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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
We are all together again friends for this next episode of The juicebox podcast.

Some of you may know John as the creator of the sugarpixel, and some of you might know him as John from episode 9081 way or the other, he's returning to have another titillating conversation with me about type one diabetes. 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. If you are the caregiver of someone with type one diabetes, or have type one yourself, please go to T 1d exchange.org/juice, box and complete the survey. This should take you about 10 minutes, and will really help type one diabetes research. You can help right from your house at T 1d exchange.org/juice, box. When you place your first order for ag one with my link, you'll get five free travel packs and a free year supply of vitamin D drink, ag one.com/juice box. Don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code juicebox at checkout. That's juicebox at checkout to save 40% at cozy earth.com

this episode of The juicebox podcast is sponsored by us Med, usmed.com/juice box, or call 888-721-1514, 87211514, get your supplies the same way we do from us med. This show is sponsored today by the glucagon that my daughter carries, gvoke hypopen. Find out more at gvoke glucagon.com, forward slash juice box.

Jon Fawcett 1:59
Hi, thanks for having me, Scott, this is John Fawcett. I'm the creator of sugarpixel, and then also loop follow app that many are using, and even the loop patches that a lot of loopers are using. So thanks for having me on the

Scott Benner 2:12
show. And John, you've been on the show before, right?

Jon Fawcett 2:15
Yes, I have. We talked about my daughter, Lily's change from being a looper for four to five years over to the OmniPod five. That's

Scott Benner 2:25
right, and your episode is smartly called from loop to OmniPod five. Episode 908. These people find you compelling and want to hear more. Thank you. Yeah, please. I enjoy talking to you very much. Now today, my my schedule's a little tighter, so I don't think we're gonna be able to go on and on like we did last time, John, I made a I'm going to tell you about it, because it's got to go somewhere. I don't know what happened to me, but a few weeks ago, I was like, I'm so tired of waiting for some of these other companies to contact me. Like, I get the idea that, like, OmniPod, for example, has been sponsoring the podcast since, like, you know, the very beginning. But I, I've always been baffled that, you know, tandem has never reached out. And been like, can we have somebody on your show? And I don't know why that is. And so I was like, All right, like, I'm just gonna put the call out. So I put up a post that was just like, hey, listen, if you have any kind of tech, or if you're helping people with diabetes or whatever, you can come on the show and tell people about it like, you know, contact me. Well, I think I've got an insulin coming, another device that reached out, which I thought was great, but mainly it was just like, more like entrepreneurs and people like you when I'm thrilled for you know what I mean. But anyway, so the last time you were on, we didn't really talk about the business of what you do very much. So tell people, give them like, a quick catch up. Like, how do you find yourself in this position?

Jon Fawcett 3:49
Yeah, so Lily was diagnosed when she was 12. She's 18 now, within weeks of her diagnosis, I had night scout up and running. We were using the spike gap at the time to get better alerts. And so I just dove in head first with all of the Hey, what's out there? What can I implement on our, you know, in our house, to make things easier for us managing this new diagnosis? So we were even tracking rudimentary, rudimentary tracking. Io be and see would be using night scouts built in decay just from manually entering that so we were using night Scout instead of that paper log book that they sent you home from the hospital with. And at the time, I also owned a company that made smartphone accessories, so I had all kinds of tech and product background, and at some point it just hit me that we're still waking her up for alerts overnight, and this was when she was 16, so she would sometimes wake up, but Mom and I still have. And our alerts set, and our alerts were going off all the time to get up and make sure she would have low carbs or take a correction for a high and I realized we're potentially only two years away from her moving out on her own, living in a dorm room, first time on her own, anything like that. Yeah, and I needed to solve the ability for her to wake up on her own, her alerts every single time. So that's how sugarpixel got started. I used my background in designing and manufacturing tech products to basically create a better alert system for her Dexcom, and it has so so a couple things that we added to it is the audio alerts peak around 105 decibels, so it's drastically louder than your alerts off the Dexcom app. But it also randomly creates the audio as it plays in real time. So there's a lot of studies. It's called Brain habituation. Clinically, we call it alert fatigue, where your brain hears the same sound repeatedly and then just literally starts to ignore it and you it just basically won't wake you up anymore because your brain has heard the sound too often. So we implemented that. And then we also have haptic alerts. So there's a vibration talk that you can put underneath your pillow to give vibration alerts also. And sort of like we're trying to combine as many things as possible to ensure that you're going to wake up to your alerts every single time reliably. So that's sort of the high level of what sugarpixel is and how I created it.

Scott Benner 6:45
That's amazing for people who may not know that you can, you know, like, how could this blaring alarm from your phone go off and it not wake you up? I will tell this brief story. I, as I've highlighted on the podcast, number of times, grew up very broke, and we lived in this place that was the front door was 12 steps from the sidewalk that butted up against a five lane highway. All right, so prime real estate, John, everybody was clamoring to be there, trucks like semis all day long, cars all. It's one I was literally 75 yards away from one of the top 10 most deadliest intersections in Pennsylvania when I grew up. Okay, that literally, I'm telling you. There was never not traffic moving, but every once in a while, that would go, and it would come and everything. But you lived there for a while, the trucks would go by, the building would shake. But I met my wife, and I was dating her, and she came over one time, and we were all sitting sort of in the living room watching television, and it was later at night, so the traffic had died down, but then a truck came cruising by, and the house shakes and does the whole thing, and the windows are rattling and everything. And she literally stands up off the sofa, like, what is happening? And I looked and my rest of my family, we didn't know what she was talking about. We had no idea what she was talking about. We're like, are you okay? What's wrong? She's like, why is the house shaking? What's that noise? And we're like, oh, that's a truck. Like, we never would have heard it. So I take your point. And you know, from my kid having diabetes, I've slept through an alarm or two, so yeah, yeah,

Jon Fawcett 8:32
not even just audio that your brain does that with. It's any stimulus. So a lot of people feel this is like phantom vibrations from their phone in their pocket where the phone didn't go off. It's because they're just so used to feeling that same vibration that it's tricking them. So even with the the vibration just it randomizes the vibration pattern, because your brain can get used to even the haptic alerts or the house shaking, or just about anything that it's a constant, repeated

Scott Benner 9:03
stimulus, that's amazing. And so you just have, like, I don't want to call it an algorithm, because everybody says everything's an algorithm, but it just randomly. It just randomly goes through and and makes changes to the vibration and to the sound, into the pitch, to the bot, like, the whole thing. If you take insulin or sofanylurias, you are at risk for your blood sugar going too low. You need a safety net when it matters most, be ready with G vo hypo pen. My daughter carries G vo hypo pen everywhere she goes, because it's a ready to use rescue pen for treating very low blood sugar in people with diabetes, ages two and above that, I trust low blood sugar. Emergencies can happen unexpectedly and they demand quick action. Luckily, jivo kypopen can be administered in two simple steps, even by yourself in certain situations. Show those around you where you store GEVO khypoped. How to use it, they need to know how to use GVO kypopen before an emergency situation happens. Learn more about why GEVO kypo Pen is in Arden's diabetes toolkit at gvoke, glucagon.com/juicebox, gvoke shouldn't be used if you have a tumor in the gland on the top of your kidneys, called a pheochromocytoma, or if you have a tumor in your pancreas called an insulinoma, visit gvoke, glucagon.com/risk, for safety information. I don't know how you guys order your diabetes supplies, like CGMS, pumps and testing equipment, but at our house, we use us Med, and I'm gonna walk you through the entire process. Right now, I'm looking at the email from us med. It says it's time to refill your prescription, dear Arden, please click the button below to place your next order. Then you click the button that was it. Two days later, I got this email, thank you for your order from us. Med, we wanted to let you know that your order and it gives you an order number was shipped via UPS ground. You can track your package at any time using the link below, and then there was a link, and then it showed up at our house. Now I'm going to walk you through the entire chain of events. On the 29th which was a Saturday, I clicked on the email. On that Monday, the first I got an email that said the order had been sent four days later on the fifth the package arrived. If you can do it easier than that, you go get it. But if you can't, us, med.com/juice, box or call 888-721-1514, get started today with us. Med, get your diabetes supplies the same way we do.

Jon Fawcett 11:45
Yeah, every time. So sugar pixel runs on a millisecond loop, basically as it's doing the alerts, and every time it hits that, it says, Okay, pick a new tone, for instance, a new pitch for the audio and pick a new duration. And obviously we have some top and bottom parameters that it can choose from, but it's, it's sort of like saying, every time it loops, pick a random number from one to 10,000 okay, and you're never, you know, you're never going to get that same number, like same pattern of numbers, sequences matching in any repetition. That's

Scott Benner 12:26
pretty cool. We've done two things already. We've just said night scout out loud, as if somebody understands what that is. And so let's start with that. What do you think of night Scout as being like, I'm, people know I'm I'm tech savvy, but I don't understand back end stuff. So I know that night scout is on my phone. I know that Arden has a night Scout URL. I can tell you that Arden's vision AI, which is not a thing I've told people about, yet, runs off of her night Scout link. And yet, I don't honestly know what night scout is.

