#1291 I Don't Understand... Jenny Two

August 28, 2024Scott Benner

I don't understand… Why the type 1 guest from episode 1230 doesn't need insulin anymore. What did the GLP do?

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

Scott Benner 0:00
Hello friends and welcome back to the juicebox podcast. Ready to have some fun?

Jenny's back for another episode of I don't understand. Did you like the last one? I hope you did, because there's gonna be more of Jenny and me and other people not understanding things and us figuring it out. Nothing you hear on the juicebox podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan. This episode of The juicebox podcast is sponsored by the Eversense CGM, an implantable six month sensor. Is what you get with ever since, but you get so much more exceptional and consistent accuracy over six months and distinct on body vibe alerts when you're high or low on body vibe alerts. You don't even know what that means. Do you ever sense cgm.com/juicebox, go find out this episode of The juicebox podcast is sponsored by us med. US med.com/juice box, or call 888-721-1514, US med is where my daughter gets her diabetes supplies from, and you could too use the link or number to get your free benefits check and get started today with us. Med

Today's episode is sponsored by Medtronic diabetes, a company that's bringing together people who are redefining what it means to live with diabetes. Later in this episode, I'll be speaking with Mark. He was diagnosed with type one diabetes at 28 he's 47 now he's going to tell you a little bit about his story, and then at the very end of the episode, you can hear my entire mini interview with Mark. To hear more stories from the Medtronic champion community, or to share your own story, visit Medtronic diabetes.com/juicebox and check out the Medtronic champion hashtag on social media. We're gonna do something here today. We're gonna try to figure this out together. Because I don't understand this, and I don't know if you do either. Okay. Now this is actually coming from a listener, so I'm gonna read, I'm gonna read their their question. But okay, truth be told, I don't understand this the way I should. I don't think you do either, and let's see if we can figure it out together. Did you hear episode 1230 with the gentleman who had type one diabetes diagnosed at age 50, and now at age 58 on Manjaro is not taking any insulin at all

Jennifer Smith, CDE 2:40
I did. I listened actually. I did listen to that episode. That's perfect, because

Scott Benner 2:44
this gentleman says, with regard to podcast number 1230 where the T 1d guest says he has been completely off of insulin for two years due to being on a GLP one medication. How does his body get nutrients without insulin? Does insulin only Shepherd glucose to muscles and cells. So now this person right here, their confusion is where my I don't understand, comes in, because what they think is, well, that guy's not making insulin anymore, because that's what I was told about. Type one. Type one means don't make insulin, which we all agree about. But then, if this guy was type one, how is he not taking man made insulin, and if he's not, how come all this stuff isn't happening to him? So my question is, Jenny, I don't understand how this happened to that guest on that episode. Do you understand why he doesn't need insulin anymore,

Jennifer Smith, CDE 3:33
not at an in depth way, but I think one, his diagnosis was at age 50, correct. So he was diagnosed as an adult. So Lata, what we do know about diagnosis as adults, and it differs adult to adult, is that they have a tendency to actually have more beta cell reserve. And the expectation is that, and if I remember correctly, he still wears a CGM, even though he just uses the GLP one right now, right? So he did say that he can see excursions in his blood sugar, but his body fixes those excursions like his blood sugar might go up to 171 80. It does it on its own and brings it back down to the goal, target for the most part. Again, generalizing people without type one that have fully functioning beta cells, their blood sugar is not going to go up to 180 it is not it takes a lot of excessive, really simple carb to get it to nudge above target, yes, right? So he's having excursions. He doesn't technically have to take insulin, but I also expect that most of the time he's not eating, you know, six plates of sushi. He's probably eating a really well balanced diet. He exercises, if I remember correctly, from the episode and. So his beta cells that were in reserve, along with the impact of the monjaro, which is the only dual hormone, right? It's a GLP one and it's a GI P, yes, so it's the one on the market that has the heaviest impact on insulin sensitivity and weight loss and glucose management. So when we consider the kind of GLP one he's on, the fact that he was diagnosed as an adult, likely has a beta cell reserve, that would be my again, tip of the iceberg, understanding as to why he's not having to inject or pump insulin at this point. Yeah,

