Scott Benner 4/15/25 Scott Benner 4/15/25

#1493 Logging Trauma

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Ellie, 33, diagnosed young, defied doctors’ warnings; managing T1D, PCOS with GLP, she used Jenny and celebrated ideal A1c pregnancy.

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

Scott Benner 0:00
Hello friends and welcome back to another episode of The Juicebox Podcast.

Ellie 0:15
Hi there. I'm Ellie. I've been type one for almost 30 years, and I am a mom of two twin toddlers.

Scott Benner 0:24
Please don't forget 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. AG, one is offering my listeners a free $76 gift. When you sign up, you'll get a welcome kit, a bottle of d3, k2, and five free travel packs in your first box. So make sure you check out drink AG, one.com/juice box. To get this offer, don't forget to save 40% off of your entire order at cozy earth.com. All you have to do is use the offer code juice box at checkout. That's Juicebox at checkout to save 40% at cozy earth.com. Are you an adult living with type one or the caregiver of someone who is and a US resident? If you are, I'd love it if you would go to T 1d exchange.org/juice box. And take the survey. When you complete that survey, your answers are used to move type one diabetes research of all kinds. So if you'd like to help with type one research, but don't have time to go to a doctor or an investigation and you want to do something right there from your sofa, this is the way t 1d exchange.org/juice, box. It should not take you more than about 10 minutes. Today's podcast is sponsored by the insulin pump that my daughter has been wearing since she was four years old. Omnipod. Omnipod.com/juice, box. You too can have the same insulin pump that my daughter has been wearing every day for 16 years. This episode of The Juicebox Podcast is brought to you by my favorite diabetes organization, touched by type one. Please take a moment to learn more about them at touched by type one.org, on Facebook and Instagram. Touched by type one.org. Check out their many programs, their annual conference, awareness campaign, their D box program, dancing for diabetes. They have a dance program for local kids, a golf night and so much more touched by type one.org. You're looking to help or you want to see people helping people with type one. You want touch by type one.org This episode of the juice box podcast is sponsored by us Med, US med.com/juice, box, or call 888-721-1514, US med is where my daughter gets her diabetes supplies from and you could, too use the link or number to get your free benefits check and get started today with us. Med,

Ellie 3:08
Hi there. I'm Ellie. I've been type one for almost 30 years, and I am a mom of two twin toddlers.

Scott Benner 3:19
Two twin toddlers. Yes, does that mean you have two children or you have two

Ellie 3:24
children? No, I have two children, just my twins.

Scott Benner 3:27
Gotcha, I wasn't sure. Was I misunderstanding that two twin toddlers?

Ellie 3:31
I made that more complicated than it needed to be. Yeah, because you

Scott Benner 3:35
would be the mother of twin toddlers,

Ellie 3:38
true, but they're twins, and that's a big part of our existence, is the fact that they're twin. I

Scott Benner 3:43
was just like, Oh my God, how did she have four kids in such a short amount of time? Now I understand. How long ago were you diagnosed? I

Ellie 3:52
was diagnosed in 1995 I was two and a half. So few months I will be marking my 30th anniversary.

Scott Benner 4:05
Wow, good for you. That's a stretch. Has it been hard? Has it been easier than you thought it was going to be? How do you describe it to people as

Ellie 4:14
a journey? It's definitely been up and down over the years. I did really well as a younger kid, especially when my parents were super involved. This was, you know, pre Dexcom days and testing in the middle of the night and all of that. But definitely in teenage years, struggled big time into early adulthood, dealt with burnout, really a big piece that was very hard for me is I was trying very hard, or felt like I was trying, pre burnout and back then. And I don't know it sounds like from various episodes I've listened to that many of the endocrinologists out there today are much more respect. Full of including teens in their care. When I was a teen, the attitude was that, from the end, does I worked with, they didn't trust teenagers. I mean, I went to a number of them over time, I switched a few times, and there really just wasn't trust there. They felt that many of them made up their log entries, and people did. There was a lot of pressure around going to those visits. I really like to do well in school, I had kind of a good girl personality, and so I would go to these appointments. And it, it very much felt like a judgment session of, you know, how our How did the log sheets look? And I definitely carry log logging trauma to this day. Anything I need to track or log is like, Oh God, I don't want to do that. That was really hard. And I think eventually, as you know, puberty hit, and my numbers started going up, and I wanted to do better, but was really struggling to do that. I wasn't getting the support I needed, and over time, they just kind of artificially kept hitting me with more and more basal to kind of cover, cover the bases. We really weren't doing carb testing or really even basal testing. It was like, well, you're running high. Let's just give you more insulin all the time. And when you do that over time, I ended up being more resistant, you know, it just it led into this really negative loop that lasted into early adulthood.

Scott Benner 6:31
Can I dig through that a little bit with you? Yeah, yeah. Absolutely. Before I do, I want everyone to know that if you go to YouTube and search logging trauma, you get a surprising number of videos about people being hit or killed by trees while they're being cut down, and a lot of instructional nursing videos about how to turn people with something called the log roll. Just so, you know, I want to make sure I understand. You're a rule follower. You're a young kid. You want to get good grades. You want people to think of you well. And this visit to this doctor's office was in no way pleasant for you, and on top of that, they probably weren't even including you in the conversation. So you're there feeling like this whole thing hinges, like your personality hinges on the outcome of this, and they're not even talking directly to you. Yes,

Ellie 7:15
exactly. And that really started around puberty, when my numbers started getting worse. You know, before that, when you're getting sixes, low sevens, every time for a one, CS, like, good job, you know, we'll see you next time. And that was it, when my numbers started going up. This is my my endo trauma story, a little bit of trauma from childhood in 30 years, my endo story was the first time my a 1c really went up. And I'm guessing it was like mid sevens, maybe low eights at the time. I don't remember. I was probably 11 or 11 when this happened. My endo came in the room. And, I mean, I picture this image in my head retelling the story of her coming up to me and saying, Do you know what happens to little girls who don't take care of their diabetes?

Scott Benner 8:11
Oh, what happens to them? They die? Oh, I thought they got a fairy. Okay, so

Ellie 8:17
I wish that's not what happened.

Scott Benner 8:21
That's what was said to you. How old were you under

Ellie 8:23
12? Like 10 or 11. And I happened to have had my best friend with me at the appointment. She asked her to leave the room. Left the room after she said that to me, and went to the bathroom and cried. Apparently I didn't announce where I was going, and the entire office was looking for me because they didn't know where

Scott Benner 8:43
I went. They probably thought you were looking for a rooftop or something. Probably Do you remember the you probably have a photo of them in your house. But like, is it an adult male female in their 60s? Now,

Ellie 8:54
how old was she? Now? How old was she? I don't recall that. I do know she's semi still practicing awesome. I worked in the same facility as her for a brief amount of time, and I'm an architect by training, and I worked as a project manager in a children's hospital. And at the time, one of one of the facilities people who I was close with, he said, you know, if there's anybody you ever have an issue with, I can manually control the temperature in their office, and whatever they set it to, it won't matter, because I have master control. Listen,

Scott Benner 9:32
I just need to know, did you freeze this lady out? I have always disliked ordering diabetes supplies. I'm guessing you have as well. It hasn't been a problem for us for the last few years, though, because we began using us Med, you can too us med.com/juice, box, or call 888-721-1514, to get your free benefits, check us med has served over 1 million people living with. Diabetes since 1996 they carry everything you need, from CGM to insulin pumps and diabetes testing supplies and more. I'm talking about all the good ones, all your favorites, libre three, Dexcom g7 and pumps like Omnipod five, Omnipod tandem, and most recently, the I let pump from beta bionics, the stuff you're looking for, they have it at us. Med, 88887211514, or go to us. Med.com/juice, box, to get started now use my link to support the podcast. That's us. Med.com/juice, box, or call 888-721-1514, today's episode of The Juicebox Podcast is sponsored by Omnipod. And before I tell you about Omnipod, the device, I'd like to tell you about Omnipod the company. I approached Omnipod in 2015 and asked them to buy an ad on a podcast that I hadn't even begun to make yet, because the podcast didn't have any listeners, all I could promise them was that I was going to try to help people living with type one diabetes, and that was enough for Omnipod. They bought their first ad, and I used that money to support myself while I was growing the Juicebox Podcast. You might even say that Omnipod is the firm foundation of the Juicebox Podcast, and it's actually the firm foundation of how my daughter manages her type one diabetes every day. Omnipod.com/juicebox whether you want the Omnipod five or the Omnipod dash, using my link, let's Omnipod know what a good decision they made in 2015 and continue to make to this day, Omnipod is easy to use, easy to fill, easy to wear. And I know that because my daughter has been wearing one every day since she was four years old, and she will be 20 this year, there is not enough time in an ad for me to tell you everything that I know about Omnipod, but please take a look omnipod.com/juicebox. I think Omnipod could be a good friend to you, just like it has been to my daughter and my family.

Ellie 12:13
I want to do so many times, Scott, but I did it. Did

Scott Benner 12:17
you ever say anything to her? Do you ever say, Hey, you ruined my life.

Ellie 12:20
I never even crossed paths with her, and I'm not even sure if she was working in that building at the time or one of the off site locations, because I just didn't want to, I just didn't want to go

Scott Benner 12:31
there. Let me tell you this, like, odd little side story. So my wife would tell me about this very like, harsh, mean, nasty teacher that she had, and she'd tell the story, sometimes almost like she was a little girl, you know. And I don't know like what to think about that, like I had horrible teachers too. I want to say Mrs. Nelson, my second grade teacher. She and I hated each other with a passion. I've never seen an adult hate a child like that, or the child hate an adult like that, but she and I had an adversarial relationship for every day of school the entire I was in second grade, so much so that on the last day of school, for just bits and giggles, she put me in the hallway for the entire eight hours, while everyone was in that room having a party and enjoying themselves. She made me stand leaning against the locker from the bell to the bell, and I'm telling you, she looked at me, and the look in her eye was you, and then she stuck me out in the hall. I know what it is, but I didn't have like. My memories of it are just funny. I just think it's funny. My wife did not does not talk about that way. We walk into a restaurant one day to give our name at the front, to wait our turn, and we step back to wait, and that woman is standing there. She's also waiting for a table. And it turns my wife to jello. Was really interesting, because she's not that person, like my wife's not like fragile, you know what I mean? And she really like crumbled, and I was like, what's going on? And she goes, that's her. And she, you know, she said her name, I'm not gonna say her name here. And I was like, are you okay? And she was shook. So I stepped up to the woman and I said, Hi, this is my wife. She had you in kindergarten, and she's still scared of you today. And the woman thought it was funny, wow. So I don't know what to make of all this. Like, I don't understand, like, under 12 years old being approached by an adult, hey, little girl. You know what happens to little girls like and you weren't not taking care of yourself, right? No.

Ellie 14:36
I mean, it was not like gross negligence by any means. My sugars started going up because I was getting hormones, that is what was happening, and we needed to adjust. And I'm not sure what possessed her to say it people have bad days, but it's one of those things that, yeah, it stayed with me for a long time.

Scott Benner 14:56
You can't use I people have bad days as an excuse when you're. Bad day could, I mean, how old are you today? 32 Uh huh. Do you still remember like it was yesterday? Oh yeah, yeah. Well, then it's not okay for her to have a bad day on you like that. You know what I mean. Now, if you sat her down here and she said, listen, the 1000s of girls I saw hit puberty and then their blood sugars got out of control. And no matter what I did, it didn't work. So 10 years in, I just started trying to scare them, like, I mean, I might understand the thinking, but like, I don't. I don't understand actually doing it for sure. Yeah. I mean, it's your job. Just have the fight every time, and it'll work for some of them and not work for the others. But anyway, I'm sorry, go ahead.

Ellie 15:36
No, it's okay. Yeah, that's just, you know, said part of my story, so that happened. I left her after that, obviously, we moved on to another Endo. Eventually, my parents were really into trying to help me be independent. And, you know, prepare for leaving home post high school, they were very there for me, very supportive. Really helped me with my diabetes as much as they could, but really wanted me to be independent, and so I studied abroad. I went to Israel after high school for a year, and then I went to college. And during that time, in both places, actually, I found endos just for extra support, or in case I needed, had an emergency or something. And my endo in New York saw where my basal were at, and he artificially just flashed them in half. He's like, you're just taking entirely too much insulin. I don't believe that you need this much insulin, and we need to step back. And it was so interesting because he did that, and it really helped, at least with some of the resistance piece. Was not a big fix by any means, but it did help just to sort of start over at that time, trying to remember exactly when Dexcom was introduced to me. They were that office was really pushing me to use it. And I really struggled with the insertion back then with the old ARPU

Scott Benner 17:08
style, that clear tube one where you push the plunger exactly

Ellie 17:12
I would every time I'd be so anxious about it, I'd shoot it halfway in and then stop because it hurt, and then would get anxious for another 30 minutes to finish pushing the fan. It was just a mess. So it was not using it consistently by any means. Around the same time, though, back at home, I was diagnosed with PCOS, which for me, was a game changer, because I finally felt like it gave me some explanation as to why things just seemed harder for me. I didn't know why it was very frustrating for me that I felt like I was putting in the effort and I wasn't getting the numbers I wanted. You know, like my a one CS, would hover around somewhere in the eights, sometimes low sevens, if it was really good, sometimes higher. I just really struggled to have the control I wanted. And you know, on occasion, when I ran into another diabetic, I could tell them all the things you're supposed to do. But taking my own advice, I wasn't getting those results. So PCOS really helped me understand that there's hormones going on in the background that are sort of unpredictable, that are making this harder.

Scott Benner 18:33
Yeah, I have a question. If you had PCOS, how did cutting your basal improve things?

Ellie 18:39
It didn't improve things necessarily right away. I think just starting over at a lower place and then doing more at meal times, I see we weren't just blanketing, giving more basal all the time to as a band aid. Like, let's give more at meals. Let's figure out, you know, my sensitivity factors were off. That all helped.

Scott Benner 19:02
You were being over basal to cover for not bolusing at meals Exactly. Gotcha, okay, all right. I was like, How was less insulin helping if you have PCOS? Okay, Sue, how did you get the PCOS diagnosis? What testing did they do? I had

Ellie 19:15
an ultrasound at some point, and I think I was complaining of heavy bleeding, and so my my gynecologist worked me up, and she said, that's probably what's going on. And so, so that was that. And then at that time, I actually went on Invokana to help with resistance, which I loved at the time, I thought it was the greatest thing ever. I felt like it was this boost in the background that just made everything easier, so that that really helped a lot. I lost weight with it. It really kept my sugars down in a lot of ways, but I knew that, you know, it was in my. A future that I wanted to get married, have a family, and knew at some point I wouldn't be able to stay on it. Fast forward, I got married in grad school. My husband encouraged me, really to start wearing my Dexcom all the time. He's like, sorry, my husband is a chemist and he's a data guy, and he's like, you have this tool. We can get tons of data. You need to wear this all the time, yeah. And so he started helping me by putting it in, which was a huge thing. I was like, here, you help me do it. I can. I don't have to deal with the mental piece of this trying to insert it. At that time, it was already spring loaded, which made it better, too.

Scott Benner 20:42
Your thumb was the spring back. Then you were like, Bush,

Ellie 20:45
oh yeah, oh God, by the

Scott Benner 20:48
time he helped you, it was the Star Wars ship with the orange button on the top. Exactly. Okay, right, yeah, hey. Just for people's knowledge, invocana is a sglt, two blocks, reabsorption of glucose into the kidneys, causing excess glucose to be excreted in the urine, not a GLP one, which is probably what people might think when they just hear like a medication word, I'm gonna guess you're on a GLP one. Now I am. I already knew it. I know. Thanks. Okay, I've told this story a couple of times in the last couple of weeks, but I was at this big dinner with a bunch of people that I didn't know, and this one guy is kind of like, you know, a couple seats down from me, he's a physician. And he stops me at some point. He goes, Hey, I'm so sorry. What kind of doctor are you? And I was like, I make a podcast. I barely got through high school. And he goes, Oh, I thought you were a physician. Sorry. Keep going. GLP ones mimic the hormone GLP one increase insulin secretion in response to meals. Slow stomach emptying, reduce appetite. They have impacts on digestive and pancreatic function. So I'm sorry. I just want people to understand the difference between the two, because I figured we were going to get to it at some point. Yes, you've got your husband sticking it in, and you start getting data back. So what do you learn there? Did he help you read the data as well?

Ellie 22:02
He did, and I remember thinking it was the funniest thing, because he was putting it into PowerPoint and making graphs and all of that for us to start really digging in and looking at it. And about a year in to our marriage, I started working with Jenny, oh, and I still work with Jenny, and that's actually how I found out about the podcast a number of years ago. Is when she told me about it. So I kind of had a backwards path. I know a lot of people find Jenny through you. We don't

Scott Benner 22:35
have to say where, but did you find Jenny through Gary? At the thing that I think you might have gone to No, no. How did you find Jenny? Then

Ellie 22:43
at that point, I had a nice endo who was supportive, but I just felt like I needed a refresh. I just felt like my numbers were not, my settings weren't where they needed to be, and I just felt like I needed more help than I was getting in my private office, and started looking online for where I could get that and found integrated, wow. And I was looking specifically for a nutritionist at the time to kind of talk through my struggles with covering for protein and fat, and those were things I was having a hard time with then. And actually, it was funny, I saw a nutritionist at my college campus, or my it was grad school at the time, but I saw one there, and her response was, you're not eating enough carbs for your body. And it was like, contrary to everything I had ever been told for anything related to diabetes, and I'm like, This is not sitting right with me. I need someone who knows diabetes really well to be helpful, and I feel like I have a good understanding. You know, I'm not trained or certified in anything, but just about basics of nutrition, I'm like, That's not my problem here. I'm struggling to cover for my food appropriately. Jenny really, really helped with it, so I started working with her in I think it was like 2017

Scott Benner 24:16
I have to stop you for a second. How do you stop yourself in that appointment from going, I'm gonna go now, because

Ellie 24:23
that's really hard. Like, I get that you think you know what you're talking about, but this is not

Scott Benner 24:30
you're there struggling with, like, higher a one season you want, like, you're using a lot of insulin, you're not getting the results you want. And this person looks you straight in the face and goes, You know what? You need? More carbohydrates, right? Yeah, and you didn't laugh or curse or bang your head on something or nothing like that.

Ellie 24:47
I politely smiled and nodded. I'm in the Midwest. Scott, so that's what we do.

Scott Benner 24:51
Wait. They're letting Jews in the Midwest now. What's going on? We've been here for a long time. I didn't know that's insane. Of. I don't know, like, I don't know what's with me, but I think I would just go, okay, hold on, stop. I'm gonna leave. You can still send the bill if you want, but I gotta go. Did you misspeak? Did you mean protein? Were you trying to say something else? You meant carbs? She

Ellie 25:13
really meant carbs. We talked about it for a while. Thankfully, I did not have to pay for this, because it was during grad school and it was through, through student health. But

Scott Benner 25:23
wait, so you've been working with Jenny for seven years. Yeah, every week. Do you see her once a month? How do you do it? Once a month? So, like a like a tune up, like a check in, Mm, hmm, valuable still. Yes,

Ellie 25:35
incredibly so. And I don't plan on stopping. I have to sign up for another year, something up in a month, it has been the best investment in my health and my life that I could have ever done.

Scott Benner 25:49
Same thing. When people tell me about how after they understand how to use their insulin, they understand what they're doing, etc, and they say, Well, I keep listening to the podcast as like a touch point, like, it keeps me connected to diabetes. I don't have to think about it constantly every day to day to day, because I stop every once in a while, and I'm kind of kept in it without it being pushed right in my face. Is that like, what you get out of seeing Jenny like this?

Ellie 26:12
Yes, and also, things evolve, you know, like, we don't stay the same. Circumstances change in our life, and things like your settings, we all have this experience where you go to the end, oh, they give you your settings, and then you don't touch them again for three months. And having this touch base is having somebody else step outside of your life and look at this data and be able to give you real feedback. We email in between. It's not even just the once a month, I can say, hey, I'm having a bad week. Can you look at my night scout? She can say, make this adjustment. Make that adjustment. I mean, there's so many pieces of my story I can point back to and say, I don't know that I could have done it without Jenny.

Scott Benner 26:55
Yeah, awesome. So she tells you to check out the podcast. At

Ellie 26:58
some point, she mentioned it to me and brought it up, and we've talked about different things that have come up before that. I'm like, Hey, Jenny, on this episode, I heard about this, or they were talking about that. What do you think? And we've chatted about it. What

Scott Benner 27:13
makes me happy? I don't Yeah, I don't know another way to tell you, like that there's an ecosystem makes me very happy, and that people can find it from different avenues and be introduced to it different ways. Is it's all just very cool. How about the Facebook group? Are you in the Facebook group?

Ellie 27:27
I am, and I was just gonna say that. I think that was the first thing she was pointing me to. I don't remember what it was for, but I joined the Facebook group first. I did everything backwards. I worked with Jenny first, then went to the group, then started listening.

Scott Benner 27:44
That's awesome. I mean, any way it works to me is, is awesome. You know, it's funny. I had a person in the Facebook group yesterday who just was hell bent on arguing about something, like a sub comment of of another post. And I don't get involved. Like, I don't know if people understand my management style, but my management style is, you're adults, you'll figure it out, but at some point that the person gets reported a number of times about being kind of, like, overly aggressively pushing an idea and that the point's been made, and they just keep, you know, like, hammering at it. So I stopped in. I tried to make it better, it got worse. I tried again to make it better, it got worse. So then I was more pointed, and I was just like, you know, trying to tell them, like, like, just count, you know, like, let's just let it go. Like, we're good. Now you've made your point. You know, everybody's heard it, and when it became clear that they just really, like, wanted to argue, uh huh, what strikes in my head about what to do next is that's not what this place is for. Like, it's helping so many people. I can't let it get sidetracked with this nonsense. So I just said to the person, look, this isn't good for you. I'm not interested in this. And that's not what this place is for. I'm suspending your account for a month. If you come back after a month, that's awesome. Like, please just find a kinder way. Like, stop proselytizing so much about your idea. It doesn't matter what the idea is. Listen, if you made 10 posts about rainbows, I'd be like, it's enough. We get it. You know what I mean? Like, you love rainbows, you know? So it doesn't matter to me. But what rings in my head over and over again is that that's not what this place is for. This place is helping people, and it should not get sidetracked, because what I think is when sometimes 2030, 4050, new people come in every day, I don't need the first thing that they see is a person having a nutty because then they're just gonna leave, and then they're gonna miss out on All the stuff that comes once you get ingrained in it and really start learning how to use it and how to interact with people in the community that comes from it, et cetera. So anyway, I see that place is very sacred.

Ellie 29:50
It is. I mean, I can't tell you how many times I've gone and searched for something, and there was a post about it, and there's a recommendation, and it. Is, I think it helps people in so many ways.

