#1344 Screen For Type 1 with Dr. Blevins

October 29, 2024Scott Benner

Dr. Blevins discusses the importance of screening for type 1 diabetes.

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

Scott Benner 0:00
Hello friends and welcome back to the juicebox podcast.

My guest today has had diabetes type one for three years. She's using robbelsus, which is a GLP and a pill, and she talks a lot about food and her diagnosis in this episode. Oh, and they thought she didn't OmniPod. That's interesting. I'm sorry. I'm looking at my own notes. They didn't think she was going to live at diagnosis, and they actually sent her family out into the community to look for medication. This is a story that's really different, interesting. You should check it out. Please don't forget that nothing you hear on the juicebox podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan or becoming bold with insulin. Don't forget to save 40% off of your entire order@cozyearth.com All you have to do is use the offer code juicebox at checkout. That's juicebox at checkout to save 40 percent@cozyearth.com 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/juicebox,

this episode of The juicebox podcast is sponsored by the continuous glucose monitor that my daughter wears the Dexcom. G7 dexcom.com/juice box. Get started today using this link, and you'll not only be doing something great for yourself, you'll be supporting the juicebox podcast. US med is sponsoring this episode of The juicebox podcast, and we've been getting our diabetes supplies from us med for years. You can as well. Usmed.com/juicebox or call 888-721-1514, use the link or the number get your free benefits. Check and get started today with 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.

Akshira 2:23
Uh, hi. My name is akshira. I am 29 years old, and I've been diagnosed with type one for the last three years. So I recently diagnosed. I'm learning new things every day. And I just wanted to come on and say hi, and wanted to share my story. Oh,

Scott Benner 2:39
I'm great. I'm I'm excited to have you. Thank you. So three, three years with diabetes. How old are you?

Akshira 2:44
I'm 2929

Scott Benner 2:47
and you, you just said I'm still learning. That's interesting. So has it been a consistent learning process over three years, or have you suddenly found different information and you're absorbing it now?

Akshira 2:59
Uh, no, I think it's been consistent learning through these three years also, because when I got diagnosed, I was, I think there were lot of things that was happening at that time in my life, just, you know, when I got diagnosed, and I think it's just been the last year that I've really focused on, you know, my diabetes, and I've come to accept the fact that I have, I live with it. I think the first two years, there was a lot of denial, and, you know, so that's I've been learning how to control, you know, my sugar levels, and, you know, just deal with it more consistently in the last year. What is denial look like, just not accepting the fact that I have diabetes, like, just thinking that's just something that's momentary, or it's just for a short period of time, and maybe it'll go away, you know? And, yeah,

Scott Benner 3:52
so while you're in that feeling you're not putting your full effort into it, because, you know what I mean, like, not I understand the Lego hopefully this will, like, maybe they're wrong, maybe it'll go away, like, that kind of thing. I understand all that. But what happens to you while you're doing that? Are you just sort of half heartedly taking care of it, or are you taking care of it very earnestly, and then suddenly you accept the fact that it's not going away?

Akshira 4:15
No, I Yeah. I think it's the latter. Like, I'm half heartedly taking care of it, like, you know, it's not that I would ignore my my numbers. I would not take the insulin, but it's more. I mean, I would just do the basic of what is required, right? Like, if I maybe I'll just take, like, five, six units, because I know that's the minimum that I would need, you know, to get through a meal or whatever, and I know that I have to take my basil at a certain time of day, and I would do that, but I was not correcting. I was not, you know, trying to understand why certain foods impacted my sugar levels the way it did. So I was just trying to, you know, just keep. My head up, but

Scott Benner 5:01
you weren't learning or digging deeper or anything like

Akshira 5:04
that. No, nothing.

Scott Benner 5:06
How did you get past the idea that hopefully this will just go away? Was there just time that did it? Was it a conversation you had a moment?

Akshira 5:16
It was time, definitely. And so I got diagnosed during covid. So it was in I when I signed from India. So we had a second wave of covid during 2021, I remember that, yeah, so where it was, like things were really intense. And, you know, there was, there was a scarcity of beds in hospitals, and, you know, it was a really difficult time getting that, you know, getting admitted. And that's when I got diagnosed. I was in the I got covid, and then in DK, and that's how I came to, I came to this new chapter of my life. So the first two years, I was dealing with a lot of after effects of covid, like, you know, still trying to come back to my strong like, like my old self, like, gaining strength. And, you know, I had lost my voice. I was doing vocal cord therapy and all of that large, a lot of other stuff was happening.

Scott Benner 6:08
Yeah, did you have or do you have long covid symptoms?

Akshira 6:12
I don't have any covid symptoms now, right? But I think for for from the year that I would diagnose, I think for a year from then I had a lot of covid symptoms. So, yeah, so I think the I think after that, like once you get back to routine, and get back to your life, and, you know, start doing everyday things, and, you know, I then I had, like, a new doctor, like a, like an endocrinologist, and then that's when I really learned what this means and why I need to take care of it, and I was, you know, paying more attention. So I think it was just time that kind of did it, and that's, that's how I came to term with the fact that, you know, it's, it's more real, and it's not gonna go away.

Scott Benner 6:54
Not gonna go away. Are you in a big city in India? Or where are you?

Akshira 6:57
Yes, I am in a big city. Yeah. What was that

Scott Benner 7:01
intake like through the hospital? Did they give you any technology? Is the technology wildly different there than it is here, that kind of stuff. If you take insulin or so faunal ureas, 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 gevok hypopen 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, gevok hypopin can be administered in two simple steps, even by yourself in certain situations. Show those around you where you store GEVO kypo pen and how to use it. They need to know how to use jivo kypopen before an emergency situation happens. Learn more about why GEVO kypo Pen is in Arden's diabetes toolkit@gevoqglukagon.com at gvoke, glucagon.com/juice, box 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. Today's episode of the podcast is sponsored by Dexcom, and I'd like to take this opportunity to tell you a little bit about the continuous glucose monitor that my daughter wears, the Dexcom g7 the Dexcom g7 is small, it is accurate, and it is easy to use and wear. Arden has been wearing a Dexcom g7 since almost day one of when they came out, and she's having a fantastic experience with it. We love the g6 but man, is the g7 small, the profile so much closer to your body, the weight, you can't really feel it. And that's coming from me, and I've worn one I've worn a g6 I've worn a g7 I found both of the experiences to be lovely, but my gosh, is that g7 tiny, and the accuracy has been fantastic. Arden's a 1c. Are right where we expect them to be, and we actually use the Dexcom clarity app to keep track of those things. That app is built right in to Arden's Dexcom g7 app on her iPhone. Oh, did you not know about that? You can use an iPhone or an Android device to see your Dexcom data. If you have a compatible phone, your Dexcom goes right to the Dexcom app. You don't have to carry the receiver, but if you don't want to use the phone, that's fine use the Dexcom receiver. It's up to you. Choice is yours with Dexcom, dexcom.com/juicebox, dexcom.com/juice, box. I don't

Akshira 9:43
remember much from when I was actually diagnosed, like, I don't have any memory of of those, of that, of those few days, but I was on MDI. They gave me like a sliding scale, like I need to take some eight units during breakfast. I. And some six units during lunch, sorry, during dinner. And I need to take some 12 units, which was my basil, so that that's what I was doing for, I think, a year. And then some friend of mine told me to this other doctor was, like, really popular in the city that I live in, and he and they have, like, this really big diabetes hospital, and then, so when I went there, that's when, this was just last year. So when I went there, that's when, you know, my I was taught a carb counting. I was taught what an insulin to carb ratio is. I was given a CGM. And I think since the last about eight, nine months, I've been on a pump as well. Okay, which pump I use? The ipso med pump, ipsumed,

Scott Benner 10:49
okay, yeah, so right now, ipsumed pump, yeah, CGM,

Akshira 10:55
freestyle, libre, libre, libre one. That's what you get here in India.

