#575 United in Manchester

Bob has type 1 diabetes and so do his children.

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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
Alright friends, this is episode 575 of the Juicebox Podcast

Bob comes to us today from Manchester, England, he has type one diabetes, and he has children with type one diabetes. He's an absolute delight to speak to. And I think you're gonna really enjoy this. I have nothing else to say about that. So, you know, settle in and soak up, Bob. Please remember while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, please Always consult a physician before making any changes to your health care plan, or becoming bold with insulin. For those of you who are worried right now that I'm going to do a ton of bad British accents and things like that. I don't even do it once. Never. That was it. I'm just I shied away from it. I'm embarrassed. I didn't try. If you're a US resident who has type one diabetes or a US resident who is the caregiver of someone with type one, please consider going to T one D exchange.org. Forward slash juice box and taking the brief survey that will help people with type one diabetes and support the show T one D exchange.org. Forward slash juice box

this show is sponsored today by the glucagon that my daughter carries G voc hypo penne Find out more at G voc glucagon.com. Forward slash Juicebox. Podcast is also sponsored by touched by type one, you can learn more about them at touched by type one.org. Also on Facebook, and Instagram.

Bob 1:55
I think I mentioned my email I used to do podcasts for like a board game. I used to play X Wing Little Star Wars spaceships. Yeah, that's that's really popular, you know, they're getting, they're still doing the show. And it's been about 1000 listens a week, something like that. So that's pretty good. And it was it was just such effort. And then when we started the idea was we do a number of short shows every week, sort of 1520 minutes, but there was just too much to talk about, particularly when I was on I can go on and on. So it just got a bit out of hand. And then I'm not playing so much anymore. So I'll let the other guys take out with that. But I kind of miss it. And I do like listening to myself, which is quite advice.

Scott Benner 2:39
Yeah, I think that's a mental illness. I don't actually, I'll listen once in a while to make sure like I'll pop open different players and different apps, there's just see that the show sounding the same over different platforms. And you know, sometimes you'll throw it on on the cars through headsets just to listen to my daughter's like, are you listening to your own podcast? I'm not just checking the audio, and then I'll like laugh and she'll go just laugh at yourself. And I went no, no, I don't think so. So

Bob 3:07
I did use to catch myself sometimes I've listened in a couple of weeks after it came out. I'm like, actually, that's a really good gag. Well done. Well done. They're funny.

Scott Benner 3:16
Yeah, you know, it's possible you do have a problem. And you're like, Oh, that guy's hilarious.

Bob 3:21
Yeah, absolutely. Absolutely.

Scott Benner 3:23
I just think that anyone who does it for a long time, and it and it doesn't generate money. That's a passion because it takes so much time. Like I don't, I mean, honestly, at the rate that I put podcasts out, if it didn't have advertisers, I just couldn't do this. Like I you know, I wouldn't be able to people who do um, I know that a lot of people in the internet like age or are trying to make businesses and places that maybe people don't see businesses all the time. And it's amazing, but it's a ton of effort especially to get to the end and find out that you had a lot of fun, but it didn't it didn't catch on with enough people for it to become like a viable thing that you could keep doing. It's just it's a ton of work. So I think with you

Bob 4:09
the advertisers are pretty cool. I mean, it's very directly because of because of juice box that I got an omni pod. And yeah, absolutely, absolutely understand. And I got a control next as well as a result and all that sort of stuff because you hear about these products and literally I trust you. And because I listened to what you say I do the things you told me to do, and it kind of works it doesn't work stunningly but it works a hell of a lot better than it was doing before. I mean I'm not one of those flatline guys, I still I still bump around quite a bit but then I have a really very diet so that doesn't help. And I'm you know, I'm pretty happy where I am and that sort of 6.1 with a one C which is much better than it was even two or three years ago. But it's the tech the tech it's amazing. Yeah, and you can

Scott Benner 4:56
do me this favor because I liked what you just said I want to leave it in So Introduce yourself very quickly.

Bob 5:02
Okay. Hi, I'm buddy. I live in Manchester in the UK. And I was diagnosed with type one diabetes all the way back in 1985 85.

Scott Benner 5:13
Wow. How old are you? How old? Were you?

Bob 5:18
I was 30. Shortly before my birthday, we do the mouse.

Scott Benner 5:24
Oh, so you and I are almost the exact same age. Yeah, pretty much. Pretty much. Yeah, no kidding. That's interesting. You know, it's funny, because you're just talking about, you know, finding, you know, technology and things are better, but they're not, you know, super flat all the time. But you come from a time where just the expectations were so much different, right? Like, oh, yeah,

Bob 5:49
it was when I was diagnosed, the the regime was humanite and cumin s, mixed together. And they were both good for about 12 hours, although nobody suggested that I should take them 12 hours apart that might have helped. And the the diet was 50 grams of carbs for breakfast, 20 grams in the middle of the morning. 50 grams of carb for lunch, 10 grams in the middle of the afternoon. 50 grams in the evening and 20 grams before bed. And that was every day. And I was I was 13 when I was diagnosed. And we stuck to that for maybe two or three years. And then I was a sort of I was teenage, I got into going out and having fun and misbehaving. And I discovered that I could sort of skip the snacks and not hypo. And that was okay. And then my dose adjustment because I hated doing fingerprints, absolutely hated fingerprints. And in fact, when I was diagnosed, we weren't sent home sent home with a fingerprint kit. We were sent home with urine tests. And the idea was I do one of those every day, but they're basically meaningless. So I had no real idea of what was going on. And then HBA would see checks came in after a while and I got a finger stick set after a bit and the doctor's advice was maybe try and do one every day, just to see where you are. And it was my numbers actually weren't when awful. I think the first time I had an HBase on seat, I was something around probably about an eight. So it wasn't it wasn't completely out of control. At the school I was at there was a lot of exercise exercise was every single day, seven days a week. So that probably helped quite a lot. But the only dietary change was don't eat sugar in anything, any product with with granulated sugar in you just don't do. It doesn't matter whether it's it's chocolate cake with a load of cream, or jelly babies, which are basically pure sugar just don't have any white sugar products at all ever. Unless you're low, at which point you can have a dexterous tablet. And that was that was the regime.

Scott Benner 7:58
Yeah, for years,

Bob 8:00
years and years. I mean, as I say, I didn't stick to the diet so much. And I got to university when I was 1819 90. And then I had about 10 years where I knew that I should change doses. But the doctors weren't particularly useful on suggesting trenches. And at that stage, you know, I was okay, I felt good. The HBA one sees a hand we're by the standards of those times. Okay, so I didn't go every every six months or even every year to see a doctor. I'd skip them. I was moving around quite a lot with University I studied at Oxford and then had two years in London, before coming to Manchester. So what I did was, I would just up my doughnuts every now and again. Until I found I was quite regularly hypo. Which isn't isn't smart, really hindsight.

Scott Benner 8:51
You know, it makes me wonder. So if we, if we took this step of defining type one diabetes, by its management, and not the not the actual impact on your body, or that kind of stuff, and we just defined a disease by its management. You have a completely different diabetes today than you did then. These are these terms. They don't recognize each other at all.

