#792 Owner of a Useless Pancreas

November 17, 2022Scott Benner

Your pancreas isn't dead. It actually still does some important stuff. Today Jenny and Scott explain what your pancreas does and what it may be struggling with that isn't insulin related.

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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 792 of the Juicebox Podcast. Do you want to know what it's about? I'll tell you in just a second

it is likely that you've seen a t shirt that says owner of a dead pancreas owner of a useless pancreas. my pancreas quit on me or, you know, any number of variations of that theme? Well, yeah, I hear what you're saying feels like that write won't make you any insulin. But maybe you didn't know that the pancreas does more than that. So even if it's not making insulin for you, it's still helping you with something else. That's very important. But for some people, it doesn't do that thing perfectly. Just listen, we're gonna go over the whole thing. It's very important that you understand what your pancreas does, and what it might not be doing. And if you're seeing symptoms of that, how you can help yourself, you're gonna love it. And of course, Jenny's here, so, I mean, even if I suck, Jenny's amazing, nothing new here on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. That's pretty much it. Except hey, don't forget to go to the TYT exchange and take the survey, T one D exchange.org. Forward slash juice box. Today's episode of the podcast is sponsored by two longtime advertisers Dexcom, makers of the Dexcom G six continuous glucose monitor, and Omni pod, the insulin pump that my daughter has been wearing since she was four years old. To learn more about the Dexcom G six and to get started today, go to dexcom.com forward slash juicebox. And if you're interested in the Omni pod five, or the Omni pod dash, you can find out about both of them at Omni pod.com Ford slash juice box. Now we'll get to the show. And Jenny who by the way, works at integrated diabetes.com. Hey, hold on. Yeah, what's up? How are you feeling? My head's a little swimming. But I can breathe.

Jennifer Smith, CDE 2:27
Good. I was going to actually see if you want to do if you were okay to do this this morning. Or he wanted to sleep until noon.

Scott Benner 2:34
What I thought was if I could do this, then I can do the thing later. Because if this doesn't go well, I gotta make a phone call. Gotcha. But hey, I was cold all night. Like that kind of like grind can't get more like insert with God my well my warm up then you but I don't know. It's it's super strange. I have no restriction in my lungs whatsoever. But if I start to cough on purpose, then it feels like something's happening. So hopefully that won't get worse today. You have no idea. I am sorry. Don't get sick.

Jennifer Smith, CDE 3:09
I know. You told me that the last time we talked, you're like I'm fine. I don't get sick. Or whatever happens to be cough on me.

Scott Benner 3:17
This thing I texted my buddy yesterday. He's a doctor. And I said what's going on around that isn't COVID and see? Is that what it is? Yeah, cuz he's I've had

Jennifer Smith, CDE 3:27
so many kids. So many parents. Like, I'm home with my kids. I hope you don't mind. They're screaming in the backyard. They all have are in the background while we talk. They all have RSV. One lady actually, their whole daycare shut down because three quarters of the daycare had Rs. RSV, so yeah, you know,

Scott Benner 3:44
yeah, he's like, it's gonna be head, chest. Tired could last 10 days or more. He said, I was like, Oh, good. So as I'm asking him that my son comes home from a place he went, he's like, I'm not okay. And I was like, Oh, all right. I was like getting bed, loaded him up with some Advil cold and sinus which seems to clear the head thing. So anyway, we just need to be better because I'm gonna find a way to go to the World Series. You are I mean, if I can, I'm gonna figure it out. If I can.

Jennifer Smith, CDE 4:15
Or you know, plenty of people. I'm quite sure that somebody would probably be very happy to give you tickets.

Scott Benner 4:22
I've already floated that on the internet to see what I was like I said, How would you like your kid to have amazing blood sugar?

Jennifer Smith, CDE 4:32
Yes. Kind of like runs with Jenny.

Scott Benner 4:36
Jenny So tell me we'll leave this all in. Tell me what happened yesterday.

Jennifer Smith, CDE 4:44
Oh, yeah, it was it's just I it's just funny. I call it diabetes in the wild right where you like, you find people or you see their tubing or you see something on someone you know, whatever. So yeah, I had a half marathon yesterday. Running Running, running, it was like mile five ish, I think. And I hear like, I always run with only one year bud in, because I, I don't like complete, like not being able to pay attention. So anyway, I hear this like, really stompy feed coming up, and somebody who's like breathing heavy to the point that I knew that they were running quickly. And this woman like speeds up next to me. And she's like, I was trying to catch you. I saw your Dexcom on your arm. And I was like, oh, yeah, she's like, I have a little girl who is had type one a long time. And she did. Yes, it was like a two day sort of event yesterday was like, the 5k, the 5k dog jog and that kind of stuff. And then the day yesterday was the half marathon. And then the kids like fun run. So her daughter had done the 5k the day before on Saturday. And she's like, I thought we were we're all good. And then she's like, double arrowing down at the end of the day. And she's like, I just wanted to know, how do you prevent low blood sugars while you're running? She said, and this is a half marathon, not a 5k. So we got to talking and you know, it was just, it's always fun to like, be able to share and whatnot. And I said, Well, I said, to be honest, I've been doing this a long time. And two, I'm a diabetes educator. And three, you should really listen to this super awesome podcast. But yeah, we got to talking and just like some ideas, she's her daughter is also just a couple of days into Omnipod. Five. So like, lots of variables in the picture there for this race. That, you know, she's like, we've been doing this a number i and her daughter had had type one already for six years. So they're not like newbies by any means. But just new technology and everything in the picture and just trying to figure things out

Scott Benner 7:02
new algorithms. And three days later on a marathon. Yeah. Let you out there in the world.

Jennifer Smith, CDE 7:11
It's always it's always fun. Excellent, you know?

Scott Benner 7:14
Alright, cool. So here's what we're gonna do today. Because just in case I don't leave in the explanation. I have the illness upon me. And I'm going to see I'm going to keep the one topic today because I think jumping around might get me I'm gonna stick to one thing.

