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Podcast Episodes

The Juicebox Podcast is from the writer of the popular diabetes parenting blog Arden's Day and the award winning parenting memoir, 'Life Is Short, Laundry Is Eternal: Confessions of a Stay-At-Home Dad'. Hosted by Scott Benner, the show features intimate conversations of living and parenting with type I diabetes.

Filtering by Category: Dexcom

#679 I Choose Leah

Scott Benner

Amy's daughter Leah has type 1 diabetes.

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

+ Click for EPISODE TRANSCRIPT


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 679 of the Juicebox Podcast.

On today's show I'll be speaking with Amy, she is the mother of Leah. Leah is the one with type one diabetes, and so many different things. I almost call this episode spicy child panic room. But in the end, I chose Lia. Please remember while you're listening, 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 healthcare plan. We're becoming bold with insulin. If you're a US resident who has type one diabetes, or is the caregiver of someone with type one, please go to T one D exchange.org. Forward slash juicebox now and fill out the survey, the survey will take you fewer than 10 minutes and you will be helping people with type one diabetes. T one D exchange.org. Forward slash juice box. Spicy child there were a lot of good options in this one you'll see.

This show is sponsored today by the glucagon that my daughter carries. G voc hypo Penn. Find out more at G voc glucagon.com. Forward slash Juicebox Podcast is also sponsored today by us med you can get your diabetes supplies at US med us med always provides 90 days worth of supplies and fast free shipping. To find out more and get your free benefits check. Go to us med.com Ford slash juice box or call 888721151 For me, I didn't start the recording because we had to shut the thing down and start it back up again. I'm shooting Oh my God. All right. Oh, no.

Amy 2:19
Okay, or we can start over this

Scott Benner 2:21
does not happen often. You were doing so it's recording now. I am mortified. Hold on. No. No. Are you kidding? What if I wouldn't have looked up in the first couple of minutes? What if like an hour from now we were like, Oh my God. What did that mean? You're like, well, that's how your face ended up on the Washington. Yeah,

Amy 2:41
I'm not I'm not gonna call my child the demons seeds. So.

Scott Benner 2:47
Now this part has to stay in, so I'll beat that out. Don't worry. Okay, Amy, I'm trying to think of the best way to do this. I don't want to make you restyle

Amy 2:58
it's fine. I can shorten it a little bit. You know,

Scott Benner 3:00
I just I don't want to put you in a weird position where you're like, Oh, God, I just had this three seconds ago. Give me a second now. I'm I'm old. I my adrenaline's pumping. I just broke out like one of those little flop sweats. I was like, guys so disappointed in myself. Hold on. It's totally. I stare at this screen four to five times a week, and I watch it go past me and I'm looking at it and I'm like, What's it not doing that? It usually does? Oh, yeah. Recording. Okay, real quick. So I'm so embarrassed. Introduce yourself again.

Amy 3:35
I'm sorry. Okay, you ready?

Scott Benner 3:37
I am. Sarcasm maybe? No, no.

Amy 3:41
Not at all. All right. Okay. Hi. I'm Amy, and I'm a mom of three kids. I have a 16 year old daughter, 13 year old son, and a 10 year old daughter and she is my type one.

Scott Benner 3:57
Okay. Boy, I'm so irritated with myself right now. I gotta let it go. Let me shake my network. Let it go. Let it fall. Good. Do this one time. She looked very relaxed when it was over. But so it's probably easier for her to forget things. Don't you think? A billion dollars you can just shrug things off a little easier.

Amy 4:17
100%.

Scott Benner 4:18
So Leah was diagnosed last year during the summer? Yes. Is that correct? I do want to hear the part that you told me before. So you shared that since she's been a little kid. What did you tell me? Her teachers told you?

Amy 4:35
Yeah. So when Leah was in preschool, her first year of preschool, her three year old class went to pick her up one day and her teacher was like, I'm really worried about Leah. She's thirsty all the time. She's going to the bathroom all the time. That's a sign of diabetes. And I was like, Okay, and so I took her to the doctor. She's like, you know, you should get her checked. So I took her to the doctor and I said her preschool teacher thinks she has diabetes. So What do we need to do? And I had no clue. You know, I knew nothing about type one. And so, you know, my dad has type two, but I just wasn't, you know, anyway, so I knew it wasn't that. But so I took her to the doctor and they checked her urine and they're like, Nope, there's no glucose in her urine. She's fine. Everything's good. And then the next year and her four year old class, the other preschool teacher said, Leah's drinking and going to the bathroom all the time. And I was like, Well,

Scott Benner 5:31
last year, same preschool as the

Amy 5:34
Yeah, same preschool. Yeah. And so I took her to the doctor again, and they checked her urine, again, no glucose in the urine. They said she's fine. And then I want to say, at least one or two more times after that, I brought it up that she pees a lot and she drinks a lot, and she wets the bed a lot. And the doctor just kind of shrugged it off. And he was like, it's probably just behaviorally. Like she's too lazy to go to the bathroom. Like, I wasn't really and I just kind of accepted it. You know? I'm like, well, they they checked what they needed to check and I just kind of moved on. They never checked her blood, which in retrospect, I would have had them do. Um, well, then. Go ahead. Sorry,

Scott Benner 6:16
a behavioral thing, like so we're gonna get to it in a second. But Leah, streak in her. We're gonna call it for now. Right? She's,

Amy 6:24
she does. Yeah, I mean, I will say like, before she was diagnosed my husband and I would joke like, every day that she's alive, we lose a day of our life. We put her to bed at night. We're like, Oh, I just lost a day off the end. Because she, she's really before then. Before she was diagnosed, she was really, really difficult. And we had no idea why. But just really extreme mood swings, fighting with her siblings all the time. Like my first two kids. Like, I will honestly say, I cannot even remember them ever having to fight ever. Like they get along so well. And they're really easy to parent, great kids. And so I was just like, wow, we really the bed. I'm sorry, my lunch,

Scott Benner 7:17
if you want Sure.

Amy 7:19
And, you know, that's just kind of how I felt. I'm like, What did I do wrong? You know? And, yeah, so she's just always been really, really, I'll just say spicy, challenging, difficult.

Scott Benner 7:31
down to little things. Like if you said, Hey, can you throw me the remote? She'd be like, go to hell.

Amy 7:36
She would throw it out. No, she. I mean, she started like, you know, I mean, my older daughter has never said a cuss word never flipped me off. Never. But this one. I'd been I think she was like two or three. She would tell people she hated them. Sticking up her middle finger the wrong way. She would do it wrong. I was like, I'm gonna do it. How

Scott Benner 8:00
do you how do you do it wrong? She would like

Amy 8:02
hold her hands straight out and just stick out her middle finger straight out at me.

Scott Benner 8:07
Oh. Like she was the casting a spell on you. Like

Amy 8:11
that's what their middle finger? Yes. And so I was like, What did I do?

Scott Benner 8:21
You know, you went to a wedding and you drank too much apparently.

Amy 8:25
Well, you know what, what it was we had just moved into our house that we live in now. And it was like a three bedroom two bath. We're like oh my gosh, this house is so perfect. We have two kids three bedrooms.

Scott Benner 8:36
Bedroom got you or your husband? Did he do that thing? We should Chris in all the rooms in the house.

Amy 8:42
We didn't have cable for like two weeks. So that's what I blame it on. There was nothing else to do

Scott Benner 8:49
$200 and lost your sanity congratulate.

Amy 8:52
Oh my gosh. Oh, yeah. We've had to add on to our house like everything we had to get a bigger car because once you go to three kids it just you know you need a bigger car. You need a bigger house you need you know, and

Scott Benner 9:05
did the add on to the house for like a timeout room or a panic room we it goes off and everyone just runs to the panic room.

Amy 9:18
Yes, yes. Seriously? Oh my gosh.

Scott Benner 9:22
Even when she was like a little kid,

Amy 9:23
huh? You know, I will say she was the easiest baby like this sweetest, easiest baby. Super easy toddler. It was just once she hit three. So in my mind, I'm like wondering if and I don't even and of course the doctor is like, no way but I'm a touchy. I've had diabetes back then. And maybe just

Scott Benner 9:42
it's like, maybe like her blood. Yeah. Isn't fall.

Amy 9:46
Yeah. And maybe her she wasn't totally because even when she was diagnosed, she was she wasn't in DKA her agency was eight, you know? And she had she was not in DKA they sent me home you know Like after two hours, they sent us home. And then we had to go back the next day for training. But yeah, I mean, I just wonder if her pancreas has been kind of, you know, going in and out for years? I don't know. Yeah, it just makes me wonder.

Scott Benner 10:15
So in the spot where I wasn't recording, you told a great story about taking her to the doctor to get. Yes. So you didn't you didn't see you didn't sniff out diabetes. First, you sniffed out celiac first, you said because you have a friend whose children had celiac and it made you think about it. So they Yes. Tell me about that for a second.

Amy 10:36
Right. So you know, I was just noticing things about her where she was just after she would eat, she would say her stomach her. And she kind of looked like she was losing weight. And I would catch her eating like spoonfuls of sugar. And I was like, What is going on? And so to me, my mind went like, oh, like nutrient deficiency, which happens when you have celiac. And so my friend's daughter had been recently diagnosed. And we, like I said, we always follow the same pattern. Like she had a daughter, I had a daughter, she had a son, I listen, she had the third surprise, baby, I had the third surprise baby. So I'm like, Oh, your daughter got an autoimmune disease. Mine probably does, too. The only pattern we haven't followed is that her husband is gay now. I mean,

Unknown Speaker 11:24
hey, it ain't over yet.

Amy 11:29
We my kids joke. They're like, lose dad coming out.

Scott Benner 11:34
Get your friend, a lottery or something that would really by

Amy 11:36
No, I know. I'm like, I'm done copying you. Okay. Like,

Scott Benner 11:42
I want to immediately hang up with you and call her instead and talk to her all about that. I would love to hear about.

Amy 11:47
Oh, yes. Very interesting. But they're our best friends. And so yeah, we joke all the time. And, and she's like, Oh, it's never gonna come out with with, with Eric. It's not coming out even if he is

Scott Benner 12:00
your husband. Yes. She believes that even if your husband was gay, he wouldn't tell anyone. Right. I don't know. I hope he does. By the way. I mean, I don't. I don't hope he comes out. But I hope if he's living in a closeted life that he he

Amy 12:15
I would be I think I would be supportive. I don't know. No, I wouldn't

Scott Benner 12:20
be like, hey, what am I gonna do with all my life that I used up here? Yes. Yeah.

Amy 12:24
These 18 years exactly. Forget the gay part

Scott Benner 12:27
like any of it like I would. I'd be upset if Kelly walked and I'll tell you what Kelly said something to me one time broke my heart. She's broken my heart a number of times, but this one specifically. We're living you know, in a house

when you have diabetes and use insulin, low blood sugar can happen when you don't expect it. G voc hypo pan is a ready to use glucagon option that can treat very low blood sugar in adults and kids with diabetes ages two and above. Find out more go to G voc glucagon.com. Forward slash juicebox G voc shouldn't be used in patients with pheochromocytoma or insulinoma visit G voc glucagon.com/risk.

At this point, I would like to talk about us met, you get your diabetes supplies from somewhere. If the place you get them is anything like the place where I used to get them. It wasn't fun, we're easy and often would have been frustrating. But at US med it won't be us med accepts Medicare nationwide and over 800 private insurers they have an A plus rating with the Better Business Bureau and they want you to get better service and better care than what you're accustomed to. US med always provides 90 days worth of supplies and fast free shipping. They carry everything from insulin pumps and diabetes testing supplies to the latest and CGM like libre two and Dexcom G six. Get your free benefits check today at us med.com forward slash juice box or call 888-721-1514 There are links in the show notes of your podcast player and at juicebox podcast.com to G voc hypo Penn, us mad and all of the sponsors. And don't forget to go to T one D exchange.org Ford slash juice box and take that survey. You know we bought together and the plan back then was little tiny house bigger piece of land at a town where it's hard to get a hold of land. So we buy this little house and the plan is we're gonna just knock it over one day like we're young. We're in our 20s But you know what I mean? We're gonna take these grand ideas, and we're like we're gonna we're gonna knock the house over one day and we are going To build a new house overtop of it, and we're living there for a long time before we even, like make a tiny bit of money to, like, try to even consider that. And one day she says to me, I hate this house. I'm like, what? And she was I never wanted to move in here. I was like, Well, you could have mentioned that before we bought the house, then we wouldn't have bought it. And she's like, it just like I really had like, a weird feeling of loss. I feel like the feeling I had that day would be the exact same thing if she walked up to me and was like, Hey, I'm gay, by the way, and I gotta go. By Yeah, I'd be like, Oh my god, like, because it's that feeling of wasted time. I hate that feeling.

Amy 15:39
Yeah, ya know, for sure. Especially like all your good years, you know?

