#1794 Had Enough - Part 1
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Justin, diagnosed at age 3 in 1987 , explores how DIY looping lowered his A1C from 10.0 to 5.1 , CGM necessity , and how stability improves relationships.
Key Takeaways
- The Criticality of CGMs: Justin emphasizes that while pumps are helpful, the Continuous Glucose Monitor (CGM) is the most valuable tool for safety and long-term health, as it provides the data necessary to stop highs and lows in real-time.
- Advocating for Pre-Bolusing: Justin expresses frustration that modern medical guidance often neglects the importance of pre-bolusing. Using rapid-acting insulin requires a lead time to match the peak of the insulin with the rise of the food.
- The Power of Community & Word of Mouth: Justin's life changed after a chance meeting with a "looper" at a diabetes event. This peer-to-peer connection provided information about Automated Insulin Delivery (AID) that he hadn't received from clinical settings.
- Overcoming "Old School" Habits: After decades of minimal testing (2-3 times a day) and higher A1cs, transitioning to an AID system helped Justin bring his A1c from the high 7s to the low 5s, significantly improving his quality of life and physical symptoms like cold extremities.
- The Impact of Blood Sugar on Relationships: Justin and Scott discuss how high blood sugars can lead to irritability and conflict in marriages ("being a prick"), and how stabilizing those numbers can lead to a more harmonious home life.
Resources Mentioned
- Juice Cruise 2026: juiceboxpodcast.com/juicecruise
- Medtronic Diabetes (MiniMed 780G): medtronicdiabetes.com/juicebox
- Contour Next Gen Meter: contournext.com/juicebox
- Tidepool Loop: tidepool.org/loop
- LoopDocs (Katie DiSimone): loopkit.github.io/loopdocs/
- Wrong Way Recording (Rob): wrongwayrecording.com
Welcome back, friends. You are listening to the Juice Box podcast.
JustinI'm Justin. I'm a type one diabetic. I've had diabetes since I was just shy of three years old, and I'm pissed off.
Scott BennerHow would you like to share a type one diabetes getaway like no other? Join me on Juice Cruise 2026. You may be asking, what is Juice Cruise? It's a week long cruise designed specifically for people and families living with type one diabetes. It's not just a vacation. It's a chance to relax, connect, and feel understood in a way that is hard to find elsewhere. We're gonna sail out of Miami, and the cruise includes stops in CocoCay, San Juan, Saint Kitts, Nevis aboard the stunning Celebrity Beyond. This ship is chosen for its comfort, accessibility, and exceptional amenities. You're gonna enjoy a welcoming environment surrounded by others who get life with type one diabetes. I'm gonna host diabetes focused conversations and meetups on the days at sea. There's thoughtfully designed spaces, incredible dining, and modern amenities all throughout the celebrity beyond. Your kids can be supervised, there's teen programs so everyone gets time to recharge. Not just the the kids going on vacation, but maybe you get the kickback a little bit too. There's gonna be zero judgment, real connections, and a whole lot of sun and fun on Juice Cruise twenty twenty six. Please come with me. You're going to have a terrific time. You can learn more or set up your deposit at juiceboxpodcast.com/juicecruise. Get ahold of Suzanne at cruise planners. She will take care of everything. Link's in the show notes. Link's at juicepodcast.com.
Scott BennerIf you're looking for community around type one diabetes, check out the juice box podcast private Facebook group. Juice box podcast, type one diabetes. But everybody is welcome. Type one, type two, gestational, loved ones, it doesn't matter to me. If you're impacted by diabetes and you're looking for support, comfort, or community, check out Juice Box Podcast, type one diabetes on Facebook. Nothing you hear on the Juicebox podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan. Today's podcast episode is sponsored by Medtronic Diabetes, who is making life with diabetes easier with the MiniMed seven eighty g system and their new sensor options, which include the Instinct sensor made by Abbott. Would you like to unleash the full potential of the MiniMed seven eighty g system? You can do that at my link, medtronicdiabetes.com/juicebox. Today's episode is also sponsored by the Kontoor Next Gen Blood Glucose Meter. This is the meter that my daughter has on her person right now. It is incredibly accurate and waiting for you at kontoornext.com/juicebox.
The "Pissed Off" Diabetic
JustinI'm Justin. I'm a type one diabetic. I've had diabetes since I was just shy of three years old, and I'm pissed off.
Scott BennerYou're mad. How old are you now?
JustinI'm 41.
Scott BennerYou're just mad because you're 41, or what are you mad about?
JustinWell, there's that. I was more mad when I turned 30. We can get to that later, but I'm just pissed off at how let down we are as as people with diabetes that it's so hard, and we don't I don't think we get good guidance from the people that we ought to.
Scott BennerYou're not just mad for yourself. You're mad for the collective community that you're aware of.
JustinMostly, yes. Naturally, there are pieces that I think are more attributable to me. But on the whole, it's more for all of us. Yeah.
Scott BennerYou know, time my wife leaves to go to a how are we starting? This is crazy. Every time my wife leaves to go to a gyno appointment, I say when it's all over, just look her dead in the eye and say, so on the whole, is everything okay? And she won't do it.
JustinShe should.
Scott BennerI well, yeah. Right? Come on, Kel.
Scott BennerQuite obviously is what should happen, nevertheless. Well, let's go back to the beginning. How old were you when you were diagnosed?
JustinJust shy of my third birthday. That was a month shy.
Scott BennerOkay. So when's the first time that you, I guess, have recollection of diabetes being in your life?
JustinThe oldest memory that I have is one morning. I was three years old. It must have been shortly after diagnosis, and I must have been whining to my dad whose name is Kelly. So I've always thought of Kelly as a man's name, but I know that he's kind of a unicorn being a man named Kelly.
Scott BennerI went to high school with a guy named Kelly.
JustinIs that right?
Scott BennerYeah. What's up, Kelly? You're listening. Yeah. No. No. And by the way, everybody, every time you're on the phone for something for Arden, they say he. They just assume Arden's a man. Really? Yeah. Anyway, sorry. Your dad's Kelly.
JustinI was complaining to him that I had to be awake so early. I was still sleepy. Blah blah blah. He says to me, well, you had an infection in your belly. That's why you have diabetes, and you have to be up at a certain schedule to eat, and that's why we have to do this. You know, it's not fun. We don't want to do it, but it's what we have to do. Because at three years old, if you've done the math already, that's 1987. So I was on a schedule of NPH and regular.
Scott BennerYeah.
JustinOkay. Unlike today, it's much more time dependent on a daily schedule and using the NPH, which has the intermediate action. It's much more difficult.
Growing Up in the NPH Era
Scott BennerHave you and your father, since then, as you've gotten older, talked about it again and again, or is your understanding of your diabetes come from when you were very young and you guys didn't really discuss it, I guess, more moving forward?
JustinBoth my parents and I were quite involved. Naturally, being so young, they drove the bus heavily probably from diagnosis at three until 96 when I went on the pump. So they definitely were heavily involved. My dad's been a firefighter since he was 18, and my mom served in and out of the fire department and then on the ambulance squad, I think, before I was born and then through parts of my childhood too. So they very much embraced the responsibilities that were laid out in front of us. And to the best that we could, they went to all the appointments. They you know, we managed it a lot with just my pediatrician up until maybe a year or two years before I went on the pump. So a lot of it was only what we learned at the hospital at diagnosis and then through the pediatrician who was very his guidance and treatment were pretty good.
Scott BennerWere you doing two shots a day until the pump?
JustinI think when I was younger, three, four, five, I did two shots a day mixing regular and NPH. Then as I got older, maybe eight, nine, 10, it was three shots. There was regular NPH in the morning to cover breakfast and lunch, then regular at dinner, and then I think NPH at bedtime.
Scott BennerSo they were they were starting to make a little adjustments. Did you ever go to more modern fast acting basal setup, or did you go right into a pump? Do you remember?
JustinRight into the pump. Yeah. It went from regular NPH. I think then it went to Humalog and NPH. Humalog came out a year or two before the pump.
Scott BennerOkay. Did that for a little bit then right into but they just put the Humalog into the pump, and you were on your way? Right. Okay. And is that the point where it sort of becomes your football? They give it to you?
JustinFor daily treatment decisions? Yes.
Scott BennerYeah. So you're you're bolusing on your I mean, you're counting carbs and bolusing on your own and stuff like that.
JustinThe carb counting came somewhat from, my parents probably more than me, at least in the beginning. And then certainly testing because it's this is before CGM, so testing was still my responsibility. It was a lot of shared responsibility.
Scott BennerStill. Okay. They didn't abandon you. They didn't go, oh, finally. Here, kid. Get out of here. No. You guys kept it together. So you had a lot of support growing up with your diabetes?
JustinGood amount. Yes. Okay. So you weren't angry then? No. No. Okay. So are you one of those people who you know, when people say all the time, like, I don't know if it's better to be diagnosed old or young. And the argument for young is, of course, you'll never know any better. Do you feel like you don't remember any kind of life without insulin?
JustinI do not remember life without insulin, and I would argue that it was better being diagnosed young because I don't know any better. Certainly, this far removed, I definitely don't know any better.
Scott BennerAnd you don't have a feeling of loss. Is that it? Or do you still?
JustinFeeling of loss? I don't know. I have it's not regret, but I have disdain. I have disdain for not having the technology we have today back then.
Scott BennerAlright. You're pissed that that you got into the game so early that they didn't have stuff like they have now.
JustinI'm disappointed by that. We haven't even gotten to the stuff that makes me angry.
Scott BennerNo. No. Don't worry. We're getting to it. Take your time, Justin. We want you to yell and scream. I'm good. Listen. I have been for, like, years hoping people would come on and talk like this, so I'm I'm up for this.
Why It Took a "Dope from Jersey"
JustinWell, it's your fault.
Scott BennerWait. Wait. It's it's my fault you're mad?
JustinWell, I'm I'm mad at you. Justin, I didn't marry you and dedicate my life to you and tell you I love you every day. How how do you have the nerve to be mad at me?
JustinBecause why is it that people have been treated with insulin for a hundred years? I've had diabetes for almost forty. Why the hell is it that it takes you, some dope from Jersey, who barely graduated high school to give me the best therapeutic decisions and strategies and counseling such a a goofy word to because you're no counselor.
Scott BennerI offer my counsel. Let's say it like that maybe.
JustinOh, fine.
Scott BennerHow come more people don't come on with this awesome, like, vibe that Justin has? I feel like you and I are improving together. This is awesome. I'm having such a good time.
JustinWell, I have what? My dad's got six cousins from Jersey. So I get you.
Scott BennerYou're accustomed to these conversations.
JustinI I'm accustomed to wacky people telling you wacky. You'd think back on it, you know, in the shower a couple weeks later and you go, oh my gosh. That's brilliant.
Scott BennerThat guy had a thought and it was I thought at the time he was an idiot, but my goodness, it's making sense. That's awesome.
JustinI mean, he's still an idiot, but, you know, it makes sense in in this one thing.
Scott BennerJustin, I'll accept idiot. I won't accept wacky. What do you think of that?
JustinWhatever helps you sleep at night.
Scott BennerAwesome. So you're telling me that even with that pump as a teenager and growing up, you don't feel like this all came together for you till you found this podcast? How long ago was that?
JustinLet's see. I, on a whim, was looking for help with Loop because I went on Loop well, so let's back up a couple minutes.
Scott BennerPlease.
JustinBack in, I don't know, 2016, my wife's a physical therapist. She was working in a hospital system, but in one of their outpatient offices. She had a patient come in who he broke both shoulders on a motorcycle spill. And turns out after he you know, she talks to him for a while, turns out his wife is a nurse in the hospital. So they strike up a conversation. Sometime, it comes out in conversation that she has type one. From what I recall, she had gestational with her first pregnancy, and it never went away Mhmm or evolved after that. So we talk about that. We become friendly and social after that time, see each other more casually. So they wrote me one gosh. I think it was a Friday night. And they said, we're both going to this ADA tour de cure event up at the center of town, up at the fairgrounds. You wanna join us? And my wife was leaving earlier that morning on a plane. So I said, well, I guess I got nothing better to do, and I'll be up anyway. So, yeah, I'll go up for the tour de cure thing. They had she was in the five k run, and I think he went on the 10 k ride.
Scott BennerOkay. Wait. You and your wife I I just want the the younger people to hear this. When you say you can't meet people, you and your wife now have friends that they met because a man had a motorcycle accident, came into the ER where your wife was. During chatting, realized that his wife works with her. They're actually colleagues, and then you guys strike up a friendship together.
JustinIt's true. it this wasn't at the ER, but it was it was in the outpatient PT stuff.
Scott BennerBut, otherwise, that's a true story. That since see, you can meet people. That's really nice. I actually find that to be a a lovely story. Think it's because I'm older. But I'm so sorry. You're the tour de cure. What happened then?
Scott BennerThe Kontoor Next Gen blood glucose meter is sponsoring this episode of the Juice Box podcast. And it's entirely possible that it is less expensive in cash than you're paying right now for your meter through your insurance company. That's right. If you go to my link, contournext.com/juicebox, you're gonna find links to Walmart, Amazon, Walgreens, CVS, Rite Aid, Kroger, and Meijer. You could be paying more right now through your insurance for your test strips and meter than you would pay through my link for the Contour Next Gen and Contour Next test strips in cash. What am I saying? My link may be cheaper out of your pocket than you're paying right now even with your insurance. And I don't know what meter you have right now. I can't say that. But what I can say for sure is that the Kontoor Next Gen meter is accurate. It is reliable, and it is the meter that we've been using for years. Kontoornext.com/juicebox. And if you already have a contour meter and you're buying test strips, doing so through the juice box podcast link will help to support the show.
Scott BennerUnlike other systems that will wait until your blood sugar is a 180 before delivering corrections, The MiniMed seven eighty g system is the only system with meal detection technology that automatically detects rising sugar levels and delivers more insulin as needed to help keep your sugar levels in range even if you're not a perfect carb counter. Today's episode of the Juice Box podcast is sponsored by Medtronic Diabetes and their MiniMed seven eighty g system, which gives you real choices because the MiniMed seven eighty g system works with the Instinct sensor made by Avid, as well as the Simplera Sync and Guardian Force sensors, giving you options. The Instinct sensor is the longest wear sensor yet, lasting fifteen days and designed exclusively for the MiniMed seven eighty g. And don't forget, Medtronic Diabetes makes technology accessible for you with comprehensive insurance support, programs to help you with your out of pocket costs, or switching from other pump and CGM systems. Learn more and get started today with my link, medtronicdiabetes.com/juicebox.
Meeting the Looper
JustinAfter all the events wrap up, they have a lunch, and I hadn't signed up for the event at all. So I figured I was gonna go without lunch because, you know, I didn't have the tickets for any of that or whatever. One of my friends gave me their ticket because they went through the line and, you know, being somebody who had a bib on and was sweaty and gross, they're like, oh, yeah. You were at the event. Go ahead. Go get your lunch. So they gave me their ticket, and I went through, and I got lunch. I sat down at the table, and there's this older fellow who he's on his phone, tinkering on his phone. And I'm saying, you're at this great event. You're sitting next to, like, two other people who have all got their phones out, which this is back in 2019 or 2018. So everybody being on their phones all the time wasn't so prevalent. But I'm like, why are you guys tinkering on your phone so much? You know, why don't you just enjoy the music that's being played?
Scott BennerYes. Talk to the people. What are you doing? Head down with this generation. That whole thing.
JustinExactly.
Scott BennerSo I didn't have the nerve to ask the guy any questions. My buddy comes over after he grabs his lunch, and he says to this other guy, what are you doing? Or maybe he asked him what pump he had. Mhmm. And he goes, oh, I've got Medtronic, but I've got an old one. And then he brings out his phone, and he's got loop on his iPhone. And we're like, what the hell is that?
Scott BennerMagic sorcery.
JustinIt was magic. You know, he shows us, you know, he's gotta take, you know, half a unit for this, I don't know, Apple that I'm gonna have with my lunch. Types it in on the phone. We heard the the Medtronic beep, you know, the pump beep. I'm like, what the hell is that?
Scott BennerYeah. That fries your mind. Yeah. The first time you see that, he's on his cell phone and then his pump gives him insulin and without context and and a life lived the way you live. That really must have really seemed awesome to you.