Scott Benner 5:41
okay. So that that is exactly my expectation, that, in truth, the poor guy might very well need his insulin again at some at some point. Yeah, right, but it is not so the so the story gets confusing, like it's confusing to this person, because, you know, I'm confused as to why this guy isn't starving because he's not taking insulin. He's on a GLP medication that suppresses appetite. Everything about it is confusing. It's exciting to see someone needing only one dose a week of GLP and that he's off insulin. I just want to understand how this works. So this guy is being very reasonable. I've seen people not be reasonable around this conversation, right? I

Jennifer Smith, CDE 6:21
have seen that as well. And I also think, in terms of the gentleman's question, the idea that type one totally and completely destroys every single little, teeny, tiny beta cell that you have in your body. It's not really the case, right? I mean, the only true measure of that would be a C peptide. And I don't know that he commented on his C peptides. I don't remember in the conversation if he did or not, but I would expect that with this down shift in delay in digestion, the body's ability to not have these major excursions in blood sugar, I would expect that again, those betas that are in reserve for him. He probably has still diagnostic of type one, but he probably has more C peptide visible than other people. Again, his time of type one has been very short, comparative to other people as well. So he it's not that he's not getting insulin. He is his betas that are there are still making it. And so to answer the guy's question about, How is he getting nutrients, his body is shuttling it in because his insulin receptors are working better. His cells are responding better to glucose and metabolizing the glucose better with this GLP one assisting with all of that, right? Right now

Scott Benner 7:44
we're going to hear from a member of the Medtronic champion community. This episode of The juicebox podcast is sponsored by Medtronic diabetes, and this is Mark.

David 7:53
I use injections for about six months, and then my endocrinologist in the Navy recommended a pump.

Scott Benner 7:59
How long had you been in the Navy eight years up to that point, I've interviewed a number of people who have been diagnosed during service, and most of the time they're discharged. What happened to you? I

David 8:09
was medically discharged, yeah, six months after my diagnosis, was it

Scott Benner 8:13
your goal to stay in the Navy for your whole life, your career? It was, yeah,

David 8:16
yeah. In fact, I think a few months before my diagnosis, my wife and I had that discussion about, you know, staying in for the long term. And you know, we'd made the decision despite all the hardships and time away from home. That was what we

Scott Benner 8:30
loved the most, was the Navy like a lifetime goal of yours. Lifetime goal.

David 8:34
I mean, as my earliest childhood memories were flying, being a fighter pilot,

Scott Benner 8:39
how did your diagnosis impact your lifelong dream.

David 8:42
It was devastating. Everything I had done in life, everything I'd worked up to, up to that point, was just taken away in an instant. I was not prepared for that at all. What does your support system look like? Friends, your family caregivers, you know, for me, the Medtronic champions community, you know, all those resources that are out there and help guide the way, but then help keep abreast on you know, the new things that are coming down the pipe, and to give you hope for eventually, that we can find a cure.

