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

Scott Benner 0:00
Hello friends, and welcome to episode 724 of the Juicebox Podcast.

On today's show, I'll be speaking with Thomas, he's in his early 20s, a medical student, and he speaks funny. So don't make fun of him when you hear it's not polite to make fun of the way people talk. While you're listening, please remember that nothing you hear on the Juicebox Podcast are making myself laugh and I probably shouldn't have said that about how Thomas speaks but whatever. But the Oh yeah, while you're listening. Please remember 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. Were becoming bold with insulin. If you're a US resident who has type one diabetes, or is the caregiver of someone with type one, please consider going to T one D exchange.org. Forward slash juicebox. Join the registry. Take the survey, the whole thing should take fewer than 10 minutes. When you answer these simple questions about type one diabetes, there'll be helping people living with type one and supporting the Juicebox Podcast super simple to do takes no time at all t one D exchange.org. Forward slash juicebox.

This episode of The Juicebox Podcast is sponsored by Dexcom, makers of the Dexcom G six continuous glucose monitoring system, head over to dexcom.com forward slash juice box right now to get started or to learn more. The podcast is also sponsored today. By Omni pod makers of the Omni pod dash and the Omni pod five, you may be eligible for a free 30 day supply of the Omni pod dash go find out at Omni pod.com forward slash juice box. I probably should have said you might be eligible for a free 10 day trial of the Dexcom G six two, but I forgot to say it. So now it's too late. Because of me, am I forcing you into the basement?

Thomas 2:16
Kind of it's actually it's a spare room we have because I live in student accommodation. And my my current bedroom because we live by main road sounds like Yeah, yeah. So I came down here which is cooler. It's cold. I'm fine. I've got a warm blanket over me.

Scott Benner 2:36
So I appreciate the effort very much. Thank you. Yeah, I know sometimes I'm talking to people and i By the way, the recording runs constantly. So it's running now.

Thomas 2:45
Oh, that's fine. Yeah.

Scott Benner 2:46
I'm talking to people and and, like, you know, are you like I hear trucks and cars. They're like, yeah, that's the backside of the house faces towards the road. I was like, could you go to the front side? Because we're recording a podcast. It's audio, you know? Oh, yeah. I didn't think that would matter. Like can you hear the car?

Thomas 3:07
too? Even down here? I can hear the cars and I'm going on now. Is this going to be the cause issue? I

Scott Benner 3:12
can I don't hear I hear you testing your blood sugar. But I don't hear that. Are you testing?

Thomas 3:18
Right now? Yeah. No,

Scott Benner 3:20
you're not without that I heard a click or something like that. Never know. Maybe

Thomas 3:23
this? Yes. Okay, I won't I will not tap that then stop.

Scott Benner 3:29
Stop being alive. While we're doing this. Just sit perfectly still. Doing whatever I was doing. I will stop doing I was your I irritated with myself. I was I listened back to the show I put up yesterday. And in the first 15 minutes. I don't know what I was doing. But I must have been turning my head and looking at a different computer while I was recording. And so once in a while I would hear my my voice go in and out. And it was making me crazy. And I thought I'm probably the only one that cares about this. But you know,

Thomas 3:56
no one else will notice but you're just so hyper aware.

Scott Benner 3:58
I just I just listening. I'm like, What am I doing? I'm an idiot. Anyway, so the way this goes, I don't know how much you listen or don't listen. But the way it goes is you just introduce yourself and we start talking and it's over when it's over.

Thomas 4:15
So sound sounds great. Yeah, I've I think I've been listening for about I won't get into that. But this is about a year now. Anyway, so Okay. All right. It's you know what, it's really odd. Because it feels like I've just listened to the podcast. Your voice is so recognizable. It's it's, it's almost like it's soothing. It's like I've moved house many a time. And yet this you are one of the constants in my life.

Scott Benner 4:38
That's lovely and odd. Appreciate. So, yeah, my wife and I went and saw To Kill a Mockingbird on Broadway on Sunday. Oh, wow. Jeff Daniels last performance and we went to see it and we're standing outside. Off of 45th I think and you know, we're in line and just waiting to qn and waiting for them to open the doors. And there's hundreds and hundreds of people out there. And my wife looks at me and she doesn't usually talk about stuff like this. She goes, Do you think one of these people listens to your podcast? And I thought, I guess it's possible, like, and then we started talking, like, I wonder how many like random people we'd have to pull together before we could say, you know, who watches Curb Your Enthusiasm? Raise your hand. Who does this? Like, you know what I mean? Like, who knows who James Corden is raise your hand, you know? Do you listen to Juicebox Podcast? I'm like, I wonder how many people we'd have to pull together to randomly see. And I told her, My one concern is that one day, someone's just going to turn to me and recognize my voice. Like, I don't think I wouldn't be bothered by it. But I think that one day, it's gonna happen. Someone's just gonna look me in the face and be like, Are you the guy from the thing? I've recognized? Yeah, if that ever happens, I'm, I'm gonna, I'm putting that on my headstone. When I die,

Thomas 5:55
I think you will be I think you'll be surprised actually, how, if you did get people to vote, I think you'd be surprised how quickly you eventually would find someone

Scott Benner 6:04
even just asking how many of you have type one diabetes, like there's got to be, you know, people there. Although, you know, as I say this, it's happened to me twice. I've been recognized in an airport, visually, which I didn't like, and I was on a small transport bus with maybe just eight or 10 people. And I was speaking to someone and the woman on the other side of me, like, put her hand on me and was like, Are you Scott? And I was like, what? I guess now I realized that this has already happened. I'm just an idiot. I don't even remember. But yeah, she's like, are you Scott, I listened to your podcast. And that was weird. Because everyone in the bus was like, Wait, that guy is somehow like she knows him.

Thomas 6:49
With a we just mundanely. That day or something? I was shocked. You're not like a dress like a superstar? I wouldn't

Scott Benner 6:56
even know how to do that. Thomas. I mean, how would a superstar dress?

Thomas 7:00
You know what soon soon you'll be recognized everywhere. From what I'm hearing you put on the Facebook group, you're more and more listening seems to be happening by the day. I'm gonna

Scott Benner 7:09
have to do a setup then if that's the case. So at least one. Anyway, you go ahead and introduce yourself.

Thomas 7:18
Yeah. So my name's Thomas, and I am a British type one diabetic. And I'm also a medical student. And I'm 22. Yeah, excellent.

Scott Benner 7:32
So you're a medical student. Fortunately, unfortunately, why? Unfortunately,

Thomas 7:40
there's a lot less stress. Stress is stressful. And there's a lot there's a lot to do. But it's fun at the end of the day,

Scott Benner 7:45
like it pays always doing something always busy. There's

Thomas 7:49
always things to learn. And there's a lot to do and it's a very kind of

it's very demanding in a different way to maybe use my usual work because we often jump from hospital to hospital at least had to do in the UK. And I will apologize at the beginning AI Rambo, Scott's you, you do need to Oh. And the second one is, if I use any medical jargon, or any British isms, you also going to have to tell me because I'm gonna I feel like I'm gonna say things and they may omit the American Language is a different language to me sometimes. So

Scott Benner 8:28
no, that's fine. I use some British isms. I'm going to be upset. That's the fibers.

Thomas 8:34
I'm just excited for you to present my accent at some point.

Scott Benner 8:36
I don't know if I can. I'm trying to figure out who famous you sound like. Because you do sound like somebody to me. I just can't think of who it is at the moment.

Thomas 8:48
You're gonna have to tell me, I'm scared. Is this going to be a compliment? Or you're going to insult me? But oh,

Scott Benner 8:53
I know. I wouldn't even know how to insult you. Although, I did learn recently speaking to someone that there are portions of the, I guess parts of England where you don't want to sound like other people and they don't want to sound like you.

Thomas 9:09
Yeah, there's, there's a lot of there's a lot of dialogue. There's a lot of like accents in the UK. And I think people would say that my accent, I think I've maybe come across posh, which is has negative intentions to it, but I'm my but then there's like the Yorkshire accent or the Welsh accent, the Scottish accent but even within those areas, like there's like many different types of Scottish accent, there's many different types of southern accent so

Scott Benner 9:37
I say once in a while my brother in law's from Scotland. I don't understand a damn word he's saying so,

Thomas 9:42
and there's some Scottish accents where even I don't understand what they're saying. So,

Scott Benner 9:48
in my mind, he mumbles and then yells i That's pretty much

Thomas 9:52
that's yeah, that's sad. Yeah, that's pretty accurate.

Scott Benner 9:55
Well, you're not in a little earlier on in the day, and I'm like, I don't know what Jim I don't know what you're saying. Oh, So I just listened for keywords and intent. And I watched his face and I wonder if he I hope he listens to this one day, I would love for him to realize. I only understand about 33% of what he's saying. So, yeah, you're just

Thomas 10:12
nodding all the time and you think I'm fully understanding and then one day he'll hear this. It'd be very upset.

Scott Benner 10:17
He just thought, oh, my gosh, I thought everyone really was down with what I was saying. That's something. Okay, when were you diagnosed with type one?

