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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
Welcome back, friends. You are listening to the Juicebox podcast.

If you are living with type one diabetes, blue circle health can provide you with support services and resources you need to help manage this difficult disease, and this is at zero cost to you. You might be thinking, wow, Scott's putting the ads up closer to the front of the episode now, but that's not true. That's not an ad that's about today's episode. Today, we're going to be speaking with Sarah from blue circle health, and wait till she explains to you what the organization does and what it will cost you. 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. When you place your first order for ag one with my link, you'll get five free travel packs and a free year supply of vitamin D drink, ag one.com/juice box. Don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code juice box at checkout. That's Juicebox at checkout to save 40% at cozy earth.com

Today's episode of The Juicebox podcast is sponsored by the ever since 365 the one year where CGM that's one insertion a year. That's it. And here's a little bonus for you. How about there's no limit on how many friends and family you can share your data with with the ever since now, app no limits, ever since, this episode of The Juicebox podcast is sponsored by the contour next gen blood glucose meter. Learn more and get started today at contour, next.com/juicebox Did you know if just one person in your family has type one diabetes, you're up to 15 times more likely to get it too. So screen it like you mean it one blood test can spot type one diabetes early. Tap now talk to a doctor or visit screened for type one.com for more info.

Sara Lerner 2:24
Hi, my name is Sarah. I live in New York City, and I was diagnosed with type one diabetes just over two years ago in June, 2022

Scott Benner 2:32
How old are you now? Sarah,

Sara Lerner 2:34
27 years old.

Scott Benner 2:36
Okay, so you're 25 How about in your family? Is there like, just like a thought like, Oh, I'm definitely gonna get diabetes, because everybody has it, or thing you never heard of before, somewhere in between, yeah,

Sara Lerner 2:47
not something super familiar with. I do have one cousin with type one. Her dad has type one as well, who's not on my blood related side, but it wasn't even something I was super cognizant of growing up. I had one or two friends who had had type one, but it really was not on my radar when I was diagnosed.

Scott Benner 3:03
Wait, Sarah, you have a familial side that's not blood related, like, like a step father's brother or something like that.

Sara Lerner 3:08
The cousin is blood related, but her dad has it who's not blood related?

Scott Benner 3:13
Oh, I see. I don't know why that confused me. I apologize. I was like, Sarah's related to people she's not related to. What a great story. And she has it though, the cousin, yes,

Sara Lerner 3:22
but we didn't grow up living in the same country even, so we we weren't super close, so it wasn't something I thought about until, actually, a few months after I was diagnosed, one of my uncles said, hey, you know, your cousin has this too, and I hadn't even remembered. So that shows you that she was living with it really well, and that I wasn't, I wasn't even aware of all that was going on. But I think it's also one of those things that until it happens to you or you have a really close friend or family member with it, it's not necessarily on your radar, unless you live with

Scott Benner 3:48
it. Yeah, can I ask if you don't know, but does her the cousin, does her mother, have autoimmune issues? I actually have no idea. I'm interested, because if the father has type one, and the mom has auto immune. Then, is that, you know? I mean, like, is that the recipe that gets you there faster,

Sara Lerner 4:06
you know, I will go find that answer out. But I know auto immune stuff runs in my family. I mean, you know, we did the I sent the screening information to my siblings. I'm one of four kids. I believe two of the four of us did it, and I know one came back with, you know, positive auto immune. The other one did not, I don't know about the the other brother,

Scott Benner 4:27
Oh, wow. I'm glad you shared that with them. That's, that's awesome. And so awesome. The two of the three of them did it by, by the way, most people don't. So, yeah, yeah, you got a good return there. I did. So there's auto immune in your family, your mom, your dad, grandmothers, grandfathers, what's what's going on. I'm going to

Sara Lerner 4:42
sound really ignorant here, but I don't know the whole history of our autoimmune and haven't really dug into it. I should. I should go into it more. Now, you know, there's some blood conditions that run in the family. I know there's some different autoimmune pieces that people have. I have a few different health things that have gone on my whole life, but this is. Only one that really came up as a as an auto immune siblings with auto immune, as I mentioned, but it wasn't something that we grew up thinking like, Oh my God. We're this family with all of these auto immune issues, right?

Scott Benner 5:10
What were your other health issues growing up? I

Sara Lerner 5:13
was diagnosed with Ehlers Danlos Syndrome when I was in high school, connective tissue disorder, so that's something I was kind of always aware of. But, you know, it didn't deeply affect me, other than, you know, when I played sports, things were a little bit harder. Sometimes my feet were really flat. Led to some some injuries that I now currently have, a broken leg that probably has something to do with that condition as well. So it's just come up throughout my life, but hasn't been been the story of it, the way that type one came and became, yeah, now

Scott Benner 5:43
I'm gonna find out more about the so you got an auto immune issue when you were a kid. And that's for people who don't know that's ligaments and stuff extra stretchy, kind of that feeling, right? Yeah,

Sara Lerner 5:52
and you know, there's different types of it, so mine is more hypermobility. So I wouldn't, you know, there's genetic markers for it, but I wouldn't even it wasn't really an autoimmune issue that

Scott Benner 6:02
I had. It is, though, by the way, it is an autoimmune disease. Yeah, I just

Sara Lerner 6:05
didn't have any other, you know. I didn't have the heart condition related or anything else. Mobility, yeah, I see yours was stuck to the mobility, different strains of it, different types. Yeah. Oh, lucky

Scott Benner 6:16
you. Now, okay, how does the type one rear its head like, what makes you realize that something's going on?