Scott Benner 9:07
You've probably heard me talk about us Med and how simple it is to reorder with us med using their email system. But did you know that if you don't see the email and you're set up for this, you have to set it up. They don't just randomly call you, but I'm set up to be called if I don't respond to the email, because I don't trust myself 100% so one time I didn't respond to the email, and the phone rings the house. It's like, ring. You know how it works? And I picked it up. I was like, hello, and it was just the recording was like, US med doesn't actually sound like that, but you know what I'm saying? It said, Hey, you're I don't remember exactly what it says, but it's basically like, Hey, your order's ready. Order's ready. You want us to send it? Push this button if you want us to send it, or if you'd like to wait. I think it lets you put it off, like, a couple of weeks, or push this button for that. That's pretty much it. I push the button to send it, and a few days later, box right at my door. That's it. Us, med.com/juice, box. Or call 888-721-1514, get your free benefits checked now and get started with us. Med, Dexcom, OmniPod, tandem freestyle, they've got all your favorites, even that new islet pump. Check them out now at us. Med.com/juice, box. Or by calling 888-721-1514, there are links in the show notes of your podcast player and links at juicebox podcast.com to us, med and all the sponsors. Right? So my, my kind of layman's expectation is he's lotta. So latas typically develops in individuals over 30, often between the ages of 30 and 50 symptoms, initial symptoms of lot of may resemble those of type two diabetes, and include, you know, everything, etc, but diagnosis, lot of can be challenging to diagnose and listen. We've had people on the podcast talking about this forever. There's always people diagnosed type two and there are lot of lot of meaning a very slow onset of type one diabetes. Wasted diagnosis. Auto antibodies, presence of auto antibodies, such as the GAD go, God ready, glutamic acid, Jesus, can you say that mic acid? What's the decarbolus thing?

Unknown Speaker 11:15
That's pretty good

Scott Benner 11:18
antibodies. These are typically found in type ones and indicate an auto immune response. That's really what I think most people stick to. If you have auto antibodies. This is auto immune. Your type one like it gets into the

Jennifer Smith, CDE 11:32
and then there are several more. I think there are four or five that are typically they this is a insulin antibody or auto antibody. There's a zinc transport there. There are a couple of them that have specifics to type one, not only the GAD, yeah. So again, regardless, he clearly was diagnosed with type one. At least one of these was positive, right, right? And

Scott Benner 11:56
your C peptide level is an indicator of your insulin production. Is that? Right? Right,

Jennifer Smith, CDE 12:01
correct. So when insulin is made in the beta cells, sort of the there's a piece of protein that's attached to, kind of move it out, and it's shaped, kind of like a C shape, is my understanding. So when it gets cleaved off and it enters circulation, that C shape remains there as an indicator of your own pancreatic insulin production, which is why, when you start injecting insulin, you can still get a C peptide level tested, because the insulin that you take via injection or pump doesn't ever put that C peptide into your body,

Scott Benner 12:33
right? And that can lower and decline over time. And that's our expectation when somebody comes with Yes, with Lada, because that's exactly what you know. What I'm looking at here is over time, individuals with LADA will typically require insulin therapy as their beta cells are gradually now, this says destroyed and and their ability to produce insulin decreases. I do. I believe in the destroyed word there, because there are definitely people you could, you know, they could drink GLP in their ears, and they're not. They're still going to need all their insulin, right, correct, like, so. So for the guy in episode, in the episode that we're talking about, I guess I should have it here, 1230 he was diagnosed at 50. He was using all the insulin by six years in like, he was really he was using a lot of insulin, which indicated to him and to his physician, I have type one diabetes, like I just do, they end up putting him on Manjaro for weight, and he suddenly doesn't need insulin. But he's also, to Jenny's point earlier, having excursions at meals that are higher than a person without diabetes would have, right

Jennifer Smith, CDE 13:40
and higher than somebody who was taking insulin to cover or clear some of that carbohydrate or food, right? That his betas are clearly not doing everything, but enough to clear it so that he's not sitting high for eight hours, right? I'm assuming that his excursions, along with his endocrine they look okay, if

Scott Benner 14:04
I remember, possibly it's only over an hour, an hour and a half, he pops 180 and comes right back, doesn't get low. And that's that. So what he's saying is, is that for however long this is going to work for me, this is magical, you know, and everyone would type one, and who's listening to this, I would assume would trade one shot a week for that situation over, over what they're in right now. Agreed, the confusion becomes, and you can tell by this gentleman's question is that, what is it? It's the um, it's older type ones, really, who think of it this way, right? Like, because, what is it? Do you think it's that argument between type one and you're old enough to know this. You're not old Jenny, but you're old enough to know this, like, okay, old head type, type ones, they don't want to be thought of as type twos,