Scott Benner 30:03
That's crazy. I just never imagined, honestly, so it's to see it. I think it went to 56,000 this year. I think we added 18,000 new people in 2024 that's incredible, which is really insane. It means it started it's something like in the mid 40 1000s at the beginning of the year. So that means that if it grows at this pace, next year, it'll be more like 75,000 people. It's really just, it's awesome, like, it's just a wonderful little thing in the internet that hopefully people find out about and and like you said, sometimes people find the Facebook group first, and then they'll eventually find the podcast. Sometimes people find the podcast, they go to the Facebook group, but I'll tell you right now, like it's there, it does exactly what I think it does, and it's free. That, to me, is the best stuff, because I don't talk about that enough anymore. It's just such a big part of when I started all this, it's hard to explain. This is my last recording of 2024 you are my last recording of 2024 I put out 299 episodes this year, and I don't remember five years ago, like right? But I, as the host of the podcast, I'm also, I'm also telling a story about me. You don't need to be interested in it, but by who I am and how I grow and how I change. Like you're following my progression as well, whether you realize it or not. And back in the day, I would really bang the drum of this should be free. Like, nobody needs to be paying for this. Like, no, don't get me wrong. You want to pay Jenny and, like, hang out with her once a month and get what you get out of it, and you can afford it. Like, I think that's awesome. But for the people who can't or don't know that that's even possible, or crappy insurance, or whatever they end up, where a doctor that tells them that little girls, you know, catch fire if they don't, whatever right, the information should be free, and it's always been a focus of mine to keep it free. Like, like, if you think I'm saying something that's magical, you're wrong, like I'm you know, I'm saying something that oftentimes you won't hear doctors say for varying reasons, that we've gone over ad nauseam. But there are people out there running coaching plans and charging people to tell you to pre bullish your meals, right? And I'm not okay with that. For me personally, if they want to charge you $1,000 or $2,000 to come on and hear, from what I've heard from some people, it sounds like maybe they listened to the Pro Tip series and took some notes. If you want to, like, pay them for that. I'm not going to stop you. I'm just saying it's here for free. You can have it for free. And you know, it exists for free because of the advertisers, because they they pay my bills basically like I've got lights on in my house. It's warm in here, in the winter time I drive somewhere in a car, my kids go to college, like all that is taken care of with my wife's job and my job, and it allows me to spend my time doing this right? I'm not against people who are health coaches. I think that's a perfectly legitimate way of making a living. It just seems weird to me that you should have to pay to hear something that is just information living in my head, and so like, I'm happy and proud that I found a way to get it out into the world at no cost to people anyway.

Ellie 33:15
No, I think that's amazing. And because it's a Facebook group, and through the podcast, it's so accessible. I think that's the biggest thing I remember. You know, when I was younger, there were various cat rooms on the different diabetes websites, and it wasn't easy to sort of get in and talk to people and find out what they were doing. And you know, I felt a lot more isolated back then,

Scott Benner 33:40
can we be philosophical about this for a minute? I don't have diabetes, so some people would tell you, I have no business doing this. I think I'm the perfect person to do this, because I do have a person who I love who has type one diabetes, and I did spend my life as that person was born with type one at two years old, I had to learn through the thing. Jenny and I were talking about this the other day. She's like, it's, you know, you taught yourself through experiences. I'm invested completely, 100% invested. Used to say this all the time, like, sometimes I meet people with type one and they'll tell me that they listen to podcasts and forget I don't have type one diabetes. I take that as a huge compliment. But my focus here, whether you guys all realize this or not, is for my daughter to be okay. You guys get to come along for the ride, but I'm here for her. I'm here for all you, by extension, but I make the podcast to talk to you, to hear things, so that one day I can turn to my daughter and say, Hey, you should try this, or think about this, or maybe I drop dead one day, and she comes back and listens to this straight through, and gets to see my progression as a human being, get to know me, and, you know, see where I have, you know, weaknesses, foibles, all that stuff, and at the same time, teach herself diabetes and live her life healthily. And maybe she'll have a kid one day and she'll be like, hey. Is this podcast your grandfather made like, go like, I don't know what's going to be, you know, but for me, the one thing that I have that those people might not have had in those groups that you're talking about back then is I have distance from it too, so I don't have any baggage. No one told me I was going to die when I was 12. I didn't lose my sight and have to get lasers. I don't have any the agony and the trauma and the pain and the resentment that you can have if you have type one diabetes. I do have all the love, the care, the support and the motivation. So I do think that's probably the difference. Like, I'm not saying because I'm the parent of someone with type one. I know better. There's a ton of stuff I don't know. That's what the interviews are for. You know what I mean? Like to get those bits of information right out of people who have type one. Anyway, you see that your episode is turning into my like 2024 recap for some Okay, sorry about that

Ellie 36:00
part of No, no, that's all good part of the reason, because I think I booked this many, many months ago. I wanted to sort of wrap up the year on a high note and with a lot of gratitude. So I think

Scott Benner 36:11
it's beautiful. Oh, you're lovely. Thank you. You're helping me do the same thing. Because, like, I can I be honest with you, I don't want to, like, I'm not on anybody, but when I see those, like 2024, recaps, like, these were the best episodes of this. And I'm like, uh, nobody cares. You should just say I'm trying to make content so that the algorithm doesn't forget about me at the end of the year. But I'm also trying to hang out with my family at Christmas. Like, like, that's what those episodes say to me. But I keep recording. Like, my kids are like, Are you recording a New Year's Eve? I'm like, Yeah, I make a podcast like, this is what I do. I'm recording tomorrow. Oh, wow, I recorded three times. But anyway, I'm so sorry. I don't even know where we're at. It's

Ellie 36:52
we were talking about Jenny. I was just gonna jump into the my sort of next piece that came working through Jenny was I started looping. That was transformative for me. And talking about gratitude, I think I posted in your group and the looping group at various points, just how grateful I am for loop, and especially with PCOS. And I use loop throughout my pregnancy, everything else. I think it was just that extra help in the background that can do what a human can't. You know, you can be looking at your Dexcom, 24/7, but to be able to micro correct throughout the day. I mean, I don't think things would have turned out the way they did, so that was a game changer for me. That was kind of funny, because a friend of mine had posted on Facebook this News Week article a number of years ago that was talking about how people were buying, you know, old pumps on eBay to do this sketchy, scary thing. And she posted the article, and I hadn't heard about looping yet, and I reached out to her and said, Hey, are you doing this? And she was like, Yeah, and it's pretty awesome. And so at some point, I asked Jenny about it, and I remember being super tentative, because, you know, this is not an FDA approved thing, and asking her about it. And she gave me this big smile and said, Yeah, I know what it is, and I don't I think if Jenny hadn't been up to speed on looping and had guided me through it, I don't know that I would have been brave enough then to start. I had a really tough time getting going with loop, mainly because I discovered in that process that I'm severely allergic to OmniPods. The adhesive. Okay, the adhesive. And that was also funny, I don't remember if that was the reason I found I went to your Facebook group at the time, but I went back to the Arden day blog, and one of your early early episodes was about adhesive allergies, yeah, in the first year. So there was a page there that had all these tips. I was trying everything, and I tried everything, and I could not get it to work for me. So I am looping with a 20 year old Medtronic with this incredible technology.

Scott Benner 39:27
It's awesome. Yeah, no. I mean, the people who helped me to learn how to do it for Arden, like, I'm so I'm grateful for that. Like, you know, I whoever you know, all the people who were involved in just bringing it up from the ground to where it is now, it's awesome, like every last one of them is their angels. Yeah, for putting their time into it, they're

Ellie 39:46
all incredible. And like you said, too, the and they made it free and accessible also, and you know, the loop docs and all of those resources that make it easy to do yourself. If you're not a coder, you. That was just so incredibly wonderful. Yeah,

Scott Benner 40:02
yeah, a number of wonderful people, and some of them have, you know, they come and go and they don't, they don't stay involved, but they all deserve, I think, like, an equal amount of credit, adulation, Joy. You know, absolutely well you're right. Like watching those algorithms work, those aggressive, you know, the iy algorithms that aren't held back by, you know, the fears that companies have when they're making things, and that's awesome, like it just really is. And I also think that I learned so much about how insulin works from watching, watching loop work. You know, I mean, back then, when Arden first started to loop, I was like, was like, Oh my god. This is what I've been doing. Like, this is how I had my daughter's a 1c in the fives with Temp Basal off, and Temp Basal increases. And, you know, more here, less here, give it away. Bowl is here. Like, I was like, it's just doing it all. I'm like, wow, and that. And while I'm sleeping, it's doing it where before I was awake, doing it. And right, it was killing me. Anyway. It's just, it's awesome. So Jenny was looping. When you approached Jenny about looping, that gave you the the courage to do it exactly.

Ellie 41:07
So I, I started looping, and I finally got my agencies where I needed to and and then I got pregnant with twins. Yeah, that's awesome. It was one of those things I was so worried about for years, not being able to get those kinds of numbers. And like I said, feeling like I was really putting in the effort and not feeling as easy as it seemed to be for other people. Whether that was true or not, that was just my experience. And so then, you know, when I was able to get those low sixes, A, one, CS and got pregnant with my twins, and it was a very healthy pregnancy. Thank god. I'm so, so grateful for that, and I really worked hard during that time, but also is having the tools and the resources, and Jenny during that time was immensely supportive as well. I mean, we were making changes all the time to my numbers, and you know, I was incredibly resistant at that time, as you may imagine, especially caring too. It happened much earlier my my MFM, high risk OB, at the time, she said to me, Well, we're not going to really treat you any differently with the type one versus the twins. You would have been here either way, but you're kind of double high risk. You check two boxes. I

Scott Benner 42:32
need to ask you if you think that part of what burnout is is trying so hard but not having the right tools. So you're putting in the work, but you don't have the right knowledge or tools, or whatever you want to call it, and so all the effort ends up falling flat. You don't get the return that you're hoping for. And then that's where the burnout comes from. Like, that's what I feel like I hear from people, but I'm wondering if that was your experience.

Ellie 42:59
It was, it absolutely was my experience. And then at some point in my college years, it turned into, I guess, what you'd call more classic burnout, because I wasn't checking as frequently as I knew I should have, and it was like, I feel X, I'm gonna Bolus y, and it's gonna be good enough, and it was good enough to not ever end up in the hospital. But I was running, you know, eight, eight and a half, eight, one CS, doing that. Yeah, but it's exactly that it was after years of trying, and then you stop trying because it's too much effort to continue when you're not getting there

Scott Benner 43:37
Right. And then I think the mistake is then the doctors see the give up, not the work, and they go see they don't care. They're non compliant, or whatever, like instead of like, like, I'm talking directly to doctors now, instead of seeing that you did not give them the right tools, and all that effort they put in, felt like it was fruitless, like it was never, ever gonna work out. And so why try this? Is just diabetes. I'm just going to let it be what it's going to be, and that's where you get like, Jesus, take the wheel from people, and then they exactly, they spiral. I'm always going to say that with the right tools and the right knowledge, people can do this, and that a lot of people who end up or people I'm thinking about right now, who I've watched online struggle, who still believe that they're brittle. But when you look at the their story, like, really stretch out their story, they started with bad info. It was reinforced along the way. You're not doing what I'm telling you to do. You know, like, blah, blah, blah. They go back and beat their head against more walls. The doctors should tell them they must not be listening. This would go back and forth, back and forth. Their blood sugars go up, they go down, they go up, they go down. The doctor says, You're brittle. They believe they're brittle. Because what they need to know, they need to think something's happening. You know what? I mean, that's diagnosable, that you know is written down in the book somewhere, right? You know, eventually they just give over to it. You. But the psychological implications do not stop afterwards. There are a couple of people I'm thinking of like you have all of my compassion, like they're spiraling and they can't find a way to listen to what we know now, probably because of glucose sensing technology and everything that they're very likely not brittle. They're just their settings are wrong. They eat at the wrong times. They use insulin incorrectly. They don't know what they're doing, and it's not their fault, and it looks like it's all out of control. And then then that psychological impact, I think, can stop them from stepping back, seeing the light, starting over again,

Ellie 45:39
exactly. Yeah, it's tough. It is. And I think, you know, for me, there was a goal in mind, and I knew I wanted to have a family, and so that at me going, and that's why I reached out to Jenny for that first time, was I need that restart because I'm stuck and can't figure out my way out of it. And like you said, I was lucky enough to do you know, to be able to afford her services, and to do that and continue working with her and with my pregnancy, I will say too, when you have that motivation, and if anyone you know thinking about Becoming pregnant, there's a huge difference about from thinking about becoming pregnant and being pregnant and the diabetes motivation. Tell me, I think when you're thinking about it, you're you're definitely trying, and, you know, I got to that place. But when you are actually pregnant, that motivation sky rockets, because these kids are growing inside you, and you don't want to mess it up for them. Getting teary eyed. Go ahead, but take your time. You want to do well for you so you can be there for them. You know, in my experience, you want them to be as healthy as they can possibly be. And so, you know, I had the lowest A, 1c, in my entire life, during my pre can see, and it was hard, but I did it, and that reminds me today that I continue to do it, and there's still challenges. And I'm not going to say I'm as tight now as I was then, but I'm a heck of a lot better than I was years before.

Scott Benner 47:20
What made you cry? I think just

Ellie 47:22
thinking about, you know, parents wanting to do everything for their kids and the best that you can do. And I think what you were saying before of being kind of separate, separated from having diabetes, but being a parent and wanting to do everything you could and you can do for Arden, it's that same feeling of you're willing to stay up in the middle of the night and watch her graph. You know, we're not always willing to do that kind of thing for ourself. I

Scott Benner 47:53
don't even know how you're supposed to, like, how are you going to live and not sleep,

Ellie 47:57
right? And at the end of the day, you can't, right? It's just

Scott Benner 48:01
It sucks. I mean, in case people don't know, diabetes sucks. Wasn't sure if everybody knew or not. It's also tough, because you can come to this conclusion, or at least I did at some point, that how do I say this? The podcast is in a place right now that you all don't know it's in yet, because I haven't spoken about it enough yet, but I'm still having the experience, so I can't talk about it yet, but that experience is hard, and going off to college and becoming an adult and taking more responsibility for herself, and how well that goes in a lot of circumstances, and how poorly it goes in others, and where the pain points are. What I had to learn to shut up about, what I had to learn to push more about, like, how important communication was the relationship we had previously, because I had to trade off of a little bit of our goodwill during the bad time. Does that make sense? Right? Had I started off with a bad relationship with her and then hit one of those speed bumps? We wouldn't have gotten past that. She would have written me off. But I had enough good will that I could, in small places, assert what needed to be asserted without overwhelming her freedom, her growth, which is also very important. And so why we spend so much time talking about that stuff with Erica, and she and I are still growing through it, and I'll probably start talking about it maybe the end of this next year. But you know, the one thing you can be comfortable with about the podcast is like, I don't, like, have a thought and just randomly blurt it out very frequently at all. Like, if I'm saying something, I've lived through it. I believe in it. It's I've seen it work over and over again. It's interesting to think that, like a part of this, like, I'm still growing through being the parent of a child with type one, even though she's going to be 21 this summer. I hear that, and you guys are all helping me. I. Because I get to absorb all your good stories, your bad stories, your you know, your like, your tales of like, Oh, be careful here, you know, like, that kind of stuff Arden has been able to avoid. I just talked to somebody the other day whose kid got an eating disorder because of how a parent pushed a certain eating style on the kid. And I knew not to do that from recording with 50 people who told me about how it worked out for them between that and everything else, from like the first person, like Arden uses a Pedra because a mom with a blog told me to try it 10 years ago. I didn't know about it. Dexcom is the thing I learned about through another person, and I ignored it, and then it came up again in a doctor's visit. But because it came up and I had heard about it before, like, I slowed down enough and heard what they were saying, you know, like, that kind of stuff, trying to make content for you guys helped me. You know, I don't know, like, actually stop and look at data, because I'm not really a data person, like, and that's strange, like, I'm not a sit down like and break the data apart person like, I do it visually with the graphs, but I'm not very good at looking at the numbers and where they are, etc. I'm making in a new series with Kenny. Do you know Kenny Fox, the fox and the loop house episodes? I'm making a new series with him right now, and there's still things that he's explaining, and it sounds like Charlie Brown's teacher to me when he's talking 100% and so I'm just like, I don't know what he's saying. Hopefully someone does. I'm not going to be the one who understands this. I see it a completely different way. But you guys help me with all that, like the conversations and the feedback and, you know, everything, like, even people have been shitty to me, have been helpful to me at some point or another. Like, and not always. Sometimes people are just mean, but sometimes they say something. You're like, oh, that's, you know, it's valid. So it's been a really interesting experience. Can I be honest with you about your note? Yeah, it's too long. I didn't read it. So are we getting are we getting through it? We are. It's all good. Can I ask about glps. Yes, that was the last thing on my list. Don't worry, go for it. When did it come up? When did you start trying? I started

Ellie 52:07
trying almost a year ago. I think it was maybe February. I did not start it while I was still breastfeeding. I waited till I finished, and that was really my time that I wanted to start it, my endo had brought it up as an option to start on. I started with ozempic first, and I'm now on one jar. Oh, it just works for me better, yeah, and I've had a really great experience with it. I mean, some ups and downs, no no real sickness. I've had nausea here and there, but it's been, it's been a big help. In a lot of ways. My basal dropped by 30 units a day. Wow,

Scott Benner 52:55
it's awesome. Did you have weight to lose? Or was that not part of it? It

Ellie 52:59
wasn't the main goal, but it, you know, was a welcome, welcome thing.

Scott Benner 53:04
Everybody over 30 is like, listen, it's cool. I took it, you know what? I mean, it wasn't a problem

Ellie 53:11
that desperately needed, but it was all right, yeah, it's, it's just helped so much. And again, you know, I was mentioning before, like, we, we keep changing in life circumstances, you know? Now I'm I work full time. I have twin, two and a half year old. I'm busy, and so it's between GLP one and loop. I feel like it's that extra help I need in the background. You know, I don't always Pre Bolus. I love to always try. It doesn't always happen, but I'm not having such negative effects when it doesn't happen, yeah.

Scott Benner 53:43
What does that mean? Like, what's your spike? Like, more like, 180

Ellie 53:47
instead of 252 70, yeah,

Scott Benner 53:51
yeah. How about your PCOS? Is it helping with that?

Ellie 53:54
I think so. It's a little hard to tell, but I think overall, in a bunch of different areas. I think it's helped. I think, you know, the weight loss has helped with the PCOS. Because of it, some of my labs have improved. So I think all it's all around been a positive thing for me, being on it.

Scott Benner 54:13
What were your PCOS symptoms? Did you have acne? I did

Ellie 54:17
not. It was really just irregular periods.

Scott Benner 54:22
Were they painful? No, they were just sometimes heavy. Okay, like, heavy, like, did you ever need iron infusion or anything like that? No,

Ellie 54:29
no, thankfully, I didn't, and it's one of those things, like, at the time, I told my doctor about they checked for it and found it. But none of us really know what anybody else is experiencing when you say you have, you know, heavy people, like, what exactly does that look like? But that's what I was saying, and it made sense from the diabetes picture. So that all really helped.

Scott Benner 54:52
Yeah, that's good. I'm glad you got what you needed. It's awesome. How did you get your insurance to cover it? Are you paying cash?

Ellie 54:58
I'm really great. Grateful my insurance is covering it, and knock on wood, I hope they don't dig into it too much. They have not asked. They haven't they just approved it right away.

My doctor keeps saying that too. He's like, this is not going to get covered. This is not going to get covered. I'm like, just, just write it. I already called them and they said it's going to be fine, and it has been. He's like, Well, don't, don't poke around too much, because they haven't noticed that you're type one. I don't know if they haven't noticed or not, but they're covering it.

Scott Benner 55:35
You shut up and do it

Ellie 55:39
on the funny thing about it, it's a really wonky program, and I can't really talk about it on here, but I have to get three months at a time for it to be affordable. It's a special diabetes program within this insurance okay? And so even when I'm testing out a dose, let's say I have to get it three months worth for it to not be like $500 it's $50 for three months. That's awesome. I can't complain. I'm very grateful. Yeah,

Scott Benner 56:08
I pay, I mean, we have good insurance, obviously, but I think I pay the co pay $20 I think I pay for a month. So you're doing better than me, because I'm paying 60 every three months. Close enough? Yeah, no. I mean, let's close enough. I'm over here. I'm looking for that. $10 is what I'm saying. But no, that's awesome, like and you know, people are finding a ton of different ways to get it, and I do think that it's going to get easier over time. The companies want to sell the drug, obviously, right? And there's such a demand for it, I don't see how the insurance companies can Stonewall on that. Ellie, listen, I got up this morning and I I put on jeans and a white t shirt. I would not have worn a white t shirt for money or love prior to me finding a GLP medication. Yeah, oh, I hear you. In a million years, I would not have and I happened to walk past Arden just brought her stuff back from college, and so there's a number of items strewn about my house. Still, if nobody's ever had a kid come home for college, you just they find, like, open space and drop things like mattress pads and ice makers and things like that. Like things they just like, suddenly don't need anymore. And they're like, where did we put this? Is this a good spot? I'm like, in the middle of the floor. No, it's not a good spot. One of the things that's abandoned is like, the back of a door mirror. And I walked past that mirror and I thought, it doesn't look like me. Yeah, and I feel so much better. And it's not just because I lost weight like the DLP is helping me in a this has been Christmas week for us. I have probably, in the last seven days, had more chocolate chip cookies than I've had in the last two years. I've eaten pizza twice. I've had pulled pork at a meal a number of other, you know, things, and my weight hasn't changed in the last seven days, and I have not once found myself in the bathroom talking to Jesus, yeah, that hasn't happened, and none of the terrible things that used to happen to me. So when people ask me, like, what does GLP do for you? Like, I'm like, I don't really know, but my life is better. So exactly

Ellie 58:27
I feel the same way I feel like, and you know, everyone who's been on has talked about the food noise reduction, but when I had heard episodes people talking about that before I started, I thought to myself, like, that's great for them, but that's not gonna be the case for me. And then when I took it, once the noise stops, you don't realize how loud it is until it's gone. How

Scott Benner 58:54
about the fact that I can still taste things, but it doesn't taste like rainbows, sunshine and orgasm all at the same time, like, it just tastes like food, right? Somebody can give me a slice of pizza and I can eat it and go, that was good, and I'm full now. Like, my brain's not yelling, salt, fat, do it again, right? It still tastes like pizza. And then I hear people who are new to GLP, they'll complain about it, like, well, it's ruining food for me. And I'm like, I think you're missing the point of this. You're taking this because you you need it, like, you know, for whatever reason you need it for part of your problem is that that pizza tastes like crack cocaine to you, like, like, that's part of the problem, you know. So take it, you know, food, noise, whatever you want to call

Ellie 59:38
it, right? And I, I'll say for myself, it took a longer time, and I think a lot of people don't give the drugs enough time to adjust in their bodies, like I stuck at the same doses before I went up for longer than that month to adjust to it, to feel good being on the dose and. And for me, that was very helpful. I'm going

Scott Benner 1:00:03
to tell you that I haven't quite found a way to, like, articulate it yet, but I've been thinking about this very same thing, which is, like, people talk about, like, like, I'm not saying if you have like, a real problem, like, if you're one of the people who gets like, you know, blocked intestines or something terrible. Like, I'm not saying, like, power through it. Ellie, are you okay with this conversation? I didn't take a reasonably human looking poop for like, nine months. I did not give a Yeah, I feel better. I don't know what's happening right now, but I figured I, you know, it took 50 years to get here. It isn't going to be like, you know, rainbows and sunshine getting away from it exactly the way the inside of my body adjusted and how whatever horribleness was in my cells was coming out. Like, it wasn't pretty, but I didn't give up on it. I wasn't like, Oh no, this is unpleasant. I'm gonna stop. But I've heard people do that like, Oh, I'm not, you know, like I'm running to the bathroom. I'm like, Well, yeah,

Ellie 1:01:00
right, but give it a little bit of time and see if you get benefit out of it, because if you are feeling better everywhere else, then it's it's worth trying to keep going with it. For me, I was pretty lucky. I mean, I just felt queasy. I mean, it really felt like morning sickness. For months, I'd wake up, I'd feel nauseous and not really want to eat anything, and started eating breakfast way later in the morning. I used to be someone who woke up and needed to eat pretty much right away. That went away. But you know, as I adjusted to different doses, that went away too for the most part, there's still days right after I take it, I get that. It hasn't been too, too rough. It is

Scott Benner 1:01:41
so funny that you bring this up because the other day, like a personal friend of like somebody I know personally, like a person I was in the room with said, you know, I wake up every morning and I feel nauseous, and I'm like, Well, what happens then? Like, well, I get up and I eat and it goes away. And I'm like, Uh huh. I'm not saying people are soft, and I'm certainly but, but if she said, Well, I don't want to feel nauseous, and I'm like, too bad,

Ellie 1:02:05
right? Some things are worth it. When I saw after the first week, I don't remember how much my basal had dropped even after the first week, it was significant, though, I mean, and my resistance, and I'm sure inflammation and all of those things are better being on it, oh, a million

Scott Benner 1:02:23
times. You know, you brought it up earlier about, like, not liking to insert the CGM, right? And we don't talk about it a ton on here, because it it wanes and it ebbs and flows in her life. But at the moment, is very bad. Like Arden has a significant needle phobia. Like a significant needle phobia. It got to the point where she was off at school, not having a good time at school, and, you know, I think, like, stress and was piling up on her. And one of the things that, like, she was just like, I like, her needle phobia got worse, yeah, and she's like, I can't do this. So I'm not sure if I've talked about this on here or not, but for about a month, every Sunday, I drove from New Jersey to Pittsburgh to give Arden, her her GLP medication. I'd get up in the morning, drive six or seven hours, give it to her, spend the hour of like crying and pleading that because she's really scared, and then it stops immediately. Like, if nobody has a needle phobia, like, if you've never really seen a real needle phobia, like, good for you. It's like she's begging for her life. Like, do you know what I mean?

