#945 In the Loop
Mike has type 1 diabetes and he knows a lot about Looping.
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Scott Benner 0:00
Hello friends and welcome to episode 945 of the Juicebox Podcast.
Today I'll be speaking with Mike He is an adult living with type one diabetes who is very involved in the looping community, the DIY, do it yourself, looping community, Mike and I are going to speak about loop and Omni pod five for a little bit today. If you're interested in algorithms and insulin pumping, this one's for you. 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, or becoming bold with insulin. If you're interested in building a foundation for better health, check out my link for ag one and it's a new link. Drink ag one.com forward slash juice box. When you start with ag one with my link you'll get a free one year supply of vitamin D and five free ag one travel packs with your first order drink ag one.com forward slash juice box and get 35% off your entire order at cozy earth.com. When you use the offer code juice box at checkout. There are links in the show notes and links at juicebox podcast.com to 81 Cozy Earth and today's sponsor. This episode of The Juicebox Podcast is sponsored by cozy Earth. I am right now this second on my way to a movie as soon as I record this ad I'm gonna do a movie with my family. I just pulled on my cozy Earth joggers because it's the most comfortable thing I can think of to go hang out that movie theater with I'm going to have on the sweatshirt from cozy Earth. I'm going to pull on the joggers. I'm going to watch me a film. And when I get home tonight, I'm slide into my bed with my cozy Earth sheets. And I'm going to take a shower and warm and dry myself off with my cozy Earth pals. I am not making any of this up. They are really cozy, cozy earth.com use the offer code juice box at checkout. The podcast is also sponsored today. By touched by type one touched by type one DoD word. They have a big event coming up in September that I'll be speaking at. I hope to see you there touched by type one.org. Why did I get the VIP? Oh, let's Did you because I was out of days? Oh, yeah, I just I was literally. So the um, so every year, I might leave this part. And just so you know, every year, I consciously think don't don't book the show so much that you can't add somebody like I have this real like, don't do it. Scott Don't you know. And so I start every year out very carefully, I put out a link at the beginning of the year, I say, Hey, we're gonna we're gonna book like the first six months right now. But then I'm not gonna book the next six months until, I don't know, June or something like I'm gonna wait a little bit. And so many people reach out with so many great ideas and stories and from different walks of life. I just keep going. Yeah, yeah, like, sign up for that sign up for that. And in three weeks, you can't get a recording until like October. And so by the time March or April rolls around the years full already. And then people reach out that I still want to have on the show. And I'm like, alright, well, I mean, I don't record on Mondays, except for with Jenny or something special like that. So go ahead, just take this special link and go ahead and take something on Mondays. And then before I know when I give away Fridays. And then before I know that I'm recording the podcast every day, five days a week and getting to the point where I did somebody on Saturday night the other day, because I just I don't know how to say no. So I want I want that problem. Yeah, I love that. I love making the podcast. So anyway, you ended up with the VIP link because I was out of days. But also, you're a VIP, like hell. Well, thank
Mike 4:05
you. Yeah,
Scott Benner 4:06
whatever your mom told you about you being special is 100% true. You go ahead Introduce yourself whenever you're ready.
Mike 4:14
Hi, Mike. I've been type one diabetic since 2003 How old are you? I am 32 You're 30 No 31
Scott Benner 4:29
You're 31 When will you be 33 that that confused you?
Mike 4:33
Oh no, I am 32
Scott Benner 4:35
Nevermind 32 Okay, my whiteboard is already a mess.
Mike 4:42
Like my birthday is in 90 So like the last digit matches like my your age, but only before after the birthday. So I got to think like right is it before after my birthday?
Scott Benner 4:54
You were born the year after I graduated from high school. Well, that doesn't make sense. So if I had 19 add to this. Oh, baby, let's make sense. 1011 Carry that it's the one I wasn't carrying the 1345. Yeah, that makes sense. That makes sense, meaning that simple math holds up yet again, like, I want to see the proof. Well, if I took a picture of it, then everyone would know how bad my my penmanship was. And I don't want that, either. So, when you were diagnosed, was there like, Oh, I'm definitely gonna get this because all my brothers and sisters have her or have seven uncles that have diabetes, or was it a surprise?
Mike 5:34
No complete surprise. There's, like at the time, I don't think there was any real autoimmune known in my family. Now, my grandmother passed. About a year ago, she had Alzheimer's. And then also type two, which I guess isn't connected. And then my cousin on that side also has lupus. And my keep going, my grandfather on my dad's side has rheumatoid arthritis or head. He's also past the past year. All
Scott Benner 6:15
right. Okay, well, yeah, you were one of you was gonna get something lucky, you might.
Mike 6:24
But I think all that happened after I got diabetes. So we didn't, didn't have the warning. So
Scott Benner 6:29
all of that happen in meaning that you realized it, or she developed Alzheimer's late. Lupus happened since you had type one. I mean, your grandfather's had arthritis his whole life, but they diagnosed it as RA or what do you what do you mean by that?
Mike 6:49
I just made like I was, I had diabetes. First before anyone else was diagnosed with anything.
Scott Benner 6:56
Okay. Well, then you will. I mean, I also
Mike 6:59
I didn't know that the autoimmune connections until listening to your podcast.
Scott Benner 7:03
Oh, okay. I see. So there would be even you might even know, my grandfather's got, like, arthritis really bad might be how people think of it.
Mike 7:14
Yeah, and I don't know if he actually had a diagnosis or not. I just know, that's what my parents had said is that he had Ra. And my brother might have it, he might not. He's got some joint issues that he's trying to work through right now and figure out but the doctors keep running in circles. Yeah,
Scott Benner 7:31
that's what happens. I think that everybody, honestly, it's a shame. Have you heard Jenny talked about how she manages it with her diet?
Mike 7:41
I think I remember like, she doesn't eat, like dairy. Eggs or RA or something
Scott Benner 7:47
is some nightshade things and it's in her she's an episode about how she eats and she talks about it in there. But I wish her brother luck. It's not. It's not fun, that's for sure. Okay, but you just type one. And when you're diagnosed, how I mean, I could figure it out, but just telling me how old you were when you were diagnosed?
Mike 8:07
1212 That's like, sixth grade. Yeah.
Scott Benner 8:13
Was it a situation where the management of it was given to you or did your parents handle it?
Mike 8:21
It was like, they they helped me in the beginning figure stuff out my mom's a dietician. So like she helped lift helped me with carb counts and figuring all that early on. Of course, I didn't know until listening to your podcast about fat and protein and other things that can affect it. So it's just counting the carbs but you think it was pretty much but yeah, me for Well, I guess. I think in the beginning, it was more so like someone else would figure out the dose or like my mom for the first six months while I was still on injections. But then as soon as it moved over to the pump that was just putting the carbs press Bolus, eat your food
Scott Benner 9:03
in the cars and so there's no Pre-Bolus thing there was no adjust no adjusting after meals if blood sugars got higher or did you even test afterwards to see where they were?
Mike 9:13
I occasionally test after and like if I was high I would like I'd put the number in the pump and if the pump said correct I'd correct
Scott Benner 9:22
okay, well that's something did you hate it as a child? Did you not mind it? Do you remember?
Mike 9:29
Um, I I'm pretty good at ignoring things. I feel like I did an okay job. Like Maitland sees I was looking back through and it saw like consistently in the sevens. I think the highest was like 8.2 the lowest was like 7.1 so it just kind of like shifted around in there. I feel like it would have been a lot lower had had been told the Pre-Bolus But yeah,
Scott Benner 9:57
how did you feel growing up like physically Did you feel healthy?
Mike 10:02
Yeah, I didn't, I didn't notice any problems. I wasn't like a super athletic kid. I was, you know, I'd play sports and stuff, but not very athletic, up until like high school where I could get out of Pe by joining band.
Scott Benner 10:20
Like, I just want to dig into that for half a second. What does it mean that you played sports? But you weren't athletic? Were you the, were you the guy that we all looked at? And we're like, I mean, we like
Mike 10:29
yeah, I was I was the one dancing in the outfield. They're like spinning around in circles and the ball get hit and be like, oh, there's a ball, I should go catch that.
Scott Benner 10:37
We like bikes, and we're going to tolerate this, but he's not going to be here long term. That was the feeling.
Mike 10:42
It's neighborhood organized sports, you can't kick a kid out.
Scott Benner 10:46
You'd be surprised, Mike, but I hear what you're saying.
Mike 10:50
Maybe for being a nuisance, but not just for not being good. Can't
Scott Benner 10:53
you just make it very uncomfortable for them until they leave?
Mike 10:59
I'm also kind of like a pleaser. So it's like, you know, my parents like sports or so they think baseball is important. And I did not. I'm kind of like, I can go with the flow with things a lot. Like even if I don't really enjoy something like, I didn't hate going. Can I Can I ask if I had the opportunity to leave?
Scott Benner 11:19
Yeah, let me if I had the opportunity to leave, I'm just getting the hell out of there. If I might, I know this is not really why you're here. But you and I talked before you came on, we might not actually have a reason for you to be here. So I can talk about whatever I want. Can you tell me a little more about that? You understood? How that baseball as example was important to your parents? They told you or they were just big fans of it? Or how did you know?
