#1920 Jenna is 28 and Still Amazing
Jenna is 28 and Still Amazing
A ten-year follow-up neither Scott nor listeners saw coming: the guest from 2015’s “Jenna is 18 and Amazing” returns as a nutrition PhD student studying hospital food — and Scott doesn’t realize it until the final minutes.
Jump to a moment
- A ballet teacher caught what daily life hid. Jenna’s mom saw her every day — it was her dance teacher, whose brother had type 1, who said “she’s not okay” after watching her sit down mid-routine.
- She took charge at 13. With busy parents who gave her room, Jenna reasoned her way to fewer carbs, ran a roughly six-month honeymoon without insulin, and built the independent management style she still uses.
- “I was my own CGM.” Five years of 20 finger sticks a day before her first sensor — today she calls the CGM a godsend she can’t imagine living without, paired with Omnipod 5.
- Advocacy is a learned skill. Semester after semester of telling professors what she needed — and not settling for less — taught her to speak up, a habit she now applies everywhere, including first dates.
- Her dissertation targets hospital food. At Emory, Jenna is enrolling 80 inpatients to document nutrition and shared decision-making, chasing a startling statistic: roughly 25% of patients experience hospital-acquired malnutrition.
- Jenna is 18 and Amazing — Episode 34 — Jenna’s first appearance on the podcast, October 2015 — the episode this ten-year follow-up pays off.
- T1D Exchange Registry — US residents 18+ with type 1 can complete the survey and help move T1D research forward.
- The Diabetes Link (formerly College Diabetes Network) — The organization Jenna joined in college and served as a fellow with during her gap years.
- Small Sips — Bite-sized, listener-voted takeaways from the podcast on insulin timing, carbs, and balancing highs and lows.
Every word of the conversation
Cold open & sponsors0:00
Hello, friends, and welcome back to the Juice Box podcast. On today's episode of the podcast, there will be nothing that you should take as advice, medical or otherwise. So please please consult a physician before making any changes to your health care plan or becoming bold with insulin. The t one d exchange is looking for you. If you're a US resident, 18 and older, you have type one diabetes, please go to t1dexchange.org/juicebox and complete the survey.
If you do, you will be helping type one diabetes research to move forward. Thank you. I've got two OG sponsors for you today, Omnipod five and Dexcom. That's right. The episode that you're about to enjoy was brought to you today by dexcom and the DexCom g seven, the same CGM that my daughter wears.
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You'll find those links in the show notes of the podcast player you're listening in right now and at juiceboxpodcast.com. Testing. Testing. I'm recording my voice. How about you?
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Meet Jenna — sixteen years with type 12:17
Alright. Hi, I am Jenna. I've had type one diabetes for sixteen years now, and excited to talk more about my experience.
Sixteen years. And how old are you?
I am 28.
28. You've had diabetes for hold on a second. Since I'm doing it in my head. It's so you were 12?
Yes. 13.
13.
Thirteen. I think I'm, like, I'm coming up on sixteen.
Coming up on sixteen.
Maybe at the end of tail end of fifteen years. Wow.
That's an interesting time. 12, 13? Yeah. Yeah. Yeah.
It is.
I
mean, it's like it's one of those big transition times in life, and it is definitely interesting to walk into it with a chronic illness diagnosis.
So Yeah. Do you have any brothers or sisters?
Yes. I have a younger sister and an older brother. No one else with type one in the family.
Okay. Other autoimmune stuff for you or them?
I have hypothyroid, but it's not autoimmune.
Mhmm.
And no other autoimmune stuff in the family.
Are you take taking Synthroid or something equivalent?
Yep. Okay. Yeah.
And do you feel like that's managed pretty well?
Yes. It's much simpler to manage than type one.
I mean, are your are your levels where you want them to be? Are you having any symptoms?
No symptoms. No. I'm good on that front, thankfully.
Yeah. Were you diagnosed, as a child with that, or was it later?
That was about a year later.
About a year later. And you don't have kids. Right?
Very similar.
No. You know how I know that? How? There's a lightness in your voice. I'm not kidding.
That's hilarious. No. No. I'm not kidding. There's a I can tell you don't have children.
There's just that I don't know what happens, but you're but life just takes you down an octave after you've had to raise a kid. You just Wow. Well You can
I'll concern myself for Warren.
You can feel it in someone. You look around today. You you'll you'll see it real quickly. There's there's a lightness. It it says I don't have any real responsibilities, and I'm not worried if another person dies.
It's, it's some yeah. Yeah. That's something. Anyway, I knew immediately. I knew nothing about you.
I could tell as soon as you started talking. I was like, well, she doesn't have any kids.
That's so funny.
Yeah. And you're either not in a relationship or in pretty, like, lighthearted one that you're happy with.
I am not in a relationship.
Yeah. No.
Well, you're good, Scott.
Jenna, listen. It's a profession. It's a calling. You understand podcasting? It's not just it's just not just you don't just buy a microphone and you're a podcaster.
That's so funny.
Trust me. I know what's going on. Alright. Let's see what else I can figure out. What were the first signs of type one?
What got you and your family to a position?
First symptoms at dance camp5:17
I was I was seeing rhythmics gymnastics at the time, and I I think the first symptom was drinking a ton of water. So it was summer camp, and I remember noticing that I was drinking a ton of water, but I thought that it was just, you know, I'm in summer camp, and I'm very active.
Yeah.
But then I started to lose weight. And then a couple months later, I was super, super tired, and then I was just falling asleep in the car, which it like, I'm not a napper. That's not normal for me.
Like an old you're like an old man on the sofa when you're, like, 13? Just nodding out everywhere? Gotcha. Okay.
Exactly.
I'm that old man. By the way, can I say I tried to stay up and watch something with my son the other night, and I just feel this, like, hand on my chest like this? He goes, are you asleep? I was like, it's after It's after midnight.
After midnight, that's definitely fair.
I thought it was fair. Okay. I'm sorry. So you're peeing, drinking, falling asleep. Keep going.
Mhmm. And I think it was actually I was in ballet at the time too. Was actually my ballet teacher who told my mom, like, she is not okay. Like, there's something wrong. And her brother actually also had type one.
Mhmm. I don't think she suspected type one, but she was basically who queued my mom into, like I think it's hard because my mom saw me every day. You know? She wasn't picking up on the changes as much. But I was like, we would do we would be doing some sort of dance routine, and I would just have to sit down.
Okay.
And my teacher was like, she's not okay. And then I also remember having a really bad heartburn, which I had never had before. So I
was gonna say it's not a thing, you know, a thing you usually hear a 12 year old talk about. Right?
Right. Yeah.
When when you say rhythmic gymnastics, am I talking about, like, ribbons on sticks? Or
Yes.
Yes. I got the right thing?
Yep. You got it.
Gotcha. You got it. Do you still dance as an adult?
No. I don't. I would like to get back into it, but I have not yet.
Is there a way for kid or for adults to do that?
Not rhythmic like, most adults don't do rhythmic tronastics because it's quite intense.
Because they you have break your old ass trying to do that. You know? Yeah. That
that would be tough. But I did baller and dance Oh. Later in my teenage years, and that's something I could do as an adult, which I think would be really fun.
Okay.
I haven't I haven't gotten back into it yet. I did do some swing dancing Wait.
What what
couple years Yeah.
What got you out of, like, all of that? Was it just age, or did diabetes slow you down?
With the
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Yeah. After I was I don't think ballet or rhythmic gymnastics was what, like, I truly loved.
Okay.
And so when I was diagnosed with type one, I think it did kinda set me on a different path in life in general.
How so?
And, well, it it definitely, made me much more focused on health. And, like, now I'm now I'm studying nutrition, and that's a whole another story that we can get into.
But Yeah.
I became very focused on my health and very interested in, like, psychology and the human condition and things like that. Okay. And I think so I think it's just kind of like
You pivoted a
little bit. Yeah. Yeah. I pivoted a little bit.
So is it fair to say that, you know, you were involved in these things as a child, and maybe it's something even your parents put you into or you had an interest in when you were younger. And then all of a sudden, when something slaps you in the face and your life shifted, you you cut away the things that didn't feel important to you?
Yes.
Yeah. Exactly. What happened? Okay. Well, that's interesting.
What was it like I'm so sorry. I know we've only been talking for five minutes, but, did you have a period when you were diagnosed, or does the thing you developed into type one ended that overlap with, like, any kind of a honeymoon? Or like, I'm looking for how you handled hormones through that time.
A six-month honeymoon without insulin11:41
I had a honeymoon period for I actually had quite a long honeymoon period. So it was maybe, like, six months or so when I did not use insulin at all.
At all?
Yeah.
Okay.
At all. And I think I I very quickly also went on to a ketogenic diet, and so I think that helped a lot with that. But I had, like, a very unusual experience with the honeymoon period, and it's pretty long.
Okay. Well, I wanna hear about that, but I first, let me ask you. Who how'd you get to a keto diet? Like, did is that a thing your parents figured out or you?
A 13-year-old takes the reins12:32
That was something that, I think my parents queued me into a little bit. I was mostly, I was mostly the one in charge, though, so to speak, because parents were pretty busy with work. And I I guess I was interested in taking care of it to a certain extent. I mean, I guess I would have to be to have taken the reins. But I think I just use a very simple logic of, like, well, if I eat fewer carbs, I need less insulin.
That led you to that idea.
Yeah. So that would make sense.
Is that a thing you still do today?
Now I eat let's see. It's basically like a low carb diet except for I add fruit because that gives me energy just like having some of those sugars Okay. In my system. But I I still don't eat any, like, grains or wheat or things like that. So
And that's just to keep the carbs down. It's not because you have celiac or anything like that.
Yeah. I mean, I don't I don't have celiac. I've been tested for it. I don't have celiac, I also don't feel good when I eat grains. Like, it gives me brain fog.
It makes me bloated. It makes me very insulin resistant. So it just it's never worked well for
me.
Okay. I don't know why, but because of that, I've always stayed away from
Avoided it.
From it.
Oh, it's yeah. Smart. It's cool. It's interesting that you figured it out as a kid too, you and you stuck to it like that. It's pretty cool.
Your parents were busy with work. Can we, like, pivot for a half a second? Was that bothersome to you? Did you need help and felt alone, or we did you feel comfortable? And if so, were you actually having good outcomes, or were you just having the outcomes of a 13 year old who was trying?
I I think it was overall good because I kind of learned how to take care of it myself really young, and that's always been my personality. Like, I'm very independent and like, to understand things myself and take charge of situations in general. And I don't think it would have worked well if my parents were, like, telling me what to do.
Is it would would that would that, give me some insight into the rest of your life with your parents, or was it just around the diabetes that you would have felt that way?
I think that would be true overall, but my parents are very good at not
Doing that.
Not, like, interjecting a lot. They give me a lot of freedom with
Is that
what I do
in a time. Is that because you pushed back so much that they learned, or are they just, like, into? It sounds like you might have beat them into submission. Is that was is that what happened? I
think no. Not quite. I mean, I have had some disagreements with them when there are when they have strong opinions because I also have strong opinions. But, in general, they have really given me a lot of freedom and flexibility to do kind of whatever I want, and I think that works really well.
Yeah. Can you talk a little bit about what it meant to you as a kid to have them listen to you and and kinda follow your lead a little bit?
Yeah. I guess, let's see. My mom has been the main one who has been involved in the type one management.
Mhmm.
I think, overall, I've I've always erred on the side of being, like, overly cautious with my management. And just because, like, my health is super important to me, of course, and I wanna be healthy as long as possible. And so I always really wanted to have my glucose numbers, like, as tight as possible. And I think that my my issue in relation to type one has always been more, like, being overly anxious about it, like, overly cautious, overly anxious. And so my mom in particular has been super great at, you know, helping me feel like, you know, it's okay.
Like, it's okay if your blood sugar goes into the two hundreds every once in a while.
Jenna, are you anxious in general?
I would say so. I would
say so.
Would say so.
Looking back, yeah, perhaps. Yeah. So your mom's not. Is your dad? Or is your mom, but she's just good at telling you it's okay?
I think that's a good question.
Oh, I know.
Don't worry. I don't think my either my parents are that anxious. I'm probably more anxious than both my parents.
How about your sister or your brother?
I I still think I'm more anxious than they are.
You win? I'm a I win, Scott.
I think I win.
I'm the winner.
I think I win on the anxiety front.
And you're the only one with type one?
Yeah.
Your anybody else have Hashimoto's or or I'm sorry. Hypothyroidism in your family?
My sister also has hypothyroid.
Okay. Is she anxious at all?
Not I wouldn't say, like, intensely.
Not intensely. Okay.
Alright. Yeah. Yeah. Like a normal level.
What is what's a normal level of anxiety?
I'd like you know.
I'd like you to describe that. That's awesome. Okay. So I I get I think I get the vibe, but your parents were a little hands off. You were doing a good job.
Were you a good student too?
Homeschool, then the shock of college18:42
Yeah. I wasn't I wasn't all that, like, interested in school until college. I was homeschooled in high school. Really?
Yes. Do you prefer that, or did you had you have you ever gone to public school? Private?
I did not go to I was not in the public school system at all until college.
Oh, wow. What what was that like making that shift?
It was very shocking. Very shocking to the system. It was it was really it was hard. It was a hard transition. I was at a private school when I was younger, so really young, like preschool and grade years.
I went to the Washington Waldorf School in Bethesda, Maryland, and it was very much, like, focused on the arts and nature and things like that. It was very wholesome and very nice. And then I was I was homeschooled all throughout the rest of middle school and high school. And it was I think it was really good for me, especially in relation to type one because I really got to focus on my health I'm figuring that out.
Yeah.
And then when I went to college, I had I already kind of had it figured out. And, I mean, as much as you can ever figure out type one,
but Yeah.
It was much
more in the
background.
You knew what you were doing in the background, all that stuff. Was this shift to homeschooling, was that religious, political, like, situational? Do why did that was that just how your parents grew up? Like, how does that happen?
Well, it happened because my sister and I were doing rhythmic gymnastics when we were young, and, my one of my teachers one time got upset that I didn't do my homework in, like, fifth grade or something like that. And it was because I was at a gymnastics competition over the weekend. And she just she kind of disciplined me about it, and I don't think my mom loved it. And so
so mom said Okay. Oh, you're not doing that. I'll just teach the kids myself for the next seven years.
Yeah. Exactly.
So this is why you and your mom have disagreements sometimes when you said strong opinions. That's, I mean, that's a fairly do know what I mean? That would be like be like if I tried to park at the grocery store and I somebody, like, stole my spot, and I was like, that's it. I'm not eating anymore. I'll show all of you.
That's a big that's a big that's a big move. I would love to hear that from your mom's perspective. I bet you there was she probably was pissed for a while about something. It might have put her over the edge. It's awesome.
I think the school we went to when we were young is very much, like, in your early years, they tried to have it not focused on, like, doing homework and
Okay.
More focused on being outside and things like that. So I think my mom probably wanted to preserve some of that. So
Sounds like she did. And and Yeah. And you Absolutely. And you headed off to college with a real firm idea of how to manage your diabetes, and then you have that shock. I can you just tell me one thing?
Because you're like, it was very shocking. What's one thing about getting to college that really hit you in the face?
I think I just kinda felt like I was all of a sudden in this huge system that I had never experienced. And I I just I think if you're used to that growing up, like, you don't it's probably not shocking, but for me, it was like, oh my god. I'm in a class of now thousands of people. I really have to, you know, look out for myself, get help when I need it. Like, there's there's just like this
Everything about the way it everything about the way it works was just different for you.
Yeah.
Yeah.
Yeah. And it was much more like I don't know. I mean
Did you enjoy it?
I did end up loving college. I mean, I found I found smaller communities within college where and that's how I got into research and some teaching and stuff like that. But, my first semester and maybe my first year was very, very much a shock to the system. I I had to adjust a lot.
Were you isolated?
I think a little bit because I went into college as a transfer student also because I was doing some community college on the side. Mhmm. And so
Little behind, didn't come in with a group, like that whole thing.
Yeah.
Yeah. Yeah. Hey. Did you maintain the person you are there, or did or is there, like, some crazy shift? Like, you know, some people get out of private school and, like, they cut their hair or grow their hair or do something crazy or, like, just start smoking or do you know what I mean?
Like, did or or you just did you just kept keep being Jenna?
I just kept being myself, but I very much kept to myself. So I think that's part of how that happened. I mean, I in college, I was literally always in my apartment or in the library studying. Studying. I was yeah.
Okay. Well, you sound, that's where I would want my kid, by the way, just hidden somewhere. But then you you like you said, you found your community branch down. Then what did you end up doing through college, and is that still what you're doing now as an adult?
Nutritional science, NIH, and a PhD24:35
Yeah. I majored in nutritional science, and I also did some research on the side. So I was in a in a lab studying viruses, and then I was doing some research on the gut microbiome brain access, which was really cool. Interesting. I really enjoyed that work.
Yeah. And
I was thinking that I would go to medical school after college, but then I found like, I just found this passion for what I was doing in college, which was really research and learning and teaching. And I thought, you know, I shouldn't let this go if I love it so much. And so then I did a couple more years of research at the National Institutes of Health in their post baccalaureate program, and then I decided to do a PhD in nutrition, which is where I am now. So
You're working on your PhD right now?
I'm working on my PhD right now.
Jenna, have you ever had a job?
I am
not really so jealous. I'm so jealous. Let me just be jealous for a second, though. Oh my god. It's awesome.
I've been a student for such a long time.
Do you think you'll I mean, is it a thing that like, how do you how do you like, for people listening who don't understand that, like, is how do you finance your life during this?
Well, I guess I'm just very lucky with family support.
Nice. And then I hear what you're saying. Dad got bags. Yeah. Is that what you're telling me?
We're good? And then as
a PhD student, you do got a little bit of a stipend.
Oh, wow. What do you think how how do you believe this will all culminate one day? Like, is there something like, what have you learned? What are you interested in? How do you think you'll point it at the world eventually?
Who do you think you are? It's a
great question.
It's a great question. Jenna's like, better figure it out. I'm 28.
Studying hospital food and malnutrition26:43
Yeah. Yeah. I I I do not know exactly how I'm going to point it. Yeah. I am doing my dissertation work on diabetes care in the hospital.
Mhmm.
Collecting data on nutrition in the hospital and shared decision making, which is part of person centered care. So that's kind of where my focus is right now, which I like. I I love being involved in diabetes research, and I've always kind of tried to give myself the space to not go into diabetes.
Mhmm.
But it always keeps coming back all throughout college. Like, in college, I did the College Diabetes Network.
Oh, they're awesome.
Yeah. Yeah. They're great. And then I did their fellowship in my gap years, and I did diabetes camp, and it's just been a continuous thread. So I I would love to stay in the diabetes space, but we'll see what happens.
Super interesting. How long did it take to collect the data about nutrition in the hospital? Eight minutes? Because there's
I'm still doing it.
No. Is I mean, what are you learning besides the food in hospital seems terrible?
So we haven't analyzed the data yet. I can't like, from seeing what they're serving in the hospital, yeah, it's very it's not ideal. No. But I started the study in November, and we're still collecting data. I enrolled the fiftieth person yesterday.
So Wow.
We're enrolling 80 people in that study.
Just to to and what's the goal of the study? Is it just to collect data and then you figure out what the data tells you afterwards, or does it have a specific goal?
So, yeah, the goal is really to just figure out what is actually, like, happening in the hospital because, right, there's not good there's there's data that says there's mountain there's hospital acquired malnutrition, and I think the latest statistic is around twenty five percent, which is really shockingly high.
But
there's no data on, like, why that's happening or how that's happening.
Can I float a theory? Is it because they're buying crappy food?
Yeah. I mean, I'm sure, but, like, there's no the thing about research is you have to show everything to change it.
I gotcha. So Well, then once you have that research, can you pressure hospital systems to do a better job? Like, how does the like, what's the back end of this world like? Like, you know what I mean? Like, once you have the information like, there's a I have a feeling sometimes that people put all this effort into something, then they publish the paper, and they go, well, there it is.
Do something with it, then nothing happens with it.
Yeah.
Yeah. Like, what
No. That is a huge problem with research.
Yeah. Like, so do you, like how do you, like, go into the like, as an example, like, you know, diabetes type two, for example. Like, people I've watched my mom in the hospital with type two or prediabetes, and everything they gave her was ridiculous. Yeah. And so, like, do you I don't know.
Like, do you how do like, do you go to the ADA? Do you say, hey. We've got this research? Like, I just wonder about, like, how do you and if you're not the person to answer that question, like, how do you meet a person who understands the other side of this, who can, like, take the research and go out in the world and, you know, use it as a cudgel and bang it over people's heads till they make changes?
Yeah. I think that's what I'm trying I mean, it's it's that's definitely something that our group is really trying to do, like, make sure that all the research turns into changes that are Yeah. Useful for people.
Action or something that somebody's using at least to make a decision down the road. I mean, it can't look. I'm just guessing, but I don't imagine the hospital believes that they're buying super healthy food and they're just being they're confused about it. In your research, they'll go, oh, no. We didn't know.
Sorry. You you know, like so it's gotta be about money. It's gotta be about
Yeah.