JustinIt was nuts. And I thought, where the hell has this been? He he gets into the whole, you know, AID pitch. And first, I'm thinking, is he selling this stuff? Like, is he trying to line his own pockets by it? But he goes he pointed to his daughter or niece or something. She had loop on her phone using the Omnipod. And I'm like, what is that? You can do either one? What?
Scott BennerIt works with yours. It works with the one without the tubes. Like, what? What? Yeah. Yeah. Yeah.
JustinRight. I always thought everything was so closed course, closed circuit that how on earth using your damn iPhone, how does that work? What do you mean? So we get the whole pitch. We get the whole description from this guy. I got his name thereafter, and I said, well, shoot. I've got a endo appointment in a week or a month or something. It was pretty close. So I mentioned it to my endo NP, and she said, well, I don't recommend it. I can't recommend it to you, but I have one other patient. Yeah. I think she said at the time she had a couple patients on t slim which was maybe just getting into the Basal IQ thing. And she said, I cannot—
Scott BennerJustin, did they do this? I felt like somebody had this written down somewhere in those years. I can't support you while you're using it, but I'll keep writing you your prescriptions, which was code for leave us out of it, but I don't care if you do it.
JustinSort of. She wanted to say you can try it, and, you know, it's like a no lifeguard on duty, swim at your own risk. But she said, you know, I've got one other patient who is a child. The parents are both in tech and software. So they had the confidence to build it, and they've been doing it, and they've been great.
JustinWell, I'm in software, so how hard could it be? And thank god for Katie DeSimone to write up the loop docs because without that, even being in software, I do a lot of Microsoft stuff. So all this Apple app development was, like, over my head. Thank goodness she does that. So I go through, buy the Riley link. Maybe a week later, that comes in. Had to buy iPhones because I was a steadfast Android person up until then. And oh, I think when we were talking about it at the tour de cure event, the other guy said that Tidepool had just had their press release that they were gonna take Tidepool Loop. So I said, well, I'm not gonna fart around with trying to do an Android thing. If Tidepool's gonna get Loop into the App Store and I'm not gonna have to build it myself forever, I'll go with them because they're already on the fast track. They're already 10 steps ahead. Let's go with that.
Scott BennerIt took them a while, but there it is. Twist exists now.
JustinYeah. Twist exists, and a fair amount of people from the Loop community early on are are working there, which is good.
Scott BennerYeah. And they're iterating still. Like, they're updating that that app too. I think that's going quickly and and in a way that makes me feel good about what they're doing.
JustinI do too. I think that's adding more CGMs, adding more pump manufacturers, I I think is a good thing. Yep. But leads to the disappointment that in 2019 or 2018, I don't know how long Loop was out before then, but where the hell is anybody to even mention it? Their hands are tied at the doctor's office, so they can't mention it.
Scott BennerYeah. I mean, if they even know about it. Right? I don't know how many people have downloaded Loop or Trio, you know, combined at this point or, you know, Android APS or any of those really. Like, I don't know how many people said, oh, I'll give it a shot. Give me the code or you know, even now it's I mean, it goes on your phone so much easier now. It's crazy. I don't know, like, how is a how is the thing that's DIY supposed to publicize itself other than the way you found out about it, was being at an event with other people at type one and somebody mentioning it to you. And I love that you described him as like, you thought he might be selling it at first because that's how stuff like that gets spread around.
Scott BennerI felt like that in the early two thousands when I was trying to tell people about TiVo. I'm like, you don't understand. It was like, records it on a hard drive. You can pause it and fast forward. There's a button that jumps to the commercials, and people looked at you like, what do you you got stock in this or something? I'm like, no. It's just you're so overwhelmed by what a leap it is that, you know, you you come off like that when you're talking about it. That's how word-of-mouth works. My podcast is completely word-of-mouth. A pump company is not gonna tell you about it. Right?
JustinWell, now they are because Tandem invites you to friends for life or, you know, other events. Omnipod is—
Scott BennerI'm doing a nice thing with Omnipod next week. You guys will see it a little bit. So I'm saying, like, Pepsi doesn't tell you that Coke is good. You know what mean? Like, so they're not gonna do that. But at the same time, Loop's interesting because it works with those old Medtronic pumps. It works with Omnipod. Listen. I've never had a conversation like this once with anybody, but I'm just gonna go out on a limb and say, I don't think Omnipod's allowed to say loop out loud. That would be a horrible thing for them and the FDA and all that stuff. Right?
JustinIt's gotta be the same with the endos. I know the ADA standards of care just came out where they're pushing endos, HCPs, CDEs to help as much as they can. Not solely shut down the DIY stuff, but to say, we'll support you as much as we can. And and really that's what my endo NP said was that we'll tweak your settings if you could show me your basils and show me your insulin to carb ratio, insulin sensitivity factor based on what we see from your CGM data.
Scott BennerThey got more comfortable with it as time went on too.
JustinI think so. And the commercial adoption with the Medtronic six seventy system that I think was announced very shortly after that, after I'd started on loop, maybe that's boosted everyone's confidence, wisdom, experience.
Scott BennerAbout an algorithm in general?
JustinYeah. And how to make productive changes to settings, to algorithms, to basal rates, you know, depending on what they see because CGM unlocks all that possibility too.
The Pre-Bolus Frustration
Scott BennerYeah. And I also think that in a world where many endocrinologists aren't comfortable or don't know to tell you to pre bolus or aren't comfortable or don't know to tell you that, you know, fat and protein might impact your blood sugars later. It's a pretty big leap to think those same people are gonna tell you, like, hey. There's a bunch of people on the Internet writing code that, gives you insulin.
JustinThat's what pisses me off.
Scott BennerI know. Go ahead.
JustinIt's you, the dope from Jersey, who stands up on your soapbox and says, pre bolus your meals. I thought back, I don't know, maybe a couple months ago, you were talking with somebody about pre bolus thing, and maybe they said that you had to prebolise with regular because the peak or the onset was so much later than Humalog. I was told going on Humalog that I could just take it because it's onsets in fifteen minutes, peaks at an hour.
Scott BennerJenny has explained this to me what her thought about this is is that so back in the day when you first started, like, you injected that insulin. It didn't work forever. Right. They didn't even call that pre bolus, and you just had to get it in and then eat at a certain time. And then when they went to insulins that were faster but not actually fast, where that faster acting insulin name comes from, Jenny supposes, is that both the clinicians at that time, it was so much faster than what they were using that they called it fast acting insulin. Maybe they should have just said, this is faster acting insulin.
Scott BennerSo then as time goes on and those old people are, you know, gone away and the people who were doing cloudy and, you know, NPH and all that other stuff, when those memories kind of fade away, what they're left with is, oh, we have this stuff now. It's modern fast acting insulin. And for the people who were used to you injecting at 8AM and eating an hour or so later, this stuff works in, fifteen minutes. Like, we don't want people to get low. Like, you know what I mean? Like, I think it's that slow transition and having to work through people with different perspectives, and that's how the naming system gets where it is, and that's how the directions get where they are. I actually think she's right about that. I think that's the pathway to somebody not telling you to pre bolus.
JustinI suspect she's right. Yeah. Certainly, Jenny's had her ear.
Scott BennerShe lived through it too. Yeah. Yeah. She lived through that time.
JustinYeah. And, you know, both as a patient as she was a teenager, young adult, and then certainly now as a CDE. It's just one of the oddities of how things make it through society. Why do certain terms and phrases run through the world Or, you know, like, that kind of thing. Or we they somebody puts out a thousand songs every summer when we're growing. How come two of them hit and everybody knew it? And it's just I don't know how all that happens. I don't think it's it might not even be trackable by a human being, but I think that's how we get to this situation.
Scott BennerAnd then, like you said, then somebody's gotta say, I don't know. This doesn't make sense to me. And by the way, when my kid gets diagnosed, I have no context for NPH regular, cloudy, clear, blah blah blah. Like, I don't I'm just here now. And they give me this insulin, and they say, inject this insulin when she eats, and that's it. And then I'm, you know, spending years, like, pulling my hair out with a a freestyle meter, you know, and not even pens. Do you know no one ever gave me a pen? What so needles and a freestyle meter.
JustinI've never had one either. I lie. I've been given the trial Lantus pens in the event that the pump crept out on me.
Scott BennerIn the two years before we started talking about pumps when Arden was four, no one ever once said, hey. This is an insulin pen. So I don't whatever. But my point is is her blood sugar shooting up. And I mean Arden's blood sugar, which shoots so far up. And then I'd stare at it. And then, you know, learn a little more and figure things out, tiny little increments. But two years into it, I wasn't good at it still. And then you get the pump and people are like, oh, the pump's gonna fix everything. That used to be how it was talked about. Wait till you see the pump. The pump will take care it. We got her on the pump. The pump didn't fix anything. It just stopped me from having to stab her, which was nice, but her a one c didn't move much. And I was like, I thought this thing was supposed to be magic.
The CGM Revelation
Scott BennerI mean, it's not until a CGM. Right? It's not till we get that first Dexcom where I'm like, oh, I can see what's happening now. And then you can fill in all the blanks. Sort of like in Jurassic Park where they have most of the DNA, but not all of it. They filled in with a frog. And I had a lot of the idea, but not all of it. And this the CGM was what I needed to fill the slots and that I didn't understand. And then I thought I really understood it. Until Arden got on loop, and then I through NightScout, I could see the algorithm working, and then it really started to make sense to me. Anyway I mean but are you really mad, or are you happy that somebody said it? Are you or are you more mad about the lost time?
JustinI'm disappointed at the lost time. Naturally.
Scott BennerYeah. No. I would be too.
JustinCGMs really came into their own and had a they became really fruitful and available. What year was that? Like, '20, what, 2010?
Scott BennerYou know, it's funny. You'd think I'd know when we got it, but I really don't. You know, I think Arden was, like, six or seven maybe. So I don't know.
JustinSo there was speaking for me, you know, from '87 to, what, the early two thousands, there's fifteen years at least where I really didn't have a better option.
Scott BennerHow did that impact your life and your health?
JustinOh, I my wife has told me that one of her old coworkers used to write progress notes for someone who would come in with a a double knee repair or something like that and go, patient has enjoyed sixty years of poor health with, you know, high blood pressure and blah blah blah. I would have to say that I enjoyed a one c's that were from the eights into probably the tens at some points during high school and college. Now high school, college ages, there's lots of growth hormone. There's lots of other hormones. Ignoring.
Scott BennerRight? Did you ignore it in college?
JustinIgnore what?
Scott BennerDiabetes. Would did you back burner it and just do the minimum, or were you working on it?
JustinOh, minimum. For sure. My endo, I had the view every three months that I was just gonna get the finger wag that test more, bring these numbers down. Let's see that a one c drop to below seven because, you know, I just floated along there. But I can also say that unless I was doing a sport, I didn't go low all that often.
Scott BennerYeah. Well, your a one c was 10. Your blood sugar is probably over 200. Right? Yeah. For good portions of the time. Certainly.
JustinIt took seeing the guy at the tour de cure event to really impose on me that you can't have this magical system running on the phone without the sensor. So put on the sensor, you get the information, and then you can run with it. Work as anybody to say that.
Scott BennerYeah. Well, no. Listen. I've tried over the years to say that I valuable as I find Arden's insulin pump, and I do. I find it incredibly valuable. Like, if you came to my house with a gun and said, hey. You gotta give me the pump or the CGM. Like, I'd throw the pump at you. You you know? Like, I don't know how to get rid of the CGM. I believe your health is going to deteriorate without it, and I think that your effort is gonna increase 20 fold if you wanna keep your health where it is without the CGM. You're be testing all the time and trying to fill in those gaps in that understanding with guesses and supposition. So—
JustinOr you're gonna be like me, test maybe three times a day for decades. Just ignore the whole damn thing. And just make guesses. Yeah. Sure. I I might get there was a while it was just two tests a day, morning and night. And in the middle of the day, if I didn't go low, I really didn't know where it was. So having that data, even when it was just the n light sensor going to the pump in the first run that I went with loop, yes, it was annoying because there were technical difficulties with the in line sensor. But for some reason, it worked fairly well for me, and I could see the graph on the MiniMed that was saying it's giving me that data. So I could stop some lows. I could stop some highs. I didn't love the eight hour check-in for having to calibrate it every eight hours. That was a pain in the neck too.
Scott BennerMoment in time too. Like, they're getting through it. Like, hey. Does that anger inside you, does that carry over if you see someone online like, my CGM only made it eight days. This thing sucks. Are you, like, shut up? Or how does that strike you when people who are newer to diabetes don't have context for what you live through?
JustinI think the people who are let's talk about it if it's a child who's diagnosed. I think the child and the parents are scared, overwhelmed, and you're not reliant on the CGM to administer the insulin. Clearly, the insulin comes in pens and pumps and vials and syringes and all that, so you don't need it. But it is so valuable. I agree with you. If I had to give one of them up, I would give up the pump. That CGM is so valuable in just keeping your numbers in range. Even if you do have the spikes up to 5,300 after a meal or something like that, at least you know it. And you know the pump is wrong or you bolus too late or you didn't bolus.
Scott BennerYeah. You do something about your blood sugar doesn't stay two fifty for a week. Right? Right. Yeah. Right. So when they are upset about the sensors, I get it. I do get it because we're also paying dearly for them.
Scott BennerNo. Yeah. No. I under I do too. Listen. You're counting on it. You've paid for it. Someone's promised you that it does the thing. I understand all that. I do. I it's the part where I wish for them and I'm not mad at them. I was just wondering where you are. I wish for them that they knew your story. In that moment, I wish that knowledge could kind of flood into their heads and they could feel like, hey, this sucks, but I'm gonna call the company and they're gonna send me another one. And this is way better than how Justin grew up. I don't want people running around angry all the time. And I don't think that technology is perfect or is gonna be perfect anytime soon. I find that it's an opportunity to be upset at a thing that you should be grateful for, and I don't want that for people. You know? I mean, listen. I'm not in charge of how you feel, but, like, I hope you could take your anger out on something else other than this thing that you have no idea what it's doing for you if you don't know Justin's story or, you know, other people who have come before.
Algorithms as the Gold Standard
Scott BennerAlso, now, they're chocolate and peanut butter at this point. Right? Like, a pump in a CGM, a pump with an algorithm in a CGM, in my mind, I know they come from two different companies. That's it. They're one and the same. They belong together now. I know it's important not to pressure people into doing things or to tell them that what they're doing isn't the gold standard. But if you're not using an algorithm, I mean, in my mind, and I don't care. Medtronic, Twist, omnipod.com/juicebox for all of them. Exactly. Links at juiceboxpodcast.com. But, like, all of the pumps, All the pumps, all the CGMs, those are gold standards now. I wish they weren't gold standards. I wish they were commonplace, and that's just what happens. Because I think you're gonna see a lot of people live a lot longer with far fewer issues as they get older.
JustinI certainly agree about the CGM given the value that it adds. Pumps are amazing. I think there's a a point of incentive. The incentive for me when I was first going on the pump, I resisted it for quite a while, and my parents kept nudging me toward the pump. And the big incentive when I finally bit on it was that it was one, quote, unquote, injection every three days as opposed to three per day. That was the easy sell back then. Right? That was the easy sell. Yeah. The at least the most compelling to me. Mhmm. Certainly, there's also the advantage of basal rates and only using short acting, no more NPH because we had a near, I I guess, near fatal thing where there was one time I grew up we had a two family house.
JustinMy grandma would put me on the bus and take me off the bus as both my parents went to work. So there was one day she knew how to give the injections, and she would do so, but my parents would draw up the needles or the syringes. And back then, it's regular in NPH, so it it's clear before cloudy. I always used to think, oh, that's kind of a lame, like, silly thing to say, but there was one day where Graham took the syringe out, and it was all clear. At the time, I was probably doing one third regular, two thirds NPH. I I don't remember specifically, but this is, in kindergarten. And she took the cap off the syringe and I go, I'm not taking that. And she thought I was just being fussy and dumb kid. I said, no. That's clear. It's all clear. Yeah. Supposed to be cloudy and clear. Where's the other one? Yeah. It should look milky.
Scott BennerJustin's going down for the count. You hit me with that whole thing. Right.
JustinWe called my mom at work. She raced home. Her heart's probably pounding. Well, I I shouldn't say that. Her heart would have been pounding more had it been delivered. But she felt like mud because, I mean, she probably just had gotten to work that we called to say the insulin isn't mixed up right. So at least we dodged a bullet there.
