Scott Benner 3/6/23 Scott Benner 3/6/23

#861 Best of Juicebox: Diabetes Concierge with Katie DiSimone

Episode 227 Diabetes Concierge was first published on April 30, 2019. Katie DiSimone is on the podcast to explain what the heck looping is and how it can change your life with type 1 diabetes.

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

Scott Benner 0:00
Hello friends, and welcome to episode 861 of the Juicebox Podcast.

Today, on Best of the Juicebox Podcast, we'll be revisiting episode 227 was called diabetes concierge and aired originally on April 30 2019. Back in 2019, I had been approached by a listener of the podcast, who asked me if I had ever considered looping for my daughter. And I wanted to learn more about it. And Katy De Simone was kind enough to come on the show and explain it to me. I didn't keep up with Katie after that, although I was very aware of all the hard work that she put into the looping community. And then I remember one day, I think in 2020, probably spring of 2020. I noticed on Katie's social media that she had like gone on this health kick and was working out and doing so like wonderfully in it. It made me track her progress. So I was keeping up with Katie on Instagram. And then one day the pictures went from workouts, to a brain scan. And that's when I learned that Katie had a tumor. She shared her experience right there on Instagram. And I'm looking now at her account. And that post was put up just at six weeks ago. I heard the bad news yesterday that Katie had passed away. And while I didn't know Katie personally and just had this one interaction with her, she was always just a very impressive person from afar. The work that she put in for loop for everybody, including her daughter, who has type one diabetes is immeasurable. Her impact on my life, my daughter's life and have many of you. It can't be properly accounted for. And so I wanted to run this episode today in honor of Katie, her family, and her her good work. Hello, and welcome to episode 227 of the Juicebox Podcast. Today's episode is sponsored by the Dexcom G six continuous glucose monitor, by real good foods, and of course dancing for diabetes, you can go to dexcom.com forward slash juicebox. Dancing the number four diabetes.com or real good foods.com To find out more about the sponsors. Now when you go to real good foods that calm and you place an order, you use the offer code juice box to save 20% on your entire purchase.

As you well know nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. And you should always consult a physician before becoming bold with insulin or making any changes to your health care plan. Today's guest is Katie De Simone. And you're going to want to hold on to something because I think what I'm about to say next is going to take you by surprise. But one of our listeners Gina brow beat me browbeat me online into trying the loop now that it's available for the Omni pod. And so I got Katy on the show because she is about the loop easiest person. That doesn't sound right. She's really entrenched in the world of looping. She's not loopy. She's actually delightful. Anyway, Katie came on. She explained to me everything about looping and I had a bit of an epiphany that I thought it might actually help me help you. So I said, All right, let me try it. So sit back and relax and listen to the conversation that I had with Katie that made me think. Alright, I'll give this a shot.

Katie DiSimone 4:15
My name is Katie De Simone. And I work for tight pool now. And I'm also part of the DIY loop group. So I have a little bit of dual hats in that respect. And so sometimes I try and clarify which hat I have on.

Scott Benner 4:31
Which one are we wearing today? Both one?

Katie DiSimone 4:34
I'm imagining probably mostly the DIY Katie hat. Because loop has had a very exciting announcement this week that it now integrates with the Omni pod.

Scott Benner 4:45
Okay, so if you have to change hats, just make an announcement before it happens.

Katie DiSimone 4:49
Yep, we'll do.

Scott Benner 4:51
Katie, I'm gonna give you a tiny bit of background on me and what I think is probably the feeling of more people than should be and And then we'll move from there. So my daughter is going to be 15. This summer, she has been using it on the pod since she was four. And because I think greatly, because of the things we talked about here on this podcast, her agency has been between five, two and six, two for over five years. She doesn't have any diet restrictions whatsoever. And we just kind of, you know, figured it out a little bit. But I also want to stay, I want to ride the wave, you know, on the crest of the wave, I don't want it to crash down and then just be, you know, going back out to see you. And I'm like, What's the loop? So I'm excited. I've said before that the documentation scares the heck out of me. But I got cajoled harshly by somebody online. And they were like, try, just try it. Just try it. And then she finally said to me, look by the Reilly link, and if you don't like it, I'll buy it from you. So Gina, this episode is for you. And for everyone else. I think we need to just first kind of it as simply as possible, let what loop means make sense to people? Can you do that?

Katie DiSimone 6:09
Yes. Basically, loop does what most of the general population I call a muggles, the people who aren't living with tea, Wendy, what most of the Mughal population thinks happens for tea Wendy. That's what loop does is that they see if you explain to a muggle that you have a continuous glucose monitor that provides you information about your blood sugar every five minutes, and you tell them that you dose insulin off your insulin pump based on your blood sugars, they assume that those two systems talk to each other. And that's, as we all know, pretty much not the case on any commercial product. These days, with the exception of very recent developments, relatively speaking of the 670 and Basal IQ, which does half of that equation, it responds to low blood sugars. So what looping does is that it takes that and closes the loop. In other words, your insulin dosing will actually be based on CGM data without having your brain involved in that or your fingers involved in making pump button pushes. So in the simplest form, that's what it's doing is that affecting any given time, you would have looked at your CGM data and known that you had eaten and thought, maybe I should give a little bit more, or I should suspend. Or I should decrease my insulin. That's what loop is doing for you. Now we're loop itself with a capital L. As opposed to a little case L of sort of the general concept of looping. What loop app itself does is that it puts all of that into a really simple, wonderful interface of an iPhone app. In all the traditional ways you love Apple products for their ease of use that you can just look at it. And it makes sense for what you're looking at. That's what loop is. It's an iPhone app that sits on your app where you can easily enter all of the information about the food you're eating the Bolus is you want to give where you're headed, what your settings are, it's basically all moved off of a device that you have to fetch out from underneath your sweater under your dress. It's all now on your iPhone, where you interact with most of your day anyway. And for my kid, the iPhone is almost an extension of her hand, because she's 16. She is on Spotify and Instagram and all of those other kinds of things. And so bolusing from her phone is a really natural place to put her diabetes management. For adult users, most of them are really psyched on the watch for bolusing and entering carbs. It's super discreet. You can do it at a professional meeting, and nobody's going to ask you, are you being rude or somehow ignoring things you can take care of it all on the watch.

Scott Benner 9:11
So most of you know that I'm speaking at the dancing for diabetes touched by type one event on May 18. in Orlando, Florida. If you're in the area and you'd like to come, I don't think it's too late. Check out dancing for diabetes.com. But if you can't make it, dancing for diabetes is like I don't know auctioned me off or something. All you have to do is go to dancing for diabetes.com Hit the Donate tab, make a suggested donation of $10. And when you do that, your name will be like in a hat. I'm gonna pull from that hat while I'm down there on the 18th. And I'm gonna pull up three names two of those names. I'm gonna have a 45 minute phone call with you. And one lucky name, one hour phone call and a 30 minute follow up and if you don't want to use the phone, we could FaceTime we could Skype, I could be out the window smoke signals. I don't care. Now listen, if you don't want to talk to me on the phone, I appreciate that but don't embarrass me okay, you hear what I'm saying? You guys gotta get on there and do this so I don't look like a schmuck. The expected numbers out of this the whole like Scott phone call thing Imagine if three of you do this I'm gonna look like an idiot. Alright, so don't do it for me don't do it for the cute kids dancing for diabetes. Oh, you know, do it for me do it for me so that I don't look identity. To have your name including this opportunity go to dancing for diabetes.com click on the Donate today button between now and May 17 2019. Make a suggested donation of $10. And be sure to mention juicebox in the notes. If you don't have internet access, or flat out just don't want to make a donation but you still want to submit your name. You can do it by mail. I mean, God bless you if you're gonna do that that's like a stamped envelope and I don't know what you're even writing there juice box and the thing and it's got to get there by this. I mean do it if you want. I'm just saying a lot of work. I hope to see on the 18th but if I don't, I hope we can talk

in its very basic form, all the things that we all sit around thinking are always simplified for us right like I think much like most people like artificial pancreas will come one day and what that means is my glucose monitor will talk to my insulin pump it will make decisions for me and I won't have to think about it. And that really is this it's this in real life. It's It's your right now it's Dexcom right you loop works with Dexcom CGM

Katie DiSimone 11:28
correct loop works with all the Dexcom CGM, so long as the g4 has share capability. It also works if you're on one of the older Medtronic pumps, it works with the older Medtronic CGM systems.

Scott Benner 11:42
Gotcha. And this is quite literally something that was done. I don't know what the word is. Is it a consortium of people like how do you think of it when you Is it a a cabal? Are you guys which is like what is? What is it exactly? Like? How did this how did this begin?

Katie DiSimone 11:58
The story started long before I ever got here. And it's a web of people in the most simplistic of forms, and it'd be too hard to name everybody who's been involved. But basically people across the nation were frustrated with where the state of diabetes gear was that it wasn't collecting information for the patient that it was residing in silos separate from each other and not being integrated. And so people started taking actions smart people who had the capabilities of and I use the term hacking, because that's what comes to mind for most people. But not hacking in the nefarious way. Hacking, as in I know my information is in here, I just want to see it, I want to use it to better. Basically all these people across the country, we're all working on separate parts, that all ended up through the wonders of internet, finding each other and they all moved closer together. So people who are working on understanding that Dexcom and making that more available before share was around, met with the people who were decoding the pumps and people who were doing algorithms, and they all started to form together till eventually, these closed loop components were all close together, okay, where my involvement came in, was my daughter was on Omni pad for about a year and a half after diagnosis, and was doing great with it. And then she started high school. And when she started high school, she told me Mom, I want to wear tube pump. I said, Well, why do you want to wear to prom? This is the opposite of where most kids go. She said, I want my diabetes to be more visible. Okay. It's an odd thing to request at high school time, but I'll go with it. And I said, Well, I've been stalking the internet. And I saw that these really smart people over here who are working on this open APS system will get on an older pump and I'm gonna have to get an older tube pump. So if I could find that maybe I could get two birds with one stone and automate some insulin delivery and that might help make our lives easier. So that's what that's how I ended up here was that my daughter wanted it to pump I knew I was gonna have to buy a used one mine as well. But the problem at the time was that the US pump system this open UPS system at the time was really bulky, and would require a lot more than a teenager was willing to give it time and attention to at the time. It's gotten better. So I was looking for small open APS systems and I was searching the internet frantically going, somebody must have worked to miniaturize this. And that's when they came across loop, which is a different system than opening EPS, but conceptually still the same automated insulin delivery based off your CGM ratings. So when I saw that it fits on a phone and it's a really small sleek form factor, it's that, yeah, I could do that. And when I got there and found where the project was, didn't have a whole lot of information about how to build it. So I spent a lot of time with Google, and putting myself out into uncomfortable spaces of trying to figure out how to build an app onto a phone when I've previously never done that. And with some help of some very nice people on the internet, who answered my questions, and Google, I got a built. And I was so excited. And it worked so well for us that my involvement that I committed to as a kind of pay it forward movement, is that I would write the documentation so that other people could come after me and be successful with it. So

Scott Benner 15:43
you're the translator you Yes, you took complicated, technical, almost geeky and weird and turned it into something my brain can absorb? Yep. Is that what's at the loop kit? Dot GitHub dot whatever dot fours? Yeah,

Katie DiSimone 16:01
even that, even that I wanted to simplify. So it's, it's loop docs.org LOPDOC s.org

Scott Benner 16:11
O P, I'm gonna write to a DSC s dot o RG

Katie DiSimone 16:15
and be intact. It's really, you know, honestly, I totally get it like when you when you come into something technical. From the first start, as soon as you tell somebody, you're gonna build an app onto your iPhone, half the audience leaves the room and goes, I can't do that. And what I promise you is that you absolutely can, it is really, really not as hard as hard as it seems. It's super, super simple.

Scott Benner 16:42
My understanding here would be that this is not, I mean, this is not a medical device company, right? That's giving you this, basically an algorithm that's going to tell your CGM gonna tell your pump what to do with the information from the CGM. So no one can take responsibility for this. If you do this, it's it's on you right now. It's it's do it yourself in the most most meaningful way you are doing it yourself, no one is helping you if something goes wrong, it's all on you. It's a decision you're making on your own. And it says that very much, right? I'm just saying now, it's the first time I'm looking at, at loop. docs.org says you take full responsibility for building and running this system, and you do so at your own risk. So if you want to get involved in this right now, Katie is going to tell us now about how to get it set up because and I know everyone who listens is going to be thrown off by this. I'm going to try it. And that trust me, Katie, you have no idea. Everybody's just like no, Scott said he was scared and he can't do it. And trust me, I am scared and I can't do it. But I think that by having Katie on the podcast, I now have a Sherpa that I can bug. I am going to figure out how to do this. And then I'm going to report back to you guys how I did it. And then I'm going to report back to you if I like it and whether or not we're gonna stay with it or not. Because Katie, while I believe that this is incredibly important for the large majority of people with type one diabetes, I think they're going to have results that they've just never seen before. We already have really good results. So if this improves my life, then I'm all for it. By the way, like I'm not I have no, I have no ego about this. I don't need to be making decisions about Temp Basal increases and Temp Basal decreases, like you know, throughout the day, I don't care if I would like it to just work. And so I'm super excited to try it.

Katie DiSimone 18:32
That's, that is, you know, you you just said something that kind of triggered in me. A funny part. But it took me a long time. We've been looping for two and a half years, roughly. And I've had an evolution and how I appreciate the system. When we got on it. We were fairly low carb only because it was the only way we slept at night. We just you know, we were going through an evolution we were only a year and a half in. It's a teenager, she's changing. We're changing. It was very, very hard. So we got on loop. And it was at the time, we were mostly focused on E one Z and blood sugar control and all of that kind of mindset. And then she became a tea and she wanted more independence and I wanted more independence. I didn't want to keep talking to her about diabetes. This was silly. That's just we had a life to live. And what looping has done is is made me realize just how much potential damage I was headed into with navigating that very complex transition of an independent type one team. And loop gave me back the ability to understand how to let her live her life and how capable she was and how she could do this and that the other Part of relieved for me is part of the reason I was doing so much help on it was I felt like if I shifted that responsibility that she was asking for even though she was asking for it, I still felt a huge, enormous guilt that I was somehow saddling her with now this enormous responsibility. And seeing Loup work for her literally like a like a, like a nanny, like a personal assistant that carries the umbrellas of the rich and famous stars. And, you know, the movie festivals kind of thing. Like, who can afford that? That's how Lupe has been for us is that it's this umbrella carrying personal assistant for her. That makes that shift over so much easier.

Scott Benner 20:41
Yeah. Insulin concierge? Yes.

Katie DiSimone 20:44
That's a great, that's a great term for it. And so,

Scott Benner 20:48
Katie, patent pending?

Katie DiSimone 20:49
I think you should. That's your new that's a new hashtag, you should, should do that. Because it really, it redefined how our relationship was. And it took a lot of diabetes conversations off the table, which I'm so grateful for. And it wasn't at the expense of good. Anyone see results or all of that kind of stuff. It was less effort, less lows, great a onesies and less conversations. It was win win win all the way around. Yeah.

Scott Benner 21:16
So we have. So here's where my excitement lies as I sit here and just look at this image that you guys have up on the screen of the the loop app on an iPhone. So I'm not even though there are a couple of people who like to say that I have a lot of ego and I brash about, like how well we're doing. What I'm saying here is, I have gotten this figured out, my daughter doesn't go over about 151 70, more than about twice a day, she doesn't get dangerously low more than maybe about once a year, you know, we don't get under 70. Very often, she's mostly between 70 and 120 give a lot of stability. But it's come through these things that I'm now realizing as I'm staring at the algorithm, there are these things that the algorithm understands mathematically that I understand. In English, I don't know if that makes sense or not. And, and so I'm super excited to see the feedback from the app as far as like active insulin, insulin delivery, and glucose levels. Because I actually think that this app can take me farther in my understanding that I am and I really thought I was about at my peak. Honestly, I didn't think there was much more I can understand about this. But seeing this information, I think I can mine a lot out of it. And and, and really go on to be able to describe to people who don't have this app, my ideas but in better detail, and maybe more easy detail to understand some bumps. I'm getting excited. So this is good. Okay, so let's go through a couple of things

I need a Dexcom I have that. I need Omni pod because it works with Omni pod. Now I have that and then I need something called a Reilly link and as soon as you say that in the past my brain would go okay, I'm out Forget it. Right. But but but let's let's make it let's take away Riley link. And I don't know did you see Spider Man into the spider verse by any chance? No, I have a tastic movie you really have to make time in that one of the Spider Man men Spider Man's one of the guy's calls something electronic a goober he says there's always something like this in every one of my problems. I just call them all goobers. So let's call the Riley Linka goober. Okay, and so. So the pump has to get information from the CGM and your phone needs to talk to everything. The problem is, how does a phone talk to an insulin pump? It talks through the goober so that's it the goober is the bridge the Riley link is the bridge. Don't be scared by it. It's a thing that makes a connection in the future. There'll be there'll be some the I guess the Bluetooth pods right when for Dash comes out and then you guys will come out with something where that's right in the app and then the Riley link will be gone at some point, right?

Katie DiSimone 24:20
Yeah, so the DIY Katie says the Riley link is necessary because the pump speaks one language and your CGM and phones speak a different language. Gotcha. Your your phone and your CGM are speaking Bluetooth. There are over there speaking that one language your pump is speaking with radio. And so those two languages need a translator. And that's what the rilink does is it bridges or translates between those two different languages. So what tide pool Katie's hat is saying is that the next phase of looping will be when you don't need that translator and that the pump is speaking Bluetooth. and the phone is speaking Bluetooth and your CGM is speaking Bluetooth you don't need a translator anymore. And so the phone will be able to directly communicate with both devices. And so tide pool loops development is focused on insulin pumps that have an eye pump designation and Bluetooth capabilities built in.

Scott Benner 25:24
And can I ask tight poke at a question real quick? On the pods all for this right? Like I've spoken to them, they're super excited to have a relationship with tide pool.

Katie DiSimone 25:34
They are incredibly supportive. And kudos to them for recognizing a community need and stepping up and partnering with tide pool to do that I I am as a parent of a team Wendy actively involved in the DIY community incredibly heartened by the commitment they've made with title to bring that forward. Yeah,

Scott Benner 25:58
because at some point so that people understand, you know, let's say that we don't I obviously Katie's not gonna tell me timelines, and because you need to be able to hit timelines and their company and all that stuff. But let's just make up a day and say that a year from now, tide pools going to have this setup. So you don't need your grouper. And it's just going to talk to the Bluetooth pods right? On the pod might not be ready with their horizon system by then. But you can use you'll be able to use basically tide pools algorithm with loop to do that. If one day or when one day, excuse me on the pod comes out with their horizon, you get to decide you get to use their algorithm, then try the loop algorithm and say, well, listen, I this one works better for me, I'm gonna use this one on the pod completely okay with that, for those of you who are who are newly diagnosed, and have not been around diabetes for a decade, or more, like like I have, that's unheard of, for a company to just be like, hey, you know what, if this works better from you, and it's not from us, we don't care. Just we want you to be happy. That's insane. Like no one says that. Everybody always wants you to tie down and locked into their thing. But this is the beginning of a whole new world. Super exciting, you should be genuinely jacked up that Omnipod Zed on this, because this is just, I think the beginning of a lot of good stuff.

Katie DiSimone 27:16
It's a monumental shift. And it really can't be oversold or overstated. How big of a shift this is towards understanding the needs of the community. And saying, I believe that the marketplace can

Scott Benner 27:34
absorb this decide for themselves too.

Katie DiSimone 27:37
Exactly. And there's so many people that aren't on pumps. And I think there is a huge portion of people that aren't on pumps, not just for access issues, but also for choice issues is that there's not a product that offers them a lot of choice, you're locked into one. And for Omnipod to say hey, listen, we support our product, we support this new tide pool, whatever the system is, like you say there into the interoperability and you can choose and it's amazing, it really, it's it's visionary, and I'm completely supportive of that kind of vision. I think tide pool has that vision to putting on a little bit of a toot their horn here, but really a nonprofit coming in and saying we're gonna take on this, this huge task, it really is a lot of work. If it's amazing, and we have JDRF support for tide pool and Helmsley Family Trust is sponsoring a job observational study for loop users in the US, that's going to provide a lot of insight into how the system's working for people. So I really look forward to kind of getting this project down the road and showing what it can do for a lot more people who perhaps like you mentioned at the start, look at building an app on their phone and say, That's just not for me. Yeah.

Scott Benner 29:03
Okay, so we're gonna get to the building part in a little bit. But I wanna understand the using part. First, I want to talk about the fun part before I talk about the heart. Okay, so, Katie, you don't know me. But when my daughter gets a plate of food, I look at it. I think that's 12 units. And I'm gonna break it down into an extended Bolus. I'm gonna do 30%. Now do the rest over half an hour, we're going to do a Temp Basal increase of 75% for an hour and a half. And that's that. And then if I'm right, great, and if I'm wrong, I adjust. I don't count carbs. I don't know my daughter's insulin to carb ratio. I don't actually believe she has one. I don't believe any of us have one. I don't think there's a static insulin to carb ratio. And I don't think there's a static Basal rate. I think all of that some old timey BS way before this stuff was available to us before this technology. I think that was just the best people could do. And so how different is it going to be for me now? When that plate of food comes out, do I still get to guess at how much insulin is? Or do I now have to count the carbs? Or what's the real? Like how does it work in a real life situation plate comes out. What do I do? Are you looking for delicious low carb snacks and meals? Well, if you are, look no further than real good foods. You ready? You want to hear it. They have newest offerings, breakfast sandwiches that come and sausage and bacon of course they have the chicken crust pizzas, and personal supreme personal pepperoni and personal three cheese. Cauliflower Crust Pizza lovers. Do not miss the vegetable pizza, pepperoni pizza margherita pizza and cheese pizza. All of these come in delightful variety packs as well as one at a time. Have you had an enchilada for lunch lately? How about a pork enchilada chicken enchilada beef cheese, or go crazy and get the mixed case. Real good foods also has real good poppers bacon and cheddar, jalapeno, white cheddar, artichoke and cheese and pepperoni and mozzarella. Maybe you want the chicken crust pizza, but you don't want the personal size, go to the seven inch, again, cheese, supreme and pepperoni. And if you go to their website, they got a pro tips area. Now it's not like our diabetes pro tips. These are pro tips about how to cook the real good foods to perfection. Because real good foods want you to have a real good experience. Now what could make your experience better, better than having what I've just described you sent right to your home is having it sent to your home and paying 20% Less, you'll see other coupon codes out there for real good foods for 10%. But please, I told you a good foods for the Juicebox Podcast listeners 20%. I demand that and so it will happen real good foods.com use the offer code juice box, you can also find a link to real good foods in the show notes of your podcast player and at juicebox podcast.com.

