#951 Suck it Out of My Thumb

July 14, 2023Scott Benner

Shirley has type 1 diabetes and the Medtronic 780G

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Scott Benner 0:00
Hello friends and welcome to episode 951 of the Juicebox Podcast.

Today I have a return guest surely is back from Episode 414 Durbin Shirley. As you may have heard with the Durbin surely is from South Africa. And she's on today to say hello and talk a little bit about her Medtronic 780 G. While you're listening today, 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. Want to save 35% off all your comfortables your towels, sheets and clothes you can at cozy earth.com When you use the offer code juice box at checkout. If you're going to check out ag one, use my link drink ag one.com forward slash juice box if you'd like to save 10% off your first month of therapy. Go to better help.com forward slash juicebox with my link, you will save 10% off your first month. All right, everybody Shirley's got a cool next and get excited this episode of The Juicebox Podcast is sponsored by Dexcom, makers of the Dexcom G six and brand new Dexcom G seven continuous glucose monitoring systems, learn more and get started today@dexcom.com forward slash Juicebox Podcast is also sponsored by Omni pod. Now you know Omni pod has the Omni pod dash and the algorithm driven Omni pod five, learn more again and get started today at Omni pod.com forward slash juicebox.

Shirley 2:09
So hi, my name is Shirley. I am from South Africa. I'm a type one diabetic. I've been diabetic for 19 years.

Scott Benner 2:17
19 years. How would you say were?

Shirley 2:21
How old am I? I'm 39.

Scott Benner 2:23
Oh, you didn't say how old you are? Trying to get away with that. Did you surely?

Shirley 2:28
No, no, no.

Scott Benner 2:31
39 is a good age.

Shirley 2:34
Getting there getting a bit older

Scott Benner 2:36
is getting where it's getting too good. Or it's getting the

Shirley 2:40
Oh, it's just getting too older.

Scott Benner 2:44
Weather your knees start to hurt. That's a fun one. For your shoulders. You're like why don't my shoulders ache? That's ridiculous. And you realize your body wasn't meant to live this long. And you're like, Oh God, I'm gonna have to get like a knee replacement or something.

Shirley 2:57
Yeah, getting to where you can't get out of bed easily anymore.

Scott Benner 3:01
Yeah. And you don't see any reason to go like, you know, I've done everything. There's nothing left. What am I going to do? The thing I did yesterday? Didn't already. I'll stay here. Anyway, so you've had diabetes for 20 years. And you live in South Africa? Interesting. Yes. Do you've been listening to the podcast for a while? Haven't you?

Shirley 3:22
I have Yes, I have.

Scott Benner 3:23
How long do you think?

Shirley 3:26
Um, probably a couple of years. I mean, I don't know. Exactly. Couple of years.

Scott Benner 3:32
Okay, look at you. You're like if I measure the time, I'll know how old I am Scott, so I can't do that. Well, what was it like being diagnosed? That? Who? 19 That seems like your crap.

Shirley 3:47
No, I was 20. I was 20 already. Okay.

Scott Benner 3:51
In university. Yes. Were you literally there when you were when you figured it out? Or were you home? How'd it go?

Shirley 3:59
I was there but I was only I mean, I went to university, like about an hour away from home. So it wasn't far. Yeah. I don't know. I kind of walked around for about two weeks before I went to a doctor to figure out what was going on. But it just had like all the classic symptoms this tiredness, blurry vision, I stopped going to lectures because I couldn't see anything. Yeah. And then I went to the doctor was very straightforward and simple data, my blood sugar, said I had diabetes. I was admitted. I think for about a week, maybe less. I can't actually even remember. And then I carried on with my life.

Scott Benner 4:46
What in those first couple of weeks for all these things were going on? Can you just give me if you can remember. It's been such a long time ago. Surely, if you can, you can remember what I mean those are You listed a number Things that would send me to the doctor. But why does it take two weeks?

Shirley 5:04
I don't know, I suppose. Lucky young. And I don't said they had no reason to think I was had diabetes. Yeah, like that didn't cross my mind at all. And then eventually, yes, my mom did come to fetch me. I said I needed to go to the doctor. So she came and actually fetched me. And y'all, we went to the doctor, our usual lack of what we call our GPS or general practitioner. So he had been our family doctor for many years. And he did a finger prick immediately. And yeah, it was straightforward. You have type one diabetes, there wasn't any lack of listen to a lot of people that have like a misdiagnosis or something like that. But it was a pretty straightforward, easy cut and dry. Yeah, type one diabetes diagnosis,

Scott Benner 5:58
I must be a baby. I'll tell you I looked up at the sky one day saw some like floaters in my vision. I was at the doctor. Four hours later.

Shirley 6:08
I just thought I needed glasses.

Scott Benner 6:14
My knee hurt. And I tried my best for two weeks to rehab it. And when it didn't get better, I went right to a surgeon and got it fixed.

Shirley 6:23
Thank god like also to be honest, the increased thirst started like after being out for like, going out with my friends and drinking. So I thought I had a hangover. I say you were the very first when I first got the increase, like thirst I didn't really like. Yeah. But also no reason to think I would have had diabetes as well. So no,

Scott Benner 6:50
of course not. But is the detail that's missing in this story that you were drunk for those two weeks?

Shirley 6:55
Not the entire two weeks before the first started.

Scott Benner 7:03
Gotcha. All right. So I mean, you sound pretty. I don't know relaxed about it, I guess. So you just head back to school and begin but 20 years ago, what did that mean? You were shooting twice a day?

Shirley 7:18
No, I had Lantus and Nova rapid Oh, wow. Cool. Humalog whichever one I had, I can't remember. And a glucometer. And that was it. Were you. Go ahead. Sorry.

Scott Benner 7:34
Were you counting carbs?

Shirley 7:37
Yes, so I'm actually a dietician by profession. And I was in my second year, becoming a dietitian. So I had some knowledge. Not all

Scott Benner 7:51
of that knowledge helped you and you were drinking directly from a keg surely.

Shirley 7:56
That was before my diagnosis changed. I changed. I stop drinking. Well, did you? Pretty much. Well, I didn't drink in any great amount after that. No. You know, I'm very responsible.

Scott Benner 8:11
Have you always been? I think so. Yeah. Do you know Arden is now a college like maybe five weeks now? Right. I

Shirley 8:19
listened to it. Oh, before she lost? Yeah.

Scott Benner 8:24
But so if the boys are starting their swarming, you know what I mean? And, and she's, like, knocking them back mostly. But she she texts, she texts me one day, and she says, this boy, came up to me in class. And, you know, I didn't know what he wanted at first. And I realized, you know, he was hitting on me. And then he asked to walk me back to my dorm. And I said, No, thank you. And then he said, Well, we're in the same dorm. So I'm just going to walk with you. And she's like, you really don't need to. And then he did. And, you know, in the course of the walk, he offered her drugs to that as as an enticement to date, though, do you know what I mean? Like, like, imagine if a man came up to you and said, Surely Will you marry me? I have a home and you'd think, oh, okay, well, I might have a home then if I married this man, if I don't have my own home. He was like, Well, you go out with me. I have acid.

Shirley 9:21
That's not a good idea.

Scott Benner 9:23
Come on. First of all, Ethan, your boys don't know what they're doing.

Shirley 9:28
But But I would stay away from that. Let me

Scott Benner 9:30
let me tell you, I told you the story. Because she says to me, I don't need that problem. I have enough trouble with my health. And I don't want to drop dead because I don't know what I'm doing. And I realized, I don't know if Arden doesn't want to do drugs or she doesn't want her blood sugar to get low. I can't tell the difference. But you know, but she was just like, she was like that was She's responsible. She is but how does that even happen? I don't know. But

Shirley 9:57
like diabetes for a long time. So I say Think back as much as parents do stuff with children diabetes, that you do have a sense of responsibility that other people don't. Right. No, it's

Scott Benner 10:08
interesting. Yeah. Yeah. I mean, listen, without the diabetes. She still thought it was a weird.