Scott BennerAnd And you saw it. That's awesome that you saw it too. You know?
JustinIt was dumb luck. Just like dumb luck going to, you know, get the invite for my friends to go up for the tour de cure event. Dumb luck sitting next to that guy who's got between him and his party, he's got one Omnipod looper and one MiniMed looper.
Scott BennerYeah. Do you ever hear that episode where the school nurse gave that little girl, like, way too much insulin, but the school nurse insisted on putting a Band Aid over top of the injection site and the mom—what the hell is that gonna do? This is where the dumb luck comes in. Hey. Have you not heard this episode? It's fantastic. I feel like I've heard you mention it to somebody else, but not the episode itself. No.
Scott BennerShe hit that kid with, like, I think, like, a 100 units of insulin or something like that. Oh. So much that it didn't fit in the syringe. Because of that, she gave her two syringes. Because of that, she put two Band Aids on her. The mom happened to be bringing something. So the reason the kid was getting injection is I think they left the PDM in the car, and the mom was bringing the PDM in the interim time they went to MDI. The nurse does it completely wrong. The mom says, why do you have two Band Aids? And that started the conversation that led them to understand what had just happened. That's wild. That kid totally goes back to class and drops dead in that school if they don't do it. You know? Oh, for certain. Or or god forbid if they went out to recess before. Kid's gonna have a seizure. Maybe somebody gets to her. Maybe somebody doesn't. Like, it would have been really bad. And just the two Band Aids, like, made her go, how come you're wearing two Band Aids? And that was it. They just figured it out like that.
Scott BennerYeah. Yeah. I'll take some good luck once in a while is what I'm saying. So okay. Just suggesting, where are you at now, man? Like, how long have you been looping what? For six years now?
JustinI think so. Yep. Yeah. Okay. By the way, for people who wonder how my brain works, every time you say 2019, you mean 2018, I hear the start of a Doce song in my head. And when you said fussy, I thought Bob Fosse. Those are references no one's gonna know, but I just wanted to let you know what pops into my mind when people are talking.
JustinThe only, thing about Fosse I know is that they mentioned him in the bird cage.
Scott BennerI swear to you. I think that's probably where I know it from. And at the same time, like, you have to be impressed with how my brain is able to fight off that whole, like, Bob Fosse Bob Fosse thing and go back to, like, staying with you. You don't know how hard it is for me to accomplish this podcast, but it's not as easy as it should be.
JustinLike, it's hard for you to accomplish because you're playing with the chameleons all day long.
Scott BennerI'm actually right now watching something run around this cage that I'm just so tickled by. I can't believe how crazy it is that it's in here with me. It's just I'm talking to you and just watching this thing live its life. My question is, first of all, I'm thrilled for you. Know, you find Loop. You find so you found Loop, and then to understand Loop better, you found the podcast. Correct. Okay. And then I'm saying things that you're just like, no one's ever mentioned this stuff before. So does Loop get you from eight ten a one c down, or is it a combination of Loop and the podcast? And now that you're down, like, how do you found your life versus prior to that?
Life with Stable Blood Sugars
JustinThe a one c started to come down with my wife's support with taking it more seriously. Like I said, she's a a physical therapist. She has a biology degree. So things like a and p and biological systems, she's privy to. So she naturally wants to see me do better so that I'm here longer. Not to mention when we were dating and newly married, because my blood sugar would go so high from either late boluses, missed boluses, bad carb counts, we would fight a lot. Yeah. You're probably a prick. Right? Still am. Yeah. But now at least it's natural. Exactly. So she wanted to see that come down. And I think the context for her was that ADA wants to see you with an a one c. Is it below eight or below seven? I mean, now I think it's seven and a half for kids, seven for adults. I forget where they're at right now. But back then, I don't know. It could have been higher at that point. I think they were at eight not that long ago.
JustinSo back in those days, the eight was probably the benchmark we were aiming for. But she wanted to see us do better and see me do better. So from what I remember, around the time where we got together, I was probably in the low eights, high sevens. And I remember it was either my memory's a little fuzzy about whether I actually started using the nLIGHT CGMs months before loop or if I really just got on nLIGHT at the same time as loop. But I remember starting at a 7.9, and within, I think, a year, I was down to 6.9, then COVID hits. So I've got some you know, I have a a longer gap when my a one c was taken because they did telemed stuff during that point. And I've had let's see. I've got recordings going back to 2021, 06/1957. My last two were 58 and 51. 51 scared me a little bit because I said, I'm not pregnant. I don't really wanna be that low.
Scott BennerWere you getting low a lot for the 51, or you just things are dialed in. You are?
JustinI was. Yeah. It was probably in every other day. Yeah. Well, we don't want that. No. We don't. But if I was gonna float around with a 54, I would take that happily.
Scott BennerYeah. No kidding. The stability is there too. Right? You're not bouncing around anymore. And is that just like, beyond not fighting with your with people in your life because your blood sugars are fascinating all over the place or high. I mean, do you feel other value? I mean, other than knowing you're gonna live longer and, like, stuff like that. But, like, is there other value day to day that you could point to people who are of a higher a one c and say, look. If you were able to bring this down and get it stable, you might enjoy these things as well?
JustinI think from a biological perspective, I remember asking my NP if my circulation had gotten better with a lower a one c because my feet felt warmer over the winter. I always struggled with cold hands and cold feet. Not to the point where they were blue or numb, but they would always be cold, always from October through April. And she said, probably not with the circulation, but the nerve endings and your neuropathy might be getting better. I was never diagnosed with neuropathy. I never had numbness or tingling long term, but she said that your neural pathways to the feet might have improved, which is why they feel warmer to you in the winter months. Yeah. That possibly could happen.
Scott BennerSo awesome. Do you have any complications right now? 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 gonna be the next episode in your feed. I'd like to thank the blood glucose meter that my daughter carries, the Kontoor Next Gen blood glucose meter. Learn more and get started today at kontoornext.com/juicebox. And don't forget, you may be paying more through your insurance right now for the meter you have than you would pay for the Kontoor Next Gen in cash. There are links in the show notes of the audio app you're listening in right now and links at juiceboxpodcast.com to Kontoor and all of the sponsors.
Scott BennerI'd like to remind you again about the MiniMed seven eighty g automated insulin delivery system, which of course anticipates, adjusts, and corrects every five minutes twenty four seven. It works around the clock so you can focus on what matters. The Juice Box community knows the importance of using technology to simplify managing diabetes. To learn more about how you can spend less time and effort managing your diabetes, visit my link, medtronicdiabetes.com/juicebox. 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 juice box podcast. The juice box podcast has been in production since January 2015. And in that time, we have amassed just a fantastic catalog of information for you. The defining diabetes series. Also, bold beginnings, diabetes pro tips, small sips, fat and protein, algorithm pumping, mental wellness, ask Scott and Jenny, diabetes variables defining thyroid, after dark, the math behind Omnipod five pregnancy, how we eat grand rounds, cold win, GLP meds, the quick start guide if you wanna get going with the podcast but you don't know where to go, diabetes myths, there's even a type two diabetes pro tip series. All of this is at juiceboxpodcast.com. Go to the menu. Click on series, and they can all be found right there. If you go to juiceboxpodcast.com/lists, you'll get all these great downloadable lists of all the the different series so you can save them on your phone, keep them for later. Every episode is listed along with its episode number. So you can go into Apple Podcasts or your you know, wherever you listen to your audio, and say you wanna hear episode fourteen sixty nine, steal a one c overnight from the small sip series. Just go to the search bar, type juice box, one word, and then the episode number fourteen sixty nine. It should be the first return you get. Hey. Do you need support? I have some stuff for you. It's all free. Juiceboxpodcast.com. Click on support in the menu. Let's see what you get there. A one c and blood glucose calculator. People love that. That's actually, I think, the most popular page on the website some months. A list of great endocrinologists from listeners. That's from all over the country. There's a link to the private Facebook group, to the Circle community, and, we have a a fantastic thing there, American Sign Language. There's a great sign language interpreter who did the entire bold beginning series in ASL. So if you know anybody who would benefit from that, please send them that way. Just go to juiceboxpodcast.com and click on support. While you're there, check out the guides like the pre bolusing guide, fat and protein insulin calculator, oh gosh, thyroid, GLP, caregiver burnout. You should go to the website. Click around a little bit on those menus. It really there's a lot more there than you think. If you have a podcast and you need a fantastic editor, you want Rob from Wrong Way Recording. Listen. Truth be told, I'm, like, 20% smarter when Rob edits me. He takes out all the, like, gaps of time and when I go, and stuff like that. And it just I don't know, man. Like, I listen back and I'm like, why do I sound smarter? And then I remember because I did one smart thing. I hired Rob at wrongwayrecording.com.
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#1793 Bolus 4 - Real Food
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.
Scott and Jenny talk about bolusing 4 real food.
Key Takeaways
- Settings Evaluation: If bolusing for "clean" or "healthy" foods (whole ingredients like salmon, broccoli, or blueberries) is difficult, it is a primary indicator that your basal rates, carb ratios, or correction factors may need reevaluation.
- The Impact of Processing: Highly processed "Rube Goldberg" meals (like Cinnabon or McDonald's) have hidden variables like high fat and complex additives that require layered boluses; simpler foods should ideally follow a straightforward "count and pre-bolus" logic.
- Dynamic Life Changes: Significant changes in activity levels (sedentary vs. active) or body composition (weight loss/gain) necessitate proactive adjustments to insulin settings, as old settings may be masking or creating management issues.
- The Value of Visual Tools: Utilizing tools like the Juicebox Podcast Settings Calculator or Bolus Simulators can provide visual motivation and a starting point for discussions with medical providers, especially when navigating weight loss or lifestyle shifts.
- Automated System Awareness: For users of automated insulin delivery (AID) systems like Omnipod 5, it's crucial to periodically check manual settings. As the algorithm adapts to growth or lifestyle changes, manual settings often become outdated and "left behind."
Resources Mentioned
- Omnipod 5 Starter Kit: omnipod.com/juicebox
- Dexcom G7 CGM: dexcom.com/juicebox
- Juicebox Podcast Settings Calculator: juiceboxpodcast.com/settings
- Meal Bolt Roadmap: juiceboxpodcast.com/meal-bolt
- Bolus Simulators: juiceboxpodcast.com/bolusfour
- Juice Cruise 2026: juiceboxpodcast.com/juicecruise
- Juicebox Podcast Facebook Group: Search "Juicebox Podcast, Type 1 Diabetes" on Facebook
Introduction and Meal Bolt Overview
Scott BennerWelcome back, friends, to another episode of the Juice Box podcast. In every episode of bolus four, Jenny Smith and I are gonna take a few minutes to talk through how to bolus for a single item of food. Jenny and I are gonna 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 gonna be very conversational and not incredibly technical.
Scott BennerWe 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 Miel Bolt in every episode, we will be thinking about it while we're talking. If you wanna learn more, go to juiceboxpodcast.com/meal-bolt. But for now, we'll find out how to bowl us for today's subject.
Scott BennerIf you're looking for community around type one diabetes, check out the Juice Box podcast private Facebook group. Juice Box podcast, type one diabetes. But everybody is welcome. Type one, type two, gestational, loved ones, it doesn't matter to me. If you're impacted by diabetes and you're looking for support, comfort, or community, check out Juice Box podcast, type one diabetes on Facebook. Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise.
Scott BennerAlways consult a physician before making any changes to your health care plan. This episode of the Juice Box podcast is sponsored by the Omnipod five. And at my link, omnipod.com/juicebox, you can get yourself a free what'd 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 juiceboxpodcast.com. Today's episode is also sponsored by Dexcom.
Scott BennerThe Dexcom g seven, the same CGM that my daughter wears. You can learn more and get started today at my link, dexcom.com/juicebox. Jenny, I I got a note from somebody the other day that said, are you and Jenny? Well, don't all yet. Are you and Jenny?
Jenny SmithAlways get lovely note. I mean, you know, some of the the notes are very inquiring. Mhmm. I think that that's great.
Defining "Healthy" and "Real" Food
Scott BennerWell, this lady said, can you do some bolus for us for healthy food? And I said, we're just doing the ones people asked about. I don't know. Like, it's funny as I started to think about it is I don't know what she meant by healthy food, but when I—
Jenny SmithOh, she didn't give any examples. It was just—
Scott BennerNo. Healthy food. Can you please well, the McDonald's one had come out. And the best I got so many, like, really interesting little notes from people about the McDonald's one. But the best one was, I don't eat at McDonald's. I just tuned in to hear Jenny try to hold her gasp inside.
Jenny SmithThat's kind of funny.
Scott BennerBut I said, that did happen. Many times Yeah, it did. But but at the same time, I think I made this person say, and, you know, what about healthy foods? As I started thinking about it, I was like, aren't healthy foods easy to bolus for? Like, aren't they carb counts for the most part and a little bit of pre bolus in the right place, and where am I misthinking it?
Jenny SmithThat would be my first, I guess, way to explain it as well. Yeah. In general, food that is and I wouldn't even say let's just say clean food. Right.
Scott BennerThat's how it makes me think. Something that's not processed or has a ton of stuff in it. Yeah.
Jenny SmithRight. I mean, the ingredients are all readable. They're real food ingredients. There might be, like, sodium or ascorbic acid or something. But, again, those are they're still real food.
Scott BennerYeah. Right? Why don't we do bolus for real food today? Alright. And—
Jenny SmithWhat kind of real food do you wanna eat?
Scott BennerWell, Jenny, now this is the problem. Right? Because she didn't give me any examples, and I am, I grew up a trash person. So I don't know how I'm supposed to think of what people eat.
Jenny SmithWell, when I think of real food, I think of the food on the plate didn't necessarily come from a box, let's say. And there are some packaged foods that are still quality foods that are somewhat processed. I think of bean. You can buy dry beans. There's a whole process, like, you have to soak them and then cook them and then drain them and rinse them. Like, it's it's a process, right, which most people in today's world, they just don't have the time for. So then you purchase canned bean. Okay. Great. They're processed, but they're not full of a bunch of junk.
Jenny SmithThings like dry let's do quinoa. Quinoa is dry. You buy it in a package. That doesn't mean it's not a quality nutrient dense food. It's just the way that we now have to buy it. Right? Even if you have a co op or something you go to and you buy it from their bulk, it's still technically dehydrated and you know what I'm saying?
When Simple Food Becomes Difficult
Scott BennerI know what I do. I wonder if when she said, you know, real food or or healthy food or however she put it. I just pulled up a list. I just I just went and I said, like, give me a list of real foods that humans eat most often worldwide. And I mean, and it's chicken, pork, fish, bananas, beans, you know, garlic, tomatoes Broccoli. Broccoli. Yeah. Cabbage, bananas, apples, oranges, grapes. And now I'm thinking, if she's having trouble bolusing for this stuff, is it more about settings and timing? Is it maybe back to the basics? Because this shouldn't be difficult. Right?
Jenny SmithIt shouldn't be difficult. And that is it's a good place to start. Is it that your settings aren't right? That's the first place of evaluation. If you're sitting down and you're eating let's give a meal of something like grilled vegetables, some baked salmon Mhmm and maybe blueberries. Okay? All real food. You might put a little oil on it to cook it. You might or butter. You might put some seasonings on or whatever. But in general, that's real food.
Jenny SmithYou can count on the nutrients that you look up, that you get from chat GPT, from a photo, from whatever. You can count on the carbs, proteins, and fat being real Mhmm and not impacted by a bunch of other additives Yeah or ingredients. And so a meal like this, you'd essentially say, well, what are my carbs? Right? I've got some broccoli, pretty low carb, very low glycemic, got a good amount of, you know, dietary fiber in it. Even has vegetables are by weight, actually a little higher in protein. Most people don't think they can get protein from veggies, but you can. And then you've got your blueberries, which are also a carbohydrate source. Again, pretty low glycemic. So a meal like this, once your settings are set, should be pretty easy to bolus for. There's not much on the back end that you're gonna have to worry about.
Scott BennerRight. It it just feels to me that a person who's eating that way like, I just know from talking to you really mostly. Like, you eat like this. And I've seen your graphs for years. They look like I expect them to look almost all the time. Right? And around food. And so her just as we're chatting about it now, I'm like, maybe this maybe I really maybe I really was onto something all those years ago when I was like, it's just timing and amount. Like, use the right amount of insulin at the right time. Like, I might have been onto something. You know?