Jon Fawcett 12:58
Yeah, so night scout is, there's two pieces to it. One is just a database behind the scenes, running on a server somewhere. And when I say database, you can think of just like an Excel file to greatly simplify it. And this Excel file has Your blood glucose reading every five minutes that it's grabbing from dexcomber libre or wherever. Loop even uploading it and then it has your carb entries, your bolus entries, your basal changes, depending on what system you're using. Night scouts flexible from the database back inside to utilize all kinds of different capabilities. So for the DI wires, using a loop, it can grab all the data possible to the very simplest form that I mentioned. We were using it just with MDI. We were just manually going to the night Scout web page for my daughter and clicking a form and typing in 30 carbs and hitting submit, and it would save that. So it's not really on that end much different than just an Excel file sitting in the cloud that has all of the data and then the other half of it is a front front end, and the front end can vary drastically. So night Scout, in and of itself, like the open source project has a web based front end, so you just open the website link that's for your night Scout site, and it shows you, sort of like looking at your Dexcom graph or the follow after libre graph, but it has a bunch of other data with it, such as little dots for your carbs and dots for your boluses. But the ecosystem with night Scout has gotten pretty large to where you really don't even necessarily need to deal with the front end anymore, the website running and only looking at it in a browser most of the apps out there and download the night Scout data and display. Them in a different app. You can display them. You can sync your sugar pixel up tonight. Scout, to display it. You can sync the loop follow app that I mentioned earlier, that I wrote up tonight. Scout, not sure about like the sweet dreams app. Guru, I know you can sync up tonight. Scout, so there's this big ecosystem of all kinds of things that can sort of plug in and utilize all this data. That's your data sitting in the cloud for your back and night Scout site.

Scott Benner 15:33
So you just did a thing where you just mentioned a bunch of other like, I'm assuming, like third party apps or that kind of stuff. They come and they go. I don't mean the ones you just said, or anything like that. I mean, over the years, I've seen people say, I've have, oh, my God, such a good idea, right? I'm gonna do this. And some stuff takes off, and some stuff doesn't. The apps, especially, they come, they go, they come, they go. It's constant. You came and you stuck. So that's my next thing. Is, like, we say sugar pixel, sugar people, again, they're like, a sugar pixel. I know you explained what it does, but like, visually, it's this little, let me see, is it about six inches long?

Jon Fawcett 16:11
It's, yeah, it's six inches long, two inches tall and two inches deep. It's about the size of an alarm clock.

Scott Benner 16:18
Okay, yeah. And it's time. It's smaller than that, I think, but, but, and then there's a screen on the front, and it just tell me everything that that screen shows me.

Jon Fawcett 16:28
So we have 25 or so different screen display options to choose from. So I won't get into all of them, but

Scott Benner 16:38
you can choose how and

Jon Fawcett 16:42
what you want to display on that the default things are going to be your blood glucose reading, the trend arrow, and then your delta, which is how much your blood sugar change between the last two readings. So did it drop by five? It would list the negative five, or did it raise by 10, it would list plus 10. But we have all kinds of options for you. Just don't want your blood sugar shown to the world sitting on your kitchen or in your dorm room. You can just display it as a clock, so it'll show the current time. And the clock is color coded, so green means you're in range, you know, red means you're urgent, low, things like that. So the time, the color of the clock just changes all the way through to we have full emoji and icon sets. So you can we have a lot of parents that that's the one they use. It shows a picture on the left, and then your blood glucose and the trend arrow, so if they have toddlers that might not even going to read, they can start associating a picture with how they feel, and the parent can still look and see the exact BG value. And we actually just had a parent email us a few weeks ago with a story where she said the pictures are absolutely fabulous because her three year old, I think, came up and said, Mommy, it shows a thunderstorm. That means I need to wait an extra 20 minutes before I eat. So the kids started associating the thunderstorm with lightning. Is one of the icons that we show for a high blood glucose value. Now

Scott Benner 18:21
here's the downside, John, that kid can't eat it's raining. Did you know that? They haven't figured it out yet, but whenever it's cloudy, she's not hungry. That's amazing how old I think the kid

Jon Fawcett 18:36
was three, and it was just a really interesting story. And we had thought of that, but that was sort of the first parent that reached out and said, you know, my kid learned to do this on his own just by, you know, the parent child communication of, no, you should wait to eat. And then the child associated that with the pictures that they were seeing on their sugarpixel,

Scott Benner 18:58
yeah. Terrible. Postscript, they eventually moved to Seattle, and he starves to death. So when you hear that story, can you tell me on a personal level, like, forget the business for a second. What's your reaction to that when you hear that? Because I have experiences like that, and I'm wondering how they strike you,

Unknown Speaker 19:16
well, and how it strikes

Jon Fawcett 19:18
me is, that's why I'm still here doing this. And he sort of back to your point about the app, you know, come and go and things like that. So I came out of consumer technology as the company that I was running, and that is, I got to see the worst parts of everything from corporate greed with competitors down to just absolute fuming customer support requests to us. So you flip the script here to making a product that's helping people, and that's quite frankly, the reason I'm still doing it is because. Is of how many times people just send us a note and say, oh my gosh, this, you know, my kid is now learning how to understand his blood sugars. Or last night, this saved my life, because my phone alert didn't go off, but this alert did go off, so all of those, that's the reason I do this, and that's the reason, you know, every morning, I get up and I basically

Scott Benner 20:23
search the 200

Jon Fawcett 20:27
Facebook type one groups that I'm part of to see if there's anybody that's having a problem or needs help with setup, or, you know, has a question

Scott Benner 20:35
about it, because

Jon Fawcett 20:38
it's, it's so gratifying just to be able to know you're doing something that's truly making a difference in 1000s of people's lives. John,

Scott Benner 20:47
that's customer service. You don't wait for them to come to you. You go find them. I mean, I do

Unknown Speaker 20:52
it, sort of a weird thing. No, I

Scott Benner 20:53
do it. I know what you're talking about. Yeah,

Jon Fawcett 20:56
I know you do it. If you look at people having Dexcom problems and you know, or pump questions. None of the major companies seem to do that, but you're a great example too. Is you hopped up on there all the time when there's stuff that needs addressed from your end,

Scott Benner 21:15
I answered a woman's question last night at 2:48am I was I was asleep, and I got a text from Arden that said, I need help. I'm working on a finals project, and I don't understand something. I said, Oh, I'll get out of bed. So I got out of bed, I came into my office, and I FaceTimed her, and I helped her work through it, which reminds me, by the way, in two minutes, I have to wake her up, but that'll be the end of the story. And when I got back in bed, I just, I was awake, and I opened my phone up, and I went to my mentions, and I just went through and answered people's questions about diabetes stuff for a couple minutes. And, you know, I take your point about the companies not doing it. They can't, like, they're they're restricted by the FDA, they can't give medical advice. And so no matter, like, you know, when it's you or it's me, I'm just a guy, I get to go on and say, hey, look, you know, here's what I would do. But you know, I'm not a doctor, like I'm nobody's, nobody's counting on me to be right. As soon as you put a company in that position, they, they have, they'd have to be correct, and everything would have to go through legal. And it just they, it's not a it's such a it would be such a valuable thing. They'd have the most popular Facebook group in the world. But there's not a thing they can do. So yeah, you know well,

Jon Fawcett 22:30
and there would be ways I think they could do because there's even times where, no matter how much we ask people to contact us directly for customer support. We can't stop people from posting to the Facebook groups, so that's the reason I do it, is I don't want someone who maybe they forgot to click the help button and contact us through there to the post to Facebook. I don't want them getting upset and not having a sugar pixel work because of a setting that needed changed or something. So that's why we do it. But there are times where I even have to say, Please, email supported custom type one.com because I'm not about to ask them to post their you know, Wi Fi information on juicebox podcast, Facebook group, you know, things like that, where we have to even

Scott Benner 23:22
take caution with

Jon Fawcett 23:24
confidential information that might be on the sugar pixel that we need to see in order to assist them so we we still direct them over

Scott Benner 23:33
you have this little ritual where you go around on on Facebook. Let me ask you a sincere question that you please feel free to answer me honestly about, Do I have the best diabetes Facebook group? Yes. Is it the most active? Yes, yeah. Okay, so I don't look at the other ones,

Jon Fawcett 23:53
so you definitely from what, from what I see, because I I am probably on at least three or four dozen,

Scott Benner 24:03
oh, my god, horrible. Globally

Jon Fawcett 24:05
there, there's, we're in ones that are, you know, in a Facebook group for Norway where I can't even read any posts on it. I have to click through to translate. Okay, try and catch, you know, they'll still write sugarpixel in in English. So I'm talking worldwide. We're on these groups, but by and large, we see the absolute most posts from juicebox group. And I think a big reason for that just sort of as not the guy who runs it like you are, that I don't know if you get the same feeling as the guy who's overseeing it is your users seem to be very, very passionate, compared to some of the other groups like they're not only passionate about sharing what they learn, but about helping people and knowing. That this is a safe space to come to, where I know I'm going to get the help I need. These questions, where there's some groups, where it's just it gets out of hand pretty quickly with, you know, very unhelpful comments. I smacked

Scott Benner 25:14
somebody on the hand the other day digitally.

