#1616 Somebody’s Always Peeing - Part 2

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.

Laura, 55, diagnosed with type 1 in March 2024 after severe illness, is now honeymooning on a GLP and hasn’t needed insulin since October. Part 2 of 2.

+ Click for EPISODE TRANSCRIPT

---

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
Here we are back together again, friends for another episode of The Juicebox podcast.

Hey everybody. This is part two of a two part episode. So this was a longer conversation, and we split it into two parts. If you have not heard part one with Monica, you gotta go find it. It should be the episode right before this in your podcast player, I am here to tell you about juice cruise. 2026 we will be departing from Miami on June 21 2026 for a seven night trip, going to the Caribbean. That's right, we're going to leave Miami and then stop at Coco k in the Bahamas. After that, it's on to St Kitts, St Thomas and a beautiful cruise through the Virgin Islands. The first juice Cruise was awesome. The second one's going to be bigger, better and bolder. This is your opportunity to relax while making lifelong friends who have type one diabetes, expand your community and your knowledge on juice cruise 2026 learn more right now at Juicebox podcast.com/juice. Cruise at that link, you'll also find photographs from the first cruise. 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.

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/juicebox This episode is sponsored by the tandem mobi system, which is powered by tandems, newest algorithm control iq plus technology. Tandem Moby has a predictive algorithm that helps prevent highs and lows, and is now available for ages two and up. Learn more and get started today at tandem diabetes.com/juicebox this episode of The Juicebox podcast is sponsored by the twist a ID 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/juicebox. That's twist with two eyes.com/juicebox. Get precision insulin delivery with a target range that you choose at twist.com/juicebox. That's t, w, i, i s t.com/juicebox.

Speaker 1 2:41
Yeah, I don't think my husband has ever heard that one. That's very interesting. That just

Scott Benner 2:46
happens, Monica, like you hear your mom and dad say something one too many times, like, I don't want to be connected to this anymore, and you don't want that to be diabetes, exactly. It's funny because you listen to adults, come on here in their late 20s, who grew up through high school with type one and went off to college, and they tell you, I wish my parents were more involved. I wish when I pushed back, that my parents wouldn't have given up. But that's hindsight. If you could go back and ask the 17 year old them, they'd say, my mom's an idiot, my dad's an adult. They don't know what they're talking about. They're bugging me. Everything's hindsight. When you hear somebody say something thoughtful, it's almost always in hindsight. So you know, the problem is, you have to deal now and in now with the person you're speaking to, and that's why I think it's always important to keep a really long view of what you're doing, like you're not trying to win the day. You're trying to make sure that in the future, you've raised a person who wants willingly to take care of themselves.

Speaker 1 3:46
That's all right. And I think that that that's really a complicated thing that move, you know, moves to a bigger point is the worrying too much about the future or obsessing too much about the past. That's where you know, you can be depressed about what you didn't do, and you could be anxious about what might happen. And they say mindfulness, you gotta, gotta concentrate on the current moment. But to count, you know, counteracting that just as you're saying, it is the current moment. But what are these current moments leading up to how is this going to play out in the future? You know what you know? What are the possible ramifications? You know, both health wise and relationship wise. So I think it's an interesting and complicated place to be, because you do need to be tactical, but then also know what I'm doing now. I need to get comfortable with the fact that the end goal is independent adult, and this is a long game.

Scott Benner 4:44
Yeah, no, I understand. I mean, honestly, the way you talked about what you enjoyed, about the nutrition, conversations about like, hey, we need to think more about the building blocks that we're putting in, this is really the same thing, right, right. You're putting in information you don't need to see. I. Mean, honestly, this works well, with my example about the vitamin D, like, you take vitamin D today, you don't wake up tomorrow and go, ha, I did it. I'm Superman, right? But you do have better outcomes over years and years and years. And the same thing goes, I think, with this stuff, like, it's not as easy just to turn to your kid and go, you have to Pre-Bolus because you have to. And now just start doing it. And because that's not how it's going to work. But if you get the idea in there, and you build it up a little bit, you add more and more building blocks of ideas and thoughts without pushing somebody away, right like so that's a very slow layering, because if you dump too much on them at once, most people are going to rebel. They're going to be some people who are rule followers or want to, you know, they're pleasers, maybe, and you'll get them to just do it, but most people are gonna just go like, eh, don't tell me what to do, and then you waste it so it's very slow. You're almost dropping seeds, you know what I mean, just hoping that they take root and sprout, and if they don't, you throw some more down. I'm telling you, I think the vibe here is, if you're raising kids in today's society, you have up until their mid 20s to impact them, right? And then after that, if you're lucky, you've got an adult on your hands who, if they have questions, will actually come back and ask you, or will go find out on their own. And if you're unlucky, you're gonna end up with somebody who's not gonna take care of themselves. But I don't know that just beating them over the head is the way to that, especially when it's between a parent a child. Now, have I heard? Listen, I'm against people trying to scare you into taking care of yourself, but I'd also be lying if I didn't tell you that people have come on this podcast and talked about being in dire health situations for many years, and that somebody, usually a doctor scared them straight, and it actually worked on them. Now I don't mean that you should try that on a 12 year old. There is a world where you might do everything right or do everything wrong, and your kid ends up 35 years old with an 11 a, 1c, and one day, some doctor says to him, are you interested in seeing for the rest of your life? And it gets to them, my brother has type two diabetes. It's in a much different situation than before, and he related that conversation to me. Our brother's a bright guy, thoughtfully, cares about himself all that stuff, but it was a doctor who said to him, like, you want to be able to, like, keep your legs and your feet and everything and like, he scared the out of him, and that made my brother call me and go, Hey, what am I not doing I should be doing exactly.

Speaker 1 7:21
Yeah. What are the things that you may have mentioned to me before that you know that now they're willing to listen and

Scott Benner 7:28
you have that podcast. What is it? You tell people on that thing?

Speaker 1 7:31
What is it? Yeah, what is that? Did you have that series for type two

Scott Benner 7:36
email that over to me please? Yeah.

Speaker 1 7:38
What's that? It's the, it's the when I had this is again, bigger picture. You know, Mel Robbins has her let them theory book and all of that. Is it that we look and we think we want to help people, but we can't. You know, you can't control someone else, nor get them to change. A person only changes when they want to change. So as much as we want to give people information about diabetes, about nutrition, all of that, right, helping people that want to be helped. That's the important part. If that's

Scott Benner 8:08
not how it worked, I could just run downstairs, grab Arden by the shoulders and start yelling tag lines to her from the podcast. She'd be okay in an hour and a half. Exactly, exactly. I mean, imagine this like I know by the way, Monica, let me say while people are listening. You're a big supporter of what I do. I really appreciate it. Thank you, and it means a lot to me. And at the same time, like, you'll know this when I tell you, like, if every one of the 67,000 Facebook member group members saw a post from somebody who was like, oh my god, I listened to blah, blah, blah, and it saved my life, which happens every day, like, you know, multiple times a day, somebody is going to write a post to me to say, hey, I really appreciate what you're doing, what you did. Here's the thing I heard that really helped me. And they'll go to the TR you can see they're trying to help other people. They go to the trouble of laying out where they were, what they did, what helped them, what they think might help somebody else. If it was that easy, that would take one of those posts, all of those people would see it and go, Oh, you know what? I can listen to 20 hours of a podcast to figure that out. But that doesn't happen. It's a daily slog of waking up, scanning that group and looking for the people who, on that day, decided I have had enough, I got to figure this out, and then being, being there to meet them with information that will

Speaker 1 9:24
help them, right? And that is something that I struggle with in in this space, and then also in others. You know, other areas of my life, when you are you maybe repeatedly are suggesting things to someone, and you realize they aren't ready to change. They don't, you know they, they, they, it's the lead the horse to water, and there they are standing next to the water. And we, you and I say water a little differently, but I didn't mean to be repeating water on purpose. It's trying to remind yourself that there are those people that want to be helped, and we can give them that information because. Yeah, I get really frustrated with the face, with the Facebook group, with people saying, Yeah, I don't. I don't have time for that. I don't, you know, that's not the way that I can learn. Like, I said I had never listened to a podcast before. I don't. I can't, for the life of me, think of who it was that had suggested this. I can't. I tried tracking down, like, was it the CDE? Somebody said Juicebox podcast, and I can't figure out who it was. You know, who it was. And I wanted to before coming on here, but I didn't figure it out. However, first podcast that I listened to, I don't like YouTube videos. I'm a reader. I've always been a reader. I don't love Facebook, you know, you know, reading on there. I want credible sources of information. First podcast that I listen to, I do listen to others now, you know, I was listening to pretty early on the episode that you did that was the 411 that was the equivalent, then, of Isabel's lists and things. And it was you talking through listen to this one, this one, this one. And I did the, you know, the Netflix binge type of, type of thing in a podcast way, and went through those episodes and then just continued to want to listen to more of that, even though I hadn't listened to a podcast. And I would tell you, I listen, you know, I learn much better from reading than I do from listening, but all of that, it was a different way of me taking in the information, but it was so helpful, and it turned me into a podcast listener, which I hadn't expected, because I didn't think that that was something that I would enjoy. Yeah,

Scott Benner 11:34
I'm glad, I'm glad you found it, and I'm glad you found other stuff that you enjoy, too. I think it's a great way to experience other people's ideas almost passively. You don't need to be sitting staring at it to hear it. I think it's awesome. I'm glad it found you and that it was helpful. You talked me, by the way, into making another kind of explainer about why you'd want to listen to certain series. Like, I can get lost sometimes and just think, like, I've said that already. I don't need to say it again. But I think that there are always new people every day showing up in the group takes on probably 100 new people a day at this point. So it's always incumbent upon me to to find those people and let them know where they can begin.

Speaker 1 12:13
True. True. I do. I do agree with what some people have said too, when we've had, had had people discussing it back and forth on the Facebook page is that there do seem to be people that are, they really are into Facebook, and they're not. They're like, No, you're not going to get me listening to a podcast. I just want and that's I think that that's hard. I think it's frustrating. It's really frustrating that they'd rather go back and forth with posts, and there's going to be a lot of noise. They might say, okay, you know, I will go to the link that Nico just posted about that episode, but I can understand that sometimes, with the overwhelm, they think podcast I, you know, now I have to download something and listen to something again. That's it is. It's a tricky thing because I see so many people that do want help, but then they say, Yeah, I can't do that.

Scott Benner 13:01
I'm I would also tell you that I think that my data tells me that they do eventually make it. It just takes some people longer than others to dive in, and so they do eventually get back to it. I've had people send me emails. They just hate me, you know? Yeah, I'll get another email from them six months later and they'll just say, Hey, I'm really sorry about that last email I sent, but I did find my way to that information now, and really has helped me, and I appreciate it. And, you know, sorry again for, you know, calling you those names, it's okay with me. I didn't, I didn't take it to heart. Don't worry about it. 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 bolused. 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 now available in select areas, so if you'd like to learn more or get on the wait list, go to twist.com/juicebox. That's twist with two eyes.com/juicebox. Get on the twist wait list and be notified as soon as it's available in your area. Links in the show notes. Links at Juicebox podcast.com This episode is sponsored by tandem Diabetes Care, and today I'm going to tell you about tandems, newest pump and algorithm, the tandem mobi system with control iq plus technology features auto Bolus, which can cover missed meals. Analysis and help prevent hyperglycemia. It has a dedicated sleep activity setting and is controlled from your personal iPhone. Tandem will help you to check your benefits today through my link, tandem diabetes.com/juicebox, this is going to help you to get started with tandem, smallest pump yet that's powered by its best algorithm ever control iq plus technology helps to keep blood sugars in range by predicting glucose levels 30 minutes ahead, and it adjusts insulin accordingly. You can wear the tandem Moby in a number of ways. Wear it on body with a patch like adhesive sleeve that is sold separately. Clip it discreetly to your clothing or slip it into your pocket head now to my link, tandem, diabetes.com/juicebox, to check out your benefits and get started today.

Speaker 1 15:48
No, no, no. Well, I think it was maybe it was no, maybe a day or two ago that you were just talking about that, that on that. I mean, this is, this is something that is really surreal to me when episodes are aired and you realize what time they must have been recorded, yeah, because there was one episode. And you said, Yeah, you know, don't take a look at any of your investments. I bet you'll know what day it is when you're listening to this stuff like that that you've you realize what's, you know, what was going on. But it was a day or two ago, and you were talking about the people that hate listen and you know, they're just, you know, they come back every day. I hate this guy, but I but I can't stop listening. And how, how much you you enjoyed the fact that, despite the fact that they cannot stand you, that they they're back for more.

Scott Benner 16:31
There's a great scene in the in the Howard Stern movie, the producer from NBC comes in and he says, we have, you know, we have the listener feedback about the Howard Stern Show. And he says something like, people who love him listen for an average of 45 minutes, and people who hate him listen for an average of four hours exactly, or something. It's something like that. I don't know the exact words of it, so, you know, there's always going to be that. But there was a girl on recently. It's called modern fairy tale. The episode she said, Yes, she was really awesome, and young, in her mid 20s, had grown up through she's her third generation of type one in her family. Her grandfather had great outcomes for no good reason. Her father thought, oh, that's what you do. You don't really need to do anything. It all just works out. Except he passed very early. She was probably on her way to following her dad's footsteps. Somebody put her in onto the podcast. She starts listening to it, and then she gets, I forget why. She gets mad at me for a reason, or she decides that it's not for people who are MDI or something. She makes some leap, but she kept listening. She was hate listening. At that point, she was mad, and she was listening. And then something got said. She was out shopping, she heard me say something, and her brain went, Oh, I could do that. And then she just did it. And now, you know, a couple of years later, she's a guest on the show talking about all the awesome success she has in her life,

Speaker 1 17:52
right, right? And yep, and it was, it was that she, because I just did listen to it. And I know that you listen to things before you post them sometimes too. But I it was, it was that she said, This doesn't relate to me. It's, it's, it's MDI. And she was listening anyway. But she was, she, you know, described as kind of bitter that this all this stuff, and it's about pumps. And then she was like, wait a minute, this does apply. This does this does work.

