#1503 Fox in the Loop House: Part 7

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Ken demystifies the Loop algorithm—how that squiggly prediction line works, when it cuts basal, and when it adds insulin. With clear talk on correction ranges and timing, he ends the confusion over why Loop acts when it does.

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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
Welcome back, friends to another episode of The Juicebox Podcast.

Kenny is back, and don't forget that you can find Kenny at Fox in the loophouse.com today, he and I are going to talk about some details around how the loop algorithm works. We're going to talk about correction ranges and overall, this is just a nice episode to make you even more comfortable with how the loop algorithm functions. 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. A g1 is offering my listeners a free $76 gift. When you sign up, you'll get a welcome kit, a bottle of d3, k2, and five free travel packs in your first box. So make sure you check out drink a G one.com/juice box. To get this offer, don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code Juicebox at checkout. That's Juicebox at checkout to save 40% at cozy earth.com my grand rounds series was designed by listeners to tell doctors what they need, and it also helps you to understand what to ask for. There's a mental wellness series that addresses the emotional side of diabetes and practical ways to stay balanced. And when we talk about GLP medications, well, we'll break down what they are, how they may help you, and if they fit into your diabetes management plan. What do these three things have in common? They're all available at Juicebox, podcast.com, up in the menu. I know it can be hard to find these things in a podcast app, so we've collected them all for you at Juicebox podcast.com Today's episode is sponsored by the tandem Moby system with control iq plus technology. If you're looking for the only system with auto Bolus, multiple wear options and full control from your personal iPhone you're looking for tandems, newest pump and algorithm. Use my link to support the podcast tandem diabetes.com/juicebox, check it out. The show you're about to listen to is sponsored by the ever since 365 the ever since 365 has exceptional accuracy over one year and is the most accurate CGM in the low range that you can get ever since cgm.com/juicebox, have you heard me talk about how I I don't even know how I accomplished getting Victor Garber on the podcast and like, the first two years of the show, right?

Kenny Fox 2:36
Oh, yeah, yeah. And then you only recorded one side, or something like that. My side.

Scott Benner 2:39
I just recorded me. It was horrifying. And he was nice, of course, he came back and did it again, but, yeah, I got like, you know, like, the first, like, genuinely famous person who has type one diabetes to come on the podcast, and super excited. And he's like, you know, doing it in between shooting a TV show and something else he's doing. And, you know, right, I have somehow his home phone number, like, this whole thing has been very kind, and the whole thing recorded, and I get done, and I'm like, Oh, God. Like, oh, it's like, his voice isn't there. I didn't know what to do, so I actually called the number I had for him and said, I'm so sorry. I just wanted to let you know this is, you know, a huge mistake on my part, but, you know, and I explained it to him, and he goes, Oh, he goes, we'll just do it again. And I was like, Oh, thank you. Just so nice.

Kenny Fox 3:23
Just really trying to nail down any other like celebs or athletes or anything.

Scott Benner 3:27
No, I haven't, I have to tell you. And by the way, Kenny, we're being recorded. I might leave this in. I don't find that episodes with famous people are any more or less popular than episodes with people who, you know, just want to be on the podcast. So it's a lot of work and effort to get people on, and then sometimes they don't know the first damn thing about their diabetes. They just happen to have it. And then people get frustrated by that, and I also think it can put them in a bad light, and I think that's unfair to them as well. So and some of the other famous people that people want to have on I've been around, and some of them are just boring, like, and then they they're so, like, guarded, and they don't want to say anything. So it just ends up being not good. I loved there are some people with a measure of fame who I thought had been great on the show. Charlotte Drury was awesome. And the girl from the TV show with the witches, Jennifer stone, she was awesome on the show. She was on Wizards of Waverly Place. Oh yeah, she was really I thought she was terrific. I'd have her on like, every week if I could. I don't think she would want to do that. But anyway, Kenny pack for Episode Four. What are we talking about? Today? We're

Kenny Fox 4:49
going to talk through a little bit of detail around the algorithm, how it performs. I want to talk about kind of the basics that make up that crazy line people see that is the the future. Answer that loop predicts, and then how and when loop adjusts, how, when it can take away basal, and how and when it it gives insulin extra insulin. And that will basically talk about correction ranges. Is all this will be a good episode for just some of the mechanics of how it works and what to expect. Kind of bullet expectations around when loops going to do stuff, and can help explain why people get confused. Okay,

Scott Benner 5:22
you dive in. I think we're gonna keep doing this the way we've been doing it. Obviously, the bulk of the information is coming from you. We're working from your notes, and I will say things that I find useful along the way.

Kenny Fox 5:34
All right, sounds good. Other the basic prediction elements people can find this if they tap on that graph on the same like the home screen of loop, that blue one gives them four pieces they can toggle on and off. It doesn't actually turn anything off. It's just letting you see what each piece is, how it's influencing the prediction. That's probably the easiest place to see it and loop docs, it's covered a fair amount, but we've talked about insulin, and people mostly understand how insulin works. It's, you know, got kind of a peak around 90 minutes and fades over six hours. So that's kind of understood, and we've talked about that. We talked about the food in episode two, about how loop just assumes that your food impact is going to be spread out over a certain time window based on the absorption time that you enter, with most of that impact being expected up in the front part of the meal. So those two pieces, most people know pretty easily, and usually when you toggle those on or off in your prediction, you'll see pretty dramatic changes, because those are kind of the main things and influencing where your blood sugar is going, whether you're using loop or not, food and insulin. And the last two pieces are the ones that I'd like to take a couple minutes just to cover real fast. And it's we have the retrospective correction, which is a big, fancy word that basically just means we're looking back at the last, I think it's 60 minutes or so, and looking at what happened versus what loops thought what happened at a high level. It's just saying, hey, in the last 60 minutes, How often have I been right versus what actually happened? And based on that difference, let's say you end up higher than loop predicted, then it'll say, Okay, let's raise the prediction up a little bit higher to make up for the fact that that didn't, it wasn't what loop expected. And so it's not a huge modification. It does just kind of bump the prediction up, but usually a couple points. Nothing crazy.

Scott Benner 7:23
Is that there to help with? If it's the third day of a site versus the second day of a site like that kind of stuff is like, because it looks back and it says, What? Like, I thought you'd be 160 by now, but you're 170 I'll be a little more aggressive. Or you're lower than I expected, I'll be a little less aggressive. Is that really what it's doing this episode of The Juicebox Podcast is sponsored by Eversense 365 and just as the name says, it lasts for a full year, imagine for a second a CGM with just one sensor placement and one warm up period every year. Imagine a sensor that has exceptional accuracy over that year and is actually the most accurate CGM in the low range that you can get. What if I told you that this sensor had no risk of falling off or being knocked off? That may seem too good to be true, but I'm not even done telling you about it yet. The ever since 365 has essentially no compression lows. It features incredibly gentle adhesive for its transmitter. You can take the transmitter off when you don't want to wear your CGM and put it right back on without having to waste the sensor or go through another warm up period. The app works with iOS and Android, even Apple Watch. You can manage your diabetes instead of your CGM with the ever since 365 learn more and get started today at Eversense cgm.com/juicebox, one year, one CGM. Let's talk about the tandem Moby insulin pump from today's sponsor tandem diabetes care, their newest algorithm control iq plus technology and the new tandem Moby pump offer you unique opportunities to have better control. It's the only system with auto Bolus that helps with missed meals and preventing hyperglycemia, the only system with a dedicated sleep setting, and the only system with off or on body wear options. Tandem mobi gives you more discretion, freedom and options for how to manage your diabetes. This is their best algorithm ever, and they'd like you to check it out at tandem diabetes.com/juicebox when you get to my link, you're going to see integrations with Dexcom sensors and a ton of other information that's going to help you learn about tandems, tiny pump that's big on control tandem diabetes.com/juicebox the tandem Moby system is available for people ages two and up who want an automated delivery system to help them sleep better, wake up in range and address high blood sugars with auto Bolus. It's really

Kenny Fox 9:59
just in the. Last hour. It's just saying, hey, stuff didn't go quite the way we expected, and so we should probably add or subtract some points based on that. Okay, so it's not anything bigger for the bulk of the day. I mean, it will help throughout the day. So even if you end up going lower and loop thinks you're going to go higher, it does kind of temper its rise prediction based on the fact that you are a little bit lower than loop expected, or maybe a lot lower than loop expected. That's really all it's doing. It's nothing super fancy in the code. You can some people played around with extending the window of time. It looks, I think, actually, retrospective correction is looking back the last 30 minutes, and it pushes the influence over the next 60 minutes. So it's a very mild like bump in blood sugar over the next 60 minutes of the prediction. So nothing too big, but there is an option that's available in the current version of loop called integral retrospective correction. It's basically just using slightly more aggressive calculation to say, hey, you were higher than expected or lower than expected. Let's move your blood sugar a few more points than we did with the regular version. It does help a little bit more. It can be more aggressive when my daughter was six, seven years old. This feature has been around for quite a few years, but it just got added to the main branch as an algorithm experiment, just so people know where to find it in the settings. But when I had it on when she was younger, I felt like the spikes up from, you know, just being a little kid eating food and jumping up real easy would make loop over correct when I had that feature on and ended up causing a low that wouldn't have been there if I used regular retrospective correction. So just be careful with turning it on, and try not to mess with too many other things at once. And run it for a day or two and see how it goes. But for the most part, people appreciate the change, because the biggest issue is when you're stuck high or stuck low, and so making this system be adjust more aggressively based on, hey, you were really low instead of high, or you've been high instead of going low, is helpful just to turn that up a little bit. So

Scott Benner 11:55
when you talk about that, like, how many people do you expect are actually digging around in the code and making changes, versus the people who just kind of use it out of the out of the box, as it were, oh yeah,

Kenny Fox 12:04
changing the code. Very, very few people. That's why it's nice that the integral retrospective correction feature was added as an option to turn on in loop. So people can, if they want to play around with it, they can. They don't have to do any extra coding to add it all in. So

Scott Benner 12:19
is there a setup that you prefer for people to start with? Like, you know, we talk about like, you can turn this on or you can turn that on. Do you have like, in your mind, a checklist of like, yes, this on, no, that not on. Like, when you set it up for someone? That's a

Kenny Fox 12:33
good question. So if we're talking about added features, would be one thing we can look at where they kind of called Code customizations, the new build scripts that have been out for a while now add the option to say, Hey, I just want this customization by either typing in a series of numbers in your X code build, or adding a couple of phrases to your browser build, I really like the bulk of the ones that are available in the loop and learn script. And there's actually a bunch on the loop and learn.org page under code customization that tells you, like, hey, copy and paste this block of text into the browser. Build to get you started, and you kind of tweak the ones from there, the ones that come to mind as the ones I find the most useful is allowing you to enter carbs further into the future. There was a restriction added a few years ago to limit insuring carb entries more than one hour in the future, because some people had some problems where they put a large carb entry way out, and the system just kept dosing and dosing and dosing every time their blood sugar would go up. So I understand the safety, but we talked about in episode two about fat and protein, and that impact is showing up around 90 minutes two hours. So it's really helpful to be able to put fat and protein entries out a couple hours from now, so you don't have to think about it later. And so there's a customization for that that kind of reverses that safety constraint. I think that's one of the biggest ones. There's a few others. If people eat large meals, if they're always eating more than a regular eating more than 100 grams, then you can there's a warning that shows up in loop that says, hey, you're entering a large meal. Are you sure about this? And it could be bothersome, I guess, if you ate low carb or high carb, and you were or were not getting those warnings. So you can add a warning that says, hey, 50 grams is a large meal. Double check if this is right. The default is 100 and the one you can change to you is 150 and then the other one that I really like is the changing the lollipop, the fast entry time from what is currently the default of 30 minutes. I think it set the two hours. And the customization I like to do 90 minutes. But if you're not going to mess with the code, you just want to click a button, then the two hour absorption time for the fast entry I find more useful just because there are things like fruit and other stuff like that. That's I think it fits better. The idea behind the 30 minute absorption time was that it was a safe way for people to enter low treatments. If they made a really short absorption time loop, would expect a rise, and then that rise would have. Because you treated with something really quick. And this actually goes into the retrospective correction. The idea was in retrospective correction wouldn't kick in and try to over correct because it expects you to kind of jump up real fast from like a glucose tab or juice or something. But with a 30 minute absorption, it would fade super fast. So even if you took a bunch of carbs, loop, wouldn't really have a long enough time window to see all those carbs and try to dose for them, but at least it would say, Hey, you're going to bump up real quick, and that's okay. I expect that, no problem, and it wouldn't be any retrospective correction coming in, which so I appreciate the idea. I really just think loop needs a dedicated low treatment button that does that because there's too many other use cases for fruit and maybe really quick acting candy or drinking juice, just on its own, just because you want to a better fit, is the two hour time frame. So those are the main ones I'd say are a big deal

Scott Benner 15:50
in that scenario. The treating a low blood sugar, I would set like overrides. Instead of it correcting and targeting. I don't know what whatever I had at targeting 85 or 90, I would set the target to more like 150 or 160 because it's the worst thing in the world. It's like, you get low. Finally, you get our blood sugar to come back up. And you know that a lot of that number is probably going to get eaten up by the insulin that caused the low. At least, you want some time to wait and see if that's what's going to happen or not. And then you're just like, oh, we fixed it. And then all of a sudden, you're like, why is it Bolus thing? Why? Like, no, not yet.

Kenny Fox 16:23
So yeah, we'll get we'll get to that here in a sec, but actually we'll break down why that works, and when you'd use it, which activity is a great time? Or treating a low is a great time to use a higher direction range or target override. That's really going to be probably the core of what we're going to talk about here. But before we leave the customization. Since you brought it up, I'm checking here, and I'd say some people really find the profile save and load feature. If you miss having be able to load profiles of different basal rates and carb ratios. I don't use that one, but I know a lot of people do. That's a big one. The other stuff is, is all fun? There's a live activity. It's a geeky iOS feature that's existed for the last two versions. Or you can create, like, a widget that you put on your home screen on your iPhone that pulls in loop data more frequently, so you don't actually have to open the app and kind of see what it's doing. So you can turn that on in the customization. That's more of a new feature that I think people are are liking. I i added it just the other day for my daughter, and she thinks it's kind of fun to look at so well, thank all right, I may get her to look at her numbers. I guess that's great, right? So

Scott Benner 17:23
Kenny, living through the time where that's still fun, that's awesome for you.

Kenny Fox 17:29
Yeah, we'll see it's but I'm it's changing already. So, yeah, retrospective, correction, just again, just trying to make adjustments for what really happened versus what loop thought would happen. The last piece of the prediction element is, oh, momentum. That's right. So momentum is kind of what it sounds like. It's the idea that if your blood sugar is moving up quickly or moving down quickly, it's probably not going to really slow down a whole lot. It's going to keep doing that for at least a little while. So this piece is really influential, sometimes more influential than I would like, where, if you start going up quickly, it makes sense that the whole prediction would kind of like slide up, would aim up a little higher, because you're accelerating from, like a steady number to a more faster rise number ends that would often, not always, but often result in loop dosing a little bit extra, which is great, right? You're going to eat food, you go up a little faster than expected, and loop should add a little bit of insulin. And if you drop relatively quickly, you start picking up speed. As your blood sugar is dropping, it's going to shift the whole prediction down a lot lower. And so it's loop is far more likely to turn off the basal, which, again, is something we really want. If you're dropping relatively quickly, you'd like the system, even if it's just one reading, you want the system to think, oh, maybe we should turn off the basal. And so I think that's, it's a really big deal. It's influential in the system. It tweaks the first like, I think it's 30 minutes or so of the prediction fairly aggressively, depending on how fast you're moving, and if you're steady, it's not really going to change the prediction elements a whole lot, because it's going to say, Okay, we'll just keep going flat for a while. So that's a big piece. And I think some people need to realize that that isn't always a setting problem. If they end up going a little bit higher, a little bit low because of the momentum. Sometimes momentum is very influential. If you have a sensor that's kind of jumpy, or if you were exercising, or you had something like juice, or something that hits kind of fast, so sometimes you don't have to, like, panic about, oh, I need to change all my settings because I went a little low or went a little high. Sometimes it's just because loop over corrected or under corrected based on the speed of your blood sugar, and they just influence the prediction a lot. So don't panic. Don't basically what I like to tell people, how

Scott Benner 19:34
many times do you want to see something go unlike you expected before you start thinking about settings?

Kenny Fox 19:40
Good question. I mean, I still think there's a lot of trust. What you know is going to happen, is going to happen right layered into this like last night, Tessa is is fighting an illness, a stomach bug, so she's needed a lot less insulin for her food, and her basal is dropped a little bit, and I'm expecting it to go back up now that she's eating more and feeling better. At her. She got a little sticky last night, she got high, kind of Rose of, she went to sleep, kind of went up to like 171 80, and I gave significant boluses, enough that I should have expected it to start coming down within an hour or hour and a half, and it didn't. And I because I even got impatient and gave more in less than an hour, and it just leveled off, and then kind of started to go back up again to, like, 190 so at that point, it's either going to be, in my mind, it's either I totally miscounted the food, which she had a really light dinner, so that probably shouldn't be it, or it's going to be bad pod site or basal. And the site's relatively new. She didn't do anything physical yesterday that would have, like, nudged it or bumped it and tweaked it. So I went with, I don't know it's probably the basal. Now, normally I would wait, normally I would Bolus a bunch more, wait for it to settle, and then look at her iob, like we talked about in the first episode, and adjust basal based on that. But I was tired, I wanted to go to bed, so I threw on I increased her basal a couple clicks and Bolus a little bit more, and then I set an override, which we'll talk about here, in a second of slightly higher correction range, in case I increase the basal too much. So for me, I only waited a couple of hours, maybe three or four hours, but I would say, in general, usually at least a whole day, if not a second day, is fine as a guide. But I'm getting to the point where I can usually make adjustments within the same day, within a few hours or half a day goes by and suspect there probably needs to be something to change. And I'd say 80, 90% of the time, I'm right. There's still times when I change a setting, it's like, oh, well, I didn't need to do that. Some of it, you just have to make sure, as a caregiver, especially, that you're getting all the information. So my go to when we're running higher, for example, or even lower, actually, is fine. I just double check, Hey, what did you actually eat? You didn't send me a picture of it. What have you what kind of activity were you doing? Were you moving around? I didn't know about it. And just try to eliminate those obvious variables. And then if nothing crazy comes up, then we might make a change, especially if it's like known meals we talked about before, then I'll make adjustments very quickly. We have a certain set of food Tesla tends to eat on Sunday, so if Sunday morning doesn't go well by lunchtime or before, we're changing settings where I'm checking the pod or whatever, because it's very mild food, it's like a smoothie, basically. It's very easy to for us to dose for and it doesn't cause a problem. So if there is a problem, we know we need to change something. So definitely dependent. Is that a fair answer? Yeah,

Scott Benner 22:30
it is. I mean, that there's no, like, rock solid, like, it's this many hours. I also think that it's important, you know, to kind of reiterate something you said a little while ago, that if it's just a thing that's happening in one scenario, if you're always in that scenario, then fair enough. Maybe your settings need to be changed. But if that scenario only pops up every four days, there's still consistency there. But maybe you have to make a physical adjustment to your approach instead of an adjustment to settings. If that's not a thing that's happening at every meal. Yeah,

Kenny Fox 23:02
and food. Food is the single largest variable, right? And we're gonna get it wrong. Get it right, it changes that. So it's you always kind of want to blame the food, you know, check the basal, check the pod site, then blame the food first. And if it's not reasonable to blame the food, then you can move on to settings. But usually that's where most of our adjustments stop. Right? Was basal. Right? Is the pod site looking okay? And where do we mess up in the food? And that's kind of the end of the conversation, right? Make an adjustment and move on.

Scott Benner 23:29
So I hear, okay, well, speaking of that, go ahead and move on. So that's the basic elements

Kenny Fox 23:33
of the prediction. And now we can talk about when loop makes adjustments. There's a section called Automated adjustments in the loop docs. I have a video on loop and learn about this as well. I think it's called something like, how does the loop algorithm work? And it's one of my videos where I step through this section of loop docs. I'm just going to cover it briefly, because a lot of it would be visual, and graphs are super helpful. But the four basic changes loop can make is it can decrease the insulin it gives which, by and large, is kind of intuitive. Is if your prediction says you're going to end up lower than your range, that you've defined the correction range that you set in the system says, Hey, I kind of want to be in this range. We'll talk more about what that means in a minute. But you're oftentimes, people are picking, kind of, you know, 100 to 115 or 120 or like an 80 to 85 to 100 or 90 to 100 sort of numbers for this sort of range. And so if your prediction says, in six hours, you're going to going to end up a little bit lower than your correction range, then it makes sense. The only way to get your blood sugar up is to turn down the amount of insulin you're getting. So it turns down your basal pretty obvious. The next one is increasing your basal rate. If you're using Temp Basal mode, or if it's auto Bolus, we're going to give insulin automatically. The initial description of that is an oversimplified version, is if your blood sugar is current, blood sugar is higher than your correction range, and your prediction is all. Higher than your correction range, and you're going to end up higher than your correction range. It's all high. Then obviously loop says you should have insulin, and so it will dose that for you that's allowed to do that, and we've talked about it before, where there's automatic Bolus, which does 40% of whatever that recommended amount is to get you from where you're predicted to be to where your correction range is. And then there's the glucose based partial application, gbpa. Fancy version of Audible is it just says, Hey, if you're really high, if you're higher than your correction range substantially, then we're going to increase the percentage that's going to get you to your correction range faster. That's all. It's just how much it's going to give so again, loop says you might need a unit to move you from where you were predicted to be to where you want to be, and it's only going to give, you know, a little less than half of that 40% so just on its own. And then in next five minutes, it'll do it again and again and again. But if you were to check the Bolus button, that orange double arrow in lube, you'd see the full amount and say, hey, yeah, you can give a unit and it will, you know, let you dose it. Otherwise, automatically, it's just going to do a portion of that. So pretty simple, the zero basal rate, or turning off basal altogether, is the third option, and that's if any part of your prediction, whether it's the end or like the near term, or somewhere in the middle, if the prediction line goes under your glucose safety limit. That's kind of like a like a hard stop, the hard ceiling for your blood sugar. So if you're predicted at any point to go below that line, that number, then the system just says, All right, we're going to turn off the basal altogether. That's the most we can do to put the brakes on this thing and it turns it off. So that can be a little frustrating for some people, when they're using these long absorption times and doing fat and protein like we discussed, where you start to kind of dip down a little bit, and that momentum kind of makes a lower inflection point in the prediction where it's dipping down low, and so then it turns off the basal but that's also a really cool feature, because you the fat and protein impact of these longer meals, or pasta or something like that. It's spread out and can be a little unpredictable. So sometimes any movement down can force the basal off, and that's okay, just know that's that's happening, and no big deal. So those three are pretty easy to understand. When you're high, you need more insulin wants to give you more. When you're a little bit low, we're gonna end up a little bit lower than desired. It'll pull back your basal. And when you're going to go lower than your glucose safety limit, then it just turns it off. The more useful example that you see in loop Docs is something called resume basal rate. When does loop decide to just leave the basal rate on and run life as normal? And some of these you only see more frequently at night. But if you're the oversimplified version is, if your blood sugar and the whole prediction are all kind of hanging out inside your correction range, let's say 100 to 110 then Luke just says, okay, like we're good. We're going to land in the safe zone. And our whole predictions in the safe zone. So cool. We'll just turn on the basal and, you know, just run do nothing, which is great. Sometimes it seems like that doesn't happen very often, but that's what it's going to do. But the other interesting part about when loop chooses to just turn on the basal rate and essentially do nothing is a situation where your blood sugar might be in or maybe slightly above your correction range, but your prediction goes below your correction range. So let's say you're starting at like 120 your correction range is 100 to 110 and you're like, we entered fat and protein and stuff, so you're going to see a dip in your prediction value. Just say, Oh well, the prediction is going to dip down to like 80. Nothing crazy. Not going to turn it off or anything. But then it very quickly rises back up again because it's waiting for the rest of that fat and protein to show up. And so let's say your eventual blood sugar is like 150 so you you do need some insulin to avoid going high later. And in that situation, you might even check the Bolus button and loop and it'll say, Yeah, sure. You need, like, a unit. That's cool. You could deliver it if you wanted to. It'll give you a warning on the Bolus screen that says, hey, like, you could give this unit, but your prediction says you're going to go below your your range. You said you wanted to kind of stay in just heads up, like, be careful. But that also means that same warning means that automatically, loop won't choose to give that insulin. So even though your prediction loops even recommending a Bolus, the system won't give the insulin for you. It's just going to say, Cool, yeah, you you could use a unit, and it wouldn't send you below your safety limit. But I the system are not going to be responsible for create, making this prediction come true and pushing you below your safety your range you want to be in. So it won't give any insulin. Those are situations where people can sometimes get frustrated and be like, Why does loop predict or recommend a Bolus, but it's not giving anything. And that's kind of that, that thing where the system is going to air on the side of caution, but if you checked for a Bolus and you really wanted to give it, you can go ahead and give it.