Scott Benner 15:45
I don't know if it's wasted. Well, no, that's a tough call isn't wasted time. I don't know. Listen, we're gonna go down the wrong rabbit

Amy 15:53
hole. Yeah, that's another podcast. Speaking wrong,

Scott Benner 15:56
but I appreciate it when the humor hits immediately. Okay, so we should absorb that one for just another second. That was funny. Take the kids to the doctor's office for celiac. But you say yes. Good,

Amy 16:18
right. So I was like I told my, you know, my husband had been in the middle of working like two weeks straight, like 12 hour shifts. And I said, like, you have to come I know you're tired. But like, you have to come with me because it's going to take two of us to get blood from Leah. You know? And it it turned out it took four so we we get there and I just know from past it's like when she would go to get shots. She would like hide under the table under the chairs. It was she

Scott Benner 16:47
was always does she does she get like this she start boxing or does she just like

Amy 16:53
she's more like a like a curled up rigid body. Like drag her out? Yes, she does a little rigor mortis. And, yeah, and it's crazy. I'm like, you're small. But when you go rigor mortis, it's really hard to lift them up on a table. So I just knew with her and especially just where her behavior was at that time. I mean, obviously she was feeling horrible. I didn't know why. And so it took me my husband, my 16 year old and the nurse we all had to like hold different limbs and body parts. Just to get the blood from her first during that. I think she cursed at us after in the car.

Scott Benner 17:40
She wouldn't in the public. Yeah, she didn't wanna do it in public, right?

Amy 17:43
No, no, she would never do it in front of people. But yeah, I'm pretty sure in the car. She threw some stuff at

Scott Benner 17:49
me. By the way to know where to do it.

Amy 17:53
Yeah, it's just like I said, I really? Wow. I don't know. So

Scott Benner 18:01
she noticed about herself. And back then do you think?

Amy 18:07
Yeah, like I think she she knows she was difficult. Yeah. And I think she realizes it was mostly because she just didn't feel good because I will say she's she's still Leah, but it's way better than it was back then. She's still she's still this there are still some similar things. It's just not as extreme you know. And my oh my kids laugh because on the Dexcom app I have a sweet Leah and they just think that's hilarious.

Scott Benner 18:37
Picked sweet because of the sugar aspect of you.

Amy 18:41
Yes. Definitely. And maybe I'm like maybe it'll just come true one day.

Scott Benner 18:49
Willard, but would you I'm in a will will are into it. But the other so the other two kids are kind of more mellow or do you think they just appear mellow next Alia?

Amy 18:58
Um, no, they're really good. I mean, I have no no complaints. My daughter My other daughter was hard when she was little. pretty challenging until she was about like nine and so we kept waiting. We're like, okay, when's Lea gonna grow out of this, you know? And, ya know, so the other two are way more and like I said, they never fight there, you know, but it's like Leah just kind of brings the house down. We know she fights with everybody. She's

Scott Benner 19:26
when I when I was younger. I used to say one day Arden's gonna make some lucky guy very unhappy.

Amy 19:33
Yes. That'll Delia to yes. But if you ask my husband, he'll be he'll always say like, mother like daughter.

Scott Benner 19:44
So okay, let's dig into that for a second. I mean, were you

Amy 19:48
I mean, you know, I'm feisty. I can be feisty for sure. And my husband's very laid back. So yeah, we're good. Good combo.

Scott Benner 19:59
When should pops off. Do you ever think like, oh, I said that when I was little too.

Amy 20:04
You know, I wasn't like that when I was little was more like teenage you know? Yes. No, I was a pretty, pretty sweet kid. I think, you know, my we had teen parents and there were four of us. My mom had four kids by the time she was 22 Holy hell. Yeah. So it was it was crazy. So there was really no room for me to be like that, who was gonna listen to me? You know, kind of put up with my,

Scott Benner 20:29
I don't want to go down this. I just need to know was that for Jesus or by mistake?

Amy 20:33
That I'm totally by mistake, like, yeah, it just kept coming. I couldn't

Scott Benner 20:39
figure out how her vagina worked for I. I was like, um, every time I use it, a baby comes out of it.

Amy 20:50
I don't know what is happening. Yeah. That was funny, you know, because with our third, we weren't trying. And the doctor was like, oh, like, how long have you guys been trying? I'm like, Well, no, we weren't. And he was like, Well, no, you know how babies are made? You were trying? I was like, Well, okay, I guess I would make a baby. Yeah,

Scott Benner 21:09
maybe you were more like not trying not to have a baby.

Amy 21:11
Right. Exactly. Okay. Exactly.

Scott Benner 21:15
To the kid you find with the pipeline in the middle of COVID. Right? Yes. Yeah. So do you think that changes how the hospital approaches you? Or what happened during Well, I

Amy 21:25
mean, okay, so I, you know, they did blood work on all three kids, but they didn't do a finger stick on her. So it was like bloodwork that they sent to the lab. And the doctor called me the next morning, and I was on my way to work. And he was like, everything's fine. Like, the kids don't have celiac. But Leah's blood sugar was really high. And I was like, Oh, okay. And I like what does that mean? Oh, my gosh, did what did she eat yesterday? You know, what I'm thinking in my head. I'm like, well, she did have a few spoonfuls of sugar for breakfast. I don't do it. I don't. So then he's like, you know, you need to bring her back in. So I was like, on my way to work, and then so, but while I'm on my way to work, then my dad calls me and my dad's a type two diabetic, he's in an assisted living facility. And he sounds really funny on the phone. And he's like, I remember, my face was swollen. It was like, and I'm like, okay, and I had just, you know, got off the phone with Leah's doctor. And so now I'm like, Okay, I go, Well, what do you mean, he's like, my mouth is swollen, and I have like a rash on my face. And I was like, what? And I'm like, okay, and I haven't been able to see my depth because of COVID. And, you know, we would go drop off stuff to him and see him through the window. And that was about it. And so I was like, Okay, I'm like, I pull over. I'm like, Dad, FaceTime me. Let me see. So we FaceTime and it was like, horrible. Like he had, like this weird rash on his face that was turning black. His face was completely swollen. And I'm like, what, like, I can't. Now I'm like, I'm like, Oh, my goodness. So then I was like, Okay, Dad, you need to go to the doctor. I'm going to call you back. So I like hang up with my dad. I call my sister and I'm like, and I think in my heart, I knew high blood sugar meant she has diabetes. You know, I'm like, I just knew it. And I called my sister and she lives up about six hours north of us. We live in Los Angeles. And I'm like, Angela, Leah's blood sugar is really high. Dad's face is falling off. Like, I need help. Like, I don't know what to do. So she was like, Oh, my God, okay, I'm coming. So she got in her car and just drove down. And she was like, I'll deal with Dad, you take care of Leah. So I got to work. And I told my co workers what was going on, and I'm like, I need to go. I told her the doctor, but Okay, bye. So I leave, I come home, pick my daughter up. And my husband was home. He was kind of like napping. But the other kids were here. And so I grabbed Leah, and I say, hey, like, you know, we gotta go back to the doctor. And, you know, they just kind of found something that they want to recheck. I didn't want to scare her, you know. And I was a little worried about going by myself, but thankfully, it was just a finger prick. And they took her blood again, and it was, you know, like 289. And, and they were like, what did she have for breakfast? And I was like, well, she had a smoothie and a spoonful of sugar or two pancreas. Yeah. And so he was very calm. And he was just like, you know, I think we're, we're catching something here, but it's early. So you're gonna have to just, you know, go to Children's Hospital, and I was like, oh, like, make an appointment. He's like, no, like, you need to go right now. And I'll call them let them know you're coming. And I was like, what?

Scott Benner 24:46
Don't want to do that because there's an impending zombie apocalypse my father.

Amy 24:52
Yeah. Okay, so then I go home and I wake up my husband and I knew what's COVID They're not gonna let him come with me. Ah, you know, and he had to go to work anyway. So it just woke him up and told them what was going on. And yeah, I mean, it was crazy. Like we went in there, there was nobody in the waiting room. They took us right back. And pretty much they didn't say it. Like she has type one diabetes, but, you know, it was it was pretty obvious, you know? So yeah, we were just there for two hours. And they sent us home and they said, Don't feed her any carbs tonight and come back tomorrow morning for training. So

Scott Benner 25:28
you know, of all the things I want to ask a question about you said your parents were young parents and your father was in an assisted living place. Why should How old is your dad?

Amy 25:36
He's really young. So he, he's 66. Now but he had a stroke when he was 47. He because he was a type two diabetic and he never took care of himself.

Scott Benner 25:47
I thought you're gonna everything early.

Amy 25:51
So and my mom and dad are divorced, obviously. Five. Yeah. Yeah. That didn't work out. Really? Shocker. Fascinating

Scott Benner 26:01
boiler alert.

Amy 26:02
Spoiler alert. They're not together anymore. But yeah, so he, he didn't take care of themselves. So he had a stroke at 47. So he's paralyzed on his website. And yeah, that's okay. And so he's just been in like nursing homes assisted living off and on. You know, since that happened, and yeah, so it turned out he had, he had shingles and the shingles rash, he scratched it and then got infected. And he also had an abscess tooth. So that's, that's what he had going on.

Scott Benner 26:39
I was gonna tell you that if your husband or when your husband comes out, if you're looking for a guy, I find you delightful. You should hunt me down. We'll see if Kelly's still here. But then I heard the rest of the story. And I was like, No. No. I don't need to help your dad with shingles.

Amy 26:59
And you don't want to be Leo stepdad either. I don't know.

Scott Benner 27:03
It'd be hilarious. I would just, I would team up with her and just pointed at you.

Amy 27:10
She, yeah. So my sister. Yeah. So she took care of him and ended up you know, he, he got on meds and they fixed. They pulled his tooth and He's okay. He's okay. Yeah.

Scott Benner 27:28
Okay. All right. So so how much of this? Did we ever have? COVID prior to this?

Amy 27:34
No, no, we never got it. I don't know how we were able to, you know, especially if my husband's job he got exposed a bunch of times that went around his office. And no, we were lucky. There was like one time where he did have like a direct exposure. And so I was like, I'm like, okay, and this was, I can't remember if it was before, after she got diagnosed, but I was, oh, it was after. And I said, Well, you better just stay in a hotel for a couple of days. And like, as I'm saying it he's already like booking his hotel and like, hey, wait a minute.

Scott Benner 28:06
I've been looking for an excuse to get the hell out of here.

Amy 28:10
I was like, Wait, why are you booking it? Like, wait a second.

Scott Benner 28:14
You want me to leave? And you're not going to be? Oh, sure. I gotta go. What was like,

Amy 28:21
oh, yeah, no, so she did not have COVID. Me. I

Scott Benner 28:24
just realized that before when we were talking. And I, you know, didn't record it. You mentioned your husband was in law enforcement. I just wanted to because he was asleep in the middle of the day, too. So yeah, we work shift work. And I think everyone else was like, Oh, God, guys just laying around the house.

Amy 28:40
No. Yeah. No, he was working a lot during that time. It was in the middle of the George Floyd protests and riots. So he was he was working 12 hours for two weeks straight. So yeah.

Scott Benner 28:53
Okay. So move. What do I want to say here? Oh, you did mention prior that there's a line of autoimmune stuff on your husband side. I just want to go over it. Celiac Hashimoto, motos, anything else?

Amy 29:07
I think that's an well type one now.

Scott Benner 29:10
Okay. Nothing on your side.

Amy 29:13
Now, we just have a lot of exciting. Yeah, we have a lot of type two diabetes, like on my dad's side of the family. So that's just always been my connection to diabetes, as you know, seeing my dad. And yeah, so we went to, you know, the next day after we were in the ER, they we went to Children's Hospital for training. And I think we were there for maybe five hours, but it was just like this total crash course you know, and they gave us like a bag of needles and a meter and some insulin and they were like, do this, this and this and then they wanted to have us give her a shot before we left but her blood sugar was in range. And so my first shot I had was like in the parking lot at Subway, and I totally made her bleed and hurt her and pretty sure she threw some things at me. Yeah, it was not good. And I just was like, Are you sure we can leave with her? Like I couldn't. I just was like,

Scott Benner 30:15
I was really on the edge to begin with. So now you're giving me another thing. And that is a, you know, a reasonable question to ask, right? I mean, if she was, if she was challenging, that's the right word. Right? Like if she was challenging to begin with. Did you? I mean, how many times did you think, Oh, it's this one. This one gets?

Amy 30:38
I was just gonna say that. I was just gonna say that. That was like, why her? Why that one?

Scott Benner 30:43
You know that you wished it was them?

Amy 30:47
I mean, you know, I kind of joked about it. It was just like, the three, it had to be this one. Okay.

Scott Benner 30:55
Okay, so Alright, let's really dig into the diabetes stuff. Yes. So after, you know, you settle a little bit. What did they send you home with? What did you have your needles and a meter? Yeah.