Bob 9:16
It's it's been kind of a step change I moved in. It was only probably about 2010 that I moved to Lantus lodging and Nova rapids and the traditional sort of modern Basal Bolus technique and that that did help me the problem again with that was they would tell me what doses to use, and they just sort of said, well see how you get on. See what see what works. do plenty of finger sticks, and I'd always be very much don't talk about diabetes. I am not disabled. I don't have a disability. I can do anything. And I did. My wife and I we traveled all over the world. I did bungee jumps in New Zealand. I flew from Manchester to Las Vegas. For 48 hour weekends where I didn't sleep, I didn't want to get on the plane. And I had a genuinely sort of crazy time for my young adult life. Until, yeah, 2010, they sent me home with the the new regime, Basal Bolus, said, see how you get along. And there wasn't really even a broad idea. I didn't know whether I was taking 40 units, or Basal or 20. So I just sort of experimented a bit and worked it out. And at that stage, I was still having some pretty catastrophic iPads. They now happily are a thing of the past. But over time, I've been hospitalized a few times. And my wife still talks of the time when, you know, I'm doing this guys would come out and think of myself as a particularly sort of big or strong guy, but it would it will take two guys to hold me down while they've got some glucagon in me. Because I'd be thrashing about so vigorously. Yeah. It's it's, one thing was I never learned to be particularly terrified of hypose in the way that some people seem to be, you know, dead in bed was not a phrase I heard when I was introduced to diabetes. And it wasn't a phrase I heard until the last five or six years, I understood they could be lethal. But that happened quite a bit. And I seem to get over it. And that was that was okay. I mean, it's obviously a very bad idea. But it was sound. Management just wasn't great.

Scott Benner 11:32
No, it's fascinating because you live through a tectonic shift in the way insulin worked. And so many people have that I've spoken to, but I mean, you really were, yeah, I sort of put it the same way every time. But they basically gave you some insulin and then told you eat on a schedule, eat about these many carbs. And if you're a one sees we're in the eights, then that makes, I mean, let's look for a second, I'm gonna pull up this thing real quickly. Never really thought about like this before. But if you're a one sees we're in the eights, then your average blood sugar was like 183, most that was an average or 10.2 for people working outside of the states. So that's your average blood sugar. And you have no real idea if you're achieving an eight a one C, because you're 50 for most of the time, and 400 Most of the time, the variability was never even, I mean, couldn't measure it, so there'd be no way to track it.

Bob 12:30
I mean, I didn't know at that stage that you didn't want your HVAC to be too low, because that would suggest that you're having too many hypose. And I mean, there are still some dinosaur doctors around to who say that kind of stuff. Because in those days, because you couldn't really measure the timing range or the level of fluctuation. The only way you're getting an HBO once the low was by spending a lot of time too low. Yeah. And then you bounced back up high. And so it was actually discouraged to be too low. I think I had something like a equivalent about 7.5. And the doctor was like, Well, you don't want to go a lot lower than that, you know, you'll be high paying a lot if you do. And that. I mean, it was just a different time. And I think what people don't get now is how really difficult it used to be. I mean, I am, I always sort of thought that I probably won't die with diabetes and the stuff that they do with the drugs now, which is pretty incredible. But it's more I'm actually in a really good place with it because of the technology. Compared to how things were really up to about well ready to buy my daughter was was diagnosed herself in about 2015.

Scott Benner 13:45
Is that what so you weren't, you weren't even using like faster acting insolence. Until, until that time, right?

Bob 13:53
I've gotten to know rapid maybe I don't know exactly when it was I think was about 2010 2011. And I remember I go to the summer music festival most years. And that's like a huge three square mile site with 300,000 people on it. It's all complete mayhem. Um, it's it's one of the few music festivals where it's just like a single site where all the camping is enclosed with the the stages, and there's like 90 stages. And I remember being there in probably 2007 And I've gone out for like an early morning walk and left my insulin at the time. And I remember thinking, I've got needles on me, but I don't have my vials of insulin. If somebody stops me at a music festival, for whatever reason and confines I've got needles on me, without any insulin to go now. That's the reason that's the reason I'm going to have a very uncomfortable day. And I remember the the rain started and it was like really quite dangerous. There was lightning coming down and all sorts of stuff. And they closed off parts of the site and I was stuck away from my incident. And there was just an no flexibility in the regime at all. So the potential for that being a problem was was really serious. Whereas with a Bolus Basal? Well, yeah. Okay, you had to you had to Basal. But take your bonus when you get around to having some breakfast. It's fine. And so yeah, that was that was 2007 I think so it was only after that I got into the faster acting stuff. But still, I was very much I can do anything, don't talk to me about diabetes, it's my problem, I'll manage it. I don't want to discuss it with anybody. I had, by that stage, a brilliant diabetes specialist nurse at my local practice on a local GP practice. And he sort of said some things to me like, well, you know, we can change this insulin. So I did, and that seemed to be better. Maybe you should get some education. Maybe he just, you know, find out a little bit more about it. Like, well, no, that's time off work. I don't want to do that. And I'm fine. Look at my experiences there. They're actually okay, because I was still living in a world where, and I was really pretty good.

Scott Benner 16:00
Yeah. Well, it's interesting, isn't it that, that when you really look like now from this distance away, that even at that time, it's not as if I wonder, I wonder, I'm trying to think of how I want to say this. It's not as if there was this rock solid way to manage diabetes in 1985. And doctors were like, here it is, this is the best thing we understand. And it works. It was just the best thing they understood. And I don't even know how well they understood it. Because if they understood it that well, when they handed you Novo rapid later, there would have been a lot of trepidation, they would have said, Hey, this insulin doesn't work anything like the insolence you've used prior. This is going to be a dangerous situation, we really need to figure out what this but they were just like, here it is. Now you figure that out.

Bob 16:48
Yeah, that's exactly how it was. And it was a little bit scary. I remember the first couple of days, I was traveling to Liverpool to do some work. And I was on the train and thought, I do not feel good. I really don't feel good. And I remember cramming sugar in before arriving at the meeting, whatever it was, I was going to it was quite scary making the switch because I thought I was doing okay, I thought I sold diabetes and sold my relationship with diabetes back in 1985. And, you know, it was as good as it was going to get. So just deal with it. And I didn't really pay a lot of attention to it. And I think, with hindsight, and I feel really lucky that something quite serious didn't happen to me. I mean, I go into my kidney checks and my checks and stuff, because I am I remain terrified of protecting my site. Well, the site is super important.

Scott Benner 17:46
No, of course and but besides the long term, things that you're worried about, I find that that, that transfer from those older insulins to the newer insulins, there are an entire generation of people living with type one diabetes that lived through that, who are all lucky to still be standing because of the lack of training, they were given about how to use the new insulin. And I'm saying that I don't think that many doctors knew the chasm that stood between regular and mph and, you know, a faster acting Novolog or Nova rapid or something like that, that these were these were two, basically two different drugs, just because they're both insulin didn't make their function even very similar. I mean, before you were just putting in a bunch, you're basically throwing on a heavy weight of insulin on top of you and then just eating at certain times to prop it up. But now they're giving you insulin that works quickly, and draws your blood sugar down really fast. And your your regular and mph didn't do that. That was that was never how they worked. And it's just it's I mean, it would be like if I gave you I don't know, like a a big pill bottle full of heart medication. And I said you about I don't know how many of these you're supposed to take you go ahead and figure that out yourself.

Bob 19:03
Just yet. Yeah, that's that's that's pretty much exactly what they said. Yeah, it just they didn't know. Well, CGM wasn't remotely a thing at that stage. So you could either do fingerprints every half hour, forget that. Or you could wait until CGM came along and try and understand diabetes. Right?

Scott Benner 19:21
Well, I think I'm sorry. I think it's important for people to hear because there is a difference between the machine that is healthcare and you and your personal story. So they're not the same thing. You know, the world is moving forward, insulins become faster. pumps work differently. You know, we keep moving forward. You have to keep up with that yourself personally, because no one really has the time or the wherewithal to go back to every person who learned befores way and reeducate them, you was difficult enough to educate you the first time. So it is a very personal thing that you need to do is to pay attention to the fact that what the machine is doing, what the world is doing and what you're doing. The goals are not aligned normally.

