#924 APS Wookie
David has type 1 diabetes and is using Android APS.
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio - Radio Public, Amazon Alexa or wherever they get audio.
+ Click for EPISODE TRANSCRIPT
DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 00:00 Hello friends and welcome to episode 924 of the Juicebox Podcast. Today, David's on the show he's using Android APS with some refinements. I'm gonna let him tell you all about them. David has a very popular diabetes blog called bionic walkie you can check it out at bionic wookie.com. While you're listening today, 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. If you'd like to get 35% off at cosy earth.com, you can do that with the offer code juice box at checkout. If you'd like to get a free year's supply of vitamin D, five free travel packs, with your first order of ag one from athletic greens, you do that at athletic greens.com forward slash juicebox. And if you'd like to save 10% off your first month of therapy, you do that@betterhelp.com forward slash juicebox. David's terrific, you're gonna love him. He's from Australia. Fantastic guy. Wait, do you hear what he's doing with this Do It Yourself algorithm. It's really astonishing. This episode of The Juicebox Podcast is sponsored by touched by type one, a fantastic organization helping people with type one diabetes, check them out on their Facebook page, their Instagram page and at touched by type one.org. I'm going to be speaking at their next big event. I hope to see you there.
David Burren 01:53 I'm David Byrne. I live in Melbourne, Australia. I've had type one diabetes for 40 years now. Wow. I mean, but in my mid 50s. Now I'll be in my mid 50s later this month. That's what my wife tells me
Scott Benner 02:12 sounds like you're 54 Yes.
David Burren 02:19 Let's see. Quite a few Australians know me because I run a website called The Bionic monkey. There's a Star Wars reference in there. Which is all about diabetes technology. I've been living with closed loop systems, self built closed loop systems for about what more than five years now? And I I I've ended up coordinating a lot of the Australian community of do it yourselfers. That's cool.
Scott Benner 02:56 Okay, so you were diagnosed? Geez, when you were like 14? Yes. Okay. 40 years ago was AD AD AD to Jesus. Wow. That's a long time ago. Okay. It's crazy. You. You said you've been doing closed loop. So you've been doing? What have you tried a bunch of different versions? Or which one did you start with? I guess.
David Burren 03:24 Okay. So I started using a pump in 2010. Just to illustrate a little bit about my life, I've done various things during it at my endo had suggested to me a few times that are these insulin pumps, that might be something that you'd be interested in. You're a really technical guy. But I had been very much in the World of Goo. I know how injections work. There's going to be this strange thing of something attached to me. What happens if I fall off a boat or I get wet or something because in those days, pumps weren't waterproof. And then in late, late 2009, I attended a local event where I actually got to see and play with some of the NMS pumps, which were Hey, they were waterproof. And I decided right, this is something I wanted to do. I think that event was in September. Then I organized with my D, my data so they're getting a pump, but then I had to put it off until February. Because over December that year, I was an artist in residence on a ship traveling up and down the Norwegian coast photographing the Northern Lights. Because as well as working in it, I've also spent quite a few years as a professional natural wildlife photographer. Oh, wow. So I've done a few different things but so I started pumping and That went on for probably six years. Before I started using libre, that was the first CGM I got access to. That was 2016. And by early 2017, I'd seen the loop system and I'd seen the open APS system and I decided that open APS was the way I want it to go. So I started, I was carrying a little Android phone. And that was being my CGM and feeding the stuff into my little pocket computer that was running the open APS stuff. I was using an old Medtronic pump. And then in 2018, I got a combo pump, which were being sold in Australia at the time, and that's a pump that has Bluetooth in it. And Android APS could talk directly to it. That's the accucheck. Yes, the accucheck combo, which has last year it was discontinued. That had
Scott Benner 06:01 that had Bluetooth in it and 2018.
David Burren 06:05 That had Bluetooth in it in 2011. When it came out, wow. I have no carry. That's cool. That's a very old and primitive pump. And the interface that talks to it is quite slow. Because basically it's pretending to be a person navigating through the menus. It's not actually sending it direct commands.
Scott Benner 06:21 Oh, no kidding. Do you? Do you see it happen on screen as it's not? The screen
David Burren 06:26 is blank at that point. And it goes faster, faster than I would but it's still slower than if you're actually sending commands directly to its interest, but it works. Yeah. And that works quite well. So I've been using Android by system since 2018.
Scott Benner 06:43 Okay, so you use open APS still today.
David Burren 06:48 I don't use open APs. But Android APS uses the same algorithm. Excuse me,
Scott Benner 06:53 I misspoke. But okay, Android APs.
David Burren 06:57 And I'm not actually using Android APs. At the moment, I'm using something that's very similar to it, which is a version of the software that we've frozen, we use in some clinical trials. Because I've been involved in running a clinical trial over the last few years of Android APs. So this is on people in the real world. But it's a randomized control trial. So it was all at the level that the medicals would actually pay attention to the results rather than people saying, oh, it works for me. I haven't killed myself. Yeah. Right. And so that's through a local hospital. And basically it feels like some of the staff there look at my clinical results of me living my own life doing stuff and they say, oh, that's, that's amazing results. But we need a clinical trial. So I can actually prove this, this works. And in other words, that I'm not just a freak.
Scott Benner 08:01 Right? Well, that it doesn't just work for you and no one else but it is interesting how you are holding up your you are holding up your self as an example. It's like, Hey, look at this. This is what's working for me that like yeah, that's nice. We need to prove it. Yeah. Like I feel like
David Burren 08:16 so the that trials over and I on that one, I was the local technical expert on this hurdle plugs together and oh, when using a different insulin pump for this, so I was the guy who wrote the bluetooth driver to talk to the pump. So I'm fully involved in the technical level as well. Okay.
Scott Benner 08:37 So let me just for people listening, I want to just make sure that they understand. So loop for example, Arden uses a version of loop. Actually, I think Arden's using open APS right now. With the auto Bolus version,
David Burren 08:56 the free APS free, six,
Scott Benner 08:59 free free APS, thank you. Well, I don't this is the part that this is why you don't come to me, David on any of this stuff. Arden's using aren't using free APS, which is a version of loop that does auto bolusing. We are waiting to see the version that works with Dash pods, which I think they have been getting, I think they're getting it close to buttoning it up
David Burren 09:24 the loop world is it seems to be a bit fragmented. So there's various branches and versions that people are experimenting with, which is fair enough. That happens in all systems, but there's loop and then some guys made a branched version that they called Three APS, which was looped with some extra auto Bolus things. And then they made a different version, which is called free APS x with letter X on the end, and some people refer to it as short in shorthand is fx. And that is the open APS algorithm that It's also used by Android APs and open APs. But running on the iPhone. It's basically using all the communication stuff that was set up by Luke to talk to the pumps and the CGM. But they've put a different algorithm in the middle. But there's at least three different systems on on iPhones and to a certain extent, they all look and feel very similar. Yeah. Is there? So it's a bit hard to know what people are using when they say, Oh, I'm using free abs? Which one?
Scott Benner 10:28 Trust me, I don't know that. I know. I think sometimes I just, I, you know, I have people around me that say, Hey, this is the one you should be using right now. Like, okay, fair enough. Do you think there's a lot of outcome difference between loop Android APS, open all that stuff? Do you think people have basically similar experiences,
David Burren 10:47 I do think there's a difference. The openaps algorithm, which is called a ref one, just in case, I mentioned that, again, that has a bunch of things. It has SMBs, super micro boluses. So it's, that's where it calculates, oh, we need this much basil to do this amount of work, because we think we know where the glucose is going. So we need this much insulin. But the basil is going to take a while to get it in there. So the super micro Bolus will take a portion of that and deliver some of it as a small Bolus now, and then in five minutes, it might say, oh, we need some more. Or it might say, Oh, I better not put too much in because we've suddenly changed direction, just as well, I didn't put it all in at once. So that has made it reasonably fast at reacting to thing. It's carbohydrate model. Unlike the commercial loop systems, it's a dynamic one where you tell it how many carbs just like loop, you tell it how many carbs and then it decays those away, it has an idea of how many carbs are on board. And that's partly affected by what your glucose has been doing. So it basically only decays them away when it says oh, it looks like that that was one of the carb effects going on. Because that wasn't the same as what we predicted was going to happen without the carbs. But then it has a mode called UAM, which is unannounced meals. Where it looks at what your glucose is doing and says that looks like food, I'm going to treat it like it was food. I have not counted carbs or declared food to my system for almost two years now.
Scott Benner 12:51 I asked chat GPT to write an ad for touched by type one. And here's what I came up with. This episode is brought to you by touched by type one, a nonprofit organization dedicated to supporting and empowering individuals living with type one diabetes. Living with type one diabetes is a daily challenge. But touched by type one is here to make that journey a little bit easier. With our incredible range of resources, educational programs and community events. They're committed to making a positive impact on the lives of those affected by type one diabetes, from the dancing for diabetes event, to their annual conference, which by the way I'll be speaking at doesn't mention me but I'm not insulted by that. Touched by type one is always striving to make a difference. And the best part touched by type one is offering our listeners an exclusive opportunity to join their community and assess their resources for free. That's actually all true. Touched by type one.org. Just visit their website or find them on Facebook or Instagram. Touched by type one.org. Love this thing. I'm not even gonna have to think anymore. Don't let type one diabetes to find you were touched by type one by your side, you can lead a fulfilling life and take control of your health. So head over to touch by type one.org and get in there learn more about it. I'm adding that part because it's pretty great. They have a wonderful website. They do a lot of amazing things for people with type one. There's a bunch of programs just seriously take a couple of minutes to look into them. And if you're coming out to their event this year, I hope we meet please say hello touched by type one.org.
David Burren 14:34 I have not counted carbs or declared food to my system for almost two years now. I do not carb count. I do not Bolus I just eat and live my life. I don't know anyone who manages to do that on loop unless they're low carb. I would probably eat 200 to 300 grams of carbs most days and sometimes I go way over that. So I would not describe So for the low carbon.
Scott Benner 15:03 So the UAM on announced, what does it stand for?
David Burren 15:06 On announced meals on announced meals.
Scott Benner 15:10 So, and this is the on the Android aps that you're using, that hasn't Yes. Okay. And it sees, so you just eat, and it sees the rise, assumes it's a meal and hits it.
David Burren 15:30 Essentially, it's doing it in that cautious way of we're not going to Bolus everything we, we don't think this is a 100 gram meals. So we're gonna give it however many units of insulin right now, it doesn't piecemeal. But because it can come along every five minutes and dose another little bit more. It reacts fairly well. Now, I knew that the system had this out that the algorithm had this functionality in it back in 2017, when I started and this was one of the things that probably affected my decision as to which system was going to go for it know anyone who went completely Bolus LIS at that point. But it's always doing that in the background and saying, Oh, you missed a snack, I'm going to follow something for it. And back in those days, I was using jemalloc. That was the fastest instrument we had access to here. When I got access to figures, I thought, Oh, this is great, I'm finally going to be able to try and go hands free. And we were going out for Mexican that night. And that was a disaster. So
Scott Benner 16:41 it didn't work out though, you
David Burren 16:42 know, it took a fair bit of fine tuning. First of all, I had to get the dosing adjustments changed for fasp. Because the system was reacting slightly differently. But then I know a lot of people who see what I'm doing, and they come along and say, quite understand, but I want that right. What do I do to plug these things and turn it on? Because I want that? I want that now. And my general feeling is, well it takes a while because you need to know that you've got your underlying settings, right? Because what I started with was, yes, I was counting everything, declaring everything I was counting in declare eating protein as well as protein I can declare as as though they were a smaller amount of carbs in the future. On sort of metrics, what the body does, right, I was I was counting and bolting for food. And then I was getting great timing range, everything was going where I wanted. And then I'd start skipping announcing on some snacks, and how it worked. I stayed in range. And then you do it on a biggest accurate meal. And it all goes out the window and haven't quite got it right. Go back and fine tune. And I went through a phase where I counted and declared the carbs, but I didn't Bolus. Actually step before that. I counted and cleared all the carbs, but I Bolus less than the full amount with the expectation this system was going to take care of the rest. Essentially, in my mind, when you're Bolus for something with these systems, the Bolus is really just giving it a heads up. The algorithm should work out what's going on. And if you've told it, what curves are in there, it's going to do great. It has to guess it all by itself. It might not go quite as well. I actually found if I under counted the curves, the system. It's almost as though the system says You told me it was this much. And it doesn't react fast enough. If I over count the carbs a bit. It says oh, you've told me it's this much. But I haven't seen all of those yet. And eventually, they must have not been there. Because the algorithms always had this thing where it dynamically decays the carbs. So that if you didn't eat the second course or you dropped your ice cream, it didn't actually eat it, then it wouldn't necessarily try and deal with all that food that you might not have actually eaten. It's fairly flexible in that way. But it was a general process of taking away the bolusing but still declaring the caps clearing all the protein and yes, everything was coming in right? Oh no, I have to tune things. My insulin to carb ratio needs a bit of tweaking or my profile needs a bit of tweaking. And then I think it was November was I made some notes in my diary November was the last time I bought last and then in February was the last time that I declared carbs. Because I've gone through Christmas with not bolusing declaring all the food but not bolusing. And this was Christmas, New Year, there was lots of food on the table, and everything sort of went in range. And that gave me the confidence to stay right, let's, let's go completely hands free and see what works. And it did me ask you a little bit
Scott Benner 20:23 about the food you're eating? So, I mean, is this like a very balanced meal of natural foods and etc? Or is this Captain Crunch? At you know what I mean? Like, are we are you not taking in a lot of high fructose corn syrup? Are you avoiding things like that?
David Burren 20:41 I do have celiac disease, but I'm avoiding things with gluten in them, which means that I tend I tend not to eat too much bread. Maybe my diet isn't completely typical. I do. I do find I try to eat sensitively. But I don't all the time, we try to have meat and veggies and a mixture of things. Breakfast is the meal that I probably pay most attention to. Because I always found that I was most sensitive to carbs after fasting. Yes. And that might be because the Gus is all primed and ready to accept these carbs and leap on. There might be one way of looking at them. I have some friends who have children with diabetes and they swear by we give the kids something to line their stomachs that like bacon and eggs or something. And then they can have cereal and it doesn't spike them through the roof. So my breakfast, I have a standard breakfast and basically yogurt and some strawberries and some psyllium husks. So there's fiber in there. It's just a simple, basic breakfast that I don't have to think about, I can just get up and go to the kitchen and have breakfast and get on with my day. I'm on autopilot. And at that point. It's not a huge amount of carbs. And once my body's reacted to that, and I chose that breakfast, when I was still in still counting and bolusing because it was just easy to organize, I didn't have to think about what's my carb count this morning, I could just say, I think it's about 17 grams. Breakfast, it's not a not a high carb breakfast. But after that, whatever food I feel like eating, whether it's at an 80 gram block of chocolate, or an apple or sometimes I'll have a like I said I tend not to eat bread. So sometimes I have things in reps, but the sweet potato wraps because there's no gluten most of my I tried to go low carb in 2017 I thought this this will help me control my my glycemia which was bouncing around all over the place. But in fact, it didn't especially help i Then I was actually thinking at the time, I need to lose weight because I was classified as obese at that point. And I didn't really lose weight. But later on I worked out now it's about actually about the calories when you're trying to lose the weight. Just just ate a reasonable number of carbs. But I've never really excellent when I say never years ago when I started out it was you inject this much and then you eat this much. We ate to the insulin whereas now it's if I ate more, I'm going to inject more or more of the point if I ate more my pump will have delivered more insulin by the end of the day.
Scott Benner 24:01 When you say staying in range, what do you mean by that? What are your goals?
David Burren 24:07 Okay, so I use I'm hesitating a little bit because my brain tends to run in millimoles and I know you're used to milligrams. So in milligrams the range I aim for myself like the green band on my setup is 70 to 140 Okay. And my target is around 90 That's where the system's aiming most of the time.
Scott Benner 24:35 How often do you get under 60 allow that you need to do something about
David Burren 24:45 let's say my neighbor brain is saying what 60
Scott Benner 24:51 I can get up my my chart. I can talk to you like this
David Burren 24:58 three point 3.3 RDL Sorry, I shouldn't wear the what I should do is one of my friends calls me sir graphology let me pull up a spreadsheet my time in range 470 to 140 is generally averages around 85%. And if I just find this stuff in here, we get my time below range, or all sorts of pretty graphs, here we go um below range for 3.3. That would be around half a percent of the day, on average.
Scott Benner 26:16 So you don't, generally speaking, find yourself rescuing your blood sugar with fast acting glucose very often,
David Burren 26:22 every now and then I've had some weird things just in the last couple of days where I will, I'll be low in the middle of the night. And this is hanging out. This is not the way the world works. But it's a timing thing. With the way I've changed a few settings recently, and to do with the high insulin on board that I've had the previous night. I'm tuning that. So I've generally got rescue curves around. And I always have rescue cows with me if I'm off on a big bike ride. Exercise makes things tricky. But I generally don't go through them very often,
Scott Benner 27:00 when you talked about earlier that you had to change your settings to work in this. In this system that you use where you're you're basically you're telling the I guess you're telling the algorithm look I'm eating, but don't give me all this insulin or don't give me any of it, and then it's on you to use it as you see fit. Are you still doing a? What's my question here? Did you change your settings to make them so heavy that they wouldn't work manually? If you went back to just you know what I'm saying?
David Burren 27:32 No, my, the Basal that's programmed in is my default Basal. If my loop turns off, I know that it will keep me fairly flat, okay with as long as I'm not changing things with food, and so on. So know that all those numbers are traditional numbers. But I'm really confident in them and some of the other things that I tweaked, were tuning the insulin modeling. So for example, the duration of the insulin in the system and the way it decays. So that hours after a big meal, the estimate of insulin onboard is actually correct. And I found that made a big difference to how the system was automatically reacting I can make its predictions actually met reality.
Scott Benner 28:24 Was that easier when you move to the ASP
David Burren 28:28 I actually found that is I found it easier to chain and notice the differences when I went to Furter insurance. So I've used an ace Nova rapid and a Piedra and human log and fierce and Liam Jeff, we can't get the longevity in Australia. It's not even it's not approved as a medicine here, but we're allowed to import it for personal use. So I got some from a friend in Europe and have done some experiments and it's quite nice. The faster insulins the decay in insulin happens faster. So it makes a lot of these things more visible.
Scott Benner 29:08 Right. So it's interesting. So that so the algorithm, it's more precise. So yes, yes decision,
David Burren 29:14 I found it easier to make that tuning but at the same time, having tuned the system, I felt like the faster insulin. Let me move into this mode where the system could take care of most things for me. But I have since experimented and gone back to the slower insurance like human logon Nova rapid and life stays the same. Interesting. It's all it's all automatic. It does. I do go high after a meal and it takes longer to come down. And looking back in the old days, I probably would have said oh, I'm too high. I need the Bolus I need to correct and get things down whereas now I have confidence in what the system is doing and then that in a couple of hours, it'll help me down at the right point. I'll be flat in the morning. It'll be fine. Oh, yeah, the fat pasta rangelands. Give me more freedom. But I know the the slower insulins work. There is a complication in trying to compare them though because I compared my timing range for a couple of weeks on one versus a couple of weeks on the other. And they were about the same. I was thinking, hang on, this can't be right that pasture insurance supposed to be better. And then I realized I wasn't eating the same because I had the faster insulin, it's Oh, I just ate that and built it, it'll take care of it. So I will be keeping everything else the same. That's
Scott Benner 30:41 interesting. I tried my hardest to switch Arden over to one and she just had the fiasco she described sometimes as burning. But But the biggest problem is that when our pump site came off, it felt bruised. For for a while after that, the loon jab was significantly worse than the ps4, which is a shame because I also talked to a lot of people who don't have any trouble with it. But
David Burren 31:09 I was aware of these going in because a bunch of people in Europe have been using it for a while and have discovered things about them. So oops, my backgrounds just gone. That's fine. The with CSVs is Nova rapid with the addition of was it's nice in a mode as the main accelerant. And yes, a lot of people report stinging, some people will report occlusions sometimes they say the occlusions in the pump. Some of them reports that their site gets red and inflamed, and they have to change the cannula more often. Some people's report that after some random time, whether it's three months, six months, or whatever, it's like it turns into water and it doesn't work anymore an advocate back to something else. I was aware of all these things before I started. So what I did was I I mixed BS with non accelerated insulin. So if you think about Nova rapid, and VS by the same thing, but BS has some of this accelerant in it, if you mix them together, it's still the same insulin, but there's less tolerance spread around. So no doctor is going to say you can do this, but it's all completely off label. But I used that sort of setup for about three months, and I didn't have any steam. And then eventually, I changed to 100%. And I didn't have any stinging and I haven't had an instinct when it came to being objective. Similarly, Liam, Jeff is the same insulin as human dog. But with the addition of a little vaso dilator trip trip is still I think if I remember that name, right? Anyway. It's also used in some other therapies as a vaso dilator. And the general reports there seem to be it stings like hell, but you get used to it after six months, and your body adjusts and it goes away. So what I did with him, Jeff was I mixed it with Humalog. So I had a lower concentration. And I did that for a few months before I went 100%. And I haven't had any singing. I did notice some stinging early on, but it didn't last long. Sorry. One of the other things relating to that is, little Jeff is available in Youtube 100 as well as new 100. And a lot of people report that the YouTube 100 doesn't sting as much. Interesting. And that makes sense because the accelerant in that is the same concentration for you 100 And you're 200 by volume. So when you administer one unit of the you 200 You're getting half the amount of accelerant than you would with the 100 So it's the same sort of thing of less accelerant. Right.
Scott Benner 34:31 Last thing Arden described the longevity is unbearable. Like she she lived with the fiasco for weeks and weeks and weeks before she finally just said this isn't getting any better. But the the looms if she was like you have to take this off of me I don't think she made it may be more than an hour or so. Which I found
David Burren 34:52 I exception. I don't I don't know if my success with them has been because I took it very slowly. Introduce it slowly or just with a, I was never gonna have a problem anyway. Right? I don't know.
Scott Benner 35:06 So this process you use, do other people use it as well? Or is it just worked for you? Like, like, I mean, I mean you're describing, basically not counting carbs and and not Pre-Bolus thing at all. And you're doing it just with settings. I mean, you know that sounds a little crazy. So I'm trying to decide if your view given to other people or not.
David Burren 35:33 I started doing this because other people were doing it with some of the faster insurance in Europe. And I've, I've been doing it for a while and I've been fairly vocal in our local community about the fact that I'm operating this way, because someone says, I have to carb count for this and the Bolus are a bit mean sometimes I say the Bolus, what's the Bolus? That some people have told me since that they've basically they've been emboldened what I'm doing by what I'm doing. And they occasionally don't Bolus for some foods, and everything works. And some people don't Bolus anymore, but they do announce most of their foods or they announced the big meals. So there's these compromised lines. Because one of the nice things about this is you don't necessarily have to put everything in go completely hands free. You can do any of those stages along the way. And it's been surprising for me how many people just pipe up every now and then and say I Yeah, it's working for me too. And it's not okay.
Scott Benner 36:44 Well, we can I guess you can kind of post date a Bolus in loop. So if Arden's taking in something that I think is like, has a lot of fat in it, or it's been deep fried or something like that. Those sorts of foods, if she makes a Bolus, and Pre-Bolus is her meal, and then tells the loop, I don't know an hour from now expect 20 more, you know, the impact of 20 more carbs, for example, I find that gives the loop the autonomy to push harder when it sees a rise than it would if you didn't put these, you know this empirically in the future. That works really well.
David Burren 37:28 Yeah, I, I used setups like that early on, to try and understand what was going on. And that works quite well. A couple of things to talk about there. So there is a strong sense of yes, this stuff works for me. But maybe it's just that I'm afraid. I don't mind being called the freak as long as it's got us doing it with a smile on your face. I know quite a few other people. I've said it's surprising. This is working for quite a few people. But there's also quite a few people who say, Well, no, it doesn't work for me. I've tried that and it doesn't work. Now, I don't know if their bodies are different. Maybe their bodies are the same and then just not holding the mouse the right way. But I think that's less likely, then we are all different because that's the nature of diabetes. We're all different. I know quite a few people in Europe as saying the totally hands free stuff works. But you have to be using looms, you have to work. And you need all of these settings. And some of them use fairly aggressive setups where they enable some of the automation in Android APs. So for example, when you're going high, it changes the rates and says we need a stronger profile to try and fight it to bring it down. And essentially they start implementing another level of loop algorithm on top of what the system is trying to do. And that sort of works for them. And I tried doing some of those things early on, but I found it often overreacted. And for me, I found it was better to get the base algorithm doing the right thing. Now, there's a bunch of people who've made variants of Android APS, there's a dynamic ISF. Boost Ami. There's a tsunami, there's a bunch of different variants where people have been changing the algorithm to make it more aggressive. So it said, Oh, it looks like we're getting food. We're going to change the rates and dose for for the next half hour or do whatever changes. And if you've been using a lot of insulin lightly, we're going to assume that you're more insulin sensitive and dynamically change things. People have been doing all sorts of experiments. And a lot of people are quite enthusiastic about other systems that they're not mainstream yet they're still experimental versions on the site. I'm probably the unusual thing about me is, I'm managing to do this with the base, the standard stuff that's been around for a while and not using those advanced algorithms. Yeah. I didn't mean, I didn't mention the last clinical trial I was involved in, which is over which was using Android APs. And showing that, yes, it's safe and effective, and we get good clinical results. We're lining up to do the next one. And I mentioned before, the researchers tend to look at what I'm doing and say, we need to work out how to do that. You can guess what the next trials about.