Shirley 10:14
Come on don't yeah, that was a weird. Yeah.

Scott Benner 10:17
Let me tell you the rest of it. He waits like a week and tries again. And she says, You know, I'm still not interested, but thank you. And he goes, I guess I'm gonna have to get used to or it goes, I think I'm gonna have to lower my expectations. And she goes, Yeah, that'd be a good idea. So, anyway, anyway, so you're back at school, but you're in your nutrition mind now. And you take things. Seriously, it sounds like so management back then. No CGM, obviously, do you know how it was going? Do you remember a one CS at the time?

Give me a moment of your attention and then I'll get you right back to surely Dexcom makes a continuous glucose monitor. Do you know what that is? It's a device you were that can tell the speed, direction and number of your blood sugar. So if for instance, while I open my phone, and I'll look at Arden's blood sugar on her Dexcom it is actually two o'clock in the morning right now because I procrastinated today and Arden's blood sugar is 98 it is stable, it is neither rising or falling. I see that on my iPhone, the number, the arrow, which tells me she's stable. It's beautiful. Do you understand what I'm saying? Do you? Where is art right now? In our bed, I think, but I still can see your blood sugar. I'm not in a room. I'm not calling her on the phone. Because you can share blood sugars with up to 10 followers with a Dexcom dexcom.com forward slash juice box. You can also set alerts for instance, Arden's low alarm is set at 70. Her high alarm is set at 120 that's on my phone, on her phone. Her low alarm is set at 70. Her high alarm is set at 130 little beep when you hit that number, he gets to that threshold and let you know oh gosh, I'm going up or I'm going down. How does it do that? The beeps have different tones. You'll learn them. b b, high B BB low. How do you know that? I know that because I've been using Dexcom along with my daughter for so many years. And I really think you would love it. Dex comm.com forward slash juice box links the shownotes links at juicebox podcast.com to Dexcom. And my next sponsor, Omni pod Omni pod.com forward slash juice box. You get two great options with Omni pod. You want to kind of go old school, get the Omni pod dash put in your settings, you make all your decisions. Or check out the new Omni pod five. It's an algorithm. It works with the Dexcom G six right now. And it's terrific. You put in your settings, but then you start telling it hey look, this is how many carbs I'm having it says this is how much insulin I think you should have. And it just kind of does it. It's redonkulous. And then if later it thinks you need more insulin, it gives you more if it thinks she needs less, it takes it away and tries to stop low blood sugars. Omni pod five is absolutely terrific. Whether you want the Omni pod dash or the Omni pod five, my link is the way to go. Omni pod.com forward slash juice box you're going to learn everything you need to know there. You can get started, ask for I think you can ask for something. There's is a bunch of stuff you can do on there. Just go check it out. It's fantastic. Absolutely fantastic website. You're gonna see my face when you first log on. Just ignore that. Don't let it scare you scroll right down and get to that good honoree pod information. Once again, when you use my links, you're supporting the show and helping to keep it free and plentiful. And I really appreciate that. Omni pod.com forward slash juice box dexcom.com forward slash juice box Use the links support the show. Let's get back to surely I eventually am going to ask her about sharks. And at some point I'll explain this stupid title this episode

Shirley 14:28
I think in the beginning, like pretty good in the sixes I mean, I suppose I don't know maybe I did have a bit of like a honeymoon phase. Um, I think the highest HBA ones see since diagnosis has been about 9% around 9%. Okay, and that was before I went on to a pump.

Scott Benner 14:50
How long were you injecting?

Shirley 14:54
Um, I'm trying to think because I've been on a pump for 11 yours now so on Yes, I just Yeah.

Scott Benner 15:05
fair amount of time. And yeah. What were pumps not available? Were you just not interested?

Shirley 15:13
I'm thinking the beginning they weren't available or if they were not very easily or they still not very easily available here. But not something that was really maybe promoted much. And then for a little while, I didn't want to pump. And then I changed my mind. And I got one. Yeah.

Scott Benner 15:35
Okay. And not want one because of it being stuck? Or that kind of thing? Oh, maybe

Shirley 15:42
I think this is just maybe just the unknown. It's not something you used to. So yeah,

Scott Benner 15:48
I think you I don't know, maybe a couple 100 People might be lifting in Africa. But that's about it. There's not South Africa, excuse me, there's just not a ton of listens down there. But there's a lot more than I thought there would be. So I

Shirley 16:04
think there are a few people I know if one or two people that listen. Yeah, that's interesting. Do you tell people to listen? Do you think? Yeah,

Scott Benner 16:12
do you think that? Will your let's say based on your diabetes and your background, like your professional background? We have every I don't know, 10 people you approached and say, Hey, this is a way to help yourself, blah, blah, how many of them? Do you think actually? Or like, leave me alone? And how many of you think get interested in go try?

Shirley 16:35
What to listen to the podcast,

Scott Benner 16:36
not even the podcast, just the idea like bettering themselves. I've

Shirley 16:40
just it's so I mean, we have like a, like a different sort of, I don't know, what would I call it like setting. So like, I work in a public health setting. So government funded setting government hospitals, where they barely have access to anything. So it's very difficult for me to give the knowledge I have and for people to use it effectively. Because they don't have a lot of access, they only have access to the, like, the mph and the older insulin, so like, you know, what, what would you call them? Like you're human, aren't in etc. And if they get test trips, it's 50 a month. So yeah. So it's very difficult for them. And then also, you're dealing with a much lower socioeconomic status. Yeah. And also education levels, etc. Can be lower, just depending where you are. So yeah, it's sometimes I think the information I give him a professional setting is very basic, and just trying to get people the basic knowledge that's needed.

Scott Benner 17:55
Right. So the goals are different because of the scenario. Yes. Yeah. Sure. How long has it been since you were on the podcast? Couple years? Yeah, thanks. Yeah. I'm gonna figure out what episode you were on and tell people before because we talked about this a lot more and

Shirley 18:10
yeah. So yeah, it's just different settings sort of thing. So

Scott Benner 18:14
you're here today to talk about on the pod five, right?

Shirley 18:18
No, no, no, we don't have Omnipod. So the the Medtronic, seven ATG. Oh, my God, I'm looking at the wrong not available.

Scott Benner 18:28
Sorry. I'm looking at my wrong notes. I'm like, how is she getting on the pod five. And then I realized that was on yesterday's notes. Sorry.

Shirley 18:36
No, no, no. We don't have Omnipod at all here. That's not an option for us.

Scott Benner 18:41
So you're using Okay, Jenny and I just talked about this the other day. Sorry for that was fine. Medtronic seven. ATG? Yes. That's the newest algorithm pump from Medtronic. Right. And it's already available. Overseas from the US, right. It's not available in the US yet, I think.

Shirley 18:59
No, no, no. Okay. So it's available in Europe, UK, and we have it I don't know what your other countries

Scott Benner 19:05
Gotcha. Okay. So how long have you been wearing it for?

Shirley 19:09
I have had it for about 18 months now. Okay, great.

Scott Benner 19:12
That sounds good. Long time for us to talk about before that. Did you have the seven seven Digi?

Shirley 19:18
No. So before that, I had an accucheck pump which was just a pump not algorithm based. Nothing, right. didn't connect to a sensor or anything.

Scott Benner 19:28
So this is your first your first algorithm. Yes, Shirley's first algorithm.

