#1825 Insurance Let Me Down - Part 2

Kelly opens up about raising two teens diagnosed with Type 1 at age six. She discusses international living , multiple miscarriages , alarm fatigue , and managing different sibling personalities.

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Key Takeaways

• Self-advocacy is a critical necessity in the modern healthcare system because insurance companies operate as for-profit businesses that prioritize holding onto money over patient wellness[cite: 588, 594, 940, 942].
• Insurance terminology is often intentionally non-transparent; for example, modern technology like CGMs may be hidden under antiquated categories like "diabetic supplies" to make them harder for consumers to find or verify[cite: 501, 506, 621].
• Legislative "fixes" for diabetes coverage can be ineffective if they do not explicitly prohibit insurance companies from using high deductibles and coinsurance to maintain cost barriers for patients[cite: 577, 578, 580].
• Modern diabetes technology significantly improves glycemic stability and safety, yet "medically necessary" is often defined by insurers as the bare minimum required for survival rather than the tools required for optimal health[cite: 733, 737, 739].
• Utilizing AI and large language models can help patients decipher complex, jargon-heavy insurance plan documents to determine true out-of-pocket costs and benefits[cite: 682, 683, 684].

Resources Mentioned

• US Med Benefits Check: usmed.com/juicebox or (888) 721-1514 [cite: 486, 726, 1023]
• Omnipod 5 Starter Kit: omnipod.com/juicebox [cite: 488, 653, 1026]
• Eversense 365 CGM: eversensecgm.com/juicebox [cite: 494, 643, 1021]
• Juicebox Podcast Facebook Group: Juice Box Podcast, Type One Diabetes [cite: 482]
• Podcast Series Lists: juiceboxpodcast.com/lists [cite: 1038]
• Wrong Way Recording: wrongwayrecording.com [cite: 1043]

FULL EPISODE TRANSCRIPT

Introduction and Part Two Context

Scott Benner (0:0)

Welcome back, friends, to another episode of the Juice Box podcast. [cite: 473]

Laura (0:15)

Hi. My name is Laura Keller. I am 52, so I'm dead solid into Gen X. And I spent twenty five years working in diabetes, and I live with type one diabetes. I've had type one diabetes for twenty seven years. [cite: 474, 475]

Scott Benner (0:33)

This is part two of a two part episode. Go look at the title. If you don't recognize it, you haven't heard part one yet. It's probably the episode right before this in your podcast player. If you're looking for community around type one diabetes, check out the Juice Box podcast private Facebook group. [cite: 476, 477, 478, 479]

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. [cite: 480, 481, 482]

Bet nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan or becoming bold with insulin. [cite: 483, 484]

US Med is sponsoring this episode of the Juice Box podcast, and we've been getting our diabetes supplies from US Med for years. You can as well. Usmed.com/juicebox or call (888) 721-1514. Use the link or the number, get your free benefits check, and get started today with US Med. [cite: 485, 486, 487]

Today's episode is also sponsored by Omnipod. Check out the Omnipod five now with my link, omnipod.com/juicebox. You may be eligible for a free starter kit, a free Omnipod five starter kit at my link. Go check it out. Omnipod.com/juicebox. Terms and conditions apply. Full terms and conditions can be found at omnipod.com/juicebox. [cite: 488, 489, 490, 491]

The podcast is also sponsored today by the Eversense three sixty five. The Eversense three sixty five has exceptional accuracy over one year and is the most accurate CGM in the low range that you can get. Eversensecgm.com/juicebox. [cite: 492, 493, 494]

The Barrier of Language in Insurance

Laura (2:35)

The only one they cover, and better covers is the Libre? [cite: 494]

Scott Benner (2:39)

No. But they're covering the pump. The pump needs the CGM. [cite: 495]

Laura (2:43)

But no. They they no. Mm-mm. They cover the Libre as a standalone. And here's what's really crazy. I also yelled at them for this. Is that, I like to use first person language because I was an advocacy director for a long time. I also don't think diabetes defines me. It's something I have. I have type one diabetes. I am not a diabetic. That's just my own personal thing. [cite: 496, 497, 498, 499]

Scott Benner (3:05)

Okay. [cite: 499]

Laura (3:06)

Everybody's different. Okay? So, anyway, when I searched on the PDL, like, for all the right things, I searched every word I could think of. The one word I didn't search for was diabetic. They said, well, it's under diabetic supplies. Well, first of all, under diabetic supplies, the only thing they list is the Libre. So they don't list lancets or needles or whatever. And I was like, that's not even good English, people. Like, how would I know to search for that? Because when I search for a continuous glucose monitor, which is the correct category for the Libre, that didn't even show up in your little PDF. And I was like, it's so bad how they treat people with type one diabetes. [cite: 500, 501, 502, 503, 504, 505, 506, 507]

Scott Benner (3:47)

Are you here to tell us that people are incompetent and large corporations are trying to keep their money? [cite: 508]

Laura (3:53)

Yes. Is that what it. And totally. And here's the thing. [cite: 509]

Scott Benner (3:57)

Make money. I have a four zero one k. [cite: 509, 510]

Laura (3:59)

I want corporations to make money, but the system with health insurance is broken. They're making billions. The parent company, they're making billions. I looked up their reports, you know, that they give to their stockholders and all the things. [cite: 510, 511, 512]

Scott Benner (4:13)

Like, shareholder reports and stuff like that. [cite: 513]

Laura (4:14)

Right? And I get it. I looked that stuff up. Fine. Make some money. But the reality is when you have something like a a chronic disease, and they're not even gonna cover for co pay anyway for a long time. [cite: 513, 514, 515]

Scott Benner (4:27)

Mhmm. It's all about holding the money as long as possible. [cite: 516]

Laura (4:30)

Yeah. It's terrible. [cite: 516]

Scott Benner (4:32)

The money in their account is more valuable than than giving it back And to and they will give it back to you eventually if they owe it to you. But you are, like you said, you're gonna have to fight and claw and cry and scream and... [cite: 517, 518, 519]

Laura (4:44)

Exactly. [cite: 519]

Scott Benner (4:45)

And doesn't it feel like you're being put on the phone purposefully with people who don't understand? [cite: 520]

Laura (4:51)

I don't know if it's that. I feel like they're doing the best they can. These are clearly people in different call centers or working remotely. And I've talked to some nice people who really have tried to advocate or at least showed some compassion. But these are frontline people. [cite: 521, 522, 523, 524]

Scott Benner (5:07)

And Yeah. I'm not saying they're not good people or they're not trying, but I'm saying, isn't it possible that the company itself is putting them in a position where they don't know what to do so that it frustrates you? [cite: 524, 525]

Laura (5:19)

Yes. A 100%. No. And they're told, like, when this first happened and my first prior authorization got denied, I said, well, can I speak to a supervisor? Can I speak to someone else? And they were like, no. No. You can't speak to anybody else. This is it. You can only talk to us. And I was like, you assholes. Like, that is not true. There is somebody else. And then the next time I called back, I was even more forceful. And I guess what? I got to someone else. Right? I mean, I'm surprised they don't block my calls as many times as I've called. And I told my husband, I was like, they might decide to drop me after all this, and it can't be any worse than what I'm dealing with now because I'm not paying for my type one stuff. [cite: 526, 527, 528, 529, 530, 531, 532, 533]

Antiquated Technology and Intentional Delays

Laura (5:55)

And what I think is crazy too is that I'm very healthy. My diabetes is the only thing. I have one other medication that I take, and that's an estradiol patch, which is cheap because I am 52. And, well, there's this thing called menopause that every woman hits at some point. But other than that, like, I'm not a high utilizer. I'm not usually sick. I get my flu shot. I get my vaccines. I'm very healthy. I work out a lot. I have low cholesterol. I'm not even on a statin. Why do they have to be jerks? [cite: 534, 535, 536, 537, 538, 539]

Scott Benner (6:28)

But you know, though, you have your answer. Right? [cite: 540]

Laura (6:31)

Yeah. I know. I did this for so long, and that's why I cried because I was so frustrated. Yeah. But that's why I was like, I have to tell people, do not give up and warn people that this is how Ambetter treats unless you're lucky enough to get into one of their diabetes plans. But even then, it says they cover syringes, meters, things like that. I don't know how they cover type one diabetes in those plans. I think those plans might be a little more targeted for type two diabetes based on what I can find. But they don't even sell that one in the exchange, their diabetes plans. Sometimes I feel like they just really don't like people with type one diabetes. That's what it feels like. It's, ridiculous. [cite: 541, 542, 543, 544, 545, 546, 547, 548]

Scott Benner (7:11)

I would tell you that no one even understands what it means. I don't think they're like, oh, we won't help people with type one diabetes. I don't think they're helping anybody with anything. I would imagine if you called with completely different circumstances, completely different disease state, you'd be running into a very similar situation. [cite: 549, 550, 551]

Laura (7:29)

No. I think you're right. I think advocating for yourself in the health insurance system is the same. It to your point, it's universal. You have to keep going, and you can't wait for them to send you something in the mail. And the fact that the way doctor's offices have to send them a fax is so nineteen ninety five. Like, come on. [cite: 552, 553, 554, 555]

Scott Benner (7:51)

I love that. Like The fax machine thing is hilarious. It's like we don't have a fax about it. I'm like, I like it when they ask you, can you fax it to us? And I go, no, because it's 2026. Right. No. I can't fax you because I don't own a fax machine. And by the way, no one else does either. Like [cite: 555, 556, 557, 558, 559]

Laura (8:08)

Exactly. And it's intentional. Right? They haven't and they can pretend to hide behind HIPAA, which is BS. Because you know who actually uses apps like Clara all the time? Health care services. That's like my endocrinology office in Scottsdale. It's a HIPAA protected app called Clara, And I just text them, and they text me, and it's efficient. And you've got digital records now and all this stuff that are HIPAA protected, but they hide behind the fax machine because they can say, oh, we didn't get it yet. It's this. It's that. There's a delay. There's whatever. It's so much easier for them to hide. Slow down claims by using a fax system. And by the way, how HIPAA protected could a fax machine be now? You send my information to my doctor's office, it's sitting on a fax machine somewhere that anybody could see? [cite: 560, 561, 562, 563, 564, 565, 566, 567]

Legislative Realities and Coinsurance

Scott Benner (9:04)

It fell on the floor and slipped underneath Right. Desk and yeah. Yeah. Listen. You're a 100% right, but there's no answer to this. [cite: 568, 569]

Laura (9:11)

I know. Well, here's the answer. The answer is, especially on the state level, they need to pass legislation that prohibits health insurance companies from doing things like this. So the health insurance companies will testify against bills, they'll say, you know, a consumer has to do all the right things. The consumer needs to advocate. They need to look at their plans. They need to look at the PDLs, whatever. I did all that, and I still got screwed. Right? And I know what I'm doing. But here's an example. There in Arizona state, there's a bill right now in session that would go into the statutes where we protected people's rights with diabetes and health care saying health insurance has to cover these things. And they were going to try to codify that if you have type one diabetes, insurance plans have to cover CGMs. That sounds great on paper, but here's where the insurance companies still get away with not covering CGMs is that the last line of that bill, because I was so pissed, I looked this stuff up, said nothing prevents insurance from using deductibles and coinsurance prohibits them from using those. Right? So until you change that language, it doesn't matter. You can say you gotta cover type one diabetes, CGMs, and insulin pumps. But if they can still do deductibles and coinsurance, that's not insurance. Deductible is you have to meet it. And some people pick deductible plans that are, like, $10,000 that you gotta meet, right, before you even get there. And then you have coinsurance. And coinsurance is such BS because people get screwed. Right? Like, it's expensive for coinsurance, and a lot of people don't understand the difference between coinsurance and, like, a co pay. Right? And coinsurance makes it sound like you've got extra insurance, not, oh, you gotta pay more and you're only getting a percentage. Right? Even the language is confusing for a lot of people. [cite: 570, 571, 572, 573, 574, 575, 576, 577, 578, 579, 580, 581, 582, 583, 584, 585]

Scott Benner (11:03)

Look. I can't tell you for certain what's happening in the world, but I can step back and be as thoughtful about it as I think I can be. This is just clearly about people with money keeping the money as long as they can or as hopefully forever. It's just a business. Yeah. They're not a health care business. They're providing insurance. They're a casino. Right? Like, you You are giving them money, and they are hoping you don't need it back. And then they get to keep it. They invest it. They make more money off your money. They pay dividends to stockholders or, you know, wherever money ends up going after that. And then anybody who asks them for money is hurting their bottom line. So you saying, please pay for this, they're gonna put five or six low level, low paid employees between you and their money, hoping that you give up on the way. Yep. That's all it is. And listen, I talked to you for the first half an hour not about this on purpose because even in the last twenty minutes of talking about this, you sound crazy now. [cite: 586, 587, 588, 589, 590, 591, 592, 593, 594, 595, 596]

Personal Impact and AI Solutions

Laura (12:09)

Right? [cite: 596]

Scott Benner (12:09)

Because they made you nuts. Yeah. Yeah. And I don't think you are. I think that this is incredibly frustrating. [cite: 596, 597, 598]

Laura (12:16)

If was I frustrating. [cite: 598]

Scott Benner (12:17)

Started talking to you about what had happened to me, I'd sound just like you by the time I got done talking about it. But how many people get to the end and forget to make the call on time or the right form doesn't come through, and the third time it's kicked back to them, they just go, you know what? Just I'll just pay the goddamn thing. Like, who cares? And, like, I can't keep doing this. And then they smile and keep your money. [cite: 599, 600, 601]

Laura (12:39)

Or they don't get the care that need, and they switch from an insulin pump to two shots. Right? And they take their care backwards, you know, or they don't use that CGM. I do think it's kind of ironic that the year that changed everything in terms of health care in The United States was 1973, which is when Richard Nixon and congress he signed it into law. Congress passed a bill that allowed health insurance to become private and to be, like, private companies and and make more money than nonprofits Really codified that. Not to say that before that's there there weren't some health insurance companies that were a little more private, but not to the extent that they are today and what they're allowed to do today, is the same year that I was born. Yeah. Well I think that's really funny. And I was like, they picked... [cite: 602, 603, 604, 605, 606]

Scott Benner (13:28)

You think they were coming after you right then? [cite: 606]

Laura (13:30)

I don't think they were coming after me. At least, Anne better picked the wrong girl to piss off with type one diabetes. [cite: 607]

Scott Benner (13:36)

It's also easy to say, like, if they just change the language or the law or something like that. But, you know, as soon as some public official says like, let's say you beat your head against the wall with your local representation and you got somebody to, you know, say, alright. I'll propose a change to this law that'll help. And as soon as they do that, those insurance companies are gonna send all kinds of, you know, muscle to DC to pressure people out of doing that because they're always listen. This hasn't take this out of our conversation for a minute. No one's giving away their money if they don't have to. If I walked up to you right now and I said, Laura, give me a $100. You would say no. Yeah. You would say no. And I say no, but I really need it. You go, well, I need it too. You can't have it. And that's all we're talking about here is people are trying to hold on to what they have and get more of it. Everything's money and power, and, you know, and you have less of it when you're in this situation. You've been told that, you know, buying insurance is going to do these things, but there are so many rules and the language is so incredibly confusing that you don't know really what's gonna get covered until they turn it down. [cite: 608, 609, 610, 611, 612, 613, 614, 615, 616, 617, 618, 619, 620]