Scott Benner 29:51
I think my most frequent text sent during high blood sugars is suggested. That's all it says, just Yeah. But. Ever suggest that just do it? Yes, yeah. And, I mean, listen, I understand why the it's not just Luke, by the way, I recall on Omnipod five the same thing, you know, and I'm sure on others as well. So I get it, but that's where you have to come in and say, I mean, I've lived through this before. I know what's gonna happen here, like this thing thinks it's coming down, it's not coming down. There's not enough basal to make it come down, one way or the other. I need to get this insulin in somehow. I would also say that in some of those stuck situations, I'm a fan of pushing, just pushing the basal and but there are times that I look at all the insulin on board, and I factor in how long the food's been in, or you know what it's doing, and there's no basal, and I think to myself, I know, if I just put the basal back on here, with all these other things happening, blood sugar is going to start falling immediately. When it happens, it almost feels like it happens too quickly. It feels like you're balancing on a line, and you're never gonna fall, unless somebody blows on you, and then, like, for sin, you tumble right off. You put that basal on, and you get a diagonal down arrow in, like, 510, minutes. Just crazy, yeah, but I don't know. Like, there are times I think, like, Am I seeing what I'm seeing, or have I just waited so long that this was about to fall anyway? And now it feels I can never tell, but, yeah,

Kenny Fox 31:26
that would peak is hitting or something, but it always feels like, you know, you're you did something, and all of a sudden it changes in five or 10 minutes or 15 minutes, I

Scott Benner 31:33
swear to you, I don't know. I don't know if it's like, I'm like, is it the thing I just did, or was this gonna happen anyway? And you know, she doesn't get low afterwards, so I guess whatever. But yeah,

Kenny Fox 31:43
it works out. I have another scenario to talk through. But I think if we take a look at this discussion here, where you know you're gonna probably not, you could be high, or you could just be, like, a little higher than your range, and your prediction drops in the middle somewhere. It's a good time to talk about something you could do if you knew this was going to happen if you knew the rides can become a little more soon, a little sooner than than loop expected, you could do one of two things, right? You could take the recommendation which is a good place to start if you want to kind of be hands off a little bit more, you could set an override. So we'll talk about overrides for a second. Overrides allow you to temporarily change the sort of settings that loop is using. And the main thing I use overrides for is just simply it says, In the override screen, when you set one up in the heart icon in the main screen, it calls it target, but the target is the same thing as correction range. I don't know why the text is inconsistent, but if I use the word target or correction range, they're interchangeable. But essentially, what we'll do is we'll create an override that maybe has a lower target, like a target, say test says gluco safety limit is 70. I have one called Target 71 just remember what it does and all it does that slides that correction range down to 71 for like an hour. What that does, in the case we described where, like, you're just dipping down to like 80 and coming back up, is it says it moves that that line, it moves the correction range. Now your entire blood sugar prediction is above this correction range, and so now it's in a situation that we talked about earlier, which is, oh, I can give insulin automatically. It's, it's cool, everything's above the range. I can go ahead and dose automatically, but less aggressively than I would if I just hit the Bolus button and gave it. So I'll do that for certain meals. I'll do a going into a meal. In case the loop aims a little bit lower and and if she's kind of coming down into a meal, it can be more aggressive in giving insulin sooner. So she pops if She slides down, she has PE before she eats lunch. And so if she's diving down, the momentum of her blood sugar drop will usually tell loop not to give any insulin, or maybe give less when she at times she gets the cafeteria. So if I if I just pop on the target 71 for an hour, when I happen to notice it, it's the nice thing about running it for an hour is if I notice it while she's dropping, or I notice it right around lunchtime, I can put it on or she can do it. I'm trying to teach Tessa to do this too. Is that if she does dip down, and then once she starts eating, starts to level out edge. Let's see she levels out at 75 Well, her normal correction range is like 85 or 87 so loop wouldn't be allowed to give any insulin automatically, and Tessa's not going to check for a Bolus after she's eating and talking with her friends and doing her thing. So if we put on an override that bumps the range all the way down to like 71 once she hits 75 and levels out, at least loop can start giving some of the insulin lower numbers sooner. And it's totally appropriate, because loops being safe, saying no, she's dropping into this meal. So I don't want to give anything, but I know she's walking across campus and in line and getting her food, she's not running anymore in PE by time she slows down then eats, the system can start to deliver at a lower number as she starts to come up, so at least we're not totally late to giving insulin sooner. So that's a really neat tool. When you think about when loop is allowed to give insulin automatically, versus not the other. Your scenario would be, let's say you start at this like lower number, like Tesla was at 71 and you're going to go, your prediction is set to go higher than your correction range, but you're starting under your correction range. So loop might suggest some insulin, but in most cases, it won't suggest a whole lot. And automatically, the system is not allowed to give anything until your blood sugar gets up into your range. Well, that could be 1520 minutes after your maybe 30 minutes after you've already entered the food. And so now you're really late to the game getting insulin, and you're the food's got a head start, like too big of a head start, so you start shooting up well past your correction range, and the loop starts finally dosing. So that's why it's nice to be able to lower that number and but conversely, like we discussed a little bit ago, and when you're treating a low or going to be active or something like that, you kind of create your own activity mode, if you will, in loop. And I create a couple of target based overrides to just change the correction range to, like 150 I ended up just recently creating a 180 and, like a 220 which initially was like, I don't want Tesla's blood sugar to be that high, but it is serving a purpose, where I put those on the essentially, what you're telling loop is, even if you predict a rise loop, even if you say you're going to go to, like, 250 your only thing you can do is turn on the basal. That's the most help you can give. And it can't dose until blood sugar gets to and the prediction, but I can't the current blood sugar has to get to or above that number. So if I set it at 150 if she hits 145 and the prediction says she's going to go to 300 the most loops doing is turning on the basal. It's not dosing at all, which may be going into activity or treating a low during activity. That's really what you want, because she might level out real quick and kind of not need any extra insulin, even though loop thinks that she does. So we're kind of moving the line. Say, Luke, when can you engage fully? When can you actually add insulin? Is super helpful. And then the other reason why I created a higher one like the 220 recently, is if that eventual number, that Prediction number, sometimes I don't want the basal on at all, and I can't, I don't want to bother Tessa to say, turn your basal off. So if I set a really high number, higher than that six hour prediction is currently set, then loop will say, Oh, not only can I not give insulin until I hit like 220 but the prediction is and then, you know, we're going to end up at 120 but now the target's being changed at 220 well now I need to turn off the basal. The only way I can get from 120 to 220 is just to turn it off. And so I had to create a couple of really high ones this year just to make sure that I get the basal off before PE, when she's entering PE, before lunch, because sometimes I loop would just leave the basal on, which is great. It's not adding any more insulin, but I need it off off. So we got to have a higher target range for, like, two hours. So those that's why I'm using, that's how I'm using the overheads. Mostly it's just target based. We're moving or moving the line. I

Scott Benner 37:49
think those overrides are awesome. I don't know if everybody uses them. And actually, even while you're talking, I'm wondering, I mean, the people that are here to, like, find out more about how to use it, obviously they're thrilled to hear it, but I worry for the people who are like I just thought this thing worked better, and I didn't really want to get into all this. They might worry that it's too in need of adjustment. But I don't find it to be that way. I think if you have good settings, and you understand the impacts of your food, and you you know, you pre bullish your meals, I think loop works like, you know, out of the box, you know really well, but these overrides once you start seeing repeating issues, right? Or things where, like, you know, this happens here, you know, off top of my head, like, you know, periods is a great example, right? You hear people talk all the time about, like, oh, well, can the algorithm? Either talk about all different kinds of algorithms, like, I have shifts in my activity, like, I'm very active during the week, and then suddenly I'm sedentary, or vice versa, and they just want the algorithm just magically, no, and it just never going to work that way, not anytime soon, at the very least. So, you know, awesome to be able to say, I know insulin needs have just gone down. I'm just going to set an override. I'm going to set a different target and a different, you know, whatever basal, you know, settings, and I'm gonna let that override run for a while during an illness or during the next two days or the next three hours, or it's awesome. I think it's a fantastic feature set inside of loop. I also, you know, wanted to ask you not to pivot too hard. But do you use the pre meal button in loop ever? I

Kenny Fox 39:19
don't like it at all. Actually, the downside is, when we change used to be used to enter the number into most of the settings, like the pre meal, and they changed it so that it's just like a scroll wheel to pick the numbers you want. So there's no way to clear it out if you set it. So every time I've actually done this where I actually deleted loop altogether and started from scratch just because I wanted the pre meal to not work. So when we set up, when I walk someone through setting up loop, I say, just don't, like, skip that screen, don't enter anything in pre meal, and move on. And what will happen is that pre meal button will stay gray and disabled, so you can't turn it on. And the reason why, well, here's how it functions. It's a 60 minute run time, and it's supposed to be some kind of lower target range. And so it will. Help in the situation. And we discuss, or should we turn it on? It'll start to dose at a lower number. The annoying part is that it turns off once you enter food. It's the idea, I think was like, Oh, it was like a little tiny Pre Bolus, you know, like, aim a little bit lower as I approach a meal. But that's just going to give you, like, tiny amounts of insulin to nudge your blood sugar down from prediction of 100 to prediction of 75 not a big adjustment. So it's really not effective for that use case, in my opinion. But as soon as you enter food, it turns off. It's like, oh, well, now you're eating. So now we turn off where? Whereas the 60 minute target, lower target ice set runs for 60 minutes no matter what, if you use the pre meal button after you enter food, then it would do the same thing you could enter the food, hit the pre meal button, and then it would stay on for 60 minutes. And that would effectively be the same, same thing, but I just avoid using it. It is a convenient button. I really wish it wasn't like you could set whatever override you wanted to that pre meal icon would be cool and it behave however you wanted. But I just, I try not to enter it at all, and don't use it. But it does work well if you're going to do it after you eat your food, not as a pre meal, but as a post meal.

Scott Benner 41:03
Your answer really is interesting to me, because I had a similar I thought, where I was like, this is going to be awesome, and then it didn't end up being awesome. So yeah,

Kenny Fox 41:11
yeah, if the pre meal button Bolus, the set amount of insulin or something, you know, that would be cool. But the other thing is that it's so easily bumped, it can turn off any existing overrides. So if I have a target 71 on for Tessa, and she bumps it on her watch, or bumps it in the app, it turns off whatever overrides running, and it runs that, which is, again, super annoying. I've had it happen on the watch a few times, and that's the reason. Main reason I don't use it is I'd set like a some kind of different override, and all of a sudden I see it's off because she bumped the pre meal on her watch. You know, there's

Scott Benner 41:39
a use in there, just, I don't know, it just needs to happen differently. I think, yeah, I agree. I see the idea of, like, let's be more aggressive now. We're gonna eat in 20 minutes. We're gonna eat an hour. Like, I'm 120 I'd love to be a drifting 80 when I get to the food, or something like that. But it just didn't, didn't end up doing that. But anyway,

Kenny Fox 41:58
yeah, I encourage people sometimes to pre meal like or Pre Bolus like you would with any other system, is you can just give insulin approaching a meal without entering carbs, especially if you kind of generally have an idea of how much you'll need, and you can just give it loop will predict you're going to go super low, because it's like, well, you don't have any food here to hold up all this insulin, but you know you're going to enter it eventually. And so I think people freak out and say, What? Loop won't let me Bolus. I was like, well, just, just throw in a couple units, and you know, then when you get to the food, you can answer it, and loop will give you, it'll adjust what it thinks based on how much insulin is left from that Bolus and the food you're answering. So I like to give people permission to defy the system a little bit and give too much. I hope people on the podcast don't, aren't too shy to doing that, like you have to do that on new pod five or random or whatever occasionally as well. So yeah, but you can Pre Bolus. It's no big deal

Scott Benner 42:49
right now. There's definitely times when the system breaches its limits and your needs are still there. So

Kenny Fox 42:55
yeah, you know stuff that the system doesn't. So yeah, right. It's limits.

Scott Benner 42:59
About making a decision is what I was gonna is what I meant. But yeah, it just it gets to the point where it's like, look, I think I'm doing the right thing, so I'm not gonna do anything else. If you know something that I don't know, and we don't have function to explain it to the system, like, then you're gonna have to make an adjustment on your

Kenny Fox 43:17
own, right? Yeah, and sometimes that means being creative on how you express that. We'll talk about exercise in a later episode, and that's where you can kind of tell loop what's going to happen if you feel like it. Otherwise, you can just use these overrides to get around it. The other thing overrides do is you can use percentage changes. The percentage changes are it modifies all of your insulin needs by a certain percentage. So if you do 110% then I'll give you 10% more basal, 10% more aggressive ISF, and 10% more aggressive carb ratio. And those can be helpful. You just have to be real careful with those. I think I've come to avoiding using those during the day, because what happens is, at least for most people, I see is the scale doesn't always work out, like sometimes it does, but sometimes 10% more aggressive carb ratio is way too much than just a 10% nudge in basal, for example, for like a little kid, I find it not super helpful. Like the balance doesn't work out. And when you go back and change your carb ratios, or go back and change your basal, Luke's gonna say that one segment where you ran 110% for a little while also adjust. So let's say you're changing your carb ratio from 15 to 12. Well, at that point of the day, loops. Gonna say, Well, when you enter this food, it was 10% stronger than 15. Now it's 10% stronger than 12. So you can't go back and fiddle with your settings and try to find the right setting, because you had an override on for part of the day. So I don't like percentage based overrides very often. I will use them most commonly when Tessa is asleep and she's across the house or she's not with me. Maybe she's sleeping somewhere else at a friend's house, or whatever, and I can see her basal needs have changed either up or down. So I'll take a guess at how much. Need to dial basal back or increase basal using a percentage based override. But I try to make sure it ends by the time she wakes up, so that she's not entering food with those changes. And then I'll text her and say, Hey, I need you to change your basal to whatever. Sometimes, if I'm sleeping in the same house and she's just too far, I don't want to get out of bed and put my feet on the cold floor. I'll grab my phone and do a remote override for a percentage change. So that's that's how I try to use them. You can use percentage based overrides during the day. It just gets a little tricky. Let me

Scott Benner 45:27
say that I the place I've run into trouble with that is like, say, you try to use a very aggressive temp override to break a high blood sugar, and then somebody eats. And you told the thing, like, Let's go 150% of your normal power, and then all of a sudden, you Bolus for carbs, and it's giving you 150% of your carb ratio. That's that's the problem? Yeah, yeah. That's not great. The remote thing through night Scout to change this stuff. Awesome. Like, just super

Kenny Fox 45:55
helpful. Yeah, yeah. I just, but you can also get yourself in trouble in that same scenario where it's like, oh, we'll just need to, just need a little more basal right now, maybe we missed on the fat and protein. I don't want to bug test it ends from our carbs. And so the thought would be, hey, let's put on like, 120 130 150% override for like an hour. But then she does something like, oh, eat something and and now you're, you're really like, coming down with a vengeance. So I'm

Scott Benner 46:19
a much bigger fan of the remote overrides when, like you said, when it's not possible that something else is going to happen in that time, like, you know, overnight, like, all the time. I'm, I'm like, Look, I love her blood sugar here, but she's just riding a little too low. So I just want to take a little bit of the basal away, for example, like, just so it kind of rises up a little bit awesome for that. You know, 110 blood sugar, super sticky. I wish it was 90. A little aggressive. There, she's asleep. Nothing's gonna happen. She's not gonna be bolusing. It's awesome. There. I do hear people, by the way, say, especially adults will hear this and think, you cannot go touching somebody's insulin without them knowing. I agree. But Kenny's point is he made earlier too. Is like, sometimes kids just don't look again. So even if you text and say, hey, look, I've made your basal more aggressive, or I've done this, like, be careful, it kind of falls out of their head sometimes. So that's not a great protection either. In the end, they need to get what they expect is going to happen. You know, you can't go changing the game and telling them and not telling them, that's not cool, right? And adults seem to know that adults living with type one diabetes seem to reactionarily, know that, maybe more intrinsically than a parents who are helping kids with diabetes. And I know this has nothing to do with loop, but I'll add this here because I think it's important. I've talked to enough adults with type one. They'll tell you, like, when somebody goes to touch their settings, like, you know, like, I've had adults say, like, look, I was the doctor's office. And Jenny said it to me recently. She's like, if the doctor ever said to me, give me your controller, I'll change your settings. She goes, I wouldn't let that happen. She's like, that's me. And she started to explain that, and I and her explanation, I don't want to bastardize here. There's a thing that happens with people with type one like that insulin is affecting them in a way. You shouldn't get to say what's going to happen to it, unless they agree to it. And anyway, sometimes the remote stuff can make that a little tricky. I think,

Kenny Fox 48:16
yeah, definitely. And that's why I like starting with just target base changes. It's you're not modifying settings really. You're just kind of changing when the system is going to respond. In case you made the wrong decision, it's easy to back out of the other thing, we'll use targets for that I find, especially parents. If you're not confident in your basal settings, like last night, I increased test is basal a fair amount, point one, five, all at once, and I wasn't sure it was going to be wasn't going to be too much, so I set an override that ran for the whole night. It changed her correction range from 87 to whatever, just like 95 to 100 to 110 just a little bit higher than normal, just in case I was wrong. Case I put too much basal on and I didn't know. So if your confidence is shaky and you're worried about lows, and just nudging the correction range up just 1015 points can make a really big difference. Because if she if I did increase the basal too much, she probably would have been running under that number of 100 she probably would have been in the 80s or 90s, whereas, if I left it as a correction range in the 80s, she might have been in the 70s, or maybe even a little bit lower if I went to overboard. So that's helpful. And the first time I created that slightly higher correction range was when she had her first sleepover while she was looping with my sister. I was like, you know, I like, everything is probably fine, but let's just, let's give a little more room for loop to catch a low and I'm comfortable with her running at 110 Right? Or if she's running a little bit higher because her basal is off, she'll be at like 120 but not like 150 so using a slightly higher correction range when you're less confident in your settings is a good thing to use, and it's great for sleepovers or just for anything that you just are not confident in. You want to let the system play around. I really encourage. Rich people to do that. When they start looping the first day they first night, they run it. I think it works best if they just run closed loop and set a correction range that's fairly wide, like maybe 100 to 130 or something like that, or 140 somewhere in that range. Or it's not super high, but they can let the system play and move and adjust, but give them room in case they have their basal too high or something like that. So correction ranges are pretty powerful tools.

Scott Benner 50:26
Is Tesla's range wide? Or is it very tight, like, is her range 89 to 89

Kenny Fox 50:32
Yeah, perfect. I don't like the one number or really tight ranges, because I feel like not. You know, the predictions are just models of what should happen, and they move enough that if the prediction kind of moves to 90 now, loop wants to, like, maybe add some insulin. If it moves to 87 it wants to take some away. I feel like loop is, like, gyrating too much. It's making too small an adjustment. Plus or minus, you don't really get a good sense of your settings. It's trying to hit this, like magical one number. It's really difficult to do. So I like to create at least a range of some kind. So at night, sometimes down as low as a five point range, but typically like kind of a five to seven or eight point range. And then during the day, it's more like a 15 point range. So right now it's like 87 to 93 or 95 I think, at night, and then during the day, she's running an 87 to 100 or some people, I'll suggest, like a 90 to 110 or something like that. So when there's more variability in the day, I like to give a little bit more range the system to play with, and not overreact either direction. That's kind of the way I approach it. And then along those lines, is because the correction range effects of that prediction interacts with the correction range for the full six hours of that prediction. I find it's really tricky to get the system to do what you want it to do. If you set a bunch of correction ranges, people like to set, oh, I'm going to set, you know, a correction range that's higher right a PE time or whatever, it doesn't really do what you want it to do, because loop is is looking six hours ahead and starts aiming for the correction range at six hours ahead of right now. So that means six hours before PE loop is aiming for the 150 which, you know, in theory, is kind of nice, but ends up not really doing what you want. I tend to tell people once you just start with either one or two ranges. I like to do, if you want a tighter range at night, create a night range that starts at midnight. That means that starting at 6pm so starting at dinner, it's sort of aiming at this lower number and then have it run until 12 one, two o'clock, somewhere in there, because six hours before, let's say two o'clock is 8am from basically 6pm the night before, all the way through to 8am loop is aiming at that lower range for Tessa, and starting at 8am It starts aiming at the higher range that we have set. Now it does change how the system reacts, like we discussed about what, what number the system can automatically dose if your prediction is dipping and those kinds of things. It does mean that she's the system slightly more responsive. It's reacting at like a lower blood sugar number from like breakfast until like lunchtime, yeah, which I find useful. Most people struggle with breakfast, but then by the time lunch comes around, we're still aiming for the higher numbers. So just pick one to two ranges, midnight to noon, one two somewhere in there, and then starting from there to midnight, and that will usually get you kind of a nighttime slash mildly more aggressive day, morning to kind of a nicer, wider range in the afternoon, until about dinner time, it tends to work out pretty well. So figure out where you want to be. Some people just like to have a higher nighttime. That's fine. Then adjust it up. It won't make a big difference. Try not to make them radically different. But, uh, yeah, one range or two ranges is enough. And then use overrides for more specific times, like PE, it just gets you. The override takes over the entire correction ranges. Oh, okay, well now I'm not looking six hours ahead. I'm looking right now. What are we doing right now with this override? Well, it's on So

Scott Benner 53:50
Ken, I'm gonna go back in a series Full of the thoughtful things that you said. I'm gonna go back and listen to this part again myself, because I think you might have just like opened up my mind a little bit on the correction range thing that was really awesome. Thank you.

Kenny Fox 54:05
Yeah, it's more influential than I tend to think. And it was kind of hard to wrap your head around for a while, especially because you have to think about it in kind of six hour chunks. You can check out, I'm gonna do that that that's really awesome. Listen to it. Check out the loop, docs page on automated adjustments, or you can watch video, you know, keep an eye on my my website, YouTube channel, Fox and the loop house. I'll probably try to do some smaller or updated segments on this topic, because it's really useful for people to right. Just know how to apply the overrides. And then the last thing I'll leave you with, as I think about it, is sometimes, because you have remote access to this stuff, I find some parents tend to obsess over looking at the numbers. And it might set, you know, a target six, a millimolar, or target seven millimolar, or target, you know, 121, 3141, 50. And they're constantly changing because you're like, Oh, I think loops gonna gonna do this, and I don't want it to or they're gonna come up on PE and do that, try to. Not let this it gives you the opportunity to drive yourself crazy and just set an override and let it run, and if you need to cancel it, cancel it. But try not to play around with setting so many overrides that you start driving yourself crazy. But you also need to make sure you have a few of these overrides pre built that way. If you're going to be setting things remotely as a parent, they're available in your list if you don't make the override, if I don't set create a one target, 150 and a target 180 they're not there for me to pick remotely. I could they'll test it and make one up. But again, we're trying to do this to minimize diabetes interactions, so it just needs to be made. So go ahead and make all the overrides you think you might need. Put them in the order, like the target based ones on the top, so you don't accidentally bump the percentage changes, and then you're going to go

Scott Benner 55:42
stop setting up an impossible parlay. Is what you're talking Yes, yes,

Kenny Fox 55:46
yeah. It's been a couple of clients of mine. We've had to work on that where it's like, okay, you're setting overrides every like, 15 minutes or so. Like, just pick one and let it go for a while and try not to look at the numbers for a little while. Like, it's it's good, but you can the remote accessibility makes it so that you can obsess over the wrong things, right?

Scott Benner 56:04
So Kenny, tell people again where to find you. Box in

Kenny Fox 56:07
the loop, house.com, I'll also be on Facebook, YouTube, Instagram. Try to do more educational videos. If you want to see some of the video content that's already been created, hop over to loop and learn. Org and the YouTube page that goes with that. There's a series on there that has has me listed as well. But yeah, if you want to come check me out and see what the courses or classes I'm offering, I'm going to open those up a couple times a year. You can find all the updates to that on my website, and love to see you there. Awesome.

Scott Benner 56:34
And we're going to do more of these together. Is that right? Yeah,

Kenny Fox 56:37
we'll have probably another series of three or four. We can go over, maybe a Q and A episode, if people have questions after these ones come out, awesome. See where it goes. Listen,

Scott Benner 56:44
you know, because my camera's on that I look super handsome today, and I have, I really do, this is my best day this week, and I have an event, so I'm gonna go, because I don't want to get sleepy and then people not see me in my glory, because I think I'm really like, I'm popping today. Kenny, I don't know if you look fantastic. I can tell. Yeah, thank you. I didn't want to take want to take this away you. You as well, look awesome. But I'm just, I'm looking at myself, and I'm thinking, if this angle is how the whole world saw me, I could probably be a model take a picture. It just, it's unfair, because if I start turning my head one way or the other, it all goes away. I've been looking at you and me for the last hour, and like five times I thought this is a good day for me, because I don't have that many of them. Ken,

Kenny Fox 57:25
I just want to be clear about that. I want to say it didn't want to distract from, yeah, you

Scott Benner 57:29
know, you didn't want to you don't want to come off like you're hitting on me. I understand. Okay, well, thank you so much for doing this, man. I really do

Kenny Fox 57:35
appreciate it. You got it? You

Scott Benner 57:44
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#1502 Melissa is not Michelle

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio -  Radio Public, Amazon Alexa or wherever they get audio.

Melissa has kept her A1C around 5.2 for three decades—yet was fired by her endo for refusing strict carb‑count rules.