Jennifer Smith, CDE 7:31
So now people are gonna think well, what kind of illness to Scott head because all you said was the ill. It could be a random whatever's going around right here

Scott Benner 7:40
it is. It's I was sleeping in bed on my side. And as I woke up, and I'm like, Oh, I'm very tired. I should text Jenny and tell her no. I'm like, No, I'm not gonna do that. I'm gonna get up. I'm gonna take a shower. I'll take the dogs out. I can do this. My voice is there. I'm gonna be okay. And I caught up and I was like, Oh, I'm freezing. Get back in bed. All my clothes on. I had my hood up to take the dogs outside. I came back upstairs. I am not a person who prepares before a shower. That might be a thing that women don't understand. But I usually get out of the shower and then look for my clothes. But this time, I got all my clothes together because I'm like, I'm not getting out being cold. Right. I finished my shower. I open the shower curtain. And I did not get a towel. Oh, no. I was like, dammit, dammit. I got a towel. And now I'm freezing and through the clothes on. And then I just did something I never do. I had 15 minutes till we had to do this. I just sat down. I was like, I'm just, I'm just gonna sit here. So I'm wearing a sweatshirt right now. By the time we're done, I can be in a tank top. I have no idea how this is gonna go. But what we're going to do today, you're going to debunk the classic diabetes phrase. Owner of Go ahead Johnny finishing a dead Pangkor Yeah, that's right. It is time to debunk owner of a dead pancreas. And there's so I've got my Google foo is all done because I don't want to be wrong. And I but I have a lot of anecdotal information about this. Oh, good. So let's start here. The Cleveland Clinic a reputable organization. Yeah, the pancreas a reputable you would think I mean, it would, I was gonna say would have to be great to be in Cleveland. But let's not do that the pancreas The pancreas is an organ in the back of your abdomen. It is part of your digestive system. Oh, the pancreas is an organ and a gland glands are organs that produce and release substances in the body. The pancreas performs two main functions, an exocrine function, which produces substances, enzymes that help with digestion.

Jennifer Smith, CDE 9:48
You just had lots and lots of enzymes, talking about Arden and her supplements. So yes,

Scott Benner 9:56
and so I'm gonna there's one more thing here. Let me finish this and says the endocrine function Sian sends out hormones that control the amount of sugar in your bloodstream. So let's tell people what's in the exocrine system. Oh jesus tear glands, mammary glands, mucous membranes, your prostate, your salivary glands. I don't know this one see Bacchus glands? sebaceous sebaceous oil, sweet glands. And then what is in the endocrine system? Adrenal glands, oh, hypothalamus, ovaries and testes, parathyroid and thyroid gland, pineal gland, pituitary gland, thymus. Well, I did really well with the pronunciations didn't lie.

Jennifer Smith, CDE 10:40
Except you called them sweet glands instead of sweat glands. I was totally chuckling like, yeah, like, yeah, you have a fever? I think,

Scott Benner 10:52
first of all I do. And But for a person who's you know, trying to sit up and keep his head still? I thought I did. Okay, you did Perfect. All right. Now. The extent that I've seen this in the diabetes community, is just this, people have t shirts. It's a proud owner of a useless pancreas, proud owner of a dead pancreas. And then someone else will come up to them and say, your pancreas does more than make insulin. And then it never goes anywhere from there. Right. But I've heard that conversation for the better part of the entire time that Ardens had diabetes. And yet, when Arden had problems with digestion, we looked at every other possibility in the world about why her stomach might hurt, except for digestion. And she suffered for a couple of years.

Jennifer Smith, CDE 11:40
Yeah, yeah. You looked at her digestive system, without looking at the pieces that help digestion. Right? It's It's like looking at just the part, or giving, which is very common, I have to say it. Oftentimes you go in with a symptom, and you get a medication to take care of the symptom. But the problem is never addressed.

Scott Benner 12:02
Yes, right. And I can for sure, say that because by the time we broke down, and I want to give my wife credit, my wife tried to get me to take her for a endoscopy for like a year. And I was so certain because of the joint pain, and all that other stuff. I was so certain it can't be that. But now I'm here to tell you that I am. I am fully down the hippie rabbit hole about your gut health. And we're going to talk about that now. So I want to Don't you think it's one of those things most people hear and they're like, Yeah, my problem is what is yeah,

Jennifer Smith, CDE 12:37
it's very it is I mean, you say hippie, it's kind of earthy, crunchy, sort of whatever. But truly, I mean, your digestive system is an enormous part of your immune system. It's an enormous part of you think, you think digestion and you think about poop? Well, at least my boys do. Like their little kids. So whatever. But if you think about what your digestive system is really supposed to be doing, it's breaking down the food that you've eaten into macronutrients, fats, proteins, carbs, and then it helps to absorb them the right way and put them back into the body, at least the ones that you hope go back into your body. Yeah, right. So if the breakdown isn't happening the right way, you're going to end up with a lot of digestive issues, possibly first or later on. And you're also going to have a lot of other things in your body that aren't functioning the way that they're supposed to be functioning. But there again, it comes off as a symptom. You may feel the joint pain, you may have an off monthly cycle, or you might have this or that but it never comes back to well gosh, is it an absorptive issue? Is it another problem with another like, you know, the pancreas? Is it something else?

Scott Benner 13:54
Oh, also, while your stomach is basically acting as I'm gonna just say something terrible here a cesspool for food, because it is not going through you quickly enough, right? It just stuff is sitting there and it's festering, it is not a healthy environment, the bad bacteria overwhelms the good bacteria. And then you slide down on like a, it's just an endless shoot. But the problem is, this is crazy. If you look back over the 700, and some episodes of this podcast, we've hit every idea around this except the idea of digestion. We have episodes 263 fat and protein 471 bolusing insulin for fat. And there you go, like right what do most people see a spike after a meal? And it's probably because their digestion has slowed down. Right? The insulin I don't know. That's how I started thinking about it. Like if you if it takes longer to digest fat, then your insulin gets in and it's gone while the fat still remains behind and the carbs holding up your blood sugar. And then we attack act that from a bolusing standpoint, which makes sense. And then low carb people come in yelling, it's cuz you eat bad food, and they're probably not wrong. But it doesn't get us to the answer.

