#1173 Grand Rounds: Dr. Maggie Mueller

Dr. Mueller is the mother of a son with type 1 diabetes and a Urogynecology and Reconstructive Pelvic Surgeon.

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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 1173 of the Juicebox Podcast.

Today we'll be speaking with Dr. Maggie Mueller. She is an associate professor of obstetrics and gynecology, an OBGYN and a reconstructive pelvic surgeon. She is also the mother of a child with type one diabetes, and she'll be lending us her perspective today. As we expand on the Grand Rounds series. Nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. If you have type one diabetes, or the caregiver of someone with type one and a US resident, this is your opportunity right now from your phone or tablet to help with type one diabetes research. T one D exchange.org/juicebox. Head over there. Answer the questions in the survey completely. And when you're done, you've helped it's super simple and you won't be asked one question that you don't know the answer to T one D exchange.org/juicebox. You can help. When you place your first order for ag one with my link, you'll get five free travel packs and a free year supply of vitamin D. Drink ag one.com/juicebox.

podcast if you're ready to level up your diabetes care, the diabetes Pro Tip series from the Juicebox Podcast focuses on simple strategies for living well with type one. The pro tip episodes contain easy to understand concepts that will increase your knowledge of how insulin works and so much more. My daughter has had an A one C between five two and six for since 2014 with zero diet restrictions, and some of those years include her in college. This information works for children, adults, and for the newly diagnosed and for those who have been struggling for years. Go to juicebox podcast.com and click on diabetes pro tip in the menu or head over to Episode 1000 of the Juicebox Podcast to get started today. With the episode newly diagnosed we're starting over and then continue right on to Episode 1025. That's the entire Pro Tip Series, Episode 1002 Episode 1026 This episode of The Juicebox Podcast is sponsored by the insulin pump that my daughter wears Omni pod learn more and get started today with the Omni pod dash or the Omni pod five at my link Omni pod.com/juicebox This episode of The Juicebox Podcast is sponsored by the ever sent CGM and implantable six month sensor is what you get with ever since. But you get so much more exceptional and consistent accuracy over six months, and distinct on body vibe alerts when you're higher low on body vibe alerts. You don't even know what that means. Do you ever since cgm.com/juicebox Go find out?

Dr. Maggie Mueller 3:12
Well my name is Maggie Mueller Knut SIG. I am a mom of a type one son who was diagnosed almost two years ago who's now 10 years old. His name is Hudson. by trade. I am a surgeon. I am a Euro gynecologic and reconstructive pelvic surgeon. I work at the University of Chicago and I'm very excited to be on your podcast.

Scott Benner 3:35
I have to tell you that I could have guessed Chicago by the last name of the man you married.

Dr. Maggie Mueller 3:39
Oh really? Because it's not common in Chicago. He's from Minnesota, where everyone? Everyone can pronounce that last name. You know, here when we go out to dinner, we use my last name for a reservation. Otherwise I have to spell out every single letter

Scott Benner 3:56
in my mind. I was just like Wisconsin, Chicago, Minnesota somewhere around there. You nailed it. Yeah. Sounds like something that would have been in a like a name that would have come from like, I don't know, a first Bueller movie or planes, trains and automobiles or something like that. So that's what got me there. That's what got me there. Okay, so Hudson was diagnosed two years ago.

Dr. Maggie Mueller 4:13
About two years ago, February of 2022.

Scott Benner 4:18
Okay, okay. And how old is he now?

Dr. Maggie Mueller 4:20
He's 10. So he was diagnosed at eight. Okay. Do you have any other children? Yes. My daughter. Our daughter Greta is seven. Any

Scott Benner 4:30
other type one in either of your families? Your husband's yours?

Dr. Maggie Mueller 4:32
No, no type ones.

Scott Benner 4:35
Any other autoimmune stuff.

Dr. Maggie Mueller 4:37
My husband Tyler has vitiligo. I have hypothyroidism.

Scott Benner 4:42
You guys are a little cocktail. Okay? Yeah, there we go. His vitiligo very obvious, not so much.

Dr. Maggie Mueller 4:52
Not so much. You really, you know, maybe a little bit on his hands when he's out in the sun, but you can't really tell if you Just a very light complexion blonde

Scott Benner 5:02
is your hypothyroidism Hashimotos? Or have you never been tested for antibodies?

Dr. Maggie Mueller 5:08
Yeah, it was Hashimotos I think I was tested for antibodies when the timeline is foggy now, but it was either college or medical school.

Scott Benner 5:17
Okay, how old? Are you just for context?

Dr. Maggie Mueller 5:20
I am 41.

Scott Benner 5:22
Okay. All right, do you manage just with a Synthroid or a tiersen, or some sort of T three or T four? Excuse me? Yeah, I just take Synthroid, and that's fine. Your energy is good and all that stuff is there. Yeah,

Dr. Maggie Mueller 5:35
I mean, I wish I had more energy. has anything to do with the hypothyroidism

Scott Benner 5:40
I have to tell you without a T three supplement a tiny little bit of side ml my daughter shuts off. Really? Yeah. Yeah, like exhaustion can't rest nothing. It's terrible. Got it's the smallest dose of cider mill you can get is at point five micrograms. Maybe I'm not sure. Or five. Oh, no, I'd like maybe huge difference for her. Okay. Am I need to look into that. Her body carries extra weight without it and her there's no, no energy whatsoever? Oh, yeah. It's terrible. Because yours to figure it out, actually. Yeah. Okay. So what was Hudson's diagnosis? Like? Was it obvious because you're a doctor, right? You knew right away on the first day imagine.

Dr. Maggie Mueller 6:19
I mean, this is where it becomes more embarrassing than anything. So. So this was, you know, kind of post COVID slash people were still masking at the time. He what we what we really noticed was that he was going to the bathroom all the time, it kind of became like a little bit of a joke, we would, you know, get in the car, we would have to stop after 15 minutes. And we just thought maybe he was just drinking too much or wasn't going to the bathroom at the right times. And then it would wax and wane, it would go away. We wouldn't think much of it. He is an active kid. He's been playing hockey, travel or travel hockey since he was seven. So the monitoring of the amount of food that he was eating, I mean, he just seemed like he was a growing a growing kid who had a really big appetite. And was always on the kind of skinny or muscular side. Looking back at it. I remember it was my husband Tyler's birthday, a week and a half before he was diagnosed, and I cooked salmon. And Hudson, who was eight at the time, he had five filets of salmon that night. And I remember thinking like, Wow, he really must be working out a lot. I'm burning a lot of energy, because he's eating so much. And then there were some other things like we saw him, he was tired a lot, you know, he, but again, we attributed that too. He's playing hockey five times a day. And then, you know, looking a little bit more carefully, we started to hear from the teachers at school, like it's Have you noticed, it takes him a long time to do something like he'll go to the bathroom, and he'll be gone for a really long time, or we'll have to remind him to do these things, which again, was easy to write off. As, you know, he's an eight year old boy, you know, it takes him a long time to do things you need to remind him. So I think we went for a really long time. You know, just kind of writing off some of these symptoms until the night he was diagnosed. I think Tyler had gotten he was at home, I was at work, I was actually in the or, I had finished my cases. And he had told me, you know, we, we really need to like test his urine. I thought maybe he had a UTI because he was going to the bathroom so much. And so I was gonna bring home some urine test strips. And then Tyler called me to just make sure that I had I was already in my car, I was downtown, and I had forgotten the urine test strips. But I turned around and went back up to my office, I grabbed the urine test strips, went home, it was a Thursday night. And you know, had Hudson pee in a cup to see if he had a UTI. And when I took the urine test strip out, like it didn't have any signs of infection, there were no white blood cells, the nitrate was negative. And it was just positive for like the largest amount of ketones and the largest amount of sugar. So I, you know, being a stupid surgeon texted some of my family medicine friends that I went to medical school with and said, you know, is there any other reason to have, you know, sugar and ketones in your urine? And most of them replied, No, it's that that's really abnormal. It sounds like it could be diabetes. And then the next thing was, is this an emergency? Can I you know, wait until the morning. And it just so happened that another one of my friends that I reached out to her friend was a an ER doctor at Larry's Children's Hospital in Chicago and said, You need to pack a bag, you need to come to the hospital. He's gonna get admitted. So all of this was happening actually. When my sister Her and her children, were making a surprise visit to come visit me for my 40th birthday. Surprise. Yeah, so she honestly walked through the door right after I had tested his urine and was figuring out that he was diabetic. And her kids are the same age as my kids. So we have this video where like, I'm in the background, probably crying. And you know, the the kids are all just like hugging and embracing. They used to live here. And then they moved to South Charleston, South Carolina. And then, you know, she walked in further and saw that there was something wrong in order to get Hudson. Now in the midst of all this, before we went to the hospital, so my family, my parents were at our house too, because they knew my sister was coming in to surprise us. So I sent my dad to the Walgreens to get a glucometer. But unfortunately, the first time he came back with just the glucometer. Then he came back with just test strips and something out. I mean, he went there three times. And I said, like, just go talk to the pharmacist and ask, you know, what exactly do you need to take somebody's blood sugar. So finally he came back after the third time, and we took Hudson's blood sugar and it was like, 590 or something like that. When

Scott Benner 11:14
you tested all your friends, or texted all your friends, were you did you know it was diabetes? You were just hoping it could be something else or did you really not know? No, I

Dr. Maggie Mueller 11:22
mean, I really was. I was caught so off guard. I thought that he you know had a UTI. Yeah. Sorry. I just was really I was you

Scott Benner 11:32
were taken aback. Okay. Yeah, I just I wasn't certain because I don't know if like, I mean, I guess people would listen from the outside and think you're a surgeon like you you put it together. You said oh I have Hashimotos has been has been a Lago. These are all autoimmune disease, but that's not how it works. You're just a regular person in that moment.

Dr. Maggie Mueller 11:51
Yeah, I mean, to be honest, I didn't really I mean, until Hudson was diagnosed, I didn't really equate type one diabetes with autoimmune diseases. So I That wasn't even like, on my radar at all. I just knew, I mean, I think I think I knew it's not normal to have, you know, sugar in your urine to be spilling sugar in your urine. And it's not normal to have ketones in your urine. I just was kind of hoping that it was potentially something else. And probably clinging to a little bit of a little bit of hope. But I I definitely wasn't putting all of that together.

Scott Benner 12:29
This episode of The Juicebox Podcast is sponsored by the only six month were implantable CGM on the market. And it's very unique. So you go into an office, it's I've actually seen an insertion done online like a live one like, well, they recorded the entire videos less than eight minutes long. And they're talking most of the time the insertion took no time at all right? So you go into the office, they insert the sensor, now it's in there and working for six months, you go back six months later, they pop out that one put in another one, so two office visits a year to get really accurate and consistent CGM data that's neither here nor there for what I'm trying to say. So this thing's under your skin, right? And you then wear a transmitter over top of it. Transmitters got this nice, gentle silicone adhesive that you change daily, so very little chance of having skin irritations. That's a plus. So you put the transmitter on it talks to your phone app tells you your blood sugar, your your alert, show arms, etc. But if you want to be discreet, for some reason, you take the transmitter off just comes right off no, like, you know, not like peeling at or having to rub off it. He's just kind of pops right off the silicone stuff really cool. You'll say it. And now you're ready for your big day. Whatever that day is. It could be a prom, or a wedding or just a moment when you don't want something hanging on your arm. The ever since CGM allows you to do that without wasting a sensor because you just take the transmitter off and then when you're ready to use it again, you pop it back on. Maybe you just want to take a shower without rocking a sensor with a bar of soap. Just remove the transmitter and put it back on when you're ready. Ever since cgm.com/juicebox, you really should check it out. Members of my private Facebook group are constantly posting about how much they love Omni pod five. Maybe you've seen those posts and thought I wish I could have that experience with an insulin pump. If you've had those feelings you might be experiencing fu fear of missing out on Omnipod. Symptoms of flu may include but are not limited to wishing you could wear outfits without pockets dreaming about walking past doorknobs without getting your tubing caught. fantasizing about jumping into a swimming pool without disconnecting from your insulin pump first. Well, I've got good news. You don't have to suffer from FOMO any longer. You can see what you're missing by trying Omni pod five for yourself. Visit Omni pod.com/juicebox To get started, for full safety and risk information, also visit Omni pod.com/juicebox. There are links to ever sent on the pod and all the sponsors in the show notes of your podcast player and at juicebox podcast.com. You know, it's funny yesterday, this is such an odd story. But yesterday I was standing in line paying for my Christmas tree. And this young woman, like probably 30 years old was off to my right. She was talking to a couple of people. And I guess her husband was ahead of me in line. So she calls past me like over me to him, Hey, honey, what's that thing I have? That's what she said to him. And he turns around, he goes, what she goes, you know, my cold fingers? What's that syndrome I have? And he goes, Raynaud's like that. And she does. She turns back to the end, she keeps talking, and she kind of made eye contact with me. And I said, Hey, does anybody else in your family have any autoimmune diseases? And she looked at me and I said, like, you know, celiac, or diabetes or anything like that, and she gets this look on her face, like, Holy hell are you from the future? And she's like, my sister has celiac. And my mom has type one diabetes, and I went, Okay, wait, wait, stop. She goes, How did you know that? And I said, Well, I didn't know I was just guessing. But I said, what you just said, Raynaud's, it's a autoimmune issue. And sometimes they run in families. So celiac, and so it was type one. And the friends she was talking to looked at me like he must be a television doctor. And I was. It was very, it was such an odd moment, and very funny. But the whole story is about the look on her face. Like, how would you know that? Possibly. And then it's funny, because I think how do you not know that? But then I realized I'm the only one making this podcast. So like it, you know it? It does make sense. Wow. So okay, I've got the scene set. Your family has just arrived, your father is inept, at best, no offense to him.

Dr. Maggie Mueller 16:54
I love him to death. And he was so helpful. And he did go back three times. But

Scott Benner 17:00
a surgeon I know, we're all wondering it. So like, so. So anyway, so like, this is all happening. You're really like you're distraught. Would you say? Yes, yeah, at this time?

Dr. Maggie Mueller 17:11
How's Hudson? He's also hysterical, because we wanted to prick his finger and get, you know, the blood sugar. And, you know, this is another like, I didn't know how to do this. So I had whatever Lancet, my dad had come back from whatever, visit back to the pharmacy, whichever, you know, series was one, two, or three. I mean, I think I like really jabbed his finger to get blood to come out. So he was hysterical from that. And then I didn't read the directions, of course, and I don't think that I had assembled everything correctly the first time, then I had to do it again. So he was hysterical, just with the finger pricking. And then when we needed to go to the hospital, you know, he was hysterical about that. So we actually had to, I had to put my nephew in the car along with Hudson, and drag both of them to the ER, because Hudson wouldn't go without his nephew or without his cousin. So that's kind of where things started. Oh,

Scott Benner 18:13
sorry. So once you get to the ER, and they get him admitted, and you're in a room, do you suddenly think, well, I'm trained on this, I went to medical school like, or do you feel as lost as everybody else in that moment?

Dr. Maggie Mueller 18:28
Well, I remember being happy. So I remember the first thing they it was very quick, you know, even in a very busy er, when I went and told the, whoever was taking intake, what we were there for, I mean, we got, you know, shuttled into a triage room. We didn't wait at all, when I said that his blood sugar was, you know, 500 something. And I remember they did it what, you know, an abg, not a real AVG, but whatever they must fit, poke your finger, not the way that we he used to have to get arterial blood gases, and they knew that he wasn't acidotic. So I was happy that he wasn't in DKA. But it turns out, you know, I guess the term they use is DK No, a so he was ketotic, but not acidotic. So I remember being happy that he didn't have DKA because I knew that was going to change things a little bit. But no, I remember being really still kind of dumbfounded. The nurses are there. And then we might have seen him a resident and then another faculty from the endocrinology team that night when we were still in the ER, and I remember them, asking about family history. And, you know, Tyler has some type two diabetes on his family, but no one had type one. And we were just, you know, we didn't really realize that this could happen. And I still wasn't even exactly sure. You know, I think they were giving him they gave him a little bit of insulin IV through you know, they had him on a drip for a little bit, and then made it plan to kind of transition in the next day. But I mean, I didn't know what was happening at all. Basically,

Scott Benner 20:05
were you about to say you didn't. At that point, you didn't even realize he was gonna need insulin. Through his life. No, I

Dr. Maggie Mueller 20:10
knew he was going to need insulin, but I didn't really know what that was going to look like, acutely, you know, how are they going to get him through this acute.

Scott Benner 20:19
Okay, situation, right? Your husband goes with you. Does everyone else come or who's in the hospital with you?

Dr. Maggie Mueller 20:25
So yeah, so my tie what was driving he was probably parking when I brought him up there. The first, you know, very quickly. Yes, I had, it was COVID. So they were strict about things still at the time. So I had, we were all together. Tyler was there. And then I had my poor nephew Fox with me, because Hudson wouldn't go by himself. So all four of us were in this room until my sister was able to kind of coax her son back home, you know?

Scott Benner 20:56
Oh, yeah. So that the thing is gonna start happening. And everyone's not not completely knocked off kilter by this. And, by the way, how crazy that that's on an a family visit from like, cross country. Oh,

Dr. Maggie Mueller 21:09
yeah. I mean, it was just like, how could this be happening? And, yeah,

Scott Benner 21:13
that ended up being helpful that she was there. It was so helpful.

Dr. Maggie Mueller 21:18
I think that it was helpful that she, I mean, she did help with a lot. My sister's not medical, but she helped with a ton of things at home. You know, I think that we obviously, would have not wanted any of this to be happening. But she was really helpful. I think my mom was also very nervous at the time. So it was helpful to have my sister there. She's very level headed, and just kind of was ready to say like, Okay, what do we need to do to make this work?

Scott Benner 21:46
It's nice that it's, I found it helpful to have support. Oh, yeah. Even when we just got home. My mother in law came and cleaned the whole house. I think she didn't know what else to do. And we did. And she was like, what if I like what would help you? And I remember saying, if the house was clean, and the laundry was done, I think I could like, focus on this for a couple of days. Like she came to our house. I cleaned everything, did the laundry. I was like, Oh my gosh, the only good thing that came out, Arden's diabetes was like, three loads of laundry. Okay, so he's he's admitted, now, things are moving along. They're getting his blood sugar to calm down. Now, the the education starts. Yes. And so I mean, I'm really I have you on here to hear your story. But I also want to hear from you. I think you have an insight that a lot of people don't have. So you know, when you hear people come on this podcast, and it's a it's a crapshoot, right, either somebody says, I got a great doctor. And they actually weren't right. Or they are like, Oh, my God, my doctor didn't teach me anything. Like, there's not usually a lot of in between, like, sometimes there's people are a little overwhelmed. They don't absorb everything. Or sometimes people give doctors a ton of credit. And then as I talk to them, like, I don't understand, like your agency is eight and a half, and you've had diabetes for six years. But you're sitting here telling me that you have a great endocrinologist. How can that be? And then when they really pick through it, they go, Oh, well, I guess, maybe I liked them a lot. And then you find out that people judge their doctors, by if they like them, not really as much about their outcomes, which is fascinating. But I'm trying to figure out, what do doctors know? What should they know? And is there a way that we can get that information to them? And I think you're in an incredibly unique situation, maybe to walk through that a little bit?

Dr. Maggie Mueller 23:35
Yeah, I mean, I think that, you know, from our experience, I think it is the acute diagnosis period requires so much support during the education. So it should be prefaced that, you know, Hudson was highly motivated to get out of the hospital. So I mean, every single time anyone came into the room, he asked, When can I go home. And, you know, being medical, I knew that it was Friday, nothing was going to happen over the weekend, like, there wouldn't be any education. I understood. They told us what needed to happen that we needed to meet with the diabetic educator that we need to meet with the nutritionist. And I was worried that none of this stuff would happen before the weekend, and we would be there until Monday etc. So they were actually very helpful and we were able to get fast tracked. We got the Dexcom in the hospital. Tyler, you know, ran over to the Apple store and bought a phone because we understood that that was the way that we needed to, you know, track the blood sugar. So we got a phone that day, and we were able to be discharged Friday night. So it was very, very quick.

Scott Benner 24:52
Who the hell told you about a Dexcom on your first day?

Dr. Maggie Mueller 24:55
So the diabetic educator said that, you know, one of the things they were waiting And they wanted to make sure that all the prescriptions were going through. And, you know, they had put the Dexcom prescription through. And so, you know, once we had the phone, she was going to come in and show us how to use the Dexcom.

Scott Benner 25:11
Okay, well, he had it on his first day. Yeah. So that I'm very

Dr. Maggie Mueller 25:16
when I hear people say that they left the hospital without a Dexcom. I mean, I'm floored. I don't know how you would deal with that.

Scott Benner 25:23
Can I ask you? I'm sorry, I some people find this very personal. But I'm just very interested because you had it on the first day. What's his a one c three months later?

Dr. Maggie Mueller 25:33
I think it probably was like in the sevens I want to say it's

Scott Benner 25:38
fair. Has it gone down since then? It has

Dr. Maggie Mueller 25:41
I mean, and that was another thing. So we didn't start off on a pump right away. I think it was probably six weeks before we got on the dash. And then I remember in June we got on the Omni pod live. Yeah. Omnipod. Five.

Scott Benner 25:56
Yeah. And that's just this past June. So he had diabetes for a few months, maybe a couple of months, MDI, then using a manual pump with Dash and now for the last four or five months, he's had an algorithm. No,

Dr. Maggie Mueller 26:10
sorry. So it was he was on dash, I think in April, right after his diagnosis. And then June after his diagnosis, we switched him to Omnipod. Fi

Scott Benner 26:19
Oh, that quickly. Okay.

Dr. Maggie Mueller 26:20
I was really like, I really wanted that, you know, immediately for the, for the night, we had a lot of lows with the dash and nighttime.

