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Scott Benner 0:00
Hello friends and welcome back to the next episode of The juicebox podcast.

Fran is 33 Why'd I say Fran? Like that? Fran is 33 she lives in England. She was diagnosed with type one diabetes 10 years ago and with autism. Just a few years ago, she was a teacher, but she's not anymore, and we're going to talk all about type one and a number of other things, including OmniPod five, AI for diabetes and much more. 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, 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/juice box. Don't forget, if you're a US resident who has type one, or is the caregiver of someone with type one, visit T 1d exchange.org/juice box right now and complete that survey. It will take you 10 minutes to complete the survey, and that effort alone will help to move type one diabetes research forward. It will cost you nothing to help. Today's episode is sponsored by Medtronic diabetes, a company that's dressing hyperglycemia head on a topic that often gets overshadowed by the focus on hypoglycemia. Learn more at Medtronic diabetes.com/hyper today's episode of The juicebox podcast is sponsored by the Eversense 365 you can experience the Eversense 365 CGM system for as low as $199 for a full year. Visit Eversense cgm.com/juicebox, for more details and eligibility. Hi,

Fran 2:05
I'm Fran. I live in England, and I have type one diabetes. Fran, how old are you? 3333

Scott Benner 2:14
How long have you had type one

Fran 2:15
since I was 23 so, yeah, 1010, years

Scott Benner 2:19
and a half out of school by the time it happened,

Fran 2:21
yeah. So I finished university, and I was just about to start teacher training. In fact, I started teacher training three days after diagnosis.

Scott Benner 2:33
Teacher Training. Oh, that's interesting. So you go to university for what? And then you get out and train. How does it work becoming a teacher there.

Fran 2:42
Yeah. So you do, like, whatever your normal degree is, usually, and then there's like a one year, I guess it's sort of like a degree. You do it at a university, but you have placements in schools. There's another way of doing it as well, but that's the one I did.

Scott Benner 3:00
What kind of teaching were you thinking about doing at that

Fran 3:03
point, secondary school, maths, maths.

Scott Benner 3:06
And did you end up doing that?

Fran 3:11
I did, yeah, for 10 years, actually.

Scott Benner 3:14
Oh, you've just recently stopped. Yeah. Had enough of those kids.

Fran 3:26
There were a lot of things about it. I guess behavior management was never something that I was going to love. And the pandemic was interesting. I started quite enjoying the mute button, and then I kind of realized that maybe that was a sign. So, yeah, now I work at an educational technology company. When we make this, like online platform where you can go and learn GCSEs and a levels, which is like

Scott Benner 3:54
I'm offering, I'm holding in a laugh, imagining those kids talking you, being like and shut up.

Fran 3:59
Oh, you know, it gets even funnier, because at one point they realized that they could do that to me,

Scott Benner 4:05
that's fantastic. It's a whole generation of kids that didn't really go to school for a few years. Yeah, yeah. I've told this before, but I once opened Arden's door and she was on her bed with her laptop, like, positioned really strangely, and she was just bending her head forward and backwards. And I'm staring at her, and I'm like, what is happening? And she kind of shoos me away, and later I say, What the hell was going on? There she goes. I was pretending to do sit ups for gym class. I'm like, I'm like, what? So I said, A, you're doing calisthenics over zoom. And B, you're not actually doing them. And she goes, No. And I was like, Uh oh, this is this. Is it? I thought. Same thing you're talking about. I was like, There's no way that the teachers feel any differently about this than the kids do, like, it's just a disaster, right? Yeah, you would have been better off if you gave them a treasure map and sent them out into the world. And were like, Here go. Fine, fine. I guess you couldn't have done that either. But whatever you figured out you had enough of kids when you stopped listening to them as you were teaching. That's smart to get out of that. I appreciate that coming out of school a bright eyed young girl thinking she's gonna go help the youth of America. You're getting ready to start your next level of training, basically. And what happens? You get sick?

Fran 5:32
Yeah, so I actually were working at a school for a year before I started the teacher training, and near the end of that year, I started getting all the classic symptoms, you know, tired, really thirsty, going to the little lot that kind of thing. I kind of put up with that for a couple of weeks. And then I went, Oh, hang on, I've heard about this on Scrubs. Yes, a TV show diagnosed me first. So then I kind of figured it out. Had a blood test. They lost the results. Had another blood test. Phoned up a week later, and the receptionist was like, it says here, it's 13. That's high normal in your money, that's 230 and I went, hang on, let me Google that. None of the scales made any sense. I was like, we're 13. That's that's nowhere on any of these scales. That must be a different scale. And she didn't know what it meant, because she was the receptionist. Yeah, that was definitely in the diabetic range. But neither of us knew that at the time, so I put up with it for another six weeks or so. Then I eventually went to a different doctor. He did a finger prick in the room, which obviously they should have done the first time, really. And he went, Yeah, we're going to send you to the hospital today. So I said, Can I have lunch first? He said, Yeah, sure. And then I went to the hospital, and the very nice endocrinologist gave me some insulin and things like that. And three days later, I had to walk up a lot of stairs in the Library at the University, which did not enjoy. But then a week after that, the stairs became much easier. So you know, insulin is good. Was

Scott Benner 7:02
there a curmudgeonly janitor at the at the hospital, like scrubs, or were you having, like, a whole thing, nothing, nothing like that?

Fran 7:09
I don't think there was. Unfortunately, I

Scott Benner 7:11
can't put So wait, what do you remember seeing on Scrubs that made you think I have diabetes? This episode of The juicebox podcast is sponsored by ever since 365 and just as the name says, it lasts for a full year, imagine for a second a CGM with just one sensor placement and one warm up period every year. Imagine a sensor that has exceptional accuracy over that year and is actually the most accurate CGM in the low range that you can get. What if I told you that this sensor had no risk of falling off or being knocked off? That may seem too good to be true, but I'm not even done telling you about it, yet, the Eversense 365 has essentially no compression lows. It features incredibly gentle adhesive for its transmitter. You can take the transmitter off when you don't want to wear your CGM and put it right back on without having to waste a sensor or go through another warm up period. The app works with iOS and Android, even Apple. Watch you can manage your diabetes instead of your CGM with the Eversense 365 learn more and get started today at Eversense cgm.com/juicebox, one year one CGM

Fran 8:23
Turk gets type two in one of the later seasons. Really? Apparently, yeah, Apparently that was enough to tick me off. I don't know. No

Scott Benner 8:31
kidding, that's crazy, and not even a British Show, an American show, yeah.

Fran 8:36
I mean, you guys have a lot of good shows,

Scott Benner 8:38
I have to tell you. I just finished up watching the gentleman on Netflix and so talking that it just came out, but it's a completely like, British thing, and like, you're just freaking me out. Like, I totally feel like you and I are going to get involved in a crime together and shoot somebody so fantastic, wonderful. I'm having such a lovely time because I'm having like, a whole feeling here. I'm like, Oh, I'm basically a Duke. She's gonna help me kill some people. It's gonna be fantastic. Anyway, people should try the gentleman on Netflix. Okay, so you, you have all this stuff happen. Can I ask a question before we get too far down the road? Yeah, why is the bathroom called the loo?

Fran 9:21
I have no answer for that question. Seriously, it just is, wait.

Scott Benner 9:24
You really don't know.

Fran 9:27
I don't know. It just always has been, because

Scott Benner 9:30
here, if you ask me why you call the bathroom the bathroom, I'd say, Well, it's the room where you take a bath, right? So can we find out together? I mean, I'm gonna look. You just wait for me

Fran 9:41
to look. Oh, I know. I've listened to enough of the podcast to know how this works.

Scott Benner 9:45
Yeah, there's got to be some like etymology, entomology, reason here. Okay, hold on a second. The term Lou is commonly British slang for a bathroom or toilet. The origin of the word Lou is uncertain. Are you kidding me? But there are several theories. When I hear the. Theories, yeah, you're like, not really, but okay, hold on. French influence could be one popular theory is that it comes from the French phrase, wait a minute. Lou des, which means places of ease or comfort stations over time. This phrase might have been shortened to Lou, let's see you do toilet. Another theory suggests that Lou might be derived from the French term e du toilette, literally water or toilet, which refers to lightly scented cologne. The idea is that the toilet water became a euphemism for the bathroom. We're getting there Gardi loo. In medieval times, people would empty their chamber pots out the window onto the streets below. Before doing so, they would shout, Gardi Lou, from the French regards Lou, meaning, watch out for the water as a warning. This could have eventually been shortened to Lou and water closet. There's also a possibility that Lou could have come from the term Waterloo, a brand name of early toilets. I

Unknown Speaker 11:05
love it.

