you need to apologize. Because I think that your genuine emotions were really powerful. And it really helped me like I've never been one to struggle with my weight. And I've never understood it. And you I think it can be such a taboo topic that you sharing vulnerably and helping just explain your perspective and what what your it's been like to battle that it helped me understand so much better. And I think it one thing that I've learned from diabetes and from like listening to your podcast is I think that it has opened up the door to, for me and I think a lot of people to just be more compassionate, and see the world through other people's eyes better. And it that episode for me, it was very powerful. And I think I cried along with you.

Scott Benner 56:33
I'm sorry. You're welcome. I appreciate your sentiment very much. It's not an apology. Like, I don't know what it is. It's I think it's the part of me that knows I'm making a podcast, you know what I mean? Like, I feel like I know you're there to hear something. And me like fall apart might not be part of it. But I take your point about how valuable it is as well. I mean, I obviously could have cut it out if I wanted to. But you know, I see how it's valuable for people. It is a thing, no different than when you were you're pumping public or or test your blood sugar in public, you're helping to spread awareness about it. Like, there's no way for you to know, like what that feels like. Like, I still can't adequately put a word as to how I feel just sitting here right now for I'm like 45 pounds lighter than I was almost a year ago. I can't explain to you what a joy that is yet, or how much better I feel like physically or like mentally, you know, or what a relief it is to go out in the world and not wonder like, am I wearing the right color shirt so that I don't look fat. And then realizing now in hindsight, looking back at pictures, it didn't make a goddamn but a difference what color shirt I was in. You know what I mean? Like so I'm now I've got all this worry about like colors and cuts. And you know, that kind of stuff to try to hide the fact that I know I'm carrying extra weight. And I mean, while I look back at these pictures, like it didn't matter what I was wearing you none of it hid anything. It didn't, it didn't matter. You don't I mean, so that's a psychological shell you're putting on not to have to worry about that it's freeing. Really cool. Like it's aesthetically nice. But it's got so much more to do with just not feeling encumbered than it knows about what you look like. And I've also been in that situation I was talking to Jenny yesterday, we were privately talking about GLP a little bit. And I said to her Jenny, I've been chubby since I was five, that was 1976. There wasn't a lot of fast food, there wasn't a lot of like things that we all now today connect with people being overweight. Like, it's just how my body works, which is to say not well, you know what I mean? And then you add this GLP and and then suddenly, that's not a problem anymore. And you're like that mean, you're just lucky. I'm not over here like banging my head against the wall, but like, how come they couldn't have come out with this 40 years ago? You know, because there's a lot of monumental steps in my family's life that there are photos of that I'm not in because I was taking the pictures, but I was probably also taking the pictures to keep myself out of the pictures, you know. And then there's like these real big ones where you just suck it up and get in the photo artist sent me a photo of her high school graduation the other day, keeping in mind She's halfway through her sophomore year. And it's a picture of her and I at her high school graduation. I gotta tell you, I don't even recognize the person that I apparently walked around. I was like, it's I don't even think I could share it online. I want to say not because I would be scared to share it. But there are some people who don't like that I talked about you know, take insulin for what you eat and sometimes they'll be mean to me online. I don't I'm not looking to give them pictures of myself looking terrible. But I'm telling you these this photo of me yesterday and a photo from me two years ago, it would really stung you. So it's not like I was out there eating like crazy. Like I know I said I just made potato chips from scratch, but it's a thing that I've done like once a year You know what I mean? Not like a thing I do every day or something like that? Well, I mean,

Christi 1:00:03
yeah, if it takes five hours, that's a reasonable thing to do. You

Scott Benner 1:00:08
know, Saturday mornings when like, everyone's asleep, you get up early, and you're like, let me do something, it takes time. But I can kind of go slow with and, yeah, that kind of thing. Again, I don't know that I'm eating much differently now than I was before. I mean, I've cut like, seed oils out of my life. But I've had done that prior to GLP. And it didn't really help me. I mean, it didn't help me with my weight at all. It helped me in other ways. And I'm still happy not to do it. But honestly, not. Not a lot is different. So yeah. And I appreciate you saying, so I appreciate that. You're listening to my weight loss diary when you don't need to lose weight. That's very nice, though. Thank you for keeping up the dowel. Well, it's

Christi 1:00:45
just it's been kind of controversial, you know, and so I just, I wanted to hear your perspective on

Scott Benner 1:00:51
it. Because I think it's controversial amongst people who don't know what they're talking about. Right?