Scott Benner 26:27
So how'd you find out about the algorithm? I'm

Dr. Maggie Mueller 26:31
sure I mean, my husband and I both listened to your podcast a lot. I think we found out a ton of information. Also, you know, very, you know, we're very thankful for this. So at the time Hudson, one of his hockey teammates, his older brother, I did not know this beforehand, but his older brother had type one diabetes, and think he was 13 at the time. So I had spoken to the mom, once her son had seen, you know, us doing some I might have been like giving him some insulin or something like that. And so we learned a little bit more about looping because her son was looping at the time. And that sounded very intriguing. But I think we were so overwhelmed with everything at that point in time, like, there was no way that we were going to be able to figure that out. I understand that. Yeah, kind of where we were. And I also was just trying to understand, you know, what the hesitancy you know, right after diagnosis to getting a kid on a pump, I didn't really understand why there's any waiting period, like, Why was there any MDI for, for whatever purpose, and I understood, like, you have to know how to do that for backup, but it just seems like if there's a better way, why wouldn't we be pursuing the better way? So that was, you know, difficult for me, you know, as a parent to, to know that there was something which I perceived to be better. And it wasn't really clear why we couldn't start with that right off the

Scott Benner 28:00
bat. I keep thinking that I would have loved to have seen the Apple employees face when he was like trying to be upbeat with your husband use Excel, you get a new phone. Hmm. Just take the credit card, and let me get the hell out of here. Yeah, this is not a big happy moment, my friend. Did. That's crazy. How did you find out about the podcast? Actually,

Dr. Maggie Mueller 28:20
someone who was on your podcast, who actually lives in our neighborhood, told us about the podcast. So she was on the podcast where her daughter was diagnosed. Yeah, camp in Maine. So

Scott Benner 28:35
oh, oh, yeah. And she had the flight. I mean, that person lives in your neighborhood,

Dr. Maggie Mueller 28:40
where she lives like, you know, I live we live in Glencoe, it's very small. So it's like 8000 people. So

Scott Benner 28:45
well, that's even crazier. Maggie, I interviewed somebody that lives in a group of 8000 people and they know you and they helped you with your diabetes, pretty

Dr. Maggie Mueller 28:54
high. And we meet we met all these people kind of around the same time. So you know, Hudson, he didn't he might I think he took a week off of school. And when he went back, he was first he didn't want to tell anyone the teacher asked Do you want to tell your classmates about and he said no. And then he reconsidered. And then I heard later that day from a mom who was in who has has a daughter in Hudson's class, who she came back home and told her parents that Hudson has type one diabetes because her parents have type one diabetes. So then they reached out and kind of set us up with I mean, I think we had like three to four people, at least that we were speaking with, right off the bat, you know, in our in Glencoe, and then another person that was kind of, you know, we called her like the diabetes fairy who was also in the community and was helping us a lot in the hospital and making sure that we had like the the right lens sets and things like that. I mean, I'm very thankful and we're all very grateful that we live in such a supportive community. But yeah, we had a bunch of people to talk to right off the bat that either had type one Diabetes themselves or their children habit. So

Scott Benner 30:02
between the people you were lucky enough to meet, and this podcast, and doctors, where's the most help come from?

Dr. Maggie Mueller 30:12
I think we all would have been really struggling without the support of the community that, you know, these, I think there were four or five individuals that were extremely helpful. And that pointed us in the direction of the podcast that just allowed us, you know, we learned so much about it. And you know, Tyler is not medical. So he learned a ton about it. You know, we listened to it all the time I left I listened to it on the way to work. I mean, it was it was really helpful. I think it's a hard pill to swallow when you leave the hospital, we left the hospital. And we were set up with an endocrinologist in three months. And that is really scary. Yeah, the team was great. I mean, we called the nurses when we know when we needed to check in and they would change things, but it was really nerve wracking, not having, you know, that appointment for so

Scott Benner 31:08
long. Yeah, that's actually kind of uncommon for for children. Yeah, for adults, it's very common, but for children, it's not usually.

Dr. Maggie Mueller 31:18
Yeah. And we're also lucky because our endocrinologist lives in our neighborhoods. So we did have that, you know, she's, she's been very helpful and was able to expedite everything. And, you know, she's our neighbor. So we've benefited a lot. Do you

Scott Benner 31:34
kind of see the podcasts and, and people as sort of one group, like a community feeling? Absolutely. Yeah. Okay, so not only is it a three month wait to get to the endocrinologist, by the way, you don't have any poll. What happened there? Geez, Oh, yeah. What good is that Tina? Doctor?

Dr. Maggie Mueller 31:49
Oh, I know. I know. Well, that I think is what really made me very nervous for lots of families. So

Scott Benner 31:56
that's my next question is how do you think that people who aren't you fair in this situation?

Dr. Maggie Mueller 32:02
Yeah, not Well, I, it was really eye opening. I'm a quality of life surgeon, I deal with zero things that are life threatening. But we have these metrics where like, I need to be able to see a new patient in one week, or we get dinged, I just didn't understand how, you know, a child with a life threatening illness was given an appointment, three months later, that seemed kind of crazy to me. And I, we are thankful that we have connections and great people to advocate for us. And we were able to get in there sooner. But I realized that many people don't. And even you know, they might not have the background information that we had. You know, when you?

Scott Benner 32:45
God, does that happen? Maggie? Do you get the doctor three months later and find out, you've learned more in the last three months? And they're able to tell you?

Dr. Maggie Mueller 32:53
I mean, I think that we, by the time we ended up seeing our endocrinologist, we were I can't I don't even really remember the first appointment that we went to anything. We were just trying to understand what exactly did we need to do in order to get the pump? I mean, I feel like that's what the entire

Scott Benner 33:13
it's about how to how to get around the insurance system. Yeah,

Dr. Maggie Mueller 33:17
it was just you know, what steps needed to happen in order to get the pump? Did

Scott Benner 33:22
you have to ask any questions at that point? I mean, you're still a seven a one, say seven and a half. So you're not like killing it or anything like that. So did you come in with questions that they were able to answer for you? Well, I

Dr. Maggie Mueller 33:34
remember. There was a great at the time, the the nurse that was there. I feel like she also had type one diabetes. Or she might have Yeah, I shouldn't. She was the nurse educator that worked with our doctor, she kind of leveled with us a lot. But a lot of the problems that we were having with the MDI was just, you know, he, he would basically just not want to eat anything that required an injection. So he would come home from school, and you know, he probably wanted to eat a snack, but he didn't want to eat any he didn't want a cheese stick or a salami stick. And I don't think that he wanted to have an injection. So he would just say that he wasn't hungry. And then other things that are so much better dealt with, with a pod or pum. You know, when he was going to have anything that required split dosing. He was also very difficult because he would not want to have a second injection, right. So we were struggling with these things that I think when you're talking to somebody who's been on a pump for a really long time, it's almost hard to even like remember oh, how do you deal with all that?

Scott Benner 34:47
Yeah, you know, the other day Arden started using I'm not going to talk about this on the show why the hell not? I wasn't sure if I was ready or not for this one, but I can I can say this much about it for now. they'll have enough details to be more valuable at the moment. But Arden began using a GLP the other day. And it's just the first injection. And I know I've talked about on here enough that people who listen no Ardennes, like, doesn't like needles. Yeah. And as a matter of fact, she has given herself one insulin injection in her entire life. That's that maybe as a little kid, but like, she's one that she recalls. And she was getting ready to go away to college. And I said, Listen, in case there's a catastrophic failure of all of our technology, I need you to be able to inject insulin. Yeah. So your next correction today, like go ahead and draw it up in this syringe and give it to yourself. And I'm still trying to get her on here to talk about that process. But I'm telling you, she sat in the bathroom with the door closed for 90 minutes before she came out and said, I did it. And she she looked like she had a run with the bulls. By the time she came out, like like, she just she just came out like she was in a car wreck. Then a bull chased her, and then someone picked her up in a helicopter and dropped her on the ground. And then she was alive somehow. And she's like, I did it. I'm dead. I did. I did it. And I'm like, Oh, okay. So the other day, she has to get this injection. And she's like, whoa, whoa, whoa, whoa, whoa, whoa. Like Arden Come on. And she did it. And it wasn't that big of a deal. But I'm going to tell you that she defended herself three times with her hand, as I came in with the the GLP pen. Yeah, like, like, not like harshly, but she reached out and defended herself, like almost uncontrollably. Yeah. And so I get when people don't want to, I daughter's had diabetes for 15 years. I get when people don't like needles, you know, like I really do. And she still, every time she answers something, she's like, Oh, come on. And I I've come to realize it's not about the pain. It's about she just, she's averse to the process. She just really is. So but but for people to hear the real story here is there are people, children, adults who are not eating the way they should, because they're trying to avoid injections. Oh, for sure. Yeah. And that's, you know, a tough fact, but needs to be heard by by physicians. I think I'm sorry, I took you off balance there. But

Dr. Maggie Mueller 37:16
no, that's, I think another thing and I think we're all really, you know, everyone, but specific, specifically physicians, nurses, we're just always very careful about what we say and, and now we know how careful we need to be when we were in the hospital. I think it was a diabetic educator who told me that, you know, there 95% He had sure he has type one diabetes or diabetes, but there's a 5% chance that he doesn't. And so I was like, waiting at home to hear what these antibody results were because I thought that it meant there was a 5% chance that we were wrong, and he doesn't have diabetes at all. And so they called me back to let me know that like every single antibody was positive, but also Oh, yeah, he has hypothyroidism too. But we were told that over the phone, because obviously we'd been discharged from the hospital there. Whoever called us said, Well, it's Don't worry, it's not as bad as type one.

Scott Benner 38:18
Person call to go, Hey, I'm just calling with test results. You have hypothyroidism, but don't worry, that's not nearly as bad as type one. And you're like, Oh, we got that too. Thanks.

Dr. Maggie Mueller 38:26
At that time, I was crying. You know, it was just like another thing. And I know that it's not as bad as type one diabetes, but he also has that

Scott Benner 38:37
look harder at the chart before you try to make me feel better.

Dr. Maggie Mueller 38:41
There's just like, oh, gosh, you know, it's it's just one of those things like I was clinging on to this potential 5% chance to have diabetes 5% chance that it was what I think they meant looking back at it, I think they meant type two diabetes, because they hadn't gotten the confirmatory antibodies back.

Scott Benner 39:00
Oh, that's not that. So you took way more hope in that than they meant? Oh, yeah. I

Dr. Maggie Mueller 39:06
thought the chance that he was like, fully misdiagnosed, and this was going to be not happening.

Scott Benner 39:11
Yeah. Have you ever heard me talking about when that happened to me? No, I didn't had this weird honeymoon. Oh, it lasted like two and a half or three days, where she just needed her Basal insulin and nothing for food and was getting low. And I I waited like two days into it. I called my friend who's a pediatrician. And I knew by the way, I knew it wasn't true. But I wanted it to be true so badly, but I I hedged my bets, and I started the conversation. I wonder if he remembers me calling him and I said, I know I'm wrong. Just tell me to get off the phone. But here's what's happening. Is that possible? Arden doesn't have diabetes, and he's like, She's had it for like, two years, or like, like, it'd been like a long time and he goes, No, no, no, she has diabetes. And I was like, Okay, thank you. And he goes, hang up, and I'm like, I will and I just got off the phone. But I had that feeling I know The exact feeling you're talking about. Yeah, like when you've got a scratcher in your hand, and you're like, I'm not gonna work again, if this is just the club dammit. Exactly. Yeah, no, it's terrible. Oh, I'm so sorry.

Dr. Maggie Mueller 40:13
No, no. And then after that we're off. It was my, you know, I really I had heard about to prism app and the trials that were going on. So I was desperate to find, you know, a trial that was still enrolling, you know, so I knew that University of Chicago was a site. So I emailed all the people there. And it, it just so happened that they had stopped enrolling his age group, you know, a couple months beforehand. So then I was devastated that we didn't have that option. So there were just a lot of ups and downs in that period.

Scott Benner 40:45
I think guilt in here. When you he has hypothyroidism Hashem, as you do, too.

Dr. Maggie Mueller 40:50
I don't think I even put that together. I think that oh, sorry,

Scott Benner 40:54
my introducing this for the first time for I didn't know, I mean, that that

Dr. Maggie Mueller 40:57
period of time? I don't think I did. You know, I think probably honestly, when we were in the hospital, and somebody if anyone asked about auto immune, I don't even think we both Tyler and I would have come up with a, you know, he probably wouldn't have talked about vitiligo, and I probably wouldn't have talked about hypothyroidism. You know, I've had it for so long, and I just didn't, it's like a vitamin

Scott Benner 41:17
you take out, I would imagine at this point. Right. Exactly. Yeah. And

Dr. Maggie Mueller 41:21
so there wasn't, you know, a lot of guilt. I think that, again, being so close around COVID. So I remember when we were leaving to the hospital, my mother, who I also love to pieces, you know, said Do you think this has something to do with the COVID vaccine? Because I Kittson vaccinated so that they go back to school. And so then I carried this guilt around that potentially, it was the COVID vaccine that caused the type one diabetes. So, you know, I had to be the person in the hospital to ask the doctor like the embarrassing question, you know, is this at all related to the COVID vaccine? And a remember her saying this is probably based on his a one see, it's probably been going on for a year or so, you know, and he had had the COVID vaccine, like a couple of months beforehand. So then that reassured me a little bit more.

Scott Benner 42:14
I mean, honestly, if there's anything there, I mean, maybe the virus from the vaccine, like sped up the process, but it sounds like the process has been going on for a very long time. First of all, and, you know, I mean, viruses do bring on diagnosis, but they don't, it's so hard to, to know if people understand how that works or not when they hear it. It's it's not I sneezed. And so I got type one diabetes. Yeah, these pieces cause type one diabetes, it's, I was going to get type one diabetes. And did you notice these this speeded up? Yeah, that's the vibe. But what you hear people say is, you know, a virus has caused type one, viruses don't cause type one viruses can cause type one in people who were predisposed, and already at some point in their life, likely going to get type one diabetes, and so different, like, I guess it's like, once you have it, it's who cares? What came first, but it when it's spoken about, it gets spoken about colloquially? And I think it just gives people the idea that oh, you know, you just get a thing. And then that happens. Like it's cause and effect. But it's, it's not it's hard to? I don't know, it's hard to explain sometimes. Well,

Dr. Maggie Mueller 43:27
yeah. Especially because there is this increase. And so people oftentimes ask, you know, why are there so many more kids with type one diabetes now? And I think everybody does want to have an explanation. And then it gets this game of telephone and all of these potential things that cause type one diabetes, when

Scott Benner 43:44
somebody says to me, what do you make of all the type one increased diagnosis during COVID? I say, yeah, there's a lot of people out there walking around with antibodies, who at some point in their life, we're going to get type one diabetes. And it just so happened. There's a virus covered the whole planet, and so they all got it at the same time, doesn't mean COVID gave them type one diabetes, right? Yeah. And so I don't know, it's just a hard thing. And then people, they don't like to believe some, some people are like, No, that's not what happened. I'm like, Okay, I don't know what to say, you know, so. My daughter had Coxsackie virus, and got type one. If I say that on the podcast, three episodes in a row. I'm gonna get five emails about like a day about oh, my kinetic coxsackievirus probably got type one. Yeah, it's a virus. Get your kid just like my kid had antibodies. They got a virus and their immune system was like, Hey, I'm confused. And then, you know, here we go. So exactly. It's kind of what it is. Socks. I'll tell you that much. He's doing well. Hudson is right. Yeah. You know, needle phobia is like, that's that's not an issue with pot. You think if you went back and needles though, do you think he'd be like I'm not hungry? No, thank you. Yes.

Dr. Maggie Mueller 44:56
So we've had, you know, a variety of incidents that have required I heard, you know, the potential for injections. So most recently, he was in a sailing camp, I bought some very expensive, waterproof family fanny pack to keep his phone and PDM min, which works very well, if you zip it closed. You know, he's uptick closed, or he thought he's uptick closed, he, you know, capsized. And, you know, this was, I had sent him to a sailing camp, which is about an hour and 15 minutes away, my parents have a house on a lake there. And, you know, that's where the Yacht Club is. And he was sailing there. But I was working in Chicago. And I get a call from my mom that this happened. She's gonna take the PDM home and put it in the dryer to see if you know she can. Because it wasn't working. So obviously I asked her not to put it in the dryer,

Scott Benner 45:56
I was gonna ask which one of your parents you took after being a surgeon? But I think you might be adopted? Yeah. Very

Dr. Maggie Mueller 46:04
helpful. And, you know, trying to do the right thing. But obviously, it was very much broken.

Scott Benner 46:11
Thank you. What if I put the phone on the grill and see if I can dry it out.

Dr. Maggie Mueller 46:14
I mean, it wasn't even like rice or anything. It was in the dryer. It didn't go in the dryer. But I told her, you know, if he's going to, I knew it was this last day of sailing, and there was going to be pizza. So I said, you know, he's gonna need an injection if he eats anything. Okay, yeah. So I get in my car, we actually had a backup PDM. Thankfully, I get in my car to go to manage that, which I also was listening to the podcast at that point in time, because I had to reset the PDM. So I was wondering, like, what did I need to change based on the algorithm? What should I put in? So I was, you know, taking the Crash Course. And I think there was one episode that you had that was resetting that some something similar had happened, and someone was talking about how they manage that, right. But the long story short, you know, he was told not to eat before getting an injection. And, you know, I got a picture on my phone for my mom, which showed like to half eaten pizzas and pieces of pizza and a popsicle or something that he just went ahead and ate without, you know, taking any insulin for

Scott Benner 47:16
did he do that on his own Maggie? Or did your mom not have the fortitude to stop him? Do you know what happened? Will you ever find out?

Dr. Maggie Mueller 47:21
Yeah, I think he was by on his own and just made a conscious decision that he was going to eat these pieces of pizza and have this popsicle without any insulin, then his blood sugar was course, like over 400 He ultimately, you know, they convinced him to take an injection. And then, you know, I was able to restart the pod and get things working. Yeah,

Scott Benner 47:44
about that. Jeez, yeah. Oh, good times. You say here that you sent me a note before you're on. He said physicians need to know that this is a chronic disease that requires constant manipulation and reliance on pharmacies, technology, doctors, nurses, and all this can change. And that also all affects the aspects of your life different aspects of your life. I wondered, do you have a message? Like if you if you could talk to other physicians? And are you talking about and those and everyone else or everyone else?

Dr. Maggie Mueller 48:18
I think it's I mean, I do think that endocrinologist probably know this best that it does take so much care coordination. I don't think many other physicians know that. You know, they see like, Oh, you're on a prescription for insulin, like make sure you get your prescription for insulin. But there are so many other things that go into this. And I also think like there was absolutely no way I did not know, I really I think we both Tyler and I struggled with this, we thought it was a mathematic equation, like I'm going to eat this many carbs, I'm going to cover with this much insulin and like my blood sugar will be perfect. And we had no idea that there were variables that existed that were going to make it so that no meal will ever be the same. No activities ever gonna behave the same. I had no idea about that. And I don't think a lot of people know about that. Let alone you know, like, specific. Maybe endocrinologist but not other physicians for sure. And I think it's, you know, easy to say like, why isn't your hemoglobin a one C better? Aren't you taking your insulin? There's just so much more to that. I add the way that this affects caregivers, the actual patient that has diabetes, there are a lot of you know, I we have Hudson, I would describe as happy go lucky type child. When we left the hospital that day, he asked, you know, he was super excited to leave the hospital. And his comment was well, because I don't have to take another shot. You really just don't understand what you're dealing with. And the amount of rationalization that can happen but also the way that it affects just, you know, he wanted to be a normal kid. He wanted to keep playing all the things things that he did, I think that we had him in a hockey game the night, the morning after he was diagnosed from the hospital, and we were trying to manage his blood sugar, you know, less than 12 hours outside of the hospital in a hockey game, it really does affect kids, it changes everything, you know, he has to go to the nurse and carry this bag and all these things that I think that Ty and I were like, well, this isn't gonna change your life at all, we minimize the fact that it definitely has changed your life, and you have to do things a little bit more or sometimes harder than some of your friends do. And I think that that was something that we neglected to validate, I guess,

Scott Benner 50:38
who says to you, you mentioned how come your agency, isn't that better? Why certain range? Are you not using it? It's on Have you gotten messaging like that? From doctors? Who does that? I

Dr. Maggie Mueller 50:47
mean, I've probably been someone who said that, as a doctor, you know, just being completely naive about what is required to improve your hemoglobin? Anyone see, I mean, in my field of work, it's elective surgery. So I never operated on anyone with a hemoglobin anyone see of under over eight, that was like a hard cut off. And, you know, we would cancel surgeries. And I think I probably did have an attitude, like, in a nice way, but you know, yeah, you need to get your hemoglobin AOC down better and like, are you taking insulin, I mean, it's

Scott Benner 51:26
just very never occurred to you to say, This person is struggling, maybe I should help them get their agency down. Like, that's just that's not how any of this works, right? Like, it's Yeah, they'll have to figure that out.

Dr. Maggie Mueller 51:37
Well, like, um, you know, work with your endocrinologist or work with your primary care doctor. And honestly, probably, neither of those things is going to change things that much. They just needed to, you know, there were probably many things that were affecting their hemoglobin a one C, and I just, I was blissfully unaware of all of the different things that need to happen in order to successfully manage diabetes.

Scott Benner 52:02
Can you explain to a regular person, a person who is not a physician has not going to medical school doesn't work in a hospital, doctor's office, etc? Why it is that they shouldn't expect their surgeon who's going to work on their pelvic floor or whatever, to understand diabetes? Why do other doctors besides endocrinologist, not understand type one. I mean, they don't understand a lot of different things, and which you and I understand to be reasonable, but to the outside person, just a regular person who looks up and says, that's a doctor. Why in the hell don't they understand? You're very in a very siloed profession, is that correct? Yeah,

Dr. Maggie Mueller 52:40
I'm, I'm like, I always tell people, I do like seven surgeries. And that's it. So I'm so siloed. And I also, you know, I don't have a background in Internal Medicine where we would probably, you know, practically learn so much about that. So I'm relying on things that I learned in medical school. Lots has changed, right? I mean, we don't the insulin is different. Pumps are really mainstay now. So it's really difficult for people who are not in it every day to be keeping up with this. And I think yes, I would hope that doctors have a cursory understanding of type one diabetes, I think most of them could tell you the difference between type two, they could probably come up with some other types of diabetes. And certainly they know that when your blood sugar is high, you need insulin, when it's low, you need sugar, which, you know, that seems like that's

Scott Benner 53:33
acute stuff. And that's probably all they know. Yeah, yeah. Also, I did not mean to use a mean to use, I did not mean to use a douchey corporate terminologies just that silo just means like, Oh, I just realized when I said I was like, That's just the thing I hear my wife say,

Dr. Maggie Mueller 53:49
No, it did come off to me that I am really siloed. For sure.