+ Click for EPISODE TRANSCRIPT

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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.

Speaker 1 0:00
Welcome back, friends. You are listening to the Juicebox Podcast.

Melissa 0:14
Hi, my name is Melissa. I live in California, and I'm from the East Coast.

Speaker 1 0:20
Nothing you hear on the Juicebox Podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan. Don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code Juicebox at checkout. That's Juicebox at checkout to save 40% at cozy earth.com AG, one is offering my listeners a free $76 gift. When you sign up, you'll get a welcome kit, a bottle of d3, k2, and five free travel packs in your first box. So make sure you check out drink. AG, one.com/juice box to get this offer, check out my algorithm pumping series to help you make sense of automated insulin delivery systems like Omnipod five loop Medtronic 780, G twist tandem control IQ and much more. Each episode will dive into the setup features and real world usage tips that can transform your daily type one diabetes management. We cut through the jargon, share personal experiences and show you how these algorithms can simplify and streamline your care. If you're curious about automated insulin pumping, go find the algorithm pumping series in the Juicebox Podcast, easiest way. Juicebox podcast.com, and go up into the menu, click on series and it'll be right there.

Speaker 1 1:45
This episode of The Juicebox Podcast is sponsored by the contour, next gen blood glucose meter. Learn more and get started today at contour. Next.com/juice box. Today's podcast is sponsored by us, med, us, med.com/juice box. You can get your diabetes supplies from the same place that we do. And I'm talking about Dexcom, libre, Omnipod, tandem, and so much more. US, med.com/juice box, or call 888-721-1514, this episode of The Juicebox Podcast is sponsored by the twist A I D system powered by tide pool that features the twist loop algorithm, which you can target to a glucose level as low as 87 Learn more at twist.com/juice box, that's twist with two eyes.com/juice. Box, get precision insulin delivery with a target range that you choose at twist.com/juice. Box. That's t, w, i. I s t.com/juice. Box. Hi.

Melissa 2:53
My name is Melissa. I live in California, and I'm from the East Coast. Melissa,

Speaker 1 2:59
why would you not tell me, while we were talking for the last five minutes that I'm calling you Michelle and your name is Melissa. I

Melissa 3:05
only heard you call me Michelle at the very end, and that, for some reason, people name Melissa always get called Michelle, really. People name Michelle never get called Melissa, because I have no idea why. Oh,

Speaker 1 3:17
wait, I know what happened. First of all, this has nothing to do with that, I am recording tomorrow with Michelle, and when I set your file up, I was looking at my calendar and looking at tomorrow, not today.

Melissa 3:30
Okay, no matter what the reason is, it happens all the time. That's

Speaker 1 3:33
crazy that it happens all the time, and I just happened to be talking to Melissa today and Michelle tomorrow.

Melissa 3:39
Maybe that's always happening every time. Is it possible that

Speaker 1 3:43
everyone you speak to has just spoken with someone named Michelle?

Melissa 3:48
It's a very common name, so yeah, I guess it's possible. Okay,

Speaker 1 3:51
that's awesome. So now just know that the only thing in front of me says Michelle. So I'm gonna try to cover it so that that I don't look at it again, and then, okay, I should be okay, awesome. I'm very sorry, that's ridiculous. Anyway, you have diabetes or something like that.

Melissa 4:09
Yeah, I do. I've had diabetes since I was nine, eight years old, since I was eight years old in 1991 eight years

Speaker 1 4:15
old in 91 which is roughly 25 years

Unknown Speaker 4:19
ago. No, it's more like 32 years ago. Why is my bad math?

Speaker 1 4:23
Hold on. So take 91 you had 10, that's 2001 then 10 more. Oh, I forgot the 2000 10s, right? 11 would be 2021. Would be 30. Then it's like 24 years ago.

Unknown Speaker 4:36
34 Yeah, it's about 34 years ago. This

Speaker 1 4:39
isn't going well, right? I almost, by the way, Melissa, I almost called you Michelle on purpose just now to be funny, but then I thought, people are gonna think I was really doing that. So, all right, so you've had diabetes for a good long time. You're in your 40s now, yeah. All right. Anybody else in the family? Sisters, brothers, mother, father, grandmother, have type one diabetes?

Melissa 4:58
Nobody. Not even type two diabetes.

Speaker 1 5:01
Do you you have a thyroid thing or anything else like that? Nothing awesome. Anybody else in the family have like, celiac thyroid? No, no, not a thing. You don't have a bipolar uncle. Well,

Melissa 5:15
my grandmother on my mother's side was schizophrenic. My grandmother on my father's side, she had Guillain Barre Syndrome. Whoa, the what? Who like? It's, I'm pretty sure it's pronounced Guillain Barre Syndrome, and it is a an autoimmune condition that's sort of similar to multiple sclerosis. I think, really, I could be, I'm not 100% on the family. This isn't something that's greatly talked about, but I'm pretty sure that she had that, and that it led to a fall that led to her death, but, but that's it. That's the only autoimmune condition in the family, and then the only other health conditions in general, I mean, not even type two diabetes. And the only condition there's been is cancers. You know, people have had cancer, or do

Speaker 1 5:59
have cancer, apparently, is it frequent with frequency? People in your family?

Melissa 6:03
My mother had cancer, and she was a smoker. She had oral cancer, but it's very strange. So I don't know if you ever read this book called diabetes rising.

You know there are audio books. I don't know if there is an audio book of this one, though, because I read this way back. Yeah. What's the book called? But yeah, in the book, diabetes rising, one of the things that's about type one diabetes, and it's about how incidents of it has has increased dramatically, you know? And this was written about 20 years ago, but even then, then the amount of cases have gone up a lot. It went into quite a lot of detail, looking into like, what are the various causes that might exist for type one diabetes? And there are no causations, obviously, that they can, like, determine, but what they have are correlations that are stronger or weaker. And one of the stronger correlations is just where on earth you're located, and where you and I are from, has very high incidence around New Jersey, Philadelphia, that area, very high incidence in that area, but especially right in my cul de sac. I lived in a cul de sac in west of Philly. There are three type one diabetes in my cul de sac. They're all up and down that street, just tons of cancer. And also a super fund site. You know what that is? No, a super fund site is just a place where there's a thing called the super fund that places can use to clean up especially toxic dirty areas, really. Yeah, that

Speaker 1 7:41
sucks. Have you ever gone back there and knocked on doors and been like, Hey, do any of your kids have type one diabetes?

Melissa 7:46
Well, we've, you know, I mean, they're our neighbors, so, oh, you're still there. I'm sorry. Well, I'm not anymore, but my family, my father and his wife, and they still live there. And they're dogs,

Speaker 1 7:59
they're dogs, they're dogs, which are, do they have any super dogs? All have diabetes, no, just kidding, and there's seven diabetic dogs. Scott,

Melissa 8:09
growing up, my babysitter, who was in our cul de sac, she had diabetes, and she still does, obviously. And I was we, you know, I had a wedding in my parents front yard recently, you know, about a year and a half ago, the

Scott Benner 8:23
bride room on the cake, I heard a Dexcom

Melissa 8:24
go off, and I was like, what? What's going on? And it turns out, I it was one of the one of my other neighbors who I always knew there was another type one there. I guess there were three type one diabetes besides myself, because there was the babysitter, her father, and then this other person who was at the wedding, and she was just ignoring her Dexcom, just like, that's fine. Which I was like, You're giving me anxiety. You got to treat this.

Speaker 1 8:47
Can you bowl this lady so I can go on with my wedding? Exactly? You just got married?

Melissa 8:53
Yeah. I mean, we've been together for over a decade, but yes, we recently got married.

Speaker 1 8:57
What happened? Did it get hard to do the taxes or something like that. I

Melissa 9:02
mean, to some extent, yes, obviously it's like, I'm just a deeply unconventional person. And I just was never like, we need to get married. You know that just like, wasn't really something where I was like, this is important to do, right? But then just one day, I think we were watching a TV show, somebody was like, unsure whether or not somebody would say yes to their marriage proposal, and I just said that, oh, man, I'd never just turned you down for a marriage proposal. If you did that, I would say yes. And he was like, really? And then he asked me, like, shortly after, I need to, like, drop all the hints in our relationship to make things happen, but it's fine. You made

Speaker 1 9:38
him ask you to get married after being together for 10 years. I

Melissa 9:41
didn't even mean to make them, No, I just, I just mentioned that that, like, I think there was a part of him that was just like, I don't know if she'd want that. She's deeply unconventional. You give off that vibe. Oh, well. I mean, I am. I mean, yeah, I guess, yeah, for sure. You

Speaker 1 9:56
think he thought if he asked you, you'd like, leave him instead. Yeah. The brand new twist. Insulin pump offers peace of mind with unmatched personalization and allows you to target a glucose level as low as 87 there are more reasons why you might be interested in checking out twist, but just in case, that one got you twist.com/juicebox, that's twist with two eyes.com/juicebox. You can target glucose levels between 87 and 180 it's completely up to you. In addition to precision insulin delivery that's made possible by twist design. Twist also offers you the ability to edit your carb entries even after you've Bolus. This gives the twist loop algorithm the best information to make its decisions with, and the twist loop algorithm lives on the pump, so you don't have to stay next to your phone for it to do its job. Twist is coming very soon. So if you'd like to learn more or get on the wait list, go to twist.com/juice box. That's twist with two eyes.com/juice. Box. Links in the show notes, links at Juicebox podcast.com 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 it 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. It'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 order's 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, Dexcom, Omnipod, tandem freestyle, they've got all your favorites, even that new eyelet pump. Check them out now at us, med.com/juice, box, 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 of the sponsors. The contour, next gen blood glucose meter is sponsoring this episode of The Juicebox Podcast, and it's entirely possible that it is less expensive in cash than you're paying right now for your meter through your insurance company. That's right. If you go to my link, contour, next.com/juicebox you're going to find links to Walmart, Amazon, Walgreens, CVS, Rite, aid, Kroger and Meyer. You could be paying more right now through your insurance for your test strips in meter than you would pay through my link for the contour next gen and contour next test strips in cash. What am I saying? My link may be cheaper out of your pocket than you're paying right now, even with your insurance, and I don't know what meter you have right now. I can't say that, but what I can say for sure is that the contour next gen meter is accurate. It is reliable, and it is the meter that we've been using for years. Contour next.com/juice box. And if you already have a contour meter and you're buying test strips, doing so through the Juicebox Podcast link will help to support the show. I

Melissa 13:38
don't know what he thought. You know, he just, he's a really great guy, like, the most top notch man you could ask for a but, okay, but he's not like, super brave, you know? And whereas I'm like, all bravery, oh, I'm like, 100% bravery. And so there's, to some extent, I have to lead the way in certain things, he's really responsible and reliable and extremely kind. Like, I'm not as kind, I'm not very kind. I

Speaker 1 14:06
love how you started going I'm not as kind, and you were like, actually, that's too much credit. I'm not that kind.

Melissa 14:13
Yeah, I'm not super kind. I mean, I try. I want to be, I don't know, I should meditate on it and become kinder, but I'm but I don't know. There's just something about me, and a whole lot of that, like this, like deeply unconventional way of living, is so much of what I want to talk about in regards to my diabetes experiences, right?

Speaker 1 14:32
Well, listen, it's possible, possible, Melissa, that you're unkind because of pollutants like heavy metals, lead, mercury, industrial chemicals, PCBs, dioxins and radioactive materials. I

Melissa 14:45
know that you just put that into chat, GPT, I asked our friend,

Speaker 1 14:49
and this is what they said. Super fun site was EPA designation, identifies, investigates and ranks sites using the national priorities list to prioritize cleanup. So there. They're actually sites that need to be cleaned up, right? Oh my gosh, abandoned factories, industrial plants, landfills leaking toxic waste, old mining sites with heavy metal contamination, chemical storage and manufacturing plants, military bases with hazardous waste. Is type one diabetes. I haven't done this in a while. Oh

Melissa 15:21
boy. I was thinking, as I was listening to the podcast, I was like, I hope he doesn't start chat. GPT, well, just

Speaker 1 15:26
this one thing I just, I want to see, because you said the thing, and I want to see, like, if there's anything out there that, okay, say it says there's no definitive, large scale study that provides the direct link exactly,

Melissa 15:38
there's nothing, I mean, so I actually, I mean, I could talk more about what's in that book, diabetes rising. Yeah, please. Some of the stronger correlations, they're not that interesting. The ones that you always hear about are, like, the weakest correlations, like, like, cows milk. That's an extremely weak correlation. A lot of the stronger ones I've got going on. So geographically, like, there were a lot of kids in my school who had type one diabetes, and you know where I lived, there was a whole diabetes floor of the hospital where I went to also like your birth order, the the higher up in your birth order that you are, the more likely you are to have diabetes. And whether or not you were breastfed, if you weren't breastfed, then you have higher incidents, but I was breastfed and I was the second child, so I wasn't even the first. But I don't know if you realize this, but every time a woman gives birth, every child, the first one gets, like the highest of her her toxic load, and then each successive child has less of the toxins that have built up, like from eating fish or whatever else, all of that, you get less and less of that. Oh,

Speaker 1 16:47
I've never heard anyone say that before. That's interesting. That's true. So you should make, like, three and throw them away, and then really get started, right? Yeah, just, just start over. Get out your toxic toxic load. Get your toxic load out. And then, yeah, oh, gosh, I didn't realize that. No, no, it's so awesome. Thank you. I

Melissa 17:04
mean, who knows? Maybe things have changed since that book was written, but it was a fascinating book.

Speaker 1 17:09
Yeah, it's interesting, by the way, even though it says here that there's no studies about the super fun sites, it does go over a number of different ways how one of those sites could impact auto immune diseases and type one diabetes. So wait, wait, you were saying something and I shifted you crap. Hold on. It was

Melissa 17:26
just about being a deeply unconventional person. Yeah,

Speaker 1 17:30
no, thank you. So Wow, good memory. I got up very early this morning. I can't believe I'm gonna say this on this podcast. I got up very early this morning to sit with Arden's new puppy, oh, so that she could sleep for a couple extra hours. I know that I've given what is rock solid advice that I didn't listen to. And my rock solid advice, of course, is don't get married, don't have kids, don't get a dog. If you can avoid these three things, your life will probably be sadder but easier. But anyway, our dog, I

Melissa 17:57
won't have kids. Why not? Well, I mean, first of all, I'm 42 Oh, that's gone over to reason. So that's a good reason in and of itself. But no, I decided when I was pretty young not to have children, but I am a nanny and a babysitter for a living, and so, I mean, I love kids, and I am really good at taking care of them and understanding them. However, like, it's almost like a physical need to be with children. For certain people, I feel like if I didn't work with kids, I would have that need very strongly, because I get so much out of it, like my nanny baby after the holidays, and I didn't see him for three weeks, and then when I came back to him, he was asleep, and when he woke up, I went and I got him out of his crib, and he just hugged me for 20 minutes. You know, he just didn't want to do anything but hug me. And that feeling like is very difficult to replicate if you don't have any access to children. And I can see like having a hunger for them for that reason. But I've been doing this for so long, working with the with children and babies, that I get all of that from my work so

Speaker 1 19:04
interesting, like when you work in a bakery and you don't want sweets Exactly, yeah, access to children, by the way, out of context, very weird statement. Well, you know, in that context, I understood exactly what you meant. How long have you been doing that kind of work since

Melissa 19:21
2011 Wow. Before that, I used to work as a like a paralegal, which is not work I recommend, because so you know, I think Karl Marx said that work robs you of your species. Being like, it makes you feel like you're, you're not part of the species. You're You're just like. It's early to me too. It's only it's 930 for me, that's early because I, like I said, I'm a deeply unconventional person, so I don't really keep regular hours. So some work very much robs you of your species being and I feel like the work that I do now, it does not rob me of my species being. It i. Makes me feel fulfilled, whereas working as a paralegal has it just makes you feel dead inside. It's it's not good.

Speaker 1 20:09
You're not you're disconnected from it by yourself, indoors, all that.

Melissa 20:13
Yeah, that. And I mean, I'm sure it has a lot to do with the culture of the different places that you work, but I think that attorneys and doctors, most notoriously, sort of like, have egos about what they do. And, you know, I think, I think in some small part, even the desire to be those things in our culture has something to do with, like, wanting to feel higher than other people, not necessarily. I don't want to put that out there as a an overarching thing, because I know a lot of you know, there are a lot of attorneys who go into it to become public defenders, and, you know, do good work and but you know, if you're going to be working as a paralegal, most likely you're going to be like me and doing slip and falls and things that are a lot less noble.

Speaker 1 21:01
Did you feel like you were part of a system that was stealing from people? Well, no,

Melissa 21:05
I actually so the last, last place I worked as a paralegal, I think was actually doing very good work, but it's still, it still wasn't a great place to work. But we used to, we sued nursing homes. I used to look through the documents of the people who were suing the nursing homes. I remember looking and seeing there was this woman who had type two diabetes, and she was taking as much insulin in a day as I took in, you know, over a week. And I said, you know, those are the people who are using all the insulin. And I was like, I don't even think that's effective. I'm not even sure why you're doing it that way. I don't know why you don't like give them, you know, fruits and vegetables instead, but whatever, what

Scott Benner 21:46
makes you want to come on the podcast,

Melissa 21:47
I want to talk about what it has been like to live in a very unconventional way, pretty much without doctors. And yet, I've figured out diabetes since well before I had the technology. So I was in college in the year 2000 till 2003 when I dropped out. During that time, I was still on regular insulin and NPH, or human still in 2000 in 2000 Wow. And nobody had ever mentioned changing anything partially, I'm a victim of my own success. All right. So for one thing, it always surprises me to hear that people have never heard of Pre Bolus saying, because, again, I was diagnosed in 1991 and you know, they had a pretty good program, I guess, at Montgomery hospital, because they definitely told us you're supposed to give yourself insulin a half hour before you eat. That was always the role, always. I mean, this was on regular insulin. I didn't always do it, and to this day, I still don't always do it, and that's one of the reasons why. Like, if I can convince myself to find an endocrinologist and go to one, I would love to get some a phrase, but I really struggle with having to beg doctors for what I need,

Speaker 1 23:04
I made an ENT appointment yesterday for myself that I should have made two years ago. Oh yeah, I just got up one day and I was like, I'm not why am I struggling with this? Why don't I just do it?

Melissa 23:13
Well, I just don't have an endocrinologist at the moment, because my last endocrinologist, like, she fired me, she doesn't want to see me anymore, which is wild, because, like, you know, she really should be asking me for advice about how I do what I do, but she was angry because I don't do carb counting, and I don't put carb counts into the pump, and she wants me to do things by carb counts, but I have had diabetes for so long, and I got so good at it that my ability to know how much insulin I need for the food that I eat is like preternatural. Yeah, I

Scott Benner 23:45
just know. Why was she insisting on you doing that? I

Melissa 23:49
don't know how long, so I mean, that was one of her issues with me, was that I refused to she was really upset about my inability to provide a carb count. I said, I know you need to put something in your chart, so just put one to 10. Because I don't care what she puts on the chart. She was like, Well, I don't like that. And I was like, Oh, I'm sorry. Like, I think I must have probably said something to her about how I was like, you know, well, I've been doing this for a really long time, and I know how to do it. And my time in range is 93% and my a 1c is 5.4 I think it was. And I'm just like, you know, I don't know what you're complaining about.

Speaker 1 24:24
Yeah, was she new to you? Were you guys just just now? No, she was

Melissa 24:28
so she was the one who finally put me on a pump. I need you to understand I didn't even have, I didn't have a CGM. I always wanted a CGM. Like, I remember, like, through the many, many years of having figured out on my own how to do diabetes. I remember, I've thought to myself, if there was just some device that would track your blood sugar all the time, test it all the time, and then it would talk to a pump. I mean, I remember, I literally, I thought that's as good as a cure. That was what my thought was at the time. I was like, that's like, that would be so great. Big deal. Yeah. And then. I knew that, like such a thing existed, but I just had always been doing so well, and I didn't have health insurance for most of my life, like when I worked as a paralegal, I did not have health insurance. I worked at a small practice for most of that time, and then I did finally get health insurance at the last place that I worked as a paralegal, and that was when I switched to Lantis. So we're talking about, like 2008 or something, when I switched to Lantis.

Speaker 1 25:27
So tell me what you mean by I figured it out the other way. So like you started with, did you start with RNN? Was that your first instance? I started with RNN. Okay. And doing what like shooting in the morning and at night, or how did

Melissa 25:40
you handle it? Yeah, and I was figuring out my own doses pretty much. I mean, I still remember, like I used to give myself eight units at night and three in the morning, or maybe it was the other way around. That doesn't matter to the audience.

Speaker 1 25:57
You don't have to edit, Melissa, you can just keep talking. That's fine. You were having outcomes back then that were like the ones you're having now, or just you were doing you were in the fives. Yes,

Melissa 26:06
5.2 usually, because I was I would go low but, but I don't want you to think that God was low all the time. I could always feel my lows. Some people live their lives in fear of lows, but I do not live my life in fear of lows. I realized very early on that having diabetes type one is sort of like you are jumping out of an airplane and there's a target on the ground, and you need to get into the bulls eye target, and the closer you are to that bulls eye target, it's more like you need to get into the bulls eye, but not in the center, like you just don't want to be in the center. You just want to be on that target, but not right in the center. But the whole world outside of that target is huge. So it's really easy to end up nowhere close to the target, but if you are consistently in that target, you're much more likely to occasionally hit that bulls eye by accident. You know, I just embraced like, Okay, well, I'm not afraid of lows. If I start to feel low, I'll just eat some sugar and I'll be okay. And so because of that, I just, I kept my plus sugars, like, fairly in range with some lows, which is not to say that I didn't have dangerous lows, because I did. They were all as a result of drinking alcohol and then going to sleep. I called an ambulance one time, pretty sure that my my deceased mother, like, visited me in a dream to get me to wake up give myself some sugar. I definitely had some dangerous loves, like, I'm not going to pretend like everything my life was perfect. Were they frequent? I mean, I would say that during that time. I mean, it's hard to know, because I didn't have a CGM. I was testing my blood sugar like 10 plus times a day, and I want you to understand something. So when I went to college, I still had health insurance. This was before the Affordable Care Act, and so I did not get to stay on my parents insurance until I was 24 and as soon as you dropped out of college, you lost your insurance. Right when I did that, I did as best as I could. I was always testing, and I was always I had a mantra, test and treat, test and treat. I repeat test and treat. I just like I honestly did, like a pump style regimen, but with MTI, where I would, I would give myself, like, the smallest bit of insulin. I, you know, on those syringes they have, like, you could get ones that have a half unit, and I used to get those, and I would just, like, I would give myself, like, a little tiny triplet of insulin. So I was giving myself a ridiculous number of shots for so many years, and I destroyed the fat

Scott Benner 28:43
on my body. Were you just shooting at the same place all the time? No,

Melissa 28:47
no, I was doing my all over my thighs and all over my stomach, and that's about it. I would love to be able to use different parts of my body, but for some reason, nobody can explain this, but my sites fail. They just fail all the time. Like, I mean, you can try to explain it, but I've never heard anyone on the podcast say it, and I've also no one's ever heard of what happens with me, but like the true steel, which is the ones that are supposed to not occlude ever. Those occlude constantly for me, non stop. And the only ones that work for me, the only infusion sites that work, are the autosoft 30s. Who makes that? That's tandem, but they these are the ones that go in at a 30 degree angle, right? And let me tell you, they scar. They really do. They scar, but they work, and so I use them. Do you have

Scott Benner 29:42
problems when you were injecting? You

Melissa 29:44
know, it's hard to say, because there were times when I felt like that shot didn't even make a difference, and it felt a lot like what used to happen with what happens when I would use, like, true steel or whatever, where I'm like, for some reason at this site, I'm getting. No absorption. I think that it's possible that that was an issue, but it's also it's, again, it's really hard to tell because, because I didn't have a CGM, and so I was just testing a lot, and I would just give myself many shots. So if one didn't work, the next one might Okay, jeez. Just kind of

Speaker 1 30:20
want to, like, refocus for a second on the RNN time you were managing tests correct test that testing correct you were doing with that. Yes, okay, yeah. And

Melissa 30:29
I did that. And, you know, I'm, honestly, I'm so thankful that I had that time doing that, because I know that no matter what happens if I was extremely broke. I mean, now I have health insurance through my husband, but if I had no health insurance and I had no money, I can totally survive off of Walmart from pretty minimal cost and not just survive, but thrive. And I could keep my my blood sugars at, you know, a 5.2 a, 1c, and I'd probably do better at it now, even then, now that I understand more due to having had a CGM for a while. Is

Speaker 1 31:06
there an eating style at play here? Or do you just eat what you want? Yeah, what's your style? I've

Melissa 31:12
been a vegan for a long time, a very long time, and but the thing is, sometimes I'm a healthy vegan, and other times I'm a junk food vegan. I find junk food vegan is veganism. It's the same as when I used to just, like, eat, you know, pizza and everything, you know, just when I used to just, you know, prior to that, I ate, like, whatever I used to eat, like, a lot of like, frozen chicken from a bag that would stick in the oven, like, I know,

Speaker 1 31:37
a junk food vegan, like, so it's interesting, they're like, I don't eat meat, but no, I don't really eat vegetables either. I eat mostly potato chips. My gotcha, yeah,

Melissa 31:46
I love me some potato chips. And actually, though, if you're gonna eat like that, like if you're gonna eat junk, really, in a way, you know, humil and R is great

Speaker 1 31:54
because you're grazing and it's spread out and that kind of, yeah, there

Melissa 31:58
was a long time, even after I switched to finally having humolog, I still kept some R. I used to keep both on hand, and I was able to get humologue. I was able to get humologue through Lily cares. You know, Lily used to get the program, yeah, I used Lily cares for a long time for that, but they don't make a lance, so I was just using n and cum log.

