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Scott Benner 0:02
Hello, everyone, welcome to Episode 369 of the Juicebox Podcast today on Ask Scott and Jenny. And these are questions that Jenny and I did our best to answer that came directly from you. Today we'll be talking about sleep overs, relocating, finding new doctors, blind management, which is the idea of being able to manage Type One Diabetes without being with the person that you're helping. And what are those other doctors that people with type one diabetes need to visit? Now you guys know Jenny, by now, Jenny has had Type One Diabetes for over 30 years. She's a certified diabetes educator and a lot of other cool things. But mostly, she's the first you know, from the pro tip series from ask Scott and Jenny, of course, and defining diabetes. Jenny really is just the cat's pajamas when it comes to type one and a couple of other things. Please remember, while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan for becoming bold with insulin. If you hold on for just one second, after the music, I have something for you.

So today's show doesn't have a sponsor in the classic sense, meaning that no one has you know, paid a fee to put an ad on the podcast today. What I do have, however, is an opportunity, one for you. And one for me. One for everybody living with Type One Diabetes, actually, but let me explain a little bit to you. If you remember back a number of weeks ago, maybe it's months now, the CEO of T one D exchange came on. It's a nonprofit that does data driven stuff to help people with type one diabetes. Anyway, after that episode, I maintained a relationship with T Wendy exchange, we're talking back and forth about a couple of things. And they asked me if I'd be interested in helping them gain participants for the T one D exchange registry. So see the T one D exchange registry is a research study conducted over time for individuals with Type One Diabetes and their supporters for like the parents of somebody with type one as well. The participants are volunteers that provide their data for research by just answering these questions in an annual survey. Once you're enrolled, registry, participants have the opportunity to sign up for other studies on various topics related to type one diabetes. The goal here is to improve knowledge of type one diabetes, help accelerate the discovery and development of new treatments, or to generate evidence that supports policy and insurance coverage changes that help people living with type one. So if you're not just paying for me to tell you this, how does this work? This is important for me to tell you, I want you to understand this.

Every one of you that goes to the link, T one d exchange.org. forward slash juicebox enters the registry, answers a couple of questions to see if you're eligible. And it's really just about having diabetes, couple other things. And then complete the questionnaire, which I've done already took me about seven minutes, I actually did it live. And I recorded it. So it's at the end of this episode. So you can hear took me about seven minutes. The questions are very basic and completely anonymous, your information will never be attached to the answers, they will never know that you. Let's say your name, for instance, is john. And john, your information, the answers to your questions will never be attached to your name. It's taken very, very, very seriously. HIPAA regulations are followed to, you know, the nth degree. Anyway, this information impacts all kinds of things. For instance, you know how Medicare started covering cgms. They used the data that the T one D exchange was able to pull together to show how important that was. And it helped move that legislation forward. It's helped coverage for test trips, it's helped to show that Dexcom can work without finger sticks, all of this different stuff. But but here ends up being the real problem. The more data that they have, the better. They can do their job. And the T one D exchange is having trouble getting enough people to do it. That's why they came to me they thought that this podcast could reach more people. It's not a situation where people don't want to do it. It's that they don't know it exists. So they don't know how to do it. So they don't just need 25 of you to do this. They don't just need 100 of you to do this. They need thousands of you to do this and it's super simple. Again, you'll see at the end, but you go online, the website is really clean. It's very intuitive. It's easy to get through a couple quick questions. Am I okay to do this? Yes, comes back immediately through your email, you keep going, right there on the web page, answer the questions, I go over every question. So you know them. And then that's it. And then annually, so yearly, you'll be asked to kind of update your answers to some things and maybe ask different questions. I put a lot more information at the end of the episode, so you can understand this. But that's it. It's super simple, and incredibly valuable for people living with type one. So if you've been looking for a way to support people with type one diabetes, and if you'd like to support the podcast, this is going to do that, you know, with one one effort two birds, one stone, think of it any way you want to, you're going to help people with type one, you're going to help yourself, you're going to help your child, you're going to help the future with type one diabetes, and you're going to help support the podcast. T one D exchange wants you to know that the purpose of the study is to collect the information from individuals with type one diabetes, and parents of children with T one D to learn more about the management of type one diabetes, how it may change over time, and how different management approaches relate to glycaemic outcomes, acute complications and the use of health services at this time, there is no end date in sight for the registry. T Wendy exchanged hopes to follow a large group of people with type one diabetes over many years, so they can get a very firm grasp of what all this data means. Anyway, I think the people listening to this podcast fit perfectly into this idea. And I know we can reach a lot of people. So if that sounds good to you, and you can spare a few minutes, T one d exchange.org. forward slash juicebox. Links near show notes and links at Juicebox podcast.com. us residents only. Oh my god. Hi.

Unknown Speaker 7:00
Hi.

Scott Benner 7:02
When you texted I was like leisurely. Just you know,

Jennifer Smith, CDE 7:05
like getting a cup of coffee or no tea. Don't drink coffee. Tea. Yeah, I was.

Scott Benner 7:10
I had a Arden's blood sugar got low on me at 4am Oh, no, just two seconds. I got up and I fixed it. But I I stayed awake to make sure. And then the dogs barked. And then before I knew it, it was 630 to get out. I hadn't been up yet. And Kelly let me sleep. So I just like 10 minutes ago, my eyes was like, Huh, it's morning. Funny, I don't sleep in ever. I never get to sleep in. So I was like,

Jennifer Smith, CDE 7:43
well, that's a long sleep. And it was.

Scott Benner 7:45
And so I was like, Okay, cool. Like, I'm gonna go set up and get ready. I'll take a shower. And then you're like, I'm ready. Lady, what's going on? All right, Jenny, let's actually get to the questions here, shall we? Get Megan Megan goes, I've heard Jenny talk about when she was little. This is about little tiny Jenny Oh, and did sleep overs. I've never let my daughter go to someone else's house overnight. She's nine years old. Any helpful hints? She doesn't wake up to her phone alarms. So it would have to be me calling in other parents when she needs something. Well, I know what I do. So you're in a different position. You're, you're not little Jenny anymore. But like, let's talk about that for a second back in the day. Like why was it easier when people knew less about diabetes? Like and I mean about the data and what was actually happening? Because

Jennifer Smith, CDE 8:37
Yeah, I mean, did you because nobody could follow anything. I mean, there was there was literally no continuous glucose monitor. And while there were pumps, they were they were nothing. So I didn't I didn't have one. I was only on daily injections. I mean, this lipo was first that I had, it wasn't like some random person down the block that was like, Hey, I met Jenny at the playground. Let's have her come sleep over. You know, I mean, these sleep overs were with good friends that knew that I had diabetes. I mean, they didn't know much about the management of it. But you know, what my parents essentially my mom really did. And she was like, the order keeper in our house. Was she just kind of hyped up a plan, right, she was, she called the parent ahead of time. She knew kind of like what kind of snacks and things what we were going to be doing, whether it be like playing outside or whatnot before or if it was just an evening kind of thing where we'd be watching movies and then talking all night or whatever it was, you know, and she essentially just gave a guideline for Jenny needs to check her blood sugar at these times. Again, we had no continuous monitor just so I had to do a finger stick right and you know, has to have a snack at this time because actually at the time of doing sleep overs, and even In through high school, the insulin that I was on required very regular meals and snacks, I didn't have the option of using a human log because it wasn't available or a nova log because it wasn't available. There was no rapid there was our right, which was longer acting. So I had very time two types of things. So I always had an evening snack plan. And it was just that my mom had to make a consideration for what that was going to be at the friend's house. Now compared to what I usually had at home,

Scott Benner 10:31
did you deal with the lows, the way people deal with lows now on that insulin.

Jennifer Smith, CDE 10:37
Um, only if you didn't eat only if you didn't eat correct, because on regular insulin, you usually mixed it in a syringe with an intermediate acting insulin, which was cloudy, right? And that had about a 12 to maybe 16 ish hour impacts, you took that kind of insulin with the our insulin every 12 hours morning, you didn't take any insulin at lunchtime, because the cloudy insulin was supposed to peak in action. And so the lunchtime met the peak of that insulin, so you didn't take insulin to cover lunch. But again, meals were also very structured, like I had a certain amount of fruit and vegetable and protein and fat. And, you know, everything at the meal was very sort of sketchy, you know, a schedule that was regimented. So I think that might have actually made it a little bit. A little simpler. I would say

Scott Benner 11:28
I'm honestly, I'm thinking your mom's real concern was eating at certain times, right testing to make sure we're not way crazy off one way or the other, and, and maybe having to adjust the insulin a little more aggressively for party foods that you didn't eat every day.