Sara Lerner 6:24
Yeah, well, I was getting sicker for about four months. I'm sure that I was aware of some of the signs and symptoms just from growing up. I was an EMT volunteer EMT in college, so there are things that we learned about, you know, DKA and looking out for, but when it's yourself, you're not necessarily realizing that. So I was getting sicker. I knew something wasn't right, seeing a bunch of doctors. Nobody took my blood, unfortunately, until I was, you know, walking around New York City, passing, feeling like I was going to pass out at any moment. I got a COVID booster shot, actually, and that was kind of what got me really, really sick. You know, some people threw up once or twice after that, but I was throwing up constantly and just wasn't getting better from it. I think conversation with my mom where she said, Sarah, you really need to find someone to quarterback this like I know you something's not right. You're falling asleep during the day, like you're losing weight. Get to the doctor. I finally had a blood test drawn, and I was hospitalized the very next day for for several days. So a lot of signs that I think I wish I had recognized earlier, but once, once I did get into great care, it was, it was much smoother sailing from there. But I will say, like many people who are diagnosed as adults immediately in the ER, they said, you know, given your age, this looks like type two diabetes. We're going to start you on Metformin, you know, we need to, you know, give you insulin to bring your blood sugar down. And I was lucky, and then my antibody test came back while I was still in the hospital. And so I didn't live with that misdiagnosis for very long, as many people do, right? But I hope that you know, a takeaway that everyone who meets a type one who gets diagnosed as an adult is, is that, like adults do get diagnosed with this and and that stat is only rising.

Scott Benner 8:03
Hey, how long till your mom was like, I told you something was wrong.

Sara Lerner 8:07
Well, when I got hospitalized, my mom, you know, I grew up in Baltimore, and my mom got on a train within minutes, I think, with no belongings, and was in the hospital with me. So she was, she has been, you know, champion supporters. Has my whole family since day one, and everyone has really rallied around me. But she definitely knew, as moms tend to often know, that something, something was up, and I needed somebody to really help quarterback that care.

Scott Benner 8:30
What a lovely woman. She didn't roll right through the door going I knew it.

Sara Lerner 8:35
She might have said to other people, but I think I was it could have happened to me too, but I think I was too overwhelmed to realize nothing but support from there,

Scott Benner 8:42
you don't remember, but on the train up everyone she bumped into second, I was telling that girl, something was wrong. She don't listen to me. And

Sara Lerner 8:50
I think she was more bummed that she didn't know the diagnosis. And was like, How did I miss this? And I'm like, Mom, you are not a you know, you're not a doctor. It's okay. But I think it was more on that might help me not realize what this

Scott Benner 9:01
says. That's very nice. Okay, so how do you leave the hospital? Meaning they know you have type one because luckily, you got the auto antibody back, right? But is it like, here's some needles like go to the pharmacy, especially in New York City. It's kind of a different vibe. So what do you physically leave the hospital with type one diabetes? Can happen at any age. Are you at risk? Screen it like you mean it. Because if just one person in your family has type one, you're up to 15 times more likely to get it too. So screen it like you mean it. One blood test can help you spot it early, and the more you know, the more you can do. So don't wait. Talk to your doctor about screening tap now or visit screen for type one.com to get more info and screen it like you mean it. Yeah.

Sara Lerner 9:49
So I was actually discharged straight into outpatient care, which is very rare. So I got in with the endocrinologist in New York, and I literally went from inpatient hospital. Hospital too, I believe we got in a taxi with a whole lot of different medical supplies and went to my outpatient Endo, who I'm still with today. And so that was a very fortunate experience. And she sat with me for at least an hour and just answered questions non stop. And so I did meet with, I think, an educator in the hospital. Gotta be honest, I don't fully remember what happened in that hour long or 30 minute session? Or I'm pretty sure she taught me how to, you know, take an injection. They slapped a CGM on me in the hospital as well, which was, you know, helpful to have that from from day one. And then I did go straight into my endocrinologist office and got my tumd, 101, and in another thing that was really rare, credit, credit to the care that I've gotten at NYU, my doctor gave me the off, you know, off hours number, and said, Call me every single night for the first two weeks, we're going to adjust your your ratios together. This is going to be a team effort. And I want you to learn how to call this number. I want you to learn how to give yourself shots. But we're going to work on this together. And so that first two weeks, we really spoke, I think, every single day, as I figured out how to get my blood sugar down from, you know, the five hundreds, and I was diagnosed with an A, 1c over 13, and we got it down together.

Scott Benner 11:12
How much weight did you lose before you knew you were type one? I don't

Sara Lerner 11:17
actually know, you know, a number there. I was going to the gym really regularly for the first time in a good, good while. So here I was thinking I was killing it at the gym. And then we, you know, kind of realized that it wasn't, it wasn't a natural situation happening in a in a positive way. So I don't know, but I would guess, like, probably 1015, pounds.

Scott Benner 11:35
You're not a big person, because I met you once in person, right? Like, am I remembering correctly? You're You're slight, right? Yeah, I

Sara Lerner 11:42
think pretty average, yeah, look at you.