Scott Benner 18:16
I tell people all the time, MDI and pumping are exactly the same. You can't change your basal. You know, you have to shoot more if you want a Bolus more, and you can't split a Bolus. But that's the extent of the difference between MDI and pumping. Now, you know algorithms are different, obviously, but yeah, if you can do it with insulin, you can mimic it with MDI,

Speaker 1 18:37
right? We did really well on with, with MDI, and then with, and then with that, with MDI, dash, Omnipod, five. We haven't. We've been steady with our good results that whole time. What's been different is the ways that I put in effort, and what you know, what you know, what I'm looking at, and the more that we've learned about the inputs, meaning the combination of the inputs of the food and then the activity related to it. I agree with you so much that it's it's time, you know, it's timing and amount of the insulin, and then also it's taking a look at the type of foods that you're eating and how to strategize for how that is going to be processed by your boy, by your body, or your type

Scott Benner 19:23
ones body. I don't know. Have you ever seen the movie Moneyball? Are you a baseball fan? You know

Speaker 1 19:28
what my my husband just was talking about this. This is a brad the Brad

Scott Benner 19:33
Pitt movie. Brad Pitt, yeah, there's an awesome scene in Moneyball where they decide to go get this beat up catcher and have him play first base, the general manager, and one of the one of the coaches, goes, sits down in his living room, and he says, hey, you know, we'd like to have you come out and play for the team. He goes, You know, I don't think I can really throw the ball anymore from, you know, from home to second. He goes, That doesn't matter. You're not playing catcher for me. You're going to play first base. And he says, I've never played. At first base, and the general manager goes, doesn't matter. It's incredibly easy. We'll teach you. And he looks at the coach, he goes, tell him wash. And the coach goes, it's incredibly difficult. And so, like, I think that about diabetes a little bit, it is just timing an amount, right? And once you understand all of it and have the tools, it is pretty easy. And but if you don't have those things, it is incredibly difficult. I think that's where the podcast helps people, not differently than the building blocks. Idea about nutrition or the building blocks. Idea about teaching somebody something, you slowly hear things, they build up over time, and then one day, you just have the full force of having taken your vitamin D every day and you get the benefit of it, you don't even know what's happening to you. You just have that benefit now. And I think that's what listening does. It gives you tools and ideas about insulin and living with diabetes and a lot more. Not that humbly, I would say, I think there's more to the podcast and all that. And then one day, you'll just have better outcomes. You might not even know why they're happening. You just suddenly have built up those building blocks almost unknowingly, and now you have more information in your head when it comes time to make a decision. Contour, next.com/juicebox that's the link you'll use to find out more about the contour. Next Gen blood glucose meter. When you get there, there's a little bit at the top you can click right on blood glucose monitoring. I'll do it with you. Go to meters, click on any of the meters, I'll click on the Next Gen, and you're going to get more information. It's easy to use and highly accurate. Smart light provides a simple understanding of your blood glucose levels. And of course, with Second Chance sampling technology, you can save money with fewer wasted test strips, as if all that wasn't enough, the contour next gen also has a compatible app for an easy way to share and see your blood glucose results. Contour next.com/juicebox and if you scroll down at that link, you're going to see things like a Buy Now button. You could register your meter after you purchase it. Or what is this? Download a coupon. Oh, receive a free contour next gen blood glucose meter. Do tell contour next.com/juicebox head over there. Now get the same accurate and reliable meter that we use.

Speaker 1 22:18
That's precisely one of, one of the points that I, that I did, did want to make, is, is that Timothy and I, again, before, you know, before different technologies even. But I wrote down here, found the podcast in January 2021, so we were diagnosed in October of 2020, so I did go, you know, I did, I did go for a while without the podcast, and I had figured out a lot of these things. So one could say, well, why are you listening almost daily to diabetes podcast? And why are you going through all of this? It is that the repetition of the of the ideas, finding out, there's always more to learn, there's all there's always interesting things to you know, to find out about ways that people deal with things. Even if you think you know a lot, there's so much more. And honestly, it's the conversations with such interesting people about all kinds of things. It's kind of little like Seinfeld. Sometimes the show is the show about nothing, you know. And that's not insulting you in any way, you know. It's just that it's entered, it is entertaining. And there was always something that I take away from someone and and their life story. And, you know, everybody comes on and says, you know, I don't have anything to say. And of of course, they do. And there's, there was always something that you can relate to, or that you know someone that could relate to. And again, lot of it is not about diabetes, and I know that that's probably going to have more people think, well, I don't have time for that stuff. But in the lessons that that I found, it's about attitude, it's about your approach to things. It's about how to deal with other people, about relationships. There are so many things that are woven through the conversation conversations that it really is about a lot more than diabetes. My husband calls it diabetes radio, and I keep talking to him about the fact that it's really not just about diabetes, because it isn't he would probably like it. I think he would

Scott Benner 24:27
just a good podcast, not like about diabetes. And I think that that's why it, it succeeds where it is, because where other, you know, offerings maybe don't get so wide. There is an entertainment factor to it. It isn't cold and calculated. It isn't buttoned up and stuffy, and yet, you know, the things you hear will definitely help you. And I couldn't agree with you more. Like I feel like I've said this a couple of times, but I'm happy to say it again. When I was a kid in the 90s, I listened to Howard Stern interview a porn star. Yeah, and he never asked her about being in porn one time, right? And she was so interesting, and her life was so interesting, and her ideas and her thoughts and her fears and everything she talked about, I just was ensorcelled by like, I really was just, I don't know, riveted by her conversation, and then I look back on it, I wish I knew who he was talking to, because I'd go listen to it again if I could. But you look back on it, and you can hear him expertly picking through her life, right? And you don't realize it's happening while it's happening, and she doesn't realize it's happening while it's happening, and she doesn't know how much she's relating to other people. I think I make a conversational podcast that happens to only talk to people who have diabetes or a kid with diabetes,

Unknown Speaker 25:49
right? And I agree, I agree,

Scott Benner 25:51
yeah, but I could easily get 10 people on here who don't have the thing to do with diabetes. And I guarantee you, I could interview them, talk to them about life, and you wouldn't unsubscribe. You'd be like, Oh, those were good conversations.

Speaker 1 26:06
That's absolutely what I'm saying. And, and then with the different series that you had, you've had, I mean, there's the thyroid series and, you know, and then now the nutrition series, and that's, that's kind of proving that too, is, is that, yes, these things can relate to people with diabetes, and are important however they you know this, you know, this is general information. This is a lot, you know, this is a lot of stuff that's applicable. A lot of this stuff, like with the talking about about social media and the way people respond, and all of that. It's, you know, it is, it is absolutely true. And it's, you know, it's important information for people to think about is, is that the, you know, when we talk about how people just want to be on a side, and then you, when you look at, when you when you've talked about the comparing how with the chameleon Facebook group and your Facebook group, and you look and you think, you know, we're all so different, and we're dealing with different things And and, no, no,

Scott Benner 27:00
it's all exactly the same. Exactly. There aren't people with diabetes on Facebook who are unpleasant. There are people who are unpleasant. Some of them are on Facebook. Some of them are talking about chameleons and some of them are talking about diabetes, like the arguments and the hot takes and the perspectives, they're all exactly the same. From topic to topic to topic. It doesn't make any it doesn't make any difference, right, right? A woman put a post up the other day. I wish I remembered her name, and she was just thanking me for an episode that went up last week called, I think it's called sorry a or something like that. And she goes on to say, like, there are so many valuable life lessons in this conversation, yes, like, Forget diabetes, they're in there. I'm touched by that, like I and I know it's me talking about me. So some people will think it sounds distasteful to talk about, but I mean what? I don't know what else I'm supposed to do when I wrote my book about being a stay at home dad. Again, I don't know how good of a writer I am, or how good of a book that is, or anything else, but I can tell you that when it was over, the publisher came to me and said, I don't think I could have paid a professional writer to do the job you just did. That entire transcript that you gave us is full of common sense, life lessons explained simply. She goes, it's a roadmap for living a better life. I know people usually brand that or they call it stuff, and then they, you know, they try to sell it to you. It's funny. I just had a long conversation this morning with a contemporary of mine, and where we were just talking about the difficulties of getting around the platforms and how they want creators to pay money to for their stuff to be seen. It's how Facebook set up. It's how it's how they're all set up right now. Like, if you're not a creator, you don't know this, but when I make a post, the next screen that pops up in front of me asks me to pay you. They pay pay them so that people will say it, ah. And so I don't do that, but then they limit who sees your stuff that's on all of the platforms. Facebook does it, Instagram does it, Tiktok does it, YouTube doesn't. But I don't put video up. I only like, I'm only like, basically like, you know, repurposing my audio on YouTube, which is not how people listen to podcasts. It's not really important, right? But no, yeah, I'll make a post on Facebook, and then it will ask me how much I want to spend to make sure people see it. And then it will tell me, if I spend this much, it'll show it to this many people, and if I shouldn't that much, it'll show it to this many people. So all the stuff you're being delivered on Facebook, if you're seeing it, you either really love that thing and you are interacting with it constantly, or you're somebody is paying to shove it in your face, right? So we were talking about that, and during that conversation, she said to me, like, Hey, you could probably make maybe do one of your episodes a week in video and put it on YouTube, maybe people would be interested in that. And I was like, Well, it's a lot of money and editing and time, and I don't know, I'd have to find people who were willing to be videoed while we were doing it. Like, I don't know if I could really make it all happen. I already have a pretty significant cost paying my editor for audio and stuff like that. And so we were talking all through that, and she said, Well, you. Probably, you know, if it got popular, you'd make money on YouTube. And I stopped her, and I was like, I don't really care about that. Yeah. And she's like, well, you know, you got to make money. I said, I make money. I'm okay. Like, I pay my bills, I save money, I'm good. My concern is that, I know you don't like me saying this, but my concern is that I'm 53 I don't, I don't like you saying that. I've already kept this thing going for 11 years, right? I mean, the honest truth is, like, if, if I made a podcast for 20 years, that would be pretty uncommon, like a popular podcast for that. So let's say I can accomplish that. Let's say I can make this for nine more seasons till I'm 62, years old. Oh,

Unknown Speaker 30:35
don't say that. I need to hear that out

Scott Benner 30:37
loud. Okay, right, right. So, like, let's say I can, I can accomplish that. I have a finite number of people I can help, and it's not grandiose, and I don't have a god complex. But trust me, I said to her, if you were me, if I sent every note that I receive every day to you every time I get one, if I just emailed it to your text it I said you'd be crying by the end of the day, and that happens to me all day long. 24/7, and it's a response. It now it feels like a responsibility. The podcast feels like a public trust to me, like I just want to get it to more people, because there'll be a day where I can't get it to anybody. And if we go back to the reason I started writing that blog in 2007 the thought in my head when I started writing that blog was is very simple. I started it because I wanted people to understand type one diabetes, and I realized that they didn't. I kept it going after reading an article about a man who passed out at a train station parking lot, a commuter train station parking lot, they kicked him off the train for being drunk. He was found early morning by commuters laying face down in stones. People passed by him. They mocked him. They made fun of him for being a drunk. And one woman recognizes, I think my sister or my brother has type one diabetes, and this looks like low blood sugar, and she stops and saves this guy's life, right? And I thought, I wonder if I could write enough stuff and put it online, it'll reach a person who might find my daughter laying face down somewhere. One day, I'm gonna write this blog and see how I make myself cry. It's late in the afternoon. This isn't good, Monica, I gotta get my headshots done in a couple hours. I don't need to have red eyes. I just can't believe I said headshots in the middle of this touching story. I know me either. Nevertheless, that is what I'm doing tonight. And so, like, maybe I can write a blog that will reach a person and educate them so they can save my daughter one day. It's how I thought about it. And now, at the end of this some I'm almost 20 years into it now, right? Like, I started in 2007 right? Is 2025, and now I'm looking at the back end of my life, at least professionally, and I'm like, I don't know if I reached enough people to find that person that's going to help her. But more importantly, now, the way I think about it is, I don't know if I've put enough into the world that when she's ready to go find it, if it's going to be there, because the biggest travesty I can imagine is that the daughter of the guy making this podcast, because she's the daughter of the guy making the podcast, doesn't listen to him, and then one day, decides to go to try to find it, and can't even find it. I'm trying to find a way to keep this all alive for my daughter and for whoever else is benefits from it on the way. But hey, spoiler alert, I'm just making this podcast for my daughter. The rest of you are benefiting from it. That's awesome. I need the last thing for this podcast to do is to find Arden in a bad moment and pick her up. That's what I'm trying to do. So anyway, that's a lot of high minded bull, right there?

Speaker 2 33:41
No, but I is, what is what you're saying, that she'd go

Speaker 1 33:46
looking for it, but she'd go looking for it in in a voice other than your voice, meaning she wouldn't look for the

Scott Benner 33:51
maybe, yeah, Monica, maybe

Speaker 1 33:55
you're saying you she, you need to educate enough of us so that, though, that those of us and our descendants, obviously, because since I'm your age, I all I will also be gone. Well, it will be done. We'll be gone. But enough of the, enough of the, the listeners and the followers will have created their own entities. Like you know is, are you thinking of it that way?

Scott Benner 34:19
Because, yeah, with any luck, and I do think it's going this way, Arden will know how to take care of

Speaker 1 34:24
herself. Yeah, I think, I think you know that she already does. Yeah, yeah, no, no. I know a lot. She knows a lot, and and I know your fear is apparent, as apparent is that she's going to turn around and have all of these unanswered questions. But you know that she's again, like you said, the little, little breadcrumbs, little dribs and drabs, the little things over all the years. You know that she's got your, she's, she's got your, your philosophy, and the, you know, the way that you look at all of these things, even if she doesn't have all, you know, all of the little ninja tricks that you might,

Scott Benner 34:56
I agree, it will surprise me if Arden ever has an A one. See that's higher than six in the sixes. Like, that'll surprise me, right? So yes and no, like, but a little bit yes, my daughter's gonna get older. She's gonna age. She's gonna end up in an ER one day. She's gonna, and I'm not gonna be with her, she's gonna end up in an endocrinologist. Like, she's got a great endocrinologist now, but that lady's older, like, she she's not gonna be around forever. Like, she's gonna have to go find another endo someday. I have the really like, I don't know what to call it, I want to make sure that people understand I feel very blessed about it and grateful, but I have a really far and wide reach, and there are plenty of we talked about it today on the call I was on, there are plenty of nurse practitioners out there that sit in your room with you while you're talking to your Endo, and they hear you getting bad information, and they grab you in the hall, and they go, let me. Let me help you out. And they grab you in the hallway, and they go, Juicebox Podcast. I'm trying to seed the world with those people, not people who are mimicking what I'm saying, right? People who understand that it's timing and amount. That's who I want out in the world. People who understand that if you're tired, you might be anemic, people who understand, if your hair is falling out, that your thyroid is probably not regulated Well, like I want people to understand the things that I've come to learn they don't understand, right? Because my kids going to ask them a question one day, and I'm going to be too old to help her, right? And one of you sons of bitches better know the right answer.