Scott BennerAnd when you're talking about, you know, chicken nuggets and french fries and Cinnabon and all the other things that are on that that bolus four list, is growing because you and I have been making it for a while now, those are like like Rube Goldberg meals. Like, there's arms sticking out of places that you have to think about and you don't, like, really understand all the pieces that are there. It's so big and unwielding.
Jenny SmithLike abstract art. You have to look at it for a long time to kind of pull the parts apart and say, I don't know. I think the artist was saying this.
Scott BennerYeah. And I think I need some insulin here for that part and a little more over here for that thing that's gonna come at me. And, oh, there's the boot down here that cooks the toaster. That's gonna need insulin forty five minutes from now. And, like, okay. Now, when you that's hard to understand. You put together a plate with fish and a broccoli and a half a potato or something like that. Like, I mean, it's count the carbs pre bolus and make sure your blood sugar is moving in the right direction when you start eating, and you should be okay.
Jenny SmithRight. And something fair to bring, which I love actually, I love this question. So whoever asked it, thank you. I think it's a wonderful way to highlight the fact that all the hard things that we've addressed, they are truly hard. They're things like you said, we have to pull them apart. We have to figure out what parts are gonna hit when, and then it still is the timing of when to put the insulin in the right way. Right? But simpler foods, real just basic. Essentially, you need the information, the carbs, and then you just need to know that your settings are starting in the right place.
Jenny SmithAnd then even bolus timing isn't that difficult. And with today's technology, we have our CGMs that are pointing our glucose trend in a direction or stable or in the other direction that then goes into the consideration too, but it's a little less cumbersome than what we get from more, I guess, full and complex meals.
The Variable Problem: A Real-Life Example
Scott BennerI'm probably chief among them at some point in my life that would look at a a Cinnabon at the mall and think, oh, that's very sugary, but not think about all the fat that's in it. Or you get a a so you people don't think about how something's cooked sometimes. Right? Like, you commented during the during the McDonald's bowls where you're like, is this all fried? And I was like, Jenny, they don't even have an oven in there. What are you talking about? I do remember that. I've never yeah.
Scott BennerSo I guess I I feel like this is maybe a good spot to bring up that there's a settings calculator on the website. And maybe if you're having that much trouble bolusing for simple clean meals, maybe your settings are off or, you know, you know what I'm saying? Like, maybe that's a good place to go.
Jenny SmithI do. I also think another consideration here is maybe maybe this person was also asking because they were considering doing a bit of turnaround in what was typical for them to eat. And maybe they've got down what they were doing. And now that they want to eat a little cleaner, let's call it, the food is simplified in a way that you're right. Maybe the settings actually were catered to the type of intake they had and they had it figured out. But now that they've started eating a little bit cleaner or home cooked meals and they know what goes into their food, they may actually be seeing things that are not responding like they'd expect with the settings they've got. Yeah. And therein lies a a good question of, well, what do you do with that? Right? You have it figured out for harder stuff, but now the simple stuff comes in and it all goes wonky and it should be easier.
Scott BennerYeah. So if you were eating differently and then changing to cleaner or I mean, honestly, if you were a sedentary person and then suddenly got more active and because maybe those two things go hand in hand. I'm gonna get some more exercise and eat better. You'd you wouldn't realize after time that the settings you have now, what your carb ratio is, your bolus, you know, correction factor, your basal insulin, those settings, what those settings are are set up for a sedentary person eating not cleanly. And now you suddenly get active and, oh gosh, I I seem to mess up all my mess.
Scott BennerListen, last night last night, I'd already told Jenny about this. I feel like I'm saying something twice to somebody. But last night, my family took me to a concert for it was my Christmas present. And Arden had a class late in the afternoon. She runs in the house. She's like, I haven't eaten yet today. And she looks around, looks around, looks around, and grabs a muffin. Then runs upstairs and gets ready to go to this thing like we are. We gotta go. You know what I mean? Right. And it's like a muffin from Costco. It's not—
Jenny Smithit's yeah. Those are gigantic.
Scott BennerAnd it wasn't the big big one. It was the smaller one. They figured out not to give you six giant ones. They now give you eight slightly less giant ones. But, like, she grabbed it off the counter, bolus while she was eating it, and now we're sitting in the car for an hour driving, and I'm watching her blood sugar just two thirty. It is just sitting there. It ain't moving. Alright? And the algorithm's pushing, and it isn't moving. So we bolus, and it's not moving. But eventually, we're like, fair enough. There's enough insulin in here. Like, we have to stop.
Scott BennerParked the car at the NJ PAC Center. By the way, NJ PAC Center, thank you for building another, parking lot because it's a disaster there, but still the traffic is horrible. And you had to walk. And you get out of the car. We're late hustling through the parking garage, up a bunch get to the escalator. Escalator's out of order. Ran up the stairs. Run inside. Get our tickets. Everybody's gotta go to bathroom. Run-in the bathroom. Like, we're going to see Yo Yo Ma. Like, I'm not seeing it. Like, I wanna be on time. Like, we're hustling. Right?
Jenny SmithYou're not seeing, like, a dog jump through hoops or something.
Scott BennerThis is one of these things that listen. This doesn't belong here, but you should go sit quietly in a room. Be very still. Listen to Yo Yo Ma play once in your life. It'll change how you feel about being alive. You can manage diabetes confidently with the powerfully simple Dexcom g seven. Dexcom.com/juicebox. The Dexcom g seven is the CGM that my daughter is wearing. The g seven is a simple CGM system that delivers real time glucose numbers to your smartphone or smartwatch.
Scott BennerThe g seven is made for all types of diabetes, type one and type two, but also people experiencing gestational diabetes. The Dexcom g seven can help you spend more time in range, which is proven to lower a one c. The more time you spend in range, the better and healthier you feel. And with the Dexcom Clarity app, you can track your glucose trends, and the app will also provide you with a projected a one c in as little as two weeks. If you're looking for clarity around your diabetes, you're looking for dexcom. Dexcom.com/juicebox.
Scott BennerWhen you use my link, you're supporting the podcast. Dexcom.com/juicebox. Head over there now. 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. 0. That's less than your daily coffee for all of the benefits of tubeless, waterproof, automated insulin delivery.
Scott BennerMy 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.
Managing the Crash: Community and Compassion
Scott BennerAnd so, like, I'm trying to get to this thing, and we sit down, and I'm not very involved in her care anymore. But I think just out of repetition, the last thing I did before we turned our phones off was look at her blood sugar. Because I know from years of experience, something's gonna go wrong. This is gonna be it right here. Right? And but I wasn't thinking about at that point, oh, we gave her a bunch of insulin. She was stuck high. We just weren't I didn't think about any of that till the next day, till today. But no kidding. I opened up my phone and I was like, hey. You're one forty five arrow straight down. Like, you're you're crashing. And I said, what do you have with you?
Scott BennerAnd she goes, I have two juice boxes and a pack of Gushers in my purse. And I said, well and I reached in my pocket and I pulled out a fistful of gummy bears. I said, I brought gummy bears. And she was like, okay. So and I don't know that I'm ever gonna be able to stop myself. Jenny, I think if you and I went somewhere, I would stick, like, snacks in my pocket for you. Like, I just think I don't, like I don't know how to not do that. You know what mean? So—
Jenny SmithYou just yeah. No. You're a good you're a good parent and a good friend. You're lovely.
Scott BennerSo she's she's having a couple of gummy bears, and I'm like, do a juice. Then And you could see on her face, goes, but I only have two juices. If I do one and we have a problem, what am I gonna do? I watched her work that out in her head, she goes, I'll just get up if it's a problem. I thought, I do not want you to have to get up and miss this. No kidding. If you have to get up, I'm gonna go with you. And I don't wanna miss this either. Yeah. And I said, drink a juice. Let's do a couple gummy bears. I think we're good. The single arrow down went to double arrows down. Arden does not see double arrows ever, ever, ever. So what was it? It was bad timing, bad amount, suddenly having more exercise.
The Juicebox Podcast Settings Tools
Scott BennerAnd so, like, in a in in that that moment, that could happen to you in your real life. And so listen, juiceboxpodcast.com/settings. You're gonna be met with a calculator. It just asks for your weight in pounds, and it's going to give you a starting point to think about your settings. I am not saying it is gonna be a it's gonna be right or anything like that, but maybe a great opportunity for you to go back to your doctor and say, hey. I looked at this calculator, and it says my basal should be more like this, but mine's way higher. Maybe that's when you're gonna find out that you're over baseling yourself to make up for the fact that you don't count carbs well or—
Jenny SmithRight. Who knows what, you know, collection of variables are being hidden by your settings. And now you take those variables away, and suddenly your settings are way off. That happens.
Jenny SmithAnd in this case, the variable being had she had, like, some scrambled eggs and, I don't know, an apple, it would have been very different. The stock high wouldn't have happened. You wouldn't have been prompted to bolus bolus to kinda get it or allow the algorithm to do what it was again, all the things and it just brings into light the true amount of variables we do have to look and consider every single day.
Scott BennerYeah. 100%. The life portion of it that's hard to write down on a list and make sense of or that I wasn't even thinking was happening while it was happening. Right? But yeah. But if your if your settings are rock solid and all all Arden would have had to have done is pre bolus, and we would have been okay. But because of the rush, that didn't happen. It threw everything off, and then you see this cascading problem. Yeah. The same thing could happen to you, you know, if you're like, hey. I used to eat like this, but now I wanna have what did the lady call it? Hell, I wanna eat healthier. Healthier. Yeah. Right. So go get your settings right.
Scott BennerI mean, I'll just for people just I'm looking at it right now. I typed in one fifty as a weight. As soon as you type in that number, it asks you if you're highly sensitive, have standard sensitivity, if you're resistant or highly resistant. When you click on one of those things, it chooses your daily dose. Right? So, like, at the standard number for a hundred and fifty, it has thirty seven and a half units. But if you go to resistant, it goes to forty four point three. If you go to highly sensitive, it goes down to thirty point seven. There's also, like, a little slider you can fine tune it to maybe, you know, if you really feel like you know better or maybe you and your doctor could do it together, whatever. As soon as and then it gives you your basal, your carb ratio, and and it's not perfect. But it's it's a good way to look at your settings now and then look at this and go, why are these so far off? You know?
Jenny SmithIt's a good starting place. I think another way to use that tool could also be let's say you feel like you are highly resistant because you know your lifestyle. And let's say it's the turn of the year and you're like, I'm gonna make some changes. Right? I'm gonna start walking three or four days a week. I'm gonna do this class. I'm gonna also clean up my pantry. I'm gonna get rid of this. I'm gonna bring this in instead. You could potentially use that tool then. You're the same weight, but now, goodness, you've cleaned things up. You've gotten a lot of the resistant generating foods out of your intake and you're adding exercise.
Jenny SmithSo maybe now you're more normal sensitivity. You could use the tool at your same weight to see, goodness, how much should my dosing change taking your current let's say you're on a pump, taking your current profile and just scaling it back to see does this now hit better? Mean, even those on MDI could do the same thing. They could say, okay. Well, it told me or I'm using this basal dose. Now that I'm more sensitive and I've cleaned things up, gosh, look at how much less I can probably start to use. And again, it's not like a big jump. It's just a scale it back and see what ends up working.
Scott BennerBut you could use that tool as a starting place instead of trying to just figure it out in your brain and pick something from the air. I'll you tell another thing you can do with it very simply is if you're looking for motivation about, like, weight loss even, like, if you put in here a 170 pounds, it tells you your total daily insulin is 42. Well, guess what? If you lost 20 pounds and you went to one fifty, it goes down to 37. You know? And especially now with GLPs, I'm getting a lot of notes from people.
Scott BennerI just got a really great one yesterday. Person thanked me. But there are people who are losing 30 pounds quickly. Right? And then they're losing another 20. Imagine you weighed two hundred pounds and you're using, you know I don't know. You're using fifty units of insulin a day. And then all of a sudden, you're down 50 pounds and it's down to 37. Like, what a great motivator. Absolutely. Listen. We'll talk to people all the time. Like, I want you to use the amount of insulin you need. I think the way I've said it before, I'm pretty comfortable with. I can't tell you how to eat, but if you're gonna make a poor health decision with food, let's not also make a poor health decision with diabetes.
Scott BennerWith your blood sugar. Yeah. Right. Let's at least have the the the blood sugar parked together. But that might be a motivator for people. I don't know what motivates people anymore. That note I got yesterday was from a guy whose kid has diabetes. It's not even him. He listens to the podcast for the child. I did that weight loss diary, and he said that motivated me. I've lost, like, 30 pounds already. That's awesome. You know, like, you how so whatever motivates people, I don't I don't know. Right? But maybe or just go mess with the calculator just to give yourself a shot.
The Bolus Simulator and Fat/Protein Impacts
Scott BennerNow once you have good numbers from it or a starting point, there is another calculator. So that one's gonna be juiceboxpodcast.com/bolusfour. By the way, these all have, like, a ton of, disclaimers. You're gonna have to click through to use them. You know, they're educational purposes only. Talk to your doctor, that kind of stuff. But once you have those numbers from the settings, then you can take those numbers and put them into the calculator. And once if I did it the way I meant to by the way, I wanna say these calculators were made by, like, vibe coding on AI just so you know, you know, how they came. So if you take that number, insulin to carb ratio for one fifty, which is I'm looking at the other one here. 13.3. Now let's just believe these insulin sensitivity, it has 48, and we're gonna make our target blood sugar on the calculator 90.
Scott BennerThere's a little thing here you can you can calculate. Like, you can put a cap on how much, you know— it can give you— kinda like yell at you if you if it goes over 25. Max bolus limit. Yeah. Very nice. Right? So then we take carbs all of sudden, and we say, hey. A 50 carb meal, no fat, no protein. I, you know, I have no insulin on board. My current blood sugar is, you know, 100. I'm trying to get the 90. I have a stable arrow. It says simulate the strategy, and it tells you 3.97 units for the 50. Yep. And and it gives you a little, like, wait ten minutes on a pre bolus thing, suggestion. But the minute— I'm sorry. No. No. Jump in.
Jenny SmithYeah. I was gonna say and to compare for, again, somebody who's considering moving to a healthier intake. Now take that carb content and add into it, especially if you're working on weight loss potentially or stabilizing your weight to keep yourself where you really want to be, Add into that 50 grams. Now the meal contains 30 grams of fat and 50 grams of protein. What is the dose difference? My goodness.
Scott BennerYeah. It doubles it, basically. It's still Right? Three point nine seven up front, but now it's asking for three point five three over the next eight hours. So the theoretical requirement is seven and a half units, and that's you know, now you're setting square wave boluses or, you know, extended boluses. A lot of you are on algorithms right now that don't accept fat as an input, so the algorithm's just gonna fight with the the rise, and it's not gonna use nearly enough. And not only that, but then now you can come back. It's it's such a great point. You come back again, and then cut the fat down to 15 and cut the protein down to 25 and then hit it again and see to yourself, oh, now it's five and a half units of insulin. And what happens if I lost 10 pounds and these settings change again? Like Yes. Whatever's gonna motivate somebody to do a bigger idea. I hope these things help you. I hope you play around with them and they they make sense for you and help you—
Jenny SmithThat's what I was gonna say. I think the beauty of technology is that tools like this can give you more insight when you're working really hard to navigate some changes that you know are going to eventually pay off. They are going to be better for you. Right? But it's hard when you I'm a very visual learner myself. And so when I can see it there, I say, oh, wow. Yeah. Look at that. It definitely makes a really big difference. Whereas, sometimes it's something that's said, but you don't really have anything to attach it to. doesn't really make sense.
Reevaluating the Big Picture
Scott BennerThis is a lot to understand, and it it's a lot easier if you don't really have to understand it. You can just see it, and it go and it makes your brain go, oh, okay. I see why that's important. And I I don't know. I've just had enough conversations with enough people to think that oddly enough around using insulin, people don't think about the food that much. Right? Like, it it it's it's the whole thing. Right? You're controlling the impact of the food with the insulin, but we don't talk about it that way. And I understand listen. I understand why bigger picture, you or your kid gets diagnosed. You don't wanna feel like your life is gonna change. And so what does the doctor say? Oh, nothing's gonna change. Just count your carbs and use insulin.