Katie DiSimone 32:01
Yeah, so for you, it will be an adjustment because conceptually, the same statements that you just made all still apply. The difference is, instead of knowing your insulin dosing, you're going to be refocusing on carb entries, because you will have to use a carb ratio still, the whole premise of loop is that it makes a prediction of your blood sugar over the next six hours, and it says this is due to these factors. And one of those factors is your carb entry that you put into it, you say I'm going to eat 12 grams, this is what based on my carb ratio and my insulin sensitivity and how much I have on board, this is where it's gonna go. So the carb ratio is still an important part of making that prediction line. That said, it's, it's not an insurmountable shift, because I actually was much like you prior to going into looping is that I knew these things needed to extend a Basal and these things needed. Or extendable as, excuse me, or maybe these ones get an extra hit of insulin in two hours. Those kinds of things all translate and instead now instead of saying I need two units here, you get a carb ratio, and you say, Okay, if that previous thing needed two units, and my carb ratio is one to 10, you just do it now as a carb entry instead of an insulin entry. So well, it will be a shift,

Scott Benner 33:38
okay. And on the image I'm looking at right here, there's like pictures of like, I see a taco, I see pizza and I see candy, do I tell it 15 grams, and it's this kind of food?

Katie DiSimone 33:47
Yeah, see, that's the really cool part loop is the only system that does this. So for people who know after, after you eat a pizza for the first time, you know, if you gave everything that you need all upfront, you'd be low, and you'd be incredibly high later. So what loop dies, it's got this really amazing ability to extend your carb absorption and say this foods going to be a really long, slow burner, I'm going to be fighting the impact of this meal for six hours, or four hours, you can tell it that and the way that as you described, you know your meals, you know that this meal impacts your daughter this way. And it might not be the same for everybody. But everybody kind of has a sense of this particular plate of food kind of does this. And you can tell loop that ahead of time and it will watch for you. So for pizza, for example, let's say you have 100 grams of pizza, and you know that you need about 60 grams worth of that bullet up front. And maybe 40 grams of that later. And you think a bit in terms of your Temp Basal is that you send stuff but you could say I need about two thirds of that upfront and maybe a third of that whole Will insulin amount later loop actually has that built in, when you tell it your food is going to take a long time to absorb, it knows that if it throws all of the insulin on board early, you're gonna go low early. So it will withhold some of that Basal some of that Bolus recommendation, because it's going to keep you from going low early. And by withholding it early. It also knows that you're going to need some later and it will automatically add that as high Temp Basal as soon as your danger of going low, has passed. So it basically functions as an extended Bolus for you when you push that pizza button. Yeah, so

Scott Benner 35:42
I have to tell you that I had I'm so bad with names. But like two years ago, I had that that woman on the girl who like made her own AP, like, you're gonna know who exactly what she has? Yes, Dana, I had Dana on. And I had Dana's husband on, they did him in two different episodes. I don't know why I did that back then. But I thought it was interesting. And what I took away from those episodes where I just asked, that still is like a silly question. I was like, So how often does it Bolus she was really most of it's handled by Basal rates. And I thought to myself, like, it was like, somebody clocked me in the head and the light went off. And I was like, That makes so much sense. And that's it, that conversation helped me, you know, supercharge what I was already doing. I was like, oh, okay, I'm going to use more basil. As I look at this, my next question is, does it learn? Does it learn?

Katie DiSimone 36:34
Yes, and no, it doesn't learn long term. So for example, it's not looking at your last day or week and say, Oh, you look like you're running a little sensitive. It doesn't do that. But it does do some near term looks at how it itself has been doing. It looks as its own predictions. So basically, it looks over the last hour. And it says How close was I and if it thinks that it was really far off, it will wait the next 30 minutes of data and say I've been off a little bit, I'm going to help you out a little bit more, because something's going on in the near term. And we'll fix that. So in the short term, yes, it looks at its data, but it's very short term, in the long term. So there's this one thing you're talking about, like learning systems within loop, there's a really incredible line within loop. That's called insulin counter ACTION EFFECTS. It's a big name. But basically, what it means is that loop has a screen that you can tap on. And at the end of the meal, it will say you told me this was a 50 gram meal, actually, based on your blood sugar response and how it handled it, it actually hit you more like 63 grams. And so you can actually learn a lot from loop. When you look at your food at the end of the meal, you can go, wow, you know what? I see what it's saying, based on my blood sugars, that meal treated me as if I was 80. So you know, nutritional labels aren't right. And sometimes you're at a restaurant and you're like, I'm still trying to learn this meal. How, how much do I give up front? How do I, how do I Bolus this meal loop will provide that imp that impactful statement towards you, or for you at the end of the meal and say, Hey, that meal treated you like this. So the next time you go back to have that meal, you'll be better informed.

Scott Benner 38:25
So this is like a blown up idea behind all carbs aren't created equal. And yeah, and it's an extension of what I told you where I say I stay flexible, I put the insulin in and I see what happens. And then I stay flexible. So in for your knowledge. If I were to do a you know, do the regular Pre-Bolus that we do you know as far as time goes, and Arden starts eating and 30 minutes later, I see a diagonal up arrow, I do what I call stop the arrow, I stop the arrow from from going up, I use little bits of insulin to make a stop. And then the next time I would say to myself and I preach it to people all the time. You look at a meal and you think oh that's five units. And then you later use a half a unit to correct it. Well then next time don't look at the same meal and go that's five units say to yourself, that's five and a half units.

Katie DiSimone 39:14
You can't see me I have my hands in the air gone. Yes, yes. Yes, exactly. is dynamic thinking is probably the biggest tool you have in your tool belt for a successful

Scott Benner 39:26
career. I wish I knew what a moron I was that anything in life has struck me well is is absolutely a miracle but that I figured this out, you have no idea that it was me. Doesn't make any sense. Like this is not something I should have figured out. And I don't know how I think I A lot of times give a lot of credit to writing on my blog for so long and wanting to help people and seeing that I had to find out what worked for me. And then I would wait months I would never share anything right away. I'd like let me make sure this is really valuable before I tell somebody about Got it. And then I would tell them about it. And I kept building. And before I knew what I realized I had like these, like 10 basic tenants of how to keep a blood sugar stable. And I was like, wow, this is like a system. Like, it's a way. Like if I put it all together, it makes sense, you know? And still, I swear, I really wish you knew me because that I figured anything out is just hilarious.

Katie DiSimone 40:20
No, it is it is absolutely huge to have a dynamic attitude. If, if I always put it as respond to the information you're seeing, not the information you thought. And so if you're seeing that a meal is actually cheating you like 10 grams more than what you thought you had to give more, take that into account the next time

Scott Benner 40:42
and if the people who are listening aren't thinking right now, trust what you know is going to happen is going to happen, then you have not been listening closely enough. Okay. So you have to trust that what you know is gonna happen, it's gonna happen, you can't get high every morning at 8am. And every morning at 745 think, Oh, well, I hope it doesn't happen today. It's gonna happen. Give yourself insulin now. Right? Like so? Oh, I'm not see. All right, okay, let's calm down. Because I think we're coming up to the point where I'm gonna get upset and sad. So I see how it works, I see that my daughter will be able to, you know, count carbs and do things like that. I also, by the way, believe, holy that people eat mostly the same thing over and over again. So it's not like you're counting carbs forever, or trying to figure out how much insulin a meal is forever. Usually, you eat about the same 20 or 30 or 40 things, eventually you'll figure out figure them out. Dex, calm, you want a Dexcom, you might not know you want it or maybe you do know you want it one way or the other. You'll want it dexcom.com forward slash juicebox. Here's what you're going to get when you have a Dexcom, a G six continuous glucose monitor, you are going to get information. And as they say information is what do they say about information? There's a saying about homozygote? I know there's a saying about information. I got a right here. There's 486 sayings about information. It's not helpful. No, that's not it. Hmm. That's kind of deep from Albert Einstein, but not the one I was thinking of. Not that one. God, turn DNA is like a compute now. Or maybe there's not a saying about information? Well, I'll tell you what, I'll make one up right now, when you get the information back from your Dexcom, you make better decisions about your insulin. That's all. There's nothing else to say that information can come to you with a Dexcom. And a couple of ways. One way, share and follow available for iPhone and Android. You know, that means share and follow. Like there's an app share, and there's a app, you know, share app follow up. One of you probably like the person you love, who has diabetes has to share up and then another one of you, like a person who cares enough to pay attention to their diabetes has the follow up. And then there you go there diabetes does something that goes up because the ad is trending in one way is trending in the other. It's moving, it's dancing. As you can tell, I'm making this episode late at night. And I'm completely dopey. So just by a Dexcom dexcom.com, forward slash juice box links in your show notes in a juicebox podcast.com. You will not regret making the jump to continuous glucose monitoring with Dexcom. So here I am. I'm Scott, I'm standing in front of my microphone. And I have ordered my Reilly link, which is on backorder. And by the way, if you know anybody who can help me with that, Katie, I would appreciate if you put in a good word. It's going to come to me, my goober is going to show up in the mail. And there's other things I could probably be doing before it gets here. Is that true?

Katie DiSimone 43:48
Yes, you can do everything before it gets here. Except actually, you can build the app, you can get other things set up. If you're ready for it. If you're a Nightscout user, you could get your Nightscout set up you can you can do everything you can except for turn on the right link and

Scott Benner 44:09
Okay, and this is not going to get in the way, by the way of my Dexcom share, that's still gonna work fine. Everybody's gonna be able to see that stuff.

Katie DiSimone 44:17
Totally. It's still you can still actually use your exact same Dexcom app, your Dexcom alarms are all still the same. Basically what Luke does is it eavesdrops on your dex comms communications, and so it doesn't interfere with your Dexcom.

Scott Benner 44:31
Okay. All right. So, if you were me, what would you do first?

Katie DiSimone 44:38
If I were you, what I would do first is kind of conceptualize what your game plan is. Number one is, get your computer up to date and also kind of let me take one step back on my Instagram account. I do have a loop advent calendar that I did just kind of on this topic, as I was trying I need to prepare the community with this is coming. And here's a really small digestible day by day. Advent Calendar of day one, make sure your computer is up to date. Do you have Mojave macOS? I'm kind of explaining what starts to sound like technical stuff, just pay make sure your computer is up to date. And it has my Mac, is that right? It does have to be a Mac, yes, it has to be a Mac running what they call Mojave operating system, which is their latest one.

Scott Benner 45:30
Oh, I see your Instagram account. Look at you. You're delightful. Look at this. Very nice.

Katie DiSimone 45:36
So yeah, so you can run through each of those admins day by day and just sort of take it in tiny digestible chunks. And do each of those. Basically, you prep your computer and and this is the part that looks intimidating on the website. But it's actually not is that each of these are natural stopping points as I've tried to lay out the pages in the building the app section into natural stopping points. And so you prep your computer, basically, you want to make sure your OS is up to date your operating system and that you download a free app from your app store that comes from Apple is called Xcode. And basically what Xcode is, is like you present that code for the application for the loop application. And it compiles it all and builds it into a nice little package, you plug your phone into your computer, and Xcode puts that app onto your phone. So you're literally downloading the loop code from us online. And you're using a free app on your computer. You press like four buttons, and the whole thing builds by itself. That's how easy it is

Scott Benner 46:43
fancy as now, yeah, I have already while Katie was saying that, even though I swear to you, I didn't know she was gonna say it. I've already downloaded Xcode onto my computer. Yes,

Katie DiSimone 46:58
that's step one. If you get that on, it's actually a pretty big download. And believe it or not, that's the longest part of building a loop app is downloading. Okay, and then I have a cup of coffee, and you're good.

Scott Benner 47:10
Okay. And I need a developer. I have to be like an Apple developer. Right? Yeah. Because Because for everyone listening, I am technically making my own iPhone app right now. And they're gonna give you obviously all, you know, Luke gives you all of the instructions and the you know, and the code and everything you need for it. But you have to do that because it remains your responsibility. And yes, right. And in the future, if I want everything, you know, work in the way we want it to work, but tide pool and everybody's got their Ok's and their FDA clearances and everything like that, I will just download this app from the App Store I'm assuming or downloaded from tide pool.org or something like that. And it's gonna go right on my phone, I'm not going to need to be a developer or have Xcode or anything like that. Is that right?

Katie DiSimone 47:52
Correct. The tide pools project is basically taking the fundamentals of the DIY loop system, and taking that through FDA approval. So the study is going to help solidify what needs to be done to make that app able to be distributed as a medical device under FDA approval through the App Store. So yeah, that's where the that's where the two projects between DIY and type lube start to diverge is that concept of being able to download this on your app store on your iPhone, and what needs to be done to make sure that all the FDA clearances are done.

Scott Benner 48:32
So yeah. So so tight pull Katie, eventually, this is just going to be checkboxes and drop down boxes on an app.

Katie DiSimone 48:41
Yeah, what we envision is that you'll as type hello, Katie, I'll speak now is that you get to go to your endocrinologist, talk to them about your settings and your carb ratios and make sure that you have some reasonable settings, they prescribe a type of loop for you. You have your components, and you get to go to the App Store with your prescription number and download it.

Scott Benner 49:05
Okay. All right. Let me think. I'm thinking that it's coming in my head, I'm figuring it out. So it's going to look, it's going to look like a lot but Katie has as a person who's done this, not knowing what she was doing and getting what would probably be the best expert advice that she could as she was going along, has turned it into the simplest steps you could possibly have now. I'm going to do this and I'm going to whatever my Reilly link comes, I'm going to I'm going to be ready. I'm going to be set up and I'm going to go and I'm going to try it and see what happens. What is my expectation for a person who lives between 70 and 128? Like, in my mind, I think my first excitement is going to be sleeping soundly overnight. Is that is that the simplest win that I get from Luke, do you

Katie DiSimone 50:01
Yes, for sure sleeping through the night is unbelievable. I think I didn't know what I had started missing until I started sleeping again. Good example last night, my daughter was out to the movies with their friends and needed a ride home at 130. In the morning, it was a drive in double feature far away. And so I was up until 130. In the morning, I can't even tell you how tired I was. Because I've gotten used to getting a full night of sleep all the time. Now, it really was daunting to have to go back to the olden days of missing hours of sleep.

Scott Benner 50:37
You're making people cry right now you don't realize that but there's like 1000s and 1000s of people listening and they're like weeping in their cars. And while they're working out at the grocery store and stuff like that. So that's, yeah,

Katie DiSimone 50:47
I'm a I'm a different person. When I sleep. I'm a nicer parent, I'm a better spouse. There's like a lot that goes with sleep. Yeah.

Scott Benner 50:54
There's plenty of conversations in this podcast where I tell a story about I was so exhausted at one point, and I didn't know it. And then I went away for a week without my daughter. And about the third or fourth day into the trip. I thought to myself, Oh, my God, this is me. Like I remember having thoughts like this. Yeah. You know, like, and being clear headed and that sort of thing. So that's my, that's my excitement. Can I ask you something? Yeah, say I decide I like loop for sleeping. But I want to just stick with what I do for eating, can I do that

Katie DiSimone 51:26
100% You can turn loop has one slider, it's super simple. It's called I opened or closed loop. If you open your loop loop will let you just get the recommendations but not automatically put them in. So it will use your scheduled basil just like your normal pump therapy would, it would just give you your basil that you have programmed in. And you can choose to deliver the insulin any way that you want to, you can enter the carbs, and you can choose your particular Bolus sport. So let's say during the day, you want to say, You know what, I still am working out my carb ratios, I'm still figuring them out. I just kind of want to do it one meal on a convenient Saturday and see how my settings are. But in the meantime, during the week, while she's at school, I just want to keep to our old paradigm until we can get to, for example, right now I'm thinking summer, you know, summer, I'll be home, this will be easier. Absolutely. You can go to school, keep it an open loop, they can enter their carbs, provide whatever Bolus number they want, and loop won't be taking any extra action. And then when you come home at night, you can go ahead before you go to sleep at night, you can turn on the Closed loop switch, you just toggle it right over. And it'll be looping overnight.

Scott Benner 52:43
So being an open loop would show me what the algorithm is thinking because it would say to me, Hey, right here, if I was you, I do a Temp Basal increase of

Katie DiSimone 52:52
absolutely, oh, every five, every five minutes across the top, you'll see the recommendation update. And I'll say this is the new Basal rate I think you should set so you'll be able to see if it's greater than or less than where your existing settings are. And you'll see the prediction too, as well. You'll see the prediction go up and down. I think that's one of the first things that kind of freaks people out as they see that prediction. They're like, Oh, do I cheat a low now because it's chosen six hours, I'm going to be low. That prediction line is always as if no other actions are taken. And that's the whole thing is that loop is going to take actions to prevent or change what is in the future. So if you see a low coming in six hours, you don't need to treat it right now. loops going to be cheating it for the next six hours and staving that off.

Scott Benner 53:43
And so that never happens. It's just like a time travel movie. In a time travel movie, sometimes they show you what's going to happen in the future. But then the people in the past make better decisions in the future never happens.

Katie DiSimone 53:56
Yes, that's exactly what loop is doing for you. Is it saying? Oh, wow.

Scott Benner 54:00
And Katie, by the way, now you know why the podcast is popular because I can take incredibly complex things and turn them into moron talk that everybody can understand.

Katie DiSimone 54:10
I have tried to do that with loot building instruction. So I think you're I think you're my kind of people

Scott Benner 54:15
like seven year old in my mind. So okay, so I also just realized I might be more people are gonna laugh because I don't think I knew this about myself. I think I'm more of a diabetes geek than I thought I was. Because when you said you could open the loop, and then see what it was thinking. That to me takes me back to back before CGM when I used to test on it all these wacko times that my endo would be like, Why did you test 45 minutes after she ate and I was like, Don't you want to know what's happening? And she was like, No, and I was like, No, I think we should know. You know, like, I'm gonna keep testing. She'd always be like, I don't understand how you're a one sees her like this. But you're showing me all these weird blood sugars that don't make sense. I'm like, because I'm tracking what her blood sugar is doing so I can make better decisions. I really think I really think that with six months with loop, I might have to have my head made larger, not for my ego, that one person that left the review, but for my knowledge of diabetes, because I really think this is going to just kick it into another stratosphere.

Katie DiSimone 55:14
It really, it's a truth serum, it really tells you a lot about your settings, your understanding how you conceptualize, reacting to things. For example, a lot of people as they're getting used to this are impatient with insulin, they'll say, I don't want to wait it out. And they'll rage Bolus or or they think the rage Bolus, and they're actually not even bold enough with insulin, you know, and they say, Oh, I'm so scared of going out, having the feedback from a loop constantly telling you, hey, here's what I would do. And here's oh, by the way, your meal absorbed 20 grams more than you initially told me it would be and lasted, it also tells you the time and took two hours longer to digest than you expected. That kind of information is so powerful to relieving the diabetes burden, because it's fine tuning your expectations. And when you change your expectations for going into it and say, Yeah, you know what, it's okay that this meal choose me as 65 I feel comfortable, something has helped me learn better.

Scott Benner 56:21
Okay, I'm so proud right now. And I don't know if you did that on purpose. Or if that was by mistake. Either way, I'm proud. You said bold with insulin, which is really the whole tagline for this podcast. It's that's my hashtag. It came from here, if you don't know that, I'm just thrilled that those words are somehow in your brain, which means it's getting out in the to the stratosphere. And if you did know that, I appreciate you listening.

Katie DiSimone 56:45
Well, I actually heard that from a podcast interview you had with T one Junebug because she's a good friend of mine for several years. And I saw her use that phrase and I thought yes, that rings true. People are scared to dynamically think they'll see the same blood sugar rise, the same blood sugar rise, the same blood sugar rise, and yet say but the label told me it should be 10 grams or my endo told me it should be this and, and stringing that along. And and being a more dynamic thinker. And being bold with the insulin taking the insulin you need for what you've seen over and over again, is really good dynamic thinking.

Scott Benner 57:29
Yeah, I appreciate that. I was just speaking with a mom last night. And I said to her, you have to I said, I know that. You know, I haven't given you any advice here because I don't give advice. I just pass on my own stories. But I told her I was like, I can give you this one piece of advice. I said, I would stop thinking about all the things that people have told you to do, and told you not to do and just apply a little more common sense to this. You know, like, like, stop overthinking it, your blood sugar's high, you need more insulin. That's kind of just I'm down to like, if I see something online, people are like, look at this graph, and I go and I type more insulin. And then I hit Enter, because I can't I can't explain it any more. We do it here enough. But sometimes I'm just like, how can you look at a 300 blood sugar and think I don't understand what's wrong, I know what to do. Of course, you go, what's wrong, you didn't use enough insulin. And so

Katie DiSimone 58:21
it's not going to be it's not going to be the same and it's not going to be perfect. My daughter gets nervous around certain situations and her blood sugar spikes. And Luke doesn't know that's coming. Nobody gave it an announced warning. Nobody gave me an announced warning or my daughter. And so there's ways that you can help correct that faster as well. You can still override and give more insulin and give a correction. There's a lot of information built into loop to help you with that decision making process if you choose to take that interactive Step. If you're the type of person that just says you know what? I'm happy. I'm happy with a little wider range. And I just want less cognitive burden of interacting with it today and or longterm. You can let Luke do that as well. It has all the information put in there that it will meet you at your comfort level and help you make the most of where you are. I'm gonna say

Scott Benner 59:17
something real quick. And then I'm gonna ask you a question. What I'm going to say first is for everybody listening who has come to count on the podcast, I just want you to know that even if I do this and stay with it, I think it's only going to enhance my ability to talk to those of you who aren't doing this. So don't worry about that. I think I want to ask, are you comfortable telling me what your daughter's a one C is on loop?

Katie DiSimone 59:38
Oh, yeah, totally. She started loop at 449 I think and again, we were low carb heavily intensively, lots of work, lots of communications, lots of texting, lots of less sleep. So we are working hard. She is now Got a five, six? What was her last 156? I think, and she is as high carb as they come has become a vegetarian. So we have no, no like low carb meals ever. And she is completely independently operating and bolusing and doing everything through loop. I have not told her how to split a Bolus in, I'm gonna say a year. She is completely handling all of that just by loop recommendations and putting it into loop. I hope I don't tear up, it has changed everything. I now have the space reclaimed for what used to be diabetes conversations I now hear about her friends at school, I hear about the things she wants to do I hear about going to the beach, and can I go on a date? And I hear the things that I'm supposed to be hearing and they're not laced with? Don't forget to bring diabetes into this conversation. I don't have to do that.