Laura (14:47)

Yeah. Because their their systems and their websites are designed not to be transparent. Right? It's it's all intentional. It's a 100% intentional. [cite: 621, 622]

Scott Benner (14:55)

Yeah. It is not difficult to make a user friendly website. If it's not user friendly, it's not user friendly on purpose. No. If the people you're talking to on the phone are not knowledgeable, they are not knowledgeable on purpose. If they are not empowered to make a decision for you that gets you to an end, that's on purpose. They are layering layering layering layering ways to keep you from your end goal. And I know this is true because I've been married for thirty years. There is a lady putting up roadblocks between me and my happiness constantly. Okay? And and if you think this is different, you're out of your mind. She's protecting herself. She's protect Yeah. I don't wanna tell you what she's protecting herself from, but she's protecting herself from something and so are the insurance companies. [cite: 623, 624, 625, 626, 627, 628, 629, 630, 631]

Laura (15:41)

Yeah. [cite: 632]

Scott Benner (15:41)

And you are fighting a war with a pea shooter, you know, and because your weapon is but I need this or it's right or it's for my health. And they Don't care about that. That's not their end goal. They have a different end goal than you. You have an end goal of being healthy, and they have an end goal of keeping your money. [cite: 632, 633, 634, 635]

This episode of the Juice Box podcast is sponsored by the Eversense three sixty five. Get three hundred and sixty five days of comfortable wear without having to change a sensor. When you think of a continuous glucose monitor, you think of a CGM that lasts ten or fourteen days. But the Eversense three sixty five, it lives up to its name, lasting three hundred and sixty five days. That's one year without having to change your CGM. With the Eversense three sixty five, you can count on comfort and consistency 365 a year because the Eversense silicone based adhesive is designed for your skin to be gentle and to allow you to take the transmitter on and off to enjoy your shower, a trip to the pool, or an activity where you don't want your CGM on your body. If you're looking for comfort, accuracy, and a one year wear, You are looking for Eversense three sixty five. Go to Eversense c g m dot com slash juice box to learn more. [cite: 636, 637, 638, 639, 640, 641, 642, 643]

This episode is brought to you by Omnipod. Would you ever buy a car without test driving at first? That's a big risk to take on a pretty large investment. You wouldn't do that. Right? So why would you do it when it comes to choosing an insulin pump? Most pumps come with a four year lock in period through the DME channel, and you don't even get to try it first. But not Omnipod five. Omnipod five is available exclusively through the pharmacy, which means it doesn't come with a typical four year DME lock in period. Plus, you can get started with a free thirty day trial to be sure it's the right choice for you or your family. My daughter has been wearing an Omnipod every day for seventeen years. Are you ready to give Omnipod five a try? Request your free starter kit today at my link, omnipod.com/juicebox. Terms and conditions apply. Eligibility may vary. Both terms and conditions can be found at omnipod.com/juicebox. Find my link in the show notes of this podcast player or at juiceboxpodcast.com. [cite: 644, 645, 646, 647, 648, 649, 650, 651, 652, 653, 654, 655]

Socioeconomics and the Healthcare Racket

Laura (18:09)

Yeah. You know, it's like Mark Cuban, really smart guy. And I've heard him talk, and I know that, know, he's got his prescription drug platform, and he's trying to get people, you know, cheaper medications and things like that. But I've heard him talk. He's like and even Scott Galloway, prop g, he's really cool guy. Love to listen to him. They talk about how they don't have health insurance, that health insurance is kind of a racket. And that you know? But they're, like, billionaires. Right? So Yeah. They're millionaires. You know? Several times over, they can afford to pay cash for the health insurance, which I think is why, especially in the Scottsdale area, there's more and more of these concierge doctors where you pay a monthly fee to them instead of paying for health insurance. The problem is though... [cite: 656, 657, 658, 659, 660, 661, 662]

Scott Benner (18:55)

That's for people with cash, with excess cash. [cite: 662, 663]

Laura (18:58)

Yes. Yeah. Yeah. And if you need a surgery or, like, let's say you're playing pickleball and you snap your Achilles or something like that because you haven't been played sports in forever, which I think happens a lot in the Scottsdale area. A lot of people start playing pickleball in there as they age and they have these injuries and they're at PT. They don't have cash prices for all those things. But if they do, you have to have so much. So you still kind of need some level of health insurance if you're a semi average person. Yeah. And so the concept is great, and I would love to give up health insurance and just pay cash for everything, but I don't have the kind of resources that they have. Right? You know? And I go on, Mark Cuban's website periodically, and I try to see if they've got type one diabetes things like insulin pumps and CGMs, and they never do. And I'm that one person who every time is like, you need to start helping people with type one diabetes for their pumps and their CGMs. I do every time I go on there. [cite: 663, 664, 665, 666, 667, 668, 669, 670, 671]

Scott Benner (19:48)

Oh, well yeah. Well, also, I hate to say it like this, but what is that? 2,000,000 Americans? Like, you know how many Americans there are? 2,000,000 is not a big percentage of that. No. No. Even if you're a company I don't know everything about Mark Cuban's company. But, like, even if he's out there trying to do the right thing, they have limited resources and limited manpower, and they're not gonna start with something that only benefits 2,000,000 people. [cite: 672, 673, 674, 675]

Laura (20:10)

Exactly. [cite: 676]

Scott Benner (20:10)

Right. Exactly. And to your point about people with enough wealth to pay for their health care not keeping insurance, my son actually, the irony of this conversation turned 26 today. Today is his 26th birthday. So Yeah. We jettison him from our insurance now. Can't participate in our health insurance any longer. He's been looking at it through his job, and they present him with three PDFs that are, like, four years old. [cite: 676, 677, 678, 679]

Laura (20:42)

Mhmm. [cite: 679]

Scott Benner (20:42)

You read them. They're they use a lot of lingo. They're difficult to figure out what they mean. You know, this one's $400 a month, and this one's $350 a month, and this one's $72 a month. And as you're reading through, if you don't like, seriously, like, who in who in their right mind reads, like, industry lingo and understands it? So what we did was we took the PDFs and threw them into a large language model into an AI, and we asked it to break them down for us. [cite: 680, 681, 682]

Laura (21:12)

Nice. [cite: 683]

Scott Benner (21:13)

And then we went in and talked to it about his health, and then asked for pros and cons, and then that stuff was at least it it made sense to us. And then we could go back and then look at the lingo and then make sense of the lingo through this plainer English that we were, you know, served back with. And Yeah. It's funny because I'm an adult and I've, you know, I have a bit of a savings. I I'm having income. Like, I'm a little ahead and everything. And when I looked at the three, I thought to myself, just buy the most expensive one because, you know, there's no way you're gonna buy the $72 one. So, like, one's $350, one's $420. Just pay the extra $70 a month because that'll probably be better. Until I looked at it and then looked at him and then took out the diabetes because my son doesn't have diabetes. Right. My son has Hashimoto's and nothing else. He he needs Tyrosine and a t three all year long. Other than that, he's incredibly healthy and athletic and doesn't get sick or hurt very often and doesn't have a family. Right? And Yeah. And when we got done, I was like, oh my god. Get the one that's $72 a month and just pay cash for the medication. Yeah. And you just saved almost $4,000 if you don't get hurt. And if you do get hurt, then you'll have to pay the $4,000, okay, before it kicks in, but you were gonna pay it anyway. So you're basically... [cite: 684, 685, 686, 687, 688, 689, 690, 691, 692, 693, 694, 695, 696]

Laura (22:35)

Right. [cite: 696]

Scott Benner (22:36)

He's basically setting a bet that he won't have a catastrophic illness this year. And if he doesn't, he saves $4,000. Well, if he does that for four years, he saves $16,000. Yeah. And that's a lot of money. Right? Like and so now he's got this and then I just told him, was like, I can't believe I'm saying this, but I guess we have the insurance we have because of Arden's diabetes. Because generally speaking, we are not particularly unhealthy people. We don't we're not buying a lot of medication. My wife's your age. She's using one of those patches too. You know what I mean? Yep. By the way, god bless them. She's way less crazy than I remember my mom in her fifties. You know? So rock and roll. Yeah. My mom used to have something we called insane Sunday. Yep. I'd be happy to tell you about it sometime. And so we, you know, we're using a patch. Now she and I both use a GLP medication. And so okay. Having an insurance policy that covers that, that benefits us. Right? Because I would tell you that I think to cover the four of us, you know, keeping my son in the picture for a second, we're probably shelling out, like, $67,000 a year in health insurance premiums. Yeah. But Arden has type one diabetes. I use a GLP. She uses a GLP. So right on. Yeah. That makes sense. If we didn't have a GLP and, you know, five years from now, we're older then. So then the value kinda stays again. And you think, okay. Well, maybe we'll stick with that one. But my son, I was like, man, unless you get married or something happens, I think I'd throw my dice and try to ride this out for a while. And I never thought I'd say that till I really dug into it last week with him and talked to him about it. Yeah. If you got type one, I mean, you just need as much coverage and help as possible. But then you're in a situation where you're getting as much coverage as you can, and then you're like, hey. I would like my 60¢ back on the dollar, and they're like, oh, you can't have that. No. Yeah. Yeah. [cite: 697, 698, 699, 700, 701, 702, 703, 704, 705, 706, 707, 708, 709, 710, 711, 712, 713, 714, 715, 716, 717, 718, 719]

"Medically Necessary" and Modern Technology

Laura (24:32)

Yeah. When they told me it wasn't medically necessary, I went ballistic. I was like, are you kidding me? I I was talking to the person on the phone to your point. Do they really understand type one? Because I was like, so I could die. Like, just to be clear, without an insulin pump, if I didn't have access to insulin and what I need, like but I could die. [cite: 720, 721, 722]

Scott Benner (24:51)

Well, they're gonna be happy to give you needles and insulin. Right? I have always disliked ordering diabetes supplies. I'm guessing you have as well. It hasn't been a problem for us for the last few years though because we began using US Med. You can too. Usmed.com/juicebox or call (888) 721-1514 to get your free benefits check. USmed has served over one million people living with diabetes since 1996. They carry everything you need from CGMs to insulin pumps and diabetes testing supplies and more. I'm talking about all the good ones, all your favorites. Libre three, Dexcom g seven, and pumps like Omnipod five, Omnipod dash, Tandem, and most recently, the Islet pump from Beta Bionics. The stuff you're looking for, they have it at US Med. (888) 721-1514, or go to usmed.com/juicebox to get started now. Use my link to support the podcast. That's usmed.com/juicebox or call (888) 721-1514. [cite: 723, 724, 725, 726, 727, 728, 729, 730, 731, 732]

Laura (26:01)

Right. But that's so archaic in terms of management. Like, my blood sugars are so stable. I to your point, I barely have lows. And I hike, and I do play pickleball, and I do go to Orangetheory and workout five days a week. Right? Like, that kind of stuff. Like, I used to have Lowe's way more often, but once I got on the Omnipod and the Dexcom, like, my blood sugar's gotten so much better. Like... [cite: 733, 734, 735, 736]

Scott Benner (26:26)

No. You're not gonna get an argument from me. You're going to be way better off, but way better off is not medically necessary. Right. [cite: 737]

Laura (26:33)

Which is such BS. [cite: 738]

Scott Benner (26:35)

Of course. Because they're not calling medically necessary as healthy as you can be. They're calling medically necessary you don't drop dead from having diabetes because here's some needles in your insulin. [cite: 739]

Laura (26:44)

Yeah. [cite: 740]

Scott Benner (26:45)

Right. [cite: 740]

Laura (26:45)

Yeah. Yeah. Yeah. Yeah. So And it's just so frustrating. [cite: 740]

Scott Benner (26:48)

Also, it probably is part of the reason why, like, pump adoption is as slow as it is because, by the way, insulin pump adoption is much less than you think it is amongst the entirety of the type one community. [cite: 741]

Laura (26:59)

That is insane to me. [cite: 742]

Scott Benner (27:01)

Yeah. Far fewer people have insulin pumps than you think. [cite: 743]

Laura (27:05)

And I've tried them all, by the way. Like, well, not all. I've been on Medtronic. I've been on the t slim, and now the pod. And the pod is by far my favorite. Yeah. I didn't know how cool it would be to go tubeless. Mhmm. And so I do owe that to my friend Vicky. Shout out to Vicky. She's a big fan of the show. She'll get a kick out of that. But it's amazing what technology has done in comparison to where it was when I started, when I was diagnosed in 1999. [cite: 743, 744, 745, 746, 747, 748]

Scott Benner (27:29)

I met a maybe a dozen people this weekend using the eyelet pump, And I think they all would have described themselves as having a concern about not wanting to be that involved with diabetes. And they tried the pump for that reason, they seemed happy with it. Like, I think there's a pump out there for everybody. [cite: 749, 750]

Laura (27:47)

I agree. [cite: 751]

Scott Benner (27:48)

If you and I wanna be, like, reasonable for a second, take out Omnipod, take out Tandem, take out Medtronic for a second. Just think of all the people probably running around with ten, eleven, 12 a one c's. And imagine if you just put an eyelet pump on them and they didn't need to do anything. They didn't need to get educated. They just said this is a small breakfast. Right? Or a average Mhmm. Or whatever those buttons tell them. Like, even if that system's not perfect, and I have to tell you, like, from my perspective, the way it sits right now, I wouldn't want my daughter to use it. Mhmm. But her a one c is also in the sixes. But for everyone else, imagine the alleviation on the health care system and on insurance if everyone could have better outcomes like this. You're not gonna get them to go with that because what they'll tell you is, well, yeah, but not enough people are gonna adopt it for us to actually to get our return back to begin with. Like, it's always gonna be about money. Like, always, always, always, always gonna be about money. [cite: 752, 753, 754, 755, 756, 757, 758, 759, 760]

The Future of Cures and Self-Advocacy

Laura (28:47)

That's why I kind of crack up a little bit when people are like, there's gonna be a cure for type there will be a cure for type one diabetes someday, whether it's a mechanical cure, islet cells, whatever it is. But the reality is, if I can't get insurance in 2026 to pay for my insulin pods... [cite: 761, 762]

Scott Benner (29:05)

You don't think they're gonna pay for your islet cell transplant ten years from now? [cite: 763]

Laura (29:09)

Hell no. You know how long that's gonna take? [cite: 764]

Scott Benner (29:12)

For just $800,000, you can cure me of my type one diabetes. [cite: 765]

Laura (29:16)

Right. Like, the only people are who are gonna get that cure are gonna be rich people who can afford to pay cash for it. Insurance is gonna not gonna pay for that. It's gonna need organizations like the ADA, Beyond Type One, Type One International. All the organizations are gonna have to come out and advocate hard, and that's gonna take years before any cure is gonna be paid for by insurance. It'll basically be a rich person's cure. [cite: 766, 767, 768]

