#531 After Dark: Diabetes Complications

ADULT TOPIC WARNING. Today's guest is an adult type 1 living with significant complications.

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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, welcome to Episode 531 of the Juicebox Podcast.

incredibly proud of this podcast. I know that I tried my hardest to talk about every topic I can think of around diabetes, I don't want to leave anything out. But when we get to those things that people don't like to talk about so much the things that you kind of keep private. I put those in a series called afterdark. If you go to Juicebox Podcast comm and scroll down a little, you'll see a ton of afterdark episodes, and I think you should check them out. They're incredibly enlightening. Today's show is with Mike. And Mike has had Type One Diabetes for a very long time, as he will tell you in just a little bit. Mike also has a number of complications. And he is going to share with you his story and his complications today. I want you to be ready that this episode is honest, it's emotional, and it might make you upset. Mike felt very strongly about sharing this with all of you. And I was grateful and honored that he wanted to do it here. Please remember while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. This episode of The Juicebox Podcast is brought to you by touched by type one. They're an organization doing wonderful things for people living with Type One Diabetes, find out more about them at touched by type one.org. You can also find them on Instagram, and Facebook. I'm pretty pleased with how my voice sounds. So I'm going to do one more. This episode is also sponsored by Omni pod. And you may be eligible for a free 30 day trial of the Omni pod dash. You can find out at Omni pod.com forward slash juice box by the way. There's no reason to wait for the next big thing because Omni pod has the Omni pod promise. And later in the episode, I'm going to tell you exactly what that is. My name is Mike. I live in San Diego. I've been type one. Whoa. Over 45 years now. And yeah. How old are you Mike? I just turned 55 today, okay. Oh, really? Congratulations.

Mike 2:38
Thank you. So I can now eat off the Denny's 55 plus menu.

Unknown Speaker 2:41
Things are really heading in your direction. Finally, you got to take the positives in this world was all the negatives.

Scott Benner 2:48
I didn't know our birthdays were so close to each other.

Mike 2:50
I know happy late birthday my my replacement service dog trainer, or my replacement service dog. The trainer was here working and we were pretty tied up so I didn't get a wish you Happy birthday. Happy belated birthday. Thank

Scott Benner 3:01
you very much and Happy birthday to you. We were five years apart and two days. That's pretty cool. Yeah. So Mike, you were on a how we episode for keto 409 or 96 or 96. There we go. Some other similar numbers for 96. And I would have to say months had gone by after that after we recorded it maybe. And I got a really I thought passionate email from you saying that you needed to come back on the show. And talk about complications and your and your life in general. So yeah, I think that's very brave. And I appreciate you wanting to do that.

Mike 3:45
Sure. I'm happy to do it. I'm happy to you know, explain to people it's kind of emotional for me when I start talking about so. Bear with me.

Scott Benner 3:59
I brought tissues to this one. Do you not have tissues? I have. I have short sleeves and the whole bottom of my shirt. I guess I guess for people who didn't hear you on how he just give them a couple of minutes. You know when about your diagnosis and how things were back then?

Mike 4:17
Sure. So back in the 70s when I was diagnosed, there was no meters no good insolence there was. Well, the I need to back up just a hair there for a quick second. So I was mis diagnosed by a general practitioner for over a year with an ulcer. Could because I had the symptoms of the doubling over stomach cramps. I guess that's when my body was attacking the beta cells of the pancreas for my understanding. So he diagnosed me with an ulcer. And he diagnosed my mom with being so mentally hard on me just as As a kid in general in life, that it stressed me out so much that caused me to have an ulcer which was farthest from the truth. I had a great loving mom a loving family.

Unknown Speaker 5:13
The

Mike 5:16
as the as the time progressed, I was getting obviously losing more and more weight. And they finally took me to the hospital because I was just skin and bones. They just they couldn't figure it out. Yeah. Wasn't a DK at that point. But I was close. Um, they said, I probably had a few more months, and I would have been in DK at that point. But it was funny. Wow, it's funny, but we're walking down the hall in the emergency room. And the doctor that was walking the other way to look at me, pointed to me and told my parents that kids are dying type one diabetic. And turns out, that's the doctor that came into the exam room and properly diagnose me. So at that time, things were pretty primitive. Again, like I said, there was no meters, no good answers, we had beef, and pork, and in and you would take the beef or pork insulin until you started getting resistant to it, then you would switch over to the other that you either or beef or pork until you are resistant to that and you kind of swap back and forth. If you got resistant to both of them, you're pretty much screwed at that point. So I was probably 500 the whole time I was a kid, because at that point, they viewed it if you weren't falling over, you were doing pretty good. And you did one shot a day you'd mix the insulin Can you had exchange rates at that time? example, breakfast, two starches, a dairy, a fat, and then lunch to kind of the same thing, you know, two or three starches for proteins. And that's how they kind of managed it. So I did, I was on one shot a day for till I was a teenager, and I went to type one backpacking camp at the doctors there. Finally switched me over to two shots a day. And again, no meters. No, no way to really monitor how much insulin you need. But I just I can remember it. At that point, when they switched me to two shots a day. How much better I felt so maybe I was I came down from 500 to 400? I don't know, we'll never know. I wonder

Scott Benner 7:35
Do you know why they somebody thought to introduce it? Was it just the new way to do it? And you were like the old one? Yeah,

Mike 7:42
I think there was doctors at the camp. They were younger doctors. And at at the time, from my understanding now of, you know, doctors and how they treated diabetics, they just they kept you. They basically kept you from not dying. And they they wouldn't they couldn't they wouldn't adjust. But that was their goal to keep you from dying. Immediately from a low, but not long term from complications. They there was just no. There was no way to tell but like, but as a teenager, the doctors at that point saw it was pretty antiquated for one shot a day. So they broke it up. So at least you had some more regular to cover dinner, instead of just covering dinner with whatever basil might be leftover from the end. Which I don't know if they really know what the peak on that was whether it was 12 hours, six hours, 24 hours. I don't know. I've I've looked back in that I can't find any good, solid documentation that kind of gives the duration of that like linty now or, you know, a trivia that's 48 hours down. I couldn't find any data on that. And at this point, doesn't matter. That's, that's over.

Scott Benner 8:59
It's gone. So what part of the 70s were you diagnosed?

Mike 9:04
mid 70s right around 7677. I remember the Freedom Train coming through. And it was like the summer before I was mis diagnosed. And then went through that school year and the summer after when I was properly diagnosed. And like I said, I've I've seen pictures from our vacations. We went on family vacation. We were fortunate enough to go for a few weeks every summer. And I just it was just skin and bones man like my my shirt was just literally hanging off my skeleton. Right and that's it was pretty sad.

Scott Benner 9:40
I think that's over five decades after someone figured out insulin that Yeah, that was still the the situation.

Mike 9:48
Did you know there was really no way to, to there was no home monitoring. I mean, I know hospitals at that time. Had glucometers but they're the only ones that really had them. And the reason they had them was if somebody came in passed out, were you a drunk? Or were you a type one diabetic, you know, passed out and

Scott Benner 10:09
they needed this thing to figure that out.

Mike 10:11
Yeah, they needed some way to quickly figure that out. So they weren't putting type one diabetics in the drunk tank, and then them dying. Right? Wow.

Scott Benner 10:20
So you live a long time with a really high blood sugar. Correct. And I'm going to kind of break your life up into segments, I think. Sure. So in the moment, do you know what's happening? Or is it just your life and there's no way to feel it or like, you know, you felt bad when you were on one shot today. Um,

Mike 10:45
I didn't know at the time because I really had nothing to judge it with because you, I was never in a lower range to feel like for instance, you know, 120 versus a 500. And your body kind of gets used to it. And I also remember, as a teenager in high school, originally, I have nothing wrong with private schools, but it wasn't my cup of tea. And I wanted to go back to the public school where all my friends were from growing up elementary school. So my mom agreed to let me go back to the public school, but I had to take up extracurricular activity. So I chose cross country and track perfect. Yeah. And I, I never had a low I never passed out. So that validates all the doctors of today's that. Yeah, you must have been 500 the whole time. Because we were running, you know, 1015 miles a day we got up to. And here's the wacky noodles part of this. My mom read in a runner's magazine that you should carbohydrate load before the day before race. So she'd make me not knowing this was a problem at the time. Again, loving mother, she made me a whole box of mac and cheese that I would eat for dinner the night before. A whole box of pasta. So I was carb carb loading without covering for insulin because there was no knowledge of covering it for insulin right?

Scott Benner 12:09
On top of all that, how did you run? Like, I guess you Really? So so for, I guess for people listening? Who are managing in today's world, the idea that you can be 500 and living for days and days and days or 400 or whatever, like that high high like that. Yeah. Is is probably confusing to them. it's inconceivable. Right, right. But really, you're in that moment. And for those years, your body's in an advanced state of aging. Basically, you're using up your life cycles faster than you should be correct. And your body had a way of making itself feel normal enough that you could function.

Mike 12:53
Correct. Yeah, the other thing, the doctor that diagnosed me when I was a kid, which I found out later in life that he told my mom that exercise equated to insulin. And anywhere I wanted to go like my friend's house that was several miles away in arcade at, you know, when I asked her Hey, can you run me over here? Well, ever since my diagnosis, she conveniently could never take me anywhere. She made me ride my bike, which that probably at that time was one of the best things for me. So which helped me in cross country and track and I still hold the record for the 100 at Christian Junior High this day. So I was in I wasn't top shape. I was just riding everywhere. So go figure I yeah, we we talked about that now with some of the like the just the therapists they see we you know, sports therapy and stuff. And it's just yeah, I think I think that her conveniently but making me go ride for that exercises. Insulin thing was probably extended. At that time. A lot of things.

Scott Benner 14:05
Yeah. But you're more time because she was driving your blood sugar down a little bit with the with the exercise and with you with all the running and everything. Yeah, which would take you right back to prior to insulin. When they started figuring out what was happening. They would just starve people and move them around. That's Yeah, yeah. That's how they would that's how they try to elongate your life. If you had type one before in something, you know, don't eat anything. And then just keep active and you're really just doing those things to stay alive. And so you are getting some function from that. Correct when? What happens next you go to college?

Mike 14:47
No, I went to automotive trade school at that time. So, first part of my life, I was a ASE certified auto mechanic. And again, just, you know, whatever insulin single dose they gave me on the day and at night, I was just taking an eating any and everything and there was no thought process behind it because there was still no. No monitoring, though. Right. I think there was a, I believe there was a meter at that time, but it took like two or five minutes to read. And what do you do with the information? Yeah. And at that point,

Scott Benner 15:30
if I'm remembering correctly, from our, our other conversation, is this the point in your life where you get fairly unhealthy in other ways? Yeah. Okay. Can you tell people about that?

Mike 15:41
Yeah, so moved to Florida, um, for with the girlfriend and, and her family. We love sailing, and it was warm water there. So, you know, we're, we're drinking and you know, eating whatever, because there's really never been told not to. And there's been no great information to Hey, you need to do these things to take care of yourself. So the doctor I saw at that time, because I knew I needed to insulin insulin was life, you could buy syringes over the counter, so I was basically seeing him for the prescription for insulin. And I was really overweight. I'm five 511. I was like 245 fish, 250 overweight, and he finally one day going to get my prescription said that you really need to do better in your life. And I'm like, okay, like, you know, get a desk job or something. To buy cars. Yeah. So he said, No, diabetes wise. He said, I'm going to send you to see this person who I'm still lifelong friends with today. See this person, if I get back good information from this person, that your will start taking care of yourself, I will keep prescribing you insulin will check in the hospital if you if I get bad information from this person. No doctor in South Florida will see you I will. I will ban you from seeing any doctor in South Florida through the medical profession, or however he worded that at that time. So I'm thinking insulin life and no insulin, not life.

Scott Benner 17:29
This next guy is gonna get to tell me whatever he wants.