Shirley 19:34
First algorithm.

Scott Benner 19:36
I'm just saying it's possible that we're going to name the episode that and so, alright, so you're using if you're using the seven ATG, then you're also using their CGM, right? Yes. What is that called?

Shirley 19:48
I am using the Medtronic Guardian three guardian. Yeah, Guardian three. There is a guardian for but I don't use it. for

Scott Benner 20:01
religious reasons rarely or what why

Shirley 20:04
I had to travel with it, it just did not work very well for me. Oh, just my personal experience with it was not very good.

Scott Benner 20:12
Well, we're just, we're just looking for your personal experience. So the Guardian three is working well for you. And by working well for you, you mean, it's giving you results that match your finger sticks and things like that?

Shirley 20:25
Yeah, I'd say most of the time. I mean, there are times when it's a bit off, but, I mean, it's they are sensors, they're not always 100% accurate. Or the, you know, there's the whole debate on that. But yes, most of the time, I get pretty, like good readings with it. Okay,

Scott Benner 20:43
and it speaks to your pump piece. And what is the Do you know, I guess for for just for context, I guess I'm the Pudge target range is as low as 110. Tandem control IQs 112 and a half, do you know what the one with the target is for the seven ATG?

Shirley 21:04
So the seven he is the lowest is 5.5. So sorry, I'm in millimoles. It's 5.5. Or you can do a 6.1 or a 6.7. Okay, hold on. I think that's lower than Omnipod. Five, I think it's 100. I don't know.

Scott Benner 21:21
Five point. I have a little calculator here on my website. 5.5 is like 99 100. Yeah. Okay. So that's the lowest that will target. Yes. Does it have any luck keeping you there?

Shirley 21:36
Obviously, it doesn't keep you there throughout the day, right.

Scott Benner 21:40
That's what it's targeting. But I mean, most of the time, do you feel like you're? You don't I mean, do you feel like it's working? Yes.

Shirley 21:46
Or like I think LACMA. So I mean, it works. Obviously, time and range, it just works on the international consensus of the fingers that 3.9 to 10. I spin. If I look at like my 14 day average, I'm always above 80%. Time and range.

Scott Benner 22:04
Well, what's your range you're shooting for?

Shirley 22:07
So I've been I don't change it. So the algorithm and it, it looks at the range of 3.9 to 10. millimoles. Between that, yeah. Alright, so between that I'm sitting above 80%. Time and range. Yeah.

Scott Benner 22:23
So 70 and one ad, it's what it's shooting for people who are listening to the millimoles and are like, I don't know what she's Yes. Or for the people overseas for like, Finally, somebody speaking in Milan. Which I get a lot about people like, can you translate them on the fly every time people say a number? And I'm like, No, I can't imagine if the whole conversation was just me going. Okay. No, wait, no, you said 68. Hold on a second that it was like, I appreciate that. That's what people would like, but I can't do that. But for this, I wanted to make sure we understood. Okay, so you're staying in that range? 80% of the time.

Shirley 22:58
Yeah, but 80% How about loads and cups? Knows what what range I've set up? Or like, how often am I low?

Scott Benner 23:07
How often are you low?

Shirley 23:09
I'm authentic about any loads today? That counts.

Scott Benner 23:18
There's someone who's had diabetes for a long time. So far today, it's been fine.

Shirley 23:24
I'll have a look at my average cookie. So my seven day average, I had 2% lows. That's terrific.

Scott Benner 23:35
All right. Yeah. Yeah, really? Well, it's wonderful. And this is I'm pulling up a picture of it. Right now. Okay, so this is the tube pump. It's kind of small. It's reminiscent of a lot of older pumps. As far as the size. You got a screen on the front. The CGM is on the screen of the pump. I imagine.

Shirley 23:56
The dots uh, yeah, yeah. And then there is an app for your phone that like, it's the app. Currently, it's not very functional. Just, it's like a mirror of the screen. So you can bring up your readings onto your phone instead of taking your pump out.

Scott Benner 24:14
So you can kind of look at what's going on in the phone. But you can't make any changes. There's no phone control at this point.

Shirley 24:20
No, not at this point. All right.

Scott Benner 24:25
You like it?

Shirley 24:27
Yeah, I'm like, I'm quite happy with it. I think it's going pretty well. I mean, obviously, there's always things that you think could be better or could be changed. I'd really like phone control. I'd like to be able to Bolus from my phone. But that's not there yet. So

Scott Benner 24:45
that yeah, that was the driving factor in Arden asking me to go back from Omnipod five to loop. Oh, really? She's like, I don't want to carry color and I want to use my phone and I was like, okay, yeah. It was a big deal to her. Actually, and they are

Shirley 25:02
that is like, really something that I wish they would bring out.

Scott Benner 25:06
Yeah, no kidding. How was it? Like not speaking about the not speaking specifically about this pump, but about algorithms in general? What was it like adjusting from a regular pump to this? Like, where did you find yourself tripping up? And what did you like immediately.

Shirley 25:26
Um, I don't think I had like a huge adjustment. So when you start the pump, it's like a similar, I listened to your Omnipod, five episodes, it's pretty similar. So you wear it in what they call manual mode for 48 hours. And it I don't know, collects its data. And then after 48 hours auto switch into what they call smart guard, which is the algorithm based mode, it switches into that. I didn't have a lot of changes. I know when I set it up, they said my carb ratios might need to be changed. But I haven't felt like I've needed to change my carb ratios. And I think, yeah, I think my settings were fine. And then once it's in the smart God or the algorithm, it controls your basil. So you don't have any input into that. It learns you over time and does the basil. And then it does auto corrections as well. So when it's does auto corrections automatically, so I don't have to use the pump or anything. It automatically will correct when it feels it needs to. So I don't feel like I've had to do much. Went out since I switched over.

Scott Benner 26:45
We did autocorrect is it moving up basil? Is it making a Bolus? How does it handle that?

Shirley 26:51
It makes a Bolus. Okay, so, I mean, they're generally pretty tiny. boluses to like, point two point 3.5. Yeah, just depends. But yeah, it it's made, but there's like a little Bolus

Scott Benner 27:07
RT in sec right now. And we've kind of cranked up the loop, you know, and, you know, told it to work at a higher percentage, like basically just told the whole, you just override it and say, Look, do everything at 140% of how you usually do it. But it's still like, you can see it weights work in a TAS off trying to hold her blood sugar down because she's sick and has her period at the same time. And so yeah, it's just auto Bolus. And these little Bolus is like every five minutes like, here's a little more, here's a little more, here's little, it just keeps happening. It's fantastic to watch. Because you realize that without this thing,

Shirley 27:43
you'd be watching it doing that, yeah,

Scott Benner 27:45
your blood sugar would be going up. And then you'd be like, oh, yeah, all right. And you try it again. And you know, it just, you know, where you'd be without it. So the reason I asked about your transition, is because many people will fight the algorithms in the beginning, like their experience. You know, managing insulin manually, doesn't mimic what they see the algorithm doing. And they they have a hard time just letting it do it. And I doesn't sound like you have that problem,

Shirley 28:15
though. Yeah, like, I think I had to have that mindset though. The when I started using it that I had to like just when I started it, just let it do what it needed to do, and not interfere with it. But I can see why. Yeah, I understand why people will do want to interfere with it, because you do things in a certain way. When you manage manually. Yeah. So I do understand why people do want to like, interfere and adjust things and change things and all the rest. But I think if you're going to use an algorithm or pump with an algorithm, whichever one you use, I think you do have to just like let it do its thing as much as possible.

Scott Benner 29:01
Do you have access to what it's doing? Can you like visually Have you seen people using loop for instance?