Scott Benner 11:46
I don't know if you took that wrong or not.

Sara Lerner 11:50
I now have a really good exercise regimen that you know. I've always been athletic. I've always played team sports growing up, and now have continued that on as an adult, but I do exercise fairly regularly. But, you know, average height,

Scott Benner 12:04
okay, yeah, no, no, I just, I meant, like there was 10 pounds when you might be a fair amount of weight. Yes,

Sara Lerner 12:10
look pretty pale when I when, you know, when I look back and see some pictures from the days leading up to my diagnosis, and I, you know, I would remember I was at a friend's birthday the day before I got diagnosed, and I was craving sugar like crazy at that time. So who knows what I did to my blood sugar that day eating like cake and cupcakes and ice cream. And I've never had that big of a sweet tooth, but in those months leading up to my diagnosis, like I my body was craving sugar so much that I was like every time I worked out, I was getting a smoothie afterwards, because that's what I kept feeling faint, and then I would have it and I would feel better, you know, I don't know what I did to my body in those months leading up to my diagnosis. Something.

Scott Benner 12:45
Wow. Okay, so now today, you have a job around diabetes, so I want to figure out from being diagnosed two years ago, like you weren't in this kind of work then, right? No, I

Sara Lerner 12:57
mean, I was a social worker, so I did work with in health and education, mostly with kids, and was working, you know, in that realm, I did make a jump into the T 1d space, and I credit that a lot to getting involved with the T 1d community. So early on, I'm a community person. I'm a relationships person. And so when I got this, this diagnosis, I think within three weeks, I had new friends with type one diabetes. I had gone to a meetup in Central Park three weeks into my diagnosis that I had kind of coincidentally found out about one of the girls who was at that Meetup is one of my best friends today, and I've met so many other people from from that community. And so I would say I have this mentality of, I need to I need to get my own care set. I'm going to lean into this community. I'm going to get involved. And then I think I probably knew while I was in the hospital that I would work in this, this space. One day, I recognized the, you know, the privilege that I was experiencing with my diagnosis, with the disease, with my access to technology and care, and never wanted to take that for granted. And knew I wanted to shift, shift into the space professionally. Wow. So where do you work? Tell people where you work. Yeah. So I work at Blue circle health. We're a non profit organization, and we have a T 1d free care, education and support program funded by the Helmsley Charitable Trust to improve the lives of people living with type one diabetes. We have this, this program. It's a virtual six month program for adults 18 and up. You know, we're live in five states right now. So it's live in Delaware, Florida, Maine, Vermont and Ohio. And we will be expanding to other states soon. And we exist to close the gap between what you get when you you know, have this disease from the traditional healthcare system versus what you really need to thrive. You know, when I say, I recognize my privilege and came into this disease getting a lot of resources like I did. I was able to get into a, you know, coaching program and get external education, diabetes education, and find community support, train my dog to be a diabetic alert dog. You know. Have a therapist who I adore, and has given me so much support through this diagnosis. So I received all this external support. I had a great healthcare team too, but I only get to see them twice a year to be able to have all that external support is what allowed me to manage my diabetes with confidence and get to a place where I felt like I was thriving with my type one, and so now with blue circle health, we have this program where we're able to fill in the gap from what you get from the traditional healthcare system and give people that education and that support. So we have diabetes educators on our team. We have endocrinologists on our team. We have social workers and we do, you know, case management and diabetes supportive counseling. We have insurance navigators, which, you know, personally, that's probably the area I need the most help with, because it's the most complicated to navigate for me, at least on a day to day basis. We have two and D support guides who all live with this disease and and can help me navigate the program, offer peer support, run group sessions. And we also have some other specialized services available, like a Prescription Assistance Program, but we'll pay for people's prescriptions. We have a CGM trial program. So there's all these supports that kind of seem a little overwhelming to manage all that, but it's really like a la carte, you know, patients get individualized care plans, and so, you know, you can use as much of those services as you need, or as little as as them, as you need, up to six months. So you may come in and say, I just want to meet with the insurance navigators and your educators three times and like, great, that's it. You may be out of there in a month. A lot of people we find, you know, stay for the the full six months, though,

Unknown Speaker 16:34
is it virtual?

Sara Lerner 16:36
It is virtual. So that's one of the eligibility requirements, is being able to connect with us virtually.

Scott Benner 16:41
Okay, so how does that? How does blue circle begin? How long has it been available? Like? How did it start? What do you, I mean, I know you, you haven't been there that long, but what do you know

Sara Lerner 16:50
about it? Yeah. So I joined the team in March, and at that time was when we were first really coming out to the world and saying, Hey, we exist. So before that, we were just in Florida. We, you know, started because there is a group of people at the Helmsley Charitable Trust sitting around and saying, What can we do to fill this gap? Like, we know the gap is there. What can we do to help people who live in the US and are struggling to manage this disease? Like, what can we do for them? And creating this virtual program with patient care as our North Star, as being able to work outside of the traditional health care system. We don't bill insurance because insurance system is what makes it so complicated sometimes to get the care you know that you really need, need and want, and what our providers want to give us, they often can't, because of that reimbursement system. And so a group of really amazing people sat together, and they dreamed this up, and it started with diabetes education, and then all the other service lines really built from there, from peer support. And our program was, first, you know, full services operating July a year and a half ago, and then in in around March this year, really January this year, but starting going out to the world in March. We opened it up so that patients could enroll themselves. They could go to our website, blue circle health.org and sign up directly. We still get provider referrals to, of course, but this is something that you know should be available to everybody, and we want to show what to Andy care can and should look like in this country. And we're out there trying to, trying to do

Scott Benner 18:14
that. And for right now, for five you're in five states. Is that right? Five states right now?