Jennifer Smith, CDE 11:47
Right? Right. And potentially knowing that, you know, the next morning, I mean, the call was always this Jenny's blood sugar. It wasn't that the parent of the house figured out what to do. It was that they called my mom and they were like, this is Jenny's blood sugar, and that we did the math, and we figured it out. You know, we knew how much to take them in. Because we did have a correction. Yeah, you know, to be able to add in. But as far as overnight, I believe I remember the parents at night, waking me up in some cases, but I can definitely say not all the time to test. I mean, that was a, that was a thing that my parents did do at home. But I'm quite sure that my mom didn't have them doing that all the time with,

Scott Benner 12:33
it'll be okay. It's usually Okay, that kind of thing.

Jennifer Smith, CDE 12:35
And she went with that, because she knew the kinds of things I was going to be snacking on at a party in the evening, were likely actually just going to drive my blood sugar higher than we would want them anyway. Yeah. And we just left him sit there. So you know, we didn't know really,

Scott Benner 12:48
so. So I think the two things here that make your experience different than Megan's question is the type of insulin right that we use now versus back then. Right? And that your mom had things pretty well structured, right? Yeah. She wasn't like, things weren't a mess at your house for your diabetes. Your mom was like, well, we'll just roll the dice and let her go. You're like, shoot, right? She had a plan? I think it sounds to me, How old is your mom?

Jennifer Smith, CDE 13:21
Um, my mom is

Scott Benner 13:22

70. How would she do on one of these interviews? Do you think I just thought it might be. might be interesting to talk to your mom one day. But, but you'll decide if that's a good idea or not. I don't I don't need to know. But But my thought was, is that she was she was more like us, the people listening to this podcast, probably. But back then. She really, like dug through it. It wasn't just as easy as you know, like, blah, blah. Like, I know, I had friends who had diabetes, you know, that long ago. And it was just sort of like, Hey, this is what they told me to do. And this is what I do. Right? They weren't looking at it any farther than that. Right? And so

Jennifer Smith, CDE 13:59
today's technology has brought in the ability to see so much more. I mean, I mean, even my mom says, today, gosh, I wish that I had had this type of visual information. When you were little right. The things that we could have done differently is kind of, and I'm like, you know what, Mom, I'm alive. I am complication free. You did a really good job with what you had. And that is what it is, you know. But in today's world with the technology we have, you kind of have to take it and say, What do you know about the people where you're sending your child's sleep over?

Scott Benner 14:34
Right really going to do this thing that you're asking to do? Or will they not see it as being important? But I also think that if Megan has a CGM, if she has a dexcom and she has shared I mean, which I think at this point, they all share like there's not one that I don't think anybody's using one that they can't see on a phone or, or something like that remotely. So is the idea for me. I mean, here's how I did it. I think I thought, okay, I can't not let Arden spend the night at someone's house, right. And I've had two different experiences. I've had parents who lets you know what, I've had three different experiences. That's interesting. I've had parents who just listened to what I said, and didn't over or under think it. And that always went well. I had a guy who had struck him so hard. The Father, not the mother. He just stayed up all night long. He couldn't bring himself and go to sleep. When I got there in the morning to pick him up. He hugged me, and we did not know each other. And it was a I'm sorry, Your daughter has this hug. Oh, like it was like that.

Jennifer Smith, CDE 15:39
Like, I'm sorry that you stay up all night? Yes.

Scott Benner 15:41
He just assumed I think that I probably know, he probably looked at me. Like, that's why that guy looks so bad. But, yeah, I mean, I wouldn't be I wouldn't be okay either if I never slept, but no, he just, he cared so much. And he and he took it so seriously, that he couldn't bring himself to have a moment he slept through. And he just sat up. Sure. And I've had people this one woman comes to mind. Who, if something would go wrong, it was fine if it went right. But if something went wrong, if Arden's blood sugar got out of toe a little bit, she'd call me and say you have to come get her. And she made me pick it up at three o'clock in the morning, once. So I've had all the different experiences. So the people you're sending them to, are a big part of this AR because you don't know how they're going to react to being able to see the data. Right?

Jennifer Smith, CDE 16:37
And I think you may want to in that, in that sense, you may want to even start with the people who really, you've come to know them, well, you don't only know their child, but you've come to know the parents of the child, right? You've gotten comfortable with them, they see your strategy of management because you've interacted socially, hopefully again, at some point.

Unknown Speaker 16:59
What right.

Jennifer Smith, CDE 17:02
video now. Right, right. So, you know, I think once you get to know people, they have a comfort level, because they can see how you strategize. And they can see your comfort level with it. It's throwing a child into a setting where again, it's like, the parent of a kid who's kind of newer, to the group of kids your child hangs out with, and you're like, they're trying to get to know people. So they're going to have a party and whatever. Well, you know, what, maybe call the parent talk, see what their comfort level really is with everything. Because people I've learned people get a sense of comfort from what you exude. Right? They, they, they feel eventually what you're feeling about it. So if you're like, oh my goodness, wow. I mean, they're gonna be all like, anxious and like, ramped up

Scott Benner 17:53
to, every time I talked about school, I tell people do not come off as crazy, because they're just gonna think you're crazy. And that's going to be the end of it. Now, the person who made me come get Arden at three o'clock in the morning, let me say this. I was not surprised that she was the one that that happened with. She was a me person. And when it got hard for me, being her she didn't want to have anything to do with anymore, but her kid was popular and art and was trying to, you know, get along. Yeah. Interestingly enough, now I think Arden's popularity has changed a better way. Yeah. So I don't see Arden trying to, you know, make friends anymore. It's she's just comfortable with the people she's comfortable with now, which is really nice. But But this bigger idea. And Megan, you're lucky you answer the SS question here. Do you know, years ago before all this fun technology, I actually sat in Manhattan for 12 hours in a television studio in a chair, and a light would come on. And someone would say you're live in Indianapolis on CBS three news in 54321. And then I would talk about sleep overs. And I did it for Lilly. And then you'd sit back and say this one's a radio, you don't have to be on camera and you sit back and then you do a radio interview. I forget what they call them. But I did one one time for Lilly diabetes, when they were putting out this little book, it was like kids books or something like yeah, like the CoCo bucks. Yeah. And it was interesting, because I got to talk about sleep overs over and over again, it was a little more like, Listen, you really need to let your kids do this, because it's a weird thing to restrict. Now, having said that, I know people who think that sleep overs are weird, and would never let their children sleep in someone else's house. And I don't know that I can argue with that. Like, I mean, if that's your feeling then right on, but what I think is, is that if this is something your kid wants to do, and something you want them to do, having to restrict them because of diabetes is gonna have some sort of psychological impact. It might be a little But it's not a good thing moving forward, I was never allowed to go anywhere, which will later build into I shouldn't go places I'm scared like it could, it could pet right it could build, some people might not care. So I think if you've got the technology, the way I ended up eventually being good at letting art and go anywhere, was I would practice managing when she wasn't with me through Texas Rangers, right, and then we got so good at it, I don't need to be with Arden to help her with their blood sugar, right, then it becomes the overnight spot, then you have to have a person who's willing to take a phone call, and knows it's possible the phone's gonna ring overnight and will wake up and can take direction from you over the phone. Correct me though.