Thomas 10:29
So I was diagnosed on the it was April 2009. Okay, I can't I think the 20th of April 2009. There you go. So I've been I've been diabetic now for 1213 years. 13 years. Okay. Yeah. 30, nearly 14. Actually,

Scott Benner 10:50
what were you like eight years old? Nine.

Thomas 10:52
I must have been I think I just turned 10. Okay. Well, so I was born in 1999. Justin, you were

Scott Benner 11:01
born in 1999 10 years after I graduated from high school. Great. Okay. Lovely. Do you remember much about being diagnosed or how it was handled.

Thomas 11:11
So I remember being so I remember being we were in Portugal at the time. And on holiday in Portugal. And I remember being, you know, really thirsty, and we in loads. And my dad had gotten to his head that for some reason, in in certain countries, you couldn't drink the tap water. And I don't know if this is actually true or not. But he certainly said you can't drink the tap water in a different country because they they treat the water differently or something. I don't got that in his head. And so my dad would buy either, he would buys like apple juice in his cartons from the local shop. And I remember being so thirsty, so I would drink some apple juice. And then I reload. And then I because I was thirsty, just drink more apple juice. So I'm just consuming sugar every time I'm drinking. And then we hang out this sugar. And this just went on and on and on. Until we were walking through some street in Portugal, and it had been like, a few seconds since I last went to the toilet. And my dad tells me from memory that apparently I was just like, we have to do what we had to do we on the street, because I was waiting that much. It was slightly. I was just having to we in the middle of the street lacquers back alley in the middle of Portugal somewhere.

Scott Benner 12:31
This was an indication to them that your health was poor or that you were injured.

Thomas 12:36
I think this was where the maybe the alarm bells went off a bit. Yeah. I read at least the apple juice. Yeah. Well, it was just the constant consuming that when you made things well, I mean, I remember result giving up on not drinking tap water and just drinking loads of tap water because it just got to the point where I was that thirsty that we ran out of apple juice.

Scott Benner 12:56
Water but we're if something's gotta be done.

Thomas 12:59
The apple juice market in Portugal that year must have you know, I was I was holding up the economy, the local apple juice economy.

Scott Benner 13:07
Children everywhere can get their juice.

Thomas 13:09
Yeah, yeah. Yes. And let me we flew back to the UK. And I'm from Nottingham. And I remember land. And when we got back and I was the Easter holidays, and I went back to school. And my dad picked me up halfway through the school day and because he managed to get me an appointment with a doctor. And we went to the doctor and I think you know, took my blood sugar if something like 23 And I realized I'm not going to convert this over so 23 is probably about 400 I think

Scott Benner 13:49
I'm just gonna go to juicebox podcast.com and click on blood glucose calculator and then do millimoles 23 and tell you that it was 414 Yes. And your your average Awan see at that blood sugar is 16. Okay, yeah. Luckily you were standing.

Thomas 14:11
Yes. Wow. Okay. I've never actually converted that to anyone see, that's quite high. So yeah. And I think my dad was my dad was on to it a bit more because the days before we went to the gym, when we landed there was a few days before my school's school started and went to see the doctor. He had some ketone weighing sticks, so you know, weed on these sticks. And I remember my dad looking he was bit disturbed and he bought me a glucose checker and, you know, took a blood sample and checked my blood sugar. And you know, he was high and he was worried and my grandma was a type two diabetic. So my dad kind of knew. Okay, something was wrong. You know, he He wasn't completely I mean, it typed is very different condition itself. But he knew what was kind of going on because he vaguely remembered it from my mom, from his grandfather, his mom, sorry. And so the GP looked at his blood sugar Sorry, I'm dying around, the GP looked at his blood sugar and went, well go straight to hospital. So I Dad drives me to the local hospital. And I remember just having a few blood tests done and from all I remember is meeting my, my diabetic nurse that day, and who I had for the first years of my treatment, and he was called Matt, and he was lovely and fantastic. And he was also a Taiwan himself. So you know, he kind of understood a lot more. And I remember him, you know, vividly this bit telling my dad that I had diabetes, and I just remember my dad crying. And really, you know, trying to comfort him this little 10 year old boy, guys, it's okay. But then me crying too. And I think it's that like, and you kind of feel I owe it you know, you kind of see your dad when you're younger is this kind of you don't like a superhero. It's the first time I saw my, my dad, cry, and also cry about something that was happening to me. And I was a bit like, what's going on? I can,

Scott Benner 16:26
I can remember when I would, when I started looking at my son and realizing he thinks he's smarter than me. And he might be right. And I was like, oh, geez, the illusions over now. Yeah. By the way, I have to tell you, it's apropos of nothing but you basically were in Portugal, then you went home. So you went Oui, oui, oui, all the way home. And I don't know if the Three Little Pigs like reference gets you or not, but it's been stuck in my head the whole time. And if I don't say it to you, then it's just gonna be there the entire time. We're talking now. I'm

Thomas 16:59
glad you know, we have we have the three pigs over here as well. Yeah. I've never thought of it like that. But I feel like that's a good. Can we summarize what happened?

Scott Benner 17:07
Can we break something down that I never understand? And maybe you're the one who taught me will explain it to me. Go ahead. Okay. You went to the local hospital, but your GP told you to go to hospitals. So you guys don't say go to the hospital. But you said go to the local hospital. Why does the word DoD get dropped? Like you get like, when you're right, you went to university, you go to university, you don't go to a university or the university or my university? Why does the word the get dropped out of some of those uses? Is a colloquial.

Thomas 17:44
So I know that I'm trying to check this out where my dad's from, they don't say the so they will say things like get on a bus. Which means get on the bus. And they dropped the the a lot of the time in terms of but yeah, I think that's probably your dad. I think that's a local thing.

Scott Benner 18:02
Okay. All right. I just we just don't say that. I'm, I'm fascinated by it. And then sometimes I'll get stuck. If it happens. The conversation I'll start saying and I'm like, why am I dropping thought? I just thought there was a reason but it's got to be colloquial. I don't know if somebody's gonna tell me one day I actually am very interested in that side. I just don't never. I've never come close. You wouldn't.

Thomas 18:23
I don't think you'd ever say I go to the university. You say I go to university, right? Because

Scott Benner 18:28
here I'd say I go to college. So you don't say I go to college? Yeah,

Thomas 18:33
you didn't say I go to the college. So in the same way for Yeah, in that instance, you you go to university.

Scott Benner 18:39
So College is a is a is a fixture in your life? Not a specific place, right. Like you go to the restaurant. Yeah, that makes Yeah, you're right. But hospital gets picked up into that for some reason. go to hospital. I'm gonna go to hospital all right. I don't I mean,

Thomas 18:56
I think that's probably a duck. That is my dialect. I'm, I'm slipping at my this. So I also my awful English as well. My English is awful.

Scott Benner 19:05
I like the earlier that you were like, you know, my accent can be considered posh. And that's not great. And then you were like, so we were and then you told me you were vacationing in Portugal and the way you said it. I was like, oh, that's why people think

Thomas 19:20
the thing is, when I first meet someone, I'm very I don't know, I put like, I don't know, I get conscious. And I think I pronounced things more maybe. Right. But when I when people know me, I'll start you know, I start dropping a lot of more local. Yeah, I become more Yorkshire for some reason, right? And become more Yorkshire.

Scott Benner 19:40
It's interesting. Okay, so do you leave the hospital with a pen or needles? How did you manage in the early days and who takes care of you? You mentioned your dad a lot, but I haven't heard about a mom. Do.

Thomas 19:51
I have a mom? Sorry. Yeah, I have a mom. My dad was just there. Had that one dealing with it that day. Um, I was lucky enough that they wanted to keep me in the hospital. And my dad was like, No, and not in like a, you know, refusing treatment way. But I was like, Well, why can't you go home and they didn't really have a good reason. And I think at the time, it was kind of standard. You stayed in for a bit, but my dad was like, well, he's not that unwell. Can we take you home? And I remember my dad taking me home that day, and I had an I had an injection pen. And I had Atlantis and Hema lager thing. And my dad buying me a hamster on the way home. Because I think, I think he, I think he felt bad for me. And so I was just like, this is this is great. You know? What, you know, I get a hamster for this. Like, you know, this is great. I love going to the hospital. I get the hamsters since died. But

Scott Benner 20:55
you're still going. That's good.

Thomas 20:57
I'm still going. But But yeah, I went home and I had was injecting. And my I remember they, they've the time, I think it was standard to kind of be on injections for a long time. But my consultant really wanted me on a pump. I was like, we're gonna get you on a pump. So I think six months later, I was put on a pump.