Mike 11:46
I don't know it like my dad's just always thinking, watching sports. Like, you know, you'd be excited for me to go play baseball, or I don't think it was also like they would encourage just because, you know, it's better to have your kids go around play sports get energy out, rather than sitting on the couch,
Scott Benner 12:07
or cooking math or something. So as 12 year olds tend to do. So she they wanted you to be active. Do you think they picked baseball? Or do you think you did?
Mike 12:21
I don't really remember it was more like that started in like T ball. So a failure. It was probably just like, hey, there's a team. Go join that.
Scott Benner 12:31
scale of one to 10. Mike, how good were you?
Mike 12:35
Oh, probably. We'll give it a two. Okay. Okay. All right. I could catch a ball and throw it but you know,
Scott Benner 12:41
do you ever remember a coach looking at you with disdain?
Mike 12:45
I don't remember. But I'm sure even if they did, I just went right over my head, you just wouldn't
Scott Benner 12:50
have cared. I'm really like now, I'm not trying to be amusing. I'm trying to like trying to gauge whether it's like as a young child, if you were taking yourself to this place and thinking, Well, my dad likes it. And I don't hate it. And I you know, I'll do it like, and if you ever looked up and thought, oh, this person doesn't want me here. So you didn't have any of that feeling like you weren't great at it? And didn't. It wasn't something you were excited to do. But But so then my question is, what's your remembrance of it? Like, how would you characterize playing baseball? I don't know. Is it a good? Like?
Mike 13:31
A neutral?
Scott Benner 13:35
Okay, I'm asking like, I'm asking you an uncomfortable question, because I want everyone who is about to force their child to play a sport that the kid doesn't want to play to hear that in hindsight, this was what you call it wasted time. Because there was there it was there something you could have done at that age that would have been better for you.
Mike 13:52
No, I mean, in hindsight, I think it was good. Like I said, it kept me kept me active kept me moving.
Scott Benner 13:59
All right, well, then they heard it from you, Mike forced your children to play sports even if they don't want to. That's what you said, right? Yeah. Keep them moving. I'm encouraged by that because I've met I know you you know what I mean? I don't know you I know kids like you. And I sometimes wonder about that. I think oh, there's two seasons where this kid just I mean, obviously, I think everybody but their father could not have cared less about this thing did not want to do this and got brought there every day. And it makes me happy to think that somewhere that kid has grown up and and not devastated by the experience hopefully using you as an example. But then you said you joined the band but what did you play an instrument?
Mike 14:45
Yeah, drums. So like marching band counted as Pe
Scott Benner 14:52
How was that for hookups marching band?
Mike 14:57
Uh, I mean, I was just a freshman year of highschool, and then I moved overseas, my dad's in the Air Force. So we moved around a lot. And every high school I went to three different high schools, and each one got smaller and smaller, and the bands got worse and worse.
Scott Benner 15:12
Did you stop going?
Mike 15:15
I kept playing. I really didn't like the last my senior year, because it was like super small schools like 200 300 kids maybe. And the band teachers spent most of the time talking about like Broadway or something nobody cared about. And I was the only percussionist so there'd be like, here's seven different instruments that are supposed to be played. And I'd be like, How many can I play at the same time?
Scott Benner 15:40
You kids don't know this, but I was the dog in a production of my fair lady in high school. By the way, is there a dog in My Fair Lady?
Mike 15:48
I don't even I don't think I've seen that.
Scott Benner 15:50
I don't know either. I just made that up. I feel let's just roll with it. Pretend there is now there. Damn. Right. As everybody's listening. It's like it's fine with me. There was a chihuahua running around the whole time. Well, that's interesting. I mean, it's interesting that that it's an it sucks a little bit that you found the thing that you liked, and then because of moving around, and dwindled on you, so you're not a drummer anymore?
Mike 16:12
No, I still drum. Oh, nice. But like, drum set, like in bands and stuff. Oh, it's
Scott Benner 16:18
excellent. You do play you play in bands? Yep. How does that
Mike 16:22
not at the moment, at the moment, I'm in between bands, but COVID kinda ended things like make things a little more difficult for a while and that band ended but yeah, I'm in for a new one.
Scott Benner 16:33
Nice. You off to college then after that?
Mike 16:37
Yeah, yeah. Went to college straight out of high school. And they were still in Germany. So and then I went in Florida to college.
Scott Benner 16:45
Did you feel any pull towards the air force or pressure?
Mike 16:51
Well, I was diabetes, so you got out of it. So in the Air Force anyway.
Scott Benner 16:55
How about your brother? Is he in?
Mike 16:59
No, he considered it for a bit but ended up not?
Scott Benner 17:02
Do you think your dad was more disappointed that you guys didn't go in the Air Force or that you couldn't play baseball?
Mike 17:08
I think he's pretty happy with this no matter what.
Scott Benner 17:11
It's a very healthy answer. Mike Good for you. I would have chosen if you gave me if somebody threw a bullshit which is what I just did choice that me I would have chosen I would have been like, I would have thought about it for a second and pick one is very healthy
Mike 17:25
weight, which was a see all the above is very healthy
Scott Benner 17:29
choice was excellent. I'm so thrilled that that's how you answered. Okay, great once you go to college for
Mike 17:37
I started electrical engineering and then the first semester I changed to computer science.
Scott Benner 17:44
And are you able to employ that education in the in the adult world.
Mike 17:49
Um, I worked at a place developing or like taking other iPhone apps and like keep updating them or for about a year, two years, maybe after college, and then I switch to another job where I print and scan stuff for lawyers. You enjoy that there's a lot of it pays the bills and it's it's something different every day. Like, I've been there like six, seven years, and there's always something like new that'll come in and be like, alright, I don't know how to do this. Let me figure out a way to do it easier quality or
Scott Benner 18:26
problems not it's not it's not just repetitive it's, it's something you can actually employ your brain with. Yeah, it's
Mike 18:33
like a mix between repetitive and not because some days you'll go in and you're literally just feeding paper into a scanner for like the entire day. Oh my god. But then the next day, it'll be something completely different. So
Scott Benner 18:45
here's my next, my next false choice for you the job or we're having to play baseball again on the schedule of a child which would you prefer right now?
Mike 18:56
What's much rather be at this job than play baseball.
Scott Benner 18:59
That's what I was getting. Okay. Alright, so you manage your diabetes? Sounds like pretty much on your own. Were you doing that MDI with a pump?
Mike 19:11
mph for the first six months and then as soon as we could get to a pump, we got a pump.
Scott Benner 19:16
Okay. Do you have a CGM now present day?
Mike 19:21
Yeah, I do now. I think I started maybe senior year of high school, maybe freshman year of college. I can't remember when I first got to CGM, but um, I was Medtronic up until a year and a half ago. So it was basically I treated it more like a don't die alarm. Like if it beeps look at it. If it's super high, then start adding corrections because I think you know, my it probably didn't beep until 200.
Scott Benner 19:48
How would you describe your your management in that time? Your management style like were you on top of it? You know, were you a person who was like I'm not, you know, 200 is my number, you can't go over 200 when it got to 200. Were you worried? Or did you feel like an intensity about how to handle it? Or just was it just part of the day and you just did what you did and didn't think about it?
Mike 20:14
Yeah, it's kind of just like in the background. I tried not to focus on it too much. But like, you know, if I thought something was wrong, if it beeps at me and says, I'm Hi, then I'm going to Bolus but then I probably won't look at it for another couple hours or until it beeps again. I see. And I'm pretty good about changing settings and stuff. Like if I'm, I noticed that I'm consistently going high after dinner, I changed my ratio, change basals and stuff. So a lot of times, that wouldn't be until like, you know, every three months, you'd have your endo appointment, and then I'd look all over the stuff like right before the appointment and wait that three months. And then I change it all and then go in and they'd be like, oh, yeah, that sounds good. You can change it to that. Or you could move this a little bit.
Scott Benner 20:59
Not incredibly helpful. At the end of this office.
Mike 21:07
Yeah, no, I mean, like a little bit, but I never really found too much use out of and two appointments. Yeah, like now I go. About once a year, a little more frequently, like nine months.
Scott Benner 21:19
Get your scripts. Yeah, basically do anything. When do you find the podcast?
Mike 21:28
Well, I just looked in the in the app. Not too long ago, we needed that Spotify end of the year thing? Yeah. Because I was on Apple podcasts. And it said, I listened to the first one in January 18 of this year.
Scott Benner 21:41
Oh, so you've just the year for the podcast for you. Yeah, interesting.
Mike 21:46
I swear, I heard the fatten protein episode in December, like a couple of like a month before that. But maybe I listened to it like on the website instead of podcast. Right?
Scott Benner 22:01
So you see, I mean, 2003 2022. So for a long time you live the way you live? And get did finding the podcast change? I mean, if it changed anything for you, what were the things that you adjusted?
Mike 22:21
Well, I found thinking like a pancreas first. And then, so like I learned like Pre-Bolus and a lot of good stuff from there. And then listening to the podcast just reinforces that a lot. As well as add a lot more stuff like the crush it and catch it. While I've you know, kind of done that before. I didn't really think about it as much. You know, it's just like more of the rage Bolus, and then you go low, so then you feed sugar. Whereas now it's like, okay, I know I can just give a massive dose and then like, so loop now. So I can look like right now I need to put in the carbs now. And then it'll even out before I get low. And let
Scott Benner 23:02
the loop jump in. How long have you been looping?