Mike 17:32
Yeah, so. So I went saw the person it was at diabetes treatment centers they had at the hospitals at that time. And she scared the bejesus out of me. If you want to put any other explicit award in there, you could go ahead and do that and bleep it out. So I, I checked, I got checked in the hospital. At that point, they checked you in for like seven days to regulate you quote unquote, I'm doing air quotes, as you can see, regulate you, as best they can and got my first meter. And I took it serious. I was on multiple injections at that time, MDI. And some pumps were considered experimental. So after that week in the hospital, I continue to strive, I, you know, hung out at the diabetes treatment center, the support groups got within at that time in the community, which made me feel really good about things started eating healthier. And the next thing was I needed to lose weight. And he said, You got to start doing some exercise. And I was working for an accurate dealership at the time. And a parts manager raced amateur bicycles. And he invited me to come out and cycle with them, you know, to try to help them lose weight. And so I bought my first bike that month, wrote over a little over 1000 miles and lost like 45 pounds. Plus that first month so Geez. I'm an I'm an all or nothing guy. In case you anybody that you know, I I don't just dabble in anything.

Scott Benner 19:15
Well, let me let me ask you a couple questions. So you basically are living in your will tell me tell me how old you are when you met this. The Second Doctor? I was in my early 20s. Okay. So early 20s. As you're young, you're a mechanic. You're living, you're sailing, you're screwing around with your boyfriend and eating whatever you want. And drinking. You said drinking I'm assuming you meant beer and stuff like that. Yeah. So just beer. Yeah. Just beer. Was it a rapid weight gain for you or no. through high school?

Mike 19:54
Weight Gain was at Well, when I was in high school running cross country and track I was like, you know Just a rail. And I got in a really bad car crash. I was in the backseat of a little, little Honda Civic, I think it was. And we have these mountains out here. And one of the cool thing is to do, which is really not cool is to go on the mountain, turn your lights out and scare the crap out everybody in the car, you know, and try to anticipate the curve you made. So this girl was driving, and she wasn't a good driver, but I'm in the backseat. You know, I should have said something but didn't because I'm with my friend trying to protect her. We grew up as his neighbor, kids. And we went off the mountain airborne into a tree. And luckily, the tree, the tree branches, as we landed about mid tree, I went back and looked at it afterwards. And it was probably the tree was taller than a two story. Not true story but a one story house. So but between that so landed in that the impacts lifted me up. And of course no seatbelts at the time. So I broke both my ankles shattered my shoulder. As the car fell down. It was pretty gentle fall through the limbs until we hit the ground. It was in front of somebody that we hobbled, hobbled in there and help. Mike, is it possible that Steven Spielberg

Scott Benner 21:24
has stolen a portion of your life story for Jurassic Park and you're owed money?

Mike 21:28
I didn't think of that. But anyways, after I healed, I went out, did six miles with the because at that point, the guy's team was running 10 to 15. And I was trying to get back into it. I did six mile loop and I hurt so bad. I never ran after that again. And it was from that progression. Through my early 20s. I started gaining weight because I was just, you know, right. You know, I could eat a whole large extra large deep dish pizza and was setting myself. So when we go to pizzas, we get three or four pizzas with the family.

Scott Benner 22:05
Well, okay, so take me into that room in your 20s. What does that doctor who scares you? What is what do they say to you?

Mike 22:12
But basically the doctor, the doctor or the diabetes treatment center,

Scott Benner 22:16
the treatment center. I'm sorry.

Mike 22:18
Oh, so she will cut to the quick. Sure. first statement was you got a girlfriend? Yeah. You like having sex? Yeah. Well, if you want to keep having sex, you better start taking care of yourself. Because that's the first thing is probably going to go No, not probably will go. That grabs the young man's attention really quick, like, literally by the short hairs.

Scott Benner 22:46
Like I did not recognize that erectile dysfunction is gonna be what you started with today?

Mike 22:51
No, but she just flat out. It was just I think I turned 50 shades of white. Right? Because it was just like, oh my god. Yeah, no, we know what, no, let's

Scott Benner 23:02
fix this quickly.

Mike 23:04
Yeah, that was when can we check me into the hospital where we have to have the doctor's note first. Can we call him now?

Scott Benner 23:10
Yeah, my ankles are fine. Can I go for a walk? So she hit you with that as a side effect of unregulated blood sugars.

Mike 23:21
Correct. Okay. And she said at that point, it had no age limit. It was just, it could happen to you tomorrow. Or, you know, the better care you take of yourself. Let's just say it could never happen. But at your rate, it will in that

Scott Benner 23:35
moment. Five seconds before that. Did you think of yourself as a person with unregulated blood sugars?

Mike 23:43
No, not at all. Matter of fact, I there was. You could go through the drive thru there. I won't say the name of the place. But you could get and I got fried the fried shrimp platter with two Coors lights to go through the drive thru window

Scott Benner 23:56
on your way to the diabetes treatment center. Yeah.

Mike 24:02
So I got fried shrimp, french fries, a couple of beers. I didn't drink them while I was driving, but I drank him in the parking lot.

Scott Benner 24:07
And that wasn't a goodbye to health because you didn't think that's what was happening. This is just a common way you would have eaten. Yeah, yeah. Yeah. Not on a work day. But yeah, I have I have a question or a jump ahead for half a second because I know you now. Yeah, no, I mean, we're not. I don't know you. Well, but I know you. And we communicate. Yeah, right. You don't seem like that person. Was it youth? Was it the high blood sugar's

that was just how I live just how you live. It's just what how things occurred to you and that's what you did.

Mike 24:41
Yeah, cuz, you know, we take the sailboat out for the weekend, you know, couple of 12 packs of beers. You know, maybe after after work, we take the sailboat out or the motorboat and you know, beer was always involved. You know, you go out for pizza have a couple beers. I I will preface this. I never drink and drive drunk. You know, a couple of three beers was about it. But when we be out on the water, we get pretty sloshed. But, you know, sailboat and go so fast.

Scott Benner 25:14
So you got to find your excitement somewhere else. Okay, alright, so she hits you with EDI. Anything else.

That was that was the opening closing statement. It's not needed. She started she's like, there's other stuff like, Nah, I'm good. I'm gonna do it. So she said they were good. You want to hear about the heart disease? Nope, don't care. I'm not gonna make it that far. No, there was heart disease involved at that point, learn that later. So they check you in. And they get you basically, it's a blood sugar detox, I guess for the lack of a better term to the day teach you about food, what happens in that time.

Mike 25:54
So they didn't really teach you about foods, they were still using the exchange rate at that point. So you know, a starches, you know, slice of bread, it's a mashed potatoes, it's about the size, the palm of your hand, a dinner roll. And you kind of went on that. And so I tried I diligently again, as I say, I'm all or nothing, if I know better. So I went into it with, you know, eyes wide open and really focused on doing the best I could had a meter. So I was, you know, test before breakfast, lunch and dinner. So you know that that's what the doctor told me to do. That's what I did. Do you

Scott Benner 26:35
remember any of those early blood sugar tests?

Mike 26:42
Yeah, you know, you know, in the high, one hundreds, low 200 was not uncommon and was praised, you know, you're doing great. And then, like I said, I didn't do the two hour test. I didn't, I wasn't told to. So I was told that I was doing good. I was now in control. I do not remember my a one C's at the time, but they're not what I've got now. They were probably, you know, under 12, maybe 11. I can't remember. But right at that time, whatever the ADA recommendation was, I was considered compliant.

Scott Benner 27:23
Okay. And so how long does this phase of your life with blood sugar's last?

Mike 27:30
Well, so because I was writing, exercising, and I was no Lance Armstrong, or, you know, Tour de France qualifier, but I held my own. And there was a group there, that was out of the Mike cyclery bicycle store just happen to be, and they call themselves to Mike's group. And it wasn't for me, those were the hardcore local guys. And they met early, like five in the morning to go train, and they would, you know, you'd get a 40 5060 mile hardcore workout before work. And on the MDI, I get up at set my alarm get up at two Bolus or inject, go to sleep for an hour, wake up at three, I would eat, and then wake up at five. And depending on my blood sugar, I would either go work out, or, you know, I couldn't because it was kind of out of whack. Being either too high, or what I thought at that point wasn't high enough to go do the strenuous workout. And by, by default of doing the same thing, seven days a week, every morning, I was able to get my breakfast style then so I could do those workouts. And then this is where I progressed to. I wanted to get an insulin pump because I was taking so many injections throughout the day cuz I ride do the hard workout before work. I'd ride my bike to work. I go right, you know, an hour at lunch hard. I'd ride home. So I was doing more and more and more exercises and picking up more and more of these little group kind of heavy workouts and the MDI was getting to be too hard. So I wanted to get on an insulin pump. I asked my doctor and he said, No, no, no, there's just there's there's two high risk for, you know, decay, infection and hospitalization and they're experimental. I don't have it anybody on one. So I did. It took me about six months, begging and pleading him. And I found the only type one diabetic at that time. Who did the Iron Man in Ohio or Ohio, Hawaii. That was on an insulin pump. And that was the straw that broke the camel's Back of his Okay, I'll let you try this. And it worked out really good. Yeah, um, you know, I still didn't have stellar, you know, a one sees that we have today. But in that time, that worked out really good because I didn't have the long acting, floating around in there, right? You know, just had the basil, and then kind of make some adjustments, and I ate a lot of Fig Newtons at that time, because they're 11 grams of carb each, I could figure out what that was going to be for the next two hours of, you know, either strenuous or non strenuous workout, and that, in fact, I had charts and graphs at that time of just about every food, the grocery store sold, what the carbs were, well, how much insulin it needed. Again, the all or nothing guy.

Scott Benner 30:45
I it's funny you say, say that, but I keep thinking. Nobody told you. And maybe nobody knew. But I mean, I think you would have done it if you would have known.

Mike 30:55
Oh, yeah. 100% had I know. Yeah, I would have been doing it. But again, he just I get my prescription see naxian you know, three months, whatever. And tell he finally just said this is insane. This and you're just killing yourself?

Scott Benner 31:10
Well, so now you're riding your bike, and you're in you lost. I mean, it sounds like you lost a lot of weight and one swing. Yeah, yeah. Okay. And now you're living like this higher a one season we would think of now as being okay, but it was way better than what was happening is a huge improvement, etc. in your mind, you're out of the woods, right?

Mike 31:30
Oh, yeah, my mind. I'm golden. I'm gonna avoid any complications, any long term effects. And really, at that point, nobody really talked about it. It was, I don't want to say it was the unspoken. But if I look back, it was kind of the unspoken, nobody talked about it unless you were anybody had the amputation? Is that what you're diabetic? You know, my uncle lost his leg. And you can hear that story from every Oh, thanks. Great. Um, but, you know, being type one, at that time, you were considered able to control it, you were the lucky diabetic, because if you wanted to take care of it, you could, which is further from the truth. But

Scott Benner 32:09
so, you know, from your diagnosis to this time, where you're, you've got the mean, from your diagnosis from one shot a day to two shots a day to, you know, the weight gain to the intervention, I'll call it to, you know, getting on a pump and having stability at eight. What do you think those agencies back then were on that first pump? Nine, eight.

Mike 32:33
I don't think it was eight, it was probably nine between nine and 11, I would imagine because, you know, you go out to do a time trial. And, you know, you might, you know, jack yourself up to 300 before you go out to do the right the the event. Same thing with a mountain bike race, you know, you're not going to start a mountain bike race at that time at 150. you're you're you're going to crash. Okay. So I have a Camelback that I had a go ahead.

Scott Benner 33:00
I just wonder how much time it was from your diagnosis to this time in your life. Like today time, then to that time, would that pump those 11 a one sees from your diagnosis?

Mike 33:12
Oh, I was probably it was pretty quick. So what's even what the multi the MDI that time was the intervention period. I pretty quickly came down to that it was probably months. Once I started exercising, and put that getting into the local amateur bike racing, amateur mountain bike racing and the weekend group rides. Okay, so I've been really physical I could I was doing 300 plus a week, easily,

Scott Benner 33:42
and you're in your mid 20s by that or no still early.