Scott Benner 11:06
I just didn't. I just figured it'd be like some like British thing, you'd tell me, but it turns out it's probably a French thing.

Fran 11:13
Oh, there you go. I would not have guessed that. I

Scott Benner 11:15
don't want to be too punny, but does it piss you off that it's a French thing and not a British thing,

Fran 11:22
not really. I mean, we have some pretty good ones. I grew up in a town called Reading, which is near London, and we have a word for now. I can't remember the real name. You know the little the little bugs that have, like armor, like tiny armadillos. We call them cheese locks, for some reason, I don't know why. Oh,

Scott Benner 11:43
wait, wait, wait, wait, oh, they're like, like, Roly Poly bugs or something like that. Oh,

Fran 11:49
yeah, I think that's yeah, okay. And it's only people in reading who call them that. It's not even just all of England,

Scott Benner 11:57
you know. So then when you say getting drunk? Do you say getting pissed sometimes? And do you think that means because you're gonna have to go to the bathroom afterwards, maybe, oh, my God, all right, I don't want to keep going down these roads with you, because you don't seem to know. And I'm just gonna wonder all day long, you get diabetes 10 years ago. Sorry about that. That was terrible. You go to what they call hospital, or do you go to a doctor? How do you handle that whole process? So

Fran 12:21
it was a doctor a GP for the original blood tests, and then I went to hospital for the kind of endo appointments, and I've been in under care of various hospitals since then.

Scott Benner 12:33
Do they keep you there? Is it an in and out? It was just in and

Fran 12:36
out. I was only there for an hour or two the first time, and then I went back a couple of times over the next week, once or twice over the next few months. Gotcha

Scott Benner 12:43
now, in your note to me, You talk a lot about just maybe what doctors could have done differently and like diagnosis issues, and so I'd like to, like, figure all that out. So first of all, there's a mistake in your diagnosis. How does that happen?

Fran 12:57
Well, that was the losing the first blood test and then the second one, you know, they they told me what the result of the blood test was, but they didn't tell me that that meant I had diabetes. Okay, so it took three months to get the final diagnosis after I'd figured it out myself.

Scott Benner 13:13
I see there's three months in there. Geez, okay, yeah. How was living for those three months? Were you declining?

Fran 13:19
Oh, it's terrible, yeah, by the time I went to that last doctor's appointment, I was, like, it was a five minute walk down the road, and I needed to lie down. When I got back, I was absolutely knackered. Like, completely useless to anyone feeling like you're dying.

Scott Benner 13:36
Oh yeah, yeah, thanks for saying knackered.

Fran 13:39
You're welcome. It came on so slowly, though, that I was kind of thinking like, Oh, I'm just lazy, or I've just gotten into bad habits, or I need to do more exercise and things like that. And you don't realize until you're feeling better, how much of a difference it

Scott Benner 13:53
was, yeah, that slow, kind of blissful drift into death, seriously, like your your body's just you're dying slowly, and it's just you're shutting off so gradually that you can't really tell, like, it's almost better if it hits you all at once, so that you're like, hey, something's viciously different than it was yesterday. You know. Yeah, that sucks. Do you think that what you're talking about here in your note about doctors being too cautious and not telling you things that you think would have helped you, is that from the start, or is it something you ran to later down the road? I want to know about that that early time and and you're coming to understand what it is you needed to do for yourself.

Fran 14:33
So I think the what I was told initially was pretty good, you know, I was after, I think, the first two days, they said, give yourself these doses at meals. And then after that, they were like, Yeah, once you're comfortable, you can just start carb counting for yourself. Did they tell you how to do that? He was doing that from the beginning. They told me to pre bolus. Yeah, they did okay. So that was, that was fine. And, you know, I'm sciency as well, so I kind of. Reassured them that that was something I'd be able to handle. And yeah, so no problems with that. But within about a week of being diagnosed, I'd started, sort of, you know, mentally inventing future solutions for myself, one of which was essentially the OmniPod you made up. Discovered that the OmniPod actually existed. I basically made up something that would do what the OmniPod does. Were you doing found out that the OmniPod existed?

Scott Benner 15:27
Fran, were you doing sketches like, how far did it go? Exactly?

Fran 15:30
I may have done a very brief sketch. The general idea was like a thing that you can kind of stick on yourself that has the insulin in it and just sort of sits there. And

Scott Benner 15:39
what was a great idea? A fantastic idea,

Fran 15:42
I know, yeah, yeah, did you not existed already?

Scott Benner 15:46
Did you not think of googling it before you started making it up? You

Fran 15:50
think I would have done? I don't know. I mean, I guess, I reckon my IQ had taken a significant hit by that point. Okay, you're

Scott Benner 15:57
a little dopey, yeah? So you're managing with syringes or pens at that point, pens, yeah, and you're just thinking like there's got to be a better way to do this than to be poking myself all these times. Yeah, yeah, you're right. That's kind of interesting, isn't it? How long did it take you to realize something like that actually existed

Fran 16:16
10 years I found out from the podcast about a year and two months ago, something like that, when

Scott Benner 16:23
you heard were you like those motherfuckers ripped me off? Yeah,

Fran 16:27
I think I swore out loud.

Scott Benner 16:33
Oh, my God. I've had this. I feel like I've told this on the podcast before, but I've had this moment where I forget what it was, and the story would have more validity if I could remember. But I used to do this, like running a little bit with my friends, where I was like, I was such a good joke. And then one day, we were sitting watching Seinfeld and first run, and it was right there, like they were doing it on the TV show. And I turned to my friend Mike, and I was like, if you sold my ideas, I will kill you the first time you realize you're not the only one having a thought. You know what? I mean, yeah, that's fantastic, though. Have you listen? Have you thought of any other things, like, maybe you got a gem in there somewhere,

Fran 17:11
quite possibly, I think I had, I did have this idea about hooking up your like, fitness tracker, like a Fitbit or something to like, a private instance of some kind of AI, and then stick your, you know, OmniPod data in there, and Dexcom data and stuff like that, and have it look for patterns. And presumably, eventually that that will be where it goes. You know, everyone has their own AI that essentially manages their blood sugar, similar to OmniPod five, but like smarter and drawing a lot more conclusions about, you know, the patterns of your life and when you're ill, what does that do to your blood sugar and all those sorts of things.

Scott Benner 17:52
Do you think it would upset you? Fran, if I told you that tomorrow's episode is with somebody who's talking about something called Vision AI, which is a thing you can actually put your Dexcom data to through your night Scout, and it will know what your blood sugar is, and you can ask it questions about your blood sugar. And it's also AI based, and it has access to, like, over 100 episodes of the podcast to help it answer things you think you'd be like, Oh, that's what I meant. I

Fran 18:21
think I'd be like, excellent. Oh, okay, let's get this going as soon as possible. Well, it's, I really don't need to own this. You

Scott Benner 18:27
don't need to own the idea. Well, it's, it's, it's, it already exists. It's um, idea brought out by a gentleman named Justin and his wife, and they approached me a number of months ago and asked if I would just help them. At first, they were just looking for, like, a little bit of advice, you know, kind of back end advice. And then at some point they said, do you think you'd be comfortable if we absorbed some of the podcast into the knowledge of the AI? And I was like, I was already working on that, but it sounds like you're way ahead of me, and you have the infrastructure for it that I don't have. So I was like, you know, go ahead. Like, go ahead and do it. And so it's pretty cool, yeah, yeah, I do believe that you're right about that being really valuable in the future for people. So any other ideas about time travel, perhaps something that hasn't been gotten to yet. Like, feels like you're, you're on what they call the wrong side of the cutting edge.