Scott Benner (29:42)

Yeah. I definitely don't think that's gonna work out in anybody's favor to any great number. No. Honestly, it's a limitation of so many different things. To fix them all would be two lifetimes. [cite: 769, 770, 771]

Laura (29:53)

Yes. [cite: 772]

Scott Benner (29:53)

You would either need a government plan that just said, hey. Look. We have a functional cure for type one diabetes, and everybody who wants it, it's just free. We'll pay the bill. Yeah. It's either that, which I mean, that's not gonna happen. [cite: 773, 774]

Laura (30:04)

But no. [cite: 775]

Scott Benner (30:05)

Right? Or it's somehow through technology, the price falls so much that there's another company that comes along almost like a generic company that comes along and says, like, well, we can reproduce this and do it cheaper. So we'll do it for everybody to make that money. You know, it's like with anything else. I was talking to a CGM company the other day, I said, why don't you cut your price down and so everyone can have it? And then make the money that way. Instead of charging a dollar for it and selling it to one person, why don't you charge 25¢ for it and sell it to four people? And, you know what I mean? Like and you still make your dollar, and everybody else gets helped. I don't know. It's just that's not how it works. [cite: 776, 777, 778, 779, 780, 781]

Laura (30:46)

No. It's not. Unfortunately, it's not. [cite: 782]

Scott Benner (30:49)

Listen. I very purposefully apolitical on my podcast, but if you're waiting for government to come save you, that is not happening. If you're waiting for government to tell the private sector, hey, we don't want your money, so don't bother lobbying with us. We're just gonna go do what's good. That is not gonna happen either. If you think if you're waiting for insurance to stop lobbying because they just want you to be healthy, I'm gonna give you the same advice that I gave those 75 women when I was talking to them about advocating for themselves in a hospital setting. You are the only one that cares about you. And if you don't treat things that way, you are very likely not gonna get the outcomes you deserve. [cite: 783, 784, 785, 786, 787]

Laura (31:26)

It's true. [cite: 788]

Scott Benner (31:26)

And I hate to say that, but you gotta come first and you gotta find a way to fight your way through it because no one's coming to help you. A woman looked at me sideways when I said that, and I said, we're in a rowboat. It's me and your kid and my kid. And the boat starts to sink. I'm gonna throw your kid right in the water. And I said, and I would expect if it was you and my kid and your kid and the same thing happened, you pick my kid up and toss him right in the river too. I said, would you? Would you throw yourself in and leave your kid behind? Would you throw your kid in to save mine? No. I'm not judging you. And I'm not saying there's anything wrong with that instinct. I was like, but you've gotta take that instinct and point it at your daily health with diabetes. It was a nice conversation, and Mhmm. Nobody was saying anything wrong. You deserve better care. The hospital should know better. You're right. All that should be that way. But since it isn't, what are you gonna do? You're gonna sit here and wait to die and point and go, oh, the world's letting me down. It's letting me down. Yeah. And I know that there's a barrier to that when we're talking about insurance and these kinds of things, and that barrier is cash. But up into the end of your ability to help yourself, you have to believe it's on you. If that's a realization you have and you can't afford it, I don't even know what to say about that. I'm not sure how you're supposed to keep your head up in that situation, perfectly honest. It's hard. [cite: 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 802, 803, 804, 805]

Humanity's Ebb and Flow

Laura (32:49)

Yeah. I think it's really hard. And I think having done advocacy for people with diabetes and passed legislation on the state level that people have told me that'll never pass or whatever, it can make a difference. The problem is laws can be changed anytime. They can be rolled back. They can be adjusted. So it's never a 100% permanent solution. And the average person can stand up, but it takes a lot. And you're pushing a boulder uphill, basically. Right? [cite: 806, 807, 808, 809]

Scott Benner (33:18)

And Yeah. That's a level of depression on this I wasn't even gonna go to. But you're saying if you somehow find a way to get the law passed and it helps somebody, as soon as you do that, just be sure those other people are gonna try to push it back the other way again. [cite: 810, 811]

Laura (33:31)

Exactly. Because they will. [cite: 812]

Scott Benner (33:32)

And why? Because you just took their money from you took their money from them. They can't let that happen. They can't let that happen. [cite: 813, 814]

Laura (33:40)

Mm-mm. No. There were so many times I testified, and other companies, insurance companies, and health insurance companies and things or whatever, they would say things that were blatant lies so that these bills wouldn't pass, and we'd have to counteract them as advocacy groups. And there's not one group who's doing all the work. It's a coalition of people. It's people sharing their stories. People don't share their stories enough, And it's hard because they're also afraid of retaliation. Right? They're afraid to share their stories and complain against health insurance or whatever because they're afraid they're gonna get retaliated against. [cite: 815, 816, 817]

Scott Benner (34:14)

Yeah. Laura, this might be a good time for me to say I don't stay in hotel rooms on high floors. I'm not depressed. I don't feel suicidal. I just want everyone to know I'm a happy person who wants to be alive. I mean, listen. It I don't know what the answer is. I don't think there's an answer. The answer is Star Trek. You know what I mean? Like, until you can get society, you get to a place where everyone's working and it's all about trade and nobody's trying to be wealthy and everybody's just trying I mean, maybe that helps more people, but it just does not to me seem like that's the way humans are wired. [cite: 818, 819, 820, 821, 822]

Laura (34:47)

Yeah. I believe in the greater good in people. I believe there's a lot of people and there's a lot of good in the world. And there's some people who are straight up evil a 100% or super greedy. I mean, I grew up Wall Street. Right? That was a pivotal movie in my life. You know? Greed is good. Right? There's a whole generation of that's very common. I I think what is hard is that, yes, make money. Yes, be profitable. People should be paid good wages. They should be able to have nice things and whatever. Right? If you work hard and the American dream, believe in that. But at some point, there's this line where that exceeds human decency. Right? Like, how much money do you need to make? Like, car insurance. They raised my car insurance this last year so much. It was insane. And so I called my insurance person, and I called and I was like, okay. Wait. Well, the Florida and this tragedy, don't live in those places. I live in Arizona. So you're telling me I have to cover their costs so you're raising my. And then they snuck in a bunch of, like, other charges for stuff that I didn't ask for, and I was like, why is this in my plan? Why is and I cut it out, and I cut it out. And she's like, well, we're not making any money. And I looked up before I talked to them. I was like, your company made $2,500,000,000 last year. And I get you're just a franchise, but you can't tell me you're not profitable. And she was like... [cite: 823, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841]

Scott Benner (36:02)

My State Farm office told me you should really consider turning that in because we might drop you. [cite: 842]

Laura (36:09)

Right. [cite: 843]

Scott Benner (36:09)

I don't think I've asked them for money in twenty years for something. We had a a small thing happen, and they were like, I wouldn't if I was you. And she said it right out to me. She didn't even hide it. She just said it to me. No. But listen. Here's the other side. May I give you the other side? For everybody who's listening right now, it's like, right on. The rich people, blah blah blah. There's they got too much. All of you out there listening, shut up. If I came to your house and I said, hey. I just wanted to give you $10,000,000 and a boat, and you'd be like, thank you, and you would take it immediately. Right. So A 100%. So don't be mad at the people who've figured out how to do it because if you could've figured out how to do it, I'm pretty sure you would have too. Yeah. Look. There's some of you hippies out there. I get it. You're like, I don't need that, man. Like, it's good. And I believe you. I believe you, hippies. And I will tell you too that I've had conversations with people. We're talking about the lottery recently. It was one of these, like, lotteries that was, like, I don't even know. Like, it felt like it was a billion dollars or something like that. Like, it was just a number that was so insane. And it sparked a conversation in our house about, like, oh my god. Like, if you woke up tomorrow and somebody's like, oh, you did it. You won a billion dollars. Like, what would you do? I have to tell you, like, I didn't have a lot of thoughts around it. I say things very similarly over and over again. I'd collect up my family and my very close friends, and I would bring them all to one location. And I'd say, hey. Listen. I've just won a whole lot of money. I wanna make sure your health is okay. I've brought doctors here to help you. Like, if you have any health issues you haven't been dealing with, like, let's talk to these people about this. And when we're done, I'd like to talk to you about clearing off your debt and giving you a little bit to get started with. But then after that, I would say, please never call me again. Yeah. I don't wanna be your mom for the rest of my life. [cite: 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868]

Laura (37:46)

So that's like a health care version of a George Clooney. I told my friends, if I ever win big, I'm gonna pull a George Clooney. And they're like, what? I go, if I tell you, you have to get on a plane to Scottsdale on these dates, your ass shows up because I'm gonna pay for the taxes. I'm gonna pay for the money. There's gonna be a security guard. They're gonna roll in some suitcases with some money in it. We're gonna throw a kick ass party. I know the hotel I would choose. Yeah. [cite: 869, 870, 871, 872, 873, 874]

Scott Benner (38:10)

And then go live your life and try not to piss my money away because I'm done. [cite: 875]

Laura (38:14)

That's it. [cite: 876]

Scott Benner (38:15)

But at the same time, like, I got done saying that, then somebody said, but what about for you? And I was like, I don't know. I think I'm okay. Like, I take your point. I also like, I also don't think you should limit people about how much money they can make. No. I take your point about, like, millionaires and billionaires, and at some point, like, they're just numbers and everybody else doesn't have any. Like, I could have that conversation forever and probably come down on your side of it. But, like, I'm not comfortable telling somebody they can't be innovative or they can't be greedy because I'm sure there's a lot of good things in the world that came from someone's greed as well. [cite: 876, 877, 878, 879, 880, 881]

Laura (38:45)

A 100%. A 100%. I believe in people being able to make money and make good money. Like, again, I have a four zero one k. My husband and I are invested in the stock market. I am considered well off. I am not poor. I am blessed that way. We worked hard. We've made good choices, all the things. Right? [cite: 882, 883, 884, 885, 886]

Scott Benner (39:04)

Yeah. [cite: 887]

Laura (39:04)

I am not complaining about my status in life. I think we're what's frustrating is when you're paying into something called insurance, particularly health insurance... [cite: 887, 888]

Scott Benner (39:12)

It should insure you. Right. Yeah. Call me crazy, but I was hoping my health insurance would pay for my health care needs. [cite: 888, 889, 890]

Laura (39:20)

Because they're not losing money. Like, that's the thing. They're not losing money. If they were losing money, that'd be different because they were paying for everything. [cite: 890, 891]

Scott Benner (39:28)

If I brought them on here and they were being honest, don't you think that they would tell you that if they did pay for everything for everybody, they would be losing money? [cite: 892]

Laura (39:35)

Well, of course, they would probably say that. Still, I don't necessarily know that that's true. Right? Because we know that if you pay for preventative stuff, people don't get the complications and the things, but that's not the way our health care system right now is designed. [cite: 893, 894]

Scott Benner (39:47)

I was gonna say, can I play health care devil's advocate for a second? Yeah. I talk to people all the time about their health. You know what one of the last things people are? Preventative. [cite: 895, 896, 897]

Laura (39:57)

I know. [cite: 898]

Scott Benner (39:58)

I think it's a thing we talk about, but I don't think it's a thing that even if we paid for that people would do, generally speaking, in mass. In a world where you it takes twenty years to talk somebody out of smoking or drinking soda, you really think they're gonna go to the doctor four times a year to check their vitamin b and d levels and make sure that their blah blah blahs are like, do you really think that's what's gonna happen? [cite: 898, 899]

Laura (40:21)

Some people. It depends. Right? Some people can and some people do, and not as many as one would hope. But some of it is have you ever been to the grocery store? And I'm like you said, I'm doing well. I'm doing okay. I'll go to the grocery store, and I'm looking at buying organic foods. And I can buy one bag of organic fruits and vegetables. And for the same price, someone could buy 12 frozen pizzas, you know, processed junk food, all of the things. So kinda depends, I think, on your socioeconomic level, what you can afford to be preventative and what you can't. You know, I think it's also crazy that as a healthy person with type one diabetes, I have to go to the doctor, what, three, four times a year to make sure I have prescriptions and stuff and things like that. Well, that's just a waste of the health care system right there. Right? Like, if I'm healthy and I don't have anything wrong, why do I have to go in and see you? Why can't you just upload my data and look at it and go, yep. Things look good. Great. Moving on. Right? Did you know that when you turn 65 and you have type one diabetes and you go on Medicare, you have to prove that you do have type one diabetes? [cite: 900, 901, 902, 903, 904, 905, 906, 907, 908, 909, 910, 911]

Laura (41:27)

What? I'm gonna live my whole life. Knock on wood. I'm gonna get turned 65. I'm gonna be healthy, and Medicare will still be there. And in order for my type one insulin CGMs, pumps, whatever it is at that point, get covered, I have to reprove. They have to give me the test again to prove that I have type one diabetes. Yeah. That is a stupid waste of money. Why? [cite: 912, 913, 914, 915, 916]

Scott Benner (41:49)

You're talking about what makes sense versus how things work. [cite: 917]

Laura (41:53)

Yes. Well, that's true. [cite: 918]

Scott Benner (41:54)

And if this just happened, if that just happened, if we only did this and if we only made sense here, like, yeah, I'm with you. But, like, that's not going to happen. Yeah. At every level of this conversation, the base of this conversation as is everything else that you talk about is people. Yeah. People have limitations. They have a limitation on how much energy they have, how much desire they have, that they also have lives and girlfriends and boyfriends and kids and bills. And they don't have twenty four hours a day, seven days a week to thinking about something. And even if they did, they're not computers. They can't come up with the right answer all the time. There are plenty of people who come up with an answer and spent their adult professional lifetime doing the wrong thing, trying to do the right thing. And so while all that's happening, this mess, you're not just cleaning up your bedroom. This is a billion intertwined things that are intertwined with billions of people. And they all have an opinion about what to do about it, and they all have pain points that are different than others. They all have different intellects and financial concerns. [cite: 918, 919, 920, 921, 922, 923, 924, 925, 926, 927]

Scott Benner (43:02)

Yeah. You can't fix this stuff. [cite: 928]

Laura (43:05)

No. [cite: 929]

Scott Benner (43:06)

This is how it works. Yeah. We will find a better way just as we have over generations and millennia and all that stuff. Mhmm. But it is not gonna be because someone woke up tomorrow and said, oh, I know how to fix this. Yeah. It's just gonna bleed towards the answer. And then eventually, in ways that our minds can't grasp, so many different things are gonna change and morph over time that we'll just end up in a better place. Or Yeah. We'll end up in a worse place for fifty years, and then it'll ebb and it'll flow. Yeah. The truth is my lifetime might be the lifetime where it goes the wrong way So that eventually, when my kids are 50, it starts to go the right way. Like, we're measuring success based on our lifespans, but you need to be measuring success or change based on humanity. Sadly enough, the speed that humanity runs at is not the speed that my life is running at. [cite: 929, 930, 931, 932, 933, 934, 935, 936]

Laura (44:07)