Jennifer Smith, CDE 20:44
And all kids too hard, a very different level of their own ability to manage, right? Some kids from early on, can wake up to their alarms, and they may not know how to treat it, but they wake up to it, they go shake their parent, they're like I'm low, or their parent is already in the kitchen getting themselves think or whatever. Some kids sleep through everything. And it's a good majority of kids who actually sleep through everything, you know, because they just kids have a very deep sleep, which is a good thing. But from the standpoint of alarms, especially when you're trying to communicate with your child at three o'clock in the morning, and they're, you know, six miles away. That's it's hard. So again, you have to have that communication piece with the parent, not necessarily saying hey, if to sit up all night and watch my child's blood sugar, but if I call you, I would hope that you're going to answer you know,

Scott Benner 21:38
two other things with technology that helped with that. One Find My iPhone for people with iPhones, if you don't know what find iPhone is it sends a piercing signal through another phone. So you know, you could send that. The other thing is to I would you know, after dexcom share was was you know, a thing. I put the the follow app on the parents phone, right? But only give them alarms for low extreme

Jennifer Smith, CDE 22:08
high or really

Scott Benner 22:10
percent right, I would put an extreme high or at 55. I said, Alright, listen, if this thing beeps you know, kind of deep and twice. Her blood sugar's too high. And if it beeps, like faster, I can't I said dumb and you'll see like, it actually sounds more panic the low beat Yeah, it feels like it's killing you, oh my god, you're low do something. Or my brain is, you know, you know, attributed that to the sound at this point. But and I said, you know, it'll be beep, beep, beep beep for really fast that's low. Low means do something right now don't wait, hi means we really should be getting her blood sugar down. And those were simple, like directions that I think they were able to understand. Yeah, maybe my

Jennifer Smith, CDE 22:55
mom, my mom went as far as all the sleepovers that I went to I always had my glue gun kit with me. I did. I mean, the parents again, were knowledgeable, good friend, parents. And they, they knew how to use it. They knew the purpose of it. So I just I brought it along. But again, never had to use it in those circumstances. Thankfully, the parents never had to try to read the directions at two o'clock in the morning. And

Scott Benner 23:22
it's a tough thing to look at another human being in the face, pull the thing out and go, if she has a seizure, what I need you to do, like, wait, what a second now. Yeah, and you're like, Oh, don't worry, that's not gonna happen. I used to say aren't had diabetes for five years, six years, eight years, that's never happened. We've never used one of these, I buy these and throw these away all the time, blah, blah, blah. Right. Having said that, if she should have a seizure, it's not a not a reassuring thing to say to another person. But it's a good thing. And so my point is, maybe have that this is how the glucagon works conversation, not at the drop off. But prior to that, so that you don't put them into shock. You know,

Jennifer Smith, CDE 24:02
and I think you'd actually just said something very appropriate. It's the prior to, it's the planning. Yeah, right. Most people don't have any plan for dropping their child off at a sleep over. Other than just saying, yes, you can go get everything ready, and they drop them off. Yeah, as a parent with diabetes, you already know that you have to have a plan for a plan and plan B for Plan C and whatever else. Yeah. So it's the plan ahead, the talk ahead, don't expect to spit everything out at the parent as you're dropping your child off at the curb and then be like, bye, bye.

Scott Benner 24:40
This is not something you should be yelling out the car window. I'm actually thinking we should add a couple other things to this. So parties, picnics, things that you don't go to because you don't you know, you don't like the parents. So you just I can't spend the afternoon over there with those drunks, you know, like gigs or whatever. Whenever you know, something you Won't be at. I think a lot of these ideas fit right along. And they're actually simpler because people are always going to be awake during them. The one thing that I know causes a hiccup is a pool party when you go in the pool, now you're not, you don't have a signal for your CGM anymore, right. And so I think still, one of my, one of my most valuable diabetes skills, is being able to blind manage diabetes, like not to have to be with the person or see exactly what's happening, to infer, from what I know about the situation or what I can see in the data. I think that's why I'm good at looking at someone's graph and being like, hey, blah, blah, blah, you know, do this and this and the way I think of it, the way I thought of it originally, when I realized I need to be better at this when I'm not with it, is I was always impressed by customer service people for computers. Like they're not looking at your computer, but they're walking you through the computer, right? Like they're like, you know, see that thing over there. Click on that,

Jennifer Smith, CDE 26:06
you know, the parts, they know where they are, they know where to poke it, they know exactly on a list of a drop down which one to write,

Scott Benner 26:12
right, like, in my mind, make yourself a marine that can take apart and put his gun back together, blindfolded. Like, like that sort of a thing with diabetes. Like I feel like I'm there now, which will help you in your own life too. But it definitely helps you when you lose the signal. And you can calmly say to yourself, okay, the signals last Arden's in the pool now, yeah, she's not gonna swim that long, she doesn't usually swim this long. So in about a half an hour, you know, she was 105 and a half an hour, if I haven't heard from her, I'm gonna send her a text and ask her to get back near the transmitter for a minute. And be okay with that. And not be sitting around your house, you know, scrolling on the walls in your own excrement because you've lost your mind. Billy's a nice boy. Like, you know what I mean? Like, like, try to hold it together is what I'm saying. And if you can't hold it together a nice phone call to the host parent who's willing to take that phone call or text just say, hey, I need you to have Arden test your blood sugar. Right? That's all

Jennifer Smith, CDE 27:12
and tell her to get out of the pool for five

Scott Benner 27:15
minutes, text me afterwards. That's, it's all very reasonable. In the end, as we're talking to Megan and talking to each other, and I'm recollecting all these things I've done throughout time with diabetes. In my mind, I feel like I'm like, I almost feel like I'm getting away with something or having a podcast, because is anything we've just said not common sense. Like, right? It's just that what happens to us around diabetes, is the fear literally knocks that common sense right out to you. Correct? Yeah. And then and you cling to I need rules, give me rules to follow, if I have rules, then nothing will happen to my kids not gonna have something happened to him, I don't want to happen. I don't think that's it. Like I don't, I think those rules are just there to make people give them like a, almost a false sense of calm, where what you really need to do is understand it, and is different than anything else in the world really. You know, also making keep in mind is your kids nine, now she's going to get a little older skin and want to go to a dance at the school, this is going to be the same, the same muscle you're going to use there, you're going to start sending her to parties, I hate to say this in the 1314 range, some little malcontent and your town is going to start drinking and think it's really super cool to bring alcohol to a party. And hopefully your kid won't be the one at 14 years old and artist that wants to try it right. But you know, by then I'd like to see you have a firm grasp on this. Because, you know, right, everything gets a little harder when they hit that, that age in there.

Jennifer Smith, CDE 28:50
And I think you brought up a point to before about, you know, it's your decision that you just don't agree with sleepovers at all has nothing to do with diabetes, then for the child who has siblings, those siblings also follow the same rules. So it's a little easier for that child to feel like has nothing to do with diabetes, it's just because mom and dad don't really agree with going to sleepovers. Whereas if your siblings are going to parties, and they're eight years old, and you're 12 years old, that's really that's not fair. It's not your call, and you're causing a problem that could be a problem later on for how that child continues to grow and feel about sharing about diabetes and being open about it and even managing it a little bit more on their own in an open way.

Scott Benner 29:36
Diabetes is already an already has the possibility of being an issue in your kid's life. You don't want to turn it into that cousin that you talk about behind their back. Where you know, I mean, where you're like, oh, yo, Patty's great. And then at home, everybody's like, Patti. So where am I? Right? You know, maybe like you, you know how it goes with family, right? Like because that's, you don't want your kid you don't want to be telling your kid. It's fun. This is manageable, you can have a normal life. And then, you know, three times a year be like, but you can't go because of this diabetes. It's not my fault. I'm not the one keeping you out of it. Because now you now know Nobody. Nobody likes Patti, and not therapy, and right, not gonna help you throughout your life.

Jennifer Smith, CDE 30:18
No, no, I mean, I can, I can remember only one. And as an adult now, well beyond my teen years, I still remember this one time that I was not allowed to go to do something. And it was in high school. And I know it had to do with diabetes. I do. Yeah. And I know, because my brother who's four years younger, so we were never in high school together, right. I finished I went to college, he started his freshman year, so we were never together. My senior year, our basketball team went to stay. And that meant that we wanted to travel with our team. And we wanted to go to state and watch them play a weekend tournament. Right? My mom wouldn't let me go. All my friends were going my known friends, good parents that my parents knew were going to be there. My mom wouldn't let me go. Yeah. And I knew the reason, despite her letting me go to a million other things, sleep away Girl Scout camp, sleep overs, all those things. But I was in high school. And she didn't want me to go out of town to sleep in a hotel, along with this like, and again, I think from a visual had she had some information technology wise, she would have been okay with it. But yeah, that was the one instance and I know it was diabetes, because my brother when he was in high school, they also at some point went to state, the varsity team, and my brother got to go

Scott Benner 31:46
could this has been a gender thing, as I'm asking was, was was your mom trying to keep Jenny pure another week? I don't know. Why, why did you really want to go to the basketball tournament?