Christi 1:00:57
Yeah. And, yeah, there's been kind of a, I was in a conversation with some friends about it the other day, and it was just good for me to be able to share a different perspective. I'm glad and then have a friend who honestly said, you know, I would, I would consider it and, you know, she kind of shared her struggles. And I thought that was good, because I don't know if she would have felt like she had a voice if I hadn't to be

Scott Benner 1:01:18
able to speak up. Oh, that's really wonderful. I hope it helps her. Yeah, I mean, there's a difference between comedians and you know, guys and bro. You know, bro guys on their podcast, like being like, oh, you know, just work harder. Like you don't I mean, like, I get up every day. Let me tell you my day, I get up at 4am I cold plunge, then I do a sauna. Then I run 75 miles, do you understand that I have tantric sex. And then I'm like, Okay, you're making $9 million a year on your podcast, like so. Like, you got a lot of free time and I'm happy for you. And then what I do, then I have tuna. Right? I love tonight, a little bit of tuna. And then we go out, we bow hunt, then we kill something. It's great. You like you don't like I'm like, okay, and ozempic is cheating. Good for you. Like, like, I'm glad it worked out for you like your genetic freak. I'm happy. It all worked out for you. I ate well, and exercise. And that all kept me chubby. At best. You know what I mean? Like I was telling you the other day, I used to work out twice a day, for two hours a day in my early 20s just to maintain a chubby vintage, like, seriously, like, just to keep my weight at like 220 pounds. And that was it just didn't matter. I don't know what's wrong with my body just didn't work, you know? Yeah. And then to hear people say like, oh, like, you know, they're gonna ozempic Fie the world. Like, maybe that's not a terrible thing. Like maybe the people who like I'm not just saying, spread it on everybody who could just go for a walk and things would change for them. I want those people out walking, I want to be out walking to. But if people genuinely have a GLP deficiency or something like that, and that all the exercising in the world is not going to help them, then what are we doing making them feel badly for feeling for getting healthy? It's no effort whatsoever. It's like, click done, I'll see in seven days. You know, and I'm gonna hear from people who are like, Well, I tried it, and it my digestion was, everything doesn't work for everybody. Like, I'm not saying that, you know, like, you might take a somebody's immediate gonna say Google GLP. And what are they gonna say intestinal blockage, like, alright, well, you don't know any of the details of that. But okay, yeah, that could be a person who's, you know, pre diabetic, they might have gastroparesis and not know it, and then you slow down their digestion more with a medication that causes the blockage. I mean, that's terrible. They definitely shouldn't take the medicine. That's what happened, you know, so. But yeah, I know, the bigger thing you're talking about is just people's attitude of like, oh, that's fat people who don't want to shut their mouth. So they're going to take an injection, get skinny. And that shouldn't be how this works. And by the way, even if that's the situation, what do you care? Like, you know what I mean, but, but, you know, I understand where they're coming from, but it's very often not actually what's happening. Right? It's not what was happening for me. So, anyway, also, you know, I know a person right now, who's typed to and has a weight issue and took a GLP medication. And a year later, confided in me that I lost my way with the eating like I was doing better with eating because the medicine kept me from eating as much and they lost like 35 pounds, and they but here's the thing, the A one C went from in the sevens to in the fives, and then they said, I think I gotta go to a therapist. I asked why. And then this person said well, because I'm eating terribly again. And I don't know why I'm just eating bad foods like I there up to the part of the medication where it's not that hard to eat, you can eat through it is the way I usually put it like your full but you're not so full that you couldn't eat if you wanted to. So this person said I may maybe I need to see a therapist because I don't know why I'm eating like this. And I said, that's a good idea. You should do that. But guess what, in the meantime, you know what their agency still is? In the fives. The fives they didn't gain any weight. And that's awesome. That's awesome. Yeah. So yeah, sorry. Anyone has a lot of talking to me. I apologize. You have anything else we haven't spoken about? Okay,