Speaker 1 32:24
So you have any eating style, it's not what I thought. I thought you're gonna say I'm, like, more low carb or something like that. But

Melissa 32:28
okay, so I used to try, I tried everything, but I actually I was using way more insulin when I was low carb, way more insulin. So, like, if you eat a healthy vegan lifestyle where you like, are eating pretty low fat. I eat my five servings of fruit and vegetables a day. And for sure, I have like, regular foods that I eat, which is also helpful. Mostly, what I eat is like, I eat like a whole unprocessed grain, like quinoa, or, you know, I use, like the most brownish rice you can find like, that's grown in India, because the ones grown in China have arsenic. If you eat, like a whole grain, like a vegetable, like some something Leafy, like a mix of like a nice, delicious sauce of some sort, that isn't, like, super sugary, but even if it is sugary, it's that's okay, because I find that a meal like that. It's just so easy to dose for I don't struggle with that at all. And if you eat like a raw food, I mean, I'm not a raw food diet or anything like that, but the easiest foods by far, like, if I'm gonna go out to eat and not struggle to dose, I really recommend a raw food restaurant, which sounds gross, but it's actually like, usually delicious. Melissa, are you a hippie? No, not at all. I'm more like a rock and roller like a punk. Okay,

Speaker 1 33:48
all right, we can bleep this out. But would you have a different last name in my Facebook group than you have on this? Yes, okay, get ready to have your mind blown. Okay, I searched for you just to see who I'm talking to about five minutes ago. Okay, the last post you put up has a reply from Do you want to

Unknown Speaker 34:13
guess who? Sure, no, I don't know

Speaker 1 34:15
who the Michelle that I'm recording with tomorrow. Oh, isn't that crazy?

Speaker 1 34:26
I couldn't believe it, like you popped up, and I'm like, Oh, this is definitely her. And then I looked down and the last comment in your last post is from that person. I can't believe that. That's ridiculous. Yeah, I don't understand. How does the world work? How does it know? You

Melissa 34:42
know you can, you can do the gateway tapes and try to figure that out.

Speaker 1 34:46
And did you just mention Lily a minute ago? Well, the Eli Lilly really cares. That person used to work there.

Melissa 34:55
What's gonna I own quite a lot of stock in Eli Lilly. Do you understand quite well? For me, yeah, you're in the market. Are you? Yeah, I am. And I don't normally own individual stocks. Mostly I just do like whole market ETFs. But when I first got started, I was just like, I'm just gonna buy a bunch of individual stocks of companies that I like. And I was like, I just like Lily because they helped me out for so many years, and so I bought a bunch of stock, and then that stock looks skyrocketed, still doing well. I mean, I'm pretty sure it's, like, just gone, even for like, maybe a year or so. But when I bought it, it was pretty cheap. And then, I guess, because of Z bound and everything, it really has skyrocketed, we're not giving stock advice. I think we have to say that, yeah, yeah, I don't, I mean, I don't have any stock advice. My stock advice is, invest in a mutual fund. I was

Speaker 1 35:47
gonna say, I know for a fact you're the first person to say whole market. ETF on the podcast, for sure, yeah. Well,

Melissa 35:55
that is honestly the most rational. That's what, like any, anybody will tell you to do if you're just like a casual investor. I mean, everybody needs to be invested in order to horse hire. Hopefully you're invested to retire. I

Speaker 1 36:08
am trying my hardest. Yes, thank you. I sure hope so. Should you should have been doing it for years. We have been putting money into a 401 K since the first year my wife, yeah. But then

Melissa 36:18
did you invest with that 401 K? Because a lot of people just put their money into these accounts thinking that it's being invested, but it's not so it's just sitting there. It's just savings. We have a

Speaker 1 36:28
person who looks at some the money and makes changes to it as the year goes on. Okay, all right, good, good.

Melissa 36:35
And then they take one you're probably paying them, like, one to 2% I pay

Speaker 1 36:39
them 1% of Oh, my god, yeah, it's terrible. But I

Melissa 36:43
would not see I would just invest in a whole market ETF. It's literally just in like, like, if you invest in an ETF, like, VT or VTi, that is just the entire stock market. And if you look at the entire stock market over time, it's just gone up and up and up and and just that, like that gives you a 10% return a year, basic, you know, on average, yeah, and that beats what individual investors do. It's insane. People make it so complicated, but it's actually so simple.

Scott Benner 37:12
My guys then nine, 10% for the last six years, right?

Melissa 37:15
I know, but it would have been like 11 or, I mean, the market the past, you know, decade has been insane. It's just

Scott Benner 37:22
what's getting ready to jump again. So I don't

Melissa 37:25
know. We'll see. Yeah, it could be. I mean, the thing is, is that everybody is greatly invested in making sure that's the case. I know

Speaker 1 37:33
very little about this, but I've been alive long enough to know that companies seem to do better under Republican presidents. So I'm expecting a little bit of a swing in the in the

Melissa 37:44
I mean, I don't think that's actually technically true. These past four years have been the market has skyrocketed, but it has been very good, and it was great through Clinton, unfortunately, George W Bush crashed the economy, and then, of course, Trump, under COVID, did as well. So there was, like, a huge crash. So I don't really think it makes a difference who's in office as far as the stock market goes, because everybody has a great deal of interest in keeping the stock market continually rising. Yeah,

Speaker 1 38:12
I would say this. I do think that as an adult, the most money I made on any money I had invested in. It wasn't very much then, obviously, but because we were pretty young, but the Clinton years were very positive. Yeah, there was a big leap this year, during these last couple years with during Biden. Yeah, what I'm saying is that when Republicans come in, a lot of times they'll kind of, they'll cut restrictions, and I think it makes everybody believe that there's going to be more money national exuberance, yeah, yeah, right, that's exactly. And everybody gets super excited for a while. The market jumps, a crash, and then about two years in, it usually starts to trend the other way.

Melissa 38:50
Usually, their horrible policies make do, do affect the economy negatively. Eventually, the thing is, is that there's a real economy, and then there's like the economy that just is affecting those who invest and those are different things, yeah, yeah.

Speaker 1 39:04
And I want to say I would prefer that water and air and stuff like that be clean, but at the same time, like I've noticed over and over again, like you said, when those restrictions get lifted, it does create and the stock market is people

Melissa 39:15
talk about restrictions, but what restrictions are you talking about? Like, do you actually,

Speaker 1 39:19
oh, I don't think anyone knows. I just think that it's the vibe in the world that that's happening, and everybody gets a little more excited with their investing, and then everything kind of pumps up a little bit for a while. And then when, you know, when it doesn't bear,

Melissa 39:32
well, there's also a lot of fraud and dishonesty under you know. So what happens is we get Enron situations when we have an SEC who's not like looking into these companies to make sure that they're actually, you know, behaving lawfully. Yeah? So, yeah, the more fraud and deceit that you have, the higher the stock prices are going to go. But it's,

Speaker 1 39:50
it's irrational. Oh no, for sure, I think everything around the stock market's irrational.

Melissa 39:54
It, I mean, to a huge it's all just vibes. It has very It used to be different. You. Used to be that those things had to do with how well the companies performed and their cost ratio and all these different things, but now it's pretty much all just vibes and so crazy, and who knows what's going to happen? Yeah,

Speaker 1 40:12
by the way, like, politically, I don't really like, I don't have an opinion that I'm I hold enough that I would want to share publicly, because I don't think it probably holds water. That is the vibe is that, like, everyone just gets excited and then things just trend for no reason. It's not like, it's not about profits, not about, like, you said, it's not about cost. It's just about like, Oh, I I think that's a good idea, or I don't like the guy that runs that company, so that, you know, it goes the other way, or that stuff is insane, you know what I mean, right? So, yeah. I

Melissa 40:41
mean, the things that have really skyrocketed are almost just entirely based on vibes, you know, like the the like the ETFs that are just invested in semiconductor stuff, like QQ, these types of ETFs. I mean, my God, those are, those are just like, those companies aren't even turning a profit,

Speaker 1 40:58
you know, no, a lot of those companies are borrowing money to stay going, yeah, they're like, we have an angel investor. I'm like, okay, like you said, meanwhile, there's companies out there. They've got, you know, they treat their employees well. They're following the rules. They're making money, they're not spending too much. They show a profit, and right? Their stock sits, and it doesn't matter. It gives you about a 10% return

Melissa 41:18
a year if you're invested in just like normal things, like, like Lily, you know, these, like blue chip stocks, where it's just like, these are proven companies. They're not going to go bankrupt. They're turning a profit, maybe inventing something that is freaking awesome. Like, you know, I mean, I don't think that Lily, Lily didn't invent zbound, but having a product like that will help your stock price, but ultimately, it's just about running a good company anyway. I didn't mean to get off on that's another

Speaker 1 41:46
thing. It's never happened before, by the way. I will say this though I had a doctor on the other day from Joslyn, and he's on staff at Harvard as well. And he was talking about, he doesn't think injectable glps will be long for the world. He thinks that they're going to get more power for their punch out of an oral medication sooner than you think, sure, yeah. So, yeah,

Melissa 42:07
nobody likes to inject. Yeah. I was just listening to your episode about injection fear, and I was thinking about how, you know, even though I have diabetes, when I watch TV, I can't stand the thought I'm okay with insulin shots. Those don't bother me to even see or to think about. But I can't watch a TV, a needle on TV going into somebody. I mean, I get all my vaccines, but I don't like how they go into my shoulder. One time, I got a breathing thing, you know, I got a nebulizer. It's just the, it's when you get really sick and you have, it's such a common word, but yeah, it's like, I got a vaccine to make sure that you don't your lungs don't fill with water. What the heck is that called? Starts with an A I feel like you've

Speaker 1 42:50
got me going in circles. I'm not sure. Yeah, I can't get off over like, I'm trying to decide how you learned about the stock market and investing.

Melissa 42:57
I'm just very smart, and I do read books. Like, a lot of them, like, like,

Scott Benner 43:01
100 or so a year, really? How many is that a week? Well,

Melissa 43:05
I listen to audio books, and I listen at like, one and 1.5 speed.

Speaker 1 43:10
I got audible recently, and I was like, so there's this book I want to read, and it's just dry, so I'll just let somebody download it into my head through audio, is the way I was thinking about it. And then I'm so spoiled about entertainment because of podcasts. Yeah, I got along. I'm like, this is boring. Well, what book was it? I don't want to say I'm not trying to bad mouth the book I hear that, but I also want to know it could have been the person reading it. Like, I have no idea. But I was like, All right, this sucks. Like, so I'm going to try a different one.

Melissa 43:42
Well, don't use Audible, because that, and then you're paying per book, and you feel bad about it, you know? Just, just get your libraries, get you have a library card, right?

Speaker 1 43:49
No, a library. We don't have a library card. I haven't been to a library since I was nine, yeah.

Melissa 43:54
But you can just go in and just show your ID and get a library card, and then that will give you access to Libby, which is an app, and then you just put whatever audio book you want on hold, and when it's ready, you'll get to take it out of the library and you can listen to it. And then you don't have to feel bad about abandoning it if you hate it. You don't feel like I just paid $15 for the month and I'm out

Speaker 1 44:16
of bowl or whatever. I don't understand what Libby is like. Libby is an app. It's audio listening.

Melissa 44:21
Also, you good. Also, you can get Kindle books as well through it, but, yeah, why do

Scott Benner 44:27
I have to wait for it to be available if it's digital? Because it's

Melissa 44:30
from the library. So there are other people online before you. So

Speaker 1 44:34
it's not digital, it's not like a a link or a file that it's it's an

Melissa 44:38
audio book. It's on, it's on an app. You know, it's just like, it's just like your audible app, except it's called Libby. I don't understand why

Speaker 1 44:44
more than one person can't listen to it at once. Well, because they've cut deals

Melissa 44:48
with the libraries to use the physical books are the same way. Honestly,

Scott Benner 44:52
they're limiting it until somebody else is done with it,

Melissa 44:55
correct, like they have a certain number of copies available, and then. After the library has used up the number of copies that they like, got the right to give, they can rebuy whatever they bought. They have to buy it again. That makes sense. Okay? And then a really popular book, you know, they might originally get 100 copies, but then as the book gets less popular, they're not going to keep buying 100 copies. They're just going to buy, you know, however many they need. I'm

Speaker 1 45:21
going to ask you a question that there's no way you should know the answer to to see if you know the answer, because you're starting to freak me out. Okay, what humidity does my chameleon want to live at? Oh, I have no idea. Okay, God, I was glad, because I thought I was going to just keep saying things that you're going to be like, Oh, I know about that. Like, freaking me out. Oh, my gosh, that's like, Rosemary's Baby. Are you familiar with Rosemary's Baby? I don't do scary movies. Oh my gosh, that's a shame. I don't like they seem silly to me. I've

Melissa 45:50
got Rosemary's Baby, like, memorized and, and, you know, there's a part where this old guy, he says, he says, you name a place, I've been there, name a place. And he's like, sit for Alaska. And he's like, I've been there, great city, you know, like, no matter what, anyway,

Scott Benner 46:05
what's the what's the town in Alaska? I think

Melissa 46:07
I said sit VA, but I'm not sure that's actually a town. Sitka might be the name of

Speaker 1 46:12
the town to find out, because I think that's what your episode is going to be called. Oh no, I hate that. You weren't going to like whatever I picked.

Melissa 46:19
Most famously, he cites Dubrovnik, which is in Croatia, as a place. At the end, Rosemary says, Don't talk to me. You're in Dubrovnik. Dubrovnik, yeah. And I think most people don't when they watch the movie, there's a lot of stuff in that movie that you it's really not a scary movie in the way that, like some movies are scary. You know, there's no Gore,

Speaker 1 46:40
I believe you. I should watch it. I know the reference. Isn't that enough? No, it's like one of the best movies, all right, I'll put it on the list of movies that I'll be you

Melissa 46:49
know what? If you prefer you can read the book by Ira Levin. Does

Scott Benner 46:53
it sound like that's gonna happen, which is exactly

Melissa 46:55
the same as the movie, except for one scene. Okay, anyway, let's talk about diabetes. I have so much to say

Speaker 1 47:03
about diabetes, so tell me what you want want to say about diabetes. Then, yeah,

Melissa 47:07
I mean, I just, I have, like, so many experiences, just so much. First of all, you know, when I was growing up, we didn't have all of this technology, and I feel so bad for the parents today, because they are worrying so much because they have so much detail about what's going on with their kids blood sugars and me like so when I was a kid, we didn't even have, like, carb counting or anything. We just had exchanges. You're supposed to have one exchange of carbohydrates and one exchange of protein or whatever. But we never did a good job keeping it any of that, and there wasn't any adjustment to my insulin dose due to blood sugar or like, the adjustment was minimal. And so eventually, I actually spent about two years where I didn't test my blood sugar at all. I never tested my blood sugar because it made no difference. Like, it just felt like it was a way for doctors to yell at you when you went into the office because your blood sugars weren't good. So I was like, Well, why not just make up all of this? All I ever used to do is just invent blood sugars and write them in those little books they would give us, which, like those books, never made sense either, because everybody expects you to be on a schedule. But I just never, even as a kid, I just never could keep to any sort of like, regular human being, schedule. Yeah.

Speaker 1 48:19
Do you think they wanted those numbers in the book to help you, or just because they were supposed to be there and they could say that it was there, I'm sure

Melissa 48:27
that the idea is to help you. I mean, I don't think they just do it to be evil or anything. Like, no, I don't think that, yeah. Like, let's torture them, make them write these numbers in a book. And actually, like, so my father, you know, he's a computer programmer, and he invented the first program to like, he was like, I'm gonna invent something where he used to hook up my one touch two glucometer. I don't know if you've ever seen those on the internet, but the old school glucometer. But he invented something that would pull the data from it and write down all the blood sugars to solve this problem. Wow. How long ago was that? I mean, it must have been in like 1994 jeez. Did

Scott Benner 49:06
he do that just for you, or do you do it?

Melissa 49:07
Yeah, just for me. Oh, that's lovely. He also invented a a program to help me spell. He made a thing where you could record, he could, I could record my spelling words, and then I had to type it in. And so he at first I record my voice, and then it would like give it to me Spelling Bee style. Can

Speaker 1 49:24
you go back to what you think about parents struggling nowadays because, because I want to hear what you're going to say and then I'm going to disagree with you.

Melissa 49:32
Okay, go ahead. You might, but you also might not. I just feel a lot of sympathy for them, because I can see how stressful it is. And like my parents, I don't get the impression that my father was super stressed about it. My mother may have been stressed about it, but I think she mostly just felt guilty, like she felt like it was like a failure as a parent that she got that I got diabetes, okay, which, of course, it was not, and I used to have middle of the night lows. Yes, and that was really the big problem, was that I would have middle of the night lows, and I would wake up, like, screaming. Well, mostly in the middle, mostly the middle of the night lows would wake me up, and I would just go to their bed and, like, wake them. And then eventually I switched to just like, I'll just go downstairs and get get some juice. But at first I used to wake them. I mean, I think what happens when you go to sleep and you have low in your sleep is that you have a nightmare, the low blood sugar nightmares are freaking crazy. I remember I had this nightmare that, like, that low and high were playing tennis, and that low was this, like, big, giant blob, and the tennis was just getting squished. The high sugar was just getting squished, and I was like, Oh my God, and I would wake up screaming. And they would like, we did have glucagon, but at the time, they told us that glucagon was for when you passed out. And I've never passed out, but I have had seizures. One time I had a seizure at a folk festival. I know I said I'm not a hippie, but I did. Used to go to some folk festivals, like the Philadelphia Folk Festival, and I had a seizure at one while I was on a hammock and in the wee hours of the morning.

Speaker 1 51:12
Do you think you and I grew up really close to each other? I think we grew up really close to each other. Yeah, I think so too. I've gotten

Melissa 51:19
that impression so many times listening to the podcast. I'm just like, You are my neighbor. I just know it interesting

Speaker 1 51:25
and listen. I have to ask at this point, do you have ADHD add, I don't know. You have not completed one thought in the last 54 minutes. Oh

Unknown Speaker 51:35
my goodness. Which I think

Speaker 1 51:37
the podcasting is awesome because I enjoy this conversation because I like the way it flows through. But I tried twice to get you to tell me what you think about how parents feel nowadays with technology and we are at a folk festival right now on the second try, right? Yeah, it's awesome.

Melissa 51:51
I mean, I don't know, listen, I work with parents. I mean, I'm constantly in different people's homes, and just the way that parenting is in general, is so different now from when I was growing up, and to some extent, like, my family cannot be blamed for anything in regards to how I was raised with diabetes, because I am a very headstrong person, it's very difficult to influence me, and so I they can't be blamed For, like, not taking stronger control of my diabetes, and, you know, letting these low blood sugars happen or whatever. But I just feel like these days they have Dexcom going off on their own phone and everything. And the worst, the thing that really makes me feel nightmarish when I hear about it is the school stuff, the stuff with the schools, because when I was at school, I wouldn't let them have anything to do with my diabetes, and I used to give myself a shot whenever I wanted. They did try to tell me that I had to go to the nurse's office for things, but I just didn't do that. I just didn't do it because some people are comfortable with breaking rules, and others aren't, and I'm somebody who is comfortable breaking a rule that I think doesn't make sense, that does no harm.

Speaker 1 53:03
When you see people, do you think they're overwhelmed, or they're paying attention to closely, or, like, where's the overwhelmed?

Melissa 53:10
I think that it's information overload. And here's what I really think. I think that children's bodies are extremely resilient. And so, you know, when I was a kid, yeah, my hemoglobin a one Cs were like, I mean, this doesn't sound that bad, but they were like, nine, eight or nine, which for me, that's very high. It seemed like I was very high. But I understand seeing other people's that that might be like a great a 1c to A lot of people nowadays. First of all, kids are not given as much autonomy as they were given when I was younger. I think that's a problem. How do you know that? I think that children need to learn how to take care of their own diabetes, especially they should never, ever be given restrictions on treating their low blood sugar. When I was a kid, the snack that they gave you for low blood sugar treating was always these crinkle crackers that are in, like a six pack, a crinkly six pack, and they had, like, peanut butter or cheese between crackers. And I got so good at opening those crinkly packets extremely silently, like when people were, like, talking or coughing. And like also, like putting the crackers into my mouth, and like, basically letting them melt in my mouth and not chewing too noticeably and not leaving any crumbs. But

Speaker 1 54:24
Melissa, where are you getting the idea that somebody's overwhelmed from, or that kids aren't allowed to treat with the certain way or like or any of the things that you've that you've seen

Melissa 54:32
it in the in the group, all this, in all the groups people are are making these, like, elaborate systems where, okay, so some of the kids, if they're like, super young, they might need some help. I don't know, maybe dosing. I guess probably dosing is what you would need help with. I see so much struggling with the schools, and I'm just like, Oh, my God, I would not let the schools have anything to do with my diabetes care taking. But they

Speaker 1 54:56
might not have a choice. In some situations, the schools might have rules, or they're being risk. This then, and they have to go to lawyers, no,

Unknown Speaker 55:01
and I hate that. I hate that for them, of

Speaker 1 55:03
course. No, I do too. I also want to say that when you were a kid, you were shooting once in the morning and once in the afternoon. No, I

Melissa 55:10
started. So at some point I started to go to to the Children's Hospital of Philadelphia, and they did teach you about carb

Speaker 1 55:17
counting. There you did MDI at some point then yeah, and this is still

Melissa 55:21
an MDI, of course, but yeah, I started to give myself insulin for whatever I ate, right? And also in order to treat high blood sugar. So that was like a revolution for me, when that's

Speaker 1 55:32
awesome, but if I put one of those parents on here and let them talk back to you, and they said, hey, that's awesome, but your a 1c was nine, and my kids a 1c is six, well,

Melissa 55:41
no, well, but then my a 1c so once I learned to carb count and everything. So that was like probably middle school sometimes. So I was in third grade when I started, and it must have been like seventh grade when I finally learned to carb count. After that, my a 1c was has never been. I mean, my ANC hasn't been above six since then, I don't think my whole life.

Speaker 1 56:02
Then why don't you go back to doing it that way? To MDI,

Melissa 56:06
yeah. Well, because the pump is a dream. Are you kidding like so first of all, the pump. I mean, I run it. I run the tandem T slim on sleep mode, 24/7 control. IQ, yeah. And that was another thing that my my endocrinologist hated. She kept asking me, why do you keep it on sleep mode? And I'm like, well, because the target blood sugar is 100 on sleep mode. And she was just like, well, I don't know what she she was just so angry about that. She really did not like me keeping it on sleep mode, but. But the thing is, is that whenever you would ask her, like, specific questions about diabetes, she would be like, Well, I don't know anything about that. Talk to the tandem rep. And so I talked to the tandem rep quite a bit. And the tandem rep was like, Yeah, keeping it on sleep mode. 24/7 is honestly one of the best things you can do. You can you'll have such great blood sugars doing it that way. So they're like, if you're that kind of person, then yeah, that's that's great. I don't

Speaker 1 56:58
think anybody spends more time looking at diabetes communities than maybe I do, and what I think happens is that there are some people who are overwhelmed, or there's some people who are helicoptering, or there are some people who are whatever, like, doesn't matter, fighting with school, whatnot. But those people are, they're not everybody, and as a matter of fact, they're so not even a high percentage of the people. But I think it's what sticks with adults with type one so much your response like, I think it's lovely that you're concerned for people, but your response that, oh my God, those people are doing something that they shouldn't be doing, or don't they're doing something

Melissa 57:40
they shouldn't be doing. To be clear, okay, well, I think they're doing great. I just feel for them, it just feels really it's very difficult to control diabetes. I mean, yeah, you're a different sort of a person, but it's really difficult to control diabetes when you can't feel your blood sugars right. For me, I know what my blood sugar is without looking at the Dexcom. I think it's a really good activity in general. You should know your blood sugars without looking. And you can learn to do that simply by before you look at what your blood sugar is. Just guess what it is. Just take a breath and then look and see if you're right. I know I'm going to go low before the Dexcom is going to tell me that I'm going to go low. I can feel it. And I also, like, I can feel if my blood sugar is over 120 you know, you know, if you're higher,

Scott Benner 58:27
you get cloudy. And

Melissa 58:30
I feel this, this like sort of vague feeling in in the center of my body that feels a little bit like thirst. But it's not true. Thirst interesting. It feels a little different. Yeah, it's interesting.

Speaker 1 58:39
So I'm misunderstanding you then, like you're not saying, like you're trying too hard or you're paying too close attention, you're just saying, I feel bad because you're aware of all this, and then we got to get through without having to be as aware of all this. You're yourself.