Preparation, about storage. Like, I'm imagining it's that stuff. Also, hospitals are, you know, don't think they're really what we imagine them to be, most of them. They're, you know, they're money making systems, and they they they have a product, and the product is trying to make you better. So Right.
You know, it's it's really sad. Have you ever had to be in the hospital yourself?
Thankfully, I haven't been in the hospital since I was diagnosed.
Nice.
I'm lucky in
that respect. Well so, like, when you can you make any pronouncements about what you see? Like, think about like like, let's take your professional life and kinda stick it in the background for a second. You're a type one. You've been living with type one for sixteen years.
You are you having great outcomes? Is do you have a one c's in the fives? Are you like, is your weight where you want it to be? You're metabolically healthy?
Yeah. Yeah. I am I am gratefully you know? I mean, I've I'm healthy. And my a one c has been in the fives and sixes for years.
I mean, I I don't I think I had some sevens and eights after I was diagnosed Yeah.
I imagine.
The most part.
Yeah. But what's your what's your as an adult now, the way you're living today, tell me a little bit about your setup. Are you using technology? How are you eating? And, you know, what would you if if you bumped into another type one and they were like, look, Jenna, you can't hurt my feelings.
Tell me what to do. Like, how would you talk about it to people?
Her setup today: Omnipod 5, Dexcom, “keto plus fruit”32:33
So I use the Omnipod five, and I'm still using the Jack Dexcom g six, although
Not much longer. Soon.
Yeah. Not much longer. But the g six for me is, like, I I just prefer the trend line and stuff, but I will have to switch to g seven soon. But, yeah, I use Omnipod five and Dexcom. And I I think for me, nutrition is a super important part of my daily management.
And so I basically eat like a I would I would call it a ketogenic diet plus fruit. Mhmm. And for me, that works really well because it keeps the insulin resistance down. And I find when I eat grains and stuff, I just go high and stay high and it gets very sticky and it takes a lot of insulin to get down. And then once it does get down, I crash.
To me, it's just a whole disaster. It it doesn't work well for my body.
Okay.
I don't know if that would help everyone. You know? Like, I think it's really hard to give other people advice because
Yeah. I
think it could super
Jenna, I don't even give people movie reviews because I just assume they don't like the same stuff I do. Yeah. But but but Yeah. So interestingly enough then, so if you're saying that you can't tell people like, this is what I do, Go do it, and you'll be okay. What can they do to figure out what will work for them to give them similar outcomes?
I I mean, I just I would eat foods and see how it impacted things. If it wasn't in a way that I liked, I would avoid them. You know? I mean and I'm not perfect by any means. Like, you know, if I'm out with people or this or that, like, I might eat something that doesn't go perfectly.
But in general, I try to, like, tell myself, you know, okay. If it's on a daily basis type of thing and the meals that I'm eating on my own are going to be the ones that are, like, as good as possible for my health.
Can I ask a question about your can I ask a question about your eating?
Yeah.
Are there any things you're not eating right now because they don't work well for your diabetes or even how you feel that you're just in the back of your head like, god. I want one of those. Like, are you are you limiting yourself in a way that's uncomfortable but necessary? Or has it you know what I mean? Or has it changed for you?
Is it not a thing you think about anymore?
I think it's turned into a thing where I prefer the way that I feel Mhmm. And can function to such an extent with the way that I eat that I don't I don't want that stuff anymore. That kinda messes me up.
Yeah. Do you I I have to tell you. I've I I might have I I think I've lost track now, but I might have been on a GLP for, like, three years now. And Okay. I think that is one of the absolute, like, gifts that it has given me that now I can look at a at a food item and say, I know that's not gonna go well for me and not be tortured by it.
And, yeah, torture is maybe a heavy word, but not, like, give in and just have it because I like it or because it's there or something like that. Like, I will walk past food I like because it just doesn't feel like a good decision, and it does not feel like a burden. But I think in the past, it I would have had that feeling of, like, oh, something got, like, taken from me, if that makes sense. Yeah. But you just have that naturally?
Interesting.
I guess so.
Yeah. You don't know because it's just how you are. You should test yourself, see if your GLP levels are naturally high. Are GLP levels a thing? Somebody get in there and figure that out.
What do you, I mean, how is all this GLP medication impacting your research and your livelihood? Because it's fundamentally changing how people eat.
Yeah.
Yeah. Are you bumping into it? Is it is it is it interesting, valuable, problematic for what you're trying to do?
It is. It is. Well, I don't know. I'm not that focused on it, honestly, because No. Okay.
I'm more focused on the, like, what is being, given to people in the hospital. And I guess medication stuff isn't as interesting to me in general. And I I think that would be because my research is mostly on, like, the nutrition content of the food in the hospital. But I think that if I were more looking at, you know, like, what people are choosing to eat and not choosing to eat, that would be a much larger consideration.
Yeah. Okay. So it's interesting, actually, because I'm wondering if the GLPs I mean, there are now people in the hospital. Right? They get sick for other reasons.
They're on GLPs, and they probably haven't been eating a certain way. But then they all everyone at the at the moment, like, standard of care is, like, they make you stop taking it for most stuff that you go into the hospital for. And Mhmm. I want but I it's interesting to me. Like, if you don't have context for it, I'm thinking of a of a hospital like Trey.
Right? And right now, Scott, on day three of his shot, I don't think I could, like, stomach any of that. And I don't mean, like, it would make me sick. Think I'd look at it and be like, I'd prefer not to eat this. Right?
But if you took me off of that for a week or two threw it in front of me, I'd probably be like, oh, chocolate pudding. Like, you you know what I mean? And I and it would I wonder if there are people in the hospital who are, like, in there having lived one way, but now all of a sudden another way. And I wonder if that will drag them back in that direction when they leave or I mean, I don't know. It's not a question you can answer, but it is just interesting to think that, you know, like I don't know.
How like, I guess, let me ask you this. Like, what's the average hospital hospital stay for a person? How long is somebody average in the hospital for?
That really depends on why they're in and what's going on. I mean, like, if someone's waiting for a procedure, like a surgery or something like that, they'll be in longer. You know, if they're if, you know, they have something that requires, they wait for dialysis or I don't know. There are there are so many variables that impact that, and that's actually a very tricky part of doing inpatient research studies because my study has a requirement that they're in the study for two to ten days, and it can be really difficult to gauge, like, the the one day it might be saying they'll be in for four more days and then they end up, know, plans change and they're discharged the next day or they end up staying for ten days. Like, it's very variable, and it's it's a little it's a very tricky part of inpatient research studies.
Oh, no kidding. Yeah. I mean, it doesn't sound easy. How many people in your like, you have, like, a group of people doing this?
Yeah. So our group is maybe around, like immediate group is maybe around seven to eight or so people. But for my dissertation research right now, it's mostly me doing it. I have one of the postdoctoral researchers was helping me a couple months back, but now we have a lot of other studies going on.
And Mhmm.
So it's a it's a relatively small group, but then there's also a ton of collaboration. So that's that's kind of expands the number of people are that are involved, but those here are, you know, like, on the ground and doing the data collection as a smaller number of people.
I see. I wanna ask you in a second, I'd like to ask you about you wrote in your note about, how how you learn to advocate for yourself, and I wanna hear about the ways that that came up. But I'm gonna ask one last question about your research first thing and because based on what you just said about how the collaboration works, how much, if at all, are you using AI models to help you?
With the research right now, Not much. I do we are looking into, you know, like, AI to detect macronutrient content of food. That's kind of a big thing right now and maybe making some twists on that and developing a sort of app or something like that. But right now, not much.
But even the back end work about, like, keeping keeping everything straight or being able to query your own research or using it for any of that?
No. No? Not right now. I think in the, the electronic health record system, it's you know, they're very protective over
Oh, what you can attach it to. I see. Oh, oh,
oh, yeah. Yeah. There's a lot of, like, PHI considerations when, of course, when you're working with people. So it's you have to be really, really careful.
Tell people PHI? PHI means?
Protected health information.
Okay. Okay. So so I'm I'm pivoting here. But, like, what what happened in your past that you thought, like, I have to advocate for myself or I'm not gonna get what I want?
Learning to advocate for herself42:12
I think that I learned a lot of that through I think through college was a big time for that for me when I was getting accommodations and talking to professors about it and just going through that process, I think, every semester with every professor, you know Mhmm. Emailing them and sitting down with them and telling them what I need. And, you know, of course, you have to, be willing to tell them what you need and not settle for anything less than what you need. And I think that was a really good experience for me.
I see. Just just having to, like, have the conversation. I have type one diabetes. This is what it might entail. I could use help here.
Did anybody ever push back? Say, well, I don't care if you have type one diabetes. Too bad.
I can't remember any experiences like that. No. It was great. I mean, I they were really, really awesome, and I would usually take my exams in the testing center where, you know, I could I could have access to whatever I needed. I think that having access to a phone with the CGM was always a little bit you know, people would ask about it, of course, which is understandable, but, I never got a ton of pushback on it.
Yeah. They were they worried you're gonna cheat. Right?
Probably. I mean, if you have access to an iPhone.
Yeah. And, Jenna, you would never cheat. Tell them.
I would never.
Of course not. This was didn't have to look at me. I was never going
to cheat.
Oh my god. What do you have you lived with and without a CGM or no? Have you always had one?
Five years as her own CGM44:09
I didn't have a CGM for the first five years, which is now looking back, I have no idea how I did it. I mean, I would poke myself, like, 20 times per day. It was
Yeah.
It was very intense.
Yeah. No. Because you were taking, like, really careful care. You were younger. You were on your own, and so you were creating your own data points even then with your blood sugars.
Yeah.
Yeah.
And I I I always joke around with people that I was, like, my own CGM.
Yeah. No. I know. I you know, we actually one time, it was during COVID. You know, everybody did this.
But during COVID, I would do, like, weekly Zooms with people. And at one point, they got a like, there's, 300 people in there. It was crazy. And this one lady, I don't remember her name, she was like, I I only have a meter. And we had her, like, draw out a graph and then just plot her blood sugars, and then she connected the lines.
And I'm like, it's not perfect, but it gives you an idea of which way your blood sugars are moving. And it was really helpful. It was, like, super helpful for her. Like, she came back the next week, and she's like, hey. That made a big difference.
I was like, awesome. But yeah. I mean, CGM I mean, it's another level, right, of of being able to see you know, get ahead of stop things before they happen. I mean, it's such a big deal. I I really hope that Yeah.
I I you know, I was listening to an interview with Lilly's CEO the other day where he he was talking about GLPs, but he was talking about that what he would like to do is get it to, like, more scale. Like, he's like, I don't know if he means what he said, but he was like, I don't need to make as much money on it. I need to get it more hands was the idea. And I thought, boy, I would love if if some diabetes device manufacturers thought like that. Like, maybe we can take a little less for it, but make the money up on, you know, on selling more of it.
That kind of thing. I don't know enough about business to know how to do that. But, boy, you know, you know, just imagine not have imagine if I came and took it from you right now. Like, how would that change your life today?
The CGM?
Yeah. I just come back. I go, you can't have it anymore, Jenna. There's no more CGM for you. What I mean, you lose your automation.
You lose all of your reference points. Your a one c probably goes up a point, I would imagine, and adds a ton more work to your life. Right?
I mean, I rely on the CGM, like, in a way where I cannot even imagine living my day to day life without it. It's it's a godsend. I mean, especially with sleep and, you know, my mom still follows me and being you know, running around on the hospital floors and, like, I just I have to have it. And then, yeah, with AID, I mean
Yeah. You just don't wanna lose it. You know what I mean? It's so awesome. Yeah.
Yeah. I was just thinking now. Like, Arden went out last night, so I'm I'm I I haven't looked. But did try to imagine. Like, I mean, she's 22.
Don't get me wrong. But she went out last night. I think, you know, she went to a club. She went with friends. Like, you know, like, she's, you know, she's out for a while.
I think she got home maybe around midnight or so. And I'm looking here. She got a little low before she left, and then she ate dinner around 06:30 or 07:00. And since then and now it's 10:00 in the morning. Her blood sugar's 71.
It has not been under 70 or over a 110 in the last sixteen hours. Wow. You know what I mean? Like and that's all just technology, really. It's it's Yeah.
Algorithms and CGMs and it's a it's just it's a it's astonishing how good it is.
No. It's so it's it's incredible. I mean, that's what allows it to be much more background for me these days too. I mean, part of the reason why I think homeschooling was good and, you know, it's great for my health is at the time, I was doing finger sticks and pen injections. And so, I mean, that just requires so much more oversight than having AID and
Oh, please.
You know, a CGM.
Oh my gosh. Hey. Yeah.
Thinking
about nutrition. So I don't know if you've ever heard it, but, like, Jenny and I like, Jenny's a CDCS, and she's got type one for, like, thirty eight years. Right? And she's a nutritionist too. I or whatever She I don't know.
She's RD, registered dietitian maybe. Mhmm. Sorry, Jenny. I've only known her for, like, fifteen years. I'll I'll commit it to memory eventually.
But but, you know, we've been doing these, like, bolus four episodes recently where it's a thing I avoided for a long time, but people are always like, just want you to tell me how to bolus for this. And, you know, so we kind of talk we talk our way through it. But as we talk our way through it, you know, we're picking through the nutrition of these items, like, online while we're doing it. And a lot of food is astonishingly horrible. Like like Yeah.
Really, like, genuinely. Like, I don't know. Like, sometimes I'll read the ingredients. Like, I don't know what any of this is. Like, any of it.
Or they're they sound like chemicals or, you know, binding agents or thickeners and stuff like that. It's just crazy. Right? Yeah. But my takeaway has been that, generally, I don't think that's what people think.
Like, you know what I mean? Like, when somebody takes a I usually say ho ho because I think it's funny. But when, like, someone takes a ho ho and takes a bite of it, I don't think that they're thinking, I'm eating thickeners and shelf stabilizers and colors and chemicals. And I know this is wrong and really unhealthy for me, but damn it. I'm just gonna do it anyway.
Like, I don't think that's I don't think that's how it works. So, like Yeah. I find myself thinking all the time. I don't know you have an answer to this because I don't either. It's like, I wonder how you could, like, meaningfully help people to understand what it is that they're fueling themselves with.
And if and even if they knew if that would would make a change for them or I mean, is it gonna take something like a GLP to change, like, the population's, like, addiction to, like, some of these foods? Do have thoughts about any of that?
Addictive food, access, and produce prescriptions50:34
I mean, this I actually think about this a lot because it's it's it's a big impediment to people eating well, like the addictiveness of food. These foods are designed to be addictive. And, like, how do you fight that? Especially because a lot of the foods that are very processed and have a lot of ingredients that could be harmful to people are less expensive
Yeah.
And more available. And it just creates a situation where it's extremely difficult to know how to, help people eat better because a lot of it comes down to access because eating well is really expensive and inconvenient because it takes time, and money and stuff like that. So I I think that there needs to be way better nutrition education just to start. Like, that should be a part of education schools
Yeah. For sure. I I just I don't feel like it's going to be. Like, there's gotta be you're gonna have to reach people at a certain age before it's just, like, ingrained in you. Like, because look.
Yeah. I mean, listen. You you you have family events at holidays. Everybody does. And there's some stuff at these events, like, you know, when you start mixing your family, like, when you, you know, you get, you know, married or something, you end up at some, you know, some guy's house for Thanksgiving, and someone brings into the room I'll tell you the one thing that shocked me.
Sweet potatoes with marshmallows melted over top of it at Thanksgiving. Like, as an ex and as an example, like, someone brought that in like Simba. They were like, like, the it's here. You know? And everybody's like, And I was like, what is that?
Did you melt marshmallows on food? And, like, you know, like, they're just one of those things where I was like, and no disrespect to anybody if that's what they do or anything. My point is is that they grew up with it. They think it's an imperative almost. Like, not Thanksgiving if we don't if we don't soak sweet potatoes, a generally healthy food, in brown sugar and then melt marshmallows over top of it.
If we don't do that, then then the pilgrims lost. Like, is is you know, is that it's what did they do any of this for? And and so when you, you know what I mean? Like, when someone starts a thing and makes it part of your life, like, imagine Jenna comes on and goes, oh, don't eat those. They're gonna be like, go to hell.
It's Thanksgiving. And and I don't know that it's ever done on purpose. Like, I again, I don't think someone made the sweet potatoes with marshmallows and went, I'm gonna poison my family. Just like when my mom Right. Went to the to the dollar grocery store because we were broke and would buy a canister, and canister is the right word for it, of powder.
And then she'd mix it with a gallon of water and be like, here's your juice. Or it or they'd call it fruit juice or lemonade or something like that. And then, you know, like, you were supposed to put, like, I don't know, 10 scoops in for a gallon, but, you know, it was sweeter if you put in 12. And then, like, and then that just sat in my refrigerator for my whole life. And every time you were thirsty, that's what you drank.
You you know what I mean? If you go find my mom, Jenna, and say, hey. Did you know you were poisoning, Scott? She'd say, no. I bought it said, like, real fruit juice on the front of it.
Like, I swear to you, I don't think it's a thing she did on purpose.
Oh, for sure not. Yeah. No. It's what's it's what's accessible, and it's also very cultural and
Yeah. You know. It's just it's Social. I don't like you're beating it is what I'm saying. I I'm listen.
I'm I'm on board. Like, I've said it before. I'll say it again. I sprayed the GLP out of planes. Like, just just put it on everybody and and and give them a month of not, like, wanting that stuff and see if it does for them what it's done for me and a lot of other people, which is just, like, really I I can't I can't say it's rewired me because I I have not been off of it.
I wouldn't know what happened if I stopped taking it for a month. Like, if a month from now, I would just be like, I'm gonna eat a bag of jelly beans now. Like, I don't know. You you know what I mean? But I don't know.
I I just I wonder if there's an actual, like, pathway that goes education, you know, more stability financially for food. Like, that sounds nice. Like, it sounds academic. It doesn't sound real world to me.
Mhmm.
You know what I mean? Like, I don't know. But but maybe you'll figure it out. Is it gonna be you?
Yeah. It's very tricky. It's very tricky. I mean, there's a lot to work through. And if nutrition is always difficult because it's it's so cultural and
Yeah. No. For sure.
And then it's comfort and everything. But I think there I think there really is room. And, like, for example, produce prescription programs are a super great thing. I are you familiar with them at all?
I've heard those words, but if you explain it to me, I would appreciate it.
Yeah. So it's basically where people's doctors essentially can give them prescriptions to get a box of produce every week.
Oh.
And they're becoming more widespread. And when you talk to people who are in these programs, they really like it. Like, they they love having access to more produce. And so I think that people like it. It just needs to be prioritized at a higher level.
Mhmm.
And then, you know, there will be more access to that type of thing, and I'll be able to help people more.
That's what I said. Yeah. As long as they don't put brown sugar on the sweet potatoes that comes in the
Exactly.
I mean, honestly. Exactly. Brown sugar and marshmallows. Think about it. Sugar sugar and then a different sugar.
Like, we'll just put it on the potatoes. So what's the point? Just eat the marshmallows for god's sakes. Yeah. You pass it.
Come across that dish at Thanksgiving. I don't know that I've ever had it, but I have seen it.
Yeah. I know. Listen. I'm not a Philistine. I've I've eaten some crappy food in my life.
But, like, that was just one that, like, I'm using it as an example, did not exist in my life. And then I went to someone else's house and, you know, the the, you know, the takeaway was, like, this is this is Mecca right here. Like, we don't have Thanksgiving if this doesn't exist. I was like, oh, okay.
Well, exactly. That that's the cultural component. You know?
Yeah. Like, it's You know those crappy sorry for everybody who's there's, like, the, like, the the the you know, the the rolls that come in the roll and you crack them open and they expand?
Yes.
Yeah. Jenna's like, I know them. I don't eat them. But, like yeah. Yeah.
But, like and then there's some that are, like, more like cinnamon buns. They come with icing. Right? Mhmm. Yep.
The way my wife grew up, it was not the morning of a holiday if they didn't exist. Like, that was a treat in her life. And so now once we're married and have kids, like, well, we you know, it's Christmas morning. Like, we need to have these, like, poison bombs on Christmas morning. And then and then and they are tasty.
Like, I'm not gonna say otherwise. They're not a high quality, like, tasty, but, like, it's sugary and sweet and etcetera. And then Art now Artin has diabetes. You know? And every morning on Christmas, I'm, like, pre bolusing, like, while she's asleep and cooking the muffin things that when it comes out, I can actually, like, intersect the insulin with the the hit from the stuff.
And and I became really good at it. But point being is it would have been way way cooler if we didn't do it, but we couldn't stop doing it because it was like telling my wife it wasn't Christmas. It's really interesting. She's a bright lady. I if you met my wife and if you met my wife, talked to her for three hours, and then I told you that story about her, you'd be flabbergasted.
You'd be like, that intelligent woman thinks this about these muffins, but it's how she it's beaten into her head from growing up. You know?
Yeah. Yeah. Yeah. No. I know.
It's tricky. I actually feel kinda bad for my siblings because after I was diagnosed, Christmas completely changed for us. My my mom was very adamant that we would do much less sugar. You know?