Fran 19:30
I do, go ahead, I feel like one of those, like, out of the box type thinker. People like, I have weird ideas, and people look at me like that, that's crazy. And I'm like, Yeah, but no, it does actually feel like it's going to be better, though. And it just seems like it often takes people a long time to be persuaded by things just because they're new. Yeah,

Scott Benner 19:49
yeah. There's going to be a lot of uncertainty, especially with AI like people, there are going to be a lot of people who are just like, This is not a good idea. Or, you know. Know it's gonna, I don't know, blow up the planet, or do blah blah. I don't know what people are gonna be concerned about. And I mean, God bless them, I could be I could be wrong, but I feel like, very strongly, actually, I feel like this is gonna help people with diabetes significantly. The idea of this stuff eventually, like right now, vision, I think, has like a 24 hour knowledge of your blood sugar. But when they expand that, and it suddenly has three days or seven days of your blood sugar knowledge, and you can start asking it like, do you see any patterns with Milo's? Are they coming? You know, after meals, before meals? Like, what do you like? What do you think is going on? And something that can actually kind of step back, see all that, and just make suggestions to you, for you to look at is a big deal, or how about, I don't know when this will be out. This week, I worked on something where I took the episodes of the podcast. There's three episodes of the podcast called the math behind the math behind basal the math behind insulin sensitivity, the math behind insulin to car ratio. I forget exactly what they are. I let those episodes be absorbed into I use chat GPT four. Oh, and then I said, you know, read this transcript and explain to me how to, you know how the 500 rule works, for example. And it explained it back to me, and I was like, Oh, my God, that's fascinating. It took that out of the conversation that Jenny and I had. I said to it, do you know the math of this? And it said, Yes. And showed me the math, and I said, Can you turn that into an app that I can embed on my website? And it was like, boom, here's code. I dropped the code into like, a non public page of my website so I could see it. And then, sure enough, there it was. I'm like, so then I did it with, like, how to find your basal insulin. And I was like, there it was. It's an app to figure out where your starting point is for your basal. And I said, Well, that's very cool, I swear to you. Fran, then I went back to it, and I said, I think this needs a disclaimer. Needs a disclaimer. And it like wrote disclaimer language. I read it, I was like, that disclaimer language looks good. And I said, I think the disclaimer language should be attached to a radial button, and until you agree to it, the app doesn't open on the page. And then it rewrote the code again.

Fran 22:18
And now that's really cool, because it doesn't always work first time like that, right?

Scott Benner 22:22
You gotta know how to talk to it. Know what I mean? Yeah, yeah. And when you stop and really think about it, the math behind figuring out, if you have, you know, if you how your basal insulin should be set up is pretty common. It's it's common math that every diabetes educator knows, but we don't know it. And, like, you know, as people walking around, and you see, people get diagnosed all the time, and they're, they're, you know, their person says, oh, here, this is your starting basal. It almost feels like they're magical. Like, oh, you just knew it's point five an hour. How did you know that? Ah, you know, like, I don't worry about it, but they're just doing this formula. And then you go out and you know, your your seven year old gains 40 pounds over the next five years, and people are running around going, I don't understand why their blood sugar's high all the time. Well, you could maybe look at your basal and so again, like, maybe you haven't moved it up enough, or or whatever. And you could just go back to these things once in a while. Plug in your weight. I'm moderately active. This is my age. Where do you think my basal should be about? Boom, there's the answer. Like, geez, you know what I mean? Like, how simple AI will do that for people all the time, and once you get accustomed to it, imagine going in division one day. I'm gonna have to bring this up to the owner. But imagine going in division one day and saying, go back and look at my blood sugars over an amount of time, and then look at my settings. Here's my current weight. Do you think there's any adjustments to be made here? And it being able to say, Oh, I think your insulin sensitivity should change. There's nothing crazy about that that's very, very doable, you know. So I like your ideas, brilliant. Yeah, they're fantastic. Okay, so you do get good knowledge. I mean, because people are telling you to pre bolus 10 years ago, that's fantastic. You know, they got you off of just start with this, count your own carbs very quickly. Does it keep progressing? Like, how do you end up finding the podcast 10 years later? Like, what's in between that leads you here, and now we're going to hear from Medtronic champion Terry. How long have you had diabetes? June 2025,

Speaker 1 24:33
it'll be 50 years. I'm very much involved in the diabetic community in a lot of areas, and I helped start the walk here in Lincoln Nebraska,

Scott Benner 24:42
when you were first diagnosed, what was management like?

Speaker 1 24:45
I started out on beef, pork insulin. And I tell people jokingly that I used to smell like a bacon cheeseburger.

Scott Benner 24:53
Tell me about the impact of Medtronic technology. Finger stick is only a

Speaker 1 24:57
point in time, and that first. Years for me was extremely difficult because I had high blood sugars all over the place. The CGM, to me, was the lifesaver.

Scott Benner 25:11
Prolonged hyperglycemia can lead to serious health problems and long term complications. Early, inconsistent management of hyperglycemia is critical. Learn more at Medtronic diabetes.com/hyper,

Fran 25:24
so I got all that information pretty much up front, and then in about three months, my a 1c went from 13 to 7.7 and then I got no more new information for about 10 years. And my a 1c stayed at 7.7 for that whole time. And I guess really, I just assumed that there wasn't other information, which, looking back on it, was obviously a really dumb thing to think. But like, you spend so much energy just keeping going day to day that you don't stop and think maybe there's something bigger here that I haven't been told. And then I went to see. It was a little show in a tiny, tiny Theater in London somewhere, and it was a guy doing kind of like DJing, but it was also a comedy show, and it was all about diabetes. So he had type one, and he was, you know, making hilarious musical puns, like going low, low, low, low, you know, that kind of thing. And it was just like an hour of that, and he mentioned the podcast, and I was like, Oh, wait, so I hold

Scott Benner 26:39
on, friend. You're blowing my mind here. There's a man in England doing a stage show about diabetes, and he brings up my podcast during it.

Fran 26:51
I mean, if I remember rightly, I think he might have actually mentioned the podcast, or at the very least, he talked about communities around type one, and more generally, maybe then I Googled it. He might have actually named the podcast.

Scott Benner 27:03
Oh, you know, that makes me like, I feel touched by that. That's something I know. I thought you'd like that. No, it made me a little weepy inside, not like out, really. I didn't get an actual moisture in my eyes, but I had that feeling in the top of my chest, you know what? I mean? Yeah, yeah. I was like, Oh, this is lovely. But then I imagined you singing that song again, that just killed the feeling completely. Oh, that's so nice. So you were like, I'm fascinated by the idea that, like somebody, you had a big high number. Somebody gave you some rules, that number went down significantly. And you probably thought that worked pretty

Fran 27:38
much, yeah. Kept saying, Oh, you're doing pretty well. Let's see if we can reduce those spikes at mealtimes with longer pre boluses. And I was like, I'm a teacher. I get like, 45 minutes for lunch. This is the best I'm going to do. But yeah, that was pretty much all I had for the next nine or 10 years. So

Scott Benner 27:53
you think if you don't go see the man sing, you don't go looking around more, and you you live a seven, seven, A, 1c, existence your whole life, quite possibly, no guiding. How about that? Whether he said juicebox podcast, or you just heard community and you went and looked so now, when you go find other people talking about it, what's that initial feeling like when you go, Wait a minute, am I listening to somebody over here with a five, five? This guy's got a six to like, how does that strike you?