Scott Benner 1:01:04
Don't forget, did you I start too many sentences with Did you? Or you know, can you tell me or what does the say? There's, there's still listen, I'm gonna be honest with you. We don't talk about diabetes around here very much. Because we really are, we just have a rhythm. Like I don't know another way to put it. But at the same time, it still happens. And if it could be less, that'd be amazing. And if it's less for me than I imagined, it's going to be much less for a lot of other people. I have to say that this is this is the future that I always imagined, I always thought it was going to come more in like 2020 like writing that was my kind of estimation. And I was always happy with that because I thought well, that's still a couple of years before are no go away to college. So I'm okay with that. But just the idea that it could happen sooner.

Katie DiSimone 1:01:57
It's got me It's amazing. I'll give you an example. When my daughter goes to summer camp, we always talk well, do you bring lip? Do you not bring loop? And, you know, I realized that sending her to camp with a non FDA device puts a little bit of burden, an ask on those camp staffers. And, you know, so I'm cognizant of maybe we don't loop when we go to camp and certain camps even don't allow it. But our particular camp is supportive. And but it's always, it's always funny, she goes to camp because she doesn't want to feel different, right? She's got her her crew, her tribe. And she doesn't feel different around them. But she does feel different. She's perceives this if we talk about it in April, or may have going to camp using loop because she's worried none of her other friends will be using the loop. And so we have this conversation every summer for the last two summers about whether or not she's going to live there. And every summer, she goes into it telling me, Well, I'll probably take it off while I'm there. I'm taking it now. But I'll probably turn it off because I don't want to be different. And she never turns it off. And she comes back to the pickup station after two weeks away. And all of her friends are around her and I'm telling you it's like a little gaggle, there'll be five teenagers with her that I'll go. Katie, can you get us on loop too? You want to use it too? And so, you know, I kind of take that, as my bellwether of how good the system is, or isn't is if adults weren't involved and parents weren't involved, what would the kid decide to do? Because I think that's a really important aspect is the informed decision making process involving the kid and letting the kid be a part of that? And so when she comes back from camp, and there's five kids with are saying, Can you help us? We want to do that, too. I think it's a good sign that the system is well designed and helpful, as opposed to an extra burden that just isn't useful.

Scott Benner 1:03:52
That makes a lot of sense. Can I pick your brain about something else as a as Yeah, as a person who's obviously given a lot of their time and effort to the diabetes community? I think that overall that shows the your concern for people who you know, who have type one and people who you don't know who have type one, I feel similarly. I don't ever have this feel fear. But I know some people do that if you take away the idea of how to manage diabetes, that if the technology is not available, you'll be lost. And I don't talk about that here. Because I think it's silly to make somebody struggle and cry and be upset and exhausted just so they can understand how a Bolus works. I don't think you need to do that. I have dedicated this podcast to fast forwarding people through that whole process. But I'm now I'm projecting into the future. Right. I talking privately and have been for weeks and months with a mom of a little girl who is so newly diagnosed that she is honeymooning to the point where she doesn't need insulin some days. And it's really going on for a long time. And I'm imagining her right now. And I'm thinking I could put this on her. And she would never know all of the tragedy that I've lived through, and that so many other people have lived through, like figuring out diabetes. And is that a good thing? Obviously, it is. It seems like it is at the onset. But what would happen if that technology like if her insurance changed or something happened, it was just taken from her? Do you think that she'd be gobsmacked blindsided by what diabetes really is without the technology? Have you ever thought about that? Like, I'm just interested in your in your like off the top of your head thoughts?

Katie DiSimone 1:05:39
Oh, yeah, I think I think people would be if it disappeared from us. For us. Would it be impactful? Would we notice it absolutely. Give you an example. We switched to Omni pods because we were having problems with sites on NEOs and Medtronic. So one day during a particularly painful yet again, cannula failure kink kind of issue day. She had to turn off loop, we were just perfect storm CGM fails. Me Oh, failed, we were flying blind. And she had to give herself a shot for the first time in two and a half years almost. And I was away from home, she was home alone. And I said, Can you do it? And she's like, Yeah, yeah, I think so. And she did. And it was daunting, and all of that. But that said, you do what you got to do. And I don't believe in keeping the covers on the couches, and not using the things that are great in life, just because something might fail later.

Scott Benner 1:06:54
I don't, I don't like it when there's fear mongering around advancement. And and I think it happens a lot. I think when Dexcom first came out, there were people running around going, you're not going to understand your diabetes. And I think there are people that tell people, you have to have a do shots for a year before we give you a pump. I think all of that, and I'll bleep this out later. I think all of that is okay, I think that you need to understand how insulin works in your body, and then you're good. And it seems to me that this algorithm is going to understand how insulin works in my body. Now should I still understand it? I should but I but what I'm foreseeing in the future is, is that you're going to go on this and write on the screen, you're going to see what's happening. And you will learn how insulin works in your body without ever having to fumble around with the algorithm is not just going to keep your blood sugar where it wants to be where it wants it to be. It's going to teach you how it's doing it visually. Yeah, that's what I'm seeing here. So now you'd have to translate that back to a pump without a loop or injections, if you got stuck in that situation, but you wouldn't be starting from zero, you'd actually have a fairly fast forwarded understanding of it, you're gonna put this podcast out of typo, you're gonna need to hire me if I can't get downloads on this podcast anymore. Because your loop seriously a fluke puts my podcast out of business, Katie, I'm gonna be pissed.

Katie DiSimone 1:08:16
I tell you what, it really died. That's like a truth serum are the assumptions that people had about their diabetes understanding is

Scott Benner 1:08:24
wrong, guys. You're always wrong. Everybody, I'm sorry to cut you off. Everybody who sends me an email is like, I think this is what's happening. I'm like, No, that's not what's happening. Your Basil is wrong. You know, like, like, no one ever really knows. Because it's, it's, it's, it's this false idea. And there I had somebody on recently who said this thing that just struck me. He said, You know, if you put a pencil in your back pocket, and you rob a bank, pencils don't cause bank robbery. But But somebody thinks it does. somebody sees this cause and effect, and they just say, I saw this, then this happened. So that thing must have been the reason why and we make that mistake so often. And diabetes, it's not funny.

Katie DiSimone 1:09:00
It really it's such a true serum is that people get on when things are automated. That means it's using the same assumptions you put into it. And when those assumptions show, hey, you're trending high, or you're trending low, consistently, people are like, what, but these numbers were set in stone, i These were fine. I was doing fine. And what they don't realize is No, you weren't doing fine. You were you were taking a lot of manual actions to make it fine. Or you were adjusting in other ways that you hadn't realized. And so when it to two wrongs can make a right and diabetes, you can overlook things very easily by having two wrongs equaling a right. Yes,

Scott Benner 1:09:48
there are so many times that people are having a good outcome at 3pm. That's really just from mistake at noon and they have no idea. Yeah, it's really it really is. Once you see it It's I joke about that it's a little old of a reference. But once you see it, it's it's like at the end of the matrix when the bullets start moving for Neo, and he's just kind of like walking in between them and moving away like once you can see it, it's fascinating

Katie DiSimone 1:10:12
loop provides that visual, that visual interface to be able to see it. So one good example. So for example, let's take your correction factor or your insulin sensitivity. A lot of people have a wild guess at that, but they don't really know and they haven't tested it. When you see your blood sugar's on an automated system, kind of roller coastering, up, and then down and up, and then down, you're also probably gonna see what I called lightning bolts of Temp Basal. So you'll get a lot of Temp Basal action trying to correct a rising blood sugar and then suddenly, you'll turn low, and or not low, but you'll start heading down and then you'll come back up, and you kind of get on this oscillation of roller coaster. That's usually because your ISF is, needs to be higher number. So I don't know I'm avoiding using the word weak or strong because people have different impressions of what that word means in terms of where the actual number needs to go. But if you had put in, if you told loop, each unit of insulin will drop my blood sugar 50 points. And you start seeing that roller coaster pattern, that's a really good indication that your your value of 50 actually might need to be up near 70, or a different number higher than 50. Because you basically undersold insulin to loop, it's actually doing more than it expected. And so some of these things about loops, ability to inform you of your diabetes assumptions are really like strikingly obvious. As soon as you start using it, as you start seeing that you go Holy smokes.

Scott Benner 1:11:52
Okay, so I have a couple of just like, like fast paced questions here. So first day of a Dexcom sensor in the first few hours, I don't really lean on it for like, you know, I don't want to put a time on it. But until it's right, like until it's soaked in, it's really working. So do I just go into open loop during that time? Is that what yeah,

Katie DiSimone 1:12:10
you could? No, it's not what I do. But you could, my daughter basically usually ends up changing her sensor at night, which is, I think, the worst time to change a G six. And so the whole first night, we basically get a lot of false lows or compression lows. And what we have found is that basically, loop still does, okay, it doesn't. And in essence, what happens is that you get some higher Basal rates, you get some suspensions, and they all evened out over the course of the night to be okay.

Scott Benner 1:12:44
hammers out the kinks and gets it gets you Yes,

Katie DiSimone 1:12:47
yeah. And then when she wakes up in the morning, finally, the Dexcom is back on an even path, and everything's fine. So for the first 12, for us, it's you know, it will depend on the person, but for us, the first six hours of a new sensor are kind of jaggedy. If it's really far off, we can go into open loop mode, and it's no problem.

Scott Benner 1:13:09
Okay, what about different insolence? Do people see different or does it not like we use a pager? That's gonna be good?

Katie DiSimone 1:13:15
You send me up on that one. Yeah, actually, within loop, we have three different insulin models. So there's four, but three are based on the type of insulin and the user. So there's a rapid acting adult, which is like Novolog Humalog. For adults, there's one setting for children. And then there's another setting for fiasco. So and then each of those settings basically describe how the insulin curve works. If you after knowing your daughter and kind of looking at how things work, say, wow. On our particular insulin, we think it peaks at this amount of minutes, that's actually something you can customize within your loop to say it peaks at this time, we have numbers put in there that are based on the published data of how these things behave and clinical trials and all of the published data. But if you find that for you, your diabetes is different, you can actually tweak and customize some of those things.

Scott Benner 1:14:19
Okay, and so a lot of it's customized Like for instance, can I pick her target blood sugar?

Katie DiSimone 1:14:24
Oh 100% Awesome. That's

Scott Benner 1:14:26
the one thing I would just not like I don't I would I want to sleep more but not at the you know what I mean, not not to say that I don't know what the Medtronic artificial pancreas but it's like at 120 or 140 or something like a target up there. Like I couldn't do that. I wouldn't be able to make that decision.

Katie DiSimone 1:14:43
I'd say out of all of the feedback I consistently hear on the development of closed loop in the commercial market. That target setpoint is is the real critical piece for a lot of people. And on this one, you can set it anywhere you want. We have people setting At that are ultra low carburetors and have a single number target that they really aim for. And there's other people that are doing a much wider range and are. So yeah, it's totally up to you what you want to set it up.

Scott Benner 1:15:12
Okay, is it my so my last kind of nuts and bolts question is do I tell it when a new pumps going on? Like, how much does it care about how old the infusion set is?

Katie DiSimone 1:15:20
If you're on Omni pod, it keeps the theme, Standard Change cycle as Omni pod, it will alert you it's well at 72 hours. Omnipod tells you just pods done but at 80 hours, it really makes you change it and it says you're done done. Loop has the same things. And you can set a custom notification for when you want it to tell you hey, it's coming up.

Scott Benner 1:15:42
What about this? Here's another I said I wasn't gonna ask any more nuts and bolts questions. I have one more. What if a cannula like comes out a little bit? I'm getting some of my insulin but not all of my insulin? Does it know that? What's that? It's not seeing what it thinks it should be saying?

Katie DiSimone 1:15:57
That's a great question. And the answer is no, in a way is that basically, if it thinks you delivered a whole unit, but the cannula actually only managed to get half of that under your skin and absorbed, loops calculations will be a little off, it will think that you have more insulin than you do. And so what you can do is there's a couple of different options, you can open your loop, until that discrepancy wears off, and you get it all changed and figured out, you can open loop and just go back to normal pump therapy. Or you can enter in a fake carb, where you say, Hey, I'm going to eat five grams Bolus mean for these five grams. And basically you're tricking the algorithm to think your blood sugar will rise because you were eating. And so therefore, it will offset some of that it's a more advanced technique. And people kind of start using that in those situations once they become a little bit experienced. But that is an option as well to kind of say, Hey, I'm going to need extra insulin that you think is there. But wasn't there.

Scott Benner 1:17:03
We call that stuff ninja level. So yeah, okay, so All right, so here's what I'm gonna do it because we've been going at it for a while and I want to make this digestible for you. We're gonna stop, I'm going to say thank you. I'm going to ask you, after I get this back, when you come back on and talk with me after I've been using it for a little bit,

Katie DiSimone 1:17:20
I would love to, I think that would be great. And can I have an ask of you?

Scott Benner 1:17:24
I guess so. But I'm not taking my pants off.

Katie DiSimone 1:17:28
So that the ask is that I want to make this system better for everybody else. And make sure it goes there, you know, is able to incorporate all of these things like soliciting impact, feedback. And that job loop observational study is a really important part. And it's the best way that people have to pay this forward and provide meaningful impact. I would love it if people would take a look at the study and donate their data, it can all be done from home. It's super convenient. It's very fast and easy. And it provides important user information, especially from new users, or like just getting on the loop. You're asked questions about like, how did the setup go? How hard was it? Are you technical? Are you not technical? How do you view diabetes, all of that's going to paint this incredibly awesome mosaic of what kind of user experiences have been and just take the system into a better place.

Scott Benner 1:18:27
Okay, so when we've talked about it here, but the next time we talk, I'll give direct, you will be able to give direction instructions to people about how to donate their their data to that. That'd be great. Excellent. Okay, I don't want anybody to worry. I still understand how to be bold with insulin after a day and a half of looping. As a matter of fact, that loop, just like Katie said, is showing me things that I don't think I understood. But I'm starting to, and then I'll be back here to report to you. So whether you want to loop or not loop or lose skipped your Lu, or just keep doing what you're doing, or do what I've been doing for years, which might be what I'm doing again, I don't know how long we're gonna do this loop thing. We're trying it. I can't do a podcast of it don't understand looping. I mean, it's 2018 Wait, is it 2019 Wait, I mean, it's 2019. It is so late at night here. I'm out of my mind. I hope you found this episode interesting. And what Katie had to say intriguing. I certainly did. It got me off my butt to try looping. And as soon as I know what I think I'll report it back here. Huge thanks to the sponsors Dexcom real good foods, and dancing for diabetes. The links to everything you want to know about them are in the show notes of your podcast player or at juicebox podcast.com. But you can always go to dancing the number for diabetes.com Real good foods.com use the offer code juice box, or of course dexcom.com forward slash juice box. I'll see you next week.

Thank you so much for listening today. Please keep Katie and her family in your thoughts and prayers. I'll be back very soon with another episode of The Juicebox Podcast.

#860 Type 2 Diabetes Pro Tip: Series Intro

A series for people with pre and Type 2 diabetes.

+ Click for EPISODE TRANSCRIPT

00:00:22 Type 2 diabetes pro tip series.
00:06:03 Understanding type 2 diabetes medications.
00:13:34 Importance of education and technology.
00:18:12 Individualized approach to diabetes management.
00:22:39 Diabetes podcast helps educate and support.
00:29:38 Food can be medicine for anyone.
00:33:54 Understanding the impact of diet
00:39:59 Guilt and shame in diabetes.
00:45:43 Misdiagnosis and stigma in diabetes.
The timestamp in the podcast where it starts to say "Standard of care for type 2 diabetes needs improvement" is 00:51:32. Standard of care for type 2 diabetes needs improvement.
01:00:03 Exercise is often overlooked.
01:04:22 Helping people with diabetes.
01:08:28 Nothing is impossible with persistence.

Scott Benner 0:00
Hello friends, and welcome to episode 860 of the Juicebox Podcast.

Welcome back, everybody. This episode of the podcast is going to be a little different than you're accustomed to. Jenny Smith and I are going to be talking today about type two diabetes, we've decided to put a type two series together, not dissimilar from the other series within the podcast, but focused on type two. This is the first episode, it's an introduction episode, and it's going to lay out what the series is going to be. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. If you're a regular listener of the podcast, I hope you check out this series and then really think about who in your life could benefit from it. If you're a person with pre diabetes, or type two diabetes who finds themselves here, welcome. I hope you enjoy this. And I hope it helps you. I really think it will find the Juicebox Podcast and your favorite audio app and hit subscribe or follow to get the next episode of the podcast and to continue to get this series.

These episodes are available, of course in any audio app by going to the Juicebox Podcast and searching type two diabetes pro tip. And of course, they're available at juicebox podcast.com, and diabetes pro tip.com. At the end of this episode, I'll introduce myself and Jenny to you. So you know a little more about us. This episode is being brought to you today ad free because of the generous support of Dexcom on the pod. The Contour Next One blood glucose meter, G fo Capo Penn ag one from athletic greens, US med touched by type one and cozy Earth. If you're interested in learning more about the sponsors, there are links in the show notes of the podcast player that you're listening in right now. And links at juicebox podcast.com. So, Jenny, it's good to see you again. I feel like I haven't seen you in a while.

Jennifer Smith, CDE 2:35
It has been a while. Yeah,

Scott Benner 2:37
I agree. Now, for the people on the podcast, they hear you all the time, but I haven't seen a little bit. So we're gonna undertake something, something it's been in the back of my mind for years. And I know you've talked about it a lot as well. And so I think we're a good match for this. So I'll just share with you that my initial idea around type two diabetes conversations. I thought to myself, like I have this podcast and this outlet, I can find people. But I'm not a doctor. And I don't know anything about diabetes, type two specifically, right? How would I help people with type two diabetes? Like how could I use the thing I have to do that. And what I kind of came up with is like, well, I could be the person. Like I could be the stand in for the person listening because I find that more and more of the people I talked to who have type two diabetes seem to sometimes have a very, I don't know what the way to say it is they they have a small understanding of what it is they're expected to do. And even what is happening to them, right. So while I might not have a lot of answers, I'll be I'm going to be your avatar. Listening, I'll be their avatar, I'll be the guy going I don't understand this. Explain this to me. And you'll be the person who understands that who says, Well, let me explain this. So but we have to figure out some bones for this series, like some structure, right? And because you and I don't work together, like every day, we're not sitting across from each other, something like that. It's not like we can talk at lunch and things. Right. So what we did was

Jennifer Smith, CDE 4:12
we don't have cubicles next to each other,

Scott Benner 4:14
right? So we're going to do the basically we're going to do the the setup part on this episode like we did with the ball beginning series. Yes. All right. So what I did was I went back to my private Facebook group, and I asked people I said, Hey, if you've got to type to list some things that you'd like to see in a type two Pro Tip series, I figured that would be a good place for us to start the conversation. I would

Jennifer Smith, CDE 4:41
expect there was a lot of feedback and I think if it if it reached the broader community of people with type two diabetes that are not listeners currently, but who are searching online for some type of tidbit of information to help i could imagine the Questions number in the hundreds. It was because of the lack of information given

Scott Benner 5:06
it was really something to see how many questions came and you know, my groups a little more. I don't know, sometimes they're a little more dialed in, but it's also a good mix. It's also a lot of people are like, I don't know what I'm doing versus I have some ideas. So I sent you that. Do you have the list? I do. Okay. Yes, yeah. So, thanks to Isabel for putting all these questions together for me,

Jennifer Smith, CDE 5:26
Isabel, in order of like category, which was lovely to see,

Scott Benner 5:32
Jenny saying that because she knows if I was in charge of this list, it's just,

Jennifer Smith, CDE 5:36
well, we can originally for the original pro tips, you know, we collected a list, and then I was like, we need to do these orders. Like, we need to start here and move here and go here. So this is very nicely organized. And

Scott Benner 5:51
I was like, here's a couple of ideas. And Jenny's like, this one would make more sense in front of this one. I was like, whatever. That's good with me. But let's go through and together. Let's mark things as stuff we want to do. Stuff we want to do and stuff maybe we want to do later. Does that make sense? Give it three orders. Alright, so let's go through this list. Of course, the question was, what topics would you like to see covered in a type two Pro Tip series? So the first thing here we're looking at is meds. Meds such as S G, l two Lt. Two GLP. One and they're multifunctional use? Well, there we go. I'm, I'm already the I'm already the avatar for people who don't know what they're talking about what the hell does that mean?

Jennifer Smith, CDE 6:36
Yeah, and I can tell you that this, the meds at least from what I can see in here, the meds list is it will be extensive. And there are different categories of meds, both oral and injectables that are not insulin that are used in the type two world and the list, the list continues to grow. So it becomes even a little bit more confusing for many people, because manufacturers have figured out ways to kind of put some of the meds together in one pill form so that people don't have to take like four pills at one time. Right. So there are multiple combinations and some things get used with other things. And so yes, the meds list, this is a really good starter, but there are there are a lot of meds.

Scott Benner 7:29
Yeah, the list so I'm seeing here GLP one is a is a category of drug right? That could be like trulicity correct by Yeah. ozempic Victoza, like okay, and,

Jennifer Smith, CDE 7:40
and the same for the stLt, twos. All any of these even things like the oldest, you know, being Metformin. There are even combinations that include Metformin, but are not just solely Metformin. Okay, so,

Scott Benner 7:54
alright, I'm seeing STL T to lower blood sugar and adults with type two in combination with that exercise. Okay, so we're this one is a yes, we're keeping that one that one's going to in the medical category. Oh, okay. This person wants to talk about GLP meds, that insurance company is still putting barriers on, we're going to make that a secondary question. So I'm gonna go yes. Why would I not? Why does my brain work like this? Why do I just put Yes, and then secondary? Why did I not put?

Jennifer Smith, CDE 8:28
You just move it underneath?

Scott Benner 8:31
Yeah. Anyway, don't worry, the series will be terrific. Don't Don't worry about how my brain works the conversation with Okay, somebody here just says, I want to talk about all the meds so we don't need to consider

Jennifer Smith, CDE 8:43
that. And I think that's a I think that might even be a good first one in terms of starting the med. list list is all the different categories of meds being used for type two diabetes. And then kind of maybe we can break them down into each of the categories and have an episode on each of the different types potentially, or if there's, if they're easy enough to discuss, we could do multiple in, you know, certain.