Jennifer Smith, CDE 31:58
And that's the funny thing that was a really like, I was I still am pretty much like a follow the rules. There are many things that I don't, you know, follow strictly everything kind of go my, but I'm pretty much like the rule follower. And I was I growing up my brother was the one that pushed the buttons. He pushed the limits. He did not me. I was the firstborn and I did it. Like I was told I'd be home by 1130. I am home at 1120. I was told to be home at 1130. I I don't know if it was the gender component. Perhaps it was. I maybe don't

Scott Benner 32:33
I don't know, either. I'm just wondering. That's all

Jennifer Smith, CDE 32:35
anyway, that's the only one situation that I

Scott Benner 32:37
can remember if your mom was like, I'm just gonna pull this diabetes card out one time here to keep Jenny a virgin.

Jennifer Smith, CDE 32:47
Boyfriend at the point.

Scott Benner 32:49
Don't need one of those at a basketball tournament. Anyway, that's nice. Do we want to talk about relocating when you have type one, like literally moving somewhere else? Or do we want to talk about it or

Unknown Speaker 33:05
have you? Oh, I've done.

Scott Benner 33:07
Alright, here we go. MC pres what to do or what to consider when relocating, especially if you're the caregiver of a younger kid with type one, what should I do before leaving? And when I get to my new location? All right, Jenny, you married somebody in the military. All right.

Jennifer Smith, CDE 33:26
I did. My husband is a retired Marines.

Scott Benner 33:29
So he actually probably does know how to take a gun apart with his eyes closed. And what else can your husband do in the dark? And? And

Unknown Speaker 33:42
we'll go with guns.

Unknown Speaker 33:42
Yeah.

Scott Benner 33:45
We're just gonna talk about Jenny's husband's pistol for a couple more seconds. And then we're going to talk about reload. I'm just kidding. Go ahead. What do you do to read now that I've got her?

Jennifer Smith, CDE 33:52
Yeah, we've, we've relocated a lot. I mean, since we got married. We have moved many numerous times, within cities as well as out I mean, we grew, we moved. When I did my internship out to Colorado, that I took my first job and we moved down to Florida. Now we, that husband took a different job. So we moved up to Washington, DC. And then the area was very busy, and we wanted to be closer to family. So we moved back to Madison, Wisconsin to be closer to family when we wanted to have kids. So we've moved a lot. And in each instance I can say that prep ahead of time and so that this is a great question. I somebody is thinking ahead here, they're thinking I know I should be planning something, but what should it be right? I mean, as as the person myself with diabetes, I always very quickly established, who to go to write with whoever my insurance was. Once we got there who I could see I called a bunch Have people I called around to see, you know, as an endocrine practice for adults? Do you see a lot of type ones? Or are you mostly type twos and you just dabble in type ones, or, you know, you're only like, this friendly to this particular pump, and you don't want to help anybody with anybody, anything else? I. So I guess, in that it's asking questions, right? In within, again, kind of your network of provider availability, yeah. As the caregiver, those are some things that you can do ahead of time, that, you know, if you're, if you know that you're moving someplace, obviously, you've got a location that you're moving to, you're not just going to like live in your car on the street corner until you find a place. So you've either got an apartment, or a home that you're renting or a home that you're buying and your new location. You know, consider distance in a city, if the best provider is 20 miles across the city, but they're the best. And you've heard the, the greatest things and they've got openings, you have to kind of fit that into your I can do that. And in the moment to see the person every three months or every six months. So I can do that? Or do you want to be closer? Do you have a lot more issues that you need to discuss, but calling around as well, like I said, if you know, especially because insurance dictates a lot of what you can do. So if you know what your provider is going to allow in the new location, look at the network of providers on that plan. Yeah, start to pick out some even even you know, with so much social networking online and the diabetes online community, there's so many Facebook groups, especially available that can give you you know, parents of kids with type one, ask a guarantee, at least in some of the big major cities, and in most of the states, you're gonna find somebody who answers you back and says, Hey, I live in this city, and I see this person and they're really, really awesome.

Scott Benner 36:59
You know, mine when you do that, though, everybody, everybody grades differently, like they do. What is awesome mean? Like, you know, in the back of someone's head, awesome could mean you know, I come in there with an 8.1. And they don't give me a hassle. I like that. It's awesome, which probably isn't is a good thing. I'm just saying that people's expectations are varying. But I do think it's a valuable way I just used my breach to try to find a an endo, for a girl in New York City. Yeah, you know, and I'm wondering as we're talking, if you don't, I wonder if you couldn't set up a short conversation, not an interview, you wouldn't call it an interview to the doctor, because they wouldn't like that. Right there. God complex would definitely not like that. But um, but you know, I conversation where you say, look, this is how I manage? Would that be okay with you? You know, like, would you be open to helping me on this path, because I don't want to take all the effort of coming to the PAC practice sitting down explaining to you what I do, and having you say, you can't do it like this, or, you know, I just don't waste your time or my time. I wonder if that's not valuable?

Jennifer Smith, CDE 38:04
I think that's kind of the it's sort of a more in depth. thing to do, I think more the tip of the iceberg for for filtering. Yeah, which is kind of what you're doing is calling the providers that you can see, you know, on your plan or whatever, and assessing, most likely you're going to get in contact with their nurse that helps them rather than the actual practitioner and ask ask them Yeah, right, you know, have a line of questions that are essentially, I use this kind of product, I use this kind of continuous monitor this kind of, you know, I use this software. Does your offer, is your office, you know, kind of allowable for these types of things. Do you use these? Would you allow me to bring in reports, if you can't physically see them? How much time will you spend with me? I've got a lot of questions. I've got other things besides diabetes, maybe they've got celiac as well. Or maybe they've right can you work with them?

Scott Benner 39:03
how flexible would you be if I said, you look, I you know, I don't wait three hours to correct the high. You know, because there's a there's some places who'd know, I'm starting to believe they know so little about it. In regard in terms of like, looking at the data and making a decision, they need to know when things happen, because that's how they think about it. I'm starting to think now that's what it's about. It's not about I don't want you correcting a high probably in the back of their mind. They're like, geez, get this blood sugar down. But if you did, then they don't know how to look at your graphs and make sense of them anymore. Right. And and so, you know, if I did that, yeah, right. I need these notes to say what I need them to say so that I can help you. Otherwise, if you bring me different data, I'm, I'm useless to you. You know, I'm starting to think it's a little less about them wanting you to do something a specific way just to control you or because they think you're wrong. And it's more about them, about you getting them out of their element. By doing things differently than they're accustomed to, right, right. But But and

Jennifer Smith, CDE 40:04
that's, that's the notes component that I always talk to the people that I work with about. Your doctor isn't necessarily like a bad doctor. Yeah, it's just that one, they have a time constraint. First. Secondly, if you only give them your pump to download, there are no notes. There's no history, and there's no information about it. They can only take the information there and make suggestions based on data, right, but they don't know the variables of your day. If you come into the office, and you've been in Aruba for the last three weeks drinking my ties on the beach. They didn't know that when they looked at your data and said, well,

Unknown Speaker 40:43
gosh, right,

Jennifer Smith, CDE 40:44
what was going on here?

Scott Benner 40:46
Sometimes people don't know, I have to say, That's weird. What's happening right there. You know, I, you know, what made me think of this. And I've never considered this before. But I think it's a good idea. Like you're saying call head talk to a nurse or practitioner or something, get a feel before you lock yourself in, and then then have to go through that trauma. It made me think of, when my son was recruiting for baseball, we went to a meeting. And I think he wanted to go to this place. And the guy started saying weird stuff. And it was like any any we walked out, he goes not here, not this guy. And I went, Okay, why he goes, I don't know, man, not here. And I'm like, all right, you know. So he just, he got some feedback back from this man that made him feel like this is not where I want to spend four years playing bass. Right?