They probably looked at you like, that's the girl that killed it right there. She ruined it for everybody.
It was like we made a lot of changes right away and you know? So
We we you were happy about them. Everybody wasn't?
I don't know. Like, I don't feel I don't remember having a strong opinion about it at the time. Now, of course, I'm grateful for it. But Yeah. At the time, I don't remember having a super strong opinion about it.
And I I always used nutrition as a way to help myself through diabetes. So I think I just kind of saw what they do were doing and thought, okay. I should I should focus more on nutrition.
Has the diabetes been difficult for you over the years? And if so, in what ways?
I think yeah. I think that, of course, there's some anxiety associated with it. I don't know that it's more anxiety than you would really expect. I mean, if you're asking someone to live with a chronic illness that requires a lot of monitoring, I think it's normal to have some anxiety with that. So I think for me, it's probably mostly been a stress thing.
Like, I'm certainly carry more stress than I would otherwise.
Mhmm.
Although, I think it's hard to kind of parse it apart at the same time because I think it also gives me a lot more perspectives, and then I'm less stressed about small things. And so I don't know.
I I overall. I Yeah.
Go ahead.
I I I take your point being that, like, I don't freak out about little stuff anymore. Like, I feel like I've I feel like I've I've said before, I feel like I have the perspective of, a 100 year old person because of the diet because of the diabetes. You're like you're like, you know, something something other people freak out about. I'm like, oh my god. I don't even have the time to be upset about that.
So Yeah. Yeah. It it does that for you. But, also, what I'm hearing you say is that, like, the the focus is ramped up, and this isn't maybe how you would be living your life if it wasn't for diabetes. Or do you think you would've do you think this is who you are and you just would've pointed this at something else if it wasn't type one?
I don't think I would be as focused on, like, my goals to help people if it weren't for being diagnosed with type one. Like, it just I felt like I was a little bit lost. I mean, granted, I was, like, 13, but I don't remember having a super strong kind of focal point. I think it's giving me a stronger focal point in life in general
Yeah.
And a lot more perspective.
And that's a positive that's a positive for you. You don't feel like you were dragged down a path you wouldn't have chosen? You just you feel happy that it kinda showed it to you and you were drawn towards it?
Yes. Yeah. I do. I I'm really I'm really happy with what I'm doing right now. Nice.
So yeah. And, of course, it's it's challenging to live with in many ways, but, you know, there are also ways that it makes the rest of life less stressful. I don't know. It's it's interesting. I I it's very I always think type one impacts every single part of life, so it's hard to parse apart what's type one, what's life, what's me.
Because it's all the same it's all the same thing at
this Yeah.
Kinda gives you one hand takes from the other too. Yeah. Yeah. Has it you said you're not dating right now. Is that a type one thing?
Is that a time thing, or is that a preference?
Dating with type 1 — bring it up early1:03:07
I think that's a time thing. I've just been, like, so focused on school for the past, I don't know, eight years or something.
Gina. Eight years? When's the last time you were on a date when I had a good time?
I go on dates. I go on dates.
You do? But Okay. You do those
me now.
You do it the way the kids do it nowadays?
Yes. Oh, absolutely.
You just swipe, and then you show up somewhere and you're like, you don't seem like you're gonna murder me and then you stay? That kind of thing? Is that about it?
That's about it.
Are you in are you in the DC area?
No. I'm in Atlanta.
Oh, you're in Atlanta? Yes. I was just there. I did a talk I did a talk for touch by type one there. Yeah.
Yeah. Yeah.
Nice. Nice. Yeah.
I my my son lived there for a year.
Oh, okay.
Yeah. And so you're at school there? Will you tell me what school you're at, or would you prefer not to say?
I'm at Emory. Emory University.
Oh, okay. Awesome. It's about to get hot there. You're gonna be alright?
I love the heat.
Oh, nice. Oh, you're I love the heat.
Here. Yeah. That's perfect. Yeah.
You think you'll stay there even after school?
We will see. We will see. I am not quite sure. I do really like it here, so I would I would be very happy to stay, but I'll have to I'll have I'll have to see what's going on at that point. I'll probably graduate in a year or two and then figure it out.
Let me ask you a very Atlanta specific question. Do you ignore the boys with the bottle of water, or do you buy them? Or do you not drive in Atlanta?
I ignore.
I do I do too. I look away. I feel better. Yeah. I think it's because they're holding a single bottle, and I'm like, I don't know.
Doesn't seem like it's in a package.
That's fair. That's That's fair. Fair.
No. By the way, I've seen the most horrendous traffic I've ever seen in my life is in Atlanta. And I once saw someone in a four wheel drive vehicle get annoyed at the pace of traffic, And they wanted to go from the middle lane to the left lane, but they went too soon, too fast, cut it too late, and drove up and over the back end of a small car. Leaving that car dis I swear to you, it all happened right in front Leaving that car disabled, they got in the left lane, zoomed away. About 200 feet later, I realized there was an officer in the middle.
I pulled over and I said, hey. I just I pointed. I was like, I just watched that truck hit that car back there. They're disabled, and you could get them. And I'd be happy to be a witness.
And he looked at me and he goes, not my job.
And I
and I was like, okay.
I know. The driving in Atlanta is crazy. And I kind of I'm lucky in that I don't drive that much, like, everything. I live very close to work and everything, but Atlanta does have a reputation for its traffic.
I mean, it's been my experience, and I was there going off a a number of times for a year. Also, there's that little open air mall where the theater is. You know what I mean? Like, that big AMC theater, and it's sort of like, am I
What area is that in?
It's right I mean, it's right near where they made The Walking Dead. That's all I know.
I think I know. I think I know what you're talking about.
Anyway, I like it. I think it's nice there.
Although, maybe not. I'm not sure. I like I feel like I only know school and the hospitals here.
No kidding. How long have you been there? How long have you been there? Jen, did I lose you? Oh, we lost her.
She's she's there, but she's not there.
Oh, sorry.
There you go. You're back.
One second.
You're fine. Can
you hear me?
Yeah. I can.
Okay. Yeah. Sorry. I got a call and everything went
a bit. That's okay. How long have you been in Atlanta?
I moved here in twenty twenty three, to start my program. So it's been about three years now.
Okay. Alright. Well, I want you I want you out in the world more meeting people, but, if that happens eventually are you interested in having kids, and do you ever think about them having type one, if so?
Yeah. I do like kids, and I guess it yeah. I I've thought about it, but it doesn't deter me. I don't know. Like, I what can you do at a certain point?
You know? I mean
You just gotta live.
Right? Do, yeah, if I do have kids with type one, at least I know how to manage it.
Yeah. No. I hear that. Do do Yeah. Put do when people okay.
So I have one last question for you, then I'll make sure I've covered what you wanna talk about, and I'll let you go. So when you date people and you meet them for the first time, you're not sure if you're ever gonna see them again. Do even tell them about the diabetes?
It usually comes up in conversation just because it's so tied into what I do.
Okay. And you're at a meal sometimes when this is happening too. Right?
Yeah.
Yeah. Now do coin flip, and I'm not trying to make it sound like you're going out with a ton of people, but, like, for every 10 people that you have a first date with, how many of them do you think go, oh, I'm not interested after they hear that? Does it shut some people off?
I don't know, but I you know, that's one reason why I like to bring it up early.
Yeah. Just you don't wanna
Because yeah. I mean, if someone has an issue with that, then I need to know ASAP.
So you don't waste time? Right. Yeah. Yeah. Gotcha.
Yeah. And then are there some people who over mother it? Do they do they get too interested too fast? You know, like, hey. Hey.
Hey. Easy. It's kinda private. I don't really mind it if someone has a lot of interest in it. So You wouldn't notice it that way.
Yeah. But, also, I don't
think I've had that experience too much. Most people are pretty pretty respectful about it.
So That's awesome. Yeah. That's cool. Well, I I always help people. Like, I think when you find somebody who really gets it, is interested, it's not off putting to them.
Like, that's a good indication you might be with a a reasonable person. You know? So Right.
Yeah. It's a good it's a good screening tool.
Awesome. Oh, it's it's pretty cool. Is there anything that I didn't ask you that I should have or anything that didn't come up that you'd be disappointed later when you think back on this?
No. I think we just about covered it.
Did you have a good time? Yeah. That was awesome. Oh, cool. Well, I'm glad.
Thank you. What made you reach out? Do you listen to podcast?
The reveal: Jenna was episode 341:10:02
I was on it when I was 18. And then, yeah, and then we were we did this, like, you know, ten year follow-up.
Jenna, how did you not mention that the entire time we were talking? What episode were you on when you were 18?
Oh my gosh. Which episode was it? Let me see. 35.
We were on the episode Jenna? Are you serious?
It's not. Wait. Is it the one before? It was 34. 34.
Wait. I'm looking it up on my website right now, which, by the way, has a new and improved search tool. Jenna is 18 and amazing. This is insane. I oh, you got you gotta give me a couple of minutes now.
Hold on. Jenna is an 18 year old college student who is diagnosed with type one diabetes at the age of 13. To say that Jenna has it together is, well, the understatement of all understatements. Seriously, I hope my kids turn out half as well. Heck, I wish her parents raised me.
That's what it says on the website. And now you're oh my god. Like, I'm so sorry. Like, you know in your note, you didn't mention that at all. Right?
You know I don't under you listen. You know I don't know what I'm doing. Like, you can't leave it I'm not an adult. You can't leave it to me.
I'm sorry, Scott. I thought you knew.
No. I have to tell you something. I like better that it went this way.
Yeah.
I I really do. Did you, at any point, while you were talking, think he does not remember me?
It's it crossed my mind.
Well, you were right. Oh my god. Well, how are you? How you been?
What You know, it's it's been crazy. It's been ten years, which is honestly bizarre. Like, I can't believe it's been ten years.
Well, not only that, but it was I mean, I have to look now to tell you when it like, let me find out when episode 34 went up. I gotta go into a different system to find that out, but give me one second. Hold on. Blah blah blah. Oh, a lot of downloads today.
Alright. I'm sorry. That's not why we're here. Wait one second. Good day.
Thanks everybody for listening. Episode 34. I've been making this so long. There's, like, 20 episodes that have the number 34 in it. You were holy hell, Jenna.
You were on this podcast in October 2015.
Isn't that crazy?
I started making it in January 2015.
Oh, really?
No. Kidding. How did you end up on the podcast back then? Do you have any recollection?
I think I reached out to you.
No kidding. You're a little go getter. Yeah. Yeah. I see what's going on.
Okay. And then oh my god. Like, you're making me feel, like, accomplished. I appreciate that. Thank you very much.
Like, it it it feels like I, like, did something, keeping it going and tying it back together like this.
Yeah. Yeah. No. You did.
Jenna is 28 and still amazing. It's definitely a good a good title for this one. What do you think you'll be doing when you're 38?
We'll have to see. I'll have to be back on, and we'll have to see.
Shannon, you don't have one guess? You don't know where you'll be in ten years?
I don't want to make any guesses I always see something I can't predict. But yeah. So I don't know. But I'm thinking right now to stay in academia, so we'll see. We'll see what happens.
You like teaching people, or you just like the learning part?
I like all of it. I like the research. I like the learning. I like the teaching. So yeah.
That's pretty awesome. Well, I'll be there. This is, like, such a genuinely nice little surprise at the end.
I'm glad.
Do you know if I wouldn't have asked you that last question, I never would have put this together?
That's so funny.
Okay. Well, I I mean, we started strong with me impressing you with my knowledge of your life just by the tone of your voice. And, we've ended it with, I would imagine, a fairly disappointing moment for my for my organizational skills.
It's all good.
Oh my god. That's awesome. Well, it's nice to talk to you again. Seriously, this has really been really cool. I, I I really do like that it happened this way.
I know most people won't believe that, but I like that it happened this way because I would have gotten I would have gotten too focused on the what's changed thing instead of just talking to you. So Yeah. Yeah. I fair. I really like this.
Okay. Well, I'm gonna have to re you know, let you go. You probably have, I don't know, hospital food to, like, vomit while you look at. I mean, what's the most vile what's the most vile thing they make in a they give in a hospital or somebody? What's the thing that when you look at it, you go, I don't understand why they would hand this to a person, let alone a person in a hospital?
Well, I I think the thing that always surprises me is the number of, like, white dinner rolls and desserts, like cakes, like chocolate cake or chocolate pudding for dessert.
Yeah.
Yeah. Like, the dinner rolls with
Yeah. You're you're not moving around. Your body's ill. You're shitting in a pan. Would you like a piece of chocolate cake to sit in your gullet for a while?
Awesome. But, yeah, you know, I wanna get out of the hospital. Thank you. What gets me out of here? Give me quinoa.
Yeah.
I yeah. I gotta go. I don't like quinoa. Don't know what the hell it is, but feed it to me and get me the hell out of here.
Oh my god.
That was fascinating.
It needs a lot of help.
So Well, I I appreciate your time very much, and I I I can't thank you enough for doing this. I guess I'll I'll see you in 2036.
There you go.
Alright. Let's do it. Cool. Put it
on the calendar.
K. Put it on the calendar. Listen. If I can keep this thing going ten more years, I would a 100% do that, first of all. And secondly, that would be quite an accomplishment.
Do do you know ever both. Nothing. I this podcast is one of probably fewer than 200 podcasts that has been going as long as it is and has as many episodes as it does. It's, like, really incredibly uncommon. So maybe I'm Congrats.
Yeah. Maybe I will do it. Although, I will be 64 at that point.
So I think you can do it.
I don't know, Jenna. Did I seem like the same person that this is a good example. Like, do you re are you experiencing me the way you remembered, or do you not have much memory of it?
I I feel like you're the same person. Yeah. Awesome. And I've listened to a lot of the episodes. So
Thank you. Yeah. Thank you. Oh, that's how I make my listeners. I just have them on the podcast.
It's a it's a it's basically like a Ponzi pyramid scheme. I'm just I just I make listeners by interviewing.
I mean, it's a good way to do it.
Hey. What works works. You know? Alright. I will, hold on one second.
I need to talk to you before we're done. I'm gonna hit stop now. Thanks again.
Thank you.
Heck of an episode today, wouldn't you say? Let's thank Dexcom and the Omnipod five for sponsoring. That's right, my friends. We were sponsored today by the Dexcom gseven. Dexcom.com/juicebox.
Head over there right now. Look into that fifteen day Dexcom g seven. Fifteen days is a long time. That's like half a month. Don't check my math, but I'm pretty sure I'm right.
And let's also thank the Omnipod five. My goodness gracious. Omnipod five tubeless. That beautiful algorithm's updated now with that new 100 target. Get in there.
Find out more about it. Omnipod.com/juicebox. You want some tubeless insulin pumping? Yeah. You do.
By any chance, have you tried the small sip series? It's curated takeaways from the Juice Box podcast voted on by listeners as the most helpful insights for managing their diabetes. These bite sized pieces of wisdom cover essential topics like insulin timing, carb management, and balancing highs and lows, making it easier for you to incorporate real life strategies into your daily routine. Take a deep dive, take a sip, and discover what our community finds most valuable on the journey to better diabetes management. For more information on small sips, go to juiceboxpodcast.com and then go oh, actually, we changed the website.
Let me see. Go to juiceboxpodcast.com. And from there, oh, there's these two little lines on the right side top. That's the menu. And click that, then click series.
Then there's pro there's small steps right there. Pro tips to top, bold beginnings, bold bolus four, asks that. There's a lot of them there. There's actually a little search there too. Could you just type small sips into the search?
Oh, wow. That search works great. Look at that. And then you could go right to, like, all results for small sips. Oh, and that takes you to the FAQ.
You should check out the FAQ page too. I think that's juiceboxpodcast.com/jbfaq. Seriously, that thing's amazing. Actually, the whole website is I mean, have you, like, seen it? You should you should go check out the website.
The website rocks. It is a potpourri, a never ending cornucopia of support for you and your diabetes journey. That's right. It really is. What else we got over here?
Oh, I don't like the way that works. I'm gonna fix that. Note to self. Change the change the masthead on the frequently asked questions page. Yeah.
I don't like that. Fix that. Oh, Claude. Oh, hell. I forgot to say thank you.
Thank you so much for listening. I'll be back again very, very soon. What is that noise? Stop it. Stop.
Can you hear that? It's my chameleon squeaking. Are you squeaking? Are you rubbing the branch against the don't tell people I have reptiles. They'll think I'm weird.
Thanks so much for listening. I'll be back very soon with another episode of the juice box podcast. Look at me. Get all deep in there with another episode of the juice box podcast. You can hear it.
What was that? Oh, I'm getting alarms and alerts on my phone. I was gonna get real deep and tell you about the juice box podcast.
Read the full disclaimer
© 2007–2026 Juicebox Podcast. All rights reserved.
#1919 Hurricane Levi
Hurricane Levi
Tendai's son was diagnosed at four in Zimbabwe. She pays cash for sensors, counts carbs on food with no labels, and found this show through a WhatsApp group of African parents.
Jump to a moment
- The signs were textbook — and easy to talk yourself out of. Levi, then four, went back to bedwetting, drank constantly, and lost weight until he was lethargic on the living-room floor. Tendai hesitated to take him in, worried a doctor would wave off “drinks water, pees a lot” as nothing. By the time they went, he was near DKA and admitted for close to two weeks. Her point for other parents: trust the pattern and go.
- Care in Zimbabwe means assembling the pieces yourself. Tendai covers insulin through her employer’s medical aid and CGMs through her husband’s; early on they paid cash — roughly $75–$90 for a single 14-day sensor. A senior nurse scolded her four-year-old that sweets were “why you’re here,” and, tellingly, the pediatrician’s best advice was to go find other parents, because he only knew the textbook.
- No food labels, so everything is observation. Most food is organic and unlabeled, so Tendai learns by watching — how much insulin pairs with a portion of sadza, the staple maize porridge, versus rice or pizza. She credits the podcast for finally making basal, bolus, timing, and insulin-on-board click after the hospital sent her home unsure of the difference between the two insulins.
- She found the show through a network of African parents. A mom in Harare pointed her to the podcast; their WhatsApp group, which includes parents in South Africa, now recommends it to every newcomer. Scott is visibly moved to learn the show’s Zimbabwe ranking is real people. Separately, a private school told her they “already have a child with type one” and didn’t want another — a heartbreak she pushed past.
- Practical moves, offered as things to raise with her doctor. Levi’s split NPH (Protaphane) basal is dated; Scott suggests asking about a modern once-daily basal like Tresiba, which could add stability and likely lower an A1c currently in the 8–9 range. He also suggests, carefully and with a doctor-first caveat, using an AI model as a sounding board to talk through dosing. None of this is medical advice.
- Bold Beginnings series — Scott and Jenny Smith for the newly diagnosed — basal, bolus, timing, and the fundamentals Tendai had to piece together.
- Diabetes Pro Tip series — Episodes 1000-1025 — the management foundation Tendai credits for making it all click.
- A1C / blood glucose estimator — The tool Scott pulls up on-air to convert Levi's target range and A1c.
Every word of the conversation
Cold open & sponsors0:06
Friends, we're all back together for another episode of the Juice Box podcast. If you or a loved one is newly diagnosed with type one diabetes and you're seeking a clear practical perspective, check out the bold beginnings series on the juice box podcast. It's hosted by myself and Jenny Smith, an experienced diabetes educator with over thirty five years personal insight into type one. Our series cuts through the medical jargon and delivers straightforward answers to your most pressing questions. Hey.
Nothing you hear on the juice box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan. This episode of the podcast is sponsored by MiniMed and the Kontoor Nextgen blood glucose meter. MiniMed, of course, the innovators behind the MiniMed Flex system, a small, sleek, and discreet insulin automated delivery system controlled from an app. Nothing comes close to freedom you can feel.
To learn more, visit minimed.com/juicebox. There is one blood glucose meter in this house, the Kontoor Next Gen blood glucose meter. That meter is on my daughter's person right now and at all times. It is incredibly accurate and waiting for you at kontoornext.com/juicebox.
Meet Tendai and Levi, in Zimbabwe1:36
Hello, Scott. My name is Tendai, and I have a six year old son, Levi, who has type one diabetes. And we live in Zimbabwe.
Tendai, it's nice to meet you. Am I saying your name right?
Yes. Yes. Awesome.
Is Levi your only child, or do you have others?
Levi is my second child. My first daughter is 17, and Levi is six.
Oh, wow. Look at you. Mhmm. Yes. There other people with type one in your family or Levi's father's family?
Anything like that?
No. There's no history of type one in in mine and my husband's family.
Okay. And and how long ago was he diagnosed?
So he was diagnosed in December 2024, just before Christmas.
Oh my. So so it'll be two years this Christmas?
Correct. Yes.
I almost said how old was he when he was introduced to type one diabetes, which is ridiculous because I've asked I've said the word diagnosed thousands of times making this podcast. And I was like, I I I I stopped myself. You'll hear me fumbling through it. Was like, why was I gonna say that? Well, so he's what was he about for when he was diagnosed?
Yes. He was, he just turned four in August of that year.
The signs, and talking herself out of the doctor3:07
Okay. And leading up to the diagnosis, things you noticed, or did it it come up very quickly? Was it a slow onset?