Scott Benner 9:15
So I'm going to, I'm going to combine these two thoughts then. Cool. All right. And new medications. Oh, why? To increase protein during weight loss with ozempic? Oh, I might know about Ha, see, this is how this always goes.

Jennifer Smith, CDE 9:32
I saw your light bulb go on.

Scott Benner 9:34
I know something about this. I think there's been some studies that say that when people use some of these drugs for weight loss, you're not just losing fat, but you might be losing muscle and bone density too. Have you heard that?

Jennifer Smith, CDE 9:51
Um, yes, in in some things.

Scott Benner 9:56
It sounds like this person heard that is what I'm saying. Yeah, and

Jennifer Smith, CDE 9:59
I think that goes along with some education, which we will obviously get to I'm sure it's a category within here that was that contained a lot of questions. It's all about food and like the piece that works and why it works and why some meds work a certain way and why you should aim for more protein or leaner quality proteins along with lower glycemic or even lower carb type of meal plans. So yes, okay.

Scott Benner 10:28
And this next one is just about the weight loss drug. Now Metformin, obviously, we're going to talk about Yeah, so that just that that gets up to the top, basically, Metformin is the go to right, like you get type two diabetes, and somebody's handing you Metformin.

Jennifer Smith, CDE 10:47
Metformin is often an initial go to I mean, there is protocol, depending on where glucose levels are wearing a onesie level is at diagnosis may give the doctor some ability to navigate starting medications, many times, yes, Metformin is one of those first starting ones. And it's one of the oldest on the market, it's well studied. It's well accepted by most bodies, meaning it doesn't cause other issues. And the initial side effects of it, they usually go away within about the first two weeks of starting to use it. As you kind of titrate up doses, which is common for some of these other meds as well that are used for type two. So

Scott Benner 11:34
yes, are those things mostly gastrointestinal?

Jennifer Smith, CDE 11:36
Most of them are? Yes, yeah. Okay.

Scott Benner 11:40
wish someone would have I wish someone had acknowledged to me that Metformin made me feel sick, and alternatives, okay. I'm understanding what your blood sugar is supposed to look like, and what the medications precisely are doing and helping with? Oh, see, I think this is every place. But I think we should talk about this too. I think people hand you something like here, take this. And you don't know why. What it's supposed to be doing? What is it you're looking for? Absolutely. So we can, I think,

Jennifer Smith, CDE 12:12
I think the biggest thing that came out of prior to working for integrated, the endocrine that I worked with previously. I ended up working with a lot of the type ones eventually. But I also helped to teach the type two classes. And many of the people that were brought into the classes on that initial class, were often very hesitant whether they had had type two for a long time, or it was a very new diagnosis for them. They came into the class, almost like what am I really here for? Like, is this even going to do anything and by it was a four Class series. And by the end of the fourth class, they were so they were so appreciative to now have the information to go forward with and the unfortunate thing is that, I mean, we had room in the classes for upwards of, you know, 10 to 15 people. And oftentimes, our classes, maybe had eight, right. And I think it's unfortunate, because the classes aren't emphasized enough they are available insurance will cover a certain number of classes upon diagnosis with type two, over a year's time. But many people aren't given the opportunity, or they're just not sent to the right place, or they just aren't given the information that, hey, this is really important. I'm telling you to use this thing and telling you to act get active and telling you to change your diet. But I as a doctor can't tell you exactly the specifics of that. Please go here. So you can get the specifics, right. So

Scott Benner 13:55
well, people are so adaptive. You know, I saw a guy in the grocery store the other day, and his gait was, like bizarre, the way he walked was it was just strange. He was a young guy. And it looked weight related. And what I noticed about him was that it was just his life like he, you don't I mean, he was just doing it. And I think that just happens to people, I think you get some news, hey, you have type two diabetes and a heart. Well, I got type two diabetes, and you just kind of people just keep going. And they You said something earlier, that was interesting, like the idea of like, believing that there's something you can do about it. I, you know, maybe they're not even left with idea, like, Hey, you could impact this.

Jennifer Smith, CDE 14:35
Right? Or they've had a strong enough family history of type two that it wasn't a surprise that they were then diagnosed with it. And they have historically, there's not been grade education for those with type two. I mean, a lot of people with type one complaint about their education, but quite honestly, for the most part, it's better than type two. Yeah, no, I understand. And so they've had this history of Looking at family members, and even maybe friends, and they say, well, they really talk very much about it. They look like they're just going about their life the way that they should or, you know, my brother never did anything. And he's seems to be perfectly fine. He doesn't talk about

Scott Benner 15:16
the other side of everybody. Everyone dies. And it's all mess. And I've been waiting for this my whole life. And here, this is just what's going to happen. Yeah. So I'm going to call that generational apathy. I know, I joke that I'm not helpful, but I'm kind of helpful. And putting that under a list here. I'm making my own while we're talking under Education. Okay, so moving on to technology. Yes. person says how helpful would a libre or Dexcom be just for the knowledge because no matter what type of diabetic you are, knowing what is going on in your body is the greatest benefit. I mean, I have a person close to me who has type two. And I think I bother them about once a month about getting a CGM. So yes, yeah,

Jennifer Smith, CDE 15:58
absolutely. I mean, if there is a teaching piece that is valuable, especially if you've left your doctor's office with very little information, but on asking, you say, you know, I'm going to try to do what the doctor said in the in the littlest amount that I can, but I need information and more than these finger sticks that are cumbersome to add into my day or whatever. If somebody has just given us CGM, the ability to see the impact as we know about what things you're doing in a day, and gosh, I did this today for breakfast and did it tomorrow. And it seems better than what I did three days ago, maybe I should keep doing this kind of thing versus the other. Right? Because that's it can be really motivating, then you're blind to information, you're less likely to make a change.

Scott Benner 16:53
And it's easy to not know any of the impacts of your diet to absolutely just, this is what we've always eaten.

I know people who just grew up a certain way. And some of the foods that they think of as healthy are fascinating. And and it's I don't know, if it gets commingled in your head, the difference between health and oh, this is good. But you know, how people talk about, oh, this is a good dinner. I love this. It could just be something from your childhood that you're like, Oh, I remember this fondly. Right. Yeah. Yeah. And I think that I want to do a blend here with this, right? Because it's my belief, not around type two diabetes, but around everything, that you don't get anywhere telling someone that they're wrong, or the way they feel is invalid. Or you should make some grand change in how you do things. Like no one's doing that. No, you know, and I think that's where type twos get screwed, honestly, is that they go into a room and a doctor says, Hey, listen, it's nothing diet, exercise won't help. And you're like, great, well, I'm 53 years old. I haven't dieted or exercise that my whole life. I'm sure I'm gonna go home and do it right now. Not that that doesn't make a great advice. Like I'm not saying that. It's just not actionable for that person.

Jennifer Smith, CDE 18:29
It's not because it's not been individualized. And that's across the board and diabetes, regardless of the type of diabetes you have. There's a lack of ability. For many caregivers, not all but many practitioners to sit down and really get to know the person. Yeah. Right. You have to get to know what they are doing in their life. And what is what's their why. Why should they do this, like what in their life is so important to them, that will be better that they can continue to enjoy? If they learn how to do some of these things that you're just giving almost like a rip off sheet that's like, do this and do this and you'll all be fine, right? It'll all just magically like, work out it for itself.

Scott Benner 19:16
Here's the list of five things you've never done in your life you have no context for and you don't want to do and you don't have time for just do those and everything will be fine. And then most people are like, Oh, I guess this isn't gonna I mean, listen, you and I are seeing each other over a camera. I don't know that can you see that? I'm losing weight by any chance are probably not right.

Jennifer Smith, CDE 19:32
Probably not you and which is funny because you and I also haven't seen you in a bit of time. So usually people lose weight like facial structure wise first or within their neck. But I've only seen you standing up in person a couple of times.

Scott Benner 19:48
What's going on for me is that my daughter went back to college, and my son got a job and moved out. And you know what I have all of a sudden, more time. And, and I'm using that some of that time to cook better for myself?

Jennifer Smith, CDE 20:01
Yes, that's it and to use the machine that's sitting behind

Scott Benner 20:04
you able to get on my bike more frequently. But that's just the point is that it's just the only thing that really changes that I suddenly had a little more time. Yeah. And you can say, well, there's nothing more important than your health. And you're going to be right when you say that. But people have bills and responsibilities. And if you don't have enough time, you don't have enough time. And so that's why I want to do this, because I want to give everybody everything they need to know. And then they can cherry pick from it, because I find that's how that's how the Juicebox Podcast works. So well. Is it like I used to think, Oh, I'll lay it out here for them. And they'll follow it like a roadmap. That's not what happens. Like, yeah, you give people a ton of options, and let them go through it ala carte. So this isn't an ad, I just wanted to let you know that as of this recording, march 1 2023. The podcast already has three episodes with people living with type two diabetes, these people all listen to the Juicebox Podcast prior to coming on the show. And they shared the really amazing transformation that they went through. Right now you can hear Leanne story at episode 665. John story in Episode 688 and Michael story at 799. And just like this episode, which is called type two pro tip, and then intro, right, there's like a prefix type two pro tip intro. There are type two stories, Michael type two stories, John, type two stories, Lian. And I'm looking for more people with type two diabetes to share their story. You can find the link on the website juicebox podcast.com. To contact me if you'd like to share your type to journey with everyone else. Also, I know it's gonna sound strange, but find our private Facebook group Juicebox Podcast type one diabetes, but there's 35,000 people in there. Each one loves someone with diabetes or has it themselves. And there are so many people in the group who have type two diabetes, this is a private group where you can hang out, watch people talk, ask questions, and it's a private group, private. So you can feel confident sharing your story there as well. Oh, and I didn't mention it's absolutely free. As a matter of fact, nothing about the podcast will ever cost you money. And I don't believe that your health should cost you something. It's not right that you should have to pay a coach or a mentor, or take some sort of a class or pay for some content that's behind a paywall. I don't believe in any of that. Everything you need to know is here in the podcast. If you want to ask somebody a question, you go to the free Facebook group where there are 35,000 people waiting to answer your questions. It's not cool, when people take your money to learn about diabetes, I'm not down with that. It shows that supported, I'll take care of paying for it, you just go ahead and help yourself to whatever information you need.

Jennifer Smith, CDE 23:10
You know, what I've I've kind of seen is that the more newly diagnosed who've joined your group and started listening, they seem to be the ones that are going through it in a in a way that moves from one topic to the next. It's more those who have had diabetes a long time and are no coming. And they're like, Well, I know how to basil test. I'm having a problem with this. Yeah, so they pick that topic, they go through it, they get the answers they want, and then it might drive them to another episode about something that's also relevant. But that's, that's the benefit of being able, you know, to go through a list that's very clearly defined.

Scott Benner 23:49
And I want this to help people who not only are in a situation where they're like, Look, I need to use insulin, right? Or maybe I'll try some of these other injectable meds and see how that goes first. I don't just want to help those people. I want to help people to who might hear something and think, Wait, potatoes, I just don't eat potatoes. Like you don't? You don't know, like you don't know what people don't know. Right? And so laying it all out there for them. And I I'm gonna tell you this right now, like if this is popular, I don't first of all, I don't care if it's popular or not. I'm gonna put it out because I think it's the right thing to do. And I'm going to put it within my within the Juicebox Podcast. But when you and I get done, if we ended up with something that is so just iron clad helpful. I might open a different podcasts up for type twos and just drop the information in there and leave it like a binder for them. Yeah, you know, and maybe I won't put episodes into it very often, but at least they'll be able to get through it easier.

Jennifer Smith, CDE 24:50
And I think that would be beneficial because from a from a one site access point. I think it would be fine to have both groups of information in one place. But I think if there is the potential that another group of interest is going to end up coming out of it, then there are a lot of topics and things that gets discussed, that are not specific, they're not worth the time of someone with type two is not all of them are. They're not as usable for that population. And or, like I said about the medications, there are so many different medications that are not going to be discussed in the type one world, but are very relevant for someone to be able to discuss with other people with type two, in you know, in that category, so

Scott Benner 25:39
am I also I bring this up under the technology banner here of our conversation, because sharing online is also technology. And there are going to be type twos who can get into that type one group. And I've almost stopped thinking of it as type one group, if I'm being perfectly honest, I think of it as a diabetes group. Because I, what I've noticed is that if you're have type two diabetes, and you're using insulin, it's pretty much the same game as having type one. And so it a lot of this stuff translates and as valuable. From both sides,

Jennifer Smith, CDE 26:17
I think to this technology category to what I see there's a lot about CGM. But I think in terms of a gadget, quite honestly, there's a lack of education about glucose meters. Yeah. Right. And that may be something in fact, it it is along with medications, it gets prescribed. But there's no education in the office about what to do, what the proper time of checking your blood sugar is. And even it may be this is further down. Somebody may be asked about it, but like, what do you do with that information? Yeah, great. My blood sugar is 133. Is that right is do I have to do something about this? Should I even take my medicine, it looks like it's it's a number where it's supposed to be. And I think, you know, years ago, when I worked with with more type twos in our endocrine practice, we often used to do around seated around glucose meters, teaching people the right times to check, okay, and what that then means and what they can do about it. So I think that's an important piece to bring in. Because while a CGM would be kind of pie in the sky for anybody who has diabetes.

Scott Benner 27:34
It might be because it might be a cash option when you're type two, right? Unless you're using insulin,

Jennifer Smith, CDE 27:39
depending on insurance coverage, and all of the things that have to get checked off in terms of prescribing it, and then what the coverage would look like. Yes, it may be a question of even being able to get

Scott Benner 27:52
it. So I added BG meter when, how and what do I do with the info? Yes, okay. Yeah, because the rest of it is like you said, people, I mean, it's not wrong, that CGM would be an amazing benefit for you if he had type two diabetes, but your insurance might not cover it as what like right

Jennifer Smith, CDE 28:10
here. Right. And there is, I mean, in terms of technology, and this kind of goes with meds and technology, quite honestly. There, there's something that bridges into both, and that would be the insulin pens, right, that if somebody with type two does use insulin, then there is actually technology that can help them use it better, and to collect the information better and make more even, I guess, evaluate their information to go back to their doctor and discuss. I mean, there are even some insulins that work with a prescribed type of device or app that allows the doctor to discuss back with the person how to titrate their doses, which is quite nice. And again, I would expect that many people don't even know that that's an option. Yeah. Okay.

Scott Benner 29:09
So yeah, alright, so diet, diet discussions, including by the way, diet, to me means what you eat, I'm not saying you're on a diet, like so. I hate the word diet. Yeah. I don't know what to say here. Give me a better word.

Jennifer Smith, CDE 29:25
Well, what are you putting in your body when you eat? You're putting fuel in, right. So I I call it fueling plan.

Scott Benner 29:33
Jenny, I've changed the fueling plan. So yeah, I'm not going to be able to change everybody's I'm not smart enough to read this and change out the word diet for fueling discussions, including Whole Foods, plant based options, intermittent fasting for weight loss and reduction of insulin resistance. Food, if it is good for you can be medicine for type twos. I mean, food can be medicine for anybody, honestly. And so that's a great one. We'll leave that there may be a more targeted how we eat conversation revolving around type two things

Jennifer Smith, CDE 30:07
similar. Yeah, that's

Scott Benner 30:08
I think that's similar. I think I'm going to take that out. So it doesn't get confusing because it's the same as the first one. How to meal prep way foods checking packaging. See, that's a big one. I always ignore that. The people maybe don't know what they're looking at when they look at that information on the package.

Jennifer Smith, CDE 30:25
Right, because it goes along with again, that rip off of eat food, eat better food, or an old one. And I have still heard it as don't eat white food. What does that mean? Right? Right. I mean, the inside of an apple is white. Right? Does that mean I should no longer eat apples? You're saying we're

Scott Benner 30:47
some slight thumbs tight TOS get told don't eat white food? They can't just say potatoes and white bread.

Jennifer Smith, CDE 30:54
Don't eat don't eat white food. Yeah. And really like white food? Come on.

Scott Benner 30:58
Yeah, that doesn't make a ton of sense having the tasty healthy recipes. And info on lower carb alternatives are huge. Well, I'll tell you, I agree and rub up against the idea of great recipes. I agree. Because I think if people had better tasting foods that were healthy, they would eat them. I also think that most people don't cook. I don't think as many people cook, as you imagine, you know, where that cooking, where the cooking is not the thing that I'm watching on chef on Netflix when I'm seeing Jon Favreau and that other guy throw together a thing you don't even like, right? I don't think we all cook like that.

Jennifer Smith, CDE 31:35
So now might be in and of itself. Maybe it's it's a whole kind of discussion is just like what does it mean to prepare a meal? And what does that have to be like, as you just said, it's not like watching Top Chef or whatever, the one where the mean guy talks to people. What's his MC? Gordon, there you go. Yeah, he goes name off the time, like Hell's Kitchen or something like that, right?

Scott Benner 32:07
Like for cooking shows,

Jennifer Smith, CDE 32:09
or whatever. But it's all the same concept of like, I think you're right, people don't think, gotta have to cook up, like cooking becomes this elaborate like, three hour process. And cooking doesn't have to need to be like that. Doesn't have to

Scott Benner 32:25
I also think that that idea stops people and I just I believe, listen, I don't know how, why believe us. I don't believe that many people. I just I think it's time like, I know what it takes to make a meal. The other night, I said to my wife, we're gonna have this in this for dinner. Is that okay? I said it's two or three o'clock in the afternoon. And she goes, Yeah, that's fine. I was like, great. That's dinner time. I'm like, I'm gonna start cooking because I don't want that anymore. And I was like, Okay, what do you want? And she goes, Don't worry about me. I'll figure out what I want you go ahead and make that for you. And I said, Well, you obviously don't cook very well, if you want me to make two meals. I was like, I don't have time for that. We have to go to bed at some point, you know, and I have the luxury of working out of my home. Yeah, and being able to say the days over 15 minutes glass of water, I'll start cooking dinner, right? Like, I don't have to get into a car and drive somewhere. Or go pick up a kid from something or something like that. I just don't think I think there's a way to help people prepare foods that will help them that doesn't leave them thinking I can't accomplish this. Correct, right. That's what I'm so I absolutely want that. Next up next thing here person says low carb makes a big difference. And so I'm just going to say here that because I make a type one podcast, and I have a type one Facebook group. And people who eat low carb and people who don't eat low carb love to argue with each other sometimes. I don't know if I've said this a million different ways. I'm just gonna put it here too. If you want to eat low carb, I think that's fine. I don't have a problem in the world with that. And as a matter of fact, it is. I mean, we can sit here and argue and say, Well, you need this or you need that in your diet. I don't know any of that. You are you have a nutrition background, you'll be able to tell better, but I want to dig into low carb when we're talking.

Jennifer Smith, CDE 34:19
I think it's an excellent topic, especially in diabetes in general. Yes. But I absolutely think type two is a very appropriate place to talk about

Scott Benner 34:31
that for sure. Yeah, absolutely. This next one, what should I be eating? What should I try to avoid? I want to leave that there. My doctor told me to eat lots of fruits and vegetables, but aren't fruit aren't fruits high in sugar. Good question. So I want to put that in with the what should we be eating?

Jennifer Smith, CDE 34:48
I love these are great. They're really they're very thoughtful questions and goes it really goes the distance of the missing information that just telling people to eat better and move their body.

Scott Benner 35:02
Missus Yeah, factors that help a bit I'm gonna reword this, but this person is talking about factors that help manipulate insulin resistance. So we can leave that insulin resistance and carbs sensitivity and how to cope with them. I

Jennifer Smith, CDE 35:18
think those are the kind of the same they are too Yeah, we're

Scott Benner 35:21
gonna lose one of those resistance how diet can affect it? Same thing, explanation of vicious cycles of insulin resistance in the body producing more insulin to manage blood glucose, storing more fat, causing more insulin resistance and on and on, you want to we can can we go over that process and explain it?

Unknown Speaker 35:40
Yes,

Scott Benner 35:41
we can. Can we do it within the the one before that? When we have that conversation? Do you think?

Jennifer Smith, CDE 35:46
I think that this one? I mean, it's not. It's like, it's not really nutrition specific. This is more in like, we don't even have a category of what is type two diabetes?

Scott Benner 36:01
How about if we put it in education? Because I make

Jennifer Smith, CDE 36:03
that would be yes, that would be appropriate. This, this would definitely fit within that. Oh,

Scott Benner 36:10
my God, there's so much here.

Jennifer Smith, CDE 36:12
Yes. That's a good thing. I'm, I'm really glad I'm, yeah, I'm super excited that so many people responded, which were really well thought again.

Scott Benner 36:23
And I'm gonna, I'm gonna say something here. You have type one diabetes, or don't have diabetes at all? I bet you this series ends up being interesting for you one way or the other? Of course, ya know, for sure. Fact.

Jennifer Smith, CDE 36:35
And I, you know why? I think because of the fact that type two diabetes is the most prevalent type of diabetes? Sure. And I guarantee that somebody knows someone, and could refer them or listen and say, hey, you know, I learned this, you've been talking to me about this and complaining about it, or, you know, you're bothered by this, go listen to this. Yeah. Or did you know this tidbit? You know,

Scott Benner 36:59
I'll add this. I hope this won't be controversial. But there are so many influences on us as people from marketing, to food manufacturing, to, you know, whether or not we exercise, whether or not we're supplementing with like things we need to like that kind of stuff. All of those things, impact all of us equally. Some of us get the ill effects of them stronger than others. So just because just because you ended up with type two diabetes, and the person next to you didn't, it doesn't mean that you're both not being impacted by the stuff similarly, and that's why I think it would be helpful for people. Okay, so if you agree with that, then I feel good. Common sense advice, but about not falling for all their net carb marketing propaganda. Ah, all right. That's a great one is that is that like when I go to buy? Shaved ice Italian ice, whatever, you people call it around the country. I call it water ice. And it says fat free. I'm always like, Well, yeah, now. But when I eat all the sugar, well, my body immediately turn it into fat, the story.

Jennifer Smith, CDE 38:14
Now burning it off right away? Yes, no,

Scott Benner 38:17
I got a giant cup of iced tea sugar.