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Bob 22:13
I mean, in practical terms, it's considerably easier to do that now. Because we have an internet. And you know, it's it's really easy to reach out and speak to people and meet people like me, which was was just impossible. 1015 20 years ago, and I remember going to university. And there was a second year there was a Lasu was a first year student she said oh, I gather that you and I have something in common? And she said oh, well, I've got diabetes, too. I was like, Look, I've never had a conversation with somebody else with diabetes. That's not That's not part of my life. I like to share with anybody else just and I never spoke to that girl again. And looking back on it, I think you absolutely can't. And I would have found thing to do to any other human being. And she was reaching out and trying probably the first person that she'd ever met, who had Taekwondo, she was new university turned around from home, trying to reach out make friends. And I just thrust it away from myself because I'm just not going anywhere near this. I do my injections, I eat my food, and everybody else can forget about it. It's not their problem. And it was it that is part of the problem with with education. And the way that medicines moving forward really quickly. And people aren't receiving education at the same pace, as scientific developments are moving forward. And that's a real shame. I mean, there's so many people who are struggling. And I just think that's just not necessary. You don't need to do that. And, you know, learn a little and get the meds,

Scott Benner 23:42
you have to have the energy and the information and the confidence. And there's just a lot you have to have before you start. And it's it's difficult to collect up all those tools when you don't even know what half of them are supposed to be. And you're already struggling. Like I mean, I'm obviously you you felt badly enough about it. But I'm thinking about that girl, like, you might have been like to her, you might have been a lifeline to her. And you're just in two different places. And she's may, you know, gosh, you think like maybe it was hard for her to say that to you. And then you know, it does make you wonder and not I'm not talking about you personally, I'm talking about everybody in general with everybody feels that way. And there's no one to reach to. And and how do you find these people? Like you said prior to the internet, there's no one out there. You can't can't make those kinds of connections. Well, I think it would be interesting to know from you if you have perspective on it. Because you live for so long the way you did and then you had a long transition through faster acting insulin before you got to see data that helps you understand it. Are you fundable? Are you fundamentally a different human being today than you were then because of insulin?

Bob 24:57
Yeah, I think well for me The big step on the journey was when my daughter was diagnosed when she was 13 years old, about five years ago. And I, we were, we've been away, I think I might, and the kids have been staying with my mom and dad. And we got there. And my mom said, Look, she's drinking an awful lot of water. And I think you probably want to test her blood. And I got the because at that stage, still finger sticks, got the finger sticks that are on, she was 20 something. And we drove it to our local hospital about an hour away from my mum and dad's. And there was quite a lot of tears in the car on the way home. And we knew then that she was was joining me in the tribe. And my wife was quite upset about it. Partly because I'd had such a not a bad attitude. But I'd been so private about it, it just wasn't something I wanted to be discussed. And my wife and I very rarely spoke about diabetes, even after something quite dramatic, dramatic have happened like like the the paramedics turning up. And I would just get really angry about any discussion of it. And we walked into that hospital, she was diagnosed, and I just sat there thinking, Well, I know all this stuff, that they're about to tell her. I know what I'm doing with this Basal Bolus business. And I sat down and listened to the education that she was getting, which was was really pretty good for newly diagnosed. And I after an hour or two, I started listening. And I realized that in the whatever it was 30 years since my diagnosis, actually, the doctors have been doing quite a bit of work. And they'd learned quite a lot of stuff. And it was stuff that I really needed to find out more about. And that really changed me, as a person, it wasn't so much that the incidence of change because I was still walking around in the dark without being properly educated. And her diagnosis really changed how I felt about diabetes, because I knew that it was going to be a part of her, it was going to be whether she liked it or not as integral to as her eye color, or how tall she is wishing that she was taller, or shorter, or fat or fatter or thinner or it's a different color dice is is just wishing, you know she's not going to grow any any taller. And she's not going to be any less tight one. And at that point, I stopped ignoring it. Because with a 13 year old, it was impossible to ignore. And I started to kind of think, well, I can either hate this, or I can get with it, and do well at it not just for her to make sure that her numbers are as good as they can be, but also for me. And I went in for another meet with my fantastic specialist nurse. And she said, Well, you should do this training course. And they have a four day training course they do locally. And it's single day over about four weeks. And I went in and sat down in a room. And it was the first time I had shared my life with diabetes with anybody else. And it was it was a slightly odd experience because obviously only bloke that there were 10 people in the room. And this was for quite a long period. And I was the only guy in the room with predominantly middle aged women, some some a little younger, for four days just talking through diabetes. And I think maybe because it was it was predominantly women, there was more discussion of feelings about diabetes with the education. And it just opened my my minds completely to the fact that I've kind of been hiding from it. For 30 years I haven't really got to grips with with who I was. And I've had quite long periods of pretty bad depression after the millennium, and I and they were you know, reasonably serious. I knew what time the last train from London past the the railway station which was a mile away from my house just in case I ever decided to go and stand in front of it. You know, I'd given real thought to I can't cope with life. And really, I hadn't analyzed in that way. But in fact I couldn't wasn't dealing with my diabetes. I wasn't embracing it. I wasn't getting on board with it. I felt that I wasn't in charge of my own body. stuff would happen that I couldn't predict that might well kill me before too long. And I was really struggling to deal with it. But then when my daughter was diagnosed, she sort of opened the door for me to start liking is probably the one word wrong word but certainly accepting diabetes into my life and it's almost a religious thing for me.

Scott Benner 29:42
Did you do it for yourself? Or do you do it for her or do you not think about it that way?

Bob 29:49
So sorry, seconds but I'm wondering

Scott Benner 29:50
if it felt like you were doing it for yourself or doing it for her. I mean, do you look at her beaten diagnosed and think oh, this is Gonna be her life, she's gonna hide a part of herself, pass out a lot and be depressed. He's like, did you look at her and feel like, like, your experience was gonna end up being hers if you didn't do something

Bob 30:14
to an extent, I think that probably puts it a bit higher than than how I felt because yet, alright, diabetes is a massive pain. But I've had a fantastic life. I mean, I talked about the depression. And and that was just so illogical, you know, I have a job that is reasonably high status, reasonably high income. It's fairly interesting most of the time, and I live in a lovely part of the world. There's a load of pubs within three minutes walk from me, which seems to be down to the ground. My wife is great, we have a great relationship, and I have nothing to be unhappy about. And yet, I still had this depression. And looking to to her when she was diagnosed, it was I didn't really see all the problems that I'd had as massive problems, because you play the hand that you're dealt, you just get on with stuff. And I certainly wasn't wasn't miserable about it, I just distance myself from it and looked at it as an administrative chore rather than a medical trauma. Yeah, even though we were having paramedics round at three o'clock in the morning. That's kind of weird.

Scott Benner 31:18
Yeah, that's why you couldn't talk to the girl at school, because you didn't have any real feelings about it. You were just, it was all nuts and bolts, you were just taking the steps that you were supposed to take at the right time. And then never thinking about it again, I imagine that for most of your life, most of the day, you did not consider diabetes at all.

Bob 31:37
No, no, no go for. I mean, it became almost an automatic process, were you having this many minutes in the evening this morning, try and make sure you remember to have lunch, otherwise, you'll be might go low. became a very sort of automatic process. And, and it was something I found very, very difficult to talk about with anybody. But when when Isabel joined me in the tribe, she, it was very difficult to load that anymore. She is an amazing girl. And it's very difficult to dislike any any part of her. She is a phenomenal young woman. And I'm extraordinarily proud of her like like every parents of their kids. And if she has diabetes, then I'll be extraordinarily proud of everything she does with her diabetes. So it doesn't make her smaller, makes it bigger, it doesn't make a weaker, it makes you stronger.