Jennifer Smith, CDE 15:14
It doesn't and, and it also doesn't get to the main point which you know, you have long. And we've emphasized when we've talked together, it is about a timing thing and understanding insulin, right. So if you it's, it's a multi piece thing that you have to put together, right, you have to understand and that's why we've talked about Bolus strategizing for fats and proteins versus carbohydrates and the timing of it and what it should look like. But if you've got some other things that are going on digestive Lee that are based on how your enzymes are working with the food, some of that may also be playing in and I mean, again, it sort of leads you into this rabbit hole of consideration. Yeah,

Scott Benner 15:59
well, here's the rabbit hole. We aren't in goes finally to get an end. What am I saying? endoscopy and the doctor. First, I'm going to read you. First I'm going to read you a definition then we're going to talk Okay? gastroparesis is a condition that affects the normal spontaneous movement of the muscles or motility in your stomach. Ordinarily strong muscular contractions propel food through your digestive tract. You'll notice that the definition for gastroparesis never mentions the word diabetes. Because in a normal person who doesn't have diabetes, if you had slow digestion, they would say to you, oh, you are digesting your food slowly. It's called gastroparesis. When we hear the word gastroparesis, we think oh my god, here it comes. Right. diabetes has gotten us and inheritance. So we do the we go to the we go to the doctor, he doesn't know art and we tell him her blood sugar's are very well controlled. Here's the range it's in. And then I realized he probably doesn't believe us, didn't ask to see it. And then he goes and looks on her stomach and finds food from the night before. He's like there's lettuce in our stomach from 12 hours ago. She has gastroparesis. So my wife and I are like whoa, whoa, like it hit you like a ton of bricks, you know? Yeah. And I was like, what what? And then my wife started saying I think he's just It's and we're just doing that going back and forth and back and forth. And we talked about it I talked about on it did a standalone episode 767 called Arden supplements, but just for 30 seconds here. We went home I called Jenny we talked about how to get Arden on a on a what is it a gastroparesis diet right? That's what they call it?

Jennifer Smith, CDE 17:51
That's yeah, for lack of a better word. Yes. Right. Yeah.

Scott Benner 17:55
And all of a sudden Arden couldn't eat anything with skin on it. She couldn't you know had to avoid proteins yet even it was difficult to digest. Well, and

Jennifer Smith, CDE 18:03
and even I said, and now I am not a gastroenterologist. I don't claim to be one. But I even told you I was like, she doesn't have gastroparesis. I said she's got something else going on that's causing this and it's been a long term thing that she's mean you guys have been dealing with this or had been dealing with this for for a while knowing something was not right. She was constantly complaining of stomach aches and you know, whatever. Like this, this isn't classic gastroparesis. This doesn't even sound like gastroparesis. But again, I am not a gastroenterologist and

Scott Benner 18:38
I'm her father and for the year so prior to that every time somebody would be like, is it this? I think I've talked to so many people who have gastroparesis and artists boluses don't mimic what gastroparesis does. So anyway, because of that kind of anecdotal information, we kept ignoring it. And I want to make sure I say this in case my wife ever hears this, I kept ignoring it. I kept saying, no, no, no, it's got to be something else. And even Arden started, you know, with her kung fu Googling and she's like, I've got fibromyalgia. I've got this, like, my knees hurt like everything, right. So anyway. So we go home and Arjun starts eating this incredibly restrictive diet, which by the way, does not make her stomach feel any better. And about a week into it, she says, I would rather my stomach just hurt. And it was just the saddest thing. You know, like I thought, oh God, her stomach is gonna hurt for her whole life. You know, she's been constipated since she was a little kid. She would have I look back now she'd do this thing where like she wouldn't go for days then diarrhea and then not go for days and diarrhea and pain up in the top of her stomach to the point where she had us like that No lie like pushing down with all of our might at the top of her stomach. And when you got pushed down hard enough, the pain would go away for a minute. And she was like, just almost like reflux. Sorry, Jenny. We would do it for hours sometimes getting No, like she'd lay on the floor and have you put your hurt your heel in her stomach, like stuff like that. And so this week's going on, I'm watching her, the diet is not doing anything. And she says to me out of nowhere, I want you to realize that at this point, I still don't think digestion, okay, right. She says, I want to go to five guys. I'm getting a cheeseburger, I'm getting fries. And I'm getting a milkshake. And I don't care what happens next. And I was like, okay, like, I don't know what to do. Right? So I said, well, first do this thing with me. I'll take you to Five Guys. You. I'm going to stop first, at a health food store. I heard somebody say something about a digestive enzyme. That's it. I don't know where I heard it online. I saw it written down somewhere through googling. I have no idea. I'm like, we're gonna get those. You take them while you eat. She was like, I'm gonna be honest with you. She was like, whatever. Like she was she I'll do it. But I don't believe in this. I don't believe in anything. It had been long enough. She had given up on the idea. So we get them. And I we get home. I'm like, Here, take two of them. Because the lovely crunchy lady at the health food store said take two if it's a high fat meal she takes to her blood sugar never spikes the way it would it didn't need nearly the insulin it would have needed. And it stayed really flat. And I was like, oh my god, we did it. Except then the next day, I was like, have you pooped? Since you ate the cheeseburger? And she goes, No.