Sara Lerner 18:19
And then we'll keep steadily expanding throughout 2025 no more new states in 2024 we just went to Ohio and Delaware, November 1. So that was the last expense expansion of 2024 but then we'll keep expanding in 2025

Scott Benner 18:33
so basically, all these different ideas, like service points that you have, these people all also aren't at a location. They probably working from their homes or whatever. And then I meet you somehow, and I'm like, I just got diabetes, and I don't understand this stuff, but I don't know how to Bolus for my food. And you can put me through like courses to help me manage insulin. Contour, next.com/juicebox that's the link you'll use to find out more about the contour next gen blood glucose meter. When you get there, there's a little bit at the top, you can click right on blood glucose monitoring. I'll do it with you. Go to meters, click on any of the meters, I'll click on the Next Gen, and you're going to get more information. It's easy to use and highly accurate. Smart light provides a simple understanding of your blood glucose levels. And of course, with Second Chance sampling technology, you can save money with fewer wasted test strips. As if all that wasn't enough, the contour next gen also has a compatible app for an easy way to share and see your blood glucose results. Contour next.com/juicebox and if you scroll down at that link, you're going to see things like a Buy Now button. You could register your meter after you purchase it. Or what is this? Download a coupon. Oh, receive a free contour next gen blood glucose meter. Do tell contour, next.com/juicebox head over there. Now. Get this. Same accurate and reliable meter that we use this episode of The Juicebox podcast is sponsored by the Eversense 365 get 365 days of comfortable wear without having to change a sensor. When you think of a continuous glucose monitor, you think of a CGM that lasts 10 or 14 days. But the ever since 365 it lives up to its name lasting 365 days. That's one year without having to change your CGM. With the ever since 365 you can count on comfort and consistency. 365 days a year, because the ever since silicon based adhesive is designed for your skin to be gentle and to allow you to take the transmitter on and off, to enjoy your shower, a trip to the pool or an activity where you don't want your CGM on your body, if you're looking for comfort, accuracy, and a one year wear You are looking for ever since 365 go to ever since cgm.com/juicebox, to learn more.

Sara Lerner 21:07
It's not courses, it's really one on one, direct patient care. And so yes, we do have people all over the country who are on our team and able to connect with you virtually. They are licensed in the states that we're live in, and that's part of the reason why we're alive in those specific states. All of our providers are licensed in the states that that we're live in. They're giving you one on one attention, and sometimes, you know, it can be nine months until you can get in with your Endo. We make that turnaround time a lot quicker. So if you were to go on and, you know, be eligible to sign up for our program, let's say in Florida right now, on a business day, usually within three hours after signing up on the website, you get a call from our clinical enrollment specialist, and you start the process of getting in, and you may have your first appointment with our endocrinologist or an educator, an insurance navigator, within a week, easily. So it's it's really about giving people the care that they they need and deserve immediately. How

Scott Benner 22:00
long is like, when I get set up with the endocrinologist, like, how long do I sit with them? That

Sara Lerner 22:04
appointment can be up to an hour, and it's free. It's totally free.

Scott Benner 22:09
So we're understand, hold on.

Sara Lerner 22:12
Like, what's the catch?

Scott Benner 22:13
Stop it. Yeah, I feel like you're gonna be like, and then you have to send us your kidney and release because we sell them. Hold on a second. I understand Helmsley is behind it, yeah, but it's all public information, right? But, like, you don't make any money. No,

Sara Lerner 22:27
we don't. So we don't bill we don't charge anything. We are fully funded by the Helmsley Charitable Trust, so it's incredible, you know, generous work that they're doing and that they're able to, you know, fund us to make this happen, and we're able to dream big for people with type one, and we're constantly working on making this program better for our patients. We're really big on feedback. We're really big on collecting all of the information we can to improve this be as efficient as possible. But the goal here is to really keep patients as our North Star and do what's best for them, and that's how the entire program has been built and developed and maintained. And, you know, the majority of our clinical staff, they live with type one diabetes. So these are people who get it, and there's a lot of people beyond the clinical staff who live with it too, like myself. You know, I'm not a patient facing member of the team, but I live with type one I work with Scott Johnson, who many people know from being in the T, 1d, community for for many years, he lives with type one. And so the team, the team is really mission driven, which has been the coolest environment I've ever worked in. No

Scott Benner 23:32
kidding. So how many people work for blue circle?

Sara Lerner 23:35
I think we're close to 45 right now.