Oh, yes. We we we noticed the the usual signs that everybody talks about. So Levi was had been fully potty trained by that age. Mhmm. But I did notice he he went back to bedwetting.
He was drinking tons of water, and and then he started to lose weight.
Mhmm.
As well as towards the towards the end, I did notice some some weight loss. Although, it wasn't until, my mother-in-law mentioned it to me because when you're living with somebody, it's hard to see weight loss. You you get used to that until you don't notice it anymore.
Sure.
But I did notice that he had lost quite a lot of weight. And then, also, by the time I decided to take him to the hospital, he was now, you know, just lethargic, and he would because he's an energetic child. Levi is quite quite a handful Mhmm. Bowls of energy. But at that time, he started to, you know, become weaker.
He would just lie down and fall asleep even in this middle of the living room on the floor. Uh-huh. So I did notice that something was wrong, but I I needed just to mention this because I feel like maybe some people may identify with such a thing that when I was seeing all these symptoms, it did occur to me to take him to see the doctor. But then I couldn't get myself to do it because it was very strange to me to go to the doctor and say, well, my son's not eating much. He's drinking lots of water, and he's going to the bathroom frequently.
Because in my mind, I thought that would come across as, you know, ridiculous. So the doctor would say, well, if he's drinking water, then obviously, he's going to pee more.
Mhmm.
You know? So that's what stopped me from going to the doctor earlier than I should have. At the time we went, I think he was he was close to DKA because we had to rush to the hospital, to the nearest hospital, And then they booked him in, and we were in there for, I think, just a little over a week, close to two weeks.
Mhmm. Two weeks? Mhmm. Really?
Yes. Yeah.
How long between when you when you talked yourself out of going to the doctor and when you actually went to the hospital? How much time was in between there?
I think that took probably a few days. Three to four days.
Okay.
Because I made the decision the night before when he looked just weak. And then I said, no. I've got to go to the doctor, and I went the very next morning.
Mhmm. Mhmm. Yeah. How far was the hospital?
It was, I think, a ten minute drive.
That's okay. Close close to your house or to where you live.
Okay. Yes.
Well well, that's crazy. So out of nowhere for you, it just he was fine one day. The next day, he seemed tired, peed a lot, drank a lot. And then sometime later, you thought he looks, like, weak, ill, close to death? Like, what was the thing that pushed you over the edge?
So he had been, you know, he'd been sleeping a lot more than usual. Like I said, he's very energetic because if he's not jumping all over the place, then something is wrong. So at that point, he was just, you know, sleeping most of the day and not active at all. Mhmm. Then when I was feeding him supper, usually, he would feed himself.
But that particular day, he wouldn't eat. He wouldn't even sit up at all.
Just lifeless. And that mhmm.
He was basically lifeless. I tried to I force fed him, and he threw up a couple of times. And then I thought, nah. Let me just let him sleep it off. I'll rush him to the doctor the following morning.
Mhmm.
And your daughter at that point is maybe 13?
Yes.
Yeah. So do you do you go as a family to the hospital, or do how do you? The Kontoor Next Gen blood glucose meter is sponsoring this episode of the juice box podcast, and it is entirely possible that it is less expensive in cash than you are paying right now for your meter through your insurance company. That's right. If you go to my link, contournext.com/juicebox, you're gonna find links to Walmart, Amazon, Walgreens, CVS, Rite Aid, Kroger, Meijer.
You could be paying more right now through your insurance for your test strips and meter than you would pay through my link for the Contour Next Gen and Contour Next Test strips in cash. What am I saying? My link may be cheaper out of your pocket than you are paying right now even with your insurance. And I don't know which meter you have on you right now. I can't say that.
But what I can say for sure is that the Contour Next Gen meter is accurate. It is reliable, and it is the meter that we've been using for years. Contournext.com/juicebox. And if you already have a contour meter and you're buying test strips, doing so through my link will help support the podcast. Let's be honest.
Most of us would love to spend less time thinking about diabetes. That's exactly what MiniMed had in mind with the new MiniMed Flex system. It's small and sleek. You can control it from an app, and it uses the trusted smart guard technology that automatically adjusts insulin every five minutes. Less juggling, less micromanaging, more freedom.
That's the MiniMed Flex system available now at minimed.com/juicebox. There are links in the show notes and links at juiceboxpodcast.com to Contour, MiniMed, and all of the sponsors. When you click on my links, you're supporting the podcast and helping to keep it free and plentiful.
Nearly two weeks in the hospital9:44
No. At that time, I just because I woke up earlier than usual. So I say to everybody, it was it was actually we call them national holidays here in Zimbabwe. So it was unity day, and everybody was home. Schools were closed.
So I said, I'm gonna rushly by to the to the to see the doctor, and I'll be back real quick. I didn't think it was going to be anything. Mhmm. I thought maybe he was just gonna prescribe him something and would come back home straight after because he was still fairly mobile. He wasn't completely out, but he was, you know, just really weak, but he was conscious.
Mhmm.
So I thought maybe we're gonna get a small prescription and, you know, rush back home. Yeah. Then when I got to the doctor, he he started asking me all these questions, which I was just thinking, okay. You know, what what what do these questions have to do with anything? Then midway through the interview, then he says to me, look.
I'm not certain, but I think he may have he called it adolescent's diabetes Mhmm. At that time. And I thought, what what is that? I've never heard of such a thing. And he says, yeah.
Anyway, I need you to to get to the nearest hospital because this was the the doctor's surgery.
Sort of like a what would we call that? Like a like a urgent care or something like that? Or Yes. Yes. Right.
And then they and that doctor's telling you, I need you to get to the hospital. They transport you to the hospital, or you have to get yourself there?
He said to me, do you are you good to drive to the hospital? And I said, yeah. Of course. I think I can drive because I still wasn't grasping exactly what was going on. And he didn't give me that much of a sense of urgency, but he did say, you get to the can you drive to the hospital and get there quickly?
And I said, yes. Mhmm. There wasn't a lot of traffic, so I did. And he says, okay. Can you get there now?
And I'm going to follow I'm gonna close the the surgery, and I'm gonna follow you in my own car.
Did that scare you then?
It did.
Yeah.
That was the sign to me that says, okay. So this is this is bigger than I thought it was.
Yeah.
And so on the way, I called my husband and said, look. This is what the doctor is saying. So I'm rushing off to to the hospital, the biggest hospital in the area that we live in. And I also called my parents, and I called his parents as well. And everybody met us there within, I think, twenty minutes.
Yeah. The doctor wanting to escort you over made you think, oh gosh. This is really I mean, he's he's closing the place up and following my my car.
And Exactly.
Yeah. And then starting to think about, like and he asked me, am I okay to drive? I bet what wait. What? Like and then Mhmm.
Yeah. Wow. So there's this Yeah. There's this heavy thing over you that you can't quite conceptualize yet, but the the clues are starting to pull it together for you. And your whole family showed up.
Your parents came. Everybody was there.
My parents were actually making their way from another town, which is far away, but my my my husband's parents actually leave. I think it's a two minute walk from from the hospital. So they were there before the hospital had even finished checking him in.
That's nice. Yeah.
Yeah. So, yeah, the support system was there Right. Quick.
“This is why you’re here” — and a rare honest doctor13:22
But then how is the how is the medical system? Like, I mean, were were you there two weeks because that's how it is there or because it's not great or because he was so poorly like, was he not doing well? What what's the reason for the long stay?
Okay. So now with with with hindsight, I think I can put it this way to say being in a third world country, Zimbabwe. Right? I think our medical system is not is not that bad. Mhmm.
But it could be better. And now, there's certain things that they do really well, you know, in our country, like, with things like I don't know. Maybe they really did well with COVID. They do well with, you know, immunizations and others, you know, pandemics and HIV and whatnot. But with, in particular, type one diabetes, I think it's still something that is being discovered for the most part because I'll tell you one incident that happened while we were at the hospital.
I think this was maybe day three or four. So we were in the children's ward, right? And being in the children's ward, obviously, there are other children with different conditions. And being Christmas time, most of these kids were getting treats and all these snacks and, you know, nice things. Meanwhile, our our doctor has put Levi on a strict diet at that point.
So he was not having, most of his favorite foods. He wasn't having snacks. He wasn't, you know, having everything else that other kids in the same room were having.
Oh, okay.
So then there's a there's a senior nurse who was just doing her rounds. I think she was just going around looking at the patients. And then she sees me struggling with Levi. Like I said, Levi is, you know, is a handful. So he was really giving me a hard time.
He wants he wants sweets or whatever because he's seeing everybody around having those. And I'm saying, you can't you can't have those right now. And then so she comes in. I think she meant well. She wanted to help.
Then she says she's trying to talk to him. And she says to him, look. You can't have sweets. This is why you are here in the first place. Oh.
So
Awesome.
Can't have sweets. And she's a she's a senior Mhmm. In that hospital.
Who thinks that your four year old who's being diagnosed with type one diabetes is there because of his poor life choices?
Exactly.
Gotcha. So
that's that's the dynamic already. You I I'm sure you get the picture.
Sure.
And, also, our pediatrician, when when he was now when we were about to go home and he's great. We're really happy with everything that he's he taught us. But I have to give him credit for something that he said to me when we were now leaving to go home. He said to me, look. I know the textbook stuff about this condition.
And he said to me, I need you to to get in touch with other parents that have kids with this condition because they're going to tell you things that I can't tell you. I don't have a child with type one, and I don't live with the condition, you know, on a day to day basis. So there's certain things you're going to learn more out there than I can ever tell you.
Well, that's that's good honest inform that's good honest information at least. Yeah. But not Yeah. Not incredibly encouraging, I would matter imagine when you're in the hospital. And the people in the hospital are like, listen.
We don't know the first thing about this. So can you go make a friend who knows about it? And you're like, probably not.
Yeah. That's yeah. It it it gave me mixed feelings, but I've noticed that, yeah, she definitely this whole this world is it's it's a crazy world to be thrown into. Sure.
No matter where you are.
She couldn't possibly know. You don't know what you don't know
Right.
As far as this condition Hey.
You understand. You listen to the podcast. Right?
I do. Yeah. I do listen to it as often as I can.
Yeah. So then, you know, when I talk to people from Canada, I tease them, and I ask them if they ride a polar bear. So it would be unfair if I didn't ask you if there's, like, lions walking around where you live. You
know, I, no. Unfortunately,
they are
not this heavy. I wish they were. Do you? We We we do have in my country, we do have, you know what they call the big five in terms of wildlife.
Okay.
Biggest, game. So we do have a lot of that, apparently.
Can I guess? You have to yes. Sure. Hippos, elephants, rhinos. I'm not gonna get the other two.
Giraffe?
Lions.
And lions. Did I get them?
Yes. Yes.
Yes. I've been to the zoo. I know what's going on. Yeah. Yeah.
Oh, wow. That's and and, like like, roaming naturally, or are they in preserves? Or how how is that handled?
Yes. They are in game reserves.
Wow.
Just in selected areas around the country. So you're you're not going to see them roaming. But but there are certain you know what? What they call them we call them rural areas. There are certain rural areas where you're going to find that elephants do roam freely, and they you you could probably see an elephant just a few feet from your your yard in in other places in the country like, I think it's, I don't know, Binga, is it?
I'm not sure.
Do people keep
them? Geography is not good.
No. Your geography is don't worry. You're asking the wrong person. I'm trying to imagine what time zone you're in right now. What do people keep them ever on, like, farms or on their property, or is that not a thing that happens?
No. No? They they wouldn't. They are protected, obviously, by the government. So they would be they just roam freely.
You wanna hear the weirdest thing?
Specific areas. Yeah.
You wanna hear the weirdest thing about America ever? Do you do you know that Texas has the has more big cats in it than that are privately owned than anywhere else in the world? Oh, really? Isn't that weird? People in Texas
People keep them as pets.
Yeah. Tigers and lions in Texas. I mean, let's go. That's strange. Yeah.
I thought so too. Nevertheless, it's absolutely true. Well, okay. So you're you're at the hospital for, you know, a a bit of time. Are you actually able to cobble together a plan while you're there, or are you just in a panic trying to go out and meet a friend who has diabetes?
Two medical aids, and paying cash for CGMs20:45
So during our stay, our doctor gave us like like I said, he gave he puts my son on a on a diet. He recommended the diet that we should follow, and then he also gave us some reading material just to get to know what's going on and how this condition came you know just information about the condition. So we did have that support because, obviously, the meals were were provided by the by the hospital, and he would come in and see us three times a day, morning, afternoon, and evening, just to check check on everything, Also, to to keep keep tabs on the readings because we were not on we didn't have a continuous glucose monitor during our time in the hospital. We were we were just using the the glucometers to test your sugar levels. Yeah.
Are the are the tools provided by by the government, by the hospital, or do you have to acquire them privately? How does it work there?
Okay. So here, we have we have medical aid. I think you call it medical insurance, same thing. So my medical aid from where I work, I work for a bank, it doesn't cover. They don't provide CGMs, but my husband's workplace does.
So we've been fortunate enough to get those from using his medical aid.
Okay. Yeah. Here, you could only use one. So if usually, a family is covered under one person's employment, that that's great that you have two opt I guess that's not completely true. I've I've seen people do it both ways.
So you were able to put your son on your husband's aid, which got him the CGM?
Yes.
I see.
And then on my aid, that's where we get the insulin and
Oh, that's interesting. You can get some from yours and some that that's actually very reasonable. It's what is it expensive for you? I can I pick in a little bit? Like, what what's a good income where you live?
What's an average income?
I want to say if you're going to be comfortable, have everything taken care of, you could probably do well with maybe 1,200, 1,500 US dollars a month
Okay.
Take home. But then I say that with a bit of reservation because, obviously, it depends on your lifestyle. Some people can get by with 500.
Okay. But you have I mean, you're a family of
just depends Yeah. On on your choices.
Yeah. And you're a family of four, but living with his mom or your mom?
No. It's just the two of us and not two kids.
Oh oh, I oh, so okay. I I misunderstood at some point where the a parent was. So you're a family of four. You're both making an income?
Yes. Yes. We're both And making an income.
And does and is diabetes manageable for you? Is it impossible? Is it somewhere in the middle?
I think it's somewhere in the middle. I think we I think we're doing better now than we were last year and then than we were in the first year.
Okay.
It's helped to listen to the podcast every day because there's definitely things that I I have discovered that I I didn't know about. I like, for instance, I didn't understand the difference between the two injections that we have to give him. We he's he's on multiple daily injections.
Right.
So he's not on a pump. But when we first came out of the hospital, it was really confusing to me which which the differences between the injections because we give him two. He's got a short acting. That's NovoRapid. And then he's got the long acting, which is Protofen.
The two injections meant you know, they were they were the same to me at first.
Right.
So it was only when I listened to your podcast and when I talked to my sister-in-law, who's a nurse, and she explained as well to me, okay. So this is what this one does, and then this is what this one does. But then there's also things like the things that you explain on your podcast about, you know, policing and basal and timing and everything and how to balance those two. That was a bit of a mystery in the beginning. It was just a mess how I think we were handling it.
But I think it's gotten better now. There's still a lot of room for improvement because I'm yet to to master the calculating the carbs, I think.
Is that because our food's not labeled properly, or how how why does that cause you an issue?
Mhmm. Because our our food here in Zimbabwe, it's it's mostly organic. It's easier to find organic food than, the processed foods. So, being organic means there's no labels.
You
basically have to you say that you know or you don't know or you are guessing at least how many carbs or how much protein or fat is in a particular, meal that you've you've pre prepared. So I think that's where I'm I'm yet to to really try and zero in on that and master that.
Counting carbs on food with no labels26:37
And Yeah. Is it are you able to use the Internet to help you, or how do you are you is it trial and error?
I've tried the Internet. Yeah. The Internet has helped. This it has definitely helped, but also is most most of it has been trial and error just by observing. I can observe that our staple food here, we call it Sada.
I've observed what salsa does and what the quantities are and how much insulin work well with what quantity of salsa.
And that's all like a it's a that's like a porridge. Right? Like a cornmeal porridge?
Exactly. But it's thicker.
Thicker. Okay.
Mhmm.
And something yeah. I believe it or not, I actually, I'm doing a little bit of, like, research because I wanna be able to talk to you about it. And I just asked it it might surprise you. I asked Chad GPT for five common meals in Zimbabwe. Sazo Sazo was the first.
And then it lists and then it lists it with beef or chicken or goat. Uh-huh. Ready? Hold on. Murawu Andovi, leafy greens cooked with peanut butter.
Is that right?
Yes.
Yeah.
Exactly. Yeah.
Yeah. And so these are things that you just contextually you just have to guess. So do you know even like, did they give you settings for him, carb ratio, basal? Or do you have to figure the whole thing out, or did they at least get him set up by his weight to begin with?
No. That that part, I really had to go onto your your website to try and figure things out on the and then to also Google the rest of the stuff.
Are you using, like, my settings estimator and things like that?
I used that one time
Yeah.
When I was trying to because we had we had a disaster with pizza one time, and I just went and I said, no. No. No. By the way, they have something on there. So let me go and try and, you know, work it out.
And I went there, and I think it worked well. I may not have given it the amount of time that I
should have. To give it more time.
I think I need to give it more time
Yeah.
Because it doesn't look like it it's too difficult. I'm just yeah. Just got a full plate on my on right now, things to do with school and everything. But I I think I'm gonna crack it. If I give it more time, I'm sure we'll be on top of things pretty quickly.
I'm sure you will too. I have to just to take a turn here for a second. This conversation, you're filling my heart up so much today. Thank you so much.
No. Great.
No. I really to hear that this has been valuable to you in a place on the globe that I never even imagined anybody would hear this at is, it's it's very fulfilling to hear this conversation. Like, it's I I I really do appreciate you taking the time to do this. You know, when I try to quantify what I do, it it's difficult. Like, I don't always understand it.
And sometimes people might hear me on here saying, like, you know, the podcast is and it is. It's the it's the best downloaded diabetes podcast in the world, in The United States by leaps and bounds. But and but in, like, 45 other countries, it ranks. And we've we we are it ranks in Zimbabwe. And there's part of me that when I see that, just assume that's a bot or, like, you know, something, but it's it's you and, you know, maybe others too.
I mean, in fairness, it could just be you. But it No. No.
Let me tell you. I heard about you from another parent of a child with type one. You know, these people that I started to connect with following
No. Tendi, shit. You're gonna make me cry. Hold on a second.
So I'm I'm in a city called Vulawayo in Zimbabwe, and this lady is in Harare. That's the capital city. So she said to me, can you go and listen to the juice juice box podcast? And then in the WhatsApp group that we have with several parents, I'm not sure how many we have, but there's quite a number of us. Yeah.
This it includes parents from South Africa as well. And everybody does mention, you know, recommend, especially when we welcome a new parent into the group. One of the first things that parents say there are you need to go and check this podcast out, and it's got a lot of information. So, yeah, I don't think you have the slightest idea of your reach in terms of helping people to understand this condition and manage it better.
A WhatsApp group, and finding the podcast31:32
Well, thanks to you. I have a much better idea. And you did make me cry a little, but I just not a lot. So I I would tell my family my eyes are just watering, and they're like, you know, you're crying. And I'm like, I don't know.
It doesn't feel like crying yet. Well, gosh. That that's that's really amazing. I really do appreciate you sharing that with me. So around cost, I just wanna make sure again, like, you feel comfortable with it, but is it a lot of out of pocket for you, or is this the medical aid cover it all?
Yeah. It's it's there is a lot of out of pocket because in the beginning, we we we did have to pay cash for the for the CGMs before I knew that I could get medical aid to pay for it. So in the first couple of months, we were paying cash for it.
Tell me. When you bought CGMs, how many zig is that to buy them?
Okay. So so interestingly, we actually don't use a lot of SIG in in this country, especially in the in the part of the country that I'm in. We mostly use the United States dollar.
Oh, you're using US dollars there? Oh, okay. Well, then I don't have to figure it out. Good. What what were you paying for CGMs?
It
It's it's $90 in some places. Seven between 75 and $90 depending on the pharmacy that you you you you've gone to.
For how many?
That is one.
Oh my gosh. For for seven days?
No. Fourteen fourteen days. Most of them last fourteen days.
They last fourteen days. Okay. So but so you're paying, like, $200 I mean, somewhere between a 150 and $200 a month for two CGMs.
Exactly.
Yeah. Gosh. Okay. So you're using what the leap you're using Libre there?
No. No? We we're using we use LYNX.
LYNX. I don't know it.
And it's a really good one.
Okay.
And then there's another one called Sinocay. That's the one we started off with, then we moved on to Lynx. I did get a Libre from from a relative from England.
I would Then
we tried it.
Shoot, Hendi. Yeah. I thought I heard a little bit of British in your accent, like, ten minutes ago. I should have said something. I would have seemed like a genius.
Damn it. But
I don't know. I don't think I don't know what it was, but my country was colonized by Britain. So maybe
That's it. That could be it.
But I've never been there. I've never been to
No kidding. Okay. No. So you had somebody send you a Libre, but you so you have two two CGMs there that you like that I've never even heard of before. So DexCom doesn't make it into into that part of Africa.