Scott Benner 53:54
When you're so isolated, I guess the like a more of like, a more real world way of saying it might be that I don't know the offensive lineman on your favorite football team doesn't know what the cornerback is doing. And yeah, they're not only don't they play corner ever, but they're not even in the defensive meetings. They don't even know what the defense is doing. They know what they're doing. They've learned a job and they do it over and over again. Just like you I run block for the left, I run block to the right I pass block for the left or but like You're like I do seven different surgeries. Like it's fun to say like what kind of doctor are you again?

Dr. Maggie Mueller 54:29
I'm a Euro gynecologist, reconstructive pelvic surgeon. It's a mouthful,

Scott Benner 54:33
I'll see. But when you say that also, there's a joke in there. It's inappropriate because you're such a nice person but like, I hear a lot. But but like there when that's your title, and that's what you do. And then I hear you say in plain English. I really only do seven different surgeries. I bet you that's not a thing people would think of you they probably think you're a magician. A wizard. Do you know what I mean? Because of that title and how long they in their mind. They believe you've gone to bed Medical School. I mean, what? Think about it what you do it you did your undergrad on

Dr. Maggie Mueller 55:04
time in medical school for four years. I did a residency for four years. And then I did a three year surgical fellowship.

Scott Benner 55:11
That's 11 years. Yeah, yeah. Okay. So you went to school for 11 years to learn how to do seven surgeries? Exactly. Yeah. And then if I say to you, how does type one diabetes work? You go, sugar makes you high insulin brings it down. Type One is, I think it I think it might be genetic. Is it auto? I think that's where you'd be stuck. If I if I went and found you three or four years ago, right?

Dr. Maggie Mueller 55:34
Yeah, I would have known that, like I would have associated type one with insulin dependent. Like, that's what I would have associated at the time.

Scott Benner 55:41
Okay. Now, I'm going to ask you to be I don't know if this is fair or not, we'll see if you're comfortable doing this? If I asked you to. So there, we've addressed why most people in the medical field don't understand it. It's not something that no, but if if people are, are with an endocrinologist, or nurse practitioner for diabetes, these kinds of like jobs, and they're not getting good information from them. How does that happen? So even take it out of diabetes, like forget diabetes, just like I shouldn't have asked it that way. How does it happen that some doctors with 11 years of practice, still aren't very adept at what they're doing. And how common is that?

Dr. Maggie Mueller 56:25
I mean, I can't really speak for, like diet, I've we've had such a good experience with our endocrinologist and I don't have enough experience with, you know, I hear some things sometimes like on the Facebook podcast, and it is concerning, like, I don't really know, why some would be less, you know, forthcoming or are in the mix. In my own specialty, I think that, you know, we this, you it requires my specialty requires fellowship training, that three year training, and also boards that are certification in this fellowship. So it's a sub specialized board certification, and I think, possibly, if I had to guess, maybe the people who are getting that subpart care or are just not seeing those specialists, could

Scott Benner 57:17
it be a communication piece, because it occurs to me as you're talking, you don't have to communicate to anybody to do your job really well. Like you don't like, you'll sit the person down and say, look, here's what we're gonna do, you know, this is what's happening. I don't know how you say it in your lady parts, and we're gonna do this. And then and then we're gonna do that. And this is what's going to alleviate, it's going to bring this to your life, it's gonna take me about this long, here's how long recovery is, you know, I have a buddy, you probably then you probably brag about, like your infection rate being low or something like that. You kick them out of the room, and you put them on the schedule, you do the thing for him, and they end up okay. Not you know, more,

Dr. Maggie Mueller 57:53
more of I don't have many long term relationships with my patient, right.

Scott Benner 57:56
But you don't have to explain anything to them for them to maintain that work that you've done for them. So you're more of a Gosh, I don't mean this pejoratively. But you're more of a, you're swinging a hammer. Really? You don't I mean, yeah, yeah, yeah. Whereas I'm expecting. I'm expecting an endocrinologist to help me with my diabetes by being able to initially, initially communicate what I need to know, to watch me grow or not grow and re communicate things or move me along and teach me and to picture what's happening when they're not around, and then accurately make adjustments to me without barely even being able to see what I do day to day. And some people are good at that. And some people aren't. It's more of a job of communication than it is of of medicine, isn't it? Oh, yeah.

Dr. Maggie Mueller 58:48
And I think that there are so many constraints right now on people in the medical profession, you know, physicians, nurse practitioners, etc. I mean, when I'm at those endocrinology appointments, the amount of stuff that has to happen, there's a lot of stuff that has to happen, you know, they review the, the Dexcom reports and things like that, and then all the preventive stuff. I mean, there's just so much that happens. So maybe focus gets lost on one area more than the other, or there's just not time spent doing some of those things with you. I think the patients also have to kind of understand where the problems are, too. Yeah. And that's hard, too. It just requires so much patient education.

Scott Benner 59:31
But fair enough, though, part of your success for your son is that you're engaged, intelligent, paying attention, you know, asking questions, going out on your own and finding out more information, you're actively participating if not directing his care. Yeah,

Dr. Maggie Mueller 59:47
I would say both Tyler and I are very active in his care. And, you know, even you know, identifying things like you He's struggling with, you know, the fact that he's different and things like that, and what do we need to do to address that? That has been? We've been able to address that. And I'm thankful that we were but yeah, I say, I think that if we weren't in tune with him that probably wouldn't have been identified.

Scott Benner 1:00:17
Yeah. Actually just made a note for myself for a different series, because it occurred to me that while it would not be easy to hear, for some people, it might be interesting to get a an anonymous doctor on a whistleblower X episode and have them whistleblow on patients, like telling me like, what what is really standing in your way if he didn't have to be polite? What is happening? Like, what are you battling against when you come into your job every day? Because fully Yeah, yeah, cuz I bet you that. I bet you that's, that would be eye opening for some people, too. Yeah, it just so that's interesting. So most physicians jobs don't require communicating directions beyond maybe a for the first 12 hours, put ice on this every three hours, or, you know, this is what this is going to feel like after your surgery. But don't worry, you're gonna come back and I'll check you if everything's good, you'll be alright, in six weeks like that. That's how most of this stuff goes. And that's our expectation is people because most of our medical problems have gone exactly like that up until you get a chronic illness.

Dr. Maggie Mueller 1:01:19
Well, yeah, and I think the other thing is that it's like an endocrinologist is kind of the directing the care, right? There's many other players of the team that provide information that's probably, you know, very, very helpful, like the diabetic educators, they feel such a huge role. And it does take off some of the burden from the endocrinologist and I think I think someone was asking me, like, you know, my endocrinologist doesn't seem to know a lot about how the different pumps work. And it's like, Well, how could your endocrinologist know every single aspect about every pump that's available? That's why they have other people on their team to help with this. It's just, I think people might have an unrealistic expectation about how much one single person can do maybe

Scott Benner 1:02:06
is it? Is it unreasonable for me to expect that my endocrinologist spends a weekend figuring out the three major pumps and how they work? Well,

Dr. Maggie Mueller 1:02:13
I think the three major pumps, I think that the endocrinologist do know that they probably know one more than the other, they're, you know, more familiar with it for whatever reason with their patient population. But they're, I mean, these pumps are really intricate and lots of different. If you're asking, like, does this one, what about the, you know, I mean, first of all, the Omnipod five algorithm is still very mysterious. And I think that, you know, you, a lot of people don't know exactly how everything works, I think you you know a lot about how the algorithm works, but it's all proprietary, right. And there are small, little tiny things that you can tweak that some endocrinologist probably know about, but I don't know if everyone knows about that,

Scott Benner 1:03:00
you know, again, it comes down to communication. And because I have this story rattling in my head that often tell you, so you'll know it, but I just had a person online tell me or was it in an interview, someone told me, they were, you know, kind of wrapping up their endocrinology appointment? And the doctor said, Hey, could you spend a couple of minutes longer? Right? Can I ask you a question? And the person's like, yeah, what do you need to know? And the doctor said, Can you explain how that pump works to me? And that, like, shook that person's confidence to their core about their doctor. And yeah, you know, but and I wonder if it wouldn't be as simple as saying, you know, because I don't live with diabetes. And I'm only getting information, you know, from people in the short visits. Could you spend a couple of minutes with me, let me ask you a few questions about the pump, I'd like to dig down and get more information. If if it was just said that much differently, then the feeling that that person left with wouldn't have been what it was, and the feeling they left with was, Oh, my God, my doctor doesn't know what the hell they're doing that because that's the feeling they left with. And I wonder if that now was true. Or if the doctor just didn't do a good job of explaining what they wanted? Like, I don't I wasn't there, obviously. But yeah,

Dr. Maggie Mueller 1:04:11
yeah. I mean, I would have before you explained your real, you know, rationale for probably why that happened. I would have probably thought the same thing. I bet that that doctor was trying to say like, Hey, you know this best because you deal with it every day, you're the expert, like what are some of the things that I need to know to better take care of my patients, but not all doctors are really good communicators? You know, they're, I think there's a lot of room for improvement in communication, just in general, but I suspect, you know, doctors all want to help people and treat people that's why we become doctors. They don't want to be, you know, providing some therapy that they don't understand how to do and I'm sure that that endocrinologist or physician didn't wasn't prescribing something they didn't know how to use. They just probably wanted that Patient Experience aspects.

Scott Benner 1:05:01
I wonder that too now that I think about that way, you know, I think in the end, I think it is what it is. I hate to say it like that. But I there's people running around all the time, like, how are we going to fix this? How are we going to get doctors? I'm like, I don't think you're going to change anything. I think it's human nature. To some degree, there's gonna be some better ones than others, there's going to be some bad ones. There's going to be some fantastic, you know, people that you meet along the way. And that communication. I mean, listen, if if communicating was something everyone was good at, I don't think the divorce rate would be one and two. So like, you know, like, yeah, people are not great communicators in general. And just because they're doctors doesn't make them better. And I don't know that there's a Listen, I'll say this. I think I'm a fairly good communicator. Yeah. I don't know that I could teach it to somebody, though. You know, I mean, like, I'm not sure how to do that. Like, I think you learned from the podcast, because I have a way of speaking about what I do. I do a good job of speaking about high level stuff. But it doesn't feel high level, I don't talk over your head, I don't actually have the ability to talk over your head, which is, which is really helpful. Because who knows if I would or not, but I understand this topic really well. I speak in pictures, which I think people find helpful.

Dr. Maggie Mueller 1:06:13
Yeah, but you also have the empathy, like you, you knew where you were, and like you're trying to communicate to a person in that position. Yeah, that

Scott Benner 1:06:22
helps as well. I guess it's funny, I, I don't even know why I'm a good communicator in this specific situation, like, so I don't, I guess what I'm trying to say is, I don't know how we could expect some maybe rigid guy or like, you know, some, some person, or some woman who's a little, I don't know, like, particular or whatever, like, you know, like, people's like, personalities are all weird and different. Or maybe they're very engineer brain like, and that's why they're a doctor. And now all of a sudden, we're expecting them to like get down on your level, commiserate with you understand this really complex thing and be able to communicate back the way to handle it. Maybe it's just not ever going to happen.

Dr. Maggie Mueller 1:06:59
I mean, I think I have a rosier outlook. I will I mean, I just, I am really a glass half full type person. And I think that, first of all, having people hear these experiences is is really important. Again, I really, I think that if doctors heard that, you know, they potentially their patients weren't getting, seeing the results that they wanted to. And we think that it's related to communication, I think everyone would want to fix that. I just think that there are so many constraints right now. And they're, you know, it's easier to say like, well, I am going to concentrate on the medical things like make sure XYZ, and I have this diabetic educator who's really going to help with like the day to day, all that other stuff, and a lot of the education and a lot of the communication. And then this nurse is going to do that, too. So I think that some of it does, unfortunately get parsed out to other individuals. And perhaps maybe that's why, you know, the the lead physician is really being seen as not communicating all that much. And so I guess maybe more of a team based approach might change that perception.

Scott Benner 1:08:14
Okay, yeah. I'm gonna ask this question a lot of physicians this year on the podcast, but what do you think of my idea about group instruction?

Dr. Maggie Mueller 1:08:22
Well, I think that's great. That would

Scott Benner 1:08:25
work right, instead of coming in for 15 or 20 minutes or half an hour at a time. What if everybody showed up and it was two and a half hours long, and it was a, you know, it was partly a q&a. And then partly, while you know, you could go off to the side and private and do whatever you needed to do with your physician while the q&a was going on? Like, I think that would be such a good idea.

Dr. Maggie Mueller 1:08:43
Yeah, well, I mean, that's definitely been shown. There's research behind that. I'm not familiar with the diabetes research. But in small group education in different disease states, there's a lot of research to, to support that. And I believe that they do something similar at the University of Chicago, I've seen flyers for diabetic education, they meet in the cafeteria and things like that. So there definitely are. There's a lot of research to support that. I think that's a fantastic idea.

Scott Benner 1:09:14
Okay, yeah, I mean, I keep thinking over and over again. It's this one simple idea that I have if if me, I am a person who listened between you and I, Maggie, you went to more like secondary school than I went to like, regular school. So I barely like crawled out of high school. I was, I was not an interested student. I did not grow up with a family who told me to be interested in academics. Yeah. And I bet like when I graduated, I was like, huh, a trick somebody. And somebody right now is not doing their job given me this diploma. And I, and I'm out in the world. But somehow, there's no other place. Right now. Like Like, I'm sure there are hospitals that do great job. I'm not saying that there's no other place. I'm saying that that visible publicly, I speak to more people with diabetes than anyone else on the planet. Yeah. And it doesn't make sense sometimes, other than to say that this format works for a lot of people. And that the one thing I think I've done, that I think everyone could do is that I've boiled diabetes down in my own head when I'm talking about it into a formula that anybody can understand what I'm saying it. And mostly, what it gives them is a very firm base to start with. And it leads to outcomes and understanding that lead you to have, like further education for yourself like you might the outcomes I give you give you some understanding, you have those experiences, build on them, and get better and better at it as you go up to the level you desire. I imagine. And that's, I think what I'm good at, I think what I'm good at is talking about diabetes and boiling it down into understandable, digestible chunks. I think that's all I've done. I mean, if I've done more than that, I'm literally not aware of it. I don't understand why a doctor can't do that.

Dr. Maggie Mueller 1:11:16
Well, I mean, I think that, you know, part, again, part of I think, you know, on a higher level definitely brought together community. And I think that that's huge. You've definitely, you know, distilled diabetes, and made it a little bit easier to understand for lots of people, I mean, including caregivers, which, you know, that can be really hard for people that aren't, they don't live with it every day, you know, but other like grandparents and things like that. But that sense of community is really huge. And I think that comes from that empathetic, you know, whether you're meeting that aspect or not like that, certainly.

Scott Benner 1:11:55
Oh, no, I haven't. No, I know how you all feel. Yeah. I mean, to some degree, I know how you feel. And by the way, by interviewing so many people who have diabetes, while I don't have it myself, I might be one of the closer people who doesn't have diabetes, to understanding what it feels like than many people because I've had these long, in depth conversations with people I've and I am an empathetic person. So I do absorb. I do I baits are hard on me sometimes, but I do absorb how they feel when I'm talking about it. And I maintain it. I will say, I think the community aspect is insanely important. I don't I don't mean to, to minimize that. But if I was going to, if I was going to say one of the things that I think that I'm doing that is leading to the success, it is something that a doctor can't do. And well, and here's what it is. And I don't know if people know the secret or not. I put out an episode of this podcast every day. I create a world where there's always something there for you. And because everybody doesn't listen every day, like some people do. Don't get me wrong. This people are like, They're my heroes right there. I put it there waiting for a new episode. Do you have any idea how many people told me like, hey, when's this coming out? Like I don't have anything to listen to over the weekend. I'm like, Hey, I'm doing my best, you know, but, but by putting content out Monday, Tuesday, Wednesday, Thursday, Friday, and having it be a mix. This is a guy who's got type one, here's a woman who has type one who is a mom, here's a dad, here's something with Jenny, here's something with Erica, we're going to talk about the psychological sides of it, like keeping that stuff all mixed together constantly. Even if you're not up for listening to the psychological part of it. You might be up for management, you're not up for management, you might not be for you might be up for a story. There's always something there to keep you connected. And that connection is the somehow unquantifiable reason why people take good care of themselves. And I don't understand completely why it is. But I know if you're listening to this podcast, you're gonna have better outcomes. And it's not always going to be because I taught you something about care. I think that's true. And that's not something we could ask a doctor to do. No, yeah, yeah, I get it. Thank you actually now teaching me with the podcast. That's Maggie appreciate

Dr. Maggie Mueller 1:14:09
explaining the way that we I mean, it is been so helpful, and I think it is filling something and I just my view is I don't think that a doctor is responsible for that. Like it just can't happen in this day and age maybe 40 years ago. But it's it's not happening. It can't there's there's too many constraints, things have gotten too complicated. Diseases are more complicated. The management of these diseases is more complicated. There have to be other people, team members, you know, that are responsible for filling in these gaps. It's It's It's untenable for a single human to manage that is that

Scott Benner 1:14:50
over and over again, and I can accomplish it because I don't actually have to sit down with each of you individually. Exactly. Yeah, that's interesting. But it's my Yeah, I guess it doesn't work. Like even what I it's easy to say, can't you just do what I'm doing? But what I'm doing is having daily connections with people. And they can't do that either. Exactly.

Dr. Maggie Mueller 1:15:09
I mean, I think, and I think that maybe this is, you know, just an experiment in that kind of group education and checkpoints and things like that. That I do think, again, I would fully support, I think that there are probably many other benefits, you know, even seeing that sense of community in that setting. Yeah. Oh,

Scott Benner 1:15:30
it would easily start like that. Because people be like, Oh, I live around here. And they start talking to each other. And I keep bringing this up Maggie over the last couple of years, because I'm convinced that's the answer. Like for institutions. I've said on the podcast, I love thinking somebody will take me up for it, I'll come out and give the talks like like, hell, I'll come out for a week, we'll do it every day for a week, you bring in 50 people a day or something like that, and let the staff listen and hear how Yeah, awesome, yeah, but nobody, in the end, what ends up happening. And this is not going to surprise you because you're in the game. But these conversations get pretty high at some institutions. And eventually what happens is, well, you're not a doctor. So we can't do that. That's what that's how it gets shut off. Eventually, it gets to some level of the organization that goes, What's his credentials, and they're like, he almost got out of high school unscathed. And they, eventually it goes away. So I don't know, I'm gonna keep making the podcast and asking the questions. And hopefully someday someone does it. Because I think to your point you just made a minute ago, I think I've proven the point. This works. But yeah, why is this not what we're doing for people? Like, because I'm reaching a lot of people, I can't reach nearly all of them. That's not possible. So I'm reaching the people who are have an iPhone or an Android phone, have the time to listen to a podcast know somebody else who would tell them about the podcast, or have the wherewithal to look for information outside of their doctor's office? I'm already limited to how many people I can reach? Yeah. So anyway, all right. I

Dr. Maggie Mueller 1:17:02
do hope that it moves in that direction. I really do. I think it would be beneficial. And, again, I think we would feel very isolated without you know, having these. I don't know Hudson would he? We're lucky enough. Again, one of the community members, I already mentioned that the family with their eldest being a type one diabetic in hockey, they the year that Hudson was diagnosed, they actually ran the first year of this camp that's dedicated to kids with type one diabetes, that's a hockey camp. It draws from Canada and the United States. And it's doubled in size. And Hudson has friends. From this. He calls him his T one D bros from this T one timer camp. That's a bunch of kids that play hockey that have type one diabetes, and they text constantly throughout the year until they can't wait for the next camp session. And I think

Scott Benner 1:17:59
it's just really important. Yeah, that's awesome. And he's got so he's got his own little community as well. Exactly. That's great. Okay, well, you were terrific. Is there anything I didn't ask you that I should have or anything we missed?

Dr. Maggie Mueller 1:18:11
No, this was a pleasure speaking with you. And I really, really hope that your idea to kind of moves things in the direction of that group education, I really do hope that it moves in that direction, I think it would be really helpful for so many reasons, and just want to thank you on behalf of my family and where we are now. You've really been instrumental.

Scott Benner 1:18:34
I really appreciate that. If I ever have any problems with my pelvic floor, I'm going to call you to find Yeah, 100%, I will tell you this on your way out the door. I just did a live event, I was in person somewhere. And we, you know, they invite me out. And they're like, he'd come out and talk for an hour. And I was like, oh, not flying there to talk for an hour. I was like, let's, let's do this. And I proposed this big idea. I said, Why don't we do four or five hours. They're like, what I'm like are we'll give him a break in the middle of eat food. And she goes, No one's gonna stay that long. And I was like, Are they well, don't worry. And so we did. I think we meet and graded it like nine I think we started talking at 10. We did a two hour talk. And I brought Jenny with me, by the way I could I don't I don't want to take anything away from Jenny. I could have done it on my own. But I thought it would be really nice for people to see Jenny. Let's like have general you know, so Jenny and I talked for two hours about diabetes. We just talked and if I'm gonna tell you, no slideshow behind me, no pre planned idea of what we were going to talk about. She and I chatted for five minutes before we took the stage. And we were like, Let's kind of start in this direction. See where it goes. And she's like, Yeah, that sounds good. And then she's like, what about this? And I said, Oh, good idea. And then we just started we sat down, said hello. We started talking to hours, everybody went to lunch. At one o'clock. Everybody came back, nobody left. So we didn't lose anybody. And then from one o'clock, two o'clock, three o'clock, four o'clock. I think a little after that, Jenny and I just talked more into q&a live with the audience. That's all we did. And the next day, a person sent me a note and said, I don't think I've had a day go better than the day that we had after we left you and the day after, like, so the next 36 hours after leaving that talk, went so well. And we were at restaurants and traveling because we had to drive to come and see you. And all these ideas that like just being around the conversations and hearing other people's questions made lightbulbs go off for even some people who never raised their hand. And that's what I'm talking about. That's, that's what I think happens. I think you give them a podcast in person. I'm not saying every doctor's appointment should be five hours long. But if every three months, you came out for a more targeted 90 minute conversation. And then you I don't know, I don't know, I don't know how dark you're gonna have to figure it out yourself. But having that that kind of like feeling and that experience for those people, they're going to take more from that than they ever would from sitting in office and hoping that they remember to ask the questions that hopefully you have the answers to, you know, it just does it's not ever going to work that way. So anyway, I appreciate your You're very kind to come on and what you said just now was was lovely. I really do appreciate it very much. Thank you. Well,

Dr. Maggie Mueller 1:21:26
thank you so much for having me. This is wonderful. My pleasure.