Melissa 58:52
You need to deal with yourself, and your kid eventually needs to learn to deal with themselves as well. I mean, already, parenting is so much like having a physical body outside of yourself as well, and like, you know, to such a large extent, like you are your children, and it's wild. I mean, I can see it with the parents, and I feel for it. It's just it's really stressful, whereas, like when I was a kid, it was kind of like, Hey, as long as she's like, She's kicking, she's doing fine.

Speaker 1 59:22
Listen, I understand also, there wasn't really a way to do better than that, right? I disagree. Is the wrong word, because I don't know if I'm right or not, but the one thing that I'm not willing to take the risk on is, oh, they're little, so it doesn't matter, right? That's not a thing. I think

Melissa 59:38
it matters a great deal, because of how the kids feel if you switch your diet, you know, especially if you do it when you're young, and you start to eat more fruits and vegetables and legumes. People always ignore the legumes. If you eat that stuff, like your body will heal itself. The harm that gets done from inflammation, you know, from the high blood sugars and it's like your your body is going to heal. But the thing that. Doesn't heal. And the thing that is a real struggle is the things that happen to your your mind and your social relationships as a result of varying blood sugars.

Speaker 1 1:00:09
Listen, I agree with all that about the psychological side of it. I don't know that I'm willing to bet my kid's future on a legume. Oh,

Melissa 1:00:18
well. I mean, I wouldn't say you should bet your kids future. I mean, I think, I mean, I think you've done an amazing job. And, I mean, and I'm not concerned for your daughter. No, no, I don't feel like you are. I noticed this across the board, not just with diabetes, but I worry about the about a lot of children's a lot of them seem to lack a preparedness, like an ability to do things on their own, in regards to a lot of things like, I mean, a lot of the times like, I ask the kids, I'll babysit, I'll be like, do you know your address? Like, when I was a kid, we knew, like, our parents phone number and our address, right my heart and like, what if you were kidnapped and you escaped? Do you know your parents full names?

Speaker 1 1:00:57
Wait, you're worried for children of people on a community web board who have diabetes because somebody you babysit doesn't know their address. It's

Melissa 1:01:04
a lot of kids. And it's also listening to teachers. I don't know if you like, listen to what teachers are saying. Not since

Speaker 1 1:01:10
I was little, and I didn't think it was a good idea then, but go ahead. Right, right.

Melissa 1:01:13
Well, I mean, I It's like, get on like, teacher YouTube sometime, and like, watch what's sort of happening with with the classrooms. I mean, COVID certainly didn't help. I think that to a large extent, in general, there's maybe, like an over involvement with kids, where it's starting to have, like a negative effect on children's ability to do things for themselves, and that concerns me. But at the same time, I also recognize that, like, literally, every generation has been like the next generation, you know, they're not, they can't do anything for themselves and but you know, so I'm like,

Speaker 1 1:01:51
I know a moron who's in their 50s, a moron that's in their 40s, a more on their 30s and 20s and 10s. And I know five teachers I wouldn't let help me cross the street? Yeah, I also know great teachers, and I also know wonderful people like what I'm thinking happens is that when you bring a bunch of people together in a community, sometimes more often than not, the people who are struggling speak up more than the people who aren't, and that it gives the impression that everyone is struggling. And I just don't think that's true, because I talk to all the people who are doing really well, whose kids are really thoughtful, and know how to, you know, know what their diabetes address is and all that stuff. Like, I don't even know how to like describe it, but I think your compassion, or other people's compassion, is somehow coupled with like, this is me from like, 1000 yards away, like, just observing, okay, but I think if you grew up with type one and you're doing well now, meaning you don't have trigger finger, you don't have neuropathy, you're not getting injections in your eyes, and you didn't spend a ton of time focusing on data and everything. What your that your takeaway was was, hey, listen, we weren't paying that close attention like you guys are. And I'm doing great. Now I can go find another person who's your age, who has neuropathy or trigger finger or doopingers, whatever, or all the other problems that can come with, like unmanaged type one, and they'll say, You know what? They'll tell me, I wish my parents would have paid closer attention, because maybe my health would be better. Now you have these two perspectives, and then you're looking at a person whose kid was just diagnosed. The people who didn't have trouble are asking them to chill out, and the people who did have trouble are asking them to pay closer attention. Well,

Melissa 1:03:32
I definitely don't think that parents shouldn't try to care for children's diabetes

Speaker 1 1:03:37
by any stretch. No, no, I know you're not saying that. I'm saying this kind of a big, broad conversation, yeah. And I think what happens is, then you're a parent, and then you pivot in, like, one of two different, like, general directions. You either go, that's the kids thing. They're gonna have to learn it because they're gonna be an adult one day. So we'll put it on them, and then out of sight, out of mind, whatever happens. Happens. This is what the Lord wanted, whatever, blah, blah, blah. And then there's other people who will say, like, look, I'm going to pay closer attention to this. Give this could a decent launch into life with good health, and hopefully that other stuff will pick up. I mean, honestly, if I blindfolded you and kept you blindfolded for three days and then stood you up and said, Okay, here's the deal, Melissa, there's either a cliff in front of you or there's not. Do you want to step forward? You'd say, No. If there's a cliff there, I don't want to fall off. But, and I think that's where those people are, like, I don't know that. They're certain that all this work and effort is definitely going to lead to good health. Like, right? It's still you could do everything right, and it could still, you could still have a medical issue. But I think they think that it gives them a better than coin flip chance, if they put this effort in now. Now where I completely agree with you is that you can't ignore people's mental health and say, Yeah, but look, they've got a five, two, A, 1c like, that's not okay either. You know what I mean? I

Melissa 1:04:55
mean my I'm not even talking about people with good a one CS who. Who might have mental health difficulties. I guess what concerns me is, I do think that there's a large extent to which kids should learn as soon as possible to have autonomy over their diabetes. I was eight when I got diabetes, which, you know, that's older than a lot of people, you know, the you know, that's older than Arden was, and that's older than a lot of kids, and yeah, and I babysit a lot of eight year olds, and I know what they're like, and I know what what it's like when they're younger. And you know what they may or may not be capable of. I was a smart kid, and I was capable of a lot pretty quickly, although I didn't give myself shots for the longest time, I used to use auto injectors. I don't know if you're familiar with those auto injectors. There were two kinds. One, like, you would put this syringe into this big, giant thing, and you would press this button that was like, and it would like, really fast, like, both inject and give the plunger. And then later they stopped making that and that one broke. And I switched to one where you just press a button and that puts it in for you, and then you push the plunger, yeah, but anyway, and then eventually, actually, it wasn't until college that I stopped using that, and it was because I lost my insurance, I had dropped out, and I was just taking part time classes. And then I had this professor who I'm still in touch with. She was a women's studies professor, and she had diabetes, and she had switched to a pump, and she gave me all of her old syringes. Which syringes was always the most difficult thing to get out of all of the stuff, and the second most difficult thing back then was test strips. Test strips were extremely expensive, and I searched all over the internet, and I found this Canadian pharmacy that had the cheapest test strips for a brand called prodigy auto code and I used to use prodigy auto code strips because they cost similar to what Walmart is today. Okay? And that's how I used to test a million times a day without any insurance, which was really what I meant to talk about this whole time. That's

Speaker 1 1:06:58
amazing. It's amazing that you figured that out. That is true, right? Like, I know that from your notes, that this, everything you were able to accomplish for yourself for a long time was without insurance, right?

Melissa 1:07:08
Yeah, without doctors too, yeah. I mean, I've never found doctors to be particularly helpful, but at the same time, I did need one to get on a pump, which, like, I mean, if I could, if I could make myself less of a stubborn a hole, and switch to a pump earlier I would, unfortunately, the past is the past didn't go that way. I just was so like. I was like, why would I switch? Everything's going great? And then I was like, oh, when everything is going great is exactly when you should switch. Because switching to the pump, it wasn't even an adjustment. I was already doing that, but now I just had to do way less. Right? I never struggled with the basal. The basal was exactly right, immediately.

Speaker 1 1:07:48
Okay, yeah, no. I mean, if you're doing all that work with MDI and it's working out for you like that, then automatically, that's exactly

Melissa 1:07:54
when you should switch. I always see people saying that they're like, everything's going great on MDI, why should I switch? Like, that's why you should switch. Because if everything's going great on MDI, you have no idea how much less work you could be doing for exactly that same result. And they're like, Well, I see people and they struggle, and it's like, well, they're struggling because they don't have their their numbers dialed in yet. They don't have their ratios and everything, right? But if you are already doing good on MDI, that's exactly when you should be able

Speaker 1 1:08:17
to accomplish it. Yeah, maybe get some more sleep too, you know? Oh,

Melissa 1:08:21
I never get sleep. I'm, like, the least sleeping person ever. But yeah, because

Scott Benner 1:08:25
you don't want to sleep, or be not, because you're just, there's just something

Melissa 1:08:28
wrong with me. I don't, I don't need, I don't need as much sleep as other people.

Scott Benner 1:08:31
I slept not enough last night. I just was, I mean,

Melissa 1:08:36
so did I because I had to get up. What for to me, is early to talk to you

Scott Benner 1:08:39
freaking podcast. I know it's horrible. I had to get

Melissa 1:08:41
up. You know what? It's okay, because if I take a little nap later, that's when you're the most likely to lucid dream.

Scott Benner 1:08:47
So you're gonna go nappy. Yeah,

Melissa 1:08:50
I might have a little nappy, nice and and that will help me lucid dream. So that's great. I

Speaker 1 1:08:56
appreciate you doing this very much sincerely. Yeah, no, I think it's a great perspective. Again, I like a free flowing conversation. They're they're more my speed, but I like digging in too. And I see people say the things you said all the time, and it was interesting to hear you pick through what you meant by like, Oh, I'm worried about them. Because I think what can happen online is, hey, I'm worried about you. Blah, blah, blah. And somebody comes back, and they're a little like, well, you don't have to worry about me because I'm doing this thing. And then they go, Well, I grew up with diabetes and I didn't put this much effort into it. I'm fine. And then before you know it, they're like, banging together. I'm like, you two guys, some people aren't fine, yeah, and right. And I'm like and you guys have so much in common that you don't know like that to me, is always the thing I'm trying to get across when adults and parents are talking to each other like you have so much to share with each other that the two of you would benefit from, you know, back and forth, and you have way more in common than you think you do. Well,

Melissa 1:09:51
I think like to a large extent, it also has to do with like, whatever each individual's feelings are about their own childhood sometimes things that people. Say it picks at wounds you have. And you're like, you know, I used to sneak food all the time, you know. And I see other people struggling with that. And what, what seems really wild to me is that those kids, you know, even though they could just press buttons on their pump, they don't Bolus for their food sneaking. And I used to, I mean, I was the biggest food sneaker you could imagine. I used to get, like, a bag of honey nut cheerios. And I, like, I would hide in my closet and read a book with a night with a flashlight and eat honey nut cheerios. I mean, you could just think of it. I mean, my blood sugar must have been 600 but I wasn't testing, you know, if I had known, then, like, oh, all I have to do is give myself some insulin and then I can have this food. Then I would have done it. But I see these parents, their kids are not doing that. They're refusing to do the insulin, and I don't understand why.

Speaker 1 1:10:52
So then when you say these parents, what I'm going to tell you is, you mean four posts over the last six months?

Melissa 1:10:58
Well, no, I think a lot of people struggle with this. I see this a lot, and it's, it's everywhere. I mean, you know, it's not the parents fault, like, because I totally understand the desire to be rebellious as, like, a diabetic youth. Yeah, I feel so bad for them, because, at least my parents, like, they didn't know, but what

Speaker 1 1:11:16
happened to you? Like you, because you just said, like, it's something from your childhood. And I'll tell you right now, like, observation, if a person has, as an adult, grown up with still has or had, at some point, an eating disorder, they are going to freak out. If you say that your kid should eat a certain like, low carb style or something like it just it triggers something in them, very, very visceral, right? I

Melissa 1:11:38
think, I think that makes a lot of sense. Of course, does like, like, I said like, I'm a vegan, but I actually think it's pretty rude to talk about your eating style, just in general. I try to avoid it.

Speaker 1 1:11:48
I don't like it when people tell other people how to eat. I just find it to be a waste of time, and all you're gonna do is rude. What happened to you when you were a kid that makes you have this strong feeling when you see people living in a certain way.

Melissa 1:12:01
I don't really feel like my feelings are that strong about it. I just feel a great deal Well, I feel a great deal of sympathy, and I feel worried about the kids who are who refuse to take on autonomy. I mean, I don't think that is that they're not being allowed to take on autonomy. I'm sure a lot of parents would be very happy to give their children more autonomy if they felt that their children were up to the task. I mean, I guess that the only thing I can say that did happen was that I had a friend whose little brother had diabetes, and he came and stayed with us for a while, and I really tried to talk him into like, just take care of your diabetes, yeah, but he never did, and then he died. Oh,

Speaker 1 1:12:39
it sucks. Maybe that's your thing. What's that? Maybe that's the thing that has you upset,

Melissa 1:12:44
yeah? Maybe. And I'm just like, why did you never just, like, take it on to yourself, like, just, like, care about yourself a little bit. For me, diabetes is like a sixth sense, yeah? Like, not taking care of it would be like, not going to the bathroom, or not ever eating, or not. You know the

Speaker 1 1:13:01
vibe works for you. You know how to you know how to do it. It doesn't upset you to take care of it.

Melissa 1:13:05
I mean, sometimes it upsets me, but yeah, there are things that really upset me. Like, there are times when I, like, I made a deal when I was a kid, like, here, I'll tell you what. Like here, diabetes is like, you just take care of me, always, constantly for the rest of your life, not stop and I'll ruin your life. How's that?

Speaker 1 1:13:23
I think that it's possible that if you take this conversation out of diabetes, you'll see that the same outcomes exist in people's lives about other things too, like some people are just more inclined or interested or able or whatever. It doesn't really matter what the modifying word is right to do a thing than other people are, and some of those people get diabetes, and so some of them, you know, has to

Melissa 1:13:47
do with intelligence, and not just until, you know different types of intelligences. But I'm, like, a highly capable person, like, if I need to learn something like, I will learn it like, you know, I wanted to learn to play an instrument. I was already 30. I learned to play. I've written a lot of stuff. I've gotten short stories published. And I was just like, I'm gonna write some short stories and get some short stories published. And so I was like, I just did it, you know, I just worked at it until

Speaker 1 1:14:13
I did it. I think that's great for people that it works out for. I don't think that people who it doesn't work out for should be, you know, held to the same standard, maybe, like, I think you are who you are, and some situations are vibe better with how some people are built than others, and but those people are all still going to have type one. They're gonna so they're gonna need something. I think it's so

Melissa 1:14:35
great that there are these, like pumps now, where it's just like, all right, if maybe my little, my friend's little brother would have survived if he had had the type of pump where it's like, it doesn't keep you at 100 all the time, but you know, it might keep you around 150 160

Speaker 1 1:14:47
Yeah, imagine that kid with a, like, an eyelet pump, and he just has to say, like, normal meal, smaller than usual, larger than usual, and he'll exactly and end up with a reasonable a one, six. I

Melissa 1:14:58
wish to God. I wish that we could go back in time. And how is that for him, you know? Yeah,

Speaker 1 1:15:03
well, I'll share with you. Michelle, finally I looked up, Melissa, I finally looked up at the screen where the word was and just said what I saw in front of me, Melissa, I'll share with you, you know. And I'm sure you've listened and you've heard, like I had that struggle about my friend Mike, who passed away. It's been a number of years now, right? And but he was diagnosed when we were just out of high school, like, right at the end of high school, end of high school, out of high school. And now I look back and I hear all these people's stories, and I see what happened to him regular and mph. Nobody ever transitioned him off of it. He wasn't testing. They didn't take it very seriously. If he was standing up, he was okay. And, you know, and then one day, in his 40s, somebody finally figures out he's not all right. They try to put him on MDI. Nobody tells him what to do. He's having seizures. He's crashing his car. He doesn't like all the terrible stuff that comes with it. He falls out of bed having a seizure. One time, breaks his breaks a limb, you know, like, and then one day, somebody tells him, Hey, man, your your kidneys are shot, and now he's on dialysis. And then, you know, a couple of years later, on dialysis, and he has a heart attack, and he's

Melissa 1:16:04
gone, right? Yeah. I mean, one thing that I feel like with diabetes is, like, even if you're not doing that great, if you're doing something like, if you are, like, just trying, you'll do like, pretty well.

Scott Benner 1:16:16
But he was trying, he

Unknown Speaker 1:16:17
was just, I find he

Speaker 1 1:16:18
was just doing the things that he was told, and those things were not valuable, right? And he never pivoted to new technology or new ideas. And maybe that's because he wasn't interested, or maybe it's because doctors didn't help. Like, I don't know what the reasons were, but I know that by the time Arden was diagnosed, and I got this figured out, and I went to him and I said, Mike, I can, I can help. Like, I really feel like, you know, like, let's get you a CGM, like, I think that's a great place to start, you know. And he was just very resistant, yeah, the truth is, is that by that time, he came off to me, like the adults that I see who want to argue with people online, yeah, like, this is harder than you think, you know, like, I have a person in mind right now who's in the group who, I mean, if you wanted my again, 1000 yard impression of this adult, like, they're in their own way. They've decided that this thing's gonna kill them, and any help, they that anybody tries to put their way like that won't work. I've tried that. Blah, blah, blah, like, always, always resistant, resistant, resistant. That's how Mike was. I mean, I'm

Melissa 1:17:22
like that. I can be like that. So I like I totally get it, and that's how I feel. Like I was being about switching to a pump for so long. I get it because I'm a stubborn person. I feel for them, for sure, me too. But I mean, the best tool that you can be given as a diabetic, and hopefully you'll get it when, when you're a child, is a feeling of autonomy, a feeling that you can you can do this, like that. You are capable of taking care of this, and if you work at it, you will get better at it.

Speaker 1 1:17:55
Oh, for sure. Well, that's true, yeah. And you might be right about the other thing, maybe Mike just didn't feel confident, like, I don't know you know, like, maybe you're the person you knew. Just didn't think they could do it. Maybe they had been through an offer. They were just like, this isn't going to work, no matter what anybody does. And then it becomes a psychological issue. It becomes a human thing, and you just can't get past it. But from my perspective, all I can tell you is that if you have your settings right and you understand how to Bolus for the food you eat, you're very likely going to have reasonable outcomes day to day, right? And that's why I'm making this podcast, is to get people to, like, see that, that there's just some pretty basic things you can do. Make sure your tools are sharp, you know, and then make sure you're using the screwdriver on the screws and the hammer on the nails, like that kind of stuff. You have experiences and you learn as you grow, and before you know it, it's six months later and you're doing it. I just got a really great note today from an adult just very simple, like, you know, I'm going to share it with you because, you know, I'll keep it vague, obviously, but I featured it in the group today. It's an adult who posts and says, 93% range, 3% low MDI, I've had a history of terrible a one, CS, complicated variables from chronic illnesses. I've been working on one thing a month. This month, I worked on candy. I'm 50 years old, and now I can actually eat candy. She says, Thank you, Scott. My diabetes team will be thrilled with this, and shares a chart, 93% in range. That's amazing, 3% low, 3% high, 1% very high. Like, my God, like, you know, and this is a person probably in Europe or Canada, 3.9 to 10 is their range and just amazing. Like, really amazing. But the overall like takeaway from this post is, Hey, I found this podcast, and look where I'm at now versus where I used to be. Yeah, I see that. I said, Though there's an adult who was able to whatever their crap was, they were able to put it aside and say, you know, I'm gonna try this new idea. And that's just kind of what I hope it's really hard

Melissa 1:19:59
to get people. Listen to a podcast, though, that's the only only trouble. I'm doing

Speaker 1 1:20:03
it a lot of people. It's not enough. It is hard to get more. Like I'm not gonna lie to you, people who listen

Melissa 1:20:08
to podcasts will listen to a podcast, and people who don't will not. I just

Speaker 1 1:20:13
I've drug A lot of people into it. There's plenty of people to listen to this podcast, and they don't have another audio interest in the world. I love that

Melissa 1:20:20
that's great. I love to hear that I drag a lot of people. I recommend your podcast to people all the time, and even though, like, I mean, to a large extent, what I mostly find the podcast to be is validating about a lot of my experiences. Because I feel I mean, I don't. I hate, like, buzz words like this, but I sometimes feel like gas lit by the doctors. I have just struggled so much with doctors, and I find that the doctors feel like this is an anti Doctor podcast, and I don't really think that's necessarily the case, but you know, my doctor thought I was condescending to her, and I'm like, I probably was being condescending to her, because, in my opinion, I know better than her, because I've been doing this longer, and I don't think her advice is good. So a large extent, I find it just extremely validating. But I also I find that although I did listen to all the bold beginnings and all and the expert ones, all that I did listen to all that I knew, all that stuff, right, yeah, what I find really helpful is just when every once a while, a guest will say something where I'm like, Oh, wait, let me try that. Never thought of that, especially when it comes to like, specific I forget what it was. It was, it was a it was a mom of a young child, and she said something about tandem. And I wish I could remember what it was now, but whatever it was, I changed because of just this thing she said, and I was like, Holy crap. I think it was about an extended Bolus. And, like, doing an extended Bolus a certain way for something, and now I just do it as second nature, and I don't even think about what it was, yeah, but I learned that from her, you know, and she was just, and that kind of stuff is just like, so I find it endlessly fascinating just to hear people's stories about living with diabetes, me too, because I could literally talk about it all day. And like when I meet a diabetic in the wild, I'm just like, let's talk about it. You know, I

Speaker 1 1:22:13
feel exactly the same way. I'm very happy that you had that experience, and you continue to have that experience. Because, you know, the first time it was said to me, I've said it on the podcast before, but I was surprised the first time when the when a person said to me, like, Oh, I love this podcast. It's, if I don't listen to it, my blood sugars get out of whack and, you know, and all this other stuff. And then I kind of just, like, I did the thing. I leaned into like, Oh, was it the Pro Tip series, like, I was trying to, like, just fish for like, so they could explain what helped them. And they said the same thing. You said, No, I've heard those. They're good. I knew all that already. And I said, What do you get out of this? And she said, I don't even really know. Maybe accountability to myself, like, you know, and so now I've heard people say accountability. I've heard them say community. I've heard them say hey. Once in a while somebody says something like, you just said, like hell, I never thought of that before. I don't even care anymore. People

Melissa 1:22:59
are so full of good ideas, and I hate the internet, I hate Facebook, and I hate how people want to and I feel like, sometimes I'll say something really mild, and people will react really strongly, and then I get this bad feeling in me, and I'm like, why am I on this platform? You just gave me a bad feeling. Let

Speaker 1 1:23:15
me tell you what I told somebody the other night. They asked me. They said, How are you so the way you are online, where you don't fight with people, and even when they're being crappy, you're not crappy back and all this stuff. And I said, I said, what I said, but overall, I just always assume that if we're arguing, we're misunderstanding each other. Because I've met a lot of people, and people don't argue like that in person, and it's fun to say, like, oh, yeah, sure, because they're keyboard warriors. I'm like, I don't even know that that's it. Like, maybe they're just taking you out of context or incorrectly, or maybe you're not saying something

Melissa 1:23:49
about being on the internet that just like, makes you forget that, like the person is like a human and like a complicated human. And it just, yeah, very well. Could be it sort of frees up your darker side to like, to like, come out. I'm

Speaker 1 1:24:03
not saying that's not true, but I'm saying the rest of it is, is that if we got together in a room and you heard me, you might go, Oh, that's not what I thought they were saying. And then you wouldn't say the crappy thing back that you said, and then I wouldn't say the crappy thing that you know, back to you. And then we wouldn't be fighting. We'd actually realize, like, we get along pretty much. I think the whole world's

Melissa 1:24:23
screwed that way. I agree. Yeah, it definitely isn't just like a diabetes No, it's not a diabetes thing. It's far from it. I mean, comparatively, diabetes groups get along pretty well. Melissa,

Speaker 1 1:24:35
I had this experience in the last like, year and a half where I'll just go through this very quickly. But my family bought me a chameleon out like a surprise gift, and I didn't really know what I was doing with it. And I did know enough to know that they're very delicate, and that if I do something wrong, it's not going to be alive very long. I needed to figure out very quickly what to do. And then one day, I thought, well, there must be someone out there doing for chameleon care. What I do about diabetes, I'll go find that person. And I found a number of them, and I honed it down to one or two people. Found this guy running a niche but large community for chameleon keepers, and I dove in, took his information, put it into practice, just like that. I had a chameleon, a 1c in the fives, and I was like, Oh, awesome. Like, and I was kind of done. I was like, All right, I don't really need this anymore. But I hung in for a while, and I kept watching, and then I realized that every hardship he has running his chameleon community is exactly the same hardships I have running a diabetes community. And I was like, Oh, this has nothing to do with diabetes or chameleons or it's just people, right? People are the worst. No, it's a limitation of discussing things in writing.