Scott Benner 11:01
They're all, yeah, there's no other one available right now.

Akshira 11:04
No, no.

Scott Benner 11:05
Does that come through a healthcare system?

Akshira 11:08
I know you buy it with cash. Cash, okay, yeah.

Scott Benner 11:11
Can you tell me? Would you mind tell me what it costs and how that translates to American money.

Akshira 11:15
It costs around 5000 rupees, which is 72 which is about $70 for one, for one, for one sensor, which would last you 14 days.

Scott Benner 11:28
What is that like, based on your income? Is that? Is that a heavy lift for you, though? Yeah,

Akshira 11:34
so, so if you do, if you do, multiplied by two, right? Like you would assume, in a month, I would need about two sensors. So that's like 10,000 rupees, which is a good portion of money for someone who earns, you know, like a who lives in a middle class lifestyle, or who has a nine to five job, that would that's, that's a good chunk of money,

Scott Benner 11:56
hold that amount up to me against, like, rent or food or something like that. Like, what? Yeah,

Akshira 12:03
okay, so in the city that I live, which is like a tier two city or almost a tier one city, doesn't matter, so it would be 1/3 of your of the rent that I pay in a month, and it would be like almost a month's worth groceries. And it would be like a month's worth of gas or pet like in India, we we say petrol, right? So it'll be a month's worth of petrol, one

Scott Benner 12:24
libre sensor, uh, two Libra. Two is the equivalent to a month's worth of of gas or a third of your a third of your more of your rent,

yep. Wow, that's crazy, yeah. Oh,

so that's like, so if you this is crazy in America, but you could pay $2,000 for an apartment American, no problem in some places. And that's like saying that the two libre sensors is like 800 bucks. Yeah, that's great. That's nuts. Okay, wow, all right, but you're doing it because, why? Because you like not having money or because you find it that necessary?

Akshira 13:05
No, obviously I like having money inspires me to work harder so that I have more money, so that I can afford the diabetes technology. And, yeah, of course the technology is important. And I think, yeah, I think I'm a I'm a lazy person, I wouldn't do too many, you know, fingersticks If I've given the choice. So I think having the CGM makes it easier. You

Scott Benner 13:28
think not wanting to do finger sticks is lazy? I don't know. I don't think that's lazy. I think that might be smart, you know, but, but this is crazy, so, but are you, I'm sorry. Are you married? Yes, I am You are okay. And do you have kids? No, are you planning on, planning on kids? No, okay. How about in your family? Is there any other type one in your family?

Akshira 13:53
No, there's no type one in my family, but there are couple of aunts who have hypothyroidism, yeah, but there's no, no one else that I know of who has any other autoimmune like celiac or type one or anything else.

Scott Benner 14:08
Getting away from autoimmune for a second. Do you have much type two in your family?

Akshira 14:12
Yeah, yeah, like some of my grandfather, I mean India. I mean a lot of people in India have type two diabetes because of our eating habits in our lifestyle and things like that. So yeah, not immediate family members, but yeah, extended family members do have step to diabetes, yeah.

Scott Benner 14:28
And that brings up a good question, like, well, first of all, did you adjust your eating? And if you didn't, would you even be able to living in India to get away from stuff like that?

Akshira 14:38
Definitely, yes, you can adjust your eating. You do get a lot of so you do get a lot of variety of foods, like, you know, which are not very carb heavy. It's just that the most affordable options tend to be white rice and, you know, some vegetables which are more heavy in carbs than other nutrients. But it's. Definitely doable. I go through phases where I'm suddenly like, Okay, I'm going to do low carb and I'm not going to eat any carb, and I do that for couple of months and and after sometime and just totally give up. And I'm like, Okay, I just want to eat my traditional food, which is very carb heavy. I would like to believe that I that I have a very balanced way when it comes to food, I think it tends to lean a little more on the carb heavy side.

Scott Benner 15:26
So let me ask you this, are you a vegetarian?

Akshira 15:30
Yes, I am a vegetarian.

Scott Benner 15:32
And so that's that makes it harder, right? Because you all the meat, you know, that would have very low or no carbs, and it isn't available to you, okay, yeah, yeah. And so you have to go maybe more towards vegetables if you're going to do that, I say, yeah, yeah. Tell people what is a classic kind of week of Indian eating look like, like in a home, like, you know what I mean? Like, what are some staple foods?

Akshira 15:58
So a lot of our food are very lentil based. So we have something called dal, which is like a lentil curry, basically. So, so a lot of your food types, like, or so, a lot of it is either like a roti or a chapati, which is like, which is like kind of a bread that's made with a wheat, whole wheat. Okay, so you have that with some, you know, some curry, which would either be like a lentil based curry, or it would be some vegetable based curry, or you would have that curry with rice, with white rice, primarily. So I am traditionally from the southern part of India, where rice is more prominent, white rice is more prominent, and we have that with different kind of lentil based curries and with one vegetable, one or two vegetables, right? So it would be like a fermentation combination, where your white rice or your whole wheat chapatis or rotis or, you know, non bread, as they say, you know, those kind of things with different curries and different.

Scott Benner 17:03
I was at a friend's house recently. It kind of like, we just dropped in, and she's like, you know, we have, I don't know what it was called, but she's like, here you want some food. And it's like, kind of like it felt like a flower pocket or dough, and inside of it was, like, rice and peas and some other stuff. And it was, I think it was fried maybe. And, yeah, was

Akshira 17:22
it like a samosa? Did she say, I

Scott Benner 17:24
don't remember what she said it was. I remember, like, eating it and thinking, like, wow, this is, this is a lot of carbs. And, like, just the thing that was just kind of sitting around to snack on or grab, you know, yeah,

Akshira 17:33
yeah, yeah. Did you go during tea time, during the afternoon time? No,

Scott Benner 17:37
it was in the evening. We were stopping by to my son could meet with her husband a little bit about something, okay? Yeah. She's like, Oh, look what we have. And I was like, Oh, great. And I was like, I don't know what this is, yeah,

Akshira 17:47
no. So a lot of our a lot of our snack time foods are all fried foods, which is more easily accessible. So you are like, like, the one that you said that's, it's usually, I think you're referring to a samosa, which has, like a potatoes and peas inside, like a pastry, kind of affiliate, like an outer shell. That's like deep fried. Yes, that's like a very common snack time, tea time, kind of a food that you have with Chai.

Scott Benner 18:13
How do you how do you bolus for that y'all

Akshira 18:16
get to that's good as mine.

Scott Benner 18:20
What have you been able to accomplish with your your outcomes and the food choices that you have? Like, where's your a 1c at? And what are your goals?

Akshira 18:28
My a 1c is definitely not the best. The most recent one that I had was a 7.2 and that's the lowest a 1c that I've had in the last three years that I've that I've been diagnosed, okay, so, yeah, I think I'm really moving towards, you know, like, I think for the for this year, my goal is to be in the low sixes, and then I would try, I would want to be closer to the five as time goes on. But, yeah, so I try to eat what is, what is more easily. Like, it's something that I can make more easily, so that, you know, it's, if it's too complicated, I'm I'm not going to make it, and then I'm not going to eat it. So I try to balance that. And I've also started the, I've recently started taking Ribes, which is like a pill. Oh, I know, sure. GLP, medication. Yeah. So that has helped a lot in terms of my insulin sensitivity and just the amount of insulin that I'm using on on a daily basis. It's just been a month since I've been on that medication, but that's helped a lot. Yeah, so tell me about

Scott Benner 19:35
that a little bit. Is that a pill, right? Is it daily? Yeah, yeah.

Akshira 19:40
It's, it's once it's, it's something that you take every day, okay, in the first thing in the morning, and you're not supposed to eat or drink anything half an hour after your at least for half an hour after you've taken that the pill. And then you go, go on about your day as usual.