Scott Benner 21:20
That must have had something to do with the fact that your nurse consultant had diabetes, they probably do you think they bumped me? Yeah. It's probably like, you know, knows the benefits of it. And, you know, your dad came off as confident in which might have been helpful, too. Do you have any idea how you were doing? I was, I was talking to my son about this the other day. And I told him how one of the fascinating things about making the podcast is when you ask somebody about their health, like, Hey, how's it going? They go great. But there's no context to it. They just say they're doing great. And I've come to believe that doing great meant I didn't pass out. You don't I mean, like, like, yeah, when you talk to people have had type one for a little longer. But they don't like if you asked me, how's Arden's health Ben? diabetes related through her life, I would instantly tell you that in the first number of years, her agency was, you know, in the eights, then I got into the sevens down the sixes started figuring it out, then I was able to really pull it down, down down into the fives. And now it's been between five, two and six, two for like, seven years. And that's how I think of her success. I mean, I would if you asked me to continue, I would talk about limited variability. Keeping spikes at a minimum, not getting low, frequently, stuff like that. But I think of it that way. Whereas you talk to somebody who's had type one for longer, and they're just like, well, I didn't get dizzy at school. Everything was fine. Yeah, yeah. It's interesting, because the measurement tools have changed. So do you think of like, what do you think of successful now for you? Like, what is it you're shooting for day to day and what was happening back better? Did you not know? Oh.

Thomas 23:03
So in the early days, my blood sugar. I was definitely honeymooning. My regime was so I think was 10 units at every meal. Think breakfast was a bit less but the same units of insulin every meal. So there's no carb counting. And of course, I had to manually when I say manually, I had to actually you know, prick my finger. Get some blood, you know, why seems the old fashioned way now. And so But initially, my blood my blood sugar's were, I think I was had a five point something, a one C. And they were happy with that they felt great. And I was like, Oh, great. You know, this isn't that bad. In hindsight, I realized I was honeymooning. And they put me on the pump. And that was great. And I love my pump. I had an animus a green animus pump.

Scott Benner 24:01
The one for the ping the Animus. Like I can't think of it. People talk about it all the time.

Thomas 24:07
I can't remember its name. I can't remember. It's Brett. But I know it was an Animus. But I can't remember what maker's animus it was. And it was cool. And I was like, oh, you know, I'm half robot, because I've got this, you know, cool little box attached to me. But I used to do stupid things. I used to get a bus and a train to school. I used to commute quite far. And I would, you know, go and have a shower in the morning and unplug the pump. And then I'd get on a bus and a train to a different city. Went to Leicester and my pump would be on my bed. just sat there. And I'm like, Oh, my dad's though panicking. Having to drive all the way and then drop off this pump like silly things like that. And I think I look back at my so getting the pump was really a messy situation because when I from so I got my pump when I was 10 I was taken off the pump when I was 16

Scott Benner 25:11
Because you kept believing it at home.

Thomas 25:14
No because I wasn't testing my blood sugar enough so I was what I then deemed myself a naughty diabetic. And I always use this phrase naughty diabetic, which is such a bad way of phrasing things. But I always think, Oh, I'm a naughty diabetic, I'm bad. You know, I'm not testing my blood sugar enough. And I got to that point where I was, this is like when I'm like 1314 15 and I'm trying to live like a normal life. And you know, your friends would your friends would run off and go eat but you have to kind of stay behind and that wasn't that it's just not appealing to a 1314 year old. Or anyone else really, because we didn't have the kind of you know, understand like even people were telling me oh, you know long term effects you just don't you don't feel that impact when you're young and stupid. Sure, so I wasn't good with my blood sugar's did not test my blood sugars. And then was often you know, thing when I went to the clinic, they were like, well, you're not testing your blood sugars. And I was like, No, but I don't like to look at high blood sugars. You know, the classic I'd rather not test and rather not know what my blood sugar is. I don't understand. And that's when my my dad found out that he's is if Colin he worked with had a freestyle Libra. And so we basically got ahold of one of them. And then that definitely helped because I was able to see my blood sugars. But just after I got the FreeStyle Libre, they remove funding from my pump. they deemed it unsafe for me to be on a pump

Scott Benner 26:54
because of your blood sugars.

Thomas 26:56
So it's an it's an odd one they were saying because I wasn't testing my blood sugar. Okay. I've spoken to people about it since and they would they would argue they would never take a child off a pump if the child unless the child wanted to, because of course there's benefits to MDI over pumping.

Scott Benner 27:14
Well, if you inject your Basal insulin consistently, if you inject your but yes, and there is

Thomas 27:21
they, they took me off of it, because they the argument was if the pump ever something ever went wrong with a pump, say the pumps stopped working or, you know, something like that, or something where the pump didn't show an error, but if something was off, I would have no idea that the pump wasn't working. Because your blood sugar because I wasn't testing blood sugar. Like I was awful at testing my blood sugar. I can't explain to you Scott, how bad I was a testicle. Bucha

Scott Benner 27:43
days would go by you wouldn't do it. Yeah, yeah.

Thomas 27:47
I think that, honestly, I think it was one tablet back when I can't remember the last time I test my blood sugar, I think was a point when I was like 1516. And he's like, the horrible years where, you know, my mom would go test your blood sugar. And I'm like, I've already done it, even though I haven't I hadn't, because I was just being a difficult teenager. And I look back on that now. And I go, What was I thinking?

Scott Benner 28:09
Well, you know, last night, Arden CGM expired, and we had to put on a new one. So we're in that two hour window on the G six waiting for it to come back up. And she's like, I'm gonna go get a shower. And I was like, Oh, that's great. Just test your blood sugar first, because I'm fine. And I'm washing dishes and I stop and I dry my hands. I turned her and I say art and I say this all the time. I'm gonna say it again. If how you felt was the marker of type one diabetes, and you wouldn't need the CGM we wouldn't need that contour meter. And we would just ask you how you felt and then give you insulin because that's how that would work. Please test your blood sugar she tests her blood sugar and she turns the meter to me and she goes I'm at seven I'm gonna go take a shower and I was like, dammit

Thomas 28:50
because you're slightly hopefully that it's just like something was slightly wrong with that blood sugar's you prove your point. I

Scott Benner 28:54
thought we could just have a nice moment where I was right and she learned something. And instead she was like, I told you I feel okay. I was like but I just smiled. Well, this time it worked out but now you know, aren't you happy to know what your blood sugar is? And she just got up and walked away. Nevermind that was thwarted pretty pretty drastically but so basically what happens here is just for people who are maybe not sure two things I want to bring up. First thing is Thomas You must really understand what I do on on the pot and I say listen, one of the things one of the great things about Omnipod is you don't have to disconnect to take a shower or to go swimming. The rest of that sentence is cuz you know you're gonna forget to put it back on again. You know, or because if you are swimming for an hour or you know, etc, your long time without basil, not good. So that must resonate with you, I imagine. Oh, yes, yeah, but my bigger thought here is if people are not understanding exactly why they would have taken your pump, it is kind of basic thinking but at least if you're MDI, you're shooting Lantus or levemir, or some sort of long acting Basal insulin every day. So, you know, you at least have that background insulin going, but your pump is delivering your background insulin as well as your meal boluses. So when you switch to a pump, Thomas, I know you know this, but I was reminded yesterday that people don't know this all the time, when you switch to a pump, your pump is now handling your Basal insulin with a fast acting insulin. So instead of giving you one big injection, once a day of, you know, level mirror Lantis, your pump has taken that number and it's breaking it down over 24 hours and giving you little bits of it constantly to keep you stable. So if your pump should stop working, gets knocked off, you take it off, forget to put it back on, you suddenly have no insulin in your body. And that is the very fast way to decay. And that can come on you very quickly and be life threatening and very dangerous. So anyway, that's kind of in a nutshell, why somebody would have said that to you. And it seems fair in your situation, because you were testing on Tuesday.

Thomas 31:06
Honestly, it was bad. And I look back and I go What was I? What was I doing but I think I was what happened was I gone from injecting to this pump very quickly. And I think in my head, I thought I was I thought I I didn't have diabetes, and I was living my life. Like I didn't have diabetes. And I and the thing that mate was bad for me is I I've never been hospitalized. Well, in a good way. I've never been hospitalized by diabetes.

Scott Benner 31:34
But it makes you feel like it's never gonna happen.

Thomas 31:37
Exactly. So I've never I never had a it wasn't like, oh, I felt so awful one day, and I you know, and and I was in hospital, and I had to stay in hospital for weeks. And I never had that. So there was that. It's good that I never had that. But it's I never had that feedback. So it's like, it doesn't matter. Like what happens if I don't demand if I don't test my blood sugar for a week? Well, it definitely does. But that was my mindset. And yeah, so and the way that that works here is they just pull the funding. So you can I could go out and buy a pump and fund a pump myself. But

Scott Benner 32:16
it's not going to come through what we would consider to be insurance or something like that.