Jon Fawcett 25:18
Yeah, I saw that.

Scott Benner 25:21
Oh, I did it again since then. Actually, here, I'll tell you this, because it'll delight her when she hears it. Isabelle helps me run the Facebook group. And Isabelle is a lovely woman who lives in Canada, who has type one diabetes. She is maybe the kindest, like so good at, you know, seeing the things to point out to me. You know what I mean, like, check at this. Look at that. You're going to, you're going to want to see this. And she's so kind to everybody, but there's like, three people in the group, if I'm being honest, she really doesn't like and sometimes she'll be like, this one's at it again. And I'm like, okay, and I'll look and I'll be like, you just don't like them. And she's like, that's not why. And I read, and she's right, they're doing something they shouldn't be doing. But yesterday, one of those people kind of like, went off half cocked, and I stepped in, and then I sent a note, and I said, Hey, I got you a present. What's the present? I said, I told this person to, you know, you know, be a little kinder, or something like that. And she's like, Oh, I feel so good about that. And I was like, I know, but generally speaking, the group is fantastic, like, and I even think, like some of the agitatoring people, I think it's just what it is. But I do take your point about the veracity that people are helpful with and how knowledgeable they are too. And, I mean, I think they're knowledgeable from listening to the podcast, and then they come back in to help other people, which is beautiful. And then what you don't see is all the lurking, like they're, yeah, oh my god, 90. It might be 95% of people don't say a word, but they're there, and I can see the data that supports that. They're there and they're looking it's really interesting how it all works. You have a couple, like, a little list of things we could talk about here. This one seems like it'll be fun to dive into CGM outages. I'm assuming, when your sugar pixel works with Dexcom, does it also work with libre? Yes. So you

Jon Fawcett 27:20
can directly connect to your g6 or g7 account, and to be clear right here, because we get this question a lot, is sugar pixel downloads from the cloud servers in the same way that the follow up, like the Dexcom follow app or the libre linkup app work, so it doesn't directly connect by Bluetooth to the CGM or even to the phone running the CGM app. I can be in Ohio, and my daughter could be in New Jersey, and I would still have readings on the sugar pixel sitting here, as long as her phone has readings with the main CGM app. So with that said, Dexcom, G 67 libre three and the updated version of libre two. And this is just one of the things that drives me crazy. Is libre has released multiple versions of the libre two, and now they even have the two plus, which causes a little more confusion. So the original libre two, you had to manually scan the sensor with your phone to see the value on in the app on your phone, they updated that in numerous countries around the world. So like UK, now it's still called libre two, but it essentially runs like the libre three, where that connections in real, real time, without you having to manually scan the sensor. So right now, we work with both of those. I like to sort of tell people, if you don't have to manually scan the sensor to see the value in the libre app, sugar pixel works, okay, but some exciting news were in beta testing for sugar pixel functionality for the original libre version, version two that requires manual scans, so it'll run a little different, but I'm hoping within the next two months, we'll have that available where it will actually trigger alerts off of the libre to where those alerts send out to the libre app and the link up app, even if there's no BG value, it's like the sensor says, Hey, I know I'm low, send that Bluetooth ping to the phone to trigger an alert. So we're about to release that for beta testing right now, and then also in sync with night scout and glue Global Connect, which is sort of like glueru runs their own night Scout backend system that can run through their own app, and we can sync with that too. It's

Scott Benner 29:50
ponderous to me that the companies don't just do this themselves, by the way, like, I mean, I'm glad everybody else does, but you're like glueru, night scout. So this one that, like, just do it yourself. My God. Like, look how valuable it is. People would like talk about adding functionality that people would be thrilled about. I haven't talked a lot about this in the podcast yet, and I will at some point, but I'm involved with a company called Vision AI, and so I'm using the product right now, going to be talking more about it moving forward, but I'm hooked to Arden's account, right? So I just went into a prompt and said, Show me my last five boluses. And it said, bolus dose one may 13, gives the time and the date point six, units two time and date point one, units three time and date point two, units, like, just like that. I said, What's my current BG? Your current BG is 98 the trend is stable, like, stuff like that. I asked the question. It can answer like, what do you think my blood sugar's gonna be in 30 minutes? And it doesn't know. But it said, predicting future glucose levels accurately requires consideration various factors. Like, it gives you, like, you know, a great like, synopsis of your question, since your glucose trend is stable at 98 without additional influence factors like recent meals or exercise, it is likely that your glucose levels will remain relatively stable in the short term, and assuming no new variable, that's hook the Arden's night Scout, yeah, it's insane. If you ask it another medical question, it takes into account that you have diabetes. It's just like, where are we going, you know what I mean, like, because wherever we're going, John, I like it. I'm a fan of all this. I

Jon Fawcett 31:26
would like I see this long term picture off of AI stuff that I would like to see into the actual algorithms, yeah, because I think it can get there. I think we've got a long way to get there, because AI still not perfect, it's sure, based on data in but ultimately, if, if we could have a system, let's just, for example, use OmniPod five. Since my daughter's on that, I was thinking about this the other day so she had, she had a cold last week, and her insulin needs just work through the roof. Well, the one concern with OmniPod five is, do you change to the next pod and then she's having a lot of lows after she's passed her cold, because TDI was like, double AI could easily solve that. Literally, all you have to do is tell it you had a cold, and it can even look through and try to determine an appropriate adjustment of TDI. One of the things I did manually years ago with loop is I pulled in, like, a month's worth of data and made a calculation that would average out, not really average, but more the median of what her blood glucose was throughout the day and after meals and stuff like that, and then determine, based on her total daily insulin, How much to adjust carb ratios and basal spy. It's really not that difficult as a human to process just massive amounts of data like that, but for a machine, I don't think we're there yet with naturally think through all of these variables of sickness or stress or extra activity or anything like that.

Scott Benner 33:20
Arden's using Iaps, and we have the functionality on where it's, I don't know what they call it in the app, but it's like a dynamic insulin on board dynamic basal like, it makes adjustments to those like, and it's still, I hear what you're saying, because I still see the same thing, like coming out of her period, for example, or, you know, a time when she needs more insulin, like, you're almost like assured she's going to get a little too low once those that insulin need changes. But, man, it adapts very quickly. I

Jon Fawcett 33:50
actually just had a discussion with someone this morning about dynamic ISF. I'm torn on it. It's a

Scott Benner 33:58
it's, it's solving a

Jon Fawcett 34:01
different problem, in my opinion. So it's it while it works, and you can solve things with that. It can also introduce, introduce more risk, if you're not for someone that may not know exactly you know what the settings are doing. And it's it sort of comes back to, like our last episode, we, I think we talked a lot about fat and protein, and I know you have other episodes about that. Is so it's dynamic. ISF to me,

Scott Benner 34:31
there's not a lot of science

Jon Fawcett 34:35
that I've seen, and if you have some, I'd love to read it, or if you have had other people on talk about it, but there hasn't. I haven't seen a lot of science to me that has sort of shown that when blood glucose is high, there's more resistance, just period in and of itself, where everything I've seen sort of falls back on the the other things, the. The hormonal changes for monthly cycles, fat, protein, taking four to eight hours, those types of things, and it's always a tricky situation on you can solve that with a TEP basal. You can solve that with dynamic ISF. You solve that with dosing for whatever underlying causes. So I think there has to be something new out there on a way to solve that. I just don't I don't think we're there yet. I don't think dynamic ISF, is it? I don't think temp basals are it. I don't think having to manually go in and dose, because even then, it's just they're all guesses in many ways. Well, what