Scott BennerThey're not thinking beyond the bigger picture. They're okay if your blood sugar goes to two fifty and comes back down five hours later. That's and if you're not okay with that, then I gotta look at the rest of these variables around exercise and body composition. What am I eating? You know? And not not and I don't mean what am I eating, like, punitively. I mean, like, what's in there and what does it need so that it doesn't cause a problem for me, blood sugar wise. That's all.
Jenny SmithAnd that's why I think these these conversations that I have the opportunity to have with you are valuable from my perspective in what I see out in the world of people with diabetes. Because these are the tidbits, the pieces that don't ever make it into the on the discussion table in the room with many clinicians. I'm not saying all, but with many clinicians, it is a starting place of count your carbs. Here's your insulin to carb ratio. This is how it works. This is easy math. But it it never goes farther than that. There aren't enough of these beyond the base discussions that people need in order to feel like they have some ability to succeed.
Scott BennerWhen I realized talking to you years ago that the settings that somebody gave my daughter at her diagnosis were from simple math equations. And I was like you were like, yeah. That's what we all do. We use them. I was like, wait. So I can know the math too? And she was like, yeah. And I'm like, oh, okay. When I realized that and then I realized that Arden was diagnosed at such a small age, at such a small weight, and she was gaining weight and no one ever reevaluated her settings. Yeah. It was the oddest thing, and it took me a a long time to figure out that that wasn't happening. And I think listen. The numbers are gonna—it's been a long time ago now, but I think I realized that when her insulin sensitivity was, like, one unit moves her 350 points, I was like, what? That's not right at all.
Scott BennerAnd I sat there thinking, like, where do we get that number from? And I'm like, oh, that's from three years ago. Yeah. And I'm like and then I sat in that office. It was one of the first times I thought, oh, these people are not gonna be helpful to me. I see. Okay. I got it. I'm gonna have to pay attention. Okay. But how does that happen? Like, because there's a little kid. She's diagnosed in the hospital, seventeen pounds on death's door. I swear to God. She a day and a half on insulin, she was nineteen and a half pounds. And then on the years that's followed, she's 20, 25, 30. Like, she's gaining weight appropriately. No one ever changed her settings again. And we're over there struggling, and I don't know why. And I and they're like, no. Are you counting the carbs right? I'm like, I mean, I think so. anyway, it could spin out of control really quickly.
Closing Thoughts and Future Planning
Scott BennerThen nothing wrong with going back once in a while and say to yourself, hey. And and I, by the way, I slow rolled this out. I put it out to the community on Facebook first. I got a lot of good feedback from it. Jenny is sharing it with people privately now, which makes me feel comfortable, talking about it more. But I got I got back from somebody who's like, I thought that calculator was gonna be a joke and I put it in. She's like, it matched all my settings. And I was like, right on. And I said, do you think you have good settings? She goes, my stuff works like right. And I was like, good. Good. Like, go Yeah. try to help yourself. I don't know. Absolutely.
Jenny SmithYeah. And No. And, you know, that's one of the things that I always take a look at, especially with my younger population. I ask all of my like, what's their weight? How are they on their growth curves, especially? Are they staying on it? Are they veering off of it in one way or another? And then we look at their their intake. And then with some of the algorithm pumps too that are adaptive algorithms, something really valuable to look at is for little kids, as the system adapts to giving them insulin, kids are also growing. So over time it has to adapt to that growth and it gives more and they need more insulin, but what gets left behind are their manual settings.
Jenny SmithAnd unfortunately, if you ever did have to use manual pumping mode then, things like the base basal for only manual mode, it might be three units behind what the system has adapted to giving in the automated basal profile. So it's really important to pay attention to all of these. Kids specifically through the growing years but even adults who might be making life changes. Again, kinda going back to this woman who may be what's healthy food look like for bolusing? Right? Maybe something changed, so you should pay attention to that.
Scott Benner100%. You and, you know, you said just now, but, like, real specifically, Omnipod five, like, you start off with a setting and that thing's adjusting your insulin now into the future, into the future, into the future. All the time. You suddenly go back to manual. Those settings have nothing to do with you anymore. Right. Maybe or maybe not. I don't know, but, like, you certainly don't know. That's for sure. And I I think it's worth just looking at once in a while. You could change your eating habits could change. Your body composition could change. Your activity level could change. There's a lot of different things that are changing. You can't just keep staring and going like, oh, well, that part is done now. It is not let's just not set it and forget it.
Scott BennerI know you want it to be, but it it just in a lot of cases isn't. Especially with growing kids or people whose lives are changing, and people's lives are changing a lot now. I mean, honestly, Jenny, look at me. I don't even look like the same person I look like two years ago. No. You don't. Yeah. It's insane. And then there's the guy or the thing, lost 25 pounds already. People I got a note from a woman the other day who said, never stop making that podcast. I believe she said she's lost a 130 pounds since she lost since listening to my weight loss diary. Right? And Wow. Then you know what the next problem becomes? One person says, I'm in the ER and DKA because of my GLP.
Scott BennerAnd I'm like, no. You are not in the ER because of your GLP. You're in the ER because you're not taking enough insulin. That's a different thing. And so, like, then people see that and they get scared of it. And and, like, so there's more to nothing listen. Between this, your relationship with your mom, politics, the world, nothing's as simple as as a banner, you know, statement. The headline's never the answer, so you gotta dig into this stuff. That's what I'm gonna leave with everybody with. Like, dig into this a little bit. Try to figure it out. Awesome. Jenny, you were terrific. Jenny Helps. We should call this episode. Jenny Helps? Yeah. Oh, I like that. Yeah. It's nice, isn't yay. It'll be called bolus for healthy food or something But like you know what I mean. Alright. I'll talk to you.
Scott BennerThis episode of the Juice Box podcast is sponsored by the Omnipod five. And at my link, omnipod dot com slash juice box, 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 juiceboxpodcast.com. Dexcom sponsored this episode of the juice box podcast. Learn more about the Dexcom g seven at my link, dexcom.com/juicebox.
Scott BennerIf you've listened to any number of podcasts or maybe watched a YouTube video, you're very accustomed to listening to the creator of that content ask you and sometimes just outright beg you without any feeling of self respect for you to follow, subscribe, share an episode. The reason that happens in podcasting specifically is because podcast players don't have a sophisticated recommendation engine like YouTube or TikTok does. They can't watch listener behavior and then give you content that you might like. Word-of-mouth skips that line completely. It's an instantly expanding reach engine and really the only thing I've ever found that helps to keep the Juice Box podcast growing.
Scott BennerSo subscribe and follow because that the algorithm understands. Set up automatic downloads, listen to the show, but share it with somebody else. Leave a five star review. Make it a thoughtful review that the algorithm can understand. I really appreciate the time it takes you to do those things, and I hate that I have to say this to you because I feel like an idiot. But subscribe and follow, tell a friend, please and thank you. How would you like to share a type one diabetes getaway like no other? Join me on Juice Cruise 2026. You may be asking, what is Juice Cruise? It's a week long cruise designed specifically for people and families living with type one diabetes.
Scott BennerIt's not just a vacation. It's a chance to relax, connect, and feel understood in a way that is hard to find elsewhere. We're gonna sail out of Miami, and the cruise includes stops in CocoCay, San Juan, Saint Kitts, and Nevis aboard the stunning Celebrity Beyond. This ship is chosen for its comfort, accessibility, and exceptional amenities. You're gonna enjoy a welcoming environment surrounded by others who get life with type one diabetes. I'm gonna host diabetes focused conversations and meetups on the days at sea. There's thoughtfully designed spaces, incredible dining, and modern amenities all throughout the celebrity beyond.
Scott BennerYour kids can be supervised, there's teen programs so everyone gets time to recharge. Not just the the kids going on vacation, but maybe you get the kickback a little bit too. There's gonna be zero judgment, real connections, and a whole lot of sun and fun on Juice Cruise twenty twenty six. Please come with me. You're going to have a terrific time. You can learn more or set up your deposit at juiceboxpodcast.com/juicecruise. Get ahold of Suzanne at cruise planners. She will take care of everything. Link's in the show notes. Link's at juiceboxpodcast.com.
Scott BennerMy 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. 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 thirty five years of personal experience, and we break down complex concepts into simple, actionable tips. The diabetes pro tip series runs between episode one thousand and one thousand twenty five in your podcast player, or you can listen to it at juiceboxpodcast.com by going up into the menu. The episode you just heard was professionally edited by Wrong Way Recording. Wrongwayrecording.com.
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#1792 Best of Juicebox: School Nurse Mistake
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 Alexaor wherever they get audio.
Lauren shared a harrowing experience where her daughter was overdosed by a school nurse - you won’t believe how much.
Key Takeaways
- Human Error in Schools: A veteran school nurse accidentally administered 150 units of insulin instead of 1.5 units, a 100x overdose caused by misreading a 100-unit syringe as a single unit.
- The Importance of CGMs: Lauren credits having her daughter on a Dexcom and being physically present at the school for saving her daughter's life during the overdose incident.
- DBH Deficiency: Two of Lauren’s children suffer from Dopamine Beta-Hydroxylase deficiency, an ultra-rare genetic condition (roughly 30 known cases) that prevents the body from making adrenaline and norepinephrine, leading to severe hypoglycemia and low blood pressure.
- Vigilance and Intervention: Managing these conditions requires constant monitoring; the children cannot sleep longer than six hours without risking dangerously low blood sugar, as their bodies cannot naturally access stored glucose.
- Medical Advocacy: Lauren’s story highlights the need to push for advanced testing, like whole genome sequencing, when standard tests fail to explain complex medical symptoms.
Resources Mentioned
Introduction and the School Nurse Story
Scott Benner OmniPod, Hello friends, and welcome back to the juicebox podcast. This one is going to curl your brain up wait to hear this. Okay, we are talking to Lauren today. She has a number of children. One of them has type one diabetes, and a crazy story about a school nurse that I will not ruin for you here, but just let me say you're going to audibly gasp when you hear her say what she says. And she's got a couple other kids who have a very rare genetic disease that we're going to talk about later has lots to do with their blood sugar, and it's incredibly interesting as well. My notes say this is my favorite episode that I've ever made. We'll see what you think. 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. When you place your first order for ag one with my link, you'll get five free travel packs and a free year supply of vitamin D drink, ag one.com/juice box. Don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code juice box at checkout. That's juicebox at checkout to save 40% at cozy earth.com three simple ways to support the podcast, subscribe or follow in your favorite audio app, tell somebody else about the show, use the sponsor links when you have the need. This episode of The juicebox podcast is sponsored by Dexcom. Dexcom.com/juicebox get the brand new Dexcom g7 with my link and get started today. This show is sponsored today by the glucagon that my daughter carries, gvoke hypopen. Find out more at gvoke glucagon.com, forward slash juicebox.
Lauren My name is Lauren. I have three children. My oldest, her name is Lacey, and she's a type one diabetic. She was diagnosed at age four, and she's nine. Now, the story that I want to talk about today is on october 3 of 2022 she was overdosed on insulin by her school nurse. The school nurse gave her 150 units of insulin when she only needed one and a half units to cover her lunch. Yeah, that's talk about that today.
Scott Benner Lauren, I already have questions. You're in luck. Okay, let's let people in on the secret that I tell people before we start. Go ahead and introduce yourself, and then after you do that, I'll ask you a question, but I don't know what that question's going to be then, while you're introducing yourself, I've never said this before. I don't think while you're introducing yourself, I'm like, I hope I come up with something to say, but I have something to say. Okay, good. Let's start with the school nurse, because this is interesting. The person who did this, had they ever given your daughter insulin prior to that, or was it their very first time?
Lauren So yes, so I'll back up a little bit. That morning, I drive my two girls to school and or to the bus stop, and then the bus drives them to school, and when they got out of the car to go to the bus, she had left her phone in the car, and I didn't realize it until I got home, and so as soon as I saw her phone was in the car, I called the school, and I said, you know, I have an appointment. I'll be there as soon as I can to drop the phone off. But, you know, she has a 504 plan. So, you know, we have things to fall back on. Should she not have her phone for her OmniPod? So she had had the OmniPod five at the time, which she still does, and that would just mean that if you need a correction, that, you know, she would get it via either the pen or a syringe or, you know, however it's worded in the 504 plan. And so I called, and I said, I'll be there, so if you want to wait for me, you know, we could just do it via the OmniPod instead of having you give an injection, stuff like that.
Scott Benner And she was like, okay, and you said this to the nurse directly?
Lauren I said it to the nurse directly. Yes, I spoke to the nurse, yep. And this is a 40 year veteran nurse, apparently, who you know has been doing this for 40 years, had worked in the hospital, had worked, you know...
Scott Benner I'm a 52 year veteran of being alive, and I'm an idiot still, so let's see what happens. Wait, but I have a question, though, this this, I feel like you misunderstood my first question, but I want to get you back to your story as soon as I can. But the nurse that did this, not that day, but in all time in history, had that person ever given your daughter insulin in the past, only via the OmniPod five, not via injection or the pen, okay, yeah,
Scott Benner okay, that's all I so they they have practice with your daughter. They know how much they usually get. She usually gets, etc, so Exactly. And so she's also accustomed to dialing the OmniPod up to one point. Five units. Yes,
Lauren okay, go ahead. Yeah. She, she normally does the OmniPod, and was very, was very thorough with it. Knew what she was doing. So I get to school right around noonish, and she had, like, literally just given her insulin. And I looked down at my daughter's arm, and I see that she has two injection marks in her arm. And I asked her, Why do you have two marks on your arm? And she said, Well, the the syringe wouldn't hold enough to just do one, so I have to do two. That's what she said. That's what the nurse told my daughter. And so I immediately, because we're in the front and the nurse's office is just like, a couple steps away. So I open the door to the nurse's office, go in there, and I said, Why does she have two injection marks? The nurse tells me the same thing. I said, let's pull out the syringes. She pulls out the syringes, and she says, this syringe is one unit. And I look at it, and I'm like, like, my heart just drops. And I'm like, this is not one unit. This is 100 units. This is 100 unit syringe. And she goes, No, no, this is one unit. And I'm, I'm praying to God, she's, she's correct. And I sat down for a second. I start Googling, and I'm trying to find something that proves her right. Because I'm like, Please let her be right. And I'm googling, and I knew it was just a matter of time, because her blood sugar was already dropping. Yeah. So anyway, I said, let's look at their syringes one more time. And this nurse goes over to the cabinet, pulls out the syringes, looks at them, and I'm like, Are you sure that's one unit? As I'm looking at the 100 unit mark, she's like, I think I made a mistake. And I'm like, yeah. So at that point, she had been dropping, and I had been giving her gummies and gummies and gummies and trying to, trying to get her to get a little bit higher. But at one at that point that we left, it had said low. It just said low,
Emergency Response
Scott Benner not gonna do it. She needed, I mean, yeah, what was her insulin to carb ratio at that point? One unit covers like 15 carbs. So 100 units would be 1500 carbs, but she got 150 units.
Lauren She got 150 so this nurse gave her not only one full syringe, 100 units. She also gave her another 50 units. On top of that,
Scott Benner 150 times 15. Hold on a second, Lauren, 2250 carbs.
Lauren That sounds about right. Well, that's about right. Oh, sure. Okay, I'm sorry. I have a couple of questions. Now, were you in shock? Is that why you spent time trying to prove her wrong when you knew she was wrong?
Lauren I was completely in shock because I wanted
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Lauren I want her to be right so badly. I was like, There's no way this. Nurses gave her 150 like, you can't wrap your head around that in the moment, you know, how old was your daughter at that point?
Lauren Um, she was seven. How much did she weigh?
Lauren She weighed maybe 60 pounds at most.
Scott Benner And you punched the nurse. How many times in the face before you left the office?
Lauren Trust me, inside is 2020? Okay, yeah,
Scott Benner I would have been like, oh my god, this is my time. I can actually assault another person, and a jury of my peers is going to let me off. Okay, okay, so wait, so there's not enough carbs in all of the land, and she's not going to be able to eat it all anyway, and so do you hit her with glucagon immediately?