Shirley 29:09
Y'all have kind of seen people using loop I haven't really gotten much into it, but I've seen on I've seen it a little bit so like What do you mean in terms of access of what it's doing? Like what

Scott Benner 29:18
yeah, like being able to see the Bolus is and where it takes away bays Lord gives extra basil. Do you like visually see that?

Shirley 29:25
Yeah, so it's on the screen. So like whether I look at my phone screen on the app or the pump, so it has it basically just has like purple lines, which are the Basal insulin so you can see where it stopped Basal etc. And then it'll have like little blue lines, which are the auto Bolus as it gives when it feels it's necessary. Gotcha. So you can see, I mean, you can't see you can see what the auto Bolus was like, how many units the Basal you can't see how much it's giving. Okay, I guess Tom,

Scott Benner 30:00
I find it so valuable to watch it happen. That's why I was wondering. And

Shirley 30:06
yeah, it is. It's very relaxed, interesting. Like, you'll see like, for a whole hour or so it doesn't get any basil. And you just sort of fun. Yeah, just carries on.

Scott Benner 30:17
Yeah, yeah, no, it's like, you can see like, on for loop, for example, like you, it's like if you're going to be low, and we're going to try to stop this. And, you know, I kind of, I kind of go back and forth between the apps and I look at the Dexcom line, I'll text art, and I'll be like, Look, the algorithms trying to stop below like an hour from now, it looks like it's gonna get it, or it doesn't look like it's gonna get it. And then, you know, like, 15 minutes before it's gonna go bad. If it's going to go bad. I'll text her and be like, Hey, this isn't like, look at this line. Like, really look at this. This isn't stopping. Like, if you put some carbs in here, you're gonna, it'll be like throwing a parachute on the fall, and you'll be able to bring it in. And it's just so it's so incredibly valuable to be able.

Shirley 31:02
It's very interesting to like, see how it. Yeah, takes away and gives and yeah.

Scott Benner 31:08
So the reason and the initial reason I asked about Liz, because oftentimes, it freaks people out when they put a Bolus in for a meal. And then they see the algorithm take the basil away. Yeah. And then that either works or doesn't work. But I'm imagining, tell me if I'm wrong. Based on your, your background, you probably eat fairly well, right? Like, reasonably clean, you're probably not eating a ton of carbs or processed food. am I guessing, right?

Shirley 31:39
You're like, I mean, I don't I don't eat a lot of processed food. I do eat carbs. But like, I suppose it's other forms of carbs. So if reasonably well, the days that I do eat other things that aren't great, but most of the time, I'm eating pretty well. Do you

Scott Benner 31:57
see that difference? Like a Bolus that doesn't spike is more attached to cleaner food than a Bolus that does end up spiking?

Shirley 32:06
Yeah. So like, I mean, I don't, I don't enjoy, like, I don't know, like, take away foods and stuff like that. So but if I do eat that, you can see the difference. And like, you need a lot more insulin for a lot longer to try and get your blood sugar's Yeah, well keep them in range. Yeah,

Scott Benner 32:25
we're fighting right now the one thing that I did not anticipate when Arden went to college, I mean, of all the things that we prepared for was that the food in the cafeteria would be crappy.

Shirley 32:36
Yeah. Can you imagine? And it's

Scott Benner 32:39
funny, because the cafeteria is beautiful. And the service is beautiful. It's set up beautifully. And they appear to have a host of offerings from, you know, salads and vegetables up to French fries. And but I don't know, like what's going on? Like, I don't know, if they just sprinkle like high fructose corn syrup on everything, or like, I can't tell what's happening. But but you know, art and, you know, art an eighth very, like very well at the house. And then, you know, she get carried out food sometimes. But it wasn't every day and we knew how to handle it. But at college, it's like every meal feels like takeout food. Yeah, I

Shirley 33:19
think like especially like us like institutionalized food. I think that's like, often the preparation. It's probably like quite high in fat where you don't realize it. Like, I don't know, I feel like it still can be like more like fast food than normal food that you prepare at home.

Scott Benner 33:38
Oh, I think so too. I'm like, she said, she told me. She does. I think these people found a way to make broccoli bad for you. And I was like, gotcha.

Shirley 33:49
Yeah, I mean, there's a huge difference in like, just making your own food at home versus buying everything.

Scott Benner 33:57
Yeah, no, it's it's just it was instantaneous, obvious. And it's proving out every meal. So it's just, I don't know what to do about it. I mean, she's not going to not go to college. And she's a freshman. She doesn't have a car with her. And even if she did, I mean, what am I going to do? I'm going to ask her to, you know, become a sous chef. You know what I mean? Like, I don't know.

Shirley 34:18
I'd maybe she'll like, I don't know, I suppose over time, you'll adjust to the different the different options and the things she chooses. What she eats there.

Scott Benner 34:30
Yeah, I have I have gone like, Hey, are you the other day? She wouldn't even tell me what she, she. I was like Arden, do you need help with this? And she goes, I'm fine. And I was like, I don't know if you've seen your CGM, but I don't think you're right about that. And she's, she's like, I've got it. And I was like, Okay. And then later I said, Hey, if you just tell me what you eat, I might be able to help you with the Bolus. And she just didn't answer me. I was like, Oh God, I wonder when she

Shirley 34:56
Yeah, I suppose like it's also that time when you go away from home and you kind of Just like, you want to do your own thing. And yeah, I don't know. I'm sure we'll have times like, yeah.

Scott Benner 35:08
And I'm fine with that. And we're doing a good job of keeping a balance of like, I'm not upper but constantly, I kind of choose moments where I'm like, you know, now I think I should say something or, you know, like, I'll say to Kelly, I'm like, you know, her blood sugar has been like, 170 for three hours since she ate like, I'm gonna, I'm gonna text her. And like, Hey, have you looked at your blood sugar? I'm doing my homework. And I'm like, Okay, you could probably still look at your blood sugar while you're doing your homework. And then she, she looks and she's like, I'll take care of it. I'll take care of it as her favorite phrase. Like the other day, she said, she said, Dad, I've got it. And I answered, I was like, both, you know? Like, we're not gonna lie to each other here. Like, this is not going well. Like, let me help. And then she, it's funny, she got a cold, like she's real stuffy and doesn't feel well. And as soon as that happened, she's like, she's not very receptive to me helping again.

Shirley 36:04
Because she's sick. So she needs her parents think she's sick.

Scott Benner 36:08
She's like, Oh, I'm in over my head. I'll let this old guy text me. I sent her a text the other day and I said, you know, there are people who would pay me for this advice. And you're not taking

Shirley 36:22
I mean, I must say like so with with the 780 G. I don't really get sick often. So I haven't really been sick. So I haven't noticed you're like I haven't been sick. Sick. Weird would affect my blood sugar's. So I don't know how it copes when somebody's really sick. Yeah,

Scott Benner 36:41
yeah. She's like, I don't even know how I got sick. She's like, No one else is sick. Just me and Arden doesn't get sick frequently at all. Obviously, you guys have super immune systems, it's hard to get use.

Shirley 36:53
You're like, honestly, like, I don't get, I don't get sick. Often. I also work in a hospital. So I'm exposed to so many things that I think my immune system is just constantly working.

Scott Benner 37:03
Yeah. Plus, it was strong enough to beat up your pancreas, it could definitely take your call. Right? Exactly. So, okay. Well, I just want to tell you, not that you care. But I imagine that people of Medtronic are thrilled that we're talking about this, like they're like, Finally, this guy,

Shirley 37:19
same. I don't think same like they, they don't give much air on your show.