Ellie 1:03:30
Oh, I 100 I have, I mean, I, I've never really called it that, but that's what it is. Yeah, I totally relate to her. She is not alone. And people often think, because we're diabetic, we're not, we don't have an issue with needles, and it doesn't go away. That's

Scott Benner 1:03:45
the dumbest thing I've heard people say. Is like, Oh, she's had diabetes forever. She's not over that yet. I'm like, no, she still has a phobia of needles. Like, you know, like,

Ellie 1:03:54
I don't give myself my GLP one the first time I tried, I tried to give it, and I hit the button, and I didn't know what to expect, because, you know, it's like, spring loaded, or whatever it is, and I jerked back, and it just squirted all over the floor. I was devastated

Scott Benner 1:04:13
for like, that was very expensive. That was very expensive, and

Ellie 1:04:17
I didn't know I had to wait another week, because I wasn't sure if I got any of it, and I was, oh, eyes, not to give. Give it again. It was my very first one, so I didn't want to give

Scott Benner 1:04:28
more than the dose. That's upsetting. It was so frustrating.

Ellie 1:04:32
After that, I was like, I can't do this, honey. You do it.

Scott Benner 1:04:34
To describe it like, if you've ever watched a bad movie where someone's about to execute somebody. And the begging that starts like, that's how she begs, like, no, no, no, wait, wait, wait, wait, I have to say one more thing I have to do. No, no, like that, like that. It's terrible, right? And so it's hard on her. It's hard on my soul, yeah? And you think like, well then Scott, don't do it. Well, you should see the physical health benefit. She's getting from it. It's not a thing she can avoid. But in those last few weeks before she came back from school, I'm gonna stop doing this. And I said, All right, Arden, you know what's gonna happen? It's up to you. Blah, blah, blah. And she stopped, and I stopped driving to Pittsburgh, and, you know, watching the Eagles games on my phone, like, sort of while I was driving. You know what I mean? By the way, I know that's probably not legal, but they're having such a great season, and I'm trying to be a good dad and like, something's got to give somewhere. She stopped, and now she's home. She got home, she was home for three days, and she said, I gotta start taking that job. He again. And I was like, Okay, now, if a person who feels that way about it and is still that young understands the impact it's giving to her, like it's significant, like her acne comes back with a vengeance. Without it, her blood sugars are significantly difficult to deal with. It takes a lot more insulin, everything for her. And I'm not saying it's everybody, but for her, everything is better with it. I hope people find value in it. They're going to be plenty of people, by the way, don't respond to it. It isn't good for them. I'm not saying it's good for everybody, etc, and so on. I mean, if you've had diabetes for a very long time and you have, like, any gastroparesis symptoms, like I would, I would be very, very cautious, like that kind of and that's not coming from an from a study or anything like that. Just seems to make good common sense to me. But for the people, it's going to work for and for the people in the future, I mean, and when they figure out how to put it into a pill form, which I'm pretty sure Novo is working on, right? Novo makes ozempic, is that? Right? Novo makes exempic, I think they're working on a pill form that's going to be more aggressive. Because right now the problem is there are pill form glps, but they just don't work as well as the injectables, right?

Ellie 1:06:45
Yeah, I honestly just wish they would give it in vials and not. Ozempic is a pen, which I preferred to. Benja, Rose spring loaded thing. I wish it was just in a straight up vial. I would much prefer that. Ellie,

Scott Benner 1:06:59
I can tell you how to do that. That's how we do it. For Arden, do you okay? So we go on Amazon. All right, listen to me. First of all, there's a phase one trial for Novo Nordisk experimental obesity drugs, blah, blah, blah, 13% weight loss three months. It's a GLP Lake pill. So they are working on it. You all do not go to Amazon and me up on this. Okay? We go to Amazon and we buy vials. You can get little packs of sterile, brand new medication vials, right? Then we balance the Manjaro pen over top of it, hold it firmly so it doesn't kick out, and then hit and hold the injector. The injector from the benjaro pen goes through the rubber in the vial, and then it's like you're almost like you're milking a snake. And then it just squirts the bonjaro into the vial, then you draw it back out with an insulin needle and put it

Ellie 1:07:55
in. That is brilliant. I'm so glad I mentioned that. Yeah,

Scott Benner 1:07:59
so, and by the way, that's not my idea. It's somebody who told me about it, who learned about it from YouTube. So well, kudos to whoever figured that out. And it allows you to modulate the amount, because the 2.5 of Manjaro is a little too much for Arden, because she's not looking for the satiation part and everything. So we are able to give her a little less also, she does better with the insulin needles than she does with the injector. And for those of you out there, Arden describes being hit with the injector as lightning flying through her leg.

Ellie 1:08:32
It burns, I don't know if she has that too, besides the jolt of you know, the injector kind of launching. For me personally, it burns terribly when it goes in, yeah,

Scott Benner 1:08:44
yeah. She says it feels like lightning. She's not a fan, and worth it. I still have enough fat on my midsection that, like, I can find, like a real, like jelly place and stick it in, and it's, you know, it's not bad. But if that ever goes away, I'm gonna be screwed too, and I'm not going to stop taking it. I just want you all to hear me. I'm going to find a maintenance level of it and stick with it because of just the digestion part. And you guys know I don't have to get, like, iron infusions anymore, because I'm on it. If I eat something that's not slightly from what my body doesn't like, I don't find myself in the bathroom talking to God and promising him things if he'll just let this part stop, which was a pretty big part of my life when I was younger, and not because I was crazy, overeating or anything like that. So my body just didn't do well with a lot of foods that now it it handles just fine. So anyway, good luck to everybody. 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. How about that? Do that off the top my head, like it's nothing, and I haven't said it in a long time. Do you guys know I pre record that stuff and then we drop them in as files.

Ellie 1:09:56
I assumed as much, but you sounded just I wasn't sure there for a second. It. You jumped it in right now.

Scott Benner 1:10:01
So for years and years, I'd say it in every episode. And then one time online, this guy, I said that must have said on the podcast. This guy online goes, Wait, that's not pre recorded. And I went, Wait, he thought it was pre recorded. Why the hell am I not pre recording it then? So I did, I think three slightly different versions of it, and then we just mix and match them as we make the episodes. That's great, all for efficiency. What I'm saying is I can't believe I just said it without thinking, because I haven't said it like I don't know that I've said it in like, a year and a half, actually,

Ellie 1:10:37
that's crazy. Oh, good job. Oh, good this

Scott Benner 1:10:39
is where I get my pats on the head. Just sad. I'm gonna ask you one last question. First of all, I want to make sure, did we go through everything that you wanted to go through? We did. Okay? I'm gonna ask you a question as an adult. Okay, if I were to put effort this year into making content that encapsulates each episode of, like the Pro Tip series, for example. So, like, if you got like a 20 minute talking head episode from me about each episode of The Pro Tip series, but it was also in video on YouTube, do you think that it would reach new people, or am I just a podcaster and that's I'm not going to be able to do that,

Ellie 1:11:18
I think it absolutely would reach new people.

Scott Benner 1:11:23
I really do think I'm going to try. There

Ellie 1:11:25
are some people, and I know you'd still be talking, but that visual component, I think, helps a lot of people process watching something. And I also think that there are people who may not be in the Facebook group and might not be listening to podcasts that would very likely find you through YouTube. I

Scott Benner 1:11:45
want more people to be able to find it, and I want it to be more accessible for non podcast people. So like podcast people don't care. They'll sit and listen for an hour. That's what they do, you know. But for people who have become accustomed to 62nd videos and they think that's content, or people who've been accustomed to YouTube and there has to be visuals with it, or that's not the kind of content that they get served. Even, like, I can't sit down and remake an episode of the podcast, like, visually, like, and we've actually tried before to animate them, oh yeah, people don't respond to that. It doesn't work because I tried, like, I took a couple of, like, defining diabetes episodes and had somebody like Punch and Judy Marionette, like Marionette, like, animate them, just so there'd be video running in front of them. Didn't matter, like, people didn't care. So I'm trying to find a way to find those people, because they're out there and I see them like you. I mean, you talked about coming in through a different pathway, but I get to see how people make it to the Facebook group, and they make it through friends, through other Facebook groups, through Reddit, through their doctor, through a person they bumped into at a store. You got to it through Jenny. And I just think that there's so many more avenues out there, and people that I think would find you know it interesting or valuable, or entertaining or whatever, and try to figure out how to get to them. So anyway, all right, now I need something to sit in front of. It doesn't look like I put too much effort into it, but it looks like I put a little bit of effort into it. Isn't that what a background of a YouTube video is, that's

Ellie 1:13:15
pretty much I mean, you could get some AI generated something there make it a little more exciting.

Scott Benner 1:13:24
Seems like a lot to me. That's my other problem too. Is that like, I'm not like, of that generation like, so like, I'll do it. I'm gonna do it under protest. Anyway, I just wanted to know if you thought, if you thought, what you thought of that. So I appreciate

Ellie 1:13:38
you. Thank you. Think that would help reach another group of people. Thank you. Well, I

Scott Benner 1:13:42
appreciate very much all you sharing this with me and letting me chat extra today and helping me end my 2024 I don't know how many times I recorded this year, but I'm gonna guess it's somewhere along the lines of probably 350 episodes this year, maybe, wow, maybe so, and you guys haven't heard. I had to look, I don't know, but I think I have like, 70 ready to go that are done and edited, and you guys haven't heard yet. And 22 episodes in that folder, two in that one. There are eight and that one, and then over on Rob's server, he has, oh, wow, Rob has been working hard. There's 16 over there that haven't been touched yet. I don't there's like, 50 or 60 that are available right now, that are ready to go. And like I said, I recorded three yesterday. I did you today. We'll do one tomorrow, one the next day, one on Friday the following week, 1235, yeah, five times the next week. I probably record every day. My God, somehow I'm recording three times, two days in three. Oh, my God, on Monday, on Friday. All right, I'll be all right.

Unknown Speaker 1:14:57
That's a lot. It's amazing. I'll be all right. It's. Be

Scott Benner 1:15:00
fine. Thank you for this. Really, it was very nice of you.

Ellie 1:15:03
No, thank you and Happy New Year to everyone for whenever you're listening to this. Yeah, they're gonna be listening in July. But that's nice. That's fine. It should be happy then too. Yeah, I hope

Scott Benner 1:15:13
your New Year's going well, hold on one second for me. Okay. Okay. You a huge thanks to Omnipod, not just my longest sponsor, but my first one, omnipod.com/juice box. If you love the podcast and you love two plus insulin pumps, this link is for you. Omnipod.com/juice box, us. Med, sponsored this episode of the juice box podcast. Check them out at us. Med.com/juice, box, or by calling 888-721-1514, get your free benefits check and get started today with us. Med, this episode was sponsored by touched by type one. I want you to go find them on Facebook, Instagram and give them a follow, and then head to touched by type one.org where you're going to learn all about their programs and resources for people with type one diabetes. Hey, thanks for listening all the way to the end. I really appreciate your loyalty and listenership. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. If you're looking for community around type one diabetes, check out the Juicebox Podcast. Private Facebook group Juicebox Podcast, type one diabetes, but everybody is welcome. Type one, type two, gestational loved ones. It doesn't matter to me, if you're impacted by diabetes and you're looking for support, comfort or community, check out Juicebox Podcast, type one diabetes on Facebook. The episode you just heard was professionally edited by wrong way recording, wrong way recording.com, you.

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Scott Benner 4/14/25 Scott Benner 4/14/25

#1492 Where Is Soho?

Ruby, a 28-year-old Welsh voice and theater actor, overcame T1D anxiety; now she advocates on TikTok with her Medtronic pump.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Welcome back, friends. You are listening to the Juicebox Podcast.

Ruby 0:14
Hi, I'm Ruby Valentino. I'm from South Wales. I'm an actor and a singer, and I've had type one diabetes for four years,

Scott Benner 0:22
nothing you hear on the Juicebox Podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan. AG, one is offering my listeners a free $76 gift. When you sign up, you'll get a welcome kit, a bottle of d3, k2, and five free travel packs in your first box, so make sure you check out drink AG, one.com/juice box. To get this offer, don't forget to save 40% off of your entire order at cozy earth.com. All you have to do is use the offer code juice box at checkout. That's Juicebox at checkout to save 40% at cozy earth.com Are you an adult living with type one or the caregiver of someone who is? If you are, I'd love it if you would go to T 1d, exchange.org/juicebox and take the survey. So if you'd like to help with type one research, but don't have time to go to a doctor or an investigation and you want to do something right there from your sofa. This is the way t 1d exchange.org/juice box. It should not take you more than about 10 minutes. This episode of The Juicebox Podcast is sponsored by the twist A I D system powered by tide pool that features the twist loop algorithm, which you can target to a glucose level as low as 87 Learn more at twist.com/juice. Box. That's twist with two eyes.com/juice. Box. Get precision insulin delivery with a target range that you choose at twist.com/juice, box that's t, w, i, i s t.com/juice. Box. Today's episode of the juice box podcast is sponsored by the contour next gen blood glucose meter. This is the meter that my daughter has on her person right now. It is incredibly accurate. And waiting for you at contour, next.com/juice box. The episode you're listening to is sponsored by us. Med, us. Med.com/juice, box, or call 888-721-1514, you can get your diabetes testing supplies the same way we do from us. Med,

Ruby 2:36
Hi, I'm Ruby Valentino. I'm from South Wales. I'm an actor and a singer, and I've had type one diabetes for four years. Four years. How old were you when

Scott Benner 2:45
you were diagnosed? Let me do that again. It's not been four years. Wait, what it has

Ruby 2:53
14 years. Oh,

Scott Benner 2:54
because Ruby, that's totally staying in just so you know. So how old were you when you were diagnosed?

Ruby 3:00
Nerves. Um, I was 13, so you're 27 Yeah, no, I'm 28 but I was like, a couple of weeks before my 14th birthday.

Scott Benner 3:10
Oh, I see. Okay, wow, all right, so 1314, years old, you've had it half your like, half your life, yeah, it's been diabetes, and half it hasn't been. It's weird thinking of it like that. Have you thought of it like that in the past?

Ruby 3:24
No, now I have. I've seen other people say, Oh, I've had it half my life, and I was, I've been like, wow, that's a long time, and now I'm at that stage. I've just realized that change.

Scott Benner 3:32
No kidding, how did you learn of diabetes? Like, did you get very sick? Did somebody in your family sniff it out? Or what happened?

Ruby 3:39
Yeah, my mum. So I lost a lot of weight, and kids in school were kind of bullying me, saying I had a Ed and saying that looked very skinny, but I was eating so much I was healthy. So my mum was like, oh, there's something wrong with her. So she spoke to somebody in her class, she's a potter, and they said, that sounds like type one diabetes. Does she going to toilet a lot? And my mum was like, yes. And so she got a home testing kit from boots, which is a pharmacy in the UK. She spent a bit of money on it. It was expensive, and it came back saying, hi, hi. So she called 111, and they were like, get her in immediately. It was a quick turnaround, and I got diagnosed with type one diabetes pretty much on the spot that

Scott Benner 4:24
quick. So your mom chatted with some people. Somebody said it sounded like diabetes test kit. You're diagnosed. Is there any type one in your extended family? No,

Ruby 4:33
no. My nan and grandad had type two as they got older, but no type ones. What about your family? Because I know your your daughter's got it right,

Scott Benner 4:41
she does. So my daughter has type one. She was diagnosed when she was two. She's 20. Now. I'm adopted, so I'm as far as I know, on my side, on my wife's side, there's a lot of autoimmune stuff, like sprinkled around people like, like celiac or Crohn's. There's. Some anxiety, there's some depression with people. There's a there's a person farther out that might have Bipolar, like, there's stuff like that that's like, auto immune or auto immune adjacent. My wife has hypothyroidism. Both of my kids do as well, interestingly enough, like some of the problems people have with PCOS, like that kind of stuff that seems to travel through some of the women on my wife's side too.

Ruby 5:24
Yeah, it can be interlinked, right? Sometimes celiacs have type one and things like that. So it could be something there. Now

Scott Benner 5:32
I think so I talk to a lot of people Ruby, and I ask everybody the same question about their extended family, and often they find sometimes people say, Oh, no, there's nothing. I think you'll chat with them for a while, and they'll say, oh my. My uncle has Viti Lago, for example. And I'll be like, Well, that's an autoimmune issue. And they go, oh. And then as they start to really, like, think about it, they find more and more.

Ruby 5:53
Yeah. No, nothing. I had chicken pox when I was young. My mom thinks that could be something, but we've all had chicken did you have it right before your diagnosis? No, no. I was like two normal age. Oh, but I think I had it quite bad. I don't know. There are other means that people think you can get it from too, like you can get it from trauma. Apparently, don't take my word for that. I heard that.

Scott Benner 6:13
No, I've heard people talk about that too, like a giant shock to the system. Kind of throws your immune system into overdrive. Yeah, listen, you're never gonna really know. I have a question, though, before we move on. Did you say your mom was a booter? And what the hell does that mean?

Ruby 6:27
A Potter, pottery? Oh, a potter, a booter.

Scott Benner 6:33
Oh, no, Potter. I'm sorry.

Ruby 6:36
Language barrier, accent. Barry, so we're gonna get over it. She,

Scott Benner 6:38
like, does that professionally, or she just does that, like, as a hobby. She's

Ruby 6:42
a ceramic artist, so she makes her own things and sells them, and then she teaches as well on the side.

Scott Benner 6:47
That's awesome. Very cool. Yeah, all right, so you're diagnosed, they take you to do you guys say to hospital? I don't say the in front of hospital, right?

Ruby 6:55
Some northerners do, I think. But yeah, the hospital, I say?

Scott Benner 7:01
You do say the hospital. You don't say hospital. Look at you. You and I are going to get along much better. What's it like being diagnosed? Do you begin to take over, like your management? Do you do it with your parents? Your mom? How does that work? When

Ruby 7:15
I was first diagnosed? Yeah, my mom went a bit mad and tried freighters to cure me the most loving way possible. We were trying cinnamon. I tried Reiki at one point, obviously she was making sure I was doing my insulin and doing it properly. But in the meantime, she was trying to find a cure and reading things online. But obviously there is no cure type one. Wait. So we went down. Hold

Scott Benner 7:38
on a second. Like she actually said, like, we're gonna go to our Reiki healer. Yeah,

Ruby 7:43
and you know what, my blood was amazing. It dropped.

Scott Benner 7:50
I was hypo. Probably you get super relaxed, don't you think? Yeah, there's

Ruby 7:54
something, something good, I mean, but I don't think it was type one, but it was definitely good for

Scott Benner 7:59
my levels that's awesome. Is your mom, what we would call a hippie. She was a punk back

Ruby 8:04
in the day. I guess she's very artistic, so maybe I

Scott Benner 8:08
unfairly know that your father was in a band. Is that right? Yeah, yeah. Okay, so I'm imagining your parents correctly, then, is that what you're saying?

Ruby 8:17
Probably, yeah, we're quite out there. Do

Scott Benner 8:22
you have other brothers and sisters?

Ruby 8:23
Yeah, I've got a sister. She lives in Sydney, and she's getting married next year, which is exciting. Congratulations. Yeah, really excited. Are you going, yeah? Well, you know what, it's in the bush. Have you ever seen I'm a celeb. Get me out of here. Yeah. So I'm terrified, because I'm a city girl. I'm obviously going to go and love it, but we have to camp for like, three days, so I'm going to be terrified, because I hate insects and I hate bugs, and I'm not looking forward to the insect side of it. Which one

Scott Benner 8:53
of your irrational fears has the hold of you? Do you think there's going to be a snake in the toilet or a spider or what is it you're worried about? You've probably heard me talk about us Med and how simple it is to reorder with us med using their email system. But did you know that if you don't see the email and you're set up for this, you have to set it up. They don't just randomly call you, but I'm set up to be called if I don't respond to the email, because I don't trust myself 100% so one time I didn't respond to the email, and the phone rings the house. It's like, ring. You know how it works? And I picked it up. I was like, hello, and it was just the recording was like, us, med doesn't actually sound like that, but you know what I'm saying. It said, Hey, you're I don't remember exactly what it says, but it's basically like, Hey, your order's ready. You want us to send it, push this button if you want us to send it, or if you'd like to wait, I think it lets you put it off, like a couple of weeks, or push this button for that, that's pretty much it. I push the button to send it and a few days later, box right at my door. That's it us. Med.com/juice, box, or call 888-721-1514, get your free benefits checked now and get started with us. Med. Dexcom, Omnipod, tandem freestyle, they've got all your favorites, even that new islet pump. Check them out now at usmed.com/juice, box, or by calling 888-721-1514, there are links in the show notes of your podcast player and links at Juicebox podcast.com, to us, med and all of the sponsors. The contour next gen blood glucose meter is sponsoring this episode of The Juicebox Podcast, and it's entirely possible that it is less expensive in cash than you're paying right now for your meter through your insurance company. That's right, if you go to my link, contour next.com/juicebox you're going to find links to Walmart, Amazon, Walgreens, CVS, Rite, aid, Kroger and Meyer. You could be paying more right now through your insurance for your test strips in meter than you would pay through my link for the contour next gen and contour next test trips in cash. What am I saying? My link may be cheaper out of your pocket than you're paying right now, even with your insurance. And I don't know what meter you have right now. I can't say that, but what I can say for sure is that the contour next gen meter is accurate. It is reliable, and it is the meter that we've been using for years. Contour next.com/juice box. And if you already have a contour meter and you're buying test strips, doing so through the Juicebox Podcast link will help to support the show. The brand new twist insulin pump offers peace of mind with unmatched personalization and allows you to target a glucose level as low as 87 there are more reasons why you might be interested in checking out twist, but just in case, that one got you twist.com/juicebox, that's twist with two eyes.com/juice. Box, you can target glucose levels between 87 and 180 it's completely up to you. In addition to precision insulin delivery that's made possible by twist design, twist also offers you the ability to edit your carb entries even after you've Bolus. This gives the twist loop algorithm the best information to make its decisions with, and the twist loop algorithm lives on the pump, so you don't have to stay next to your phone for it to do its job. Twist is coming very soon. So if you'd like to learn more or get on the wait list, go to twist.com/juice. Box. That's twist with two eyes.com/juice. Box. Links in the show notes. Links at Juicebox podcast.com. Rats. I hate Rats. Rats is your concern? That's awesome. Yeah, I

Ruby 12:44
love animals, and I think every animal has the right to live. And, you know, I try and be as meat free as I can, but I just don't want to see a rat.