Scott Benner 19:54
Are you on a seven or a 14 milligram pill?

Akshira 19:57
So I'm currently on a seven. I. G milligram pill. I started off with three mg, but now I'm on 17. Sorry, seven mg. But from next week, I will move to 14 mg.

Scott Benner 20:08
They'll move you up gastro stomach. Any issues from it? What did you get from it?

Akshira 20:13
Yeah, I think the first few weeks was a little difficult. I mean, I've heard some of your stories where you said that you feel the foot sits in your feels like it's up here in your chest, yeah. So, I mean, I did have those sensations in the beginning, but I think otherwise, it's been okay. There was just one time where I had, like, instant noodles and I couldn't keep it in. I threw up, and I've never I've not touched instant noodles since then, like, it haunts me now to even think about it, just like

Scott Benner 20:44
those, like pre made noodles, you put hot water in them, and, yeah, that you couldn't handle, but yeah, had you not thrown up? You think you could do it now that you've been on it longer? I

Akshira 20:53
don't want to think that. And I think more importantly, I don't feel that. I don't crave for for that kind of food, like, I don't feel like eating it, you know? I mean, I could take maybe two bites and I'm done, like, I don't want to eat more of that. So it's really working. It's working for you, yeah? Yes, yes. I'm also some Sorry, I just want to say one thing, yeah. I'm also somebody who's always thinking about food. Like, I wake up in the morning, think What's for breakfast? And, you know, I would when I'm eating breakfast, I think, what do I have for lunch? Like, that's how my brain works. And I can tell you, I've not thought about food in the last one month at all, and I've gone days having just one meal, and I'm totally okay. Have you lost weight? I've not lost weight. Maybe, like, like, one kg, okay, here and there, but it's helped a lot with just how much my insulin needs have gone down. It's gone yeah, by 25 30% like, my basil has gone down like crazy. And even my ISF, like, my sensitivity has improved quite a bit too. So in that way, it's really helped. That's

Scott Benner 21:58
excellent. Good for you. I'm sure over time it'll I mean, do you need it or want it to impact your weight? Or maybe you don't. I used to hate ordering my daughter's diabetes supplies. I never had a good experience, and it was frustrating. But it hasn't been that way for a while, actually, for about three years now, because that's how long we've been using us Med, usmed.com/g, usmed.com/juice, box, or call 888-721-1514, US med is the number one distributor for FreeStyle Libre systems nationwide. They are the number one specialty distributor for OmniPod dash, the number one fastest growing tandem distributor nationwide, the number one rated distributor in Dexcom customer satisfaction surveys. They have served over 1 million people with diabetes since 1996 and they always provide 90 days worth of supplies and fast and free shipping us med carries everything from insulin pumps and diabetes testing supplies to the latest CGMS, like the libre three and Dexcom g7 they accept Medicare nationwide and over 800 private insurers find out why us med has an A plus rating with a better business bureau At US med.com/juice, box, or just call them at 88872115141, 7211514, get started right now, and you'll be getting your supplies the same way we do. I

Akshira 23:28
do. I would like to, I initially read a lot about how it does, you know, affect we I was, I was earlier, wanting to take it on me for a week. I didn't even care about the all the side effects would have, like, good side effects on, you know, the insulin, yeah, on the insulin aspect. But I'm so glad, like, now I don't care about the weight, as long as, you know, my insulin is affecting much better and all of that stuff. Has

Scott Benner 23:53
it impacted your spikes at meals, yeah, it has, right? Yeah,

Akshira 23:58
it has earlier, just to be like a mountain, you know, like, up down, up down, right now it's more gradual. And it was already gradual, you know, listening to you guys in your podcast, and thank you so much for that, but I think it's much more smoother. The curve is more smoother now, right? GLP medication right

Scott Benner 24:18
before we recorded, to get we started recording. I actually sat in on Arden's doctor's appointment. Arden just got back from college, so she had a doctor's appointment today that was just virtual, and we went over her GLP, you know, her insulin, all of her stuff. Obviously, we're gonna try to cut her GLP dose back, because she is having trouble being hungry and and she's like, you know, she's lost too much weight at this point. So she's, you know, we're, we're like, well, we want to get this GLP down to where it will help her with her diabetes, help with the PCOS stuff, but not keep her from eating. You know what I mean. So, like, that's the spot she's in right now. The doctor asked her to, like, you know, she's like, let's try to put. Put like, seven pounds on, you know, kind of as healthy as possible, like, put, put seven pounds on. So that's what we're working on right now. What it's done to our blood sugar control is insane, you know. So, like, I mean, I actually showed this to the doctor, but I have it here. I'll show it to you as well. Now, this is, um, obviously injected mandarno, this is her last 24 hours. And that's a 70 to 120 blood sugar. Those two excursions up went to 160 and that was it. It's just crazy, you know, like, I mean, for people who can't see, it's super stable for I'd say 20 of the 24 hours between 80 and 100 and, you know, pops up to 120 once or twice, pops to 160 once or twice. It's probably looks better than most people's. Do you know, yeah, the glps are crazy, but I'm, I'm excited that the pills working for you. Is that the way they go there in India, with a robust or do you see people injecting glps as well?

Akshira 25:59
There are people who are injecting, who take ozempic, or I think ozempic is available in India, but it's more type two medication, and my doctor just couldn't give it to me. He said, I wouldn't. I don't want to prescribe it for you, so I take the pill

Scott Benner 26:16
every day. If he did, I don't know how your like coverage works. If he did prescribe it for you? Would it be paid for? So

Akshira 26:23
none of this is covered by anything I'm paying out of cash, out of my pocket for all of this. So it's my GLP. So the GLP medication is really expensive too. Yeah, the rival says, yeah. So the pill, the pill that I take, so it's once you need to take 30 pills, right for a month. So it costs the same as much as the sensors do. So it's like 10,000 rupees a month. Is what the pill also cost. Wow, for a month, it's very expensive. Well,

Scott Benner 26:51
no wonder you don't want to have kids. You already have one. Your Diabetes is a kid. Yeah, your diabetes might need to go to college one day, and you're going to have to

Akshira 27:00
save up, and if I'm gonna live to like, whatever, exactly, I need to have so much money in my account that I have to do this, whatever. So

Scott Benner 27:12
explain to me, so there's no like, you have a job. You work, yeah, okay, I do. And there's no like, here in America, you might get a job, and then your job might offer you health coverage. You pay for it. And does that exist there or no? Yeah,

Akshira 27:26
so insurance does exist, but it's it only covers hospitalization. So if you are admitted in hospital for something, you need to go through a procedure, or you have some operation, blah, blah, blah, all of that stuff is covered under insurance. You don't have to pay for all of that stuff. But your treatment so you so you have a disease and you're treating it by by any means that is not covered by insurance, no

Scott Benner 27:52
matter what. Like diabetes,

Akshira 27:55
it could be anything. Yeah, it could be heart disease, it could be diabetes, could be whatever. It's not covered.

Scott Benner 27:59
That's it. I see, wow. Well, so then everybody growing up in India is thinking about that. It could affect everybody at some point. And with the type two population, the way it is, which is massive, right? I'm not wrong about that, yeah, yes, yeah, yeah.

Akshira 28:14
But so for type two, it's they usually prescribe me for men, like 90% of people who are diagnosed with type two is prescribed Metformin, and metformin is really affordable. It's very easily available, and it's not that's not a very expensive they've

Scott Benner 28:30
been making it forever. It's basically free. Yeah, yeah, here too. It's not expensive either, yeah. Okay, so in your note, you said that you'd like to talk about dealing with some depression around your diagnosis. Can you tell me about that?

Akshira 28:46
Yeah, so, you know, just referring back to what I said, like, I was diagnosed during covid, and was so crazy. It was so intense, and I don't have any memory of it, because I was, you know, in the ICU, and I was admitted for like, couple of days, maybe unconscious.