Mike 23:05
Since almost two years now, years, which is when everything, Eric actually I guess the first big switch was getting a Dexcom. Like I was, I remember watching seeing commercials for it on TV commercials kept coming up. And then it kept telling me like, you don't need a finger prick. And I'd be like, bullcrap, I know you need a finger prick, because I have to ferment Medtronic, like he still got to do it once a day. Like it's better than having to do it as much but. And I just kept ignoring the commercial, because I kept thinking that like, they're quite right. When I finally looked into it, working from home and COVID. So, a lot more time on my hands. I looked it up and I was like, Oh, you actually don't need to calibrate this thing. So then I got that. And then I was I also hesitant to get it because I wanted. I like like I've always been trying to get the next best thing, but it's always a Medtronic. Up until recently.
Scott Benner 24:05
Is that just what your doctor's office gave? You? know, it's
Mike 24:09
I mean, that's what it's, well, no, it started out. I remember I think my mom picked the like, she went to a thing and they had the Animus ping or the whatever the Animus one was and a Tronic. And like she thought the the only perk of the Animus that she saw was like it said pizza in it. And then the Medtronic said square wave for dual wave, right? And she was like, well, he can figure it out either way, and the reps seem to like Medtronic better. Yeah, I got with that stuck with that a while. And actually the last Medtronic I got the dreaded six seven D. My endo tried to convince me not to get it. But I was like, No, this is this is the new best thing. This is going to be auto mode. This is going to figure everything out. It's going to be easy sailing. And I was very wrong.
Scott Benner 25:01
All right, we're gonna dig into a couple of things. Here I have notes. My first thing is I want to, I want to say, I know a lot of people because of what I do that, you know, work behind the scenes that companies like, you know, Dexcom. And in places like that, and a lot of those people who make those television ads and whose job it is to try to reach people and and send the message to them that they might want to check more of it out. And I think any of them that heard what you said a second ago are still banging their head against the desk. They're working so hard. They're like, Hey, listen, just come check this thing out. Here's what it does. And you're at home gone. No, it doesn't. wires. Exactly. What I said, is people crankies people, Mike are killing themselves, trying to make people just learn about a thing. So they can decide if they want to do it. And I guarantee your answer just that it ruin their whole day. They're just like, I Why am I trying? Why do I give up? I actually, you might have seen this online. But I just put out an episode the other day with Jake Leach. And this is going to be six months later after people when people hear this but Dexcom G seven got FDA approval. And I hustled my little butt around getting Jake on to talk about G seven and go over all the questions that I had, you know, people gave me through the Facebook page, I had a couple questions on my own. I put together this really tight 30 minutes with just rapid fire great questions. His answers are super clear and valuable. We'll help you make decisions about what you want to do or what you don't want to do. And then the next part is I put it online, and then I have to support it through social media. My job is repetitive too. So I you know, put a post on Facebook, I put a post on Instagram, put a post here and then I and then I involve myself in conversations with people and try to answer questions and point them in the direction of the things they want. It's a bit of a, it takes a lot of time. And in the end, what I want is for people to listen, I made a thing. I think it's helpful for you. If you think it's helpful, I'd like you to listen to it. The other side of it the business side of it is I need people to listen to the podcasts that they hear the ads so that maybe they click on a link so that somebody will buy another ad again the following year so that I can continue to make the podcast It's the circle of life kind of thing. If people don't click on the ads, I lose the advertisers. If I lose the advertisers, I have to go get a different job, you understand. And so, so every time this happens, and I never say like I never speak out loud about it goes on for years, you put up a link. And inevitably, or three or four people come into some sort of a commenting thread and say, I don't have time to listen to this. Just tell me does it do this? And when I see you know, where does it do that. And I see that it crushes my soul. So like you don't know the way the SparkNotes Yeah, I don't want to listen to your little podcast thing just now. I don't want to just give me the answer. But put it here so everyone can see it. So no one has to listen to the podcast. And and what you don't realize about that is that I spent my entire day on Friday getting that out to you in a timely fashion. I did not eat dinner with my family because of that.
Mike 28:17
We posted those questions and it was up like the next day.
Scott Benner 28:20
I hustle Mike, you understand? I grew up a sheetmetal shop. I take that attitude. I applied to podcasting. So I'm a hard working like person. And then it just I don't I put up this what I thought was a funny post about like, are you people I put it up as a poll. Are you people trying to kill me? Oh, I
Mike 28:37
am not trying to kill you. I think you might accidentally voted for yes. Because I wanted to see who voted for yes. And I was like, Oh, wait, no.
Scott Benner 28:44
Well, overwhelmingly, I think there's like 500 votes that people were not trying to kill me. But not the point. I'll
Mike 28:51
take this one. Yes, though. Once successful, yes, we'll do it.
Scott Benner 28:56
You mean to get me dead or just to make me feel badly about it? I don't, because I don't feel badly about it that you should know. i It's to me, it's like, Oh, you shouldn't it's all in fun. You know, and, um, but I did. It is an exam, it is an opportunity to, to let people understand kind of the back end of this thing, which is, you know, if you like the podcast, I'm happy like, and I want you to like it. I am trying to help people. If you heard me speak privately, you know, this is the time of year where I mean, this is the time of the year where I'm renegotiating with all the advertisers. And inevitably, in every meeting, I say every year, I can't believe how lucky I am I do this thing that I really enjoy and love. It actually helps people and it pays my bill. I have bills that get paid because of that I can like send my kids to, you know, the grocery store. And I feel very lucky about that. And then somebody comes along a person who, you know, has been around for a really long time. And it was like This is all about money to you. And I was like, what? In the hell are you talking about? Like, if this was all about money to me, I would have put this ad, I would have put this this episode together slowly over days and given it to you sometime next week, which, by the way, is what everyone else will do. They don't they're not in a rush and released it on Patreon or something. Yeah, right, or, you know, put it here and there. And we're charged you to do it or do it some shows do which is give you like, 10% of the information and then push you towards a coaching service or something. And I was like, That's so not me. I'm so transparent. And anyway, I just don't know, it's, it's not easy to do. The marketing of your content. It's not as easy as it might look from the consumer side. We're like, oh, I you know, I, this guy on YouTube, I really love he talks about cars that I drive and puts up an episode every week, and it's well produced, and you just kind of take it for granted. But that person is probably spending. I mean, I spend 70 hours a week making this podcast. And then you know, and then we're like, stop pushing your links. And I was like, Look, if you don't click on these fucking links Mike Marino podcast, like, like, I don't do not understand how the world works. Like, I can't just, I got a family. You know what I mean? So anyway, I don't know, like, I was trying to,
Mike 31:23
I think I think Dexcom should start putting you in their commercials be like, This is our product. But if you want to know how to really use it, check out that Juicebox Podcast? Well, I'll tell you on the positive, you can get a put out to whoever watches TV. Well, on
Scott Benner 31:37
the pod made the three on the pod five episodes with me this year. That was yeah, those are good. Yeah, it was a lovely, like partnership there between those. I think, if I'm being honest, I stay on the periphery of that space. Like, you know, companies don't put my face on things. But it makes sense to me, because I don't I don't have diabetes. Like you can't you imagine the backlash they would get if they were like, Hey, this guy follow him? You don't I mean, like, Does that bother you at all that I don't have type one?
Mike 32:12
No, not at all. Because of all the content that I get out of it. Like, I don't really care who's telling me as long as it's good information.
Scott Benner 32:20
I mean, that's makes that makes sense to me. But I don't know where people's sensitivities lie, you know, and they overall, it hasn't been a problem for me. I just imagine. It's my imagination that people sit in the room in a meeting and they go, who do we want to put on this? And somebody goes, that podcast is very popular. And then someone else says he does not have diabetes? And I bet you that puts a stop to it every time. You don't I mean, I feel like
Mike 32:43
it's it's almost even better that it's that you're the caregiver rather than the diabetic, because I feel like a lot of the times are, it seems like some parents are like, super into taking care of their children like you. So it's like, focus on every detail, make sure everything's right, figure this out. Because you're hearing about another person, whereas like, for, like, in my case for myself. Up until like two years ago, it was just kind of like, well just try something if it works, it doesn't just try something else.
Scott Benner 33:15
In that vein, like it's not as fine tuned. Yeah, in that vein of thinking, what is what was, I guess, like, go back a couple of years. When you think about managing your health, around diabetes, specifically, what's the goal? Is it a daily goal, a yearly goal, a lifetime goal.
Mike 33:40
I mean, like, ultimately, the goal is just to live without complications as long as you can, or to minimize the complications. And then, but then there's, there's so many different data points now, especially now that I have all these different naps and Dexcom. And so like, now I like every day, there's a goal to hit for like your time and range or, and then you can shift that into different ranges be like, your 70 to 140 range should be some number and your 70 to 180 number should be a different percentage. And then there's a one C there's standard deviation. There's a lot of goals now.
Scott Benner 34:24
Yeah, well, there is do you think of your diabetes as a in the moment thing? Is it a big picture thing? Is that a blend?
Mike 34:37
Me I think it's got to be a blend, because your sugar affects you now, but it also affects you later?