Scott Benner 12:51
Hey, listen, I'm with you. I interview a lot of people from all around the world, and I'm constantly asking people in Australia. I'm like, There's snakes and spiders and like, yeah. Some people act like, Oh no, no, no. But then once in a while, you'll get them to tell a story of, like, no kidding, like, the time they sat down on the toilet and there was a snake in the toilet or something. Yeah, I'm telling you, look in the toilet before you use it in. Haven't got anything

Ruby 13:15
like that here, hopefully. I mean, today I've seen a tick tock video of a rock coming out of the toilet in New York, and I was like, Okay, I'm never

Scott Benner 13:22
going our rats over here on the East Coast are pretty, uh, stout, I would say, All right, so you have a sister, she doesn't have type one or anything else, right? No, no, okay. What's your management like when you first start out that they give you just like needles and vials. Do you get pens? How does it work? I

Ruby 13:39
was on Nova rapid pens. And I did that for 13 years with a blood kit, the old fashioned blood kit. And then I didn't switch to a CGM until 2017 which was the Libra, yep, and it was good, but I was very self conscious of the Libra at first, because I wanted to hide my type one and, you know, not speaking for you, but probably your daughter did too, right? Because I feel like I feel like a lot of young girls are a bit self conscious

Scott Benner 14:05
of it. She was so young Ruby, I don't think she she didn't know any better. She doesn't think about diabetes that

Ruby 14:10
way. Yeah, amazing. That's good. I get so many people on my content, on my videos, saying, oh, you know, I'm embarrassed. I take it off and I pretend I don't have it. And I think now I don't think like that at all. I think maybe because I was diagnosed as a teenager when I started to go out, that's why I was trying to hide it. Maybe, yeah, so I was embarrassed to wear the Libra at first, and nowadays you get all sorts of influences choosing to wear them. It's cool. Yeah.

Scott Benner 14:38
Does that even help you as an adult? Does it make you feel more comfortable when you see other people

Ruby 14:42
doing it? Oh, yeah, absolutely. And I love wearing it now. I'm really proud to be a type one diabetic, because it makes you you, and it makes you unique, and gives you a sort of strength, an image of strength. What do you do professionally? Tell people I'm an actor. I do a lot of. Voiceover acting. I did Macbeth last year on tour, which was fun across the UK, and just in a radio play,

Scott Benner 15:08
I keep thinking, I want somebody to come get me for a voiceover. I don't know why they want. I have a lovely speaking voice. You do, yeah, and it's not never does someone come. Like one time I got teased. I'm not calling the guy out, but I had the creator of a like, a Netflix cartoon on last year, and his daughter has type one. His daughter, by the way, it's the weirdest story. My daughter's name is kind of different. It's Arden, and there's not a lot of Arden's, and there's not a lot of people in the world with type one diabetes. And this guy, who I really did enjoy, his daughter's name is Arden, and she has type one. It was crazy. Oh, my goodness, yeah. But anyway, he's like, I'm gonna come get you for season two. And then he didn't call. I

Ruby 15:46
just want to say it's okay. What about me? Yeah.

Scott Benner 15:49
Oh, trust me, Ruby, if he would have known about you, you'd be in the fairy show. For sure, you would be, as a matter of fact, I probably just got you a job in season three of fairies. But not me, is what I was saying. One day, one day, he did hire a number of type one actors.

Ruby 16:03
Oh, I love that. Well, they've got that type one diabetic film coming out, right?

Scott Benner 16:07
Yeah, Kelly, what's Kelly's last name? Damn you know, I don't It's okay. She, yeah, she's a type one. And I think she wrote it and is directing it. Kelly, bacon, you got it right, damn it. Kelly, hold on a second. I'm sorry. I know she listens, and now I feel bad. How does diabetes intersect with working is what I was wondering. This

Ruby 16:28
is what I'm a little bit stressed about with my pump. So when I did my first film two, three years ago, actually, sorry, let me backtrack when I did a film 10 years ago, say when I was a child actress. It didn't affect it. Obviously, I had to check in between cakes and things like that, because I was on insulin pens three years ago when I did a new film, I was on the Libra. So they were very, very supportive. And I said, Oh, my Libras on show, is that okay? And they're like, yeah, why not? Why wouldn't she have type one diabetes? And they were, they were amazing in costume, nice, but, but now I'm on the insulin pump. I'm I'm not, I'm not filming anything as of yet in the pipeline, but I'm slightly stressed because I'm like, is that going to interfere with wires and things like that? So I'm hoping it. I mean, there are loads of actors with type one, with insulin pump, so I'm hoping it doesn't, yeah.

Scott Benner 17:17
I mean, I would imagine they could hide it if they wanted to. I would think you'd be more worried about alarms than anything else. Oh, yeah, I turned this off. Yeah. By the way, Kelly's last name is Bascom. It's, I think we both had a little bit of it. It's B, A, S, C, O, N, I'm thinking of Kevin Bacon. It's awesome. If we had time, we could see how many degrees of Kevin Bacon. Kelly is from Kevin Bacon. But her film, it's a feature film. She's the writer and actor in it. It's called quarter amazing. I don't know when it's coming out, but I hope she comes on to talk about it when it does.

Ruby 17:47
Yes, that. I literally can't wait for that. I'm so grateful that they're making it, and they've made it, and it sounds amazing, and they've got type one diabetic actors in it, obviously, Kelly and Brooke Shields, his daughter. Oh, is she in it as well? That's awesome. Yeah, she's a type one

Scott Benner 18:02
there. Yeah, she is, um, who else? Who's the models? There's a model, Kate Moss, her daughter. Yeah, right. There's a lot out there. Even now, when you go online and go clothes shopping and there's models, there's a lot of models wearing diabetes devices. Now, I've

Ruby 18:15
not seen that here yet. No, we have stoma bags and things and things that are represented on telly and modeling shoots, which is so amazing, but I've not seen any type one diabetic representation in our media yet in the UK, except for adverts, advertising Libra, obviously. Yeah,

Scott Benner 18:31
right, right. How about dating with type one? What is that like? I've

Ruby 18:35
got a partner now, but before I just hid it, I'll be honest, it was awful. And I did a video quite recently on Tiktok. Reason number 942, to tell people that you're on a date with that you've got type one. I went on a date, and I didn't tell him, and I was injecting under the table, and he saw it, and he was like, what's that? And I was like, it's a pen. It's a pen. And then my blood went super low, and I didn't tell him, so I was just scoffing a bag of Harry bows after a three course meal. And he was like, Are you hungry still? And I was like,

Scott Benner 19:06
yeah. He's like, I can't afford. I don't think I'm gonna be able to afford this girl.

Ruby 19:12
So I would definitely recommend telling people. When I first got with my partner, he cracked a diabetes joke when I told him, I went, Oh, yeah, I've got type in diabetes. And he said, he said something like, diabetes, you know that American meme, that man. And I was like, it's actually really serious. And I scared him. Then

Scott Benner 19:29
he hung around while you were you pressured him lecturing. He did a Wilford Brimley impression. Is that who that guy is? Yes, yeah, it's awesome that you know of him, but not who he is.

Ruby 19:41
No, I've just seen his face, diabetes,

Scott Benner 19:44
diabetes. It's actually like kind of a southern thing in America. So it's, yeah, I've had a doctor on this year who was just brilliant with his understanding of, like, GLP medications, for example, and I had him on to talk about it. But when he's an older. Gentleman. He's from Texas, and he says diabetes. He just, that's how he says it. I love

Ruby 20:05
that accent so much. It sounds so nice. Makes me want to buy something. I'm like, Are you selling me diabetes?

Scott Benner 20:11
I'll take three, please, and

Ruby 20:15
such a nice accent. So dating with

Scott Benner 20:17
it, you just, can I ask? Can I dig a little deeper there? Yeah, did that cause trouble with you trying to form bonds with people, because you were always hiding something,

Ruby 20:26
not really. I did eventually tell them if we became an item, but never told them on dates and things like that. But I do think is important, especially if you're going out drinking and things like that. If anything bad happens, they need to know,

Scott Benner 20:36
yeah, what's your plan when you drink? How do you handle it? I'm

Ruby 20:40
going out tonight, actually, so I'm glad that this isn't a filmed one, because I have my hair in rollers. So we're going to go out, and I just make sure I eat when I come back. Just check your levels. I'd rather be a little bit higher going to bed, not high. But you know, around 10, which for you is, what's that? 200

Scott Benner 20:59
is liquor easier than beer? Are there easier ways to handle things?

Ruby 21:04
I like wine because wine doesn't have many carbs in but I didn't even think about this until quite recently. But when you have beer, or, you know, like record big, do you have that there? It's like, fruity ciders and things like that, yeah,

Scott Benner 21:17
but I don't What did you call it record lake? I definitely don't know that word, but go ahead, yeah,

Ruby 21:22
yeah. They're really nice, but they're full of sugar. And for years, I used to drink that and be like, Why is my blood high? And that's why, see, obviously, you can drink what you like and eat what you like as long as you dose for it, but it's just easier for me to have a little bit of wine. Yeah.

Scott Benner 21:35
Do you have any other autoimmune issues? No, I wasn't sure if you're gonna say Not yet. No, don't see that judgment. Did they test your like, thyroid levels there yearly and things like that.

Ruby 21:45
No. I mean, I think my mom's got a thy Well, she did have a thyroid issue. I'm not sure, overactive. I think she said

Scott Benner 21:53
no. So your mom might have an autoimmune issue. Maybe see how it works. Ruby, we talk for a while, and then the next thing you know, you're like, my uncle has type one diabetes. I forgot. I

Ruby 22:02
mean, I don't think I have I should probably get tested. I mean, I'm allergic to oysters, and I have a lot of allergies. I

Scott Benner 22:07
think of allergies as your immune system being overactive. You know what I mean? Yeah, I mean, nobody's gonna call an allergy auto immune. But I mean, it's your immune system being overactive and coming after your body. I don't know, sounds like your immune system not doing what it should be doing. No. It's awesome that I asked you earlier if anybody in your extended family had it, and I explained to you that people often will say no and then be I did exactly that, and that you still told me the truth 15 minutes later. I thought that was really nice, because that would have been a perfect time to lie,

Ruby 22:39
by the way. I mean, my mom has anemia. She's anemic as well. I don't know if that's one as well. That an autoimmune? Well,

Scott Benner 22:46
it's not autoimmune, but it runs pretty heavily through this community, right? Yeah, a lot of anemia. Do you have any trouble like digesting food, bread? Yeah. Do you think you have celiac or no, I've been wheat

Ruby 23:01
free for I'm wheat free a lot. Sometimes I'm not, but I'm I'm careful, because I just have trouble digesting it. I don't think I'm allergic

Scott Benner 23:09
interesting. I ask because it's another thing that your pancreas is involved in that sometimes goes kind of caplu. For people with type one is just digestion. So a lot of people find themselves taking, like, a little digestive enzyme with some, like, more difficult foods, and it seems to help them. I feel like we could pick around that I could find out a lot about you that you don't know. Yeah, how did you end up here? Did I reach out to you? Did you reach out to me? I

Ruby 23:32
reached out to you a year ago. I've been waiting every day

Scott Benner 23:36
I got right on it. Ruby, here's the good news, though, and let me be like, incredibly Frank, you have a really nice following on Tiktok, so I'm going to put your episode out really quick. I had

Ruby 23:48
to message you recently because I was like, what is the date we have? Because I cannot remember,

Scott Benner 23:52
yeah, because you were afraid they might cure diabetes before we got to do the podcast. Yeah. And then there's no point. Usually, people are six months out to record, and then six months out to get their episode up. It usually takes a year from the email, but I am putting yourself in a couple of weeks you reached out. Because why forget me for a second in the podcast? Like, when you're interacting with people through social media with type one diabetes, like, what is that like for you? Like, what do you get out of it? What do you think they get out of it. That's

Ruby 24:20
a good question. I think, like, we have very different views. You're so far away from each other in the world. Yeah, we agree on so much, and we relate so much, especially me, with your daughter as well. So we have so many similarities, but also we probably have dissimilarities. Might disagree on some things, but I reached out to you because I thought you were the best diabetic podcast I could find, and I thought you were great You were great.

Scott Benner 24:43
Oh, thank you. You just wanted to come out and say, Hey, I just wanted to join Yeah, that's awesome. No, thank you. I wondered, like, because you talked about, like, having interactions with people online about diabetes, and I get what they get from you. You're a public figure, and Ruby, I might be three times your age, so just. Make this with where I mean it from, please. But like, You're a very attractive girl, right? Like, do you think that people look at you and think, role model? Do you think they think I'd like to, like, look at her, she looks like she's killing it. Like, oh, are you killing it? Like, you

Ruby 25:16
know what I mean? Oh, God. I wanted to make content a year ago, and I thought, well, what am I going to do it on there was over a year ago. I thought, why don't I try diabetes? I never speak about it. So I started doing it, and I just started doing relatable things. And then I grew a following, and I was like, Okay, there's loads of us out there. This is amazing. Mainly, I get a lot from other people. I've never felt less alone in my life with type one diabetes. My Health's the best it's ever been. I reverse diabetic retinopathy because I started to look after my health more, and my eyes awesome. My HPA 1c went to the best it's ever been. I've made so many friends, so many opportunities. This year alone, I went to Madrid and Florence because of diabetes, and I've got so much from it in return. And I think doing something good, like, I'm a very positive person on Tik Tok, and I don't want to talk about the negatives. Obviously, there's so many, you know, diabetes is rubbish. There are so many, you know, ups we can get from it too. Like, you know, you can go on your phone in class, you can eat sweets when you can bring in food to concerts when other people can't. You've got to look at the positives. I just did a video quite recently, and I think type one diabetes are some of the most empathetic, strong people in the world. They go through so much on a daily basis, and I love that we're so supportive in the community. Yeah.

Scott Benner 26:32
So even though you've had type one for 14 years, like this experience of going out online and meeting other people, it's been kind of transformative for you, and by the way, I would say, not dissimilar to what other people find like. I think a lot of people use the podcast for community. I have a private Facebook group that has, I think, like, 57,000 people in it. Now you can see that, well, I can see that community and support is maybe more important even them learning how to manage their insulin better, but that when you're connected to diabetes and other people with type one so frequently, I think the outcome you had where your a 1c got better. I'm sure your time and range got better, and everything else. Oh yeah, yeah, those things come from being aware, you know what I mean, and having the the community keeps you aware in a way that doesn't make you feel like you're just staring at your meter. Does that make sense? Absolutely,

Ruby 27:30
because in my everyday life, there are no diabetes in my day to day life that I see, and no so online. That's why social media is so great in so many ways. Obviously, there are negatives to it, but it's so great if you use it, right? No,

Scott Benner 27:43
I I'm old Ruby. Like, I'm not lying. I'm like, 53 and so somebody said to me recently, like, you're an influencer. And I was like, That's ridiculous, yeah, law the land, you know, letter of the word like you are. And I was like, I don't see it that way. I'm like, I just talk about diabetes with people, and I put their conversations out in the world, and then the person's like, Well, yeah, and then those people write to you and say that they did better, or that they found community, or that they're happier, like you influenced that in their lives. I don't like the word because of the connotation it has when it started for me, but I don't know that it's the same connotation today. And like, it's interesting that, to me, that you were just like, I'm gonna do what, you know, people put content out in the world. I'm gonna do that. But like, what am I gonna do? And then you found a world that I've known about, you know, my daughter's had diabetes for 18 years. I've been writing a blog for 17 years, like, about type one. And you just were like, oh, there's this whole thing out here. I didn't know about, Yeah,

Ruby 28:39
it's awesome. I never, I never searched it on, on tick tock, and I was on tick tock for years, and I loved it, Yeah, isn't that

Scott Benner 28:45
great? And then just all of a sudden you're just like, Oh, I'll look into this and look at, look at all it brought to you. Now, do you think you're bringing that to the people who are are following you? Hopefully, yeah, I think you probably are. I would guess that, from my experience, that that's what happens, is that now suddenly somebody, through you can find that same feeling of community and be more connected to their diabetes and hopefully have better outcomes in the long run as well.

Ruby 29:10
Yeah, yeah, absolutely. And if I hadn't have searched it, I wouldn't have come across, you know, my my online diabetic friends like Ryan, who you interviewed on here. Yeah, you

Scott Benner 29:21
can understand Ryan when he's talking like, like you're laughing, you're sometimes okay, because, like, what's the movie where the guy from The Walking Dead tells the girl he loves her with the cards? Love? Actually, yes, talking to you is just love. Actually, I can follow you, no problem, Ryan. I had both my hands on the desk, and I was staring at a spot on the desk, just listening to every sound so that I could keep up with him. And it might have taken me like, 15 minutes speaking with him before I was like, I hear him now I know.

Ruby 29:52
Yeah, he's got a strong accent in me. Yeah.

Scott Benner 29:53
Well, that's one way to say it. I guess mostly people who come on here from. The UK end up sounding like Adele, and then they take that as like an insult. If you tell them, why is that? I

Ruby 30:06
don't know she's from London, right? I don't know Ruby you lived or don't talk like that, though. No, yeah. Oh,

Scott Benner 30:13
so there's more that. Oh, I see you can do it if you need to. I

Ruby 30:16
gotcha. What do you what do you think I sound like? Do you think I sound like Adele? No, you sound

Scott Benner 30:19
you sound like that little, skinny girl from the pirate movie, Keira

Ruby 30:22
Knightley, yes, I've been told that I'm from Wales, so I'm from I should be really relish like that, but I lost my accent because I went to drama

Scott Benner 30:32
school. Oh my gosh. That was like, is that was awesome? Yeah, it turned into a leprechaun from a bad cartoon all of a sudden.

Ruby 30:40
Oh, I missed my accent. And when I go back, they're all like, oh, you sound English.

Scott Benner 30:43
That's crazy. So where were you born?

Ruby 30:46
Wales. I'm born and bred, and I should be, I should be Welsh, and I have still got the accent, but I've it's been melted a little bit because I've lived in England for so long.

Scott Benner 30:55
I have to tell you, if that's your lineage, I think if you dig around in your background a little more, you're going to find a lot more. Autoimmune stuff. I'm serious, if you don't find at least, like, Crohn's or colitis, I'd be stunned.

Ruby 31:08
I don't think there's anything like that. What's colitis? Like, you know, like your belly

Scott Benner 31:13
gets upset after you eat and stuff like that. Oh, right, yeah. And it comes out not pleasantly. You understand. I can't wait for you to, like, go home for like, Christmas and start asking people like, Hey, does anybody have anything going on? Because people like, look you, you tried to hide it a little bit like people hide things. Yeah, you know, yeah. All right. Okay, listen, what should we actually be talking about instead of this bullshit that I'm like, digging around in your life? What did you want to talk about when you came on? Just everything. Yeah, you're right with this. There's five. You're good. Okay, so you mentioned in your notes a little bit about stigma, like, what have you interacted with daily?

Ruby 31:47
I get comments saying, just reverse it really daily.

Scott Benner 31:54
That's from your mom.

Ruby 31:57
Try some cinnamon, and I'm like, one. How thick Do you think I am? If it was just cinnamon or, you know, eating less sweets, I think I would have just done it. But how? I mean, a hell of a lot easier. So

Scott Benner 32:09
you interact with a lot of people every day who think that you have made a lifestyle choice or aren't doing something that caused you to have diabetes. I

Ruby 32:17
get so many trolls. I get so many amazing, lovely people, and you can have 100 nice comments, but when you get one horrible comment, it sticks with you. And I get so many. I don't know why people are so like, upset when you talk about type one diabetes online, and if you look at the top performing videos on Instagram and Tiktok about type one comments are vile. Top comments are vile. I don't know what on earth going on, if you

Scott Benner 32:40
want. When we're done, I can read you some of the worst reviews I've ever gotten. Yeah, listen, Ruby, between me and you, you can't let them stick to you. It just like, first of all, you shouldn't read them. Yeah, you should do a thing that they call post and ghost, but it's difficult to do. There's different kinds of famous people. There are people who are not really famous, but they have a relationship with the people who follow them, and you have to go back and forth, like, that's part of the agreement, really, you know what I mean. And so you can't do that. But when you read and you're like, oh god, that's horrifying. I mean, I know how you feel. Like my best example is that in I think 2013 I wrote a book, and it went out for professional review, and like, the first seven professional reviews that came back were really good. And because of that, I was, like, rolling. I was like, This is it. I'm a genius. Everyone loves it. Like, you know what I mean? Like, then a bad review came the way I joke about it is, like he didn't just dislike me, he hated people who loved me. He hated letters for existing so that I could turn them into words. Like, you know what I mean? Like, he really didn't like that book, and I have to admit, like, it rolled me up, yeah, like, for a week, I was like, whoa. Why does this person hate me so much? But I've learned to get past that, and so I don't feel that way anymore. And there's still people who listen to the podcast and are like, I'll tell you my top ones, right? Yeah, there's a very small sliver of a group of people who eat a certain way, and they hate my guts, vegans. Well, no, they're like, low carb, like, very low carb pain, right? Yes, by the way, I also have interacted with a ton of people who eat that way, who are lovely, but just like the rest of the world, like, there's a side of that side, and I am the devil to them. I push insulin on people and, you know, I don't care about people's health. And I say things that they're like, you know, you can eat whatever you want. And like, of course, I don't think you could eat whatever you want. I think that, you know, if you want to be healthy, there's healthy ways to eat. But what I also think is that if you're not aware of that, if you're not a person who understands like the nutrition that they're taking in, and you have type one diabetes, you shouldn't get poor nutrition and bad blood sugars like you should at least understand how your insulin works so you can manage your blood sugars that and then hope. Fully. You know, along your life, you'll figure out how to eat in a healthier way. But I don't feel like that's a thing I can make somebody do, yeah, yeah. So those people definitely don't like

Ruby 35:10
me. I did keto for about a month, and my blood was amazing, but I found it very hard to keep up, especially when I was a teenager.

Scott Benner 35:18
Did you get angry with me, like, three

Ruby 35:19
weeks into it. Yeah, that was me. Sorry.

Scott Benner 35:22
He's like, Listen, you idiot. I got one last night. It was horrifying from a from a low car person, but what I did was I blocked them. I was just like, you don't exist anymore, and then they can go hate me somewhere else. That's fine. Were they type

Ruby 35:39
two or type one one, right? Because I, I went to a Daphne course, which is basically diabetic health and and the nurses told me that it's really bad for type ones to be keto. And I always thought it was the opposite. I always thought that it was great for type ones to be keto, because I know an Olympian that is keto, and she's had, like, amazing levels her whole life.