Speaker 1 36:21
I have to say, I think that you, you must be feeling bad for Rob and think that he needs to be paid more, because I think that you've, you're giving him a lot of work during this episode, actually,

Scott Benner 36:32
that'll make him laugh. Okay, you're a good point. Good. We're done, Monica, is that what you're

Speaker 1 36:36
saying? It's over. No, no, no, no. But you

Scott Benner 36:40
go ahead, I'll tell you something like this. Is also another consideration. We've been talking for an hour and 20 minutes. Rob will do a great edit on it. He'll probably take 10 minutes of noise and gaps out and stuff like that. It'll go down to around 100 you know, about an hour 10. He'll put in the ads. He'll do all the good work, etc. But if it was me, I'm more of a two hour, three hour podcast person, I'd keep going with everybody, but I don't think anybody cares. Like, I don't think the people listening are looking for 15 hours worth of podcasts every week, but for my personal listening, I prefer to listen to longer podcasts, right? Yeah, and we're all down to like, now it's all one hour because of editing costs, or it's 10 minutes, because that's what YouTube wants. I just think, talk till you're done talking, and then those who like it will listen to it, and those who don't will stop. At some point. It's all right with me. The reason I put five episodes out a week is because I don't think you're gonna wanna listen to all of them. And I say to myself, imagine if I had five episodes. I think they're all good, but they're not all for you, and I only put them out on Mondays. Well, that's five weeks of a podcast where you might only see one episode you're interested in. I want to give you five days and then let you say, hey, you know what I'm going to listen to Tuesday and Friday, and maybe I'll maybe I'll check out Wednesday on the weekend. But I don't give a shit about Monday to your husband's point, it is diabetes radio, to me, because I think there should always be something new being broadcasted, in case you want to turn it on and listen to it,

Speaker 1 38:09
right? That's how, in that sense, right? And what he's thinking is, is that I'm I'm long, I'm listening to a podcast, you know? I download this and start listening, and it's discussion about dosing of insulin. 24/7, that's what he doesn't understand. He does not understand that. You know, he likes smart lists. And he, you know, I said it's it, honestly, it's a lot more like smart list than you than you would think, yeah,

Scott Benner 38:34
no, it's very, I mean, this is completely conversational in my head. I'll tell you something. This will sound, I'll sound like an asshole for a second. I don't mind see and you're paying Rob again. All right, Rob, hang in there. Rob. I was listening to smart list one day, and they were talking about something that we had kind of talked about on this podcast. And I thought, Oh, I handled this conversation better than they did. Not to say they don't have a good podcast, but I've heard them, and thought I did a better job on that. Or, like, I think mine's more conversational than this one ended up being or more open minded. Like, not pre I'm not calling out smart list. Like, I also think, by the way, if you have not watched the HBO documentary on the Smart List podcast, you're missing out because it is, if you like watching people be mean to each other who are friends. It is very, very funny. Oh,

Speaker 1 39:19
and I have to tell him he's big fans of all especially will he loves Will Arnett, he loves all of them. But

Scott Benner 39:25
you tell your husband to go on to max and watch that. It's just, I think it's six parts. It's very well done. It's hilarious. But also, you know, I mean, like I said, I grew up listening to Howard Stern like, I want to turn my radio on at six in the morning, and I don't want him to be done till I go to lunch. I want five hours of that. That's how I like listening to things. But I like hearing people talking who I'm acquainted with. I will turn talking on in the car more often than music. That's just sort of my vibe. I listen to podcasts that I don't even agree with the host on. Be like, oh, that's an interesting topic. And like, I know. Don't really agree with this person's perspective, but I'd still like to listen to this, or they have on somebody who I'm interested in, and I think, well, I don't like them, but I do want to hear what that person has to say. Like, I'm not a person who's like, I can't listen to this because I don't like that guy's politics, or I don't like what he said about this or that, or the car they drive, or, like, I don't care about anything. Like, I just want to hear what you're saying. If it makes sense to me, it makes sense to me. I think it's possible the closest thing you have to Howard Stern right now is a comedian named Tim Dylan, and his YouTube he is trying to make socially relevant content that is so biting and sarcastic that while you're listening to it, I guarantee you won't know if he's kidding or not. I think that's an interesting way to try to talk to people about the world. Wait Anyway, like I don't hear every one of his episodes, but when I see him, I'll stop and listen for a minute to see what he's doing. Yeah, you know,

Speaker 1 40:49
I'll put it on as long as, as long as I'm caught up. Yeah,

Scott Benner 40:53
don't, don't. If you start listening to other stuff instead of me, I'm in trouble.

Speaker 1 40:57
Yeah? No, no, no. Subscribe and download. All of you. Thank you. Subscribe and

Scott Benner 41:01
download. Please follow in a podcast app. Set up auto downloads in your apple. I mean, if you want to help me follow an apple podcast and make sure auto downloads are on and then listen to this, listen to the show. That's the biggest way

Speaker 1 41:13
to help. Yep, nope. And that's you know that that's what we keep doing. We'll keep getting out there. Get the get the downloads. My plight. She does. I do. I do. I know pictures for the algorithm.

Scott Benner 41:25
Here's the business model. Monica, I wake up and think about how to try to help you and your son, Omnipod, Dexcom. Ever since they pay me to do that. Now they don't really. They pay me for ads. They buy the ads because you guys click on the ads, and they get a reasonable percentage of you looking seriously at their devices. That's what they want, right? So as long as I'm delivering those clicks to them, they don't care what we talk about on this podcast, right? Like this, we could get on here and talk about Spider Man movies for 50 years, if you guys were still clicking on a, you know, an ad for, you know, touch by type one, then that would all be fine. And so that's the I take their money to make the content for you, and that's so that I don't have to take your money to make the content. Because the other, the only alternative, other alternative is, is to charge you guys for the podcast. By the way, not everybody would do that. I wouldn't make a living off it, so I wouldn't be able to actually make the podcast. And a lot of people who could use the information might get priced out of it, and I don't want that either. So it's just a very simple business model. I make content people listen to. Enough of you guys click on the links, click through, and that's why they buy the ads. They're also good people in a lot of those companies, like I as an example, the circle group that I have set up is being funded by an advertiser who does not want their name on it and does not want credit for it. They just want to give me a chance to see if I can make it work for you. It's very cool. That's a very trust me. Yeah, that's awesome. There's not a lot of companies. I'll give you clarity. That group cost me about $5,000 a year to run. There is a company who just wrote a check for $5,000 and said, Here, go see if you can make something that will help people with diabetes with this. They don't want credit, they don't want ads, they don't want their name on it. They're just trying to help. They're just That's it, and as long as you guys use it and enjoy it and it's valuable for you, they'll keep paying for it. And the alternative to that is that most of those private groups charge people between 25 and $50 a month to be members, right, right? And I'm saying, just take it for free. And even knowing, by the way, that if I got it set up and running and it was super popular, I could just charge you for it, not take their money, and I could probably make a lot more money on it. I'm not even trying to make. I don't ask them for $1 more than it costs me. I said, Can you please cover this? This is what it'll cost. They wrote a check. To be perfectly honest with you, I forgot that I have to pay taxes on the five grand they gave me. So I'm now, oh, don't do that. No, I'm paying the difference. I think it's a thing worth looking at. It could be really great for you guys. And if it works out, great, and if it doesn't, I'll put my head down and say it didn't work out, but, like, I'm giving it a shot, and I found somebody to support that. So anyway, you guys are being supported by a lot of diabetes device companies and other companies that you know they want your business. I'm not gonna lie to you, but they're also supporting this podcast because they know how much it helps people, right, right? Not just because it creates clicks.

Speaker 1 44:20
That is a great story, and the fact that they don't want credit for it, that's, you know, that's something that that really says something is that they believe in this. And they're saying, Hey, we don't, you know, we're not, we're not going to try to get a pat on the back for this. We just know it's the right thing to do, and it's what we want to do at this time. But you know, really, really, that that that also does speak to that their belief in your ability to continue to grow the community, and that they know that you know, if you've got this idea that there, there's something to investigate here,

Scott Benner 44:52
I appreciate that, and I agree, and that they've said that much to me, that's absolutely true. And they said, look, we've seen you help people in other avenues. Because this sounds reasonable to us, we think you could probably help people here too. Like, here, take some money and go see what you can figure out. And so, like, that's what I'm doing now. I'm going very slow at it, because I'm still learning the space as well, but I would tell you, like, to me, it's a much better version of Facebook.

Speaker 1 45:17
You know, as I said before, I am not a fan of Facebook. And I don't, you know, I go on it and I go, you know, I go in, and I can only do small doses of trying to help some people in the group. And I feel overwhelmed. I, you know, I wish there were different, and again, different channels and things like that, and this circle community, I think I when I look at the Facebook group, I have always wanted there to be a spot where you could clearly go and discuss the recent episodes, that you could talk about the guests, and ask if they're there, all that kind of stuff. But you try to post about an episode, and it gets it gets lost. And so this is, you know, this is becoming more and more of an anti Facebook discussion, but it's true, we're not able to see what we want to see. We can't organize things the way we want to organize that because I, you know, I love talking about the specific episodes, and that was one thing that and my husband's always like this, as soon as you lay down your head on the pillow, and all of a sudden I've got admin that I need to talk about. But in closing, I do have to publicly say, say thank you to you, because I have a dear friend, I guess they would say across the pond in England, Sarah. And she was her, she is Mom of poppy, who you interviewed back I think maybe it was March or so, but I wouldn't have become friends with her if I hadn't seen her post on the Facebook site. And then I probably wasn't supposed to just message her privately, but I did. We've become good friends. And we talk, you know, we talk on on WhatsApp, or you know, or you know, voice to voice every once in a while, and we love to discuss, did you hear the episode? What's you know? What do you think about those? What did she just say on that? I can't believe, you know, we love going back and forth, and I would love more people to be able to talk about the episodes, and I'm hoping the circle group can eventually.

Scott Benner 47:08
It will be, I think, and but I also think it's a slow build. It's going to take a it's going to be a bit of a heavy lift, and it's going to take a long time. The one thing I'm not anti Facebook group. I love that Facebook group. I think it's awesome.

Speaker 1 47:18
I'm overwhelmed by it. I really am. Because, again, you know how you saying you've got the helper mentality and all that. And I look, there's so much here, and what did I miss? And, you know, I

Scott Benner 47:27
can't think like that, Monica, you can't, you can't manage that and think that way. It's, it's all very like, whatever I can do, I can do whatever I see, I see, you can't put it on you to go find more or to do more. Yeah, it's all out there, and it gives you access to, I'm telling you, I love Facebook, and Facebook gives you the opportunity to get more new followers more frequently, and you know, and you're never gonna, and most people just, you know, they go the Facebook's their go to. So to get them to even leave an app, to go to another app is difficult, but it's there. Hopefully people will, will go find it, enjoy it. Okay, now we are gonna have to go where Rob's gonna like, he's gonna call you for $20

Speaker 1 48:04
well, that that, and you've got to go powder your nose for your headshot. I do. So I

Scott Benner 48:08
just want to let people know that I was asked for headshots by the people who are taking me for children with diabetes. I need headshots for the cruise. And I need, I

Speaker 1 48:18
was gonna say it was about the crew. About the cruise is they're going to have those, they're going to have glossy flyers that they're handing out. Yes, they're going to they're going to embark, and they're going to be handed the glossy flyer with the schedule.

Scott Benner 48:30
That's not what's going to happen. Yes, it is. A friend of mine is actually a headshot artist, so he does an awesome job, and I'm going to go meet him very soon. He's going to take care of it for me. So thank you. I appreciate this was great of you. I really do appreciate your

Unknown Speaker 48:45
time. No problem. Take care. You too.

Scott Benner 48:55
Head now to tandem diabetes.com/juicebox and check out today's sponsor tandem diabetes care. I think you're going to find exactly what you're looking for at that link, including a way to sign up and get started with the tandem Moby system. The episode you just enjoyed was sponsored by the twist a ID system powered by tide pool if you want a commercially available insulin pump with twist loop that offers unmatched personalization and precision or peace of mind. You want, twist, twist.com/juicebox, having an easy to use and accurate blood glucose meter is just one click away. Contour, next.com/juicebox, that's right. Today's episode is sponsored by the contour next gen blood glucose meter. 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. When I created the defining diabetes series, I picked. Lectured a dictionary in my mind to help you understand key terms that shape type one diabetes management. Along with Jenny Smith, who, of course, is an experienced diabetes educator, we break down concepts like basal, time and range, insulin on board and much more. This series must have 70 short episodes in it. We have to take the jargon out of the jargon so that you can focus on what really matters, living confidently and staying healthy. You can't do these things if you don't know what they mean. Go get your diabetes to find Juicebox podcast.com, go up in the menu and click on series, Hey kids, listen up. You've made it to the end of the podcast. You must have enjoyed it. You know what else you might enjoy? The private Facebook group for the Juicebox podcast. I know you're thinking, uh, Facebook, Scott, please. But no. Beautiful group, wonderful people, a fantastic community. Juicebox podcast. Type one diabetes on Facebook. Of course, if you have type two, are you touched by diabetes in any way? You're absolutely welcome. It's a private group, so you'll have to answer a couple of questions before you come in, but make sure you're not a body. Not a bot or an evildoer. Then you're on your way. You'll be part of the family. The episode you just heard was professionally edited by wrong way recording, wrong wayrecording.com,

Please support the sponsors

---

The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!

Donate

#1614 Somebody’s Always Peeing - Part 1

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.

Monica shares her son Timothy’s type 1 diabetes journey, from diagnosis to teenage independence, opening up about fear, resilience, and finding balance as a parent learning to let go. Part 1 of 2

+ Click for EPISODE TRANSCRIPT

---

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
Friends, we're all back together for the next episode of The Juicebox podcast. Welcome.

Monica 0:16
Hi. I'm Monica. I am mom of Timothy, who is 17 years old, and he was diagnosed with type one in October of 2020

Scott Benner 0:27
I am here to tell you about juice cruise. 2026 we will be departing from Miami on June 21 2026 for a seven night trip going to the Caribbean. That's right. We're going to leave Miami and then stop at Coco k in the Bahamas. After that, it's on to St Kitts, St Thomas and a beautiful cruise through the Virgin Islands. The first juice Cruise was awesome. The second one's going to be bigger, better and bolder. This is your opportunity to relax while making lifelong friends who have type one diabetes, expand your community and your knowledge on juice cruise 2026 learn more right now at Juicebox podcast.com/juice. Cruise. At that link, you'll also find photographs from the first cruise. 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. 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. I'm having an on body vibe alert. This episode of The Juicebox podcast is sponsored by ever since 365 the only one year where CGM that's one insertion and one CGM a year, one CGM one year, not every 10 or 14 days ever since cgm.com/juicebox this episode of The Juicebox podcast is sponsored by the Omnipod five and At my link, omnipod.com/juicebox you can get yourself a free, what I just say, a free Omnipod five starter kit, free. Get out of here. Go click on that link, omnipod.com/juicebox check it out. Terms and Conditions. Apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox links in the show notes. Links at Juicebox podcast.com.

Monica 3:05
Hi. I'm Monica. I am mom of Timothy, who is 17 years old, and he was diagnosed with type one in October of 2020, almost five years ago. Yes, almost five years ago. Okay. He was 12 at the time. He was 12 at the time.

Scott Benner 3:21
Okay, do you have any hype, any autoimmune stuff like hypothyroidism, or anything like that?