Scott Benner 1:21:35
Head over to Omni pod.com/juice box to get rid of your FUBU Omni pod.com/juice box get yourself an omni pod five. A huge thank you to ever since CGM for sponsoring this episode of the podcast. Are you tired of having to change your sensor every seven to 14 days with the ever sent CGM, you just replace it once every six months via a simple in office visit. Learn more and get started today at ever since cgm.com/juicebox. I know that Facebook has a bad reputation. But please give the private Facebook group for the Juicebox Podcast. A healthy once over Juicebox Podcast type one diabetes. That Juicebox Podcast is full of so many series that you want and need afterdark s Gatan Jenny, algorithm pumping bold beginnings defining diabetes the finding thyroid, the diabetes Pro Tip series for type one, the diabetes variable series mental wellness, type two diabetes pro tip, how we eat. Oh my goodness, there's so much at juicebox podcast.com. Add up into that menu and pick around. And if you're in the private Facebook group, just go to the feature tab for lists upon lists of all of the series. always free. Always helpful. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com

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#1172 Perfection vs. Health

Erika Forsyth and Scott discuss the balance between perfection and healthy.

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android  -  Radio Public, Amazon 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, welcome to episode 1172 of the Juicebox Podcast.

In this episode of the podcast, Erica Forsythe is back, and we're gonna discuss the balance between perfection and health. Learn more about Erica at Erica forsythe.com Nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. When you place your first order for ag one with my link, you'll get five free travel packs and a free year supply of vitamin D. Drink ag one.com/juice box don't forget to save 40% off of your entire order at cosy earth.com All you have to do is use the offer code juice box at checkout that's juice box at checkout to save 40% at cosy earth.com If you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes, but everybody is welcome type one type two gestational loved ones. It doesn't matter to me. If you're impacted by diabetes and you're looking for support, comfort or community check out Juicebox Podcast type one diabetes on Facebook this show is sponsored today by the glucagon that my daughter carries G voc hypo pen. Find out more at G voc glucagon.com forward slash juicebox. Today's episode of The Juicebox Podcast is sponsored by the contour next gen blood glucose meter. This is the meter that my daughter has on her person right now. It is incredibly accurate and waiting for you at contour next one.com/juice box. This episode of The Juicebox Podcast is sponsored by the ever sent CGM and implantable six month sensor is what you get with ever since. But you get so much more exceptional and consistent accuracy over six months. And distinct on body vibe alerts when you're higher low on body vibe alerts. You don't even know what that means to you. Ever since cgm.com/juicebox. Go find out. Eric, I feel like I haven't heard from you in a while. What happened?

Erika Forsyth, MFT, LMFT 2:32
It does feel like it's been a while January and February happened. I think it was a disease two months the holidays. Yes. Well, this

Scott Benner 2:39
is better than the last time there was a gap in me hearing from you when you have like some surgery or something like that. Yes,

Erika Forsyth, MFT, LMFT 2:44
I had my knee replacement. That was a couple months. It was couple two years ago. But we were we didn't talk for a couple of

Scott Benner 2:51
months. Cuz you were busy rehabbing. You have a life or something like that, that I'm not completely aware of. So what I did this time, because we're getting back together, and we finished up the parenting series, which by the way, the last episode of it goes up in a couple of days. Okay, what I did was I sent you for ideas that were sent to me by the moderator of my Facebook group based on things that people had said in the Facebook group. And they're, by the way, literally saying, Hey, would you talk to Erica about this? It wasn't just like a abstract question. It was like you should talk to Eric about this. And it's like, all right. Oh, that's fun. Yeah. So you picked one of the four tell people what you picked. So

Erika Forsyth, MFT, LMFT 3:33
I thought that we could focus on finding the right balance of, you know, living with a chronic disease. But I think we can hear that with perfectionism and trying to go back and forth between what is it like to try to manage your blood sugar from a perfectionist perspective? And then how can we move to a more balanced way of managing and living it whether you're living with it or the caregiver,

Scott Benner 4:04
right? Do you know while you were talking, I did my best Google foo and I typed in finding balance between perfectionism and chronic illness. And a lot of scholarly articles came back. That interesting that

Erika Forsyth, MFT, LMFT 4:17
is, and I did some Googling and I just perpetually impressed by how many articles there are on mental health and diabetes that was not present. Even 10 years ago, you know, as a the prevalence of it. Yeah. Yeah.

Scott Benner 4:33
Nobody was thinking about that. I don't think so. Okay, so what do we have here? We have an every day situation that some days is more in the forefront and some days more in the background, always very important. You know, when you're ignoring it, it's to your detriment. And at the same time, if you run around trying to be perfect about it, it's going to burn you out or make you crazy. Yes. And so what's the middle of that?

Erika Forsyth, MFT, LMFT 4:59
Yeah. is one of our first few episodes I think we ever recorded was on burnout. And I think we'll definitely touch on that. But I think and we've talked about, you know, the mental load of, of being a parent in general. And I also thought I just realized I'm holding up to Scott, my February 2024 issue of Psychology Today. Oh, look at and what is the title burnout

Scott Benner 5:23
about that burnout? Yeah, that's not specifically about diabetes. No, no, but

Erika Forsyth, MFT, LMFT 5:29
in and I'll probably reference it maybe a few times because I just was reading through it this morning. Talking about you know, the data with parenting with children with chronic illness. And that right currently, as many as 20% of parents identify as feeling burnout but the rates are higher from parents of children with a chronic illness and that's According to research from or re bro Sweden forgive me for the pronunciation but 20% so that that's a that's a significant amount without chronic illness

Scott Benner 6:00
no chronic illness in the life and parents are still one in five parents is like I am I visit them too much.

Erika Forsyth, MFT, LMFT 6:08
Yes, gotcha. Yes. And we can talk about those factors. Yeah. So

Scott Benner 6:12
I my brain goes immediately to that there's a utopia in your mind when you get married. That's something you expect and then when you have children, you build a family and then the further it gets away from your image. The more I Gosh, I don't want to say disappointing but maybe the more disappointed you are and then maybe the more difficult that is then to rev up to do the things that you didn't expect you don't I mean, like it's a very simple idea but on the 7000 day in a row that you've made lunch there's a voice in your head that goes through it is gonna be dead soon. Like you're wondering why do I keep making lunch? It just it the repetition is is numbing sometimes if you take insulin or sulfonylureas you are at risk for your blood sugar going too low. You need a safety net when it matters most. Be ready with G voc hypo pen. My daughter carries G voc hypo pen everywhere she goes because it's a ready to use rescue pen for treating very low blood sugar and people with diabetes ages two and above that I trust. Low blood sugar emergencies can happen unexpectedly and they demand quick action. Luckily, G vo Capo pen can be administered in two simple steps even by yourself in certain situations. Show those around you where you storage evoke hypo pen and how to use it. They need to know how to use G vo Capo pen before an emergency situation happens. Learn more about why G voc hypo pan is in Ardens diabetes toolkit at G voc glucagon.com/juicebox. G voc shouldn't be used if you have a tumor in the gland on the top of your kidneys called a pheochromocytoma. Or if you have a tumor in your pancreas called an insulinoma. Visit G voc glucagon.com/risk. For safety information. Far too often we accept the blood glucose meter that someone hands to us, the doctor reaches into a drawer and goes here and take this one. That is that is that the one you want. Is that accurate, you have no way of knowing. But if you want accuracy, and you want to be confident in the blood glucose readings that you're getting from your meter, you want that contour next gen, it's incredibly easy to get the same meter that Arden uses, just go to contour next one.com/juice box, that's all you have to do. The cons are next gen is easy to use, and highly accurate. It features a smart light that provides a simple understanding of your blood glucose levels. And of course, Second Chance sampling technology that can help you to save money with fewer wasted strips, contour next one.com/juicebox. And sometimes

Erika Forsyth, MFT, LMFT 8:59
you might not even be aware of the level of either anxiety or burnout that you're feeling. But perhaps you've noticed that you're really irritable, or you're not performing well at work or your relationships are deteriorating. Those are indicators that like you might be feeling the frustration of not wanting to make the lunch for the 7000 a day. Yeah, but you can't quite connect the pieces but then you're screaming at you know your colleagues. Yeah,

Scott Benner 9:25
no, i By the way, I'm not kidding. I picked the big number on purpose because I'm talking 25 years into it. You're like another egg. Okay, I'll make an egg. What and then you go to put the fork to your mouth. This is my life. As soon as my food gets warm, the dog has to go outside. I personally feel like he's waiting for my food to hit the table. Then he goes, Oh, look how happy that guy looks pretty good bark by the door now. So but with your kids, with your spouse. I mean even especially to when you start settling into the norms. And this is just who I am this is just who you are right? And I'm not a bad guy, you're not a bad lady. But I wish you would do this a little differently. And you wish this about me and we've talked about it and it doesn't change, but it's not a deal breaker. But then there it is, every day, you know what I mean? And, and then you have 1000 things going right in your life. And you see the four things that aren't that I think is what puts you into that space. And then you made such a good point a moment ago, you don't necessarily know you're in that space. Right? Yeah, and I think too, when you're, I was gonna say UNGA. Bissen. But I don't know how much interest we're gonna get out to people here. But like, when you're feeling like, you know, unsteady, it is not your first thought. To look at yourself. It's always you always look at what is happening around you these things, these people, they're making me feel this way. You know what I mean? So

Erika Forsyth, MFT, LMFT 10:55
yes, are you right? Yeah, the circumstances, any kind of environmental stressor?

Scott Benner 10:59
Yeah, I'd be fine. If it if it wasn't for my dog barking when I when I went to eat every day, or if my husband just wouldn't do this all the time like that. But the truth is, is if you fix that thing, you would just move on to the next thing in your head. Right? Yes.

Erika Forsyth, MFT, LMFT 11:14
Yes, our brains, our brains are really, they like to hold on to the the negatives and the misses. Yeah, instead of like, we don't fixate on cashed, I really nailed my dinner Bolus.

Scott Benner 11:31
We don't fixate on that, I'm happy to say here and never tell her it's here. But if she finds that, that's fine with me telling you that my wife has a point system in her head that she doesn't know that she has. And it only works in one direction. So every time I do something unfavorable. I lose a point. But if I were to cure cancer, I would not gain 10 points. It would be well, it's about time he cured cancer. I like like, right. Because it's always felt like it's me. It's not just her by the way. I think it's personal relationships. Like it feels like you start with 100 stars, and you lose one and lose one and lose one. But you don't gain them back ever. Like you never, you know, you never give people their flowers, you just go take them from them. And then to kind of bring this to diabetes, I think that same thing can happen. Like that's why I try pointing out like, hey, there's a lot of good that comes from having type one. I know it's not something you would willfully take type one for. But people are often much better at their own health more in tune with their bodies. You know what I mean? Like, yes, that's a big deal. You don't see that in the aggregate maybe. But as it shakes out over your lifetime, you'll notice it. So I don't know. So what do you think like how do we talk to people about understanding that it's going to be difficult, and that these things that we just talked about are kind of drag you backwards and backwards and backwards. But at the same time, there's a lot of pluses happening. And while your health goals are very important and can't be ignored, they also can't be the reason that you give in? No, no, that's a lot, actually. Yes,

Erika Forsyth, MFT, LMFT 13:13
it is. So we have we have the understanding, we all know the chronic illness of this chronic illness that maybe feels different than other chronic illnesses because of the consistent decision making and mindfulness that we have to have around it and I like that word mindfulness instead of like we're having to worry about it oftentimes I hear others talk about like I'm always worried about my numbers. I'm worried about my my daughter's going high my dad I'm just worried worried worried. And what's driving that is there's fear right? There's the anxiety is being driven by fear of the higher the low.

Scott Benner 13:54
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Erika Forsyth, MFT, LMFT 15:17
And even just changing the language from anxiety, like I'm worried, too, I want to be mindful is reminding yourself reminding your mind and your body of like, okay, we do need to be mindful and intentional. But what I don't want is the motivation to be driven by fear. And I will kind of get through I want to do I think it's important to talk about the perfectionism and how that is develops with sorry, go ahead.

Scott Benner 15:42
Does that stem like, I feel like what I hear you saying is that because there are so many decisions to make, so consistently, that I'm being put into an anxiety inducing situation, every five minutes or every hour or a couple of times a day, even depending on how, you know, well, I have things balance for myself. And so you never really get a chance to what, like go into that. Because I don't have that thing. But my wife talks about it. She said, I talked to my sleep the other night, and I said something very loud. And she described how her adrenaline popped up. And then she couldn't go back to sleep. And I was like, oh my god, like I swear to you, you could bang a garbage can in my bedroom. And I'd be like, what is happening? But that garbage can away? And then I go right back asleep. But that's not that way for everybody. Cuz you hear this all the time, by the way? Yeah. It's a it's a thing in the community that you hear frequently. The idea about like, oh, it's been said that people with type one diabetes make X amount more decisions a day than everybody else. And I've always just thought like, oh, I don't why does that matter? But I think that's because of my personality. I don't think of it that way. But a lot of people can be dragged down by that.

Erika Forsyth, MFT, LMFT 16:51
Well, and I think in the beginning, everyone, I sure, regardless of personality, or coping mechanisms are going to experience that level of you know, the nervous system is on kind of flares up and you're in fight or flight like trying to make these decisions. I don't know, is one unit gonna help us too? Is it too much? You know, those types of things. So you're in like the cortisol level is pumping pretty consistently in the beginning. And so what we want to address is over time, how can the cortisol levels be reduced by not only just experience, but also mindset of? Does it have to be an 80 to 120 95% of the time? Because I think people do feel like an end, you know, obviously, I'm not a medical doctor. And the ADA recommends 70 to 180 70% of the time, but there really isn't data yet. or long term CGM used to back that up. But yeah, like that's maybe a good window. It's a

Scott Benner 17:57
tough world where you need to make a health decision for a mental health decision, because you are trading one for the other at some point, because I mean, listen, you've had diabetes. A long time i Arden's had it now, for my God. She's how long, almost 18 years? Wow, is that true? Yeah, well, I don't want her blood sugar to be 180 didn't mean like, if it is we get it back, and that's fine. And we don't like we don't like cling to it. But honestly, if you take the mental health out of it, and look at the physical health, that is not a thing you want. And so there it is, again, right. Like and you you mentioned the cortisol, the goal is not to like learn to live in it. The goal is to not have it happen, right? Because learning to live in, it just probably just killed me when I'm 50. But I'll be like, people be like, Oh, my God, he was so cool under pressure, but you're not cool under pressure. If you're still feeling it, you're just making good decisions in a bad situation. It makes sense. Yes,

Erika Forsyth, MFT, LMFT 18:54
yes. And I often will ask clients who are struggling with this very issue of, you know, feeling like they need to live in his perfect line, or zone or range. But then I said, you know, at what expense, right? Like, is it? Are you living in a heightened state of cortisol pumping, you cannot sleep you cannot function. You're hysterical crying. And I'm not talking about like, the initial grief stages. And that is that is normal. Yeah, in the beginning, it just is and that will subside. But years and years and years of living with this kind of I need to be perfect needs to be perfect, but that is not sustainable. And that's where you get into the burnout phase. Obviously,

Scott Benner 19:40
I didn't mean earlier to say that I wasn't ever like that. I'm just not like that now, but I the beginning. I was crying like every day for three years. By the way, like a couple of years. I would just in the afternoon. I tell people all the time, my wife would come home and be like, Oh, I didn't have a chance to get a shower. Then I'd get in the shower. So I could cry because nobody can hear me that I'd come out and I'd be like, everything's great. But it was And even on the third day of Arden's diagnosis in the hospital, I recognized what a shift this was going to be like to my, my own personal health. And even I remember saying to my wife, do you think we'll get divorced because of this? Like, just a couple of days, because I was extrapolating it out. Yes. And I was like, oh my god, like, she's not what we thought she was now. Right. So you have to re, like, configure that in your mind, we could kill her with the medication. If we don't get rid of the medication, we could kill her. There's going to be the possibility of long term complications, we won't see them while we're happening. So they'll always be in the back of our head, we're gonna disagree, we're going to argue we're going to be short on sleep, we're going to be all jacked up on cortisol, which isn't a thing I talked about 20 years ago, but you knew you were going to be on edge, you know. And I kept thinking, like, Oh, this is how we're going to get divorced. Because it is a coin flip steal to get divorced, by the way. And then it wasn't six weeks later that the endocrinologist said, the incidence of divorce in America is one and two. But if you have a chronically ill child, it goes to two and three. And I was like, Oh, my goodness. Yeah. So yes.

Erika Forsyth, MFT, LMFT 21:14
And when you're in that stressful state, worst case, scenario, thinking can feel real. Like that's like, it's really going to happen.

Scott Benner 21:21
Yeah. Oh, no, it definitely felt like it was gonna happen. I was like, Well, this is I felt like a self fulfilling prophecy. To me, I was like, Well, this is it, all the cards are out on the table, they all point to this, you know, we're going to flip one over one day, and one of us is going to get pissed about something and say something we can't take back. And that's gonna be the end of it. Like it really is what it felt like. But day to day, that same pressure exists if you're managing type one for a child, or if you're an adult living with it, like, When am I going to experience something that just pushes me over an edge? I don't come back from and I just say to myself off, it may once he's eight, I don't care. You know? Yes.

Erika Forsyth, MFT, LMFT 22:01
Well, I think in that sentence, and question, it is the day to day, which is so different from, we used to have this evaluation every three months with the agency, we did not have this data. And I think there is the shift, just like I know, you know, social media and all this instant, you know, news and numbers like feed like you, if you're using that data to determine your sense of like self worth, there's two pieces, right? There's the data determine, am I going low? Or am I having long term complications? And then you can connect it to I'm a terrible person, or I'm a terrible diabetic, or I'm failing my child. And that's the piece. I mean, there are there are the real truth of having lows and long and highs. And that is real. So I'm not dismissing that. But where we're talking is the is the gray area of what is that data? How is that defining you as a human being? I'm

Scott Benner 23:05
following you completely. Yeah, I know it feels convoluted, but I don't find it to be when you're saying it. You know what I'm is that weird example, ever seen those jumped videos, the scare videos where people like turn a corner and scare a lady and she's like, goes crazy. And then they just do it to her over and over and over again. If you did that, to me, I would punch you, I wouldn't go back and go, I would come forward at you. And so it's personality driven. Like I just had a conversation with someone the other day about their young son 12 years old, a little bit in his hands a little bit in his parents hands, parents, one of the parents has type one diabetes. But the kids they once he was in the AIDS, and then G seven came out, they put the clarity app in with the G seven app, the kids now seeing it sort of like a goal. And he got his a one seen on a six one, the little 12 year old boy, like by himself amazing, right? Because his personality and how he's wired. When you jump scare him, he comes forward. And now you put that same technology in someone's hands, who goes backwards and they go, Oh, look at me. Now I'm being judged every day by my app, this is terrific. And he thought, Oh, this is great. I can battle with this and have a good time like a game. And so you don't know who you are. And again, like we were talking about earlier, as it's happening to you, you can't step out of yourself and go, Oh, I'm just reacting to this wrong. You know, this, this could be really good information for me if I just changed the way I'm perceiving it. And is that right? Yes,

Erika Forsyth, MFT, LMFT 24:33
it will. And I would as a practical tip, I would if you are looking at a clarity app or any of the apps that are connected to your your meters, I mean, your your meters, your CGM or your pumps. If you're looking at that constantly and looking at the trends or the percentages, and that is too much data for you. And that is leading you to shame based thinking. I would definitely encourage like Those are great information, maybe could look at your clarity report once a week, like when you get your weekly email or pull back a little bit

Scott Benner 25:07
weekly, not daily. Don't make yourself like if you if you're feeling shaken up by it, don't keep doing the thing that makes you feel shaken up about it. Correct? Correct. Isn't that great advice for so many things in life that nobody takes that advice? Like, shouldn't I also not pick up my fan? dewlap? Like, you know, right, like, how do you Yeah, sometimes we feed ourselves the exact thing we, we know, we don't need, and I didn't use feed to like invoke food, but maybe there too. And so like, it's very, I don't know, like, I once said to somebody, it feels like you're happier when things are shaken up. And then as I thought about that person, I think, well, that's how they grew up. Like they grew up in a household that was like, always, like, it felt frenetic right and off kilter, and nothing was ever stable. And so when things get good and stable, that person gets uncomfortable, because that's not what that's not where they, they're comfortable, because they didn't grow up like that. There's so many different ways to get you. So I come into your office, because nobody's going to come in and say, Hey, I need therapy. I'm great under pressure, like so like, so someone comes in and says, Hey, look, I've got all this great data. I know, it's valuable for me, but I can't stop looking at it, as you know, condemnation. Is that a self confidence? Like, where do you start with that when you try to help them? So

Erika Forsyth, MFT, LMFT 26:35
I would want to understand how are they perceiving themselves in other areas of their lives in their work? Is there are they you, I think, we talked about the different types of perfectionism, there's the self oriented perfectionism, where you have the expectation that you will perform and perfectly in all areas, and then there's the socially prescribed perfectionism where you think others around you are expecting you to be perfect. So I would look at those two factors in other areas of your life. Do you have that in your relationships, in your work? In your own self image body image? Or is it just with diabetes, oftentimes, you might see in other areas, so you'd start there. And then I would want to understand your what is the self talk going on? So if you are feeling like, gosh, I cannot maintain, I cannot stay in range all the time. And therefore I'm telling myself, I'm not good enough. Again, met medical data aside, we wouldn't be necessarily looking at that. But we'd be looking at that to see how was that prescribing who you are? And how much are you listening to that? And where can we find moments for truth, and grace and compassion? In kind of the broader sense,

Scott Benner 28:01
when I talk to people who are what's the phrase I would use here? realists, right, this is somebody who's not willing to ignore the idea that a 250 blood sugar is bad for me. But they also live in the world where their cortisol has jumped up, and they're having these self doubts, and you know, and all this stuff is happening, they're feeling, you know, they're feeling like everything is a judgment, they're failing that whole thing. So when you feel that way, but you can't let go of the reality of what those numbers mean to your health. That's where I see people get stuck the most. They seem like ping pong balls, like flying back and forth. You know what I mean? Like, I know, I should be kinder to myself, but I'm dying here. But I'm gonna go crazy before I die. Like, like, you don't even like in that. That's, that's the part I feel. When I see people in that space. That's the one I feel the worst for. I think you don't I mean, because yes, because it's not like you're tricking yourself into being upset, you're really upset for a good reason. And the thing that you're trying to avoid, it's real, like so. I mean, it would be no different than if you and I were in this house together. And there was a guy outside with a gun. And I was like, oh, Erica, don't worry about it. You don't I mean, like, and we all feel great for 10 minutes till he came flying through the door with his gun pointed and we're like, oh, you know, we probably should have thought about that. So like, that's how it feels to me, ya know? Yeah.