Scott Benner 34:43
Well, yeah, it definitely has to be but how do you think of it? Like, like, overwhelmingly what is most of your time spent doing? Like don't get low right now? Don't get high right now. I want the week to be good. I want the day to be, you know, in range or like, you know, I'm trying to figure out out, help, it's probably
Mike 35:01
more immediate, like what's going on right now? Or like, what's go? What's about to happen? Or what just happened? Like, the next hour in the past hour? And now? Because you can't really change stuff for next week. I mean, I guess you could, like bagels and stuff like overall, but
Scott Benner 35:22
yeah, I you don't even know like so is that you brought up that, um, you know, the parent of someone with type one and my my role changes drastically as she gets older, right. But my vision of it, my perspective on the issue is completely different than hers. Because I hold all the perspectives at the same time. I want her blood sugar to be stable and steady and low now. And I'm worried about her future. Both in the short term and long term, I'm worried about how she'll deal with this while she's in college, will she keep focusing on it? Will she not? Will she give it away at times to do other things, which I expect? Will that translate into her her young adult life as I got away with it in college, so I'm not going to put too much effort to it now does that go into her late 20s That she started having problems when she's 30? Like, when I when I think about Arden's health. I think of it the same way I think of my son going to college and meeting people and maybe having a relationship and looking for a job like I see the whole like, Mike, you don't do you have kids? Yeah, no, you worry about the entirety of everything when you have children. I don't think of it as worry. For me, I think of it is concerned, it's considering I'm always considering the whole thing. But I don't think that as an adult living with type one. That that's the same for everybody. I mean, I've spoken to a lot of people. And I think overwhelmingly, that's not how people think of it. I think it would be too much to think of it that way. I could see why you wouldn't. But I also think that a certain amount of that is what leads to these outcomes that you want. So it's just interesting for me to hear from an adult about how they like conceive day to day of diabetes. That makes sense. Yeah. Yeah. Okay.
Mike 37:24
And, like I said, for the, like, the consideration also changed a lot once once I got Dexcom, because then it's on the phone, because like, even when it's on the pump, like I'm not looking at the pump a lot. Like I said, Whenever it would be, I'd look at it. But now that it's on my phone, it's on my watch. Like, I can see it a lot more often. So it's a lot more. There's a lot more management or like things to do. Yeah, but I'm trying to say,
Scott Benner 37:53
but that stuff helps. And that's what I want to know, like, being able to see it more readily on your watch, for example, not having to dig into even an app or do a blood sugar test or pull out a meter or something like that. Having it there helps. Having goals helps having an app that says hey, you're in, you know, we're our time and ranges, you know, 60%, and it's 40% here, and we're low 5% of the time, or whatever the numbers are, like it gives you something that you can kind of quickly focus on. But then do you adjust after that? Like when you see it, if the numbers not where you want, do you consciously think oh, I've been high too much this week? That's probably because I ate out a number of times, I didn't have a lot of success boasting for my meals or like, do you give it that much thought? Or do you just think, Oh, I've been high a lot, I don't want to be high as much.
Mike 38:43
Yet. Now I do. So now like about once a week, I'll look back at in Nightscout. Like, I'll look at like the daily reports and kind of see what the trends have been. Like, if I'm more consistently higher or lower in a certain timeframe, then I'll adjust either basil or carb ratios or ISF
Scott Benner 39:05
I'm excited for. But then I'm
Mike 39:09
also like tweaking those in the moment too.
Scott Benner 39:13
Yeah, like when something just goes the way you don't expect it to you you're in the moment helping it and then big picture, you're looking at it as well.
Mike 39:20
And I'm I'm a pretty competitive person too. So like having, like having all these stats to like, when I zoom out, I look at my management now. And I'm like, Oh, I'm doing pretty good. I'm like, you know, 91% between 70 and 180 75% between one and 130 or 70 and 130. But then when I zoom in and like the day to day I feel like I'm always like, Oh, am I again? I'm messing up fix it. I'm low again messing up fix it. But like when I zoom out then I'm like okay, overall it's it's going well
Scott Benner 39:59
yeah, it's I think of it the way I do because you're 100%, right? If you look at any 24 hour graph, most of the time, you're gonna be like, Well, what happened there? You know, and then you look back over a month ago, the month was good. So if that day existed within that month, you think, Alright, well, the month was good. But there's things happening during the day that I'd like to have a better handle on. And which one, I think the problem is that the people can just then go, well, the 30 Day was good, I won't worry about a spike to 240 that lasted five hours. And so that's why I think like thinking about it super simply, it works best for me. I'm not, you know, I'm still in the middle of trying to get Arden to think the same way I think about it. Or if I can't, I'm going to have to find a way to take the way she thinks and apply it to diabetes and adjust that, or she's going to have to find that maybe more specifically, right? Because for me, give me you've heard me talk about a million times, like just, you know, one of the big people are like, what are the rules of diabetes as far as you're concerned, and it's Pre-Bolus, don't let a spike happen. Understand the impacts of your food. But then right after that, when I say like, stay flexible. I think what I mean by that sometimes is like, you know, kind of go with it just okay, this happened. Let me keep working. But it half of that is Don't stare at high blood sugars. Like that's the biggest thing. Like, I watched art and try to do something yesterday. And she's home from school for the holidays. And I kept she's like, I have this, like, let me do it. And I'm like, that's fine. So I let her do it. But four hours into it. I'm like, I could have fixed this two hours ago. You know what I mean? Like, and I see what she's doing, but it's, as she's doing it, am I good? I ain't gonna work. And so I kind of find a time to walk into a room and I was like, Hey, listen, you know, I've seen what you've been trying to do. And I understand why he did it that way. I'm like, that's not going to work, you're gonna have to do this. And she loops and I said, You got to open the loop. You got to make an aggressive Bolus. And then we got to close the loop again to stop the low, right. So she does that she actually Bolus more insulin than I would have done. She created a fall inside of 30 minutes. And I kept an eye on it was later at night. And she was up and I sent her a text. And I said, instead of saying, like, close the loop, I said, What do you think? Does it look like it's time? And let her decide. And then she closed the loop off the loop, the algorithm kicked back and shut off the basil caught the blood sugar. And she was like, I mean, I can look. But she was super stable overnight. Yeah, so the drop happened. It fixed itself around 230. And she's been like 90 for the last 10 At least eight hours. Anyway, it's everybody's got to find their motivation, and their style. And you know, and then just, I think then the hardest. It's all that sounds hard. But then the hardest part is after you figure all that out, it's applying it over and over again, without getting just burned out by the whole thing. Oddly, it's like your job really is right? You just keep feeding those papers and that scanner, like, alright, I don't want to do this today. But this is the job and then you do it. And then you look for ways to be engaged by it. Is that right?
Mike 43:32
Yeah, yeah, I think so.
Scott Benner 43:35
All right. Well, if we could pay everybody for diabetes will probably make them more engaged. Do you think just get it? There you go. I get behind that get a nice hourly salary for taking care of yourself.
Mike 43:46
24/7 365 jobs. So
Scott Benner 43:49
like, do you think that would work?
Mike 43:53
Think about probably not, well, no. I mean, even when I was a kid, like I remember my mom giving me like a list of like, it was like a packet of meals that I had to go through and like calculate the carb counts of everything. And I think it was like, I don't know if it actually was, but I think she told me it was like something for her work. And she was like, Oh, I'll pay you to do it. And I feel like the real mastermind plan behind it was like if I could just, you know, pay him to learn more about carb counting. But the money wasn't worth it. Or not not worth it. But
Scott Benner 44:28
Mike was the juice not worth the squeeze?
Mike 44:31
Yeah, there's the idiom. I love that one. That's one
Scott Benner 44:34
of my favorite ones. Why do I love that one because it was taught to me by Charles, this big, very Italian man that that whose son played baseball with my son when they were in high school, not for their high school, but for their travel team. And we spent a number of years together. Standing in the outfield watching our kids play baseball, and he would say stuff like that all the time. He's from from, from the city from one of the boroughs and he'd be like, pow, let me tell you, the juice ain't worth the squeeze. And I it's not what he sounds like, but I'm just approximating it for you. And it's just delightful. It's so wonderful guy. I'm going to tell some story here. That is because you're on and because of what you said earlier. I've never been mean to a child on purpose Mike.