Amy 31:08
Um, pen needle, like a pen? And pen needles, a meter? Some Lantis? And some homologue? Okay. Yeah.

Scott Benner 31:17
How did you find learning about diabetes?

Amy 31:21
I mean, I was so overwhelmed. And so I had reached out, you know, like, I think a lot of my friends had heard, so everybody was like, Oh, I know somebody who has a kid. And so I called like, four different moms who all had kids with type one, and got some good advice, and maybe a couple not very good. But it was good. Like it, you know, so it just kind of made me feel a little more confident. And, you know, Children's Hospital was great, like keeping in touch and keeping in contact. But I think, you know, like you've said before, their whole advice was just like the the don't die advice. And not necessarily like, how is Leah going to be the healthiest? How is she going to feel the best? You know, it was just the, you know, the don't die don't. And so I think, and they said nothing about a pump or a glucose monitor or anything. I didn't know anything about that. And so I think my husband had heard from someone I don't know, he knew something about a glucose monitor. And they were like, oh, yeah, you can ask for that at your next appointment. Well, then I found your podcast. And I was like, oh, no, this is what she needs. So about, like two or three weeks in, I think I found your podcast. And I called right away. And I said, we want the Dexcom. And, and we had it within about like five or six weeks. And I was horrified. You know, seeing how high her blood sugar was going every time she ate. And you know, I called the nurse and they were like, yeah, like, that's what happens. I'm like, but how do we stop that from happening? She's like, you're just getting more information now. You know? And

Scott Benner 33:04
so you'd like So okay, so their, their reaction to you finally being able to see what was happening was, oh, yeah, it's always been a mess like this. But yeah, but nothing to do about it.

Amy 33:15
No, no, she's they were just again, it was that whole, like, we don't want her to go low. We don't want her. And I did a parent. So my friend who had the daughter with celiac, she had come to visit, they had a visit plan, like a week after she was diagnosed. And I was almost like, No, you guys can't come like I'm too overwhelmed. And then we decided, you know, it's fine, you know. And so they came. And so she had a friend who had a daughter who was an adult with type one. And I called her because it was just a situation where there's all these kids or six kids here, and they're just like, eating non stop. And they told me like, No, you can't give her insulin more than every two hours. And so of course, like we're watching a movie, they want popcorn, they want smores they want candy, and is just all the stuff was happening. And I'm like, No, I can't get a stack insulin. I can't, she has to wait two hours. And so I called her and she just was like, Well, you know, the way you have to see it as like a high blood sugar is not going to send you to the hospital. It's a low blood sugar. You know, so then I kind of got that in my head where it was like, Okay, let's keep her on a higher end, you know, but, like I said, I learned pretty quickly that that that wasn't right. And once we got her Dexcom and, and as I started listening to the podcast, I've been having to, you know, advocate for her with, you know, and it's like, I don't want to discount like the help that the nurses gave in the hospital and everything. But at the same time, it just was like she doesn't feel good, you know? Yeah. And well, you know, go ahead, sorry,

Scott Benner 34:53
Dorie, you're fine, you just you're very chatty, and I'm taking advantage of you and letting you talk. You give me be a very fun hour, and I don't have to do very much. It's great. Thank you. I feel like I should send you some of the ad money from this one. But I'm sure I won't do that me just I just wanted to okay, I feel like it, but it's not gonna happen. So I do want to know if, you know, when you get caught in that situation where you feel like, oh, gosh, they're, they're lovely people. And they're, they're really trying, but they're, they're wrong. But I don't want to tell them they're wrong. But I don't want to let my daughter continue on like this.

Amy 35:30
It's a tough spot. Yeah. How do you make sure to do I mean, I choose Leah, you know, I, and so I just started like, you know, giving her more insulin, but I was really afraid of it. At first, I was really afraid to make her go low. And she did honeymoon for a whole year. But we were able to get her agency down by her first appointment, her three month checkup to 6.1 on MDI, you know? Yeah, and this just kind of stayed there. We just so I just was like, no, like, I, I have to figure this out. Like, I can't let her sit at these high numbers. I've seen what high numbers can do to somebody, you know, like my dad. Yeah. And, you know,

Scott Benner 36:13
I let that happen again, no, and

Amy 36:15
I'm like, I'm not gonna kick the can down the road. And trade my fear, you know, for her health. You know, I just, I just couldn't do it. You know, I so I just, I just started making decisions on my own and increasing. You know, we and my husband was always on board, thankfully. And so, uh, he, he's more he was even more than me, like, Oh, he's like, I think we need to have her long acting. And, you know, so we just started kind of doing it on our own. And we would just tell them that we did it.

Scott Benner 36:45
Hey, yeah, microphones hitting your hair or your shirt.

Amy 36:48
Oh, sorry. Yeah, it's my hair. Sorry about that. Yeah, so we just started, you know, just kind of following, you know, stuff on the podcast and stuff on the Facebook page. And we, you know, she just started really, like her levels have just been really good. We just switched. She just got to Omni pod about five weeks ago, which is great. But we're still I'm still trying to figure that out. Now. Now. I feel kinda like I'm starting over. So it's been a little rough. And again, it's the same little battle with where they don't want to let me make adjustments. And so,

Scott Benner 37:27
so we started off with their advice. Went to yours, it got better switched. And then we back to their advice again.

Amy 37:35
Yeah, so now I am, you know, it's like for me, because it's a new thing. I'm trying to still figure it out. And, but I have, go ahead.

Scott Benner 37:43
So how was it?

Amy 37:46
Five weeks, or about five weeks? And yeah, so

Scott Benner 37:51
let me ask question. You were your husband, he, I know why you went to that hotel room so quick. He's like, I'm gonna go have a conversation with myself and see if I can get into yes, no, by the way, I'm teasing you. You are super chatty. It's just, it's perfect. I just need to jump in once a while we're not looking. We're not looking at each other. So it's harder to do. Now, now all that I'm gonna forget my freakin statement. Oh, okay. What what are you finding different about being on a pump versus on MDI?

Amy 38:25
I mean, I guess I Well, the things I love about it is being able to adjust the basals for the different times of day, but they were very conservative with it. And so, you know, they want me to wait, like three days before I make changes to anything. And, you know, and I just I know, better, you know, so, I'm start but at the same time, I also, I don't know all the functions of the pump yet. So I'm still trying to figure it out. And that's so it's hard. I'm,

Scott Benner 38:54
yeah, that's what I wanted to talk to you about, like, because there's nothing really different about it, like I know. I mean, it's, it's, you go into the Bazelon zone first. You either inject it once a day or twice a day, some people split, right. But you're just putting the insulin in. And so that's all the pumps doing, it's just putting it in, it's just putting it in in a different way. But you just go into the basil program and just, I mean, it's as simple as how much like what what, what basil was she using prior to the pump? Let's go for this.

Amy 39:25
Like the type? Yeah, what brand TriCity back. Okay.

Scott Benner 39:29
And how many units? Was

Amy 39:30
she getting a day? Um, we had her up to 10 when she was diagnosed, they had her at six and then we went all the way down to one because she was going low so much she honeymooned for a long time. Right? Then she, yeah, she was up to 10 units a day. So how many she getting through the pump? Like less than nine? So that's where I feel like I need to.

Scott Benner 39:52
I was gonna say is that is that like when she's stable and steady, like overnight, where she's sitting.

Amy 39:59
You know, she He's not state she's going high every night. And so we keep upping it from the night to three. And she's I think she's growing. She's going through puberty right now. So I feel like I almost need to double it because she's every night from midnight to three, she's going into the two hundreds.

Scott Benner 40:14
Okay, well, well, yeah. Well, let's try something.

Amy 40:17
I'm gonna try it.

Scott Benner 40:19
Yeah. But I'm trying to like dig into this one specific thought, like, you're a person who was doing it on their own. And you're making decisions. Not only were you making decisions, but you broke away from the idea of like, oh, this is what they're saying. It's hard to go against them. So you did it. What about moving to a pump? Made you go back to who you were in the beginning?

Amy 40:39
I think because I'm not familiar with it yet. Okay, you know, so I'm not 100% Confident. So and the I think that's it. So I just, I feel a little bit nervous about messing with things. Yeah. Because it's new,

Scott Benner 40:52
try just thinking of the pump as Basal insulin. And you can control the timeframes. So yeah, you know what I mean? And don't even worry about the, the number as much as like the strength like if, if she needs more certain time also, by the way, is she going up at midnight? Or is she going up? When is she going up?

Amy 41:11
Like literally at midnight? Every night, you need to start the Basal increase

Scott Benner 41:16
sooner then. Okay, so I will start at 11. And then then see, because you can't it's the same thing as a Bolus, right? Like, I mean, you know, you listen to the podcast. So yeah, you can't Bolus a meal and start eating at the same time. And you definitely can't change a Basal program. And at the exact moment when the impact is coming, right, because you need to pre Basal the impact, basically. And so Basal insulin, not only is, you know, it's a smaller amount, it's not going in all at once. So she's getting point six an hour. You know, and, like, right now, there's a little bit of insulin going in through her pump for her Basal, right, that, that bit that goes in right now is not impacting her right now. It's impacting her in, you know, 2030 4050 minutes from now, because they're little tiny bits. So you want to jack that basil up? I mean, I'm gonna say an hour to start, I bet you Jenny would say 90 minutes.

Amy 42:17
And but like, how much do I go up? Because they're only having to go up like point five, you know,

Scott Benner 42:23
how's that gonna help anything you should know? 200, right,

Amy 42:28
like, over 200, and I'm up, like, constantly correcting and then sometimes I'll just, like, give her like a Bolus, you know, just to try to get it down how much you Bolus thing in that timeframe? Um, I mean, it's like, I'm just up all night, trying to get it down.

Scott Benner 42:45
I mean, as much as mount, like, units, oh,

Amy 42:49
oh, in units. I'm just doing corrections. So whatever the correction will let me do and sometimes that won't let me so then I'll just put in, I'll just, I kind of do go back to what I know before. Like, okay, if she was 250, and we were on shots, I would give her two units. You know,

Scott Benner 43:05
this is, this isn't an algorithm. It's just the pump, right? So don't worry, ready? Nothing you hear the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician. Don't don't Yes. Don't worry about the insulin on board. Do what? Okay, but it says do what you know is right. Because insulin on board is a dumb. It's a dumb number, it's calculated. And if you're if it's set up incorrectly, it's not going to be right to begin with. And if you count the carbs incorrectly, it's not going to count. It's not going to work and getting a hormone impact. It's not going to work, but barebones. Somewhere in your pump, you've got setting set for how long insulin works in her body. And so if they I don't know, maybe they set that to six hours. It's two hours. Okay, so that's pretty. That's pretty short. That's so that. So it is set up to be a little more aggressive. So okay, yeah. All right. But to finish the thought, just for people listening, if the insulinoma if the insulin action time, I think that's what they call it on the pod, if that was set at six hours, that it makes this assumption that the insolence alive for six hours, if they set it for three hours, then it makes the assumption that it's alive for three hours, meaning that two hours into a meal, if it's set at three hours, it assumes it has less insulin on board. If it's set at six hours, it assumes it has more insulin on board, and then that impacts how much it wants you do to correct if they if it even thinks or corrections necessary. But yeah, okay, I would just and it sounds crazy, but I would use the pump, like injections in your mind. Like okay, don't worry about everything else, like just do what you know is right. And so my point is going to be if you're if you're correcting over those three hours with two units of insulin, first of all, are those two units bringing her back down and leveling her out? Yeah. Okay, so then I would just try to break the two units up into the Basal over the impact time of the hormones.

Amy 45:08
Okay. And I have done that like where I've done like an extended Bolus and just kind of done exactly what you said, but I want to do it. So it's automatic, you know?

Scott Benner 45:17
Yeah. Yeah. So she's getting point six now. You're gonna make me sit up. I'm so relaxed talking to you. I'm way back in my chair. The chair you guys bought me? Thank you so much. Oh, yeah. put a picture up on the Facebook page. And I said, I'm talking to Amy, I tagged you. And I was like, I'm having such a good time. To units, let's just divide it by you think you think the impact is ends around? Like three in the morning?

Amy 45:48
I feel like it's like three or four in the morning. And then she finally comes down. Yeah.

Scott Benner 45:51
So then what if you just, you take the two units, break it out over four hours, give her an extra half a unit for those four hours and see what happens. Okay, now, you might try it, you might have to end it sooner, like so just like we had to start it sooner, you may end up seeing the ended sooner. So, okay, you want to start the Bayes little 11? You know, we're going to try that for an impact at 12. And so if the impact disappears at two, or three, excuse me, you may want to stop the basil at two. Okay, so that by the time three o'clock comes around, and the impact is gone, we don't have a basil. That's too heavy. Okay, that makes sense. Yes.

Amy 46:33
Yeah, it does. Thank you. And I'm just,

Scott Benner 46:34
I'm just using your your number from your correction, like trying to get the correction into the base. Yeah.