Scott Benner 29:03
You were in DK, unconscious. Oh my gosh, did you almost die?

Akshira 29:06
Yeah, I almost died. So I had co I got covid here in India, when they, when they do your covid test, they give you, like, a number that you know is representative of how high or low your infection is in the body. Higher the number the most severe is your infection. So I think the highest it goes is about 20 or something. And mine was like 18. So so the level of covid, or whatever, the infection that I had, is

Scott Benner 29:37
that the viral load, maybe? Is that how they talk about that, okay, yeah,

Akshira 29:41
something like that. So that was, like, really high. And I remember when I got covid, I saw the the report, and I was okay, you know, I was fine. I just had some fatigue, and I was having some body pain. But apart from that, I was okay. But two days after that, I was just constant. Throwing up. I couldn't keep a bite of food down, and like, one week later, I wake up in the hospital in the ICU. I don't know what happened on those five, seven days. I have no How

Scott Benner 30:13
did your husband like describe it to you later?

Akshira 30:15
Yeah, I think more. So my parents also live very close by me i At that time they did. So, you know, they were the ones who were really taking care of me. My husband also got covid, subsequently, like, couple of days after I got it, so they were like, nobody could come with me. They have like, these crazy stories about how they make some 100 calls in a day to get a hospital to get a bed with a bed with an oxygen cylinder so that, you know, I needed to be on o2 so, you know, they they did like, a, like, a ICU bed, basically. So they were, like, making so many calls and pulling random people from their contact list and trying to find some hospital bed somewhere. And I think, after like, couple of hours, like, I think towards the end of that day where I went unconscious. I think that's when they found a hospital bed and they admitted me, and they couldn't they were they used to get, like, a whatsapp video call from my from the doctor who was taking care of me in the ICU, just to give updates about how my health was on that particular day. And you know, they would always say things like, Oh, her, you know, her organs are feeling or, you know, we're not able to revive her, or, you know, it's going to be really messy we need. And they would call, they would ask for a very specific type of medication, which was a treatment for covid. At that point in time, at least here in India, it was called Italy, zumab, or something like that, some steroid medication. I think, wow. So, yeah, so they would ask for that, and my parents were, you know, trying to source that medication again, from so many different like, they put up Twitter posts, on Twitter, on Facebook, and, you know, everywhere else, trying to find that vial of medication. How common

Scott Benner 32:00
is that like? So you're in a hospital dying, and your parents are on social media trying to find medication for you?

Akshira 32:06
Yeah, yeah, because the hospitals couldn't store it, there was such a dire shortage of that medication. And you know, it was such a difficult time for them, because they were really pulling the weight for the family and for me. So my husband was not feeling well. He was he was also subsequently admitted in some other hospital in another part of the city, right? So it was my parents and my sister, the three of them who were, you know, trying to do a lot of sourcing of this medication, and the and the and the doctors told my parents that you try if you can get this medication, because we are not able to get

Scott Benner 32:44
it. Is that common in India, or was it just specific around covid? No, just

Akshira 32:49
around covid. It was just around that time because it was so intense, the like the second wave that we had, was so crazy. You guys

Scott Benner 32:56
got crushed the second time around, I remember, yeah,

Akshira 33:00
from from April 2021, till, I think October of that year it was that. That's when I think the second wave was, and it was so crazy. It was really intense. And the India,

Scott Benner 33:11
India population is pretty, pretty equal to China, like you guys almost have, like, 1.5 billion people there, right? Yeah, yeah, yes, yeah. And in a much smaller area. I mean, we have maybe three 30 million people and, yeah, geez, that's a lot more. So that covid must have spread like crazy, right? Yes,

Akshira 33:33
it did also, because after the initial wave of covid, I think, I think that kind of went a little mellow, and then, so towards the end of 2020, a lot of places opened up. And a lot of places, you know, started like, like restaurants and hotels, you know, start were open to people to come visit and stay and all of that. So I think that triggered the second wave. And the spread of the second wave so crazy, sure that you know it was like widespread at that time. So now

Scott Benner 34:04
you when you get, first of all, you got through it. But how long did it take them to get you conscious and get you moving again? Yeah,

Akshira 34:11
so I think it took about like five, six days. I was in the ICU for about five days, and then I so when I like, it was a week of no memory, right? Like, so I wake up and it's a week later and I have no recollection of where I am. How did I end up in the hospital, and there's nobody around, because it was all isolated. Was a covid board, like OmniPod patients were there in that ICU, so, yeah, even doctors were wearing, like, those, those suits, right? That protected them from head to toe. And so I was like, I was like, Dude, what the hell am I doing here? You know, like, what happened? You

Scott Benner 34:45
didn't think I knew it zombies. It's happening.

Akshira 34:50
Am I in some rehab center somewhere? Like, what's happening? I believe

Scott Benner 34:53
you're describing episode one of The Walking Dead, by the way.

Akshira 34:59
Okay. It, and I was really mad at my parents for, like, abandoning me, and my husband for abandoning me, and I'm like, why am I in the hospital alone? Like, what's happening? And I was so delusional because of the amount of pain of medication I was on. I don't know what medication I was, just like, my body was so beat, I didn't have energy to do anything. I remember, like, they had to teach me how to walk after a couple of days after I woke up in the ice, they had to, like, like, a baby, yeah, the baby had a box. Like, that's how it felt. Yeah, I took like, couple of steps and Yeah, well,

Scott Benner 35:33
you're lucky to be alive. Obviously, I

Akshira 35:35
know.

Scott Benner 35:36
But then how long after that, does the diabetes happen?

Akshira 35:39
So I woke up, and the first question, so when I met the doctor, the first time the doctor came to visit me after I became conscious, and the doctor asked me, So do you have diabetes? I'm like, what? I don't have any diabetes. What are you talking about? She's like, No, you definitely have diabetes. And I'm like, No, I don't, um, are you joking? You're joking right now, I definitely don't have diabetes, and the nurses and the ICUs come and give me insulin injections. I had no idea how much insulin they were giving me. What is the insulin that they were giving me? What they were giving me a basal? I remember my vision was so blurry, I couldn't see anything. Yeah, during the day, I mean, I would wake up and my vision would be so blurred, and then they'd give me, I think during before breakfast, they would give me some insulin. By 12 till four, maybe I could see a little bit, my vision would be back to normal. And then again, after dinner, it would be so blurry I couldn't see a damn thing. Yeah,

Scott Benner 36:32
that it's why I asked, like, when did the diabetes come? Because I thought that, did they just wake you up and spring it on you? But they also, I realized, then they might have just thought that you had it and just went to DKA, yeah, which

Akshira 36:46
nobody told me that I was in DKA until, I think a month after, like I was discharged. So this happened in April 2021, I think sometime in May, I went to meet, like a doc, like that doctor who took care of me, who was, like, my, you know, my primary doctor in the ICU, so she asked me to come and meet her, like, a month after, and that's when she's like, okay, so you're a diabetic. Now you need to be on insulin. You need to take this you need to take whatever X amount of units at this day, at this time, before, you know, before breakfast and before dinner, and just, you need to take in the morning after breakfast. After breakfast. And I was like, okay, yeah, cool, whatever. Like, I had no idea what I was doing. I didn't know why I was doing it. Pissed at

Scott Benner 37:28
your parents and your husband for leaving me in the hospital just all over the place.

Akshira 37:35
Oh, and, and I also lost my voice. I couldn't speak completely, yeah, like it was just air that would come out of my mouth. No kidding, I used to sound so it was so scary if someone would speak to me at that point in time, they were like, Oh, my God, what is wrong with you?

Scott Benner 37:53
Did they tell you? Why were you intubated?