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I've never been mean to a child on purpose Mike. Except for once to get started. And and I want to be clear, this was never to the kid's face. And the kid never knew about this. Never. But my son played baseball with a kid. And again, I've never met a kid that I like it's hard to dislike a child. Do you know what I mean? Like it's just it just it is and and um probably started knowing this kid at the end of middle school, so I don't know how old they are, they're like, ninth grade eighth, ninth grade right there, and all through high school right into going into college and actually, still was tangentially aware of them in college. And the and the, the kindest thing I can say about this person was that he was a dick. He just someone told this kid, I assume, hourly, how wonderful he was, and how everyone else around him was subpar compared to him, either that or he had a significant mental issue, I don't know. But this person believed in themselves in a way that was unwarranted, and, and cruel, to the point where my son said one day that he could hit a ball and got thrown out trying to stretch a single into a double, which he would frequently do get thrown out trying to make a double into his triple A single to double the gauges, just always cocky. And anyway, the kid gets thrown out doing this comes into the dugout, everyone's pretty quiet. Because I mean, it was an obvious situation where this was just a single, like, you would never go to second on this. And he comes in, and he takes off his gloves and his puts him in his helmet, slams his helmet down, turns the everyone in the dugout, and goes, I'm better than all of you. And then just walks away. And that is but one small example of the dickish pneus of this person. This happened constantly, I once saw him hit a legitimate double. He's running the third even though the third base coach, he just has his hands up going stop, go back, like this is not a triple you and boom gets, you know, gets thrown out at third, I swear to you after the fourth time that happened this summer, the kids slides into third gets tugged out. He stands up and the coach goes, What are you doing? And the kid goes, you like like this was the kid, right? So one year, the kid decides that he's so good, he's gonna go to this out of state camp where he's obviously gonna get drafted from because this is how he feels, which by the way was never gonna happen. But he goes to this thing, it's one of these things you pay money to go to, it's not a special thing. It's if your mommy and daddy have money, then you can do it. And he went and did it. And he came back with batting gloves that had the American flag on it. And that is when myself and the other parents started referring to him as Captain America. And then Superman. And then one night, on a Friday night when we got stuck with the last game of the day. And it's 11 o'clock, and the kids are still playing. And we have to be back again at like seven o'clock in the morning. He comes to the plate. And one of the guys pulls out their cell phone and plays the orchestral music from the first Superman movie, Dan, Dan intentar. And like no one knows, but us it's just we're literally we're out in right field. There's no one within 100 yards of us. We're just hiding watching this game. And we just start snickering like little girls. And then it became a habit where we would find big important music to play as this kid walked to the plate and then like children, we would laugh. And I believe that the the the Olympic music, the thrill of victory and the agony of defeat was the funniest one for some reason. They're dead and dead and just have to imagine his kids just you have to you don't know him and I can't but he would stand up so straight, like two straight. And he walked with his chest out. Like like that he just anyway, he was just a deck. He was he was a child that was a deck and I always thought like, Oh, I hope this like not I hope he goes to college and, you know, maybe finds himself or relaxes a little bit. But no lie in my son's senior year of college. They ended up playing him. Same attitude. Same person just kept going. And I was like, wow, that's who he is. It's fascinating. He's a deck. So I don't know I just at some point that had to be put on the record somewhere. So here it is. I just put one kid in the I've never met another kid I didn't like and it's not even that you don't like him. You just you can't root for him. I don't know if that makes sense or not. But um, he's like his worst his own worst enemy or something. Anyways, the opposite of you. You seem delightful. Alright, so hey, I
Mike 54:41
got a delightful.
Scott Benner 54:43
You are delightful. I want to dig a little bit into the Medtronic thing. So you said you got 670 G right, the automated version you're using their thing. It didn't go the way you expected. Why is that?
Mike 54:58
I'm not a very cool sistent person. So having it like an automated black box, change all your settings and do everything. Like if I'm active one week, go into the gym bike ride. And then the next week I'm sitting on the couch like the algorithm doesn't know how to handle that, or like, one day I'll have 300 carbs the next day I'll have 30 carbs. So like if your Basal is more like, not where it actually should be, but because like you can't actually set the Basal on that one, like it takes care of itself. So if you're eating more fatty foods, and not putting the fat in to the cart Bolus, then it's thinking that you're going to need more basil. And then the next week when you're not eating as fatty foods, then you have too much basil. Okay. And the sensor also just, I don't know if it was, it might have been a problem with me not calibrating it correctly, like not calibrating it at a flatline. But also, it's hard to have a flatline a lot of the times, so like it's always going up and down. But with that, when you have to calibrate it, then it's not like you can wait until you get a certain line, it yells at you at three in the morning. And unless you just turn it off.
Scott Benner 56:16
I have to say that anything that is set up to wake me up at three o'clock in the morning, do something doesn't seem well thought out?
Mike 56:22
Well, it may just because like it has an error or something. Or, you know, it's got to be like every nine hours and like if I don't time it right, or I think it was like every 12 hours, it claimed it was every 12 or 24 hours, but it was always way more than that. Like it would say you have 12 hours until your next calibration and then like six hours later, it'd be like, You need to calibrate.
Scott Benner 56:45
Do you do you find the experience with Dexcom to be better or different, or
Mike 56:53
what insanely better, okay, but it's also like, because I started with like Dexcom. As soon as I got that I was like, because I was a little hesitant getting it because it didn't work with my pump. And even before the six, seven D they had the, I forget what they call it, but like it stopped to your Basal if you go if it thinks you're gonna go low. And I like typing that safety feature in it. Of course, when the six seven D, like does calibration errors or overnight or like, it'll just turn that you'll it'll kick you out to auto mode, and it won't turn on that safeguard. To stop your Basal.
Scott Benner 57:26
Yeah. So you think you have to say that you have to safeguard your mind. Like I'm sleeping, at least it'll like sort of like control IQ had Basal IQ first, where are they? Yeah, it was just Its goal was really just not to let you get too low. And then but um, but the problem is the Medtronic would kick you out of automation, if it didn't like where it was. And then this protection you thought you had didn't exist.
Mike 57:48
Yeah, but so as you know, it has a tint going over your Dexcom because like I wanted it to talk to my pump to prevent me from getting low. And I realized, you know, Dexcom can't do that. But then I started looking at I was like, alright, well, how do I at least see the graphs of everything like side by side. So that's when I found tide pool. And then from tide pool, I found loop. And loop it's like, you know, what you tell it to do? It
Scott Benner 58:15
does it shows you everything that it's thinking it's, it shows you like this is what this is how we think your blood sugar is gonna go in the next six hours. Yeah, you don't like the way you're talking? You can fine tune everything. You the way you're talking makes me think to say something I've never said before, which is loop feels like automation, that you're a partner? And if Yeah, if you want to be I mean, you can set it and leave it if you want. But if you want to be a partner in it, you absolutely can be.
Mike 58:45
And you can also go back and like look to see kind of why it made a decision, it made a decision. It's not just this little black box, like you can't even I don't think you can even see like what the basil is we're
Scott Benner 58:58
okay, yeah. And on the pod five, it's a similar idea where they want it to be very automated, and kind of happening in the background. I think it works for who it works for. You don't I mean, and
Mike 59:09
I think if you're a consistent person that it probably works great. But if you're not,
Scott Benner 59:14
I also have to hope. I don't know. I mean, I'm not a computer engineer for certain, or software engineer, but I have to imagine that these are really the first generations of these things. And it does make me wonder what it'll look like in five more years. You know, like, will it be able to, excuse me? Like, will it be able to sense something and just ask you on the screen, like, are you inactive today? Yes or no? Like something simple like that. You know, I'm noticing like, you would think the algorithm could see that you need more or less.
Mike 59:53
And I like how like, I haven't used Android APS but on there like it'll tell you like if you're You're more sensitive or less sensitive than you are previously, so then you can look at it and be like, Okay, I need to increase things or decrease things. And it'll do some of that automatically, I think.
Scott Benner 1:00:10
Yeah, I mean, that's, that's the stuff I'm talking about, like, I mean, they have to let
Mike 1:00:15
you know, the FDA gets involved in and then pushes, like anything they wanted to do, like, you know, tide pools coming out with their, their version for I'm assuming it's still gonna go on me pod if that ever happens, but like, I think the I think the app that they're trying to push through the FDA is like what Luke looked like four years ago. Like they can't put like, I'm using LWC dev now. And like, they can't put remote control in or a bunch of other stuff. Yeah, God Oh, Bolus and like, they got to taper it down enough to get it through the FDA. And then it just, you know, the whole hashtag, we're not waiting movement
Scott Benner 1:00:55
started to wait when it got to the FDA. We're not waiting tide pools, like we're gonna take this and we're gonna go through even when they settled, I was like, how's that gonna work? Okay. I thought, good, go do it, you know, but now, like you said, it's been years. Right? And it, it's not here yet. And I'm Arden's not using the same version of lupus, she was back when they made that. So they have to take some version of the app and say, This is what we're going to send to the FDA for them to judge. You can't keep adjusting what the algorithm does. While you're in that process. Once you're in that process. That's that. What version of
Mike 1:01:34
30 have oh, sorry, go ahead. No, I just didn't like because like, you know, Dexcom g7. Like it's going to be from your episode. I think he said, like, mid 2023, like mid next year for tandem. And like a little later for Omni pod, whereas it already works with loop.
Scott Benner 1:01:51
Doesn't really seven, I didn't even know. Yeah.
Mike 1:01:56
Well, you like it's got to be looped up at like one of the more recent ones. And I think you have to go in and do a little more tweaking, but but you can get it to work.
Scott Benner 1:02:05
Yeah. And and more quickly than you imagined, it will just one day, they'll put out a version. And they'll just they'll be like, here you are using the GSX or the g7. You just tell it and that's it, and then it works. Well, that's the idea of I mean, that's what happens when you put software engineers on to something. And they have to make sure it works. But they don't have to send it out to somebody else to say yeah, you're right, that works. So what what version are you using right now of loop?
Mike 1:02:32
I'm using loop Dev, but the one in the build the fixed. Fix Dev, build script, Nick, it's called?
Scott Benner 1:02:40
Is it? So like? Good?
Mike 1:02:43
So Luke three. And then I'm also using John facets patches.
Scott Benner 1:02:50
Why did you choose those,
Mike 1:02:52
just because I like a lot of the features they have in them, like it'll switch between, like, depending on what blood sugar you're bait, or what your blood sugar is, like, if you're if you set that to 110, you can have it anything under 110. It'll just do auto boat or auto Basal, anything over 110 it'll switch to auto Bolus mode. That way, it'll kind of be a little less aggressive when you're at a lower and you don't have as much time to catch like too much insulin. Oh, I
Scott Benner 1:03:18
love that.