Jennifer Smith, CDE 38:22
In fact, I think that that could be because type two has a metabolic component to it. For many people, I think that besides net carb things like even just label reading, in general in this category, such as its fat free, or the one that came out years and years ago was everything started getting labeled fat free and no cholesterol. Why? Why would oats have cholesterol in them? I mean, from a physiology standpoint, I know why I had the education to understand that. But many people have no idea why a plant wouldn't have.

Scott Benner 39:02
Oh, just marketing. It's just to make you think like, Oh, good. It's the you know, and here's a label that is actually helpful. no high fructose corn syrup. That Oh, yeah, there's one that's not marketing. That one's smart. You know, that one will actually help you. How about this here? Does this belong in education don't get stuck on a sliding scale. It sounds like her father in law got put on a sliding scale? And it just kind of languished there.

Jennifer Smith, CDE 39:28
No, I Well, I don't think it's I think it should be in meds. Okay. Mainly because it discusses that we know more about insulin these days. Now, it also for in this case and for many people who are in insulin who may not have the means to support some of them newer insolence, right. I think it's an important piece to discuss and talk Talk about because we don't know her father in law's story. Maybe he's using sliding scale because it's a monetary or it's a coverage based thing. And or maybe nobody's ever told him that something else is available. Yeah. Yeah, right.

Scott Benner 40:17
Okay, so All right. Next category is labeled guilt and shame. Battling stigma culture is placed upon those with type two. That's obvious now, do I? Do I do that one with Erica? Try to imagine this as a compendium, you and I talking about type two, but then sometimes they're going to be more like, I think they're going to be I think the episodes are going to be a little like a pro tip series. But every once in a while, I think they might be almost like a defining episode. But like, you know, I think I'm gonna package it all together so that people can find it.

Jennifer Smith, CDE 40:56
And then I think if, for a moment, this is a mental health, yeah, it is it and it rolls into how somebody may be managing or maybe seeking additional help or not. Right. So that it might be more of a mental health discussion. Okay. Yeah, because I agree.

Scott Benner 41:18
The second one here is I think a huge factor for type twos is guilt and shame. And it getting in the way of good medical care, I don't know how to compress this down into a snappy little title, she says, or he says, or a buzzword, but it's crippling. So okay, so we're gonna do that. And

Jennifer Smith, CDE 41:37
there are a few we may we may even be able to define a little bit of, of what that might mean. But I think it would be better with a mental health specialist. Yeah,

Scott Benner 41:47
there are so many myths about type two to come down and about shaming people. The only like that only fat people get it or if you eat garbage, you got it. The diet and exercise while he's fix it, and it taking meds but this is an interesting one taking meds is a lazy way out. And that insulin isn't boy, people think of insulin as losing.

Jennifer Smith, CDE 42:10
Absolutely, yeah. Yeah, absolutely they do. And there is, like I said before, type two has a heavy metabolic component to it. And there are some people that do everything necessary. They follow the rules, they do the you know, lean quality foods, and they exercise and maybe they've even lost a large amount of weight. And eventually, they may lose enough data self function, that they may end up needing insulin, and it is from their personal, it's seen as I've clearly not done enough, I failed in this. And now I'm on insulin. And that is it's the place I didn't want to get to or that's what I was working to avoid doing when really as we know, I mean, with type one, we're like, hey, insulin, that's like, like my saving grace, right? Like I take it because I have to take it where I think a big piece that's also not really defined well is prior to diagnosis with type two, how many people have actually had mismanaged glucose levels four years prior to a proper diagnosis. And in that timeframe, what ends up happening is that they are taxing their pancreas, right? They're taxing those beta cells to help Help Help. And in fact, many times those beta cells, they work in overdrive. They try try try to keep up. And so eventually, even with all of those stuff that they may do to get control and keep it for a while. They may have pooped some things out earlier than they realized, where they weren't doing the things that they're now doing. Does that make sense? Yes, yeah.

Scott Benner 43:56
This next one says, I discovered that I was misdiagnosed as a type two when I was actually a type one. And so we're going to talk about that, like just this. But here's the rest of what they said. And I don't think this whole I don't know if it'll call her the conversation you and I have, but it's interesting enough to bring it up here. It was a huge relief for me to be type one, because that meant I wasn't a fat failure. That is that crazy that somebody felt that I mean, it's not crazy. It's horrible. Right? And that is, you know, this person is like, No one deserves to feel like that. No, okay, if I was type two, I didn't deserve to feel like that. If I was type one, I didn't deserve to feel like that. But we do have to. I think we do have to admit that. This is how this is just what happens to most people when they get this diagnosis. Right. They just feel like I blew it, you know, right? Or my genetics blew it or right so I mean, this is I don't know how not to feel terrible about it, you know, like, but I'm gonna I want to keep the first part of it for you and I About being misdiagnosed? Yes, because it's so prevalent, but I'm going to take the rest of what she said and move it up and make sure I talk about it. When I speak with Erica to why their type twos get told insulin is bad for you. We'll go over that. Yeah, I mean, I've I've had three people on the show right now so far that have type two diabetes and have been the whose lives have been changed immensely by using insulin and algorithms by the way people are using like, yeah, like pump algorithms with their insulin everything else this one I don't know that we can figure out why or type two communities foolish shaming.

Actually, for you listening though, I think there'll be an episode of the podcast coming up, where we talk about how people talk to each other online, Eric and I are going to do I think the answer lies a lot less with the topic than you might think. Being rediagnosis lotto or type one is a story we hear more often because it's a because it feels like it's better than being typed to. Oh, so people Oh, I see what they're saying. They're saying people are happy to tell the story. Oh, they thought I was type two. But it turns out no, I have type one or I'm Lada. And that's a badge of honor, almost because you're saying you're not type two. So what this person is really saying is that is how horrible. I think what they're saying is that no one wants to be labeled as a type two type two.

Jennifer Smith, CDE 46:41
Yeah, that's what it sounds like. And I would say that there might be a step behind it that they're reading a surface level of, I'm not type two, thank goodness, I actually have lotto or type one, right? I don't think that that person who was misdiagnosed is actually happy. But what they're what they're actually and I don't even think that they're saying, Gosh, I'm not type two. Thank goodness, I'm not going to be labeled with this like thing that everybody considers is my own fault. I actually think that somebody who is appropriately diagnosed with type one or Lada feels that relief because finally they're they're getting a diagnosis. That's gonna get them the right meds to help. Yeah,

Scott Benner 47:26
relief. That was in my head. I kept thinking, are you gonna say relief? Just yeah,

Jennifer Smith, CDE 47:30
it's relief. It's I somebody's gonna listen to what I've been trying to say. And my blood sugar's aren't coming down. All this medicine you're giving, nothing is helping. I'm eating lettuce leaves, and I'm running 70 miles a week, and nothing is helping and this is the reason. Thank goodness, I have the right answer. Finally,

Scott Benner 47:49
anyone who's ever been sick, knows that. You don't want to hear bad news. But you do want an answer. And yeah, yeah, I think that's what that is as well. Okay, under medical care, how to advocate for yourself. Through misdiagnosis treated, I was treated terribly assumptions that surrounded type two. There's no shame about medication. So I think we're going to keep the AVID I mean, I'm gonna highlight the advocating piece of this. Assumptions I'm going to highlight. And I received the medical field to case owner part of it. I'm sorry, I received from the medical field and the type two online communities I was a part of, Oh, they got shame from that. Okay. Well, we're not going to be any shame in my community. So you can you can go be tight to the Juicebox Podcast, private Facebook group, if we weren't able to control. See, I also think, Jenny, I don't want to get on a tangent here. But I think that some of the things that we just talked about are why I'll give you I'll give the people listening a little inside baseball, I said that I've had this in the back of my head for a long time, and I've wanted to do it. And I plugged away and plug which I have agreed with Thank you, of course you have. And I've plugged away and plugged in by and plugged away and tried to get somebody to sponsor it, so that I couldn't afford to put it up. And finally, it became obvious to me that no one was going to do that. And I was like, Alright, I'm just gonna do it on my own. Right. But here's why. And this is what I think. I think that establishments believe that type twos don't want to be in a community together. I think they think that there's no possibility to build a thing that helps type twos because they don't want to participate in it because they don't want to be labeled. That's what I think the overall feeling is and be I'm saying I have a lot more hope for people than that. And I think that it's a build if they will come situation. I think you can't just To open up a Facebook group and call it type two diabetes support and expect that people are going to flood in because this is the stuff that they think. And then they're going to have horrible social interactions with each other that everybody's going to like everyone's. And that's going to be the end of it. But why does my Facebook group work for type one? I think it's because it began with the core of information that existed in the podcast already that we were able to bring in people who are already thinking, like, this is doable for me, you know, so I'm going to build another place. And dammit, if you all don't come, then Jenny and I just wasted our time, that's fine. But I think I think your

Jennifer Smith, CDE 50:38
wasn't a waste at some point. If you build it, people will.

Scott Benner 50:41
I really think that's what's gonna happen. So okay, I feel medical community judge type twos. Yeah. All right. Well, we'll talk about that, too. I'm sure that is what's happening. A standard,

Jennifer Smith, CDE 50:53
I actually actually think this is a good one.

Scott Benner 50:55
Yeah, I do too. Because I because people are just people. Like, you know, I know a guy who's a doctor, please it just because he goes to his job and puts out a coat, you know,

Jennifer Smith, CDE 51:12
doesn't mean that you are a good person.

Scott Benner 51:15
By the way, it's not my friend who's a doctor, I don't want him here in this and be like, That's not me, is it? It's a person I know, peripherally, who's a physician who's just kind of a jerk. And I could see that person looking at you if you had type two diabetes and being like, okay, you know, like, I really do. So.

Jennifer Smith, CDE 51:32
Right. We're not listening. And I think that's the bigger point that this comment brings up is that this person seems to have been doing everything that was the right thing. And upon entering a medical based, like setting wasn't being listened to. Yeah, right. Which is sad. So

Scott Benner 51:50
we'll we'll dig through that one standard of care for type two globally is terrible. It goes Metformin, long acting. My parents can be oh, gosh, 20 plus millimoles after a meal and they say that's okay. Yeah. Yeah. Okay. We're gonna talk about what goal I think I'm gonna mark this as goals.

Jennifer Smith, CDE 52:11
Yeah, right. Why is that seen as Okay, well, it shouldn't be seen as okay. We all know that. Well, we know that. Yeah.

Scott Benner 52:19
glacial pace of Medicare, Medicare type two seem to get finger wagging and eat better. Boy, you know, who gets hit with that to thyroid patients? Sometimes? Yeah, they just tell him like, oh, just exercise lose weight, you'll feel better. Oh, look at this. As I read down, it reminds me of thyroid issues. Okay, yeah, I'm sorry. I'm just I just like somebody agreed. Hey, hey, I'm type two and I would love to be on the show. Perfect. See that we'll have people who will come on and talk to keep an eye on that. I have. Oh, here you go. I have late stage complications from type two diabetes, and I've only had it for nine years. gastroparesis. I have moderate cognitive impairment, multiple other rare, chronic illnesses. Over the past three years, the Medicare, the medical care I've received has been negligent and appalling. Right, well, we're gonna get this person on the show. And other person. Okay, yeah. So this is, this is a person who has thoughts about how to name it so we can bring people in. When should I get a C peptide test? Oh, all right. We can throw that in somewhere.

Jennifer Smith, CDE 53:37
Yes, it's good under Oh, yeah. This is all test.

Scott Benner 53:39
Testing. Yeah. What other blood panels should be run examples to find out if your iron deficient, vitamin deficient exam, etc? Yeah, we'll do that blood panels. How to know if you have missed I have been misdiagnosed. Is there a way to figure out if you've been misdiagnosed, it's, it's just C peptide.

Jennifer Smith, CDE 54:00
Well, if you've been misdiagnosed as a type two, but you're really type one or ladder, obviously autoimmune diabetes, you are going to have some type of visible difference from that antibody based setting. Right? As many people I mean, there are previous comments in here that I was really happy to be finally diagnosed with latah or type one after having had type two for numbers of years. So there are you have to find the right doctor. And you know, as primary cares could write orders for blood tests to check but really from a, from a treatment standpoint, they really should be going to an endocrinologist. And if you have I guess the answer to this question would really be if you're questioning your diagnosis, ask for an appointment with an endocrinologist. Just because you have type two doesn't mean you can can't see. Right? You don't have to be being treated by your PCP. So

Scott Benner 55:05
yeah, all right. That's a good one. I'm gonna go through the rest of that testing stuff and go down to miscellaneous people are asked about Dawn phenomenon. I guess that happens with type twos as well. How cells you sugar for energy discuss metabolic disorder. This boy, something came up here that I was excited about. I'll tell you in a minute true, some myths about natural supplements. What's the progression of type two with age? Any difference in type two as an adult versus as a child? Is insulin helpful for type twos early on, or only later? What interact, interactions and comorbidities must type choose know about proper education on using a pump? If you're type two, I'd like to see an episode about why does it matter what type I am, I truly don't get that. I'm gonna go this is this is the thing that got I found super interesting. And I think is going to be a big part of what we end up doing. A Mythbusters episode. So the I really started thinking when somebody said that, to me, it well, they just brought it up like this, they said the most hurtful, hurtful myth that you only have tied to because you're overweight. But then I started thinking about all of the inaccurate statements about so many different things. And then I started imagining a Mythbusters series, almost like the defining diabetes series, where we take a list of things that people bullshit things people say, like cinnamon. Yeah. And we break them down about why they're, they're not accurate. Yes, yeah, that's gonna be outside of this, I think. But whoever said that whoever used that word first, you really got my brain moving. So thank you very much. And then there's weird things in here. And I'd look at this Agent Orange exposure as a cause for type two.

Jennifer Smith, CDE 57:00
Well, there are a lot of things with Agent Orange that I mean, that's not it's not a untrue. Yeah. But there are a lot of things that agent orange definitely did.

Scott Benner 57:11
So, yeah, this one says, I think COVID-19 can make type two complications worse. Oh, we can figure that out. And some other stuff here they have listed as maybe it would be interesting. I like so

Jennifer Smith, CDE 57:27
these are laughing about them. Because they're not they're not funny, but like to read them like they they make you like giggle a little bit, because it's amazing. Honestly, what, what is potentially out there in terms of Well, looking for me?

Scott Benner 57:45
Yeah. Are you ready? Is it this one? The there's a second one. There's the secret cure that big pharma doesn't want you to know about? Yes, yes, exactly. Listen, I've I've met a lot of people in my life. And the one thing I'm fairly certain of is they're not very good at keeping secrets. So and what would the cure be?

Jennifer Smith, CDE 58:10
I mean, that's, that's a great question. It really would be because I think I think in terms of the two types of diabetes, there, there a big difference in terms of why you have diabetes, type one or type two, there's even a big difference in terms of why you have gestational diabetes, right? Or any of the Modi, which never gets talked about. Right. So I mean, if there really is a big secret out there, then there are a lot of little secrets within the big secret. Yeah,

Scott Benner 58:46
I listen count on this, some doctor with a big ego would run out and yell, I've figured out the I've done it. But But aside of that, in the 15 years or so that I've been in this space, the amount of times that I've seen somebody say I know for certain that there's a cure for type one diabetes, and they whoever they is, they just don't want us to have it. It's because they're making money. And then I'm like, Look, I don't disagree that diabetes is a big moneymaker it just, I mean, if you look at science, where it is right now, we're just not at that point. You know, like, we don't know how to just turn I I've said this before, but I think we've only actually cured like eight things in the history of mankind.

Jennifer Smith, CDE 59:34
Or stop them from continuing to happen. Things like, you know, immunizations and whatnot. Right. There are things that have been eradicated because of but yeah, it's very, very few.

Scott Benner 59:45
Yeah, yeah. I mean, like, let's not talk about how we fix leprosy. So yeah, that's, I don't think that's the, if you're type one, I don't think you want to. I don't think you want that to happen. So you know, like a lot of different things. So okay, so Alright, let's just wrapped us up. Cool. This is the series we can do this right? Okay, and we're going to break it down into meds. We're going to put it so we're going to do meds education, testing allergy technology, medical care, guilt and shame. Fueling plan. Yes, that sounds right. Oh,

Jennifer Smith, CDE 1:00:21
what about activity?

Scott Benner 1:00:23
Oh, how do we forget that?

Jennifer Smith, CDE 1:00:24
That is something that is not in here? At all?

Scott Benner 1:00:28
Yes. Okay. Go ahead, Jenny. Do you need a soapbox to stand on? Or can you just say this out loud? So what Jenny is gonna about to say is that we asked a lot of people tell me how to help with type one, type two diabetes, and not one person asked about exercise.

Jennifer Smith, CDE 1:00:45
Right? Yeah, I mean, I in any in what? What kind of exercise? How do I get started with exercise? I'm already doing this. Am I supposed to change it and do something different? Or why is it not working this way? I mean, and again, it's sort of an effect of multiple variables. Right, all together. But I do think that it's interesting that there wasn't at least a question of, I've been told to get active. What does that mean?

Scott Benner 1:01:10
I don't think it's that interesting. I think it's pretty, I don't mean, because these because the people have type two diabetes that asked, I mean, just generally people in general, like, there are people who love to exercise, and the rest of us really wish it didn't exist. So I'm one of those people. I am clearly in the other category, right? And he's like, can we get this done? So I can go for a walk right now. And so but, but it is telling, right, it is telling that not one person said hey, is there anything I can do here? Because and I and maybe this is why maybe I'm being flippant? Maybe it's because doctors have so frequently told these poor people? Oh, yeah. Diet and exercise, go home, eat less and go for a walk and you'll be okay. Maybe it's because it's been minimized and marginalized a little bit, you know, same time,

Jennifer Smith, CDE 1:02:00
right. I mean, and rightly so even the information about or the questions about, you know, nutrition are fueling really, they're not, they're not as focused, because I think, again, it's a point that people are told about, but there's been no definition given to it. So many people don't even know what to ask about it. Sure.

Scott Benner 1:02:23
It's similar. It's similar to cooking to like, What do you mean, eat better? Exercise? Okay, well, what does that mean? You know, and I know, listen, other people can listen and go, it's obvious what it means. I don't know how obvious it is to everybody. You know, so, alright, so we'll, we'll put together a reasonable exercise plan for people? Sure. All right. A way to start a

Jennifer Smith, CDE 1:02:48
way to start that would be, especially considering some people might already be doing something, but if not, it's just a place to give you an idea of what to start.

Scott Benner 1:03:00
So I wrote how to start exercising, we'll talk about that. And then maybe it'll like lead from here. Maybe I can have on other people who can talk about, you know, more specific ways of handling things. Sure. But yeah, again, I just think that if you're listening if I'm, if I have type two diabetes, and my blood sugar's aren't great. And, you know, I don't know how I'm like, What am I going to, like, jump up and get on a stair climber, like yummy meals? Like, how, what the hell, you know? Right. So okay.

Jennifer Smith, CDE 1:03:31
I mean, they're, they're simple things. But I think that's a good title for it is how to get started, how to get started.

Scott Benner 1:03:36
And then we'll see what we can get make we can make out of it.

Jennifer Smith, CDE 1:03:40
Cool. Yay. I'm very excited. I

Scott Benner 1:03:43
am to actually I know that just means we're dorks about diabetes. I just think, listen, there were a couple of people in my life, who have type two, and they are just not in any meaningful way impacting it. But if you talk to them about it, they're always worried about it. They are in trying as hard as they can. And I just think that maybe, maybe we could help turn some people. Some people are walking into brick walls, maybe we could help turn them around and let them walk in a better direction. Right. Right. And I think we can definitely do this. Alright, well, we start in three days, Jenny.

Jennifer Smith, CDE 1:04:26
Yes, we do. We've got a couple of days. And then we're

Scott Benner 1:04:29
recording. Alright, we'll break this down into into easier to understand pieces for us, and then we'll get started. Thank you. Awesome. Thank

Jennifer Smith, CDE 1:04:39
you Take care.

Scott Benner 1:04:43
So that's how this is gonna go. And as of this day, when I'm putting this episode online for you, we've already recorded five of the episodes for this series, and there's much more coming. I'm going to put them out every week until the core of the series has been posted. And then we'll be adding to it as needed, Jenny and I are going to talk about the diabetes. I'm going to have a therapist on named Erica, she's lovely. We're going to talk about the psychological side of this, we're going to have more people on to talk about nutrition. I'm even thinking maybe having some chefs on some cooks to talk about cooking. We've talked about intermittent fasting before on the podcast, but I want to bring somebody back on to talk more about that. There's going to be so much here for you. I know you can do this. And we're here to help. If you want to hear about Jenny and I hold on, but if you want to go, this is pretty much the end. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. Okay, it's me, Scott. So if you're finding this show, because someone gave it to you and said, Hey, you have type two diabetes. And I'm assuming they're already listeners of the show, probably because of a type one connection. And they're sharing this with you. And you're thinking, why am I listening to this guy, and that lady talk about type two diabetes? Well, here's how you came to this. I began making this podcast in 2015. This is the ninth year of it. Before that, I wrote a very popular blog about type one diabetes. And I come to this by way of my then two year old daughter's diagnosis with type one, my daughter is 18. Now, she is living a lovely life off a college. The podcast began because I think it really began for the same reason that this this series is here. People don't get good direction about diabetes. It we didn't, we certainly did. I didn't know what I was doing. My daughter was diagnosed, my wife didn't know we were left to our own devices. And it soon became obvious that we were either going to figure it out for ourselves, or our daughter's lot in life was not going to be so rosy. So we figured it out. And then I started writing about a long line. And that became popular. And then I started talking about it in a podcast. And I started seeing how well this podcast was helping people live. And it's just bothered me for so long with people in my, my sphere and in my family who have type two diabetes and aren't being helped. And I thought I need to find a way to help them. So then one day, a couple of years ago, I started realizing that there were people listening to the podcast already who had type two diabetes, but we're figuring out how to help themselves through the type one conversations and I thought, wow, this is helping people, we could give them information more tailored to them, and find even more people and help more people. And that's it for me. I'm doing this for the same reason I started doing it. There are people in my life, they're not getting good direction. They deserve better health. And I think I can help you find it. That's pretty much it. I'm just the guy whose 18 year old daughter got type one diabetes when she was two and I started a blog and a podcast and it just took off. Jenny has had type one diabetes for well over 30 years. She is a registered and licensed dietitian, a certified diabetes educator, she is certified on tons of insulin pumps, and continuous glucose monitors. She works at a place called Integrated diabetes, which classically helps type ones with their management. But Jenny is just a good soul. And this means a lot to her. She just wants to help. So that's why she's here. You know why I'm here? I hope you I hope you feel like you're in the right place. There's going to be more. Honestly, if you're listening to this past like April 2023, the other episodes are probably already up and ready for you. I hope you enjoy them. I hope they help you. And I hope one day you'll be one of those type two stories in those episodes I mentioned earlier, I really think you can be. I really, really do. I know this isn't easy, but it's not impossible. And I know you can do it. I've seen so many people succeed with their health in moments when they just thought it was impossible. But this podcast and the people who listen to it have taught me that nothing's impossible. It can seem difficult. It can seem like your life is ending. But there's a way through. You just need to know the path to take. And I think this podcast can help you see that path and light your journey. I know you can do this. I'm excited that you're here. Please come back and listen to a few more episodes. And if you start having great success, let me know about it. I'd love to tell your story on the podcast. I know you can do this. Thank you very much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

#859 I Was Just Thirsty

Dan's child has type 1 diabetes.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, and welcome to episode 859 of the Juicebox Podcast.