Scott Benner 40:46 They're gonna try to figure out why you're not you're not having to Pre-Bolus your meals.
David Burren 40:50 So we're gonna have a whole bunch of people in two countries who will be doing that, in a randomized control trial. Wow,
Scott Benner 40:57 how long does that take to do that? That study?
David Burren 41:02 It's gonna take about two years to run, I think.
Scott Benner 41:06 How many people will be involved in it?
David Burren 41:08 It's less than 100. And they're not all running at once. That's why it gets spread out a little bit. But people will be involved in the trial for over six months. Ah,
Scott Benner 41:17 wow, that's pretty great. When they get that when these hospitals get this information, what do they do with it? Right, because it's not like, it's not like, Android. APS is a company, you don't go back to them and say, here's what we're learning you there's not a there's not like a dedicated group of a half a million people sitting in a circle waiting for you to come back with it and tell them what to do. Like, what happens when you get the data? Is it just inform more research? Or you know what I mean? What's it? What's the goal of it, I guess?
David Burren 41:50 Well, they call it a hospital. That's the sort of hospital I'm working with is actually not a hospital. It's a Medical Research Institute. Okay, that happened that happens to have patients and run endocrinology practice and do all that stuff. And most of the participants in trials, they do lots of trials, most of the participants in trials come from their client base. I see.
Scott Benner 42:17 Okay, so they have things they're trying to, to move forward as well.
David Burren 42:23 Yeah. And certainly, the results of this stuff gets fed back to the community. Because this stuff is used in multiple, by multiple software systems, it's used on some of the iPhone systems. So the three MPs X, for example, that same algorithm. And there's a general feeling of everyone should be able to benefit from this because the algorithm that's been used is not some secret sauce, not hoping that type zero have made up in the lab and or am I ever made up in a lab and not telling people exactly how it works, because that's their secret sauce, this is all open source, everyone can see what it's happening. So hopefully, new products will come out and be able to take advantage of this because this stuff is really making life easier and better for me and for lots of other people. And it needs to be able to do that for a lot more. Well, everyone deserves one of those systems.
Scott Benner 43:28 Yeah, that's the real goal isn't it is and what I was thinking earlier, while you were talking is even though the even though the retail systems are all really relatively new, in the last couple of years, it's still kind of astonishing that they can mass market, put it on people and get results like that. Because I mean, like what you're talking about is I have a system, but now I significantly understand the implementation of how it works. I significantly understand my settings, like really specific stuff that you put a lot of time and effort attention to, while other people are just like, look at buying this thing. It's on I wanted to go and they're having reasonable like results for the most part. And that's astonishing to me, like, I don't know how you make something that that needs this level of detail. And yet, you know what I mean? Like you don't ask the people what they eat, you don't ask them if they're hydrated. You don't ask them if they exercise if they don't exercise and people are, I don't know, it's amazing, you know.
David Burren 44:32 I do still tell my system when I'm exercising, I tell it to change targets because I'm managing the insulin on board. And I think most of the commercial systems have that whether it's ma PS has, you're going to ease off or a boost. It's basically gotten a braking and accelerator function and control IQ has exercise mode. And
Scott Benner 44:54 what I meant is that you can't you can't know that when you hand something out to the masses. they're not they're not they're not all doing it the way you are, you know what I mean?
David Burren 45:03 And this is the big compromise that we're all dealing with. And this is why the commercial systems like this, it's one of the reasons why the commercial systems don't have all the functionality that, for example, I have access to because they've had to go through the regulators, because the regulators say this needs to be safe or not kill people.
Scott Benner 45:27 And for everybody, not just people who will take a ton of time to understand it. But you know,
David Burren 45:32 that, unfortunately, some of those regular sheet decisions, I think sometimes because they don't, it may be because they don't always include people with diabetes in the decision making process, I think they sometimes end up with less safe things, such as the examples of the Medtronic system. So they had the first commercial, closed loop. And it's basically, oh, we've been working too hard with I've been giving you so much extra insulin, and you're not coming down. So I now need to stop and drop into manual mode and stop helping you because it's obviously not working. That was some bean counter said, Well, the best thing to do. Whereas if I'm sick in bed with the flu, I want the damn thing to keep delivering insulin. And to help me get through this problem.
Scott Benner 46:27 Yeah. Yeah, well, no, it's 100%. I mean, all of them are, I'm assuming, at some point, drawing a line in the sand and saying this is this is, as far as we'll, we'll say, we can help. And you know, if something happens past that, it's got to go back on the user.
David Burren 46:45 Yeah, and I think some of those fall back on the user have been a little bit primitive, in terms of, well, that's the way it used to work when you had a manual system, or we just say, or the user take care of it again. But the user at that point has gotten used to it doing a lot of work for them. So it's suddenly a bigger drop out for them and it becomes less safe. So finding a compromise on all of this is a challenge for everyone
Scott Benner 47:09 Arden's a college now, and just last night, she had a meal a while she was, you know, she's in a room working. And I think I'm watching it, like Get away from her. And I sent her a text, and I don't think she saw the first one. And then she gets this rise that just goes 141 5160 on my garden, you know, but you didn't put in a secondary Bolus if the meal was and now I'm in a bit of a loss. I don't know what she ate, you know. So I'm like, if the meal was heavy in this, or this, you know, you forgot your secondary bowl. She's like, well, it wasn't. So I'm just going to make a correction here. And I'm like, okay, but I didn't see it working. And now she's fighting with it for a few, you know, a few hours in the late evening. And she just, she loses the fight with the Bolus, and she loses the fight with being tired. And she just goes to sleep. And, you know, I tried to wake her up, I, you know, it's a higher blood sugar, not a lower one. So I'm like, alright, well, you know, I sent her a text like, Hey, you got a Bolus, again, I don't hear from her, I finally called and woke her up. And I said, Hey, you know, put put some insulin in here. But at that point, David, I don't know what to tell her. I don't know what she ate, I can see what the the algorithms been trying its hardest over the last couple of hours. It's not working, you know, it's just keeping her level at a higher number. I know she needs more insulin. But I don't know how much and I'm tired. And you and I got to we're gonna do this. I'm gonna be up early in the morning my sunlight or doing something later tonight. Like, I've been sick recently. And like, I got asleep a little bit here. And so we put in enough insulin, we weren't as aggressive with it as I would have been if we were wide awake and looking at the same example. But she woke up this morning at like 110. And, I mean, on any manual system, or if a system would have kicked into manual, she would have been, I mean, I'm assuming she would have been 200 Plus, and it would, and she would not have woken up with any kind of resolution to the blood sugar. This doesn't happen to her all the time. But it's your point about you know, I know this thing's gonna do what it's going to do. And I'm going to end up okay. It's an amazing benefit, you know. So, anyway, what, what else did you want to talk about? What, what? What made you think I want to come on and talk about this on my podcast?
David Burren 49:28 I think it was probably something I posted in the Facebook group that you responded to and thought he sounds like an interesting person to talk to.
Scott Benner 49:38 I definitely do that. But I have to admit, David, 45 minutes into this. I don't especially understand why you don't have to Bolus. I don't I don't know that I Okay. Yeah. I don't know that. I understand why it's working for you or the, you know, like if somebody's listening to this right now. And they're like, Well, I don't want to Bolus for For like, this sounds great. Like, what do I do?
David Burren 50:02 Yeah. I don't have easy answers. But I've got some things that might help understanding a little bit. Because I've talked to a lot of people who say, How can this how can this work? This person personnel at the CGM is always lagging behind. And then when when in when we inject the insulin, it's going to take a while to happen. So when the system sees the arm going up, how can it react in time, it's hard enough for me to Bolus and Pre-Bolus enough for something to act in time. But I think part of it is the way the dosing works. Because it does all these predictions, the RF one algorithm, when using loop, you see the predictions of where we're going to go. And, or I should say the prediction, singular prediction, it's a line that goes off somewhere, and it might go down below zero at some point, then come back up three hours later and go sky high, which doesn't make any sense. Because if the line went that way, you'd be dead by then. The RF one algorithm draws, that's called an announcer ensemble forecast multiple lines. One of them says, This is where we'll go. If you didn't eat any of the food you just told us about. This is where you'll go, if you did eat the food. This is where you go, this is where you'd go. If we turned off the insulin now. It makes a bunch of predictions. And there's another line of this is where we go, we'll go with UAM. So when we think you're going based on what we've noticed about the food, that's where the longer seat, there's these massive lines that go up to the right on the graph. A lot of people look at that in different colors, they look at it and say, Well, how do I know which one is right? Well, the system doesn't know which one is right, because those are all different possibilities. But it plays a safe game, so that any of those are going down into hypo territory, it's gonna make this decision to try and keep you out of there. It makes a guess as to which one of those is more likely ending point. But that guests may change in five minutes time. Every five minutes is growing new predictions, and saying, Alright, looks like we're going over there, it looks like we need this much insulin to try and get us back to target. And then, if we ever calculates the we need, oh, looks like we need three units of insulin. And then it might deliver one of those or one and a half of those. And then five minutes later, because I know, I know, no, no, we need 10 units of insulin, if that would start putting some more in. So it actually does that at a much final level. So if I was looking at my CGM and saying, oh, it's struggling along, it's going up and down, it's going up and down at about level, or is that going up? Oh, the next rating comes in. How's that going? Yeah, I think that's going up a little bit. I'm going to have to Bolus the automated system. By that point, we'll have been doing a bunch of little micro boluses. Along the way, saying looks like we might be going up we'll need a little bit. Looks like we're going up a little bit more, we need a little bit more. The point is those little bits of insulin already in your system and working. So when we're looking at things manually and saying, Alright, I need to dose now. We've introduced a big delay, and the insulin is going to have to play catch up. So I think that regular dosing actually helps the system stay on top because it's taken a few choices kind of face to face along the way and added some insulin into the system. already.
Scott Benner 53:49 It's almost like it works better when it has the insulin working, and it can adjust by taking away instead of
David Burren 53:57 well. We can never take the internet well. No, no, no, not
Scott Benner 54:01 not taking away what's in there. But taking away basil in the future. Do you know what I mean? Like instead of you using a unit of basil over an hour, it's sometimes it feels like if you just gave it the unit, and then let it decide, okay, well, I'm I'm going to I'll turn the basil off. I'll put it back on 2.2. And I'll bring it like you give it a lot of autonomy that way. And I have noticed that it, it works well. When it has the the insulin at its disposal and then kind of works backwards from that. I don't know if that makes sense or not. But
David Burren 54:35 it it sort of does in a nonliving environment. It will start off in the assumption that the basil is just constant. Whereas now now we know we can turn that off. Turn it back on in the future. Though historically endos often talk about your Basal Bolus ratio or 50 50% is a nice balance and Crazy Talk as far as I'm concerned, for a start, if you're eating, if you're having a high carb day, you're gonna have a lot more Bolus, that your Basal is not necessarily going to be more. But then it doesn't really matter if it's a Basal or Bolus, it's just insulin that goes in doesn't matter if it gets given as a bunch of separate bonuses, or as increased by basil. It's just insulin, as long as this system of tracking when it goes in, we're getting the right amount at the right time, that mix of which one it is doesn't really matter. Yeah. Which makes it a little bit hard when you have an endo who says, but the percentage,
Scott Benner 55:38 but I know something about the setup of on the pod five, they want it near 5050. But then the algorithm almost immediately makes decisions after that and moves things around. So I don't think you know, it's something about the way that one set up. It's important, but you know, when you go back and look at the insulin, it's not, not always going to be like that. Yeah, I don't see why that's I don't understand why 5050 is important. That sounds arbitrary.
David Burren 56:08 Yeah, I think it's a historical artifact. When people were dealing with Basal and Bolus injections, that was sort of a guideline as to this sort of works. For most people. That's a good starting point. But I don't think it's the goal that you need to try and get back to right.
Scott Benner 56:24 Now you need Basal you need and you need the bang, you need the Bolus you need. That's it. It's just
David Burren 56:29 well, in today's world with the pumps, adjusting things up and down, you just need the right amount of insulin at the right time. And the basil and Bolus is all the same stuff. Right? You know, whether you take away what we're going to give it by default by basil in the future, which is what you were talking about, and answer the same thing?
Scott Benner 56:50 Well, I think, too, I want to I want to mention that the idea of like, I don't understand, why do why do I notice things working very immediately on a on a looping system. When we know the data is behind from the CGM when the insulin takes time to work. I don't know how to describe why that is. But I do know it's true. Like I do, I do think it's just, I think the algorithm by by guessing at the future or predicting so many different possibilities in the future, I think it's somehow shortening the, the distance between what's actually happening in this moment, and what the data can tell us is happening. Because you can tell me if you've seen this, too, you can look at a blood sugar that's not moving, right? And the algorithm is trying it's given like with with loop, what is it giving you like I think 40% of what it's suggesting. So it suggests a unit, it gives you point four, it waits five minutes, there's still point six less than it hasn't given you, it gives you another like 40% of that it's making those Bolus as long the way you look and go, this is not enough, it's clearly not enough. If you manually in that moment, push up the Basal insulin, or you manually in that moment, give all the suggested insulin, the blood sugar almost turns, I don't want to say immediately. But it's shockingly quick after that, like it really does feel like cause and effect in a way that you don't expect. I've never seen that manually working with an insulin pump. But I have I've seen it so many times and loop that I trust that that's what's about to happen.
David Burren 58:28 And I think that's largely those earlier doses that I was talking about is been giving you partial doses along the way. And those are all adding up.
Scott Benner 58:36 Yep. And you're and you're this close, but it's just not tipping. And then you just push a little harder, and then all of a sudden, I see it. So some
David Burren 58:44 of the some of the things that I was adjusting when I was tuning my system and making it more effective is some of the safety limit. You talked to there about the 40%, right? So in the IRF, one system, there's some controls for what it will do 50% of the calculated insulin, it will do 50% Now and then in five minutes might do another 50% of the new production. But there's also a limit of it's essentially borrowing Basal from the future calculates this is how much basil we need. And then they'll say, All right, I can use the next 90 minutes of that I can bring forward into this initial dose. Yeah. Or maybe the next 45 minutes or maybe the next 120 minutes. So you can make it more aggressive and borrowing stuff in the future. And if you do that too much and your settings aren't right, then it can end up potentially overdosing and you'll go low later, right. Right. So the the safety limits are set relatively low initially because they don't want to overreacting so it was watch the system and see that I can be that I'm going up and I can see what it's dosing. And I don't think it's doing enough, I look at the calculations, there's all these messages coming out in the logs. If you go and look at the right page in the software, it says, we've constrained this because of this. And it's alright, I'll increase the safety limits a bit. So there were some tweaking, they're not just changing my, my ratios, and so on, but also freeing up the system. So it was gonna make the right choices without just opening the floodgates and letting it overdose me too much.
Scott Benner 1:00:31 So let me ask you this. There's a person like yourself, who understands all this and donates the time to it to help themselves out. But generally speaking, how many people do you think are doing this? Even across the globe? Like, how many people with type one do you think are using some sort of a do it yourself algorithm?
David Burren 1:00:53 Can it be that many? 10s of 1000s at least
Scott Benner 1:00:58 okay. I mean, that's, so that's one of those things. We're like, that's a substantial number. Until you look at the whole of everybody who uses insulin to stay alive. And then you're like, well, nobody, nobody does it. Why do you think that is? Because, I mean, Arden has been looping for years now. You know, she took a break and did on the pod five for a while, which worked exactly the way we expected it to. But she really did not want to carry around the receiver that was necessary for so bright before she went back to college. She's like, can I please switch back to to loop? And I was like, Yeah, that's fine. She's like, I just like it on my phone. And it's interesting, because she doesn't really have a lot of the concern about the, you know, the switches in the lever, she was just like, this is fine, or this is fine. And in her mind, it came down to carry a thing. Yeah, I know how well it works, David, like any of them, like but why can't we get people onto them? Like, why? Why is there not like a mass get any mean? Like in your Do you have any idea? Well,
David Burren 1:02:04 I think the commercial loop systems. The good thing about those is they become more accessible to more people easily because the doctors can just basically scribble on the books and say, right, we need to get you this and get you set up, and they've got a better chance than not having access to it at all. One of the things that's changed here in Australia is halfway through this year, we finally got CGM subsidized for everyone was tight one, right. So instead of paying 330 Australian dollars for a month's worth of sensors, we now pay $32. And, strangely enough, that's making it a lot more accessible for the companies to introduce their loop systems, because now Medtronic is saying, Well, if you look, here's what we have to do is that the subsidy is we have to specify which PGM system we're using. So Medtronic is saying, if you walk into the Medtronic CGM, we will give you a Medtronic seven ATG, we will upgrade you. Because they get to sell sensors. And everyone gets the benefit along the way of all, the closed loop system. ipso Med, you're in Australia, I had a little crypto pump. And that's they've now got cam APS, which is another closed loop system that runs against that pump that's now rolling out in Australia. And suddenly a lot more people are saying, Oh, I've got access to this stuff. Great. I think I think the uptake of people who are using closed loop systems, I think it's going up dramatically. And we want to see some more statistics and polls on that to sort of see what's going on. I ran a poll a couple of years ago on the number of leakers in Australia a couple of 100 at the time, but that was all due itself stuff.
Scott Benner 1:04:16 Yeah, I mean, here in America, where things are, I mean, these a lot of these different devices are readily available and, you know, number of people have coverage that would allow them to get them. I just, I don't know, I, I know. It's not how things work. But if this if this was me, the minute This was available, I'd be I'd take the day off and just say to myself, Well, I'm gonna sit down and figure out how to make this happen right now. And I don't I don't know. I don't know why. There are so many more people who will never pump even versus the ones who will and there are, you know, at all and all of this stuff in between.
David Burren 1:04:57 That I think of it as a sense of inertia. Like for me, my my endo suggested quite a few times. This pump might be good for you and I know how this system works. I'm still alive, it's running fine. But in my clinical results when I got access to a seat to a CGM, and I started being able to look at the data myself and see what was going on, it was, Oh, this isn't good enough.
Scott Benner 1:05:24 Right. Nick, well, back then you just alive is your Mendoza line, like, I'm not dead. This is working well.
David Burren 1:05:30 Well, I'm not dead. And I got an HBO one see from my doctor when I saw him. And it was a good one this time. So he said, Come back in 12 months time, and oh, look, it was a bad one. It's come back in three months. And it was, I didn't know what I was doing differently. Because I didn't have the tools to see what was going on. Yeah,
Scott Benner 1:05:49 even that was random. Hmm. So and yeah. So when you found yourself in that situation, if you were being given the golden ticket, if you don't have to come back for a year, it doesn't mean that six weeks from now you're a one see wasn't on its way up? And you had no idea really? Yeah, I
David Burren 1:06:04 had, I had no idea. But I've, I've got my path results back to 2000 or so. And I can see my HBO one. So he bounced around and got up to 8.1. It was down at seven, it got down to a massively low six when I started on the pump, and it was gradually started creeping up again. But after I started looping in 2017, it went down to 5.8. On down to 5.6. It has never been as high as 5.6 cents. Yeah. So it ranges between 5.0 and 5.4. And you're active
Scott Benner 1:06:43 as well. You have you're paying attention, you know, all that stuff. Yeah.
David Burren 1:06:49 I mentioned before my timing range for 70 to 140 is around 85. But my timing range for 70 to 180, which is the more traditional clinical range is about 95%. Right now. And my time below 70 is about 2%.
Scott Benner 1:07:10 You know, it's an I say, I don't see, we don't see it. I mean, lows just are very infrequent,
David Burren 1:07:17 you know, so So I feel very comfortable with where all by senior is I know day to day will go up and down and bounce around. But overall, I'm in a good place. I'm feeling quite good, because I actually had a scare a few years ago with them. That there are sclerosis. So partial blockages around the heart, I didn't have a heart attack or anything but a random stress. Echo said all that said no more than we went down the investigation path. And I thought I was going to have stents and all sorts of stuff. But I managed to get out of it without that. And this was about the time that I was advancing a bunch of my glucose management. And the cardiologist now looks at and says, Oh, you're fine. Great. I've got the general feeling that health wise, I'm in as good a place as I can be, right? A lot of what I'm trying to do is make sure that it's there, but also do what I can to make this stuff available to more people.
Scott Benner 1:08:18 Back then were you feeding insulin? Did you have a lot of like, Were you eating a lot to stop lows and things like that? Or well,
David Burren 1:08:27 they actually the heart issue was about two and a half years ago. But I think I'd already started fixing things. But we hadn't noticed anything. Made an ideal world, you know who maybe it's already healing. Who knows? There's we didn't find it because of how to Tech, we found it because I had a fight because of low blood pressure, which the cardiologist says, Oh, that was probably just that you are exercising more. And so we've reduced the blood pressure meds. And I was on mild dose on that. And now I'm on a half a mile dose, right. So we sort of found it by accident. So maybe it was something that was happening earlier. And it's been getting better through this. But it's certainly notably been getting better, because we've been looking a lot more closely our stuff over the last few years. And everything just keeps staying stable. And that's
Scott Benner 1:09:28 good for you. And that really is wonderful. You don't do you have any of what we consider. I don't know issues from diabetes.
David Burren 1:09:38 We're trying to avoid the complications that weren't I want to
Scott Benner 1:09:41 say complications. But do you have any do you have anything that you talked that you are dealing with?
David Burren 1:09:48 This there's no no. I saw my ophthalmologist a couple of weeks ago and she said Because very nice relinking accent and I'm paraphrasing slightly, but she says there are no diabetes in your eyes. Oh, good. That's what I like to hear. There's no effective diabetes, but it sounds funny the way she says it, bro. And it was going back in 18 months out and I'm in fact thing. Her particularly because of congenital thing, we found one of my optic nerves we found years ago, and we started trading that we wouldn't have found it if I wasn't having my regular diabetes examinations. So I believe in in my eyes is not an issue. But I feel that my eyes are healthier than they would have been without diabetes, because we wouldn't have found this thing.
Scott Benner 1:10:43 Yeah. So maybe saved you from a from a different issue.
David Burren 1:10:47 Yep. So the cardiologist says, the heart stuff is not related to diabetes. It's just stuff that happens when you get older. Although he's only ever known me when I've had normal HPMC, etc, levels. So I don't know if it was something in the past who knows? I've got most of the hand physiologists said, I've got the early signs of something that may turn into contracture of one of the tendons on my hand. But it's something that they can fix. It's not a thing is it's just an early sign that maybe that might develop, but that's about as close to a diabetes issue is I can imagine it sounds.
Scott Benner 1:11:32 It sounds pretty terrific. Honestly.
David Burren 1:11:35 I'm very lucky. Yeah.
Scott Benner 1:11:37 Is it in your family at all? Type one? No, no,
David Burren 1:11:40 no. Well I, I remember, you know, stories about there was an aunt or something or great art, whatever he died or something, but back then. Maybe in the 80s. Going back in time, from what people knew about 10 years ago, if they'd gone back, they might have said she had type two. But if they'd gone back now and done better tests, they might have said, Oh, she actually had type one. Who knows?
Scott Benner 1:12:11 Right? How about other autoimmune stuff?
David Burren 1:12:15 Like celiac disease? Celiac disease is the only thing and that came on after several decades. Okay, so that's the closest thing to a second autoimmune thing that I've got for
Scott Benner 1:12:26 you. How about in your family? Do you see any other thyroid stuff for digestive issues? Anything at all with people? Not? Not yet? It's interesting. Do you have children again?
David Burren 1:12:38 No, no, I have nieces and nephews, I can wind them up and hand them back. I don't have my
Scott Benner 1:12:45 listen. There are days that sounds right to me. Interesting, okay. Has it been? I mean, you said you, you've done wildlife photography and other things like that. I mean, it doesn't sound like diabetes has stopped you from doing things throughout your life.
David Burren 1:13:05 No, not, not really. If I was looking at going on a Australian Antarctic Division runs supply trips every year down to the bases in Antarctica. And they have some humanities births on there, where basically artists can go along and record what's happening, and so on. So there was an opportunity as a photographer to get on to that. So I thought this is exciting. looked into that. And as soon as you've got diabetes, you're not eligible. Because they make you go through all the same medical things, as someone who was going to overwinter and stay there, right. And if you don't have enough insulin, you're gonna die, basically. So I was basically not not eligible. So that was a little bit disappointing. But it guess what I found another way, I've been to Antarctica four times now. Really? I run photography trips down there.
Scott Benner 1:14:01 You make the rules so you, you can allow people diabetes to go.