I wanted to try out the Dexcom. I even have one, which we also got from from the same relative. But then I think I need to somebody said I need to change my Google account
to Africa. Yeah.
Because there's no support services in ZIM. Same thing for Libre. So those those people in ZIM who use Libre have configured their settings to make to make it look like they are in South Africa.
Yeah. I was just gonna
can download the app.
Yeah. Yeah. I was just thinking. I I just heard I don't think it's out yet, but I did this interview with this lady. Her son was diagnosed in South America on a ski trip, and she had type she has type one, the mom.
So when she flew to meet him at the hospital because he was there not speaking the language, being diagnosed as, a teenager. Right? And, she flew there to help him. She put a bunch of her supplies together, brought them down, and then tried to slap a Dexcom on him, but it wouldn't work because her app was was coded as she lived in America, so it wouldn't let her start it. And that's gotta be the same problem.
I see. I wonder why they do that.
Yeah. It doesn't. It sucks. It really does.
Yeah. We're already paid for it. What do you care?
The desk phone.
Yeah. Yeah. Yeah. You know?
I don't I don't want to see them go to waste because we've got three of them right now that we can't use because of this problem.
Right. Not something
gonna hold on to them and then figure it out.
Yeah. So now he comes home. He's diagnosed. Does is he in school at that point? How do you manage all of this?
So he was in preschool at the time. Mhmm. And I I had to quickly message his teacher just before schools opened in January. That that was the second week of January. So I told her, and I said, so this is the this is what's going on with Levi, and I'm going to need help with a, b, c, d.
And they were very, very helpful. I have to say They was open to to learning about everything that was going on, and they reacted very quickly.
That's lovely.
So luckily, my employer was able to give me the time to work from home whilst we tried to to to
Figure it out.
Get to understand and figure the whole thing out. So I had, I think, about a month of working from home and being able to go to school and react as quickly. However, I wanted to mention that when when he was now coming into into primary school
“We already have a child with type one”37:05
Right.
So he started primary school this year. And I was looking for I decided to change him and put him in a smaller school than the one we originally wanted to take him to. So I had an interview with the the headmaster of the school. I think it was the deputy head or something. And I said, look.
Could we please have our son come here? It's a it's a very one of the most popular private schools in Laulauayo here. And I explained to him what the condition was and and everything. And to my absolute horror, he said to me, look. We already have a child with type one, and we're not we're not jumping up and down to get another one.
We're not we're not too keen on this. Why don't you keep that kid? My Yeah. God. That's gonna break your heart.
Yeah. Yeah. It's a strain on our teachers and all this and all that. So so we went back to the big school where we had we had already planned to take him since he was a baby. And to my surprise, they were, you know, more welcoming and more receptive.
Of course, there's they they had a healthy amount of fear
Mhmm.
And, you know, just hesitation about, okay. Can we do this?
So did they
really been helpful.
Yeah. The school he ends up at, did they have background in this, or were they just willing to learn?
No. I think I think there could be one or maybe one or two other kids, but they are older kids. So the teachers don't have to intervene as
much. Involved.
Yeah. They have to with with Levi who's six. Yeah. Six in August.
It would be interesting to hear from that that deputy headmaster, like, what what what makes it such a struggle? Like, maybe that child comes there with no I mean, to, like, listen to what you left the hospital with. You weren't sure the difference between basal and bolus insulin. Right? That maybe that kid's in that situation, and they're like, no.
You don't understand. This is a shit show. And and they don't they we can't do two. You know? And, yeah, that's it is very interesting.
It's a lot. It is a lot because I've asked the teacher his teacher right now, she has to help him with injections. I had to ask her because, of course, now I'm trying to get him to to inject himself. He can he can inject himself.
Oh, awesome.
If you mhmm. If you of course, you have to measure out the units for him. Mhmm. But she still has to help with that. She has to communicate with me when she sees the signs of a of a hypo.
Yeah.
And I have to call her when I get the the alerts to say, okay. He needs an injection now or things like that. But they've been really great with that.
That's awesome. Hey. Is there a cultural belief about lifespan or health with type one diabetes? Is, like, did you get the big speech in the hospital? Like, his life's gonna be different or shorter, or do they tell you anything?
No. No. They never told us any of that. But there is no shortage of, of advice that you get in myths from society about how it can be cured by, you know, by this plant or that diet and things like that.
Are you in the Facebook group by any chance in mind?
Yes. I've yes. I am.
There's a post in there the other day. Some lady said she was on a vacation, and I I I forget if it was an Uber driver. Somebody told her if the kid just sat in a cold, dark room, it would go.
Oh my gosh.
So do you get a lot of you get a lot of that around there? A lot a lot of a lot of grandmoms telling you how to handle it?
Yes. We do get a lot of that.
Yeah.
So I always try to explain that. Look. There's a difference. There's two two types. And so the other one is reversible.
The other one isn't.
Myths, and one test strip a day41:03
Yeah. I I just I asked because it's been a long time ago now. And by a long time ago, ten years ago, I did a talk in the Dominican Republic. I did a diabetes talk in the Dominican Republic. And while I was there, the the the, you know, the community there was sharing a story with me about a thirteen year old who had passed away from, like, advanced issues from type one diabetes, and and the child had only had it for five or six years.
But that's how that's it's sad, but that's how little the understanding of the management was in the air. It was almost like, well, you have it, but, you know, I think I if I'm if I'm not mistaken, they were allotted one test trip a day.
Oh, no.
Yeah. So so really difficult. But so you you I mean, you you described where you live as as third world, and I don't know what that means. Like, I I I find myself think sitting here thinking, like, you described an amount of money that you could live on for a month that some people here pay for their car payment. And and so I was I'm like, I I know I don't have context for for your situation.
You know? Mhmm. But I so I was wondering, do people hear type one and go, that's like, I was wondering if maybe you heard, you know, death sentence and thought, no. No. I'm gonna go figure this out on my own.
Or
I don't think I don't think my mind went there Mhmm. At first. I was I was taking it one day at a time, literally, because I also don't remember a lot of what was going on during those days. It was all a blur.
Sure.
But I was just taking it one day at a time. I never thought beyond the next couple of days. Mhmm. Yeah. Do you think that could have helped.
Yeah. You think that, I I mean, do you have context for if you didn't go out into the world to learn about this, what would following doctor's advice get you?
Yeah. We we would we would be struggling.
Okay. You mean
I think we would be.
What what do you think the struggle like, what do you think the struggle would look like?
Just to understand what is even going on.
Okay.
Because it's a lot with with diabetes. So we got basic information. Like I said, it was what he called textbook information.
Mhmm.
And that that had nothing to do with you understanding that rice does that that sugar levels react differently to rice than to salsa than to pasta than to pizza.
Right.
And there was nothing said about insulin on board. There was nothing said about, you know, even the ratios, the carb to insulin ratios, or things like physical activity at school. All of that
Nothing at all. To you know? So the basic information they gave you was his pancreas isn't making insulin anymore, and you're gonna need to inject this?
You inject five units of this one in the morning
Oh gosh.
And in the evening, and you inject five units of this one thirty minutes before every meal. And you test and you correct and
And that's got yeah. Are they testing his his a one c?
We we've gotten it. We've we've we've had that done twice since his diagnosis.
Yeah.
I figure we're getting the test once a year.
What what what was his last day once a year? Do you know?
It was eight, nine.
Eight or nine. Okay. And then on Nine. And on his does his CGM give you information about about, like, time and range or an average a one c?
Yeah. It does. It gives us time and range. It give it gives us, you know, the average glucose level over the last three hours, six hours, twelve, twenty four. Then, of course, you get the the reports once it's it's done Mhmm.
The the fourteen days.
Settings, winter sensitivity, and the numbers45:30
And what are your goals? What are you trying to accomplish? What are you trying to get to as far as as far as those outcomes go?
We're trying to be in range maybe I I I think 100% of the time would be very ambitious. I'm just trying to get to maybe be in range maybe 80% of the time.
Mhmm. What what what's the range you're you're trying to stay in?
So we're trying to stay between five and ten. Okay.
Five.
If that's if that's okay.
Hold on a second. I have to pull up my little my little a one c estimator available at juiceboxpodcast.com. And five and ten. So somewhere between 99 and a 180, you're shooting for. Mhmm.
Right around there. Yeah. Okay. Mhmm. 90 and $1.80.
Okay. Well, I mean, that's a very reasonable range. Are you having luck with that, or is he I mean, if his a one c is eight or nine, he's higher more than you want him to be. Right?
Yes. Definitely. There's lots of work to be done. Yeah.
And what would you say that is? Is that your understanding of the insulin? Is it the food? Is it the time you're able to spend with him? Like, what do you think I is
think it's the time that I'm able to spend with him because I'm only with him when I get back home from work. Mhmm. And then he's at school from from seven up to twelve, and then he's with the nanny from the until I get back home.
Is he experiencing many hypers? Any a lot of lows, or is he mostly higher?
It's a it's a combination of both, to be honest, because sometimes it it has to do with maybe he went to school and then they went for swimming. Mhmm. Or he went and did some type of sport, and then the the particular teacher or coach that was with him during that time didn't know to watch for the for the alerts, and then they didn't give him the the glucose tablets that he needed.
So he can get he can get low and stay low. And are you mostly are you not being as aggressive with insulin because you're worried about him getting very low when he's away from you? Or
Yeah. Sometimes I'm conservative because the the another thing is that I've noticed it's winter here right now.
Okay.
Just started the winter season, and I've noticed that he's more insulin sensitive for some reason.
Some people talk about that.
Yeah. To pull it back a little bit, and I'm still trying to figure figure out what the right dosage should be. Yeah. And I think I changed it yes just yesterday.
And what insulin is he using right now?
We're using NovoRapid and Protofen.
NovoRapid. Okay. And how how much does he weigh?
He's twenty twenty two kgs.
Okay. And and you're so you're shooting does that basal insulin go in once a day?
No. We gay we give him basal in the morning.
Yeah.
We give him for the morning, I I give him between between seven and nine units of, the basal. And then in the evening, I give him five.
So they have you're splitting it because that's the directions for the medication or because it's what you found worked better?
That's what the doctor told us to do.
The doctor told you know, can you spell the name of that that basal insulin for me?
It's p r o t o p h e n.
Got it. Yeah. So they say it it I wonder if that's Levemir. Hold on a second. I'm gonna try to find out.
Okay.
Is because if they're asking you to split it it's not Levemir. It's Miles per hour. Okay. So he's using Miles per hour and NovoRapid. Mhmm.
Do they not do you not have available something like hold on. List basal insulin's available.
I know people who use Tresiba.
Yeah. That's what I'm wondering about.
You know, I kept meaning to ask him about it because I I I haven't heard of other people who use Protofim for basal Yeah. As
I think the reason I didn't recognize the name is because it's so old. Most people don't use it around here anymore. If you have access to Tresiba, I would switch to that.
Okay.
The basal insulin conversation50:56
Yeah. That would be one injection every twenty four hours.
And Oh, really?
Yeah. And I would wonder if you wouldn't see a fairly reasonable reduction in his a one c too.
Okay.
Yeah.
Alright.
Yeah. I think that would be a a great idea for you, actually. I mean, ask the doctor and see what they say.
Yeah. I kept meaning to ask him, but the last appointment, I think it slipped my mind. I'll give him a call. Thanks for that.
No. Of course. Did hey. Treat that like that's an important thing to do because because I think it really could end up being meaningful for him.
Yeah. Yeah. Okay.
And save him a shot at the very least a day.
Yeah.
Yeah. Are are there pumps there? Are you thinking about pumps?
We've thought about pumps, but right now, we we had to shelve it because I for me, it was just having aside from the cost, of course, because I don't think our medical aids would cover pumps.
Okay.
Because they're already bulking at the CGM. So Really? Yes.
Okay.
It it was quite
A fight.
I had to do a lot of research to get them to cover that. I think they may have been hoping I didn't know that I was entitled
to it. Oh, I see. There's a lot of whistling and looking at the ceiling. Yes. Yeah.
Yeah. Yeah. So it
happens a lot around GA. If if you don't know your entitlements, you might miss out on things Mhmm. That you should be getting. So you really need to do your research, and so we got them to cover that. And I think pumps I don't even know if there would be support.
I don't know anyone who is on a pump, I think.
I see.
One or two other parents in Harare, but they may have had to go to South Africa to to to get set up and and all that. So I know very little about
that About about a pump.
And the costs.
Well, I would tell you that whether you can get a pump or not, if you can get your hands on Tresiba as the basal insulin, I think that would be a big deal for him. Okay. Yeah.
Alright.
For real. Because you are I mean, listen. You're educating yourself. You're paying attention. You're doing the best you can with the communication tools you have for during the day when he's not with you.
People are looking out for him for the most part. With that much effort, I think you should be seeing I think you could easily see an a one c in the sevens. And
Okay.
And if that's and if that's the case, I'm I'm asking myself what's holding you back, I think it might be the Miles per or or, you know, or not having a more modern basal insulin. And Tresiba is maybe like, I did a little bit of googling here. It looks like you can get, what you're using now. You can get Lantus, Basagar, some might might be Semigle, Glargivin, Levemir, Tresiba, but I think if you're asking me, I'd shoot for the Tresiba.
Okay.
I don't think you want I you know, Lantus would be great if you could get it. Levemir, you might have to split the way you are now doing one every 12 to get really good effect out of it. But, honestly, any of them, Lantus, Levemir, Tresiba, would be better than what you're doing, I think.
Okay.
Alright.
Just trying to write that down
so that I I would go Tresiba first. If you can't get Tresiba, ask for Lantus, l a n t u s. If you if you can't get Lantus, see if they have Levemir. Although, I'm hearing it's being discontinued in America, but I don't know if that means it's being discontinued in other places.
I see.
Yeah. So k. I I honestly, I think that'd be a big deal for him.
Oh, great. Yeah. We'll we'll definitely
Add some more stability to his background insulin, add more stability to his blood sugars. I would bet it would balance out his time and range and give you a a more of a fighting chance when you're making decisions.
Great.
Alright. Let yeah. Yeah. We're not done yet, but let me know if you're able would you send me a note and let me know if you're able to get ahold of that?
Yeah. Sure. Okay. I'll give you an update because
Thanks.
We actually scheduled to see him this Saturday. Oh, awesome. A conversation we're going to have.
Awesome. Tell him the guy from the Juice Box podcast said to give it to you. And if that carries any weight in Zimbabwe, I'm running for president. What do you think of that? So
It does. Trust me. It does.
That that's crazy. I can't wait to go downstairs and tell my wife about this after we're done. I tell my own kids stuff, and they don't listen to me. And you're telling me that people in there in Zimbabwe going, like, you gotta listen to this guy, Scott, on that podcast.
You should come and maybe have a few conferences because I'm sure you would be surprised with the turnout.
No kid. I I was surprised in in the Dominican. I spoke at a big I spoke at a big event there. It was really it shocked me. But it was so long ago, I I it's kinda out of my out of my it's been so long since I was there.
It's hard to remember. I actually the one thing I'll tell you is that I got there, and I had this whole talk set up to give. And I I looked around at my surroundings, the you know, where people lived, what the level of, income seemed to be, what and I thought, oh, my talk is completely wasted here. I had to I actually, was supposed to go to dinner that night. Instead, I went back to my hotel, and I I sat down and rewrote everything I was gonna say because they Oh.
They would have had no context for what I was gonna say. And, yeah, it was real you know, for similar reasons back then, availability to to technology and and, the way they even think about it. It was all just it was different than how so much different than how I thought about it that I thought, oh, what I'm gonna say isn't gonna be helpful. So I changed my I changed my talk up. But, listen, if anybody wants to fly me to to Africa to give a talk Lovely.
I'm in. Yeah. Like, I would are you kidding me? How many shots am I gonna have to get to go do that? They're gonna make me do a bunch of inoculations?
I don't think so, really. You may I don't know. You may get a malaria shots, I doubt, though.
I I can handle that. I would I get to go on a safari while I was there? I would like to do that.
Oh, yeah. There's you would I think you would love it. Yeah. If you love the outdoors and
Yeah. I do.
And animals and and nature. Yeah. There's really some some beautiful places to to visit.
I'm looking at my list of advertisers right here trying to think of which one would wanna send me to Africa. I'm pretty sure none of them are is the answer, but I'm putting the call out right now. Yeah. Oh my gosh. Well, okay.
So he's in school. There's some struggles. You're getting through them. You're getting good support from the school, which is awesome. How involved if this is cultural, I'm not sure what my question is, and I don't wanna cause you a problem.
But is your husband involved in his care too? Is it all on you? Are you guys splitting it? How do you do that?
Yes. He's he's involved in the care, a lot, more so on the financial side, only because I I think I've had I've really had a a tough time relinquishing control over this thing because I I obsessed over it in the beginning and getting all the information and and all that. So I felt I'm I'm only now starting to to release a little bit of of responsibilities even to my daughter. She's she's great.
Mhmm.
She also helps quite a lot. But, yeah, everybody's involved. My husband is a bit, you know, hesitant with the injections, but he's good with everything else. Okay. The alerts and just keeping an eye on on everything.
And, also, our parents are great.
Yeah.
Mother-in-law has been awesome. And my sister-in-law
Not scared to help and give insulin and stuff like that?
Exactly. Yeah. Yeah.
That's great. Hey. Do you have guilt? Do you feel guilty about it or anxiety from it? How would you describe why you're holding on so tight?
I think it's anxiety. Because when when I when I was researching about it, I at first, I did ask myself what I could have done wrong that led to to this condition. But when I when I realized what it was, I didn't have any guilt at all, but I am anxious, especially with, you know, the the these long term effects that come with with poor management.
I'm
really anxious about that. But, yeah, I think I'm I'm one person who likes to do everything myself.
I have
a tough time delegating.
Were you like that before the diabetes too?
Yeah. I've always been like that.
Yeah. Do you have are there any other autoimmune issues in your family? Do people have hypothyroidism or celiac or anything like that?
My brother has hypothyroidism. Yeah.
Mhmm. Have you ever been tested for it?
No. I've never.
Make sure they test make sure they test Levi once a year for it. Okay?
Okay.
Yeah. Alright. You wanna watch for that. Symptoms are, you know, unexplained weight loss or weight gain, hair loss for you could be brittle nails, weight gain. No matter how much you sleep, you can't feel rested, always always cold, heat intolerant, stuff like that.
Okay.
Yeah. Alright. So make sure you're you're paying attention for that because it's once you get one, it's not crazy to get another one. Didn't surprise me that your brother has hypothyroidism, for example. Mhmm.
So, you know, just keep keep an eye. Anybody anemic?
My mom.
Your mom is? Yeah. Mhmm. Again, not totally surprised. So One.
Yeah. Autoimmune issues
Both ties in.
Yeah. Autoimmune issues can kinda run-in families. You don't always all get the same one, though. Okay. Yeah.
And anxiety, while not an autoimmune issue, is a thing that I like, from my personal experience talking to so many people, I see a lot of anxiety in families who have type one.
I had anxiety myself, but that was I think that was linked to that was in the few months before I got diagnosed with with epilepsy myself, I used to have a lot of anxiety.
Did you?
But I think that was because of stress from work.
Mhmm. Yeah. Well
I didn't think that was connected.
What what's more stressful, work or that diabetes? Hard to tell some days? It's hard to tell. Good
question. I really couldn't make up my mind. But I think that's the the diabetes was stressful when I didn't know what what I was doing. But I know that it's something that I can I can perfect at some point? Yeah.
Not perfect, but get as close to perfection as possible. And the fact that I I have some sort of control over, you know, how things may go make makes it less stressful than work, I think.
You've said a few things while we've been talking that I I'm I I don't wanna ask because I think it sounds distasteful to ask, but it feels like you're mimicking some of my words back at me. So are you learning those ideas from the podcast?
I don't know because maybe it's possible because I do listen to to your podcast every morning when we're getting ready, you know, in the morning to go out. We we usually have your podcast playing, and, you know, that could be that could be it. Mhmm.
Well, that's just it's all good things about, like, you know, just having expectations for, you know, getting better at this over time and stuff like that. Like, it it's nice to think that you're you're finding value in it at all, honestly. Does your husband ask like, does he make fun of you for listening to a podcast from a guy in New Jersey? He does. Right?
You know what? He he has he has several times, something has been said on the podcast, and he's he's looked at me and said, can you replay that? Can you rewind? I didn't hear that.
Well, you know me. You're making my day. I have to tell you. Yeah.
I think it could be a joke and something that you would have said that
Oh. You know, The guy part of me. He likes that part. I gotcha. Okay.
Yeah. I gotcha. Well, that's like, hey. However however you get them listening, who cares exactly? Right?
Hey. How old are you? I didn't ask you in the beginning.
I'll be 40 in July.
You'll be 40 in July. Oh, happy birthday. I'm I'm July too on the twelfth.
Oh, nice. Yeah. Nice.
Yeah. Do you find any of that zodiac stuff to be true about Cancers?
No. I've never
You're not emotional or, like like, have you ever read, like, the I I don't believe in a straw I wanna say I don't believe in astrology at all, but Arden read me something the other day, I was like, that all does really sound like me.