Christi 1:05:22
I had a couple things I wanted to just go share with you. Okay. One thing was that you've talked about a few times too. These are my encouraged my little encouragement. So I want to share is when you you've sometimes said, You're sometimes discouraged that you're not helping enough people, because the people with access are the ones who are. Yeah, and I agree, I feel like good management of type one is, it takes a lot of knowledge that a lot of people don't have. And it takes, I think the technology that a lot of people don't have access to. But I think that the part you're doing is multiplicative, like you, you share with me. And then I'm sharing with friends, yes, sharing the podcast, but also just sharing what I've learned, then trying to do some outreach with JDRF, with new families. And then thinking for me, one thing that was eye opening was when we had our foster kids, they had a lot of like, cognitive, some deficits, especially around that. And so now, I don't know what it's going to look like. But I think one day like I want to figure out how to how to help people who don't have those like they, they don't have, like my, my nine year old could count his carbs and tell you how, like he knew his carb ratio. And he knew how to do that at nine, that's not normal. You know, it's not normal. For us. I know that a lot of people struggle with that even as adults. And so I think that what we're doing is, I think that you're creating a movement. And I think that that movement will continue to reach more and more people in in more and more diverse socio economic levels and all over because this vision of how do we help one another and share victories and not just share, you know, frustration, so I don't know what it'll look like in the future. But having those anyway, having those sweet foster kids seeing like, I don't know how they got type one, how would they manage? And how would their their mom definitely wouldn't be able to, you know what I mean? Like, how do we help people in the margins? Yeah,

Scott Benner 1:07:26
they'd be on a fast path to bed to some bad health problems,

Christi 1:07:29
right? And all because they just don't have the education or the access. Yeah. And what do we do about that? So?

Scott Benner 1:07:37
Well, I want you to know that when I, when you'll hear me sometimes say, like, I'm not doing enough, I'm not reaching enough people like that's a momentary frustration, because I'm in it constantly. Like, every day, Monday through Friday, I get up in the morning, I do the things around my house that everyone else does. And then I make this podcast. And I do that all day long, in one way or the other, like Monday through Friday, and oftentimes on the weekends, it is my job, but it's also a lot to do with my life. And when you have a moment, like you put out like remaster the Pro Tip series, and put it back out again, and you see it downloaded, you know, you see each episode download, like 20,000 times, and you're like, oh my god, it's amazing, right up until you realize that there's 1.8 million people with type one diabetes in America, and you go, Oh, 20,000, I didn't do anything. And then the bigger picture comes up and you recognize like, there are people that are sent to the podcast every day or to the group from doctor's offices, that means that somebody in a doctor's office listens to the show, and talks about diabetes and insulin in a way that's valuable for people that that will like you're talking about, like grow very slowly. And then I think that feels good. And I'm like, okay, good, because in generations to come, I've had a real impact on this. But I'm also 52 So, you know, I'll probably be dead. And then, you know, I'm gonna be like, I would like to see it once. You don't mean like, I'd like to see it like workout. I guess that's not really how things like this work. But anyway, you've also named the episode finally multiplicative.

Christi 1:09:14
Oh, wow. Okay.

Scott Benner 1:09:16
A funny word. That's definitely going to be the title of the episode.

Christi 1:09:21
Okay. I like that word. Actually.

Scott Benner 1:09:24
I love it. You like whipped it out. Like you said, it's amazing. I use this word all the time. And I was like, pride myself on having a fairly large vocabulary when you said it. I was like, she made that up. She made up a word, or she said a word wrong and she's just cruising over and I love the attitude. I love that I'm just gonna say multiplicative and keep going and then I looked it up and I was like, God damn, that's an actual word. So for sure that's the title of the episode but but okay, don't worry. I'm not over here like crucifying myself. It just every once in a while when you're really like in the nitty gritty of it? How have I built the most popular diabetes podcast in the world, and it's never once had a leap. It always just grows consistently, which is not something. Anybody who wants growth knows not to complain about consistent growth. I'm certainly not but like, could I not just wake up one day, and 20,000 new people have found the podcast, but it's never gonna happen like that. It's always gonna be 510 15 new people a day, it's just gonna go like that, you know? So, unless,

Christi 1:10:33
okay, this is my other thought. Okay, so you were a, I'm sure you've heard it a long time ago, but it just came out the episode with Gregory. He was the Fisher on the fisherman. Yeah, yeah. Okay. And you talked about the app, your app idea? Okay. Well, my thought was, if you can do an app like that, when it can be translated to different languages, I would think so that could break your language barrier.