David Burren 1:14:06 So yeah, I've that also called the travel bug. So I've been to lots of places around the world. Whether it's, you know, jungles in Borneo or up in the Himalayas, with snow leopards in the middle of winter. And most places I go, I need to worry about keeping my insulin. cool enough. There. I need to make sure it wasn't going to freeze overnight. Yeah. So yeah, I feel that I live my life and diabetes has to come along for the ride. That's one of the other things that you were asking before, what we what we should talk about. One of the other things that a lot of people might find interesting is Something that I'm not responsible for, but a lot of people seem to associate my name with. And it's the NuBus G six transmitters. So the X column G six transmitters, they run for 100 days. And then they turn off mailing lists. And in the early days, people were able to cut them open and replace the batteries and seal them up again, and then they'd go for another 100 days. But Dexcom, change things so that you can't do that. So, I know some I know some people who've did some engineering, and they basically they modify G six transmitters now. And we went through a phase where we're trying to work out how to get this working, I managed to get a bunch of people in the US, including some of the people from the Facebook group, I donated all transmitters, and we sent them over here and then basically pulling them apart and using them as test beds and how to make things work. So what they have now is a system where an old Dexcom J six gets recycle, and it becomes an A novice GC. And the NuBus comes with a battery that sealed in the bottom with clear silicone. But when it's time to replace the battery, you can actually see that's where I dig in and dig out the battery and I stick this other new battery and never seal it up again. And it automatically resets. These are really convenient because they have a bunch of other advantages. The transmitter doesn't timeout after 100 days, pumps out after 190 days because they have a bigger than normal battery. And it doesn't stop your sensor after 10 days, it stops your sensor after 60 days. So I can run my sensors for 20 days and not have to do any restarts along the way. That's really convenient.
Scott Benner 1:17:05 And you do you notice that it holds up as far as accuracy goes,
David Burren 1:17:10 Oh, it's the J six. They didn't change any of that stuff. Yeah,
Scott Benner 1:17:13 right. I just been having the wiring for that long. Oh,
David Burren 1:17:17 with J five, my record was 53 days. What I'm doing now is I used to run sensors for as long as I could, because we had to pay for them all ourselves, and it cost a lot of money. So you'd be saying alright, is it unstable yet? Is it time to change it? Now I can go another day, and then suddenly it goes out the window. And right now I've got this outage I need to start up. So I set up something where I could, if I've got two transmitters, I put in a new sensor with new transmitter and I've essentially got another program talking to it and I start the session on that transmitter. And then when it's when it's warmed up and it's ready. Hopefully before the old one has completely died. I tell my loop system use that transmitter instead of that transmitter. And it gets gets good data to I don't have to warm up as long as I've done everything right because it's already warmed up and had the first day of weirdness out of the way before I switch over. So now that we've got things subsidized, and they subsidize them for essentially one every 10 days, I'm actually putting a new one in every 12 days. And then I'll I'll switch over to the new one. After another day or so, once I know it's stable, and it's really nice being able to see two lines and say no that had old sensors going weird or the new sensors going to it. Suddenly, it's not just finger pricks and CGM. We've got fingerprints and two CGM so that we can compare. And it means that my the amount of time my system is actually making decisions and looping is pretty much 100% all the time, because the CGM never actually has to disconnect and warm up, right?
Scott Benner 1:19:07 Do you think that G seven will cause problems for the DIY community? Or do you think people will
David Burren 1:19:12 you know, not especially the g7 is essentially doing some of the same stuff because each, each sensor has its own transmitter. That's where That's where this new stuff comes on. Where after 10 days, it's not the new one. But I'll keep using the old one for 12 hours. Yeah, so it's essentially doing the same thing. And but it automatically switches over. Now it it'll be harder for people to try and extend the system in the way that we've managed to do with the newer stuff. Now the reason people associate me with somebody whenever stuff is on my blog, I posted an article saying these amazing thing and works really well because I've been testing it for them. And I get people sending me messages saying Hang on, can you sell me one? It's not mine. I'm not involved.
Scott Benner 1:20:06 I'm just using it,
David Burren 1:20:08 talked about it. But the guys who distribute those, by the way, that they're not selling them for profit, they're pretty much essentially giving the way they get donated trans old transmitters that are getting recycled. And they're just set up little machine shops that have laser engravers and everything out. And it's all automated home workshops, stuff from people who have diabetes, hell bent.
Scott Benner 1:20:35 That can't afford to do it.
David Burren 1:20:37 It's hard, hard to imagine how any of that could be applied to a G six, where everything's integrated, and then applied, and then you take it off, and then it's done. G seven, obviously. Yeah, sorry. So I am thankful that we have subsidies here. So if I have to use them one every 10 days, I'll be able to afford them.
Scott Benner 1:21:01 No, it's amazing. I've talked to people just you know, in the last two years in Australia, who are like, I can't afford anything to those same people sending me notes and say, hey, look, I have a CGM. Now or I have a pump now. It's like, it's amazing how quickly things are kind of moving there.
David Burren 1:21:16 Yeah, exactly. So I think I expect people will be able to use G seven in the with the open source software that Do It Yourself stuff. I believe that's already happening in your head to talk to them.
Scott Benner 1:21:34 Yeah, well, I mean, it's been out for just a handful of weeks now, right? In Europe. And I mean, my expectation is, it's going to be the next couple of months, it'll be in the US. So you're gonna start seeing it everywhere pretty soon saw as the FDA, I don't know what the hell they're, they're holed up. It's but as soon as that goes away, I guess we're gonna see it here.
David Burren 1:21:57 Now in Australia, because most people are getting it through subsidy. I think introducing it here. It's not as though it'll get introduced and sold will cash sales. And then eventually added to the subsidy, I think they'll be lining everything up so that when it comes here, it'll be with the subsidy. So I don't know how long that's going to take. Yeah. But we've only had G six here for about two years. I think you've had to do six for longer over there. Yeah.
Scott Benner 1:22:28 I know. I hear Canadians often talk about the feels like a chasm of time between when new stuff comes out. And they actually got it. I guess it's similar. I don't know. I wish I understood more why that happens. But I just don't. You would think that people would diabetes everywhere, right? And there's governments you can charge for this stuff. Like, let's get going.
David Burren 1:22:52 Yeah. Life is life is multifactorial. So there's a limited market in Australia, compared to the US. So all their costs for going through and setting up things with the regulators and importing and doing all those things. There's more overhead. So are they going to make enough sales for it to happen? Now that things are subsidized, if they can get onto the subsidized list, it's easier for them to say, alright, we're going to have a steady supply. Right. So hopefully, that will enable things to move quicker. But But yeah, dealing with different regulators in different places. does add a lot of time. Yeah,
Scott Benner 1:23:32 it really does. And in the meantime, there's people who mean, you would think that if you were the government, why would you not say, All right, well, maybe we were not the maybe we don't have as many people here with type one. But let's make it attractive for these companies to come in and service, at least the people that we do have. That part is a little interesting, you know, like,
David Burren 1:23:53 the other thing is only on Jeff, and Jeff has been available overseas for ages. And, and we're over here saying it's really great with important time it used it and it's great. Why can't we actually get it properly. And we're saying the same thing. We had years before fierce was approved here and then still years before it actually became available. But when it becomes available here, again, the drugs subsidized through the pharmacy benefit scheme for PBS. But the price that the manufacturer gets is controlled by the government. Basically, the Australian Government doesn't pay a lot for the drugs. Right. So that will play into are we going to make enough sales at that price to make it worthwhile to bring it in? Yeah. Novo got to CBRE approved in Australia a few years back. They don't actually import it, sell it because they're not going to move enough of it. They sell that I rise adag that mixed one. But not not peintre saber, just as an example, someone said, No, it's not going to be worthwhile. And there's all sorts of weird things. Because there's the way the drug subsidy stuff was set up. There's, you can't introduce a newer, or a different form of the same drug. You can't have too many forms of there's all sorts of controls without having to get a basically get less money for the drugs. And it's all this competitive stuff built in. But that actually meant a few years ago that when FISP was introduced here, it was available in out because VSP is actually insolent as part. So it's not actually a separate drug. It's the same as Novo rapid, which was already in the list, which was available in prefilled, pens, in pen cartridges and in vials, okay. And then faster is faster acting insulin ESPAR is available in pens, and vials. But they didn't introduce pen cartridges, because that would be too many. And then they wouldn't get as much money from the government for the drug. But it's complicated, it's
Scott Benner 1:26:23 dizzying. Yeah, it really is, um, just, you know, people need stuff, it'd be nice to find a way to get it to them in a way that is affordable, and unreasonable and easy. You know, it's tough to RDS have to have diabetes. You know, you start jumping through hoops to get things accomplished. And you can see easily why it doesn't have I mean, to take it out of diabetes for a second, my mom just moved with my brother. And she had to live with him for a little while, while she established residency in a new in a new state before she could go to this place that she wanted to go to and get the assistance she needed. And she, you know, she wanted and everything. And the amount of phone calls and paperwork. If my brother and his wife were not doing this work for him, my 80 year old mother could not accomplish any of this, like there is a system set up for people that they functionally can't take part in. And you have to have somebody helping you what if you don't? What if you don't have someone helping you? Like, then what happens? You don't I mean, like, it's, it's fascinating.
David Burren 1:27:30 That actually opens up another concern with the fancy technology we use these days. What happens when we get older? Yeah, I think and we go, and we're going to aged care. That's, I mean, we have quite a few loopers in Australia who are in their 70s. And I think some are in their 80s. Now, and it's something that people talk about what's going to happen later on at some point in my life, and I guess it could happen to all of us what happens if I'm involved in accident, I have a friend from university who has an acquired brain injury, and later develops diabetes, and isn't able to deal with any of this stuff. Everything has to be through a carer and what's going to happen when the family carer gets old. So that feeds back into winning to make this technology as accessible to people as possible, so that not just Can people without the background and experience that say I have been using, but also that someone looking after them who isn't especially skilled and more comfortable.
Scott Benner 1:28:41 No. And I think about that. I mean, you have diabetes, I'm sure you think about it for yourself, but as somebody who's looking at a child with it, I think about that constantly, because my daughter is going to be older, and in need of help at a time where I won't exist anymore. That's hard to deal with, you know, like, is she going to meet a person who will help her or, you know, will she have enough money to be in a healthcare system that can help her also, I've seen my mom in that health care system. And due respect, they're not great with giving you a pill when they're supposed to sometimes, or you know, managing things that are not nearly as complicated as diabetes. So I don't know. It's, well frightening idea.
David Burren 1:29:23 It still comes up every now and then but we still we are hopefully moving away from the world where someone would go into hospital for and they have diabetes for them unrelated thing and the doctors would take and the nurses would take their insulin away and then it's our youth you need to have your evening insulin there. But you haven't given me a food yet. The food's not here. No, no, we need to chat this now. Or you have your food now. We'll come around later with the insulin. All of this stuff is totally in integrated into into our lives that, like I have a colonoscopy coming up in a little while, and I'm thinking ahead to when it comes to what day is it on? When am I going to be starting my CGM sensor? Where is my prompt site going to be because I'm going to be lying on the bed this way. And they're going to need to put a cuff there and put a line in here. And it's no good if I have technology in the way. So all this stuff is tightly integrated into how we live our lives. Yeah. And,
Scott Benner 1:30:34 anyway, alright, you're bumming me out there.
David Burren 1:30:38 It's okay, I'm actually participating in a summit in a couple of weeks. One of the big research bodies here is having a series of panel discussions and one of the things we're talking about is how this stuff integrates. And the reason that's in my mind is that kind of some of the things we talked about before, some of the design design decisions behind this technology are often made by people who don't actually live with and don't actually realize that, oh, it affects this, or that means you're going to put this site there. For me and Omnipod, I use Omnipod dash every now and then. Not regularly, but I've got a couple of boxes. And if I'm going for watersports or something I might change to a a pod on a waterproof looping phone for that weekend. But I need to be very careful about where I put the pod. Because it's very particular about the radio reception. If someone's dealing with the PDM, which is the insolent way of doing things, you pick up your PDM. And you also you change a Basal or something and then you put the PDM away. Whereas me I've got the looping phone that's talking to it, and it needs to talk to it every five minutes. And if the part is on my right hand side, and the phone is on my left hand side, and I'm a big bag of water right in the middle blocking radio signals. Things don't always work neatly and people finding that with the Omnipod five that you need to make. It's better if the CGM has good line of sight line of sight to the to the pod, it's the same sort of thing, I have to think about where my phone is where the CGM is and where the pump is. So, flexibility for me the when I'm using a tube pump, I can have my pump in pretty much the same spot every time and the tubing just goes to wherever the site is. So in some ways, a tube to pump is better for me than a pod.
Scott Benner 1:32:50 Because you have that that option. Yeah. So you'll always know where the pump is going to be. And that you just move the site.
David Burren 1:32:57 Yeah, I mean, there have been times when it's old enough for these couple of weeks, it's on my right side. So I need to make sure I put the looping phone in the pocket on my right or a pocket on my left. Whereas these days, it's just no baby every time my pump lives in little running belt has to be built. Yep, that's underneath my clothes around my waist. It's always in the same spot. And then the tubing runs along the belt and then up or down to wherever the site is,
Scott Benner 1:33:22 you know, if you tried to make this argument, the art and she'd be like, I don't know what you're talking about, but I'm not attaching anything to me. So I can't get up. It's just so interesting. What where you're everybody's perspective comes from their entry point. Really, you know, yeah, different perspective.
David Burren 1:33:40 This thing of tubes versus unsheathed I started off with an NMS pump. And I had a a talisman around my neck and an SOS, whatever tells me medical thing. So if I was going, it was in the middle of the night, I was going to the toilet or something and I had to do my pump somewhere. I would probably clip it the bed around my neck. And then the tubing runs down to where the site is. But I always had this extra thing I was carrying around and having to put somewhere or back into a pocket or something. Yeah. But yes, there was something attached to me. But when I started using the looping systems, I no longer had to touch the pump. The pump would hide away in a pocket. And my relationship with it changed. Yeah, because now now the pump is in that little running belt around my waist and including when I go to bed. So if I wake up in the middle of the night and I have to go to the bathroom, I just get up and I walk down to the bathroom. The pump comes with me I don't have to. There's no feeling of oh, I've got something's actually the tubing somewhere is comfortable with me. Yeah.
Scott Benner 1:34:50 I know some people who put it like on their bedside table or lives in the they leave it loose in the bed with them. I've heard people describe what you just described. It's interesting how it all works differently for
David Burren 1:35:01 it, find a system that works for you. And I've used different systems along the way. And that and they've all, whatever I've been using at the time has mostly worked for me at the time. But you know, when the pugs were introduced here, a year and a half or so ago there were some people other companies find people with diabetes, who are they become advocates, basically? Yes, it's wonderful system, it's changed my life, which is great, and it's fine. But many times. Some of those people, the first pump, a lot of things they described about, oh, I can change this I can change that is, you can do that on any pump. And they say, but there are no tubes, I don't have something dangling attached to me. And I say, I don't have some, I don't feel like I have anything dangling attached to me anymore. So in fact, when I use a pod, I'm restricted in terms of I need to fill it with the right amount of insulin, because there's this decision, when I get to the end, have I put enough in it to last the 70 to 80 hours, if I've put more in it? Am I going to pull some of that out and put it into something else? Because my insulin doesn't cost as much here, you can sort of say, well, I'll just using using new pod and fill it with new insulin. When I was using these new images that I imported, myself, I was a little bit more sensitive, because every drop was was money. The and there are issues, if I have a problem with my site, then I have to put a new part on. Tonight, I put a new cannula in for my pump, and I put it in and it was out that's not working, I can feel that that's completely uncomfortable. I took it off and the drop of blood comes out. And it's no, that's a bad site, I'll just put it in somewhere else. And suddenly I've wasted 50 cents, or $1 or something on an annual that's I haven't wasted a whole pod and then have to ring up and say you know all this hassle about
Scott Benner 1:37:15 So David, here's the other the other side of it. In your in America, you get your your doctor to write you for more pods than you need. And then you draw out the insulin if it's new, and pop it in the other one and keep moving. Like it's all the same. But yeah,
David Burren 1:37:29 I know. But. And there are there are ways around this we live, we each live within the constraints of existence that we're using. Yeah. But each time we use a pod, and I get to the end of it. And it's right, I'm going back to my other hub that feels like Old Faithful, comfortable territory going back to my tube pod so that that the pod to me at the moment feels more restrictive. It's less restrictive, I can go swimming, I can everything keep running. But in terms of general where it doesn't feel the same, because I'm not used to it.
Scott Benner 1:38:01 Well, you've just described exactly why all these device manufacturers are so focused on getting people when they're newly diagnosed as customers, because then this becomes your norm. And you know, it's hard to imagine otherwise, you know, it doesn't make doesn't make the other option. untenable. It just makes it different than what you're accustomed to. So and you are right, like no matter what scenario you get put in, you do find a way to make it work as seamlessly as possible with your life doesn't matter if it's a pumper. A CGM or whatever it is you you fit it in and you make it work. And then suddenly it feels like this is the option, the only option? Makes sense.
David Burren 1:38:43 Yeah. And different systems have different advantages. And I think a lot of people as you say they get locked into the system that they're using. And they don't necessarily realize that the grass might be greener on the other side of of that fence, or maybe on the other side of the highway, maybe just in the next paddock, whatever. So when I started on an LMS pump, I was using the infusion sets that my my diabetes educator had suggested. And I was using them for years. Those were the ones that I used, oh, if there's a supply issue, and I can't get those, what am I going to do? I'll manage to get some or I've got an A got out of it. It's okay. And some of our friends who are interstate they were using some different ones and they were having supply issues and all sorts of dramas. And I realized that well, maybe I should try one of these other ones. Maybe if I wasn't tied to this one, I'd have some flexibility if there was a shortage Yeah. Now, it's convenient here that all of our infusion sets are subsidized to the same level once you've registered as a pump Use a you can get any of those at subsidized price I say so so I can, in fact switch to a different pump type. If I have the pump, I can buy the other supplies. I don't need a prescription for each one. But that meant that oh, let's try the stoop cannula. Let's try the ankle cannula. I'll get a box of those and see how they go. So I've now used pretty much everything. And I found the ones that I like. And I've got to the stage that I get all secondhand pumps of different types, I've now used pretty much every type of pump on the market. Yeah, and most CGM. So my decisions about which ones I'm going to keep using is I've used some of the others, they don't necessarily feel right. But sometimes there's something that oh, that's nicer, because, for example, I started using the were they the comfort sites, which tenem now call them the very soft Medtronic call them the silhouette, the angled one. And they turned out to be about great. They were nice and comfortable. Manual insertion, which was quite daunting. But once you got that over and done with it was fine. And it actually turned out that I can pack a lot more of them in a camera bag when I'm going to Africa. All sorts of other advantages. It's so interesting
Scott Benner 1:41:28 to hear people talk about these little things. I remember when Arden was really young, and we were looking for pumps. And we were drawn to the idea of the Omni pod, a nurse practitioner who tried everything they could to scare us away from like, don't use that. They everything they could think of like your daughter is too lean, it won't work. You're not gonna like the angle that the cannula goes in on if you don't like the angle, the cannula goes in on you can't go to a different set. And I just was like, wow, like I look back on that now. And I realized she was just coming from the perspective that she had, which was, you know, this this back then this insulin pump was brand new. She didn't have any experience with it. These were her experiences before, she didn't really know if what she was saying was going to apply to us. She was just like, here's all the things you should be scared about. And you know, I'm like, Okay, thanks. We tried it anyway. And, and then those things didn't end up being an issue. And so long story, but in 20 seconds, like two years after Arden started an insulin pump, our our practice, apologized to us. They came to us and said, We're sorry for how we tried to scare you away from using this pump. Like your daughter is having so much success with it. We're gonna start talking to other kids her age about it. And I thought like that's just always stuck with me. Like they were so adamant. They had rules and lists and reasons. They were like, This is why you can't buy this, this thing and then later, they're like, Yeah, we were wrong about that. Sorry. Jesus. Okay, what else you're wrong about, you know, is how it made me feel?
David Burren 1:43:04 Well, yeah. I, in my own head, I have lots of experience with I've used lots of different equipment, different CGM, different glucose meters, pumps and stuff. I'm not necessarily an expert in all of them. But I've noticed some of the differences. And I sometimes point those out to people because they haven't necessarily noticed those. They don't know those things going in. So try to give people as much information as possible. But yeah, I guess, the track the track there. I shouldn't necessarily be trying, I shouldn't be trying to frighten someone away from using something because I find something in issue. I can point out to them that this thing exists, then it might be an issue for them that personify that. That middle ground of trying to scare someone or trying to inform someone is always tricky.
Scott Benner 1:44:01 It's our communication had that person done what you just explained, it would have been completely different. You know, we just said, look, here's some things that could possibly happen. Here's why this may or may not be important to you. This pump over here won't do that. This one will like I would have been like, Okay, that would have been information to take in. But instead it felt like I don't know, it felt like a scared person or an anti sales pitch. Like you started looking around, like, do they work for somebody like they were so just, you know, pushy. But I don't think looking back that's not wasn't their intention. I just think they had a certain set of pride. I was gonna say priorities, but I think it's perspective. I think they've they had experiences and perspective and they were unknowingly defending that perspective against what they saw as being different. It's just, it's fascinating in my heart, I think people should use what works best for them. Like I you know, I mean, I take ads on the podcast, but, I mean, I have to be honest, like, I don't care if you buy an AMI pot or not, like I want you to have an insulin pump that works for You? And if I'm the pods the one great. I don't mean like, I'm not. I don't know, like, sometimes I think that can get blended a little bit like, well, he has ads for Dexcom. But you get a libre. I mean, what do I get?
David Burren 1:45:11 Well, presumably, presumably, you might not be so comfortable running ads for a company if you had concerns about the product?
Scott Benner 1:45:20 Of course, no, there have been plenty that I've turned down over the years. And there are some that have been easier to take, because I have that personal experience with them like I can, you know, like when Dexcom comes to me and says, Hey, can we buy an ad on your podcast? I immediately think, what are the reasons why? When anyone comes to me and asks for an ad, I, my first thought is, I want to know all the reasons why I shouldn't do this, because if they're too great, or it's bad for the people listening, I won't do that. They may, then that may sound like that may sound like I'm protecting you all which I am to some degree, but I'm also protecting myself. Because if I say, hey, use this pen, and you all run out and buy this pen and it sucks. Well, then you're gonna stop listening to the podcast and be like, Oh, the guy was wrong about the pen. I wonder what else he's wrong about, like, you know, I mean, like, there's a, there's a bit of self preservation in there as well for me, and I have comfort with the things that I advertise for. I mean, like, Chivo Capo pens, a great example, that thing came out. And I was like, well, that's brilliant. Like, like, Yes, finally a form factor. I can put my daughter's hand, her friends can understand it and etc. You ever tried to explain the lily red kit to a nine year old? You know,
David Burren 1:46:38 yeah, we, the only glucagon we have here is the NoVo hypo kit, which is essentially the same thing as the red Lily kit.
Scott Benner 1:46:47 They're gonna keep me because Lily stopping
David Burren 1:46:50 that? Well, that's no most product at glucagon product at the moment. Yeah. So it's no signs that they're stopping. We don't have access to vaccine, me or GMO? Or any of those?
Scott Benner 1:47:01 Yeah, no. And, guys, I'm sorry.
David Burren 1:47:04 I was reminded from what you're saying some of the stuff that comes up on my blog. And what we're saying about advising other people, is always when I started writing things, and putting it down on the blog, I was always conscious that this stuff is going to be up there. Anyone can read it. Yeah, and I don't want to be saying the wrong thing. But there's also this big thing with the, the open source, the do it yourself, equipment of this is not medically approved. If I tell someone, I can't tell someone, you should, you should build this system and it will work for you. I can't do that, legally, I will get myself in a lot of trouble. But luckily what I can do and stay on the right side of the law is say, this is what I'm doing. And it's working for me. These are the things that I've noticed about it example, I always try to keep that in mind. And try to not cross the line of giving something that could be misconstrued as medical advice. Always have it in the context of my experience. I write about a lot of technology. But it's mostly in terms of I have actually used this. This is my opinion of it. These are the things that I've noticed. Right. And I think that's been working very well. It's quite pleasing when I'm at a diabetes conference. As one of the community advocates there, and I get stopped in the hallway by endocrinologist to say thank you for the blog, I was able to direct some of my patients to it. Yeah. Oh, that's great.
Scott Benner 1:48:39 I completely understand what you're talking about. And I'm never not knocked over when somebody comes into the Facebook group. And they answer this quick questions about, you know, what's your attachment to diabetes? Bah, bah, how did you hear about this? When people say, Oh, my doctor sent me hear, I'm always like, Wow, that's great. Like, just terrific. And, and I take all your points to like, you're just I'm just sharing what's worked for, for my daughter, basically, and things that I've noticed along the way. And, but the, the feeling of I mean, I guess the way I handled it is I might do a good job of sometimes sounding like, I'm like, Oh, I just thought of this, which has happened a time or two where something's clicked popped into my head as we're talking. But for the most part, I don't say stuff on here, until I've seen it work over and over and over again for my daughter. That would be irresponsible. I don't understand. I couldn't do that either. So it's a it's a great thing. It really
David Burren 1:49:35 it. It does feel sometimes when I'm moderating some of the Facebook groups. And it does feel sometimes that I'm being very wishy washy with my answer saying, Well, you could do this, but you should see your doctor.