Jennifer Smith, CDE 14:51
right? I guess in in general, yeah,

Scott Benner 14:53
because back in the day, if you have type two diabetes, you don't control yourself. You're overweight. That's your fault, right? That was the narrative. And type one defense of that was, I can't help this. This is auto immune. This just happened to me, and Don't lump me in with people who aren't taking good care of themselves, right? When that gets into the zeitgeist, and that's how people think my concern has been, and I'm using this episode to clear it up. I hope is that now that we're in the future and we're learning new things, we don't want to jump on this poor guy and say, because I saw him take it after the episode, you know, you're not a type one prove to me that you had auto antibodies. Blah, blah, blah. I'm like, just listen to the guy's story and like, I don't understand how nobody listens to type to episode 1230 and thinks, wow, there's a lot to learn about this. GLP, well,

Jennifer Smith, CDE 15:43
and I think to go right along with it, while it wasn't a complete loss of insulin use, I know that you've It was either an episode or you've talked to somebody who has a teenager whose insulin needs have come down like 90% of what this person was using now, being on a GLP one, so again, not completely off of insulin. But you can see, even in this person with, I don't know if she has longer diabetes than this gentleman or whatever, but diagnosed as a as a child, she probably had more B to cell initial destruction, and so has enough left to assist, along with what the GLP one is contributing, but still needs some insulin. And if

Scott Benner 16:31
she gets years like that, then good for her, then good for her, yeah, not just good for her, like her happiness, but her health and her longevity. It's going to help a lot of different things. So let's go into this gentleman's question a little deeper. The guy we're talking about needs insulin. He's taking a basal insulin and a meal time insulin. He's got type one diabetes. Obviously, it's going to be a very slow onset, like, probably what he was taking six years in, wouldn't have managed him well, 10 years from now, even you know, as possibly as his possibly as his beta cells continue to degrade,

Jennifer Smith, CDE 17:04
especially considering he was already having a weight management issue, and that was the reason you said the mole jar was started given to

Scott Benner 17:13
him to begin with, right? So, so, so then my question is, what changed? What did the GLP do? Like, I know it increases insulin sensitivity, but, but how? Like, what does that mean? Do we even know that part, or do we just know it happens

Jennifer Smith, CDE 17:27
the insulin sensitivity part? Yeah. Like, how

Scott Benner 17:30
does the GLP, like, magically? Because it feels magic, like you need insulin and now you don't, or you need even when you need less. Like, forget this guy for a second, right? My daughter takes a GLP medication. She's using significantly less insulin than she was without it. Okay, right? Why? What

Jennifer Smith, CDE 17:47
happened? Well, I mean, the GLP ones work several ways. One is for those who do still have some beta cells, or essentially, you know, type twos who have beta cells, but it's really the use of insulin and whatnot. That's the problem. These GLP ones do help with release of insulin. So for him, if his insulin resistance was cleared up because his weight came down and he had enough beta cell response then that his body wasn't having to overcome the resistance, then that could be a piece of it, in terms of the GLP ones helping to trigger the insulin release actually, and maybe more in the correct way, and usability improves. Obviously, GLP ones obviously also block glucagon release from the liver, and so, you know our response, it's a big reason that we actually have the idea of pre bolusing and understanding insulin use around meal times, because we do have this release of like stored gluco so to speak, and output of the liver. And if we block that, we are going to have lower post meal blood sugars, which is, again, probably a piece of why. Maybe his blood sugar goes up, but he responds very well. And now that he's had enough insulin release and his body is sensitized to the insulin, we have to remember that these meds also slow gastric emptying or delayed digestion, so the slower the things kind of sneak into with somebody who may have better insulin sensitivity. Now it allows the insulin that their betas are producing to actually gain traction right to work. And then, of course, you know whether this is helping him or not, and I can't remember whether he spoke much about it, but obviously the satiety factor with all of the GLP ones, most people, that's a big thing they talk about is, gosh, I feel like my head is clear from not considering food all day long anymore, like I can eat when I want to eat, or I choose to eat, but I'm no longer. I. I no longer so hungry, so to speak. Yeah,