Thomas 32:19
No, and everything. You know, it's expensive, right? So pump was gone. But I had I had the Libra and I know you said before, but honestly, technically it was a flash glucose monitor but having your blood sugar data is actually was way more valuable to me than than having a pump because I can still give myself insulin with an injection pen. But the knowing what my blood sugar various were doing after I've eaten or before I've eaten or when I've exercised, or while I'm asleep at night like that stuff you can't get without

Scott Benner 33:01
it without Thomas, if you came to this house right now and told me you were taking the Omnipod out of here, I would meet you with force at the door. I want to be clear about that. But I agree with you. If I had to pick one if there was a false choice where I had to pick one, I would pick a CGM over a pump. You know, it just I could do the other stuff with MDI. But without the data it gets I mean you just blind and you're testing constantly you know, to get any kind of reasonable results you know, it's funny all this makes me think of a conversation I was having recently and I don't know if you'll see the connection right away but I was talking to someone about why believe there's community online that's so open and honest about their diabetes around type one diabetes, but not type two diabetes like why do type ones see this immediate need to get a hold on their their health quickly where type twos don't. And I think that the one mean the one thing that makes sense to me is that type one diabetes can kill you today. And type two diabetes feels like it'll kill you later.

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if it's going to and that makes you feel like you have time I think type ones don't feel like they have time. Like you don't have time not to understand this. You don't have time to not test you don't you can't just ignore it for a week. You can't do what you were saying which is try to live like it's not like it doesn't exist because the truth is is that its existence will come on you very quickly if you just try to plainly ignore it. So that wasn't happening to you. So you were doing enough. So were you just like blindly bolusing meals?

Thomas 38:36
Like yes. And sometimes not even bolusing I mean I would sort of either not Bolus or eat a meal. And this was the this this was what I thought was this was a good day for me was if I ate a meal and Bolus after I ate that meal that was that was a good afterwards today. Yeah afterwards

Scott Benner 39:00
so what was your Do you know what you're able to see was around then like I'm guessing it was like eight or nine?

Thomas 39:06
Yeah, my my him going into the Yeah, it could have been higher. It could have been higher.

Scott Benner 39:15
You see where my guest comes from? It's from you're taking your Basal I assume it's about right you're not Pre-Bolus thing so you're spiking your meals are probably keeping you in the two to three hundreds most of the time, but they're not staying up there forever. Do you think you're getting low?

Thomas 39:31
Do you know I had really I had really good hyper awareness and I think that was simply because I was running high. So time so much of the time that when I was going low, it was probably because I put way too much into that I'm really feeling so and then I would just eat and I would and this is true. I would I would feel low and I wouldn't test my blood sugar. I would just eat foods.

Scott Benner 39:50
I was going to be my question so you don't know. But you don't know if you are actually low like numerically dangerously low or if you are just feeling like you could have felt low it like you You know, a blood sugar of last I got like 150 which would be like 11. Or excuse me, like 115 for you is 270. Right? So say you say 10 is 180 for it, right. So

Thomas 40:14
when it is 10 for you, so

Scott Benner 40:15
you could have, you could have felt low at a 10 or a 180 and been eating when you really probably should have just wrote it out, but your body was probably so accustomed to being high that you and we don't even know because you didn't Yeah, we don't like you didn't

Thomas 40:28
find. This is like the my threshold for feeling low would have probably completely changed. And I went when Yeah, especially when I started to actually, you know, take this seriously, I remember feeling lower, you know, values, which now I don't feel out. Because I was adjusting I've all of a sudden was was, was having blood sugars that, you know, 100 and I was, which I shouldn't I feel fine at now. But I was feeling lower because my body has come so accustomed to thinking that this was laughing. No, it's very true.

Scott Benner 41:04
I do a lot of people that when they're bringing their blood sugar's down, the thing I have to tell them is, look, if you you might feel dizzy at 110 You're not in danger, but you are dizzy, like the desert, the desert doesn't make the Disney has any less real, you know, or that feeling any less real. And you kind of have to bring your blood sugar. That's why people talk about bringing your blood sugar down more slowly. I mean, those your decisions, you they're gonna bring it down slowly. So that that can do that, or you're going to live through some dizziness at that, you know, at numbers that aren't actually physically dangerous, except for you know, these now, these side effects. So when, how old were you when you I mean, you just said took it seriously, and what made you do it?

Thomas 41:48
So probably about three years ago, 232 years ago, so I must have been 1920. So I was at

university at this point. And this is, you know, with my placement and going around on the wards, I would see and meet people who were had kind of suffered the consequences of maybe what I was doing. And that was a that was a kick. I think I just grew up as well, I think I matured later than I would have liked and realized that I was just doing a lot of damage to myself. And I think I just remember getting sick and tired or I went I'm gonna sort this out. And I I don't quite know how I did it really the pot that mean this podcast was. It's like, if you know, I, when I'm older, I want to be an endocrinologist, because I kind of you know, have invested interest. And this would be that just prescribe this just prescribe this podcast. It's, it's fantastic. And I will I will, I will sing your praises, and which is what I can probably tell you're blushing. On the other side of this,

Scott Benner 43:12
I'm just being quiet trying to figure out where I jump in and stop you so that I don't feel like

Thomas 43:17
No, honestly, the podcast is great. And if I if I win, I'm a future clinician. It's something I've easily recommend, because it's it's a community and it's it's gives real life advice that makes it all of a sudden tangible. It's easy. I mean, I benefit as kind of seeing both sides of it of being diabetic and being a clinician, and you kind of it's very easy to kind of just, it's very easy to say, I'll just do this, because I knew when I was younger, I need to test my blood sugar. Or, you know, I need to Pre-Bolus but I never really it never really clicked with me until this podcast kind of. I don't know. I'm glad. Yeah, something clicked Scott. I can't put my finger on it. But yeah, let's just say it was me. i i Yeah, it was you. It was all you.

Scott Benner 44:14
I'll tell you one of the things about the show that I mean, if you've ever heard me say that my theory about parenting is that it's my job to say the same things a million times without acting annoyed mom saying it. So instead of turning to your kids and be like, How many times do I have to tell you to do this, you just say it again, in a different way. Try to find a more engaging way. Look for a different, you know, kind of psychological in and I sort of see the podcasts like that too. You know, like it just it's sort of like a daily reminder to Pre-Bolus and you know, check out your basil and understand the differences between different food impacts. But the bigger picture it's a reminder to be engaged and care and You know, not just the kind of carrying that makes you upset because it's not going well. But the kind of carrying that makes you look at the reasons why things are happening and make adjustments. And then, you know, how do you make those adjustments, but you can't be afraid, you know, you can't feel like well, I have to wait for someone else to tell me this is okay. Because, you know, if you're waiting for a doctor to tell you how to get your six, five to a six, you're out of your mind, because your doctor is going to look at the six, five and go, you're doing great. And that's going to be the end of it. To me, the podcast is just sort of, it's like World War Two propaganda radio. Just running in the background remind reminding you that, you know, Jerry is bad. And it's just it's a it's a, it's a white noise that keeps you focused. And I think it's got great information in it. So hopefully, it helps you. Can I tell you this, though, I've been dying to tell somebody this. I, I receive a ton of messages. People say that all the time. Most of them are lying. I'm not. And I got one the other day, from the person who said I saw a graph that you reshard How did the person do this? And I said, Well, I think I responded. I said, this person listens to my podcast, they probably listen to these episodes, gained some knowledge and some tools and they put them to work. Have you tried listening to the podcast? And they responded, I'm gonna get it for you. Because I'd like to. I'd like it to you on the quote. Yeah, I don't want to get this wrong. Hold on a second, because I laughed so hard. When I saw this. Where's it at? Here? It is. Have you tried listening to the podcast? She says I have. But it's just boring, not what I'm looking for.

Thomas 47:01
I think that should that you could quote that and put that on our post.

Scott Benner 47:05
Oh, I'm gonna make it. Solid turned to my wife and my wife laughed at me. And she goes, I don't think she likes you. And I was like, I don't think so either. She goes, Do you think she knows? It's you she's talking to right now. It's like, there's no way to know that, you know? So I responded. And I said, Okay, well, the person got the tools they needed from the show, I hope you're able to find something helpful that you don't find boring, Happy New Year. And I didn't hear back from now I can tell you, I do my best for this not to be boring, but apparently to this person. It is. But here's the thought it got caught my head. Who cares? It's all right here. Just listen to it. And you'll be okay. But the truth is, it matters. And it's what I've been saying forever, is that you can put the secret to life 45 minutes into a podcast. And if the audio is bad, people won't even make it to it. Forget it. If they don't like my voice or my delivery, or, you know, think I'm boring or whatever. You know what it means like so this podcast really only helps people who have motivation, drive. And oddly, it can take me. I mean, you know, I talk all the time about my favorite review, the show says the podcast is great. I don't like the guy. Like to me. That's amazing. Like you listen anyway, even though you hate me, like I think of you all the time, the person who leaves that review should know, I am delighted constantly by the idea that you're forced to listen to me and you don't like me?