There are two things that I would tell you to look at first, if you have diabetes. First one I'm going to tell you about is the Dexcom G six continuous glucose monitor. This little device shows you on the receiver that comes with it or on your cell phone. Your blood sugar's number, direction and speed constantly. Like it's always there when you look at it. And you can set alarms. So like you say, you don't want your blood sugar to go over. I don't know 150 You make an alarm at 150. And when it gets to 150 Go say BB baby. We're at 150 It doesn't say it exactly like that. But there's beeping, then you look and see the 150 and say, oh I might have missed on my Bolus. Let me do what I'm gonna do. Or you set an alarm for a lower number. Say you don't want to know. Let's say you want to know when your blood sugar's at five. Beep beep beep I'm at five. Oh, I hear BBB I take a little 85 and then I take a little I do what I'm gonna do whatever you're gonna do you do it then you can keep in this range. Seriously, when you when you're aware of the range, your blood sugar's then it's easier to stay in it. It's easier not to ping pong all over the place, roller coaster. I mean, listen, we talked about all the time in the podcast, you can check the podcast out later. But this Dexcom G six is at the core, right? I mean for that for that management stuff 100% needed, but also for safety, security, convenience, how about that up to 10 people can follow someone so say your kids at school, you can see their blood sugar on your phone. And so could nine other people of your choosing, we're not whatever you want to do, Dex comm.com, forward slash juice box, please head over there today. And check it out. You may be eligible for a free 10 day trial that XCOM G six, you'll only find that out on my site. So hit the link. Guys, you're also going to want to get yourself that. And guys, you're also going to want to get yourself the Omni pod. It's a tubeless insulin pump. It's really terrific. Tiny little device filled up with insulin, put it on, no tubing, you understand you're not connected to anything, you just wear it. And then there's a handheld controller that you say like I'm having 12 grams of carbs and then it tells you because you put in settings it tells you well this is how much insulin you'll need for those 12 grams, push the button, whole thing happens wirelessly. You're not connected to the controller, there's no tubing, you have an insulin pump that you can swim with, that you can bathe with that you can play your sports with, and sleep comfortably with no tubing no controller attached to you. Now that's for the on the pod five, which is an automated insulin pump system or for the AMI pod dash. Both of them are tubeless. Both of them give you that freedom. Now the AMI pod five is the only tubeless automated insulin delivery system that integrates with the Dexcom G six CGM and it uses smart adjust technology to automatically adjust your insulin delivery every five minutes helping to protect against highs and lows without multiple daily injections. That's the only part five tubeless and automated on the VA dash tubeless not automated still an amazing system. So whether you want an automated system, or a system that you kind of take the reins on one way or the other. You want tubeless you want the Omni pod Omni pod.com forward slash juicebox for full safety risk information and free trial terms and conditions. You can also visit on the pod.com forward slash juice box. And I know what you're just that free trial terms and conditions you didn't mention a free trial. Well, how about this, you may be eligible for a free 30 day trial of the Omni pod dash, go find out at my link on the pod.com forward slash juice box

Have you pooped? Since you ate the cheeseburger? And she goes, No. So now it's days that go by. She's taking them under duress because we're making her but her stomach still hurts and all this stuff. And finally I said to my wife, I'm seeing something with her insulin. I know this is working. But there's got to be another component to it. I go back to the health food store. Explain it to the crunchy lady. And by the way, the crunchy lady has a Russian accent. So the whole thing is a ton of fun, right? She's like, it's like, I'm telling you. It's out of like a Rocky and Bullwinkle movie. She's like moose and squirrel. You know what I mean? Like, just like that, right? And it's so I tell her what goes on. She, uh, she walks across the room grabs this big jug. She says, magnesium oxide, this will make her go. And I was like right now. And she goes here and take this probiotic too. So I went home, Arden had noticed that enough improvement that she took the other stuff. And like, for three days, I'm like, Have you booked a you poop she actually wants said to me, please stop asking me if I've gone to the bathroom. I don't want to tell you. And I kept asking I

Jennifer Smith, CDE 26:32
am at home dad, please don't ask if I have.

Scott Benner 26:36
One day I asked her and she smiled. And she goes, Oh, you idiot. I went days ago. And I was like, why are you doing this to me? So then hers, that cycle started happening with frequency. Then I shared it in Episode 767, where I go over the supplements that artists taking But Kelly and Arden were leaving to go to a restaurant one day, they left the house. I thought they were gone. Arden came back in the house, I forgot something she says goes in the kitchen, and she grabbed the digestive enzymes. And I was like holy hell it worked. Because there's no way she would have come back for it if not, like just the way you know. So it's such a cheap and easy attempt, right? Like if you have digestion issues, or you're not pooping, these are two very safe, very simple supplements that you could give a shot to. Am I wrong?

Jennifer Smith, CDE 27:30
Could no you, you certainly could give a shot to them. And again, in terms of like, long term effect the build, especially if the digestive enzymes, if you truly do have some type of digestive enzyme issue, whether it's an absorption issue with them, or it is a release of them in the right way in your body. You should notice some definite benefit from using them. But if you don't clearly it's not something you just keep taking to see if it's going to work.

Scott Benner 28:04
No are in solid improvement really quickly. Right? Like a week. And I and you were like okay, well, this is working. Yeah, something else is wrong. Something else is wrong. But now as the weeks have gone by, and she's building up what I'm assuming is the healthier gut because there's no like rotted foods sitting in her stomach for days. Right now the probiotics are having a chance to work. I have not now she's college and Fair's fair, she could be down there right now going God My knee hurts. But she has not said anything. And she's on

Jennifer Smith, CDE 28:36
she's pretty honest with you about things, it seems well.

Scott Benner 28:41
There's also this, um, there's this look that goes over her once the medical stuff has, like, beaten her down. And you can see it, like you can see the like, I give up on her face. And now she's walking to classes. She's, you know, getting on buses going somewhere walking up and down stairs more than usual. I've not heard a word from her about it. And I don't know, I mean, hopefully it keeps working. But your pancreas does more than make insulin. So this makes sense. So does it do anything else? Or just those? It just has basically those two functions?

Jennifer Smith, CDE 29:21
It has those two, right? I mean, essentially, the exocrine the endocrine, I mean, if you think about you go to an endocrinologist, an endocrinologist, especially by people with diabetes are specifically thought of as being like the diabetes doctor, but there are some endos who don't even do diabetes at all. Like they are specifically thyroid endocrine physicians, right. Some are very much just the you know, the ones that deal with like the ovaries and those kinds of things. That aspect and they may not know very much at all about diabetes because that's not Really what they've gone into. So that, you know, again, those are the primary functions. But again, it would be better for the T shirts to actually say, proud owner of like dead islet cells or dead beta cells. And even that isn't 100% the truth because we still know that betas still have some little, little bit of action, even if it doesn't really look like they're doing much of anything. People have had diabetes for a number of years can still have minor output from some of the betas that are still left. So nothing's technically dead.

Scott Benner 30:41
So the idea I've heard in the past is that those cells are so overwhelmed with inflammation that they can't move and fun. Yes, right. And that's the other part of like, you're still like, if you're listening, like Scott, I understand why they're nice, stop hurting because you fixed her stomach. Inflammation, your stomach is, is, again, it's a cesspool, nothing's flowing through you. It's rotten in there. And it is, and the bacteria is now off balance. So even throwing in a probiotic, which by the way, we tried, like a year and a half before that, when people are like, Oh, what's your stomach? Here? Give her all these probiotics and stuff like that. She kept taking them. And she's like, these are not doing anything because we were throwing them into a pit of vileness. That's why it's like throwing an air freshener into a cesspool. That's what we were doing here. Like, yeah. So once you get the food moving through it, and this is how it went in my head, I'll get the food moving. And then I'll address the bacteria in your stomach. And, I mean,

Jennifer Smith, CDE 31:40
the seems to be a good combination.