Mike 1:03:20
There's also a Basal lock feature so you can have it so like if you hit whatever you set. So if you set it to like 220 that means it won't cut your Basal off. If it's above that number. It'll just keep it on and like once you're under that number, then it'll cut it off.
Scott Benner 1:03:34
You know, I feel like I just got an email from him the other day his kids using Omni pod five now.
Mike 1:03:39
Yeah, doing really well on it here. Yeah,
Scott Benner 1:03:42
it's funny. This is the that I'm aware of I'm sure it's happened more than this. But then I'm aware of like a handful of times where somebody has been very involved in the looping community and really helping with it, you know, and then control IQ comes out one of the people's like, Hey, listen, I'm putting my kid on control IQ. And then that and then that's it. That person like kind of disappears out of the community. And then I mean, I just set John up to be on the show, I think. So to come on and talk about it. But But But what you just said is amazing, like switching between Otto Bolus and like basil instead, depending on the the blood sugar is kind of genius. Because like one of the problems we have. What in the hell excuse me, Mike, this is unconscionable. Why would that happen? Thing Nevitt I've owned this phone a long time and I don't know how to use it. One of the problems Arden's had you know it happens a handful of times a year as you can get into this situation where you're fighting a low and you got it and then it starts to come up but it's been one of those days where you've just been low, you know what I mean? Like you just don't need as much as usually need. You finally get the blood sugar to like kind of stabilize and it rises up a little bit and hits, I think Arden's thresholds are like 90 or 95 on loop. And then you get to 95. And it sees a rise, and that Bolus is in auto Bolus. And you're like, No, like, don't do that. Not now, not today, you like
Mike 1:05:16
it with with the patch two, there's another feature that helps out with that a lot called negative IO B factor. And you can go into the settings and tell it to only count like, whatever percentage of negative iob that you want. So like if you stop your basil, if your basil leaves two units an hour, and you stop it for a half hour, your iob is a little less than negative one, like at the end of that Temp Basal. Okay. But if you set the negative IB factor to 50%, your negative iob will only be negative point five. So then it won't try to give you as much insulin.
Scott Benner 1:05:51
Yeah. Well, I What I've learned to do in that scenario is just say like, like turn off micro boluses. Without carbs, until you find some stability, then we'll put it back on. And that
Mike 1:06:02
free APS has that setting. Yeah, which isn't in,
Scott Benner 1:06:05
right. Yeah, right and aren't using free abs. But the truth is, at this point, there's so many different versions, I don't even know what to do anymore. Like, wait, maybe there's a better version I could be using, I don't even know how to know that at this point. So you're using it on the pod or using it with what kind of pump.
Mike 1:06:24
I will I started out with a Medtronic because I had one in my drawer that I worked with. The nice thing about having met tronics for 20 years. But then I switched to Omnipod. More. So just because I was worried about the warranty situation. Like if this pump breaks, I don't have a replacement for it, I can't get it repaired really. So then I started using arrows, and I didn't really think I'd care much about the tubeless feature. But then like six months later, Thanksgiving came up. And it was like I kept hearing people talk about the tunneling, like for too big a boluses. And like, Alright, I'm gonna put my Medtronic back on. And those were the most annoying three days of like, my pump going everywhere and having to take it off, put it back on. Getting caught on things. Yeah. And like, I guess, like, well, when it happens for 18 years, you just kind of deal with it, you don't really notice it. But then having six months without that, and then going back to it, it was like, Oh, this actually is a huge improvement. I've tried dash and I like like, I would like to move to dash, but it's billed as pharmacy instead of DME. And my insurance, the way it works like it's way better for DME for me.
Scott Benner 1:07:34
I'm at the point now where I'd like to move out into loop with Dash. And
Mike 1:07:40
you can keep using free APS with dash right now. It's a different version of it. But it's still free P for APS, it should look almost exactly like what you're using now.
Scott Benner 1:07:52
Is it a stable bill? Yes. Yeah, I might have,
Mike 1:07:56
it's the exact same thing, just with Dash added. I think there's a couple other bugs that are fixed or something. But
Scott Benner 1:08:03
I don't want to send her back to school with a prop with something that she wouldn't know how to deal with. But at the same time, this is
Mike 1:08:12
I posted a Dr. We tutorial thing a while ago. Yeah. So like you can remotely install it on her phone to I've actually got even when she's in Georgia, like you can just remotely update it or
Scott Benner 1:08:25
Yeah, Mike, we're supposed to say Chicago, she goes to school in Chicago. That's what,
Mike 1:08:30
that's what I said. Right? Yeah.
Scott Benner 1:08:32
And interestingly enough, Kenny just sent me that same thing. And he any and he's like, you know, you can just do it remotely now. And I was like, really? Like, that's crazy. Yeah, that sounds good. So that's what I want to do. I just need to find the time to sit down. And I mean, I am assuming all I really do is just rebuild the app and then restart a pod with dashboards. And that's it. Yep, yeah, it does. What do you know about? So here's the thing. I put up a post the other day on Facebook. There's two things I want to talk to you about before I let you go. I put up this thing on Facebook. And I was like, tell me something you don't know. This is like the most popular thing I think I've ever posted online. It's just been seen by Oh, your Heroku thing? What? Yeah, yeah, because I don't understand it. I know I have a Heroku app or page. I know I pay for it. For the life of me. I don't know you do. Really? Yeah, they made me start paying for it. For the life of me. I don't really know what it does. I know it's, if I if I didn't have it, I wouldn't have Nightscout. I do like Nightscout. And so like, I don't know, like I don't understand. I've never done a thing I don't understand before as much as this.
Mike 1:09:50
So like Heroku is basically it's the website that hosts your Nightscout app. And then do you have another Yeah, MongoDB like on another website holds all the database. So Heroku or the Salesforce that people who own them, they decided they can't keep the free tier anymore. So then they had to, like now it cost $5 A month is the minimum you can do. So the easiest way is to just pay that $5 a month, and then you don't have to do anything different. Heroku just keeps working with your NetScout. or Now there's also as soon as like the Heroku started, like announced that they were going to start charging $5 A lot of people started to look at other websites that could host it instead of Heroku. So like I've moved mine over to Google Cloud now. So that'll that'll just be free. And then I also with Google clouds, nice because you don't have to go back and clean up the database. Because like, with Heroku, or with the Mongo DB, you're limited to half a gig, I think. So once you have like, you know, every six months or so you gotta go back in and clear the data. ON CLOUD one, I don't even know you really not do that.
Scott Benner 1:11:12
Yeah, I'm fascinated that you're saying that. I was like, Oh, is that a thing? I'm supposed to be doing that I'm not doing too. Even I don't
Mike 1:11:18
if underpinning if it's working, then I guess it doesn't? Doesn't matter. Yeah. But under penalty
Scott Benner 1:11:23
of death. I've seen the word like the word MongoDB. before. And I even feel like I know that if I tried to log into it. I have a way to save your password somewhere. Yeah, but I don't know what it is. And I, but but I don't know, I just listened to somebody. They told me like, do this. I did it. And it works. And it works amazingly. But I mean, that's the part of it. Like all of that is where this gets like sketchy. Like for people coming in trying to like, Oh, I'll try it. But then you're like what you just said, I know makes sense to you. But as you're talking my brains, like, I don't know, it sounds like there's an app. That's Nightscout. It has to be put somewhere. It has to exist somewhere. And then I think well, how come I can't just build it in the Apple Store, like in Xcode like I do with the app for the blue. Like, why is that not okay? And then
Mike 1:12:18
it's got to be, it can't run on your phone, it's got to run like somewhere in the cloud. And like it, if it's an app, it's got to someone, like, if someone put it in the app store, they'd have to pay for their own big giant server for everyone that runs Nightscout. Okay, so this way, like you're just building it yourself. That way someone doesn't have to hold everybody's like, there are some websites that, like, there's a couple. What did you call them like monitored? That's not the word. It's got it set to like, are just for web or just for Nightscout. Like, so you can set it up, and they take care of all the database work stuff behind it.
Scott Benner 1:13:00
I mean, you think, Well, if you switch to this, because people have come on people like go to rail, is it railway?
Mike 1:13:05
Yeah, railway is nice. It's probably the easiest one to switch to.
Scott Benner 1:13:10
And then I'm like, I don't know, like, what what if that company goes out of business? Or what is it like, you know, you like?
Mike 1:13:16
And then you got to switch to a different one or Yeah, that's also why I didn't go with real quick, because I'm not really sure what the future of it is where Google's not gonna go away. Like, I suppose they could get rid of the free tier. But if that happens, I'll figure something else out.
Scott Benner 1:13:29
Yeah. See? That's because you understand it gives you Well,
Mike 1:13:33
I know where to go online to find other people that understand,
Scott Benner 1:13:37
oh, well, that's probably better than understanding yourself. I, I just feel bad. When I ask people questions. I'm like, I don't know what to do. Can you help me? Like I feel badly about it? But I think you know, in the end, I do talk about it on here. So it does, it does get the word out. So I guess it's a fair trade. But I just I keep thinking about in the future. Like, you know, I mean, this aren't going to have a Mongo DB when she's 30. I bet she won't. So anyway, I like the way that it's progressing. So So you're telling me right now there's a version of free APS for dash that stable?