Monica 3:28
It's interesting because I was hypothyroid during my last couple years of high school, and then beginning of college, was on Synthroid, and then it went back that I didn't need to take thyroid. I've had it tested for the rest of my life since then, and right now, I have a very kind Doctor Who is saying, Hey, your t3 and t4 levels are a little bit low. I don't have antibodies showing that it definitely has Hashimotos or anything. But she said, let's, you know, let's try working with a little bit of the natural thyroid to see if we can improve some symptoms. And thanks. So it's interesting, because I do, I know your next question may relate to any auto immune in the family. My sister has mixed tissue mix connective tissue disorder, which has features of scleroderma and dermatomyositis, so they kind of can't categorize it, but I have a sister in law, not related, who has lupus, and she said, really, with a lot of the autoimmune you've got overlapping symptoms, and they doesn't really matter what they call them, they're using the same treatments for most of them. So it doesn't really matter, but you have characteristics of

Scott Benner 4:47
each different things, right? Yeah, so you have how many children

Monica 4:52
I have, three. I have Peter, who's 13, Timothy is 17, and Jacob is 19,

Scott Benner 4:56
and when he was diagnosed, to. You by surprise,

Monica 5:01
yes and no. So it was, it was October, and during that summer, it was covid, and we had decided to get a water cooler. We noticed that he was drinking a lot of water. Actually, my my husband noticed it, and he had been diagnosed pre diabetic, and then type two. And he, he first started saying to him himself, oh, I'm drinking so much water. I'm drinking so much water. So when Timothy started drinking on a lot of water, he had, you know, Dave was thinking, hey, you know what? You know what, if there's diabetes. And so he was thinking it from a type two perspective. I think, you know, there was no reason for us to believe that there was a type one issue. But he's he was drinking more and more. Your

Scott Benner 5:45
husband gone through that, and he saw it with you know, at first he probably just thought, See, I knew they were going to drink all this water is going to cost me an arm and a leg to have this water cooler here

Monica 5:55
Precisely, precisely what we thought, because it's a novelty. And it was the summertime, and it was hot, and we were home all the time. We weren't out and about as much, so the water consumption was high. And I Yeah, and I looked at and I thought, oh. I said, No, you know. And I I didn't want anything to be wrong, so I didn't in. And I am tend to, I do tend to worry about, you know, possible things. I overthink things. But I didn't jump on that. And I didn't, I didn't really think anything of it. Then as the summer went on, Timothy said, you know, I've lost some weight, and now he had gotten a little bit, I mean, thicker, I guess. And teenage boys tend to do that as if they'll go through phases where they grow out and then up and out and then up. So he was, he had a little bit of a punch, but nothing big. But he said, You know, I've lost weight, but then he had lost a bunch more weight. And I called the pediatrician. I said, you know, we need to come in and get checked out. We got in there and he had lost, I'm trying to think, 10 pounds or so, and I could see on the his face, the PA his face, that, you know, he was like, because he was reassuring me, you know, everything's probably fine. Then he looked and he said, he went, Okay, let's, let's

Scott Benner 7:12
test him. Did you bring up diabetes when you brought him in, or did they bring it up?

Monica 7:16
I honestly am blanking. I remember, I think I said we're wondering if he possibly has diabetes, and it was the weight loss, and the, I said he's got weight loss and he's he wasn't saying that he was going to the bathroom all the time. And I don't know Sure, my my boys, somebody's always going to the bathroom. I don't know. Um,

Scott Benner 7:35
three boys is a lot, isn't it? Plus your husband is four, right? Yeah, right,

Monica 7:39
exactly. So I don't know somebody is always peeing, so I hadn't noticed that, but I say he's been drinking a lot of water, and he's lost weight. And so I think they thought, okay, nervous, mom. But then when he got on the scale, then he said, Okay, so they had someone in to did blood work for the A, 1c, but then after that, they came in with the meter, which I don't know why it wasn't in the other order, it read high and they said, Wait a minute. And they got the doctor to come in and try it again. And they said, Okay, we're sending you over to Morristown hospital, to the children's hospital there. You want to go there instead of the hospital that's near me, because they'll be well equipped to deal with this.

Scott Benner 8:21
You said you can overreact to things, right? And so did you have that kind of reaction, or did you hold it together? Was your husband with you in the office? Did you go right to the hospital? I

Monica 8:31
came home, and I don't know where. I'm trying to think of where Dave was at the time, but I remember very clearly I went out in the in the driveway, and I called my dad, and I said, we're going to be, you know, Timothy has type one diabetes, we're going to be going over to the hospital. And I said, you know, it's all going to be okay, but I don't know how much more i i can take, because in March of 2020, my mom passed away from stage four cancer. It was the weekend that everything shut down for CO for covid, yeah, so we actually were driving back to New Jersey. Exits were shutting down, and everything hers was the last funeral they were able to have at that church. So I had been grieving, and, you know, at home and by myself with the kids over the course of that summer, but then to be hit with this and say, All right, I'm going to pick myself up, and now we're going to, we're going to work on this. But I thought I remember feeling this is this is overwhelming. And you know what was me? And you know, how come I gotta deal with one more thing.

Scott Benner 9:42
How old are you today? I am 5353 Oh, wow. Are you okay? Yeah, yeah. So you're, you're in, you're 48 when this is happening. Then, yep, yep, your mom, your mom's passed away. Cove, it's happening. Your son gets type one diabetes. So I hear you saying that I know this is going to be okay, but I. Don't know if I'm gonna make it to the point where it's okay or not. Was that the idea like, maybe I'll sputter out here before we even get to the part where this has worked out,

Monica 10:07
I see, and I've noticed this too, is, is that I I'll get really nervous ahead of time. Of a lot of things now, all kinds of things with parenting, things going on is, and I keep telling this to my kids too, is that most of the time, that anticipation and the worry of what if is way worse than when you're actually dealing with something? Yeah. So when I when I am in a situation where there is something that's wrong and I need to fix it, I am not freaking out until afterwards, and there's a letdown. So I, you know, I shed a little tear in the in the driveway, went in, finished packing up the bag with Timothy.

Scott Benner 10:50
How did your son handle it like it not just in the moment, but in the preceding days and weeks? Was it overwhelming for him, or did he seem like he was feeling

Monica 10:59
again, knock on everything, because I do still have two kids who, you know, have a lifetime ahead of them. But we say if one of them was the one, Timothy was the Timothy is the one, the chill just rolled with it. This is kind of funny that there was this magazine. I think it's run by like, the same place they made highlights. You, since we're the same age, you might know the highlights magazine that we all look looked at as kid. There's these different ones, and one of them is a science magazine, and they had had a cartoon thing about type one diabetes, like a two pager. We had gotten home from a pediatrician, he went over to that he's a big reader, and he flipped to it, and like re read the little cartoon of this girl on a playground explaining to her classmates in the cartoon format that she has type one and what that means. And so he read again over what those details were as we were getting ready to go to the hospital. My story about how he accepted it, though, is after our stay, and we stayed, I think, about three days, they asked him if he wanted a wheelchair out, and he kind of looked at them and he, you know, he was like, you know, he's like, I'm fine. He said, Really, not that much has changed. Now I'm going to be taking a little blood out and putting some insulin in. And

Scott Benner 12:22
that was just his attitude about it. Yeah, that's awesome, yeah. And you think just seeing that little cartoon gave him some, I guess, perspective that he that he needed,

Monica 12:32
you know, context and a little bit of information about what it was, yeah, that was his only sense of what I mean. Thankfully, he'd had that. Because I don't know how with 12 year olds, you say to them, what's type one diabetes? Yeah, I think it varies depending on the people's families, and you know who they've come in contact with that, they may have no understanding of that, but what he had, and he could kind of grasp at was, wait a minute, I just read about type one diabetes. Let me read through that. And I think that cartoon probably did calm him down.

Scott Benner 13:09
Yeah, as much about how he deals with it changed in the five years.

Monica 13:15
No. One of the things that I, that I did want, want to talk about was the transition that I'm dealing with now, with him at age 17, with me starting off in the beginning, I am a researcher. I immediately I read, think like a pancreas and pumping insulin. And I I have not been a Facebook person, and I had never listened to a podcast, so I reached out for books, and I knew of I knew someone who that knew someone who had been diagnosed with LADA and was put into contact with her, and those were my initial sources of information, along with the people at at the hospital. So I have always been, okay, I've got all this information. This is what we're going to do now. As the years go by, I'm explaining to him more and more what's going on, what to do, how I handle it, and this process of what I think a range should be. And what Timothy thinks an acceptable range is is a bit of a difference.

Scott Benner 14:27
Is what he thinks of as an acceptable range based on health, or is it based on his desire to touch diabetes? And how many times a day, today's episode is brought to you by Omnipod. Did you know that the majority of Omnipod five users pay less than $30 per month at the pharmacy? That's less than $1 a day for tube free automated insulin delivery, and a third of Omnipod five users pay $0 per month. You heard that right? Zero? That's less than your daily coffee. For all of the benefits of tubeless, waterproof, automated insulin delivery. My daughter has been wearing an Omnipod every day since she was four years old, and she's about to be 21 my family relies on Omnipod, and I think you'll love it, and you can try it for free right now by requesting your free Starter Kit today at my link, omnipod.com/juicebox, Omnipod has been an advertiser for a decade. But even if they weren't, I would tell you proudly, my daughter wears an Omnipod. Omnipod.com/juicebox Terms and Conditions apply. Eligibility may vary. Why don't you get yourself that free starter kit, full terms and conditions can be found at omnipod.com/juicebox when you think of a CGM and all the good that it brings in your life, is the first thing you think about. I love that I have to change it all the time. I love the warm up period every time I have to change it. I love that when I bump into a door frame, sometimes it gets ripped off. I love that the adhesive kind of gets mushy sometimes when I sweat and falls off. No, these are not the things that you love about a CGM. Today's episode of The Juicebox podcast is sponsored by the Eversense 365 the only CGM that you only have to put on once a year, and the only CGM that won't give you any of those problems. The Eversense 365 is the only one year CGM designed to minimize the vice frustration. It has exceptional accuracy for one year with almost no false alarms from compression lows while you're sleeping, you can manage your diabetes instead of your CGM with the ever since 365 learn more and get started today at ever since cgm.com/juicebox one year, one CGM.

Monica 16:44
I think it's it's that. But then also he and my husband, they, they were told from the beginning they don't die, advice, right? 70 to 180 7180 and so I don't want to scare Timothy, and I'm not doing it out of panic, either, but I know that every time you're going higher, you're introducing some more possibility of risk, or a possibility of things that are not good for your body. So I, you know, I really do want to keep it in a tighter range he doesn't understand the, you know, stickiness, and the, you know, the tiny little vessels, and all the stuff that we've talked about

Scott Benner 17:30
Monica, because you haven't shared that with him yet.

Monica 17:34
I have, you have, but I have, and I say, you know, every time your blood sugar gets high, it's sort of, it's kind of scraping. You've, you've described it as the scraping, you know, sort of scraping away in there. And that's not good. But he doesn't have, and I'm glad he's chill, and he doesn't have the sense of the sense of urgency, but I see something, and I think, crush it. Crush it. We gotta take care of this. And he's like, Yeah, I, you know, I took some insulin, it'll be fine again. It's the sense of urgency and how he reacts, and it's not that he ignores anything, yeah, but he isn't as aggressive, and he doesn't act as as quickly as I would. And I need to gradually accept that we're different people, and I've been managing this, but the goal as a parent is to have your child become independent and manage their own life, and you are equipping them with the skills to do that.

Scott Benner 18:32
It's probably one of the more difficult parts of the maturation of this relationship, the diabetes, part of the of the relationship between a parent and child. I think maybe one of the most difficult parts is when you make the realization that you've told them they understand, and now you're waiting to see if they care enough to implement Yes,

Monica 18:52
exactly, and that is what I really am struggling with as especially during this past year, because he's gotten his driver's license. His friends have driver's licenses. There's a lot more of hey, we're going out to eat, and then I'm texting him. I do have to say that I really, really wish that insulet would have given a View app for us, because when we were on the dash and I could see what boluses he had given, I felt like so, you know, so much less of a nag than I do now texting him saying, Did you correct already fat and protein, please. And he'll say already did. Or, you know, sometimes he doesn't. But I could see before I could look at the I could look at my app, as you know, in that follower sense, and say, Oh, I see what's on board. I see that he just gave so then I didn't have to nag him. So I feel a little bit more helicopter ish now, because I'm always having to ask.

Scott Benner 19:57
So the visualization that you can make. Often stops you from needing to actually contact him, which stops you from bugging him, and him feeling bugged, and vice versa, you feeling like you're bugging him, right?

Monica 20:09
If I had the data, which I don't anymore, because, because of Omnipod five,

Scott Benner 20:13
Omnipod five doesn't have an app where another person can kind of see what's going on, how much insulin is in that, right?

Monica 20:19
Because the dash had the View app. It was Omnipod view. And then so you would look, and you would see, you would see iob, and you would see the lat the time of the last dose. Now we've got the three hour delay in these glue row and different apps that I've because I've looked to see if there's anything, but no, you you can't get that information.

Scott Benner 20:40
Omnipod say they were going to make that and they haven't, or did they never mention it? Never

Monica 20:45
mentioned it. And I've looked and I haven't seen anything. I've, you know, I, you know, I'm sure I was on the customer satisfaction review survey things. I'm filled it out a dozen times because we went to Omnipod five in June of 2022 as soon as it came out, we had been on dash for four months, and I switched right away went, you know, went with it, and just was figuring this out, and then realized over time how much I missed, even just the four months of having that the view, yeah, before that was we had in pen, and So I had visibility with that. And I really do think that that was, that was an awesome thing for us, the in pen, because you could see the doses. And so I again, we had a history of what's going on, and with two people doing don't and with the doses, and with having a teenager, that's an, I think it's a really an excellent thing to be able to see that without the nagging

Scott Benner 21:42
part, yeah, of course. Well, I mean, you're making your plea here, they'll definitely hear it here. So, oh,

Monica 21:49
hopefully. So trust me, it would be great. Yeah,

Scott Benner 21:53
that's awesome. Well, there you go. I think it's a great idea. I see the value in it, like, beyond just management stuff. But like you said, like helping to, you know, not put extra stressors on people's relationships. It's a big I think it could be a big deal, you know, right?

Monica 22:08
I would love to loop, but I know that both my husband and my son would be hesitant to do that. They would be concerned not FDA approved. What is this? You're just dealing with some guy on the internet who's creating something they they would be opposed to that. I would love to have the ability to loop for several reasons, but one of them is being able to have that real time information without constantly being, you know, the diet and the diabetes. Why do

Scott Benner 22:38
you think you're comfortable with it, and they wouldn't be, is it because you're involved online? You see people using it?