Fran 28:22
So I basically listened to the podcast, like, I don't know, four hours a day for the next two weeks or something. I was just sort of head on in the background the whole time, and my brain sort of exploded sort of continuously for that entire time. And I had an end of appointment coming up, and this is where the whole story gets really intense. Again, for context, I'm also autistic, which most of the time is like, you know, just kind of the quiet little thing in the background, but just sometimes I'll kind of get worried and anxious about something, and then I'll sort of feel very intense about fixing it. And that's what happened here. So I made myself a great big list of things that I wanted based on the podcast, and then at the beginning of the list, I put the answers to all the questions that my endo asked every time I saw him, because I didn't want to talk about that. I wanted to give him the piece of paper and then talk about the stuff I wanted to talk about. So I was very prepared. Feeling good, I went into my appointment, he insisted on asking me all of those questions verbally anyway, despite having a copy of my nice long list in front of him, he talked a lot, very slowly, as he always did, and we got nearly to the end of the appointment before we really talked about any of these things I wanted, like OmniPod and Dexcom. I was doing my best to hold in my frustration, but also be as efficient as possible, because, you know, he's got, like, 15 minutes to see me, I want to get this done. And basically all I got was like, Oh, I don't know if we can give you a pump, which was frustrating, because he'd mentioned pumps to me three times before. And then if every time it was, oh, we'll talk about it next time. And it's not like I was going, Oh, no, I don't want to pump. I just every time. And my answer was, I don't know, it sounds a little invasive, which to me, is not negative enough that a doctor should immediately give up, right? Yeah,

Scott Benner 30:07
but then when you finally came back and showed initiative, now they're now, it's not, it's off the table now,

Fran 30:13
well, he said he just didn't know. He didn't know the answer. He wasn't even telling me no. And I was like, but what? How? How can you the Endo, like the top of the food chain, not know the answer to this question? So anyway, that was very frustrating. I went home and had, honestly, a pretty significant meltdown on the phone to my parents, but I did manage to get transferred to, like, a different group of doctors in the hospital. They started, you know, contacting me. One of them was like a, like a dietitian slash diabetes nurse, and I got in contact with him, and I started having lots of appointments with him, just sort of trying to figure out the other stuff that was going on, which I'll tell you about in a minute. And eventually, I got switched to a new Endo. I got approved for the OmniPod dash, and I got the dash. And then about three months after that, the OmniPod five came out, and I got that almost immediately when it was available in the UK. So I did get what I wanted. Just gonna

Scott Benner 31:17
say, I know the man that went over to the UK to set that up for OmniPod, it's like, it's so funny. You don't think about it like that. But somebody from here had to go, all right, I'll go live there. And then, you know, went over there, set up an office, got the whole thing together. Took, takes a lot of time to get something like that happening. It's really interesting how it to see the end of it, where you just get it. It's pretty cool. Actually, did you ever figure out why the doctor slow walked you? Or did you just, like, move on, like, I don't I'm not gonna deal with him anymore. I'll go to somebody else. Yeah,

Fran 31:49
I mostly just kind of fired him, to be honest. Like I tried to do it as gently as possible, and, you know, not be rude about it or anything, but I just sort of said, like, Could I be switched to this other one who I've heard good things about from other patients, and who knows lots of about pumps and things. You

Scott Benner 32:06
should have said it very slowly over 15 minutes while you were telling him so that it was, I mean, quite possibly as frustrating as possible for him. Yeah, you live 10 years, basically within a 1c in the sevens, injecting with a pen. Yeah? And no CGM,

Fran 32:24
I started funding FreeStyle Libre after about a year and a half. You did that out of pocket, yeah, which was just not cheap. After a while, I managed to persuade the NHS to start paying for that. For me, I think I was still self funding for a year or two, something like that, praying. You know, I

Scott Benner 32:44
don't know how this happens. Like, yesterday, I interviewed somebody from India today, England. I don't know how that happens, like, because it's not like, I put out a call and I'm like, if you don't live in America, I want to talk to you like, it just, it's random. But she was telling me yesterday that her libres. She can, she can only get the libre one, and the sensors cost her the equivalent of a third of her rent. And then she started, yeah, she started telling me what stuff cost there, and it's, my God, it's as insane as it is anywhere else. And even maybe more so, really interesting. So you're self funding a libre for how long? I think it was a year or two. And then you pushed and got, what do you got? Dexcom after that?

Fran 33:27
No, I stayed on the libres, actually. And after a while, switched to libre two, and I didn't get the Dexcom until I was getting onto the dash and preparing for omnipodent pod five,

Scott Benner 33:41
I see you're moving towards that. How did you like libre it

Fran 33:43
worked well for me, yeah, nothing, yeah, particularly once it become, once it became pretty much a scene. Basically, the scanning was good. It was a huge improvement on the finger pricks, but the CGM functionality was really cool.

Scott Benner 33:57
Yeah. I mean, not having to scan it is a big deal. As far as accuracy, do you see a difference between Lee Berry and Dexcom?

Fran 34:05
I think maybe the Dexcom is a tiny little bit more delayed, but nothing major. Okay, I actually wore both, both together for a little while at the beginning, just because I wondered. And yeah, it seemed to be pretty

Scott Benner 34:20
similar, gotcha. And you're wearing a g6 now, obviously, because you're wearing OmniPod five.

Fran 34:24
Yeah.

Scott Benner 34:25
Okay. How do you like having the algorithm?

Fran 34:27
Oh, I love it. So okay, so this is the second half of this year's story where this becomes really interesting. Is about a month after that really frustrating endo appointment, I started having lows at night, and like a lot of lows at night, every single night, I was having multiple lows, and they were very persistent, and then it was going high in the morning. And I don't think it was the hypo treatments, because I stopped. I tried starting myself high in the evening, and then I watched it go down, but not quite high. Post, I didn't need to treat, and then came back up again, and there was this huge drop, like, really, quite a large drop, and then it was going back up again. I was like, What am I? What is going on here? Yeah, this dietitian who was great, he's really good at talking through, like, dosing and stuff. We fiddled with stuff. We changed my basals. I was already splitting the dose, so we fiddled that around. Nothing was working. The only thing that fixed it, after a good three months of multiple hypos a night, was the dash. And I did that by, you know, they they get you on the dash, and they're like, so you probably go with a fairly flat basal rate all day. And I was like, No, that's not what I'm doing. I'm gonna go for naught point eight an hour during the day, and at night, we're doing naught point one, five in the middle of the night. And it kind of ramps up and down like the end of that, and immediately perfectly flat blood sugar all night. Yeah? So not only do I have this weird basal profile, but also it completely changed overnight, yeah,

Scott Benner 35:57
that's the interesting part, right? Like you were doing fine, and then all of the sudden, is there any hindsight that helps you? There? Do you have any changes in like, God, I I'm sorry, menstruation, stuff. Like, I don't know. Like, why I, like, no, why did I think I was never gonna have to talk about this if I had a podcast? But, like, stress, uh, big life change, nothing that you can kind of look back on and go something shifted. I'm

Fran 36:24
autistic, Scott. I've been stressed since I was about six. No, nothing. The only thing that changed, well, okay, admittedly, I was more stressed because my expectations around my blood sugar had changed very suddenly. There was a bit of extra stress there, but that was by no means the first time that had happened. You

Scott Benner 36:45
didn't start exercising. Did you start using cocaine? Like, nothing big, right? It just was like, No, nothing. How about that? No.

Fran 36:53
Just my expectations around diabetes changed and my diabetes changed at the same

Scott Benner 36:58
time. How about that? I'll be down, and then the doctors are not interested

Fran 37:01
in this. They don't want to look into why that might have been or anything like that.

Scott Benner 37:05
Oh, no. You tell them about the lows. They just talk about, like, shutting off. Like, did they talk what did they do? Anything? They just tell you to treat it. Did they tell you to eat a snack? Like, what kind of banal bullshit Did they give you

Fran 37:17
while I was on pens? It was, yeah, treat it. Consider running yourself higher at the start of the night. And yet, to be honest, pens can't fix this. So I was like, good, so I'll be on the dash really soon then. And they were like, well, but I got funding relatively quickly compared to most people. I think because I was just really pushy about it. Before

Scott Benner 37:37
the pump, you were shooting basal insulin once a day. What kind of insulin was

Fran 37:41
it twice a day? And it was levemere lever mirror,

Scott Benner 37:45
and you were always getting low at the same time overnight. Did you try moving the lever mirror around? Oh,

Fran 37:52
yeah, didn't work. Yeah. I drew diagrams. There was a whole scientific investigation going on, and at the end of that, the dietician guy was like, Yeah, we This just can't be done.

Scott Benner 38:02
I wonder if everyone listening isn't imagining, like I am, like that you have a diary somewhere with, like, every amazing thing that's ever been invented and and you've got it sketched out, but the date is always three years after it was invented. And then in there also is your love mirror diagram and everything. Scott, I think we can take oil out of the ground and turn it to gasoline and run engines with it. I've been having some big thoughts about that. Oh my god. I love the diagram idea about the lever mirror, though, but I know what you mean, like, because you're because you've already learned to how did you learn to split lever mirror? By the way?