Scott Benner 23:38
Get out of here. Yeah,

Sara Lerner 23:40
we got a pretty, pretty large, growing staff. What

Scott Benner 23:43
happens if we put this podcast up and 2000 people call blue circle health, they still gonna like sign up tomorrow and get going? Yeah,

Sara Lerner 23:51
you know. So we have built out systems for wait lists and whatnot, just in case, in case that happens. But we've actually found that that that hasn't been the case yet, because people need to hear, hear from people who have gone through the program that there isn't a catch. Because right, like we've been taught nothing is is free in health care, and here we are saying, Hey, we have this free program. And so having people you know meet us, we're going to events. I met you for the first time at the touch by type one conference. So we're showing up events to say, hey, we're actually real, but we've had to do a lot of myth busting to get the word out. So I would encourage anybody listening to like, if you know an adult who lives with type one who's in one of the states I mentioned, Florida, Delaware, Maine, Vermont, Ohio, tell them about this program. Tell them about this resource. I really believe that there's something for everybody who lives with type one that they could benefit from this program. And and if there's not, I want to know it. We want the feedback. But I truly believe this is, this is top notch care. Sarah,

Scott Benner 24:46
when I met you at touch by type one, you started explaining this to me. I was like, This sounds like a scam

Sara Lerner 24:55
battle we're facing. And you know, my circle health is, is partner relations. So I spend my days talking to. Providers. I talk to patients directly. I talk to nonprofit organizations. And I love getting to do that, because I get to myth bust every day and be like, No, this is actually real. It's out there, and it's an incredible resource for the T and D community. It's a blessing that we're able to do what we do every day. And I'm, I'm excited for it to be even bigger as we spread the word. And, you know, work with partners like you to spread the word. But this is a resource that belongs to the T 1d, community, and I'm excited to get it out there.

Scott Benner 25:26
I'd be remiss if I didn't ask you this. So, like, somebody found blue circle six months ago, right? And they're like, Hey, what's up? I'm an adult living with type one. My A, 1c is, like, 11 and a half, and I struggle all the time. Blah, blah. Like, if I found that person today, are you tracking their outcomes? Like, are you seeing how it's going? Do you see what I'm saying? Yeah, someone who signed up six months ago, yeah? Like, are they in a better place today? Yeah, absolutely. So

Sara Lerner 25:50
we're tracking that. We're tracking so many, many things. And you know, there's a lot of data scientists and engineers on our team who are doing great work on that, and because we've only had our program in its full form as it is now, for under a year, really out in the world, we are still getting some of that information back, so I think if you come back to me in three months, I'm going to have a lot more data to share with you. But our initial, you know, feedback, our net promoter scores, are wonderful. The feedback we're getting from our patients and providers is great. You know, I just heard a story last week of a patient who we saw really early on, and you know, she said her ANC is, is the best that it's been in in many, many years. And so we do hear those stories. We do have access to some patients, you know, CGM data, if they're on CGM. And so there's, there's a lot that we're tracking. We do a DDS score. So we're, we're looking at diabetes, distress at entry and exit. We're learning as much as we can, because we want you know, as I said, patients are a North Star. We want to deliver excellent patient care. That's our that's our mission here. But our mission is also to show what this can look like in a much bigger scale throughout the country. And so we are, we are taking those learnings so that hopefully this can have policy implications one day.

Scott Benner 27:03
Awesome. It's really great. How long are you funded for? Like, do you have a an amount of time, or you have to make this work? Or they're like, yeah, it's enough of you. So

Sara Lerner 27:10
they fund in three year cycles. But we're very confident that funding is going to be with us for a while. And with the funding that we have right now, we're able to care for 1000s, which is amazing. You know, I think there's, there's going to be a point when we want to be in all 50 states, and we want to be caring for 10s of 1000s of people, then we'll have to look into, you know, what does it look like to to have additional funding sources here? But where we are right now, we're very comfortable.

Scott Benner 27:37
I'm going to, I feel like I'm going to say something, but I don't want to be controversial, because I'm about to get, I love getting this story out about this, but I love this a little extra, because I have like, a, you know, there's some things in the world that bother you, yeah, so listen, I take ads, right? So I make a living making the podcast. So I don't want to come off, like, I'm just over here doing it, and, like, you know, like in the evenings, after work, like, it's a job I make a living, like, so I want to be clear about that. I've always been, like, you talk about North Star, like, when I started doing this, the way I thought about it was that people shouldn't have to pay for good health. Like, that didn't make sense to me, right? So you know, where a lot of people might, you know, make a podcast popular, and then tell you a couple things. Then say, Hey, if you click on this link over here and pay me. And pay me, I'll tell you the rest of it. You know, a coaching model, or something like that. And I, by the way, this is going to sound like I'm talking in circles for a second, Sarah, but I have two actual minds of thought about this. I don't mind people making a living. If you want to go out there and do like health coaching, I say, God bless you. I hope it helps people, right? But from my perspective, I don't like that. It costs people money, and so, like, the one thing you won't hear on the podcast ever is a health coach. Like, I don't allow health coaches in my private Facebook group. I don't let them on the podcast because I am not about you selling what, in the end, ends up being explaining to people how to, like, set their settings up and pre Bolus for their meals, and how to Bolus for fat. Like, I don't think you should be selling that information to people, so I make it all very available, very free on the podcast for the people listening. I'm very proud of that, but I am also a little personally irritated when people make money with coaching. So I not that I don't think it's necessary or Okay, and Sarah is not going to bad mouth anybody, because she's here kind of in an official like, I'm not bad mouthing anybody either. I don't like it personally. Like, I think, like, find another way to pay to get them this information. I found a way I sell ads on a podcast, right? And you guys found a way. And I think that's really awesome. Like, I'm super excited that you're gonna be helping people and not charging them money. I think that's wonderful. So thank you and anybody else who's involved in it, because I think it's really great. You don't have to respond even to all that stuff. I just said, I'm not asking