No. It's true. I really I really like that there's a lot of people in humanity who were fighting the good fights trying for the right things. And I'd like to believe I'm on the right side of that line of fighting for other people and caring about people's rights and access to health care and healthy foods and the environment, all that. But you're right. It's a slow moving thing. And in the meantime, I think to sum it up, you have to advocate for yourself. That's kinda where we started. Right? You talked about how you were talking to those women. You have to advocate for yourself. You have to advocate for yourself in your job, in your health insurance, in the hospital, whatever it is for other people because that really will make change over time. Yep. And you can have positive impacts on your life and other people's life even when it's hard. Don't give up because, like I said in my story, I am a trained professional, and I still got screwed. And I'm still advocating for myself. I'll follow-up with you if I ever even get my insulin cost covered because you just don't know. I might be paying out of pocket for the next year until I can get out of this silly plan. But... [cite: 937, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947]

Closing Perspectives and Taylor Swift

Scott Benner (45:11)

So much of it is perspective. Whether you're sitting there listening now and you're thinking, like, I'm broke, and there's no reason for somebody to have $5,000,000,000 in the bank. And look at all the people that could help. I guarantee if you take that person and sit them down, they have a different perspective than you. Yeah. And their perspective is gonna be trying to take care of them and theirs and what they see as the world order. So are you and so is everyone else in between, and you are not gonna get somebody to just agree that they should give you their money. Whether that's you being asked to pay 60¢ on the dollar for something or that's some maniacal, like, cartoonish character out in the world that has all the money in the world. And you say to them, like, I mean, they all figure it out in the end. Right? Because you see they get old and they give it all away. They they figure it out at the end. They go like, oh god. What am I doing? And then it's but but in the middle, you can't get people to do that. [cite: 947, 948, 949, 950, 951, 952, 953, 954, 955, 956]

Laura (46:03)

Yeah. [cite: 957]

Scott Benner (46:04)

To give away your money, imagine how hard it would be to make all that money. And then imagine in your thirties, someone said you give it to somebody, but you feel immortal still. You're like, I can't give it away. I have to stay alive. Like, what if this happens? What if that happens? You don't think a person with a billion dollars has a, like, what if I lose all this feeling? Of course, they do. Probably more so than somebody who makes $60,000 a year does. [cite: 957, 958, 959, 960, 961]

Laura (46:28)

Yeah. [cite: 962]

Scott Benner (46:28)

Again, everyone's perspective is different. Their pressure points and pain points are different. [cite: 962]

Laura (46:33)

Yep. [cite: 963]

Scott Benner (46:34)

And by the way, even if there was a right answer, I don't trust you to come up with it. I'm talking to people listening, and you don't trust me to come up with it or somebody else. Right? So Right. When you hear people say, like, the only answer is to, like, hope the AI doesn't kill us and then ask it for an answer, that considers all of us. Like, our brains are not big enough to hold the entirety of what needs to be considered to make a decision that big. Having said that, I go very back to what you just said. I wanna say a million percent I agree with you. If everyone's out there doing their best and fighting, I think the fight moves us in the right direction. And I do think it's important to stick up and argue and push for what seems right because overall, like, I'm sure whatever it is you out there think is right is probably right. And so, you know, like, just think about civil rights or something that's a little easier to comprehend. If people don't stand up, if people aren't willing to stick their neck out, these things do not move forward. So No. You know, whatever the thing is you're worried about, like, I hope you can find a way to get out there and fight for it. [cite: 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973]

Laura (47:42)

I agree. [cite: 974]

Scott Benner (47:43)

I'm doing that in my own life in ways that some of you might know and some ways that are more private and you're never gonna know about. So you know? No. Laura, we fixed the whole world here. It's fantastic. [cite: 974, 975]

Laura (47:55)

I wish because then I'd go buy a boat or a... [cite: 976]

Scott Benner (47:58)

You don't need a boat. It would be free. [cite: 976, 977]

Laura (48:00)

Yeah. Well, there you go. I don't know that we need to go a 100% free. I have a business major. So I was a business major. I believe in nice things and working hard. I just hope that everybody is able to be happy. Sometimes attitude is everything. [cite: 978, 979, 980]

Scott Benner (48:11)

Can I paint a picture for you? We're all millionaires. Mhmm. You couldn't even get your yacht out of the harbor. There'd be too many yachts there. It would cause a different problem. [cite: 981, 982, 983]

Laura (48:22)

It would cause a different problem. [cite: 983]

Scott Benner (48:24)

There's gonna be a different problem. You're gonna get murdered by one of your crazy kids who wants all your money. [cite: 984, 985]

Laura (48:30)

Yeah. It's like that Taylor Swift song. Yeah. [cite: 985, 986]

Scott Benner (48:32)

What is it? [cite: 986]

Laura (48:34)

There's a Taylor Swift song where she talks about how her daughter-in-law thinks she left money for her in the will, but she didn't. It's that thing. Yeah. [cite: 987, 988]

Scott Benner (48:40)

Wow. I don't know anything about Taylor Swift. I just realized. [cite: 988, 989]

Laura (48:43)

Oh, I'm a big Swifty. I'm a big Swifty. [cite: 989]

Scott Benner (48:45)

So I'm happy for you. You think that she'll marry that football boy? [cite: 990]

Laura (48:48)

I do think she's gonna marry mister Kelsey. Yeah. Mhmm. I like it. I think they're a good match. [cite: 991, 992]

Scott Benner (48:53)

Will she be Taylor Kelsey when it's over? [cite: 992]

Laura (48:56)

I think there's a difference between what she might do privately and what she'll do publicly because she's obviously a billionaire, and her name, obviously is copyrighted and all of the things. So you never know. Especially if they decide to have kids, it's easier for your kids if your kids have the same last name than different last names, and that's even true if your parents aren't rich. I think sometimes that can be tricky. The only thing I have to say about her marrying Travis Kelce is that I'm a 49ers fan, and they beat us one too many times in big games and things like the Super Bowl. So when they lose the Super Bowl, it doesn't make me sad. But I am happy that a lot of young girls have started watching football now because of the Taylor Swift phenomenon. Because I started watching football when I was a kid with my dad Yeah. In Oregon, and that we would bet quarters on quarters and things like that so that I would get into the games. [cite: 993, 994, 995, 996, 997, 998, 999]

Scott Benner (49:44)

Your dad used sports betting to get you excited? [cite: 1000]

Laura (49:47)

He did. Yeah. He did. We played with quarters. It was part of my allowance money. It was very fun. I learned how to swear while my dad was watching football. He was a LA Rams fan when, like, Eric Dickerson and stuff was there. [cite: 1000, 1001, 1002, 1003]

Scott Benner (49:57)

Yeah. Well, that'll make you a curse. [cite: 1004]

Laura (49:59)

Right? It it can be a very good bonding for girls and their dads to watch sports together, so I commend them for that. That's that's pretty cool. [cite: 1004, 1005]

Scott Benner (50:09)

That Taylor Swift, her dad noticed years ago that they were spending so much money on tour buses, And then he thought about all the acts are out on tour, they took some of Taylor's money and bought up tour buses. And now they're basically the largest owner of tour buses in the world, so they make money off of that too. [cite: 1005, 1006]

Laura (50:25)

That's brilliant. [cite: 1007]

Scott Benner (50:26)

There's an interesting way how money makes money because if you had a thought like that, you'd be like, oh my god. If only I had enough money to buy tour buses, but I don't. [cite: 1007, 1008]

Laura (50:33)

Tour bus. Right? [cite: 1009]

Scott Benner (50:34)

Anyway, I'm just gonna say this here, and then I'm gonna stop the recording because I don't even wanna hear your reply. I don't think she has a very good voice. [cite: 1009, 1010]

Laura (50:42)

Disagree. Disagree. A 100% disagree. I'm in the Amazon top point 05% of listeners to Taylor Swift in my year review from 2025. She's got so many albums. She could listen for hours. [cite: 1010, 1011, 1012]

Scott Benner (50:53)

It's possible you're in a cult, Laura. It's possible. [cite: 1013]

Laura (50:56)

But we can agree to disagree. We can agree to disagree. It's totally fine. Everybody can, like I... [cite: 1013, 1014]

Scott Benner (51:01)

don't care if you listen to Taylor Swift or not. That's for certain. [cite: 1014]

Laura (51:05)

Exactly. Not hurting anybody. [cite: 1015]

Scott Benner (51:07)

She has a few boppy songs I like. I I'm not, against it. I'm just telling you why. I think there's a reason she started in country. There, I'll just piss everybody off, and then we'll stop right here. Thanks so much, Lara. You were terrific. [cite: 1016, 1017, 1018, 1019]

Laura (51:19)

It was a pleasure. Thank you. [cite: 1019]

Scott Benner (51:20)

Of course. Hold on one second for me. The podcast episode that you just enjoyed was sponsored by Eversense CGM. They make the Eversense three sixty five. That thing lasts a whole year. One insertion. Every year? Come on. You probably feel like I'm messing with you, but I'm not. Eversensecgm.com/juicebox. [cite: 1020, 1021, 1022, 1023]

This episode of the Juice Box podcast was sponsored by US Med. Usmed.com/juicebox or call (888) 721-1514. Get started today with US Med. Link's in the show notes. Links at juiceboxpodcast.com. [cite: 1023, 1024, 1025]

A huge thanks to my longest sponsor, Omnipod. Check out the Omnipod five now with my link, omnipod.com/juicebox. You may be eligible for a free starter kit, a free Omnipod five starter kit at my link. Go check it out. Omnipod.com/juicebox. Terms and conditions apply. Full terms and conditions can be found at omnipod.com/juicebox. Thank you so much for listening. I'll be back very soon with another episode of the juice box podcast. If you're not already subscribed or following the podcast in your favorite audio app, like Spotify or Apple Podcasts, please do that now. Seriously, just to hit follow or subscribe will really help the show. If you go a little further in Apple Podcasts and set it up so that it downloads all new episodes, I'll be your best friend. And if you leave a five star review, oh, I'll probably send you a Christmas card. Would you like a Christmas card? 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. [cite: 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035]

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. You 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. Have a podcast? Want it to sound fantastic? Wrongwayrecording.com. [cite: 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1043]

READ FULL TRANSCRIPT

#1824 Insurance Let Me Down - Part 1

Discussion of type 1 diabetes , Gen X identity , and advocacy against systemic insurance technology denials.

Proudly supported by

Key Takeaways

• Persistence in Advocacy: Even professionals face insurance denials; success often requires constant follow-ups, resubmissions, and refusing to accept "medically unnecessary" labels at face value.
• Strategic Communication: Utilizing gender-neutral or male-coded communication (like sending emails from a husband’s account or bringing a male companion to meetings) can unfortunately result in better institutional responsiveness in school and medical settings.
• Generational Confidence: The Gen X "heartiness" and self-confidence can be a powerful tool in healthcare advocacy, allowing patients to remain firm and assertive without taking system failures personally.
• Technology Evolution: Moving from older insulin regimens (NPH/Regular) to modern tools like CGMs and smart pumps (Omnipod 5) significantly improves glycemic control and can even halt the progression of complications like retinopathy.
• Insurance Strategy: For those with chronic illnesses, choosing a higher-tier Silver or Gold plan on health exchanges is typically more cost-effective long-term than low-premium, high-deductible plans.

Resources Mentioned

• Touched By Type One: touchedbytype1.org
• Omnipod 5 Starter Kit: omnipod.com/juicebox
• Eversense 365 CGM: eversensecgm.com/juicebox
• American Diabetes Association (ADA): diabetes.org
• Juicebox Podcast Resource Lists: juiceboxpodcast.com/lists
• Wrong Way Recording: wrongwayrecording.com

FULL EPISODE TRANSCRIPT

Introduction and Background

Scott Benner (0:00) Welcome back, friends. You are listening to the Juice Box podcast.

Laura (0:13) Hi. My name is Laura Keller. I am 52, so I'm dead solid into Gen X. And I spent twenty five years working in diabetes, and I live with type one diabetes. I've had type one diabetes for twenty seven years.

Scott Benner (0:30) This episode of the juice box podcast is brought to you by my favorite diabetes organization, touched by type one. Please take a moment to learn more about them at touchedbytype1.org on Facebook and Instagram. Touchedbytype1.org. Check out their many programs, their annual conference, awareness campaign, their d box program, dancing for diabetes. They have a dance program for local kids, a golf night, and so much more. Touchedbytype1.org. You're looking to help or you wanna see people helping people with type one, you want touched by type1.org. While you're listening, please remember that nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan or becoming bold with insulin. I'm having an on body vibe alert.

Scott Benner (1:31) This episode of the Juice Box podcast is sponsored by Eversense three sixty five, the only one year wear CGM. That's one insertion and one CGM a year. One CGM, one year. Not every ten or fourteen days. Ever since cgm.com/juicebox.

Scott Benner (1:51) Today's episode is also 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.

A Career in Diabetes Advocacy

Laura (2:22) Hi. My name is Laura Keller. I am 52, so I'm dead solid into Gen X. And I spent twenty five years working in diabetes, and I live with type one diabetes. I've had type one diabetes for twenty seven years.

Scott Benner (2:39) Twenty seven years. What does it mean you worked in diabetes?

Laura (2:42) I worked for the American Diabetes Association for twenty five years. So I did everything you could do, basically. I did camps for kids with diabetes, family retreats, diabetes expos. I did fundraising, black tie events like our father of the year event, and I got into advocacy. So when I first got diagnosed with type one, I was 25 years old. And I was a manager of an athletic club at the time up in the sort of North Of Seattle area. Mhmm. And I got diagnosed, and I called the American Diabetes Association to volunteer, and I called JDRF, which is now beyond type one. They used to be called JDRF didn't wanna have anything to do with me because I was 25 and basically poor. Right? So they never responded, especially in Seattle because they have a really big following, and they have a lot of money, which is great. They do great work, but they weren't interested in me. The ADA, I called, and they called me back. And within about three weeks, I had a job. And so I started out as the youth program director. And in doing that for five years, I gotta do other things, fundraising, all of that. And then I started working on advocacy. And I got really into advocacy, not because I thought that was gonna be a career, but I spent about twenty years working for the ADA in advocacy. I retired from the ADA about three years ago now as the vice president of grassroots advocacy.

Scott Benner (4:11) Oh, wow.

Laura (4:12) So I spent my whole adult career in nonprofit work. I love nonprofit work. I do nonprofit consulting now, and I volunteer for several organizations as well in my retirement. And, yeah. So I'm very passionate about the nonprofit space.

The Gen X Perspective

Scott Benner (4:26) Awesome. When you say you're firmly would you say Gen X? Is that what it is?

Laura (4:30) Gen X. Yeah. Mhmm.

Scott Benner (4:31) What does that mean to you?

Laura (4:33) That means to me, don't piss me off. If you push me too far, I will find a way to come back and kick your ass. Ethically, of course, but I will do it. Like Ethically. I, I have those, sensibilities. I'm the the chick that is at Orangetheory working out five days a week, and I will sing and dance on the treadmill because I hate cardio, so I'll keep it going. I get the sweetest things. I get these other people in class. They're like, it's dancing, Laura. Because I don't care what you think of me. But if I need to do cardio for twenty five minutes on a treadmill, I have to do something to make it fun. And that's what I do.