Mike 33:47
I'm in the middle, my late early starting on my mid,

Scott Benner 33:50
okay. And you're diagnosed again at how old? like eight or nine and are between nine and 10. Okay, so fair to say about 15 years of your life is spent at least over on 11 a one C and, and going this whole process that you just described? Yes, right now from that point into I'm sorry, I feel like I'm I feel like the bad guy in the story for some reason. But from that point until your first complication, how long is it and what is that first one?

Mike 34:28
So my first noticeable complication, and I was I've been a type one diabetic Test, test monkey for new drugs and, and apparatuses for, oh 2530 years. And this has to be I'm trying to think of numbers here. I'm not. So this is before my trophy wife now. After I moved back to, so this is around. Right around 2000, maybe one of the studies I was signing up for was people, people with or without neuropathy of known degree, there was a beat, excuse me a pill that they were going to give you for a year or whatever it was to see if once they measured your neuropathy and your lower like, your own or between your foot, and like your calf, they did a measurement. And whatever that was, there was a there was a your inner out parameter. kind of go no go. And they would measure that over the year to see what the improvement was. So they had an electrode on my calf, like it was a, what are they called acupuncture needles, it's how they had the probe in there on your nerve, and they would fire that nerve, and they measured it somewhere in the bottom of your foot. And I'm not looking at what you know, cuz I'm laying on a table, you know, on my belly, and this guy is doing this measurement, feats, you know, straight out, you know, knee bent up, and he's doing this and doing this and spend a little bit time and he's, you know, he kept asking me, are you okay? Yeah, yeah, man, I'm fine. It is okay. Are you sure you're okay? So Yeah, why? And he goes,

Scott Benner 36:42
when you use my links for the sponsors, you're helping the podcast. And I appreciate when you listen to the ads. So earlier I mentioned you may be eligible for a free 30 day trial of the Omni pod dash, that's a tubeless insulin pump. All you have to do is go to Omni pod comm Ford slash juice box to find out if you are eligible and to get started. But if you're sitting there right now thinking, that's okay, Scott, I'm going to wait for the next big thing from Omni pod. And then I'm going to get going. Well, here's the thing about that you don't need to. Because of the Omni pod promise, you can upgrade to Omni pods latest technologies for no additional cost as soon as they're available to you and covered by insurance. Now terms and conditions apply. But you can find out more about that as well. At Omni pod comm forward slash juice box. So if you're excited to get started with tubeless insulin pumping with the Omni pod, you don't have to wait. Here's some of the things you're going to get out of this. You can bave or swim with an omni pod on. So that means no disconnecting for those activities, which means no high blood sugars later from not having your insulin. You can also wear it on the pod while you're playing soccer, lacrosse, going for a run a bike ride, making dinner, running through the house yelling it's raining close the windows. I'm just saying you like you won't get tubing cut on like door handles and drawers and things like that. Because on the pot doesn't have tubing. So if you've been waiting, there's no need to wait. And if you're using MDI right now and thinking I would like that, Scott, I'd like to be able to set a Temp Basal increase when I'm having pizza or extended Bolus, or, you know, I don't want to give myself six injections at a big meal because I'm like, Oh, I'm gonna have a little more I give myself a little more than just push a button and boom Here comes right through your Omnipod if that sounds good to you. If you want to use the insulin pump that my daughter has been wearing since she was four years old, go to Omni pod.com forward slash juice box there are links in the show notes of your podcast player links at Juicebox Podcast comm where you can just type it into a browser on the pod comm forward slash juice box. Last thing before we go, I want to thank touched by type one for being a longtime sponsor of the podcast touched by type one is an organization who is helping people with type one diabetes. All they want you to do is learn more about them. That's pretty simple. And you can do that at touched by type one.org. Alright, I'm going to get you back to Mike now.

Mike 39:41
He kept asking me Are you okay? I've got this thing cranked up and I cannot get a response. Well, what does that mean? It goes, you've got serious, serious, serious, lower neuropathy. And like that can't be true. I can feel he called fuzzy carpet. And he goes no. So my nurse practitioner at that time who I saw as my doctor, quote, unquote, she also did research with the use UCSD VA where a lot of the research was performed. And she kind of just got the result. We're talking about skills now. I'm sorry, I didn't know this things were that bad. I'm like, What do you mean that bad? And I did it. The levity of it didn't hit me. Because I'm thinking that's wrong. I can feel you know, again, hot, cold water. You know, I still I can feel everything. So I, I dismissed it, as you know, kind of whatever. But looking back on that now is, um, yeah, I guess that was kind of harder to take when I look back at it, but I just I blocked it. I'm sorry. You're fine. Um, I guess I just blocked it out in my mind thinking that this this is This can't be true. So that was the first. That was the first on record, I guess you could say, yeah. Results of a test. And that was all because I was, you know, going to do studies.

Scott Benner 41:23
So that's about 25 years in to your life with type one. And literally over 20 years ago now. Yeah. Yeah. Do the, does that progress in a way that's measurable? Or do you just notice one day that it's worse or how does that go?

Mike 41:43
I it's hard to say. Again, I still dismissed it, thinking that they were wrong. But again, it was a machine. They measured it. So yeah, I don't know. I still did a bunch dozens of more studies on different drugs and different things. But that was the first one had a measurement that couldn't do the study. And I noticed there was a you know, something was going down.

Scott Benner 42:20
Well, okay. What's the next thing that happens?

Mike 42:25
Next noticeable? Which I didn't know. And in the, in the meantime, I've had, do you know what the dupa Chin contractures are? No. So duper contracture a lot of people call it trigger finger. But it's not trigger finger trigger fingers, you're using your finger, and it locks. Okay, it's painful. And then it at some point, it straightens up a duplicate contracture, it's really common and type one diabetics, they don't know why, other than they believe it's something to do with the synthetic insulin, but it's basically a growth of collagen weed that goes around your tendons, nerves, and starts pulling your fingers down in a lock so that they want to extend past a certain point, okay. And I've had several on my left hand, and my left Pinky. The last one I did, I had by done by a hand specialist who turned out to be a butcher. And you can see, I don't have a pinky, right? He did the repair, cut the nerve, did it write it in hand therapy. And the nerve repair popped in my finger got stuck at an angle like that, and it would get caught in places. Wow. And for the record, for those of you can't see me, it was bent over more than halfway toward my palm. But it would flex to my palm, but it wouldn't flex past. So as I'm working on a car or something, you squeeze it in somewhere and you figure can't pull out. Oh my gosh, the now you got to get a screwdriver or something in there, pack the crap out of your finger trying to get it bit down your palm and pull out. So that's why they ended up amputating that one at the so they took two thirds off. So

Scott Benner 44:22
I got the nub to two thirds of your left hand pinky is gone. Correct? Right. Okay. Here it is. Yeah, I just want to make sure people understand.

Mike 44:32
Yeah, I believe that's the distal phalanges. I think they call it No, I don't know. But it's one of those phalanges it's I can only count to four and a third on my left hand.

Scott Benner 44:47
But if you hold up both your fingers you can get the eight and a half.

Mike 44:50
Yeah, yeah, cuz I recently lost my other one. But one of the things the complications I felt next After the feet, the finger as I started getting really bad frozen shoulder on my right side to start with, so you'd throw a frisbee or something. It'd be like, Ah, you know, just be that thing at different times.

Scott Benner 45:18
Is there anything they can do for that,

Mike 45:20
uh, when it gets so bad? Well, they can inject steroids, but you know, steroids does. So a type one, so they can go in there. And when it gets to a point, you can't move it and clean it out. I went to the shoulder doctor, and he said, Oh, also my right biceps. The the part, the neuropathy, whatever you wanna call it, it crystallizes the muscles, tendons, and nerves. So when that happens, and you move your arm out real quick, that rips. And that ripping of the crystallization is just painful. That that's a problem. I'm trying to think of. I'm trying to think of the progression of the other complications. So I work with my hands. I'm no longer a auto mechanic, but I'm a piano and incident repair technician. So I'm still working with my hands. And it was several years ago. My mic, as I'm working with my hands, my fingers would just lock up in these contorted positions. And at any given time, and I would drop the tool I'm working with, I'd asked my hand therapist or my hand, my hand doctor, specialist, what what's causing it? Do I have arthritis? And he says, No, you don't have arthritis. Why is the locking up? He's I have no idea why they're locking up. But that that will get worse and worse. And worse, and then recently diagnosed as severe neuropathy. Yeah.

Scott Benner 47:06
When did the brain fog come?

Mike 47:08
Oh, gosh. So the brain fog. So here's what most of my type one buddies my age. We, we can't diabetic drop out. You're talking and, and you you've, you forget where you were talking about or the word or whatever. And that was that that was happening over the years. But that was also it's basically also if

Scott Benner 47:51
you want to take a break.

Mike 47:53
Now, all right, it's the up the crystallization of your fine blood cells in your, in your brain? which they've recently basically it's, it's, it's basically Alzheimer's, there's nothing you could say, Alright, that's what it really gets for I think about that. But they I still haven't had the MRI yet. Because I don't, I don't want to know that. I don't want to know the results. About what what the measurement of it is. You can't take all simers meds because the side effects are harder on you, then what the benefit might be. But that's just years and years of, you know, out of control blood sugars. But there's nothing nothing we can do. We didn't know about it. They didn't know about it. You know, 2030 years ago. This is something there's there's puppies and kittens, puppies and kittens, puppies and kittens. Um

Scott Benner 49:06
Can I ask you why you wanted to do this?

Mike 49:10
Yeah. I hear so often from from people who are newly diagnosed the past few years. If there was ever a time to be diagnosed, now's the time. Sorry, both my sleeves should have a long sleeve shirt but hot out but yeah, so. And it really what really tied this all together is I used to say, you know, it's pretty good time to be diagnosed with diabetes. I've volunteered in a lot of kids ski camps that I can't do anymore because of my neuropathy, but just letting people know that it's pretty good time. Now, fast forward, back forward a little bit. As you know, I started listening to you. When COVID hit, and I started First off, employed bumping nudge. And I got down to the, the high, low six, high fives just with that regular diet. That's figured out stuff. And then that's when I decided to go keto, not because of the juice box method, but it just seemed like something to do easy to do. I love barbecue. And then when we did our first recording, back in October, I was that I believe it was five, seven. Since then, I've been rocking a solid five, five. And then that's when it tied in. to, to myself, and why I wanted to do this. So the parents of kids nowadays, to give them some relief, that by once you learn how to use insulin, and I will say until I listened to your podcasts, your gift to the world, whatever you want to call it. I never really knew how to use insulin, if you really want to take it because the doctors are Oh yeah, your seven your eight, don't eight, five, you know, it's just, it's, that's still not healthy, that's long term. No good. But by keeping good agencies and keeping in the low fives, even at a low six, my heart of hearts, my belief and talking with my neurologists, you're gonna avoid all that you're not going to have

Unknown Speaker 51:53
this

Mike 51:56
this stuff happened to you. You know, when you think about your sandblaster you know, vision that's just that just hits home and feeling the salt, the sugar crystals, it's like, duh. But I really wanted to give some comfort to these new parents and I see it all the time on the on the Facebook group, you know, diagnosed you know, four months ago, a when he was five, seven, you know, it's like, you can get it, you can grasp it, you can live a life without complications. And there's no doctor in the world that will tell you that. And that's what's both. Sorry, that just No, you're fine. Please, you kidding me? You can say whatever you want. But it's it. It took a non diabetic and a non doctor to figure this out and share this with the world to you know, you can do this without the complications if you you know, do the 88 recommendations seven to eight. You're gonna have something happen to you, man. Yeah. And as of now 55 years old. I'm having to go out on disability because like, I can't work who my shoulders, my hands. So I had to have my, my right hand, my right pinky advocated a few months back, they'd fix that dupa trend several times. And within a year, it kept coming back. The blood supply on the outer finger was compromised. So there's just no way to do another surgery. Right? I just wouldn't live. So now I'm doubled up. But in that hand therapy, so you do a grip test. And I've always been in the 95. And that's an average average male, between 9095 100 and this last grip test I did, which proves my point I I can't even open a Gatorade bottle. It was 20. Wow. How quickly did that drop off happen? Hey, it happened over the last couple of years. It started getting really bad. But it was just a progression from all the years gone by. They did a upper and lower neuropathy test where they do same thing with the acupuncture needle and they electrically they started your hip and they go down and it's on this little speaker. I don't know the name of the procedure but it's as they're working the way down. When the nerves are firing here, this should be noise on the on the speaker and the closer they got to my knee the the quieter it got once they got below my knee it was dead silent you know I used to we used to walk miles and miles and hike I I can do about two miles maybe on a walk. I walk with a walking stick now. And that's not hard pavement. You know we don't hike anymore. I just can't.