Lauren I didn't I, the only thing I, at the moment, thought to do was to rush her to the ER. And while I'm getting her in the car, I'm noticing she's starting to, like, slump over, yeah, and I'm like, Lacy, like. See, wake up, open your eyes. Open your eyes, open it. Like the whole car, right? And I'm like, the house is closer than the hospital, so I rush to my house, and I get on the phone with her endo and the nurse, and I let them know what's going on, and they walk me through the whole glucagon thing, because I get to my house extremely quickly, and I give her the glucagon, she's still, you know, out of it, and I rushed to the hospital. And when we get to the hospital, thankfully, she's able to walk inside by a miracle, like looking back on it, I don't know how she was able to walk inside, but she was able to walk inside. They took her blood sugar, and it was like 79 at that point, I think the glucagon had started working, yeah, and however, you know, flowing through, yeah, it was, it was dropping, dropping, dropping. All night at the hospital, she was on a, like a glucose strip. I bet it was still a drop, like I was. Obviously we're not used to that.
Questioning the Oversight
Scott Benner I have thought you were going to tell me you went into snakebite mode, cut her arm and sucked the insulin out of her, because, honestly, it would have been one of the things that went through my head. So I might have stuck the syringe back in and pulled and see if I could have got some of it back again. By the way, not not medical advice, because I have no idea if that would work or not. But um, I mean, so you're only three years into diabetes at that point, right? Yeah, okay, because Lauren, between you and I as now we have distance. You made a couple of tactical errors along the way. I did absolutely, yeah. Okay, so I gave your daughter 150 units of of insulin, you should have hit her with a glutagon in that moment. 100%
Lauren I completely agree. And I think it was just the fact that I didn't want to believe that, that that's what just happened, like I could not wrap my head around that that had just happened.
Scott Benner Are you a kind person in general? Am I a what person? Kind person I'm trying to figure out, like, I'm trying to juxtapose your reaction to my brain, and I can't find any sense in it, because I would have been shooting glucagon with one hand and choking that fcking lady with my other one. Like, yeah, and so like, I mean, listen, people can make a mistake. God bless. But 150 and how about how other kids come through there with diabetes, right? Had she ever, ever drawn up that much insulin in her life?
Lauren I have the same questions, damn, right? You do go ahead, yeah, yeah. So at that point, and even to this day, Lacey is only one at that school with type one diabetes, and obviously that's for a reason. I'm sure that there were other diabetics I had gone through there and were like, you know, screw this place.
Scott Benner she shot so much liquid into her. If I was her, I would have stopped and thought, like, could that little pot even hold all this like, like, Do you know what I mean? Like, it's just such a I'm telling you. Can I ask you, what did, what did she do for a living after they fired her, I have no idea. I she was fired, right? If you take insulin or so final ureas, you are at risk for your blood sugar going too low. You need a safety net when it matters most, be ready with G vo hypo pen. My daughter carries gevok hypopen everywhere she goes, because it's a ready to use rescue pen for treating very low blood sugar in people with diabetes ages two and above that. I trust low blood sugar emergencies can happen unexpectedly and they demand quick action. Luckily, gevoc hypopne can be administered in two simple steps, even by yourself in certain situations. Show those around you where you store GEVO kypo pen and how to use it. They need to know how to use jivo kypo pen before an emergency situation happens. Learn more about why GEVO kypo Pen is in Arden's diabetes toolkit at jivok, glucagon.com/juicebox, juicebox gvoke shouldn't be used if you have a tumor in the gland on the top of your kidneys called a pheochromocytoma, or if you have a tumor in your pancreas called an insulinoma, visit gvoke, glucagon.com/risk. For safety information. She was fired, right? Um,
Lauren yeah, and only because I went in there and I had to demand her be fired. I said, I'm not trusting this lady with my daughter. And at that point, you know, she was still treating children with their other there was no type one diabetics except for my daughter. However, she was treating other children with medications. And you know, the they wanted to keep that nurse on, they did everything they could to keep that nurse on. And I had to go to two different meetings and fight for my daughter to get that nurse out of that school. And if my daughter did not like that school as much as she did, obviously she would be out like I would have pulled her immediately.
Scott Benner For nothing. But if your kid dies. Is that manslaughter maybe, like, I don't even know how that works, but like, she would have gone to prison. Yeah, yeah, so, and they couldn't, by the way, in my perfect world, she would have gone to prison. I don't really know the law, but in my world, firing her is like, like, the least thing,
Lauren yep, that's the least they should do. Yep, trust me, I know it's so infuriating. And when, when the principal came in to talk to me, and she obviously doesn't know anything about diabetes, even though I have had meetings upon meetings with her about it, she didn't understand the gravity of the situation. She just didn't until I had to pretty much yell at her, and I'm not somebody who raises their voice honestly, I do not yell at people, but this, this whole situation, was just like a nightmare, and it's like, probably the one thing that you know you're worried about happening that's kind of like an irrational fear, but it actually came to light unless
Scott Benner it happens to you, and that is less than irrational all of a sudden, yeah,
Lauren I guess. So. Okay, so,
The Pre-Bolus Comparison and Car Ride Story
Scott Benner so listen, here's an important note for people. You know, when people are like, well, I don't want to pre bolus because I'm afraid my blood sugar will drop too fast. Your daughter pre bolus 150 carbs. You didn't even give her a Snickers bar out the door. And how long until they put her on a knife? Well, how long until you hit her with a glucagon? First I did.
Lauren I did get, I did give her a bunch of she had so many gummies. I know, I know.
Scott Benner So she's eating gummy bears. You hit her with glucagon. That that, but my point is, is that bridges the gap, because insulin does not work immediately when you put it in now 150 units and a 70 pound little kid, you know, you're gonna get some quick motion, but like so you had time to hit there with the glue gun. Then you put her right back in the car and drove the hospital. Yeah?
Lauren Well, I did the glue gun in the car. I ran inside with her in the car with the line. And I, yeah, yeah. Interesting. I was shaking like a leaf.
Scott Benner Hey, listen, one time when Arden was little, before I knew what I was doing, her blood sugar was falling, like, really quickly, and she got, like, super, like, combative, and she's like, I'm like, oh, drink the juice. And she's like, I want ice cream. And I was like, well, we don't have ice cream. Drink juice. And we were in the car, and so I drove her home, and she's like, why are we here? And I'm like, for ice cream. She goes, that's not the high ice cream I want. Oh my gosh. So now I'm speeding to a like, a soft serve place. I'm not lying. I get pulled over by a cop, and in my little ass town with four cops, they're never anywhere when you need them and like so I'm flying down this road, fair enough. He pulls me over. I pull over. I say, I look at him. I go. My daughter has type one diabetes. She has too much insulin. I'm trying to get her to food. You got to let me go. And he goes after I run your license. And I'm like, No. I'm like, what? Okay, here. I said, can I get out of the car and test her blood sugar? I'm testing her blood sugar. It's in like the 40s, I think at that point, right? And he gives me my license back. I looked at him, I said, I'm gonna be speeding again. Please don't pull me over. And I got in the car and I took off. You know, I got a ticket in the mail. Are you kidding me? Motherfucker sent me a ticket. I had to go fighting. I did get out of the ticket, in case you're wondering. Wow, but yeah, he said he mailed me a ticket. I don't know who that person is, but if he's listening, you so. But by the way, anybody could be listening because a woman just messaged my brother at their job and said, Hey, are you the ROB that edits the juicebox podcast? Are you kidding me? Oh, my God. My brother goes, A, how do you know about that? And B, my brother's like, I've never told anybody you have a podcast. He's like, it's embarrassing. I was like, I know. And he's like, No, I'm not. And she goes, Oh, and she, you know, she, they started talking about it. But anyway, my brother's name is my other brother's name is Rob. I have two brothers. And so anyway, where are we at? Oh, okay, you're in the hospital, and they're dumping an IV into your kid with dextrose in it. For how long? Just to combat this, 150 units,
Lauren I want to say eight hours, eight hours, yeah,
Scott Benner do you send the bill to the school?
Lauren Well, it was wiped clean somehow, the I did, we did try to to sue her, and all the lawyers said, Oh, well, because she didn't die, you pretty much don't really have a case. And
Scott Benner if you could go hold a pillow over that kid's head, I think we're gonna be rich, like, well, listen, I mean, she's gotta be protect. I don't know nothing about nothing, but physicians and doctors have to be protected by some good samaritan clause, which I understand. I don't feel like you could wouldn't have been my inclination to Sewer, but I definitely would have wanted to see her lose her job.
Lauren Yeah, yeah. No, definitely. I definitely made that happen at least. And I guess the state had picked up the case, and I'm not sure where it's at at this point, but somebody at the state looked at the looked at everything, and said, something needs to happen. Because this wasn't just like a little oversight, you know what I mean? Like, no, no,
Scott Benner it's not just a little oversight. Also, Lauren, it's a willful decision. Like, it's so much liquid. Like, do you know what I mean? Like, so much? Yes, it really is. She's a nurse, so the measurement of units is universal through all liquid medications, right? Did she not go this doesn't seem like one and a half like Do you have any explanation for it? Well,
Lauren when I was at that point in the nurse's office, she had said that she thought that it was a TB syringe, which I'm not exactly sure what that means. I'm assuming that a TB syringe is smaller, but even still, what I cannot fathom drawing up that much insulin and injecting a small child with it. Here's
Scott Benner another idea, Lauren, you know insulin is dangerous, right? She had to have known that much, right? Absolutely, if you find yourself in a position where you're saying to yourself, I'm not certain if this is the correct amount. Do you not stop? You just go get let's see what happens now, exactly,
Lauren yeah, that's what it seems like happened though, you know, it's like, you know, it really does. Listen, there's
Scott Benner no chance she was drinking her high or something like that, right? Because that would make sense. Well, that would at least makes sense. You know what I mean? I mean, yeah, little the mothers help her. You know what I'm saying? That might help. Okay, not to say she was obviously, I have no idea who we're talking about. I'm just saying it seems like you'd have to be impaired, if you've been a nurse for 40 years to make that
Lauren absolutely I agree. I completely agree. Okay, yeah, and she was, like she was an older lady. I'm not gonna say any names, but you know, she was an older lady who seems like she knew what she was doing, which is why I trusted her.
Scott Benner My mom was an older lady. I wouldn't have trusted you with anything if I'm being perfectly honest with him, and I'm 10 years I'm 10 years away from you not being able to trust me. In case you're wondering. Well anyway, that's terrible. I would she contrite? Did she apologize? Or Yes, really,
Lauren she did apologize. What she said after she said, I think I made a mistake. I'm so sorry. That was the first time. And then she just kept saying she was sorry, and she did call me later that night to check on her, and, you know, it's so like, it's so infuriating that she did what she did, and at the same time, she's calling me and apologizing, and you know, she was crying on the on the phone, a lovely person, you know, yeah, and,
Lauren but It's also in the same at the same time. It's like, I think I would have put if I were in that position, you know, however she she continued going to the school and treating children and kind of acting like nothing happened. mommy,
Scott Benner my stomach hurts. How come I drank a quart of Tylenol at school today? Yeah,
Lauren exactly. But like, who knows? You know? Like, nobody knew at that point. And if I was not there to bring her her phone, she would have just sent her right back to class after the 150 units, and she would have been gone. Let's be
Scott Benner clear, you getting there when you did absolutely saved your daughter's life. Yeah, she would have been just so dead, like, like, there's no, exactly, no nothing. Would have got her back once the insulin was rolling, and
Lauren they would have to figure out, you know, what had happened. And the nurse would have been like, oh, I don't know, you know.
Scott Benner Well, they would have seen the vampire bite on her arm and maybe figured it out. Like, maybe listen, not for nothing, but not that it would have been her responsibility to but your daughter didn't do the like, Hey, I've never gotten two of these before in my life.
Lauren I believe she did question her like, why are you giving two? And the explanation was the same as given to me. That doesn't all fit. It didn't all fit. Yeah, exactly. Hello.
Scott Benner Can I continue to, like, sprinkle common sense on this? Because the manufacturers of insulin needles would obviously manufacture needles that don't hold enough insulin for someone to use.
Lauren Literally labeled units. It literally says units on it. I'm
Scott Benner only 52 I can't see without my glasses, so I don't know that part I don't understand, okay, but, but like, but I'm talking like bigger ideas, right? I'm in a room with a computer monitor, a computer monitor company wouldn't make a monitor with the image on the back of it, because I need to see it if people are regularly giving them. Insulin? Wouldn't the needles be big enough to hold the insulin? Like, that's exactly. That's a thing. Your common sense should go, hey, hold up a second. Like, you know what I mean? And I don't know if it's age or comments, I don't know what. I don't know the person, obviously. And I'm not trying to say that I do. I'm just saying big picture is a lot of confusing things in this story. Yes, you know what I mean, there is,
Scott Benner did it have any psychological impacts on you, on me? I mean, have trouble leaving her with people or anything like that after that?
Lauren Absolutely. I mean, it's always kind of been that way, and I think this just kind of made it worse, because I guess I live in a small town where there's not many people diagnosed with diabetes. And I literally know one other family who has type one, and that's pretty much it leaving her before this happened with somebody I really didn't do unless it was like my mom, who I had trained for months before, you know, sure. And so even after this, you know, I still, she's still extremely sheltered. And, you know, I'd
Dopamine Beta Hydroxylase (DBH) Deficiency
Scott Benner be wrapping that kid with bubble wrap and armor. I'd be like, listen, well, I have three children with medical conditions, and my other two, it happens to be a genetic condition, and they are actually hypoglycemic. So I have a hyperglycemic and I have a hypoglycemic. Wait your kid. You have two younger children whose blood sugars are always lower. Excuse me, you said hypo. I miss surgery. Okay, all right, so they're Oh, no kidding. What is that? Is that a like a diagnosable thing?
Lauren Yes, it's, it's a long name. It's called dopamine beta hydroxylase deficiency, and only 30 people in the world have ever been diagnosed with it. And it's where your body has a complete deficiency of adrenaline and norepinephrine, 3030, yes, I'm assuming you've had your husband's tubes tied, or your tubes tied, and your husband's got like, yeah, you're not gonna
Lauren make it as soon as we found out with genetic is, yeah, we were done. Scott Benner 27:04 What a pairing you two are, right? Do you get along really well? At least we do. We are a great match. It's just we both happen to have a recessive variant that only a handful of people have. And, you know, that's crazy. That's just kind of how my life kind of goes. I feel like everything happens for a reason, and I'm kind of like the guinea pig in life, Lauren. Scott Benner 27:33 There are so many people in the world this. Odds of you matching up with that boy are so slim. That's crazy, telling
Lauren you, I'm telling you, they they said it was astronomical that we found each other and we're not related. Scott Benner 27:48 Did they test? Did they go, Uh oh, they did. Yeah, this lady might have married her second cousin. Hold on, a second. You imagine? Can I imagine? I mean, after this story, sure. Why not, right? Jesus Christ, did your daughter? Sorry. No, I love it. So I guess are there other people in the town married to relations? No, okay, good. It's
Lauren just the chances are higher if you're related of having the same that's what I meant by that. Scott Benner 28:23 No, no, I knew what you meant by it. I was just thinking, like, it might be more common to marry somebody you're related to than somebody who you have, like, like, these two genetic like, matches with. It's really just incredible. Yeah, it would be, but, yeah, okay, how do you help the other two kids? What's the the treatment or the help for them, pretty
Lauren much just give sugar. Um, it's they get hypoglycemic, especially when they're sick, so they have to, like, have sugar or carbs every like two to three hours when they're sick, during a regular day, they can't sleep longer than six ish hours, because that's when they really start to drop? How far will they drop until they're dead? Honestly? Seriously? Yeah, my son, he's two now, but June 25 of last year, I went to go wake him up, and his Dexcom said no signal. And it hadn't said no signal for that long. It had been, maybe been like 30 minutes, yeah, um, went to go wake him up, and he was limp. Checked his blood sugar, and it was like 26 I didn't know it at the time. However, he was having silent seizures, which I had, no I didn't know anything about sure, you know, called the hospital and everything. And when he came to he started having, I guess more you know you could see the seizure. So the doctor had said he had been having silent ones, and now he's having to where you can see them. I'm not really sure what that's called, but he was like biting his tongue and stuff. So, yeah, he they because they don't, they cannot get their stored glucagon. Yeah, naturally, they can't access it, because you need adrenaline to do that. That's why it's so dangerous.