Scott Benner (5:07) In your mind, it's a generation of people who aren't worried what externally people think of them?

Laura (5:13) I think so as a general rule. Yeah. I think it's a general rule. Obviously, there's exceptions to everything, but I think as a generation, we're a little bit more I hate to say the word hearty, but I do think so. Having raised a child, my bonus daughter, and dealt with her friends and things, I think, you know, all those things you see on the gram in social media about we really did drink from hoses, and we really did run around and do all those things. And I feel so blessed and lucky in so many ways that I didn't have to deal with social media growing up because I'm loud, and I'm tall, and I'm outspoken, and all the things I can't imagine having gone to parties and stuff with evidence.

Scott Benner (5:54) Somebody pointing at Cam.

Laura (5:55) These kids have no plausible deniability. They have none. It's like, you know, they think they can get away with stuff, and you're like, nope. You put it on your socials. Like, sorry. Busted. It's like you idiots.

Scott Benner (6:07) My wife asked me one time. She's like, if you murdered somebody, she's like, would you ever stop saying you didn't do it? I was like, it'd be the last thing I said in the electric chair. Wasn't me. You got the wrong guy. Yeah.

Laura (6:16) Right. Exactly. There'd be no evidence. Right? Because we're like, we just didn't have to deal with that stuff. So yeah. So I definitely identify with that.

Scott Benner (6:25) I'm a couple years older than you, but I'm your age. And it's funny because to bring it back to the podcast for a minute, people call me direct. And, Laura, I don't know what they're talking about. Somebody will say, like, you're very direct. And I'll think, like, what does that mean? I can't wrap my head around why they would see me differently than they see themselves.

Laura (6:47) That is interesting.

Scott Benner (6:48) Yeah. Because I think I'm just so accustomed to living in the world where, you know, where everyone says what they think and you can agree with them or not. And, you know, and

Laura (6:57) Exactly.

Scott Benner (6:59) And if you don't agree with them, you just kinda quietly call them an asshole with your friends and never talk to them again. You don't have to go make sure the world knows they're wrong. You just go, oh, that guy's an asshole, and that's the end of it. And then people think that of me, I would assume. And I go, okay. When I met my wife I'm sorry. I promise we'll get the diabetes. When I met my wife mean, we've been married for a very long time now. Like, I think Mhmm. I think. I shouldn't say I think. I know for sure we'll be married this summer for thirty years.

Laura (7:25) Congratulations.

Scott Benner (7:26) Oh, thank you. She just didn't leave me because she wanted the kids to look the same. And then eventually, she was like, There's so much stuff in this house. Like, how could I move it all out? You know what I mean?

Laura (7:37) Right.

Scott Benner (7:38) When I met her, she had grown up like she's Catholic and kinda told to be quiet, like that kind of thing. Like, she you're not running around telling people. And one day, we're not dating for very long, maybe a year. And she says to me, not everyone likes you. And I said, right. She goes, does that bother you? And I swear, I said, it would bother me if everyone liked me. Yeah. I don't know. What would I be then? Like, just this kind of milk toast thing that is okay for everybody? And then, going down, you know, that rabbit hole a little bit, she started pointing out different people. And I said, well, that person over there, that person doesn't like me at all. And she's like, I know and that doesn't bother you. I said, what do you think of that person? And she said, well, he's kind of a, you know, a dick. And I was like, yeah. I said, then what would it say about me if he liked me? I was like, you don't need everybody to like you, and you shouldn't even want everyone to like you. And I and I kinda translated that into this podcast too because there are plenty of people I'm sure that have listened to this and been like, oh my god. What a horrible person. And and and plenty of people who and I have a note from this morning that if I write it to you, you and I would start crying together. Do you know what I mean? Like, it's it's just been so impactful for someone. Anyway, I appreciate that attitude of, this is who I am, and here's how I And you can like it or not, and it's cool with me, but I'm not gonna spend any time helping you parse your feelings about me. So cool. Yeah.

Laura (9:09) Why give people the power over you? Right? If they don't like that's their problem, and it's never my husband always says, you have more self confidence than anybody ever I've ever met. Because I don't take stuff like that personal. It's like, why?

Scott Benner (9:25) Yeah. No. I don't either.

Laura (9:26) Why would I let someone else make me feel bad? I can do that all on my own if I want to, You know?

Self-Confidence and Gender in Advocacy

Scott Benner (9:32) I was on a panel the other day talking to about 75 women about how to advocate for themselves in a health situation in the hospital. I said to them at some point, I said, if I could just give all of you just a little bit of my narcissism, I said, I think you'd be fine. But I don't mean narcissism, like, in a, like Yeah. What would they say now, like, a toxic way. I have an insane amount of confidence in myself. Yep. And in places where I don't you know, listen. I'm sure I overvalue myself in some places, but there's also places where I know I don't measure up, and I just say, okay. I'm not very good at that, or I I don't understand that part. And you're right. I've never once thought of that as a judgment about myself.

Laura (10:16) And I think you're right about women in particular, especially when they're advocating for themselves. They have a tendency we're sort of trained from the time we're little to be nice and to be polite. And instead of being firm and just stating what you believe, it's really easy for women to feel like they can't be assertive and not in a douchebaggy way. If you advocate for yourself, people are like, she's a bit. Instead of if a man said the exact same thing

Scott Benner (10:43) Yeah. They're confident or they're sticking up for themselves or something. And, know, it's funny because I think that's fairly obvious. And at the same time, said so many times, people could hear it and think like, oh, yeah. Sure. That's a thing people say now. But there's some predictors in business, for example. You know, you ask somebody to do something, and a qualified woman will decline thinking they're not qualified enough. And a man who's unqualified and realizes they're unqualified will leap forward and and say, do it.

Laura (11:12) Yeah. You know? They'll fake it till they make it. Yeah. Enough women don't always do that. Here's an advocacy one that I used to do. So I used to, when I worked for the ADA, do these state advocacy presentations in the states that I covered for parents of kids with diabetes. And I would talk to them about what their five zero four rights were and what their rights were in schools and how to advocate. And in the school system and I don't care what state it was in, it could be Washington state, it could be Idaho, it could be New Mexico, didn't matter the state. In a lot of situations, school districts would assume that the mom was crazy because the mom would be emotional. This is her child. This is her baby. She's they've got type one diabetes. They're trying to figure things out. They're newly diagnosed or they don't know, and nobody in their family's ever had type one diabetes. Right? It's very traumatic. And sometimes women were a little more emotional sometimes, and they might start to cry. Well, as soon as a mom gets emotional and has a conflict with the school, they just write her off. And I used to tell people in my advocacy presentations, and this was not ADA station, but I would tell them this. If you have to, just bring a man. Even if the man is your bartender, your dad, your hairdresser, it doesn't matter. You put a man in that room. If the school has, like, labeled you as just an emotional mom, they'll take you more seriously. I also used to tell moms and parents in these advocacy trainings I would do, send the email, the same one that you sent, but from your husband's email address and let me know if you get a better response. Every single time, they would. Every single time. If they sent it from their husband's, like, work address or their husband's email address, and they put their husband's name on it, even if they wrote it, even if it was the exact same thing, they would get a better response from the school principal or the five zero four coordinator than if it was from them.

Scott Benner (13:05) And would it matter if the principal, the coordinator, whatever, was male or female?

Omnipod and Eversense Sponsorship

Scott Benner (13:10) 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. My daughter has been wearing an Omnipod every day since she was four years old. 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.

Scott Benner (14:14) Today's episode is sponsored by a long term CGM. It's going to help you to stay on top of your glucose readings, the Eversense three sixty five. I'm talking, of course, about the world's first and only CGM that lasts for one year. One year, one CGM. Are you tired of those other CGMs, The ones that give you all those problems that you didn't expect? Knocking them off, false alerts, not lasting as long as they're supposed to. If you're tired of those constant frustrations, use my link ever since cgm.com/juicebox, to learn more about the Eversense three sixty five. Some of you may be able to experience the Eversense three sixty five for as low as a $199 for a full year. At my link, you'll find those details and can learn about eligibility. Ever since cgm.com/juicebox. Check it out.

Universal Advocacy Truths

Laura (15:08) It really wouldn't. Honestly, it really wouldn't. I would love to say that it did, but it it was just kind of a universal truth. So I I would literally would make that joke at the end of presentations. Like, hey. If you have to, bring your bartender. Bring your hairdresser. Bring your uncle. And you they don't even have to talk in the meeting. Just have a dude in the chair in the meeting with you if you're not getting good results.

Scott Benner (15:31) Laura, I, I'm five nine. I'm not particularly tall. I'm taller than a lot of people I meet during the day, but, know, as soon as you see somebody taller than me, I look fairly short. Right? And then until, I don't know, three years ago when I found a GLP medication, I was overweight. But I have a deep voice, so I would try very hard to do business over the phone because over the phone, people took me more seriously. Isn't that interesting? I bought a car over the phone once because I knew I could negotiate the price better if they couldn't see me. When my son was trying to find a place to play baseball in college, after the first time of doing something in person, I realized that they couldn't meet me until they liked him because they'd look at me and then judge him. It was really like Interesting. Yeah. I I take your point about what you're talking about. People have baked in preconceptions. I don't think they're conscious even.

Laura (16:33) No. Probably not.

Scott Benner (16:35) And by the way, I've also given that same advice to people for probably over a decade now. I tell them all the time, like, when you find yourself explaining type one diabetes to a stranger, an outsider to diabetes, right You sound insane even when you're not. Right? Because there's so much to know and worry about and think about and preplan for. Yeah. You sound like a bipolar prepper when you're talking about diabetes. Like, there's no way two ways around it. Right? Yeah. And then if you are actually emotional on top of all that, then you really do. You sound nuts. You know, you can't let them go out on the playground by themselves without checking their blood sugar first, you know, thinking about what I've said to people prior to CGMs, like, she's gonna die out there. And they'd be like Right. What? There's been kids with type one diabetes here before. And said, well, those kids a one c's were higher, and they were keeping their blood sugars high, but we're not gonna do that. And then they go, why don't you just leave their blood sugars higher? Then I'm why didn't we and then, you know, now that road. And if you're not calm and and measured, boy, it's it'd be super simple for someone to write you off quickly. So yeah. Yeah.

Diagnosis and Family History

Scott Benner (17:42) Well, okay. So you get type let's we're gonna kinda go backwards to go forwards. But you're 25 and you're diagnosed. Is there type one in your family at the time or other autoimmune?

Laura (17:53) Yeah. So my father had type one diabetes. Oh. And so I grew up watching him use the sticks to figure out what his blood sugar was and all of that. And it was actually kinda cool having my dad have type one diabetes because when he thought he needed it, we'd go to Dairy Queen. And it was like, yes. Ice cream. So, like, type one diabetes was not necessarily this, like, horrible thing in my family. Mhmm. My mom was a registered nurse, and what was interesting was that when my parents went to go have kids, the doctors told them not to have kids because they would probably have a kid with type one diabetes. And my mom said, screw you, basically. And they had two, my sister and I. I'm the oldest. And when I got diagnosed at 25, I found out that my father got diagnosed at basically the same age, 24. And then his half brother also got diagnosed about the same age. So for whatever reason in my family, that's kind of the trigger point. Now I personally think knowing what I know now, I probably should have been diagnosed when I went off to college because I remember doing my college health paperwork or whatever. Like, I'm 18. I'm headed off to school. You do your last physical and all that stuff. Mhmm. And my fasting blood glucose at that point was one twenty three, which now that would have flagged something, but I very clearly remember the pediatrician that I saw, and my mother was in the appointment with me at the time. He said, you can't get diabetes now because they just didn't know. Right? Because that was, like, 1991 when I was going off to college.

Scott Benner (19:38) That doctor was saying that at your age, you couldn't get type one diabetes?

Laura (19:42) Yep. Yep. And they just didn't know. Right? And so, you know, you're like, okay. Fine. But yeah. So my father had type one diabetes. You know? We dealt with when he was low, bring him a Coke, whatever. But once I got diagnosed and I realized how different his diabetes management was compared to what mine was gonna be starting in 1999, like, that was just shocking to realize that he was working on old data. It's amazing that people now we have so much better technology even from when I was diagnosed twenty five years ago. You know? I was on NPH and regular, and talk about having to have snacks and all kinds of BS to carry with you and all these things. Right? It's just a completely different world. We're very lucky with the technology that we have now, but I feel, like, very blessed to have had a parent who had it. Like, if one of us would get a paper cut, we would joke. Quick. Check your blood sugar. Right? Don't waste it. Don't waste you know, like, you gotta have a sense of humor about it.

Scott Benner (20:45) I'm thinking these CGMs are gonna put Dairy Queen out of business.

Laura (20:49) I don't know. Because you know what? But one of the things is, I mean, I do like my treats, and that's why I go to Orangetheory and workout. So I can do that and drink wine. But I think you just got a carb for it. That's that's the key.

Scott Benner (21:00) Oh, no. I'm dad got low and went to Dairy Queen. Now all these people have CGMs are probably not getting low anymore. What's gonna happen to Dairy Queen?

Laura (21:09) Yeah. It's more of a choice now. Right? It's a choice to go to Dairy Queen. You gotta factor it in.

Modernizing Care for the Next Generation

Scott Benner (21:14) Okay. So you're diagnosed. You noticed the difference between you and your dad. Does this help your father modernize his care?

Laura (21:23) Okay. So that is exactly what happened. So he was not on even Lantus at the time or a fast acting insulin. Like, he didn't have the ability to adjust for what he was eating. There was no carb to insulin ratio. None of that.

Scott Benner (21:39) Wait. I'm sorry. In '99, your dad's doing NPH and regular still?

Laura (21:43) NPH and regular. Yeah. So he wasn't even on Lantus or anything. And I remember being like, what the heck? Because I at least had a sliding scale Mhmm. And was on Lantus after After about six months, I got on Lantus since maybe it a little bit longer. But I was a patient at the University of Washington in Seattle, and I was a patient there. And their diabetes endocrinology center is fantastic. I had gotten to know doctor Earl Hirsch because of working at the ADA and then being a patient there. And my father had definitely not been treated well in his endocrinology that he was seeing in Oregon. Mhmm. They weren't, like, trying to get him to modern care and and up to standards. And my father got diagnosed with a rare kind of, tumor on his adrenal glands. It is autoimmune kind of genetic tumor, but my sister and I got tested. We don't have that, which was nice. You know? One autoimmune is great.

Scott Benner (22:47) I might have the word is it pheochromocytoma? Or is that it? I don't am I using the wrong words?