Scott Benner 35:46
do you see as the answer? AI to put something else in charge. Be like, Look, you figure it out. Because you know, even like, considering fat as an example is not something people do, you know, and even if you were to do it now, you're asking them to know the fat content of a cheeseburger and french fries and like, you know, I'm wondering if these other fixes are while maybe not at the root of the problem. Does it not maybe? Does it just not matter, because it's doing what it needs to do, well and

Jon Fawcett 36:24
to some degree. But I mentioned there's more risks, and ultimately it comes down to the greatest low blood sugar risk is from a bolus, no matter what. So if you're so dynamic, ISF is essentially just adding automated bolusing when you're high dosing, trying to dose and time fatter protein doses. That's adding a bolus. And there's just so many variables that the risk to me, that I see with all of those is that

Scott Benner 37:01
you misjudged the

Jon Fawcett 37:03
reason for the high. So if it, if it is fat and protein, you're going to work out dynamic ISF is going to work out, an extra dose is going to work out, if it's a timing issue, and I know that, you know, a lot of people post that chart, but I don't know if you made it or someone else, but I see it all the time on juicebox of sort of, how do you determine, is it timing or ratio, or what of the dose based on what the graph does after you eat? So if it was a timing issue, you could already have way too much on board, but you hit 250, or 300 because the bolus timing was off from the carb time, and

Scott Benner 37:48
it goes again, yeah, that dynamic

Jon Fawcett 37:50
ISF could cause a major low, or doing an extra fat protein dose too soon could cause an extra low. So that's sort of my concern from both of those so

Scott Benner 38:02
far, what I'm seeing with Arden while she's at college, because her her pre bolusing isn't great. At college, she'll spike to like 202 20 if she doesn't pre bolus, but it hits her pretty hard. It brings her back. It does not normally make her low. That's good. So yeah, the last few months, she's been completely all of her settings in Iaps have been the dynamic version of those settings, and I have not touched it at all. She's doing well, that's great. Yeah. Now I don't know that the stability, like the the rises, are the same. It's, they'll be once she's, you know, not up, you know, overnight, three days a week, trying to get work done. Yeah, right now. It's making her life manageable, and it's allowing her not to think about diabetes while she's so busy. And I'm taking that as a win in the moment, and I'm also counting on the people who are working on this to continue to work on it. You know, that kind of thing, actually, can we, John, can we just take a second here? Arden was up all night working on a project, and I'm in charge of waking her up so she can keep working. So hold on. One second for me, you're gonna hear, hey, it's 1145 you want to get up now, or you want me to call you back in a little bit. 10 minutes. Okay, bye, by the way. Could you hear? Yeah, the Hello was this and 10 minutes, by the way, I already called her 15 minutes later than she wanted me to. So she was up all she did an all nighter, Friday night. So on Friday she went to the lab at one a 1pm they worked there all day. Came home at 8pm ate something, went back at 930 and then left at 11:30am the next day. Then she slept, then she slept through the day, then she got up in the evening, worked all night, again, I think, went to bed at like three or four o'clock and. Got up at 11 or 12, worked all day yesterday, all night, last night, and went to sleep this morning. At time did she go to sleep 10:15am and asked me to wake her up at 1130 so she's been asleep now for an hour and a half after doing well, she's got one more thing that has to be in by five o'clock tonight, and then she's got to go to class all week. So is this the last week? No, this is the last two weeks. Somehow, John, I don't understand this, and maybe it answers a lot of my questions in my cold wind episodes, have you heard those? Don't remember? Oh, there are healthcare workers. Come on and tell you how shitty their jobs are and how bad everybody is at what they're doing. If you haven't heard it, it's really eye opening, and it'll scare the living out of you, while Arden's friends who are becoming teachers and nurses and all these, you know, other things are already home and like, you know, out at parties on Friday night and everything, my daughter, who's learning how to make clothing, is being treated like she actually works in a sweatshop at college. Basically, she went somewhere where the instructors are like, ex, you know, industry people, and they're basically like, tell them, like, look, this is this is it? If you can't do it here, you can't do it there, and I'm going to give you something to do, and I'm not really going to tell you how to do it and get it done and be right. And so that's the situation she's in. So she had to make a pattern from nothing. They gave her a piece of clothing that is already made and told her, deconstruct this, make a pattern for it, and then remake the thing she calls us. She goes, what the AM? I supposed I'm like, I don't know you wanted to do this. Not me. I was like, it was like, go figure it out. Right now, she finally met a really good friend that's in the same track as her, and ironically, that person is a type one from New Jersey. Oh, wow, yeah. So they were there. That's great, and then insane. So they become very fast friends, and they're helping each other and doing great and everything. Yeah, no kidding. Like I'm not lying to you. I very close with all these other girls who are in these other, you know, like tracks in different colleges all over the country. And we talk all the time, and they they say over and over again, it's insane, but Arden's college is way harder than ours is. So yeah, anyway, this is gonna kill her, for sure. She's

Jon Fawcett 42:36
like you said something really interesting that triggered something in my head that it's sort of all the dynamic studies that made it manageable so she doesn't have to think as much about diabetes, especially with how but you know how hard this program is for her right now, and I more and more see Facebook posts or questions where somebody is worried about, you know, hey, I had the same meal this morning that I had yesterday. And here's the two graphs, and they look different. What study should I change? And more and more, I think that the technology is getting there with, at least with loop, IPS, Android, APS, OmniPod, five and tandem. The technology is getting there to where you don't really need to worry about, well, why did it, why did it react different, unless you start seeing it, you know, for a week straight, obviously, because we're at the point with Lily where we almost never talk to her. Think about what she's dosing, how much she's dosing, what her blood glucose is, because the systems are so good at handling it with the algorithms. And even when you have a mistake, it's sort of just, you know, mistakes happen, either go small if you're high, or have some carbs if you're low, and then move on. And it's probably not going to be the same thing that happens tomorrow or the next. I

Scott Benner 44:14
think quality of life is becoming a focus, and as the as the technology expands and grows, and the companies have more time with it, and even the well as DIY people have more time with it, the focus is more and more on quality of life, like not just, can I keep my a 1c at 5.2 I mean, I'll go backwards, right? Arden's diagnosed. She's two years old. I don't know what I'm doing. I'm thrown into the same cement mixture that all of you are thrown into. I feel like I'm killing her. I might very well maybe her a 1c and the eights. I can't seem to affect it. I don't know what's going on. What happens next? Dexcom makes a CGM. All of a sudden, they have more context for what's happening. I'm like, Okay, I'm getting this. I bring her a 1c down a little bit. She gets a pump. I. Know, I'm using the pump just as an injection replacement. So it's not, I'm not getting any of the functionality out of it. Yet, all of a sudden I start learning about extending boluses. And, you know, temp basal increases and decreases. And you know, I'm bumping and nudging blood sugars. And all of a sudden I can bring a 1c down and down, down. It comes out of the eighths and the sevens, the sixes, the fives. And it takes a lot of effort in the beginning, especially a lot of effort now, as time moved on, I got better at it. It took less of my effort, but didn't let you sleep still all the time. You know, there was a lot of downside to it. OmniPod five comes along. And while they're even talking about it in the in the planning stages, the way they're talking about it is like, look, you know, it's not going to be loop, but people aren't going to need to understand all this to still live a nice life and have a good a 1c and some stability and all that stuff. And as they were saying that to me and to whoever they were saying it to, out loud, I was thinking, oh yeah, but my kids got like, a five, three, A, 1c A, five, five, a, 1c, A, five, seven, A, 1c, like, that's what I want, right until you sleep through the night the first time, yeah, and then you're like, hey, you know what? Maybe a six, one's okay. I was gonna die, and I didn't realize it, like, I was worried about her dying. I was the one that was dying. Like, you know? And now you're an adult, and you have type one, and your mom and your dad aren't helping you. You're burning your candle from six different ends. And, you know, and then you get into a situation like I said to Arden the other day. I'm like, Are you taking your vitamin D? And she goes, dude, after finals, talk to me about that. Like, I'm like, they're right next to your bedside. I put them in this little, like pill container, Monday, Tuesday, Wednesday, Thursday, Friday, just to open one and take it out, put it out, put it in your mouth and swallow it. You're sitting next to it right now. Can you see it? Put it I can't like, she's got no bandwidth. If she was taking care of her diabetes, like MDI, on top of all this, I don't know if she'd be, like, hanging the way she is and doing as well. And so I say, let OmniPod work on that OmniPod five algorithm, like, you know, sure, though I'm assuming they're gonna keep working on it. I like that. The thing what I find in diabetes, John, is that the thing that first scares people is the thing they end up loving at some point. My example is Dexcom came out and all the old head moms were like, you're gonna make these kids crazy. My kid's 35 and she's fine. We didn't have a CGM, like, these. Oh, I can, by the way, I got one in my mind right now. Old Cal just going on and on about, I don't mean that in a gender way, by the way, just, she's just doing anyway. I'm gonna go back to old Cal. Old Cal just mooing and mooing about CGM, and it's gonna ruin these kids and blah, blah, blah. And I'm like, OmniPod, you have never seen one. Your kid doesn't wear it. You've never had any experience with it. You sound like a lady going, get off my grass. You goddamn kids. Like, like, and I'm like, I'm like, you don't know what you're talking about. But then that becomes pervasive throughout the space. Oh, I don't know. People are too focused on their data. It's gonna give people anxiety. You know, who gives people anxiety? People have anxiety. People who don't have anxiety are very calmed by the whole thing. So it's not for everybody, but that initial panic, it's change. People hate change. Like, do you remember when Facebook was massaging its way to what it is now. There was a revolution online. Every time Facebook changed their their the way Facebook looked right, because people don't want to change. I get that. I understand the whole human thing about that. But anyway, a couple of years later, that cow stopped mooing. You know what she said this CGM is fantastic. My daughter's never had better blood sugars. Blah, blah, blah, blah, blah, Oh, good. I'm glad you figured it out two years later. For the last 24 months, you've been setting brush fires in people's minds on the internet, and all those people now believe that CGM data is a bad thing to have. And then OmniPod five comes out, and they say, Hey, look, we're not going to show you all the settings. We don't want you to think about this. We want you to just live your life. People like, I gotta see my settings. A year and a half later, I hear you go, I love OmniPod five. So I'm like, I think just wait. You know what I mean, like, and I can't wait to go. It's