Fran 38:47
I think it was suggested by one of my doctors, to be fair, just to get it a bit smoother. I think I was on Lantus before that, and that was once a day. Yeah.

Scott Benner 38:59
I mean, splitting lever mirror is, like a classic use of it, but I just didn't know, like, it's interesting. You do get decent information from your doctors, more so than a lot of people, actually, yeah, yeah. But then they fall short in other places. Sometimes, I guess this is what it is, though, you know, you do really have to chase down the ones that can help you. And,

Fran 39:21
like, to be fair to them, it's only recent that really, you could actually reasonably get hold of omnipodney pod on the NHS. Like, Oh, yeah. I

Scott Benner 39:29
mean, yeah, you live in a country that's, like, the size of Jersey. What's that?

Fran 39:32
You guys are just really far ahead of us? Yeah, yeah. I

Scott Benner 39:35
mean, we have a whole, like, I don't know if you've noticed, it's a we're a superpower, tons of land, money, missiles, we could pretty much do whatever we want. You're, I mean, you're living over there on a patch of dirt, like, it's, it's like, as big as, like, one of our highways, you know what? I mean, like, it's just, Oh yeah, absolutely, don't make us send Texas after you wait what

Fran 39:57
we do have cars here. Oh,

Scott Benner 39:58
I know. But you put the steering wheel. Was on the wrong side.

Fran 40:00
That's true.

Scott Benner 40:02
How'd you mess that up?

Fran 40:06
Maybe we just like to be different. Fran,

Scott Benner 40:08
I gotta tell you something. There's a whole like thing to be made there. Like, how does that like? Why does that matter? Like, why does some people drive on one side of the road and some people drive on the other side of the road? Why is that not a universal thing,

Fran 40:20
organizational issues, I guess, yeah, just interesting. Two people were like, We need to be able to drive. I mean, when we had carts, you could sit on either side of the car, right? Yeah. And then somebody invented cars, and somebody over on the other side of the pond was like, Hey, that's a great idea. I'll build one like that. But wasn't looking closely enough. So they, I don't know it. Just had to pick one side or the other. I guess you

Scott Benner 40:41
got any diagrams of cars in that book of yours over there, 1970 drawn in 1995 and it says, I think we could revolutionize this horse thing. I refuse to drive a car. They're terrified, really. For you you don't like Yeah.

Fran 40:57
I mean, I passed my test first time because my parents told me that if I passed, I wouldn't have to drive again.

Scott Benner 41:03
What a parenting move. I love driving. I don't drive enough. I feel like there are days when I'll, like, in the middle of the day, like, I don't know, one of the things you might want to learn about being a podcaster is that I can kind of make my own schedule to some degree. And there'll be times that I'm just sitting here working, and I'll stand up and I'll be like, I'm going out. And I sometimes don't believe that the place I'm going is important. I just get in my car, I put the windows down, I put on some pretty obnoxious music, and I drive for a little bit, and at some point I enjoy driving a little faster to let out my adrenaline. But none of this is appealing to you.

Fran 41:39
Oh no, that's, that's fine.

Unknown Speaker 41:46
Oh my god.

Fran 41:46
I mean, I have to say, like, I live in a world of privilege, because London has good public transport, so I didn't need to drive. Well,

Scott Benner 41:54
yeah. I mean, you're, you are in a city, so yeah, I take your point, like, but I've, like, like, a couple of months from now, Arnold go back to college, and I'm gonna go down there to help her get set up in a new place. And I'm looking forward to, like, driving 700 miles, like, by myself for a full day, like just getting in a car. And just none of that sounds attractive to you at all.

Unknown Speaker 42:17
Not much. Okay,

Scott Benner 42:19
no problem. Can I ask about this? Because I always feel like people hear this from adults and say, Where did this come from? So like, you're 33 you feel like you've been you know, you've known you've had autism your whole life. Like, how has that impacted you as a child, and how does it work as an adult? How do you get diagnosed? And why do you, in my opinion, like, just from talking to you for 45 minutes now, like, if that's not a thing, you would have told me that is not a thing I would have guessed about you. So can you walk me through all that?

Fran 42:57
I actually got diagnosed at the age of 28 okay, I don't know. So when I was a kid, I had, like, a lot of anxiety and a lot of meltdowns. Academically, I was ahead, but some of the kind of social stuff was a lot airplanes used to cause major meltdowns. I didn't really like the cinema because it was too loud. Apparently, those sort of situations were just short with anxiety, things like that. I don't know. Nobody ever really thought to find out, I guess. But then I sort of suspected as I grew up, and then I met somebody who he's autistic, and we chatted for a bit, and and he, he just kind of asked me, like, like, had you guessed that I was autistic? And I was like, I think, I think you've mentioned it in fact. And then I said, Well, I think, I think, you know, it's possible that I'm also autistic. And he went, Yeah, you are. I was like, Oh, okay. So then I got diagnosed, and

Scott Benner 43:59
explained a lot, and did it help you getting the diagnosis, like, how did it, how did it comfort you, or, or, or help you?

Fran 44:06
There's, there's a kind of description that I think fits quite well. It it's really comforting to know that you're a normal zebra, not a broken horse. Okay, say

Scott Benner 44:20
zebra one more time for me now I kind

Fran 44:21
of have a word please.

Scott Benner 44:23
Yeah, thank you. I appreciate that so, but it's not like, I mean, it's not like you have a job, right, and you taught kids. I mean, not Well, it sounds like at the end, but in so I was doing an

Fran 44:35
excellent job. Thank you,

Unknown Speaker 44:38
even when you couldn't hear them.

Fran 44:42
Hey, they don't necessarily need to be talking in order for them to be doing that, not all the time. The mute button was a toggle thing. You know, you turn them on and off

Scott Benner 44:50
when you the mute button might be the name of your episode, by the way. So, so there's a comfort level to it, like, is there just because, you know, there's this. Kind of like, I mean, it's hard not to have this feeling that, like nowadays, like in the last handful of years, everyone feels like they want to be diagnosed with something I don't even mean, like autism. Like, people really want to be labeled, isn't it funny? Like, how things change? Like, you know, when I was growing up, it was like, I'm different. Don't label me. Don't lump me in with those people. Like, that's how everyone thought. And now they're like, tell me what's happening to me, what's wrong with me, what category do I fit in? It's interesting how people's like minds shift so like, that helps you though to know where you fit.

Fran 45:38
I mean, I think there's two aspects of it right. First one being society and people in general are a lot better at looking at a label and not necessarily assuming that everyone that uses that label is the same, yeah. And the other one is, is just, I think, okay, if I said, Scott, what's your job? And I and you weren't allowed to use the word podcaster, you'd have to go, oh, you know, well, I do this thing where I sit in my chair and I talk to somebody, but they're not really there. They're somewhere else. And we talk about this stuff, and then I put it somewhere where other people can hear it later. And you have to do that every time you know and explaining yourself becomes difficult, and that means that being understood is difficult, and particularly when you're autistic, that's been a problem your whole life anyway, and it's very frustrating, and it it makes it harder to connect with people. I think

Scott Benner 46:33
what a great explanation. It's fantastic. Thank you. That very clarified it for me. Okay, did you have that written in your book, or did you come up with that off the top of your head, I

Fran 46:42
guess off the top of my head, but with the benefit of having thought about it before?

Scott Benner 46:46
Yeah, no, it's not your first time putting it into words, but I I really appreciate that, because I'm trying to understand that. Like, why do like? It just feels like everybody wants to be something. And I don't know if that's me being old, you know what I mean, and like, but it does feel like that to me, like everybody's like, I want to do this. You're like, tell me I fit here. Or like, I'm like, Just go be yourself. But your explanation is really clarifying. If you were 25 in 1980 How do you think people would have described you? People already

Fran 47:16
described me as weird. I described myself as weird. I decided to reclaim that word very early in my life. Yeah, I think they just think I'm slightly weird. You know, you heard of Uncanny Valley. I think, I think people get that with me when they don't know me very well. Okay, I think it gets in the way when I'm auditioning for musicals

Scott Benner 47:34
as well. You do the singing and the dancing I do. I do

Fran 47:38
a lot of the singing and the dancing just for funsies, not a professional thing or anything,

Scott Benner 47:42
but it's lovely. How do you do that? Is that a group of, like, a group that you have, you belong to a club, I don't know what to call it, but, like, how does that happen? Yeah, it's

Fran 47:52
essentially, it's an amdram society amateur dramatics, yeah, just kind of the thing we do in the evenings

Scott Benner 47:59
is this because you don't like Dungeons and Dragons? I do like Dungeons and Dragons. I

Fran 48:03
do that for weekends. I

Scott Benner 48:04
was just kidding. I knew you did. I was just checking. So I'm oddly good at picking out people's things. It's possible, if someone said, Scott, what do you do for a living? I'd say I generalize, but I'm really accurate about it.