Laura (22:53) Don't remember what it was called. Okay. But I remember they tested us because they said it was genetic. But while he was there and then going in, I kept talking to my dad. Was like, you need to have a sliding scale. You need of options because he would just take the same thing every day. And I I called it the rule of sevens. No matter what, he always just, like, took seven units. Right? And his doctor wouldn't do anything. And I got frustrated because I tried to advocate for my dad with his endocrinologist that was in Oregon. And so I was telling Earl this one day, and I said, hey. I'm gonna give my dad your book because he had a book about and it had all this, like, data and why. And my dad was an analytical business guy, and he was data minded, and he was really smart. But his doctor just wouldn't give him the information needed the way that it would work for my dad. So I gave him Earl's book, and then he was like, oh, that makes sense. So then he went to his doctor and asked for it, and his doctor still said no. So god bless Earl Hershey. I told him that. He called my dad's endocrinologist and said, look. This guy can handle and do it. I don't know. I'm not privy to that conversation. This was a while ago. My dad passed away about twelve years ago. But he did that. And when my dad had his surgery for his adrenal glands, his endocrinologist came out into the waiting room where my sister and my mom and I were waiting at Kaiser Hospital in Oregon. And he wasn't very happy because he goes, yeah. Earl Hirsch called me about your dad. We'll get him on that. And then what was so funny is this after his surgery, they got him on Lantus and more of a sliding scale with Humalog. And my dad's a one c was never above 7.5 the rest of his life.

Scott Benner (24:30) Awesome. Oh, that's amazing. By the way, I blurted out the name of a tumor, but that's an adrenal gland tumor just in case. I don't want people or my dad was an adrenal gland tumor. Oh, it was. So it might have been that. It was on his adrenal glands. Yeah. So that might be it. Thiachromocytoma. Maybe. Anyway okay. Well, that's awesome. By the way, very common to type ones, I would say, especially men whose children are later diagnosed, they often upgrade their care. It's a fairly common story that I've heard. Do you have any other autoimmune?

Laura (25:32) I don't. Luckily, knock on wood, I do not.

Scott Benner (25:35) How about your sister?

Laura (25:37) She does not either, and she was tested as part of, like, the type one testing to see if she carried the gene. She seems to be okay, so that's good. Anything else, though, like thyroid, celiac, anything like that? Well, so my sister does have some thyroid issues. I do not. Mhmm. But she doesn't have, like, Hashimoto's or anything.

Scott Benner (25:58) But she's taking Synthroid? Good. I'm not sure, honestly, if she's taking Synthroid or not. You're in your fifties. I don't know if you're chatting with each other about everything all the time.

Laura (26:11) Yeah. I mean, we talk almost every day. But we're pretty lucky that way. But I don't know. I'll have to ask her after this is over Mhmm. Just for curiosity's sake.

Genetic Roots and Nordic Heritage

Scott Benner (26:21) And then my last little backwards question before we move forward is your dad's half brother on his mom's or his dad's side?

Laura (26:28) It is on mom's side. So it was my dad's mother. What's interesting, and I don't know if this is scientifically proven or not, but I do know that some of the highest concentration of people with type one diabetes is in, like, the Nordic cultures Mhmm. And, like Sweden, Norway. And my dad's mom's family was very Swedish. When I was growing up, my mom used to yell at my dad sometimes and say he was a stubborn Swede and was always told we were Swedish. I'm actually blonde in five eleven, so I kinda have that Viking look, I guess, a little bit. But I always thought that was interesting that that sort of rang true that we had type one diabetes a little bit.

Scott Benner (27:12) Yeah. I see it when I interview people, like, Nordic backgrounds, Irish, is another one where I see the Irish English Yep. Like, there. Even Nordic people kind of immigrated towards Minnesota and Wisconsin and everything, and there's clusters there of diabetes. Yep. Yeah. No. I I think it's fairly common. So it's on my mom's my grandma's on my dad's side. So it's mom. Yep. Now you get this job with the ADA. And is it overwhelmingly a positive experience, it sounds like?

Laura (27:45) For me, yes. I loved working at the ADA. It was really good. I mean, you know, at the end of the day, a job's a job, and there's always gonna parts of each job that Are frustrating or great. But I had a great twenty five years, met some great people, passed some great legislation to protect people's rights in schools and jobs, access to health care, things like that during my advocacy time.

Scott Benner (28:08) I was gonna say, what things do you think you saw better for people while you were there?

Laura (28:13) So pass a lot of, school legislation and did some discrimination for kids in schools to a certain extent. By passing the laws, I think, you know, there's still a lot of work to be done. And, unfortunately, in advocacy, I think one of the things that is frustrating for me as a person living with type one diabetes is that things are sort of going backwards in terms of protections, cost, health insurance access, the way they can defray costs, all of those things. So that is sad and frustrating. Pick something specific you think is going backwards.

The Current State of Health Protections

Laura (28:52) Okay. I'll give you something specific. Yeah. With the Department of Education federally making changes and, you know, trying to get rid of some of the protections that all kids with disabilities have in schools, that's gonna be hard. Right? Because I remember when I was a state advocacy director, and I would get calls and people wouldn't allow their kids with diabetes to play basketball because they'd have to go on a bus. And they said no one else could help them or assist them, and that's kinda scary, I think, for kids with disabilities of all kinds, some of the rollbacks and the protections they're putting in place. And, you know, they get calls and say things like, your kid is too smart. They don't need a five zero four plan, or they don't need protections. Well, the reason why they need those protections is so that they can continue to excel at school. Right? Like, you need protections in place. And so some of those kinds of things, I think, are getting rolled back from the federal level, and that sucks. From a health insurance perspective, I have been trained on diabetes advocacy. I know what to do. I used to train people on how to pick a health insurance plan in the exchange, what to look for, all of the things. And I got screwed this year, and I'm pissed about it, quite frankly, because I did everything right.

Scott Benner (30:08) Yeah. Yeah. This is actually why you're on. So I feel like I don't know if you realize, like, I got your whole backstory and we had some fun, now I'm just lighting a fuse and I'm gonna let you explode.

Laura (30:17) Fair enough. Yeah. This is why you wanted to come on the podcast. So lay it out for people. Yeah. So I know what I'm doing. I was a diabetes advocate for twenty years, and I trained people. I fought health insurance at the state level. I went to congress, taught advocates how to advocate for themselves. I did all the things. I'm a trained professional, and I was looking at the exchange. I had to buy an exchange this year. Mhmm. I did everything right. And so I wanted to come on to share my story so that, one, people know they're not alone. Two, kinda share so we can commiserate together, but also so that people know what to keep doing. So I went to the exchange this year, and I looked. And I had a great plan last year. My plan last year was a Aetna banner plan in the state of Arizona, and it was awesome. It covered my insulin pods. I'm on the Omnipod Mhmm. At $40 a co pay, covered my insulin, all the things. Great plan. Loved it. All the things. So they pulled out of the Arizona exchange because, obviously, things are changing. Subsidies are changing, and so they decided not to have any plans. So I get a letter that says the comparable plan now in Arizona is this Ambetter Arizona Complete plan. And I never take that stuff for face value. I know as a consumer, you have to do your due diligence. So I did. I looked at the other plans. I looked at who covers my endocrinologist, all of the things. Right? The hospitals I wanna go to, the specialists. And then I went on Ambetter's website, and I pulled their PDL, which is their list of all the medications and what tiers they cover them under and and what are the rules. And I searched for insulin. I search for insulin pumps. I search for continuous glucose monitors. I search for CGMs. I search for type one diabetes. Nothing came up. Nothing came up. And I was like, okay. So because they don't have any of those categories, and I read through that, you know, several page document Mhmm. That must mean they cover those things. Right? So then I call Ambetter, and I talked to one of their like, if you're not buying through the exchange, you're just asking them questions, the people who sell you their plans. Do you cover type one diabetes, insulin pods, and CGMs? And they all said yes. I was like, great. Then I went on the World Wide Web, and I used AI, ChatGPT, and Copilot, and I searched. And I said, does Ambetter cover insulin pods and pumps and CGMs for people with type one diabetes? Everything said yes. K?

The Insurance Nightmare: Denials and Dead Ends

Laura (33:05) Then I also saw that they have these diabetes plans, then they cover these things. Right? And they covered my endocrinologist office, which is like a stand alone endocrinology office in the Scottsdale area. And so I was like, okay. All the signs are there. Right? It's all good news. All good news. Yep. And I tell my husband. I was like, okay. I can't guarantee this is the plan, but based on everything, this is what I know. And what I also know is that when you have a chronic disease, like type one diabetes, type two diabetes, any other kind of chronic disease, if you can, you should buy, like, a silver or a gold plan or higher because the cost sharing and things like that are gonna be better, and your prescription drug coverage are gonna be better. You're usually better off to pay a little bit more monthly than to have these, like, high deductible, low monthly costs because it works better if you're

Scott Benner (33:59) You need your insurance. You're gonna be using your insurance. Right.

Laura (34:02) Yeah. Yeah. Yeah. And so I picked a a silver plan. And nowhere on there does it say like, I don't even need referrals for my Ambetter Arizona Complete silver plan. I don't even need referrals. Okay? I picked a solid plan, but it had a $5,000 deductible. And then anything after that was 40% coinsurance, but nowhere on their website does it say they don't cover insulin pumps. So my endocrinologist fills out at the January the prior authorization for my CGM and my insulin pods, and they get denied. And the reason they got denied was because they said it wasn't medically necessary. K? That was the reason I was told Okay. By Ambetter that an insulin pump was not medically necessary. The only reason why I knew that is because I called them and asked. You can't just sit around and wait. You have to call. Yeah. K? You have to call and you have to ask. So I called and asked, like, what's going on? Because on their website, they have this section where they tell you if your claims have been denied or if they're pending or whatever in my account, but it doesn't tell you anything. It's just numbers. So you have no idea what that pending denial whatever means. Mhmm. Only the numbers. And there's no grid or anything, and you can't click on it to get more detail. It's just numbers up there. So, anyway, I was like, why aren't my pods coming through? Right? And it said they were denied when I called. And I was like, why? And they said it wasn't medically necessary. And I was like, what do you mean not medically necessary? I have type one diabetes. I'm gonna have type one diabetes for my whole life. Right? This isn't something I can control in terms of if I have it or not. And so I kinda lit up the customer service people. Now I was very direct. I was very frustrated, but I always thank them for their time and told them I know this is not your fault. This is a systemic company problem and not a them problem, but I was very direct. And they said, well, it was because they only gave three months of blood glucose information. Well, first of all, have type one diabetes. Why would you need more than three months if my endocrinologist says I need this? Like, that's ridiculous, but okay. We're gonna play the paperwork game. I go back to my endocrinology office. I ask them to resubmit. They do. K? I give it three, four days. I call them back, the Ambetter. And they go, well, your account was closed. I go, excuse me? Your appeal was closed. And at this point, I am just livid. Okay? Livid. And they go, your account's closed. And I go, what do you mean you close it? And they go, well, because they sent in the six months of data on the wrong form. And I was like, what? And there's nothing in my account online that says this. They didn't mail me a letter. And I asked them. I was like, did you tell my endocrinology office that you closed my appeal because they sent it on the wrong form? Well, no. Do you even understand type one honestly, even though I'm a trained professional and I would consider myself pretty tough, like, I'm not a quitter by any means, and clearly, I'm not because I'm still talking about this.

Scott Benner (37:30) A lot, though. Right? Like, you're

Laura (37:31) It is a lot. And I started crying. I started crying because I was so mad at myself. Right? I was so frustrated, and they so didn't understand what type one diabetes was. These people, even in their pharmacy that I'm talking to about this appeal Right. And they're not taking it seriously, that I started crying. And I get off the phone, and my husband's like, don't cry. You never cry. I don't like to see you cry. And I was like, know, but I just feel like an idiot.

Scott Benner (37:54) Did you say I should have brought my bartender with me? This would have went better.

Laura (37:57) Exactly. Seriously. Right? So then I go back to my endocrinology office, and I say, hey. I'm sorry to bother you, but I need you guys to resubmit. They need six months of data. So they go back, then they resubmit it again. Nothing happens. So then I call up a few days later. They said they never got anything. I was like, what do you mean? I mean, I'm going through all the paces. I've talked to so many people. It's ridiculous. So now we're at, like, the February. So it's been a month, and I don't have any insulin pods unless I pay out of pocket, which I did. I did call Omnipod. Shout out to Omnipod. Best customer service in the world. They've called to check-in on me to see how I'm doing. They have tried to help me and give me advice. They actually sent me a couple free pods here and there to get me so that I didn't have to spend quite as much money out of pocket, and they do have, like, a co pay card. They have a co pay card if you have insurance for secondary insurance. Mhmm. They've been great. So just know that if anybody's got the pod. Fantastic customer service.

Scott Benner (39:03) Omnipod.com/juicebox if you'd like to get started today. Okay.

Laura (39:07) Well, there you go. Highly recommend. So I'm dealing with all this, trying to keep this going. Just I get them on the February to send the right form because they sent it on the wrong form, I guess, the six months that they needed or whatever on the wrong form. They fax it to my endocrinologist's office, they said to me. So then I check-in the following week, which is so we're now at the February, and they said they didn't get it. I reach out to my endocrinology office, and they say, no. We sent it. We sent the information. So I called back the next day. They said they didn't get it. I was like, how is this possible? How is this possible? Like, I don't know. We didn't get it. We didn't get it. So then last week, I reached back out to my endocrinologist. I'd say, hey. They didn't get your forms. They said they're gonna fax you a new form. Friday, my endocrinologist, this is the February 13, says, yeah. We'll resend it. So then last week, same thing. They still don't have it. They didn't get it. They resent the form. I'm talking to my endocrinology office. So we're talking multiple time I'm wasting with their customer service, with their pharmacy people, you know, my own time, my endocrinology's office time. Finally, Monday of this week, they say they got the actual form, a new form or whatever, and they sent it in. And I said, hey. Just to confirm, is this the first time you've sent this information in? And they said, no. They have done this several times and that my second appeal was denied. I was like and they didn't even tell me that at Ambetter. Yeah. Like, it is horrible. And I was so frustrated when I was talking to the Ambetter people the last time. I was like, okay. If you don't like people with type one diabetes, just put it on your damn website. Just be honest. Just put it on there.

The Reality of Out-of-Pocket Costs

Scott Benner (40:57) I talked to you, and I'll have to tell you when I'm done. I am not better when I speak to you. Exactly. It's true. It's true. The rigmarole is set up to try to get you to to give Yeah.

Laura (41:11) Yep. Yeah. And if you don't dog them and call them and call them, that's how people give up. That's how people spend all this money out of pocket. And here is the most insane part of this. Besides the fact that they're supposed to cover this and probably eventually they will, I hope, but they don't cover your insulin comps or your CGM until you've met your deductible and you pay your max out of pocket. So even if they were approved this today, okay Or tomorrow or next week or whatever, even though it's been two months in, so they've gotten away with two months of not having to pay for my insulin pumps at all. They're going to have to charge me now 40% coinsurance. Because I was able to switch my plan to a no deductible plan because my income has changed because I'm no longer working right now. So my income changed. So I could go into the exchange and change my plan. That was really nice. I'm very lucky I could do that. Otherwise, I would have had to have reached $5,000 out of pocket and then pay 40% coinsurance. So in this plan, I pay no out of pocket, and I still have to pay 40% coinsurance. So even when they approve it, I'm still paying 40 which is several $100 For a month's worth of insulin pods. Right? And then once I get my max out of pocket, then they'll start covering it instead of just offering it as a co pay. That is ridiculous. And I was like, I was so frustrated. I was like, you also could put a statement on your plan about how you cover type one diabetes, how you cover insulin, how you cover insulin pods. And shout out to CVS because those pharmacists, like, they have been trying to help me so much, find me copay cards, find me things with CGMs. Yeah. They also won't pay for my Dexcom because you have to use the Libre. I'm not saying the Libre is not a great product, but it's not the same. The Dexcom, I'm on the g seven fifteen. I can bolus from my phone. It's one less thing that I have to carry around. And I'm already carrying around goo for low blood sugars and granola bars and extra diabetes supplies as backup.