Akshira 37:56
No, I was not intubated. Really. They don't know why I lost my voice, and so I was only worried, why is my voice gone, and when am I going to get my voice back? You know, like, I care about, Yeah,

Scott Benner 38:10
this guy says I have diabetes. I definitely don't have diabetes and, like,

Akshira 38:16
and I was abandoned the hospital. Please? Something good.

Scott Benner 38:20
Any good news? What's for lunch? Yeah, my gosh, was it a depression that hit you right away? Did it come over time? Was it like, like, a clinical depression, or were you sad? Like, how did it feel? Yeah, yeah.

Akshira 38:33
So I think I was really upset by the whole thing. I think losing my voice was something that really, I think that was, like the last, that was the last shot, yeah, that pushed me over and because I couldn't talk to anyone, I couldn't do anything. I couldn't like even, you know, I like the work that I do. I don't need to speak to people, you know, I couldn't do that. So I was like, Oh my god. Why? So I kind of, you know, I was, I was thinking, why am I alive? Like, you know, why did I make it through this? Because a lot of the doctors said that, you know, you're lucky to be alive. I'm like, What is, what am I lucky? What did I feel lucky about? You know, I can't

Scott Benner 39:12
talk, I can't walk, I have diabetes, yeah, I

Akshira 39:17
can't eat. What I want, no, so, like, what am I lucky? Like, what should I feel lucky about? You know, so I so I remember, you know, being like, so I don't want to say survivor's guilt, but it was like, why, why did I make it out? Like, I just couldn't figure it out, and how I did take, take couple of therapy sessions. But, you know, in therapy you need to speak, and I couldn't speak, so that didn't go really well for me.

Scott Benner 39:42
You just sat there and somebody told you how to feel.

Akshira 39:46
No, I mean, I would try to, you know, get involved, yeah.

Scott Benner 39:53
How long till your voice came back? 810, months. No kidding, really? Yeah.

Akshira 39:58
Wow. So I. Did vocal cord, vocal cord therapy. So the lot of exercises that involve you making different kind of noise and vibrations with your mouth, and, you know, so I saw vocal cord like a like, voice therapist, yeah, had to do that for some time. And is

Scott Benner 40:18
that, I think, like a common thing from, like covid or from, have you heard any? Has anybody given any explanation for it? No,

Akshira 40:27
no. Nobody could explain why that happened, or how did it happen? Is it common? Very, very, unheard of. I think, I think it was just me, or maybe I don't know. Sometimes they say it could be fatigue, or maybe you know you nobody knows, you know, nobody knows why it happened, and nobody knows how I got it back as well. Well,

Scott Benner 40:48
it's lucky. I mean, I guess you are lucky. Do you feel Do you feel luckier now that you've had time?

Akshira 40:54
I'm not lucky, is the right word, but I do feel grateful that, you know I'm that I had the support system, that I had people who, you know, who took care of me and were there for me, and you know, who could help me through it. And, you know, I think it was more difficult for my family than it was for me, because I don't remember a damn thing. And you know, they had to live through those few days where they had these intense calls from the doctor, and doctor was just giving them bad news. And, you know, yeah, so I think, I think I'm just grateful that I had those people who were taking care of me, and I made maybe I made it. Maybe I'm lucky because I have them. Yeah,

Scott Benner 41:30
I just well for sure, but it is really, it's such a good point, honestly, though, that not that I think people would have skipped over in your conversation, but your family is being told it's on you to go find medication. She's gonna die, and there's nothing we can do about it. That's I mean, have you talked to your parents about that? Yeah,

Akshira 41:51
I did. So this, this response they were given at that time was very common. A lot of doctors were giving that response because they couldn't find that medication, and it was so scary,

Scott Benner 42:01
but still, forget what's going on in the world. Like, on a personal side, somebody comes to you and says, Hey, you don't know how to get medication, but if you could do it, it'll save her. And if you can't, we're not sure what's gonna happen, right? Like, yeah, yeah, lot of pressure. I

Akshira 42:15
mean, yeah, they were, like, really stressed at that time too, you know, and I, even now, my dad says that I was so glad that that they didn't get covid at that time, because I think covid got everybody except for my mom and dad. You know, there were, there were the two people in my house who did not get covid, and because of that, they were able to, you know, do all of this running around and, you know, arranged all these, you know, all these medications, and, you know, get, they were able to visit in the hospital whenever they could, a lot of that stuff. So no,

Scott Benner 42:50
Jesus, really crazy. So I think I've kind of saved this last bit of our conversation, because you just, in your note said, like, existential questions. And I want to, I want to, I want to talk through that. That's That's really interesting. But first I have to ask you, I mean, you're sitting, do you want to share your location? Or no, you're sitting somewhere in Southern India, and I'm in New Jersey, like, how the hell do you know who I am? And I had that feeling, and then I went and looked. And today the podcast is number 62 in India, in the medicine category. So you're not the only one listening to it. I think

Akshira 43:20
I've heard you say that before that it's very big in India. I want to single handedly take credit. No, I feel like I'm your biggest listener. Like, that's what I mean, you know.

Scott Benner 43:34
No, listen, if you're out there telling people about it, I'm happy to give you credit. But, like, how does that initially? Listen? You're younger than me. And so the internet, I don't want to say that the internet is surprising to me. It's not but I grew up through all kinds of shifts in technology, like I know that there were things that I used day to day in my life that if I put it in front of you, you'd be like, I don't know what this is. I can't even imagine what this does, right? And so there's been these big leaps I've kept up because of my job. So to be perfectly honest, I might be on the bleeding edge of technology with everybody else, but it still somehow finds the 12 year old inside of me, and he goes, I don't understand how a lady in India knows who you are. Like? Do you know what I mean, like or like. So how does that happen?

Akshira 44:23
I think it's about last year, or maybe it towards in 2022 end of 2022 where that's when I was coming to terms with the fact that, okay, I do have diabetes. My voice is back. Now I have to focus on, you know, the other aspect of my aspects of my health, and, you know, get that into order. And like any millennial word, you know, there were, I was on Instagram trying to find people who also have type one. And I found somebody who said, Oh, talked about your Pro Tip series. And I think podcasts were becoming really popular in India around that time, during covid time, I think. And, yeah, so I. Started listening to your Pro Tip series, and yeah. So that's and from there, I have not listened to many of your older episodes. I do listen like maybe 800 and upwards. Is when it's when I started, yeah, yeah, yeah. So that's, that's when I started listening to your podcast. And I listened to it every day. It's what I listen to when I go to work. Because I think, I think when you upload is kind of coincides with when I'm going back from work, so, you know, time difference? Yeah, yeah. So

Scott Benner 45:28
I'm just gonna go get my kids after this and tell them, because they they just laugh at me constantly. It's very funny to see, like, like, right now we're having this conversation. Like, I seriously might be announcing a cruise for listeners like, like, next year, right? And I said that, like, in the house, and both of my kids were like, no one's gonna do that with you. And I was like, I think they might. And she both of them are like, you're out of your mind. And one of them started just laughing. And I was like, I wonder if I said to them, like, Hey, I just met this person. By the way, she listens to my podcast in India every day. If they'd be like, No, she doesn't. But, I mean, I'm aware, obviously, the podcast charts in 48 different countries, but it's limited by English speaking, like the ability to speak English. Can I ask you one quick question before I move on in your story? For me, we're researching right now. We have some back end work happening with putting the podcast into different languages, but like the the spoken word will be aI generated. Do you think that's listenable?

Akshira 46:32
Not really. I think, I think, I think in India, I think English is fine. I don't think that's it's not

Scott Benner 46:40
English isn't a barrier there. No,

Akshira 46:42
it isn't. And I didn't want to tell you this, but I listened to your podcast at 2x speed.

Scott Benner 46:49
I must be really fast at 2x speed. No, yeah.