Erika Forsyth, MFT, LMFT 29:28
So if the person with the with the 250. We would want to look at okay, what is yes, we all want to be in range and have, you know, an agency under seven. So we that's like the goal. But what are the behaviors that are leading to the the ups and downs? Are they consistent highs? And is it burnout coming from perfectionism? Is it ambivalence which maybe, I guess we're kind of talking about that right now? But no, we'll get into that. it later and is it or is it not knowing how to to manage? Is it the depression a lot? You know, there's no real motivation. And is that due to the diabetes is it also is it in general depression. And so we would want to kind of suss that out, like what is. And it could be a combination of all of those things. So knowing how to do it, having the motivation, not really caring. And those can be a messy trio, right, and then cycle of all impacting to be feeling like crap physically and emotionally, not knowing how to manage,

Scott Benner 30:40
right. So from my perspective, as the person who's raised a two year old to a 20 year old, and I've gone from not knowing what I was doing, being incredibly upset all the time having all the feelings that we've described, to slowly figure it out. And now to getting to a point where, honestly, I don't really know what you could ask me about diabetes, where I wouldn't be like, oh, yeah, just do this. Right. Right, like so. And that took a long time. People get to fast forward a little bit, listen to the podcast, because I had to figure it out. So I could come here and talk about it. You guys just get to hear somebody talk about it and go, Oh, okay, I'll do that. You know, and which is, which is terrific. But what I keep thinking while you're talking is maybe you got to fake it till you make it. Like maybe you have to say to yourself, I know one ad is not great. I know, 250 is way higher than I want to be or 300 My God, like, you know, I mean, like, I know all that's true. But I believe that I'm not going to be there one day. And this is part of my learning process. Like while I'm learning, I can't get 100 on every test. So I'll accept the B plus, I'll accept the C minus as this is where I am. But here's where I'm going. And when I get there, I won't see 250 blood sugars anymore. And I really I want to tell you, between you, me and everybody listening, I do not know the last time Martin's budget has been over 250. Like they didn't You mean, like unless there's like a failure of something, or something like that. But day to day making decisions. We just don't see that. You know, I would call 180 A spike like a like a pretty, like, drastic spike for her. But that's because we know what to do we know when to do it. And we do those things. Yes. Now, back in the day. 250 was a Tuesday. Didn't you mean like, I would have been like 250 We're killing it. Like it's not 350. Let's go Yeah, like this is going our way. But but if I could look back and give my my backward looking advice would be that if you're working towards it, and you're getting good information, and you're taking meaningful steps, you will actually get to a point that I've just described. And honestly, the easier you are yourself, the more grace you give yourself in the moment, the more you're able to say, yeah, it didn't go this way today, but I know I'm getting to it. I think the quicker you'll get there, because now you're spending time learning and and moving forward instead of spending time beating yourself up and woe is me. And we're hand wringing and stuff like that. Does that all make sense? Yes.

Erika Forsyth, MFT, LMFT 33:14
Because yes, because shame, as we've talked about before, likes to keep you there. Yeah, it does not want it to, to shift. Yeah. So when and, you know, I certainly have fluctuations. And it'll be, you know, whatever number and I will say, oops, like that. That was Miss. Oops, I forgot to Pre-Bolus for dinner tonight because I had 18,000 things going on, right? But I'm gonna I'll catch it up. But that also comes from 34 years of living with it. And knowing how and like all the things, all the factors, right, like protective factors. But I could wear and I certainly have been here in my past, like, oh, my gosh, I'm at this number. I'm in the TOS. And I'm going to this is going to affect me long term. How did I do this I terrible person. And you get stuck there, you almost

Scott Benner 34:14
become a parasite in your own story. And I don't know if How do I mean that? Oh, there are some parasites that go into animals that rewild rewire the animal's brain to poop on its own food so that other animals will eat the food with the parasite in it so that the parasite can spread itself apart. That's an actual thing.

Erika Forsyth, MFT, LMFT 34:34
That's That's so crazy. I can't even I don't even know why you know that. Yeah.

Scott Benner 34:38
Okay. Well, we all know anybody who's listening now knows why I know this. But so there's a parasite that can go into an animal. It will tell the animal like literally, like crap on the food, because I know other animals will come by and eat the food and then I'll get the spread myself out and go on my journey. You kind of become that in your own life when you have the self doubt hits you. And almost the feeling bad feels normal, like I talked about a minute ago. And so you almost make yourself keep feeling bad. And also, when you're feeling badly about your health, you can do this thing where you like, again, like we talked about earlier, isn't it interesting how this all comes together? And I don't mean for it to, you can point to a doctor and go, it's her fault. She didn't tell me. That doctor I spoke to he could have told me about Pre-Bolus thing, but he didn't. So my blood sugar spice now my fault, therefore, likely my parents fault or Oh, my parents didn't tell me they left me alone too long with it. They didn't stay with me till I figured it out. They stayed with me too long and made me you know, what's the word? When you're now can't help yourself, help us. It's a psychological word that I just lost. It's not going to be important data, they can see me it'll pop, it'll pop up into my head, like 10 minutes after we're done, I'll be gone. But agency agency took away my agency. And so I it was always them doing it's their fault that I don't know how to do it because they were doing it for me. Like no matter what happens to you, that's the thing you're going to blame. That is just such a human thing. Like I mean, you go find a billionaire somewhere right now and be like, Tell me who's screwing you and they're gonna have a list. They're gonna be like, well, here's what's happening to me, like, but I'm like, nothing's happening to you. If a billion dollars, it's all going well, like, like, just try looking at the good things. But we can't do that. Like we never do that. Something's always wrong. It's always something else or someone else's fault. Because that's the only way you can sometimes stop from feeling like this. Like, look what I'm doing. to shame we can we blame? Yeah. Is that Is it a t shirt slogan that I just go to?

Erika Forsyth, MFT, LMFT 36:45
Yeah, that's it is it is a common phrase for sure. To avoid

Scott Benner 36:49
the shame. We can blame we can blame. Nice. I'm putting that on a t shirt. Shirt. Can you imagine you walk into the shoe people like what does that say? And then they start going, Oh, I do that on my butt. But that's the point to is. It's that feeling of like, oh, look what I do. When I feel ashamed. I blame other people. It's not what you do. It's what everyone standing on two feet does. That's the fake it till you make it give it away. Because you know, you're headed in the right direction. Part of it like this is just how people's brains work. Like don't get stuck in this part. And I know that's easier said than done. But that is a clue, though. I mean, you're, you're almost willfully keeping yourself here. And eventually, you know, the secret is, most people get out of it eventually. It's how long you're stuck in it. That is really the thing. I think you have more sway over than you think. Yes. Because you know what I mean, I interview a lot of people. And I enjoy talking to a 65 year old person whose story when they were 15, you would go oh, God, if I heard that story while they were 15. I think this person's done. Like they're never getting out of this. But they do. You know, like, I don't know. I don't know what the answer. Obviously, these are just conversations. I don't think there's a hard and fast answer in any of this. But right.

Erika Forsyth, MFT, LMFT 38:05
And I think that the sooner and this might be a lifelong process to realize that blaming is a dead end, and you will get stuck in that. Not that conversely, I want to say well, you should just shame yourself because, like, be read that way, right? Like, well, don't blame others. But shame yourself because shame is not a productive, proactive feeling. But we often get stuck in that and I know as parents to care as caregivers, that can be a very common experience. And particularly when you're managing blood sugar's feeling like you're responsible for your child's health. And so it's naturally, you know, feeling like oh my gosh, I mismanaged their blood sugar. Shame on me, now they're gonna have they're gonna lose their their vision.

Scott Benner 38:54
Does it have to be shamed as taking responsibility have to be shame? No, no, no. But that's where, where our minds go. Our minds

Erika Forsyth, MFT, LMFT 39:02
go. Because who? Because then like a parent would say, or I would say if I if I, you know, I don't my children don't have type one. But if I were to make a mistake, that caused them pain in the moment, it was on me because

Scott Benner 39:17
there has to be a reason because that's how black and white we are. That's why everyone comes on. And they they're so adamant to tell that diagnosis story because they want to show you where they got diabetes. This wasn't my fault is Coxsackie virus and by the way, that's true, but they need to say it out loud. And they want to tell other Pete Oh, it's about the reason. Like I need a reason. This is not just about diabetes to people need that's why everybody works in, in black and white. That's why the that's why the ambiguity. Ambiguity is not comfortable to people. Is that right? People like an answer. That's why they want to be on a team you If

Erika Forsyth, MFT, LMFT 40:00
we want to ascribe ascribe a meaning and a reason behind things and not I mean we, you can get stuck in black and white thinking or all or nothing thinking for sure. And where you want to move out of because oftentimes, it's all bad, or it's all on me when the alternative could also be true. But that's hard, it's hard to retrain your brain. And that's where, you know, trading, retraining your neuro pathways and your thought patterns is really significant and helpful. And you can do that and in therapy.

Scott Benner 40:31
So to use another example, oh, my God, I see it, okay. So there are some people who will tell you, it's just diabetes, there's nothing you can do about it, it's gonna go up and down, you're a once he's not really in your control, I've given it up to God or whatever like, like saying you want to do and that makes you comfortable that you're not hurting yourself. And then there's the other, there's an opposite side, say, like a very keto diet person who's taken in 10 carbs a day, and they're barely using any insulin, but they have a lot of stability. They know if they if they try to weight from that edge, that they've found their, their comfort in, and they start letting more carbs in, then they're going to have more variability, then they're not going to know what's going on. So they have to defend their their position, you have to defend that position is the right decision. Because look, it works out well, for me, just like the person on the other side can defend that this isn't on me, it's on, it's on something else. And both of them are trying to avoid feeling like it's their fault if something goes wrong. And on the one side, you get to take credit for the decision you've made, I'm going to eat very low carbon doing this thing. And on the other side, you get to take credit for believing in a different power this in charge of you and not yourself. And I'm in the middle here telling people you have to understand what foods impact you how they impact you how to use your insulin, and that uncertainty is uncomfortable for the edges. But there's also a great amount of people who are very comfortable in that I want the knowledge so I can decide. And these are the three different psychological, like, norms that you find around diabetes. Did I just figure all that out while we were talking? Or am I wrong? Am I making sense? Yes,

Erika Forsyth, MFT, LMFT 42:17
I think and I think I can almost see you thinking about all of all of the stories. Yeah, that's exactly what all of the comments from the Facebook group and kind of synthesizing

Scott Benner 42:29
Yeah, I just acted like my own AI from it. I just fed everything, did some research, like data collection, I was like, wait, I know what I'm saying. Because I don't by the way, I don't care. If you eat low carb, I think that's terrific. I don't care if you are like, hey, my a one C seven and a half. And I'm happy and this is the best thing to do. If that's you, then that's terrific. But I'm trying to see the psychological side of it. Because then there's also people who are like, look, sometimes I eat low carb because it's easier. And sometimes my blood sugar gets out of whack. And I say, whatever. And like, I don't think there's anything wrong with any of those three perspectives. But understanding where they're coming from. It's just very interesting. Because I've heard these stories, so many different ways, so many different times. And in the end, it's all about it's just all about humans and how they react to things. And we do fall into buckets, to some degree. And I think specifically about this, these are kind of the three buckets. You know, I have found myself recently, as I'm recording those cold wind episodes, and talking more about like how doctors should talk to patients and stuff like that. Every time I get done one of one of those conversations, I have this like enduring thought, almost like when I get done talking to you, I think, I don't know if this is a thing you can ever make black and white to just tell somebody, like follow these steps and you'll feel better. Like that's what I think I believe in the therapy so much because you need somebody to walk you through it. And while you don't even know you're being walked through it, but to this other thing with a cold wind and you see all these people who like became a nurse or became a doctor and are still delivering substandard care and their understanding is not that and when I get to the end of the conversations, I always think to myself, so it's just it's a human problem. And then everything's a human problem on one level or another right like it's our ability or inability or desire or you know, to work hard at something and make an impact or in some of us are just like look, it's just the job I'm going to show up I'm going to do the thing, and I'm gonna leave I don't I'm not trying to make an impact. And you mix that all together in a soup and you get you get society I should have gone to college I might have enjoyed it

Erika Forsyth, MFT, LMFT 44:44
oh gosh. Yes. I mean is it is it. It's human nature. But in going back to kind of these these buckets, it's you know, where do you feel comfortable? Is it is it control? Like we all want to feel like we're in control. And I know we've talked about this before too. look like, but if I don't know how to control and we can't perfectly control diabetes, do we? Can we stay in that gray zone of I'm going to do what kind of works for me, I'm going to make mistakes, and I'm gonna have to move on? Or do I have to live in the rigid? Yeah, like, you know, on the on the rigidity of, it has to be this way. And if it's not, then I'm gonna mess up. And I'm going to feel terrible about myself,

Scott Benner 45:24
all these different decisions are just different levels of you. Giving your brain and the way it works, the freedom to do what it does, like I don't know if that makes sense or not, like if you if I took a low carb person with a four or five, a one C, and I tried to drag them over to the other side and said, Hey, you're not going to worry if your blood sugar goes to 200. They couldn't make sense of that. Like that would not work for them. It's not how their brain works. If I took that person who said, hey, you know, once in a while it is what it is. And I made them eat low carb forever. They couldn't deal with that. And I think the people in the middle, if you took them to either side would say this is too rigid one way or the other. I need a blend, I need gray. Like, you know, that's so interesting. We should rename this episode, watch Scott, understand everything we all got in our first Psych class in our freshman year of college, as if it was a new idea that the world just found, it really is interesting for me, because I've learned about life. The same way I learned about diabetes, like I didn't ask anybody for help. I didn't go to a class, I just picked my way through it. And I didn't go to college like so as I live. I know there are times I see things. And I'm like, I bet you this was described to somebody and like, you know, their sophomore year Psych class, I'm seeing it like, like a newborn, sometimes. You know what I mean? And maybe that's valuable, because it can be explained to all the other people who didn't end up in college, listening to this. Because once you understand how people think, you stop being mad at them. In any mean, you're just like, oh, this is just who they are. Like, it's and I know, it's a simple thing. And people say all the time, but once you really see it when somebody is doing something, and you don't ascribe like bad actor, like vibes to them, like, Oh, they're doing this on purpose, or she's trying to make me feel this way or something like that, once you realize that's not what's going on, life just gets so much easier. And I wonder if diabetes couldn't be the same way?

Erika Forsyth, MFT, LMFT 47:24
It makes sense. Yes, you know, you're making me think of, you know, one of my faves Brene Brown, who did research on and data collection on people's stories. And that's how she came up with the, you know, the concept of vulnerability. I mean, she didn't come up with that concept. But how that is really challenging for people to be vulnerable, based on all of the interviews and research she did, and did data collection based on people's stories, which is what you're doing, you know, through the podcast, and the in the group, I

Scott Benner 47:57
just have always felt like, I know, there's more to life than I understand. And I like to wonder what it is, if you ask me my favorite thing to do. I know I've said this before, but like, like going out to the end of my understanding and wondering what's beyond it is one of my favorite things to do. And you can't just do it in your head. Because you only know what you know, you have to talk to other people and listen to other people or, and then instead of judging them think where did that come from? Like, you know, and not be upset about it. Like if it came from a bad place or a good place. It's like, whatever this is where it came from. So I love the after dark episodes sometimes to people who are willing to like, come on and say like, Hey, I'm a heroin addict. Here's my story. Be vulnerable. Yeah, yeah. And and let that out there. And if you're willing to, if you're willing to meet that vulnerability with your own kind of openness, then you can you grow from it. Like I actually found myself thinking it's funny, I was thinking about this in the shower this morning. But I didn't know I was thinking about this. I kept wondering how can I pass on my life's experiences to my kids so that they can fast forward a little bit. But I can't think of a way to do it. Because sharing my experience as a story only goes so far, they actually need to go through this too. This is why we progress so slowly. You know, and maybe that's by design or, or necessary. You know what I mean? Like maybe if we kept leaping forward, we wouldn't be able to readjust fast enough. Oh, maybe that's what we're seeing with social media too. Right? Like technology keeps leaping forward and people can't catch up and then we're all anxious because this isn't the soup we're supposed to be swimming in. That's

Erika Forsyth, MFT, LMFT 49:38
right. Yeah. You have to do the work yourself. And while yes, it would be so wonderful if we could say here's exactly how to live a balanced life, living with a chronic illness or caregiving for your child with diabetes. Take a walk go outside like you know, everyone knows all those tools. Take a break do deep breathing, be kind to yourself, but it really is slowing down to understand the process that you are undergoing. And doing the work yourself, which is not an easy answer,

Scott Benner 50:15
right? I almost wonder if it doesn't help you to like, take a large step back and say to yourself, can I really be mad at somebody in 1950, for how they treated women, when that's how it was done. And now that we've moved forward, we see, that's not the way to do that. Like, right, and you can see, like, we've made progress. And I guarantee you that in another 70 years, you'll look back on, you know, 2024, and think, Oh, I can't believe that's what we thought about those things. And then, you know, but then understand that along the way, there were these people's lives that were, you know, finite and shorter, given the grand scheme of things, and that they were stuck in one thinking pattern, and they probably were never gonna get out, or they'd grow a little bit by the time they got to the end. And their growth would rub off on their children a little bit, their children would start slightly ahead of them and grow a little more, and we keep going. And if you can take that idea, and flip it back on your, on your diabetes, then I think that's what I'm saying. I think you're faking it till you make it like you're like, I know, I'm not perfect, but I'm not bad. And I'm trying, and then level up, and then do it again. But don't judge yourself on what happened in 1950. Just go, Okay, three years ago, I didn't know to Pre-Bolus. But I know now. And let's level that up and keep going. And hopefully do that quickly enough that you avoid. You know, I mean, catastrophic, like health concerns, and so on. There's no answer, but that's the answer. It's all in there. Just listen to that over and over again until it makes sense to you. Or go see a therapist. And again, we're gonna call this episode watch Erica, watch Scott. Figure out common ideas. Sometimes when she looks at like, where's Eric and I see each other while we're doing this, it's sometimes I have there's this look on her face that I remember my mom like looking at me like, oh, look, he figured it out.

Erika Forsyth, MFT, LMFT 52:09
It's an encouraging expression. Yeah, she's

Scott Benner 52:12
like dummies getting it. I see it happen. No, I know. You don't think that way?

Erika Forsyth, MFT, LMFT 52:17
No, it is. It's it's fun to watch. Yeah, the process.

Scott Benner 52:20
I can never tell if you're like, I'm glad I have these conversations with him. Or if you think I should get on a podcast or somebody understands more.

Erika Forsyth, MFT, LMFT 52:30
No, it's good stuff.

Scott Benner 52:31
Good. It's excellent. I appreciate doing this with you so much. Like, if I just sat down by myself and tried to think my way through this. I wouldn't get as far as I do as I do when I'm with you. Like I'm actually I'm getting tired. My I'm warm from thinking do you know what I mean by that? Yes. Yeah. Yes. My fingers overheating. It's hard. It was how hard is it not to look at me and think look how thin Scott looks. It's amazing.

Erika Forsyth, MFT, LMFT 52:59
You really you really have Yeah, I mean, pretty soon. Not gonna see Yeah. Oh, no,

Scott Benner 53:04
that's not going to happen. But, but I'm still it's funny. Like talking about how your brain works. Like, I still like I'm focusing at looking at you because if I look at myself, I start going. I don't even look like myself. Again. You can feel like a you can feel yourself drifting away a little bit. And you can go oh, I should have done this sooner. Or how come I didn't figure this out earlier. But you know, to me like, shame, shame pop. Yeah, I feel ashamed immediately, actually. But I have felt that way. But then turned it. Then I just I just turned it on the pharmaceutical industry. I was like, well, they should have come up with that drug faster. But I did say to my wife the other day. Do you ever get sad that this drug didn't exist sooner? Because we're 50. Now like, what if they would have come out with these jell PS when we were 30? Like, would we have had a different life? Like, you know what I mean? Like, it's I'll never know,

Erika Forsyth, MFT, LMFT 53:55
do you? Because I'll I asked that about CGM 's and automated insulin.

Scott Benner 53:59
I bet you do. Right? Yeah. Oh, I had I had that conversation with someone the other day. Guys had diabetes for like 45 years or something like that. And I asked him, Do you ever wonder about what your life would have been like if you were born now instead of that? And he said he tries not to think about it. Yes.

Erika Forsyth, MFT, LMFT 54:16
And I think just the question you asked why, why didn't I do this sooner? Of course, as soon as you want it is you're starting to have a healthier mindset of how you view yourself think about others in the world. The old way of thinking shaming still wants to pop back in so it just still was trying to like ah, you should have coulda woulda

Scott Benner 54:34
as I felt it coming. I got in front of it. Because this isn't my fault. Like, I mean, honestly, Erica, I'm not a doctor, quite obviously. Obviously, I'm not educated it anyway, if you've been listening for the last 15 minutes, the GLP has made a big difference. I must have a GLP deficiency because I have not drastically changed how I eat. I had pizza this week. I just want to tell you I bought a pizza, ate at one night, got up the next day, had it for lunch and then had it for dinner a third day and I lost a pound this week. So like, you know, like, I'm not to say that I eat like that all the time. But this week, I wasn't eating very much. And I didn't have a flavor for anything. And I thought, Well, maybe it's better for that eat something than nothing. So I mean, I got this pizza, not the point. The point is, is that even on a GLP, I'll lose a pound this week, having eaten six slices of pizza spread out over three days, if I would have done that, without the GLP, I easily would have gained four or five pounds. And so it's not a thing I couldn't have. I couldn't have done it, the thing didn't exist. It's so funny how my brain was willing to leap over that truth. Like, this was not a thing you could have done. 20 years ago, Scott, this didn't exist 20 years ago, and I went right to why didn't I do this? Like I let go of all the reasons why to blame myself for a second. And I stopped myself. And I said, this isn't my fault. It's Eli, Lilly's fault for not making stuff down sooner, or whatever. I don't know. And I let it go. But there are people who will they get stuck in that pothole right there? Oh, it's my Yes. Yeah, and why?