Scott Benner 32:28
So it tangibly speaking, if you ignore your own diabetes, or you allow yourself to treat it, like it's not a part of you, then you can't treat your daughter the way you want to treat her. You can't you can't see her the way you want to see her and how you have seen and treated her prior to this. So that's the shift right there. Like her diabetes probably saves you from the rest of your life being segmented up like it was.

Bob 33:01
Yeah, very much very much. And, and it was really, I think, psychologically, her being diagnosed made me engage with it, because I enjoy engaging with her. I enjoy being part of her life. And it's big for me. And I couldn't take diabetes away from that. So that prompted me to go and get some, some education and sit in a room with people like me, many of whom had been through the same kind of experiences at school and through their, their 20s with these older insolence. And we all had the same kind of common experience. So not really knowing how to deal with it. And we have this education. And it was it was just mind blowing. So it didn't work. It didn't work. But it was just the ideas were fantastic. And the knowledge was fundamental to everything I'm trying to do now. But it did not get me to where I wanted to be.

Scott Benner 33:56
Well, I asked you about that in a second. But, but it's just fascinating that, like a personal human connection is really what you lacked. And it's just so it just it runs right through every part of life. But I mean, it's one of those things that sounds obvious when you hear it said but yet it troubles and and weighs on so many people just isolation of any kind can be so difficult. I'm just I'm very much reminded of the notes that I get from adults who who want to tell me about how they've had diabetes for a long time and that the podcast has allowed them to hear people with type one. And they've never met anybody with type one prior something like that. It's just very cool that you're that you and your daughter got to be the beginning of your own little community then you branch out so you go to this class, but the class you said as as probably cathartic as it was for you emotionally it wasn't that valuable. management wise.

Bob 34:54
Well, it wasn't because the sea change on management is CGM. When I say CGM in the UK, Libre is huge, because it's NHS funding, whereas getting Dexcom funding on our system is really very difficult. So everyone's using the brain. And that really enabled me to manage my diabetes actively. But just the teaching, I had that that class as to how insulins were working. And as to how you could judge Basal and Bolus and get them into a better spot was was really useful. And the dietary advice about how carbohydrates worked, and how mixing carbohydrates with fats and proteins would alter the impact of those carbs was just really valuable to enable me to understand why my body was doing some of the things I didn't want it to do, I didn't really have a solution at that stage because it's it's bumping and nudging, and it's very difficult to bump a nudge within six, we'll need to be doing an awful lot of them. But the the human side of that class was fantastic. I made really good friends, my friend Jill, who struggled and struggled with her tight one. And she messaged me about two weeks ago, she was celebrating her first week of being 100% in range. And she's come a long way. I mean, she exercises a hell of a lot. She's a big dancer, and she cycles. And that is a good thing. But it does impact on management. And she's also a very low carb person. And and she struggled for years and years to get the numbers of the comptroller just had this last week of 100% in range, which is, is fantastic. I think back to when we met maybe five years ago in that room, and how difficult she was finding stuff and how she just didn't understand how she would go to bed a sudden wake up at 19.

Scott Benner 36:47
I, as you're talking, it occurs to me that I don't feel the full weight of the podcast. I just I don't I don't I don't know that I ever am going to I guess. Because as you're talking I feel I don't know, Gil, right? I don't even know you. And I I'm so elated for her as you're telling me that story. And I just It just occurred to me, I was like, I really don't. I don't know, you know, I guess unless I have diabetes one day, I'm never gonna really understand. But

Bob 37:24
what I mean, I'm not a big fan of, you've not had this experience. So you can't comprehend what it's like, you know, if I go to the North Pole, I'm taking a big coat, I understand it's going to be cold. But I do feel that with with Taiwan, maybe like other I use the word carefully. But invisible disabilities. Design disabled does not mean less abled, it just means you have a long term medical condition that has an impact on your life on a day to day basis. And that is absolutely diabetes. And the legal definition applies to us. So invisible disabilities are really hard to deal with, because they are very lonely. Yeah, you know, we can reach out and just see people living your life.

Scott Benner 38:05
So just because I'm good at talking about how to use insulin, and maybe I'm engaging or something like that, whatever. It's, um, you're making me? Don't worry, I'm not going to do this. But I would like to right now just stop making a diabetes podcast and just pick a different topic. Because I'm realizing that I'm wondering how much more there is about other people and other things in the world? That I wish I understood. Like, I don't know what it was about how you just spoke about Jill, but I, I? I mean, I know. I don't know, you don't mean? Like, I know, I don't have diabetes. I understand it. I think I understand it as well as anybody who doesn't have it could. Yeah, right. Thank you, but I don't, but there's just, there's a human interaction between you and her. That that means something to the both of you that I can't fully make sense of. I just don't have the perspective for and I'm wondering what else I don't have the perspective for in the world. And I'm wondering, and, and these conversations are how you find it. I just want to keep having more conversations with people and trying to figure out more about the stuff I guess that I don't intersect with in the normal part of my life. I just I don't know, it was very nice. What you just said, and it made me feel good. I might be a little unclear right now because I got thrown off a little bit emotionally.

Bob 39:28
Well, I think something that you say about the podcast episodes is that the ones with people talking are amongst the most popular. Yeah. And I think for a lot of people maybe because they are the person that they know, who has diabetes and listening to to all the hundreds of people that you've spoken with and listening to their stories and how they're managing and how things are and just their massive array of life experience. Right? It diabetes isn't stop anybody from doing anything. It really doesn't matter. In order to make the most of your life with diabetes, I do think it's hugely helpful to, to know that other people out there are other people going through it. Other people are dealing with it. I mean, my wife now feels a bit lonely because she's the only person in our house without diabetes.

Scott Benner 40:17
That's a good loneliness, I guess. But, you know, it really is. I don't know, it just it's me You said something a second ago about that people find the conversational episodes more. The I see more people listen to those. And it's fascinating because when people are in the part where they're, they're mining for, for understanding about management stuff, they don't even care about those people don't really care so much about the conversations, which I think is a mistake, because I think a lot of management stuff comes out in conversations. But yeah, but neither here nor there. So what you see is on the Facebook page, those people are are, they're voraciously trying to figure out diabetes. And if I, if I were to go up and say, Hey, I have an episode, I've done this before, just kind of amuse myself, like I tomorrow, I can put up a pro tip episode where I can put up a conversation with a person who is you know, and some description of a person living with type one, overwhelmingly, those people in that space will want the management conversation. Because that's the part they're in right now. Like, it's fascinating that, that you could live for 15 or 20 years with no real idea of management. And now because of measurement tools, you actually have a real chance of figuring it out. And I just hope that after those people figure out that management stuff that they don't do what you did, and just see diabetes as Pull lever, a throw switch B go live life, I think that you can't ignore the emotional part of it, you're not going to ignore it out of existence, it is going to come get you in some way. in some form.

Bob 42:01
Yeah, right. Yeah. I mean, I also, for me, I like about technology. I like tinkering with stuff. And I almost look at myself as a, like an old car in the garage that I'm constantly working on, to make it a little bit better, and it'll never be finished. I'll never drive it out the garage. Just like I'll probably never lose the diabetes, maybe who knows. But it's probably just going to stay in the garage. I'm always gonna be out there, making sure the sparkles are working, or the carburetor or whatever it is. And I like tinkering. I like learning more and getting better at diabetes.

Scott Benner 42:33
I do so you can? Yeah, I don't know. I do too. I love when somebody says something that makes me think like, oh, that's a great idea. Like I look, I understand how impactful fat is in a diet, right? And how it changes carbs and everything. I understand it backwards and forwards. And yet when you said it earlier, it it meant I found myself like inside thinking am I paying close enough attention to that. Like like then and just that little like Spark will make me pay better attention to it moving forward. And that doesn't, it doesn't happen if you and I don't don't talk like this.