I've never I've never paid attention to any of that stuff, actually.
Me either.
Been in front of me.
Until yeah. The other day, she just like she's like, hey. Does this describe you? And she read a whole bunch of stuff, and I was like, oh, I think it does. Then we read some other ones.
I'm like, these all this I think these are just written so they describe everybody. But but They're generalized like that. Yeah. Are you getting sleep? Are you sleeping okay?
I think I sleep okay.
You're not worried about Right
now, I'm not sleeping much because I'm also studying. I'm doing further studies, so I I don't get to sleep because of that.
But the diabetes isn't keeping you from sleeping?
There've been days. There there've been days, especially in the beginning when we couldn't figure a lot of things out. But now I know I know what to do, especially with the CGM. The arrows tell me how to how to react or how to respond to an alert Yeah. Which usually keeps us good for the next few hours.
Especially if I'm with him, I'm able to to get ahead of of it so I can get some sleep.
Good. Good. You know, I have to tell you, like, I I I I I try I don't wanna be, like I don't wanna say something that sounds stupid, I guess. I'm trying to be careful here. But you have you have an AI model?
Do you have, like, chat GPT there or something you can use to break down the the food? Because that's gotta be like, it just occurred to me. Like, why don't we why don't we do this? Can you give a nutritional breakdown for salsa? I need fat, protein, and carbs.
Let's see what happens.
Okay.
I'll give a plain serving estimates, and salsa changes a lot depending on how much maze or meal is packed into the portion, it says. And now it's looking online for answers. So let's see what happens. And while it's doing that, I'm gonna ask a different model, the same question to see if we get a reasonably similar answer. Alright.
So I I did chat GPT first. It says that a 100 grams cooked salsa should be between twenty and forty five carbs, between two and five grams of protein, and it only has about a gram of fat in it. A medium serving, which they're calling 45 to 55 carbs. So four to six protein. Okay.
So the wide range has become a size that can be soft or thick. Water adds weight, but not calories. So a wetter size that has fewer carbs per 100 grams than a dense one. So that might be helpful to know too. If it's denser, it might have more carbs in it if it's wet or less.
And then I used I also used something called Claude. I don't know how many of these you guys have there, but, a rough nutritional breakdown for a typical one cup serving, which is about 240 to 250 grams of cooked salsa. Again, 40 to 45 carbs, four to five proteins, and fat, one to two grams. So does that is that about what you imagine, or is that helpful information?
I think this is helpful. I've never I don't think I've ever broken it down like this.
I have to tell you. I just it makes a ton of sense to me because do you guys eat boda? Am I saying it right? What? Or Capenta with Sada?
Capenta is not a favorite of mine.
No? Okay. Well, I don't know what I'm doing. I'm just going by I'm just giving you a list of what's been sent back to me. But what I think is, no kidding, if you have access to ChatGPT, it's as simple as give me a nutritional breakdown for the food and ask for fat, protein, and carbs.
Do know it's it's actually quite funny because I use chat GPT almost daily for my school. Yeah. I never thought to to ask for a breakdown for for food.
I would give it a I'd give it a shot. And and if you go if you wanna go back to my website, there's a a bolus estimator there. So you could if you you if you know his settings, his insulin to carb ratio, his sensitivity, you can plug that all into that little estimator and then put in the carbs, the fat, the protein, and it'll give you a suggestion about where to start with the bolus.
Yeah. Yeah. It's crazy. I never thought to to prompt charging p t about that. But I did go to to your the calculator thing on your website.
The only thing that that threw me off was how to how to get how to determine sensitivity.
His insulin sensitivity.
So The metrics. Yeah.
That number is
only know that he's more sensitive or he's less sensitive, but the numbers
don't move. So what you what you would do there is that's how much how much how many how far, like, what number does one unit of insulin move him? So when you put in the the the fast acting insulin, like, I guess the the question here would be if his blood sugar is oh, I have to bring up the I have to bring up till I can talk to you in in your I'm not good at talking in millimoles. Hold on a second. If let's say his blood sugar was let's say it was 10, and you wanted it to be so for people listening, it was a 180.
His blood sugar was 10, and you wanted it to be 80. How much insulin moves him from one eighty to 80? Do you know? Do have a guess?
So that's from 10 to Four.
Yeah. To 10 to, like, four and a half. So think about it like five. How how much insulin moves in five millimoles? Wow.
Because there's also the time factor to say how quickly does it get him there. Right?
Exact maybe time a day for his activity and stuff like that? Mhmm. Yeah. So
Okay. Maybe if I if I give you the if I give you the correction scale
Okay.
Does that does that give you
Maybe but first
a better picture.
At first, tell me what does he weigh? How many kilograms does he weigh?
Twenty two. Twenty two. So
he's about forty nine pounds, maybe forty eight pounds. And I so you're not using a a a modern basal insulin yet. So there's a little bit here that I don't know. But my the guess here from this is that a unit of insulin moves him about a hundred and forty six milligrams per deciliter, which should be let me find out how many millimoles that is. I know the people who know this are like they just know it because they do the math real quick.
So a hundred and forty six would be about eight millimoles. Okay. Yeah. So would a unit move him about that far, do you think? Oh, wait.
I have it here. I'm so sorry. Yeah. Yeah. Eight.
My my my estimator does that. I did I never clicked on it before. Oh, it works. Congratulations. So there's, like, there's a settings calculator here, that helps you guess by weight about what settings would be.
So Oh. So my point is is that if to to check, you could check to see does one unit of insulin move him about eight millimoles. If that's right, then you understand his insulin sensitivity to be one to eight.
Okay.
Okay? And and then and then you can you know, when you use the calculator, that's about the sensitivity you would put in. And his carb ratio is what do you think? Like, how many car like, the how many carbs does a unit of insulin cover for?
Let me see where I look. One second.
Take your time. Because this has a guess based on his weight, so I'm interested to see how close this is to your reality.
Okay. So I well, on average, maybe if if we give him if if he's having a meal with maybe thirty thirty calves
Mhmm.
That could go with roughly two two to three units.
Two to three units. And that's
the short acting Okay. Of the the normal rapid. Yeah.
And that's probably because you're not getting a lot of backing from the the background insulin. Oh. So it's possible it's hard to talk about right now because you're using that, but it's possible that if you can get him moved to Tresiba, what you're gonna find is that he's gonna use about six units of Tresiba a day. Oh. And then then you might find that a unit of insulin covers about 40 carbs for him with the basal insulin.
With the NPH, I honestly don't know how to talk about that. Like, I'm I'm not sure. But if you're finding if you're finding that it it takes two units to move him for 30 carbs, then at least that calculator could probably give you an idea of, like, well, about how much is here based on your settings. And then you could, you know, you can hold that up against what you've been finding. And my thought here is what if you what if you say, oh, well, I would put in, I don't know, three units for this meal, but this this estimator is telling me it's more like four and a half.
And maybe that's why his a one c is eight and not seven or not six. Do you see what I'm saying? But, again, I might hold that thought until you shake that Tresiba out of that doctor on Saturday. I think that's that's that's the that's the way to go. If you wanna point your anxiety at somebody, point it at the doctor and ask for Tresiba.
So Yeah. See what you can get.
Definitely going to ask for it.
Yeah. I mean, it would be a big deal. And and listen. Once you have that hopefully, you get it and it works well for you. Go tell your friend group too in case they're doing the same thing because you're managing with insulin that we don't really even use here anymore.
Okay.
You know? Yeah. And if you have the other stuff available, then then I say go for a more modern Bazel and so on.
Okay.
Yeah. Is there anything that we haven't talked about that you wanted to? I don't wanna skip anything that you wanna talk about.
No. I think, yeah, I think I got everything out that I wanted to.
Good. I wanna tell you and people listening, I'm not telling you to let an AI model manage your your insulin. But a person in your situation, I don't know why you wouldn't at least try to get a background from it and say, look. My son is this old. He weighs this much.
Using AI as a sounding board1:16:50
He takes this this insulin at this time of day, this much. He takes this he takes another shot of twelve hours later, that much. This is what he's using for meals. Remember that. And now here's what we're eating.
Can you help me bolus for this? And see if it can and see if it can give you some direction. Yeah. I don't Okay. I don't listen.
Again, everyone should talk to their doctor first. But
Of course. Yeah.
Thank you for saying that. Nothing you hear on the Juice Box podcast should be considered advice, medical, or otherwise, always consult a physician before making any changes to your health care plan. But I'm seeing some people online who are doing this, and it's helping them a lot. A lady put up some graphs the other day, and she's like, I didn't know what to do. I had trouble understanding the podcast.
I've been talking it through with a large language model and look at my kids' graphs. So, basically, just treating it like a sounding board for what and and giving it as much information as they could about what was going on, and it was helpful for her.
It's interesting because I just I don't know why I never thought of
it Yeah.
This whole time.
Yeah. Maybe maybe because it's a little silly, but it works. So for a lot of people, so maybe it's worth the shot.
Makes a lot of sense.
Sure.
Yeah.
Listen. I was in a store the other day. I had to buy lumber, just two by four, you know, to build something with. And I got there and realized I'm like, I don't wanna buy extra. I just wanna I wanna be able to make you know, I don't wanna have a bunch left over.
And so I I opened up my phone, opened up ChatGPT. I was talking to it in the store, and I was like, I'm building a frame in this area. Like, here, here, here. It's gonna have four sides, then four legs, and then four other sides. I'm gonna make a stay a stand out of it.
I don't wanna buy extra two by fours. Tell me exactly how many I need to get these pieces out of it. And it did the math in, like, a split second and told me. And I was like, right on. And then I bought four two by fours, and I left.
So And and I and I even said to her, I was like, hey. Are you accounting for all the cuts I have to make? Like, not just giving me, like, the number of inches I need, you know, or the amount of distant and it said, no. I already I already thought about all that. I was like, oh, awesome.
So, anyway, I don't wanna get replaced in Zimbabwe by chat GPT, but I do want I do want you guys to be healthy and happy. So I think any any tools you can find that are valuable, you should use
them. Yeah.
You know? That's also hey. What time is it there? You're about eight hours ahead of me?
Right now, it's 07:21 in the evening.
Okay. You're six hours ahead of me. Okay. I could I wasn't sure if you like, you said you weren't good at geography, and I couldn't figure out if you were East, West, or Central Africa. So
Neither can I? Trust me. I don't even know where Harare is from where I am. So
Do you not get to leave ever? Have you ever been to another country?
Yeah. I've been to I've been to South Africa. I've been to Botswana, and I've been to Mozambique.
Mhmm. Have you ever left the have you ever left the the continent?
Nope. No? Not yet.
Is there a place you'd like to see?
Yeah. Of course. I want to see, you know, I want to see New York, Los Angeles, Las Vegas, France.
Those places will flip you out. I listen. I watched my I watched somebody once come into New York City through the subway from the airport. So Okay. I got to walk up from underground into the middle of Manhattan with them for the first time.
Mhmm.
And they walked up out of that hole, and their head just kept going back and going back and And going the bill the she she was from she was from Wisconsin from the middle of
Oh, okay.
And she's like, oh my god. This is insane. I've never seen anything like this before. Until you see all those skyscrapers stacked on top of each other, it is it's only a thing you can it pictures don't do it justice when you're standing on the ground. Really So, it's really if you make it over here and you can get a look, it'll it gives you a different perspective.
That's for sure.
So you're telling me that, this person from Wisconsin, the difference between where where she's from and
Manhattan was starkly, shockingly different.
Still shocking.
Okay. Yeah. There's the 100 story buildings there, and they're just one after another. And you're this tiny little speck on the ground looking up at them. And Wow.
Cars are going in a thousand directions. All you can hear are cars, motors, tires, people talking, feet moving on a breezy day. There's this really interesting thing that happens in Manhattan that the that the wind only goes in one direction. So you could be walking down one road, be in a wind tunnel, then get to another, like, to an intersection, and it just stops. And but but it's just a very different place to be.
So, yeah, I've never been to Vegas, but I am going next year, for my for the first time to see it. I'm gonna go see a concert in the sphere. Oh, okay. That big like, have you ever have you seen that? The it's like this giant building that's literally in a sphere, and you I'm going there next next year to see Metallica, I guess.
Never heard of that. I I know there's a there's a Las Vegas Strip. I don't know.
Yeah. That's all I know. I think that's just casinos and hookers. I'm not really sure if that's anything else. You might wanna skip that.
You might wanna skip that. Unless you're I don't what know you're looking for. So maybe you maybe it's up your alley. I have no idea. But It's
just to see, the most common places that we hear that that America is famous for.
Yeah. But New York will it's different than any other place, but it is very it is very much, I guess, an American icon in New York City. Yeah. Philadelphia is pretty awesome, but it's nowhere near, New York. I hate to say that because I'm from Philly.
But
Ah, okay.
Yeah. Alright.
I have a friend who's who says she stays in Philadelphia somewhere. Mhmm. An old high school friend of mine.
No kidding. Yeah. No. I'm very I'm close to there now, actually. I don't wanna tell people exactly where I am, but I'm within an hour of Philadelphia.
Because I have had people send things to my home before, which I appreciate it. Thank you all. But it freaks me out, so don't do that. Okay? But but, nevertheless, I really do appreciate you doing this with me.
This has been a lovely conversation. I hope you found it valuable.
I did. Thank you very much.
Naming the episode1:23:37
Yeah. I appreciate it. What should we Beau, of course. What should we call this? There's no way that I I at one point, you said you said you said that we had a pizza disaster.
I thought, is Zimbabwe pizza disaster too good? Is that too much of a title?
You could call it hurricane Levi. Yeah. Because we spoke about, you know, how energetic he is, and sometimes that's what I call him.
What do you call him? Say it again.
Hurricane Levi.
Hurricane Levi? Okay. I know you've mentioned it, like, four times. That kid does you were like, he's a handful. He is a
handful. I I think I should have had him because my kids are far apart in age.
You're a little tired.
Had him in my twenties when he was younger.
Well, let but let's be honest, Azil. Is he more like you or your husband?
He's more like my husband. Definitely.
I see. So you got two little boys. You're you're wrangled over there. Yeah. Yeah.
Well well, thank you so much. If you hang on the line for just one more second, I'll I'll tell you a couple of things about how this will come out. But but you're all done, and I do I really do appreciate it. Hold on one second. You.
Of course. So it's a pleasure. Something new just arrived from MiniMed. It's the MiniMed Flex system. Think about everything people love about MiniMed technology, designed for great outcomes, helping keep you in range, and made to be easy to use.
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Kontoornext.com/juicebox. That's right. Today's episode was sponsored by the Kontoor Nextgen blood glucose meter. It's the meter my daughter uses. She has it on it right now, and you're one click away from having it too.
And don't forget using JuiceBox podcast links helps support the show. Friends, my diabetes pro tip series is about cutting through the clutter of diabetes management to give you the straightforward practical insights that truly make a difference. This series is all about mastering the fundamentals, whether it's the basics of insulin, dosing adjustments, or everyday management strategies that will empower you to take control. I am joined by Jenny Smith, who is a diabetes educator with over thirty five years of personal experience, and we break down the complex concepts into simple actionable tips. The diabetes pro tip series runs between episode one thousand and one thousand twenty five in your podcast player, or you can listen to it at juiceboxpodcast.com by going up in the menu.
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#1917 Around the World
Around the World
Bella was diagnosed at four and spent two decades at an A1C near ten, with an endocrinologist whose method was yelling. She also bet Scott he couldn't guess what state she's from.
Jump to a moment
- Twenty-plus years at an A1C around nine or ten, and it was never a motivation problem. Bella was diagnosed at four, giving her own injections by six and doing her own carb math by eight. She bolused for every meal. What she did not have was direction — she describes an endocrinologist whose method was yelling, a lot of demands and very little instruction, and a household where the doctor was the professional and you did not question the professional.
- “Magical thinking” is her own term for how the numbers drifted. Working from a fixed carbs-per-meal plan and perpetually hungry, she would round a portion down in her head so an extra item would still fit the allowance — and she was never taught that she could simply take more insulin to cover more food. It is one of the most honest descriptions of how good-faith carb counting quietly comes apart that this show has had.
- The endocrinologist accused her of an eating disorder she did not have. Once she hit puberty he began attributing her build to anorexia. Bella is emphatic that she never had one, points out that her parents' builds explained hers, and adds that a persistently high A1C explains thinness too. She carries an obvious grudge about it, and describes years of being told she was doing it wrong without ever being told what to do instead.
- Three things moved the needle, and none of them were being yelled at. A CGM, a community post about a pre-meal timing heuristic — wait roughly a tenth of your glucose number in minutes before eating — and then learning that protein and fat are not free, and working with the Warsaw method for higher-fat meals. Her A1C is now 6.2. Her summary of it is that she just needed information and tools. Settings and dosing changes belong to your own care team.
- Better numbers came with a cost she is candid about. As her A1C fell she gained weight, which she found genuinely hard, and she is clear-eyed about why — higher blood sugars had been keeping her thinner. She also describes childhood verbal and emotional abuse, depression and anxiety she did not have language for until she read the definition in a college textbook, and PMDD she was diagnosed with much later. She names therapy, medication, her faith, and her own long work on herself — and explicitly warns against the idea that meeting the right person fixes any of it.
- Rule of 10 — The pre-meal timing page Scott announces on tape — divide your glucose by ten for a starting lead time in minutes.
- 30/60/90 Forecast — Companion page: where a glucose number and a trend arrow may be heading.
- Reading Your CGM Trace — The third page in the set — what the shape after a meal suggests about timing.
- Diabetes Pro Tip series — The fundamentals series with Jenny Smith that Bella found after the Facebook group.
- Mental Wellness series — Episodes with therapist Erika Forsyth on depression, anxiety, and the emotional side of a lifetime with type 1.
- MiniMed Flex — Sponsor of this episode — app-controlled automated insulin delivery.
- Juicebox Podcast Facebook group — Where Bella's nurse pointed her, and where she saw the post that changed her management.
- 988 Suicide & Crisis Lifeline — Free, confidential, 24/7. Call or text 988 in the US. Outside the US, Find A Helpline lists services by country at findahelpline.com.
Every word of the conversation
Welcome & Sponsors0:07
Friends, we're all back together for another episode of the Juice Box podcast. Hey. Nothing you hear on the juice box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan.
Hey. My name is Bella, and my god.
It's hard to introduce yourself, isn't it? This episode of the podcast is sponsored by MiniMed and the Kontoor NextGen blood glucose meter. MiniMed, of course, the innovators behind the MiniMed Flex system, a small, sleek, and discreet insulin automated delivery system controlled from an app. Nothing comes close to freedom you can feel. To learn more, visit minimed.com/juicebox.
There is one blood glucose meter in this house, the Kontoor Next Gen blood glucose meter. That meter is on my daughter's person right now and at all times. It is incredibly accurate and waiting for you at kontoornext.com/juicebox.
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Try this. Hey. My name is Bella, and I have type one diabetes.
Perfect.
Okay. How long have you had type one, Bella?
I have had it since I was four, and I'm 30 now. So I guess that makes it twenty six years.
Look at you doing the big math. That's excellent. Excellent. Excellent. Excellent.
A Challenge: Guess the State1:59
So you you've you've thrown a challenge down to me before we've began. You said, I wanna see through the through this conversation if you can figure out what state I'm from.
Yeah. Alright.
We'll we'll see what happens.
Yeah. Absolutely. You have this huge catalog of so many people that you've interviewed. And the last person that I've heard you interview, you were able to identify, yeah, the birth order that she was in. Oh, that no.
That that's right. They, What was her name? She's 19.
19 year old.
Yeah. Yeah. Yeah. You can tell by anyway, I can tell. Alright.
Well, we'll we'll see what I I I feel a lot of pressure right now, but that's okay. I and it's good for me. Keeps the morning moving. Let's figure out why you came on the podcast and a little bit about your story. So I mean, I'm gonna guess you don't remember a ton about being four years old.
Is that right?
Yeah. Pretty much.
Well, that's that's fair. When's the first time in your life you remember having, like, conscious thoughts about I have diabetes and it's part of your story now?
Diagnosed at Four3:03
Yeah. I would definitely say it was when I was diagnosed, when I was in the hospital, actually.
You do remember that? Yeah.
I do.
Go ahead.
It was, you know, a little traumatic, as I would say for most people.
Kinda kinda thing that sticks with you, Pella, a little bit. Yeah. So you don't make sure I understand. You don't you don't remember a ton about being four years old, but you do remember about being diagnosed?
I do. Yeah. Go ahead, Tara. So I asked my parents, and they do bring it up from time to time. Because I went in four days before my dad's birthday, and then I came out on his birthday.
So happy birthday, dad. So my mom says that I was you know, had the typical signs of drinking a lot more. And so in the typical fashion of the day, she gave me juices Mhmm. Which was such a great idea, right, but she didn't know any better to satisfy my thirst. And I was four at the time, so, of course, I was potty trained.
And but I started wetting the bed, and she was like, what's going on? And she said I was cranky and which was not, like, my typical behavior Yeah. Not my typical typical mood. And she was like, something's going on. And, you know, I looked tired all the time.