Scott Benner 55:34
Yeah, hurts too much. Is the issues you're having relegated to your extremities? Or have you willfully not been looking internally at yourself or what what is the rest of it? Like? mean physically or mentally? I was gonna get to mentally in a second I metaphysically first.

Mike 55:52
Yeah, physically. Um, yeah, it's just the neuropathy is so bad at this point. Um, you know, I can step on a it's like the Princess and the Pea by step by a little pebble with bare feet, man. It's just it's excruciating. Wow.

Scott Benner 56:10
Yeah, I guess I mean, I feel compelled to ask you about, like, how? How do you manage? Seeing cuz I mean, what's really happening is you're seeing aging happening happen at an accelerated rate. Yeah,

Mike 56:28
I thought the wheels wouldn't fall off till my late 60s, early 70s. That happened a whole lot quicker. I had jet fuel to me, I guess.

Scott Benner 56:39
Well, immediate, even really. I mean, I hate to talk about it like this, but it must be frustrating for you. Because now looking back and understanding where your blood sugars are, your body really was resilient. Honestly, to get you this far. And I mean, am I wrong, but it can't hate. I hate asking this but

Mike 56:58
ask anything. I'm an open book do you play or to tell I'll be or whatever people need to hear this. They need to. It was hushed and shushed and everything was behind, you know, don't talk about that. So, people need to hear the truth and why it is so crucial to live the way you have are living and of these other people that are in their fives. Yeah, you're going to get to 160 but you're not hanging out there for four or five hours, not the excursion. It's okay to be 300 for seven hours. No, no, it's not.

Unknown Speaker 57:36
But do you play?

Mike 57:37
What if ever, do you ever think about? Like, what if you learned it sooner? Oh, 100 Yeah, every 24 hours a day. You can't avoid it. I imagine right? You can't Well, it was really bad there man. I was I was so spun out. Especially after I lost my right finger that oh my god would have you know, what am I gonna do? And you know, what am I gonna do? You know, my wife? What are you gonna do when I die? And if What if I die? It's like, I was just a such a bad mental place. And you know what's gonna happen tomorrow? Well, God is this doctor would have told me 20 years and yeah, I, I I have sought mental health. I mean, you have to write to do you see a therapist?

Yeah, yeah. So I knew. I knew after my right amputation. I mean, I just I spun out man, I just I spun out because it was it. It threw me off the cliff. And I got so spawned out of you know, what if what next? You know, right if I'm this way now, what's tomorrow? What was next year gonna bring? Yeah. And I just, it was so bad. My trophy wife said if you keep this up, I'm not living this life. It's not what I signed up for. I was I was always known as a it's all good, man. And rule number one. Rule number two. See rule number one. And I was I was in a dark, dark, really dark valley that I just the moon wasn't even shining in. Your wife didn't have any trouble with your, your health issues. She

Scott Benner 59:17
had trouble with how you were facing them. Correct? Yeah,

Mike 59:21
okay. Correct. Yeah. And even when you're dating, so I was in my I wasn't quite 40 yet when we started dating. And you know, you're diabetic you think you're 40 who's going to want you you and so I met her we kind of the, from the first date we went on, we haven't been separated other than a business trip or something like that. We've never really fought until I won't say we fought recently, really recently is when she said I can't This is not what I signed up for. And this is the funny thing. She has a really close relative who is a nurse who is type one. Who had 911 calls on her dozens of times? And knowing that, and she got with me as a diabetic, I'm thinking, What? But you know, we fell in love and she's like, it doesn't matter. You know, things happen, things are gonna happen. And thank God, I haven't had to have 911 called on me but and then after five or six years later, she asked me why. And I, you know why? Yeah, well, I test my blood sugar's, but I was always higher than lower because I developed really bad hyperglycaemic on awareness. And I was paranoid going low,

Scott Benner 1:00:36
right? Like, you're, you're shining a light on something, but I contend constantly, I don't say it out loud as much as maybe I think it. But everyone who's come into this life, you know, in the in the past handful of years and seeing technology like it exists now. I don't think the vast majority of them will see the issues that you're having. No. And I wonder if they don't want to pretend like they don't exist, so they don't have to think about it. And that I understand. But my responsibility becomes such that as the, as the podcast grew, and it started reaching more and more people. I thought, I'm not just talking to, you know, moms with good insurance, or, you know, you know, kids who grew up well and have DAX coms like any more like I realize now that I'm, I realized that then, but as it grew, I'm reaching more people. And my contention is, is that there are way more people like you living in the world right now with Type One Diabetes, than there are the average parent of a child who's got good insurance and found a podcast. You don't I mean, like, so I don't want to be a boutique show. And I, I mean, I was really grateful that you reached out and want to talk about all this. And I have to admit, when you asked, I didn't know how you were going to do it. I have to admit that personally, for me, it gets less than I don't have any of your health issues, you know, and when this is over, I don't have to do whatever you have to do today. But your name being Mike is hard for me. That's the weirdest thing, but at the same time. Like, I feel like I missed my friend Mike. And I feel like I missed you, too. You know what I mean? So it's a weird thing. It's obviously not it's it's not all of your health is not my responsibility. But it's, um, it's a real, it turns up stuff for me, because when I start thinking about my friend, Mike, I don't believe that by the time Arden was diagnosed, and I figured this the end, by the time I figured this stuff out, it was likely too late for him to begin with. But it would have been cool to see him feel hopeful once or to hear him talk about his five, five, a one C or something like that. And it's just it's, it's tough for me to to hear you describing what's happening to you. Because I feel like I I feel like I can see your future already. And I think you feel like you can see it too.

Mike 1:03:26
I do I know what you're talking about. I've heard you talk about Mike and it, who knows, but I I truly believe in my heart of hearts now that I'm not going to get better per se. But hopefully, I won't get worse. And I will say this. Um, I've always worn glasses to drive at night since I was 18. And since I've been doing your techniques, strategies, not medical advice, I know, but employing how to use insulin, and how to bump a nudge and Pre-Bolus and all those. I no longer wear glasses.

Scott Benner 1:04:14
Oh, that's cool. I wish I could do something to get myself to stop. I'll tell you what, if anybody wants to start a podcast that gets me away from these reading glasses, I'd be really really grateful.

Mike 1:04:25
Well, it's in a talk to my doctor about that and the eye doctor and it's because my eyes aren't you know, shrinking, swelling, shrinking, shrinking, shrinking, shrinking, shrinking. The blood sugar's my my mom wears pretty heavy glasses. My dad, my granddad, nobody else did. So, for what that's worth while

Scott Benner 1:04:45
I'm Thank you. I mean, that's a weird. I'm sorry that I turned this into you making me feel better, but I appreciate knowing that. I was just Charlie give context. Really? Yeah. Yeah. Like I know we're in a weird setup right now where I don't have a camera on it. You do, but I, there are times I've had to look away from you. Because I'm like, Oh my god, I need to be able to keep this moving and, and put a podcast together. We can't both start crying because I don't think anybody would listen to it.

Mike 1:05:15
And the other reason why I was happy to do it, and I knew I was gonna break down, but it's, it's, you know, it's sad, it's it's, it's you look back and you think you know what I used to do and what I warm at now, but you know what? I honestly believe my heart of hearts, how much worse it would have gotten so much faster. The other issues, had I not found the podcast and been able to employ those tools to hopefully stop the future, you know, and carry on where I'm at? And I, I believe that.

I'm glad I do. And it's. And that was? Well, that was part part of it. We'll go ahead.

Scott Benner 1:06:08
I didn't mean to cut you off. I'm sorry. No, I thought it's all you know, I just part of what I was trying to say, and what I've been trying to say about why this all needs to be kind of bulletproof and easy to understand. Because, in my mind, what if the podcast finds you, but it's too convoluted or too difficult? And you're like, yeah, and then you walk away from it. You know, like it needs to be like there was there's a person online last night, who put up some graphs. And people were, you know, pretty much it's interesting to watch people from the podcast talk because they they're like, there's two factions. One of them's right. Okay, this person, this bait, this person's basil is either not strong enough. Or they're bad apologising for their meals, right? It's one of these two things. I saw that but Right, right, but the point is, is that it is definitely going to be one of those two things, but you're talking to a parent of a child is a fairly new diagnosis, they don't know what they're talking about. And yet they're trying to figure it out. And I think that, if I can give myself credit for anything I can give myself credit for, for coming up with the idea, the very simple idea that you first make sure your basil is right, then you learn to Pre-Bolus, then you learn the glycemic load and index of your different foods, and stay flexible. And it's a four step idea. That is doable. And no matter whether you're a person whose basil is too weak, or you don't know how to polish your food, if you go through those four steps, you're going to come out on the other side with an answer that's valuable for yourself. And while these people were talking to this person, I realized that the one difference between all those people who all had rock solid advice and me was that I have a concept of what it's like to talk to a person without having all of their information without really understanding and and knowing that if you go back to get your Basal, right, make sure your Pre-Bolus etc, etc. that no matter what problem, ask what problem perspective you're coming from with using your insulin that will get you to the answer, like maybe this woman's basil is right. For her kid, it could be, but maybe it's not that far off. But understanding that you can't just look and tell somebody something because if somebody were so somebody to swoop in, in that moment on that person in that post and say, Hey, your boluses are way off, which they probably are. But they don't. They don't address the basil first, then these people are going to be making these aggressive boluses forever. And they're going to have these lingering highs. And so I came in, I said, Look, your Bolus looks looks weak to me. People are like no, no, no, look, how stable are blood sugars are these blood sugars are it's just high because they're missing on the meals. And I'm like, well, that could be yet but I know enough to say Well, yeah, maybe where everyone else where everyone else is like no, no, this is it. This is but they only think that's it because it's what happened to them. And and you know, and so understanding how to deliver this information in a way where everybody comes in ends up at the same place if they kind of go through the steps. That's the part. That's super important. Because you miss people, you don't catch them all if you don't have something that everybody can work out. And I don't know, I just think that it means a lot to me that you found the podcast. It struck you and it worked.

Unknown Speaker 1:09:55
Yeah

Mike 1:09:56
and part of it white work. I I understood what you're saying. But you got to remember, I've never changed my own basil rates or adjusted those. Yeah, I've, I've obviously fluctuated my boluses from what I'm eating. And that was always never enough. And then the two or three hours later, you're covering for 250 to 75 300. And that was just a way of life. So I, when, when I first started doing this, I needed somebody there in my corner to agree with what I was seeing, and saying and adjusting. So I hired Jenny from integrated diabetes. As my coach, my mic person in my corner my Yeah, yeah, you're, you're absolutely right. That's the right thing to do. Right. And by having that, that person as my crutch, though, I got it dialed in, you know, you know, we got it dialed in, you know, cuz she was there with me too. But it validated everything that I understood, to make those adjustments. You know, I couldn't do it on my own. But I was terrified, because I didn't again, I'd never made my adjustments. I go see my doctor twice a year, and she'd have my PDM. And you

Scott Benner 1:11:14
go, Okay, well, we should make sure people definitely understand what you're saying. So you listening to the podcast, you're like, Oh, that makes sense. Now, how do I pull the trigger on this like that, then that's a really difficult thing to do. Whether you're a person has been living with diabetes for decades, or a person who's only had it for few weeks, like the the idea that you could move that number, turn that dial, like flip that switch, is, it's freezes people. And I'm telling you, the only my Give me one more second, the only reason I had the nerve to do it was because in the back of my dark mind, I was imagining things that have happened to you happening to my daughter, and I thought we got to do something. Like we can't just look at it, you know, but a lot of people get stuck looking at it.