Bob 43:14
Talking is the way through. I mean, I'm I love also sharing knowledge. I love learning and I love other people learning. I'm working mentoring someone else at the moment. She's a lady who was 53 at diagnosis. And she's having she started out I started chatting with her maybe three months ago. And she was permanently out of range. When her average blood glucose must have been something in the two hundreds. I mean, it was it was just crazy. And now she's having days where she's almost she's in certainly 70 80% in range. There is still a problem with the Basal she's crashing a lot at night. And that's not good. And we're trying to iron that out. But it's just talking about ideas and working it through. And I mean, as an amateur, I've got no medical qualifications. If I'm talking to somebody about the incident they're taking, I will be super careful. Super, super, super careful. And you know, she's going to get libre too soon, so she'll have an overnight alarm. And that will give me more confidence that nothing terrible will happen if we make some some bigger changes. But she can't get enough time with her with her doctors and nurses, for them to see the changes that that she needs to make.

Scott Benner 44:24
Are you happier now than you were in your?

Bob 44:28
Oh, unbelievably, unbelievably. I mean, it got to a stage just to finish the family story. My son was was diagnosed in fact, the moment I got that call. I was doing a commentary on a board game, sort of high level tournament and I was offered they were halfway through the game. I was chatting about what they were doing on the board, etc. And then they got this call from a wife. Yeah, Matthew is drinking an awful lot of water. I've done fingerprick and I've watched the sounds and I've done another fingerprick then I did a fingerprint with different machine, I'll meet with the hospital. So 12 months ago, he got diagnosed. And he is honeymooning beautifully at the moment. I think still, his numbers are lovely. And we rolled up at the hospital. And by that stage, I got enough education, enough confidence that I felt like I was the one educating the nurses, you know, they would come and ask me questions. And that felt very flattering. But it also felt that I'm, I'm on top of this now I'm in charge of diabetes, because I've put the the hard miles in of reading the books and you know, reading bright spots in my mind reading sugar surfing, find it and getting over the depression as well, which was was huge, because once I felt in control that kind of melted away.

Scott Benner 45:46
diabetes, your diabetes, super spreader?

Bob 45:51
Yes, definitely. There's definitely some sort of connection. And I was diagnosed at 13 years old, I think 11 months, is he was 13 years and 10 months. Matthew was 13 years and nine months. And I think that's just because we were a bit more students in signs with with the kids. When I was first diagnosed

Scott Benner 46:10
about your family before you, anybody else.

Bob 46:13
No, no, I had a grandfather with type two. But that's as close as we get Nobody I know, no thyroid. I have a cousin with really serious arthritis, which apparently has some autoimmune connection. But there's no particular family history of type one before before me. Wow.

Scott Benner 46:32
Look at that. And now, did you get all your kids? Or do you have more kids?

Bob 46:37
Just to just to to just the two kids. I've got the full set? Yeah, I got one of each. I said to the consultant. I saw her one evening after Matt was diagnosed, I brought you another one. And she seemed less excited about that than me, which was I was disappointed by

Scott Benner 46:52
Do you have those sandwich cards in England where you go into a shop and you buy 10? They punch at one time? And?

Bob 47:01
Yeah. I mean, I do know the team, the pediatric team at our local hospital pretty well. They're fairly conventional. I mean, they're they're good doctors. But they're a little bit a little bit conventional. And, you know, libre, the medics who been doing this job, that jobs, they've done those for 20 years or something, and now having to relearn everything, because kind of all the stuff before Dexcom and labor just doesn't matter.

Scott Benner 47:35
Right? Well, it just isn't important. What happens to the what's happening to those doctors is the same thing that happened to those diabetics back then, right, you were brought up in one generation of how to do it. And then there was a switchover. And some people were able to traverse that and some people got left behind. And now the same things happening to doctors, that CGM technology is obviously it obviously elevates your ability to manage diabetes, tenfold better, it's got to be more.

Bob 48:07
It's night and day, Brian, it's just a different way of life. And it means I use libre, with a with a mouse. So it talks to my watch. And I can I can just look at it and say, Okay, I'm 5.2 right now, that's pretty good. The nice healthy lunch I had today is settled nicely with insulin. And the libre was just a complete life changer. And it was recommended to me by a man who's an orthopedic surgeon who said, I've seen these things, they look really good. You should get one of those. And I was still at the stage of No, no, no, don't talk to me about diabetes, you know, I'm managing fine, leave me alone. And it was I think we have that conversation a little before his diagnosis. And, and I got hold of libre, probably maybe six, eight months, I had to pay for it at that stage. But it was just so good. I was like, I will stop the mortgage payments, I will stop the pension payments, whatever it is. Libra is the thing that my family needs to be spending money on for me and the kids.

Scott Benner 49:11
Now I agree. Can you tell me a little bit about that when someone showed you that technology and you didn't want to? Was that real anger? Like how does that fit?

Bob 49:21
Well, it obviously one word, it was more like I'm on top of diabetes. Don't you be telling me? Don't you be telling me how to manage things better? First of all, you're the wrong kind of doctor. And secondly, even if you were adopted, my experiences are okay. You know, I've consistently been told that since 1990. Don't you be introducing things that are going to tell me that I've wasted 20 years of my life doing the wrong sec. That's

Scott Benner 49:48
it, right. But that's it right there. Right. It's the time lost and you can't get it back. And so you don't want to know that the time wasn't used as well as it could have been because that's it crushing feeling but it didn't end up crushing it. Right? It liberated you?

Bob 50:03
Oh, yeah, it was, I mean, once I got into it, it was absolutely liberating. And as I say, it's night and day, night and day to have that information on hand all the time, we're having this chat, I'm telling you 5.2, which is 9192. Ish. And that is something I can tell you about just by looking at my wrist, you know, I'm not getting they're not changing the answer, like all good boys and girls do all the time. And then during the finger stick, and then waiting for the result. And then backing all the stuff back in the little box are the bag and get it and it's a process. Whereas now I'm just constantly in touch with what my bloods doing, you're to the point where I can tell you the carbohydrate content or different pints of beer, by what my Libra does, after I've dropped the beer.

Scott Benner 50:51
You're a really inspirational mixture of before and, and now. But you don't see, as often as I would like, it's just so hard to drag somebody from the 80s into the diabetes of the 2000 and 20s.

Bob 51:07
It's been a hell of a journey. I mean, it really has been, for me a massive, massive journey. Also, for the family as a whole, because I'm now in touch with diabetes. And I got involved working with diabetes UK, I sit on the non exec board for a thing called Daphne, which is the major provider of education for adults with type one in the UK. I'm really active on quite a few Facebook groups, including the juice box one, which I love, because people are nice. And we're understanding and they're open minded, and they exchange ideas. And instead of saying, Well, I didn't have the idea, it must be wrong. They're like, Oh, that's interesting. You know, Susan's on there looking at low carb, and not everyone is with the low carb thing. But she's she's courteous and polite and open minded and helpful about it. She presents it as a very positive choice rather than what if you don't do this, you're all going to die. And it's a lovely space. It's a really lovely space. And I love exchanging ideas, I've learned so much,

Scott Benner 52:08
I should knock on some wood. And at the same time tell you that as an almost 50 year old person, I feel silly saying this a little bit. But I am as genuinely proud of how that Facebook page operates as I am of many, almost anything else. It is really uncommon for people that many people to get into one space and talk so well about any kind of topic it just, especially on social media in general. So yeah, I don't know if how much credit I can take for how it works. But it I'm just thrilled that it works the way it does.