Scott Benner 1:49:53 Yeah, I tried to just say if this was me, or the way I see this, it could be wrong for you. I'm only looking at one graph, there's no way for me to relate. No, you don't. I mean, like that kind of stuff. But you should be going in this direction.
David Burren 1:50:07 I guess I just realized, I guess I had a lot of experience in that before the diabetes advocacy because I've been involved in amateur photography stuff for a long time, the Australian photographic society and various photo competitions and getting critique on photos. And you learn very early on to give constructive critique, not criticism, per se. And you can always find something constructive to say about pictures, when I'm giving feedback on photos, and it's something that I still do to some of the camera clubs. I'm very careful to try and give suggestions and things that they may not have thought about. Without saying this is good. This is bad. Yeah. Because yeah, I'm setting myself up for being attacked. At that point,
Scott Benner 1:51:00 I tend to lean into the, what is the call? Is it the Socrates questioning method? Or, like the idea of teaching by asking questions, you know, like, oftentimes, it's almost it's a version of you can, you know, teach a man to fish kind of a thing. And
David Burren 1:51:18 I have gotten into trouble with that with my family. At times when they say, don't ask me another question. Just answer the question.
Scott Benner 1:51:24 Well, online, I find, it's great to say, hey, well, do you think this or this just happened? And then you kind of let that they almost sometimes people know, they just don't know how to put the pieces together. And you know, I find that pretty, a pretty valuable way to talk to everybody. But, David, I have to jump off in a minute. But this was terrific. I just want to make sure that we covered everything that you don't have anything left hanging that you that you didn't get out.
David Burren 1:51:50 I don't think so at this point. I think I've covered a broad selection. There'll be something new and different. That's happening next month, or whatever. But that's next month, I guess this will this will take a while for this to come out anyway, it'll still hopefully be fairly up to date when it does.
Scott Benner 1:52:06 Yeah, well, because we're talking about things that are more time sensitive with technology, I will slide up on the schedule. So it doesn't, doesn't sound like it came out of left field. But the other things things change quickly, right. Like Arden is off at school right now using arrows pods and, and the version of the loop that she's using now. And she might come home and over, like the holiday break, and we might switch her to be you know, something different and send her back with something different, I have no idea.
David Burren 1:52:37 We'll just reminded me about something that went through my head earlier, when she was saying, I don't want to carry this PDM I want the system running off my phone. But she's still happy to carry around an orange link or rolling link or whatever.
Scott Benner 1:52:53 So that is the gateway what she's not happy about it. It was a trust me, she hates that. But But I got her to be okay with that by telling her that eventually there'll be a system that doesn't require that. And it's smaller. And she has it she keeps it in her diabetes bag. And the orange link seems to have a much better a field of coverage than the Riley LinkedIn. So she's the Riley Link was like you had to bring the bag with you everywhere you went. But now in you know, if she's in her dorm room, where she's in our house, she can walk away from the orange link and still has a good connection to it. So that's become less of an issue over time. And then I assumed we're gonna go to the dash version and, and lose that. That.
David Burren 1:53:42 So we never had the arrows here in Australia. So they finally got approved but never sold here. And then eventually they tried to sell but they decided to do it with the dash, they switched over. So the the reason that came to mind is I've been an iPhone user for well over a decade. But I don't use the iPhone for my diabetes, I use an Android phone. So I'm carrying two phones, right? My Android, Android phone is like,
Scott Benner 1:54:16 teeny, tiny. Yeah.
David Burren 1:54:19 Almost the size of my palm, right. And it just had enough battery to run all day. And it's doing all the stuff. It's sitting in the background. And it displays an outdoor watch. So I can just see my CGM data at any point if I need it. Yeah, but I'm happy during that second device. Whereas some people come to these systems say I'm an iPhone user. I, I wouldn't touch Android. That's, that's the dark side.
Scott Benner 1:54:48 I don't care about that. You're basically using your controller as well just didn't come from a company, honestly. Right by using
David Burren 1:54:57 and in fact, it's spades. way hidden in a pocket most of the times, I am a guy, I sometimes wear cargo pants, I have a lot more pocket options than many girls. I do understand this. Yeah.
Scott Benner 1:55:08 It just doesn't want to. I don't know if you should say like the idea of holding two devices I eat if I offer two phones, she'd be like, No, I don't I mean, I don't know why you would. But I mean, she wouldn't want to do that either. Like she just says she's trying to be very minimalistic with what she's carrying. So she's doing a good job, her bag for diabetes is it's tiny, it's got a phone in it, that orange link, G voc meter, the Contour, Next One meter test strips, and, you know, some gummy bears and a juice box and she gets it all into this little tiny thing. It's pretty crazy. But yeah.
David Burren 1:55:44 And the other thing that came to mind was sort of paraphrasing. One of the other things we were talking about in terms of people look at the stuff that's working for me with my hands free loop system. Let's not loop with a capital hands free looping system. And say, Well, you don't have to do any work. But then I can point it out to them and various friends of mine, who were there in conversations turn around, say Yeah, but he put in a lot of learning to get there. He did a lot of work early on to work out how to control it. And now he can take the benefit of hands free. So part of the the thing that we're hoping to get out of things like this trial and other stuff is more knowledge about how to actually turn it on for people without them having to put in all that homework.
Scott Benner 1:56:34 Yeah, no, that's gonna be the next big step right is not having to understand the background to make it do all these amazing things. So I don't know, like I've seen some people try to make that turn that into a business. I don't know how well that'll work out as time moves forward or not, but it seems it's a weird thing to be involved in, you know, setting up a do it yourself algorithm to give somebody else insulin like it's, I don't know, it sounds like you're gonna have to sign a couple of things and say, you're not holding anybody responsible in the beginning. To get to that what you know,
David Burren 1:57:07 well, I'm dealing with algorithms to give myself insulin. So if I make modifications to the code, which I occasionally do, it's, I'm running them, I've got a bank of test phones and test pumps here that are running on a copy of my CGM feed to make sure they're doing the right thing. And eventually, I'll decide yes, I'm willing to run that myself. Don't have to go through ethics approval once all sorts of stuff to do that. So when it comes time to running the algorithms through the clinical trials, that will give the evidence for it. Hopefully, at some point, a commercial company will say, Well, we will take that we'll make a product out of that using that algorithm, which has been proven. So I hope that'll I don't care if someone makes money out of selling that. Yeah. Hopefully, it'd be nice if I can earn a living along the way, somewhere as as well as the help I need to do but the end goal is improving everyone's lives. Yeah,
Scott Benner 1:58:09 I always think that like, like when I'm how God what's his name came along and said, We're going to bring a version of loop to, to mark it. God white power, the
David Burren 1:58:21 title tide pool?
Scott Benner 1:58:23 I mean, I'm starting to feel like that's so long ago, I can't remember the word tide pool is easy to like, and I understand that. You don't I mean, like I understand the processes. Is, is what it is. But I mean, by the time you get that thing through, there's so many more versions of it, you think, well, you should have started with that one. You know what I mean? And I guess that's also if you make that decision, you'll never get to the end. But it is what's exciting about people doing it in a in a do it yourself atmosphere is that, you know, I mean, something comes out and they go, Okay, we'll adapt it, we'll test it, you know, we'll get a few people together, we'll make a beta test out of it. We feel comfortable giving it out to people here, you know, give it a shot like that stuff doesn't isn't taking three years when it's being done by regular people. So no.
David Burren 1:59:10 So generally, the do it yourself stuff is always gonna be a little bit ahead in terms of features and functions. Sure, hopefully people do it in a safe way. Yeah. Many of us are keeping all the safety in mind when we're designing this stuff. I've seen all the meetings, I've heard an endo stand up and ask the question, now that there are all these commercial systems available. Why would anyone why would you use it yourself system that you have to build yourself? And it's because it's current technology. It's not technology from three years ago. It's got it's got more features. Not everyone will want to do this, but that's why I do it. Yeah. There's
Scott Benner 1:59:53 no reason why we should take any kind of options away from people like I don't care if it gets to Under Yeah, I guess
David Burren 2:00:02 his his thought is, why do I need to deal with this problematic dry stuff now that there's a commercial thing. So
Scott Benner 2:00:09 I can see feeling that way, I can also see like, I'm not gonna lie to you, it's still like going into I'm so bad at this, I don't even know, the program on the Mac that runs the the simulator and then puts it on your phone is called Xcode, right? And so and every time I look at Xcode, I don't know what I'm looking at. I know where I have to click, and I know what I have to do. But if you asked me to explain any of that to somebody, I'd be like, I don't know what any of this is. And so I get not wanting to feel like that, because it's uncomfortable. You know, I, I sent a complete, my daughter got a new, you know, got a laptop when she started school. And then got another one when she started college, and the one that she was done with after high school was shot, it's basically useless. And she's like, Well, what do we do with this, and most of the time, we would trade it in for credit or something like that, and try to, you know, make a little money off of it. I was like, keep it, we'll put X code on it. And you can take it to school with you because Xcode wouldn't even fit on the laptop that she had, along with all the other things she needed for school, I get not wanting to be involved in all that. But being able to text her last night and say, hey, it looks like you needed a secondary Bolus, or, you know, being able to look at a meal remotely and say, hey, the algorithm is struggling, because I don't think it has enough autonomy, you should go back to the meal from two hours ago, and tell it it was 75 carbs, not 65 carbs, like that. And then all of a sudden the algorithms like oh, I didn't know that. And then bang, it works. And like that kind of stuff is. It's pretty great. I can't lie about that. You know that stuff is? It's pretty damn great. So anyway, David, this was really wonderful. I appreciate you doing this with me. I'm sorry. I kept you so long. But thank you very much.
David Burren 2:01:56 It's totally 2am
Scott Benner 2:01:59 Well, that's why you don't know you're half of you at this point. You're just like, Ah, it's all good. But
David Burren 2:02:05 I'm a night owl. I'm a night owl. Thank you for the chat. No, I appreciate it. For people on the podcast. I
Scott Benner 2:02:12 know I'm sure people are gonna love it. I really do appreciate you taking the time. And I know it's hard to get on the show. And it takes forever. So thank you for being patient.
David Burren 2:02:20 And people with can message me on the Facebook group on there?
Scott Benner 2:02:25 Yeah, and and I wanted to say to your bionic wilkie.com. Is that right? It's dot com. That is correct. Yeah. Excellent. So people can see some of the stuff you were talking about there. It's great website. Well, I want to thank David for coming on the show and sharing all that great diabetes knowledge with us some really astonishing stuff in this one. Thanks also to touched by type one. Don't forget to go to touched by type one.org and find them on Facebook and Instagram. Give them a follow. Check out what they're doing. Long, longtime supporter of me and the podcast. Hope you can support them. If you're enjoying the show, tell someone else about it. share this episode with them. Go find the private Facebook group Juicebox Podcast type one diabetes. And of course subscribe and an app. Amazon music, Apple podcasts Spotify wherever you get your audio you don't I mean, Subscribe and follow. Thank you so much for listening. I'll be back again very soon with another episode of The Juicebox Podcast.
Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!
#923 For the Love of a Timbit
Isha has type 1 diabetes.
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio - Radio Public, Amazon Alexa or wherever they get audio.
+ Click for EPISODE TRANSCRIPT
DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 00:00 Hello friends and welcome to episode 923 of the Juicebox Podcast Isha is the type one who came on the show to talk about a ton of different things actually, we talked about gastroparesis, pregnancy type one diabetes, having a high stress and busy job with type one the impact type one has on relationships and creating emotional agility. While you're listening today. 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. We're becoming bold with insulin. Hey, if you'd like to save 35% off your entire order at Cozi earth.com. use the offer code juice box at checkout cozy Earth makes luxurious, comfortable and just really soft clothing, bedding and bath supplies cozy earth.com offer code juice box at checkout save 10% off your first month of therapy at my link better help.com forward slash juicebox and you will in fact get a free year supply of vitamin D and five free travel packs with your first order of ag one from Athletic Greens when you use this link athletic greens.com forward slash Juicebox Podcast this episode of The Juicebox Podcast is sponsored by the company that makes just in my opinion the best blood glucose meters. Today we're going to be talking about the Contour Next One. And you can learn more about it at contour next one.com forward slash juicebox I love me a contour meter when you're ready.
Isha 01:54 All righty. Am I ready? No. Is this now
Scott Benner 02:00 we are officially started no matter what you say next just
Isha 02:03 I was just checking. So I'm supposed to introduce myself. Hi, everyone. My name is Isha. I'm based in Toronto, Ontario, Canada. Stella Canadian here. And I don't know.
Scott Benner 02:15 Are you in the farm? You don't have to know anything else. Are you in the private Facebook group?
Isha 02:19 I am for Sam. Isabel is gonna it's funny. I actually joined the group before any but the podcast.
Scott Benner 02:26 We'll talk about that. Yeah, go.
Isha 02:29 It was interesting, because I've been a type one diabetic since I was four. I'm 35 now, and I've never kind of seen proper advice in a group before not to be judgmental of anyone or any groups, you know, usually someone being like, have cinnamon and you know, run up and down and do this. And I think I was struggling with trying to figure out I was pregnant. I think it was like right before I got pregnant. And I was trying to figure out incident rates and just like you know, stages of pregnancy impacting like blood sugars and someone tagged the juicebox group and they were like, This is a great resource. Like I go here for everything. Blah, blah, blah, blah. And I was like, okay, and I at that point in time, like I hadn't listened to the podcast and even know there was a podcast. To be honest, I thought it was maybe like a drink to treat low blood sugar. I was like, what is it? Oh, wait, you
Scott Benner 03:17 thought maybe I was like shilling, like a glucose drink or something like
Isha 03:21 that. I didn't know, I just joined the juice box, like Face Book Group. And I was like, What is this? That's horrible.
Scott Benner 03:27 But let me just just say this word here. If there's any company that makes a glucose drink that they want to brand with my name, please let me know.
Isha 03:34 Right, you gotta get all over that. So anyways, when I joined the group, I will say it is probably one of the best communities I've ever seen. And so much so like my brother was recently diagnosed with type one. He's 40. And I literally was just like, you have to listen to this. Like it's the best. And you know, he's a really busy, he's like, I don't have time because I'm like, no, just be part of the group. And he's like, You sound like you're part of a cult. Like,
Scott Benner 03:59 perfect, I'm winning. That's all I hear when I hear that. That's the description you gave and how it felt to him was yes, good. Because it's hard to get people to do stuff like that. And if you're not, if you're not consistent and excited about it, how are they going to believe Alright, let me click on this, you know,
Isha 04:20 I know. But it's interesting because I also find like, it's very hard to change habits, but the group is really good at giving you a very holistic perspective of everything. I think one of the best examples that you've used and like that I've seen is like with diets or with like different types of lifestyles or different professions. It's, you know, it's nobody's a cookie cutter mold. everyone kind of has their own thing. And the group really does a good job kind of catering to whether you're a parent, whether you're diabetic, whether you're a child, whether you're a sibling of someone who's type one, a grandparent like I've really seen such a variety of folks in there and it's it's it's refreshing. It's nice.
Scott Benner 04:57 Yeah, no, I'm glad I think it takes on If I'm wrong about the side when I saw your douche bag, but that's okay. I think it takes on my personality to some degree. This good
Isha 05:08 duty. Yeah. Sounds so nice. The nice thing that's good to be adaptable, right?
Scott Benner 05:14 Yeah, I think it's just, I think that enough people in the beginning. I mean, in the beginning, everybody in that group listen to the podcast. So it's that whole kind of like it's serious and do a good job. But, you know, don't kill yourself over it. And don't make yourself feel terrible. And there's more than one way to accomplish this. And I don't care what you eat, just let's make sure we know how to use the insulin. Like all those kinds of vibes. I think that's how it got built. I mean, I'm not taking credit for that. It just it happened that way. But now that it's so big, it hit 29,000 people. Yesterday,
Isha 05:50 I saw that. And I was like, Oh my gosh, like, I'm excited for you.
Scott Benner 05:55 I'm like, Jesus, this is getting so big. Control. It's so large now that there are times that I post things and nobody sees them. And I'm like, and I'm like, Oh, God, I'm not I was not interesting, because the algorithm did not push up by my thing.
Isha 06:14 10 things though, I'm sure there's ways around. Yeah, I
Scott Benner 06:17 do. I don't Yeah, but it seems like I don't want to do that with everything I put up. But anyway, it's, it's great. Because I kept I got worried, like, the bigger gets, things are gonna get lost, but they don't get lost. Like if somebody comments, and then it gets pushed up, and more people can see it. And it still works. I mean, people complain about Facebook all the time, but it's a
Isha 06:38 I think it really depends on what you use Facebook for. I know, obviously, with like, teenagers, whatnot, it's probably other social media platforms. But I mean, it makes me sound so old. And I hate that I had to say that. But I think it works really well. Like I know if I ever have a diabetes related question or issue or concern, like, I can search that group or I can go and ask. And I'll get a fast response. You know, it's not like I have to kind of book an appoint with my endo and schedule a call. I literally can get that in five minutes. And it's today's
Scott Benner 07:07 right. You know, speaking of feeling old, Arden's been at school for like three weeks now. And of course, this hurricane is coming right at her. And so she's staying with one of her roommates, and they had to go shopping and the roommate didn't have money and artists like, Hey, can you send her some money? She's buying me some stuff. I'm still in class. I'm like, Sure. So I text her and I say, hey, you know, Nazar, how, how do you want me to get you this money? And I said, I could pay pal or Venmo it and she goes, Do you have Zell and I went, I'm 51 Do you want me to pay pal or Venmo? And I said, it'd be honest, if you had Apple Pay, that'd be better. And she's like, Okay, I could take it through Pay Pal. I was like, All right, like, it's you. You know,
Isha 07:51 isn't it funny how there's certain things that indicate when you've kind of reached that point where you're like, Yeah, I'm an adult. Yeah, I'm not doing that. I'm not learning that. Like, I'm not going there.
Scott Benner 07:59 I can't have 75 Cash apps on my phone. I'm sorry. Like, I'm not doing that. Yeah.
Isha 08:04 No, I refused. And like, I have friends who have Snapchat and I'm like, Nope, I'm not going there. I'm not doing it.
Scott Benner 08:10 That's a good idea. I think, Well, okay, so. Alright, so I want to get dig in a little further. First, I wanted to say because I'm going to completely forget that. I started to say it in the beginning. But when Isabel from the private Facebook group hears that you're from Toronto, she's going to be thrilled. So she said, Oh, yeah. Hi, Isabelle. She's such a proud Canadian. But isn't it interesting? So you're from India and live in Canada.
Isha 08:36 I was born like my parents are from India. I was born and raised in Toronto. My parents originally from North India.
Scott Benner 08:43 Got it. Got it. And Isabel is from France. So it's a little melting pot.
Isha 08:49 It you know, I try? No, I will say and I'm sure you've probably heard is like, incredibly diverse. And it's probably one of the few things like there's many things I love about it. But like that's one thing that I absolutely love. You have every background, every culture, every language, it's pretty good. A lot of good food.
Scott Benner 09:05 Yeah, that's excellent. Very cool. Okay. So tell me when you you get into the Facebook group, and then we'll get away from this. And then it's just a Facebook group, but then you realize it's attached to something else. I'm interested about how you decide I'm going to have this as a podcast, let me go listen to it.
Isha 09:24 I'll be very transparent. So at first, I was like, Okay, I'll start at the very beginning. Because I think for a lot of folks, that's just you start something new, you want to kind of you feel like you want to do it, right. Like I want to start right at the very start and work my way down. But it's not like it's not like a step by step process that way. I remember I listened to the first episode, and I was like, okay, and I started listening and they were great. There were some episodes that definitely intrigued me more than the others. And then I think I saw someone online reference certain episodes that talked about, like, just common themes, I guess, with managing diabetes, like, you know, I don't know like Basal rates Sir, you know, it's under carbery, stuff like that. And then I kind of recognized, oh my gosh, I can listen at any point in time, and it'll still make sense. And that was, I think, really eye opening for me. And then from there, I was like, okay, like, this is kind of a community where you talk about things that will help you in terms of your management, but also in terms of just lifestyle, and just, you know, like an interesting podcast that has benefits to me personally, this is fantastic.
Scott Benner 10:29 Yeah, I, at the time, when I started the podcast in 2015, I think, My God, in January, jeez, a long time ago, when I started it, I didn't quite know what I was doing. What you could expect. And in my, my mind's eye, I thought I was gonna take my most popular blog posts and read them. I know that sounds silly now. And I sat down and did it once and I got a few minutes into it. I stopped the recording. And I thought to myself, like, I wouldn't even listen to this. So why would anyone else. And I started kind of reformulating what I was going to do. And I decided I would just hit on some of the big topics, but I didn't have guests. So it's like, well, I'll just talk to myself, you know, I'll, I'll do that. And as I'm getting that all together, this kid with type one diabetes is on American Idol. And I just sort of like oddly was like, messaged him. And I was like, Hey, I have a diabetes podcast, you want to come on it? And he said, Yeah. And so at the time, I was super excited, because I felt like I had an interview that was like something of interest and, you know, pop culture, and that it might help me get the whole thing started. But now I look back in hindsight, and I think that's a weird first episode for people to hear.
Isha 11:47 I will say, given everything I saw in the Facebook group in terms of discussions, questions, topics, and then hearing the first episode, I think it threw me off a little bit, because I was like, I don't quite get it just yet. Yeah. But I think in and now there's obviously so much in that group where people tell you like, if you want like the Pro Tip series, if you want this, like, if you're a beginner like it, that's very, very helpful. But there's a lot in there to listen to. So it's good.
Scott Benner 12:13 Well, I also don't want to like, totally crap on the fact that I had that guy, I can't even think of his name. That's terrible, that I'll figure that part out. Because I did enjoy talking to him. And so I think that helped me understand, well, sometimes we can talk to people who have diabetes, and sometimes we can talk about managing diabetes. And then I went into the management stuff, I think in the first 10 or so, people actually really love Episode Four on episode 11. And they're like cornerstones of like, how I manage diabetes. But then people started coming on, and started doing interviews, and it gave me a chance to get better at it. But I agree with you that by the time I was like, 200 episodes into the show, I thought there's a lot of information in the show it spread out. And I should consolidate at some places, because I'm noticing that some people are super interested in hearing about, like stories, and some people are super interested in hearing about management. And I can't tell them listen, if you listen to the first 150 episodes of this, I guarantee your agency is gonna go into the sixes, which I think is true. But, you know, seems unreasonable. So that's yeah, that's when we started putting this series together that were more management based. And, and they're
Isha 13:30 great, because they're quick lessons. Like, the thing I like about it is, it's something you can listen to like in the car, or just kind of doing other things, which is nice. I recognize it's really hard to listen to podcasts all the time when you're so busy. But I like that you have things broken down into bite sized information so that it's extremely focused. So if you're looking for just kind of like the Go twos, or you have more time and you want to just, you know, enjoy, listen and kind of get a bit of both, you can
Scott Benner 13:53 Yeah, no, I think it's terrific. I actually, I can't believe that it's so well, is doing two different things, which it really is like it's talking about the management of diabetes. And it's actually a podcast too. And I mean, by that, I mean, people come on and talk and there's no real focus. And a lot of people enjoy that most of my downloads come from the fact that people want to listen to a podcast, and they liked it the like that you have diabetes. But the people who want the management stuff very fervently want the management stuff. It's it's a it's a interesting mix. I don't even know why it works. I'm not asking a lot.
Isha 14:32 Don't argue with it. It's working really well. Exactly. Just keep going.
Scott Benner 14:35 Right. Okay, so you said you got type one when you were four, I
Isha 14:40 guess I was four and a half when I was diagnosed. My I remember at the time, like my mom was like, something's off. Like my daughter has lost a lot of weight. And, you know, at that stage, you know, I think her pediatrician was like, oh, kids are fussy eaters, like you just need to be a little bit more strict with like when she eats and I was like, I don't know something's off and like, you know, typically Besides, like, I thought he was wetting the bed, which wasn't normal. And then my mom literally was like, You need to go and do a blood test. Like, I am not going to leave you alone until you do. And sure enough, they were like, mother's instinct is right.
Scott Benner 15:13 Wow. And then she takes you to the hospital. And we're on our
Isha 15:15 way. Yeah, it was a blur, because even when I was going through all the signs, like, you know, my parents are both from India, and like, they're brilliant, very well versed and, like, have a soldier and a lot of things. But, you know, you think of it, you're like, my kids losing weight. So like, you know, we have family members who were like, You should eat things with higher sugar content, or like, have more carbs. Which looking back at obviously, like, I know, is not what, you know, if you're not taking insulin, and you're having all that you're kind of killing yourself slowly. But you don't know what you don't know, until you kind of have some guidance from, I guess, a medical professional or you know, a little bit more about what you're actually dealing with? Or
Scott Benner 15:54 was there any, any reason to think there might be diabetes, people in the family or anything? Like, no,
Isha 16:01 no one in our family has it. And I think that's why my parents were really shocked. They didn't, you know, like anyone, you don't know about much of it type one until it impacts someone you love, or someone close to. So they were it was very new. And during that time, like now, you know, you listen to the podcast, and you're talking about the sensors and the pump, and like, you know, looping and all these things that just weren't existent at that point. And I remember, like, I still have the meter, it was like massive, like took a minute to test your blood sugar. And you know, you're taking needles, and at that point in time, it was like twice a day. So it wasn't like your carb counting accordingly. It was like you take your morning insulin, and then your bedtime insulin. And that's it. And I remember like my mum and dad woke up multiple times a night to check my blood sugar and just check on me and, like coming to my school to make sure that I was okay. And like, just now I look at parents and even people in that Facebook group, and I'm almost in awe, just the amount of advancements there have been in diabetes. It's it's really, really, really incredible.