Scott Benner 37:25
You know, you know, what's funny is that people don't come on like, I listen, I don't know why, obviously, maybe people are drawn to the show who use certain stuff because Arden uses it. I have no idea. But specifically like outside of the show, like inside of the show, like you and I'd have all these conversations in the world. I wish people more people would contact me with them. As far as ads go, I have like a non like I have a non compete with people that I signed stuff with. So if you come to me and you're like, Charlize, like I'm a nutritionist, and I wanted to buy ads on the show, I will tell you, no problem. And part of the deal is I won't take ads from other people who do what you do. Yeah, and so. But I don't know, like, maybe I should stop being so kind, I'll stop doing that. Like,

Shirley 38:14
I think also with Medtronic, I mean, they had the 670 G, which was the first algorithm pump, I had a very brief experience with it. I did a trial with it for like two weeks. It wasn't like the greatest seven ATG is 100 times better. But I only had a very brief experience with the 670 G, so I probably shouldn't even comment on it.

Scott Benner 38:40
But you're one of the spies,

Shirley 38:42
like maybe, I don't know, maybe people are drawn to other products, because the 670 G wasn't the greatest. But it was the first

Scott Benner 38:53
one I often give algorithms. I often give them credit for being first with that, because it's a brave world you're jumping into and you're like, Oh, I you imagine this isn't gonna go great. Maybe Maybe you're saying they weren't excited to tell people about the 670 G but the 780 They're like, yes, now we're getting out there. And and now they've got it going overseas, and it's got to come to America soon, I would imagine.

Shirley 39:19
Yeah. So what are understand so they have the 770 G in America, which is basically the 670 G. But when the seven ATG is available, so the pump, you can upgrade the software. So I think it's just a software upgrade to the 780. That's interest to the new algorithm, I think, I mean, like I could stand to be corrected on that. But I think that's what will happen once they're allowed to, I don't know have the seven ATG within the USA. I think it's just a software upgrade if you're on the 770 G. Yeah,

Scott Benner 39:55
I don't know. If Medtronic is looking for some free advice from me. You might want to hire a couple of like I don't know people to sit in the room and come up with a name that that I can remember, that isn't a bunch of numbers and letters slung together. You know what I mean? Like that? Like, I mean, not for nothing. I can remember guardian. That's a, that's one like guardian. That's your sensor. I can remember that. 670 g 660 g 770 just haven't ate like, what the hell? Like, I don't know. But I do know that this one. I've heard Jenny's told me about it, too. She's like, you know, I talked to people overseas who are having? You know, some good good luck with it. With that, so where is Yeah,

Shirley 40:39
I think because also the 670 G, from what I know about it, like it had like a lot of alarms, it would kick you out of the algorithm quite often. That would randomly ask for blood glucose levels. This pump? I mean, yeah, doesn't have a lot of that. I stay in the algorithm, but like, generally 100% of the time, unless I've physically got out of it for whatever reason.

Scott Benner 41:04
Do you have do you do that sometimes? Do you sometimes leave the algorithm to be more aggressive or something like that? No, I

Shirley 41:11
actually don't. I think the only time I've gone out of it for a short while is if I haven't changed my sensor quick enough. Like when my senses expired?

Scott Benner 41:23
Oh, I see. Okay, so the sooner you're without a sensor for a while. So you just go into manual? Yeah. Okay. Well, that makes sense. So, since basically, I mean, it's a very similar experience to what I'm hearing people talk about with tandem and on the pod and all that stuff. You're having a fairly like, when you see people talking about it, you think, Oh, I'm I'm having about the same experience?

Shirley 41:45
Yeah, I would say so. I also use tandem for a very short period of time before I got this pump. So like, originally, I had motivated with my medical insurance, or tandem pump, which they wouldn't give me. And then they wanted me to take the 670 G, which I refused to take, because they were launching this one. So then they gave me this. So that's a whole different story or insurance thing. But yeah, I originally actually had motivated for tandem because I also tried that for a short period of time with the control IQ.

Scott Benner 42:17
So you were wearing that with the G six. Yeah. Dexcom. Okay. And did you like that?

Shirley 42:24
I did, actually, I really liked it.

Scott Benner 42:28
Surely shot? Are you trying to say that? If you had your druthers, you would still have your tandem control? Like you would Dexcom G six?

Shirley 42:35
Well, if it had been approved, yes, I wouldn't know I would have had it. But I wouldn't have ever experienced the seven ATG, so I wouldn't have known any better. Or I wouldn't have known anything about it. So

Scott Benner 42:46
yeah. Okay. Well, now, you know, which one do you want?

Shirley 42:51
I don't know. I think either one. Really? They both? Do a really good job. Yeah, I think either. I like I feel like the tandem pumps just a little bit smaller, which I did like,

Scott Benner 43:05
just the form factor because you're wearing it's a two pumps. So you have to carry this controller with you. Right.

Shirley 43:10
But that's the only thing like I do feel like they could really redesign the pump. It's a little bit bulky, in my opinion.

Scott Benner 43:18
What a marketing tag. It's a little,

Shirley 43:21
but other people don't have issues with it. So I don't know everyone's different.

Scott Benner 43:27
Well, no, I actually think this is I mean, I think this is exciting. And I'm enjoying hearing what you're saying. Because the truth is that not everybody can have access to one pump or the other or one CGM or the other and the more people who are using these algorithms. I think the better off you know, people with diabetes are going to be I mean, what's your excellency right now?

Shirley 43:46
6.2 That's amazing.

Scott Benner 43:50
How much effort are you putting into being the into having diabetes?

Shirley 43:56
Not like a lot. I mean, I still Pre-Bolus I've also just started using PST but I still Pre-Bolus I do all like that kind of thing. If I am eating a meal, that's pretty high, in fact, because there's no extended Bolus when you're in the algorithm when you're smart God, I do tend to do like a split boiler. So like, just remembering to give myself some more insulin about an hour hour and a half later to help to decrease that factorize later. Yeah. Yeah, I mean, I feel like a lot of people think if they put a pump on with an algorithm, they'll do absolutely nothing. diabetes, which is not really true,

Scott Benner 44:39
right. That's why I ask the question, because I do feel like this is a I mean, what would we call this right now? You know, a new day in diabetes pumping. There's so many algorithms ready now. And I do think that is what most people expect. Like there's a person in my facebook page today who's wearing it on the podcast. For the first day, their kid is I think, sort of like go on to the second day. And well, the first day was too high. And I was up all night and blah, blah. I'm like, well, they tell you that the first day, the first part is like data collection. Like, why are you? Yeah, but they're already judging the whole thing based on the first 12 hours. I'm like, Did you listen to the episode? Like I laid it all out in the episode? And the answer is, Oh, I heard it. So you heard the episode, you knew what to expect. You knew how this worked, the trainer probably told you to, and you're still upset by it. Fascinating.

Shirley 45:31
And then also, cuz I feel like Omnipod five and the 780 Ti are similar in terms of the way they do the Basal or how the algorithm does the Basal, where you kind of wearing it in manual mode for like, that 48 hours, and then it starts to do it itself. But the longer you wear it, I feel like the better it gets. Yeah.

Scott Benner 45:53
Well, that the Omnipod five is not in manual when you first put it on? Well, yeah. But it's in like a learning process. I just, I sit through a lot of trainings with lawyers. I just heard my I just heard a lawyer tell me make sure you say that. That's not true. But I

Shirley 46:11
learning basically,

Scott Benner 46:12
I took your point, just so you know, I understood what you were saying. Yeah, yeah. Right. So it's figuring things out in this first number of days, and then starting to apply it. And then I mean, Part Five is interesting. Like it takes what it what it figured out with the pod you're wearing now, and it applies it to the next one. And then it figured out what that pod experienced implies the next one again, it's, and they're all sort of in their infancy, which is terrific, because that means there's a lot of ceiling, as long as they all keep pushing towards that ceiling. Because I mean, Medtronic is a good example, right? Like you just said the seventh ADG would you say is like 1000 times better than the other one? Your?