Amy 46:39
No, that's, that makes sense that those corrections need to be part of her Basal. Yeah, you should try. I know. I just it's funny because like, once, I felt like I had it down with MDI. I was like, Okay, I'm going broke. I'm doing what I want to do. And I just think switching to the new technology. I was like, Oh, I don't know what I'm doing. I have to listen to everything. They say, I am a little bit, you know, like a people pleaser. So, I mean, not with my husband. I'll fight him on everything.

Scott Benner 47:08
No reason for him to be happy. But everyone else

Amy 47:11
know everybody else. I know. My husband will tell me he'll be like, talk to me. Like you're talking to one of your friends. We eats

Scott Benner 47:19
wheat? Or like, could you talk to us with your gas station voice please?

Amy 47:25
Yeah. Hi, I

Scott Benner 47:27
want to just fill this with AD seven. Oh, why? Nice to him? Never gonna see again. Never. Yeah,

Amy 47:34
I'm only 100. Yeah, that's about right. He's probably

Scott Benner 47:37
taking an impression of our credit card to buy furniture in Mongolia right now. And you you're being nice to him. And you've been to me in 10 years. That's great. Yes.

Amy 47:48
Yeah, so I just I do so I think I just because I'm not confident with it yet. It's just it's taking me a little bit of time to get that courage to just take it matters into my own hands. But yeah, when I see her not feeling well, not wanting to go to school, obviously, it makes me want to be a little more aggressive. So

Scott Benner 48:05
you know, you named the episode earlier. I did. I think it's gonna be called I choose Leah.

Amy 48:13
Oh, I do. Yeah. And, and I just And that's the thing. When I see her, her numbers steadier, her personality is completely different. And I think that's always like my motivation. Like, I want her to be the LEA. She's meant to be, you know, and so yes, I will. I will always choose her over what anybody is going to tell me.

Scott Benner 48:35
Yeah. So you're, you're, you're gonna figure this out and your actions will help her be happier, and probably save your life. If the earlier stories are accurate at all?

Amy 48:45
Yes, yeah. Maybe I'll give some days back to my plate. But yeah, I mean, it's just it's kind of crazy. Because everything I've learned with her, I'm now able to help my dad, even though he's type two. You know, we just recently I just recently I take care of my dad to like, if he has to go to the doctor, I take him and any kind of his appointments, I take him to everything. And his last doctor's appointment, his agency's kind of been sitting in the sevens and eights for a while, which, you know, I'd love to see it lower, but it jumped up to 10.8. And I was like, Okay, I've been in the fog of like taking care of Lea. And so now I'm like, Okay, I know, I know. I know what this means you need more insulin, right? He's an insulin dependent type two. And so I took him to the endocrinologist, they adjusted all his insulin. And while I was there, you know, my dad's on Medicare. I said, Hey, can he get a Dexcom? So they he got one, it was fully covered. And he's on the Dexcom now, and now my dad is seeing in real time when he eats a cookie, what happens to his blood sugar, you know? So his projected agency now since he's been on the Dexcom, is 6.5.

Scott Benner 49:53
Wow. So are you taking what you've learned from the podcast and it's helping him as well?

Amy 49:58
100% Yes. Oh, yes, absolutely. Because, yeah, I mean, it's like you're helping a type two and a type one.

Scott Benner 50:06
Oh, no, I that's really wonderful. I was Yeah, super excited. I mean, you know, I say things. I don't know if people listen. But, you know, like, even like, I slip it in the ad sometimes I'm like, if you're using insulin to get

Amy 50:19
Yeah. Well, and that, yeah. And that's the thing. So I went to his, his facility. And I was like, Well, how, you know, they, they printed out his blood sugar. They don't only check it three times a day. And he's taking probably close to 100 units of insulin a day. Wow. And I'm like, that's not enough. You know. And so I asked the doctor for a Dexcom. And you'd see his numbers. He's in the three and four hundreds all the time. And already now he's just oh my gosh, his line is so straight. I'm like, I'm so jealous. That's such a straight line. But he still has a somewhat working pancreas. But and he's done a couple of times. What's our

Scott Benner 50:56
view on any Basal insulin?

Amy 50:58
Yeah, so he takes, he takes 35 units of basil twice a day, and then he gets insulin, a fast acting for his meals. Wow. Okay. And, yeah, so but the last week, he went low, he was in the 40s. And I called him and I'm like, Dad, are you feeling okay? And he was like, what I go, your blood sugar is really low right now. Are you okay? And he was like, Oh, I didn't eat my lunch. I'm like, but they gave you insulin, right? And he's like, yeah, man, get going. I said, You need to have a good tea, don't eat a cookie, go eat some candy. And so it's happened a couple of times where I've seen his blood sugar dip low. Because he'll just he doesn't eat but it's good. Because he's changed what he eats for breakfast. He's completely changed because he's seen what it does on Sunday. He ate a cookie, his blood sugar went to like 300. And he called me he's like, I'm sorry, I ate a cookie. It's okay.

Scott Benner 51:54
So it's changing his habits to

Amy 51:57
it is because he's seeing it in real time. What's happening? And it's great. Yeah. And I mean, it's just, you know, it sucks that Leah has diabetes. And, you know, it sucks that he has type two, but I'm just so glad I'm able to help both of them. Me too. You know? Yeah,

Scott Benner 52:13
yeah. Wonderful. Wow. Good for you. That's actually you weren't? Well, I take it back. Maybe now. When your husband comes out, I will call you because, yeah, that was really lovely. Plus, I need somebody to help me with my mom. So I'm

Amy 52:25
sure Okay, I am a caretaker. That is my, you know, I do I like to take care of people for sure.

Scott Benner 52:31
has, as the diagnosis caused you, like you said, you kind of lost track your Dad, is it hard with the other two kids?

Amy 52:42
Um, you know, they're so great. Like, they're so supportive. And, and we do, like, my husband and I, like, our kids are everything. And so we do. Like my husband, coaches, my son's baseball team. So they spend a lot of time together. And my older daughter, I, you know, try to spend so we do try to like, balance it all out. But it was hard, especially when Leah was being so challenging. And so we actually worked with Erica for a little bit. And because we're in California, so we were able to, to have some sessions with Erica and that was really helpful as a family and then individually with Leah. So

Scott Benner 53:21
while this podcast is pretty damn helpful.

Amy 53:24
Yeah. And yeah, so

Scott Benner 53:27
I have Erica, like I've ever got on my, my calendar next week.

Amy 53:31
Yeah, she's amazing. And it was great. Like, we did one as a family. And, you know, I think my husband in the beginning was, it is just like, my husband's a type of guy. Like he, like, he'll

watch a Disney movie, he cries, you know, and when Leah got diagnosed, I mean, I cried for a month. You know, I was just,

I was devastated. You know, because my kids have always been healthy. I've always had healthy kids. And, you know, I've always kind of almost been like, proud of that, like, I have some kind of superior genetics or something. I don't know

Unknown Speaker 54:01
what I've done. But what

Amy 54:04
I remember my daughter had a friend she had a couple friends that were allergic to dogs and we have dogs and I'm like, can you stop making friends that have allergies please?

Scott Benner 54:12
Let's say I'm bringing these weak kids into the house. I know

Amy 54:15
that these weak immune systems Yeah, and so I just kind of it so it really you know, nothing humbles you more than being put through something like this and having you know, now I'm just so sensitive to like, celiac and peanut allergies and everything where I think you know, before I just didn't really think about it much and I would kind of be annoyed by it. And it really it really humbled me quite a bit and you know, I just Anyway, are you gonna cry? No.

Scott Benner 54:52
She need help her she crying

Amy 54:56
but it didn't know I do. I feel a little emotional about it. But um, It really did humbled me for sure. And I forgot what I was going to say. But

Scott Benner 55:06
you probably want to apologize for making fun of people with allergies is what I was.

Amy 55:10
Yeah, I mean, for sure. And yeah, and oh, what I was gonna say was that, you know, so when that happened, I was really upset. And then my husband just like, never cried. And I was like, What's wrong with you? Like, why aren't you sad about this? And he was, he did try to kind of be like, Oh, you're so good at it, you do everything. And I was like, No, I can't be the only one who knows how to take care of her because we have other kids. And, you know, I like I need to spend time with other kids and or take them to do things. And so you need to be able to take care of her too. And so he didn't, he was afraid it was hard for him to put a needle in his child and, but he did it and he helps a lot. Now he's very involved. And it was, but anyway, we had a session with Erica and and again, I just think like it, it was hard, because I felt like he didn't, he didn't feel it the same way I did. And we had our session with her and she kind of like went around and asked everybody, you know, how they felt when Leah was diagnosed, and then he, he totally cried, and then we all started crying. We were all on different computers in the house, you know, and, and all of us is just like, so it was good. And it was good to hear how my kids felt about it. You know, the other kids and how they took it in? And what's

Scott Benner 56:24
different for each of them?

Amy 56:27
Um, yeah, I think, you know, like my son, he was so sweet. He was just like, you know, oh, I just only knew my grandpa had type two diabetes, and I, I really didn't understand it. And he's like, I just feel I feel really bad for her. And, you know, he's 12 At the time, and he's like, I just want to learn how to, like, give her shots and take care of her. And he was so cute. And, and he was like, you know, sometimes we ride our bikes home from school, like, I want to be able to go like, get food with her and be able to give her a shot. And, and Erica was just like, I'm so touched hearing that, Charles. Like, that's so sweet. And then she's like, Leah, how does it make you feel to hear your brother say that? And she's like,

Scott Benner 57:04
I guess what she said? Yeah, can I guess what she said? What did she say? Yeah, that kids?

Amy 57:12
Pretty much. Um, yeah, I mean, I guess that's nice. You know, cuz sometimes I'm hungry on the way home from school. It's just like this touching moment. And she was like, Yeah, I don't care. Yes. And she's really mean. What? One of our sessions with Erica, it was just me, Eric and Leah. And she was in her room on her device. And my husband, you know, he hasn't mastered the zoom. Okay. This zoom, kind of had it on a bad angle. You know, he kind of had a double chin, you know, on display. And she just sent him a text message that said, nice chin therapy. Tech says message that says nice chin. Yeah, she's She's charming. Charming, ya know, so it's been so helpful. And I just I feel like I owe you so much. Because, yeah, I mean, our whole family is better because of it. You know, including my dad.

Scott Benner 58:21
Happy to hear that. Thank you for telling me. That's wonderful. Yeah.

Amy 58:23
Yeah, for sure. I,

Scott Benner 58:26
I don't know what to say usually. So I'm going to try not to say something silly, and just say thank you. But you're welcome. Very. It's a humbling like, I try not to say things that I think people think sound just cliched. But you want to try sitting over here and having someone tell you that story. And then thank you at the end of it. It's, it's hard to absorb. So

Amy 58:49
yeah, well absorb it. Cuz I just I don't I just I'm like, what would I Where would we be? Had I not found your podcast? I don't even want to know. Do you know, I don't even want to know.

Scott Benner 59:01
Do you know that this week, has my mom's having a health issue. And I didn't feel like that she was getting the care she needed through the doctor that she basically landed on when she was at the hospital. So I looked at our our options for how to get her a second opinion. And they were all you know, like call the cold call and office and tell a story and hope a doctor was interested. And then I was telling my neighbor about it. And her son had grown up to be a surgeon. And she's like, why don't you call him and see, you know if he knows anybody. So I texted him. And it turns out he went to medical school with a doctor who is the exact kind of doctor that my mom would meet. So she he texted his friend, his friend then called a mentor. And yesterday, the mentors office reached out and treated us so much better than my mom has been treated so far. You know, which sucks. I'm not gonna lie like it sucks. It's like the you need to know somebody to get treated. Yeah, you know, but yeah, but it's, it's happening, right? And I text him to thank him. And I sent him a very thoughtful text and it, you know, I'm telling him how much of an impact he's made. And I'm thanking him. And he responds, it's no trouble. So I was happy to do it. And I was immediately like, No, man, you don't understand. Like, you can't just say no trouble. I'm happy to do it. This is a really big deal. My mom's been, you know, my mom's happy for the first time and months. My family feels relief for the first time in a long time like this is I'm so I'm now trying to explain to him what a big deal is. And as I'm explaining it to him, I'm thinking, Oh, this is what I do to people. They tell me, they tell me something. And they thank me and I go, it's no trouble. Don't worry about Yeah. Damn, I got mad at myself. I was like, I gotta stop doing that. But I don't know

Amy 1:01:07
what Yeah, it's hard. Yeah, I know, it's hard, because you still want to remain humble. But at the same time, you know, it's

Scott Benner 1:01:16
not even that it's, it's, I mean, I made the thing it's recorded. So we keeps helping people. It's not like, I have to do it over and over again to help them. Do you know what I mean? Like, I talked to you once, if something valuable gets set in this hour, which is 100%. Sure, we did. But maybe we didn't talk about the diesel thing overnight. So that might be okay. But you know, somebody takes something from this episode. And it helps them it'll, then and this episode gets downloaded, you know, a lot. And then it helps all those other people. My effort only happen once. You know what I mean? And so it's hard to feel like, I don't know, you know, if 10s of 1000s of people tell you something, but you only did something once for them to all get that reaction. It doesn't feel like are my effort is equal to their. To their thanks. I don't know, to their appreciation. Yeah. And, um, I know, it's a weird thing, but I really do like hearing it. And I appreciate knowing

Amy 1:02:20
ya know, we're I just like I said, because a lot of the advice I got was the, like you've said before the don't die advice, which is great. And I don't want that to happen. But I would have never been able to help her the way I have. Had I not found it. Yeah. And not only her health but emotionally because then we found Erica, so Right.