Scott Benner 1:10:57
Yeah, I'm already doing that with AI stuff behind the scenes, I haven't really put it up yet. I've done key takeaways from the Pro Tip series through AI. So you'd be surprised. Or you might not be surprised how accurately AI can pull the key takeaways out of it. When you look at the list, it sounds like you went up to me and said, Hey, tell me the key takeaways from Episode 1000. And everything I would think to say is right there. It's fascinating. So then I said to him, Give me the key takeaways in English, Spanish and Hindi. I chose those right? And then boom, it spits them right out.

Christi 1:11:35
That's awesome.

Scott Benner 1:11:37
I don't speak Spanish. And I don't speak Hindi. But I have pretty big Spanish in Hindi, like listening populations, like who are who are multilingual. And so I'm like, boy, how do I make sure this is right? Do they mean like, is it as easy as putting a disclaimer on it and saying, Hey, this is AI generated, it might not be right? Or do you ask somebody to prove it, then you know, it's not a thing, I can afford to pay a proofreader so and you can't hold them to task, they would if they get it wrong, like that kind of idea, too. Those are the kind of like the leaps you have to make. What I think I'm landing on is just like, look, here's the disclaimer, these are key takeaways from Episode 1000, as derived by AI and translated by AI, I cannot be certain that any of this is accurate, or in any way, shape or form, you're reading it at your own risk. Like I think that's what I have to do if I want to put, but I do think it would help a lot of people because I get a lot of, especially just from the Indian population, they're like, You have no idea how big because I have a pretty big following in India. They're like, but not enough people speak English, enough to listen to the podcasts. So those are big idea, things that are more possible now with technology. And then you just have to like get to wrap your head around how you're going to introduce them to people. And then once they're out there in the world, Christie, the next trouble is the like, again, it's spreading it. Now you're down to one person telling another person and then waiting for that exponential, but very slow growth to happen. And that's, you know, I'm not going to outlive that. You know what I mean? But I do think it's completely possible that 15 years from now, somebody in India will learn how to use an insulin pump because of me, and I won't know anything about it. You know, so it's, it's kind of that anyway, what else you got?

Christi 1:13:24
Okay. Last thing, I think, one reason that people resonate with you so much, and I heard you ask a couple of ladies about why you had such a large like Christian population who listens to your podcast, okay, because you're not okay. Yeah. And part of the reason is your story is so redemptive. Because you took a really heartbreaking situation, and you turn it into hope, you turned it into hope for all of us who got this life altering diagnosis, and I heard your story and saw what you'd done with it and saw how well your daughter was doing. And sad. You can do this, too. So I think that it's just it's very inspirational. I think that every Christian resonates around this idea of redemption. And you're not. You're preaching a different gospel. It's not that it's not the you know, the gospel of Jesus Christ, but it's the gospel. It's a gospel of it's a good news. It's like good news to us, to anybody to say, you can turn this and you've made something really good out of that, which is so inspirational to say, to say, Oh, now what do I do like what Silas my, you know, 11 year old, I wish he could have come to talk to you, but he wants to be an entrepreneur. ologists and he's like, he always wanted to be a doctor. And now because he wants to help people. Like he's been helped. And I just think that it's it resonates so much with us, but I think that's one reason people are so drawn to you. And everything that you share because you said it haunted you. I think that Once I knew I was gonna be on the podcast, I like started picking him, like picking up little things. But what did you say recently about? You said something about how you thought and I did that same episode, but you might have ended up being the better person to make a podcast like this and someone who actually had type one, because I feel more positive,

Scott Benner 1:15:18
I find that I can be dispassionate about it, because not happening to me.