I had a fantastic time speaking with today's guest. His name is Dan. Dan's father had type one diabetes, and one of his children now has type one. While you're listening to me, talk to Dan and have a great time. Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. Or becoming bold with insulin. I want you guys to know I wanted very badly to call this episode animal husbandry. But I went with my heart and said, hey, don't forget if you have type one diabetes, or are the caregiver of someone and you are a US resident, you can go to T one D exchange.org. Forward slash juice box and fill out the survey completing that survey helps type one diabetes research T one D exchange.org. Forward slash juice box with my heart I did when this episode should clearly be called animal husbandry.

This episode of The Juicebox Podcast is sponsored by the Dexcom G seven continuous glucose monitor. That's right baby G seven is ready for you@dexcom.com forward slash Juicebox Podcast is also sponsored today by the Omni pod five, and the Omni pod dash. check them both out at my link Omni pod.com forward slash juicebox. And if you're getting ready to use the Omni pod five, I have a great resource at juicebox podcast.com forward slash Omni pod five. If you want Dexcom or Omni pod, please consider using my links typing them in a browser or clicking on them at juicebox podcast.com. Or in the audio app you're listening in right now. Because when you go to those links through my links, you are supporting the show helping to keep it free. Thank you so much. Let's get started with it.

Dan 2:25
My name is Dan, the father of a six year old girl that has type one diabetes that was diagnosed almost exactly a year ago. And then I grew up my father had type one diabetes. He was diagnosed, I think around six or seven. So it's been a part of my life for pretty much my entire life.

Scott Benner 2:51
Dan, you're a little far from your mic.

Dan 2:54
All right. Well, maybe I just need to talk louder.

Scott Benner 2:58
Did you get to the middle? Maybe? Like he's fading quickly?

Dan 3:03
Enough. Is it better now? That yeah,

Scott Benner 3:06
you just got soft while you were talking? Like Soft? Soft enough, though. I'm gonna say your daughter was diagnosed a year ago when she was five. And you grew up with a father who had type one. Correct? Gotcha. Yeah. Yep. Your dad have type one your entire life, or was he diagnosed as an adult?

Dan 3:23
So he was diagnosed at around six years old, I think from what I can gather from talking about the family. And you know, it took him a really long time to figure it out with him. They just didn't know as much back then.

Scott Benner 3:39
Is he alive now?

Dan 3:41
No, he passed away. About five years ago.

Scott Benner 3:45
I say I'm sorry. How long would he how old? Would he have been if he was alive?

Dan 3:50
Let's see. He was he'd be about 70. He was 65. From he,

Scott Benner 3:53
okay, passed away. So he was on. May I do the math on this. So it's 2022. Now if we take 20 from that it's 2050. More your was your dad born like in the 1950s? The early 50s. The late like right there.

Dan 4:09
I am terrible with those.

Scott Benner 4:10
I love that you don't know. But I'm just one. The one thing that

Dan 4:14
with my daughter, I will never forget her birthday now because every time I call to, you know, get some supplies or go get a prescription. I've got to give them her birthday. And so yeah, I'm bad with birthdays and dates, but I think your math is pretty close.

Scott Benner 4:27
Yeah. I'm guessing 52 ish diagnosed in 58. Yeah. Yeah. Okay. Yep. Was it a point of discussion throughout your life was it never mentioned? How did that go?

Dan 4:42
It was weird. It's very different, I think than it is now for me with being you know, the parent. We really lived in normal life. It wasn't a big deal at all. I never thought about it too much. I remember it being really annoying, as in Junior High in high school that we had to eat dinner at the same Same time, like every day, my friends would be out playing and I'd have to come home for dinner. But other than that, he just kind of took care of it. And and that was that he

Scott Benner 5:11
would not notice? Well, okay, that's what I'm asking like, what parts of it? Did you say?

Dan 5:17
Yeah, he would get low, and just get kind of crazy and combative with my mom about it. And for whatever reason, he would listen to me. And, you know, have some orange juice, that was kind of his big thing. And then he would kind of snap back out of it. And then test himself, I think the lowest, I remember him being when we were out camping once was like in the teens, and he almost almost kind of, you know, fell asleep. I guess. At that point, he was starting to fade, you can see it in his eyes and

Scott Benner 5:56
but who handled that, in that time camping who handled that low?

Dan 6:02
I think I eventually talked him into, you know, treating himself with something. And that, you know, he always had like some candy bars or something in his car. But he just he lived a pretty normal life. We had a boat went waterskiing every weekend. We camping a lot. He worked out in the woods all by himself all the time. So totally different. I really never thought about how, you know, potentially dangerous some of that stuff was with him. I just expected he would handle it.

Scott Benner 6:38
Yeah, I've two questions. So first, I'd like you to talk about what it's like, for a person who's bigger and stronger than you to decide they don't want to listen and be in that situation where you're trying to save them? How do you handle that?

Dan 6:57
I would just try to reason with him. And I think that was the difference with with my mom, he would just, you know, there's probably more there. For him to sort of hold on to and not want to listen to her advice. And for whatever reason, it was pretty easy for me.

Scott Benner 7:17
And I figured that out when you said he was out in the woods by himself.

Dan 7:24
Well, and that was the funny thing, too. It's, it seems like when he was by himself, he was much more aware of that stuff. And then when we were all together, he would be more likely to get low.

Scott Benner 7:35
focused on other things. Maybe? Yeah, yeah. Um, I'm not sure if you're moving things on the desk or moving around or not. But if you are stopped, I will start okay. So you didn't really you never had to overpower your voice for some reason, shone through to him and he would listen to you eventually. Yes, so then that's right. That brings me into my second question. Looking back now as an adult, how old are you know?

Dan 8:02
42.

Scott Benner 8:03
Looking back on that time, do you think it had any impact on you having to be that person?

Dan 8:12
Yeah, I think so. I think it's, it's helped a little bit now that with with my daughter, Eleanor, you know, kind of knowing how we had the first time with her just a couple days ago, where she was starting to get a little bit confused. And it helped. I think, being able to that. I've seen that before. And now and now with the CGM. It's so much easier. I know exactly where she's at

Scott Benner 8:39
right. Now. It's it's instant. I was wondering if you had any, like resentment or anxiety or anything like that from it, but Oh, no, I don't think so. Yeah, I liked the way you talked about it. Much better. The way it kind of prepares you for this. Yeah, yeah. Okay. So any brothers and sisters for you?

Dan 9:01
So yeah, I have one half brother. And he

Scott Benner 9:05
does he live in the woods. I'm just kidding.

Dan 9:08
Kind of my poor parents when I was born, he was he had a brain tumor. And so they had to remove the tumor from his brain and ended up also removing most of his pituitary gland and damaged his optic nerves. So he's mostly blind, and he had to take growth hormone for my whole life, you know, while he was. He's eight years older than me, but I never really thought about it until just now. I wonder if my dad's thing wasn't such a big deal. Well, because

Scott Benner 9:46
so half brother from your father, from my mother from your mother, prior marriage or after they were done with each other or prior marriage. Okay, gotcha. Yeah. And then and this goes for all the people who come on the show if I'm getting Ready to make a joke about a family member who's had brain surgery and grew up partially blind? Could you please stop me? Right? That's run me over next time. Dang. Oh, nevermind.

Dan 10:11
It's all fair game.

Scott Benner 10:14
You know what I mean? I didn't know it. As soon as you started talking. I was like, Oh, God. Like, because you said half brother. I figured your dad was out in the woods making a baby with Sasquatch. And that's where you know what I mean? Like, I built a whole story in my head. Yeah, no. Okay. Well, okay, so he and what about other autoimmune issues?

Dan 10:37
Nothing. Okay. Except for well, my dead sister. My aunt she was diagnosed with type one diabetes at about 18

Scott Benner 10:47
Let me stop you go back and take back then nothing's gonna last the question again. Is there other? Is there other autoimmune in the family?

Dan 10:54
So yes, my aunt also is a type one diabetic. She has rheumatoid arthritis. Pretty bad

Scott Benner 11:03
as to for toe really impacts her?

Dan 11:07
Yes, yeah. She's still alive. But it's, it's rough on her. A lot of pain.

Scott Benner 11:13
How about celiac? Thyroid stuff? Anything like that? No. Okay. I am fascinated, not fascinated. It's interesting. How frequently I asked the question, and people go, No. And then they list six autoimmune diseases.

Dan 11:30
Really? Didn't really even make the connection until I started talking about it.

Scott Benner 11:34
No, no, that's, that's why I brought it up. It's um, you know, Hey, did you know anybody in your family? No, no, well, not at all. We have this. My aunt has celiac. My father's hypothyroidism, my mom's got Hashimotos. And, and before you're done, you're like, those are all autoimmune diseases. They go? Well, it's crazy. I didn't know. It's just it's interesting. That's why it's why I asked the question every time because I'm trying to listen to Dan, I don't know if this is obvious or not. I'm trying to get people to ask these questions in their family privately. So they can have a better idea of what's going on with their health history. But I don't know if I'm being tricky enough to get it done or not. Well, that you put it out there. Well, you know, I mean, now I'm just saying it like, go ask your family members for God's sakes and find out what's going on. You know what I mean? Like, maybe maybe Uncle Bill doesn't just fart a lot. Maybe he's got something going on, you know? Yeah. Yeah. So okay, so your aunt has type one your brother had your father had type one. Did they have any other brothers or sisters?

Dan 12:38
There? Yeah, there were two others in my dad's family that didn't have any autoimmune issues that I know. Okay.

Scott Benner 12:49
And now, and you haven't had any? Nope, no. How about your wife's side of the family?

Dan 12:57
Hers is hard. You know how diabetes thing is? They all say that her grandfather or someone had type one diabetes, but a lot of them have type two diabetes. And so she doesn't. She doesn't really know if, if that's a real thing or not,

Scott Benner 13:17
again, fascinating that people don't know. Stuff like that about their own history. Yeah.

Dan 13:21
Yeah. They're very different.

Scott Benner 13:25
I mean, I'm not even talking about like your aunt or your uncle, like somebody you see at Christmas, and New Year's, something like that. I'm talking about people you've like that are in your life. Like, you know, Grandma, did she have diabetes? I don't know. You don't know. She's around for the first 10 years of your life. She wouldn't leave you alone. Yeah. But it's, it goes to show and your story about your father goes to show how people find a way to exist with these things. You know, yeah. Yeah. And that's really that's kind of terrific. So did you think when your dad was six, when he's diagnosed, how old were you? You're at roughly, do you have any idea?

Dan 14:06
How old was she when she was diagnosed? Yeah, she was 18.

Scott Benner 14:09
Okay, so by the team meeting, so by the time you're in your 30s, you think you're free and clear? Or is it something you've never thought of, or something you always worried about?

Dan 14:18
I was pretty sure I was free and clear. And then, when my wife and I talked about having our first kid it was a conversation that we had and talk to some different people about it. And then after we had my, my older daughter is 12. So we had her and I remember taking her to the doctor and talking to the doctor about it when she was just an infant and he was really kind of on the ball about stuff. He's he said that diabetes now they don't know if it's all genetic, or partly genetic, or he said there's some environmental factors involved, and they're just trying to figure it out. And so the optimist in me heard it was all just environmental factors with my dad and my aunt. And so we're good. We will

Scott Benner 15:14
you know, Dr. Here, he doesn't seem like he knows what he's talking about. I'm just going to pick and choose from what he said. We're gonna move forward and make my own thing. Yeah, I'm also imagining the conversation you and your wife had was having, like, you know, in bed. While you're thinking we should do this, you're like, Yeah, you're just Yes. Anything, right? Like, it's possible that kid's gonna have diabetes. Like, I don't care. So we talked about it. You think the kid loves diabetes? Probably not. Let's go. Yeah. Yeah, yeah. Pretty much how it happened. Yeah, we've all had that conversation about a condom at one point or another. It's right there. Should we just get it? Yeah, it's gonna be alright. Yeah. So exactly. But But I take I mean, listen, it, at least you thought about it and talks about out loud when you talk when you talked about it. Did you ever give over to the idea that it could happen and have that conversation? Or did you do the I'm now making air quotes with my fingers? Like the talk about it where you decided it was going to be okay.

Dan 16:16
We, we didn't decide that it was going to be okay. It was we knew there was a risk involved. And we're just going to see what happens. Yeah.

Scott Benner 16:28
I mean, listen, it's a valid, it's a valid way to go. You don't I mean, there's no right or wrong answer for certain. I'm just interested in how it happens. You know, because people say stuff like that all the time. We talked about it, but then they never told me what they talked about. So if the pick, it's my job. Yeah, yeah, yeah. Okay, so now you're still your second child is the one with type one. And she makes it to five before she was diagnosed. But did you see anything prior to that?

Dan 16:52
No, no, I really thought I thought we were free and clear. So my dad passed away when she was not even one yet. So for the next four odd years, there was no diabetes going on. And I just I didn't I really didn't think about it, you know, kind of got over the morning part with my my dad. And she was, she was good. She's super. I know, all parents are bias. But she's like a super smart kid. She's doing well and everything in life, and we're doing good, you know, and the whole pandemic thing kind of started and we went through that, and

Scott Benner 17:37
anybody would get COVID.

Dan 17:41
Our whole family got it. So we were all vaccinated. And my wife and I had our boosters. And we had a trip coming up to go to Disneyland, actually, that I was just thinking about touching all the stuff, all the kids stuff at Disneyland. And about a month before our trip, Eleanor was just kind of being whiny, and had a little bit of a runny nose and almost out of spite. Like, we'll test you for COVID. And it was positive. So we all went down, got the test done. And both the kids were positive, my wife was never positive. And I was just walking around Walgreens with no mask on feeling great and got the email that I was positive. We should probably go home I guess.

Scott Benner 18:31
Did you do you think you got it from Mickey Mouse or you got somewhere else?

Dan 18:35
Well, so that was before this word. We're actually glad that we got it. We don't have to worry so much. Disneyland. So I don't know where we got it. You know, school? Probably. Yeah, it's picking stuff up.

Scott Benner 18:47
All that learning mess and everything. Oh, yeah.

Dan 18:50
Well, especially at the kindergarten age. You know,

Scott Benner 18:53
you think it's possible. It's okay to skip that. And maybe you could count to 10 at home? Not now kindergarten teachers like I do more. Now. I know you don't. I'm just I'm just it's fine. I'm just saying. Yeah, if you're gonna skip a grade. I mean, I would think one of the easier ones to manage personally might be the lower grades. I guess what I'm getting from

Dan 19:14
there might be easier to catch up from that. Yeah.

Scott Benner 19:18
Well, I mean, you might be able to handle on your own. I also love when people say their kids are smart. And I'm like, I don't know how smart you are. This is all perspective. People like like, it's brilliant. I'm like, smarter than you. Maybe.

Dan 19:32
She scored. So she's in the 99th percentile. You had her test things. No, they do the standardized tests, standardized tests. I was teasing. We actually did. All right. I said no, but but we did.

Scott Benner 19:48
How many times you're gonna lie to me in the first one.

Dan 19:52
To get into the school that she's in. We had to do an IQ test. So she goes to this school. That's an old charter school that's looped in through public funding now, and they can still use their old requirements so they can be selective about who they let in. And so we did we did have our IQ test and that was also

Scott Benner 20:15
high. So you get throw over that word, the wall that walled garden, Dan, get her back there. But the other smart Yeah, let's Yeah, exactly. Don't get too excited. I was one of those kids when I was little, and I make a podcast now. So you don't I mean, yeah, don't get too excited. I don't think the money is just gonna start falling over the walls.

Dan 20:33
No, no, I know. I already disappointed me several times with telling me what she wants to do when she grows.

Scott Benner 20:43
Now we're getting to it. Dan's willing to say he's been disappointed by his five year old. But what is what does she want to do?

Dan 20:51
Well, I don't remember it's been all over the place. She Well, she wants to do what I do. And what my wife does, which I guess are, are both good. My wife's a veterinarian and you'll get a kick out of my job. I know you get a kick out of people's weird nature jobs. I own a company that installs fish tanks, and does fish tank maintenance all over the area. You and

Scott Benner 21:12
you own a company. I own the company when's the last time you had your arm elbow deep in a fish tank.

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Dan 26:06
Yesterday,

Scott Benner 26:07
okay, I'd like to get you to a place where the other people are taking care of the work. But I bet that sounds good. That sounds well lucrative actually.

Dan 26:16
I have three people that work for me, and they go do most of the work especially since the COVID stuff. My job was flexible, and I was able to stay home with the kids more than my wife. And so I sort of transition to working more from home. But all of the all of our fish tanks that we that when I ordered fish, they come from all over the world. A lot of the saltwater fish are caught in the wild. And so I have to put them in fish tanks first to make sure they're not carrying parasites that delete fish food and all of that stuff. So those are all in a room in my garage. And so that's where I had my hand in a fish tank yesterday. I

Scott Benner 26:57
see. I have not. I used to have tanks because my dad had them and I have not had one since my little brother poured I used to have had a probably like a 55 gallon saltwater tank. It wasn't huge, but it was great and ran really well. It had live car oil on it and all it was really great. And one day my little brother put when you want to smell nice Dan, what do you spot cologne, he put Kelowna to see what would happen. Do you want to guess what? Oh? Yeah, that probably wasn't good. Yeah, killed everything pretty quickly. Yeah, yeah. And then we had good.

Dan 27:36
We had a, we do a lot of assisted living places. And one of my clients called a while back and said that one of the old guys there dumped his milkshake in the fish tank. Fish like it. Yeah. She wanted to know what would happen. So I said, I'm not sure.

Scott Benner 27:53
Here's what's gonna happen. I'm gonna be over and send you a bill. Don't you worry. Yeah. Get lost right now. I just never had the I did not have the fortitude to do it again. It was it was a lot of work and an expense. I was young, you know. And I just but my son asks me about it pretty frequently. How can we? Yeah. And he's never had one. And he asks about it. It's really, really kind of interesting. So yeah. All right. Well, that's, that's how did you get into that, by the way?

Dan 28:22
In college, I switched around a couple times what I was going to major in, and I ended up majoring in fisheries biology. And I was going to do like, research, you know, streams and fish. And

Scott Benner 28:38
when you like that you're mad at your parents when you chose that.

Dan 28:42
Yeah, that was originally gonna do physical therapy. And then

Scott Benner 28:46
I'm trying to picture I'm trying to picture 15 years from now little l&r comes up to you and says she wants to get into fishery sciences. You go in oh, wait a minute. Who's gonna pay the bills? Yeah. You know, my very I don't I've never said this before. My very first job was at a pet store. Oh, yeah, I was 13. And the local guy had a pet store. And we were always in there buying fish and stuff like that. And one day, I think he saw us as a nice, a nice revenue stream. And he thought, Well, I'm like, just basically I was free labor for fish. I basically worked for fish. Now that I think, I think back on it. Yeah. And you'd go in and clean tanks, and we're on the register and stuff like that. And I know people were like, 13 year olds can't have jobs, but it was the 80s We could do whatever we wanted. So you know, go in there and work and and then he'd pay me at the end of the week. At the end of the week, I'd basically end up paying him all my money back for whatever I bought during the week. It was brilliant. Actually, it was a mad genius, wasn't it?

Dan 29:48
Yeah, but yeah, that's a great job. Another job in college.

Scott Benner 29:51
Now, there was a couple things I wouldn't do. i If you bought a snake while I was working by myself. You got the snake out yourself. It was self service. I was like, that's fine. Go ahead and get it. I'm not doing this.

Dan 30:03
Yeah. Not a snake person.

Scott Benner 30:05
No, no, no, no, not in any way, shape or form. It's not happening for me. Okay, so Eleanor shows, signs, symptoms, anything. What's your first look at diabetes?

Dan 30:18
Yeah. So her kind of diagnosis story. She went to Oregon when kids turned five, I don't know if you are aware of this, they can fly by themselves on the airplane. And so she wanted to go on a on a trip. So the first she went with just my mom, my mom took her to Oregon to see some family. And I went to the airport to pick them up when they got back. And my mom was just saying that she was just thirsty the whole time just going through bottles and bottles of water. And it just kind of had that feeling. When she said that I just sort of knew

Scott Benner 31:00
well, did your mom not know from your dad? Well, that's

Dan 31:04
why she was telling me is she was kind of thinking it too. But it was like the first thing she said to me. I was like, hi, thanks.

Scott Benner 31:14
How was your trip? I think the kid asked the diabetes. Yeah. Still in the, in the runway, little ball thing coming off the plane, you know?

Dan 31:24
Right. Yeah. So that the following day, she was flying by herself with her sister. So let's see. They were five. They were she had just had her fifth birthday. And Kimberly was probably 10.

Scott Benner 31:41
And you're coming off like a real hippie here with this flying alone thing. Go ahead. Keep talking. I'm interested. Yeah.

Dan 31:45
So. So we sent them the next day on the plane. In hindsight, I would not have done that. But they flew to see some family in Las Vegas. And we asked my mother in law, you know, about halfway through that trip? If if it was still going on? And she said, yeah, she's definitely been drinking a lot of water and peeing a lot. But we were still in denial. We're thinking it's hot in Las Vegas. And she's five. Yeah, so it's just a habit. But my mother in law has type two diabetes and had glucometer. So we said, Well, can you just test her? You know, finger poker? Well, we're on the phone. She couldn't figure it out. She doesn't never use her. glucometer I guess. So. She's poking. We can hear screaming in the background and your mom is the kids screaming? Okay. Yeah. Yeah. My mother in law. I think she was putting the blood on the on the like, stick, you know, the test called test strips, and then putting and then putting the test strip in the glucometer. Oh, wasn't working

Scott Benner 33:01
it? Yeah. No, it has to go in first. I've never said that out loud before. I just thought people knew. But

Dan 33:07
yeah. So we just said, alright, you know, we'll just figure it out when we get back. And then her uncle kept telling us just how much she was eating and weird foods. She ate like a whole jar of pickled okra, and like, five hamburgers. And so it was getting to be where, you know, we really

Scott Benner 33:30
she was feral at this point. Yeah. Yep.