Sara Lerner 29:49
you to I think, look, health care in this country is an incredibly complicated thing. Our program is not available in every state, right? We want that to be the goal. And so we want this to spread. We want this, you know, we have to. Work hand in hand with the existing health care system to do what we do, and we love doing that, like we act as an extension of somebody's care team. That is, you know, a huge part of our mission, part of our eligibility requirement, is that our patients have a medical home or are willing for us to be, you know, connect them to one. Because we're a short term program. We want people to have that in person care. We also recognize that some people can't meet with a diabetes educator. I think I've only met with my diabetes educator once or twice since my diagnosis, and that's just because the health care system is complicated. So I say like, for anyone who can go out there and seek external resources and afford it like, that's amazing. That's an extra thing that you know you can do. We also want to make this available for people who can't afford it, and we started by recruiting out of free clinics and federally qualified health centers and giving people who had predominantly only seen a primary care doctor to manage their type one diabetes some specialty care. Now we've opened the doors and say, Hey, anyone who needs to help with their T 1d and is eligible, like, great. Sign up. We do this program, you know, in English and in Spanish right now, hopefully one day that's even, even more languages. But this is, this is a resource that that really belongs to the people with type one, but for anyone who can access additional resources, like, I support, you know, whatever you can, can build in your circle. Oh, listen, I

Scott Benner 31:17
for everybody that can afford it. Like, it's cool. Like, if you want to go buy a, you know, rent a health coach. I think that's awesome. Like, go do it. You know what I mean, like, but for all the people who can't afford it. So for as long as I've been in this space, a back room, conversation has been about reaching more people. Like, it gets nice to say, like, oh, I have a podcast, or I'm a coaching service. And people who go with me, they leave with, like, five, a, one, CS. It's awesome, but like, you're reaching people who have that access. You're reaching people who have the time, who have the wherewithal, who have the money to pay and what about everybody else? And I always hear people talking about, what about everybody else? But then nobody does anything about it, and this is actually doing something about it. Absolutely, yeah, I think it's even, I'm gonna listen. I'm just gonna come out and tell you, Sarah, like, there is very likely no other entity, person, whatever, in the diabetes space reaching as many people as I do, and I reach a small fraction of people with diabetes.

Sara Lerner 32:12
That's what we're finding, too. Is like the Facebook communities, like the one that you have built, that is where so much of the conversation is happening. And so that's where I'm hoping that we can take blue circle health into these groups too, to make sure that people know, hey, like, if you're eligible. And a lot of times it's parents who are in those Facebook groups with kids with type one who, of course, will become, you know, 18 and older and be eligible for a program. And we do a lot with that transition. You're going from Pete's to adult, you need a soft landing pad. It's a while till you can get into an adult endo or you're navigating new challenges of college early career. Like, we can help fill that gap. It's a huge area that we help, but a lot of times in these Facebook communities, it's not actually adults with type one who are there, but it's a powerhouse moms and dads and caregivers. So we're hoping to use that to spread the word about this resource and to be able to share, but it's also finding people who have said, like, I want this to be in the background, like, I don't want, you know, type one to be something that is my identity, like I'm the weirdo who's chosen to do that, right? Like, I talk about this with my team all the time, like we're like, we're the T, 1d, weirdos who have made this our careers and made this our social circles, and that's not the average person. So for us at Blue circle, like a huge task is like, how do we find the people who they may not want the T and D community to be their biggest thing, or they may not realize what that you know that could fill in their life right now, but how do we find them and offer them an extra hand so that they don't feel like they have to carry the burden of this disease all

Scott Benner 33:35
by themselves? Yeah, everyone needs help, like, right, but children and adults, but adults, I think, specifically because they don't have a parent with them, like, maybe you're going to get lucky and get a decent parent who jumps on a train and goes from Baltimore to New York, because you need help, right?

Sara Lerner 33:49
Does not do it justice for what my parents have done for me and my siblings and, you know, the whole, my whole friend group has has really rallied around here. It's

Scott Benner 33:58
amazing, but a lot of people don't have that right? Sometimes people have parents, and their parents just aren't like, go getters, you know what I mean, or they don't understand diabetes or whatever, but at least they're still with their parents, and they go to their doctor's appointments and they get to see doctors, you know, like they have more touch points. But once you become an adult, and you're by yourself, and if you didn't have good diabetes knowledge or practices as a child, and you become an adult with diabetes, it is only going to go in one direction. You know what I mean, like you and you need something that is, is a base. It's a firm foundation to say to you, like, look, here are the I mean, Sarah, this entire podcast, if you listen to the management stuff, it's really very simple stuff. No one's saying anything crazy that nobody knows about except for me. You know what I mean? Like, it's just, it's about have your basal right, Bolus for your food properly. Don't look at a high blood sugar all day. Bring it back down. Trying to be scared of being low. Fix it. Get back, don't, you know, don't get up on a roller coaster, up and down. Like, I actually think that once you have those, those tools, you. Diabetes is manageable, right? And I don't want to say easy, I don't mean easy, but it's easier when you understand the foundational stuff. And what I've come to learn over a decade is that most people don't get foundational information ever