Mike 1:12:02
Well, you got to remember that I have 27 years of a habit in me of Never making an adjustment to now make this adjustment versus somebody that's a year or two in it. Six months in it. You know, yeah. Okay. You don't have that. Don't touch that. Don't touch that. Don't touch that. Don't touch that. Don't touch that. Don't touch that. Yeah, just looming over you. Um, you know, and I'm not saying we're, we're, you know, sitting in a great place, but you know, I can afford to hire as you know, that help. And I know, she's a big help to the show. And I knew from listening to her in you that that was going to be what I needed. That help, and anybody that needs it. I mean, it's just, it's such a great ability to have that resource. I mean, you're only one man, you know, you've only got so much time in the data. I know, you'll help people and you do all the time. But I didn't need to bog you down at that point. I could afford to. Does that

Scott Benner 1:13:08
make sense? Yeah, well, not only that, but Jenny has something that I don't know how much it comes through. And she's talking on the podcast, but I know Jenny more personally. And the anger. I think that might be the right word that came out of you earlier, when you talked about doctors not helping, like Jenny has that. Like she has that inside, she does a good job of masking it. And it might not come out a lot. But she's driven by the desire, in my opinion, to fart bad information. 100% Yeah,

Mike 1:13:44
I 100% see that and after work with her listening to you, and yeah, 100% and she does a really good job putting the makeup over.

Scott Benner 1:13:54
And she and she really cares about people to which I there's, as soon as I met her, and we started to get to know each other. I just thought like, you know, I joke on that, like, you'll hear me joke on the podcast. I'll say I wanted to have Jenny back on because she agreed with me. But that's just me trying to be funny. I don't know if it works or not. But I guess I like when people agree with me, but that's for a different reason. But what I liked about Jenny was her desire, like I just spoke about. Yeah, I like her knowledge. I like the practicality of how she thinks about it. And I think the first time I said to her, I don't believe that your diabetes may vary. I believe that everybody's diabetes at its core works the same way. And if you had your settings right, knew how to use insulin, it would work out mostly the same for everybody. And she's like, I agree with you. And when she said that, I was like, Yeah, okay, fine, finally, and she validates me. I don't think I don't I don't know that she ever thought about it. I've definitely never said it to her. But her being on the show. Helps me reach more people because there's a validation that that she agrees Yeah, and when she doesn't agree, she just So, and when I don't understand, I just say, I don't understand that, you know, like, it's it. You gotta have no, it's crazy. I'm gonna say this because people will laugh, but you have to have no ego about it. And then once you know, you're right, you have to steadfastly defend the fact that you're right. And because other people will come in and say no, I think the Basal I think it's this. So, you know, the this story online that I told earlier, it's not over yet. It's still happening right now. And this person came back and showed a basil rate overnight that held this, this kid's blood sugar super steady. Like it was great. And everybody's like, Oh, see. And she I think she moved the basil from point five 2.55 or something like that. And everybody's together. Basil is great. And I still was like, well, what's the number? Yeah, and the number was like, 141 3140. I'm like, Okay, so the basil is great. It could still take a little more, like, you could still put a little more maybe point six is the answer. I don't know. I'm not there. But if that basil was right, overnight, your blood sugar would be lower. And maybe you're not comfortable there. Maybe she loves 140. And then God bless. Like, right. But if, but if if not, I mean, Arden's blood sugar last night was like 85 all night. Yeah. So you can say that's not a big of a deal. That's 50 points. 50 points every every minute you're alive. That's 50 points less blood sugar, like sugar, like coursing through your blood?

Mike 1:16:23
Is Yeah, it's that sandblasters just trickling.

Scott Benner 1:16:25
Yeah, it's a big deal. And I'm not saying like, Listen, if your kids blood sugar's 140 for a week, while you're figuring out or honestly for three months, while you're figuring it out. Oh, absolutely. You're gonna be okay. Like, right, but. But what Mike's telling me is it can't be 10 years, it can't be 11 years, it can't be 20 years, it's no, it's not going to be okay.

Mike 1:16:43
No, it's going to happen. You're going to have sick days, sick weeks, six months or six months, you know, that that little time periods is not going to do you know, long term damage. I believe that my heart of hearts because the body does repair damaged cells. But there's a point where it can't repair it anymore,

Scott Benner 1:17:04
right? You're hoping to hang on just to stay steady, stable, where you're at? Yeah. And you've given yourself the best chance possible, honestly. Yeah, absolutely. You're doing an amazing job. Look, man, for people who don't understand what we're talking about. Still, I mean, if you've listened to Mike, and you still don't understand. My friend, Mike, who was diagnosed in the mid to late 80s, passed a couple of years ago. And I would say that his care mimics yours. But he never really until the very last couple years of his life made it to modern insulin. And he was discussing what to eat for dinner, when he stood up and ceased to exist. And that he did not know that was coming.

Mike 1:17:49
No, you don't. And I've, I've heard from my doctor was it was a copy your company a couple years ago. You know, we were making some adjustments or whatever. And

Unknown Speaker 1:18:01
it might have

Mike 1:18:03
I don't it was several years ago. But she goes yeah, you know, right now everybody's dropping their heart attacks. I'm like, right, what 6070 she goes no, 40s and 50s. You know, all these long term type ones. They're dead. We're just, you know, doing their habit doing their thing. So it but and I want to preface right base listening by doing right now, you're gonna avoid that later.

Scott Benner 1:18:28
Yeah, it is very likely not going to be the outcome for most people. 40

Mike 1:18:32
No, five years from now. And I want to stress to these teenagers out there that you think you're invincible. You're not. You know, if you're in college, and you go to the mess hall and you come out of that with a 300 for four or five, six hours and think it's funny. It's not, you're gonna more than likely have problems. And I know the teenage years are tough. I know. They're tough. I know, their early 20s are tough. You think you're that warrior, brave, you're invincible. You can be Take care of yourself. If I can't get any, any across. You got to do that in those years. Because I know a mom and dad's taking care of you. But when you go off to teenage and you want to not be on insulin for a while, because you're tired of being a diabetic, just me. I know what it's like, Been there, done that got the shirt hat sticker, but you just can't do that. And if I can get any message across, you can't do that. do what's right, you're gonna be fine. Anecdotally,

Scott Benner 1:19:35
I've spoken to enough people now. Where I have to agree with what you're saying. Because, you know, you're diagnosed when you're younger. And if you're lucky, you have parents who are on top of it, right? If you're not lucky, I've talked to every I think I feel like I've talked to almost every version of a person who's out there, right? And by the way, every time I say that someone sends me an email and I was like, I bet you haven't heard this story before. Like all I have But, you know, say say you're diagnosed when you're young, and you're and you get me, and I'm your dad. And so you're okay. And then you get the college, and you let it go. And a night turns into and these aren't my this isn't me making it up. These are the stories people tell on the podcast and it turns into a week week turns into a year, your turns into grad school. The next thing you know, you're 27 years old, and some girl are guys telling ya, listen, I mean, I want to have kids one day, are you sure you can do that? And then you go, Oh, no, no, no, jeez, you're right. And then you'll whip it back into shape. And these are the stories people tell. But in that time you lose 1819 2021 2223 24. I don't know what your blood sugar's were during there, you don't know either. And as much as it sucks, you don't know what's going to happen. And what's going to happen from that isn't going to happen until you're in your 40s maybe, you know, and, and if something doesn't luckily snap you back into it, which is what I hear from most people, it's usually it's usually not. It's not usually like a come to Jesus moment. Like you just realized though, I should take better care of myself, it ends up being for other people. I hear a lot of women say I wanted to get pregnant. So I got my blood sugar together, or I got pregnant, I didn't realize I was gonna get pregnant. And I had to pull my blood sugar together, or I met a guy. And I realized I wanted to have a life where I met a woman I realized I want to have a life or vice versa, or whatever, whoever meets whoever. The point is, it seems to be the trigger seems to be when you suddenly care about somebody else. You realize how much you weren't concerned about yourself? Yeah. And then suddenly that love or that connection? Makes you feel like you want to do better for yourself? Almost for other people. Yeah, but if 50 people haven't said that, to me in the last three years, I'm lying. Like, you know what I mean? Like it's been that many.

Mike 1:21:57
But circle back to the pregnancy thing. When when they die big ones get pregnant, the doctors make them get their ABCs below six. And then once they had the baby, they go back to wherever they were like, why did you do that? Oh, it's just so exhausting. But I gotta honestly tell you, I've recently taken on a new primary doctor because of my insurance who is a type one? And when they look at your, you're able to see five, five, that's too low.

Why is it too low? Well, that, you know, I told him, I'm doing a juice box. Well, that's just stressful. Why is it stressful?

Well, aren't you? Are you being stressed? I'm like, honestly, Scott, I think so much less about diabetes every day than I did before I started doing the math because you'd eat lunch. Two hours, three hours, like two senators gas said about that. Yeah. So now you're fighting that and trying to get that down to what you know, should be a good number. Yeah, um, but my high alarm is that 120. And I told the doctor that because you need to raise that. Like, why? Because it's too stressful. I go, why is it stressful? I'm Pre-Bolus saying, Look at my graph, if I'm off a little bit, because you know, stress, happiness, sadness, a car pulled out in front of you, adrenaline, all those things happen everyday in life. So that same turkey sandwich is going to be a little different day to day because of those factors. If I hit 120, and Dexcom, if you're listening, I love you. But please put a Delta in there. So I got to go to sugar mate at 120. Look at the Delta, if it's plus four, I'll give a couple of tenths a unit. If it's 120 plus zero, a watch it and it usually goes right back down.

Scott Benner 1:23:42
Jake's coming on next week from Dexcom. And he's gonna beg him to put it down. I think he's gonna tell me what the what the new apps look like. So I'm hoping that that's something If not, I'll just I'll have to bring it up again. But please do yeah, no shelter they have to have to rely on for anybody listening to us understand Mike's talking about rate of change. Like he wants to know, if his blood sugar's like not just the arrow, like diagnol up, he really wants to know it changed. You know, four points in the last time since the last reading or something like that. Yeah, affirmation.

Mike 1:24:13
I look at that religion, it could be 120 minus three, I'm definitely not gonna do nothing. But even if Dexcom says it's a straight arrow, it's a good reference. Yeah. But I want to see that delta to know, do I need to be aggressive? Like, instead of two tenths, four tenths of a unit?

Scott Benner 1:24:30
No, I completely agree that it's incredibly important. If I was making an app, they would have it on there. Don't go high. You won't go low. Maybe we'll maybe there'll be a Juicebox Podcast app one day, you can just imagine. I started a three app game. That's branching out. Is it? Well, I mean, I do want to ask if there's anything else you want to talk about before we we start to wrap up. I don't want to leave you without Having said the things you want to say, but

Mike 1:25:03
Well, I'd said pretty much everything I want to say, um, if you know if anybody wants to talk, I'm open. I'm in the in the Facebook group. I'm, I'm an open book, I don't hide any, from anybody, anything from anybody I talk about I see a therapist. I'm not mentally and you know, people think you're seeing a therapist, you're meant to say, No, I needed help to try to figure this out. I didn't have the tools. So it's not shameful. And I, I talk about that to anybody, because maybe I've had a couple of my friends say, Hey, I really appreciate you talking about that, you know, what, I need to see somebody because of this, that the other. And so I talked about it, and they see that what normal is normal, you know, they can equate to that. So I, I'm a big advocate of that. re educate, re education, to keep up with the times the new technologies. I heard you talk about,

Unknown Speaker 1:26:03
excuse me,

Mike 1:26:05
why you don't write a book, why you don't write a book, quick notes. because things are fluid, things change, the technology changes, you need to re educate yourself with what's new. Don't rely on your doctor. You know, do your research, you know, you know, look at these drug companies go online, on forum on the Facebook group, and you know, what's new? What's the newest and latest and greatest? I got a buddy in Arizona, who I've recently met, you'll, he's I'm not gonna say his name just for his privacy, but because I don't know if he'd want me to talk about him. But he's on regular and mph. MDI is like there's way better insolence. Really. I mean, he just didn't know because he had it. He didn't know who to talk to reach out. He and I connected to another friend. We text every day. And, you know, he's gonna, he's doing better. I'm so proud of him. So you, Tucson chef, you hear me saying this man. My heart goes out to you. I'm so proud of how how hard you work and you're getting Sorry, man. I didn't think I was gonna break down for that one. It just fills my heart with joy, that he's getting the help he needs and he's finding these tools. Which It's so sad because so many people are just diagnosed from the doctor that graduated 1986 and that's the technology they know. Get a new doctor asked what's the latest from you new doctor don't take their word that this old insulin is great. Just go to Walmart do that. $25 vital insulin. You know, just re educate, re educate, re educated. I just I can't hammer that enough. And after finding the podcast. As I said, I didn't realize I didn't know how insulin worked. Nobody ever taught me. I never asked anybody because my doctor got it. So why would you ask him without the reeducation? And these better ensigns we have I just I can't push that enough. And

Scott Benner 1:28:09
you don't want to be the lobster in the pot, man. All right, it's fine. Everything's good. This feels nice, actually. Yeah. Nice. I like not worried about it. And and yeah, it just I mean, the way I usually say it on the podcast, right is you don't want to look back one day and see that you're doing something the way people used to do it.