Christi 1:15:22
Exactly. Yeah. But that is actually redemptive to that one feels more. Yeah, cuz it feels more like, like, what you're, I think what you're saying, it just seems more hopeful, in some ways.

Scott Benner 1:15:35
You know, there's one person listening to this right now, who's about to text me and say, you're going to be on a candle one day? And I don't I won't tell you who that person is. But we have. We have not Catholic? No, we have, we have this little like, we have this little like back and forth. Like it's not a joke. But it's, this person will say to me, sometimes those people would put you on a candle if they could. And she's meaning the little Religious Candles that you get in the grocery store. And it gets that meaning. And I think that's very nice. She's like the way some people talk about you sometimes. And I was like, oh, that's, it's first of all, it's lovely. But you know, like, just joking between me and one other person. But I hear what you're saying. I'm like Jesus Christ, I hear you. Wait, that's not what you were saying. I might have misunderstood. No. I think I'm, I'm following you. This terrible thing happens to you, you kind of rise above it, then you walk out into the world and try to help other people not have to go through the same thing. Exactly. Yeah. Yeah. No, I listen, I it will sound weird for me to say, but I agree with you. I think that's a good reason why people would resonate with the podcast in general. But I have wondered like, at times, like, I am very much and Christie, I don't mean this in a pejorative way. But I am not a religious person. Like, not at all. Like if you asked me if I thought there was a God, I would definitely tell you no, I don't think after I die. I'm going anywhere. Like I don't hold any of those feelings or beliefs. But people who do often feel very close to me, and I get that's a great insight. I appreciate it very much.

Unknown Speaker 1:17:10
Well, you're welcome. Thank

Scott Benner 1:17:11
you. Also, I am also not a what's the word when you don't believe at all? Atheist? Yeah. Because trust me, I know myself if like, I get hit by a truck and I opened my eyes back up and there's like pearly gates are something and I'm like, sign it up, like a registration book or something like that. I will start backpedaling 100 miles. Oh, my God, I will be like, I'll start my own podcast in heaven about how wrong Scott was about heaven. God, yeah, I don't, I don't want anybody to take that. Personally. I was just going off my best of the best I could tell. I am a failed person. Like trust me, I'd be fallible right valve valve would be different. How would it be if I pooped my pants? Right? Like it's not that but no, I would I would backpedal 100 miles an hour.

Unknown Speaker 1:17:57
People would be like, holy, she's

Scott Benner 1:17:58
going back in time he's talking. I knew really, Paul, you might have heard me tell that joke about the missionary position in your body one day, but I was just walking around trying to make a fun podcast and people would listen to it, learn about their diabetes. That's all. You're very nice to say that. I appreciate it. I'm gonna get off now because the editor is going to charge me extra for how long this is. Okay. Okay. All right. Thank you for doing this. I really appreciate it.

Christi 1:18:26
Yeah, you bet. Thank you

Scott Benner 1:18:35
this episode of The Juicebox Podcast was sponsored by us med us med.com/juice box or call 888-721-1514 Get started today with us med links in the show notes links at juicebox podcast.com. A huge thank you to one of today's sponsors. Je voc glucagon. Find out more about Chivo Capo pen at G Vogue glucagon.com forward slash juicebox. you spell that GVOKEGLUC AG o n.com. Forward slash juice box. Mark is an incredible example of what so many experience living with diabetes, you show up for yourself and others every day, never letting diabetes to find you. And that is what the Medtronic champion community is all about. Each of us is strong, and together we're even stronger. To hear more stories from the Medtronic champion community where to share your own story. Visit Medtronic diabetes.com/juice box. Alright kids, we're done. We're at the end. Just do me one last favor if you can, if you could please, if you have the need or the desire for something that one of the sponsors is providing. Please use my links or my offer codes. They help the show so much and that means me you're helping me to make this podcast every day. I'm helping me to support the private Facebook group, do all the things that I'm doing. I'm not asking you to buy something you don't want or something you don't need. But if you're gonna get one of these items, use my links or my offer codes. They helped me a ton. Thank you so much for listening and for supporting. I really do genuinely appreciate it. I'll be back very soon with another episode. 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