Scott Benner 17:00 Yeah, no, it certainly is even. I mean, Arden hasn't had nearly as long as you have. But it's wildly different from when she was diagnosed till now. Like, yeah, just wildly but we, we hit, you know, I almost said we got in, like it was an investment opportunity. And we were there just in time to get the boom. But I don't know why it occurred to me that way. But Artem was diagnosed just a few years before CGM and B started happening. So she wasn't too long without some of that stuff. It didn't work as well back then, as it does now. But
Isha 17:37 of course, there's probably so many advancements. But I mean, like, even that is interesting, because when I was diagnosed, I was four. So I had really good control. My dad was really diligent with like, you know, if I was like, oh, I want ice cream, he's like, you gotta run up and down the stairs 20 times before we have that ice. And I would do it and it would help. And like, my agency, for the longest time was like six, well, growing up with my parents, it was really good. And like, I remember when the pumps came out, my endo was like, I think you'd be really good candidate for this. And I was like, No, I don't want it. And I think I only got a pump a few years before having kids. Because I was just, I had this thing about like, No, I manage it. I don't need a pump to kind of like manage I already do a good job on my own. So I find like those who have kind of come into diabetes where like those tools are there. It's such a great, great tool. Like, I think a lot of people prior to you get stuck in your ways, you know, you're kind of like this works for me, and I don't need to change it by change can be a good thing.
Scott Benner 18:33 Was it? Was it really working? Like I I'm always interested by those statements like this works for me. Was it really working for you? Did you have low variability? Did you?
Isha 18:44 So abs? So great, great question. And I think a lot of it is like you feel like you're doing, you're managing because there's certain benchmarks are like my agency is good. Or like, you know, I know my insulin to carb ratio, and I don't need a pump. But you know, there were so many unknowns, like I remember, you know, you take your insulin, you don't know if you're which direction your blood sugar is going. And you know, if you're going up, you're going down, you're going across, like you don't know how much insulin is in your system. I didn't understand the idea of stacking, like stocking insulin at one point. So I'd eat to give myself like a shot. And then like a couple of minutes. I'm like, oh, yeah, I really want me to eat that too. And I do that and then all of a sudden my blood sugar be crashing and I couldn't understand why. So, you know, overall, I think I had good control. But there were just things that I could have done so much better. And now that I have a pump and I have a sensor, like I rave about it to everyone. I'm probably part of like the cult who's like, you've got to get this.
Scott Benner 19:39 That's fine. Listen, I think that if people can afford technology and they want it, there's a lot of benefit. And it's just I'm not saying you can't manage while with MDI, you certainly can. But I mean, not having to unless it just doesn't bother you and there are some people I talked to that are just like I I don't care how many times I stick myself with this needle doesn't matter to me. So
Isha 20:03 funny you say that, like, you were, you know, we're talking about where my parents are from and all that stuff like so my parents originally from India, I remember when I was younger, we went there. And we think our luggage got lost. And we had a few needles with us. But the rest of my supplies were in my bags, we had like enough for a few days. And my cousin went out. And my parents were like, We need to get these needles, because like, we have to give Isha her insulin. And they got the like, he didn't know and it was it. I remember, like, my cousin felt terrible, but the, the, the needle like units were different than what my parents were using. And I think I ended up taking like, it was just so much more insulin than what I was normally taking, and no one noticed. And I had a really bad really, really, really bad reaction like seizure. And we were all confused. And like, it took them a little while to recognize that the units were actually different. We were in a different country, like it wasn't the same. So you know, don't get me wrong, MDI is fantastic if you can do it, but there's, you know, we're all human. Like, sometimes something gets missed sometimes, like, I just find with a pump that the insight you get from that, like, and especially to the point where you can factor things out like I can change my Basal rate at 3am when I'm sleeping, rather than having to get up and do a shot if I need to. I find that really, really, really incredible.
Scott Benner 21:21 Yeah, we actually did something last night that all right, chat GPT. Let's see if you can write a podcast ad for the contour next gen blood glucose meter. Wow, it works quick, ready. managing your diabetes can be a challenge. But with the contour next gen blood glucose meter, you'll have the confidence and control you need to stay on top of your health. This state of the art device offers exceptional accuracy, ensuring you get the most reliable results every time you test. That's actually true. This episode of the podcast is brought to you by the contour next gen blood glucose meter contour next.com forward slash juice box. It says I should have put a sound effect in of the meter beeping, but I won't be doing that. Let's see the contour. Next Gen blood glucose meter comes with a user friendly app that helps you track your glucose levels. That's actually true. You don't have to use the app. But you absolutely can. And it is pretty fantastic. And the app lets you set reminders and keep an eye on your trends. It's like having your own personal diabetes coach right at your fingertips. Well, it's a lot like having an app but I see what it's getting at. And for your valued our valued podcast listeners. Listen, guys, I got a website. Contour next one.com forward slash juice box. You can learn a lot about the meters there, they really are terrific. They're super accurate, easy to use, easy to hold absolutely fantastic favorite meters my daughter's ever used hands down. So don't let diabetes holds you back. Take charge of your health and experience the freedom and peace of mind that comes with using that contour next gen blood glucose meter. I believe that by the way, it's a great meter, you need accurate tests. It's not mentioning the Second Chance test strips here which I mean blows my mind because that's the best part of the meter. Obviously you can touch the blood not get enough go back get more not impact the accuracy or waste a test strip. Second Test test strips are fantastic. Which is not to say that the meter needs a lot of blood. It's just you know if you mess up you can go back without without you know ruining the stripper the accuracy of the test. seriously fantastic meters. I love them. My daughter has been carrying them for years. They they're great long time sponsors of the podcast contour next one.com forward slash juice box when you click on the links, you're supporting the podcast there's links in the show notes of the podcast player you're listening in right now. Links at juicebox podcast.com. And of course you can just type in contour next.com forward slash juicebox and you will be helping the podcast So aren't you know she's three weeks into college She's actually doing really well with her blood sugar's and everything and she comes home, they're gonna do some dishes and then she's like, I don't know, I was just gonna make something in the room like ramen or something like that. So she gave herself a big Bolus. And she's doing dishes and then some boy from downstairs calls and says, Hey guys, the taco place is still open, we should go and Arden's like Yeah. And she goes and they get there. And she she thought she got there in time and ate but then she got low afterwards because it's just way too much of a Pre-Bolus and then she didn't eat the same thing that she thought she was going to eat. So okay so you know Dexcom catches the low before it happens. I texture okay, you see this? She was Yeah. And I'm like I think this is going to keep going the line has like I said that that line is talking to me. This is trying to go there. out, like, really? You don't I mean, so she's like, okay, so she starts, you know, she does something, she's like, I'll just drink a juice and she drank a juice and it caught it and held it for a while. And then suddenly, it wanted to go lower again. So it was late, and she's like, I want to go to bed. So she ate something more substantial. And then she's like that if I Bolus for what I just ate, it's gonna give me like seven units of insulin. And I thought, That's right. But I don't, but I don't want her to sit up all night. So I said, Okay, I was like, well, instead of telling you it was 40, carbs on she told it was 20 carbs, let it give you the four units that wants to give her something like that. And then we'll go to sleep. And if that's not right, which I don't think it's going to be, the algorithm will stop and bring you back down again. So you might go up, but you're not going to go much past 200. And you can sleep and this thing will level you out. And I have to say she should have just Bolus, probably closer to 40 carbs, not all of them. And exactly what I thought was gonna happen happened, her blood sugar went up like 190. It stayed up there for a while, and then it came back down. But you know, her day off is today. So she's trying to sleep in so Arden's blood sugar right now is 130. And she has not been tending to it for the last eight hours. And so that's the thing, we're back in the day, if you would have done that your blood sugar, gone up to 450. And it was you would have woken up with a 400 blood sugar.
Isha 26:24 Yeah. And you wouldn't necessarily know because again, it gives you a fragment time. It doesn't give you like that big picture of how it is what direction for how long. Yeah, yeah, this thing.
Scott Benner 26:34 So with this technology, I was able to say, Okay, I know we're not going to be perfect tonight. But everybody's going to sleep and our blood sugar is going to be okay in the morning. And that's all technology. It's really
Isha 26:44 incredible. I am I shared with you earlier, I just had my third child like four weeks ago. Oh, wow. And thank you, thank you. And when I was pregnant with my first before I got pregnant with him, my husband was the one who actually pushed me to get a pump. And he was like, because I think he came with me once to my endo appointment, because he just wanted to learn more. And they brought up the pump and he was like, this would be really good for you. I was like, no, like, I got this like, you don't think I can manage my diabetes. Like I came from a very like defensive perspective, which to be honest, was not smart. But anyways, he was like, let's just go and take a look at it. And anyways, I ended up going in the pump. And I will say I don't know how it would have managed pregnancy without an insulin pump. I didn't have a CGM for my first pregnancy. And I managed well, but it was now that I had it for the next two. It was a game changer. Like my insulin needs went up like 75% During my like more than that during my pregnancy. And I managed my my insulin and my blood sugar is during delivery. And it was like a breeze. It was obviously very hard. I'm not going to put that at all. Just because so much fluctuates in pregnancy with blood sugars and how much insulin you need and how your body reacts. But I don't know how anyone would have done that without it.
Scott Benner 27:58 Tell me Wait a minute. You were like pushing out a baby and running your insulin at the same time?
Isha 28:04 Yeah, I did that for all three of my pregnancies. That's so
Scott Benner 28:06 cool. But the first two you did it with them di and at a meter.
Isha 28:10 No, no, no. So with my first I had the pump, but I didn't have a CGM. Gotcha. So I was still testing. And it was great. Like my endo and I came up with a plan. She's like, once you deliver, you're gonna cut back your insulin by this much. Like bring everything down by 50% and 70%. And it was it was so helpful because like, again, unless you're dealing with a specialist, a lot of people don't know the ins and outs of diabetes, like I remember, came across the hospitals. That was phenomenal. Like, they were amazing. But the nurse was like, am I supposed to give you your insulin like every hour? And I was like, No, you'll kill me. Don't do that. I got those. Don't worry.
Scott Benner 28:42 You're a sweet lady. Please go away.
Isha 28:45 I was like, yeah, exactly. I was like, please stay away from me. But you know, when you know something so well, you know how your body reacts. And again, with the pomp and with the CGM like you just, it's just a different. A different level.
Scott Benner 29:00 Yeah. So in your note to me, you mentioned a couple of other things. One of them was that you kind of have a high stress job, is that right?
Isha 29:08 And yeah, it's it's funny, I guess I probably responded A little while back, it was in a different position, a different company at that point in time, but I traveled a lot for work. Prior to having kids, it was like I was traveling at some points, like every week. And like, you know, you're doing presentations, you're meeting with high profile people, and it's a it's busy and stressful and, you know, you kind of have to react accordingly. So with diabetes, it's, it's, it's different. It's hard
Scott Benner 29:37 when you were on a lot of flights. And yeah, and did you have any trouble with that? Or did you find what was the secret to doing it? Well, I guess
Isha 29:46 it's interesting because until like you guys had an episode about this, which I was very grateful for, but I would always have like a significant drop or a significant increase and I would never understand why like to the point where like one time on a plane I was with a colleague And I like I kind of blacked out. And I couldn't understand why I was like, I don't I don't get it. Like what happened. And I remember talking to my Endo, and I was like, Does my insulin pump give me more insulin? Like, will it go down? I'm not on a to like, I want to I want to AMI pod. And they were like, No, there's nothing in here that would indicate it. But after listening to your, I think the episode on it, and then like reading a lot of the comments, it just seemed like a common theme. So you know, I just made sure to like chug a little bit more before going on the on like going into flight, like, suspend my insulin at certain times. And like, I would always keep my blood sugar slightly higher, because I was traveling by myself. Yeah, and just to be safe. And then I knew like what to do once my sugars came down. So it was it, I think when you're in a really busy job, or when you're in a really high stress job. One of the things with having diabetes is like you have to figure it out. And like you just you're kind of learning on the fly too. And I'd have like presentations and like you're super prepared. And then you know, for me, if I get nervous, my blood sugar drops. And then you know, you're going up on stage or you're talking to like, ton of people and then you're like, oh my god, I'm shaking, like how am I supposed to do this? So you kind of have to kind of plan a little bit ahead to be like, Okay, I know, I get nervous, I gotta have an extra juice before going on. You know, my blood sugar might be a little bit high for like 20 minutes afterwards, but then I have it because I'm catching it right in time. So you kind of you kind of look at trends and see how you how you respond,
Scott Benner 31:28 you build you build like guardrails into the moment, right? Absolutely, absolutely. I'm noticing Arden doing that. Even in just a few weeks that she's school times where she would not have been concerned about getting low because she would have said like, first of all, I know this is gonna work. But if I were to get low, I'll take care of it. But now she's not airing like, she's not erring on the side of caution to the point where she's pushing her blood sugar way up. But I do see her thinking about it a little bit. Like she, she caught. She caught a little bit of a drop during a class yesterday. And I was gonna say, maybe we could. I don't even know. Like, I texted her. I was like, What are you going to do here? And she had already done like three things instead, like, you know, I might have said, like, you could try a couple of gummy bears here and see what happens. Or I think it's too late to cut back your basil. Like that kind of stuff. She's like, I cut back my baseline of gummy bear and I drank a half a juice and I was like, Oh, wow, like, you're way ahead of me. Well, not only that, but she's just like, look, I'm by myself. Exactly. This is different. And it hit her very quickly. You know what I mean? So
Isha 32:33 I think that's one of the things when you are by yourself like I'm not gonna when I was with when I lived at home, you know, my parents were always very helpful. But when you're by yourself, you recognize like the world does not know what you have to do and the world does not know how to respond to you. And I had again before being on a pump before being on a CGM. We went a friend a few friends and I went to Buffalo for the day to go shopping. Because first of all, you guys have target. That's freaking amazing. That's a different podcast story. And we gone shopping and we came back and I think on the way we we got like Timbits or like those little donut holes. We have Tim Hortons here they have these things called Timbits. And it was I dosed for like three of them. And one of them fell on the floor. And I just forgot about it. So the example you get with Arden where like her blood sugar is going down, she could see it cuz she forgot I forgot about that template. And I was attending to something and in the duty free I passed out and I hit something and I was bleeding everywhere. And my friends were like freaking out and it was it was bad.
Scott Benner 33:34 For the love of a Timbit you're on the floor. Oh,
Isha 33:37 look at the things I had to go through. But I even just forgot what you're talking about. Because I've just so sleep deprived.
Scott Benner 33:46 What did you make a third baby for the two? Not enough? What were you doing? There's a moto interhouse was like you can do hard things. Okay, well trust me bigger three babies persevere. That's gonna be hard. By the way for the love of a Timbit can we make that the episode title because for the
Isha 34:02 love of the timber. There was a reason I was telling you the story. And now I forgot because I'm like sleep deprived or a reason there was a purpose while we're talking about
Scott Benner 34:10 know what it was. And I'll take you back to it in a second. But let me just tell you this, prior to the Timbits story, I've been sitting here trying to decide if I am a genius and came up with something that no one has ever thought of before. Or if I just thought of something that everyone's thought of before because I thought can we call this episode can Indian? Oh my god.
Isha 34:31 You know, it's funny. So my husband's Jewish and we always call like our kids, little Hindu babies.
Scott Benner 34:37 Well, I can see your last name. And I have to tell you that when you got on and we were chatting before we started recording you're like I'm Indian. I was like well definitely married then because
Isha 34:48 yeah, sure. You can call whatever you want. And why did they tell you that story?
Scott Benner 34:56 I'm almost feel by the way I feel like so powerful. Now that I know what we were Oh, am I at your mercy? I really don't like let me just I'll just manipulate the conversation anyway. I won't because she's stuck. No. So anyway, I just use you know, I was like, Googling while you were like, I wanted to make sure like, what if Ken Indians like a bad word or something like that? And my stupid head just came up with it anyway. No, no, here we go. So we were talking about, you talked about how Arden Bolus for something. Yeah, she forgot about she forgot about it. And then we talked about how being by yourself is much different than being rude people. Remember now.
Isha 35:34 Thank you, Scott. Thank you for being my memory. Yeah, when you're by yourself, like you have to figure things out. And some things sometimes things go sideways, like they really go sideways, but you learn from it. Like I know now when I'm by myself, I don't have that luxury of forgetting. You know what I mean, and with the CGM, and with the pump, it's a different story. You have indicators to tell you if you have. But I mean, when you're by yourself, you have no one else to rely on. Nobody else knows, oh, I know why he was telling us. So I had that I passed out. And my friend really, like ran to go get me a pop. And I didn't have like my glucagon or whatever it was on me. And my other friend who's with us, someone tried to give me my insulin. And my friend had to fight them off me. And she was like, What are you doing? You're gonna kill her. And the person was like, my mom has diabetes, like she needs her insulin. And my friend was like, your mom's probably not a type one diabetic, like she has low blood sugar, like, gotta get the hell away from her. And I remember my friend was shaking for like days after that, because she's like, that person would have killed you if I wasn't there. Or helpful, or somebody is really a stranger because because again, like I had passed out in the duty free, like I was surrounded by blood, it was a pretty intense situation. But it was just a reminder to me that you know, people mean, well, but even with good intentions, people still don't know what we know. You know, you know how your body responds to something. Arden probably knows now, how she responds to certain foods, certain incidents, or like events in her life. Like we all kind of learned as we go when you're diabetic, too, or you have a child who's diabetic, whatever. But a stranger to them a lot. For a lot of people. It's like you're diabetic, you take insulin, like that's what it is.
Scott Benner 37:14 Well, well, in that movie with Julia Roberts, that's definitely what they would have done. Right? They either made her drink juice or gave her a shot. So
Isha 37:20 yeah, it's definitely a huge oversimplification. But I,
Scott Benner 37:25 but that's what people see, though. I mean, because they don't know. Although I am fascinated that a stranger would be comfortable just giving a medication to somebody.
Isha 37:33 Don't worry, that's that's another like, scary thing. I was like,
Scott Benner 37:36 I know what to do. And you're over there, like, bleeding and low. And you don't know, please don't kill me. You don't know what's happening right
Isha 37:44 now? No. And like, I think that, you know, I'm obviously little embarrassed sharing that with, like, so many people who listen to your podcast. But the reason I share that is like, I think if you have a kid who's diabetic, or you're diabetic, you quickly learn that, like, you can prepare them up to a point, but they'll have to learn certain things on their own. And like you really hope obviously, it's nothing that hurts them or damages them in any way. But I think a lot of those events, whether it's passing out are like a high profile job or a high stress job is you're quickly have to figure things out. Like you don't have a choice.
Scott Benner 38:16 Yeah, no, I think to that there's ways to recognize scenarios that are going to be that could be more problematic than others and defend yourself around those like keeping your blood sugar a little higher. If you're on a plane and you know, you get on a plane and you're by yourself. Or you know that I just I realized now that if this were to happen to you again, you'd snatch that die that doughnut hole up off the floor and just eat it dirty you Yeah, I'd
Isha 38:41 be like five second rule. That's fine.
Scott Benner 38:42 I need this. I gotta I'm sorry. No one judge me. I'm eating this doughnut hole.
Isha 38:46 Oh, yeah, for sure. And or, like, I know, like, I could suspend or like put a Temp Basal until I find something like there's so many things. Now I would do differently. If I had those tools back then. Yeah. But even with the with even a pumpkin sensor, like things go wrong sometimes. But I still think that you're kind of given advantage because you kind of, you know, the direction in which things are going.
Scott Benner 39:07 This is a good conversation for me to have at this point in my life, because I made a good decision the other day, but I wasn't certain if I did and talking to you tells me that I did Arden was concerned she was going to get lower, and she's looping. And so she did the she she didn't override and she took her like all the power of the loop away from it for a little while. And I thought I think she's gonna get high after this. But I didn't say anything because I wanted her to run it herself and see what happens. But now I'm seeing that the other benefit of not saying anything, is that she needs to feel free to protect herself.
Isha 39:43 And yeah, and that's tough because like, you know, none of my children are type one. But I mean, I think as a parent, you want to protect your kids, you want the best for them. You never want to see them get hurt, but you also don't want them to be independent and prepared and equipped. And I think finding that balance especially when you have to Ah, that's type one must be so challenging.
Scott Benner 40:03 Yeah. Well, so you said, gosh, did you say this on the recording that your brother was just diagnosed? Yeah, just 40. That's insane. So do you have any other brothers and sisters? And are they? Yeah, I
Isha 40:14 just have an older brother. And it was a huge shock to my brother's amazing. Like, he's brilliant. He's got a great job. He's married with two beautiful kids. And they had just had their second child and they just bought a house. So it was like all stressful things. And I think a lot of everyone would just was kind of like, Oh, he did. He looks really weak. And like, he's last week. And so the signs were clearly there. But I think we just all made excuses for them. We're like, oh, he you know, he looks tired and weak, but like, Oh, he's probably not sleeping as a newborn. And it's like, oh, he looks stressed out. Well, they just bought a house and they're moving like, of course. But his wife pushed him to go get a blood sugar. And it was weird. millimoles per liter here. So like, his blood sugar was like 26. Wow. And I, I went to the hospital with him, like forcibly stayed to just ensure that they tested for the right things like from the Facebook group, I knew like push for C peptide tests, like push for like an antibody test. You know, like, make sure you get the proper diagnosis. Because initially, it was like, Oh, you might have type two diabetes. And that was kind of the first first thing that I was like, no, no, no, no, like you need to get with a proper Endo. Who knows what this is. Everyone else is just going to treat you like, you know, even
Scott Benner 41:29 you standing next to him with type one diabetes. They said maybe he has type two diabetes?
Isha 41:33 Yeah, no. Before it was like I hovered. My brother was like, go home. I was like, I'm not going anywhere.
Scott Benner 41:38 Well, boy, I'll tell you what, that's interesting. I, I'd love to ask him like, did he think his whole life? Do you think I'm getting away with this? Like, he should has it but I don't? Or like, I wonder if siblings I guess my question is, I wonder if siblings that don't have type one. spend their whole life wondering if they're going to get it?
Isha 41:59 You know, I I don't know. I like, I think everyone around was pretty shocked. Because they were like, he's 40, though. And I think it's a good reminder that like, you know, used to be called juvenile diabetes. It's not called juvenile diabetes anymore, right? Or at least I don't think it is
Scott Benner 42:13 no. Reason I believe that I've been. I've no, listen. For some reason. I don't really remember the podcast so well.
Isha 42:22 You understand what I blocked out and I fold totally forgot what I was talking about. You make me feel better.
Scott Benner 42:26 I got a text from Isabel like three days ago. And she goes, What do you want to do with this? And I looked at it and I said, I have no idea what this is. And she goes, What's from a person you interviewed three days ago, and it's it's information she said she was gonna send to you. And I was like, Oh, I don't remember that. I was like, what was it about? Like, because I'm not on the same timeline you guys are. So I, like if you download the podcast this week, you hear stuff I recorded six months ago. And so I don't I don't remember it anymore. Anyway, but getting out what the hell was I gonna say you're rubbing off on me Isha?
Isha 43:04 I know. I know, it was we were just taught using group interviewed a number of people, siblings, like everything like,
Scott Benner 43:11 well, I don't have it written down somewhere. But I would bet that if I took, I don't know, a flowchart, I have probably interviewed somebody who's been diagnosed at every age, like 1234. Like it 5055. Like set, I think I did somebody recently who was diagnosed, like at the end of their 60s or their early 70s. Like, so there's no, I mean, is it uncommon for you to get diabetes? If you're 60? type one diabetes, if you're 69 years old? Maybe. But it could happen. And if you have a sibling who has it, like do you like you? Don't I mean, like, you know, when your father somebody's father dies of a heart attack when they're full. You spend your whole life thinking, Well, I'm not going to live past 40. I don't know. I just I always wonder that
Isha 43:56 it is interesting, though, because I've heard of people who, you know, have multiple kids who are type one, and some who have none. And like, I know, I think if you're a type one diabetic, like you, for me, like I'm always like, when my kids have this, like, is this something that they will have to worry about? I never really thought about it in terms of like other family members, and I feel bad about that. But I will say the silver lining is I'm grateful. Like, I know what I know, because I was able to help my brother out like I brought him a sensor in the hospital. I was like, You're not waiting for anyone like where this is cool. So it gives him an advantage, I think and like I can guide him to the podcast and the Facebook group above the other things that I think are really, really helpful. It's excellent.
Scott Benner 44:37 So do you. I mean, you obviously you just had a third kid. Do you think about that? Do you consider like trial and error?