Erika Forsyth, MFT, LMFT 56:03
Why didn't Why didn't I make this change sooner? Why didn't like even you said the Pre-Bolus thing. I mean, I didn't Pre-Bolus For the first 25 years of my diabetes life. And, but I didn't know. And that's okay. And now and so like, when you as soon as you hear yourself going whitened. I coulda shoulda just say, Okay, where are you right now, in this moment, going back and doing a mindful exercise or doing the grounding that we've talked about, and bringing yourself to the present. And you can say, wow, look where I am today? Yeah, like the journey is right now.

Scott Benner 56:38
I talked to a guy the other day, who had had diabetes for over four decades. And he told me that in the last handful of years, I taught him to Pre-Bolus his meals.

Erika Forsyth, MFT, LMFT 56:47
I honestly might have heard about people's for the first time through the podcast. Yeah, honestly, it's a crazy,

Scott Benner 56:52
it's such a, it's such a stupid idea. Like, like, like, I used to talk about it like this. I used to say, if I taught you to drive, and you never driven before, and I said, Okay, Eric, as we approach this curve, I only want you to push down on the brake halfway, and then go through the curve. And I said, if you were doing that, and you press down on the brake halfway and saw you were gonna go off the road into a stone, would you just hold the brake down halfway and go, it's what the guy said to do? Or would you push harder and say, I don't want to hit the rock off to the side of a road. But so many times with diabetes, we just go That's what they told us to do. I guess I'll crash. You know what I mean? And then I'll tomorrow I'm gonna get a new car and crash again. And they over and over again. And how much of that is mixed in with, like the godly way we see physicians. So the guy didn't tell me the lady didn't tell me. So it's obviously not a reason or a rule. So I'll just keep doing what they said over and over again. It's fascinating. It really is like, how do you not say to yourself, I give myself insulin at noon, I eat at noon, my blood sugar goes up. What if I gave it to myself? Five minutes before that, or 10 minutes before though? What would have happened? Again, that's me. If you jump scare me, I'm gonna punch you in the face. Like so when I saw the thing happening with the blood sugar's I was like, that's not right. Like, I always think that I always, by the way, I always think that's not right. And they don't know. But that's just, but that's an abundance of, I would call it self confidence. Yeah, I'm sure somebody else would call it narcissism. That's between me and my therapist. And, but, but I trust myself more than other people. But I also had to count on myself growing. And I had some wins along the way. So I had a reason to trust myself. I've made decisions in the past before that have gone well. So I think well, I'll try it again. I bought it worked out the last time. Let me see what Scott brain thinks this time. You don't I mean?

Erika Forsyth, MFT, LMFT 58:49
Yeah. I wonder I'm sure. I know. We're totally now in a different topic, but not really. But with the the Pre-Bolus concept. I'm sure you and Jenny have talked about this before. Did did the Pre-Bolus. I mean, I used to Pre-Bolus with regular insulin. And it was like third way to give her injection 30 minutes before we ate. But then when we transitioned to cue melodic fast acting,

Scott Benner 59:14
Jenny blames the naming.

Erika Forsyth, MFT, LMFT 59:15
Yeah. Is that what it is? Because I feel like then I got the concept just left. Yeah,

Scott Benner 59:20
they told us it was fast acting insulin. We stopped talking about the timing of the insulin. Yes, yeah. Okay. And you're old enough to remember that. Yeah. It's just a naming. Again, that's a that's a human mistake. It really is. Like when you listen to that Grand Rounds series that she and I are making. Everything that a doctor does that throws you on the wrong path is is usually a communication error. Just not knowing how to talk about things and see the implications of the words you're using. Super simple. I mean, nobody knows how to talk. So it's not super simple. Yeah, diagnosing it is simple. Like I see what's happening. I don't know how to get somebody to fix it. I also don't know how you It's funny because a scientist called it fast acting insulin, or faster acting insulin,

Erika Forsyth, MFT, LMFT 1:00:05
because it was faster than that regular. Yeah, yeah. But again,

Scott Benner 1:00:09
a person who you should not put in charge of artistic endeavors. Like you don't you mean, like you don't ask a structural engineer to write a poem, because their brain doesn't work that way. So you should get the structural engineer to build the bridge, and then have an artist come in and call it something. Yeah, right. And because they know how to talk to people, and I know how to talk to people I don't like and I have enough understanding of diabetes, that I can take that understanding and put it into words that you can hear and pick up and use somewhere else. I think that's my whole value to this is that I had to teach myself diabetes because I couldn't let my daughter be unwell. And I'm a good storyteller. Like, I know how to talk. And it's not on purpose. Like I swear to you, here, I'm going to tell everybody something that will let them go. I sent you four topics. And I said, ladies choice. That was the extent of our preparation for today. Okay. And then you texted me a half an hour before going, Oh, I forgot to tell you, this is the thing I chose. I didn't read what you sent me. So when we popped on and started talking about it, as you hear me warming up in the first couple of minutes, it's the first time I've considered this today. So and then I start accessing all the stories I've heard on the podcast, and then trying to work my way through it. That's all you're hearing is, that's what you just heard for the last hour and Erica artfully pointing me at the truth about how people's minds work to keep me on that path, which is I'm assuming what you? Yeah. Which was, I'm assuming what you would do if you were my therapist, this you would keep going, Hey, look up, dummy. Keep walking in this direction. You only go back to the theme and the goal right now it's beautiful. Anyway, if anybody heard this and doesn't believe in therapy, they you're not paying attention. Erica forsyth.com. What are your states that you can help people remotely? California?

Erika Forsyth, MFT, LMFT 1:02:04
Oregon, Utah, Florida and Vermont. Oh, Vermont. Sticking? Yes. Vermont sticking nicer now? Yes. Good. Good. Good. And

Scott Benner 1:02:14
if you live local to Erica, she will tell you where she's at. And you can sit with her and do this.

Erika Forsyth, MFT, LMFT 1:02:18
Yes, I'm leaving office in Pasadena in person, but also virtual as well. Again,

Scott Benner 1:02:25
Erica forsyth.com. If you don't see what she did this hour with me and think that could help me to again, I don't think you're paying attention because I couldn't have put these thoughts together without you today.

Erika Forsyth, MFT, LMFT 1:02:37
So Wow. Thank you, Scott. Seriously, nice compliment.

Scott Benner 1:02:42
Oh, hurricane. You know, I've had a couple of therapists on here before I landed on you. You're the right one. Don't you worry. I saw what was going on. I paid attention. I was like, yeah, good conversation, but not right for me. And then I pick through and I was like, Erica works for me. And you know, the big, I'll let you go. But the first reason that I thought that about you is that if I tried to generalize you wouldn't let me when we were first together. Like I would try to generalize think to be entertaining, and you'd be like, No, I was like, Oh, she pushed it back for we're trying to have fun here. And then I was like, Oh, I remember. I was like, she'll be good to talk to you about this stuff. So anyway, I love you. So thank you very much. Oh,

Erika Forsyth, MFT, LMFT 1:03:21
thanks, God. I appreciate that. Bye. Oh, gosh.

Scott Benner 1:03:26
There you go. That's perfectly a blessing. Don't please.

I want to thank the ever since CGM for sponsoring this episode of The Juicebox Podcast. Learn more about its implantable sensor, smart transmitter and terrific mobile application at ever since cgm.com/juicebox. Get the only implantable sensor for long term wear get ever since. A huge thanks to the contour next gen blood glucose meter for sponsoring this episode of The Juicebox Podcast. Learn more and get started today at contour next one.com/juice box. A huge thank you to one of today's sponsors, G voc glucagon, find out more about Chico Capo pen at G voc glucagon.com Ford slash juicebox. you spell that GVOKEGLUC AG o n.com. Forward slash juicebox. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. The diabetes variable series from the Juicebox Podcast goes over all the little things that affect your diabetes that you might not think about true Travel and exercise the hydration and even trampolines. juicebox podcast.com Go up in the menu and click on diabetes variables. Lots of people with autoimmune seem to have trouble with their thyroid. And that's why I've made the defining thyroid series juicebox podcast.com Click on defining thyroid the menu to find out more. The episode you just heard was professionally edited by wrong way recording. Wrongwayrecording.com

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#1171 Pump and CGM Overview - Part 2

Scott and Jenny look at the pumps and CGMs available on the market. Part II

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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 1171 of the Juicebox Podcast.

This is part two of my pump and CGM overview Part one is it episode 1166. Today Jenny Smith and I are going to be talking more about CGM sump pumps overviewing everything that we could find on the internet to talk about nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Don't forget to save 40% off of your entire order at cozy earth.com. All you have to do is use the offer code juice box at checkout. That's juice box at checkout to save 40% at cozy earth.com. If you're a US resident who has type one diabetes, or is the caregiver of someone with type one, please do me a favor and go to T one D exchange.org/juicebox. and complete the survey. Every time you do that. You're helping with type one research, you're supporting the show and you might just be helping yourself T one D exchange.org/juicebox. This episode of The Juicebox Podcast is sponsored by ag one drink ag one.com/juice box. head there now to learn more about ag one. It's vegan friendly, gluten free, dairy free, non GMO, no sugar added no artificial sweeteners. And when you make your first order with my link, you're going to get a G one and a welcome kit that includes a shaker scoop and canister. You're also going to get five free travel packs and a year supply of vitamin D with that first order at drink a G one.com/juice box. This episode of The Juicebox Podcast is sponsored by Dexcom dexcom.com/juice box get the brand new Dexcom G seven with my link and get started today. Today's episode is sponsored by Medtronic diabetes, a company that's bringing people together to redefine what it means to live with diabetes. Later in this episode, I'll be speaking with Jalen, he was diagnosed with type one diabetes at 14. He's 29. Now he's going to tell you a little bit about his story. And then later at the end of this episode, you can hear my entire conversation with Jalen to hear more stories with Medtronic champions. Go to Medtronic diabetes.com/juice box or search the hashtag Medtronic champion on your favorite social media platform. Jennifer, we are back to finish up our insulin pump conversation part two, yay. And we're gonna go over some CGM at the end. So far we've talked about manual pumps, we went over Omnipod five, Medtronic is offering and tandem control IQ in the x two. As far as automated today we're going to talk about I let and then the new mobi pump, again from tandem. So let's start with eyelet. Actually, yay, cool. Tube pump. Correct, right. But the way that it wants to work is, I would say completely different from all the other automated systems that are currently available. That's fair, right?

Jennifer Smith, CDE 3:35
That is 100% Fair, automated tubed. But definitely automated very differently than any of the other systems. Yeah.

Scott Benner 3:46
And here's why. It doesn't really want you to be involved. That's a good way to describe it. I mean, right? It doesn't want you to be and that's the idea here is beta bionics made a pump, in my opinion, like I'm not speaking for them. I did interview Ed from beta bionics for a couple of hours when it first came out. And the vibe I got from them was there are people out there who are going to use DIY algorithms, and they are going to like, they are going to get their a one season to the low fives. They're not going to see an excursion above 140. These people are like, they're dialed in. Right? Right. And there's people who will use other automated systems have nice a one sees and the six is like they'll put some effort into it here and there. We want to make an automated system. I felt like he was saying for people who do not want to be involved in their diabetes, or people who doesn't matter how much they've tried. They just can't find success. And so we wanted to help these people who are running around with 910 11. I know some people find it hard to believe there's people running around with 12 and 13. A one sees Right, right? We want to put a thing on them gives them an A one seat in the seven. Yeah, and I thought that was really cool. So tell me how it works. because it's pretty basic, right? It

Jennifer Smith, CDE 5:02
is pretty basic. And I would also say that while it's a pump that doesn't really want the user to do much, the user still clearly has to do some things. I mean, it's not going to fill the insulin or pop the tubing, you know, yeah, the infusion site. So there's obviously those basic things, call

Scott Benner 5:21
your brother on his birthday.

Jennifer Smith, CDE 5:25
or fancy things for you that you still do have to acknowledge when you're eating. The nice thing is that there's no calculation to what you're eating. And for, you know, that population who is really looking for some assistance in navigating because they just, they can't do what the do it yourselfers they're doing? Are those on other automated systems that can tweak and adjust and really are into paying more attention, I guess. Yeah. This system really is just like, hey, tell me when you're going to eat food? And how much? Is it about the same as you would normally eat your your standard meal size? Is it less than that thinking like snack size, so to speak? Or is it like you're sitting down to the Super Bowl meal? Right? If

Scott Benner 6:16
I recall the way he explained it to me, it was you tell the pump? This is breakfast, lunch or dinner? Correct? And then you tell it this is a average smaller than average or larger than average? Person

Jennifer Smith, CDE 6:30
normal for you less than normal, larger than normal. Exactly.

Scott Benner 6:34
And when you set the pump up, you tell it how much you weigh. And that's it. Correct? Right? Yeah. So you don't have a carb ratio, Basal rates, correction factors. And you don't have to count carbs.

Jennifer Smith, CDE 6:48
Correct. There is no carbohydrate counting. I do think though, from what I see, as far as what the system could do better for you as it adapts and adjusts those insulin delivery kind of amounts, is if you at least have an idea of approximately how many carbs are at your average meal, you again, individually, not the average person, but you, let's say you've got a big appetite, or you have a lot of energy expenditure. And your average meal is pretty big, big, not for you. But big. You know, according to others, maybe it's 60 grams of carb is your average meal. If you at least have an idea of about how much you're eating, it gives you an A an easier idea of navigating this is definitely smaller than I usually eat, or this is much more than I would usually eat. So yeah,

Scott Benner 7:41
I'm gonna have somebody I mean, eventually I'll find somebody that's using the pump that be on the show, but it's pretty new still, you know, I don't think I've bumped into five people who are say they're using it. I also can't make a correction with it, right? Like, I can't look at my blood sugar at 250. And go I really wish I had more insulin. It's just doing what it's directions.

Jennifer Smith, CDE 7:59
Yep, no calculating bowls, that Bolus is on the user's part. That's all the pumps sort of driven, adjusted kind of right. doses, right? Yeah,

Scott Benner 8:09
this is a pump that I think for I think they're a segment of people who are going to hear about it and think I do not want that. I want control. I want to do what I you know, I don't want a seven a one se right. And I think there are probably more people who are going to hear it and go, are you kidding me? Like Give me that? Yes. You know, like, so nothing's for everybody. This one's more specifically, obviously not for one segment of people. Do you know what I mean? Like there's like, right, I can make an argument for x two for Medtronic for Omnipod. Five for anybody. I could say, Hey, here's why this would help you. Right? And here's reasons where it won't help you. This one's more cut and dry. I think it's more about your goals. And or the ability you have to do this because I think I said earlier people who don't want to like try as hard but I don't think that's it. Like I think it's whatever I'm trying as hard as I can I just don't get it. Right. You don't you mean? Like I never figure out diabetes? What am I damn to live forever with a 12 a one seat because I can't figure this out. Right?

Jennifer Smith, CDE 9:09
Absolutely. Or that you don't have somebody there assisting in teaching you what you could do a little bit better, right? And I think a system like this also, because it is body weight initially driven in what it starts with in insulin delivery amounts. Yeah. In general, again, along with meal entry being small, medium, large kind of entries thing. Most people, regardless of their education level, are going to very easily be able to determine Yeah, well this is a normal meal.

Scott Benner 9:44
I mean, the top of my head, you're sending a kid off to college and you think they are not going to take care of themselves. This seems like a pretty good idea. They're like that kind of stuff. Now, I want to be clear, I don't have trouble with it. And I'm not judging anybody. But if you told me my daughter is a once he was seven and a half I'd be like, what are we doing wrong? I gotta fix. So you know, that's the consideration, right? Beta bionics.com. It's the pumps called islet. It's a very simple marketing plan, which tells you how simple the pump is. The front page just says the islet is an automated insulin delivery system that reduces the need to make decisions about your diabetes management because it makes the decisions for you. There's no more carb counting correction factors, carb ratios, preset Basal rates or any other settings that might be overwhelming about other insulin delivery devices. And that's it, right? Yeah, let just needs one number, your weight at the end of the website. Right. So you know, there

Jennifer Smith, CDE 10:37
are some minor adjustables in terms of, it's important

Scott Benner 10:40
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Jennifer Smith, CDE 13:19
Containing things a little bit more or giving it a little bit more wiggle room and it's really targets right. Those there are some adjustable targets within the pump in order for what it's aiming for. Because it does work with CGM, obviously, as an automated kind of algorithm. Yeah, the one place I would say that, in looking at all automated types of systems and even manual systems, I think they all fall short in terms of exercise, and navigating the right adjustment. I think this system by far has some things that somebody really needs to sit down if they do exercise or they're going to start to do some type of exercise. They really need to sit down with somebody who knows the system and knows how it works in that capacity to give some starting sort of adjustments, whether it's taking no Bolus or taking a small snack that you don't cover or tell the system about or even, you know, I mean, I hesitate to say disconnecting, but honestly, if sometimes we're a system like this, there's no exercise setting.

Scott Benner 14:25
So is this coming from like conversations you've had with people using it? Yeah, yeah. So I'm gonna guess that because it's so in specific about what it's doing to some degree. If you're a fairly sedentary person for 20 hours a day and then go for a run, you're gonna get low or a person who just like works out on the weekends or something like that. It's no no different but more aggressive than when you hear people talk about like, Oh, my kid, you know, just goes to school Monday through Friday. They get up they walk, they sit down. That's it. Then on the weekends, soccer practice. Oh my god, we're flooding lows all weekend. But we're on on we're on a podcast, I don't understand why that's happening, right happening because for five days in a row, the pumps been helping a sedentary child. Now all the sudden you're running around, right. But you think your experience this is a little I don't want to say worse but a little bigger of an issue. Correct?

Jennifer Smith, CDE 15:18
Yes, that's yeah, I wouldn't say worse. But I would say there are definite differences in how to accommodate for planned exercise and planned being the optimal word for this system. Not all of them, it works better if you're planning something and you can adjust ahead of time. But this definitely, you have to have an idea that activity is coming, or just plan to feed insulin, right? Because you haven't adjusted people

Scott Benner 15:43
don't. Not everybody, but a lot of people don't think about activity as a variable for their diabetes, right? And, you know, you should, you should think of, you know, if you're steadily active all week long, at one activity level, you're going to see, you know, less insulin resistance, you know, your insulin is going to work better, right. And I do think it's important to bring up because in the discussions of these, like different pumps, if you hear any one of them and think oh I Delic I got it. That's the right one you miss heard, because they all have speed bumps, you don't I mean, like there's nothing's perfect at this point, right? I'm going to do a conversation about you know, loop and Iaps and stuff like that, at some point down the road to kind of bundle on to this, but they're not perfect. No, this morning I Arden's like I'm sleeping in. I have one day off, she's had a head cold at school, like forever. She's on Iaps right now, I had to wake her up at 30 in the morning, I'm like, Hey, you're low. Right? You know, like so. And it tried. I saw it took her basil away for two hours it tried, but it is what it is. Okay, so I left beta bionics. Now, the tandem. Moby is a Yeah, like a brand new pump. That This one's interesting. I don't know a lot about patent law. This one makes me think we wanted it to be like an omni pod, but we couldn't make it to Bliss. So we put out a really short piece of doing on it. I don't I don't know. Like this one baffles me a little bit. You tell me? Where's the use case for this? Because it's still a tube pump.

Jennifer Smith, CDE 17:20
It is a tube pump? And I think that it fills the need for it. How many people have you heard comment, even in your online community, right? About, I love my Omni pad. But I really wish there was a time that I could disconnect it, and then just put it back on without restarting a new one without restarting a new one without losing all of that insulin without dealing with a new pod start site, etc, etc. This is where that fits the bill. And quite honestly, the little device is smaller than a pod.

Scott Benner 17:52
Oh, it's teeny. I'm looking at it here. Tiny. I mean, it's a marketing picture. But it's a little bigger than maybe four and a half, like flat quarters laid together. Like maybe if you put four quarters and a little like, I mean, like it's east, the west, north to south. I don't know about the thickness of it. Yeah,

Jennifer Smith, CDE 18:09
the thickness of it. If I remember correctly, I saw I've seen it only in like, handheld person, once. It is not as thick as a pod, if I remember correctly. Yeah. And it is definitely like shorter from top of pod to bottom of pod it is definitely shorter than a pod is it holds 200 units of insulin. So for those, I mean, if we're talking about best use versus consider maybe something else, or how could I use this, again, 200 units of insulin for somebody who really is going through heavy, heavy doses of insulin, It either means you're going to change the reservoir more often, right? Or you choose something that's got a bigger reservoir to it. I mean, pods themselves only hold 202

Scott Benner 18:54
I'm looking at the marketing here for the movie. It's interesting. Basically, they're saying look slip in your pocket. So it's still a pump, but it's really teeny tiny. Or they say we have like an adhesive patch that you can slap on it almost looks like a like it's a patch that goes on your skin that then it seems like it has like a loop on it. And then you would like slide it into the you know, I'm saying

Jennifer Smith, CDE 19:14
it's like a pocket almost, if you imagine Omnipod with Omnipod adhesive, right? And instead of seeing the pod just sort of wobbly on the top of that adhesive. This actually has almost like a little like a

Scott Benner 19:29
wrapper. It's another piece of like, of that fabric that goes over top of it. Yeah, exactly. It reminds me of you know the men's wallets now that are metal and the cards slide into them. But then there's a rubber strap over to put your cash under. Yes, my husband has one. And I think that's that's what it reminds me of like, like visually. Yeah,

Jennifer Smith, CDE 19:48
absolutely. I think the other nice thing as you said it could be put in a pocket, right, that allows you to actually have longer tubing. I mean, it does have really really teeny tiny short tubing if you Want to wear it with that patch piece like we were just talking about? Again, it offers the ability to wear it on the back of your arm, if you would like, you know, with a little navigation and maybe taping down the tubing or whatever to keep it from sort of flopping around. But the other really great thing that is a big difference between it and the only other pod, there is a Bolus button on the Mobi device. So if you do not have your phone, which drives the typical delivery and boluses, and whatever else you're going to do with it, the Bolus button right on the Mobi allows you to have a preset amount that gets delivered with the tap of that button. And it offers you the ability to also see that the delivery has gone through with vibration, which is it's nice, it's just a confirmatory, hey, this definitely worked it went through you don't have to worry

Scott Benner 20:52
it runs control IQ to correct okay, so you can run control IQ with it, there's a button on it that you can say, hey, I want that button to do two units and like pre program it if you want to give yourself like a turbo boost of insulin, yes, but you need the phone to run the algorithm and that otherwise. This episode is sponsored by Medtronic diabetes, Medtronic diabetes.com/juice box. And now we're going to hear from Medtronic champion Jalen.