Melissa 1:25:47
Yeah, yeah. I mean, that is a huge part of it. I mean, this is gonna, this is gonna sound pretty hippy dippy, but I feel like there's like a, like a spiritual sickness that's sort of like come down on us as a society, that that makes us feel, like, less connected. I just

Speaker 1 1:26:02
think we're all misunderstanding each other just enough to fight that's it, because I know

Melissa 1:26:07
some pretty fundamental differences. Well, sure, yeah, there's always

Speaker 1 1:26:11
going to be like, Yeah, but still, like, I grew up, my parents had friends who had completely different political views, and, like fundamentally different political views. I never once heard them fight about it or argue about it. They didn't talk about each other behind their backs like nothing. There

Melissa 1:26:27
are some people in particular who are very invested in sewing such divides and turning them really, you know, sometimes violent. And, you know, I find that very concerning. I

Speaker 1 1:26:39
would tell you that what I see is that it's become, it's always been a business to divide people, right? Because you divide them, you put them on your team. Now you're on their team, except, like, it's a, it's a tale as old as time, but it's so much easier digitally. And I agree with you. There are people who are like, I'll just say a thing to get everybody fighting. And then I think people do it with eating online, yeah, like, I think they'll, they'll come on and they'll like, they'll start a fight about whatever to draw attention to it so that the other people who would be mad at it go, oh, look, I found an ally. And I know who to hate. This is awesome. And then they, the people who think they're an ally, will go over there, and then they build up their Facebook group or their coaching service, or whatever it is, they're trying to, like, pump up, right? And I just have an opposite opinion of it. I'm like, Yeah, I think we can all get along and still do what we need to do and share with each other, and I don't need to steal you from someone. Like, if you want to go to another Facebook group out of my Facebook, you should go, yeah. Like, in the beginning, like, people were like, hey, you know, they posted another thing in there. I'm like, that's fine. If that helps them, then that's awesome. Now, if it's their group and they're pimping it, that's not okay, yeah. But if it's a thing that they help, that they feel helped by, then they should share it. You know what I mean? Like, I'm not trying to keep people geo fenced, yeah? And in my space, like, I think they should, I hope they go out and find whatever it is that's best for them. Well, I

Melissa 1:28:02
was just, I find it very fascinating people's desire to, I mean, I understand why, why vegans have a desire to, like, get other people to go vegan. Because a lot of vegans are concerned about, like, animal welfare and about, you know, the environment and that sort of thing. And so I guess I can understand their need. For me, I feel like you can't influence people in that way, and so there's no point in trying. I don't have anything that makes me be like I need to. I actually don't even want people to know that I'm vegan. Usually, I'd rather just do it silently.

Speaker 1 1:28:33
I agree with you. I sort of believe that what happens is, is that people feel saved. Then once they feel saved, they want to share it, yeah, then when they share it with you and you don't want to be saved, then they're mad at you for not wanting to be saved. So

Melissa 1:28:45
I do find low carb people, like, will sometimes get super, I mean, it feels like they're like, super invested in this diet in a way that, like, I mean, I think it's great to eat fruit and vegetables, like, can, you know, like, have healthy food, you know? I mean, and I don't feel like that's like, a super big deal. And it also, like, doesn't bother me if you don't eat that way, like, I'm not if I, if I was bothered by that, I would be constantly bothered. You know, I would live a life of just being bothered. I

Speaker 1 1:29:12
don't think of it as low carb people. I think of it as, there are some people in that eat a low carb lifestyle who they proselytize about. And I can't, I can't guess why. Like, it's, I mean, I could guess why, but like, it's not, it's not up to me to figure.

Melissa 1:29:27
I don't understand why they're possible. Because I do understand why vegans do it. I don't agree with it, but I understand why they do it, or what are they getting. It doesn't matter to

Speaker 1 1:29:36
me, if you understand it. What I'm going to tell you is, like, I don't think there are as many of them as you think, I think it's always fringes, of fringes. I would never say low carb people, because I believe that probably 98% of the low car people I've met are lovely, just like 90. Just being quiet about it, yeah, just doing what works for them. Yeah. And then there's 2% of them that feel like and I've had people explain this to me right. From that perspective, I thought this. Saved my kid's life. When I tried to share it with somebody and they disagreed with me, it made me feel like they didn't care about their kid's life. And then that upset me. And then later, I realized there was more than one way to skin this cat, and I was just unaware to say more than one way to peel a potato. I was unaware of what that was. I just came up with that. I don't know. Yeah, I thought you made that up. They say, like, Look, I just thought that the thing that I knew was the only thing. It turns out it's not. But back then, when I thought it was, oh my gosh, I thought those people must be monsters for doing this to their children, right? Again, I don't think, except for the people who are trying to make business out of it, I don't think people are being on purpose almost ever. I

Melissa 1:30:44
agree what bothers me, I guess. I mean, doesn't even bother me that much. I don't want to sound overly bothered, because I'm not. I don't appreciate it when anybody like acts like there's just one way to do things like for me. I mean, I did try the low carb thing, and I was very unhappy eating that way because I love carbs and also, like, I don't know if this is just something that was, like, handed to me by the schools or something, but in my head, like, fruit is healthy to eat like that. That's like, how is race? I was like, we're not it's like, you eat like, you know, fruits and vegetables and like, I'm not gonna like, I'm like, I'm not gonna stop eating like, what to me, sounds like some of the most healthy foods, and also, like my favorite foods, I'm not gonna just, like, stop eating them because of the carb content. And I did try to do that, though, and it just that's just not for me. I just, I also like, it doesn't, it doesn't feel like it satisfies my hunger. Yeah, it's

Speaker 1 1:31:39
not right for you. That's cool, yeah, yeah. And so

Melissa 1:31:43
I'm just like, and also, again, I was using so much more insulin when I ate that way. It was like, I guess it made my insulin resistance really high to like, have I was eating, like, a lot of meat and cheese and just like, fatty foods, I guess. And what I find actually like. So there are studies about this, like, about post prandial blood sugars, or after meal blood sugars. If I eat just one high fat meal, just one then, even then my insulin will resistance will go up just just during that meal, which I think we all know that. We know that, like fat does that? It causes that to happen? Well,

Speaker 1 1:32:16
yeah, I mean, it doesn't work for you. I'm also sure that somebody would who eats low carb, but say, Oh, you're doing it wrong. You know what? I mean, like, who know i and that's all well and good. Like, I think that's, I genuinely don't care how people eat. I mean,

Melissa 1:32:27
this is the other thing, is that I just, I'm never gonna be somebody who can just stick to one thing, like, you can't tell me, like, you can never eat a banana again. You know? Like, and like, that's how not for you. When people tell you to eat low carb. I'm like, like, that would work great if you are good at eating low carb and like, not eating carbs, then eating low carb works like, exceedingly well for blood sugar control. But the problem is, is that your insulin resistance becomes very high, and so if you do, like, eat a banana one time, it's going to take like, five units of insulin or more. I don't know how much insulin, but for me, you know, like a banana is less than the unit of insulin because my insulin resistance is very low, because I'm eating very low fat.

Speaker 1 1:33:12
Was that resistance, or is it just that your settings are way dialed back now from low carb, and then you go to do something in your basal low carb. But you know what I mean, like, if somebody was very low carb and then all of a sudden went to a banana, I would think that their settings wouldn't be set up to handle that.

Melissa 1:33:27
To a large extent. I think that I still have, like, an MDI state of mind. So I'm just, like, I'm just talking about how much insulin you would give yourself to treat something. Yeah,

Speaker 1 1:33:35
you're calling it resistance. I just think that you'd need more insulin, but I don't know that that's resistance. I think

Melissa 1:33:40
if you ate a certain way, let's say you ate very low fat, and then you ate a banana, and it would only take one unit of insulin, but if you ate very low carb, you might eat a banana. That same person, it might take them five units of insulin or whatever. I'm just making up numbers, but it indicates an inability for insulin to take care of carbohydrates and glucose as well as it used to. But that doesn't mean that it's a bad way to eat, because if you're somebody who doesn't have to eat carbohydrates, like to feel good, or whatever, then low carb is, like amazing for your blood sugars. Like amazing, like, if you're somebody who who doesn't want to think about dosing or just finds either unable to think about dosing, then low carb is like incredible.

Speaker 1 1:34:26
I think it's a very reasonable way to manage if you have type one diabetes, for sure, for sure, you were awesome. You really were thank you for doing this with me. I really appreciate it. I appreciate you being in the group and sharing your perspectives and right it was great talking to you. Can you hold on one second for

Unknown Speaker 1:34:42
me? You the

Speaker 1 1:34:45
episode you just enjoyed was sponsored by the twist aid system, powered by tide pool if you want, a commercially available insulin pump with twist loop that offers unmatched personalization and precision for peace of mind. The. Want Twist, twist.com/juice, box. Having an easy to use, an accurate blood glucose meter is just one click away. Contour, next.com/juice box, that's right. Today's episode is sponsored by the contour next gen blood glucose meter. Arden has been getting her diabetes supplies from us med for three years. You can as well us med.com/juice, box or call 888-721-1514, my thanks to us med for sponsoring this episode and for being long time sponsors of the juice box podcast. There are links in the show notes and links at Juicebox podcast.com. To us, med and all of the sponsors. Hey, thanks for listening all the way to the end. I really appreciate your loyalty and listenership. 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, you.

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Ali went from pork insulin to cutting‑edge looping and shows—with effortless chill—that life with diabetes really can be OK.

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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.

Speaker 1 0:00
Hello friends, and welcome back to another episode of The Juicebox Podcast.

Speaker 1 0:15
Ally is Australian. She's 52 years old, and she's here today to tell you that it's going to be okay. 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 healthcare plan or becoming bold with insulin. AG, one is offering my listeners a free $76 gift. When you sign up, you'll get a welcome kit, a bottle of d3, k2, and five, free travel packs in your first box. So make sure you check out drink AG, one.com/juice box. To get this offer, don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code juice box at checkout. That's Juicebox at checkout to save 40% at cozy earth.com I created the diabetes variables series because I know that in type one diabetes management, the little things aren't that little, and they really add up. In this series, we'll break down everyday factors like stress, sleep, exercise and those other variables that impact your day more than you might think. Jenny Smith and I are going to get straight to the point with practical advice that you can trust to check out the diabetes variable series in your podcast player or at Juicebox podcast.com this episode of The Juicebox Podcast is sponsored by Medtronic diabetes and their mini med 780 G system designed to help ease the burden of diabetes management, imagine fewer worries about mis Bolus is or miscalculated carbs thanks to meal detection technology and automatic correction doses, learn more and get started today at Medtronic diabetes.com/juice box. Today's episode of The Juicebox Podcast is sponsored by the ever since 365 the one year where CGM that's one insertion a year. That's it. And here's a little bonus for you. How about there's no limit on how many friends and family you can share your data with with the ever since now, app no limits. Ever since, this episode of The Juicebox Podcast is brought to you by my favorite diabetes organization, touched by type one, please take a moment to learn more about them at touched by type one.org, on Facebook and Instagram. Touched by type one.org, check out their many programs, their annual conference awareness campaign, their D box program, dancing for diabetes. They have a dance program for local kids, a golf night and so much more touched by type one.org. You're looking to help, or you want to see people helping people with type one. You want touched by type one.org?

Ally 2:57
Hi, I'm Ali. I live in Australia, and I thought I'd like to come on the podcast, because I've had diabetes for a really long time, and I have had an excellent life so far, and plan to continue having an excellent life. And I just thought that might be reassuring to some of the newly diagnosed mums and dads of little kids who are really worried and panicky.

Speaker 1 3:21
That's awesome. Thank you. I appreciate you doing that. Where do you get the feeling that they're worried and panicky?

Ally 3:27
Oh, your Facebook group. Hello.

Speaker 1 3:31
So interesting. I watched this conversation happen half a dozen times a year, right? Yep, a post will start with a group of adults who are just like, my god, you guys are going crazy, like they're gonna be okay. And I'm always like, Yeah, you don't know that you're just okay.

Ally 3:48
True, true. That is, that is correct, yeah,

Speaker 1 3:52
yeah. But tell me how it I'm genuinely interested. How does it make you feel knowing that you had a good life and seeing them worry about it going opposite.

Ally 4:05
It really worries me. I think these poor little kids, they're not going to have the same freedom and just a normal life that I did. Why do you think that? Well, I was basically left to my own devices and had a wonderful time.

Speaker 1 4:26
So in fairness, Ali, because your experience ended well, yeah, you're afraid that people who don't have your experience will end poorly.

Ally 4:36
No, I think they will be very safe and well cared for and possibly have far more delightful glucose than I managed. Okay, but it's the whole, you know, over protected, over helicopter

Speaker 1 4:53
parent thing. I'm playing devil's advocate. I'm going to go back and forth here on this one a little bit. Okay, yeah, yeah, sure. Do you imagine that? People who grew up that there's no one who grew up with somebody paying very close attention to their health that also felt free. I

Ally 5:10
knew some people growing up, and I don't think they had the same experience I did, and I know some people growing up that probably had a very similar experience that I did, yeah, and I kind of know who's got the better mental health.

Speaker 1 5:27
Okay, good point. If you were unwell physically right now, would you still be making this argument? If you had trigger finger and frozen shoulder and neuropathy. Would you be on here? What would you say? Then? Do you think?

Ally 5:45
I don't know. I think I would be in quite a different space. Yeah, no, I know, yeah, yeah. And that. I get it. I get it. People want the best for their kids and the best for themselves, but at what price?

Speaker 1 6:01
I don't know. What's the answer, yeah, that's the question. I

Ally 6:04
don't I don't think there is, I don't think there is one to be honest, I know I have been lucky.

Speaker 1 6:10
That's genuinely how you feel, that you've maybe just lucked out a little,

Ally 6:14
yeah, really. But also, I can say confidently that my control was never awful.

Speaker 1 6:22
Why? How did you accomplish it? First of all, how old were you when you're diagnosed? I was five, five, and you told me before we started, you're 52 so yeah, 47

Ally 6:31
years. Yeah, coming up. 47 years. Good for you. Yeah.

Speaker 1 6:35
And back then, obviously, well, not even obviously, were you even beef and pork? Pork, pork. Insulin. Okay, and so you've transitioned through you've seen a lot of it, that's for sure. Oh yeah, yeah. What was your parents reaction? Do you know? Have you spoken to them in hindsight? Like, how did they manage? What did they think to do?

Ally 6:56
Oh yeah. My mom diagnosed me. She was not shocked and horrified. She was like, Oh, great. Think the kids got diabetes. Terrific. Here. Pee in this clean glass jar and we'll take it to the GP.

Speaker 1 7:10
Why was she so comfortable around it? Other people in the family

Ally 7:15
have it? No, she's just not a Panicker. None of us are. So, you know, just a few signs, and it was when I I never got sick, I guess I started losing a little bit of weight, and she went, Ah, that's abnormal for this kid. Yeah, drinking and peeing, yeah, kids got diabetes. How

Speaker 1 7:33
many brothers and sisters do you have just me? No kidding. Well, you don't usually. So this is interesting. So your mom is? Your mom is your mom still with us? Yeah, she's fighting fit. What did you wait? What did you say? She is fighting fit, fighting fit. Gotcha, okay, yeah, yeah, you don't normally see the mother of an only child. Be so chill.

Ally 7:55
Yeah. I don't know why she is, but she is, always has been. It's

Scott Benner 7:59
not weed, is it? No, she wasn't a hippie. No. She

Ally 8:04
spent the better part of the 70s trying to get stoned, and it just doesn't work for it.

Speaker 2 8:10
How many times did she try? Oh, quite a few.

Ally 8:15
And then it was only she. She eventually tried a water Bong, and that worked. And all of a sudden, tomato and cheese sandwiches the most hysterical concept ever.

Speaker 1 8:28
That's what I'm saying. Was your mom, like a free spirit, yeah, yeah. How about your father?

Ally 8:33
Less so, less so free spirit, but very chill. Okay, you know, you never let anybody see you're panicking.

Speaker 1 8:41
Do you think that it's more just your mom's but Well, first of all, let me ask this, are you chill like that? Like, what's your Yeah, yeah, you more like her, more like him.

Ally 8:51
Oh, look, people say we're clones, my mom and I, but my brain works probably a little more like my dad.

Speaker 1 9:00
Okay, who had control of the diabetes? Like was there? Was it both of them or one of them? Do you remember from being a kid? Today's episode is sponsored by a long term CGM. It's going to help you to stay on top of your glucose readings, the ever since 365 I'm talking, of course, about the world's first and only CGM that lasts for one year, one year, one CGM. Are you tired of those other CGMS, the ones that give you all those problems that you didn't expect, knocking them off, false alerts not lasting as long as they're supposed to. If you're tired of those constant frustrations, use my link ever since cgm.com/juicebox, to learn more about the ever since 365 some of you may be able to experience the ever since 365 for as low as $199 for a full year at my link, you'll find those details and can learn about eligibility ever since cgm.com/juice box, check it out. Music. Today's episode is sponsored by Medtronic diabetes, who is making life with diabetes easier with the mini med 780 G system. The mini med 780 G automated insulin delivery system, anticipates, adjusts and corrects every five minutes. Real world results show people achieving up to 80% time and range with recommended settings without increasing lows. But of course, Individual results may vary. The 780 G works around the clock, so you can focus on what matters. Have you heard about Medtronic extended infusion set? It's the first and only infusion set labeled for up to a seven day wear. This feature is repeatedly asked for, and Medtronic has delivered. 97% of people using the 780 G reported that they could manage their diabetes without major disruptions of sleep. They felt more free to eat what they wanted, and they felt less stress with fewer alarms and alerts you can't beat that learn more about how you can spend less time and effort managing your diabetes by visiting Medtronic diabetes.com/juicebox

Ally 11:06
mom spent the most time with me in in the hospital, learning, obviously, but dad, you know, visited and everything. But the Children's Hospital where I was admitted for education was two and a half hours away from where we lived, so he had to work. And so, yeah, mom did, I guess, most of the learning and education, but day to day, yeah, day to day, day to day, we just, well, I was learning as well. So we counted the carbs and did the injections and peed in the test tubes. And, yeah,

Speaker 1 11:38
that was it. And so, so for people that, how do you manage now? Like, what do you do today? Closed

Ally 11:43
loop. It's a commercial closed loop. I'd actually prefer to use DIY, but the only real option we have is Omnipod, and they don't work

Speaker 1 11:55
for me. Okay, so you're not good, was it? Maybe you think the infusion doesn't work fuel it,

Ally 12:00
yeah, just eat dribbles down my leg or, um,

Scott Benner 12:05
yeah. So I don't think that's the way you want to put that. Allie,

Ally 12:10
okay, fine. There is some leakage of insulin around the infusion site.

Speaker 1 12:16
It's Monday morning, it's early, and where you are is late. I was like, Wait, what is she saying?

Unknown Speaker 12:21
Yeah. Okay,

Speaker 1 12:25
fine. So, you know, you know, modern management and so you have a real, that's my point. Is that you have a real, like feeling for how it's been over the last 50 years, really, yeah, yeah,

Ally 12:34
okay. And I use the latest and greatest now. Well, in Australia, you know the latest and greatest we have access to. I use cam APS at the moment. And look, it's not the best fit for me, but it'll do for now. Okay.

Speaker 1 12:50
How did you go from being like chill to using a closed loop system? What's the progression through that? Like, if you my point, I guess is that if your health was not an issue growing up and your diabetes didn't feel like an issue, like, why did you continue to like, why didn't you just keep doing what you were doing? I guess is my question.

Ally 13:11
Oh, well, because that would be one shot a day of monetard. I didn't

Scott Benner 13:16
mean that far back. I mean,

Ally 13:21
okay, so yeah, I Yeah. I think I needed a little more flexibility as time went on. I only started MDI when I was just about finished university for the first time, and that was because I just needed a little more flexibility in exercise, food, that sort of thing. I needed even more flexibility and fewer 3am hypos. A few years later, I've never gotten along particularly well with long acting. I don't have a huge basal requirement between about, you know, 3am and 6am and that's hypo city a lot for me, and so I, I progressed to a dumb pump, as one does in the early in the late 1990s right? There wasn't a whole lot of technology. But, yeah, I've been using a pump since 9999

Scott Benner 14:14
Wow, are you pretty early on. Then, yeah, you jump. Then

Ally 14:17
reasonably, okay, yeah, I just wanted some sleep. I was like, I need to turn my freaking basal down and get some sleep. So

Speaker 1 14:26
describe to me, like, once you go to MDI, Oh, is there a lot of hypos? Yep. A lot of management, lot of fiddling, yep, okay,

Ally 14:36
lot of fiddling, which I was happy to do. You know, I was okay with fiddling. And I already knew carb counting, because I grew up with the portion system, which was, you know, you have 30 grams for breakfast, and which is three portions and 20 grams for a snack, and then another 30 grams for a lunch, and, you know, that sort of thing. So carb counting was. And unfamiliar to me. A bit of fiddling, okay, and I always preferred to be low than high, so hypos were always a thing.

Speaker 2 15:09
Okay, where did you come up with that plan? I just feel better. You feel better. Okay, yeah, so you went with how you feel. I do not feel good. High. Never have no, I wouldn't expect you to but was the doctor telling you to do that, or that? Was you on your own? That was on my own. What were the doctors telling you?

Unknown Speaker 15:28
Oh, not a great deal to be honest.

Speaker 1 15:30
Okay, sorry, I apologize. Yeah, no, I know, not

Ally 15:34
a great deal like I'm also perhaps someone that doesn't do well being told what to do.

Speaker 2 15:41
Why is that just a personality? Yeah,

Unknown Speaker 15:45
character four. I guess it's a character. Are

Speaker 1 15:51
your parents like that? Too? Little bit? Yeah, okay, do you think it's a little bit about being an only child? I was only child for five years. It was awesome. Yeah? Yeah, yeah, yeah. You really are accustomed to things going the way you expect them to.

Ally 16:03
Yeah, yeah. And then, you know, somebody giving you instructions, and you're like, how about I just work through that and see what actually works now,

Speaker 1 16:13
did you need instruction? How were you doing? Like, I know I feel like we're jumping around a little bit, but like, let's take you to like, your earliest remembrances of a one CS and how they went through the years. Never

Ally 16:26
particularly awful. Like, I think, you know, eight I'm sorry

Speaker 1 16:30
I'm laughing because I think on my 50th wedding, wedding anniversary, I'm going to give my wife a photo book that on the front says, never particularly awful. What a lovely description you're like, it was never particularly awful. So around an eight,

Ally 16:48
yeah, around an eight. And then on MDI, it was sort of low sevens, but a lot of lows,

Speaker 1 16:53
yeah, yeah, quite a few lows. Do you remember the transition back then to to multiple daily injections? I'm trying to understand if this problem of the technology changes and the doctors can't change quickly enough to explain it to you, I think it just probably has been there through every iteration. Yeah, yeah. I mean, how difficult was that? Do you remember it like going from like, one or two shots a day to all of a sudden people telling you, like, you know you're gonna shoot this basal insulin every 24 hours, you're going to cover all your carbs with this other one. Like, oh,

Ally 17:24
I remember it very clearly. Go ahead, yeah, I chose to do that. I went to an endo and said, I need to change this up clearly. You know, this is old technology, the long acting alone with a little bit of fast acting to start with. This is, this is old school. Yeah, I've been doing okay on it, but I think I need to embrace the more modern treatment. The end I went, Yeah, Phil, try this. Did you

Speaker 1 17:54
have your mom's water Bong? Why was he so chill? I don't know, yeah, how did you hear about it back then, like, back then, how did you say to yourself, Oh, I know there's a better way. I've heard about

Ally 18:06
it. Oh, because most of my friends were already. MDI,

Scott Benner 18:10
okay, you

Ally 18:12
had other type one friends. Yeah, I just thought, oh, I don't really need that yet. I don't need that yet. I'm doing okay, yeah, maybe I need that now, how

Speaker 1 18:21
many people did you know with type one when you were growing up?

Ally 18:24
Oh, lots. Really? Yeah, because, well, when I was little, you got chucked into kids camp for a week every year, and you made all sorts of buddies. I don't know

Speaker 1 18:35
if I'm maybe not going to call your episode chucked into kids camp. That's where you made your friend. Okay, so there was, I was

Unknown Speaker 18:40
I was six. The first year I went six,

Speaker 2 18:42
yeah, oh, they sent you right away. Yeah, okay, yeah, all right, not

Ally 18:47
the first year. They thought that might be a bit soon. That would have been like a month after diagnosis or so, okay, so

Speaker 1 18:53
everything you would eventually know about diabetes, you guys would just trade that information amongst yourselves. Yeah. Okay, so they're over their fancy MDI, and you're like, I don't need this. But then one day,

Ally 19:05
yeah, I thought, Yeah, I kind of do okay, because I made that decision, and I presented myself to the end though with, you know, this is what I think I need to do. And he was like, yeah, cool, yeah. Try this insulin. So

Speaker 1 19:21
you get a lower a, 1c from MDI, but you're fighting more lows and then, yeah,

Ally 19:25
yeah, and they were bad. They were bad. And it was the I changed to long acting called Ultra lente, and that just about killed me.

Scott Benner 19:37
What year do you think that was? How well do were you? I can

Ally 19:40
tell you exactly the year it was 1995 Yeah, probably going into 1996

Speaker 1 19:48
thinking about my friend Mike, and how he struggled when they moved him from two shots a day to to that he never could. He just never could figure it out, you know, yeah, why do. You think, is it because you have the idea in your head about how you used to do it, and you're trying to apply that to a new system or,

Ally 20:06
Oh no, it was actually the long acting. Oh, it was the long acting just really did not work for me. I think it was longer than 24 hours, and then it it kind of stacked.