Scott Benner 31:43
Yeah, I mean, so far, I should knock on all the wood in the house. But yeah, I mean, you know, I don't jump on the podcasts and say stuff, I've seen it work for a while. You know what,

Jennifer Smith, CDE 31:52
and to be true, you know, and we're talking about the comparison of the supplement that she takes, or these digestive enzyme supplements, the majority of the kind of ingredients in them are to supplement what should be some of the enzymes that are being put out by the pancreas to again, deal with your macronutrients, being fats and proteins and carbohydrates, right? Even the saliva in your mouth does contain some of a carbohydrate based digestive enzyme. So you know, digestion to some degree starts in your mouth, mainly of carbohydrates, as you move further down the digestive system, those other enzymes that are supposed to be coming from your pancreas, like lipase and amylase, and pro protease, yes, to think of the third one, you'll look on the digestive enzyme label for the ingredients. And those should be within there if you're getting a true digestive enzyme. Because what you're, what you're doing is replacing them into the body for whatever reason, your pancreas isn't doing enough of the job or your body is just not using it right, whatever.

Scott Benner 33:01
So here's a Google search. What can poor gut health leads to when your body doesn't have enough good bacteria bad bacteria can thrive the following can be signs of gut bacteria imbalance, autoimmune problems, such as thyroid issues, rheumatoid arthritis, that type one diabetes, digestive issues, such as irritable bowel syndrome, constipation, diarrhea, heartburn, or bloating. Now, I'm going to tell you this. After I watched this work with Arden for a week or two, I thought, you know, I have most of the problems Arden has. I've, like powered through it my whole life. But I have right, and I've got checked for celiac and I don't have celiac. But even as a child, I can remember my uncle and aunt used to like to take us to a pizza joint near where they worked on Friday nights. And we'd eat at the pizza place and have a 15 minute ride home. And I would have to make them stop at the business. They don't halfway through so I could go to the bathroom or the bathroom. Yeah. And even when I was like six or eight years old, and I can remember being in the bathroom and people like why Scott in the bathroom for so long. And I wanted to yell because I'm in agonizing pain. Thank you. Because I ate the pizza was like 1979 and nobody doesn't like the pizza. Picking me for pizza, please. So I said to Kelly, I'm like, I'm gonna take these enzymes, you know, because I've been doing fiber supplements for years to get ahead of the problem. But it always felt like what you talked about before, it was like a band aid. It was helping, but it wasn't nothing was stopping. You know what I mean? Like everything got through easier. But it's still like if I would forget the fiber one day, I'd wake up in the morning and think, Oh, God, I didn't take the fiber yesterday. Oh, here it was my day, you know. So I start taking the enzymes and the magnesium and the probiotic. And while I don't need the fiber anymore. I get up every morning just like the rest of you and take a nice puppy and then live my life. did not use to happen for me. So I don't mind sharing it here where, really more people are gonna hear it than I'd like to imagine right now. But But I want you all to know, because when I went into the Facebook group and I said, here's the episode about Ardens supplements, the amount of people who came in and were like, hey, my kids stomach hurts all the time, my kids always constipated. This is since diabetes, blah, blah, blah, adults. But like, I got a note from a woman in her 50s. She's like, you should like you save me. So I just want to tell people, that's all. And I'm trying to draw them in with the title, proud owner of a dead pancreas. I think, yeah, I think I can get them into the episode.

Jennifer Smith, CDE 35:43
I could be Well, I think there are a lot of I mean, even if you look at some of the research that's been done on the digestive system, in terms of and I absolutely I hate the term, like leaky gut, I think it's too, it's too broadly used. And it's not, it doesn't give any definition to what might actually be going on. But for people that are more predisposed to autoimmune conditions, the potential that they're got may be sort of like, let's call it, you know, like Swiss cheese, if you will. And there are more holes that allow things to get back into the body that should have been being held in the digestive system and then passed out, right. So if some of these things that are your attempts, if you will get back into the body, they can create enough problem that your immune system sort of goes haywire, right? autoimmune disorder, and whether it's thyroid or celiac or type one or the other autoimmune disorders, the gut is heavily studied in terms of autoimmune conditions. So if you can keep a healthy gut, while you know that you already have an autoimmune condition, you may be able to potentially hold down or prevent other autoimmune conditions as well.

Scott Benner 37:05
Why is this not a mainstream idea? Why did that doctor give Arden a medication for pain, a medication for something else? He gave her three meds and a diet that a 90 year old person would be like, I don't want to eat this, like it was it was a it was a restrictive diet? Why didn't you just say, hey, go to the health food store and buy a handful of digestive enzymes. Let's give that a whirl and see what happens. Like how does he not know that I didn't go to medical school? Jimmy, it took me two years, but I figured it out. Right?

Jennifer Smith, CDE 37:37
He really you want to really dive into that big hot topic, in terms of what get again, I think the best thing to say is that there are a lot of band aids that are being given. Yeah, instead of and instead of, let's really, let's really study and figure out let me listen to all of your symptoms. And let's figure this out from the standpoint of actually attacking the true problem. And I've encountered that in terms of, you know, like my own health stuff. I was amazed when I first started seeing a naturopathic physician, someone who had gone to medical school, and then had gone back after getting her MD to focus on women's health, and many of the things that are very specific to females versus males. And, you know, she's like, well, all these things, you know, why? Why wasn't this tried? Or why wasn't this looked at, or let's get a check to make sure that all of these types of things in your body are actually at the right level. And there were a number of things. I mean, even just vitamin D, she's the she's the one that got my vitamin D level backup by simply telling me to take a drop that went under my tongue, instead of a supplemental tablet that went into my just my digestive system and it didn't get absorbed.