Sara Lerner 35:15
Well, and what you don't know you don't know. So if you're taught one thing, like, I still remember that, you know, I was taught every time you go low 1515, grams of carbs. And so that's what I thought was the prescription there. And then I was going high every time I was doing that, and I was honeymooning at the time, and I I just didn't know that, you know, we were in control of adapting that, and that I could be empowered to make my own choices about that, and that, you know, I may not need a 15 grams of carb snack every time I was dropping a little bit low, and it may look different. And some days I only need five grams of carbs to correct a low, and sometimes I need 30 grams of carbs to correct a low, depending on so many factors of insulin on board and what activity I was doing and how fast it was dropping. And it's just impossible to put all that into a doctor's appointment once or twice a year.

Scott Benner 35:59
Never gonna happen. And I have found, speaking to countless adults over the years, that the ones who feel empowered to change their settings right to adjust their insulin, they're the ones that do better, and the ones who think I have to wait until I talk to the doctor, because he'll know better, she'll know better. I gotta wait. And they wait three months, the doctor turns their basal from point, you know, six, five to point seven. Like, let's see what this does. Well, the answer is my A, 1c, is like, you know, eight, it's gonna not do anything and like, and then we'll wait three more months and do it again. And then that gets frustrating, and the doctors forget. They don't listen. God bless doctors and all, but they don't remember you the last thing they do before they walk in the doors, open up your chart and go, okay, and then they run through the door. You remember them, because you're, you know, they're your doctor, but they look at you like, oh, you're a pat. I remember pat a little. They're not tracking your health the way you can, right?

Sara Lerner 36:55
And we have too many tools to do that now too, that it's just about learning how to to use them to our strength. No, 100% like

Scott Benner 37:01
this is super exciting, because I think you're going to learn a lot while you're doing this as well, lessons that maybe leap over the patients and go back into health care again, because you're you're paying attention, you're in a, you know, I mean, a few 1000 people. It's a nice, focused experience where you're going to really be able to, like, see lessons, see what repeats, start saying when we do it like this, this works more frequently, you know. And then that's good advice to hand out to doctors, too. I can see a world where one day doctors can come to blue circle to ask questions about, like, you know, what are the foundational steps? Like, what do I do to put these people in a good position? Because I don't think they know either. This is really cool, this is this has a lot of like, upside potential. You must be excited to be involved with it

Sara Lerner 37:46
absolutely. I mean, it feels like the the great honor of my life, and I don't say that lightly, to be involved with this organization and this group of people that's making it happen. There's just so much heart, like I go to work every day with this a smile on my face, getting to do what I do every day, and with this group of people, and most of them, I've only met in person once, you know, and actually it was my second diversary this year at our team retreat. And so I was still fairly new on the team, and I just was reflecting that day being like, wow, I couldn't imagine being in a cooler spot right now in my T 1d journey than at this in person team retreat on my second diversity and able to think about, you know, where I came from day one, because it has not been, you know, smooth sailing from the start. There was a period of time where I was eating the same thing every day for breakfast, lunch, dinner and like, that's what felt comfortable. And I had to learn How to gain Confidence with my T and D management, and now that I can work in this space and be, be putting this out there for other people with T and D. It's, it's an honor. Awesome.

Scott Benner 38:45
That's really something. Okay, let's go over it. Where somebody's listening to this, they're like, I'm going to try that. Where do they go? Yeah.

Sara Lerner 38:52
So blue circle health.org, you can sign up from our website. There's a button there to sign up yourself. You know, if you're a provider listening to this, you can there's a button that you can refer patients to sign up on the form. There's also, you know, a phone number that's listed on our website that you can call to with filling out the web form. You're like, I want to talk someone. I want a little more before, before I do this, you can do that. You can reach out to our team, team at Blue circle health org, via email if you fear, like, Hey, I'd rather, you know, set up a time and figure something out to talk and learn more about this. But we're on Instagram, we're on Facebook, we're on LinkedIn, trying to tell our story and share, share what we're doing. And so if you want to go explore, check it out. If you're like, I don't live in one of the states that you mentioned yet, Sarah, but hopefully you're coming to mind soon. Give us a follow. You'll be the first person to know when we go live and and I'm always happy to connect with people and share more so you can reach out to me. My email would be connect at Blue circle, health.org, and I would be more than happy to get on a phone with you, a zoom call and chat more about what we do. We're also showing up more at events like I saw you at, touched by type one and conferences actually was in Columbus, Ohio on Saturday for Ohio. Diabetes Day. So we're getting out there, and my team will be in Chicago for a conference this week, so you'll start seeing us, hopefully around more, but until then, you know, sign up on the website. Give it, give it a try. And I really hope that we can help you, and we feel honored to be part of your two and D Journey. Jeez, this

Scott Benner 40:18
is great. Oh, I'm so excited about this. Oh, thank

Sara Lerner 40:21
you so much.