Thomas 48:36
I think Well, I think the way the podcast is stroked, I think you're very good at simplifying things, sometimes very difficult concepts, and just kind of humanizing them a bit and making them really appliable. And so I actually think I have to totally disagree with whoever left that review because I think although Yeah, although may people may or may not like you Scott, I find that hard to believe it. Although there may be people out there that don't I think you are integral because you digest concepts and what people are saying and and make it

Scott Benner 49:13
it's very title, I will tell you that my best understanding of this is that I'm adopted and was raised by some very blue collar people. I think my mind works on one level, and my thinking works on another, if that makes any sense. So I talk like an average, hardworking person, because that's how I was brought up and it's who I am like, I've my jobs before this were not fancy. You know, I've I've cut lawns, worked in a sheetmetal shop worked in a bakery, like I've done pretty, you know, regular the Down to Earth quality. I've been surrounded by people who've done those jobs my whole life and I am one of those people you know, so I know how to speak in a plain way, mainly because that's just how I speak. But I do think my brains working thing. I don't know how to put it. I'm finding myself cornered. I feel like I'm going to sound like a pompous asshole in a second. And I don't want. But I might be a little, I might be a little brighter than my upbringing. Let's say that. And so I think that's why I can understand it. But I say it in a way that's digestible. Yeah, yeah, that makes sense. So anyway, I'm glad that it found you. I'm super interested in the idea that you were living a fairly unhealthy life as a child, but apparently, we're focused on being a doctor. Is that right?

Thomas 50:31
Isn't it bizarre? Isn't it? So 20 minutes? I am. I think I just some I somehow I wanted to Well, I wanted to and the weird thing is I wanted to do medicine because of my experiences with my consultants. It's so bizarre when I say it out loud. But I was like, Oh, I like this. I like talking to people. And I like science. And this is kind of a nice mesh of the two. is

Scott Benner 51:06
So yeah, sorry. No, no, don't be sorry. You see your consultants as great partners in your health. Except, honestly, your health wasn't great. So obviously, what they were doing wasn't helping you.

Thomas 51:18
In fact that Yeah, well, what was what was odd? The the doctor, the doctor that removed me from the pump later gave me work experience in a hospital to help me with my medical school application.

Scott Benner 51:31
He knew it was you.

Thomas 51:34
Yeah, she Yeah, she knew it was me. You know, it was,

Scott Benner 51:37
it can help. I'm just assuming a doctor was the man. Everyone always, you

Thomas 51:41
know, well, it's like she always used to say to me, she was used to go, Well, if you want to be a doctor, you've got to look after your own health. And I'm like, yeah, yeah. I mean, it. It's so true, though. It's so it's so it is so true. And the problem is, I think I was just a horrible, horrible teenager. And if anyone is currently having to deal with a horrible, horrible teenager, I will say that when they leave that teenage phase they are will be ever thankful for whatever you're doing, because even though I was probably horrible to my parents, you know, snapping back at them saying, I've tested my blood sugar. I look back now and I go, you know, they've got me through, they got me through the difficult times. Actually, we've a lot, you know, they did a lot of stuff. And I did not share my appreciation at the time. So if anyone's dealing with a teenager right now, just, they'll appreciate the future. Just hold on, hold on.

Scott Benner 52:37
Don't lose your mind quite yet. There's gonna be Yeah, well, I, you know, I always joke about like, I see a movie trailer for like a movie, it's coming out next year that I want to see. And I actually think in my head, well, there's a good reason to stay alive another year. And you know, that's the motivation I need to do do a sit up, take a walk, I want to see whatever. And sometimes I think about parenting like that, too. Like, I, I want to live to be older, because the day it happens that day, one of my kids rolls into my house, and it's like, Hey, I just wanted to stop by and tell you, I appreciate it. I am gonna, like, it's gonna be the best day of my life.

Thomas 53:13
It's gonna be the, it's going to be exactly what you wanted, when you went out and asked her what her blood sugar was, when she when she was waiting for the Dexcom to warm up, you'll have that but 100 times better feeling

Scott Benner 53:24
and it's going to be my job in that moment not to stand up using my walker, and to better myself, look her dead in the eye and go, I told you

Thomas 53:36
it will happen one day and you will feel fantastic.

Scott Benner 53:39
I'm going to do everything in my power not to say I told you so I'm gonna just say oh, I'm very glad and give her a hug. You know, but to your point, you know, it takes time and that this I mean, listen, I've been doing this a long time I've spoken to a lot of people in your age range. Your story is not uncommon for people who just like I just didn't want to think about diabetes and so I didn't and then I lied to my parents about it and I've had people on here who are the gentleman on recently is an older person that he used to lie to his parents back when he had to run like urine strips underneath a water to make it looked like his blood sugar was low. Like he was lying back then to like, it's it's not uncommon, right? The caveat is, you got to make it to the part where you figure out you want to be healthy with enough health to actually live your life. And I've also spoken to those people who figured it out. And it was too late for them already. And that's a horrifying conversation to have. And very real and more frequent than I would like it to be. So your your health is good.

Thomas 54:45
So yeah, so since all I the way in the in the UK, we're not looking at the way the UK funding works is currently at the moment the Libra the Libra two is what we have in the UK. So if you speak to any most diabetes in the UK, they'll have a Libra to it. And the exception being if you're pregnant, you get the Dexcom. Or if you have, you can apply for special funding to get the Dexcom. Or of course you can pay out of pocket. Right, right. And so with the Libra I think the the reason I mentioned Libra is the cause of the technology of it. I'm I love technology, a bit addicted to technology and all the bad ways. And I think it just hit a part of my brain and I was like, This is great. And so I started hacking my Libra and putting like, Meow Meow on my libre one. And then I've hacked my Libra too. So currently, right now my setup is I have a Libra two which sends data to my phone to extra IP, extra IP then communicates with a Android artificial pancreas system. And that then directly communicates to my dash Omnipod dash are using

Scott Benner 56:01
GPS. Yes. Okay.

Thomas 56:06
Currently, I am months in so if this is my third month, second month,

Scott Benner 56:12
how long have they hacked into the dash? Like, okay, just let me do this real quick. You're using a do it yourself system. It's not been FDA approved. It's not been NHS approved. And somebody has built out an app that works on an Android phone. That's getting Wow, your libre data through? So the Libre is made by that company. You're using the what do they call it? The MT Mt? What

Thomas 56:38
does it call? Not anymore? Now that leap? They've had the libre two, so it directly communicates with the phone. Okay. And and it sends data every minute. Okay, so the phone it? So for clarity? Everything's been hacked? Like the Yes. Okay.

Scott Benner 56:51
Right. And but how long have they been hacked into the dashboard, I wonder.

Thomas 56:59
So the dash has. So the dash there, how they hacked it. And then they released it in beta, November of the end of 2021, November 2021. And the beauty of the dashes compared to the Eros or the pumps is you don't need a Reilly link or anything like that. Because you can Bluetooth from the pod. Yeah, so the pod directly communicates with the phone. And, and all that. Yeah, it's, it's really, I'm really ever hacked everything. So yeah, basically, what happens is, is I don't know who there's some very clever people that figured it out. Now, I know, currently, it's only be in beta. And so it's currently going to release I think in the next month. So everyone who uses a AAPs? Yeah, the Android loop system can can access it,

Scott Benner 57:59
I keep wondering how much longer will the you know, do it yourself systems be worthwhile, when some of these new systems that the companies are coming up with like these, their next generation stuff is already like has learning functions in it? Where where they're going to start making adjustments based on history? And then that's pretty crazy. You know what I mean? So maybe retail pumping, or retail algorithms might actually leap forward, beyond the do it yourself, right. And I listened art and uses loop. So you know, as we're recording this on the pod five is not available yet. But Arden uses loop currently. And I think it's the best. I think it's the best system I've ever seen. And you know, will on the pod five, you know, have a learning aspect to it. I don't even know I haven't seen it yet. But I do know that control IQ is in testing with their next version. And their next version sounds like it's going to learn and change. So this stuff is really going quickly. It's super exciting.

Thomas 59:07
I mean, I remember first reading about Android loop. And it's it does things I'm like how how does it do this? So one of the things it does is every time you put a new cannula in it will see your your glucose data, and then it will go oh, well this site, but you've put this cannula in for some reason is a bit more insulin resistant. And it will say on the side like, Oh, you're 20% more resistant. So when you give a Bolus, we'll recommend a bit 20% Extra Because currently, this site isn't working as well as we'd like it to. Or this site is actually oversensitive. And actually we recommend a little bit of insulin, like how have you worked that out like it has and it works because I'm getting these as you experienced these beautifully flat lines when I sleep and I'm still A bit of a rookie in trying to understand the eating with a loop system. But yeah, it's It's remarkable and that Android APS has all the I could go on all day about I find it so fast, it has all these settings that you can make it. So a phone, a phone, that's not the phone that's connected to the pump, from anywhere in the world can send a text to the phone that controls the pump, and change things of the pump, like change. And I just like wow, someone, they've really used all the resources here to make diabetes like so much easier and used slightly. Yeah, it's just remarkable.