Scott Benner 38:57
Some people can absorb it, some people can't. And now, let us let us go back. Everyone knows that I have trouble absorbing iron. Oh, isn't that interesting? So you know, I can't so even if I take an iron supplement, it doesn't move my iron level up. I have to take it with a sorbic acid or vitamin like vitamin C. I don't know why that makes the gut lining pull it up better, but it does. And it's it's a similar thing. And when you start putting the pieces together and drawing lines from A to B, Arden has diabetes. And you know, she was she We thought she was fine, but she was young, who knows maybe Her stomach's been hurting forever, and she just didn't notice anything. My stomach hurt when I was a kid. And so even that, like when that happens, you think Oh, maybe it's just genetic. Like my stomach hurts. Her stomach hurts. I guess this is what we get. And then you just start putting everything together. Now one of the other things that made this difficult to figure out was Arden's hormonal issues. So incredibly long period 11 to 14 days. It would restart after two or three days, go back to 11 or 14 days, like it just was she was constantly bleeding. She would get a vicious nosebleed once a month, like on like clockwork, her acne a couple of years ago, just out of nowhere, just it was really terrible. Like she's tried everything that you can think of the fixture acting right. And we had gone through so many things. And Dr. BENITO who did the thyroid episode with me. She said, Well, I think Arden is going to need Metformin. And I was like, okay, and she goes, I think it's going to be an insulin resistant thing. I think she's going to need Metformin. But before we try that, would you go buy this supplement called of acetone? And when I said that to Jenny to kind of check things, Jenny's like, oh, yeah, people use that all the time. And I was like, oh, hell, so of acetone, a little powder, you melt it in the water. You've only drink it, you can't taste it. And I don't know how long it took. Not long, a month or two. And our period started regulating the nosebleed stopped her acne started going away. I mean, she Yes, you know, girl, poor girls, you guys, it's and then you got a little bit boys

Jennifer Smith, CDE 41:11
who have no clue too much. So sorry, to all you boys. But really like, I think it's right. I

Scott Benner 41:18
think it's too much all this happens. And then there are boys there who are like Sunday, I'm watching football. Right? Yes. Or whatever they do. So anyway, so that's it. So are we missing anything around gut health? What the pancreas does, or any of the issues that you know, Arden went through? Did I miss anything?

Jennifer Smith, CDE 41:38
I don't think so. I mean, if you really wanted to dig deeper into each of those little pieces or enzymes, you certainly could but you know, that's what Google's

Scott Benner 41:49
not here to tell you what to do. I'm here to tell you, yeah, you can figure it out. Right, you know,

Jennifer Smith, CDE 41:53
but to let people know that clearly your your pancreas has a lot of other definitely good things that it should be doing. And if you're noticing anything digestive Lee, it could be a piece of maybe some of that, quote unquote, dead pancreas that isn't quite working the way that it's supposed

Scott Benner 42:10
to. I'll tell you this is interesting, because I don't think many people, I think a lot of people who have like constipation problems will be like I heard to take magnesium. But they're like three different kinds of magnesium, maybe more, I have no idea. And I remember somebody telling us to give Arden magnesium, and we gave her the wrong kind. So a year and a half ago, we could have had this right. But instead of magnesium oxide, we gave her hold on a second, I'll tell you what it was.

Jennifer Smith, CDE 42:37
And I'm like, I don't know what her supplement magnesium citrate,

Scott Benner 42:40
we gave her magnesium citrate or glycinate. So no kidding. There's glycinate, citrate and oxide, we tried glycinate and citrate. And when it didn't work out, it's like, I'm not taking these things anymore. Well, one more to go.

Jennifer Smith, CDE 42:55
When many people actually with diabetes are low and a number of different things, magnesium being one of them. Sometimes zinc is also on the lower end. I always recommend if you're considering some symptoms, and some of the things that again, I mean, Google is great, but it is a rabbit hole of information that you can really get into and not quite, you end up coming out thinking you got 50 more things than you've thought you had. Right. So a simple I mean, blood test will tell you where these levels are, to be able to start at the right place. Because obviously, if you're not low in something or whatnot, there's really not a need for you to go crazy on supplement.

Scott Benner 43:37
What about though, in the case of like when Addy came on and talked about thyroid, she also talked about ferritin levels. And she said, she said, I don't care what those tests say, if you're a woman of menstruating age, your heart needs to be above 70. But the but the test won't say that. But this is from her own practice and anecdotal, you know, experiences. So that's the other problem because we see it happen with thyroid all the time. They're like I have all these thyroid systems and I got your labs are in range. And then no and then that's it. Right but

Jennifer Smith, CDE 44:08
the labs is a good example is vitamin D for a second one. Mean labs typically have you in target as long as you're between 30 and 100 an optimal truly I got this from my naturopathic doctor, she's like, optimal is much tighter. It's actually 50 to 70 that's where you want to sit. So I mean, when I started out mine was 18 my doctor thought that had to completely be wrong. He's like let's do the test again. Oh, no, it came back at at it and I was like, Oh, look at that.

Scott Benner 44:38
What did you experience when you got the level up?

Jennifer Smith, CDE 44:42
Um, when I got the level up, I can definitely say that insulin and this was years ago, but I can definitely say that my insulin sensitivity I guess for lack of a better word was more stable. Because of course vitamin D work It's on a cellular level in terms of how it responds to glucose as well as insulin. So I just know that if I keep in target if I keep in range, I noticed more consistency just in overall, like glucose and insulin sensitivity. That's, so that's a big thing that I noticed.

Scott Benner 45:22
Alright, so I want to say this at the end because we are finished. I want to tell people notice here at the end, I'm not trying to sell you something Jenny's not telling you to go to a link to get more information. There are no clickable links when you buy magnesium oxide that I make money, nothing like that. I'm just here to tell you what happened to Artem because it was it was it was really horrible. And it was daily. And she was held down by it. It I think emotionally, and I was too I started feeling like I'm definitely failing around this because there must be some sort of an answer. And, and then when I see everybody talking about it online, I can't believe how many people jumped up and said, What What's that magnesium? What? What's the what's the enzyme Tell me about that? I don't digest food. Well, I'm constipated. By it all the time. Like and sometimes. Sometimes I hear people say it almost like it's a badge of honor. I poop once a week. Like it's like it's almost like it's dainty. Do you know what I mean? Right? Not dainty. How many times we want to poop Jenny?

Jennifer Smith, CDE 46:23
Daily. Yeah, absolutely daily. In fact, I thought it was the weirdest question when I first started taking my, my first child to the to the pediatrician who was like, Well, how many times a week because he goes into the bathroom and like, my kid goes to the bathroom every day. People are supposed to poop every day your body is supposed to transit things in and move on out. That's the end at least I mean, honestly, good. Good. Digestion is at least twice a day. And if you go even further to the more earthy, crunchy, you should be pooping after every single meal.