Jon Fawcett 49:15
all of them, yeah. So it's, it's,

Scott Benner 49:19
we saw this

Jon Fawcett 49:21
when Lily started looping. So she started looping the week that loop added OmniPod arrows functionality, more than just their private just the private test group, and she actually that was her first bump. So she she got the OmniPod. One week later, I switched her to loop with OmniPod. I never even had time to learn extended bolus. Literally, I've never used it a single time, right? So you kind of look at that, though. And one of the things I hear from OmniPod five people, is, oh my gosh. How do you do extended bolus? How do you do extended bolus like we've never done that ever with her OmniPods now, in what, seven years, or whatever, six years, because she went right to loop. But with every system, see, then you had, you know, always saw the loop. People who were coming in from MDI, and, you know not, not necessarily understanding how loop handles things differently. It could be looped by APS, Android, APS, whatever is just, I tell a lot of people, there's no such thing in my mind as an empirical setting, basal, card ratio ISF, etc, nothing that's empirical, that works on every single system out there, because every single system out there handles those things in such a different way.

Speaker 1 50:48
But once you sort of, from

Jon Fawcett 50:52
our viewpoint of how it's happened in our family, is once you embrace how whatever system you switch to is different than what you used to be on, and start adjusting your management style to how to the strengths of that system. Yes, the quality, the quality of life, goes way up. And your point about the first time you sleep through the night. So we have, we have our alerts. I still have a sugar pixel in my room, even though Lily has one in her room. Mine is set at, I think, 50 and 300 like, I don't want woken up unless she hasn't handled it, and it's truly approaching an emergency level. But I've had people ask me like, you know, hey, I want my low alert on sugarpixel set to 120 but then I want to easily change it. If it goes off, I want to change it down to 100 and then change it down to 90. Like, if BG,

Scott Benner 51:51
like, that's just counterintuitive.

Jon Fawcett 51:55
It's counterintuitive. It's it's really degrading the quality of life. And so for us, we've started focusing more on quality of life. And I think her a 1c might have gone up a point one or point two, and that's fabulous, because everything else, the burden of management, has dropped, yeah, by 90%

Scott Benner 52:18
Yeah. I mean, I think Arden would have been sad if she had a five, three, a one scene, her father was dead. You know what I mean? So, because there were nights I laid in bed and I was like, oh my god, I'm going crazy. My head is shaking. I'm vibrating, you know, I need to sleep. The

Jon Fawcett 52:33
other thing that concerns me, and this was sort of back to me creating sugarpixel, I was concerned that, you know, Lily has to go to wake up to her alerts well. And then I started also thinking, okay, in two years now, she's also going to be managing this way more on her own, with way less involvement from her parents. And the one thing that started concerning me was, can an 18 year old shift from their parents handling everything and getting down to this 5.5 a 1c to then becoming an adult who's having to do that same stuff on their own, my fear was a swing of like 5.5 up to nine, a 1c just because a kid's going to get burned out. You and I, we sort of push through it over the years, and most parents do, but the fear is an 18 year old just going to get burned out in the first month of that, and then they're not going to those they're not going to bolus at all. They're just going to let the pump do whatever it does. And that's so I kind of felt that, you know, going from a 5.5 to a six or 6.5 that's way safer and healthier in the long term and not that much different in the short term than a swing up to sort of not managing your diabetes as a young adult and jumping up into the eights, nines, 10s, A, one CS, and

Scott Benner 54:01
you give her the opportunity to come to it on her own without it going wildly the other way. And so it's a thing she'll come to like, you know, I could probably put my a 1c back down under six if I tried it on her time, which will be important, you know? I mean, you can't force people to do things. Yeah, exactly. Those are the big picture ideas you have to keep in mind, when you're talking about stuff like this, like you're not going to be able to force people to just to do a good job. You can't. I mean, I don't know how many times I have to, like, have somebody on to make the point to people, mostly humans, just do stuff for other people, never for themselves. So like, you're doing that thing for your daughter. I'm doing that thing for my daughter. She's not going to do it for herself. She doesn't see the situation like that. She didn't watch her come out of my wife. She doesn't see herself the way I see her, like she's my most important like focus, her most important focus is learning how to put sleeves on a thing before the lady yells at her on Friday. Like, you know what I mean? Like she's not she's not prioritizing life the way I do. She doesn't have the same ability. To do that. She's not as far along in her career, in her life and her understanding, and she hasn't had enough experiences like if a six five, My God, what a great a 1c to have. You know, if a six five, a 1c is the price to pay, and I'm making quotes around that to get you through that part of your life. You know when, God bless that's fantastic. We never did go to CGM outage is when I brought it up, John, I'm going to run out of time for you, but it might seem like a left turn. I do just enjoy, maybe more talking to you about algorithms, stuff like that. I assume you see what happens? The Dexcom lost their but I don't know the technical term, but like, overnight, like people didn't have access to their stuff, unlike other people's phones, right? The share stuff.

Jon Fawcett 55:41
This one this time it was even on the main Dexcom app was getting logged out.

Scott Benner 55:47
That didn't happen to us, but, but okay, yeah, I did see it happen to some people, like people are getting kicked out of their app or something. Yeah.

Jon Fawcett 55:54
So, so they were getting kicked out of their app, having to being forced to re log in, being told they have to re log in, and then sometimes they weren't able to log in again. Lily was able to log in immediately, and everything was back up and running. But I know other people who, gosh, even this week, are still having issues with it with CGM outages. So the first thing is that we always tell people, because I have a lot of we've got 1000s and 1000s of sugarpixel users all over the world. So I hear, anytime there's any outage anywhere, basically, and

Scott Benner 56:32
they treat you like it's your problem. I bet,

Jon Fawcett 56:35
yeah, yeah, quite frequently that's okay, because I have enough experience to you know, even help them with it. Is the first thing everybody should do if they don't have readings in their follow up, or if they're Libra the libre link up app is check the main app. So check the Dexcom G 67 app, check the libre View app, because if you don't have readings there, you're not going to have readings on not only the follow app, but also every other app service device, whether it be sugarpixel or night scout or everything. So the first thing you always want to do is go see if the main app is running correctly, has readings, doesn't have any error messages, like the Dexcom will report a big red X on the server air error for the sharing page when they're having a lot of these outages. So that's the first step to always look at the main app. So as the main app is logged in and has readings, then you start looking at the follow up. And companies have status pages, so status.dexcom.com is you can easily check if they're having an outage. Now it does seem like they might update that page manually, so it's not like automated flip over when they detect outages. So it might not necessarily always be accurate, but it is a good place to check from a sugar pixel standpoint, is, obviously, we rely on those services.