Isha 44:44 I actually have so I did try that with my son. And I came back clear, which was really nice. I haven't done my daughter yet. She's three now and my son is literally like four weeks old. So he's got some time I'm not gonna He's got to get to be above to write,
Scott Benner 45:01 yeah, I think you have to be a certain age. And then if you get a completely clear no child that won't test you again, if you don't get any antibodies, I think, yeah.
Isha 45:11 So it was nice. Like, I had a conversation with someone, once we're like, what's the benefit of doing that? And I said, you know, it's peace of mind. And I think of it my brother, and I'm like, your sibling who has type one, and everyone around him, even myself, like I feel guilty about that was like, Oh, he just had a kid. Like, that makes sense. You're tired, you've lost weight, because you're not eating and sleeping properly. And, you know, looking back when we pieced together other symptoms, and like, yeah, those are like, textbook symptoms. But I think you know, with your own kids, like, my, my son, we drink a lot of water. And I'm like, Oh, my God, he must have diabetes. And I, my husband would be like, No, it's like, 40 degrees outside, your sun is hot, and he's drink water, like, relax. I think getting that test gave me some peace of mind to be like, okay, he's, you can just be a normal kid, like, not everything has to be a symptom. Or if he was, if he did have the antibodies, at least I know what major things to look out for. So that it doesn't get to a point where it's terrible. You know,
Scott Benner 46:06 people's brains work one way or the other on that. It's either exactly what you just said, or the people are like, Look, if it's gonna happen, it's gonna happen. I'd like to live blissfully ignorant till it happens, like one or the other. You know, like, it's,
Isha 46:17 yeah, yeah. And I hear you. And I think there's, there's advantages to everything. I just think that, you know, sometimes we, we think we'll catch everything. And I think we kind of underestimate like how complex and crazy life gets because you're right, like, you could lose a lot of weight, and attribute it to something completely different. And you could be really thirsty. And you know, maybe it's a side effect of the medication you're on. And I've heard so many stories of people getting diagnosis is take diagnoses, this is how you know, I'm tired. Diagnosis
Scott Benner 46:48 about stuff.
Isha 46:50 Yeah. And then, you know, they're like, I don't know why I didn't see that. My father in law, just had a quadruple bypass, he's doing really well now. But for the longest time, we were like, you're just out of shape. Like, go for another walk, like you probably need to just exert like, you know, get your heart rate up and like, eat better. And now, when we look back, we're like, No, it was because you had this underlying heart condition, and you didn't realize the symptoms. So hindsight is always 2020. But I mean, if there's anything you can do to kind of give yourself markers to look out for I think it's always helpful. But that's my perspective, I reckon recognize teachers on.
Scott Benner 47:24 You know, it's funny when you were stumbling over diagnosis. Here, a guy came up to me that it popped in my head that there's a word I can never remember. And I think I've said it on the podcast recently. And I thought, well, I'm aware that I can't remember it. So I'll think of it right now. And while you were talking, I still couldn't come up with it. So the word means when, oh my god, it's amazing. The word means this is gotta be like, I'm gonna have an aneurysm or something. Like there's gotta be a part of my brain that's like, burned, right? So when you are afraid that if you do something, oh, I got it. Superstitious? Very good. I can't think of the word superstitious when I need it. Isn't that ridiculous?
Isha 48:11 Yeah, it's verbal. I remember there's a term for it. It's like when the neural connections your brain are weak, you have to like strengthen them. So it's things like verbal fluency or something like
Scott Benner 48:18 I, I, I've been in multiple conversations. If you listen, listen, if somebody wants to do a deep dive on this podcast, go back and listen, for every time the word superstition could have been used, and I talk around the word to explain it. Because I can't
Isha 48:33 at least you recognize that you don't remember it. And then you can like make do I always just sit there and I'm like, I don't know what I'm talking about anymore.
Scott Benner 48:39 I'll tell you that this. I think making a podcast like this is really good for your brain. Because Oh, absolutely. There are days that I sit down, I'm exhausted. And I'm like, Alright, Scott, like this is it we're gonna have a good conversation with this person. It doesn't matter that you're tired, like go and I pull it together for an hour. And then I'll leave the room and just be like, I gotta take a nap. Although I'll tell you I did yesterday. I have more questions for you. But I interviewed Jennifer stone yesterday. So she's the girl the redhead from Wizards of Waverly Place. Do you know that show? On Disney?
Isha 49:17 I'm so terrible. I wouldn't heads down for like to be back in society.
Scott Benner 49:22 It's an older show. Like she's older now. She's 29. But she's got type one and she became a nurse. So Wow. So she's in this incredibly popular TV show was Selena Gomez. And she's
Isha 49:33 also That's why her name. So much. Her name sounds so familiar, but don't know who she is. Yeah, that's probably why
Scott Benner 49:38 so I believe she played a character called Harper Finkel in Wizards of Waverly Place, but not the point. The point is, is that I've interviewed a number of famous people who have type one diabetes, and sometimes they're I'm just not I don't think I'm going to say anything. Sometimes they're not a great conversationalist for some reason. but Jennifer was amazing. Like so much so that when it ended, I thanked her for being a person and being able to hold a conversation. Thank you for being here. Yeah, like this was amazing. Like, we stopped recording and I was like, thank you so much. I was like you were thoughtful and articulate and engaged and didn't run away the minute the recording was over. And, you know, like it was. It was it was lovely, actually. Yeah. Anyway, she didn't have any trouble coming up with words while she was talking, I think is where that
Isha 50:30 we all have different skills we need to work on okay.
Scott Benner 50:32 Yeah, well, mine is remembering. Dammit, superstition. There we go. Okay, so do you have gastroparesis?
Isha 50:46 So it's funny enough, actually looked at the notes. And I was like, I don't even want to talk about that anymore. So I actually didn't officially get a diagnosis for many years. I was like, I think I have an ulcer. And then I remember going for like an endo. And they're like, No, you're an endoscopy. And they're like, you're totally fine. And I was like, but I feel like there's a hole in my stomach. And I don't like this is really weird. And I'm, like, bulging and, like, I couldn't get answers. And I remember I did that. Like, there's a test you do, where you eat like a sandwich. And they kind of see how it travels down your system. I was like, am I eating something that's nuclear reactive, like what is happening. But anyways, they were like, you're fine. But I knew like, that's another thing, I think when you live with a medical condition is you really are forced to notice how you feel, you know, like, you pay attention to certain symptoms at times, like pay if something feels off. And finally, I met with a doctor. And this was like, after a few years of pushing, because I was like, this comes and goes and like, I don't know what's happening. And, and he was like, you've had diabetes for over 20 years, like we do see this for and I was like, but I have really good control, like, my blood sugar is really good. Like, I have loads here and there. But like, for the most part, they're great. And he was like, just being like one of the risk factors. Unfortunately, if you live with something for a very, very long time, like you can have it. And anyways, I haven't had a flare up in like years. But I got kind of like an indirect diagnosis from a gastroenterologist. And it was to be honest, kind of like a relief, because it was like, Okay, I'm not crazy. That makes a lot of sense. I have all the symptoms, but like, I don't need to, I don't know if it's because like, my blood sugars are so good. Now, like, I haven't had a flare up, I don't have to control my diet. I do know how to manage it when it impacts my blood sugar now. So if it does kick in, I kind of know to put a Temp Basal on for like a higher rate for a couple of hours to kind of avoid any delay, but to be honest, like how you deal with proteins and fats probably the same way. Right.
Scott Benner 52:39 Right. And so do you have stomach you have stomach pain?
Isha 52:43 Yeah, like I would eat something. And I would like be sitting down the friend and I'd be like, I like I burped. And they'd be like, Whoa, and I was like, I don't know what's wrong with me, like, what didn't happen. So it's like, you belch like you. And I think it's just because you haven't digested food properly for for a little bit.
Scott Benner 53:01 How bad? How did things work? On the other side? Were they coming through? Okay.
Isha 53:05 Yeah. And that's, that's why I think a lot of the times, everyone's like, you're totally fine. Like, we don't see anything. But I had certain symptoms that I was like, No, I know, this is not normal. And I know that something's happening, because I see it reflected in my blood sugars. And, and, you know, obviously did a lot of research and a lot of things that I read is like, you can have a very mild form and like, you know, going through blood sugar control, and it's not you can manage I know, for some, it's, they need to be on medication, and like they have to, like remove certain foods from their diet. And thankfully, I haven't gotten to the right and but I do know if every now and then it kind of slipped like habit creep up, but it's probably been a few years. And I'm grateful for that. But I haven't had that as a concern.
Scott Benner 53:48 Have you noticed any impacts from stress on it?
Isha 53:55 No, no way. Interestingly enough, no, I see it reflected obviously, my blood sugar and other things like the only other health conditions that I have, I have psoriasis. And like, that's something that I see flared up with stress stress. And but other than that, no, and I'm I've kind of forgotten about it until you brought it up was like, oh, yeah, that's a thing.
Scott Benner 54:13 Just because Arden for I mean, a while, like longer than I think could be like, Oh, my stomach hurts. Like, you know, like, she asked us to push on her stomach, things like that. And she was constipated on top of all that. And then we ended up you know, you go through. It's interesting how sometimes you skip over common sense and go to a doctor. Yeah. And so we did everything we could think of he you know, like every test and everything and everything always came back. Okay. So finally we got her, you know, a scope. And the guy comes back and says it's very similar to what you heard. He goes, Well, there's some undigested food in her stomach, that's gastroparesis. And I was like, Well, I just talked about this in another episode as a way, way way. Like, I like what you're talking about, like So, you know, and he's anxious, you know? And so he goes, Well, that's just the term we use for slow digestion. I was like, well call it slow digestion then because I
Isha 55:09 no doubt within that's the thing, like when you get to a certain diagnosis, we all think of things, I think is probably the worst case, or a very, like severe case. Um, so sometimes it's hard to see where we fit into that where you're like, I'm not like that, or like, I'm, you know, I can eat my foods and I'm not in pain curled up on a ball. But it's, I can totally understand that because I, I joined a group online to learn more about it, and I couldn't relate to anything. I was like, Oh, my God, this is terrible. Like, is this what my life is going to be like? Like, you know, these people are incredible what they're dealing with on a daily basis. That sounds so hard. But I kind of recognized as you can have varying forms of things. And again, like it's just slow digestion at time. So I do agree with you, like the name of it probably throws you off.
Scott Benner 55:54 Yeah, I was it because in my mind, I was like, Well, duh. So there's nerve damage and heart and stomach and he goes, Well, no. And I was like, well, then, let's not call it gastroparesis while we're talking because you're, you're messing my head up, like, Yeah, but just, and he's like, okay, so he goes, Well, we're gonna put her he goes, let's put her on a gastro precice diet. And I was like, Are you not following this man? I was like, because you clearly can't hear so. So where I was lucky is that I got to call Jenny, who's a nutritionist and has type one diabetes. And we talked through and she goes, I don't Arden doesn't have gastroparesis the way we're talking about, like thinking about and I was like, oh, yeah,
Isha 56:32 yeah. So and I think I probably have Wait, wait, you saw with Arden? Yeah, times. And I think like, you know, listen, we for those of us who are diabetic, like even with good control, there's just certain things that I think we're probably more prone to, but I think names of things can really mess with your head.
Scott Benner 56:46 Exactly. I was like, wait, because also, he's talking about significantly restricting your diet forever. And putting her on pain medication. Yeah. And instead, she's taking a couple of supplements, and she's okay.
Isha 56:59 Yep. Yeah, exactly what I did. I remember the doctor gave me like, I think I crushed my endo to give me like medication. And I didn't take it. And she was like, Why did you ask me for this then? And I was like, I thought I needed it. But I think I don't and I don't want to take it because I don't want to become I don't want this to become part of my like, I'm not where everyone else is who has got gastroparesis, and I didn't eat it. And it was just, again, like monitoring certain things and being more mindful of how he felt.
Scott Benner 57:25 How about we didn't even ask for the medication. He gave it to us in the first office visit before only talking to us, like, here's some samples. And I'm like, What in the hell you're giving us you're giving like an 18 year old samples of a pain medication before you're actually like you said, Well, I don't want her to be in pain. And I was like, aren't we got up mcaren oranges. I'd rather my stomach just hurt. And I was like, Okay, gotcha. So, it is funny though, after she got the school. And she's forced to eat in the cafeteria the whole time. She's like, hey, my stomach starting to hurt once in a while again. And we went over what she's eating. And I say garden, you have to avoid like fried foods. Like just because you don't eat. You know, she's like, there's french fries here all the time and stuff like that. I'm like, Yeah, you can't like, stay away from it, like oily stuff. And she's like, okay, by the way, my stomach would hurt if I eat fried food all the time. Yeah,
Isha 58:20 absolutely. So it's, it's interesting, like hearing like, just, what you guys how you guys were kind of like, problem solving. With that. I just find, because we were talking about like high stress jobs. I think one of the things that I noticed with everyone who's type one, is that there is this like, you figure it out. You know, I mean, like, it's it's actually like, a skill that I think not everyone has is just that mechanism to be like, Okay, this might be hard, but I'm still gonna figure it out. And I love that.
Scott Benner 58:47 Yeah, I think she's starting to finally get it too. Because when she was younger, and I'd say stuff like, well, it might be this. She'd be like, you're not even hurt. If you listen to her on the podcast recently. She's like, I haven't. Okay, she's like, you know, you're not Dr. House. And I was like, Well, I felt like it. And she goes, he goes like this. I know you did. And I said, Well, I was very proud of myself. But I think that can be annoying. But it's interesting how as soon as she went off to college, and she's by herself, it wasn't like, Oh, don't annoy me with your ideas about what was wrong. She's like, hey, what do you think is wrong here? I think she you know, she switched pretty quickly to being interested in what I thought was like,
Isha 59:24 okay, distance makes the heart grow fonder.
Scott Benner 59:28 I think I think it made her realize she was by herself. And she didn't want to be by herself. You know, like in the thought process even like course
Isha 59:35 and you probably start to look at things differently to like you recognize something may have been annoying because you had access to it all the time. But now you're like, oh my gosh, that was actually giving me insight to figure this out or like to find a solution. So I do think perspective.
Scott Benner 59:49 I'm also like, irritatingly consistent. So, when she I have to find this text from last night because I similar like I said, I saw her going down, she saw herself going down. She was taking care of it. And I said, I almost have it one second. I said, Hey, she goes, Why were you just calling me? I said, I'm checking on you. I don't like the way this drop looks. I said, it's all good. If it's all good, but don't forget, you know, that's it. And testing would be a good idea in this situation, I love you. And she goes, Dad, I know. And I responded, I know, you know, but I'm 13 hours away, and I'm going to worry. So please test your frickin blood sugar, and drink some juice. And I said, again, I love you. And then you know what she did, she tested her blood. She tested her blood sugar, and she sent me the number. So it was just, it was one of those. I mean, anybody who has a CGM knows, like, this wasn't just a fall, like we described earlier, she over I could tell just by the, by the the angle of the line that this wasn't stopping. And I don't know if she can see that yet. So I also said during the text, I was like, look at the I was like, bring up a three hour graph, look at the angle that line that and that line tells me if you don't do something, you're going to be 40. And even though you're 70 right now, and so I'm hoping she learns that stuff to through this experience.
Isha 1:01:19 I think in a lot of those skills, like relating it back to your home, it was work, it's I think all of the skills we get from being diabetic or living with someone who's type one or managing somebody's type one is there a lot of transferable skills that way that I think are so valuable, like so, so valuable, just being able to look at trends, like being able to kind of look two to three steps ahead and be like, Okay, this is going to happen if I do this.
Scott Benner 1:01:44 I understand how people who are maybe newly diagnosed are struggling, don't want to hear this. But diabetes teaches you so many things, like if you if you let yourself have the experiences that are really valuable in a ton of other ways in life, like it doesn't make your diabetes go away. But you do become much more agile
Isha 1:02:07 100% 100% Like Scott, one of the things in our household, like tooth, actually two things, let me backtrack a bit. One, I always struggle when people are like, diabetes doesn't define me. And I'm like, I get that, like, you are so much more than your diagnosis. But when people like it's not, it's not who I am, so much of who I am. And so much of my personality has been shaped by my experiences from being type one, or from my management or from my Outlook, or from just how I kind of navigate it on a day to day basis. Yeah, and a lot of the things we, in our household that we teach our kids are a lot of them are based on my experiences, like we always say in our household, like we can do hard things. Like just because something's hard doesn't mean we don't do it. You know, we always figure things out. Like it's free. It's hard, but we figure it out. There's always like, there's always a way to figure it out. Like that perseverance aspect. You know, like, you may know now that it's stress that impacts your blood sugar's maybe you have a drop in your stress. Now it's like, what are you doing over and over again, to figure out how to avoid that. So you don't have a dangerous low? Yeah. Or with my kids. It's like, okay, you don't get the first time. But we got to keep trying, like, you don't just stop after the first try.
Scott Benner 1:03:12 It forced me to, I'm sorry, cut you off. Good.
Isha 1:03:15 No, no, no, like, I'm just saying, there's so many things. It's why like when people kind of shy away from being like, oh, diabetes is not who I am. And like, but there's so many good things like obviously, you know, in a heartbeat, I would take it away from everyone and anyone but I mean, it really depends on the way you look at it. Like there's so much it teaches you. And there are things that I think that people in general value, you know, like they're valuable skill sets to have it or value to call it qualities.
Scott Benner 1:03:40 It's a big idea that I don't know that I have completely figured through. But diabetes forces you not to ignore things. And it forces you to learn about what's happening to you instead of just drifting through because the consequence, every time the consequence of diabetes of not paying attention is dying now or dying later, sooner than you should you know what I mean? Like, that's always the consequence of them being sick, dying, having like massive trouble. So you're always working to stop yourself from getting to that spot, which seems like dire and terrible. And I guess it is on some level, but I think it works well against human nature where there's something about people that's not in their own best interest. So I think you're born in this like, perfect, like little baby shell, right? And then we all have this kind of expectation that this perfection will last throughout life. And then every time something happens, that's not perfect. We get dinged by it really harshly. Yeah, but these things like, I don't know, I needed glasses when I was seven, or some kid called me fat when I was in eighth grade or like those little things like they're all in my mind. You start with whatever perfect is at 100%. And every time one of these little things happens. You get like a little chip comes off of your, of your perfect stone. You know what I mean? And you lose a little bit us a little bit, but you don't have to, I think we, sometimes we let the chip get taken away. And because you're like, Oh, I was supposed to have a perfect life, and it's not perfect. I'm not as tall as I wanted to be. I don't have as much money as I wanted. I didn't get to go to the school, I wanted to go to people don't talk to me the way I like and whatever it ends up being. But diabetes, if you're going to live well with diabetes, you're not you can't let that happen. Every time every time it dings. You, you have to put your hands up sort of like your friend at the duty free and be like, Oh, no, no, no, no, we're not
Isha 1:05:39 100% Yeah, 100%, my parents used to say to me, like, I remember when I was diagnosed. And I think once or twice, I just have a memory of kind of being annoyed about something. And my dad said to me, this is a good like, diabetes is a good excuse for you to take care of yourself. Some people don't have good excuses to take care of themselves, you do. So there are people who don't have diabetes, and they're in terrible health, because they have nothing to pay attention to, like everything you're paying attention to is just gonna make you better, you're gonna be more in tune with your body, you will be healthier than the average person. And I kind of like to think of it like that. Like, it's not all like rainbows and unicorns, it sucks sometimes for sure. But I really think if you kind of look at it from that perspective, it really changes the way you view these day to day like, chips that you were talking about.
Scott Benner 1:06:21 You were just so much more succinct than I was. But thank you, because I wasn't talking about words I couldn't think of so I don't know why it was so verbose. But it's because I think it's because I mean, your father was very smart. And I think it's 100%. True. I just think that there's something about people's desire for nothing to ever go wrong. That makes everything feel terrible. And so,
Isha 1:06:48 yeah, you're working towards something that's unattainable. Like, nobody's perfect. Right? You know, I mean, like, it's, I think it's just changing. I think it's more like, You got to view it on a day to day like, how, how much better can I get? Like, how much better can I get it at managing this? Or like, How can I do that in different way? That makes me feel better? Yeah, something, you know,
Scott Benner 1:07:10 no, I, I believe in it a lot. And I, for myself, personally, the way I talk to my family, you know, like, Okay, this didn't go right. But we're just gonna let it go. And we're not going to devolve into whatever, terrible, like sinkhole, this thing could pull you in if you let it. You know, it's almost like sometimes people throw themselves into the hole. Instead, instead of just walking around it. I guess. I don't know. And I don't think I think conscious, by the way.
Isha 1:07:39 I don't think so. Of course not. Yeah, not intentionally. No.
Scott Benner 1:07:42 Nobody's saying like, Oh, I give up. Let me just fall into this mud pit and be done. You know, I think it's just, oh, this thing went wrong. And I don't know how to fix it. That's the
Isha 1:07:52 hopelessness like you feel helped. I totally understand that too. Sometimes, like, if you don't know what to do, you feel like, this is how it is forever. Like, this sucks. And I'm stuck here. And I can't do anything about it. But I think if you take a few steps back, you recognize like, this sucks right now. But, you know, climate like you can pull yourself out of that hole. Like, let's try to climb out.
Scott Benner 1:08:13 Yeah, I also think to the secret to it is understanding that you don't know how to fix it. But that's not really the important part. Like, I know, I know that when I started making this podcast, I wouldn't have said this. But I I've had so many conversations with people with mental health struggles, that I think that giving voice to your struggle, I suppose that does sound like, like hippie dippie. But giving voice to your struggle really does alleviate it, like saying out and saying out loud. Something even if it's to yourself personally in your head or in a room that you know, this happens. It takes it away. I'll tell you. It cathartic. It just really is. And it lets you leave it behind. So that you can instead of like, instead of constantly thinking about it thinking about like, how do I fix this? How do I make this better? How do I make people like me? How do I make myself not feel so anxious? Like how do I like just accept that you're anxious and keep moving? Just accept that everybody doesn't like you and keep moving? And I don't know, I think you can leave those things behind on your path. And then look at the things in front of you. And all those things in front of you aren't going to be perfect. But again, you sidestep the ones that don't work for you and stick with the ones that do and
Isha 1:09:25 yeah, I think the big part of what you're saying is like, you got to keep moving. Like that's the inodes and it was hard and obviously like I feel for anyone who's been through anything that's tough, but I think when you put a label to something, it validates that it's real, right? Like it's a thing. It's not just something that's inside your head, it's something that you're actually dealing with and that's okay. Right. But you can keep going Yeah,
Scott Benner 1:09:45 that sucks. Keep going. That's pretty much it. And I listen, I recognize that everybody's in my situation like I am wearing clothes and I have food and I'm sheltered and things like that. Like I'm I hope nobody thinks that I'm saying You know, if you're homeless, just ignore it and keep going like that. No, of course not like and
Isha 1:10:04 it's, it's, it's it's like it's subject like, again, context is everything. Just to anyone listening, Scott is very in tune with everyone. So my we mean well,
Scott Benner 1:10:14 no, I think I think people get it you know what I mean? It's just obviously that advice doesn't work for everything. But I think it can work for things that burden you psychologically or about diabetes. Like in general, I think diabetes, I think diabetes can easily become a psychological burden, obviously. And so you have to figure out the parts of it that you can work with the parts of it that you can kind of control and the parts of it that you have to just kind of shrug and go. Alright, well, let's see if I can do about that. You start fighting, you start fighting their own battles, you'll be stuck fighting those battles forever, I think,
Isha 1:10:52 Oh, for sure. I actually like, yeah, I was going to mention because you were talking about the whole part of just keep moving or like, you know, trying to fit well, we were talking about trying to figure things out. I remember before listening to your podcast, I would have these like, there was a moment in time where I had these hills, like in my butt, like, you probably know, I'm talking about when you look at your CGM, and it's like, looks like little mountains. And I could never figure it out. And I was getting so upset. Like, this sucks. Like I don't, I think was my husband was like, Well, how are you going to solve that? Like, you just have to keep moving? You can't just sit there and complain about it. Like, is there something you can do? It's baby steps, like I started recording what I ate, and then kind of trying to find patterns. And of course, it came across a few episodes. And I think some screen like screenshots that people shared in your community group that were really helpful. So it's like any little bit you can do to help move yourself forward, even if it's just like an edge is still very, very, very important to kind of factor into progress.
Scott Benner 1:11:45 Yeah. No, I agree. It's, by the way, you about a couple of times you gave me I know.
Isha 1:11:50 I was like someone's gonna bring it up. Go away, everyone. Appreciate.
Scott Benner 1:11:53 I appreciate that. Thank you. It's, um, I don't know. It. Just enjoyed it. So do your parents find
Isha 1:11:59 you? Because do you do you see, I'm gonna ask you something. Because, like, so if you ever did, I don't think you have an accident. But I always find it amazing for like, oh, you say it like this? I'm like, I don't think I say like this because everyone around me says it like this. So it's fine. Oh, do you talk to people who just are not aware of accents? Or is everyone kind of just like, there's something wrong with your voice? Not mine?
Scott Benner 1:12:20 No, I don't think I think most people don't hear any difference in how people speak. Honestly, unless it's really like, I don't know, severe. But and you're like, You're interesting to me, because the abouts were just there was only two or three. And they were very slight. And if I didn't know you're Canadian, I might have like, I might have missed them. They weren't like really, like significant. So
Isha 1:12:49 a plus you have to go further eastern Canada.