Shirley 46:53
I feel? So yeah, because also it does the autocorrection. So, I mean, I don't have to, it just does it. So you know, I don't have to do that myself. I don't have to go into look at the Bolus, whatever it's called the Bolus calculator to see if it's going to AutoCorrect. It just does that automatically. So you don't have to think about that either. You don't have to look at your blood glucose in the garbage to see if it needs to give a correction. It just automatically does it. So I think those auto corrections on top of the basil that's been managed by the algorithm was really great as well.

Scott Benner 47:26
Yeah. Well, and listen to of all the things that it is for you. It's covered by your insurance, right.

Shirley 47:34
Well, yeah, I mean, South African medical insurance is a bit of a, it was motivated for and it took a lot of trying to get it. So I mean, I was refused the tandem based on the Dexcom cost, basically. So the cost of the Dexcom was the biggest issue. So yeah, there's no like clear. What would I say? Like no clear. Path funding? Oh, funding, there's no clear funding for insulin pumps or CGM. So they don't actually have to find it.

Scott Benner 48:11
That's yeah, but you were able to finagle this and get it through? Yes. Yeah. How much effort in time? Did it take you to get this covered?

Shirley 48:21
A lot, many months?

Scott Benner 48:25
Is that the two? Do you think other people in South Africa could achieve what you did if they knew how to go about it? Or?

Shirley 48:33
No, I mean, there's there's been progress made with some medical insurance in terms of funding sensors, they fund up into a certain amount for sensors. And they find pumps they all kind of funded in a little bit of a different way. But then the medical insurance arm with the funded mine fully, but not other people, so I don't I don't even know what they base it on. I don't know they just suck it out their thumb. I really don't know. I don't know if I just annoyed them too much that I keep on at them for like ever. until I'm happy with what I'm getting. But I honestly don't really know what basis they actually decide on their funding.

Scott Benner 49:21
Just literally just you've just beat on them until they said yes, yes. Hey, real quick match. Surely, just reading from the internet. I was born and raised in South Africa, we frequently used the term to suck it out of one's thumb implying that an answer was just a wild guess. Or the notion had no evidence, but was rather just surmise. You know, here

Shirley 49:43
I'm sorry. Is that not a term used anywhere else?

Scott Benner 49:46
I mean, I guessed what you were saying. But I think the closest thing I can think of for America would be pull it out of their ass. I guess is one that would, I guess pull it out of their ass and suck it out of their thumb. Oh, Now we're talking about thumbs and asked isn't sucking so it doesn't sound right to me, but, but I think that's a more of an apples to apples. The I didn't. I was like What did she say?

Shirley 50:08
Sorry? I didn't even think like, no, it's weird had these like different? Yeah What did they call it like colloquialism? Yeah, I don't know what it's called, in places

Scott Benner 50:19
colloquial phrases. Look at you. Oh, I

Shirley 50:22
see some stuff.

Scott Benner 50:23
I only know that word because my publisher used it on the jacket of my book. It made me. I was like, wait, what do I have? I have colloquial wisdom. I do. What does that mean?

Shirley 50:36
I know a big word.

Scott Benner 50:37
Yeah, that's where I learned. That's how I learned it. Anyway, okay. Yeah, I just imagined like, you live on a beautiful beach and there's sharks. It's pretty much what I think of where you live. I don't even know if that's true.

Shirley 50:50
I mean, I work like, pretty much on the beach. But I don't. I don't live far. Like, I mean, it's a 20 minute drive to the beach.

Scott Benner 51:02
Yeah, no, that's pretty nice, actually.

Shirley 51:06
But there's not a lot of shocks and things. I mean, now shocks

Scott Benner 51:10
walking on the beach. You know, it?

Shirley 51:13
Was this sharks Yeah,

Scott Benner 51:14
of course upright on their tails just wandering around in like board shorts and sunglasses. That's how I see.

Shirley 51:24
Sharks. I mean, obviously, there's sharks, but like, they're not like swimming on the show.

Scott Benner 51:30
What time of year is that? there right now.

Shirley 51:33
It's like spring Espace spring for you. Okay. Yeah, that's just too hot.

Scott Benner 51:39
Hot. How hot is spring?

Shirley 51:42
Um, depends on the day. I can tell you what our temperature was today. We had a high of 27 degrees Celsius. Sorry. 27.

Scott Benner 51:54
So that's about 80. Here. That sounds nice. Yeah. Warm but comfortable.

Shirley 52:00
Still a bit comfortable. The humidity hasn't hit. Yet. The humidity. Yeah, it's not as humid yet some as pretty unbearable with humidity.

Scott Benner 52:10
Surely, how is life so close to being good, then it's not nice and warm, good sun, but humid, right. Or people that get it? I mean, like lovely. But then something inside of them breaks and doesn't work. And now you need insulin to come in through a pop. Like we're always so close to it being like, this is pretty close.

Shirley 52:27
I mean, if you really want to know where I live winters the best season?

Scott Benner 52:33
Because it's not cold. Yeah.

Shirley 52:36
It's like the perfect temperature.

Scott Benner 52:38
Yeah. All right. I mean, I don't want to be like mugged by a shark. So I'm not sure what to do about. How do you leave? Very often or no? Sorry. Do you travel?

Shirley 52:52
Like elsewhere? Like what in the world? Or like,

Scott Benner 52:55
yeah, like, do you leave South Africa free with any frequency?

Shirley 52:59
Well, I haven't in the last few years because of COVID. That's a good point. No one's been going anywhere. I have been to the states, and I've been to the United Kingdom and France and Italy.

Scott Benner 53:14
Think that's all nice. My wife went to Paris two weeks ago for work and came back with French COVID. So we stuffed her into a room and did not let her out. was a shame for her.

Shirley 53:28
Shame. No, I haven't had any COVID yet. So I have

Scott Benner 53:32
not either. I'm very happy about that. My son and I were like, she's sick. And we're like, are you sick? And she's like, I think I'm sick. I'm like, Alright, so we like jam to COVID Dessner knows what we did. And we made her do it. And then she's like, Oh, it's positive. We're like, Okay, we all held our breath and shoved her upstairs. Go away. I was like, open the windows. So we

Shirley 53:53
don't feel like we do much COVID testing here anymore. Anyway, so

Scott Benner 53:58
Well, we had a couple in the house. I don't know why, honestly. And I was just like, test her. And then she I think she's must have spent almost a full week upstairs. Like I slept in Arden's bed. I texted artists like I'm sleeping in your bed. She's like, do not sleep in my bed. I'm like, too late. I'm laying in your bed right now. I'm sleeping in your bed. So,

Shirley 54:17
no, I don't feel like we do like a lot of COVID testing here anymore. I don't even think we ever had home kits. So

Scott Benner 54:24
yeah, be honest for her was not I mean, she was sick, and she was tired. And she had a sore throat. But not as bad as like, for instance, the like a friend of mine, if somebody I do work with got it coming back from Europe, I believe coming back from Europe and said the sore throat was unbearable. So

Shirley 54:45
I have heard that, is it? I mean, I think yeah, I think it's different for different people. I don't think it's as like, what would it be like as certainly not like it was a couple years was yeah, when I first started

Scott Benner 54:59
Yeah, anyway, she's fine now. I mean by fine. I mean, she lived through it. You know, they mean, the height of the illness as like how many setups that I have to do to start dating again. You don't I mean, just in case something went wrong surely. Well, you know, I'm too young up by myself, don't you think?