Scott Benner So this is a vigilance thing. You have to be constantly at this. Yeah,
Lauren I have all three on dexcoms, yeah, it's yeah, it's a lot, yeah, it's a lot. How old are all three of them? Again, they're nine and
Lauren nine, six and two. Oh, my God. So what's the plan? You're just gonna, like, go out for cigarettes and not come back. What do you what do you think they're doing? You're gonna be an old lady when you're 20 more years. People are gonna be like, That's Lauren. What is she 80? She's like, No, she's 45 like, Oh, no kidding. It's her kids. Your kids are dragging her down. Like she actually kept them alive. It's insane. Like, seriously, though, like, not to be a bummer, but you did come on and talk about the lady trying to, like, off your kid. Yeah, it's already in your head, right? I'm going to send them away. They're going to fall asleep and they're not going to wake up.
Lauren Absolutely. I don't even think about sending them away. To be completely honest with you, honestly, my younger two would not be here if I was not completely like because with their condition, and I didn't know this till afterwards, of course, but with their condition in the third trimester, your body or you need norepinephrine in order to continue the third trimester. And so I did have two stillbirths in the third trimester, after I had my oldest, which now we know is due to this condition. So like every single aspect, like all three of my children, would be dead if, if there was no intervention, like Lacey with a type one, and then my youngest two with this condition. They had to have emergency C section in order to be, you know, alive. Tell me you've had five pregnancies, two of them ended in the third trimester with a stillbirth. Yes, yes. Jesus, are you okay?
Lauren Seriously, I'm not, but I'm hanging in there. I'm not,
Scott Benner but I'm hanging in there. That's the most honest goddamn answer anybody's ever given to that question? No, Scott, actually, I'm not okay. I mean, would you be but no, I wouldn't be. That's why I asked. That's why I asked. So therapy? Do you see an actual psychiatrist? Does one follow you around all day? Like, how do you deal you drink? Are you a drinker? Lauren, are you putting them away? No. What's going on.
Lauren I think my kids kind of keep me so busy that it's like, you know, I don't really have time to even think about other things. But, like, honestly, no, I did do therapy for for a while, and, you know, that's why I'm here today. Okay, your husband is he rich, handsome, got a really big like, what's the deal? Like, is something is making you happy? Or are you looking at him thinking I could have picked someone else? Like,
Lauren he's a very good guy. He is extremely smart. No, he, I've known him since middle school. And, yeah, we, we're just, you know, like I said, I feel like everything happens for a reason. So I feel like something has, has to be at the end of this, you know, like, Lauren's down to Lauren. How old are you? How old are you? I'm 31 you're 31 and you're down to, there better be a Jesus at the end. And he better put me, yeah, there better be like, I better go live in a nice, like, maybe a park setting. I would like a castle. I'm telling you. God, damn, 31 years old and you're like, you better be can gift at the end of this. Oh, my god, yeah, my No, I Why am I doing this? How did the kids I'm sweating, I'm laughing so hard, it's ridiculous. All I can picture is you walking around muttering to yourself in the quiet moments.
Lauren You must have a camera. Oh no. I just know people. Learn, and I understand implications of things the kids, did they know how screwed up things are, or do they live pretty normally. They don't have any kind of, like, other issues other than, you know, shutting off. Yeah. I mean, as as far as you know, cognitively, they are completely, quote, unquote, normal, but they have to have a Dexcom, and they complain about that. They understand, and I've tried to explain as much as I could. So what's their understanding of the eating thing? Because you said sugar specifically, but could it be any carbohydrates?
Lauren Yeah, actually, like, carbs are better for, like, when they're sleeping. Yeah, yeah. It takes longer, like starchy stuff takes longer to, you know, break down. But is this having an impact on their weight? Is to the point where it's not healthy amount of calories? Or do you have that figured out? Yes, they have, like, a sort of a little bit of a faster metabolism. And as far as the research goes. There's not, there's not a lot of research at all, but the but what I can find is their metal metabolism seems to be a little bit faster than the average, and that's why they're able to keep up there. Because if you think of stimulants, stimulants stimulate, you know, norepinephrine and adrenaline in your body. And because they lack that, there has to be some kind of other mechanism, you know, coming into play. Otherwise they would just be obese. You know, how did you figure this out in such a small town? Did you have to go to a children's hospital? Or were they actually able to figure it out there,
Lauren after multiple so many hospital visits, they referred us to a pediatric geneticist. We live in Florida. So this was in Orlando that they were able to figure out what was going on after they did after we were cleared from genetic, you know, things, I asked to go further, and I say, Could we just do a, like, a whole, you know, Genome Sequencing thing? And the geneticist was like, I don't think we're going to find anything, but, you know, I can try to push insurance to see if we'll cover it. And I was like, please. And because I did that, you know, she she called me back, and she was like, You will not believe what I found. And she was in shock, I bet I want to look it up. I want to know how to spell it. I want to know how to spell it again. But first I opened up a Google page, and I typed in what is. Then I was going to ask you to spell the the thing, sure, yeah. Before you do, let's look at what other people have been googling. What is CTE? I'm going to blame the Tom Brady roast for that. Okay, okay. What is Hoda? Is she not like the person from, like a TV show?
Lauren Oh, yeah, she's from, yeah, that morning show, right? Yeah. What is my IP address? Oh, what is Doge, D, O, G, E, that's a, like, Bitcoin kind of a thing. I right, yeah. What is Ramadan? What is today. You're telling you're telling me that the way some people figure out the date is to write into Google, what is today. What is today. I want to say right now, if you do that, stop listening to the podcast. I don't want you as a listener. Okay, what is the be giving insulin? If that's what you're Googling, yeah, if you're Googling what is today? You shouldn't be giving people medication. There's a calendar. Also, there's 1000 better ways to phrase that. What is the weather? What is the weather today? Also, I don't agree with that. I like looking outside if you wanna know what the weather is, what is mewing and what is a solar eclipse? Interesting. Do you know what mewing is? Well, so
Lauren I have a nine year old, so I think that I don't, I don't 100% No, but it has something to do with like, this newer generation. I'm clicking like it's the only it's the only one I don't know. I was so proud to know that today is Thursday, the 16th Hold on a second mewing is an internet craze that promises to change the shape of your jaw line and fix other problems. That's not what I thought it was Lauren's like I thought it was a sexual position form of oral posture training purported to improve jaw and facial structure. It was named after Mike and John mu the controversial British, British orthodontist who created the technique as part of a practice called orthotropics. Does mewing actually reshape your jaw? I don't care if it does or not. I want to be clear, but I do want to say this, Lauren and I know you might be disappointed your episode is 100% called what is mewing. Oh God, all right now spell this thing that your poor two kids have. Okay,
Lauren so dopamine, D, O, P, A, M, I, N, E, next word is beta B, E, T, A, hydroxyl, hydroxylase, h, y, D, R, O, X, Y, L, A, S, E, deficiency, also known as dopamine, beta mono, oxygen, yes, is an enzyme that in Humans, is encoded by the D BH gene, dopamine, beta hydroxylas catalyzes the conversion of dopamine to noreparin norepinephrine. The three substrates of the enzyme are dopamine, vitamin C and oxygen. How about that? And your kids just don't have that. It's a deficiency, right?
Lauren Yeah, it's a complete deficiency. So they do not create DBH at all, which means they do not create the norepinephrine or the adrenaline. Does this sound? Right? Is a condition that affects the autonomic nervous system, which controls involuntary body processes such as the regulation of blood pressure, blood temperature. I'm going to guess blood glucose is in this list too, huh? Yeah. When they become around the teenage years is when they have a little bit of it now, but the orthostatic hypotension, which means when you stand up, your blood pressure drops to the point where you can faint. They have it a little bit now, but it's just going to get progressively worse. There's a medication that's called droxy dopa, which acts as kind of like a synthetic precursor, so it acts as DBH, but not naturally. So that helps with the orthostatic hypotension. But is it just so few people have it that there's no medication for it, or is that there's no way to impact it with a medication?
Lauren Yeah, the drugsy dopa does help. It's never my daughter is actually the first child to be on it. So that's kind of scary. And, yeah, I'm serious, yeah, the dosage that she's on right now is like 40 milligrams twice a day, but adults are known to have like 600 milligrams three or four times a day, so the dosage is like, all over the place and holy, you know, obviously it's not a perfect science. So, yeah, this is terrible. Like, I'm sorry to say it like that to you, but like, yeah, sudden drop in blood pressure, severe when getting out of bed in the morning during hot weather. As a person gets older, deficiency. Experience extreme fatigue during exercise due to the problems maintaining a normal blood pressure, droopy eyelids, nasal congestion. Males may experience retrograde ejaculation. Now, for those of you who don't know what that means, the discharge of semen goes backwards into the bladder. Less common that I mean, less common features include unusually large range of joint movement, like hypermobility and muscle weakness. Holy Christ, yeah, yeah, you're not okay. No, no, yeah, you answered honestly. I got that. Okay, good, yeah, no. Do you cry a lot? I'd cry a lot.
Lauren I used to not as much, is kind of like the normal, I guess I've kind of transitioned into this being a little bit more, you know, Lawrence, like I said something, I have resting sad face exactly well, how do you keep up the thing you're supposed to do as a parent around your kids, the like, every little thing gonna be like, how do you do all that for them? I try to compare them to, like, you know, worse situations. Honestly, have you seen Frankenstein again? Well, like, like to be completely serious with my daughters that type one diagnosis, we didn't know what the heck it was like. I had only heard of type one, you know, a handful of times, and I still wasn't 100% sure. So when she had the symptoms of, like, losing weight, like she was so skinny and she was vomiting, and the two things that popped up when I would go online was type one diabetes and cancer. And so I'd, I'd say, there's so much worse that you can have, you know, she complains about the pod, or she complains about, you know, my, my other kids will complain about the Dexcom, and I'll be like, there's so much worse. Like, we're lucky that, you know, it's not worse. And obviously I do mean that, but you know, it is hard, because they do have it pretty rough. So yeah, just trying to see the the light. Well, listen again, to be serious, you have to, first of all, yeah, like, and yeah, it does give you, I mean, this is not a thing you would have asked for, but you have more perspective at 31 years old than most people are going to gather, gather in five lifetimes and that, and that will be valuable. Like, like, moving through, you know, for your kids and for you and for your husband, everybody else, I guess that's really the move though. Like, how do you not say to them, like, at least it's not that and to try to make them feel a little better. So, I mean, I guess there's no I have to ask you, like, if you could give one of these away, the diabetes, or what your other two have? Like, there's no, like, pause, even, right? Like, diabetes is way easier or no?
Lauren Well, they are both very hard in their own ways. But I think the way I think of it in my mind is my youngest two, like, they shouldn't be here, you know, according to nature, because we had to, like, intervene. So during my pregnancy, I had to be seen every single day at the hospital to measure what's called the umbilical artery, because it's very technical and complicated, but they get reverse umbilical flow in their umbilical cord, and when that happens, you have to deliver that day like so they shouldn't be here. You know, it's hard for me to think which one I would take away, because they're both. I know that that my younger two are going to progress, and I don't know what the future holds. You know what I mean? So I have such a difficult question that for the first time, and I'm not kidding you, I stopped myself from asking a question, and I don't. Well, I don't know if I can say it out loud or not. Please ask it. I'm less worried about you and more worried about what people are going to think about me. Oh, gosh. So the two stillbirths happened prior to these children being born, right?
Lauren Yeah, my oldest, who does not have that condition, however, does have type one diabetes. Was my first, and then after my first, the two that we lost, okay, we're in the middle, and then you find out this thing, when, like, when do you know what's happening during the second or during the, what I guess would be your fourth pregnancy, or after they're both born? When do you learn about the the issue,
Lauren um, I learned when I was eight weeks pregnant with my fifth child, so with my youngest now. So I was already pregnant when we found out it was genetic. Because we did get cleared by the geneticist after we did the initial test, okay, and she had said to me, you know, there it's so unlikely that this is genetic. Like she didn't even want to do the in depth, you know, whole genome sequencing, because she she was like, we're not going to find anything. Well, there's another person who let you down. so Exactly, yeah, but so when you know that is there a moment in that fifth pregnancy where you think, I'll let this go naturally to its conclusion and not intervene, or Absolutely
Lauren not. You never know, knowing what I knew like, because I had to give birth to pretty much full term, you know, infants who had passed, and I knew something, so I did something, you know what I mean, like, I would never, yeah, yeah, if it, it would have turned out horribly if I didn't intervene. So, you know, and obviously I was asked the question, do you want to terminate? Because when we I did an amniocentesis, when I found out it was genetic, and they did find out that he did have it. So, you know, I was given that option at the time because I guess it was still legal, but I don't think I'd be able to live with myself, because everything that's happened in my life was not technically my fault, you know what I mean. And so I didn't want to cause something, you know, Oh, that's interesting. You didn't want to be, you didn't want to be the decider on it, yeah, yeah, yeah. I mean, like, everything that's happened has not been something that I've chosen, you know what I mean. And so I understand if I were to choose, yeah, nothing, no, I completely understand. Yeah. I mean, it just, it bears asking, right? Like, no, yeah, you're not gonna have other children. Absolutely not. Yeah, no, you and your husband don't even sleep in the same room anymore, right? Just, just in case.
Lauren No, they removed my tubes. Did you like, say I want to watch you throw them in the trash.
Lauren Yeah, pretty much. And they the doctor still questioned me, like, Are you sure? What if this one doesn't survive? And I'm like, Okay, we're gonna take them out no matter what, am I sure? Are you out of your mind? Like, yeah, they don't understand the content. Like, like, you have more of an understanding just talking to you, and I can tell, than talking to any other medical professional. You know what I mean? Like? Because I feel like they just they don't. I don't listen, my brain works very simply. You just told me your kids can't sleep more than six hours without it being dangerous for them. One of the great joys of life is like going to bed late on a Friday night after working a full week and waking up whenever the hell you wake up on Saturday. Your kids are never going to do that. And that point is, is that they're going to be 18 and they're going to go to college, and then they're going to drink or something, and then you're it's going to happen like you're literally going to be on the phone going, someone's got to wake her up and give her something to eat like you don't need, like that's and that's not a thing you're going to forget about. And it's doesn't matter how old you get, it doesn't matter how long this goes on for. You're going to think about this every goddamn day for the rest of your life, and that's not fair to you. It's not fair to them, and it's brave to deal with it, but to not understand it from a third party perspective. Why you might not want to do it is predict. I mean, that's just silly. Like, yeah, please. Oh, my God, it is. Yeah. No, yeah, yeah. Seriously, what the hell? Like, who would not understand that? Like, and, you know, the same thing with the diabetes stuff. When people say, like, look, I'm all for sitting around and speaking high mindedly about things and doing some like, gazitas and like, you know, being whimsical, and saying, oh, there's a ton of stuff that I've learned because my daughter has diabetes, and I am probably a smarter person and a stronger person and more resilient, and all that stuff because my kid has type one. It doesn't matter. I'd give it away. In a half a second, I'd go back to not understanding things and not having perspective and being less intelligent and all the other I'd give away the podcast. It wouldn't matter to me. Can all go I'd give it away for anything. And that's why that conversations makes people upset. When people say, hey, what's something you've learned from diabetes? And you'll hear. From people who say, Oh, like, you know, I'm, you know, I think I'm actually overall healthier because I pay more attention to my body. That's a very valid statement. And then somebody else will come in and be like, you're, you're out of your mind, like, there's nothing I wouldn't give away to get rid of this. And so I'm with you, like, I see how hard it's also why I decided to be jokey with you, because I didn't think we could make it through an hour of talking about this, because I'd be, I'd be like, half out the window crying right now, if we treated this too seriously. So I got the space for that. It's getting towards the end of the week, you know what I mean, Lauren, like, I'm trying to get the Saturday, you know? Yeah, I can't be walking around all day thinking about your kids not being able to sleep. To sleep more than six hours, and your other daughter, your other daughter, surviving a hit. I mean, Jesus Christ, it's like one thing after another. There's no way you guys are gonna have other bad stuff. Either you've used it all up already or you're just a target for it. I can't decide what's gonna happen. Your house is Never No No. You don't live in like a tornado part of the country or something.