Fran 48:20
Well, to be fair, Scott, you don't get that many points for figuring out that I'm a raging nerd. It's kind of obvious.

Scott Benner 48:28
Fine, but the people who are surprised just now, like, how do they know that? Let them be surprised by it. Okay, to them. I look like, I look like a soothsayer to them. So what that be? Yeah, the last line of your note to me, I don't understand shameless bribery in the form of a limerick.

Unknown Speaker 48:47
Yeah? So I have a poem,

Scott Benner 48:50
but you have a poem that you want to share with me? Yeah? Okay, all right, go ahead. See. No,

Fran 48:55
I didn't know how difficult it was going to be to get onto this podcast, and I wanted it to be successful, so I thought I'd use bribery.

Scott Benner 49:01
I was just like, I don't know what this means, but I do know what a limerick is, and does it doesn't start with There once was a girl in Nantucket. Does it? Because I don't want to hear that one. It doesn't, okay, okay,

Fran 49:13
all right. Here we go. There once was a guy named Scott. We think he's smart. He says, Not if your blood sugar's high and you want to know why he says, Don't overthink, take a shot.

Scott Benner 49:23
Oh, my God, that's fantastic. How quickly is that in your book? That's got to be in your book, right?

Fran 49:28
It's on a Google Doc. Okay, Google.

Scott Benner 49:30
Your diary is a Google Doc. But how long does it take to come up with that?

Fran 49:34
Oh, like, two or three minutes. No, see,

Scott Benner 49:38
I could never do that. I don't think there's something I like the sing song. There's like a beautiful sing songy thing to it. I'm very not well. Thank you. I'm touched.

Fran 49:47
Thank you. Well, you know you don't like a proper compliment too often, do you?

Scott Benner 49:53
No, I know it does work better this way. I'm learning right now, actually, as you're doing it, because I can ignore the part where you said. I was smart, and just go to the funny part of it. Exactly, yeah, that's good for me. You think I'm smart?

Fran 50:06
Yeah, Scott, you got my a 1c from 7.7 to like, 5.6 in six months.

Scott Benner 50:12
I got your a 1c from seven, seven to five, six in six months. Don't leave out the part where I did it over the internet. I don't know you, and I never spoke to you. Exactly, yeah, no, I'm pretty much a genius, but I don't want it to be said out loud, because I think it ruins my ever man quality. Okay, let me share something with you. I hope this is funny for people. I was texting with a friend yesterday, and she paid me a compliment about the about the podcast, and hold on, let me I want to find it for you. Okay, she said you have Scott Benner, I don't think you realize how unique you are. So she was talking about, like, diabetes organizations and how I appear to be outpacing them significantly on doing the thing that they say they're doing, which is helping people. She says, you have this advantage that they don't have you have you. And she says at the end, I you know, I don't think you realize that. And I said, Hold on a second. I'm sorry. And then I lost my place. I said, you're very nice. But trust me, I know it's just distasteful to say out loud, I appreciate that. You know as well. I don't think I'm I actually, I would have to tell you that in most walks of life. I'm, I'm a fairly average person. I do think that I'm, I'm good at building a narrative like so there's this thing that's happening, if you're listening to the podcast, that you don't know is happening. So Monday show and Tuesday's show don't seem connected, and they're not. And so I don't run themes that are obvious when you look at a micro snapshot of the podcast, but if you stick with the podcast and you keep listening, there's a macro idea that covers the whole thing. And if you stay in it long enough, like you did, you power listen for hours and hours and hours for months like so you basically just got your 10,000 hours of the podcast real quickly. There is a theme that is spread out so widely that you almost can't see how it ties together. It just kind of magically ties together as you're listening. And I will tell you, and I will take full credit for this. I am doing that on purpose. I fully believe that, yeah, but I don't know how I'm doing it, and that you have to believe too. Like, there, there are people in my life. Isabel's one of them. She'll remind me once in a while what I'm doing, because she's like, I don't think you know, and I do think that's true, like, to some degree, like, I just get up every day do the thing I do. I don't have notes. Nothing's written down. I've never planned anything. All I have is a whiteboard with words like scribbled all over it. And I look at that board sometimes while I'm recording, sometimes while I'm working, and then I go, okay, that part's next. And then I move in that direction. But you guys don't see it, because I'm not like a person who's like, this week we're gonna talk about this, you know what I mean? Or this episode is about this thought. I would much rather have a conversation like the one I just had with you, which I think is entertaining and interesting, and then let the takeaways be what they are for whoever can take whatever is in this one. And if I went back, I could thoughtfully hammer apart our conversation and tell you where the lessons are in it. But I don't even care, like people will take them out, or they won't, or they'll get the same lesson out of a different conversation later. I don't like with a mallet, like teaching. Do you know what I mean? Like, I just I like it being there. You'll absorb it. If you want it, it's yours. When you realize that, that seems like the best time to me to make a change, like it's not going to help if I sit down and tell you, Hey, you probably shouldn't eat cupcakes every day. If I said that, people would think I was a bore and terrible, and they wouldn't listen. But if you listen to this podcast, there is an underlying message in it somewhere that you should eat better. But I've never once said it out loud, and that's kind of how I think about this whole thing. But also to say that I think about it consciously

Speaker 2 54:38
is not accurate,

Scott Benner 54:43
and so I don't really know how to explain it. And so often I don't even know what it is I'm doing. I'm just doing it. And then once in a while, Isabelle reminds me, or my friend texts me or something, and tells me, I can't believe what you accomplished this week. And you know, on Tuesday's show, and by the way. I while they're saying that, I don't even know what the hell they're talking about. So it's a really weird position to ban to not be able to explain yourself completely.

Speaker 2 55:08
But I guess maybe here we are. So

Scott Benner 55:11
I appreciate that you liked it and that it helped you. That means a lot to me.

Fran 55:16
Yeah, it really did good. I'm glad, and it will continue helping. I hope so. I'm gonna have to listen to tomorrow's episode immediately, yes,

Scott Benner 55:22
to find out about vision AI and and I would love to tell you what's and being sincere about this, I would love to tell you what's on my whiteboard. I was gonna ask people will rip me off if I say it on the podcast. So I can't do it. I learned that years ago, where I'd say something and then I'd wake up and someone else would be doing it on a website or a podcast, and I'd be like, well, that's a very unique idea. Where'd they get that idea from? If you hear me mentioned on the podcast, it's because I already have it recorded, and I know I'm maybe

Fran 55:54
that's where I'm going wrong. Maybe all my ideas are just getting stolen, and that's why, yeah, Henry Ford,

Scott Benner 56:05
my God, I love that you dreamt up the I really do love that you jumped up the insulin pump.

Fran 56:09
Yeah, should have, should have looked into it, yeah. Definitely

Scott Benner 56:13
could have, like, Googled it. It would have been quicker. Yeah. Is there a device that helps you put insulin in without a needle? And you would have been like, Oh, my God, there it is. Is that the Autism?