Scott Benner 1:00:39
What's funny, you just brought that up, because Arden just changed her pump like an hour ago. And I just didn't last five minutes, send her a text. So I, when we change the pump, we left the loop open, so not act not working so that her basil would be consistent. Because I know she's going to be a little, she's going to need an influx of insulin to get past this, you know, this site change. So we did a Bolus and left the loop open when we changed it. And I just looked up a few minutes ago and I was like, ah, it didn't work as well as I hoped. And I just told her to use two more units again, because we're trying to get that site working properly so that we can then close the loop up and let the algorithm start working. It's not it's really cool. I'm I love it all like I really do I think it's all just fantastic. I think that if you took no excuse me, let me take a drink I'm not sure what happened. I think if you get in the time machine with on the pod five or control like you are you know, Android APs and go find little 10 year old you and slap all that stuff on you. Most of what you experienced probably doesn't happen. And yeah, I'm really thinking as crazy as it sounds. Your entire problem was was just testing. It was the it was you did not want to test you did not want this thing to be in the way testing was the was the was the bridge too far for you. You're like, Look, I'll give myself insulin. But I'm not going to stop before I eat to test my blood sugar. I'm not going to like that was really it for you. And all this technology fixes that problem.

Thomas 1:02:14
And I think a lot of it comes from me being a grumpy teenager. But I look at it now. And I mean, I'm the Dexcom is probably going to start to be funded on the NHS, for everyone. And I probably jumped to the Dexcom where that happens and you know, because it's I think it's slightly is more accurate than the libre to is. But I just I mean, my my Hesperia ones see now is I'm trying remember the conversion. I think it's five, it's just telling me it's 40 which I think is 578 Something like that. Okay. 5.8 I think I mean, yeah, and, um, and on top, you know, on top of all that is the stress of medical school, which complicates these things. But the, the i Yeah, to this day, I'm still shocked. And I find it really cool that I literally have a device that's constantly tweaking my Basal rate to make sure it's, you know, perfect. That it's not going too high or too low. It's it's really cool.

Scott Benner 1:03:29
Do you agree with me that watching the algorithm work teaches you about insulin toe?

Thomas 1:03:34
Oh, yeah. Cuz I'm like, Wait, why is it why is it deciding to give, you know, to increase my Basal rate? And I'm like, oh, yeah, cuz yeah. Because actually, if that blood sugar kept on going up, I probably would be rocking a, you know, one 190

Scott Benner 1:03:50
Yeah, it's fascinating when you watch it, just like, even make these pledge I've seen Arden's budget could be like at 790. And it's like 11 o'clock at night. And it's like Bolus and point two point 2.4. And I'm like, Oh, my God, like, you know, and it's always it's okay. Like, it's one of those things I would have never known to give her insulin there. She would have gone off, I would have had to wait to my alarm went off at 120 would have said, okay, she's 120, then I would have had to use more insulin than the loop ended up using which may made her low later. And all that just gets avoided because it knows she's heading up and it's trying to stay ahead of it.

Thomas 1:04:25
It's isn't sleep fantastic.

Scott Benner 1:04:27
I feel so much better. I can't even tell you. Now, my life has been changed in the last couple of years. Most by being able to sleep seriously. It was a big problem. My daughter had diabetes for a very long time. I was I was killing myself, like, at times, you know, with with how I wasn't sleeping. Even when I was doing a great job. They were still like that thing. Were like, well, she's going to bed now. I'll wait a little longer to make sure it's okay. You know what I mean? You'd have to wake up sometimes give a little insulin give a little juice And it was just, it was forever I was it was killing me. I think it's taking me years to bounce back from it, it was I was so beat up from it at times. Anyway, how is medical school and diabetes

Thomas 1:05:18
it's, it's, it's it brings different challenges. I mean, it's hard to tell I've what to compare it to the what the hardest thing I think is, which is not exclusive to most schools probably is the night shifts. Because you will have a lovely, you have a lovely Basal rate or setup and you'll have you know, all your everything's perfectly set up on your, whatever device you're using. And then you decide to one day stay up until really, really late until 8am. And then you drive back home, and then you go to bed at 10am. So you stayed up all night. And all those growth hormones or and all those other hormones that usually get released while you sleep, have a bit confused. They're like, but we've not really been sleeping. And so I remember the first time I did a night shift, I think, three or four days afterwards, I was like, I just my insulin resistance just shot up. It's almost like my body was so confused, because it went from, you know, normal nine to five days to now doing 8pm to ATM. And then quickly reverting back to a nine to five. My body, I don't think was used to it either. Now, it's not as bad. And now I have a different Basal setup. If I'm, I've got like a Basal rate before the days before I'm going into a night shifts during the night shift, and then afterwards, because everything changes. At least for me,

Scott Benner 1:06:57
it's all. So the switching of the shifts is the closest thing I'm seeing who is a woman getting her period having those different kinds of weeks of impact and hormones and like different Oh, that's really interesting.

Thomas 1:07:11
That's how I kind of treat it. Yeah, I almost have like it's similar to way that you would you would change women often change their Basal rates based on the monthly cycle. Yeah, well, I'm changing mind based on my, my, your monthly cycle. Yeah,

Scott Benner 1:07:28
my monthly cycle, it's just your cycle of when you're awake, and when you're active. And when you're thinking and doing things. Yeah,

Thomas 1:07:35
that's because it's almost like, the first the first night I'm probably I try and stay in bed as long as I can during the day before to wake up as late as I can. But then your course staying up, I probably wait try and get up at like 1pm. But I'm still then wait, go into bed at 9am the next day. And so that's a long, that's a long time to be working and be, you know, awake. And all of a sudden, my body's like, Well, why? Why are these hormones not being released at this time. So I basically have to have a different Basal rate for that period of time. And that I did that by doing Basal rate checks. during those periods, I was like, oh, okay, for some reason, at this time, I get crazy insulin resistant, I need to bump this up. And that's how I just went from there. But like most of these things, it's all trial and error. And it's kind of adjusting and having the confidence to adjust these things. Because I think I see this was the biggest thing I get when I talk to patients when I when I've worked in in endocrinology is there's a lot of there's like you said, there's a fear of insulin, there really is a fear of insulin. Yeah, there's a fear of hypose. And I completely understand that that fear. But you won't get your blood sugar's down to a range you want them if you're not giving the drug that helps bring those blood sugars down. Yeah. And there's a fear that that people will go see, I used to do this myself, I'd go see my doctor, and my Basal rate was that, and then I wouldn't see my doctor for God knows how long and my Basal rate would stay the same. But my body's not sat there going, Oh, well, we can keep this Basal rate the same? Yeah, my body was changing and growing. And, you know, then I'm wondering why things aren't right. You know, so, having the confidence to go, right, my blood sugar rises in the evening. Well, you know, this could be due to multiple things, but I probably just need more insulin around this time, be that, you know, a different carb ratio or more Basal insulin, you know. And, yeah,

Scott Benner 1:09:46
I'm telling you the one of the things that I learned first, back when my daughter is eight once he was hired, and I didn't know what I was doing is that the fear I had events on had to go away, like everything else that I could see that seemed like reasonable steps, I couldn't get to any of them without getting rid of the fear. So, you know, to me, that's, that's step one. And my best bet, based on everything I've learned and seen and written about and talked about, is that you get your Basal right first. And that at least should keep you from having those low drifts. And like, you know, constantly being low all day, it should help with your meal insulin, then it gives you time to figure out how to balance out the meals and get them working better. So that you're not spiking and not getting low later. But if you're afraid of the insulin, none of that's possible. It's just It's because you're constantly in a state of like, oh, I don't want to do this doesn't seem right. I don't want to change this. And you're 1,000,000%, right? Like, as you're growing, or becoming, even as it gets colder outside, you become more sedentary, it gets warmer outside, you start moving around more, all of these things, change your insulin needs. And we all just act like oh, you know, the guy told me this is my Basal rate, it's gonna stay like this forever. And that's not even true. I mean, you watch the algorithm work. That's not even true, sometimes hour to hour. You know, let alone Yeah.

Thomas 1:11:08
And I remember when I went to you first, I mean, my Basal rate was the same constantly, throughout the day, when I when I used to be on the pump when I was younger. And I look back now and I go, I mean, it may have been right at the time, we don't know, I wasn't testing my blood sugar, but I looked down and I go, that surely could have been right because at least for me, there may be people out there that have a flat base all the time. But for me, my changes throughout the day, from when I'm waking up from from a weekend to a week day, but it's having a big and the problem is you'll never have enough time for the doctor to work out every single scenario in your life. Never has it as it changes. Yeah. Especially as you're growing up when you're young, you know. And so actually having the gaining the confidence to be like I'm quoting you now I'm bold of insolent There you go. To Be bold events, I feel so cliched saying

Scott Benner 1:12:07
I didn't even honestly purpose. So don't worry about it.

Thomas 1:12:11
But honestly, to be bold of insulin is is what you need to be able to do because then you can it gets to the point where I go, I remember going to my I had an appointment with one of my diabetic nurse and I called her and she looked at my my HP on scene she went and oh, that's, that's, I mean, you're so your Patreon see so low. And I was like, Yeah, sure. And she went, Oh, you're like, you're you're not even you wouldn't even show up as diabetic. And I laughed at it. Yeah. And then she goes, you might want to raise it a little bit. I went, what? Why ever questions. This is the thing. I think she was so she was so confused. She was like, but usually when I talk to patients, it's not that but I think she's got worried that it was, it was

Scott Benner 1:12:57
so hard. Yeah, yeah.