Scott Benner 20:04
the episode that went up today I told you about before we started recording, so it's not on here. It's called, I'm getting the name for it. But this one is with a mom of a young type one daughter, and it's called Ken, GLP, meds, impact mental health. Oh, episode 1254 because this little girl is bipolar, and a mixture of lithium and GLP medications took away so many of her issues, it's like it's almost insane. But during one of the during a part of the conversation, the mom said that you could not keep packaged food around the house, because she would just attack it and just eat it. And she's like, what the GLP med has done just specifically to that kid's desire for sugar is amazing. But I want to say this sincerely. It's going to sound like I'm joking. If I had a private plane when we got done recording it, I'd get on it. I'd fly to where you are. I drive to your house, I'd give you a big hug. I'd tell you you are a national treasure. Have lunch with you. Let you give me some of that weird food you eat. And then I would drive home and let me tell you why. Let me tell everyone why. While Jenny was just saying what she said, and she is looking at me in the camera, she is not reading. She right, you know. Okay,

Jennifer Smith, CDE 21:19
I have nothing because I know that podcasts get recorded. Well, when nothing else is open on the computer screen, I have learned so. Scott, thank you. Jen. Jay is

Scott Benner 21:29
like, it doesn't open anything because I don't want anything to crash. Well, while, while Jenny was doing that dummy over here, went to chat GPT, and I said this, how do GLP meds remove the need for man made insulin be technical, but at a fifth grade level, that was so that I could understand it. And it said, and I am not kidding everything, you just no more or no less. You just pulled that right out of your ass, okay? And it was exactly Jenny is as smart as chat GPT when it comes to diabetes. That's all I wanted to say, boosting insulin production, lowering other hormones like glucagon, slowing down digestion, helping you feel full. And the wrap up was, GLP, one meds help your body make more of its own insulin, lower extra sugar, slow down sugar spikes and reduce how much you can eat. Your blood sugar stays more stable because your own insulin and these other effects are working better. You might not need as much man made insulin to keep your blood sugar in check. God, damn, you're a fcking brilliant person. I love to

Jennifer Smith, CDE 22:30
know the medication, because it's I mean, thank you very much for

Scott Benner 22:34
Oh, seriously, Jenny, I could have lined up 1000 people and asked that question. I would have got no

Jennifer Smith, CDE 22:43
well, thanks. Seriously, it's such the new I mean, honestly, this

Scott Benner 22:48
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Jennifer Smith, CDE 24:13
I've also, you know, GOP ones have been on the market for a long time, despite them really gaining ground because of the new formulations that really do have a lot more power than the older versions had, but the older versions still worked. I mean, they were, they were what we had initially, that we, you know, the victos and the by durians and those types of things. They they did a good job, just not what our current day does.

Scott Benner 24:42
I was having this thought this morning because it became so popular for weight loss, we ended up and listen, there was a lot of bitching in the media and everywhere else about it. But in the end, it ended up being a good thing, because instead of target, using it for one thing and finding a lot of very similar. Are people. There are people with all different kinds of health implications across the world who needed to lose weight. So we basically spread it out over everybody. And that's why you're getting back these like, Hey, um, I'm getting pregnant on this. Or my again, more I'm hearing about people saying their airs danlers syndrome is, like, I know I never say that correctly, but like, like, they're having lessening facts. Now, I got a girl here that says that, you know, a significant amount of her bipolar issues are cleared up. I mean, come on, right and then, and the guy from the episode we're talking about, he's gonna listen, if you want my opinion about what happened to the gentleman episode 1230 which you should really listen to, is that he is going to get a much longer honeymoon than he was going to and need less insulin during it than he was doing fantastic right