Scott Benner (43:25) Wait. I'm sorry. Are you saying because you're on Omnipod five?

Laura (43:28) Yeah.

Scott Benner (43:30) Well, how would they possibly be tell you that Omnipod five's okay, but the CGM that makes it work is not okay? 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. The conversation you just heard was sponsored by Touched by Type One. Check them out, please, at touchedbytype1.org, on Instagram, and Facebook. You're gonna love them. I love them. They're helping so many people at touchedbytype1.org.

Podcast Support and Community

Scott Benner (44:13) Are you tired of getting a rash from your CGM adhesive? Give the Eversense three sixty five a try. Eversensecgm.com/juicebox. Beautiful silicone that they use. It changes every day. It keeps it fresh. Not only that, you only have to change the sensor once a year. So, I mean, that's better. 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. 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. Alright. Let's get down to it. You want the management stuff from the podcast. You don't care about all this chitting and chatting with other people. Juiceboxpodcast.com/lists. They are downloadable, easy to read, every series, every episode. They're all numbered. Makes it super simple for you to go right into that search feature. In your audio app, type juice box one seven nine five to find episode one seven nine five. Juiceboxpodcast.com/lists. If 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. Have a podcast? Want it to sound fantastic? Wrongwayrecording.com.

READ FULL TRANSCRIPT

#1823 Bolus 4 - Salmon Dinner

Scott and Jenny Bolus 4 salmon and the rest.

Proudly supported by

Key Takeaways

• The "Meal Bolt" Strategy: This structured approach to bolusing stands for Measure the meal, Evaluate yourself, Add the base units, Layer a correction, Build the bolus shape, Offset the timing, Look at the CGM, and Tweak for next time.
• Protein and Fat Matter: High-protein and high-fat meals (like salmon and olive oil-cooked vegetables) require insulin. These macros can be calculated as equivalent carbohydrates using Fat Protein Units (FPUs).
• Extend the Bolus: Because fat and protein digest slowly, insulin meant to cover them should be delivered as an extended bolus (often over 4 to 5 hours) to match the delayed blood sugar rise.
• Meal Sequencing: Changing the order of what you eat—starting with vegetables, moving to protein, and finishing with carbohydrates—can sometimes reduce or completely eliminate the need for a pre-bolus.
• Leveraging Technology: Tools like AI and online calculators can quickly synthesize complex nutritional data (like the Warsaw Method) to suggest actionable bolusing strategies, helping ease the cognitive load of managing Type 1 diabetes.

Resources Mentioned

• Meal Bolt Info: juiceboxpodcast.com/meal-bolt
• Warsaw Method Calculator (Wurcal): juiceboxpodcast.com/warcal
• Omnipod 5: omnipod.com/juicebox
• Contour Next Gen Meter: contournext.com/juicebox
• Paprika Recipe Manager App
• Wrong Way Recording: wrongwayrecording.com

FULL EPISODE TRANSCRIPT

Introduction to Meal Bolt

Scott Benner (0:0)

Here we are back together again, friends, for 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. We want you to hear how we think about it, but we also would like you to know that this is kind of the pathway we're considering while we're talking about it. So while you might not hear us say every letter of Mielbolt 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. While you're listening, please remember that nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan or becoming bold with insulin.

Sponsor Messages

Scott Benner (1:30)

A huge thanks to my longest sponsor, Omnipod. Check out the Omnipod five now with my link, omnipod.com/juicebox. You may be eligible for a free starter kit, a free Omnipod five starter kit at my link. Go check it out. Omnipod.com/juicebox. Terms and conditions apply. Full terms and conditions can be found at omnipod.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 contournext.com/juicebox.

Building a Healthy Meal

Scott Benner (2:13)

Jenny, I mentioned, I think, the time or two before that we recorded that somebody asked me, are we gonna do anything healthy in these bolus four episodes? So I and I remarked then, and I'll tell you again. We went out to the community. I asked what you wanna hear about bolusing for. We're just doing the list. You know? I didn't sit around and think, oh, Cinnabons. I haven't had a Cinnabon in twenty years. So but I wanna do a meal, like, one healthy meal right now.

Jenny Smith (2:40)

Okay.

Scott Benner (2:41)

So I'm gonna let you build the meal. And then, like so if you were putting together a dinner for people tonight, would you do salmon? Would you do chicken? Like, what would you do? What would you put with it?

Jenny Smith (2:52)

Sure. Oh my gosh. A healthy meal. Salmon, definitely. We We do a lot of seafood. So salmon, grilled salmon, And I really like, let's say, a grilled asparagus.

Scott Benner (3:14)

Okay. For grilled salmon.

Jenny Smith (3:19)

And, like, either a baked or a grilled, like, something yummy. We're gonna go

Scott Benner (3:24)

piece by piece as we build the meal out. Okay? So, when tracking grilled salmon, the nutritional value varies slightly depending on whether it is wild caught, leaner, and high protein or farmed. Isn't that interesting? Mhmm. Do you buy one specifically?

Jenny Smith (3:39)

I do not buy farmed ever. Any kind of farmed fish, I do not buy. Again, totally personal preference, but the farmed often if you look at the packaging, it will have color added, especially for salmon. Mhmm. And most often, the farmed fish, not just salmon, but the farmed fish, the nutrient quality is just not there comparative to the wild Ain't that interesting? Caught.

Scott Benner (4:05)

See, look at us. By doing it like this, I learn things. Six ounces is a serving, or you think it should be more or less?

Jenny Smith (4:13)

A typical I mean, if we're talking about a serving of what people eat, their portion, or a serving in designating, like, what a serving should be, serving is about three ounces.

Scott Benner (4:26)

Okay.

Jenny Smith (4:26)

But nobody eats just three ounces. Usually, a portion is about six, so that was a good estimate.

Scott Benner (4:32)

Awesome. Okay. So here's what we're gonna learn right now by grilling the fillet. Calories, 265 k cals, 45 grams of protein, nine and a half grams of fat, no carbs. Cholesterol, 104. Sodium, 156. That is a pretty balanced thing. Okay. So we're going to keep that there. There's no carbs yet. But is there bolusing to be done for salmon, you think?

Jenny Smith (4:58)

If it's and that's why I brought up portion versus serving. Right? A typical serving of any kind of protein's about three ounces as as designated by whoever designated that as the serving size eons ago, whatever. So anything more than that, and I usually explain it by, like, the size of the palm of a hand's about three ounces ish once it's cooked. So anything larger than that, yes, to answer your question. We're going to need in need insulin in order to cover the rise up later.

Scott Benner (5:30)

K.

Jenny Smith (5:30)

So salmon or any kind of protein like that isn't gonna be an immediate effect. It's not it's gonna not gonna be the like eating grapes, for example. But you will need something to cover the larger portion of protein over time.

Scott Benner (5:44)

Did you say grilled broccoli? Did you say broccoli?

Jenny Smith (5:47)

Oh, well, I like broccoli too. I said asparagus. Said asparagus? Almost done. Different.

Scott Benner (5:51)

Aspergeras. I know how to spell it because of that. And what do you cook it with? Just the olive oil, or how do you grill it?

Jenny Smith (6:00)

Yeah. I usually put a little bit of olive oil. Like, if it's in the oven outside in the, you know, summertime, it's just on the grill. Mhmm. But in the wintertime or whatever, in the oven just baking it, I usually use a little bit of olive oil in the pan.

Scott Benner (6:14)

Okay. Here we go. Grilled asparagus breakdown. I put EVO on there because I'm super, super, hip. Calories. Let's see. Serving.

Jenny Smith (6:24)

Good job with the acronym.

Scott Benner (6:25)

Thank you. Grilled asparagus with extra virgin olive oil is a nutrition powerhouse. The addition of healthy fats in the oil is actually beneficial here. So six to eight spears or one cup, 55 to 70 calories, four and a half grams of fat, three grams of protein, five grams of carbs. Mhmm. Okay. So now we have five carbs. Let me get a piece of paper. Is that okay?

Jenny Smith (6:48)

Yeah. You have to do all your math adding it all together. Right?

Scott Benner (6:51)

So far, got zero and five for the for the carbs.

Jenny Smith (6:55)

Just for the carbs. Yep. Did you wanna do all the macros for each of them to add them all together by the end?

Scott Benner (7:01)

Can you do that?

Jenny Smith (7:03)

You should be able to. I mean, if you're doing, you know, salmon while you have zero carbs, you do have a fair amount of protein.

Scott Benner (7:10)

Okay. So

Jenny Smith (7:11)

And they're in that portion should also be a certain amount of fat.

Scott Benner (7:16)

Alright. So let's do that. And then actually, I know what to do. Don't worry. Okay. What else are we gonna put with the food? Jenny's done eating already. She's like, that's enough. I'm good. Yeah. But what what what do you think, an average person would put? You think they put a piece of bread with it? Do you think they would do another vegetable?

Jenny Smith (7:37)

I think some people would do another vegetable, maybe like a side salad. But if they do want a true carbohydrate with it, they might add let's try, like, the little fingerling potatoes.

Scott Benner (7:49)

Oh, good job.

Jenny Smith (7:51)

Just for fun.

Scott Benner (7:54)

You caught Jenny on her on her anniversary out to eat. She's like, I'll take a potato too. I

Jenny Smith (7:59)

sent you a picture actually from our anniversary, didn't I?

Scott Benner (8:02)

That's what made me think of it. Because when I looked at it, I was like, this is exciting for Jenny, this plate.

Jenny Smith (8:07)

It was very, very yummy. Yeah.

Scott Benner (8:09)

I thought I thought I thought for sure. Four ounces of potatoes, three to five, small potatoes grilled with a teaspoon of extra virgin olive oil, 4.8 grams of fat, 125 to 140 calories, 2.5 protein, 22 carbs, sodium 10. Okay. So now what I'm gonna tell it to do is Go ahead.

Jenny Smith (8:31)

And I like that that portion shows that things like a potato do not have to be a steakhouse baked potato that's the size of, like, a basketball player's hand. Mhmm. Like, there's there's no reason you have to eat that much potato to enjoy a potato.

Scott Benner (8:51)

I love that you're now horrified. You're like, why 22 carbs of potatoes? Why couldn't it be

Jenny Smith (8:55)

two twenty two grams is a lovely little portion of these these little potatoes, and it's not gigantic.

Using AI and the Warsaw Calculator

Scott Benner (9:02)

Okay. And I am all I'm telling you to do is I said combine these three items and create a bolus based on and I'm dropping in the link to juiceboxpodcast.com/warcal,warcal Yep. The Warsaw calculator.

Jenny Smith (9:19)

That's gonna use the FPUs Yep. And everything.

Scott Benner (9:22)

So I show people, like, you don't need to understand all that to have this broken out for you by I'm using, Google Gemini today. The new version, this is pro. So I don't think I pay for it. Do I? I might pay $20 a month for this.

Jenny Smith (9:37)

In Chrome, Gemini becomes like, it's an option right up in the corner. I don't know if the pro is a paid version or not. Mhmm. My Gemini just shows up as Gemini. It doesn't say Gemini pro.

Scott Benner (9:49)

I think I must pay $20 a month for it then. Okay. Contournext.com/juicebox. That's the link you'll use to find out more about the Contour next gen blood glucose meter. When you get there, there's a little bit at the top. You can click right on blood glucose monitoring. I'll do it with you. Go to meters. Click on any of the meters. I'll click on the next gen, and you're gonna get more information. It's easy to use and highly accurate. SmartLight provides a simple understanding of your blood glucose levels. And, of course, with second chance sampling technology, you can save money with fewer wasted test strips. As if all that wasn't enough, the Kontoor Next Gen also has a compatible app for an easy way to share and see your blood glucose results. Kontoornext.com/juicebox. And if you scroll down at that link, you're gonna see things like a buy now button. You could register your meter after you purchase it. Or what is this? Download a coupon. Oh, receive a free contour next gen blood glucose meter? Do tell. Contournext.com/juicebox. Head over there now. Get the same accurate and reliable meter that we use. This episode is brought to you by Omnipod. Would you ever buy a car without test driving it first? That's a big risk to take on a pretty large investment. You wouldn't do that. Right? So why would you do it when it comes to choosing an insulin pump? Most pumps come with a four year lock in period through the DME channel, and you don't even get to try it first. But not Omnipod five. Omnipod five is available exclusively through the pharmacy, which means it doesn't come with a typical four year DME lock in period. Plus, you can get started with a free thirty day trial to be sure it's the right choice for you or your family. My daughter has been wearing an Omnipod every day for seventeen years. Are you ready to give Omnipod five a try? Request your free starter kit today at my link, omnipod.com/juicebox. Terms and conditions apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox. Find my link in the show notes of this podcast player or at juiceboxpodcast.com.

Calculating the Final Bolus Strategy

Scott Benner (12:03)

To create a bolus for this meal using the work, workout the Warsaw Method Calculator from the Juice Box podcast, we must account for both the immediate impact of the carbohydrates and the delayed impact of the fat and protein. So now by giving it that link, let me explain to people what that link has there. You and I have talked about this stuff in a number of different episodes.

Jenny Smith (12:22)

Correct.

Scott Benner (12:23)

I've synthesized all of those conversations into what's on that website describing how to bolus for fat and protein. Plus, there's an actual calculator there that you guys could use, you know, at your own risk, please. There's a disclaimer there that helps you break this bolus out. But this is AI doing it for you. AI even wants you to know that they're not doctor. And this information is based on the podcast, which, by the way, will tell you that I'm not a doctor either. So we're all disclaimered out the butt. Let's keep going. Yes. The nutritional breakdown based on six ounces of wild caught salmon fillet, six to eight asparagus spears, and four ounces of fingerling potatoes, we're looking at 27 total carbs, 22 from the potatoes, five from the asparagus, 19 grams of fat, 10 from the salmon, nine from the vegetables and the olive oil, and the total protein, 50.5 grams. 45 of it is from the salmon, 2.5 from the potatoes, three from the asparagus. You're gonna start feeling bad about going to college in a second. Now it says step one, the bolus for the carbs. So calculate your standard carb dose using your insulin to carb ratio. So we're gonna do one to 10 just so we're gonna we're gonna pit Jenny against AI. Yeah. And to pit it against the AI. Because I'm gonna put you on this to figure this out too on your own.

Jenny Smith (13:42)

Okay.