Thomas 1:13:01
I remember she's going are you just constantly running in a Hypo? And I went, No, that would, that would be horrible. But I was able to, like you get to that point, you have to speak out like you have to. And the thing is, what's annoying is I look back at myself and I go, I knew my blood sugar was always high in the evening. But I remember I would just sit and watch it get higher. And I'd have to treat a high blood sugar. It's almost like I knew it was coming. I knew this high blood sugar was coming. And I just sit and wait for this high blood sugar. And I was chasing these high blood sugars, even though I knew that was coming. And I just needed to go, right. I know, I'm gonna go high. I get high every evening at this time. I need more insulin at this time. Right. But for some reason that sounds so simple. I it's just I think the fear maybe I had stopped me from doing well, Thomas,

Scott Benner 1:13:51
here's the here's the truth. The fear that I had of the insulin wasn't as strong as the fear I had of my daughter being unhealthy. So I basically just took one fear and overpowered the other one with it. And then that proved to me, I didn't have to be afraid of the first thing. I'm still afraid of the second thing. Like, I still don't want anything bad to happen to my daughter. So when I see a blood sugar, that most people are like, Oh, that's cool, like after dinner. 140 I'm like, wow, what did I do wrong? Like I you know, like, we got to stop this, like, I'll let it go a little bit to make sure that it wasn't just a simple timing thing, and it's not going to come back. But I wouldn't stare at a 140 any more than I would stare to 300 like the reason I don't see 300 is because I don't stare at 140 and, you know, it's just sort of its mindset. And for me the mindset is your blood sugar supposed to be if my daughter didn't have diabetes, her blood sugar would be somewhere between 65 and maybe 140 You know, on the high side, maybe 160 If she had three slices of pizza, you know, six handfuls or rice or something like that. With Chinese food, but that's got to be the goal. And you can't just look at 160 after Chinese food for seven hours and go, it's okay people's blood sugar goes up to 160. Every Chinese food Yeah, it does not for that long. So you know, if if I've worn a CGM, I've, I've pressed myself and driven my blood sugar to like into the 160s. And it'll go up and hang there for a couple hours. But then as soon as the pizza was gone out of my system, it was down again, quickly. You know, it didn't linger for 567 hours. And the problem with that becomes it's sort of like you just get lulled into a comfort zone, you're like, oh, you know, you know, I know my blood sugar. Best case scenario is between this range, but it's only 150. And then you get used to 150, which then makes you Okay, with 160. It's like gaining weight. It's like I only gained three pounds, it's fine. I'm only up 10 pounds, no big deal. And then you reset and you go, I'm only up three pounds. Yeah, you're only up three pounds, and she gained 10 pounds. Now you're up 13 pounds, you know, like your brain. Your brain starts making excuses for you along the way. And that's how people's blood sugar's then end up at 200 All the time they go, it's fine. It's only 100 pounds higher than it's supposed to be. That's not bad. 100 is a pretty relatively low number, it could be 300 points higher. So it's only 100. And that's how you trick yourself out of it. It's your cognitive something. I forget the word. I didn't go to college Thomas. So I don't know everything.

Thomas 1:16:26
I think I was at that point as well. I was having I remember going oh,

I have a blood sugar of 175 I was like, Oh, that's good. Because, you know, I

was taught when I first became a diabetic that between 70 and 180 was good. So I was like anything, but you know, and yeah, below 180 Is is fun. And of course it depends where you are in your diabetes journey, I guess. But to me, it was like, Oh, I had one reading below 10 That was good. But actually most of the time I was already above 10 And that's because I got so adjusted to I you know, I'd wake up on my blood sugar be like 21 on the were times that I tested it when I was younger. And I just give a load of insulin and get on with my day. Yeah, and I got so I got so used to that I got so used to this kind of that that that that when I was actually on the high side of good you know 175 ish that that I realized I'm I'm darting back and forth between American and British convert. I actually what I did it actually what I did it I listened to the podcast and I'm going what's what's what's one at a political one at that will be, I'd be dead? Because of course the highest my blood meter can read is 33. Yeah. So 100 Whoa. But I actually then changed all my devices to the American system. So you could be roll with me? A little bit. Yeah. But also because I actually I found the American system to be slightly more tangible for for my brain. Okay. I don't know why I found that the range of 70 to 180 work works better with me than I think that's because in my head, I'd see a blood sugar of one. You know, 200. And that's to me st is probably seems higher than it actually is. Or 200. Really high because to me 200 Sounds like 20, which is a height which is 20 converted over is about 380 I think something like that

Scott Benner 1:18:41
you're using you're tricking yourself, but in a good way. In a good way. Yeah.

Thomas 1:18:45
And I noticed this way. I'm not necessarily advising this for anyone. It may work. It may not. But when I switched it over, my blood sugar range almost just became tighter. It was so bizarre. It was almost like it was because I was having to think about the blood sugar's a lot more. I didn't know what 100 meant. I have to have to

Scott Benner 1:19:03
bring it down. Yeah, I

Thomas 1:19:05
had to go okay. 100 Okay, that's good. Yeah. Okay, it's good. And there's a flat and there's a flat area there. That's good. I'll take that. Yeah. But when was like, Okay, it's, it's 180. And it's got an upward arrow. Okay, well, what's 180? Okay, that's not as good. Right. And so it kind of reframed it. I think I got so used to being blinded by that. Actually, for me switching the system over helped.

Scott Benner 1:19:28
helped you just think it sounds like what it did was it took you out of reality for a second just made you focus on your diabetes for 30 seconds.

Thomas 1:19:35
It got me out of my own habit in a very bizarre way. Yeah, that's

Scott Benner 1:19:39
why I have a list here of the top 50 cognitive biases. And I'm working hard on getting a professional someone who can speak on them thoughtfully to break them down into small episodes because I think that the way people's minds work are Some of the reasons why they they falter with their diabetes care. So I'm going to try to add this to the podcast at some point, just little things like confirmation biases and but there's way more than just the ones you've heard about on TV, there's a lot of things your brain does to you, that that stops you from being successful. So I'm gonna see if I can't make some of those into the show. Because, you know, I've already been put, by the way you didn't like, you didn't just make me think of that. I've been planning this for a while, but I

Thomas 1:20:28
take no responsibility on how that that you know, section of podcasts that you can make your eight games. That's all on you.

Scott Benner 1:20:36
If it doesn't go, Well, you don't want to see one of those reviews. I mean, Tom has ruined the podcast with his ideas.

Thomas 1:20:44
But that actually sounds really interesting. Yeah. Yeah, that sounds really interesting.

Scott Benner 1:20:50
I just really, I tried to like, I tried to sneak in an episode about sunk cost fallacy last year, I was like, I wonder if people listen to this. And but, you know, there, there's just a lot of ways that your brain gets in your own way. And, and it's, you know, it's if you recognize it and see it coming, you might have a chance of, of not doing it. I mean, you don't see it any more and more obviously, in, in modern culture than in social media, where, you know, someone says something, and you see somebody have a crazy hard reaction to it, but another person will read it not see it the same way. But the same thing has been said. So it's, it's often your perspective that's stopping you from taking something in or understanding it the way it's intended. And you can fix that. So anyway, I will say, the only other thing I have left that I need to tell you is that I love the picture from your Facebook page. I don't know. Oh,

Thomas 1:21:45
the one where I'm in snow?

Scott Benner 1:21:47
No, no, the one where you're in a crowd of people in a club.

Thomas 1:21:50
Oh, that one? Yes.

Scott Benner 1:21:54
I don't know how that photo, but it's fantastic.

Thomas 1:21:56
I was in I study I studied at the University of Leeds, which is a city in North of England in the county of Yorkshire. And there's a club called I can't be the same. It's so bizarre. There's a club called fruity. And that's the club I'm at. And there's a cameraman who is at the front of this stage. And I think I remember

as you the picture, I'm I'm not sober in that picture. I don't know if that's good.

Scott Benner 1:22:28
I can't imagine what but there's something about the perspective. It's almost as if you were the only person in the crowd of people who leaped upwards. And so and so they all appear to be like you I can almost imagine the people is water and you popping out of the water. That makes sense. And it's like you've it's like you've you've broken through, you can feel the sunshine. And you're like I'm above the whole thing for a second and that the photo is just caught in that moment. And it's

Thomas 1:22:57
it's an interesting picture. I love it. I've got I'm blushing now I'm blushing. Because I think

Scott Benner 1:23:02
your photos interesting. Stop it. Yes. I love how your mind thinks you didn't care when you were killing yourself.

Thomas 1:23:11
But yeah, exactly. Such a weird weird mind. Such a weird weird mind

Scott Benner 1:23:16
any other autoimmune stuff in your life or in your family?

Thomas 1:23:21
My mom has hypothyroidism.

Scott Benner 1:23:24
Hashimotos or just hypothyroidism? Just hypothyroidism.

Thomas 1:23:27
Okay. Apart from that, nothing exciting.