Monica 22:43
Yeah, I know so much more about it. My husband is not past a lot of the information that we got at the hospital. He didn't read books, he didn't dive into that. That's always been how I was, how I have been. I thought I wanted to be a reference librarian when I was in elementary school, I just dive into a topic, learn all that I can about it. I just love information. So I when I had something to direct this information, the information gathering, you know, I went into and I read all of that. So I have a more of a comfort level, because I hear of so many people and listen to the loop and learn videos, stuff like that, that I am comfortable with it, but they think, Wait a minute, you know? What if something goes wrong with with the computer program? You know? What if,

Scott Benner 23:32
well, when you share that with them, I mean, have you shared that with your husband? Like, Hey, I've really researched this, and I think this is a great idea, yeah. And you don't get a lot of response back on that, not

Monica 23:43
enthusiasm. No, we started out in the beginning with that, with the MDI, Dave, you know, I have always had a big problem with needles, so, and then now, all of a sudden, I got to inject my kid all the time, and our hospital and malar endo had said, No, it's a year until you can have a pump. So that's, you know, as you know, a lot of needles. He gave a lot of the shots in the beginning, and then I got more comfortable with it. So in the beginning, we were real good with the you count the number of carbs we had our little log. We had to write every single thing down how much we'd given. He was involved in a lot of that. And then we were waking up, Timothy up for blood sugar checks every three hours overnight for the first couple weeks. Couple months in, we got the Dexcom. So Dave was involved more in the beginning, but again, as I'm saying, he still believes that it's you do this, you do this, and you and then you've got to you've got a good outcome, because you did what you were

Scott Benner 24:39
told. He bought the sales pitch that he got the first time, exactly,

Monica 24:43
yeah. And he missed the part where someone in the hospital did say, this is more of an art than a science. But he sort of missed that part. It truly is with all the variables. And he'll look and say, Well, what you know, didn't he dose? Yes, he dosed. How? However, there's the fact that another thing, Timothy likes to run the pods right up into the end. And I know that at two and a half days, or less than 50 units, if we get that,

Scott Benner 25:12
that's not the best time to have a loaf of bread. No,

Monica 25:15
no, because we know that the absorption something's going on and it requires X percentage increase in the doses. But I don't really know how to figure out how much. I just know it definitely takes more insulin on the last 12 hours or so. I say, Timothy, can you change the pod?

Scott Benner 25:35
So, yeah, well, no, I hear what you're saying. That's the human part of it, like if people with type one who don't have kids with type one are listening to you. Probably think when I say it too, they're probably like, oh, yeah, get out of their business. It's up to them. There's more to it than all that, right? And that's part of it, like, but then the the rest of it for you is to realize that they're right to some degree as well. Yes, like, it is just, it is his thing, and it's just, it's hard I imagine, if you're anywhere in your mind, like I am, it's hard to imagine that 10 years from now, you'll have absolutely no sway over your son whatsoever. And what if he's a person who just doesn't take care of his health, right? Like, that's what scares you. And it's funny, because you have two other kids, I bet you don't think about it once, about them. I

Monica 26:20
mean concerns about what, about what they might do 10 years from now.

Scott Benner 26:25
It's tough, because it puts you into that like, into that mindset cost. I think about stuff like that all the time, and when I talk to my brother in law or my sister in laws or whatever, like people, I know that I can sit down and speak like very candidly with about their parenting styles. They don't think about their kids at all, all, not at all. Like, you know, like, I one point, somebody close to me is kid, you know, kid in their 20s is having trouble. And I was like, Well, are they going to the bathroom regularly? And she goes, How would I know that? And I was like, Oh, all right, you know, I said, What about, like, vitamins and this and, like, I'm asking questions. I have no idea, right? Like, no idea. And I was like, oh, okay, right. By the way, there's part of me, Monica, that yearns for that, but then there's also part of me that looks up and sees 60 and 70 year old people with their 30 and 40 year old kids, and their kids are in horrible health situations, and I think they didn't get the information they needed. And now it really, I mean, it's not too late. You could certainly do something for yourself, but it's a lot of wasted time, right? Yeah, right. So you have that feeling too, yeah,

Monica 27:29
it's, it's that balance, because, again, like I said, always into into research, diving into stuff. So I've, before all of this, I've been super interested in nutrition and the effect, you know, the effects on, you know, what, you know, what we eat, and the, you know, supplements and all of that. So when I look at this and think, all right, pre, you know, for long term health, the, you know, these are things that are good for you. And you know, with all three kids and my husband, too, with, you know, I really like the it won't be new now, but it's new as of right now. The series with Jenny about nutrition and looking at these, these building blocks that we're putting in, and how our bodies are processing all of that. So I have to say that in the beginning, I felt a little carb phobic, because we had to count everything. And I thought, okay, so we should be reasonable, not restricting, but kind of restricting the carbs, because that's going to cause more variability. And so we looked for lower carb options, and I realized some of that was fear, so I started working towards being able to dose for what he wanted to eat. However, as Jenny points out, and you were pointing out yesterday with a story about Velveeta, what we want to eat is not necessarily what's best for us to eat. So like you've said just before, you can't you can figure out how to dose for a pop tart. Is that the goal to try to support your child eating Pop Tarts. If you know that that is not the way that long term health is is going to be secured. Yeah,

Scott Benner 29:08
it's a balancing act, that's for sure. If it makes anybody feel any better, this wasn't about diabetes, but it was something health related. Still, I suggested something to Arden recently, and she goes, You don't know what you're talking about. Like, she just hit, and I was like, I've had 17 different conversations with 14 different doctors about this. I might have a grasp of this stronger than a lot of people, you know, like, and what I realized was, is that it was one of those things where she was like, I think this happens to a lot of people. Like, I was trying to talk to her about a supplement, like, nothing crazy, just, you know, keeping her vitamin D level up. That's not a thing she sees impact from Do you understand, like, what I mean? Like, she doesn't wake up one day go I took a vitamin D tablet yesterday, and the next day I felt better. Nobody feels that, but I know it's important to keep her vitamin D level up for a number of reasons. And when she turned to me and she's and I realized for a moment, she just saw me as like, Oh, that's my dad. He thinks he knows something. Thing. And, like, then there was part of me that was, like, on this, like, I'm wrong about a lot of stuff, but on this, I'm right. I absolutely do okay. And then I realized, like, That's it, like, this is a is this a thing you're gonna argue about? Like, it's not, like, I don't wanna create a divide with her over vitamin D, but at the same time, I can think off top my head of four really good reasons why she should be taking it, and I think they're all backed up by a lot of science and a lot of experience with people. And then I just sit there, and I think there's going to be a time she'll be in her mid 20s, like I just have to wait till then, because then you say it again, and she'll take it more seriously, like she's still growing as a pre I know she wouldn't think this. If you brought her in here right now, she'd be like, I'm a fully formed person. I'm as smart as I've ever been. I'm smarter than you, old man. I've heard you say stupid stuff, like she's still stuck in that. But I know, because my son's a little older, that once you get through that last push of defiance, like you start turning into an adult. I really am beginning to believe, like, that's going to be my last stand with Arden. Like that's the spot where I'll have the most success now that she's older, it's going to be like after she's in her mid 20s. I think,

Monica 31:17
anyway, I'm I am hoping for that. But then when I look at talking to people about nutrition and health and wellness in general, I think you have people that are in the realm of they can see why they might want to try something, and some that are not that's just not a higher priority thing for them. Yeah,

Scott Benner 31:39
and they, they might not connect the dots to ever that can happen as well. I mean, nutrition is an example of, like, it's such a good one. Like, I know I'm probably losing listeners by putting up content about nutrition, because some people are probably like, don't tell me how to eat. And I'm I certainly don't think we're doing that. But no, no, no, definitely not. But at the same time, like, I watched a conversation online the other day about soda and there, I mean, people do not understand how bad soda is for them. Like, generally, spam me people, there are people who do understand, but like, the of those who don't, they're just like, it's a drink. They don't see it, you know, like, and you could, you could try to sit down and make that argument anything like, I would tell you right now not to drink orange juice that is, generally speaking, not healthy. Like, have I had a small glass of orange juice with breakfast? Sometimes, because it's, like, very tasty, like I have, but there's 3000 better ways to get the nutrients in orange juice without all the sugar that comes with it.

Monica 32:31
Absolutely, absolutely. I just heard someone, a medical doctor, on a podcast, talking about metal you know, metabolic issues, and you know how? You know how we're looking at glucose spikes in every day, you know in everyday people, and why, and the effects over time of what happens and metabolically what happens as we get older. And he said, I love the taste of oranges. I love to eat an orange, and I do love to drink a glass of orange juice, but within a couple of seconds I have consumed eight oranges, yeah? And so our body wasn't meant to process that delicious orange in that quantity that quickly, yeah, 100%

Scott Benner 33:12
and anyway, my point is, you say that to somebody and they really don't know or something so, like, prevalent in their life, they don't even, like, they're like, Wow, how could that be bad? Like, there's a whole aisle of that at the grocery store. Like, how could that be bad for people? I see all kinds of people buying it. They're not dropping dead in the driveway Exactly, exactly. And I tried to be open about it. Like, when I was talking to the person online, I was like, Look, you should do you I don't care. Like, don't do whatever you want. I was like, but I don't think you should drink sugar. And I said, I think that a lot of what's in soda is bad for you. And I want to be clear. I'm saying that as a person who's literally drinking a diet soda while I'm having this conversation, I'm not like, perfect. I'm just and I know that I'm having all the bad things that you're having, but at least my bad thing doesn't have all the sugar in it, and it takes five seconds for someone to come in and go, you're using an artificial sweetener that's more dangerous than sugar. And I'm like, I just said, I know this is bad too. Exactly, both not good for you. I'm just trying to limit the sugar. And my point isn't that you should be drinking diets so deep. And my point is that that's not good for you at all. Now I know you're going to have some of it like and a lot of people are, but that point that Jenny and I are gonna, you know, either have made in an episode that you've heard, or you're gonna hear us make at some point we both, I think it is the one that just went out. You probably just didn't hear it like we both related a story of watching someone walk out of a grocery store with what appeared to be months worth of soda, hundreds and hundreds of dollars of it stacked up in carts, and I'm like, God, like, have a glass of water that's gonna kill you. And in my experience, the person I saw doing it did not look like they were having great health outcomes. And so anyway, like, it's neither here nor there. I'm not even sure how we got farther down.

Monica 34:57
Yeah, no, I Well, I do. Yeah. It's because I'm here. But the the episode was yesterday, while I was mowing the lawn, I was listening to you and Jenny talk about this and how you had similar people. And she said, I think I saw her in my grocery store too. What I liked about that is, in that afterwards you were talking talking about, and I do sounds dramatic when we say it and we talk about, well, there becomes somewhat of a an addiction, that you get hooked on the taste, and you get hooked on these, the the formulas that they've they've got, and then that becomes a habit that what you do is you drink several, several sodas. Or we're in the day, you know, we're in the days now of you know, oh, you know what that that restaurant doesn't have free refills,

Scott Benner 35:42
yeah? And then it turns into a quantity issue. Yeah, you're just taking in so much like, yeah, like, Listen, I'm not a perfect person. I have a diet soda with me while I'm recording the podcast constantly, because it keeps my mouth wet without I don't know how to put this, but if you talk a lot, and you're being recorded, water's not the way to go, because it somehow dries your mouth at the same time you get, like, Smacky. And so there's something in this poison that's in this cup that stops that from happening. So I use it while I'm recording. Also the not for nothing, I take in no caffeine except for this. So it does also help me. While I'm recording, it gives me a little, a little bump. You know what? I mean? I

Monica 36:24
kind of wanted to ask about that. You net coffee tea. You never did you try it and not like it. Or

Scott Benner 36:30
as an adult, I have never drank coffee. Okay? As a teenager, I've never drank it. I probably had a few sips of it when I was a kid, because my parents drank it all the time. It just never occurred to me to try to coffee. I will have a cup of tea a few times a year. But I have to admit, that's even a thing that bothers me. I like hot tea. This is going to sound ridiculous to people, but like, I'm so busy and running around so much that warming up the kettle and putting in the it's almost more time than I can, I can give away, and I know that once my life gets calmer, I will drink more tea. But no, I've never had coffee, and I don't think I'm missing anything, and I don't care,

Monica 37:11
see, I do like the smell of it, and that, you know, like it's, it's something that I smell it, and it's, you know, it's part of my morning, all of that. And I think for a lot of people, it does feel that way, but, and then no one in the house drinks, drinks coffee.

Scott Benner 37:24
No, my wife doesn't drink coffee. My kids don't drink it. Yeah, my kids don't drink alcohol generally. I mean, I'm certain that they've, you know, I'm certain Arden's been in a party and had a shot of something or something like that, but she doesn't drink at all. My son went to college and, like, he's, like, I don't drink. Like, it's just not a thing I do. It's, I don't know, we're not that's not the stuff we do, I guess, and for no reason, like, it's not a I'm not making a judgment about anything or anything like that. And I think coffee smells good. I think it smells awesome. Actually, it just never occurred to me to try it. And now the truth is, is that, like, even if I wanted to, I'm so cheap, like, I don't know what a coffee cost at Starbucks, for an example, or dollars? Yeah, no, no, you wouldn't get that money out of me if I was bleeding to death. Nope. Yeah. So

Monica 38:10
me, no, me either maybe is a little bit of a segue, as it's something that I did when I saw there was an email that went out earlier today saying, you know, say, you know, sign up to be on the podcast. And I looked and I thought, hmm, if I did what I need to tell Scott is that he needs to stop saying how old he is, because this I'm so old. I'm so old when you are about a week older than me, you know, I'm yelling back at you. You upset? Yeah, I'm guess, because we are not that old, sir,

Scott Benner 38:43
yeah. Well, I'll tell you, Monica, I just, I brought this up the other day, so I don't, I won't belabor it, but there's a tick tock trend right now, of like, this is 50 or something like that. And every one I've seen I'm like, Man, those people look way older than I do, right? I have to tell you, I don't feel old. Like, the only time I feel old is now when I get tired, I'll tell you that I think the thing that saved my life is the woman who came on and told me to try looping back before tandem had control IQ, before Omnipod had Omnipod five, before Medtronic had so before all those automations were available, this person was like, you should try this. Do it yourself. System and it let me sleep, sleep, and when I got rested, I had the opportunity to look back to see how exhausted I was, right? I think it would have killed me eventually, especially now this many years later. Of all the things that I used to be able to just put my head down and run through a wall like if I don't get sick often at all, but if I did, I'd get up the next day. I'd be fine. If I didn't get a good night's sleep, it didn't matter. I'd get it the following night. But now, if I just had this happen to me a week ago, Arden like got high overnight. It woke me up. I got up. I realized she was asleep already. I made a Bolus. I adjusted some basal. This whole like, I pushed her like, I pushed her blood sugar back in the other direction. And I found myself thinking, I want to wait 20 minutes to make sure this does what I think it's going to do. If it does what I think is going to do, 20 minutes from now, it's going to be okay, and if it doesn't, I probably have to put in another half a unit. This was my thought, right? Well, in that 20 minutes, I woke up, and then it was two o'clock in the morning, and Scotty wasn't sleepy anymore, and then I didn't go back to sleep till four, and I just missed two hours of sleep in the middle of the night and the entire next day. I wasn't worth Yep, and that, I think, is my age, honestly, Yep,

Monica 40:35
yeah, I see that with the with the sleep and the effects of sleep, yet I still do the stand up a little bit too late get, you know, reading something, whatever. I really should be in bed, because I know I'll, you know, I'm going to pay for it in the morning there. I still kind of believe that I'm able to do that, and I'm not. The other thing is, driving at night. That's some, that's where I do see that I feel

Scott Benner 41:00
older part on your eyes you can't see. Well, yeah,

Monica 41:03
I have contact lenses, and I've had glasses since I was six years old, and so because of that, and then the slightest stigmatism, but just with getting older, the eye doctor says, yeah, the you know, the nighttime driving vision is,

Scott Benner 41:16
yeah. Every day I come in this office and I sit down, and for the first five minutes, my eyes have to adjust the distance I am from the keyboard and the monitors. And I sit here. I don't want to lie to you. I sit here angry, waiting for that to happen. My eyes were so perfect my whole life. When I first sit down and fire up my monitors, they're not clear. And then after I'm here and I adjust to the distance they are, and even, like, I'll look down at the keyboard in the beginning, I can't even start working because the keyboard is blowing like, if I didn't know how to type, I'd be stuck sitting there waiting for everything to come into

Monica 41:49
focus. I wonder what that is, though, because that's not like a reading glasses sort of issue.