Scott Benner 46:57
As the new food comes in and pushes the old stuff out.

Jennifer Smith, CDE 47:00
That's right. You gotta clean bacteria. It's moving it in. It's getting it out. It's doing what it's supposed to be doing. That's a

Scott Benner 47:07
health so that's the thing we make fun of people for by the way. Oh, absolutely. Yes.

Jennifer Smith, CDE 47:11
I mean, this should be well formed poop. I mean, if you want to get in depth about it, right? It shouldn't be. It shouldn't be disgusting. It shouldn't be like liquidy whatever. This good poop. Couple times a day should be well formed. It should come out easily. You should not have the strain to go to the bathroom.

Scott Benner 47:30
Yeah, shouldn't be stuck under the toilet seat when you're over.

Jennifer Smith, CDE 47:32
No, it should not.

Scott Benner 47:36
Those are moments reserved for days of drinking and then what happens at the end or illness. When you really think about having a virus or something like that. What happens is you're getting better from the virus you like evacuate because your body's like there's a lot of badness in here. Let's throw it out.

Jennifer Smith, CDE 47:52
Let's move it on out. That's exactly right.

Scott Benner 47:55
Yeah, right. We've done it gently. We've saved lives here. I'm not sure call this

Jennifer Smith, CDE 47:59
like the pooping episode.

Scott Benner 48:05
proud owner of a dead pancreas. That, though I don't know there's nothing there. There's nothing there. No. Anyway, I, I have to say. I almost feel like I want to apologize to the people listening for not figuring it out sooner. Like that. That terrible feeling I had watching Arden's struggle. When you start getting the emails and the notes online, I actually for a second thought, like I let all those people down to they really felt like that for a minute. You know?

Jennifer Smith, CDE 48:36
Well, I think this goes a level further in terms of I mean, you shouldn't have to apologize, and I don't think anybody obviously, I mean, they've probably listening thinking, Oh, my gosh, like, please don't apologize for something that you should you've had nothing to do with right. I think it goes again to a deeper level of overall medical evaluation. And, I mean, it truly takes it into the you mentioned Metformin before, right. As a potential thing that a doctor was recommending for Arden. Well, I've even worked with a number of women who actually, I knew from all of their issues that they probably had PCOS, right polycystic ovarian syndrome. I could I knew insulin resistance, all the things that they were having, as they just get a prescription for Metformin. Just get one. And I had a couple of doctors tell them, there's no reason for you to use this. I don't know why this would have been recommended. So you know, I think from an overall sometimes you end up having to be your best you do end up having to be your best advocate. But you also have to have an idea of where to start. And when you can say like you did, but this medicine is just a bandaid. It's something that's going to cover up a symptom. I want to know why the symptom is here. Let's dig deeper. I want to find the reason that I'm having this or these symptoms and take care of the reason. So I don't have to take six other things.

Scott Benner 50:09
Yeah. Well, I still don't know where Arden's path is going to lead on this. Like maybe she'll end up on Metformin because maybe she has PCOS, because that's one of the things that we vet. I mean, we looked into a PCOS clinic down south, where they do they do a like a surgery to try to correct it. And oh, wow, how bad things were like they go in there and like, just it's crazy. You know what I mean? And but that's how far down the rabbit hole we were. We were like, This pain is not stopping like what she does. So maybe maybe, I have to say Dr. BENITO still said we want to give the old acetone more time on Arden's acne. But if it doesn't clear up the entire way, I don't think we're done yet. So we'll have to wait and see. Yeah, anyway, because

Jennifer Smith, CDE 50:53
her insulin, since the enzymes especially has her have her insulin needs gone down. And I know you just

Scott Benner 51:02
did, and then she went to college. And now she's now she's eating I think Styrofoam sprinkled with high fructose corn syrup. So all the little things that we adjusted out of our diet like dreamfields Pasta instead of regular pasta or low fat, you know, I don't know sauce that goes on something. It's it's everything's frozen pizza and french fries. And so I have no idea. It took us weeks to like, get on top of it, because she kept saying, I can do this. Like I can do it. But her blood sugar's were going to 20 after meals, they weren't coming down. So finally a little while ago, I called her up and I said, Hey, Arden, listen, we need to talk for a minute. And she's like, okay, so we got on FaceTime. And I said, I know you're trying. I don't think you're not trying. But bolusing for this food is, it's hard. So why don't you let me help you a little bit. So we did Jenny's post date with loop, which worked really well. So big, big Bolus up front for this design, whatever this disaster is, they're feeding her. And then about 60 To know that an hour to hour and a half later, about a 15 or 20 carb Bolus that the jury to give the loop some autonomy to make harsher. Yeah, adjust options. Yeah, I don't think that's not something you can do with any other algorithm, right?

Jennifer Smith, CDE 52:22
It is not? No, the easiest I think is, uh, you can't, you can't forward stamp anything in any other in any other system. I think the closest would be knowing that something's coming. The ability to potentially start an extended Bolus with control like you to hit out further. But even with that, it's only a two hour extension. And there's no visual to absorption of food, right? That's where, you know, the looping types of systems are very unique in that they truly do allow the system to still pay attention to why is this blood sugar where it is, there's still food in the system. Let's take care of this completely, not just attack a blood sugar because the blood sugar is here. There's a reason behind it.

Scott Benner 53:14
Can you see her graph? This is 24 hours. So we're back to it now. Right? But before oh my god, like I was like, We don't know. It's It's the food. It took me a couple of days to figure it out. Because our settings because she had because of all these adjustments. She was using significantly less insulin all of a sudden, then she started eating there. And then I was like, Oh my God, we've got to move everything back again. But I wasn't with her. And it seemed like a lot to move it. Because what if it goes wrong? Like you don't you mean? So we moved it really slowly over a couple of weeks, which I I'll tell you, I don't think back in the day. I could have done it like that. But now I have a little more of a like a long view. I'm like, it sucks that our blood sugar's high, but I'm not going to write I'm not gonna ever pass out Welcome to class because we're we moved things too quickly.