Scott Benner 1:23:33
Okay. I just I just like to ask. I find a lot of it's just interesting that you find a lot of people here in America whose roots tie back to where you live, who have autoimmune stuff. So I was just interested in like, yeah, everyone in your in your family line is stricken or, you know?

Thomas 1:23:54
No, just mine. Just my mother.

Scott Benner 1:23:56
None of us had I just bred Scott.

Thomas 1:23:59
I didn't even listen to one of your podcast I made I misheard this one. But Wasn't there some link between the coating on pans

Scott Benner 1:24:08
Oh, we I was talking to Addy Dr. BENITO about thyroid stuff. And she brought up just kind of off the top just out of nowhere that she won't use nonstick pans. And I was like, Well, me either. And she's and she started talking about the chemicals. And I was like, I sound like a hippie all the sudden, which obviously Thomas I am not. But I just there are certain things that make sense to me. And coating metal with a chemical and then making it really hot and then touching your food to it has never made sense to me. I don't know if I'm right or wrong. It just throughout my life. I just use stainless steel pans. They're harder to clean and I don't care. So I don't know if I'm right or wrong. I could be I could be out of my mind. It's just it's one of those things it didn't it didn't make sense in my mind. Like why would I heat up chemicals and then rub my food

Thomas 1:24:58
and then yeah, and when you Say it like that it is making me want to throw all of my nonstick pans in the bin. It just feels weird actually, there was a substance on there that stops my food sticking. Yeah. And isn't it that I could go down?

Scott Benner 1:25:13
You know when the venom gets on the Spider Man it to me like that. I'm gonna end I'm gonna end with this. Why are you people taking all of our superhero roles and movies? Can you? Can you just stay over there? Like what's going on? I can outcome every time. I see a character in a movie. He talks like me and then when I hear him in an interview, he's like, talks like you like what's going on? Like,

Thomas 1:25:38
dance a lot is from my understand. I think Superman Henry Cavill is British he is and the spider who is British. Right. Tom Holland is British. Have you seen the new Spider Man?

Scott Benner 1:25:50
It was fantastic. Yeah. Okay.

Thomas 1:25:53
I'm trying not to say too much. Oh, I loved it. It was fun. It was fantastic. But I don't want to spoil it at all of course.

But yeah, so yeah, Tom Holland is was British and I think the guy who played spider man before him Andrew Garfield. I think he's half British. Yeah, we're everywhere. Oh, yeah. And yeah, because Dr. Strange is British.

Scott Benner 1:26:15
Keep going.

Thomas 1:26:16
Oh, come on my brains working hand. Someone else in that film?

Scott Benner 1:26:23
There's a ton of people. I'm just saying you guys like I mean,

Thomas 1:26:26
like, I know Lok Lok the guy who plays Low Keys British. Yeah, we're everywhere. I do apologize. Your fault as I slow down. We just do you know, do you know what I do? You know, this is a thing that I think as as a British person, and I listen to and listen to Americans and I go wow, their voices are so cool. Like you've your accents are just so really, maybe yeah, maybe you've maybe it's the same way that maybe I think my accent is terribly boring. I your accent I hate them. Like, that just sounds so cool. To me. It's that idea. I think if I went to it if I went back to America, I'd I feel like I feel like everyone be fascinated by my voice. But actually, I think it's a very round I think American accent is so different variation.

Scott Benner 1:27:19
It's just wherever you come from. You want something else because in my mind, I sound like I have like a bucket full of bolts in my head for a brain. And you sound you sound elegant.

Thomas 1:27:31
Oh, I'm I'm I know. I know nothing. So this world.

Scott Benner 1:27:36
You don't have to know anything to sound good. Listen to. I'm gonna tell you right now. I think part of my success in podcasting is just that I have a deep voice.

Thomas 1:27:46
I think your voice sounds it's I gotta be careful. I'm gonna sound like I'm flirting. Go ahead. I'll take your your your voice is like deep boomy. But it's good. It's it's good for it's good for radio. It's fantastic.

Scott Benner 1:27:59
It's and I didn't even sound like this in person. I have no idea. I can't hear myself.

Thomas 1:28:04
This is where we find out that you actually put a filter on your voice.

Scott Benner 1:28:07
I am not changing my voice at all. No, I mean, I am. I'm speaking into an incredibly expensive microphone. And it's very high quality. But I'm not like, I mean, I use a couple of digital items to take my voice through an analog microphone microphone and have it picked up digitally on a computer. I don't have any like great setup. You'd be surprised I have almost no overhead. Actually, when I do my taxes at the end of the year, my accountant says to me, like do you not have any bills associated with this podcast? And I was like, no, he's like, there's nothing we can write off. I'm like, it's just me. And that microphone, man. I don't really need much else. And I was like, once in a while, like, I have to buy computers and things like that. But there's no one to like, there's no employees to pay, or I don't have to I don't need an office. Like I don't have any costs that are associated with it. I just have this very expensive microphone. So

Thomas 1:28:58
but it's it works. There was this is probably way too much information. But I remember I'm someone who often sometimes listens to podcasts before I see. And I don't know why. It was the I think it was the Pro Tip series. I mean, I've listened to it probably hundreds of times before. But I was like, I'm just gonna play this before I go to sleep. And then there's like a month where I just every night I would put on a protip and fall asleep. And I don't know a bit me was like maybe if I constantly listen to this while I'm sleeping, but actually, it will get into my brain even more like I remember every word. And then it will it will be so easy to apply to my day to day life because it's like ingrained in my mind.

Scott Benner 1:29:37
I hope that works. I think I think that's how i Alright, I'll leave you with this. But first I'll tell you that when I before I was married, I used to sleep with cello music, but my wife won't let me do it so I can I'm not allowed to do it anymore. But just just unaccompanied cello music is how I used to like to sleep anyway. I'm a senior in high school I'm taking a psychology class, I am incredibly bored by the class, I do not like the teacher. And I It must hit in that time in the afternoon when people are sleepy. Also, we've learned now as I've gotten older, I may have had like an iron deficiency a lot of my life. So I'll blame that a little bit. But I would get to this class every day. And despite my best effort could not stay awake in this class. So I would come in every day, put my head down on the desk and go to sleep. I didn't do the classwork. I was failing this class horribly, it didn't matter. I already had enough credits to graduate, I never once thought about it. We come in one day, towards the end of the of the term, I think this was like a half year class. And we're going to take the final exam. So it's the final exam, but in the middle of the year, and I come in, and I think okay for the final exam, and I put my head down, like go to sleep. And a couple of minutes later, a friend of mine named Mike, who I don't even know anymore. But, Mike, if you're out there, I enjoyed going to high school with you. He reached over and shook me. And I remember him saying, don't you think you should at least take the final. And I was like, that makes sense. So I sat. And I hammered my way through the final exam. Well, the next day, we came in last day of class, and the teacher is handing the final exams back out and he's gonna go over the grading and he looks angry. Like Thomas, I'm not kidding. The man seems pissed. Like somebody kicked his dog and cheated on him with his wife and the whole thing, right? And then, no kidding. Hold on a second. My wife is like you have to stop recording now. I need your help. So anyway, he's super pissed. And he gets up to the front of the room. He leans on his desk in absolute defeat. And says, Does anyone want to guess who got the best grade on the final?

And listen, I'm just gonna say I can be such a dick. Sometimes I raise my hand. I was like, Was it me? He goes, it was and he put his head down, almost like he had wasted his entire life. Do you know what I mean? Like he was like, Why did I do this? Why do I think teaching is important? Why did I go to college? This kids? I'm not like, I'm not overblowing this I slept every day. I did not listen to anything this so I said maybe I just learned it in my sleep. Is that called osmosis. And he goes, I don't think that's what it's called. I'm like, I probably just learned it in my sleep. And we all laughed and I gotta be plus, and everyone else did worse than me on that test. So maybe you are learning diabetes while you're sleeping.

Thomas 1:32:40
You ruin that man's life. Scott, you you made that man think that his his whole career

Scott Benner 1:32:46
was worthless. I felt it very strongly in that moment. Like I Oh god, I bet she's not a teacher anymore. Like and he tried to imagine seriously every day he shows up and does this thing with his high minded idea that he's going to educate people and the one person who didn't pay a lick of attention to him and by the way, I never read anything. It's not like I went home and taught myself it was just psychology was like high school psychologist common sense kinda you know? So I just like I don't know man, I just I'll remember that forever. Anyway. I'm so sorry to jump off quickly for you but I do have to go

Thomas 1:33:22
no, that's absolutely fine. Cool.

Scott Benner 1:33:32
A huge thanks to Thomas for coming on the show and sharing his story. And I'd also like to thank Dex COMM And on the pod for sponsoring this episode, don't forget, you may be eligible for a free 10 day trial of the Dexcom G six go to dexcom.com forward slash juice box to find out. Also you may be eligible for a 330 day trial of the Omni pod dash Omni pod.com forward slash juicebox. Don't forget if you're a US citizen, head to T one D exchange.org. Forward slash juicebox. Take the survey. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.