Scott Benner 41:53
No, if I put my reading glasses on, it would be fine right away. I don't want to do that, so I sit there and I just wait for my eyes to adjust, and I'm irritated the entire time. Like irritated is the wrong word. I'm angry the entire time, and I do, and I think that's age as well. Now, having said that, I don't look like I'm 25 but I think if you line me up against a bunch of people in their mid 50s, no, you could easily believe I was 10 years younger than they

Monica 42:17
are. You've told several of these anecdotes on the podcast. I'm very young looking. So there are, there are young women. And who are, you know, who are baristas and sort of things. And they comment about, about how useful you are.

Scott Benner 42:29
It's lovely, you know, it's, it's, it's lovely. This is the secret, Monica, it's there. It really is like, if my hair is dark, so I pull it off. Well, I haven't gotten to that spot yet where my hair looks like it's markered onto my face because my skin is too light, you know what I mean? Like, when white? Yeah, that hasn't happened to me yet. So that's it. The day that happens, I just give up. It's

Monica 42:49
over. Yeah, I have friends that hate me, but I haven't had to color my hair yet. Yeah, either. And so it's, it's a big deal.

Scott Benner 42:57
I'm not going to color my hair. I'm just going to give up.

Monica 43:01
I don't know if I'll just give up, but, but, yeah, I, you know, I get it. I think it's part of it, though, because you you can tell when somebody's got a natural hair, hair color, male or female, yeah. And I think that that might be part of it. I don't know. Inside, I definitely don't feel as old as as we are. There are things that I think, wow, I used to be able to do X or Y, but, you know, I think it's true. It's the stuff with the sleep and then, yeah, the vision, the vision stuff. It's, yeah, it's, I mean, there's nothing we could have done about it.

Scott Benner 43:31
No, not at all. It just is what it is. But I'll tell you that one of the things that I'm very aware of is that I know my personality, my language, and how I think about things, probably comes off decades younger than I am, right? So when you're in public and you start talking, I can see sometimes that either, like, younger people are, like, confused. I mean, I'm not gonna use the word creepy, but it comes off. I probably comes off oddly to them that apart like I look, I look younger than most 53 year old people, but I don't look like I'm 25 you know, I'm an older person right here I am talking about, like, stuff that they just don't see people their parents age talking about. And I know at some point I'm just gonna have to bite my tongue, because it's gonna come off so weird. And then when I get around people my own age, I have no interest talking about any of the crap that they want to talk about, I know. Like, so that becomes a problem, too. So you're around a bunch of people your own age, and you're like, Have you heard this song from this like button? They're like, What are you talking about? I'm like, oh, it's really great. Like, you start talking about it. You're like, you bring up something, and you know that's happening, you know? And you're and they're, I'm like, Have you heard about this? And they go, No. And I'm like, What do you think about Kanye? And they're like, who? And I'm like, Oh, okay. Now people don't know this, yeah, but Monica has wanted to come on the podcast. Was too nervous to do it. She's been listening for a long time. She's very active in the Facebook group. She's a great supporter of the things I do. And she and I were messaging about something today. She was literally trying to help me with. Something. And I said, Have you ever thought of coming on the podcast because I suddenly have a slot available today? And she's like, Oh, I'd be too nervous to do that. But then two and a half hours later, here we are recording, so she didn't get the time to, like, write a note and tell me what she wanted to talk about. So is there anything you really want to make sure we get

Monica 45:16
into I when I thought about that in the couple of hours of thinking that I had Timothy and his development there. And, I mean, we've talked, we've talked about that a little bit. I'm trying to think about anything

Scott Benner 45:27
else, because I have stuff to ask you, but I want to make sure you get what you want to

Monica 45:31
say. I'm looking over here because I did have a note, a little page, in case I ever did have the nerve to go on the podcast, the details of when he was diagnosed, what we're doing it now I think that, like, it's a recap what we were talking talking about, just I think that it really is hard for us as parents when we take a look at what we always want better for our children, and that combined with the overthinking, and I'm saying, All right, so I, you know I want, you know, I want between 70 And 140 I want 70% or more in that. And with all the data and information that we have, we can keep looking at that, and we can get into the area where we are bugging our children, or, you know, stepping in too much. That's something that I that, I definitely think that that, you know, balance is important, but really difficult to do because you want the best for your kid, but you also don't want things to be all about. Come on, you should have given more. Yeah, come on. You've got to correct this. This now

Scott Benner 46:30
it's definitely the fast track to you not having a good relationship as the as adults, or them pushing back and willfully not doing what you're asking, because it's the thing you're asking for them to do. I mean, like, listen, the easy example is, is that nobody makes more Democrats than Republican parents, and nobody makes more Republicans than democratic you know what I mean? Because you're because your kids are going to just hear what you're saying and then look to the other direction. That's all.

Monica 46:56
I don't think my husband has ever heard that one that that's very interesting.

Scott Benner 47:01
Monica, like you hear your mom and dad say something one too many times, like, I don't want to be connected to this anymore, and you don't want that to be diabetes, right? Exactly. It's funny because you listen to adults come on here in their late 20s, who have who grew up through high school with type one and went off to college, and they tell you, I wish my parents were more involved. I wish when I pushed back, that my parents wouldn't have given up. But that's hindsight. You can if you could go back and ask the 17 year old them, they'd say, my mom's an idiot, my dad's an Assal. They don't know what they're talking about. They're bugging me like but like, everything's hindsight. When you hear somebody say something thoughtful, it's almost always in hindsight. So you know, the problem is you have to deal now and in now with with the person you're speaking to. And that's why I think it's always important to keep a really long view of what you're doing, like you're not trying to win the day. You're trying to make sure that in the future, you've raised a person who wants willingly to take care of themselves.

This episode was too good to cut anything out of but too long to make just one episode. So this is part one. Make sure you go find part two. Right now it's going to be the next episode in your feet. I'd like to thank the ever since 365 for sponsoring this episode of The Juicebox podcast, and remind you that if you want the only sensor that gets inserted once a year and not every 14 days, you want the ever since CGM, ever since cgm.com/juicebox cgm.com/juicebox one year one CGM, touched by type one sponsored this episode of The Juicebox podcast. Check them out at touched by type one.org. On Instagram and Facebook. Give them a follow. Go check out what they're doing. They are helping people with type one diabetes in ways you just can't imagine. This episode of The Juicebox podcast is sponsored by the Omnipod five. And at my link, omnipod.com/juicebox you can get yourself a free, what I just say, a free Omnipod five starter kit, free. Get out of here. Go click on that link, omnipod.com/juicebox check it out. Terms and Conditions. Apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox links in the show notes, links at Juicebox podcast.com. I can't thank you enough for listening. Please make sure you're subscribed, you're following in your audio app. I'll be back tomorrow with another episode of The Juicebox podcast. My diabetes Pro Tip series is about cutting through the clutter of diabetes management to give you the straightforward, practical insights that truly make a difference. Ins, this series is all about mastering the fundamentals, whether it's the basics of insulin dosing adjustments or everyday management strategies that will empower you to take control. I'm joined by Jenny Smith, who is a diabetes educator with over 35 years of personal experience, and we break down complex concepts into simple, actionable tips. The Diabetes Pro Tip series runs between Episode 1001 1025, in your podcast player, where you can listen to it at Juicebox podcast.com by going up into the menu if you're looking for community around type one diabetes, check out the Juicebox podcast. Private Facebook group Juicebox 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,

Please support the sponsors

---

The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!

Donate

#1613 Bolus 4 - Intro and Doritos

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.

Jenny and Scott talk about bolusing for Doritos

+ Click for EPISODE TRANSCRIPT

---

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.

In every episode of Bolus four, Jenny Smith and I are going to take a few minutes to talk through how to Bolus for a single item of food. Jenny and I are going to follow a little bit of a road map called meal bolt. Measure the meal, evaluate yourself. Add the base units, layer a correction. Build the Bolus shape, offset the timing. Look at the CGM tweak for next time. Having said that these episodes are going to be very conversational and not incredibly technical. We want you to hear how we think about it, but we also would like you to know that this is kind of the pathway we're considering while we're talking about it. So while you might not hear us say every letter of meal bolt in every episode, we will be thinking about it while we're talking. If you want to learn more, go to Juicebox podcast.com. Forward slash meal, dash, bolt. But for now, we'll find out how to Bolus for today's subject, 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.

This episode is sponsored by the tandem mobi system, which is powered by tandems, newest algorithm control iq plus technology. Tandem Moby has a predictive algorithm that helps prevent highs and lows, and is now available for ages two and up. Learn more and get started today at tandem diabetes.com/juicebox All right. Jennifer, I have an idea, okay, and I've been workshopping it in my mind now for a few weeks, and I want to work through the rest of it with you now. Awesome. I'm very worried that I'm going to say something to you and you're going to go, oh, Scott, I already have that. And I don't want to steal your thing if that's the case, or maybe you don't, but I want to make a series of short episodes that's just about each episode is about bolusing for one food item. So imagine, right? So imagine that I might already have a list of hundreds of food items from listeners, and they're like, please tell me how to Bolus for this. Or, you know, this specifically, not just pizza. I want to know how to Bolus for Domino's Pizza, very specific stuff, not just cereal. I want to understand how to Bolus for Lucky Charms. Okay, that kind of stuff. And actually, good foods on the list too, Jenny, don't worry. Great. But when I started thinking about you, and I doing that, the first way I imagined it was me just saying to you, okay, Jenny, let's figure out how to Bolus for and then say the food item, and then us just talk it through, which I think is valuable, but I also think that there's got to be steps, like, whether we know it or not, there are steps in Our head about what we think about when we're bolusing, even if we're not actually thinking about it.

Jennifer Smith, CDE 3:05
Yeah, they're unconscious. They're sort of in a file cabinet. I've done this. I know how to it's almost like a behind the scene. Absolutely, there's their steps.

Scott Benner 3:14
Yes, do you have these steps written down? Ah, you don't. Excellent. Do

Speaker 1 3:19
I have steps written down for how I Bolus through things. No, that's 37 years.

Scott Benner 3:25
But like, what I'm thinking is, is that if there was a framework, then while we talk about it in each episode, we can use the framework, and then it'll become just a thing that happens without you having to know the framework. Can I give you the

Jennifer Smith, CDE 3:39
frame you can and I think it's probably while I don't have it written down, this is probably exactly how I teach bolusing for food, despite not having it written down, as I think about it, I know that I teach bolusing for food the same way, person to person and variable to variable. And then the one other thing that I was thinking about to, you know, you always talk about these ideas a little bit ahead of, you know, whatever. But my consideration too was, how do we bring into this Bolus thing for, let's say, an apple, and considering, then, is there something to adjust because of the aid system you might be using? Yep, right? So which I, I consider kind of, and I think you probably coined it. I don't think I've heard it anywhere other community in diabetes, but like the ninja level is now, you know, bolusing, you know the steps, but what's the system you're using? How does your algorithm work? Because that's going to make a difference in how you choose to Bolus for this particular

Scott Benner 4:52
food. Okay, I think this is going to be exciting. I'm pretty excited. So

Jennifer Smith, CDE 4:56
that was on, that was the only thing on this topic that I was like, You. This changes things, because people aren't just MDI and conventional pumps anymore, and

Scott Benner 5:06
I want them to, because CGM exists too, like all right. So here's how I have it laid out. I almost had it in an acronym, so close. Oh, so it's meal bolt, M, E, A, l, B, O, L, T, all right, meal measure the meal. So that step is list your carbs, fat, protein, glycemic impact, yep. E, evaluate yourself. Check your CGM, your blood sugar, insulin on board planned activity and stress level, okay. A, add the base units, calculate the food Bolus, the carbs divided by insulin to carb ratio. What is A? A is what add the base units? So the base units tough here. Okay, I'm trying to get an acronym in here. I don't know that we're going to end up with meal bowl, but I think the steps are here. So like, think about it right. List the carbs, the fat, the protein. Get that information. Check your blood sugar and your insulin on board. Am I about to go sit down on the sofa? Am I about to go for a run? Yep, now like calculate our food boluses using our insulin to carb ratio, yep. L, layer a correction look at the current blood sugar and the target. Use your correction factor right. Check on your insulin on board again. B, build the Bolus shape. Decide upfront percentage versus extended and duration. Yep. Offset the timing. Choose Pre-Bolus lead time or maybe a split dose. Okay. L, look at your CGM right to see to look for your curve. Are you on the way down? Are you on the way up? Maybe you need a little more. Maybe you need a little less. And then tweak for next time, log the outcome, adjust ratios split, so be flexible at the end. Yeah. All right, so I put it online, and people are like, that's a lot to remember. And I thought that's exactly what I think about every time I think about bolusing for food, but I don't consciously think about it that way.

Jennifer Smith, CDE 7:01
Well, that's why I said when you asked if I had steps 100% I have steps. They're just I've done them so much that I don't would have never come up with an acronym for them.

Scott Benner 7:13
Do you have any idea how hard it was to, like, sit down and go through it? I'm doing things so automatically, I couldn't find them when I was looking for them right away. It took me a while. Actually, I've been working on this for

Jennifer Smith, CDE 7:24
a while. Can I tell you what my favorite one of this is being the more type A versus that I tend to be. I really like tea tweak for next time. This encourages as much as people hate doing. It encourages some records. It encourages paying attention to the data that is all systems, even if you're just using injections, there is some place that's gathering that data for you that you can look back and say, Okay, I really want to figure out my apple, or I really want to figure out this great mark it down. Do these steps what didn't work. Tweak it for next time. That's my favorite step.