Bob 52:46
I think for me, part of your philosophy is about open mindedness, it's about using the tools available to get to the place that you want to be. And whilst it is a sensible, reasonable goal to get your blood glucose in normal range all the time. And that's that's definitely the ambition behind what you promote and what you eat what you teach. The ideas behind that it's not, well, you have to do it like this, you have to make sure that you eat you have these vitamins or you don't eat those foods. It's all about doing what works for you. Yeah, well, I think people really get on board with that

Scott Benner 53:25
in the history of my life. I have not seen one dogmatic thing work out well. Just haven't. And, and this is too important for people to fight about, you know, like, we don't have five years to figure out who's right. We don't have 10 years to decide which eating method like, you know, people make this mistake of when they the first time they happen upon something they believe it's the first time it's happened in the world. And because I've right and because, you know, I mean, like you know, you know, when you meet a 23 year old, it's like, I don't think these politicians have my best interest at heart. You're like, oh, did you just figure fascinating, you're right on top of things finger on the pulse. Congratulations. But um, but like styles of eating as an example. This is not a new argument just because we've renamed stuff keto, you don't mean like, yeah, people had these arguments in the 80s about and they didn't call it low carb, they just were like, I eat a lot of meat. Like that's, you know, I don't eat bread and I eat a lot of meat. That was how somebody talked about it back then it's not till until social media came up and the idea of branding something could lend lead you to making money with it, that people even bothered with stuff like this. But But my point is, is that I've been around the diabetes space online long enough to watch it ebb and flow. And I realized that we're not growing. We're just rehashing the same conversations with different titles. And I thought, why does any of this matter like Why is everyone busy trying to figure out the best way to eat, or the best technology to use or whatever, just like, Let's Get everybody as close to good as is individually possible for them without, without making them crazy or torturing them about how they how they eat, or, you know, what, it's up to us, etc.

Bob 55:21
But it's the one size fits all concept that this works for me. So therefore it must work for you. If only that were true, only there was one right answer for everyone, everyone trying to manage their blood glucose. And of course there isn't. I mean, at the moment, it seems to a lot of people seem to be chatting about which Basal insulin to use. And there's been a big study in the UK, which is out for consultation at the moment, comparing the impact of different types of Basal insulin. And actually, the result of that is the sort of study or studies thing, the result of that is probably going to conclude after the consultation that some of them worked really well, for some people. And some of them worked really well for other people. I mean, I really love to see, but when by the time I was, I was finishing my MBA before I got some, I love to see that. And that was by far the best for me. But then there's other people who do really, really well with blank, Sklar gene or whatever else it is. And the idea that those are sort of best, you know, this isn't a video game. It's not like a high school where your doctor will let you finally let you have the good insulin. You've got to experiment and try different stuff and just see what works for you. Yeah,

Scott Benner 56:34
no, it's fascinating how somebody can say something. And it doesn't have to be based on anything. And you're like, Well, I heard somebody say it. Now I would tell you, if Arden had to go back to MDI, right now, it would be my inclination to try to Seba, but that's just based on anecdotal stories that I've heard from other people. And if it turned out to not work well, for I would pivot in two seconds, like I don't sit still and let bad things happen, just because somebody said, Here's your insulin,

Bob 57:02
well, then you get all the information from people who are active on the internet, and the people who are active on the internet talking about their diabetes are also the ones are going to talk to their doctors about different insulins, because they're engaged. And then the doctor is gonna go, Well, you know, why don't we try some of this, to see the stuff that we've got now. And, and that may work really well for them so that other people who are succeeding with it are the ones who are talking on the internet about it. Whereas there may be loads of people using nonsense largely and have been doing it for years that's working for them, who aren't on the internet, who aren't really engaged with the conversation, right? And I feel I feel a little for those people because it's a big part of your life. It's 180 decisions a day, going to talk to other people doing this thing. It's not easy. It really isn't easy. Do this day in day out and talk to people.

Scott Benner 57:48
It's still tough, even with the internet for other people to find answers. I will tell you for certain that even though Arden's nurse practitioner was the first one to bring up Dexcom. And I've told the story about how she, she she started telling me about this kid in the practice who wanted to teach himself to eat m&ms. So he literally got a Dexcom just so you could eat m&ms. And, and then she was explaining to me how he got this flat line. And she was super excited because the kid could eat m&ms. And I was sitting there thinking, Well, if he could do it with m&ms, like I could do with everything, probably like what would stop me from doing it with other foods. But still, the leap was still difficult to make until a woman who none of you probably know named Lorraine, who was just very big in like diabetes blogging a really long time ago. I heard her say Dexcom. And then I that's when I took two and two as well. Now the CDE said it. I liked the idea of how she put it. And now I see Lorraine a person who is friendly, and I feel good about. She said she's trying it too. I'm going to ask about it. And then she's the same person who brought up a Pedro and I could listen, I can go back now in my mind and tell you I don't know if Novolog caused Arden's like drastic peaks and crashes or if I just wasn't very good at diabetes back then. And switching to a Piedra maybe partly just coincided with a time when I figured things out. But in that moment, it felt better a Piedra. In my best estimation in Arden works more gradually. There. It's not as like vicious. And so you can I don't know. I like it a lot. I know how to use a pager really well, I was not good at Novolog. Having said that, if you put Arden back on Novolog right now, I don't think I'd have the same experience I had prior because I'm better at it now than I was all those years ago.

Bob 59:43
But we're all we're all we're all biased. And I can tell you that fire school takes somewhere between 10 and 20 minutes to get going on the it will hit Isabelle within 10 and it will hit Matthew almost before he's drawn it up and You know he just puts need near his like his blood sugar and starts to go down. And that to me is is one size does not fit all the fact that that your doctor says and Novo Nordisk say, this is how the insulin should work does not mean that's how it's going to work. It's so you don't trust these guys, but you've got to do it yourself and look and learn.

Scott Benner 1:00:21
Yeah, what because even that there's numbers they give you they tested on however many people they tested on, and then these are an average of, you know, yeah, in 1000 people on average and started working within this time frame. But this time frame, it doesn't mean like you said, it's gonna be the same for you, I love the way he works. It seems to make Arden feel a little bruised at our spots. So we don't, we haven't, we tried it a couple of times. And she's like, she gets sore from it. Like she feels bruised after the pump comes off in that spot. So alright, you know, that sucks. But I did like the way it worked. It was easier for us. And I'll tell you, the next person that comes out with another insulin that is supposed to work more quickly, I'm gonna try that one too. And it just keep going I the worst thing I can imagine, is complacency. In a space that is moving this quickly. And this positively, it just doesn't make any sense to sit still.

Bob 1:01:18
I mean, the terrifying thing is that the doc's are very reluctant to make decisions about treatment until they've seen studies. And that makes sense, because they're scientists, and they're relying on those studies to justify that decision making. But it's happening so fast, the changes happen so quickly, that they can't keep up. Yeah. I mean, I mean, for me, I don't know how excited I'm going to get about it. But the idea of a linear relationship between amount of carbohydrate and amount of insulin is obviously nonsense. Like anything yet, we're all taught it, we're all using it. But I know that if I have my regular breakfast, 22 grams of carb in there, I will take 5.25 units of insulin. But if I doubled that amount of carb if I woke up from really hungry, and I double the insulin, so I'm at 10.5, then I know that I will hypo two hours later, because it isn't a straight line relationship for me.

Scott Benner 1:02:18
So you need all that info that insulin upfront because of the piling on of carbs, but down the road, that leaves too much insulin in your system. Still when the carbs are gone.

Bob 1:02:28
I'm upset. Yeah, exactly. And yet, nobody wants to talk about finding some kind of differential equation and some sort of software to put that in.