Scott Benner 35:57
Yeah, I don't think that. I think, I guess, low car people would be stunned to hear me say this, but I believe the thing that they throw around in your face online, which is, you know, the fewer carbs you eat, the less insulin you're going to use. The less insulin you use, the lower chance you have of a, you know, having too much insulin on board. Local that's where

Ruby 36:14
the nurses are saying that's really bad for you, because they're saying that that could lead to ketoacidosis. I don't know if this is true. This isn't my words. This is what the nurse said, because you don't get ketones from high blood, you get ketones from the lack of insulin. So

Scott Benner 36:27
I would tell you that's 100% true. If you don't have enough insulin, you're going to get ketones. But I think there can also be confusion between the ketones that come from like starvation, which are not the same as not having insulin, and a lot of people, well, not a lot of people, but many people who are low carb are still utilizing old, like, types of insulin that kind of stay in your system, in the background, and right? And I think again, low carb people who hate me would be stunned to know that I think what they do is cool, and, yeah, that it works for them. Like, I just don't think you should be running around yelling at everyone who doesn't do what you do. That's all, yeah,

Ruby 37:03
especially when there's little kids out there, if they want to have an ice cream, they can have an ice cream. Well,

Scott Benner 37:07
I mean, it's up to them and their parents, that's for sure. Not a guy online who gets to yell at them about it for some reason and call me a bad guy in between, I've had it happen. What I've learned, and I hope you take from this conversation is that I also see all the people who are helped by the thing that I make and I focus on them. That's all, yeah, yeah.

Ruby 37:29
It's a Larry David. He said that he can have like, 100 nice comments and then he will focus on that. Mean, one, it's just because we're not used to it. In real life, people don't, don't go up to you and say, I hate you.

Scott Benner 37:39
Oh, in your life, they don't do that. You're right. Nobody does that. In real life, I'd have a

Ruby 37:45
meltdown. And then daily I get it online. I'm like, Oh, I'm such an easy like, my content is so like, it's just like, memes, me joking around, so I don't know how, like a video of my boyfriend drinking diet coke to prove that it's Diet Coke that, for some reason, got 100 horrible comments. I'm like, What is wrong with that?

Scott Benner 38:03
The people fly in and they're like, if you just would eat one carb a day or drink cinnamon water. Listen,

Ruby 38:08
I can't even have Diet Coke. I can only drink water. What? For 14

Scott Benner 38:12
years you can't have Why can't you have Diet Coke? But they say,

Ruby 38:14
Oh, I don't know, aspartame. I'm sure that it's not great for you, but you know, you only live once. Listen,

Scott Benner 38:19
I do a fair amount of public speaking, and there's no doubt that if you look out into the sea of people, and someone seems like they got a face, like they're sour, you're suddenly I you start performing for that one person. Like you start thinking, like, if I can get that guy to like me, then everything's gonna be okay. Now absolutely, I guess the secret is, is that I pick a couple of people in the audience in different locations, and I only talk i I'm basically in my mind. I'm talking to them. It's a great advice. Yeah, so you just like, you find a smiling person in the center, you find a smiling person on the right, a laughing person on the left, and then you go, okay, happy people. And they think, I'm funny. This is awesome. How does it work when you're acting or doing any kind of work where you're being recorded or you're in real time, and your blood sugar gets funky, like, there, you must keep it a little higher to work. No,

Ruby 39:13
yeah, I would keep going if I was, like, going low, but not, not, not low, low. So if I was four, I'd probably keep it going for another 10 minutes, and then if I was below four, I would treat it. I would just say it's happened on stage before, and I had to get through it, and then I rushed off. And had, I always keep dextro tablets on the side, and, yeah, definitely important to always have something there. But

Scott Benner 39:35
you've never, like, hit a trolley in the middle of Macbeth or something like that. No, no, I think

Ruby 39:40
it has happened on stage, yeah, with Macbeth and I just had to get through the scene, because obviously you feel when I'm hypo I feel drunk. So I was just like, just say the words and get off. Probably not my best performance.

Scott Benner 39:51
My daughter has this like spot. She doesn't get low. Like this, actually almost at all, but very often. But you can get. Her into that place where, if she's falling through the 70s into the 60s, which is, let's see if she's falling through that space, like, let's say she's going under, sorry, I'm doing the thing for you. Let's say she's going under 3.9 right? And she's heading down in that way. If you're like, hey, you know, Hey, your blood sugar is falling, you should do something before it gets out of hand. If it keeps falling, she can get into that place where she's like, like, it the vibe from her is almost like, free and easy. Like, whatever, you know, I mean, like, if I die, I die, it's okay. Like, it almost hits that. Do you is that the drunk feeling, or is that something different? Sometimes,

Ruby 40:36
for me, it's like, when you're tired, when you're really tired, you're just like, oh, hopefully, just fade away and I'll be okay. But, and also, 3.9 you're not dangerously low. So you're like, maybe it'll go up.

Scott Benner 40:47
Oh. And so that thing happens where you think, like, maybe I can not do something about this, yeah,

Ruby 40:52
but I definitely recommend doing something about it. But I think it's part of the burnout, probably for having it so long.

Scott Benner 40:58
I was talking to Erica. Erica is a therapist who has type one, who comes on the show a lot. I was talking to her about a little bit of the frustration I have sometimes when my daughter, like, rides her pump down to, like, the last drop of insulin, and Erica goes, she starts laughing. She goes, I I do that. And I was like, oh, okay, maybe that's just the thing. You know, waste it for Arden. She's just trying to put off the change as long as possible. Like, she doesn't have any trouble doing it once it's done. But she's like, Hey, the thing's working and it still has insulin in it. I'm not changing it yet.

Ruby 41:32
What is she on? Insulin pump wise, Omnipod. Ah,

Scott Benner 41:35
yeah. So she just rides it to the like, end, but she'll do that, like she does the math where she's like, Oh, this will make it till tomorrow morning at 8am and I'm like, just, it's like, midnight, you know? She's like, I'm like, just change it now. Like, you know? She's like, No, it's gonna make it. I'm like, does she make content? You know, she doesn't. I mean, she's got, like, a personal Little Thing She was for a couple of years in school learning how to create clothing at fashion school, and she was making content then, just because she felt like she had to, but she pivoted away from it. And so she hasn't been doing that for a while, but she's got insane style. My daughter

Ruby 42:15
amazing. One day she can work with Lila Moss, Kate Moss in store.

Scott Benner 42:19
I think that would be lovely, except she doesn't appear to love the sewing part of making clothing, so that kind of threw her off a little bit. But she has, I'll send you. I'll send you. Can find her, and she always has, too, by the way, like, like, since she was little, like, she's picked out her own clothing and put things together that you would just never like no one would think to put together. So that makes me wonder, have you been like theatrical your whole life?

Ruby 42:44
Yeah, always. I've never wanted to do anything else. Not good at anything else.

Scott Benner 42:49
You must be good at something else. No, I

Ruby 42:52
can't. If I'm not amazing at something I don't want to do

Scott Benner 42:54
it interesting, because why? Because it's hard, or because it's not fun, because I'm

Ruby 42:59
not the best, and it'll take years. I've been an actor. This sounds ridiculous, but I was on stage when I was

Scott Benner 43:04
two. Ruby, are you type A? Are you all like, I gotta be best. Yeah,

Ruby 43:07
I'm a little bit, I think so maybe I'm type A. Does it

Scott Benner 43:11
come with any anxiety? Oh, yeah, absolutely. Do you know that? I have a theory that a lot of people who have autoimmune issues have anxiety as well.

Ruby 43:23
Yeah, it's always there in the back of your mind. That's why, probably, I

Scott Benner 43:28
think it's got something to do with, like, inflammation, really. I mean, again, I'm a guy making a podcast, so I, like you said earlier, I wouldn't listen to me. I feel like it's, I mean, it's not classified as auto immune. Like, don't get me wrong, right? It's classified as a mental health condition, anxiety and everything else. But a lot of people would type one, come on and talk about anxiety.

Ruby 43:50
I had it so bad yesterday in London, Oxford Street, and it was just so busy, and I just wanted to go into a corner and just scream

Scott Benner 43:57
so you're out on the street and it just hits you. Tell me about it. Yeah,

Ruby 44:01
it was just because it was so busy. I don't know if you've seen the videos online, but people are stealing phones constantly, and I was lost, and I needed to get to Soho, so I needed to go on my phone. I was scared, because if somebody stole my phone, I would be, oh, can I say the F word?

Scott Benner 44:15
Yeah, go ahead. Please paint in that lovely effort.

Ruby 44:17
I would be because imagine someone nicking my phone on the street, and I no way to get home and no way to pay for anything because I don't have a debit card, physical debit card, because we're living in a digital age, and my insulin pump and my you know, it needs to be connected to my phone.

Scott Benner 44:35
Yeah, it's not just your, it's your. Your life is literally that phone, literally

Ruby 44:38
on my phone, right? So I just had like, an anxiety attack in the corner. It was so busy. I've definitely got ADHD, but I think I might have some other traits as well. I need to get diagnosed.

Scott Benner 44:48
I believe you and my daughter would get along very well. So you're out and about. You need to get somewhere. You don't know where it's at. You think, Well, I can figure it out with my phone, but people are stealing phones. I can't. And take my phone out, because my phone is how I take care of my diet, my life, and I can't pay for anything. And what if I get like, what if I get low, and I don't have my phone and I don't even know if I'm low, and I don't have a way to pay for it, and that just like, snowballs, yeah,

Ruby 45:11
absolutely. And it was just so busy, and I just everywhere you were walking, you were bumping into someone. It was like, awful Oxford Street at Christmas. Don't do it.

Scott Benner 45:19
How do you get through it? What anxiety? Yeah, well, that moment yesterday, what did you do to like, did it just pass? Did you bump into Soho by mistake? Like, what happened? It

Ruby 45:28
didn't pass. I just needed to get out of there. And when it was a quieter Street, it was much better.

Scott Benner 45:32
So literally, getting off of that street helped you. Yeah? Yeah.

Ruby 45:35
I was overstimulated completely. I knew I was meeting with a friend. As soon as I was with a friend, I was okay. I was still a little bit hyper aware, but since I met my friend, I felt like the load had, like, lessened a bit, and if my phone got stolen, then he'd help me with other things.

Scott Benner 45:48
Oh, no, kidding. Like, that's the Oh, and this has been your whole life, yeah, but

Ruby 45:53
I do feel like it's gotten worse since COVID. Okay. Like, like, maybe we all got adapted to staying in all the time, and then I started going out, and I was freaking out. I couldn't even go to Tesco. Wait, what is that like Walmart? Okay,

Scott Benner 46:05
let's dig into that for a second, because I've been really interested in this lately, because over here, the social media news is that there are drones flying in the sky, and there are theories all over the place about Russian nuclear like waste, like uh, dirty bombs, and there's warheads and, like, people like, and it's social media, like, it just is, you know, people take videos so worried about your tick tock, but, yeah, but that's what I'm saying. Like, social media, like, tick tock, Instagram. Like, both of my children have come up to me in the last week and said, Hey, are we gonna blow up? And I'm like, maybe you guys, like, should get rid of it, is what I'm saying. Because I haven't once thought this week, I wonder if I'm gonna blow up. Like, don't get me wrong. Like, I think there are things happening in the world that I'm unaware of, right? I'm not saying. I'm not, I'm not like, a head in the sand person. Like, I understand that. Like, governments lie and, you know, there's things happening that I don't know. I also think that everybody online who's trying to get clicks and likes because it generates money for them, or hopefully a brand will come to them and pay them to say something, and they're trying to build their channels up. They see stuff like this out in the world, and then they'll do almost anything to amplify their signal and use this as an example. But I've noticed that younger people don't know how to like, I don't know like, separate those ideas. Like, yes, there's something going on in the world, but that guy right there is just showing me a fuzzy picture of Christmas lights and saying it's a drone. You know what I mean? I see what you

Ruby 47:32
mean. Because, you know, people, some people do believe everything they see online. But at the same time, I think Tik Tok is amazing, and I think that they give you resources and videos and news that you don't necessarily get on your own news outlet, which is why American of Americans are banning tick tock, right? Well,

Scott Benner 47:47
it came up again. It's never going to happen. It's scary. I don't talk about a lot of political stuff, but if they're going to ban tick tock, the reasons that they're looking at tick tock, those reasons exist with Facebook and Instagram and every other thing else. So I know what they're trying to say. They're trying to say because it's a Chinese owned company and like, that's the road they're going down politically. I mean, Tik Tok is not doing anything with your I'm going to stop myself, because I'm not sure that that's true. Facebook is doing the same things that Tik Tok is doing with your

Ruby 48:18
data. I'm not that interested in though. What happens. Well,

Scott Benner 48:21
people say that all the time. You're not interested. But, like, that's not, I don't think that's how they I don't know

Ruby 48:26
what they get all my information on. Like, what information do you want? Selfies? They don't care about me. Ruby's

Scott Benner 48:33
like, as long as I could see my blood sugar, I honestly don't care about anything else. Yeah,

Ruby 48:38
with, with tick tock as well. You can't post, misinformation. So I posted a video once talking about a cure for diabetes. Somebody said, why didn't you just cure it? Stupid? And I did a video back, going, oh my god, I had no idea. Wow,

Scott Benner 48:51
sarcastic. Yeah, the sarcasm didn't play through.

Ruby 48:55
The sarcasm didn't play through, and it got taken down from misinformation. Yeah, I

Scott Benner 49:00
actually just had one of these conversations in my Facebook group, because inevitably, laboratories who are doing research, they need funding, so they put out news of the things that are going right for them, and then somebody says, Oh my God, look, there's a Chinese like, literally, this one was, there's a lady in China, and she doesn't have type one anymore, and they, they cured her with stem cells or something like that. And so that story gets around, and then everyone starts talking about it, which is great. I'm glad people talk about stuff, but then eventually you're gonna get 54321, there's already a cure. We don't have it. They're hiding it from us. There's more money in keeping us sick than there isn't helping us? Like, like, that whole thing starts and, I mean, on that point, yes, there's greed in the world, but that same greed will lead somebody to say, Hey, I've got the cure for something here. I'm gonna go make a bunch of money off of it. Like, I think people are confusing the idea with the cure being readily available and free in America. Yeah, trust me, if a greedy person has the cure for type one diabetes and wants to go charge like, $5 million for it somewhere, there's got to be five or six billionaires who have type one in their family. You know what? I mean, they're going to sell it somehow, like, it's not necessarily going to be like, you know, a thing at Walmart that you buy off the shelf and, like, inject on your way out the door and you don't have diabetes anymore. And I just think that people get so caught up in that, like, the worry that they're being screwed. I don't believe in humanity enough to believe that they have a cure for something yet, like my example online was that people can't make a left turn without confusion. They can't walk through a supermarket without bumping into somebody like, I don't think they cured diabetes, and I definitely think that if there was a cure, that people couldn't keep their mouth shut. You know what I mean? Like, it's somebody would open up them. Don't you think somebody would blow the whistle on that? If that, if that existed,

Ruby 50:54
I don't know. I don't know a lot to think about it is Ruby. I don't have the resources or the information well and

Scott Benner 51:01
I and listen, I don't either. Neither do the people online. So my point to them was, I would stop torturing yourself believing that this thing is exists and it's being kept from you live your life like, you know what I mean? Like, I don't know Anyway, I think social media makes people paranoid sometimes, yeah, yeah, that's all, but you don't think you're younger. Like, it definitely like you said something a second ago that, if I would have said, when I was 27 my dad would have, like, gasped and fell over, what are you going to do with my data? My father would have talked to you about personal privacy and for an hour and how important your privacy is. And like, you know, but you're just like, Yeah, whatever. Who cares? Because I'm

Ruby 51:43
not important. Like, nobody wants to. What if I got a picture of me sitting on the toilet by accident?

Scott Benner 51:49
Would there be a snake in the toilet by any chance?

Ruby 51:54
No. But like, I don't have any thing, like, interesting, or any anything, anyone can blackmail me. Not yet. I don't even have that much money.

Scott Benner 52:03
Ruby. I just want you to know that I believe that at some point around your sister's wedding, you are going to reach down to open a toilet seat. Pause and think, Scott, put this in my head, that there's

Ruby 52:19
a toilet in here, toilet seats there. We'll be going in the Bucha. You're

Scott Benner 52:22
just gonna be like, you son of a bitch. Why did you put this in my head?

Ruby 52:30
No, my Instagram companies have fallen out.

Scott Benner 52:33
How are you gonna handle, like, How long's the flight to Australia? Don't

Ruby 52:36
know. I've never been I think it's like, 24 hours or something. I think it might be longer

Scott Benner 52:41
than that. How do you do flying? How does your blood sugar act? I'm okay.

Ruby 52:44
I've not done a flight that long with a pump. Yeah, nervous. I have to make sure I over pack, just in case. Always over pack, because you'd rather have more than less if you go away. Oh, I'm nervous, but we get an extra bag on board, right?

Scott Benner 52:58
Yeah. No, you just have to bring enough insulin and supplies in case something goes wrong. But there's other stuff to look into. Like, sometimes with the air pressure, right? It can, like, force a little insulin through the tubing. So you sometimes people get low because they get a little extra insulin. I did go low, yeah, when I went to Madrid. Also, people tend to get low at the baggage claim afterwards, like and it's got something to do with the air pressure. I honestly, I think I have an episode on it, but I'm just not remembering it

Ruby 53:27
right now. Interesting. And obviously you're running around at the airport and you're stressed and things like that, that'll

Scott Benner 53:32
affect you too. Yeah, some people find themselves a little more resistant in the air. And then the idea is they Bolus, Bolus, Bolus, and then they land. The pressure changes. The sometimes people are stressed by flying, and they don't realize that that changes. Then they start running around the airport with all that extra insulin

Ruby 53:49
on board. We can't get away with anything diabetics. That sucks, right?

Scott Benner 53:53
Like it really does. How often do you think you think about your diabetes

Ruby 53:56
with an insulin pump? So much less. And I'm so grateful for it. I only went on it this year. Before that, I used to think about it all the time, but now it's so much less.

Scott Benner 54:06
What do you attribute your improvement in a 1c to? What did you do differently just

Ruby 54:11
thinking about it more, and I learned about the complications, which scared me, and we've all been triggered and scared about the complications with eye health and things like that. And you get people saying, oh, you know, my my grandma lost her foot from diabetes and things like that. The scare the life at you when you're a child, you don't want to hear things like that. So, yeah, I just started really taking care of myself. And it doesn't matter about your past. You can't change the past. You can only change the now and the moving forward. Yeah,

Scott Benner 54:36
I agree. I tell people that all the time, like, you know now, like, don't spend any time beating yourself up about before, but yeah, why do you think you didn't know what educated you recently, and why was that not information that you had when you were younger? I knew

Ruby 54:52
about the complications, but I kind of forced out my mind. I was like, Oh, what happened to me, even though I didn't look after myself when I was young? Well, I did, in a way, but I you. I heard that some people just took their insulin pumps out and didn't, didn't inject at all, but I did to some extent, but I nowhere near as healthy as I am. Now,

Scott Benner 55:09
your mom not involved when you were younger, or dad, she

Ruby 55:11
was, she was very helpful. There were just things I didn't know, like I used to inject after I ate, and I only started bolusing before I eat. Now, wow, don't think about, where did you learn about Pre Bolus? That was Ryan Taylor, really, yeah, like

Scott Benner 55:24
knowing him personally or watching his videos,

Ruby 55:26
both, I think knowing him personally. The first time I met him, he told me that, yeah, it's awesome. I

Scott Benner 55:31
have to tell you that, of all the things that people give me credit for that stun me, it's telling them to Pre Bolus their meals. Yeah, I don't know why. I wasn't told that. No one ever explained to you, like the action of the insulin and the timeline that it works on, or anything like that, for years, it's

Ruby 55:47
mad, crazy. I mean, we're learning new things all the time. Maybe when I was diagnosed, it wasn't as talked about. Maybe they get told it now, I'm not sure. Oh, 14

Scott Benner 55:54
years ago, they knew Arden's had diabetes since she was two, and she's 20, so she said diabetes for 18. Yeah. I mean, that's not a new idea. It's just the thing that people, just like doctors, don't talk about it, yeah. By the way, I've had a lot of people go through that Daphne program and tell me that it was really valuable for them. It was really valuable. Yeah, yeah. But nobody mentioned that there.

Ruby 56:18
No, I asked, I asked that question there, and they did tell me, yeah. Oh, okay, yeah, quite recently. Oh, I'm sorry to the pump, yeah. Oh, Ruby,

Scott Benner 56:26
I'm sorry the Daphne course you took very recently, yeah, because I had to do it before the insulin pump. Oh, I see that's what pump did you get? Medtronic, the seven ADG, yes. And you're in automation. How do you like it. I love it. It's so good. That's awesome. That really is awesome. I hear, Oh, and you're in Europe. Are you using their new CGM, the little round one,

Ruby 56:49
you know, I just switched two days ago. Did you really? Yeah, it's so much easier, because the other one was great, but I just struggled to put it on because I felt like I needed my partner to help me. But with this, it's, you know, kind of similar to the Libra in a way, because you just one step,

Scott Benner 57:05
yeah. How are you finding the accuracy? It's perfect. The first time I

Ruby 57:09
put it on, I was a little bit up and down, because every time I changed my sensor, and I have to wait in that two hour warm up period. I don't know what I am, and I usually go high. So I was a little bit high to begin with, and it was getting used to it all over again. But now I'm absolutely fine, and it looks great too. It's so small. It

Scott Benner 57:24
is tiny. It's in your picture of you that I'm looking at now, yes, or is that a libre? That's a Libra, that's from a few years ago. Oh, that's from a few years ago. Okay, yeah, no, I can't believe you just switched. That's awesome. They're, uh, sponsors of the podcast, so, oh, amazing. Yeah. Medtronic Scott, that system has been overseas for me for a while now. I've been hearing people telling me overseas about how great it is. It just isn't. Didn't catch on here as quickly, and so trying to get the word out about it for people as well. Yeah, yeah, that's awesome. Are you a citizen or, like, how do you pay for your supplies?

Ruby 57:57
So we have the NHS, so I get it all through the NHS, luckily, crazy, and it's free, yeah? But, well, when we get paid for work, money comes out of your taxes for things like that. So I get, in a way, it's free. I don't know if I've explained that. Well, if British people are watching out, yeah? So in a way, it's free. You can't it kind of comes out of your paycheck,

Scott Benner 58:15
if that makes sense, yeah? Oh, listen, Ruby, I pay taxes, and then my healthcare is not free after that. So, yeah, that's okay. It's

Ruby 58:23
so unfair that you have to pay to do you think so have a medical condition? I do you don't choose diabetes? Do you? No,

Scott Benner 58:28
but this is an, I think this is an interesting question. I might not I'm gonna play devil's advocate for a second. What should I pay for? Like, what shouldn't be free?

Ruby 58:38
Like, luxuries? No, I think a set like living should be free food I should pay for No, no, because that's, that's food that's been you've had to pay for that for 1000s of years, okay? But diabetes, you know, you would have been dead in a few years. Unfortunately, that's an opinion.

Scott Benner 58:54
So if I have a heart issue, of my heart medication should be free.

Ruby 58:57
Yeah, absolutely. That's my opinion. I might want to live in your place better. Why should you have to pay for it? Because if somebody else has a healthy heart, yeah, I mean, I hear you, but yeah, all

Scott Benner 59:07
right, I'm not arguing with you. I'm just saying. I'm just trying to get your world view so cool. So like, if I take, let's really dig into this. I get a hang nail, and I buy a pale and narrow clippers to clip my nails. Should that be free?

Ruby 59:18
No, because if you, if you don't do it, you're not going to die.