Lauren No, but we get hurricanes. We're in Florida, so the hell out of there right now. If I was you, you're clearly gonna find your ass on a raft floating out to sea one day. Oh, no, I knew it. Hopefully we'll win the lottery, because we're just that, you know that are, that's our odds. I feel like, I swear, I always make that joke with people like you have these incredibly rare things that never works out with the lottery. Like, you know what I mean? Like, I know, right? Terrible, really, terrible. Oh, are you at least, really pretty Lauren, or something like that. Like, is there any like, No, I might not even have that go over something I could feel less. Are you six feet tall? You're like, a runway model? No, no, no. I mean something I can, like, at least go, oh, well, she got that. Are you driving, like, one of those Range Rover trucks or something I wish. No, I'm just normal. This is terrible. Do you find money on the ground ever? Oh, you know what I have before go ahead, enough to buy something or not. When I was living somewhere else, I actually found $100 in like, random bills all over the street. All right, I would like for that to happen to you every five hours. Okay, thank you. I think that's the way to go. Like, you know, like, when I have stuff bad, I always think, like, at least if I was tall, this would be acceptable.
Lauren Yeah, if I was a supermodel, then maybe I can handle it better. I would prefer if my teeth were a little straighter. I feel like I could live with this easier. And like, you know, like, seriously, like, why? I don't know, yeah, it just some people are so goddamn handsome. Just like, that's gotta make up for something, doesn't it, right, money or something like, anything to just like, move this offset it a little bit back to the center, a little for me, for God's sakes, I know all the way on the edge. Like, come on now, listen your kids, they don't end up ejaculating to their bladder. Can they have children? Or they're not. I know he's like two. Sorry. No, they can't have well, they,
Lauren I mean, there's not enough studies, but when they're taking that medication, apparently they, there's a possibility that they may be able to reproduce. So I don't know. I won't, I won't advise any of my children really to reproduce, because it scares the crap out of me. And so even your oldest that has type one, like, does she have the gene?
Lauren She's a carrier. And so, like, she doesn't actually have the condition so she carries it. So the odds of her finding somebody who is also a carrier is like slim to none. But, you know, I the, you know, guess what? Anything could happen now, so, you know, unless she meets her third cousin somewhere, oh, God, I like how that shocks you more than the other thing that's fantastic. Do you like, put the all the word out to your entire family about this?
Lauren I've tried, you know, it's just talking anything medical. Anybody tell me. I mean, you know how, if you try to explain diabetes to anybody on the street, and they're just kind of like, nodding their head and pretending like they're understanding, I feel like that's how the conversation goes. Yep, it's upsetting on a different isn't it upsetting on a different level, it is. Yeah. And my brother, who is also a carry this condition, is having a child, and we're getting his girlfriend tested to make sure that this child does not have the condition, or, I guess we're testing the mother to make sure she's not also a carrier. Jesus, so I'd never not ejaculate into a condom if I was in your family, even if I was by myself. What do you think of that? Like this ain't getting on anybody. Dang. Course, Yeah, no kidding. Thank God you came on the podcast somehow oddly, Lauren, this is the most fun I've had making the podcast. Thank you. Thank you for having me. Oh my god, are you and crazy. Thank you for coming on and shame on you for not doing it sooner.
Lauren I tried. That's my fault. Yeah, fair enough. Although I did, I did record an episode. I found this great doctor, this endocrinologist in Texas, Blevins, and he's going to come on a number of times to talk about GLP medications. Okay? And so we're on yesterday, and we're recording together, and it's a, he's a nice man, and it's not, it's very it's serious, but it's not so dry. And at one point I brought up this like scenario where this person started using a GLP and lost five pounds in the first 36 hours. And I was like, could that be water weight? Like, black and forth, and he goes, I would imagine it would be a water weight or, like, maybe they experienced diarrhea or something like that, and like, we're talking about it. And I said, Yeah, but in fairness, this person's a very clean eater. They have PCOS, right? They're very clean eater, and they're gaining weight uncontrollably, very clean eater, exercising constantly, uncontrollably, gaining weight. This poor girl in her 20s, right? And I said, you know, never had a five pound loss for any reason. And they're in during this entire thing, they injected that GLP and lost five pounds. I was like, it's, you know, and then I think I said, No, whether that's because they exploded out there or not, is neither here nor there, in my opinion. And he kiss kind of giggled just a little bit. And I was like, Oh, I like this guy because, because, as I said it, I thought that's not what I should have said. But oddly enough, exploded from their is less creepy to me than the word diarrhea. Yeah, I agree. So I just rolled with it. I think I'm going to receive a Nobel Peace Prize one day for the conversation I had with you. I would like that to happen. I can I be serious for a second and at the same time say something really nice about myself? I think that this thing that your kids are going through, right and this experience you had with your daughter, seriously, they're two really important conversations, like blended together here with us today. Yes, these are not things that people would sit and listen to. It's too goddamn depressing. It's too obtuse. Nobody's going to have this happen to them. You know what? I mean, like, like, but it's, it's valuable to hear about. And I think maybe the biggest value is to hear, like, your reaction to it more than anything else as a podcast. Like, like, seriously, because there are plenty of people, plenty of people who would just leave. They'd just be, like, these kids are a problem. I gotta go, yeah. Like, like, right. And that's not what you're doing, and you've got their best interest at heart. You're working every day at it. It's obviously a 24/7 situation. You're aware that it's going to have detrimental effects on your health, and you don't care. You're going to take care of them still. Yes, yeah, that's the story to me. The joking around and the laughing part is so that I don't cry while we're talking about it, in case you're wondering, and I don't need you crying, because if you cry, I'm gonna cry. And then, you know what everybody's gonna do with their podcast player. They're gonna go dis depressing and they're gonna shut it off. Instead, we laugh the whole time, and yes, we have a cartoonish vision of me shooting glucagon with one hand and choking a one in their 60s with my other hand. So yeah, oh, my God. I honestly think I might ended up in jail.
Lauren I know, right, yeah, someone come in here and give my kid glued gun while I murder this person. Like, just, what in the hell? You didn't say anything. Mean, no, oh, I would have been so incredibly mean. I'm disappointed in myself saying that I did. But, yeah, I don't. I'm not really that kind of person. I guess. I don't know if I I was just so, like, out of it, like I was in such shock. I think I, you know, it's just, I mean, listen, maybe I wouldn't, truth be told, it's possible I wouldn't, but in my heart, I kind of hope I don't think I'm that person. To be perfectly honest with you, people now are probably laughing going, oh my god, Scott, you're 100% that person. But I think I'd be shooting glucagon while yelling, you dumb mother and like, I think I would have said such horrible things to her, and I probably would have apologized afterwards, but I don't know how you stopped yourself. You were in shock, obviously,
Lauren yeah, I was just like, not, I don't know. I was not present in my head. I guess I sometimes, like, you just have to, like, remove your brain. I don't know. Well, no, it sounds, it sounds like you, you. It took you a second, but then once you did it. You pulled it together and you started taking steps, right? Yeah, that's true. I would have been disappointed in myself, but I definitely would have cursed a lot and said is probably the most hurtful things I could think of. Yeah, I'll see a third Yeah. About that, maybe, but, going back to the other conversation with my other two, I just want to mention that there's something called pots. I don't know if you heard of its Yeah. So, yeah, you know, they don't really know a whole lot about it. And this condition, the dbhd, of main beta hydroxyl, place efficiency, actually kind of mirrors it, in a way. And the researchers think that the dbhd may be a little bit more common, you know, then we know of because it's just so not really tested for so, you know, if anybody does have pots likes and you know, symptoms and medications are not helping them, and also, if they've been like, born, low birth weight or prematurely, then I would look, you know, I encourage you to look into that diagnosis, because, You know, there's potential for other people to be diagnosed with it as well. It's just not, you know, it's not researched and studied enough interesting.
Scott Benner That's very interesting. I was speaking with a person who has pots recently, who also has a heart issue, like a medication for I wish I was paying enough attention at the time to remember the name of it, or I would share it with you, but it makes me wonder, like, yeah, POTS is one of those things. They're like, that's that ultra step. I can't I'm saying the word wrong when you stand up and you get very dizzy,
Lauren exactly, yeah, orthostatic hypotension type syndromes, yeah, yeah. Interesting. All right, Lauren, is there anything that we haven't talked about today that you want to No, I believe we covered a lot of it. Yeah, I think that was, that was really good. Mm, hmm, yeah, okay, anything you want to say, you want to curse once, or anything like that, let it out a little bit sometimes. But yeah, I like how you blended the at the end there with, though you were, like, you were very strong with the mother. And then you, you kind of got a little, like, like, a little, like, a criminally there with the part that was nice, yeah, like, I felt like you could have stolen my car. We're done some good voiceover work for children's cartoons over 18 years old. Thank you. Yeah, somebody needs to hire me now. Somebody needs to hire you. Listen to me. God bless you. You should find $100 on the ground every five hours. As I've just said, Someone should call you immediately and give you a job where you make $90 million a year. And some researchers should end up with, uh, whatever your kids have. So maybe they pay attention to it for five seconds. But for real, though, by the way, seriously, yeah, 30 people,
Lauren 30? Yep, yeah. Online, you can read it says between 25 and 30. So my kids are two of them. Holy shit. All right, yeah, listen, you're a saint. What do you think of that? If there is a heaven on a bumper sticker, if there's a heaven. You don't get into it. Something went wrong. Okay, you murdered 43 nuns, if that happens. Okay, holy hell, man, I don't know what. Hey, listen, I didn't want to ask because I was afraid I'd get a sad story. But is your husband? Like? Is Is he okay?
Lauren Yeah, he's okay. Ask each other, are you okay? Like, every so often, so we just have continuous, like, rusting bitch face, I guess, oh, are you kidding? 1,000,000% don't let the kids say it, though you gotta figure that out. Yeah, Jesus. You know, In what world, what family does the kid with type one run around going, Whoo, dodged a bullet. No kidding, I got lucky. Exactly you too. I can't believe you two met. Did you at least meet in a small town, or was it like a way at college or something like that? No,
Lauren it wasn't a small town. Yeah, we were in middle school, and that's where we met initially, and then we we ended up getting together later on, when we were in our early 20s. So like, sixth, seventh grade, yeah, yeah, we were sixth grade, sixth grade, yeah, did you like, make, like, hold hands and stuff when you're in sixth grade?
Lauren No, no, but we knew of each other, you know, yeah, yeah. He's like, I'm gonna get that lady pregnant a bunch of times one day, and it's gonna be all kinds of horror that comes afterwards. Also, children are a blessing, etc, and absolutely, absolutely, well, listen, I gotta tell you something. I have my last question for you. I know how you're gonna answer it, so it's almost silly to ask it, but I think it but I think it makes a good point, if you could get in a time machine and not have these kids, would you do that?
Lauren I'm telling you, I think about this question daily. Go ahead, I really do. I can't say with 100% certainty, but I don't know if I could go through it all again, to be honest with you, I really don't if you went back. Back in time and you knew what was going to happen, you could stop yourself, right?
Lauren Absolutely, yeah, it would be a completely different narrative if I knew what I know now, right? Absolutely, because you wouldn't know the kids. You just know the like, what like? Because I if I gave you a magic wand, you wouldn't make the kids disappear, right? Right? She's like, Yeah, no, of course not. What? Take away their take away the shitty part. Did I sound convincing when I said that? No, but, but seriously, I understand what you mean. You go back in time. You don't know the people, you just know the situation. Yeah, and you and so listen, I gotta be honest with you, I would do the same thing. Yeah, yeah. 100% now, if I took you back in time and showed you a picture of the three kids and had all the memories of loving them, and then said it, what happens then?
Lauren I didn't know any better than Yeah, go for it. You know what I mean? Like, it's rough. If I could go back to 14 and tell her everything that went down by the time you're 30. Like, there's a little boy in sixth grade. He's gonna smile at you when he does, kick him in the balls as hard as you can and yell no, and then uppercut palm into his nose. Exactly. We might want to believe your name. All right, I need more people on the podcast being this honest, uh, send me an email. Okay. All right. All right, Lauren, let's let you go before one of us has a stroke from laughing and then or more people judge us for being terrible. People, whatever is going on right now. I know, listen, that's on them. Okay, never heard your tits been through a ringer. Your whole show gone through a couple of times. I think they pushed me through the whole thing barn. We would be friends if we were near each other, we really would be sure, no, we would definitely be friends. I would never, ever get you pregnant because you you were very dangerous, as far as I can tell. But we could definitely friends. Yes, oh my gosh, you must be the lady in the neighborhood that other ladies point to and go, Oh, don't worry. At least that didn't happen to us. Like you're like, oh, there's some out there that are still absolutely Lauren just said there are people in my town I wouldn't trade places with. That hurts if you're hearing it. No kidding. Are you a stand up comedian in your in your private life? What do you do for a living?
Lauren No, I can't. I don't really have time to do anything. It's like your job. Is that, right? But no, yeah, so let me ask one last question. Have you always had, like, a in my estimation, you have a terrific sense of humor. Okay? I think sense of humor is measured by your ability to make fun of things that are clearly not funny, but you can say something funny about them. I mean, obviously nothing that has happened to you is fun, right? And so did you have this before all this? Have you always been like this? The sense of humor part,
Lauren I think, a little bit, and I think I also had to kind of acquire it, because it's like, kind of like a coping mechanism, I guess, because if you know, if you don't laugh, you'll cry, yeah, you know, it is a little bit of a coping thing for you, but, yeah, yeah, no, I've always, I guess, yeah, but it is mostly coping. and maybe I don't usually do this while I'm being recorded, but Have I done anything that's made you uncomfortable? No, okay, not at all. Okay, because if you have been you could just tell me, I'll just delete it. You know that? Right? No, okay, oh yeah, of course, because there are going to be some people who don't have a good sense of humor, gonna be like that lady just took that for an hour and blah, blah, blah, like I hear you old hens out there. Don't you worry. I want to say this. I'm gonna say something, because there's no place I'd ever say this again on any episode when I was growing up. Like, between me and my friends, our measure of if you had a good sense of humor basically boiled down to, could you laugh at a very well crafted dead baby joke? Because that there's nothing funny about that. So like, if somebody could actually craft a piece of humor that would take something that horrible and still, your brain could go, Oh, I see why that's funny, huh? Like, like, and laugh like that. To me, is a pure sense of humor, because there are obviously plenty of things in the world that are not funny. It's not the thing you're laughing at. It's it's actually the structure of it, right? It's the Yeah, it's the conversation around it that makes it, that makes you laugh. It doesn't make you laugh at the horrible thing and it just makes you be able to laugh at the situation. Absolutely,
Lauren yeah. I mean, could you imagine being that serious about like, I don't think I'd be here if I didn't have some kind of, you know, way of thinking otherwise, yeah, I think you'd be on six different pharmaceutical medications, right? Absolutely, yeah, totally, yeah. You have to, you have to. Well, you have to be able to laugh at yourself and laugh at the situation regardless of what it is, because if you don't, then you're just going to be miserable. You know, I think that attitude gives your children a very good chance at finding that for themselves too. So I applaud that, honestly. Okay, yeah, all right, well, that was weird to get serious at the end, but, all right, you want to curse anymore, Lauren, because you were really great at it okay? Because, I mean, if anybody needs to scream into a pillow, I feel like it might be you, so I'm gonna let you go. Yeah. All right. Hold on one second. All right. Thank you for having me a huge thank you to one of today's sponsors, gvoke glucagon. Find out more about gvokopen at gvoke glucagon.com, forward slash, juicebox. You spell that, G, V, O, k, e, g, l, U, C, A, G, o, n.com, forward slash juicebox. This episode of The juicebox podcast was sponsored by Dexcom. The Dexcom g7 is what you need. It's what my daughter wears, and you can learn more about it at dexcom.com/juicebox. Links in the show notes links at juicebox podcast.com, the diabetes variables series from the juicebox podcast goes over all the little things that affect your diabetes that you might not think about, travel and exercise to hydration and even trampolines. Juicebox podcast.com, go up in the menu and click on diabetes variables. Alright, kids, we're done. We're at the end. Just do me one last favor, if you can, if you could please, if you have the need or the desire for something that one of the sponsors is providing, please use my links or my offer codes. They help the show so much, and that means me, you're helping me to make this podcast every day. You're helping me to support the private Facebook group do all the things that I'm doing, I'm not asking you to buy something you don't want or something you don't need, but if you're going to get one of these items, use my links or my offer codes. They help me a ton. Thank you so much for listening and for supporting. I really do genuinely appreciate it. I'll be back very soon with another episode, the episode you just heard was professionally edited by wrong way recording. Wrongwayrecording.com you.
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