Akshira 46:55
So the last week, I've been listening to it in normal speed, just so that, you know, I can understand your voice modulation, all of that other stuff better. But I don't think English is I did hear in in some episode, I think with Jenny, you were talking about doing it in translating it in Hindi, and you were saying that Hindi is the largest speaking language in India. So I don't think English has too much of a barrier. Okay, if I'm being honest, I think, I think English is fine. Okay, that's what

Scott Benner 47:22
I wanted to know. Thank you, because it's a lot of work and effort behind the scenes. Yeah, also, let me put this out to you. There will be a cold wind episode in the next couple of months with me and an Israeli doctor, and she talks faster than I do. So if you can listen to us speak at two times, I'll be very impressed. I It's not often that I'm recording with somebody and I think, oh my god, slow down. But she was so fast. Oh my god. Okay, all right. So what did you mean by like, existential questions, like, what's happened to you in the last couple of years? Yeah,

Akshira 48:01
yeah. I think I'm just going back to what I said, you know, in terms of why, why did I make it out like, you know, I went through such a difficult time, you know? And if the dka complications were really tough, and it was really hard to wrap my head around the fact that I'm here today, and, you know, my that I that I get to live, and I didn't know why. I honestly thought if I weren't here today, it wouldn't make any difference,

Scott Benner 48:26
had you felt like that prior to this?

Speaker 1 48:28
No, no, I didn't know. Why

Scott Benner 48:31
do you think you have that kind of like, because it's because you're not, you're not suicidal, right? No, you don't want to be dead. Like, right? Like, so something happened. You got close to the edge of death, and, yeah, you are suddenly seeing the bigger picture about life in existence. Yeah, I

Akshira 48:47
guess. So I just started really pondering about so a lot of people in India, like, I think, all around the world, right? Many people died during that time. So I was just wondering, why am I the lucky one, you know, why? Why am I here?

Scott Benner 49:02
Has it given you a different focus? Do you attack things differently now? Do you appreciate things differently, or is it just a nagging question in the back of your head?

Akshira 49:10
No, I think it definitely made me take my health a lot more seriously, and really wanting to do better, and wanting to, you know, just be there for my family like they were there for me. Yeah, I think, I think just gave me a lot of gratitude and a sense of appreciation for those around me. Yeah, mostly, yeah. How

Scott Benner 49:30
do you see that materializing in your day to day life? Have you noticed changes about yourself? Is it more about how you think about things, or are you are you consciously doing things differently.

Akshira 49:40
Yeah, I think I'm just a little bit more mindful, I guess. And I think a lot of that does go to the way, you know, I started really looking at my diabetes and, you know, started taking care of it. And I think, like, a year, year and a half ago, I really didn't care if I was sitting at 202 50. You. All like, you know, the whole night, yeah, I didn't think anything of it, yeah, but I think there are times now that I do, you know, that I do think about how difficult it was when I was diagnosed during 2021 and I really want to be more careful about those things. And, you know, really want to be on top of my health and of my diabetes, yeah, was

Scott Benner 50:22
my Pro Tip series helpful for you to make changes? Or did you know definitely it wasn't like you knew what to do and you just weren't doing it? Or does it like, does it give you a motivation, or does it give you knowledge? Or both,

Akshira 50:35
um, I Yeah, it was knowledge primarily. I had no idea what I was doing. I had no idea what to do, nobody so until a year ago at my doctor's what I'm trying to say is that only a year ago in my doctor's office, they taught me how what is the carb ratio, but I learned it much before that, thanks to your podcast and your Pro Tip series. Wow. I think there was one episode that you did with someone who talked about the water method of fat and protein impacting in, you know, blood sugars, yeah. So that was like a game changer of Indian food is very fat heavy, yeah, has a lot of fat and a very common way when, when people go out to eat, a very common thing that you would see a buffet, and buffets would have, like, a lot of mixture of food from all over the world, like you would have into, like Chinese food, like Indian ice, Chinese food, and, you know, Indian food and and bread and all of that, you know. And I think, and I will always see that fat spike, like, four or five hours after I've eaten, right my food. And I never understood why I was like, What am I doing? Because three hours after I've eaten, maybe I'm in range, but then the fourth hour I'm just like, high, high, high, and it's not going down. I had no idea, yeah,

Scott Benner 51:50
so no one told you that. When you hear people talk about the direction they get from doctors in America, is it the same thing that happened to you? So

Akshira 51:59
I had like, three doctors in three years, okay, who were really not helping me at all, like not helping me on the day to day stuff, like, you know, they would like, if I would go to them once in couple of months, they would say, okay, increase two units, you know, of your breakfast. And so they would call it like breakfast insulin and lunch insulin, which is, like, so irritating now that, you know, look back on it. Nobody even taught me what a basal bolus regime is. Nobody taught me how does basal work? Nobody, you know, nobody educated me on all of these things. I think I learned a lot of that from the podcast and and just a year ago, the doctor that I go to now are the, you know, the hospital that I go to now that's where I, you know, get a little bit more help from, you know, from my from them, and they put me on the pump. And are

Scott Benner 52:51
you getting more help from them? Because you know the right questions to ask, yeah,

Akshira 52:55
yeah, yeah. And I know what to look for. And sometimes when I ask these questions, I already know the answers. But, you know, but you just, you just asked, you did

Scott Benner 53:04
ask it? Because I would give anything to be there in an Indian hospital when they're like, how did you know that you said there's a man named Scott on the internet. I would love to be there for that conversation. I just see the look on their face, yeah. So moving forward, do you think? Like, do you have goals that are out of the sevens with your A, 1c, and how do you think you get to that? Yes,

Akshira 53:27
there are definitely. I don't want to be in the sevens. And I think that was another aspect why I wanted to come on the podcast. Because all these so inspiring stories, like, within three months, you know, I came from an eight to a 5.2 and I'm just filling the corner and crying. I'm like, Oh, my God, no, I can't do it. I think in three months I can move it by point two. Like, so I've been so consistent. Like, I go from a 7.8 to 7.6 to 7.4 to 7.2 that's how my graph, you know, have been in the last year. Yeah. So my goal is definitely to be, like, I said this year. I really want to be in the like, that's that's my goal, and

Scott Benner 54:01
that's doable, you think, yeah, I think that's doable. What do you change to get to that? What do you have to do? Yeah, a lot

Akshira 54:08
of it has to be, you know, more diligent with, you know, pre bolusing for my meals and and the bumping energy and the corrections, like, you know, if I'm sitting at 141 50, I think I don't care about it during the day. I think I need to be more diligent about that. And kind of, you know, I ensure that I'm below 120

Scott Benner 54:29
at least. I see, what are your alarms set out on your Libra? Oh, they doesn't have alarms. It's the libre one. So,

Akshira 54:35
yeah, correct. So, so what? So what i So, what you can do is, there is this transmitter called the mm three or something. Okay, so it's, like a, it's a made in China thing, so you can add that,

Scott Benner 54:50
are you wearing it? Oh, I've seen that before, yeah. And

Akshira 54:52
then that, like, little box, yeah, correct, correct, correct, yeah, I've seen that before. So that works. Like that sends data to my phone. So I don't have to keep scanning up with the libre one, you have to scan it to your device. Right with that transmitter, it sends data to your phone, and you use a third party app that you know gives you those numbers. So I do have alarm set at 150 so post 150 I am, like, really mindful about it, and then try to push it down. But if I'm sitting between 130 to 150 I think I don't take too much action. I think I can be a model. I can be more diligent with that, okay. And secondly, I think the right, the GLP medication has literally helped as well. I wonder

Scott Benner 55:33
what happens when you go to the 14 milligrams too? If that, if that maybe does something as well. Yeah. And