Mike 1:28:28
No, no. And part of my therapy. My therapist, I just want to put this out there. I was so focused on yesterday, what happened 20 years ago, and so worried about what's going to happen in 10 years. The best thing that broke through to me, and I think anybody can relate to this is you got to be in the now you got to be in the present. Throw away yesterday, focus on today and have some concern about tomorrow. But tomorrow that's when you'd be the president present president president president and by to help you set yourself up and here's the easiest tool that anybody can us wake up in the morning, get your coffee and focus just on three things you're grateful for that day. And like and what I do for instance, you know, I teach barbecue and I got a barbecue store. I work with a volunteer there I work for product which I was unaware of this. But when I my first dog I had to retire because of this had to have his kidney removed. And she knew I didn't have the dog there to look out for me. She looked out for me we were at one barbecue competition one time and I was overheating so I pop slept in the motor or you know kind of, you know what in the motorhome I took a shower, and I came out and she says where'd you go? I go What do you mean she goes, you need to tell me if you're going to be out of sight. I got I'm watching you. So one of my days of being grateful I thought about that. So I physically call that person, there's something I do. And I explained about my three things. I'm gratitude, Greg grateful for that day. And if it's a particular person, a friend, you know, I want them to know that I'm thinking about them that day, and focus on three things. So since I've been doing that, and that buddy of mine in in Tucson, he and I will text our three for the day just to kind of, you know, see how we're doing and checking in. And there's several days that I've been practicing this, what am I grateful today I'm in the present, there's some days, I can't think of three, I just feel such gratitude. That it's just, I can't focus on three. And that has helped me huge and that I got directly from my therapist, to as an easy tool to work on. It is so effective, B. And now, don't worry about 20 years from now, because the asteroid could hit tomorrow and we get I'll be gone.

Unknown Speaker 1:31:07
Yeah, worry is a waste of imagination. That's for sure.

Mike 1:31:10
It is. But I got so spun up in that I couldn't, I couldn't pull myself out.

Scott Benner 1:31:15
Yeah, no, I understand happens. The people. I don't generally worry a lot. But two days ago, I woke up and I was I just literally worried about the thing I went to sleep worried about. So it felt like it just started over again. Yeah, I have to say that. Being positive for other people to it is really valuable, like not just seeing, like I talked about when I was talking to the doctor the other day, which I heard you referenced earlier. But I think you you if you're having success, and you want to show your work, that's really great, because someone is going to see it and feel hopeful about it. I think it's really important to remember that as we share online, the people you're intersecting with who you can physically see commenting or liking, there are a very small portion of the people who are seeing it. And, and you know, as you're, I mean, listen, if you're if you're in a, if you're in a room with four people, and you're talking, you're impacting four people. But I can tell you, from my personal experience, I don't even at this point, know how many people I'm talking to, I just have to imagine that they're there. And, and I've now heard from so many different people in so many different walks of life, I understand that they're there. I know they're there, whether I can see them or not. And being positive. Not falsely, but but in a tangible way, is very valuable for people. And I'm glad to see that. I'm not hearing from so many people anymore, that you don't show people when you're doing well, because it makes them feel badly. I think I think that they'd much rather know that better exists. And even get the idea that reaching for it might be valuable, rather than just to make them feel like this is horrible. And this is what it's always going to be and look, everybody else agrees with me. So I'm just gonna sit here in this pot and boil. That's all. I don't know why you made me think of a lobster today.

Mike 1:33:19
That Well, that's like, that's a great analogy. It's like putting the frog in cold water and turn it on. And he doesn't feel the difference. He

Scott Benner 1:33:25
doesn't know. This is like, tapping, but I don't know it. Yeah, you don't you just you got to try. He just I mean, the point really is, is that you have a finite amount of time. And even if it all goes perfectly, it's not enough time. So when things start, you know, creeping up, and I think everyone's going to have roadblocks. I think a lot of them are going to be health, even if you don't have type one. And you know, sometimes you only get stretches the time stretches a time where you don't have to think about something. But if you don't pay attention to what you're doing, and try to address it, those stretches are going to get shorter and shorter and shorter, and they're going to disappear one day.

Mike 1:34:03
Yeah, I think you reference roadblock and um, you look at some of these, like military leaders or these lieutenants and stuff and in the way they look at things and right there's a roadblock. What's the solution? Don't focus on the roadblock. You sit there and keep looking at the roadblock? That's how you're going to stare at Yeah, you get caught? What's the solution? What ever it is, whether it's diabetes, whether it's whatever it is, but that's a that's a that's a real valuable message I've got out of you know, some of these discussions and talks. It's like, don't just and you get these negative nouns that keep focused on what happened. That's like being in yesterday. Why didn't somebody tell me to do better 20 years from now, but that that's gone? What's the solution? Now

Scott Benner 1:34:47
you got today and forward and that's it. So yeah, yeah, right. Mike, I really appreciate this. I can't thank you enough. I, I imagined that it wasn't going to be easy for you, and I appreciate what it must have taken to tell everybody. All this stuff. Yeah,

Mike 1:35:05
I know it's gonna be hard. Like I said, I'm, I'm reachable, I'm not I don't know what I can do for anybody. But if somebody is in a dark place or having the same issues or worried about it, you know, I don't know what I can do for money. I'm not Superman. I'm just a normal guy. But I understand sometimes you need to be able to associate that or talk with that, or, you know, I'm saying, Yeah, I'm

Scott Benner 1:35:30
saying find somebody who's in a similar situation as you and see if they know how to get out of the hole. Yeah, I have to tell you that I thought early on when you were describing, I was so tickled I knew how serious everything was going to be today. So I didn't make this joke at the time, but it stuck with me through an hour and a half. The image of you walking through a hospital, just on death's door as a child and this doctor kind of like sachet and pasty and be like, that kid has type one diabetes. I pictured john travolta in Saturday Night Fever. I don't

like swinging his hips with like his like fancy white suit. And he was just like, Hey, kids. Oh, handover. Yeah, he just kind of like made like finger guns at you and was like, type one diabetes. And how proud he must have been of himself later. Like, you know, there was like a moment where he was like, I knew that kid had diabetes. Yeah. Oh, yeah. Yeah. Didn't think he said that. I just had that. That poster image of the movie poster might show my age. But you said that and that's exactly i got i had a guy strutting down a hallway in my head. And he was like, That kid's got the rickets, that kid's got type one, I can just tell

Mike 1:36:42
it. Can I say one of the things from a reference from please the podcast with a doctor when you were asking her? What's the answer? And she said, 42. And you said, No, no, we're not going there. That was a reference from The Hitchhiker's Guide to the universe. Oh,

Scott Benner 1:36:58
no kidding. I don't know that one.

Mike 1:37:00
You've got to watch that movie. Because as soon as she said that, I say, Oh, that was a what a timely reference.

Scott Benner 1:37:07
I wish I would have known that I I You see, my level of understanding is just 37 from clerks, which is not appropriate for here. But does turn out to be like I said to her, when you ask people for a random number between one and 100, more frequently than not people will say 37 for some reason. Yeah. So yeah. Anyway. All right, Mike, I really appreciate you doing this. I am going to I'm going to think about this a lot. And I hope everybody else does, too.

Mike 1:37:40
Yeah. Thanks for having me on. I'm I'm like I said, I'm happy to spread the story that for people now. do your due diligence. It's not doom and gloom. Yeah.

Scott Benner 1:37:51
Well, I'll tell you what, when this goes up, I will put a post on the private Facebook group, that talk that announces this episode, and I will tag you in it so people can find you.

Mike 1:38:02
Sure. All right. You got to do the john travolta the Saturday Night Live. movie poster is the pitcher.

Scott Benner 1:38:08
Oh, for the episode I have. Yeah. All right. Damn it. I will. Alright, man, thanks so much. Hold on. Was that Thank you, I really appreciate you and all you doing. And thank you, man. It really is my pleasure. I mean, stuff like this makes this not that it's hard to do to begin with. But if it was, this makes it much easier. He you said something earlier, that, um, you know, I don't think I'll ever forget. And I know I've said it a number of times. But when somebody who has type one references that I don't have it. But in a positive way. Like I can't believe somebody who doesn't have type one was able to talk to me about this. I mean, I'm very touched by that. It's a the only world where I have it, it means a lot to me, but that I don't come off as as false, you know, so. So thank you very much. Thank you, Scott. I want to personally thank Mike for coming on the show and sharing all of this with us today. And thank you for listening. I also need to thank touched by type one for their sponsorship of the Juicebox Podcast to remind you to go to touched by type one.org. I'd also like to remind you about the Omni pod promise and say that you may be eligible for a free 30 day trial of the Omni pod dash right now. Go to Omni pod.com forward slash juicebox to find out more. If this is your first afterdark episode, you should go look for the rest of them. Childhood divorce living with bipolar sexual assault and PTSD using psychedelics. Amy, heroin addiction Believe me and depression, divorce and co parents thing, sex from a female perspective sex from a male perspective when you have type one diabetes, depression and self harm, trauma and addiction, smoking, weed, and drinking. Those are the ones we have so far. If you think you can add to the afterdark episodes reach out. Besides all of the great episodes of the podcast, there are other series, those about using algorithm based pumping the defining diabetes episodes. The affer mentioned after dark and so much more. Take a look at Juicebox Podcast calm Oh and don't forget the how we eat series intermittent fasting flexitarian keto fodmap Bernstein, low carb gluten free plant based carnivore vegan so many to choose from find out how other people eat. Thanks so much for listening to the podcast. If you're enjoying the show, please feel free to leave a five star rating and a great review wherever you listen. I'll be back soon with another episode.

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#529 Gail Force

Gail has type 1 diabetes and a number of other autoimmune issues.

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio -  Radio Public, Amazon Alexa or wherever they get audio.

+ Click for EPISODE TRANSCRIPT

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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.

comiong soon

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Please support the sponsors

The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!

Donate

#528 ReliOn Novolog from Walmart

Warren Moore, Vice President, Walmart Neighborhood Market Pharmacy Operations is here to talk about ReliOn Novolog Insulin from Walmart.

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio -  Radio Public, Amazon Alexa or wherever they get audio.

+ Click for EPISODE TRANSCRIPT

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

Scott Benner 0:00
Hello friends, and welcome to Episode 528 of the Juicebox Podcast.

today's show we're gonna be speaking with Warren Moore. Warren is vice president Walmart neighborhood market pharmacy operations. And he's here to tell us about rely on novolog insulin, just now available at Walmart. What this insulin is may surprise you.

If this is your first time listening, please subscribe or follow in a podcast that if you're looking for the diabetes pro tip series, you can find them beginning in Episode 210 in your podcast app, or at Juicebox Podcast comm or or doubler diabetes pro tip calm. While you're listening today, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan for becoming bold with insulin.

Today's episode of The Juicebox Podcast is sponsored by touched by type one touched by type one is an organization focused on helping people with type one diabetes, you can learn more about them at touched by type one.org. or on Facebook, or Instagram.