Jennifer Smith, CDE 54:03
No, not at all. I mean, I you know, college, I had none of the technology. I mean, I was on injections in college, and I had a glucometer that I carried around with me. So I didn't have any of the information. But even I found out really quickly what the difference between going to like the burger joint, which wasn't it was a veggie burger. So what's really real a burger, but the burger joint on campus versus going just to the cafeteria. I figured out pretty quickly that I just ended up living mostly on salads at school a lot of the time because they seem to work out better from a standpoint of what I was finding on my next finger sticks.

Scott Benner 54:43
Well, as I google the words freshman 15 college students have been warned about the dreaded freshman 15 The extra 15 pounds that so often accompany the first year of college. It turns out from our experience, it's because the food is terrible. Oh, you're all making enough money to give the kids real Food shouldn't be that hard. Right? And it's presented so nicely, Jenny. Oh, yeah, you go through like, Arden looks like she's getting lunch at, you know, at the Taj Mahal. Yeah, who plays Yeah. Then she sits down. She's like, this food is terrible. I'm like, Okay. And then, you know, finally I'm like, send me pictures so I can help you with the thing. And I think at first I think she was eating a lot of French fries when she was like, like when she first got there. I think she was a little. She had problems that I don't want to talk about on here with it with a roommate. Yeah. But there was a lot of anxiety in the first couple of weeks. And I think she was I think she was treating the anxiety with the French fries with food. Yeah. And then when I told her, I'm like, I need to see what you're eating. She wouldn't answer me. That's the first time that's ever happened. Arden show me your plate? Like not? No, she just didn't answer.

Jennifer Smith, CDE 55:47
She just didn't answer. Yeah,

Scott Benner 55:49
I was like, Okay, what's

Jennifer Smith, CDE 55:51
this? Did she do a lot? I mean, the food on campus? I'm curious if anyone has any nutrition facts? Or is she mostly estimating?

Scott Benner 56:00
Well, she's estimating, but she just, she realized just a lot is the measurement she needs. So we so far have not given have not found a way to give her too much insulin for a meal? Or a

Jennifer Smith, CDE 56:11
meal. Yeah, I wonder if I mean, you know, whether she use it or not depends on the person. But there are some really good visual apps like the fig we app is really nice, from a visual standpoint, because you can adjust, like you type french fries in, for example, it shows you like a portion of French fries on a plate. And then you can adjust the portion, there's little slide rule below the picture, you can make the portion on the plate look smaller, or you can make the pile of fries look larger. And right below it are all the nutrition facts, carbs, proteins, fats, salt, everything. What's it called? Fig, we fit G W E. It's a great app, it's really sweet. Because instead of looking through, like Calorie King is the long term used one, but it's just a list. And it might tell you three ounces, or four pieces or whatever. And a lot of people, they don't know what three ounces looks like or even what a half a cup looks like anymore. So if you're looking through a list, you're gonna get annoyed and irritated. And most teens and college students are not going to use that. But this being a visual, it's, it's really kind of sweet.

Scott Benner 57:16
I'm looking. It's pretty cool. All right, we have no connection to that unless Jenny's know me. And I don't

Jennifer Smith, CDE 57:21
know. No, absolutely not. No, I've used it for a number of years. Actually, I found it at a conference probably five or six years ago.

Scott Benner 57:30
Well, I'm gonna say one last thing. Here on the podcast, I am an on the Facebook group. And anywhere you've ever heard me talk about diabetes, I say I don't care what you eat. It's not my business. I just want you to know how to Bolus for it. But if you don't think that every once in a while, I don't go. You guys like what are you doing? Like Like, he can't. He can't eat every terrible thing and then say, I don't know what's happening. Like Like, right, you know, if you can't put a cupcake on a piece of pizza and wash it down with a soda and go, can you believe my blood sugar went up i Bolus like it's there are times when I when I want to just say Come on, like please. And this happened. That feeling ended up being how we sort of figured out Arden's thing, right, like fats are sitting in are too long stuff like this is happening, blah, blah, blah. She's not digesting it. And keeping in mind that the doctor wanted to give her a pill that he said would numb her stomach so it wouldn't hurt anymore.

Jennifer Smith, CDE 58:31
See, again, covering a symptom. Yeah, he didn't want to cover up a symptom.

Scott Benner 58:34
He didn't want to help her. He just and by the way, on our first visit before the the look down or stomach, he handed us samples in the room. Of course, I was like, this sucks. You know what I mean? And that

Jennifer Smith, CDE 58:47
that could be a whole episode about

Scott Benner 58:51
you know, their recommended by a number of physicians that I know in the area. That's how we ended up there. So anyway, sorry, Jenny, thank you so much for doing this with me. Absolutely. Yes, always.

I'm gonna thank Dexcom makers, the Dexcom G six and remind you that you may be eligible for a free 10 day trial, find out more@dexcom.com forward slash juicebox. And of course, maybe you'll want a 30 day free trial, the dash and you're eligible could be maybe you're gonna want to find out about the Omni pod five automated system. Either way, the link you want is Omni pod.com forward slash juicebox. I know it's the end of the year and people like it's the holidays. I'll wait. Don't wait. Just don't wait. Just jump in. Get going if it's what you want. There's no time like the president. Not the president, the president. There's no time like the present on the pod.com forward slash juice box links in the show notes links at juicebox podcast.com. I'd like to thank you so much for listening remind you that the private face Facebook group is an amazing place to be Juicebox Podcast type one diabetes, completely free Facebook group. Everything about the podcast is free. Thank you to the sponsors. That's why That's why I'm off the charger for episodes and stuff not behind paywalls or how come I don't do like a 15 minute episode where I kind of tickle your ass with a feather but don't give you all the information then drive you back to my website where I'm like, sign up for coaching. I don't do that crap. I'm not up for that. I don't like it. Everything, everything I offers free, go, go use the Facebook page, meet the people build a community for yourself. I'll make sure it's there for you. And it's it's a nice place to be. You go ahead and take advantage of it. Same with the podcast all the episodes absolutely free. i My pleasure to make them seriously. Anyway. What am I supposed to say here? Thanks so much for listening. Come back soon. There'll be more episodes the Juicebox Podcast please subscribe or follow in your podcast app. If you're not listening in a podcast app or an audio app. Please check them out. Spotify, Apple podcast, Amazon music are some of the most popular ones. They work great. They're free. I think that's it, my friends. Alright, I'll talk to you soon.