Scott Benner 1:02:39
Yeah, you're not gonna find anybody to talk about that? Well, not when there's variability between people to people like, what what you what you're taught, is, it's an amalgam of everything they've learned about everybody that falls as close to the center as possible, that won't cause too many people, too many highs or too many lows. It's just, it's just trying to keep you alive. It's not trying to keep you healthy. And that's where it becomes personal then. And it's difficult for people to, to parse out that information and see it like you have no idea how many people I speak to, who don't see the correlation between different impacts of different foods. Like they'll just say, like some mornings, I don't know, like, it works great. And other mornings, I get really high later. How come? I don't know. And then you talk to them for hours upon hours on Days and texting back and forth. And then you realize, like, I now know how to ask and ask the question, so I don't have to waste the time. But they don't. That one day, they're telling you about a fried egg they had with a half a piece of toast and a cantaloupe. And the next day it's oatmeal. They don't understand why is it so bad. One two, I counted the carbs and I put in the insulin, same both days. It didn't work. And but people's minds don't make that leap. And and I don't not understand why like it's it takes it an investigative person to sift through that and not everybody thinks that way.

Bob 1:04:08
And it's about the compromises you're prepared to make in your life. When you have a thing during after the the first lockdown in UK finished, there was a thing called etail. To help out where our lovely government decided this was quite a nice thing for the restaurants at the time that they would pay the first 1010 pounds about $13 of your meal, or half of the cost of the meal if it was less than 20 pounds. So whichever was the smaller, but they were just trying to kill the restaurants because they were worried that nobody would go out because it was post COVID. And we're finally through the first way, there's definitely not going to be a second one. Look at that, too. But anyway, we went out there for 13 days in August and we ate out every single day. At different restaurants every single day. Were cooked the days when when the wife and the kids went away and they ate breakfast, lunch and dinner. And of course when We go out to new restaurants, new places, places that haven't been open for four months because of lockdown. You're trying new foods, and I love challenging myself to get them right. You know, I don't I don't go into meltdown if I if I hit 200. I do insulin. That's what it's for. And I live trying to get ahead of the meal to work out. Actually, I know there's a load of fatness, but there's a load of rice in it as well. Or maybe pizza. I mean, people talk about pizza, like pizza is one thing. And the difference between a frozen pizza that you might eat at home, and then the really nice Italian restaurant down the road, and the big chain pizza restaurant, those pieces are all different. They all work differently for me. Yeah,

Scott Benner 1:05:43
they might as well. They might as well be three different foods. You calling them all pizza is like calling diabetes in 1985. The same as diabetes in 2020.

Bob 1:05:54
Yeah, absolutely. Absolutely. And I love the tools. And they're great. And I believe in what I call di positivity. And there is no point sitting around feeling sorry for yourself about diabetes, a lot of people find it hard. And hard things are often unwelcome. But anybody who tries to do a poor you, you know, when I talk about about the kids, and they're in the team with me, like Don't you dare pity my children do not dare, they are grown up in a reasonably accurate household in one of the most comfortable countries on the planets, with internet in every room, you know, they are, they may have to worry about the planet in a few years time. But they are basically the luckiest generation of the board. And we're going to do a couple of injections before or before they you know, that's that's do not pity them. And diabetes makes them stronger, tougher, more forward thinking. It teaches them to prepare for things. And teaches them self management, all of that stuff. And I remember when I was at school, I used to have to go and do my injections in the evenings, because I had dinner to have an evening. And there was a teacher that you saw me doing that once. And she gave me this sort of sad smile. And that made me so angry. Yeah, that made me furious.

Scott Benner 1:07:19
Well, struggles good. Might not be it might not be preferable to get it through your health, but it's how you got it. And there's a lot to be made of it. So that's it, you get a you know, you get hardened under fire, right? Isn't that what they say?

Bob 1:07:34
Yeah, maybe? I mean, I think diabetes is science. It's reality. I know that people sometimes don't understand. But the answer to that is improve your understanding. You know, and don't spend time going, Oh, this disease is terrible. And the people who make me furious, and the people who say they don't want to have kids in case they get diabetes. You know, I ask

Scott Benner 1:07:57
that question a lot, just because I'm interested to hear the answers. And they've got such varied answers over the years. I don't know that I've ever I understand that you wouldn't want to hear somebody say it. And I understand when somebody says it to like I like it feels like they're so overwhelmed. They just can't imagine it again. And there's people who put it on themselves. Like, they feel like they gave it to somebody which is of course it's silly and silly and understandable at the same time. Like I understand you feel that way. And of course, that's not how anything works like you. You don't walk around being like, oh my god, I get my kid brown eyes. I wish they were blue. This is my fault. Like nobody feels that you know, like it's the emotion gets twisted up with the logic a little bit.

Bob 1:08:44
And it's about okay, diabetes fault for what it can be. And it teaches you all kinds of things about nutrition is he did an exam 16 GCSE which they all do. She the grades go from one to nine, and nine is supposed to be like one in 1000 kids will get a grade that high. She walked in and scored a nine in the feed nutrition exam, food tech, whatever they call it. She just got a nine because she walked in there with so much knowledge about food before she started. And, you know, that's that's just a bonus from diabetes. And I self pity is I understand how difficult people find I really do follow how hard some people find it. And and I think particularly for parents, you know, their kid has not turned out to be having the childhood that they were hoping for. Right? But don't let that stop. You're sad about that. You know that they're still having a childhood, they're still enjoying out 50 years ago, they wouldn't have be. And in fact, 30 years ago, they would have had really bad management and they'd be hyping all the time. Yeah. And that's not where we are that oh no,

Scott Benner 1:09:53
yeah, we like to say that the you know, back in 1920 You would have died if you were diagnosed with type one diabetes. There was no insulin, but you were diagnosed in 1985. And it wasn't great for you either. It's only become kind of what it is. I'd have to say in the last decade because of glucose sensing because of CGM, like, Yeah, this is the advanced right here, like you're living in the golden age of, of having type one diabetes, if that's the thing. It really, I mean, that's how I see it as well. Hey, can I ask you a question? Because there are a couple of things that you've said that I have to imagine that I understand. And one of them is that they might have trouble with the plumbing. Are you saying the sewer systems in England are getting old? Is that? Was that your inference? Or has your house only new pipes? You know, you said, you, you said that your kids live in the greatest and one of the greatest countries in the world. They don't have a lot to worry about, but they might have to worry about the plumbing. Oh, the planet,

Bob 1:10:56
not the plumbing the planet? Oh, thank

Scott Benner 1:10:58
God. I was like,

Bob 1:10:59
Yeah, I know, the plumbing. I thought this house

Scott Benner 1:11:04
is England filling up with it. And I don't understand what's the plan?

Bob 1:11:10
What's the plan? I mean, it's the thing that I mean, I travel in the states quite a lot. We really enjoy life over there. Generally, I think that the time will come in a few years where I'll be spending a lot more time there. And the the curious thing is that you describe something called a British accent. And I don't know what that is. It's how

Unknown Speaker 1:11:30
you that there isn't

Bob 1:11:34
anything like somebody from Liverpool, or somebody from London, let alone anyone from Scotland or Wales, and they're all places in Britain. And you know, you get really, really interesting accidents like up in in Newcastle. And I think what you guys often mean when you say Brushos, somebody who speaks very much like this as if they've recently been released from Downton Abbey. And that's not how we talk. You know, you do meet those people, but they're few and far between

Scott Benner 1:11:59
there is someone on once who I said privately afterwards, I said that I thought she sounded like Adele and I think she was insulted by that. But I couldn't tell why. So

Bob 1:12:09
well, there is a great quote that no Englishman can open his mouth about another English. Mm hmm. Okay. And, and the way we speak conveys a lot of information to people. Anybody who knows the northwest of England, where I grew up in, in Blackpool, which is like a little seaside town, a bit like sort of Atlantic City. And there is a, there's two types of accent in that part of the world. There's my accent, which is a broad, fairly gentle Northwestern Lancashire accent, but it rises at the end. And that wasn't something that came with Australian soap operas, people from my part of the world have always spoken with their sentences rising a little bit towards the end. And then there's a really broad, like Lancashire accent that goes like this with quite flat bones and all that sort of thing. And, and you can tell what kind of school people went to, as to whether they've got an accent like mine, or whether they've got the broad Lancashire and it's in where I live, there are maybe four or five towns around the north of Manchester no more than five or 10 miles apart. I can I can tell with a fair degree of accuracy which one someone was born in because of the way that the accent changes just from one town to another. Okay. So that of course, you know, you sound like you're from Burnley and you're walking around Blackburn which is the the rival town five miles away. Everybody with a Burnley accent will not be popular in button so that's the and there's also the plus thing as well. Yeah, I

Scott Benner 1:13:36
backpedal very quick. I think I found it delightful, but she she didn't like that too much. I don't think I forget.