Scott Benner 8:08
Yay. So I think that everything's that's in these kind of like eight ideas. If you went right now and listened to the Pro Tip series, you'd hear they're there some version of that in the conversation, but it's very conversational. And I want these episodes to be small. I actually think I'm just gonna make them part of the small sip series, right? Like little tiny, like pieces of information. So what I was afraid was gonna happen was that I'd bring up a food, like choice, and then you and I would talk for a half an hour about bolusing for the food, because I think we could get lost talking about it. So I thought, like, we need a structure. Yes, yes, right? That's all so now, but, but what we really have to figure out is, is this actually, can there be fewer steps? Is this the step? Like, you know, like, that's the thing I want to figure out with you. So I'm gonna, like, I'm gonna actually make a thing and send it over to you. Okay, hold on one second.

Jennifer Smith, CDE 9:02
And for clarification, we're also talking about some of these foods will be simple, one item, foods like Apple, for example, and some things will be mixed meals. In fact, many of these are likely to be mixed meals

Scott Benner 9:17
as we go, yes, but in the beginning, you

Jennifer Smith, CDE 9:21
have them in order, from easy to hard. I'm still working on that. Okay,

Scott Benner 9:25
yeah, in the beginning, what I want is an encyclopedia of there must be like, I know I'm gonna say something crazy, like 50, but there must be like, 50 food items that most people eat, right? And

Jennifer Smith, CDE 9:40
most people have 20 to 25 themselves that are consistent over and over. Yeah,

Scott Benner 9:45
okay, I just sent you a link in your text. Okay, all right. So, so we'll, we'll look at these items, and I think we should practice a little bit, and then we'll like you and I will practice together, and then that's how we'll you. Start get these steps in order so that they're ready for when the next time we get on and we just start, like, because you guys don't know how Jenny, I make these, but we'll basically sit down for an hour and just hammer out as many as we possibly can, and you'll hear them five six minutes at a time. Like, so looking at it, tell me when you have it in front of you. I've got it in front of me. Is there anything glaringly missing, right? Like, really think about it like you're looking at food. How many carbs are in it? That's obvious. Is there fat or protein in it? Am I gonna have to Bolus for that? Yes. Is this a high glycemic or a low glycemic? Like, is it gonna hit me hard and fast, or is it gonna hit me, you know? Like, is

Jennifer Smith, CDE 10:36
it along with this? I think in measuring the meal, I think that's an

Scott Benner 10:40
appropriate I guess it's complete. We don't need anything else in that thought. I

Jennifer Smith, CDE 10:44
don't think so. But it also, when you're measuring, what are your look you're looking at measuring includes portion, how much are you eating, right? So beyond glycemic impact, there's also glycemic load, okay? And I think that that's valuable, because if we don't address portion size in the measure and talk about the impact or the difference that that can make, I think it may we may miss something right. We don't

Scott Benner 11:13
want to tell somebody how to Bolus for a bagel, but not talk about what would happen if you were going to eat three of those bagels, correct? Yeah, yeah.

Jennifer Smith, CDE 11:24
And my favorite one in that is watermelon, right? Watermelons got a really high glycemic index, but a portion, a single serving of it, doesn't have the load impact of eating four cups of it at a time, same glycemic index, but the load is what makes the difference, and then Bolus timing and all that kind of stuff goes along with it.

Scott Benner 11:45
Quite a handful or a cup of of watermelon, that's one thing. If I'm at a picnic and someone takes out a giant knife and slices off a two inch slab of it, and I sit down and shove it into my head, that's going to be different. Okay, so I added load to that. So list, carbs, fat, protein, glycemic impact and load, all right? The next step, evaluate yourself, check your CGM, your BGM, insulin, on board planned activity and stress. Is there anything else that the people could quickly assess about themselves?

Jennifer Smith, CDE 12:15
No, I think evaluate is. I think you've got everything here that would make sense. Okay. I mean, all evaluate yourself is not only where are you sitting in terms of hard numbers, but also what do you have going on? And those are the outside things, like variables that stress, illness, activity level, etc,

Scott Benner 12:38
right? Okay, the next one. I don't even know if I love the way I have this, like, add the base units, but calculate food Bolus, carbs divided by insulin to carb ratio. So calculate your food Bolus, so it doesn't have to be meal bulk, by the way. Like, I don't care what the acronym is. By the time it's over, this episode is sponsored by tandem Diabetes Care, and today I'm going to tell you about tandems, newest pump and algorithm, the tandem mobi system with control iq plus technology features auto Bolus, which can cover missed meal boluses and help prevent hyperglycemia. It has a dedicated sleep activity setting and is controlled from your personal iPhone. Tandem will help you to check your benefits today through my link, tandem diabetes.com/juicebox, this is going to help you to get started with tandem, smallest pump yet that's powered by its best algorithm ever control iq plus technology helps to keep blood sugars in range by predicting glucose levels 30 minutes ahead, and it adjusts insulin accordingly. You can wear the tandem Moby in a number of ways. Wear it on body with a patch like adhesive sleeve that is sold separately. Clip it discreetly to your clothing or slip it into your pocket head. Now to my link, tandem diabetes.com/juicebox to check out your benefits and get started today.

Jennifer Smith, CDE 14:00
No, the way you have this is correct, though, because the beginning steps of first you've measured, you know exactly, not exactly as precise as possible, what you're doing, right, and what the content kind of looks like. And then you're saying, Okay, well, my blood sugar's starting here, it's going up here, it's dropping here, I'm already low, blah, blah, blah. And then you're getting a calculation of knowing BG and knowing carbs, you're calculating what the dose would be just for the food to begin with. And then the next step is adding kind of a coating to that if needed a correction, or even taking insulin away, it could be correction in one way or another, more or a little bit less, yeah. And then the deciding pieces come in with the second word, which you know, the B, O, L, T, right when you're building in how you're gonna Bolus,

Scott Benner 14:52
Yep, yeah. So now we have, like, what the situation is, what situation I'm in, what are the details? Cells of how this insulin is going to get measured. Am I correcting for a blood sugar that exists already one way or the other? Like, you know, I know people hear that and think, Oh, if I'm 150 I need the meal, plus the, you know, the correction for the 150 but also you might get hungry and be 65 so we can still Bolus for that too. If we then look at the rest of it right, like, the side upfront percentage versus, am I going to extend this and how long am I going to extend it for? So build the Bolus like, shape like, think about how I'm going to apply this insulin to the situation. The B and the O kind of go together honestly, right? Because, you know, am I going to put it all up front? Am I going to spread it out? Am I going to spread it out for three hours? And how much of it is needs to be pre bolused? Right? Is kind of another way of thinking about it, because I don't know that like putting pre bolusing and split dosing together is really much I mean, is a split dose really much different than an extended I think that's kind of the same

Jennifer Smith, CDE 15:59
thing it is. But again, the way that, as you said, the build and the offset and they kind of go together. Sure they do, but for somebody who is newer, maybe to considering how to approach a meal, let's say they've used kind of pro tips, right, and now they need something like this as a stepping piece of in their decision making, because this brings it together. It kind of condenses all the pro tips in a way, which is, is nice somebody like me, all of these, they just float together like it's a quick, quick, quick, quick, quick decision. And if I had to, I guess I would have listed them like I had to think about a plan, but my brain just goes through these automatically.

Scott Benner 16:45
Yeah, you know. And I think that it does for most people, but there are still so many people online that are just like, I don't know how to Bolus for this item. And what that makes me think is they don't really know how to use their insulin well yet. But instead of continuing to tell them, like, Don't worry, you'll get it. You'll figure it out, which I do think is true. You know what? If there was a, like, a short Encyclopedia of 2040, 50 items that you just heard somebody say, because we're going to take a label and actually walk through this like, that's how you and I are going to handle this, right? If I figured that out for my basic stuff, and I did it over and over again, wouldn't there, like, that magic part you're talking about, where you just kind of know when it all comes out of your head, right? Like, maybe that would get them to it more quickly, is, like, kind of my hope also, you know, Jenny, there's stuff that I've thought I wanted to put into the podcast, and there's stuff that people have told me I should put in the podcast. And oftentimes those things are not things that occur to me. This is one of them. People have been asking for this for years, and I'll tell you the other thing they want us to do. They want us to break graphs down. Oh, and I always talk about, like, by the way, this might be the next series, but like, I always say, well, like, how am I going to do that without visuals. Like, the people listening can't see the graphs. And somebody said to me the other day, I was like, spitballing with a few people, and they said, why don't you just name the shapes? Because we all know them, right, right? Like, there's, like, you call them excursions at meals, but, like, a meal spike, right? There's a slow drift, there's a drop, a drop. Like, there's probably not that many different shapes on the graph. Most of us already probably think about them a certain way. Name them and then talk about the graph. And I was like, All right, I'll talk to Jenny about that and see Sure, let's, let's focus on this first Yes, yes. Okay, so you know, how long is the pre e Bolus gonna be? Then this is a step that I think can get lost. Like, look at your CGM, right? You know, Spot check your CGM. Are you one hour, three hour, five hours. Take a look at the curve. Are you on your way up? Are you on your way down? The way I talk about that in the Pro Tip series is I always tell people like, go to the three hour CGM line, go to the last three dots and see which way they're curving and like that gives you an idea of what what direction your blood sugar is going into. But I like the idea of thinking that part through for a half a second, because that's the one thing I still think I don't really get Arden to pay attention to all the time, is the trend. It's nice that you're eating. It's nice that you're Bolus sing for it. It's great that you're pre bolusing for it. But if you are pre bolusing 10 minutes before you were about to go from 150 to 220 I mean, you were screwed already. Anyway, yeah, right, right. And then your favorite one.

Jennifer Smith, CDE 19:33
The other thing is, in the look at the CGM, it is a slippery slope, so I think that it's valuable to point out when we're encouraging look at the CGM, the idea of spot checking at specific points along the post meal time period. And in the case of what we're trying to do is bring up specific foods or. Types of meals. If this is your meal that you really want to figure out, looking at the CGM doesn't mean every single day for every minute you're looking at your CGM, yeah? This

Scott Benner 20:09
is why you're learning how to do it right, like, right? Yeah. This is a

Jennifer Smith, CDE 20:13
spot check the Domino's Pizza at an hour. How are we looking you had a strategy in mind. The other piece to looking at the CGM is not being reactive, because you're trying to learn

Scott Benner 20:28
Yes. So like, just don't, like, freak out every time you see some like, let it play out so that you can, yes, you can figure it out. Like, so it's funny because you you kind of key down on one side to look at the CGM, and I keyed in on the other side for me, like, which is like, pay attention to where you are before you make this Bolus, but after you make the Bolus, the spot checking, like, go back an hour, three hours, five hours. Like, what's happening now, did this work the way I expected it to? If not, what am I seeing before CGM? So can you imagine the first person who figured out, like a fat rise, like, you know what I mean, like, without that, like, how many times they must have checked their blood sugar to be like, I'm telling you, if I eat a french fry, my blood sugar goes up faster than if this happens. You know, you've made these good decisions. You've you know, you've taken these steps. You put the Bolus in. An hour later you're still stable. Awesome. You know what I mean? Like, three hours later you're getting low, that'll help you with the Tweak for next time. Right, right. Maybe I didn't Pre-Bolus correctly, or, you know, whatever. And the

Jennifer Smith, CDE 21:27
only way that you can get, and I think that's why it is my favorite, the only way that you can really, truly get to tweaking what was an initial attempt is to really only do those spot checks. It's not a minute by minute, watch and react and hyperventilate because something's going on. It's a I am testing something out in order to adjust it for next time I have to let the scenario play out. Yes, I made a decision. It looks like my decision was not correct, but I'm gonna let it work itself out, because next time now I can spot what to

Scott Benner 22:05
change. This is a granular breakdown of the Eminem story that I tell in the Pro Tip series of somebody who just one day was like, Oh, I have a CGM now I can figure this out, and I'll put the insulin and see what happens. You can't, like, Jenny said, you can't, like, 10 minutes into it, freak out, like if you asked me, you know, at what point after a meal, Bolus, do you think, Oh, we missed. I need more insulin. I have an answer, but that answer is also based on me really understanding all these other steps that we just talked about. So while you're learning you can't just because you're just guessing the wrong direction, you'll cause, you'll probably over Bolus, cause a low or you'll eat at 120 because it's starting to go down and freak yourself out. And sometimes you just gotta wait. Okay? And

Jennifer Smith, CDE 22:47
the reason for these steps again, well, put together the very first step is what measure. So at the end of all of these steps, where you are watching the CGM trend, you know that your beginning pieces were well considered. It wasn't the random, I don't know it looks like 98 grams of carb, and this is what I put in, and this is the meal I'm no, no, no. Like, if you really want to figure out again your pizza or whatever it is, then take the

Scott Benner 23:21
steps, yeah, and you'll get there more quickly, because, yeah, this should work if you're swagging too, yeah, like, right, but you just might have to eat more pizza to get to the answer.

Jennifer Smith, CDE 23:30
And eventually, when you when you swag There's historical perspective to swagging. Yeah, you know when I go someplace and I'm on vacation and I am eating out 100% that's a swag. I mean, majority of the places that you go when you're on a vacation are not national chains.

Scott Benner 23:51
Yeah, right, yeah. You have no idea what you're eating. But I

Jennifer Smith, CDE 23:54
also know that I'm not going to choose the octopus plate, because I don't eat octopus so I usually on a menu. People are still more creatures of habit, right? They're more I know what I like. I'm going to choose something within the realm of my preferences, and because of that, I have some history around a food like this, yeah, so swaging becomes easier,

Scott Benner 24:19
sure. And I think that this process gets you to a place where you you talk about the way Jenny did earlier, like, I don't know, I know I do these things, but I don't think about them, right? But in the in the beginning, I just, I think this will be interesting, and there's a entire section of people listening who genuinely want this. So yeah, and they'll be sure that's awesome. Yeah. So now, do you have time to pick one thing and or do we do it next time we have

Jennifer Smith, CDE 24:44
let's see what do I'm full of my schedule. Look at your schedule. It's very

Scott Benner 24:47
busy schedule. People, people clamoring to speak with Jenny.

Jennifer Smith, CDE 24:52
Line out the door. I have about 15 minutes. Okay, so

Scott Benner 24:57
let's do this, since we have so maligned to read. Do's in the nutrition episodes, all right, let's use Doritos. Yeah, let's use Doritos nutrition

Jennifer Smith, CDE 25:08
label. Hold on, fabulous. Oh, poor Dorito Doritos took it hard, actually, everybody, right? They took it hard. But I guarantee that every time we said Doritos, people are like, Oh, Doritos. I haven't had Doritos in a really long time. I don't

Scott Benner 25:23
care about being healthy. They are so good. Okay, I've got a picture of a of a nutrition label from a Doritos bag. This is going to be clunky the first time because we don't have this worked out. Give a pen. Can you jot down something?

Jennifer Smith, CDE 25:37
I have a pen and I have a piece of paper?

Scott Benner 25:41
Yes. So let's start with the just so you know the serving size of this Doritos thing is, it's, oh, wait,

Jennifer Smith, CDE 25:47
wait, can I, can I guess what the serving size? Does it give it per chip? It's

Scott Benner 25:51
a grab bag. Oh, let me get it. Maybe I should get it off of a large bag so that I have how many chips it is. Hold on a second,

Jennifer Smith, CDE 26:00
because I want to try to guess how many chips is a serving?