Speaker 1 20:21
Okay, so you felt like you were stacking basal, like every 24 hours. Yeah, okay, so you'd get low I'm sorry. You'd get lows around your injection time for basal. No,

Ally 20:30
anytime, anything, anytime. Yeah, they were bad. They were severe. I've never been hyper unaware, apart from a couple of months shortly after, I switched to MDI, and I was scared, yeah, I was like, This is bad. How

Scott Benner 20:46
old are you then? Are you living by yourself? Yeah,

Ally 20:48
yeah, oh, yes. I was yes, okay, yeah, I was 2425 Are

Scott Benner 20:55
you married now? No, no. So have you lived by yourself the entire time? No,

Ally 21:01
no, I've, I've never been in a long term relationship. I'm not very good at those. But, yeah, I've, I've had flat mates and lived with my best friend off and on for, you know, okay, quite a few years here and there in

Speaker 1 21:16
a couple sentences. Why are you not good at long term relationships? Oh,

Ally 21:20
don't really have a long, terribly long attention span. You're not a supportive partner, not not at all. I realized that pretty early on. Have

Speaker 1 21:33
you ever, I'm sorry, I'm gonna pivot here for a second. Have you ever been with someone that you wanted to be attentive with but just couldn't be? Not really. No, no. Do you think if you found a different, I don't want to say the right person, because it sounds like we're making a rom com, but if you found the right person, do you think it would change, or do you think it wouldn't? Probably not. Okay. All right, probably not. Do you think that's because you're an only child to some degree, a

Ally 22:00
little bit and little bit of little bit of ADHD maybe, you know, yeah,

Speaker 1 22:07
I got you don't worry. Your parents together the whole time. Yeah, yeah, okay. You didn't want to mimic that. You didn't say, like, Oh, that's nice to do that. No,

Ally 22:17
no. And you know what, I think in some ways, my mum would have preferred my sort of life rather than motherhood and marriage. In a way,

Speaker 1 22:29
you think you've gotten a vibe from her that she didn't want to be a mom.

Ally 22:33
She enjoyed motherhood in some ways, but in other ways, she's very she was very pleased when I grew up and moved out.

Speaker 1 22:42
Your dad's crying. Your mom's like, goodbye, goodbye. Oh, I

Ally 22:47
can tell you a funny. I can tell you an absolute funny. I finished school very early, as did my best friend. We were 16 when we finished school, just because that's how it works in our state. At that time, we were both young for our school year, and I turned 17 shortly after I finished school, and she was still 16, she got a job working for the post office, and needed to move to the city, and our collective parents thought it would be a good idea if I got a job in the city. I was working in the country at the time, and they thought, well, you know, it'd be really good idea if, if Ali got a job in the city and moved into fees, flat fees, my best friend and they could share expenses and, you know, look after each other to a degree. I thought, oh, yeah, cool. Yep. And so I applied for jobs in the city, you know, minimum wage kind of laboratory work I was mostly doing then, and I got a job, and I got off the phone having received this job offer, to tell my mom and dad that I got this job, and, yeah, wasn't it fantastic? The next thing I know, I'm in the back of the family car with doonas and pillows being thrown in on top of me, and we're cheering and off to the city. You

Speaker 1 24:14
got off the phone, I was gonna say, You got off the phone. Your mom had already found a bag and was putting stuff in it

Ally 24:19
pretty much, yes, it's leaving

Scott Benner 24:22
honey. Look, yeah,

Ally 24:27
but I mean, she says she was really excited for me, and because I think she'd wanted that sort of adventure.

Speaker 1 24:34
Oh, okay, you were getting what she wanted. Yeah, you

Ally 24:38
know, you know she she had because when she grew up, she had certain expectations. Okay, yeah, did

Speaker 1 24:47
your dad? I don't want to be crass, but did your dad knock her up when they were young, or something? No, no.

Ally 24:53
Okay. I don't think mom ever really intended to get married, but Well, my father was. Quite nice, and she decided that they could go overseas after they'd finished uni or teaching for a while or something. And he said, Oh, I thought maybe we could get married. And she said, Oh yeah, okay, fine. They got married and went overseas. Aren't people

Speaker 1 25:17
funny? Like, you know, like Boys, boys are like that, one's pretty, and girls are like that. One's Nice. That's good, pleasant. Yeah,

Unknown Speaker 25:28
he's a lovely chap.

Speaker 1 25:30
Is he doesn't care too much about football. No, see, that's what she told that's what she liked, that

Ally 25:36
that was the thing. That was the thing. He didn't care about football at

Speaker 1 25:41
time it time to look, talk to her and do things. Yeah, she's like, okay, that makes sense. Okay, so, okay. So hilarious. I love hearing about people's lives, although, um, it makes me sad when you're talking about the MDI and the lows, because it really does make me feel it does. It really does make me think about Mike, and it's so interesting just to hear you have, like, a good role, and back to it being lucky and then, and for some people, it just doesn't go well, like, yeah. So I think that's what stuck in people's minds when they're parenting, right? Like, is, yeah. Like, your mom, listen, your mom had the luxury of ignorance, meaning that they didn't really know a ton about this. You were, you know, shoot this in the morning and the night, you know, 30 carbs here, 30 here, you know, look, look, she's still alive. We're doing it like that. Was it? Yeah, yeah. And,

Ally 26:29
look, I was pretty self caring pretty early. I didn't want a whole lot of input from them. Do you

Speaker 1 26:36
think if you were counting carbs, changing CGM and setting up algorithms.

Ally 26:42
It would be different. Yeah, it would be different and more difficult. But you know what, I'd still probably want to have a bit more autonomy over things, then maybe some kids are allowed, I don't know.

Speaker 1 26:56
See I appreciate your story and others like it that I've heard, and I think it's awesome like that. It went that way for you. But I think it's after speaking to so many people, like, there's a mix of things that I don't even know, that people appreciate while they're living in it, right? Like your personality, your mom's personality, your physiology, how you, you know how you I don't know handled being low that you didn't you weren't scared to go off by yourself, like all those things that make you you turn this out this way?

Ally 27:25
Yeah, they're not typical of everybody. Are they exactly right? And

Speaker 1 27:29
so then what do you do when your kid's six, and now you have all this data, and you understand exactly what's going on and what could happen, and you think, Well, I'm going to try to set this person up for the best possible outcome, yeah? But then the other side of it ends up being the part that you're that you're also talking about, which is just sort of like the Yeah, mental

Ally 27:52
side. Can't stay overnight anywhere, right by the kid's self, you know, kid can't go in school camp. Yeah, right.

Speaker 1 27:59
Can't do it well, any Well, yeah. And then then I think it feels like your actions are the reason things are okay. Tarzan is a, is a, is an interesting story. They, uh, dropped that kid in the jungle and it was still alive. Yeah, you start getting into that feeling of like, well, I did this, and things are okay, so I'm keeping things going right? Like, I think that's the fallacy, you know what? I mean, yeah,

Ally 28:24
yeah, yeah. I mean they're just back then there just wasn't that option to to have that much worry about things, because we're talking no finger sticks for the first couple of years. Yeah,

Speaker 2 28:37
you wouldn't have even known what to be worried about. No, we didn't know, and it worked out for you. Yeah, yeah. That's awesome, by the way, congratulations. That's very cool.

Ally 28:49
I could also tell what my glucose was fairly easily. And I know,

Speaker 1 28:54
wait a minute, not one of those, you think you know what your blood sugar is by how you feel. Well,

Ally 28:59
it kind of worked out. Yep, it kind of worked out. We had competitions at the kids camps about who could guess their glucose the closest. Okay, before finger sticking right, and it was to try and convince us that it didn't work. Guessing didn't work.

Scott Benner 29:17
You kept getting it right. Oh, I won

Ally 29:20
so many bottles of freaking shampoo because that was the price

Speaker 1 29:25
ally, you know, they would have given you that shampoo anyway, right? Like, they didn't want you dirt. No,

Ally 29:30
I had, I'd like, six bottles of it, and I'm like, do you want to share it around guys? You know?

Speaker 1 29:35
Hey, listen, I made my living in school on stuff like that. So, like, the teachers would say things like, I once passed an entire half of a year of science because I knew the first Mickey Mouse movie was called Steamboat Willie, because the teacher had thought that they had this piece of like, inane trivia that nobody would know. And he makes this big pronouncement if anybody knows. Was the name of the first Mickey Mouse movie. I'll give you 100 extra points, and then you could use those points in the way you wanted. So what I would do is I would get a bad grade on a on a test, and then move some of my extra points over, or not, do my homework, and then move over the but so I worked, like, like, those extra points were a savings account for me, and, you know, so he's trying to be like, funny. Like, you know, I'll tell the kids something they don't know. But it worked. I popped my hand up, and I was like, steamboat, Willie. And he looked at me like, Hey, what the so I took my points. I walked up to the boat, I walked up to his book, and I was like, I want to see him. Put him in there, and he put them all in and I lived off them for the last half of the year, perfect. Yeah, I didn't just that rest of that year, but I see what you're saying. Like, you Yeah, they're trying to Yeah. They

Ally 30:49
were trying to prove the opposite. And I'm like, it actually kind of works for quite a few of us. You know, some people

Speaker 1 30:55
can tell you, think, yeah, at least you could. Does that still bear out? Now, can you still, Oh, yeah. Like, if I said to you, right now, what's your blood sugar, you think you would know it? Yeah, no kidding, all

Ally 31:06
right. Well, yeah, yeah, I can tell if I get above, you know, 910, millimol, okay, without looking, I mean, because, you know, obviously one uses CGM now, but yeah, and I pick lows coming on pretty early, earlier than CGM does.

Speaker 1 31:23
We're adjusting Arden's insulin right now. I She's doing something. She's using ovacetol Every day. Oh, okay, just a supplement that helps people with like PCOS and women with insulin resistance, stuff like that. And so she'd been using it for a while. It was really helping her, but then they just got away from her. And I got her back home, and I was like, Look, I really think this is a thing you're missing. So as she's been back on it now, she's not micro dosing a GLP, but she's, we're underdosing it, meaning she doesn't get the whole pin once a week. And then this, this ovacet Every day, her insulin sensitivity. I just moved it last night to 110 one unit moves, or 110 Yep. That number had been like in the early like maybe 43 at one point, yeah. And now it's 110 her basal rates are down almost a half a unit an hour. So she clearly has implications from from, you know, from hormones or PCOS or

Ally 32:32
something, yeah, yeah. And she's a young, fertile woman. She is,

Speaker 1 32:36
I assume, yeah. Well, the two of us together, we're adjusting our insulin down and down and down. And so we did it again last night, and we did it after the meal, right? So I guess we all expected her to get a little low still after the meal. But to your point, I'm leaning on the counter doing something in the kitchen. She walks over, opens up a candy dish, takes out a piece of candy, starts eating it. I don't really think anything of it. And I swear to you, 10 seconds later, beep, beep, beep, beep, beep, she talks to her phone, and she goes, I know that's why I'm getting the candy. And so, yeah, yeah. So she felt it before the CGM did, yeah,

Ally 33:16
yeah. Shut up. I know I've dealt with it. That is something we all say, I

Speaker 1 33:23
got it. I got it. The timing was just so perfect, because she had just kind of put the candy in her mouth, then it beeped, and she was like, Oh my God. I think she felt good about it. I think she felt like, Yeah, I'm ahead of this. Yeah, you know. But you had that thought done, Yep, yeah. What's the best thing that's happened to you about diabetes management wise, like, what's been the single most impactful thing looping 100% more so than just getting a CGM, they basically

Ally 33:51
went together. I didn't I wasn't particularly interested in CGM when I had to have alerts and alarms. I don't like them. I don't need them. They irritate the crap out of me. So when libre came to Australia, I was like, Oh no, noises. Let me add it. So I got a libre and loved it. And then I decided to use spike, you know the DIY app for iPhone. I remember that, yeah, to read the libre with. I think I had a blue con to put over it, or something like that, or a meow, meow,

Speaker 1 34:33
Alex, let's tell people what we're talking about, just in case it gets away from so when the first libre came out, you had to scan it to get the number. It wasn't giving you a constant number on your phone. No, as a matter of fact, they were calling it a CGM, and people were like, what's not continuous?

Ally 34:48
No, it's not a CGM flash glucose monitor.

Speaker 2 34:51
Yes, but that's what you liked about it. Yes, okay, it

Ally 34:55
didn't make noises, okay? And then I could have more or less continue. Was data if I scan. But I was just a little bit curious. I don't dislike tech at all. So I read about, I think it was a Facebook group or something, and I had a blue con. I thought, Well, I'll see what happens with this spike app. And in the spike app, there was some information about if looping into the following, you know, change the following bit of information. And I'm like, What the hell is looping?

Speaker 1 35:34
Okay? Just like that. That's where, just like your friend told you about MDI almost,

Ally 35:39
yeah, yeah. I was like, Well, I think I need to know more about this. That led me further down the loop pathway. I'm like, oh,

Speaker 1 35:48
oh, I love that. You went from I don't want this thing beeping to I think I could automate this entire system,

Unknown Speaker 35:54
yeah, yeah. And that that happened in about a week. Not a lot

Scott Benner 35:57
of conviction to that I don't want this thing beeping

Ally 36:01
not but I could turn all the alarms off, right? No, I know, yeah, I still didn't want to beep it. Okay, so I need night Scout, right? Let's set that up. Set that up in an afternoon. That was easy back then, it's not so much now, right? I'm gonna build this, build this loop app, and then I was working away at the time, I had a fly in, fly out job in a different state, and I flew home. And then I thought, I wonder if I've got one of these compatible pumps, one of these old pumps. And it turned out I'd had it in my bag the entire time anyway, because it was my backup pump. I had an old Medtronic, 754, okay? And I'm like, Oh, but I need a Riley link. So got a Riley link, and then we're all

Speaker 1 36:48
good. It's funny. I bet you, most people don't even know those words anymore. I know,

Ally 36:52
I know we're talking a while ago, but it's not that long ago. It's only six, seven years.

Speaker 1 36:58
Not at all, not at all, but yeah, but when the DIY systems first came out, you had a very specific couple of pumps that would work with it, and the pump couldn't actually talk to the app on your phone, so you had to have this link in between, which was this, just like a Raspberry Pi, like it's just a little and those are even probably words people barely know. But there was a thing you bought online from a guy he made them, and there was eventually a group of people making them, because there was a call for them, and they'd pump these things out to you, and it would let your phone talk to the link and the link to the pump and vice versa. Yeah, it's awesome. And

Ally 37:34
you know what I had dinner with, alas, just on Saturday night, and she's still using an orange link with her loop setup. The

Speaker 1 37:44
friend of yours is still doing it, yeah? Nice. It's nice that it works. Yeah, you know, yeah,

Ally 37:50
it does, yeah. And that, honestly, that was just like, that was mind blowing, and it put me in contact with people with a lot of knowledge and a lot of ideas and a lot of really good common sense, that was mind blowing.

Speaker 1 38:09
Yeah, it's wonderful. How many people are out there doing stuff like that? Yeah, really is I

Ally 38:14
didn't actually change my HBA 1c much by looping,

Speaker 1 38:17
because you were already doing pretty well, or because it wasn't working that way. Well,

Ally 38:22
I was already low, like, it was quite low. And, yeah, I was doing fine, but it made life easier, yeah, so much easier.

Scott Benner 38:32
Sleep, right? Sleeping overnight,

Ally 38:33
yeah, not having to, you know, think, Oh, crap. I, you know, forgot to Bolus for X, Y and Z, you know? Oh, look, you know, the algorithms actually taken pretty good care of that. And, yeah,

Speaker 1 38:47
yeah, no, I mean the difference between forgetting to Bolus on a, like, a dumb pump, like you said, or on an algorithm. Honestly, it's the difference between, like, a 202 20 blood sugar and a 400 blood sugar.

Ally 38:59
Yeah, yeah. It's pretty awesome. It's amazing. And I don't even get that high. I maybe get to 180 Yeah, maybe 200 I am fairly freakishly sensitive to insulin. You said Arden's was 110 Yeah, Yeah, mine's closer to 180

Speaker 1 39:18
Wow, yeah. Are you very tall? How much do you weigh? Like I

Ally 39:23
am a short, stocky little Muppet, yeah, but I'm also very active. And, yeah, I'm five foot, nothing, and you'd want pounds, wouldn't you? Maybe 150 pounds.

Speaker 1 39:38
Okay, Ali, can I call the episode active Muppet, yeah, why not? Okay,

Ally 39:44
like, you know, I, I mean, for instance, tonight, I finished work, went to two hours of ballet classes. Came home, ate dinner, and yeah,

Speaker 2 39:53
oh, you went your ballet classes. Yeah, that's a

Ally 39:57
couple of hours of ballet classes. I've got three tomorrow night. Three hours.

Speaker 1 40:00
You do it for the dancing or do it for the exercise? I honestly

Ally 40:04
it's for the exercise. Yeah, I'm not a ballerina, but I love the technical nature of it.

Speaker 1 40:11
Excellent. Now we're going to call the episode not a ballerina. Yeah, tell me you have a list here of you're talking about. Let me see what you said here, the disaster that is having type one and trying to access good general health care without people making dangerous assumptions that everything is related to your diabetes, hospital nightmares. What has gone on over the years?

Ally 40:31
Oh, well, I have actually been quite lucky in terms of that sort of thing, but I hear so many horror stories. For instance, young woman goes into hospital for an elective semi cosmetic thing, like a vein stripping. For instance, they take her pump off because that's policy, and don't replace it with anything. Oh, yeah, major public hospital is somebody

Speaker 2 41:03
you know this happened to, Yep, yeah, were they okay?

Ally 41:10
Yeah, she got out, but they wouldn't even bring her her pump

Speaker 1 41:14
back. So do you think they just didn't understand that she had type one? Yeah?

Ally 41:17
They don't. They don't. Once you hit 18, they don't get it,

Scott Benner 41:21
yeah, I guess so, right? Everybody's Yeah,

Unknown Speaker 41:25
oh, you're not eating, you'll be okay. And

Speaker 1 41:27
we don't want this pump on you, because it'll make you low because you're not eating, yeah, yeah.

Ally 41:31
I say they don't understand it. And there's no real sort of oversight in certainly in public hospitals, if you're going in for, say, orthopedic surgery, or, you know, gastrointestinal surgery, the endocrinology team doesn't necessarily get involved. Okay, really, yeah, yeah. They don't, you know, say, if it's a day surgery, oh, wait, in and out. Yeah, in and out, I think, but there's a lot people can stuff up in, you know, five, six hours, sure, you know, I could

Speaker 1 42:05
go wrong. Yeah, no, and, but you've been okay, like, have you been in the hospital and you've just managed it on your own or, yeah?

Ally 42:12
But the only situations I've had around, you know, injuries and orthopedic stuff, okay, I've been very, very healthy, you know, fairly blessed sort of life, yeah, but, yeah, I'm a bit injury pride, then I break things and need to have things put back together. Ali,

Speaker 1 42:35
is this a cry for help, or do you actually get hurt a lot? What's happening? No one's hurting

Ally 42:39
you, right? Martial arts, gymnastics, you know, no kidding, that sort of thing. It's awesome.

Speaker 1 42:44
You know what? You're making not being married sound really attractive to people. It's fantastic.

Unknown Speaker 42:54
It's the best farm. So,

Speaker 1 42:56
you know what I really want to, I'd like to, like talk to you about some more, is that everything you put on your list about that wanting to talk about is stuff that you're worried about for other people. Yeah, you're like, I'm okay,

Ally 43:10
yeah, I am. I legit am. I'm cool, yeah.

Speaker 1 43:14
So is it fair to say that, like your message to people is that try to let it be okay, yeah. And if it is, then great. And if it needs more attention, then give it more attention.

Ally 43:28
Yeah. A lot of people talk about fighting and being a warrior and all of that sort of stuff. I don't actually think diabetes works like that. You kind of got to go with it.

Speaker 1 43:40
I do agree. It's a lot about being flexible, yeah, not not fighting it, but like, yeah, being a part of just responding

Ally 43:48
to it. You know, it's sort of more like a dance than a fight.

Speaker 1 43:52
Yeah? If we're gonna go on with your analogy, I like the idea of it being a dance that you're leading.

Ally 43:59
Yeah, yes, yes. You gotta lead. You've got to tell it where to go. But if you're constantly uptight about it, well, you know that's going to shoot your cortisol up and, you know, mess with things. No, of course,

Speaker 1 44:13
you're not unfeeling for the idea that some people just have anxiety or are more kind of prone to worrying, but,

Ally 44:21
yeah, I don't understand it, but I get it. I mean, no, I don't get I get people are different, yeah?

Speaker 1 44:29
No, I listen. I'm right there with you. I try people. If you listen to this, you hear me. I'm trying very hard to understand that other people that are different than I am, yeah? But yeah, it's one that I have just a hard time wrapping my head around in my personal life, or, you know, here on the podcast, or anything like that. Just it sucks to have a thing impacting you that you don't want that's, you know, not a decision you made, but you also, you think you have a little ADHD,

Ally 44:52
oh yeah, yeah. Not diagnosed, not formally, but I've been repeatedly told. I've

Speaker 1 44:59
been repeated. Totally cold. Yeah. Do you have any other autoimmune issues besides type one? I have psoriatic

Ally 45:04
arthritis, probably off and on since childhood, but it really hit home when I was in my mid 30s. Where do you feel at the most? Hands and feet, mostly. But then, you know, I'll get focuses of, you know, a tendinopathy in the shoulder or something like that.

Scott Benner 45:23
It's a come and go, Yeah,

Ally 45:26
but it comes and it stays for months. It's troublesome. Needs steroid shots occasionally, which is, you know, bit of a disaster glucose wise. But, you know, it can be dealt with. I take biologics for it, which I think has kept me pretty comfortable and active. Which one I take xeljan. It's a Janus kinase inhibitor, yeah.

Speaker 1 45:51
How long you've been doing that? Probably 10 plus years. Okay? And if they're helping you, you haven't had to change meds or anything like that.

Ally 45:58
I have not. That's awesome. No, I'm pretty lucky, like the first one I tried, the first biologic I tried. I'm like, Oh, this is a miracle. Yep. Cool.

Speaker 1 46:06
So your wrists, hands, feet, like, ankles, like that, yep. And then sometimes your shoulder feels like, what shoulder or

Ally 46:16
hip or I've even had knee tendinopathy, which is weird. You know, how'd you get your diagnosis? I came back from a trip to South Africa on a flight, and I'd felt perfectly fine when I hopped on the flight, and when I went to disembark, I couldn't hold my suitcase. My hands were so fat and red and swollen, I thought, Oh, it must just be a reaction to the anti malarial tablets or, you know, whatever. But it didn't go away for months. And I was working in a fairly technical job at the time, and it was quite problematic. And so eventually I saw a rheumatologist, and he looked at my hands and went, Yeah, you've got psoriatic arthritis. Cheers. Take these. Wow,

Scott Benner 47:05
geez. How quickly did it take the medication to work?

Ally 47:08
Well, initially I didn't need a biologic. I just used a disease modifying anti rheumatic drugs, hydroxychloroquine and sulfasalazine, and got a fairly quick remission, so about two months, okay, yeah, and that, that was really good, and then I stayed pretty good for 10 years. And then I broke a finger and needed surgery, and that set everything off again. Do

Speaker 2 47:33
you get the psoriasis as well? No, no, no. Well, maybe,

Ally 47:38
maybe a little patch on my left elbow maybe. Okay, it's not convincing.

Scott Benner 47:45
Sorry. Do you get any fatigue from it?

Ally 47:48
Then I, I, you know, I get tired because I do far too many things and don't sleep that well, um, how long have

Speaker 1 47:57
you not been sleeping? Yeah, wait. Have you not slept well your whole life? Or is this like a perimenopause thing or not a good sleeper? Not a good sleeper. I'm such an awesome sleeper. I'm bragging. Now, I just close my eyes and I go right to sleep.

Ally 48:12
Oh, I wish. Oh yeah,

Speaker 1 48:16
I'm awake right now. Ally, I mean, I know it's late where you are, it's early where I am, right? And I'm awake now. I'm ready for the day. I'm fully, fully energized. I have no, no problem at all. If I lay down right now and thoughtfully tried to go to sleep, I could be asleep in four minutes. Oh, that's

Ally 48:33
irritating. I'm sorry. I know it is. No, no. It takes me an hour, you know, three chapters of a novel, some YouTube clips, three changes of position. Yeah, I

Speaker 1 48:44
know. I watched my wife try to go to sleep. Don't worry. Yeah, I'm just like, I know. I know it pisses her off, but I'm like, Look, I tried to sit up with you for a while, but this is it. Now. I'm going to sleep now. And I'm like, Yes, anywhere, anytime, just let me know where you need me to fall asleep. I'll fall asleep if you if you bet me money, I could probably fall asleep while driving, if I tried hard enough. Oh, oh dear, not like I would just pass out while driving. I'm just saying that if you said to me, Look, there was the opportunity. We'll catch the car. Nothing will happen. But go ahead, like, with the pressure of driving the car, like, could you fall asleep? I probably could. Oh, gosh, yeah, I wish. I'm so sorry for you. That sucks. I'm glad you found the the biologic zones, they're helping because, I mean, otherwise, even, like, early on, hydroxychloroquine, that's a great drug for Yeah, it was like this, yeah. So there's a couple, a couple of drugs that have been around a good long time that help with things like that, that are cheap and easy to get everything like that. Yeah,

Unknown Speaker 49:41
the biologics are not cheap.