Scott Benner 1:02:44
No, and yeah, and their behavior to like, I know, yes. Still, like spirited, but she says, yeah, she's not like flipping you off anymore.

Amy 1:02:53
I mean, oh, yes. When we got her her pump, I put a picture of it on the page. But when she got her pump, I was like, oh, Leah, let me take a picture of you with your pump and I'll send it to grandma.

Scott Benner 1:03:03
Oh, she's the one that flipped you off in the pie. Remember that picture?

Amy 1:03:05
Yes. Yeah, she flipped me off. But that was just like, yeah, that was more fun. But yeah. Oh, and she's told me like, she does not identify where her diabetes. You know what I mean? Like, she's fine with talking about it. But she's not like, I'm a type one where you're like, that is so not her personality at all. And she told me if I ever were a type one where your mom t shirt that she would set it on fire while I'm wearing it. So

Scott Benner 1:03:34
that kid's gonna kill you.

Amy 1:03:35
She is yes. Somehow. Slowly, slowly over time, or yet or just one day? Yeah.

Scott Benner 1:03:43
Kelly, why don't you just smother me with a pillow? Wouldn't it be quicker? Why are you torture me like this? Just we just get this done, please. It's just the this this water torture thing is taking forever. Like

Amy 1:04:01
I know My poor husband, too. He's got all these feisty girls in the house. There's three of us. So He said that once. We're all like synced up with our cycles that he and my son are going to leave town every month during that time. So

Scott Benner 1:04:15
I've never been so delighted as how you describe him running to the to the hotel when you were like

Amy 1:04:22
it was like as I was saying it was already booked. I'm like, Oh,

Scott Benner 1:04:26
should I use Travelocity or the one with the

Amy 1:04:30
oh my gosh, it was so funny. To look

Scott Benner 1:04:33
at the sun and go see a sucker.

Amy 1:04:35
I know. Sorry. Don't want to give you COVID

Scott Benner 1:04:39
Oh, it's a shame you're gonna have to say I gotta go goodbye. Three days he's probably

Amy 1:04:46
Oh yeah, eating cookie dough. Yeah, see what

Scott Benner 1:04:51
Well, it means there anything that we haven't talked about that we should have?

Amy 1:04:55
No, I'm just thank you for helping me with the competence again. cuz I just I felt like I did I have lost a little confidence since switching to the pump. So I'm trying to, to get that back, but I love it. You know, I mean, it's amazing. We were giving her, you know, 12 shots a day sometimes. So wow, this is an especially with a difficult child like her there was some running around pinning her down, you know? So but I'm like, I will not like up high

Scott Benner 1:05:28
like flopped on top of Ronda. So Oh, yeah.

Amy 1:05:32
Very accurate. And it's the same with like, you know, the Dexcom, you know, and some of the advice that I've been given by people is like, Oh, well set a timer. And, you know, and then tell her Okay, it's time now. And I'm like, that's not going to work. Like, I'll set the timer for five minutes, and she's still not gonna let me do it. So,

Scott Benner 1:05:50
to do these things, like sneaking up on a wild animal, you just throw it back over her head?

Amy 1:05:54
Yes. Yeah, seriously. And so it's just like that. Dexcom you know how, you know, you stick it on? And then that sometimes she'll be like, no, wait, wait, wait. And I'm like, No, I'm not waiting. And I'll just, I'll just do it. And I know, maybe that's not in the parenting books and or whatever. But I'm like, no, she will literally walk around with that thing hanging on her arm. She will do the long game, she will walk around for days, and never let me inject it. So I just know. I just have

Scott Benner 1:06:23
to do it. So I think the waiting just builds the anxiety. Honestly, it does. Yeah,

Amy 1:06:27
it does. And I just do it. And she might, you know, get a little combative. But you know, then it's done. And you know, we move

Scott Benner 1:06:34
on? I'm I have to I have to tell you be honest. I'm a proponent of do it quick.

Amy 1:06:40
Yeah, yeah, I just know her, you know,

Scott Benner 1:06:44
but even when people take off their devices, and sometimes I see them and like soaking them and stuff. Like why like to get it nice and wet. You know, I know some people have skin issues where pulling it off quickly really does mess with them. But Arden we just like peel up a corner and I'm like, you're ready. She goes. Yeah. And I hold her skin down with one hand like, I just Oh, wow. It doesn't feel great. But it's over and then it stops hurting. And that's it. Yeah. You know, I mean, I don't know. Like if you want to soak, you know, you want to soak your pod for an hour before you pull it off. Like it's cool with me like I don't I don't have time for that. I don't care that we do it. We're just like ripping go.

Amy 1:07:22
Yeah, I also did a little bit but now we we don't wait more than a couple of minutes. I'm like, Nope. Okay, it's coming off now. So I just I just don't and I know her and it doesn't matter how patient I am. She's never going to be ready. You know, she's never going to be like, okay, Mom, you can take money. You can inject it now or you can take it off. Now. You just have to. You just have to get it done.

Scott Benner 1:07:43
And one more second. One more. So hold on. Hold on. Hold on. Hold on. Wait, wait, wait, wait, wait, wait, wait, why are we waiting? Just wait one second like that. It just goes on forever.

Amy 1:07:49
Right? Yeah. Oh, totally. Yeah. 100%.

Scott Benner 1:07:53
I've lived through that once or twice. Okay. My son was taking a pill when he was a little kid. Holy crap. I still my wife and I are traumatized by one time. We just were hours in the kitchen. Like just swallow the pill. Oh, my father, like retired, like you'll feel better if you just he was little, you know, and he says I don't want to do it and I shut up and to swallow the pill. And he fought for ever. And then finally did it like an hour later. He's like, my head feels better than we were likely. Gonna Majan that. Okay. Thanks. All right. All right, Amy. I'm gonna let you go. And I'm gonna delete out all the cursing that we did.

Amy 1:08:32
Yes, I'm sorry. Everybody knows.

Scott Benner 1:08:35
I curse the biggest curse. Don't worry about all right. Do not remember.

Amy 1:08:40
I you know I? I said I think yes, that's right. That's right. Yes. That's

Scott Benner 1:08:45
got to come out. That has to come out. Yeah. Well, I imagine. I can imagine your daughter saying it. So

Amy 1:08:52
she calls him a little bit all the time. She tells him he's a little and she tells him he's never gonna move out. She's been and he's so nice to her

Scott Benner 1:09:05
because she gets older and she started saying stuff like girls aren't gonna go out with you and

Amy 1:09:09
oh, she's Yeah, she's very mean. But he's thankfully he. He's pretty good about ignoring it.

Scott Benner 1:09:17
Alright, listen, if your friend ever wants to come on and talk about her husband coming out, I don't care that it doesn't

Amy 1:09:24
it's an interesting story for sure. And I'll let you know if my husband ever does. I'll keep you posted for

Scott Benner 1:09:29
when I hear you. Okay. Hold on. Let's take care you to

a huge thank you to one of today's sponsors, GE voc glucagon. Find out more about Chivo Capo pen at G Vogue glucagon.com Ford slash juicebox. you spell that GVOKEG l u c h GE o n.com forward slash juicebox. I'd also like to thank Amy for coming on the show and sharing her story. And us med for sponsoring this episode. Go to us med.com Ford slash juice box or call 888-721-1514 Get your free benefits check get started with us med if you're enjoying the Juicebox Podcast, please share it with someone else who you think might also enjoy it. And if they don't know about podcast, take their phone from them and show them be like here. Download this, do this search for that. Listen here. Some people need help. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.


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#677 Defining Diabetes: Hypo and Hyper

Scott Benner

Scott and Jenny Smith define diabetes terms

Scott and Jenny Smith define diabetes terms In this Defining Diabetes episode, Scott and Jenny explain Hyper and Hypo.

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon AlexaGoogle Play/Android - iHeart Radio -  Radio Public or their favorite podcast app.

+ Click for EPISODE TRANSCRIPT


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 677. It's a short one, but it's good

Hello, everybody on this episode of The Juicebox Podcast, Jenny Smith and I will be defining hyper and hypo as it relates to all things, not just diabetes. Please remember, while you're listening that nothing you'll hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician. Before making any changes to your health care plan, or becoming bold with insulin. I'm going to just ask you the briefest of favors. If you are a US citizen who has type one diabetes, or is the caregiver of someone with type one diabetes, please go to T one D exchange.org. Forward slash juicebox. When you get there, join the registry take the survey takes fewer than 10 minutes, I would consider it a personal favor T one D exchange.org. Forward slash juicebox. If you're enjoying the Juicebox Podcast, please share it with someone who you think might also enjoy it. If you're loving the defining diabetes series. There are so many of them to choose from right there in your podcast player, where diabetes pro tip.com. This episode of The Juicebox Podcast is sponsored by us med. US med is a place where you get diabetes supplies, and they do it. Well they do it better. They offer you better service and better care than you're accustomed to getting. All you need to do to get a free benefits check is to go to us med.com forward slash juice box or call 888-721-1514 Hi, Jenny. Hi, Scott. How are you?

Jennifer Smith, CDE 2:05
I'm fine. How are you today?

Scott Benner 2:07
Good. Have you seen the little animations of you and I talking on Instagram and and Tiktok yet?

Jennifer Smith, CDE 2:14
I have I saw when you originally showed me what was going to be there but I have not seen recently. Because I have to admit I'm not a tic tac, or Instagrammer.

Scott Benner 2:26
So the person making the videos Maggie, who is a great young artist whose sister has type one diabetes. She has now added what I'm gonna call googly eyes to us. So while we're talking now the eyeballs move around inside of the eyes. Oh no, I'm absolutely like enamored by it. So

Jennifer Smith, CDE 2:43
I'm sure that if I showed it to my boys, they would probably think it was the coolest thing in the world to see

Scott Benner 2:47
your voice coming out of a cartoon. Yeah. Oh, yeah. All right. Well, you should check it out. I don't think you should get on Tik Tok because I have to tell you, it really is a time suck. Like it is it is the scrolling. Like I got it just to put this stuff, you know, for the for the podcast app. And then I'm like scrolling and I'm like, oh my god, I can see how people get lost in this. It's fascinating. So

Jennifer Smith, CDE 3:06
yes, I have stay away. I have more things that I need to do then.

Scott Benner 3:11
Yeah. If you're not on Tik Tok, you're doing okay. I think I was hoping today that we could define something that I mean, in all honesty, I had skipped over we I'd made a list and thought this isn't necessary. But it is. So we're going to do it. I want to define hypo and hyper just those words, and then we'll attach them to diabetes, and a couple of other things. So you know, everybody understands, again, Isabel helping me with the Facebook page, she said, I know this seems basic, but you really could use an episode on what hyper and hypothyroidism is people ask especially new newly diagnosed people, we don't have anywhere to send them. So here we are. Great. Awesome. Okay, so let's start like super simple, right? We're just going to use the dictionary. Hypo is a noun, and it means

Jennifer Smith, CDE 4:11
under or beneath a level of where you want to be. Right? And, yes, I mean, hypo hypoglycemia, hypo thyroid, hypo, many other medical terms that come along with hypo, it is like, it's low, right? It's under where a level of comfort would be.

Scott Benner 4:35
I also should have said and this is going to be a good indication to all of you that I stopped paying attention to my English teacher in about seventh grade, but it actually can be used as a verb as well, but we mostly think of it as a prefix, under beneath down less than normal, in a lower state of oxidation, for example, in a low and usually the lowest position in a series of compounds. So glycemia You know, I didn't think of this but darn it. Let's define. Let's define glycemia for a minute. Why not? I don't even think glycemia is a word, right? It is the presence of glucose in the blood. Now I'm learning. Yes. All right, like this podcast, okay? Jenny, then you

Jennifer Smith, CDE 5:21
can then you can put them together low presence of glucose in the blood. Yeah. Jenny, I hypoglycemia.