Akshira 55:39
so, so I just wanted to, so I was also having insulin resistance and PCOD before I had covid, right? Like, so I, so I live like, 26 years of my life as a normal human being, right? Like, I didn't have, not that I'm not normal now a functioning pancreas, right? Yeah. So I did have PCOD at that time, and then did have insulin resistance, so, if any, so if I were, if I was not diagnosed in the way that I was, like, you know, I had covid and decay and all of that stuff, I'm 100% sure that I would have been diagnosed as type two diabetes, type two diabetic, and I would have been given metformin and all of that stuff, and I would have struggled for years and years, yeah, in a way, I'm really grateful that I did get diagnosed the way I did, because that that it clearly pushed me into the type one category. Then they quickly, then they did the JD antibodies test, and then the C peptide test and all of that. It was like it really indicated on the type one realm, whereas if I hadn't been if I hadn't had that diagnosed story, I would have definitely, you know, clearly classified into type two. I'm, I was always a little bit on the, you know, the not on, not on the leaner side, like I was a little bit on the heaviest guy, I would carry more weight in my stomach. So anybody would look at me, would, you know, probably think of me as, yeah, she has, you know, she would definitely have type two diabetes. Yeah. So India,

Scott Benner 56:59
I see here that type one in India is growing by 6.7% a year. Yeah. And actually type two only grows well only, but grows by 4.4% in India. So it's it's outpacing type two is in growth. That's really something. And then you have to go find all this information for yourself. And then you've got to self pay your stuff. Is your pump? Are you paying for your pump? Out of your pocket too? Your pocket

Akshira 57:23
too? Yeah, I did. I did, yeah, that's like maybe a year's worth in rent. Maybe that's like a one time cost for the pump, and then the supplies are additional.

Scott Benner 57:34
Yeah. So when you hear people in America complain about stuff, do you giggle a little bit when you're listening the podcast?

Akshira 57:42
I No. I mean, I understand the sure, like each system has their own struggles, I guess. Yeah, you know, I do understand the perspective. But see, the thing is, in India, if you can pay cash, things are easy, like a life is easy, like if you have more disposable income? Yeah?

Scott Benner 58:01
Well, you're describing the entire world. But okay, yeah,

Akshira 58:05
no, what I meant, no, no. So what I'm trying to say is, from what I've heard, like a while of insulin, just in clear monetary terms, is more cheaper to buy in India than it is to buy or in out of cash, in in the US, I would imagine. Okay, yeah, yeah. So what I'm trying to say is that if you have, if you have that disposable income, and then it is more easier to do it in India than it would be to do in in the US, sure.

Scott Benner 58:32
But you also just said, If I, in case I, unless I misunderstood, is that the ipsumed pump cost you the equivalent of a year's worth of rent.

Akshira 58:39
Yeah, right.

Scott Benner 58:41
So, you know, I'm just saying that's, it's insane, like it just Yeah, and you'll have to pay that. Are there supplies that you'll have to

Akshira 58:52
Yeah, yeah. So, so if you count the cost of the libre sensor, my rival, and the pump supplies. So that's so I'm paying like, I'm paying my rent, and I'm paying the equivalent of amount of my rent for for my diabetes supplies as well. Jesus, yeah, yeah, my gosh, a lot of money. Well, it

Scott Benner 59:15
is, and it's money that could be going towards your savings or your living situation, or, you know, any number of things, honestly, Yep, exactly. Wow, was this hard for your husband to accept? Yeah,

Akshira 59:27
it was. So we were married a year before I got I got diabetes, so, and we were dating for a couple of years before that. So it was definitely harder, and I think so. So I think a lot of it was more incremental. It was not like one day, it was 3x the expense that, like, initially, we started with MDI, so that was a little manageable. Then we moved to the pump, and that was like a little extra, a little more money. So that's okay, we could manage. And then now I'm on ribs, so that's like a little more money, and now to manage that as well. So yeah,

Scott Benner 59:59
are you guys? We. Guys arranged? Or did you meet on your own?

Akshira 1:00:03
No, we met. We met on a dating site, actually. So yeah, and we've been together for, I think, seven years now. Good for

Scott Benner 1:00:10
you. Congratulations. That's lovely. Yeah, gosh, is there anything that we haven't talked about that we should have, anything you wanted to bring up that I haven't gotten to? Yeah,

Akshira 1:00:18
so I just wanted to talk a little bit about the pump, and so we so I don't use, I don't have any looping system that I can use with the ipso med pump. If you have, I think if you have the Medtronic, you can do some, there are some, there are some ways to a loop with using the Medtronic.

Scott Benner 1:00:36
There's an APS that works with Medtronic, and a couple of other things that you

Akshira 1:00:42
can do, yeah, I think there's something called a Riley link, or something like that that also works. If you have that, you are able to loop with that, with that pump. But I, but my, my doctor asked me to go for this, and I, I, yeah, I think I just went for it without thinking too much about it. So, yeah. So I think using that, using the pump, is definitely really helped and just just, and again, thanks to, you know, the episodes that you did on the on the Pro Tip series on, you know, how to manipulate diesel, how to do extended, you know, boluses, and how to eat I didn't even know, like doing, you know, 2x you could increase your beetle by, you know, right, 100% for a period of time. All of those things were so helpful. Like, nobody told me that, nobody taught me that. So a lot of that was, you know, self learn, self taught, I guess I said I learned it from, you know, the podcast. So a lot of people in India, do, you know, kind of argue about, should they, you know, use the pump, or should they stick with the NDI because it's more affordable and it's, you know, it's more easily available, rather than the pump, yeah, and I think it's not just a mode of delivery of insulin. I think it really, you know, helps you understand how to adjust your insulin to the way that you eat food. So, yeah, that was, that was another thing that I wanted to talk

Scott Benner 1:02:08
about. I'm I was looking around a little bit here the my life, ipsumed pump does pair with the Dexcom g6 and the my life cam, APS, FX, which is an algorithm. It also goes to FreeStyle Libre three,

Akshira 1:02:22
yeah, I don't get, we don't get any of that in India, yeah. I mean,

Scott Benner 1:02:26
if you just have the one now, you could be years away from seeing any of the other generations of that stuff. The company's gonna have to stop making it so that you can probably so that they start giving it to you. That sucks.

Akshira 1:02:39
Oh, maybe you can put in the word, I'll

Scott Benner 1:02:43
call up. What I'll do is I'll call up Parliament, and I'll call up a couple of other places, and I'll get the whole thing worked out for you right here from New Jersey, yeah, yeah, that would be great. Somebody, somebody said something to me recently. They were like, How come you don't just get this? And I was like, I think you overestimate my power. I can't make that happen. That's funny, though, but, oh, geez, bumps, you know, because you would use an algorithm if you could, wouldn't you? Yeah, yeah, definitely. 100% you're way ahead of the curve for India, for understanding this stuff. Or do you know a

Akshira 1:03:14
lot of people, no. So a lot of people do low carb just because it's easier to manage with the technology that you have, and it gives you more stability, or, you know, more more predictability in the way that you're in your blood sugars look like. A lot of people who have diabetes do low carb in India, or that's what so any doc, the minute you go to a doctor and they see that you have diabetes, the first thing that's going to come out of their mouth is low carb, they're just going to tell you to do low carb. And I was, like, really frustrated by that advice, because I don't want to look up, yeah, you know. But, and that's also not addressing the problem, right? You're they're not teaching you how insulin works. They're not teaching you how to manage your diabetes. They're just telling you stopping the foods that you've eaten for the last 20 years and eat something completely different, and that's going to help with diabetes. But that's also not sustainable. I, for me personally, in the long term, right? So, but rather than spending time to educate people, they would, they give you give out the easier advice, which is to, you know, do low carb.

Scott Benner 1:04:18
I wonder why? I mean, there's got to be something I don't understand about the business side of this. But why, if I sold an insulin pump, would I not want to sell them in India? You know what? I mean? Like, there's a lot of you, and there's a lot of you who are having like, diabetes. Like, why would I? I wonder if India does India stop American companies from doing business in India, or, I don't know, but, like, it just seems like such an obvious thing.