Scott Benner 49:44
No, no, no, no,

Unknown Speaker 49:47
jump through, but yeah,

Speaker 1 49:49
how does the health care system there work? Like is that on you to pay for it? No.

Ally 49:53
If one's rheumatologist fills in the correct paperwork every six months or so. I. Just pay a normal prescription price, which is 30 Australian dollars per month. Awesome. Yeah, so it's but, yeah, we're pretty lucky. Here we we have so much access to insulin. It's not funny. I feel so sorry for your Americans with the health insurance and, you know, not getting things written out properly. So people are running short and, oh yeah, it's dreadful. It

Speaker 1 50:24
sucks, for sure, anybody who's impacted by it, it's just an extra struggle, an extra thing, an extra thing to worry about. And, like, I often wonder, like, when you see people worried about their kids, like that, if it's not part of that too, like, like, we got to take really good care of you and teach you what to do. Because, you know, you also have to learn how to, like, navigate the healthcare system, and you're gonna have to get a job with insurance and, you know, yep,

Ally 50:48
yep, everything, yeah, yeah, such a pressure. Yeah. I

Speaker 1 50:53
want to tell you I think that it's really great to hear you talk long form, because if you see the conversations that we started off talking about online, where somebody's like, look, you know, I just, like, trying to get across, like, just chill out a little bit. Someone's gonna be like, you know, like, go to hell. And then like, you know, like, you're gonna

Ally 51:13
get my precious, sacred little, little puppet, you know, needs my constant attention because they're special.

Speaker 1 51:19
It also doesn't help that you don't have kids and you're an only child when you're talking about

Unknown Speaker 51:28
it, what would I know your

Speaker 1 51:29
kids not that special, but the people listening are thinking, Well, yes, they are, and they're right. They are special. They're I know, yeah, but it's just an interesting like that conversation becomes very contentious. It's predictable by me, because I've seen it. I've seen it so many times and and I understand it from both perspectives, like I want adults to hear what the parents are saying, and I want the parents to hear what the adults are saying, because there's so much value in both of you being in the same group, like so many people, what do I get all the time? There's no adults in here. It's only parents. And I'm like, No, there's a lot of adults in here. They don't talk as much as the parents do. No, I right. And then, you know, when you hear someone come in and leave good advice behind, it's always valuable. Somebody eventually becomes flippant. If somebody eventually becomes flippant, that's not a good path. But I also think that there are plenty of adults who give their advice, and sometimes the parents want to be offended by it. I don't know, like that's a weird

Ally 52:37
way to say it, but their little puppet is sacred and precious. Wait, wait, well, you you

Speaker 1 52:42
feel like you're you're on the moral high ground. I guess while you're having the conversation like I'm just trying to protect the kid, yeah? Which is, yeah, not invalid. I'm not saying that. I also think it works backwards, back and forth, too, because I see a lot of adults who will say, There's nothing here for me. It's just parents talking, except there's a ton to take from that. Yeah, because you guys are older, you live through a different time. You don't have the same focuses, or maybe even the same understanding of it that somebody who's just been dropped into it does. And then on top of that, someone who's just been dropped into it that feels the pull of taking care of their kids, they might have a very specific understanding of something. And if you can get past the argument, like, though they're a kid and I'm an adult, so it's not the same. It is the same. It's how insulin works. Yeah, yeah, the advice is always the same. It works for anybody. You take the nature of insulin and the way diabetes is from someone else's perspective, listen to their perspective, and then try to see how much of it is valuable for you. And that works both ways.

Ally 53:45
Yeah, you know, yeah, because insulin is insulin, exactly.

Speaker 1 53:49
But everybody gets whole like not everybody. Actually, it's not everybody. It's hardly everybody. It's barely every anybody. It's but when it's a couple of voices in a conversation, it feels like everybody. I always try to remind people, like somebody said to me the other day, this group is whatever they say like this. And I say to them, there are 125 new posts every day in here, 8000 comments and likes every 24 hours, 57,000 people as of right now. You saw two people arguing, and you think this is a place where everybody's mean, I don't understand your your logic, like, isn't this a place where 57,000 people are nice and these two people are nudniks? Isn't that and isn't that great, you know? And by the way, too, Ally, those two people aren't even nudniks, because if you got them on the right day and talk to them the right way, like you'd realize they're nice people too, yeah, if

Ally 54:43
they'd had enough sleep because kid wasn't hypo in constantly overnight, yes, you know, yeah,

Speaker 1 54:49
right, right. If they had enough sleep, if it hadn't been a month since they had sex, if it hadn't been like, also, by the way, like as a moderator of a Facebook group, the thing. I hold in more often than not, is, like, you guys should just go get laid and come back. Everybody's got to Calm the down and, like, you know, like, just, just chill. Or, by the way, like, drink o'clock comes up and then everybody wants to talk about their stuff. I'm, like, not a drink o'clock. Don't do that. No, we'll start talking about diabetes with a beer in your hand, you're all going to be shitty. Like, like, just relax a little bit,

Ally 55:23
go and have a quick share, like, a bomb, come back, and they'll all be better,

Speaker 1 55:29
yeah, and you'll realize you know stuff that they don't know, and they know stuff that you don't know, and we'll all be okay. Like, seriously, I swear to you. Like, that's it. There's times that I put this some quote from an episode of mash, which is ridiculous, but it's this line in a TV show from the 70s where this guy, like he just sees everybody upset. They're all having a bad time. And he's a psychiatrist that comes in and out of the camp sometimes, and he stops, oh, yeah, yeah, Sydney, Sydney. And he stops on his way out one day, and he says, Ladies and Gentlemen, take my advice. Pull down your pants and slide on the ice, and then he just walks away. Right? I half completely understand what that means, and I half don't know what the hell he's talking about, but it's perfect advice while you're all upset, just go do the thing you do that chills you out right now. Why is arguing with each other the way to go? And again, I want to say for people listening, it is very infrequent. I've done a couple of things right in my lifetime. Not a ton. Not a ton. The way I have that Facebook group set up, I'm proud of it works really well. And there's going to be times like that. It that a couple of people fire shots and people and some people get caught by shrapnel. You know what I mean? Like, but like to to extend this Korean War metaphor for the most part, it's a really lovely place, yeah. And I just want to remind everybody that, if you're only seeing people arguing, the algorithm is feeding you what you're interested in Oh, so, yeah, that's it. Ali, have you ever heard people say, How did the algorithm figure out I was gay before I knew? Have you ever heard someone say that? Yeah. So there are. It's a phenomenon on the internet where people are shown by the algorithm that they have a tendency in one way or the other that they didn't even realize.

Ally 57:21
Well, I wondered about that a couple of years ago, I kept getting advertisements for lesbian or, you know, gender fluid trousers, and I'm like, they're horrible. I don't want those. They're really ugly trousers. Why would I want those? It turns out, I was involved in a project to make bag pipes out of carbon fiber tubing. It was a short lived project, but I was Googling a lot of tools,

Speaker 1 57:54
a lot of what Tell me again, tools, tools, like tools. Oh, my God. So you think the algorithm saw a female your age looking for, like, looking for tools, hand tools, and thought,

Ally 58:07
obviously, I need extremely ugly trousers. I want

Speaker 1 58:11
to say that some people probably think those trousers are lovely, but, um, but either, no, that's exactly what I'm talking about. Like, yeah, that algorithm figures out what you care about before you know it, what it is, and it makes assumptions that it can be wrong about as well. Like, don't get me wrong, right? But at the same time, if you're seeing a lot of people fighting online, that means that you are pausing, reading and interacting with people fighting online, and that's the algorithm telling you, whether you know it or not, you like this. You like the drama. I'll share this with you, yeah, very quietly, in case people are listening. Ali, okay, my wife's family are more comfortable when they're fighting, oh, and they're more comfortable when one of them is the bad guy? Oh, they pass the bad guy thing around, and they don't know it. Oh, they take it in turns. Yeah, they don't realize it, but they don't So, and it gets to be one of them for a while, yep. Then that's that's not fun anymore, or whatever, or it calms down, so they give it off to someone else, yeah. And then sometimes, sometimes they get lucky, and one of them actually does something shitty. And then, though they get it, they are the most comfortable when that is happening. If things, I will tell you this, it took me, if my wife heard me put it like this, she would definitely smack me in the head. But it took me decades to get this out of my wife, but she was more comfortable when there was a problem than when things were good. Oh, gosh, yeah, not terrible. The algorithm knows that about you, yeah? And it feeds you the three people that are arguing tonight in my group. And then you go, this place is just people arguing all the time. And I'm like, turns out you're just attracted to it. Yeah. Yeah, yeah, because I see the whole group alley, and the group is people being lovely to people all the time, yeah, with a couple of people arguing. So anyway, by the way, in my moderating style is getting to, it's starting to, like, slide into my parenting style, like last night,

Unknown Speaker 1:00:15
it's a big family. There's this

Speaker 1 1:00:17
lovely woman. I know she's lovely. I see How lovely she is, but she's going through something right now. Oh, okay, every time she gets into something, she gets offended and starts arguing and yelling at people. And I've tried to moderate anybody through it, but last night, puts up a post that could be just a regular, lovely post asking for advice, and then people give their advice, and then she yells at them and tells them they're wrong. And I'm like, Hey, don't go on the internet and ask people for advice, if what you want is for people to agree with you, okay? And yeah, you might have said something that they don't agree with. And these people, I read through everything they were they saw her as needing help. They gave really thoughtful responses. Nobody was being mean to her. She fired back. Fired back, but it was late at night. I deleted the entire thread and sent a note to the person that says, I hope you're okay. I don't know what's going on, but you have to stop wanting to fight with people. And I just, I just, I can't do this. I gotta sleep too. Ali, you know what I mean? Yeah. Anyway, oh gosh. I think everyone who moderates a Facebook group thoughtfully should be brought together. They could probably fix every problem. They probably know everything that's going to happen before

Ally 1:01:32
it happens. Yep, peace in Gaza get the Ukraine situation sorted out. I would

Speaker 1 1:01:37
have saw it coming six months before it happened. I would have been like that one said that this one responded this way. It must be Thanksgiving. That's, by the way, how it works. Like everyone starts to lose their mind right before Thanksgiving. Oh, okay. And then it travels through into Christmas. They happy up for eight seconds around Christmas, and then

Ally 1:01:59
it and then tails off again at New Year, yep, decompensates, yep, yep.

Speaker 1 1:02:03
And then now, January is almost over, and everyone's coming out of their their haze now and then, yeah, and everybody be a little quiet. February, March, spring will come, and then everybody's as happy as can be, right until they realize their kids are going to stop going to school, and then,

Unknown Speaker 1:02:24
and they've got a whole summer of to deal with.

Speaker 1 1:02:27
Then it gets a little off kilter. But then a lot of people go into like, I don't even know how to put it, the summertime, they just they go away in their heads. They give it away, if that makes sense, yep, and then they're great through the summer, even the fall. People love the fall, but when they sniff Thanksgiving,

Ally 1:02:49
that's when it happens again. That's late November, isn't it? Yep, yeah, we don't have that here.

Speaker 1 1:02:55
No, you're lucky, because all you get is Turkey and potatoes and anxiety, apparently, I don't know, but, like, Yeah, I know how people are going to act in a group based on the time of year. Oh, okay, it's really interesting. So, and it's consistent, because I've been doing it for so long now. Like, it just happens. So we get ahead of it, like, we try to, like, move people in a better direction, give them, like, happier things to look at, like, like, the whole thing, it's really purposeful. So,

Ally 1:03:23
yeah, look, puppies, kittens. Oh yeah, I'm trying to

Speaker 1 1:03:27
help you guys fight against your inner demons, or whatever it is that we've, um, you're a maybe personal human algorithm. Maybe, I don't know. Yeah, anyway, anything, we didn't talk about what people are, weird people are, yeah. Look, I can look at it that way. There are times I do. There are times that I'll just, I'll be like, Man, what is wrong with that person? Just like, yeah. But then when you really look and you see it is what you talked about, there's a reason. There's a reason. Yeah, I'm gonna go out on a limb here and say, I don't think there are bad people. I just think there are people that are in so many different bad circumstances that the only reaction, reaction that's left is the one they're having, yeah,

Ally 1:04:08
yeah, you know. And that's just to strike back.

Speaker 1 1:04:11
I think so like i because I've seen really terrible things, and I've seen lesser versions of it. I don't know what I am. Am I a pacifist? Is that possible? Because I look, when I look at them from from 100 yards, you know, when I step way back, I don't see bad people. I just see people in some version of hell and, yeah, this is what they're doing to get through it. Yeah, I don't know it's, it's something anyway, all right. Well, Ally, you've had a great life. I have, I hope it continues. I also think it's interesting, by the way that I didn't even think to pick through if you had anything else going on because of your attitude, because you have such a good attitude about having diabetes. But you know, arthritis is no

Ally 1:04:57
like, this is like. I think I prefer that I have diabetes maybe, than somebody else, really, because I'm okay with it. I mean, it's not fun. Sure, I'd love to get rid of it, but I guess I've been blessed with the physiology and genetics to be able to deal with it reasonably well.

Speaker 1 1:05:19
Yeah, no, I I've come to believe that too, like some people just get a better mix.

Ally 1:05:25
Yeah, yeah. And my parents are and grandparents are ridiculously long lived. So, you know, yeah, I mean, my father is 81 and still working. Do

Speaker 1 1:05:37
you worry about being older with type one? Oh, yeah,

Ally 1:05:41
yeah, yeah, yeah, my friends and I talk about this a bit like, we really need to set up nursing homes, retirement homes specifically for type ones with sensible carers. Yeah, that's a good idea, because that's scary. I

Speaker 1 1:05:58
take your vibe right away, like you're not going to be able to spread enough knowledgeable people around to all the places. So

Ally 1:06:05
no, we're not. We need to consolidate. Yeah, I've one of my school friends has a mom. She's now in her mid 80s, and she developed type one when she was in her late teens. Okay, she's in a nursing home now, because she's physically very frail, but thankfully, she's still able to self care good, yeah, so she's got a pump and a CGM and all of that, but if she had Alzheimer's, no

Speaker 1 1:06:33
now, they put her on a they probably, they probably put her on once a day, yeah, just basal and then let her drift away at her time. This is a thing that a lot of people around me, even privately talk about all the time, like, I don't just, I don't mean personally even like just people, you know, we're always thinking about ways to help people with type one, and, yeah, it's a big concern about people getting older and not being able to see their pumps like pump companies. No pump company puts any effort into a pump that an older person can use easily.

Ally 1:07:03
No, right? No, because, yeah, where's the market? Old people aren't sexy,

Speaker 1 1:07:08
right? And they and they're also not a long live the market. No, either. Yeah. That's why you don't see any cars marketed towards 75 year old people like, yeah, they drive three miles a week, and that's only going to be for another month and a half. Well, that's where the sexiness is, then, is in the home for people with type one. Yeah, right, plenty of people with diabetes, like, why not make a diabetes specific place to help them? Yeah,

Ally 1:07:33
yeah, you know, get sensible carers and, you know, yeah. And you could even extend that into maybe daycare. How do you mean, like, you know, for little kids?

Scott Benner 1:07:46
Oh, yeah. Well, you gotta have enough of them too. You gotta

Ally 1:07:48
Yeah, yeah, right. And that, that could be tricky, but yeah, um, certainly, where I live, there's probably not the population density. Yeah, I live in a capital city, but it's still only a million people.

Speaker 1 1:08:00
Can you imagine the beeping 20 minutes after snack time at a type one daycare? God, yeah, lot of beeping. Hey, can I ask one last question before I let you go? Sure. Do you like me? Like, how do you know about this? How

Ally 1:08:13
do I know about the podcast and all that I first heard about it when I was knee deep in loop territory. Okay? And I didn't really have time then, but then I worked out what podcasts actually were, and started listening. And then I found the Facebook page,

Speaker 1 1:08:36
okay, I've drug A lot of people into listening to podcasts that I don't think ever would.

Unknown Speaker 1:08:40
I didn't know what a bloody podcast was. But,

Speaker 1 1:08:43
I mean, like, I don't have type one. Why is that okay with you? You've got sensible

Ally 1:08:47
advice. Okay? And look, I mean, to be honest, I haven't been through all the, you know, the technical series. Oh, you like the stories. I like stories, yeah, because I've kind of, I've kind of done the technical stuff, I've kind of figured it out. That's not to say there's nothing to learn that I you know. No,

Speaker 1 1:09:09
no, I understand. But yeah, it just, it doesn't feel like a focus for you right now.

Ally 1:09:13
No, no. Awesome. I I love people's stories. Yeah, that's

Speaker 1 1:09:17
awesome. Well, yours was great. I appreciate you adding it. Oh,

Ally 1:09:21
thank you. I look. I just hope I can reassure some of the parents that are really struggling out there that their kid is probably going to have a really good life. Yeah,

Speaker 1 1:09:32
it's funny. The way you put that is exactly how I would say it, like, don't worry too much. It's probably going to be okay.

Ally 1:09:38
Yeah, yeah. I mean, the thing is, we can't predict the future. We don't know what society is going to be like in 20 years. Do we?

Speaker 1 1:09:48
Well, yeah, that's a good point. Like, because, yeah, because, like, using as an example, like, I put up an episode today with this guy using the eyelet pump. Yeah, and he's doing really well. Yeah. Think, you know, doing really well, saying normal meal, smaller than normal, larger than normal. I also put up an episode with that same comp of the company, like, a week before, yeah, I listened to that one, yeah, and I pushed, like, I pushed a little bit. I was like, Are you guys going to keep trying to make this better? Because, yeah, I think you should. And I think it would be a big deal. You know what I mean? Like, if you, if you kept pressing and and you figured out a way to make this better and let AI, you know, like, help you, like, expand it more quickly. Yep, you're not wrong. Like, you could wake up. I hate saying this, because I know people, poor people with diabetes, been told it's going to be cured forever. I don't mean cured, but I mean No, no, of course not. If you look at the sheer number of things that humanity can't figure out. Yeah, you think we're gonna leap over how to not argue on the internet and get right to curing diabetes? Yep, yep, that's it. Yeah, you're all lucky that it's going this well. But my point is, is that if you don't think that five years from now, all these pumps might not be making insanely accurate insulin decisions with less input from you. Yep, yeah, I don't think that's out of the realm of possibility at all.

Ally 1:11:09
You mentioned it in the islet podcast. You mentioned that particular individual who doesn't announce meals. Yeah, I know him quite well, yeah. And I also know his settings quite well, okay? And not everybody can do those settings. No, they are not appropriate for most of the population. My

Speaker 1 1:11:32
imagination is they're very aggressive, right? Yes, yeah, yes,

Ally 1:11:36
and we both use probably a similar amount of insulin per day, but in very, very different ways. Okay, yeah, yeah. So there is no way I could, like, I can get away with not announcing about 20 grams, no more than that, okay, yeah, because my correction factor is so pathetic, yeah?

Speaker 1 1:12:00
Well, exactly I that's what I tell ardent. I was like, now that you know, now that your correction factor, basal rate, etc, is where it is, you're gonna have to be very like vestibious, about, about, about pre bossing too,

Ally 1:12:13
yep, yep, absolutely, yeah. So yeah, but yeah. I mean, for some people, and I'm thinking perhaps middle aged blokes, for some people, that may be doable in the near future.

Speaker 1 1:12:29
Oh, yeah. I mean, I don't see how it can't get at least better. Yeah,

Ally 1:12:35
better, yeah, because, I mean, the islets doing the meal estimations now, yeah, you know, I mean, we're probably not going to get the islet in Australia for another 10 years, but, you know, whatever.

Speaker 1 1:12:49
Well, that's, yeah, a different problem. My thought would be, and I know very little about this, but, but my thought would be, couldn't there one day be an onboard, personalized AI model that's just paying attention to your insulin needs and making adjustments and things like that, yeah, and working

Ally 1:13:11
out your movement patterns. And do you know what I'd like? I would like my pump to identify if I have a different ballet teacher? Oh,

Speaker 1 1:13:23
that's interesting, because, because you get different, like, like, workouts with them, yeah, different workouts, yep, that's something, yeah, yeah. Well, again, somebody would have to put a ton of effort into that. But, like, it really is just an AB model, right? Like, you know, forget the teacher. Like, a, I have this outcome. B, I have this outcome. Walking into ballet class and saying, This is going to be an A experience, or a B experience, like C experience, right? Yeah, yeah. You could put as much into it as you want, as far as efforts, that'd be that'd be great, yeah. I just think it's there. I think the more data we have, the more data can train. And if you had data on yourself, the machine learning was just paying attention to you, I would think that after time, it could make some pretty reasonable guesses. Yeah, so I don't know. Yeah, true. I put it the same way all the time, like I read a news story that led me down a rabbit hole a little bit, and using the idea of, like, self driving cars, yeah? And the the company Tesla, like they had so much data coming from their cars at one point that the computers they had available to them weren't even powerful enough to crunch the deal with the information, yeah. So they pivoted and built their own processors and date and computers so that, like, like they they brought their own computer system together just to date, deal with the data. And once they did that, the ability for the car to drive itself has, like, expanded exponentially over a short amount of time. And that's a. Much bigger problem I would imagine than your blood sugar. So I just wonder how close we are to somebody like thinking that and moving in that direction. I actually have tried to set up an interview right now with a company who's talking about that. Let's hope that, um, they come through and get me the guy. So anyway, awesome. Yeah. All right, I gotta let you go. It's part you're it's probably like two o'clock. What time is it there? It's two o'clock in the morning. Oh, Jesus Christ, go

Unknown Speaker 1:15:27
to sleep. Alright, I've got a late start tomorrow.

Speaker 1 1:15:30
I appreciate you doing this with me so much. Ali, thank you. Well, thank

Ally 1:15:33
you for the opportunity. I just hope I've been vaguely reassuring

Speaker 1 1:15:37
that was awesome. Well, I didn't ask you. I guess if I asked the Canadians that they have a penguin, have you ever sat down on a toilet and there was a snake in it? Frogs, no snake. Have you ever seen a spider that you thought, Oh, I'm gonna die,

Unknown Speaker 1:15:50
yeah, frequently. And snakes, yeah,

Speaker 1 1:15:55
that you think, Oh, that could trick me and then eat me face first. Yeah?

Ally 1:15:59
Yeah. Okay, yeah, absolutely, yeah. I'm staying here, and I worked in the outback for many, many years. There was some scary out there.

Speaker 1 1:16:11
What's more scary? Snakes or crocodiles? Oh,

Ally 1:16:15
snakes might kill you. Crocodiles almost certainly will, yeah, if it's a salt water, okay, canoeing next to a freshie, yeah, they're pretty harmless.

Speaker 1 1:16:25
How about sharks? How many times have you been on a beach and somebody's yelled, shark? Never, awesome, never No, okay, and a kangaroo is a weird animal, right? Yeah,

Ally 1:16:37
I've hit a few, you know, with your car,

Scott Benner 1:16:40
yeah, how do they make out in that scenario?

Unknown Speaker 1:16:44
Not great, nor does the car.

Speaker 1 1:16:48
Our deer are crazy like, yeah. Similar concept, yeah. They'll wreck your car and get up and walk away. Yeah, yeah. Similar concept, yeah. No kidding. All right, thank you. Thank you for verifying what I thought about the spiders and the snakes. I appreciate that. Oh,

Unknown Speaker 1:17:03
terrifying, yeah. Hold on a second.

Speaker 1 1:17:13
This episode was sponsored by touched by type one. I want you to go find them on Facebook, Instagram, and give them a follow, and then head to touched by type one.org where you're going to learn all about their programs and resources for people with type one diabetes. Are you tired of getting a rash from your CGM adhesive? Give the ever since 365 a try, ever since cgm.com/juice box. Beautiful silicone that they use it changes every day, keeps it fresh. Not only that, you only have to change the sensor once a year. So I mean, that's better. Thanks for tuning in today, and thanks to Medtronic diabetes for sponsoring this episode. We've been talking about Medtronic mini med 780 G system today, an automated insulin delivery system that helps make diabetes management easier day and night, whether it's their meal detection technology or the Medtronic extended infusion set, it all comes together to simplify life with diabetes. Go find out more at my link, Medtronic diabetes.com/juice box. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. If you're not already subscribed or following the podcast in your favorite audio app, like Spotify or Apple podcasts, please do that now. Seriously, just to hit follow or subscribe will really help the show. If you go a little further in Apple podcast and set it up so that it downloads all new episodes, I'll be your best friend, and if you leave a five star review, ooh, I'll probably send you a Christmas card. Would you like a Christmas card if you're looking for community around type one diabetes, check out the Juicebox Podcast. Private, Facebook group. Juice box podcast, type one diabetes, but everybody is welcome type one, type two gestational loved ones. It doesn't matter to me, if you're impacted by diabetes and you're looking for support, comfort or community, check out Juicebox Podcast. Type one diabetes on Facebook. The episode you just heard was professionally edited by wrong way recording, wrongway recording.com, you.

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