Scott Benner 1:12:52 Well, you also have that weird blend. Like I'm trying to decide. Do your parents have Canadian accents or Indian?
Isha 1:12:57 My I'm like what you said sometimes you don't notice it? Like I don't think my parents do. But I think someone who might hear them from like, outside of the family might be like, yeah, there's an accent there a little bit. My mom, like my parents have been in Canada for such a long time. So I would, I don't know. So now I'm gonna record them and listen to them and be like, do you
Scott Benner 1:13:17 my my daughter's friend Santanna? Like, she's incredibly Americanized, but you can hear the Indian in her voice if she starts speaking quickly.
Isha 1:13:26 Yeah, I can see that. There's Listen, we all like our parents will rub off on us. Yeah,
Scott Benner 1:13:30 yeah, that's where you hear it with her when she's when her when her speech patterns picks up in speed. It quickly goes like that. But you just sound like you could be from anywhere from the sound. Okay, yeah,
Isha 1:13:42 I should have told you I was from a place that doesn't exist and see if you can figure that out.
Scott Benner 1:13:46 Or try to embarrass me that I don't know that Mesopotamia is not on the map anymore. So I'm actually I
Isha 1:13:51 will tell you a story. And I don't you can cut this out if it's like so it appropriate. But I think it's hilarious. Years ago, I had gone to Sarasota, and in Florida. And I was meeting some friends and I was at the hotel and and I was talking to someone there. And they're like, oh, what's your background? And I was like, I'm Indian. And this guy comes over. He's like, What tribe are you from? And I was like, why? And he was like, What tribe? You're like, no, no, like, my parents are from India. And for the longest time like he couldn't figure that out.
Scott Benner 1:14:18 Oh, he wanted to know if like you were Comanche or something like that.
Isha 1:14:21 Yeah, it was like he thought it was like it like, like, at like, it was native or average. And depending on where you are in America, it's us. First Nations are in and I was like, no, no, like, I had no idea where India was.
Scott Benner 1:14:36 Well, Florida is a special place. Yeah.
Isha 1:14:39 Like what are you talking about? I don't know why that made me think of that.
Scott Benner 1:14:42 Well, no, now that I know you're willing to talk about things like this. I have a last question before I let you go. How hard was it to get your husband's Jewish parents to be okay with this?
Isha 1:14:53 Oh my God, it was they were great. It was funny because it's actually quite sweet when we met. I was like, I don't don't have to work like my parents are from India, like it's very family oriented. They're gonna want to know who your parents are. And like, I don't know, it's work. So my husband like called my inlaws up at the time, it was like a wrap. We have some ages, parents are gonna do dinner. Me like major, our families, like, got to know each other. So my parents were more comfortable with it, his family, parents were totally fine. My parents were like, okay, and then, you know, after that, we were like, Oh, they're two different cultures, like, how are you gonna have this ceremony? So my husband, like, looked at a Hindu, Hindu? Like, it's not even a real thing?
Scott Benner 1:15:29 Is that what you just said?
Isha 1:15:32 Like Hindu customs and Jewish customs, and like, basically, we created ceremony together. So it was quite nice. kind of took a lot of effort to mold both our families together.
Scott Benner 1:15:42 Do you think I'd get in trouble if I called this episode Hindu? connait? Can Indians
Isha 1:15:47 Oh, my God, my, my hashtag for wedding was Hindu 2015.
Scott Benner 1:15:50 It's amazing. So your parents didn't everybody, nobody rubbed up against the cross cultural nature of it. It was okay.
Isha 1:15:58 I think at first, my parents were more again, like my parents came to Canada at a time, I think we're, you know, we don't, there's a lot more exposure now and knowledge and acceptance. But like, my parents hit certain things where people wouldn't give them a like, my dad's an aerospace engineer. And when he came here, like, couldn't get a job. Because again, like, if you weren't a certain, you know, skin color background, they weren't opportunities. And there's Yeah, and I think as a society, at least, we hope things are really progressed. And like my in laws are wonderful. My parents like love My in laws so much. And my husband's like, very protective over if anyone ever is kind of like racist, or just kind of gives pushback or anything. He's quite vocal about it. So we've kind of molded our families together really nicely. It's nice. Yeah, it's really nice.
Scott Benner 1:16:43 I only ask because I have a reasonably personal knowledge of a couple of Indian girls that we've known over the years who got pushed away from their boyfriends by their families. And I'm thinking of a couple, but I know one girl was not allowed to marry her Pakistani boyfriend. Like she could date him. And nobody said anything about it. But when it came time to, to get married, and I think
Isha 1:17:07 I think it exists and like, maybe I'll get like, I don't know if you'll actually play this part or not. But I don't know, use your judgment. But I mean, I think in every culture, there's always this protection of wanting to preserve your customs and traditions. And I think a lot of people feel that if you move away from that you're losing a sense of like years of ancestry and things like being passed down. And I think now, when I see it is like, people are raised differently. Like, I don't see someone and be like, Oh, they're this color in this background. I'm like, Oh, that's so and so like, great, right? Um, whereas they think, you know, a lot of the experiences that my parents generation or their generation went through really shaped their outlook in terms of why they feel that way. Like it was just something you do. Like, they also didn't have options like we have options now. Like you can date someone now who's have any background, any color, any age, whereas if you grew up elsewhere, like you didn't have those opportunities.
Scott Benner 1:18:01 No, I'm, I always think of it as a sad story. Like, I don't know, I'm sure her life turned out fine. I no idea. But I just remember in that moment, thinking, wow, like, she's got to break up with a person she loves now, like, that's it, it's time to get married. Stop seeing that, boy.
Isha 1:18:17 That's hard. And that's really hard. I know of a lot of things I would have my own experience with people who are like, can't be with you because you're, you're Indian, or you're you're not this you're not it's, I happen still a lot today. And I think every group, it is really sad.
Scott Benner 1:18:30 All very frankly. Yeah. And listen, diversity is important. And I'll tell you why. If for no other reason, I now know to get my eyebrows threaded, because of my because of my daughter's Indian friends. So and it's way better, just
Isha 1:18:47 so first off, I need to look at your eyebrows. Now. Second, I'm very impressed. Because not everyone knows about threading and it is a game changer with your eyebrows. So good on you, Scott.
Scott Benner 1:18:56 That's amazing. My daughter used to art nice to get waxed. And one day her friend was like, you really should just get threaded, a it's an insanely cheaper and be it's better. And so we
Isha 1:19:08 get hurt. It's like if you're not used to that someone would start screaming.
Scott Benner 1:19:11 Oh my God, he's just so artists like I'm gonna go I'm gonna try it while you drive me. It's before she had before she had a license. So I drove her to this place. And you know, we went in, and I will say the first time we went in, they looked at us like, why are there white people in here? It was very, are you here? Are you the right place? Okay, the pizza place is right over there. And you know, but like when she sat down, she got threaded. And she did it again. And again. She's like, can you take me to get thread and this became a thing we did together. And then one one day, one day, she's like, You should try it. Your eyebrows are terrible. And I was like, Okay, so I'm just you're a good sport. Oh my god, it hurts so bad.
Isha 1:19:51 Yeah, I was like, I'm impressed that you know what that is because not many people do. Second I'm impressed that you actually like went through it.
Scott Benner 1:19:59 Oh, it hurts so bad. that'd be like your eyes water and like afterwards you're like, Oh my God, but then you look at like, oh, they do look better. Okay, so then she'd go back. And I'd go back to we have little like punch cards, like if we go 10 times to get like a free one. And and then she like, it's one of the last things we did before she left for college.
Isha 1:20:18 So threading is like your thing. I wonder, like, I wonder if Arden like thinks of you anytime. So when gets threaded?
Scott Benner 1:20:24 Well, she's like, I don't know what I'm gonna do. When I'm down here. I think I found a place to go get threaded, I'm not sure. And I'm having the feeling like, I don't want to go without her.
Isha 1:20:31 Like, I'll be there in like, four days.
Scott Benner 1:20:35 I'll wait till you get home. We'll do it together. But yeah, it hurts less and less as time goes on. But if you skip, if you skip a couple of like, I don't know, weeks or whatever, and you come back, it's like, Alright, I'm ready. Go ahead, do it. It's absolutely amazing. Anyway, there's the end, by the way, you're getting charged like 30 or $40. If you're a person being waxed, like your lip and your brows, you're paying a lot of money for that. I think threading with a tip is like, eight or nine bucks. Like it's nothing. So
Isha 1:21:05 just so you know, Scott Funny enough, it started off that way. Like I haven't gotten my restaurant in forever, because I think they're just like permanently, like the way they were once they were sorting by and they people start to realize like, it's a desired method of like doing your eyebrows or whatever. And like you like, you can go some places and it's like, $25 I
Scott Benner 1:21:22 can't do that. Like,
Isha 1:21:24 I know. Okay, inflation. Well,
Scott Benner 1:21:27 I will fight against it. I'll pick it. Although I will tell you this one thing when we call to make an appointment. This is so delightful. We must like, literally we must be the only white people that come here. And so like we'll call I'll be like Hi. Like, I used to do it. Like I get a text from art and she'd be at school she'd like, I want to get my eyebrows started this afternoon. And somebody to answer the phone no big Hi. I'd like to come in and bring my daughter and for threading. And and the voice on the phone goes Arden and hike. Yes for art. And she goes okay, we will see her then I was like, Okay, great. And then I hang up the phone. I'm like, I have to be the only Caucasian person who calls here or I'm the only man. Oh, hey, Scott, what's up? Like, like, it got to the point where she got there. And it's in a different town than ours. And a woman's threading Arden and she goes, Do you know, this girl and she brings up a girl's name and and goes, Yeah, I go to high school with her. And she goes, How do you know, I know her. And so obviously what happened was they were together somewhere personally and privately. And they're like, hey, there's a white girl that comes in here and gets her eyebrows threaded. And her name's Arden and the girls like I know her. I go to high school with her. And that actually like Arden, she's it's just hilarious. So that is really funny. We're made home. Now we walk in, we're like, hello, everyone. And they're like, you're here. It's
Isha 1:22:44 like celebrities. They're
Scott Benner 1:22:45 like cheers almost. It's very funny. So anyway, I really appreciate you doing this. Is there anything we didn't talk about that we should have?
Isha 1:22:54 I'm probably so many things, Scott. But I probably will harass you at some point in the future. And I'll be like, Hey, I have things that I remembered. I forgot about.
Scott Benner 1:23:01 I had a wonderful time speaking with you. So
Isha 1:23:04 vice versa. Thank you for giving me a break from newborn life. It's amazing. But it's nice to be able to like use my brain a little bit.
Scott Benner 1:23:11 I'm sure it will come back eventually. Or it won't. There are times there are times when we look at Kelly and we're like, Oh, I think she she slipped over a hill she's not able to climb back up.
Isha 1:23:22 So I'll tell you a quick story quickly that I'll let you go when I had my first kid and everyone's like mommy brain is a real thing. I remember I took him to the family to his pediatrician appointment, and I came back to the car and the trunk was open. The passenger side door was open the front and see through and it was all open. Like I just left it there. And I was like, Oh no.
Scott Benner 1:23:40 My neighbor never closes their trunk. And that's my dad. One day I went over and I I just I couldn't take it anymore had been open for hours. And so I closed it the next time I saw him I said hey, I closed your trunk and he went why? I went it was open for hours because he I don't mind that I was like oh sorry. And then I realized he wasn't forgetful. He just was just didn't want to do he was just cool with this trunk being open. So I was like, Alright, well I won't do that again. I'm
Isha 1:24:06 sorry. Anyway, kind of thing to do though.
Scott Benner 1:24:09 I'm gonna go take out the place where you curse Do you know you're cursed one time? Did I really? Yeah, very small course. But
Isha 1:24:14 you did. I'm sorry. No,
Scott Benner 1:24:16 don't be sorry. i It surprised me that like in a bad way. Just
Isha 1:24:20 it's funny. A lot of people say that to me when I'm like Oh, I'm like I was swearing so much like I could never picture that from you and I was like, thank you but I don't know if I should say thank you for that.
Scott Benner 1:24:28 I am 5926 And you said so check that out and then we're I just set it at 121 So Alright cool. Hold on one second for me. After we got done recording Isha told me her a one C was six with her first pregnancy 5.5 with their second and with the help of the podcast 4.8 with her third pregnancy can Indian is a possibility for the podcast title and no, I can't do the other one. Can Indian it's close or For the love of a Timbit Well, I just thought you might enjoy hearing my notes to myself at the end of an episode. I want to thank Isha for coming on the show and sharing her terrific story with us. And I want to thank the contour next gen blood glucose meter contour next.com forward slash Juicebox Podcast our next is a great meter contour is a great sponsor. Check them out, would you please thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast
Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!
#922 Diabetes Myths: Poof It's Gone
A brand new series examining the myths surrounding diabetes.
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio - Radio Public, Amazon Alexa or wherever they get audio.
+ Click for EPISODE TRANSCRIPT
DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 00:00 Hello friends and welcome to episode 922 of the Juicebox Podcast Welcome back everybody, this is the fourth episode of the diabetes myth series. Today Jenny Smith and I are going to tackle the myth that your diabetes might just magically get better or disappear. While you're listening. Please remember that nothing you hear the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan are becoming bold with insulin. Now if you want incredibly comfortable joggers, shirts, sheets, towels scrunchies go to cozy earth.com and use the offer code juicebox at checkout to save 35% If you'd like to save 10% On your first month of therapy@betterhelp.com Just use the link betterhelp.com forward slash juicebox and if you want to get a free year supply of vitamin D and five free travel packs with your first order of ag one from athletic greens, use my link athletic greens.com forward slash juicebox. If you're looking for great community around type one type two or any kind of diabetes, you're looking for the private Facebook group Juicebox Podcast type one diabetes on Facebook this episode of The Juicebox Podcast is sponsored by the Dexcom G seven and Dexcom G six continuous glucose monitoring systems. Both are astonishingly accurate and fantastic to use. My daughter is currently wearing the g7 but she wore the G six for years. With great success. You could to Dex comm.com forward slash juicebox. If you have diabetes, you're not going to do better than wearing a Dexcom CGM. There are links in the show notes of your podcast player links at juicebox podcast.com. Links everywhere to Dexcom on the pod all the sponsors, please click on my links. It really does help the show dexcom.com forward slash juice box. Hey, Jenny, welcome back. We are going to do another diabetes myth series. Today's topic is that your diabetes will just of course, disappear, stabilize or in fact, just get better.
Jennifer Smith, CDE 02:33 When that's what's happened,
Scott Benner 02:35 Oh, it's coming. Don't worry if I had $1 for every time someone has told me that my four year old daughter diagnosed the two will grow out of being diabetic. I would in fact be rich. That's got to be the juvenile diabetes holdover. Right.
Jennifer Smith, CDE 02:51 I would expect so because actually, my my mom was told the same thing. She and my dad, I heard them having a conversation. I don't know it must have been within the year after I was diagnosed I had that I heard them having a conversation that uh, my mom was a teacher. And one of the teachers in her school said in discussion, well, you know, at least she'll grow out of it. Yeah. And my mom was like, so upset and talk to my dad. She's like, people just don't get it. She was just, like, completely overwhelmed with the fact that people aren't that dumb. Right. And I at when I was diagnosed, it was definitely still called juvenile diabetes. Right. I mean, it was type one too, but I think that is a holdover. Absolutely.
Scott Benner 03:36 Yeah. I mean, and now look, your story is 35 years old. And this is from somebody whose kids had diabetes for two years. I think, to me, the the real kind of desire I have for the myth series, is for you to maybe people to realize that this has got a lot less to do with diabetes and just a lot more to do with, you know, misinformation and correct
Jennifer Smith, CDE 03:59 misinformation. That is, as you just said, it's ages old. Why is it with all the new information? All the new technology and everything we have? Why is it still so misunderstood? Why are we still looking at diabetes management like it was in the 1970s or the 1980s? Even Yeah,
Scott Benner 04:19 because it's very human to jump to conclusions. That's why I had a person ask when my son's type one was going to be over. Oh, no, like like the flu right?
Jennifer Smith, CDE 04:33 The Oh, right. Like I've got a cold now, waiting for it to be over.
Scott Benner 04:37 When's it gonna kick this? Have you tried matzah ball Sue? Can you imagine? Well, it same thing right? My Type One did not magically disappear when I grew up. This is an adult said oh, somebody told me it was going to and it didn't. That's the part I find. Concerning like you You had to hear your parents have a conversation, where your mom was like, there are people who think that Jennifer's diabetes is gonna go away. And you probably heard that as a little kid, you were like, god damn right. It's gonna go away. Like, yeah, like, Yeah, let's go. And then the conversation keeps going, and your mom's like, it's not going to. And now you're like, oh, like, picked up and dropped and picked up and dropped. That sucks. Yeah, I was told my diabetes would get better, our son would just grow out of it. The quote is, you'll soon get sick of doing this whole insulin thing. We watched it a few months. Oh, wow. Let me start at the beginning and read it straight through. This is a quote, you'll soon get sick of doing the whole insulin thing in a few months, and you won't even bother with it anymore. Where's that? So that, so let's dig into the psyche of the person that said that.
Jennifer Smith, CDE 05:56 So is this. This is as if I got it, the person was told this or this is as if
Scott Benner 06:03 they were told this by an acquaintance by adequate. Yeah, so I got this one, though. I got this one. You can eat in a way with type two diabetes, where your blood sugars will be higher, and it will hurt your long term health. But it's not going to hurt you today, but meaning you're not going to fall over and die. So sure you could diet and exercise but just don't, you'll get tired of doing that. And then your life will be what it'll be sort of that. That very accepting, oh, he's got the sugars feeling like there's nothing, it's just the way that it is the way it is. You can't do anything about it. So then that gets translated to a person with type one. And they think that the effort, meaning instead of diet and exercise, the effort is insulin, but if you don't, you don't need to put in that effort. I mean, what are you trying to live forever? I think that's what I'm hearing. That's what I think I hear that. That's the thing to say to somebody. Oh, absolutely.
Jennifer Smith, CDE 07:02 Yeah. Either that or the person was just like, you're just getting get fed up with taking insulin, just stop taking it in that, that it'll just be what it is. I mean, that can be taken a lot of different ways.
Scott Benner 07:17 Oh, yeah. If I wasn't trying to be charitable towards what I think they were thinking, then you could easily take that and probably would, in fact, if you were just blindsided by it, as you'll probably just give up and die. Or let them talking about their kid. Yeah. Right. Yeah, I don't know where you're gonna go with that.
Jennifer Smith, CDE 07:33 I mean, again, please think before you say something to somebody, I can't reiterate. I like I can't say that enough. Just please think
Scott Benner 07:44 what if getting it, I don't want to be. I don't want to be like, I
Jennifer Smith, CDE 07:49 wish people without diabetes, were listening to this, like, I wish we could just blast this out, like right in the middle of a city and be like, listen, here.
Unknown Speaker 08:00 If you don't know anything about diabetes, please just dip your lips.
Scott Benner 08:04 Oh, I think just think is, is that because what I was gonna say is I don't want to be critical. But what if this is them thinking? You know, it's different rabbit hole, I don't want to go down. But everybody you bump into is not, you know, Einstein's birthday. So maybe they just don't understand. Again, with the juvenile diabetes thing. It's a great time to talk about how a lovely thing that was done, I think in the 70s ended up having such an unintended impact on things, just by calling it the Juvenile diabetes Research Foundation. You let people who didn't understand believe that you turn 18. And this goes away and probably bolstered by people's understanding of like gestational diabetes to
Jennifer Smith, CDE 08:53 could be it could also be that up until a certain point, and I don't know how many years ago, I would say that it has possibly gotten better. But you know, in the 60s 70s, maybe even the 80s. It was looked at as juvenile because that was the the time period of life that you could get type one, right? And after you reached adulthood, you could no longer get type one, you may still have diabetes, as a person diagnosed as a child, and now you're an adult with juvenile diabetes because that's when it was diagnosed. But I think people were misdiagnosed even eons ago as an adult with type two and they really had type one diabetes. And so at some point, you know, the JDRF I mean, it's still called the juveniles diabetes, right? But it is type one diabetes. There isn't a foundation like Got that I know is called type two.
Scott Benner 10:02 Yeah. Also, they try pretty hard not to use the word juvenile anymore to you really just the JDRF. It's yeah, for I think it's there for historical purposes. But, you know, it's funny, like, these next couple, you'll grow out of it, it'll end and then this word starts popping up. Don't worry, it just hasn't stabilized yet. That's another one. Like, like this person said, My I was in the hospital was told that when I got out of the hospital, they were in the hospital with DKA with a lot of diagnosis. And they were like, flat out told when it gets leveled out. It's fine. Don't worry, it just has to stabilize, even I don't even know like, and that's, it's a static void.
Jennifer Smith, CDE 10:44 It is because that's a that's a statement as if there is nothing the person has to do themselves in order for that stabilization to happen, right? You're just diagnosed this person sounds like was with Lada, right. And then they go home thinking, Well, I just have to wait for this magical like hour. Yeah, right. It's magical hour, when the insulin that they told me to take, it's just gonna start working the right way. It's almost like the magic wand idea, right? Like, at some point, this is just gonna work all the way that it's supposed to work, I'm gonna count my carbs, I'm gonna take my insulin the way they told me to take it, I'm gonna check my blood sugar. And it's just gonna even out and those of us with diabetes know that that's not me, there's a lot of work that we have to do to get to that stabilization point. And even once you get there, at some point, you're going to have to rethink to get to another stable point,
Scott Benner 11:48 well consider this. We're mostly talking about this from the perspective of somebody who has type one and is, you know, impacted by these statements. But but there are people who believe that who end up getting type one. And that's a completely different problem. And I have spoken to those people throughout my time, where they're just like, oh, you know, it's okay. It's not that bad. I don't have to, you know, I tested a couple times today, they, but they, you can hear them. They're not apathetic, they really don't understand. Right? Yeah. And they have it, where their, their kid has it, I there's a person the other day that came into the Facebook group, whose kid, the kids, like, they had a kid with type one. And the graph was just all over the place. But what struck me was the person said, I'm an adult who has type one diabetes. And I don't know what's happening. I thought, I don't understand, like, how do you not, I don't understand, like, like you. But there, it was, like, it just gets you to the idea that even the success they're having, they don't even know why they're having it. Like they couldn't make like simple meaning
Jennifer Smith, CDE 12:59 it's not translatable into helping the child because they don't know how the success they're having is actually being achieved. They
Scott Benner 13:06 really don't understand it yet. It's just weights working for them. So they don't think about it, then somebody else comes along, who obviously has different impacts and different variables affecting them. Smaller body size, and is a different state of life. Yeah, right. Well, that's, that's this here, you know, this person that says, multiple occasions, I've been told that my daughter will outgrow the condition a family friend, and an educator tried to explain to me that as she gets older, her body will just start to level out, and it won't be so crazy. So, you know,
Jennifer Smith, CDE 13:39 I Yeah. And to some degree, I think that the childhood years and the teen years and even college years, probably where there's still a lot of change, and growing and development and whatnot. I think that they are they're the least stable potential times for most people, because they're the growing years. That's the case. But as you grow into being an adult, there are I think, many more variables. And that could lead to a loss of stability to
Scott Benner 14:13 Yeah, no, I mean this, but you take it from the mother's perspective. She's sitting there thinking, I'm waiting for puberty, because I think this is going to mess everything up. And you're telling me don't worry if they get it. Now listen, I would tell you, if you asked me about a very little kid, I would say Well listen, as their body gets bigger. It gets a little easier to measure insulin. Yeah, that's got nothing to do with their, their age or things like magically like, I don't do people not understand science at all. Like Like, like the it'll stabilize, it's gonna balance like, what does that mean? It's gonna balance.
Jennifer Smith, CDE 14:50 We're, I think we're thinking about it too, from a perspective of long term understanding. Right? We We just know enough to be able to say that statement is Just so incorrect, like, balance really? Like?
Scott Benner 15:07 I've had several friends asked me if it will settle down. Don't worry, it should clear up after puberty somebody else was told houses diabetes, have the numbers leveled out yet? Oh, is her diabetes under control it just like these these go on and on and on? Oh, you should by the way, then the judgment comes you should have had this under control by now.
Jennifer Smith, CDE 15:26 Or what also comes in with this is people have heard or seen technology. Right? Don't you have this under control? Now? You got those fancy devices? Yeah. You put? Sure do.
Scott Benner 15:41 Yeah, I put the machine on and it all got fixed straight up, don't you worry. Push the button. And that was it. I saw. It's all better woman today is like, in the group. She's like, I don't understand. I'm on my fifth on the pod five, look how bad my blood sugars are. But not doing any of the things that you need to do. She just thought the magic machine was going to take care of what was
Jennifer Smith, CDE 16:02 going to take. And that's unfortunately, I think what a lot of people with or without diabetes who haven't had enough, enough information given to them about what the product that they're getting, will and will not do. And the fact that there is still interaction, you still have to know what you're telling it. Because this device is not a learning device. None of them are.