Speaker 1 21:20
I was going straight into high school. So it was a summer, getting into high school was that particularly difficult, unimaginable, you know, I missed my entire summer. So I went, I was going to a brand new school, I was around a bunch of new people that I had not been going to school with. So it was alright, trying to balance that while also explaining to people what type one diabetes was, my hometown did not have an endocrinologist. So I was traveling over an hour to the nearest endocrinologist for children. So you know, I outside of that I didn't have any type of support in my hometown. Did

Scott Benner 21:54
you try to explain to people or did you find it easier just to stay private?

Speaker 1 21:59
I honestly I just held back I didn't really like talking about it. It was just it felt like it was just an repeating record where I was saying things and people weren't understanding it. And I also was still in the process of learning it. So I just kept it to myself didn't really talk about it.

Scott Benner 22:13
Did you eventually find people in real life that you could confide in,

Speaker 1 22:18
I never really got the experience until after getting to college. And then once I graduated college, it's all I see, you know, you can easily search Medtronic champions, you see people that pop up, and you're like, wow, look at all this content. And I think that's something that motivates me started embracing more, you know, how I'm able to type one diabetes? To hear

Scott Benner 22:39
Jay Lin's entire conversation stay till the very end, Medtronic diabetes.com/juice box to hear more stories from the Medtronic champion community.

Jennifer Smith, CDE 22:50
The algorithm, that's the interesting thing. So a lot of people have kind of asked if, well, what happens if my phone dies? Right? Yeah, Does that just mean that I'm not getting anything or what happens and really, the algorithm continues to deliver with communication to with the CGM, from what I understand. So the nice thing is that while the phone app is really your, your control device, 100% extended Bolus is if you're using it in manual mode, you'd only be able to use a temporary basil, etc. But that is a nice piece to know that the system keeps running for you. Right? It's

Scott Benner 23:30
funny, I see the value of each one of these as I look at Yes, like I really do. I think a downside to any device I have to be honest, is if you have to charge it. That's one of the things that always throws me off a little bit like so this movie looks like it has to be it's wireless charging, but you're still gonna flop it on a charger at some point. Yes, yeah, you're on the pods not gonna run out of battery in the three days that you're using it. So no, no. I mean, it's there's give and take, right? Like with all of these, right? This is an interesting one though. It really is. Yeah,

Jennifer Smith, CDE 23:58
it is. I actually I just got an email from a trainer in this area to kind of get fully trained on it. And I'm really excited. I kind of like to give it a try personally, because I think it's a just an interesting new piece on the market of

Scott Benner 24:15
choice. Yeah. Jenny's not trying this until it runs some do it yourself out. I will tell you this. I know Arden really well. And obviously Arden has been wearing it. I think I misspoke in the first half of it. Arden was diagnosed when she was two she started wearing a pump when she was four and an omni pod. So when she was two it was 2006 which means she was starting to wear on the pot, I think in 2008. Anyway, neither here nor there. But if I showed this to Arden right now and explained all the good parts about it, she'd see the piece of tubing on it and go I am not interested in this. Yeah, like it's fascinating. What happens to some people after you've worn a tubeless insulin pump? Yeah, you're just like, I don't care what the other thing does. I don't even want to hear about it like 10 First thing, you know,

Jennifer Smith, CDE 25:00
I think that too, this is really, while their typical T slim x two can be worn under the clothes, and now it's controllable by the app. So you technically don't really have to pull the pump out. It's still a piece to navigate. Where do I clip the pump? Where do I put it? Where do I hide it under my clothing? And in this case, I mean, there are a lot of people who wear their pump site on very different parts of their body than what are technically recommended by the pump companies. Right? Kind of the upper area of the back, I know there are women and even men who wear it like on their chest or kind of their upper breast tissue, right? This it's another alternative to wearing something completely underneath clothing that you don't really even have tubing to deal with hanging out well

Scott Benner 25:49
that I can see for sure. Like, yes, there's tubing on it. But it looks like you could do a short piece to the infusion set and then use the tape thing to tape it to yourself. And then you kind of have that functionality of being tubeless even though it's not quite

Jennifer Smith, CDE 26:02
the shortest tubing is five inches. Yeah, okay. No,

Scott Benner 26:05
yeah. Jenny, I almost said that's a good size. Why would you make fun to fight and I'm just kidding. But what I think about is back before all the bluetooth headphones, right? That you know, I mean, we're all on our phones, by the way, you should all all day long be listening to the podcast on your phone. But back then there used to be, you'd have wired headphones, they kind of hook in your ears, the wire would go to your phone, and then you'd take your pants off in a bathroom sit down the wire would yank your your iPod out of your pants and go bouncing across the bus station floor. Not that this has ever happened to me. And I'm gonna say that's very specific, very specific. Yeah. And then you find yourself saying to a man that you don't know. Could you kick that back here, please. And anyway, that's the one thing I worried about when I saw Oh, you can put it in your pocket. It's neat. But what happens when the distance I stopped thinking about it, you know what I mean? But again, I'm guarantee and people are gonna use this pump, people are gonna love it. Yeah, I think people love control IQ. And a lot of people have a lot of success with it. So it's another

Jennifer Smith, CDE 27:11
another group, probably that may do better with something like this is maybe a group that has some dexterity types of issues, because there really is a little bit less fiddling, right? If anybody takes a peek online, you can actually see that the reservoir in this is clear. You can see into it, you can tell if there are bubbles there, or any issues. So that makes it from a visibility. That's a big difference compared to the T slim pump, where the reservoir is entirely enclosed. You can't tell what's happening within the reservoir. Right? So and the field process is really I've seen the field process only once. It's pretty darn easy.

Scott Benner 27:55
So So you got options. You got Omnipod five, Medtronic 670 G is that the latest 177 DJ Jesus with a numbering system seven ad. Boy, if you got me into a marketing meeting at Medtronic, the first thing I would do is say stop using numbers. It sounds so similar to each other. Tandem control like you on the X two, you're gonna have tandem control IQ on the movi then the AI let and then we don't have enough to say about it right now, because it's not nearly available. But Roche is trying to get a pump into the market, right? accucheck solo, is that right? So

Jennifer Smith, CDE 28:32
Correct. Although that will not be unless there's something changing or something updated. There's no automation or CGM. That's gonna

Scott Benner 28:42
be one of the clicky pumps, like we talked about in the manual thing. And then they have the accucheck combo. That's a tube pump. But is that available right now?

Jennifer Smith, CDE 28:51
The Accu check combo was here, or is

Scott Benner 28:55
this am I looking at the wrong website? Might be? Hold on a second. Let me look, let me make sure I'm saying the right thing. Roche pump. I think the combo is there's an article finally wrote back in the insulin pump market. That's a that's a hurtful one from from a from an investor.

Jennifer Smith, CDE 29:14
Yeah. So while ago because right?

Scott Benner 29:17
They have something they're working on, but it's nowhere near like you're not going to use it know, in the next couple of years. Okay, no. All right. So we'll see if they actually get back to that or not, but the FDA did approve the accucheck solo tubeless patch pump, which is just like those other pumps we talked about where you push a button and you get a designated amount of insulin. I have it here dispose solo, correct and he's a pump holder and replaced every three days. And he's of infusion cannula. A disposable 200 unit reservoir replaces every four days a reusable pump bass. Okay, so you put the bass on and you click the thing on top of it. It does come with that handheld diabetes manager. Quick Bolus button transmitter errant reservoir, which you said you thought was important. Oh, okay. Yeah. So anyway, if that's what you're looking for, you're not looking for automation. You could check those out. Let's go over CGM is at the end here. Awesome. All right. So there's Dexcom. There's freestyle. And there's ever since. Correct? Oh, that's all right. Three for people using insulin. Two, three. Yeah. The other ones are like, bro science guys and like biohackers and stuff like that. Right? Okay, bro science guys.

Jennifer Smith, CDE 30:34
Are people who want to monitor their metrics don't have diabetes.

Scott Benner 30:38
Very nice way of saying it. I think of guys with like so many abs. They look like they're moving on to their sides.

Jennifer Smith, CDE 30:43
What's really funny about So years ago, 2006, I think is when I first started wearing a CGM. And I had one that's not even on the market anymore. It was called the Navigator. Yes. And I loved it. It was fantastic. And I had it on my arm and I was at the gym, I was running on the treadmill. And I guy next to me, I could tell he kept like looking over at my arm. Like, after I finished, I went over and I was like, do you do have questions? Or something, you know? And he said, I'm just curious if that's one of those, those new heart rate monitors, you know, kind of evaluate your your metrics, again, kind of devices. And I was like, yeah, no, I probably wouldn't be wearing that if I didn't have to. I said, this manages and, you know, looks at my blood sugar, blah, blah. And he's like, Oh, that's, that's really it. He was interested, obviously. But yes, I think a lot of people used to question and now clearly don't

Scott Benner 31:43
Gotcha. All right. So before we start here, let me just say that Dexcom and ever since our advertisers on the podcast, so I should say that out loud. And I should say to freestyle, what are you waiting for? But so here's what we have. I'm gonna start with ever since because it's so much different than the others. Okay, so ever since is an implantable CGM? Yes, that lasts six months. And so you'll need to a year Correct. You go into a doctor's office. I've seen the procedure happen on video, I had to watch it to become like an advertiser. It takes literally five minutes. It seems like the tiny little like, they have a tool they give the doctor it makes a little like barely an incision, they slipped the thing underneath. Butterfly bandage holds it closed. You're on your way. Yep. Then this thing, then you were a trance. What do they call it?

Jennifer Smith, CDE 32:34
A smart it's a smart transmitter transmitter

Scott Benner 32:36
overtop of it. Right? But it's interesting. It has sort of a silicone adhesive. So you're not dealing with those harsh adhesives because you change it every day. In fairness, it needs to be calibrated twice a day for like the first. I don't want to say this wrong, but like for the first few weeks, twice a day. And then after that once a day you calibrate today, right? Yep, the sensors under your skin. And then you can set high and low alarms. And it vibrates to tell you your higher low when you get. That's kind of awesome. It's called on body vibe. Distinct on body vibe alerts when higher low. Additionally, ever since is the only CGM with on body vibrations to alert users glucose fluctuations, which is beneficial while sleeping driving or otherwise unable to check mobile apps devices. Yeah, smart transmitter vibration patterns, low glucose alert three vibes appears in yellow, high glucose level one vibe. It's pretty cool, man. I mean, like, it's under your skin. If you you know you're going to your prom one day, and you're like, I don't want to deal with this today. You just take it off, throw it on the charger and wait, come back and pop it back on again. It does not currently pair with any automated pumps. Correct? And I don't know. I mean, they're a publicly traded company. They don't usually talk about stuff like this. I think they're interested in that happening. I don't know where they are in that process, when or

Jennifer Smith, CDE 34:00
where, right. And they've been I mean, they've been around for a really long time. Yeah, already

Scott Benner 34:05
passed through a couple of hands, didn't it? Before a Sensia grabbed them. And there's

Jennifer Smith, CDE 34:10
been a lot of change. But the great thing is that they've I think they've started to gain some ground, which is a good thing, especially considering the fact of changing and people complain all the time about, oh, it's that day that I have to change everything else. Right? This is really just as you said, you go in, you get it popped under the skin, when it's done, you can get the sensor removed and pop in a new one and you go forward

Scott Benner 34:38
and the accuracy is good. I mean, it's not it's not wildly different than what anybody else is offering. So I mean, I know they all in their marketing are trying to like they talk about their margin and stuff like that. And they try to get like, you know, real specific but if you look at those, they're all pretty they're all

Jennifer Smith, CDE 34:53
within a range of and you know, like anybody again, you'll see people comment all the time. This one didn't work for me. but this one worked really well for me. I mean, I've got several people who Dexcom really didn't work the greatest for them in terms of accuracy or reliability. And they chose to go with the Libra. And that one works really well for them. So

Scott Benner 35:14
I just spoke to a woman online today who tried Libra and tried Dexcom. And she's like, it feels like my kids body rejects them at like day six, like they just don't work anymore. I mean, that's not crazy for people with autoimmune issues who might have heightened immune responses, then you're sticking a thing in your arm. And you know, now I don't know how that works with you ever since obviously, I haven't dug into it enough yet. But if the filament from those other ones is what's bothering you, maybe this is maybe this is your answer, Lucien Yeah, right. Also, I can see for if you're not automated right now. And you're just one of those kind of old school like, you know, pen people. It's pretty awesome. Because a lot of those pen people don't move to pumps because they don't like things connected to them. I don't know another way to put this but like old school type ones. Sometimes they fall into camps on wearing something, you know what I mean. So maybe this is a way they can get a CGM and not have to have anything on them.

Jennifer Smith, CDE 36:08
I think it's a nice way to for people to be able to evaluate something that has changed a variable in their life that's been added. And maybe they don't like you just said maybe they don't really want information or alerts or whatever, all the time. But in certain scenarios, they really need some heightened awareness, or they need to relearn something about Yeah, whatever's changed, right, is a great way because it just sits under your skin and you pop on the transmitter when you want to wear it and get the information and then you don't have to pop it out anymore. Listen,

Scott Benner 36:42
always with the caveat if you can afford it, if your insurance covers that, etc. But right, just from the perspective of a person who cares about people with diabetes, I wish you were all wearing a CGM. Like I don't care how but how you get to it if it's implantable, or if it's a lever a or if it's a Dexcom. Like I just think your life would be measurably better if you had one, long term health especially. I agree. Yeah, short term safety long term health get a CGM. All right. What's the next one? You say Libra? What do I say? Libra.

Jennifer Smith, CDE 37:12
Libra Libra. I've heard it both ways quite honestly. So yes,

Scott Benner 37:17
nothing better than picking a name that people can pronounce nine different ways. What do we got now? We're up to the libre three. Yes. Okay. What would you call it? A quarter size maybe smaller little sensor for

Jennifer Smith, CDE 37:29
those who are already using like Dexcom G seven more comparable? It's definitely it's flat it's like quarter would be a good overall like thickness and roundness. Okay, order nickel two quarter kind of Yep.

Scott Benner 37:45
Are they calling the libre three is a 14 day where at this point all right. Yeah, FreeStyle Libre 14 basis 13 Okay, so there's libre two there's libre three they pair with I mean at this point let's go over at libre works with what pumps as far as automation goes.

Jennifer Smith, CDE 38:06
Yeah, as far as automation libre definitely works with the do it yourself. System. Yeah. And is it? Definitely I mean, it's not Medtronic, they have their own proprietary. Anybody say they don't? Yeah. It does not work with Omnipod five, right. And if it works with Ken, does it work with control IQ yet?

Scott Benner 38:30
Control?

Jennifer Smith, CDE 38:31
I'm trying to remember I knew something was in the works.

Scott Benner 38:34
I don't think so yet. Yep. So but I think they're actually working towards it though.

Jennifer Smith, CDE 38:39
They are. I mean, that all goes into that line of interoperability right. Companies have made their systems designated as interoperable which means that at some point in the future, you would get to pick and choose your system. I want to use this pump but I want to use this CGM because this one is what works best for me. So to have those those choices down the road that's the whole

Scott Benner 39:07
I'm on tandems website tandem diabetes Care Plus FreeStyle Libre two plus well okay, so they're showing me working with the x two Congri to the libre two does not the libre three okay libre three. Why? What not? Again?

Jennifer Smith, CDE 39:25
They have multiple Yeah, why

Scott Benner 39:27
is everything so confusing? Why, Why would two people who know as much about this as anyone else be sitting around going? I don't know. Maybe does it like it's all over the place? You don't I

Jennifer Smith, CDE 39:39
mean, that's where the confusing things come in. And then they all end up having sort of like different actions they work for or last for this amount of time versus 14 days, seven days, 10 days, 14 days. This one does give you alerts without having to actually hold the device over it and wave a wand and chant some mad check something or another right even

Scott Benner 40:01
that each point is something people aren't going to know when the first libre came out. Like it wasn't a content it wasn't really a continuous glucose monitor it was a glucose monitor that you had to hold a device to to get your reading. So it was basically like checking your finger without poking your finger. But it also gave trends but it would show you the trends that Yeah, correct. So it starts like that. Also here, it looks like the libre two plus is a 15. day wear. So once a 14 once a 15 once a 10. Like, how am I supposed to keep up with all this? It naming systems with Medtronic 677 7782. Gentlemen, if you put me in charge, everything would be so easy. I

Jennifer Smith, CDE 40:41
have an asset before that. I don't know if anybody would live in the land of Jenny wouldn't do this audit. And these rules would be very straightforward. We were doing that.

Scott Benner 40:51
I remember two years. Omnipod was like we're gonna come out with the Omni pod horizon. It's gonna be one day they were like it's the Omni pod vibe. And I was like what happened?

Jennifer Smith, CDE 41:00
Right? Yes, it was. And it's still sometimes I even run across the horizon still being like, mentioned somewhere and I was like, well, we're kind of bad. beyond that. We know what it's called now, but let me be

Scott Benner 41:12
clear with everybody. iPhone. iPhone to iPhone three. iphone four. iPhone five. iPhone six. See how easy it is? The biggest number is the latest one all done. Like one time they tried SC and then they were like, stop it. Don't do that. Oh my god. Anyway. Yeah, I'm not coming down on anybody. You guys make amazing products. Yeah. So why do I care? So is is what's the biggest difference between Dexcom and Libre is that Dexcom has interoperability with all these pumps.

Jennifer Smith, CDE 41:41
Outside of like you just said the libre two plus, as interoperability obviously with the x two. Right? And, you know, system and control IQ. I would say to that there are no other cent. I mean, again, we'll get to Medtronic. But that's again, a proprietary type of

Scott Benner 41:59
use. So Jenny, just being honest, right? What's the I know? They're all their marketing is all gonna say we're accurate. We're this or that? Like, what is the real difference? Like you talk to people every day who use both of these? Like, you use a Dexcom do you use a Dexcom? Because it works with the thing you use or do you use it because you prefer? Yes. You don't prefer Dexcom over libre?

Jennifer Smith, CDE 42:17
I actually I do so my personal my n of one. And I haven't tried the new so I have not used a libre three. I don't know its accuracy. For me. The earlier versions of libre, just like med tronics sensor early versions, they were not accurate for me. Dexcom long term has been the most accurate and stays very accurate for me. So I stay with it. Because again, it also works with the system that I'm using and you know, it is what it is. Yeah, if it didn't, I would absolutely be searching for something that works to buy

Scott Benner 42:55
benefit. You know, the thing I like about I might like about Dexcom the most is the Dexcom makes Dex coms. Abbott makes freestyles like so big company, small, like department kind of a thing. Like I like that everybody that shows up at Dexcom. Every morning if this thing doesn't work, we all lose our jobs. That's what I like. Yeah,

Jennifer Smith, CDE 43:15
yeah. They are on their on one track. Now. I love that about

Scott Benner 43:19
Omnipod too, by the way, like Medtronic makes tools that heart surgeons use. Yeah, like, right. If Omnipod stops working. A lot of people in trouble. Yeah. And I'm talking about paying their bills. I like that kind of pressure on people when they go to work. Especially when it's around my daughter's, you know, medical supplies. But yeah, I mean, I think the same thing. I think if the library works for you, great. Use it. Yeah, if the Dexcom works for you. Great. I also think if your insurance covers it, great. Like there's a lot of, you know, decisions,

Jennifer Smith, CDE 43:51
which I feel a lot online to, again, comments about why prefer this one, I think it might work better, but my coverage or my pay out of pocket is a lot less with this one. And it seems to be okay. So this is what I'm going to stick with, right. I mean, that's, it's not really what the person wants, but from an affordability standpoint, it's what they're using.

Scott Benner 44:13
Yeah, yeah, no, I mean, again, I want you using the CGM whichever one is like I tried to I was telling my brother my brother's got type two. And I said, Hey, Dexcom is coming out with stello. It's, you know, for for type twos. And he said, Yeah, I'm gonna like cash buy some Libras right now because I can afford them until that happens. He's like, then I'm going to look again. I didn't tell him Oh, no, wait a couple of months. Delos. Come in the song I said good. I want the data come in and within a week type to by the way, he said to me, Scott, the amount of foods I stopped eating this week, just because he's like, I don't even know how to explain it to you. Like I see that line go up and I go, Oh, I'm not gonna eat that again. You know, like real quick, just that's a valuable thing for him. And safety wise. I like you All for safety especially you're using insulin, you know wearing a CGM? Yes. So Dexcom has the Dexcom G six, and the G seven. Here's interesting because visually speaking, freestyle to freestyle three look pretty similar, right? Correct. But the form factor of the g7 is now more much more like the libre small, thin, round, but the G six is still old school where you, you know you have like a sensor bed and then you click a transmitter into it. It's pretty raised up off your body, maybe a half an inch if I had to guess like, just visually. Are you wearing one right now? Yeah, yeah, it's about a half inch. Right?