Scott Benner 58:09
The one thing that we do that is different than like

Jon Fawcett 58:14
the Dexcom follow up, for instance, is sugar pixel handles, no data alerts locally on the device. So it doesn't matter why it has no data. It could be from a sensor warm up or sensor error, or a major Dexcom outage like they had last week, where the follow up is completely down, or even your home Wi Fi goes out, or your home internet is out, as long as sugar pixels has power. If it has no readings for any reason, it can trigger the no data alert. So one thing for our users specifically is you might not get readings, but you can still go to sleep knowing that if follow goes out in the middle of the night, you're still going to get an alert for no data if you have that set up

Scott Benner 59:07
nice and get your meter out like, like people used to do for years, check your check your blood sugar. Yeah, it's interesting. The girl that Arden met at school, she doesn't use any technology and yeah and, and Arden's like, you know, we, we were working, and she stopped and checked her blood sugar. And I was like, Oh, that's interesting.

Jon Fawcett 59:28
Well, and you know what's, what's really going to be fascinating in the next few years is so the rumors of Apple and Samsung both working on glucose monitoring, non invasive, just through the watch. If that gets to the point where it's actually reliable and accurate, rather than just a sort of a you're in range, you're high, you're low, not an actual Well, am I 70 versus 150 if those get to the level where. You can rely on them. What starts looking way and way more appealing is potentially some sort of hybrid combination system, where you might be doing a freza just for super simple meal times, or the weekly basal that's coming out, where it could potentially be like one injection a week of a weekly basal, and then that's it, that could potentially actually be a drastic quality of life improvement, because technology

Unknown Speaker 1:00:34
fails, sincerely,

Jon Fawcett 1:00:37
pods fail, pumps fail,

Unknown Speaker 1:00:38
your phones

Jon Fawcett 1:00:40
break and die. And so there could be the opposite swing from sort of add more AI and more technology to if we can get there with the insulins and the non evasive CGMS, where that could potentially be a much improved quality life all

Scott Benner 1:00:57
different pathways. How about there's I did an interview recently with the mother of a 15 year old girl who's had type one for three years. Was using 70 units of insulin a day, combined basal bolus. Mom has PCOS. Daughter started showing signs of PCOS. Mom got relief from PCOS, from wegovy. They put the daughter on the wegovy. And now that that I just talked to the mom again recently, when she was on the podcast, her kid was down to seven units of injected basal a day, no other insulin from 70, wow.

Jon Fawcett 1:01:30
And that's not, that's not the first story like that that I've heard, yeah.

Scott Benner 1:01:35
And now, by the way, they're thinking of moving it down to five units of basil a day, wow. So she's not bolusing for meals at the moment. Now, people hear that, they go, she doesn't have type one diabetes. She does. She does have type one diabetes, and, you know, and I'm, I'm sure, as time goes on, her insulin needs will increase. But that, it sounds to me like that kid was in the middle of Lada that looked worse for insulin needs because of PCOS, and now the GLP is helping with the PCOS symptoms and maybe bringing down her inflammation. I have a doctor coming on next week to really explain to me everything glps are doing for people. I have a family member. I won't say who they are. Again, PCOS Not, not somebody in my immediate family. She started wegovy On Saturday, and it was point two, five, not even what they would consider to be a therapeutic dose. Here is the text from her this morning, I lost five pounds in the first 36 hours. This is a miracle. I said, How did you do you know? Did change your appetite? Do you feel full? Etc. She said, I'd had a headache for the first bit, but I chugged a bunch of water and that went away. I've not thought about food once, and I had to consciously think about taking smaller portion sizes. So she so she, as she was getting herself for food, she she said, Oh, I here's how much I would normally take, but I'm not hungry like that. So she took less. So there's one way it helped her. I've eaten significantly less. I didn't think about breakfast until I got to work. I'm going to eat something now because you told me to, but I really I'm not hungry. I feel full faster, so that now you can say, well, she hasn't eaten as much. You don't lose five pounds in 36 hours by stopping eating.

Jon Fawcett 1:03:22
Yeah, so one pound is 3500 calories. Yeah, that, you know, there's no way to just, and

Scott Benner 1:03:30
I'm sure some of it's water weight. Like, don't get me wrong, I don't think she's like, reshaping herself, but look, look at how excited she is before that. She's a kid who works out all the time. She's an adult, works out all the time is eating it clean and just gaining weight. It has seemed frustrating to me. I think we're still, seems

Jon Fawcett 1:03:55
like we're at the early side of kind of what this whole classification of drugs can actually do for benefits for people, and

Scott Benner 1:04:03
it almost seems like back to your story about the other one who drastically

Jon Fawcett 1:04:09
reduced the insulin usage it. It almost seems like the press has caused some problems at a drastic disservice for the this class of drugs by basically just saying it's, you know, the from a public perspective in just a weight loss drug, but when you look at it from like, insulin resistance and things like that that may or may not be weight related, it seems like there's going To be a lot of benefits that I think people are going to start to see from it that aren't necessarily publicized very much today because of how the press has handled it, that you know just just because you have type one doesn't mean you can't have the same insulin resistance the type two. Have, yeah, and just because you have type two doesn't mean you can't have the same insulin dependency as type one can have. Now, I think from a truly clinical perspective, they've said you can't, you can't, essentially have type one and type two, but from an actual, real life perspective, just Google, they call it double diabetes, or things like that, where you have you have symptoms and signs of both. And I think a lot of those types of people, this class of drugs is going to really help, talking about insulin resistance, weight loss and even other things that, who knows what this drug's gonna be found to? Yeah, you know, other benefits right

Scott Benner 1:05:47
now we're having mostly an insurance designation problem because people talk about it the way it's covered by insurance. Yeah, you know, and that's one side of the issue, the other side of the issue. And I shared this with you before we started recording, I don't have any trouble saying it here. If you look hard at the people who are telling you, oh, my God, it's a crutch. You can do it on your own. Blah, blah, if you look real hard, there are people who are making a living selling that side of weight loss. Okay, so you can tell me that like, you know, I mean, I see people, I don't want to use people's names, but I see people online or on television shows and they're like, We don't know. There's a lot of side effects. It's killing people. Blah, blah. You know what kills people? Tylenol, way more than a GLP does. Okay? Now, I don't see that person on television going, you have a headache, don't take Tylenol. You're gonna die. It's a killer. That's true, by the way, Tylenol has killed more people this year than a GLP medication. Has people die taking medications all the time. It's not going to be right for everybody. If you're scared, don't do it like that's that okay. But I've lost 50 goddamn pounds this year, and I was not running around eating with both hands, with donuts around my fingers. Okay? My body doesn't, doesn't work right, and now it does. That's all I can tell you. I plateaued for a while. My doctor's like, here we'll just up your dose, up the dose. Two days later, I lost two pounds. I could literally feel it like somebody flipped the switch of me. I went to the higher dose. I got a little like, I've been on it for a long time now, like a year. So I went up to a higher dose, I got that weird nausea feeling. I was like, Oh, I can feel it like, I feel it in there. I don't know what it's doing, but it's doing something, and then bang right back. Like I was starting to have sugar cravings again. The sugar cravings went away. You want to argue about what's right way to do something? I'm 52 man. I was gonna die, like I was gonna have a heart attack, like, now I'm not going to I went to the doctor. My doctor says, My God, your your vitals are like your child. They're amazing. You look fantastic. You look 10 years younger. Your vitals are amazing. Good for you. If it's not working, I'll give you a little more. She said, I heard the real weight loss, like, heard she's seeing with her patients. I'm using zepbound now. The real weight loss doesn't even happen until the 10 to 12 milligram injections I was back on 7.5 so here's my point. If you're listening and you're like mad about it, you don't know what you're talking about. This whole like, I'm always scared of what's coming, and you don't know what this stuff's gonna do to you. They've been working on a GLP since in the 80s, I think by Eto was 2005 that's 20 years of data, but, but people are running around like it just came out five days ago, yelling, You don't know what this stuff's gonna do to you. They've been using it since 2005 they just they're turning the screws. They're making it work better. Now, you know, like, I don't know, like, in the end, you got to make a decision who you are in this life. Like, are you scared? Are you going to go for it?

Jon Fawcett 1:08:48
It's really no different than talking about omnipodify or bloom Joe or placebo versus basr. It's not everything is for everybody. We say that a lot. Of course, some people like my our OmniPod five and loom Jeff experience, which is what Lily's using. She's been using loom Gen for probably six months to a year now, absolutely fabulous. And I tell everybody that. But is it for everybody? No, might not work as well for other people, but burns

Scott Benner 1:09:24
Arden like a mother. She can't she can't get anywhere near it. Whatever the additive is it? It hurts her like literal pain.