Scott Benner 40:22
Seriously, actually, can I ask a personal question for a second? Absolutely. So you said you made your dog into a diabetes alert dog. You just come home and go, Hey, listen, rover, I got diabetes. Now you got to get involved. Or, like, how did that happen? Basically,

Sara Lerner 40:34
but his name is Louis, not rover. Now, okay, when I was hospitalized, one of the like, obviously I was not feeling, feeling my finest as I was getting, you know, re acclimated, and my blood sugar brought down. But one of the hardest part was that I lost my my vision. It was extremely blurry for about three weeks. But the worst was the, you know, five days I was in the hospitals, the sugar was coming in and out of my lenses, so I couldn't even use my phone or read a text at the time, my dog, Louie, was about a year and a half at the time. So I there, there again, mom, super hero. Mom was, you know, by my side. And I said, Mom, my dream would be for Louis to be a service dog. Like, can you look up? Can your your dog become your adult dog, become a service dog? So that's what I had my mom googling from the side of my hospital bed. I had wanted him to be a therapy dog. I said I was, you know, working in schools as a social worker. And so I'd seen dogs that went and you helped kids get confident with reading. And so he had great basic obedience foundation, but he had no, you know, he was a silly dog and had fun. And he's, you know, 50 pound doodle mix. I wasn't sure what would happen there. We found many dogs training. They're based out of Wisconsin. Annie, the head trainer, is absolutely amazing, and she has a program where, you know, she does board and trains and will fully train dogs, but she also has, you know, the ability to do an adult, you know, an adult dog owner training program. And so we zoomed twice a week for almost two years before Louie was fully, you know, a service dog, and passed his his test for public access, but he was alerting me within about six months. So he learned how to do my high and low blood sugar alerts, and he will go on runs with me and alert me. You know, he's he's sitting by my side right now, sleeping on the couch, but if my blood sugar dropped or rose, he would get off and come wake up and alert me. Same with overnight. He can smell it in his sleep, which to me, is still the craziest thing to wake up. To them wake me up. And he's usually 20 to 40 minutes ahead of my CGM. So I always say, like the technology is a huge tool, but it lags. It's not always correct. I trust Louis 1000 times over, and he sometimes will alert me at 130 and say it's low. And I'm like, really, like, Are you sure? And without fail, like the blood sugar is dropping within 20 to 40 minutes, is if he's given me that alert. So he's, he's pretty amazing. And there is actually, like, we've, we've worked, I've worked with Annie to start a diabetic alert dog scholarship program there to make it something that's more accessible to other people too. Because it's expensive owning a dog. It's expensive training a service dog, and it's something that has been a silver lining of my diagnosis, for sure, getting to go through life with Louie and train him, and have this extra, extra tool and silver lining. So we're hoping to make that available for more people

Scott Benner 43:15
too. Oh, what are you trying to be a saint? What's going on here?

Sara Lerner 43:19
I told you, you know, I've had a lot of a lot of people looking out for me since my diagnosis, and an amazing support system, and I've been able to take advantage of a lot of resources. So anything I can do to give back to this community, I want to be a part of

Scott Benner 43:31
lovely I feel the same way. Actually, that's wonderful. Am I missing anything? No.

Sara Lerner 43:35
I mean, I would just say that, like with blue circle health to me, like, you know, that's why we started this conversation. I'm so excited to be here spreading the word about spreading the word about that. And so do you know somebody, if you can share something on Facebook, Instagram, anywhere you're at in Facebook groups, know somebody who could use a hand with their T 1d please, please let them know about this resource. It's really free. It's really here to help adults living with type one diabetes. Florida, Maine, Vermont, Delaware, Ohio, more states coming soon. Please check out our website and sign up if we can help you out.

Scott Benner 44:05
Awesome. Okay, great. I appreciate you coming on doing this. Thank you very much. Thank

Sara Lerner 44:09
you so much for having me. Oh, of course, it's my pleasure.

Scott Benner 44:18
Your Kids mean everything to you, and you do anything for them, especially if they're at risk. So when it comes to type one diabetes, screen it like you mean it, because if even just one person in your family has type one, your child is up to 15 times more likely to get it. But just one blood test can help you spot it early. So don't wait. Talk to your doctor about screening tap now or visit screen for type one.com to get more info and screen it like you mean it. The podcast episode that you just enjoyed was sponsored by ever since CGM. They make the ever since 365 that thing lasts a whole year. One insertion every year. Come on, you probably feel like I'm messing with you, but I'm not. Ever since cgm.com/juicebox Arden started using a contour meter because of its accuracy, but she continues to use it because it's durable and trustworthy. If you have diabetes you want the contour next gen blood glucose meter. There's already so many decisions. Let me take this one off your plate. Contour next.com/juicebox if you or a loved one, was just diagnosed with type one diabetes, and you're looking for some fresh perspective, the bold beginning series from the Juicebox podcast is a terrific place to start. That series is with myself and Jenny Smith. Jenny is a CD CES, a registered dietitian and a type one for over 35 years, and in the bowl beginning series, Jenny and I are going to answer the questions that most people have after a type one diabetes diagnosis. The series begins at episode 698, in your podcast player, or you can go to Juicebox podcast.com and click on bold beginnings in the menu. Learn more about what you heard today at Blue circle health.org I can't thank you enough for listening. Please make sure you're subscribed or following in your audio app. I'll be back tomorrow with another episode of The Juicebox podcast. The episode you just heard was professionally edited by wrong way recording, wrong way recording.com, you.