Dan 33:33
And so it, it was a busy little time that we had planned. She came back in two days. After that. We had rented this RV. We were gonna go RV camping. And so we called the pediatrician and told them what was going on that we'd like to get her in there and the receptionist. She's like, so she's just eating a lot and drinking a lot of water. City and she's like, Okay, well, I think you're fine. You know, have our triage nurse call you and say as I said, you know, we're going to kind of remote area. I'd really like to get her in. I'm going to pay you for this right now. But we had to fight to get her in there and get her there.

Scott Benner 34:15
You had to fight through the reception people. Yep. No medical people whatsoever at that point.

Dan 34:21
Right. Yeah. Again,

Scott Benner 34:23
I joked about this a minute ago, but I need to ask are you a hippie? Upper Midwest, anything or upper? Right, like Northwest

Dan 34:35
that's where I grew up. My dad was in the timber industry there so I couldn't be a hippie because he's you're cutting all the trees drying the forest.

Scott Benner 34:46
Okay, but I'll tell you I have to tell you like no judgment. The putting kids on a plane thing is a leap for me I don't think I can make so I really I just assumed you're a little high when he did it. That's all but it's

Dan 34:59
no I feel it's the first couple of times it was I was nervous. But

Scott Benner 35:04
yeah, that's what I mean. It's, it's cool. Like, thinking about it now I'm like, take them to the airport, you watch them go down the, you know, the little loader thing, they go into the plane, there's people there, you got to think they're relatively safe. And then, you know, they get off, walk off and there's a family member, it's actually makes a ton of sense. I just don't think I could do it. And I don't know why. Yeah, as I'm thinking about, it's interesting.

Dan 35:26
You have to let go a little bit. It's,

Scott Benner 35:28
you think I'm uptight? Maybe? No, I'm saying

Dan 35:31
a person has to be able to, you know, it's like, you know, it's like, when you have a baby and you leave them, go on your first date, or whatever thought you're gonna

Scott Benner 35:43
say, all by themselves. You know, sometimes you leave a kid in a Strawbridge and Clothier or something like that for a couple of minutes while you go get a pretzel, you know, as long as they're sleeping in a pile of soft laundry or something that they're really it's hard for them to hurt themselves. Strawbridge and clothier? What was that? Straw bridges? Did you have a clover near you when you were growing up? was like an offshoot of straw bridges. Is that is that affiliate? No. No, sorry for anybody who doesn't know what that is? A big store. There you go. Okay. Yeah, yeah.

Dan 36:19
Yeah, so we got her in, and then off to the emergency room from there. And, of course, you know, even growing up with my dad, I still didn't really know how diabetes works. So we're like, let's go through the Wendy's drive thru. grab some lunch on the way to the ER, because she'll probably never get french fries again in her life. And so we did that. And

Scott Benner 36:46
well, your your expectation to diabetes, I'd have to imagine was somewhere near we're gonna have to buy orange juice. And it must not be that bad, because I never saw my dad do anything with it. Really?

Dan 36:58
Yeah, yeah. It was still, you know, pretty mind blowing learning about it. So my dad, he did have some things. He, in his 40s had a lower leg amputation, which definitely changed the way he did life. And then he had a heart attack when he was older. And

Scott Benner 37:26
yeah, I didn't expect I didn't expect that he died in his early 60s Because he fell out of a window. I figured if you're diagnosed with diabetes in the 50s. And you know, you're basically because what you described down. I mean, listen, people come on all the time. They tell their stories, which I think is really, it's amazing. But you described basically a time and a place where people didn't really understand diabetes, too. Well, and in all honesty, if your dad wasn't falling over, he was winning. And that was it.

Dan 37:52
Yeah, yeah. Yeah. When I I remember, when I was young, he was still doing that. It was like a test strip that you pee on. And then you compare the color to the thing on the little jar of test strips, and then that's how you figure out how much insulin you need. And

Scott Benner 38:11
yeah, and now you I mean, do you have any technology with your daughter?

Dan 38:16
Yeah, she has a Dexcom. And then she's on the T slim with the control IQ. Okay,

Scott Benner 38:22
so a completely different world. And now so different. Yeah. So when you look at your daughter's care, and you juxtapose your memories of your dad, you realize, I mean, it's, I guess obvious, right?

Dan 38:34
Yeah, that's a big thing for me, after, you know, seeing that, it definitely took years off of his life and some other stuff that you know, if you can control it as much as possible, you know, hopefully prep prevent a lot of those side effects.

Scott Benner 38:53
Alright, I'm gonna test you real quick. Dan, would you live feed a lionfish? A goldfish?

Dan 38:58
Oh. No, not usually, unless they're not eating.

Scott Benner 39:04
flakes are okay for them. So

Dan 39:06
I would do like frozen prawns and fish things like frozen shrimp that are thought out? Yes, squid, stuff like that.

Scott Benner 39:15
Ah, interesting. Okay, I was just checking. I'm testing you down. I was just testing from little bits that I remembered from working in a pet shop. Let me see 2333 4337 years ago, so

Dan 39:28
yeah, yeah, no, that's Well, usually you can only get like live goldfish and that's not very good for them. It'll cause a lot of fat buildup in their organs and

Scott Benner 39:39
really look at you know, and stuff about your child. Yeah. And your wife is she like a buttoned up veterinarian or she one of those hair going in 16 directions. I love the animals veterinarians.

Dan 39:52
She's kind of in between. She's a she's just dogs and cats. That she does and she is a works for someone that owns the practice. There's two of them there. And you know, I think, especially when she was younger, she loved the dogs and cats, but yeah, working with all the dog and cat owners might have changed that slightly.

Scott Benner 40:16
I have a question when you realize that your girlfriend is one day gonna have to put her finger in a dog's butt regularly do you think she's, you go like she's applying right like this girl. This girl will be okay.

Dan 40:27
Well, that's, that's for the vet techs. Oh, when I met her. She was already doing.

Scott Benner 40:35
How was your day? I had my finger and six dogs. But yeah, don't worry. I was just expressing a gland. Great.

Dan 40:43
Gosh, she had her arm. So at her school. They had this cow that had a spot where you could stick your whole arm

Scott Benner 40:53
and stuff. Like you might have found that line. Hold on.

Dan 41:00
So it sounds like a sealed off area and the cow that that's could stick their arm in

Scott Benner 41:06
we okay, go slow. I gotta get my breath back. I actually thought oh my god, here we are 800 episodes into it. I really figured out what I don't want to talk about. So not not in the cows. orifice. Right. Okay, the cow was surgically opened. Yes. So that med so that students could Oh my God, that's fascinating. Yeah. Wow, cow has done a real service for other cows. No, I think it has a plaque somewhere the school it should.

Dan 41:38
It should it should have a statue. Yeah. Okay, monument.

Scott Benner 41:42
I've been serious. That's I know, it's, I know the cow doesn't. I mean, I know. I'm guessing it thought This isn't good. But I'm saying that contextually? I don't believe it knew it was helping other cows. But that No, really. That's kind of lovely. Actually. Wow, that's that's really something else. Thank God. You didn't say what I thought you're gonna say. I just, I was in a panic. I started feeling like a little air when you started like, Oh, don't please don't tell me about this. Nice living. We're happy we married her all that stuff. She getting the bills.

Dan 42:17
It's you know what she she is the pandemic. They have never been busier. You know, so many people have

Scott Benner 42:27
paid? Literally. Yeah, they probably dogs and cats. Oh, people buying more animals? Yeah. So I thought maybe they had time to pay attention. But that was just me being kind to people, I guess. Well, it's Yeah.

Dan 42:40
And now it's the opposite. People are going back to work. So there's a lot of animals that are having separation anxiety, you know, dogs that are used to their owners being home all day.

Scott Benner 42:51
And now they're peeing on everything. Now,

Dan 42:53
yeah. Now they're not

Scott Benner 42:55
telling your wife about it. She's like, Yeah, exactly. What's wrong with my dog? Leave me alone. My kids got diabetes. I'm done. I'm out. Check out how does your daughter handle type one? Is it? Is it smooth four? Is it choppy? I, I see people online a lot, who talked about? It's, you know, it's nice that they share, like some of the problems their kids have. But people don't talk about it. When they come on here. It's the one thing about the podcasts that I still wish went slightly different than it does is that a lot of empowered people come on. So their stories are generally like, we got this. But I mean, how is that for her?

Dan 43:35
It's been a bit of a roller coaster. So when, when she was first diagnosed at five, she really didn't understand what a chronic thing was. And so I remember having some really, really hard conversations with her. When she'd say, you know, I think I'm better. When am I going to be better? You know, I feel fine. And she told me one time, we're driving around that. She's like, I know, all that water and stuff like that. But I think I was just thirsty. And I don't think I have diabetes. And so I think that part was harder for me. But, you know, you just kind of see in their eyes, they're trying to understand what you're telling them

Scott Benner 44:25
it and she's not my daughter and it was hard for me to hear. So yeah.

Dan 44:30
And then then it just became part of life. So about I think maybe a couple of weeks to a month into it. We got the CGM and you know, that changed things a little bit because you know, the way that we we treat her and then every time things change for her she gets it gets hard again for a little while. She didn't really want to stab this thing into her arm and then You know get used to get her clothes off and on with that on has been rough. She's really good at it now. But you know ripped a couple off and that hurts and the at all the adhesive and, and stuff like that she's had to get used to just like we have. And so and then the shots we were doing, you know, injections, multiple injections. For the first six months, we tried to get a pump, but got denied by our insurance and had to go through the whole appeal process. So we figured out we found those I ports. And that worked really well right with the CGM because we were able to give her a little bit of insulin for a snack if she wanted it. Or, you know, if we just messed up the Bolus and had to make a correction or something like that we could do it without actually having to stab a needle into her.

Scott Benner 45:53
Yeah. Hey, free plug iport from Medtronic diabetes. Oh, yeah, sorry. No, no, no, I they're not. They're a sponsor for something else. But not for this. But we don't talk about I poured enough, right. So this little port that your daughter wore, and then the needle, the actual syringe went into the port, so you weren't technically, like you weren't stabbing her over and over again. So you're saying, if she wanted to have a couple of carbs, you could pop a half a unit in there or something like that without actually having a sticker?

Dan 46:18
Yeah, it was life changing when we tried it. And nobody told us about it. We might have seen someone mentioned on the on the Facebook page. Yeah. But like the medical staff. They're like, Yeah, sure. You know, you want to try it? Well, we can write you a prescription but not really into it at all is

Scott Benner 46:38
nobody else if you liked it, and and it was valuable.

Dan 46:42
It was amazing. Yeah, good. And so that got us by until we got the pump and then then the pumps a whole nother thing, you know that she took some getting used to and didn't really want it at first and but now we've, we've adapted and most days are fine. We've had to I think she just got out of the honeymoon period. So I've like been doubling her Basal insulin. It feels like it's take so much now. I'm still struggling with it. I almost they're

Scott Benner 47:18
hard to get over the number change, right?

Dan 47:21
Yeah, it's, you know, it's kind of scary. And I don't know why. Because every time I do it, it ends up just making it better. But it's still a little, it's just intimidating to, to add that much more. You know, she, when she got the pump, she was only barely using like 10 units a day. And it's just probably in the 30s. Now,

Scott Benner 47:42
yeah, it's interesting. Like I get it, like, I get it MDI, like if you are using three units a day, basil, and you're, you know, multiple daily injections, and then suddenly it's six you think, Wow, I'm going to put in double the the insulin. I can't get it out again. But I mean, when it's when it's a pump, you'd change the setting up if you start seeing it go the wrong way. Just, you know, have a snack and put it back. Yep. Right. Yeah, but I still I still get the eggs. I mean, get it by get it. I mean, I see it happen to a lot of people. Yeah. And then there's something about the numbers that freak them out. Like,

Dan 48:19
yeah, I think with repetition, you know, it becomes these get a little easier, right? But so yeah, and then there's still the stuff a couple days ago, we switched the kids rooms. And we're kind of letting them decorate stuff. l&r. She was super excited and just kind of bouncing off the walls and she hit the bathroom hinge and ripped her Dexcom off and it just took the wind out of her sails, you know? So

Scott Benner 48:51
how do you how do you handle that? Do you you come in with the big enthusiasm don't worry about it, we'll fix it no problem, or do you let her feel bad about it? Or how did you handle that?

Dan 49:02
I tell her we'll fix it and it's okay and you know that I let her talk about it and say I understand but you know she she'll hit me with like the Sometimes I hate my life sort of thing. It's it's hard to to you know

Scott Benner 49:18
kids IQs too high do you understand times let's get you a nice kid with an 80 IQ just goes everything's fine don't just kids kids thinking around the deeper corners we don't know yeah I can everything difficult for you. Well, so we had

Dan 49:37
just gotten a new a new transmitter for this one and so this time i i Let her I was like, Do you want to put a Dexcom on me first you know before we do your so I am wearing one for the first time which has been interesting, but that helped a lot. She thought that was pretty fun.

Scott Benner 49:53
Okay, hey, interesting, Dan, like you think you have diabetes are interesting to see how a functioning pancreas works.

Dan 50:00
Interesting to see how a functioning pancreas works. And it also kind of kind of sad. You know, it's so easy for me I can pretty much do whatever I want

Scott Benner 50:13
to eat something exciting happens, right? It just Yeah, nothing. Well, I'll tell you that I think I've worn a CGM a couple of times, and just seeing the ebbs and flows and how different foods impact, I found it really valuable. It changed my perspective a little bit to about meal times. You know, I, there would have been a time in my life where I just thought that any rise in blood sugar was a mistake. And now I get me talking about all the time but I you know, I think of like after a meal, I don't want it to go up. If it doesn't, it's great. If you don't get any kind of a rise, and you don't get a low later. Be right on. That's perfect. But if you go 131 40 And it comes back in 30 minutes, I don't I don't think about that the same way as I did years and years ago.

Dan 50:59
Yeah, yeah. Yeah. It's interesting to see that and with me. Sometimes, there's not even any meal correlation. I'll see my blood sugar go up to whatever 120 And then go back down and like it. What's That was weird.

Scott Benner 51:14
Stress, anxiety. Yeah. Yeah. Could be and

Dan 51:19
the lows too. You know, I'll get down to the upper 60s.

Scott Benner 51:25
And you feel fine.

Dan 51:27
Oh, yeah. Yeah, I wouldn't know if I wasn't didn't have this on

Scott Benner 51:31
right. Yeah. Somebody came on years ago, a long time type ones. First time I heard somebody say that. Every person experiences blood sugars in the 60s like once or twice a day or and sometimes for extended times, people without obviously if you have active insulin working manmade insulin, it's a different concern. But it was that was another thing that I heard that was valuable for me. You mean like my blood sugar gets down to 65? Sometimes, and you know, no one runs around goes crazy. Yeah, helped me a lot.

Dan 51:59
Yeah, yeah. You don't freak out quite as much when?

Scott Benner 52:02
Yeah, I mean, if my blood sugar 65 I don't. I'm also not like riding around with for it, you know, four units of of NovaLogic in my arm or something like that. Right? I'm but yeah, it's not an apples to apples comparison. But it is enough to give you different perspective.

Dan 52:19
Yep, yeah. Well, what my wife and I do with that, you know, if Eleanor is starting to get down into the safe, lower 70s. We just like to give it one more reading, we usually say you know, we'll text each other one of us is working. So what do you think and kind of look at the line, but, but we'd like to just kind of give it one more to see what happens before we make any

Scott Benner 52:46
decision before you turn a 73 into 120? For no reason. Right? Yeah. Yeah. Listen, that's the one of the great aspects of the Dexcom. It's just yeah, you know, it allows you not to panic about things. Once you see it once you can, like see the big picture. It's it's excellent. I mean, just really life changing.

Dan 53:10
It's made me think a lot about my dad. Because he never, he had a pump, I think the last couple years. But he didn't like it. And he never had a CGM. And so, who knows, you know, he used to eat these big bowls of Honey Bunches of Oats as favorite cereal. I see what elder eats something like that. You know, probably by the time he went and tested himself again. He was fine. But in between, who knows what was going on? Well, I'm

Scott Benner 53:41
gonna guess that he wasn't fine because he had a lot of a lot of issues. Yeah, so I'm gonna guess that his blood sugar was high most of the time and if he lost a leg and had heart damage, I mean, we'll never know I guess but you probably had a one season attends and a loved ones. It would it would it would make it would make

Dan 54:01
I would imagine. Yeah. Especially you know, as a kid, you know? Yeah. 20s, late teens and 20s

Scott Benner 54:09
was the how do you remember him? His disposition?

Dan 54:15
Always he was always very positive. Until Until the leg amputation and then it it really kind of slowed him down. A lot of the stuff that he liked to do and you know, like, he was sensitive to people seeing it at first, and then it just hurt his leg would hurt a lot.

Scott Benner 54:40
So you had neuropathy as well, I'd imagine. No, no. Huh. Okay. All right. That's interesting. Yeah. And the heart disease eventually.

Dan 54:52
Yeah. So he had a heart attack. We were out. out camping. Actually. My sister in law was with us. She's an ICU nurse. My dad was explaining what's going on. And she's like, sounds like you're having a heart attack. He's like, No, I'm fine. He went to bed. And then we ended up taking my wife to the ER because she had a reaction to some antibiotics she was on, never took my dad to the doctor when he was a woman. Because you know, life was in danger.

Scott Benner 55:23
You have an incredible sense of humor. Well, at one point, you said something like my dad's leg was amputated. And it stopped him from and you paused. And I thought in my mind, those voices in my head when playing soccer, and because I didn't know where you were gonna go, because you've, you've had such a, like, you're quietly very funny. And you have, and you have a great sense, a dark sense of humor, and I didn't know where you were going, like, I didn't know if you're going to be serious, or like, tell me what really happened to him. And it just You just laugh, like, my dad was having a heart attack. And we took my wife to the hospital.

Dan 56:01
It was kind of funny. In hindsight, but

Scott Benner 56:06
it didn't end up being didn't work out great for him. Yeah,

Dan 56:10
no, he had a quintuple bypass after that. And

Scott Benner 56:13
wow, how long did you live after the bypass?

Dan 56:16
I'm gonna say, about six or seven years,

Scott Benner 56:19
I was hoping it was a while so that your story seemed like it was okay for it to be funny. I was very worried you were gonna be like four months got it was four months after that. But yeah, cuz then I really would have, it would be hard to laugh about. You're not taking him to the hospital. But older people. Older people are like that, too. Like, it'll be alright. You know what I mean? Yeah,

Dan 56:37
he was he thought he was just fine. And the doctor said he had had multiple heart attacks, probably with the tests that they did. Wow. And then, yeah, he had a lot of circulatory circulatory problems. And, you know, that was probably from having a lot of high blood sugar. I would

Scott Benner 56:58
imagine his life. So is that a driving force for you now with your daughter? The memory your dad?

Dan 57:05
Yeah. 100% I, I think I listened to a podcast where you mentioned you had a friend, you know, that Mike? Yeah, that had kind of poor management. And it was a motivating factor for you.

Scott Benner 57:20
It helps me it helps me with the podcasts for sure. And, and I do think about him, in certain ways in relationship to my daughter, but I Mike's memory is stronger for me when I imagine the people listening to the podcast. Yeah, you know, because you, you describe it. I mean, listen, your dad was it was in the 50s. Like, you know, he's a kid, like, I get it, you know, but I mean, an amputation, you know, a quadruple bypass, you know, circulatory issues, those those are problems from high blood sugars, like prolonged high or fluctuating, but, you know, most I bet he wasn't fluctuating that much. And he was probably just high all the time. And yeah, and you also described a mother in law who didn't know how to use your own glucometer a type two. Yeah. And that's why I think, you know, keep having these conversations, you know, so that, you know, what happened to Mike can, and your dad and, you know, everybody else can can hopefully benefit someone, be a more positive influence and with like, if you hear this story and think like, oh, it's sad diabetes, it's gonna get me. You're missing my point, you know? Yeah.

Dan 58:35
Yeah. Yeah. Well, to answer your question better about my dad, I, I think that it taught me I saw him low, many times, growing up, and it was always fixable. And, you know, of course, it's dangerous and scary not to be taken lightly, but never caused any real problems once we've resolved that. But it was the high blood sugars that ended up you know, really ending his life.

Scott Benner 59:12
And they were the thing that he didn't really pay attention. He didn't really pay attention to as much

Dan 59:17
you know, he will feel uncomfortable.

Scott Benner 59:21
So then let me amend what I said just because the tools didn't exist not that your dad was like, Screw it. Like he was living the life that was was available to him.

Dan 59:32
Yeah, he was and he just wasn't, wasn't his thing. He didn't really know about carbs much or I don't think he really knew how things worked. He just did what the doctors told him.

Scott Benner 59:46
The doctors tell him to eat Honey Bunches of Oats because I'm pretty certain none of us should be eating Honey Bunches of Oats.

Dan 59:53
I don't think they told them that. That was the best food

Scott Benner 59:58
Oh my gosh. Wow. So, are we are we covering everything the way you were hoping? Or is there? Is there something I'm not getting to?

Dan 1:00:06
Um No, I think I think we covered it all.

Scott Benner 1:00:16
We're doing okay. Yeah, yeah, I'm not kicking you off. I just wanted to make sure I wasn't missing anything. That's all. Because, you know, like, there's stuff that you've thought of since you I mean, I'm assuming you signed up for this, like six months ago.

Dan 1:00:29
Yeah. Yeah. Like, I'm gonna email Scott. See? So then, you know, I've been nervous about it for the last six months.

Scott Benner 1:00:38
Have you really?

Dan 1:00:40
No, not really real as well. today? This morning. I wasn't like, oh, no, I've got to do it.

Scott Benner 1:00:45
Are you nervous now? No, I'm

Dan 1:00:47
fine. Now. Okay. Yeah. Okay.