Jon Fawcett 1:09:32
So, exactly, yeah, so, but there's no difference between talking about those versus how lugovi has helped you and 1000s and 1000s of other people, yeah,

Scott Benner 1:09:45
John, the difference is, I'm not a nudnick. I don't run around telling everybody loom Jeff hurts. It didn't work for Arden. Like you know, you have to ask yourself, I'm gonna have to let you go in a second. But you have to ask yourself, when someone comes online and says, I took. A look. I took a GLP, and now I have, like, you know, I have real problems, like digestive issues. It's I'm not even on it anymore, and I'm having problems. I'm having a real problem from it. That's horrible. Okay, I feel a ton of empathy for that person. You do not know where their body was when they started, and maybe a doctor should have said to them, hey, you've had a one season the nines your whole life. You might actually have gastroparesis. Maybe this isn't something we should try with you. Or let's wait till there's more data on this. But instead, you don't hear their whole story. You just hear, I took this and my foot fell off. Oh, my God, did you hear that? It makes your foot fall off? Like I'm hearing people's feet are falling off. That's literally how the Internet goes after that. I had to tell a woman online the other day. She goes, we're seeing catastrophic problems from this GLP medication, life threatening. And I was like, who's We? Are you a doctor? No, are you a research scientist? No, when you say we, who are you talking about? Well, I heard it on a project. Yeah, you heard it somewhere. Are you kidding me? That's who we. Is we? Is you heard it somewhere from WHO? What are their credentials? That's how the world works.

Jon Fawcett 1:11:16
But it's a reminds me of the all I probably see posts once a day about two things, actually, probably more like five times a day about two things recently. One is,

Scott Benner 1:11:29
Hey, first time flying. What do you guys do for

Jon Fawcett 1:11:34
for TSA, or whatever security in the country you're in, there are 1000s and 1000s and 1000s of people walk through whatever scanner they're required to put all supplies through the X rays, and have never had a single issue. I'm

Unknown Speaker 1:11:50
one of them. And so are we.

Jon Fawcett 1:11:53
Yeah, you get one person had a pump failure after going through security, I don't have to, you know, hear stories like this

Scott Benner 1:12:03
noise or beams aren't good for it, yeah?

Jon Fawcett 1:12:08
But, I mean, there's nothing saying that actually caused the pump failure. There's, you know, correlation is a causation, yeah? But then that, meanwhile, there's probably hundreds or millions, hundreds of 1000s or millions of individuals who have gone through that never had a single one, so one in a million. And then the other one I hear is, and this is my new favorite, is the insulin temperatures. So all the recent studies that are out there, there's, if you Google Cochrane, insulin, temperature, you'll find it on Google. But there been like a dozen different studies, one of them, one of them, put it in, I think, like a clay pot at 100 almost 100 Fahrenheit, for two months, and it had zero loss of efficacy in the in the study, yet, you know one person you know had insulin fail, right? You know, because it was in the car for an hour. That may or may not have been the case, but all the clinical stuff shows there's no issues at all. There's a risk with everything in life, though, and right? You know, you're going to have the outlier, people who this just didn't work for you, or, yeah, I'm starting to get a pat down at security, whatever. John,

Scott Benner 1:13:30
isn't it fascinating. People generally are distrustful of each other until they say something bombastic, and then they believe them completely. That's the thing. That's the thing that's fantastic. Like, Listen, if you and I got together quietly, I'd say, give me a list of people you don't trust in your life. You would be writing for a half an hour. Oh my god, this guy don't know what he's talking about. I've seen this guy and this guy lost three jobs. A guy don't know how to like, Oh my God. This guy refinanced this house six times. Like, you know, you'd be like, I wouldn't listen to him about this, but you could do that all day long. But someone gets online and says, Hey, I went through an x ray machine, and my T slim exploded like I knew it laser beams like and then, and then the next thing you know, you had 20 people going I went through it one time, and my blood sugar went up. Yeah, that might be adrenaline, because you were really worried about it. No, no, no, no. It's the pump. The pump stopped working after the X ray like no one knows what they're talking about. John, go listen to the cold wind series. Go listen to doctors and nurses tell you things like, my favorite one is an ER nurse who told me I'd be safer having a seizure in your living room, Scott, than in the ER I work in. Okay, one of those people who can't save her life, and that er is online telling you about something else, and you're going see I knew it. No one knows what they're talking about. I don't know what I'm talking about. I'm having conversations. I'm explaining to you my experiences. You don't hear me say, do a thing. I know for sure. I don't know anything. I barely got out of high school. You shouldn't be listening to me. You don't know who John is. Is he's just an even tempered guy with a good speaking voice who understands things. He could be at home kicking a dog right now. He might have a dog under his desk right now, and he says, kicking it, kicking it. Hates dogs. You don't know who John is like, right? So you listen and you make good you make good decisions. But you can't just blindly, just take what everyone says you want to watch a conversation get out of hand online. Go ahead and say, Hey, I got type one diabetes after covid.

Jon Fawcett 1:15:29
I knew you were going to say that, Oh,

Speaker 2 1:15:31
my God in heaven, it won't stop. And like, right? And so, like, by the way, covid is a virus. Type one diabetes is frequently diagnosed after a virus.

Jon Fawcett 1:15:43
The funny ones with those that get me are the ones that are like, I was diagnosed with type one a week after getting covid or a week after a vaccine or whatever, when, yeah, they don't really know, but it can be months or years. Even there could have been, there could have been a trigger five years prior that. Yeah, was it? None of us know.

Scott Benner 1:16:12
Of course, it. You don't know how it happens and then, but they do. Oh, you don't know. Oh, I know exactly what happened. Sure you do. You know exactly what happened? Everything else in your life is a freaking disaster. You don't know which way is up this You're right about like, Finally, seriously, I love people. People are terrific. Don't get me wrong. I sound like I don't, but I really do. I love humanity. I think people are amazing. We are not nearly any of us as smart as we think we are, and we see a lot of shadows and ghosts and believe that they're the cause. And if it checks out in our brain, we move on. And that's fine, because for most of your things, day to day, you really don't need to know why things are happening. You know, like, it's not important. But this drill down stuff, by the way, I could jump into any one of those covid conversations and argue both sides of it. Absolutely I could, I could argue both sides of it and but that's all people are doing. Is they're arguing from their perspective, in their or the way they're colored, you know, whatever bro podcast they heard. They're like, Oh, yeah, that's it. It's giving everybody diabetes. Like, look at the numbers diabetes. You're going, Well, yeah, the whole population of the planet got a virus. Viruses can cause your type one diabetes, not cause it like it flipped a diabetes switch, but you have an autoimmune issue. Your body attacked the virus. It got a little funky, confused, got into those beta cells. Now you have type one diabetes, same way my daughter got Hand, Foot Mouth, which is Coxsackie virus, which is a large that there's data that shows that a large amount of people with type one diabetes had Coxsackie before, like so, yes, the whole planet got a virus, and now more people have type one diabetes. This is not surprising, unless you don't understand that that. And then if you do, if you don't understand that, then, Oh, my God, I knew it. And then, and then, it takes four seconds for somebody to go. It was probably the vaccine that got them. Like, here we go. Like, I don't know. I don't have a thought about the vaccine one way or the other. I took two, two. No, I got the I got the J and j1 the one that everybody's like, you got that trashy vaccine? Yeah, I got the vaccine that was built on data from the last 50 years, I got a vaccine that was built from like, the basis of what they vaccinate the whole world with. To me, that seemed like a better move. Also, my wife could see the safety data of it, and I wanted to go with that one. But the point is, is that, you know, if my foot falls off three years from now, someone's gonna be like that J and J vaccine got his foot. We don't know what's going on. Like, just shut up and live. I don't know, John, you've made me very upset. Of

Jon Fawcett 1:18:48
people, I have a feeling we're gonna get some angry people yelling at us when you post this.

Scott Benner 1:18:54
Oh, maybe you don't, maybe you care. We won't mention sugarpixel again. But

Jon Fawcett 1:19:01
you know how often I type something in Facebook just to get it out of my off my chest, and then I delete it without posting? Is 99% of my Facebook posts never make it public. I

Scott Benner 1:19:15
want to be clear. If my foot does fall off five years from now, and it is because of a vaccine, I also won't go, No, it isn't like I'm not defending anything one way or the other. I don't know. That's what I'm trying to say. I don't know. You don't know. I don't know. No one knows. Everyone's just trying to get by the same nudnik that you stand behind in the grocery store who can't figure out how to key in their code for something in the little thing, and start going, I'm so bad at this. That person works at a pharma company. Sometimes, like, right? Yeah, that person's a congressman. Sometimes it happened, and people were like, What should we do? And then our dumb asses came up with the best thing we could think of, and then it got bastardized all over the place through media and people making money. And then. Thing, you know, they're like, you know, you just need 17 boosters. I'm like, I feel like you're trying to make money. And you know what I said? I said, No, thank you. That's all. I don't need a conspiracy theory. Hey, hey, you want to hear conspiracy theory? John companies try to make money selling the stuff they have. Oh, no, do they?