Jennifer Smith, CDE 41:31
Well, and you bring in a good point there too, from you know, this, this person is asking specifically for their child, they don't know how old this child might be a young or might be a teen or whatnot. But I think especially for all ages, finding this would be a pediatric and no practice, right? But finding one that the doctor really has interaction with the child and expects the child to be a part of the conversation too. Even if it's you, right? It's it's not just I'm talking to your parent, and you're off in the corner playing on your iPad, because I don't give two hoots about talking to you. I'm just going to look at your data. In my opinion, if it was my child, that's not the kind of practitioner I want. My child needs to be engaged in that visit, even if they're three years old. And the doctor just asks, Where do you like to put your pump? Or which finger Do you like to stick or write? I mean, there needs to be and that those are questions again, that you can ask ahead of time. How do you work with kids? Yeah,

Scott Benner 42:35
and that's good, because it might not be so important in the moment, but it's important for when your kids 25 and feels comfortable talking to their doctor about their diabetes, right? Yeah, I our endo is very good about that with Arden. Because, you know, in honesty, Jenny's right, they're just they're honestly those kids are really there. So they can check their sites to make sure their sites aren't going bad. And like, you know, right, ask them, you know, the rest of the questions or to make them comfortable. And now you're making a point, though, about being an adult. I think about this all the time for Arden. I wouldn't know this if I wasn't so involved in community. But adult endos are a bit of a grab bag. Right? It there's not a ton of really good ones. And so, unfortunately, I want Yeah, I wonder how long I have to start prior to art and getting booted from a children's hospital. How old? Do they let you be at a children's hospital? You're done college 18. Is it not? If you go to college, you can keep going there because PD pediatric? That's a good question. Yeah. also find out about that.

Jennifer Smith, CDE 43:40
Yeah, I would definitely ask about that. Because I know it used to be like, when I was kicked out of my pedes it I was 18 Yeah, it didn't matter. That was in college. I was 18. And I had to switch over to a an adult and oh,

Scott Benner 43:53
yeah, I'll tell you, I might very well lead with Listen, here's Arden's records for all these years. I just need you to write some prescriptions. Can you do that for me? You got an A one c machine back there somewhere, you know what I mean? Like, like, that sort of thing. Without being cocky in a way that will make them be like not like you to like there's that's the other part of it is like you have to realize you're building a real personal relationship even though it only happens 20 minutes at a time every three months. You don't want the doctor to walk in and look you in the face again. This one? Yeah. I remember him. He didn't need me, like didn't mean like you're you need to avoid that kind of stuff. So. Alright. That makes sense to be cover that,

Unknown Speaker 44:40
I think All right, cool.

Scott Benner 44:46
So here's a pretty simple one. And now you got you go.

Jennifer Smith, CDE 44:48
Oh, I was gonna say the one. The only other thing that I would add to the end of that would also be from a prep standpoint, which is the quote, you know the question make sure that priority tubing, you have enough supplies that you're not in a rat race of establishing with a practitioner to actually get new prescriptions for things. Yeah. Because that a new new provider will usually not do, right. If they don't know you from the corner, man. They are not going to write a prescription for you just because you're in urgent need of one, but

Scott Benner 45:22
the person you're currently with would probably be happy to load you up before you moved. Yeah, right. I know. Um, one time, Kelly switched jobs, unexpectedly. Nice way of saying that, isn't it? One time? Oh, and don't worry, we're fine. But but but you know, she switched jobs unexpectedly one time. And I was right on the phone, nurse practitioner, I was like, Hey, we might have a gap in medical insurance. And she's she, I didn't even have to like, finish my sentence. She's like, Oh, okay. I'll just send all the scripts here because we bought online pharmacies. Like I'll send everything in right now. for it. I was like, thank you. There was it. So what I'm saying is that while my wife was transitioning, there was a stack of insulin in my refrigerator big enough that like, we couldn't buy hotdogs get on me. Yeah, so we're a little low on space. And, and, and that's because we had a great relationship with her. But you know, she's the one we know. So if you're going to relocate, stopped up with the person who knows you beforehand. All right. We I think we can do this one before you go. Brittany said, all of the other. By the way, there's a before I start, there's there's a question here that I don't know if we can ever, I'm going to read your question, and we're not going to do it. But it says I feel like so many of us struggle with finding the right balance of explaining diabetes, like fitting in the right amount of details. So they understand it's more than a couple of shots, but not too many details where you give, but they give you the glazed over last

Jennifer Smith, CDE 46:54
is like explaining to somebody else about

Scott Benner 46:58
just like not necessarily the how or the why or the scientific medical part. But like a, hey, if you're listening to this, someone you know, love has type one diabetes feel they need insulin for food they eat but not all carbs are equal, you know, and she goes, this is really interesting. She goes, basically, you know, could you roll all of the episodes of the podcast into a quick 30 minutes that I can hand off to another person? I don't know. I don't know if we could and at the same time, I'm I'm invigorated by the idea of trying.

Jennifer Smith, CDE 47:31
Well, actually, that strikes of funny because I had a thought the other day, like as I was, I usually try to like read or like do a little bit of journaling before bed. Just like my down mental shift. And I was thinking, we've done a lot of like informative, I was like, I wonder if somebody would take all of these and like write them into a book. I make a book for

Scott Benner 47:56
waiting for somebody to ask me to make the podcast the book. And to be perfectly honest with you. I started having that conversation with someone last year, and then it died somewhere along the way. But interestingly enough, for you know, I've written a book, I have this podcast, there's a couple of things I've done throughout my life. If you knew how many things how many irons went into the fire and never came back out of the fire again, you gotta throw a lot against the wall to make something work, you know? Yeah. Yes, you do. I'll tell you what I you know, hold on. Let's do one more quick question about that. Okay. So Brittany says all of the other type one diabetes related appointments we need to make diagnosed for nine months and just heard last week, we need to make eye appointments for my four year old what else Don't I know about? So I appointments are the, you know, the big one, right? They dilate your eyes, and they look all the way back there and they get a baseline for the health of your eye? And then you go back every year and do it again and again. Yep. Right? And what do they just tell people what they're looking forward to that.

Jennifer Smith, CDE 48:56
They're really looking at the vessels in the back of the eye? Anytime you go to an ophthalmologist, not just an optoma optometry, you know, Dr. omala, just actually has studied enough and knows, like, kind of the diseases of the eyes. And also can really focus in and do that where they dilate the eye. They look at the back of the eye. They're essentially looking at the vessels and they're looking for what are called micro like hemorrhages, or big hemorrhages, potentially, but they're looking for those vessels to have kind of opened, right. And when that happens, the eye tries to heal itself and it makes these tinier little vessels. But unfortunately, in that healing and making of little vessels, those little vessels are not as stable so they have more potential to break and or hemorrhage yet again, creating more problem in the eye so that you just we really want to establish and when I was first diagnosed, my doctor told my parents Not to have me visit the eye doctor until my blood sugar's had actually stabilized after diagnosis. Because those high blood sugars can affect so much early on, it makes

Scott Benner 50:09
it look wonky right there,

Jennifer Smith, CDE 50:11
it makes it looks wonky. So you, you really want some stability after initial diagnosis to go in and get an eye exam, right. So, you know, nine months post diagnosis certainly get been established, where is the eye health right now, whether the child has to or 80, or 96, you want to have kind of an established, this is where your eyes are, because then every year at least, you should be having new checks. And if there are problems that do end up coming up, they'll have you come in more frequently then, and there are therapies and things that they can do if there is a problem down the road. But that early on, gives you baseline, right. And for little kids, it's it's really mostly the eye doctor, really, I think of one two that many people don't really consider relevant to diabetes, but it's the dentist. Yeah, if you don't have a regular dental routine for your children with diabetes, get on board with that right now. They should be having a cleaning evaluation checkup every six months at least. Right?

Scott Benner 51:16
Yeah, it's a for a couple of reasons a diabetes, but by your kid is, you know, we always talk about it, like, you don't think of juice is a bad thing. Cuz it's medicine. You know? Oh, my kid takes Smarties by do. You know, like, there's a lot of simple sugars, especially in the beginning, when you're really learning how to keep things, they are a lot of sugar that is not followed up by much teeth brushing. So you really have to be ahead of it. And I've talked about it on here before we just one time switch juice boxes, because Arden just was sick of hers. But I had the right one meaning I could track it, it did what I wanted, it didn't have too much sugar in it. In the six months, she used the other box. And thank God she had baby teeth, teeth still, she developed 10 cavities from this different juice box. So you know, yeah. T says, Is there anything else you should be doing that she can't think of right now.