Bob 1:13:44
Oh, Adele is a real Eastern BLUs okay. She's She's a proper, I was lucky enough to see Glastonbury and she sang to 120,000 people and it was like every single one of them she was going to go and have a gin and tonic with after the gig. It felt like she had the whole crowd in the palm of the hand.

Scott Benner 1:14:01
I've seen her live as well and it did feel like that a little bit like oh my god there there's that person I wish I knew personally she's standing right there. Yeah, has that feeling

Bob 1:14:11
she just genuinely a lovely human being but she is a real East End girls and from a pretty sort of working class background. And English people get very offended not not that they think the other classes are worse. It's just no no my identity is this class. You must you must put me in that unless the middle class in which face all the time you either pretending your upper class or working class depending on who you with. It's it's very complicated.

Scott Benner 1:14:37
It sounds it sounds it sounds more complicated than than diabetes.

Bob 1:14:42
It's yeah, but less significant.

Scott Benner 1:14:45
In I guess it doesn't make you past that. Unless you try to drink and keep up with people you can't drink with I guess then maybe it could.

Bob 1:14:52
Yeah, I mean, drinking is a really rich thing. It is a popular sport over here. But interestingly, the America seems to be doing divided into people who drink and people who don't drink. And the guys who drink really drink in America. If you were to order a whiskey in a bar in the States, you get like half a pint of stuff. Whereas over here it's it's a generous thimbleful. When you order a whiskey in a bar what then everybody, not everybody playing him instruments but but most people will enjoy a beer or, or whatever it's, it's, I remember going to there was one chain restaurants states were and they didn't serve alcohol. I was genuinely appalled. You have a restaurant without beer, but it makes no sense. But the the drinking culture is very different.

Scott Benner 1:15:41
Okay, well, I really appreciate you doing this and reaching out and wanting to share your story. And I mean, it's fascinating that you have this like, long tail of experience. And then you're also the parent of kids with diabetes to like your, you really have all there's a lot of wealth in what you were saying. So I appreciate you taking the time to record it with me.

Bob 1:16:05
That's really kind that's really kind and it's a privilege to be on. I mean, you are at the forefront of all of this. There are a couple of people who are heroes, for me with diabetes, and I've had a couple of amazing nurses. And I think what Professor Pathak cars doing for diabetes in the UK is phenomenal. He is absolutely they're fighting for us to get everything we need. And the stuff that you've been doing for us is building as well. So I'm very grateful.

Scott Benner 1:16:32
I'd say incredibly kind. I appreciate you saying that. I'm gonna stop now because this is where I get weird and sappy, so we'll just put

a huge thank you to one of today's sponsors, G voc glucagon, find out more about Chivo Kaipa pen at G Vogue glucagon.com Ford slash juicebox. you spell that GVOKEGL? You see? Ag o n.com. Forward slash juicebox. And I'm not kidding, this is the last chance to get your tickets for dancing for diabetes. Are you in the Orlando area touched by type one.org, click on the program's tab, take on dance take on can click on dancing. Click on let's start over touch by type one.org Click on the Programs tab. I'm so sorry. Click on the Programs tab. Click on my brain. Go to touch by type one.org Click on the Programs tab. Click on dancing for diabetes, and then get your tickets. I'm so sorry. I don't know what happened there. My brain hurts now. Please don't let my ability to not remember what I wanted to say reflect on how you feel about touched by type one touch by type one.org. We're also on Facebook and Instagram, and they're wonderful supporters of the Juicebox Podcast you're gonna have a great time at dancing for diabetes. Hey, if you're a new listener, and you're looking for the Pro Tip series, there at Juicebox Podcast comm you just click the link at the top that says diabetes pro tip. There's a whole list of them there. You'll also see the defining diabetes series there. As a matter of fact, the website is pretty great. I can go to it for a second. tell you more about it. You would think I could do it off the top of my head but after what we just heard about the dancing for diabetes thing better if I pull it up and show it to you. When you first bring it up, there's links all across the top episodes. Pro Tips juicebox Doc's best anchor and boy here we go. juicebox Doc's best endocrinologist. Those are doctor sent in from all over the world by listeners just like you. There's an A one C and blood glucose calculator translates it's great, really just check it out. There's a link to the private Facebook group there. Knowing the signs of type one diabetes merchandisers, everything that's not the point then you scroll down. There's different ways to listen. There's just links for like Pandora, Android, Amazon, Alexa, Apple, podcasts, Spotify, Google, Amazon Music any way you want to listen, you click right there, that a little lower recent episodes of the podcast, you can click on them and I don't say this enough, but like here's one episode 573 You click on it. It's called adaption. diabetes has a short little one. You know blurb gives you some links to listen, you can listen right there on the web if you want. And there's another clicky clicky at the bottom says click for episode transcripts. You can actually read a transcript of every episode on their pages that are available at juicebox podcast.com. We scroll a little farther it's all the diabetes pro tips are listed there. The great sponsors Dexcom Contour Next One Omnipod T one They exchanged evoke I bullpen touched by type one that's there. Then you go down. There's some articles on the blog. If you like to read, do people still read if they do, that's their defining diabetes series, everything from understanding crush it and catch it, which is a phrase we use in the podcast to see peptide, hydration, all the tools that you use every day managing diabetes, described to you by me and Jenny Smith, very briefly, I think entertainingly. And helpfully, there's a lot of fillies and well, why isn't those words go down a little farther. There's diabetes, the diabetes variable series, little variables that you're going to run into while you're managing type one, and how to understand them. Sleep pumps, light placement, bad sites, growth hormone, a whole bunch of stuff there. Then we get down to the after dark series. Oh, so much goodness, they're eating disorders, diabetes, complications, divorce, bipolar disorder.

Geez, heroin addiction, bulimia, using psychedelics with type one, sex, drugs, booze, it's all there. type one diabetes and all the things that nobody else talks about. If you keep scrolling, you're going to come to algorithm pumping, which are episodes all about looping, and other algorithm based pumps. Like the mini med 670, G, and the control IQ. There'll be more coming soon about Omni pod five, and what other and what other and whatever. Oh, boy, and whatever other algorithms come to be. You scroll down more some of the more popular diabetes blog posts there. How I got to be bold. How to Bolus how I Bolus for Chinese takeout. It's a breakdown there's a breakdown there of how I Bolus for a high carb breakfast. It's just it's helpful and then the how we eat series How do people eat intermittent fasting flexitarian keto FODMAP Bernstein, low carb gluten free plant based carnivore vegan it's all their people have come on and talked about the different ways they eat. That's everything that's on the first page of Juicebox Podcast calm. Are you kidding me? You see how much effort they put into that? Once you go look at it. Alright guys, I'm so tired from talking like that. I gotta go.

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