Scott Benner 16:29 Well, that's just Well, yeah, I don't know, there's a lot of misconceptions on both sides. This one here, I just this lovely this person says. I've just learned I just learned she said to say when somebody says how she doing has as she gotten her diabetes under control yet. She says I respond. Yep. Thank you so much for asking. Yeah, that's it, just like I don't like. What does it matter is I think that it's still like infuriating. And I mean, some of the terminology again, like settled down, you imagine,
Jennifer Smith, CDE 17:02 right, right. And I think to some degree, too, you have to look at the person who's asking. They wouldn't be asking if there wasn't some sense of care, no coming from their side, right? They really do want to know, they're just asking it in an absurd way. They're just like, not understanding.
Scott Benner 17:23 Yeah. And this person's response here gives you a lot of context for being on the other side of it. Like, she's like, I am making mental calculations forever. Like, sure. I've got my kids a one seat, like, amazing. Like, this lady really does this. She's saying the kids a one sees 4.9 She's got less than 2% lows. But that's a person who's putting a massive amount of effort into it. Right? And, and then just to have someone come along and say like, has it stabilized? You'd be like, oh, yeah, sure. It's stabilized. I sleep four hours a night. Thanks for asking. Oh, my gosh. Let's see. Not how it works, but blah. I hate this question. Does she have her diabetes under control? Yeah, it's just it's because you know what, it's funny. Jenny asked me if my daughter's diabetes is under control. You can make better decisions in the moment with the most accurate CGM on the market the Dexcom G seven dexcom.com. Forward slash juicebox. My daughter just moved to the g7 from the G six and she already loves the new smaller size and ease of use. You can learn more and get started today@dexcom.com forward slash juice box. Due to recent Medicare changes. Millions more people are now covered for the Dexcom CGM. The g7 is the smallest most accurate CGM system covered by Medicare. And it is easy to use and to get started with no other CGM system is more affordable than the Dexcom g7. For Medicare patients. The g7 is a simple to use system that delivers real time glucose numbers to your smartphone or your smartwatch. With no finger sticks required. Effortlessly see your glucose levels and where they're headed. So you can make smarter decisions about food and activity in the moment. This amazing tool is going to help you to take better control of your diabetes dexcom.com forward slash juice box whether you're looking for a brand new system, changing from another company, or looking to upgrade that G six dexcom.com forward slash juice box. The new G seven comes with a refreshed app that is just a delight to use. My daughter is 19 years old. She's been using index comm for well over a decade. It is at the core of how we make decisions about in Ceylan food activity. All of the variables that impact diabetes, check it out@dexcom.com forward slash juice box. There are links in the show notes of your podcast player and links at juicebox podcast.com to Dexcom. At all the sponsors when you click the links, you're supporting the podcast
Jennifer Smith, CDE 20:30 Yeah, what is your daughter's diabetes under control?
Scott Benner 20:34 Yeah, it is. Yeah. How about yours? Yes, yeah. So it also matters where you are. It isn't to say that Arden doesn't have a high blood sugar sometimes or a low blood sugar. Sometimes there have days where she's like, my periods coming and I can't, I can't see. Blah, blah, blah, and all that other stuff. But overall Arden's Okay, she is stable. And yeah, under control, like, but then you, you know, people I know, you know, people who the words under control or management, those words piss them off to no end. You know, yeah, it's because of the other things that these people are sharing that it's hard, and you're not seeing all the work that goes into making it under control, you know, quote, unquote, right? Yeah. I mean, if you really asked me to be specific with words, I would not use the words Ardens diabetes is under control. I would
Jennifer Smith, CDE 21:32 control control means you have the ultimate manage, you have the ultimate reins, right. It is entirely absolutely contained. There is no further issue. I also don't love the word control at all in terms of diabetes discussion. It's, it's a management strategy. Yeah.
Scott Benner 21:53 Yeah, but the real control the real answer to is Arden's blood sugar under control, the real answer is 15 minutes long. Get it? I mean, it's a it's a very complex answer that ends with so most of the time, things are very manageable. Manageable. Yes. And, and manageable is not a word. If I said to you, Jenny, how's your life going? And you said, it's manageable? That's not an exciting statement. That's not I was at the What's that a ball in where they all dress up? The Met Gala, you know? Oh, it's not it's not I was just at the Met Gala. It's, it's manageable is not is not an exciting way to describe your life. You know what I mean? And no, I
Jennifer Smith, CDE 22:41 it almost has a hint of it could be a lot better. Just making it. I'm just getting through. It's manageable.
Scott Benner 22:52 We haven't closed the garage door and listen to music yet. Yeah, we're trying. Oh, God, hey, when your kids teacher tells you don't worry, they're gonna grow out of it. That's fun. My 19 month old went into DKA. After dental surgery. The Secretary, the secretary called us while he was in the PICU, to see how he was doing and said, Don't worry, at least they'll grow out of it. Oh, yeah. 19 month old kid in the PICU. You're probably thinking, Oh, my baby's gonna die. And you got to hear from from the from. I got from the receptionist at the dental office who was probably told, please call all those people check on and make sure they know we care. You know what I mean? Yeah. And though, I wonder if you go back there for your dental work after that. chatty, do you know, Jenny says no shake. Oh, this is interesting. There. And we talked about this in the previous episode, this person was told, Well, if you have a normal a one, see you're cured.
Jennifer Smith, CDE 24:01 Oh, my goodness, I'll cure Oh, silver. Wow. Then I would I would expect that a fair number of your listeners are completely cured. I'm completely here. The people are all cured. It's all good. I mean, I can stop paying for products I can talk to the pharmacy. Yay.
Scott Benner 24:26 The next statement is from a person who was told well, if you're a one C is under control, that means you're in remission.
Jennifer Smith, CDE 24:33 Oh, where are these here? I don't understand. Hopefully, these are not medical practitioners telling these things.
Scott Benner 24:40 Keep in mind that these responses just came from me making a Facebook post that said, can you tell me some of the myths? misnomers have chairs that you've heard about diabetes and on? I didn't break it down by topics. No, I didn't say tell me this topic and this topic and this topic, the topics that we'll talk about Add an indication of what people mostly here posted. Yeah. And in. Also this post wasn't up for a month and a half. Like I had somebody mine these answers after about 18 hours late, like I was like, that's enough grab them, we can definitely use those in the episode. Yeah, yeah. It didn't end there
Jennifer Smith, CDE 25:17 were what was it? 52 pages of evidence, right.
Scott Benner 25:22 Yeah. And this is Isabel paring it down or ripping out like, like, she told me like, I took out all the duplicate answers, because that's the other thing is that she's like, you can start reading one person's answer and another person's answer. And she's like, they're just exactly the same. You know, these people have had the exact same experience with, in most cases, a loved one or a close personal friend or something like that.
Jennifer Smith, CDE 25:47 Yeah, I'd be curious. And I know that it wasn't, you can't filter it that way. But I would be really curious. How many people in the past? Let's call it two years, versus how many people who have had diabetes for a lengthy period of time? 10 plus years, right? What's the difference in the myths that people have heard more recently, versus those that they're pulling from memory? Like my memory of my parents talking about that is eons ago, right? versus how many people these are, these are still circulating types of,
Scott Benner 26:26 well, the cabinet, the pump ones got to be more like, hey, you've got the machine, right like that. That has to be to be more recent. Yeah, yeah. I wish that. Like, I don't have diabetes. But telling me hey, you have a CGM. So it must be so much easier. You have a pump, so it must be so much easier, is like saying, I don't know. Like, I'm, I don't know, like I'm being beaten by a gang in the street. But they played music in the background while it was happening. You like so wasn't it better that they were playing Marvin Gaye while they were kicking your ass? Like, I mean, I guess so. Like, but
Jennifer Smith, CDE 27:03 not yes, my ears were pleased. But
Scott Benner 27:05 I take your point, it was better than them not playing Marvin Gaye and kicking my ass little history. But I don't know why that is the thing you would say to somebody that that part is still like, I don't think I'm gonna get through this series and understand that part. And I tried. I talked to I talked to Erica, she talked to me like a really mentally stable, healthy person. And I was still like, I don't know those people. So I'm starting to think this is the last one, Jenny. Okay. She's not surprised, she says, but she thinks it's silly and frustrating to have to correct after being diagnosed as an adult. I was explaining to an old school friend, and she could not for the life of her understand that taking insulin wouldn't just cure me. She kept asking when I'd be able to stop, and when the insulin would make me better. And it took me ages to get her to understand. So that's that one, I think is simple, though. Like I think most people who haven't had a real, like a serious illness, right? Or something that's habitual in their life. Everything else that they get? You take the medicine and the medicine and
Jennifer Smith, CDE 28:20 it's all better. You feel great. Yeah.
Scott Benner 28:23 That one I almost just understand. Like, yeah,
Jennifer Smith, CDE 28:28 yeah. Although I think is simple. What I think is simple explanation should have been Is that Well, imagine if I took your pancreas out of your body or your I shouldn't say pancreas, I should say beta cells, right? What if I took your beta cells out of your body? Now your body no longer has the cells to make the insulin? Right? So what are you going to do about it? Well, I don't know. Right? You're gonna take insulin, which means that my body which now has destroyed beta cells, I have to keep taking insulin, because I keep eating. Right? I mean, doesn't that just make sense? To me, I
Scott Benner 29:10 add a more shocking example. Like if I said, If I said you, your lungs just stopped working. But we put a tube down your throat, and you were breathing again. You're not fixed. We've patched we've patched patch the issue? Exactly. We've given you enough of a crutch that you can go on. But let's not ignore the fact that there's a tube down your throat breathing for you, etc. Like, like, crack. Yeah, that's the I guess that is the harshness of it. I mean, for you, as someone with type one, like we've done three of these episodes now. Like what's the overall feeling you get when you hear this stuff? Is it sadness? Anger, like where does it strike you?
Jennifer Smith, CDE 30:00 I think that I am most, most sad, I guess, because there is such a lack of understanding. And that because diabetes, whether it's type one or type two, it's very invisible, right? It's invisible outside of the products and the technology and everything else that we wear on our bodies. So it could look to the outsider who has no understanding of life with diabetes, it could look to them as if we just have to do XY and Z. Or you just have to take this technology and put it on and use it. And then it's gonna be all all better for you. Right? Like there's a magic band aid for it. So it's sad to me that in this day and age, with the amount of information that circulates on the internet, that people still have these thoughts that are so old. And so lacking understanding,
Scott Benner 31:06 is that upsetting because you have to deal with it, or because you realize it's never going to end. Because it's not gonna end?
Jennifer Smith, CDE 31:14 I don't think so either. Yeah, at all. I mean, you can have you can have famous people on the Superbowl wearing their CGM. Right. And either people weren't watching, or they just think, Oh, great. That's new technology. And again, oh, the technology is doing it. Yeah. Fabulous. Right.
Scott Benner 31:32 Well, yeah, yeah. If we, and in fairness, media, social media in general, seeing someone in their best moment in five years, it's not a good way to judge them whether they have diabetes or not. But yeah, I mean, you see Nick Jonas, and he's handsome. And he's standing there gone. I have type one and your life on he's looking at him. I wish I was Nick Jonas. Must be okay. Must be fine. Yeah. Must be fine. I think the only
Jennifer Smith, CDE 32:00 mass and or it must take nothing to be an itch, baby. I mean, what I get from that? Watch the Super Bowl door. Did I ever? I don't even think Eagles
Scott Benner 32:09 won the Super Bowl last year, and you should have been watching. But go ahead. Yeah.
Jennifer Smith, CDE 32:13 Sorry about that. But I look at it, you know, there's this very famous person. And there are many famous people who have diabetes. But there's this famous person in Gosh, he's living a good life. He's just got this fancy technology. And he puts it out and look at he's still enjoying, he's doing his thing. He's living life. But they don't also see, they don't see the Nick Jonas at two o'clock in the morning, who's got a low blood sugar, right? Yeah, they don't see it, because the commercial highlights only the beautiful piece of his life. And it's funny
Scott Benner 32:49 too, because I see both sides of that, like, it can make people who don't understand diabetes, think exactly what you just said. But it could also take a bunch of people who have diabetes, get them to try that product. And what they would learn in my opinion is, wow, this is a lot better. Like, correct, yeah. And so you're marketing to them trying to get Listen, I am a person who might my life is very odd, like, I make this podcast to try to inform and help people, right. But I can't make it unless it pays my bills. And so like I have to a business thing on the other side of it. It is hard to get people to do things, even things that are really good for them. And I mean, the truth is, if you asked me if if I could get I don't know a 32nd commercial, Nick Jonas telling you to listen to the Juicebox Podcast, if I would take it, I absolutely would. I'd be like, Yeah, you got people over here so they can learn how to Pre-Bolus and etc, and so on. And so it's a weird, it's a weird split. Because I take both sides of that point, like very well, like it does leave people who don't understand what the feeling like, Oh, it must not be that bad. And then it leads to people saying things like, we've been going over? Well, they
Jennifer Smith, CDE 34:05 think there is, you know, many of them. There's so many of them now on television. I mean, we don't really even watch television, but when I do catch it, there's so much pharmacy based commercial. Yeah, on television these days that I can definitely say, from seeing other medications advertised. I don't. Because it's not affecting me and my life. I don't even pay attention to what they're talking about, right? I do a channel serve, or I go up, get up and go to the bathroom or something. I don't pay attention. So I see what you're saying in terms of marketing. When something like the commercial for Dexcom comes out. They are marketing to a hopeful group of people that will have will think that they need the product. Yeah, this isn't meant for the general public to see and be like, Well, gosh, I should probably Dexcom things right? They probably walked away and went and got more chips and salsa. I will
Scott Benner 35:09 make your point for you. I'm using weego V for weight loss right now we go via is just those Empik. Okay, yes rebranded for weight loss. I could sing the ozempic song for two years. And I didn't really know what it was, or care, but I was like, Oh, it was and I know this one. Like, you know.
Jennifer Smith, CDE 35:33 I don't even know that.
Scott Benner 35:35 I never I never looked up and thought, I wonder what ozempic is. And then people listening might be like, that's crazy. Scott, you have a diabetes podcast. But until I started seeing people talk about it in the space, I was like, oh, that's for diabetes. I didn't know Yes. And that's just true. Like, that's 100% True. I did not know what that was. And I could sing the song about it. So, you know, when a famous person stands up and goes, diabetes is hard, but and then the rest of it is a sales pitch. You forget the diabetes is hard part. So you're an outsider, you're not going to leave that going diabetes as hard. You're going to leave that going. Apparently, diabetes, isn't that bad? Because that kid's handsome.
Jennifer Smith, CDE 36:15 He's got right.
Scott Benner 36:17 Have you seen his ads? diabetes, Basal for you?
Unknown Speaker 36:20 Everybody knows him. So gosh, we're
Scott Benner 36:23 gonna remake this myths thing in five years. Somebody's gonna be like, I think diabetes gives you abs.
Jennifer Smith, CDE 36:30 That's all they're gonna take out.
Scott Benner 36:32 B, they're taken away from seeing Nick Jonas on TV. They'll be like, I think diabetes gives you abs. And then one day somebody will say it anyway. All right, Jenny, I appreciate you fighting through not feeling well. And doing this.
Jennifer Smith, CDE 36:44 Can I also say something? You have time for two seconds?
Scott Benner 36:48 Are we recording it? Yes. Okay, then. Yeah, come on. Like not for not recorded?
Jennifer Smith, CDE 36:55 Oh, no, no, no, we're recording this. It's just a simple thank you, honestly, to all of your listeners. Because of the really just wonderful, wonderful number of comments that I got for my diabetes anniversary. I'm just really, it was really kind of you to post something. And it was just, it was nice to hear all of the comments and, and everything. It just it kind of made my day. So I just wanted to thank everybody.
Scott Benner 37:21 That's wonderful. I'm sure they, they, they're all excited to hear that because they do love you. And I mean, it's Jenny's 35th anniversary today, you know, wish her well, if you want. It didn't stop for like two days. Did you go back to it? It kept going on?
Jennifer Smith, CDE 37:37 I did I went I mean, it was just all of the comments. So many different I mean, different comments to about things. And so yeah, it made me it just makes me smile. Thank you for your
Scott Benner 37:48 welcome. But you know why? Right? You understand or no?
Jennifer Smith, CDE 37:53 I, I guess I do understand. I mean, it makes me appreciate also, and I've told you this before, it just makes me appreciate the ability to connect with a community that I didn't have when I was growing up. Yeah, at all. I mean, I don't post or anything. I'm kind of a lurker. But it's it's a good connection. Even with the career that I have that's specific to diabetes. It's a really good personal connection to a community. That means a lot to me. So
Scott Benner 38:25 Well, I think that I think that one of the things that probably overwhelms people, I mean, you were celebrating your 35th year having diabetes. And you and I are sitting on a Friday afternoon doing this and you're sick, and I don't pay you for this. And you really do want to help people. And I do listen, I don't keep there's not much on my desk, but I want you to watch me, I'm just going to reach forward. All right. This is a thank you note you wrote me years ago, about the about the podcast, it's a Christmas note and just the you telling me what, what you were, what you thought of what I was doing and how it was helping people. And I just, I just keep it it's in front of me when I make the podcast like I see I see it all the time. Because yeah, no, because it would be easy to leave the space. Like you don't, you don't need this, like like, I mean, professionally, take that out for a second, you know how to take care of yourself. And yeah, and you and I know that the support is a big deal in the community is a big deal. But there's a lot of work and effort that goes into helping people. And, you know, I mean, we talked about a little earlier in this episode, right? Like it's not that easy to help people. Like you can have all the great information you want the barriers to it, getting to them to them finding you to use saying it in a way that they understand that they can actually put in a process and it's not easy. It's really difficult. And so When you get a note from someone on your birthday, or your diversionary or something like that, where they're telling you, you saved my kid's life, like, that's no small thing, like, oh, yeah, just to get to them, and then for them to actually take all this and put it into practice. And then it's huge. It's just, it's just, it's almost unlikely, you know, and that's why it's such a big deal. I had a converse, I have a lot of conversations about this podcast privately where I'm just trying to keep it going in the right direction and doing the right thing. And so I asked, I asked trusted people last night about just you and I, and like, how we get along together. And even that's completely just, it's random, Jenny, get any more like, it's completely random. Like, you know, I think that you and I equally bring something to these conversations that the other doesn't have. Yes, you know what I mean, and, and not just that, but like the simple things like we can, we can have a conversation and not talk over each other. True, there are people I talked to, I can't find, I can't find a rhythm with them. Like I try and I try and I'm like, I just can't find it. Like they can't find me. I can't find them. It just never works. It's always frustrating. And, and I mean, just think like, what did we say in that post about your diversity? The first time you were on the podcast was in 2015 15? I
Jennifer Smith, CDE 41:28 think Yeah. Yeah. That's a that's a, it was a I know, it was a long time ago. I feel like really, I looked at the date. And I was like, really? 2015 2023? Yes, I know. It was a long time ago.
Scott Benner 41:43 So it's well deserved for you, obviously. And I was happy to wish it to you in public and a place where I can tell you, you listen to everyone who has diabetes deserves to be celebrated like that. I mean, seriously, I really do agree. Yeah. But I mean, it just, it just makes a lot of sense to shout you out. That's for sure. I'm 35 years, Jennifer. That's pretty awesome. Don't you think?
Jennifer Smith, CDE 42:07 It is pretty awesome. I know. I still have I think he had my 25 I did the Joslin where they said do you like the metal, you know, and I still have it and the little letter that they send and everything. But I looked at it the other day, and I was like, I like 10 years behind. I didn't really feel kind of old. I was like, oh my god, like 10 years ago already? Yeah,
Scott Benner 42:29 it's not easy. It's not it is not easy at all. I just, I got on the scale this morning. To see how much weight I've lost. I am now down. Do you want to guess?
Jennifer Smith, CDE 42:40 Um, I have to remember the last time you told me I'm 15.
Scott Benner 42:45 I'm up to 18 pounds now. Wow. And I could not find any record of me being this low as like in the last five or so years? Because I would like Like you've heard me talk before. Like I did a baked potato diet one time. Does anybody know I did a big potato fast. One time it really worked. The tall magician. whichever one it is Penner Taylor is the tall one pen.
Jennifer Smith, CDE 43:11 It is I don't even know. I know the names, but I couldn't tell them apart.
Scott Benner 43:14 I one day was listening to him on a podcast. He's like I lost 100 pounds eating baked potatoes. I was like, Get out of here. I'll try that. And so I did it for as long as I could like muster. And I did lose weight. Like it was
Jennifer Smith, CDE 43:27 like it was just I'm curious about this. No, just potato. You couldn't put anything on it. It was just baked potato. And that's it. Yeah.
Scott Benner 43:34 Baked potato. And then I think you called it and then you rewarm and like, if you were to put salt and pepper on it, you were like cheating, if I remember. So, and I'll tell you what it works. It fills you up. You can't eat anymore, because it's the big potato. And it's particularly tasty. So it's not like you're like, oh, you know what I want more big.
Unknown Speaker 43:57 You are big.
Scott Benner 43:59 But that made me realize that, like, how many how many years have gone by even since I've done that? Right? It's really
Jennifer Smith, CDE 44:07 I remember the cabbage soup diet. My mom did the cabbage soup diet like eons ago. And I mean, there are lovely things in the cabbage soup recipe. But that's that's like all you ate was the cabbage soup.
Scott Benner 44:21 Didn't work. Do you remember it working?
Jennifer Smith, CDE 44:23 I do remember my mom. I do remember and she stuck with it for a fair amount of time but she clearly didn't. Long term. I mean, that's one of those things that when you find something that works great, but can you really can you really do this for the next 60 years? Yeah,
Scott Benner 44:40 handful of grass water and a little salt. No, thank you. That's not gonna that's not gonna anyway. Screw all that. That's awesome. Yeah. GLP is works but my point was the time has gone by like so quickly and without you noticing and I have to be honest, like when I saw that one because I had to go do it. I'm like, Oh, let me go. Find out the first time Jenny was on the podcast because I want to say like when when we first met, I was like, wow, that's insane. You know, so but yeah, it was
Jennifer Smith, CDE 45:08 a long time ago, well, and I look at all the episodes, the things that we've done, but the wealth of what you've provided for the community is, is not necessarily the education episodes. It's, I think, bringing a community of people together to, let's say, they they find the episode by doing a search for mental health. And your episode comes up because it includes some of the ones with Erica, right. And that, that's an in for somebody, they listen, and it makes sense. And there's a hint of diabetes in it. But the other piece is that it helps them on an on another level. Because we don't just live with diabetes, we live with all these other things in our life, right? And so then they look for more. And they say, Well, gosh, there's also these education pieces. And maybe I could listen to these I like this guy, like, oh, talks, like maybe I maybe I can get around doing something extra for myself and my diabetes. So I think it's, it's a welcoming place. And it's a place where you can say, I'm gonna pick and choose. And yeah, that was interesting. I'm going to learn more, I'm going to go to this episode, because it's got a touch of this as well. And I think that that's why it makes sense to so many people.
Scott Benner 46:23 I agree. I agree that especially that's very nice to have you, thank you. But I agree very much that you can't just say to somebody, listen to these 10. And it'll be okay. Like, people's minds just don't work that way. So you have to build this world that they come into, and then get lost in and then learn things mostly by mistake. You know, I said to somebody the other day, and I don't mind repeating it over and over again, part of me thinks my job is to almost trick you into taking care of yourself. You know what I mean? Like, it's a good way to bring you in, and like, here's some crazy conversation, and you leave it with a little more knowledge about yourself than you had. And yeah, it just really works. Like there's, there are episodes of this podcast, you can listen to an episode of this podcast where a young girl was diagnosed with type one diabetes on a heroin Bender, and you will learn something about your diabetes. That episode, she jumped out of her grandfather's window to score and while she was out passed out from decay, and it's Wow, one of the it's one of my most favorite conversations I've ever had. I mean that listen to that. Yeah. Oh, it's amazing. I just, I just did a search Jenny, your name, the word Jenny appears in 30 episode titles. And that is not all the episodes you're in. So you've just done quite a quite a lovely thing for all these people. So thank you for and for me, by the way, I should say that my understanding of diabetes is deeper and richer, because of you and my understanding of how to talk to people about it. Is just, I mean, you brought a lot to my life. So thank you very much. Thank you.
Jennifer Smith, CDE 48:01 Yeah, so that was very nice. Thank you.
Scott Benner 48:03 Try to try to do it for 35 more years. I got bills to pay. Okay. I mean, we, I mean, we want to help people. We want to help people. Yes, I'm just teasing. Hopefully people can hear the sarcasm. Happy 35th anniversary Jenny Jenny works at integrated diabetes.com You can hire her there. And thank you so much to Dexcom makers, the Dexcom G six and Dexcom G seven continuous glucose monitoring systems. dexcom.com forward slash juicebox. Looking for diabetes community Juicebox Podcast type one diabetes on Facebook is a great place to find it. And if you're enjoying the podcast, please share it with someone else who you think might also enjoy it. And leave a beautiful rating and review somewhere. Or I don't know just like yell out the window. I love the Juicebox Podcast but at the very least subscribe or follow in your podcast or audio app. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.
Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!