Scott Benner 5:29
I was gonna say I would listen to this podcast. Okay, so glycaemia the presence of glucose in the blood. So hypo, beneath normal, less than normal, presence of glycine, of glucose in the blood, and then hyper, which, if you've anyone's ever had a hyper kid, you know, this won't sound crazy, highly excited, extremely active, excessively excessive. That is or exists in a space of more than three dimensions that one doesn't really like It's like hyperspace. Oh, yeah, I really should have paid attention in school. This is all very interesting. I feel like an idiot. Okay, so but excessive, is where we're going to ride on this. So hyperglycemia excessive presence of glucose in the blood. That's it. Now, why somebody couldn't just call it high blood sugar and low blood sugar. You know, smart people, doctors, they fancy.

Jennifer Smith, CDE 6:25
Right? Well, and they're just medical terms, right? I mean, hyper and hypo, even in the sense of other medical conditions that carry that same prefix, if you will. They're just a medical term, rather than saying high and low blood sugar or high and low blood glucose even I also think, just glucose and sugar, right? I mean, when you say, my blood sugar is this, some people say my blood glucose is this, it's just another word for the same thing.

Scott Benner 6:54
Do you have a preference? Personally, when you write it out? And you know, someone else is gonna say it? Do you think blood glucose or blood sugar? How do you write it out?

Jennifer Smith, CDE 7:02
I abbreviate the G, because that's my quick way to type up something.

Scott Benner 7:08
After writing blogs, for so long, I did the same thing. But in the beginning, I had this like this blood sugar sound. I don't know. Like, I like this is not sound, I don't know, appropriate or something like that. But I don't think of it now. It's however it comes off my fingers when I'm typing. Like when I'm talking to somebody, I don't think of it one way I don't care. I

Jennifer Smith, CDE 7:28
guess if you, if I think about when I write about it, when I'm writing more professionally, I use the term blood glucose. And when I'm writing more from just a general kind of public, I typically use blood sugar. Okay, not that people don't know what glucose is, especially within the diabetes realm. I just think that blood sugar is often more what we say. Yeah. And so it's more readable. I don't know if that makes sense.

Scott Benner 8:02
Yeah, I think it just makes it feel more affable, honestly, just sure available to people. As an example, and we're not going to turn this into a third grade English lesson, but hypothyroidism is a condition in which the thyroid gland doesn't produce enough thyroid hormone. So back to hypo, low last, etc. Hyperthyroidism, the overproduction of a hormone by the butterfly shaped gland and the neck called the thyroid. Excessive too much. I just pulled up a couple of other words to make the point that it's not always about. It's not always about medicine. Hyperbole, as an example, is an exaggerated statement. We're claimed not meant to be taken literally hyper hyper. Right? Is the prefix. My, my last thought is just to get away away and Jenny used to be a nurse. Right, Jenny? What is hypo perfusion?

Jennifer Smith, CDE 8:56
Good to correct you I wasn't a nurse, or I'm not a dietician.

Scott Benner 9:01
Sorry. It's the same thing.

Jennifer Smith, CDE 9:05
Oh, well, you know, if I had thought that when I was going to school, then I probably would have ended up being a nurse. But yeah, so that different,

Scott Benner 9:15
I make a suggestion. Sure. We'll have to add CDE to the defining diabetes series.

Jennifer Smith, CDE 9:23
That would be great because you can have many credentials that precede CDE, which is actually not CDE even anymore. It's now c d c e s certified diabetes care and education specialists to make it even more complicated than it ever was.

Scott Benner 9:40
Have you given over to that yet? Because you you said you were gonna fight it in the big guy

Jennifer Smith, CDE 9:44
in credentialing just in terms of my signature and the way that I you know, put, again, sort of publications and that kind of stuff out I do. But I still call myself a CDE because I that's just like, what I've been long term.

Scott Benner 9:59
I have to Say I like these. Oh my gosh, I've gotten too hot tea and it doesn't matter. Oh no. I'm just gonna start drinking scalding water. When I'm recording from Elon just, I'll drip a little lemon in it and pour down my throat. I was gonna say I like the free flowing pneus of our conversations, because my just miss speaking for a second, immediately made my brain go, Hey, why are we not defining this stuff for people? Because people all the time, say, who just see today? I don't know, I saw the lady. You don't I mean, like, the doctor is the doctor, an endocrinologist? I don't know, what's the woman I don't know. Like, like, you know, she writes the prescriptions. It seems like she's got a medical degree.

Jennifer Smith, CDE 10:37
That's I saw these people. And they told me to do this. And I don't necessarily know what they are, you know, in fact, in terms of like that defining of even clinicians, many endo offices now sort of transition often on between, you see the Endo, you see the nurse practitioner or you see the Endo, or you see the PA, a physician's assistant, right, and you go back and forth. So it's not every three or four months, you're seeing the same Endo, you may see them only twice a year and in between, you actually follow up with the nurse practitioner, the physician's assistant, because that's the time that they have.

Scott Benner 11:13
So my brain like, I know, you have a firm background in nutrition. Like I understand all that. And I guess my brain just was like, well, she's the CDE she must have had to have been a nurse in the middle of it. And now so Okay, so we have more stuff anyway. Just

Jennifer Smith, CDE 11:27
remember things in nursing school that I was like, Yeah, I don't want to do that. I don't want to ever ever do that to a person. So no, I'm not going to be a nurse.

Scott Benner 11:37
Well, then just for fun.

Jennifer Smith, CDE 11:38
I I very much appreciate the nurses who do and can do those types of things. But I That's not me. I can do blood. You could bleed all over me. I could do wounds, weird looking gashes.

Scott Benner 11:51
Where's the line pee?

Jennifer Smith, CDE 11:53
Oh, the line is mucus. Oh,

Scott Benner 11:57
I wish you could have saw the face Jenny just made we should make it a poster. I just sideways or tongue came out or one of her eyes went one way she's like,

Jennifer Smith, CDE 12:05
yes. No, I was I was an ICU dietitian. So I did like tube feedings and IV nutrition and all that kind of stuff. And I would have to move away when they were doing like suctioning of patients and stuff. I like the noises and not for you. Not for me. Nope. My Oh, come back. Thank you. My wife

Scott Benner 12:27
is like three clinicals away from being an RN. And I mistakenly got her pregnant before she could finish off. So I do remember that she never got back to it. But she even said that. She thought by the time if she would have finished she's like, I don't think I could have like actually helped people. Like it just was Yeah, her vibe. And it wasn't about the people. It was more about the that stuff. Okay, but anyway, just for shits and giggles Do you know what hyper perfusion is? Now that I brought it up? Because if not, I gotta tell people.

Jennifer Smith, CDE 12:57
What and why? I'm curious actually. Why?

Scott Benner 13:00
Because it had the word hypo in it. And I thought I wonder if anyone just randomly know what this is? Oh,

Jennifer Smith, CDE 13:05
well, it has to do with like blood flow. It's hyper. Hyper is more and hypo is a reduction in the amount of blood flow.

Scott Benner 13:15
This is why you're listening to the podcast because Jenny knows stuff about stuff she doesn't know about. Hypo fusion has nothing to do with diabetes, but it describes a reduced amount of blood flow. There you go. You can't trust somebody who knows stuff. They're not supposed to know who you're supposed to trust.

Jennifer Smith, CDE 13:29
Correct. There you go. Well, thank

Scott Benner 13:31
you so much for doing this. I

Jennifer Smith, CDE 13:32
really You're welcome. Absolutely.

Scott Benner 13:36
That was good. That was hilarious. Actually. It's always fun. Good time. All right. hyperperfusion. I'm getting rid of tabs on my

Jennifer Smith, CDE 13:43
Yeah. Are we stalled for a second? I need to I think I forgot my orange link in my kitchen. And I need to go grab it because my loop is red right now. We'll be right back.

Scott Benner 13:54
No problem. While Jenny's off getting her orange link. I'm going to tell you about today's sponsor, US med

just the other day, I had Omni pod send Arden's prescription for Omni pod five over to us med. All of this happened without problems. That's what we want. Right? Nice and easy access to our supplies. US med offers that with their white glove treatment. US med accepts Medicare nationwide and over 800 private insurers. They carry everything from insulin pumps and diabetes testing supplies to the latest CGM, like FreeStyle Libre two and the Dexcom G six. US met always provides 90 days worth of supplies with that fast free shipping that I've been telling you about. If you want better service and better care than you've been accustomed to getting with your other suppliers, check out us med. They've helped over 1 million diabetes customers since 1996 are the number one rated distributor index com customer satisfaction surveys, the number one specialty distributor for Omnipod dash, the number one distributor for FreeStyle Libre, and the number one fastest growing tandem distributor nationwide. US med get your free benefits check right now. Us med.com Ford slash juice box or call 888-721-1514. There are links to us Med and all of the sponsors in the podcast player shownotes that you're listening in right now. Or at juicebox podcast.com. And don't forget to take that T one D exchange survey AT T one D exchange.org. Forward slash Juicebox. Podcast support T one D exchange, you're helping people with type one diabetes, and you're supporting the Juicebox Podcast, keep the show free and plentiful by supporting the sponsors.

on next week's defining diabetes, Jenny and I will be defining all of the different types of diabetes. And there are more than you think. To find a list of all of the defining diabetes episodes, go to Juicebox Podcast type one diabetes on Facebook, it's a private group for people who listen to this podcast. And right there at the top of the page. You click on a little tab called where the is it God, I can never remember the name of this. I'm going to curse. I'm going to curse. I don't want to curse just trying to finish this ad and I'm done for the week when I get this done. Like I actually get a day off tomorrow. I mean, I still have to record but I don't have to edit and I just want to tell you the name of this. Featured, you go to the Juicebox Podcast type one diabetes, it's a private Facebook group. Almost 25,000 people in it. They use insulin, they chat with each other, they help each other. And under the featured tab at the top. There's lists of episodes in different series, including the defining diabetes episodes. So if I didn't sound too crazy, just then maybe you'll go check them out. I just didn't want to curse. That's the end of my week and I had knee surgery. I'm feeling okay, but I'm not supposed to be sitting here right now. I'm supposed to have my flights. This is not your problem. Just go find that. Just go find it. It's Juicebox Podcast type one diabetes. It's a private group answer a couple questions you get right in. It really is a magical place. I'm not kidding

you. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.


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!

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#676 Dexcom G7 is Getting Close

Scott Benner

Jake Leach Executive Vice President and Chief Technology Officer at Dexcom is back to talk G7.

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

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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 676 of the Juicebox Podcast.

Today on the Juicebox Podcast, I don't know why I'm talking like this. Let me start over again. On this episode of The Juicebox Podcast, I'll be speaking with Jake leech. Jake is, you know from Dexcom. He's been on the show a bunch of times. And he's here today to talk about g7. It's a short episode, but it's full of good information. If you're looking forward to the Dexcom g7, you're going to like what comes next. 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 healthcare plan, or becoming bold with insulin. If you are a US resident who has type one diabetes, or is the caregiver of someone with type one, your answers to simple questions are valuable. Go take the survey AT T one D exchange.org. Forward slash juice box in fewer than 10 minutes, you will help people living with type one diabetes while you're supporting the Juicebox Podcast.

This episode of The Juicebox Podcast is sponsored by us Med, get your diabetes supplies from us med find out more and get your free benefits check by going to us med.com forward slash juicebox. Or you can call I love reading the phone number. It brings me back to my childhood when I watched television, I was who my parents were the television. And then the ad was nevertheless ready. 888-721-1514 That's 88721514 Call now. That is how every ad when I was a kid ended? Was that the phone number that they said call now. Anyway, if you call that number, or you go to the link, you can get a free benefits check and get started with us, man. I'll tell you more about them later. I actually just switched over Arden's on the pods to us med.

Jake Leach 2:25
We're working on getting g7 approved, sorry about being late. It's not a stupid excuse. That's literally what I was on the phone talking about. That it's approved, don't take that as long as the record is more of like three questions. All

Scott Benner 2:42
right, hold on a second, I can't get my light to come on. So I'm going to be in the dark. But I'll still be see if I can throw a secondary light on. No worries. Let's see. Hey, how are you? Good, man. How you doing? I'm on okay. So is that really what you were doing? You weren't just like in the bathroom? And you couldn't get here on time? What was that? No,

Jake Leach 3:08
no, literally, I was I was on the phone with our team, we're, you know, back and forth with the FDA, they ask a question and you answer it, then they want some more clarification you answered. And I mean, it really comes down to there's just so much in these filings that they you know, they can't possibly read all 38,000 pages. So they just kind of pick areas that they want to spend some time with. So we ended up helping point them to the right places. And so it's very, it's really interactive. It's great. And very thorough, but it takes a little time.

Scott Benner 3:36
Yeah. Does the integration with algorithms change your submission? Or is that on the pump person side?

Jake Leach 3:42
That's on the pump side. Yes, the pump side, they basically once we get G seven approved as an IC GM, then they quickly do their submission. They've a little bit of validation work they have to do on their side to show that they have compatibility with the new G seven system. But it's all of this is based on the work that FDA has done to do the I CGM and the AI Controller it really facilitates quicker approvals. If if they wouldn't have done that, it almost likely wouldn't, you'd have to run a new study with every generation of technology instead of trying to make them more compatible. So it's pretty it was good forward thinking on the FDA has purposely set it up. So yeah, each of those pump companies will have a submission right after we achieve seven approved that they'll have to go through to get the g7 approved for use with their automated insulin delivery systems.