Fran 56:24
I don't know. I feel like it's, it's so intertangled with my personality in general that it's quite hard to know what's autism and what's just like, something that I'm quite good at, or something that I'm not very good at, what really, yeah, because you, you're like, This

Scott Benner 56:40
is a good idea. You believed in yourself, and you kind of went down. Kind of went down the rabbit hole with it. I must have no self esteem, which people are probably laughing about now, after I just said a bunch of nice stuff about myself, but because I if I had that thought, I would immediately think, if I thought it, then somebody else has already thought it. It's interesting. I doubt myself constantly like that. I

Fran 56:59
guess I probably did think that. And then, because I hadn't heard about it from the doctors, maybe I just kind of assumed that it couldn't be done yet, or been tried and didn't work very well, or something like that. I guess I didn't really think about it in that much detail. No, I

Scott Benner 57:16
think it's fast. I really do find that whole like aspect of the conversation fascinating, because I would have been like, Oh, if you thought of it, somebody else has already thought of it before. I definitely had that problem growing up. Like, if I was good at something, I just assumed everybody must be good at it, because there'd be no way I'd be good at something that somebody else wasn't, but that might be from being brought up poorly. Did you have good parents? Yeah, yeah.

Fran 57:39
They handled all the autism stuff like really well, especially considering that they weren't given any actual advice about it. They did make me go on airplanes quite a lot, but they put up with the constant, you know, 12 hours of crying very well. And my mum's catchphrase was, normal is boring, which is probably become like, a foundational part of my psyche, and it's kind of how I went through life, not feeling kind of crap about myself, I think, yeah,

Scott Benner 58:10
I was gonna say you seem to have an incredibly cheery outlook. Is that accurate?

Unknown Speaker 58:15
Yeah, I think so.

Scott Benner 58:16
I mean, you come off that way. So yeah, yeah. Like, I haven't heard one part of I have diabetes or this or that, and it's holding me down, or I'm upset, like you have anxiety, but the anxiety seems generalized, not about specifically about your diabetes or about anything else. And you don't, I haven't, I haven't heard you lament anything at all.

Fran 58:42
Well, if I was going to lament something, it would be the fact that I am tired all the time, and that has been true pretty much my whole life. And haven't been able to figure out. Why

Scott Benner 58:51
did you have your thyroid checked? Yeah, it's

Fran 58:55
been in range, even mostly within what you would call range, right? But weirdly, it's changed a lot within that range over the last four years. How? So it was not point eight, not point nine, 2.5 and then 1.3 I don't know if that's normal for it to jump around like that.

Scott Benner 59:15
Have they ever imaged your thyroid to see if you have nodules or anything like that, or done antibody testing.

Fran 59:21
They haven't imaged my thyroid. I think they did antibody testing for type one,

Scott Benner 59:27
but not for the thyroid.

Fran 59:28
Nothing for thyroid. Well, listen,

Scott Benner 59:31
that's a that. That's a road to look down. What about um, do you have very heavy periods? Could you have low iron?

Fran 59:38
I don't have any. Actually, the the pill I'm on just makes them not happen, which is glorious. No kidding,

Scott Benner 59:44
fantastic. I'm taking a pill, basically a shot that made me thin, and that's fantastic, too.

Fran 59:51
I was tempted by that too. Oh, it's lovely.

Scott Benner 59:53
Where do you see if you do it, where do you see what that does to your insulin needs, seriously? Well, they won't

Fran 59:57
let me have it. My BMI is not. Really when they are high enough. I'm just, I'm just frustrated that I've got, like, a lot of fat on my stomach, which never existed before, diabetes. And then recently, I was told that it was all like, lipo, hypertrophy, and the exercise and dieting wouldn't make it go away. So that's the thing. What's

Scott Benner 1:00:16
your Do you want to tell me your BMI and does it change? And

Fran 1:00:20
it's like 22 or something. I think it's like almost perfectly on the normal, slightly above maybe, right?

Scott Benner 1:00:25
Well, I'll tell you. Do you think you have insulin resistance issues or no? So

Fran 1:00:31
I definitely do think I did. I for most of that 10 years where I was on pence, it felt like there was no amount of pre bolus that was enough, because it wasn't so much about the speed that the insulin started happening. It was more that it was the peak was too wide for the food. The food would dissolve incredibly quickly in a really sort of narrow peak. The insulin would be a really wide peak. So I'd get a spike in blood sugar, whatever I did. And sometime around about when I got onto the dash, I started asking about Metformin, and I actually, I managed to persuade the NHS to give me Metformin, because I was borderline for PCOS, so I didn't have like, the ultrasound was negative, the blood test was sort of kind of borderline, and symptoms wise, I managed to persuade them that that was a potential positive. So I said, You know what, why don't we try and metformin? Because that's what one does for PCOS. And hey, maybe it'll help with the diabetes. And now, because it's clearly helping with the diabetes, that letting me keep it.

Scott Benner 1:01:40
Did it help with the PCOS? No particular

Fran 1:01:43
difference, as far as I can tell. And as I say, it's, it's only borderline as to whether I even have that. It was just a good way of persuading,

Scott Benner 1:01:53
well, at the moment in America, they're not, they're not allowing glps for anything more than they allow them for. But, I mean, we got Arden one for insulin resistance. It's working astonishingly well. We are adjusting her dose right now because she lost more weight than you know, anybody would have like, liked or guessed. We're trying to find an adjustment spot where the GLP is impacting her blood sugars positively, but allowing her to eat a little more. And we also don't know if she can't eat or if she just got to that point where she was in college. Biggest problem was, is that we started her on a GLP right before she left for school, and so she was gone for six months, and we couldn't really see her, you know what I mean? Like, she's like, my clothes don't fit the same. And we're like, you know, looking at her on FaceTime, we're like, yeah, it looks like you're losing weight and everything. But she lost more than we wanted her to, like, we didn't want her to lose any. And she lost more than we would have wanted her to, I guess is what I should say. But her blood sugars are, like, legit. You know what I mean? Like, fantastic. And like her, high excursions are near, you know, nothingness. There's no lows that you know that are like, frequent, nothing you could point to. So it's all really wonderful. She's using much less insulin. PCOS symptoms are really being like, impacted nicely. There's no, at this moment, scientific study that says that glps work on PCOS symptoms like so you can't just walk into a doctor and say, Hey, I have PCOS, and I hear glps really might help with that. Can I give it a shot? And they're going to say, well, it's not covered for that. And most doctors wouldn't even write you a prescription for it, for that, yeah, but if you had type one, then you could probably see the insulin resistance, and then you can kind of couple them together, but still, insurance here doesn't cover glps for insulin resistance, unless you have type two right now. But I think studies are coming. As a matter of fact, I know of one. I think we'll get to it, but it's probably going to take a bit of time,

Fran 1:03:54
yeah, which is a shame. And I guess the thing is, like, the only place I want to lose any fat is on my stomach. The rest of me, I'm like, Yeah, that'll do. That's fine. And I feel like that's not really what they're for. They're more of a kind of general fat loss, weight loss kind of thing. And you know, if diet and exercise doesn't get rid of lipo hypertrophy, then it feels like GLP wouldn't either, because it would be the same mechanism, but just more efficient? Yes. I mean,

Scott Benner 1:04:22
in a magical world where you know you can get whatever your doctor gives you, and it's not about insurance or coverage or anything like that, I would think for you, if it was valuable, and I don't know that it would be, if it was valuable, it would be more about insulin resistance, PCOS, symptoms, is where you'd want the value. Yeah. And then if you lost some belly fat, then good. You know what I mean? It can't make you lose more weight than you have. That's one way to look at it. But you also don't want to be super in shape and your ass, your legs, your arms and your bellies just like round

Fran 1:04:55
Well, now let's be fair, super in shape is not it's not a phrase that I would use for myself. I. But, like, mostly just because I'm not a big fan of the exercise, but why

Scott Benner 1:05:04
don't you add some sit ups into your dancing? Add some sit ups into your dancing. Yeah,

Fran 1:05:09
you'd think that would be easy. No,

Scott Benner 1:05:13
like, it was so artistic. But in the middle, it was in the middle, she started doing aerobics. It's very strange. Fran, have we not said anything that we should? Have we missed anything?