Akshira 1:04:44
Maybe it's a one time cost that's associated with buying the pump is, like, really expensive. Yeah, I think that because it's not like, so insurance doesn't cover those that kind of expense, right? Like, you have to pay in cash. Much. So it's a lot of money, you know, like, the amount of money that I use for that I used to buy mine. So I can do it. I can, like, you know, put a down payment for a house in a very good area, right? Like, Well, what

Scott Benner 1:05:11
I'm getting at is, why would the insulin pump company not say, look, let's sell them cheap there. Because we're going to sell so many of them will be okay. Like, you know, because there's two ways to go to value your your your product. It's either I'll make something expensive so that we make a bunch of money off of it, or I'll make it cheap and sell a lot of it like there's those are basic business ideas. There's got to be, there's got to be a component there that I don't understand, because it just seems like an untapped market and and a very I'm generalizing, here a little bit, but a very technologically adept population in India too, you know what I mean? Like, this is the kind of stuff you guys would love if you had it.

Akshira 1:05:52
Yes, yeah, yeah, maybe, maybe it's the education aspect of it. Maybe there are too many people and not enough educators to, you know, help spend the time. I don't know

Scott Benner 1:06:03
feels like people don't want to make

Akshira 1:06:08
money to me, or maybe they should just send links of your podcast to everybody that. I mean, that would be simpler, right? Yeah, that would just be easy, yeah, because episodes are already there, all you have to do is press play

Scott Benner 1:06:18
exactly. Can you imagine if I do a talk in India one day, that'd be nice.

Akshira 1:06:22
I think that would be, yeah, well, thank

Scott Benner 1:06:24
you. I appreciate that. It is, I mean, in the end, just having people's best interest at heart and giving them the information that they need to grow and make decisions with is really most of it. It really is like it's, you know, there's, I'm not saying anything. I don't say anything on the podcast that's that difficult to understand or that crazy, like, you don't even mean it's not like I'm saying something. People like, oh my god, I can't believe it. Did you hear what he said? I should, I should bolus before my meal. Like, you know, like it's, I know, if you never heard it before, it sounds crazy, but once you're accustomed to it. This is not like brain surgery level stuff I'm saying here, like it just, I'm just, you know, I'm just the only one saying it, you know what? I mean, like on a big platform, yeah,

Akshira 1:07:12
yeah, you know. I remember very vividly the doctor, when they distract me from the hospital after I was diagnosed, literally said, do not take your insulin 10 to 15 minutes before you eat. You have to take it 30 seconds before you eat.

Scott Benner 1:07:28
I mean, then you're gonna have anyone seen anybody? Yeah,

Akshira 1:07:30
and I did, and I did have, and they even seen the age for, like, two years, two and a half years. And I was like, What am I doing wrong? I'm doing exactly what I was told.

Scott Benner 1:07:39
Yeah, no. I mean, it's, it's, it's obvious. And then you add the high carb, high fat, you could, you could easily get an eight or a nine, A, 1c, and be trying with that, with that information, and God, if you gave up, you could, I mean, it wouldn't be any trouble to have a 1214, A, 1c,

Akshira 1:07:57
yeah, definitely. That's true, you know, and, and I knew that I didn't want to do low carb, and I, and I still don't want to do it. I had, I had lost so much weight just before I was diagnosed, so, you know, and I gained so much of it back after I was diagnosed. And I think, I think in those so and I was never scared of insulin either, because I would never see, you know, I've heard stories of people telling how one unit, you know, push them to a severe low and they were like, drinking juice, allowed to juice, and getting it back up. I have not seen any of that like I have not seen those kind of effects ever in the three years that I've been diagnosed. I had so much resistance already, because maybe I had PCOD, I had insulin resistance, right, right? So that insulin didn't work like that. And I can tell you, after being on the on the GLP medication, I have seen one unit moving me like crazy.

Scott Benner 1:08:47
Yeah, oh, I bet. Listen, I swear to God, Arden's going to use 16,000 fewer units of insulin this year. Being on a GLP medication, 16,000 fewer units of insulin. It's just fantastic. But while we were sitting with her doctor an hour and a half ago, she's like, Well, we definitely wanted to be able to eat more frequently, and we wanted to not, you know, we wanted to put a little more weight back on very important nutrition, etc. Like nobody's saying no, but the next pause step was, but we got to find a way to keep this going. We can't give away what's happening with her diabetes here, like, this is, so we're going to back her dose off. If that doesn't work, we'll start spreading the dose out. Like, we're going to try all kinds of different things, but she's getting such a benefit that I'm not saying we want her to be, you know, underweight, obviously. No, just like, obviously, we want her weight to be good. We want her nutrition to be good, etc, and so on. And we're gonna, you know, make sure things are balanced for that, but at the same time, I mean, you saw her graph. We can't give that away. You know what? I mean, like, that's some sincere, long term health implications there. So, so we're looking for a balance. We're gonna move her, remove her dose again, a hell and. Anything, if rybelsis is is good for people, then let's go, I mean, you're gonna see the injectables be more aggressive and maybe work better if you know, overall weight loss, etc, everything else that comes with it. But my God, like if, if rybelsus is helping you, like this, then every type one should be taking one of those pills every day to see what it does for them, you know, yeah, see if they can help.

Akshira 1:10:23
Once, when I was eating something and I took, like, I think, two units extra, and I was like, in the 40s or something, I was like, Oh, my God, it's happening to me. Finally, that one extra unit that I took, it's the same thing that those other people on the podcast talking

Scott Benner 1:10:41
about, yeah, well, it's not do. It's not, not doable. Like, you know, people all the time think that it's, oh, that's for someone else. But, you know, listen, there's going to be situations where people can't do everything that somebody else does. But for the most part, using insulin correctly. It does what it's, you know, it does what I say, generally speaking. And for a lot of people who glps work for, they're going to see these kind of benefits. It's just what's going to happen. You're going to look back in a couple of years and look at all these people are right now going, Oh, type you or type one. You can't take a GLP and like, you wait till you see, like, how it changes. So, yeah, big time stuff. Yeah, I'm going to have to say goodbye. I'm running out of time. Also, I'm choking to death. I want to thank you very much for doing this is absolutely terrific. You were, you're fantastic.

Akshira 1:11:25
Thank you so much. Great time.

Scott Benner 1:11:28
Oh, good. I'm glad. What time is it there? By the way,

Akshira 1:11:31
it's 1050 at night. Oh, well, also, you

Scott Benner 1:11:33
got to go to bed, so but Hold, hold on one second for me. Don't go away. Okay, thank you. Yeah, you

this episode of The juicebox podcast was sponsored by us Med, usmed.com/juice, box, or call 888-721-1514, get started today with us. Med, links in the show notes, links at juicebox podcast.com. A huge thank you to one of today's sponsors, gvoke glucagon. Find out more about gvoke hypopen at gvoke glucagon.com. Forward slash juicebox. You spell that, G, V, O, k, e, g, l, U, C, A, G O n.com forward slash juice box. US med sponsored this episode of The juicebox podcast. Check them out at usmed.com/juice box, or by calling 888-721-1514, get your free benefits. Check and get started today with us. Med the diabetes variables 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. Alright, guys, I'm out of here. Do me a favor. If you need or want anything that is sold by one of the sponsors, please use my links. When you do that, you are supporting the production of this podcast, helping to keep it free and plentiful, and you're just helping me out. I pay my electric bill with this money. I keep the podcast going. I'm not saying buy something you don't want, but I mean, if you're getting an OmniPod, then go to my link. You know what? I mean, that kind of thing. Thank you so much for listening. I'll be back very soon with another episode of The juicebox podcast. The episode you just heard was professionally edited by wrong way recording. Wrongwayrecording.com. You.