Scott Benner (13:43)

So 27 carbs, one to 10 ratio.

Jenny Smith (13:45)

Two point seven units just for the carbs.

Scott Benner (13:47)

Yep. And it agrees. Okay. Great. It says that, I would Scott would recommend a pre bolus between fifteen and thirty minutes before eating to ensure the insulin is active when the potatoes begin to digest. It says step two, you can use the Wurcal calculator to figure out your later dose. The Wurcal method converts fat and protein into fat and protein units, FPUs, to calculate on extra extended bolus to calculate an extend extended bolus. Calories from fat, 19 times nine equals a 171 kcals. Calories from protein, 50.5 times four is 202 kcals. Total fat and protein calories, three seventy three kcals. FPU is three seventy three divided by 100 equals 3.73 FPUs.

Jenny Smith (14:38)

Nice.

Scott Benner (14:38)

Okay. The calculation carb equivalent, each one FPU is treated like 10 grams of carbs. So 3.73 FPUs times 10 grams equals 37.3 grams of equivalent carbohydrates. Now that is not a thing anybody would imagine.

Jenny Smith (14:52)

No. And that's from fats and proteins.

Scott Benner (14:54)

Yes. Extra insulin divide the equivalent carbs by your insulin to carb ratio. Example, if your insulin carb ratio is one to 10, you'll need an extra how much for 37.3?

Jenny Smith (15:05)

I'm sorry. Ask it again. My brain was thinking through the whole sorry.

Scott Benner (15:08)

Sorry. 37.3 equivalent carbs at a one to 10 ratio needs how much insulin?

Jenny Smith (15:14)

Three point seven three. Wait. Let's say it's 3.7.

Scott Benner (15:19)

It rounded the 3.7. Now Okay. Here's where it helps you. It helps you with the duration. Per the Warsaw method calculator, since you have 3.7 FPUs, the extra insulin should be delivered as an extended bolus over how would you do it? How many hours?

Jenny Smith (15:33)

So this this is where sometimes the Warsaw can be too extensive in that extended piece, that extended bolus of insulin Mhmm. Most people end up finding with some experimentation that they have to shave down the extended bolus amount or time, I should say. Not the amount, but the time. Okay. My expectation would be extending this over probably four to five hours.

Scott Benner (16:02)

Mhmm.

Jenny Smith (16:03)

My expectation, Warsaw probably said six hours.

Scott Benner (16:07)

It said five to eight. That's

Jenny Smith (16:08)

it. Okay.

Scott Benner (16:09)

But it it's super interesting to listen to your to you think about it. So we're just gonna say, I'm going with you. So we'll say an extended bolus over four to five hours. Yes. Tell me if you agree. Summary bolus strategy. Upfront pre bolus 2.7 units for the 27 carbs and extend a bolus of 3.7 for the fat and protein delivered over it actually says five hours. So delivered over five hours. It says this is a pro tip from the Juice Box podcast. If you use a pump like Omnipod, you can set a dual combo type bolus if you're using MDI injections. Some listeners use a split dose or a small nudge injection two to three hours after the meal when the protein starts to rise. Mhmm. Right?

Jenny Smith (16:49)

I and it you know, what's also interesting is it's giving you a generalized idea for that pre bolus. Right? Maybe you're the type of person who has learned that you can get away without a pre bolus if you start the meal with the vegetables and then move to the protein and then finish off with the carbohydrates. And because of the large portion of protein and fat in this meal Yep. If you started out with that structure of intake, you maybe don't even need a pre bolus for this.

Scott Benner (17:20)

Right.

Jenny Smith (17:21)

Again, using your CGM, using your glucose values, using a trend, these are all pieces to build in that, obviously, even an AI like this can't give you all of that complex information. You have to use your intuitive brain of how you how things work for you and what you've seen before from historical perspective

Scott Benner (17:44)

Right.

Jenny Smith (17:44)

To actually move into and approach the bolus thing for this meal. But in terms of the dosing for it, it does a great job of telling you what to do and what to expect. And I think building in, we've thankfully in the past five years with more AID systems, we've also started to talk a lot more about protein and fat Mhmm. Thankfully. Because, you know, in the past when I was educated, my goodness, like, protein was just it was a free food. Yeah. Right? We didn't count it. There was a certain amount that I needed from a growth perspective, right, that was built into my intake, but proteins were free just like cucumbers and celery. They were free food.

Scott Benner (18:26)

As much as you want. Jenny's over there eating a chicken like a caveman. Well, I'm smiling while we're doing this because, you know, I've had the conversations, and I've had some with you and some with other people about bolusing for fat and protein.

Jenny Smith (18:43)

Mhmm.

Scott Benner (18:43)

But the truth is is that in the end, like, I can give you as much detail as you want. You're either gonna understand it in that detail or you're not. I mean, for me Right. I'm always just like high fat meal. I make a secondary bolus, like,

Jenny Smith (18:56)

in Yep.

Scott Benner (18:56)

Eighty or sixty to ninety minutes later.

Jenny Smith (18:58)

Right.

Scott Benner (18:59)

And I know that people hear this stuff and they want they want this. They want, like, do this here, do that. But Jenny pops right in to tell you that's not exactly what's gonna happen. And Right. I think that's great. The reason it makes me smile is because even if you got to that link I'm not gonna lie to you. That link is overwhelming. Mhmm. Like, understanding how the Warsaw method works and FPUs and KCALs, and I mean, I'm out already. Like, you know me long enough. Like, I start hearing that stuff. I get fuzzy. I'm like, I'm done. Right. Yeah. And so

Jenny Smith (19:31)

You're like, I don't know. This meal looks like three and a half units. We're gonna give. And then it's gonna hit later. So we're just gonna do a little bit of a nudge extra here. I mean, that's great. But I do also really like that this calculator piece, once you feed it the right information yes, it has to be a little detailed information. But once it's there, it actually does the calculations. It even asks for your insulin to carb ratio. It can be very directing where you may have had no idea rather than just a wild guess before.

Scott Benner (20:03)

Yeah. And a 100%. And I still think people need to understand though that a large part of how it came up with this so cleanly and easily is because I was able to give it the link back to all of the information. I'm not asking you to go out on the Internet and, like, just I didn't say, like, take these three things. My insulin to carb ratio is one to 10. Use the Warsaw method and figure it out. I don't know if we would have gotten this clear language if that would have happened. Maybe I maybe I would have. I don't know. But I just I saw a person online the other day scolding someone for using AI to help them with something like this. And I thought, my gosh. Aw. They were making all these arguments. And I said I said to myself, those arguments are twelve months old now around AI. And I realized it's crazy to think that, you know, twelve months ago, you know, the person said, how they put it? Like, that thing's just telling you what you want to hear. And I was like, oh, that was a year ago. It's not doing that anymore. Like, they they they whipped that right out of it already. And so this thing's gonna move so quickly, like, going forward. And if you can already accomplish this with it

Jenny Smith (21:05)

It is.

Scott Benner (21:05)

I mean, it's pretty amazing. Without AI, I don't have that web page. Right. I could not have I I had those conversations, and I could not have sat down and synthesized all that information and put it together like that. Like, I don't have that mind.

Jenny Smith (21:18)

Right.

Scott Benner (21:19)

You you know? So

Jenny Smith (21:20)

And because we walk around with computers in our pockets. Right? I mean, we don't have phones. We've got computers, small, little, tiny computers that we walk around in our back pocket all day long. And so with diabetes, you can use it to your advantage in today's world of technology because the information is pretty clean and pretty accurate.

Scott Benner (21:45)

Yeah.

Jenny Smith (21:46)

Again, two years ago, not so much. Your best bet was to look up the nutrition facts probably from the USDA or, you know, another website. Right? But now the nice thing is that all that data is put into AI already, then you can ask it directed questions about, hey. What do you think about this? They can give you some feedback.

The Future of Tech and Bolusing

Scott Benner (22:09)

It is really, I think, valuable and gonna become more valuable to people. I sent something to Jenny recently that I've been kinda working on over here because a lot of how AI works is is the direction you give it. Right?

Jenny Smith (22:21)

Yes.

Scott Benner (22:21)

So I was I I don't think I should say Oh. I don't know. I I was working out a prompt that wasn't just a prompt. It wasn't a sentence or two. It it was it actually, like, pages of prompting Right. But that you could put in and then literally just give it a link to a recipe. Mhmm. And it would it would it would turn out a bolus on the other side. And I'm pretty close to getting it worked out. And I don't know That's awesome. I don't know shit about Jenny. And like, I can't code. I can't do anything else, but I just kept taking information and saying, no. You need to be more and do it over and over again. Make a mistake and I'll go, oh, here. You made a mistake here. Like, we need to rewrite this. Right. You can turn it into code and put it on a website where you just, like, drop a link in, push a button, and boom. That's your bolus for this. Now you still gotta think

Jenny Smith (23:06)

Right.

Scott Benner (23:07)

Maybe that's not right. I mean, I'm not saying I would blindly do it, but it gets you a hell of a lot closer than where a lot of people end up.

Jenny Smith (23:16)

And it would be lovely if, you know, an app like that would actually also take in maybe an app that somebody uses. Like, I use to keep recipes all in one place rather than having 6,000 pictures of recipes that I've looked at online. So I actually copy the link into the Paprika app

Scott Benner (23:37)

Yep.

Jenny Smith (23:37)

Which saves your recipe. It saves it in a recipe format, just not just the website view, which is awesome. And it would be great if an app that could also take that recipe and then dictate to you when you do eat this meal, This is what your bolus strategy is gonna look like. Yes. You're still gonna have to feed it things like this is my insulin to carb ratio. This is maybe my starting blood sugar. Maybe eventually you could feed it, like, the trend in your blood sugar and what you know what I mean? Like, there is there's so much that could be done the right way using technology to make the advantage for people with type one to take a little bit of that stress away.

Scott Benner (24:19)

Yeah. The thing I'm making, which is just me, you know, I don't know if he

Jenny Smith (24:23)

Fiddling around.

Scott Benner (24:24)

Call vibe coding, I guess. Yeah. The the way he can basically just talk to it into changing code and stuff like that. But what I wanted to to do is, like, go to a link, find the recipe, break down all of the ingredients, and then apply all these other ideas from, you know, from the podcast and from people's conversations and from what's, you know, well established and known in the world and come back and tell me how to bolus for this. So Mhmm. Basically, drop in the recipe, your vitals, you know, your insulin to carb ratio, stuff like that, starting blood sugar, and boom. And there's your answer. And I think that by the time I figure that out, some dorks at some pump company are gonna be feeding that into a pump somewhere. And if they're not, you guys aren't paying attention to what's possible. So at the very least, it could be an app, and, somebody should do it.

Jenny Smith (25:12)

Well, I think you touch on actually a really good point. You know, we we have these wonderful hardware devices with soft software that's becoming more, I guess, intelligent depending on how we interact with it. Right? It is not up to current potential like the DIY community, the open source community has. That potential has gone beyond what our typical FDA pumps. Right?

Scott Benner (25:43)

Yes.

Jenny Smith (25:43)

But somebody needs to step up in one of these companies, and they need to say, we've got this part of it. But this greater percentage of life with diabetes, what if we integrate in just the ability of somebody to say all of these pieces? And then the pump can actually do more for you, and its algorithm can do more for you. Right? Even exercise. Right? Being able to take it. Well, I'm gonna take a light yoga class versus I'm gonna go run for 10 miles.

Scott Benner (26:16)

Mhmm.

Jenny Smith (26:17)

Right? The ability of the app to actually interact or, algorithm to actually interact.

Scott Benner (26:25)

Well, everybody's Huge. Everybody's gonna control their pumps from their phone to begin with. So I I mean, honestly, just think of it

Jenny Smith (26:32)

gone that way.

Scott Benner (26:33)

Another screen that says, this is what I'm eating. You know? Make a make a a bolusing strategy for me. And then, you know, I I I realized the legality people listening are like, oh, we we we wouldn't put ourselves in the line like that. Make make somebody who agree to a disclaimer. You know? Right. Like, I mean, your stuff works as well as it works. It still isn't perfect. Like, so same idea. You know, I agree that this is the bolusing strategy I wanna use and let the app talk to the and just feed it over. Right. You

Jenny Smith (27:02)

And who with diabetes

Scott Benner (27:04)

Wouldn't love that.

Jenny Smith (27:05)

With type one, not only would love that, but as you just said, like, a disclaimer, really, we're given we're given a hormone that people use a 100% off the prescribed label of what to do with it.

Scott Benner (27:21)

All day long.

Jenny Smith (27:22)

They do all day long. You're sent off with take ten units or put this in your pump at the basal rate, and then the person goes home and they fiddle with things, and they adjust things. They take more, and they're like, nope. That's not enough. Let's take some more. Like, that's entire there's no disclaimer for that.

Scott Benner (27:37)

No. No. No. No. Come on. Yeah. Yeah. I know. And they don't tell you you really get the least direction in the beginning too.

Jenny Smith (27:44)

Oh, a 100%.

Scott Benner (27:44)

And sometimes they don't even tell you, like, if you get dizzy, maybe that was too much. But like

Jenny Smith (27:49)

Right. Yeah. I know.

Scott Benner (27:51)

So It's awesome. Alright.

Jenny Smith (27:52)

I don't think there's a disclaimer needed.

Scott Benner (27:54)

No. Yeah. Well, the the companies are gonna disagree with you, but maybe somebody will make an app that does that. I mean, listen. I just laid it out there for you. Steal the idea. I don't care. I'm not looking to make an app. You know, I was gonna do it for myself.

Jenny Smith (28:06)

Right.

Scott Benner (28:07)

But anyway, I I appreciate this conversation. Thank you.

Jenny Smith (28:09)

No. Thank you very much. It was great.

Closing Thoughts and Links

Scott Benner (28:19)

A huge thanks to my longest sponsor, Omnipod. Check out the Omnipod five now with my link, omnipod.com/juicebox. You may be eligible for a free starter kit, a free Omnipod five starter kit at my link. Go check it out. Omnipod.com/juicebox. Terms and conditions apply. Full terms and conditions can be found at omnipod.com/juicebox. Having an easy to use and accurate blood glucose meter is just one click away. Contournext.com/juicebox. That's right. Today's episode is sponsored by the Kontoor Next Gen blood glucose meter. Okay. Well, here we are at the end of the episode. You're still with me? Thank you. I really do appreciate that. What else could you do for me? Why don't you tell a friend about the show or leave a five star review? Maybe you could make sure you're following or subscribe in your podcast app, go to YouTube and follow me or Instagram, TikTok. Oh, gosh. Here's one. Make sure you're following the podcast in the private Facebook group as well as the public Facebook page. You don't wanna miss please, do you not know about the private group? You have to join the private group. As of this recording, it has 74,000 members. They're active talking about diabetes. Whatever you need to know, there's a conversation happening in there right now. And I'm there all the time. Tag me. I'll say hi. My diabetes pro tip series is about cutting through the clutter of diabetes management to give you the straightforward practical insights that truly make a difference. 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. Have a podcast? Want it to sound fantastic? Wrongwayrecording.com.

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