Warren Moore 1:54
Hello, Scott Warren more vice president health and wellness at Walmart. Happy to be here with you today.

Scott Benner 2:01
And I really appreciate you doing this. Thank you, I, I took a shot that I knew somebody that I could get to you. And it worked. And I'm sometimes amazed when it all works out. So I I'll tell you that when it kind of came up, right. So I'm in an interesting position that I'd like to explain to you. So when I saw the press release about rely on insulin coming out, the first thing I thought was they already have insulin, right. It's like it's a different kind of insulin, it's you know, I hear people say certain things about it. And then I listened a little closer. And I realized that this was the thing that I had kind of knew was going to happen for a while. You're You're basically just selling novolog but it's called something different now. And I thought how are we going to explain that to anybody and what happened? So I thought we could get together and ask a couple questions. Can you tell me first a little bit about rely on and and how it got started and what its aim is?

Warren Moore 3:00
Yeah, rely on his his private brand at Walmart. And so how people you think about it you shopping our stores, probably the biggest private brand that we have that people look at is great. And so within our health and wellness space, rely on its label, we put products out both OTC and so over the counter, as well as pharmaceutical products. And it's under our private label. And it allows us to, to lower the cost so that we can lower the price. And it helps our customers save money each and every day.

Scott Benner 3:37
Now do you manufacture your own products? Or are they is the whole brand just kind of repackaged something out? Like you know me like are you buying it from a corporation and already making a thing? And it just gets this new kind of facelift? Or how does it work? Or is it from product to product is that change?

Warren Moore 3:57
I think for the for the artists today it's you know, for us we think about Nova law. It is the actual product that Nova notice, produces. And and so we were able to come together in a partnership and can do that and real grateful for their partnership that we were able to come together to lower the price. So I will say, Scott, if you think about the rely on brand as a whole. We continue to have conversations and understand what's the right way to make sure that we bring products to market that our quality as well. So we never sacrifice on quality. And as you think about incident around this, we want to make sure that the FDA approved exact product. But we were able to bring our assets and in partnership with no one notice to lower the price.

Scott Benner 4:47
Okay, jumping to just something randomly different like a test strip. For instance, I'm assuming you sell test strips, is that something that Walmart makes? Or is it the same situation where it's a product from somewhere else that it's It's kind of rebranded

Warren Moore 5:02
its partnerships. And so as a, as a company, we use partnerships that we have on the produce for us on the under private brands, just like with, with all Gen, obviously, most private brands, I should say, within the industry, what we do is to rely on product brand has become one that our customers can trust. So, you mentioned OTC, you can go to our stores today, you can buy a 50 count box of test strips, and you can get a meter, both for $9. So you can start testing your blood sugar for $18. Again, we don't sacrifice quality. So we get make sure that everything goes to the right approvals the partners we have. And, and we we believe that it's so important to make sure we do it in a way in order to increase access and affordability for all of our customers.

Scott Benner 5:59
So that's part of it, then right, the idea of getting the populations that would not normally have access to these things to begin with.

Warren Moore 6:07
Yeah, you know, Walmart will say equity is is really at top of mind for so you will take where our stores are today. So we operate when you look at Walmart and Sam's Club, we operate over 5000 pharmacies. And actually 90% of the American population lives within 10 miles of a Walmart. And so what that does for us, because we have stores that reach rule and metro areas, we have a lot of our stores that are in medically underserved areas as defined by hersa, which is a subset of HHS. And, and so we're able to in these communities, where individuals struggle to have access to quality, affordable health care, they can't get access to a Walmart or Sam's Club. And then in there, we also have great pharmacists that are there that know the community that are part of community, ask your questions, and be a part of that healthcare continuum. So we believe that that we're positioned here not only by the law on a price, our footprint allows us to reach the communities and really increase access and equity. And, and so we're, we're, we're happy that we're able to touch that many customers across the US. That's

Scott Benner 7:26
amazing. Okay, so what this this insulin that you just started selling now? What do you guys calling it?

Warren Moore 7:34
It's called rely on Nova log. And so it's, it's underneath our brand and and Scott, one of the things we haven't talked about is really, you know, the the price evens that are associated with this. Yeah. For for a vow love of this canceling for the rely on overlock is $72.86 versus the branded price of $174. Wow, so almost Oh, but

Scott Benner 8:02
Geez, it's $100 off, right?

Warren Moore 8:05
Yeah, that's $100 off, and then you get into flex pens, we do the flex pens as well. The Price Is 8588. And the national brand new price is $337. So we got $251. So you're talking 58 to 75 5% savings, respectively, on these products that we're bringing to market.

Scott Benner 8:25
Can I ask you the kind of a back room question to this is, is there something about are we avoiding the insurance process? Is that how the prices go down? Or do you are you being Are you able to buy it directly from novo at a lower price? Like I don't understand how that I think what I'm thinking is that most people listening aren't going to understand how that could be. And I'm trying to find a way to explain it to them. You're laughing well.

Warren Moore 8:51
Scott, I will say that it's it's one of those things obviously how we go to market first it is it is the first ever private branded analog penciling on the market. So it is unique and so we were able to bring that to market. I will say without getting into the nuts and bolts of it is really due to partnership with with Novo Nordisk, and the US bringing our assets together to Lord O to lower their costs. It is we have focused on the cash payment customer because we know that there are a lot of people today that still don't have insurance, this that really challenged by the high prices of insulin. And so we've been able to partner remove that cost and again pass it directly on to the to the customers and what it does is it allows those savings to be used for things like healthy foods or everyday household essential so we do take your insurance so we take all major insurances within our Walmart pharmacies, and what you can then come to Walmart and understand that you know When you use your insurance, and this is one that is prescription, so when you run your prescription, if you have insurance, we'll we will give you the lowest price your insurance does. And if you don't have insurance, you can see the savings of $100 $1 $250.04 bucks. And we believe that that's going to revolutionize accessibility and affordability around,

Scott Benner 10:21
I would say so. So the real struggle here is to get out to people. This is why I asked you to come on because the in my mind this is the real struggle is to get to people and tell them if I'm holding a vial of insulin from Walmart that says, you know, rely on Nova log on it and I'm holding a vial of insulin, it says no vlog on it. I am holding the same thing right down to the molecule. Absolutely, yeah. Yeah. And I happen to know that's true. With this with this announcement, I just, it feels like something probably people couldn't believe. And I have to tell you that some of the questions I got really, like, I'll tell you might, they might even make you chuckle because you're so aware of it. But, you know, someone asked, Is this FDA approved? You know, like someone said, Would you give this to your children like these were the kinds of questions I got, because that was the type of fear that this is not the same thing. That other people I'm making air quotes other people with insurance are allowed to have. But this is the exact same thing. And I went to my wife who many years ago worked at Novo Nordisk, and I asked her about this and she says, she said, yeah, this has been like, you know, in the making for quite some time. And I was like, okay, she's like, it's the same stuff. I was like, Okay, I'm gonna have him on to talk about that. So it's not a generic, it's not see people's fear are going to be that you that you have, you guys are in a bathtub pharmacist over at Walmart. And you, you've you is something's going on generic and you're making a generic and this is coming right from wherever Novo Nordisk is making novolog they're making your insulin as well.

Warren Moore 11:57
Yes, that is correct. And one of the things that, you know, we talk about whether it's, you know, with insulin, whether it's with generic, so, you think about us as a company, we've had a history around, lowering the price, and saving people money so they can live better. It goes back to, like you said, we've had a reliable suite of products that have been there, we've had a $4 generic list, which again, FDA approved, saying, manufacturer go into any other generic that you would get for your blood pressure, or your cholesterol. And, and, and so this is an extension of that. I will say this to Scott, I am a former, I guess, let's say, white coat pharmacist for Walmart as well. And so I've been with the company now 19 years. And I have I have, you know, always had respect for for my peers and a pharmacist we employ in our company. And I think a lot of people got a chance to experience it even more then doing doing this COVID vaccination Ron that we've had. And so, you know, pharmacists have been important part of the continuum they will do, and bite us, we talked about being in medically underserved areas, not only do we want them to have reach from immunizations reach from being a part of the community, we need to give them you know, products that can help remove barriers, like rely on overlong insulin, that again, allow them the suite of services at their fingertips to beta offer, when they talk to the patient and a doctor around the care. We want to give them the tools to do it. And so, yeah, we know that that's why we want to come on and continue to tell their story that this is the exact same product, that they're we are not changing anything we're just in partnership with, with no one notice able to bring this to market. And again, an exclusive offering at Walmart.

Scott Benner 13:53
And I'm glad you did because as you're talking, I looked up at someone's question, very earnest question. Have you made a change to the product? So you could price it lower? Is there less volume? And that's the I know the answer is no. I'll let you say it out loud in a second. But I think that's it really is indicative of what happens when you tell somebody I'm going to I can give you something cheaper than you have been able to find it before. Is this a pure? Speaking of volume, is it is it because you're going to buy so much of it that it can be cheaper? I mean, I guess you're maybe not allowed to tell me exactly how you guys work the prices out, but I want to I want to do something for people's, because it's hard. Like I love what you're saying. But I think it's hard for people to hear and then just swallow like oh, you just want to do a nice thing. But it's a bigger idea at Walmart, right? Like you guys. You guys kind of get a bad rap a little bit like you said something earlier about being would you say 90% of Americans are within 10 miles of a Walmart or something like that. Is that what you said okay. And so I think it's easy when you're involved in something Like I I'll speak for the people I believe are listening to the podcast, like, you know, people have access to technology that is cutting edge, they mostly have insulin, they have insurance. This is a side of the world I don't think they know exists very much that there are people who are, you know, maybe unable to follow simple basic orders from their doctors because they can't afford any of this stuff. It's it's really lovely that it's been handled like this. Can I ask, do you have a Basal insulin? Like, did you work with them? to try to get a Basal insulin at a lower price as well? Is there any plans for that?

Warren Moore 15:40
Scott, as we think about that, I will say that we are always looking as a company for ways to continue to innovate. And so we're open to conversations with others too, who are looking to do the same. And, and, you know, when you you mentioned a minute ago, around Walmart, in how people experience us, I often say that if you could be an I was a really listened to how much we truly talk about making that flywheel work, how do we lower costs to lower prices, to serve Americans every day, people will be astonished. And so it's not a game. It's not a gimmick, it's who we are, and our DNA. And, and so with that history that we've had, with a desire to continue to innovate, we will continue to look forward to new solutions. So our customers can access their care, you know, they both want and deserve and, and when you think about making diabetes products affordable. And the more choices that we can have, when patients get with their doctors again and give with their medical team, we know that each individual responds uniquely to different therapies and treatments. And so we want to have the largest suite of services that we can for for our customers, we actually there are 3 million people who live with diabetes, who trust us every month at Walmart to serve. And so we will continue to, to do our best to innovate and bring solutions to market.

Scott Benner 17:18
Do you do you cover a wide range of health insurances? Like, can you think of a company who you can accept? Or do you accept? How does that work?

Warren Moore 17:27
Yeah, we accept all the major insurances across so in in the major ones that you can, you can think from the blues, etc. We can we accept those. And so yeah, bring your insurance there we, we say that we have a hap I guess I can talk about the company how easy it is to to do business with us too. We have a Walmart app where people can go on and create a profile. And they can request to transfer their prescriptions to Walmart. That way, they can come into our stores, we talked about the proximity within communities so they can come into our stores and, and visit us at the counter and meet our great team. We have drive thru pharmacies and a lot of our locations, especially on labor market locations, as well as some of our super centers, we do curbside. So we started standing up curbside during the pandemic. So if a individual don't want to come into the store, we can bring it out to your car. And we can also mail it a whole new to have mail order. So we try to make it easy we're trying to serve, we're trying to make sure that this is seamless, you can interact with us in different ways, how you choose. And what we want to do is be able to meet those. And so we're, we're striving every day to do just that.

Scott Benner 18:44
So yeah, so you do mail order to then.