Shirley 55:17
Just in case Yeah, I always tell the kids what do you want to hear that? Yeah.

Scott Benner 55:21
Oh, I don't know. You think she gives us? Like she cares? Surely we were together a really long time. You don't think she's like, Yeah, if I died, I died. Get away from this guy for a little bit. Anyway, Alright, is there what else should we be talking about? About the 780? J.

Shirley 55:37
denies notice anything else you want to know? I mean, it does like the normal pump things.

Scott Benner 55:41
Yeah. Maybe you basically just came on. And we're like, hey, look, it does what you're expected to do. And yeah,

Shirley 55:48
I mean, I think I'm having a good experience with it. Maybe other people don't? I don't know. I have started using fast with it. I don't notice a huge difference with Yes. Like, I don't know.

Scott Benner 56:00
No, no. Yeah. Well, don't you think people imagine it's gonna just work like, instantaneously, instantly?

Shirley 56:04
Well, that's how it's marketed. I feel like that's how it's marketed, which is not really great. Yeah, I can say things like that.

Scott Benner 56:13
No, I agree. I like the way it worked. For Arden. Of course, she couldn't keep using it because it stung like it burned her.

Shirley 56:21
I really I didn't have I don't have that. Yeah,

Scott Benner 56:23
apparently, either you do or you don't. And I have heard some people say that. They use it and it works really well. But then it sort of tails off. And over time. You don't get the same kind of jump from it. I don't know if that's accurate. But I have heard it enough from people. Okay. Yeah. So keep an eye out for that. But yeah, I mean,

Shirley 56:47
I mean, yeah, I feel like the only other things that it really has, which most of the algorithm pumps have, but I know like, whether they call it on tandem exercise mode or whatever, like this, you can set it to target if you're going to exercise. And I think it goes to a point three, so it tries to keep your 8.3. And then it also won't give any auto corrections in that time.

Scott Benner 57:11
Yeah, yeah. That's a good idea. To my settings.

Shirley 57:15
Yeah. And then you can adjust the active incident time. So I can go as low as two hours. I think it's any for anything from two to four hours.

Scott Benner 57:24
That's interesting. You would think that that wouldn't be it's interesting that they give you access to that adjustment.

Shirley 57:31
Yeah, so you can set it as what you want. And I think when they set it up, so like, from my experiences, when they set it up to like, optimize it, they make you go to the obviously the lowest the 5.5 target range, and the to our active insulin term. I think because then it will autocorrect quicker, but I mean, I'm not I don't know, the actual, you know,

Scott Benner 57:56
I've heard a number of people who are, are involved in looping, like say, you can they now believe from watching the algorithm work that insulin is in you for six hours.

Shirley 58:10
Well, I do feel some mine is not I did have it set at two hours. And I've actually changed that setting. I think it's on three hours. Now. It's not a huge difference, but I definitely think it is there for much longer. Yeah,

Scott Benner 58:27
yeah. I mean, obviously if you make the action time shorter than the algorithm gets more aggressive, because it believes the insulin is gone sooner. Yeah.

Shirley 58:36
But then you do is you would experience like I'd then like sort of almost crash eventually. Was it will be correcting tomorrow, and then I'd obviously have too much.

Scott Benner 58:47
Yeah, two hours shocked me. I thought I thought How did you keep it at two hours? That doesn't sound like doable?

Shirley 58:53
So yeah, that you can go as low as two hours right? You weren't and it's it's a it's a setting that is adjustable by the user.

Scott Benner 59:03
Interesting so you don't get beat you don't I guess it makes it well, what I the way I was just thinking about it was like more like looping like, like, okay, I guess you could make that more aggressive and then makes some of the other settings weaker, and maybe you could find a balance there. But in the in the 780 G you have access to the insulin action time, but you don't have access to other settings. Do you

Shirley 59:25
mean like your correction, what is it insulin sensitivity factor or your correction factor that's adjustable, your carb ratios.

Scott Benner 59:37
So you, you do have a lot of autonomy inside of the algorithm to make changes to it.

Shirley 59:42
Um, yeah, it's just obviously then back when you first put it on, you have it at your set, whatever your Basal was, prior to. Yeah. And then after that, I don't I think those 48 hours is just learning and then after that, it doesn't consider that Those Basal rates does its own.

Scott Benner 1:00:03
Yeah, gotcha. So that's where there's a lot of similarity with Omnipod 512. Yeah, yeah. Because that does the same thing like you tell it on day one, like my Basal rates one. And it'll decide later that well, that's not what you need are getting out there. So I mean, it's all very exciting. Like, I just hope they

Shirley 1:00:22
can Yeah, and then I mean, it does. So like if you're out of the algorithm, so between like sensor changes, because there's a two hour warm up, plus, you got to charge the transmitter. So you have a four hour window where it just reverts to. I don't know what Basal right, but it keeps you within the algorithm, but it doesn't keep adjusting its asset base. Alright. Does that make sense? Yeah. No, it does. Yeah. So within those four hours, so if you take longer than those four hours to put out a new sensor, etc, then it'll kick you out the algorithm.

Scott Benner 1:00:54
If you take, say that again,

Shirley 1:00:57
sorry, like when you're doing a sensor change, so you're gonna have sensor readings, it'll keep you on the algorithm for four hours. But in that time, it gives like a set sort of Basal and it doesn't do auto corrections, because obviously, it has no data, glucose data feeding to it. Got it. Yeah. And then after four hours, if you haven't got a new sensor on, then it will kick you out the algorithm, then you just go back to manual, right? I didn't do setup was,

Scott Benner 1:01:26
that's how I handle artists, like, When are the changes the sensor, I'm like, just to open the loop. Because we know our settings are pretty good, and it won't auto Bolus that way. And then I just have her test, which sometimes she does, and sometimes she doesn't, you know, during the two hours, but okay, well, that makes sense. So it's using, it's using historical data to kind of float you through the sensor change.

Shirley 1:01:49
Yeah, so yeah, you've just got that, like, four hour time period. Yeah. And then at all. So as soon as it stops getting sensor readings, you have four hours before it will accept the smart card,

Scott Benner 1:02:03
and then kick you back to manual. Yeah. How long does it take for the Guardian sensor to spin up? Sorry, how long does it take for the Guardian sensor to come online when you change it?

Shirley 1:02:16
So it's, I've got a two hour warm up two hours. But the transmitter needs to be charged between the changes. Okay, so that takes about an hour. I found. Oh, I mean, that is like, like something also they could really improve on their senses. I know that is in the pipeline is a new sensor. That's meant to be I don't know when it would ever be released, but it is in the pipeline. But you know, that like having to charge the transmitter just delays the whole

Scott Benner 1:02:49
it sucks, right? True.

Shirley 1:02:53
Yeah, I mean, not that works. It's not that bad. It works. Like I mean, there's times when it's off, but I have one Dexcom. And there were times when Dex comes off. Like it's I feel like it's a normal sort of thing. Yeah. I didn't like I said, I didn't have good experience with the news. The guardian for it just didn't seem to work for me at all. I don't know what was wrong. But the Guardian three I'd say like, 90% of the time, it's doing a good job.

Scott Benner 1:03:24
Nice. That's excellent. Good. I mean, in the end, what you have is what you have you get very accustomed to it at some point. Yeah, you do. Yeah. A lot of it's just I don't know. Like, it's braids, personal preference. Like, do I want tubing? Do I not want tubing? That's a personal thing. You don't I mean, like, that's, there are plenty of people using two pumps or don't think twice about it having tubing. And

Shirley 1:03:47
yeah, I mean, like, I don't really think about it, but we don't have the option of Omnipod. So I don't actually we don't even have that option. So we have to have tubed so happy. Like, I don't even think about it anymore.