Jennifer Smith, CDE 25:51
on so many fronts, you know, glucose, glucose management ties into so much in terms of long term health. It does a cardiovascular health, brain health, I mean, all the things that are now being studied and understand, understood about true glucose management, whether you have diabetes or not, it's tied into a lot of body function. So you know, if we can sensitize our bodies in multiple ways, this doesn't necessarily mean you throw out all of the good lifestyle habits that you've been trying to put into action keeping them. In fact, exercise, by far, is the top the tip of the pyramid of anything good that you can do for your body, for like an ongoing health into your later years, even as little as walking every single day, right? But if we keep those things in the picture, along with something that could help when those lifestyle things aren't doing enough for us, then great. Yeah.

Scott Benner 27:00
I mean, listen, you say lower your inflammation prior to GLP, if you tell somebody, you would tell them to eat low inflammatory foods and blah, blah, you can't eat enough of that goddamn food to help you if you have a real problem. I mean, come on, you know, use fermented. Okay, great. Like sauerkraut and myself. You think if I ate sauerkraut, I'd have lost 50 pounds? No, okay, you know, I don't have diabetes. I have no my doctor told me all the time, like I actually was told by my endocrinologist, I don't foresee you ever getting Type Two Diabetes, like at your age, where you're fasting glucose is and everything I see from you, you just don't present as somebody who's gonna end up with type two and I'm like, Oh, great. I'm still significantly overweight, unhealthy, etc, and so on. But I wasn't doing any of the things that classically people would say, oh, it's because he's doing this. Like, I really don't live a much different life right now than I did before. While we're looking for, like, spreading out over people who needed to lose weight and learning things. I was getting iron infusions yearly, maybe twice a year. Some years or I would fall apart and die. My ferritin level was going down into the single digits, right? That doesn't happen anymore. My body is absorbing iron now, and I'm fine. I haven't needed an infusion in a year and a half, and

Jennifer Smith, CDE 28:19
I wonder there, you know, just in in that small, little, narrow, I wonder if it has to do something with the way that these meds slow digestion. I wonder if it's your body now has enough time to completely absorb what it needs to and so you don't have to medically manage your irons, yours,

Scott Benner 28:39
yeah, and keep in mind that, prior to that, my fartin drops, and the doctor, so first of all, they think you have cancer right away, because if you're of a young enough age, and it looks like you're losing, you know, iron, they just so I gotta go through all that. I scope one way I get scope, the other way, well, Oh, you don't have cancer. Good, good. Congratulations, thanks. I'm still having all these problems, right? Maybe have celiac don't eat gluten for a month. A month later, nothing changes. I'm like, Look that that wasn't it. You know what they said after that, take an iron supplement with vitamin C. It helps it uptake it faster. So I did that. You know what? That did? Not a lot, nothing. Yeah, right. And so I was going to be one of those people that they were like, Hmm, don't understand. Bye, bye. Like, you know, like, that was it? Like, we did all the things that we understand. We go off and think I took the GLP because I went to when my kids, my second kid, went off to college. I went to my kids endocrinologist, and I said, Hey, yo, I did it. I raised those kids. They're good people. They're not going to murder anybody. Now, I

Jennifer Smith, CDE 29:42
have time for me. I

Scott Benner 29:42
need to stay alive, right, right, right, like and, and she looks at me. She knows me. She'd been helping me with things, right? And she didn't know what was happening still. And I said, I need to lose weight. And she looked at me and said, why? And we were standing face to face. See, and I said, and she goes, I said, you don't see. And she goes, No. She goes, Scott. She's like, you could lose weight, but you don't look like that's your problem. And I said, Well, that's very nice. And I stood up. I don't know if I've told this in the podcast, I stood up, I took off my sweatshirt, and I said, I'm gonna get on a scale in a minute. You guessed my weight? And she guessed my weight at about 175 pounds, which, by the way, is well under, yes, is eight pounds less than I weigh right now, and I've already lost 48 pounds like so when I told her my weight, she goes, Oh God, we'll get you a GLP medication. And the stuff that came after it, she didn't say, I'll get you the GLP medication. And, by the way, you won't need iron infusions anymore because this, she didn't know that was going to happen. No, yeah, right.