Scott Benner 4:31
Do you think that I'm going to ask you to speculate Do you think that's something they have ready to go and they're just waiting for you to get your Okay, so they can submit theirs? Or is it a process that like starts at day one when you

Jake Leach 4:40
know No, there are both both of them in tandem and insulet are already working on g7 integration. I've already seen prototypes working of their systems so they you know, they're not ready to like file it right away. They might be by the time we get to seven approval we'll see you know, because you know, probably a little More review time on D seven. So we'll see. Hopefully, I mean, they're moving as fast as they can. We're supporting them in every way to help them move as fast as possible. But there will be some time where people will stay on G six, if they're on those systems before they can move to G seven. What was I'm going to jump around a little bit here. Do you mind? No, I'm no problem, man.

Scott Benner 5:19
Good to see you got approval overseas already? Yeah,

Jake Leach 5:24
we got to see Mark last last month. And you know, we'd like to move fast. So we already moved into a limited launch. So g7 is in the hands of customers in the UK right now. That the recent attd show that just is wrapping up in Europe, they, we had a number of clinicians that have used the product as well as some of their customers. And they shared a little bit feedback, feedbacks been great. No surprises. Everyone loves the smaller size, easy use new app, the grace period, the 30 minutes start up, the more configurable alerts. For convenience, there's just there's a whole lot in g7. So pretty, everyone's pretty happy with it. We're happy with how it's going. We do these limited launches just to test, you know about the product, but also just our systems technical support, make sure we know how to support this, the last thing you'd want to do is go big and then have an issue that while it's fit, correctable it's kind of hard to correct when you're hurt. Yeah. At the scale we're at. So you want to get it going a little bit slower at first,

Scott Benner 6:23
was that the first time that that's happened that you've gotten something moving overseas before in the US on a new products?

Jake Leach 6:30
No, it's you know, there's been lots of different reasons over time where this has happened. I'll give you one example is g4 actually was approved first in Europe, with the Animus pump of all things right. So that was actually a previously approved version. So that was, you know, then we ended up redesigning some of the GE for for a product, he made it g4 Platinum, and then launched it. This one was just the case here is that the clinical trial that we had to run for the FDA is a little bit larger and takes longer than we the one that is required for the regulatory agencies in Europe. So we purposefully ran two separate trials, we wanted to get the product out as fast as we could. So we ran a trial for Europe. And we ran a separate trial for the US. And we submitted the European submission while we were still running the US trial.

Scott Benner 7:21
Okay. Can I flow through some questions real quick? I think they're going to be kind of kind of quick ones? No, of course. Excellent. I have these are from people who listened to the podcast who want to know what they want to know. I'll, I'll start with, they're wondering if the new form factor of G seven cuts down on compression lows. I've asked you guys this question in the past? And the answer has been We hope so. But I was wondering if you have any more data? Yeah, we don't, I don't have anything valid validated to say, you know, if

Jake Leach 7:51
you place the sensors in the exact same spot, and you lay on it in a, you know, statistical format, does it reduce compression, those, I don't have that, but what we have seen is that with the size of g7, it can be worn, you know, in slightly different locations on the particular the arm, where you can kind of move it around that because the sensor probes shorter, it's also more comfortable in the arm. So people have found like they can wear a little bit lower and there are a little bit higher. So we have seen people that they experienced professional have figured out how to move it around a bit so that they don't don't have it, but they still can happen on g7. But from a statistically significant perspective, I don't have an exact answer. Is it less, but it's certainly more comfortable to wear? Because it's so much thinner.

Scott Benner 8:36
Yeah. Hey, you just mentioned the sensor probe, does it go on in on a different angle than the G six?

Jake Leach 8:42
It does? Yeah, it goes straight in. It's a 90 degree angle versus the 45 degree angle. And what we were able to develop sensor technology within our electrodes that allow us to have a shorter sensor probe. So the depth is actually slightly shallower than G seven or G six. So G seven shallower than G six. And it's also less sensor probe under the skin because it's straight in versus that 45 degree angle.

Scott Benner 9:04
Oh, no kidding. So the G six is it? Am I ready? Test my memories at 13 millimeters? Yes, yes, exactly. I can't believe this is how long I've been doing this chicken. Bird right off the top of my head. What about the g7? Is it? Do you know the measurements? six millimeters? six millimeters? Oh, that's amazing. Oh, cool. Is the change in size going to impact the cost at all? I think what people are asking. Moreover, as do you see yourself as a competitor with libre or a different? Are you in a different space than they are?

Jake Leach 9:38
Well, actually, Scott, that is a very good question. So we're definitely looking at a portfolio of products. So in Europe, we've launched a new product called Dexcom one which is going to be in same the same markets as our G seven product as well. Usually six but we'll be replacing G six with G seven. The ideas There's certain in certain countries, people have access to GS six, but they may not. There's some people that don't have access to G six. So for example, right now, it's some countries categorize if you're at higher risk, meaning maybe a pediatric whose parents are taking care of their diabetes management or someone who's hypoglycemic and aware, they absolutely have to have alerts and alarms. Those folks have access to G six, there's a large population of people that don't have access to G six, they have access to other technologies. And so what we did was with Dexcom, one, we brought in the product, it's doesn't have all the same functionality as G six. It's a simpler product, but it still has alerts and alarms, it's still all based on the same accuracy, same hardware platform with a new mobile application, the whole purpose of that product is to help grow our business internationally and give more people access to Dexcom CGM. And so that product, you know, just over the past year, we've we've opened up over a million new people who have access to Dexcom that have never had it before around the globe. So that and then we're kind of just starting with that we've launched in a few countries with Dexcom. One, and we plan to launch in quite a few more. But, you know, getting back to that question around cost, you know, g7 is not intended to be more expensive, or at a higher out of pocket for people, it's, you know, part of people's cost of the product is have their insurance coverage. But you know, there's 30% of our customers don't pay anything. And you know, the other 30% pay quite a low copay, I think it's less than 30 $60 per month. So it's, you know, g7, one of the things about launching it is there's some coverage that we have to get for the product to ensure people can transition from G six to G seven, or get coverage for D seven. So there's some steps we take once we get FDA approval.

Scott Benner 11:51
So for people who are out of pocket, though, will there be an increase from cheese?

Jake Leach 11:55
I don't believe so. Yeah, I'm not. I mean, I'm not deep into the pricing discussions, but I don't expect it we don't have any expectation that we're increasing price for QBO. Customers,

Scott Benner 12:06
okay, great. When, eventually, one day when on the pod five and control, like you are compatible with G seven, and they're through FDA and everything, this is a big, I know this isn't really a question for you. But I got asked so many times, today, I'm going to bring it up anyway. If someone set up with GE six on one of those systems, and they move to G seven is it going to just be as simple as going into a setting and telling it I'm using the G seven now not the G six

Jake Leach 12:33
there, you know, each each, the architecture, these systems are a little bit unique, right? Each one is, you know, the Omni pod has the algorithm on on top of the disposable, you can look at control IQ, it's built in to the pump. And so you take control IQ for an example, when you want to upgrade to G seven, there'll be a firmware update that's required on the pump. Similar to my expectations be similar going from Basal IQ to control IQ, and they did the you could do the update is going to be something similar to that is what I would expect. And, you know, with Omnipod, it's likely a new firmware version on the pod, right that can communicate with G seven. So I think it's gonna be you know, the whole point is it's very easy for customers to do it. It's not like you have to get a whole new system. It just you know, it's about making these systems upgradeable. That's the whole point of trying to be able to keep up with the innovation that's going on in you know, sensors AI D they're all on slightly different timelines, but you want them to come together. So Right. That's why the FDA is approach with a CGM was such a good approach

Scott Benner 13:37
of let's see, oh, people want to know about overlaying session time. So we'll with g7, will there be a possibility of putting on a new one while you're still wearing an old one?

Jake Leach 13:47
There? There is completely you can do that if you want. With the 30 Minute startup time, though, it's it's not quite the same challenge that you're trying to solve for. Because right now, you know, I get feedback from customers that the two hours that they don't have the CGM data while it's doing its warm up at the initial beginning session is a terrible time because you know that the ID systems are not working or they're not getting that data, they're flying blind. So you do have a 30 minute startup with G seven, G seven starts the sensor session immediately upon insertion automatically you don't have to do anything so it just starts Okay. And you get into 30 minutes later I get data. Literally you get data Yeah, accurate, reliable data.

Scott Benner 14:35
US med is a place where you can get your diabetes supplies, they offer you white glove treatment. US med is a number of things. I'm gonna rattle them off for you right now ready, the number one distributor for FreeStyle Libre systems nationwide. They are the number one specialty distributor for Omnipod dash, the number one fastest growing tandem distributor nationwide, the number one rated distributor index com customer status faction surveys. How about that? They have served over 1 million people with diabetes since 1996. They always provide 90 days worth of supplies and they have fast and free shipping. That's right us med carries everything from insulin pumps and diabetes testing supplies to the latest and CGM, like FreeStyle Libre two, and the Dexcom G six. Here's a little personal information for you that you really have no business knowing, but I will tell you anyway, I just had Arden's prescription for Omni pod five, sent to us Med, they accept Medicare nationwide, and over 800 private insurers, you should check out us Med and find out why they have an A plus rating with the Better Business Bureau. How do you do this? Well, you can do it with a link us med.com forward slash juice box or by calling this special number just for Juicebox Podcast listeners. That number is 888721151 for us med wants you to get your diabetes supplies, they want you to have a better experience than the one you might be having now with whatever company is sending you your supplies, switch to us Smith. But also remind you to go to T one D exchange.org. Forward slash juice box and fill out the survey. And lastly, that the links to us med T one D exchange and all the sponsors are available in the podcast player that you're listening in right now. Like go in there. There's like shownotes, they're right in there, or they're available at juicebox podcast.com. Super important. When you click on the links, you're supporting the podcast if you love the podcast, if you love how much content there is, and that it's free for you. Supporting the sponsors and sharing the show with others are the two quickest way is to keeping it going.

Is there is there any kind of wonkiness in the first 24 hours like some people see what G six

Jake Leach 17:03
the all, you know, my experience with CGM technology over you know, last 20 years is that always the first day, and there's more a little more variability in that day at times some people experience it more than others, some people, you know, experience once in a while. And it really just comes from the form of kind of wound response from inserting a sensory of a brand new sensory insertion site. There's a whole lot that's actually going on from a physiology perspective. And so that does create variability in the first day. And so the performance is still really good. But yeah, you can have some of that, you know, signals that generally they run a little lower sometimes, you know, that give you a bit of a dip in the sensor signal. But still still accurate and reliable, but not, you know, not perfect. It's clearly the meds on the later days are better than the initial days.

Scott Benner 17:58
Things I think we know already were times 10 days.

Jake Leach 18:00
It's actually 10 and a half days. Okay, there's a there's a new feature called grace period. And

Scott Benner 18:07
we talked about that before. I have not spoken anything about it yet. No. So yes,

Jake Leach 18:11
we have this new new feature on G seven that was basically designed based on feedback from customers saying, you know, when the sensor stops showing data exactly 10 days after I insert it, it's not always the most convenient time to change my sensor. So sometimes I have to stop my sensor session earlier to replace the sensor, because you want to do what's convenient. So the the 10 and a half day we're on g7. The grace period, which is 12 hours is basically once you get to your 10 days from sensor insertion time, so let's say you did at four o'clock in the afternoon 10 days later at four o'clock in the afternoon and it's saying hey, we're going to time your sensor off we actually want you seven extend it we notify you saying hey, your sensors expired, but you have another 12 hours to find a time that's convenient for you to replace your sensor.

Scott Benner 18:56
Wow. Do you have anything that will make my daughter actually pay attention to that message when it pops up and says a little arm that'll come out of it and like knock around their house or something like that? I say change your sensor art and what happened? I don't know. It told me something earlier but I didn't read it. That was great. Thank you

Jake Leach 19:17
every time you go every Yeah, we're trying.