Unknown Speaker 52:13
I mean,

Jennifer Smith, CDE 52:15
you know, we always talk about like, foot health as well with diabetes, right, just from the standpoint of like nerve health and everything. podiatry. I mean,

Scott Benner 52:25
you know, taking your No, no, your four year old to the house. Yeah, this

Jennifer Smith, CDE 52:29
unless for some reason they already have been established with flat feet, or something else, or they've got shoe inserts or whatnot, obviously, you want to talk to your podiatrist and inform them. Well, now we have a diagnosis of diabetes in the picture here, as well, just to you know, I obviously chart should show them that, but you just want to bring it up.

Scott Benner 52:48
Yeah, if you don't understand the reason, foot health is so important for diabetics, if you should develop neuropathy, and you can't feel your feet now suddenly a small wound that you'd be aware of you might not be aware of any more wrapping that could be your fat goes on long enough, that can be a really terrible problem.

Jennifer Smith, CDE 53:06
Correct. And in the same vein, you know, kids are kids. I mean, sometimes my kids run around in the backyard in the nice grass without shoes on. Yeah, I mean, technically, as somebody with diabetes, and technically, you know, we're told Don't, don't not wear shoes, you know, walk in the backyard without shoes, and walk out to get the mail in the morning or whatever, you know, without my flip flops on, and, but I have feeling in my feet, no

Unknown Speaker 53:33
buttons, nobody dresses.

Jennifer Smith, CDE 53:35
But even for kids, you know, kids, sometimes they're not very like a tune to their body, right? So check your kid's feed every time you give them a bath or at night when you're taking their socks off to put them in bed. Just check their feet. And that's better than anything but don't have

Scott Benner 53:51
a paranoia around it puts don't happen. Right, right. I mean, the only thing, the only other thing I would say to Brittany is that through the years, you know, I pay a little closer attention to blood tests. I think I don't just take it's in range as an answer. So, you know, what does that mean? Am I at the low end of the range of she thought, like were in that range? Is she and you know, I'll go into it in another episode. But, you know, Arden has hypothyroidism but her labs were quote unquote, in range, but we were watching her like, shut off like a, you know, like a light. That battery was dying. Yeah. And and the doctor is like, no, she's fine. We don't treat in this range. And I was like, ooh, you treat my kid in this range. So make make with the Synthroid, you know, right, but right. I'll talk about that at some point.

Unknown Speaker 54:39
Yeah,

Jennifer Smith, CDE 54:40
I think the the only other thing I was gonna say would be um, this is a, I feel like this is a missed point entirely. And I know I've talked about it, we talked about nutrition, and kind of impact of foods and whatnot. But for kids who have diabetes, working with A good dietitian, who's a diabetes educator. Yeah. It's a great way to establish what are your child's needs? Not because they have diabetes, but as a child, what should your child be eating? How much and it's not, you know, work with somebody who really understands that it's not all about, I'm not here to talk about carbohydrates, I get it, I know how to count my carbs don't teach me how to read a label. I want to know what my kid needs, how much extra protein do they need, they're in gymnastics for hours, three times a week, or they're playing soccer, you know, two hours, four times, whatever it is, those are really important, because then the diabetes management works in to what you're

Scott Benner 55:43
feeding them. We really don't talk about, like, food as fuel. No, in America at all the way we should. And sometimes you're pushing through activities. And your body is, you know, it's it's lacking. It's eating itself to get through what it wants to do. And you're like, Look, they're fine. They're kids, kids are resilient, you know? Right, whatever stupid thing people say.

Hey, huge thanks to everybody out there for sending in their questions. And of course, the Jenny from integrated diabetes.com for coming on and checking it out. If you want to hire Jenny, you can do that at integrated diabetes.com. Okay, if you want to join the T one D exchange registry, just go to T one d exchange.org. forward slash juicebox. And you can do everything that I explained at the beginning of the podcast episode. But if you'd like to actually hear me go through the questions first, that's going to happen right now. So settle in and keep listening or jump over there to T one d exchange.org. forward slash juice box right now. And get started. Okay, guys, I'm gonna sign up for the T one D registry right here. My name is Scott, enter. My email address is Scott Juicebox podcast.com. password, phone number for added security for a one time identification code to your mobile phone. All right, do that. Who am I completing these questions for my child who is under 18. The other option is myself over 18 because I picked my child I put in hardens name. Sign up. Well, that was easy. confirmation code. That quick submit success. Your account has been created. Let's get started. Okay, now I'm going to answer the questions. Start the study. Are you and your child able to read understand English? Yes. What's your child's date of birth? was easy. I knew that. What is your child currently live which state? Okay, was easy. And the code you can also answer my child does not live in the US or US territory. Let's say. Has your child been diagnosed with Type One Diabetes? Why she has been easier child currently using insulin? Yes, I'm finished. You are all finished the screen questions? That was easy. Once you're ready, you can submit your answers. I have submitted my answers. But this is going to tell me if I'm if Arden's eligible for success your child is eligible to take part in the registry, you will now move on to the informed consent and decide to go to consent. There's some legal stuff here I say continue what is good for my son? Can I stop being the study? You or your child can stop participating at any time you will be told about new information or is there a cost related to being the study no cost? Is there a payment for taking part in the study? There is no payment for taking part in the study at this time. How will my child's or my information be kept confidential? Very, very, very. There's a lot of stuff here confidential. Okay. Now consent, I agree to take part and then type your name like a signature and agree received an email says, Oh, it's a copy of the consent form. That's lovely. That was easy. And you do a cent you're being asked to be in a research study. The purpose of this asset form is to help you decide if you want to be in the research study then you should not join this study until you've answered all the questions are answered. Okay. Who's doing the study done by the T one D Exchange and is being funded by the Helmsley charitable trust. He went to exchange we use the funding to organize the study. purpose of the study is to collect information from individuals with one D and parents of children went to India to learn more about the management of T one D, how it may change over time and how different management approaches relate to glycaemic outcomes, acute complications and use of health services So at this time, we do not have an end date for the registry, but we hope to enroll and follow a large group of people with T one D for multiple years. That's cool. And I hope that a large amount of those people come from this podcast. Alright, so we say yes to assent we have your consent you have completed the informed consent process, you are signed and dated consent form has been sent to your email. Oh, there it is. Okay, now there's a questionnaire. Before you start, you will be reading and answering the following questions on behalf of a minor. Okay. What's your child's biological sex at birth? They identify race and ethnicity. What percentage of the time does your child reside in your home? When was your child diagnosed with Type One Diabetes? You know, I don't remember the exact day. What's interesting, just put month in year how was your child diagnosed? Or it was in DK? What was your child's last day one see this one? I know

5.8 How did you or your child find out about the registry I found out from the Juicebox Podcast that's other juice box make sure you put that in their podcast Cool. Thanks. What's the highest level of education that you the parent of the parent or caregiver completed Please select only one answer. What is your the parent or caregivers current household income from all sources? How would you best describe your the parent caregivers current employment status? I think I'm employed right here on the podcast. Call that part time. What kind of health coverage does your child currently have? Who does your child see for diabetes care? And you can choose more than one like she has an endocrinologist but also a nurse practitioner he which of course we go by Be specific match practitioner got it in a certified diabetes educator. How tall is your job? I know this to Arden is five seven feet seven inches.

Unknown Speaker 1:02:21
wants to see why. I know that as well.

Scott Benner 1:02:26
Just any of her immediate biological family members have diabetes. Does your child have any other immune diseases? Seems so hypothyroidism? I look at this psoriasis is listed there. It's interesting.

Unknown Speaker 1:02:44
Is your child currently pregnant?

Scott Benner 1:02:46
No. How many biological children does your child have? Zero? Has your child ever been treated for and or diagnosed with any of the following frozen shoulder? anxiety Alzheimer's substance abuse I'm not gonna read all these let me just roll through here real quick cardiovascular disease

Unknown Speaker 1:03:07
No, no, no, no.