Warren Moore 18:47
Yeah, yeah, we have a mail order form data, which is based off the insurance contracts we have. But we also are able to, at times when individual can't get out to actually mail it from our store to the home as well. So we Yeah, so we hope that, you know, innovation and things like that continue, as the rules and regulations change as more. You know, we become you know, more of a digital experience within healthcare as well. But yeah, we were able to mail it we weren't, we were literally looking for ways that we can we can strive to meet the needs of our customers, in a way they choose to shop with us.

Scott Benner 19:26
So at your pharmacies. If I if a person has type one diabetes, or type two diabetes, you have everything they would need. It's not like I gotta get this cheaper novalogic from you and I got to go somewhere else. You have it covered?

Warren Moore 19:41
That's correct. We have it covered. And so when you type one and type two, we talked about, you know, we have a $4 generic list and afford our generic list has been on the market guys approaching 15 years so so we have items like Metformin on there for four hours and 30 days. The player we, we talked about, rely on overlock. We have humanist and as well, we have the OTC so we have your test strips, you have meters, we have your glucose tablets and your alcohol wipes. So yes, you can come to us. And then when all else fails, if you have questions, you can come to our pharmacy counter and talk to our pharmacists, we will be happy to help answer the questions. Okay. And so yeah, we want to be that destination. And we strive each and every day to live up to the trust that our customers put in.

Scott Benner 20:36
I have a question that just popped into my head that I haven't told anybody I was gonna ask him because it just occurred to me now, but I'm sitting here thinking, if you got this accomplished, there must be other things you're trying to get accomplished, too. insulin pumps, glucose monitors, are you are you not allowed? I know, you're a publicly traded company. Right. But like, I like ask a different question a different way. That sounds like a good idea, doesn't it work?

Warren Moore 21:04
God you, you are, I will say that, you know, we we really are in a in a thralls of our health and wellness strategy. And, and again, trying to bring things that I would say, really promote equity within the system as well, because that's what one of the things that that happens to you is when price gets involved, and people can't afford their their products. So whether it's medication, whether it's, you know, they were Central's, they, they make choices, and we want to make sure we're thinking about communities, we're thinking about people in the communities, and we're doing it in ways that are sustainable. So we come to market with products like this, we don't do it, and they, they stay around for one or two years, we we keep them around. And so that'll be our continued focus of as to how we can bring forward solutions in ways that are sustainable. Do them in ways that promote equity. And when I say equity, we're considering, you know, where people are starting in life, and what do they need in order to, to achieve their best possible health outcomes? And, and so yeah, we're we're up to quite a bit as a company, and looking at the whole suite of healthcare and doing it in a ways that that, again, promotes trust that people understand in these communities. Yeah, where there, there are health deserts that we can we can we can play a part in and people achieving the best outcome,

Scott Benner 22:34
you could have just said, we're up quite a bit, I would have accepted that as an answer. No, it just occurred to me, like, you know, you, you went to a large company, you took a product that is out of reach for some people, and you brought the price or lower, why couldn't that happen with an insulin pump? Or with anything else? Like, obviously, whatever the business function that that goes towards making that happen? I don't see why that couldn't happen for other things as well. So I mean, you're doing it with, you know, but the other stuff, you're talking about test trips, and things like that, right. So, you know, that's exciting. How long does? Um, here's a question for you, maybe you can answer, if we were all sitting in a Walmart meeting today. And I said that out loud, no one had ever had the thought before. And, and we all agree, that's a great idea, from having that idea, to bringing more affordable products into the store. How long of a process is that?

Warren Moore 23:30
I will say, you know, as we think through process, there's always puts and takes around each decision, as we think through, you know, Walmart EAC you know, we make decisions and then obviously, the portfolio to to do the right things for for the consumers as well as the impact to us, right. So, we can continue to keep that flywheel going. And so, I will say that that process would win opinions, I will say what you have to have and that Scott again, are willing partners to come to come to the table, you have to have people who are who are like minded and trying to, to really save money and then and then you know, willing to disrupt the market. And so you know, we, we, it takes process, it takes work and it takes trust in these relationships and and so I would say that timetable depends on it.

Scott Benner 24:28
Yeah, so this this, this thing about the novolog insulin that we're talking about right here, it's not a one way street for you like you had the idea but they had to be willing is what is what you're saying to Okay. Is that price so the price I it's tough when everybody has different insurance. I know you can't just speak in a blanket way. But cash price Tell me again, for a vile

Warren Moore 24:53
gas price for ball $72.88 a box of pens $85 Isn't at 80 cents

Scott Benner 25:01
versus what the cash price would be for someone who doesn't have health insurance, but then you might, I might hand my health insurance card to you ask for a vial of this insulin and find out it cost me $20 or $10 or 40. Like it could be less than the 72, depending on my insurance.

Warren Moore 25:19
That's correct. So because this is by prescription, we will run it through your insurance. And we will make sure that individual gets the lowest price. So that's what makes you know, to ensure that the product can do a whole segment of Teflon Scott different insurances. But yeah, we wanted to have an A an offering. So if someone has insurance, and they're paying a copay, that's lor, great, we want to continue to make sure that you are compliant on it, that you're managing your career the same for someone who is challenged with, with, you know, again, the price and economics of taking care of their condition, we wanted to have an offering there as well. So again, we it's it's, you, you can come in and say you're going to get the lowest price. Because based on what your insurance allows you if they were worth the cash price with the lowest on the market. And so you can come in and trust that you will get that.

Scott Benner 26:17
So if if a person is hearing this and thinking, well, I buy novolog, and I pay this much for it. I don't know how this is gonna go, but can they call? Do they have to come into a store? Like how do they find out if this is a valuable decision for them to make? Like, I think it's obvious for people who are paying cash, this is just a no brainer. But But if I'm in that other situation, how do I find out if this is a good idea for me?

Warren Moore 26:43
Yeah, for people bancaires I'm thinking come call and do that. For those with insurance, we will we will, at this point need a prescription to process it. Just based on how we do we don't we don't run test claims that way. So we have to bring it in have a prescription to it. And so I will say that the best price if you're if your copay is, is less than the cash price. You know, you won't be won't pay that you will pay your copay. But if it's if you're paying out or you're wondering how the ADA be this cash price will be there. And then, you know, again, come and talk and as you're as you're there, I would say experience our team because I think it's the it's the hose we Scott it's it's not only having, you know, quality medications at low affordable prices, but it's the cure you get from from your pharmacist there, it's the this the days we have an OTC and so I think that's what gets me excited is knowing that our our teams are out there talking about it, our teams get a chance to interact with customers who may not know. And so if you have any questions, I will say, say everyone calling in so even if you if you have insurance, you want to know more about it. Call me and speak to our pharmacist, and we'll be sure to should ask you a question.

Scott Benner 28:10
Okay. And so if I were to put my, my script through, and I thought oh, this isn't any better, you just wouldn't fill it. And I would just keep doing what I was doing. It's not like it's not something I would get caught up in if I if it wasn't what I wanted.

Warren Moore 28:22
No, I'm probably not the so that the patient isn't in control or where they get it. Get it feel that we you know, we we believe that if you if you come to us and give us give us a try you you'll love our team there but yeah, no, we we won't keep it we won't take you take it hostage anything we will we will just ensure that we answer all your questions. Okay.

Scott Benner 28:43
Now I just want to make sure I had everybody's questions covered. Is there anything that I haven't asked you that I should have?

Warren Moore 28:51
Now Scott, I appreciate the opportunity. And I think that what you're doing here to bring gold to the spill any any myths about the incident there we appreciate and we are doing the same thing I want people to know that that you know just who we are as a company and what we're trying to do and and again, it's it's been a part of our history, there is who we are excited about this and I will say you know we talked about the price of it. The other thing is we're excited about this most people here know about analog though we're excited about you know, you can you understand the duration and a piece better and the action on it. So it makes it great for meal time dosing. We also have Nick's as well, so it's, it's exciting. Thanks for for bringing it on and happy to join you here happy to what you're doing for the audience here and I look forward to future conversations and become I would be lovely. I

Scott Benner 29:48
just I just realized that. I mean, you know, there are other insulins that you guys sell, right and it's, you know, within the diabetes community, I don't know if You're aware of this or not. So within the diabetes community prior to this announcement, that the term Walmart insulin meant, it's a cheaper insulin, it doesn't work as well, you know, like, this is what they're selling. And I just thought, like, I don't know how they're going to get over this hump in people's minds, you know that. And it's cool. Like it was, I mean, if I'm guessing it was probably the the insulin, you were able to make a deal with somewhere and get it in there. And it was probably a really big deal for the people who were using it, I would think it's amazing for them, especially if they couldn't find anything before. But I couldn't figure out how people who already were thinking of it in that light, were going to be able to make the leap in their minds that no, this is, this is no vlog. And I just didn't know without talking to you how to do that, because I've seen articles that explain it perfectly. And yet, every time I hear from somebody, they say, Oh, that's insulin you don't want I'm like, No, I think they've done a whole new thing here. You know, like, let's figure it out. So it was very kind of you to come on and, and talk about it. I really do appreciate it, especially on a Friday afternoon. Because, you know, we're winding down here.

Warren Moore 31:05
Scott and I would say that the last thing on that one of the things that I don't want individuals to walk away thinking that even our humans, we're talking about analog today, but even our human insulin is is in partnership. With Novo Nordisk as well, so so how people understand this is what you can trust, the big note is that people shouldn't switch between the two, of course, if you own an analog and humanism, without consulting your position, yeah, and so and so that's the message there, but know that we anything that we bring the market will be helped da approved quality products that you can trust. And but this one, yeah, this analog instrument is B. Yeah, it's unique. And we're, we're excited to be able to bring it tomorrow.

Scott Benner 31:53
Listen, you know, for people who've had diabetes for a long time, they know that there's been, you know, insulin, and then improvements on insulin and improvements on insulin. And analog is the fastest acting, you know, it's the best you can do right now. Like it just is. And it gets into that kind of, you start hearing people say, Well, just because somebody can't afford it doesn't mean they should have the last generation of insulin. And that's where that sort of gets. I don't know what I think it riles some people up and maybe rightfully so. Right. But it's not that's not a Walmart conversation. It's a it's a state of the world conversation. Really, it's a it's a bigger, more existential conversation. I just love that you guys have this analog now that it's not a generic it's not, you know, you didn't meet four guys in Arkansas, and they said that you could make insulin. This is the stuff you know, so if this can be this stuff, and it can be my rough numbers are slightly over $100 less per vial cash price for just the vial. And what did you say? How much cheaper for the pens 250 to 250 here God, that's a lot of money. Okay. All right. I'm glad you're here. This is fantastic. Thank you. What else? What else you guys got over there. I might come over.

Warren Moore 33:11
We walk you down when it is? Hopefully it's you know, we don't get too much further in this pandemic. But if you ever want to come down we welcome you down to Arkansas Scott. Oh, wait a minute.

Scott Benner 33:21
I randomly said Arkansas. Are you actually in Arkansas? Right. Well, you thought I knew that. I yeah. I just picked the state out of my head real quick. I like I wanted people to realize that you didn't bump into five guys that were like we can make insulin to you know, like it was coming right from the place. How did I pick our consult? How is random?

Warren Moore 33:43
Yeah, that's what we were base.

Scott Benner 33:44
Oh, you know how I picked it. This is crazy. I just put an episode up with a razor back that just got drafted. That's how like I went from one computer doing that work to turn to talk to you and that's where I got and I and there's a picture of him in front of me and he's in an Arkansas Razorbacks you Wow, the mines that crazy thing, isn't it? And then you're in Arkansas, but I freaked me out. Okay, that's enough of this, this episode's ever. I really appreciate Warren coming on the show today and explaining about the new insulin at Walmart rely on novolog. Same molecule, same insulin, same size, same stuff. Different cash price, check it out at Walmart. They're not a sponsor. By the way. They didn't pay me to be here. I just thought this was amazing information for you to have. And I hope I was right. Before we go, let me tell you again about touched by type one. Their mission is to elevate awareness of type one diabetes, raise funds to find a cure and inspire those with diabetes to thrive, touched by type one.org also on Instagram and Facebook Spot

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