Fran 1:05:24
I guess I was going to ask you about AAPs, because with OmniPod five, it feels like it's sort of broadly thinking of flattish basal profile is the starting point, right? Because all it does is look at your daily insulin and kind of like spread some out over the day. And because my basal profile seems to be so weird, it feels like its default is probably a bit too much insulin at night and not enough during the day, whereas it feels like if it was sort of looking at my basal profile and saying, Okay, I already know she needs less at night and more in the day. Then it would be more able to remove some insulin to prevent a Hypo at night, and it just might be a bit more effective. And I'm wondering if Android APS would be worth looking into for something like that. Well,

Scott Benner 1:06:21
I mean, you're gonna have more adjust and Iaps, but you're gonna have, I mean, in any of the DIYs, whether it's loop or that, you're gonna have more ability to make changes like so you can go into loop as an example, or Iaps, and set your basal much lower overnight the expectations for what you need. You can change your insulin sensitivity hour by hour if you want to those kinds of things. And so you could make impacts there that I think were more fine tuned than you could with a retail system. But I mean to say that Arden's never had a low overnight isn't true either. You know what I mean, like, so, you know, like, we had dinner last night. Arden went out. Her blood sugar was, like, legitimately fantastic. And then around, like, 1am that when it was I'm looking right now, yeah, she was riding, like, 10 o'clock last night, 9783 8575 then all of a sudden, like it just dropped into the into, like the 60, and she had to adjust. She had to give herself insulin, or, excuse me, carbs and like, that was fine. And then this morning, while sleeping at 6:30am her blood sugar got into the mid 60s for a half a second, but the algorithm pulled it out. Not a lot of lows, but they still happen, and they're not like, I shouldn't say never, but generally speaking, they're not tumbling, crashing. Oh my god. We have to stop this with four juice boxes and, you know, like that kind of thing. Yeah, you're gonna get low on everything. I think at some point. I don't think that's true. You know, completely avoidable. But you know, any of the algorithms that you can do do it yourself are going to be much more user friendly. As far as adjustments go, you just have to decide how much you want to be involved in it,

Fran 1:08:26
yeah, that is always, always going to be a question. Because, I guess the other thing is, you can set like, like profiles on, on the DIYs, right? So I could be like, This is my profile for when I'm ill. And then if I'm getting a cold, I can switch to that. It'll be more aggressive, but then I can switch back when I'm feeling better, whereas with OmniPod, it's got to slowly figure out that I'm ill, adjust for that, and then figure out that I'm not ill anymore, and adjust for that. So you get the highs at the start of being ill, but you get the lows start of being healthy again. And just being able to give it that extra bit of information might just sort of help it adjust more quickly. I guess

Scott Benner 1:09:02
I think that's a completely valid if it's a criticism, but, but, you know, it's a completely valid criticism of OmniPod five. So, yeah, that it doesn't, it's not adjusting. Nothing adjusts on a dime. But that to your point, that other stuff, you can go in and say, Hey, not so much today. You know what I mean? Like, we did it like, Arden's home, you know, just from school for the last couple of days, and her first or second night, I said to her, like, you knock your algorithm back like, by like. So basically, we have like settings. I have a 90 and an 80 like preset in her IEPs, it basically just turns everything down to 80% or everything down to 90% we just buy a push of a button, and I realized that she's gonna get home after all the like stress and anxiety and rushing around at the end of her like her finals and all these overnight. Was pulling and probably not eating well and etc. And so as soon as she got home and she relaxed, I was pretty sure she was gonna get low. So like, night one, I was like, put that thing to 80 before you go to bed. And we've used 80 overnight a couple of times, then 90, and now we're getting back 200% again. Like, because the algorithm is going to the way I have Iaps set up, it's using the dynamic settings. So all the settings, basal, insulin to car ratio, insulin sensitivity, it is dynamically changing them as her needs change. So I basically, yeah. So I basically said, like, look, I think you have less need coming up over these next couple nights. Let's tell it 80% 80% 90% let it see that, and then go head back and tell it, you know, go back to 100% now and then it can. It kind of makes the adjustments smoother, and that's how I've been using it for that. And that is not something you're going to do on OmniPod five. That sounds pretty tempting.

Fran 1:10:59
Yeah. Might have to start doing doing objectives in the background. Well,

Scott Benner 1:11:03
I think after you get your Google Doc all filled up with your notes on it, you'll figure out if you want to do it or not. And then, you know, from there you're building apps, you're also fall into other situations, which is, and I don't know enough about this to speak completely, with a lot of Clarion of statements, I guess. But you know, it is a do it yourself thing, which means that there's some people online who are working on it, and let me be a little obtuse, those people don't always get along with each other, and sometimes some of them do things that aren't great, and, you know, make changes to algorithms, and don't go through the Testing like they should, and just throw them out into the world. And sometimes people over test things and anywhere in between, and you know, then you see a branch break off because these people didn't get along with that person. And like, that's a thing that's happening. Like, you know, OmniPod is never going to be. Like, here's six different versions of OmniPod, five based on the feelings of six different people who work in the office, and so, like, you know there, there is stability with that. That is attractive. You know what I mean. So I don't know. There's a lot to think about, in my opinion. Oh,

Fran 1:12:11
also, while I've got you, if you could just let OmniPod know that being on automated mode but still being able to do extended bonuses would be incredibly helpful. That would be just lovely. I

Scott Benner 1:12:21
think you just lovely. I

Fran 1:12:22
think you just let them, because I have to split, but I have to split almost all my boluses now, which is definitely better, right? Because there is now something I can do that makes the peaks match up a bit better, but it means that I have to do a lot of thinking and remembering and coming back to it later and stuff

Scott Benner 1:12:39
like that. So being able to split a bolus in OmniPod five would be a big deal for you.

Fran 1:12:45
Yeah, split and or extend, I guess, yeah,

Scott Benner 1:12:48
it is a weird. Well, it's not weird that they removed it, but I see, I mean, I see what they're going for, if that makes sense, you know, like, I definitely get what they're going for. They want, they want a thing that you don't have to think about like that you're not very involved in. And I think that that for a lot of, a great many people, I think that's fantastic, but for you who you wants to make an adjustment, leaves it a little short for you, yeah, because

Fran 1:13:15
it means now that I basically, for most meals, I can't put all the insulin up front, because I'll have a low while I'm eating. Yeah, yeah. No, I

Scott Benner 1:13:24
understand, I mean, I understand why,

Fran 1:13:25
which actually is more thinking than if they just let me do it.

Scott Benner 1:13:29
Let me do it myself. All right. Well, you heard her omnipodge, for the love of God, let him have extended bolus as an automated mode. Yay. I took care of it for you. I I've said this a couple of times in the last couple of days, because people keep asking me for things I'm like, I am not nearly as powerful as you think I am, but I certainly will mention it

Fran 1:13:49
to somebody you know more people from OmniPod that I do, so I'm counting that as a win. They are lovely people

Scott Benner 1:13:53
too. Actually, 100% true. Okay. Well, thank you very much for doing this with me. I really do appreciate it. Thank you. Would you? Would you hold on one second for me? Thanks.

The episode you just enjoyed was sponsored by Medtronic diabetes. Learn more about hyperglycemia and what you can do about it at Medtronic diabetes.com/hyper a huge thanks to a long time sponsor, ever since 365 learn more and get started today at Eversense cgm.com/juicebox. One year, one CGM. Ever since 365 Are you starting to see patterns, but you can't quite make sense of them. You're like, Oh, if I bolus here, this happens, but I don't know what to do. Should I put in a little less, a little more? If you're starting to have those thoughts, if you're starting to think this isn't going the way the doctor said it would, I think I see something here, but I can't be sure. Once you're having those thoughts, you're ready for the diabetes Pro Tip series from the juicebox podcast. Podcast. It begins at Episode 1000 you can also find it at juicebox podcast.com up in the menu, and you can find a list in the private Facebook group. Just check right under the featured tab at the top, it'll show you lists of a ton of stuff, including the Pro Tip series, which runs from episode 1000 to 1025 Hey, you listened all the way to the end. You might want to know more about the juicebox podcast. If you do go to juicebox podcast.com scroll down to the bottom and subscribe to the juicebox podcast newsletter. Each week, you'll get a rundown of the shows from the past week, just in case you missed something and you think, Oh, I would have loved that now I know. Thank you so much for listening. I'll be back soon with another episode of The juicebox podcast. Hey, what's up, everybody? If you've noticed that the podcast sounds better and you're thinking like, how does that happen? What you're hearing is Rob at wrong way recording, doing his magic to these files. So if you want him to do his magic to you, wrongwayrecording.com, you got a podcast. You want somebody to edit it. You want rob you.