Scott Benner 1:03:11
It feels pretty good to be able to say no to these things. That's cool. No I should child had an ice slit transplant. No. pancreas transplant No. Types of insulin does your child take a pee next How does your child usually take insulin? insulin pump tubeless Omni pod it's very specific was also on here for if you loop you can put on here open APS Android. Oh, there's very uh, insulin, pens, oranges and helbling. Everything's here. addition to insulin. Is your child currently using medications to lower blood sugar? No. Child ever used a real time continuous glucose monitor? Yes. The dexcom g six. How many times per day? Does your child check their blood sugar with a glucose meter? Doing a little averaging here? Which glucose monitors your child use? Oh, that's easy. Contour. Next One blood glucose meter. Where's that? From a sensia Contour. Next One. Got it. Next, describe your child's experience starting in January of 2020 with Coronavirus.

No, my child has not had symptoms. And then okay. And my child did not get tested. Okay. I finished it was it I submit my answers. I've done it. I have successfully joined the T one D exchange and completed the questions. Now what's gonna happen is once a year they're going to reach out to me and ask me to update some questions. And that's it. That's all this is completely complete. pletely blinded meaning no one knows who you are. Nobody knows who your kid is. These are just questions that you're answering to help other people with type one diabetes. The T one D exchange registry is a research study conducted over time for individuals with Type One Diabetes and their supporters. Participants volunteer to provide their data for research, for example, by answering questions in an annual survey. Once enrolled, registry participants have the opportunity to sign up for other studies on various topics related to type one diabetes. The goal here is to improve knowledge of type one, help accelerate the discovery and development of new treatments, and to generate evidence to support policy or insurance coverage changes that help people with type one diabetes, all participant information is kept confidential participation is completely voluntary, your information will be kept in an encrypted database in an anonymous way, this means in place of your name, you will be issued a randomly generated identification number, opting out at any point will not affect your care. By sharing your opinions, experiences and data, you will help create the most comprehensive data set of those diagnosed with Type One Diabetes in the United States. This will advance meaningful treatment care and policy, all participation information is kept confidential. And participation is completely voluntary. This questionnaire can be done from your mobile device on the go or in the comfort of your own home. It is fast as you just heard, easy as you just heard, and confidential. As I've promised you now three times, and the T one t exchange has promised me over and over again, I asked them a million times before I did this, the online platform is very easy to use. I just did it in front of you. But I'm telling you super simple and clear. The screens are clear what to do next is clear, there's no you know what I mean? Like it's not a messy setup online, you can really see what it is you're supposed to be doing. It is not difficult to get through this. The T one D exchange, of course takes your data very seriously. That's why they are HIPAA compliant. When you register, you're assigned a unique identifier. So none of your personal identifiable information will ever be linked to the data, you provide your what I'm saying, you and the data, even though I mean, you heard what they just asked me it's not like it's a big deal or anything but you and the data are never associated to each other within the database. Nobody could. I'm so nervous talking about this, because I'm going to keep saying data and data because I jump between data and data just like it's super easy. Oh, by the way, everything you do with T when the exchange is online, you'll never be asked to go to a doctor or an in person study or anything like that. But if they have something like that in the future, that's going to be completely optional. So if you've ever wanted to support the Type One Diabetes community, and didn't know how this is a really super simple way for you to do it. And full disclosure, it supports the podcast. But I want to be absolutely clear. This is an ad. Now it doesn't mean that the T one D exchange just said Look, I'll pay you some money to be on this episode, you'll tell people about the exchange. It's not an ad like that you just hearing this is not is not making money to understand I'm saying I'm going to get some money every time one of you completes the survey. So if you're looking for a super simple way to support the T one D community research development, things like that, and the podcast without having to buy anything, right. So here's a way for you to support the podcast without $1 leave in your pocket. You don't have to get yourself an omni pod tubeless insulin pump, you don't have to get yourself a dexcom g six continuous glucose monitor. You don't have to get yourself a Contour. Next One blood glucose meter. You don't have to buy Lily's chocolates. You don't have to get some GMO glucagon through a link. Like none of that just do this thing. You'll support the podcast. Obviously, supporting goals of people with type one diabetes comes first. But if you can help the podcast at the same time, I mean, double bonus. Right? Like Bingo.

I just want to add that as you know you hear me say all the time I'm very careful about the advertisers that come on the podcast. I think you know that I believe on the pod Dexcom Contour Next One to be gold standard in their spaces and the T one D exchange gives me that same feeling. I don't know if you remember back a little while ago but the CEO of the T one D exchange, Dave Walton came on the show and I had a really interesting conversation with him. That led to more conversations that led to this opportunity. So being superduper honest, the T one D exchange has thousands of spots open and they need this data from the from thousands of people and they're not getting it. So they came to me and said we were hoping you could reach a broader audience with more people and fill these slots. So Everybody, please go. They don't just need 50 people, they don't just need 500 people, they need thousands. And I know you're all out there, I can see, I can see who's listening. So if you guys could just jump in and do this, you'd be helping them, helping me helping the podcast, helping yourself helping other people with type one diabetes, it is a win, win, win, win, win, win, win. Okay, guys, T one d exchange.org, forward slash juicebox. I put that link right there in the show notes to the podcast app. And there'll be a page at Juicebox podcast.com. But all you need to do is go to T one d exchange.org. Ford slash juice box and do the things you just heard me do. It's that simple. Thanks so much for listening to this episode of the Juicebox Podcast. We'll be back very soon. With more interviews, information, and fun. Oh, hey, I'm glad you're still here. Listen, I bought any new microphone and we had a time set up this to get it all set up for and it happened to be as I was finishing up this episode, the editing of this episode, so I recorded it. I don't know if you want to hear Jenny and I set up a microphone. But if you do keep listening,

Jennifer Smith, CDE 1:11:17
stay in place. And then I hooked on the microphone and just see where it was supposed to be. So I was

Scott Benner 1:11:22
like, clearly that's all I had to do. By the way a second ago. I decided I'm recording this because I'm going to put it at the end of the episode. I was trying to hook your microphone and microphone. So if you want to curse I'll BPL Okay, so you already hooked up your one mic, it shouldn't be that hard. This is just a USB cable just like the other one, right?

Jennifer Smith, CDE 1:11:41
Um, yes, it's got a USB cable. Again, I didn't like connected or plug it in yet. And it looks like it's got a place for like, it just got a headphone jack to

Scott Benner 1:11:51
Yes, that is not something you'll need.

Jennifer Smith, CDE 1:11:54
So just keep doing my headphones through the computer like I do. 100%

Scott Benner 1:11:57
that's for if you were doing recording and you wanted to do something where you could hear yourself before you got processed through the computer, you'd listen to that. And that's actually those dials are for that as well. So you won't need those dials either. Okay.

Jennifer Smith, CDE 1:12:13
So I don't really have to play with either of these, which I don't really know what they mean nothing

Scott Benner 1:12:17
for you to do there.

Jennifer Smith, CDE 1:12:19
Okay, so just plug this into the computer and then hopefully the microphone goes through this. I

Scott Benner 1:12:25
think it's gonna magically begin to work. Let's see. I'm just finishing an episode that's gonna go up now, but with you and I, oh, yeah, I can ask Scott and Jenny episode.

Jennifer Smith, CDE 1:12:38
Oh, nice. Yay. Okay, I've got like a little blue light on this thing in the jigger. Okay. It's all fancy. Like I walked into my office, I set it up, like, at night, it was like 10 o'clock, because then everybody's asleep, right? And nobody bugs me. And little boys aren't like, Can I play with the buttons and like, dial everything and like, see how the arm works and whatever. Yeah. And so then I walked into my office the other day, and I was like, outside my office being completely deranged right now because we'll be doing the floor and everything in it. So everything works for it. This is art and stuff from

Scott Benner 1:13:11
her room or painting her room. Everything of hers is behind me right now. So I hear you.

Jennifer Smith, CDE 1:13:16
Yes, if you could see the floor, it looks it's like a disaster. for it. They walked in and I was like, outside of the horrid stuff. I was like, my desk actually looks like it looks like like a studio.

Scott Benner 1:13:30
Kind of is. So um, alright, so I think what you need to do is go you're Are you in zoom the application? Are you on zoom online, you have the application zoom on your, on your computer, right?

Jennifer Smith, CDE 1:13:43
I do have the zoom app on my computer, and that I clicked the link that you sent me in the the message and I just pulled up my messenger messages on my computer. And I just clicked the link through the messages. So I'm assuming it's coming through the app on my computer.