Scott Benner 26:03
I think it's gonna be one. That's fun, yeah, they're like, oh, there's only 1000 grams in this. How many is it? Oh, don't, don't worry about how many for the serving.

Jennifer Smith, CDE 26:12
Well, I think it also begs a description of the difference between serving and portion. Yeah, right. Oh. Serving is what the label tells you is a single side or a single, you know, portion, and that's what everything on that label, then, is associated with that particular serving. Your portion might be for servings according to what the bag lists as a serving. I think it's a very valuable difference to make. What you put on your plate may be your portion, but I guarantee it's probably not one serving per the bag.

Scott Benner 26:47
So a nine and 9.25 ounce bag of Doritos, nacho cheese flavor tortilla chips contains approximately nine servings. So we're calling what a serving? An ounce? Yes. Wait. Is that gonna be like? That's just a few chips.

Jennifer Smith, CDE 27:01
It is usually from tortilla chip. Historically, is somewhere between nine to 12

Scott Benner 27:11
chips. This has it as 12. Oh, it has it as well. I

Jennifer Smith, CDE 27:14
just want to hear you guess first. Yes, nine to 12 is typical for tortilla

Scott Benner 27:18
chips. Okay, so 12 Doritos is a serving, okay? That's 150 calories, okay, it's eight grams of fat, okay, a gram of saturated fat, okay, fair amount of sodium in here. But that's what do we care about, sodium? Well,

Jennifer Smith, CDE 27:34
we care about sodium, but not from a store from, not from a standpoint or a Bolus thing, all

Scott Benner 27:39
right? It's 210 milligrams, just for that. Carbs. You wanna guess carbs

Unknown Speaker 27:45
for 1219,

Scott Benner 27:46
18. See, that's pretty close. Dietary Fiber, one sugar, one protein, two, calcium, calcium. How they get calcium into it? I

Jennifer Smith, CDE 27:57
would guess calcium is probably pretty minor. It's probably like one or 2% but it's because

Scott Benner 28:03
their daily value.

Jennifer Smith, CDE 28:05
If there's milk, there's some type of and I would expect it's also an enriched or a fortified product. So I would expect some of these are also added back pieces.

Scott Benner 28:15
Okay, yeah, there's potassium in it too. It's interesting, not an amount that you need. Okay, so, but that's not the point. So now we are, let's be a person who's, I mean, we got to keep this easy, right? Like, my insulin to carb ratio is one unit for 10 carbs,

Jennifer Smith, CDE 28:30
and we're following our steps. Measure,

Scott Benner 28:33
yeah, and, and, let's, let's, let's set up this person. Let's do, one unit is 10 carbs. That's our insulin to carb ratio. One unit moves us 100 points that

Jennifer Smith, CDE 28:45
way. So we've got a correction factor of 100

Scott Benner 28:48
Yeah, just to keep everything simple, okay, and and then we have to give the person a blood sugar, all right, so let's start, because this is us just practicing. Let's start with like, a blood sugar. We're not looking to correct 100 Okay, let's just

Jennifer Smith, CDE 29:04
do that. That's the unicorn number, right? Everybody takes pictures of 100 right? Yeah, I

Scott Benner 29:08
take pictures of 70 sixes. But okay, so, okay, so person has the blood sugar of 100 their one unit moves them 10 carbs. One unit moves them 100 points. They're going to eat Doritos. Now, let's go back to our list. All right, we've evaluated the carbs. There is fat in it. Yes, is it fat that we're going to need to Bolus for it in an extended way?

Jennifer Smith, CDE 29:31
No, in one single serving. No 12 chips. No, what if I eat the whole bag? Jenny ate the whole how many servings? Do you say? Five servings in a bag? Oh, nine, yeah. Oh, my God. Well, what's Scott, what's your math? Nine times eight is what

Scott Benner 29:45
70? That would be 72 grams of fat.

Unknown Speaker 29:47
Wow, that's a lot of fat. Oh, my goodness, it's

Scott Benner 29:50
only nine ounces of Doritos. Jenny, this easily could happen during I'm watching mob land on Paramount plus, right? Now, easily, right, right? You don't know mob land. You. I don't know Rob land, I don't, yeah, it's neither here nor there. So, so, okay, that's a good point. Like, so is it one? Let's say they're eating one serving. The hell is eating 12 chips? All right, okay. He's like, I haven't had 12 chips in a year. That Dorito is insulin to carb ratio is one to 10. We're going to be having 18. So, you know, I'd go two units, just for fun, but it's one. What is it? 1.8 units,

Jennifer Smith, CDE 30:28
right? One to 10 at 18, yep,

Scott Benner 30:31
and it's going to be, I don't think the impact is going to be crazy, like, I think any kind of a reasonable I mean, if, if my blood sugar is nice and stable. There's no insulin on board, and I'm having 12 chips. I mean, I think a Pre-Bolus of five to 10 minutes probably get you there. Do you think more? Do you think more?

Jennifer Smith, CDE 30:52
What I know about the processed nature of chips and the fact that these have fat, but it's not a considerable amount of I mean, eight grams is eight grams, but it's not like 50 at once, right? The fact of the matter being that these chips are, they're processed. What are Doritos? Are they corn? I don't

Scott Benner 31:12
even know. I'm sure there's corn in them somewhere,

Jennifer Smith, CDE 31:15
whatever the ingredients are. I don't even know. I can find out. Feel like I should

Scott Benner 31:18
know that. How would you know that,

Jennifer Smith, CDE 31:22
I feel like I should know. I would guess corn. Corn is there wheat.

Scott Benner 31:26
I'm looking for an image I can blow up and see corn, vegetable oil from sunflower, canola and or corn oil, something called malted dextrin, made from corn less than 2% of the following salt, cheddar cheese, milk cheese, culture salt, enzymes, whey, mono sodium,

Jennifer Smith, CDE 31:48
glutamate, glutamate, butter, MSG, buttermilk,

Scott Benner 31:52
romano cheese, part skim, cow's milk cheese, cultures salt, enzymes, Romano cheese, cow's milk cheese, culture, salt enzymes, whey protein concentrate, onion powder, corn flour, natural and artificial flavor, dextrose, tomato powder, lactose spices, artificial colors, yellow, six, yellow, five, red, 40. Lactic acid, citric acid, sugar, garlic powder, skim milk, red and green bell pepper powder, the sodium inosit Nate, the sodium guilate, potassium chloride and sodium calcium. Eight contains milk ingredients,

Jennifer Smith, CDE 32:36
so mostly corn, right? I think so corn. And then what struck me there was kind of funny. It's not really anything here and there, what we're doing, but is the fact that they have naturally an artificially flavored dextrose. Like dextrose is just sugar, right? We have to artificially flavor it in Benner Rita,

Scott Benner 32:54
I might not have had a comma, natural and artificial flavor. Comma, dextrose.

Unknown Speaker 32:59
Sorry. Anyway, that

Scott Benner 33:02
was just sorry about that.

Jennifer Smith, CDE 33:04
No, no, it's all good. But corn, that was my purpose in, yeah, going back now in the Bolus strategy, right? Because we're on the step of building the Bolus shape, and that includes the timing the Pre-Bolus, right? So we're really looking at, you're at a stable looking blood sugar. No, iob, you haven't treated anything in the past. This brings in and builds in the variables you might be considering, right? And my expectation is that you'd need at least a 10 to 15 minute Pre-Bolus. Okay, for

Scott Benner 33:34
Doritos, 10 to 15 minute Pre-Bolus, by then, you're not even gonna want the Doritos anymore, so you might as well give up. Seriously, right. Do I have to split the dose? No, not for Doritos, okay. And when do you think I checked to see if I missed on this?

Jennifer Smith, CDE 33:49
Yeah, great, because these are more processed, again, like most packaged snacky kinds of foods like this, I would be checking at the one hour mark, because, again, these are more true carbies, and they're going to have an impact that tends to be a bit quicker. And also, because you're not eating in this environment, we're talking about single food digestion, kind of like glycemic index was sort of, you know, established. It's an in and out. Okay, so you're usually going to have potentially a quicker rise followed by a quicker plateau point, based on your timing of insulin and what you know about how your insulin works for you, with a finish out and aiming to be back at baseline again, if you've tested all of your other settings, etc, does

Scott Benner 34:39
any of this change for you if it's three servings,

Jennifer Smith, CDE 34:42
I would expect it would change

Scott Benner 34:43
if it were three servings, yes, how so do you think

Jennifer Smith, CDE 34:47
that first step measure the meal? Now we're looking at what, 36 grams of 1812, chips, 18. So that's a heck of a lot more carbohydrate. So we are not changing like. Glycemic index, but we're changing the glycemic load. We're changing how much of this is actually going in. I would expect that Pre-Bolus timing probably about the same, because the more of a food that you have, it's still going to take you longer to eat that many chips compared to just eating 12 chips. Now you're eating a lot more chip, 36

Scott Benner 35:22
chips. It's 54 carbs. Yeah, all of a sudden I just hit me, like, these conversations gonna be great for people, because I don't think anybody thinks about it that way. You know what? I mean, a handful potato chips, 15 carbs. I go, like, right? You're at the next handful. I don't even know if you're like, you've got it in your head the same way after that.

Jennifer Smith, CDE 35:40
And what a great time of the year. I mean, I don't know when these episodes will come out, but what a great time of the year to be discussing this. Because where are we? We're heading into most kids getting done with school, heading into summer, heading into a lot of vacation time, heading into a lot of family or gathering type of spaces, cookouts, et cetera. And what do we have at most of those things, it's not your usual, prepared, great stuff that you focus on eating at home. It's everybody brings something along, and most often, what's on the table, chips and potato salad. Exactly. We're

Scott Benner 36:17
gonna have burgers later. Kids, fruit salad is everyone's grandmother not put three baskets out with three paper towels in it and run around and dump three different kinds of potato chips in them and go, Hey everybody, like, you know, like, I just want everybody to be happy and dead. So okay, now, you know, this person's blood sugar is 150 before they start. And now my heart that changes the Pre-Bolus time, because I like to see a falling blood sugar before, like, you know what I mean? Like, if you, if you're 150 and you throw in a Pre-Bolus for, you know, 56 carbs of Doritos, and 10 minutes later, you're like, Oh, I'm eating now, but your blood sugar hasn't moved. I mean, I think you're 185 in 10 minutes,

Jennifer Smith, CDE 37:00
you're going to be rising and again, that also begs, you know, evaluate, which is your second step. Evaluate, where are you? Is that 150 stable, and you've been stable and just hovering there? The correction for adding into the food Bolus, maybe it takes hold a little bit faster and starts that drift down that you're looking for before you start to eat. And this then begs the consideration of evaluating your CGM along the way, even because don't get hard tied, I guess is my point to an actual I always Pre-Bolus 10 minutes. My Pre-Bolus is always 15 minutes? Well, maybe that has to be a floating a variable, depending on where are you and where are you headed. If the 150 is stable, flat, no insulin on board, great, right? You could probably turn that around pretty quick, and your Pre-Bolus maybe isn't very much longer. But are you 150 and still rising? You are that rise indicates a deficit of insulin. It means a longer Pre-Bolus. Okay?

Scott Benner 38:04
Kid comes downstairs, Mom, I'm gonna take a handful of Doritos that I'm going outside to kick a soccer ball. You do it differently? Yeah,

Jennifer Smith, CDE 38:10
absolutely. There's a variable in the picture, a handful of the Doritos again. What are we looking at? We're evaluating, is there insulin on board already? Blood Sugar might be 150 going to hit the soccer ball around, or throw a football with a friend, or whatever it is at that point, do even Bolus, right? And that begs the consideration. Then, as I said about what kind of system are they on? Yeah, has the system already kicked in some help that handful of Doritos might be totally fine,

Scott Benner 38:39
right? Right? Yeah, you're gonna have to look to see. It's not as easy as that evaluate part becomes a big deal like it does. Yeah, you're 150 and the algorithm just bolused for it, and you're about to go outside and run around, and maybe you can have a few Doritos and go, and we're not gonna see a difference here, right?

Jennifer Smith, CDE 38:56
You may not even need to Bolus at all for it, and it's totally fine,

Scott Benner 39:00
yep. Okay, all right, so this is how we're gonna do this. Is this gonna work for you? I love this is awesome. Having way too good of a time. I looked up and I thought, we're a couple of dorks.

Jennifer Smith, CDE 39:13
I'll be in the dorky nerve.

Scott Benner 39:15
I was like, we're gonna talk. I'm gonna love this. Okay, so hopefully people love it too. Thank you. Yeah, I really appreciate this. Thank you, of course, yeah.

The podcast you just enjoyed was sponsored by tandem diabetes care. Learn more about tandems, newest automated insulin delivery system, tandem Moby with control iq plus technology at tandem diabetes.com/juicebox. There are links in the show notes and links at Juicebox podcast.com. You.

In each episode of The Bolus four series, Jenny Smith and I are going to pick one food and talk through the bolusing for that food. We hope you find it valuable. Generally speaking, we're going to follow a bit of a formula, the meal bolt formula, M, E, A, l, B, O, L, T. You can learn more about it at Juicebox podcast.com, forward, slash, meal, dash, bolt. But here's what it is. Step 1m, measure the meal. E, evaluate yourself. A, add the base units, l, layer, a, correction B, build the Bolus shape, O, offset the timing, l, look at the CGM and T, tweak for next time. In a nutshell, we measure our meal, total carbohydrates, protein, fat, consider the glycemic index and the glycemic load, and then we evaluate yourself. What's your current blood sugar? How much insulin is on board, and what kind of activity are you going to be involved in or not involved in? You have any stress hormones, illness, what's going on with you? Then a we add the base units your carbs divided by insulin to carb ratio, just a simple Bolus l layer a correction, right? Do you have to add or subtract insulin based on your current blood sugar? Build the Bolus shape? Are we going to give it all up front, 100% for a fast digesting meal, or is there going to be like a combo or a square wave Bolus? Does it have to be extended? I'll set the timing. This is about pre bolusing. Does it take a couple of minutes this meal, or maybe 20 minutes are we going to have to again, consider combo square wave boluses and meals, figure out the timing of that meal and then l look at the CGM an hour later, was there a fast spike? Three hours later? Was there a delayed rise five hours later? Is there any lingering effect from fat and protein? Tweak, tweak for next time. T What did you eat? How much insulin and when? What did your blood sugar curve look like? What would you do next time? This is what we're going to talk about in every episode of Bolus for measure the meal, evaluate yourself. Add the base units, layer, a correction, build the Bolus shape, offset, the timing, look at the CGM tweak for next time. But it's not going to be that confusing, and we're not going to ask you to remember all of that stuff, but that's the pathway that Jenny and I are going to use to speak about each Bolus. The episode you just heard was professionally edited by wrong way recording. Wrong wayrecording.com.

Please support the sponsors

---

The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!

Donate