Scott Benner 59:23
Okay, so if I'm going to die and I need to be medicated or get a device, that should be free,

Ruby 59:28
do you think that you should have to pay because diabetes is a disability as of the Equality Act 2010 in the UK, rather than so it's a disability. So do you think you should pay to be disabled? Let me spin that question on you. Scott,

Scott Benner 59:39
no, I'm going to answer you. I'm trying to, I'm trying to decide who pays for all this, if everything's free.

Ruby 59:45
I think the NHS is a great idea, and it's there are ups and downs, but I think it's great at the moment. But you know, you kind of pay your way, and then if you need to go to hospital, things like, you never know what's going to happen,

Scott Benner 59:58
right? So these things are paid. For through taxes? Yeah, what would happen again? Just devil's advocate. All you with diabetes, don't get mad at me for a second. My kid has the two I would like free insulin. Relax. What would happen if the tax burden went up to, I don't know, 80% so every dollar I make, I lose 80 cents of it. But everything's free. But it's not because food still costs money and housing and those sorts of things like and then wouldn't a person who doesn't have diabetes or doesn't have a heart issue, I know they don't understand, like those people generally aren't gonna understand until they're sick, that the impact of it, but don't you think they're gonna raise a red flag and say, Why do I have to pay for your diabetes? No,

Ruby 1:00:39
because they're not paying for your diabetes, they're paying for their health care too. So for example, if my boyfriend breaks his leg and needs to go to the hospital, needs to get a cast, and

Scott Benner 1:00:47
he'll get it for free too, yeah? But you don't break your

Ruby 1:00:49
leg every week, yeah? But you never know. Everybody goes to the hospital at one point in their life when you die.

Scott Benner 1:00:54
I'm saying I like your vision. I don't think it's as easy as it sounds.

Ruby 1:00:59
I mean, for me, I'm like, It's not about us at the end of the day, it's not about me. It's about if you, let's put it into the shoes of little kids, right? Yeah, two little girls, AJ, one's got diabetes. One doesn't. So how much in America are you paying for diabetes every month? It depends

Scott Benner 1:01:16
on your insurance. A lot of it depends on how much your insurance covers. So I can. I'll explain back to you that I raised a family with two children, so four people in a family, and currently I'm still insuring all of them for health insurance. They're still young enough to stay on my insurance. I believe that I pay between seven and $8,000 a year just to have the insurance. Then there are deductibles that I have to pay out before the insurance starts to cover at 80% my rough guess is, is that it costs me, if nobody has anything tragic happen, it costs me and my wife about 10, $11,000 a year to have health insurance and to cover everybody. So

Ruby 1:02:02
I can't speak for I'm I don't know enough about it, American health insurance. I can't speak about it, but I do think here we've got it pretty good.

Scott Benner 1:02:10
Yeah, no, I also, and in fairness, and I don't know, like, I'm sure you can make an argument for scaling, but your country is like, the size of, like, one of our smaller states, isn't it, like, how rails? Is tiny. Is it really teeny? Tiny? Yeah,

Ruby 1:02:22
I can't think of a state that's the same size as it. I'm sure there's one. What's the smallest state? I'm gonna

Scott Benner 1:02:26
find out how many people live in Wales, and I know it doesn't have an h in it, like that. Probably a million. Okay, estimated population of whales in 2023 was 3,164,000 Wow. A lot of people. What US state is it sized like. Sized like is not English, but it's gonna work. It's gonna work. Chat. GPT, actually, chat. GPT was like, hey, use more English. No, hold on. Said, Oh, Wales is about the size of New Jersey, the state I live

Ruby 1:02:58
in. Oh, wow. And that's quite small. No, 22

Scott Benner 1:03:01
and a half 1000 square kilometers, 8700 miles.

Ruby 1:03:06
I could hear the New Jersey. Then when you

Scott Benner 1:03:09
said, Here, I'm actually from Philly originally, but it's all mixed up now. All right, so you get your stuff and you're managing well. You just made a switch because you're learning more about taking better care of yourself. Do you feel differently today than you did before you made these switches in your care?

Ruby 1:03:27
Oh, yeah, I feel so much happier with myself, and I'm proud of myself, and I'm proud to be a T 1d now, whereas before, I didn't even think about it. And do

Scott Benner 1:03:36
you think that not thinking about it was partially defensive because you knew you weren't doing what you're supposed to be doing. Yeah,

Ruby 1:03:41
yeah, it's a shame to be different. And like now, as you said, in the world, we're all about diversity, and it's great to be different and to show off representation, but at the time, I guess we weren't as inclusive back

Scott Benner 1:03:56
then, or you just weren't ready to be seen, maybe, but

Ruby 1:03:59
also the media as well. Like, you never saw it talked about,

Scott Benner 1:04:02
and that really does impact you, right? Like, the things that, yeah, no, I think that's generational, by the way, too, because I don't need, I don't need to be represented somewhere. That's not a thing that I care about. Like, but I just grew up in a completely different

Ruby 1:04:15
time. Yeah, you're represented enough, Scott, don't we?

Scott Benner 1:04:19
I think white guys in their 50s are being well represented. No comment. Well, now what you've caught me there. Look at that. That was, that was good. So you're saying I was being represented the whole time. I just didn't know it. Yeah, yeah, that's fair. My favorite thing has happened this week, making the podcast. That was great. I just meant like me, like my little personal like my personal idiosyncrasies, like the thing,

Ruby 1:04:44
it's not about, like, representation. I don't want, you know, to scream from the rooftops, but it makes a child's life, for example, in inside out. You know that Disney, Disney film? Sure, I've seen it. Yeah, yeah. Like having a CGM in the background of a character, one that's more inventive and more imaginative for creators to create. Eight and two. If there's a little diabetic kid watching it in the audience, that's going to change their whole bloody life. Yeah, no, I hear you. What difference does it make sticking a sticker on a little character in the background of the film?

Scott Benner 1:05:12
Well, what is going to happen then, if everybody needs to be represented in inside out, next time, it's just going to be like every character has a thing. I'm

Ruby 1:05:20
going to be more interesting. Not, not that a thing, but like, I don't know. I've not, I'll be honest, I've not seen inside

Scott Benner 1:05:29
out. It wasn't inside out that you're thinking of. I think it was, No,

Ruby 1:05:32
it was, it was inside out too. But there's another one called turning red, which I have seen, yes,

Scott Benner 1:05:37
with the with the red panda, yeah, yes. And the kids wearing a CGM in that, right?

Ruby 1:05:42
Yeah. And it's only, like, in the background for like, two seconds. But I think it's great idea. No,

Scott Benner 1:05:46
it's lovely. It really is. Have we not talked about anything that you wanted to talk about? I want to make sure I don't

Ruby 1:05:52
miss anything for you. No, it's been fun. I think I've spoken about everything. Yeah. Did you actually have

Scott Benner 1:05:55
a good time? Are you just like, I'm getting through this? Because, no, I did. It was interesting,

Ruby 1:05:58
because I didn't know what was going to come. I was like, Oh, what are we going to talk about? So it's nice and natural

Scott Benner 1:06:03
conversation. Which was nice. Oh, awesome. Did you feel anxious when we started? Maybe

Ruby 1:06:07
when I spoke about myself and I messed up how many years I've had diabetes? I've had

Scott Benner 1:06:11
diabetes for four years. You were like, wait, no, that's not right. Yeah, you're not the first person to do that, Ruby. Don't worry. I just have a question about doing voiceover work. So like, you have an agent, I imagine, yeah, is it recorded? Or is this for your own personal gain? No, no, this is recorded. I think people would find this interesting. Here's what I think people would find interesting. You're a 27 year old, living, breathing person who acts and does voice over work, and I'm assuming you're paying for yourself to stay alive. Is that right? What do you mean? I mean, like, you can afford your bills. Oh, right, yeah, yeah. Like, so you're making a living doing this. I just think it's interesting and not a way that most people know about making a living. So, like, do you go into a studio to do this? Is it done in your home? How do you do it?

Ruby 1:06:53
A bit, both at the moment, doing a lot of stuff from home, but yeah, you just audition for things, and then it comes through, and then you get it hopefully.

Scott Benner 1:06:59
What do you give them? Like, a ton of different reads, and they choose

Ruby 1:07:02
with auditions. I usually just send to no

Scott Benner 1:07:05
kidding and then, and so you cut something, send it back to them, and do they give you notes and ask you to recut it? Or, like, unless,

Ruby 1:07:12
unless they want you, and they want you to try a different part, or something like that, most of the time you don't even get a rejection. It's harsh right now,

Scott Benner 1:07:18
oh, you just apply and you'd never even hear back sometimes. Yeah, that's how looking for work here is, by the way, too. Yeah, yeah. My son spent nine months looking for a job and, and he's like, by the time, and he's got one now, and it's, you know, going really well and everything. But like, he's like, that, I don't know. I might have applied for 500 jobs online and, and he's like, and you do not hear back from 98% of them at all. Yeah, and then, yeah, that's crazy. Do you live with this person who you're partnered with now? Yes, yeah. Was there any adjustment there with diabetes stuff? Or had you been together long enough that it all just kind of blended together nicely? Yeah,

Ruby 1:07:57
pleasure to get nicely. As long as I've got my shelf on the fridge wicked and my cupboards. He doesn't need much, but we do fight over wardrobe space. You fight

Scott Benner 1:08:04
over water. No, wardrobe space. Oh, wardrobes. Oh, yeah. Is he a handsome boy? Yeah,

Ruby 1:08:13
he's an Italian Stallion.

Scott Benner 1:08:17
Ruby, I might call your episode Italian Stallion. Why

Ruby 1:08:21
is everything I do about him, you'll love that. Like, yes,

Scott Benner 1:08:26
I was also thinking of calling it, where is Soho? Oh, this is interesting. Like, my wife does not have this problem. I barely take up any space for my clothing in the house at all. Well, wow, I guess it's nice. Is it weird? Do other girls look at him? Is that strange? I think I'd be offended if

Ruby 1:08:46
they didn't. I don't know. I didn't really notice. We got stared a lot in Disney this year, you know. And I got recognized for the first time ever in Disney, which was amazing, no kidding, yeah, by a little diabetic girl, and she was lovely with her dad. But we got stared a lot in Disney, and I think that's because we had, I don't know,

Scott Benner 1:09:03
wait, you were walking around Disney and a little girl knew you from tick tock. Yeah, that's insane, isn't

Ruby 1:09:09
it? I knew, and we were chatting over how we could skip all the cues. It was amazing. Yeah,

Scott Benner 1:09:14
do you know I've been recognized in public by my voice? Really? It's insane. Yeah, that is cool. I make a diabetes podcast, and people will turn like, it's happened so many times, I've lost count, but they'll turn like, shocked, oh my god. And I'm like, Hey, what's up? And they're like, you're the guy from the podcast. And I'm like, I am like, that's insane. That's happened a number of times. I once was in an airport, I was I had my headphones on, and I was listening to music. I couldn't hear another thing in the world, but across the seats. And I mean, like, I know I'm gonna say yards, and you're not gonna how long that is, but like, 50 yards away from me, this woman stands up, and she catches my eye somehow, and she's making like she's walking in a pattern, and it feels like she's walking right at me, but that's. So insane to think in a room full of that many people that large, and then she ends up right in front of me, and I like, take my earphones out, and I'm like, hey. And she goes, You're Scott from the Juicebox Podcast. That's amazing. And I thought, How do you know that you didn't hear me talk? She's just like, I recognize you from your website. I was like, Oh my God, you go on my website. Like, the whole thing just seems strange to me, but I liked it in your I mean, I'm sure it was shocking, but, like, I was genuinely like, I don't know, knocked over by it. Did you feel that way?

Ruby 1:10:30
Yeah, I did. I felt fuzzy and warm inside. Did

Scott Benner 1:10:35
it give you the feeling of like, hey, my my channel is working? Or did it give you the feeling like, wow, people are really out there and connecting. It

Ruby 1:10:41
was it was nice, because a few weeks before somebody else commented on my Tiktok videos, and I think I saw you today, were you in Warwick Castle? And I was like, Yeah, that was me. So I was like, Maybe I should I was getting a bit scared, to be honest. I was like, Oh no. How am I gonna go to the supermarket?

Scott Benner 1:10:54
Does that freak you out? No, no. I was at a gas station one time and a person walked up to me and was like, hi, and I'm like, hi, she goes Scott, right? And I was like, Uh oh, but she ended up being lovely, and she's been on the show, and she shared an amazing story since then. But like, there is a moment where you're like, Oh my gosh. Like, I guess I can't pick my nose anymore.

Ruby 1:11:22
Don't get too big headed.

Scott Benner 1:11:24
Well, if the people that hate me see me, they're gonna have a field day if I have my finger in my nose, you know what I mean? All right, Ruby, you're awesome. I this is my fault. We're doing this on a Saturday because I had a technical problem the other day when we tried to do this. I really appreciate you being flexible like this. It's

Ruby 1:11:40
been amazing. Thanks. So hopefully I'll meet you one day, if there's an event on,

Scott Benner 1:11:44
Oh, that'd be awesome. Yeah, I think I'm I think I might be going to, Oh, should I float this? Yeah, why not? I think I might be going to friends for life this year in Orlando, this summer. How do I get invited for how do you get invited? Just be, only be yourself and get invited. You can do it. Okay, listen, you wear the Medtronic 670 G, yeah, Medtronic, fly this girl to friends for life and let her stand at your booth.

Ruby 1:12:10
Orlando. I love it. Disney, yeah.

Scott Benner 1:12:14
All right, we'll go on a roller coaster. If this works out,

Ruby 1:12:16
let's do it. Awesome. Total crush. Hold on one second.

Scott Benner 1:12:26
The episode you just enjoyed was sponsored by the twist A I D system powered by tide pool. If you want a commercially available insulin pump with twist loop that offers unmatched personalization and precision for peace of mind you want twist twist.com/juice, box. The conversation you just enjoyed was brought to you by us. Med, us. Med.com/juice, box, or call 888-721-1514, get started today and get your supplies from us. Med, having an easy to use, an accurate blood glucose meter is just one click away. Contour next.com/juice box. That's right. Today's episode is sponsored by the contour next gen blood glucose meter. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. If you're not already subscribed or following the podcast in your favorite audio app, like Spotify or Apple podcasts. Please do that now. Seriously, just to hit follow or subscribe will really help the show. If you go a little further in Apple podcast and set it up so that it downloads all new episodes, I'll be your best friend, and if you leave a five star review, ooh, I'll probably send you a Christmas card. Would you like a Christmas card? The Diabetes variables series from the Juicebox Podcast goes over all the little things that affect your diabetes that you might not think about travel and exercise to hydration and even trampolines. Juicebox podcast.com go up in the menu and click on diabetes variables, the episode you just heard was professionally edited by wrong way. Recording, wrong way, recording.com, do.

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Scott Benner 4/13/25 Scott Benner 4/13/25

#1491 Best of Juicebox: Dr. Blevins on GLP Medications Part 2

Dr. Tom Blevins discusses GLP medications. Part 2

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends and welcome to episode 1238 of the Juicebox Podcast

Dr. Blevins is back today to expand on his GLP conversation from a few weeks ago. Today we're going to be taking listener questions Dr. Blevins is going to do his best to answer them. 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. Hey, if you have type one diabetes or are the caregiver of someone with type one and a US resident, I need you to go to T one D exchange.org/juicebox. and complete that survey that survey helps the T one D exchange to move type one diabetes research forward T one D exchange.org/juice box. If you've ever wanted to help, this is your chance it will only take you about 10 minutes. When you place your first order for ag one with my link you'll get five free travel packs and a free year supply of vitamin D. Drink ag one.com/juicebox I know that Facebook has a bad reputation, but please give the private Facebook group for the Juicebox Podcast. A healthy once over Juicebox Podcast type one diabetes

today's episode of The Juicebox Podcast is sponsored by the contour next gen blood glucose meter. This is the meter that my daughter has on her person right now. It is incredibly accurate and waiting for you at contour next one.com/juice Box. Today's episode is sponsored by Medtronic diabetes, a company that's bringing people together to redefine what it means to live with diabetes. Later in this episode, I'll be speaking with Jalen, he was diagnosed with type one diabetes at 14. He's 29. Now he's going to tell you a little bit about his story. To hear more stories with Medtronic champions. Go to Medtronic diabetes.com/juicebox or search the hashtag Medtronic champion on your favorite social media platform. Alright everybody. So Dr. Tom Blevins is back, we're going to do another episode around GLP medications. If you have not heard his first one, it's episode 1212. But today, we're going to do all questions from the audience. So Tom, welcome back.

Dr. Blevins 2:35
Scott, good to be here.

Scott Benner 2:37
I'm glad you were so good the first time I'm excited for you to be back again. I'm just going to jump right into questions that came from the audience about GLP meds I don't know that we're gonna get through all of them. But but let's do it. All right, so I'm gonna start right at the top, my seven year old is very overweight doctor suggested possibly giving her one to help her lose weight over the summer. Is this safe for young children and effective she's type one. She lost 40 pounds before diagnosis and is gained 60 back cannot stop eating.

Dr. Blevins 3:06
Yeah, that, you know, that is a tough problem that she's lost because of the high blood sugar to begin with. And now she's gained back everything and then some. And she's she's hungry. And hunger is a is a tough deal as possible. Certainly that insulin induces some hunger or promotes it. And she's overweight. Now, we don't know the details. But you know, here comes the summer, you wanted to lose weight? And the question is about GLP. One's a glucagon like peptide, one meds? And I'll tell you, it's important to look at what what's been done in terms of studies. And all that when I answered this question, and the answer is there is no medicine approved at this point for a seven year old. And for for any purpose for diabetes, or for weight loss, and there's no GLP one approved, the approvals are the one called saxenda, which is liraglutide, the once a day injection, that one is approved for weight loss in the pediatric population down to age 12. So that's not going to go and the bottom line when it comes to approvals here is that we just don't have data. So we don't know, the person who asked the question could talk to their, their doctor and ask about that. That's certainly something they can talk about. But I would be reluctant to go that direction. It's a really good thought. And you'd love to get her to lose weight, that's for sure. But anyway, I'd be very, very cautious about that talk to a doctor. And and work maybe with this might be a time you know, everyone that's listening probably has talked to a dietitian before. Dieticians can be very effective. So it might be a good time to talk to a person like a dietitian to talk about the eating.

Scott Benner 4:58
Is there a possibility of so for spa this, this suggestion is coming from their physician. So, I don't know, I can't make you guess about this. But is there a world where you would ever look at a seven year old in a similar situation and have this thought or you wouldn't go this way? Full

Dr. Blevins 5:13
disclosure? I do. Mainly, I see mainly adults, and I don't really see seven year olds. So I couldn't answer that about a seven year old. But, you know, this is a place where the doctor, doctors can use medicines, as you know, off label. And and they can look at the indication. And and they could use a medicine that doesn't kind of fit the indication it's a clinical judgment call. We don't know about safety for young kids. And would it be less effective, more effective? We don't know, I suspect it would work the way it does for older children. So the answer is we just don't have much data there.

Scott Benner 5:50
Okay. Let me jump to the next question. This is I'm going to jump around a little bit on this list. But just a very simple question does GLP medication cause muscle loss? So if you're paying attention in the space, when GLP has became kind of in the, in the limelight maybe two years ago, I think Dr. Peter Atea, pretty famously said that he is his practice, took a look and said that people were losing muscle. And I think that became one of the one of the concerns out in the in the media and everything now. Yeah, I've been on it for 13 months now. I don't feel like I've lost muscle. But as a matter of fact, I feel stronger now than I did before. But does it cause muscle loss? Or is that just part of losing weight? Or what are we seeing? Contour next one.com/juicebox. That's the link you'll use. To find out more about the contour next gen blood glucose meter, when you get there, there's a little bit at the top, you can click right on blood glucose monitoring, I'll do it with you go to meters, click on any of the meters, I'll click on the Next Gen. And you're gonna get more information. It's easy to use, and highly accurate. smartlight provides a simple understanding of your blood glucose levels. And of course, with Second Chance sampling technology, you can save money with fewer wasted test strips. As if all that wasn't enough, the contour next gen also has a compatible app for an easy way to share and see your blood glucose results. Contour next one.com/juicebox. And if you scroll down at that link, you're gonna see things like a Buy Now button, you could register your meter after you purchase it, or what is this? Download a coupon? Oh, receive a free Contour Next One blood glucose meter? Do tell contour next.com/juicebox head over there now get the same accurate and reliable meter that we use.

Dr. Blevins 7:44
Great question. And it is a concern. And there there have been people who said oh, these medicines, the GLP ones cause muscle loss. And that's been that's been an inhibitory kind of commentary or idea for many people when they when it comes to using them. But here's what we know, if a person takes a medicine or of any kind or loses weight for any reason, and they're sedentary, they're going to lose fat and muscle both. And probably preferentially even in that situation. If they stay sedentary, they're going to lose more muscle more that is fat than muscle. And typically the first fat loss is the visceral the abdominal fat. And that's what you want to lose as that rapid turnover fat. So that will go first yet if a person maintains a certain amount of activity. And and I would say it's always important for a person to be active walking like 150 minutes a week or whatever a person does. Many people do much more than that, of course, like lifting weights, that kind of thing resistance exercise, those people are not going to have much muscle loss when they use a GLP one or when they lose weight for any reason. This is really a weight loss phenomena. It is true that when a person loses weight, especially a substantial amount that some muscle areas are just not needed as much not having to carry as much weight, so they might lose those muscles a little bit. There have actually been some pretty good studies done that have looked at body composition with GLP ones and the combined GLP one tip Med and remember we're talking about GLP one glucagon like peptide one. And the GI P is glucose glucose dependent insulinotropic polypeptide. Those that abbreviations we use tip for that one and then GLP one, that's a pretty good body composition data that shows that yeah, people can lose a little bit of muscle but mainly they're losing fat. So I'm not worried about muscle loss. When people use GLP ones and less they're completely sedentary. And one of the first things I'm gonna recommend that people do when they take one of these meds I say be active and burn some calories to these medicines reduce calorie intake, but also it's very important that people burn calories and and use their muscles. I

Scott Benner 10:01
have to say, I've been wondering about this question for a while, because Did someone just say something in public? And it just stuck? You know what I mean? Was it like a knee jerk reaction or one of their first things like even would you go back to them now? Maybe? And they'd say, Oh, I've looked further. And I agree more of what I just heard. So I'm glad you were able to answer that. So completely. Thank you.

Dr. Blevins 10:22
Yeah. You know, Scott, I think some of the studies that have been done with body composition will be published, and will become more common knowledge. And it's an important concept. It's an important question. And it's important that we advise people to, you know, do their own thing about reducing calorie intake and also increase muscle activity when they're using these methods. Yeah,

Scott Benner 10:43
I saw a big difference. Just adding like low intensity like dumbbells from my arms, my chest, my shoulders. Yeah.

Dr. Blevins 10:49
I'm glad you said that, too. Because your experience is very important. You're not you don't feel like you've lost muscle mass. And you're, you're doing activities, you're lifting weights, and that I'm not talking about heavy and you're not either. We're not talking about heavy duty weightlifting, we're just talking about lightweight resistance. Yeah, resistance exercise.