So she took me in, and the story goes that she took me to the doctor. They tested my blood, and they looked her in the eyes and said, you need to go home, pack for a week, and take her to the hospital right away. So she's packing. She's crying. She's trying to get ahold of my dad.
She can't get ahold of him, And so she called my uncle. He says that he'll get ahold of him, and I guess he was, like, working out on the track. And
On the on the track, your your uncle's your father works out on the track or your uncle?
He my dad was just working out on the track. He was just running.
Oh, okay. He was out running.
Yeah. He was out running.
What time of year was this? You remember?
July.
July. Okay. Yes. I was hoping that it was a winter month so that I could I could narrow down the states you live in to warm weather states. I was trying to trick you.
Okay. Yeah. Very smart.
We'll see. How many brothers and sisters? Do you have any?
It was July 8.
July 8. Okay. Do you have brothers
and sisters? I have an older sister. She's nine years older. She's my half sister.
Okay. Okay. So a nine year
old sister. Estranged.
You don't talk to your sister?
I do not.
Do you talk to your dad?
Yes. I do. Actually, he's supposed to come and see me in a tomorrow.
Nice. I guess I gotta ask, do you speak to your mom still?
I do. Yeah.
You do.
So just I have a good relationship with mom.
The sister then.
Just the sister.
Okay. Okay. Alright. So your mom gets a hold of your dad out there working out trying to be thin or no? Does she head off to the hospital by herself with you?
So he gets the voice mail once, you know, once he's done working out, and, he meets her there at the hospital. And, that's that's kind of all I have of the story there.
Do you And then think, Bella, do you think that story is your memory, or do you think it's been told to you so many times that you remember it?
Oh, yeah. For sure that
Okay.
The latter.
Right. Right. So then when the the actual hospital stay, they told you to be ready for a week. Were you there for that long?
I definitely remember being there for multiple days, so I could see it definitely being a week. From what I remember, there was a nice nurse, and we were doing some arts and crafts. And I actually had one of those arts and crafts for a long time. I don't remember if I eventually turned away when I was older, like a like a angsty teen, like, I don't need this anymore. But
You wish you had it
now? Maybe.
Maybe. Well, okay. Yeah. Alright. So what about growing up with type one?
I mean, is it I mean, twenty six years ago is what year? It's 2000.
It was 2000. Yeah.
So my god. You were, okay, you were diagnosed at four years old the year that the year my son was born. That's interesting. So I'm putting myself back in that space and that situation. That's Mhmm.
Six years before Arden was diagnosed. When Arden was diagnosed, they only gave you so were you getting would you have, like, Humalog and Lantus? Or do you were were you still the back end of regular and Miles per hour? Do you remember?
I genuinely don't remember.
Okay. Alright. What's the first time you remember, like, how you managed? Like, when you look back, do you think, like, did you give yourself your own shots at some point? Were you
Giving Her Own Shots at Six8:21
on a pump? I was my parents and I were really proud. So I was six years old when I started giving myself my own shots. Nice. My own injections.
Yeah.
And how often how often did you do them?
For every meal, of course. And then, I had, morning and a nighttime long acting.
Okay. Alright. So you were using probably Humalog and Lantus or something like that?
Probably. Yeah.
Okay. And so are you doing the math at your meals at six or no? You're just your parents are handing you a needle and you're you're doing the the work?
I would say probably at eight, I was doing the math. I remember distinctly being very proud, at winning, like, around the world. I don't know if you know that game, like, school game, around the world in math class.
I thought that was a guessing game. So I guess I don't know what you're talking
about. What?
I thought that I thought that wasn't that like a party game? Like sorry. No.
Thinking of, like, seven minutes in heaven?
I don't know. Maybe. Is that what I'm thinking of? I can't believe you just pulled that out, like, it was a real thing. Is that when they shove you in a closet?
Yeah. Okay.
Alright. I don't know what I'm thinking of then. No.
Absolutely not. Obviously, it's
not what you were doing when you were eight years old. That's not what I was saying.
Not in the not in the math classroom. No.
Not in the math classroom. Okay. So you remember go ahead. You were very proud. Sorry.
So, basically, the teacher would hold up a flashcard, like a multiplication flashcard, and one person would stand up next to, like, the the front row desk. And so it was, like, one person against the other student. And whoever got the flashcard correctly would move on to the next student and then the next and the next. And, if you got, like, you know, through all of the students, then you won around the world.
And you won this because your math was so excellent. Your math
was so excellent due to diabetes.
There you go. And today, you're an accountant.
My mom is, actually.
Oh, no kidding.
Today, I am a special education teacher.
Oh, that's lovely. Look at you. Okay. Alright. So you had you had some nice moments growing up.
Do you know what your outcomes were like or even what goals were were set as? Like, what did healthy mean to you when you were younger?
An Endo Whose Method Was Yelling10:49
Yeah. Healthy meant just playing sports a lot. I really love just being outside and playing sports with my dad and my cousin. And, yeah, I just I just loved being outside. And then going I hated going to the endo, honestly, because he his form of doctoring was yelling.
Really? And yes. And then once I hit puberty, his form of doctoring well, that's that's such a great verb, was accusing me of being anorexic.
What were
Which
Okay. Were you? Were you?
No. No. No. I never actually had any form of ED, and which is so funny because you can tell I have a bone to pick with him.
So I can't you know, I'm I'm trying to get to it. Don't worry. Go ahead.
Yeah. Yeah. Yeah. My mom is a very petite woman, and my dad is very tall. So I'm just like, sir, the math is right in front of your eyes.
Like, I don't understand why you think me being a skinny tall girl, like, is an issue.
Oh, so that was it. It was your body style that made him think that? Yeah. And you're saying he could have easily looked at your parents and saw that you had a tiny mom and a really tall thin dad and thought that makes sense that she's built this way.
Yeah. I mean, my don't get me wrong. My dad was not thin. He's he's he's a big boy, he's also very tall, and my mom is very thin and tiny. And, also, as an endocrinologist, he also should have seen that my blood sugars were very out of control.
And, obviously, we all know that when you have a high a one c, you tend to be skinny.
So, also, you're, what do you mean out of control? Like, how where were your a one c's at?
I mean, about 10.
Pretty consistently? Like, stably 10, or did they bounce around?
I mean, nine, ten. It was it was pretty bad.
Okay. Why do you think that was?
Magical Thinking and a Sixty-Carb Rule13:16
I think lack of education. You know, the we didn't have the juice box podcast. So
You just think we just don't think you like I mean, but but seriously, like, you miscounting carbs? Are you even being told to count carbs? Are you not injecting for everything you eat? Are you, like, forgetting the basal?
I I was not pre bolusing long enough. I did I did bolus on, like, every single time. Mhmm. And I also, with reflection, believe there was a lot of magical thinking because I was so hungry all the time. Like, I was I had a, like, a high metabolism for sure.
So we have, like, a set like, you eat 60 carbs at every meal type of deal.
Okay.
And so if I wanted, like like, 20 more carbs, but I was at, like, 50, I was like, oh, well, like, that might have only been 45 and, like, so maybe I can have this biscuit that's 20, but, like, 15 carbs is not so far from 20. So it's okay.
You start lying to yourself about the the truth about the math of what you're eating.
Exactly.
And then so eating more, but then not giving insulin later for that.
Yeah.
Okay.
Because you're not because I wasn't really taught, you know, to give more in those situations so that I can cover the carbs. It was just like, oh, no. You only have 60 and, like, this is how much.
Okay. I gotcha. But then you go to the doctor and your a one c is higher. Does that not say to you, I must not be using enough insulin?
I think the culture that I grew up in, my parents and I, we were just taught, like, the doctor is the professional, and you listen to the professionals, and that's that. Like, you don't question. You don't you don't get creative.
What what culture? You did this
I see what you're doing.
You did this spelling, not me. Go ahead. What culture? I mean, I can see I can you know what I mean? Like, I I I can guess, but it's so if you can tell me, it'll it'll go quicker when I tell you probably live in California.
But go ahead.
So they grew up my mom I guess, like
You don't wanna say?
Screw up.
You don't have to say. No.
No. No. No. No. No.
I at first, I I didn't wanna say because then it would give you a hint as to if he grew up.
Listen. You can't you can't defend. I get to ask questions. Questions. Go ahead.
Yes. Yes. That's true. Okay. They both grew up very, very low income, like, you know, stamps and all that.
Mhmm. So I think that has, like, a huge impact on, you know, having great respect for those who have a much higher education than you. And then, also, they both grew up Catholic. And, again, like, that's, like, rule following and all of that.
Okay. So by culture, you mean, maybe looking up to people who have, you know, achieved more than they feel like they have and Mhmm. That they were Catholics, so there was a lot of you do what you're told.
Right.
Okay. Little do what you're told, little bit of that. I got you. So then but then if the doctor's yelling that you're I'm assuming that yelling was your a one c is 10. Right?
Mhmm.
Okay. Then why didn't we then not do what we were told and take care of it? Was it because you didn't get actual information about what to do next? You know what I mean? Like, sometimes they're like they're like, just fix it.
And then you're like, well, how? And then there's no answer to that.
Yeah. I mean, from what I remember, that's basically what it felt like.
Okay. So a lot of demands, not a lot of direction.
Mhmm.
Okay. So how does that strike you then when you're a kid? Like, you're being told you're doing the wrong thing. Meanwhile, you said your your bowl is synced for all your food. You feel you probably feel you probably feel like, hey, I'm putting a lot of effort into this.
I'm not I'm not getting outcomes. You're telling me I'm wrong, but you're not giving me any direction. So what does that, like, turn on yourself and makes you just feel like you're messing it up?
Yeah. It just felt very stressful.
Okay. Constantly. I would I would imagine. Yeah.
Yeah. I mean, like, I grew up as a kid that was very placating, just for the way that I grew up.
What do you mean by that? So
What Was Happening at Home18:28
both my parents were abused in different ways, and my dad especially let me know, and he probably should not have because it took a toll on, like, my mental health. And so and then he kind of, like, passed down some of that to me.
So your father so your father was abused. He he abused you and told you about what was done to
him. Right. Okay.
And
Which kind of, like, was an excuse.
For what he was doing. Mhmm. Okay. And how and I'm sorry. We got to that kind of, like, oddly.
So I started off by asking you if you're being told what to do and your family's a bunch of rule followers, how come the out the outcome isn't different? And I think we get to it's probably because there was no actual direction about what to do. Just you're not doing well, like, do better. And then what happens? Does your dad do the same thing?
He tells you do better?
Mhmm.
Okay. And again, you're a young kid and you don't have any context for what do better means. So the doctor doesn't tell you what to do. Your dad doesn't tell you what to do. Everyone's yelling, some people are hitting you?
No. No. It's it's just verbal and emotional abuse and it's just like trying to figure out how best I can please people.
So you're being badgered and that turns you into a people pleaser?
Mhmm.
Gotcha. Is that still a problem for you today?
Yes. But I have grown quite a bit this past decade once I figured out that that's what was going on when I was a kid.
Yeah. Did you go to therapy to figure it out?
Finding the Words for It20:32
I started going to therapy in high school when I realized I was depressed, but I didn't figure out that I had been experiencing, like, verbal and emotional abuse until college when I was when I took, like, a psychological class and was reading, like, the definition and symptoms in a book. And I was like, oh my gosh. Like, that's me.
Yeah. Oh, isn't that something? You you found out in a book what was happening to you?
Yeah. Well, that's
was that really
They call it
Good.
They call it Sorry. They they call it something when it's, like, co co something. It's it's not normal where, like, a parent relies on the kid.
Oh, codependency.
Codependency. Thank you. Mhmm. And that's basically what was happening. Like, the like, my dad was relying on me as, like, his therapist, and he and we shouldn't be doing that.
Yeah. No kidding. When you read in when you're in college and you read about like this thing that you're like, oh, that's my life. Is that relieving to you or is it is it just tell you, gosh, I probably have some things to figure out? Like, where do you go from there once you read that?
Yeah. I I'd say it's both. It was it was definitely like a relief. It was it was like, wow. This this makes a lot of sense as to why I am the way I am.
Meaning people pleasing? Yeah. Depressed too?
Depressed, people pleasing, anxious.
Describe the depression.
Well, it's it's difficult because the anxiety and depression, like, kind of work together. Like, the anxiety will push me out of the depression to, like, go and, like, work so hard, but then, like, to get good grades and, like, to overachieve and things like that. But then the depression is like, oh, like, all these people hate me and, like, I I suck at, like, everything even though, like, I've achieved so much. So it's
You're doing well.
It's really negative self talk.
Yeah. Yeah. You're doing well on the outside, but you're you're telling yourself well, you're not telling yourself, but yourself is telling you that it's a failure and people don't like you. And so all that Mhmm. All that is likely from how you were treated at home, you feel.
Yeah.
Yeah. And then you go to a therapist and but they go, like, magic wand. Right? And then it just goes away. Or do you talk for That's okay.
You talk for a number of years till you get through it?
No. No?
Did did are you married now or dating or anything?
I am. Yeah.
Did you meet a meet a guy that was helpful with you for this stuff?
Yeah. I mean, I I I don't wanna say that he I don't I don't want anyone to think that, like, you if you're in my situation, all you gotta do is, like, go out and find the right person. They're gonna fix you because that's not what happened. Like, I worked on myself for so long, and I found out as well that I have PMDD, which is premenstrual dysphoric disorder. So my depression actually gets worse around that time of the month.
So it is also, like, hormonal as well.
Yeah.
So I found, like, the right medication to help me through that. And
Very nice. What what what medication helps with that?
It's Lexapro.
Okay. Hey, Bella. I'm sorry. Is there a fan on behind you or something that's making a consistent noise?
No.
No? Okay. Lexapro, how long you've been using that?
Four years.
Okay. And describe what it's done for you.
It has helped me with mood swings and helped those negative voices, like, help me check those negative voices.
Any value for the anxiety? Any value for anything else that you're seeing a benefit anywhere besides that?
Yeah. I would say the anxiety has quieted as well. I no, baby. My cat wants to go on my lap right now, but I have my laptop open. Yeah.
I would say it's turned my PMDD into regular PMS symptoms.
I gotcha. So you went from bad to
yeah. Yeah.
That's not bad. It's a good that's a good reduction in Absolutely. Yeah. How about the way you deal with other people? Was that ever an issue or did was most of this internal for you?
Like, did you well, my question is is did you lash out at other people the way you probably should have fought back against your parents?
I would sometimes snap, and I don't know if that was oh, oh, hello. Can you hear my cat burn?
No. Don't listen. That people will find that delightful if they can hear your cat burn. Don't worry about that. I'm actually worried about I I think I should take a five second break and go feed this lizard because he's running around like crazy, making all kinds of noise.
And he's just
Oh, I can't hear it.
He oh, you can't? Good. He is just desperately looking for a bug. And I feel like if I just gave him one, he would relax a little bit. Oh.
Sorry.
You should do that.
Do you want me to do that? Alright. Hold on one second. I'm actually going to because I think it'll help me, to not have to worry about it. Give me one second while I pause.
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Alright. I'm back. We're being recorded again. What I just did can only be described as horrifying, but it's what they eat. So now it'll it'll take I said him.
It's her. I feel bad about misgendering the lizard.
How dare you?
But she's gonna start, like, walking around. She's flicking her tongue. She's figuring out, like, there's something in here that smells like food. She's doing it right now. Like, she slowed down completely and is, like, is now, like, kind of instead of running around, she's I wish you could see her.
She's like a snake with legs. Here she goes. She's climbing up the side of the wall. Up. She's by the cup.
There's there's there's more flicking flicking. They're in there. Go ahead. Go get them. She she she doesn't understand English.
I and I don't know any other languages. So, I mean, if she
That's a shame.
Yeah. If do do you speak any other languages? Okay. There we go. We're getting there.
I'm also learning Romanian.
Romanian?
Yeah. For what? My husband's Romanian. Oh, go and visit the old the old country.
Oh, very nice. Your husband's Romanian. You have a little Spanish. I got I okay. I mean, I I
I can I can converse in Spanish, actually?
You have a very clean, American accent
Thank you.
Which which trends West Coast. Am I right?
Okay.
Like, okay. I think I hit it early and you just you don't wanna say.
I will tell you that I have a lot of international friends.
Okay. You have a lot of international friends? What does that mean? You live near an airport? What's going on there with that?
Okay. So Maybe. So your story is it's interesting. When we started talking before we recorded, you were like, you know, I have something to share, and I don't think it's really an after dark. But so far, you've talked about a lot of I mean, I don't find it to be after dark's a weird thing for me because I don't particularly enjoy calling the episodes after dark.
It's just a way to let people know we're gonna be talking about stuff like this. Mhmm. But I don't see this as anything different than anybody else's, you know, day to day struggles or lives or whatever. Yeah. It's just stuff that happens.
So Okay. Yeah. Yeah. Yeah. Okay.
So let's make sure we understand where we're at here so far. You are a young girl, back in our story. You're going through a lot. You get to college. You start figuring out what's going on.
You go to therapy. You move through those things. But through that time, is your a one c changing at all? Or are you in college at a nine or a 10?
I think I got it down to like an eight. I am like like moving all around a lot more, of course. Ow, gosh. She just headbutted me, my cat sugar.
The cat's coming for you.
Yeah. I mean, like, in a good way. She just wants attention. She's so sweet.
But I
can Don't you find it ironic also that her name is Sugar?
Well, you have diabetes.
Yeah. But I didn't name her. She chose me.
Oh, you you when you got the cat, it already had the name Sugar?
Yeah. I adopted her and she was like she literally reached her paw paw out to my mom and she my mom's like, oh my gosh, she wants us. And I looked at her and I was like, I
don't know if
I want a gray cat.
Well, here it is. So you get it how do you get it down to an eight? You think it's just activity, like walking around? Was a big campus you were walking around all
the time? Think it yeah. It was a big campus. I think I just was walking around, and I started to utilize the gym more. And I started boxing, so, like, I was lifting weights as well so I could get stronger.
Mhmm. And
so just activity alone, did you change how you ate at school versus home? I
was I was working, and I didn't wanna ask my parents for money. So I was eating, like, cans of peas and, like, salads and stuff, and I was not eating super healthy.
Why didn't you wanna eat why didn't you wanna excuse me. Why didn't you wanna ask your parents for help?
Because they just worked so hard, and I and I don't know. I just didn't wanna, like, take from them.
Okay. So they grew up broke, but as you were in by the time you were in college, were they still on the broke side?
Were middle class.
Middle class by then. Okay. So they could have afforded to help you eat.
Yeah. For sure.
No one ever said, hey. What are you eating? Do you need a do you eat 50? Nothing
like that. My dad would come up and buy me groceries, but I just hated to, like, use their money. So I would just kinda rely on the money that I got from working on campus. Okay. And I also just hated to, like, go to the store using the bus.
You're like, listen. I was hungry, but not hungry enough to get on the bus. Okay? That's all. I I the I've got a line.
So you're eating cans of peas?
These are good.
Yeah. I know. But that's happened more than once. You're like, for like, I'm hungry. I'm gonna crack open a can of peas now.
When the Injections Stopped Working33:59
Yeah. Also, Scott, this was the time that my legs were just and my stomach was were just, like, rejecting shots.
What do you mean?
Like, they were rejecting the the needles. I was trying to poke myself, like, up to five times and having such a tough time. Like, my skin was becoming tough.
Were you injecting in, like, the same areas over and over again?
I would go, like, all around the world.
So so you it's not that you were, like, injecting one, like, small area over and over and it got, like, scarred. No. You what do you mean? What would you do were you bit by a radioactive spider at any point in that time? Or, like, what do mean your your skin?
But that doesn't make any sense.
Yeah. I don't know. I just couldn't find, like, any space in my body that, you know, I
was supposed to go in?
Yeah. Where the needle would go in. It was getting crazy. And so finally, I was like, this is ridiculous. So I started looking into an insulin pump by then, and I wish I had done it sooner because it's changed my life as I'm sure thousands of people, can attest to.
So insulin pump takes your eight a one c to where?
The Pump, Then the CGM35:22
Now I'm at a 6.2.
And did you have a CGM in college?
No.
Do you have one now?
I do.
Okay. How long have you had a CGM?
Let's see. I got the CGM. Which one did I get first? Well, anyway, I got them about the same time.
In somewhere around college time.
So I got the insulin pump in 2017, I wanna say, or so.
Okay.
And then I got this actually, I got the CGM much later. I got it in, like, 2021.
Oh, so you've only had a CGM for about four or five years?
Yeah. Because I remember teaching and the and I had to, like, check my blood sugar and the kids all literally, everyone just stopped. You coulda heard a pin drop, and they all just looked at me. And I was like, I'm I'm fine, guys.
Just look at him and go, hey. Listen. My dad was abused. Do you want me to tell you about that? Alright?
Oh my gosh. That'll that'll that'll that'll shut you up, kids. But you hear the stories that I was told. You're getting off light watching you're getting off light watching me test my blood sugar.
They were so kind, though.
Oh, that's nice. So so you've had a CGM for five years or so. Are you automated now or you automatic? You are. What what system are you using?
So I'm on the Dexcom Mhmm. And Omnipod five.