Scott Benner 1:00:49
But this morning? I wonder how often that happens. Because, you know, I mentioned on here sometimes, but I part of my screening process is that there's no screening process. So you have to want to be here. When I sit down to record to you with you. Get me like you get, I think two emails that remind you, yeah, and it's a six month wait. I mean, imagine like in June that you'd be like, I'm going to be on a podcast, and then in December, you get an email, like four days before, whatever. And it's like, hey, don't forget, you're gonna be on that podcast. I don't call you and be like, Hey, don't mess this up. I'm like, there's the link, you'll be there if you want to be. And everybody shows up like it. I'd say twice a year, there's no one there. And they usually just need to reschedule. People don't bail on me. But yeah, because of that I get I get well thought out and people who who have a real desire to tell a story, you know?

Dan 1:01:43
Yeah, that's, that's really good that I would assume that more people bail on you.

Scott Benner 1:01:49
But when that starts happening down, I'll get panicky, don't you worry.

Dan 1:01:54
I think that it's, it's kind of part of the community that, like, when Eleanor was diagnosed, there was we had all the vaccine stuff going on, where everybody, you know, hated each other, based on your opinion of that, and all the political stuff going on. And the one good thing that I kind of got out of it was the people in this community are so supportive of each other. Nobody, nobody cares about that stuff. Once you start talking about type one diabetes, and it's really kind of refreshing.

Scott Benner 1:02:30
I agree. It's a wonderful community. It really is. And, and a large part of why people are here, like, I'm sure if I was running a podcast about, you know, animal husbandry, people would bail more frequently. They'd be like, why wait six months to record that animal husbandry Podcast?

Dan 1:02:48
I'm gonna start one, I'm gonna see

Scott Benner 1:02:50
the end. You know what's funny? I'm about 86%. Sure, I know what animal husbandry is, it just sounded like funny words in my head when I thought of something.

Dan 1:03:01
You probably it's just taking care of animals, right? Is it?

Scott Benner 1:03:04
It's not about inseminate them? It's that I hope it's not that was what I started panicking and worrying about by saying something creepy.

Dan 1:03:12
husbandry is just like, you know, at the at the zoo. The zoo keeper practices Hold

Scott Benner 1:03:19
on a second. husbandry and animal husbandry is a branch of agriculture concerned with animals that are raised for meat, fiber, milk, or other products. It includes day to day care, selective breeding and raising of livestock. There we go. Anyway, if I had one of those podcasts, I'd expect people doing I'm not waiting six months to get on this damn thing. I don't know we throw the feed in the bucket. What a bad podcast that would probably be

Dan 1:03:48
very interesting, at the end

Scott Benner 1:03:49
of this whole thing, then I'll torture you guys. Like whenever I decide I'm going to be done. I'm gonna torture you by doing an entire year of interviews that have nothing to do with diabetes and are about the craziest, most bizarre thing, bizarre things that I don't understand. I will spend the last year of my life trying to understand all like, I'll find somebody to talk about animal husbandry, they'll come on and walk me through the whole thing. Seriously,

Dan 1:04:13
what if you did that? And then that got really popular even more?

Scott Benner 1:04:18
Well, that would go to my head down. I just want to tell you one thing, God.

Dan 1:04:27
One thing I just for whatever reason thought of that I think some people might enjoy hearing about is so I've been seeing a lot of stuff about airports on on the different Facebook pages and you know, going through the security and with all your equipment and stuff like that. And so with my dad with his prosthetic leg, they had no idea what to do. It was different every time and I remember one time the most awkward one. They made him take his leg off. Put it through the scanner, and then hop through the metal detector on one foot, and then put his leg back on the other

Scott Benner 1:05:07
one airport was this call them out?

Dan 1:05:10
I don't remember it might have been might have been in Portland.

Scott Benner 1:05:14
Why are you guys flying so much?

Dan 1:05:19
You know, it's an entire lifetime.

Scott Benner 1:05:21
It's like how much of your yearly income goes to airfare by the way? I can't believe I'm saying this. This podcast episode is definitely gonna be called animal husbandry. All right, nice. Because I want people to listen the whole time and think, nothing to do with that.

Dan 1:05:41
That's the funniest thing about this podcast is when I'm looking for one I didn't like I didn't go in order on them, but you really can't get anything from the title.

Scott Benner 1:05:51
I'm making you listen, damn, I don't need you. I don't need you disregarding an episode because you see a word you're not sure of.

Dan 1:05:59
That sounds interesting. I think the first one that I listened to. My wife sent me a picture that she got off of the Facebook page of like, the first ones to listen to, I guess. And the first one that I listened to was texting diabetes. And it was right before Eleanor started kindergarten. So her first like public school thing, and we were just freshly diagnosed. And I'm gonna have to do it different this year, because I was like, I was like hot walking. School telling them what they're gonna do.

Scott Benner 1:06:33
Yeah, I got you all charged up then. And then you went in there.

Dan 1:06:37
They're all fired up.

Scott Benner 1:06:40
There's an episode of the podcast called The frozen urine part of diabetes. I can't for the life of me remember why that is? Was to that one. The other day? butthole adjacent came out?

Dan 1:06:55
Oh, yeah. I saw you. I saw on the Facebook page that you asked how people feel about

Scott Benner 1:07:02
that. Yeah, I actually was concerned. You know, I was like, let me just see, by the way, overwhelmingly, people did not care. And yeah, it's funny because I'm, you know, I mean, if you listen enough, you probably get my sensibility. Like, I might go, I'm going to listen, it's an episode about a girl who got a fissure or something like that. What did they call those? You would think I know, because I recorded the opposite. Sounds right. Yeah. harassed, exploded. Okay. And it was, it was prior to her diagnosis. And so it's a big part of her diagnosis story. She had this pain, she went to a doctor, etc, etc. And the, you know, the damage, you know, where she had the injury, you know, is it's an injury of her skin, right? It's, it was between her. It was it was it was entertained. So, I was I was, I was waiting for you to say, yeah, so I couldn't say like, you know, blah, blah, blah, pain exploded. And then I was like, that doesn't work, you know. So I was like, Well, where is it? I was adjacent to her butthole. I was like, I'll call it butthole adjacent, and I'm typing that out. And there is no voice in my head that says, you should probably not do that. But I'm just like, that makes sense to me. Right? And then I set up the post. A couple hours later, I thought, maybe I ought to just throw a poll up on the Facebook page. Just real quick to check myself.

Dan 1:08:29
Yeah, when I started, most people are okay, I don't care.

Scott Benner 1:08:31
overwhelmingly people were okay with butthole Jason. And now, five years from now someone's going to trip across that and be like, what does that mean? What does that have to do with diabetes? You know, yeah, I'm looking here. I typed in but beauty to bring up you know, I got butthole adjacent Rocky and Bullwinkle, Bullwinkle, this Jenny burnout. Navigating bureaucracies with type one defining diabetes bumping nudge under the shade bus with MADI bushwhacking with Justin like I'm starting to wonder like what would happen like just say a word in any short word god

Dan 1:09:06
OH. husbandry

Scott Benner 1:09:10
bastard What are you doing? So I will type in don't have

Dan 1:09:15
anything now about how about how I'm trying to think I was gonna say food but that

Scott Benner 1:09:21
probably has everything that funny will have something Yeah, yeah. co parenting So I typed in food co parenting through divorce came up. Printing a one sees the word food must be in the description somewhere mature onset of the here's one mature onset of young love. Oh, what does that mean? We'll see. But I know Dan. Right. This person had Modi i think so mature onset of Baba bah is Modi. And she met her husband when they were really young. And to me those were the two keys of the story. And so but what would I need like You know, what would I do? Like what title? Should it be? You know, Jill has Modi and she got married young. If you read that, you'd be like, What the? Listen. Yeah, yeah, yeah. So yep. Trust me, I know what I'm doing. Am I doing Oh, am I being tested here, Dan?

Dan 1:10:17
Successful. So keep doing it.

Scott Benner 1:10:18
Yeah. Against all odds. And I seriously mean, if you knew me when I was younger, you'd be like, really worked out anything for him. That's interesting. Pull it together.

Dan 1:10:32
I don't know how you. You are very good at just letting that Facebook page go. Most of the time, I've only seen a couple things where you get mad, because someone's trying to sell something which I get because you're not doing this, you know, you could probably make a lot more money than you are doing. someone stealing your stuff to try to sell things that would kind of piss me off.

Scott Benner 1:10:55
I don't I don't like people taking advantage of other people. So yeah, if I come in there, and I say, look, here's a link for G voc hypo pan. If you click on it, it helps the podcast, you know, that's aboveboard? No problem. If somebody comes up and says, I found this thing that I use, it's really helpful, and I want to share it with people. That's great. But you can see the sneaky, you know, affiliate links, where they try to act like Oh, my God, this thing really helped me you should check it out. Or, you know, T shirts, scammers, that's really the biggest problem is that I don't want people to get scammed. And it happens constantly look at this shirt, and then people like, can you make me one? And then before you know what, everybody send him money to people, I'm like, stop, stop. No, no, no. Yeah, I mean, the truth is that, that that Facebook page, I think, right now is 20. I it's weird when I say it in the podcast, because then I listened back six months later, there's so many more, but now there's like 20 26,000 people in there. And there are people who are helping themselves. They're helping each other. They're sharing information. They're being supportive, they're creating a community, they're, they're, you know, they're helping people with questions. And they need to feel safe there, they shouldn't have to think that you're trying to steal 20 bucks from them. And Facebook is, you know, you have to protect that. So it's not. And then the other thing is, it's not a marketplace. I can't just let people come in there and pimp their businesses like crazy because those people are 26,000 people trying to help each other. But from a cynical perspective, they're also a bloc of people who are primed to buy certain things. And that's not that's not right, either, you know, and I don't get mad as much as I'm just like, ah, like, can you just leave me alone, I don't want to do this. But, but to your original point about the Facebook page, it works really well. Because it runs off my general vibe, which is speaking adult, just just stop it. I mean, like don't Don't, don't be looking to be upset and don't pick on people and don't be crappy to people just just be a be a human being and talk about your diabetes and people follow my lead do gratefully because it's a that Facebook pages is valuable to people diabetes, this podcast is I believe,

Dan 1:13:14
yeah, yeah, I don't really ever comment. Well, I haven't made my own Facebook page for posts for probably five years. My wife just does it and tagged me in it. So I don't ever comment on there. But I read people's stuff all the time. And I'm glad that other people comment because it really helps you learn all kinds of different tricks. And you know, it's such an individualized thing. type one diabetes is not the same for anybody and so I just getting all these ideas from so many different people. It's pretty amazing. It

Scott Benner 1:13:47
is it's um oh, it's one of the most amazing things I've ever seen actually people helping people like I sound goofy sang it, but you're from the you're from the northwest. You don't care if I sound Yeah, right, right. Yeah. So yeah, we're help each other man. Let's go in the woods. What's that a mushroom? Let's eat it. I know. I haven't figured it out completely. But I'm getting there. And so fish like how often have you stare at those fish? That you just like if you find them relaxing? Still? Are they still just work?

Dan 1:14:16
Oh, yeah. So no. Fish Tanks will bring your blood pressure down. Study that they've done. But yeah, definitely raises mine. I can't go to like a public aquarium without trying to see the problems. And then usually if I find some problems, I feel better. I'm like, Oh, they have

Scott Benner 1:14:34
issues too. You start throwing business cards around or what do you do?

Dan 1:14:39
Yeah, I'll fix that for you.

Scott Benner 1:14:42
Anything about your job help you balance say a hot tub pH? Does it lend itself to other parts of your life at all?

Dan 1:14:49
That is an interesting question, because when I was in college, I worked at a pet store that sold fish and reptiles and hot tubs half Hi. So my boss's idea was that it's more or less the same thing. It's a thing full of what? You know.

Scott Benner 1:15:10
Let's just go for simpler distributors similar skills. How many people do you know who believe in Sasquatch?

Dan 1:15:18
I think just my older daughter.

Scott Benner 1:15:20
Okay. Well, she's 12 I'm okay with that.

Dan 1:15:22
Yeah. Yeah. So it's funny. I just looked at the follow app, you know, saying I was nervous to get on here. My blood sugar. I haven't. I haven't had breakfast today. My blood sugar is 158. Wow. And I just had my a one C done a couple of weeks ago. And it was like 5.2. So I think I'm okay.

Scott Benner 1:15:44
Artists, blood sugar is 94 at the moment. So she's doing better than your pancreas.

Dan 1:15:51
It started going up right around 1015.

Scott Benner 1:15:54
I hear it sometimes people like get on and they're talking for 10 minutes, I hear beep beep and I'm like, You're right. Like, yeah, my blood sugar is just going up. I don't know why I'm like, You're nervous. I'm famous. And then you know, which I'm Dan, you know, right. I don't know. I don't think that kind of a big deal. So who? To you?

Dan 1:16:11
Yeah, to the people that know about you? Yeah,

Scott Benner 1:16:13
it's an oddity, really, I'm gonna go back downstairs, when we're done here, and my wife will make sure that I know I'm not a big deal. We'll take care of take care of the whole thing right now. I I wanted to get back to though just the idea of community for people super important. We don't talk about enough, it sounds kind of hokey, when you say it, it doesn't need to mean that you're like at diabetes camp for a week, it doesn't need to be it doesn't need to mean that you ever post on that Facebook page. It can just be the practice of watching the conversations, I think is incredibly valuable. And and just being around people who are are in a shared experience is was very comforting. Yeah. It's weird that I'm the one that facilitates it, but maybe not, you know, I was thinking it's funny. It's funny, you bring this up, I saw an email today from a person that I know who is the community manager, right. So it's a real job, it's 2022, this person makes a real honest living owns a home. And they're they manage a community online. That community that they manage has a small fraction of the members that mine does, it does not run well. And I've never thought of myself as a community manager in my life. And I realized when I was looking at it, it was all kind of like coalescing in my head, I thought, Oh, I am a community manager. I just do it differently than people do it. I don't put rules on people constraints. I mean, the basically, the rule of the Facebook page is be nice. That's yeah, that's it really, you know, I don't know, once a while people try to argue about politics, there's no politics. He just say no politics, that's the end. And when people say things that are kind of, you know, I was gonna say off color, but it's not true. I think what happens is, I think what happens most of the time is that people just don't communicate the way they want to sometimes they have an intention in their head but doesn't come out, right, or they don't think about how it reads. And there was a thing this morning, where I just I said to the person, hey, I don't think you're I don't think you meant this this way. Like, could you look at it again, please. And I didn't say it to them privately, or send them a message or I wrote under their comment I said, I don't believe that you, you know, I hear what you're saying. I have a ton of respect for the situation you've been through. Can you please look at this again, to see how the original poster might read it. And then the person came back and said, Oh, I didn't mean it that way. Like it, it was very, like, cordial. It again, to me, it's the you got to you can't walk around wanting to be upset. You know, you got to give people the benefit of the doubt. And, and assume that they mean good things, too. And then a lot of times you'll find out they did or you'll catch somebody in a bad moment. And they'll they'll adjust themselves. And the ones who don't are crazy. So what are we doing? We're gonna argue with them. You don't I mean?

Dan 1:19:07
Yeah, yeah, well, I write and delete emails to my clients all the time because like, caught me in a bad mood and I'm gonna I'm gonna wait to send that

Scott Benner 1:19:20
let me just take a second here and think this through i I said to somebody recently might have been on the podcast, I don't know, I feel bad if I'm repeating myself, but the podcast and the Facebook page and in general, interacting with people with diabetes for so long. It's made me a better communicator. But I I know how to talk to people in a way that I mean, that is still unique to me but sincere and does not. And takes into account how people might be feeling in ways that I don't know so you don't. I'm not a person who uses the word triggered really, but they're, you know, So you don't trigger people. So you don't get them. Yeah, you know, you don't put them in a in a disadvantageous situation the first time you talk to them, and that's how you, you breed conversations. So,

Dan 1:20:11
yep. Yeah, I agree that you have that unique skill that it's hard to do. It's hard to get people to tell you, especially things like this that are can be so personal.

Scott Benner 1:20:25
Without, well, then your barriers. You're nice to call it a skill, but it my whole life, people just tell me stuff. I don't know why it is natural. Yeah. My wife's like, when people tell you things they shouldn't tell you. And I'm like, I know. It's been happening forever. I have no idea. So probably just my deep voice then makes everybody comfortable and a little woozy. And then they're like, Yeah, my wife wants to put her hand inside of a cow.

Dan 1:20:50
I just, I just started a podcast this morning. Sounds like Alright, I'm gonna wait, just see how this goes. And it was all you the All I got to was you just talking about how great your voice was?

Scott Benner 1:21:03
Oh, you started one of my episodes. I thought you were like, This is the end. Now. I'm going to pimp my new podcast.

Dan 1:21:09
It was yours. It was the like divorce attorney. Oh,

Scott Benner 1:21:13
yeah. Great episode with a divorce attorney who is also the parent of a type one, she comes on gives great, great conversation about how to manage that situation. So I do the edit on it. You know, I know we recorded it a couple of months ago, I she wrote a great blog post for it that's on juicebox podcast.com. That's a companion like a real step by step how to like great advice. Anyway, I edited it. And it was ready. So the audio gets chopped up into blocks. And it's waiting for me to do the open like the Hello friends like that part. And you know, this episode of The Juicebox Podcast, and then I put the ads the middle, and I do the outro like the thank blah, blah, blah. And that happens later. And a lot of times that happens later at night. So I sat down to do that one. And I hadn't recorded in 12 hours, like I hadn't had these headphones on, you know, since noon. And I put them on. It's midnight. I'm probably a little dry and a little tired. And I go Hello friends. And my voice was so deep. It frightened me. And then I got okay, because I'm hearing it my ears like you and I are the same. You and I are the same audio level in my ears. So it keeps me from talking over you because I hear you on my level. Right? And so when I sit down to do the Edit, and I just my voice was booming, and then I got intoxicated, I was like oh my god, like it wasn't stopping. I was like, my voice is so deep right now. Anyway, that's the end if I had the opportunity, or the idea or the knowledge of how to pretend to be a different person, I guess I would but this is really just sort of me. So Oh, my God, my voice.

Dan 1:22:56
I think it's likeable for most people.

Scott Benner 1:22:59
Why are you listening to it? Dan, do you think you're getting divorced?

Dan 1:23:02
Yeah, that's what I actually thought about that afterwards, it was I wanted to find one that had the normal like intro that wasn't like a famous person or something like that just to sort of get my bearings. And then after I clicked on it, I was like if this like, somehow shows up in my history, and my wife's listening to that one.

Scott Benner 1:23:24
So don't think I didn't worry about that when I made it. Because I thought, are people going to listen to this? Like like it because it's great. I mean, she's terrific, like no life. Like, really, it's a great interview. You know, she talks about her, her, you know, her professional ideas around the topic, we talk a little bit about her, you know, her daughter as type one in the regular life. It's it's a nice mix, like you would expect. But when I put it up, I thought I wonder if people will just not want this in their history. Because it says co parenting through divorce. And if you're married, and that's in your history, somebody might not think that's great. And I just wonder what will happen. So I'm going to look right now to see if stats wise, it's different from the episode that went up right before it. Let's see. First day stats, I'm not gonna say the numbers out loud because you people don't get to know that. Yeah, but let me look at the next one. This one? Yeah, it's down a little bit. It's down. It's down a little bit over the one that came out just before it, which was my expectation. And to your point earlier about, you know, that's still a great conversation. If you're not thinking of getting divorced, still listen to it. Talks about communication and mediation and how people talk to each other and problems that arise in relationships and all this stuff but you write divorce on it, then everybody's like I'm not getting divorces and they won't listen to it.

Dan 1:24:55
Well, now I can listen to it and then if my wife you know this suspicious about I'll be like, just wait, you know, four or five months.

Scott Benner 1:25:06
Meanwhile, review. Your wife's listen to her three times already. She's like, Yeah, how to books she's making a man or guy was serious about these fish tanks. I didn't realize I gotta go. Oh my gosh. All right. Well, then you've been terrific. I really appreciate you doing this.

Dan 1:25:25
Yeah, thank you. I enjoyed talking to you. And, you know, it goes without saying, if you're just saying that, and it's terrible. I will not have never. You'd never use this one.

Scott Benner 1:25:38
You listen to the show right there? I do. I don't I don't throw away interviews ever.

Dan 1:25:43
I didn't. I didn't think so. Yeah, no, I

Scott Benner 1:25:46
mean, so I've been a handful of them that have gone wrong for reasons that have nothing to do with the person giving it. And I've put up episodes that I wasn't personally attached to. And I still hear back from people about how much they love them. It's not just about me, or one person or one aesthetic. Like you're right for somebody, you know? Yeah.

Dan 1:26:07
Yeah. That's kind of why I wanted to do it. Good.

Scott Benner 1:26:10
I really appreciate you taking the time. I sincerely do.

Dan 1:26:14
Alright, yeah. I appreciate you. And so well, how long how does it work? You just decide, like, how long does it how does what work?

Scott Benner 1:26:23
We're done. How do I? How do you ask me a question?

Dan 1:26:27
How do I know? How does one know when there? Interview gets?

Scott Benner 1:26:33
Oh? Well, then the machine takes care of it. We have a large intricate staff over here. I don't know Damn, it goes up. It goes up in your podcast player and you go animal husbandry Holy crap. All of that. What an idiot. That guy is. I have no idea why that podcast is listened to by anybody. No, I don't. I'm not going to tell you just gonna Yeah,

Dan 1:26:55
okay. Just kind of watch it. And then

Scott Benner 1:26:57
six months is six months is about the measuring stick. Okay, so pretty close six months and beyond. See how I've trained you six months to be on six months to go on? Record. So it's a year from when you emailed me? And you're like, Oh, that's not bad.

Dan 1:27:16
I think that is it. I already

Scott Benner 1:27:17
waited six months for this. Like I'm teaching people patience. I'm really I'm doing a public service. You know, I really happy yeah. All right. Yeah. Hold on one second. Okay.

Did I not tell you Dan was terrific. I was right. Thank you, Dan. And thank you, Omni pod makers of the Omni pod five, and the Omni pod dash Omni pod.com forward slash juice box. What are you waiting for? Speaking of waiting, how long have we been waiting for the Dexcom G seven and now it's here, Dex comm.com forward slash juice box. Go go go go. I want to thank you for listening and for sharing the show with other people. And for all the kind things that you do for each other. I'll remind you that I'll be back very soon with another episode. And that you should check out the private Facebook group Juicebox Podcast type one diabetes. Alright, I'm out of here. Don't forget to use my links