Scott Benner 11:07
I'm also very careful to mix a fair amount of beef and chicken into my diet for protein to Yeah, good. Yeah. I'm going to jump off the list for a second. This is actually a question that came in to me through a there's somebody I know personally. So they start zap bound for weight loss. This person does not have diabetes, yes. But they were pretty significantly overweight. And not just hungry, Dr. Blevins but like ravenously, hungry 24/7, like could eat to being stuffed, and someone could offer them a dessert and they go, Yeah, bring it on. Like that kind of thing. Knowing sitting there thinking I'm not hungry. Not only am I not hungry, my stomach hurts. But yes, I'm gonna eat this, but they go on zap bound. It took a couple of months. And the fruit noise did not go away for a couple of months. And I said to them, just keep going. It will. And one day, I get a text. It's working on me all the sudden, like I'm starting to lose weight. I don't feel ravenously hungry all the time, I'm filling up quicker, it took months for to start working for them. And they're having success, they lost 14 pounds, things were getting better. And then all the sudden, the doctor does the blood work. And they have a significantly increased lipase and amylase. So lipase 394, Emily's 204, Doctor pulls them off the med. And those numbers go back down. So my first question is, are those bigger numbers a reason to say oh, my god pancreatitis is coming get off the med or is that just the thing that happens? Well,

Dr. Blevins 12:42
that is a great question. And I'm not sure I have the the perfect answer here either. But we've done quite a number of studies and I can talk about published information. And it is clear that those enzymes can sometimes go up and down. And and while on treatment. The question is what happens in people who are not on those meds at all on a day to day, week to week, month to month basis? And we don't know there really hardly any studies, if any at all. I don't like that. I can cite one that looks at amylase and lipase and as you said those are for the audience. Those are the enzymes from the pancreas. And they tend to be really high when people have pancreatitis. Well keep in mind that pancreatitis is a clinical syndrome of pain, Amin pain, like bad pain, and inflamed pancreas, and very high numbers. So what does it mean when those numbers are high, and a person is not having pain? We don't know. And, of course, I agree those numbers are are depending on the normal range, depending on the normal range in that lab. Those numbers are concerning. And I do understand the concern of the doctor there. And using a medicine that remember these medicines stimulate the beta cells to make insulin they they affect the alpha cells that make glucagon in the pancreas EndyMed that might affect the pancreas could maybe inflame it, but there's really no clear evidence that these meds do that. So I agree with the concern. It's an unknown and this is going to be a clinical thing there with the person who was on the zet bound. That person I know will be talking to the doctor further. And do they want to re reintroduce the medicine that's there? That's a judgment call. Yeah. Is it pre pancreatitis? Who knows? That's a great question. Do I normally measure lipase amylase? Do we always routinely do that? No. Was there a reason in that patient and the person you're talking about to measure at night where they have in some pain? Maybe I don't

Scott Benner 14:44
know Tom. Absolutely no, no pancreatitis Oh

Dr. Blevins 14:47
symptoms at all. One at all. So it wasn't pancreatitis. Almost certainly. And in that one's going to be a call it as you go, and do I recommend that people check amylase and lipase not really Everybody has a different level of caution. Some practitioners may want to check them along the way. And that's their call.

Scott Benner 15:07
Yeah. All right. So here's another one that's not on the list, person using medication for mood stabilization and anxiety, yes, starts using a GLP medication for weight loss. And then it messes up the absorption of their medication. And their anxiety gets significantly worse. Is there a way to manage that they're already on a large dose of the anxiety? medication, the doctor was uncomfortable giving them more. And that's why they took this person off of the off the GLP. But was there a better way to manage that, that you know, if you

Dr. Blevins 15:47
get that's gonna be very much a clinical thing up kind of between the person you're talking about and the doctor would a lower dose of the GLP one work and make it all okay, maybe would timing help of the medicine? Maybe, but not not horribly likely. Because, as you know, these GLP one meds like the ones we use once a week, and they have a very long life. So there's not really a predictable time during the day that the effect would be less on the stomach emptying, would it gradually improve over time, but not hard to know. As you know, the effect on gastric emptying that these medicines have the slowing down of gastric emptying is something that happens, especially early on when you start the medicine and every time you increase the dose, it kind of recreates itself. But as the gastric emptying kind of goes back a little bit more towards normal, after a person has been on the bed for a while. And after a few weeks, it doesn't go back to normal. That's going to be very much a play about your thing. That's what this is why the people say it's the art of medicine, just the science and that's gonna be an art thing. I

Scott Benner 17:00
asked the question here just so people can hear like if you are taking medications by mouth, you might be seeing absorption changes, it is the thing to take care of. You notice that is true. Take note of Alright, let's stay in that vein a little bit. I have gastro problems when I use these drugs. I have a very low carb diet, which helps me keep my numbers in five, five range, but I need to lose weight. Low Carb means high fat some of the time, which can make me sick with the drugs. Is there anything that can be done to help me use GRPs without so much sickness? This episode is sponsored by Medtronic diabetes, Medtronic diabetes.com/juice box. And now we're going to hear from Medtronic champion Jalen. I

Speaker 1 17:44
was going straight into high school. So it was a summer heading into high school was that particularly difficult, unimaginable, you know, I missed my entire summer. So I went, I was going to a brand new school, I was around a bunch of new people that I had not been going to school with. So it was hard trying to balance that while also explaining to people what type one diabetes was. My hometown did not have an endocrinologist. So I was traveling over an hour to the nearest endocrinologist for children. So you know, I outside of that I didn't have any type of support in my hometown.

Scott Benner 18:17
Did you try to explain to people or did you find it easier just to stay private?

Speaker 1 18:22
I honestly I just held back I didn't really like talking about it. It was just it felt like it was just an repeating record where I was saying things and people weren't understanding it. And I also was still in the process of learning it. So I just kept it to myself didn't really talk about it.

Scott Benner 18:36
Did you eventually find people in real life that you could confide in. I

Speaker 1 18:41
never really got the experience until after getting to college. And then once I graduated college, it's all I see. You know, you can easily search Medtronic champions, you see people that pop up and you're like, wow, look at all this content. And I think that's something that motivates me started embracing more, you know, how I'm able to type one diabetes, Medtronic

Scott Benner 19:02
diabetes.com/juice box to hear more stories from the Medtronic champion community.

Dr. Blevins 19:09
Yeah, you know, this is this a question has many different components in a way and keep in mind that fat does slow down the stomach emptying already. And then you add a medicine on top of it, that slows it down and you get a double slowing and away maybe not double but you get more slowly. And that can lead them to more or not nausea, and even vomiting. And and so one of the strategies of course, when people start a GLP one or GLP one gi P method is to reduce the fat. So those of you out there who are taking these meds, if you have a high fat diet, then you're taking a GLP one cut back because that will help the nausea if you're getting nausea. Low Carb doesn't necessarily have to mean high fat. Low Carb can be accompanied by kind of a lean lean protein type, elite meat type intake, and it can be okay in terms of weight loss. So I would say that, though it's not as simple as I might try to make it here, that the person here doesn't have to go high fat, and I think they could modify down to, and I think low carb, in my mind, is it many different definitions of different definitions of low carb. I think it's low, simple, simple car, but I think vegetables fit very well into a low carb diet. It's the potatoes, pasta, rice bread stuff that I try to get people to avoid more simple carb and other simple carbs to. So I think I think the vegetable lean meat approach would be okay. And so I hope that helps the person. And if they take that approach,

Scott Benner 20:49
I think it might actually, yeah, here's one. I've been on rebel sis. Since mid February. I'm type one, I'm taking it for weight loss, my a one C is six, eight, no side effects. I've gone from 190 to 169 pounds. Now today, my endo said she's really concerned with me using a GLP medication being a type one, and then notes the risk of pancreatic and thyroid cancer. Is that a genuine concern?

Dr. Blevins 21:15
Okay, so a couple things, I'm always going to want to kind of refer back to the idea of the approvals. And I know this is being used off label for this patient numbers, you know that Rob Bell's is not approved and type one, right? We've talked about this before. And Scott, you know, I'll continue to repeat that because it is up to the clinician, and the patient to decide some some of the many of these things is called off label use of a medicine. So that's one thing to say congratulations to the person who has such a great a one C, and weight loss. That's great. So this is gonna be a discussion that's going to be important for the person to have with their Endo, and go back in and say, Hey, tell me more about this. And let's talk about it. And and I certainly don't want to get in the middle of that. I will say that the thyroid cancer issue with GLP ones and GLP one gi P meds, and it's a boxed warning for virtually all of them has to do with a cancer called Med galeri. Thyroid cancer. That's a route that's I'm not going to go as far as say it's rare, but it's really uncommon. And it runs in families many times not always, there's something called multiple endocrine neoplasia syndrome type two runs on and we do see people I'm an endocrinologist, I see people who have immune to and I would never give them GLP one meds because it's contraindicated because their cells in the thyroid called C cells that were stimulated in rodents, when they were given GLP one meds now humans aren't rodents. But we don't know the whole story here in terms of how humans might respond, who have either the cancer or family history, we don't know that we would promote it. So those people shouldn't take it. Most thyroid cancers have absolutely no implication when it comes to GLP. One, there's no sign that GLP one meds can cause the routine, the common kinds of thyroid cancer. So that's something that person needs to talk to their endo about a little bit to try to find out more about that. And if the person has no family history of medi Larry, thyroid cancer, no family history of me and multiple endocrine neoplasia, then they could go in and talk to their endo about that. Pancreatic cancer, there's really no evidence that these males cause pancreatic cancer. So I think the person wants to go back and talk to endo and say this talk about that issue. What are we talking about here? I think that's the best approach. Go back in and talk to the talk to the endo and find out more about the concerns that we know. Yeah,

Scott Benner 23:50
I'm going to read you something then I'm going to ask you a question about how you think about things. So yes, medullary. Thyroid cancer is a rare type of thyroid cancer accounting for about one to 2% of all thyroid cancers in the US, approximately 1000 people are diagnosed with modularity thyroid cancer each year in the United States. So if you're one of those 1000 people, then their odds aren't great. But that's a pretty low number. And that's fair to say, right? 1000 people is a fairly,

Dr. Blevins 24:18
that's pretty low number. Okay. I agree with the concept. I think one to 2% doesn't fit rare, but it's really, really uncommon. I know it's called rare. It's really, most cancers are thyroid cancers are called papillary, or follicular or mixed. Those are the ones that we see if someone has that kind of cancer in their personal history or family history. There is no contraindication to using this method. So you are you're right. You know, one thing to point out is and we don't want to go too far here, but these meds have been around for quite some time. You know, ozempic was approved in 2017. And then true listed He's been out for a long time. And it's been used in millions of people. And we're not seeing a thyroid cancer, med Valarie? Or any other answers signal in it. Now you could say, well, it's not being followed very closely. I mean, how would you know, because there's not a, there's not a study going on here. But people do report these things. There is no signal that showing up. So I think it's very important that a person not take GLP wants to have if a person has a personal history of modularity, thyroid cancer, or that multiple endocrine neoplasia syndrome, but we are right, it's really, really, really uncommon.

Scott Benner 25:35
So my question to you is, because your common sense person, this is one thing I've learned from you. In the short time I've met you and known you, in your own life, medications you might take or as a, as a doctor who's prescribing? How do you think about the problem of Yes, some people die in car accidents, but we need to drive when it comes to medicine? Like, do you know what I mean? Like that bigger, right? Because you hear people all the time, like, you know, I'll post on the Facebook group, hey, you know, we're talking about GLP. Today on the podcast, and 50 people be like, Oh, my God, I've been on GLP. For two years, I've lost so much weight, my one sees down, blah, blah, blah, it's all in one person's like, it makes me throw up and everyone goes, Oh, my God, it makes people throw up. It's a really interesting way our minds work. Like I know, we're, we're risk averse as humans on purpose. And that's a good reason. But But how do you think about it personally, like when you're standing in front of a person, you decide to give them something? And this and whatever else is in that label is out there? How do you make the risk reward decision?

Dr. Blevins 26:39
Yeah, it's what you said it's a benefit risk equation, it's a benefit risk analysis, you want the benefit, the potential benefit, when you start a medicine, when I run a medicine, I want the benefit, the potential benefit to way exceed the risk in risk is a very, very thing too. I mean, some some medicines have a risk of some really nasty things. Some medicines have risk of some fairly mild things. So nausea can be anything from mild to nothing too terrible. It is true. And I tell people this all the time, or if I'm ever presenting this data, I say, Well, some people can't take it, for sure. And that's true of most myths. And that's when I take them out. I know I'm going to try it. If I'm having a symptom I don't like I'm going to stop it. And I'm going to look for an alternative. Maybe it depends on what it's all about the the condition, and the benefit and the risk. And so people need to know going into taking this type of medicine or any type of medicine, why they're taking it, what it can do for them and the risk, and they need to realize it especially with GLP ones that sometimes people just simply can't take because of nausea. Yeah, if one person has nausea and vomiting, and they stop taking it does that is that a clarion call to say everyone should go off of it? Not at all, not at not at all, the vast majority of people have no problems with it, they might have mild nausea, they may have moderate nausea, or even even notable non nausea, which tends to get better over time. It doesn't always get better over time, though. And I'll tell you, if you look at most studies, I'll just kind of ballpark it anywhere from 4%. Up to 8% of people in the studies had to discontinue the GLP one or GLP one tip meds because of GI symptoms. And as we've talked about before, that would be nausea, vomiting, diarrhea, constipation, I tell people, Hey, you may get nausea, vomiting, diarrhea, constipation, and you don't get to choose, you know, one of those and you may not, you may not tolerate it. Many times we can mitigate the we can reduce the side effects by reducing the dose. And in their other things I could go on and on about that can also reduce the risk of that like lower fat. We talked about that while ago. lower volume in the in the food intake. There's lots of things people can do to modify. But yeah, you're right. If one person has a significant side effect, and they can't take it that does has that's interesting. And that's that's it, and I'm sorry for that person. Of course, it doesn't mean other people should go off of the medicine

Scott Benner 29:12
or not try it out either. Yeah, exactly. My mindset is simple. Like, we're here now. Like, the rules have changed. Like I'm not, I'm not standing in front of you. Me personally, super fit and muscular with no fat on me and no risks of heart attacks. I'm 52. I'm carrying extra weight. A lot of it's in my stomach. You give me this medication. I'm not as hungry, I fill up sooner. I'm losing weight, and I have diarrhea feels like the cost of doing business to me. You know what I mean? Now, it wasn't so bad that I couldn't exist. And of course, if it was that would change it. I want to know too. And this is going to call for speculation but how many people have you stood in front of who experienced the side effects and you think yeah, stop taking this and how many of them do you think tougher out, it'll be okay. And like, it's sometimes it's just the resiliency of the person, not necessarily the medication. I know that I'm not blaming them. But I mean, people do have different tolerances for for trouble. Do you know what I mean? By do?

Dr. Blevins 30:16
You know? The answer is it's highly variable. I had a person in the office yesterday who was having pretty bad constipation, connected to a GLP. One method. And we did a few things. First of all, she didn't want to stop the meth because she's had good results. And just what you said, she's had good results, she understands the importance of the results, she's had her sugars are better, her weights down, everything's better, she feels better. But she has pretty notable constipation. So what do we do we cut back the dose a bit, I gave her some advice about treating constipation in general. And there ways to deal with it. Now some people come and say, is so bad, I can't take it. I go, you're the boss, not me. And let's let's go off of it. Or we might try different GLP one GRP. Med. This is surprisingly, sometimes changing the med can change the symptoms. And you wouldn't think it would be true. You would think that I'll be kind of similar in that way. But there are some there are some differences.

Scott Benner 31:14
My endo told me going from Wiko V to zap bound might help me with loose stool. Yeah, yeah. And she indicated that it's possible my acid reflux, which had gotten much better, could actually even get a little better again, yeah, it has been my finding. If I had known enough about the drug before I started, which I think people should, should know that I was very careful to take magnesium oxide every day, when I started the medication, like, I did not want to be constipated. And I also very thoughtfully, even though I am not a high fat person to begin with, I was extra careful not to eat high fat. Now, I mean, truth is, depending on the dose, I've had, you know, it's funny, I've had French fries in front of me at a table with a bunch of people. And I've reached out and had two or three of them, and you get to the third round, and you just like, I don't want this. And it just it's interesting how your brain works so much differently on this med than then it worked for me that my brain worked without it. Because I could have eaten them. But I was just like, I don't I don't want to do this.

Dr. Blevins 32:18
And that is so cool. Because you just saved yourself a few 100 calories. Yeah, that is that is the way those work, meds work. They do such a nice job with that. Fascinating.

Scott Benner 32:27
Yeah, let me ask you one, it's a little generalized, but just so that this information is in each episode that you do about GLP is this question, what specifically? Is it about a GLP? That helps lower insulin needs for type ones? And is there one that is preferred over another specifically for type ones? Well, the so forget, forget, for a minute. FDA approved, right? We know none of them are for type ones. But what's the mechanism of how a GLP helps lower your insulin needs? Yeah.

Dr. Blevins 32:58
And you're right, none of these were approved for type one. And we are doing a study you as we've talked about before, here in Austin, that's looking at one of these people with type one. And I hope that study pans out to show it's effective and safe. And maybe we'll get one approved, we sure hope so. But the way it could reduce insulin needs would be number one, it does slow down gastric emptying, so therefore, anything that goes in, it's absorbed more slowly. So there's less peaking of the carbohydrate, less less glucose flow from the intestine, at least it's delayed. And so that's a better way to put it. In addition, the medicine can reduce appetite a bit, so fewer calories and fewer carbs in lower glucose and lower insulin need. It can reduce then weight as a result of the decrease in appetite or early satiety. And that improves insulin sensitivity itself, as you know. Now, is there one that's preferred? I don't know. And I'm not gonna I don't think so. I will say that the one called terzetto appetite, which is Mount Yarrow. And set bound has the effect that the GLP one has on slowing emptying and reducing appetite, but also seems to increase insulin sensitivity. And so that that's an interesting phenomena to where everybody's still kind of working their way through that one. So it has that effect. So all of those mechanisms together, or intervene individually can help reduce the need for insulin

Scott Benner 34:41
to follow up questions, so ones for me personally, if it's slowing gastric emptying, meaning I'm probably going to bed with food, my stomach, how is my stomach acid going down? How come it's having that impact for the life of me the first time I lay down at night I thought Oh God, I don't think my dinners like through For me at and I expected more gastric reflux and I got less, what's the mechanism there? Yeah,

Dr. Blevins 35:07
you know, this is going to be something that varies from person to person, these meds can cause a worsening of reflux because they slow emptying. And that's what you'd expect. And some things happen that we can't explain, I will say this, when a person loses weight, they lose visceral, adiposity, visceral fat early on, they don't lose it all, they lose some of it. And that reduces then pressure on the stomach, that's just a mechanical thing that reduces reflux. And so and perhaps a person eats less as as they use the med to. And that might reduce volume. And that might actually reduce pressure in the in the stomach, then the pressure is what leads to the reflux into the esophagus, and the acid feeling. So there are a number of possible reasons that your symptoms are better. One may be the weight loss or reduction adiposity, visceral fat, and the other may be that you're eating lower volumes, and maybe not even notice and you are but the possibly you are I know that that's not have intrinsically any anti acid effect. I'll tell you that. Right. So

Scott Benner 36:15
it's more physical structural implications.

Dr. Blevins 36:19
I think so

Scott Benner 36:20
yeah, it makes sense to me, I'm going to ask a very specific question. This is actually for, like an acquaintance of mine. Yes, at birth, this person lost some of their intestine. So it had to be removed their whole life, they basically eat and then dump, right? Like it just That's how it goes. Right? Did GLP be bad for them? With that structural change? Interesting

Dr. Blevins 36:42
question. And this may also more generally be something people who have gastric bypass his might ask or gastric sleeve to in the answer is, well, first of all, the best answer is, I don't know. The other part of the answer is that person if they wanted to explore that would need to talk with their doctor and find out the you know, the pros and cons and whether it's even possible or feasible. And the answer is, it could in theory, because it slows down gastric emptying that slows down the lower intestine as well in many people. So how that how's that gonna work? I don't know. But it's an interesting thought.

Scott Benner 37:21
It's not a question that makes you like, throw up a stop sign up. Oh, hell no, don't do that. No,

Dr. Blevins 37:26
yeah. Okay. No, that's, it's, this is one of those things, you know, it's a negotiation with the doctor, of course, or that person may have a GI specialist, I don't know. But it's a negotiation, like so many things is, well, what about this? Would it be worth worth? worth trying? And that's, that's where I would take it. Let's

Scott Benner 37:43
listen. That's what I told them, especially when you're, this would be for weight loss for them, not diabetes. I said, My God, they're gonna give you a quarter of like, Wiko V to start, like, I don't think you're gonna get thrown into a giant problem. And if it's a problem, you're gonna live through it and stop, you know, so yeah,

Dr. Blevins 38:00
probably, you know, it's probably the only gi history and there's, there's some I might in general, that I would say as is kind of a contraindication to using them as would be if somebody has established gastroparesis, then adding a medicine that slows down the stomach even more, just, generally speaking, not a great idea. Yeah, most of these is recommended. You don't use them and people have gastroparesis hasn't been studied. And people have gastric sleeve or gastric bypass or a person like the person you're talking about. Know. And could it be tried? Possibly, you'll know pretty quickly. If it's a problem.

Scott Benner 38:37
Yeah, I have a note here to myself, because I knew this would probably come up at some point, talking about the difference between a person with type one who starts to experience digestion issues. Maybe because your pancreas has been impacted the way it has been, you're not getting digestive enzymes, maybe correctly from your pancreas anymore. People don't know that. But the frequency that I hear from newly diagnosed people or my son has stomach issues now that they have type one and they've had it for a year. For some reason, a lot of endos. Don't talk to type ones about using a pancreatic enzyme or a digestive enzyme, excuse me to help with digestion, or maybe add a magnesium oxide to help with elimination, and instead they end up eventually at a gastro who just says, Oh, if your stomach's emptying slowly, you have gastroparesis. The difference between that and someone who's had type one for 30 or 40 years and likely has nerve damage if they have gastroparesis, and I do think there's going to be a section of type ones who GLP aren't going to be a choice for because of actual gastroparesis, that that's affected that is a front what does that nerve called the feel like it starts with an F but I can't think of the name of it all of a sudden, Renick

Dr. Blevins 39:53
is one of the nerves but vagus nerve is there and I mean some people with with Type one do you have that neuropathy? The autonomic type neuropathy? Yeah, which leads to gastroparesis. And some of them don't know, they have gastroparesis. And they might find out if they, of course, it would be off label, if they used GLP, one type method. Yeah. And I've seen that, and they're gonna have more notable, and there could be people who have gastroparesis, who have had diabetes a short period of time, but But it's probably not caused by the diabetes. And so there are certain tests like a gastric emptying study, which is kind of funny study where people may have to intake some food that's got some radioactive stuff kind of mixed in with it. And then it's observed the emptying from the stomach is observed after they eat it. Yeah. But that kind of a test is an objective way to look at gastric emptying.

Scott Benner 40:46
I just want to bring it up. Because there's, there's a lot of thinking to be done around this issue around type one and GLP meds, I think, yeah, I think you're right. Scary. Scrambled eggs aside the gift that they give you for that? Right? Oh, stuff? That sounds kind of awful. Yeah. Would it be better? GLP? Is they mean than taking Metformin? I'm asking because my teenager has major insulin resistance and weight gain.

Dr. Blevins 41:14
Yeah. You know, Metformin, has a little bit of there's data in type one diabetes with metformin, and it can help a little bit, but it's not very consistent. Metformin, primarily seems to reduce a paddock that has liver glucose output. Is it an insulin sensitizer? Can it treat insulin resistance very effectively? The answer is well, in general, it's not a classic sensitizer can it lead to weight loss, and not very often and infrequently, occasionally, though, people get sort of almost like anorectic on Metformin. And we have to take them off. And that is very unusual. So I think Metformin has a potential role, it might be worth a try. It is, of course, it's not approved for type one either, but we try it at times. And so I don't think I mean, that for me might have some effect. What was Scott, what was the other part of that question?