Jennifer Smith, CDE 30:42
I think that's, I mean, you bring up a good point there. I think that again, despite GLP ones having been around for a while, this new generation of them being so much more impactful, there are so many things being discovered and found that are, let's call them positives, yeah, or other health related things. Now, I do think that longer term, we need a lot of evaluation and study and everything, because you know, you're putting something in your body that technically, while, while it is a hormone that your body would normally make for whatever reason, environmental, food system, whatever's happening in our today's life, body, there's something that's not working the right way. Otherwise people wouldn't be responding. I think people like you, as an example, would it really be responding if your body was actually doing what it should be doing? That's my

Scott Benner 31:46
only point. Is that for me and for many other people, your body's not doing something, and this medication is is covering for it, somehow covering what do we care? Like, like, I Why do you like? Just listen, I know this isn't like. I'd spread it on everybody. I'd sprinkle it over top of us and be like, let's see what else it fixes. We're gonna figure that out. Like, it's the baseline stuff. Like, Oh, I lost weight so my knees don't hurt anymore, and I'm not gonna have to have a hip surgery or something. Like, that's nice and all. And don't get me wrong, it's amazing. But listen, this is new. Recent studies have highlighted the potential of GLP one agonists such as ozempic and reducing the risk of dementia, particularly Alzheimer's disease and people with type two diabetes. A large study involving 88,000 participants showed that those treated with GLP one agonists had a significantly lower risk of developing dementia compared to those using other diabetes medications like sulfonylureas and DPP four inhibitors, the reduction in risk was 30% compared to sulfonylureas at 23% compared to DPP four inhibitors. Come on. Like,

Unknown Speaker 32:53
yay. Like,

Scott Benner 32:55
you know what I mean? Like, you mean I don't have to be overweight, and when I'm 85 I'm not gonna be like, banging my head on a wall, like, you know what I mean? Like, this is wonderful. Jenny, for 20 years, I heard people say inflammation is the problem, but they didn't know what to do with it. After that, it feels like we know what to do. Now a little better, a little better. Yeah.

Jennifer Smith, CDE 33:18
I mean, they're only, I think the biggest thing that I'd like to see with these medications is the right kind of education in use of them. You know, in terms of prescribing, as a prescriber, you're a caregiver, and you should really be checking in with your patients. You should really be checking in and saying, How are things going? You know, you start them on this a weekend, there should be a follow up, even a quick message, right? They How are things going? Let's see, how are you feeling, etc, because some people may respond better to one than another, yeah, you know. And if there's not enough information given up front about how you might feel, is this normal? When should I call if it's not feeling back to normal or whatever? I think on the case of clinicians, they really need to do a lot of self educating about these to know what's appropriate and how to help people use them to their advantage. Yeah, they

Scott Benner 34:19
also have to understand what they're what they're actually doing for people. Because right one of the bigger problems with the glps right now, as it's being reported, is that the dropout rate is like around two years. So you know, my opinion of that is that this medication may be doing a lot more for you than you understand, and just because you didn't continue to lose weight or didn't get to your goal weight might it might

Jennifer Smith, CDE 34:41
not be, might not be. The only thing that it was helping Exactly, right? And doctors