Mike 1:14:17
Yes. The problem is that free APS like it won't keep getting updated. Like it'll, right now it's at a point where, like, they'll keep like, when a new version of iOS or Xcode comes out. Maryann will go in and do like, she'll try to keep it updated so that it continues to work and stuff, but there won't be other features that like it won't improve at all from here on out. And if something happens with the new version of iOS that breaks it, like not going to spend a lot of time to fix it. I see. So really, I mean, it really I think most people including you should just just move over to the well, like like, by the time this comes out, loop three will should be out on Last year, hopefully,
Scott Benner 1:15:01
you think that's the way to go. Loop three.
Mike 1:15:05
Yeah, which is what loop Dev is.
Scott Benner 1:15:09
But right now, if you if you like, go to the if you go to any if you'd like Google loop three right now, don't do it later because like I said, this will be six months later. But it the way it reads on the, on the on the GitHub document, it's like it says right now, like this is being tested by experienced loopers right now. Yeah. So it's still in the in a beta phase.
Mike 1:15:33
Yeah, but I mean, I've been using it since March, I think, okay. And I haven't had an issue with it. But I also like, I keep tabs, like, I'm always in the loop group, and I'm part of the loop and learn group. And then I'll check the zulip Every once in a while, where it's like more than the actual developers hanging out there. So but then also like, like, it probably won't really matter, because it'll be six months in the future. But there is a version in loop docs called fixed Dev, I think, where it's where Marian like, froze loop dev at a certain point. So she's like this, look at this version right now, like is fairly stable. Like working well. So then, that's the version that you'll download just from that. It's like a build script works the same way that the master build script does. And you're so then you're like, Oh, I'm sorry, you won't keep getting the new update stuff like so when they keep putting new stuff in. And they're like, because if you just take the very newest version of loop dev every time, you don't know how much that's been tested, you don't really know if there's something that might break the app that gets added to it. But if you use the fixed Dev, then there's nothing added to it anymore. Like that's just where it stops for some time. They're unstable. Yeah. So and if something comes in, and like a bug comes out, and they're like, oh, this actually does affect the, that version too well, then they'll both go in and look at the options and update that script to download a version that that bug would have been fixed. And
Scott Benner 1:17:09
but even if that happens now with this new like, I forget what you call it earlier, what Kenny was telling me about but But if, yeah, if so if something happened to the app, and it just crashed, or it had a problem, it's now as easy as putting a link on like a cloud server, sending it to art and having her downloaded to her phone, click on it. And it just rebuilds the app right on our phone. Yep, that's insane. How come we haven't been doing that the whole time. Like, that seems amazing.
Mike 1:17:39
And the one caveat is like it has to be a phone that you've already plugged into Xcode and built loop to
Scott Benner 1:17:44
write you can't just install it fresh with that
Mike 1:17:47
with like, if if she threw her phone off the bridge, and like needed to get your new phone, you like there are ways to get around it to add that phone to your Apple account without actually plugging it into your computer. But it's a lot more clicking around online. And like kind of a roundabout way to find like the specific number of the phone to enter. So it is possible, but more difficult. It's
Scott Benner 1:18:12
interesting. So I'm gonna put you in charge for a second. Should should Artem be using loop Dev. The loop three.
Mike 1:18:22
Yeah, I think as long as I mean, as long as you're active in the diabetes, like online community for loop blooped. And like so if there there is a bug or something catastrophic that comes up like you would see it. Other than that, like I for you, I would say yeah, like, you know, look well enough, like, better than anyone else really. So like, if something's not working right on it, I feel like you would see it and realize, but like I said, since March, I haven't noticed anything really.
Scott Benner 1:18:54
So you haven't rebuilt the app in nine months?
Mike 1:18:58
Oh, no, I rebuild that a lot. But, um, the well, the version I'm using now, I think is from like, two months ago. Okay, that's when it stopped getting updated. For the fixed one.
Scott Benner 1:19:09
Yeah. And so you do you think it's getting close for them to say this is a like a stable version?
Mike 1:19:16
I hope so. But I'm sure it'll probably go to like a release candidate where like, they're like, this is the version we think passes all the tests, and then that'll sit there for a little bit. And then though, as long as they don't have any problems with it, then we'll move that to master.
Scott Benner 1:19:30
Yeah. Hey, can I can I move her to a version that supports dash and then four months from now remotely move her to loop three?
Mike 1:19:47
Yes, Inchon Yeah, you can do that. It'll be a little more difficult to move her back to free APS from three. But I think it's just basically you have to make sure everything's uninstalled on the phone.
Scott Benner 1:20:02
Just like to take the app off it completely.
Mike 1:20:05
Yeah, there might be another step or two that you have to go through. But that'll be in like loop docs, he could find that or message me and I'll figure it out.
Scott Benner 1:20:15
Interesting. So if so if I went through a version right now that was dash compatible, but wasn't loop three, which version would I be looking at?
Mike 1:20:27
If you don't want loop three, you still use the fix dev build script. But that script has free APS dev in it. Okay. And that's step B, which basically what you're using now free APS, except with Dash support added in,
Scott Benner 1:20:42
got it. And that one's pretty people seem pretty happy with that right now. As near as I can tell, from people talking online.
Mike 1:20:51
So yeah, well, I think like I said, we're like the people running loop docks and like, trying to push people more toward like, if you want to use dash, especially if you're an experienced user, or Looper to move towards the loop Dev, just because it's, it's what everyone will move to, to and hopefully, once it's released as master, it's interesting. Three, APS will eventually die out.
Scott Benner 1:21:18
I think that very few people listening to this understand what we're talking about.
Mike 1:21:25
That's a good chance. Because I also tried to, I tried free APS X. And like, February this year, and it's so like, it runs off the same as like the open APS or Android APS, like off that same base algorithm. But developed by Ivan, the same guy who created free aps that you're using. But it was still pretty early on in the development. So it was neat and interesting. But then as soon as the Russia stuff happening, he can't really update it since then. Right. So it's just been kind of sitting there stagnant. So like, once that, like, once the rest of the situation kind of figures itself out, or like once he can start pushing updates to it. I might try that one again.
Scott Benner 1:22:14
I feel like we should smuggle him out of the country and get them here. Seriously, every time I talk to somebody, I'm like, I don't know who Ivan is because someone hire him, please. What are we doing? Go get them all from a job for God's sakes. All right. Okay. Is there anything we haven't talked about that you want to because I have one last thing for you?
Mike 1:22:39
Oh, maybe I mentioned a new bus. Have you heard of that? A new bus, a new bus. So it's made by it's made by people in Australia. And it's a Dexcom transmitter that they've like, drilled into and modified the firmware on. So that sensors don't end. So like you can just keep it running. You don't have to restart it, really. And then it also puts the warmup time down to 15 minutes. And it comes with a battery that lasts. I think I got mine in like sometime early this year, and the battery is still going like I think the battery is supposed to last six months instead of three months. But then you can take the battery out put a new one in
Scott Benner 1:23:24
that I've seen people do I've seen them like dig into it, pull the battery out put another like put like hot glue over top of it to hold it in something like that. Is that the kind of thing you're talking about? Yeah, basically. Amazing.
Mike 1:23:38
Then you can just have one transmitter, and that'll just keep working. And then the restart thing is what's really helpful then, like I had a sensor on that lasted 30 days, and was still like within 10 points.
Scott Benner 1:23:50
It was just what I use. Sometimes it was just one
Mike 1:23:53
drawing like normally I get like 14 days and then it starts getting noisy. So then I pull it. I really wish g7 just lasted 14 days. Like I can't wait until they get to that point.
Scott Benner 1:24:04
I thought it was going to I thought that early on. That was the chair and
Mike 1:24:08
then I think there is something with like the adhesive like they had problems getting it staying on everybody for 14 days without making the adhesive too crazy. Yeah, but libre has been doing it for a while. So I don't know why.
Scott Benner 1:24:22
I imagine it comes eventually. So I don't know. Okay, my last thing for you. You left a review for the podcast. That was the it was the most like thoughtful and lovely and then cake made me cringe and it made me laugh and I just I very much appreciate it. Thank you. I've never read something that took me aback. It's only a paragraph and I'm started reading it. Now I got to Google. I don't know who this person is, like Google. I'm like, alright, that's who that is. And then you said something that I was like, Oh, I don't like don't don't Don't compare me to that. Like that made me feel really? Yeah, I don't know. It's just so funny. But I there was
Mike 1:25:06
a lot of parts of that. I was like, oh, I should take that. No, maybe I'll leave it in, like I almost rewrote, or like, deleted that and read it a couple times. So I'm glad I left it there.
Scott Benner 1:25:15
Yeah, no, I'm glad you did too, because I feel like most people who read it, we'll just pick I don't know what this means. Exactly. But I, I was, I was just very, it was heartwarming, and, and it made me feel weird at the same time, which is how I know I liked it. But I appreciate you. I appreciate the podcast being valuable for you in a way that made you think to write that. So
Mike 1:25:36
I think I've got 105 episodes left. And then I'm all caught up.
Scott Benner 1:25:40
I'm thinking of giving out an award for people who listened to all of them. Now, it'll be it'll be a digital real award. I will not be sending a trophy to your house. You know, the trophy might that you never won playing baseball.
Mike 1:25:54
Are you the trophy?