Scott Benner 19:21
I know you guys have been doing I know that you've been doing testing on adhesives because listeners of the podcast through T one D exchange have gotten opportunities to be in trials for but have you got any? Any results from that yet? Or people are asking a lot about adhesives. We have

Jake Leach 19:38
Yes. So a couple couple things on adhesive. So G seven has a new adhesive. It's different than G six. It looks similar, but it doesn't have some of the compounds that we've identified that can be irritants for some people. So the within the adhesive of G six we've through those tests that we were really happy that people were supporting those trials and participating in them, and wearing all the different types of patches, because it really did help us learn about some of the compounds that can cause irritation. They're not identified as irritants, but they ultimately can become them for certain people. So g7 doesn't have those in it. And actually, with G six, we've been working on a version of the patch that doesn't have those same compounds in it, a little bit of its proprietary between us and our patch supplier. But we basically are very focused on ensuring that we have as little irritation as possible, while still sensitive, having sensors last you know, that he here to the body, it's kind of like this little bit of a balancing act at work. But we've learned quite a bit over the last year and a half with those studies. So appreciate everyone participating in those that can and people will see it in the products, which is seven in particular, did it become more easy? Because the product is smaller? Does the adhesive not need to be as strong because it's not holding on as much weight? Or did that not? No, it was just it's just basically using some different types of adhesives and not including the same ingredients. And also some of the manufacturing processes we use are different with G seven that also helped enable using some different adhesives, they literally if you look at it, you can't tell the difference. But the g7 adhesive is, is strong. It's not less strong than G six. You're right, though it's quite a bit smaller, which is nice. Yeah. And then also with every g7, we supply the over patch for use if folks want to it's automatically placed in the box. And so you'd have to call for that separate

Scott Benner 21:39
burners, DME, durable medical, pharmacy, Medicare, how is that all going to be covered?

Jake Leach 21:48
So generally, for GCC, so you're basically asking me when we transition to g7? Yeah, well, there's a basic Yeah, the it's a bit of a, it's a bit of a process, the DME and Medicare usually moves a little faster than all of the pharmacy contracting. So you would expect that DME coverage would come quite quickly upon FDA approval, and then the pharmacy contracts will work their way over time. But we are working on programs to ensure that customers can get G seven as fast as they can. So more to come there. But it does, it does take a little bit of time to get the G seven into everybody's systems in the pharmacy and available for every all the patients that have G six today.

Scott Benner 22:29
Okay, well, G seven, show any improvement over sensor errors and not lasting 10 days for people.

Jake Leach 22:36
Yeah, it's, it's similar. It's similar in terms of g six. But what we have seen is that, and I know a lot of customers do wear G six in their arms. But we are seeing with G seven quite good sensor longevity when worn in the arm. And so if you look at the clinical trial results that we've published, we get better performance in the arm that we do the abdomen, the abdomen, still very good performance, but the arm is better. And so we we've we've kind of known that, or we thought that that was the case for quite a while, but we'd never run enough large clinical validation study work to really prove it. But with the g7 studies that we ran for approvals, they were quite large, you know, hundreds and hundreds of customers or patients subjects in the study, and both pediatrics and adults. And that we saw in both cases the arm performance was it was more accurate and lasted longer in the arm.

Scott Benner 23:30
Interesting. Are you expanding the approved places? Or is it still the same as before?

Jake Leach 23:34
No are no g7 Our intent is to get an arm indication to get definitely it'll be indicated for use in the arm.

Scott Benner 23:40
I often only wear scars on her hips. So I'll be interested, I wonder if the size change would maybe get her to move it to her arm. That'd be great.

Jake Leach 23:50
It's it's it is quite convenient. With the size and it's one of the things like it's kind of obvious, but when you actually experience a product, you You do understand how much smaller it is and basically forget you're wearing it is really quite different than my LG six experience. Okay, excellent.

Scott Benner 24:07
Smartphones at launch, are you adding any, are there going to be the same ones that people get for G six.

Jake Leach 24:12
So we so we're basically the way we approach smartphones is we're always working on whatever the latest available phones are. And so with Apple, you know, always takes us a little bit a little bit of time to get all of the validations and testing approved and you know, through the system. So you often get a little warning that says we're still in the middle of testing this GPU kit. Okay, and you can continue to use it. But we are still in the formal validation phase. So won't be any different with G seven Apple will we're working on the latest phones and iOS is there. Same with Android, right? The Samsung models are are the ones that we support the most number of phones, but we you know we are internally working on programs where we do want to support more handsets. We think about it as we go global right? We're During this global business in the US and outside the US and you know, there's a lot of different handsets out there. And so we're working on ways to be able to support more. And for us, it's really just about can we enhance our efficiency in the testing that we do to validate, we have to validate every single phone to ensure that the Bluetooth performance meets the requirements, because the alerts and alarms of our products are so important. And if the Bluetooth isn't reliable on that particular handset, which is not uncommon, then we really don't want customers using them. So that's why they end up not being supported. Yeah. A lot. A lot of people say, Well, we get support, tubular support anything, but it's actually interesting. And within each cell phone, there's some different hard functionality, in particular on the Bluetooth chips. And they're not all as reliable as we would want.

Scott Benner 25:46
Yeah, I guess Speaking of things that integrates with Apple Watch g7 to Apple Watch.

Jake Leach 25:53
So geez, yeah, so at launch, you'll have the same functionality as G six in the US launch with, with a secondary display of your information on on your watch, you can clear your alerts. So you basically you get the alert, you can acknowledge it on the watch. But the director, watch, we did build it into the hardware of G seven. So the wearable has the capability to do that functionality. And we're looking forward to some an upcoming release of a new watch OS that has a bunch of support in it that we need to help us make that feature actually happened.

Scott Benner 26:31
How about Garmin,

Jake Leach 26:32
Garmin will be the same as it is today, which is the functionality where if you have the Garmin Connect app, then you can, you know, basically put G seven data on your garmin watch, you just it's it'll be the exact same process. The beautiful thing about those cloud API's that we've launched with partners like Garmin is that which is G 60, G seven, it's a very simple update on our side. And then you may have to log back in, log out and log back into your account with that g7 credential. But really simple

Scott Benner 27:03
check, you have to go where do I have more time? Now you have a few more time? Yeah, I

Jake Leach 27:07
was late. You have more time.

Scott Benner 27:08
Excellent. Thank you. I was like, I'm not sure if I'm getting if we have to go or not. So I didn't want to I don't want to drag you along. So let's talk about that for half a second. Somebody asked me a question that I wasn't going to ask you. But based on what you were just talking about with Apple Watch, I'd like to understand this piece a little better. The question was, could you get me functionality with the apps where it calls me for a low at like sugar made has was which was the statement? And what made? What made me think I wouldn't ask the question is, in my mind, if you can't say that it's going to do it? Definitely, then you can't get it through the FDA. And so that's where functionality like that becomes less easy to try to put into place. Am I right about that?

Jake Leach 27:51
You are you are Scott, you know, the one of the most critical things our product does is the alerting in the FDA and our Dexcom as well view that is it's a really important aspect of the product. And so when it comes to safety, it is the thing that saves lives, when you get those low alerts. And so it, it is something that validation of those things takes, you really have to go through a lot of different use cases, edge cases, all kinds of stuff to make sure you have absolutely everything covered. And that's really been what you know, as we've worked on the director watch with on the Apple Watch platform, ensuring that every user gets reliable alerts, when that thing becomes your main receiver, your phone's not around, your receivers are on your pumps not around. So you're not getting an alert, unless it comes from that watch. And so being able to do that reliably has been something that Apple and Dexcom have worked together on to ensure that that can happen. And from my perspective, on the technology side, we're really close to being being able to introduce that functionality. But as you mentioned, the call feature, it's very similar in that it just has to happen. We do know our partner, sugar mate has that functionality. And trigger mate quickly connected up to our real time API once it's been available now and so there, they do have that. So it's not on our roadmap to add that. But you're right though about it gets pretty difficult to do some of those things what

Scott Benner 29:21
it scared you if I if you say hey, if this thing reaches a certain number, we're gonna send you a phone call. And I don't know it has to do with a cell network and the cell network was down. Then suddenly the alert you told me I was gonna get didn't come and there's nothing you can do about it. So you can't put yourself in that position to begin with.

Jake Leach 29:38
Yeah, yeah. And you probably will call us and it'll be a complaint that hey, it didn't work and we're gonna have to investigate it. And so yeah, it definitely is one of the things that when we when we're doing you know, we listen to customer feedback. A lot of the features in G seven are based on the great feedback that we've gotten from customers around g six, right. And so we we We're very thoughtful about which features we introduced and how we prioritize them. And you're bringing up one of the things that's can actually can add some complexity for sure. G seven is going to be approved for what ages? It's same as G. 602. And up to that's the intent.

Scott Benner 30:17
And let me just ask you about the apps little bit because I feel like we've been talking about these revamped apps for I'm gonna say forever. Maybe, so little things, you wouldn't you wouldn't tell me last time we talked, but are we gonna see rate of change on the new apps?

Jake Leach 30:33
So not not immediately. But it is definitely in the roadmap, because we've gotten a lot of feedback on that. And actually, after our last call, I dug in to see where in the feature priority list it was. So it's not in the initial release. But one of the things that we're doing different with G seven is we have a cadence, we call it our release trains. But we have a whole cadence of things planned for the next couple of years to bring significant value to customers through new versions of the app we've been in the past, you know, which is six, we didn't bring, you know, we did a number of enhancements to it. But they weren't as frequent as I want, as we want. And so what we're working on is, how do we bring more value faster, and it's really doing a lot of what, you know, the tech industry does, in our software team looks much, much different today than it did even a couple of years ago in terms of size, capability and breadth. So what I'm really excited about what we're going to be doing with our apps, as we continue to go forward,

Scott Benner 31:32
do you anticipate more frequent app updates than have been normal in the past?

Jake Leach 31:37
That's, that's the intent. That's what that's the expectation we've set for ourselves is that we're going to be developing features at a much faster cadence than we had in the past.

Scott Benner 31:47
Okay, so I'll hit you with these little things that seem like messages more than questions since the last one, like it might have helped in the past. One of them was overwhelmingly more Android phones, please, which we already talked about. People feel very passionate about the packaging being lesser every time and the ability to recycle things. A lot of people give feedback about that. And then there's a message for you here, which I'll save to the end. But this is the last question, which I think is hilarious as you're trying to get g7 through the FDA. What is GA going to be like?

Jake Leach 32:23
Well, we wouldn't be we wouldn't be Dexcom if we weren't already working on that. So yeah, absolutely, we are working on GA, it's a another kind of step in the wearable technology, making it you know, less than even, you know, more discrete. Manufacturing scale, right, that's become a very important part of how we design our sensors is we need to be able to manufacture you know, hundreds of millions of them. And so there's a bunch of that kind of technology that's going into g8 g7 is going to be a big focus for us, though, our plan is to roll it out as fast as we can across the globe and reach millions of customers with it. And so, yeah, GA is a program, we are running it, and we're excited about what's going on there. But you're not gonna get any secrets at me today.

Scott Benner 33:11
Well, then I'm still gonna ask my last question. Do you have any idea when this might happen?

Jake Leach 33:17
You say an FDA approval and g7 lunch? Yeah, my expectation is it happens this year. We've got you know, we're in that back and forth period with the FDA. Things are going great. We're really happy with how the good the interaction. And so you know, we're thinking sometime after Ada, likely So Ada is coming up here in June. And so, you know, our last earnings call we talked a little bit about, you know, our expectation is sometime after AD will get approval, and then we'll be launching but in a meaningful way this within this this year. It's not like we're launching on December 31. That's not our intent, right? Of course, regulatory timelines are always I've always Kevin CRC, you know, everybody asks us to predict when the FDA approves the product. And so it's, you know, we basically are saying our best estimate at this point, given what we know today is that it'll be some time after ADA but will allow a full launch at but this year, Jake,

Scott Benner 34:14
Kevin's more fun around these questions. And you are, I just want you

Jake Leach 34:17
to know he can be

Scott Benner 34:20
and there's a number of messages from here from people who just wanted me to say thank you for the technology. So I won't I can't read them all to you. But a lot of heartfelt thanks came through as well.

Jake Leach 34:31
Very, very much appreciate all the folks that that use our technology every day to you know, help them manage diabetes.

Scott Benner 34:38
Yeah, no, thank you for taking the time to do this. I appreciate it. Cool. Thanks, guys. Take care Jake. Jake, you think we'll be doing this

I bet you want to know what I asked Jake when I shut off the recording and what he answered, but I guess I'm telling you thank you so much to Jake leech for coming on the show and talking today about Dexcom g7. And thank you to us med for sponsoring this episode of The Juicebox Podcast head over now to us med.com forward slash juice box or call 888-721-1514 Get your free benefits check and get started today with us med. Getting your diabetes supplies should not be difficult, and with us med it won't be

if you're new to the Juicebox Podcast, hit subscribe in your podcast app or any audio app that you're listening in, for instance, audible Spotify, Apple podcasts, etc. etc, etc. Hit subscribe or follow follow and subscribe. Get the next episode right there on your phone. If you're looking for support online, the Juicebox Podcast has a Facebook page it is a private page with nearly 25,000 people in it. They all use insulin or love someone who uses insulin. And they're having vibrant and valuable conversations all day long that you may enjoy. You could get involved in them or just kind of look around and see how people handle things. It's actually very helpful. And a great way to learn about type one diabetes management and the use of insulin in general. So I'm saying type two as well. You hear me? Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.


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