Okay. And before Omnipod five, you were using Omnipod dash?
Right.
Okay. So you've only ever been Omnipod?
Only Omnipod. Yep.
Okay. And that took your a one c from the eights down further. And then were you getting low a lot with out of CGM, or how did you were you testing a bunch? How did you manage your your, you know, understanding what your blood sugar was?
No. I would say I was still kind of high, honestly.
Even with okay.
Yeah. Even with the Omnipod, I was still kind of high. I guess my set like, I I was scared to, like, dial in my settings too much.
Mhmm. How do you
Until I got my CGM.
So you got your CGM. And how long have you been married?
Our first anniversary was June 14.
Oh, you've only been married a year?
Mhmm.
Oh, congratulations.
Thank you so much.
One year's paper. What did you get? Was there a gift? Listen. I'm gonna be married thirty years in, two weeks.
I haven't gotten my wife anything. The only thing that's making me feel better is that I know for sure she didn't give me anything. So I'm good.
We we went out and we had a great time at Dave and Buster's, and which is what we like to do. We prefer experiences. But I also made him he likes those ranking videos. I don't know if you've seen those on YouTube.
What do you mean?
Like, you rank like, a lot of a lot of people, they'll rank, like, their favorite movies, and it'll be, like, a b c d e. Yeah. Or, like, there's an s tier. And so I did that, but, like, with our dates. And so I had pictures from, like, a lot of our dates this past year.
And so I just ranked, like, the dates based on, like, romance, food, funny moments, and things like that.
What a nice night date.
Then did, like, a like a overview of them and he loved it.
That's really cool. What did he get you?
I don't remember.
Oh my gosh. This is where guys go wrong. We're not good at gift giving. Women are much better, I think. I'm generalizing.
I believe women are much better at gift giving than men are. You know, big big picture.
So You know what? Yeah. He was also working nights, so I understand.
Yeah. Working nights in the hospital?
Yeah.
Okay. What kind of doctor is he?
A hospitalist.
And did your well, I guess I should ask you. You've been married for a year, but how long have you been together?
We started dating ow. She just bit my neck.
Sugar bit your neck?
Yeah. Is
she a vampire cat?
She's not Romanian.
I was trying to get to that, Bella. How come you didn't let me get to it?
She didn't I'm quicker.
She didn't whisper in your ear, I want to suck your blood. Nothing like that happened first?
No. No. She was she was being very sweet actually, which is, I guess, very vampirical.
What if your husband is a vampire and he's just setting you up?
That's a long setup. How
long have you been together now? What you were getting ready to say when the cat attacked you?
Yeah. June '23.
Okay. So twenty four, twenty five, twenty so you've been together about three years?
Mhmm.
And how long have you had a CGM for?
Since, like
About five years.
'21. Yeah. Five years.
And when did your a one c start coming down?
Oh my gosh. Oh, well, it really came down in '20 in, like, January '23
Okay.
Or or late twenty two.
So a little after you had a CGM?
Yeah. Yeah. Yeah.
And what did what changed?
The Post That Changed Everything41:15
Well, I got the CGM, and I was actually looking to move out of state. And one of my nurses that I've had since I was diagnosed, she suggested your Facebook group. And so then I started listening to your podcast, and I was convicted to start prevo listening. Actually, no. No.
No. Before that, I saw a post by someone. I don't remember, so I apologize to that person, but thank you. They told me about the 10% rule to prebolise 10% of your blood sugar, and I have followed that, like, bible since. That's working.
That's working. That person.
Mhmm. No kidding. So to explain it explain it to people.
Yeah. So if your blood sugar is, like, 100, then you're going to pre bolus by ten minutes. So you're gonna wait ten minutes, and then you're gonna start eating after you take your shot.
Well, I'm interested that you brought this up because I have added pages to my website about this. I haven't told anybody about it yet. So can I tell people about it now?
Please do.
Juiceboxpodcast.com/rule,rule,101zero. It's not like a rule rule, but it's it's what I it says right on the website. Rule is just what the community calls it. A juice box idea for thinking about pre meal timing divided b g by 10 starting lead time in minutes. So there's a little thing here.
You can, like, click in. Let's say your blood sugar is one fifty six, then your pre bolus should be sixteen minutes. If you're above your target, if you're in range and you can like it's so you can there's a little slider here. Right? And it will tell you, like, you can slide up and down your BG, you can type your BG in.
So 135 is an in range blood sugar. Fourteen minutes is an illustrated illustrated start window, and that's it. Now it explains kinda what the the rule. I know it's, like, not really a rule, but they it's a mental shortcut for pre bolus timing. And then when you're done with that page, if you want to continue on, at the bottom, you can go to the thirty, sixty, 90 forecast.
And once you get to that page, it'll tell you where possibly your blood sugar will be in thirty minutes. So it's an interesting way to, like, before the bolus, after the bolus. So again, you put in, like, a one fifty six blood sugar and then attribute an arrow to it. Very fast rate up, fast rate up, slow rise, all that stuff will call it a slow fall. So if you have a one fifty six blood sugar with a slow fall, a diagonal down arrow, in thirty minutes, your blood sugar might be about one twenty six.
It just kinda shows you what fall rates can it's just it's just so that you can kind of visualize those arrows direction and where you might be headed. Does that make sense?
That is so cool.
Thank you. And there's like a little slide here you can like change to mess with it. It's to kinda help yourself like visualize things better.
I love that. Did you make that with AI?
Of course, did. And it's it's my ideas that I turned it into hold on. Then there's the thing at the end that's called after. So it's like, it's before the rule of 10, during the thirty, sixty, 90, and then after reading your CGM trace. And then you can sort of do this.
It it gives you little things like you saw this. You saw a BG spike then came back down on its own. The timing clue about that is that the insulin eventually caught up, and brought glucose back in range, which suggests the dose was probably about right. But the spike tells you the insulin wasn't working yet. When the carbs arrived, the insulin didn't get enough of a head start before it had to compete with the meal.
So what you can explore is whether a longer pre bolus window fits a similar meal, blah blah blah. So, anyway, it gives you, like, you saw a BG spike, then it came back down on its own. You saw a BG went low within an hour of eating. BG went up gradually and kinda stayed there. BG shot up and stayed up.
BG went low two to three hours after eating. So there are three different web pages that all connect to each other and kinda help you before, during, and after your meal. I was I've been working on that for a while. I can't believe I haven't told anybody about that yet. You guys there's so much on that website I never tell you about.
I apologize. But it's called it's called rule of 10. It's in the menu at the top if you wanna go to it. Rule of ten, thirty, sixty, ninety forecast, and reading your CGM trace. So those are three new pages on the website.
And I can't believe it's a
thing. Amazing.
Thank you. You'll check it out. You'll love it. But but you but you saw somebody talking about that online, and you're like, oh, that's a a rule of thumb that I could probably make sense of.
Protein Isn't Free, and the Warsaw Method46:19
Yeah. Absolutely. So I started doing that, and things just started getting better and better. And then, you know, people were talking about your podcast. I was like, like a lot of people say, I'm not a podcast person.
But I started looking around, and then I started doing other things and learned about how protein actually isn't free carbs like I was told when I was a kid.
Mhmm.
And then recently heard about the Warsaw method, and I've been implementing that. And I really appreciate whoever made the website, the calculator. So I've been implementing that, and I'm telling everybody about it.
I The the one on
my only half.
The one on my the one on my site? The the the estimator on my site? Is that what you're talking about? Or you talking did you find a different one?
I, no. It's a different one. I I apologize.
Don't you have to apologize. You can I'm
It's sure the Omni calculator.
Okay. I'm sorry. I'm assuming they're all based on the same math. Yeah. Wait.
But if you want, you can check mine out too. When you're when you're on the site later, take a look at it.
I will.
Yeah. But the Warsaw method of understanding how to cover fat with insulin, huge help.
Oh, absolutely. Yeah. It's crazy. Especially with pizza, I'm like, oh my gosh. I'd literally every time I eat pizza, I'm like, oh my gosh.
I stay within range.
It's awesome. So what you're basically telling me is that you just needed some tools to figure out how to do this stuff. A little bit of information, a little bit of tools.
Yeah. Basically.
So yelling at you was never gonna get you to understand that fat can impact your blood sugar.
Crazy.
Fascinating. Who knew?
Right. Knew?
Knew? Certainly not me. I am really touched and thrilled that this podcast has been so helpful for you and the group and the community around it. And I would say to people who say I'm not a podcast person, I think you're just not a crappy podcast person. And I understand.
I've I've heard some bad podcasts in my life, but this isn't one of them. So, you know
Yeah. No. I greatly appreciate it. If you're you know, even if you set it, like, on while you're cleaning, you'll still glean, like, a lot of great information. And I really wish that I'd found it sooner.
I appreciate that. I'm glad and I appreciate you taking the time to tell people that too because
Oh, yeah. I tell everyone that. Like, anyone I meet who is either in the health care field or has diabetes, whether it's type one, type two, three c, whatever, you know, I tell literally everyone about your podcast, about the Facebook group. I tell them about the Warsaw method.
Look at you. You know, when you're out there spreading the good word as they say.
And the actual good word as well.
Finally, something actually, based in Catholicism is happening to you Catholic.
I'm not Catholic, actually. Oh,
you what they call a reformed Catholic? Or
No. Absolutely not.
No? You just ran from the whole thing when you saw your parents?
My parents are not Catholic, actually. They were raised Catholic, but if you don't mind
Oh, they they they they're reformed Catholics. Gave it up. They gave it up way before they had you.
So they stopped going, but I if I may Mhmm. I could not have gotten through my childhood situation without, like, the holy spirit guiding me. And, like, with the the abuse and the the diabetes and just everything, I really felt like the holy spirit was guiding me.
You you found another church, or you just found
I I continued to go to, like, protestant churches, and then eventually, a friend from high school invited me to his church. And that became my home church for twelve years until I got married, and we had to move for my husband's job. But I was very involved. I had helpless food pantry and went on a mission trip and helpless children's ministry. And, oh my gosh, I love my church so much, the way they're involved in the community.
That's beautiful.
Amazing. Like, they I'll just say the Lord saved my life.
Oh, that's wonderful. I'm that I'm thrilled for you. I'd I'd be happy to hear that anything saved your life. That's a fantastic thing. So you even though your parents didn't give you, I mean, they they seem probably disenchanted with their religious upbringing.
But even though they
They come to Christ. They did. They they were always they were always Christian, just not Catholic.
Gotcha. I gotcha. No. I I understand. Well, that's really fantastic.
And you're still practicing now?
Oh, yeah. Oh, yeah. I'm very, very much involved. Very, very enchanted. Lovely.
Lovely. And
you have kids or no? I didn't ask.
Not yet. We're waiting for him to be done with residency.
Oh, and then we're gonna start I was gonna say bang them out, but that's what I meant. You're gonna start you're gonna you're gonna have a bunch of them or you're have one. What's your play?
Probably about four.
Four? That's one for each appendage. You'll have to hold two with your feet, two with your hands. It's gonna be something.
He also has two
Oh, no.
No. Two arms.
No. We we we can't help with that stuff. There's football on. Do you understand? No.
He can't he really can't wait to be a dad.
That's awesome. How old are you again? You're 30?
We're both 30. Yeah.
About 30. Well, you better I mean, I don't but, you know, it's it's time. You know what I mean?
Trust me. I know. It's hard to wait, but at the same time, like
You're waiting for money? Like, the for things to stabilize?
No. No. No. No. We're not waiting for money.
No? We're just we don't wanna be so stressed. You know?
I mean, I I know. I I've got two kids. I know exactly what you're talking about.
Yeah. You totally understand.
Yeah. I do.
Because, like, he he'll be working nights and then also, like, twelve, fourteen hour shifts, and it's just why when when we have the ability to wait, not everyone a lot of people don't have the ability to wait. But, like, when we have the ability to wait, why not take that advantage?
I mean, it's it's smart to do it when you think it's best. That's all. Yeah. That's that's awesome. So he's what?
He's in residency still?
Yeah. Yeah.
But not much longer.
He has two more years. So, like, next year is when we'll start.
Yeah. Yeah. That's right. We only he only needs about three day break after residency before the baby comes. So Exactly.
Yeah. Yeah. Plus, it would give him something to be excited about that last year.
Exactly. Unless
you get pregnant immediately and ruin it, which I do, which does happen sometimes. You know? Talk to so many guys and they're like, we're gonna have a baby. I'm gonna have sex all the time. And then they're back, like, five minutes later, like, well, she's pregnant.
I was like, I don't think you're supposed to do it the first time, but it happens the way it happens. You know what I mean? Take all the fun out of babies. But if you're gonna do four, he'll at least get three more tries after that.
That's right.
It's gonna be fantastic. And are you gonna continue working when you have kids, or are you thinking about staying home?
So, you know, I'll take care of them until they're school age. So I'll stay at home until they're school age and then go back to work Nice. As a special education teacher. So, yeah, I'll keep up with my, professional degree
Nice.
In that way.
And you are prepared for I mean, it sounds like to me like you're fine with your blood sugars, but, know, you if you're having hormonal fluctuations already, you're prepared for all that. You you know the you know the playbook. You're probably gonna need more insulin when you're pregnant kind of thing. It's gonna ramp up and then suddenly you give they say you pass the placenta and your needs almost immediately go back to where they were before you were pregnant. It's great.
Like Really? Yeah. You gotta listen to some of those pregnancy episodes. Get get get yourself ready.
After the A1C Came Down54:37
I actually have been on a weight loss journey. So I I did kinda wanna talk about this a little bit. So when I when my a one c went, like, crashing down to 6.2, which I was very, like, amazed by and, like, happy with, but I gained, like, 25 pounds immediately. And then over the past year, I gained another, like, 15 pounds. And that's been, like, really difficult mentally
Yeah.
Because I've always been finally started
you finally well, you're not for nothing. You're probably skinnier because your blood sugars were higher.
And Exactly.
And now you're taking the right amount of insulin. And what'd you learn that you were probably eating more calories than you needed?
I think a little bit, but yeah. I think probably a little bit more, but not like an excessive amount. Okay. I also think that this is probably the weight that my body prefers. And as we all know, like, the scale doesn't tell you how much muscle you have, and I know I do have, like, quite a bit of muscle.
Yeah. But at the same time, it's just difficult Mhmm. To, like, look in the mirror and not see, that that
Who you think you are?
I'm not, like, saying that I'm, like, a model, but I'm saying, like, my body was, like, that model size.
And now So what are you doing? Are you exercising, changing how you're eating, what you're eating?
I am. I'm counting my calories. I'm counting my fat and protein. I'm sorry. My fiber and protein, and I'm weightlifting.
And so I actually have increased my weights recently and noticed that I am going low a lot more often. So I'm currently in a state of, like, recalibrating, you know, my my settings and all of that. So I bring that up because I'm like, well, I will continue to weight lift when I am pregnant in order to, like, offset the
Kinda keep your needs
from there. Yeah.
Yeah. Oh, that that's fantastic. And, yeah, I mean, if you have you lost weight as your weight as you're working out too?
Not that I can see. No. Just more activity. Stable.
Okay. So you think your insulin needs have changed, but your weight hasn't changed?
Right.
Okay. Oh, it's interesting. Have you considered the GLPs or you you think you're gonna be able to handle it the way you're handling it?
The I don't qualify for the GLPs.
Because of you're not
because I'm not heavy enough.
Your weight your weight's not.
So I am five nine and I weigh one seventy four.
That should get you a GLP. No? No. Okay. Well, I I assume they're going to be prescribing them for type ones the next I mean, I don't know how soon, but it's gotta be sooner than later because there are studies going on right now for it.
So if it's something you're interested in, it it might be it it might be something that's prescribed just, you know, to help with type one diabetes in the in the near future, which I think would be awesome. Well, that's cool. I mean, it's it's good if you do, like, see what was going on, make changes, work towards stuff. I mean, that's Mhmm. That's really fantastic.
Twenty Questions58:09
So now is it time now for us to guess where you're from? Yeah. Alright. So I think I unfairly know your last name, which is right. That kinda gives me a hint about your ethnic background.
Does it?
That isn't that my married name that you know?
I how is that possibly your that's the Romanian last name?
Is it the one that starts with a v? Which one are you looking at?
Yeah. The v.
Yeah. That's my married name.
That's your married name. Oh, now I don't know what's going on. Okay. So so you have okay. So you have, like, a clean accent.
So I don't hear any I don't hear Midwest. I don't hear Southern. You're not from around here. You could maybe be no. You're not a New Yorker.
Alright. So you're not from New York. You're not from Texas. You're not from the Mid States. You're not from the Midwest.
I think you're from Arizona or California. You talked about moving. You talked about I don't know. I'm going why are you giggling? This is not funny.
Is so fun for me.
It's fun for you. Okay.
Yeah. It's like taking a BuzzFeed quiz, but like
Yeah. Well, a little bit more difficult with nobody no questions being asked. I gotta come up with the questions and the answers.
You can ask more questions.
Well, I don't wanna turn do you wanna turn it to 20 questions?
If you want.
Wait. Unless unless you wanna like, don't like, if I've if I've already guessed it correctly, you have to tell me.
Okay.
Okay. So have I?
No. No.
Alright. 20. Oh, alright. Ready? I guess I'll ask 20 yes or no questions.
We've never done this before. So you and I doing this together for the first time.
Are you I love it.
Are you on the are you on the left side of the country? Like, let's first like, knock the country right down the middle. Are you on the left side?
No.
No. Alright. Florida.
No.
No. You're on the right side of the country. I did one time here, Michigan for a second, but it wasn't it wasn't a lot. Plus the husband's probably got an accent. It's probably ruining your accent.
You are a little giggly. Could be Rhode Island. You're not from Virginia. Alright. Ready?
You're not from Virginia. Right?
Correct.
Why are you having so much fun? I I don't hear Pennsylvania. I'm just gonna use up my my this way. Right? No Pennsylvania?
No Pennsylvania.
No Pennsylvania, not Florida, not Virginia, not god. I'm just gonna say New York in case you're from Upstate.
No. No.
Not Michigan. Right side of the country going to Maryland?
No.
North Carolina?
Yeah.
I don't know. You didn't say anything that gets me to figure it out. I think you were holding stuff back that would have helped me figure it out. You did.
No. I was not.
You were not. You in the beginning, you didn't wanna answer a question. You're like, well, I don't wanna give you any answers. Alright. Well, you don't live in the state that you were born in right now.
Is that correct?
I I do live in the state I was born in.
So you moved out and moved back?
No.
I thought you moved at one point.
No. I said I was I wanted to move.
You wanted to move. Alright.
But there were some things that happened. Hurricane Ian happened.
Okay. So you couldn't move?
Correct.
You're not from New Orleans. I don't I mean, what am I missing here? You're not from Alabama. I mean, you said your parents were broke. I guess you could be from Kentucky or Alabama, but I would think you'd have an accent then.
You just have to tell me I give up.
Oh, Scott. Oh, Scott. You were so close.
I was so close. Oh, wait. I do hear
So many times.
There's so there's a little southern in there now. A tight oh, is South Carolina? No. What is that? Oh, and I hear it.
Where is that from? Just tell me.
Michigan1:03:17
I'm from Michigan.
I said Michigan.
You said not Michigan.
No. No. No. No. No.
I I said, oh, I talked myself out of it?
You talked yourself out of it so many times.
Damn it. Damn. Damn. Damn. Damn.
Damn. Accent, broke parents. Mhmm. I was right there. Not the way
You're so close.
You're not you don't you don't have any Spanish background?
No? No. I mean, I've been to Mexico
That doesn't count.
Taught myself Spanish since I was a kid.
Well, you threw me off knowing Spanish. And I and that married last name, I don't He stole that from somebody. That's not that's not Count Dracula, whatever that is.
That's from me. No.
No. It's not. Stop it.
Yes. Is. Look it up.
Look it up. I don't have
Are you familiar?
I don't I don't have time to look it up. Okay? Today is Arden's birthday, and she is texting me Oh my god.
About Happy birthday. No.
Thank you. I'll let her know. She's texting me about, like, are we going? Are we going we're supposed to go pick out a cake for to take to dinner with us tonight. So Alright.
I can't believe I had because I got Michigan early on once I split the country in half, and then I gave up on it.
You did. You kept saying not Michigan.
So I know it. I I just wanna say I know everybody in Michigan is not broke. There are broke people everywhere. Just like I by the way, I was completely broke growing up when I was in Pennsylvania. I don't know.
I was just generalizing trying to find something. You know what I do. I can't believe it didn't work this time. That's fine. Will you win?
That's fine. Yeah. The thing that I didn't wanna tell you earlier was that my dad's side is Irish, and my mom's side is mainly English German. So I felt like that would have told you Michigan. Or at least if you know anything about Michigan, then that would have
I know.
Given you a hint.
I know m and m's. Car industry used to be there. I know these things. I know the I know every
Our industry is so here.
I know everybody thought the lions were gonna be good, but they still suck. What do you think of that? You care about comments. Alright. Listen.
Go make a bunch of babies with that doctor boy of yours and and
I will.
And go forth and prosper. I appreciate you doing this with me. Hold on one second. Okay?
Okay.
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