Scott Benner 1:13:59
So top left of your so when you click on the zoom window and activate it, you should see on the top left of your screen and your Apple it should say zoom.us next Yeah. Okay, good. So go up to that and then go down to preferences. Yep. And microphone. What's the show?

Jennifer Smith, CDE 1:14:18
I have? Oh, yeah. So it's on audio already. And then

Scott Benner 1:14:22
this is a microphone microphone on turn. All right now,

Jennifer Smith, CDE 1:14:26
it looks like it says built in microphone. internal microphone. Yes.

Scott Benner 1:14:31
Click on that. And then the new microphone should be there as well.

Jennifer Smith, CDE 1:14:34
Yes. And click on there.

Scott Benner 1:14:36
Yeah. Okay. Oh is the volume all the way up the volume slider underneath of it.

Jennifer Smith, CDE 1:14:41
The volume slide is like a little bit down lower than half. We should

Scott Benner 1:14:46
all the way to the top. Let's see what happens at the top.

Jennifer Smith, CDE 1:14:51
Hello, move, move, move, move, move. almost to the top. Wow.

Scott Benner 1:14:58
Okay, let's try halfway.

Jennifer Smith, CDE 1:15:02
Alright, let's see here. Oh, I don't know what it's, it's not sliding down. Now, let's just

Scott Benner 1:15:11
click on it. You can click on the dot and then drag it.

Jennifer Smith, CDE 1:15:16
It's not dragging for me. It's not doing anything. It's kind of weird. Did you click on automatically adjust microphone volume by mistake? Oh, let's take that off. There. So now it's in the now it's in the middle.

Scott Benner 1:15:28
Okay. So, now you can see, I my microphone is different than yours, but I'm up on my mic, right? Yes, I'm like, about next to it like next to him. I don't want you to have to be that much. So let's try bringing it How far are we from your face right now, I guess. Jenny's measuring with their fingers, probably about 434 inches. Okay, three inches, so try bringing it a little closer. But there are that,

Unknown Speaker 1:16:00
hey, that's like, two inches right

Scott Benner 1:16:03
there. Whoo. It sounds really good.

Jennifer Smith, CDE 1:16:05
Okay, I'll have to just mark this little like, space. Well, like, I feel like I like cfcu. Because the microphones like covering. I know,

Scott Benner 1:16:14
I feel the same way. Sometimes. Actually, there are times when people say you go away from the mic. It's because I'm looking at a person and I kind of turn my face to try to feel more like something which is not the there's not good, better, better, they can hear us. Cool. So I'm with you at that desk. Here's why I like you at that distance. Because when that slider was higher, we were getting a little noise but but slide that slider up just a little bit more. And let me see where the noise comes in.

Unknown Speaker 1:16:43
See.

Jennifer Smith, CDE 1:16:47
So now it's at like three quarters.

Scott Benner 1:16:50
And there's a little bit of noise. So slide it down. Go back a little bit. I'm trying to get it so that's louder, and you can take the mic a little farther away from your mouth, if that makes sense.

Jennifer Smith, CDE 1:16:59
So now it's probably at like 60% of the way towards full volume. I love this.

Scott Benner 1:17:04
This sounds terrific. It really really does sound good. Yay. Oh, I'm so excited. I'm glad it's because this good.

Jennifer Smith, CDE 1:17:13
I don't I don't hear anything like different but I also don't do this, like, you know, I don't record and do all of the listening and the editing. So I don't hear the differences. Yeah,

Scott Benner 1:17:23
it is literally not going to sound any different here, but it's just gonna be way better for the people listening. So this actually ended up being Oh, I lost my ears for a second. But I know why give me a second. Um, hold on one second.

Jennifer Smith, CDE 1:17:38
Yeah, thank my my tea and like slosh around the ice cubes anymore. While we're actually

Scott Benner 1:17:44
because the irony here everything The irony is, is that microphone is going to hear less of the background in your room than they did. So that one is more just right here around your mouth. Because interest. It's so odd the way this worked out. Because you and I set up this microphone test randomly. And I spent the morning editing an episode, the episode that made me think I am buying Jenny a new microphone. Because there was something I don't know if you remember we must have recorded How would you remember this was like April right? As Corona was starting. We did an ask Scott and Jenny, which is this episode right here. Okay, um, because I'm just going to leave this conversation at the end of it so people can hear it. And there was a noise behind you. And we couldn't get rid of it. And we were like, Is it the fan from your computer? You remember? So there's some small noise in the background? That that microphone was just picking it up? Right?

Jennifer Smith, CDE 1:18:38
Yeah, I remember picking up the mic that I had, which is a much better mic than I had ever had before. And I was like moving it around. You're like Yep, nope, I can still hear it. I can still hear I don't know what else

Scott Benner 1:18:50
was picking something up in the room, right like a background noise in the room. And so I'm getting a text that Arden is hungry. One second. Apparently I'm the short order cook. today. I would never say this in front of my wife. But when we're both working for home, I think to her Her work is more important than mine. So when something like this comes up, I tend to be the verse that takes a break and goes and handles it. But I'm not complaining. It's fine. No. But anyway, yeah, like so we're recording and there's this background noise and you're talking I'm really interested. And then I'm just annoyed by the noise and I thought yeah, I have to get any better microphones so you have a much better microphone now. And you sound super clear. As a matter of fact, in an hour or two when this is on the internet, you should go listen to some of it from the beginning and then and then listen to this you'll be totally different in the difference in it. I am jacked up excited about this. This is a really great thank you and you don't have anything else to do so. Is it okay like you'll be able to keep it out of your way when you don't need it like or Yeah,

Jennifer Smith, CDE 1:19:52
absolutely the arm is really actually quite nice because I it did come the microphone itself came with like a stand to pop it up.

Scott Benner 1:19:59
I saw that. I didn't like that though, for you

Jennifer Smith, CDE 1:20:02
that Yeah, the nice thing is that this I can just slide off to the side and pot often over. Um, so yeah,

Scott Benner 1:20:10
plus Thank you very much. No, please, thank you. Here's some stuff you don't know about yourself when you're being when you're making a point. You bang the table. Do I really you get excited? You're like, you bang the table. So I couldn't give you the mic stand on the table because it would like go think when you were doing that that was and so I'm like, I she can't have that. That's why when I didn't by the way for anyone listening I did not force Jenny. I said Do you want a boom arm? Or do you want a table? She got the pic. And but when you said you under the boom arm? I was quietly like, yes. Okay, that's gonna be better. But you're gonna use this now for your calls. Now? I would imagine, right?

Jennifer Smith, CDE 1:20:45
I guess I certainly could try it and see if the call like, if the noise and everything is certainly better, especially since you said that it deletes much of the noise in the background. I mean, I do work from home. So especially with everything the way that it is now and the fact that my upcoming second grader will be virtually school from home.

Unknown Speaker 1:21:06
I'm ever feeling it was gonna be on the podcast sometime this year.

Unknown Speaker 1:21:10
Or noise? background.

Jennifer Smith, CDE 1:21:12
But that'll be kind of nice. Because if I do use this, I would expect that then maybe some of that background noise will be less Yeah, I'm can't guarantee that my 85 pound chocolate lab barking will be completely gone. But

Scott Benner 1:21:26
no, no, this is a way to you just hear those a clarity in your voice now. And like a like a, I think you would call it a timber. Like there's a depth to it that didn't exist before. So isn't there's perfect? Listen, we never do this. But when we're going to record on Friday, let's see. Can we do an episode of you and I talking to significant others in people's lives, teachers, co workers, family members and explain diabetes to them. Like this is the first time they're hearing about it.

Jennifer Smith, CDE 1:21:57
Like layman's term? Well,

Scott Benner 1:21:59
well, so like imagine you get diagnosed or you have type one and you have people around you who want to know more, but it's overwhelming to explain it to them. I want them to be able to say here's an episode of this podcast. It will explain diabetes too. Can we do though? That sounds fun. I think we can. Okay, absolutely. All right. You go back to your life. This is super exciting. I will send you a text when this is available so you can hear it. Thanks Scott. CJ, you want to say goodbye to the people are gonna hear

Jennifer Smith, CDE 1:22:23
Bye bye. Bye

Scott Benner 1:22:27
bye. See you