Jon Fawcett 1:20:20
Where's the worst? Ones are the the worst, to me, are the conspiracies over the insulin companies preventing a cure from getting released. Yeah, because of that, yeah,

Scott Benner 1:20:33
I have to tell you something. I know people, most of them, can't do anything. They're not they're not out there making like, great plans to, like, Stop, like, trust me, if there's money to be made, someone's going to make it. There's and right away, people go, there's no money in a cure. Yes, there is,

Jon Fawcett 1:20:50
yeah, there is. And it's potentially, not really any difference than what they're making today, because I have to imagine it. Well, maybe the pump companies, but the the CGMS, you're probably gonna still need CGMS, at least for a long time, to make sure that you know everything's working, and stuff like, let me be

Scott Benner 1:21:10
clear what I mean, John is a company making insulin, trying to find a cure for diabetes. Maybe not, but somebody else is. There's not one magic company, like there's people all over the place. There's people getting out of college every day going, you know what? I'm gonna try, I'm gonna try to do this like they don't work for the company that makes the insulin. I like to when there's a shortage, one person calls their pharmacy and they say, hey, no vlogs back ordered. They're online, dear internet. There's no insulin in New Jersey. We're all gonna die. Oh, my God. I'm like, Listen, your pharmacy goes to a distributor who, at the moment, doesn't have Nova log. 17 other people in New Jersey. I'm like, I live in Westfield. There's plenty of it. I'm here in orange New Jersey, plenty of insulin, but insulin here, blah, blah, blah, blah, oh my. My guy says there's the shortage. Your guy, you mean the 22 year old that works at the counter at CVS. That's who you're listening to. It's fascinating. I love you all. You're fascinating people. I enjoy every one of you. And you know why it's okay to talk like this. John, I'm gonna give the secret. Nobody listening thinks that I'm talking about them, but I am talking about something. You're

Jon Fawcett 1:22:28
sitting here talking about me. I know that talking

Scott Benner 1:22:33
about everybody like, like, there's, there's, listen, let me be clear, if there's an insulin shortage, and it really is, you're all gonna die. Just let it go. Like, my daughter's going, we're all going. Anybody who needs insulin is going. So what are you worried about that for? Like, that's literally not a thing. You can't stockpile enough insulin to live forever. Like, this is the world that we live in. This is how things work. Could everything fall apart and there not be any more insulin? Sure, there could also be no more fresh water. There could also be no more food. I mean, I think we saw how quickly during covid, people were willing to listen to anything. They were told, like it would only take one charismatic guy to make you all kill each other in like seven days, if they wanted to. It's not the point. The point is that there are companies who sell insulin. They're going to keep selling insulin. If they tried to stop the government would step in and force them to make it. There are plenty of drugs that the government makes. Pharma companies make. The pharma company says, Look, we don't make enough money on this anymore. We literally can't afford to do it. And the government steps up and goes, here, here's some money. Keep making it, shut up. That's how that works. Okay? I know you don't know that, but that's how that works. And so there's never, not going to be companies making insulin. That's just true. If that happens, you can come find me and tell me I'm wrong and slap me once across the face with your non dominant hand. Okay? And so, but I could not, by the way, even hit you in the face with my left hand. I don't think I'd be able to do it. I'm so uncoordinated with it. But there it goes, and I get where it comes from. By the way, like you're newly diagnosed, you're looking at your little kid. You can't get insulin. The place I get insulin from says it's discon, you know, it's back ordered, you know, we can't, we can't get it. Those are the words they use. You get very upset. I don't know you're going to Facebook, call your doctor. Like, call your doctor up and go, Hey, I can't get insulin, by the way. If you're really out of it, go to the emergency room. Walk in and say, Hi, I'm out of insulin. I need help. Like, right? Like,

Jon Fawcett 1:24:34
most of the doctors should have samples that they could give you immediately,

Scott Benner 1:24:38
samples of everything. Those doctors are flush with samples, flush with samples, everything gonna be all right. What did that go? Who is that? Bob Marley, every little thing's gonna be all right. It'll be fine. You got sugar pixel. You're fine. John, tell me something did I turn you down when you tried to give me a sugar pixel, like offer code or something like. That. Yeah,

Jon Fawcett 1:25:00
you said, you said your accountant wouldn't let you do one more affiliate.

Scott Benner 1:25:06
I'm gonna do it for people. You send me a link, I'm gonna put it in this episode. I love your device. I and I know we got pretty far away from it. Yeah, it's really fantastic. It's got a great feel. It feels like it sits in this space between like professionally made and DIY, which has this just great feeling. It's not junky. It's not working by the seat of its pants. It's a perfected device that works really well. Looks handsome, but the DIY part of it is kind of like the community part of it, where you're like, Hey, I'm gonna put emoticons in here. That'll be fun. Like, you know what? I mean? Like, that's the thing a company wouldn't do.

Jon Fawcett 1:25:41
One of the display choices is the emojis with slang. So Lily actually came up with all the slang. So one, just one example, is urgent high one of them is a dumpster fire icon, and it just says,

Scott Benner 1:25:58
perfect. It's absolutely perfect. Sugarpixel.com

Unknown Speaker 1:26:02
custom, type one.com. Custom

Scott Benner 1:26:04
type one.com. Wait, wait. Custom type one.com/juice.

Unknown Speaker 1:26:08
Box. It'll be,

Jon Fawcett 1:26:11
I could, I could make that happen, all right.

Scott Benner 1:26:12
Well, then let's just say it like that. How much money am I going to make every time somebody buys one, John, I'm gonna start planning. I might buy a rocket ship. How about we go, yeah, we'll chat off air. Now. I'm gonna make at least $1 everybody, all right? And then, and then you can get online and go, Scott just got that John guy on because he's getting rich off his sugar pixel. And at the end of the year, I'll make 200 bucks, okay? And then I'll go to my account to do my taxes, and they'll be like, What are you doing? Stop it. These are more lines I write. When I write more lines, I charge you more, you idiot. Oh, my God. I just want people to know about it. It really is fantastic. Thank you. No, no, it's quite a thing and and you're doing it over time, and I brought that up earlier. There's a lot of stuff comes and goes. People have good ideas. Sometimes they have big ideas. They get into it, they realize what it really is, and it goes away. And I hate that, because then some people in the community come along and they love the app, or they love the thing, or whatever, and then it's gone again, and you don't know where to jump in, because, you know, Jesus, how many of these things have come and gone. But you're a steady guy, John, I like you a lot. And to be perfectly honest, I like you a lot because you're smart and thoughtful and steady. I like that about you.

Jon Fawcett 1:27:29
Thank you, and we're not planning on going anywhere. This is my full time job, just like juicebox is yours, and

Scott Benner 1:27:35
we already have three release

Jon Fawcett 1:27:41
feature sets for the next three releases already planned out that we're going to be working on. Wow. So, yeah,

Scott Benner 1:27:48
that's cool. Listen, I noticed when I said something nice about you, you didn't reciprocate. But that's okay. I'm not gonna that's fine. I have no problem with that at all. I I love No Stop. Don't do that. Don't do that. Buy sugar, even though John doesn't like me, go ahead and buy sugar. Pixel. It's fine, because our our recordings feel like just BS, ing with

Jon Fawcett 1:28:14
a friend hanging out at your house, you know, which I think is the the way more personal. Is what cuts through everything. Yeah?

Scott Benner 1:28:24
Well, can we be friends? John, do you want to be friends? What does that mean? I'm not coming to your house to play Atari or anything. Not

Jon Fawcett 1:28:29
on. Don't send me a Facebook friend request, but anything else, yeah,

Scott Benner 1:28:35
all right, man, I appreciate you doing this. Thank you. Hold on one

Unknown Speaker 1:28:42
second. This

Scott Benner 1:28:44
the conversation you just enjoyed was brought to you by us. Med, us. Med.com/juice, Boxer, call 888-721-1514, get started today and get your supplies from us. Med, a huge thank you to one of today's sponsors, gvoke glucagon, find out more about gvoke hypopen at gvoke glucagon.com, forward slash juice box. You spell that, G, V, O, k, e, g, l, U, C, A, G, o, n.com, forward slash juice box. I can't thank you enough for listening. Please make sure you're subscribed or following in your audio app. I'll be back tomorrow with another episode of The juicebox podcast. The episode you just heard was professionally edited by wrong way recording, wrongwayrecording.com, the diabetes variable series from the juicebox podcast goes over all the little things that affect your diabetes that you might not think about, travel and exercise to hydration and even trampolines. Juicebox podcast.com go up in the menu and click on diabetes variables.