Jennifer Smith, CDE 45:36
I wear GS six. Yeah, it's about I would say it's maybe it's not nearly a half an inch, but I would say it's probably a third

Scott Benner 45:42
but it's not like having a coin tape to you. It's more like having a, you know, half a double A battery tape T or something. I don't know. Meanwhile, I've worn a G six. I can tell you it takes about eight minutes for you to forget you're wearing it. You don't even notice it ever again. So, but you're on G six. How come you haven't moved to g7 yet? Do you know what to say? Do you want my answer? Yeah, listen, I'll tell you right now I moved to Arden to g7 right away. It works freaking terrific for but Arden is a person who CGM is have always worked really well for her. She can wear them right out to their grace periods. She doesn't lose her. Her graphs don't get wonky. Like it just they work for her. You know what I mean? So, but what about you? So

Jennifer Smith, CDE 46:26
I have not tried g7. So I don't have anything to compare to G six, right? My hesitation in moving to G seven is a lot of the feedback I get from people using G seven it is now you've had really good success with it. Arden likes it. The accuracy is there. It's you know, whatever it's doing with the system that she's using seems to be very compatible. And it works well. I have seen that in a lot of people where they're really happy with it. I've also seen about 50% who are not who complain for the whole first day. There's inaccuracy or the numbers jump up and down or there's wide variance from finger stick to actual CGM, or I do think that the compression lows I've heard a lot less issue with with G seven, compared to G six. I've seen that cleared up which is nice to hear. I'm usually a Gosh, this is new. Let's try it in the diabetes realm. I think it's right. I want to keep up. Listen,

Scott Benner 47:32
I'm no business expert. But the GS six production the way you produce that and the way I'm assuming they'll phase it out eventually. Right. Thanks. Sure. Yeah. And also what I like about them. I'm sure this goes for libre as well, too, is a lot of what happens in your CGM is software based, whether you believe like, I don't know if people know that or not. But they can tweak the algorithm tweak the software and make it more accurate. So they get better as they go. Correct. Yeah. And that's why I try hard not to listen in the very beginning because I don't think a company would call it like a it's not a beta test. I'm sure it's not but once they get it out on more people and they get more data back, I'm assuming they know. It helps them make adjustments, little tweaks to it. Tune it.

Jennifer Smith, CDE 48:13
Yeah, exactly. I'm just I guess I personally I'm kind of waiting. All the all the tweaks aspects.

Scott Benner 48:19
there's anything wrong with that. I think some people wait and some people jump in and that I think gets a difference in how people think about technology. I took you down to the last minute, we didn't talk about the Medtronic sensor. Oh, let's talk go go go.

Jennifer Smith, CDE 48:30
Quick. So yeah, the Medtronic sensor is their guardian for right, their newest that comes works with the 780, which is their, you know, most recent algorithms system. I will say that from the small handful of people that I am working with that use it. They really do like it and having been long term users of the Medtronic systems. They've even commented in terms of like accuracy, improvement with the algorithm and everything, which is really lovely to hear. I'd be curious, quite honestly, to try the new sensor and see how it does work for me because they're their earlier versions. As I said, just they were not accurate for me at all.

Scott Benner 49:12
Yeah, well, I mean, they've come a long way from I've had people come on this podcast and call one of their old sensors a harpoon. That's not a fun word.

Jennifer Smith, CDE 49:19
And that was from the way that it was inserted. 100% Yeah. But

Scott Benner 49:23
obviously, it's come a long way. I've heard a ton of people using seven ATG that are very happy with it. Yeah. And if you're using a Medtronic automated system, you are using the Medtronic navigator CGM. That's the only thing that works with you

Jennifer Smith, CDE 49:35
are and you can use it as so for those who are MDI, you can actually use their CGM as a standalone, they do have just a sensor system too, which again, quite nice. So it pairs along with Dexcom or, or libre as a standalone system. You don't have to have a pump to use it which with and again, that's quite nice, I think They're CGM. And they have a smart, they have a smart piece to part of their sort of data analysis software that actually does do some analysis of your data. And it helps to give you sort of some feedback on what is what's being collected by the system and what it's seeing and trends and that kind of stuff. And that's a really wonderful,

Scott Benner 50:25
right? I'll say this. For Medtronic, too, they have some other stuff that you might not know about. One thing is a super simple thing called an eye port. And it's just this little cord you put on, it's a one injection, and then you can put your needle or your pen into that injection. So I think over three days, you can wear it right, so for three days, all of your injections can go through the eye port, so you get stuck once for every 72 hours, they have the in pen, which is you know, an insulin pen that's also paired to an app that gives you a ton of functionality that people want in insulin pumps, too. So

Jennifer Smith, CDE 50:57
yeah, it's kind of like pumping without a pump. Really, it gives you all of that calculation part that a pump does without the tubing or anything. You know, it's very, very nice to be able to use. I'm glad you brought up the iport Because I think that's a, it's an under utilized piece.

Scott Benner 51:15
I tried to get them to buy ads for it, because I thought it was so valuable for people, but I don't think it makes enough money to have a marketing budget. But like, seriously, but yeah, but I ports if you're injecting, and you want to limit the amount of actual pokes, like, look into that, it's it's fantastic. You know, what about accuracy with the Navigator? Do you see, like with the people you just as good as everything else, this point? Yeah,

Jennifer Smith, CDE 51:38
with the with Medtronic, they're there for sentry guardian for sensor is is accurate from the people that have been using, it seems quite accurate. Like I said earlier, that you've even seen improved accuracy, having been long term Medtronic sensor wearers already, to say that they notice a difference good in accuracy is is huge, which means that they've done a nice job of, of making improvements. Honestly,

Scott Benner 52:05
it's all we want. We want everybody working hard to make these things as good as they can be. And then you guys are all going to, I mean, less than these companies are going to listen and say, Oh, I wish you would have said Mine's the best in everything. But I mean, it's not how this works. And I think they know that like Unity mean, like it's, you know, a marketing meeting. You're like, no, say ours, but they're all good. You know, so find one that works for you and use it like in the end, what I want is for people to be healthy and happy and safe. Not right now. Not a it's

Jennifer Smith, CDE 52:31
just like a favorite pump. I can give a favorite pump from my personal use. Yeah, but from other people, you have to be wide. And you have to be able to analyze and say, You know what, you're looking at this one, but based on your lifestyle based on these factors. I actually think this probably would be better for you. Yeah,

Scott Benner 52:48
I'll say this. Arden has been using an omni pod since she was four. She's about to turn 20 It's a friend to her to my family. If someone made something better. I jump in two seconds. So like, you know, you'd be like, Yeah, you got it. You gotta be out for you in the end. Yeah, you know, so, do all that. All right, Jenny, you're terrific. Obviously, I'll talk to you soon.

Jennifer Smith, CDE 53:07
Okay, thank you.

Scott Benner 53:18
Jalen is an incredible example of what's so many experience living with diabetes. You show up for yourself and others every day, never letting diabetes define you. And that is what the Medtronic champion community is all about. Each of us is strong, and together, we're even stronger. To hear more stories from the Medtronic champion community where to share your own story, visit Medtronic diabetes.com/juice box and look out online for the hashtag Medtronic champion. Thank you so much for listening. I hope you enjoy my full conversation with Jalen coming up in just a moment. A huge thanks to Dexcom for being longtime sponsors of the Juicebox Podcast dexcom.com/juice box head over there now get started today. I'd like to thank ag one for sponsoring this episode of The Juicebox Podcast and remind you that with your first order, you're going to get a free welcome kit. Five free travel packs in a year supply of vitamin D. That's at AG one.com/juice box. Thinking about getting an algorithm pump, don't know where to begin juicebox podcast.com up in the menu, click on algorithm pumping and you're gonna get a long list of a lot of episodes that will help you to understand better juicebox podcast.com Find algorithm pumping. Thanks for hanging out until the end. Now you're going to hear my entire conversation with Jalen don't forget Medtronic diabetes.com/juice box or the hashtag Medtronic champion on your favorite social media platform.

Speaker 1 54:53
My name is Jalen Mayfield. I am 29 years old. I live in Milwaukee, Wisconsin where I am Originally from Waynesboro, Mississippi, so I've kind of traveled all over. I've just landed here in the Midwest and haven't left since ice.

Scott Benner 55:07
How old were you? When you were diagnosed with type one diabetes?

Speaker 1 55:10
I was 14 years old when I was diagnosed with type one diabetes 15

Scott Benner 55:14
years ago. Wow. Yes. Okay. 14 years old. What do you like? Do you remember what grade you were in?

Speaker 1 55:20
I actually do because we, we have like an eighth grade promotion. So I had just had a great promotion. So I was going straight into high school. So it was a summer, heading into high school was that

Scott Benner 55:29
particularly difficult going into high school with this new thing?

Speaker 1 55:32
I it was unimaginable, you know, I missed my entire summer. So I went, I was going to a brand new school with, you know, our community, we brought three different schools together. So I was around a bunch of new people that I had not been going to school with. So it was hard trying to balance that while also explaining to people what type one diabetes was,

Scott Benner 55:53
did you even know? Or were you just learning at the same time, I

Speaker 1 55:56
honestly was learning at the same time, my hometown did not have an endocrinologist. So I was traveling almost over an hour to the nearest, you know, pediatrician, like endocrinologist for children. So you know, outside of that I didn't have any type of support in my hometown.

Scott Benner 56:13
Was there any expectation of diabetes? Is somebody else in your family have type one?

Unknown Speaker 56:18
No, I was the first one to have type one in my family.

Scott Benner 56:20
And do you have children? Now?

Unknown Speaker 56:22
I do not know.

Scott Benner 56:23
Do you think you will one day, still

Speaker 1 56:25
thinking about it? But right now, I've just been traveling books at all my career myself. So

Scott Benner 56:30
what do you do? What's your career? Yeah, so

Speaker 1 56:32
I am a marketing leasing specialist for a student housing company. So we oversee about 90 properties throughout the US. So I've been working for them for about eight years now. And you get to travel a lot in that job. Yes, I experience a lot of travel. It's fun, but also difficult, especially with all your type one diabetes supplies, and all your electronics. So it's a bit of a hassle sometimes.

Scott Benner 56:54
What do you find that you absolutely need with you while you're traveling? diabetes wise,

Speaker 1 56:59
I have learned my biggest thing I need is some type of glucose. I have experienced lows, whether that's on a flight traveling, walking through the airport, and I used to always experience just being nervous to ask for some type of snack or anything. So I just felt, I felt like I needed to always have something on me. And that has made it my travel a lot easier.

Scott Benner 57:21
So growing up in the small town, what was your initial challenge during diagnosis? And what other challenges did you find along the way?

Speaker 1 57:31
Yeah, I think the initial one, I felt isolated, I had no one to talk to that it was experiencing what I was going through, you know, they were people would say, Oh, I know, this is like hard for you. But I was like, you really don't like I, I just felt lonely. I didn't know you know, people were watching everything I did. He was like, You can't eat this, you can't eat that. I felt like all of my childhood had been you know, I don't even remember what it was like for life before diabetes at this point, because I felt like that's the only thing I could focus on was trying to do a life with type one diabetes,

Scott Benner 58:06
when you found yourself misunderstood? Did you try to explain to people or did you find it easier just to stay private?

Speaker 1 58:13
I honestly I just held back I didn't really like talking about it. It was just it felt like it was just an repeating record where I was saying things and people weren't understanding it. And I also was still in the process of learning it. So I just, you know, kept it to myself didn't really talk about it when I absolutely had to,

Scott Benner 58:30
did you eventually find people in real life that you could confide in?

Speaker 1 58:34
I think I never really got the experience until after getting to college. And then once I graduated college, and moving to an even bigger town, that's what I finally found out was people were I was like, Okay, there's a lot of other people that have type one diabetes. And you know, there's a community out there, which I had never experienced before, is college

Scott Benner 58:56
where you met somebody with diabetes for the first time or just where you met more people with different ways of thinking.

Speaker 1 59:02
So I met my first person with diabetes, actually, my freshman year of high school, there was only one other person, and he had had it since he was a kid like y'all once this was like, maybe born, or like right after that timeframe. So that was the only other person I knew until I got to college and I started meeting other people. I was a member of the band and I was an RA. So I was like, Okay, there's, you know, there's a small handful of people also at my university, but then, once I moved to I moved to St. Louis, and a lot of my friends I met were like med students, and they were young professionals. And that's where I started really getting involved with one of my really close friends to this day. He was also type one diabetic and I was like, that's who introduced me to all these different types of communities and technologies and which is really what helped jumpstart my learning more in depth with type one diabetes.

Scott Benner 59:53
Do you think I mean, there was that one person in high school but you were young? Do you really think you were ready to build a relationship And around diabetes, or did you even know the reason why that would be important at the time? I

Speaker 1 1:00:05
didn't, uh, you know, I honestly didn't think about it, I just was I, oh, there's another person in my class that's kind of going through the same thing as I am. But they've also had it a lot longer than I have. So they kind of got it down. They don't really talk about it. And I was like, Well, I don't really have much to, like, connect with him. So sorry, connect with him on Yeah, no. So

Scott Benner 1:00:25
now once your world expands as far as different people, different backgrounds, different places in college, you see the need to connect in real life, but there's still only a few people, but there's still value in that, right?

Unknown Speaker 1:00:36
Correct.

Scott Benner 1:00:38
What do you think that value was at the time?

Speaker 1 1:00:40
I think it was just what making me feel like I was just a normal person. I just wanted that. And I just, I needed to know that like, you know, there was other people out there with type one diabetes experiencing the same type of, you know, thoughts that I was having.

Scott Benner 1:00:55
When were you first introduced to the Medtronic champions community? Yeah.

Speaker 1 1:01:00
So about two years ago, I was, you know, becoming more I was looking around and I noticed stumbled upon the Medtronic community. And I was like, this is something I really, really, I kind of need, you know, I said, I, all throughout these years, I was, you know, afraid to show my pump. You couldn't, I would wear long sleeves, like, didn't want people to see my CGM, because I didn't want people to ask me questions. And you know, I just felt so uncomfortable. And then I noticed seeing these people really, in the Medtronic community just, they embraced it, you can see them, they weren't afraid to show it. And that was something I was really looking forward to. How

Scott Benner 1:01:35
was it knowing that your diabetes technology is such an important part of your health and your care? And having to hide it? What did it feel like to have to hide that diabetes technology? And how did it feel to be able to kind of let it go,

Speaker 1 1:01:48
I will refuse to go anywhere, like, Hey, I would run to the bathroom, I just didn't want to do it in public, because I felt like people were watching me. And that was just one of the hardest things I was trying to overcome. You know, I was fresh out of college, going into the young, professional world. So you know, going out on work events and things like that. I just, I just didn't think I just didn't think to have it out. Because I was so afraid. But then, once I did start, you know, embracing again and showing it that's when the curiosity came and it was actually genuine questions and people wanting to know more about the equipment that I'm on, and how does this work? And what does this mean? And things like that, which made it kind of inspired me? Because I was like, Okay, people actually do want to understand what I'm experiencing with type one diabetes. What

Scott Benner 1:02:33
did you experience when, when the internet came into play? And now suddenly as easy as a hashtag, and you can meet all these other people who are living with diabetes as well? Can you tell me how that is? Either different or valuable? I guess, compared to meeting a few people in real life?

Speaker 1 1:02:50
Absolutely. I think if you look back from when I was first diagnosed to now, you, I would have never thought of like, you know, searching anything for someone with, you know, with type one diabetes. And now it's like, it's all I see, you know, you can easily search Medtronic champions, and you see people that pop up, and you're like, wow, look at all this content. And I think that's something that that kind of just motivates me, and which is how I've kind of came out of my shell and started embracing more and posting more on my social media with about, you know, how I live with type one diabetes. And I think that's something that I hope can inspire everyone else.

Scott Benner 1:03:24
What was it like having more personal intimate relationships in college with type one?

Speaker 1 1:03:29
I think it was kind of hard to explain, you know, just, for example, like, no one really knows, it understands like what alo is. And I think that was a very hard thing for me to explain, like I, you know, it can happen in a in a moment, and I'm sweating. I'm just really like, not all there. And I'm trying to explain, like, Hey, this is what's going on. I need your help. And I think that was something that was hard for me to, you know, I did talk to people about it. So when this happened, they were like, oh, you know, what's going on with your mate? I'm actually a type one diabetic. This is what's going on? I need your help. What about

Scott Benner 1:04:07
once you've had an experience like that in front of someone? Was it always bonding? Or did it ever have people kind of step back and be maybe more leery of your relationship?

Speaker 1 1:04:19
After I would tell someone I had type one diabetes after some type of event or anything like they were kind of more upset with me that I didn't tell them up front? Because they were like, you know, I care about you as a person I would have loved to knowing this about you. It's not anything you should have to hide from me. And that was a lot of the realization that I was going through with a lot of people.

Scott Benner 1:04:37
Okay, let me ask you this. So now we talked about what it was like to be low, and to have that more kind of emergent situation, but what about when your blood sugar has been high or stubborn? And you're not thinking correctly, but it's not as obvious maybe to you or to them? Yeah.

Speaker 1 1:04:52
So I also I go through my same experiences when I have high blood sugars, you know, I can tell like For my coworkers, for example, I didn't really talk to you know, when I go out backtrack, when I visit multiple sites for work, I usually don't announce it. And so sometimes I'm working throughout the day, I might have snacks, forgot to take some insulin, and my blood sugar is running high and I'm a little bit more irritable, I'm all over the place. And I'm like, let me stop. Hey, guys, I need to like take some insulin, and I'm sorry, I'm not. I didn't tell you guys. I'm a diabetic. So you may be wondering why I'm kind of just a little bit snippy, you know, so I like to make sure I do that now going forward, because that's something I noticed. And it was kind of hindering me with my career because I was, you know, getting irritable, because I'm working nonstop. And I'm forgetting to take a step back and focus on my diabetes,

Scott Benner 1:05:43
right? Hey, with the advent of new technologies, like Medtronic, CGM, and other diabetes technology, can you tell me how that's improved your life and those interactions with people? Yeah,

Speaker 1 1:05:54
I can. I feel confident knowing that it's working in the background, as someone and I've always at least said it, I have been someone that's really bad with counting my carbs. So sometimes I kind of undershoot it because I'm scared. But it allows me to just know that, hey, it's gonna it's got my back if I forget something, and I think that allows me to have a quick, have a quick lunch. And then I'm able to get back into the work day because it's such a fast paced industry that I work in. So sometimes it is easy to forget. And so I love that I have that system that's keeping track of everything for me.

Scott Benner 1:06:27
Let me ask you one last question. When you have interactions online with other people who have type one diabetes, what social media do you find the most valuable for you personally? Like? What platforms do you see the most people and have the most good interactions on?

Speaker 1 1:06:43
Yeah, I've honestly, I've had tremendous interactions on Instagram. That's where I've kind of seen a lot of other diabetics reach out to me and ask me questions or comment and be like, Hey, you're experiencing this too. But I've recently also been seeing tic TOCs. And, you know, finding on that side of it, I didn't, you know, see the videos and upload videos. And I'm like, I would love to do stuff like that. But I just never had the courage. So I've seen people make, like, just the fun engagement videos now, which I love, you know, really bringing that awareness to diabetes. Yeah.

Scott Benner 1:07:13
Isn't it interesting? Maybe you don't know this, but there's some sort of an age cut off somewhere where there is an entire world of people with type one diabetes existing on Facebook, that don't go into Tik Tok or Instagram and vice versa. Yeah. And I do think it's pretty broken down by, you know, when that platform was most popular for those people by age, but your younger people, I'm acting like, I'm 100 years old, but younger people seem to enjoy video more.

Speaker 1 1:07:40
Yes, I think it's just because it's something you see. And so it's like, and I think that one thing, and obviously, it's a big stereotype around diabetes is you don't like you have diabetes. And that's something I always face. And so when I see other people that are just, you know, normal, everyday people, and I'm like, they have type one diabetes, just like me, they're literally living their life having fun. That's just something you'd want to see. Because you don't get to see people living their everyday lives with diabetes. I think that's something I've really enjoyed. What

Scott Benner 1:08:09
are your health goals? When you go to the endocrinologist, and you make a plan for the next few months? What are you hoping to achieve? And where do you struggle? And where do you see your successes,

Speaker 1 1:08:20
I'll be honest, I was not someone who was, you know, involved with my diabetes, I wasn't really focused on my health. And that was something that, you know, you go into an endocrinologist and you get these results back. And it's not what you want to hear. It makes you nervous, it makes you scared. And so I personally for myself, you know, I was like, This is my shake. This is my chance to change. I know, there's people that are living just like me, everyday lives, and they can keep their agencies and their blood sugar's under control. How can I do this? So I go in with, you know, I would like to see it down a certain number of points each time I would love for my doctor to be like, Hey, I see you're entering your carbs. I see. You're, you know, you're not having lows. You're not running high too often. That's my goal. And I've been seeing that. And that's what motivates me, every time I go to the endocrinologist where I don't dread going. It's like an exciting visit for me. So you'd

Scott Benner 1:09:08
like to set a goal for yourself and then for someone to acknowledge it to give you kind of that energy to keep going for the next goal.

Speaker 1 1:09:15
Yeah, I feel as a type one diabetic for me, and it's just a lot to balance. It's a hard our journey. And so I want someone when I go in, I want to be able to know like, Hey, I see what you're doing. Let's work together to do this. Let's you don't want to be put down like you know, you're doing horrible you're doing it's just, it's not going to motivate you because it's you're you're already fighting a tough battle. So just having that motivation and acknowledging the goods and also how we can improve. That's what really has been the game changer for me in the past two years. Jalen,

Scott Benner 1:09:52
I appreciate you spending this time with me. This was terrific. Thank you very much.

Unknown Speaker 1:09:56
Absolutely. Thank you.

Scott Benner 1:09:58
If you enjoy Jalen Story check out Medtronic diabetes.com/juice box if you're ready to level up your diabetes care, the diabetes Pro Tip series from the Juicebox Podcast focuses on simple strategies for living well with type one. The pro tip episodes contain easy to understand concepts that will increase your knowledge of how insulin works, and so much more. My daughter has had an A one C between five two and six for since 2014, with zero diet restrictions, and some of those years include her in college. This information works for children, adults, and for the newly diagnosed and for those who have been struggling for years. Go to juicebox podcast.com and click on diabetes pro tip in the menu, or head over to Episode 1000 of the Juicebox Podcast to get started today. With the episode newly diagnosed we're starting over and then continue right on to Episode 1025. That's the entire Pro Tip series episode 1002 1025. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com

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