Scott Benner 42:14
They have major insulin resistance and weight gain? Yeah. So I mean, let me ask you a different question about Metformin. And then we'll circle back around. It's one of those drugs that's used a lot by biohackers. Like with the idea of like Metformin fixes everything makes you live on like, is there any studies that tell me that just pop into Metformin is good for my longevity?

Dr. Blevins 42:38
You know, there's a lot of theory here. And Metformin may have some anti inflammatory effect. There are people that feel like it has some effect on reducing dementia. And as an effect on longevity, the data is not in on that one yet. And there's some studies going on. Actually, there's a large study going on to look at that kind of thing, but it's going to take that kind of study clearly can take a while to finish. And they'll hopefully be some stops along the way they will get information but the answer is unclear. Does it lower glucose and sugar? Yeah, it does. And is it good for type two diabetes? For sure. Is it is it a strong met? Not really. It's kind of a weak man, when it comes to lowering glucose. It plays well with virtually every medicine that we have in the type two space. And we do use it off label sometimes in type one.

Scott Benner 43:27
Okay. But GLP is are leaning towards packing some similar ideas with like me right away? What's the one that they want to they were trumpeting like heart disease with GRPs is down and and what else kidney disease. But is that? Is that just the function of keeping weight off and or blood sugars lower? You

Dr. Blevins 43:47
know, it's not really clear. I think that's a lot of it. But you know, that semaglutide which of course would be ozempic will go V rebel says the ozempic component that is looked at people went with type two diabetes and with existing heart disease, and found that there was a reduction in what was called major adverse cardiovascular events, and that would be cardiovascular death, and then also non fatal mi heart attack and non fatal stroke. So is it because of the weight loss? Hard to know? Is it because of the consequences of weight loss? Probably, yes. The lowering of blood pressure or maybe improving lipids, other anti inflammatory or other effects we don't even know about? And maybe so but in people with known heart disease, cardiovascular disease, and type two diabetes ozempic has really good data. And you know, that will go V recently, which is of course, the same thing for the weight loss is semaglutide with GAVI recently was approved to reduce the risk of those major adverse cardiovascular events, and people that have known heart disease and either obesity or overweight. So we know that these meds and other meds are the other meds like Manjaro is at bound, they're being studied in the same way. Trulicity showed improvement, you know, truelist, these Dula glue tie the other GLP. One. liraglutide showed that too, so that that whole area is very good. Usually, though I'll point this out. They're looking at people I've known known known cardiovascular disease, they're not looking at people who have type two diabetes and don't have any known disease. And they certainly have not looked at people with type one. Kidney, yes, there's some good data that shows that these meds and specifically semaglutide might actually have a beneficial effect on the kidneys. Interesting.

Scott Benner 45:47
Let's do one for people who are using now what happens if I go up and down on my dose? Because of the shortage of the medications? Is that gonna hurt me?

Dr. Blevins 45:56
And the answer is, it's gonna be really annoying, and it's gonna hurt your feelings for sure. And I don't know, I don't think it's going to hurt you, you're gonna have to chase the glucose is a little bit when you go down on the dose, or you have if if a person, for example, can get one dose, but they could get the lower dose, the pharmacy has the lower dose, they don't have the dose they're taking? Well, the lower dose is gonna be less effective. The person might have to adjust their glucose, sugar lowering meds a little bit. And, and they may feel differently. And then, you know, in a month or two months, they might get the dose, they were on that as now the higher dose, and they might have to reduce their their meds a bit. Is that going to hurt you? I don't think so. Is it going to annoy the heck out of you? Yes.

Scott Benner 46:42
Yeah. It's almost like somebody's going to reach in and change your Basal rates or something like that without telling you. Right? Right. And even if you're just on it, for I'm seeing people who are just on it for weight loss, they don't have diabetes, and the same things happen. And they call their pharmacy and their pharmacies like, Yeah, we don't have it. And you know, but we have this one, and you go, all right, I mean, some is better than none, if it's lower, but you can't just go from like, for example, you can't just go from five milligrams of zinc bound up to 12. Because that's what they have that'll crush you. Right?

Dr. Blevins 47:14
That can be a problem. And I think some people could probably tolerate that. But we don't know. And the whole idea about going up slowly, is just what you're implying is so that you maintain your tolerability of the medicine, and going up too far too fast, could bring out GI symptoms that you wouldn't have had otherwise. So that Euro it's a funny world right now, where the supply is difficult. I think there's been some improvement recently, you know, we're talking right now, late May 2024. And I think by by later in the year, the supplies gonna be better. I will tell you this, though, I said the same thing last year at the same time, and the supply didn't improve that much demand is so high for these meds, that it's been hard for the companies to keep up with supply.

Scott Benner 47:59
I think there's an indication there, by the way that because the demand is so high and consistently high and grows, that should be some indication that it's working for people, because sure everybody might want to try it. But if you try and it doesn't do anything you're not going to keep you're not going to keep doing it. You know, it's obviously at best, you know, just me guessing out into the world. But I don't imagine there'd be this trouble locating I mean, I've run around looking for this stuff, like a crackhead a couple of times. You know what I mean? Like, right, yeah, yeah. Yeah, hard to find sometimes hard to find and CVS Caremark just announced, they're just not going to carry it anymore through mail order. Because it's so inconsistent their ability to get it. But okay, but that explains the the moving around in in doses, I went, I'm into my second week of 10 milligrams is that bound? And I was I had plateaued on Rigo V, I couldn't I just wasn't losing any more weight on the go V. I got moved to that bound. My doctor, I think, started me at what is it two and a half, maybe with that, I quickly went to five. Yes, I lost six pounds. But after I and then they put me on, I plateaued she put me at seven and a half. And seven and a half just nothin. Like I started to gain those five or six pounds back that I lost with a switch. And now I'm on 10 for two weeks, and I've lost those six pounds again, right? And everything's back to where it was meaning I started to have sugar cravings at the end of when I was on lower dose of set bound. Now that it's higher, the cravings are gone. The weight loss is happening again. It's fascinating to watch, but you really do have to pay attention to do Yeah, I make a diary of it. I do it on the podcast, but I think if I wasn't making the diary, I wouldn't even be able to keep up with what's happening to me. Like I think it's that's my by the way, that's my little bit of help. I think you should make a diary about it if you're on it.

Dr. Blevins 49:55
I think that's a great idea. And I think I'm really glad you said what you did about titrating To increase the dose and then that you had results on the weight loss side, and because sometimes people will start at the lower doses, nothing's happening, this is not working. And, you know, hang in there titrate the dose, you get up to 7.5 of zet bound 10 12.5. Sometimes people attend, don't get results and got to 12.5 and their work. And there's a chance. I mean, they're always people that don't respond to any dose, that's for sure. But usually titrating up is going to allow a person to get some results, and that goes for what GAVI that goes for all of them.

Scott Benner 50:35
But Dr. Blevins, you're sitting here with this grand amount of knowledge and you're articulate about it, you know how to explain it in a way that people can understand. A lot of people don't get that from their physicians, a lot of some of their physicians are making decisions based on what they hear on Access Hollywood, you know what I mean? Like I hear it's making people throw up, you don't always get real thoughtful advice. And even the advice I'm getting is from a, from a very learned, like, level headed person, you know what I mean? And, and I have good communication with her as well. Like if I texted my endo right, now, she texts me back. Well, that's great. Like that kind of like, you know, like, if I said, Hey, I'm doing this and this happen, what do you think I should do? I'm thinking this, I'd get a note back. Yeah, yeah. And not most people don't have that, you know, it is

Dr. Blevins 51:23
important to realize that people who are prescribing, there's that thing in medicine called do no harm, and you don't want to make people sick with your medicine. And so realize that, the audience realize that, you know, you may not tolerate the medicine, and and you're communicating many times back and forth, just got, as you said, by text or by phone, or by, you know, Portal message or whatever. And you can't express exactly what's going on. And, and then the person on the other end is going to read, if the person said, Hey, I can't tolerate this medicine, they can say, Oh, you want to stop it. But there may be some middle middle ground there and actually communicating in person. Yeah. Or, you know, more completely can really make a big difference that

Scott Benner 52:06
knee jerk reactions from happening to Yeah, exactly. Here. Do GLP s reduce inflammation in the body? And has it shown any benefits for other autoimmune issues? Yeah,

Dr. Blevins 52:17
that's a great question. And that's, that's the hotbed of a lot of of research and a lot of discussion, and a number of studies. And the answer is, if you look at the studies that are so far available, you can see some reduction in markers of inflammation. Is that going to translate into some really good treatment for inflammatory conditions? I don't know. I don't think anybody knows. Like, if somebody has rheumatoid arthritis, as a GLP. One help? Who knows? I wouldn't predict Yes, because I don't see how that could happen. But it may be there. There'll be something down the road. That'll tell us more if a person has say osteo arthritis, the bone, bone on bone in their knees, hips. Does losing weight help that? Of course it does. And so, lots to learn here.

Scott Benner 53:08
Is AstraZeneca, developing a GLP that you know if I know

Dr. Blevins 53:12
that Boehringer Ingelheim is developing, and also there's some other companies developing company called structure. I'm not aware that AstraZeneca is and I'll just be the first to say, I don't know everything here. And we do a lot of clinical research here. And there may be things going on, I don't know about but I suspect that question was about boy and girl Ingelheim. The bigger answer here is, you know, there are a number of companies that are developing new GLP, one meds GLP, one gi P meds, and even those are dual agonists. And they're triple. And there's a whole wave of new generation meds coming through. And they're going to have different characteristics and they're going to have favorable characteristics we think. So, you know, hold on, and as you might expect, there's a lot of attention in this area in the pharmaceutical research industry. And there'll be more meds coming down the pike. Let

Scott Benner 54:05
me read you this. And I'll tell you what I think cat GPT four o says AstraZeneca is actively involved in developing a GLP medication. They have recently acquired the rights to a promising oral GLP one agonist called AECC 5004 from a Chinese biotech company called Echo gene. So good now, so great, let everyone he

Dr. Blevins 54:24
says AC is a big company. And many of the big companies have have focused a little bit more on on this area. So that is great news.

Scott Benner 54:35
I'm also excited for biosimilars to start popping up because obviously, these things are working for people, it's hard to turn them out. Some of the molecules work better. And you know, for some things, some for others, I think you can only benefit to have options and a fresh set of eyes. Doesn't always hurt either when people are trying to find something that does the job but isn't copying because that's the real problem right now. So people have patents. So you can't like nobody can knock it off as a generic yet there's, that's not going to happen for a while. And so if you want there to be more innovation, you've got to have all these companies looking at this at the same time. So

Dr. Blevins 55:13
that is so true. Yeah. Yeah, you know, this, this thing about these methods and their effect on what you talked about appetite. And one of the people asked a question asked about appetite. And these, these medicines help regulate appetite, which appetite gets people into trouble. And, like, you have three French fries, and you stop, that's great. Most of the time, you know, over the past, if you were me, a few French fries, oh, man, they all that looks good, I'm gonna have that whole basket. And if some cuts, something good tells me to stop that be really good and very healthy. It'd be interesting to see these meds approved just for appetite reduction, although that's probably going to happen, because I don't think the FDA is going to allow that approval for something they're going to want a disease condition. But appetite is frequently the root cause and these medicines reduce appetite, all of them.

Scott Benner 56:01
I'm waiting for Agra companies to start getting involved in trying to put a stop to them. Because you don't I mean, if I made Oreos, I'd be scared. Seriously? Yeah,

Dr. Blevins 56:11
that's a good point. And no carrying. I don't think Oreos have anything to worry about.

Scott Benner 56:16
I'll tell you what, are

Dr. Blevins 56:17
not the only an Oreo, and I'll eat it. What

Scott Benner 56:20
is is there any concern with long term use? Like I mean, for some people, listen, this is me looking online, right? I've seen some people say I lost the weight, I lost the med because of my insurance. And guess what, I'm fine. I didn't get any back. I learned how to eat better. Everything's going well, I'm active, etc. I've seen people say I've lost the med because of insurance. And I didn't change a thing about what I was doing, I put all the weight back on. So some people are going to have to take it forever. Is there a concern a safety concern with that, that you can think of

Dr. Blevins 56:50
Forever is a long time. And we have a lot of data with these meds. And we don't have like 20 year data yet. Trulicity ozempic have been, we talked about this earlier been a long time. And so far, no new signals have shown up like some weird findings. And so they look safe for long term. In general, I would say that for person to maintain the effect of the Med, most of the data says the person has to continue the Med, they might be able to reduce the frequency of administration and the dose to maintain. But they're going to need to continue the Med, they're going to be exceptions to that rule. They're going to be people who can stop and maintain. That is great. And they're going to people, the only people who take it on and on and on and they regain. But in general, if you continue to Matthew, if the effect continues. So we're looking at everybody's looking at the scientific community to look and see if there's anything long term that turned out to be a negative, but so far, so good. So it's not like the duration of time people are on it to the number of people. And they're really millions and millions and millions of people who've been on these meds now and no clear new signals have shown

Scott Benner 58:04
up. Yeah. Do you have a little more time? Are we done?

Dr. Blevins 58:07
Yeah, we can go? How about we could aim for another 10 or so

Scott Benner 58:11
minutes? Okay. I like to know if GLP is used in patients with thyroid concerns, Hashimoto specifically and or hyper cholesterol OMYA. Is that what that is? hypercholesterolemia?

Dr. Blevins 58:23
III, I think is what they're saying.

Scott Benner 58:26
What are their concerns with that?

Dr. Blevins 58:28
The answer is, there's no sign that GLP one meds or GLP. One GRP meds can make Hashimoto as improve, or worse, there's really no evidence there. And there, there is no evidence that these meds would make cholesterol worse. In fact, if you look at most of the data, you would see that the cholesterol levels improve. I could go through each fraction, I'll just say they improve when people are on these meds probably because of the effect on weight loss. There's no sign that there's a direct effect of these meds on cholesterol synthesis or absorption or any of that. But weight loss is magic. When it comes to improving cholesterol.

Scott Benner 59:11
I'm going to ask one for myself. And this is about you specifically, in your practice. You deal with a lot of adults. Yes. If I was your patient, and I came in, I said, Hey, you know, here's where I'm at so far. And you've watched me for the last 13 months. And I said I want to continue to make my my body stronger and give myself the best chance to live longer if I said I don't know anything about this Dr. Blevins but should I be on some sort of a testosterone replacement? Is that a conversation you would have with me or do you not see the value?

Dr. Blevins 59:40
I would definitely have the conversation with you about that. And what I would wind up what do I do? It was I would first of all ask you about any symptoms related to low testosterone. And then I would check your levels. And then if you're low I would I would say you know your About your muscles, your mood, many things in your body will do better if you're normal. Would I put you on testosterone? If I find you to be normal? And the answer is I wouldn't. There's no evidence that putting people on testosterone who have normal levels is going to prolong life or improve things. And, and so it's another one of those benefit risk things. If the benefit, if you're low, the benefit, I think exceeds the risk, there is some risk potentially. So testosterone is not a cure all for everything. And if the levels normal, there's really no evidence that it could could help. And, you know, testosterone given to people who buy either gel injection, pellet, whatever, can have some negative kind of has some side effects and negatives. And like, they can increase the blood count, which could increase the thickness of your blood or viscosity, which could lead to stroke, things like that it gets overstimulate the prostate. That's another possibility. And I've had some people who are given testosterone who get very agitated, and that's not very often but it happens. And then we just we back off, or we stop it,

Scott Benner 1:01:10
you handled it exactly the way my doctor did. So I was just, I'm just, I was just interested in your response. Yeah. And my levels were didn't need addition. But I was in that mindset, I was like, how do I make sure that I'm stronger and fitter and have the best chance of staying alive as long as I can? Okay, so I'm gonna go to what I think is going to be a little bit of a long answer. So we'll finish with this one. Okay. This person says, I want to know the doctor's thoughts on micro dosing. GLP is specifically for people with autoimmune disease. And for people who do not need it to lose weight. My thoughts are that maybe a pharmaceutical version of these peptides, those far too high and too fast for type ones. Maybe micro dosing will negate many of the side effects, and maybe you'll get some of the inflammation, increased insulin sensitivity, and the other benefits that come along with it. I'm super interested in this because I just did an interview last week with CEOs from xirrus and beta bionics because they're working on a dual hormone pump. And I mean, honestly, what are we talking about there? We're talking about micro dosing glucagon in an insulin pump. So Exactly, yeah. So what do you think here about the idea of this possibility with GLP? Yes.

Dr. Blevins 1:02:19
You know, the micro dosing ideas are really interesting idea. And I will I'll be the algo right out and say, I'm not sure exactly what that dose is. But well, I know that means less than normal. And I would think it might be the same frequency or more frequent lower dose? Who knows, but micro dosing less than normal dosing, specifically for autoimmune diseases? And I'll say very quickly, no data? Would I do that before an autoimmune disease? Depends on which one you're talking about? Of course, some are more serious than others the answers for all of them, I guess, so is that independence? The answer is no, I wouldn't do that. I don't know, I don't have data for that. And what I use it for people who don't need to lose weight, well, that would be people who have diabetes, as to who don't need to lose weight, and some people's because it does have an effect on glucose metabolism. So I would use, the concept of micro dosing is interesting data is not available, it's all going to be personal use, and we'll really need I mean, you know, I'm a scientist, we need a study to tell us what to do anecdote is, is going to get people in trouble. And the thought the pharmaceutical dose could be dosed far too high, maybe for certain things, but not for what we're looking at that dose about right for blood sugar, and the weight loss and that, and then maybe people would have fewer side effects of micro dosing, that's true, they also may have no effect. So we really have to have a clear cut target, like, use it in someone who has a particular type of autoimmune, a group of people who have a certain kind of autoimmune condition, and have a placebo control, and use a lower dose and find out. I don't think those studies are being done, but you whoever wants to can suggest that to their people they know in the pharmaceutical industry? And would that increase some of the benefits like inflammation and sensitivity and things like that? I don't know, maybe, I think the current doses are pretty well worked out. These doses are taken from the bench to clinic, and all kinds of doses are looked at, you want a dose that actually has an effect, and it need to have a target like blood sugar or weight loss or something like that. And then you want to be sure that dose actually works. So I think the I think the current doses are effective. The concept of exploring other areas a great idea, and there are studies being done looking at like arthritis, like osteoarthritis, looking at sleep apnea. There's been some positive there already. That's about weight loss, I think. Yeah, and other other conditions, that maybe even some cognitive conditions like my Alzheimer's Could, could these meds help people, people looking at all kinds of things but until we have a good study, I don't think I would jump in and start using it that way. Yeah.

Scott Benner 1:05:03
Do you think you've seen anything? Even just, you know, N of one kind of like returns? Where people have experienced less gambling habits like other addictive natures that you've heard that talked about, but do you actually say it? I

Dr. Blevins 1:05:18
have not had a person come back and tell me that they took it and they were not going to Las Vegas as often, though, I've read about that. And I think it's fascinating cravings. Appetite is a type of craving, gambling as a type of craving alcohol, and alcoholism. I know for a fact some studies are going on looking at that. Do I know results? No. But I've had a few people come back and tell me they were less interested in drinking alcohol about drinks. And there may be something there? If so I sure hope there is. But I want to see a good study, come back and tell me that that actually was true. Yeah. And it may just be it's not, it's not a consistent thing. I've asked some people, do you drink any less? And they say no. So we need something to tell us more about that.

Scott Benner 1:06:05
I've noticed this thing. I'll end with this and ask you if you've seen it, too. I think it's possible that as a society, we've become so used to people's body mass being a larger, that now I'm seeing people use these medications, get down to what looks like a very nice healthy weight. And yet the people around them are shocked and say like, Oh, my God, you're too thin put weight back on, like, bah, bah, bah. And you if you really look at them, like from a reasonable perspective, they're not too thin, they're not to anything, they just look like a healthy human being. It almost feels like that's not what people are accustomed to looking at maybe with you personally or with people in general. But I was wondering if you've seen those kind of more psychological reactions? Absolutely.

Dr. Blevins 1:06:48
That that's true. Change is something that people notice and comment on. And in historically, when people have lost weight, it's because they're sick, and cancer or something like that. And I've certainly had people comment in that direction, or have people tell me, they've, they've been told they look sick, they need to eat? Yeah, their family, their friends, I'd say here, you need to pat yourself, get some get, you know, eat and gain some weight back. Even though what you said is correct. Their weight is now more normal than ever. I would tell people in the audience expect that and understand it, and take it as a compliment. And let people know what you're doing. And if you want to

Scott Benner 1:07:34
don't let it thwart you, I've seen people, it happened to somebody around me recently, they were so pressured by the oh my god, you're losing too much weight, pressure that they started thinking about not doing the medication, I said, Look, between you and me, I need to lose 15 pounds. And maybe more, I don't know, like, I have to tell you like my ability to understand how much weight I needed to lose is completely skewed. Because I started this thing thinking 20 pounds, I'll be great. When I got that 20 pounds. I was like, I don't even look any different. And now, if I said to somebody, somebody says, Hey, you look great. I'm like, thanks, I still have 1520 pounds loose. They go, that's not possible. And I'm like, Well, I can take my shirt off and share it with you if you want. But like I definitely still need to. Yeah, I just don't want people to get thrown off by knee jerk reactions to their visual appearance.

Dr. Blevins 1:08:21
You know what I mean? I agree. Yeah. Yeah, the nice thing about it is people are concerned. And they notice and, and there is a compliment. You know, it's it's people who are concerned, they think, Oh, is there something going on? I care? I want to know, or they may be they just playing nosy, I don't know. But then you could reassure them and say, you know, and now now everybody knows about these methods, almost everybody. And you could divulge or you don't have to you don't want to maybe tell people what you're doing. You could say now that I don't have cancer. I don't have some bad disease. I'm working on weight loss, and, and, or something like that. But yeah, it's a common phenomena. And everybody should just expect it. And it's actually a real big positive, but it comes off as Oh, you look, you've lost too much weight. And of course, the answer is no, you haven't.

Scott Benner 1:09:07
Yeah. And by the way, I don't actually care about the number of my weight. I care about the fat My body's holding. That's yeah, my concern is so exact whatever I end up looking like after I'm carrying a healthy amount of fat on me, is what I'm going to look like. Right. All right. Well, Dr. Bill Evans again, this is terrific. I feel like I could just have a podcast where I chat with you about anything and it would be good. So thank you. I appreciate your time again.

Dr. Blevins 1:09:32
Scott, thank you very much. It's fun. Yeah, I've enjoyed it.

Scott Benner 1:09:35
Great. And we're gonna head back again. Is that right? Yes. Oh, excellent. Great. Great. I'm super excited. Hold on one second.

Jalen is an incredible example of what's so many experience living with diabetes. You show up for yourself and others every day, never letting diabetes define you. And that is what the Medtronic champion Community is all about. Each of us is strong and together, we're even stronger. To hear more stories from the Medtronic champion community or to share your own story visit Medtronic diabetes.com/juicebox And look out online for the hashtag Medtronic champion. Having an easy to use an accurate blood glucose meter is just one click away. Contour next one.com/juicebox That's right Today's episode is sponsored by the contour next gen blood glucose meter. We're starting to get a nice grouping of GLP focused episodes. There's a full list of them in the featured tab in the private Facebook group. Thank you so much for listening. I'll be back soon with another episode of The Juicebox Podcast. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com