Scott Benner 1:03:58
Yeah. If it was available, do you think you'd want to try it?

Shirley 1:04:02
Yeah, I like trying the different things. I think it'd be nice to just try it. Just to see.

Scott Benner 1:04:08
I definitely I definitely feel that about you. By the way. You're very like, think you're sensible. But you're like, I'll give it a whirl. It's fine. I like it.

Shirley 1:04:16
Yeah. I mean, like, if I had Yeah, I suppose if you have access to try all the different things, I would happily try them. Like I'd wait all the senses if I could at one time just to see what they will say.

Scott Benner 1:04:28
That would be interesting, wouldn't it?

Shirley 1:04:31
So I got put this on. I've won a Dexcom and a Medtronic sensor at the same time. Just out of

Scott Benner 1:04:36
Yeah, because I had them were they close?

Shirley 1:04:40
Yeah, they were. I think I think like for me the Dexcom. What how can I say it so the initial the first like 24 hours I think it leveled out a lot quicker than a guardian does. But once they working well, they were pretty similar.

Scott Benner 1:05:01
Good now I mean, you know you would pretty far generations I mean are we're in now like Dexcom five, six, you know sevens coming soon, actually sevens available in places in Europe already. And then there's libre three

Shirley 1:05:16
good we heard we getting seven lakh next month so I don't know if we are on the Dexcom Dexcom g7

Scott Benner 1:05:24
Super interesting isn't it doesn't usually go that way doesn't usually go outside of us then us with XCOM Yeah, it's nice for you get ahead a little bit.

Shirley 1:05:34
So I don't know, waiting to see. Yeah,

Scott Benner 1:05:37
well, hopefully. I mean, I'm hearing good things about libre three from people too.

Shirley 1:05:42
Yes, that's we we still only have the libre one. I think it is. We don't even have to. So I don't even know why they haven't

Scott Benner 1:05:49
come up with South Africa.

Shirley 1:05:50
What the heck? Yeah. I don't know. How big is that? Kim that has been marketed black, quite extensively in South Africa. And a lot of people use it. So I don't know why they haven't moved on to the next generation of it.

Scott Benner 1:06:05
South Africa is only 470 Square 470,000 square miles. We can't get people libre to at least what the heck. You should start a revolution surely.

Shirley 1:06:21
I don't know why. I don't know why they I'm busy. But no idea. I don't know what like I don't know what approval they need. I don't really know all that stuff. You need to sign this off. There's not a market. I don't know. I feel like there's not I suppose we don't have a huge market because I've done a lot of people have access to ATMs. Ya know, so maybe maybe like having a libre too is not worth their while.

Scott Benner 1:06:46
Sucks. It really does. I wish everybody could have this stuff. Honestly. Yeah. Okay. Well, surely if that? If you're done. I'm done. I think this was terrific. I appreciate you doing it very much.

Shirley 1:06:58
Yeah, I think that's all I mean, I don't think there's any other. I think maybe yours was just to like, say they they have vastly improved on the original algorithm base pump. So if anybody's on the fence about Medtronic, the 780 G is a vast improvement.

Scott Benner 1:07:17
That's excellent. You were on episode 414. It's called Dark. Okay. Just think it Yeah. Yeah, I mean, listen, I tried algorithm. That's my that's my opinion. You know, really?

Shirley 1:07:32
Definitely. Yeah. I don't care which I think it would like for anybody gives a some improvement. I mean, they still input, I think people need to realize you still have to have input. But there's some like, it will improve your quality of life.

Scott Benner 1:07:49
Yeah, I see them work the best on like pre pubescent kids where there's not a lot of hormones happening there. It's pretty amazing. Yeah, you know, and then once you kind of are through your growing period, again, if you eat reasonably well, like they they work really, really great. I mean, that's the one, you know, good.

Shirley 1:08:12
I think for like females if they could, like, I don't know, somehow sink like a something play a cycle to the pump. I don't know how, I don't know how these things work. But I mean, I think that would be helpful.

Scott Benner 1:08:25
Well, surely, listen, I want people working on all kinds of things around that. I prefer. Listen, I think you should probably have like us, like a small warning light on your forehead. What do you think of that? Other people know? What's happening, you know, and and maybe they could approach you differently. For example.

Shirley 1:08:43
Yeah, yeah, maybe. But I mean, I think the pump like the pump companies need to like, I don't know, integrate some sort of Doctor somehow. Yeah, like that. It's

Scott Benner 1:08:52
like a holler button or something like that, where you go, Oh, my God. But But honestly, what it needs to know is it needs to know, the the time before the period, right? It needs to know when you're ovulating. It needs to know after the periods over like there's I mean, for a lot of women, you're gonna see almost three different insulin needs a month, don't you think? I think so. Yeah. Now well, I and yeah, no lie. Somebody should try. Like just I must

Shirley 1:09:20
be able to there's so many like tracking apps. And I don't know, you could track your period on your garmin watch. So

Scott Benner 1:09:29
there's some of those health straps are measuring like ovulation and periods by body temperature.

Shirley 1:09:36
Wow, they must be able to, like integrate, like Apple Health or something because you can track on there. I don't know. There's just like so many. But I suppose maybe it's

Scott Benner 1:09:47
I'll tell you right now get a couple of women of type one diabetes, put them in charge of these research and development portions of these companies and I guarantee you somebody will start looking into it really quickly. I

Shirley 1:09:57
feel like there must be a way to integrate it somehow. setting on the pump so that if you're female, you can switch that setting on.

Scott Benner 1:10:04
What would be very nice, because if I wasn't helping my daughter right now, illness and a period at the same time, she's only 18 She wouldn't know what to do. She'd be making herself crazy Bolus and constantly and just would never get her anywhere.

Shirley 1:10:17
So, but I mean, a lot of like, it's not only her I mean, there's there's plenty of females that don't even consider it. Well, they don't think they don't consider it, but they don't actually like, look at the patterns or look, you know, know what it is? Yeah. Well, if you don't know, like, Oh, my goodness, I'm so hard on a worm Ha, I'm like, Cool. You can track your cycle. You can? I don't know, there's a way to figure it out.

Scott Benner 1:10:41
No, no, I agree with you. I think that a lot of people because they don't know what some of the variables could be. They just end up thinking that this is the randomness of diabetes attacking them, you know?

Shirley 1:10:51
Yeah. And when it's when it's possibly not like we are in your cycle, like what hormones are being produced. So

Scott Benner 1:11:00
that's why there's a whole variable series inside of the podcast. Sure, exactly. Yeah. I'm doing my best over here. Okay. I feel attacked. I'm just getting I don't feel. You're terrific. I know. It's evening for you. I'm gonna let you go live your life and I really appreciate you doing this for me. Thank you. Yeah. My pleasure for having me. Of course, anytime Hold on one second.

Durbin, Shirley, thank you so much. And thank you to Omni pod for sponsoring this episode Omni pod.com forward slash juice box. And of course dexcom.com forward slash juice box. Use the links get started with Omni pod or Dexcom today, learn more. Check out their websites. Yeah, gotta love it. dexcom.com forward slash juice box Omni pod.com forward slash juice box. Once again, Shirley was terrific. Thank her so much for coming back on talking about her life with diabetes, her seven ATG and all the rest. I think she makes she makes me feel bad about my accent. Versus just so nice. Oh, geez. Thanks so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. I just was like talking to myself there. I forgot. I was trying to end the show.