Scott Benner 1:25:56
Am I the trophy? I am nobody's trophy that's for sure. No one would get me and go. Oh, I feel very accomplished right now. No, I just, I mean, it occurs to me, especially as the as the podcast gets into the eight hundreds as far as and nine years. Like in a couple of weeks. I started that ninth year, but I saw this podcast the other day. So funny. It's been out for like three years. And they're like, we're in the season nine. And I thought to myself, No, you're not. Like, stop it. You can't make a season 10 episodes and then tell me you're that's a year, that's a month. That's two weeks for me. Like I think that episodes in a half a month. And they're like we're in season nine. I'm like you just started in 2000. And like 20, like, What are you talking about? But, but anyway,
Mike 1:26:45
I just we're going back through the podcasts and because of how, like you started off, I think like once a week and then moved it up and up and up. And now it's like four times a week. So like going back through the podcast, it's like the last half of it is like the last two years. Yeah, may not pass. But a good chunk of it is just like since COVID. And then like, as soon as I hit the point that was like, pre COVID. It was weird. Well, COVID
Scott Benner 1:27:08
changed it for me. Because Because I saw overwhelmingly if people heard this already, they can probably you could probably shut this off now. But overwhelmingly podcasters I thought made the wrong decision at COVID. They, they they were saying, well, people aren't going to be in their cars as much. So they're not going to listen as much. So they started making like less content. And I it just struck me the complete opposite way. I was like I'm gonna make more, because I think people are gonna have a lot of time. And that for you? Well, except for me, I'm the only one that didn't get the cruise through COVID. And, and by the way, was up all night on Friday getting you the Dexcom g7. So just listen to it. But that's not the point. The point is that and I also stopped thinking my I stopped thinking of myself as a podcast. I mean, it's a podcast, obviously. But you know, once a week, or some come out twice a month or something like that. I started thinking about who who is successful in the space of delivering audio to people. Like I looked at those people, those people don't put out an episode a week, they put out three or four a week. And when you listen to it, you might not always be interested, you might like log on on Tuesday and go I don't care about this interview. But I love the one on Monday, and I might like the one on Wednesday. And I looked at that and I thought that's the model for me. I'm going to put out a lot of good content, you're not going to care about all of it maybe and it's there if you want it. And that's just where I went when COVID switched and to your point a minute ago, this year 2022. The podcast is just by a hair's breadth gonna miss 5 million downloads in 2022. So is a big number for people who are not in podcasting this show I don't think I usually say this on the show. But I'm in the 96th percentile of all podcasts that exist. As far as I know all like not even just health. All not just in health actually today in health. I actually have this in front of me because I pulled up I was pulling up your review today in health. The podcast is 134 in health and fitness which is the parent category and that is that's high they only track the top 200 shows to begin with. Like your your charting if you're in the top 200 So I have I have a parent category health and fitness which I'm 134 in today and it pretty consistently stays in the top 200 all year long. But in its in its subcategory which is health and fitness medicine. I'm number 12 Today in and there's some Pretty big podcasts ahead of me, like, like stuff that has, you know, dozens of people working for them. And they are a part of a media company. And like I read down from the top, Peter Atea, who is just a huge help body has Mark Hyman, Rhonda Patrick. Paul Saladino. Like, you know, these are the people Peter McCollum, these Matt Walker, they're the only ones really out of me. And then it's me today. And I guarantee you that they don't make that podcast by themselves. So it's pretty cool. RFK is there too, but I'm not sure of what it is he's peddling. So I didn't. I haven't looked too deeply. I've heard people on two different sides of him. So I'm staying away from that one. But, but yeah, the podcast is popularity is measured by downloads and by new subscribers. So the one great thing about charting is, if you're not constantly getting new subscribers, you don't chart no interest. Yeah. And that's the big deal about being in the I think in the medicine category. I've I've been pretty consistently the top 20 for like the last three years. So anyway, I just want I put content out and if you want it, that's great. If you don't want God, I got it. Like you don't I mean, so you'll be like the one that I
Mike 1:31:23
just don't go look for a summary of it online. Yeah. Because what the, well, the crazy thing, too, is like, your transcripts are on the website. So if they really wanted to just read it, they could just skim it there.
Scott Benner 1:31:35
I also don't think that these people are like bad people who are like, please just tell them like, I just need to know this. Yeah, they don't know my and that's why I I thought, I thought in a joking way, like and and yet, like very like, I don't know, honestly, I was just trying to say like, please understand my side of this. If we all give away what's in the podcast, and nobody has to listen to the podcast, then there won't be a podcast. Like that's it unless you want me to start charging you for the show. And, you know, the truth is, if people did that, I'd make a lot more money, like a significant amount more, and I still don't think it's right to charge you for the show. So I don't do it that way. I guess.
Mike 1:32:17
You'd be making more money, maybe, but you'd be reaching less people.
Scott Benner 1:32:21
Exactly. And I don't want that. I don't want to limit who gets to hear it. Because you can say something. I mean, think about it. The 5 million downloads. What if I charged 10 cents an episode? Just 10 cents? I don't know the math on that because I'm not smart. Okay,
Mike 1:32:38
but I spent $80 This year then, right?
Scott Benner 1:32:42
You're one person. So if I take 5 million? That's a lot of zeros. Okay, so I take 5 million. you to help me on this because I might be wrong. That's 500000. Wait, is that wrong? Six years 50823456 5 million. And I say times point one. That'd be 10 cents, right? Yep. Ah, yes. I would have made $500,000 this year. I want you didn't know I don't make $500,000. So. So just every other year well now. So now think about that. That was 10 cents. What if I just made it 20 cents a download, I would have made a million dollars this year. And instead I take ads. And I let the advertisers pay for it. And you guys don't have to pay anything for it. So it because of what Mike just said like your smart person. Like Like, even if you charge 20 cents 20 cents for something, it will eventually eliminate some people. And then what happens if that's the person who doesn't know how to Bolus fat. And then they spent their entire life with a seven and a half a one C when it could have been a five and a half a one C if they only would have known to put in some more for French fries an hour later. I don't I don't want to. I don't want to think that I'm limiting people from getting good information. Just to make money. Although now that we did that with the calculator, I really would like to charge 20 cents for each episode. I've been thinking about it for a little while. And it's gonna make me a little sad inside but I'm gonna be okay. I'll be like, I'll get past it. But anyway, I just think it's I think it's a it's a it's an endeavor that I like being part of I like trying to help people in mass. And I I'm not telling you that one day maybe the advertisers will dry up one day and you'll hear me get on here and go look, the podcasts cost 20 cents an episode now. You don't like it don't listen, there's nothing I can do about it. But for now I'm I've been able to keep it for eight solid years 800 app episodes, I've been able to keep this podcast free for people. And, and still, my house is heated, you know. So that's my goal. Although I guess maybe I should take a swing at the end. Right, Mike? What do you think? Like the last year go completely dirty, just curse through the whole thing charge like 25 cents and
Mike 1:35:20
oh, I think if you just made a separate one that was unedited, not edited, but like uncensored. Yeah. And then just charge for that one. I think people might buy that you think I could
Scott Benner 1:35:30
do that just curse like, what am I going to record? Jesus holiday time, I might have to get an editor. Let's make enough money that that can happen. Although I also need to, like, I have these people, these wonderful people who help for free with the Facebook page. And that's important too. I need I need more money all the advertisers have to pay twice as much. I gotta I have to start paying moderators online. That's it. I'll call them right now. Let them know the price is doubling. You think they'll be okay with that?
Mike 1:36:01
I think there'll be okay with whatever you tell them.
Scott Benner 1:36:02
I don't think they will. I think they told me to go to
a huge thanks to Mike. Hey, a huge thanks to Mike for being on the show today. And for all he does for people living with type one diabetes. I also want to thank cozy Earth and remind you to use the offer code juicebox at checkout to save 35% off your entire order. And of course touched by type one.org. Go check out the event. Find out the details. And while you're at it, why not find them on Instagram and Facebook and give them a follow. At the end of the music. I have a little note for you for Mike to add on to what he said here. I will read it in just a second. Thanks so much for listening. If you're enjoying the show, please share it with someone else. And give it a follow or subscribe in your favorite audio app.
If you're looking for community around diabetes, look no farther than the Juicebox Podcast on Facebook, a private group with 40,000 members. There's a conversation happening right now that you want to know about Juicebox Podcast type one diabetes on Facebook. I don't care if you have type one or type two. Lada doesn't matter to me. I don't care if you eat keto, if you eat a bunch of hotdogs or potato chips doesn't matter to me how I eat doesn't matter to me, but you do matters to me that you know how to use insulin and you feel supported Juicebox Podcast type one diabetes on Facebook. Mike sent me a note the other day that said Hey Scott, I mentioned I might switch back to free APS X when I was recording your episode. So could you please update people that I did switch back, except now it's called AI APs. Anyway, about a month ago, he switched back and he's loving it. He said I opened the app far less than I used to with loop. And now that I switched to loom Jove, which is a faster acting insulin. I'm sitting 98% of the time in my target range of 70 to 180. Prior to that, he was sitting at 90% Since he switched to Dexcom and loop to two years ago for two years. He was Dexcom and loop two. Now he's using something called I APs and see him better time and range. And Mike just wanted to let you know. Alright, everybody. This was a good day. I'm feeling good. I'm gonna go check out my movie. I am seriously gonna go put on my joggers. And I'll let you know how the movie was later. Even though I didn't tell you what movie it is. You guys can wonder what movie I went to say. Hey, go follow that Facebook Group. Subscribe and follow the podcast in an audio app. Share the show with somebody else and except my thank you for doing all of that. I'll see you very soon. When I'm back again with another episode of The Juicebox Podcast
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