Scott Benner 34:47
need to understand, like, Listen, if you are one of the people who takes it and you're nauseous and vomiting constantly, it's not for you, obviously, like, but I'm not talking about just force yourself through it. But right? I made it through some side effects, like. There was, there was a a fair amount of time in there where I was like, I'm never gonna have a solid bowel movement ever again in my entire life. And like, but I was losing weight to the point where I was like, You know what I actually thought? And this is nothing technical, obviously, this was my thought. I'll let you go. Yeah, it took me this many years to get this fat. I wonder what horrible things were happening inside of me then that I never, like, I never batted an eye against I didn't, I didn't go out and, you know, eat greasy food, because I used to eat greasy food, I don't anymore. I didn't go out eat greasy food, come home, have distress in the bathroom, and then go, Well, I'm never gonna eat greasy food again. Like, like, I'm like, I struggled through that to get to my next french fry. I better, like, I'll try this, you know what I mean, right? And I stuck with it. Now I don't have that problem anymore. But I mean, if you're really impacted by it in a way that you just can't function, I understand it's not for you that's fine, but for everyone else, like, we gotta keep paying attention to this, I think. Yeah, so, to answer the gentleman's initial question, I don't understand why this guy doesn't need insulin. He does need insulin, and his body is making it right now. Yes,

Jennifer Smith, CDE 36:03
that's it. That's the bottom line, without all the biochemistry and physiology and all the stuff, yes, that's the bottom line. I mean, we

Scott Benner 36:13
made a good podcast episode here. I'm

Speaker 1 36:14
gonna let you go. Thank you. Of course, you I

Scott Benner 36:23
want to thank the ever since CGM for sponsoring this episode of The juicebox podcast, and invite you to go to ever sense cgm.com/juicebox to learn more about this terrific device, you can head over now and just absorb everything that the website has to offer, and that way you'll know if ever since feels right for you, ever since cgm.com/juice box, Arden has been getting her diabetes supplies from us med for three years, you can As well us med.com/juice box, or call 888-721-1514, my thanks to us, med for sponsoring this episode and for being long time sponsors of the juicebox podcast. There are links in the show notes and links at juicebox podcast. Com to us, med and all of the sponsors. Mark is an incredible example of what so many experience living with diabetes. You show up for yourself and others every day, never letting diabetes define you, and that is what the Medtronic champion community is all about. Each of us is strong, and together, we're even stronger. To hear more stories from the Medtronic champion community or to share your own story, visit Medtronic diabetes.com/juicebox Once, there was a time when I just told people, if you want a low and stable a 1c just listen to the juicebox podcast. But as the years went on and the podcast episodes grew, it became more and more difficult for people to listen to everyone. So I made the diabetes Pro Tip series. This series is with me and Jenny Smith. Jenny is a Certified Diabetes Care and Education Specialist. She's also a registered and licensed dietitian and a type one herself for over 30 years. And I, of course, am the father of a child who was diagnosed at age two in 2006 head now to juicebox podcast com, go up in the menu at the top and click on diabetes pro tip. Or if you're in the private Facebook group, there's a list of these episodes right in the featured tab. Find out how I help keep my daughters A, 1c, between five, two and six, two for the last 10 years without diet restrictions. Juicebox podcast.com start listening today. It's absolutely free. Okay. Well, here we are at the end of the episode. You're still with me. Thank you. I really do appreciate that. What else could you do for me? Uh, why don't you tell a friend about the show or leave a five star review? Maybe you could make sure you're following or subscribed in your podcast app, go to YouTube and follow me or Instagram. Tik, Tok. Oh gosh, here's one. Make sure you're following the podcast in the private Facebook group as well as the public Facebook page you don't want to miss. Please do not know about the private group. You have to join the private group. As of this recording, it has 51,000 members in it. They're active, talking about diabetes, whatever you need to know. There's a conversation happening in there right now, and I'm there all the time. Tag me. I'll say, hi, hey. What's up everybody? If you've noticed that the podcast sounds better, and you're thinking like, how does that happen? What you're hearing is Rob at wrong way recording, doing his magic to these files. So if you want him to do his magic to you, wrong way. Recording.com, you got a podcast? You want somebody to edit it? You want rob you?